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HomeMy WebLinkAbout3205 VERMONT AVE - Building Permits�. _ January 18, 1984 �. -----..__ --_ ,.._- -�"/� --^-� - •-s- RE: vcteia resiaence room addition, 3205 '•lermont, Costa Mesa Grading Plan Certification, Review Requirement Per telephone conversation xith Building Inspector Scott Pringle; In accordance with DSD Admin. Manual, Building Safety #B-4, sections 3.� thorough 3.6. The remodeling room addition Nas a replacement of exi6ting temporary �portable metal rooml on a concrete slab. The new construction was designed to build an up to code new concrete slap and foundation after removing the old. Walkways around the etructure were to be slopped as required for 3rainage aWay from the structure and normal flow out to the street. This ie to certify that the structure and propertq are in compliance with eections 3.� thorough 3.6 for gradiag plan, drainage/ mater flow of Costa Mesa code. I project has been inspected by myself as the designer and Eesponsible Managing Officer of AS Construction Co. and the contractor Akim Sezenole dba AS Construction Co. This completes all permit requirements and the atucture is ready for occupancy, please, issue the permit for occupancy. Ja C r� ���g�g� Cali£. Contractors I,ic.# 81-425972 a.rs.o. AS Con�truction C0. 155 Rochester� Costa Mesa, CA 92�2'J cc; Mr. & Mrs. Morris Stein w • : BF/� aS�iS -, . . � . : r--- • From: Akin Sesenol � . 12/13�1983 � . : - General Qontractor " ,. '.. 155 Rochester Ave . ' , ' � , �. , ..Costa'Mesa. CA.92627 • . � "Phone: 642 1323 . , • ' :s �: ; . . , . . , , ,.. . To: City Of Costa�`T4esa'r •' . . � , -. . � ,� '. . "" ' ' Building Division , � ,,� , " 1� ' ;Costa Mesa CA. n i , . . . ' . . . �' ..�6 .� . • • • . r, . , � ,G ,. .. . . . � . �.. = b � ,. .. . • ' : • "`' ,� .. 'Re: lioom addition at 3205 Verriionta`Costa Mesa��.CA. ' T,-Ak?n,Sezenol, Contractor fos,the':above mentioned,..project, . � �hereby,rassume'i'ull`responaibility�that;may'a"rise� from`any damage � ' due to leakeage �related, to �the� :place, of. the, oven . hood in the .yalley of the 'roof.where it now; standsi �,.,'' � �' w - -• � a. w::. : ,„ � . ' _ ' .`�The owners P+lrs and Mi, Stein has no objection in this matter and • . your cooperation will be apprec�ated; thank,you. . - ' , • : Since ely yours.. . - ;' .. '. • ` . . ; `. .s . � ��(��� . � �. . � . . - � �--� ��� -* = � . � - , • .. 'Akin SFs�enol . . �.,G�.. ; , . � • . ii . ' . .. . . • • . .. . 1. � . , ' ' ' . .., . . �. . , ' ��. • 1 .'� . . .. . _ . ' . .lyA . i � • ' . � . '�:{��'�.Ji�. . � . . .r . . .. � . . ' � . 1' a From: Akin Sezenol 12/13/19II3 General Contractor 15j Rochester Ave Costa N�esa, CG.92627 Phone: 642 13Z3 To: City Of Costa T4esa Building Division costa r�e:,a CA. Ae: i2oom addition at 3205 Vermont Costa 1�iesa, CA. I, ,ikin Sezenol, Contractor for the above mentioned project, hereby assume full re&poneibility that may arise from any damage due to leakeage relaiPd to the place of the oyen hood in the yalley of the roof where it now stands. The owners F1rs and Pir, Stein has no objection in this matter a��3 your cooperation will be appreciated, thank you. Sincerely yours. i%. � . ; �f�% � ��ll.t/ C �_._/ ,?kir. :'c;;enol ----�--_� , _ • +� Applicant to (ill in all s aces exce t those wit�in heavY boraer Ilnes antl sl n all a . D V 9 pprop�iata declarations. ' G7u OF COSTA MESA - - ' ' - . - - PERMI I NO. TRACT NO. LOT NO. tl�D . �^r_:CL�SFf�UCT�ON P�RMIT , ; � ' _ - Z�EM -- S� 3;, ` l,C ��2�� ; - �_��. . .: ro�ectq8dress• �.Z; C S� J E 4�i O N. L. � C•M TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R � • �Appl¢anf'S Mailing Add�e55 � � � ❑ CONVERSION ❑ DEMOLISH �0 OTHER - M� /�C ' �"�/N` ' T ^ DESCRIPTION OF WORK ' "1 � � � � � � �• "I• r'+. _ Owner's Name �_o_�i Phone • �� Ep�-S . . t Address zJ.7 � P F`An/aN i C y�:I 2.30 i�rtlo C�yOC/F��' � TVPE OF PERMIT GRADING' . FOUNDATION �ry STRUCTURAL � i- Afch/Eng'._ - : LiCense No. ^- � � ❑ TENANT � ELECTRICAL � PLUMBING ❑ MEGHANICAL �Addre55 - ' _p ' ; ' " '�//�� ��- y` - ❑ �OTHER ' � ' _ � _� ContractorsNam �•k/iL� �,�F��� A�phone�-E-IL.3 PROJECTDESCRIPTION .F7.� �- O• CCUaANCv (\. ,-Addre55�mailing) ?��O �SAA./%fJ AN17•�IUF ' , � CONSTRUCTIONTVP � � VALUATION$�-I�B�'� �-''O ' ' 20NE GRADINGCU.VOS. �ACRE�� City License No. �'1 9.S'7 c/ •• � LICENSED CONTRACTOR DECLARATION r � '_ � Remarkr. ��G` �, ��_ fl� I�hereby�a�/irm that I.am licensetl under provi5ion5 of Charter 9(commencing ; V� , wi[h`section ]000) of Divislon 3 of the Business antl Professions Cotle, antl �� � . my II<ense iz in full torce antl eitecL . \ LicenseClaSs_�' •- � Li ns No.y��47� �' � ' \ Date�(- %��_ Signature . WORKERS' COMPENSATION DECLARA ON �' � Bar Sink . I hereby affirm that I have a certificate of consent to s =insure or a certificate Backflow Preventer of Workers"Compensation'Insurance,For'a'certifietl copyihereof (Section' ' - - 3800, Lab. C.) ' -� � ' " Iq : ' Backfloyr Irr:gation PolicY No. 3-�7 �'�_ ComPanY"f°'R�Z.40� inIS.