HomeMy WebLinkAbout227 24TH PL - Building Permits • \
- , Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
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C4 PERMIT O�� ' TRACT NO. LOT NO. UNIT NO. I Cr^
CITY OF COSTA MESA CONST CTION PERMIT C1^ 8525 5/27/L'/
Project Address 0.-)i - 4). CrE
TYPE OF CONSTRUCTION ID NEW ❑ ADD U ALTERATION U REPAIR
ant's Mallin• a•dr¢55 S a
Owner's Name I f.' 1- s - -' Phone sllffyy� ❑ CONVERSION El DEMOLISH El OTHER A.P.# Zone
DESCRIPTION OF WOR USE OF BLDG.
Addres% c, - a ll fa • 1 • •• A - •o (r �s� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF !RMI U GRADING a FOUNDATION U STRUCTURAL E Front O
Address �'y ❑ OTHER ❑ ELECTRICAL PLUMBING ❑ MECHANICAL BA Rear N
Contractor's Name C9/-zL5 Phone C Right N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) _ G
CON ST RUCTION TYPE VALUATIONS S Left
City License No. ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION fes• Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: {^ y i p s P 1c, cal, s Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and �'�(r_ 'Y A V✓t
my license is in full force and effect. _ T
License Class License No. ---- - - - - - - - -- S
Date Signature PLUMBING FEES •
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
t. Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
„jj 30, Lab. C.) " Automatic Washer Transformer 0 15-50 KW
" oocy No. Company Backflow irrigation Sewer Ca 0 50+ KW
Ailey
8 Certified copy is hereby furnished._ p COnStruCtion POI¢$Ub.
Certified copy is filed with-the city Building Division. Bathtubs Sewer Connection _ • Cooking Unit • Meter ❑up to 100 amps
Date Applicant -
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). 3• Dishwasher Solar Piping •Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the-work for which this per it is Issued,I -
shall not employ any person in any'man-er so . to bee a subject,yo the Drinking Fountains Solar Tank ' Fan Motors 00-1 HP 011/2-8
Workers' ompensatio Laws of California // - _
Date 3 947 n , Signature / i !.�-X1'� Floor Drains Swimming Pool w/Spa �— F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE: If,after Making this declaratio ou should be me subject to e
Workers' Compensation provisions of Labor Code, you must forth th Floor Sinks Urinal Fixtures
comply with such provisions or thj permit shall be deemed revo ed. Microwave
CONSTRUCTION LENDING AGEN '' 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
Lender's Name Range
-
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
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00.5 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 p / »»
the Contractor's License Law(Chapter 9(commencing with Section 7000)of f1Q-/[X'et/(041.!///•' ' s o(] ? p�'-q�/t.0(/( �lb1l 7 ��
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
031.5 by any applicant for a permit subjects the applicant to a civil
RIty of not more than five hundred dollars($500).
, as owner of the property or my employees with wages as their solo 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 ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration S Application Issued By �A/ Dat
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 120.100•%a BTU 0100,000 BTU ! SUMMARY OF FE
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 thatExhaust System 0 Multiple 0 s em Repair/Alteration 5 BUILDING PERMIT $ SMIP $
proof at their Worker's Compensation insurance should be provided to me. PLAN CHECK $ P
0 I am exempt under Section — B.& P.C.f•r this re. on Firepl/Fact.Bit. ICBG# Fire Dampers EXPI R t V PERMIT
ERMIT
�w / ul.itG�L ' PLUMBING $ C-� ISSUANCE $
-
Date sir owner � �i� �•i��i n� Heating System& Du g Registers In�(nPtete 1115a PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read to s application and sta e that the ab-i- ❑o-100,000 BT 5 100,000BTL ELECTRICAL /.2--•p O GRADING S
information is correct. I agree to cu•••ly with all city and county ordinances • r- $
and state laws relating to building construction, and hereby authorize repre- S18PLAN CHECK 50% $ MICROFILM S
sentatives • is city to enter ••n the •ove-mentioned property for pate _------- /d
inspectio s, i •��`/ MECHANICAL $ TOTAL FEE S ! O . 90
Signature / J Date.J-,,7-/S ? -
Drivers' Lice 3•r SS# / �a Reinspection Fee I $15 I -----
Issue Fee $ 3 fF PLAN CHECK -25% $
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. .
