HomeMy WebLinkAbout2173 MEYER PL - Building PermitsAVGlicant to f111 in all soaees exceot those wit�in heavy Oortler Iines antl sign all approoriate aeclarations.
PERMIT NO. TRACT NO. LOT NO. UNIT NO.
- CITY OF COSTA MESA CONSTRUCTION RERMIT E� 7 / A.P. qW zooa
` 2/T3 ,GIE�/�,� /�C
Project Address _ S Main Building: Accessory Building:
•.�AppliC Mailin�re55 p / TYPEOFCONSTRUCTION NEW ADD A�TERATION REPAIR E Z
� �OlYN A O/SGL Jry�' ypy � CONVERSION ❑ DEMOLISH ❑ OTHER T Ffont 0
Ownei.�� Phone DESCRIPTION OF WORKNSE OF BLDG. I A Rear N
Addresy�J��. � �!G .�'-f � �t�I} '
Arch/Eng. � License No. TYPE OP PERMIT GRADING FOUN�ATION S7RVCTURAL I K Right G
Addre55 � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' S� Left R
Contrector's Name ^ Phone � �'oTHER Ping. Ref. # Parking Req./Provided E
�/� J]� PROJECT DESCRIPTION Sq. FT. oCCVPANCv a
Address (mailingl �����%K �!�-� CONSTRUCTION TVPE VALUATION $ P�anning Notes: M
T
�City LicenSe No. ZONE GRA�ING CU.YOS. ACRES $,
LICENSED CONTRACTOR DECLAFNTION
I bereby a�firm that 1 am licensatl untler provisions of Charter 9(commencing Remarks:
with section 7000) of Division 3 0( the Business antl ProfesSions Cotle, antl
�my license iz in full force an effect ELECTRICAL FEES
License Class �' License No� PLUMBING FEES P.utomatic Washer Transformer ❑ 75-50 KW
Date Si9nature
WORKERS' COMPENSATION DECLP.RATION Construction PoleSuh. � 50+KW
I bereby affirm tM1at I have a certiticate of consent to self-insure or a certificate Bar $ink Showers �
oi Workers' Compensation Inzurance, or a certifletl copy thereof (Section gackflow Preventer Service Sink Cooking Unit Meter up to 100 amps �
3800, Lab. CJ
Poiicy rvo. Company Backflow Irrigation Sewer Cap Oishwasher Meter ❑over 100 amps
8 Certitied copy is hereby turnisnetl. Dryers ❑Ga5 ❑Electric Sub Panel
Certifietl copy is �iletl with the city Builtling Division. Bathtubs Sewer Connection
�ate Applicant Fan Motors �0.1 HP �1'h - 8
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - Clarifiers Solar COIlectol5
iss�ssection neetl not be completea if tne permit Is for one hunaretl (5100) or Dishwasher Solar Piping F�p`��� Inc. Solar �9-15 HP 016-15+
I ce�tify that in tM1e pe�fo�mance ot the wo�k fo� which this pe�m�t ISlssuetl I FixLUf25
snall not employ any person in any manner o to b ome syyb%j))ct to t�e Drinking Fountain5 Solar Tank Microwave
Workers' ` e ti s of California. ������ ! Devic2 Bozes Pole Li ht
Date 5iqnature Floor Dreins Swimming Pool w/Spa . 9
NOTICE: If, after iakm this tleclarati , you shoultl become ubject to the Outlets Ran e
Workers' Compensation provisions ot e Labor Cotle, you must forthwith FloorSinks U�inal 9
comply with such p�ovisions o� is Oe�mit shall be tleemetl revoketl. $WitCh¢5
CONSTRUCTION'LENDING AGENCV � GaSSerViCe Outlets WaterC1o52t Sign
I hereby affirm that there is a construction lentling agency for the performance '
of tne work ror wnicn mis perm�' is issuetl (Section 3097 eiv. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lentler's Name
Lentler's Atltlre55 � Kitchen Sink Water Service Generamr �65 KW 05-15 KW Trash Compactor
OWNEH BUILDER DECLARATION
I hereby atfirm lhat I am exempt flom the Contfactor'S License Ldw tOr the LdVdtOIiCS AtltO-WdSh
following reason (Section ]03L5 Business antl Professional Cotle: Any tlty or
county which tequir¢s a pe�mit to tonst�uct, alter, imp/ove, tlemolisn o� �epdir p—Trap �dUndly T�dyS
any structu�e, p�ior to its issuanC¢, also �equire5 the aOP�icant to� such perrtiit
to file a signetl Statement that he/she is litensetl pursuant to the provi5ions o( ROOf D�einS
the Contractor's License Law (GhaO�er 9(commencin9 with Section ]000) of
