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HomeMy WebLinkAbout195 MAGNOLIA ST - Building Permits PROJECT ADDRESS: 195 MAGNOLIA ST UNIT: CITY 'OF 'COSTA MESA - BUILDING PERMIT ' PERM NO; P 049970 OWNERS NAME: GENE ROBERTSON • - - ADDRESS: SAME • PERMIT NO: P 049970 PLAN CHECK NO; N GOVT; N SUPP; N . CONSTRUCTION TYPE: PERMIT TYPE; PLU PURPOSE: OTH 760-8364 • ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION • : CONNECT SEWER LINE TO CITY 'S LINE. SQ FT; f tMDDRESS: UNIT: f CLAIM VALUE: CALC—VALUE; GROUP OCC: / • ,f�' PERMITTEE: GENE ROBERTSON ( 714 ) 760-8364 • • . ADDRESS: 600 W 19TH ST F COMMENTS: X • • - C.M. CA 92627 **************>F****�R****RE*�F�P**'�RE>ERF >ESP�r�E*.s **4*sE*t�µRE�ESPy ****w**�R* * *�R*sr�r*xg ****�P • LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section - ZONING R E Q U I R E M E'N T S• 7000)of Division 3 of the Business and Professions Code, and my license is in full force and effect. SETBACKS . CITY LIC.: STATE LIC.: CLASS: . •Date. Signature: MAIN BUILDING ACCESSORY BUILDING — FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN 'RGHT; FT IN Compensation Insurance.-or a certified copy thereof(Section 3800, Lab.C). PCMY : EXP.DATE: • PARKING REQ: PROV; PARCEL: 00000000 ZNE: REF NO: COMPANY: PLANNING NOTES>• ' 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. > Date: Applicant: DEVELOPMENT SERVICES:- R E Q U I R E M E N T S . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section nee be completed if th ermit is for one hundred($100)or less). I certify that in the performance of the work for hick this permit is issued. not mploy p rs n any manner so as to become ' ZONING APPROVED BY subject the in the erCompensation Laws California. DATE Dale: ( l -1S 'CIO ( Signature: 'r BUILDING APPROVED BY : - DATE: NOTICE:If.after making this declaration,you should become subject to the Workers Compensation provisions of the Labor 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• ' �E DATE• ` I ' which this permit is issued(Section 3097.Civ.C). **'N'**'******'***'x'*'N'***'*'*'x'x'x'*'x'**'M'iE N'*i('****.'***'*' * *.x.i<"1Fi('**i('*'*.x"x'N'*x">t.'N'*.*")E*'�('*' �. * ** LENDER: • ******************************************************************************* ADDRESS: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N • a,. OWNER BUILDER DECLARATION: (hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG, PMT PLUMBING ELECTRIC 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 5 0 0 • repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% -- 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 PLAN ' . and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE ' FEE • . 3. 00 ..;x ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). • BUILDING—DIV—> PERMIT ISSUE PLANTCHECK TOTAL PAID DUE .SC I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the 'TOTALS ---> 5 .00 ' ' 3, 00 0. 00 8 . 00 8 . 00 . 00 L: structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State 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 employees.provided that such improvements are not intended or offered for sale If, however the building or REVENUE DIVISION TOTALS > COLLECTED • 8, 00 OVER/SHORT: 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE , SM.IP/TOT GRADING PLAN—CHECK for the purpose of sale). 8 . 00 . . •I,as owner of the property.am exclusive/ contracting with licensed contractors to construct the project(Section 7044,Business " ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon **,****,*****,***,*****,************,*,*;***,*,******,*,**,*,***,*******. ******,*)L.*.*.**.**{t.*.I(,**** and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL ',F E E BREAKDOWN • ❑ 1 am exempt under Section: B.8 P.C for this reason: _ ee I.1 / TYPE QTY , D E S C R I P T I 'O NI UNIT COST' TOTAL COST / / . i. Dale: • L /'� — /owner. ���!��' PLU 1 SEWER,, CONNECTION ,TOi•BUILDING EACH 5. 00 5 .00 I do hereby certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,andEND). 