HomeMy WebLinkAbout503 TRAVERSE DR - Building Permitsrxaecraooxess: 503 TRAVERSE DR
OWNER'SNAME: SHANK� ALBERT F
nooxeas: 503 TRAVERSE DR
GOSTA MESAiGA
qPC1UENGINEEP: 546-6 7 7�
ROUflE33: n
uxir:
92626
flE0.N0.:
uxiT:
PEeMmEE: OOOOO
nooness: NUCK PLUNBING t714)895-1246
i 11610 SEABOARD CIR
STANTON CA 90680
I, LICENSED CONTMC708 OECUMTION: I Aereby attirm that I am IkenseU unOer Dmvisions oi ChaD�er 9(commendn0 wit� Section
i7000� o� OivLtion 3 al tAe Business anU Pmteuions Cotle. an0 my licenu is in fu0 force anE effect.
cm uc.: 5038b qsTn� uc.: 511971 ��� G— 6
I.Data:�...��(%p_� Siqnamre:— �
WOPNENS' COMPENSATION OECUWITION: I Aeahy affirm ihat I ave a uNficate ol wn nt ro selbinsura or a cetli/icate ol WaMers'
fqmDen5dGd1 InSutant¢. Or a ttrtilie0 fApy Ih¢r¢0� (SeCtion 3800, LdO. C).
��creo.:116799290 Exa.oeh: 03/O1/92
iMv�xr: STATE
�I CeNIieE caDY is herehy Iumis�e0. � Cetlifietl coOY � h�e0 vnth t�e dry BuilEinp avision.
,—��, 6 -ie —R� �,a���:
i
IXEMPf10N FBOM VIONNEPS' COMPENSATOX OFQAMTION: (�Ns secuon neeE not Ee co IeIM i� Ne pertm k lor one huMreA �5100) a lar�.
I certiy Ihat in IM pedormance ol the woA lor wNCA this permit Is issue0, I sAall not emDby any person in any manner w as to Oewme
suhjat to iM Workers' Compemation Laws of Calilomu.
Oate: SiOnatura:
NOTICE: It, atler malJnp thls Aeclaration, you sAaultl become subject ro I�e Workers' Campensation Dravisions oi Ne LaEor
CoAe, you must fortAwit� comDh ��� wc� pmvisio�¢ or INs permit shall Ee deemeG rewkeE.
CON87BUCTION LENOING �GENCY: I �ere6y aifirm that Nem 6 a construction Ientlin0 a0ency lor IAe pedormance af I�e work lor
which ihis Dermil is issueA (Section 3097, Civ. C).
�xoee:
aoosess:
OWNEB BUILOEN �ECUMTION: I hereby atlirm tAat I am exempt from iha ConlraRors' Stata Licensa Law far the followinp reason
(Seciion 7037.5 Busineu antl Professional Cotla: My ciry ot counry whic� requias a permit ro consimct, alter, imDrove, Oemolish, or
repair airy stmcture, D�or to its iuuance, alm requires I�e aODlicant for such permrt to tite a siqne0 sutement t�al he/she is IlcenseE
pursuant to Ihe Dmvisions of the Contractors' State Licensa Law (C�apter 9(commencinq wiN Section 7000) ot Division 3 oi iha Business
an0 Pmfassions Cotle) or ihat ha/s�e is exemD� �herefmm anA the basis for roe alleqed aeemDtlon. Any violation ol Section 7031.5 by
any ap0licant lor a permit su0lects Ihe aDDlicant ro a ciWl penalry oi not more than fNe �unOretl tlollars (5500�.
, I, as ovmer al Ihe properry ar my employees with waBes as iheir sole compensatian, will Eo I�e work, anE tAe
slructure is nat intentleA ar ottere0 for sate (Section 7044, Business antl Pmfessianal Cotle: TAa Coniraclors' SWte Licensa Law
aoes nat aDDlyla an ownerol a propetly w�o bullEs orlm0�ovuthereon, antl wla Ooes suc� woM �imulVhersell orlhrouAh
. �is or Aer own employees. D�oNtleO Itwt wc� impmvemena are not imenAeC or alfereA for sale. II, Mwever Itre OuiWinp ar
improvement is sold wlt�in one year of completbn, the owner xitl Aave the 6urden of OmNnp M1sAe AiO�not Uuiltl ar impmve
lar Na Durpose of ule).
