HomeMy WebLinkAbout2642 WESTMINSTER PL - Building Permits S
CITY OF COSTA MESA
o FFt BUILDING DIVISION
Ff S' 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
t � FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER: BX10-00233
PERMIT TYPE B_MISC STATUS: ISSUED. .
APN: 43920112 DATE ISSUED: ' 11/10/2010
Zoning: ISSUED BY: KJB
JOB ADDRESS: 2642 WESTMINSTER PL CM Suite/Unit:
Vicinity: ROOF TOP Primary Occ: Const Type :??
SQ. FT: 660 Valuation: $9,800.00
SCOPE OF WORK:
INSTALLATION OF A 660 SF ROOF MOUNTED PHOTOVOLTAIC ARRAY;8.6 KW .2 OUTLETS, 1 CONDUIT AND 1 INVERTER
OWNER: CHANDLER, DONALD P TR Address:: 2642 WESTMINSTER PL Unit
City/State: COSTA MESA,CA Zip Code: 92627-4643
Phone: 949-650-5225
APPLICANT: SALTZMAN, DAVID • Address: Unit:
City/State: Zip Code:
Phone: 562-633-4400
CONTRACTOR: AMECO SOLAR INC License No. 483820
Address: 7623 SOMERSET BL - - Unit:
City/State: PARAMOUNT,CA
Zip Code: 90723 Phone 562-633-4400 Cell:
ARCHITECT: License No.
Phone
ENGINEER: License No.
Phone
FEE SUMMARY
Building Plan Check: $117.81
Building Permit: $181.25
Electrical Permit: $62.10
SMIP Residential • $0.98
SMIP Commercial $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $363.14
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Satrudays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal Holidays:
New Years Day,Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
COOEN. INSPECTION TYPE DATE INTInALs CODE% INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall • 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition - 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by
s . n 3700 of a Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issu My wo ers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number ar : person is required to descend,will be made in connection with work authorized
LA ,. / C by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrierl� fJ1 (/s L W toter-5 or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(This sec n need rrotbecpmpt ed Athe perm at one hu ed dollars($100)or less) 2,Art 2,Sec.341,Title 8,California Administrative Code).
` /`/ 3(//t(y (!/
Policy-Number
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
be e sub' t to the workers' compensation provisions of Section 3700 of Applicant's Signature Date
th L r C ,I I orthwith comply with these provision .
'( 0// Division of Industrial Safety Permit Number:
p nts -ure (,Date_ I
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEYS FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. ,1 a registration form for acutely hazardous materials? ❑Yes ❑No
I �j ♦ (j
LLic.7f� ( r p w Class'# (Section 25533 of the California Health and Safety Code, with some
1(/'� C) �_ _ _
it al exceptions, requires registration with the Costa Mesa Fire Department by
4each business which at any one time has on hand a quantity of acutely
ors Sig a Dje hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑ No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303
. five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and'Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
1:1 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Si Lure Own r /1(// U p1. /7 d
signature Date
3057-46(31071
., A3 or.Authon cam. Lgate_1
•
PROJEl,S'ADDRESS: 2642 WESTMINSTER AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05581`.
' OWNER'S NAME: CHANDLER DON
ADDRESS: 2642 WESTMINSTER PERMIT NO; B 055815 PLAN CHECK NO: N GOVT: N SUPP: N
CM CA 92627
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
6505225
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL EXT. VINYL SIDING ( ICBO# 3663) SQ FT: 7, 700
ADDRESS: UNIT;
CLAIM VALUE: 7, 700. 00 CALC—VALUE: 7, 700. 00 GROUP OCC: R-3 /
PERMITTEE: AMRE ( 714 )937-0101
ADDRESS: 620 N ECKHOFF ST COMMENTS- SMOKE DETECTOR(S) REQUIRED IN HOME.
