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HomeMy WebLinkAbout3314 MARYLAND CIR - Building Permits�� � �3 �`�� / �����.���� � � �wny�+c, rv15, y ��,.J, C, � ��aQosecQ �o� In�qln WOoc� �.vUl1-- e � JobAddress: 3H'I4 MARYLANDCI Suite No vicinity: Parcel Nunmber: 13961148 Applicant: LITTLEFIELD, SCOTT Address: 24707 SAN FERNANDO RD SANTA CLARITA, CA Owner: DREW, RENDELL E Address � 3314 MARYLAND CIR COSTA MESA, CA �XpZg,�� - �6 DgS£ Phone: 888-611-4328 Zip: 91321 Phone: Zip: 92626-2020 Contractor: AFFORDABLE WATER HEATERS AND PLUMBING Aiidress: 24707 SAN FERNANDO RD � SANTA CLARITA, CA WATER HEATER CHANGE OUT ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor . Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceplors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 � Phone: 661-259-7131 Zip: 91321 . License: 627368 SCOPE OF PERMIT FEE SUMMARY , • ," -AMT � � LaundryTub/Washer _.$0.00 . 0 Landscape Irrigation $0.00 0 P-Trap $0.00 � 0� Pressure Regulator $0.00 - 0 - Process Piping (per 10 ft) $0.00 0 ,. Receptors - . . $0.00 0 Septic Tank $0.00 0 � Sewer Cap for Demo $0.00 0 Sewer Connect � $0.00 0 Sewer Private Line . -- $0.00 0 Shower $0.00 0 Sink, bar . � � � $0.00 0 Sink, commercial $0.00 0 Sink,Floor $0.00- - 0 Sink, kitchen $0.00 0 Sink, service/mop � $0.00 0� � Spa (private) . $0.00 0 Spa (public) � $0.00 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 03/13/2007 Issued: 03/13/2007 ��%� _ ISSUED BY: v �' SumpPump Swimming Pool Trap Primer Urinal - Vacuum Brkr Bktlow(1-0) - Vacuum Brkr Bk(low(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Insl or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION . PLAN CHECK REINSPECTION , " TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 so.00 $0.00 50.00 $0.00 $0.00 $0.00 E35.so QN 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal. such work must comply with all applicable codes, antl all required Inspections and finel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 eaaaaa �ww� WORKERS' COMPENSATION DECLARATION: I hereby aHirtn untler penalty of perjury one of the tollowing declarations: ❑ I have and will meintain a cenifiwte ot �nsent b self-Insure for workers' compensatlon, es provitled br by section 3700 of ihe Lebor Code, for Ihe pertormance of ihe lwork far which this permit is issued. ' ��.I have and wiil maintain workers' compensation insurance, as required by sec�ion 3700 of Iha Labor Code, tor the peAormence oi the work for which NIs partnit is issued. My workers' com nsatio� Insurance Garner en0 policy number are: �Q-n�� Policy�Number. ��Io�Q lr_P�Or} not 6e comp/etetl i! the pe�it is veluetl at one hundretl tlollars ($f 00) or IessJ ❑ I certity ihat in the performance of ihe work for which this pertnit is issued, I shall not employ eny person in any manner so es to become subject to Ihe workars' compensation laws of Califomia, antl agree that if I shoul0 become sublect b the workers' compensetlon provisions of Section 3700 of the Labor Cotle, I shell forthwith comply with thesa provisions. ` D Applicant SignatuTe:��� (—� �- -L � --"':Date:--- � - � 3 '� �) � WFFNING: FAILURE TO SECURE4YORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIES ANDCIVIL FINES UP TOONE MUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO TME COST OF CAMPENSATION, OAMAGES AS PiiOVIDED FOR IN SECTION 3]O60i THE LABOR CODE, IfJrEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby