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HomeMy WebLinkAbout282 21ST ST - Building Permits)SOJECT ADDRESS: OWNER'S NAME: 282 21ST ST ADDRESS: KIECH JAMES H 225 WAKEFOREST RD COSTA MESA,CA ARCHIENGINEER: 435-0960 ADDRESS: UNIT: 92626 / REG.NO.: UNIT: PERMITTEE: ROSS 6 BARROWS INC, (714)557-7440 ADDRESS: G$Jj{A2''E6E''j0jAL jEjL. ALTON AV 7n --- LICENSED CONTRACTMECLARAYION: N hAereby affirm that am licensed und�Cr provisions 2 L'fia0ler 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full force and effect. CI Y LIC.: STATE LIC.: CLASS: Q20v327802 C-39 EXP: 11/95 Date' .� who_ Signature: _ BKER COM NSATION DECLARATION: I hereby affirm that have a certificate of consent le self -insure or a certificate Of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab. C). POLICY NO.: 606531-94 EXP. DATE: 07/01/95 COMPANY: STATE FUND p ❑ Candied copy is therapy furnished. 9C Certified copy is filed with the city Building Division. d L/ J Applicant:-! plsu�bfliION FROM WORKERS' COMPENSATION DECLARATION: (Thb section nee0 not oe wmpleted if the Dermic is for ane huMred (5100( or less). 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 became to the WorkersCompensation Laws of California. Date: Signature: NOTICE: 11. 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 which this permit is issued (Section 3097. Civ. Cl. k (I0E \ E D E T E ^ ^ LENDER: C t fV' !li ADDRESS: REQUIRED OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cade: Any city of 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 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 and Professions Code) or that he/she rs exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered far sale (Section 7D54. Business and Professional Code: The Contractors' State 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 employees, provided that such improvements are not intended or offered for sale. If, however the building or 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). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: The Contractors' State License Law dues not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' Stale License Law). I am aware that proof at their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section. B. 8 P. C. for this reason: Date'. Owner: I do hereby ceruty that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that l or any future building occupant wilf/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification Irom the Air Quality Management District. Residential construction applications are exempt from ;nese provisions. Date: Applicant: I hereby certify that i have read this application and stale that the above information is correct. l agree to comply with all city and county O;IiNnces and slate laws relating to building construction and hereby authorize representatives Of this city to enter upon the above mentioned rop ty for inspection purposes. s./� ere: Signature: Driver's License or Social Security a: 164146 While—Bwldmg: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 070783 PERMIT NO: B 070783 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION T/OFF E REROOF W/COMP, SQ FT: 4,100 CLAIM VALUE: 4,100,00 CALL—VALUE: 4,100,00 GROUP OCC: B-2 / COMMENTS: REROOF W/COMP, SMOKE DETECTORS ARE REQUIRED M M M M M M M M MM M M M MM M M M M M M M M M M M M MMMM M M M M M M M M M M MM M M MMM M M M M Miert M M M MM M M M M MM M M M MM M M M M M MM M 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 PARKING RE • PROV: PARCEL: 42615106 ZNE: AEF NO: PLANNING N TES> > iEMMMifMMa6 M if BeMMMMM Miert Mie Bt