HomeMy WebLinkAbout671 WILSON ST - Building Permits• � CITY OF COSTA MESA �
BlIILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: P09-00068
PERMIT TYPE PLUM
APN: 42217104
JOB ADDRESS: 671 W WILSON ST CM
Vicinity: SFD
SCOPE OF WORK: COPPER REPIPE OF AN EXISTING SFD.
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
OWNER:
PHONE:
APPLICANT;
PHONE:
WORTH. EDGAR R AND CAROLYN J
HOVSERPIAN, ART
818-566-1390
STATUS: ISSUED
DATE ISSUED: O6/OB/2009
ISSUED BY: BJK
SuitelUnit:
Address: 671 W WILSON ST
City/State/Zip: COSTA MESA, CA
Address: 400 N GLENOAKS BLVD
City/State/zZip: BURBANK, CA
CONTRAC70R: NUMBER ONE STATE PLUMBING INC License No. 818637
Address: 400 N GLENOAKS BLVD PHONE: 818-566-7390
Ciry/State: BURBANK, CA �- ZipCode: 91502 CELL:
ARCHITECT; License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$33.30
$33.30
NOTICE: The work authorized by Ihis pertnit shall comply with all applicable handicap access requirements under Califomia statules and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
COOEp. INSPEChONTYPE UATE INIITIALS COOEN INSPECTIONME DAT� INTITIALS
161fi Fised System Final Fire Prevention 206 Final Mechaniwl /h1�
7266 Pool Spa Final 208 Final Plumbing 6_�dA%�
200 Final Re-Roof 210 Final Electriral
201 Final ylock/Retaining Wall 212 Final Fire Prevention
202 Finai Factory Fire Place 220 Final Planning Approval
203 Final $ign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSA710N DECLARATIO�
I hereby aRrm under penalty of perjury one of Ihe following tleclarations:
❑ I have and will maintain a ceAifcate of consent to selFlnsure for vrorkers'
compensation, as provided for by section 3700 of the Labor Code, for the
peAo ance of the work for which this permit is issued.
L� I have and vnll maintain workers' compensation insurance, as required by
ection 3700 of the Labor Code, for the perfortnance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number ar�,:
Carrier, ��-!.c/'���. ��j/1�ibP
(This sed�on ne� be mmde�ed � Mepeimrt i� uM at one hundred dollars (3f 00) w less.)
Policy Number: ( r� 3^�3 U
❑ I certify �hat in the peAormance of [he work for which this permit is
issued, I shall no[ employ any person in any manner so as to become subjec[
to the workers' compensation laws of California, and agree that if I should
become subject to Ihe workers' compensation provisions of Section 3700 of
the Labor Code, I shall forthwith com I wi �hese pmvisions.
��0"�'�5 � (�/i '� 8 '� i�
Appliranl'sSiB�aWre � Da�e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 0( the Business antl Professions Code, and
my license is in fui�l jforce and effect.
Lic: #s--- ��6 � 3 � Class # � ��fJ
Co tFaclofs ignatur�6 e D� `O�� D�
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirm Iha� Ihere is a construction lending agency (or Ihe
peAormance of the wurk fa which �his permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atldress:
Oate
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Pro(essions Cotle: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any slructure. prior to its
issuance, also requires Ihe applicant for such permit to fle a signed statement
Nat he or she is licensetl pursuaM to ihe provisions o( Ihe Contracrors
License Law (Chapter 9(commencing wi�h Section 7000) of Division 3 of ihe
Business and Pmfessions Code) or that he or she is exempt therefrom and
the basis for Ihe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjecls Ihe applican[ to a civil penalty of not more Ihan
fve hundred dollars ($500).):
❑ I, as owner ot the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the siructure is not in[ended or
oBered for sale (Sec. 7044, Business and Professions Code: The Contrac[ors
License Law tloes not apply ro an ovmer ot pmpeAy who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided ihat such improvements are not intended or oKered for
sale. If, however, ihe building or improvement is soltl within one year of
completion, the owner-huilder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner oi the property, am EXCLUSNELY CONTRACTING WITH
LICENSED CONTR4CTORS b construct [he project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an ovmer of
property wfio builds or improves ihereon, and who conlracts for such project vnth
a contractor(s) license pursuanl to the Contraclors License Lavrs.).
❑ I am exemp[ under sec.
