HomeMy WebLinkAbout941 JUNIPERO DR - Building Permits_ � • � . ,
r . ,�
f .� CITY OF COSTA MESA
BUILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714j 754-5273 • Fax (714) 754-4856 • w.vw.ci.costa-mesa.ca.0
�, FOR INSPECTIONS CALL: (714) 754-5626 �
�.�o'�
PERMIT NUMBER: E08-00218
PERMIT TYPE ELEC
APN: 14132304
STATUS: ISSUED
DATE ISSUED: 06/19/2008
- �SSUED BY: RMD
JOB ADDRESS: 941 JUNIPERO DR CM Suite/Unit: "
vicinity: - ' � � ' _ , . - � _
SCOPE OF WORK: ELECTRICAL PERMIT TO UPGRADE SERVICE PANEL TO 200A, SAME LOCATION�.(REAR OF HOUSE).
OWNER: HAMMON, JOAN '
PHONE:
i„
APPLICANT: HAMMON, JOAN ,', , ,
PHONE: 949-395-6830
CONTRACTOR: OW NER-BUILDER
Address: Unit: � � - PHONE:
City/State: ' , ZipCode:
ELECTRICA� PERMIT FEES
Electrical Plan Check Fee:
Electrical Permit Fee:
Reinspection Fee
TOTALFEES
Address: 2900 INDIAN OAKS DR Unit: -
City/State2ip: � LINCOLN,:CA •, � "
� �- Address: 2900 INDIAN OAKS DR UnitC-
Ciry/State/zZip; LINCOLN, CA - - � .
License No. 000000
CELL:
$0.00
$54.00
$0.00
$54.00
NOTICE: The work authonzed by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92) '
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODEI, iHsrecnoxm� pn.E innm�s cooet iNsaecnoxrvre �o� ixnnus
1876 Fixed System Final Fire Prevention 206 Final Mechanical
7286 Pool SOa Final 208 Final Plumbing � �
200 Final Re-Rop( 210 Final Elettnwl i7/�. ���' U
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site �
204 Final Demolition 250 Final Building/Occupancy
, �
Z
WORK6P,S' COMPENSATION DECLARATION. .
I hereby aNirm under penalty of perjury one of Ne following declarations: ,,
� I have and will maintain a certifcate of consent to self-Insure for workers'
compensation, as pmvltled for by section 3700 ot the Labor Code, for the
peAormance of the work for which this permit is issued.
❑ I have and will maintain wnrkers' compensation insurdnce, as required by
section 3700 of the Labor Cotle, (or the pertormance of the wurk (or which Ihis
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carriec
(T�is sedqn neM ipl fRCwnpleled L t�e pMn4 is valuM at me �undred �llars (E1001 o/Ie55 )
Policy Number: _
�'I certify that in Ihe peAormance of the work for which this permit is
issuetl, I shall not employ any person in any manner so as to become subjecl
lo the workers' compensation laws of California, and agree that i( I should
heco subjecl to the �+'orkers' compensa[ion provisions o( Section 3700 0!
[he or Cotle, I sl I�orthwith comply with these provisions. /%�`
�'!'l�F " U
Apqicanfs SlBnalure 1
W NING: FAILURE 70 SECURE WORKERS' COMPEN TION COVERAGE
IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVI4 FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDfTION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 0( the Business and Professions Code, and
my license is in full forGe and eNect.
�Ljd,# � � Class #
Conlraclor5 SignaWre Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn thal there is a cons[ruction lentling agency (or Ihe
peAormance of the �noAc fa wtiich ihis pertnit is issued. (Sec. 3097, Civil Code).
Lender'S Name:
Lender's Address:
$ign9lure D21e
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalry o( perjury that I am E%EMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pro(essi0ns Code: Any ciry or county which requires a permit to
construct, alter, improve. demolis�, or repair any structure, prior to its
issuance, also requires �he apPliwnt for such pertnit to file a signetl statement
that he or she is licensed pursuant to the provisions of lhe Contrecbrs
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Code) or that he or she is exempt there(rom antl
the basis (or the alleged exemption. Any violation of Section 7031.5 by any
applicaN tor a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of Ihe p�opetly, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, antl the structure is not intended or
oftered for sale (Sec. 7a14, Business and Professions Cotle: The Contractors
License Law tloes not apply to an owner o( pmperty who builds or improves
thereon, and�who does such vrork himself or herself or thmugh his or her ovm
employees, provided tnat such improvements are not intentled or oHered for
sale. I/, however, ihe building or impmvement is sold within one year of
completion, the owner-builder will have the burden of proving lhat he�or she
tlid not build or improve �or purpose of sale.). .
