HomeMy WebLinkAbout679 18TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.e{,yfLDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 679 W 18TH ST
Suile:
Vicinity:
Pnmary Occ: MR
Parcel Number: 42426115
Applicant: SAYWITZ, BARRY
Address: 4740 VpN KARMAN #700
NEWPORT BEACH, CA
Owner: SAYWITZ, BARRY
Address 4740 VON KARMAN #100
NEWPORT BEACH, CA
Contractor.
Address:
Zip:
Arch :
Address:
Zip:
Phone:
License:
CONDO CONVERSION INSPECTION OF 4 UNITS.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other.
Inspection:
Total:
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
5360.00
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0. 0
PARKING Exis in : o
Type of ConstruIXion:
Zoning:
Rear 0-0
Rear 0-0
Re uired: 0
Phone: 949-930-7502
Zip: 92660-2172
ISSUED BY:
Status: ISSUED
Applied: 02/032006
Issued: 0?J03/2006
Phone:
Zip: 92660-2172
�I�H RA1NN
Phone:
DA E: o�
License:
Eng:
Address:
SCOPE OF PERMIT
FEE SUMMARY
PLANNING & ZONING
LeN 0- 0
Lefl 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation
Right 0. 0
Right 0• 0
Phone:
License:
So.00
so.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with ell epplicable codes, and al�
required Inspeetlone end final epprovel must be obtalned. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (71 q) 754-5626
:wo-,c�nuu�
WORKERS'COMPENSAnON DECLAAAnON:
I �ereby aflirm unaer penetly ol per�ury one ol Ihe following tleclareHons:
❑ I �ave end will malntaln a cenifiGete ot consent to sell-Insura tor workers' wmpensatlon, es provitled for by section 3700 of Ihe Lebor Gode, tor Ihe peAarmance ol the
work for which Ihis pemtit is IssUed.
❑ I have entl wlll maintain workers' cwnpe�setian insurance, es repuiretl by sectlon 3700 of Ne Lebor Code, lor Ne poAortnance o1 Ne wark fw w�kh ihis pertnit is issued,
My workers' compensatbn Insulance wrrier entl pdicy number are:
Carrier. Pdiry Numbec
(Tbis section need nol be comp/etetl il fhe permi! is valuetl et one huntlred dW/ars (S 100) or /ess.J
❑ I certify that in ihe pertormence 0� the work for whic� ihis pertnit is issued, I s�all not employ eny person in any manner so as to become su6ject to Ihe workers'
compensation lews af Celitornla, enU egree thet II I should become sublect to the workers' campensatlan provislons ot Sectlon 3700 ot �he Lebor Code, I shell lonhwith
comply with these Drovisions,
Applicanl Signeture: Dele:
WARNINCi: fAILURE TO SEGURE WORKEPS' COMPENSAiION OpVEMGE IS UNLAW FUl AND SIW.L SUBJEGT rW EMPLOVER TO CWMINAL PENFLTIES AND CML FlNES UP TO ONE HUNDRED
i/10USrW 0 OOUARE ($IOOpO]), W AOUfTIDN TO THE CQST OF COMPENSATION, OPNACaES AS PFiOV10E0 FOR IN SECTION 3i060F THE IABOR WDE, INTEREST, AND ASTORNE'f5 FEES.
LICENSED CONTRACTOHS DECLAflATION:
I hereby aHirtn tha� I am licensed untle� Provisions of Chepter 9(commencing wilh Section 7000) of Division 3 0l ihe Business antl Professlons Cotle, entl my license Is In full
lorce and eHect. lic. a Cless q
ContreaoYs Signature: Data:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aftirm ihat there is e construction lending egenty tor the performence oi the work tor which Ihis permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendels Address:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby eHirm Ihat under penelty ot pe�lury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Prafesslons
Cotle: Any ciry or county which requires a Oermit to construct, elter, improve, tlemolish, or repair eny sirudure, pnor to its Issuance, elso requires the epplicant Por such permil
to lile e sipned statemem Ihat �e or s�e 15licensetl pursuant to Ne pmvisions ot the Cantrecrors License Lew (C�apter 8(commenGng with Section 7000) of DiWslon 3 ot the
Businuss antl Prolessions Code) or thdl he or she is exompt therefrom enA t�e basis tor the allegetl exemptian. Any violation of Section 7031.5 by eny epplicant for e pertnit
suhjects Iha apD�iwnt to e ciNl penelry a� not more than live hundred tlollars ($500).):
❑ I, es owner ot the property, or my employees wlth wages as their sde compensetlon, WILL DO 7HE WORK, enC ihe structure is not intantletl or oHeretl lor sala (Sec.
