HomeMy WebLinkAbout2515 ORANGE AVE - Building Permitsoeesr. � S 1 S ORANGE AV
o�., xame: BRIGG�!, EDWIN J
RDOflESS: SUITr. .71 CJ
2";096 AVE DE LA CARLOTA
LAGUNA HILLS CA 92653
719> _180-068�+
pqLHIENGINEFfl: flEC.NO.:
aooaess:
UNIT:
uxir:
PEFMITTEE: SORDAN ROQF COMPANY ( 714 ) 897-5105
aoosess: y20 N. TOWN$R ST,
SANTA ANA CA 92703
UCENSEU CONTflFCTOB �ECIAXATION: I here�y atlirm IqaU am licensed untler provisions ol ChaD�er 9(commencing wit� Section
7000) ol Divisian 3 0l Ihe Business antl Pmlessions Cotle. dn0 m li nse is in ull force antl e�feci.
Y
ciTruc.:0 �916 srnreuc.:406783 C 39
�aTe, � 4 Signature:
WOPNEflS' COMPENSATION UECIABATION: I �ereby allirrri I�a� I ve a c ificate o� consem lo sell�insure or a cenilicale oi Workers'
ComDensation Insurance, or a certilietl copy IAereol (Seclion 3800. Lab. C�.
voucrNo.:'710209-9.�. EXP.DATF: OSIOS�9j
comraer: STATE FUND
7 Cerliliea coOY/ is� here0y IumiSA¢a. � C¢tli�ieG coDY is lile wi�� �e C/p�p/�BuilOing Division.
�.:� //�/' pPPlican�: �� A��
EREMPTIONFPOMWOflNENS'COMPENSATIONOECLAPRTION: (This5eclionneeAfio�becompleledi�thepermi�islaronehuntlretl(5100�orles5).
I cetlity ��ai in Ihe Oedormance o� I�e work br w�ich Ihis permil is i55ue0, I shall nal employ any Derson in any manner so as l0 6ecom¢
suhiect lo Ihe Workers' Compensa�ion Laws of Calilomia.
Oale: Sipnature:
NOTICE: II, aller makinp Ihis Oeclaraiion. you ShoWd OEcome 5u�lecl lo Ihe Workers' ComDensation pmvisians ol the Laoor
COde. you musl lotlhwil� tompty wilh SUCh D�ovisi0ns Or this permi� 5�all Oe tle¢meG revokeU.
LONSTBUCTION LENOING AGENCY: I hereGy ailirm I�ai �here is a constmc�ion lendinp agency lor �he pedarmance ol t�e work �or
w�icA Ihis permil is issue0 (Sec�ion 3097. Civ, C�.
LEN�EN:
RODflFSS:
OWNEfl BUILUEfl UELLRNATION: I here0y allirm Ihal I arti ex¢mp� Irom Ihe CAnlraClorS' Sia�e License Law lar IAe lollowinp reason
�SeCliOn 7031.5 Bu5ine5T anC Pm�essi0nal CaOe: Any cily u� wunry whit� repuire5 a permil �o ConslrUc�, al�er, impmv¢, aemalish. Or
repair any simclure, prior �o its issuance. also repuires �he applicant lOr such De�mil �o lile a siAned slatemeni �ha� �e/she is licensed
pursuanl lo Ihe pmvisions al ihe Coniracbrs' State License L�w (Chap�er 9(commencinA with Section 7000) of Division 3 of Ihe Business
and Pm�essions CoDe) or Ihal he/she is exemp� I�erelrom antl �he basis br Ihe allegetl exemp�ion. Nny viola�ion ol Sectian 7031.5 by
any apPlicant lor a permit subie��s ihe aoPlicant to a civil penally of not more ihan five hunOretl Oollars (5500).