LI I. as ovmer ot Ihs property, am EXClUS1YE�Y CONTRACTING WITH
- IJCENSED CONTRACYORS to construd the project (Sec. 7044, Business and
Professions Code: The contractors License Law dces not apply to an ovmer of
property who builds or improves Ihereon, and who cont2cts for such project with
a coniractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt unAer sec.
Business an0 Professions Code for Ihis reason:�
�g���/ ��
Oate
0051 (3/0]) '
. _ ,
Ovmer ID verified by dri icen`se. � Yes ❑ No �,,, �ti.
Driver's License No. �� � Expires: ✓� B
Veri(wtion of Ownership by (lype of document, i.e. - property tax II or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby certify �hat no excavation fve (5) or more (ee� in tlepth into which a
person is required to descefW, will be made in conneciion wilh worh authorized
by this permit, and Ihal no builtling slrucNre, scaf(dtling, (alsework, a demolition
or tlismantling thereof, will be more ihan lhirty-siz (36) feet high. (Chap. 3.2, Grp
2. Art 2. Sec. 341, Title 8, Califomia Administrative Code).
❑ As ovmer-builder, I will not employ anyone lo do work which would
require a permit lrom the Division of Industrial Safery, as no�ed abo�e, unless
such person has a permit to do such work fmm the division.
AOPliram's SignaWre
Division o! Indus�rial Safely Permil Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre building occupant need to fle and
certify a Business Plan �or emergency response to release or threatenetl
release o( a hazardous matenal? ❑ Yes ❑ No
(Section 25505 0( the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed wilh the Costa Mesa Fire
Deparlment by every business which has at any one lime during a reported
year a quantity of hazardous materials equal to or greater t�an a weig�t of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will Ihe applicanl or present or (uture building occupant need b(le
a registration tortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Satery Code, wilh some
exceptions, requires registration wiN the Costa Mesa Fire Depariment by
each business v+hich at any one time has on hantl a quantity of acutely
hazardous materials equal to or grealer Ihan a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet o( compressed gas at stantlard
temperature and pressure).
3. Does or will the applicant or present or (uNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous matenals)? � Yes ❑ No
(Section 25534 of �he Cali(omia Health and Safety Code provitles lhat the
Costa Mesa Fire Department may require the preparation, cenifiration antl
filing vrith the Fire Department of an RMPP by businesses which are requireG
to register acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Sa(ety Cotle been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require !or
the vrork which is Ihe subject of Ihis application a permit (or such construclion
or modification (rom the South Coas� Air �uality Management District or from
any other air polNtion control tlisMct or agency? ❑ Yes ❑ No
(Seclion 65850.2 of the Califomia Govemment Code requires lhat the requestetl
intortnation be tumishetl on applications fa rron-resitlential builtling permits).
6. Will any part of the facility to be constructed untler Ihis permit be within
1000 teet from the outer boundanes of a school? ❑ Yes ❑ No
(If "yes", the facility mus[ meet Ihe requirement of Sec�ion5 25534 and 42303
of the Califomia Health antl Safery Code).
7. If a permit from the Soulh Coast Air Quality Management'District or other
air polWtion control dislrict or agency is requiretl for ihe work which is the
subject of this application, have all of the disclosures prescribed by California
Health antl Safety Code Seclion 42303 been made? ❑ Yes ❑ No
8. (If yes'. attach certifcaie of wmpliance from the appropnate air pollution
control oKcer). , ' � - -
CERTIFICATE OF COMPLIANCE: I.certify that under penally�of perjury lhe
information given above is correcl I agree to comply with all state lavrs and
city ortlinances regarding Hazartlous Materials and Emissions.
SignaWre Date �
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury Ihat I have read Nis application and sWte that
the information given is correct. I agree to wmply with all state laws and ciry
ordinances relating to building construction, and authonze representalives ot
the City o( Costa Mesa to enter upon the above-descnbetl pmperty for
inspecti purposes. I agree not lo occupy or allow occupancy of any building
authori bythi �i���in inspection. ��
SignaWreo(Leg�qs) a 9
MClor AutM1onzetl Appl�ran� Dale
ADDRESSOFBUILqNG: J
OVMEfl 5 NMIE IF ppWN: HAM
�ooness: 216
APPI. WUIJN. IipD11E55:
4HCNRECT OXFNC�MEEN:
IICN.OH EN6'S AWRESS:
CONffllGiql'SN�IIE:
cwrn�ctoxs uuuxc
ADDFE55:
JUNIPERO DR
NO JOAN F
E bCEAN HLVD
A,CA
UNT:
92661
uc. ea:
UNT:
11C. ND:
UNT:
LICENSED COHTPACTOPS DECLAXATION: I Mreby eflsm under paneYy d pe�ury thel I em IiceneeE uMm yovieions ai Chepter 9
�wmmee�iq wilh Saction J000) of Dmabn 3 d Ure Buai�was arM Pm/essims CoEe, enE my liceme o in tull lau vd eXee.
