HomeMy WebLinkAbout3202 NEBRASKA PL - Building Permits� 'CTAODflES$: 3zO2 NEBRASKA PL
�• �'NEN'$NAME: CONNELI�Y BERNARD J
aooeEss: 3202 N$B�tASKA PL
COSTA MESA,CA 92626
FflCHIENGINEEH: S 4 9— 1 3 3 8 flEG.NO.:
aoosess:
uxir:
uxir:
PE""unEE' SMOTHERMON ROOFING CO ( 714 ) 997-0255
aooxess: 568 S, GARDNER STREET
ORANGE CA 92666
ULENSEO CONTBACTOfl OECLABATION; I �ere�y affirm Ihat I am licensed unEer pmv6ions ol CIuO�er 9(commencinA wilh Section
7000� ol Divsion 3 oi Ihe Business antl Profe55ion5 Code, an0 my licenu is in �ull lorce and ¢Oecl.
ciTr uc._ �� S T sTaTe uc.:30861 �SS C39 _
a0'r'� L Signalure: _ ��
WONRENS' COMPENSATION OECLAFATION: I here6y alfirm ��at I have a ceni�ica�e ol consen� m sell�insure or a ceni�icale ol Workers'
Compensation Insurance. or a cenified copY ��ereol (Section 3800. Lab. C).
roucvxo.:0427911-91 cxr.oaTe: 09/O1/92
comraNr: STATE FUND
❑ Cenitiea coDY �s AereGy Iumishe0. [� Ce�ili¢U capy is liletl wit� Ihe ciry BuilUinq Divisio/n./
a„�- d —��9L APPlicani: ��— "
E%EMMION FPOM WOflRfPS' COMPENSATION UECLAPA710N: �This 5eciian neetl no� be comple�eU il �he permit is �or one hundretl �5140) ar less).
I certify Ihat in Ihe pedormance of Ihe work lor which Nis Dermit is is5ue0. I shall no� employ any person in any manner so as lo become
suble�� �o Ihe Workers' Compensation Laws ol Calibmia.
Da�e: Signamre:
NOTILE: If. alter making i�is declaratian. yau s�oulG Gecome su01e�� �o the Workers' Compensation Dwvisions of ihe Labor
CoEe. yau must ton�wn� compN'M�� suc� O�ovisions or tNs permit shall be UeemeG revoke0.
LONSTNUCTION LEN�ING AGENCY: I p¢�e0y affirm t�at �here is a canslmction lending aAency br the pedormance af tAe work far
which Ihis permit is issuea �Sec�ion 3097, Civ. C�.
IENOEN:
AODNESS:
OWNEN BWLDEN DECUBRTION: I he�¢by allirm IAaf I am ¢K¢mpi Imm Ihe CAnVactOrS' Slate Lic¢nse Law for I�e IOIlowinB �eason
(Section 7031.5 6usine55 ana Pmlessional Co�e: Any ciry ot coun�y w�ich repuires a p¢rmil to mns�mtl alter, improve, Oemolish, ar
re0air any simcture. O�or lo its iuuancp, also requires Ihe aDVlicant for such permit to lile a sipneG statement that �Gs�e is licensetl
pursuam to tAe D�ovisions ol t�e Contraclors' State License Law (C�aD�er 9(commencinp with S¢ction 7000) of Division 3 of Ihe Business
an0 Pmlessions CoOe� or Ihat he/s�e is ¢K¢mpl i�ereimm antl I�e Gasis lor Ihe alleged eremp�ian. Any violation ol S¢qion 7031.5 6y
any apPlican� for a permii suUle�ts ��e applicanl Io a civil penalry ol nol more ��an �ive �unUreO dollars (5500�.
I, az owner oi Ihe D�operiy or my employees witn wages as Iheir sole wmpensalion, will Oo ��e work, antl t�e
❑ simcture is no� inrenUea or al�erp0lar ule (Sectian 70aa, Business anG Profeuional CaGe: The Contractors' State License Law
aoes not aoP�Y �o an owner ol a propeny who Ouiles or imOmves tnereon, an0 who Ooes such work himsell/hersell or throuAh
his or her own employees, O�ovioed ihat suc� impmvemems are not intentled or allere0 lor sale. Ii, Aowever ihe 6uilding or
imDmvement is soltl witAin one year oi completion, ihe owner will have the �urden of pmving he/she di0 not bui10 or impmve
for tlte Durpose ol sale).