�L
ORANGE CA 92668 ******** ********************* ******>ESE* ********+t********************* *******
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 0491 6 STATE LIC.;47304
S'
Date: /� ` � Signature i!� / MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: Ihereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance or a certified copy thereof(Section 3800, Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
' fcY BD.: RMWC1233532 EXP.DATE: 11 /01 /92
DMPANY: NATL UNION FIRE PARKING REQ- PROV: PARCEL; 42541508 ZNE: REF NO:
IX) Certified copy is hereby furnished. ❑ Certified copy is filed with the '1y Building Division. PLANNING NOTES>
Date' /O 9L Applicant; 4 *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• _tl --"IIM!., DATE• OH 6 9 •7
which this permit is issued(Section 3097.Civ.CI. *.*******.*{(..x.*.*{p*..)(.***** •i•:'a- •--_----------
*******4******* *)****
LENDER; *************************************** ***************************************
ADDRESS: LEGALIZATION;N F E E S MMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTR, C MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 99 . 00 • 77
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 99 . 77 0. 00 0. 00 99, 77 99 , 77 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his ro herm owntisemployees, provided that ph improvements are not intended or offeredoffor sh/. If,howeverod building or REVENUE DIVISION TOTALS--> COLLECTED: 9 9 . 77 OVER/SHORT; 00
improvement or hosold withins,one year oth tsuhcompletion,ithe entsr will have the burden of provingforhe/sheldid not buildthor improve T
' for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADNG PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 99 . 00 , 77
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). l am aware **********************************************************.*********************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner' SFR 1• 7700 ALTER BY VALUE (RESIDENTIAL NOZONE 1 .00 7, 700. 00
I do hereby certify that I am aware of and understand the requirements of California Heatth and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from EXPIRED
these provisions.
Date: Applicant: _ Imo pl:te Inspections
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county /
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned Date - - A -
prppelty for inspection/ purposes.
_� 4 ��� y.
Date //M1 � Signature: {= ':I UCIL tL -C''''' ' .. T
•
1.Driver's License or Social Security if: S.-- '� }`'T'• '�' a- "
1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING .& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings / 58. Electrical Conduit-Undrgrnd.
•
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection ` 62. Backwash & Receptor-Final •
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14, Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
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. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil r .
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. FIXED SYSTEM FINAL •t
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 Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co I
51. CERTIFICATE OF OCCUPANCY
No. Date
"•tbl
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. tri
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. i
Project Address 2Ctfa 4E5IP fNsfi2 �, r ' b �s3 I� 2660 I ( /26/04 5.50 •IL:
Applicant's Mailing Addressp �I 7� �.(�a rJ •
TYPE OF CONSTRUCTION U NEW SA' ADD U ALTERATION U REPAIR
Owner's Name _{CAU A r • D,(L.NNUN Phone 71D�1'f1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone _
Address -2‘4/.2 w .57-P1 /$rt e. DESCRIPTION OF WORK/USE OF BLDG.
PL 5 Main Building: Accessory Building:
Arch/Eng. �!`AU4/a'vr� (•rill- License No. 3S 3-2 O 3 TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL E Front 0
Address ❑ TENANT ❑ ELECTRICAL fr PLUMBING 0 MECHANICAL B Rear N
Contractor's Name /1r CA's/.4,,,t4 C0Iv it Phone 977'378' ❑ 'OTHER C Right N
Lir/ '1 •
Address(mailing) cc CYJf/�.Q'd D/-,a, n£ <p PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G
p27 �� ,/ CON ST RUCTION TYPE VALUATION$ $ Left
City License No. L ZONE GRADING CU.YOS- ACRESR
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E
I hereby affirm thbl I am licensed under provisions of Charter 9 (commencing Remarks: G'-1 1 y �Q Q
with section 7000) of Division 3 of tne Business and Professions Code,and / l t 7 Planning Notes:
my licenseis in full fo J and effect. T
3
\-....„,_ LicensenceClass / Li ense TVo 5- 2 0 S
Date J/-2L-F`l Signature -ac- f PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEE$ •
of Workers' Compensation Insurance, or a certified copy thereof (Section -
'600, Lab. C.)���“4,a� /�-T (u�� Backflow Preventer • Service Sink Automatic Washer Transformer 0 15-50 KW
olicy No. Company J (t r Backflow Irrigation •
Sewer Ca - 0 50+KW
P Construction Pole Sub.
Certified copy is hereby furnished.
