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Home My WebLink About365 WAKE FOREST RD - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT .lob Address: 365 WAKE FOREST RD Status: ISSUED Suite Na Applied: 11/OS/2003 Vicinity: � Issued: 11/05/2003 Parcel Nunmber: 14148604 Applicant: EUGENE ELLLIS Address: 3801 LENAWEE AV - CUWER CITY, CA " Owner: � JONES, AVA JACK TR Address � 365 WAKE FOREST RD COSTA MESA, CA Phane: 310-383-0408 Zip: 90232 Phone: Zip: 92626 Contractor: ALASKA AIR CONDITIONING'HEATING SERVICES INC Address: , 1401 N BAXTER ST � . ISSUE FEE Temp service test Res: a/c package New Res,(1-2 units) . New Res (3+units) Pool / Spa Lighting Fixts � Recept Outlets: Switches Non Res Appl � Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Mo[ors [0 10hp Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a ANAHEIM,CA "Phone: 714-752-1250 Zip: 92806 License: 812494 � � ISSUED BY: - SCOPE OF PERMIT , REPLACE EXISTING 100,000 BTU CLOSET FURNACE &�4 TON A/C CONDENSOR ELECTRICAL TO INCLUDE: 1 MOTOR TO 10 HP. � $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY - Quantity . � Temp Dist System / Lighting Busway /100 ft � � Standing Section 0 .��'•, - �MiscElectricalEquipment 0 Transformers up to 1 kva/kw �; 0 � ' ................up to�10 kva/kw 0 : ,. ..._:...........up to SO�kva/kw:.=-- 0- � .................up fo 100 kva/kw 0 " ..................over 100 kva/kw �0 Low Voltage Equipment 0 � Low Volt Wiring System / Ckt 0 Misa Conduit , 0 MisaConductoc..� � 0 Circus ( gen or ride)" � � 0 Circus (mech ride.or lights) 1 - Christmas Tree Stand �. , Fireworks.Stand � � . 0 . Other Electrical Fee � . 0 0 . .Investigation Fee 0 Plan Check Fee Quantity $0.00 0 $0.00 0 $0.00 0 $O.W 0 $0.00 i-.- .0 So.00 -' o $0.00 0 �$0.00 0 $0.00, , , 0 $0.00 0 $0;00, 0 $0.00 0, $0.00� �0' 30.00 , 0" $0.00 0 50.00 0 $0.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related I regulations. (Ord. No. 92-28, § 1, 12-21-92) , EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. INSPEC710NS: In ord0r for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all' required inspeetlons end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. f FOR INSPECTIONS CqLL: (714) 7545626 2M&a8(b/ao) WORKERS' COMPENSAnON DECIiARAnO� � � I �ereby aHirm under penelry oi periury one of the tollowing tleclarations: ' � , ❑ I have end wlll malntain e ceNficate ot consent to selt-Insure for workers' wmpensallon, es provided for hy 5eclion 3700 of ihe Labor Coda, tOr lhe peAormenc�a of the , work for which IhiS permit i5 issuea. - - \I liave entl will maintain workers' compensation Insurence, as requiretl by seMion 3700 of the Lebor Cotle, for the perfortnance of ihe work for whiU tFtis permit is issuetl. My worker ' wm%�en-�sa7t�i Insu/�an�ce c/az�rie/r/�¢ �tl policy number are: J � ''') Certier: �!� / r /—li/ ✓/✓ Polity uN mber. _J �� !)�LO � (7Tris section need not be comp/ete0/1 fhe permit is valuetl af one huntlred tlollars ($700) or less.) ❑ I cenify that in the pertormance o he work}o wl �� i his p is issued, I shall not employ any person in any manner so as to become subject to Ihe workere' compensatlon laws oi Calilor '� , i r 4 t � �o I ec me subject to the workers' compensetion pmvisions of Sectlon 3700 of the Labor Code, I shall lorthwith comply wiih Ihesa pmvision . _ j /j ApPlicantSigneNre: � SDate: � /<��`-�� WARNING: FWLURE TO SECURE WORKER COIAPENSATIqJ COVE E IS UNLAWFUL AND SHALL