Business and Professions Code for this reason:
Signawre oaie
305]a6 (3/0])
�
Owner ID verifed by driv r's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
� I hereby certHy that no excavation five (5) or more feet in tlepth into wfiich a
person is required to tlescend, will be made in connection vrith work au[honzed
by Ihis pertnit, and [hat no builtling slrucWre, scaFfdding, falsework, a demolition
or dismantling [hereof, will 6e more lhan thirty-six (36) fee� high. (Chap. 32, Gry
2, Art 2. Sec. 341, Title 8, Califomia Atlministrative Code).
❑ As owner-6uilder, I will not employ anyone lo tlo vrork which woultl
require a permit (rom the Division of Intlustrial Sa(ery, as noted above, unless
such person has a permit to do such work from the division.
Applicanfs Signalme
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neetl to fle and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Sec[ion 25505 0/ the Cali(ornia Health and Safety Code requires, wi[h some
exceptions, [hat a Business Plan be filed with [he Cos[a Mesa Fire
Depariment by every husiness which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weigM of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas
at standard temperature and pressure).
2. Does or will Ihe applicant or present or future building occupaN need [o (le
a registration form for acutety hazartlous ma[erials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registralion with the Cos[a Mesa Fire Department hy
each business which at any one time has on hand a quantity of acutely
hazardous matenals equal to or greater [han a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
tempereture and pressure�.
3. Does or will the appiicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for awtely
hazardous materials)? ❑ Yes ❑ No
(Sec�ion 25534 of [he Califomia Health and Safery Code provides that the
Costa Mesa Fire Department may require the preparalion, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous ma�erials with the Fire Deparimenl.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Safety Code been Wlly complietl with? ❑ Yes ❑ No
5. Does or will lhe applicant or present or fuNre building occupant require for
the work which is Ihe subject of this application a permit for such constmction
or modi(cation /rom the South Coast Air Quality Management District or from
any other air polWtion contml dis[rici or agency? ❑ Yes ❑ No
(Section 658502 0( Ihe Califomia Govemment Code requires that the requestetl
information be fumished on applications fa non-residential building permits).
6. Will any part of Ihe facility to be constructetl under this permit be within
1000 (eet (rom Ihe outer boundaries of a school? ❑ Ves ❑ No
(If "yes", the (acility must meet Ihe requirement of Sec[ions 25534 and 42303
o( fhe California Health and Sa�ety Code).
7. If a permit from the South Coast Air Quality Management Dishict or other
air pollution control district or agency is required for the work which is the
subject of Ihis application, have all of Ihe disclosures prescribed by California
Health and Safery Cotle Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certifcare of compliance from the appropriate air polWtion
control offcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is correcL I agree to comply with all state laws and
city ordinances regarding Hazartlous Materials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state ihat
the information given is correcL I agree to comply with all state laws and ciry
ordinances relating to building constmction, and aWhonze representatives of
the City of Costa Mesa ro enter upon the above-tlescribed property for
inspection purposes. I agree not to occupy or allow occupancy ot any building
authorized by [his permi[ until fnal inspection.
SignaNre of Legal Owner Date
J�' »� (2l -D�2�f�
AndlorAuthonztU'A}f �nl� -) D01¢L��
oi w wli�5 5i CITY OF COSTA MESA — BUILDING PERMIT ,�R1 • A 055950
PflOJECTR00NE$5: GARCIA LT7.AkD0 TR uNiT:
OWNEH'SNAME: SSO W.�LPINE ST PERMIT NO: B 055950 PLAN CH CK NO; N I GOVT': N SUPP: N
�� ,,,.�oosess: 510 W ALPINE
SANTA ANA, CA 92707 CONSTRUCTION TYPE; V—N PERM T TYPE; STR PURPOSE; DEM
662-1329
AflCHIENGINEEP:
AODflESS:
KATY MACIAS
PERMITTEE: S S U W. ALP INE
aooeess: SANTA ANA
HEG.NO.:
UNIT:
(714)662-1329
CA 92707
LICENSEO CONTBALTON OELIAFFTION: I hereby allirm lha� I am licensetl untler provisions o� ChaD�e� 9(commencing wi�h Section
7000� o� Division 3 oi I�e Business and Pmlessions Code. antl my license is in �u0 �orce anG e��eci.
CITY IIC.: STpTE UC.: C1A55:
Oate: Signalure:
wO8REB5' COMPENSpTION OECLABRTION: I nereby allirm ihat I have a cenificate oi consem to selbinsure or a certiliwte al Warkers'
'oenution Inmrance. or a cenili¢E wpy t�ereof (Stt�ion 3800. LaE. q.