Certifiecopy is filed with the city uill 9 ivision Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date i U 21,-. Applicant I I L,O�5 1�n�
EXEMPTIO FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter
(This section need not be completed if tne permit i5 for one hundred ($100)or - - Dover 100 amps
less). • Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued,I •
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 01'f,-8
Workers' Compensation Laws of California.
pate Signature Floor Drains SwimmingPool w/S a
'NOTICE:If,after making this declaration,you should become subject to the p F.A.U. Inc-Solar 09-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks UrinalFixtures
comply with such provisions or this Permit Shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY X Gas Service Outlets •
Water Closet ` Cr Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets
Lender's Name Range
Lender's AddressKitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the LavatoriesAuto-Wash -
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW
any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/She Is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 0 (commencing with Section 7000)of
Division-3 of the Business and Professions Code) or that he/she is exempt -
therefrom and the basis for the alleged exemption. Any violation of Section -
^31.5 by any applicant for a permit subjects the applicant to a civil
laity of not more than five hundred dollars($500). • --
. I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and tne structure Is not intended or offered - - Reinspection Fee $15 loos Fee $ 3
for sale,(Section 7044, Business and Professional Code: The Contractor's , MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own 2 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. 1f, however, the building or improvement Is sold within one year of com- - Canopy Type II ❑ Zoning Approved By Date
Motion, the owner will have the burden of Proving he/she did not build or im- Duct- Under Ground --
rola for the rpurpose of oe). _ - _ BuildinglApproved By Dat
U i,t as owner o the property,rojectSe tion 7 44, contracting ing wrof licensedioncon- Duct-Structural Refrigeration System Application Issued By Dat l I
hetors tactorsconstruct the project (Section Business and Professions Code:
The Contractor's License Law does not apply to an owner je is hta who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves (hereon,and who contracts for such projects with a con- - ,
tractor(s)
license pursuant'to the•Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration •- BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation Insurance should be provided to me. PLAN CHECK $ ' PERMIT
❑ I am exempt under Section B.8 P.C.for this reason Firepl/Fact.BII. ICBO# Fire Dampers /
7 t PLUMBING $ p -C) ISSUANCE $
Date Owner Heating'System& Ducting Registers PLAN CHECK 25% '$ - 5,L) ENERGY P.C. $
I hereby certify that I have read this application and state that the above • 00-100,000 BTU 0100,000 BTL • GRADING $
information Is correct. I agree to comply with ail city.and county ordinances ' ELECTRICAL ,$
and state laws relating to building construction, and hereby authorize repre- • MICROFILM $
sentatives of this city to enter po the above-mentioned property for PLAN CHECK 50% $ _
inspection purgqggses. /+ /y --2
MECHANICAL $
Signature IJi-Jv- L2- - Date �� ���i I . TOTAL FEE $ g.CO
Drivers' License or 55# Reinspection Fee 1 $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building: CanaryApplicant; Pink -
/ - Accounting; Goldenrod - Assessor
- CONSTRUCTION AND.PLANNING •
POOL A
APPROVALS Permit# Date ,= Inspector" - APPROVALS Permit # - Date Inspector
•
• 1. Temporary Electrical,Service or Pole _ 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ; 53. Steel Reinforcement
'-.3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4. Electrical Conduit,-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement. • 56. Rough Plumbing & Pressure Test •
6. Electrical UFER Grnd.. 57. APPROVAL TO COVER-GUNITE
•7. Footings ' 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -
1-2. Sewer:Cap • 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System.- Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit .66. Solar System-Final
16.'Rough Electric Wiring 67. Fencing & Access Approval • • •
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•. Product Piping 0 Gas' O Oil
23. Gas Pipe-Rough & Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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. 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 Nntes:410.4 g.q P(0 maze ma.am ci60
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test 4. 1/127,Q'-( C..€O •
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer I
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 -- -
•
50. Gas Release to Southern California Gas Co
51'. CERTIFICATE OF OCCUPANCY _ -- .
k. - Date
f. .