�CO , `- gCerti(ietl copY is hereby fu[nishetl:,1� i I BathNbs i�y� I � ' ❑ Cert/itietl copy Cis tlleE with the aty�Bu' g divi , Date J/•• //�' q�_ APOlicant ' � .�.--- . . £XEMPTION FROM WORKERS' COMPEN-� � � ATION - . (This sectlon neetl not be complatetl if the p¢rmlt i5 tor one'huntlretl (§100) or'�� Iessl: ' ; t �-'. • ' �." • , I certify tnat in the per,formance of the"work lor:which thls perm�t is�issuetl I v shall' not employ any person im any.-manner so as to�become subject to t{�e Workers' Compensatiom Laws of Californla. � ' • Date � Si9nature NOTICE: If,'after making this tleclaration, you shoultl become suGject to the 'Workers' Compensafion provisions of'the Labor Cotle; you'must'torthwith ' comply +with such -provislons; or this� permit shall be�tleemeQ revoketl.. CONSTRUCTION�LENDINGI:AGENCY ' - ` I hereby atHrm that there is a mnstruction lentling agency for the performance of the work for which' this � ermit i Issuetl .( cypC 3p 97 Civ. C:) � Lender's Name �SECUL'��y Of�C/E'/�••�fr/- 6'IRit �t�__�•J/ Lentler's Fitltlress����p,�,�OF Rb!/. 2'M: - " ' , OWNER BUILDER DECLARATION - ' I hereby affirm'that I am exempt trom the�Contractor's License Law tor the ' followinq reason (Section�]031'.5 Businessantl Professional Cotle:�Any city or county which requires a permit [o constru<t, alter, improve, tlemolish or;repair - .any structure, prlor to iti issuance, also requir¢5 th¢ applicant for Such'permit :s file aisiqnetl sta[ement that he/she is IicenseE pursuant to the provisions of - �the Contractor's License law (Chapter 9(commencing with'Section 7000) of Division 3 of tne Business antl Professions Cotle) or that he/she is exempt � therefrom antl tne basis for t�e alleqetl exemption. Any.violation ot Section 7031'.5 by any applicant tor a permit subjectz the ao0��cant to a, civil eenalty o! not more [han five huntlretl dollare �$500). ,. � LJ I, as owner of the`property bi my employees with wages as their sole <ompensation, will tlo the work, antl tne structure�ls not intentletl or aiterea for sale (Section 7044, Business antl, Protessional Cotle: The Contractor's License Law tloes not apply to an owner of a property who builtls or improves � the�20n, antl who tloes such work himself/he�selt or thrOugh his o� he� own employees, provitletl that such improvements are not intentletl or offeretl for sale. If, howeveq the builtling or improvement.is soltl within one year of com-' oletion, the owner wlll �ave�the burtlen of provin9 he/she tlitl not builtl or im- �rove for the purpose of sale). I, as owner of the property, am exclusively contracting with Ilcensetl con- tractorzto construct the oroject (Section 7044, Business antl Proiessionz Cotla: The Cont�acto�'s LI<ense Law does not dpply to an owne�� of property who � builtls or iTptoves the�eon, antl who contracts tor such projecl5 wlth a con- tractor(5)license pursuant to the Contractor's License l.aw). � a5her - ing Fountain5 Drains� "��� Sinks ' arvice �Outle ep[ors, xnSink � ' . ServiceSink' � SewekCap ' �-1'"�n�' SewecConnection , - Solar�Collecmrs,' � �" . � �Solar Fipmg � - SolarTank - "� �-f- '- - Swimmin9 Pool�av/SPa . ' I ` ' Urinal � Water Closet � - Water Heater . Water Service . . �- ' �avatories T . � � P-Trap �_ " ' - . Roof DrainS� , ' ' � . � Reinspection Fee - •$25' Issue Fee , Boilei Duct- Under Ground Duct-Structural ' Exhaust System ❑ Multiple ❑ ❑�i'am ezempt untler Section � B. & P. C. for tnis reason ' Firepl/Fact BIt. ICBO # - Date /�- ' Own � niry. ' Heating System & Ducting I hereby certify chat I nave reatl this appliwtion antl state that the above , ❑4100,000 BTU �100,OOOBTI information is mrrect. I agree to mmply wi[h all city antl county ortlinances . antl'state laws relatin9 to Ouiltling,constructlon, ana nereby autnorize repre- sentatives of this city t en r- upon the ove-mentionetl property for inspettiOn pu�pozei. ' + ' Signaiure ' �Da� /�-/I/' •i�3 peinspeetion Fee $Z5 Orivers' License or 55 � ='^a65-46 re�White - Builtling; Canary - Applicant; Pink = Accountin9: Gol_ G_enrotl - Assezsor � ' Hood or' Type I ❑ Canopy Type I I ❑ iefrigeration System i �0�100,OOOBTU ❑100,000 SVstem Repair/Alteration Iwue Fee ... $ 3 fEES $ 3 A.P.'# � �% � S Main Buildin9: E. 7 Front B Rear � A C Right ' � gLeft , y � Ping. Ref. # Parking Req./Provided Use of Building: Plannina Notes: _ Cooking Uriit . � - � � Dishwasher Dryers ❑Gas';�Elecn Fan� ' -> F.P,�.U. ' ' Fikwres ' Device Boxes • O`utlets ' ' `,�a..