HomeMy WebLinkAbout956 WILSON ST - Building Permits�
CITY OF COSTA MESA � �
4(,0'�pMFy'q B!/ILDING DIVISION
i�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us
���Po��. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B11-00052
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 42235332 � DATE ISSUED: 02/17/2011
ISSUED BY: RMD
�,...�,---,�-R,.,-W....-�.-..--.
JOB ADDRESS::�956-W WIL'SON ST CM>:._;
Vicinity: HOUSE AND GARAGE ROOF
Squares: 1800
Suite/Unit:
Valuation: $4,000.00
SCOPE OF WORK: INS7ALL 1 LAYER OF 30# FE�T AND 30 YEAR ASPHALT SHINGLES OVER (1) EXISTING LAYER OF ASPHALT
SHINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 18 SQUARES. COMPLIANCE FORM ATTACHED TO JOB
CARD AND CITY PERMIT.
NOTE:RESIDENTIAL RE.ROOF: Final approval of permit shall not be granted until access to dwelling unit{s) is provided for
verifcation of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/lnspection Card
OWNER: MUSULIN,CYNTHIAA
PHONE: 949-631-4027
APPLICANT: RAY, ROSS
PHONE: 949-232-7663
CONTRACTOR: ALL W�ATHER ROOFING
Address: 2192 AMERICAN AVUnit:
City/State2ip: COSTA MESq, CA 92626
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$0.00
$9725
$0.00
$1.00
Address: 956 W WILSON ST
City/StatelZip: COSTA MESA, CA
Address:
Ciry/State/Zip:
License No. 739271
SUITE A PNONE: 949-646-8694
CELL:
License No.
License No.
PHONE:
PHONE:
Unit:
UNt: :
MOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. P�ohibitied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoivino Dav antl Christmas Dav
NO710E: The work authonxed by this permit shall comply with all applicable handicap access requiremenls under Califomia siatutes and related
regulalions. (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. FaiWre to obtain inspections and final approval will result in the expiration of this pertnit.
CODE t. INSGECiIONTYPE
1676 Fixed System Final Fire Pr¢vention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIxIURetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
ORTE INTITIALS
�( /�l-/9-// /2�
�
LOOEN INSPECTIONME
206 Final Mechaniwl
20B Final Plumbing
210 Final Electriwl
212 Final Fire Prevention
220 FinalPlanningApproval
222 FinalSite
250 Final Building/Occupancy
ORTE IN�TIpLS
WORKER�' COMPENSATION DEC�,qRATION:
I nereby affrm under penally of perjury one of Ihe following declarations:
❑ I have and will maintain a certifi�y�e of consent to self-Insure for vrorkers'
compensation, as provided for by section 3700 of the Labor Code, for Ihe
pertormance of the work for which Ihis permit is issued.
❑ I have antl will maintain workers' compensalion insurance, as requiretl by
section 3700 of the Labor Code, for the peAortnance of the work for which this
permit is issued. My workers' compensation Insurance carner antl policy
number are:
��: S`��i-%� �[JA1 �i
�j(iMs sec(m need rrol Ce cwn[d7etMll(neT �peimrt a iryryipy at one nundredOOAars (5100) a leu )
Po iTcy Number: I�C 71 � 75 D
❑! certi/y lhat in �he peAormanCe o/ the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' wmpensation laws of Califomia, and agree that if I should
become subject to the vrorkers' compensation pmvisions o( Section 3700 of
lhe Code. I sh vnth comply with these provisions.
n l�pfa�siprww� � ��-��
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed unqer provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Cotle, and
my license is in full force and ef(ect.
