HomeMy WebLinkAbout322 VILLANOVA RD - Building PermitsMF
4�
o �> _
J�! lF
(714)754-5273 • Fax(714)754-4856
CITY OF COSTA MESA
BUILDING DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 322 VILLANOVARD
Suite:
Vicinity:
Parcel Nunmber: 14147103
Applicant: LE, VINNY
Address:
BUILDING PERMIT
Zoning:
Phone:
� Zip:
Owner: TRAN, MANH
Address ANH, NGOC CHIEU
COSTA MESA,CA . '
322 VILLANOVA RD �
.
Contrecroc WESTMINSTER ROOFING CO
�
Address: 09612 SUTHERLAND WAY
Phone:
Zip: 92626
r-_- 4
J
� PERMIT NUMBER
898-02044
77 FAIR DRIVE, COSTA MESA, CA 92626
Phone:
, GARDEN GROVE CA Zip: 92844
License: 694940
Arch / Eng : . .
Address: "
� �Phone:
, Zip:
� License: ' -
SCOPE OF PERMIT
T/O EXISTING & REROOF WITH COMP. SHINGLE, ROOF CERT ATTACHED TO PERMIT.
Status: ISSUED ��
Applied: 11/12/1998
Issued: 11/12/1998
e
FEE SUMMARY
Plan Check: $0.00 _ - Calc Valuation: $a,2oo.00
Permit: $9975 Claim Valuation: Sn,2oo.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $100.25
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Re uired: 0
Left 0- 0
Left 0- 0
Pr000sed: 0
Right 0- 0
Right 0- 0
EXPIRATION: 7his permit shall automatically expire and become void if work is rrot commenced within 1H0 days, or if work is suspended or abandoned
for a period of 180 days. .
INSPECTIONS: In ortler tor the work authorized untler this permit to be considered legal, such work must comply with all applicable codes, and all
required inapectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSA710N DECLARATION:
I hereby aflirtn under penalry of perjury one oi ihe following decla2tions:
❑ I have and will maintain e certiticate of consent to setl-Insure tor workers' compensation, as provitletl tor by section 3700 of ihe Labor Code, for the padortnence of the
work for which ihis permit is issued. `�
❑ I have end will maintain workers' compensetion insurance, as requiretl by section 3700 ot the Labor Code, for the pedormence of the woB for which this pemi2. is issuetl.
My workers' compensetion Insurance cartier end policy number are: �
Cartier: Policy Numbar:
(7his secUon neetl not be completed il the permi! is velued et one hundretl tlollars ($100) or less.J
❑ I certity that in the peAormance ol Ihe work for which this permit is issuetl, I shall not employ any person in eny manner so as ro becoma subject to the workers'
compensation lews ol Califomia, antl egree Ihat if I should b come subject to the workers' compensation provislons of Section 3700 of the Labor Cotle, I shell fort�with
comply with thes�e dd'/r�oYIis ns. //�.,✓��yi�
ApplicaniSigneNre: yJ����1.1��1 Date: l/�l/Ti7 < C /
WFRNINQ:FAILURETOSECUREWORKERS'COId E TIONWVE ISUNLAWiUlANDSHALLSUBJECTANEMPLOVERTOCRI PE LTIESANDCIVILFWESUPTOONEHUNDRED
THOUSANDOOLLARE�5IW.00O�,INADDITIIXJTO C0.STOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECfION31060FTHELABORCOOE,INTEREST,ANDATTORNEV'$FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm thet I em lice sed under pmvisions of C epter 9(commencing with Section 7000) of Division 3 of Ihe E
force end ettecL Lic. # �� 9/����� qass N
Contractafs Signeture: Dete:�
Code, antl my license is in full
CONSTRUCTION LENDING AGENCY: �
❑ 1 hereby aflirm that thera is a construction lentling agenry for the pedortnance of the work tor which this pertnit is issuatl. (Sec. 3097, Civil Code).
Lenders Name: Lenders Atldress:
SignaNre: Date:
OWNER-BUILDER DECLARA710NS:
I hereby aHirm thet untler penelry ot perjury that I am EXEMPT FiiOM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business antl Protessions
Coda: Any ciry or counry which requires a permit to consiruct, alter, impmva, demolish, or repair eny siructure, prior to its Issuance, elso requires the appliceN tor such permit
b Ble e signed stetement ihat he or she is licensed pursuant to iha provisions oi the Contrectore License Lew (C�apter 9(commencing with Saction 7000) oi Division 3 of tne
8usiness and Professions Cotle) or that he or s�e is axempt tharetmm and the 6asis for the elleged exemption. Any violation of Section 7031.5 by any epplicant tor e permit
subjecLs the applicent to a civd Oenalry ot not more Ihan five huntlred dollars (5500).):
❑ I, as awner oi Ihe properry, or my employees with wages as their sole compensetion, WILL DO THE WORK, and ihe structure is not intendetl or ottered for sale (Sec.
7044, Business antl Professions Code: The Contractors License Law tloes not apply to an owner of property who huiltls or improves thereon. antl who tloes such work
himsell or herself or ihrough his or her own employees, provitled ihet such Improvemants are not intentled or offered for sele. If, however, Ihe bullding or Improvement is
sold wli�in one year of wmpletion, the owner-builder will have the burden of proving that he or she ditl not bulla or improve for purposa ot sale.).
❑ I, es owner oi the pm0erry, am EXCWSIVELY CONTRACTING WI7Fi LICENSED CONTRACTORS to construct the pryect (Sec. 7044, Business entl Professions
Code: The contrectors License Law tloes not apply to en owner of property who buiids or improves ihereon, and who coniracis br such project wit� a contrector(s)
license pureuant to Ihe Coniractors License Laws.).
❑ I am exempt under sec. Business and Professions Code tor this reason:
SignaWre: Date:
Owner ID verified by dnveYs license. ❑ Yes ❑ No Driver'S LiCense No. Ezpires:
Verificetion ot Ownership by (rypa ot daumeN, i.e. - property taz bill or tlead):
DIVISION OF INOUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certify lhat no ezcavation five (5) ar more feet in depih Into which a person is required to descend, will be made in connection with work euthorlied by lhis
permit, end ihal no huilding strucNre. scattolding, falsework, or demolition or dismantling ihereoi, will be more then thirry-siz (36) teet hig�. (Chap. 32, Grp 2, Art 2, Sec.
341, Trtle 8, Celifamia Atlministwtiva Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Intlusirial Satery, as noted ebove, unless such person has a
pertnit ta do such work tmm ihe divisian.
Signature: � Date:
Division ot IndusMal Sefery Permlt Number.
