HomeMy WebLinkAbout2410 NIAGARA WAY - Building Permitsea�aw zq10 NIAGAAA WY
���^+ VALENCIA, VICENTE
�ooness: 2Q10 NIAGARA WAY
COSTA MESA,CA
MPL. YNIINa AODNE59:
YiCHRECT ON FNfdlFFA:
u�cx on �o.�s wo�ss:
mNm.crwsru�: STOUT ROOFING INC
cwm.cran�u�uio P O BOX 4309
wo�ss: DOWNEY
90241
92626
r
uNr: I CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 073629 PLAN CHECK NO: N
uc no:
UNT:
(310)923-6775
CA ucra, 402536
UNT:
IJCENSEU COMP�CTOq9 DKLAF�TION: 1 AsraEy ellfm udr pspvy Nn I em fcwmd ivdse p iom d CMpx 9
(oommp�mp wilh Sxtion 1000) d Di�'vion � d Ns eM P�G ' n Code. and my k.ems "v in IW b d eHsq.
cmuc.no.: p59 �7 uc.c s: 39 uc o.: qp 36 E SO 95
� l.P�
ome: / co�wwv:
OW NEN BUI�OEN DECUN�TION: I M�eDy dfrm uMer pmNy d prjvy thm I am siemq hom tM Comrmm ' e lew la Ns
idlaxiq iaefon (SeQion )0]1.5 &eiq�a vd Rdmom COEe: �ny c�y a cauniY Mwi� nQ�titm e Oam� lo aonnWd. Mx. impwe.
demd'eA, a repv eery euudure. p'n b ia ueuence. ebo nawe� the eppl'raM la ach penM to fJe e dprod eltlemem thei M a ehe
ie IicemeE Wnueni io �M Woviviam W tM Corureuon licen�e Law �CMqm 9(oommendM wilh Setlion 1000) d Dveion � d �he
Bwiroa erd Prdwbm Coda� a ihx he a ehe w azemp thvdeum erd tM bem /a Ihe allaped ssemqion. My v'dmion d SerJion
)031.5 by eiry eppFcani lar e permn wbjees tAe eppfcem to e dvi perolry d nd mae ihen Me hwMred EOAen �5500�.
� 1. ai mmer dthe popony a my «nWo/ase wth wapea m iM1ei �ob rompe'netion. wY Eo Ne work, end Ne svucluie e ml inlenEed
a Mered far veb (��ion )Oaa. Budirv eM Proleaebns COEe: The Conirmon Liunse lew doee rwi appty io en ownerd propeity
wM Wida a inpmvea IMrean. eM Mo dom vuch xak IimaeX rc heissi a Nraph he a her oxn empbyeee, pmAded �hm vuch
impovemant� ere nd InieMed or dlereE Ia eeb. H. hawewr. iM buiki�q a inpwemeM u�oltl xilM1in ppY� b�mpW ion. ihe
owMr-0uikx xill Aeve iM EUNen d povinp M a Me did nd ddtl a"unprwa lu iM purpose d seb�.
❑ l.. o.nw a ine ww«n..m ..��N w�vnu�u .W 4mn,.d mn..ciu, ro canmua mn ada (swion )ou. a�.in...m
Prolwione CaAe: T�e Conireaon Licems lew doee �w epply b en oxmr W popeny who builds or imqovas tlwaon aM who
tomracU fa p�tli pG+� xiN e aorYrenor(t14ca�uM P��aM a IM CaY�enan limtua Ler.1.
� I em enemq untlar Secwi: B. 8 P.C., br Nu �mson:
�.�. o.,�«
I do hereby c<�Jf' Yw I em ewu� M aM �ndr�unE Ne �ePwammb W Cellmtie Ilselh end SetetY Code Saabm P5505.155�.t. eM
25SL, vd Net I a arry Mun dnMinp aawpW wi0 / wa na (mcb one) naed b comply xtA uid ems mdw end iM rpuinmwib tar
eprmGtamn�wc�ionamodJiWionhaniM�iswity�.�u JonaNDvlritl.RmidwtlWmM�utlianapphtioroarsusmqlromNaa
o,a+.�..
om.: �oor�+:
WOPKEP'S COMPEN9�TON DECLAP�TION: I Iwaby �Kvm wdr psvly d paj�ry ans A Ne b0ow"vq dderet'vu:
� �new.nd.i�meuaen.c.tlrsudimwvw..n�mv.b�.vwan•ou�pwuetia+•naa'�ta.Mswonalaoa�Mleea.