Rf lfMMMMMMMMM4E M iEM MiEMMMMMMaEMMMMMxMMMMMMMMMMMMMMMMMMMMMMMMMMM 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 ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: T APPLICATION ISSUED BY: DATE: (( dMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMiF7F��l�ii i1 M 1f 1e 1f at M 1EMMBEMMafMMMMMIEM MR6 iEMMMiEMM1E if 4eMMMMMiKMMMafMMaFM M4EMMMMMMMMMMMMMMMMMMMMMM}MMMMMMM LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72,00 .50 PLAN SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 72,50 0,00 0,00 72.50 72,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 72,00 .50 MMMiRMMMMMMBe M BeM MaeMMMMieMMMM1FMMMM1f iL MR6M Mil Mik efM M4EMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM I N D I V I D U A L F E E B R E A K D O W•N TYPE QTY D E S C R I P T I O N SFR 4100 REROOF BY VALUE RESIDENTIAL NOZONE END OF FEES UNIT COST TOTAL COST 1,00 4,100,00 01 00175188-00175185 T O T 72.50 DATE: 01/1E/95 TIfiE: 15:12 r CONSTRUCTION AND PLANNING ' APPROVALS Permit i# Date Inspector POOL PA 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 46 Electrioal 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, O Undrgrnd., Test - 9. Water Pipe-Undrgrrid. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House'Connection •• 62. Backwash & Receptor -Final 12. Sewer Cap �7 �. 63. Heater & Vent -Final 13. Roof Drains _ - '1 4. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final ' 15. Rough Electrical -Conduit - 66. Solar System -Final 16. Rough Electric Wiring f 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 APPROVAL$,. - Permit #�T 20. Rough Factory Fireplace 21. Ducts; in Structure- •• 70. Underground Hydro 22. Ducts; Ventilating ' - , - �; j1. Product Piping 11 6a Coil 23. Gas Pipe -Rough & Test - .. • 72. Underground Flush - 24. Roof Framing J3. Qndergrnd.,StorageTack QGas E! Oil 25. Roof Sheathing - z, -2, -RS (�6/k- 74. Overhead Hydro 26, T -Bar Ceiling (Structural) & Monbcoat '= "' 75. Dry Chemical 27. Frame and, Flashing '. 76. Dry Standpipe - 28. Lathing & Siding - - 77. FIXED SYSTEMFkNAL , 29. Insulation i 78. FIRE PREV. FINAL•" 30. Drywall Nailing r 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 - n 35. Final Gas Pipe' -Test. i 36. Hood or Canopy •_ 37. Final;Factory Fireplace 38. Final Plumbing 39. Water -Service -Final' - 40. Gas Service -Final ., , , .. i �• _� 41. Solar Domestic -Final -• - 42. Backflow Preventer a _ 43. Backflow Irrigation _ _R _Gjs'- LC re•�� C� 7_• 44. Landscape irrigation System r ,; _ 'j. -.((//�;�41_:� 45. Sound Attenuation W 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • ', L7 !i6ele, 48. FINAL PLANNING 49. Electric Release to Edisont�� - = 50. Gas Release to Southern California Gas Co - - •• 51. CERTIFICATE OF OCCUPANCY No. Date _ CITY OF COSTA MESA CALIFORNIA 92626 _ P.O. BOX 1200 I FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY November 10, 1976 s Costa Mesa Sanitary District Board of Directors Post Office Box 1200 . Costa Mesa, CA 92626 RE: Refund of Sanitary District Permit #1845 Johnny O'Connor, 282 East 21st Street Gentlemen: There was a duplication of certain fees paid for the above Sanitary District permit. The Building Safety Depart- ment verifies the duplication and requests a reimbursement be made for the first District fee paid. Sincerely, WILLIAM B. KDMER Assistant Director, Building Safety WBK%jzp CITY OF COSTA MESA PLANNING DEPARTMENT A.P. No. Bldg. Permit No. 03Tzo i PAID 00 98ZiJ*** 120.00 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address ?P2 4, R, A C. DIST 21st STRFFT. f PA Owner's Name Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 3 - Bedroom Units $40.00 = $1'".UO $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Number of Dwelling Units 3 Total Fee .