I, as owner ol IAe O�operty, am G�clusively conVaciing with licensetl contracmrs lo conStmci IAe O�oiec� (Seciion 70dd, Business
❑ an0 Prolessions COUe: T�e Con��acmrs' S�ate License Law Uou nol appty m an owner ol property who Uuiltls or improves thereon
anE who coniracis br sucn Oro�¢ps mih a contractaqs�license Dursuanito t�e Coniractors' State Luense Law1.l am aware
��at prool ol I�¢ir Workei5 Camp¢nsalion in5urance SMuIE E¢ provi0e0 �o me.
� I am exempt under Seciion: B. 8 P. C.
IOf �i115 fCd500:
oaie: ow�e�:
I eo hereby cenify ihat I am aware ol ana un0erstanA ihe requiremenis o1 CaliPornia Health and Salety Code Sections 25505, 25533, antl
2553< antl that I or any INure Duiltling o��u0ant vnNwill noi (circle one) neetl �o compiy with SaiE sia�e coEes antl the repuirements tor a
Dermil lor consimc�ion or maailication I;om ��e Air Oualiiy Managemenl DisVicL Fevaential cpnslmciion applications are eKemD� �rom
mese v�avisions.
Oale: AOPlicani:
I heieby ceriifythal I havereatl�his application an0 sla�e�hai IAe a�oveinlormation is correci. I aA�ee�o compiy wi�� all ti�y anA county
orainances antl slaie laws relaling lo �uilqing consimc�ian and hereby aNhorize representa�ives ol Ihis cily lo enier upon Ihe above�menlione0
pmperW �oi i/nspeclion purpo5e5. ` '
�7ale; �/ �� Z�Signalure: dY% ;�
Oriver's Ucense o� Social Seariiy x: �
�6A646 WMe-8mltling; Green—Cppa Eniorcemenl; Canary—AOP���ant: Pink—Revenue; GdEenroa—Assesmr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05765
PERMIT NO: B 057655 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : T/OFF REROOF W/CLASS A ASAALT SHINGLES SQ FT: 4,000
CLAIM VALUE: 9,000,00 CALC—VALUE; 4,000,00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR RE�UIRED IN THE HOME
*�r+r�r�r�t�t�t�r�r�r**�t�t**�t��r�e�r*�r�r�r* �r�r�t�+t�r�t�t�t�t�r*+t�t*�r�t+t�t*�t*�r�r*�t�t�t�t�t�t+r+t�r*�t�r�r�r�e�r+t�+t+t�t�e�rx��r+t
Z O N I N GS ERTEH�AUCjRRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARRING REQ• PROV; PARCEL; 13908301 2NE: REF NO;
PLANNING Nt7TES>
%
*�t�t�r*�r�e�**�r**�t�r�t�r�r*+t***�r****�t***�t�t�r�t�e**�t+t+t�r*�t�r�t+t�r�t**�r�t**���r�r**+t�t****�r*�t�t*�t*��*+r
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: ��—
IFlF M if �1F�F iF 1F IF �t1E �FiF �f,if iF M it if 1Fif iE iFiE if iF ik 1E iliF iF iF��iF7FiF if
�kifififiFiF�fihlklflllFlk�fifififiFitiFkiFiFkiFlf�f�flEiF�t�FiflFlf�fifikif 1flfiFififklfifkiFkiE3fkifkiflFiflf�f�flFk3fkifklk�fiEiF3flfif�f
LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 63.00 50
PL� SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.50 0.00 0,00 63,50 63,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 63,50 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK
63.00 .50
M if iE if iF if iF iE iF �E iEiE 1FiF iE If iF iF k if iF iF iF iF k iF if M if ik 1t 1k 1E �E if if if if iF iF if iF M iF if iF iF �f k if M M M iF IE�f iE if if if aFlf iE 1E 3f if iE 1E �E M�E if IE IE iE iF ik 1f aF
I N D I V I D U A L F E E B R E A K D O H N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 4000 REROOF BY VALDE RESIDENTIAL NOZONE 1,00 4,000.00
END OF FEES
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^ /� _ , ,
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�GONSTRUCTION AND PLAIyNING � POOL & SPA j
APPROVALS Permit# � fbate Inspector qppROVALS Permit# Date inspector
1, Temporery Elec[rical Servi�eor Pole_ ,. ��. 52. Pool & Equipmen[ Location ,
2, Soif Pipe�Undrgmd. _ ¢- '•'� �t 53. Stee1 Feinforcement
,`3�'Elggtri�l Cond�i l.fi�iity-Undrgmd ="'`� . 54. Forms
.
