The URL can be used to link to this page

Home My WebLink About3412 MEADOW BROOK - Building Permits� � CITY OF COSTA MESA � � B!/ILDING pIY1S10N ` � _ � DEVELOPMENT SERVICES DEPARTMENT y$-00561 �•w PERMIT EFiM1T NUMBER "^�aw�m � . (774) 754-5273 • Fax (714) 7543&56 pLUMBING PERMIT n FAIR DRIVE, CASTA MESA, CA 92626 JobAddress: 3412 MEADOW BROOK Suite No Vicinity: Parcel Nunmber. 93506028 App��cant: NOCK, RON Address: ' Status: ISSUED � Applled: 07I07/1998 Issued: 07l0711998 , , Phone:_ - __ - _ . , _ %r> . Zip: � -" � ;`! � /��/j'� �- � , ' � , ' /� �, � - ' _ / , Owner: PHILLIBS; EL"IZABETH J � � ' �� ,/ � � � � �; : _ Address °hDELLA-3ANTA, MELBA'_ - � - : . . - � � � �- " " �A � � � DECLA-SANTA, MELBA LOUISE � '"� Phone: � � � , ,� � � � � � � �� ;LOUISE \`��;�:.�:�- Zip: 92708 �.�� - � �\,\ �� .,�%��=' �:� `� � �� nv� � � i" ii��/ ` \ � � ��_ Contractor.!' NOCK�P,LIJMBING : � � �y i, - r, v„ /' '�o= . - Address:�' �11872 KNOTT ST ,9, ��A . � < Y ,- ' . ��; ° �; j� ;i Phone: s'714 895-1246 ; - � ,, � �...GARDEN GROVE . CA � ' Zip:- '92841 . . ' . .. ' �,i � �.Llcense:� 707775 � - i -� �. " - i� _� �:,• ,-, � '�. � �; �,� 1 i � � ,� � - - � �ArchlEng� � � � -- - - _` . c� , _ �� Address: ' , ,��,- '' i , ; '-�A : . ��/ �..� Phone: � j - � , -,'.� ..,\ _ _ - ZiP�.,�r;�`��./,� , - � � . ,( ',�' `Cicense:. ,'c, , < � . .. -..,p-,_ , . .. . �t' , � ,,SCOPE OF PERMIT ;� � 'z - '. � INST W.H. � , . . .�- �..� � -._ r cl., II ,1: , ♦ . "' ___ .--. - _.' .y' � � -. t� � FEE SUMMARY/ �� ., � `�. AMT OTY 'AMT i QTY ISSUE FEE �. � �522.00 , Laundry Tub / Washer � $0.00 � - 0 Backflow imgation � �.$0.00 0 Landscape Irrigation 50.00 0 Backflow�Preventer $0,00 0 � P-Trap � $0.00 0 Bathtub .�� . � 50.00 �, 0 Pressure Regulatoi -��50.00 0 Clarifier System� E0.00; �,, 0 Process Piping (per 10 R) - E0:00 0 Connect (�ce,Soda,etc) - -�50.00 ��`��0„ Receptors '�' ,, \„ �, � r , 30.00 -, 0 Dental Units \ . �� $0.00 A'0� �' � Seplic Tank , � - �50.00- • --0 � � Dishwasher - � $0.00 � �0 ,�, ��, �. Sewer Cap-for Demo', '�, � $0.00, ; a0' . orain,Floor $O.oO �>o �� :-.SewerConnect ., "� ,� $0.00 ��'0� Drein, Rainwater 50.00 �j0� �- Sewer Private'Une �- � 30.00 0� Drain, Roof $0.00 � � '0 � �Shower `= � ��_ " , , _$0.00 0 - Drinking Fountain 50.00 '� 0= �`� Sink, bar - � 50.00 � 0 Expansion Tank $0.00 :.. 0 � ; � � - Sink, wmmercial 80.00 � , 0 Gas Earthquake Valve $0.00 �, �0� � ��, Sink, Floor,- � � �, � $0.00 - 0 Gas (7-a outlets) 50.00 �'-_0- 'Sink, kitchen � � SO.W � 0�- Gas (Over 4 outlets) $0.00 D . - Sink, seriice/mop '�. �. . $0.00 0 . Gas Repipe $0.00 0 .� Spa{pnvate) � . . � 50.00 � 0� ' Gas Service $0.00 0 Spa (public) .- . 