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HomeMy WebLinkAbout829 17TH ST - Building Permits� � ---- - -- � , crasm i �^x sm�r es2� ...c �3r. ., � 33555 - 2-7-72 �.�a:s- ='=�1 3ia6. $33,750• j 3397z - 3-6-72 u�c scu.�r;e ,��-.., l,000. -� . i 33995 - 1-28-72 ?ire Sc:io:c _rz 5,440. I 6oloi - 3-z-72 ' e_t„ t<r, (�a� ) �37082 - 12-12-73 '�. . E�.cplosion repair 30,000. ? � 36552 - 20-16-73 •.. � ?1:c. :,C (cr�.::r.ecer) � 3TB3C - Z�S�%�1 'I:C21'.i:E=.:0 S::Q. SOO. , ' 04955 - 2-5-7� °1:•,.:(.C.(,i.�.) � ��+- � _ B6oi� /o/q� i � � � i i I i i � .____.- ----- �...�..J �OB AC GENER � P No. u C sc .� c•s WIT6R L PL CON. ING MEATING ANO AIR CONDITIONI ROUGM M'�R�NG TRENFNES � FORMS STEEL NEINF. SHEATHING Fq4ME RNO FLASHING 1 fTuiNG - IN n NF F F vn�� BUILDING SUBCONTRACTOR OWNER SHASd & SONS JOB ADDRESS 829 W. 17th St. ��,FNERAL CONTRACTOR secur3t Fire '?�,�o.11 -25 - LOT TRACT I%i�PBCTIONS Si notu SOIL G AS WATER ROUGH P�UMBING PROP. SWR. LINE � HOUSE CON. � SPPINK��NG SVSTEM � MISCE4LANEOUS . ROUGM XEATING AND FIR CONOITIONING TEMPORARY SERVICE OR POLE UNDERGAOUND � POWER � ROUGH N'IRING TRENCHES � FORMS � STEEL REINF. � FLOOR SYSTEM BONO BEAM STEEL REINFORCE SHEATN�NG FRAME AN� FLASNING LATHING — IN pUT P' 'THR. BROWN COAT :YURpL, FINAL DATE �-7-7� �' E ZONE SUBCONTRACTOR OWNER SHAW & Sons 1108 ADDRESS 9 West 17th Street :i GEP S �Ih�f SOIL \ GAS ` WAT DATE 12-i6-7i LO7 TRACT FIRE ZONE VALUE E ROUGH PLUMBING PROP. SWR. LINE � HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGX HEATING ANO AIR CON�ITIONING TEMPORARY SERVICE OR POLE UNOERGROUND � POWER � ROUGH WIRING TRENCHES � FORMS � STEEL RE PLOOR SYSTEM BON� BEAM ❑ STEEL AEINFORCE [ SHEATHING FRAME AND F�ASHING LATMING - IN ❑ OUT ❑ P� 'ER, BROWN COAT S iURAL, FINAL HEATING. VENT.. REFRIG. ANO A.C.. FI SUBCONTRACTOR �uowFssaem�nu+� gz9 W 17TH ST w�xs""�E"anxr�LEROY SHAW • "�"��829 W 17TH ST COSTA MESA A 92627 642-0660 /�PCXRECTOPEW�lE�i: iXC11.011FN .'S IWRE55: comm�ctarsrw� CONINACTORSYIII➢Ifi ,�oo�ss: uNr: q uc. ia.: UM: ua ra_ uNr: UCFNSED COMNACTONS OECLAflAT10N: I hereby Mrm uMer pendy d pajury ihet I em IcereeE uMer provivims d Cheqa B (wrvnmen0 weh Seclian 1000) d Oimnn J d the Bueirou end Pmlesaima CoEe. end mY Ywr�ae e in IW lam end dlsp. cmuc.No.: uc.cuss: uc.No.: EXP: ome: cwwm«: OWNEP BUILDER OECLhflATION: I Mraby tlfiim uMer penaly d pxjury thm I am uemq ham iM CaMratlas Lke�ue lew la Ihs IWbwnB �ae.+on (Setlan )031.5 Buairv enE Rdasa'vu Code: MYW a cauYY xfiirh npu'ves s G�'s �o mmvuU. Wer.'vnVo.e. Eemdoh, a reper e�ry N�uduro, p'w to ila eweroe, e6o iepurea IM epd� �a vuch ppmn �o fYe a eqneE �talemmi Mm M p eM '� licm+ed W�wam Io iha Yovitim+ d ihe Conireaoro l'xeme lew IChaO�m 8(carvnaeK'uq wu� SWion )000) d D'v'vbn � N tAe usinam eM Pedeesbm Cadel a Ihe� ha or ahe n ewemN tAndmn eM �M bme la iM aAeOb examWion. /uiY vidmion d Setlun i031.5 by enY WW� lor e permn wbpae IM eppl'ram to e tivil perielly d �wl maa Ihen 1'vs huMreE Adlen �5500�). � I.mormardiMpopMYaim'�PM�v.thwepaamtMiWecanPe��.wldotlaxak.eMtM�m¢twe'sml'vYxNd rc Mered M eele (Senion )oee. Bwima ark PMmsbna Code: The Conirman Linrue lewdoee iwt nppyto an owrier ol properry vAa WiCa a inP�*9lherem. eM wfa doee �udi xqk Nmfetl a henN aWaph he a her am rnDbRe�. po+� IM wcA impwemeM+era nol iMmdad u ofleiM Iw eda. M, however, tM Witli�p a inpwemaM u eold vmhm ms yaer d mmpblion, tlro �owmrbu0tler WI hava �M bu'dm d provinp M a ehe did m� buiW a impeova lu Ihe qupma d ula). I. ea ormer d tM popeM. ��NwrvdV �^t�rfiq �m� liceneed canlrmlae lo oonqvf tM qqea (�� �. �eiiwss aM Prdewions Coda: TM Contmfan L'cenv lew dma nol eppty b en ow'wr d popeny who Euitls a impm�ro IM�aan ud x1n convecu la eud� pqane xilh a wMreeor�e) ficemad punuem io �� nueaas li `e Lew�. � I em e�emq uMa Sxiion: B. 8 P.C.. fa �h' � o�,: 3 - I � - �? a.,,., I do hareby cMM � I em ewera d ud uMentend ihe reyuirem e d Cal�anu Heetlh eM Selely Code Swiane?5505, 255�. erM Y5531, eM tlut 1 u mry Mun Mdd'rcq ooaiWm M+II / wil ml (' ore) need p canpy wih eeiE Yels mCm xM tM �emuremama br eparmn/wmnxlrutlimamodifrcmionhantMAi ue�iy ar�eOe��Dielrid.PesidenlielmMrvaionevG�iauueeRemNlmmlM�a a�.