8. Foundation 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd: - 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 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 0Gas 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
42. Backflow Preventer
43. Backflow Irrigation Ir X P I R 0
44. Landscape Irrigation System 1000MP►ete 1n5 ction5/45. Sound Attenuation .3/24,1,1$Ig
46. Handicap Regulations ltd
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 4 _
t �
•• -a •••''--.' '•-/7 g Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. .III. f CITY OF COST ESA CON.SIRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 7299 I /I /0E 098,7,4 711
2, SIM
Project Address 20- L`i G—aGS3a /492 :27L REPAIR
< 9 TYPE OF CONSTRUCTION L NEW ADD Li ALTERATION
Applicant's Mailin Addjtss �`�'//• /e•
/ W% -�•s�Ks[�l .—Phone�To^49� ,•• ❑ CONVERSION ❑ DEMOLISH OTHEq A•p.# / /G� ,- ��� QOJ Zone /
Owner's Name^ y� ,. -/7 T • DESCRIPTION OF WORK/USE OF BLDG. `s l'31't •SlOry ' ' ' '
Address Z/ti�[7- Pt 7 I A�p� To jc r•t7. CP'() S Main Building: Accessory Building:
Arch/Eng./34g-
rch/Eng. g- WA �/ QLicense NNoo.A6. 7Tv TYPE OF PERMIT y�/7�� ❑ GRADING FOUNDATION STRUCTURAL . T Front An- 0
' Address &A ii I- .0 • VT • ❑ TENANT ELECTRICAL PLUMBING MECHANICAL
8 Rear ,q '-' vc • N
❑ OTHER. A 7
Contractor's Name Phone C Right �/_ O // N
PROJECT DESCRIPTION S T. I, CC UpAN _
Address(mailing) ^ _P�— ('V�i %lir /'
CONSTRUCTION TYPE V S Left c.i C', 7_ Q U G
City License No. •" ZONE GRADING CU.YDS. ^' ACRES. R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ,nes . PlanningNotes: C ,i
with section 7000) of Division 3 of the Business and Professions Code,and �� v _ �� s "�"� �PdfoA� �a LjZ/ ST/yE 7/� M
my license is In full force and effect. ? SIC .C/4/44e /CAA'/ L rwoLL.uvb {/7c& Y T
License Class License No. /�/t, Wyk S
PLUMBING FEES HOLII BR SPECIAL �WI $Jill1:41i TS:. �+.i & e
Date Signature i i
WORKERS'COMPENSATION DECLARATION N.Sink Showers
ihereby affirm that I have a certificate of consent to self-Insure -
nsure or a certificate _ ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
)0, Lab. C.) Automatic Washer Transformer 0 15-50 KW ,
Policy No. Company Backflow Irrigation Sewer Cap0 50+KW •,
Construction Pole Sub.
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. I Bathtubs Sewer Connection .Z- Cr_ Cooking Unit Meter Dula to 100 amps
Date Applicant -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher / 'Meter ❑over 100 amps • 7 5C> i1
(This section need not be completed if the permit is for one hundred($100) or
less). Dishwasher Solar Piping Dryers -as XEIectric Sub Panel • f-00
I certify that in the performance of the work for which this permit is issued,I
shall not employ any person in any ner so as to beep subjec to the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑i%'B
Workers' Compensa ion Laws of Cali o!n a. • - -
Date //-/7 ,? Signature C�� �� Floor Drains Swimming Pool w/Spa F.A.U. Inc Solar 09-15 HP ❑16.15+
NOTICE: If,after aking this declarati you should become subject the
Workers' Compensation provisions of he Labor Code, you must f hwilh Floor Sinks Urinal --/ Fixtures i
comply with such provisions or t is permit shall be deemed revoked. — ` Microwave •
/, 90
CONSTRUCTION LENDING AGENCY - Gas Service ` Outlets r •f• Water Closet ��� Device Boxes Pole Light
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. C.) Interceptors r r - Water Heater
Lender's Name op 7/ Outlets Range -
.5.-'Re
.`k,p^'�/
Lender's Address Kitchen Sink Water Service Switches p
OWNER BUILDER DECLARATION _ Sign •
_
(o
I hereby affirm that Lam exempt from the Contractor's License Law for the le 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 - LaundryTrays '
any structure, prior to its issuance, also requires the applicant for such permit _ y Generator ❑0.5 KW❑5-15 KW Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of RQOf Dral05 -
the Contractor's License Law(Chapter 9(commencing with Section 7000) of -- e .
Division 3 of the Business and Professions Cn-e) or that he/she is exempt -
'� ''erefrom.and the basis for the allegedexemption. Any violation of Section '
'31.5 by any applicant for a permit subjects the applicant to a civil
malty of not more than five hundred dollars($500).
