HomeMy WebLinkAbout2228 MAPLE ST - Building Permits PROJECT ADDRESS: 2228 MAPLE ST 0N1T' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062434
OWNER'SWNER'SNAME:NOVAK DUANE C
ADDREss: 2228 MAPLE ST PERMIT NO: B 062434 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: ALT
f`A ARCH/ENGINEER:
ADDRESS: REG.NO.:
UNIT: JOB DESCRIPTION : T/O SHAKES,APPLY1 /2"CDX PLY & COMPO ROOF SQ FT: 5, 000
PERMITTEE: CLAIM VALUE: 5,000. 00 CALC—VALUE; 5, 000 . 00 GROUP OCC: R-3 /M-1
' ONUS:RAYr S ROOFING ( 714 ) 559-9369
14571 HIGHCREST CI COMMENTS. SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC
IRVINE CA 9274 *****�E*�E�F*********** E*se+E**** :r*aF*+E****ie� ****+ ***err:r**rft:tftft**:r�Esrsr:E******1E*******
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 0l the Business and Professions Code.and my license is in full force and effect. SETBACKS E DETECTOR
CITY LIC.:019427 STATE 110:361047% cuss 39 nVOK
Date:.4— 2— 9, Signature: _ _ _ MAIN BUILDING j ACCESSORY BU LD C 'a'E)
WORKERS'COMPENSATION DECLARATION: I hereby affirm tha G1Sve acenificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN/ FRNT: FT IN REAR: t ,E2t,4.js'a "YN
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:
i COMPANY: PARKING REQ: PROV; PARCEL: 42219205 ZNE: REF NO:
7 Certified copy is hereby furnished. ❑ Certified copy is Med with the city Building Division. PLANNING NOTES>
Date: Applicant. *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be=Metal if the derail is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N.-T S
I certify that in the performance of the work for which this permit is issued.I shag not employ any person in any manner so as to become /
subjecttothe Workers Compensationlaws.ofCahfornia. ZONING APPROVED -BY _ DATE: - -
-� Date:�. �7—/� Signature: d
NOTICE:II.after making this declaration,you shoo become ed to the Workers Compensation provisions of the Labor BUILDING APPROVED BY DATE, 1 .
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. x
CONSTRUCTION LENDING AGENCY: I hereby affirm that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED BY. —(/or
DATE: r —2.--9 3
which this permit is issued(Section.3097,Civ.C). ************************* *** * ***** **** **** ************** **** * **
LENDER: ****************************************** *** ******************************
ADDRESS: LEGALIZATION:,N F E E S U M MAR Y STRUCTURAL SEGMENT:Y
V
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the lollowing 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 - 72 . 00 5 0
repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
and Prolessions 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 Dl not more than five hundred dollars(5500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, wit 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----> 72. 50 0.00 0 , 00 72 . 50 72 . 50 , 00
does not apply to an owner al 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.II,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: 72 . 50 OVER/SHORT: .00
for the purpose ol sale). 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 72 . 00 , 50 , 4
❑ 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(5)license pursuant to the Contractors'Slate License Law).l am aware *******************************************************************************
that prool of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.s P.C. INDIVIDUAL F E E BREAKDOWN "/
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 / 5, 000, 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 wit/will not(circle one)need to comply with said state codes and the requirements for a
•
permit for construction or modification from the Air Ovally Management District.Residential construction applications are exempt from
these provisions. • `,
Date: Applicant: --11
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
IN
ordinances and state laws relating to building construction and here authorize represen lives of this city to enter upon the above-mentioned
property for inspection p
urposes.
_ Date: 6—.2- 93 Signature: 01 00140301-00140302 TOT 72.50
Driver's License or Social Security 4: DATE. 06/02/93 TIME: 14:13
1641-46 white—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING PO. SPA - p 1
I Date I Inspector I Date 1 Ine ector I
APPROVALS Permit g;• • I I APPROVALS Permit p
i 1 1 I
1. Temporary Electrical Service Jr Po.e I 1 52. Pool & Equipment Locat.un
2,,Seli PlarUr.drg;nd. - 1- • 53. S-014 Reinforcement
j.-� . -- -------nom _-Y- - - --- t-- --'
3,•F-actrlra. Cor butt UZ'rv.Lc-r{':.o. ' 54. Fn-nn I
_ w:F:ectnc:.' •
Conduit- �J c•nd �--- -
�,Y' 55. Electrical cal 6-ending -�-
1.