1, as owner of I�e pmDe�Y or my employees vn�� waAes as their sole compensation, will tlo Ne work, antl ihe
❑ slmclureis nolinlentlea oroffere0lorsale (5¢ction 7pn4, Business antl ProlessionalCotle: The Conttatiars' State License Law
aoes noi aDoly Io an owner ol a pmpeny who euileg orimD�oves ihereon, antl who aoes suctl wark himselflherself orinrough
�is or her own employee5. proviDeA �ha� Suth improvemenis are nOt in�¢ntl¢tl or ol�¢red lof Sale. If, howev¢r IAe builEing Or
improvemeni is sold wi�hin one year ol comple�ion, �pe owner will �ave Ihe burtlen o� pmvinA he/sAe Oitl no� builtl or improve
lor t�e purpose of sale�.
I, as owner o� the pwper�y, am exclusively wnVacling wi�� Iicen5e0 conlramors to conslmc� ��e prolect (Sec�ion 704d, Busine55
❑ antl Prolessions Cotlel TAe Contrac�ors' Slale License Law tloes nol aOPly lo an owner of proDetly wAo bWltls or impmves �hereon
, antl who conlracls lor such pmlecls wilh a conVactm�s) license pursuanl �o �he Comractors' Slate License Law�.l am aware
ttlat pmal ol Iheir Worker s Compensation insurance shoNA he DroviUetl �o me.
� I am exemD� untler Sec�ion: B, g P. C.
lor Ihis reason:
�ale: Ownec
I Uo hereby cenily Ihal I am aware ol and un0erstantl ��e requiremen�s ol Calilomia Heallh and Sa�ery CoOe Sec�ions 25505, 25533, antl
2553a antl Ihal I or any IWure UuilOing occupani will/will no� �circle one) need Io comply with said state cotles and Ihe reQuiremen(s lor a
permi� lor consimclion or moaificaiion �rom I�e Air Oualiiy ManaAement Oistnc�. flesidenlial consimc�ion applications are exempi �mm
ihese D�ovisi0n5.
�ale: Applicant:
I hereby cerlity Ihal I have reaU Ihis applicalion antl state iha� ihe a oveinlormation is correcl. I aA�ee lo comply wilh all city anU coun�y
orAinances ana slate laws relaling lo builtling conslmclion ane here autharize resen�atives al Ihis city �o enier uDon Ihe above�mentioneU
pmpetly lor m eclion Ourposes.
Oaie: �� Signamr �
oriver's license or Social Security
AoolicanL Pink—Rovenua'. Golaonmd—Assa.asnr
- CZTY OF COSTA MnSA — BUILDING PaRMIT PERM D10: B 0605:!3
PERMIT NO: B 060528 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: AL"'
JOB DESCRIPTION : T/OFF REROOF W/COMP. SQ FT: 6,60�
CLAZM VALUE; 6,603.00 CALC—VALUE: 6,603.00 GkOUP OCC; R-1 /
COMMENTS: SMOKE DETECTOR RE�UIRED PRIOR TO fiINAL
at�**�x�*�*ita�**�*ir*�*���**itlt* �***��sr**�x,��.r�e***��r3e�r+r+t�**�;�*��x•*x*�-�*i!+turtit�***�**
Z O N I N GS ERTEB�AUCIHRSE M E N T S
------------ MAIN HUILDZNG ---------- --------- ACCESSORY HUiLDING ---------
FRNT; FT IN REAR• FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: F7' IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 93916142 2UE: REF NO;
PLANNING NCSTES>
i
�lf 1E 1l� iE Y.` iF �lEiFik iE iF if K� f(-'if if �1F if iF if iE iE iE if il-If iF%ih +f �f iF * i4 iE �f if if ih if aF iF if aF ik it # iF �1F iE i'r i'r �I4 ih if if 3f if jF iF iF iE �)k ��F iE �F �f 1i iF?41Fik 3G =E ii� iF # iF iF
D E V&'L O P M E N T S E R V I C E S R E Q TJ I R E N � N T S
ZONING APPROVED HY . DATE:
BUILDING APPROVED HY :� _ DATE:
APPLICATION ISSUED HY:`� DATE' ���
1flfiFifiFiFiEfhM�fF�lEif�%iFffiflEiFlEiFiFlf r � 'i�'ii•3E'i6iFi4�lElfifiFi6iFiF . t� 3i��FE
if k if df 1f- if� �lE if �IE 1h iF if 1t If ik ik ib iF iF 3f �1t-1F iE iF �lk fE-If if ik iE if M� 4 if iF k if iF �lE ik 1F iF if� 1F !t 1Fif iE �F k� ih itM� 3t if��lf �f �! itlf at k iE i4 jF ik 1F if-i4?F M�E �1f� if �E i(� 36�M 3f
LEGALI7,ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIkE SMZP/RES GRADING
PERMIT 90,00 66
pIAN SMIP/NON—RES
ISSUE FEE ;�
BUILDIt�7G—DIV—> PERMIT ISSUE PLAN—CHECIC TOTAL PAID '•'� DUE
TOTALS----> 90.66 O.OU 0.00 90,66 90,66�'; ,00
REVENUE DIVISION TOTALS--> COLLECTED: 90,66 OVER/SHORT: � .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING,�PLAN—CHECK
90.00 .66
iF If �N� �1E �)f iE if d4 1F ih if fk if� �R iE �lE !M1%iF if iE 3F iF ik iE iP iE ik �7E IE 1E if IF iF if� �1! if at 1f iE #` �f i6 iF �f- if iE ik �If ik iE if- %� iE if� if if ik 3F i6 if �lF�)f ie �lE iF i(� dF 3E % 3F?f iF �lE if �1f� fE iF �1F
I N D Z 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 iJNIT COST ;'��TOTAL COST
SFR 6603 REROOF BY VALUE RESIDENTIAI. NOZONE 1.00 6,603,00
ENll OF FEES
�, i
i
EXPIR��t16ns
�f1COfT1P�@t� If�Sj�%
liOtE �-.�.�.---�'_ Slg .�—=—�a"
r CONSTRUCTION ANDPLANNING.
� APPROVALS Permit # �
I. Temporary Electrical Service,or Pole
2. Soil Pipe•Undrgrnd.
3. Electriw� Conduit UtilityUndrgrnd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation
�_ i �
9. Water Pipe-Undrgrnd. � '
10. Structural Floor System _ , •
11. Property Sewer Line & HouSe�Connection �,,
12. Sewer Cap �'�,
13. Roof Drains �i
14. Rough Plumbing �i
15. Rough Electrical-Conduit
16. Rough Electric Wiring
17. Rough Wiring Si9n
18. Rough Electrica6T Bar Ceiling
19. Fough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts,in Structure
22. Ducts, Ventilat��g
23. Gas Pipe-RougN & Test
24. Roof Framing
25. Roof Sheathing
26. T•Bar Ceiling (Svucturap & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat
32. Electrical Power Meter�Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Finai Gas Pipe�Test
36. Hood or CanopY
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service•F�nal
40. Gas Service-Final
41. Solar pomestirFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape IrriAation System
45. Sound Attenu2tion
46. Handicap Regulations
47. FINAL STRUGTURE & BUILDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
`Date
Inspector
P00 >PA (
APPROVALS Permit # Date inspector
52. Pool & Equipment Location
53. Steel Reinforcement
54. forms
55. Electrical8ond�ng
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Cqnduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrqrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Finat
63. Heater & Vent•Final
64. Plum6in9 System - Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Anv�oval
68. APPROVED FOR PLASTERING
69. POO�/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Pipin� �Gas ❑Oil
72. Underground Flush
73. Undergrnd.Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Ory Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. FEQUIREMENT
79. FINAL INSPECTION �
80. FOOD CERTIFICATE ISSUED
Notes:
EXPIRED
tYate ��'' '_'/ Sig
8
0
oWNER KOLL, M. H.