� !� �^��
Li � �y��es57F�
. . 2-/� �9
� ontracmr's Signat �sBet�
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum Ihal there is a consWction lending agency for Ihe
pedortnance of the v.ork tor which this permil is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lentler's Address:
SgnaWre Date
OWNER-BUILDER DECLARATION$:
I hereby aKrm that under penalty oP perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe follovnng reason (Sec. 703t5,
Business and Professions Coae: Any city or county which requires a permit to
consWct, alter, improve, demolish, or repair any struclure, prior [o i[s
issuance. also requires Ihe applicant for such permit ro Poe a signed statement
that he or she is licensed pursuant ro lhe provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 0! the
Business and Professions Cotle) or that he or she is exempt therefrom antl
the basis (or the alleged exemption. Any violation of Seclion 7031.5 by any
applicant for a permit subjecls the applicant to a civil penal[y o( not more than
five hundred dollars (5500).�:
❑ I, as owner of the property, or my employees with v2ges as their sole
compensation, WILL DO THE WORK, and lhe structure is no[ intended or
oHered for sale (Sec. 7044, Businesg and Professions Code: The Contractors
License Law does not apply to an ovmer of property vfio builds or improves
thereon, and who does such work himself or herself or ihrough his or her ovm
employees, provided that such improvemems are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner-builtler will have the burden of proving that he or she
did not budd or improve �a purpose of sate.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo constn�ct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an owner of
pmperty who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant ro Ihe Contractors License Laws.).
❑ I am exempt under sec.
Business and Pro(essions Code for lhis reason:
SiB^awre Date
�OS]<6 (3/0])
Ovmer ID veri(ed by drive, _�icense. ❑ Yes ❑ No �
Driver's License No. Expires:
Verificalion of Ovmership by (type of tlocument, i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certAy Ihal no excavalion frve (5) or mOre feet in tleplh inro wfiich a
person is required to descen4 vrill be made in connecCon with v.ork authorized
by this pertnit, and that no building structure, scaffdding, falsework, a demolition
or dismantling fhereol. vrill be more than thitly-siz (36) feel high. (Chap. 32, Gry
2, M 2, Sec. 3A7, Ttle 8, Califomia Atlministrative Code).
❑ As owner-builtler, I will not employ anyone to do work which would
require a permi� from the Division o! I�dustrial Sa(ety, as noted above, unless
such person has a pertnit to do such work from the division.
ApPliwnl's SiB��ure
Division of Industrial Safety Permit Num6er: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or presenl or future building occupant need to (le and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 0( the Califomia Heallh and Safery CoOe requires, with some
exceptions, that a Business Plan be filed with the Cos�a Mesa Fire
Departmenl by every 6usiness which has at any one time during a reported
year a ouantity ot hazardous matenals equal to or 9reater than a weight of
500 pounds, or a volume o! 55 gallons, or 200 cubic feel of compressed gas
at standard temperature and pressure�.
2. Does or will the applicant or present or fuW re builGing occupant need to fle
a regisVation form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( the Califomia Health and Salety Code, with some
exceptions, requires regislration with Ihe Costa Mesa Fire Departmenl by
each business which at any one time has on hand a quantity of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard
temperaNre and pressure).
3. Does or vnll the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and PreveNion Pmgram tor acWely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safery Code provides that the
Costa Mesa Fire Department may require the preparation, certifwtion and
51ing with the Fire Department o( an RMPP by businesses which are required
to regisler acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 0( the Cali(omia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the appliwnt or present or fuWre building occupant require for
lhe work which is the suDject of ihis application a permit for such construction
or modification from the South Coast Air Quality Management DisMct or from
any other air polNtion control Cistrict or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemmenl Cotle requires tha[ the requestetl
in(ortnation be fumishe0 on appliwtions for rromresidential building pertnits).
6. Will any part of Ihe facility lo be consWcted under Ihis pertnit be within
1000 feet fmm the ouler boundaries of a school? ❑ Yes ❑ No
Qf'yes", the (aciliry must meel the requirement o( Sections 25534 and 42303
of the Califomia Health and Safery Code).
7. If a permit from the Soulh Coast Air �ualiry Management DisMct or other
air polWtion control dishict or agency is required for the work which is the
subjecl of this applica[ion, have all of the tlisclosures prescribed by Califomia
Health and Safery Cotle Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach ceAifcate ot compliance from ihe appropriate air polWtion
conVol officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is correcL I agree to comply with all slate laws and
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state tha[
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building consWction, antl authorize representatives of
the City of Costa Mesa to enter upon the above-described pmperty for
inspection purposes. I agree not to occupy or allow occupancy of any builaing
authorized by Ihis permil until final inspection.
SignaWre eqs) Oate
GLn _ _���7���
nn nw�urzee MW . ny-- �.�
1(lnam�e Surface Detail5 Par Nie (urred oortioned oTMass Walls see Furrine Strius Construction Tab1e below. I
A
Framing Th
Tag/ Assembly Name Material S�
ID� orTvoe� and Size' or
Nole: For rurmAassernb(iee. accourstingJa' Cbntim
Fm�ring Ca�suvclimi mble Aelmr.