7044, Business and Pmtessions Code: The Contractors License Law does not appN to an owner of property who builds or Improves the�eon, ana who tloes such work
himself or herseif or through his tl� her own employees, pmvided that such improvemenis are not intentletl or oMered br sale. If, however, the builtling or improvemam is
sold within one year ol completion, ihe owner�6uilder wiil heva the burden ol proving tha� he or she did not builtl or improve for purpose ol sale.). '
❑ I, as owner ol the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo construct the project (Soc. 7044, Business and Prolessions
Cotle: The contrectors License L9w tloes not apPly to an owner ol pmperty who builtls or improves Ihereon, entl who coniracis tor such project wit� a comractor(s)
Ilcense pursuant to the Contrec�o�s license Lews.).
❑ I em ezempt untler sec. Businass antl Professions Code tor t�is reason:
Signawra: Date:
Owner ID ventied by tldvefs license. ❑ Yes ❑ No Drivefs Llcense No.
Venfication ol Ownership by (type oi tlo�ument, i.e. - properry tar bill or tlaed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby cehify Ihat no excavation M1�e (5) or more feet in tlepth inio which e person is required to descend, will be matle in connection with work authonzed by Ihis
permit, end Ihat no building SlrucWre, scaMoltling, felsework, or tlemolition or dismantling t�ereof, will be more �hen thirry-six (36) fee� high. (Chap. 32, Grp 2, ArI 2, Sec.
341, TUe B, Celifomia AdministreU�e CoOe).
❑ As owner�builder, I will nol empl0y anyone to tla work w�ich would require e permi� trom Ihe Divlslon at Intlustrial Safery, es natetl aDove, unless such person hes e
permit to do such work Irom Ihe division.
SignaNre: Date:
Division of IntlusMal Safery Pertnit Number:
CERTIFlCA7E OF COMPLIANCE AND AllTHORVATION OF EMAY: I cenify under penalry of perjury that I have read ihis application and stele lhat the intormation given is
conect. I egree to compty with ell state laws and ciry ordinances relating ro huilding cnnsWction, and authodze representatives of tha City of Costa Mesa to enter uDon the
ebove-0escdbed pmpetly tor inspe 'on pu ses. I egree no� to occupy ar allaw occupanry of eny building authorized by Ihis permit until finel inspection.
— Z3c�lr
Slgnemre 01 gaFOw r( ) oate �
-��
n�ninr n��t orizod Aooli Date
COOE I. INSPECTIONTYPE
1616 Fixed System Final Fire Preven�ion
7266 Pod Spa Final
200 Flnel RB-Rool
201 Final BIocWRetaining Well
202 Final Factory Fira Place
203 FInelSign
204 Finel Damolitlon
Qdj( I�IAL$ �f�}i INSVECTIONttPE
206 Final Mechanical
208 Final Plumbing
210 Fnel Elecirical
2tt Pinel Flre Preventian
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupency
BAIE 1t�L$
ra7
PflOJKT RDOflESS: �'� (3 [y 1 8�: H �J ��
OWNEfl'SNAME: (� .����vl
nooxess: 679 W 187'n 5.'