<,j2±,p0 Planning Department Approval Date in -j0_72 Park Area No. A By W.L.D. Bob Applicant's Signature CITY OF COSTA MESA PLANNING DEPARTMENT A.P. No.�I OCT 20-72FC„SA00 982_Rd***120.00 Bldg. Permit No. PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address zoo .� 9, g C FAST 21st STREET r J Owner's Name J. L- O'CONNOR Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 3 @ $40.00 = `12.0.00 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Number of Dwelling Units 3 Total Fee $120.00 Planning Department Approval Date 10-20-72 Park Area No. S By W.L.O. Bob Applicant's Signature ti. . . . . . . M-07507 .+4s7{;_, — Z M0�4-1 IRR CERTIFICATE OF INSULATION THIS IS TO CERTIFY that insulation has been installed in conformance with the current energy regulations, California Administrative Code, Title 25, State of California, in the building located at: Street City Lot Number Tract No. EXTERIOR WALLS Manufacturer Thickness/Type P Value CEILINGS Manufacturer Thickness R Value il Blown: Manufacturer Thickness R Value Sq. ft. covered No. Bags Wt./Bag 1AqtZL 0o//47//-r/4Cufacturer Thickness/Type R Value 6.�,z Manufacturer Thickness/Type R Value i General Contractor License Number By I ate yT't IV adams insulation company By --T;4 -Dc(Ke e 931 N. Poinsettia St., Santa Ana, Co. 92701 �`icense Number 280,595 UWNCR KIECH. .lames & Jeannie UAIC 4-2-76 JOB ADDRESS ono _ oi..« c._..... n_u K r BUILDING PERMIT NO. 41506 GAS WATER ROUGH PLUMBING PROP. SWR. LINE [-j HOUSE CON, UP SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITION TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING TRENCHES Lj FORMS STEEL FLOOR SYSTEM BOND BEAM [] STEEL REINFORC SHEATHING FRAME AND FLA§,RING SUBCONTRACTOR PLASTER. BROWN COAT S_TP^CTURAL, FINAL H IG, VENT., REFRIG. AND A.C., FR4AL I M fllljt9744 Tm ( tf PLnm GING, FINAL AND GAS TEST ELECTRIC. FINAL FINAL GBUILDING. FINAL �u w 41506 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 q APR -7_-76„tPAll, 00 129” ��n2183C APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only REC DATE RECEIVED D EISSVED 4 p BUILD ADDRESS 8� .2CO pPERMIT —C% NO. OWNER "E G A.P. NO. p'IS3 MAIL ADDRESS .�9G E..2 ADDRESS 2-Y2 BUILDING ESS E I cos TEL. B r"- 'S CITY L^p,jj-jj NO. -sZ TRACT LOT BLOCK CONSTRUCTION NEW I ADD ALTER REPAIR LENDER BRANCH OWNER �q/VJ f3, r NSF /LS�/y ADDRESS VALUE ARCHITECT/4/O(�•FJIG�iI�+ TEL. _ OR ENGINEER S FIRE ADDRESS ZONE TYP GROUP/ APPROVED CONTRACTOR ® BY DAT — Z ADDRESS If TEL. ZON NO. OF USE OF N W CITY NO. PLANS BUILDIN / STATE CITV YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE ' 26-t P� NO. OF BLDGS. Z (FROM C/ Tfi j)) OF LOT �j OI NOW ON LOT J ONT FT. USE OF Q EXISTING BLDG. ESO FT Separate permits are required for L SIDE F plumbing and heating work. REAR FT. FT. U��Felectric, USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & s.0 / MAIN BLDGS. ACCESS BLDGS. VAR. 906 DATE C.U.P..y. APO 09YED APPROVED r. 1 hereby acknowledge that I have read this application and state �� r* 2-1 that the eInformation Is Correct and apnea to comply all laws regulating building construction, and I shall not employ i any person In violation of the workman's compensation taws of s c� the State of California. 1 hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUN O ND AL R the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON LV: am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE E e o PLAN CHECK E �. Signature of / J! i / /1 00 TAX E � 3Q Permittee _/�w��c+ i�ly..