50.00 0 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 ,� AMT, Sump Pump ; � ' $0.00' Swimming Pool� -. , $0.00 Trap Primer�� " ' .50.00 Urinal _�%,,'/ � -�� ' $0.00 VacuumBrkrBk9ow(7-0) %;: $0.00 Vacuum Brkr BkFlow(5+) - 50.00 � 'Wesh Basin ' ' $0.00 ��Wash Basin Sgt � � ' $0.00 - = � Waste anil vent System� $0.00 � - � ,Water Closet (Toilet)� E0.0o , ' Wate� Heater / vent $11.00 � Water�Piping (Inst or Rep.) $0.00 Water Re•pipe $0.00 Water Service $0.00 � � � Water Softener 50.00 � OTHER $0.00 " � VIOLATION 30.00 PLAN CHECK $0.00 REINSPECTION 50.00 COMMENTS / SPECIAL CONDITIONS TOTALCALCULATEDFEES: $33.00 : ��- D . �X�' �, o0 va'f` - aN 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 EXPIRATION: This permit shall automaticaity e�ire and become void it work is not commenced within 180 days, or if vrork is suspended or abandoned for e perlod of 180 days. INSPEC710NS: In order for the work aulhorized under this permit to be considered legel, such work must comply with all applicable codes, end all requlred Inapeetlone en0 flnal approval must be obtalned. Feilure to obtein inspeclions and final approval wiil result in the expiration of ihls permlt. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSATION DECLARATION: — —' I �ereby eMirtn under penelry of perJury one at Ihe tdlowing tledarations: ❑ I have end will melntein e certilicate o1 consent to selt-Insure for workera' compensation, es provi0ed for by sectlon 3700 of t�e Lebor Code, for Ne peAortnence of Ihe `vroAc for w�ich this permit Is IssueO. �J I heve entl will maintein workers' compensetlon insurence, es requireE by sectbn 3700 of ihe Lebor Cade, ta the pertormance of Na work iw wNch ihis pertnit is issued. My worke pompef� tion Insuren�a.caMer endy� Iicy number are: .-� \ Cartier. �rOC<�i..liy �C�G�f ,i] . Polic.yNumber. �/75'> YYac7� (Thfs sectlon neetl not De completea U the pemf�valued ef one hundre� tlo0ers (S 700) or /ess.J ❑ I certity ihel In the Oertortnanca of the wark ior which this Dertnit Is issued, I s�all not employ eny person In eny manner eo es to become sublec� �o the workera' compensetlan lews of Celitomla, entl egree that If I should bewme sub�ed to the workara' compensatlon pmWsions ot SecUon 3700 al lhe Lebor Code, I shell fort�wit� comply with those O�a��e�—°1n�s. pllcentSlgneWre: �l D�� '= Deta: �' �� WARNINO: FAILUPE TO SECURE WORI(EAS' COMPENSATION COVERAOE IS UNIAWFUL AND SHALL SUBIECr AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED TiqUSPND DOLLARE (5100,000),IN ADIXiIIXJ TO THE COST OF COMPENSATION, DPhN�E$ 0.S PROVIDED fOR IN SECiION 37080F TNE IABOR COOE, IMEREST, ANO RTTORNEI"S iEES. LICENSED CONTRACTORS DECLARATON: I �ereby ettirm Ihet I am licensed untler provis CMpter 9(commencing with Section 7000) ot D'Msian 3 of Ue Business antl Pratessions Code, end my Iicense is in tull force and ettect. Llc. a �id �% � Cless a ConVectofaSlpneture: o � . Date: —%� -i--g CONSTRUCTION LENDING AGENCY: ❑ I �ereby afflrtn that there Is e canstructlon Iending egency tor the peAortnance ol Ihe work tor which Uis pertnit Is issuetl. (Sec. 3097, CMI Cotla). Lendefs Name: Lendels Atltlress: Signature: Date: OWNER-BUILDER DECLAHATIONS: I nereby eiflrtn Ihet under penelry of perJury thet I em EXEMPT FROM THE CONTqACTORS LICENSE LAW for the follawing reeson (Sec. 7031.5, Buslness end Protessians