Division 3 of the Business antl Professions Cotle) or that he/she is exempt Reinspeetion Fee $15 Issue Fee � $x
therefrom antl the ba5i5 (or the allegetl exemption. Any violation of Section
703L5 by any applican[ for a permii subjects the applicant to a civil
enalty oi not more than tive huntlretl doiiars (E500). DEVELOPMENT SERVICES REQUIREMENTS:
-� I, as owner of the property or my employees with wages as their sole Reinspection FBB $15 IAue Fee $ 3 Zpping Approved By pate
compensation, will tlo the wo�k, antl tM1e structure is not intentletl O/ ofte�etl
for sale (Section �044, Business antl Professional Cotle: The Contractor's MECHANICAL fEES Buildin8 APP�oved By Dat�
License law tloes not apply to an owner of a property wha builtls or improves �Q
thereon; antl wM10 Eoes such work himsel(/helselt or thrOuqh his or hel own App11C8t100ISt11Bd By D0t v_
employees, p�ovitletl that such imp�ovements ar¢ nOt intentletl or otfe�etl (or BOil2! HOOd Of TypE I ❑
sa1e. If, however, the builtlin9 or improvement is soltl within one year ot com- Canopy Type II ❑ SUMMARV OF FEES
pletion, the owner will have the burtlen of proving he/she tlitl not builtl o� Im- Duct - UndE� C"ilOuOd
prove tor the purpose oi sale). BUILDING PERMIT $ SMIP $
as owner af the property, am exclusively contractin9 with licensetl con- Duct -Structural Refrigeration System PLAN CHECK $ PERMIT
actors to mnstruct the project (Section �044, BuSinesS antl Prote55ions Cotle:
he Coniractor's License Law tloes not apply to an owner oi property who Duct- Ventilating ❑0.100,OOOBTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or impraves thereon. antl'who cont�act5 tor Such oroiects wrtn a mn-
tractor(s) 6cense pursuanc ro me convactors License Law). I am aware thac Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $� ENERGV P.C. $
proot of their Worker's Compensation insurance shoultl be provitletl to me. ELECTRICAL $ GRADING $
❑ I am exempt untler Section e. 8 P. C. for this reason Firepl/Fact. BIL ICBO # Fire Dampers PLAN CHECK 50% $ MICROFI LM $
D t ^ o • Heating System & Ducting Registers MECHANICAL $ � 3-rl%
❑P700,000 BTU Ot00,0006T TOTAL FEE $
I hereby certify that I ave reatl this application antl state that ihe above PLAN CHECK 25%
infotmation is correct. I agree to comply with all city antl county ortlinances $
antl State laws relating building constructio , and he�eby autho�ize repre-
sentatives o( thi ci o e � on E e ove-mentionetl property fo�
inspection Ourp s rl
Signature Date `� peinspection Fee $15 I�sue Fee $ 3
o�i�e�:� �se o� ss � -^ ` 0? G00?7173-QQ027173 T4a�f 33.SU
0865-4fi, rev. 5/80 White - Builtling; Canary � Applicant; Pink - Accounting; GOltlen�otl - ASSezso� � ' DiiTE% O2I?%I�R�I fJ�iL� iJ+ �9 �
COiUSTRUCTION AND PLANNING POOL & SPA
Date Inspector �� Date Inspector
'�,UAPPROVFjLS Permit # A�PROVALS " Permit #
1. T rary Electrical Service or Pole �, 52. Pool & Equipment Location �:
�'2. Soil p2-Undrgrnd. i •�; 53. Steel Reinforcement � ' �
� 3.� Electrical Conduit Utility-Undrgind. � 54. Forms �
� 4.� Electrical Conduit-Undrgrnd. ��' /�'' 55. Electrical Bonding _ !,'
�
5..Steel Reinforcement - 56. Rough Plumbing & Pressure Test _,- ��
6. Electrical UFER Grnd. �r 57. APPROVAL TO COVER-GUNITE �, �
7. �Footings ' � 1 .58. Electrical Conduit-Undrgrnd. � ��,
8^. Foundation ' � 59. Gas Pipe, O Undrgrnd., Test _ '
9. Water Pipe-Undrgrnd. • 60. Backwash Li,nes, P-Trap, O Undrgrnd. �
.R
10.�Structu'ralFloorSystem . 61. APPROVALTODECK '�
11. Property Sewer Line,& House Connection �. 62. Backwash & Receptor-Final ��'
,
12. Sewe� Cap �� / 63. Heater & Vent-Final � •
il'r
13. Roof Drains '� �• 64. Plumbing System - Final
�'.