_Sfi -St5_'' Re '.:c-:'_:3'-it 1 I 56. flour,'" Plumbing & Piessu:e T "t I
'It rE..it _ I•:-. ,:F C ?rd - -i- - --I - - - ---I- 7 APPPROVA1 TQ COVER CL'.. TE
4..117 tPcat. gs :7-b7 .1I 58 Peet-Ical Corti l t-Lr_IIg no
I-1 ...n-- _"-
. a'�_ -_ '_ :
•
8. Fnu tlaUon f- 59. Gam; P p:-, r , L ulrgrrd.,T:st ------19. ;':V ucLn,'ater Pip? Undreird, _ _ _L _L_-___ 60. 3eeIp...dsh Liss, P.TrJo, ' L d•n "d ! - _- __
10. S1 Floc• Systun I 1 61. APPROVAL TO Df CIC ! I
11. Pi Riperty S.•v.',r Link & la.-4.1 s I Connection 1 62. Back'.-/hh & Rec?ptu•.Fuel 1
v , -I
12. Scr-cr Cep I 63. Healer & Vent-Fini.l !
-i- -- -
13. Root Drain; 64. Plumbing System • FinalI ---�
14. Rough F,um.n nq 65. Elcctrical•Final T 1
-- -- - ...
- --- -- ---` - - ------- ---- -- - -- -'----- '--1
15 Rough Elect(cy-Condu.t 66. Solar System-F;na, I �
16. Rough F!ectrc Iris -�---- --- -----" -_ - 1
9 9 _ j- 67. Fencing & Across Approval _I
17. Rough Wiring $tgn 68. APPROVED FOR PLASTERING ,
18. Rough Electrica•T Ba• Ceding 69. POOL/SPA SYSTEt..S F'NAL
19. Roush Heatin & AIr Convi7tionily _.FII DEPT. REQUIRF7N.ENT
i n -. rI C:a. i .r _ tY .r ., SLI A._ * - .. �. ...
rh Q,- .: x •-.'--#tel_"=-[) ., x x Y r' •
20.;z-n.ign F.ctgr Reek'.o_ I i r ,G •i I I r.. a ,SPPRIIVAGF;'--.0Por.w>tt -.: - :--v-.
<_ .1t _•'„ r+-f•--+'CS •
« .---+ ._ - . •;,^rv+L-.,..r a_r -� 1 1
71.'-Duct, it-Stritctuin'r I •• •• --S I x > I -'n rr' ? 1
I-, s, ;-.e i S.. c !� C:.g tt '70_lFr�dcrgrNild:Hy.do
22..Du�, 1{ant Ittlnlf;* . eg .c. t_ rt I r -, x .}J1. Product-Pi9irg cl Cra. :2011 ,