�. Dete� APVlkem: WOHKEN'S COMPEN5ITON DECLAPITION: 1 Mnby efimi uMer pwully d pajury aw d Ms blbvrirp Eedvelnm: ❑ IM`aerdwJmmnlaii.canilkm.dmiwn�ovaMimunbrworkme'campenWion.uP�^dlnbY9aribna)aoatMlebar Code, la IM peilmneMe d IM wak la wlich tNe peimG u be�eE. �1 hevs a�d xil mmnlein xwk»' mmpemelon mwrenm. m epu'vW by Setlion 9'ro0 d Ihs lnEw Cads. b tM pnbrmenn al IM w«k la wliich Ihie pennM1 ie oued. My worMere' oompeneelbn Im�rarce wmx eM poliry numba are: c�..: ('AT,IF COMP EXPIRES Paliry Number. W 4 7 l i�(1 � 4 9 O 1/ O L/ 9 8 �, .ee� „�e �a ae �d�.e i u» vmm• p ro. w�. w�e edr� fs,aol d�.1 � I cendy ihet in IM pMormenca d �M work br xfich Ihie pamil ie iauetl, I ahell iw employ e�ry perwn in eny mannx ao u io becoma abptl to iM xMe�s' oompenWim lewe d CaNanu 0� �' I dw�N bxaro wbjsrJ to IM v.almr�' companee�ion proweone d Se tion 3]00 M I�e Leba Coda, I lalh h compy �1th Ihwe p W ons. o�,: ?� — 19 � 9 7 ���. '" �— Wemlrp: F�Nun ro Neuro norkw�i rompru�tlon rovs� 1� �n I, �nd �I �11 ulJ�ef en rrrplqw to dlMrel p.neltlq aM c/v/l fliro� W ro aa hwrtlrW tMuurM tlallen (SfOqP001, M tlon b M� cwf ol romprwtbT ��vp� �� M��bb � In 9ectlon 9I06 0l tlro Le6or Cods, IntenaL aM ettomry'a /�u CONSTflUCT10N LENUIN� �QENCY: I Mnby elfirm uMx panelry d perNN �w them w e conatiudbn bMiip apency br the paAamarwe d IM xoh In whitl� t�e pmmY u eweE (Seaion 90B1. CH. CI. LENOER'S NI1NE: LENDEN'4 �UORESS: 1 cerlM tIW 1 have rend Nia eVD�ratim eM qaU �het Ns ebove iMametian e oorratl.l eYne to camdY wn� e0 mY W munlY adinenm� arM stma lewv mletiq to WilEiip con�ruQion eM Mreby eNhor¢e npeeenteiivae d Ihie dly lo anlar upon �M abwe�memuned pmpeny la in0�ion W�Wsea., JOiTtd L WILI�S � /�„' /�' ome: 3 - ( 9 -9'7 SiOn ure a OvnnrlApaM/Apptiun4Comreda (5151de.WP) While-Buitliq 8 Selaty: G�eeMFJa: Cenery-ADN�I: Rnk-Revanue:Oddamo0.Meeewr , CITY OF COSTA MESA - BUILDING PERMIT PERM NO; E 082103 PERMIT NO: E 082103 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: I-FR PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION : UPGRADE ELECTRICAL SUBPANEL IN UNIT 4 SQ ET: CLAIM VALUE: CALC-VALUE: GROUP OCC: H / COMMENTS: "SHAW AND SON CONCRETE CO,"/NO OTHER WORK RELATED TO THIS PERMIT iE if 1E 1E iE iF iE ik 1f iF k if ik iF 1E 1E 1E iE 1f-iF 1f 1k k 1E iE 1E 1f if 4 ik iE iE 1E'k 1E iE k ik ik 1k 1E 1E 1t 1E iFlE ik 1lik 4 iE iE fE k iE 1E 1E iE 1f fE 1E 1f !E ik fE 1E fE 1E iE 1E iF if 1E if 1f iE 1E k iF 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 BOILDING ---------- --------- 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 REQ• PROV; PARCEL: 42410204 ZNE; REF NO; PLANNING NdTES> i • `� Ik i! iE 1E 1f� ik'lf IE 1klF iE 1E 1E 1ElE 1E 1F 1E iE 1E f(' 1E 1F fE fI� fE 1f IElf 1E 1k fE 1! 1f fF 1k 1F 1! 1E 1E 1E fE 1F 1E 1E'lE 1F'If k 1E 1E'lE IE'li 1E IE 1f 1k 1E 1F ik 1E 1E iE'1F 1E'1F 1F if if iE 1F iE iFlf if if �f 1f 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 APPAOVED BY : DATE; APPLICATION ISSUED BY: DATE: 3�� �**�*�������������**�* ���*���������� LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC EIRE SMIP/RES GRADING PERMIT 48.75 508 SMIP/NON-RES PLAN ISSUE FEE 22.00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAZD DUE TOTALS----> 48.75 22.00 0.00 70.75 70.75 .00 REL�ENUE DIVISION TOTALS--> COLLECTED: 70,75 OVER/SHORT: .00 BLDG PMT PL�UMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN-CHECK '70.75 1E if 1E if 1F iE if 1E 1E 1F 1f 3f it iE if iF k k k iE k iElf iE if iE if iE if !f if !E 1ElF iF 1f if 1f !f 1E 1f iE k Ik k 1F k 1F iE iElE 1E k 1F iE 1E k iE 1E 1k if iElk 1ElE 1E k k 1E if 1E ik 1f 1E 1Elf 1F iE iE I N D T V I D U A L F E E B R E A K D O W N TYPE q�rY D E S C R�I`P T I O N UNIT COST TOTAL COST ELE 7. SUB-PANEL 1.6.25 16.25 EI�E 1 MISC CONDUCTOR NOT LISTED REp PERMIT 16.25 ].6.25 ELE 1 MISC CONDUIT NOT LISTED RE(5 PERMIT ].6.25 1.6,25 � - -- END OF FEES .v' The work aufhorized by this pertnit shall comply with all appllCaWe handicap 83-19-1997/12:29 PM/f78.75 accesa requlrements under Califomia RCPTq:01-A80365A stetutoe and related regulatlons. PERM I T: 082103 /Ord. No. 92-28, § 1, 12-21-92) f CONSTRUCTION AND PLANNING _ POOL !A ' APPROVAl.S Permit # 'Date Inspector qppROVALS Permit # Date Inspeitor 1. Temporary Electrical Service or Pole _ 52. Pool & Equipment Location � . 2. $oil Pipe•Undr9��d:• . - � .53. Steet Reinforcement . . . "8. Electrical Conduit Utility�Undrgrnd.� 54. Forms. : 4, Electricai Conduit-Undrgrnd. � � � ' ' 55. Electribal Bonding - • 5.- Steel Reinforcement � � ' ' 56. Aough P.lurnhing & Pressure Tesi � '6. �Electrical UFER Gmd. � � - � .. � �57. APPROVAL,TO CQVEfl�GUNITE . 7. Footings . ' 58. Electrical ConduitUndrgrnd. � 8. Foundation , � 59. Gas Pipe, O Urn1�'giqd., Test � 9. Water Pipe-Undrgrnd. • �. 60. Backwaeh Lines, P�Trap, � Undrqrnd. 70. Structural Ploor SYstem , 61. APPROVAL Tb-DECK ' . ' 1 t. Property Sewer �ine & House Connection _ 62. Backwash & RecOptor�Pinal . 