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 Ouality Management District.Residential construction applications are exempt from • `pt 1 these provisions = Date: Applicant: • • I hereby certify that I have read this applicaho nd stale that the above information is correct.I agree to comply with all city and C my • 'Y- F ordinances and state laws relating to building nstruction and hereby Guth, resentatives oflhi • ter poo the above-mer oned �'t (1 ri • 01 00074316-00074316 ? OT 8.00 property lonspecuon purposes_ 24;M _ i,4, • DATE: 11/15/90 TINE: 15:47 • Date: Signature: ��� 4.11• 11.= Driver's License or Social Security n: '-` -4 1641,46 Whrte—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTIO4ND.PLANNING POOL & SPA' Date Inspector Date Inspector APPROVALS• Permit# APPROVALS Permit # V • 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 UFEfttGrnd. 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 84.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 . - - r?: 20.4Rough Factory Fireplace r -_ . . r = _ .:APPROVALS' Permit# ' ' 21: Ducts,in Structure. , •� i '-. r .70. Underground Hydro -r. 22. Ducts, Ventilating: ' I • 'r • 71.• Product Piping 0 Gas 0 Oil 23.,Gas-Pi e;Rou h &Nest ' t 1`• tr P 9 i �. tr+ : + . .72. Underground Flush 24. Roof Framing ••'- + -> r 73FUndergrn`d.Storage.Tank'OGas ❑Oil • 25. Roof Sheathing , , •' "� -_ - `•:• ; a 74:. Overhead-Hydro" 267 T-Bar Ceiling (Structural) &-.Monocoat • ;• '_t '7 _! 757 Dry Chemical -Li t- '-• - ' 27: Frame and Flashing ; .•° „ .rig 1 • " 76.E Dry Standpipe ,,• . . ' ' 1 ;- • 281•Lathing & Siding + r-: ' ) it I : - ''-•c t 777' FIXED SYSTEM,FINAL' 4. ' , ,_. n , ..' ..1 I: s ,-, _• r . ,-I it '29. Insulatibn � . 78i' FIRE PREV. FINAL i .'• 't: ctOf . I • ,.HEALTH .iREQUIREMENT iDEPT 30. Drywall Nailing 1 . I I b + ' ' 31. Plaster Brown Coat i ., :� I I I, ' , . 79.'FINAL`INSPECTION L 32.: Electrical Power MeterFinall _• >' • t• - ,80: FOOD CERTIFICATE ISSUED tt 6G f ro Thio o ^oci b-tbinE - -&Co • 33:'Final Electric - , ;- Notes: ,;34; Final Heating & Air Conditioning i l: .t -F403'11-torotCt, OP ‘444% COCS&Rot S SWIM Caen 35TFinal Gas Pipe-Test o' - I � I� r ` ' , 36 Hood or Canopy .-1 I I 114: .7 1 i, . ,..-, n .' : -0.4 . .. • 37 Final Factory Fireplace , • ' m- I I ,};, - r j,.,, Coal 38. Final Plumbing • _+O Zltj?l LS4j '> - s 39. Water Service-Final 1 4 4 , •x E . . 40. Gas Service-Final : ,.n •, 7 : it, I i+ _ _ ; ' _ - 41. Solar Domestic-Final I;_ ' - 42:Backflow Preventer f- - 43. Backflow Irrigation ...4• -, 44. Landscape Irrigation System - 7 - _ _ -. - _ 45. Sound Attenuation '' - -' .46. Handicap Regulations • 47.:FINAL STRUCTURE & BUILDINGI ,�' - 48:1•FINALPLANNING : - •` .' I I ' Ii - 497-Electric Release to Edison I I I- " i • .' 50. Gas Release to Southern California Gas Co , I ! -11 : -1 . • 51. CERTIFICATE OFrOCCUPANCY : _ - ,r.;) . , : No. • Date - , L . PRaeZ'TADDREss: 195 MAGNOLIA ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BP 055072 OWNER'S NAME: GENE ROBERTSON ADDRESS: SAME PERMIT NO: BP 055072 PLAN CHECK NO: N GOVT: N .SUPP: N • • CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE: DEM 760-8364 ARCNIENGINEER:' REG.NO.: JOBDESCRIPTION : .DEMO SFD SQ FT: ADDRESS: • UNIT: - CLAIM VALUE CALC—VALUE: 1 ,000. 00 GROUP OCC:• R-3 /M-1 PERMITTEE: GENE ROBERTSON ( 714 ) 760-8364 , ADDRESS: 536SEAWEARD RD • - COMMENTS: DEMO SFD REF B55068 - • I CORONA DEL MAR CA 92625 *****************************dEiE3EiEaE-)EiE**********.# *****3E*****af#ifif+E9t****>E********9E9E , LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000).of Division 3 of the Business and Professions Code,and my license is in full force and effect. • SE TB ACK S . CITY LIC.: STATE LIC.: CLASS: Date: 'Signature. MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby 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 °OLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 42523112 ZNE: REF NO: 3 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: i Applicant: <. ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This secdon need not be completedif the permit is for one hundred($100)or less). DEVELOPMEN T SERVICES R E Q U I R E M E Nx•T' S 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 f1 subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: - . NOTICE:If.alter making this declaration.you should become subject to the Workersti 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'5gency for the performance of the work for. APPLICATION ISSUED Bk —� _ DATE• 1 1 • which this permit is issued(Section 3097.Civ.Cl. ********************* '—'___— ********{E** f8e** **** LENDER: ********************************** .