HomeMy WebLinkAbout292 16TH PL - Building Permits lilt^ PROJECT-ADDRESS: )-92 16TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B (/690F,5 a
OWNER'S NAME: MURRAY, STEPHEN T
ADDRESS: HURRAY JANET A PERMIT NO; B 85 PLAN CHECK NO: N GOVT; N SUPP : :i
492 16TH PL
COSTA MESA, CA 92627 CONSTRUCTION TYPE0690: V—N PERMIT TYPE ; STR PURPOSE: 0th
ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : T/OFF & REROOF W/COMP , SHINGLES SQ FT: 1 , 500
ADDRESS: UNIT:
CLAIM VALUE; 1 , 500 . 00 CALL—VALUE: 1 , 500 , 00 GROUP OCC; R-1 /
PERMITTEE: LEE ROOFING OF COSTA MESA ( 714 ) 642-7223
ADDREss: 1653 SUPERIOR COMMENTS : SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 1200SF PART OF APARTME
*
COSTA MESA CA 92627 ##*** ***rt*******u3e********fr x****3r*x*91. **TE*x*y ****#TF*i<#*FK ***** ria+.ts', **** **
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am Ik under provisions of Chapter 9(commencing with Section ZONING R EQU I R E M E N T S : ��E D ErE�^�
7000)of Division 3 of the Business and Professions Code.and my b nse in lull force and effect. SETBACKS L,Jr'?
CITY MC.: 0/28751 STATE LIC.: 349686 c ss: i EXP; 03/95
Date:�T / '� �y Signature: G�( MAIN BUILDING ACCESSORY BURSO R
WORKERS'COMPENSATION DECLARATION: (hereby affirm that lhave ateniliWle of consent to self-insure oracertificate of Workers' FRNT : FT IN REAR; FT IN FRNT; FT IN REAR; FT EDIN
Compensabpnls acertified.t py thereof(Section 3800.Lab.C. LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT : FT IN
POLICY NO.: 1' a-9 e 0948 -94 EXP.D • 06/30/95
COMPANY: STATE FUND PARKING REQ• PROV; PARCEL: 42515207 ZNE; REF NO:
• Certified copy is herebytarnished. EN PLANNING NOTES>
�y 1-.1 Certified copy is I h the cit mm[inn iiyiSion. >
Date: 70 - V / ! �' ****************#***********************************#*********************#****
3-�7 Applicant:
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY •
•
DATE;
Date: Signature: BUILDING APPROVED BY
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE;
Code.you must tdnhwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y 7 DATE; �.j
which this permit is issued(Section 3097.Civ.C). ********************************************#* ******************** *..-*3F Fi�&**
LENDER: ****************************************************************#**************
ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt Irom the Contractors'State License Law for the followingreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city 01 county which requires a permit to construct,alter,improve,demolish,or PERMIT 35 , 00 5 0
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN . SM I P/NON—RES
and Prolessions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(5500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL , PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 35 , 50 0 , 00 0 , 00 35 . 50 35 , 50 • , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale. II,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 35 . 50 OVER/SHORT: 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purposeof sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner o1 the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 35 , 00 ;50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon -
andwhocontractslorsuchprojectswithacontractor(s)license pursuant to the Contractors'state License Law).l am aware ********************#***************************#*#**************************4#
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BR EAKDOWN
❑ I am exempt under Section: B.&P.C.
or this reason: TYPE QTY DESCRIPTIO N UNIT- COST TOTAL COST
Date: Owner: SFR 1500 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 •
1 , 500 , 00
I do hereby cenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES '
25534 and thatnor any or mo buildingio occupant will/will not Management one)t Dd to comply with saidstate i codes and the are
erexempt for a /
permit and thI r ny future
uildifrom the Air uxManagementeedttpwitlalaconstructionandr requirements from `'//////
these provisions.