14. Rough Plumbing �� 65. Electrical-Final
.
15. Rough Electrical-Conduit 66. Solar System-Final �
1r6. Rough Electric Wiring 67. Fencing & Access Approval
: �
�17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA 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 Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �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 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . FINAL INSPECTION
32. Electrical Power MeterFinal ��jr . FOOD CERTIPICATE ISSUED
33. Final Electric ��p9 Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
�
42. Backflow Preventer � „� vi
43. Backflow Irrigation ;V
44. Landscape Irrigation System �
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDWG '
48. Special Requirements Completed �
49. Electric Release to Edison �,
.,•�'
50. Gas Release to Southern California GasCo -� a7
51. CERTIFICATE OF OCCUPANCY �� �• ! �
No. Date y%
v
h
�
�
/
PPOJECT AOUXESS: z 1 7 3 1y1�.+YE}� PL UNIT:
OWNEP'SNAME:BALL, JOHN A
nooeess:BJ�L, MARJORIE T
2173 MEYER PL
COSTA MESA,CA 92627
AflCHIENGINEEfl: AEG.NO.:
nooeess: uxir:
PEHMITTEE:JOHN HA7.�1. ( 714 ) 548-4640
aooness: �173 MEYER PL
C.M. CA 9267.6
LICENSEU CONTBACTOB DECLANATION: I hereby allirm �hat I am bcense0 untler Dmvisions o� Chapier 9(commencing wi�h Section
]000) ol Division 3 oi ihe Business antl Pmlessions Code. antl my IicenSe is in lu�l brce and e�fec[.
CITY LIC.: STATE LIC.: C1A55:
�
�a�e'. Signa�ure:
WOBNEflS' COMPENSATION OECIAPATION: I �ereby aifirm Nat I have a ceriificate oi consent �o selbinsure or a certilica�e o� Workers'
Compensation Insurance. ar a cetlitied copY thereot �Seclion 3804 La�. C�.
POLICY NO.: E%P. OATE:
COMPPNY:
❑ Cenified copy is hereby fumishetl. ❑ Ce�ifietl copY is filed wiih ihe ciry Builtling Division.
�ate: Applicani:
E%EMPTION FflOM WOHREPS' COMPENSATION DECLAFRTION: (i�i55eciwn neetl nol �e comple�e0 if �he permit is �orone hun4fe0 (5100) or less�.
I cetlity Ihat in the peAormance oi the woB lor which this permi� is iss ,. I s I noi emplC any person in an manner so as �o became
su�le�� �o the Workers' Compensati�ony Laws of Calitornia.
�ate: � • �� � y � Signa�ure: �= -"! �
NOTILE: It, ai�er making Ihis ec aration, you shoW� ome sublec� to the Workers' Compensation pmvisions ot �he Labor
Cotle. you must fonnwnh comply wiih such Omvis or this permii shall be tleemea revoked.
CONSTBUCTION LENOING RGENCY: I here�y a�lirm a� Ihere is a cons�mc�ion IenOing agency �ar �he pedormance ol Ihe work for
which Ihis permil is i=.sued (Section 3097. Civ. C�.
LENOEB:
AOOXESS:
OWNEN BUILOEN OECLANATION: I herehy af�irm Ihat I am exemp� tmm Ihe ConVac�ars' State License Law for Ihe �ollowing reason
(Section 7031.5 Business and Pmfessional Cotle: Any cily oi coun�y which requires a permit �o cons�mct, alter, impmve, demolish, or
re0air any s�mclure. prior to iis issuance. also repuires Ihe applican� for such permil ta file a 5igne0 sta�ement that he/she is licensed
pursuanl m the pmvision5 oi Ihe ConVacmrs' Siale Litense Law (Chapter 9(commencmg with Seclion 7000) of Uivision 3 al ihe Business
and Pmlessions Cod¢) ar �hat he/she is exempi Ihereimm antl Ihe basis lar �he alleged exemption. Any violalian o� Seclion 7031.5 by
any aOPlicanl lor a permit subjecis �he aDPlican� Io a civil penalry o� not more than �ive huntlred dallars (5500).