SUBJECT AN EMPI.OYER TO CRIMINAL PENALTIES AND GVIL FINE$ UP TO ONE HUNDRED THOUSANDDOLLARE(5100,000),INADORI NTOTHECOSTOF ENSATION,DAMAGESPSPFOVIDEDWRINSECTION31060FTHELABOFCODE,INTEREST,qNDFTTORNEV'SFEES. LICENSED CONTRACTORS DECLAHATION: I hereby affirtn that I am license d rpWv' ic lorce enC'ettecCClc: a-'- L Contrecmrs Signature: CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirtn ihat Ihere is a wnsWction lending Lendefs Name: Signeture: 9(commencing with Section 7000) at Division 3 of ihe and my license is In full performance of Ihe work for which this pertnit is issuetl. (Sec. 3097, Givil Coda). Lender's Address: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm �hat under penaliy of perjury that I am EXEMPT FROM T1E CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Busineu end Protesslons Cotle: Any ciry or wunry which requires a permit lo construc6 elter, improve, demolish, or repair any structure, prior to its issuance, also requires the a00�icant for such Dermil to lile e signed sletement that he or she is Ilcensed pursuant to Ihe provisions ot the Contrectors License Law (Chapter 9(wmmencing with Sectlon 7000) of Division 3 of the Business end Professians Code) or Ihat he or she is exempt theretrom anA t�e basis for the allegatl axemption. Any violation of Section 7031.5 by any applicant for e pertnit subjects the applicant lo a civil penfllty of not more than fiva hundred tlollars ($500).): ❑ I, es owner of the properly, or my employees with wages es their sole compensation, WILL DO THE WORK, and the structure is not intentled or oHeretl for sale (Sec. 7044, Business an0 Professions Coae: Tha Contractors License Lew dces not apply to an owner of property who builds or improves t�ereon, and who does such work himself or �ersetl or thmugh his or her own employaes, providetl Ihat such improvements ere not intended or ottered tor sale. It, however, the builtling or impmvemem is sold within one year of wmplation, the owner-builder will have ihe burden ot proving that he or she did not builtl or improve tor purpose ot sale.). � ❑ I, as owner ot tha pmperty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTHACTORS to consiruct the prolect (SecJ044,�Business antl Profeuions Code: The comractors Llcense Law does not apply to an owner of property who builds or improves thereon, antl who contrects tor such projec� with a contracmr(s) license pursuani to Ihe Contractors Licensa Laws.). • ❑ I em exempt under sec. Business antl Protessions Cotle tor this reason: Signature: Date: Owner ID verifiatl by tlnvers license. ❑ Ves ❑ No Dnver's License No. Expires: Vedtiwtlon oi Ownership by (rype of document, I.e. - pmperty taz bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION: ❑ I hereby certity that no excavation five (5) or more feat in tlepih into which a person is required to descend, will be mede in connection wiih work euthonzed by this pertnit, end that no building slrucNre, swttolding, falsework, or demolition or dismantling Ihereot, will be more than ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, T1Ile 8, Califomia Aaministrative Code). ❑ As owner-builtler, I will not employ anyone to do work which woultl require a permit from the Division oi Indusirial Sefery, as noted above, unless such person �es e permit to do such work irom �ha tlivision. Signature: Date: Division of Induslnel Safe�y Permi� Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certify untler penalry ot perjury that I have read �his ep0�ication and state Ihet ihe information given is correct. I egree to comply wlth all state laws end ciry ordinances relating to building construction, and authonze representatives ot the Ciry of Coste Mesa to enter upon the ebove-descnbed Oroperty tor inspection purposes. I agree not to occupy or allow occupency oi any building authonzed by Ihis permit until Tinal inspection. 