�GdC/-i/ 3 (/f/ l/isyr/� Autho zed Agent TOTAL PAID E OWNER F1:r DATE AD No. 118-15-4—01 LOT TRACT FIRE ZONE VALUE $ 46.500.00 I ECTIONS Si nature Dote GROUP T TYPE V ZONE SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Si nature WATER Pl umbin ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ROUGH WIRING Heatina and V nt. TRENCHES E) FORMS ED STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE In ir Jt SHEATHING FRAME AND FLASHING LATHING — IN n OUT n V PLASTER, BROWN COAT ST-TURAL, FINAL cf 'aIt A H. IG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL RIM nlNr: FINGI11 lift/ I _`M"W 35412 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 PAID rp 70-7?cnsa0O 689 **75.26 I m N D m E `o A C TION FOR BUILDING PERMIT For Applicant to Fill in Cpmpletely REC IV D Y TE ECE E DAT ISSUED /�. BVILDING i �/ �Qn ADDRES rJr/ OWNER (/ ' i 1w�;�.. J A.P. NO. S3�©/i f MAIL BUILDING 7 ADDRESS ADDRESS^S � TEL (/1J': �/ CITY,,,/��. (•d/ f (' NO. ,7 TRACT /'C(6 LOT �s BLOCK CONSTRUCTION NEW .ADD ALT PDF LISH LENDER BRANCH OWNER ADDRESS ! VALUE S /• ARCHITECT !� :57-0/tEL. OR ENGINEER f Nt NO. ® " !FIRE ADDRESS C Er l ZONE TYPE GROUP J CONTRACTOAL/f/e' (.: J ,� APPROVE BY DATE ADDRESS TEL. ZONE � NO.N PLANS USE OF NE �/ L BUILDING CITY NO. K STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE / t'2t NO. OF BLDGS. (FROM C/L(S �REET)_ OF LOT Li : NOW ON LOT FRONT FT. USE OF J r EXISTING BLDG. y+ " -J R SIDE ♦ FT. FT. SIZE OF NO. OF ( h r %3—FT. NEW BLDGA� i ROOMS STORIES /--- L. SIDE FT. EXTERIOR WALL ST, U O ROOF y `,.p -`6''14,9 COVERING COVERINGwi REAR 3- FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR. 4L DATE a 4�•, t �. C� C.U.P.# APPROVED APPROVED QATF STATE 1 hereby acknowledge that I have read this application and state HOLD FOR SPE AL R that the above information is correct and agree to comply with lIf TAX all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of - ^ the State of California. I hereby certify that I am properly licensed as a contractor under /j�) '"� o SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Divisicn 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Code, ivision 3, Chapter9. PERMIT FEE $ Signature of /� Permittee fR ✓./sC-� f! (-/ Yrr i-4 1 $ l� PLAN CHECK $ Authori dd Agent TOTAL FEE $ I m N D m E `o Z a cwj Z Z_Q ON o. m JD J to to J J m Q Z Q Z WaW J Q m Z J 2 W W Z 2 Z_H W0 N K 'OCT 20-77P°S;00 980** 144.00 crl_ COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 PP CATION FOR BUILDING PERMIT For Applicant to Fill in Completely RE V D V /6 1Q ATE RZVEDE - ISSUED BUILDING �i /s 2t �T�� ADDRESS ` y m Na.^ OWNER A.P. NO. j BUILDINGMAIL �JQ 4,5 21 ADDRESS ADDRESS TEL.TggCT BLOCK NO. .(iCONSTRUCTIONLENDERBRANCH OWNER O ADDRESSARCHITECTTEL. t.� awirOR ENGINEERFIRE ADDRESS ZONE TYPPAPPROVED - �I - CONTRACTOR BV L�� ADDRESS ZONE NO.OF USE OF NEW TEL. 1 PLANS BUILDING CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS (FROM C/LSTREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT, FT SIZE OF NO.OF NEW BLDG. ROOMS STORIES L. SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR. sW DATE C.U.P.