cm uc. xo.: uc. cuss: uc. No.: EXP :
Dele�. COMreaor:
OWNEN BUILOER DECIAflATION: I hereby alfirtn under pmety d perNry ihei l em ezemq Imn IM Cantradan Licenae law la dw
folbwmB ��s^^ (�ion ]O�t.5 Busiress enE PMmsione Code: Any cYy ar munty xfiirA repuirae e partnn to cpnwci, el�ar, imprwa,
demolah, or reper eny simnure, pnor l0 8e eeuerce, eko requiree Iha eppliranl Im such permil to file e egneE atelement Ihet M or ehe
iicenaed punuenl lo iM Oransiom o/ Ihe Contrepore Liceroe Lew �Chepler 9(mmmeinnB �h Saann ]OW) d �Mcian 3 M the
iinec aM Prdeaiau CoEej a �hei M a she e exemq �haehwn eM �he bme iw ihe dlepeE e�emqion. My v'detion of Sedion
,J1.5 by enY rod�t Iw a qrtnn wbjeae IM applieanl �o a mil penelly d m� mae then IWe hueMied ddlen �550011�
❑ I, m ow+wr d �he propany a my empbyaee wlh wapes av ihev wle compansetion, will do tha wwk, end tha ewciure'v rwi inierMed
a dlered br ula (Seciion 10ad, Busimss end Prolassiona Coda: The Cantruvore License Lew tloae ml epptyloen ownerol D��M
wM10 W2Ez or inprwea ihareon, eM x1w doea euc� work M1imseM or Mne1 w Ihrough he a Mr own em0loyeae, provided tMt euch
impvaemenie ere na intaMeE a Wxed tw aeb. tl. lwwmar. the buiNiiq a inqwemeM ia edd Mithin me Y� d mmpbiion. Ne
X ownar-0uika� xill heve �M buNen d qoviep M or sM Ek �wl W ik a im0� fw tM WR�a d aele). .
� I. as oxmer d ihe properly, em axdueivay comrectirp �mh licenead coniredae b conelrua �ha o�l� (Seclion )Oa4, Buainme enJ
Professioro Coda: The Conlredon Licensa lew does � eppty to en owner d qoparly who Witle w'unpovm ihmeon aM who
wnvecte I« wtli qqeaa wnh e mnlmdor(e) Icenaetl punueM b tM Cantrmare lioense lewl.
� I em ezemq uMar Seclion: B. 8 P.C., for t reeun:
o�. G— s-Qc, o,�, �ti..� 1�.�..-..-.r
I Eo M1eraby eMify ihe� I em ewere d ud undeesteM �he mquirem t Celioma MeeXh vd Sefery Code Seeiom T5505, 25SU, uM
25534, enE Ihel I or eny lNure buiMirq o¢upem vnll / wtl nd (oic ) med lo wmpty wYh eaid qete codes eM Ihe req�iremeMe M
epaimnlorwnniiuctionormoCiXfalionhwnlhaA'M�ep IDislnd.ReviEeMialmnMiuc1bnep0��s�exemptirom�hese
Dete: Applicaril:
WOflKEfl'S COMFENSATION DECURATION: I Mreby etFrm uMer peneM1y M pe�ury wr d the /ollowinp daderetbna:
� I heve eM wit meimein e cenBicme d mneem m eeX�nwm for warken' compensetion, u prmbdetl Iw Ey SeUbn 9100 d Ihe Lebar
COM. fa IM perlormeMe d ihe xoM1 lor xtic� thia pertnn is inued.
� I liew arM wil meinten wrkers rompenee�bn inaurerka, m mQuireE by Swbn 3]UO d Ihe lebor COAe, br the peiformarae d the
work iw which ihie parmii ia ivued. My wakeri mmpanselion ineurence umer eM paliry n�mber va:
c�.�:
Pdiry Number:
, senion neee � be romaerea i me w�A;s ro. a�e nund.ed duners Isiool w kas.l
V I cerlty Ihe� in Ihe perlormance d tM woM for whkh ihia peimn is iawd, I e1Wl � empby eny persan in eny menner eo n ta
becoma wbM io iM warkers' comG+�amion lawe d cm�nmb. e ec� imm � i.nwa ��ewa �o m. wa�•
�re��� o��,e a sea� a�oo a me �eor coea. i�i � wan oomar wnn mya._ p�o�;,oti. f
o�a: �i � ST � f b nvd��c �Q�►It�nw�.�
W�m/np: Fellun ro�xun worteri mn�oxwtlon cov�r�ys b unl mtl �NII �u6/K� � MW�oyer ro ctlMm/ pmeNu erM
c/N/ nroa up ro wro h�ntlrsd MouunE Oolkn (Sloqao0/. In eM/ M� coat o/ compmuHon, Wm�ps� u proHdsE br /n
Sxf/on J]O6 0l Ms LWor COM, lnrorost, eMaflamey i/ns.