�: � i i f�ii-: ' Zone Accessory Building: ' Park:Fees $ � �� , . � Z • O N 1 N ' G i .. � q � E , Q . U ' .. . . .. R � E M r C � E . ELECTRICAL ' ' � FEES _� �Transformei ❑ 15-50:KW, � . � ❑ SO+,KW ', . � '� 'Meter'�upto'100amps' � ( � �SE �Meter pover100ampsr ' i .Sub Panel , � _ " . Disposal �r 065 KW �5-15 KW I �,_ �'Motors�61 HPOi%_-�8 : � � '`_� ;Inc.Solar�09-75 H7 016-15+ � I Pole L Range Sign ing�Sections ' - Compactor ' 0 I Reinspection Fee I$25I luue Fee� . � � $�3 � PUBLICSERVICESHE�UIH�FNTS: � ��_1 $.t Zoning�Approved By �G r'�J Date Application Approved By ' � Date��T Application Issued By � Dat y�� �? �- ,SU/M �M� RV,O...F� FEES ' � !!D �- -sBUILDINGPERMIT $ J.(�O._1S2 SMIP $ jf�L;�P.LAN CHECK $ �S 6� PERMIT � ' ` PLUMBING $ ISSUANCE $ ^'� „PLAN CHECK $ �'� ENERGV P.C. $ -rELECTRICAL $ � D.00 GRADING $ � lPLANCHECK $ ,3�5� MICROFILM $ � MECHANICAL $ �•0� TOTALFEE $ /sb.ys J' PLAN CHECK $ �• 2� i 1<•„�bNSTRUCTION AND PLANNING � ; . , P�j7,L & SPA ' I �' �j��pPPROVALS Permit# ��m� Date � Inspector AppROVALS Permit# Date Inspector .,���.�Te'mporary Electrical Service or Pole _ � 52. �Pool & Equipment�Location � ' � �2. Soil Pipe-Undrgrnd. �� . �,� . . 53. Steel Reinfoicement . � 3. Electrical Conduit Utilit'y-Undrgrnd�. -� � • 54. Forms - � � 4. Electrical Conduit•UndrgrnU. � � 55. �Electrical Bonding - - _ � � 5. Steel Reinforcement , ,� . 56. �Rough Plumbing & Pressure Tesi . �6. �Electrical UFER G;nd. ��' �. 57. APPROVAL TO COVER-GUNITE ' 7. F.00tings ' . . "� � ' '� ' � , 58. Electrical Conduit-Undrgmd. . � - 6. 'Foundation '� S T _' • 59. Gas Pipe, O Undrgrnd., Test ,' 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. . • t, 70.' Structural-Floor,System ' ;��3 �� .61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � �"" 62. Backwash & Receptor-Final � . , . 12. Sewer Cap � '' � �� 63. Heater & Vent-Final . 13. Roof Drains • . ' . , , 64. Plumbing System - Final . - , 14. RoughPlum6ing� ` � (Z...�qjjy b"` �e� 65. Electrical-Final � 15.'Rough Electrical-Conduit . �"66. Solar System-Final " -- T6. Rough Electric Wiring ' �Z � $3 . � 67. Fencing & Access Approval ' - ' u .1:7. Rough Wiring Sign. � � ` � '� � , 68. APPROVED FOR PLASTERING � 18.• Rough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAI , 19. Rough Heating & AirConditioning ���� FIRE DEPT. REQUIREMENT ' ,. ,20. Rough Factory Fireplace ,� . APPROVALS Permit # i 21. Ducts, in Structure'.�j - � � 70. Underground Hydro 22. Ducts,�Ventilating ' � . ; 71. ProductPiping�Gas �OOiI 23. Gas Pipe-fiough &•�Test . � • 72. Underground Flush � - 24; Roof FFaming . � . � , � 73�. Undergrnd: Storage Tank � Gas ❑ Oil - 25. Roof SReathing r,`.� -' �Z �Z $� �CJ� 74. Overhead Hydro � � . � 26. T-Bar Ceiling (Structuraq & Monocoat ,= 75. Dry Chemical . , � 27: Frame and Flashi�ng . �.�-�j � 76. Dry Standpipe 28�. Lathing,&'Siding�? � 10.fs3 �� 77. FIXED SYSTEM FINAL ��f W is Only o 29:�Insulation . ._ � � f2,�� � 78. FIREPREV.FINAL - -30. Drywall'Nailing • , �_ � HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat'.' %� � _y.�� ' 79. FINAL INSPECTION , i � 32. Electrical PowerMeteriFinal • ' ! � 80. .FOOD CERTIFICATE ISSUED � 33. Final Electric ' ' Notes: �� 34. Final Heating & Air Conditioning Jg �� ; 2� rb -83' w�r i G !n L�� � f'p I h a '�' n 35. Final Gas Pipe-TestJ � ' A-f �/ '�ppv r T Ab�� , 36. Hood or Canopy � ` • � . ' � � � . 37. Final Factory Fireplace ` . ,� . � 38. Firial Plumbing��.rft, ; -��/ y fOr e � • 39. Water Service-Final > . , � � . . 40. Gas Service-Final " "`' �- -� � � 41. Solar pomesticFinal i • . �. � _ . - ' ' 42. Backflow Preventer � � n'� � �. � � ��'• � ,`} � - 43. Backflow Irrigation , , � . - � •- �� � =' i �: 44. ,Landscape Irrigation Systetri - • • ' ' : 45. Sound,.Attenuation -. i � � � . 46. Hantlirap Regulations � - � . � , , 47. FINAL STRUCTURE & BUi�DirvG � e y � 48..Special Requirements Completed ', . . - � . ' 49. Electric Release to Edison ' � � � � . . � ' , . 50. Gas Release to Southem California•Gas Co , �� �-� � t� �-' .� . 51. CEfiTIFICATE OF OCCUPANCY � � ' • , " � ' ; � . . . , .:�� � : . No. Date ' ;•� r� ':. . , . . , . � INSULATION CERTIFICATION ; , : 310� i/�er�-lort � � • �d � F 2 � NomDer �nO SL�et C�IY County . SuoE�vl>lon - Lot NumDer DESCRIPTION OF INSTALLATION ROOF Materiel Thickness (in�hes) EXTERIOR WA�L .,C / Materiel � G'/�'/�� ! TAickness (inehesl 3 ��y CEILING B�tt or Bi+nket 7vv� TAickness I�nchrsl � Loose Fi11 Type M�n�mum Thickness (inchesl Area Cover[d (fi�l FLOOR,ELEVATED Materiat TAickne�s (inchesl FLOOR,SLAB h;attrial T�icknefs (inc!�esl Width (inthesl ___ FOUNDATION WALL ` Maitrial ' ` T�:tknets linchesl ' Brand Name Thermal Pesistancc IR Vslue) i / Brand Nam! C`e��, n Te e��1 Tnermel Resisisnce IR Vs�ue) n- �� i /� r / Br�nd Name L� r�cri/1 ,��/1 e eC.[ T�ermal Aesisvnce (R Valuel �n-1 �� B.and Name • Number of bags Weight per Eag IE . Thermal Resisiana IR Value) _ Brand Name Thermal qesirtance IR Valuel � � � `BranC hame Tnermai Resma�ce (R Vaiue) Br�nd Name T�ermal Rrsiitan[t (ii Value) DECLARATION 1 �ereby errtify that the abovr' insWatio� was instailed in the bvilding at the above butio� im m�torma�ce witn the CWrmi regu�aKom utli�g E�ergy Comrrvation S�andardz 1or.new residential �uildings (lOuted in Trtle 74 of t�e Ghfornia Admiristra ve Code1. � --��i'it/ f �r,�4L g-1 • yL5"`}'7L ` %� Gmeni COMractm (Buiitler) l�ceme rvumuu � iy^�"� ��t -.r?