HomeMy WebLinkAbout624 TERMINAL WAY - Building PermitsAODlicant to /ill in all spaces except those witnin heavy eortler Ilnes ana slgn all aooroorlata aeclarations.
CITY OF COSTA MESA CONSTR UCTI ON PERMIT ?ER�MI�NO.� �� TRACT NO. LOT NO. UNIT NO.
Y
Project Address _� �� T F�- +�/11 4l ��I
P� � � 4 NEw-� p Qp����'3 TYP❑E OF CONSTRUCTI❑ON NEW^� AQD ALTERATION REPAIR
Applicant'sMailingAddress y p�
Owner's Name "r'o ^�Y - R�-f J:.. ��_Phone �-`�2�SSL L��
Address ("j'�� �='=+�+w ��(
Arch/Eng. License No.
Address
Contractor's Name � � Phone
Addresslmeilingl- P� ;� V`� � `-�o+`+"'BP��� �2V�.�
City License No. -`� �j 4 (
IICEN5E0 CONTRACTOR OELLARATION
I hereby allirm that i am Iicensetl untler provisions ot CM1arter 9(commencing
witn section 7000) of Divislon 3 ot the Buiinais antl Profezsions Code, antl
my license ii in full force antl eflec
�icense C�ass �' � ice se rvo. y 8�`� S
Date s-�3 �4'7 Signature
WONKERS'COMPENSATION DECLARA ION
I hereby allirm that I have a<ertifitata ot consent to se Llnsure or a certificate
'' Wo�ke�5' CompenSation Insu�ance, o� a certi�ietl copy Ihe�eof ($ectlon
:00, Lab. CJ
Policy No. Company
eCertifietl mpy is hereey fumishea.
Cer[ifi¢tl copy i5 filetl with the City Builtling Division.
Date Applicdnt
E%EMPTION FROM WORKERS' COMVENSNTION DECLARATION
(This zection neetl not be <ompla[etl if the permit iz for one huntlretl (E300) or
less).
I certJy Ihat in the pertOrmdnCC Of h0 w0 f0 hI thli p¢!mR i5 ISSuetl, I
shall not employ any parsOn in an ma � t come subject [o [he
worker� 1cynP,Gn�Non Laws ol Ca o a.
Date 5 Y Si9nalure
NOTICE: If, alter making tnis tleclaratfon, y u shoultl Oecome ubject ro[he
Workers' Comp¢n5allon provi5ion5 Ot th8 bOr Cotle, you St tolthwith
comply with such Otovisions or tnis perTit shall be EGO e0 ravoketl.
CONSTRUCTION LENDING AGENCV
I hereby aHirm tnat tnere is a mnstructlon Ienaing agoncy for tno pnrformanco
of l�e work for whicb lhi5 permit Is Issuetl (Section 309] Civ. C.)
Lentler'S Name
LenEer's AtlOress
OWNER BUIL�EN UECLAftAT10N
I hereGy afflrm tnat 1 am axompt from tho Conlractor'z �Icensa Law lor tha
lollowing reason (SecHon 7031.5 Business antl Professional Cotlr. Any tltY or
CouOty which requi�os a permit lo construct, alte�, ImprOve, tl<mollih o� wpair
any structure, prlor to its issuance, also roqulres the applicant ior such pormlt
to tiie a signetl slalement tM1at ne/she is Ilcensetl pursuant to Ine provisions ol
lhe Contraclor'S Ucnnse Law (ChaO�er 9(commencing with SeCtiOn 7000) of
Division 3 0/ thc Business antl Professions Cotlo) or that he/sho is exompt
nefrom anE tne basis tor the allegotl exemption. Any violatlon of Saction
31.5 by any applicant tor a permit subjoctt lhe applicant to a civll
.ialty of not more tnan tive hundretl tlollars (E500).
L� I, a5 ownar ot tM1e pwperty Or my amployce5 wllh wagus as lM1ai� Solo
<oTp¢nSdtlOn, wlll tlo thC wOrk, antl the SlruCturO IS nol Inlantletl of olfErOtl
/or sale (Seclion ]044, Business antl Profassional Cotle: Tho Contractor's
License Law tloes not apply to an owner ot a property who builtls or Improvos
lhereOn, antl wM10 tloe5 TUGh work nlm5ell/ho�salf or through hi5 Or hCr own
em0�oyees, provitl¢tl that such ImprovCments ar¢ nOt Intentletl o� otteretl tor
sdla If, however, lM1u Eulltlin9 or improvoment is sold wlthln one yoar ot com�
pletloq tne owner wlll have tna bu.tlan oi proving he/shn tlb not bulltl or Im-
prove tor the purposo of Salo).