CONSTFUCTION LENDINO AOENC�: I Mreby eXirm under penelry W pa�INry �hat �Aere is e conel�udion Iendin0 epenry lar �M
perlarmeMe d Ihe xwk la whitl� the perm� ia'snuad (Sedion 3091, CN. C).
LENDEF'S NAME:
LENDEP'S �OOPE55:
1 ceniy ihet I heve reed �hv epd��im uM nete �he� the ebove inl«melion ia mrtea. I eqree to mmpN �h ell dry end munry oNinenme
eM eiele levn nWiq to WJdmp consuWion eM Mreby eulhwize represanieiivea ol ihb tllyb enler upon iM abova�mentionad propeiry
�«��'°°°�°°°"`0°'°�JOAN F. HAMMONO
Dem: � �� p�
/\ (5151-16.WP) WhBe-Build'vq 8 Selery; Greeo-Fle; Cenery-App[rani: Pink-Rewnue; Gddenrod-Aaseeeor
CITY OF COSTA MESA — DUILDING PERMIT
PERM NO: B 078002
PERMIT NO: B 078002 PLAN CFIECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/O SHING/SHAKE ROOF 6 REROOF W/COMPO SQ FT: 4,500
CLAIM VALUE: 4,500.00 CALC—VALUE: 4,500.00 GROUP OCC: R-3 /U-1
COMMENTS: TEAR OFF EXISTING ROOF REPLACE W/NEW COMPO ROOFING
*�*����*x it�**�t�it�t*x ic *+��itiE*�***+��*ir� x iE*it**��***atiex �******�*x �***�***+e***at**�*at��
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 BUZLDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGAT: FT IN
PARKING REQ: � PROV: PARCEL: 14132304 ZNE: REF NO: ,,�
PLANNING NOTES>' �
i
jE iElE iE if iE iE ik if--IF 1f iE ik 1E �ElF�IE iE iE iE iElE 1E iE if iE iE 1E 1f 1E iE iE if 1E if 1E if * 1f ik if iE iE if 1E iE iE if if iElE 1E 3f iE iElE')E �E IE iF 1E 1E iE 1E if if dE 3E aE fElE 1E �E iE iE 1E if if iE
D E V E lL 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 APPROVED BY : DATE;
APPLICATION ISSUED BY: DATE: ((�
iEiFiEiEiEiEiEx��t**iE*iEiE"iEiEiE**iEiE iF'iF'iF7F '�iF'iF7F iF TF 3f3F3FiF 7€iFif3FTFiF�FiE*�-�*�FiE*iE�E�FiF '. iEiE
LEGALIZATION:N F E E S U M� STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 99.75 50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 100.25 0.00 0,00 100,25 100.25 .00
AEVENUE DIVISION TOTALS--> COLLECTED: 100.25 OVER/SHORT; .00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
99.75 .50
!E 3f iE iE iF ik iE iE jF if iF 1f !E iE iF iE if IE if iE iE iE iE iE iF iE iF iE iE * iE ih Ik iE if ik iE 3E iE iE IE fE fE iE �E �E iE 1E iE iE iE iFlE �E �E IE 3E �E iE aE iE 1E iE iE 1E iE iE iE 1E 1Elf 9ElE 3E 3E 3E if if if
I N D Z V I D 0 A L F E E H 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
SFR 4500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,500.00
END OF FEES
��, �r. . , , -, - -- . . .
�` � ,. �� . ., . i�: .
.-'� � -
CONS7RUCTION ANDPIANNING POOI 'A
APPROVALS Permit # Date inspector qppROVALS Permit # Date inspector
1. Temporary Electrical Service or Po1e 52. Poot & Equipment Location � -- .
2. Soii Pipe-Undrgrnd. � 53. Steel Reinforcement •
3. Electrical Conduit Uiility-Undrgmd. 54. Forms
4. Electrical ConduibUndrgmd. 55. Electrical Bonding
� 5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Electricai UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footin9s 58. Electrical Conduii�Unclrgrnd. �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. "� 60. Backwash �ines, P-Trap,'�7 Urdrgrnd.