40UE �. INSPELTIONTYPE 1616 Fixad System Final Fire Preventlon i268 Pool Spe Finel 20o Final Re-Roof 201 Final BIocWReteining Well 202 Final Factory Fira Place 203 Final Sign 204 Finel Demolilion QbjE �$ �� INSPECTONTYPE . 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupancy �� .: �.1 .1111. �/� / �C' '-1i��5; 2F��+3 E�9: <ti ��r . • 'r14356"/13; AL.'�=KA :;C HEATIN, PLOT PL.�1'� � �- .x�� 7. ✓. 7l �� r D�� / -`� 0 n-'�'_ �' Phone f �1 aoa aaa� �F,� r?,r� .�� ;- ; �r1 TractlP'arc�d �I$Q __TM___�_�____ Lox —�---�—�-_ Asseslor's Perce� �Oo. P.l�OG7DE NO1tTli .�4J?ltOii� 1 � s+ i� d+ �� g� ��_�r------ i I0. 1 0 � t a t Y L t ►+ --- �. E �F�-�c�� t� ijt%�'Y�_t° �o�C.c.s -r APP�OV�D CITY OF COS1'A MESA PLANNING DIVISION SUBJECT TO BLDG. DEPT. RE NOTE: ADDITIONS, DELETIOi OR CORRECTIONS SHALL B PPROV�D BY TFI�YLANNING PpGE 05 s ► r i ► x 0 r E e T r t (714) 754-52�3 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 365 WAKE FOREST RD Suite No Vicinity: Parcel Number: 14148604 Applicant: EUGENE ELLLIS Address: 3801 LENAWEE AV CUIVER�CITY, CA MECHANICAL PERMIT Phone: 310-383-0408 Zip: 90232 Owner , 'JONES; AVA JACK TR Address: � 365 WAKE FOREST RD Phone: COSTA MESA, CA Zip: 92626 Contrector: ALASKA AIR CONDITIONING HEATING SERVICES INC ' Address: 1401 N BAXTER ST - � ANAHEIM,CA Phone: 714-752-1250 Zip: 92806 . License: 812494 Status: ISSUED Applied: 11/05/2003 Issued: 11/05/2003 ISSUED BY: '� SCOPE OF PERMIT REPLACE EXISTING 100,000 BTU CLOSET FURNACE & 4 TON A/C CON�ENSOR MECHANICAL TO INCLUDE: 1.INST FUA>100K BTU. � � � � ' � � � -. ISSUE FEE Inst FAU <100 k BTU Inst FAU >t00�k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys e100 k BTU � Refrig Sys a100 k BTU , Gas Piping � ' Factory Fireplace Hood w/MeCh Exhaust VAV Box � � � � , Vent Fan / Single Duct Appliance . Fire Dampers ` Smoke Dampers � Inst or Relocate Appl Vent� � Air Handlers < 10000cfm '� Air Handlerg > 10000cim Floor Furnace Floor or Suspend Heater Quantity $23.50 $0.00 0 $18.20 1 $0.00 0 $0.00 0 $0.00 0 $�.�� $0.00 0 $0.00 0 $0.00 '"'0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 FEE SUMMARY Repair / Alt Absorbtion Unit � Repair / Alt Refrigeration Unit Ventillation System . Evaporative Cooler Commercia� Incinerator .�.Domestic Incinerator � � � � Compressofs / AbSofDtion Systems `� ' .. � Upto3hp/100kBTU ,�- " � 3To15hp/500kBTU; /-" � , 15 To 30 hp / 1,000 k�BTU . 30 To 50 hp / 1,750 k BTU ' Over 50 hp / Over'1,750 BTU -- Boilers , � , - , Upto3hp ., , 3To15hp ' 15ta30hp ' .� , � " � 30 to 50�hp , . ' Over 50 hp Other Mechanical Fee . � Investigation Fee . Plan Check Fee � � - Reinspection Fee � Quantity� $0.00 0. $0.00 0 $0.00 0 , , - - $0.00 0 - . � � �$0.00� 0 � . $0.00 �� 0 � $0.00 . 0 ' $0.00 . 