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HomeMy WebLinkAbout640 TERMINAL WAY - Building Permits(714) 754-5273 • Fau (714) 754-4866 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite: Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address/ �� ;� i Contractor: ` i � ;' Address, /�' . i J/ , %\ ` , ��. i 640 TERMINAL WY 42428105 JOHN TAN 12035 DOHERN � � �, /�" � , , �,:'INST . lr -. . r !, . . Zoning: _ - . - �, �-..i._ . �-i, _ ISSUED BY: �^�%��� ,Phone: � 951-279-8208 • � i'�j!i _- - �, , � �� CA.�� ; 'jC_ � , Zip: 92505 , , � ` � �� ; .//�r = � i � , : -_ �, NER RUTH�A TR • �' � � ��`�� ITRUST- i i . - � ` � � '` \ / \\ .\ °L MAR CA� . �Phone - "�- - � �. � ��,� %E� �j� -.: � Zip 92625 2538 '� iV� � � � � . �� �/- � � ;� ' i'i - �� �, � 1RE AND SAFETY CO �� �� � �.�A � , � �� . �: � � �RTY \- `. � � ��� : ,��`•�\ �� ` � Phone: 951-279-8208 .. � .. ,; A ` � CA Zip: � 92505 � .� � � � . . .. i��; �;�'�= ;- License: 621096 , .. _ `, . . \' , . , . , , Slatus: ISSUED Applied: 07/13/2006 Issued: 09/20/2006 r.. _l A FIRE SUPPRESSIO� i �! C'�J . ; .�SCOP.E OF PERMIT SYSYTEM�INSIDE AN EXISTWG SPRAY BOOTH, , �. ' � _ _ . . . .. -. ' . � � i�, � ,-'�A '`� FEE SUMMARY � � -;� ; . - � �� r . � � , Plan Check ✓ � $54.11 �/�� � �Calc ValuaYion: � �, Ss,000.00 ���� � , Permit:; - $83.25 � ' , Claimed Valuation: �Ss,000.00 ` � Othert !$0.00 �� ��-v--r,�'� i/' '�' '''�7�:f T' � ,� l, i %,=� � -a � ` ` , �' -\ ' � , _ . . _ �..�- . . _ L . C %:.. / . _ -- \ , � l , ��' 1 - � �.Y . .-_ � I �� . � Total: �� $137.36 � . „ ; _. �� �. ;,�•`�t � ��i �� �;' `n � � � � � ,����°" ' �`-� :' — . . � , - , � • _ . � .... - ._ . . ._ i , - . . . - , � �. , , � j. . - , ,. , ,,.A. -_. .� i l , _ . i � - � �`. � r �_ - - . / � _ J r \�� {'` A� �\A� �" . �' y/ / '' �� \�\ .\. / '\ '. ;h . %i�' . i � �� � i : �� -�c,.� i j . . _ �� ��� if ' �' � - � , ' � . �� ' �"� �� �f' '1 ./ ., � �� � � '/ % `��� `� i /� �f�V� w 1'S��i �jj "' �. . . ,� 'i^ " �� . � i � � � .��V �� ) �� f%. .�_l �� �/. 2 f . ��� �� �' �/. �� V� ` . � - ' , i �• /, � , . / �� ���� ..J/ =�� ��r .�. ��. '_� - � _.�:A�iii /i'� ��`��� �''� — - —' �.�� ' C/ ��% � ���� /j '/ '� � � ;l � ��� �`� ��;, �l �� , �, .i_-- ' . .. ,�� � / �`� �. ,�- ' _ � , , . , = � �i ��.;�^ ` � ., .��.1 .. ' ' � ii' NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspendad or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlona and (inal approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�as �sioo� WORKERS' COMPENSATION DECLARATION: I hereby eXirtn under penalty ot perjury one of tha following tleclarations: ❑ I have entl will maintein e cenificete ot consent to self-Insure for workers' compensetion, es provided for hy section 3700 of ihe Lebor Cotle, for ihe perfortnence o} the work for which lhis permit is issued. ❑, I,have end will maintain workers' compensation Insurance, as required by section 3700 of Ihe Lebor Cotle,.Poctha,pertormance of ihe work for which Ihis pertnit is issuetl. . My w/or�kere�' wm nsation Insura carrier end policy numUer are: i/. ` --�-� �j �. Carrie, ��'--��/A�G����� ' Policy Number:-"' /�7�/ J � � �-S ❑ I certity ihat in the peAormance w rk tor which this partnit is issueq I shell not employ any person in any menner so as to become su�jea to the workers' compensation laws of Calitomla, d ee that If I should become subject to the workers' compensatlon provisions ot Sectio 37 0 oi the�LLpp666000 r Code, I shell forthwith comply.with these provisio� ��^� ,��i��' //�/ �� /v r Applicenl SlgnaWre: ' Date:.-----" � � WARNING: FAILUPE TO SECUflE WORKERS' COMPENSATION COVEMOE IS UNUWFUL ANO SHALL SUBJECT PN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED T}10USAND DOLLARE (5100,000), IN ADDRION TO THE COST OF COMPENSqT10N, DAMAGES AS PROVIDED FOF IN SECiION 37060F THE UBOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATON: I hereby affirtn that I em Ilcens�ct deJp{ojy'�i s ofc� epter 9(commencing wilh Sectlon 7000) of to cer antl e-�—ttecuCic. a (c� /F/ 7 // �% Pfef�65ions Code, end my licanse Is in full x CONSTRUCTION LENOING AGENCV: ❑ I hereby eHirtn thet there is a construction lending egency for Ihe peAortnance of Ihe woAc for which this pertnit is issued. (Sec. 3097, Civil CoCe). Lendefs Name: LentleYs Atltlreu: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby eMirtn ihat untler penalty of perjury that I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or wunry which requires e pertnit to construct, alter, improve, demolish, or repair any strudure, pnor