L7 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
-
1-\ 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 through his or her own DEVELOPMENT SERVICS$REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 (� il�, 7-
sale- If, however, the building or improvement Is sold within one year of tom- Canopy Type 11 0 Zoning Approved By Date
pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By 7 rni' ate //-17 G
rIe the purpose of sale). -f
, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By - C_- - IIS L/ -✓• pate /1'1 7-S',C
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 / G SUMMARY OF FEES
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 0 Multiple 0 System Repair/Alteration Y BUILDING PERMIT $ �3�`vV SMTP $ �t 7
proof oft their Worker's Compensation insurance should be provided to me. ( LAN CHECK $ PERMIT
0 1 am exempt under Section B. . P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ !l 7 ISSUANCE S
4.4./.41;0_
DateOwner c_
- ` - ' (-Att...... %-- Heating System& Ducting . Registers 00 PLAN CHECK 25% $ r at2 SENERGY P.C. S
I hereby certify that I have read I� application and state that Off- above El 0-100,000 BTU ❑100,000BTL<- ELECTRICAL $ `�5. 7� GRADING $ _
information is correct. I agree to c•• ply with all city and county ordinances
and state;aws relating to building c nstruction, and hereby authorize repre-
sentatives of his ci to a ter on Ili above-mentioned proper,/ for - 9d
inspectio pur••se C pCPOl O J
Signature i' Dat -r-+6 —
MECHANICAL $ Ti. �y� TOTAL FEE $
9-
Drivers' Lic:/ or - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ i • `�0
CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor '
P9 7:-. ' 0
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. /%'/'7 �i � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 'j" 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement (407 %'�" 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. it-'g7w�7 57. APPROVAL TO COVER-GUNITE ,
7. Footings • l/gez _AL.??? 58. Electrical Conduit-Undrgrnd.
1
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
7�] 9 65. Electrical-Final • .
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring �_lh>r) 7:0>L. 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 W Q.7X 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 -// �/J 73. Undergrnd.Storage Tank 0 Gas 0 Oil •
25. Roof Sheathing �Z8/87 JJy, 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat ,,/ l /�6'� 75. Dry Chemical '
27. Frame and Flashing I/ redtfa 76. Dry Standpipe '
28. Lathing & Siding �/ y77 ri/ 77. FIXED SYSTEM FINAL , • -
29. Insulation zip if 78. FIRE PREY. FINAL
30. Drywall Nailing L-`/} OJ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 7 � 79. FINAL INSPECTION •�
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric `(della C.to Notes:Wo Sub 612'/,{yW///,////�'//
34. Final Heating& Air Conditioning (0-( z L� 410 SUd ` ' % �7
35. Final Gas Pipe-Test (I.el.- •L LrtiO
36. Hood or Canopy . .
37. Final Factory Fireplace -
38. Final Plumbing [(-jo-fl Lit? ••
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 t/P1I,I L[1/���, , •.•
48. Special Requirements Completed //// ' {{ oo// Y/r""_ i.
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co r
51.. CERTIFICATE OF OCCUPANCY ,
No. Date
t • All
.•
a • r
. C
•
COUNTY OF ORANGE • - Application for Building Perm., - // �//
BUILDING DEPT. Permit No.%/C9! Ca
636 No.Broadway AND FOR A
Santa Ana,Californiahone: Certificate of Use and Occupancy
Phone:KI 2-6211 p y
Date. Se1tA...42s...19.52
1. OWNER'S NAME F• ki• Paulsen PHONE• Beacon 6749J
MAILING ADDRESS 258 Santa Izabal St. CITY Costa Mesa
Name Owner Name X81'
(Architect or Engineer) (Contractor)
Address - Address
City City
State State
Lic. No Phone Lic. No Phone
PROPOSED USE• .A.Sxe111ng._an&.AtetaQhed gang
2. JOB LOCATION 227 24th.Ylaaa 000141...11eaa.
(House No.) (Name of Street) (Town or School District)
NAME OF AND DIRECTION FROM NEAREST CROSS STREET Tlastganatex..Place East
3. LEGAL DESCRIPTION: Lot 27 Block Tract 1442
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( ) INTERIOR LOT ( Y ) THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OF BLDG • $.67[41 AREA• 900 SIZE OF LOT• 96,X89 AREA 729Q
6. HEIGHT OF BLDG • 14 CEILING HEIGHT a-.4 NO. OF STORIES 1
7. NO. FAMILIES 1 Size of Smallest Bedroom 10x12 Size of Kitchen 9-6 x 16
8. EXTERIOR WALL CONSTRUCTION- stgAcQ INTERIOR WALL COVERING.....plaster
(Frame, Stucco, Etc.) (Plaster-Drywall,Etc.)
ROOFING COVERING Com_pce'Lion shinglep
9. STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EACH rioae
10. SETBACKS; Front Yard From Center Line of Street 50'
Nearest Side Yard 8'9" Rear Yard 25' Distance in Feet Between Bldgs. on Same Lot ZIQM
(Property Line) (Property Line)
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
12. (a) Footing: Width 14" Depth in Ground 12" Width of Wall 6"
(b) Size of Studs- 2x4 Spacing 16 "CC Material of Floor woad.
(c) Size of Floor Joists• 2X8 Spacing 11 "CC
(d) Size of Rafters: 2z4 Spacing 24. • "CC
13. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $.6§00.00 f29Q 0
14. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNI//A APPLICABLE THERETO.
