HomeMy WebLinkAbout2482 NAPOLI WAY - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIF DRIVE, COSTA MESA, CA 92626
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Job Address: 2482 NAPOLI WY
Suite No
Vicihity:
Parcel Nunmber: 43914142
Applicant: KAMINSKY, PAUL
Address: 11612 KNOTT ST
GARDEN GROVE, CA
Owner: SMITH, SUSAN E TR
Address 15970 W-DALE LN
SURPRISE, AZ
Contractor: NOCK PLUMBiNG
Address: 11612 KNOTT ST
Arch / Eng :
Address:
GARDEN GROVE, CA
WATER HEATER CHANGE OUT.
ISSUE FEE
BackFlow irrigation
BackFlow Preventer
Bathtub
Clarifer System
Connect Qce,Soda,etc)
Dental Unils
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlels)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
PLUMBING PERMIT
Phone: (714) 8951246
Zip: 92841 �
Phone:
Zip: 85375
Phone: (714)895-1246
Zip: 92841
License: 707775
Phone:
Zip:
License:
SCOPE OF PERMIT
FEE SUMMARY ..
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
Septic Tank $0.00
SewerCapforDemo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS I SPECIAL CONDITIONS
Status: ISSUED
Applied: O6/24/2002
Issued: O6/24/2002
ISSUED �Y:
Sump Pump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: $35.80
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
C
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) ,
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetlons and tfnal approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 ,
zaao-ao �aw�
WORKERS' COMPENSATION DECLARATION: "
I hereby aHirtn undef penalty Of p@�jury one of ihe follOwing deClarations: . �
❑ I have antl will maintain a canificate ot consem to self-Insure for workers' compensation, es provided tor by section 3700 of ihe Labor Code, for ihe OeAormance of the
work for whichahis pertnil is issuetl. . -
❑ I have and will maintain workers' compensation insurence, as required by section 3700 of the Labor Code, for the peAortnance of the work for which ihis pertnit is issuetl.
My workers' compensation Insurence carrier antl policy num6er are:
Carrier: � -� Policy Number:
(This section need nof be completed iI the permit is valuetl at one hundred dollars ($f 00J or /ess.J
❑ I certity that i�n j6e-pe� a o e work tor �9hich ihis permit is issued, I shall not employ any person in any manner so as to 6ecome subject to Ihe workers'
compensation laws oi Caf , d a r!e that if I should become subject to ihe workers' compensation provisions of Saction 370 of the Labor Code, I shall fonhwith
comply with ihese ' w � P�� /��
Applicant Signeture: Date: � %
WARNING: FAILURE TO SECURE WOpKERS' NS TION COVERAGE IS UNL4WPUL AND SHALL SU9IECT AN EMPLOVER TO CRIMINAL PENAL IES AND CIVIL FMES UP TOONE HUNDRED
THOUSANDOOLL4RE($100,000),INADDITIONT THE STOFCAMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]O60FTHELABOFCODE,INTERESi,ANDATiORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm ihat I am licensed Under provisic
force antl eHect. Lic. N�
Coniractor's Signa�ure:
CONSTRUCTION LENDING AG�NCY:
❑ I hereby aHirm tha� thare is a cons
Lender's Name:
Signature:
OWNER-BUILDER DECLARATIONS:
of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
qass k
Da�e:
agency for the performance of the work tor which this permit is issued. (Sec. 3097, Civil Code).
Lender's Address:
Date:
I here6y aHirm that untler penalry ot perjury ihat I am EXEMP7 PROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Cotle: Any city or counry which requires a permit to constmct, alter, improve, damolish, or repair any slrucNre, pnor to its issuance, also requires Ihe applicant for such permit
to file a signetl statement ihat he or she is Iicense0 pursuant to the provisions of Iha Contractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 of the
Business and Professions Code) or Ihat he or she is exempt iheretrom and ihe basis tor ihe alleged exemption. Any violation of Section 7031.5 by any applicent tor a pertnit
subjects tha applicant to e civil penalty of not more ihan five huntlretl tlollars ($500).):
❑ I, as owner of the property, or my employees with wagas as Iheir sole compensation, WILL DO THE WORK, and the simcWre is not intended or oHered for sale (Sec.