D !-------3:- _-_i-��_ -17o- -r-,4i-'' ;-- n -r--c.-U---:c.----•ter -1
23. L_:vPipa-Ro,.dh & Ft st I 7 S :' ?+ tr a r'* *it-72. Undergro rJ Flu 1C t-- 0 i
24.'rtoe. Fi sting• e>±::„
' F:, .. C z N� tth 9 d4? C'' -I
173.x... ndtr rnd Stor- rt k tz:Gas -•U-
--- 3--=t-r----s_-- ..3r :+ to-l-E3 -tom ----;'FVC- ' - --i----1 --•
75 R ,:.*Si-S1l h.cp :a S
''4‘ 3 fi 7 .�-•__n 74COccrhe.id HynroG -r1°• _-_ __-_
2C - �# C 1 'r .St u & 1.:a - 5+ , .: ::x �` -*� '•r. --'1
1 V -I'. 1 Pir l T (� y 1 J•, x 75...eta* C,1UI11MJ _tom X.
4..4 01 {
�.-_-._t �-Y,-i�-• -- -_ ca -_l II t > sax 71 6. Dry St.mJF:rt -t A C , --- .--1-
1 --•
1 h J t' -- r. N Q:r 7. I s_ .. I .. .. * C t, r 1-_ -
8 _. Mng•„ SH: -0 ��: O x ••x r- /7�-7FI --- S•.'.t - ---,U ;:ALS : C: I 1
Pf to r+. - 1- -- -- --ter ` -
7.3. ;14.!,t*. •___I__,-..ti--' ---C--------1tom --- "tl 78 ;E PREV. FI YAr� � ? x r
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''30. .^. r.. : •.'`T.y -e'-, _ x ,^ •
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-r- - - - -Zr_- 1_-. .. .,z 'i- -C- - -' S' t-4.:. - --- ---.
X31. PI!At E r.:r Co.) • •-c r T * < X tr79. FINAL INri2 T!'x'. J`'
-•3- - -t•-Lam.-u-._ iE .t= - - - -- -- --n!-!- - - - •'-'- - I. ; --- ---
`r32L114r, cc P.'.t..a' ..�'''i_TEC`1./ a. . ¢ .l 1 '60_:'�Ci Q'1 CEH IfI0CT:- Sit 7 1 .
?�3. 1r EI !.,p x r d * • ' I Nails: -: :..0 * - .. .= r
-•+.___.•_tom_ • -
1;j94 },ns? k.-ct1,:;3,': /,l4c,i+3I-orha7: tr i 1 .r c .5 c- i s .
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35.1•'•Fin„I Gtr Pipe-TgSi•. ;1 •� ! .-. I .k r S:: t
-36. Ho.F o:•'Cenopy rx r•ti a :. C " v. : x r c Ti t J.
L-T7. irCJ.FacJory r-1r3Flac. r. i '1 I- ' a X ----- -----
1 3, - ^ {I .. a 1-' --- �- -- --5•J-- -- -- -
38. F1n P.umblr.g ,* ns.
r xtrz x
C. 3. \'tater Sevice-Fin�'; •Z - ,- r I . .. c • * s. S I
• - -� ••. '--�J '
. Ga S_raica"ins ,* Z .i x - a C'' J: 1
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41. So' r Dermeslto Flay] 's -- c�'- - t r -S'_, - .rc
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42. 8ac'tfIo Prevont ry vw i a r c - t
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43. 9zckflo.. IrrIg1t:u;� . I, t ( ,: w - - •
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-46. Handicap•Regul:t cr. C '. 'o •
n7. SINAL ST2 TOE & BUILDC•G ▪ 1 1 ' Vwl/%--_
48 �INALPLANNING i I* x _ , L - - -I
�-;49.Elee`nc Rel sr. to Pisan-- ___ "(..- �_ . l'14-7
, ? ___--_-- _.I
•
50. Gas Release to Southern California Gas Co --r-l• • 's'� - '�,�
s y �y
51. CERTIFICATE OF-OCCUPANCY ' _.. . .. -
Na. - Date •
J . 1
FEB 24-70M°0O 691RZ.4****Z5.00
CITY OF COSTA MESA PLANNING APARTMENT
A. p. No. - . "• ,.. ;' . '`r. .- Fj r
Bldg. Permit No.
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address '" s'.t' 1,(fiz `, t t .
Owner's Name ti r",r'i ;.a•V
Bachelor or 1 - Bedroom Units = •''� (r) @ $25.00 =
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
- Bedroom Units @ $70.00 =
5 - or more Units @ $75.00=
Total Fee
Total number of Dwelling Units .",S<f='.t!