�w
ca.. �« in. o.nomwc. a 0,. wak �n wYcn �nu c�+ u x.uea.
�I hm end wll meimen xaVan' eomMbdion vuurvo. n n��E W 6wion 3]00 d tlr leEar CoM. M IM Wbrmenn d IM
wak la MJN Nu C�ro b muM. MY waken' oomD�ion Luwarc� weiar eM W4M �wn We a�:
c.m..: STATE EXPIRES
Pofry NumEr. �d�4dFiiSiii�68'�— S O/ 19 / 9 5
�mi.sxrio,m.e�aacm�da.drwc«m�oro.on.nuw.eem.n t�minw../
❑ � anh uw m N. c.�amwca M ur .iaw a wni�, mo o«mB i a. � we nu «naM �r o� N r meruw .o n �o
Wcmr wljsq io �M xoM1sY compenWian Is�++ d pns N t I elnWA Ecae� jeq to iM
compenmpovo.i���� d y�Vbar CoE�. I 1 ' a m i yVM1 iMr pmri�i
om.: �� � �cdm.: l�L1� �
W�mMp: FiNun b ueun workri rnmpru�tlon eov�rp� l� unl�wfu4 ��tl MWI �uDNct �n wAvloyx fo erlM pNultlls �rW
elvll flrw� up ro on� Iru�dM llnua�ntl Ed4n /i1PqP00A M Wlqon ro N� cwt ol cemp.nufbn� tl�rnp� pnHWtl br In
5�ctlon J�O6 0l Ih� L�bor cob, IntMut �ne �Romry'� Hu.
CONSTPUCl10N LENDINO AOENCY: I haeby �rtn uMs penetly d pmjury Ihm ihxe a e cwu�nqion MMiip epenry br �M
perlormairce W Iha wdk br xfiic� Ihe Mmi� u uuwE (Swion ]081. Cw. C).
LENDEP'S N1AIE:
LENDEP'S AODRE59:
I cerlily Ihet I heve reeE I�u eppl'raiion ud nele Iliei Na eEwe iNamatbn u rortw. I eyrea to compy wilh ell ay eM oounly ordinenme
uMeWak'MRIPoiylodlikTpCOn%llMMudAMWVeWvRa�OpfpfMlB(IhMd11YlCIybeNxupT�hOeL �mN�tlOnadpOpOM
lo� irt4petlqn Wrpouf.
/1DARLENE BURFqbtD w
��
Date:
(SiSt <B W Pl �ne-Buiknp 8 Seldy. G�ee'rFb: Cenery-Appiram: Rnk-Av+erun: (iddenmd-Asaeva
PEKM NO: B 0'7362
GOVT: N SUPP: N
CONSTRUCTION TYPE: VN PERMIT TYPE: STR PORPOSE: OTH
JOB DESCRIPTION ; T/OFF, SHEATH 5 REROOE W/COMP SHINGLES SQ FT: 2,999
CLAIM VALUE: 2,999.00 CALC-VALUE: 2,999.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS ARE RE�QUIRED PER 91 UHC
��x**�r*x�r*****�*���*******�*�*+�* *+r*�r*****��*�***x��+�***x�x��x�**x�*+��r���r*+��r*�*x**�*
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 S
T----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41916579 ZNE: REF NO:
PLANNING NOTES>
� .