CERTIFlCA7E OF COMPLIANCE AND AUTHORIZATON OF EHTRY: I ceRify undar penalry of perjury Ihai I have read this application and state tha� tha infortnation given is
correcL I egree to comply with all stete laws and ciry ordinances relating to building consiruction, and authorize representatives of ihe City of Costa Mesa to enter upon ihe
above-descri6ed property lor inspection purposes. I agree not to occupy or allow occupancy of any building auihorized by ihis permit until final inspaction.
COOE �. INSPECTIONTYPE
1616 Fixed System Final Fira Prevenlion
1266
200
201
202
203
204
2496 46
Pool Spe Final
Finel Re-Rooi
Final BIocWRetaining Wall
Final Factory Fire Place
Final Sign
Final Demolition
QA7E It�lALS
'y_ 1i=
COOE� INSPECTIONTYPE
206 Final Machenicel
208 Final Plumbing
210 Final Electdcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBullding/Occupancy
QASE It�EIS
PB0.IECTRODBESS: �'J1.1 VII�LANOVA RD' ��5� � uxir: . ` . '. �` , " � • �ITY OF' COS'TA, MESA -,BUILnTNG PL'RMIT- - PERM NO� FS13P'p4�G'"1Ci2 .� ,
owxex•sn�MerMRSi. .MARCERY•. SCHUBERT � ' ' ' � � '' . �
�ooness: �22. VILL�ANC�VA'HD ' PE�MI:-,�UU: BF:P 0461b2 . , PLAN CHFCK NO: 0�2.798-90 S� GOVT: 'N'SUPF: N�. �
I \ � COSTA MESA, � : : , _ . - � . ' . . ` . . . � . �, . � ��
' CA 9'2626 • . _ . . � CUNSTRUCTIdN. T'YPE: S-N• �. ' PFRMII' TYPE: ELE PLU aTR ' - FORPOSE: � AI,T
' (714)"/50-1353 _ , t . � •
�
NCN/ENCINEEfl: ' � ' � - ' - : pEG.NO.: � �• = � � JOB DESC_P,'[P1'ION � : ENliARGE EXSSTI�IG �BATHROOM � � ' SQ .I?T:,� - 2, 50� �
R�DPE55: ' , ' . � - . . , ' ' UNIT:. � . � . . . . . - . . .: �' . ,
`�' i ,CL'AIM VALUE:_ ' 2.,500.U0� CAI.C—VALOG: . 2'..ri00..00' GROUP OCCo Rr-3 /' �'; ;: . Y'
renrnmee: VI�N Ii'. BL'AKE � � ( 714 )�637-367R - � ' � , . . � . �
nooeess: . 9102 EL RITO DR, " . 'CUMM]?NTS: NO INCREASL IN TOTAL 'PI.�OOR AREA. � :' �' � ` � ' � • '� �
.. . VII.LA PARK� ' � GA 92GG7 � ��*x-�-��r**+r+�**.*ac-��c*��*�****x'�x��x-��**�r�-���*****x�u-*��**+t-x�*�x�x-****��*���*���x-,*�**x�**a%x�*ir*�*x � ,
LICENSED CONTIIACTUq DECLAMTION: I hereby aKrm Ihat I am licen unEer proNsions o� C�apter 9(commancinp wit� Sec�ion •• Z O N I� N G 12 '. b: Q U I`R E M E� N T Si " � � �
7W0) of UiNsian 3 0� ihe Business an0 Professions Cotle, anA my lice is m ful6rorce ane enect. � . ' ' ' ;.i E T B A C R i.-� - � `' ''• � �
cinuc.:04'3983 STRTEUC.:Qn']]J;7 cu �/% � . ,' - •.
oate:,Z —2e��-,�C� siqnature: �A' � � X� -'-'-' •'---'-'--- MAI'N AUILDING --------•--'- —r---�- ACCF•.SSORY AUILD'ING ----'---';-�
WONRERS'COMPFNERTIONOECUMTION: IherehyaKrmihatlhaveacertif¢ateo/consenitosetl-insureoracerti�cateofWOMers' PRN'C: FT �IN RE.�R: PT iN : e�N7: • rr IN RE:AR: � FT IN' • _
Campenu�ioninsurance,oraceninedcoovteereo�(sectianseoo;�a�.c�. . LEFT: F.T IN; RGHT; PT IN T EFT: t 'FT IN RGHT: FT . IN ,
PoUCY NO.: � . ' ' , �P. O�TE: r � � . . � � . , � � � �
cornraxr: � `'� PARKINC; RE�• PROV: PARCEL: 14147103 7.NE: R1 REF NO• ,. ;
a Cenifledcopyisherebytumishe0.�❑ Ceni�iedcoovis�iieowimteeciryeui�ainqoiv�sion. . PLANNING�NOTE.S'> INTCRTOR ALTL'RATION TO CONVL•:RT A• PQR'P'ION OF AN EXI.ST�TNC DED-. �
. `. . . . _ , t . . - _> I200M IN1'O A ➢ATIIROUM EXFAN;ION-. - • -- — . - '. , =; -.. - ' _.
�ate: � MDlicant: ' 'S" � ' 3EiEif3Ei43f3EK-iE�EiEjEifiEiEifiEiEiC.-%�iEi[!(jEftiE�3E.iE'7t%�E#�6iE.if%�ititiPiE�dli'iE�k�rtlEi6iE'iEiE3(�iEiEiF±EiEi:�3E1@iFiE�%ikiEit3EftitiE�E)EitdEit�3E.�1EiE� .
'BFMPfION FROM V/OflNFqS' COMPENSITION OECUMTION: (Ihis utu nee�ne 'e camo�d n ihe ermit is ta ane hmwrea'�Stao� or less). . ll, E . V F L O P� �M E N rT; ' S E,_' R V� I C E S; R E Q U T' R E M� N`'.1'j ' S � i
I cerliry �hat in �Ae DaAormanca of the work for w�icA �his permi is eQ� shall n t empl an so n any manner m zs to Eecome ' � � � j . '
suEieamtAeWarkers'CompensationLawsmCaiitornia�� G/���/� ,'� . ZONING APPROV�D BY (, __��_✓ �:���Q�y� ---- DAT�: aZ��Q/�Q�. �
'Uate: �-'—'� SipnaWre: � � ' • . � -
NOTICE: If, aiter maldng tAis declaration, you shoulE Oecome subject to ihe�Warkers' ComDenuiion provisions o�,ihe LaDor D U I LD I NG : AP PROV �D B Y _ _ ' � ______ � D ATF•. :�'�I/,�� ,
� CoOe, you must forthwitA compty with such provisions or this permit shall be 4eeme0 revokeA. . �;-;{ � c �'j . �E��aGG�� ` .t
CONSTNUCTION tFN01N0 �GENCY: I herehy atlirm ihat Nere is a construition IenAing aqency for t�e pedormanie�aYthe work far AP P G L CAT ]:ON I S., UED �� A.X : � '• • T ' UAT H: ri. �� �
wAic�IhisPermiti5issuedl5ection3097.Civ.Cl. � *'*********-****.*-�-*�•*..*�-*�g ' �'.{�'*.�.�'F"�-'t�,,.*.�� .�-, �. -'��.�..�.�..�.�.**.�.�.�.����*.��;.K
' IFNUEH: ' . ' . � � r������ kitiEiEKiE�(�iEiEit�lF�t�ir#3EaE-x�i(�#i(iEk#iE�3EiEiEiEiEit?(1(-i(-iEi(�dE'.�itiEiaiEit�ti(���EiE � it�iEit3EiEiE#itit�x�iEiEaFifiEi:3E3ti��,#;ie�-�3F-x�3ElEifitK .
