HomeMy WebLinkAbout274 22ND ST - Building Permits ADORESSOcBUILDING:
I274 22ND ST WIT: CITY OF COSTA MESA BUILDING PERMIT
�CWNERSNANEIvawm: SHEPPARD, W CARTWRIGHT JR PERM NO: B 074297
. ADDRESS: SHEPPARD, LINDA DANSKIN •
• ' 274 E 22ND ST PERMIT NO: B 074297 PLAN CHECK NO: N GOVT: N SUPP : N
- COSTA MESA, CA 92627548-8751
MAKINGAPPL,MMADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCNRECT ORENgNEER: UC NO.: JOB DESCRIPTION : REROOF W/COMP . SHINGLES OVER 1 LAYER SQ FT: 2 , 400
ARCH.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 2, 400 . 00 CALC—VALUE: 2, 400 . 00 GROUP OCC: R-3 /
CONTRACTORS NAME: CLASSIC ROOFING ( 714 ) 376-8885
cONTRACTORSYMUNG 1000 N. COAST HWY COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 1991 UBC
ADDRESS: LAGUNA BEACH CA uc.NO.: 692490 *+ *****tEx-SE**aESE***********+pit -**it**->E*+EiESE****Ic**+ESE*********SEx* Eat****Sc-N-*******Ak****
92651 uNT: 9 ZONING REQUIREMENTS
LICENSED C•NTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing 'h 'on 700• d Division 3 of the Business and Professions Code,and my license is in full farce and effect. .
CTTYUC.N•: i rUC.CLASS: C-39 • • _ - • : I- Ie.` MAIN BUILDING ACCESSORY BUILDING
LEFT: FT IN REAR: FT IN LEFT: FT IN REAR: FT IN
XDate: Contractor) LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BU DER 0 CLARATION:I hereby affirm under penaly of perjury that . e t ors license Law I. the
following reason( .•ion 70315 Business and Professions Code:Any city or county which requires aperm strut',alter,im..ove, pARKING REQ: PROV: PARCEL : 42632211 ZNE: REF NO:
demolish.or repair any structure,prior to as issuance,also requires the applicant for such permit to file a signed .tlul. .or she PLANNING NOTES>
A ) ,js licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the .1
P )usiness end Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
P031.5 by any applicant for a permisubjecs the applicant to a civil penalty of not more than/'ve hundred dollars 1S5001). *******************************************************************************
0 I,as owner of the properly or my employees with wages as Meg sole compensation,will do Om work,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044.Business and Professions Cade:The Contractors License Law does not apply loan ownerof property
who builds or'improves thereon,and who does such work himself or herself Cf through his or her own employees,provided that such r
improvements ere not intended«offered for sale.i,however.the building or inprovement is sold within ore year of completion,the ZONING APPROVED BY DATE:
ownerbuirder will have the burden d proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the property.son exclusively contracting with licensed contractors to MAWS the project(Section 7044,Business and BUILDING APPROVED BY : DATE:
Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon end who
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ lam exempt under Section: B.AP.C.•for this reason: APPLICATION ISSUED BY : 4 # DATE:
Dae' Owner: LEGALIZATION: N F E E SUMMARY STRUCTURAL' SEGMENT: Y
I do hereby certify that I am aware of and understand the requirements of Caldomia Heath and Safety Code Sections 25505.25533.and
25534,and that l or any future building occupant will/will nol(circle one)need to comply with said mate codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM1rP/RES GRADING
a permit forconstmction or modifcationfrom the Ai usably Management District.Residential construction applications are exempt from these
provisions. PERMIT 54 . 00 . 50
Date: Applicant: SMIP/NON—RES
PLAN r
WORKER'S COMPENSATION DECLARATION:thereby affirm under penalty of perjury one of the following declarations: ISSUE FEE
❑ Ihave and wilmeintanacMirciaeaconsent toself-insure for workers'compensation,asprovidedfor bySection 3700ofthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,f«tMoadothe nn
which this TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 544 50 . 00
A I have and wit maintain workers'compensation insurance.as required by Section 3700 of the Leber Code,for the performance of the
•
work for which this perm)is issued.My workers'compensation insurance caner end policy number are:
Carder: ARGONUT INS . EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00
Pdtcy Number: ')11cS811 ' 444 01/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
his section need not 1»completed I the panne is for one hundred dollars(s100)or less.) ' 54 . 000 n
U] I candy that in the performance of the work for which this permit is issued,I shall not employ any ye in any manner so as to ,
becom subjec to the workers compensation laws of Calilonie,and agree that H I shouts biotome subject to the workers' ********************************************************'{(.n**********************
compe 'Anion pr visions of-Section 3700 of the Labor C... onhwah comply INDIVIDUAL FEE BREAKDOWN .—
Date: Applicant:
Warning:F Juno tos ure workers'compensation coverage Is un a 'advisor an amp!ysrtocriminal pinatassanal TYPE QTY DESCRIPTIO N UNIT COST . TOTAL COST
civil Ares up to one undred thousand dollars(3104000).In addition to..a cost of connanastlo damages as provided for In
s«don37osof tits LaborCoda,Interest,and attorney's loos SFR 2400 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 400 .00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction tending agency for the END OF FEES -�"
performance of the work for which this perm)is issued(Section 3097.Chi.C). '
LENDER'S NAME: t
LENDER'S ADDRESS: ) I
I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances v
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned propendr
for inspection purposes. I
,,, ,UDY JIMENEZ
Print Name / /-� 7
.�I_ Date. 7,1 331T001fCI93-031906994 ESOT 54.50
?nature of Ova«es....Appliaen.- actor '22/c7. TINE.
