HomeMy WebLinkAbout680 WILSON ST - Building PermitsJobAddress: 680 W WILSON ST
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Primary Occ: R-3 Dwellings/ Cong Res <10 Type ot Consiruction: V-N
Parcel Number: 42215323 Zoning:
Applicant: KIM, DANIEL
Address: 13900 E ROSECRANS AV
SANTA FE SPRINGS, CA
Owner: STONE, GERDA E AND BLAIR A
Address 680 W WILSON ST a -
COSTA MESA, CA
Contractor: JEUN'S ROOFING & PAINTING INC
Address: : 13900 E ROSECRANS AV
�, SANTA FE SPRINGS„CA
.-Zipi' 90670 �
Arth :
Address:
Zip:
Phone:
License:
Phone: 562-407-5350
Zip: 90670
Phone:
Zip: .,. 92627
Phone: 562-407-5350
License: 830895
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: OB/OS/2005
Issued: 08/OS/2005
Phone:
License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING ROOF, 1/2" CDX SHTG, 2 LAYERS 40# FELT, APPLY 30-YEAR COMP --�
SHINGLES."22S�UARES " �
�.
FEE SUMMARY
Plan Check: $0.00 � Calc Valuation: ss,soo.00
Permit: $97.25 Claim Valuation: 53,900.00
SMIP Res: $0.50
SMIP Com: $0.00 .
Other: ` $0.00
Inspechon: $0.00 � � `
"Total: � $97J5 �� �
PL`ANNING & ZONING
SETBACKS `
MAINSTRUCiURE Front 0-0 ' =^-Rear- 0-0 �Lefl .0-0 ;� �. � '�Right 0-0
ACCESSORY` � pront 0.0 � � Rear 0-0 - "�Left�'� 0-0 - �� Right 0-0 � � �
PARKING xistin : 0 � Reauired:. 0 �� Pr000Sed: �0 ��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1. 1241-92)
EXPIRATION: This permit shall automatically expire antl become void if work is not commenced within 1 BO tlays, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized undei this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlons and f��al epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zauas (aroo)
WORKERS'COMPENSATON DECLARATION:
I hereby aflirtn untler penelry ot perjury one of ihe FWlowing dederetions:
❑ I heve end will mainteln e cehl0wte of wnsent to self-Insure lar workers' compensetlon, es providatl for by section 3700 at the Lebor Cade, for Ihe pertortnence of the
rk for which this permit Is issued.
� y I have flntl will maintain workers' compensa6on insurence, as requiretl �y section 3700 of ihe LeDor CoUe, for �he peAortnance of Ihe work tor whic� Uis pertnit is Issued.
My workers' compensation Insurence carrier enA policy number are:
�Cartter-r 4�-_p�(� �tww,�. P� um ePl b� �hl��-��
(This�section neetl nat be complefed /l the permi( is valuetl et one hundred dallen ($700) or /ess.) -
❑ I certity Ihet in the pedormence of the work for which thls pefmit Is issued, I shall not employ any Derson in any menner so es to Gecome su�ject to the workers'
campensetl0n lews ot Calllornla, end egree thet II I should Decome subject to the workers' campensatlon provislons at Sectlon 3700 oi the Labor Cotle, I s�ell forthwlih
comply with these pr ' � p
_ n� Signe ilfe: �L _ � Date:_ � 6I ��� �O�
WARtdING: FNLURE 70 SEW RE WOHKERS' COMPENSAT1dJ COVEMGE IS UMAWFUL AN� SMALL SUBIECT M! EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED
hKK1SAND DOl1ARE (5100,000). IN ADDfiION TO T}1E COST OF COMPENSATION, DMIAGES AS PROVIDED FOR IN SECiION 3]O60F THE UBOR COOE, INiEREST, AND ATfORNE1"3 FEES.
LICENSED CONTqACTORS DECLARATON:
I hereby eHirtn ihat I am licensed under provisions ot Chapter 9(commencing wiih Section 7000) ol Division 3 ot Ihe Business end Prolessions Code, and my license is in tull
torce end enecC�ia l� �aOSr� � Cla`ss'y G'zi�l L� 4 j?
c.�.�rn�Gr�s���'si;�.e.�_ 17 � r\ L n ir.��i }S / r/�C
CONSTRUCTON LENDING AGENCY:
❑ I hereby affirtn ihat there is e consiruction lending agency tor the performance ol �he work lor which this pertnit is issued. (Sec. 3097, Civil Code). �
Lendefs Name: Lendets Atldress:
Signeture: Date:
OWNER-BUILD�p DECLARATIONS:
I hereby eHirtn Ihet untler penelry oi perjury Ihat I em EXEMPT FROM THE COMRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Busineu antl Professions
Code: Any ciry or counry which requires a permit to construct, elter, Improve, demolish, or repair eny swcture, prior to its issuence, elso requires the epplicant for such pertnit
ta tlle e signetl steiement I�eI he or she Is Iicensetl pursuent to Ihe provisions af ihe Contractore License Law (Chapter 9(CommenCing with Secllon 7000) ol DlWsion 3 of iha
Business and Professions Cotle) or thet he or she Is exempt therelrom end the basis lor the elleqatl ezemption. Any violetlan ol Section 7031.5 by eny epplicant for a permit
suhjecis the epplicant to a clvll penelry of not more than Ilve huntlretl tlollers (5500).):
❑ I, as owner o1 the propeny, or my employees with weges as Ihelr sole compensatlon, WILL DO TME WORK, end Ihe structure is not Intended or oHered tor sale (Sec.