�E iE 3E iE IE 1E 1E If 1E 1E iE iE 1E iFlE 1E 1E IE iE 1E 1E i! 1E iE 1E 1E iE 1E 1E iE 1(�!f iE 1E if 1E 1E iE i41f 1E iE 14 iE 1f iE 1E 1f 1E 1E 1E 1F iE 1E if iE If 1E 1ElE iF iklF 1k 1E 1f 1E 1F 1EN IE iE fE 1E if iE 1f IE ff
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
ZONING APPROVED BY DATE: ��
BUILDING APPROVED BY ; DATE: i. /
APPLICATION ISSUED BY; DATE:
1E1E1EIE1t1E1k7k1E1E1f1E1FiE1EkaE�EiEfEiE1E 1E1E1f7E1i1E1E7F1E1E if
LEGALIZATION;N F E E S M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
PERMIT 54.00 50
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 54.50 0.00 0.00 54.50 54.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
54.00 .50
1f 1f 1E 1E 1k 1t iE iE iE iE 1E 1E 1k fE if iE if iE 1E 1E 1E ik if if k!E 1E 1E 1i 1E 1E 1f 1! 1E 1t 41k iE 1E 1E 1f 1t 1k 1k �E Ik iE k Ik 1E i! 1E iE 1E 1E 1E 1f 1E 1E 1f 1E 1E 1E 7E 1k 1E'IE k iE 1E 1E'N' 4 iE 1k iF 1E 1E 1f
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 2999 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 2,999.00
END OF FEES
31 C�:ci6SS-L�1187e9S �i"� � �5,5Q
DA7E: 0$iL'4/45 "li,E: 0''•:20
�4
�`. CONSTRUCTION AND PIANNING PQOL & SPA
�_� APPROVALS Permit# Date tnspector qppROVALS Permit# Date Inspector
1. Temporary Elec[rical Service or Pole 52. Pool & Equipmenc Loca[ion
2. Soil Pipe-Undrgrnd. y, . 53. Steel Reinforcement
3. Elettrical Conduii Ui}lity-Undigrnd. 54. Forms •
'�4. Electrical COnduit-Uixlrgrnd. 55. Electricdl Bonding
:3_'6teel Reinforceme�at � 56. Rough Piumbing & Pressure Test -
" 6.'��IectricalUFERjf,�nd. 57. APPROVALTOCOVER-GUNITE �
�
''�� �ootings � : - 58. Electrical Condui�;Undr9rnd. -
�?9:; Foundation -� � -• 59. Gas Pipe, O Undrgrnd., Test ,
^`. 9." Water Pipe�Und�gmd. ; .:� . 60, Backwash Lines, RTrap,�O Undrgrnd. • •
10. Structural F1oor System � 61. APPROVALTO DECK t- '
11. property Sewer Line & House Connection 62. Backwash & Rece�tor•Final
12. 5ewer Cap ` - 63. Heater & Ven[�Final
13. Roof Drains 64. Plumbing System - Final ,
74. Rough Plumbing`_ � 65. Electrical•Final i
15. Rough Electricaf•Conduii ," 66. Solar SYstem•Fiqal �
16. Rough Electric UVving _ 67. Fencing & AccessApproval. • "
17. Rough Wiring Sign 68. APPROVED FO.Fi'PLAS7ERING
78. Rough ElectricaGT Bar Ceiling' 69. POOUSPA SYSFEMS FINAt
19. Rough Heating & Air Conditionin9 FIRE D�PT. REQUIREMEIVT �
�T ^� V -t .!J . rY' .
20. �ough Factory Fir.eplace � �•- _ � - . „ � APPH'OV`ALS_. � PerYnit # ��
� 21. Aucts,in:Structure;a � �•• � -S = - -_ - 70.�'tJnderrt6und HYdro ��
22.puccs,ventiigting,-.; � - _ � - 77. ProduatPiping'O�Gas ❑Oil
23. Gas P�pe•�ough & T¢st - +. ^' 72, Underground Flu� - �
24. Roo�raming" � '. " " _ ` � � 73. Under9r�il.Stor��eTank;OGas O'Oil
. 25. Roof:Sh�thing - . � Z�S' ��u/� , 74.'Overhead HYdrb' .. , .