(5151-48.WP) White-Building&Safety:Green-rue:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING _ 600L Z A
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 UF ER 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, (3 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
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
q
42. Backflow Preventer - 2 2.-^ [ -- A( - hdi9-
43. Backf low Irrigation ■ 6Lt.-4.-
44. Landscape Irrigation System q- 2 -75- A-
45. Sound Attenuation - e
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -��
48. FINAL PLANNING
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 except those within heavy border lines and sign all appropriate declarations. 6996 11/10/86 5.00 TLS`
• I CITY OF COSTA MES CONSTRUCT ON P RMIT RMIT NO, Q) TRACT NO. LOT NO. UNIT NO.
I
-19
Project Address �7lt 1 t• Q4.f ♦ v m(�l�
Applicant's Mailing Ad/dr ss $ _ 4, / TYPE OF CONSTRUCTION LJ NEW U ADD LJ ALTERATION IfCREPAIR r
, Owner's Name X70 A5a7) Phones 0 CONY ERSION ❑ DEMOLISH ❑ OTHER A.P.# LZone
El
OF WORK/USE OF BLDG.
Address -OPT", S Main Building: r e 'Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT LJ GRADING rt�LJ FFPdNDATION L I STRUCTURAL T Front rS ECEIVcD Nov0
Address {�• ••p��� ❑ TENANT ❑ ELECTRICAL LIJ'P LUMBING ❑ MECHANICAL B Rear hi n } e N
Contractor's Name ` b��sgf Phone�/.�`ZLIdI.J ❑ OTHER A +.�•G
:kr 7 a (/ PROJECT.DESCRIPTION SO, FT. OCCUPANCY C Right G
Address(mailing) . +J pp CONSTRUCTION TYPE
VALUATION$ S Left •
City License No. h ZONE' GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION - Ping. Ref. # Parking Req./Provided E
hereby affirm that I am licensed under provisions of Charter 9 (commencing *-Remarks:' Planning Notes: CIM
with section 7000) of Division 3 of the Business and Professions Code, and -
my license is in fur fo and effect. ..�� T
License Class . . / Lice,:- IA., . II ! - $
Date tail, ' -./- - '" PLUMBING FEES
�l Signature /
WORKERS'COMPENSATION DECLARATION f
j I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink • Showers • ' ELECTRICAL FEES
'^f Workers' Compensation Insurance, or a certified copy thereof (Section
Automatic Washer ' - 'Transformer 0'15-50 KW
1 100, Lab. /)t pp fj, � Backflow Preventer Service Sink . .
1 olicy No. rcQ6Q7�� Company �q'•ar� Backflow Irrigation Sewer Cap - Construction Pole Sub, 0 50+ KW
yCertif fed copy is hereby furnished. I
/ Cer/tJ'fifGdtl ppis tiled with the city � d l. i -i•n i ,, Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date /f-1'�tPy� :AV_/.
Applicant _ A /. .e % .
EXEMPTION FROM WORKERS'COMPENSATION 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 2 00 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 ❑0-1 HP 011/2-8
Workers' Compensation Laws of California. -
Date Signature Floor Drains Swimming Pool w/Spa
—
.NOTICE:If,after making this declaration, you should become subject to the F.A.U. - Inc.Solar 09-15 HP ❑1615+ .
• Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal
' comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCYGas Service Outlets Water ClosetDevice Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work fop which this permit is issued (Section 3097 Civ. C.) interceptors Water Heater
lender's Name Outlets Range g
' 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
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 - -
nalty of not more than five hundred dollars($500).