•
Date: Applicant: EXPIRED
I hereby certify that I have read this application and state that Ih information is correct.I agree to comply with all city and county Ineom
ordinances and state laws relating to building construction and here , Drize reprep Wives of this city to enter upon the above-mentioned gplete InspeCllOnS
property for rin1spection purposes.os� `� �/J,��"T f/ \ 0 i €:1G: .:-??'1697517• .4,1-1.1 _`
(((vii - !y .J_ _ Sig GATE: 1t,,._ . . . -tr
Date' Signature: •C% JI —_
Driver's License or Social Security A::
I
1641-46 White—Building;Green—Code Enforcement:Canary—Appbcanu Pink—Revenue;Goldenrod—Assessor
I.JNST�CTION AND PLANNING - POOL ,PA
APPROVALS Permits Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms •
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNiTE
7. Footings 58. Electrical Conduit-Undrgrnd. _ I
8. Foundation 59. Gas Pipe, CI Undrgr.,d., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 7 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & Housa Connection - 62. Backwash & Receptor•Final
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14, Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑C
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
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 Domestic-Final
42. Backflow Preventer /0-17-11:1- 5 414 r / r_ ,/`
1
43. Backflow Irrigation /0 414Sw dj � rL `/hhh, (�
44. Landscape Irrigation System
45. Sound Attenuation
t /0-7-et/ "-` 417?Ar s
46. Handicap Regulations
47. FINAL STRUCTURE & BLitLDING p. Maft-SeArj-
48. FINAL PLANNING t •
49. Electric Release to Edispn .'1R
r . .
50. Gas Release to Southeft.California Gas Co
51. CERTIFICATE OF 0(.cer'iPANCY
No. D
ute-
al\
PROJECT ADDRESS: 196 16TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069086
,/ OWNER'SNAME: MURRAY, STEPHEN T
ADDRESS: MURRAY JANET A PERMIT NO: B 069086 PLAN CHECK NO: N GOVT: N SUPP ; N
492 16TH PL
P COSTA MESA, CA 92627 CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; OTH
' ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/OFF 6 REROOF W/COMP. SHINGLES SQ FT; 3, 150
--'4a ADDRESS: UNIT:
CLAIM VALUE; 3, 150 , 00 CALC—VALUE; 3, 150 .00 GROUP OCC: R-1 /
PERMITTEE: LEE ROOFING OF COSTA MESA ( 714 ) 642-7223
ADDRESS; 1653 SUPERIOR COMMENTS : SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 2800SF 4 UNIT APARTMEN
COSTA MESA CA 92627 ******************************************TE****** -*****Tc*Tt********�c4'uc .,
,. ..
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I icensed under provisions of Chapter 9(commencing with Section Z O N I N GREQUC I KRSE M E N T S SMOKE DETECTOR
SETBACKS
7000)of Division 3 of the Business and Professions Code,and ense is in Lull force and effect. �y
CITYLIC.: 028751 STATELIC.: 349686 c C-39 EXP : 03/95 - RG�UIRED
MAIN BUILDING
ACCESSORY BUIL_1_ �
Date:__/10 Ca.3—.111 Signature: ,8-- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT- FT IN
Compensation lYstmqtr%ce tified copy thereof(Section 3800.Lab.D8.6/30/9
30/9 5
POLICY NO.: O EXP.DATE
COMPANY: STATE FUND PARKING RE PROV; PARCEL: 42515207 2NE; REF NO:
❑ Certified copy is hereby furnished. Certified copy is filed Ith the y Buil ' Division, PLANNING NOTES>
>
Date: i0“3 ' Of Applicant D E V E L O P M E N T
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thus section need not be completed it the permit is for one hundred($100)or less). Q
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become
subject I0 the Workers'Compensation Laws of California. *******************************************************************************
ZONING APPROVED BY S E R V I C E S R E U I R E M E N T SDATE;
Date: signature: BUILDING APPROVED BY • DATE:
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: to 3 NA.
which this permit is issued(Section 3097.Civ.C)
LENDER: *******************************************************************************
ADDRESS; LEGALIZATION; N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 63 , 00 . 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).
I BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I. as owner al the property or my employees with wages as their sale compensation, wit do the work, and the TOTALS----> 63 , 50 0 , 00 0 , 00 63 , 50 63 , 50 , 00
❑ structure is not intended or offered for sale lection 7044,Business and Professional Code: The Contractors'State License Law
I does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED • 63 . 50 OVER/SHORT; 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
BLDG PMT PLUMBING SL.ECTR IC MECHANIC FIRE SM I P/TOT • GRADING PLAN—CHECK
63 . 00 50
I, rofesr of ts C de: h.amCo texclusively tecontractingLicnLaw licensednot appy to
an toconstructowner
the project hbuilds ov, thereon
❑ and who contra Code: The projects wit State License Law does suto o the Co of properly' or w).improvesI thereon
and who contracts for such projects wilhatontreclpr(S)license pursuant to the Contractors'State License Ldw),I am aware 'xAN'*'**'**'*-'-E*****'*****************************************************-1E**********
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D O 'W N
0 I am exempt under Section: B.8.P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 3150 REROOF BY VALUE RESIDENTIAL NOZONE - 1 ,00 3, 150 ,00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES •
2e534 and that I or any future building occupant will/will not alomen need rocomply with said state codes and therequirements
r eiremept for a
permitlot construction or modification from the Air Quality ManagementDielti t.Residential construction applications are exempt
from
these provisions. v r
I
Date: Applicant: EXP 1 R E D
I hereby certify that I have read this application and state Ma he a ve information is correct.I agree to comply with all city and county incomplete InspeeUons
ordinances and state laws relating to building construction and hereby Ihorize rept entatives this city to enter upon the above-mentioned / �� 41 0016B794-001537”
. Q o.— r
property for inspection purposes. `-/C///// Ol. 3']15.7 4 s 4 iSZ79 1iTOT <�,
/b3 �ry 9 �i _ �- _ -- DATE; 1e„-..;;ti r:r.E: 11:r.S
Date' Signature:
Driver's License on Social Security 4f
1641.46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
I
CONSTRUCTION AND PLANNING POOL er SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd, 60. Backwash Lines. P-Trap, 0 Undrgrnd.
10. Structural Floor Svstem61. APPROVAL TO DECK
00
11. Property Sewer Line & House Connection J• 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater &Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
I
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 Meter•Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Ser vice-Final
41. Solar Domestic-Final •
42. Backflow Preventer iL1--F-1-4- 5 �L `Cady - 6-CgL
43. Backflow Irrigation rr,, .. <o-C-f9 84er_ ( - j`)
44. Landscape IrrigationWtem
45. Sound Attenuation 2 /6
__ Cell@ q." E-04- t.�r.,l A0.
46. Handicap Regulation* ',,,� c_ n /I
47. FINAL STRUCTUR •& i3 DINGP lSl '
I
48. FINAL PLANNING.
49. Electric Release to EdisorCC
50. Gas Release to Southern r. I ornia Gas Co
51. CERTIFICATE OF pCCNCY
No. '"Date
.�
Applicant to/ill in all spaces except those within heavy border lines and sign all appropriate declarations.
1111
CITY OF COSTA MESA CONSTRUCTION PERMIT - PERM NO. TRACT NO. LOT NO. UNIT NO.
Project Address 292 F. 16th Place, C.M
,Mie
3sato5-
y,sUn
Y Applicant's MailingAddressr� 7 TYPE OF CONSTRUCTION ❑ NEW U ADD 24 ALTERATION Li REPAIR
pp 126 Commercial , C.M. 92622 ❑ CONVERSION T❑ DEMOLISH ❑ OTF�ER
Owner's Name _Pall Bennett Phone 548-0166 Remove existing, apply A.P.'1`- Zone
•
-- DESCRIPTION OF WORK/USE OF BLDG. g l
Address 292 E. 16th P1. , C.M. 92627 1-2R# & 2-11# f fl. . I. _ . - II- • s Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING L_I. .T Z
GRADING FOUNDATION STRUCTURAL E Front 0
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - N
Address /� A Rear I
Contractor's Name�Gr�nk Bros.. Roofing Cpl,pne ❑ OTHER C Ri ht N
oc �p PROJECT DESCRIPTION SQ. FT. 594 OCCUPANpCY_SS ng le g K G
Address(mailing)�Gl.s Commercial Way, CSM 426L-( CON ST RUCTION TYPE garage VALUATION$ 891 .50 s Left
City License No. (1(15999 ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 0
with section 7000) of Division 3 of the Business and Professions Code,and T
my license is in full force and effect.