Code: Any clry or counry which repuires e permit to construct, elter, Improva, demolish, or repalr eny structure, pAor to Its Issuance, elso ropuiros Ihe epplicant for such permlt to flle e cipnetl stetement Ihet he or s�a is IlcenseA pursuent to t�e proNalona ot Ihe Contreqora lJcense Lew (Chepter 9(commencinp wlth Sectlon 7000) of DlNslon 3 oi the Buslneu and ProlesSions Code) or that ha or she Is exempt therelrom en0 the besis lor tha elleped esemptlon. Any vloletlon ot Section 7031.5 by any appllcant tor e pertnit sub�ecls Me epplicent lo e dNl penalry of no� more than flve �undred tlollere ($500).): ❑ I, es owner of t�e property. or my emplayees with weges es Ihelr sole compenseUon, WILL DO T}1E WORK, antl Ne structure Is not intentlatl or oXered tor sflle (Sec. 704a, Business and Pmtessions Cotle: Tha Coniractors Licensa Lew does not appy ro an owner o1 property who builds or Impraves thereon, entl who does such woAc Nmsetl or hereelf or through Ms or her own employaes, proNded that such Improvements are not intended or ottereG for sale. It, hov.ever, ihe Duilding or Improvement Is soltl vAthln one year of completlon, Ne owner-builtler will have the burtlen of proving ihet he or she tlitl not build or Imprwe for Ouryase oi sale.). ❑ I, es owner of t�e propeRy, am El(CWSIVELV CONTRAC7ING WIiH LICENSED CONTRACTORS to consiruct Ne praJect (Sec. 704a. Business flnA Pmfessions Codo: Tlie contrectors Lkense Lew Goes not epDN �o an owner of pmperry who builds or improves Ihereon, entl wfw contrects tor suU pro�ec� with e cantrecror(s) Ilcense pursuent to Ne GonVactors license Lews.). ❑ I em exempt under sec. Signeture: Owner ID verllleA by drlvefs Iicense. ❑ Yes ❑ No Buslneu and Prolesslons Cotle for Ihis reeson: Verlticetlon of Ownershlp by (rype of tlacument, I.e. - praperty tex blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFlCATION: Drivefs llcense No. Data: �pires: ❑ I hereby certly that no excavetlon fNe (5) or more leet In depth Into which e person is required to Oascend, will be mede in cronneclion with work aulharizatl by t�ls pertni�, antl thet no builtlinp struaure, aceXolding, felsework, or tlemolitlon ar dismemling thereoi, will be more t�en ihirry-six (38) teet �Ig�. (Chep. 3.2, Grp 2, Atl 2, Sec. 347, 71t1e B, Celllamle Administretive Code). ❑ As ownar•bullder, I wlll not employ enyone to tlo work w�lch woula require e pertnit irom Vie Dlvision ot Industrlel Sefery, es noted ebave, unlesa wch person hes e peimit lo do such wOrk trom the divislon. Slgneture: Date: DMtion ot Industrial Safery Permit NumDer. CEHTIFlCATE OF COMPIJANGE AND AllTHORVATON OF ENTHY: I cehity under penalry oi perjury Ihat I have read Ihis eppllcation and stete thet Ihe infortnation given is cortect. I egree to comply with all stete laws entl dty ordinances relating to building cronstrudion, and authorize reprasenlatNes ot the Ciry ot Cosla Masa to enter upon the abovatlescribed proparry for inspection purposes. I egree not to occupy or ellow occupenry of