******************************************** ADDRESS: LEGALIZATION:N FE r SUMMARY ' STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING E ECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 25 , 00- '2p 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she'is licensed 25t 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 PLAN . S O and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by . any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3. 00 I. as owner of the property or my employees with wages as their safe compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ' I structure is not intended or of fered for sale(Section 7044,Business and Prof essional Code: The Contractors'State License Law TOTALS----> 27, 50 3,00 0 , 00 30 : 50 30 , 50 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through ' • his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 30. 50 OVER/SHORT improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). • BLDG PMT PLUMBING ELECTRIC ,MECHANIC FIRE SM I P/TOT GRADING PLAN—CHECK 0 CHECK •I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25' 0 5 ' 0 0 S0 tal and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Stale License Law).l am aware *****************************************************************'***"******4**** That proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN 0 I am exempt under Section: B.8,P.C. for thisreasson: TYPE QTY . DESCRIPTIO N UNIT COST TOTAL COST Date: i i`/3 -7I owner PLU' 1 SEWER' CAP / DEMOLITION EACH 2, 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health 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 Ouality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: , 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 stale laws relating to building construction and hereby authorize repres lives of O's city toe' ir upon fh'above mentioned property for inspection purposes. r____, Dale: / I•'/ 3 Signature: Drivers License or Social Security e: 01 20102139-051021.1. TCT 1641.46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor DATE: 1w/13/91 T:tE: 11:S) ,. . • CONSTRUCTION.AND PLANNING _ - F & 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.�Electr tal Cond&Itltility-Undrgrnd. 54. Forms 0u'4, Electrical Conduit•Undrgrnd. 55: Electrical Bonding' - , • 5t. Steel F[einforcevs%nt• • 56. Rough Plumbing & Pressure Test - _;t`�'• Electrical UFEF,G?*id. 57. APPROVAL TO COVER-GUNITE a ,l 771. Footings n. _� 58. Electrical Conduit-Undrgrnd. a `•C'if. Foundation S - .; • 59. Gas Pipe, 0 Undrgrnd.,Test c'' ��9. Water Pipe-UndrgEnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ..t. 11. Property Sewer Line,& House Connection 62. Backwash & Receptor-Fina. 12. Sewer Cap 1213/4( GOP 63. Heater & Vent-Final 13. Roof Drains tr . . 64. Plumbing System • Final 14. Rough Plumbing 't- 65. ElectricarFinal . 15. Rough Electridl-Conduit 66. Solar System-Final • 16. Rough Electric-Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - a 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • n, 20.,Rough Factory Fireplace it t `• I:. j - = tAPPR,QVAI S�CPemit# �•21 Ducts, in_Strµcti��� ' ";', , ?ys �70. IJnde �u'�d H'y�ro 22. Ducts, Ventilating:. ::^ 5 S4- .. -71. ProduarE ing C�6as Oil.- .t ^ _ait1r '23`GasEPipefRough &'Test "'t • ? -k ' "72. Under round Fib C- •r] 1�< tw tr ti't- > 0.. .fix 3. r • --i ce 24a.Roo! Framing ,r,e : i-F- = * > p r :F t 573:oUndergrnffi.Storage Tank:i0 Gas ❑9+1 I 25. Rogf Shgathin Crc ni * an 'ti :C1 iti3 a. 7 C .G • 9 y ,,:� �; v.t. ;� 74,.1O}.erhead hydra=,- 26._T- ar Ceiling (Structural) &. onocoat s " Wi C- tnt r �J • _ tilt - 75'S-:- Chemical •:; - -+ •� sv_ 27FFrame and Flashing y r [:i .a *: 7&crl My Stan,}}ti)'ie -5 x ='t :'' " [- 'T. ';CC:^ 3 : >+ -I` :+: .`S!••," Et tuft: x ._ �28.LOLathin '' Sidin�"y r'--t:11 r y _ .0. ,r •. T. > -� :u �r; g• _ :.7 .0. a. E .-*A c 77•.. FIXED S•Y�STE .