attirm,ihah m�licensed under provisic force and eHect.:Lic. k. �nr�l � �n � ;, CONSTRUCTION LENDING AGENCY: of Chapter 9(commenr.ing with Section 7000) oi Division 3 of ihe:Business ena Professions Cotle, end my license Is In full � Class'q C 31e � �:oate 3- i 3 - �"7 ❑ I hereby aflirm ihat there is a cons(ructlon lending agency tor �he peAormance of ihe work for which t�is permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lenders Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aflirtn that untler penalry of perjury thet I am E%EMPT FpOM THE CON7RACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Busine5s and Professlons Cotle: Any ciry or counry which requires a pp�mit to construct, alter, improve, demolish, or repair any siructure, pnor to its issuance, also requires Ihe applicant for such permit to file a signed statement that he or she is liGensed pursuant to the pmvisions ol tha Contrectors llcense Law (Chapter 9(commencing with Sectlon 7000) of Divislon 3 of the Business and Protessions Coda) or ihet he P� she is exempt Iherefrom anA ihe basis tor ihe ellegetl exemption. Any violation oi Sectlon 7031.5 Dy eny applicant far e permit subjects the applicanl to a civil penelty of nol more than tive hundred dollars ($500).): � ❑ 1, as ownar of the proparty, or my amployeas with wages as thair sole wmpensation, Wlll 00 TNE WaRK, afW the structure Is not Intended or oHeretl tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves Iheraon, and who tloes such work himself or herself or ihrough his or her own employees, providad ihat such improvements ere nm Intended or oflered for sale. Ii, howaver, ihe builtlinq or improvement is sold within ona year of completion, ihe owner-builtler will have ihe burden ot proving ihat he or she did not build or improve for purpose of sale.). ' ❑ I, as ownar of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to �:onstruct the project (Sec. 7040, Business and Proteuions Cotle: The contractors Licensa Lew tloes not epply to an owner of property who builds or Improves iherean, and who contracis tor such project with a contrecior(s) license pursuant to ihe Conirectors Licanse Laws.). ❑ I am exempt untler sec. Signature: Owner ID verifietl by tlnvers license. ❑ Yes ❑ No eusiness and Professions Code for this reeson: Venfication of Ownership by (type of document, i.e. - property tex bill or deetl): Drivefs License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby certity ihat no excavation five (5) or more teet in depth imo which a parson is required to descenq will De matle in connection with work authorized by this pertnit, and ihat no builtling sirudure, s�holding, talsework, or tlemolition or dismantling thereoi, will be more than ihirty-six (36) feet high. (Chep. 3.2, Gry 2, Art 2, Sec. 341, Title 8, Califomia AOministretive Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit irom the Division of Industnel Sefety, as nated above, unless 5uch person has e pertnit to do such work from Ihe division. Signawre: Date: Division of Indusirial Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty of perjury that I have read ihis application and state that the infortnation given is wrrect I agree to comply with all state laws and city ordinances relating to buiiding consimction, and authodze representatives of the Ciry ol Casta Mese to enter upon the above-descnbed propeAy