nooeess: � - - � •- - , : � I.�GALTZATION:N ', " F E E��'"S '0 M M A R Y " • STRUCTURAL SEGMFDIT:Y"" '
. .. . ' '`� - - � .. : �. - . � . � - . � . � ' ,r , . . , . . . �.
OWNEBBUIlDEBOECUMTIOX: IherebyamrmtAatlamexempiimmtheContractors'StateLiienseLawiorlhafollowingreason � BI.DG PMT PLUMDING ' EI,ECTR,I�C M�CHANIC FIRE SMIP/RES GRADINC�
(Section 7031.5 Business anA Professional Code: Any ciry of wunry which reQuires a Dermit to consiruct, alter, improve, UemolisA, or P F�RM I T, � S 9. 0 0 �. � �., � �.��5 , � � ,`J � ' � ' � `
reDair any simcture, D�or to its issuance, also requires the applicant for such permit to tile a siprretl statement that Ae/she is IicenseG � • , ' �. , � Z �� �' �y ' � ' r. �- �
pursuan� to the provisions ol the Contractors'�Siate License Law (C�a'pter 9(cammencing with Seclion 70W) of Division 3 of ihe Business - � �" ' ' S�Y� '� M 7�� N�N � R£'� �
anU Professians CoOe) or Ihat Ae/she is evempl therefrom antl �he basis 1ar the alleAed exemDtion. My Nolation ol Section 7031.5 6y P LAN � , � 3 S.� 10 � �� �. . . . , . �
any aDPlhant tor a Dermit suDlecis Ihe aOPlicant lo a civil penalry oi not more ihan five �unOreO aollars.�5500). , � I.�'i S U E F C� � ' 3. 0 U 1 5. � Q�' ' ' � � '
� I az owner m the pmperry ar my employees'witn wapes as meir sole,comcensation, wiu tld ihe work; antl�� the ��Z;UILDtNG—DIV•-? � PF.RMIT �I.SaUE PLAN�CHECK 1'O'PAL . YAID ' 'P(JL•".
❑ structua is not imentleA or otlere0 for sale �Section 7D44, Business anA P�otessional Code: Tne Comractars' State License Law �TOTAli S; -- �- -�>. ,� 6 0. 2 S' 7� �l . 0 0 � 3 5. 10 �:L 13 . 3 5 1 1 3. 3.`�i � . . i10 ;
Aoes not apDly ta an owner of a pruDertY �o DuilAs or impmves thereon, anE who Eoes suc� woB �imul//hersell or thmuph � ' ' - ' � - ' � .
-his ar ner own emplayees, praviaea that sucn imDrwements are not intenaed or ottereo ror sale. u, however tne buildinq or ,�.rtG V GNU E L S V I S T UI�I TOTAI,S -�-�> � � GOI�L F1C.T.EIL�: � ]. 7. �. 3 5� OV GR / SiIOR'P � � �. V t� �� �
impmvement iS m10 xit�in one year oi completioq tAe awner will have Na burtlen ol Dravinq he/she tli0 not Ouiltl or impmve
for�hepurposeolsale�. , . , - , , . ' � . , - �� . _ TJT�L.tG .FMT PLOML;ING TiLECTRIC MECHANIC . PIRG SMIP/TOT �RIallIPiG PLAAI�-��HEt:R
I, as owner m me propeM, am exclusively contrectinp wim licensed comractors m construct the proiect (Section 7044, Business S 4�. � 0 � 5. 0 0 . i 8�: � 5 �'. ' , . 5!1 , . : 3`,i , 1. (7 ,
'� ' an0 Pmfessions Catle: TAe Cantracrors' State Licenx Law does not apD�Y �o an owner ol OrapeM who 6mIAs or improves tAerean - i � �� L ' � � ' �
anA.w�oconlract5forsuchDralectswithaconiractor(s)IicensepursuanitatAeContracrors'StateLicenseLaw).lamawere �%�*��-�F1Qk�7(�Ifk3EiEaE#�N-ic��[�it3(-iE3f�EaFif#t3Eif?riEif,�iE#ik%��-1Efti(:it��%�E�iE#i(:(��x-iEifiE9E�-jE�7EjfY.��E�(fE#iEi4iE�le*?'IE��EaE"�E�(�c'x�#k..Y..-fE .
ihat prool o� ineir worker's Compenution insurance shaula oe orovidee to me. , �, , ' �T P•I D I V I' D U'A I. J i F�� r. 13 R E A� I( ' D O W �7 . � ' � ,
� I am exempt un0er Seciian: ' , B: 8 P. C. � ' - '� ' .. . . ' . '� � � �}" . . . ' .
munisreamn: • ` TYC�� Q1'Y ' D G S C.R I..P D 7 O DL�✓ %� /" UDIIT'• COST TO'CAL�.CpaT
, � ,
Date: � . . • . Ownec . . . � . � �., . . ' : ^(�! ' , f
;PR' 2500- AL7'Ek BY VP.I�UC RESIL�I'sNTrI;7�I; N07.ON� l.00 , ;, 500.OQ
i tla nereby ceniry ihat I am aware of antl untlerstane me requirements ot Califomia Healm ana Safery Code Sectians 25505; 25533, ana ' j:L E. �7 r.• r x�r� ort � S, f" '" �� �� � � �
25534 ane ihat I or an luture nuilnin occu am will/wiil not circle one neetl ro com I with saitl state codes 5nd �he requirements for a' .,, L i.r, I I T I DI G �]� � f a � ' B P.' . . 7� � .-1 S
r e o ( 1 or GLE � 3 �.RL'CrP.I,/OU'PT,G'C 1" SC �0 GA. .7� 2 2`i
permit br constructian ar modification irom ihe tir Oualiry Manaqement District ResiAential consimction apDlications are exempt imm .