7044, Business and Profassions Code: The Coniractors License Law does not appiy �o an owner of proparty who builds or improves thereon, and who dces such work
himselt or herself or through his or her own employees, provided ihat such improvements are not intendetl or oHered for sale. H, howaver, iha building or improvement is
sold within one year oi completion, the owner-builder will have lhe burden o� proving that he or she tlitl not build or improve for purpose of sale.).
❑ I, as owner of the propeAy, em EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consimct ihe project (SecJ044, Business and Protessions
Code: The contracbrs License Law does not epply to an owner of proparty who builds or improves Ihareon, and who con�racts for such pmject with a contractor(s)
license pursuant to ihe Contrectors License Laws.).
❑ I am exampt under sec. Business antl Professions Code tor ihis reason:
SignaNre: �ate:
Owner ID venfietl by tlrivers licen6e. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership 6y (type of document, i.e. - property taa bill or deed):
DIVISION OF INDUSTRIAL SAFETY pERM1T CER7IFICATION:
❑ I hereby certify that no excavation five (5) or more teet in depih into which a person is requiretl to descend, will be made in connection with work authorized by ihis
permit, and that no builtling simcture, scattolding, falsework, or demolition or dismantling �hereof, will ba more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title e, Califomia Admihistretive Code).
❑ As owner-builtler, I will not employ anyone to do work which would require a permit from the Division of Industriel Sefety, as noted above, unless such parson has a
� permit to do such work from the division.
SignaWre: Date:
Division oi Indusirial SefeN Permit Number:
CEHTIFlCATE OP COMPLIANCE qND Al7THORIZA710N OF ENTRY: 1 certify under penalry of perjury that I have read this application and state that the information given is
correct. I agree to c with all state laws and city ordinances relating to builtling wnstmction, and authorize representatives ot Ihe Ciry of Costa Mesa to anter upon ihe
above-descri ropedy f r inspection purposes. I ag�ee not to occupy or allow occupancy ot any building authorized by lhis permit until fi�al iospection.
CODE N. MSPECTIONTYPE 1
\
1616 Fixed System Final Fire pr
1266 Pool Spe Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203
204
Final Sign
Final Demoli�ion
Legal
D�ljE IMRIpLS
COUEX INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Eledrical
212
220
222
250
c 0 Z� i�a�
Date
Final Fire Prevention
Final Planning Approval
Final Site
Finai Building/Occupancy
OpTE R L
ti -a 5 aa I3n�
�II
ri
�
PHOJECT AODPESS: 2 4 8 2 NAPOL I WY
OWNEfl'SNAME: PAYNE BETTY M TR �� �
nooxess: Z q 8 Z �IAPOL I WY
COSTA MESA,CA 92627
631-2260
ANCNIENGINEEfl:
FDONE55:
UNIT:
xec.xo.:
UNIT:
PEPMITTEE: A—AMES PLUMHING 6 HEATING (714)530-2940
aooacss: 9911 LARSON AV B
GARDEN GROVE CA 92642
LICENSED CONiNAtTOB DECUPRTION: I hereDy alfirm tlw1 I am Iirertte0 untler D�ovisions af C�apier 9 �mmmencinp witll Section
70001 0l Om �on 3 a� 0 BUSineR anE Pmtession5 Coae. an0 my lic¢n5e rs in IM brte and CHttt.
ciTruc.: a066�4 STPTELIC.:2SOd97� �u :-36 EX ; 6/95
Oa�e: _, � � ��j-1 y Siqnature�_ _�_
wOBREBS' COMPENSPTION oECUNRiION: I hereGyallirm that I lwve a ceniliwre ol consent m selbinsure or a certifkate of work '
Compensauon ��g�6ejoZ �c�mieo caov ��ereoi ISec�ron 7soo, �ao. (�.3 / O 1/ 9 S
roucrwo.: REPUBLIC EXP.ORTE:
COMPANV: �(
CenAiea coOY is �ereUy tumis�ed. Cf tertili copy a,: witn me dry uil0i Divisian.