I, az awner al lhe property� am exclusNeIy coniracting wit� Iicense0 mntracrors to consWct tAe D�oject (Sactlon 7044, Busineu
❑ aM Protessiorrs Code: TM Comnctas' Stata license Law tices not apDN �o an wmer oi Droperty wAo MdEs a ImDroves Ihereon
anE wtq coniracls lor SucA prqects ii� a contactor(s) liunse pursuant to 0e Cantmctars State License Law�. I am aware
��� D��� of Iheir Warker's ComDensGion insu2nce sMu10 �e OroviOeU ro me.
� I am exampl unCer Sectian: B. d P. C.
tnr N5 rea5on:
Date: Owne[
I Eo herz0y uNry ttat I am awam ol and understanE Ne rtQuirements oi Calitomia Mealt� anE Salery COGe Sectbre 255W. 25533, an0
2553d anE tAat I or my luture OuilGinp occupant wiiVwill not (cirde ane) neeE to compy witn saiE sUte co0w anO Ne repWrements tar a
permlt tor construction or motliliwuon imm Ine Nr aliry Manapement Disinct. HesiOential canstruction apDGatians am eeemD� �mm
Ihe59 D�a�iSions.
Od�e: AppliCdnl:
I �er¢Ey certiy ihat I luve rea0 tAis appliwtion an0 stata ttut the above intormation is correct. I apae ta comDM �h atl ciry anE counry
ortlinances and stata Wws relatin0 �o CuilCinO ���mciion an0 �ereby authorize represenUtives al t�¢ city to en er uDon t�e ova-mantloneE
DroDertY �orinsDeclion Durposes. //
� (�
.Oa�e: � Gy_` ��'' —1 � SipnaNrO: _�lti �� ,
a
oriver's L�cense or Socia� security x:
16at�08 While—BuIlEinp; Green—CaCe Enio¢ament; Canary—AppliwnC Plnk—Revenue; GolOanroO—Aaaenor
CITY OF COSTA MESA — BUILOING.PERMIT PERN N�: P 052310
PERMIT NG: P 05231C PLAN GHEGK N0:' R GOVT: N SUPP: �
GONSTRUCT7CN 7YPF: V—N PERMIT 7YPEs PLU PURPOSE: GTH
JOB LESCkIP7I0N : CHAP,IGE OUT DiSHWASHER SC FT:
GLAIM VALUE: GALC—VAW E: GRQUP GGG: R-3 /
COMMENTS: SMGKE DETECTOR RE6IUIRED iN THE HOME
�a:a**s#�ax�����aa#oa#xi�sa�aaa#ass**tsas*sasp�a*�sa#��z*s#�ssa*o**s��zss�*o#ata##�cs*#
Z � N I N GS ERTEBeAU`IKRSE M E N T S
— MAIN BUIL�IN6 ------ ---- — AGCESSORY BUILDIhG. -----
FR�T: FT iN kEAR- FT I� FRNT: � fT If� REAH: FT IN
LEFT: FT IN RGHT: FT 1N LtFT: F7 IN AGHT_ fT .IN
PARKING RE4: PROV: PARCE�: 04180320 2NE: REF N0=
PLaNNING NOTES>
>
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D E Y E L 0 P P9 E N T 5 F R V I C E S' R E 9 U I R E k E N T S
ZONING APPROVEO BY ' DATE:
BUILOING APPROVEC BY : DATE: !�,, _
APPLICATION ISSUEU BY: _�������3������� DATE: ���E��
#�3��#X�X�*#�R�##3#######R#�-3#�3� � 3 # ���C#3#35��0�!#• #�Fi��F#�t#
�#A�t�#�i3#.�R#t#�k##S�3###II###t��R#�Q*II�k�Y*�t���C### #�t#####�Y##�F3##i#A�#*#3##3##fC�CO##X�
LEGALIZATiONsN F E E S U M M A R Y STRUCTUAAL SEGI9ENT:h
BLOG PMT PLUMBING ELECTRIC MEGHANIG FIRE SkIP/RES GRADING
PERMIT ZZ5$ SKIP/NCA—RES
FL AN �
ISSUE FEE 3.00