I. For Tag/ID iiedreale tlre identiftcation name
tandard Values From IA4 Table
Framed Continuous JA4 Proposed
U- 7A4 Table Caviry Insulation Assembiy Assembly
factor° Number° R-value� R-Value' Cell Valueb U-factor9
see Page 1A4.3 mid
use
lndicaie the Assembl�� Nume or ,rype: Roof/Cei(ing, Walls, Flaors, Slabs, Crawl Sp4ce, Doors and e�c,..lndicate the Frome rype and Size: For
WooA, Me1a1, Metai Buildings, 1vlass, enter ?z4, 2x6, m' eic... see JA4 for other possible frame type asserrblies.
Enter tlie �hiclutess fa� mass in inches m� Spacino Genveen (raming mem6ers enter; 1 G"w� 24 "OC,- or Other for all other assem6lp descriprioiv
such as Cnncrete Sandwich Panel, Spandrel Panel, Logs, Sv�ar� Bale Panel and etc.... ,
4. Bosed on die Clima�e Zane; enter the Slanda�d U;facior fi�om Table /51-l3, C or D for each dif(erent assemblp Name or rype.
5. Emer the Table wumber d�ai dosel�� resem6les (he proposed assembli�.
6. L'nler Ihe R-i�alue ihnl is being installed in the n�a/I caviq� or between Oie fi�nming; alheryvise, en(er "0 ".
7. Emer �he Conlinuous Insulalian R-nalue for Ihe proposed asse�nbl��; o(her-wise. en7er "0 ".
b'. Enler' !he rnN� m�d cn/wnn ofthe U factm' value based on Coluron� FTable Num6er �nd enter (he As.semblP U-facmr in Co[unm J
). The Yropnsed �la•semGlr U-(acior, Coliimn J, nru.ri be eqiml to or less than �he Stwulnrd U-fac�or in Co(umn E �o cmnph�.
Fun�ing Strips Construction TaUle for Mass Walls Ooly �
A B C D � F G H 7 d 1< L M
I'roposed 1'roperties of MasonrY.mid Concrele Added Interim' or �zterim� Insulxtiun
Wmlls Prom Reference in Furring Spnce (rom Reference
Juint A endiz Tablc 43.5, 4.3.G. 43.7 Joini A>>endiz 7'able 4.3,13
� v 4 7. �
U VU � J Y � U
� p � � a� � v�
Assembly =' j � c'a° F U � a��� " v`u Fin21
�� L.` F 'O '� �'�
Muss Namc ur JA4 Table �_ v- F F o t A Q_ " � Assembl/y
Thickness� Ty c' Number' ��1° =� � � � � � N �''O � N I.J-{�Ctol'"'� COmment
�
I I
2egi,rtruiinn Nimaber: Registrution Uuie/Time: HL•RS Prnvider':
200d' Resfdential Conrpliance Farri7s Augus/ 2009
T
Alteratinns
ROOFING PRODUCTS (COOL ROOFS) §15](p12
When the area of rxterior roof svrjace to be replaced exreeds uvore than 50% oJdze nxisting roojuren, or iuore Niun 1,000 jf, �vhichever is
less, the ne�v roofing aren uius� �iiee( !he roofiwg prodac� "Coo! Roof'requlrenrenls oj§I52(b)IHi, 152(b)1Hii, or l52(bJlHiii.
Check applicaG/e al�ernntrve or uceptio�+ be/aH� if �he rnoJa/(eration is esemp! fi�om �he roofingproduc/ "Cool Roof" requirements. Nofe: /Jpny
one of (he ahernalives m� exceptimv below is checked (he Aged Solar Reflecmnce and Therma/ Emitfance requiremenis for roofing produc�.s in
�,�'l18(i) m'e no pplicable. Do no�fill table below. �'
❑ C oofs Not Required in Climate Zones 1-]2, 14, and 16 with a Low Sloped. Less or 2:12 pitch.
ool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs (pi[ch greater than 2:12) and product unit weight less
than 516/ft�.