'Planning Department Approval Date. " ' /0 Park Area No. it
F
By Applicant's Signature.. ,. _ ¢ .',w,
CITY OF COSTA MESA PLANNING DEPARTMENT :FR24-7CC115�O0 691 J****25.0
A. P. No. //S — 08z — OS
Bldg. Permit No. 1/(1-sec>"'
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 22 Z 8 MAPLE STREET
Owner's Name £2 6044.1) /J/4fZOA'
Bachelor or 1 - Bedroom Units OMS 0) @ $25.00 = 2_5:670
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00=
Total Fee a S.to)
Total number of Dwelling Units Z S.O O
Planning Department Approval Date.2 - 6- 70 Park Area No. //
By Applicant's Signature Qysya-e_,-‘742-11
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•
OWNER RIMER, JACK C: DATE 32_13_56
JOB ADDRESS 2228 Maple St.- - - BUILDING PERMIT NO. 4095
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 9,268;00 •
LOT 5 BLOCK TRACT 2966 Single Fam. Rea. w/ att gar._
C. .UP I & J TYPE V ZONE Rli FIRE DISTRICT 4138
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench 1
Foundation Forms and Grade to Gara e
Rough Framing r 1 - ' , y
flY /ft nn n y
Plumbing,Rough to Slab s IRA
3 1 _'2 R. C.- -r-L1� _ /.2 -/S'-,S6 / 55 7 —
Plumbing, Rough Complete gi+1' -/ -.S-7
Temporary Pole
Wiring, Rough FF7a • 19 t 1, iitu�-, .
-,. ..--../ JAN 1 0 195' 3rr'O —
Heating,Rough lJ/1/✓
Heating, Final • ,/„ AZ.,A7. / .Z C-7---
Sewer,JHouse, , / ewer, - /- ''f t , ,,r_,,,,,,"o /--2S— 7 /_d' 2 '7 "-
Septic Tank or+Cessp••1/
Lathing, In lei 9Out Isla I-242_
lir
P' '^ring 07 tV,A s7
F. .Ding,Final,Fixtures Complete ' 5 - 3-47 •
Plumbing,Final Gas Test/S- MOS e_er_Zijve-✓ S . 3 -S-7
ja./
Wiring,Final , APR 1 ' 1951
ii i, `r_ i _C1 _ mss.-��C.....01
Occupancy 11/M7 S
/
FORM 210 3M 10-53
Costa Mesa Building Department I APPLICATION FOR PERMIT
,f; P. O. Box 317 ae :gg BUILDING 1
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 1 Receipt No. Permit No.
Building
Address 2221$ Maple Street 49 is
Costa Mesa, California Received by Date Recd. Date Issued
Nearest '�� /42, ^/. .1 i// /A -/3-It
Cross st. Wilson Street Building
C. Hirtler Address
Owner Jack
Mail Costa Mesa, California
Address ME 419 D. 17th St. Nearest
Tel. - Cross St.
City Costa MesaNohi. 5-1159 Zone,e I No. (/
of I Type ,/ Group vy.
Architect or Lic. Plans
Engineer Carl son & Midal ebro&i!• Approved
by Date
-4dress Garden Grove CORRECTIONS
City Lic.
...ntractor Dike and ColegroveNo• 4615
Address 41q E. 17th St.. Costa Mesa - -
Legal I Lot
Description No. 5 I Block Tract2966 -
(Attach Metes and Bounds)
Size of Lot 65 a 96 1No.Nowof onBldLogts.
none o
Use ofNo.of 1 No.of„3. M
Existing Bldg. none I Families I Roomt$ 5
Setback Line from Rear Yard 301
Center of Street 50t Side Yard 50 y
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
0
Repair I I Moving I I Demolish I Ci
Building No.of „.: W
s>>e 1051 sq ft.Rooms 5 Stories
'dor WallRoof
stunering_ stuI Covering Camp. & rod APPROVALS t
Use of New
Building Sin amily residence Foundation Location Inspector Date
e Under-orms, innerials,
ee,�„ , ander-Pinning
Plan 63on a _ Frame: Fire Stops,
Bracing,Bolts C
I hereby acknowledge that I have read this Application CD
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating 11
building construction. Lath.Ext.
Signature of
Permittee _ — Plaster, Int.