C�: CA 5262'T
b!6-9660
AHCNIENGINEEfl:
�ODflESS:
REG.NO.:
uwr: n
UNIT:
PEBMITTEE: �;��5 i�LBG G dTG ( 714 ) 530-2440
noosess: 10 4 2 2 'i RASK AV
G.G CA 9 ^• 0
LILENSED CONTIULTOB UELUIUTION: I Imrehy allirm �lut I am ' etl unCer pr ' ons ol apter 9 mencinp with Section
7000� ol DiNsion J o� ine Business an0 Pwlesaions Co�e. anE rten is in iM rce and en.
ciTr uc.: p� h(j STRTE UC.: OO Z � 0 3� �uu 3 F
Date: f $ignaWr '
WOBNEpg•LOMPENS�TIONDECu11ATtON: Ih¢rtEyatfirmttutllWveac dka:eo senitoself-inwreoracenilicateolWorkers'
ComOensation Inw�ance, or a cenilietl co0 �hereol �SecUon 3800, �ab.
PaucrNo.: dC941094.9� exr.onTe: 03/ 1/93
COMPpNY: Rt.PUBLIC
� Cenifie0 wpy is �ere�y fumisn¢E. � C¢nitiea copy is iletl N ciry BuilOi Division
Oaie: 7 ` � � � �� Applicant: l
EXEMPTIpN FflOM WOPIIENS' �OMPENSATION OE�IAMTION: (itis seaim neN noi com �Ne perml a br one huMmE (5700) Of less�.
I cetlity �pat in ��e perlormance 01 tM1e work fo� whit� iNs permit K isSueA. I sh not e o ifny person in any manner so as �o Oecome
su�lecl lo t�e Workers' CAmDe�sation Laws of falifomia.
Date: Sipruture:
NOTICE: I�. al�er making IOis 0¢tlaratbn, y0u shoultl 0¢fAme suEjeCl la t�e WOrkers' CompenSaGon pmvisions ot �he LaOor
Code. you mus� brt�Wi�h COmply wil� SUCh pmvisions Or IAiS permil Shall be GeemeO revoketl.
CONSTpUCTION LENDING AGENCV: I �ere0y atlirm I�at I�ere is a conSlmclion lentling agency tor Ihe p¢rformante ol Ihe work lor
which inis permit is issue0 (Section 3097. Gv. CI.
LENDEN:
ADOPESS:
OWNEq BWLOEP DECUBaiION: I nertUy allirm Rut I am e.empi imm tAe Caniractars' Stare License Law lor the lollowinp reason
(Section 7031.5 Business antl Pmlessional Coae: pny city ol county whicn repuires a permit to constmct, alter, imD�o�e, tlemoiish, or
repair any 9mciure. O�ior to its issuance. also reQuir¢5 tlle appliwni lor suctl pemnl to lile a 5ipneE statement llui �¢Ishe is Iicense0
pursuanl �o t�e D�a�sions of ine Contractars' State License Law (Ctwprer 9(commencinp with Seclion 7000) oi DiNsion 3 of t�e 9usiness
antl Pr0lessions Code) or Ihat �e/sAa is ecempl l�eRlrom anU t�e Oa5i5 lor t0e alleA� exemption. My violation of Section 7031.5 by
any aDD�icanl for a pamit su�l��s I�e appliWnt Io a tivil penalty ot not rtlom than fiVe �uMrtE UaIWrs (550�.
1, as awner ol I�e Oropeny or rtry employees v.hih vrepes as t�rir sde comperisation, vrill Oo I�e work. and the
❑ slmcNre i5 nol inlenEeO ar O��erea lor sate (Section 7Daa, Business an0 Pmfessional Co�e: TAe Comractors' State License law
Goes not appN �a an owner of a propercy who Euibz or improves iherean. anO wiw Coes wc� work �imull/�ersell ol t�muph
�is or �er own emD�oyees, proNtleO tlut suc� impmvements are noi imenEeO or aBereA lor sale. II, hawever i�e UuilOinq or
improvement is soW xi��in we yeai ol ppmpletion. ��e owna wfll luve ��e OurEen al pravin0 hUshe Gid no� DuilA or improve
, la� ihe purpose ol sate�.