Alternatives to §252(b)1Hi and §152(b)Hii, Steep-slope roof (pirc/i > 2:12J
,O' Insulation witl� a thermal resistance of at least 0.85 hrfl �°F/B[u or at least a 3/4 inch airvspace is added to the roof deck �
over an attic; or
❑ Bxisting ducts in the attic are insulated and sealed according to §151(�10; or .
. � In climate zones 10, 12 and 13, with 1 ft'-of (ree ventilation area o(attic ventiladon for every l50 ft� of attic floor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or
❑ Building has a[ least R30 ceiling insulation; or
❑ Building has radiant barrier in the attic meeting the requiremencs of §151(�2; or
❑ Building has no ducts in tlie attic; or
❑ ln climate zones ]0, I 1, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)1Hiii, Low-slope roof (pitcli <2:72)
❑ Building l�as no ducts in the attic.
Other Exceptions
❑ Roofmg area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from ffie below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft is exempt from the below Cool Roof criteria.
Note: If no CRRG 1 Iabel is availa6le, ihis compliance method cannot be used, use the Performance Approach to show compliance, otherwise,
Check the a licable box below if Exem t from the RooSn Products "Cool RooF' Re uirement:
� Roof Slope Product Weight Product Aged Solar Thermai
CRRC Prnducl ID Numher� < 2�12 > 2:12 < 516/ft� > 516/ft2 Tvne' Reflectance�'4 Emittence SRIS
����_�
����_�
����_�
����_�
����—�
/ndicale !be qye ofproduc! is being use� (or Ure rooflop, i.e. single-plp raof, asphall roof, melol rooj, elc.
1(Ihe Aged RePeclance ia� nol avnilaGle in.lhe Cnol Roof Roling Cmmcil'.e Raled Pruduc! Direclop� Ihen use !he /nilial Reflec(m�ce va[ve fi�om Ure sume
director�� ond use rfie equu�ion (0.2+OJ(p��������— 0.1) lo obluin n calculn�ed aged vulue Where p is fhe /nilipl So(ar Refleclm�ce.
Check Ga.r if (he Aged Rejleclance is n calctJored value vsiirg Ure eqnaNan aGove.
CnlciJo�e Ihe SIU value G,r using Uie SR/- Workshee� u� hl�n'// vwu' enerm� cagnv/lide24/and enrer (hc resediing value irr !he SRI Column obove ond o�mch uconr af
the SRl- IVorksheei ia �he CFJR.
� apply Liquid Pield Applied Coatings, thc coa[ing must bc applied across tlie entire roof surface and meet the dry mil [hickness or coverage
commended by the coatings manufacturer and meet minimum performance requirements iisted in §l I8(i)4. Selec� the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating
Cement-Based Roof Coa[ing
O[her
Registrntian Num6er': Regisbn(ion DuielCime: FIERS Provider:
2008 Residential Campliance Farms �
Augus� 2009
�
H�RS V�RIFICATION SUMMARY The en(orcemem �igencr shmdd y¢!r speciu! at+e�v�on to ll�e HE/iS hleaslu-es� specified in lhis
cheddisi Gelrnr. A con>yleteci and s�gned C'F-41( Fmnr for n]l die nren.sw�es specilied shnfl Ge suLnvned ru fi�e bi�ilding inspecior be/mr linnl
DuCt Senlinp & ieSYinp HERS nerifica�ion is re9mimd Jor lhi� mem�ure. .
❑ 1'�S ❑ NO vCS: ln Climate Zones'_' and )-I G, i1' ma�e than 40 linear feei of new or replacemem ducts m�e insialled in unconditioned
� space, ihe duc�s yre tn be se:iled per jU52fbpDii and t6e newly installed dncts are to be insulai�ed pe� §751(f)] 0.
❑�XC�PT10f�: Lzisfing duct sVstems Ihal are estended, which xre cunshvc[ed, insulsned ur sealeci with asbestos.
❑ Y�S ❑ NU Y�S: ln Climate Zones 2 xnd 9-] G, if the ezSsting apace-conditioning sysiem (H\�AC equipment and duciingl is replaced, [he
� ducts are to be sealed per §152(b)1Di. � -
❑ Y�5 ❑ NO 1'�S: ln Climate Zones .'', and y-] 6, if the existing HVAC equipmem is repluced (includin� the replacemem of� the ai� handler;
� outdom� condensing unii of a splii system, cooling m� henting coil, or the furnace lieai exehangerj the ducts are to be
sezled pei §]52(b)lE.