theseproWsions. ' . . ,� ELG, � .L ` R1iCT:YT/S{•?]:T'CI�T �G.ST 20 � GA. • .7.5 � � ?5
�' , ' i PLU � 'I B?,TII'I'.Ul? ; 2. QO 2. 00
oate: tapiicant: ' ' � titQf> '�F' P'T:FS ., ! . � • ' ;
I hereby certiry tAat I Aave,read this application an0 state Ihat the abave' ation is correct I apree ta comply vntA all ciry an0 caunry , . '• ; . ,
' artlinances antl state laxs alatinp to CuilOing consiructian an0 hereby a ' e resentatives of ' iry,to enter upon the above�mentioneU . . . � " � ,. ' ,- . � .
pmpeiry fo� insPectian Ouryoses. � . . . , • � , . � . .� . . , � . , .
oa�e: �'— � r'Q'd siq�amr. ' ' ' OS OOOS4413-00054417 9"t�tT f13.3�.
o��er'suce�searsocia�secu�yx: �? k � , ' �ATE: 02/20f9Q TItlE: 1�:Q3
18a1-48 W�ite—BuilEing; Green—Code Eubrcement; Cenary—ApplicanC Pink=Revenue;'GOIEenrotl=Assessor - ' '� ' � • � � � � � -•- - - � . � - � '""' -� -�- � �
r . '
� � COh . ..... i AND PLANNING. -, .i�• • ' .' � : POOL & SPA. . . . .' . .
� ' � 'Date Inspector � '�Date Inspector.
APPROVALS .:.Pe�mit # - � . t t . ' APPROVALS . Permit # �,,
�`� 1.•.Tempora 'ry Electrital Service`or,Pole " . 52.��Pool &-Equipment Location - � !
2. Soil Pipe�Undrgrnd: � - ,7 . �.. 53. Steel Reinforcement , , ���
3: Electrical Conduit Utility-Undrgrnd. 54. Forms � � ,
.i .
4: Electrical Conduit-Undrgmd � �.__ � ' � � 55. Electrical Bonding � }�_'
5. Steel Reinforcement • ' . .56.. Rough Plumbing & Pressure Test '-�
`'6.'Electrical UFER G�nd. � ' , � 57. �APPROVALTO.COVER�GUNITE
`7��Footings ' • 58. ElectricalConduit-Undrgmd.. -
, '8. Foundation ,_ � . . . �� � ' 59. Gas Pipe, O Undrgrnd., Test •� ,
,�9. Water Pipe�Undrgrnd. � ... � - 60. Backwash Lines, P�Trap, O Undrgrnd. - �
10. Structural Floor SYstem • � � � - • � � 61. APPROVAL TO DECK � -
11. Property Sewer Line & House�Connection , 62. Backwash &�ReceptorFinal ' '
; �12. Sewer Cap ' - . � � c 63. Heater & Vent-Final . �
.r
13. �Roof Drains '� _ _• - 64. Plumbing System � Final
14. RoughPlumbing � ' 65.-Electrical�Final-�� , . �
15. Rough Electrical-Conduit� ' 66.� Solar SYstem-Final •� s '
16. Rough Electric Wiring �� � � 67. Pencing & Access'ApProJal . •
17. Rough Wiring Sign �� 68.� AP.PROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling " 69. POOUSPA SYSTEMS FINAL . .�
19. Rough�Heating & Air Conditioning , _ FIRE DEPT. REQUIREMENT
20. �Rough Factory Fireplace = _ �. . . APPROVALS _ : Permit # � - - �
,
21 . Ducts, in, Stiuctur¢ '' . �" a, � 70. Underground Hydro
i
22��ucts,Ventilating: � . . - - . •77. Product`PipingOGas ❑Oil
23. Gas Pipe-Rough & Test "' � � - ,. � . 7p, Underground Flush :
. 24..�Roof Framing • " .. �.73-Undergmd.StorageTank.OGas �Oil -
25. Roof Sheathing - . . .. � 74. Overhead Hydro _
26. T-Bar Ceiling (Structural) & Monocoat - . . 75.-Dry Chemical � ' - � •
27. Frame and Flashin9 ' : 2 li%G� �'��' i 76. Dry Standpipe �
'28. Lathing & Siding � _. " . � � 77�.-� FIXED SYSTEM�FINAL
29. Insulation � . '• 78.� PIRE PREV. FINAL
r i ^
30. Drywall Nailing '� . . l-qQ �� � � � HE'ALTH DEPT. REQUIREMENT
31. Plaster Brown Coai ` ' .�'�� j�+ �� 79. FINAL INSPECTION �
� 32. Electrical Power Meter�Final - �`� �✓/c�%._ � 80.- FOOD CERTIFICATE ISSUED_
33. Final Electric _ '. ^ � - , 8 2-�O l�,�aqy� Notes: � ' . : �
34. Final Heating & Air Conditioning " i��� ,. �` j� �.� � �
35. Final Gas Pipe-Test , . � � � - �
L-L
36. Hood or Canopy �� . ' - � i / _ � . . �
37`�Final Factory FirePlace � • Ly ,���-' . . �
38t'Final Plumbing . _ � � -�'b" �., -�f ' �
39. Water Service�Final . �� � - � . - - '
J� . .
40. Gas Service-Final • ' • ' ' ' -
� ; ,
41� Solar pomestic-Final �� �� ' - �
42. Backflow Prevente� ' � - - -
43. Backflow Irrigatio� � � � ' . , •• �
44. Landscape Irrigation System' � ' : . � - .
� -
' 45. Sound Attenuati0� . • . � � - , . .
46. Handicap Regulations ' ' " '
7 FINALSTRUCTURE&BUILDING �zj�,�;��� ' . . .
48. FINALPLANNING `f ;: �•' .
ti .
49..,Elearic Release to Edison - /�„ �� r%: �, r-
� �i !'/ '
50. Gas �Re�ease to Southern� California Gas Co (�� �ii � ^ � � � •
51. CERTIFICATE OF OCCUPANCY
No. � " Date . � . �
�_
;;
_1
�y
g'o" I
�30
£a IS i� �'"6
/� ��
q �O" —
SH"'Ee
,Jstc !�/'aJ�, �
-_-�p�-� - - �--_
r�� -- - - - -
SLoT
�
��}.Z �iac�- '
�,,o-�ilv.�eo 6chss �
�':rv�ba�_ A�'e��
trl",rcpr' C�V,��'�
t�iri(�
Mlw � f�NL� GF(a,/R;(
/✓gW u,acc .�'�
[ i�r, r
y'✓.rl.._'02 �Ix`r'v=1
. -i ,., .� u,s
CX�4i/NL C_�-o��f$
ELoS��
a
3�p°�,..'D- �� .