26. 'F-Bar�Ceiling �Svuc,�raq & M�p�oat ' . - 75. -0ry Chemical ' , �
27. �,FramC ar�d. Fla{hing. �� �� 76. Dry StarttlpipeF :� y� _
- 28. Lathing &•Sic]inq �� - n =:..' � . ..,. 77. FIXED�Y�STE141=FINA;�. . � "
� 29. Insulation • � �� � ^ � - � 78. FIRE PREV. FINAL - �
30. D�Ywall CLeiling �' ' j = .7-IEALTN DEP,Y.�iEGUIR�MENT
. J
�� 31. Plaster BiqwrrCoai , . -• 79. FINAL tD1SPECT�iDN x-
,; 32. ElectricaRPov;'"�r �ter'Fiqal -' 8(�; FOOD CERTIFICATE ISS.UE4 -
,� - y - . - •
33. �ina?:�leciric. .� . 4 . ' Nrites: =! �� - . -�':
34. finai7-leaung_& A�t ConditionicFg_ ' _ � ' �. � �` ' S ' _
y
:. .. . _ -
, 35. �inat�GafPipe;�Tesi-;, �` .. , . - � - �_-. . � r
" 36. NooB-or Canopy ' a' �' � �
37. Final Fattory Fireplace - _ _ - � .. .a
' 38. Finat Plumbing =%�' � ' ' - ; ` �
- 39. Watef $ecvice;.Final"�- � ' ' -• ` ��
•. 40. Gas Service-final - : � ' � - • - '
Y
� 41. 5olar Ooinestic-Fi�al ' :r � � _ - _ z -
42, �ackflow�. reventer � • � ' - ��
� - � -
43. 6ackflow Irrigation ._ - - � . , , - -- � `� ��
qA. Landscape IrdgatiortSystem= .. * � � �' :1: ;� .. � � �
' T l:.Y.
45. Sound Atienaztion, - - • ' _ - -� r' : _ ". - -
r r . . . d i-� .-
�C6. Mandicap�Regulations - � x' � •= ��� =•
:: r �;�� n
q7, FINAi STRUCTURE & BUILDING (��`'�ql �(,��C �' '- -
48. FINAL PLANNING - - � ' " � `� y
. �
49. �leciric Release to Fslison . , "' . „
50. Gas Release to Southern California Gas Cn ' - _ '
51. CER7IFICATE OF OCCUPANCY ��V • `
No. Date
CiTv QF coSTAcESA CONSTRULTION PERM�T.' a�C
�t
Project Address
Applicant's Mailing Address ' � r
Owner's Name / Phone �
Address .�.(��/�,.� � '
Arch/Eng. ' License No.
Address D
Contractor'sNam /^ Phone_ � �
Addresslma'I"ng) ��J -y I�_
CityLicenseNn. C /.�i_
LICENSED CONTRACTOR DECLARNTION
I M1ereby atfi�m tha[ I am litensetl untle� provisions o/ Chartcr 9(commenUng
with seciion 7000) of Division 3 oi lhe Business antl PrOf¢sslons Cotle, anC
my licc�se is in tull E e(fec ' �qSd�7
License � �
Date �e $I9 t ��/�/%l�=
� WORKERS' COMVENSATION DECLARHTION
� I hereby ailirm that I have a certificate o/ ronzent to selt-insure or a ccrtiticate
� of Workeri' Compens/ation InSurance, or a certifietl copy'thoreof (Section
� PoIOIc�Y No.� �'/�� ComPanY ��1,�`/•C�
�Certifietl coOY is hereby furnishetl. � %—
Datee�tit� (� I' etl wAPOhtanitY B�(/������/Z��
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section need not be com0letetl i( the permi[ Is fOr On¢ huntlred ($100) or
less). �
1 certify that in the pertormance o( the work for which this permR is Issuetl, I
shall not employ any person in any manner so as ta become subject to the
Wo�kers' Compensatlon Laws of California. '
�ale Si9nature �
NOTICE: It, alter makin9 this tleclaratlon, you snoultl become subject to the
Workers' ComDensation provisions of the Labor Cotle. You must forthwith
Comply wilh such p�ovi5iOn5 or th15 permit Shall be tle¢metl rOVOk¢tl.