CY NO.: EXP. OATE:
�OMPANY:
•0 Cetlitie0 topY is �¢reby Iumishe0. ❑ C¢riiliea copy is IileA wilh the cily Building �ivi5ion.
i Date: Applicant:
E%EMPTION iBOM WOPNEflS' COMPENSATION OECLRNPTION: (ihis sRlion ne¢0 nat G¢ complettd if Ihe pelmit i51a on¢ huMreO �5100� or less�.
I cetlily �hat in �he pedormance o� IAe work lor w�ic� Ihis p¢rmi� is issuetl, I shall nol employ any person in any manner so as to become
suGjecuo iAe Workers ComDensation laws al Calilomia.
Oate: Signamre:
NOTItE: If, alter makinp ihis declaration, you sAoutO become suDlect to ihe Workers' Compensatian Omvisions of ihe Labor
CoOe. you musl lo�hwil� compty wilh suc� pmvisions or ��is permi� shall �e OeemeA revoke0.
CONSTqUt710N LENOING AGENCY: I Aere�y aifirm �hai there is a consimction lentling aAenry far the pedormance ol tAe wark tor
which Ihis permi� is i55uetl ($¢ction 3097. Civ. C�.
LENOEfl:
ADOXESS:
OWNEB BWIUEB �ECLANATION: I her¢Gy a��irm Ihal I am exemD� ��om Ihe Conlratiors' State License Law lor t�e I011owinA �eason
(Sec�ion 7Q71.5 Business anA Pmlessional CoOe: Nny ciry of counry which requires a permit lo cons�mct, alter, improve, tlemolish, or
repair anY slNCWre, orior to ils issuance. also requires Ihe applicant 1or sucn permil to tile a signe0 statement Ihat helshe is licensetl
pursuam m Ihe pmvisions ol �he Conlrac�ors' Stale License Law (Chapler 9(commencing with Sec�ion 7000) ol Division 3 a� ihe Business
antl Prolessions Cotle) or ihat he/s�e is exempt iherefrom antl t�e basis for t�e alleBed eMemO�ion. Any violation al Section 7031.5 �)'
any applicanllor a permil SuElects tAe ap0litanl lo a civil penally of not more Ihan live AunOreO Uollaf5 (5500�.
1. as owner oi �he pmpeny or my employees with wapes as t�eir sole compensation, will Aa the wark, antl ihe
� simmure is no� inlenaeA or ollerea �or sale (Secuon 7044. Business antl 7m�essional Code'. The ConUac�orY S�a�e License Law
� Goes nol apply lo an owner o� a pmperty who builds or impmves �hereon, and who tloes such woM hlmselBAersel� or �hmuAh
Ais or her own employees, proviCea t�at such impmvemenis are not intentletl or offereC lor sale. II, �owever ihe builAinA or
impmvemeni is saltl wilhin one year o� compleiian, the awner vnll have the burtlen ol pmvinp he/s�e Gid noi huild ar impmve
lor Ine outDose of Satel.
I, as owner of ihe pm0erty, am exclusively con�mcting wi�� licensetl comracmrs to canstmc� �Ae Orole�� I,Seclion 7604, Business
❑ and Pmfessqns Coae: The Contracrors' State Licenu Law Goes not appry ro an owner oi proDeM �o CwICs or impmves t�ereon
an0 w�o coniratls br suc� pmjetls wil� a coniractoqs) license pursuani �o Ihe fqniratlor5' Slaie L¢ense Law�. I am aware
g ��� o�aoi oi me�r workers �rr�pet��o4 i4curance shaUC ee pmviUed Io me.
� I am eAempl unde� $�{lgij;� WORK H]e. ed9I4NER
loi Inis ieason: ��y�7�'
Oate� �� � 9'?'� O�mer. /�'""7 �R«�
I Ao here0y rertily IAaI I am aware ot and un0erstanA the repuiBmenis ol Califomia Heatth ane $alety CAee Setlions 2550.5. 25533, ana
2553a antl I�at I or any IUWre Cuildmg occupant will/witl nol (circle one) neetl to compty vnih saiU state coUes anA Ihe requiremenis lor a
permil lor cons�mcl�on or modilication Iwm ��e Fir Ouaiily Management Uis�ncl. flesidential consiruttian appliwtions are eM¢mpt Imm
inese o�ovisions.