= i �J',
�
Ex -,?/iG
�� � o�
Si{'----- -
�n, � 22° a e
g'o'
fH
JB--- �•
�E�� !1
� � /JoFT/J�.
8�6" � � � �.
3'
0
r�it #��_f.C-�
S NUMBER MUST ACCOMPANY
ALL INSPECTlON REQUESTS
-TU P�
E R� ST�•YG y��n �.e����y��
CF�•iu� �—'"-'--7VI1_UL
� NOTE
ppOlTIONS, D�LETIONS, OR CORRECTIONS SHALL'
BE APPR01�tD B'f Tk1E PLANNING DEPART119ENT.
�'. '�` �� �� F�i .. i� ;�f�
�I • �� � I /,i • ♦
a • •• �
..,u, , �
. �.. ` + .' I
' e ` G7 �
� �
�vh�cl-. n�iCr�Tz�
cu��>ca e �, . o::.
zxY- 3'o.e .
(�f�,c/L.}/b �
City of Costa ,A''��3;sh'r, ` '�"�er�;� !'
�"Yy ��c�'« � 2v
K . _ .._ �DATEv� 19.,�C
c5c PIAtJ� h1UJT 6E C+N .i('t; AT ALL TIMES �AAK[
CHANGES ��JITHOIi? Fr,!OF AFPROVAL pF DEPT.
ISSOA�CE CR G,Ai�'i�Pl:3 OF A. i_R:+hiT 04 AP?"nGVl.i OF
i AND $pF.C�FiCAi IONS SHAt1 N�:1 6E CONSfRUED lp SE A
:�tXi!'�:s'< AN �'.PFP,OVF.I, CI, AP1Y ViOIATION Of FlN'i OF
�'9p�d5 CF ?HU COJE. �O PEdMIT PRESUMING ?p GIVE
!ntTi Ki VIGil�.ic O� CANC:I. Tn`c ?itOVISIONS �'R115
/`/NALL dE Y�AiID, EKCEP7 RJ S�J FAi2 tij iH:f WORK OR USE
/Y'np2.c/-�Rt1:s i�w��.. �
'e I$SUANCc Gi` A?SJdfi Fi:Sf:G UFv:! FiANS AND
�r^idO:S �J1ALL NCT 7f:'cv�;�' ?.IF SUI.DInIG O%fICIAI
/O2REAF7F.R RE(;Ui4ING 71'E CC?nf��Tlqrv CF EBFCdS IN
VtANS �ND SFECIf9Ci+.i1GN: ^F FfiCi:1 Pd'c'/ENTIhG
I\G (:i'Ek.A1CN5 kF�NG G,41.ic`✓ n;v 74F.�tEUr.DER WhiEN
I�A710N OF THfS COUc GR G� AiJ't GIHER ORDINANCE Uf
3�„ .
'�-' %C�/$78 ,,
OK TO PROCEE'.) �N�TH PIAN CHECW..
THIS DOES NU-i CON3TITUTE FINAL
p��PiIOVAt. �a-CJ � 9 Z�
INITIALS DATE
I�l�,�t �(�_y -�'C��UL�E.��
322 VICL!i��V/-�
�o�sr,� ,°,��� �,<; �TY:iJr
. \
AOP���ant,to fill in all spaces ea�ept those within heavy Dortler lines antl Slgn all aOP�opriate tlecla�ation5. ' . , coo�
�. CITY OF COSTA MESA" " ", ' -' ' -' . � - - PE MIT NO. - �RACT NO. � -LOT NO.- , BLD . ' ' �� - "'- � ' � 'I 3�I�B �I 2�?�Z�Qa - -, �
i L
, CONSTRUCTION PERMIT •. -�Q�,� � " ' ' : : _. " �; ; . - ' - r
Pioj¢ct Addf¢ss " � . TVPE OF CONSTRUCTION� NEW �' AD� ALTERATION' REPAIR " ' � ' • � `
� 1
ApplitanYs Maili Addr 55 � ✓` � � � '� CONVERSION : ❑ DEMOLISH OTHE ' � ' . , " � '
A'.P. # . . . Zone
DESCR�PTION OF WORK , � , /'
Owner'sNam � � .�Phon . . � ��� i� S Main Building: � Acce£sory Building: � • - Z
� AddfeSs� -�' ' , - � 7ypE,OFPERMIT- GRADING FOUNOATION' ❑ STRUCTURAL' T Front - " ' ' • � ' N
' Arch/Eng. - Lic¢ns¢ No. � ❑ TENANT ❑ ELECTRICAL �LVMBING ❑ MECHANICAL � • � g .. . . - � _ �
Address ' � ❑ ,OTHER . ' � ' ' . A Rear � � � ^ . N
- � C Right . . - . . -. . . - ' � G
Contracior's Name � Phon PROJECT DESCRIPTION: 5c�. FT. ' - oCCUPANCv' ' ' ' •
Addfes5{mailing) �" `" �% ' J ONSTRUCTIONTVPE � VALUATION$ g Left . � . E
` ` ' ;_ . '2711�'� ' ZONE ' GRADING CU.YDS. ACRES Ping. Ref. # � � Palk.Fees $� � � ' � ' n �
�� City-CicanseNo. 7iZ. � ;
Kl LICENSEO CONTRACTOR DECLARATION Remarks: . . 1 Parking Feq./Provided • � I'
� I_hereby afflrm that_I am Ilcensetl untle� provisions oT Charter 9(commencin9 ' . , . � R .
with section 7000) of Division 3 ot tne Bus ess� Pr �es ions COCe, antl . � .., ' � . ' ' ' • Use of Building:, _ ; ' ' '' i E
en " my Iicense is in full t6 antl etiect. ' ���,]�� 7 � ' . . , . � , - - . M
v License Cla s � Li' se No + � PLUMBING - � fEES • P�anninglNotes: � . . . . E �
�I Date_ Si9nature . . , , j , . , , � x � N
t WORKE S'C MP,ENSATION DECLARATION� .,.. ' BafSink ; . Showen • T
�1 hereGy'affirm that I have a certificate of consent to self-Insure or�a certificate i -� l� . ; ' 1 ' . : . � �
of Workers' Co penwtion Insurance, or' a cer ietl� copyc ereof (Section Backflow Preventer ServiceSink S
3800. Lab. CJ /�� O� . . � . . � - � .
i Backflow Irrigation Sewer Cap � �<�,- � ELECTRICAL . � FEES
PolicY No. � ll ComPanY 1 . t "- . • •
�Certifled c py is nereby (umishea. ' � � ,� Bathtuhs � Sewer Connection Automatic Washer:�- � '� Trensformer � 75-50 KW
Certf tl c is filetl with the aity B in ' o � . - - -
• Date �`�I� APPlicent Clarifiers J ' . � SolarCollectors � � - ' ❑ 50+KW
Construction PoleSub.