�%� 3 � --7-, I �� /z• �o•�vN � 5�9�+ antl T�u Date ' SuC Conb�tt0� �1MulltiOn ADD�i�lO�J Licrose Numper "" ' S1qn�ture �nE TiUe D�te F�gure a-/. E.ampie of a mm011snce ceni�icive 4-9 J ADVlicant to till in a11 soaces exceo� t�ose wit�in heavy boraer lines antl sign al1 avVrov��ate aeclarations. CITiOF COSTA MESA " �� � " � � PE rf NO. ' - ' TRACT NO. ; LOT NO. • � BLD . � � ' "� - � � - ' � i !]4!6 Ic/09/83 • 60�� T! CONSTRUCTION PERMIT ' . . , , . • — • ' .�E./,y y ' . ��, 32 DS . • , ., ,. , . . � PlOjectAddreSs' `y�{�'7�''1. L=QILICh./( %Q-1/C� TYBEOFCONSTflUCTION '� 'NEW 'A00 ALTERATION 'REPAIR ' � ' � ApplicanYs Mailing Address ; - � ' � ' � . A.P. # - ' " �- . - � ' -❑ CONVERSION ❑ DEMOLISH ❑ OT ER Zone' Owner'sName ��%!.P/�S� ��Fiill Phone�� l� O7S OESCRIPTIONOF'WORK � Q� . � , - - � - ' ' & Main Building: � Accessory Building: ' Z Address i Gi .�/F. Po1.f+.U% ,�J Lk� .r"�/Lf . _ � ' - ' � E, . . . , . , -. . O � , 1� � TVPE OF PERMIT GRADING' ❑O FOUNDATION STRUCTV RAL T FfOnt - - ; i' '' N AfCh/Eng. LiCenSeNo. ❑ TENANT ❑ ELECTRIGAL �PLUMBING, ❑.M,ECHANICAL � B Rear - � . � ' ; ' ' � C ' I � Address� - �- � . � � � - ,.��o'rHea � �' . � ,� . ' . . A : N G Contrecmr,s NamP p��'� � � •rc_l i=n 1('� L �phone 4'42 «Zz � PROJECT DESCRIPTION SQ. FT.� ' � OCCUaArvCv � ` C Right . . ' � - ' � ' � ' � � K Left � . . R , Addresslmailing) /�«- Qn�'yF.ST�''e QU� C�/�• , C�NSTRtlCTION.TVPE ' � � VALUATION$ � � S : - ' ' . " E City LiCPnse No �� Q7 �/ • ' ' ZONE � � GRADING CU. VDS. ' ACRES 9 • ' n � ' ' Pln Ref.# � Park.Fees $` U LICENSED CONTRACtOR DECLARATION ' ' . Remarks: "' - Sg � , • Pafking Req./Provided . ' ' � . � � .. • I I.h¢reby;a/firm that I am licensetl untler provi5ion5 of Chdrter 9(commencing , p with,section 7000) oi, Division 3 of the Busine5s antl Professions Cotle, antl. . � ' ' ' ' � . Useof Building: ' " E my:license is in tull for<e antl effect. - - License Cla'ss � Licen �o. yZ5 97Z ' , PLUM8ING - FEES P�anning Notes: � ' ' � E � " Oate �'_ ���� � Si9natute -- ' . . ' � � . nJ f WORKERS' COMPENSATION DE AT,I�N � � Bar Sink - Showers - T I hereby attirm that I have a<ertificate of consent to se -�sure o� a certificate ' gackflow Preventer Service Sink ' ' � S "ot Workers' Compensation Insu�ance; o�'a certi/ietl"CopY tM1e� ot (58ction, - ' - ' -- - � � 3800, Lab. C.)�Z���'�Qr�.l !r� Backflowlrri ation , . ' ^"-' � � Policy rvo. �'� �� �Company Y '' 9 Sewer Cap ELECTRICAL FEES ACertifietl topy is hereby (umished. • �, Bathtubs' � Sewet Connection ' ' Aummatic Washer' Transformer ❑ 15-50 KW GCertifietl co y iletl with the city i 9 Divi on - (� � ❑ 50+ KW Date �,� ' Appucant Clarifiers . . Solar Collectors Construction Pole'Sub. � ' EXEMPTION FROM WORKERS' C PENSATION OEC � Di5hwa5he� Solar Pi in -� (This section neetl not be completetl if the permit is tor one untlretl (§700) or'� P 9 Cooking Unit �� �Meter� �up to 700 amps � less) � , �- � - • I certify'tbat in the� pe�fo�mance of the wo�k�or whichAii�S Oe�m�t is issuetl -I'% D�inking FOUnL2in5 $012� T2nk Di5hW25h2� r-.� � M2t2f ❑over 700 amps shall not employ any person In any ma {o a t Ecome subj to the Workers' Compensation Laws oi Califo '.. '� � Floor Dreins Swimming Pool w/Spa Dryers ❑Gas �,�Electric Sub Panel Da[e /7 �.�__Signature � ` , — _ NOTIC�E: I(,�atte� making this tlecla [i you sl oW come ubject to the Floot Sinks Urinal � Fan ' Workers' Compensation p�ovlsions ot'the Labo� Cotle, u must torthwith MOt0�500-1 HP �1'/:-B _ _ comply with. such provisions or this permit snall ,Ce�tleemetl revoketl. ' GasService ' �OuUets Wate�Closet � F.A:U. InaSolar�9-15HP�16-75+ ' CONSTRUGTION LENDING AGENCV� � � I hereby�atfirm that there is a'const�uction lentling agency fOr the perfo�mance Interceptors' . Water Heater � Fixtures . ' Microwave � of the �work for which� this permit is issuetl- (Section 3097 Civ. C.) Lentler's Name � Kitchen Sink � � Water Service Device Boxes � Pole Light � ' L.entler's Atltlress ' OWNER BUILDE0. �ECLARATION ' ' Lavatories _. ' , - Outlets . Range I hereby. aftirm th5t I am exempt from the Contractor's License Law tor the , . � tollowin9 reason (Section 7031.5 Business antl Professional Cotle: Any city or P-Trap . ' � . ' • Switches Si9n county which requires a permit to construct, alter, iinprove, tlemolish or'repair , any structure, prior to its'issuance, also requires the appliwnt for such permit � Roof�Drains - � - - � � Garbage Disposal Standing Sections � [O file a siqnetl Statem¢n[ thdLhe/she is licensetl pu�suant to the prOvisions ot � . the ContractorY License Law (Cnapter 9(commencing with Section 7000) of ' � � Generator 00.5 