HomeMy WebLinkAbout410 LENWOOD DR - Building PermitsPHOJvECTqDOflESS: 91O LENWOOD DR uNiT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06889t
� OWNEH'SNAME: CI-IAMBERLAIN HYRON K TR
nooRes;: z535 W COASf HWY PERMIT NO: H 068898 PLAN CHECK NO; N GOVT: N SUPP: N
NEWPORT BEACH,CA 92660
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
642-5174
FPCHIENGINEEX: NEG.NO.: SOB DESCRIPTION ; T/OFF RESHT. REROOF W/FIHERGLASS SHINGLE S FT: 9,675
p00XESS: UNIT: Q
� CLAIM VALUE; 4,675.00 CALC—VALUE: 4,675,00 GROUP C7CC; R-3 /
reemmee: FAIRWEATAER ROOFING (71' � 7
nooeess: 3845 E CASSELLE AVE COMMENTS: SMOKE DETECTOR REQ�UIRED PRIOR TO FINAL
ORANGE CA 92669 ' �*x-x��x***x*�r�r**��r�r*��+�*�r*�rx� i�**�r�r�-***+r**�r+r**x��*�*�r�r�ir�*x�****�r*x-****+r��r�-�r*+r**+�**
LICENSE� CONTNFCTOH OECLABPTION: I hereby d��i�m Ihd� I am IicenS¢d und¢� prOvi5i0n5 0� Chdpt¢t 9(COmm¢nting with $¢C�iOn 'L � N I N G R E U I R E M E N T $
7000� of Div,sion 3 of �Ae Business ana Pmlessions Coae, an0 my license is in full force and eHect. S E T B�A C K S
ci�ruc.:/7�� �gZg STRTELIC.: SLSSZS ��'�.0 39 EXP; 06/95
.J_��S �/ Signature: �������--- ------------ MAIN BOILPING ---------- -------- ACCESSORY BUILDING
_ _'—______
WOBNEHS'COMPENSATIONOECNNp710N: Ihere6yaffirmihatl�aveacertificateofconsemmsetl�insureoracertilicateofWarkers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensationlnsurance.oracenifiedcopyihereo�(Sec�ion3000,La6.C�. j,$FZ': FT IN RGHT; F'T IN LEFT: FT IN fiGHT; FT IN
POLICY NO.: E%P. DRTE:
comraNv: PARHING REQ• PROV; PARCEL; 42514303 ZNE: AEF NO:
❑ Ceniliea copy is nereby Wmishea. �`,' CehifieU covY is filetl wim the ciiy Building �ivision. PLANNING NOTES>
�y,w
r �.
�ate: APVlicanl i! 3(-iE iE iE iE iE iE ik iE i(� iE iE it� M iF iF if iE it iE # it fE iE tE iE ik �E i(� iE iE 1E ik iE iE iE N-fE aE fE �IElf iE iE if it 3E iE i! iF iE iE 3f fE if if i! iE iM1 iE iE iE if iM1 iM1 iE iE iE-0f iE if iF if tf iE 3E iE ih
El(EMPTIONFPOMWOBNENS'COMPENSATION�ECLABATION: QhiSseclionneetlnotbecample�eAiitliepermi�isioronehu�rcd(511p�OrIeSS�. P E V E. 1. � i� M$ N T $$ ii �� 1 C$$ ji E Q[) I R E M E N;T $
I cenity Ihat in Ne edo �ance ot Ihe work br which t�is permil is issuetl, I shall noi employ any person in any manner so as to �ecome r�
sublecllolheW ker Co�moensationLawsotCalitomia. �1� ^ $ONING APPAO�.iEL1 BY DATE; ^
.. � /� � Si9nature: ����(� .y
NO710E: II, atler making Ihis Aeclaration, you shoum become suhlem m �he Workers' Compensa�ion pmvisions o� ihe labor i3 U I LD I NG AP P ROV ELl B Y DAT E;
Code. you musl fori�vn(h comply with such pmvisions ar t�is permi� shalt be OeemeO rewke0. '
CONSTBOLTION LENOING AGENCY: I �ereby affirm ihat there is a conslmction lentling agency for t�e performance of ihe work lor �
which mis Dermi� is issueo �Sepian 3097, Civ. q. APPI.IC�1"1�ION ISSUED BY ; ` _.