Licenses ass—_C- Licen Nwn_ aipZ7_ - $
�- Date !- Signature rC� � PLUMBING FEES
ELECTRICAL FEES
±•+� WORK RS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate
' Workers' Compensation Insurance, or a certified copy thereof (Section
00, Lab. C.) Backflow Preventer Service Sink • Automatic Washer Transformer ❑ 15-50 KW
/olicy No. 2R5 224 -88 Company State Fund Backflow Irrigation Sewer Cap ❑ 50+ KW
g Construction Pole Sub.
Certified copy is hereby furnished.
Ceriaied is Applicant-copy led with the city B g Iv n.
ate 7 -19 - Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
((TI re✓�•+/�
EXEMPTION FROM WORKERS'COMPS SATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit Is for one hundred($100)or
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
I certify that in the performance of the work for which this permit is Issued, I '
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1`fi-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F,A.U. Inc.Solar 09-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the
-
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets e Ran
Lender's Name 9
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I.am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or 1
county which requires-a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW
•
any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9 (commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she Is exempt .. - -- -
therefrom and the basis for the alleged exemption. Any violation Of Section
131.5 by any applicant for a permit subjects the applicant to a civil
realty of not more than five hundred dollars($500).
J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure Is not intended or offered — Reinspection Fee f $15 Issue Fee . $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through hIs or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 Zoning Approved By Date
pletion, t
e the owner will have the burden of proving hC/she did not build or im- Duct-Under Ground
glove Building Approved By Date
ove for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By j2PDat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU .
builds or improves thereon,and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ X3. 0 SMTP $ r S
proof of their Worker's Compensation insurance Should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section - B. 8. P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING S ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ - ENERGY P.C: $
I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000BTL— ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
•
and state laws relating to building construction, and hereby authorize repre-
sentatives of this cit to enter upon the above-mentioned property for
inspection our s. / MECHANICAL $ TOTAL FEE $ �A•�
- 13
S •—
Drivers'
fiat.,
Date //S�/f' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or$5
CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00014366-00014367 TOT 23.50
DATC± 00/11/DO TTMC. Oa.Oa
CONSTRUCTION AND'PLANNING POOL & SPA
Date Inspector Date Inspector
APPROVALS Permit* APPROVALS Permit#
1 :,Temporary Electricah$er"vice or Pole 52. Pool & Equipment Location
•
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd.
•
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 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 Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: '
34. Final Heating & Air Conditioning i=r
•
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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation ,
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING V4,6
(ij it48. Special Requirements Completed !� P7 •
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY _
•
No. Date -
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PE MIT NO� TRACT NO. LOT NO. BLDG.NO. 1F 3695 7/22/82 7.00 IL
CONSTRUCTION PERMIT A.
Friaje �y 71 _ .7GL ` TYPE OF CONSTRUCTION
AC/2
Ow
---
Friar
LI j 0 NEW 0 ADD 0 ALT RATION \le - -
•/ Add . '- /Ale i 0 REPAIR 0 ))4 ERSI ❑DEMOLISH I
LAO _���FrMs �_ ZONING REGULATIONS
Arch/Eng. -- Licen a No. 0 OTHER PPj ��RK A P
( DESCRIPTION O ORK ZONE PLNG. REF.
I�( Address y
`u Contraeto_- Ie - icyBUILDING Tp g�JIL�QpiNG
.� TYPE OF PERMIT SETBACK C/L ST. PROPS RTV LINE
Addressyy/
c /1(w.Le _ µr. 0 GRADING 0 FOUNDATION 0 STRUCTURAL SLIDE YARD
LICENSED CONTRACTOR DECLARATION C�J/ //��a[,, ❑ TENANT ❑ ECTRI AL- ❑PLUMBING Q�MECHANICAL/ SIEDFET YARD
I hereby affirm that I am licensed under provisions of CI(aAi 9(cdFn- $ RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER - .
Professions Co• , a.• my license is in fu ay feet. REAR YARD(TO P/L)
s� PROJECT DESCRIPTION
Lice eC�s D PKG.SPACE REQ. PROVIDE
Dat. I5 ha, /'w. r SQ.FT. ._. _
WORKERS'COMPENSAT4ON DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE $
I hereby affirm that I have a certificate of consent to self-ins a or a VALUATION ZONE ZONING APPROVED BY - DATE
"certificate of Workers' Compensation Ins nce, or a certlfi copy
ytl0 ) • GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
II a (c'oy eny #70 no,// -1
❑Certified copy is hereby furnished. - vv�J 'REMARKS: ,
❑ Certified copy Is filed with the city Building Division.
.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -
(This section need not be completed II the permit is for one hundred
($100) or less). -
I.certify that in the performance of the work for which this permit is
issued, I shall not employ any person In any manner 5o as to.become PLUMBING - PLAN CHECK - ELECTRICAL PLAN CHECK
-subject to the Workers'-Compensation Laws of California. UW ELLIN(o GARAGE
Date Signature BATHTUBS SHOWERS SO. FT. SO FT
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR ' 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must — TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+ KW
revoked. - '
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP ""
_ •
1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC.SOLAR) 10-50 HP 50 +•HP
formance of the work for which this permit is issued (Section 3097
Civ. C.). - FLOOR SINKS FLOOR DRAINS - FIXTURES • OUTLETS SWITCHES
Lender's Name
Lender's Address DRINKING FOUNTAINS , - GAS TUBE SIGNS '
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERSPOLE LIGHTS .
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL - -P TRAP . -Lurvo I Rut-I run -
Any city or county which requires a permit to construct, alter, POLES METERED .SUB
Improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION - PANELS MAIN SUB -,
quires the apylicant for such permit to file a signed statement that he -
Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE , OUTLETS "' - SERV ICE - 'AMP '
(Chapter 9 (commencing with Section.7000) of Division 3,of the- - - • 1
Business's nd Professions Code) or that-he Is exempt therefrom and the ' WATER HEATERS• BTU OUTPUT: ' - - -- '
basis-for the alleged exemption. Any-violation-of Section 703115'by - - '•
• any applicant for'a'permit'subjects 'the applicant to.a civil 'penalty' -SEWER CONNECTIONS - - ' ' • - '
of not more than five hundred\dollars ($500). '
❑ I, as owner-of the'property;or my employees with wages as their SOLAR%TANK•\ COLLECTORS - -
sole compensation; will do the work, and the structure-is not intended _ ' '
or offered for sale. (Section`7044, Business and Professions Code: The SOLAR PIPING SVS. - ISSUE FEE
Contractor's License Law does not apply to an owner,of a property '
who builds or improves thereon, and who does such work himself or ISSUE FEE - APPLICATION APPROVED BY DATE
through his own employees, provided that such Improvements are not '
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
is sold within one year of completion, the owner will have tho burden
of proving he did not build or improve for the purpose of sale). BUILDING
HEATING SYSTEM 0-100,000 BTU / PERMIT $ ' SMIP $
❑ I, as owner of the-property,- am exclusively contracting with AND DUCTING �/ X7/1
licensed contractors to construct the project (Section 7044, Business 100,000 +BTU - 4 (/f/ PLAN CHECK $ PERMIT •
and Professions Code: The Contractor's License Law does not apply to ISSUANCE $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ '
tracts from such projects with a contractor(s) licesned pursuant to SYSTEM '- - - GRADING $
the Contractor's License Law). 100,000 +BTU PLAN CHECK $ _ '
❑ I am exempt under-Section B.& P.C.for thisBOILERS BTU ELECTRICAL $ $
reason - PLAN CHECK $ ' - - MICROFILM $
Date Owner SYSTEM REPAIR,ALTERATION e/•O 0 TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM_ MULTIPLE MECHANICAL $
Infor . ion Is correct. I agree to comply with all city and county - - - - 'PLAN CHECK $ LESS AD- - •
VANCE •PC $_ -
ortli•- es and state laws relalin• to construction .nd hereby authorize . —
rep e tatives % y 3'r enter upon e Above mentioned ' //� BU
pr. -rty for -CUCS✓. •/es. } ?� - FINAL FEE $ / ,
/, ✓�. .3 00
D 'vers'License or 55� / ISSUE-FEE - • • ' _ -
CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
•
CONSTRUCTION AND PLANNING POOL& SPA- . • ,
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS . ' Permit# , `. -- - .