❑ i, as owner ot tha property, am exclusively ConlraCting with IlcenS¢tl <on-
lractors to construct lhe project (SecHon 7044, Buziness antl ProfaS5ion5 Cotlo:
The COnVattot's License law does not apPly b an owner Of proparty who
builtls or improves thewon, and wno contracts for sucn projects with a con-
traCtor(51 bcense pu�suant lo lhe Contracto�'s Licenze Law�. 1 am aware Ihat
proo/ of their WorkeYs COmOensa[ion inzuranca ShOultl be provltletl to me.
❑ I am exemo� untler Sectlon B. 6 P. C. for this reason
Date Owner _
I nerebvi cerNtv that I have reatl this
Signature � \
Driver5' License Or 5'
CMF 0865-46, rev. 10/B4
upon Ihe abbva-mantionea O�oPmty for
oa�z s-� 3 - 8'1
� �
CONVERSION DEMOl15H THER p,p..�j6
DE FIPTIONOFWO /USEOFBLDG. ��2C"�+�F�S411
S Main Buildi
E
TVPEO ERMIT RADING FOVNDATION STRUCTVRAL T Ffont
❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Reer
❑ OTHER %�
PRQIECT DESCRIPTION 5�. F7. OCCUPANCv C Righ[
K Left
CONSTRUCTION TVPE VALUATION $ $
20NE GRADING CU. VOS. ACRES Plny. R¢L �/+
Remarks: /� �� Q, �, �._ _,._ Planning Notes:
Bar Sink
Back w Preventer
Backflow I � ation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Oreins
Floor Sinks
Gas Service
Intercepmrs
Kitchen Sink
Lavatories
P-Tiap
Roof Drains
Reinspaction Feo
Showers
Service Sink
$ewEr Cap
Sewer Connection
Solar Collectors
Solar Piping
olar Tank
Swi ing Pool w/Spa
Urinal
Outlets Water Closet
Water Heater
Water Service
Auto-Wash
Lnundrv Travs
Ground
Duct - Ventilating �
Exhaust System � Mul[i
Firepl/FacL BIL ICBO #
Heating System & Ducting
❑6700,000 BTU 0100,(
Reinspection Fee
� _
Whit¢ - Builtling; Canary - qpp���ant; Pink - Accounting; Goltlen�otl - Assesso�
$15
S15
Isue Fe0
Hood or Typel ❑
CanOpy Type I I ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
, Fire Dampers
Issue Fee
FEES
Automatic Washer
Consttuction PoleSi
Cooking Unit
Dishwasher
Dryers ❑Gas ❑E
Fan
F.A.U.
Fintures
Device Boxes
Outlets
Switches
Garbaga Disposal
Generator �0-5 KN
lectric
7890 5/13/37
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 75-50 KW
❑ SO + KW
Meter ❑up ro 100 amps
Meter ❑over 100 amps
Sub Panel
Motors�61 HP 1'f,-8
Inc.Solar 09�15 HP �16�15+
Microwave
Pole Light
I I Standing Sections
5�15 KW T�ash Compactor
t;o:�� TL
FEES
2
O
N
1
N
G
R
E
Q
M
T
S
5 3
Reinspection Fee $15 Issue Fee $ 3
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
Building Approved By Data
Appliwtion Issuad By W Date S_ �3"�
SUMMARV Of FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE S
PLAN CHECK 25% $ ENERGV P.C. S
ELECTfiICAL $ �.�5 (l GRADING S
PLANCHECK 50% $ MICROFILM S �T
MECHANICAL S TOTAL FEE S � 1� �
5 3 PLAN CHECK 25% $
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Elgctrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Contluit Utility�Undrgrnd. 54. Forms
4. Electrica� Conduit-Undrgrnd. 55.� Electrica� Bonding
5. Steel Reinforcement 56. Rough Plumbing'& Pressure Test
6. Electrical UF�R Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. 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. ElectricabFinal
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 Electri�l-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 S[ructure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank�Gas ❑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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric S � Notes:
' 34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canapy . �
37. Final Factory Fireplace . '
38. Final Plumbing �
39. Water Service•Final � �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer k �
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 tb Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY "
No. Date
�
ADO���ant to fi11 In all spaces except those wilhin heavY �orGer lines antl�fi9n all aOPropriate Geclarationi.
`CITYAF CO,S`TA MESA CONSTRUCTION PERMIT PER IT NO. TRACT NO. LOT NO. UNIT NO.