JOII ADDRESS 2515 O]
GGNERAL CONTRACTOI2
AP Nn.],19-Q'jQ-63 T.OT
7 'ECTIONS
5.,-'
Gas
Water -/�� ._.
[%ufi�LtiG,�
17nunh Nrslinr -
OCCUPANCY
�nau aue _su —
TRACT
Signature
nATr
� L BUILDING PERMIT NO.
VALUE $_�4��lyp.QQ
FIRL ZONE DESCRiPTION OR WORK
DATE GROUP gg�,j' TYPE �7 7.ONE
SU6CONTRACTOR
Y�
f�
., --t . ..
issr9 - FEE REC�iU�u
. • j'� :" /� fE� .z 5 1963
COSTA MESA BUILDING-SAFETY DEPARTMEM /�
P.0.90X9'17 COBTAMlBA.CALIRORNIA V• i FINANC[ �DEPT.
I- CITY OF COSTA MESA
For Applican► !o Fill ►n Completely 't /y�l APPLICATION FOR PERMR
, :' T�YPE � OR �PRINT l/`�'i - . ' BUILDING ... ' .
. For Oiiice Use Only ' -
BUILDIN6 . � . . _ �•. . . . `P�/ � . ' .
AOORESS . �' ' i'" � �fJ i/rl `- ' . ..
11GC61I� NO. PCR �j'
COSTA MESA, CALIFORNIA � ��/'
PCCEIV D CY ' . OAT 1!6 N5CD � I
. . . ' ' , ��'^'._� 1 . D�E IQGUfiU,
OWNER . �!: �� � .. .. . . .... , _ ' 1 0^ �D\
MAIL , . • . ��.. . , . ... . .. BUILOINO : ¢' , / `. ,
ADDRESS � ��� ADORES9 � C�W
�'JI t� �;� ,..�. '
- ' F�Re'� .. . _ .
��E'SC NO. �<. .�r .=ONE.`.�;- TYPH ' � GR UP.
CITY /7 � /I .
APPROYED
ARCHITECT �� BY DATB
ORFNGINEER. � ' NO.� �� , � . .
ZONING
AD. _SS -
, P.� NO.OR UBEOPNeW :1 E�
L= PLANB BUILDI O �T
CONTRACTOR // � /�/ / �
r��/ LEOAL 211Fi r,- @� � y�
ADDRE53 hGCL�' NP.'l� J/r ��/��. �sstR�PnoN �lJv �
/ / A. P. NO. I I J�7O'�'t7 _ ��� �G i
cirv _eJ'S�i /�%P_s`C-0 C,GI�f
STATE � _ C. � TEL. / j 3 fj 90T TO SOIDE $ REAR p, LN6 SHALL 9E 8$[Ij1AM ..
LIC. NO. If �� NO. 4� �C C1Y+—'`t r+�tc
EAVES
SIZE �y� � ��/ �- rvO.OPeLoOe.� ALLOWED (U.B.C.REOUIREMENTI
OF LOT V� G J��Ji,/ il � Y�JI NOW ON LAT
YARO9APPROVED YARDSAPPROVEO
USEOF _ -� L�: ��J...._. �� /, -...o /I MAIN BUILOING ACCESSORY BUILDINO
rc�� ..�..n. _ __-__.._—_. ,
DESCRIPTION OF WORK �. sioe . Fr. Fr. Q
�
NF _ZC ALTERATION _ AODITION REAR �� Ff. Ff• y
D18TANCE BET. BET. MAIN @ �
REPAIR MOVINO DEMOLISH MAIN BLDG9. ACCESS.BL�69. �
BUILDIN6A // � NO.OF F �''°'R.JC OATE �
SIZE 'X��Y �CtG!4' ROOMS I�5 6TORIEB / C.U.P.$C APPROVEO ,,
EXTERIOR WALL < ROOF APPROV v�1 2 ].. ,
COVERING ✓t['IC`CC% COVERINO ����✓ ���' BY (}�- oL DATH ✓`� S�� �
USEOFBUILOINGANDWORKTOBEPERFORMED' ���Oh-IS;�- Fr T �O
�i'"� ' �?X .�>'d� //i/IC%.S
� � ��yD =G f�an.#�
- a ry_, -6 „
bi' sa. F7. At-L o .