0 $0.00 0 $0.00 0 $0.00 0 $0.00 : � $0.00 �i' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abantloned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 244646(&00) WORKERS' COMPENSATION DECLARATION: I hereby attirm unaer penalry of perjury one of the following tladarations: � ❑ I have end will maintain a certificate oi consent to setl-Insure for workers' compensatlon, as provided for by section 3700 0l ihe Labor Cotle, for the pertormence of the wOM tor which Ihis pertnit is issued. �`I have end will maintain workers' compensatlan insurance, as requiretl by section 3700 of the Labor Cotle, for the pedortnance ot the work br which ihis pertnit is issued. My wolkers �/g�758�1on Ufen CBff��B1f 8ntly❑lOIiC% nUmEBf 9rB: �7 � /� Q �Carrier. � � �� /'7 � �U✓ ✓/✓ Policy Number. /l0 � 7 .(This�sec(lon need nof be'Qomp/efe0 i/ the permif is valued et one hundred dollars ($ f00) or less.) �• � ❑ I certity that in ihe pertortnance of the wo� wff'ch this� wit-�s issueQ I shall not amploy any person in eny manner so as to become subject to the workers' wmpensatlon lews of Celiloyr i a e t t h aTd bec �ne subject to Ihe workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith compty with these provis' 6s // � �, _Applksnt Signatu7e: � �Date:" ' �/ WARNINO:�FAILURE TO SECURE WORI� ' COMPENSATION CO RAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAI PENALilES ANO GVIL FINES UP TOONE HUNDRED "TIIOUSAND DOLLARE (5100.000�. IN AO TIqJ TO TME COST OF PENSATION, DAM4GES AS PROVIDED FOP IN SELTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn thet I am licens n pr vl i C pter 9(commencing with Section 7000) of Division 3 of t�e Buslness� ProfgS5loryiCode, end my license Is in tull force'enE eHecL Oc. p TClass Y---' LU Contradors Signature: � Date:— �— ti � _. �� CONS7RUCTION LENDING AGENCV: ❑ I hereby aRirm �hat there is a consiruction lentling agency tor the peAortnance oi the work for w�ich ihis permit is issued. (Sec. 3097, Civil Code). Lentlers Neme: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eltirm that unCar penalry ol perjury that I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons Cotle: Any ciry or counry which requires e pertnit to construct, alter, improve, demolish, or repair eny structure, prior to its issuance, also requires the apPlicant lor suc� permil to lile a signed statemant that he or she Is Iicensetl pursuant b Ihe provisions of the Contrectors LJcense Law (Chapter 9(commencing wi�h Secllon 70W) ot DiWslon 3 of the Business entl Professions Code) or Ihet ha or she Is axempi thereirom and Ne basis for Ihe elleged esemption. Any violation of Section 7031.5 by any applicenl for e pertnit subjects the applicant to a civll penelry of nat more than live hundred dollars (8500).): . ❑ 1, es owner ol the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intended or otteretl for sale (Sec. 7044, Business and Professions Code: The Coniractors License Law tices not apply to an owner of property who builds or improves thereon, and who tloes such work himself or herself or Ihrough his or her own employees, provitletl that such improvements are not intended or ofleretl for sale. tl, however, Ihe building or improvement is soltl within one year ol completion, the owner-builder will heve the burden of proving that he or she did not build or improve for purpose oi saleJ. ' ❑ I, es owner ol the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CON7RAC70RS to consWct ihe project (Sec. 7044, Business end Protesslons Coda: The coniractors Llcensa Law tloas not apply to en owner of property who bullds or Improves thereon, and who coniracts tor such prolec� wlih e contrector(s) license pursuant to iha Contrectors