HomeMy WebLinkAbout292 PALMER ST - Building Permits (3)(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 292 PALMER ST
Suite:
Viciniry: BLDG C
Parcel Number: TPN003183 Zoning:
Applican�: PELLICIO, JEFFREY
Address: 1653 SUPERIOR AVE .
� � Phone: (949)642-7222
COSTA MESA, CA Zip: 92627
Owner: PALM COURT HOA
Address 292 PALMER
� � . Phone: 949-642-7222 .
- "COSTA MESA, CA . Zip:
Contracror: -LEE'ROOEING OF COSTA MESA
�Address: 1653 SUPERIOR AVE
� " Phone: (949) 642-7222
COSTA MESA, CA
Zip: - 92627 License: - 349686
Arch :
Address:
Zip:
Phone:
License:
Eng:
Address:
Slatus: ISSUED
Applied: 11/10/2003
Issued: 11/10/2003
ISSUED BY:
' �,A-` �
� �
Phone: _
License:
_ SCOPE OF PERMIT
TEAR OFF EXISTING SHAKE ROOF, RE-SHEATH, COVER WITH 30 YEAR COMP_SHINGLES.�INCLUDES UNITS C001 AND C002.
Plan Check: $0.00
Permit: $22325
SMIP Res: $1.23
SMIP Com: $0.00
Other: $0.00
Inspection: ` $0.00
� � -Total: $224.48
�
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY ` Front 0- 0
PARKING Existin : 0
NOTES:
FEE SUMMARY
Calc Valuation: �
--- - — Claim Valuation:
. . — � c
_ � � �. , �
PLANNING & ZONING
� Rear 0-0 Left �0-0 _Right 0-0 - -
Rear 0-0 Left 0-0 Right . 0-0�
Required: 0 Praposed: 0 �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statuU
regulationa (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspende�
for a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabl�
requlred inapectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration c
POR INSPECTIONS CALL: (714) 7545626
2aasas��oo�
WORKERS'COMPENSAnON DECLARATION; �'
I hereby attirtn under penalry ot perjury one of thp tollowing daclarations: �
❑ I have and will mainteln a certificate of wngent to setl-Insure for workers' compensation, es provided for by section 3700 of the Labor Code, for Ihe pedormenca of the
wo tor which t�is permit is issuetl.
ave antl will maintain workers' compensation insurance, as required tysection 3700 of the Labor Code, for ihe pedormance of the work for which this pertnit is Issued.
My workers' compensation Insurance carri�r end policy number ere: ` �
Carrier: Policy Number:
(TTis section neetl not be complered il fhe permif is valued et one huntlred dollars ($100) or less.)
❑ I certify that in tha pedormance of the work }or which this permit is issuetl, I shall not employ any person in any manner so as to become subject to Ihe workers'
compensation law pt Calif �rr�ia, egree that if I should bacome subject to ihe workers' compensetlon provisions of Saction 700 of e Labor Cotle, I s�all forihwith
comply with thes �v io ! �f� � � ` j� �l��
Applicent Signetur . � P���� Date: `� I`�'� U� )
WARNIN�: FAI�UF T CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU6IECT AN EMPLOYER TO CRIMINAL PE TIES D dVIL FMES UP TOONE NUNDRED
TFiIX15AND $100,OW�,INADDITIONTOTHEpp$TOFCOMPENSATION,OAMHGESASPROVIDEDFORINSECTION3]WOFTHEL4BORCADE,INTEREST,ANDATTORNEV'SFEES.
LICENSED CONTRAC70R5 DECLARATON:
I hereby aHirtn that I am licensed under provis'ons of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Profe sions Code, and my license is In tull
force antl eHecL Lia u Class a
GontractoYs Signature: Date:
i
CONSTRUCTION LE ING AGENCV:
❑ I hereby aHirm that there is a consimction IBnding agency for the pertormance of the work br which this parmit is issuetl. (Sec. 3097, Civil Code).
Lendeis Name: Lender's Address:
Signetura:
OWNER•BUILDER DECLARA710NS:
Date:
I hereby ettirm ihat under penalry of perjury that I am E%EMPT FROM THE CONTRAC70RS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business and Profeuions
Code: Any ciry or counry which requires e permit to constmct, alter, improve, demolish, or repair any sWCNre, prior to its issuance, also requires the apDlicant tor such permit
to file a signetl stetement ihat he or she Is licensed pursuant to the provisions of lhe Contractors License Lew (Chapter 9(commencing with Sec�lon 7000) ot Division 3 oi the
Business end Professions Cotle) or ihat he or she is exempt therefrom end the Dasis tor the alleged exemption. Any violetion oi Section 7031.5 by any epplicent tor a pertnit
subjects ihe epplicant to e civil penelty of not more Ihan tive huntlred dollars ($500).):
❑ I, es owner ot ihe property, or my employees with wages as iheir sole compensation, WILL DO TME WORK, and the structure is not imentletl or ofleretl for sale (SeC.