Signed• {` a- • - YL.v i'.- -�-
Plans Filed• SEP 2 4 1962 (Owner)
By•
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY -
FEES: _ H CKING BY
Bldg. Permit $ is, O a GROUP ') APPLICATION.... HEALTH
Plan Check - $ 3'iv TYPE ZONING Lam- FIRE
Total - $ 2 / ro DIST. L y PLANS ANDMARSHAL
Receipt No. - 5.., 2 7 MAP _ SPEC'S..._ ....-----
STATE
Paid to - SHEET NO ,J CORRECTIONS ENGINEER
Date SEP 2 4 1952 VERIFIED CAL. ,
"1'1, I (fir/ CO • =
PE'
=----.tI '---. tai INSP: . .
SEP 2 4 1952 wit%e.ryr
DATE ef---. .. -E€1?t.TY
sono--v-sa .,-..... .-._
' �, e nl./
• ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
-CITY OF COSTA MESA• • PAR IT NO. T/R'£1CT-NO& - LOT NO. BLDG.NO. . - 1 - - -U OI -7I2bI B2 B�QQ TL
•
CONSTRUCTION PERMIT — i3G2Q • `�44t- �1
Project Address near _ - .c TYPE OF CONSTRUCTION . I r -
Owner ��ti 1 I. • • s Phone SEEM '❑ NEW 0 ADD 0 ALTERATION _
, Address - �-7-1 • • .
a 0 REPAIR 0 CONVERSION.❑DEMOLISH ZONING REGULATIONS
•
'Arch/Eng: License•No: - ❑ OTHER ' ;. p'�_���',
,Address - A r - -- DESCRIPTION OF WORK A.P. . - �ERu�
w - ' ,ZONE 1, PLNTTG.. R t/ p
E $F..
▪ . Contractor V(' Phone - TYPE OF PERMIT - Cg
SETBACK
/L ST. -- P ROPEIRTNG
LINE
Address - -- - - - - ' ❑ GRADING - 0 FOUNDA1U ON 0 STRUCTURAL -SIDEFYARD I 1 ^0 if - _
LICENSED CONTRACTOR DECLARATION ❑ TENANT LKELECTRICAL! yUS UMBING ❑MECHANICAL, SIDE YARD _
I hereby affirm that I am licensed under provisions of Charter 9 (com- r ( RIGHT - '
-rnencing with section 7000) -of Division 3 .of -the--Business and. DOTHER ( ,
Professions Code, and my license is in full force and effect. ,l REAR YARD'(TO P/L') 'r1 ---U r - - - - -
y- , - License _ . PROJECT,DESCRIPTION 44��
License Class - License No. • - •-- - r - • -- - - 'PKG.SPACE REQ,- -- PROVIDED — '
Date . - - Signature - ` - . .
WORKERS'COMPENSATION DECLARATION . OCCUPANCY - CONSTRUCTION TYPE • STREET WIDTH PARK FEE E -
I.hereby affirm that I have a cern of consent to self-insure or a _ -ZONING APPROVED 4FY :mumDATE^_ "4-
certificate of Workers'-Compensat • s • -nee. or a ertitied copy - VALUATION ZONE - ' _7
,thereof (Section 3800,y(. C.). '_ ,.GRADING CU.YDS. ACRES r SPECIAL CONDITIONS: - - -. - '
Policy No. 2- at-_B" ) Company 1U\f1 a _ - -- - • -- _ . . . . . . _ _ - -
;ertified copy.is-hereby furnished. _ 4 _ ,,_ REMARKS:.- - - - _ • 1 ' ' ' •
.ertitied copy is filed with the city a wilding Division. - - - - - - - - - -
LXEMPTION'FROM WORKERS' COMPENSATION DECLARATION - -- - - - -- --- .• . - s' '
(This section need not.be completed if the permit_is for one hundred I ' ' -
($100) or less). - - -• - - - _. - - - - _ - _ - - - .
•
I certify that in the performance of the work for which this permit is , , j
issued, I shall not employ any person in any-rnanner so a5 to become- PLUMBING - 'PLAN CHECK - -- - - -- ELECTRICAL - -- - - PLAN-CHECK " - ' _
subject to the Workers'Compensation Laws of California. -- _ �e„
Date Signature 'BATHTUBS -- SHOWERS`- - - - , - - - - e - - SO FT_- '` - "-
,NOTICE: If after making this declaration, you should become subject -TOILETS. , 1, rt.,URINALS - --- -- - 'GENERATOR- -
,to the Workers' Compensation proQisions of the Labor Code,you must - - i -TRANSFORMER
,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAYS - - . i- •-- -- {APPLIANCE-- 10-50,KW 50.+,KW s _ ' 4.