❑�XCEPTION: Duct systems thsf are ducumented tu have been previuusir seaied confirmeA tl�ruugii H�RS
. � verification iu �ccm�dance �vitli prucedures in the Reference Residential Appendia P.A3.
� � ❑�XCEPTION: Uuct systems with less than 40 linear teet in unconditioned spnce. .
❑ ESCEPT)O�': �xistin� duct svstems construc[ed, insulated a� sealed wifli asbestos.
Ref'riperant Charee - Split System HERS veriJication is reguirec7 for thi.s measruc.
❑ YES ❑ NO YCS: ln Climace Zones 2 and R-15, when the existing HVAC equipment is replaced (including th: replacement of the air
handJet, outdoor condensing unit of a spJit system A/C m� l�eat pump, coo7ing or I�eating coil; or Ihe fumace heat
Central Fan Inte;rated (CFI) Ventilation S,ystem and Fan Watt Draw
Tl�e ventiJation renuirements of F150fo) do not appJv tn existine residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS reri)icaiion is reguired_for this nieasure.
❑ 1�5 ❑ NO YES�. ln Climate Zones 1 U thmugh ] 5, when the existing space-conditioning system (H VAC equipment and ducting) is
renlaced, the airtlow and ian watt draw shal I be veri5ed ner �+152(b)1 Ci to meet the ronuirements of & I51(�7B.
Documentation Author's
• I certltv that this Certi
Name: �i �
If Applicable � CEA or ❑
(CertiGcation q):
o I am eligible under Dirision ; of ihe Californiu Business and 7'ro(essions Cude to accepi responsibility lor the builcling desi@n identi5eil'oii
this CertiScate of Complianee.
• 7 certify thai thc energy features and perlormance speci5cation:: for the. building dcsigu identiiied on this CeniLaue of Compliunce cmiform
tn the requircments ofTi�Ic 24, Pmts 1 Eind G of tfie Culifurnia CoAe of Regula�iona.
• Thc bulldmg design ieatures idemiGed on thie. Cenific�te of Compliancc arc cunsistem wilh thc intormatiun provided to ducumeni thi:�,
bulldin� design on th� other applic,�ble cumpliuncc fonns: worl:shcc�s; culculations, plan:; and 5peciLctuion:�. submiLLcd tu thc eniorcement
aeencti' f'oi apprt�vul wrth this buildinE penni� a�nlication.
Namc` � Si;!nature:
Compemp:
Hddress.
Uate:
License'.
Phone:
Tnr u.��.ci.i'tru:ce nr que.stinne� reEau�dua� fl:e Liie�e;l' St<endard.t, cnnlrec7 Lu� L•ncie:l' Hatline «t: 1-BOD-?72-i3/J(l.
Itegi.xu�minn IJurnbcr: lfeg(.rrratiun Uac/Timc:
200[, Rea'idenlia! Compliunce For�ms
HGItS Prm•icier.-
Azigua�13U0J
OW NER Br15t01 EStBteS ` DATE �-18-56
JOB ADDRESS 9S6 Wilson Street BUILDING PERMIT NO. 2511
G' '.RALCONTRACTOR $•Q•HllI1S2ker VALUE $ 8,856.0�
LOT 3� BLOCK TRACT 2873 Single Res. w/att �ar
GROUP I& J TVPE V ZONE R(1 FIRE DISTRICT 2837
/ PERMITSISSUED
INSPECTIONS Dq?E / SUBCONTRACTOR
\, ,99 �/ � DATE I NUMBER
FootingTrench ��Y(/✓ '
Foundation Forms and Grade o Garage
Rough Framing
Plumbing, Rough to S -��
Plumbing, Rough Complete �
Temporary Pole
Wiring,Rough ���
Heatinn; Rounh
Meavng, rmai ,C!_ �c�G�vt7�c� y- p7—
SeM-^r„Ho e� Seweq st. 7_�-y—� "/ ,jf .�,._y, /-,26 ��
& Tank or,Ce ss p_ool� �._ i i� ii ` /.,�.�-
Lathing, In Out � . y��PT
Plastering O—� �y�
Plumbing, Finai, Fixtures Complete � � '
Plumbing, Fin,al Gas Test �. [;�� J^ � A�pi�(i ,.��ti '�/—a G
Wiring, Final c�. /�� � 5"L // �! %— Z/
occupancr ,�,�; (�-,l.b'%J�
FOFM 310 9M 10�55
. �osta Mesa Bailding Department
- P. O. Box 3!7
• ' � COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
e�na��9 qS (�.- Wi�.SoA� ST.