��'4T.. �le6trical Conduia^F}nlirgmd. � �� , - 55. Electrical Bonding
n r�
;,5;,.�t�gl {{�inforcem�nt � C:� 56. Rough Plumbing & Pressure Test �
�.6..E12'ctrital UFER:C'iFnd. 0 57. APPROVAL TO COVER-GUNITE �
'�;�� f�4tings `' r T 58. Eiectrical Conduit-Undr9rnd.
�fl,•Foundation ��•%r �• ' 59. Gas Pipe, O Undrgrnd., Test •�
��3: Water Pipe-Undr�r�d. � 60. Backwash Lines, P-Trap, O Undrgrnd.
70. 5tructural FloorSpstem , a . 61. APPROVA� TO DECK
7 t. Property Sewer �Lit�& Hou3e Conne'ction 62. Backwash & Receptor�Final
12. 5 er CaP °i -
r� . 63. Heater & Vent-Fina!
13. Roof Drains �� � 64. Plumbing System - Final
m
14. Rou h Plumbi ' �' • � � �
9 � 65. Electrical-Final
15. Fiough Electrical�Conduit . 66. Solar SYstem-Final .
16. Rough EleMric Wiring 67. Fencing & Access Approvat
17. Rough Wiring Sgn 68. APPROVED FOfl P�ASTERING
18, Rough Electric�i?T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - - ^ x F-� ?:
20.'Rough Factor� F�r.g,place � ,s:i' 's� - � - * APPROVALS�%�'-'Per�t # * �' T'
1 '
21.,pucis.in-Strueture;R � r.�- !:'� .. � �:> r�-70. Undergr`ou7id-J-IYdro
22. Ducld. V'enTifeting-,y � :: � ' ^ y y^ � �71. Product�Pi{yirjg Ci' `�ss ❑T,�il
23.'�arPipe��iough &'1"est _ T '� x' � . '.,
. i r � . �T ..0 C� � -�2. Underground FIUs'�1: � a
24, cRooKframing• ^» � � - W '> � � ° � �73. -Undergrnd?StoraY�e�Ta� k 0 Gas O O4P
25. Ro Sheathin '� � ' ° '� L `: � , -.� .
� , 9 . _ ;� : �(�j�>-�74.;Ogerhead Hydro�^
.. � �-
26. 7�BaaCeiling ISvacfural) & AAonocoat '� '=' � !�:�' x 75. pry Chemical - � - 1
ro y ^ .�1} �� U !t
27. �rem,e and FI shi a: �'-+ " u1 Y v. "�2 �'. . -"
,1, �1B* :;�k Y'^} ro 76. �y Standgipe ._ r
•28. Lathinng:& Sidingt^�� %: ��'i .S � } �•� - > 77, yFIXED S�STEN�INAL�, V �r
'29. Insulation � �x � S � �� : Y ��' I • y Y 78.�:FIRE PREV. FINAk y -, ^ ,,�
�QO. p�Ywall:Nailiag r+� � x� I '-�- + HEALTH DEPT. REQUfREMENT
� �
i � - , . .�
�.31. Plaster 8r�wn,Co�t k.� ;�� �r :� j i -� i,79.'fINAL If�SP.fCT10ApJ "
�22. �E�eciricel Power Meter;Finai i� •. t I �.$O.�.FOOD CERT fl I�A?E 159UED � �
� �
33.' , in j Electric 1 ` ,�' � y. " `� � --� ' ' Note�s: '� -: � ;: - L ti .� .
< -
�34. Fina�=He31i�9$� A1r�Cor�d+tiooiap5 .i " ( � > ;, �r .> � ' * e -
1 1 , � 1 'it �
35. Final�Ga3%PipF,T�Test t ._ • •-! • • , �i� p �r � To - ��:
FI o ' . i
' � -' � � " . ..
,r�6.'Hood�or��anoPY x � :J i n - - .... . i ��,* sr ... ;^ � � ,y �
�7.�inal Fa�'torv Fir�p�ace'.' � ` ; `' � � i ; � :i t ;"i
38. FinaL•Plumbing ', •i,.� � .. .. I � 1 v �y � . + �� C -
�39. Wat�'r Service-Finalx - " .' � � � J � .T.'� z �
�: a �z I A :Y ;N
,' � ..
730. Gas SeN��y�'e-F�;nal , _.� t„ p ,� � ,., : � �• r- _ �;�,
�
A7. 5olar Dcfinesfio-FinaM :. ' .. '" =` i h .' '¢"' .