it*ititf�at*w-*ftie�t�tit�it**iti��x-�t+r�F'iF'�i� r r �e �� �* e ***�t*****�- a i x ���
LENOEfl: �E af �IE iF iE ik iE jf-9E 1E iF aE iF iE iF iF 1E 1E iE iF iE iE iE if if 3E iE fE 9E iElElE jE it jf iE iE iE 1E �E 1f if iE ik iE iP iE if 3F fE iE iE iE iE iF iE iF iE iE iF 9F iE iF iE �F jF * iF iE �Y: iE iF iE iF iF if iE �!h
aoonEss: LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OwNEBBUILOEBOECLnBnTION: Ihere�yanirmihatlamexemp��mm�heComracmrs'SiateLicenseLawforthetollowingreason BLDG PMT PI.UMBING EL$CTRIC MECHANIC FIRE SMIP/RES GRI{DING
(Seclion 7031.5 Business antl Pm�essional Cotle: Any ci�y ol counry whic� requires a De�mii to cons�mc�, alier, impmve, tlemolis�, or p ERM I T % Z, � � , 5 Q
repair any S�mtWre. Orior Io ils i55uante. als0 requires Ihe apPlican� Ior Such permii �o �ile a signed statemeni Iha� helshe is litensetl
pursuant to Ihe pmvisions o� �he Conirac�ors' Sta�e License Law (Chap�er 9(commencing wilA Section 7000) ol Division 3 0� Ihe Business SM I P/ NON—R ES
antl Pm�e55ion5 Cotle� Or �ha� he/5�e i5 exempt ��ere�rom ana Ihe basis �or th¢ allegetl ¢eem0�i0n. Nny violafion Of $ettion 703L5 6y j�j�Arj
any applicani for a permi� SuUle��S �he applican� �o a civil penalry o� no� more �han five hunOreU tlollars (E500�. i S SUE FEE
i, as owner oi tAe D�oDeny or my em ioyees witn wages as ineir soie campensation, wiii tlo me work, and ihe BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ stmcmre is not mtended or oueretl mr saie (5�ection ioaa, Business antl Pro�essional Coae: me Contractors' State License �aw TOTAL S----> 7 2, 5 0 0, 00 0, 0 0 7 2, S 0 7 2, 5 0 , 0 �
tloes not apply �o an owner o� a pmpeny who builds or improves �hereon, anU w�o does such work himself/herself or IhmuAh
his or her own ¢mploy¢¢5. provitletl Iha� 5uch impmvemenii are n0i in�entle0 of otleretl �ar Sale. I�, however �Ae huiltling of � '
improvemem is sol0 wnhin one year a� completion. �he owner will have the buraen of pwving he/she ditl no� huild or impmve R E V ENUE D I V I S ION TOTALS --> COLL ECT ED • 7 2. 5 0 <OV $R / S HORT '
m�meou�ooseoisaiel. BLDG PMT PLOMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner ol the pmpeny. am exclusively conlracting with Iicense0 conVactars to consimcl �Ae pwjecl (Section 7044, Business 7 2, Q � ,'�j 0
❑ ana Pmlessions CaOe'. The Convactors' Slate License Law does noi apply m an owner of D�oPe�Y who 6uilds or improves Ihereon
antlwhocontraclsfor5uc�proleclswilhacontraclor�5�licen5e0ur5uan�lolheConiractors'StateLicenselaw�.lamaware �.X..K.*.*,*.K.,�,*,*.,K,*�.k.,�,.�,*..�,.K„x,*iEiE,IE*i(,%,k,�il,K,�(,�(-i�,�E*i(-{�,f(-,)E�,�E,1�**,k„K„x,�,if,k�lFit,�,k*fEil��,�t-*****�E,%iE**!t*i(,ili�*.�..�.�.
Nat proof of ihair Worker's Compen6atlon Insurence should be provitled to me.