12. Sewer Cap 63. Heater & Vent�Final� � ' - 13. Root Drains � 64, Plumbing Sy'stem � Final- �" � 14. Rough Plumbing � 65. Eiectrical-Final � 15. Rough Electrical�Conduit' � 6&. Solar System�Fin,a! 76. Rough Electric4Viring � � 67. Fencing�& Access Approval . 17. Rough Wiring Sign � � 68,� APPROVED FOR PLASTERING 18. Rough Eleetrica6T Bar Ceiling � 69. POOUSPA $YSTEMS FINAL 79: Rough Heating & Air Conditionin� . „ FIRE DEPT..REQUIREMENT _ 20. Rough Faamry Piieqlace � - w� . ' _ _ � �AppROVALS�. = Permit # - 21, Ductt, in �5truciure'• z. �_ � * ' _- 70. Underground HYdro r � N� ., 22. DuMs, Ventilatin9 j. � �� . -•c <� 77. Product piping O-Gas OOiI '" � �� i a c � - 23. Gas Pipe-Rough & Test '? ` i " � ,- " "' 7z, Underground F�ush - � y .� � � 24. Roof�Prarr+ing' ' � ��- � ' _ _ ,_ -�.73�.. Undergrnd.StoraggTankOGas ❑Oi� ? � -'�� . �. 25. Roof Sheatbing � ' _ ? "- � 7q; Overhead Hydro . , = = ' `a ' - r �- t a� ^ eJ'. 25,!�T•Bar Ceilin9 (Structural� & Monocoat , - ��, 75. Dry Chefnicaf . T '� o rt �"- I - ' � L^ C1 � 27. Frame and Flashing -. � - _ � , � 76. Dry Standpipe � ':� ' _ . � w .� � ti 28. Lathing&Siding � _:_ ' ' � ��, 77- FIXEDSYSTENI-FINAL ��� c N 29. Insulation '' ' ' 78. FIRE PREV. FINAI. Ev' ' r 30. Drywall NOi�ing '- ._ t : - HEALTH DEPT. REQUtREMENT � `� 37. Plaster Brown Coar •` • � �9. FINAL INSPECTION 32. E�ectrical_Power Meier-final , '_ '' 80. FOOD CERTIFICATE ISSUED . 33. Finat�Elea��c. - =,-� � Notes: � " '�: ' � � • 34. F�nal Heatiog & Air Contlitioning � ' _ � '' _ . _ - ' 35. Final Gas-PiDe-Te4t � _ � � � - r _ � � -� 36. Hood or`CanoPY ' . ' `" .� . � ' ' .. •1 T'.-. . .- �. 37. Final FactO�Y Ffreplace r --� + � ' 38. Final�Plumbing , � _� ' ' � . 39. Water Service�Finai ' . r .. • _ 40. Gae Service-Final . � � " - ' � ' e . . - 47. Solar pomesticPinal - - - ' 42. Backflow prevenier ' ' �' "' C r' � . ' 43. Backflow Irrisation - _ . 44. Landscape Ir�iqacion System = ' � � .- , � * e - - _ 45. Soand AtCenuation . � . �,. ; ; < -_ _ _ , . 46. Handicav �e9ulatioris _ - � ' 47. �FINAL STRUCTURE & BUILDING ._ . ' -• _ -- - 48. 61NAL PLANNING - - � ,. - ' 49. Electric Release to �dison . �, �- �- -• �" ' - 50. Gas Release to Southern California'Gas Co � -. _ �'� : ' r 51. CERTIFICATE OF OCCUPANCY •� No Date ,s����fiJ��,a -,�r��� ,?fi dZ - I: �., ���' . (��`•�,cida�..1 ' �wr) ✓��/ p�z'az •• � . � ' • " � � ���.,�i�}a�a� �wb '�L-) , . � � �� � y s.-� Jw y �t - ! ; ;:.� . �„�,a,,�:�$ � o�d� � � - .. . ._ . ............... - , d w � 001 --�. ,� - , • -- �� % � ,� � � ;n��X/ , Q�4 �. � � �v�d., ��a�{ :: � ��--. . ... - .- � -.-_ -..._ , r� �, o., .�� �. � ?. p .. .�.,.. , ` ° ;° :` ' ��� � � �j „ � � -�` ,y;,t»�� �,,,��y . ' �.� - _. � _., . ._. � � . .�. �_~� �\ .....1 � ,_. �� 1, ,...: .._.,.._..�: ............ .: , ' �� � a w �.Si �� . '--��1iNll '1sL/'/J �2� _ 5.'yo���*�.)_�vn, 'a.�a1��J'�, .,,' �o� l. �'»�J � y 'id Wd9£:60 L66S Zi 'aeW 'cG£S bL6 CtL +:'ON 3FJUHd � aOSQNi(1 3f131S : W�J?J�. � PPOJECT PDUNESS: 8 2 9 W 1 7Tx ST OWNEn'S NnME: LEROY SHAW �...% aooeess:8z9 W 17TH ST CAS92627SA AflCH1ENGINEEP: aec.xo.: UNIT: ADDRE55: UNIT: r PEqminEE: COASTRIDGE ROOFING ( 714 ) 557-6048 aooness: z480 FAIRVIEW RD COSTA MESA CA 92626 LICENSED CONTPACTOp OECNflATION: I hereEy allirm �hal I am IirenseG untler Omvisions ol Clup[er 9(commencing with Seclion 7(p0� of Oiy��sign3 AI 1�eB usiness antl Proi�Ssiyn$ aq�, nA my license is in f II r ej nd efiect. U4Y711 J91�7� ���7 CITY LIL.: STRTE LIC.: � CIAS� Oa�e: 1 i — �£] —92 Signa�ure: _ �'/ �` WOflKEXS' COMPENSR710N OECLAflAT10N: I �ereby a irm IM1a� I ha c¢rii�i[aie o� COn en� to Sell�in5ure or a Cetli�ica�e 0� Workers' Comoensa�ion Insurance. or a cetliliea cooY �hereof ISeciion 3800. Lab. C�. PO�ICY NO.: E%P. URTE: ZOMPANY: ❑ Cenifiea copY �s hereby Iumis�e0. ❑ Cenilied copy is IileA wi�� ��e cily Building Division. Oa�e: aPPlican�: ' E%EMPTIDN FPDM WOPREPS' COMPENS0.TION DEClAMT19N'. �tM55ec�ion �¢6 irol be campleted I� l�e petmit is Iw a�e IwMted �510�) w �e55�. �� I cerlily �ha� in t�e Oerlormance 0� Ne work lor which Ihis permil rz i55ue4. I shall nol D�oy any person in any manner so a5 io 6ecOme �� su�jecl to tne Workers' Comoensatian �aws of Calibmia. �. Da�e: /� —3•� — 92 Signa�ure: � � � � NOTILE: II. alier making this tleclaration, you shaul ecome sublect to orkers' Compey n�provisions of Ihe Labor COEe, you mus� �on�wrt� Comply wdh suc� �mvisions nr I�is permit 5�511 �e Ceemetl rev�e0. CONSTflUC7lON LENOING �GENCY: I here�y aflirm inat tnere is a tonsVucVon lentling agency lar Ihe petlormance ol ihe wark lor wpich Ihis permit is issuetl �Seciion 3097. Civ. C�. . LENDEN: aooxess: pWNEfl BWLUEB UECIABATION: I herehy afllrm �ha� I am exempl Imm Ihe CONraCi0r5' S�ale License Law for me following reason �Section 7031.5 Busineu anC Professional CoOe: A�y cily of counry whic� reQuires a Dermii Ia conStmcl, aVer, improve. demolis0. or �epair any siNtlure. D�ior ta ils issuance, al5o requires ihe ap0�icanl for such permit to file a signetl statement t�at �e/she is Iitense0 p�rsuam to Ihe pmvisions of I�e Comractors' State License Law (Chapter 9(commencinp wit� Section 7000) ol Oivision 3 0l tM1e Business and Professions Cotle) or ihat hehhe is exempt I�erefmm antl �he hasis lor ihe alleAeO exemption. Any violation of Section 7037.5 6y anY aoV�iCanifor a permit su0lecis ihe ap0licantlo a civil penalty of not rtwre ihan live huntlre0 tlolla4 (5500�. p I. as owner of t�e pmDeny or my employees vnlh waAes as tAeir sole comDensation, wiil Ao ihe wark. an0 Ihe s�mclure is no� imenUed or oilerea lor sale (Sec�ion 70a4, Business and Pm�essional Code: The Coniracbrs' S�aie LiCense Law tices noi 2DP�Y �o an Owne� at a pwpertY w� 6Ui145 0� impmves thereon, antl who tloes Such work �imSelf/heriel� Or �hrouph his or ner own employees. pwviGetl t�at such impmvemenls are not intenOeJ or aHereE lor sale. II, however Ne buJdinq or improvement is solA witAin ane year of camp@lion, Ihe owner mll have t�e burden of pmNng �e/she Gitl not 6uilU or impmve lor I�e Durpose ol sale). I. as owner o� �Ae pmpehy, am exclusively ton(raCtinA Wiih liCensetl tonlraClorS io can5�mG1 �he proletl (SeCtiOn 7044, Businesi [a aotl Pml¢66on5 CaOe: i�e Conlraciors' Slale Llcense Law �ces nal appty to an ovmer 0� Vroperty who builEs or improves thereon and who comraas br such Orojecis witA a contractoqA ��cense pursuant to t�e Contractars' State Licenu Law�.l am aware Ihat proof ol t�eir Warker's Compensalion insurance sM1oultl be D/ovided lo me. � I am exempt unAer Seclion�. B, 8 P. C. br �his teasOn: � Da�e: � Owner. I do hereby cenily Ihat I am aware oi ana untlers�and ihe re0uirements ol California Healih and Satety Cotle Sections 25505, 25533, and 2553a and �hat I or any fumre builGing acupant w7Uwi�1 not (d�Ge one) nee0 m compty with saitl state caCes antl the requiremenis for a pe�mi� fo� consVuclion or moailica�ion Imm I�e Ah Ouabiy Management Disinc�. flesitlential conStNction aOVlications ar¢ eremp� Irom �hese pravisions, . Daie: ApPIiWm: I nere�y certily Inat I navereatl Inis applicalion antl stalelnatine above inbrmalionis correct. I agree lo tomply witn allcity an0 county ortlinances antl s�ale laws rela�ing �o DutlOing conslmclion antl �ere6y aWhorize represemalives oi I�is ciry lo enter upon �he a6ove�mentionetl p�opeity 1m inSDe�tion po�poses. /� � / oaie: � � —30 _ 9Z ' Sigwm�e: /�+—/ /�% �YJ'�- �� ____— � orivcr's Licensc or Social Secunty a.� , 16aL<6 W�ne—Buileing: Green—Co�e EnlorcemenL Can9ry—/pplicant: Pink—Revenuv: GolOenrotl—Assessor CITY OF COSTA MESA - BUILDING PERMIT , PERMIT NO; H 060127 PLAN CHECR NO: N , , CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: ALT JOB DESCRIPTION ; REROOF WITH 'HOT MOP' SQ FT; 9,500 CLAIM VALUE; 9,500,00 CALC-VALUE; 4,500,00 GROUP OCC; B-2 / COMMENTS; THE "SHAW AND SON CONCRETE CO," �t�r**�r+r*�r��t�t*it�r�t*�r�t�r**********�tx�t+t�t*�t**�t******�t�t��t�*�r�t��t�it*�t�t�t*it*ic��rit*x��r�r�tit�ti��t�t*it+r* Z O N I N GS ERTEBQAUCIKRSE M E N T S , ------------ MAIN BUZLDING ---------- --------- ACCESSORY BUILDII3G --------- FRNT: F'T IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; � FT IN PARKING REQ• PROV; PARCEL: 92410204 ZNE; REF N�; /� PLANNING NOTES> i ���*��****�e**�*,r*�*�*�r,r���*��**,e**�*�r�+�*****��*****�e**�����,�*��+r*+���***���e�***�e D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E.N�Tr�$ ZONING APPROVED BY '� BUILDING APPROVED BY ; APPLICATION ISSUED BY; 1F�Fif1EiEMifiE1E1!!EMlf�f1ElEiFfflflEkiE . . ikMiF3Fff�lkif�lfikiFifiFiFiFifkiEiFiflElf�t�fififkif�fififiElFikiEikk�EifiFififikiEiFiFlE ik LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLOMHING ELECTRIC MECHANIC PERMIT 72,00 . , PLAN ISSUE FEE DATE: - `.•' DATE: +� > / %/ , DATE: +„/ .Y� � **�***+�**x�. +��r iF if klEff 1F 1!