I. as awner ot t�e pmpenY, am <etlusivery conlracqnq ml� Iicense0 caniraqors ta cans�mcl Ihe projeci (Seclion 70C4, Business
❑ anG Prales4ms CaEe: Tl�e Coniractas' Sute Liceme Law tloes wl apply to an ovmer ol praperry vAp ONIGs or imOroves Ihereon
anG w0o convac�s br suc� pmlec6 vnt� a conUactor(s�license Durswnl lo tAe Contractors' State License Law),I am aware
Ihat prool ol I�eir Work¢r's Compen5ati0n irtwraxe SiroNE De DrmiOM Io me.
� I am eeempt un0ei Settion: B. 8 P. t.
lor Inis reason:
Oate: Ovmer.
1 Eo h!r¢by Cemty Itwt 1 am awart ol an0 uMGrSIanG l�e requiremenls o� CalilOrnia Heallh aM Safery Cotl¢ Seclions 25505. 25533, an0
25534 ana �Aat I or any tutUre OuilGing o¢upanl vnlVwill nol (tircle one) neeU Io compty vnt� saiG state coAes an0 �he reQuiremenls lor a
perml lor Conslmciion or rtqEiliulion hom Ine Aii ahty Manaqemem Oistrict. NevUen6al conswction apDlications are eKemD� ��om
these pmvisions.
Oate: qppliwm: _
I hereby ter�i�y I�al I have r¢atl��i5 aD�litaiion anG Slaie lhal
or0inap�es an0 s�alelax5relalinpla Ouilaing constmclion aM t
pmpeqy lorin5peclion purpo5e .
Da�e: � � � � '� Signaiure: _
�nvers ucense or Sociai Securi�y p: ��<
tbat�aq Wn��„—Bulltling; Green—Coae Enforcemonc C
ily with all cily antl couniy
uponl�e above�menlioned
Pink—Revenue; Goltlenrod—Assessor
�:i PY Ur' �:US'ir�. N.cSA .......0 i��G �:.RN..: i i'fiitv .L�: r' �.,'/- ,l
i'BRNT'i' NO: P 0�7460 1�.,AN ChtCK NU; N GUVT; .r S�r�P: N
CONS7'�tLC,'iUr3 'PYPE; V—N PEKMLT 7'YPE; PLU PiJ�PUSE: UiH
JU3 Ur:SCRIPTIUK ; RE�LACE :JATER FicAT'r;R SQ rT;
CLA1:: VAL'JE: CAiC—VAL'UE; GROUP OCC: R-3 /
CON'✓E:1 i S: SMOKE llE i BC'iOR RE{�UIRED
icieii-IEdfiflk�kiE#'#�w�EleK%it�iflf�lC�#i(if#i:#�% �#iF�)ti(##�)F�li�%1F1E•%IF��k'1F�iiif�V.li1E�1FH�lE#X1FlE�1E1E#Y��IE�i�lf�%#JfjErt#�i!iclk>.:+ie
Z O N i N G R E Q iJ I R E M� N T S
�J F. i B � C �( $
------------ N.A:N Bu�LDING ---------- ----- ACCESSORY HUZi.D�NG
FRNT: FT lN R..AR; FT IN FRNT: FT iN R=AR: F� �N
LEF'i: FT TN RGHT; rT IN iEFT; rT IN RGHi': FT iN
PARKING REp • PROV; PARCEL; 43923102 7NE; REF NO:
PLANNING NGT'ES>
�
iE �le iE !'r fF �# ii� iF ##E if K� ic # ic #�IF iE i't ## iE # 3E *#�JE if -%�'r iF if �1F ie iF i4 ## ii� �IE # iF ii� iE ii• if # 1t # 7k iE ic �16 iF IEl41F %� i4 iF iF 3e 3F 3E �(� iF i'r �lE?i� iF # 3: 3't 3h if # N� iE
D E V E L O P M E N'T S E R C� T C E S, R B Q U i k E M E N T S
7,ON1NG APPROVED BY DATE;
BUILUING AVPROVED HY : DA'PE;
APPLiCAT:iON ISSUED BY• r� DATE� O'Z
i4'lEicifii�ie7ti6iF#iFi'riEii�if�iF1F#MiEifje - . .-x1r ��£7r R xi!�3f�1i�lei(-#ii�iFj(�jE .r-ir R nf:{t3i�
14 a- iF iF 3(� 3F iF %� if if if if # iE 3E ie if iE iE iE i4 iF x� 3f �e i� if� Y� j4 i:� iF 3F if ?f i'r iF 3F 3F iF .[� if iE if %ik �7F ii-1f iF ii ii� iE iF iE iP i4 �: ih 1e if i'r it #� iE Y: IE � if if 3f it iF ##,'r�. ii� iF kk
LEGALI7.ATIpN; N F E E , S'U M M A R Y STRUCTURAL ScG�'IENT: N
BLUG PMT PLUMBING ELECTH C M.ECHANIC FIRE SN.IP/RES GRADSNG
PER,uIT 2 , 00
?�k SMIP/NON—RES
PLAN
ISSUE FEE 3,00
BUIiDING—DIV—> PERM�T 1SSUE }Si,Ati--CHECK TOTAL PAiD DUE