KW �5-75 KW Trash Com actor Division 3 ot the Business antl Professions CotleJ or that he/she is exempt ' ' � .' P thereirom anC the Gasis !or the allegetl exemption. Any violation-of Section . - , �031'S by'� any applicant Tor. a De�mi[. subj2cts the applicant to 'a <ivil ' � . ' penalty of not more than five huntlretl tlollars�($500). ' , -FZBinSpBGti00 F¢B � $25 � ISSUB F¢0 $? ' , ❑ I, as. owner of the, property,or my employees with wa9es as their sole � Reinspection Fee $$5 �ssue Fee $'3 compensation, will tlo the work, antl the structure is not intentletl or offeretl � ' '' - ' MECHANICAL . ' FEES tor sale. �Section �044, Business antl Vrofessional Cotle: The Contractor's . PUBLIC SERVICES REQUIREMENTS: ' Lic¢nse Law tloes not appty to an,own¢r OT a prope�ty,who builtls o� imp�oves BOi12� , HOOd O�� Typ¢ I� ❑ � � the�e0n, antl �who tloes sucn wo�k hlmsel(/he�selt o� through hi5 0� he� own - ZOning App�OVed By Date employee5, piovitletl that Such imp�ovements a�e not intentletl or offeretl•for Cd�Opy Typ¢ II ❑ � sale. It, however, the builtlin or im rovement is soltl within one ear ot com- Duct'- Under Ground � . . ' Date 9 P Y . Applica[ion Approved By pletion, [he owner will have�the burtlen of provinq tie/she tlitl not builtl or im- - ' -�rove for the purpose of sale). Duct - Structural �' Refrigeration Sys[em ' Application Issued By ���' Data �%� % � LJ I, as owner of the properry, ain ezclusivety mntracting wRh Ilcensetl con- ❑4100,000 BTU ❑100,000 BTU tractors to construct the oroject (Section 7044, Business antl Professions Cotle: Duct - Ventilating ' � SUMMARV OF FEES The Contractor's.License Law does not appty to an�owner of property who • . � BUILDING PERMIT $ SMIP $ � builtls or improves thereon, and who mntracts for such projects with a con- Exhaust System ❑ Multiple ❑ Sys[em Fepair/Alteration • � tracmr(s) license pursuant to ihe Contractor's License �w). PLAN CHECK $ ��Y..��� PERMIT ❑ I am ezempt unaer Section B. & P. C. tor this reason r Firepl/Fact BIL IC80 # PLUMBING $_�Q!(1V �IS$UANCE $ � Date ' Owner ' Heatin9 System & Ducting i • PLAN CHECK � $ ii m U. ENERGY P.C. $ i hereby certify tnat I have reaC thls app�i<ation antl state that the above ❑0-100,OOOBTU �100,OOOBT ELECTRICAL $ GRAOING $ information is correct. I agree to.compl With all tlty antl'wunty ortlinances " "� "' antl�state laws relating ii�tling co ifuction, antl ereby authorize repre- i � :$ MICROFILM $ � sentativez of this cit ' ent r u n the above eniionetl ,property for � , , PIAN CHECK . inspection purposes. � C�. - �a y $3 � � � MECHANICAL $ ' TOTAL FEE $ � S�gnature � �- < ✓ Oate peins ction Fee Issue Fee ' �rivers' Licerise oy55 � Pa �$25 $ 3 PLAN CHECK $ CMF�0865-46 rev: ]/83 White - Builtling; Canary -qppiicznp Plnk -Accounting; Goltlenrotl -Assessor � � - ' - - � -� � ' � - - � - ' �� � �� - � � - � � � CONSTRUCTION AND PLANNING . � � • � �. , ,' : ;: � ; _POOL & SPA - . ��-.APPROVAIS � 'Peimit#i0 • Date ,Inspector. " � ' . � -. Date. � Inspector ����" _ � �APPROVALS "'Permit# r : �1.,Temporary Electrical Service'oc Pole ' � �. � 52. Pool & Equipment Location � " ; , _ . " tp.; $oil;pipe-Undrgmd: �- - - ' _ . , ' ) ' . �53,- Steel Rei�nforcement . . . �_ ..3. �Elec[rical Conduit Utilrity=Undrgrnq. ' ._ � � { � 54. -Forms- - � . - � - �� � � • 4.. Electrical Conduit'Undrgrnd.,'-. ' � - � 55. - Electrical Bonding . � . . :, , <6., Steel Reinforcement � - •� .� " ' . - � , - �' 56. � Rough Plumbing & Pressure Test , - ' 6.i Electrical-UFER Gmd. � j � = � • - � � ' � 57.�APPROVAL TO COVER-GUNITE � , � .� . 7.� Footings " , ��' � - r , ,� '. . 58. � Electrical Conduit-Undrgrnd. - _ 8.�; Foundation ' ' � � • ` _ ' ' - 59. Gas Pipe, O Undrgrnd., TesY • � ��f 9. Water Pipe-Undrgmd:i , . , � - � - '60. Backwash:Lines, P-Trap, � Undrgrnd. � ' 10. Structural Floor System � � � , �- 61. APPROVAL TO DECK � 17.� Property Sewer Lirie & House Connection - ' ; 62.- Backwash & ReceptorFinal . . . 12.�Sewer Cap ' �- ' • � - ' ' •.i 63. Neater & Vent-Final � � ' 13.� Roof �Drains � • . . � � - ' � 64. .Plumbing System,- Final - 14.°Rough�Plumbing, �� � � . ���j f' 65.�Electrical-Final' �� � 15: Rough'Electrical-Conduit - � ' � ` -' 66. Solar SYstem-Final � ' � T6'.' Rough Eleotric Wiring ; � - - r : - ; ' , 67. Fencing;& Access Approval � l ' - 17. Rough Wiring Sign � ' � � ' . � - . � , ' 68.. APPROVED FOR PLASTERING 18: Rough Electriral-T;Bar Ceiling ., ' - 69. .POOL/SPA SYSTEMS FINAL� � . 19. RoughHeating&`P,ii�Conditioning ' . . . FIRE.DEPT.REQUIREMENT _ 20: Rough Factory Fireplace � , � 'APPROVALS t Permit # �' 21. Ducts, in Structure �� - �. . . 70. Underground Hydro � � 22. Ducts;Ventilating � � _' ' � � 77. Product'Piping�Gas ❑Oil 23. Gas Pipe;Rough & Test � � � , ' 72. Underground Flush � 24. Roof Framing - � � ! � . ' 73.. Undergrnd �Storage Tank.O Gas ❑ Oil, � 25. Roof Sheathing � , - • . ' • 7q, pverhead Hydro . , � 26. T-BarCeiling�(Structurall�& Monocoat � , . � 75. �Dry Ch�emical . • 27. Frarrie and Flashing � ' , , � � � '� 76. Dry �Standpipe � � 28. �Lathing & Siding .