• Applicant.to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
A MES CQNSTRUCTTON PERMIT s P IT NO TRACT NO. n.LOT NO. UNIT NO. E37/: e/ F/,f� 7A' 1
Proj tAddress a65Pa 1111 7V54�ER P�"ke-� '- `� 697 �� ��..�as�l -`�.- ��
/ q� TYPE OF CONSTRUCTION NEW Id ADD U ALTERATION LJ REPAIR
Applicant's�blailing Address ab}��{Oap�� _`L�(�(6 f'TX/.Z.1(fT6-�` '/''�1t1R/•�C�Ep�QQ
Y I3Aa 'A(Orl Phone S4 �Rp ❑ CONVERSION ❑ DEMOLISH ❑ OTH Np
Owner's Name 'NJ/LP Pr FL00t tesokleati A.P.# 4 39 -X171 -! Zone /f'
I(�EtT)�1SN57uC DESCRIPTION OF WO USE OF B D
Address 2' h.V2 i4.. COSTA- Iii /S . ppm, �[ . XT. �s� i S Main Building: ,[//J Accessory Building:
Z
Arch/Eng.(1f- 1/KRA'MealLa License Non. .23 d4 TYPDE.OF PERMITID❑ GRADIIIG N FOUNDATION�' XI STRUCTURAL T Front ":14- �r•-/LXG/ - 0
-
Address fen ELCArkt+Vo/VfJn1•'L/T4 f'rod/c'4.,fl(i$Q ❑ TENANT L7 ELECTRICAL SI PLUMBING ® MECHANICAL B Rear � l " N
Contractor's NampM tCha(S Lr{eYp S.YA/l'�¢e7Zic4one If T-3781
LI OTHER l}��y�� ''jj A - I
i�1 PROJECT DESCRIPTION SQ. F OCCUPANCY L_Fiyb_`� C Right •C 7 N
Addressilmailing)SYT C �N/w L.OICr{'•Y4a / G}• QZGC'9 CONSTRUCTION TYPE S VALUATION$_30060-� S Left 3/ • R
City License No. ' .-2,.I(1 3(Tj ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# �,C gy.-1/6 Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with session 7000) of Division 3 of the Business and Professions Code, and
my license is in full rce and effect. ,qs... -T7 HOLDT
License C ss j Li. ns• Nc� � ��' J w _��S FOR SPFf Al RF�flto cstr,I;,. S.
}}}aaa J
Date 1 4.7 Re/' Signature / ,pw. PLUMBING ' FEES •y
•
WORK RS' OMPENSATION DECLARATIO Bar Sink Showers 2
I hereby affirm that I have a certificate of consent to self-insure or a certificateIn
( ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. Cc�� - Automatic Washer .Transformer D 15-50 KW _
C Policy No. 370°9.�8 el:co $11 r't Backflow Irrigation Sewer Ca0 50+ KW K
` P - Construction Pole Sub. . .
R Certified copy is hereby furnished. ///���
DS cent$qC.y is lep city Build)" Div_ or✓. r // 1 Bathtubs . Sewer Connection - 2 7O Cooking Unit Meter Cup to 100 amps
Date d"'/S mer with theant�'uild) Z{,(v j
EXEMPTION FROM WORKERS'COM PE NSA ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
•
1�. (This section need not be completed If the permit is for one hundred ($100) or. '
` _ less). Dishwasher Solar Piping • Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I ,
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank .., • Fan Motors ❑0-1 HP ❑1'/::-8
Workers' Compensation Laws of California. , _
Date Signature - - • Floor Drains' • Swimming Pool w/Spa ( F.A.U. 'Inc.Solar ❑9-15 HP ❑' 16-15+ / Q 0
NOTICE: If,after making this declaration, you should become subject to the - - -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 5 Fixtures • • / OO
comply with such provisions or this permit shall be,deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY - - Gas Service Outlets ( Water Closet 2 o 022 Device Boxes Pole Li ht (f
I hereby affirm that there is a construction lending agency for the performance 9 Q
of the work for which this permit is Issued Section 3097 Civ. C.) Interceptors Water Heater
Lender's Name O,tn+1&eCdryN>N ear-t- — Kai.T-0.4 P OO Outlets•• 2 D
�� Range
Lender's Address I;90 a- row 4o.0 SW,' QNavfq Cassa 944,643 Kitchen Sink Water Service 7 Switches Sign / *