TOTAL5----> 2,00 3,00 � O,QO 5,00 5,00 ,00
REVENUE D'IViSiUN 10TALS--> COLLECTED•• 5.00 OVF.R/SHORT; 00
H,,DG F'N.'i P1,UMHING ELECTRIC MECHANlC ctRE SMlP/TOT GRADTNG PLAN—CRr:Cri
5,0� .l
k�1F iE iF 1e iF iFi(' �4 iF i't iF i'r if if iE ii� iE IE #!f iE # if iF iE �?E %� ii 1E iF iE if� 7i # 1�iE iFi[ iE ik i! k� i(� ii� i4 iF M 3( ih iF le k ih H� ?F %iE �%� iF it ii� i(� 3E if R ii� ?'t?E ii i't # i'r if # M� if� 9!�
i N D I V i D U A i. F E E B R E A K D O W N
iYPE QTY D E S C R I P T i O N UN�T COST i'OTA:, CUS:"
. �
PLU � wATER HE�.TER Ann�iOR VENT ?,00 2,00
�ND OF rEES
��
• 'r
7.
CONSTRUCTION AND PLANNING POO SPA
APPROVALS Permit # Date tnspector AppROVALS Permit # Date Inspector
t. TemPorary Electrica� Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Ut�lity-Undrgrnd. 54. Forms
4. Electriwl Condurt�Undrgrnd. 55. Electrical 8onding
5. Stee� Reinforcement 56. Rough P�umbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GU�ITE
7. Footings 58. Electrical Condui[-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. WatB� Pipe-Undrgmd. ' 60. Backwash Lines, P�Trap, l7 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
� 1. Proparty Sewer Line & House Conrreciion 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent•Final
73 Roof Drains 64. Plumbing System � Final
14. Rough Plumbing 65. Electrical•Final
15. Rough Electrica4-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. 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. Oucts, Ventilating 71. P�oduct Piping �Gas ❑Oil
23. Gas Pipe•Rough & Tesc 72. Underground Flush
24. RooY Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roo4 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. F�RE PflEV. 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: S%L8/qL �:O OAIjljOH'►E,- (w2.i4'�'��O �L�
t
34. Final Heating & Air Conditioning " 7/7lriZ f.��V,��.��_ ���r�A_ �y�
�
35. Finai Gas Pipe�Test ff-(0112 �T Q'c.'+i.P�� �,S (aEP� Z+�•3
36. Hood or Canopy V P L L.����
� 37. Final Factory Pireplate ,
38. Final P�umbing
39. Water Service-Final
� 40. Gas 5ervice-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. �andscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUIL�ING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
City of Costa Mesa
Building Safety Department
P.O. Box 1200
Costa Meu, California
CERTIFICATE DF OCCUPANCY �"_ `���`�
The Building located at CJ4 ect � 9th ;tro��t_ li�i tc 1-!�. �
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group 14Ci Occupancy. ,
Use of Building Rour��ler. +a/rnr?.�es V
LegalDescription ��r_ian_ni,
(See reverse side for Metes and�Bounds)
Building Permit No �-�����, Electrical Permit No. 7�'997 Plumbing Permit No. '�"
Number of apartments and/or guest rooms �
ISSUED TO: BuildingOfficial � �
by '�/ �� ; �� i� ,, , .-/
.'�.I � t�) c ,T.:.�ii•.Sn^� '��
�2iB Fnhruo.�., '1 1073
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises�and SHALL NOT.BE removed except by the
Building Official of the City of Costa-Mesa under Sec. 306 (e) U.B.C. � �
Form BU 34 Rev. 11/]0 ��
m
� • • -- 3650�
; .