E%EMPTION FROM WORKERS' COMPENSATION�OECLARATION' � _ � -
(Thisseciion neetl notbe completetl if tne permit is for one huntlretl ($100) or ; Dishwdshei �� Solar Piping' ' ' ' • Cooking Unit .��` Meter ❑up to, 100 amps ' ' '
leSsJ. � • . . . . .
I certlfy that �in the pe�formance of the wOrk for��which this pe�m�t is issuetl, I Drinking Fountains ' Solar Tank � � Distiwasher �-= % MCte� ❑Ovel 100 amps .' �
shall not employ any person in any manner so.as td becoma subject to the . . '- � .
workers' CompensatioNLaws of California.� , . FlOor Drains' F Swimming Pool w/Spa � Dryers ❑Gas DElectric Sub'Panel
Date Si9nature • � � " ,
NOTICE: If; after making this tleclaracion, you shoultl become subject to the Floor Sinks ' � Urinal ' Fan� � _ Motofs �0-1 HP 01 %- 8
. Workers"Compensatioo�provisions'of'the Labor Cotle, you riiust forthwith'- '"" - - - - - - - . " � ' - � " '
comply-with such-'provision5'o��thi5�pe�mit,shall b¢ tle¢metl revoketl. GasService 'Outlets� ^� WaterC�loset,' . " ' � ' -
GONSTRUCTION CENDING 'AGENCV-� � - � -��
F.A:U. Inc.Solar �9-15 HP �16-15*
I hereby atfirm that there is a constructioppp lentling agency for the performance • � Interceptors � ' '� Water Heater Fixtures ' � Microwave ' t
of the �wark tor �which [his per�fiit/li5�issuetl..(Section 3097 Civ. ,CJ' -
Lentler's Name �� � >+' ' Kitchen Sink � - Water Service � � � � - �
���-/ Device eoxes � . ; Pole•Light �
� Lentler'S" Atltlres+ - / �/ E � �,�' ' ' � r LavatOries • � � �' � ' . �,
OWNER BUILDER DECLA�� ' - � � ' �- � , � i OUtlets �� Range
I hereby affirm that I am exempt from the C6ntrac[or's Licenze Law for the .
following reason (Section ]03L5•Buslness antl Professional Cotle: Any Gty or ' P-Trap � • _ � ' Switch¢5'. Sign �
Couoty whlch requires a permit;to consbuct, alter, improve, tlemolisM1 or.�epab r
:any structure, prior to its issuance, also requires tne applicanLfor such permil Roofbrains � � ' ' � Garbage Disposal Standing Sections '
,to file a signetl statement�that he/she is IicenSetl pur5uant to the prOvisions of '
' �the Contractor'S'License taw (Chapter 9(commencinq with Section 7000) of ' � �• ._ . � � Gen¢re[o� 00.5 KW �5-15 KW ' T�ash Com act0� i
Division 3 of the Business antl Professions Cotle)-or that he/she-is exempt 1 j .�', �. � � � ' �� . � � P �'
�,therefrom antl Ihe basis for'.the allegetl exemptlon. Any,violation of Sectlon � - ' � • .
7031':5 by.; any applicant ton a' permit. subjects. the -applicant to a civil ° ' -. - . . �
`�enxlty ot not more Ihan five huntlretl tlollars (§500).. , � ' . , . -Reinipection Fea.•• $25' : Issue Fee • $ 3 ' , �
LI I; �as owner ot the� prooerty br my employees with wages as their sole , Reinspection Fea , '$25 Issue Fe9' !$ 3
compensation, will tlo the work, antl the strutture is not intentletl or otteretl ' -'- - MECHANICAL ' FEES
tor sale� (Section ��044, Business antl Professional Cotle: The Contractor's : ' PUBLIC SERVICES REQUIREMENTS: � � �
Lic¢nse Law tloes not apply to an'owner of a p�ope�ty wh0 builtls oi iTproves BOiI¢� �� � ' ' HOOd On Typ¢ I ❑. � � '
tM1ereon; antl'who tloes such work•hims¢If/herselt o� tnrough hi5 0� he� own ��'' - Ddt¢
amoloyees, provitlea that such improvements are not intentletl or oReretl'tor � Canopy Type I I ❑ � Zoning Approved By ' '
sale. 1!, however, the Duiltling or Improvement is soltl within one year ot com- ' Duct - Under Ground . � � ' � , Application Approved By ' Date
pletion„the owne�. will have the bu�0en ot proving h¢/she tlItl not builC o�-iT- � - - ' •
�rove for the purpose of sale). �, .: , , F . Duct - Structural � Refrigeration Syrtem � �� � j ' APplicatian Issuad�6y - " / � � Dat =" � %
LJ I, as owner of the property, am exclusively contractin9 with Ilcensetl con- ❑0-100,000 BTU ❑100,000 BTU ' �
tractorsto construct the project (Section 7044, Business antl Profezsions Cotle: Duct- Ventila[ing � . ' SUMMARV OF FEES ' �
The-Contractor'r License Law tloes�mt apply-to an owner of oroperty who� � " BUILDING PERMIT' $' � SMIP � ,$' �
buims or improves thereon,�antl who contracts Tor such projects wkh a mm Exhaust System ❑ Mul[iple ❑ Sys[em Repair/Alteretion ' �
tractor(s) Ilcense Oursuant to'the Contractor's �icense Law): � PLAN CHECK $ ---�— ' PERMIT
❑ I am exempt untler Section � B. & P. G �or this reason FirepUFact. BIL ICBO # ' - ' pLUMBING ,$ S. O V ISSUANCE ;$
- • . i . . � ' ' � .
oate � pwner ' � �� ' Heating System & Ducting � t � ' � PLAN CHECK $. ' � ENERG�',P.C. �, $ �•�
I hereby certify that i have reaG thi3 applicatlon antl state that the abbve ❑0-100,OOOBTU �100,OOOBT � � GRADING ,$ +
information is co"rrect: I agree to mmply ith all city antl munty ortlinances - - - ' ' -- � ELECTRICAL $� �
antl�state laws reiati �to builtlin9 Sonstr ction antl hereby authorize repre- � � - � $ � MICROFILM $ �
sentatives ot th i. t ent on e above-mentionetl .- erty Tor � ' > PLAN CHECK . - , r
inspectian purp � C � � � � ' � � MECHANICAL , 7 �
S�9nature � ' • Date ' �Z � � � � ' $ TOTAL FEE , $ �
ori'vers' �Lican � 5 � � ReinsPection Fee ' $25; ' Issue Fee • $ 3 PLAN CHECK ' $ � . . .