� iE iE 1E iF if iklf fF �k�iF if iF if if �f if iE iEiF iE �E iF STRUCTURP.L SEGMENT:Y FIRE •SMIP/FtES GRADING SMIP/NON-RES .95 BUILDING-DIV-> PERMIT TSSUE PLAN,-CHECK TOTAL PAID DUE TOTALS----> 72,95 0,00 � 0,00 72,95 72,95 .00 REVENUE D NISION TOTAI,S--> COLLECTED; 72,95 OVER/SHORT: ,00 BLD72P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOS GRADING PLAN-CHECK - �1 iE iE iF 1E 3ElE i! if 3E if 1F �F iE iF Y 1! iE if iE iE i! iF ik iE iEik if 1E 1E iE �E iF iFlE iE iE iE IE iF iE iF 1E jEif if iF 1k iF iE itjE ik k iE iE ik if i4 iElE iE ik �E iE �k iE ik iF iF 1f iE ik iF if ik iF �f iF iE 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� UNIT COST TOTAL COST SFC 4500 REROOF BY VALUE COMMEl2CIAL NOZONE 1,00 4,500.00 ' END OF FEES >' , �I,�I93 0 � - 1, � r � CONSTRUCTION AND PLANNING POOL �.,PA � APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2.. Soil Pipe-Undrgrnd; . � 53. Steel Reinforcement _�[ �. . � :3.�Electrical Conc}uit1C�tility-Undrgrnd. 54. Forms •'-4. E�ectrical Conduit-Undrgrnd. � 55. Electrical Bonding �' "':5.. $teel Reinforcemeni 56. Rough Plumbing & Pressure Test -�-'s•"ElectriwlUFERiG%nd. - 57. APPROVALTOCOVER-GUNITE � ' 7� Pootings V � y ;a, 58. Electrical Conduit�Undrgrnd. ' - 8. Foundation = �. 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. �� 10. Structurel Floor System 61. APPROVAL TO DECK 17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - ¢ 72. Sewer Cap � �;, . 63. �Heater�& Vent-Final ' � 73. Roof Orains '� 64. P�umbing System - Final 74. Rough Plumbi0g ` 65. Electrical-Final � 15. Rough E�ectrical-Conduit 66. Solar SVstem-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electri'ral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - - - rr:.�S•: .� •c ,:U 20" RouqKEactory Fireplace �� '� �!�' J 7 v'r x' �APpqDVAGS� % Pe7mit# " ;" r .c i I S'r' r.6 5 iy 7x w[' �N�- ✓ �� fS '� '. .• ; i . ' s ` i-. l �x . ^ �... - , • � .�: 21. D'ucts,�in Stcuct"ure • .... ,�,.; ,: g .-< �. -- 70..�Undergro'i.rnd Hydro < - 22.. Ducts,UenfllatCig� � �:5' ' i_ 't �" x% 71.'Produ��Eiping��as �Oil 2i3,'. Gas Pipe�Rough &;�est , `� � `� ` �' ` •� T � " `_ ` �r � ': �r � �� x x r � 72. Underground �u � ,_ -� 24': Roof Framing .:�' '-F �•�- x> ', ri•i %� 73j Undergrrid.Std{99P1`anIFOGas O�OiI x 25. RoofShEathin '`' S ''" ` ' �' `}" ` � �i��' ' 9. d v . 7�„Overhea�Hydro K 26: T-Bar Ceiling (Structural) &Monocoat r �f K 75 Dry Chemical •- _ �� . - ,- 27; Frame and _F�lasfnr3g °� z ,. �. �.` # 76.cDry Stan�p�pe_. � K S r -� J �+28� Lathing:&SidinQ=.. -�y:. � '� f 7T., FIXEDSIFBTE(vi�FINA'L _ ^ - 29. Insulatibn =, , = � '� * '� x �` - � '� � ... ,- x' -� . r c 7g; FIRE PREV. FINAL �.; � „ � 30. DrywaKNaiting� < � � ; �� ��` x " •- .HEALTM DEP�': REQUIR�EMENT � � .� 31. Plaster Brown Coat ,_ ��r;r, ;, ;2 79: FINAL IAISPECT�ON x" � ' 3�, Electrical Power'MetBrFinel� -. `i< •<:. 80:� FOOD CERTIF,ICP.TE ISSUED � , ^ ,; ,: �-• : x . , ;a = s •� _ 33t Finai Electr4c ,• . r <� ;� '. . • , ,� ; - f�otes: , _ = �; ., r.�� ,. , 34: Final Heating &iaf G�onditio_Riag �j � '� �. (y .. �� � E,� r ' - - /1/�- _ ' � L y � �S % r i ~', -_ % � i!v 3,rr,, Firral Gas Pipe-TEst , 36: Hood or Cano -" ' �' � ` � ` PY ^�] .: j c. z_ C?`. �7 r i 37. Finai Factory FireP�ce ;.' � 1 '✓/ .. r ;. `. ,� � 38. Fina� Plumbing # �i , I ��, x . � ; - .y , � 39. Water Service-Final � - "' ?' �� -' ` � ; � . r . z �� a' . cn � . 40. Gas Service=Final r .; � ,. ,. � ; ,,� �; '>` � �� . � ' ' • : 41. Solar pomesticFina6 � •• . � � � •� " -�LL - ' _ _ ,� m .� ' •. a; .r - 42: Backflow Preventer-' �" , � r , � ��! �' , . , 43. Backflow Irwgation� '��>> :• i •_ . � ' ' c z ^ + �� � 44. Landscape Itriqati.on System = T �r , r. � - - �. �- :c z; �� < � ._ ' ' 45' Sound Attenuation �l �� �� ' '`" - " - ' � '_' �-� i .. ' � n � f � � 46. Handica,p Regulations L �" � � _ � . _ ` ��� . -+- 47; FINAL STRUCTURE & BUILDING -%.� i � -"' .- i _ � � > i 48: FiNALPLANNING T`� � I L f• ` `r ` ' . ; 49: Electric•Release to Edison : `� � �r � • _ :� . - - - 50. Gas RetOase to So4them Catiifornia Gas Co'; � �!' ' Y` " -.' , . .�t� • _ 51. CERTIFICATE OF OCCUPANCY �,� x; „ a J.- ti : No. Date • ,� "TI�Fr�+G) �T�.VU �Y+ll. i��i�L��iJ ��J L F.. 1 � �/ �:G. � .�:ufi�:zc =.�.:t:iy d:,:,�."•*,_ �.`.C::u�:._ :CL !:.i.c'vP'f;n.:b � i. •...PIP.NNING DEPT. SlB1K� 'BLDO. DEP7. 0.EG IBY//!/�`�--- �ATEJ• -`S , � 01RECf0R� O� ��N�NG ���� _ .�.�.,..... ti r; / J _,_ ; � � � _, � . ,! -:- ... _ . : ..�_.—_ . _ ! ��.�a _{ �..��� I y �i ' ..............�..�i��.� 1 =�'����-4- =-- � ;� -.=.:��i�_-=_.�__-- , --�---= . ---- --- �� _a� -==�_—=,` % �.�m- _-u_.a��' .. 4 I II �i I � --- --. --. _ : !�-_-_=_—� t====-� �:_ � ,� , I - -_. . - ._,i�t--{ I;----- ,1--= �_-- i�.' `' .! �. - -- --- ...�-.