HomeMy WebLinkAbout1002 NANCY LN - Building Permitsco�amcsa
CMF 0569-26
City of Costa Mesa Plar Department
Post Office Box 1200
77 Fair Drive
Costa Mesa, California 92626
(714) 556-5245
REQUEST FOR OCCUPANCY
JAN 5 '78 PIA
(Single Family Residential or 9= r _3
Condominium Units)
W -CEI 'ED
CITY OF C-0 PAESI
Pili?J)LI. a DF;�AFtTAAEI
Tract No. �l0 / I Date 171
Lot No. n
Address
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 .Nhe7) ALL (was or -were} ,'t!�dvised 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 undersigned by
reason of the aforementioned uncompleted condition.
1"ca-President
JOB ADDRESS 1000.1002.1004 Nancv Lane BUILDING PERMIT NO'tt' 43572
APNo115-023-11 LOT TRACT 9691 FIRE ZONE VALUE $120.200.00
INSPECTIONS et al
Si nature
Data
TYPE
v GROUP
R & T ZONE
Sou
2S
SUBCONTRACTOR
GAS
1 Dote Number Si nature
WATER �16- C'15 Z7-,Zg,;77
117L
Plumbin
ROUGH PLUMBING
•-'�
PROP: SWR. LINE ❑ HOUSE CON.
`�
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING'
(e
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER
ROUGH WIRING
TRENCHES FORMS STEEL REINF.
Gsatin
„(T.,
a Vent
y
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN M OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
y
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TESTZ
•
'
ELECTRIC, FINAL
BUILDING, FINAL
u--
CaG!'IAI aFnIIIaFMFNTC
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1 43572 1
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
T�fAFON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RE I E V
DATE RECEIVED DATE ISdO�
��/�
BUILDING
ADDRESSO01 �O/ illus( t4al
PERMIT
—
OWNER • P1,15 IvEK I
A.P. NO�
MAIL
ADDRESS p$- f;LLSOli 6LV0. ,�.
ADIDRESS _
TEL
//
96q/TRACT
CITY /k7 € NO. `
OT B
CONSTRUCTION
NE
ADD
ALTER
REPAIR
LENDER
BRANCH
I
OWNER RALAJ PC
ADDRESS
r•,�nM VALUg
S OtJ/C
ARCHITECT L TEL
OR ENGINEER C 4 �L Ef T 9L
FIRE
ADDRESS ILK R. Y113,
ZONE YPE GROUP
APPROVED
CONTRACTOR I
BV DATE
ADDRESS
TEL.
Z NE
NO. OF
USE OF NE
CITY NO.
PLANS
BUI LDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLDGS.
(FROMC/ RE
OF LOT
NOW ON LOT
OM F L
FT.
USE OF
EXISTING BLDG.
FT
permits are required for
keSeparate
L. SIDE
FT.
electric, plumbing and heating work.
-
REAR FT,
FT.
USE OF BUILDING AND WORK -rP BEP RFORMED
DISTANCE BET.
BET. MAIN &
(/N GG DO
MAIN BLDGS.
ACCESS. BLDGS.
VAR. $
DATE
C.V.P.
APPROVED _/
APPROVBY
DATEE
I hereby acknowledge that I have read this application and state
that the above Information is correct and agree to comply with
nth
OLD FOP, SRs.~CIA
SP170A.
r
all laws regulating building construction, and I shall not employ
any person In violation of the workman's compensation laws of
_
DSO.
the State of California.
1 hereby certify that I am properly licensed as a contractor under
FT. ..35 c 021
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the p vislons of the State of California Business
VALUATION
PERMIT FEE E
end Professions Code ivislon 3aCh9.
Slgneture of A
06
PLAN CHECK S
Permittee
$IoV 20�
/(
TAX i
Authorize Agent
TOTAL PAID E
2 15". 9' rq
c
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