�
CMF0865-46rev:7/63�' White=BUIIdIng;Canary-AOP�IcanhPink-Accounting;Goltlenrotl-Assessor -' "' � - -" -- -- - � - � - � -, � -�� • - - - � - �� • - - - - - -�
,
CONSTRUCT.ION AND PLA NING � �- � _ - � . :POOL & SPA . ,
APPROVALS �Permit#�- ' Date- Inspector= ��APPROVALS. Permit# ' .� Dafe.- Inspector
� 1.�Temporery Electric8l Service or Pole'��� � �� � � , 52.,Pool & Equipment�Location ', '
, .t
� 2. Soil.Pipe-Undrgrnd. �.� � ; : � .��1� . . � � 53. Steel Reinforcement � � - � - � � �
i �
� � 3.� Electrical Conduib Utility-Undrge��d �J.", - � �" . 54. •Forms - � •
,
� 4.{Electrical Conduit-Und}grnd:�' � . t• :' � - 55.. Electrical�Bonding � � ' �
.� �
5. Steel Reinforcementi-' -' :-f � ' 56. Rough'.Plum6ing.& Pressure�Test� .. l.
• 6•'-Electcical UFER Grnd-. � " � - ' 57. APPROVAL_TO COVER-GUNITE � � �'
. � - ..
7..-Footings'� � :�� �,-':! ' • , � � "' 58.� Electrical Conduit-Undrgrnd. � � j��.,
%; '-
`'� � � f V � ' ' � � � 59.=Gas' Pi e, O Undr rnd.,_Test.
8. �Foundation � � ']-� � : {�, � � y' i p g �
i. .t.
9.`Wa`er Pipe-Undrgrrid , ^ ' 1 � '�= � � `, �,• � 60.;Backwash Lines, P-Trap, O Undrgmd. . i• �
10. �Str.uctural�Floor System � �%. ., ' �� �� ` 61.'APPROVAL TO DECK� - �
i
71. Pioperfy�Sewer Line.& House Con�ection . , �j �'� � . . 62. _Backwash & ReceptorFinal ' - . ..;;
�
12. Sewer."Cap ., . - ! � . ' 63. Heater & Vent-Final ' � � •
�
13. Roof�Drains � �;. "� ' . 64. Plumbing_System - Final , � . � , •;
14.� Rou�h;�Plumbing� - �� ` ? • - 65. Electrical=Final - ` ,
15.. Rough Electrical-Con`duit . � ' 66. SolaF System-Final " ''
Y6:, Rough Electric Wiring�, - ' ' � � , 67.'�Fencing,& Access Approval r� � '
�t
17. Rough Wiring Sign; ' ' � 68. �APPROVED FOR PLASTERING '�
� 18. Rough Electrical-T Bar Ceiling . 69. ;POOL/SPA SYSTEMS FINAL
�19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT � -
,20. �Rough Factory Fireplace � APPROVALS Permit # � �
21. Ducts; in Structure ' � 70. Underground Hydro �
�• 22. Ducts, Ventilating ' � 71. ProductPiping OGas ❑Oil
. 23. Gas Fipe-Rough & Test . 72. Underground Flush �
, 24. Roof Framirig .• - 73. Undergmd.Storage Tank_O Gas ❑ Oil
25. Roof•Sheathing , . , • 74. Overhead Hydro . ' � '
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical .
27. Frame and Flashing � � _ . 76. Dry Standpipe -
28. Lathing&Siding'. 77. FIXEDSYSTEMFINAL
29. Insulstion : �' ' � 78. FIRE PREV. FINAL
' 30. Drywall Nailing . �� . ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power•Meter-Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric . � � . Notes: �
34. FinaL Heating & Air Coriditioning ,, �
35. Final Gas Pipe-Test � � , - . . � .. � �
36. Hood or Canopy • � ' ' , ' - � ' � .
37. Final'Factory Fireplace ,. . � � . � . , �
38. Final�Plumbing � . � Ll�1 � . � , ' ° • � � ,
39. Water Service-Final . � - . . • � � ,�
40. Gas Service-Final . , , � - �
41. Solar pomestic=Final ' � . _ _' .. . .
42. Backflow Preventer ' ' � �
� 43. Backflow Irrigation � � � . � � , - . . , •
44. ,Landscape Irrigation System � ' ' � ' '. ' . � ,
,
45. Sound� Attenuation '.� �. . � � , � ,
46. Handicap Regulations � . � � , .
I
47. FINAL STRUCTURE & BUILDING �
,
� 48. Special Requirements�Completed , , ' � ' ' ' ' ,
49. Electric Release to Edison � � - �, . ' - �- � , ' • , �
50. Gas Release to Southem Califomia Gas Co � � • ' • � '
i
51. CERTiFICATE 0F OCCUPANCY. � ' _. � , , .
,
No. � ���Date . ' � . � � � �
- "1
.,
t
,
COSTA MESA BUILDING DEPARTMENT
�, P. 0. BOX 317 0�� ��
COSTA MESA CALIFORNIA
f
UJ
w
¢
�
�
�
0
C•L. OF STREE
' �sPROP. TLINE _
r 10 FT. FOR 60 FT. STREET
�,
�
�
�
�
i
iw
�a
lo
��
a
EY OR
�
�
h
� r
PROP IINE LL
� i
C. L. OF
OP LIN
q w
� �
�
� y i
Q 41 p
�
r�a
(j ';Z J
�_�
.,
oJ�
.-
},�
� `m
u �
:n
�
i I
1
- � ------�
�
FIPlANCE
CITY�OF CO
F-
w
w
�
F
y
a
0
�
ti
FT
60 FT1 ST.
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES
/
�� E D I '729'7 I_ .
�45/�8/55? FOR AP'PLICANT, TO FILL IN
HT. v� BUILDINGADDRESS!�(1/��-/�NOlJ� �.
iAESA /S�L. /�EGTCN _..
i OMa 1 Addres � zr �2'� L�iS'ND G�f� �A �
City ��5 %!� /'7� S�i Ph. No �1-`�'����
� — - - - - - - - - - - - - - - - - - - - - - - -
� Contractor D��NE,�, Ph. No �I �� '2�J"�
� .,,
City Lic. No. State Lic. No.