� - ' � ' ' 77. FIXED.SYSTEM FINAL -' � 29: Insulation` _ - � � �� � ' ' 78. FIR�E PREV. FINAL � � 30. Drywall Nailing . � ' ' � � � . HEALTH DEPT. REQUIREMENT �� ` 31, Plaster Brown Coat � � � ' � . 79. FINAL INSPECTION , � . � � 32: Electrica.l Power Meter-Final, ' , ' 80. FOOD'CERTIFICATE ISSUED . . . 33. Final Electric � � � • . Notes: � - � � . 34. Final'Heating & Air Conditioning � � � � 35. Final'Gas Pipe-Test �. : ' . - � , � . ` ' _ 36. Hood or'Canopy - � ' � � . . ' � � � 37. F�inal Facto'ry Fireplace ' � . - � � . , . . 38. Final Plum6ingi � � ' � f -lb- �% ' - - 39. Water Service-F,inal � ' . . , . i • 40. Gas Service;Final i . � � . '. = . - , 47. Solar pomesticFinal � - ; � _ _ ,. � , 42. Backflow Preventer � ' , � . � ' �l v .43. Backflow Irrigation . _ � � ' � � , � . - - � . 44. ,Landscape Irrigation System ' . , " - . _ , 45. Sound-Attenuation , , , � , � • � � - � � 46. Handicap Regulations� � � _ . � � . , � . _ 47. FINAL STRUCTURE & BUILDING � � � � � . . � . � � ' � � 48. Special Requirements Completed . . � ' � � ' , . . . . 49. Electric�Release to Edison . . - - � - - - •. �� - ' ' - ' , r� 50. Gas Release'to'SouthemCalifor.niaGasCo';, � � ' ' ' ' � � = 51. CERTIFICATE.OF OCCUPANCY .. � _ �_ i. _� _ _ , _ No. - ' Date � � . � .� `— ,/�OP��cant to fill in all spaces except those within heavy Eortler lines antl sign all ap0�opriate Eeclarations. � � CITY OF COSTA MESA-- � ' � ' � � — - PERMi I NU. + � - ` 7RACT NO. ; " LOT NO. - — tl�DG. ' -- - � - "' ' - ` - - . " � `' CONSTRUCTION PERMIT. ; ' - — ' 'd p- � ' ;;36 y• , , o � � �- , . - Y - - . . `, ; �;E"c9" I'2/ Ili7H3 6.tlp -"1L t� � '; �� Prol?�t?ddress. �� � �- ' -TYPEAFCONSTRUCTION' �'.- �NEW�,' ADD-� ALTERATION � REPAIR� � ' _ AppllCant'S Mailing AddIE55 ' `y '�� �?� � �>� � �� CONVERSION ;O DEMOLISH ❑ OTHER ' - � - ` � A:P `# � ` ., - � I Zp�a - . Owner's Name �� ,���R/�%, '�?-F/%SL--ahone/�/15.11/� •, l "DESCRIPTION OF WORK � � �C.-��/L� � � � � � _ , _ � � � � . � . { _ , . : - � > : , i ' r � � S. Main BuJdmg. _ , . Aciessory Building � ' O , ; Address � - ' ' � " ' � ' � � � �'�� �(�f IPvLLON� .' ' ` n � . TVPE�OFPERMIT � ; 'G,RADING FOUNDATION 'STRVCTURAL' ' � T FfOnt ' { t � _ . ' � � N ' AfCh/Eng �' ^ LicenSeNo � �� ; l ; O TENANT ��ELECTR'CAI.�PLUMBING ❑ MECHANICAL - A Reaf� - ' � � - ' � ' N j � Addre55 � -. • . '' O �OTHER • � - r� ' � -. , ` ' - �� G � �. . , i � . . . . . . C Rigtit - - � - t � , Contracfor s Name' � = Phone 1'42�322 � PROJECT DESCRIPTION. 54. FT. - .'- OCCUPANCV -' ' _ �9 � /!"� ��_ g�-��J/� ,` ; ' - CONSTRVCTIONTVVE ' � VALUATION$ . - g' Left� � � � ' � � ' ; ' � � �- ' � E . Address Imailin 1 f d � � C-� � � �, . � � , � ; , • � ZONE � GRADINGCU.YDS. ' tACRES � p�n Ref.# ' . Palk'Fees $� • n � City LmPnse No. • • . . . 9 ' . . - U t � � LICENSED CONTRACTOR DECLA ATION � - , 4 - ' • , ' ' ' � ' 1 � .\. . •. . Remarks: , C . . Parking Req./Provided . � _„ ��: 1 � \ I�nereby affirm that I. am licensetl untler provivons of Charter 9(<ommennn9 I , . . _, , . � . R wi[h section 7000) ot Division 3� of the Business antl Professions Cotle, antl , i '�+ ' � Use of Building: �� �� � -� E myiicense is In (ull fo�ce antl effect. � - - - ` ; . , � - . M � � �Gicense Ciass �� �' ' �icense .�/2 S%�77 � ' . i - ' PLUM6ING � , j ' FEES � P�anning Notes: . � � i � - i: � � Date'� � �Signature � � � . _ � ' i ' � ' , " N � WORKERS'_�SATIONOEC � � � BafSink � � Showers'. ' � T F 1 hereby'affirm that I have a certiticate of wnsent o self-insur o`r a certiticate � - ' ' • � i � . ' ' � . ' . .rof Wo�kers' Compen5dtion In5u�5nce,,o� a certitietl copY he�eof•(Section���� @ackflowPreventer ServiceSink _ , ! _• : I , �I ���, S ( 3800, Lab. Cj r • // ' � ; � � � .� eackflow Irrigation � Seuver Cap � ( � i . � ! ; j-" - ELECTRICAL -� ' � FEES Policy No. =�Z �s� y� ComPanY ' . , . . . ; . . eCerti�ietl copy is hereby fumis etl. : � � " � � Ba[htu6s � � Sewer Connection �• � ',Automatic Washer ' i � c Transformer ❑ 15�50 KW i • Certified copy is filed witn the�Nty Builtli iviv�ion '�' � - ' ' - � � ' Date � • ApPlicant � � � � •�r � Clarifiers ' ; Solar Collectors � � . 'ConsVuction PoleSuh. � � � . 