BUILDING—DIV—> PERMIT ISSUE PLAk—CHEGK TOTAL PAID DUE
TOTALS----> 2.U0 3.00 0.00 5.00 5.U0 .00
REVENUE GIVISION TOTALS—> COLLECTED: 5.00 GVER/SHORT: .00
BLQG PMT PLUMBING,ELECiRIG AIECHANIG FIRE SMIP/TOT GRADING PLAf�--CHEGK
5.00
*.e��mtx�##$�z#�a#a�#�#a��#s�#��*asas#s#*sasaasasaa��aa*�xas��aa*�*sss�asastas*sss*
I N D I V I 0 U A l F E E 8 R E A K C 0 Yi A
TYPE 9TY D E S G R I P T I O k UNIT CGST TOTAL GOST
PLU 1 DISHWASHER 2.00 2.00
END OF FEES
�'A�2 .�i�.– ��`-�' �i,, � .
l,yT. '�: �.:: .::.. ' ,
CONSTRUCTION AND PLANNING F _& SPA
' APPROVALS Permit # ' -Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole, � 52. Pool & Equipment Location
2. So;l Piee�Undrgr��j,. a "� " �.,n�', 53. Steel Reinforcement '
i3:.Electrical Conduit�UtJlity-Undr.grnd.: ��. � 54. Forms -
��4��Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
�
�5: Steel Reinforceroent - 56. Rough Plumbing & Pressure Test
�6; El�ctriwl UFER'G�nd. _; 57. APPROVAL TO COVER�GUNITE j
;Z. Footings �� _� 58. Electrical Conduit�Undrgmd. i�
8' Foundatio� , 59. Gas Pipe, 0 U�drgrnd., Test �
9. Water Pipe-Undrgmd. �y % 60. Backwash Lines, P•Trap, O Undrgmd. ' .
10. Structural Floor System f � 61. APPROVAL 70 DECK '
11. Property Sewer Line;& HoYse Conne�tion - � 62. Backwash & Receptor�Final
72. Sewer Cap . -., � . 63. Heater & Vent-Final
�,.
73. Roof Drains � �
�.., 64. Plumbing System � Final
14. Rough Plumbingi � 65. Electrical�Final �
15. Rough ElectricakConduit � " 66. Solar SYstem�Final . ,^
76. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectricaCT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Ari ConditioninQ r. A - �� n� FIRE DEPT. REQUIREMENT_ �.
� - t x � �a � x .i s w a � •-i �_i n. . r 1
20. Rough FactorY Fireplace � _ ,. z _. ,-..r � ljPPROVALS� ,3ermit # . _
21. -Ducts, in�Structure �+ i •"` ^' � '� � � "Q'� 0. U�3dergrourid�HYdro
I it � ^�;! •.5 ..� ..
22. Ducts, Ventile'ting�. � '�,j � y -> w:tj� -71. Product�P.iping �Gas ❑�Oil
23.•6as Ripe•Fiough & Test i • ' ^ _ :?,F .} -9p, Underground�Flush � '} �,
24. Roof•Framin§� --:r I �-'- •,- n > ] s -;. e - � � - �
� �:• � n ... u.t .73. �Undergrnd� Storag�_Tank O Gas ❑ Oil
25. RoofSheathing � ��` � ���•'+ 7q, �Overhead Hydro : ''r
M1
26. �T-Ba� Ceiling (Structural) & Moiiocoat ,' ,� � '" j` y � ` ` ' �
i 7,_ ,p � i , ,. 75. Dr Chemical ._ � ,r� ...,
27._Frameand Flashing� > >r.r � �;x 76. Dry Standpipe " � ' i _ -r
� .� � �
28. Lathing�& Siding �r� "� �•s� '* "� "� ' � � „ 77,�FIXED SYSTEM,FI,N�QL„ _ � ,�
29. Insulation + C�� �� � x. I I 7?y 78. FIRE PREV. flf� 'L' '} � • _'
1a ` s� I I•t :s .r . � � t+
30. Drywall Nailing „� � � F„ I � �ri �j :�� � -�Fi�FjLTH DEPT:,R�QU�REMENT
� _ � � �• i �a �., •, � . .