€'kNAlt' _ y29. Insulatigr = • "' x. '` I i • f i .. 7F FIRE PREY. FIN&L v s ti•30. DrywalF_Nailing fry* I i.. _ �.:HEAL-Fh4_DEPT.REQUIREMENT •.31. Plaster Brown Coat` _r _ _ * • ) • I- r79t••FIN'ALcFNSPECT(k1N * _� r Cr 7"32.,Electrical Power Meten•Final' `-'• , ro .;` ,80„FOOD CERTlFIC(ctE ISSUED-+ j 33.`+Fi al Electric i' 'i Nottes: 1:34.-..”34. Heating& t,iS.Crdndition fn „ ``' I ] re t x 5 _-r r •S O'� 1. b 35.rFinal Gas Pipe-Test= - * ^ i I tt: t . . t�rz* rr C i•- .. , _ .. i. •- i : F. .do .:-i ,- ,c •tc36:`Fiogcl or Canopy �;� t -= r :- i t. I tti: y. _ x !r • �•:� 4.to tr, -37:•Firial Factory Fireplace^_ ',i . Ui I E. 4 '• 17! '? tri • :i'i T. ,d ;_38. Final Plumbing 'J I I w e r I I s 3 m e i .-t x • ' Cr. .re n v ^39. Water Service-Finale •' x ai '?40. Gas'Service-fjnal r t., .fir• _� It Y•C :S > [n j e a ^.;; '3i r� s ^ ^ + {'s•41. Solar Domestic-Fina.; •• '-.x ;: : F. iY: rs a rt- _ r' S ,� �' f Iu t- ti� * 5i_42`$ackflow Preventee' E v: 43. Backflow Irrigation 7:5:S 'i r, ,It •s„-.o 4 n ,,, '-+ e-' i r, m44. Landscape lco irigati n. Syste .. .- ; tit } `Y' 'a �' ` t u- `., • \ :. .:��... .f V, +. .' :.--# �. i. K i.+.... Z45:-Sound Attenuation .t^•F- +- 1- :4;2.."" .-' t+a u;� a: •i .r en tr t 't. - Pr tr• T . rti J •y ?465'"Handica i. Regulations - 'S : "' T. 7:11- g • •t70 ''. 't f C t 47{S;FIi AL STRUCTURE& BUILDING "c Y. -' ii is 7, er'48 .flFcl'AL PLANNING •-cam.., .K r,,7 1 I ft f. r o t .rf :r- 0 -7 . a rrJv _: 049.7EIeptric Release to.Edison • t •I t.. ,_ •r1 el o "-50: GasJlelease to So1xhern California Gas Co "- I ft .f. •E: " L. -. LI •;"51. CEFLTIFICATE OF`OCCUPAf�C� �•' No. • Date • I - -' , - ' - - -Applicant to fill in-alPspa ees except those within heavy border lines and sign all appropriate declarations: • 7940 1 /22/86 1,001 TL •F COSTA MESA,,,ACONSTRUCTION PERMIT - PE$j�1T NO. /' 17(,// TRACT NO. LOT NO. UNIT NO. - - ect Address 1'9S 111-AGry6Ll,( . NtA•Q' 6-E. E aa`l / / -. - . - . •pplicant s Mailing Address' y54LZ TPAHJCO 4V%05./9,9 G, 9z63n TYPE OF CONSTRUCTION LJ NEW-❑ ADD' LI A�LTGE�R�ATION LJ REPAI•(i ,/ • , "❑ CONVERSION.-❑ DEMOLISH • BLDG. R Etic�/ 21 L t�L{/ P # - • • Zone Owners Name A0 g' 4-47-622- Phone760•/0 99. - Y DESCRIPTION OF WORK/USE OF /Q ES DFJ'!�� Address . ' 9 - Soft. v' .� . cd Rn-, Dec MH4 " • ' , ? , _ S Main Building: Accessory Building: - Z Arch/Eng. ' I - License No. - - - TYPE OF PERMIT�y, ❑ GRADING1❑ FOUNDATION 0 STRUCTURAL, • T' Front •• i ' . . - D Address, - ' ' =:1 ../. � 1 - • - . : ❑ TENANT _IN ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - B �. - - ' ' N ' Contractor's Name i4t-S CI-ECT¢ a• - Phone.8 74/2f4 -.11J 'OTHER I - - i A Rear I Address lmailingl��Zi 1?48t/C /d.r_296. et 7o& 92630 PROJECT DESCRIPTION SQ. FT.' ' OCCUPANCY• ' ' C Right N G • /�/.fg /J/_ • •- CONSTRUCTION TYPE - VALUATION$ - K Left ' _ City License No. • RJ7 7 7 C!/ ZONE R LICENSED CONTRACTOR DECLARATION - 1 GRADING CU.YDS. ACRES PI09. fl¢f. # • Parking Req./Provided r E t hereby affirm that I am licensed under provisions of,Charter 9 (commencing ' 1 Planning Notes:• ' ' Q M with section 7000) of Division 3 of the BuRemarks: siness antl Professions Cotle, and - my license is in full force and effect. ^ $ • Q - — License Class _ License No 1 Date/- 22 'e 6 Signature' I I i . PLUMBING 1 FEES ' - i . • ' ' WORKERS'COMPENSATION DEC LA RAT,I I Bar Sink Showers •• I hereby affirm that I have a certificate of consent to self-insure or a certificate ' _ • - ELECTRICAL _ _ FEES of Workers' Compensation Irisurance, or a -certified copy thereof (Section Backflow Preventer • ' Service Sink, f 3800, La). C.) ix?. ' Automatic Washer 'Transformer III 15-50 KW Policy No. Company Backflow Irrigation , Sewer Ce ' -' : :, - • ❑ 50+ KW Certified copy is hereby furnished. , 4 p Construction Pole Sub. Certified copy is filed with the city Building Division. I .Bathtubs - . Sewer Connection • - ®, Cooking Unit Meter -i p to 100 amps //����r-�`1 r Date Applicant - i I EXEMPTION FROMt be completed i MPENSATION DECLARATION t' ` �Clarifiefs - Solar Collectors -- �� Dishwasher Meter[Dover 100 amps' ' (This section need not be completed if the permit is for one hundred($100) or - - less). I Dishwasher