HomeMy WebLinkAbout604 LASSEN LN - Building PermitsF�
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applicant to Fill :n CompleteVy — Use Ink Only
BV�LDING/��/„ii�.//�/_/�p ��i.[Gt/
MAIL 7�Q NI L� /�IC�/F.
AODRESS /
CITY �'� Gnd�� TEL.
NO.
BRANCH �Y,�(/�((
AOORESS
ARCHITECT TEL.
CONTRACTOR (p CD M�t�GG�L-
ADDRESS
TEL.
CITY NO.
STATE � �i) ��� CITV
�IG NO. (/ 4C. NO.
SIZE NO.OF 8LOG5.
OF LOT I NOW ON LOT
VSE �F
EXISTING BLpG.
Separate permits are required for
elec[ric, plumbing and heating wock.
USE OF BUILDING AND WOftK TO BE PEfiFOFMED
�i U/(1 � �` a1tl�n
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APPLIG�}'�pN FOR STRUCTURAL PERNIT
FECEIVED Bv OATE RECEI ED pqTE ISSUED
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A.P. NO.
/ -D -D/ P
BUILOING �-�� � I , __ —_ / _
A D D R ESS (.,�}�J f'�„�
TFACT LOT Y BLOCK
N ,W/ AD A T R PAIR
ry
OWNER ��(,.F n
I IA F
'J if/��� GNf/dAW5 //����
ROVED
DATE
(�lE NO.OF USE OF NEW S(� /'r'
)�GQ PlANS 2 BVILDING Gy �DO
VARDSAPPROVEO YARCSAPPROVEO
MAIN BUILDING ACCESSOFY BUIL�ING
FT
DISTANCE BET. BEf. MAIN &
MAIN BLDGa. ACCES3. BLDCaS.
VAR. #�' % � pATE
C.U.P.sie ( APPROVED
APPROVE
�1.�./� 1 r'.... ..- �if � .�'''_• ' ""..".
I �e�eby acknOwledge that I hava reatl thia application antl siate '^
n
thai iM1a above info�mation is ca��ect antl agrea So comply with
m
all 18ws regulatlnp builtling conrtruction, and I shali not emoloy
any person in vlolaHon of the workman's compansation laws of m
t�e State af California. .
1 �eroby cartity thaS I am properly licensetl as a cantractor vnder
SQ. GT, N
the Sta2e of Calitornie Businezs and Prafeuions Cotle, Division 3, THE AMOUNT SNOWN UNDER VALUATIpN IS FOR m
Chapxer 9, and thet such licenus are in full forca antl effact, or I THE PURP�E OF ESTABLISHING A PERMIT FEE ONIY:
am a�ampt trom the p�ovisions ot tha State Of Califotnia Business `�
antl GrofessionsCode, Division 3, Chaptar 9. VALUATION PERMIT FEE S �� � N
�
Signa[ure of � I�/ �L �j�A �� /S` / /� � _ PLAN CHECK y '1 � /� Q
Permit[ee �' � L ��� ���J �l � $��� / QO TA% �
E u
AucnorizetlABeni TOTALPAID 3 %�� ��
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VIIIVCK [-[�LTZER INTERPRISES ° uAit g-20-76
JOB ADDRESS 6�0-608 Lassen Lane BUILDING PERMIT N0. 42516
FIR
�qs � _ I SUBCONTRACTOR
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PROP. SWR. LINE U HOUSE CON. I J
SPRINKLING SVSTEM
MISCELLRNEOUS
ROUGN HEATING AND AI CONOITIONING
TEMPOF4RY SERVICE OR POLE
UNDERGROUND � PDWER CI
ROUGM WIRING
TRENCHES f00.M5 STEEL flE1NF.
FLOOR SVSTEM
BOND BEAM I-1 STFEL PEINFORCE I-1
FRRME AN� FLASHING '
LFTHING - IN OUT �
PLASTEF.BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. FND A.C.. FINAL
PLUMBIN0. FINAL ANO GAS TEST �.
IN/+L
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cmi� 056546
City of Costa Mesa Plai ; Department
Port Office Box 7200
77 Fair Drive
Costa Mew, California 92626
(714) 55fr5245
REQUESTFOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. �� Y' � Date �; —��- / 7
Lot No. / � 9
Address to O y� ���� � �,,,,.�_ ��1'J, l%��o�
The developer of the above entitled tract desires to sell the above
set forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(�+e; she, they) �?� (was ec-taere{�(/9�advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the
City at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless
from any claim resulting in damage or personal injury to the undersigned by
reason of the aforementioned uncompleted condition.
RECEIVED
C17Y OF COSTA MESA
v, • , . . -,_
AU G 1 9 1977
AM PA1
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Tustin, California 92680