to its issuance, elso requires ihe epplicent tor such permit to file e signed statement thet he or she Is Ilcensetl pursuant to Ihe provisions oi ihe Contraclore lJcanse Law (Chepter 9(commencing with Seclian 7000) of Dlvision 3 oi the Business and Professlons Code) or thet he or she is ezempt thereirom end the besis for Ihe alleged ezamption. Any violation oi Sectlon 7031.5 by eny epplicent far a pertnit subjects the epplicant to e civil penalry of not more ihan five hundretl tlollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as Ihelr sole compensatlon, WILL DO TNE WORK, end the structure Is not intentle7 or oflere0 for sele (Sec. 7044, Business entl Professions Cotle: The Contractors License Lew dces not apply to an owner of proparty who builds or improves �hereon, end who Ooes such work himsalt ar herself or ihrough hls or her own employees, pravidetl thet such improvements are not Intentled or oNered for sale. If, however, iho builtling or Improvement Is sold within one yeer of completion, the owner-builder will heva the burden ot proving that he ar she did not build or imprave for purpose oi sale.). ' ❑ I, as owner of the pmperty, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the pro�ect (Sec. 7044, Buslness and Professlons Cotle: The contrectors License Lew does not epply to an owner of propeny w�a bulltls or Improves thereon, antl who contrects tor such pro�ect with a contracror(s) license pursuant to the Contreaors License LewsJ. ❑ I em esempt under sec. Business end Professions Code for Ihis reason: Signature: Date: Owne� ID verified by drlvers license. ❑ Yes ❑ No Driver's License No. Expires: Verifiwtlon of Ownership by (type of document, i.e. - property tan bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihet no excavetion five (5) or mora teet in depih into which a person is required to descend, wlll be mede in connection with work authorizetl by this pertnit, end that no builtling sirucWre, sceftolding, talsework, or demolition or dismantling thereof, will Ce more Ihen thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, T1Ile 8, Celifomle Administrative Code). ❑ As owner-builtler, I will not employ anyone to do work which woultl require e pertnit from the Division of Intlusinel Setery, es notatl ebovo, unless such person has e permit to tlo such work irom the divisian. Signature: Date: Divislon o1 Intlusirial Safery Permit Number: CERTIFlCATE OF COMPIJANCE AND AUIHORIZATON OF EN7AV: I certiy under penalry of perjury that I have read this ap0lication antl state that ihe intormation given is conect I egree to comply with all stete lews ena ciry ordinances releting to builtling conswction, end authodze representatives ot the Ciry ot Costa Mesa to enter upon the flbove-described D�aPerty for inspect� purpQses. I egree not to occupy or allow occupency of any building authorized by ihis permit until fnel inspection. COUE Y. INSPECTIONTYPE PATE INTRIRLS 1616 Fixed System Flnel Fire Prevention 1266 Paal Spa Final pp0 Finel fie-Rooi 201 Finel Black/Retaining Well 202 203 204 Final Fadory Fire Place Flnel Sign Finel Demolition � COOE� INSPELl10NTYPE 206 Final Mechanical 20B Finel Plumbing 210 Final Electricel 212 Flnal Fire Preventlon 220 Final Planning Approval 222 Flnal Site 250 Final Building/Occupency PAIE IIIIIDEL9 2'8'0� �H _ � � 1 � � � ' ; ; CITV OF COSTA MESA - ° BI/ILDING p/V/SION > _ � � DEVELOPMENT SERVICES DEPARTMENT B98-00850 J• � PERMIT PERMIT NUMBER �� (714) 754-5273 • Fax (714) 754-4856 BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 640 TERMINALWY Suite: Vicinity: Parcel Nunmber: 42428105 App�icant FORD, E.L. Address: Owner: SCHAUPPNER, VERNON E TR Address 37305THAVE CORONA DEL MAR,CA Contrector: HOLMES ROOFING Address: 00947 NORTH ELM Status: ISSUED �^ Applied: OS/18/7998 Issued: 05/18/1998 Zoning: Phone: Zip: Phone: Zip: 92625 .'