� i am e�empi under section. e. a P. c. I N D I V I D U A L F E E B A E A K D O W N
roneisreason: TYPE �TY D E S C R I P T I O N UNIT COST TOTAL LOST
oate: Owner: '
Idohereoycendyina�Iamawareofanaunders�antliherequirememsofCalifomiaHealihanaSaleryCotleSections255�5,25533,an0 SFR 4675 REROOF BY VALIIE RESIDENTIAL NOZONE 1,00 4,675.00 /
2553a ane Inat I or any fuiure �uilding occupant wiluwill nai (circle one) need Io comply with saitl slaie cotles antl the reQuiremen�s �or a END OF FEES �
permi� �ar con5imction or matlificalion Imm Ihe Air �uality Managemen� �istricl. Residenlial cons�mciion ap0lica�ian5 are exempt �mm '/
Inese provisians. l/
oa�e: noPrca�c 01 4C71673?3-601673?4 T l� T 7q, ��
I here6y cetlity ��a� I �ave reatl Ihis appliw�ion and s�ate �hat �he above intormaiion is correcL I agree �o comply wilh all ciry antl county DHTE� 09/ 15l94 TIf1E: 10 � 2E
ortlinances and stale laws relaling lo builamg constmction antl hereby authorize represen�a�ives a� �his ci�y lo en�er upon �he above�men�ioneU
pmper�y for inspe �ion prposes. ^ ,
. • -( SgnaWre: � �/�
Diiver's License or Social Securily wr
qpplsant: Plnk—Revenue; Goltlenrotl—Assessor
:
CONSTRUCTION AND PLANNtNG POOL & SPA
1' APPROVALS Permit# �ate �Inspector AppROVAI.S Permit?k Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipmenc Location _
.. -
2. Soil PiPe�Undrgrnd. 53. Steel Reinforceme�t .
3. Electrical ConduF Utility-Undrgrnd. 54. Forms
4. Elettrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinfo�cement 56. Rough Plumbing & Pressure Test
6. Elect��cal UFER Gmd_ . 57. A?PROVALTO COVER�GUNITE
7. Footings 58. Eiectrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, G� Uadrgrnd., Test �
�
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, C Undrgrnd. .
10. Structural Floor System 61. APPROVAL Tp DECK
7 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Firial
12. Sewel Cap 63. Heater & Vent-Final
73. Roof Drains 64. Plumbing Syscem - Final
14. Rough Plumbing 65. Electrical-Finai
15. Rough Electricx6Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wirin9 Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOLlSPA SYSTEDAS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENS
20. Rou9h Factory Fireptace � APPROVALS Permit #
21. Ducts,in Structure ' . , 70. Under9round NYdro
22. Ducts. Ventilating 71. Product Piping QGas ❑Oii
23. Ga: Pipe-Rough & Test � 72. Undergrot�ad Flush �
24. Roof �raming ' 73. Undergr�d.StorageTank �Gas �Oil
25. Roof Sheathing . � L� OiD � - 74. Overhead Hydro I
tr
26. T�Bar Ceiling (Svucturaq & R4onocoai 75. Dry Chernical I
27. Frame and Ffashing ' 76. Dry Standpipe S
28. La.hing & Siding . ' � 77. FIXED SYSTEM FINAL
29. Insulation � � - 78. FIRE PREV. FINAL
30. Dry�vall Nailing . , HEALTH DEPT. REQUIREMENT
31. Plaste� Brown Coat � 79. FINAL WSPECTION �
32. Electrical Power Aleter�Final • 80. FOOD CERTIFICAT'c ISSUED
33. Final Eleciric � � - Notes:
34. Finai Heating & Air Conditioning - - ,
35. Final Gas Pipe-Test
�'
36. Hood or Canopy �
37. Final Factory Fireplace
3$. FinaV Pl�mbing �
39. Water Service-Final .
40. Gas Service-Final
41. Soiar pomestic-Finai
a2. Backflow Preventer � �
43. 8ackflow Irrigation
44. Landscape irriqation System
45. Sound Attenuation
A6. Hand�caP Regulations
47. F(NAL STftUCTURE & BUILDING u�j y�
48. FINAL PLANNING � � ��
49. Electtic Release to Edieon .`
50. Gas Release to Southem California Gas Co ,.
51. CER7IFICATE OF OCCUPANCY
No. Date � �,
_ .^ r�vv...^.�. ... ..�..•••••••ra..�a cn.�v. ....�ac wun�n neaq ..o.oce unef anu nYn au aV V�oY�m�� ..=...o.a.�v.�.. I BJ
5599 9/IB 46087 '
� CITY OF COSTA M/EISA CO/N.ST'RUCTION PERMIT P MIT NO. TRACT NO. LOTNO. � UNIT NO. . , - ' .
,
Project Address Y� � .�G�W�O� �1� �(E � - 30 3�f�2 �I � ,� , • � i , . , �
Applicant's Mailing Address S 11 A.l��. TYPE OF CONSTRUCTION NEW /aDD �ALTERATION REPAIR
' ^ 1 t ` ❑ CONVERSION ❑ DEMOLISH ❑ OTHER /� i -
Owner's Name `l PY1Y11� .H O �, v� tl Phone 6�F �-�FF , A.P. #_4 L�7 '�. I 3' -� . 2one I ' _
DESCRIPTION�j F�WQ RK/USEOFg� D�G�.