7044, Busiqess entl Professions Code: The Coniractors License Law dces not apply to en owner of properry w�o builtls or improves thereon, and who Eoes such work
himself or herselt or through his or her own employees, provided thet such impmvemems ere nat Intended or oNeretl for sale. N, however, iha 6uiltling or improvement Is
soltl within ane yeer a� completion, the owner-builtler will heve the burden of proving ihet he or she tlid not build or imprave tor purpose ot sale.). �
❑ I, es owner of Ihe pmperty, em E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct the pm�ed (Sec. 7044, Business end Protesslons
Code: The Contreciors LJcense Lew does not epply to an owner ol property who Dulltls or Improves ihereon, and who wntracts tor such project with e contrector(s)
license pursuanl tO lhe Comrector5 License LewSJ.
❑ I am exempt under sec. Business end Pmfessions Coda tor this reason:
Signature: Date:
Owner ID venfied by driver511cense. ❑ Ves ❑ No Dnvefs License No. Ezpires:
Vedficetion o1 Ownership by (type ol document, i.e. - pmperty tex �ill or daed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby ceryity that no excevation tive (5) or more feet In depth Into which a person Is requlred to tlescend, will be made In connectlon wlih work euthodzed by ihls
permit, end ihat no building slrucWre, scafloltling, falsework, or tlemolition or dismantling t�ereoi, will be more then Ihirry-slx (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Titla 8, Califomia Administrative Code).
❑ As owner-huilder, I will not employ an}rone to tla wark w�ich would require e permlt trom the DiWsion of Industrial Sefery, as noted ebove, unless such person hes a
pertnit to do such work irom t�e tlivision,
Signature: Date:
Division of Indusirial Salery Pertnit Number:
CERT1FtCA7E OF COMPLIANCE AND AllIMOR¢A710N OF ENTRY: I ceniry under penaly ot perjury that I have read Mis eppliraUon and state ibat ihe intormation given is
correct. I agree to comply with all siete laws and ciry ortlinences relating to building conslruciion, end euthorize representatives of the Ciry of Costa Mesa to enter upon the
ebove-described property tor inspection purposes. I egree not to occupy or allow occupancy of eny builtling authorized by Ihis pertnit until final inspection.
Of Legal
COOE �. INSYECTIONTYPE
1616 Fixed 3ystem Flnal Fire Prevention
7266 Pool Spa Final
200 Final R�-Roof
201 Finel BIocWReteining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
GOOE I INSVECTION TYPE
206 Final Mechaniwl
208 Final Plumbing
210 Final Elacincal
212 Final Flre Preventlon
220 Finel Planning Approval
222 Final Site
250 Final Building/Occupency
P9IE I[�L&
ADDHRSOFBNLOWO: bl}V W WILSVN 5�1�
wmursouieivio+avx: STONE, GERDA E
�o� STONE, BLAIR A
680 W WILSON ST
COSTA MESA,CA 92627
�vri. �uimo �now�ss:
uuxrtEcr oa �ern:
urcx. on e++a•s �ooxEa:
uu r�o.:
UNT:
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cormucrarsuu� NOCK PLUMBING ( 714 ) 895-1246
cam�croxs�uia+o 11612 KNOTT ST
�sz GARDEN GROVE CA ucra_ 707775
92891 w.r: 17
4CENSED COMF�CfONS DECLAPATION: I hereb/ Nim ivdar pndy d per'ryry tlW I un IimnwA ivMr pwmvu d Cheqa 9
�mmmaMinp xiih Sxtion ]OW) d Oniaion 3 d IM &ni�m ard Pmleseiona CoCe. aM mY ��� u in IW lace mk ellatl.
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 08393
PERMIT NO: P 083933 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION ; DISHWASHER CHANGE OUT . SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
c c.No.:05038 uc.cuss:C-36 uc.No.: 7Q7775 EXP: 02/98 ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
� �0<� P�j�3i�� FRNT: FT IN REAR• FT ZN FRNT: FT IN REAR: FT IN
om,: �«���� LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
N 9UILDEN OECIANRTION: I Mmby etfirm uMer panely W perjury �het I am ezmmq Iram IM Contrepas Licenee law Iv Na
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wwiava.
WOPNEH'S COYPENS�TION DECL�PATION: I Mreby atfirm uMa parWry d perjury an d iM b0ow'uq datleemum:
� IheveenEwilmein�enewnifratedmnaeniioseMiroureMwdkan'cpnpenWion.upvridadlabySatlian3lWd�hslebar
COEe. la iM pe�ortnerca W ihe xwk /a wNch Iho pemiit u ueued.
�] � nw. ene wi� meimein.onbn mmv�� ����,�. %+roa���.e M s«rim s�oo a m. �mw cae. r« m. romormenc. d �n.
work�w�.h�mia��mnieimuee.Myw«ke�e'GdLDEN �EAGLE ���um���: EXPIRES
c�a�:
Por y N�mn,.: 0 9/ O S/ 9 7
• .s eMion r�eed na bs comdeteE l the permAie ro. or�e hundrad ddlere /$tOVI or buJ
� I cenAy Nm in ihe paRormence d �he wwk lor xhch Ihie pemin ia iuuad, I ehell mi empby e�ry peiron in ury mennar eo m to
becane wbjea ia tM waken wmpenmtion lews d Celitwnu. ns Ihel il I ehouW become wbjep b �he xvAae'
peneelbn 'siona 1 Seaion 3]00 d iM labor CoCe, I Mh ' aomoky' ihwe piwieims.
�
oa.: 30 �ndww: —
aml : F�llun ro ueun woM1'eri ronpauetlon rovsnp� l� unlawNl, mtl aIWI u!/�el �n w�vlqw ro ulm'ixl puWtlw aml
nu iy ro am nu�end tnoua.M ew�an (s�o0.ronA H���� w N+. n.l o� romp.nulron d.�w.. u pov�wd ror �n
Sxtlm �]P6 0l IM laCor Cols. Infw4 ��m7� I�
consrnuenoN �Eddra �eewcr: i i,«�er .� �, v�r a wrwr �nn in.. e a oamw�, w�q m�y i« u,.
perlarmance M iM �.ak In Mitli Ne V�l'u ewsd (Sedion ]09). CH. C).