III Solar Piping • I • Dryers Gas' ['Electric Sub Panel Y 1 certify that'in the performance of the work for which this permit is issued, I shall not not employ any person in any mann¢ so o become su bj to the Drinking Fountains Solar Tank 1 . Fan Motors❑0-1 HP O1'/:-6 Workers' Compensation Laws of Californi I , Date / -2-7_-S 6 Signature Floor Drains 1 , Swimming Pool w/Spa. F.AIU. - 'Ine Solar 09-15-RIP-016-15+ 'NOTICE:If,after making this declaration, you should ecome subject _the. - _ - -_ Workers' Compensation provisions of the Labor Cod , you must forthwith ®Floor Sinks ' . ,Urinal . ' � Fixtures ' comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY , Gas Service ,Outlets Water Closet, Boxes I Device l 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 - - i, -Water Heater - T Outlets Lender's Name- Range ' r Lender's Address - - - Kitchen Sink r - , Water Service ' Switches- I Sign - • ' OWNER BUILDER DECLARATION l ? - , - , hereby afilrm,t hat I am:exempt from the Contractor's License Law for the Lavatories- ci I (Auto-Wash ,• �t • Garbage Disposal • 'Standing Sections - following reason (Section-7031.5'business and Professional Code: Any,city or ' county which requires a permit to construct,alter,improve,demolish or repair P-Trap t: +.Laundry Trays-, Generator ❑0-5 KW ❑5-15 KW Trash Compactor -any structure, prior to its`issuance, also requires,the applicant for such permit - • to file a signed statement-that he/she is licenseencin uant to the provisions of - , a. ! - Roof Drains the Contractor's License Levi(Chapter 9s ons Con).or with Section is x) of - _ • -f ''1 I _ - - ' 1 Division 3 of the Business and Professions Code).or that he/she is exempt r , -I - l therefrom and the basis for,the alleged exemption. Any violation of Section 1 -, „7031-.5 by' any applicant for a Permit subjects the applicant to a civil ' .� - f , •I(_enalty of not more than five hundred dollars($500). - 3 • - •f I .:LJ 1„ mw as' owner of the property or' y employees with aged as their sole M -,RelnSpelOn Fee I ;$15) Issue Fee.' ! $ 1 , compensation, will do the work, and the structure is not intended or offered l - - Reinspection Fee , $15 Issue Fee' $ 3 for sale (Section '7044, Business and Professional Code: The Contractor's • 1 r . c -MECHANICAL I '- . FEES -. - - , - ' License Law does not apply to art 'himself/herself a property who builds or improves • _ - - - thereon, and'who.does such work'h veme/herself or through his or her own ' . - , - - • - • l r ---- ,a DEVELOPMENT SERVICES REQUIREMENTS'. I ' employees, provided that such Improvements are not intended or offered;for . Boiler i i Hood or, Type I I ❑ - , sale. If, however, the building or improvement is sold within one year of com- ' Canopy Type II! • Zoning Approved By Date prove ,.the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground , I �\ , • prove for the purpose of sale). - ! t I Building Approved By \ Date ❑ I,astowner of the property, am exclusively contracting'with licensed con- ! i Duct-Structural - ' Refrigeration System I ' ' • Application Issued,By N v1 ' Data_ tractors to construct the project (Section 7044,Business and Professions Code: ' ',1 The'Contractor's License Law does•not apply-to an owner of property who - -t Duct'Ventilating'-'1 -• • 00-100,000-BTU' 0100,000 BTU -'"- - I 1 'SUMMARY OF FEES ' I • i builds or improves thereon,•antl who contracts for such projects with a con- - , tractor(s) license pursuant to the Contractor's License Law). I am aware thatEll BUILDING PERMIT $ • SMTP $ _ • Exhaust System ❑ Multiple EL System Repair/Alteration - proof of their Worker's Compensation insurance should be provided to,me.. , I PLAN CHECK j $ ' PERMIT I ❑ I am exempt under section ' B.