for inspection purposes. I agree not to occupy or ellow occupancy of eny building eulhonzed by this permit until tinal inspection. AndlOr COUE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 . Finel Re-Roof 201 Final BIocWRetaining Wall 202 Final Fec�ory Fire Place 203 Final Sign 204 Final Demolition ps¢, �[{jjjJ�� CODEt INSPECTI�NTYPE 206 Finel M<ichanicel 208 Final Phimbing 210 finel Elodrical 212 Flnel Flre Prevention 220 Final Pl:mninq Appraval 222 250 Final Site Finel Building/Occupancy D�TE It�ELfl ;' August 31, 2009 Rendell e. Drew CITY OF COSTA MESA P.O- BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-12�0 DEVELOPMENTSERVICES DEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION 3314 Maryland Circle Costa Mesa, CA 92626 PERMIT NUMBERS: PROJECT FOR: P07-00148 3314 Maryland CI., Costa Mesa, CA Water Heater Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of the last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on September 11, 2009. Additional fees will be required to finalize expired permits. Requestinq an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requestinq an extension -If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records affecting your property is matfer. Sincerely, �� �Barbara J, wart Office Specialist II our goal and we appreciate your working with us to resolve this cc: Affordable Water Heaters & Plumbing 8uilding Division (714) 754-5273 • Code En(orcemen� (714) 754-5623 • Planning Dwision (714) 754-5245 FN%f"l�41754-4856 • T�Df7141754-5244 • www.ci.GOs�a-mesaca.Us Pfl01kCT PDUPESS: 3 j 1 4 MARYI,AND C I aWNEfl'SNAME: RESECK, JOHN :IR aooeess: MATTOS MARLEEN M 33I4 M�RYLAND CSR COSTA MESA,CA 92626 ABCHIENGINEEP: p00flES5: NEG.NO.: UNIT: UNIT: PEPMITTEE: BI.UE PACIFIC CON1'RAC1'ING ( 714 ) 735-3244 ADDPESS: SOI� MEADQWVIEW CORONA CA 91719 LICENSED WNTFACTOfl OECLAPATION: I �ereby al�irm tha� I am licensetl unCer pmvisions ol Chapler 9(commencing with Section 7000) ot �iv�si n J ol i� Business antl Pmiessions CoCe, antl y license is in full iorce and effect. ciTv uc.: 3 9 3_ 9 srare uc.: 4 6 9� c�ass: B Oate: Signa�u WOBRE ' COMP SpTION OECLANpTION: I hereby aflirm I�al I have a cetlilica�e oi consent �o sell-insure or a cehificale ol Workers Compen ation In rance. ar a ceriified copy �hereoi (Sec�lon 3804 Lab. L). � POIICY NO.: E%P. ORTE: COMPRNY: 7 Cetlifietl capy is here6y �urnished. ❑ Ceni�ietl copy is IileA wi�h ihe ciry Builtling Division. Daie: AD�licant: E%EMPTIONFH MWOFREPS'LOMPENSpTIONOECIAflATION: (ThissedionneeOnolhecomple�eOiftAepermitis�oronehundre0(8100)orless�. I ceriily Iha� i the petl mance oi �he woB br which Ihis permi� is i uetl, I shall not employ any person in any mannef so as to become subjeci lo 1 Worker Compensation Laws ot Califomia. Oate: SignaWre: NO CE: IL �er making Ihis tleclara�ion, you shoultl become sub�ect to ��e Workers' C�mpensapon promsi C e. you us� brthwi�h comply wi�� such pmvisions or �his permi� shall he aeemed revoked. CONSTflUCTION LENOING ACENCY: I hereby aflum Ihai there is a constNctmn lending agenty for ��e p¢rlormance af the work �or w�ich Ihis permil is issuetl (Semion 3097, Crv. C�. lENOEN: nooxess: OWNEB BUILDEN UECIAPFTION: I hereby a��irm that I am exempl iwm I�e Comrac�ors' $tate License Law �ar Ihe following reason �Seclion 703L5 Business antl Pmlessional Code'. Any ci�y oi counry which repuires a permi� lo cons�mc�, al�er, impmve, tlemolish, ar