50�+ KW i � : , �EXEMPTION�FRO � ORKERS'�COMPE 5 I Nb CL N � ' �. Dishwasher . ': ` 'i ' olar Pi in ' - ' -- - � � '" - (Thissection neetl not be completetl if the permit is for one h tl tl($300) or .' . P 9 ' ' �-Cooking Unit �'�i �- "' � 'Meter' �up�to 100�amps -( �-� ' less) � , f ' " � - � � . Drinkin Fountairis � ' ' � I certity�that'in the perto�mdnce of ih¢ work torjwhich thi5 �m�t is issuetl I%�� 9 � Solar Tank ' - Dishwasher , � �Meter ❑OV2� 10� dTpS � � sha11 not employ any person In any manner s as to bec e subject to � te` ; � � . , �'` ' ' ' ' Workers'� m ensatio� � Laws ot California � . . � ;� ( Floor Diams' � ,. Swimming Pool w/Spa •- i ' �Dryers �Gasi �Electnc �Sub Panel � � � � Date Si9nature • - � � ' r NOTICE: If,'after a ung this tledarati u's ultl becom suE' ct to the � Floor $inks . � � Urinal . � Fan� � • ��Motors DO 1 HP 01 f. 8 ' , 'Workers"Compensation-provision5'of, he Labor.Cotle,'yo� t6rthwrth'� " -' ' ' -- - � �- '�- - - --- � - � comply witn; such D�oNslons. or�this rPermit 5hall ,be�tleem tl revoketl. " Ga55Crvice �Outlets - WatefCloset - � � � '. �F.A:U. � -InaSolar'.�9-15 HP �16-15+ I I ' '"' CONSTRUCTION�LENDING �AGENCV, � < <' ' �- ' t �' . '_ - ' ' - ^ - ' ' : _ - 1 hereby affirm that tnere is a'mnstruction lentling agency for the performance `. IpterceptOrs � � � Water Heater � �� Fixtures ' ! � "Microwave � ' t j � � " ot the �work for which:this Oermk�-is,issuetl� (Sechon.909] Civ -C) �, ' ' ' � , � Lentler's� Name� � - : " - Kitchen'Sink � -� � 'WaterService 1 � � �` � ` ; ' . ' . � � , Lenders. Atlaress - � � � - - ' � � �Device Boxes • i i � ,PoletLight ; OWNER BUILDER DECLARATION ( � ' Cavatories ?' ' ' � �� � ' ' '�� Outlets r � � ' ' YRangE ' ' : I hereGy a(tir'rci.th5t 1 am�ezempC from the�Con[ractor's.License �aw for the . p_T�a '.7 . following reasom(SecHon..7031.5 Businessantl Professional�Cotle: Any city or � P � � � � � ' � Switches: � ' � . � Sign � � 1 � � � county which requires a permit to construct, alter, improve, tlemolish�oc.repair ' � � _ ' �. . ' 'any structure; prior to its issuance, also'req Wres the applicant tor iuch permit � Roof-Drain . ' " " i '� ' ,i �_' Gar6a9e Dispo'sal -' - ' � Standing Sections ' � � ' �to file a si9netl stat¢ment thdt he/sh¢ i5 licensetl pu�suant to the p[ovisions of � ' �� � � ^� ,� - � � � � ' I, �the Contractor's License L.aw (Chapter 9'(commencing with,5ection 7000) of � t,�1' �p Q -' . � � : � � � � , Division' 3'�of tne,Business 5ntl. Protessions Coae), or that he/she_is exempt Y�,/�Q� ,� M1�•� i° - � , +� Generetor �0.5 KW �5-15 KW .Trash Compactor , , , [herefrom antl t�e ba5i5 fortt�e alle9etl exeinptlon. Any'violation of Section ' � _ � , � - � i� 7031'.5 by; any applicant for a permit subjects the applicanY�to a civil ' . � ' - } � _ • • - � - � ! - ' � ; � . enalty of not more tnan tive nuntlretl tlollars (E500�. . •� ' � .Reinspact�on Fae $25• �. Issue Fee � �$ 3 � I, asi owner ot� the property �or my employees with waqes' as their sola � J - �� ReinspeCtion Fee � ' $25 � luu6 Fee . �$' 3 compensation', wiu tlo tne work, antl the structure Is not intentletl or ofieretl � � �� - � �MECHANICAL � FEES tor sale.:(Section ]044, Business.antl Pro�essional Cotle:�TheiContractor's ' ' � � PUBLICSERVICESREQUIREMENTS: ' � ' �� � � ' License Law tloes not apPry to_an,owner of a property�who;builtls or improvez Boiler , . . Hood or� Type I, ❑ - � � " � ' � Nereon, antllwho,does such work�himself/herself or through hls or her own � �'�� t�� ' � � � Zoning Approved By Date � ' ' . employees, Orovitletl tnat such imp�ovements are-not intentlatl or otferetl Por � •' Canopy Type II ❑, ' AS• ; . � sale. If, however, the builtling or im rovement Is soltl wHhin one ear.ot com- Duct - Under� Ground ' i . � . � v v � Application Approved By. ` � Dat� , pletion, the owne� wlll have ithe bu�tlen of prOving he/she tlItl not builtl or im- � � � - . � � � � � ' �rove,to� tne purpose of sale). � ; i �- � � , � . Duct-Strucfural � ; Refrigere[ion System � - � � �' qpplication Iisued�By � ' � � � � Dat �"� I„as owner of the pYOpCIi�/� dfll CXCIUSIV2IY COOLYdCiIl19� WIIh IICCf152E COO- � � DO-100,000 BTU ❑i00,�00 BTl1 ' � � � ' tractors to construct the project (Section �044, eusiness antl Protessions Cotle: � Duct - Ventilating � . BUMMARV OF FEES � . j 'Tne�Contractor's�License� Law tloes not.appiy to.an.owner-ot�property who-- ' � � � � - BUILDING�PERMIT � $ SMIP. . $ � muiltls �or improves thereon,lantl who wntracts for such pro�ects with a con- Exhaust System ❑ Multiple O' System Repair/Alteration ( r p�qN CHECK I$�� � � PERMIT . tractor(s) license pursuant to'-tM1e Contractor's License Ldw): : ! � � ❑`.I am exempt untler Section B. & P. C. �or tnis reason � Firepl/Fact.8lt. ICBO,# ' . � � ' PLUMBING. � , $ __�2_[SL-„- ISSUANCE � $ ' � � Da4e owner' Heating System & Ducting � � � PLAN CHECK ; $ � � 0 �l� ENERGV P.C. � $ : I hereby certi�y that'I have reatl this application antl state that tlie above � �❑0.100,OOOBTU 0100,000BT � � � � - . � GRADING $ � . 'intormation is'wrrect.'I agree to comply ith all dty any tounty ortlinances" - "- - - � • - ^5 - - ' ELECTRICAL � $ ' - antl:state laws relating't b Itlin con ction; antl h eby authorize repre- � � - � PLAN CHECK � $ � MICROFILM f$ � -�� sentatives oh this city ertter up tM1e above- ntionetl property for , . i . � � � r , � � ' inspection pu�pose5. � � /� Cq ' 1 , � � � Signature ' � Date �2' �7'O J, . � , , . , , , MECHANICAL � � $ TOTALFEE $ _4'��_r��' �� E� Drivers' �License o 5� Reinspec[ion Fee '$p5� laue Fee � $ 3 PLAN CHECK $� ' ' � � 'CMF-0865-46rev.