.i Phone: OR4NGE CA - Zip: 92667 License: - 607894 Arch / Eng : � Address: F� ' � Phone: Zip: . License: � " SCOPE OF PERMIT reroof 6250sf commercial building w/built-up FEE SUMMARY Plan Check: 50.00 Calc Valuation: $o.00 Permit: $124.75 Claimed Valuation: gs,2ao.00 Other: $0.00 •� , Inspection: $0.00 Total: $125.37 PLANNING 8 ZONING SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fmnt 0-0 PARKING Existin : o NOTES: Rear 0-0 Rear 0-0 Required: 0 teft, 0- 0 Left 0- 0 Proposed: 0 u Right 0= 0 Right 0- 0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 tlays, or ii work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspactions end final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit: FOR INSPECTIONS CALL: (714) 7545826 WORKERS' COMPENSATION DECLAqATION: . I hereby eifirtn under penalry ot perjury one oi ihe following declarations: ❑ I �eve and will maln�ein e certificata af cansent to self-Insure for workers' compensatlon, es pioNGetl tor by section 3700 of the Labor Code, tor Ue pertortnance of ihe work br which this pertnit is issued. ❑ I have and will meintain woilcers' compensation insurance, es required by Section 3700 of the Labor Code, tor ihe perfortnance of ihe work fw which ihis permit is issued. My workers' compensalion Insurant¢ �Mer entl poliq number ara: Cartler: Policy Number: (ThJs section need naf be completed i! thm permit is velued et one hundred dollers ($f 00) o� less.) ❑ I certity that in the partortnance of ihe work for whic� �his permit is issued, I shall not employ any persan in any manner so es to become subject to ihe workers' compensetion laws of Celifomia, end egree that N I shoultl become subject to the workew' compensatian provislons of Sectlon 3700 ot the Lebor Coae, I shell fonhwith comply with thesa provisions. � / ._p Appllcant SignaNre: /. � /I Date: S � // d� / �i d� '� WARNINO: FAILURE TO SECURE WORKERS' �pMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TFKKISAND DOLLARE (5/00,000}. IN AOOff10N TO THE COST OF C/JMPENSAiION, DAMAGES AS PROVIOED WF IN SECfION 3lOfi OF THE LABOR �DE, IMEflEST, AND ATTORNEI^S FEES. � LICENSED CON7RACTORS DECLARA710N: I hareby ettirtn that I em licensed under provisions of Chepter 9(commencing wlth Sectian 7000) oi Division 3 of the Business end Professions Code, end my license is in full rorce and eflect. Lic. a d f< qass a G 3 S Contractors Signeture: . o�- Date: r/ i.+� -`�i d� CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that there is a construction landing egency tor Ihe pertortnance oi the work for w�ich ihis pertnit is issued. (Sec. 3097, Civil Code). Lendafs Name: Lentler's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn that under penelry of perj4ry that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the follawing reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires e pertnit to consiruct, elter, Improve, demolish, or repair any sWcture, pnor to iGs issuflnce, also requires the applicant for such pertnit to file e slgnetl s[etement thet he or sha iy licensed pursuant [o the provisions ol the Contrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 oi ihe Business and Professions Cotle) or ihat he or s�e Is exempt iherefrom end ihe basis for Ihe alleged ezamption. Any violation of Section 7031.5 by eny applicant for e parmit subjects �he applicant to a civll panalry ot not more ihen five hundred dollars ($500).): ❑ 1, es owner ot lhe D�aPerry, or my Bmployees with wages as their sole compensation, WILL 00 7HE WORK, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Cnde: The Contractors License Law tloes not appty to an owner oi property who huiltls or improves Ihereon, and who does such work �Imself or herself or through his or her own employees, provlded that such Improvements are not intended or oflered for sale. If, however, Ihe buildinq or imDrovemen� Is sold within one yeer of completion, Ihe owner-bullder will have ihe burtlen of proving thet he or sha tlitl not bulltl or improve for purpose of sale.). ❑ I, es owner oi the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Businass and Professions Code: The contrectors License LeW does not epply to an owner of properry who builtls or improves Ihereon, and who conirflcts for such pro�eq with e contractor(s) license pursuant to ihe Contradors License Lews.). ❑ I em exemp� under sec. Business and Protessions Cotle for Ihis raason: Signelure: Date: Owner ID venfeC by dnvers license. ❑ Yes ❑ No Dnvefs License No. EKpires: Vedflcetlon of Ownerehip by (rype ot tlocument, i.e. - property lex bill or deed): DIVISION OF INDUSTRIAL SAFETV P�pMR CERTIFICATION: ❑ I hereby certiy ihat no excavetion five (5) or more feet in Cepth into which a pereon Is required to tlescenQ will be mede in connectlon with work authodzed by this permit, and thet no buildfng structure, scaffolding, falsework, or demoGtion or dismantling thareof, will be more ihan thirty-sfx (36) feei MgR (Chep. 32, Grp Z, Art 2, Sec. 341, Title 8, Celifomle Adminisirative Code). ❑ As owner-builder, I will not employ enyone to do work which would raquire e pertnit from iha Division ot IndusMal Safery, es notetl ebove, unless such person has a partnit to tlo such work imm the