reDair any stmclu�e. prior to iis issuance. also repuir¢s the aDDlicant �or such permil to lile a signetl sia�ement tha� hrJshe is licensetl pur5uani m �he pmvisions ol the Contractors' Stale License Law (C�aO�e� 9lcommencing wi�� Section 7000) of �ivision 3 0� �he Business an0 Pmfessions Code) orihal he/she is exemvt therelmm and ine basis for ine allegetl exemption Any violation ot Section 703L5 by any applicani �or a permit suble��s the apPlicant to a civil penatly oi no� more �han �ive huntlre0 tlollars (5500�. I. as owner ot Ihe O�oOerty or my employees wi�� wages as their sole compensa�ion, vnll tlo the wark, and Ihe ❑ 5�mciure is not inlen0e0 or o�feretl for sale (Sec�ion 7044, Business and Pmfessional Cotle: The Contractors' S�a�e License Law aoes not appty �a an owner o� a pmpe�y w�o �uilds or impmves �hereon, antl who aoes such work himself/hersel� or I�rough �is or her own employees, provided tha� such impmvemenis are not in�entletl or oRe�eO for sale. I�, however the builtling or impmvement is soltl wilhin one year ol comple�ion. �Ire owner wili �ave the �urAen oi pmving he/she Eitl no� builtl or impmve � for tne Durpose ol sale�. I, as ownerof the property, am exdusively canVac�ing with licensed conlrac�ors �a conSVuct ihe pmlect (Sec�ion 704d, Busine55 ❑ antl Pm�essions Cotle: The Conlrac�ors' Sta�e License Law tloes not apOty to an owner of property who huilAs or impmves [hereon antl who coniracls lor such pmjecls with a contrac�oqs�license pursuant�o Ihe Contrac�ol5' 3tate License Law). I am aware Ihai pmo� ol their Worker's ComDensaiion insurance shaultl Le D�ovidetl Io me. � I am exempl untler Section: B. & P, C. tor t�is reason: Dale'. Ownec I Oo hereby cenily Ihal I am aware oi and untlerstana Ihe requiremen�s of Calilomia Heallh an� Sate�y Cotle Sec�ions 25505, 25533, and 2553G and ihal l oi any fulure building occupant wilVwill not �circle one) neeU to compty wA� sai0 state cotles antl ihe repuiremenis for a permi� lor conslm[lion or motlilica�ion �mm �he Air Oualiry Managemeni DiSUicL Fesitlenlial constmc�ion appficalions are exempi fmm Ihese provisions. Oate: Npplicant: I hereCy cerlilylhail have reaA lhis apP�iCaliOn antl Slaie Natth¢ a0ove ortlmances a tl siate la� s relating to buildmg consimction antl h 6y aNh pro0erty br mspeclio purposes. Oate: Signalure. Sociai5ecuriiya� ma�ion is cor2cl. I agree to tompty wilh all ciry anA county represen�atives af �his ciry io en�er u0on lhe above-mentionetl 1fiat�A6 W�ite—Bmltlina: Green—CoOe Eniorcemen�; Canarv—AoolicanL Pmk—Revenoe: Goldenrotl—qssasmr CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; B 055965 PLAN CHECK NO; N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR C� . • SU ,, PURPOSE; ALT JOB DESCRIPTION ; REROOF W/ COMP OI WOQD SHINGLES SQ FT: 2,500 CLAIM VALUE: 2,500,00 CALC—VALUE: 2,500.00 GROi7P OCC: R-3 / COMMENTS: SMOKE DETECTOR(S) RE�UIRED IN HOME 3EiFiEiE3E�ElE1EiE�F�IE3fiElEiEiEiFiEiEjEjEiF3E1E3ENN�iE3Eif� 1EiE�lhiEjf�tikiF�IE±EiFifiF3E1FfE3fif3E3FlE#N�iE3k3FiEiEiEaFiFifiF3fiElEiflE#iE3FifiFiE�EiFiEi£ Z O N I N G R E Q U Z R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BdILDING --------- FRNT; FT ZN REAR; FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT ZN RGHT; FT IN PAR3(ING REp • PROV; FARCEL; 13961199 ZNE; REF NO; PLANNZNG Ni5'PES> ! 