IProject Address �- 2 y �fF%2+`+' "' 1; L ( A 1� ��7 �9� —_
Applicant's Mailin9 Address P�% � ��+`� �P-+i-Y�.•�+rfiGnw��
Owner's Name TaA�Y ��2.P_� Ti+n�✓ pryo�e
Addfiess L 2't T�.,�.�:� n� . W,�
Arch�E�9� License No.
Ad�ress
Contractor's Name �`�='��5�_� Phone LY 5-0729
Address (mailin9) 0 L u � - `'�
Ciry License No. �+ 7 g� �
LICENSE� CONTRACTOR DECLARATION
I hereby alfirm tnat I am licensetl untler Provi5ion5 of Chartet 9(commencing
wi[h section 7000) ot Division 3 of the Bu51ne5s and Professionz Cotle, antl
my license is in full forcgantl effect.
Licensc Class G-� �U ic e rvo. 4�Y�'ikS
Oale N-^��_g'1 $i9nature �
WORKERS' COMPENSATION DECL/1R ION
' hereby aifirm that I have a certifitate ot tonsenl to selt-i sure or a certiflcate
` Wotke�s' Compensation Insurance, o� a certifietl copy thereof (Section
800, Lab. C.)
Policy No. Company
eCerEfietl mpy is hereby fumish¢tl.
Certifietl topy is /iletl with the City Bulltlin9 Division.
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION
(Thissection neetl not be com0�etetl if the Oermi[ is fo� one huntlretl (5300) or
less).
I certi(y tnat in tne pe�fo�mance of the wo�k fo� which thls pe�m�t is issuetl, I
shall no[ employ any person in any r so e to ecome subject to the
Workers' Compessa[ion �aws o/ Calif mi .
Date H-)-Y� Signature
NOTICE: 1f, alter makin9 this tleclaralion, yo zhoultl ec e subje<t to the
Wo�kers' Compen5alion provisions ol Ihe La or Cotle, y0 must tor[hwilh
wmpty with such provisions or thi5 permit shall be tleeme0 revoke�.
CONSTRUCTION LENDING AGENCV
I hereby allirm that lhere is a construclimi lentling agenCy (or t�e performance
of the work tor which Ihis permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atlaress
OWNER BUIL�E12 pECLFRATION
I hereDy atfirm that I am exemp[ from tbe Gontractor's License Law for Ihe
followin9 reason (Section 703L5 Business antl Protessional Coae: Any city or
county whiGh requires a pe�mii to construG[, altCr, imProvo, tlemolish or r¢pair
any ztruciure, prlor to Ils issuance, alm reqWres tne applicant tor such pmmit
to tile a siqnetl Sfatem¢nt that he/She Is Iicensetl pur5udnt t0 th¢ plOvisions of
ihe Contrattor's License Law �Cnao�er 9(commencinq witb Sectlon 7000) of
�livision 3 0( the Bu5ine55 and P�ofe55ion5 COtl¢) o� tha[ he/zne I5 exempl
ereirom antl the Dasis fo� the allegetl ezCmpllon. Any vlolation ol SectiOn
i31.5 Dy any applicant lor a permll subject5 th0 appliGant to a civil
w¢ndlty of not more than five huntlretl tlollars (E500�.
❑ 1, as owner of lhe proper�y o� my emPloyees witn wages a5 th¢ir sole
compen5ation, will GO Ihe wo�k, antl Ih¢ 5[�ucture i5 not inlCntled o� otfe�atl
for sale (Section 7044, Business antl Profezsional Cotle: The Contractor's
�iren5e Law tloe5 nOt apply [o an own¢r Of a property who bulltls ot Improves
tnareon, antl who tloes sucb work nimzolf/h¢rselr m througn his or her own
employees, provitletl that such improvements are no[ Intentletl or orteretl tor
sale. If, howeveq the builtlin9 or Improvemeni is soltl within one year of com-
pletlon, the owner will have tne buraen of proving he/she tlla not bulltl or im-
. p�ove for [he pu�pose of Sale�.
❑ I, a5 owner ot ihe Oroperty, am extlusively cont�acting wilh Iicensetl con-
tractors to conSV ucl lhe project (Sec[ion 7044, Busine55 antl Prote55ions Cotle:
The Contractor's License Law tloes not aOPly to an owner oi property who
builtls or improves thereon, antl who conVacts for such projects wltn a mn-
tractor(s1 ucense pursuant to the Contracior's Licenze Law). 1 am aware mat
proof of their Worker's Compensation insurance shoultl be provitl¢tl [o me.