divisian. Signature: � Date: Division ot Industrial Safery Permit Number: CERI7FlCATE OF COMPLIANCE AND qUiHORVA710N OF ENTRY: I certify under penalry of perjury iha� I have read this applica�ion end state thet the information given is correct. I egree �o comply with all stete lews and ciry ordinances releting to builtling construction, end eulhonze representetives of Ihe City of Costa Mesa lo enter upon ihe above-described property for inspection puryoses. I egree not to occupy or allow occupancy oi any huilding authonzed by Ihis pertnit until final inspodion. �� � -�,,, � -r/ i d' / 5' 6� Signa ure pf Legal Owner(s) Date And/Or AuNorized Applicant Date _ _ CODE �. ixsvecnox*rve 1616 Fiaetl System Final Fire Prevention 1266 Pool Spa Final 200 201 202 203 204 2446-66 Final Re-Roof Final BIocWRetaining Wall Final Factory Fire Plece Final Sign Final Demolition QATE It�llS S =it —y� :vt� CODE♦ INSYECTIONTYVE 206 Flnel Mechenicel 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Preventlon 220 Finel Planning Approval 222 250 Final Site Final Builtling/Occupancy �� U1I�96S � FH0.IECTRODflESS: 64O �(ERMINAL WY OWNEfl'SNAME: S'C.iAuYPNEx VER�ON E 1R aooeess: � 3 31 HEATH�R LN NEWPORT BEACH,CA 92660 AflCNIENGINEEfl: �DOflE53: flEC.NO.: UNIT: UNIT: PERMITTEE: EARLS PLUN,BING ( 714 ) 772-3470 RDDPESS: i533 W, T,INCOS.N ANANHEIM CA 92A01 UCENSEO CONTHRCTOB OECLAMTION: I �ereGy aflirm Ilui I am IiCrnSeE uMer O�oviSions 0� ChaOter 9(tOmmeridn0 �^�� Settian 7000� ol �rvision 9 al iha Business antl Pmtessions Code. anG my licBnSe iS in lull �orte anG e�fect. cirruc.:005�3F� STqTELIC.:zS%SS����'�S C-36 oaie: �� ^ � `�Z- Signawre: _ WONREBS' COMPENSATION OECLAI1A710N: I hereUy aflir � I �ave a certilicaie al consent to sell-insure or a certificaie oi Workers' ComDensation Insurance. or a cenilieA copy t�ereol (Section 3800, LaD. C). roucrxo.: UCA-1 ] 686 E%P.ORTE: O3IOS I93 comraNr: �NICARE ❑ Ceniliea coOY �s ner/eE�y IumisneA. G� Certilietl copy is/jl.il¢�O�xii� t�e tiry BuJdinq DiviSan. Daie: �� _I � / • � AppliWni: /1` �-/ a/� E%EMPTION fPOM WONIIEBS' COMPENSATION OECIAMTION: (itis 5ettqn IIMG noi Ge cqnpkle0 il Ne pamt 6 �a ane huMreU (5100� or Itts�. I cenily ItWt in Ine oetlormance of ihe wOrk tar wNCI� tNs permil is it5ue0. I Slull nol emDloy a�ry Derson in atry manner so as to become su�iec� to tne Workers' fAmcensauon Lavrs oi Ca4lamia. Oate: 7�� SignaWre: NOTILE: II. alter makinA ihis aeclaratim. you s�ou10 Oecome su0ject to I�e Workers' Cumpensa6on pmvisions o� I�e LaUor COE¢. you mu5t lari�wilh tomDN �+t� SUt� provrsiwn Or INS p¢rmit Slull �¢ Geem¢E revakeG. CONSTBIlCTION LFNOING AGENCV: I AereOy atfirm lhat Ihea is a conslruclian lentlinq agenry tor the Dedormante ol Ihe wark for wnicn �nis permit is issued �Sation 3097. Civ. CI. LENDEP: ADONESS: OWNEfl BWIDEB OECLABRTIDN: I her¢by a��irm IIWI I am C�¢m0� ��dm IIIB fAnlraClorS' Siate License Law for ihe folloxinp reasan (Section 7031.5 Business ana Pmlessional fAAe: Any cily ol couniy v/�icn re0uires a Dermi�to conslNct, atier, improve, demolish, or repair a0y 9rutlWe, D�iw �a iI5 iSSuance. al5p rEpmreS I�e apptiCdni loi suCA permil Io lile a SiqnCE Slaiement llidt IlPlshe is lic¢OSeA pursuam Io t�e pmvision5 ot Ine Comracmrs' State License Law (C�ap�er 9(commencinp with Section 7000) ol Division J ol IAe Business anE Pmteuions CaOe) or iNt lie/s�e is e�empt t�erelrom anE rtre Easis for t�e allepeE eremptmn. My violation ot Section 7N1.5 Dy any ao0licam lor a permit sublects ihe applicam io a civil Denatty al nat mom ttun iNe �unEreE Uollars �f500�. I. as owner of Iha D�oOerlY a� �' employees wii� waAes as t�eir sole wmpensation, wi0 Aa ihe woM, antl tAa ❑ slmcWre is nat inttnEeO or allere0lar sale (Seciwn 70aa. Busineu aM Pmfessional COEe: The Coniractors' Stata Licensa �aw Oces not ao7N �o an owner of a propeny wM 6uilOs or imvroves Ihereon. an0 wtro aoes sucn woM himsellmersell or �nmupn �is Or �er Ovm empl0y¢CS. prOviGet Itul Sucl� impfwemenls arE n0� inlenOeE w offere0 fOr sate. I1, howev¢r I�0 DuilUinp or imOmvement is wW wit�in one year ol compleiian. ihe axner will tuve �he EurCen al 0«B �she Oitl nol UuiW or improve lon�e Ourpose ot sale). I, as owner ol Ine proDeny. am erclu9very coniractinp vnin Iimnse0 contracta�s to consiNct ihe projep (Section 704a, Business ❑ anU Proleuions Catle: Tlie Contrxtors' State �iceree Law Oces nW apply lo an owner al property who �uilAs or improves �Aereon and who contracis lor suc� projects wit� a contractm�s�license pursuam m i�e Contracmrs' Sta�e License