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Home My WebLink About378 18TH ST - Building PermitsCITY OF COSTA MESA O�pMFS,p -,'T.BUILDING DIVISION ' �� 14�� 77 PAIR DRIVE. COSTA MESA. CA 92626 •(774) 754-5273 • Fax (714) 754-4856 • w�.vw.ci.costa-mesa.ca.us � > FOR INSPECTIONS CALL: (714) 754-5626 4°�'" PERMIT NUMBER: 611-00198 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 1172912$ DATE ISSUED: 06/3012011 ISSUED BY: KJB JOB ADDRESS: 378 E 18TH ST CM Viciniry: Squares: 2200 Suite/Unit: Valuation: $5,465.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY. COVER WITH CLASS A COMP SHINGLES. ROOF PITCH IS 4:12. APPROX 2200 SQ Ff. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: ROMERO, RUBEN H TR PHONE: APPLICANT: TATENCO, ANGEL PHONE: 310-781-3012 CONTRACTOR: PACIFIC HOMEWORKS INC Address: 1602 LOCKNESS PLUnit: CitylState/Zip: TORRANCE, CA 90501 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund $0.00 $12525 $0.00 $1.00 Address: 378 E 18TH ST CirylState/Zip: COSTA MESA, CA Address: 20725 S WESTERN AVE CirylSfatelZip: TORRANCE, CA ' License No. License No. PHONE: License No. 784477 310-534•7033 CELL: PHONE: PHONE: Unit: Unit: HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3118I2010 - PER CMMC Set. 13-279 Monday thru Fritlay - 7:00 am thru 7:00 pm. Saturdays • 9:00 am thni 6:00 pm. Prohibitled all hours - Sundays and the following Federal New Years Day, Memorial Day, Intleoendence Dav. Labor Dav. Thanksqivino Dav and Christmas Dav NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1. 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In ortler for the work auihorized under this permit to be wnsidered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this pertnit. CODE p, INSPELTONTYYE 1676 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Firg Place 203 FinalSign 204 Final Dertrolition onh ixnnn�s X�-��-�� rnP� cooea 206 20B 210 n+svecnox rrre Final Mechanical Final Plumhing Final Electncal 212 Final Fire Prevention 220 FinalPianningApproval 222 Final Sile 250 Final Building/Occupancy on� ixnnn�s WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalry of perjury one of the follovnng declarations: ❑ I have and vrill maintain a certificate ol consent to self-Insure for vrorkers' compensation, as provided for by sectiqn 3700 of ihe Labor Code, lor the peAortnance of the work for which this permit is issued. ❑ I have antl v+ill maintain v.orkers' wmpensation insurance, as required by section 3700 of the Labor Cotle, lor the ppAortnance o( Itie v.ork fw which this pertnit is issued. My workers' compensation Insurance carrier and policy num6er are: (� . v Carrier. SY �`� � I�n. �'[h./"l P• ' (TnusManneednof0e�ca7npMteOltlreperm4�vy,5reyarwrenurdrMtlW.�rs(S100)aieul Policy Number. �� L�'C% K-� �(� QD � ❑ I certi(y that in Ihe peAortnance o( the work for which this pertnil is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cali(ornia, and agree that if I should become subject to the vrorkers' compengation provisions o( Section 3700 of the Labor Code, I sh ort t� comply with these provisions. 4 �'. 6 .