Address �f/U �(,eniwoo s� �r•�/s �l�Q/LqC.'E' SFfL�, E'4hL' /�� S MainBuildin9: AccessoryBuilding: ' �
Arch/Eng. �• '� License No. TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front �� � ' p
Addre55 � �' � ^ ^�^ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 6 R¢ar ' L � . � N
Contractor'sNamP D�%���� Phone OTHER . A _ ,, _ , ,
I
F- PROJECT DESCRIPTION� 5�.� ���8 oCcuaa.ncv .:�1' � K Right � -r'j , G
Address Imailing) .ff��. / _ • i
�, : � CONSTRUCTIONTVPE � VAIUATION$ /¢�'`+� g Left �/
City LicenSe No. "' 20NE GRADING CU. VDS. ACRES � E
LICENSED CONTRACJOR DECLARATION Ping. Ref. # Parking Req./Provided �
I hereby at/irm fhat I am+licensetl untler provisions o( Charte� 9(commencing Remarkz: Planning Not25: �.t. ' I� M
WI(�I SCCll00 %Q��) of �Divislon�� 3 of tM1e BII510255 dfltl Professions Cotle, antl T
Ty IIC2fI5C IS Ifl }p�� (O�CQ d�tl Qii2CI. ' , ' � I l '
LicenSe Class �%� � LicenSe No. S
oate Signature. � PLUMBING FEES �
wORKERS' cOMPEN9AT,lON DEClARA710N ' Bar Sink �Showers ' � � ELECTRICAL FEES
I hereCy affirm tM1at I'have.a'certificate of consent to self-insure or a certificate ' ' •
of Workers' Compensation Insurance, or a certifietl copy thereof (Section Backflow Preventer Service $ink ' �
3800, Lab. C.) a� � P.utomatic Washer Transformer ❑ 15-50 KW
PolicyNo. ~- -�� Company Backflowlrrigation SewerCa � ' ❑50+KW - ,
8 Certifietl copY is hereby furnishetl. P Construction PoleSuh.
Certifietl copy is filetl with the ciiy Builtling pivisian. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps '
�ate � Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARHTION Clafifiers Solar ColleCtOrs Dishwa5her ' Meter� �over 100amp5
(TM1issection neetl not be completetl if the permlt is for one huntl�etl ($100) or
less). .�. �_�' Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel , '
I certify that in the performance of the work for which this permtt is issuetl, I
shall not empl��"�8oy� any person in.any rpanner so as t_o bpppme subject to the Orinking Fountains Solar Tank Fan � ' Motors �0-1 HP �1 %- 8'
Worke ' Co pe sation Laws of.,Calig§rl�ia. !\ 1 //Q
x Da[e � Signature (]��J�1�VMn � A.LAX� ni.rQ Floor Dreins Swimmin9 Pool w/Spa F.A.U. Ina Solar �9-15 HP �16-15+
NOTIC : If, after makin9 this tleclara[i2f , you shoultl became subject to the
Wo�kers' Compensation p�ovisions of the Labor Cotle, you must forthwith PloorSinks � Urinal Fixtut¢5 '
comply with such provision5 or thi5 permit shall be tleemetl revoketl. MiCroWav2
CONSTRUGTION LENDING AGENCV GasServiCe OUtlets WaterCloSet DeviCe6o%es POIeLi ht
1 M1ereby atfirm that Ihere is a construc[ion lentling a9enty for the performance 9
of the work for which this permit is issuetl (Section 3097 Civ. C.) Intetcepto�s ' Water Heate� Outlets Ran e �
Lender's Name � 9 '
,. �entleCs Atltlress — Kitchen Sink Water Service Switches � Sign ' .