Law�. I am aware I�al pmal OI 1�¢ir Worke(5 Compenuii0n insurantt SMUIE Ee prOviGeE IO m¢. � I am e�empt unCei Seclion: B. 8 P. C for IhiS reason; oaie: O+vnec 1 Go nereGy cendy I�al I am aware al anG unGerstanG Rrc r¢puiremenis ol Cdlilomu Mealt� anA $alety CaUe Seciians 25505, 25533, an0 255� ana Ihat I or any IuWre 6uilding occupanl wilUvnll nolldrtle one) neeG io wmpry mih uie state codes anE ine repuiremenis lor a permil bt conslNction or moGi6Wiion imm I�e Air Oua4iy Mandqemeni DiStrici, qe5i0ential conS�Nttion applia�ions are exempl Imm Inese pwvisions. Oate: pppbwm: I Aer¢py [etlily Ihal I have read IN5 applltation an0 itale ttNt I�e a0pve iniotmation is cOrrlCL I agree Io fAmpty vnih all ciiy anE cauniy orOmances an0 9a�e Wws relating to OWNng [onSVuttqn lntl hert0y auttpr¢e reD���u�iv¢5 ot tlris dry to enler upon I�e above�mentioneU prop¢tly IarinSDection pCu/tposes. �a�e: �D'I � � /Z SignaWre'� Oriver's License or Sociai Security AOplicanl: Pmk—Revenue; Galdenrod—Assessor CliY OF COS'iA Mt.'SA BUILilZNG PERMIT PERM NO: P 05947.6 PE:RMIT NO: F 059926 PLAN CH�CK NO; � GOVT: N SUPP; N CONSTRUCTION '_YPE; PERMIT 1'YPE; PLU PURAOSE: U":d JOd Dc;SCRIl� � iOiV , IN5IALLED WATER HEATER SQ FT; CLAIM VALGd; CALC—VALUE; GROU? OCC: / COMMEN'.S: MAL :N PERMIT i4 i( 3f �lE �1F �lE �)E %i( K it iE K it i( # it #�f 1f� i!� k�If R�1( k 3F if iF 7P iE if %#�K 9F 1h #�1F iE #�}; lE 9(-�1E •IE if #��iE i6 �% IE lE if �t i( �lE iE A iM1 iE K lE-l( iF iE-% �iF �lE K iE i( X# df ### Z O N I N G R E Q U I R E N E N'i S s�TbAcxs ------------ N.AIN BUILDiNG ---------- ------ -- ACCESSORY BUILDTNG --------- FRNT; f'7' IN REAR: FT IN FRNT; FT IN REAR: FT ZN LEFT: F7' IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL; 42928105 ZNE; REF NO; PLANNING NGTcS> i if ik iF 1E 1F if iF IFiElt iE ik!(- N� K# if if Y. if iF iE iE iFiF # iF iF iE # iE ## # M� �E �E �7F iE%if 3E iE if iE iE �f=k # iE 3( fE It iF ih iF ##3E ik #±E 3E lf # 1tlE i4 iE 3E �i ie i'r if iE ##!4 il� D E V E i O P M E N T S E R V I C E S� R E Q U I R E N. E N T S y 20NING APPROVED BY f llATE; BUILDING APPROVED BY ; DAlE; � APPLICATION ISSJED BY; . DATE• ��� y(/ � IFifiFiE'N'ikifi%iEiP#i('1Eif!EiF1FiEiF161fiF :1l. ' ). R R iI'if1E#14H'3EiFifIE '�'�3f# iF iE iP H� iF i41(� iE %d(� fE iF iF�l! iF if iF 1h ih ## if if iF # iF i(� if ## 1ElE ## iF # if k'� iF F i!� if iF ## i6 if ff #!1�lk !F # if K� K# M iF # it iE ##?F # i(� ## ih ## if !#!E #'.f LEGALIZATION;N F E E S � M M A R Y STRUCTURAL SEG�NF.:V::N BLDG PMT PLUMBING ELECTRIC MECHANIC FlRE SMIP/RES G�ADING PERMI7' PLAN ISSUE FEE ��SY 20,00 SMIP/NON—RES BUILDING—DIV—> NERMIT ISSU� PLAN-CHECK TOT'AL PAID DUE To•rr.Ls----> �.00 zo.00 o.00 z�.00 z-i.00 ,00 REVENUE DIVISION TOTALS--> COLLECT�.D; 27,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM,IP/TOT GRADIhG FLAN—CHECK 27.00 ## 3E i!- N� N� ## iE it if # iE N� iF fE iE #b If if� iE # tE �f k 3E # iF if i(� lE K-!f k%!f i(� if �t iE 9E iF-X� iE% M- iP I( ff 3f 1F #�)f IE fE # i( #�f� X� i( iE #% if # M� f(� i4 iF Y. iE \� �t iE # iF IE X� I N D I V Z D fJ A L� F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAi, COST PLU 1 WATER HEAT'ER AND/OR VENT 7,00 '1,00 END OF FEES CONSTRUCTION AND PLANNING PO�_ & SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Tempo�ary Electriwl Service or Pole 52. Poo1 &£quipment Location 2. Soil Pipe�Undrgrnd. 53. Steoi Reinforcement 3. Electrical Conduit UtilitV�Undrgmd. 54. Forms 4. ElectriCal Conduit•Undrgrnd. 55. Electricai Bonding 5. Steel Reinforcement 56. Rouqh Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Foocings 58. Electrical Conduit•Undrgmd. 8. Found2tion , , 59. Gas Pipe, O Undrqmd., Tet[ 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. ' 70. Structu�al Floor System 61. APPROVAL TO DECK i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent�Final 73. Roof �rains 64. Plumbing Systum - Final 74. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 7 G. Rough Elettric Wiring 67. Fencing & Access ApProval 77. Rou9h Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Oucts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping O Gas OOiI 23. Gas Pipe�Rough & Tesc 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Ta�k � Gas ❑ Od 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Geiling (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry StandpiPe 28. Lathing & Siding i 77. FIXED SYSTEM FINAL 29. Insulation ; 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIRE1v1ENT 31. Plaster Brown Coat 79, FINAL �NSPECTION 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED 33. Final Electric ��� Notes: 34. Final Heating & Air Conditioning �-• . 