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location".+- . - ----- - - . - - - • -
2. Soil Pipe-Undrgrn N,44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. -•Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing &-Pressure Test'- - -- 1----. - • •-- - -
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUN ITE '" - - - • • - - -
7. Footings '.49. Electrical Conduit-Undrgrn ' ' '
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test- . •• , •
9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap. ❑Undrgrn'
10. Structural Floor System _ 52. APPROVAL TO DECK " -" -, '" -
11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final
12. Street Sewer Connection 54. Heater & Vent-Final - - • -
13. Rough Plumbing _55 Plumbing System - Final
14. Rough Electric-Conduit 56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating &Air Conditioning b8.. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18, Ducts, Ventilating •
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof
andtFlNOTES: .�/Z?/s y Lerma' C4ea LE7g
22. Frame and Flashing •
23. Insulation ..
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. FinaLEleetrk, / / ,J /� re,h5 i•
29. Cinal Heating & Air Conditioning �----+ q�(��%`� ' • /� 1,2�1 � , 44 44 4�*IX
30. FinaFtnas Pipe-lest /T-
31. Final Plumbing ._�/!
3L 7 f fat. 77L /ecc32. Water Service-Final
•
33. Gas Service-Final ,,,,.�rf .�7�
34. Solar Domestic-Final ' ir'
35. Landscape Sprinkling System • - • d
36. Sound Attenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY `
No. Date ` -
CinG 0 4/7 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT /j -to ' - //42?) '
Project Address TYPE OF CONSTRUCTION Li NEW U ADD U ALTERATION H REPAIR
Applicant's Mailin/o./�,ddr /y ❑ CONVERSION ❑ DEM• ' H r OTHER / q-p,# ��12one I�,\\ ('{ p (n
/ .�• 4e ri a D RIPTION 0. W•- / - �i ii t
Owner's Name / L.I���, �� S Main Building: •p4ory'BlbIiding: ' 1 Z
/ ./ - / _—me / /-
Address/7� • , TYPE OF PERMIT v GRADING U F•UNDATION STRUCTURAL E Front I N
Arch/Eng. License No. �• ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
B Rear FEB 27
19R4 �,
AddressII7C,n ❑ OTHER A - N
4 i� •- --- • r, .I / . PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right ''tt �{ q 99�r,f,qq G
Address(mailing) a�y,C 111 CONSTRUCTION TYPE VALUATION$ S Left I,IIY VF t,OSTH IfILJ11 R
GE
ZONE GRADING CU.YDS. ACRES Ping. Ref.ld Park.Fees $ Q
CityC License No. U
LICENSED CO NTRACTO DECLARATION Remarks: Parking Req./Provided
I hereby affirm that I am licensed under provisions of Charter 9(commencing R
(1- with section 7000) of Division 3 of the Business and Professions Co•e, nd Use of Building: E
\�1 my license is in IIf•- And eff• t. S/
Licen Cla: /License • . PLUMBING FEES Planning Notes: M
ff_ Da - a� Sig 1e %Sfl.i. ', i E
s+� WORKERS'COMP NSA I• •ECLARATION Bar Sink Showers T
T
,',;,hereby affirm that I have a certificate of consen o self-insure or a certificate Backflow Preventer Service Sink S
`_z'- Worker Compensation Insurance, or ertified copy then.f (Section
P,�sss• ' Backfiow Irrigation Sewer Cap ELECTRICAL FEES
ty . a .• - Co ..; . //4L/
Certified co y is hereby furnBathtubs Sewer Connection . Automatic Washer Transformer 0 15-50 KW
ifl c is 11 ith ti.s cl nl•- •!vision. •
0 50+ KW
_ - Clarifiers
Da A•• ic. - .-�.- Solar Collectors Construction Pole Sub.