7044, Business and Professions Code: The Contracbrs License Law tices not apply to an owner oi properry w�o builds or improves thereon, and who tloes such work
himself or herseN or through his or her own employees, provided that such improvemenis are not intended or oHerea tor sale. tl, however, the building or improvement is
soltl within one year of completion, the owner-builder will heve the burtlen of proving that he or she did not build or improve for purpose of sale.). '
❑ I, es owner ot the propetly, am EXCWSIVELV CON7RACTING WITH LICENSED CONTRACTORS b consiruct the project (Sec. 7044, Business and Prolessions
Coda: The contrectors License Law does not apply to en owner of pmpeny who bullds or imOroves �hereon, antl who contracis for such prolect with a contrador(s)
licensa pursuant to ihe Contractors License Laws.).
❑ I am ezempt under sec. Business antl Pwfessions Code br this reason:
Signature: Date:
Owner ID verified by tlrivar's license. ❑ Yes ❑ No Oriver's License No.
Verificetion of Ownership by (type of tlocument, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Espires:
❑ I hereby certify that no excavation tive (5) or more feet in depth into which e person is �equiretl �o tlescend, wi�l be made in connection with work authorized by thls
permit, antl Ihat no building strucNre, scaflbiding, falsework, or demolition or tlismamling ihereot, will be more ihan thirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celifomla Adminisiretive CotleJ.
❑ As owner-builder, I wiil not employ anyone to tlo work which woultl require a permit from the Division of Industrial Sefery, as noted ebove, unless such person has e
pertnit to do such work from ihe division.
Signature: oate:
Division of Intlusirial Satery Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHOR17A710N OF EMAY: I cenity untler penalty ot perjury that I have read Ihis application an0 state that the informatlon given is
correct I egree to comply with all state laws and ciry ortlinances ralating to building cons�mction, antl authorize representetives of iha Ciry of Costa Mesa to enter upon ihe
ebove-descnbed property for inspection purposes, I agree not to occupy or allow occupency ot eny building authorized by this permit until tinal inspection.
COOif, INSPECTIONTYPE
1676 Fixed System Finel Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final Block/Retaining Wall
202
203
Final Factory Fire Place
Final Sign
20d Final Demolition
G�TF INTRIALg
_ I z-a -03 �
��
COUE� INSPECTIONTYPE
206 Final Mechanical
20B Final Plum6ing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
PdIE II�Li
oc euaw�c: L`J L YALMt:Ii S�1�
sruueiF�woxw: HARRIS, GEORGE JOHN TR
'r �o�u 300 FISCHER AVE
. COSTA MESA,CA 92626
APPL. NAll1N0 MDRESS
ARCNRECT OP FlK�NEEP:
�RCH ON E/A'4 AODNESS:
uc wo.:
uNr: /� 2
f'��
�S S
UNT:
I�+�T�'S�+u� NOCK PLUMBING ( 714 ) 895-1296
CONfPAtt0A5WJ4N0 11612 KNOTT ST
moxess GAADEN GROVE CA uc.ra.: 511971
9 2 6 41 urar: 17
ILICENSEO CONfqACTOHS DECLAflATION: I Mreby efl'vm unEar paneAy o/ perjury Iha� I vn licenaetl �Mm povisiom d Cheper B
(cammenarq xilh Saction ]OW) d Drvonn 3 d Na Budmu vM Pmfeasiore Code. eM mY licenae o in lull brtt eM etlerl.
c c.no.:050 86 u/c.cuss: C-36 uc.No.: 5 19�1 EXP: 02/96
da�. Q co�v,aa: LU/ylli / /U��O
'1W NER BUILDEN DECLAHRTION: I Mmby etfi�m uMer per�ely ot perj.iry ihet I em e�empt Irom IM Comrauaa Liwma Lew la iM
Ilowvi9 reeaon (5edian ]03�.5 8usire+a vd Prdeasiona Coda: AnY <ry a coumY �� reCuires e pe�mil to mnslrucY. eher. impraro.
amal'ah, or rapeir eny ewcNre, priv ro in 6weMe, a6o rpuirav iM eppliraM lor auch permX lo Rb e s0� �e�emam ihal M or eM
ie licenaed W�uent io tM Orovisiona W �M Conlreparo Lioensa Lew ILhepar 91�memrip wnh Seaon ]0001 d Dv'wion 9 d ihe
BI19111899 BIIE PfMB98D119 CWB� Of �IIB� M IX BIIB ia ezemq Iherehom end iM bnvia la Iha albpatl a�emqian. My vidmion ot Seaian
]031.5 by eny eppliren� lar e permn aubjacn �M eppliceni io e avil penelry d M maa ihen INa huMred dol4n [E;AO�).