.n I, as owner ol �he pmpetly or my employees wilh wages as ��eir sole compensa�ion, will tlo ��e work, and Ihe
4� slmcWre is not inientletl or ollered for sale (Section 7046, Business ana Pm�essional COUe: The Coniractars' State License Law
Ooes nai apDly �o an owner oi a pmDerty who builtls or impmves �hereon, antl wha tloes such wo�k �imsell/hersell or thmugh
his or her own emDloyees. pmvide0 tha� such impmvemenls are not inientled or o��ereJ �or sale. If, however ihe building or
improvement is 5o10 wi�hm one year oi compleiion. Ihe owner will have the burtlen o� pmving he/she tli0 nol build or impmve
lor Ihe purpose oi sale�.
I, as owner of ��e pmperty, am exdusively contrac�ing wi�h Iicen5e0 canVac�ars ro cons�mc� Ihe pmlec� (Section 7044, Business
❑ and Pmiessions Cotle: The CanUac�ors' S1ate License Law does nol apP�Y �o an ownerol DmDerty who builds onmproves Ihereon
antl who cantraQs �or suc� pmlecls with a conlraclor(s) license Dursuan� ta Ihe Comraciors' Sta�e License Law�. I am aware
Iha� O�oai of their WorkerS Campen5aiion insurance should he pmvi0ed lo me.
� I am exempt untler Section: B. 8 P. C. � /'�
�or IhiS f¢a50:n7: ��
Oale-. � L � —�� Owner: /�
I tlo hereby cenify ihat I am aware of antl understand ihe requiremenis ol omia Health ana Salery Code Sections 25505, 25533, antl
2559A and Iha� I or any fulure builtling occupan� willlwill not (circle one) tl lo comDly with said s�a�e codes antl the reduiremenls for a
peimit lor constmciion or modifica�ion irom Ihe Air Ouality Managem �istric�. Fesiden�ial conslruction applica�ians are exemD� �mm
I�ese provisions
Dale'. ApPlicanL
Ihereby certityt�al I haverea0 Ihis application antl slatelhai Ihe above
ortlinances antl siale laws relating �o builtling cons�mc�ion ana herebY auth
pmpetly �or inspeciion purooses/.>
�ate'. ���'__T � Signamre:
oriver's License o� Social Securiry u: �
�eai-aa weno—a,�xn�„�� nraen—Cotle Entorcemen��. anarv—A�,
correcl. I agree to compty wi�� all ciiy anU coun�y
Vives ol�his ciryto enierupory��e above-men�ionea
Pink—Revenue: Galaenma—Assessor
CITY OF COST'A MESA — BUILPING PERMIT I�ERM NO: B 063?.40
PERN,IT NO; B 063240 PLAN CHECK NO; N GOVT; N SUPP: t�
CONSTRUCTION 1'YPE: PERMIT TYPE; STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF REROOF W/COMP SHINGLES SQ ?T; 2,400
CLAIM VAZUE; 2,,400,00 CALC—VALUE; 2,400,00 GROUP OCC; R-3 /M-2
COMMENTS: REROOF 2400SF RESID & GARAGE W/COMP SHINGLES. SMOKE DE'P RE UIRELi
���**������.��*��***����*���.��#��**����**��*.�#*.�*�.�*����-***� E�pE�E��T�.R��.��
Z O N Z N GS_ERTEB�AUCIKRSE M Er{y,�rG1!