EXEMPT! N FROM WOR E-5'COMPENSATIO ` CLARATION Dishwasher Solar Piping - Cooking Unit Meter ❑up to 100 amps
(This section need not be completed if the permit is one hundred ($100) or
less). DrinkingFountains
I certify that In the performance of the work fpr which this permit is issued, I Solar Tank Dishwasher Meter Dover 100 amps
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa • Dryers DGas DElectric Sub Panel
Date - Signature —
NOTICE: If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP 011/2-8
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar 09-15 HP ❑16.15+
CONSTRUCTION LENDING AGENCY _ - ---
I hereby affirm that there is a construction lending agency for the performance Interceptors - Water Heater Fixtures 'Microwave
of the work for which this permit Is Issued (Section 3097 Civ. C.)
Lender's Name Kitchen Sink • Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILDER DECLARATION Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the p_Tra -
following reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign
county which requires a permit to construct,alter Improve,demolish or repair - •
any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains . Garbage Disposal Standing Sections
to file a signed statement that he/she Is licensed pursuant to the provisions of - '
the Contractor's License Law (Chapter 9(commencing with Section'7000)of Generator ❑Q5 KW ❑5-15 KW Trash Compactor
Division 3 of the Business and Professions Code) or that he/she is exempt P
erefrom and the basis for the alleged exemption. Any violation of Section '
31.5 by any applicant for a permit subjects the applicant to a civil
natty of not more than five hundred dollars($500). Reinspection Fee - $25 Issue Fee $ 3 ,
❑ I, as owner of the property or my employees with wages as their sole • MECHANICAL Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - - - PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a-property who builds or Improves Boiler Hood or Type I 0
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date
employees, provided that such improvements are not Intended or offered for Canopy Type II 0 .
sale. If, however, the building or improvement Is sold within one year of cam- Duct-Under Ground Application Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- a
LJrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By r�� ( Date
I, as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a con- Exhaust System D Multiple❑ System Repair/Alteration - BUILDING PERMIT $ SMIP $
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
❑ I am exempt under Section B.&P.C.for this reason Firepl/Fact.Bit. ICBG# •
PLUMBING $ ISSUANCE $
Date Owner / Heating,eSystem&Ducting PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ` yy0-100,000 BTU ❑100,000 BTL GRADING $
information is correct. I agree to comply with all cit and county ordinanc I 1 ELECTRICAL $
and .:te laws rela 'm to builds..,construction,a hereby autho ze re • MICROFILM
seat. Ives of thi y :Jr upon the abo -mentioned ay
or / 9 PLAN CHECK S $ yr
.action PurP•." ' !/ - C/
: ..; . .i i Dat - MECHANICAL $ ( /-d TOTAL FEE $
Drivers' License or SS yp�
Pink-Accounting;Goldenrod-Assessor _
CONSTRUCTION AND PLANNING , ,`-s.-. POOL ?A �••
APPROVALS Permit# -Noll/ r Date / Inspector Date InSpeetor
APPROVALS Permit# i
.1. Temporary.Electrical Service or Pole!, ce 52. Pool & Equipment Location ;
2. Soil Pipe=Undrgrnd: /‘..°- !,• ':� 53. Steel Reinforcement
3.f•E'lectncal.ConduitUtilhy-Undrgr4d! ' r,, 54. Forms , f
4,Electrical Conduit-Undrtnd. / `/ / 55. Electrical Bonding ;• /
5. Steel'Reinforcement . ', ;' ,• it i ••-• 56. Rough Plumbing & Pressure Test ......4,-•
' 6. Electrical UFER'Grnd. %• - r 57. APPROVAL TO COVER-GUNITE
7. Fobtina • 1 , ;• .�/ 58. Electrical Conduit-Undrgrnd. •�'
8/Fou dation • -, i '� ! 59. Gas Pipe, 0 Undrgrnd.,Test
.� -9.-Water. h 60. Backwash Lines, P-Trap, 0 Undrgrnd. f.r.60.