� I.esovmerWlMpropenyamyemployeaswihwepeaeathaieolerompenemion,willdoihewwk,mM�heel�ucturteM'vuemleE
w oflered la sda (Section )OIi. Busimv eM Profeaabna Coda: The Coniredon Licerua Lewdoea � applyta an ox.ierd papeily
wla WdEa a impmvea �Mmon• eM who daea auch xwk himaell or henaM ar Nrouph he a Mr oxn empb�eea, povided thm euch
improvements ere nd inlmded aWerod la eda. H, however, iha buiNirq ar'unqovemem ia eoN wil�in am year d oomple�ion, Me
oweror-WiNer will heve tM WNen d provi�p M a¢M d'vJ nd build w improve la tha Durposa d aeb).
❑ I. m mmer d iM O�WaM. em uduaiveN mntraein9 wnh IiceneeE convenaa �o cmnrue Me p9� (SMion>W4. &uirons eM
Pmte�ns Cotle: TM CaMrepore lironx Lew daea na epply to en owmr al p�opany xM10 WiNa « imqwn thereon eM who
rnnirecn lar eudi prqees wnh e mMrxJor�a) licensad Wnuanl lo Ihe Coniredwa Limnse lew�.
❑ I em uemp� uMar Sec�im: B. 8 PC., la Nn renun:
Data: Ownar
I Eo MreEy ceNry ihel I em eware M eM uMenlenE IM raQuiremeMs d Celfamie Heellh eM $efety Code Sediore 25505, 2553�. aM
255J0. ard ihei I«e'ry INure bu'iWi�p am�pent vnll / wdl na (arcb «re) neeE Io mmply wIh eaid tlate mbs eM �M rxryiremanre M
epertnillwmuVuclionwmodifice�bnhom�haAr�iy anepemenlD'uUitl.ReaidmiilcwmruqioneppYWiwuenezamptlmmiheee
povisionB. .
oms: novi�m:
WOflNEfl'3 COYGENSATION DEttARArION: I Mreby dfirm unEar penelry ol pxjury dr d Hr ldbwiip dadeeazuau:
❑ I heve eM wil maintein e ceniliceb d caneenl to eeHinw�e br xwkere' canpevalion. u w�ed lor by $aqion 3100 d the Labor
Coda. iw Ihe parlormerce d ihe xwk la which thia pemiil b iss�eA.
I heve eM wil meiMen woMe1s' eanpanselian imurenee. ea rapuiead by $eqim 3100 d IM Lebor CaEe. W ihe pMamenee d Ihe
woM lar which thn perm� u mued. MY ��' mmpanwion ineurence rarriar erd pdicy number me:
c�<,: STATF. EXPIRES
Pa�'N�me«: �16�9Q�-QS 03/O1/96
�mr:.�;w, ��e,wr a. romda�ee i rM ro�x � ro. o,b n�„d,ad ea� Is,00l a r�.�
❑ I cenM �M1e� I� iM1e Veilamence d IM woA la whkh t�is parmn in ieaued, I aha11 ml em eny parean in eny man�wr m u lo
becoma wbpe to iha xakere' rompensmion lewa d Cali/omia. ay� eprea Ihet il 1 a� bacama wbjW �o iM worken'
oe�e: ��,r / ! n�d�c _ p//F� v /
Wem/n0� Fallun ro axun woiGsn'rompslu�tlon coverps li unlewNl, antlWll �ubJ�ct an �mploysr ro cNMrol pxultlu entl
c/vll Ilrros up ro aw hi.ntlmtl tlrousW tla/Nn (SIOQOOOA /n eEeitlon ro M� cwt ol eo�ewtbn, Mms(p� ia povWeC br In
SxHon 91lM ol fhs laborCods, InMuf, erM ettom�y'� Isu.
CONSTFUCTION LENqKKi AOENCY: I Mnq ��m uMer penelry d perµry thei iham ia e mnrrudion kMiip apeMy f« Un
oenormenm a me wak �a wnicn mw va^^� n m�a (smun aos]. c'v. q.