CONSTRUCTION LENDING AGENCV
I hereby ai(i�m that there is a constru[tion lentling agency for the p¢rformant¢
of the work for whic� this permit is issuetl (Section 3097,�Civ. CJ
Lentler'S Name -
Lentler:s Atltlress
OWNER BUILDEH �ECLARATION
I nereby attirm ihat 1 am exempt from the ConVactor's License Law tor the
foliowin9 reason (Section ]031.5 Business antl Professional Cotle: Any city or
county whicb requires a permit to construct, alter, improve, tlemolish or repair
any structure, O��or to its issuance, also requlres the applicant for such permit
to file a signetl statement that M1e/she is Ilcensetl pursuant to the provisions ot
the Contrac:or's License Law (Chapter 9(tommencing with Section 7000) of
Division 3 ot the Business antl ProfessiOns Cotle) or that he/She is exempt �
lnerefrom antl the basis for the allegetl exemption. Any violation of Section
]031.5 by any applicant for a pe�mit subjects the applicant to a civil
�endlty oi nol more lhan tive huntlretl tlollars (5500).
I, as awner ot the prope�ry o� my employees with wages as their sole
� compen5ation, will tlo the work, antl the sbuctu�e is not intentletl o� otte�etl
far sale (Section 7044, Business and Pmfezsional COtle:.Th¢ ContraCtor'S
License law tloez not appiy to an owner oi a property who builds or improvas
thereon, antl wM10 tloes such work himself/herself or through M1is or her own
em0�oyee5, P�ovltletl [hal SUCh Improv2ments aru nut Intentletl or offoretl for
sale. If, h0�+ever, the bWltling or improvement is soltl within on¢ Year of com-
plelion, [�e ownGr will havC the burtlen Of proving h¢/Sh¢ tlltl not builtl or im-
prov<fo�the purpose olsale).
❑ 1, as owner of the property, am exclusively contraclinq with Ilcensetl con-
Ifactor5 to cOnStru[t Ih¢ O�oject (Section 7044, BuSin¢55 antl PrOte55ion5 Cotle:
The ConUactor's License L.nw tloes not apply to an owner of prooerty who
builtls or ImprovCi lhereon, antl who contracts for suCh prOj¢Cts with a con-
bactor(s) i�cense pursuant to tlte Con[ractor's Llcense Law). I am awaro thaD
o�oor ot Ihelr Worker'S COmpensation insurance Shoultl' be provltlatl lo me.
❑ I am eaempt unaer Section B. & P: C. (or this reason
Date Owner _
1 hareby certlly that I have reatl th
informatian is mtrect. 1 aaree lo cort
$i9nature ���
Ddvers' Ucense or 5`
CMF OB65-46, rev. 30/84
a
nt to till in all spaces exce0� those within M1eavy Cortler Iines antl si9n all apPropriate tleclarations.
.� ,a� ..��...�. ��...�. ��.�,���
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
� ❑ GONVERSION ❑ DEMOLISH ❑ OTHER A p#
DESCRIPTION OF WORK/USE Of BLDG.
S Main Buildi
E
TYPE OF PERMIT GRADING OUNDATION STRUCTVRAL T Front
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B R¢ef
❑ OTHER C Rlght
PROJECT DESCRIPTION 5(]. F7. oCCUPaNCv K
CONSTRUGTIONTVPE VALUATION�$ S left
20NE GRADING CU. VDS. ACRES Ping. Ref. il�
Remarks: � , ' Ptanninq Notes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Clarifiers
Dishevasher
�rinking Fountains
Floor Dreins '
Floor Sinks
Gas Service
I nterceprors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspeetion Fee
Outlets
$15
Boiler
Duct � Under Ground
Duct � Structural
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fac[. Blc ICBO #
Heating System & Ducting
❑ 0� 100,000 BTU O 100,000
ReinspeRion Fee
White - Bulltling; Canary - ApplicanL Pink - Accounting; Goltlenrotl - Assessor
$15
Showers
Servite Sink �
Sewer Cap .
Sewer Connection . •
Solar Collectors
Solar Piping
Solar Tank '
Swimming Pool w/Spa
Urinal
Water Closet �
Water Heater
Water Service � -
Auto-Wash
Issue Fee
Hood or Typel .❑
Canopy Type II ❑
Refrigeration System -
❑0-100,OOOBTU ❑100,000
System Repair/Alterotion
Fire Dampers
Registers
Issue Fae
FEES
8225 12/04/86
ZOne
Accessory Building:
Parking Req./P�ovided
�€4V€B 8E� 0'2 3986
Auromatic Washer
Construction�Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes �
Outlets
c...:.,.�..._ _ . _ .
ELECTRICAL .