1 HEqEBY ACKNOWLEDOE AT 1 XAVH REAO TH18 APPLICATION TM6 AMOUNT 9HOWN UNDEP VALU ION IB FOR THE £'
AND BTATE TNAT THE ABOVE IB COpREGT AND AOpEE TO COM. PURP08E OP EBTABLIBHINO A PENMIT FEE ONLY. p
PLY WITH ALL CITYpRUlNANC88 ANO 8TAT8 IA P80ULATINO yALUATION m
BUILDIN6CON8TRIICTIO . � ^ H
A PERMIT FEE $ Q°j__ �
SIGNATURE OF � C- V� � i���+ � ��
PERMITTE ' m
� S� J.� i`O E ./. .S s
AUTHORiZEO AGENT � y" '�^^ °'
TOTAL FEE $ ��/' •J `'
�� N
j. . , . . : . _. . .. -. . . . ' . - . .. _- . _ . . ,
, . ' ' , . . . . . . r� � }". S.
. . .. . . . . . .NI'��•� i .. 4j`1 `.
f'?•��_ ...'�]� . ' • � ' .. . ^` �` .
. . . . . . . ) U .. ' . � .
.. . . , .. _... .. �... ,. .-... _ ,........._..,._.. ... ..,.... .. ... _ . .
Conditiofla: . - ,
1. Subject to all the conditions'as l.istecl in the City Etigineer!s
recommendati:on of May 2, 1962 and the Planning Director''s �
reco�endations of May 8, 1962 on'Record,of-Survey-No.-lj''.
� ,�
2. That the driveways along property lines on parcels.A,. B, C, D and
E of Reco"rd' of Survey #15_be coimnon 'driveway's and that an
Agreement to'this effect be recorded and that;.the coiimmon.drideway
,;,` easement_ b;e recorded on the individual deeds,subject to:the
"' approval _of the �City Attomey; , .
_ . , _ , .. ,....
� ' --
, ,, ,.. _... _.._....,_.__..__...... .. _._ , .
3. That Car Space_�+ be_rq-aligned under the direction of the Dir: �-
of Planning. . . - _ -
� ., ,� . : _ - -
6j � . 1 . .. .y .� . . . . . .. .
i�-v �!1'.�� . _ i ' . . • ,
, , , , , ;y,, . i ��� `;i'�� _ . .
. .
�
- � � • � �--� -- , . . ..
, , . . , ; ,. � � :, .:
, __ _____.. _ ._
, , x; _ . , . , _. , : .._ .
,
, . .
_..... _ .._., . ., . ., _..
, , _ , . _
�. �.....:t '3 , . � �. .__.. ... _:�. . ..... ... . .
, _ ' ' ". . _ '_ , ��.t' � .... . ,
1. . . . - , .. . - -.... , .: _r-: - - - ' . - '
L'. , . '.'_ .' - ,t. ... . : . ._ . ....- .. . . . .
�
.. . _ . . . . � 4 � .. . . . . . . � . . . .
. . .. . . . -.r . .. .. . . .
.. • . . : . � � . :j . .. ; � . . . . . _ . . . . . ... . . _... . ..... .
. 1 '' � . • _ � . �1 ' ' .
. . . � .. . ... .._. _ .. _ .
' �� . � . .. - . . .. . � .. , _ � � . `
.
i . ..
' '
. ,y ,-
' . . . .. . � . .. . .. " . ___ .. . .
. . . . . . . � l � • � ' . . .... .
l. .. �, 1_ � ,� 1 "` .r,. . � . . ._ ... .. . .. �._.. . . .