91. Plaster Brown�Coac:r > i^� �> I tf s+ �*99, FINAL INSPffCTION
- ^�-
�'32:�lectrica,l`Power M'et'erFinal � '� `� � � � �� � 90._�'OOD CERTIFIC�/��E ISSUED.,
.� � ,a �.� I o I I, la a
� I ? J a .. s u..
�,83. �Final�Electric� -.a i i 3 a 1 1 .I�� o Notes: J� '�•'� �f � . �
7 T '
34.'Final'Heating'& Air-£o ditiohirig� ? ^ T � � �+++� ' � �_ +` c .�
t � -n .i c � I 1 .rltlo.� -+ I .-c
i35.;'Fina-fGa;�PipRTei4s� �� .• a� � i, la a-� _�� .7-� o T
36. Hood or CanoPY =�• � t r� .� �'� � f 'kr x s -- -» ..r ~ �'
�, - r -'la � I�- ta e I 1.,.>o �, C..7 e}.i .,
'1 :C'�7.�' '�T -� .� 4� t. i
�7.�.Fin�I,FactorV FirepJace„- �-�.. n e I e 2 o v
.
•98. Final"Plumbin9 " "� � -'� • ��I i >a � c -� o n
.. �-! I �f i I (tt U^. -• t iF
39. Watei Service-Final¢ : � `� #_ j � �;y y y � � �. "
• 40. Gas Service�Final a� a"' � � 1 I I» � .� u ...� d a~
x ��.- *•. n I I Nta �•.• ..��: us
41. Solar pomestic-Fina ' � '� * '� I '� � ,.. ""' '
.� ` Tt � I I la o .. � J S ,; � J
42. BackflowPreventersr^ rv ir � I 1 Mt� ��- ec� ^
�+- -1-.r #-» 3}# n �t1'] J
r it CG�: # Stii r.� ' �� '� .
43. Backflow Irrigation� r a x i! # 17 / t� 7 �
r .� . _
�44. Landscape Ic�igatioRSystemAir.,� w' it n'7 a Ja ri a; V v =<� � •v _,
�T �-� n d a LKo7 i 4 7.T 4� r-'
Q rlSe /t Yf? �... � rDfY7 r.� ry JiJ A v
'45. pSound Atten�ation� .�„„ ,i. .,.� .�.� .,��y � � � ,r a • �. � tt
x
46..Handicap.Reg�lations -+ a � na,c '.;. � �J ' w
� nv i btt it n n n
�7.'FINALSTRI�CTURE&BUILDING �y� .�;}�� � � r n '-
48.�:EIN'AL PLANNING� 1 r-.- t� v I 1�' ti+t .7 n a a� �-
.> 1 la z r� !� v G a
49.�Eleciric Relea'se to Edison � �` � '}'T � '� " '
n, ,• i :i ' t,+ # *7 1 • "1 r
..50.<Gas�Release ta Southem Califocaia�Gas Co tt I I# � �- .. � '� . •��+'t ++ � : �
.� u . e; -r. ? � ti v �
r51. CERTIFICA7E OF+OCCUPA'NCY n "' � '� "� -� • N - �
No. Date
�I
` I
PN0.IECT RUOflESS: S O 3 TRAVERS E DR
OWNEN'S NAME: SHANK JEAt�IETTE D TR
�! AD�flE55: SO3 T�AVERSE DR
COSTA MESA,CA 92626
546-6710
• RBCH/ENGINEEfl:
RODHE55:
flEG.NO.:
UNIT:
UNIT:
vesminec: JEANETTE SHANK ( 714 ) 546-6710
aooeess: 503 TRAVERSE
C.M, CA 92627
LICENSEO CONTNAC70B oECIABAT10N: I nereey allirm �nat I am licensea untler o�ovisions af Cnapter 9(commencing wi1A Section
7000� ol DiNvon 3 0l Ihe Pvsiness antl Pro�essions CoEe. anG my license is in full force anE ellecl.