1f if IF � 3E iF �1F if jF IF 3E'lE 3f iE 3E 1f� ie iF 1F jE if �lE iF 3F iE IE iF�lf iE �1F if 3E iE iE iE 3E if !k iF iF iE dt 3! if 3k iE 161E iF iE if IElF'�k1E-0F �7F if iE 3f 3E if if if i(� iE iE iF iE iE-%iE if �lc # 3f # if iE 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 20NING APPROVED BY ._ DATE; ". BUILDING APPROVED BY ; APPLICATION ISSUED �-Yc L ���s k jE iE if iF # if iFiE iF i(� 3E-!t iE iF iF k IE �iFi�`�F3FiF iE 9E iE iE 1E iE �1F iF 1E iF # iE iE 1E iE if if iE i(�!(� �E IE If � IE IE �E 1E !F 1l� 9f �!E if� If� LEGALIZATZON:N F E E: BLDG PMT PI,UMBING ELE PERMIT 54,00 PLAN / ISS[JE FEE _ DATE; �a � DATE- p'/Z Z �3Fi€iEikiEiFiEiEiE1EiE�E �� iF3FiEiF iF iF iE if )f 3E if 1E �lf if �IE lE 1E 3E if 1f iE �It�lE iE IF it ie 3f jf # 1E i( iE iE iFiF ic i(• if 3(� if if iP� iE 3E 0 M M A A Y STRUCTURAL SEGMnNT;Y C MECHANIC FIRE SMIP/RES'' GRAIJII3G ;p.� SMIP/2JUN-RES ��. BUILDSNG—DIV—> PERMIT ISSUE PLAN—CHECI( T01'AL PAID • DUE TOTALS----> 59,50 0,00 0.00 59,50 54,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 59,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING,P'LAN—CHECR 54.00 .50 '-�� iE if iE af if iF if 1E if 3E iE 3F iF 3E iEif 1F iE iE iE iE jE 3E iE iE �E �F iE 3E af iE iE iE if 1E iE 1E iE iE iE ik iF iE k if if �E 3E #F iF if if iE iE iE IF 3E iE iE fE 3E±� 1E 3E jF 1E if 36 iEjF iF if� !F 3E iF if 3E iE if I N D I V I D U A L F E E H R E A K D O W N �� TYPE QTY ll E S C R I P T I O 13 SFR ?500 REROOF BY VALUE RESIDENTIAL N020NE END OF FEES 7/l3l�i �� C UNIT COST 1,00 "1 :::L. i. T�: L. �OTAL COST ��, "2,5��,�� � ♦ . I CONSTRUCTION ANDPLANNING • POO SPA � '-� APPROVALS Permit # Date Inspector pppROVA�S Permit # Date Inspector . . t. Temporary Electrical Service o/ Pole �- � 52. Pool & Eq�ipment Location - 2. Soil Pipe�Undrgmd. -' . 53. Steel FeinForcement 3. Electrical Conduit Utitity-Undfgrnd. 54. Forms -' 4. Electrical Conduit-Undrgrnd. 55. Electrical I3onding 5�. Steel Reinforcement 56. Rough Plu�bing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVP,L TO COVER�GUNITE 7. Footings 58. Electrical (:onduit-Undrgrnd. 8. FoundatiDn "� 59. Gas Pipe, C7 Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash ;.ines, P�Trap, O Undrgmd. tQ. Structural Fioor SVstem 6l. APPROVA�TOOECK i t. Property Sewer Line & House Connection 62. Backwash !� fleceptor�Final 72. Sewer Cap 63. Heater & Vent-Final ' - 13. Roof Drains 64. Plumbing :,ystem - Final 14. Rough Plumbing 65. Electrical-F'inal 75. Rough Electrical•Condu�t 66. Solar System•Final 76. Rough Electric Wiring 1 67. Fencinq & Access ApProval 77. Rough Wirin9 Sign ' � 68. APPROVE� FOR PLASTERING 78. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT ` 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product PiFing �Gas ❑Oil 23. Gas Pipe�Rough & 7est 72. Undergrour�.d Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing ' 74. Overhead Hydro 26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical � 27. Frame and Flashing _ 76. Dry Standp pe 28. Lathing & Siding 77. FIXED SY;STEM FINAL ' � 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing HF:ALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INS'ECTION 32. Electrical Power MeterFinal 80. FOOD CER'TIFICATE ISSUED 33. Finai Electric Notes: 34. Final Heating & Air Conditioning 35. Finat Gas P�Pe�Test 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plumhing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestirFinal 42. Backflow Preventer , : 43. Backflow Irriqation 44. Landscape Irrigation System - � 45. Sound Attenuation 46. Handicap Regulations 47�. FINALSTRUCTURE&BUILDING ��_� Z %r�Aj- l'i. _����-�-4=G-�4'` `�'-� � YC�..