"-1 '-• f � . ' J4l. � . ' . , � � � ,
_ , �`� 1��C `ft.,�"� . f -Y� !(f���' . _ _,...,_. ._.... .,.... �� � .
• Ai . ' .'. �' . . ` ' . ' , ' ' ' " .
. . _ .-.�. ., � � ..�..._., L�s�
t�.� ��� _t p,' . i'. `� ' rt \'. . � � .' _ . . . : ' "'__ '. . . .
. A. � . \ i,` . . 1 � � t-'S . . ... . v . _ .. .
,'� ' � ���}. � �. .N� . . .. . .. .. ...._ . � ._..._. ...... .. . .
i
. _ . � .. . . ._ . . . _. . . , . _ ' • ' ' . . . " _. . .
.. . . . ..._ ..., �.� _
. .. ,- � , .. ... .
, . ,
�'_,w"t. � . .. _ r ... - ' _'' _'
. .. .. .. . . . . . . _ .
� , . .. . . .: . , .. . �
q:.'
. . ` . . , . . _ � - . . .. ... ._ : . , ... . ..
f ' ��'\� � . . • _ _ ' . _ . . . . . . .. ... . .
OWNEft
GENERAL CONTRACTOR
AP Nou9-o7o-63 LOT
? '�CTIONS
OCCUPANCY
BUILDING PERMIT
TRACT FIRE ZONE DESCRIPTION OF WORK Ik'IDO
DATE I GROUP.r TYPP u ZONE
SUQCONTRACTOR
- , ;�:�- 19066
�COS'fA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 91] COSTA MC9A� CALIFORNIA
For Applicant ►o Fill In Completely
TYPE OR PRINT
BUILDINQ '�/� DYGH -2
ADDRE55
COSTA MESA, CALIFORNIA
� AO RES9 !."7� � �<I%� S
'��� :.t..l". ..��
G/✓
�4Ii G 5v38'
f1NO.OPBLD08. -�
' EX ST� N6 BLDO. ��O !JP to�'r� c�UuJ/7
1 SETBACK LINE FFlOM
CENTER OF BTREET �� REAR YARD �
� �� Y�� �] 11 � ��� \ ��T��1`l�� �\,\
EXTERIOR WALL ROOP
COVERING COVERINO
USE OF BUILDIN6 ANO WORK TO BE PfiRFORM6D
n---_/._, . �__
'1 HEREBY ACKNOWLEOOH TXAT 1 X�VB RCAD TX19 APPLICATION
FNU BTATB THAT THE ABOVE IB CORqBCT ANO /�6qEE TO COM-
PLY WITX ALL QTY O[[DINANC AND 9TAT8 LAW9 RHOUtATINO
BUILDINOLONBiRUCiPoN. / J
' AUTHORIZED 6A ENTfR .TAGK y'v�~A��
FEE RECEIVED
�9AR 1 e 1663
FINANCE DEPT.
naP�ic �.tN(1�o�E(T�faAnrtAESA
BUILDING
For Office Use Only
I NECEIPT NO. PERMIT NO.
BY
APPROVED
�
�
ZONING
ZO H NO.OF UBEOPNEW%��';
�_ Z PLANe �� OUILO�NO
�eo�� /h � /2.0 %�l 3 co
DE9CFIPTION
�/'r — 0 70 — i�
A. P. NO.
NOTE: NO EAVE OVERHANG BHALL BE LE6S THAN
80" TO SIDE Q REAR P. L.
EAVES
ALLOWEO (U.B.C.REpU1RE
YARDSAPPROYED YARDSAPPR EI
MAIN BUILDINO AGCES RV ILD�.