cm uc.: srnre uc.: cuss:
�aie: SignaNre:
WOBREXS' COMPENSATION OECU�BRTION: I hereby allirm I�aI I Aave a certilicate of consem m sell�insure or a cenilicale oi Workers'
Compensanon Insurance, or a cerlifie0 copy Ihereof (Section 3800. Lab. C�.
POLICY N�.: EXP. ORTE:
COMPpNY:
� Cenilied coDY is �ere0y lumis�etl. ❑ Cetlilie0 coDY is IileO vnlh Ihe ci�y Building Uivisi0n.
Oale: Applicanl: ���///
E%EMPTION fPOM WOPNEAS' fAMPENSATION OECUflFTION: (This seclion neetl nol be complete0 ii t�e permit is for o t,nunAreA (51W� or less�.
I ceriity �ha� in I�e petlormance o� �he work �or whi ermi issueq I shall noi em loy any Derson in an ( nner sa as �o ecome
sublecl to t�Work�s'fA-Oensaiion Laws ol ah�omia. /
Date: b �� Si ure'
NO710E: If, atter making IAis declara�ion, you u me suUlect lo I�e orker ion pmvi5ions of 11e a�or
CoEe. you musi Ianhwil� comDly wit� suc� ovi ' or tAis permit s�all be OeemeG revokeG.
CONSTBUCTION LENOING RGENCV: I hereby a' t�a� t�ere is a consimciion IenAinA aAency for the pedormance ol the work for
wnich Ihis permii is issued �Sec�ion 3097, Civ. C�.
LENDEX: �
IIOOflESS:
OWNEfl BWLOEB OECUM7lON: I heRDy alfrm tlWt 1 am e.empt irom tne COntractors' State License Law tor tne tollovnng Bason
(Sec�bn 7031.5 Business anG Pmfessional CoEe: Any city oi caunty which reQuires a permit to consimct, alier, impmve, Oertwl¢h, ar
r¢pair any SlmtWr¢. D�iOr Io iis isivante. also feQUireS �he ap0�icani br SUCh Dermil ro lile a 5ipnetl Slalemen� tha� �e/she is litensed
Oursuant m the pmvisions ol IOe ConVactors' Slale Littnse Law (ChaD�er 9(commencing with Setlion 7000) of Divivon 3 oi lAe Busineu
ana Pmfessions CAOe) ar Ihal he/she is exemD� ��erelrom antl ine basis lor Ine alleged e�emD�ion. Fny violation ol Sec�ion 703t5 by
any aDP�icantfor a oermil subiects Ihe apo�iCan�lo a civil penalry of not mort tAan five nuntlre0 Oollars (A500).
1, as owner al ihe pmDeny or rtry empIoyeeS with waq¢5 a5 IAeir Sole fAmDensatian, wiu tla ihe wotk, antl the
� slmciure is no1 intenCeG or o�lere0 for sale (Seclion 7044, Buvness an0 Pmfe55ional Coae: TAe Contrac�ors' SUie Licenu Law
Goes nat aD01y m an owner of a pmDeny who �uilOs or imprwes ihereon, antl wtw Ea5 suc� work �imsell/Aerself ar through
�is or her own employees, pmviEeG i�ai such imDmvemems are not inten0etl or offere0 lor ule. Ii, however tAe �uilAing or
— impmvemenl is sa10 within one year 01 rAmpl¢lion, tA¢ awner vnll twve Ihe burden ol pmving �¢/she Eitl nol Euild or impmve
for the purpose ot sale�.