,
revoked..._ _
CONSTRUCTION LENDING AGENCY
IN CU DISHWASHERS - • - . - '- - - .MOTORS - -0-1 HP_1-10.HP
EN — -
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKSSUMPS --- — - 1 _ (INC.SOLAR) 10-50 HP + HP ' f
formance of the work for which this permit is issued (Section 3097 --III, - ' T - - -
CIvfC:)r- - - • - - - -- - -' - •- -FLOOR SINKS"-'--- ' -'FLOOR-DRAINS•---=-- - - 'FIXTURES-- ---OUTLETS--_SWI.TCHES- ' ' I
.'Lender's Name _ - '-'- -
�Lentler's Address - - - - " - " DRINKING FOUNTAINS - - - - - -- - GAS TUBE SIGNS _ _-_ _. - __ . _" ' j
OWNER'BUILDER DECLARATION-- • - - -- - INTERCEPTOR$ -""CLARIFIERS- '-' - POLE 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 •-. f (-UNSI HUO nury
Any city or county which requires a permit to construct, alter, ,V POLES METERED SUB - - - • -- -
improve, demolish-or repair any-structure, prior to its-issuance,also re- WATER SERVICE' -- -ALTERATION- -- - - • PANELS -- MAIN 'SUB • -
quires the ap,licant 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 - - - • _ SERVICE. - AMP__
'(Chapter 9 (commencing with Section 7000) of Division 3 of the - - a -
'Business and Professions-Cotle)-or that he is exempt therefrom antlthe -WATER HEATERS - -BTU OUTPUT --_ _ d ,
basis for the alleged exemption. Any violation of Section 7031,5 by -
• applicant-for a- permit.subjects the applicant to-a civil-penalty -SEWER CONNECTIONS - - .- - l__ _ -- ^ '
of more than five hundred dollars ($500). - - - --
-, as owner of'the property, or myemployees with wages as their SOLAR TANK- - -- - COLLECTORS - -- ----- - - - f -- - -_"_., _- - .- . _ __ __. .. . .. . ..
sale compensation, will do the work,and the structure is not intended -.
or offered for sale. (Section 7044, Business!and Professions Code: The SOLAR'PIPING SYS. - - - -- - --- --- L - - -- ISSUE FEE - - . - _ ' •
'Contractor's License Law does not apply to an owner of a property ' l - -- -
who builds or improves thereon, and who-does Such work himself or - ISSUE FEE - -- - - - V
-, - ' ' APPLICATION APPROVED BY _ - _DATE
through l,io-ewn-e. pin•yeee,-provided that such improvements are not •
intended or offered for sale. If, however, the building or improvement • MECHANICAL- - PLet CHECK •- - -
is Sold within one year of completion, the owner will have the burden I - - SUMMARY OFFEES
of proving he did not build or improve for'the purpose-of- sale). '- - - - - r - ' BUILDING _ _ ` _
HEATING SYSTEM 0--10 ,000 BTU 'PERMIT $ $MIP $
❑ I, -as owner--of .the-property,-am-exclusively contracting with. AND-DUCTING '- . -- R - i
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU - ,PLAN CHECK $ - PERMIT,
'and Professions Code: The-Conlds orr's.Licvese Law does not apply.to _ /_ ISSUANCE S
(an owner of property who builds improves thereon, and who con- REFRIGERATION 0-100,000 BTU � " - TPLUMBING . .$ CO •00 "- " - ' -
ttracts heCofrom such projects with a .contractor(s) licesned-pursuant to SYSTEM - __ -'GRADING' $ ' -•
;the Contractor's License Law). 100,000,+ BTU - i PLAN CHECK-3 - • - - - I
•'❑ I em exempt untler Section - - '' - - - - B.& P.C.for this -- --- - - ' - •- ;ELECTRICAL - /a-Old - ' ` E •
BOILERS BT,V $ -
yeason --- - - _ _ - , MICROFILM.$ ' -•-
'Date Owner SYSTEM REPAIR,ALTERATION - . - - ._ PLAN CHECK $ - _ . '
- .MECHANICAL $ 1.* •, TOTAL FEE - ^
•I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE , AD-
informati•• is correct. I-agree to"comply with all city and county - - _ _ PLAN CHECK $ - - VANCE'PC ' 9_
'repres d'- d state laws relating to construction,and hereby authorize
represent: -s •f this cit to enter- upon the' above 'mentioned - -- - - _ /�r•O,
property npction `(s .oses. - - /� ; FINAL FEE $ 6/Uy
Signature toi• _ •ate+ Doh - - •
Drivers'.1.1 •r�• r - ISSUE FEE --- _ _ t
1 _ - ,
—
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor -
CONSTRUCTION AND PLANNING `---PQOL& SPA _ • • . .