LENDEfl'S NAYE
LENUEN'S ADDPE53:
I wnJY �nm I haw nea Ne ew�'� end vme Ihm iM ebo+e iNametion u oorreq. I ep�es to camdY wM1n m�Yy rq ma+Y ad'v�ercse
enE stme lewa nlatiq w duk^Y w�mon eid heratr/ eWwr¢a nppmietivm d ihu mY m aeua upon tM eEwa�meNbnad peopary
���°�°�°� RON NOCK
PnN Neme
./17 Dme: ��
Sii rlqpenVAp edar
(515t-ae.WP) W�ne-BuiWvp85alely:Orean-FAe:C�-AppNfanl;Fnk-Revenue;Ookemo�qevavaor
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE; q �+
APPLICATION ZSSUED HY• DATE: Z 6{�
ifikitiffFiFiFMifififMkMNMkifikilikiE iE3fiEifififikifilif itif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL GMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 8,75
25$ SMIP/NON—RES
PLAN
ISSUE FEE 22,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8,75 22.00 0.00 30.75 30.75 ,00
REVENLTE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.75
ik k 1f 1f k if 1t If M!f fhlf if !F!f iflf if if �f if 1f 1E 1f 1E ft if iF �F M it 1f if 1t M 1E 1E M k iF if it ft 3F 1f iE iF 3f k iF iE it 1E jF ik iE iP �E M�f f! �f if iF fF 1E iF ik M if iF ik it IE iE �E 1E 1k iE
I N D I V I D U A L F E E H 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
PLU 1 DISHWASHER 8.75 8.75
END OF FEES
EXPIRED
DATE 'J' I Z 'q 0
W-30-1997/18:18 HN/430.75
RCPTq:Bl-0635981
PERMIT:083933
CONSTRUCTION AND PLANNING'� _ POO' SPA
APPROVALS Permit �# : Date Inspector qppROVALS Permit # � Date Inspector
t. Temporary Electrical Service or Poie . 52. Pooi & Equipment Location •
2. Soil Pipe�U�drgrnd. ' 53. Steel Reinforcement �
:.3'. ;Efectrical Cond'u'�t..Ua�iliry-Undrgrnd. 54. Forms S �
-= 4': EleCtrical CondJi°tlndrgmd. '�. 55. Eiectrical 8onding �
- .r- �
�5� Steel ReinforcemeCC` 56. Rough Plumbing & Pressure Test =
�6. ElectricalUFER.GFnd. 57. APPROVALTOCOVER-GUNITE
.�
'� ��7�.footing5 ` ~'r,�'.� ' ' 58. Electricai Conduii',-'Undrgrnd.
^-�8..Foundation � � ^ c 59. Gas Pipe, O UnrJrgmd., Test �
.:, .
' 9. Water Pipe�Undrgrnd. � 60. Backwash Lines P'-Trap, O Undrgrnd,
_ l
10. Structural Floor SYstem 67. APPROVAL TO. DECK
11. Property Sewer Line & House•Connaction 62. Backwash & ReieptorFinal '
12. Sewer Cap � ",� 63. Heater & Vent-Final
13. Foof Drains . 64. Plumbing System � final
14. Rough Plumbing, �.. � 65. Electrical�Final �
15. Rough ElectricaJ�Condu�t . , 66. So�ar System-P�,nal �
16. Rough ElectricWiring , _ � 67. fencing & Acc�S-APAroval -
17. Rough Wiring S+gn � � 68. APPROVED FdRaPLASTERING
i'
78. Fough Electrica7�T Bar Ceiling` .� 69. POOL/SPA SYS�EMS FINAL
19. Rough Heating & Air C�nditioning FIFE DEPT. REQUIREMENT
- - „ � �: tr- �r
20.�iou9h Fa�tor� Fi�place ' S r �� ' -� �,�: �; qppROVALS��,� Pefmit#�'��
21..Ducii, in;Stryctur,e�t � ��•- �'� ^ _ �-+• ' 70.^Unded9Fe71�d Hydro �
22. Ducts. Ventil2tin ` ' �= ' _ �' �
9;. t . r.- ..Z _ 1. . 71. Produ�t'�iping ��ias (] Oil
23. Gas �ipe;Aoug}i &�Test � -- G n T S!'+ - 72. UndergroLnd Ffus"ki �
24.'Roof`.Framing• '�� � - ' ",� +. ; - •,� . 73. Undergrrid,Sm�ra�Tank�Gas OOiI
25. Roof�Sheathing :� E •� i� ->.,i♦ 7A, Overhead HYdrb x
26. T-BaPCeiling (StrUt#ural) & Morlo�oat ; _ "-' - "� ; 75. Dry Chemical ,�� " � "
h�
27. -Frame and Flashin�c j = - � _ .. yi 76. Dry Starntpipe,-a:o + � � � 's
- 28. Lattii�g&Siding :� %� �5,�? 3 F�- . ..y 77. FtXED,$�STEA�}'`•f:iNAL,.� -�, v
_ � .- "; .. .. x -;y
29. Insulation .�x. � S •• ! � � �� 78. FIRE PREV. FINAL ' '� =� M
' 30. Drywall Nailing �i � � * �, . �K - ' ;,LHf�ALTI� DEPT. REQUIREMENT
'� 31. PlasterB�Bwn-FoA4; <- � �� � � � 79.y�INAL fi1SPECTION � �- �
� 32. Electrical'AowAr M1t}eter.•Final + �' j ! � 8U� PO00 CERTIF.1'GATE I�SSUED
.� C rl .1. � � 4 :rl :1 � p. .�� �1 i. i�
33.,FinaL�EleGtric; � r, � .f, 'r I r Notes: - -.-� .c'� _ .
.� 34. Fina� �Heating-& Air Cond'HionintjS � • + �� ' ' z ' = 7
� f V � R l �Y � � K� ��
35. �inai"Gas�PiPe;Tes'T; '- .: i .� � �Y _ . _ .�• - , �" '
,- � . � .