Dare:_i�-19�.—�— M7u�^��
E%EMPiION FflOM WOBKEN$' COMPENSATION OECLAHIITIIIN: (. ' n.. m� � pumt rs � one �uMrM �5100) or �.
I cetlily Ilul in I�e pe�orman[e oi I�e moB tor w�icli Iltis Oermit is iSsuetl, I SAall nol employ any person in any manner so as �0 become
subiect to tne worker5' CAmoensation Laws o� Calilomia.
Daie: Siqnature:
NOTICE: If, atler making t�is Ueclaration. you shoultl bewme suUject lo t�e Workers' ComDensatian pmvisions oi the Lahor
Code. you musl �onnwit� comply wit� sucll Omvisions or tilis Oermit s�all Ge EeemeG revokeU.
CDNSTflUCTION LEN�ING RGENCY: I here�y allirm Ihal lh¢r¢ is a[OnSimtli0n lending aAency �or I�e petlotmante ol t�e work lOr
wAit� IOis O¢imit i5 issued �Seclion J097, Gv. C�.
LENOER:
aooxess:
OWNEN BUILOEB OECLARATION: I hereGy allirm �nat I am eKemO� ��om Ine Contractors' State License Law br the PollowinA �eason
(Sec�ian 7031.5 Business an0 Pmlessional CoOe: Any ciiy ol counly whic� repuirts a Dermit to constmct, alter, impmve, tlemolisR or
repair any s�mc�ure. priar m i�s issuance. also repuires ine applicant lor such oe�mit to fi�e a signe0 statement ihat ne/sne is Iicense0
pursuam to the pmvisions ol t�e Cantracmrs' Staie License Law (Chapie� 9 �commencin0 ��� �«ion 7000) ol Division 9 0l the Business
anE Pmlessions Cotle) or ihai he/s�e is eremD� �hem�mm an0 t�e Gasis for ��e alteqeE eKemO��on. My Nolatian of Sectan 7031.5 6y
any aDDlitanl lor a permit suUjetls ine aOoliWnt lo a ciNl penalry of nol more than live nunOreO Ooilar5 (�`�).
1. as owner ol ine omveny or my empIoyees mt� wa0es as ttrcir wle compensation. vnll Co tha work, an0 t�e
❑ s�mclure is not imenEed ar ollere0lar sale (Section 70a4, Business ana Prolessional Code: TAe Contractors' Stata Llcense Law
GoeS n01 ap01y lo an Ownef at a O�Op¢rty w0o OuilUS or imOmveSl�ere0n, an0 wtio tloes Suc� wnrk himsell/herself or IhmupA
nis o� ner own empbyees. OmviCeO Ilut sucn im0�wements are not immEeO or oneree for ule. II, Mwever ihe OuilainB or
improvement is solC wit�in one yeat of complelion, t�e axne� vNl �ave Ihe Uurtlen ol D�ovinp �e/slle Aitl not 6uiltl or impmve
� lor Ihe purpose al Sale�.
I. as ownei af I�e O�opehy, am evUusively wntractinp vnth IicenseG contractors �o wnstmct t�e pmlect (Sectian 7044, Business
❑ an0 Pmfe55ion5 fAGe: The Coniratlof5 S�alO Lk¢(ne Law Oces noi apph/ Io an ownef ol Orop¢rry wlio WiIdS Or imprwES �A¢feon
an0 w�0 mnlratl5 �Or Sut� prqEc(5 wii� a CanlrattOr�S� Gttnie WrsWni lO l�B COniratiars State License Lawl. I am aware
ina� pmol ot Ineir Worker's CAmpenSation iniurance snoWO Ce pmvitle0 to me.
� I am exempi un0ei Setlion: B. 8 P. C.
br t�is �eason:
Date: Ownec
I ao �ereCy cenily Inal I am aware ol an0 unaerslan0l�e repuiremenR ol Califomu Heallh ana $afery CaOe Sections 255115, 25533, antl
2553< anU rt�ai I or any luwre Uuilamq acupam vriMviO not (arUe ane) ntt0 to comDN ��� saiE state m0es an0 t�e repuiremems far a
perrttii for consimctim or moaifica�pn trwn t�e Air wlny Muupemem Oistrici. PevEentul wnstmnion aODliwGms are e�empt imm
I�ese prwisions.