any builCing euModzed Dy Mis permit until final inspection. ��w'4r .. �f�'�,$C,y'S�g�aWre Of Lege�er(s) Dat �--��,,� � � — �7— 9�� And�OrAuNodze Icant Data COOF �. IN@pEC110NTYPE � �� ¢ ItfI�ALS 1818 Flxetl System Finel Fire PrevenGon t268 200 201 202 Pool Spe Flnal Flnal Re-Roof Finel Black/Reteining Weli Flnel Fectory Fire Place 203 Flnal Sign 204 Flnal Dem 2448J8 LOOE � INSPECTION ME 206 Final Mechenicel 208 Final Plumbing 2t0 Flnal ElecMcel 212 Final Fre Preventlon 220 Finel Plenninp Approvel Yl2 Final Slte 250 Final Builtling/Occupanc.y �g �� s i Pfl0.1ECT ROOflFSS: 3 f] S Z MEADOW BROOR OWNEfl'SNAME: VZT+LAGE CREEK HOMEOWNERS noosess: ASSOCIATION 397.9 TIMBER LAFCE CM VA 92626 UNIi: AflCHIENGINEEH: CH�STER CARVILLE flEG.NO.: C18jOS aoosess: 7yzz pgp,OUR ST UNIT: S,D. CA 92111 PENMI7TEE: FHOENIX ENTERPRISES INC. ( 213 ) 690-9554 AODNE55: AII COMERCIAL WAY LA HABRA CA 90631 UCENSEU CONTPACTOfl OEG�RpTION: I her¢Oy allirm t�al I am Iiten5e0 pr ions o� Chapter 91 enCinA ��h Set�ion 7000� ol Oivision 3 ol t�e Business antl Pmfessions CaOe, and my license II � e antl eilect. � ciTvuc.:�50 8� `�*jEJ�c.:376639 �� oaie: _[_(— SignaWre: _ _ _ �" WOBI(EBS' LOMPENSATION �ECIABFTION: I hereoy allirm ihat I have a certilicate of mnsent m seli-insure or a wnilicate Jorkers' Compensa�ion Ins anc r¢nified copy i�ertof (Seciion 3800. La6. � �oucrxo.:W�0�0�3�4 EXP.�RTE: 7�OSI9S COMPANY: CA CUMi� 6 F I R E � Cenibee .opy is he�reb/ N/mq�h etlI ❑ Cenifietl copY is tiled with ' Buil Oiv ion. Oate:� � ` i_( Appli[anC � �'r E%EMP�IONFROMWONNEPS'WMPENSATIONOECIABAT10N: �ThisSetlionnee0nol�e[omDleleOillhepermilis�aone�u �5100�or1e55�. I certi�y Ihal in Ihe perlarman(e ol 1he work �or whicn ��is permi� is issueq I shall not employ any person in any manner so a5 io �ecome subleci �o Ihe Workers ComDensation Laws ol Calilomia. Dale' Signalure: NO710E: I1. afier ma'ung t11is aeUaration, yau snaul0 befAme su6jett to Ihe Worker5' fAmDen5dti0n prOviSions ol Ihe la�ar C04¢. you mu51 fori�vnth tompty wiU Sut� ptwision5 0� lhis pelmil 5hall �e tleemeA (evokeJ. CONSTPUCTION LENUING pGENCY: I nereby allirm Ihal there is a consiNction lending agency for t�e pedormance ol t�e work for whlch Ihis permlt I5 lssued ($eclion 3UJ7, Clv. G�. LENDEP: AODNESS: OWNEfl BWLDEfl OELLAflATION: I hereby aifirm t�al I am exemp� imm t�e Contractors' State License law lor �he follovnng reason �Sedion 70.31,5 Business antl 7rolessional Cotle: Any cily of coun�y which requires a De�mi� to conSlmci, aller, ilnpmve, tlemolish, or repair any simclure, prior to iis issuance, also reQuires �he apDlicani IOr such permit Io �ile a signed statemen� �M1a� he/she i5licenSeU pursuanuo IAe provisions ol lhe Conlraciors' Slate License Law (Chaple� 9(commencinp witA Section 7000) oi DiviSion 3 oi the Business ana Pmfessions Coae) or �ha� he/sAe is exempl iherelmm and Itle Oasis lor ihe allegeE exemption. Any Mola�ion ol Sec�ion 70.31.5 by any aDPlicant lor a Oermit su�lecis Ihe ap0licant to a civil penalty ol nol more