: COS7A MESA BUILDING-SAFETY DEPARTMENT
P.O, BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
no�o ess ( % (N. �YJ/%�-' �M
Z .
w w
a U
� Z
ZQ
ON
am
J �
J N
Q W
00 J
J m
Q
U Q
Z ¢
d W
W Z
J Q
m Z
J ¢
W W
0 =
Z F-
O
W
�O
�
z
Q
U
J
a
a
Q
Q
F
y
Z
O
H
U
�
�
F
H
Z
OWNER
MAIL
ADORE
CITv
BFANCH
ARCMITE�
OR ENGINE
ADDRESS
CITY ��JJ�
STATE
LIC. NO. �
SIZE
OF LOT
USE OF
E%ISTING BLDG.
SIZE OF
TE
TE�.
TEL.
NO. 2'
CITV �
IIC. NO. � �
INO. OF BLDGS.
NOW ON LOT
EXTERIOR WALI ROOF
COVERING_ COVEPING
VSE OF BUILDING ANO WOFK TO BE PERFORMED
�.�; ,�-,-s�F.=o�, ��s�> ,:;.,�::,,s.�a
APPLICATION FOR BUILDING PERMIT
BUILDING
ADDRESS
F
_�d � �/��
�IC^ v/ PERMDTV�� JJ
ov J
7 /�/r / ^— �
.45t-� .O/
ilEfif' LO � BLOCK
�LTER
•��
VALVE ��
�• V s
TVPE GROUP _/ �
� DATE �^/�— O" (�
�\\
N NO.OF USE OF NE -
_ PLP.fS �J BUILDING
VARDSAPPFOVED YARDSAPPROVEO �
MAIN BVILDING ACCESSORV BVILDING �
IOM GL STREET) �
DISTANCE
MAIN BLD(
VAR #
C.U.P.�
APPROVED
FT
BET. MAIN &
ACCESS. BLOCS.
DATE
APPROVED
I horeby Bcknowledgo that I have reetl this applica[ion and stete `
that tha ebova iniormation is corroet antl apree SO cOmply with
all laws rBBuletinp builtlinB construction, antl I shell nol amploy i`�
any perso� in violatlon of tho wOrkmen's compansallon laws of �� ��
Me Smte of Celitomia. T� �
I hareby Certity that I em proparlV Iicensetl as a convactor �ndor SQ. FT. o
the Stete oi Californin Business entl Professiona Cotla, Divisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR �
Cheptar 9, antl that sueh licensez ero in fuil torce antl eftect, or I THE PURPOSE OF ESfABLISHING A PERMIT FEE ONLV: °
om ezampt f.om ttie O�ovisions o( tha S[eta of Culifornia Business ¢
antl Professions Cnda, Divislon 3, Chapter 9. VALUATION —� y
'') PERMIT FEE S �
rv 7
SIB�a[ura of m
Permltteo �G' � § O^�� � PL4N CHECK $ �� o
Authorizetl ABant `.� LL
TOTAL FEE 5
,� ' �• �` 41493
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ [orFlll in Completety — Use Ink Only
BUILDING /r-/ /j � / Q �
F
�
a
¢
�
h
F
G
F
O
`a
Q
>
�.
a
a
W
a
O
CC
a
Z
W
`y'
�
OWNER
MAIL
CITV /Sj�/1J��IA��nP17OlN NC
BRANCH
ADDRESS-��
AqCHITECT �
OR ENGINEER�P/ �
ADDFE55 Z
�o d dA T.