I, as owner ol �he pmpetly. am exclusivelq conVacting wii� licensetl contracmrs lo consimct the D�olect (Section 7044, Business
❑ antl Prolessions CoEe: The CAnlractar5' Slate License Law tloes nol apply to an owner ol pmpefiy who bmlUs ar imprOves ihereon
an0 wha tonlratts tor Such pmjetl5 wil� a tonVatlor�s) lit¢nse pursuanl to �he ConlratlOrs' Sta�e Litens¢ Law�. I am aware
I�at D�ool ol iheir Wotlter'S Compen5alian insurance pmvi0e0 to me.
� I am e�empl untler Seclian: . 8 P. C. ///�
tor �Ais reason: / � / /i A
Oate, �� — ���,/,L—
I tlo here�y certify I�al I am aware oi and
25594 antl I�at I or any lulure building on
Oe�mit lor cons�mclion or motlilicalion Iri
Inese pmvisions.
Oate: QODlicam
I here�y wtlity �hal I have reatl Ihis applicalion antl slal
ordinances antl stalelawsrelatinglo buileing conslN �
pmpetly lor inspeclion purpases.
oaie: � '� � nawre
Urive�'S License or Social Securily k:
16a1-a6 W�ile—BuilEing; Green—Catle Enlor I
Ith and Salely Cotle Sections 25505, 25533,antl
witn saitl state codes and t�e requiremenis for a
emial constmction applications are eKempt imm
to
Canary—AppLcanC Pink—Revanue: Goltlenrotl—Assessor
• CITY GF COSTA MESA — BUILDING PERMIT PERM NO: B U59106
PERMIT NO; B 059105 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUC'TION TYPE: PERMIT TYPE: STR �� PURPOSE; OTH
JOB DESCRIPTION : T/O APPLY SHEATHING REROOF W/COMP SHINGL �'SQ FT; 4,000
CLAIM VALUE: 4,000.00 CALC—VALUE: 4,000.00 GROUP OCC: R-3 /M-1
COMMENTS: REROOF 165F RESIll & GARAGT:
�x��t�-�-�t��x�*+c*�x�*x��t��-ar�-�x�x�-x��tit�x***x��x���t-���t�x�tit�t��t*�x��x��t�xx*it*-�-�*�x�t�t*�t�*�x.se)�� Y .. **�V���
Z O N I N G R E� U I R E M E N T I �����
-- --------- MAIN BUILDING _____S_E—T B A—C—K—S—_— ACCESSORY BVIL�Iid� ��Q ---
FRN'i': FT IN REAR; FT IN FRN7'; FT IN REAR: FT IN
LEF1': FT IN RGHT: FT IN LEFT: FT IN RGHT: E'T IN
PARRING REQ• PROV; PARCEL; 41803207 7.NE: REF NU:
PLANNING Nt7TES>
i
�1E iE iE * iF *�k iE i(� k�l! iE it iFiE �tF �E i(� ik ik iE iE k*�k iF iF �r i(� iE iF �I-* iE �E iE �E i�� iF i(� �t� it iE iF #* iE �lE it � i! �lF iF il� it� iF i! �(� k ic� 1F * iF�1F i� 1t� iE �(- ��* iF iE iF f� it iE it� iE �E
D E V E I.. O P M E N T S E R V I C E S R E�i U I R E M E N T S
ZONING APPROVEf1; BY DATE: -
HUILDING APPROVED BY ; DATE; _
APPLICATZON ISSUED BY; �— DA'PE; `�I ��0
1fiFiFiEfElEiEi4ifiEififiFiElEiFiEfEiFiEiE3tiFiFiF7firifiF7t�iriFiF�riFTrTriFTriFif7F �F3FiF3F3FiFiFiFif7FiFiF1F-IFi'rif�FiEifikifiF r t IEif
i(� if 1F lE 1FlE !f if�if ihlF IEiE iE iE iFlE 1E 1E if if 1E iE il� IE iE iE if� iE iF if 3Eif if if 3E iF iF iE #�1f� iF iE if iF 1E iF iFiE if iFiE It iE �IF if if i(� i4 ih ib iF ik iE 1E i(� iF aF i(�!E!f• iF ih if ii iF 3E iF 3(�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
.� -. �.