+ APPROVED APPROVED RY DATE I hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and 1 shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. o THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PER T F E qNLV: a em exempt from the provisions of the State of California Business antl Professions CogDivision 3, Chapter 9. VALUATIONe, PERMIT FEE $ N J Signature of m Permlttae $ PLAN CHECK $ E 0 Authorized Agent u TOTAL FEE $ OWNER O'CONNOR J6hnny L. DATE 10/20/72 JOB ADDRESS PAp G 9let St_ BUILDING PERMIT NO. 35602 lip-lqa-m FIRE ZONE VALUE $ 400.00 ECTIONS Signature Dat. GROUP TYPE V ZONE R-2 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Pl umbin ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heatina and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT PLASTER, BROWN COAT S 'TUBAL, FINAL j M .NG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL z z a Z ZQ O N a Co J � J to ¢w m J . 6] J Q z Q Z W aW W Z Jp m Z J W W O Z F= - W to 2 70 H z Q U J CL CL Q O F to Z 0 F- L) U M cc co fA Z 35602 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING �.7nt07 / �J%— it—. — OWNE MAIL TEL// NO.0 BRANCH ADDRESS ARCHITECT TEL. CONTRACTOR ADDRESS CITY STATE LIC. NO. SIZE OF LOT USE OF EXISTING BLDG. SIZE OF NO. OF TEL. NO. CITV LIC. NO. NO. OF E NOW ON PA OCT 20-7?c�,—Sf:O 00 979k ***,=::5-03 APPIIICATION FOR BUILDING PERMIT RE V D �ATYECE1VED DATE IMSUEOPERIvA.P. NO.BUILDING ADDRES IU?T- VTS i5 0 E ZONE �l NO.OF PLA IS , YARDS APPROVED dJ h 1 7 "VALU:BUILDIN:G C �GR DATEUSE OF NEBUILDINGYARDS ACCESSO USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLOCS. BET. MAIN & ACCESS. SLDGS. VAR.* DATE Q C.U.P.+ APPROVED APPROVED ljOL 1S ... �� 6ahav/-"- I hereby acknowledge that I have read this application and state ' that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ s any person in violation of the workman's compensation laws of the State of California. m b 1 herebycertify that 1 am SO. FT. O y properly licensed as a contractor under V-0— the State of California Business and Professions Code. Divislcn 3, TH AMOUNT SHOWN UNDER VALUATION IS FOR j Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a am exempt from the provisions of the State of California Business VALUATION l and Professions Cotla, ivislon 3, Chapter 9. to 6•-`1 PERMIT FEE S Signa Permittee S /�/ PLAN CHECK S E �G' 0 Authors Agant TOTAL FEE $ ER 0. 118-153-01 DATE FIRE ZONE VALUE $ -, 1 + ':,- CTIDNS Signature Data TYPE IT GROUP T ZONE SOIL SUBCONTRACTOR MI S S GAS Dote Namber I Si nature WATER lum in ROUGH PLUMBING PROP. SWR. LINE HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING Heatina and Vent. TRENCHES Lj FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN Q OUT PLASTER, BROWN COAT ',TURAL, FINAL h, .NG. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL a i r .p ?3-- (0111721'• :tect:r.r.5C -042721 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BY I DATE RECEIVED E ISSUED DA13 —� —� ADDREBUILDING SS 9 II 6' PERMIT NO. OWNER '�!� A.P. NO. Q—e/l� MAIL ADDRE / kt$-'�♦ BUILDING ADDRESS - /RACT CITY ell NO. LOT BLOCK CONSTRUCTION WMOVING LENDER BRANCH OWNER ADDRESS VALUE S s • $ S^�u-v� ARCHITECT TEL. OR ENGINEE0. FIRE AD SS ZONE TYPE GROU .1 B APPROVED CW CONTRACTOR BY DATE ADDRESS ,�(( T A CITY /J.j'�a� N J�'QJ.s s7 OM—( ��� NO.OF PLANS— USE OF NEW 'P (i^'rG — BUILDING Z: � )� STATE J 7- 8l YARDS YARDS APPROVED LIC. NO. o 3 �5 LICVNO.' / BVII.ROVED LDIING ACCESSORY BUILDING SIZE NO.OF BLDGS. / (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF r EXISTING BLDG. R. SIDEFT FT Separate permits are required for L. SIDE F FT. electric, plumbing and heating work. REA FT, FT. VSE J,�F INA WORK OBE PERFORM DISTANCE BET. BET. MAIN MAIN SLOGS. ACCESS. SLOGS. i VAR. # DATE C.U.P.# APPROVED -✓s .tw.�— ( r ROVED94101 J/ DATE 1 hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as o contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Code Division 3, Chapter 9. PLAN CHECK $ Signature of ^ r �K � /p TAX $ Permittee $ 4f 1 Authorized A ht TOTAL PAID $