CITV /J'��//lU / �/ iQ� N� �/�II/�
STATE f—���— CITY
IIC. NO. LIC. NO.
SIZE NO.OF BLDGS.
OF LOT �O � 3 O O NOW ON LOT "'—
USE OF
EXISTING BLDG.
Separate permits are required f r �
electric, plumbing and heating work.
USE OF�BUILI'�{NG gND WpFK•TOBE PERFO�°IEQ •
u�1
1 haraby acknowledpe that I have �eatl this application antl state
Met the above Informatlon is corract antl apree to eomply with
all lews repulatfng builtlinp construction, and I shail not employ
any person (n violation of the workman's compenmtion laws of
MB Stata of California.
I hereby cartity ihet I am prope�ly licensetl as e conirector under
ihe State of Califo�nla Busineas entl Profassions Code, Division 3,
Chapter 9, and tha uch Iicenses are in full to ce and effect, or I
am enempt from provislons of the Sxeie Callfornle Businass
and Professions e, Olvislon 3 ef 9
SIB�etura o
Parmittae
R
4'4:U
4iAR 31 -76��i ,.001683>r *** *26.°d
TION FOR STRUCTURAL PERMIT
3V DATE RECEIVED ncrc �csuF�
�tl����Y►�.�—�I%Lr��I��
• I � . — —
.��-
r�'i: � H!� . .� � �
�ul_ •, • �: •
� . � � �� u • � • ut�73R�1�F9C�.
�.--�—
� .:r %� � / ' t-f!�
Gsi"' `. ►Y `' % ur���
� / •
:..., ,�/ , r
20NE NO.OF
PLAN$
i
VARDS APPROVED
MAIN BUILOING
(FROM C/L STREET)
VAR. qW
C.U.P. s
VAFDS APPROV ED
,CCESSORV BUIIDING
T
OFT.
.T
T
� :Y) cT I , -I
DATE
APPROVED
��r� 3 31=
THE AMOUNTSHOWN UNDER VALUATION IS
THE PURPOSE OF E5TABLISHING A PERMIT F OI
VALUATION � PERMIT FEE $ +
g /�� PLAN CHECK E �
TAX 5 �
TOTALPAID $ :�
O
�
�
�
�
m
i
m
m
J
m
d
a
N
0
f
U
♦
4•
� � � " • _ 42360
� , COSTA MESA BUIIDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING � � ^
AD�RESS
OWNER � �S
MAIL � �
ADORESS .
TEL. e
CITY �%fj'�L�%A/i: Pla.s/r NO.%l��
BRANCH ��
ADDRESS �
ARCHITECT
P
AODRESS •
r" E L -
CITV f .I Np 7
F STATE CITV
c� LIC. NO. ��— LIC. NOF�
rG
{8 512E � � � A NO.OF BlDGS.
0. OF LOT ��� (f NOW ON LOT
a USE OF
� EXISTING BLDG. ��
=
F Separate permits are required for
� electric, plumbing and heating work.
� USE OF BUILOING AND WORK TO BE PERFORMED
F
a
0
� N
Q
�
}
..1
C
W
a
All 26-7G�K�°OQ2923� ***210.27
�ORSTRUCTURALPERMiT
'u
A.P. NO.I I � _ I{�� '
BUILDING /�7p /_.
A�ORESS(p ( 7 w
1
TRAC ' � I
OWNER
FIRE
ZONE
APPROVED
� �-: 7�j.