35. Finat Gas Pipe�Test ', , � 36. Hood Or Canopy 37. Final Factory Fireplace 38. Final Plumbing ,L/ Q�I G� 1 �- 39. Water 5ervice-Final . 40. Gas Service-Final 41. Solar pomestic-Final 42. BackflOW Preventer ' 43. BackflOW Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap fiegulacions 47. FINAL STRUCTURE & BUILDING % 48. FINALPLANNING 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co '�� 51. CERTIFICATE OF OCCUPANCY � No. Date .:._ . � , . � • � : . . i }: I " ' '_ _�' t . . . . . .. � . . i . - ._ ' -t �s � � � � � T ;F- 1 ��6 ! 1 I I � t'- �-� I � , � .--. . �. . . _ � ,' ... : , � -- I ; I I I . ' -- --- - - - ' a �., __ _ ._'.._ "__ 4`_ F. , i • j , � � 1 � • - �-- : � ! ; ' ! : i d3iN,�s sr�I�y . ��'y-� -- --�- I ! ' '' � � ' � IJ o � 1 J�w 5+►Md , , _ � � , �.�: `3 __. . _. 1. .. . _ __ . . — — -- - --•----- —• - -- -- - ._ . , . . � . I --- --'f-.__. . _ __ , _ �._ . . 1 o i ; Oo7W0l �{ _fi:OM �ON . � . . 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I � i � !.._'�-i4`f;' '��'�,,j:7 - C �:' /i/,ii�•G^�+ � � � I � _� . . � y:f..1_ ��er..� � . i . j � I _1_`i _.�_ ' _ _ i /•`a.{,.�.�� ''.P�� j�;r"it'�..'_'=, ✓ � � , I � I � � .C_-. -+.� -�._ . . _ ._. _ . , -- . ,_ . - ----_.__ .�r_.,�' � ' ! � � ' , '� ' I ' ._ , i �_ _ _.-- -�- --� - - --�- - ------- - - - - - / --- �-�� - - - — � --.— —�-- — - — — ; --- ; — — r 1 I . ; . : r . ; � �, �Si �A� ; C,/i�.� � _ ,. . � , � � � � � , ; .� ; �' . . � i ( � , , , - � i ._ , � , , , . �/�'� in� �iao,-✓�O �i9��i��f�c//J � ' i l : � : . . ; : : . : : ,�,��'°,f� � /i ;�� :�� � %� -- ;'--' �;'-"— -{--' --,---�--i .._.--- - .. j_-1- _ � � Z_a GLt/!7 + .i � r.q . li A-P-��OVED�--;-;- , ����� ;�_� _� � � � � f _-�� � � � - I gy , . , � . F HI$- �u,� '-r�c.�� � � . a , _ � � � _ : . tI I ��l � �t ' � i 4 . ` ;C05TA MESA FIRE DEPT. � ; ' . � : -: '��C b�'S�z� �au;�r,��o . -. .- -: . : . , , Bl1REA0 0� FIRE PIlE4ENT[ON ' ~� '��-�'O,u n'' ANY ' � � C05TA� MESA, CALIF. I I �APPR(QVED �PLANS , � � Q��sr� - ; -- • , a + � � • . ` � MUST__ E_ON�JOB-SITE-- � ! � ' ` { , � I __.-- DATE %Z�-%7=79�--i----- , --- --- --�--�— - ----- ------ �---�- � i i , I 1 �, � BY : � {���� ; {. � i � t � -+ , � � rt _ a , _ ; .. . ( � � � . _ , . ' . ; . . : N O P E: App�o �al applioe t�plei e-�ub. t 1 i -tI ' � } ? ' '� ' �I ' - � milted; nnd t4r coaetnwtiou, tadicetad � i . i --1. t__ _� ' _�I_- _ _ i t ! - - � � ' - — I I '- - + .• � � , . j , � ' t i � + l6oreon. lnatal! Hoa subject .to 1 ncl in , i , I Y i p.�nt•!t i.T�{�11 t• IA�- � �I� � � I I '�� � t�j��. ���y�� I I �` � i f r� � � I I I-i• I � I I � fI I 1 � � � � � -t 1 I , r- 1 � � 1 . � } { � � 1 ♦ �_.. . _ 1 J . r . I I � � � I � i ' � I � � � � � j - r � ' -��� j � f ' �--- { j - - -{- - I -- r - T �-- - -j- + -t -j r- � � ! - , i I � « i � i i I ' i � f . . � I . , .. i � � . , _ , _ �{_.�_�_ _.�L� � I �-- —i , I— -�—i—I --�—{--�— —�—+ I —� - -�--4-- —�--�--- -- - i � I � � -�- - �--�-- - i � {� � I ' � �� i � i � i I ! � I � i i } i ' �I i �I" I ' I� i i �.- r•, —, • � � f : I i t- � � � # � � 1 I � . V . {_ l I � �. � « . , � i � � I I i i I I � j I � ' � � i � � � i t ( I � � - -:��_ � ,,. �I� l ', �: �', � i; j_ ; j lI ; j i i , i � t � � I� 1 j i;-� i i _�� �; _ � � _ ' f + + i - � i- {- � -; � j -; »- J i �. � Conti2o� ✓' , i i y,.� � : I I � � � , � � I i � ; ' VA�vcB j,�,�� � � _ :_ r � 1 � � l. I t � { r — —� � � � J— �— � t - ; � { � _�'��';% - -- 1—',--'— � '---F� -��_� ._� ' ' , — � � - --`- —i-p. I —I—*— � l ��='3 � � —f-- —r--- � � � � i � I .. � � � � I � �—� � i � 1 � ' (' !¢�: � � � � � , a i � � r � , � + ; a , i � , � t � �— : ` i , ,�', ,— �, h �� -- � � � �-� -� — � � � J � - �_ � � . ��/I�� < I I � � � t - � -i � = f- � f � � � _ � - � - � 1 :_ - � h ; � = i - �,�� -;- ��--}- , i I 1 i � f I; i I-- - , I� � � rlR �1. � � __��i � � � 1 � � ' � � � � � � � � �-� � � � i i { ; t- � ,- 1 � � -; � i 1 , � ; r t ; � , � �i 1 ! � � � ' � , � i j i {- } + � - j- - i f - C � - { - � - i � {- { j i � - � — -a—�-- -- - ' � - —t- - I � ' ' � ' � -1—' � ; � i, —*—j-- �— --T-i- - -- -!-� - - �--�--- - —�- �— - - - -�- -- , � ' � t � � V' TI � -- _� � i I . - - -� . � � � - - . . - - 7- � I- --= r�� .- � ;��� - - APPRO�i�D � ���ffi�� .� �r��_/�� __ .�� ,� .s� ����":�f s�,��/ � }_ -� � /' ��b, /_�o �i',i� � �//d� . _. _ _ _ Y I , BY .- t _ _} , - I T IS �NUM3ER i�1U5T F,^�UM, _ I � /�� -_ . . _ - t _ - �- - *-- -t - �-+—�AL`L IVS C7� T PWNY -. ..