�.a�.=,, ,_- _ ---- - _,!--- - --�--- —.-_I�===-�-.������.�-_--�----- - �� —,_. �:; ; - _ = __. , �-:,------- i �_�--� _ . _ .. . ; � -__----��--�---._.�,:. --_-:-�'_,----__ I� � 'l.f.i�4K[7[' �� � - t�li —.i._c_ _:... tr__=_c_cl '_" y_s _c— r' I � I '�'-- ► :�:__i�—�i f—C--1'—t�'�—� �"T�—?i i �_. ' � �,..� �� 1� Id Q 1 r LI �11 1 t�! � L�, �. : '(' I�� �2.-{_�:��u'� ✓�' . t �rl:. ^' �'' , ^_. -t"YP '' - - �- .� __�.._._...__...._ .... � - ._._-- STRUCTURAL APP�Q AL 0� —_.�-�-- SEPARATE PERMITS �R �BQN'RED FOR ELEC'i����t�'�- HEA7ING, \'ENTIL�TI4}G AND � REFRIGERATION WORK 'i �iQsi�i��9 ii All' TH�ALL INSPECTIOIVTRFQUESTSN �---�— FOZ BJ�LDiP:�S y'�y:. E P�ES�� fHATETOF BE EiBP��'(tD�.L1�QjNIA DIVISI�N STATE OF C' INO'JST3IAL Si+FETV BE CONSULTED FOR � ADDIiVONAI REQUIREMENT� 79P�cM� �`i �'lI�D.C. � ,th�:f�'NRi,�ir+. �q' N�6N vnanT�c.U. �y�j�,�,� DaYw1� fSoyRo o�l `—� ��4 vJe �vA�2e Nn;:, , �..�� �o� {„-..��-.��.... � i I -__-_ :, :, � � a f. Q.•,g t.l,i\1,'.!. lll:�l{ ':i1�7aC,� ��� v- DB i guild�^ . Go o es / �v C'RY °{ � �o�t �� � ,,,_...-.-.. MUSi gE �OUj P0.10R I3PQ�VPL � ,pES P�pNSnNGES V11SH p��p� CH pR PP KE N� �TtBE CON UE�1 Of �F.P�• �R �4pNt1N� �H YPl OF. AN`I V10���. pEF 5 �HE SS�CgyEGIFIGat1oNSRr4A� GpDE. �� PI0.�,j jxE �p BE A PETNE PF OVIS 0 a,�, TG �J101AVAL ��G���� SUMNN�OTO GIV TH ST �� E WNIGH� IB AIfTHOR12ES 1S PROVISIO NE WORS( Ofi BASED ��N1N� IC1P� FAF �'TMT o��SHPI� N1o1R N�EVNE�c�OR FROMnPND R� .Flc � _ iRum .... NS Ho� S BE1NE pA pF PNV IN SPID P OPERPTIONIS ��� gU1LDIN T10N �F �pF THE 1Tf. � I �/ '('� V �( ;.{L ;? F•�1 � � / r 1� 0 �. C3 E�:..�'. N/y � � �� I Pl,Q�S ��'.��i', � � � I � � _ _. _.. �: �+--__._—_.. :� - 2 � I : .� _� _oFFi4E I� _ . _..__�_ ._,-:- __-� _z ��i � '- E �, ; � � il" i! ; i � *�� �; I� I 3`xbsXi��' �3 z6x6SX����, '�5� ,p ��_,.. � C-ti!'1'�� / --'iT- h� � � " j.... �__.r..'� ,-- y. � t '- r_ F_ , ' - ` . . . ' �. . i' � , � � . � t . . ' .. . . . . � � � � � .�I� ��P � � V..��D . _��� a �,�� h �. .� t�� _ . . T ;. , •. n i SL � '� �' -} �.o-:;. ��'`� F-�` 'y, {� � p Crh� ?f CostQ Mesa Buildmg D`ep � * , � ' _•• �l, 3`n_t.fn`' }, f ♦ frt.�:�_ hil'I'{� ° __� Yf �`•.d�^. .t', j .' `'�',, �.. _ . . s,4 .� iyJ' a � A } . � .�"� .� '' � x 5 h "`� � ! ' / i � _ �•.: � 1"'v+�t t'b' � � tx �rf � $y $'�e� � �._ � ~ DAi �,C1019 �t. �. � i . i � 2 lrz �'� f : . � % .t..� 1 � � � �s .t _ y "� t . y y . . 1'> . . �' .. d �¢ ;l.ir ��4 � j F} i��S. rFt . .�i�-THESEk@lANS M(IST BE�.ON'�.:lfJB.AT�ALL 71ME5' � , ;. r.' � 'r,,••. / � N''`r. ` .y�`f ` � �.r' '��`E'°t��'CFIAt16f5 WIThIOIJTrPRIOR APPROYAL' � -�. .: � .. � �+-i /-5�� ' T - , te `� � ]+y -� .; Of�OEP,T.�iti. ., : i x�_ : F ' J I '�A� . Y �I � M { . l+�"�' lyj-, i. . I'y, �.� 4 ' .'.+ Y :� � �, . ) ., i�. 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'r.j,: �,,[ '� f�i!'at��t't'� i��^ v'A4�,.�r-��t, sr� r'i' `, ,.. } � yr.` � �r 1 f L3 { AJ �`1 r i, .' �4' �` i.:f f> •, tt.. �``� t {a �� 4���'� . � f. T . 1 m� j . ) ' ) . 1 J . 4 1: �I h � � `i `�f%,+� A I ' ��'�y� R`.��/f ,� `I I, . F � a ° + f�C � � � � r` � �`�.^y Y i yi(/� i. � . I �t�. �i3^1�Yii ?'y t�'�j`jM. � 1�' -i/ 1 � (/v{� t .. �E.Ai, x`.r.n-.,i � �F,,t '�< 'ji:�.3�- � ,' �� RR�G r �.' � � L _i'�-'L �< �� -.U�l �(%R(%� , ; , �n �?� ,4.,^if�-r,'VJ �-��I.�,yxx,''� rY�;. � ' ':?' f� '. Y F t ,, *_' '..t � . `i ',�".- ' �.. t kr . � i . � ?f „ J '�.,, � -y4 ' . . i ie� .l}• 1 J � : � I� :y ,. :c- � . M1.7, i r'.•4b- ��. ae.,.. ��. �. 3:2 .•,. �v--•' . 2 _ ' � , .� Y. . ' . . _ ' . . � �; � -�,: �r .� d5 .�_„- ' BuildinB Safety,Department F.o. 6ox 1200 CoSta Mesa, Celifarnie - .m:.� _ .. r:. CERTIFICATE OF OCCUPANCY L4.i.�-�v,'y+• . , � i�$15 T,heEB`uilding located at � � `:�� - �dF:".� �.�rt�l7 F �7C^J1.'F: � ' .. � ,a,x+ �^�,:,a:: � ��':Fias.been�inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto , �„� ' for,a Group T Occupancy. Use.of Building '�r:zt.:.n.Cr�irL1 ii�ii2.ciinr Legal Description � �� � ��.lr`9�,`?�.11—�"??: • (See reverse side for Metes and Bounds) :2''�:, ' Building Permit No �����y Electrical Permit No. �'���� Plumbing Permit No. Number of apartments � and/or guest rooms � ISSU ED T0: Building Official ' by }'. � a '�l-. r:.i�0l1.+ . • � � Date 'N'hhrh�nrv 7. 1 G, An This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE �removed except by tha Building Official of the City of Costa�Mesa undeF Sec. 306 (e) U.B.C. ' . �� Form BU 34 Rev. 11p0 � . . � � . . ' " --__ _1.'_ - , _ �Y s _ COSTA P.O. B 33555 For Applicant to Fill in �mpletely BUILDING (j� �b�'.