Oaie: M^"' ^'
I het¢Ey teilily IAai I�averea0i�i5 applitalion a SIaI¢ 1—=�e a0ov mtOrm � ni5 COrreci. I gt o cOmply wifh all y antl
ordinances anU s�aie laws �eWting to Uuilaing constm ��m ana �•�y aut� rae reW talives af I dry I nier upon t�e ah -m[
piope�y btin50eClion purpO5e5.
G `
Daie�_,. �_�_/—�_ Siqnature.
Driver's tmense or Saia� Security �:
Canary—ApP���^�� P�^k—Revenue; GolEenrotl—Aueswr
CZTY OF COSTA MESA — BUILDING PERMIT PERM NO; P 06938
PERMZT NO; P 069380 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOH DESCRIPTION : WATER HEATER CHANGE OUT SQ FT:
CLAZM VALUE: CALC—VALUE: GKOUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
***+t*r**r«�r*rrr+rrrrrr�r*�r****�***+titw*�r**rirr*rr�*rwrkrrrr**�t**w*r*�rr*********�r+e*
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR• FT IN FRNT: FT IN REAR; ET IN
LEFT; FT IN RGHT; FT IN LEFT; FT ZN RGHT; FT ZN
PARKING RE • PROV; PARCEL: 43914142 ZNE: REF NO:
PLANNING N TES>
>
MlfMMkMMlfMifMifltM1f1F1FMitMifMMMifM1f1!lf1fMM/fitlFifltM/fiFif1fM41f47fifMMM1FMMMlkikifiEifMlflfMlflfMMililMlFik1t1E1kifMlf
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 HY � DATE:
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY; DATE: (OF�
iflfMMitMMM1fMMMiFitMMkMMiFM1f MM1FitkiFifitikifiF3Fi iEiE
1f fflf k1fMM4MikMMM1tMM MMMIMIEIkMMiFMMM1f MitMif MMk1f M%Mif Ifif If MMMYMMkMMifMihif!lMkMYMMMMMMMMiF�tif M1f kik1E1F
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
PERMIT 7.00
25S � SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7,00 20,00 0,00 27,00 27,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27.0 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN—CHECK
zi,00 �
MMif1FMlfkMiFk1lM/FMMM�FMihMM1lMM1lMMMMffk/tifMMM4.M1fkMil4MlFkifMMMMM1Fff4MifMMiFMMMMMMMMMMkkMlfM4ifM1k
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
PLU 1 WATER HEATER AND/OR VENT 7,00
END OF FEES
01 OD159$76—003o9876 TcGY
GATE� 10/19/94 7IfiE: 14:14
27.Up
CONSTRUCTION ANDPLANNING POC SPA
pPPROVALS Permit#f Date I�spector pppROVALS Permit# Date Inspecto*
1. Temporary Electrical Ser�ce or Pole_ 52. Pool & Equipment Location -
2. Soil Pipe-Undrg�nd. �� - - 53. Sieel Reinforcement
'-3;,�E�ectricalConflu�t�ltility-Umdrgrdd'.`_j • 54. Porms
�;.' fectrical Condait•C/ndrgmd. ' i` ' 55. Electrical Bonding
�z5��eel Reinforc�mCat :t 56. Rough Piumbing & Pressure Test � �
T}'�
�'�.''�tectrical UFFf7�rnd, ^� 57. APPROVA� TO COVER�GUNITE �"
�:9, Fbotings ".T. �� 58. Electrical Co�durt�Undrgrnd. '
;, �B."Foundation ..j:y " •-` 59. Gas Pipe, O Undrymd„ Test
�9. YYa[er Pipe-U�Orgrnd. 60. Backwash Lines, P�Trap, O Undrgmd. �
10. Structural Flaqr SYs�em ,� 61. APPROVAL TO DECK
11, roperty Sewec Line & Houte Con�ctio� 62. Backwash & Recuptor�Finaf
i
7�. $2wer Cap - 63. Hea2er & Vent�Final
73. Roof Orains �o ,� � � 64. Plumbing System - Finai
14. Rough Plumbing -' T • 65. Electrical�Final
15. flough Electrical�Conduitc 66. Solar SVstem-Final
16. Rough Electria Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign ' ' 68. APPROVED FOR PLASTERING
78. Rough Electric�ebT Bar Ceiling - 69. POOL;SPA SYSTEMS FINAL
79, Rough Heating & Air Gonditioning FIRE DEPT. REQUIREMENT
- �� Y- �� v; - _ .