BLDG PMT PLUMBING ELECTRZC MECHANZC FSRE �$MIP/ii£S GRADING
PERMIT 63.00
�� SMIP/�IQN—RES
PI,AN ;;.- ; •
ISSUE FEE .! .+
BIIILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL � PAID DUE
TOTALS----> 63.50 0.00 0.00 63.50 63.50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 63,50 OVER/-5HORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT/'GRADID(G'PLAN—CHECK
63.00 ,50� ,%
iE iF if i! If �f K iE aE aE iP !E 3(� ft iE if 1E if ff 3E ib IE iE iE iE if it iF 1FiE iE iF-)E iE 1E iE iE iF iE 3f 3F iF iE iF iF iE �F iE�IE 3P iF if 1E ik iF iC� iE 3(� iE 1E 1E iF�1F if iE 1F�E'3f if !E 3E iF �F �E 3f jE �k iE jE
I N D I V I D U A L F E E b R c A K D 07W N
TYPE QTY D E S C R I P T I O N UNIT (,'OST TOTAL COST
SFR 4000 REROOF BY VALDE RESZDENTIAL NOZONE 1��0' � 4,OOO,UO
END OF FEES �
I /:
i• .
'U !.
��. 7 - '
'!� i•��
��93 �:ti �
CONSTRUCTION AND PLANNING PO� i SPA
Date Inspector Date inspector
APPROVAIS Permit # � - APPflOVAIS Permit #
1. Temporary Electrical SCrvice or Pole 52. Pool & Equipment �ocation
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 54. forms �
4. Electricai Conduit�Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcemeni 56. Rough Plumbing & Pressure Test �
� 6. Electrical UFER Grnd. � 57. APPROVAG TO COVER-GUNITE
7. Footings 58. Etecxrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgmd.
10. Structurai Floor System 61. APPROVAI TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal .
12. Sewer Cap _ 63. Heater & Vent-Final
13. Roof Drains ' 64. Plumbing System � Final
14. Rough Plumbing � 65. Electricai-Pinal
15. Rough Electrica6Conduit � 66. Solar System-Final -
76. Rough Electric Wiring 67. Fencing & Access App�ovai �
77. Rough Wiring Sign ' 68. APPflOVED FOR PLASTERING
18. Rough Electricai�T Bar Ceiiing 69. POOUSPA SYSTEMS F�INAL
79. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fiieplace " � � APPROVALS� Permit # -
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating �-71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Undergrovnd Flush �
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing - i�/e�/Q� 74. Overhead Hvdro
l �� f t -
26. T�Bar Ceiling IStructurall & Monocoat l _ � 75. Dry Chemical
27. Frame and Flashing 76. Dry Sta�dpipe
28. Lathing & Siding _ i � 77. FIXED SYSTEM FINA�
29. Insulatio❑ � �
I 78. fIRE PREV. FINAL
�30. DrYwall Nailing � I � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai i � 79. FINAL INSPECTION
�
� 32. Electrical Power Meter�Final � � i 80. FOOD CERTIFICATE ISSUED
33. Finai Eleciric ' � � Notes:
34. Finaf Heating & Air Conditioning I I � , -
35. Final Gas Pipe�Test i � � . �
36. Hood or fanopy ` � �
37. Finai FaMory Firepiace �- .'
38. Final Piumbing '
39. Water Service-Fina� �
40. Gas Service-Final
41. Solar pomestic-Finai
42. 8ackflow Preventer � I
43. Backfiow Irrigation g 17 GJL�
� i . _
44. Landscape Irripation System q..«�i � �a��` � � �l�
45. Souod Attenuation � , ` /_�^
46. Handicap Regulations � � � '7%-- � x`'� ��
47. FINAL STRUCTURE & BUILDING ��� '� � ��
48. FINALPLANNING
49. Electric Refease to Edison
50. Gas Release to Southem California Gas Co i �
51. CERTIPICATE OF OCCUPANCY
No. Date
GENliRAL CONTHACTOR i
INSPECTIONS
�DESCRIPTION OF WORK
VALUE
GROUP ,T TYPE
SUBCONTRACTOR
`iV O(
PERMIT NO.