(�-/�/'y ADDRESS 6 /Y / OWNEF Q. LJ � D/✓ S MAIL � Z ADDRESS sD Se r r a. W W TEL., a U CITY t Tp �NO 54.. NO. � z ODI�STRUCTION O � IENDER am J � BRAMCFf J N m J ADORESS J m ARCNITECT a OR ENGINEER U Q w � ADDRESS aW W Z CONTRACTOR J Q �m Z J � ADDRESS W W ZF CITV W � STATE y K LIC. NO. 7 � S12E OF I.OT 63 i! USE OF EXISTING BLOG. ,�e� t .'� TE NO. CITV UC. NO. NO. OF BLDGS. NOW ON LOT a',Go -�_'-�___.�"_ " ' ' _ ' � _ Pr.ir��� ��7.: . .� . �; . APPLICATION FOR BUILDING PERMIT :EIH D B DATE RECEIVED DATE ISSUED ,�:� ,� .� �-=»r ,� �-�, BUILDINf3 ADDRES: VALUE FIRE � ZONE �_� APPROVED NE NO.OF USE OF NF PLAPS�-- BUILDING VARDSAPPFOVED VARDS H SIZE OF NO. OF Z NEWBLOG. a-�� ROOMS S STORIES L.SIDE � FT. a EXTERIOR WALL ROOF R V COVERING C� COVERING �':d i�i F�A�i FT. J VSE OF BUILDING AND WORK TO BE PERFOFiMED DbTANCE BEf. a y nnnw s�ocs. Q � �� / VAR.�W � � Ccc. S�C.. O/ �y - c.u.v. � ~ A7PROVED N Z � ~ I �eraby acknowletlpe that 1 have raetl this eppiicailon and stnro HOLD FOR � that the ebova Informetion is corract antl oprea to comply with � ell laws regulatlnp bu(Itling conrtruction, antl I ihall not empioy F, eny person in violatlon of ihe workman's companution laws of DATE APPROVED � �� � 7 i y Me Staro o( Cali(omla. (/� -- m ? I haraby cartify that I em properly Ilcemed aa a contrector untlar Y n. FT. o ihe Stero of Celifornie Business antl Pro(anlona Cotle, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR C�apter 9, end t�at �uch licenses ara In /ull forca antl effoct, cr I iT1E PVRPOSE OF ESTABL6HING A PERMR FEE ONLV: Q em eKampt from tha provisions of Ne State oi California Builnau entl Professiona Cotle, Dlvislon 3, Chapter 9. VALUATION % /1 � � PERMR FEE S' ( ] Sipnet�re of �/ • �!� ' ~ m Permlttae «� /� s�� ^ �.^Or �V P�qN CHECK $ �+ � � E �J C `o Authorixetl ApenT J � J LL TOTAL FEE _' � '� 33972 COSTA MESA BUILDING-SAFETY DEPARTMENT " P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILOING G 7� 7. / i h��"y4 ww aV H � Z ON am J � J � QW mJ .� J Q U Q za aw W �J mz J p,' W w �� zr � � � z Q U J O. � � r � z 0 � U � � F N Z OWNER BPANCH ADDRESS ARCHITECT CONTRACTOR ADDRESS C�TY STATE LI0. NO. / SI2E OF LOT USE OF EXISTING BLDG. SIZEOF .�7L BVI TEL. NO. n�Cth-11�r�,���� �19'! o+.:.,�10C:,'i; APPLICATION FOR BUILDING PERMIT �E�IVpE�D�BV DATEq/�� EIVED D TEISSUI %Y.CT7f �i2 %h—%� ��/i _ A.P. NO. /� BUILDING ADDRESS � TiiACT TE L. l. N FIRE 20NE APPROVED BY �. �.r� e r. TEL. ZONE o ,' Na. M-1 .�/ , CITY �'Afl I LIC. NO. MAIN B NO. OF BIOGS. ( F ROM GL ��f r/ NOW ON LOT RONT i Z �O / NO.OF � /, ROOMS STORIES I L.S�DE ROOF � COVERING O REAR � WORK TO BE PERFORMED DI5fANCE BE MAIN BLDGS /" l, i_ i. VAR. vE I heraby acknowletl8e thet I he�e reatl this application and stete that Me ebo�e informetion is correct antl agrae io comply wlth all laws reBulating building construction, antl I shell not employ any permn in violallon of Me workman's compansatlon laws of i�e Statt of California. 1 he�eby cettity that I am property {icensetl as a cOntrnctor untlar [he State of Celifornle Business end Pro(ezsions Code, Divisicn 3, Chapter 9, antl that such licenses are in full forca antl effect, or I em Bzempt trom the provisions of the S[ate of California BUsineas ana Professb�s Cod/e,� Oivisian 3, CM1apcer 9. sie�ature ot // /�_ C Parmlttee ��Y��L Authorizetl Agant _ � �� 7 _ � I P�p� ,q W. 1%�' CP �-�0. S/o I LOT VALUE NO.OF USE OF NEW TANK`• 71AN5 � eU1LD1IJG ROVED VARDSAPPROVEO LDING CCESSOFV BUIIDIi BET. MAIN & ACCESS.BLD DATE APPFOVED m SQ, FT, O THE AMOUNTSHOWN UNDER VALUATION IS FOR ' THE PVRP06E OF ESTABLISHING A PERMIT FEE ONLY: a VALVATION � � PERMIT FEE $ D � 7 m $/w-11...� � � PLAN CHECK $ �� E / ��v�. � `o LL TOTAL FEE 3 O J' . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING O� /i �� / �T�S/• ADDRESS CJ J OWNER MAIL TEL. CITV NO. BRANCH ADDRESS ARCHITECT TEL. CONTRAC70R� 7r-��vyk'%T�/`�l'C-"%�5'"l�/. C_ ADDFESS I O I7 �`� / �� /� . TEL. CITV �[�'f/v(,'%O NO.SS'�� STATE n�� �y�� CITY LIC. NO���� � f � LIC NO. SI2E ` � NO.OF BLOGS. OF LOT I NOW ON LOT USE OF EXISTING BLDG. SIZE OF /�' NO. OF NEWBLDG. �DD �� ROOMS STORIE�� EMEFIOR WALL ROOF COVERING COVERlNG USE OF BUILDING AND WORK TO BE PEFFORMED I hareby acknowletlBe xhat I hava reatl this npp�icotion antl staca thot the ebove informatian is correct entl agrea ro comply wiffi oll taws regulaNng builtling consttuc�ion, antl I shnll not employ ony person in violotton of che workman's companse[ion lawz ot the State ot Celitomia. I hereby certify that I nm p�operly licens¢tl es a conirouo� untlw [he Stare of Calitornia Business antl Protessions Cotle, Divisicn 3, Chapter 9, and that such licenus are in tull force entl aftaci, or I am exempt from tha.provisions of th�ta?e of California Buzinesz antl Professionj�C'�tle�f��w$I 3, C epcer�9. //// � /� i. S(B�aNre ot ,/ ���i � n Q�'_v Permlttee �1 rl/ f (ii I ' AuthOrized Ageni n'C3n-7;vauOQ L5 ; � [hc• 71 [Jii:: fr!.