& P.C.for this reason IIIII Firepl/Fact.Bit. ICBOI# ! I. Fire Dampers 'ISSUANCE • $ • PLUMBING ' $ I Date ' I Owner' Heating System& Ducting I i Registers I_ . _- •- PLAN CHECK 25% $ • Q¢ /�• ENERGY11).C. $ I hereby certify that I have read this application and state that the above i , 00-100,000 BTU ❑100,000BT i ELECTRICAL /7.OD GRADING I $ - I • information is correct. I agree to comply with all city and'county ordinances 1 1 I , I ' r , ' $ I , and state laws relating to building construction,land hereby authorize repre- , { I I I MICROFILM $ sentatives of,this city,to e ter l upon the ab•ve-mentioned property 'for ' PLAN CHECK 50% $ inspection purposes. . ' I ' 1 - { Q /i MECHANICAL �1 �� /-12'4( l , i $ TOTAL FEE 'i $ Signature A/- ��f Date Reinspection Fee $15 I Issue Fee PLAN CHECK 25% $ ' Drivers' License ori SS#. ._ .. .. -- - - -. _- _ _ -_.. _. -_ - • - CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 11 .STRUCTION AND PLANNING POOL & SPA PROVALS 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 Conduit1Utility-Undrgrnd.' . - 54. •Forms - - 4. Electrioal:Conduit-Uridrgrnd. 55. Electrical Bohding . t 5. Steel Reinforcement: 56. Rough Plumbing & Pressure Test • 6. Electr.. .. FER G'rnd: .•'.1 57. APPROVAL TO COVER-GUNITE 7. Footings - ;c 58. Electrical Conduit-Undrgrnd. ' 8. Foundation -,,;N' 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 - 12. Sewer Cap • :'I 63. Heater & Vent-Final 13. Roof Drains ;; '� ' '.• 64. Plumbing System Final 14. Stoi.1 ugh-Plumbing ', -,,ist 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. RooffFraming 73. Undergrnd.Storage Tank 0 Gas 0 Oil . 25. Roof Sheathing 74. Overhead Hydro , i 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - - 27. Frame acid Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL . • 29. Insulation 78. FIRE PREY. FINAL' • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ' 31. Plastei Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 4 ;oft' 33. Final.Electric , Notes: s 34. FinaltHeating & Air Conditioning 35. Final Gas Pipe-Test ' 36. Hood or Canopy . 37. Final Factory Fireplace I - - 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final - 41. Solar Domestic-Final . . _ i.,i 42. Backflow Preventer • - 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 No. Date , E n . PROJECT ADDRESS: 195 MAGNOLIA ST ""IT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: BP 055071 OWNER'S NAME: GENE ROBERTSON ADDRESS: SAMEPERMIT NO: BP 055071 PLAN CHECK NO: N GOVT: N SUPP: N' CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE: DEM • ARCH/ENGINEER: 760-8364 REG.ND.: JOB DESCRIPTION : 1360SF 2ND FL RESID, 880SF GAR, 272SF ST SQ FT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC-VALUE: 1 ,000 .00 GROUP OCC: R-3 1M-1 ORBS: 536 ROBERTSON ( 714 ) 760-8364 536 SEAWEARD RD COMMENTS: DEMO SFD REF B55068 CORONA DEL MAR CA 92625 **************************+t***+E***>'F*FF*****FE***********xFE*******FPiF*******+E*EE**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Dale: Signature: MAIN BUILDING . ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby 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 POLICY NO.: EXP. DATE: ' KOMPANY: PARKING REQ: PROV: PARCEL: 42523112 ZNE: REF NO: Certified copy is hereby furnished. El Certified copy is filed with the city Building Division. PLANNING NOTES> Date: Applicant: 1`^ *********************************************************************'********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be compleeed,if the permit is for one hundred($110)or less). DEVELOPMENT S E -R V I C E S REQUIREMEWT S I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of Caefornia. ZONING APPROVED BY DATE: .. Date: ' Signature: NOTICE;If.after making this declaration,you should become subject to the Workers"Oompensation 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: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY. �� T_Z., DATE•. ' 1 1 3 • which this permit is issued(Section 3097.Civ. C). ********************** _ *********** **** **** LENDER: ************************************** *************************************** ADDRESS: LEGALIZATION:N • F E E UMMAR Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason ' • BLDG PMT PLUMBING 'ELECT' IC 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 2 5. 00 2 00 ' repair any structure.prioi to its issuance,also requires the applicant for such permit to lite a signed statement that he/she is licensed r) $MIP/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 , 50 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). E FEE 3. 00 I. as owner of the property 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----> 27. 