_ 36. Flood�or CanoPY � i ' Y _ ^ � : t i` : � _ t� ,r ,y . .
�; 37.'FinalPactory Pirepldce :- .� _ � *'�' ,� ` -� 4 -� •
� 38. Pina��-Plumbing ^�� �:t7 -�� + " �'' . - ' = . -
-. �
� 39. Water'Service�Fin� �, _� ' '" . 4 . � " • �
:J• K 'd
��40. GatService•Final t, � �;-��+ - r^ , ��i� �'� *�.v 4 �
� �
= 41. Solar pomestic�Fina� � " �' -' , ' -- -• ` `
'� , j 7-_ # :'c �
� � -
42.'Backflow Preventer �� t I � _ -�
i, n _
43. Backflow Irrigation ` J � � � * ' ':
r i � !
' ' -
44. Landscape Irripation�System s=�,. - • . 7 `:'y ' ' - �� ��
- T l X
4�. $ound Attenu0tion Y - ; � " ;. '� � • � �. •' ' a =
. -,. z_
46. Handicap.Regulatioris - - ' _ _ <
� +
47'. FINA�. STRUGTURE & BUIL•DING T �_. �_, � ;
48. FINAL PLANNING � . - � ,F :_� - �� � • .-. r: , •
49. �Electric Release to Edison �'� �� - _ '
� � �,�� � '
50. Gas Release to Souttiem California Gas Co . - -` � - + •
-« - i
57. CERTIFICATEOFOCGUPANCY � . -" • � '�
No. Date .
�nonessaeu�w+c 68U W WILSON ST
OYMER4IUYEIFppWN: STONE, GERDA E
nnonEss: gTONE, BLAIR A
680 W WILSON ST
COSTA MESA,CA 92627
�rv�. Muuxa �uoecss:
urcxrtEcr on u+m+ax:
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UMT:
urn:
���T�S� NOCK PLUMHING ( 714 ) 895-1296
ca+m�croas�uunc 11612 KNOTT ST
�op� GARDEN GROVE CA �G�� 707775
92841 urn: 17
UCENSED CONfPACTONS DECLAHATION: I hareby eflim urber penetly d perjury thet I em IicenxE unEer povidane d CMpx 9
(oommeewirq hilh Sxtion 1000) ��aion � G tha Buai�ron eM Prdeaeions CaN. erd mY lioenae u in IWI bree enE Nlatl.
cmuc.No.: 503 6 uc.cuss: C-36 uc.No.: �70p(� 77 EXPy�: 02/98
�ma� caarm«:�,(;X'� ��/%%4')l�
EN BUILOEN OECLAR�TON: I Iweb� elfirm untler pnWy d perjvy ihel I em eramq han Ihe Cad�atlm Lkams lew la IM
IdbwnB nemn (5etlion lrol.s Buanea� eM Prdse'vu Coda: Rny ciY a mwly v.fiirh �Wwa a Cmmd b owumc�. als.'vnpw+.
Eemd'eh, a repv mry auucfive. p'n io n euurce. ebo npuiies IM epplimN la arJi peniw lo fJa s epneE eletemem tlut M a�M
u �benud w�suem iu �ne awimaie d in. caureams Liceme lew Iclap« s(omim«idnu .an smun r000) a oiveon a ar ��r
Buvma erd Fde»iau Godel «Net he a Me b ezemq iharehwn vM iM Emie In IM elbped ewmmqion. My vioW ion d SaUion
]0'J1.5 by enY a0d�^t f« e permil wEjetle iM1e eppfram to e aW panehy of mi mws �han � s huMred ddlen RSWII.
� 1. a� o�mer dtha popeny ar my empbyeee v.yh wepas m �hai eda mmpanealion, xill Eo Ihe xwk, uM tM alrvclun u ml imeMed
w attered lor seb (Sectim ]OM, Buuirm eM Protessbna CaEe: The CaNredon Lioeme lewEma not epply lo en ow�wrd piopMy
wlw Wide a inpwea iherean. arM Mn don vudi xwk limeett a hanN «ihrpph ho a her oxn «nWqw. pwidad ihm wch
ITp1pYBRIBNa Na M Nbfldl� IX OI:MBj ip 99�8. M, �1OWBVBf, IM bUibifl� Of 111�'Ipy110N m fOb WIIhN tlM yYf d tlM11pMY11, al0
.,,.,�w�a« �u na.� m. n�a� a�� n. o..i» ed m w�e «�ww. �« me �one d.w�.
❑ �. m o.n., w ine a�w«ir. �..a�:�ar oau�u:a .w, u�e oow.��a. m�.m,e roma waw �sw� �a�. a�.:,... �a
Prdemms Code: The CaNratlm liema lew doea nal ePdY b en ovnw N VrW�Y xAo dnlde a'vnpwr IMraon W Mu
contrecu br w4i Y4�+ wdh e mNretla(s) ficenaed V�uw �o Ihe CoM�etlas Liane Lew).
� I em azmmq under Section: B. 8 P.C.. la Nb imam:
Oete: Oxna:
i m ner�M �enM um i�...aa a.ne u�,aeaie�a me rem+��e�. a ca�ewnie H.ean.�w sderv coa. sea�on. usos. un3..na
zssaa, �e inm i«eny nnu�a w�u�m �v� wn i wai na (meb an.) need �o ea�oh.�+n .de .u�. ma..ne in. nw��«ro ea
apumillpconelrucfronamodifKalbnhaniMA'r ue�y anpemant0imrid.Reeidemidamtiupioneppica�iwauewmqlmmUwa
pfWiaiOne.
Dma: APWiraN:
W ONKEP'S COMPEN5ITION OECL�X�TON: 1 Mreby eK�m uMw paroEy W px�vy pn d Ne fo0m�'vp dWumiom:
❑ �ne�e.�d.am.wene�«wiuteam�.mvio..n;�ueb.on�m.�como.��.ma�t«Wswimr�ooam.�em.
coa., ia m. v��e a m..on� i« w:d� u,m v� m��.d.