2Q:tRoggh Faciery �jreplace ��.� �S`� C; c' F- ! , :AppROVki:6�CPeranit #
-�r �. .� , r ��u,...�•� � .
21�;04's sxwctQc � ;-'E-� %[S + . ~:. . s::�-�` :; , ;. -
f.t ,�W .,e, a � �. �:70. �nderg�qu'+y Hj*liro r
22. Ottcts.'Venc�tatifg• i C'�= + � _ Gx ;�.77. .Produ'"��pfng ��yes �Oii
23:�GaHPi ��'e-Ra'tigh & Test i � r �� p��;� 72. Under����d F{µ�F. �; p b
24-Rog'f Fcaming i �; J �. . � ^ �+• ' 73?ti Underyrrttl. Stor��'Tank!O Gas ❑ Oil
25. Rddf S�athing�-: � � � � - � ui ! � 7q OverheaddHydrQ�'- F �
26y 7�6�r Ceiiing (Sityictura�) 8n_jNvrwcoat � �r. �� �J*7 �� 7g'^ pry Chemical J^ "+ ^ I
_ r,.
27: �Frame and FlashiP� �' ' 1 �' y 76 Dr Scan hi e�l '' �` � T �
.. �r.s } T:v Y � D i� . s
�,,,28' Lathing$ Siding;a r•: ;�;,�:. r �} �# 77^ FIXED SY�TEM�FINAIt V ^
>'29. Insulati'on `� �• . .. .. .: r �"' � I ' �. 7� F�RE P$EV. FIjV,,hL x � r, ��%
�:�30. DrywalE�Vailing .�'J. � �� � � •�� •�kiEALTM9EPT�. REQ111RBA1ENT
_37. P�asrer,�ro � CQ�t __ ' ,,,,�, ; �F x .79�'f�INAL`�N�.�,�ECTIaN , �'
�32.- Electrical Po er Meter�Finali �� s�+ e+ � 80�r,F00D CERT Fi�l'CATE ISSUED
33ZFin�Tal EIp',ctric C � ° C• � �`' '�No[�, s: � �,`', y _y - ..,
� v � t � , .�y � . �n e . � , �
,i34: Fin°��1 F�datirig & Ai5 dnditioning t-, r ( �> a �: ,�. <-
• . - _ � j0 Zc;_- l`�-��t,�c,cZ
35�iFirtaf G�s Pi¢e•Test� ,_ � ` H I , � . � C. �i_• • t`� _ : _
`� �'y a . r
�
x,36 Hog� ar.'CanoPv�. � � ;,.� n a ,i 1 ; � ; � ��• . �
i K�,
^37�FirfSl Factory Fi%�IaL$ ' =�' • :`; A _ �' • R'
., �r ;r , �.;_, . a x
`38. Finad Plum6in9 E�. 'iy i .... � ^� � � r • � - y -
'�39. WaLEr Service�FiRalk � � :.+ : r �* ` „ C� >>: , .
��44. Gas Service-Final �' S. t 5 e['7 � � Y i 0.- _- ,
3 �i' 1� Y
s41, Solar pomesticFinal_ .'• � •• � C:� a �-`�-
r� � � s tr r1� ^ �.
F"42 =�8ackflow Preventery � E� a � �: , -
i a 'S, ? .
- � . . . . . . � _ .