50 3. 00 0. 00 30, 50 30 . 50 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 30'. 50 OVER/SHORT: 00 for the purposeof safe). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 25.00 5. 00. . 50 X and Professions Code: The Contractors'State License Law does not apply to an owner of properly 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 .N.*.*.*.********************.***************************************************.*.*** 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 D E 'S C R I P T I O N UNIT COST TOTAL COST y s Date: / —l� —C Owner �� '"�� ` PLU 1 SEWER CAP I 'DEMOLITION EACH 2 . 00 2 , 00 do 4 hereby certify that am aware in and understand thellrequirements e of California jHealth with and SstaCode and Sections 2equir 25me ts,andra END OF FEES • per mit andr that or any or o building occupant frm tAiriOu not Ma cag one)need toit.Rcomply with said state i codes and tions are for a permit for provisions construction or modification from the Ouahty Management District.Residential construction applications are exempt from those provisions • Date: Applicant: I hereby certify that I have read this application and state that the above informatio is correct.I agree to comply with all city and county ' ordinances and state laws relating to building construction and hereby authorize reysenlalive • this cif nlee upon he above-mentioned • property for inspection urposos. �/ ���// Dale: 1-13-?( Signature: • �' d� �`'�'�—f}/ Driver's License or Social Security a: 01 0010214 86102142- _TCT 164646 Wlure—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor f}f1TE: 1:.f Ids 41 1 !i'!: 1 i:42 L • , ~' CONSTRUCTION AND PLANNING PO SPA ItAPPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ..4.4lectrfEal CondtUtility-Undrgrnd. - 54. Forms 4.,,Electrical Condui diudrgrnd. " 55. Electrical Bonding it .. Steel F inforceriffdt_ ' - >^ 56. Rough Plumbing & Pressure Test r• ,6; Electrical UFERQrni. 57. APPROVAL TO COVER-GUNITE 41 r,1. ...7.- '1V. Footings t_n+.:. 58. Electrical Conduit-Undrgrnd. .r tC` _ `r 8. Foundation ' •'J' 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 Lint& House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap a - 1Z/33`41 too 63. Heater & VenYFinal , ' ' ••" .- . - 13. Roof Drains ra 1 64. Plumbing System - Final- .• 14. Rough Piumbiijy, - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring . 67. Fencing & Access Approval • 17. Rough Wiring $jgn 68. APPROVED FOR PLASTERING , 18. Rough Electrig'-T Bar:Ceiling • 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . - 'S .�' 7 A"�T-* u; 4 Zr 20. :Rough Factory Replace ! S",r. - - -L Q •+ t PPROWALS DCPenviit# * •)-1 sS ' 'r ':t X I S:- !.=•" r S - J., * . tK 41r.1,At- :> :Y. c. 21.'tud's i $tr' Uig:. . -_ .. rS a - �a y i.,-.S tr >t ,n ,yct ._5 i:.:-i; :. -770. andergrdig:Hy_ro >< 22. Ducts, \entUatin:127. t 2 r . S r .a ' 71. Productsjpipg ©:Ges O(Oil 23.c.Gas:Pipe-Rough 8i test r . uh,Z; r„ y �4 :r X72. Underground Fls ,L; , '° '- j. . 24aRodf Framing tr* E-r- -•=- ' J •- t- CI S733:UndergrntP.Stora e;Jank ©Gas OOri' - •5.. • r x 7 u t :-.-1. :1: 1 .r9 e.:: 25. Roof S eathin z• Y In .ri J cox *� a -• 1-,s-.c :z tL 9 •',, w co.,. 1: 4;:Qverhead Hydra 26.3-Bat Ceiling (Structural) &;jylonocoat W v I1 ' t 75t:1Dry Chemical -+ ;a f o. Dr. Irt 27 Frame and Flashing7,,,, r o b7X x 76,157y StandkDe :-';nn r `11 n I ; .28."Lathing-& Siding-:-.'..."T. c: ;r(ir- t.^. *: >: .. .. ....1 * 771r FIXED SYSTEKRIlsdAL-' 29. Insulation R;t Y ``1 I I I, * 78rFIRE PR EV. FINQL x ,•. .z •: n1 • , .r30. Drywall-Nailing O i. r ~ I I. p m -�~• w•HEALTH=DEPT; REQUIREMENT 1r tr •` ,31. Plaster Brown Coat s I I *-•* ,.79:`F7NALciliiStP_ECTION * r 5f � * -r *t lc - . • , •-32:;Electricat�Power Meter:Final: 'r CU h. * r80.rfOOD CERTIFICAiTE ISSUED J D 533:SFinsl E4tric, c .r, i 1. :� _; ft, '. "'Nous: ;?q ti ^- ti, t�tst D4:-Firtal Heatin & Airr<G'onditioning,; r• * u. { R :. r. +>; c . .S Or-. 35�FinalGa(PipP-Test` •rc i -I^ *' Tia: `xtr �-D "Y .. ' = i 0 ' iii '.`^•.C, r-{ , ". 1-. - . �, :1 I -4. + to - .1 pI .....36. Hood oriCanopy a nI z• - no tr • I Lt.'' 1 -rte -37:C-Final Factory Fireplace^ ' �i* i I ' Ir l- r C * -*t .. 