❑ �nev.ene.amevuar�.ata.•mmv���rence..,nuu:eeMssa:nrroowu»�ee«coe..�«m.v��am.
j� wwk la whitli mb o�� o uaued. Mv.aken' canw�ian inwrerce fnnir md w�r manba. va:
c�. r.nT.nFU Far,1.F EXPIRES
Pd'ryNumber: NWC 32t1A1�1 09/01/97
�rn�: senim �reee �a ae co��da�.d r rne o�� n rw ono n��erea exrers (s,ao/ a r.s..�
❑ � cenA' u� m �na w�ormenca a �ne wonc �« �.ncn �na v�a a bwea. �.neo na ancM em v� � drv �+.m...o o m
Exmie wbjetl b ihe xvM1are' mmpen+eiion lewe M CeYlame� � I Mwk becone aEjW b IM Mvlan'
campanaetion ' iore f Satlbn 3)0p d the labor Code. I onhwn oomplj v' ma prow'vn.
e: Mv��+:
0
Mp: FW b scun �oilron'rolrywu�tlon cwwap Is wJeNul, uWWll ulNcl �n wmploy�r b cMmllrl p�nWr uM
v0 !1� �p b me hlndnE fMuurd Ed/�n (51IX{POOA h�AGlfbn b tlw cw! O/ cronp�rwUoM1 Quripp 4 povlGM bf In
S�ctlon 9]06 0l tlro Ia4orCotls, Imrpl, uW ertumsy� Iroa
CONSTIi11CT10N LENOINO AGENCY: I hrMy elfirm wder peneQy d peejrty tIW Ihse b e emq�uqion Wd'oq yrr.y tar Mr
partamerae d IM xak fn xfiirh th"v peimi e bwieE (�� �). Civ. C).
LENOER'S N/JIE:
LENOEH'S AOOHES3:
I cenily thet I here re 1 Nu appl'ratian enE pde IMt Ihe ebove'vdametian u conetl. l qpee to ednyy rrith M �Yy enE wuMy adi��
eM emte lexa mlmM b butlE'rq c�uvueion eM herebl'aWar¢a rev���ntiwa d ihe W b emx w� iM Wma�mentiuiad popany
Irc irepeuion p�rpoeas.
(S15te6.WP) Whne-Buitliq d Se1My:OreemFb: Cerery-App5cenl: Pink-Rewnue: Gddenmd-Naeav
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 083933 PLAN CHECIC NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
JOB DESCRIPTION : DISHWASHER CHANGE OUT
PERM NO: P 08393
GOVT: N SUPP: N
SQ FT:
PURPOSE: OTH
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT
****�t*�r*a***x***�t**wr�r�r*****�t***x�r***�r*******a�t�t*�t�r*********�r��t*�t***�r�t**�t*�r****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PAAKING REQ: PROV: PARCEL: 11737240 ZNE: REF NO:
PLANNING NOTES>
i
kifilkMkitihiFiF'1fMifMitihihihMiFfhffif�fifitlFifMfkMM�fikihM'kififikilMiFkkMifMifiFMM'IkiFMMifiFiFiFk3FMiE3EiE1ki1*iFikiFiFiEiE3FiE�F3f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NZNG APPROVED HY .
BUILDING APPROVED HY :
APPLICATION ISSUED BY;
*+��r*�*******w*r****�tft�t
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTAIC MECHANIC
PERMIT 8z5=
DATE:
DATE:
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMZP/NON—RES
PLAN
ZSSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8.75 22,00 0.00 30.75 30.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.75
kMilMifilkifihMkMififififitMlfitifitkiFihihifihififlFitiflfititMiEihfl9fMMitihitlEilkiEiEiFkkMitiFiFififkifil�ififilMitlf�tifiFikikiF3fiFMif
I N D I V I D U A L F E E H 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
PLU 1 DISHWASHER 8.75 8.75
END OF FEES
EXPIRED
DATE 3' � Z' �Ig
B7-3A-1997/10:17 pN/f30.75
RCPTk:AI-02B9899
PERMIT:083933
CONSTRUCTION AND PLANNING � PO�UL & SPA _
APPROVALS Permit # �` Date Inspecto� qpPROVALS Permit # Date Inspector
1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location =
2. Soil Pipe-Undrgmd. ',� � 53. Sreel Reinfortement � .
,.,3:61ectricalCond`�ij:ll�ity-Undigmd. 54. Forms ' -�
�4: Elecirical Cond6it•tJn7Jr9md. V " 55. Electrical Bonding �
:t �` 3 M
_�5.' Sc�el ReinforcerTeat�' S6. Rough Plumbing & Pressure Test
'�=6�'6lectricalUFER'GrnA. 57. APPROVALTOCOVER�GUNITE
--r,�-- ..•�-
j 7Z Footings ��" �y �� 58. Electricai CondUih.Undrgrnd.
;;8.^,•Fnundation �''�. •� 59. Gas Pipe, O Und�g�nd., Test � 1
' .�
i�
' 9. Water Pipe-Undrgmd. ,i 60. Backwash Lines'P;Trap, O Undrgrnd. , ,
�
10. Structural Floor System � 61. APPROVAL T6IDECK �:
11. Preperty Sewer Line & 4ouse=fnnnection 62. Backwash & Re�eptor-Final -
72. Sewer Cap '" " _ 63. Heacer & Vent-Final .
73. Roof Drains � •• _ 64. Plumbing System � Final �
14. Rough Plumbin�. -� j, 65. Electrical�Final ,
75. Rough ElectricaLConduit -+� :- ' 66. Solar $vstem�Final
16. Rough Electric Nlirin�g__ .__ ,. 67. Fencing & Accesi�,nproval ��.
�
77. Rough Wiring Sign ��� i� 68. APPROVED FOR-PLASTER�NG �
M
18. Rough Electricai:T Bar Ceilincj� � 69. POOL/SPA SYS�'EMS FINAL � �
� 19. Rough Heacing & Air Conditioning � - - FIRE DEPT. REQUIREMENT
' ': 7'NM _ �. .�
20. �Rough Factor� Fifgplace � ^ ^ = � =� r ^'��' ' !AppB'�Vpj{���-� P27mit # �' "
't. i a 2 i, . r :�. I � ti rr'.K C, u. �... NF� .