� � AOOL nYs Sgnalure Dat WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IEC7 AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby aKrm thal I am Iicense0 under provisions of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business antl Professions Code. and my license�i7s in full�jforce and eHect. q, Lic. # < 8/ 7 Class # e�/ 3 � Gonvactw's �B��ure oaie CONSTRUCTION LENDING AGENCY: ❑ I hereby affum that [here is a construction lending agency for [he perfortnance of the xoAe fa vAiich IN5 pertriit is issued. (Sec. 3097, Civil Code�. lender's Name: Lentler's Address: SignaWre Oate OWNER-BUILDER DECLARATIONS: I he�eby aKrm lhal under penalty of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cale: Any city or county vmich requires a permit to Construct, alter, improve, demolish, or repair any slrucWre, prior to iIs issuance, also requires the apDlicant for such permil to file a signed statement that he or She is licensed pursuant to the provisions of Ihe ContraClors License Law (Chapter 9(commencing wi�h Section 7000) o! Division 3 of the Business and Professions Code) or thal he or she is ezempt theretrom antl the 6asis for the alleged exemption. Any violation of Seclion 7031.5 by any applicant lor a permit subjecls the applicant to a civil penalry of not more than fve hundred dollars ($500�.�: ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe structure is not inlended or offered for sale (Sec. 7044, Business and professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who tloes such work himself or herself or through his or her own employees, provided that suc� improvements are no1 intended or offered for sale. II, hovrever, the buildinq or improvemenl is sold within one year of wmpletion, the owner-builder will have lhe burden of pmving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business and Protessions Code: The wntractors license Law dces not appy to an ovmer ot pmpeny who builtls or improves mereon, and vmo contractslor such project vrith a cmtractor(s) license pursuanl lo the Contractds ticense laws.�. ❑ I am exempt under sec. Business antl Professions Code for this reason: Ovmer ID verifed by drive. .. �icense. ❑ Yes ❑ No Driver's License No. Expires: Verifcation of OwnerSl(ip by pype, o( documeN, i.e. - propeny Iax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby ceAify Ihat no excavation (rve (5) or more feet in depth into which a person is requiretl to descend, will be made in connection vrith work authomed by Ihis pertnit, and thal no DuilOing stnicture, scaffdtling, falsework, or demdition or dismantlinq thereof. will be more Ihan Ihiny-six (36) feel high. (Chap. 3.2, Grp 2. M 2, Sec. 341, Tille 8, Califomia Atlministrative Code). ❑ As owner-builder, I will nol empl0y anyone to do work which woultl require a permit from the Division of Industrial Safety, as noted above, unless such person has a permil to do such vrork from Ihe division. AO�liwm's Signnlure Dyte Division of Intlustrial Safety Permil Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicanl or present or future builtling occupant neetl to fle and certify a Business Plan (or emergency response to release or threatened rr,lease of a hazardous material? ❑ Yes ❑ No (Seclion 25505 of lhe Califomia Health antl Safety Cotle requires, wilh some exceptions, that a Business Plan be (led with the Costa Mesa Fire Department by every business which has at any one time tlunng a reporteC year a quantity of hazardous malerials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic leel of wmpressetl gas at standartl temperaNre and pressure�. 2. Does or will the applicant or present or luture building occupant need to file a registration fortn for acutely hazardous materials? ❑ Ves ❑ No (Sect"ron 25533 0� the Cali7omia Health arW Salety Code, vnth some exceptions, requires registretion with the Cosla Mesa Fire Department by each business which at any one time has on hand a quan[ity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume oi 55 gallons, or 200 cubic feel of compressed gas at standard temperature antl pressure). 