-� �d 46. FINALPLANNING -. 49. Etectric Pe{eate to Editon � 50. Gas Release to Southem California Gas Co � � 51. CEFTIFICATE OF OCCUPANCY No. Date Cl.i OF COSTA MESA REQUEST FOR OCCUreNCY TRACT N0. Z IAT N0. % � nnD�SS��'� 14— �%iL,�ii �%..�c � ��. DATE 2- 2 ^�� The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undexsigned by reason of the afotementioned uncompleted condition. BY BY Developer and/or representative BY Lender G OWNER o. LOT 21 TRACT 65t32 FIRE INSPECTIONS SOIL GAS WATER ROUGH PLUMBING PROP. $WR. LINE ��HOUSE CON. SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEATING AN� AIR CONOITIONING TEMPORARY SERV�CE OR POl.E UNOERGRDUND � POWER � ROUGH WIRING TRENCHES FORMS STEEL REINF. FLOOR SYSTEM BOND 6EAM n STEEL REINFORCE ❑ SHEATHING FRAME ANO FLASNING LATHING - IN PL Z, BROWN COA 5T1. .URAL, FINAL HEATING, VENT., REFI PLUMBING, FINAL AN[ ELECTRIC, FINFL DATE 7 SUBCONTRACTOR PERMIT N0. Z . d U Z ZQ O c~ii am J � J N 0] J J m U N Z� aw W Z J Q m Z J � W w O= Z � w � �o � z Q U J a a Q O F N z 0 � V � � � N Z 9� COSTq MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 Pnto ` JUL 20-71�M;f,001 *>'* 152.2� APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVE�BV' DATERECEIVE D lSSUEO BUILDING ay� ��Z ^ � �/CZ"7 ADORESS � / P O. OWNER Modula,r Technology� IT1C. A.P.NO. MAI L I� BUIIDING AODRESS 1104 E' , 17th Street p.DDRE55 g nd Circle cirv Santa Ana No`. 54 - 6 TRACT 6582 �or 21 a�ocK CANSTRUC7�ON W AO A ft P LEN�EF X BRANCH OWNER ADDRESS L(�� // VALU v• ARCHITECT TEI.� SE Residen.ee/ � (. $ OR ENGIN ER Kermit DOT'lUS N — . �/ FIRE ADDFESS 3111 2nd Ave. Corona Del Mar ZONE TVPE GROUP APPROVED CONTRACTOR Owner BV DA7E ' ADOftESS S2Al2 � TEL. ZO NO.OF USE OF NEW CITY S1TR2 NO. PLANS �� BUILDING STATE CITV �ARDSAPPROVED VARDSAPPR VED ���. No. 252549 LIQ NO. 16 O MAIN @UILDING ACCESSORV BUILDING � S12E NO.OF BLDGS. (FROM GL ST�.ETI OF LOT O X ZOO NOW ON LOT FFONT - FT. � FT. USE OF � EXISTING9LDG. SI �S FT. FT. SIZE OF NO.OF NEWBLO(3. 1 8`z F ROOMS STOFIES L.SIDE FT. FT. EXTEFIOR W L ROOF /� COVERING�er P13T1S COVERING Wood Shin 12 REAR `�' FT. FT. USE OF BUILDING AND WOIiK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDC'8. ACCESS. BLDGS. VAR.# OATE �" � Construct new residence with attached c.u.P.� ��-0—(�� APPROVED S—ur�q APPROVE� � / �'�'� �'Y� I hereby acknowledge that � have reatl this application and staie „pLD FOR SPECIF L REQUIREMENTS that ffie above information is correct and agree m<omply wiih � all laws rggulating builtling consVuction, antl I shall not employ c.� � any persoh in violation of the workman's compenzatiOn laws ot J the State of Califomia. � �]/} m 1 hereby certity that I am properlY licensetl as a contractar under � SQ. FT. /✓ o the State ot California eusinass antl Protessions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR � Chapter 9, and that such licenses ara In full force antl effect, or I THE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLY: � am exempt from the pro isjons ot the Scate ot California eusiness V ALUATI ON O/ S� antl Professions Cotle, vi fon 3, Ch pter . PERMIT FEE $/ � � �� � ] Signature of m Permittee $ �� PLAN CHECK $ D� —� E e i ���/ /��.�5 0 � I" � .. LL Authorizetl A ant TOTAL FEE $