� i APPLICATION FOR BUILDING PERMIT '�EI V DATE RECEIVED D E ISSUED / � /''7- 72 %7-7� T OWNER FIRE ZONE APPROVED ZONF/J� � NO.OF /�% PLANS i VAFDSAPPROV�D VAR. qW C.U.P. W+ OF vAR & u O� � b SQ. FT. O THE AMOUNT SHOWN VNDER VALUATION IS FOR � THE PURPpgE OF ESTABLISHING A PERMfT FEE ONLV: m Q VALUATION �� � � (%(J pERM1T FEE $ �" � m S5 �� P�p,N CHECK $ E 0 3� - " TOTAL FEE 5 � 7lJ COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant [o Fi// in Completely ADIDREf^S �� / LJ � � � S�� OWNEF Lv{- t�r u'F Crtrcf Sn�-W MAIL p � ADDRESS .'�..,p �.I TihGti.Al? — CITV �,� %' l/�... ' NOLSYb'c�'� C '�yi �% C0�1S�RUCTION LENDER �/�{i �/:. , � �. � BRANCH ADDRESS i CONTRqCTOR QW�J�Q j-- AODRESS Sf)/y,.G CITY STATE LIC. NO. C' (�' ��i <I / Y � SI2E OF LOT C� j.�' 3p D USE OF EXISTING BIOG. ,S%I r.� q { SIZE OF NO. OF NEW BL G. � 1 o ROOMS EXTERIQq WALL ROOF COVEFWG L�o N� COVERI USE OF BUILDING AND WORK TO BE _ i/���— .i.E.�'ri 6 2 70i CITV LIC. NO. INO.O LBF�DGS. NOW ON LOT IES � .+=H v JUL 31-73Pato002917� ***154.35 CNSA APPLICATION FOR BUILDING PERMIT BVILDING ADORESS FIRE ZONE APPROVE NE _ _ �fJO.�OF /1// / I PLANS ' .LL_L_I �'ARDS APPqOVED VAR. qW C.U.P.qW U USE OF N W BUILDIN A.D AA i r� ��� VAROSAPPROVED ACCESSORV BUILDING DATE APPPOVED I hereby acknowledpe that I have reatl this application antl state �—�� ��VVW �Nilf2l chat the Bbove informa[ion is correct end agree to comply wiM vu{�,$ all laws reBulating builGinB �onsttuction, antl I shall not employ � any parson in violation of ihe workmen's compansetion 1¢ws of Me Stoto ot Coli�omla. � � m I hereb certif thot I am SQ. FT. o V y p�op¢�ly litensetl as a cOrtt/ac[or untlet Me Stato ot Calitornie B�siness antl Professions Cotla, Divisicn 3, THE AMOUNT $NOWN UNDE V� ATION IS FOR ^ Chapter 9, and thar suc� licenses are In full forca entl aftect, or I THE PVRP06E OF ESTABLISMING A PERMR FEE ONLv: ¢ am axempt from tlie provisioos of Ne State of Celifornia Busineu VALVATION an0 Psolosslons Cocia, Di✓rsion 3, Chepter 9. � N PERMIT FEE $ ] Sienature �f�/� _% / / I (r(� ��j m PermittBn •�'�--� �>/ L� d �i1/ / $�O A A el P�p,N CHECK $ � E V / u-u•v �� � g Authoriiatl AOent LL TOTAI FEE $ . . _ :�7A34 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. 00X 1200 COSTA MESA, CAIIFORNIA 92626 For Applicant to Fill in Completely R PAID iAN 15-74����.00 544* u*���5.50 fOR BUILDING PERMIT �TE RECEIVED D TE ISSUE �/,'f% %/�_ OWNER �� S A.P.NO � MAIL BUILDING � Z ADDIiESS S I�-�C' ADDRESS 8 a U CITY 5 �� No � ya-Iw2 TRACT zZ Q CANSTRUCTION W A Q N LENDER /(%C^ am J � BFANCH J N OWNER m J ADDRESS m ARCHITECT �� NEL. _ S J N OR ENGINEER V Q FIFE w K ADDRESS ZONE T a w APPROVE w Z CONTRACTOR ' 0'� J Q m z J Q ADORESS W W EL. ZON NO.OF ZF CITY NO. P�� w � STATE CITV �'AFDS APPROVE� tnCL LIC. NO. LIC. NO. MAIN BUILDING �� SI2E NO.OF BLDGS. (FROM Ul STREET) OF LOT NOW ON LOT ROM FT. VSE OF �/ � � � � S EXIS�ING BLDG. H SIZE OF NO. OF Z NEWBLDG. ROOMS STORIES L.SID FT U EMERIOR WALL ROOF COVERING COVERING REAR F J USE QF BUILDING ANDnW ORK ZO BE PEPFORMED DISTANCE BET. a �(I LL /, ( � MAIN BLDGS. a Q VAR. 5W O _ C.U.P.sW 1 F • APPROVE / y Z O Vi heraby acknowled8e thet I �ave read this application antl state� � that Ne above information is correct and agree to comply with � el� laws reg�latlnB builtlinB �onstruction, an0 I shall not employ' F any person in violation Ot the workman'z Componzation lowa Of _ y Me State of Californla. Z 1 hereb ceriif thut 1 am SQ. FT. V y properly Iicenud as a cantractor untler�, tha Staro of Calitornie Businuzs antl Profeaiona Cotle, DWlsicn 3,^ THE AMOUNT SHO� . Chapter 9, antl thar sueh licenses ara in full force antl etfect, or I TME PURPOSE OF ES em ezempt from tFe provlsions of Ne $tata of Californla Bustnoss VALUATION antl Protassions Coa � Division 3, Chap[er 9. � Sipna[aroof ��j� �� Pnrmlttee § 6 % Auihorizatl ABent LOT BLOCK VALUE C6U l ' GROVP � DATE � ^� USE OF N BUILDIN � VARDS APPROVED ACCESSORV BUILDII BET. MAIN & ACCESS. BLd OATE APPROVED - m T� � 0 JN UNDER VA�VATION IS FOR j 'ABLISNING A PEFiMIT FEE ONLV: m a VERMIT FEE 5 �_ � � m PLAN CHECK $ E `o / LL TOTAL FEE '$ I