_ �Iv1�Jn ,4 �
------------ MAIN BUILDING ------ --- -------- ACCESS(�'E�.iL'S���R,E3D --------
FkNT; FT IN RcAR; FT IN FRNT; FT N REAk; FT IN
LEFT; ET IN RGHT: FT IN LEFT; FT IN RGH'P; F"I' SN
PARRING REp • PkOV; PARCEL; 42218217 ZNE: REF NO:
PLANNING N6TES>
;� n.
fFiE%iF ik 1f 1E iE if iF iE iE iF iFlt )E� iE iE-M� iE ff fE-k iF 3f If 1E lE � if iF if-iE �)t k il�'lE iF 1F 1ElE iE lF 7f iE iE if dF N� %� %� 1(� i611� iFlF iF )F # iF dt iPlF�IE 7f 1(� 1(� iFlE iF 7l� 1(• jF 3F �IF i(�-16 ib±E
D E V E.�L O P M E N T 5 E R V I C E S R E� U I R E M E N!�' S
20NING APPROVEI3'. BY nATE;
HUII,AING APPROUED HY ; llATE:
�
APPLICATION ISa�UED HX; � llATE: i 2—�I 3
lFiEiE3EifiEifiEiFiFififiEiE3f�iEiEiEitiFifiEiF�fiF�F�Fi�iFAifiF�3F�FitiFiT-itiFiriF ftu3FiFi't3FFiF3r3Fif3F%�K%iEiE#iE#]tiF � #3E
iElF �7Eif if jf )k jt iE if �)F iE iE ih !( 1(� ik iE 1E IElE if 3f �Ik iE �1E �!f iE it i( iF if �lt if i! it� !E iE iE iliE iF iE 1E iE 1E 3f� 1F it if iF if !E iC k�PE iE iE if �7F aE �N� 3(� �lt �1( Y� 1F # il� 1Fi(� # i(�!!� N� �N� �t #?E
LEGALI'LATION;N F E E 5 U M M A R Y STRUCTURAL SEGNENT;Y
HI�DG PMT PLUMBING ELECTRIC MECHANIC F'IRE SMIP/RES / GRADING
PERMIT 54,00 50;
PLAN �MIP/NON�RES
ISSUE FEE
BOZLDING—DIV—> PERMIT ISSUfi PLAN—CHECK TOTAL PAID '� DUE
TOTALS----> 54.50 0.00 0,00 54,50 59.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVEk/SHOkT; 00
HLDG PMT PLU,NHING ELECTRZC MECHANZC fiIRE SMIP/TOT GRADING PS,AN—CHECK
54.00 .50 -
ik ih !E if ik iF % k iklE if iF �f iE 1E if )E #�]E 1E iE ik iE il� % IEiE iF iE iE iE R 1F iF if fF if iE # iF i4 X-iF iE iE�j(� x� i! iP K� iF i4 3F it�M�if it it iE �If it if� iE �)f -1F iF i(� ik it^1f�lk if i(� �f� 1F ik ik iE iE
I N D I V I U II A L F E E: B R E A K D O W N
TYPE QTY D E 5 C R I P T I O N UNIT COST iOTAL COST
SFR 2900 REROOF BY VALUE RESIDENTIAL NO'I,ONF 1,00 ' 2,400,00
END OF r^EES
01 D0143727-00143?EE T�7T 54.50
DAT�: U7/29/93 TIME: 09:1�
CONSTRUCTION AND P4ANNfNG
APPROVALS Permit #
1. Temporary Eleetncal Service or Poie
2. Soil Pipe�Undrgrnd.
3. ElecttiCal Conduit Utility�Undrgmd.
4. Electricai Condurt�Und:grnd. '
5. Steel Reinforcemenc
6. Electrical UFER Grnd.
7. Foot�ngs
8. Foundation
9. Water Pipe�Undrgmd. _
70. SYructural Floor Svstem
11. Property Sewer Line & House Connection
i2. Sewer Cap .