1r a -F .,- '' m* - 1. r :V :38. Final Plgmbing a s. It :. 1 •o t'?39. Water Setvice'Finah- •-• i tr * 1.j•n T rr Ir. • i .. tC • i kr. ;. N .y TAO. GasServ_ice-Final r r S • .s: a G:_, "Littc 41. Solar D.l r-, nalz. •• , 4 -f -o :4 - la ' 1. .42:' ow BackflPreventer¢ '�, y :o jt-- • 4`. r- _ 43. Backflow Irrigations 'r s s ` Ir,� u -' "- - r C. • :;44. Landscape ft igaugn SystemD.:,.1, rr x. to q �,* .. Cr; n1 •� ^r,? :V c. <'45Sound Atte.Uation: -2"- K .. .. >. IC itt : _r1:1 :K - • fr CC 4-•1� Y 46:J1andicag Regulations ,'-. _k 1 •- -- -• • ••c 47:sFftFAL STRUCTURE& BUILDING t ^�• ke :J CrC/l! i9 S o • 481fINJAL PLANNING' _ Y 1 h-' r -1)J 1 f+: • i ti cL * c49,`-Eleciric Release to Edison t r it S. it.: • y R.; Gas`Release.to Soulhern California Gas Co a I � e' `'u' - • 1 o S * Ir _. - r • ow C _- :':51. CERTIFICATE OF OCCUPANCY p ;j0 j. :i' _ No.. Date lillUcilltst. taalne �^ ' 1-2:f—lb (`JOB ADDRESS 195 Magnolia Street BUILDING PERMIT NO. 42347 GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Demo. 7J legal Addition Q)AP No. 117-121-20 LOT TRACT FIRE ZONE VALUE $500.00 INSPECTIONS Signature Date TYPE V GROUP I ZONE R-2 SOIL .. GAS D SUBCONTRACTOR PERMITS ler ISi Date 1 Number Signature WATER Plumbing ROUGH PLUMBING PROP, SWR. LINE f] HOUSE CON. n SPRINKLING SYSTEM MISCELLANEOUS j — "^—, ====,g ROUGH HEATING AND AIR CONDITIONING t .,r ' raj �, ___ TEMPORARY SERVICE OR POLE E P I1 C': Y f f >i •I UNDERGROUND n POWER ❑ n Ii.--*'‘ t; ‘:. I G iE�;`� ROUGH WIRING teat)q and Verft. LItl `LJ/ A_ , 4 TRENCHES [ FORMS ❑ STEEL REINF. ❑ ....'a FLOOR SYSTEM v/ / BOND BEAM [1 STEEL REINFORCE n f nn Tit 1-/..9�/x ,� y 1�o SHEATHING t --- � O U. :j —. _J FRAME AND FLASHING _ LATHING — IN n OUT n PLASTER, BROWN COAT * STRUCTURAL, FINAL (OVER) Electric _ HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL SPECIAL REQUIREMENTS PAW JULn23-76?K47002707* ****10.50 42347 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O,BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only PL AT N FOR STRUCTURAL PERMIT R C E DATE RECEIVED D 'EJAS$�jI�E BUILDING no iiki/ 9/47't %✓Ir u. l- I i — ' P'✓ ^. ADDRESS U/ 2 0 r OWNER \ ,/_ AA / A.P. NO. — �, MAILQ'y^l / ' '.II ' BUILDING /' n ADDRESS 2/ r�Ct/Lp O- �.L 1/.0741(C .I!!. . ADDRESS Fs fit's [ `' . • , (7�' (/�t��/ � 019‘ /��/� f CITV Q� c / .�V [„� No.�J� ,/u Gt/; RAC r--' I iSc/Z i :LOCK CONSTR ION �7� NEW ADD ALTER REPAIR MOVING DEMO!ISH LENDER �'I,�t'I/Le X BRANCH OWNER c/g1$IPJ t✓u� ueP .,x) ADDRESS a /S-4 di /` / VAL /tet r�{,,/� .` ARCHITECT TEL. USE n fl,Yt €0 t XS'a $ fr OR ENGINEER NO. • FIRE ��'/yy ADDRESS [ ZONE T PE GROUP-t �, fujjeb t APPROVED /f_�� �/ CONTRACTOR +x+'/ / / l�'L BY DATE 1 '/%�_ / ADDRESS `.2!'r ,..tt S36/2 U 6 /f�C/.j/ /'\ _ ZO NO.OF USE OF NEW,e/neWe/1 /-- CI�1'- _. �S& Pa 4 / NOL. c_ y a 11,111 _ PLANS' BUILDING / ///.1.. - F STATIC. CITY. YARDS NGD V RDSAPP BUILD • LIC. NO. LIC.NO. MAIN BUILDING ,(, pCCESSORY BUILDING W SIZE I ,v NO.OF BLDGS. (FROM C/L STREET. 4 OF LOT / X /, ..) I NOW ON LOT FRONT F I) / FT. Q USE OF (1� lU ✓ am EXISTING BLDG. 15t,teen.r / _ 4.../nit. ' 11 R.SIDE FTn 1 FT. _ rn VVV Z Separate permits are required fo L.SIDE cif' FT. H electric,plumbing and heating work. RE F FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTAN BET. BET. MAIN& �Q MAIN BLDGS. ACCESS.SLOGS. •/ / .1 a.: VAR.# DATE Q .�STQ%C((//Y�' xi' //d st. / / C.U.P.# �t / APPROVED �7 ,Ar,fiat.. / 147'V oI�//hs9 1yy�cj- APPROVED// ) P(� DATF '7 3 74 ce W 1 / l a • Q I hereby acknowledge that I have read this application and state N X that the above information is correct and agree to comply with m 4 all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of v W the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. . w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN D�fi,V ALUATION IS FOR m Chapter 9, and that such licenses are in full force end effect,or I THE PURPOSE OF ESTAB S �jJ(G/A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION P MI FEE $ and Professions Code, Division 3,Ch pier 9. Signature of •�� w / m t PLAN CHECK $ �� In /J. Permittee A, co .(/c 4 .c-! O/ in ort,h _il — TAX $ LL U Authorized Agent TOTAL PAID $/ a 0 `