10'Structural Floor.System q L•` / 61. APPROVAL TO DECK
/ i
10Pfoperty'Sewer bile & House Connection '+ 62. Backwash & Receptor-Final
12�°Sewer:Ca9 •../I - ./ 63. Heater & Vent-Final �
13`.Roof,Drains •^ I ` 64. Plumbing System - Final
1'4:•Rough Plumbin . Ig9 9 65.' Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rough Electric Wiring 67. Fencing & Acdess Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '
19. Rough,Pleating & Air Conditioning FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace APPROVALS Permit# '-
21. Ducts, i(p Structure 70. Underground Hydro
22. Ducfs Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roo`f_{Framing - 73. Undergrnd.Storage Tank O Gas 0 Oil
25. Roof 13heathing 74. Overhead Hydro
26. T-Bariling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Latfiiiw& Siding 77. FIXED SYSTEM FINAL
29. .Insulation 78. FIRE PREV. FINAL
• 30. Drywall Nailing . . HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown Coat 79. FINAL INSPECTION
I
' 32. Electtical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning 82.04.( Leo
35. Final Gas Pipe-Test -!!�I 1
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final •
41. Solar Domestic-Final
42. Backflow Preventer _
43. Backflow Irrigation •
44. Landscape Irrigation System • .
45. Sound Attenuation
46. Handicap Regulations . '
47. FINAL STRUCTURE& BUILDING '
48. Special Requirements Completed
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE.OF OCCUPANCY '
No. Date '
.
nA h:V._I II..S1 .k
9367 ®c. MAY 21 1958
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O. BOX 317 PI!' ,- r rnQI11 mccl
COSTA MESA. CALIFORNIA - - .�
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
AD292 - 16th PIme . Al B, C
ADDRESS BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
,may •� i] RECEIPT NO. 71 NO7
OWNER Santa Ana Patio Homes, Inc. JJ(( C/
MAIL 1555Placentia RECy(I�VSD BY OL^_TE RECEIVED
DATE ISSUED
ADDRESS
(/ Qr_J J s'�/�vg
CITY Newport Beach, Cal. TNO. Mt 6-3227 ADDkESS f
ARCHITECT same LIC.
OR ENEINEER NO. COSTA MESA. CALIFORNIA
FIRE
ADDhh. .a same ZONE
CONT ANORKoll Const. CONO.
1217 SONE////��T� NO.PLANSOF TYPE GROUP
CITY NO. �{G
TEL. APP{{{{ROVED i J
ADDRESS °ArBe NO.same BY or ATE
'} i �/S/
LEGAL LOT CTFO S
DESCRIPTION NO. ll BLOCK TRACT 2996 C S • y �A l% T r'
l
A.P.NO. Y LA i. X N t ie,
SIZE NO.OF SLOGS �( I;TI T1 ^'T
OF LOT 102.5 x 125 NOW ON LOT 0 P P. Sl 1,, I.1
USE OF 1:'1 IJ . ,a' I. 11�. 1.-1 II
)
EXISTING BLDG.
SETBACK LINE FROM ' a �T
CENTER OF STREET 461--211 C
* REAR YARD15 tO ,/I I3>t'141ALe. "'�'
C>9
UAlt
SIDE YARD RIGHT11 LEFT 81 I VA� No !+ V APPROVED S---V-S,
•
DESCRIPTION OF WORK VV
NEW p ALTERATION ADDITION
REPAI. • MOVING DEMOLISH •
BUILDING NO.OF
SIZE3123 ROOMS 16 STORIES 2 r
EXTERIOR WALL stucco ROOF hot-mop
COVERING p
USE OF NEW
BUILDING
Triplex residence and att. garage
Plan 4-BR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC•
TION. VALUATION
SIGNATURE OF ( •N •' /- PERMIT FEE $ 6.00
' /
$ 26,378.00 PLAN CHECK $ 23.00
AUTHORIZED AGENT TOTAL FEE $ 69.00Vlwt.