tAan five �unCreE Gollars (5500�. I. as owner of ine O�openy or my employees with waAes as iheir sole compensation, will eo Ihe work, antl ihe 7 s�mmure is not intenaea or offered for sale (Section 70a4. Business antl Pmiessional Code: The Contractors' S�ate License Law does noi apply Io an owner o� a pmperly who Ouilas or imprOves �Aereon, antl wha tloes such work himsell/hersell o� IhmuAh � his or �er own emplOY¢e5. pmvitletl Ifiai such impmvemenis 2re not intenC¢G or o��eretl lor sale. II, �owever ��e UuilOing o� impmvement is so10 wi�hin One year ol compl¢lion. �he owner vnll have the burden ol O�ovinp he/s�e tlitl nol builU ar impmve lar me purpose ol sa�el. I, as owne� ol lhe proPariy, am exclusively conVacting wi�h license� canlrac�ors �o conslmcl t�e D�ole�� (Seclion 7044, BuSin¢ss ❑ and Pmlessions Cotle: T�e Contrac�ors' Sia�e License Law Coes noi ap01y lo an mvner oi Ompe�y who builOs or impmves Ihereon antl who contratls far suc� O�olec�s wM1� a ConlracloqS�Iicense pursuanl m Ihe Conrcactors' State License Law�. I am aware ��al pmol of their WO�ker'S Compensalion insumnce should U¢ pmviaed lo me. , � I am exempl under Seclion: B. 8 P. C. lor Inis reason: oate: Owner. I Oo nere�y cenify ihat I am aware oi and uneerslana ine requiremenis ol Calilomia Healtn ana Satery Cqae Sections 25505, 25533, ane 25534 ana i�at I or any fuwre Cuileing occupam wilUwill not (circle ane) neeU to comDq wii� saia state mAes ane tne repuiremenls lar a permil br conslmclion or mod�licalion Imm t�e Air Ouality Managemenl OislricL NesiGenlial cons�mciion applica�ions are eaempi hom these pmvisions. Oa�e: ApV�ieanl: I �e�e�y cei�i�Y ��al I have re341�rs aDD�icauon anC Slate �hat t�e aGov fo• atio� correcC I agree lo r•- 'y vnth all ciry an0 counry or0inances an0 sla�elawsrelal�nglo builtling conslNclion ana hereq' +' �eD� ��alivesolln6 ciry� pont�e�nlianeE O��PQ��Y � IOSpP On fp�i��j � Date: �� y.( Signalure'. _ Dmrner's �icense a� souai Secu�ny x: i6aba6 White-6uiltling; G�een—Catle EnlorcemenL Ganary—ApP��ant; Pink—Revenue: GOltlenroE—Assessor CITY OF COST'A MESA – BUILDING PERMIT PERM NO: B 05058 PERMIT NO: B 050584 PLAN CHECK NO: 00136-91 A GOVT: N SUPP: N CONSTRUCTION TYPE: V–N PERMIT TYPE: STR FURFOSE; REP JOB DESCRIPTION ; REPAIR SETTLEMENT DAMAGE SQ FT; 193 CLAIM VALUE: 14,300.00 CALC–VALUE; 14,300:00 GROUP OCC: R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION x*x�t�tx**�t***xx*�t***�t�t****�t�***�t�t�t��t�t �t***�****�t+t*f�**x*�c��t�*u•**�t*x******�t****�%��t* 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 3 ------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: rT IN LEFT; FT IN RGHT: FT iN LEFT: FT IN RGHT; FT IN �RKING REp • PROV: PAF2CEL; 93506124 ZNE; R2 REF ND: PLANNING Ni�'!'ES> FOUNDATION REPATR. ! if iE iE iE iE if iE �f jF if iF �E iF iF iE �lE iE if lE iE le iE iE if iF if iE if 3E iE iE if iF if if if iE iE if iE iF ik iE iElf 3E 1f If 3E IE if #� X� iE if IE±f if iE iElE iF iE fE iE iF �fF �)f )Eaf 3F iEiE �F �F IE 1ElE 