3. Does or will the appliwnt or present or future building occupant need to prepare an RMPP (Risk Management anA Prevention Program for acutety hazartlous materials�? ❑ Ves ❑ No (Section 25534 of the Calitomia Health and Safery Cotle provides that the Costa Mesa Fire Department may require the preparation, certification antl filing with the Fire Depanment of an RMPP by businesses which are required lo register awtely hazardous matedals with the Fire Department. 4. I( an RMPP is presently requiretl, �as Section 25534 0l the Caiifomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or Oresent or fWure building occupaN require for the work which is Ihe subject of this application a permit for such wnstruction or motlification from the South Coast Air Quali�y Management DiSlrict or Irom any other air polNlion coMrol tlistrict or agency? � Yes ❑ No (Section 65850.2 of the Calilornia Government Code requires Ihat the requesled intortnation be lumishetl on applications lor non-residential builtling permits). 6. Will any patl o( Ihe (ociliry to be constructed untler ihis permit be vrithin 1000 feet from lhe outer boundaries ot a school7 ❑ Yes ❑ No (II "yes", lhe lacility musl meet Ihe requirement ol Sections 25534 antl 42303 of Ihe Calilornia Health and Salely Cotle�. 7. If a permit Irom the Soulh Coast Air Quality Management District or other air pollution control dislrict or agency is required for the work which is the subjecl ot this application, have all of the disclosures prescnbed by Cali(omia Health an0 Safety Code Seclion 42303 been made? ❑ Yes ❑ No 8. Qf yes", attach ceAificate of compliance from the appropriate air polWtion contml offcer). CERTIFICATE OF COMPLIANCE: I certify that under Oenalty of perjury the informa�ion given above is correct I agree to comply with all state laws antl city ordinances reqartling Hazardous Materials and Emissions. Signaiore Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry o! perjury thal I have read this aDP�ication and state that the information given is correct. I agree to wmply with ali state laws and ciry ortlinances relating to buil0ing consWction, antl authorize representatives o( the City of Costa Mesa to enter upon t�e above-0escribed property for inspection purposes. I a9ree not to occupy or allow occupancy of any buildin9 authonzed by this permil until final inspection. Signawre of L ai Owner(s) Ua�e Signalure Date �`�� 6 J � ]OS]<61y0]I MCIaAu�aiz pplit�ant Date C reaecTaooxess: j�� g 18TFi Si OWNEP'SNAMF: ROMERO� RUHL.N H A�OpESS: ROMERO, SARA:i H 378 E 18TH s'T CO:iTA ME.SA, CA '� ppCN/ENGINEEfl: S 4 8 9 6 6 9 FOONESS: UNIT: 92627 XFC,NO.: UNIT: PEflMITTEE: aooness: SARrlii H ROMERO ("114 ) 548-9669 �M 378 E 18TH ST (�n Q7 '7 LILENSEO CONTNACTOfl OECLAflATION: I hereGy a��irm Ihat I am li[ens¢0 WE¢TqtOviSiohSb��dp(er 9(tommenting wilh SeCilon 7000) ol Orvision 7 0� tne Business antl Pmles;ions COEe, antl my license is in lull �orce and efleci, CITY LIC.: STATE LIC.: CNSS: �ale'. Signalure: WOPNEPS' COMPENSATION UECIABATION; I hereby aftirm Ihat I have a cenificale of tonsent ta sell.insure or a certificate of workers' ComDe�salion Inswance, ar a ceniliea capy �n¢reof (Sectron 3800. 