21..'Duc�s, in_$trt�eture� �� � .. .. k .S � t: � 70. Flndergr6u'ntl ,dro i , •
- - .�
22.�DucfS',Vg�ntila�in���' � `"' r: _ n r# •�7�, ProduCt�qinc���l'Gas f*Oil
' C .-w.: ,t � '.J' y D ,�
23. Gas,P.ipeBougji &�Y�sc � � �; ;,, q. -y -r:� :, 72, UndergroLnd FIaSb �t� -
24. 'Roof:Framing•� O+ -� F� V`.-� �� _J c" ^�� .' 7� Under r�tJ. Stoi', g4: Tan ❑ Gas ❑ Dii
t: o T, � r 7 9� ,�' • ��
25. iioot�Sheathin ��' '" �� ��� �` °''-" �~ �
9 + v v t > .! x 74�� Overhead HydrQ a:
26. T-Bar:Cefling (Strtucural) & Nlo�ocoac « � � = �^� 75" Dry Che�pical r, = '� " - ,�
- -,
27.'Frame and Flashing � ' � .a � "''
� � �r a ; ,, �; 76. DrySca �ipe=� �� i ` ` �=
:28. Lathing&'Sidin9� �'. ='M` � �':- ••� 71� FIXED`S'Y��yTEJ�`F�VA{� `r
.. 29. Insulatio_n' .s C . .. > � :T' ! + ^.
<,;.. �. � t 7g: FIRE�PREV.FIlV9,L .� �: -t
' 30. DrywalltVailing :'+ � y �+- � ' `' "' •- .��NEALTFtDEPT.`RE�UIREPoIENT . _ -
� 31. Plasier B own CoaL . _ , �� j � . 7��FI�I�lAC1��pECTj�N j -" " ' '
� 32. Electriwl�Power hletErFFinal ��^ � ti� -t , 80� FOOD CERTf�G"ATE I�SS�ED
.., � -
33..Fina�Ele�tric -�•. � f n � � '" •��-.
„ ., �-.1 E �. i tr. � �{e es: "f R7
. $ ' N ' '
� 34. �Fine1 Heating-& Au Conditioni�g� n . I �; 'x s : +.: ��� _. , . �
- � 1 � H .- �'
35. �Finat"Gai-Pipe Tes��'� ; '" " � r � � �� • � r t ' . .
y � � � -, _ .
36. Hood.or Canopy ::} 5 �- ��C1 i x. .<..1 - x T
� ;�, k "{
37. Finaf;Fac[ory Fire�}I�oe'_ _ ' � ' � � �� �� ;�
A ��
}.
-, 38. FinaFPlumbing ��a: N � � v ; .n � �• :�
_
� 39. Wate'i Service�Fina�.�. � `� � . � : �' _• .' •. �
� � ;-' �' r
� 40. Gas Service-Final h �r, ,;, .-rr � . . I � '�'* ' - �
= 47. Solar pomesticFinal. � z,,, i" it �, ?;� ".', ,
42.'Backf�owPreventer.� ^ � � t ;R :�� � - -
r� - .
- 43. Backflow Irriq�tion'K � '��-`-' � e ^- ' O y �
:r r ! _. + " ` ��
�4• Landsca�elriigation,SYstem-, , r,- ;, � ;a � " r o� ..
:45. Sound Attenyiation' "' '" '- '� -' �'" � ` -' '' e�� ^¢ '
- t� ' � '] '*] ?7F � C •f r' J r
� ..
�6. fiandicap.Regutations �. i :t c �'�. "' �
47.:FINAL STRUCTUR� & BUIGOING ` � '� => #
� t t- � � `"x ..
48. �SiNALPLANNfNGF - '� r �. �c ` . � -
' ;,'r. . � ;�.
49. Eleccric Release to Edison +. �.�;;y : �r. + -
r r c . __r . • - ,
50. Gas Release to Souttiem California.GasCo * � �''-•'.� - � - � � i _ •
:, .
�511 CERFIFICATE OF OCCUPANCY" r + , . r -- _
No. Date
�oonessawnawo: 6A0 FJ WILSON ST
wmeasxweiFaaxm: STONE, GERDA E
wonFss: STONE, BLAIR A
68U W WILSON ST
.OSTA MESA,CA 92627548-9890
�PYL. MAIIING �DUNE39:
4iCXREttOFEN(tlNEEN:
urcx. on �r+c.�s wowess:
ca+rn�aarsruxE: NOCK PLUMBING
carrn�crorcswuura 1161U SEABOARD CIR
,�ooxess: STANTON CA
9068U
uNr: CITY OF COSTA MF.SA HUILDIPIG FERMIT
PERMIT NO: P 074695 PLAN CHECK NO: N
CONSTP,UCTION TYPE: V—N PERMIT TYPE: PLU
uc. rio.:
uNr:
(714)695-124(i
„�,�, 511971
uxr:
LICENSE� CONTRACTONS DECLAN�TION: I Mroby Nim uMx penetly d perjury ihel I em IicmeeE uMer pwivanv d Clieqx 9
(mmmemiq x+l� Sectian )oao) d Divuun J d iM Buairom arM Prdmeione CoCs. eM my licenee 4 in lull lorte vW ellea.
cmuc.No.:050386 uc.cuss —36 uc.-No\.: 51�`9�71Q E,Xy/P: 02/96
' Z 1 � �� IVOC� /� ✓�'/3��Er
Dete: � � 7 Conlreaor.