License Lews.). � I am exempt untler sec. Busineu and Protessions Code for this reason: Slqnalure: Date: Owner ID ventieC by tlnver's license. ❑ Yes ❑ No Drivefs Litense No. Expires: Vedflcetlon ot Ownership by (typa af tlocument, i.e. - propeny lex bill or tleatl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � I hereby certify that no axcavaiion five (5) or more teei in dept� into which a person is requirad to descenq will be made in connection with work euthorizetl by thls pertnit, and that no building siructure, scaHolding, falsework, or demolition or tlismantling thereof, will be more Ihen thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Calilomia Adminis�ra�ive Code). ❑ As owner-builder, I will not employ enyone to do work which would require a pertnit from �he Division of Industnel Safery, as noted ebove, unless such person has e permit to tlo such wark irom the division. Signature: Date: Division of Industrial Sefery Permit Number. CERTIFlCATE OF CAMPLIANCE AND AUTHORIZA710N OF ENiAV: I certify under penalry of perjury that I have read this application and state Ihet Ihe Information given is wrrect 1 agree to comply with all stete laws end city ordinances relating �0 6uilding consWction, entl euthonze representatives of t�e Ciry of Costa Mesa to enter upon Ihe ebove-described property for inspection purposes. I egree not to occupy or ellow occupancy of any building authorized by this permil uniil tinal inspection. COOE 1.' INSPECiIONTYPE 1618 Fi:ed System Final Fire Prevention 1268 Paol Spe Final 200 Finel Re-Roof 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Final Sign Final Demoli�ion L�97E INTRIALS LODEj INSPEGfWNTYVE 206 Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Final Flre Prevention 220 Final Planninq Approval 222 Final Sita 250 Finfll Building/Occupency � }�e�s � °� -� -03 I�'S n/ - ,, . OWNER COS'td M238 ESLBLeS DATE 4-12-56 . JOBADDRESS 3(jS WgICO FOTBSt R08d � BUILDING PERMIT NO. 2670 GENERALCONTRACTOR Ro'ven-Spiegel Co VALUE � 11�ZOO,OO LOT Jr� BLOCK TRACT 275� Single Res W�att�garage GROUP j,Q� J TVPE V ZONE � FIRE DISTRICT 2672 , PERMITSISSUED INSPECTIONS I DATE I SUBCONTRACTOR I . Foundation F Rouph Frami toS�ab w Gi=v,,'eS I Hr'fi�=l I/1'On. __.,_, �/0-_L I a-ii-.f/I /_ 7 17 — Plumbing, Roug Temaorarv Pole Heatinq, Rough H/t �� 3 � !�-�Ii' /o S'�, / .... Heating, Final i {i =7.-Si Sewer, Housed `Q/�� Sewer, St./)') elj �� „-S6 (,P' k, � �� , fl-/s =�� ,3-a si - Septic Tank or Cesspool � � Lathing, In , Out ,/ //�-E./ -'yr�p - Plu Fin,al Gas Test Occupancy FOflM 210 3M 10-ii _ Qost� Mesa Bnilding Department � : '��" . 111 EA3T 20th 8TREET � � COSTA MESA, CALIFORNIA FOR APPLICANT TO FII.L �- Building � /� //; z�� Address A� Gr/ Costa Mesa, alifornia Owner Address �1 � S7 �/ J yft �j'O . �J � Tel. City ��G'CZf-Ci 3�fv No��' ArchitectorlD_( /(E i^��C Lic. Engineer ��J _ �� No. Address��/��/2� �3�. � a ., �%�i �' City Lic, Contractor �/�✓ �/c�GL�C�o. /'Z Address�� u%. � t� � � �•�1'. Legal Lot 1 Description I No. �n Black I T� Size of Lot / QX�� Z Use of Existing Bldg. Setback Line from / Center of Strcet ��d DESCRIP'1'I New I�Alter; Repalr I I �Movin Building,/� 3x�Y Size `fC' Now on Lot No.of No. Families Roa Rear Yard-7 . �f / ns �'� Roof C Demolish APPLICATION FOR PERMIT �� BUILDiNG � FOR O&'FICE USE ONLY Receipt No. Permft No. �G�S'r� ;eived by I Date Rec'd. I Dah Issued 'Zi" iL� ia_C%: 4�-i�7-.i Costa Mesa, California T APPROVAY.S � Foundation Location I- Inspector Forms, Materials, Under-Pinning Frame: Fire Stops, I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply with all City Ordinances and State Laws regulating building construction. //� Signatureof `I�S.