/ FROM C/L STREEI' )
VAR. $k
onre
a
SQ.FT. e
TX8 AMOUNT BHOWN UNDER VALUATION 18 FOR THE �
PlIRP08H OP EBTABLI6HIN6 A PEFMIT FEE ONLY. 0
VALUATION m
PERMIT FEE $ LLO �
�
�� 0
$ //J / � C ' 0
�. � � �
OWNER HOWARD
JOB ADDRE55 2515 0
�
IHSPECTIONS
sai�
G�5 �
WFTER
QOUGH PLUMB�N
PROP. SWR. LIN
SPRIHKLING SYS
�nISCELL�NE0U5
ROUGN HEATING
TEMPOA�AV SER
UN�ERGROUN� [
AOUGH wIRING
SHEPiHING
FRAME nND F
�` ^''ER. BR
5 :TURnL
HE4TING,VE1
PlUM81NG, F
ELECTRIC.F
BIIILOING, FI
ANO 11R CONDITIONING
VICE OR POLE
� POWER �
�ORMS STEEL REINF.
STEEL NEINiORCE n
♦SHING
r
DATE 11-1-77
fIRE ZONE VA
SUBCOHTRACTOR
- -�;�� 44958
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BDX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING ° L_
ADDFE55 J
OWNER
MAIL
ADDRESS
CITV NO((7� �(,
�pNSiqVC{lON
LENDER
BRANCH
ADDRESS
���V —�'�T7PpI�OO 060�' ***TM53.30
[NSA
�PL CATION FOR STRUCTURAL PERMIT
�
RE I ED BV DATE RECEIVED TE I SU
E T
A.P. NO. �/ �
BUILDING �� � ��/,/��
ADDRESS /7///(�
TRACT �OO LO I BLOGK •
W
� ,✓
> `�
OWNER /�hf7LT .d �6i'HJT/Ul
FIiiE
� 20NE T PE � GROUP -
� _ � APPROVED � � ,�.��II� �-
ADDFiESS " (i(.+"DY�l�K.t✓
� . TE ZONE NO.OF USE OF NE �
CITV NO. P�� BUILDING
i-Fi STATE 7� pTV YARDSAPPROVED VARDSAPPROVED
� LIC. NO. � V LIC. NO. �/3 MAIN BUILDING ACCESSORV BUILDING
W 512E NO.OF BLDGS. (FROM C/L STFlEET) �
a OF LOT NOW ON LOT OM
^ VSE OF � I � _ )
E%ISTING B4DC. t �TJC/
y
� Separate permits are required for � si
� electric, plumbing and heating work. FT. �
� USE OF BU��DING AND WORK TO BE PERFORMED
D ANCE BET. BET. MAIN &
MAIN BLDGS. ACCESi. BLOGS.
� � VAR.� DATE
QC.U.P. �/s APPROVED
� !/ 1 �� /� APPROV // � �
} — tl¢,L ( �
a �
w
0 1 hereby eck�Owledpa thet I hava raatl t�Ic epplication entl state �
N
p,' Met tha obo�a informatlon It correct end epree �o comply wiM m
d ell lewt reBNletinp bulltlinp conatructlon, anC I�hell not employ �
Z ony pa�eon �� ��oletion of tha workmpn'e eompeneeHon lawe of m
2 Me Steie of Celifornle. m
3 I �e�aby eartlfy that I am praparly Ilc�neetl ef e eontracfor untler SQ. FT, a
the State of Callfarnie Bu�inen entl Profaielonc Cotle, Dlvlaion 3, THE AMOUNT SNOWN UNDER VALUATION IS FOfi m
Cheptar 9, tl�tl t�et tuch Iicanwa are In full forca end eifect, or I THE GURPO".sE OF ESTABLSNING A PERMR FEE ONLY: �
am exemOt from tha provlsiont of t�e Stete o} CelHornla Businefs VALUATION PERMIT FEE S �
end Profe�siP�s otla, Olvl�lon 3, Choptar 9. � .� u+
� � m
PLAN CMECK E �
Slpnomre o1 �
Permittoe � $ TAX S �� �
u
Autharizad Apent TOTAL PAID E �� 3 O