t3. floof Dra�ns
14. Rough Piumbing
15. Rough Electrical-Condu�t
i6. Rough Electric Wiring
77. Rough 4Viring Siyn
18. Rough Electricai-T Bar Ce�i�ng
19. Rouqh Heac�ng & A�r CondiUon�ng
20. Rough Factory Fireplace
21. Ducts, �n Struc;ure
22. Ducts, Ventitating _
23. Gas Pipe�Ro�gh & Test �
24. Roof Framing
25. Roof Sheathing �
i
26. T�Bar Ceiling (Structural! & Vto^ocoat
27. frame and Flashing
2$. Lathing & Sid�ng
29. Insulation
30. D•ywall \'aiting
31. Piastcr Brown Coat
32. Electncal Povrer MeterF�nal
33. Pinal Electnc
34. Final HeaLng & Air Ccnditionicg
35. Final Gas ?ipe�Test
36. Hood or Canopy
37. P�nal Factory Fire�tace
3$. Final Piumbing
39. 4Vater Service�Finai
40. Gas Service-Final
41. Sola! Domest�o-Flnal � �
G2. Backflow Preventer
��
43. 8ackflow Irrigation '_ • �I�
44. Landscape Irrigacion,�st�ml
45. Sound Attenuation��^-�
...�
�
46. Handicap Regulatio�- jr..t�
47. FINALSTRUCTL'�£.&,-.'�'�j.iLDING �
48. FINAL PLANNIN6.�'�
49. Elactric Release to i;�iison
�0. Gas Release to Southem Califomia Gas Cc
51. CEftTIFICATE OP OCCUFANCY
Date
��.
• POOI. & SPA
Date Inspector pppROVALS Permit# Date tnspector
52. Pooi & Equipment Location '
' � 53. Steel Reintorcoment �
54. Forms - ' ��
55. Electrical Bondmg • �
56. Rough Plumbing & Press�ve Test j
_�
57. APPROVALTGCOVER-GV'�:iTE -}--
58. Electr�cal Condwt-Undrgmd. ���
59. Gas P�Ae, 7 Un�rc�rnd., Tcst �
60. Hackwash Lmee, P.Trap. C7 Undrg�nd � ,
�
67. APPROVAI TU UECK --� �- I
62. Backnesh & Receptc- Fi�,ai ' �
� - - i
� / 63. Heatei & Vent-F:r.a: • - '
----1
� 64. Plumbing SYstem � F�nal ' ,
4
�
' 65. Electrfcal�Final • � �
i
66, Solar Svstem-Finui � {
� 67. Fencin� & Access ApRrovai �- i
68. APPROVED FOR °LASTEflING
69. POOL�SPASYSTEa:iSFWAL
-�-- �
FIRE DEPT. REQUIREh4ENT �
APPROVA!_S Permit :
�
�
' '!
70. Underground HyJro � _ �
3}, product�-P�n�n9C7Gas C7.Qil � '
72. Undsrqround Flush
73. Undergmd. Smrayc Ta�k � 1 Gas '' O�I �
74. O•�erhead Fiyc,ro � - -
75. Ory Chemical �� �
- ,
79. Dry Stancp�pe �
77. FIXED SYSTee^. FINAL i
78. FIRE PREV. FIP!AL i � _�
HEALYH DEPT. REQUIREhiENT � '
79. FINALIMS�4CT'C;d I ..I'.
80. FOODCE6T�FiCA'EISSL'�D ! '�
«- ----�---L---- �
Notes:
-- --------� i
�._f
e��- ��.�'� - ",
OWNER POLK7N,unaN r.nusm�_ co_ onTe 3_�_5�
JOBADDRESS 2173 Mever Place BUILDINGPERMITNO. �fys(�Q
GENERAL CONTRACTOR OWI182` BZdT'. VALUE $ ],O�iBZ.00
LOT 17 BLOCK TRACT 3135 R25 H�Bt.t �3T'
TVPE
INSPECTIONS /�_� L.. _/9Ay I�/}T�j'li SUBCONTRACTOR I DATE P IRMITS INS,UryEgD
iiiv�CS��K�r Gf/ q /1 9
Foundation Forms and Grade to GeFage —/ 1 4% ('fa•f%�/4�GG0�.+�
Rough Framing /�J— V
Plumbing, Rough to Slab �'yf s �'y
Plumbing, Rough Complete /� /•/�5 —/2-5—
Temporary Pole
Wiring. Rou9h APR ti �.,.-' '.'_ '. . W�Js�-.�
H
Lathinq, In
Plumbing, Final, Fixtures (
Plumbina� Final Gas Test/
Oecupancy
FORM210 9M 10-05
�. ; 46�3
�COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING /�Z/� � �I��G
ADDRESS
� COSTA MESA. C LIFORNIA
O W N ER ,J��/C /�tl �A�//��/ �Q�T I
MAIL .�,� � //J /"//�///��
ADDRE55 �
CITY�/ ���J���_�� NO�
ARCHITECT LIC.
OR ENGINEER NO.
AODRE55
CONTRACTOR �A�� CITV LIC.