� � �"i �„���/ior,n_ P-__/k � � COSTA MESA FIRE DEPT. � , o,v REQu�srs I�2_� Ju„� /� fT f,.,� _/ v� - _ � OA 1 - r --- -- � - - - - - - t CUSl'A -MESAC� � � �- } — -� -;--.- .- � - BIIAEAII�OF"FIR �-- -�-- , - � . -- - - �- � � - - ; . - - - - DATE �- Z � - �__- _ _ -- -- - -- � • - - -- - �- - � - -- - - - / /7:7-9- -- _1_ _! :APPROV ;D-PL'AN3— - '� - - - BY. � /3 cv. /-� �_ � MUST BE_ON.JOB-SIT - � - -- �- --�--- - - - � - ` . � H.O.R.E.7.Appxmd�PRtle'�tn�Plant_aul�. � . . ' ' � ." ' _ ' e ' mltled, � and tory caaatiuellon' indiceted • i I � � � � � , ' � ' ' ' 1 � I I I I _-1 ;�_--i—�_L _F-.__-i__ __J-__k. . .�___i'_ _ �-_«__ti'_—.-- _"__ �—. ' - -' ' —'—thareon.'Inefallntion- �ub{aat-to� Ilunl-lo� i - --�— �px.tion end aceeotnnce. i I � � � � I � , ' ' _ — "_ i_ '— ._ � _ _` 'a—_ �— _� _ —_ _ � ! -- �—•---•- _ �—'— � _ � +_ *_ _ —' ___'—_—_,- •_- -«_. __ _'_ I ' � ' ___—_ !._ ._—._ __— ' . � . �_ ___+— �—+ �-�— _ -- - ' ; �i � I � � =7ry � i , I;'� I I I L_ ' I I� � ''� I _� I � I ' I _��� _ __ � -,—•-- :-- - ` _ - —i— - , I - � - � - _ �-�—�.-- � - i '-,'- ��-�- --C- , �, , : , __��. _ , I . r � _ � _' --- - � � - -- � . _i-m_� I i -�- �-:--�- -� -�-�- I - i � I -f-- i - I I i i i i i I � I� I ' ' - I i I � . � — i G� I � — —� � I � ' .�.— � _ _ _ _.. — __— p 5—_-,_ —�--� t—_ I � — I i i � �� ' � � . ,� -, - -.-��—n�—`- -�_ � I I I ---- i - `"--�— --�'— _ �'� O ._ � . , � I , 4 —I— ' _ .`_ --f— ' , —{—�/ ' % ' , �}_ _ �=_.—f—!— T - I I i � i � i � � I � � � _F I ��•5'I I�_ � - , , � � - � � - - �-}-'--' i ' '� ; � , � ' - - i - - r-�- - -a-Y-+-- - ° � i ---� � - - v- �I-� ' ' '� � - � ' - �- � - .�=f-.T _ � --a -- �-}--I- � ' - � T i ', - ' �--r--- - -�-� I -c � � ; � � � I I �-T - j = t— �—?- T� I W � . . . I i � I ' i ! � , - � � I I � . _x. y� _. �� � � � �`_ ' ' � ' � _ _' _ b, I � I I I I I I I I I � I I � I_ -Z - ��---� �� i I � �� � -�- � � r- � r-� �- I � I r; � I I I I � .� _ ' r. ' � _'—'--- j�{j��— � i 1 I —�--" ' —. � _ !—_ _ ' _ j _ . 1' ', ', � ! ! � � ; � ' ', ' ' �. � I i - '';�_*---''-� .,�=��'�i;��i� J� ''i' i 'j � -t- - - -,-� . � - - - � � � , --�- i , � r-- ; - - -r ��- ,- -� -,- i �-�- , J -T , ; -i I - � �_-- - �- -! � , ��+- --�-- ---� -� - � - - , -- � --- -- - �'t-- -�-.- -- - . ; --,--�� - - - - - -- - � - � ; � , � � , � �P'No" ARTCRpP'T IL�CORPORA' JOB ADDRES$ ��p TPrminal W GENERAL CONTRACTOR �,,,,e,._R. �.6-2oo-i2 INSPECTIONS �SOIL GAS W ATEP ROUGH PLUM6ING � PROP. SwR. LINE HOUSE CON.� YSPRINNLING SYSTEM MISCELLANEOUS ROIIGH MEATING RN� qIR CONDITIONING TEMPORARV SERVICE OR POLE UN�ERGROUND � POWER � ROUGM WIRING TRENCHES (1 FORMS I—I SiEEL REINF FLOOR SYSTEM BONO BEAM [� SHEqTHING FRAME AND FLA51 LATHING — IN [ PLASTER. OROWN STRUCTURAL, FIN HENTING, VENT., PLUMBING. FINNL ELECTRIC, FINAL BUILOING, FINnI REINFORCE CDii via i � LDING PERMIT N0. SUBCONTRACTOR T � _w►=�'_ y�� 7� r P ... • COSTA MESA BUILOINGSAFEYY DEPAR MENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING . . _ �r� , i �. ... OWNER ffR CR/lGT.1 MAIL /� ADDRESS •O• �:16X %� ci7v �OST/� �%lFSA CONSTRUCTtON Nm � I FNf]FF BRANCH ADDFES'. AODRESS TEL. No. (o'fG TEL. ADDRESS TEL. CITV NO. � STATE GTV IIC. NO. LIC. NO. � SI2E NO.OF BLOGS o. OF LOT L NOW ON LOT a VSE OF � E%ISfING BLDO. � � Sep2rate permits are required for � elec[ric, plumbing and heating work. VSE OF BUILD�NG AND WOFK TO BE PERFORMED C � a > r .a x w a� � � G z W x 3 1 horoby ackno�+ledBe t�et I �avo reatl this appllcaUon and state thnt t�a oEove ��7ormation Is corract antl eB�eo to comply with nll laws regulatlnp bu(itlinp consvueNon, antl I ahall not amploy eny parson In a�alntion ot the workman'� compansation laws of tho Steta of Ca��farnie. 1 �araby cartify thet 1 am proporly Iicansetl ea e conttaeto� untler the Stata of Ce��lornia Busineu entl Protassiona Cotle, Dlvlsion 3, Chepnr 9, entl ihat sueh lieenses ere In full forea entl effxt, or I em exampt frorn Na provisipna of t�a S te of Ca =ornle euainesa antl Pro4euiona Cotle; • bn 3, �ep 9. Sipnatura o � � Parmittea AuthorizaG Apa�t @,1921 I/15i79 ��• 10.50 TL � Uf� APPLICATION FOR STRUCTURAL PERMIT RF�CEIVEDR� DATERECE1�(f.D nn.TciscuFn� � I / � / \ � RMIT NO. FIRE � ZONE TV E GROUP APPROVED BV DATE ZOf� NO.OF USE OF NEW �r/ PLAf�S BUILDING VARDSAPPROVED VARDSAPPROVEC MAIN BUILDING ACCESSORV BUILD (FROM C/L:/FFEET) & VAR � c.u.v. � APPROVED VALVATION PERMIT FEE S d PLAN CHECK S $ ���m TAX S �V TOTALPAID S � n m i 0 m TION IS FOR m T FEE ONLV: � 0 N �� m 0 OWNER Gpyp�y CONSTRUCTION "'� � DaTE 8-io-55 JOBADDRE33 6lt0 Terminal Wa,y B�iLDfNGPERMITNO. 