APPROVALS Permit# APPROVALS Permit# -Date _ - Inspector
1... Temporary Electrical Service or Pole _ 43. Pool & Equipment Location - - . - .- -
2. - Soil Pipe-Undrgrn.;- _ _ ' _ . - 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 - - - . -
--6. Electrical UFER Grn_ . . - . _ , . - 48. APPROVAL TO COVER-GUN ITE- - -, - -
7. 49. Electrical Conduit-Undrgrn. ': _ - .^ -- I q.,"�
8. -Foundation •--- - - --- - - -- - -- - _ 50. Gas Pipe, Undrgrn,Test ' 'r'Pie - O t-
-9. Water Pipe-Undrgrn- - - - - - .- - -- 51. Backwash Lines-P-Tri. ❑ ridrIrn ' ' - - a
52. APPROVAL TO DECK . - •__ -
. i I. Structural Floor-System-11. Property Sewer-Line & House Connection - -- - 53. Backwash & Receptor-Final' -' ' - s ^ • . ,
- 12. -Street Sewer Connection - ---- - 54. Heater &Vent-Final .
13: Rough Plumbing - - -- - 55. Plumbina System -Final '
14. -Rough_Electric-Conduit '56: Electrical-Final - - - •
15. Rough Electric-Wiring 57. Solar•System-Final - _ . : ' ,
16. Rough-Heating & Air Conditioning - - - . - .-58. Fencing &Access Approval , •
' lit Ducts, in Structure -r.- - - - _ 59._ APPROVED FOR PLASTERING .
18-` - Ducts, Ventilating- '- -
. 19: Gas Pipe-Rough_&Test ' - - 60. POOL/SPA SYSTEMS FINAL ' :
20: Roof,Framing_ -_ - - - - - --- , .
' 21: Roof Sheathing - . - - - • . . - -
- 22i- "Frame-and Flashing . . ... .. _ NOTES: : •- _ - "
23` -- -
Insulation ' • _... -_ - �� _ _ _
• 24: Lathing & Siding . . .. - • - -. - - - - ..... - -_ - - --- _ ' _ _ _
25. Drywall Nailing- - - - - _ - -- - - • -
26. Plaster Brown Coat - - - - - -
27•. Electrical Power Meter-Final. - - • -
28. `.Final Electric
. '29', Final Heating & Air Conditioning - - - - • • • . - - -
30. Final.Gas Pipe-Test .. - - -- - - -
. 31. _Final Plumbing - • - • - • -
32. Water Service-Final - -, -33. Gas Service•Final - - - -- '- . ,
34. Solar Domestic-Final - ..:
' 35. Landscape Sprinkling System .. • '
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
City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division
24 Place PuSZA MgsA-- 02nr�G�
Number and Street City County
Subdivision Lot Number
DESCRIPTION OF INSTALLATION
ROOF
Material - ' ':- .S . / Brand Name ,
Thickness (inches) Thermal Resistance (R Value)
EXTERIOR WALL
('J
Material Ggp-c fC-s 't`j/tTr Brand Name Gtr R^-S CCot,PVC
Thickness (inches) 3 h_ Thermal Resistance (R Value) P,-.‘
CEI LING
Batt or Blanket Type C;/X'S 7 Brand Name O JR r'S C[12nit0/4.
Thickness (inches) Thermal Resistance (R Value) R —1 c►
Loose Fill Type - _ Brand Name
Minimum Thickness (inches) Number of bags Weight per bag lb.
Area Covered (ft2) Thermal Resistance (R Value)
FLOOR, ELEVATED
Material Brand Name
Thickness (inches) _ _ Thermal Resistance (R Value)
FLOOR,SLAB
Material Brand Name
Thickness (inches) Thermal Resistance (R Value)
Width (inches)
FOUNDATION WALL
Material Brand Name
Thickness (inches) Thermal Resistance (R Value)
DECLARATION
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24
of the California Administrative Code).
n/S C&Sian. ft,UIt-0PrkS ?, $9 UD
Gene actor(Builder) License Number
0(,, V 13a7
Signature and Title Date
Sub Contractor(Insulation Applicator) License Number
Signature and Title Date
CMF 1106-46
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1 . John T . and Jackie Hawley •
227 24th Place •
Costa Mesa, California 92627
Phone # 642-5241
2 . Catalina Spas
1130 W . Trenton
Orange , California 92667'
' Ph . # 997-2360
3 . See attached drawing. •
4. ,. ..
5 ..
6 . „ It It
7 . Iron Pi e . Rigid Pipe # 10 Wire .
8. See Drawing.
24C
9 . 1 1/2 HP Spa Pump 208-230V Max amp. 21.4/10 .7 . Air Blower 2 HP /
10 . 250 ,000 . - 4113M4,0
11 . . 80' 1 1/4" +, : . -7 :
12 . None. .e.
13 .
13 . 725. i , 7 Ir1 •
14. None . /o 7 43. i.(
• 15 . None . Li 3 if 3
16. None . • / 5-. a ( '
17. Prefabricated fibreglas .
18. See drawing.
19 . See attached .