1 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 • I $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 tnrough 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, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground '
prove for the purpose of sale). - Building Approved By ' Date
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Application Issued By (Ljy/ •
l�AI,
' tractors to construct the project (Section 7044,Business and Professions Code: • Dale
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ' 00-100,000, t 0100,000 t
builds or improves thereon,and who contracts for such projects with a.con- - SUMMARY OF FEES
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 BUILDING PERMIT . $ SMTP $
proof of their Worker's Compensation insurance Should be provided to me. PLAN CHECK $ O� PERMIT •
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# . ISSUANCE $
PLUMBING •$
Date - owner PLAN CHECK 25% $ ENERGY,P.C. $
1 hereby certify that I have read this application and state that the above 00-100,000 0100,000 BT ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
•
i• and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
i sentatives o this city to enter upon he above-mentioned property for • _ _Ca /�
inspection"p., J/ /�Q / . • MECHANICAL $ TOTAL FEE $ CD t/
' Signature ��� l �_-/ ' , ' Date / 0 (O Reinspection Fee $15 Issue Fee $ 3 - PLAN CHECK 25% $ '
Drivers' License or SS# ' -
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL& 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. •'m
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 13j
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: Q,• -�„ l -� g . 4 V_
34. Final Heating & Air Conditioning - 13 U./F"-'Z / .Ff
35. Final Gas Pipe-Test /�L/�!
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
. 35662 PAIp 49:39
7
GV -8-77 .,.00 280* **.t*
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
.�-•-�c� APP I ATION F!!!R BUILDING PERMIT
ADDRESS For'�4 .Applicant to in Completely R c€I tY D r2,,7VED //-
BUILDING / / !J j DATE ISSLE
22-57 , e/
/�
L p PERMIT NO.
OWNER A/-/ hO le 6- hiewta.Id ,
A.P.NO. i
MAIL /� // \ BUILDING �J (��j
Z
ADDRESS/7cr (",pzs.r•F HV e+= 1 � Jl ADDRESS p�� 'i=�-AtwP� te"•<
us U CITY .. • .f l NO(L
0O ,4t' Y/f LOTS.9 BLOCK
i- Z -
l-!J]fr`r i.1�/�lQ li'1-�i77 TRA
Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMfII LSH
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LENDER \C-
J D BRANCH Jj` //�z/� /��yJ
JN OWNER yE� ile/i'It -- 1
a w ADDRESS
f----
CO m ,�J ��y���(((///111 VALUE _/L7
J•a OR ENGINEER J r TEL. USE G'->• 11 $? /Dao
co
FIRE q .Tnm/ I e c t» NO-44'-)O4O / T�
W a T E1 CS"' wR/:s Q+. P .i �./Tf�ZONE TYPE ROUP (��
Z < ADDRESS
2 W APPROVED
W Z CONTRACTOR Ow77 P .- BY DATE
J Q
goZ
J cc ADDRESS '''���
ww TEL. ZONE 2 NO.O_F 7 USE OF NEV#C- . tc%rT
O= CITY NO. �/ I PLANS . BUILDING GApor��
Z l- CITY
STATE CITY YARDS APPROVED YARDS APPROVED
to CC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D SIZE NO.OF BLD . (FROM CIL STREET/
OF LOT S 2..,5x /2.), 7 I BLDGS.
NOW ON LOT .6-- FRONT 65 FT. FT.
USE OF "'eV
EXISTING BLDG. R.SIDE 6 FT,U FT.
F' SIZE OF NO.OF C
Z NEW BLDG. /6•3-0 e1' ROOMS 6 STORIES / L.SIDE FT. FT.
a EXTERIOR WALL Woe of J. I ROOF / �. / •
V COVERINGg-i-C.OC r, COVERING 1'Y[It7��f REAR p`6 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
0-
[[ ''.// MAIN BLDGS. ACCESS BLOCS. _
VA
Q ,f etoif_V e ✓f at/2Q/J • C.U.P.# APPROVED
F / APPROVEO4 //
f.4 RY // DATE
/fir
p �°HOLD^/QOR SPECIA RE 04 '1. 1.'•? r S
1- I hereby acknowledge that I have read this application and state v� /f/ I
Dthat the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ 1.�[W'
I- any person in violation of the workman's compensation laws of
Ca the State of California. ,_ /s ,/ m
z I hereby certify that I am properly licensed as a contractor under SQ. FT. '9
o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UND R VALUATION IS FOR s
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:1 .
cc
am exempt from the provisions of the State of California Business
and Professions ode,Division 3,Chapter 9. VALUATION m
PERMIT FEE $ N
Signature o / �/ /' m
Permittee L' �'e . • - 'Air $a2w, PLAN CHECK $ �/
Authorized Agent u
TOTAL FEE $
i'
1
a ?�- . , r • -) 1
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 --- -. l
__' '.P IC'TION FOR BUILDING PERMIT
For Applic nt to Fill in Completely -- '
/� C R s DATE^R(EC))EIVED DA 6 ISSUED BUILDING �J
ADDRESS 27
t?� 'QST //-.Pi-71 /.-`'7'/ C'
OWNER A.P. NO. .;/7 /
rgn 7i
MAIL BUILDING Li � y2a.Z ADDRESS
ADDRESS 7
W IL TEL.
d TRACT I LOT BLOCK
Z CITY NO.