1630 GENERALCONTRACTOR O�.mer-builder VALUE $ 2"j��,QQ Subdiviaion $3It LOT BLOCK TRACT Industrial INSPECTIONS Footiqg Trench i Foundation Forms and Grade to Garage Rough Framing �K� Plumbing, Rough to Slab Plumbing, Rouph Cnm lele Z� Temporary Pole.r;j Wiring,Roughli ' ,Heatiryg, Rough .Heating, Final Sewer. House Sewer. St. �//i� Tank or Cesspool a.ln� Out Plumhing, Final, Fixtures Plum6ina. Fin.al GasTest • �. �iCiiTiF6��L� �'�� DATE I SUBCONTRACTOR PERMITSISSUED I NUMBE �. �'a� �"��`"°-`-`.�"` l�°'� ��``�°-'c�--y /i -% �'!� a Bnilding Department APPI.ICATION FOR PERMIT \ N1 EAST 20th STREET 19 B U I L D 1 N G ' . COSTA MESA� CALIFORNIA � PLOT PLAN Show location and distances from property line and between buildinga e�� �,' •.�\•l, OWNER A�.�*r a1C. JOBADDRE55 640 Tenn GENERAL CONTRACTOR AP No. 116-7O0-1 ➢,�,]�� INSPECTIONS SOIL G�5 W ATER ROUGH PLUMB�NG PADP. SWR. 41NE I � MOUSE GON. MISCELLANEOUS ROUGM HEATING eN� �IR CONDITIONING TEMPOR4RY SERVICE OR POLE UNDEAGROUNO ❑ POWER ❑ ROUGN WIRING TRENCNES I J FOFmS STEEL REINF FLOOR SYSTEM BOND BEAM 1 STEEL REINFORCE (—] SHE4THING FRAME AND �LFSHING LFTHING — IN �� OUT � PUSTEA. BROWN COnT STRURURFL, FIN4L HEnTING. VENT�. AEGRIG. ANO �.C.. FIN�L PLl1MBING. F�NAL ANO GA$ TEST � E�ERRIC. FiNRL BUILOING, FIN4L DAT�2-17-79 2 )ING PERMIT N0. �193br-- ZONE VALUE PE V GROUI SUBCONTRACTOR F � L Q � h ti'i F O W .d Q 7 r � a u� a O C a z W S' 3 .-_: � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX1200 COSTAMESA,CALIFORNIA92626 For Applicant to Fdl in Comple[ely — Use Ink Only BUILDING O / AODFESS OWNER OR TENANT MAILING ADDRESS ' TEL��� � CITV i. . i. Pf/J NO. BRANCH +� AODRESS I( ARCHITECT OR ENGINEER ' ADDRESS " CONTRACTOR l` ADDRESS 1` CITV II STATE �� LIC. NO. S12E OF LOT VSE OF /� TEL. TEL. NO. CITV UC. NO. NO. OF BLDGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work. VSE OF BUIIDING AND WORK TO BE PEPFORMED I hereby acknowletlBa that I have reatl thls applicetion antl rtete that the ebove intormation is eorrect antl apr80 to cOmply with ell lews reBulatlnp builtlinB conrtruction, antl I shall no2 employ eny person in violatlon of the workman's comp¢nsntion lewa of t�e State of California. I hereby certlfy thet 1 em proparly Iicansatl aa a eonttector untlar the State ot Callfornia Bualnesa and Profeulons Code, Dlvlsion 3, Chaptar 9, and that auch licenses are In full force end effect, ar I am ezempt fram the provisions of the Stete of California B�sinecs end Professlons Cotle, Dlvislan 3, Chep er 9 � Sipnotura ot Permlttae - ' � or �7 Avthorizetl Agant Date APPLICATION FORiSTRI)CTCiRii. PERMIi' 5.50 TL RECEIVED V PERMIT N� 49361 A.P. NO. �% �' � f � � BUILDING / ./Q ADDRE55 `.V L F— VNIT OR SPACE NO. TR.NO. LOT NEW ADD LTER USE ROVE � PLANNING ACTION �%/9/A�I'3L /� BLY R MOVING DEMOLI: 1N�. � VALUE DD E � /�... GROUP / 'e flavE �at � � � DATE APPROVED m C > 0 J THE AMOUNTSHOWN UNDER VALUATION IS F m THE PUFPOSE OF E5TABLISHING A PERMIT FEE ONL . � VALUATION PERMIT FEE S � Q Q � O PLAN CHECK y � '^ 0 $�� TA% E � f � � U TOTALPAID E ,t��/\ `' ' :i�i� . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA, CALIFORNIA FOR APP[/CANT TO f/Ll /N COMPLETELY TYPE OR PRINT BUILDING �O TCISQ�� W ADDRESS IS COSTA MESA. CALIFORNIA ER TEL. CITY NO. AR iCT LIC. OR ,INEER NO. c.��Y STATE JC11 LIC. NO. LEGAL I LOT /I �{I� OESCRIPTION NO. U BLOCK RACT APNO //(p� �J Q�'� I �� SIZE // NO.OF BLDGS. OF LOT �Q�� I T G NOW ON LOT � USE OF �V � EXISTING BLDG. SETB4CK LINE FFOM � CENTER OF STREET �O � FEAR YARD , Private IRoad _ I _ SIDE VARD LEFT � RIGHT � DESCRIPTION OF WORK NEV. I S II ALTERATION I II ADDITION I REPAIR I IIMOVING I SIZIEDING 1Z B l�i ROOMS 1 EXTERIOR�WALL [p�. ROOF COVERING •+x COVERING 1 USE OF BUILOING AND WORK TO BE PE 1 HEPEBY ACKNOWLEOGE THAT 1 HRVE RETO THIS FPPLICATION pND STATE THAT THE f�BOVE IS CORRECT AND FGREE TO COM- PLY WITH ALL CITV OPOINRNCE$ ANO STATE LRWS REGVLATING BVILDING CONSTRIICTION. J��A/'r—' //l /' SIGNATURE OF � �A PERMITTEE Servonic Instrumenta� Inc. AUTHORIZED AGENT BY ;.,j a�sc.�j,j1 ;: . FEE RECEIVED APPLICATION FOR PERMIT eu��o�r�?�ANCE DEPT. CITY OF COSTA MESA. foR oFficF usE on�cy I'�'RECEIPT NO. I PERMIT NO. i 0Y COSTA MESA, CALIFORNIA � ZONING NO.OF USE OF N I PL1N5 � BUILO�NG issueo LINE ST,� ��.�S ' �D�.cY.J FT. IN. �� �. e / FT. IN. �/ O FT. �N. _ _' THE AMOVNT SXOWN IINOER VpLllAT10N IS FOF THE PUFPOSE OF ESTRBLISHING A PERMIT FEE ONLY. VALUATION � — PEftMIT FEE $ g /// � PLAN CHECK $ CJ TOTAL FEE $ � �