OWNER BUILDER DECLARATION —
I hereby affirm that I am exempt from the Contractor's License Law for the ` Lavatories 00
Garbage
\
following reason (Section 7031.5 Business and Professional Code: Any city or ` Disposal 'Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap ❑0-5 KW ❑5-15 KW Trash Compactor
any structure, prior tom itst issuance, aa iso requires theapplicanttier suchpermit p P
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains n
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of _ - - - , f.�ry
Division 3 of the Business and Professions Code) or that he/she is exempt - - -- � I
therefrom and the basis for the alleged exemption. Any violation of Section
'031.5 by any applicant for a permit subjects the applicant to a civil
nalty of not more than five hundred dollars($500). - f
. I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves ''
thereon, and who does such work.himself/herself or through his or her own - - DEVELOPMENT SERVICESl/ REQUIREMENTS:
employees, provided that such improvements are not intended or offered for • Boiler Hood or Type I 0 ZoningApproved Byn^C _/K14� /5--81.9
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 - pp Date
tion, the owner will have the burden of proving he/she did not build or im- - Building Approved BY Duct-Under Ground -
rove for the purpose of sale). Date /s /
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application,Issued By Date !!// �r /!
tractors to construct the project (Section 7044,Business and Professions Code: - -- - --
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU •
SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con- /�
tractor licenseeipursuant Compensationoo the Cooinsurance
License should be I aware thatBUILDING PERMIT $ -yl 00 SMIP $ 2.io
ofExhaust System 0 Multiple 0 System Repair/Alteration
proof their Worker's insurance be provideds his me- • PLAN CHECK $ Sr PERMIT
❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ 3a OO ISSUANCE $
•
Date Owner Heating System& Ducting ET "t PLAN CHECK 25% $ 2.Cb ENERGY P.C. $
• I hereby certify that I have read-this application and state that the above I -gi0-100,000 BTU 0100,000 BTU . $O GRADING $
information is correct. I agree to comply with all city and county ordinances /CO -I ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ • MICROFILM $
sentatives of this,'ity o e -r up- the ).•ove entioned pr.perty for 3 4 .e'ci/S(t•�+s SiO 00 �7
inspection pur.o7 - r / 'L xr7•--- 361r /-
Signature ,i, _ Date `Z-7 Q' T MECHANICAL $ TOTAL FEE $
Drivers' License or 5' # ' ' - _ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ e 00
CMF 0865-46,rev.4/84 White-Building; Canary -Applicant; Pink-Accounting;Goldenrod-Assessor -
CONSTRUCTION AND PLANNING d. POOL , A
.PPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
. T`mporary'Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pi pe•Undrgrnd. 4 7/�� ��/ 53. Steel Reinforcement
1. r
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
J ,
4. Electrical Conduit-Undrgrnd. ... 55. Electrical Bonding '�
u
r
5.;Steel Reinforcement j; `' 56. Rough Plumbing & Pressure Test • t.
-1. 6.. Electrical UFER;Grndt 9�a9/gq t ) 57. APPROVAL TO COVER-GUNITE tl
3
7.:7.- , • n? • 58. Electrical Conduit-Undrgrnd.
• 8:-Fpuridation S94 59. Gas Pipe, 0 Undrgrnd.,Test ''
-4."