�7/83��-White- Iicant;�Pink-Accountlng;�Goltlenrotl-'Assessor��- - ' �� � ^ � -- �- �•_- -� - ,-. - � � ' - - - -- - - _- ,. _ . .. ._ ... _ . _ ' CONSTRUCTION AND PL NING -. � = POOI & SPA�. . , . APPROVALS�, Permit# �0 0��.Date 'Inspector : AppROVALS �Permit# � Date Inspector 1; Temporary Electrical'Service�or Pole, .;' , 52. Pool & Equipment,Location � ' � 2: Soil Pipe-Undrgmd. _ � � ' � 53. Steel Reinforcement � - - �..3.�Electrical Conduit.Utility-Undrgrnd. - ' - 54. Forms?� _ . • - � - - • �'4: Elect�ical Conduit-0ndrgmd.: . � � � 55. �Electrical Bonding'. „ � ' ?.; -� -5. Steel Reinforcemerit , ` ' t , ' 56. Rougfi Plumbing &'Pressure Test � . � 6: Electrical'UFERGrnd.�:� • ' . . � 57.3APPROVALTOCOVER-GUNITE � . � " 7. Footings' � ; r •t . ,_ . 58.' Electrical Conduit-Undrgmd. � � } _ 8. Foundation ; ':� ',' ' � _ _ 59. Gas Pipe, O Undrgrnd., Test � _ _ . � 9. Water Pipe-Undrgrnd.� . ' ''r . '60. Backwash Lines, P-Trap, O Undrgmd�. � • ' �.+' 10. Structural Floor System , � ' � • . - , .61. APPFOVAL TO DECK � � � : : . 1 7., Property Sewer Line & House Connection ' ' •''- _ - �62. Backwash�& ReceptorFinal "� ' � 12. Sewer Cap ' � ' 63. Heater & VenriFinal � � � - � 13. Roof Drains �� . • . � � 64.-Plumbing System - Final � � � . � ' 14. Rou9h�Plumbing - ` � /�j 65. Electrical-F.inal �' � � � � � 15. Rough Electrical-Conduit. ' 66. Solar'System-Final. - ` ' . .16. Rough Electric Wi�ing �� � � . - -" � 67.� Fencing' & Access Approval"" - - �' ' - 17!•.Rough Witing Sign � � � , � 68. APPROVED FOR PLASTERING . - _ . 18. Rough Electrical-T'Bar Ceiling � ' 69. POOUSPA SYSTEMS FINAL - ' 19� Rough Heating & Air.Conditioning l � . , FIRE DEPT.'REQUIREMENT , 20�. Rough Factory Fireplac� , , � APPROVALS • Permit#� , 21. Ducts, in Structure � 70. Underground Hydro . .-22. Ducts, Ventilating 71. Product Piping OGas �OOiI 23: Gas Pipe-Rough & Test ' ��� 72. Underground Flush . � .24. Roof Framing , • .' , 73. Undergrnd.StorageTank OGas D�OiI� � ' 25. Roof Sheathing • r .' . - . 74. Overhead Hydro � 26. T-Bar.Ceiling�lStructurel) & Monocoat 75. �Dry Chemical � . � 27: Frame and Flashing . ' - 76. Dry Standpipe . � . 28. Lathing &�Siding 77. FIXED SYSTEM FINAL 29. Insulation ' , 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 � � ' ' Nbtes: � 34. Fina(Heating &•Air Conditioning j � ' � . . � 35. Final Gas Pipe-Test. � < � , . � � `; � , ' 36. Hood or Canopy � , ' ' • , . . � 37. Final Faaor,y Fireplace � . , , � � ' . � 38. Final Plumbing , ' a: - ' , � � 39. Water Service-Final • . • � � � � , 40. Gas Service,Final • _ � � � � , , , � 41. Solar"Domestic-Final ' � � ' _ _ ' _ � , 42. Backflow Preventer � � ' • , • 43. B�ackflow Irrigation � � , � � ' ' ,_ , , : , � ' 44. �Landscape Irrigaiion System . � , ' � � " 45. Sound Attenuation , � ; • . � � � . 46. Handicap Regulations ' � . . ' � � � � ., . . ' , 47. FINAL STRUCTURE & BUILDING • � ' � 48. Special Requirements Completed j ` , , . 49. Electrie Release to Edison . � - , � 50. Gas Release; to Southern �lifornia Gas Co � � ' . � . ' ' � � ' 51. CERTIFICATE OF OCCUPANC.Y.� .� _ � . . � _ � __ . , , . , , . No. Date � � � - . OK'NER JOB ADDRESS GENERAL COI nY. No. LOT l0y TRACT � bL� FIRE ZONE DESCRIPTION OP WORK ReS.W/att INSPECTIONS >��y-�6 I DaTE � GROUP I&�J TYPE V ZONE R-1 SUBCONTRACTOR OCCUPANCY � Form 270-SM-11�59 S-B P �0 ' 12.3 :'_9_ COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MEBA. CALIRORNIA For Applitanf fo �ill In Completely TYPE OR PRINT AODRHSS 3z05 Vermont Ave. COSTA MESA. CAUFORNIA OWNER �rermont Avenue Land Co. Inc. ADORESA l.19 E_ '17t.h �U• E. TEL. TEL. No. Li. 8� I NO. OF USE OF EXIBTING BLDG. � B _ BHTBACK LINB FPOM CEMER OP 6TRCCT O� REAR YARD 61DE YARD I LEFf � I RIGHT � DESCRIPTION OF WORK NEW I X II ALTERATION I II ADDI710N AND WORK T� BE PERFORME ils residence with F EE RECEIV ED � �UN 211960 '�" FINANCE DEPpT. APPLICATI�IyFOR ����I T"ESA BUILDING For Office Use Only RECEIPT NO. � PEHMI;_NO� 2 �7 "1!/ 1� A ! RECEIV6D BY OATE RECE�VED DATE IB6UE0 _ _n e � �,�,.�n � ,..... _ _ ,..., COSTA MESA, CALIFORNIA FIRE ZONE TYPE GROUP APPROVED ZONING zo/ �!� I no. ov I use oF n (�p� nuNs 'i� amLolNc LEGAL � , � __ ,�, O' (ClNT6R LINE BTJ _ FRONT Fl .i — R. SIDE Fl / _ L.SIDE Fl — REAR � F1 APPROVED — BV 1 ck --A��- 1, y 30 °'- r a 1 HEPEBY ACKNOWLED6E THAT 1 NAVE ftEAO TH18 APPLIGTION TXE AMOUNT 9HOWN IINDeR VALUATION 16 FOR TH¢ AND BTATC THAT TH6 ABOVE IS COAR6CT AND AGPEE TO CON• pURPOBE OF E9TABL19HING A PERMIT FEE ONLY. PLY WITX ALL GITY ORDINANCE9 �D BTAT6 LAWB fi6OULATINO Bu1tDINa CONe'rnucnoN. VALUATION BIGNATURH OF � PERMIi FEE $ iL,. PERMITfE $ 14,179• PLAN CHECK $ 17• AUTHORIZED AGENT �'ike & � egrove� Inc. � 51. TOTAL FEE i