Dale: Applicani:
I here�y cerlily�Aa1 I have reatlihis applicalion antl Slate�Aatthe aboveintarmationis correcL I aA�ee�o camply wilh all cily antl coun�y
orCinances antl state lavrs ielating io huitaing constmciwn an0 �ereby aut�onze re0resenutives oi t�is city to enter upon the ahove�mentionetl
pmperlY �or Insp¢tlion purposes. S�` ' �.
� 9 ��.G��
-BefCi /— d' y �C- � ] .. -. . 'i�rf/ /GGiv>
oriver's License or Social Secmily M:
164ba6 WNie—Buildinq; Green—CoOe EnlorcemenC Canarv—Aoolicanl: Pink—Reven�o: Goldenro0—A�snssnr
JOB DESCR.iPTT.ON : RETURN GARAGE TO ORZGINAL SQ FT;
CI;AIM VALUE: CAI,C—VALUE; 1,000,00 GRO[JP OCC: R-3 /
COMMENTS: RETURN GARAGE TO ORIGINAL GARAGE
�*�*****�r**�***�****�rx******�***�***«*����*���**�***�***+�*****�� �x•****�*�c•�c+�****
7. O N I N GS ERTEB�AUCIKRSE M E iV T S
------------ MAZN BUZLDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT ZN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PAOV; PARCEL: 42217109 ZNE: REF NO:
PLANNING Nt7'I'ES>
�
If iF IF iE iE iE 1E 1E iF iE 3(� iE if iF Ik it 1E if iE iE iE 1E �f �h iE iElE jE iElE iF iE if 1f ik iElE !E iElE 3E if if 3f 1E 1E 1F if IF iPiE if i� 3f iF iE iF 1f iE 1E 1E 7E IE fE fF 3E iElE iE iE IE iElF iE aE �Elf iF iF
D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED'HY DATE;
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY: 1.� — �� DATE; � a� 1�Z—
if �f 3f if if lE iE 3E if 1E i! 3F 1f iE if 1f iE aE iE if iE iF3F�F'iF3FiF�3F3F7FiFiFTEiF3F itiFiF3F . if3FiF7F�F3FTF7FiFiF iF7F�iFiFiF iE ir iF ia ik �f ik i! k IE if
ik 1E �f if iE 3f if dE iF iE iE if if if iE if 3E iE 1E if if iF 3f if iE if �f !f iE iE !f iE iE iE if * iE iE iElf )f 1f IF #F i! �E �f 3E k iE iEiE 3E iFiE iE iE if 1E iF 3F iE!! iE ±E iE IF If� iE iF iF 3f if If !E # k if ak
LEGALIZATION:N F E E S U M M A R Y STRUCTQRAL SEGMENT:Y
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25.00
SMIF/NON—RES
PI,AN ' , 50
IS50E FEE
HUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE:
TOTALS----> 25.50 0,00 0,00 25.50 25,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 25,50 OVEA/SHORT; ,DO
BLDG PMT FLUMBING ELECTRIC MECAANIC FiRE SN,YP/TOT GRADING FLAN—CHECR
25.00 - ,50
k i! if� !F if iE if IE if 1f� iF 1E+f iE jf iE jh 3E iE �k if i(� �1E 3E if if if �1E iF iE if if ±F iF�lf IE iE �F if if 1f �lE 3f if # 1E iE �lf 1E i'r if #+if #e iF iE #E 1E 3E # IE iE iE iE iE iE �IF if #f if at IF if !E 1E �It iE IF iF
I N D I V I D U A l F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
�S �
EXPIRED •
1 lete lnspections • .
�� .��� � �
��'
.. j�_ - ," �i . .
L�d7L: �' :��'�' -
" " L_ _ , _,
, , ,
L'ONSTRUCTION AND PLANNID JL & SPA ;
- A'PROVALS Permit # Date Inspector pppROVALS Permit # � Date Inspector �
t.
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locallon
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electricai Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undcgrnd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. E�ectrical Conduit-Undrgrnd.
8. Foundation . 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
70. Structural Floor System 67. APPROVAL TO DECK
1 i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Pfumbing SYstem - finai
14. Rough Plumbin9 65. Eleclrical�Final
15. fiough Electrica�-Conduit 66. So�ar System•Final
i6. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Cpnditioning FIRE DEPT. REQUIREMENT
20. Rough FactorY Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilating 71. Product Piping O.Gas �Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
s
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling IStructuraQ & Monocoat 75. Dry Chemical . '
27. Frame and F�ashing 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. Electrical Power MeterFinal 80. FOOD CERZIFICATE ISSUED
33. Final Electric Notes: i_� r�L /'� �_ Qj (/�- �
w .�"��.�
34. Final Heating& Air Conditioning • nAn� '
. ��"16
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. Batkflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations '
47. FINALSTRUCTURE&BUILDING
48. FINALPLANNING
49. Electric Release to Edison �
59. Ga: ReYease to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
, ,�
OWNER Hi7NSAKER. S. V.