OWNER BUILDER UECLARATION "
I hereby affirm that I am exempt trom the Con[ractor'S License Law tor [he LavaLO�ieS � AutO-W25h Gar6age Disposal Standing Sections �
tollowin9 reason (Section ]03L5 Business antl Professional Code: Any city or ,
county which requires�a permit to const�uct, alter, improve, tlemolish o� repair p_7�ap Ldund� T�3 5
any sVucture, prior to'its issuance, also requires the applicant for such permit Y Y Generator �0-5 KW �5�15 KW Trash Compactor
to file a signetl statement that he/she is licensetl pu�suant to Ihe provision5 of ROOf D�3ins � �
the Contractor's License Law (Ghapier 9(commencing with Section ]000) of �
Divixion 3 of the-Business antl Professions-Cotle) or that he/she is exempt - --� � , -
therefrom antl the basis for the alle9etl exemption. Any violation of $ection , � �
']03L5 by any applicant fo� a pe�mit Subjects tne applicant to a civil
�p nalty ot not mo�e than �ive huntlretl tlollars.($500). ,
I„ as owne� of the property or my employee5 with wa9es as their sole fiein5pettion'F¢e $15 � ISSu¢ Fee $ 3
compensation, will do the work, antl the structure is mt infendetl or offeretl Rainsp¢ction Fee $15 Issue Fee ' ' c$ 3
for sale (Section �044, Business antl vrofessional Cotle: The ConVacror's MECHANICAL ' FEES �
License Law tloes not apply to an owner of a properry wM10 builtls or improves '
thereon, antl who tloes such work himself/herself or through his or her own � DEVELOPMENT SERVICES R�Q�JI M NTS: ; �±
employees, provitletl [hat such imOrovements are not inlentletl or offeretl tor Boiler Hood or Type I ❑ . � /7 i// �/� ��' _� 5� X
sale. If, howeveq.tM1e builtling or improvement is soltl within one yea� of com- CdnOpy Type II ❑ . ZOning App�oved By 6A Y�"'��'� Date �1 �V �-
pletion, the owner will have the bu�tlen of proving he/she tlitl not builtl ar im- Duc[ - Under Ground Building Approved By y�Deta�z
prove fOr the purpose of sale). .. ' , �� f�.
❑ I, as'owner of the Droperty, am exclusively contractinq with licensetl con- Duct - Structural � ' Refrigeretion System' Application Issued By ' V-/ Dat 1 8
Vacto�s to construct the project (Section ]044, Business antl P�ote55ion5 Cotle: �
The Contracmr's License Law tloes not appty to an owner of property who Duct - Ventilating . ❑0-100,000 BTU ���100,000 BTU . . SUMMARV OF FEES � '
builtls or improves thereon, antl who cont�acts for Such projects with a con- ' ' ' ,
tractor(s) iicense pursuant to me ConVactor's License Law). I am awAre that ExhaustSystem•❑ MWtiple ❑ System Repair/Alteretion BUILDING PERMIT $ '.35� $MIP '' $`' �.�D
proof of their Worker's Compensation insurance shoultl be providetl to me. PLAN CHECK $ ���37 PERMIT � '
C�. I am exempt untler Section B. & P. 0.�tor this reason Firepl/Fact Blt. ICBO # Fire Dampers ' PLUMBING $ ISSUANCE. $
Date owner 3 U. Heating System & Ducting Registers ' PLAN CHECK 25% $- ENERGV P.C. $
i hereby certify that i have reaa this appiication antl state mat the above ❑0-t00,0006TU �100,0006T ELECTRICAL GRADING $
iniormation is correcL I agree to comply witn all city antl county ortlinances $ . �
antl state laws relating to builtling consVuction, and hereby authorize repre- � PLAN CHECK 50% $ :MICROFILM $
Sentatives of i city to enter pon the ab ve-mentionrtl property for . � . . �. � �
inspection pu os s. Q .p. �� ,�-7 MECHANICAL $ TOTAL FEE $ �0.8
Signature Date �4R]J� �lZ �
Drivers' License oi SS � U Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% �$
CMF OB65-46, rev. 10/84 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - ASsesSor ^
CONSTRUCTION AND�PLANNING � • POOL & SPA - -, �
�APPROVALS Permit# � Date Inspector AppROVALS Permit# � "Date Inspector
' irTemporary Electrical�Serviceor 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. APPROVALTO COVER-GUNITE
7. Footings � . � 58. Electrical Conduit-Undrgrnd.
8. Foundation�� ' � - - 59. Gas Pipe, O Undrgrnd., Test -�� �
9. Water Pipe-Undrgmd. , � 60. Backwash �Lines, P-Trap, � Undrgrnd.
10. Strucwral Floor System � 61. APPROVAL TO DECK ;'
11. Property Sewer Line & Ho�use Connection 62. Backwash & Receptor-final � .
12. Sewer Cap - 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing System � Final
14. Rou9h 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 � Perrriit # '
21. Ducts, in Structure � 70. Undergiound Hydro ' -
22. Ducts, Ventilating � ' 71. Product Piping OGas �Oil ,
23. Gas Pipe�Rough & Test . 72. Underground Flush ��
24. Roof Framing , � ,' 73. Unde�grnd.StorageTank OGas ❑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 �; . .
i•.