NO.
TEL.
ADDRE55 � NO.
LEGFL LOT
DESCaIPTION NO. BIOCK THA
A.P. NO.
SIZE
OF LOT
�
SETBACK LINE FPOM �
NO.OF BLOGS.
NOW ON LOT
cErvrea ov sra[cr REAR YARD
r ` j
SIDE YAR❑ RIGHT � LcFT �
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION
REPAIR I �MOVING I IIDEMOLISH
BUII.pING NO.OF (�
SIZE ��� ROOMS y STORIES
f
EXTERIOR WA�L ROOF
t'nvFwiur. .�T/1f'//fCOVERIN ./7�/ii
i �r E:::.t�Cl`Y�u
�v.,, . �, � "��`� -- �
������i� ���.
CITi' Of COSTA ME�A
APPLICATION FO PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PE�I�T.f/fl�T
.�� I .s ^ ,L�/ � niHn
,
BUILfIING
ADDRE55
COSTA MESA. CALIFORNIA
20NE V.O TVPE
PLAN$ ' /
v
APPROVED
BY DATE
CORRECTIONS
STATE TH4T THE r�80VE IS CORRECT 1NO .�GREE TO COMPLY WITN 1LL
CITY OROINFNCE$ PNO STFTE LPWS REGUI.AT�NG BUILDING CONSTRUC-
norv. � VALUATION �j
SIGNATURE O PERmii FEE 5 p�
PERMITTEE O vq e
/ '3 (J p,� � PLAN CHECK $ �J �-
5 � p
nurNnancn nr,FNr TOTAL FEE S �/ � �°'��
�n
H. DATE 6-13-�
]OB ADDRESS Z� %3 MEYER PLACE BUILDING PERMIT NO. E9SZ
GENERAL CONTRACTOR �N�p_qi, �� nF a VALUE $ 1�063.�0
AP. No. � � S—S��I % TRACT FIRE ZONE DESCRIPTION OF WORK PAT I 0 COVER
GROUP ,1 TYPE V ZONE R4 PLAN NO. 695Z
INSPECTIONS I DATE I gUBCONTRACTOR I DATE PERM�TgNUMBER
coat
Final Gas Test
t - 6952
. �
COgTA MESA BUILDING DEPARTMENT
P.O. BO% 31]
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
COSTA tNESA. CALIFORNIA
MAIL
ADDRES I
C�TY
ARCHITECT
OR ENGINEER
ADDRE55
LEWL ILOT
OESCRIPTION NO.
A.P. NO. L
S�TE �� _
OF LOT
USE OF
E%ISTING BLDG.
(f TEL
�(,Q�C� NO.
LIC.
NO.
ry�, ^ . CITY LIC.
(� NO.
TEL.
NU.
BLOCN TRAC
. � _`� 3 �o. oF al��'
$ETBFCK LINE FROM ]� r
CENTER OF siweer � y� REAR VARD �i
� �SIDE YAf2D FIGHT � LEFT
I��Y��l
DESCRIPTION OF WORK
!� ALTERATION AO�ITION
MOVING DEMOLISH
p/NO.OF
! ROOMS STORIES
E%TERIOR WALL ROOF
COVERING COVERING (���,Hyy
USE OF NEW T. .o .,
_ _ ,,. � �
. �� ������
..� - .-
C-_�.3—sk
FINP.P!CE DEPT.
cnr or "03TR MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PEP�T N//jl
/
RECEIVEO BY OATE RECEIVED T SSUF
� / � �—� ��
AooR'S5 2 � 73 /fI� r« P
I
COSTA MESA. CALIFORNIA
� ' V
q i- DATE
CORRECTIONS
��' J
IV . .
... r,�= �'~ �`
���
�
a s- -
I HEREOV LCRNOWLEOLE THPT I HPVE HEFO THIS PPPLIC4TION iNO
STPTE TM4T TME f�BOVE IS CORflECT LNO PGREE TO COMPLY WITH ALL
CITY OROIrvLNCES ANO ST<TE LAWS PEGUL>TING BUILUING CONSTPUC-
nOrv. VALUATION � —
SIGNATURE OF � PERMIT FEE S
PERMITTEE �'�
� �63 � PLAN CHECK 2r �
S /
AUTHORIZED AGENT TOTAL FEE $ !� � `��