� //��ir/ �� j�� Permittee / �� r�" Authorized AgS�%2� /J Valuatton r'mit Fee $ � — $ � � /jn� Plan Check $ '� I�"�0� Total ^-- ' C�.7 � Lath. int Lath. Ext. Plaster. Int. M Date O � G) 2 D r ._. . . �.. . �, .- - - �� at. .. - . . � . . � ... - - 1. � . . � . . r. . . . . . .� _ _'_". ._.._"_""_"`_ _ __ "'`t.: . _ __' "" "_ '_ . _ ._ '." ' - i -.. . . . . .. . �_ ' " ' — ' p COSTF� . �;"�73 J.u{��;J�SA.'Z>91 t`ut'ri'i12.(1� i . �� . �� _ � - . -- - - ; . . .. . . � ,y .. . ' ' . _ Street - , . � " - � . • __:- " PLO� PLAN - -- - . _ � _ � ,.'- _- - - - Bhow loeatian and disYances from ., � . y-;,;,^, � � � . .proPerty lineand between buildings - ` . ._ .._. _ . , }-, — - . . - . . _. . �'�... -' -� -- -� . - " "— --. - . ' . -- -' - • � � . �- . . . -'— — �- ,-�. . . , ,- ---'.-� _� �.c� '- .. ` J\- ♦. � ... � .. r. 1. � . . , . ' "'_ . . � � . � l . . r - . . , ' . . ' "" ' . "' �'. ' . � . . . . . . .' _ _ .. . " ' l .,'.. " . '-. . - - . • ., ' : . _ , � ' "' " _ . . . - . . . . . .. � � _.._ . . _ ' _" Y ' _ . . ' i ' . r ( ' '... '. COiS__ .`I � . . . ." ^ "�� ' , a• �._ _ ' "_'_ "_ '_' . _ . _' " ._ ' _.. ' _ ' '"'._ _ ""„" _' ._'�'_ zw i : ••_ ER ROUGH PLUMBING PROP. SWR. LINE SPRINKLING SYS7 MISCELLANEOUS ROUGH MEATING AN� AIR CONDITI TEMPORARV SERVICE OR POLE UNDERGROUNO � POWER � ROUGH WIRING TRENCHES 'Q FORMS � STEEL REINF FLOOR SVSTEM SHEATHING FRAME ANo FLA^SHING LATHING — IN I � OUT PLASTER.BftOWN COAT HEFTING, VENT., REFRIG. PLUMBING, FINAL AN� GA EIECTRIC, FINAL DATE BUILDING PERMIT N0. FIRE ZONE VALUE GROUP TYPE SUBCONTRACTOR f r� �i.l :'�0802 Z a cWj z za � y am J � J y Q W m J • p] J Q U Q Z � aW w Z J � m Z J Q W w 0 2� w � N � �O F Z a U J a a Q � H N Z O F- U � � f' N 2 COSTA P.o. B� for Applicent ro F!llln Complete/y BUIIDING �—, i r�. i.. i: ,— ��. _ MAIL ' c�rv L' U� TH '/r/�� f CONSTRUCTION LENDEH .�YLlJYI..Q � BRANCH ,/li— ADDRESS .A.e �N..TE«e � n CONTRACTOR ' ADDRE55 --��- CITY STATE LIC. NO. 512E OF LOT % Z X IOD � SIZE OF C�3Y �p � n,"'; � �� Edl�SA S�P 251969 ON�.S A.P. NO. /7 /— 7 0 6 � u . � 7 ADORIE S 36-r wRKE FciCFJ": (la�v ESf /�ic% TEL.._ _ .� .�ewrr Z%SO �n�rS� TEL. TEL. NO. �J CITV LIC. NO. NO.OF BLDGS. . NOw ON LOT I VALUE ��M �' 20NE NO.OF USE OF NEW P`,y�jb R—I o�� BUILDING VARDSAPPROVED VAPDSAPPROVED MAIN B$U�ILDI�N7Q ACCESSOiiV BUILDI (FROMC[�/fHFh) T• =X�/�• FT. n „ �� /o -XUrt. G/ (O t FT. ---- 3a � -- Y I — •: 5��11 APPROVED 1 naraby acknowlWp� tMt I hw� nW ffiis applleatlon end �b '- Mat tne ebova in/ormetlon Is corr�et anA eprw to comply wIM all lew� repuletin0 bulldinp co��truction, �nA I Malt not �mploy any Oe�wn in violation ol M� workman'� campsn�atlon I»w ef ffia State of CelHornia - . 1 heraby certify <het I am p�opwlY Ilc�nrtl es e conusctar undm SQ. FT Me S�are oI CslHwnla BuYn�u snA Vrofmion� COG, Oivldon 3, TME AMOUNT 3 Cnapte. 9, entl thet tuc� Ilemw en In tull fofc� and Hfxt, or 1 THE PURPO6E OF em exempt f�am M� provlYon� o� M� Stet� of Calitornis Butlnm ypLUATION antl Prof�s�ions Cotl Ivldon �, Ch�par 9. � s�o�e��. of G I( � PermlttN � '� � ///-��'� �v Authori:ed p�nt 0.4TE m � 0 DER VALUATION IS FOR ' iINO A PERMIT FEE ONLV: � � �1 ¢ R FEE S O' V'�/ � � m CHECK S E . LL