JOBADDRESS (��l WllSOri St BUILDINGPERMITNO. j�}5j
NERALCONTRACTOR
VALUE
L 2 BLOCK TRACT 2387 S1gI1 — D�F' $xlfi
GROUP J TVPE ZONE � FIRE DISTRICT w67
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER .
Footing Trench
Foundation Forms and Grade to G
Rough Framing __
Plumbing, Ro�gh to Slab
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heating, Rough
� Heating, Final
Sewer, House Sewer, St.
Septic Tank or Cesspool
L �g, In Out
R_..�ering
Plumbing, Final, Fixtures Complel
Plumbing, Fin.al Gas Test
Wiring, Final
Occupancy
Fnrm `)1 fl (:-H 1 Fflfl 1-55
OWN�ER". HUNNY INV• CO• DATE ��Z%—SS �
JOB ADDRESS 671 Wilson SL. BUILD�NG PERMIT NO. �I.6%
GENERALCONTRACTOR S. V Ht�nwlkeP VALUE $ 9�'j�,�]}.00 �
1 2 BLOCK TRACT 2387 $].rig18 Family Dwell.ing
GROUP I TYPE V ZONE ��-1 FIREDISTRIGT �-176
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
Foundation Forms and Grade to
Rough Framing
Plumbinq. Rouqh to Slab �ZG
Heating, Final O ���; 'l��l ��- ,( ; � - ('� /
Sewer, House Sewer, St.[°1N• 6" %� � rQ. M-w.J L, r�,;_�) ,Qa, �� L�(,��i _�f
Septie Tank or Cesspool � � �
L�" -�g, In Out � /D �
P� ring i
Plumbing;Final,FixturesComplete C -/ -J � _,�
Plumbing, Fin�al Gas Test/ "� � / , // � - .L�,,�(,tni'.�.-r'.
Wiring, Final � %�C o.l,i //��'Q�s�O/ 1�i,c/ 'l� 7�D ��r _�
Occupancy �
CostR Mesa Building Department
111 EAST 20th STREET
�— COSTA MESA, CALIFORNIA
FOR APPLICANT TO �ILI. IN
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Costa Mesa, California
Nearest
Cross St.
Size of Lot ,
Use of
Existing Bldf
Setback Line
� No.
City LiC.
� i No.
e � �
j�
Lot
No. B�ock Tracj��
and Bounda)
No. of Bldgx
� G� � D�g Now on Lot �
INo.of No.of
Families Rooma
�om ,, Rear Yard ZS �
t S n Side Yard S-�
ICRIPTION OF WORH
//j� Alteratfon I I Addition I
I Moving � I Demolish I
No. oi
� z/J Rooms � Stori
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Covering
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APPLICATION FOR PERMIT
g1�7� BUILDING '�
FOR O++ CE USE O1VLI' •
_ _Receipt No, Permit N . ,
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Received by Date Rec'd. Date issued '
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Costa Mesa, California
Nearest
Cross St.
Zone I plans I TYPe i
Approved
by Da
CORRECTIONS
APPROVALS
Foundation Lxation Inspector��
Forms, Materials, m
Under-Pinning y
Frame: Fire Stops, _
� Bracing, Bolts
(�
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is correet and agree to comply ' Lath. Ext.
with all City Ordinances and State Laws regulating
building construction.
Sfgnatureof Plaster, Int.
Permitte
Plaster, E�R.
Authorized Agt �
Masonry Reinforced
Valuation ermit Fee $ y�f. �
3�/ �/ Plan Check $ 3. �� Bond Beam
s 9, T r Total �, �
,:^^..'^.'_u'vG-c^ Fee $ d% FINAL
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PLOT PLAN
Show locatlon and dis4lnces irom
property line and between buildfnga
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Costa Mesa Building Department /i4_APPLICA�`ION FOR PERM[T
� 111 EAST 20th STREET v b�7 g U I L D,� N G �'�
, COSTA MESA� CALIFORNIA
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PLOT PLAN - - � � " . . . -�' .- - - -
Show Iocatlon and disMances from � - �� . ' �- • � � ��
propeRy line and between bufldings. . _ .
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