❑ I am exempt untler Section B. & P. C. tor this reason
Date
Signature �__
_ Owner
1 have reatl this application antl state that the abave
I agree to comply with all city antl county ortlinantes
to builtlmg const�uctlon, antl he�eby authoriie repre-
.�n[er upOn Ihe above-mentionetl Property for
� I ' Reinspection Pee
CMF OB65-46, rev. 10/84 White - Builtling; Canary - AOP�icant; Pink - Accounting; Golaenrotl - Assessor
$75
A.P. #
S Main Buildi
E
T Fronl
8 Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elee.
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Swi[ches
Garbage Disposal
Generator �0�5 KW C
5252 4/02/87
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter vert00amps
Su6 Panel
Motors �0.1 HP II] 1 f, - 8
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
I I Standing Sections
5�15 KW I � Trash Compacmr
Reinspection Fee �$15 luue Fee
IANICAL F S
Hoodor T DEVELOPMENTSERVICESREQUIREMENTS:
YPeI ❑ 2aning APProved By
CanopY Type I I ❑
Building Approved By
iefrigeratio stem APPlication luuad By
70.�00 BTU ❑ 100,000
>�tem Repair/Alteration
Fire Dampers
Registers
Issue Fee � $ 3
IOa50 Tl
2
O
N
I
N
G
R
E
�
M
T
S
FEES
$ 3
SUMMARV OF FEES"
BUILDING PERMIT $ SMIP 5
PLAN CHECK $ PEFMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. 5
ELECTRICAL $ IO • _S8 GRADING .5
PLAN CHECK 50% $ MICROFILM $
MECHANICAL S TOTALPEE $ �' SO
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING � POOL & 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 ConduiY Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55" Electriral Bonding
5. Steel Reinforcement 56. Raugh Plumbing & Pressure Test
6. Electrical UFER Grnd. - 57. APPFtOVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd'. 60. Backwash Lines, P-Trap, L� Undrgmd.
10. Structural Floor System 61. APPROVAL TO DECK
7 t. Property Sewer L.ine & 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-Conduii ' 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 �Gas ❑Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing ' � 73. Undergrnd.StorageTank C7Gas ❑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 . R � 79. FINAL INSPECTION '�
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED . �j
33. Final Electric � Notes: L���� ��'z J,�pi d'To cJ i[c �
34. Final Heating & Air Conditioning � J �,G1 �� � �.
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 .
44. Landscape Irripation System '
45.�Sound Attenuation
46. Nandicap Regulations
47. FINALSTRUCTURE & BUILDING
48. Special Requirements Completed �
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co . , '
51. CERTIFICATEOFOCCUPANCY � L � � •
No. Daie ,
OWNER ODt•1ARK� H T Rr RA7.TT.� R, Tl, // \ DA7E jy_� ��
\ -
JOBADDRESS 62lt Terminal Wa.y BUILDINGPERMITNO. 1(�(�cZ_
C ERALCONTRACTOR vwner-Huilder VALUE $ Q7+(j00.00
�ariance 136
�OT BLOCK TRACT Storg rentalc
GROUP F+3 TYPE III ZONE NQ FIRE DISTRICT #ZC)Z9
PERMITS ISSUED
�INSPECTIONS DATE SUBCONTRACTOR
DATE I NUMBER
Trench �
�.ion Forms and Grade to
'ramina n . _
Plumbing, Rough to Slab - - � � '"'
Plumbino. Rouqh Complete _ /ii .n20�„ .�J 9-/�
ir
Wiring, Roug
Heating, Rou�
Heating, Fina
Sv-ar, House
5 cTankc
_athinq. In
Plumbing, Final, Fixtures Com let4 "/'/ � f
Plumbing, Fin.al GasTest L( i-/. j� ,+�
Wiring, Final ��'� ', 3- _ <l�'�, l'
Occupancy �v!/ - �� - 2 _,J
c,....., �i n r_ u i snn i sc -
L
esa Bnilding Departmenl
111 EAST 20th STREET
SYA MESA, CALIFORNIA
�R APPLICANT TO Fiid. IN
� �f� TFi2M�Nr��W,
Costa Mesa, California
�A,°AF4Ei11 S''("
.�.00MA�z►��R•a, aAz��
�tSt3 Twcr-1iuE ST
y83
Lot �I
Block
.4PPLICATION FOR PERMIT
� BUILDiNG �
FOR OF&'ICE USE ONLY
IRecefpt No. Permit N
eceived b Date Rec'd. Date �
- ���-/� �� 8- i-�� �-a-s
3�� 'i Zone
CF�2�� Approved
� C� � Now on Got �
No.of � No.o1
Families Room
Rear Vard pf+�-
5 cin.va�a 2.r n
Demo{ish
02 ry� -��i 1 !/
�
:osta Mesa, California
� i� �
Size� a�f:i x 1'�-4 Rooms ' Stories �
' rior Wall Roof �j
.ring �'O�j('•s{,QCfKI Coveringl.OMPQ. APPROVALS
Use ot New M A A �, t_/� A �Foundation Location I Inspecto
Building � �0 iV! � �' Forms, Materials,
/ �/V _'
F
I hereby aclmowledge that I have read this Application
and state that the above is correct and agree to compiy L
with All Clty Ordinances and State Laws regulating
building construction. �
Signatureof 1 µ'.