3: D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N'F S ZONING AFPROVED BY ;_� �. � . DATE; O I� S"1( HUILDING APPROVED HY : �✓/c��✓– DATE; APPLICATION ISSliED HY• DATE: � k 3E 1f 3f if iE 1E ib iF iE iF 4 �E iE iF iF if )f 1f *!f iE if iF iE #E If iE iE 3E 1F IFiF�'�£'�F7eiFif if lE1EiEififlEiklEiEififiliklEif�FiFN�NiFlFiEiEif#iFIEiE �lfiEiflEiEiEiEiE3E1FiEif�lEIE3EjEiE#dEiEiElflfif�flElEiFjE�1-JEifiE3kIFiF7Eifif# LEGALIZATION:N F E E S U M M A R Y STRUCTliRAL�SEGMENT:Y HLDG PMT PLUMBING E'CTRIC MECHANIC FIRE SMIP/RES GRADIiVG PERMIT 162,00 1.00 SMIP/NON–RES PLAN 7.6.33 ISSUE FEE BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTAL PAID DUc TOTALS----> 163.00 0.00 26.33 189.33 189.33 .00 REVEN[JE DIVISION TOTALS--> COLL&CTED; 189.33 OVER/SHORT: 00 HLDG FMT FLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN–CHECK 162,00 1.00 26.33 if iF 3E ff if �lE �IE if iE iF iE IE ik �f iE iF IE iE 1f ik !f 1F jE iE �E 1E 1E iF iE iElf !k if �f If iF �E if iE iE fE iF iF iF If iF IFjf ff �lE iE 3F iFif iE 7F if jE iE fE k iF aE iE iE jF iElf iE 1(� i(• iE 3i 1E jF 3E 1F ib 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 SFR 143 STRUCTURAL HY VALUE PER $100,00 100.00 14,300,00 END Oc FEES UI uUOiSlb`–GC�97is7a7 L"�e'� ,:y,,;;; 4AiE% ff?J3"s/91 TiME: 1)��3 . _ _—� _: - -� CONSTRUCTION AND PLANNING � � �` �' SPA APPROVALS Permit�# Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole. + 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ..� - 53. Steel Reinforcement � 3. Electrical Conduit Utility-U d grnd. ! 54. Forms �. 4. Electrical Condui[-Undrgrr�?., "�. 55. Electrical Bonding '' 5. Steel Reinforcement� �� 56. Rough Plumbing & Pressure Test 6. �Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test � � •, ' 9. Water Pipe-Undrqind. -'i� J� 60. Backwash Lines, P-Trap, O Undrgrnd. �� 10. Structural Floor System!'��, '"�� 67. APPROVAL TO DECK ,� ^ 11. Property SewerLine &"jouse�Connection` �% 62. Backwash & Receptor-Final - �, 12. Sewer Cap '� �` ��''/,` 63. Heater & Vent-Final + 13. Roof Drains � � � 64. Plumbing System - Final ��1 14. Rough Plumbing �ry '� ��,� 65. Electrical-Final ��^� 15. Rough Electrical-Cond�it ,i� '� ��' 66. Solar SYstem�Final ��' 16. Rough Electric Wiring %� �• i� � 67. Fencing & Access ApProval � 17. Rough Wiring Sign i'�/n: •/'� 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. 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�Piping�Gas OOiI 23. Gas Pipe-Rough & Test 72. Underground Flush� 24. Roof Framing � ' 73. Undergrnd. Storage�Tank O Gas ❑ Oil 25. Roof Sheathing - , ' . - . 74,'Overhead Hydro . 26. T�Bar Ceiling (Structural) & Monocoat • � 75.� Dry Chemical . ' 27. Frame and Flashing , � . 76. Dry Standpipe ' 28. Lathing & Siding . ._ .. �� - 77, FIXED SYSTEM FINAL' �29. Insulation � - I 78:,.FIRE PREV. FINAL • . 30. Drywall Nailing � � � I�- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat�' . I � �./ � 79: FINAL IN$PECTION 32. Elecirical Power Meter�Final � � ") �� 80. FOOD CERTIFICATE ISSUED . 