Authorized Agt. Ae �� or Plaster,Ext. �'
Valuation Permit Fee $ Masonry Reinforced al
Plan Check$ .��I I Bond Beam
$ ?, .2C g— FeeTotal CD
$ O FINAL
/ O
-re
'71k
:i• ;:^ . r.r • 4,7.: -
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Street
717
C".
PLOT PLAN
Show location and distances from
••
c—: property line and between buildings.
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JOB ADDRESS 2228 Maple Street BUILDING PERMIT NO. 31438
pGENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Add Bedroom, Kitichen 6. Dininf
AP "11.115-082-05 LOT 5 TRACT 2966 FIRE ZONE VALUE $ 6,000.00 Rm,
IN CTIONS Sign ureto GROUP I TYPE Y ZONE R-1
GAS �',Y,W
- 7 7° SUBCONTRACTOR I PERMITS ISS ED
GAS K !�(-j Dote Number Signature
WATER / Plumbing
ROUGH PLUMBING /� �/'t0-7Q // �,yA/`y�f� 1 7:� b-75677
PROP. SWR. LINE HOUSE CON. V A/[/, I _j0 �a� /SQ- ..„ f-_' S S6L
SPRINKLING SYSTEM ���
MISCELLANEOUS c
ROUGH HEATING AND AIR CONDITIONING /&. f-in.70
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER 0 y
ROUGH WIRING A// F-1J� Seatin nd V t. K^/ Ac
TRENCHES E FORMS i& STEEL REINF. 0 la-a& C!/7 .Ie J 7- /J�
FLOOR SYSTEM /! g� �t�/ 1yZ-7r 74/
BOND BEAM U STEEL REI F•RCE •
SHEATHING &I, ,' tl lib 7> rrr_
FRAME AND FLAS 1 .� (! U / � /9f6,7 79O
LATHING — IN r; '}t OUT Air cal A //
PLASTER, BROWN COAT O (A731 7 0
PLUMBING,5- 'TURAL. FINAL
FINALRAF AS TEST 1•-1rJ� J/ � /,--
/3 7 Cc(/fl' 8/7-76' e?_/ SI
ELECTRIC, FINAL 17- t JJ
BUILDING. FINAL O 1
f'
3143
•
PAID
690* ****48.00
COSTA MESA BUILDING-SAFETY DEPARTMENT FEB 24 7G
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RFr E V DATE RECEIVED DATE ISSUED
BUILDING s( '/f EP B 2-6_ 'O a aa�-7-
t D
ADDRESS Z�ZP `70a ea r9T,...te-_
/ /� 140,_...S0.-4_,/I /n/ l �C—ofl — PE MIT,N
OWNER �6LC]Q.5,,.1/ LLr2...S0-vL,/ A.P.APDIN ��y�r�
MAIL ` 666" ��� —_____ BUILDING zZ Z8 Atnd fir s/�C6r
ADDRESS SC.—'— �- ADDRESS
d U `,. TEL TRACTZ.9f 6 LOT r BLOCK
CITY($ 54CQ fl.( Gj� NO.6,9'6-I ZJ�
I— Z
Z C CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI ISH
O N LENDER
am
BRANCH
— `�
OWNER FJ Agnew
W ADDRESS --
CL ( .+ A / ,s/q LUE
_Ls,
Q ARCHITECT JII'' TEL. USE s/��icJ�/6Y''..Y/ .OlCfl$t $/K).UVQ
N OR ENGINEER ((90. t k in S NO. 5/r-3r4/
z Q �f t FIRE T'
w It ADDRESS 7S/o /0J. /g TR s+-, cc..YYI. ZONE 7/..11.4
,,,,,,///TTYPE �J GROUP �.L�
W Z CONTRACTOR �t(T2�4 h , APPROVED %y� `7 ATE 2-2 —70
—10
// J`\
CO Z
J c0 ADDRESS
u.lLu TEL. ZONE 0 NO.OF USE OF NEW 440int�
ZiCITY NO. A —I PLANS BUILDING K,-ttc.,s /�
Lu—O STATE CITY YARDS APPROVED YARDS APPROVED
to CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D 0 SIZE NO.OF BLDCS. (FROM,CI/yL ySTRE�yj1
( Ex tr TirF-
OF LOT I TG NOW ON LOT FRONT/17744Y
r44T. FT.