Z < CONSTRUCTION NEW I ADD(ALTER I REPAIR MOVING DFMOI ISH
—N LENDER
0- m
J D BRANCH
JN OWNER
ct W ADDRESS r�
mJ r�J A O rr�/��/VALU M��._
J Q ARCHITECT TEL. USE (\ et, 6,TTY��� $./'�(/F:/�
OR ENGINEER NO A
V Q FIRE
w 2 ADDRESS ZONE TYPE GROUP ..r
O.LU APPROVED ')
W Z CONTRACTOR BV .� "' DATEJ/� /-i--7 Z
J Q
In Z
Jct ADDRESS
W W TEL. ZONE NO.OF USE OF NEW
0= CITY NO.
_ PLANS BUILDING
ZF
w0 STATE CITY YARDS APPROVED YARDS APPROVED
to CC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/L STREET)
SIZE 1NO.OF BLDGS.
OF LOT 1 NOW ON LOT FRONT FT. FT.
USE OF
EXISTING BLDG. R SIDE FT. FT,
I— SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L,SIDE FT. FT.
0EXTERIOR WALL ROOF ,
COVERING I COVERING REAR FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. - BET.MAIN&
CL
CL MAIN BLOCS. ACCESS. BLDGS.
CL
Q
SC-VA-7-7— /VJ/ _ VAR.. DATEPPR
0
�rr C.U.P.qik APPROVED
I— APPROVED
U) —BY DATE
Z .,
0 .
UI hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I— any person in violation of the workmen's compensation laws of
V) the State of California. �j �� �s to
? I hereby certify that I am properly licensed as a contractor under 53 SQ. FT. C7Jy7c: 57:5-r o
the State of California Business and Professions Code, Division 3. THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: R
am exempt from the provisions of the State of California Business VALUATION /J) /);'y _
and Professions Code,Division 3,Chapter 9. 7 7 m
PERMIT FEE $ DN
Signature of al
Permittee S —� PLAN CHECK $ [NL/ 17-��%' E
/ / o
Authorized Agent u
TOTAL FEE $
.... .. H2tnfUFZx JHnwARD 1-11-111- 1f_iZi/'!4
rJOB ADDRESS 274C22nd St. BUILDING PERMIT NO. 35662
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Res. w/att Gar.
AP No. 118-161-01 LOT TRACT FIRE ZONE . VALUE $ 27,000.00
\IN`-'-CTIONS Signature Date GROUP T & STYPE V ZONE 77_1
4s 445 1-2-73 SUBCONTRACTOR PERMITS ISSUED
N/GAS
\WATER€44/44/-74...-73 PIumbinq / DateI Number Signature
ROUGH PLUMBING A...7 3- y-I./-77...-- /e,n C'-�'
PROP. SWR. LINE'HOUSE CON. laly f "+ ti7"5 I 7S.6 o��j,�
SPRINKLING SYSTEM /14 '5-* 27-- 3 �G) �y,� �/l 0..4 . /,2/r�4 ,7-3�2 /
MISCELLANEOUS A- i / --73 ,flet
ROUGH HEATING AND AIR CONDITIONING .2--
TEMPORARY
LL6��i _�- 1111
TEMPORARY SERVICE OR POLE �J 1277-7'L-
UNDERGROUND 0 POWER 0
ROUGH WIRING 11,1E .1 `I 7,V N ring and Vent.
TRENCHES El FORMS 0 STEEL REINF. I� e i- 3- '7y G�q,/Litnla Bwf , // o Y(y$' ---
FLOOR SYSTEM 4Th d.-/.-- /1-73 (�
BOND BEAM n STEEL REINFORCE 7
SHEATHING at- i2/--7
FRAME AND FLASHING Ft-- C ,0 r;) '
LATHING - IN I Fr OUT /� 2
-
PLASTER, BROWN COAT rine V'/- .
STRUCTURAL, FINAL Al EI ctr'G / /J
HE" '., VENT., REF RI G. AND A.C., FINAL 547�'�73 1I'/�{J-fit - �')NJ/�7�"-� ^� .J�p{(y�[1�/.
PL .NG, FINAL AND GAS TEST El / $7-'/14- 1 4. 4. p1/pCt' �"�,�',(i!„�y� =
ELECTRIC. FINAL j� p-/3.73 <'G-�
BUILDING, FINAL ma- 6-=/2-7i
SPECIAL REQUIREMENTS A . y, 7/p-7S