�
OW NEN BUILDEH DECLRHATION: I hereby eHi�m under penelry W perjury ihq I em esempt Imm Ihe COMreaon Liceme Lew lor Ihe
Idlowing reason (Sedion )03t.5 Busroaa eM Prdea�iona Code: R�ry c1y a munty MiiM iepuirea a permil lo mmVucY. Mx, impan,
•olsh, ar repei eny eiiucturo, par w na uauarKe, ebo 1equiroe the eppliren� lo� euch psmA lo Rle e eqrwd ewamant Ihel M a sM
nsetl W�+�� �a �he powiom d the Contreqon Lioen�e lew �Gheqer B(canmenemp wnA Seqion ]OOq d Diveion � d Ib
.eva eM Prdeaiona CoCel a Ihel M a Me u uemq �herehvm enE iha Wab la ihe elbpeE memqion. My violaiion d Seaion
,...�t.5 by enY ePV�ifant Ip e parmil wbpqs iM applicenl lo e frvil peruM1y o1 twl mae Ihen fve huMreE tldkn �550011.
� I, a� oxrbr W tM qopeny a my ampbyaes wvh wepee a� IMi wls aompenee�ian, wJl do ihe xork, end Ihe aNMuro c nd imerded
w oHareE fa sab (Seclion 10a1. Buai�ee eM GMmeime Code: The Comreqon Limma law doee roi epplytoan owner d popeily
who buida or impmvae iharean, and wM10 doea euch xnA MmuH or henoX or ihrouph ho a her own empbyeee, provided ihet euch
im0�*menia era rd InteMed « Weeed la vele. tl, �owsver, iM buiNinp w imqovement ia wM wilhin ane yeer d mmpbton, Ne
owner-buiNm will heve Ihe Widen d povi�p M a eha did M Wik a impow lor tM W�Paa d mle).
� I. m ownar d �M pWeM. em ea bunM' mnvapnY xilh 4ceneed convectae lo m�uuue Na pnlb (SeUion �o1I. Bus'vre W
wdea.ons coee: rne com.ma, ucan.. �.. m.. m wW w en w�s a ww«ry wio wua. « vnww« �n«.on .iw wno
mmrxv br euch aMws wn a mured«(e) IianaeA Wnuem �o �he Cmu�mae liunes lewl.
❑ I em aaemq uMm Szlbn: 8. 8 P.C.. br Nu �aem:
Ome: Owner:
I do hereEy cenEy OW I em awere d enE u�Menbn man/�d CelAanie IbeXh aM Sefery CoEs Sed'aro 25505, 255]J, vd
25Ua, vM iMt I a eny Mure Wiki�q / wll ml (crcb one) nsed to canply wlh aae mdm end iM n4u'uamanb br
.v��«mmm,c�ion«modir � m�' I�y enewm.uojyrl�a�ierualmim�wo��.d.ea�p��moe
WOXKEfl'S COMGEN9ATION OECL�RATION: I hsreby e1Nm un�Qi�paruXy d perjwy ana W iM Mbwiiq dxlutlipp:
� 1 heve arM wJ manian a ceMctle d con�eni lo �aXinauro br xpkeri campenwbn, u povidep lor Ey Sadian 9]W d ihs labor
coe.. �« �n. anoemene. a in. wrk a, wliem m� w�n u wwd.
p in�..�aw�,.�m.�.���o�m���,�.�,o..ona�o-.ews.n�a�roam.i.e«coe..ro,in.o.e«�.a�ti
•• woek lor whirh ihu P�a u iuued. MY worken' eanWmation imu��nCa W�w end W�Y number us:
c.ma GULllEN tAC;L�: EXPIRES
varyro,me,r i�w��cii�ivv 09/O1/96
(This n imad rw� M candMM 1 NrGw'mt u br am hurMrsd dd4n �S�WI a lm.)
❑ I caniy thet in tM pMmwes d IM work tor whc� Ihu peem� i� imsd. I tlull na empby ury pucn in em� meruiu w n lo
bewma wbpa �o iM v.wkwe' compemeibn lewe d Celilomi piq B I 4wuM berome wbjw to tM xvM1en'
mmP/ametion DA`�es�bm rd Sea�ion�-)/W �COM. rmh �' Cau�
Dtls: / � _ f/ / [ � ium�� r'",����
W�minp: F�Yun M��cun woikwi wmpmutlon cov�rap� Il+m4m./W �Iv/l �uG,YM �n urp�eyv ro pIMNI pxvMx�
clHl flnu �p ro m� �vrtlrW tlauuM OalYn (tIPqP00A b��n ro IM cwt o/ cwrywu�tbM1 Wm�pu u pvr/dW br In
Sctlon J](A6 oI tli� lapor Cod�. Infw��L �� ��mry'� Iw.
CONSTIiUCfION LENDINO �OENCY: I hereby ��m vMor perWry d perjury IhN tMn u e eonpiuqbn Mqiip aperKy lor iM
perlwmerca d �M xwk la whiM Ihi Po�1 ia e�wd I�� �8]. Civ. CI.
LENDEH'9 NAME:
LENOER'S AODflE33:
I CanAY IIW I h9v! �W Um MP��bn Ld p9U TAtl IM GMIG uddmYun f� WIIW.I MIN IO Mn�P�Y xilh O0 mY pd odmiY IXd4bMt
ud Mte lews mlmn0 to buJEvq canauCian eM MraEy eulhoras leqarmdh+� d �hie c1Yb anir uD� �M ebv.e-meMionM p�openy
t«�baec;.,w�.. RON ""�CK
Pnni eme
�
� Sipntlun W Ovrter �nVApWunV Deia� ��
(515t-M.WP) WAns-BUJdip 8 Selery; OiseMFle: Cenery-Appfun�; Pink-Rmarv�s; poken�od-Neseeor
PERM NO: P 07469�
GOVT: N SUPP: P!