1a0. C�. POLICY NO.: E%P. DRTE: COMPANY: ❑ Ceniliea coDY is here�y Wmisnee. [] Cenilietl copy is filea vnth tne city BuilOinp Division. Dale: ApDlicane E%EMPTION FNOM WOflKEPS' COMPENSIITIDN pECtAfllITION: Rh6 secGon need irot 6e rompkteG i� ihe perm� 51a one AuMreO (5100) or less�. I tertily IMI in th¢ peAorma�rc¢ 0� t�e work lor wNch tNs permit ¢ i55ue0. I Shall n0i lmDloy any perspn in any maMer so as lo become su�ject lo ihe Workers' Compensation law; ol CaliPomia. Da�e: SignaNre: NOTICE: II, alter making �nis aeclaraiion, you shoulE Decome sublect to ine Workers' Comce�satian Owvisions of ihe LaUor Coae. you musl �onMnN rAmply wiln such W�3ion5 ar INs cermit shdll Oe aeemea revOkeO. CONSTPUCTION LENOING AGENCY: I her¢py altirm ttut Ihere ¢ a wnstmciion lentlinq apency lar Ihe petlormance ai ihe work for whiGh Ihis OClmii i5 issuetl �$¢Liion 3W7, �v, C). LENDEP: pOUHESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05239. PERMIT NO: B 052392 PLAN CHECK NO: U2066-91 S GOVT: N SUPP; N CONSTRUCTI013 TYPE: V—N PERMIT TYPE: STR PURPOSE: UTH JOB DESCRIPTION : CITY STll PATIO COVER SQ FT: 160. CLAIM VALUE: 450.00 CALC—VALUE: 2,208.UU GROUP OCC; M-1 / COM,NENTS: CITY STD PATIO COVER .1C.1e.X..IE.%.k i( iF �x� k iE�if �1(� ic �lE �� lf if �Y �k 1E if 1E if iE iE k 7c �ti #: iF'� �Y.� it iE��?:� iF if �if iF if If �1'r�K�tif it� j( �M iE iF iE X� �K�iE 3E lE iE iE iF ��3(� �Y� 3f dE �lf df iF �1(� d!� iE R�%�li iE dE iE 1` 'I. O N I N GS ERT�BQAUCIxRSE M E N T S ------------ MAIN BIIILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REi4R: 18 F'I' IN FRNT: FT IN REAR: FT tN I.EFi: FT IN AGHT: 24 FT IN LEFT: FT IN RGHT: Fi IN PARKTNG REQ• PROV: PARCEL: 11729128 ZNE: Ri REF NO: PLANNING NZ7T'ES> LATT,ICE PATIO COVER TO HE CONST. AT THE REi1R OF AN EX. > SINGLE FAMSLY RES, 310 S.F. REAR YD. COVER OK; 66 S,�F: PROY. �fE �f -%��le 3[� iE �lF iE if �k 3F �)f ��if * iE �dE �k iF-1E �lf IE 1E�lf �lf iE �lE 9F if � iE iE iF�Rir �)f 3E if iE �1f��lF �lE j(-�%�� iE iE �Y. if �7( iEiE i(-iF�� 1e�1t } iF �1F �X� if # iE �)f �7( {F iE Y�if �� le �iE iE �� iF-� �� D E V E L O P' N 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 HY . � DATE: - BUILDING APPROVED BY : DATE: APPLICATION ISSUED DATE:*!��{�� iC�j(�%iti(%�)F�1F�EiflEif��if�F3fi4 ' . .'�fif�MdfaE�K�%ifiE IF'1E �(� iE��df �% IF #�%�K•�lE if� •lE �1F �%��1C� �7E �K �if dE �1E If if �lE iE iF �lf if # dE �lf df # # .lE.1F.�.1E. .7E •lf lE.x"X �% JE i(• �R iE �lE �le �if 7F �lE iFif dE �%iE �lf �lf if X� iE �% �� lE iC �%�dE lE �1(� �N iF �le' �% iE �% LEGALIZATION:N £ E E S U M M A R Y 5TRUCTURAL SEGMENT:Y OWNEB BUILDEP �EUABRTIUN: 1 �ere0y allirm tlut I am exempt fmm tAe Caniractors' S�ate License �aw for iAe follovnnp reason . HI�DG PMT PLUMH IN�i EC 1 R IC MECHANIC FIRE S1�7IP /R E$ GRAD ING (Seclion 7031.5 Business antl Protessional Catle: Any city oi wunty whic� 2Quires a Oermii to constmct, alter, impmve, demolish, or reoair any simcmre, prior m its issuance, also reauires ine apo��ant lor sucn pe�mit to file a si0nea statement tAat Ae/she is licensetl P ERM I T S 4. 00 S 0, pursuam io tAe D�avisions ol i�e Comractors' State Lic¢nse Law (Ctwpter 9(wmmencinp vnt� Section 70W) ol 0ivision 3 of ihe Bus�ness SI�i T P/ NON—R ES antl Pmlessions Cotlel or tnai ne/she is eKemD� therelmm ana me uasis br Ine alle0ed exemo�ion. Any violalion ol Section 7031.5 by pLAN 3 5; 10 any aoo�icam mr a uermii suoieas tne aouiicant io a civu penatty o� not more man irve nunarea ed�are �5500). j SSUE FEE � i, as owner o� me o�openy or my em7ioyees x+tn wages as tneir mie compensation, win ao tne wark, antl ine BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID , DtJE ❑ smclwe is nat imenaeA or ofleree Iw sale (Secipn 70ad. Business and Profeuianal Cotla: The Conlrac�ars' State license �aw TOTAL S--- —> 5 4. 