1 � Y. -J � �
42, 6ackflow,`Preventer� -- �� fi � (�.:, ;z' ;y� • �> L �+
43. 8ackflow Irri�ation �- � v .S =' . ° ' ii'�c v ^ _ '
x i �:' .a . / .. �
Sc �T.« ,
.(34. Landscape Ir{jgatioq System�D.,•,^ - .. - � pa t �r, p• p! ' ; x. :7 �.
45..5ound Atten'�ation>. -. •�E h' •. T. - ' c e a,- '- "�^ a'1 +.
I� 1. Y � �' q T� v y -` r'!' � ' i.' A
x' Y .�I •� ..7 ? . ; , � � � V
'�y6. Nlandicap Reqylatio4s - � + u �, � _ ,
47.�FINALSTRUCTURf&BUfL'DING fj^ �� ✓^"' � '-�'. '
• x /, - . -
r [r .;- - I' � -e ; n, � � ' -
48.''FINXIL PLANNING: o.�� �-- t- � iq .. �+ . n
49.' Electtic Release to Edison i .• � , �. ��: � • ' 1 :
e .�
;�50. Gas �ele�se to Sout�ern California Gas Co y I � %. �; ' � ` . ; �� � . •
51. CEqTiFICATE OF OCCUPANCY : , ,- � : _
Na. Date
AOp�icant lo fill in all s0aces except t�ose within heavy Gortler Ilnes antl sign all appro0riate tlecla�atians.
ciTY OF coSra. Esa _CONSTRUCJlT N PERMIT .< PE IT NO. TRACT NO. LOT NO. UNIT NU.
' JJ
ProlectAddress � ^
�--- ' J TYPEOFCONSTRUCTION NEW ADD ALTERATION EPAIR
Applicant'sMailing dress .
❑ CONVERSION ❑ DEMOLISH ❑ OTHER p.p, # 2on8
'Owner's Name Phone � DESCRIPTION OF WORK/USE OF BLDG.
Address ��� m Q� S Main Buildin9: Accessory Buildin9:
TVPE OF PERMIT ❑ GRADING FOUNDATION STRUCTURAL E Front Z
Arch/Eng. � Licenu No. � � T �
Address ❑ TENANT ❑ ELECTRICAL �(,�RLUMBING ❑ MECHANICAL 6 qear N
❑ OTHER A �
Contractor'sName Ph�e 5 C Right N
PROJECT DESCRIPTION 5Q.F7. ocCUaANGv K G
Addresslmailingl CONSTRUCTIONTVPE VALUATION$ S LCit
R
, CityLiCenSeNo. ZONE GRADINGCU.YDS. ACRES
LICENSED CONTRACTOR OECLARATION Ping. Ref. # . Parking Req.IPwvided E
V °
I hereby atfirm tnat I am licensetl untler provislons oi Charter 9(commencing Remarks: Planning Notes: � ry�
with section �000) oi DiviSion 3 of tha Business antl Profe55ion5 Cotle, antl
T
my license is in fu❑ ntl etfect.
S
Licen qa � ' ense No. PLUMBING FEES
Date Signature
WOftKERS' COMPENSATION DECLARATION 82f Sink ShOW2�5 ELECTRICAL FEES
1 hereby atfirm ihat 1 have a certiticate of con5ent to self-insure or a<ertificate
� of Worke�s' Compensation Inswance, o� a certitietl coOY the�eof (Settion gackflowPreventer $erviceSink
3800, Lab. �/ T F�utomatic Washer Transformer ❑ 15-50 KW
� PolicyNo.���������� Companyr�'�77'i T// � Backflowlrrigation SewerCap ❑SO+KW
Construction Pole Su6.
�ertitietl copy is hereby furni5hetl.
�Q� �ifiytl rq� is filea with the city i i09s A Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
DateJ� � APPlicant ��,�.�� !1� /� /
EXEMPTION FROM WORKERS' COMP�NSATION DECLARHTION Cla�ifi¢�5 $013r CoIICCto�s Dishwash2� Mete� ❑Ove� l0�amp5
(Thissectlon need not be wmpletetl if the permit is for ane huntlretl ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Elec[ric Sub Panel -
I certity that in the performance ot tM1e wo�k fOr whlch this petm�t is is5uetl, I
5ha11 not employ any pelson in any manner so as to become subject to the � DfiOking FOunLd105 SOIa� Tank Fdn Moto15 �0-7 HP 01'/a - 8
Workevs' Compensation LawS of CalifOrnia.