20.. Moderately expansive .
o2 o QuQC :
• consulting Aructurol engineers . • . - •
• -
• ` 180 moDee bo"1793
mon Dene
durongo,col xodo 81301 (303)2471972
subject _SL-- _ /,./DoELe - 8r' GCTA(DON job no. I S sheet no. I of / -
•
for Ci-1 7-\I-/!u/9 ,S P4 S . dote /1/6r) designed by R. J,
7L Il "
•
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41 .:
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•
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:01. MIII11111I111 00999n 1 IIIIIIIIIIIORMSSQQ1111111 I CM,(t' ,
INTERNATIONAL ASSOCIATION OF •
PLUMBING AND MECHANICAL OFFICIALS K
-<
ANON-PROFIT CORPORATION
. -<
RECOMMENDATION OF SWIMMING POOL RESEARCH COMMITTEE k'.<
or- .<
The product described herein has been nevi:. er1, tested:Ind recommended for acceptance by the Swimming Pool .K<
- Research Committee of the International Association ul Plumbing and Mechanical 011icials as meeting the re- --<
qulrements of the Unitorm S'wir nming Pool Codi . This reel nendation is subject to the conditions set forth in the -<
pper�'� characteristics below and is not to be construed as assurance or guarantee by the Association of product accep- '.�‹
tance by local jurisdictions,or authorities using the Uniform Swimming Pool Code or otherwise affiliated with the '<
+ Association. •-<
+ -<
s `<
.... Accepted_ NovPmbpr- 148.1 Void after November 1982 - -<
+ -<
e. PRODUCT:• Spas/Spa Shells FILE NO. SP-1114 .mac
+ -<
5 • APPLICANT: Catalina Spas
• 1130 W. Trenton •
. Orange, CA 92667
.
MODEL: 5 ft. Round, 5 ft. x 5 ft. Square,•4 ft. x 6 ft. Mini Lounge,
55 ft. x 8 ft. Oval, 5 ft. x 7 ft. Rectangular, 6 ft. Octagon,
S. 7 1/2 ft. Lounge, 8 ft. Octagon, 8 ft. Round, 7 ft. Round,
S.
'VS : i 7 ft. x'9 ft. Oval, 7 ft. x 11 ft. Kidney, 8 ft. x 14 ft. Oval,
6 ft. Square, 55 1/2" x 71" Roman Bathtub, 10 ft. x 20 ft.
IS . Athletic Spa
S
r
S. IDENTIFICATION: Catalina Spas, model number, serial number, maintenance
instructions and USPC shield on a decal permanently affixed
.to exterior adjacent to skimmer area. Catalina molded into
step area on finished side. -
VS MS -<-
CHARACTERISTICS: Gel-coated, fiberglass reinforced spas in 15 various sizes
and-shapes. Seats and steps are reinforced with plywood se
which is overcoated with resin. A foam insulation is provided
g under.the flange, seats and side panels to reduce heat loss. -t
7
a '- .
Y
0 -
0 -
- This recommendation is for the period indicated herein and an equitable service policy, may be deemed p,4��,f.A/^" ti
is void after date shown above. Any change in material, cause for revocation of this recomrnendahct/-- . _ _ _
marking or design, without having first obtained the ap- tional Association of Plumbing and Me_, - ��-- '�
a. proval of the Swimming Pool Research Committee, or grants permission for reproduction of �; ---c --
o evid ce of interior workmanship, or failure to follow form citric USPC Shielq,for adverlisir,; -- -
_ _\
S1'
1 /�- CGc- .CC e r u7;t ; Grp, E .s _
CHAIRMAN.SWIMMING POOL RESEARCH COL0d11 i EE f E. ECU1NE.IRECtO i '-' ' '
Sponsors of UNIFORM MECHANICAL CODES and UNIFORM SWIMMING POc. -I, tv
0
_ /�f�f�(lI 1} (} �/ I\7 /`J /`1\� JVD(\/\'(\�,r��(�(�������1��f���\fit\,} //,`\'/\{ ms's.
721)6 a661A ll�l1 //1 )Aplin � � \Yl 111 lll11:11111/1111111111l111N 11111 I11 thh iADI?lire
': 2fl-777---.00 841 • -::90.E1
43316
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
// RECEIVED BY DATE RECEIVED DATE ISS ED ��}}
BUILDING /92 7 _ 42W/4'
OWNER e4 I( ' - --S Ue& +hW l A.P.NO/ —/O/— C P/ • 7Y6'
�
ADDRESS � 7 0? T IV BUILOIES n/tI 3/4.4..1(
CITY Cr 111 . NOL'6�_23 4,14/ TRACT/W LOT BLOCK
CONSTRUCTION NEW IAD A R (REPAIR MOVING DFMOI ISH
LENDER
BRANCH //y// j''
OWNE /• OAS/#/S.Y A//
ADDRESSARCHITECT / I_ r1 [ f 4644907
' V / / `l
OR ENGINEER q�Q-hneS,t]YG Irp13 NO. (SJOSSU U� '''�'if!(�//GGRRL�7J1..1,4-11 �/ S {/NLq�/J
FIRE
ADDRESS /O I .66 U e, , ( evila ZONE TYPE J GROUP (/�V
CONTRACTOR _ I-- a, •� AWNS APPROVED �` / DATE 2.4 —77
ADDRESS IT C Cirtii/a_, ;In ,.