c'� 27506
i
� C05TA MESA BUILDING-SAFETY DEPARTMEM
P.O• BOX 1200 COSTA MESA� CALIFORNIA A262E
For ApplimM fo FIII In CompbNly
TYPE OR PRINT
m
COSTA MESA. CALIFORNIA
�S
o <!C
P:.Iq
f,UG 30�67���;�,001307<` ����'''�1=.5�
AIPLICATION FOR PERMR
BUILDIN6
for OH(c� Us� Only
ZONING
[ / no. or ues oi ni
�ur�� OUILGINO
BHALL DH Ll88 TXAN
� �D 1 NOW ON LOT �/ ALLOWBD (U. B. C. HEQUIR8M6NT7
YARD/APPROVED YARG9APPROVHD
� 'EL/( MAINBUILDIN6' ACC6880RYBUILDINO
tFROM C/L iTRH[T)
rxo� FR NT RT.
ieaT 11RAR YAR
i / � �-
LEPT S RIOIiT R.� ID IT.
DESCRIPT{ON OF WORK �.aio rr. � rr.
ALTBRATIO �CDITION R�� � �� ��
DIBTANG6 B6T. BHT. MAIN Q
MOVINO DBMOLI H MAIN BLDO . AGCES9.BLDOS.
� NO.OP VAX.�j DATB
ROOM6 � HiORI / G. . APPROVHD
•,• noor �rreovm f, J/1 �.� �. n
r
1 XBP69Y ACKNOWL[UO[ TMAT.1 X�V6 NfAD TNI� AV►LIGTION
AND BTATC TNAT TI[ AOOVi IB CORq�C} I1ND AOR6[ YO COM.
PLY WITH ALL GITY OROINANCp AND RA�p[OYL11TN6
eu�tolNa eoNBTRumo 1.
816NATURE OF T
P8RM1TT6 "
AUTHORI3[D A � ��
cv � � • a
w
�
�. �. �
TIB I1MOUlR tXOWN YN061i VALUATION 19 POR TN6 �
►URPO9i OI i@IAlYeHINO A PHpMIi Pfi8 ONLY.
VALUATION 7
� PBRMIT FHB � p
s �(/�/ / •,5—� w
i 7 ._._
'� ' 245�5
;,.
�CQSTA MESA BUILDING-SAFETY DEPARTMENT
P.0.90%Df] COSTAMHHA,CALIFORNIA
For Appllcant to Fill In Comple}ely
TYPE OR PRINT
eu��oiNo SQ'� ��
ADDRESB
COSTA MESA, CALIFORNIA
� AR�""TECT
� STATE
EXISTING BLDO. ��
BETBACK LINB PHOM
TEL.
NO. OI OLDOB.
DESCRIPTION OF WORK
1 HBREOY ACKNO
ANO 6TATB THAT
GLY W�TH ALL CI
em�owo coHari
SIGNATURE OF
PERMITTE�'
AUTHORIZED A
NO. OP
ROOMB
I ROOF
n
CITY OF COSTA MESA
AUG 19 1965
APPLICATION FOR PERM
I �? ��'��,,,.
FIRB
LlOAL
YARDS MPROVED
MAIN BUILDINO
VAR. JC
ft��������i
/Q' L�'C CC�L,Z '✓(C�/ �
�h �' �b
HHALL BE LESS THAN
fU.B.C.RE0UIREMENT;
YARD9APPROVED
ACCESSORYBUILDING
DATB
a
6 64. �. �
�pp�,�GT�pry TM8 AMOUNT 9HOWN UNDHP VALUATION IB POR TH8 =
'.!8 TO COM. VI1RP08¢ OR EBTABL�6HIN0 • PEFMIT PEE ONLY. �
x80uLwTINO ypLUAT10N
� 72 c9 0 „
PERMIT FEE j
s 2�t 3�j,(� 3 e
a
� O� �
TOTALFEE
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