43. Backflow IrFigation� tr:�S r a" TF' ^ ��
-. . . a i,
: v
?44. 4andscapelcrigaticj�System,;;°;i'= . -' :� C` x � N �� � '� ��
�45��Sound �AttenUation �+a1r: ?' � '� 4 � F. < e-i � .- .= � a ^
ti . 'r Y C. � � r7
`�46�Handiw� RegulatioPs ._ � � �r . . �� x - ti; O�� ..'c'
�47 _:pll�AL STRUCTURE & BUtLDING � �� � ' I* + a� s y
� � i I i c� -
48�IN`�,LPLANNINC� � °`� ; -. �: ; ,; �
,
yA9.�.flectric Release to �Edison � •. n; i • .
� ;�
;50._Gas-Release to SoUjpem Catijorni� Gas Co ; l�, ; � �; �-� . '�' ;; , � �
51. CEFl.71FICATE OF.00CUPANCY - " „ . �
, , C� �t a •�
No. Date
. �
COSTA MESA BUILD G- AFEfY DEPARTMENT
P.O. BOX 91] C09TA MEBA� CALIPORNIA
For Applicanf fo Fill In Complately
T/YP)E OR PRINT
BLIILDING � �ya; �
ADDRESS V
COSTA MESA, CALI RNIA
_ !` _ , /. 7� .0 '
c�rr /7 a. P
ARCHITEGT
OR ENGINEER 0.,
ADDRESS �/ O O I
/'v"7/ 'i NO�R J.a"ZO
I /lN NO.O/I�J'o�0
FEE RECEIVED
C FIN`I�E �E��
A�i�d3f06OSdik R+�tBAR
BUILDING
For Office Use Only
RHC61�T NO. PCRMIT NO.
�Y DAT[ R[C[IVQO DA TS
s-a 9-c 3 �uN-�
�..,. _ i.., _ _. /.
NO.
�� �eo��
nooRess �.J LI vN e� �oeacn�rtion o
r^ /'
CITY V�� P A. P. NO. �
��^�///'''��� NOTE: NOEAVEOVERt
STATE / I��/ TEL'y( y I'1'. IT2O 90' TO SIDE 8 REAR P,
LIC. NO. NO. / �+� ZP "
'` EAVEB
SIZE � �/ �� � I no. ov eLnae� ALLOWED
OF LOT /� NOW oN Wi ypRDB APPROVED.
USE OF ^ e ^' �_ ' MAIN BUILDING
6ETBACK LINE FROM
cervTers oF BTnEer • �.I a REAR YARD _
61DEYARDI LEFf � I RIG�
DESCRIPTION OP WORK
NEW ALTERATION AOOITION
REPAIR MOVINO �HMOLISM
S ZIEDIN6 ' ��x. � � NO.OP . 6•
ROOMS 8T RIE9 �
EXTERIOR WALIr/ �� I COV�ERIN6 ,N��6L�
COVERING i ITtI
C
I HEREBY ACKNOWLEOOE THAT �HAVH RHA� /IB APPLICATION
AN� STATQ THAT THE ABOV6 IB CORRECT ANO AORHH TO COM-
PLY WITH wLL CITY ORDINANC68 ANG 8TAT6 LAWB p80ULATING
BUILOING CONSTRUCTION. /
SIGNATUREOF`�� � �/ J/ /p����/ Q���,
PERMITTEF-�+�� �w� `+"'� �• �'/�w
AUTHORIZED A6ENT� ' ��
OIHTANCBBET
MAIN BLDGS.
VAR. iC
/•rb sc. Fr
TH8 AMOUNT O
PURP036 OF
VALUATION
s �� �JS °-'
\
IUB80PMHY/� C
eui�wna -f
`�� lra�' Y33
IO SHALL BE LE55 TMAN
(U.B.C.REQUIREMENT)
YAR�SAPPROVED
ACCESSORY BUILDIN6
BET.I
AGCE
DATE
.�/P"d A � "
O
UNDHR VAlUAT10N 10 FOR TH6 �
ISXINO A PEAMIT FEQ ONLY. p
�y(N „
PERMIT FEE $ J / j
� m
PLAN CHECK 3 �� F
¢
� r(f 4
DOYLE & SHIELDS Develozmment Co.,Inc.
GENERAL
IN�PECTIONS
'LOA'E D�SCRIF'TION OF WORK 1
lOUPI&J TYPE V ZONE
PER11ll'.
SUBCONTR.AC'POR nnm� �