5 0 0, � 0 3 S. 1 � 8 9. 6 0 8 9. 6 0 . 0 0 • AoeS nol appty lo an Owner ol i O�Op¢riy wlro Ouiltls or impmves thereon. anG wh0 Aaes SucM1 work AimSeli/herseil or IhroupA Ilis or ner own employees. D��'^Oed t�at such im0�wemen45 are noi intenGeE or alhretl for ule. 11, Mwever I�e builtling or imOmvement is so10 vntlun one ywr al completion. t�e owner wi0 luve ��e Eurtl¢n oi provin0 ��e OW no� builA or impmve RE VENUE D I V I S ION TOTALS-- > COLLEC TED • 8 y, fi � OVER /SHORT • 0 0 mrmeo�rposeoisaie). BLDG PMT PLUMBING ELECTRIC MECHANIC FTRE SMIP/TOT GRADING PLAN—CAECK I, as awner al I�e pmpe�9, am exUuvvely comractinp vni� IicenseO wmraciors lo constmtt Ine O�oleci (Sectian 7044, Business 5 4. 0 0 . 5 0 . 3 5. 10 ❑ anA Prolessoos CaOe: The Contraqors State Liceree Law Gces not appy io an ovmer ol proper1y wAo hmlds ar improves Ihereon anUw�ocomractslar5uc�pwject5withacaniracto��s�liren5epurnuanitoiheConinclor¢'$�ateLicenSeLaw).lamaware ***�**��****��*�,**�.*�,�,*,�.�_K.;*,*�*,��*,**,x,�,*�,*�,*K,}..�,*�K.�**x.ti��***%***�**��,NiE�KM'�1'riPlf3fik Ihal 0�001 01 I�eir WOrkei 5 Compen5alion insurance 51wuIG Oe OmviAeO IO me. I am eKempl unGer Seciion: B. 8 P. C. I N D I V I D U A L F E E B R E A K D O W N Q ro/r.?m'reaso/n: A WORK4BY OWNER �� `3 �—� � TYPE QTY D E S C R I P T I O N -Oate;.CJ�G.! Al�� rNs>w Ownec F L_�—_ � I4o�ereUycenilythallamawareotanOunCerstanOlAerequiremenlsolCalilomiaHeallhanOSalelyCoaeSections25505,25533,an4 SFti 16� RES—VATIO COVER—POST 6 TRELLIS 2553a antl i�at I or any lumre builtling occupam will/will not (cirtle one) need m compty vnih said stale codes ane tne requiremenis lor a c.ND OF FEES permit br conslmction ot mo0ilicalion iram Ne Air Oualily Management OisVicl. Fesidenlial conslruclion ap0litations are exempt imm ��ese Dmvisions, . Daie: FpWkam: I heteUy rertity inat I nave reae ihis ao0��tian antl state ihai lne aGwe info�ma�ion 6 fArtett. 1 a0ree to wmpry wilh all city anU fAunty ortlinances and staie laws relating Io builCinq �p�tmciion ana OereOy aN�or¢e �epr¢Senia�ives ol tlti5 uty �o enier u0on the above-menlioneG pmperly lor inspeclio�nJDurposes /' /� Da�e: � // �/O $i0naiurel O � / � / / 16<Fa6 wm�e—Bmking: Green—CoEB Enlo¢ement Canary—AOV��t: Flnk—qevenue; GOMenroE—Aweswr UASIT COST TOTAL COST 13.R0 ' 2,206,OU •t CS �6L3454s—u�QE9`50 'F�:a?' "s%oc_ i;Aik: QolS3,'9: T?��: 1�:1� CONSTR`UCTION AND PLANNING POOL & SPA � APPROVALS Permit # Aate Inspector pppROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion 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 Co�duit-Undrgrnd. $, 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. Electriwl-Final 15. Fiough Electrical•Conduit 66. Solar System-Finai 16. Rough Electric Wiring 67. Fencing & Access ApProval 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 1g, Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Ro�gh Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure, 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test . 72. Underground Flush 2q, Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheaihing � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical Z7. Frame and Flashing Q.- �p.