FURPOSE: OTH
JOB DESCRIPTION : C/O DISHWASHER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO HUILDING PERMIT REFERENCE
if �Ih if fF �F jf �JE iE%iE iE aF �1F 9E iF if 1E iF if # iE �IE iF �N-�N� #!-jE iE aE 1E iE 9E �E iE-lE •k if -IF iE iE iF iE jE if 3f IE� it # jf if �lf iF jF ik 1E 3f # if aE jf iF 1F df �E iE �(� #�N� jE iE if iE �7F iE'E 1E 9f iE �
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MATN BUILDING ----------
FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN
PARKING RE�: PROV: PARCEL: 42215323 ZNE: REF NO:
PLANNING NOTES>
>
if iI' iE iE iE 1f if iE if if �f'7%'lE i' i4 iE'1E'k iE iE'lf iE')f' iE if if'IE 1E'lE iE # iE!%'lE �f d% If iE iE ii' -0E 1E if 1i' if i4 ih iE # iE iE iE iE iE iE if if If if')f 1E i(-iE iI-iE �f'1� iE iE iE 1%if iE iE 1f'� if-0f iE
D E C' E L O P M E N T S E R C� I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
BUILDING APPROVED HY
APPLICATION ISSO£D BY
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LEGALIZATIOPI:N
BLDG PMT
PERMIT
F E E S U M M A R Y
PLUMBING ELECTRIC MECHANIC
7.00
258
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 7.00 20.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING £LECTRIC MECHANIC
27.00
_ DATE:
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STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
2%.�0 2%.�� .a�
27.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
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� I N D I C' I D U A L F E E B R E A K D O W N
""'--fE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
PLU 1 DISHWASHER 7.00 7.00
END OF FEES
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DATE J,L _ �%
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CONSTRUCTION AND PLANNING POO� & SPA
APPROVALS Permit # Date Inspector qPPROVALS P t# Date inspector
i. Temporary Electrical Service or Pole 52, Pool & Equipment Location
2. Soil Pipe-Undr9rnd. 53. Steei Reinforcement
3. Electrical Conduit Utility-Undrgrrid. 54. Forms �
4. Electrica� Conduit-Undrgrnd. 55. Electrica� Bonding
5. Steel Reinforcement ' S6. Fough Plumbing & Pressure Test �
6. Electrical UFER Grnd�. 57. APPflOVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgmd., Test �
9. Water Pipe�Undrgmd. -• 60. Backwash Lines, P-Trap, � Undrgrnd. I
10. Structural Floor System � 67'._ APPROV AL TO DECK ��
11. Property Sewer �ine & House Connection 62. Backiaash & ReceptorPinal �
12. Sewer Cap 63. Heater & Vent-Final
13. Roof DrBins � 64. Piu�pbing System - Final
14. Rough Plumbing 65. Electrical-Final :
15. iiough E�ectrica6Conduit 66. Solar System�Final
76. Rough E�ectric Wiring .� 67. Fencing & Access Approval .
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough E�ectrical-T 8ar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. Oucts, in Structure �0. Underground Hydro
22. Ducts, Ventilating 71. Product Pipiny O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground F1ush
24. Roof Framing 73. Undergrnd. Storage Tank i7 Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ce�ling (Structurep & l,Aonocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. InsulatiDn 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Powzr Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning '
/. '
35. Ffnal Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Plumbing
39. Water Service-Finai i �
40. Gas Service-Finai '
41. $olar �omestic-Finai
42. Backflow Preventer
43. Backflow Irrigation
44. L.andscape Irrigation System
45. Sou�d Attenuation
46. Handicap Regulations
47. FINAL 5TRUCTURE & BUILDING
48. FINAL PLANNING
A9. Efectric Release to Editon
50. Gas Release to Southem California Gas Co `-�.
51. CERTIFICATE OF OCCUPANCY
No. Date
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' 15�_'Li...�
COSTA MESA BUILDiNGSAFETY DEPARTMENT
P, p. BOX 917 C06TA MEBA. CALIFORNIA
For Applicani to Fill In Compleiefy
J G TYPE OR PRINT �,
—��P�.
BUI�DING � � I� (\T-� 1 ��
ADDRESS �f l�U/V
COSTA MESA CALIFORNIA
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� ARCH
■ SIZE
TEL. � - �� '�
NO. OF
BETBACK LINe FPOM /
eeerrew or Bema� '� REAR YARI
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SIDE YARO LEFT I RIGXT
DESCRIPTION OF WORK
ROOF
�.(_,(,�S COVERit
AND WOR�('p0 BE
1 XERBBY ACNNOWLeD6H THAT 1 HAVe PEAD TH19 APPlJGT10N
AND 8TAT6 TH�T TNE ABOV6 IB GORfiEGT AND AGR¢6 TO COM-
PLY WITH ALL CITY OP�INANCFS M!D TE LAWB R66UL11TIN0
BUIlDINO GaNBTRURION.
81GNATUR� OP __�
� AUTHORIZED AGENT
LHOAL
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' FIN�1i'!CE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
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GOSTA MESA. CALIFORNIA I ,
ZONING
NO. OP ,. I UeE OF
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APPROVED ALLOWED
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Pl1RP098 OP [6TABLIBNINa � PERMIT P88 ONLY. Q
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PERMIT FEE $ � � a �
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PLAN CHECK S � � 'jp'�
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OWNER MyRRCn� TNC_ DA' 9-6-b1
JOB ADDRESS (�n W Wi1 cnn St.rcat BUILLING PERMIT NO.
GENEAAL CONTAACTOR pi,mar-hnildar VALUli $ �5�900 Q(
AP No. LOT ,$' TAACT Zi,�,f' FIRE ZON� D�SCRIYTION OF WORK F
]N5PECTIONS Signature DA19: GROUP I py J TYPE V ZONE
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