' 9::Water Pipe-Undrgrnd: , - 60. Backwash Lines,P-Trap, 0 Undrgrnd. ,7: 1
10. Structural Floor'System • `a 61. APPROVAL- TO DECK
11.1Property Sewer Line-& House Connection (c/(0q c-9 62. Backwash & Receptor-Final _ •
i1
12.'Sewe' Cap. ' _ " 1 - 63. Heater & Vent-Final
13. Roof D`ains ;, ✓ ' r r 64. Plumbing System - Final
t ,♦
.14. Rough Plumbing`-• Jsa ( c4p 65. Electrical-Final A
15. Rough Electrical-Conduit , 66. Solar System-Final -
1'6t Rough Electric Wiring ./ ��y � 67. Fencing & Access Approval
NJR
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
19.,Rough Heating & Air Conditioning /83/06( `¢O FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21: Ducts, in Structure - 70. Underground Hydro
22. Ducts,Ventilating !- i 71. Product Piping O Gas 0 Oil '•
23. Gas Pipe-Rough & Test 72. -Underground Flush
. r
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathingtk-9/74l'f - 74. Overhead Hydro •
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frariie.and Flashing 1°/(et. - 76. Dry Standpipe
&
28. Lathing 'Siding /0/j (� ✓L--- 77. FIXED SYSTEM FINAL
29. Insulation /pity Ifs le--' 78. FIRE PR EV. FINAL
30. Drywall Nailing /D/WI if VL- HEALTH DEPT. REQUIREMENT
31. Plastet Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED '
33. Final-Electric //i)•1/f}'4' " - - wt_U. f..a,Vs- QS ycZ -
7Jlo�, Notes:
34. Final Heating& Air Conditioning /// el Ggj. : /..)F < % :V�t?- (7C r
35. Final Gas Pipe-Test cot-1- , s ) ti R.. 1.3454 ,ts,_- Q-A
36. Hood or Canopy
c ,`(v PlLa.J c b5 8 a 4
37. Final Factory Fireplace 3/.c4 f /27.0.-0-p.>Hec.,7z &'-A'- re.vr6Vc=7
38. Final Plumbing -
///2(61-1GE.O t.ii .,_
39. Water Service-Final _ 4k �CpLe- 1Y1 /-
40. Gas Service-Final • �lr
41. Solar Domestic-Final
42. Backflow Preventer -
43. Backflow.Irrigation -
44. -Landscape Irrigation System '
"45. Sound Attenuation ,
46. Handicap Regulations `
47. FINAL STRUCTURE & BUILDING r(a/av Vt.--
48. Special Requirements Completed Ag/LC 'r
49. Electric Release to Edison • -
- 56. Gas Release to Southern California Gas Co - .
51. CERTIFICATE OF OCCUPANCY '
No. Date. ? ,•
.OWNER $RENNAN DAVID DATE 1-3-78 -
JOB ADDRESS 2642 Westminster Place BUILDING PERMIT NO. 45297
GENERAL CONTRACTOR Newport Home Center DESCRIPTION of WORK Convert Patio to Familyroom
a>' 9-1. -12 LOT 9 TRACT 1778 FIRE ZONE
A iVALUES 6,000.
IN"'- CTIONS Signature Date TYPE V GROUP I ZONE R-1
SOIL PERMITS ISSQED
GAS SUBCONTRACTOR I J
Date Number Signature
ATER Plumbing •
ROUGH PLUMBING
ROP. SWR. LINE Q HOUSE CON. 0
I SPRINKLING SYSTEM
ISCELLANEOUS
OUGH HEATING AND AIR CONDITIONING •
EMPORARY SERVICE OR POLE _
NDERGROUND CI POWER 0 /T n
UGH WIRING ` ` int Heating and Vent. •
r
ENCHES f . FORMS STEEL REINF. Iit� ^^ -. I -OOR SYSTEM •``V(�. �dUl-/�
BOND BEAM STEE EINFORCE In
SHEATHINGatsr. Y-io_ t
y-iv:7a''
FRAME AND FLASHINGY t-Jr
LATHING - IN XOUT n A Ser Jr-2.�
PLACTER, BROWN COAT 6/1/79/
_-
ST URAL, FINAL //// Re HEA,,NG, VENT., REFRIG. AND A.C., FINAL - /-%3-)T 4/ g'3/PLUMBING. FINAL AND GAS TEST in w.l ._in J _ Ct' .3L�..'�ce c/yy/pq�
ELECTRIC, FINAL `.,/�f r,, a2 lif "'
BUILDING. FINAL - I� , 174%)` "
4 F r' I=7I I: 5/4o 50 TL
�2 9 r
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A L A ON FOR STRUCTURAL:PERMIT 514,5E1 TL
For Applicant to Fill in Completely — Use Ink Only
_
ADDR /.r lac �7 1
v
RE EI E V DATE RECEIVED DATE
ISSUEIY,,
BUILDING
.267 .7 s.7/)1/�'n.7- /-i. • -is/
/� //ma /-3 k". PERMIT NO.