PermitTee ' ` � Y�'�-� p
Valuation p0 Permit Fee $ �% O O
$ �� �j00^ Plan Check $ /j-. 60
'J Total
Fee a2 � D O
Ext
:r, 1nt.
;r. Ext
Date
r
ri.v'i' ri.ti��
Show location and distances fram
property line and between 6uildings.
�
�
1 4
cosTn
�:'1G —1 -55PDwEsn = 75a t.l*c�r2.00
OWNER ODh�RK� H_ T / DATE 1—Z%—S6 �
JOB ADDRESS 624 Terminal Way BUILDING PERMIT NO. 2'jQ3
G" 'ERAL CONTRACTOR Qy�pep—j�lli1dPp - VALUE $ KOn 00 �
LOT C�O% BLOCK TRACT Npt Mesa IriStall officP nartit.ion4
�GROUP Ei
INSPECTIONS
Footing Trench
Foundation Forms and Grade to
Rough Framing � Q
Plumbing, Rough to Slab �
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heatinn. Rouah
Sewer, House S<
: cTank or Cesspool
Lathing, In �
Rlastering
Plumbing, Final, Fixtures
Plumbing, Fin,al Gas Test
Wiring, Final
Occupancy
c,,....,�»nr__z��snn� s�
DATE
20NE
SUBCONTRACTOR
FIREDISTRICT 2336
PERMITSISSUED
DATE � NUMBER
m g Lepartment
� 111 EAST 20th 6TREET
bSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
naare�gs iv�'� rERHrhJ/�L. (�i4
Co§ta Mesa, California
Nearest ^ N'� �� � �
Cross St Y7
Owner �,T ��M�R�
addre:5 �iFi3 �RSM/A/C
���Y L a�.� ,��� t3���� No'.' �Fyy:;
Arohitect or Lic.
Address
m �.v u C-'/Z
ach Metesand Bounds) s�c-e b.C'G� Src
No. of Bldgs
of Lot �% S X %�% O Naw on Lot �
of No.of No.of ,
ting BIdA. M�� � I Famlllea I Rooma
Addition
Demolish
rr�utiiiuN r'Vx� r��vu;
BUILDiNG
FOR OE+'FICE USE ONLY
Recelpt No. Permit No.
, a 3 a3
�ed by j` ate Rec'd. Dah Isaued
� � �7�5` �- �%-���i
B
Costa Mesa,
Nearest g
Cross St.�i'-d e � .
CORRECTIONS
_,/ �_.�^` .` �
�--. __
Building No.of
Size Rooms Stories
'" --rior Wall I Roof
rtny covering APPROVALS
use oi New /
Building � / � Foundation Laeation Inspecto
" �T R Forms, Materials,
� / C k/ i�// O lUS Under-Pinning
' � Frame: Fire Stops,
Brecing, Bofts
I hemby acknowledge that I have read this Application
and state that the above is crorreM and agree to comply Lath. Int
with all City Ordinances and State Laws regulating
building mnstntction. � Lath. Ext
Signature of 1 f �1
Permittee ��C J 'Plaster, Int.
Valuation �
g �2_
d
�
e-ss
Permft Fee $ � � � Masonry Reinforced
Plan Check $ �D � -L' Bond Beam
Total � � �
:�
�
PLOT PLAN
Show Ioeation and distances from
proper[y line and between buildinga
e
� 7� �o � l�- 3 3�0 • o. ��
� 40 7 -�"J'�a �Z` �o�i' �%'leSa.
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� � 1� :I 2�-56P� fESAr �:�Sa ^':..,. �L1.r�
i:ri.. .,. •
a