Size of Lo d� AP No. v O �
Setbacks: C/L Street � c� � Rear S�� 4
�E-�
Side Yard - Right �' � Leff
Type of Fence��� w�p'� s J ��l�y
�-�.r�uN�c/i��' f�eT
I hereby acknowledge that I have read this application and state
that the above is correct and agree to comply with all City Ord-
inances and State Laws regulating building construction.
FOR OFFICE USE ONLY
VALUATION
�� •�V
Date Received
���� �
,�%% � ��/
Permit Fee
Plan Check
TOTAL FEE
U.SE REVERSE SIDE FOR DETAILS
'729'�
Date Issued /–
�–�C��J �
� . � �
$ c
� �• D �
�� . . � .
�� -�: � so��
...
-COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31'1
� COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING
ADDRE55 499 Villannva Rnari
A MESA. CALIFORNIA
OWNER �( �
MAIL
AODRE55 � Faat. l7th
c�rv Cost2 Mesa
ARCHITECT Carlson BC
OR ENGINEER
ADDRE55 Garden Grove
CONTRACTOR D1ke azld Co�
k19 East 17th Street
LEGAI LOT
OESCRIPTION NO.
A.P. NO.
SIZE
OF LOT
USE OF
E%�STING BLDG.
SETBhCK t NE F
CENTER OF STREETM
TEL.
NO.
LIC.
N O,
irakf L.
NO. '
K TRAGT
NO.OF BLDGS.
��OW ON LOT non
REAR VARD 97t
. DESCRIPTION OF WORK .
NEW ]� ALTERATION AODITION
REPAIR MOVING DEMOLISi
STORIES
WALL
�EE RECEIVED
it- �3..s'� v�`
FINANCE DEPT.
GITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO; pERMIT NC
����i i ii-i„�-.��rynt
BUILfJING
ADDRE55
COSTA MESA, CA�IFORNIA
TVPE
PLANS
DATE
CORRECTIONS
I MEREBY ACNNOWIEOGE THRT I HAVE PELO THIS TPPIICRTION 4N0
ST4TE THPT THE ABOVE IS CORRECT 4NO AGREE i0 COMPLV WITH ALL
CITY OROINRNCE$ /NO $TATE LAWS REGUL<TING BUILOING CONSTftUC�
TiO�u. VALUATION
SIGNATURE OF �
PERMITTEE • 0
� 13',07�2.00
Dike and Colegrove, Inc.
PERMIT FEE $ 3��y��
PLAN CHECK $ O
TOTAL FEE $ '�4g.� �eMr
OWNER T.�,TpN, HAROLD
JOB ADDRESS
GENERAL CONTR CTOR T. M.
P;P No. 11G1-471-0� LOT �p
INSPECTIONS
SOIL
GHS
W ATER
ROUGH PLUM9ING
PROP. SWR. LINE � HOUSE CON. �
SPRINKIING SVSTEM
MISCELLANEOUS
ROUGH HEATING AN� AIR CONOITIONING
TEMPORARY SERVICE OR POLE
UN�ERGROIIN� � POWER �
ROUGH WIRING
TRENCNES � FORMS O STEEL REINF
FLOOR SVSTEM
BON� BEAM � STEEL REINFORCE �]
SHEATHING
FRAME ANO FLASHING
LATHING - IN OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., ftEFRIG. AND A.C., FINAL
PLUM6ING, FINAL AN� GAS TEST n
ELECTRIC, FINAL
BUILOING, FINAL
DATE $_6_6g
BUILDING PERMIT N0.
17\�
SUBCONTRACTOR
;; - ` 28952
COSTA MESA BUILDINGSAFETY DEPARTMEPtT
P.O. BOX 7200 � COSTA MESA, CALIFORNIA 92828
For Applicanf to Flll In Complaroly
TYPE OR PRINT
em�oiNo
ADDRE58 � / L L Y O.
COSTA MESA, CALIFORNIA
OWNER R /: R�LD Lr L�
MAIL �-r �/�
ADDRH9II ..J Z Z. // . ) / _ d ii h//.Q %��i .
nuc —6-68PA7000 342� ***�21.00
CMSA
APPLICATION FOR PERMR
BUILDING
For Offlce Usa On1y
R[C[IIT NO. �� P I�T �l�[
fL�L_
I 1i�T[ 6C[IV D rq/Ig=UgD�/.
a 6 be
�
�.,... n.... - - � �- �a,� ' � o �0 1 ,� .� _ 3
ADDRBDf Ge ENOOZ,�Q o�cnimox
' A.P.NO. � �U �
CITY
STATE T8L M0T6: N06AV60VfRHAN63HALLBHLE88THAN
LIC. NO. G� p� L�/L'-� 90' TO HIDH 0 RBAR P. L.
SIZB � Ho. o� �LOoe. ` ��,pWgp N. B. C.,REQUIRHMENT) _ .
OFLOT U , �Gd nOW N !
YARDSMPROVHD YARDSAPPROVfiD
USEOP ' MAINHUILDIN6 ACCE980RYBUILDINO
EXISTIN6BLOO. 0�✓E t L/N
d FROM C/L iTR[[T)
asrew<K un� �nox � FRONT� PT.
CeNT¢11 0� eTR[aT SO RtAR YA O ��
91DQYA DI RT t RIQM' t A�o�D[ �. FT.
DESCRIPTION OR WORK �. aioe � vr.
NF.W 7tRAT1 N ADDITI N � RGR � FI'. FT.
.DIBTANC[![T. BR.MAINQ
REPAIR MO IN 8M LIBX MAIN BLD i ACCE54.BLD68. - �
. • vwe.7R V - 36 -6� owre
BUILDINO G � NO.OP
BRE S Y-'� ROOMB Z RI I C. V. P. MPROVBD '/�
EXTERIOR WA ROOr MPROV[D / �//n
COVERINa � GCG COYBNINO K� c ' er L'/�,/ DAT!
UDH OF DUILDINY AND WORKTO!! PBRFORM[D a
6eN W
�
3�J , HC.FT. �
0
1 NCftl6Y ACKNOWL[DG6 THAT 1 MAY[ RBAD TX18 APPLICATION Z wxoUtR aXOWN UNDert VALUATON le POR TX6
ANU 8TAT6 TXAT TX8 I�GOVB �Y COPqGCT�AND AOpEB TO COM• ��RP088 OP CBiABL18X�xo w v ew� .
PLY WITX ALL CITY OROJNANCt/ ANO fiATL N1WB P[OYIATINO yALUATION �
BUILDINO CONBTRUCTION. Rl
PERMIT FEE p
SIGNATUREOP,� av G�
PERMI7TB 5��� - � W
AUTXORIZ6D A6CNT � i
TOTAL FEE