Date Signature Ploor Orains Swimming Pool w/Spa F.A.U. �na Solar 09-15 HP 076-75+
NOTICE: If, afte� making thi5 tleclaration, you shoultl become subject to the
Workers' Compensation provi5ion5 ot the Labor Cotle, you mu5t (orthwith FIOo�Sinks U�in21 FixtU�ES MiG�ow2ve
compty with such provisions or this petmit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV GasService Qutl2L5 W2[EfC105¢t
I hereby affirm that there is a construction lentling agency for the peiformance Devic2 BOxes PoIE Light
of the work for whi[h this petmit i5 issuetl ($ection 309�f Civ. CJ IntCIc2pLOf5 Watef Heat2l / OuL12i5 Rdng2
Lentler'S Name
Lentler's'Aatlress Kitchen Sink Water Service Switches Sign
OWNER BUILDEN �ECLARATION
1 M1ereby affirm that 1 am exemDt irom [he Contractor'S License Law for the Lavatories AuLO�WdSh GB�bagE Di5p0581 Stdnding S¢CtiOnS
following reason (Section 7031.5 Business antl Professional Cotle:.Any cl[y or
county wM1ich requires a permit to construct, alte�, improve, tlem0lish o� �epair P-T�ap Laund� T�d s _
any structure, prior to its issuance, also requires me applicant tor such permit Y � Generator 0-5 KW 5�15 KW Trash Compactor
lo file a si9ne4 sla[ement lhat he/she is licensetl pursuant to the'Arovisions of ROOf D�dinS
[he Contractor's License Law (Chapter 9(commencin9 witn $ectian �000) of
Division 3 of the Bu5ine55 antl P�ofe55ions Cotle) or that ite/she i5 exempt
therefrom antl the basis for tM1e allegetl exemption. Any violation of Section .
7031.5 by any applican[ for a pe�mit subj¢cts tM1e applicant to a Civil
�endlty oi not more than five huntlretl tlollars ($500). �
LI I, as owner ot the property or my employees with wa9es as their sole ReinspeMion Fee $15 Issue Fee $ 3
compensation, will tlo the wo�k, antl the stru[ture is not intentletl o� off¢retl R¢insp¢CtiO� Fee $15 ISSUe F¢e $ 3
for sale (Section 704a, Business antl Pmtessional Cotle: The Contractor's MECHANICAL FEES
License Law tloes not apply to an owner of a property who builds o� improves
thereon, antl who tloes such work himselt/herselt or throu9h his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, O�ovitletl [hat such improvements are not iMentletl or offeretl for BOil2l HOOd Of Typ¢ I ❑
' sale. H, howeveq the building or improvement is soltl within one year of mm- Canopy Type I I ❑ Za��^9 APP�oved By Date
pletion, the owner will have the burtlen Of proving he/she tlitl not builtl or im- DUct- Und2� i�i�oUnd
, p�Ova for the purpose of sale). Building Approved By D2t0
❑ 1, as owner of the prooerty, am exclusively contracting with licensetl con- Duct -$tructural Refrigeration System Appliwtion Issued By Dat
tractorsto constructthe project (Section 7044, Business antl Professions Cotle:
The Contractor's Li<ense Law does not apply to an owner of property who ' Duct - Ventilating ❑0-100,000 8TU ❑100,000 BTU SUMMARV OF FEES
builtls o� impwves thereon, antl who conVacts for Such project5 with a con- -
tractor(sl �icense pursuant to the Contratror's License Law�. I am aware that � BUILDING PERMIT $ SMIP $
proof o( tM1elr Worker'S Compensatlon insulance shoultl be plovitletl to me. ExhaUSt SyStCT ❑ MWtiple Syst2T R2pdif%AIL¢IdtiOn .
