HomeMy WebLinkAbout2558 WESTMINSTER AVE - Building Permits 4.,05TR"'FS- Cala DF COSTA MESA
O A CALIFORNIA 92626 P.O. SOX 1200
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• FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY •
Project Address o2568 LJD&sr n R± 'Tee . Permit 17g/73
Project Name 'Type ��Ty—
Owners Name u 4,4,� //4J
Cwners Address 7C65�/��f
32_ /VG/Sc� +� 5-F—(4-15511,14/..)/-( , City Use Cnly
Owners Telephone x O K3 ' Ce Y�
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49190rX ��Owne �, - (strike out all
except one) do hereby attest thaemp oyrent of any person, or persons, is not
anticipated at the time of seeking the above-referenced permit. In theevent that
any person, or persons, are employed under the provisions of this permit, i shall
immediately cause a valid Certificate of Workmen Catenation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own cost, arca to indemnify and hold harmless, the City,
its officers, agents and/or employees, frau and against, any and all liability,
damage, costs, losses, claims and expenses, howsoever caused, resulting directly
or indirectly from, or connected with the improverrent under this permit.
I further state that I have read and fully understand the implications and re-
sponsibilities of the above statements, and will comply with all provisions of the
Contractors State License Law found under the Business and Professions Code,
Division 3, Chapter 9, of the State of California.
0(19 PQA1( 5
int Name
R12G - // — 70
Si-nature Date
1,
OWNER aPHILIp PANICS DATE 6/6/80
JOB ADDRESS 2558 Westminster Ave. BUILDING PERMIT NO. 50205
GENERAL CONTRACTOR Owner-builder DESCRIPTION of WORK Bathroom Legalization
AP No. 439-192-13 LOT 10 TRACT 1382 FIRE ZONE VALUES 2,000.00
I =CTIONS Signature Date ,TYPE V GROUP R-3 ZONE
so.- PERMITS ISSUED
As SUBCONTRACTOR
Date Number Signature
WATER Plumbing
ROUGH PLUMBING d ��
PROP. SWR. LINE n HOUSE CON. ��
1. -/i-83 'tb D
SPRINKLING SYSTEM �"��1'
MISCELLANEOUS
OUCH HEATING AND AIR CONDITIONING
4T MPORARY SERVICE OR POLE l
UNDERGROUND ❑ POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES [0 FORMS E STEEL REINF. 9
FLOOR SYSTEM
OND BEAM n STEEL REINFORCE 9
HEATHING
FRAME AND FLASHING
LATHING — IN 1-1 OUT n
astLASTER. BROWN COAT y(,
' 'TUBAL. FINAL Ko ' ['S4 /� Electric 41 / Jay
JG. VENT., REFRIG. AND A.C., FINAL ,�//JJ` //� r- -go ��/ �blX
PLUMBING, FINAL AND GAS TEST n /[q` C'jpc�spo
ELECTRIC, FINAL `. 4,'c2J •ei
BUILDING, FINAL 1e `I-a¢-$(J
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR'STRUCTURAL PERMIT c
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ,•
RECEIVED Y 'PERMIT
N ,5`O205 °°L
For Applicant to Fill in Completely - Use Ink Only 1 V
ADDRESS 2 J
BUILDING ['S8 P� /i'I,A / h^�n �� AV 11 A.P.NO. H34 - 192- 13
vV
/� / BUILDING 25 ` s / • e_si / /_ 1�
OWNER OR A/I A/// •/ an
/' ADDRESS .? Oo W j�,(�/�V C.�s
TENANT /'I �/ /I I1
UNIT OR
MAILING SPACE NO.
A i
ADDRESS 74'03-2 Air i0/t ��
TPACE LOT / 6 BLK.
TEL. /35-2--k /35-
CITY 1� 5
� in)iK}�e, NO-.�,.yJr 6/4' NEW ADD ALTEAR REPAIR MOVING DEMOLISH
CONSTRUCTION `//'
LENDER I •'^ //�� /'
BRANCH OWNER Mr. ph I`/lt// /�aM let S
ADDRESS 1 JALUE
ARCHITECT TEL. USE g� tem.., 44.A . $9.000. T
OR ENGINEER NO �' //�� •
ADDRESS ZONE (TYPE �/ GROUP t\- 3
APPROVED
CONTRACTOR 0 //I; /�/—go
QBY �/J DATE (� 6
ADDRESS ' �
TEL. V
CITY NO.
F. STATECITY APPROVED SETBACKS
LIC.NO. LIC.NO.
512E J _ NO.OF BLOTS. (FROM C/L STR4
. OF LOT Q
EE
6 S NOW ON LOT FRONT
Q USE OF / NN
N., EXISTING BLDG. fr I L/ V
U
/ h-7 R SIDE F 1
, /
FSeparate permits are required for L.SIDE T.
electric,plumbing and heating work: REAR FT.
IN
USE OF BUI DING AND WWI(T BE PERFORMED PLANNING ACTION
e !/ �tw tafiinvoMM • .
0
c/nom 4 L7) DATE
•
C APPROVED / c
y. e, // /; 0./iIO�'L. APPROVEDA4..a2/.."-74 DATE 40[ 646
1Ig
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0 I hereby acknowledge that I have read this application and state n
g, that the above information is correct and agree to comply with
Ca all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of
,T5, the State of California.
SQ. FT. // �] "J�LJ 009� 2/.y-�
0 •-�m°j
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR at
Chapter 9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT/FEE ONLY: ��,
am exempt from the provisions of the State of California Business d
and Professions C Di sion 3,Chapter 9. VALUATION PERMIT FEE $ a•
Signature of PLAN CHECK $ /n , r o
/ \ Permittee / "' / YgY " �`/"�— q�) $ . •�— TAX $ •
�'thorized Agent Date T" C . �L7� TOTAL PAID $SD ti c c