(,c� 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 76. FIRE PREV. FINAL 30. D�Ywal! Nailing HEALTN 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 Canopv 37. Final FactorV Fireplace � 38. final Plumbing ' . 39. Water Service�Final 40. Gas Service�Final 41. 5oiar pomesticFinal ' _ 42. 0ackflow Preventer . 43. 6ackftow Irrlgation 44. Landscape Irriqation System , 45. 5ound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING B�/6.,� �ly�L � 5'�� [ 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY � No. Date !, - . , -- � 6�46 COSTA MESA BUILDING DEPARTMENT � P.O.BOX 31] COSTA MESA. CALIFORNIA FOR ARCHITECT OR EP'^iNEER TO FILL IN COSTA MESA. CALIFORNIA �Ec�� LOT DESCNIPTION NO. A.P. NO. /I / SIZE / %) n��1 LIC. NO. 0 �BLOCK �TRACT --a9/ -�v %/1 J NO.OF BLOGS. � NOW ON LOT SETB/�CN IINE FXOM /-� / CENTEN Oi STREEi �/ U REAR YAR� ,; , �� SIDE YARD RIGHT �� ,� L'cFT � � DESCRIPTION OF WORK i i NEW ALTERATION qDO1TION REPAi.. MOVING DEMOLISH BUILDIIJG��GVU��"�W'�- NO.OF J SIZE V I` ROOMS STORIES / E%TERIOR WALLP�i� ROOF � ��,...,,�:,. ,r.... �, �� '�(`��D ry(��?�� /�� U'JJV C1 C:�iJ � APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY NECEIFT NO. PEFMIT NO � d �-�. eui�oirv y/y /� � . ADDRE55 � �V `l �� • COSTA MESA. CALIFORNIA ( p%�p� `/ DATE CORRECTIONS CITY OF COSTA MESA Pb.tl�4df�d6�EP'F. SUBJECT TO BLDG. DEPT. REG. �z ST1TE TN�T TNE �BOVE IS CORRECT �ND �GXEE TO COMPLV WITH ALL �� CITY ORpIN�NCE4 ANp STATE L�W$ REGUL�TING BUILDING CONSTRUC� 1iON. � , � VALUATION q �-' / � PERMiT FEE S p,L � SIGNATURE OF iw i�` � (��L� PERMITTEE ��i / $ lO S�� PLAN CHECK S I�� AUTHORIZEO AGENT / TOTAL FEE 8� � �'"� ,.-- `� • 04'7�36 ,,y' 11 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant [o Fill in Completely — Use Ink Only UI LDING ^'7 �� D�RESS / � � � Ty� � � �.�/'I WNER %(L/.� P_YI H' /� /: /Y7 P Y^ 6 MAIL — ADDRESS — CITY ( � } CANSTRUCTI( LENDER BFANCH O A S ARCHITECT F L � W a a � y S F C � F � '!S G1 � N � 7 �M A.P. _ � �� . _ nuiwirvu r. (• � ADDHESS �/ TEL y e � iP_ � 2 NO p-9�s TRi � W AC t � 1'.^ ' ��. /J_ OWNER L. v TEL. / SE C /O , ` /�/ ,( FIRE �, tj'it/N �' � ZpNE y� APPROVE �P.h . l�n /Yi ef"� av ADDFESSvj �T G . /(1 f�f4 _�Y/—� •- /)— /�� TEL ��J� CITY�� ll.lr � /r/('•C� CL NO�J": I STATE CITY LIC. NO. �� IIC. NO.�� 512E �� / (� NO.OFBLOGS OF LOT ^ n NOW ON LOT � USE OF J EXISTING BLOG. �pr./ r0 OYY1 Separate permi[s are required for elec[ric, plumbing and heating work. 8713 11/�9/78 60.50 TL�� ON FOR STRUCTURAL PERMIT "•?`.-' 8V OATE RECEIVE� ne o iccimn 20N NO.OF� PLAN$ VARDS APPROVED DISTANCE BET. MAIN BLOGS. VAR. aY+ 'J�_ PERMIT NO, BLOCK VALUE VSE OF NEW fiUILDING YARDS Ai DATE APPROVED �] �� % - I heraby acknowlatlpa thet I have reatl this eppllcoNon antl stato '^ that the ebove informatlon Is correct end apreo to comply with � m ell lews reBuletinp bulltling construction, and I shall not employ � any Detson In violetion af No�workmon's companaetion tews of m Me Stete af Californle. � - I haraby canify t�a[ I em proparly Ilcensatl ns e contreeior under SQ. FT. H Mo Smta of Celifornle Businass entl Prafasslona Cotle, Dlvision 3, TNE AMOVNT SHOWN UNDER VALUATION IS FOR m Chaptar 9, antl thai such Iicansas ore In full forco nntl attect, or 1 THE PURPO6E OF ESTABLISHING A PERMIT FEE ONLV: � am exempt from the provlalons of tha Stete of Cellfornia eusiness VALUATION 9 an Profasslo� d�lon 3, �hapter// I B_ PERMIT FEE S a m / // (�'�/ %/ (/ PLANCHECK S .� ^� natura of L/ I lyy,� p � � mlttea^�I Il7- ^�•••��ti $ OOp TA% s LL E u Authorized Agent TOTAL Pq10 5