Address
Costa Mesa, California
Nearest
Cross St. ��-f4G �Q� � //� (%� •
ownerB2�STaL �s�"A7.�.5
Mail T
Address 9oZCv ��. Las i vrJ,4s VQ.
� Tel.
CitY��(iip�.� C..IT"'� Ne.�?'1-h-i�
P' 'ress
City Ltc
�_.�cractor 5.1�� U USh �L.EQ.. �vo. ZCo�'' �
Address �/\-A�(.7�
Legal Lat . �/ � z8��3
Description No. 3 b 81ock � Traet
(Attach Metes and Bounds)
� No. of Bldgs
SizeofLot �� x �C� NowonLot �
l�seof I No.oT I No.of
Existing Bldg. � Famillea Rooms
Setback Line irom Rear Vard 'Z �-F
Center of Street �O Side Vard S I Cj
DESCRIPTION OF WORH
New � I I Alteratlon I I Addition I
B
I hemby acl+
and state th�
with all CIt
building con
Signature of
Permittee _
;�83:�tPPLICATION FOR PERMIT
BUILDING �
FOR OFFICE USE ONLY
Receipt No. Permit No.
�$ //
Recei by Date Rec'd. Date Issued
� �.Y�,S� ��/X-.s6
Address
Costa Mesa, California
Nearest
Cross St. �
Zone ./ I No.of I Type �
Date
CORRECTIONS
� Moving � � Demolish �
' �-/ No. oi .�
� � � Rooms 5 Stories '
I Roof �cc- /i_ APPROVALS
:'�["fiG�,C Covering
C� ' ��J Foundation LocaUon Inspecto
Forms, Materials,
- � '� Under-Pinning
�'_ Frame: Fire Stops,
Bracing, Bolts
owledge that I have read this Application
the above is correM and agree to comply Lath. Int.
Ordinances and State Iaws regulating
PUCh'Oy ` u �n �o � Lath. ExL
� ��
Valuation Perh
$ �Q� e O Plan
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Fee
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FeeS 'LZ•�a
ieck $ ! � • O O
$ 33�°"
Ext.
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2
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PLOT PLAN
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property line and between 6uildinpa
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.i0s nDnitEss 95 W. Wilson Street suu.nixc r�xmiT No.
or
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N OF WORK Add
vat.uE S
J TYPE N
SUBCONTRACTOR
, 262e5
� COSTA MESA BUIIDINCrSAFE7Y DEPARTMENT
P.O. BOX t200 � COSTA MESA, CALIFORNIA 9262E
For Appllcant fo FIII In Completaly.
TYPE OR PRINT •
1DDRE'S8 9'7'lY L(/� �/� � •�ON
COSTA MEBA, CALIFORNIA
TEL.
ScX�s X
DESCRIPTION OF WORK '
V I "=1 :;l :�
eui�o�Ho v
srze )
EXTERIOR WALL
�1 H!MleY
AN� BTAT
SIGNATUR80P �
PERMITf6
AUTHORIZiO A6[NT
MAV[ 116AD TNIB AIPLIGTION
�ORR[R�AXD I100.H[ TO COM.
wno �rwrs uwa iouunno
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OCT 17-66 00 756 ���`��`�6.00
APPLICATION FOR PERMR
BUILDING
For Offlce Use Only
11[C[IRNO. � P
ZONIN(i
NO. O� ^ YD[ O� N[W
�LAN� �y lYILDINO
A. P. NO. �� i � L'7 /r .� '� .'f �
N0T6: NO BAV6 OV iRHAN6 SHALL 06 LE88 THAN
YARDBMPROVHD I YARDSAPPROVHD
MAINBUILDINO ACCEY80RYBUILUINO
aR.
vwFe. $
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TNB AMOUNT BMOWN UHDBR VALU�TON IB FOR TH6 j
PUNPOBH O� [lTI�BLIBNINO A PlqMIT PEB ONLY. FS
VALUATION � / � �
PERMIT FEE $ �O E
��J /� � o
s % �7 �
TOTAL FE6 � r
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