OWNER ///P/j%(� �����I1/�A A.P.NO. Yy—
MAIL BUILDING 2/y2 AWIScn Pe
ADDRESS �/J?.P ADDRESS ff777G N'
H TEL. TRACT/2. � LOT ? BLOCK
CITY C. / "7 NCL.syf'-f/frC�+
CONSTRUCTION NEW ADD t1LTER REPAIR MOVING DFMOIISH
LENDER
BRANCH
OWNER y /CC ✓n�,y� BetA-�dw-' i
ADDRESS tt.omv. Miro TO VALUE �
c.y
ARCHITECT TEL. ` USE If son. $ G,e�
OR ENGINEER - NO.
FIRE
ADDRESS ���p�7 ,,,f' ZONE TYPE/ GROUP
yJO' / APPROVE• .7 ^�
CON ACTOR �� - y'J- 27 BY L, ! , DAT j '/
' ADDRESS 2277 /f,cnij1/C /y1/E' -
�rp ZONE NO.OF USE OF NEWC'O f
TEL. 9 N/G ` PLANS 2 BUILDIN3'J�a /O ♦ow,
F CITY�0S7�9 SSA TNo EL. U /
STATE ...,, CITY YARDS APPROVED YARDS APPROVED
$a LIC. NO. ? ',i�',746 9 LIC.NO../5,91/6MAIN BUILDING ACCESSORY BUILDING
(y SIZENO.OF BLDGS. (FROM C/ SIRE
O. OF LOT 61 X /2 3 NOW ON LOT EFIONT 77 E`-'frr.r— FT.
Q USE OF
EXISTING BLDG. R.SIDE''.2r4 FT. FT.
/',/�,,,
F Separate permits are required for L.SIDE A �P, !/ FT.
electric,plumbing and heating work. //
W _ REAR //J 6 FT. FT.
USE F BUILDING AND WORK T B PERFORMED
F C LL ;I��, DISTANCE BET. BET.MAIN&
Q f2'/5%0f7 �/ /+s /I� /U Ff/K6rSHI MAIN BLDGS. ACCESS.BLOCS.
CI
(/ VAR. DATE
.] -rjn.n ��jl C.UVAR.'S.•:14 APPROVED
?- 78
APPROV
r-1 - —BY DATE
IX
w I.
0 I hereby acknowledge that I have read this application and state 'n
r.. that the above information is correct and agree to comply with m
0. ell laws regulating building construction, and I shall not employ
Z
any person In violation of the workman's compensation laws of
x the State of California. it m
a
I hereby certify that I am properly licensed as a contractor under !^J SO. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR mD
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business VALUATION PERMIT / .vl
and Professions Code, Division 3,Chapter s FEE E 1.....Z.
€ V s. m
Signature o PLAN CHECK s /2 (� o
Permitte / /(}//�/J/y� -., on
/ u.
e ��/j�7t "2� -" S �"(/ d TAX S 57 F
U
Authorized Agent TOTAL PAID s c�i.