��/'�t riy.�O - ZO e9 NO.OF USE OF s .
ry
CITY r Ne,.t/ Q, — A. —PLANSBUILDING / Are ,
(' STATE CITY YARDS APPROVED YARDS •PPROVED
LIC.NO. LIC.NO. MAIN BUILD( ACCESSORY BUILDING
W SIZE NO.OF BLOCS. (FROM C/LST T)
CL, OF LOT NOW ON LOT FRONT FT.
Q USE OF
col EXISTING BLDG. R SIDE •FT. FT.
cd ..4)
F 577/01/4.0)Separate permits are required for L.SIDE 577/01/4.0)
Cl electric,plumbing and heating work. REAR nF
W sl / m ;j FT.
[.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q< �/[/�f ,///nom/ IAA MAIN BLDGS. ACCESS.BLDGS.
d Ods "�Tz4..s,�(/ 4 _it% C UVARP.3j'+ DATE
//11APPROV/ED D �J
.rl ,,, %%% APPROVED ��/d�/_ 1/ ^/O ^7/
(Y. DAT
W
O. I hereby acknowledge that I have read this application and state n
C that the above Information Is correct and agree to comply with m
CI. all laws regulating building construction, and I shall not employ
Z any parson In violation of the workman's compensation laws of s
W `.
x the State of California. 5/� m
I hereby certify that I am properly licensed as a contractor under SO. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: —
to
am exempt from the provisions of the State of California Business y
and Protect ns Code,Division 3,Chapter 9. VALUATION PERMIT FEE § Ga•6.6N•
�f re
Signature Of A/J PLAN CHECK § so, d�1 m
Permittee �T' ^"‘' $i/ry C/ ..----
TAX § 0 / IL
N(Jv r iv
�j / U
Authorize Bent - TOTAL PAID § •+�/y
Y
A.
yr
A I
41732 ••"'a ?7-7Fz `-001435' ¢tet -aP.50
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
q / _ RECEI 3 Q-'F�i CLg DAj+E $_:E•
ADBUILDING DRESS dLd 7 — mm� � Is... Pie-Cc /Q Y G7-L7 [%/- 7r e
OWNERZ—Okt\ . �12s& V - r• �. U-I l ' A.P.N• //- # -o ,( PIP// Mi
BUILD
ADDRESS..? 7 - cP y/ Es , /OA_V.. ADDRESSMAIL
tt- - 9r"''7 //4r
CITY Qo �1e-5 J� TE NOI.Qye)-�ay t TRACT'�"+U2 I LOTL / 'BLOCK
CONSTRUCTION NEW ADD ALTER(REPAIR (MOVING DFMDI ISH
LENDER v
BRANCH
OWNER S A/AA/14y
ADDRESS VALUE q�/
ARCHITECT TEL. gri a I 5-tc-�//"
OR ENGINEER 'YVles / k r I S NO.
FIRE
ADDRESS ZONETVP GRO�/JUJy
APPROVED / DATE 7
CONTRACTOR - •11. k. /7 BY
ADDRESS / � 1-1
TEL. ZOO is INO.OF V USE OF
Ne
CITY NO.
/�- PLANS USE BUILDIN
Im
--. STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
LW SIZE NO.OFBLDGS. (FROM C/j.SATS RE ET)
O. OF LOT NOW ON LOT FRONT 0.o FT. FT.
Q USE OF
EXISTING BLDG. R.SIDE Q fT. FT.
✓ p
E Separate permits are required for L.SIDE t 0 FT. FT.
Celectric,plumbing and heating work. REAR T. FT.
[sl USE OF BUILDING AND WORK TO BE PERFORMED 0
^ DISTANCE BET. BET.MAIN&
GI / '�...� MAIN BLOCS. ACCESS.BLOCS.
t(�(Q�(J VAR.SA DATE
', �4-. 3 5 (° C.U.P.# APPROVED
-C (54,..Z7
ROVE �/ /� DATE -7G
CCW
M.
I hereby acknowledge that I have read this application and state in
r.
EC that the above Information Is correct and agree to comply with m
0. all laws regulating building construction, and I shall not employ
Zany person In violation of the workman's compensation laws of
0
the State of California. r,0
S0FT
I hereby certify that I am properly licensed as a contractor under / . . n
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9,and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: "
am exemp from the provisions of the State of California Business vs
VALUATION PERMIT FEE $
and Professl• a Code,Division 3,Chapter 9. ��0 m
PLAN CHECK b2
Signature of \ , D o
Permitt 'ee _Q V ,� $ 60 00 TAX $ •- U.
1 a U
Authorized t / TOTAL PAID $ 4