Transformer ❑ 15-50 KW
_ O 50+KW
� Meter �up to 100 amps
Meter �over 100amps
Sub Panel
Motors Q O-7 HP � 1 Yh - 8
Inc.Solar �9�15 HP �16�15+
Mivowave.
Pole Light
Range
Garbage Dispoul
Generator �0.5 KW �5-15 KW
$ 3 I _
� Reinspection Fee $15
FEES
�DEVELOPMENT SERVICES REQUI
. Zoning APProved By
Building Approved By
ApplicatiOn IuuBd BV
$ 3
SU
Standing Sections
Trash Compactor
luua Fee
OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT - -
PLUMBING $ � ��UANCE $ .
PLAN CHECK 25% $ ENERGV P.C. �$
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �Ov
MECHANICAL $ TOTALFEE $ �
PLAN CHECK Z5% $ '
5.00 • TL
Z
O
N
I
N
G
R
E
�
M
T
S
FEES
$ 3
O
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding i's^
n.
5. Steel Reinforcement 56. �Rough Plumbing & Pressure`T.est
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-G17NITE
7. Footings 58. Electrical Conduit-Undrgrnd.•.
8. Foundation 59. Gas Pipe, O Undrgrnd., Tesa�
i... �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ��Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK l.t.l
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fina111
12. Sewer Cap 63. Heater & Vent�Final M
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. 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. Duc[s, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. FrameandFlashing 76. DryStandpipe _
28: �athing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT -
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:3'3•a`) LE� (aq� .(.•E�i
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace _
38. Final Plumbing L� 7 �
39. Water Service-Final
. 40, Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer -
43. Backflow Irrigation
44.' Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING '
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co i '
51. CERTIFICATE OF OCCUPANCY ,
No. Date ,
OWNEA $AN VI9i'A $jJILDING COMPANY DATE
70B ADDRESS 2410 Niaaara Wav BUILI
SUBCONTRACPOR
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' COSTA MESA B ILDIN - FETY DEPARTMENT
P. O. BO%31] C06TA M86A. CALIFORNIA
0
For Applicanf ►o Fill In Completely
TYPE OR PRINT
BUILDIN6 O
ADDRE53 � I
COSTA MESA, CALIFORNIA
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STATfi �{ T6L.
LIC. NO. .L � NO.
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USE OF
EXISTIN� BLDO.
BETOACK LINH PqOM
CENiER OF 6TREiT '� REAR YARD
3mHYARDI LEFT ' I R16HT �
DESCRIPTION OF WORK
FEE RECEIVED
�'AY 1 9 i684
APPL I CAT10N �P.EWGIU '
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For Office Use Only
R[CHIII' NO. PE 111���Jq�
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.OWE� fU.B.C.RE0U1REMfiNT1
YAROSAPPROVED VARDSAPPROVED
MAIN BUILDINO AGCESSORY BUILDIN6
D18TANCH BiT. BHT. MAIN d UJ
REPAIR MO INO DEMOLISH MAIN BLD68. ACCE55. BLDO9. �+
BUILpINO n NO.OR H VAR.jF DATE �
6IZE o(D � Z. ROOMB � 6TOR1 8 Z C. U. P APPROVED
EXTERIOR W ROOP � APPR �r� / l� Q�
COVERING COVERINO �' �I` DATE . 1 {yJ
U86 BUILDIf�IG DWORKTOBEP PORMED �
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1/3(�sa.�. - � � � �
1 HEqEBY ACKNOWLBDOH THI1T 1 H�V¢ qBAD THIB APPLICATION THE �MOUNT BHOWN OER VALU�TION IB FOP THe 8 O
AND BTATH THAT THE ABOVB 19 CORRCCT AND AORHB TO COM- Pl1RP08E Op HBTABLI8HIN0 ♦ PEHMIT FEE ONLY. Q
PLT WITX ALL cIT OHDINANCBII ANO 9TAT8 L/�WH p80UlATINO yqLUATION /� m' {L
BUIL�INO CON PURION. , Q
SIGNATURE OR ' PERMIT FEE Cl� ��7
PERMI7TE �I I) S�O� � • , � O �q
AUTHORIZHDAO H�1 �
TOTAL FEE $ ���