33. Final Electric _ . . I � �, � Notes: :34. Final Heating & Air Conditioning� � ' - � f' . �l �. � /�//�/ / / / 35. Final Gas Pipe-Test ' __ ',�� i/C:fil� � .36. Hood or'Canopy � . . � � 37. Final Factory Fireplace � , � 38. Final Plumbing . � , � i I � 39. Water Service=Final i ; � ' " 40. Gas Service�Final � � � i- � _, , -41. Solar pomesticFinal - � I� ' . i ' 42. Backflow Preventer . � � � _ _ � 43. Backflow Irrigation ` - . � ' � . � 44. Landscape Irrigation SYstem � � - . 45. Sound Attenuation - � � 46. Handicap Regulations � � . 47. FiNALSTRUCTURE&BUILDING ��/f�/ - 48. FINAL PLANNING . - 49. Electric Release to Edison � � � � 50. Gas Release to Southern California Gas Co ; � �. 51. CERTIFICATE OF OCCUPANCY � No. Date OWNER RTATF._WTnF. Tleveln�r±rs� 2nc_ DATE 4-28-76 JOB ADDRESS zlai� Moo,�,,,, Rrnnk BUILDING PERMIT N0. 41793 n� �o.Tt6=t li 'CTIONS soi� W ATER ROUGH PLUMBING PpOP. SWR. LINE MISCELLr1NE0U5 ROUGH HEATING AN� RIR CONOITIONING TEMPORARY SERVICE Oft POLE UNOERGROUNO I-I POWER I-I FLOOR SYSTEM FRAME ANO FLASHING LATHIN� PLASTER,BROWN COAT S" TURPL, FINFL PWM6ING, FINAL AN� GAS ELECTFIC, FINAL BIIILOING, FINAL E VALUE SUBCONTRACTOR Z . a cWj �z ZQ O v~i am J � J N Q W [O J • C1 J Q UN Za w� aw W Z 1 Q m Z J � W w � _ Z � �O N � � � F' z Q U J a a Q 0 H y Z O F- U � � F N Z � =_. ..J., , . . , � COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING ADDRESS 3412 Meadow Brook OWNER State-Wide Developers, Inc. ADDRE55 9461 Grindla� cirv No 'gp6-4550 Cvpress CAN5TRUCTION BRANCH ADDRESS AHCHITECT TEL, CONTFACTOR State-41ide Developers, Inc. ADDRESS 9461 Grindlav ��TY Cypress N�L$26-455 lIC NO. 224�� Q LI0. NO. oF �oT 12.093 eCY'es I NOW ON LO S O USE OF SIZE OF NO. OF NEW BLDG. ROOM$ STOf EXTERIOF WALL a$ er ROOF COVERING Wnp(� COVERING SFIdICE USE OF HUILDING AND WOFK TO BE PEFFORMED I hereby acknowlatlga Mat I have reetl this application entl state that the above information is correct antl agree to comply with all laws regulating builtltng construction, entl 1 shall not employ any person in violatian ot the workmen's compensation laws of tM1e State of California. I hereby certity [hat I am proporly licensetl as a conttactor untler the State of Celifornia Business antl Protessions Cotle, Divisicn 3, Chapter 9, antl that such licenses are in tull iorce antl effatt, or I em exempt trom the pro�isions ot the State of Calif rnia eusiness entl Profassions Cotle, Di�ision 3 ChaPter 9. _ �.State-Wide Developer�s Inc. Permlttee . Authorized PAID � �� :} 'aAY 13-76�;.,�.-00 757�- 238."L APPLICATION FOR BUILDING PERMIT RECEIVEDBY DATERECEIVEO nnT[�ss�mn . BUILDING ADDflE55 ROVED �AooE NE NO.OF USE OF NEW /6(� (AI/ 2ZCP P�'� � BUILDING C.�I•q�I YARDS APPFOVED VAROS APPRO D MAIN BUILOING ACCESSORV BVILDING VAR. 3W APPROVED � HOLD FOR BET. MAIN & ACCESS. BLOGS. DATE //� I APPROVED THEAMOVNTSHOWNVNDERVALUATIONISfOR THE PURPC6E OP ESTA61.1SHING A P£AM1T FEE ONLY: VALUATION � 3 � O� �� PERMIT FEE $ $ PLAN CHECK $ / �� 0 � Q m N � m E LL