�
NE NO.OF�J USEOFNEW4uN�
C.� PLAN$ L BUILOING(���
VARDSAPPROVED VAROSAPPROVED
MAIN BUILDING ACCESSORV B ILDL
(FROM GL$T$EE /� / /'
VAR. qW
C.U.P.M
BET. MAIN &
G' �-('�VO
� �� 7�
� 1 heraby acknowleCge that I heva reetl Nis appli<aHon and stete �
CL Mat tha ebova Informatton is correet entl egrae to comply wiM m
a all lews raBuleting DuilEinp conttrucNon, antl 1 shull not amploy �
Z eny parsan in violation of t�o workman's eompensation laws of m
S the Stato of California. � � -
3 I heroby certify that 1 em proparly Ilcanxtl as o eonttnctor untlor Sa. FT. N
the Stnta of Celifornie Buainoss antl P�ofoulona Cotle, DIvlslon 3, THE AMOUNT SIiOWN UNDER VALUATION IS FOR m
Chapter 9, entl that ch Ilcanmc aro In f�ll fo entl affxt, or 1 THE VURP06E OF ESTAB�ISMING A PERMIT PEE ONLV: �
am exampt from i rovisloneof thaStoto allfornla Businesz VALUATION PERMIT FEE S a
entl Profacaions , Divlalon 3, C r 9 �{ m
'r PLAN CHECK E �
SI neturo of `'_ • �
Permittea . $ //� /�//�/� ✓ q LL
VrV TAX 5 « �
` u
Auihorized Agent I TOTAL PAID E �
/
� �� 44258
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING / Q
ADDRESS (� �� Q �
OWNER
^^A" 3 / �G
ADDRESS
TE
CITV O�,( N �
CONSTRUCTION �
LENDER
BRANCN Q
ADDRESS .2 %{/
ARCHITECT / � � ,� � ,� TEI►�i'��_ � /
BUILDING
AD�RESS
R
FIRE
ZONE
APPROVED
Palu
��r —F—����,�:00 5�7> �-{=•1�5c
DN FOR STRUCTURAL PERMIT
DATE qECEIVED OATE ISSUEC
_/ O 1 v RMIT NO`
7 9 I..J. � �"yl� S%
ADDRESS U f�
TE Z NE_ �� NO.OF
CITV .e(�� N i- Lr PLP'NS
F STATE CITY - �ARDSAPPROVE
� LIC. NO. �� LIC. NO.�� MAIN BUILDINC
Lri 512E M ^J NO.OF BLDGS.�j (FROM C/L STREET)
� OF LOT G(/ J � O NOW ON LOT G FRONT FT.
� USE OF �
EXISTING BLDG. {�/l, S T. �
h
� Separate permi[s are required for L SIDE Fr.
F
� electric, plumbing and heating work. REAa FT
[.. USE OF BUIlO1NG ANO WORK TO BE PERFOFMED OISTANCE B �
QMAIN BLDGS.
� VAR.9W - 6
Q, jiL�� C.U.P.9WZt
1 r v APPHOVE �
}
.d
C
{cl
a
Q I hareby acknowletlge that I hava reatl this application antl rtate
CC tha[ ffie ebove Informatlon is correct an� a0ree ro compty wlth
4i all laws repuiotlnB builtling conetruction, end I ahall noi amploy
Z any person in vlolation of the workman's compensatlon lawa ot
� tha Stata of California. �
3 I hareby cerNfy that I em properly licensed esa conttactor untlar FT.
the State ot Celitorn7a Businese antl Profess7ons Cotla, Dlvisfon 3, THE AMOUNT SH
Chepter 9, entl that/ ch Iicenses ere in full f ce and effect, or I THE PURPp$E OF I
am exempt from tF� rovisions o} the Stata Celifornia Business VALUATION
antl Professlons C b Divislon 3 ter 9
Signeture ot �� � �
Permlttea $�
Authorizetl AOont
DATE
USE OF NEW
BUILDING Ti
DATE
PERMIT FEE S
PLAN CHECK y
TAX E
TOTALPAID E
�
n
m
i
m
N
t5 FOR m
ONLV: �
a
N
m
m
0
LL
i
U