—
USE OF
EXISTING BLDG. —O(-c,C-t/Ir f C/, B.SIDE tr. FL ---- FTS
I— SIZE OF NO.O7 _
2 NEW BLDG. ROOMS STORIES / L.SIDE FT. FT. _
Cr
EXTERIOR WALL ROOF 2O 3 "f
COVERING COVERING REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
MAIN BLOCS. ACCESS.BLOCS.
Q ,�J { // VAR.ak DATE
O /1' /AS/-B✓' 14120 tit, /I /,�i � C.U.P.qW APPROVED
I— n APPROVED 2 _-G— 70
z A N L147 A re-al • �Y DATE —
'i 0 I hereby acknowledge that I have read this application end state
Dthat the above information is correct and agree to comply with
cc all laws regulating building construction, and I shall not employ
any persoO in violation of the workman's compensation laws of
US the State of California. 4/1 m
I hereby certify that I am properly licensed as a contractor under 31� SO. FT. o_
the State Of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9. and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business VALUATION
and Professions Code,Divisio 3,Che ter 9, .
C.)
00 PERMIT FEE $ Z t D O n
V QQ 0
Signature Ofe..... 7 /
Permittee //� / S (p, DO0 PLAN CHECK S /4 r d E
/ 0
Authorized Agent / Op LL
TOTAL FEE $
COSTA MESA BUILDING—SAFETY DEPARTMENT *- o` tff 15-71icp5y001275 0****x=3.50
7 P. 0. BOX 1200
Costa Mesa, California ��.PERMIT NO.PERM
PLUMBING PERMIT-APPLICATION TRACT NO. RECD. BY
CONTRACTOR Iaytnn Snft Water, Lac LOT NO. DATE ISSUED
BUILDING USE P 41/ /
Address 502 South Lynn St4 ie
City SAnta Ana Tel. No.547 617s BUILDING 2228 Maple /We,
State License No. Class. COSTA ME A. CALIFORNIA
Q / it99� ) rrl rl NEACROSSSSr.
w City License No. --147-9— //CC' -
I— a� OWNER Fred Mason
< NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL
0 Water Closet(Toilet) ADDRESS i
Bath Tub CITY Oas t a Mesa 1= . TEL. NO.
Shower I hereby acknowledge that I have read this application
Lavatory(Wash Basin) and state that the'above is correct and agree to comply
> Kitchen Sink with all City Ordinances and State Laws regulating
-JLaundry Tub or Tray plumbing. .
UI I • - I certify that I possess the above valid state of Cali-
1 Service Sink forma classification or I am the legal owner of the resi-
0 / Floor Sink dential property described above.
CC a ,' Floor brain Signature o/ La ton ' ft Water, Inc .
Dishwasher Permittee �/ , ,A ,a. --
Z Drinking Fountain .
W Urinal
= GarbageUisposal INSPECT ON RECORD
Autom Lai c Washing Mach.
/ Water Softener i - — 1 . 50
2 Water Beater& VenE
CC lReceptor
W
D_ Swim'Pool Filter System
CC Gas System . . . Outlets •
D Lawn Sprinklers
O Installation or Alteration
Water Piping APPROVALS
Back Flow Preventer
- y Prop- Sewer ft.
INSPECTOR DATE
(louse Sewer Connection U/G Soil
I-
F Cesspool, Septic Tank U/G Water
Services—Water O Gas 0
Miscellaneous Rough Plumbing
Sprinkler System
__ Gas
Property Sewer
Pool Receptor
Filter System
Pool Heater
Miscellaneous
Issuing Permit 2 00
Final Gas
TOTAL FEE I 3 5 0 Plumbing Final I -Q 2 14 -'ev
Utility Co. Notified !`
FORM OU-3A
BLDG. PERMIT NO. V