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 pomestic-Final .
•42. Backflow Preventer � � .-
,43. Backflow Irrigation � . - � ,
i. �
i
44. Landscape Irrigation System � �
'45. Sound Attenuation � � L Q Qp � (�.�JIL���0. �vhq ��Ji..A)
- }
46. Handicap Regulations � _ -Q J � � � � ��
47. FINALSTRUCTURE&BUILDING . .� � {�
A�c. So �Y i Sv��'
48.-Special,RequirementsCompleted � . �. i
i - ,
; 49.=Electric Release to Edison '. ' . - . � ,' �
' 50. Gas Release to Southern California Gas Co � . ..
51. CERTIFICATE OF OCCUPANCY � � • . - �
No. ' Date ' � - ' � �
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NOTE
ADDITIONS, DELETIONS, OR CORRECTIONS SHALL
BE APPROVED BY THE PLAP�iJING DEPARTMENi
_ APp,R��ll
�� s� bF CO� ESA
pIqNNING DEPT•
wueci To s�uc;. oE.et. ua
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�A w ��� �..AIU P1hN• AND SPEOFICASICNS Ok FROM FRE`/£NS1NG
�` U dUILDINi; O ERATIONS BEING CAFRIEG ON iHEREUNDEft WMEN
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owNEa K t,r Knrr rntaSm r�_ IN.c DATE 6-6-57 _
JOB ADDRESS 1 l c1 T.en4r�nd nri va BIDLDING PERMIT NO. 52�9
GENERALCONTRACTOR .Ga�P VALUE$ 13�ppp.n(�
AP. No. LOT � TRACT q� �RE ZONE DESCRIPTION OF WORK RPS w,att �ar
GROiIP T R .T TYPE n ZONE AI, PLAN NO. r.,r�
INSPECTIONS J I DATE I SUBCONTRACTOR I DATE PERMITSNUM ER
Floor
Test /.N�- Yn � S I l r�. � e_ tro I�,. /i�v //� z-
Costa Mesa Bnilding De�artment APPLICATION FOR PERMIT
� • - P.O.Box3�, 5251 BUiLDING '
COSTA MESA, CqLIFORNIA
� FOR OI+�FICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit N
� Building 52�
Address L;10 LenF;ood D.-ive
Costa Mesa, ri8,]1fOP1113� Received by Date Rec'd. Date Issui
Nearest � -7 7 S / C
CrossSk. l�.�.150 Buildin
ow�er fC, ?�I, Xoll Cons���L-ion Co
Mail
naaress 2S?_(i I�Tei,�o_�t Bl_vd. ,
city rle:no_-t i3each, Cal No��F.h5
Arohitector Y1ari5 c�y Lic.
Engineer idilde 2� 1'. 0-ca No. 1�?0
naaress ?_025 itec•�port tivenue
City Lic.
Contractor �i•iri2T No.
Metes and
Setback Line
Center of Str
D�
New
r Wall
J I esl0ck I Tract
ounds)
I No. of Bldgs ,
D}Li5 Nowon Lot ?`
INo.of No.�
F,amilles I Roor
Rear Yard ]
� � ��� Side Yard 5 �
[PTION OF WORH �
Alteration I I Addition
Moving I I Demolish
I he�tiy acknowledge that i haVe read this Application
and state that the abwe is correct an agree to comply
with all City Ordinances and Stat Iaws regulating
building construc ' n.
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Signature of
Permfttee Plaster, Int.
Plaster, Ext
Permi! Fee $ ,3 �� Masonry Reinforced
Plan Check $ �S^ � gond Beam
Totai
Fee $ ��� I FINAL
9
Address
Costa 1VEesa, California
Nearest
Cross St.
zo� i.� I Plans I Type �
Ap ov d
yy Da
CORRECTIONS
APPROVALS
Foundation Location Inspecto
Forms, Makerials,
Under-Pinning
Frame: Fire Stops,
Valuation
s �3� o0 0
RM 304 10�55 D. P. D 5.
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6how locatlon and distancea Trom
property Iine and between bulldings
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