70. Structu�al Floor System 61. APPROVAL TO DECK
i t. Property Sewer Line & House Connection - 62. Backwash & Receptor�Final '
12. Sewer Cap 63. Heater & VenFEinal
13. Roof Oreins 64. Plumbing System - Finai �
14. Rough Plumbing ' 65. Electrical�Final .
15. Rough Electrical-Conduit � 66. Solar SVstem-Final .
16. Aough Eiectric Wiring 67. Fencing & Access ApP�oval -
57. Rough Wiring Sign 68. APPROVED FOR PLASTEflING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heaiing & Afr Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPt30VALS . Permit #
21. puc:s, in Svucture , �� 70. Underground Hydro
22.Ducts,Veniilating - �� � 71.ProductPipingCGas ❑Oil
23. Gas PiPe•Raugh & Tesx � -, 72. Under9round Fiush � - .
24. Roof Framing 73. Undergrnd.StorageTanl� OGas ❑Oil
25. Roo4 Sheathing , �-�-C�6 �G�/ 74. Overhead Hydro
26. T-Ba. Ceiti�g (Structura�) & Monocoat 75. Dry Chemical �
27. Frame and Flashing�. _ 76. Dry Standpipe -
28. Lathing&Siding � �' �_ 77, FIXED SYSTEM FINA�
29. Insulation . � . � 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTN DEPT,.REQUIREMENT
31. Plaster Brown Coat �' 79. FiNAL 1NSPECTtON
32. �Electr�cal Power MeterFinal 80. FOOD CERTIFICATE ISSUED '
33. Finat Electric- � ,�_ Notes: �
34. Final Heating & Air Conditioning �� . ' ^ �
35. Finai Gas Pipe-Test • " ",`' ' .
36. Hood or Canopy , � � -
37. FinaiPaMoryFireplace' ' . �� .
38. FinaF Plumbing � . _
39. Water Service-Final � ',� - ' -
40. GasService-final � �
41. Solar PomesticFinai , .
42. Backfiow Preventer � �
43. Backflow Irrigation . �
44. Landscape Irrigation SYstem - � - ' �' .
45. Sound Attenuation , • . -
46. Handicap Regutations - -� � � - .
47. FWAL STRUCTURE & BUILDING L 1(�� :%�
Y :
48. F.INAL PIANNING
49. Electric Release to Edison , , _
50. Gas Release 2o Southern California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
• �u�ti�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOl( 9f7 COBTA MEBA. GALIFORNIA
For ApplJcanf fo Fill In Complefiely
TYPE OR PRINT
BUILDING �.. . _ ' _ _ _ _ ..—'_"_
COSTA MESA. CALIFORNIA
� MAIL
� ARCHITEGT
an Corona del Mar
STATE � TEL.
IIC. NO. " NO.
SIZE .�„/ . �.. �
34220
NO. OP BLD08.
86TBACR 1JNH PRON / �
ceNTeR OP BiReET REAR YARD
i/ �
SIDE YAR� I LEF7' S RIGHT S
DESCRIPTION OF WORK
� BUILDING
IROOF
e COVEI
WORK TO I
�n� REC�i"��.t�
'd' DEC 9 1980 "'
� FINANCE DEPT.
Lo t 3�, �� q�✓ �3Y �1�.iA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. MleIT NO8
�uLR'/:..� Y
NECEIV D!Y DA RE VE OATE 185UED
�-� � /•�'�—�� �nFc� n �9�
11LDING
)DRESS OG7 .h,ni�re Drivn
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
ZONING .��, -0�_
ZONE NO.OPn USE OF NEW n y
R�� IPLANSG IBUILDING W/ BtU gAT•
LEOAL ./ . � .�1 L �� i.n
LIN6 8TJ
APPROVED
O
�
� HEREBY.AENNOW�OO THAT 1 XAVB RHAD HI9 �PPLIGTION THE �MOUM eHOWN IINDER VALUATION IS FOR THE
AND BTA{L�THAT TXE A OVH 18 CONRECT A AGREB TO COM- pURPOBE OF 66TABL19HING A PERMIT FEE ONLY.
PLY WITH ALL CITY OF �N NCEB AN 9TAT lAWB fi¢�ULJRING
Bu1t�INo coNei�ucil� VALUATION
BIGNATURE OF �'/ � PERMIT FEE $ 3�• D D
PERMITTE ,� "`"`�-' . n
\ $ J�� �3 O. O O PLAN CHECK $ I7. U O
ALJTHORIZED AGENT I s I. O a o
TOTAL FEE 4