; o
/ 27 P^;. 00 234* ****49.50
� ;6
N COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP;LICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely '`
^ R / El ED <Y DATE RECEIVED DATE ISSUE•
BUILDING s O . G - f�/ns v^ — 5
ADDRESS ��tt
from . — /lJ -A.P. i
BUILDING 1 • / /�/
ADDRESS Plti7.S i �yfl••-//r�'� ADDRESS Q4, 10 WCC nilu 5/re Pt
ill Lk;
E 0 CITY /� /�,1� NOLJTd TS08 TRACT �`(, IoLbT 65/ BLOCK
I— Z
C CCOLENDE_ RCTION NEW
ADD ALTER REPAIR MOVING OFMOI ISH
Ct. CO
JO BRANCH I / �7 �` ,r �, /1
OWNER /)/J�/<D ,ft- �'V1
m J ADDRESS (/��-�,/b/J no-A)
���/(`/� �U
Jm ARCHITECT TEL. USE IiI,//L Q`J /V 'V $ ✓r/!/
< OR ENGINEER NO
n
W < FIRE
CC ADDRESS ZONE , J/ TYPE GROUP V
J
ZCONTRACTOR �j/��� . BYPROV Ey4/////7/. DAT 69-279cm Z
J cc ADDRESS
W w TEL. ZONE I NO.OF^^ USE OF NEV tt#c&c1 ad
Z= CITY NO. R/ (PLANS L. BUILDINCS�A- r` d'
H
W O STATE CITY YARDS APPROVED YARDS APPRO ED&a r
co rt LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING&L'am
7 - 1 y 123 NO,OF BLDGS. ��.p (FROM C/L STREET)
SIZE �•C _ t f �t
OF LOT J NOW ON LOT Li FRONT FT. <S col FT:-d57401 /
•
USE OF y,.�1 .� t�
EXISTING BLDG. , 1OI7� R SIRE FL ^ " FT.
F SIZE OF �//1r�. '3Q1 NO.
STORIES O 4 L.SIDE FT. rys3 FT.Z NEW BLDG. s'.1.�
--
Q EXTERIOR WALL/f / ROOF 4. '/ 1
_V COVERING (ff{N/(JQ� COVERING , ^] �s/ REAR FT. �J FT.
J USE OF BUILDIN AND WORK TO BE PERFO ppp�^^,,,,,,ED DISTANCE BET. BET.MAIN&
Cl- MAIN BLOCS. ACCESS. BLOCS.
C. //� } J • DATE
Vd✓d�1e (,Je>✓C►'Lhvh � iCe `CURP APPROVED 1I�\
•
~ <•/ APPROVE `'g�'v 5Iac—�-s� 1 \
N �Y (!�'��Y DATE (`s`�'\
0
oI hereby acknowledge that I have read this application and state $T{)'�E \ /��"
M that the above information is correct and agree to comply with ��(J// 1 t1
CC all laws regulating building construction, and I shall not employ 1. f
F any person in violation of the workman's compensation laws of ll
y the State of California. /J/�� / fe
Z I hereby certify that I am properly licensed as a contractor under (ori ✓ SO. FT. T '=� ,// o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR • Ce)
Chapter 9, and that s h licenses ar ' full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
IC
am exempt from jrovis; , 6eis9ateons o of California Business VALUATION /�and Professions Civision pter 9. '/ co
g � ortiPERMIT FEE $ L G D
Signature of �`/ / O�tJ co
E
Permittee $ PLAN CHECK $ E
Authorized Agent ` X v15
� LL
TOTAL FEE $ .0
OWNER BRENNAN, David P. DATE 8-27-75
JOB ADDRESS 2642 Westminster Place BUILDING PERMIT NO. 40496
GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Add Gar., Darffim & Office
AF 119-163-12 LOT TRACT FIRE ZONE VALUE $ 4,300.00
INSPECTIONS Si�n_ature Date TYPE V GROUP J ZONE R-1
SOIL 7-rf.5 /O.2/ 77 PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number Signature
WATER. `£a.5 /1•/L•7C. Plumbing •
O"
ROUGH PLUMBING �.�ro.r _ t /0-G-7S(7 yyy
r
PROP. SWR. LINE E HOUSE CON. ❑ `R.* co-Y,'aa L �/ so�2f. 7Q(/68e
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND Er POWER ❑ /9/-6-d /1ILJs
ROUGH WIRING ❑ .4Y(, //Z$ Heating and Vent.
TRENCHES FORMS STEEL REINF. O 0 S
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n �•I
SHEATHING R•V p�y k7(t-5 9C
A 4
FRAME AND FLASHING - �
LATHING — IN n OUT n III '
PLO 1, BROWN COAT
5Th JRAL, FINALElencAtric
HEATING, VENT., REFRIG. AND A.C., FINAL Q� 9 a-nt�Jt'yQAA• /0 4-7.r 39•rg�� _
PLUMBING, FINAL AND GAS TEST n 1�• -4T7
ELECTRIC. FINAL ,/j'�i,