- PLAN CHECK $ PERMIT
❑ I am exempt under Section B. & P.0. for this reason Firepl/Pact. Blt. ICBO # Fire Dampers PLUMBING $� ISSUANCE $�
Date Owner Heating System & Ducting Registers P�AN CHECK 25% $ ENERGY P.C. $
i hereby certity that I have reaa this appiiwtion ana state that me above �0-100,OOOBTU �100,000BT EIECTRICAL $ GRADING $
intormation �s wrrect. I agree to <omply with all city antl county ortlinances
antl state laws relating to builtling construction, antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of [his city to ente� upon [he above-mentionetl property for �/rJ�
inspection p es �� _dp � MECHANICAL $ TOTAI. FEE . $ _•y`i ���—
Signature l Date '�O
Drivers' License or 55 � Reinspec[ion Fee $15 � Issue Fee $ 3 PLAN CHECK 25°�, $
CMF 0865-46, /ev. 10/84 White - Builtling: Canary - Applicanl; Pink - Accounting; Goltlenrotl - AssesSo� ��i OQ�1¢���J-Q�}�1�100` Tr�T S,Qp
' On7te ii0/00/94 rTtir. �o.nn
CONSTRUCTION AND'PLANNING POOL & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
7. Temporary Electrical 5ervice or Pole 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .:
h
3. Electrical Conduit Utility-Undrgrnd. 54. Forms -" -
caa
4. Electrical Conduit-Undrgrnd. 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�Undrgrnd. 60. Backwash Lines, P�Trap, O l'lridrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK '�
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
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 F�NAL
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 OGas OOiI
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. 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 79. FINAL INSPECTION .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .;
33. Final Electric Notes: �f
34. Final Heating & Air Conditioning "
35. Final Gas Pipe-Tesi
36. Hood or Canopy
37. Final Factory Fireplace ,
38. Final Plumbing cr (�/b (( (.�j� . .
39. Water Service-Final � ' •
�
40. Gas Service-Final t%'
41. Solar pomestic-Final y✓J
"�i
42. Backtlow Preventer � ' �:�
43. Backflow Irrigation � �
�
44. Landscape Irripation SYstem � �Q
45. Sound Attenuation 'd`�
46. liandicap Regulations �7
.7
47. FINAL STRUCTURE & BUILDING . � jjJ
,
48. Special Requirements Completed "
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co . �
51. CERTIFICATE OF OCCUPANCY
No. Date '
�\�� �
\ `
�or �� - TRACT 3625
�1.�1.��fo
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MHBA. CALIPORNIA
For Applieani io Fill In Completely
9UILDING
AD�REss �202 NEBRASKA PLAGE
' COSYA MESA. CALIFORNIA
MAIL �555 �PLACENTIA %1VENUE
ADDRE55
cirY NEWPORT BEACH
ARGHITECT '
K•W• KOLL
��.�, NEb1PORT BEACH
STATE 6i i g5 TE�. M i -3227
LIG. NO. NO.
SI2E 62XZ�X O IRREG INO.OFBIDGB.
BfiiH�CK LJN6 GROM %O � REAR YARD �`'
CENT6N OP BTRElT �
f 1
SIDE YMD I LEFT � RIGHT � O
DESCRIPTION OF WORK
NEW I X IIALTERATIONI IIADDITION I
BUILDING �$ SF NO. OF 6 �
SIZE ROOMS STORIES
PJ(TERIOR WA IROOF ROCK
COVERING �UCCO COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
SINGIE-FAMl4Y RESIDENCE AND ATTACHED
GARAGE PLAN �-B SPECIAL
I HEPEBY ALNNOWLE�OH THAT 1 HAVE H4D THIB APPLlGT10N
AND BTATE THAT TXe ABOV6 IS CORRER ANO A6R88 TO CON-
PLY WITH ALL CIiY OftDINANCEe AND 9TI�TE lAWB RBOULATINa
BUItDINO CON9iqUGT/�ON^.\
81GNATORE OF / 1 _
� AUTHORIZED
FIRE
�r, �,,,�,,,m.� ,
7 � � � � a
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-��'' TS - � 3-[ c.
r��<,�Ler �r.= �,
GiT'd 1� ,{4,�St1 CiE�:�
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. PlRMIT NO.
COSTA MESA. CALIFORNIA
ZONING
NO.OF USE OP NE �
PLANB � I BUILDIf�§ y..� ��yyA�
�.ec�� �//
DFBCRIPTION H�
v
A. P. NO.
YARDS E
APPROVED A
ICBNT[P LINt BT.I (
FRONT . .J T.
R. SIDE l U FT.
L. SIDE �FT.
REAR T.
APPROVED
BY I� r
/L� i ,� i � /'.-`
TXB AMOUM BHOWN UNOEq VpLUAT�ON IB POR TXE
' PUIiPO6E OF EBTABLI6HING A PEftMIT FEE ONLY.
VALIlAT10N /
PERMIT FEE $ �b �
$ �/ y �3 PLAN CHECK $ � o ~
IG�
___" ___ .. 5
7
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4