LENUEfl'S NAME: '
. LENUEX'S ADDFESS:
I ceniN inel I here reaE Ine eod' �ion vM ume Ihel iM ebova inlorme�ion ia conea. I Wree �o mnW wiln ell d1Y eM counry adiiwwee
enE ste�e levn reW iq ia WilEip canSruGion eM hareby authorae rapreean�etiv» M ihis ary to enter upon IM ebove�maMioned pmperry
lor inaPecYion vumoses.
RON NOCK /
P IN /� p /
ove: (� ! �
(St51d6.WP) Whne-BuiWip8SelMy:GreaMFle;Cener/-AppFceM:Pink-limenue;(ialAmroE-Naessor
-�� d�� CITY OF COSTA MESA - B LUI DING'
PERMIT NO: P 072748. PLAN CHECK NO;
CONSTRUCTION TYPE: PERMIT TYPE: PLU
JOB DESCRIPTION ; C/O DISHWASHER
� PERM NO: P--U i't-i+�l
N GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
��x***�r**�r�r*x*�**����***�r*x**�r��r+r�**�r�*�r**��*+r**x�***�x�**�r�r�r*+�*�******�*�*�*�r� **
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HOILDING ---------
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: 92808002 ZNE; REF NO:
PLANNING NOTES>
%
iE iE iE i!'1F ii iE'IE iE 1E iE iE i! iE 1E 1E 1E if Ik if if iE iE IE 1E if 1E 1E iE iE 1E 1ElE 1E ih iE 1E iE iE 16 if 1F if iF ik 1F 1E if 1E iE Ik 1E iE iE iE 3E iE IE 1E 1E 1(� 1F 1f !f if 1E 1F iE if� fE iE if iE iE 1f' 1�' iF iE iE
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 APPAOVED HY : DATE:
APPLICATION ISSUED HY: DATE: ��F��a�r7
iEaF1FiE7EiE141fi('iE1ElE3Fi(�1EikiElEiE1EiE1E iEiEiE1EiF1E1EiM11EiE '1E�IE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7.00 �,
25R �u- ✓, SMIP/NON-RES
PLAN , �
ISSUE FEE 20.00
BUILDING-DIV-> PERMIT ZSSUE PLAN=CHECK TOTAL PAID DU,E
TOTALS----> 7,0.0 20.00 i�„ � 0,00 27.00 27,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHOAT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
27,00
.`
ik i! fE �Ik fE iE 1E 1k �E iF1t iE iF iE 1E 1F 1E iF 1F ik 1f iE iE 1E 1F iF 1f iF i! iE 1f 1f !f 1E iF�1E 1E 1E iE 1F df iE 1F 1f !E 1E 1E 1E 1E fEfE fk 1E fE 1F 1! ft 1E 1ElE 1F iE 1ElE 1E 1E i! iE iE iE 1F ik 1E if 1E iE iElE iE
I N D I V I D U A L' F E E H 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
I ^
PLU 1 DISHWASHER �, 7,00 7.00
END"OF FEES
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DF.'I . 06109/9i TSh1c: Q}':y'?
�CONSTRUCTION AND PLANNING
�iPPRpVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. ,
3?�Electricat Conduit•h1tSlitY-Undrgrnd.
P(. _ & SPA
APPROVALS , Permit #
52. Pooi & Equipment Location ��
53. Steel Reinforcement .
54. Forms '
Date Inspector
�
� 4. �leMricai Conduit�Ui?drgmd. ' S5. Electrical Bonding �
��•5:• Steei Reinforcement� ' 56. Rough Plumbing & Pressure Test
_;.:��Electrical UFER:G„d. � 57. APPROVAI TO COVER�GUNITE
��7. Footin s -�
g ;r ,� 58. Electrical Conduit-Undrgrnd.
'$:_ Foundation � - - 59. Gas Pipe, O Undigrnd., Test
;�9. Water Pipe-Undr9rnd. i. 'r' 60. Backwash Lines, P-Trap, � Undrgmd.
�1�0. Strucmral Floor System - 6i. APPROVAI TO DECK �'
11. Property Sewer Line.& House Connection 62. Backwash & Receptor�Finai
12. Sewer Cap ' � - 63. Heater & Vent-Finai �
73. Root Drains � 64. Plumbing SYstem - Final,
��
14. Rough Plumbing. -; 65. Electrical-Final • �
1Er.Rough Electricai_Corzduit : 66. Solar SYstem-Final,
�
i 6. Rough Eleciric,YViring_ -. 67. Fencing & Access�Approval .
17. Rough Wiring Sign 66. APPROVEO FO.R P�ASTERING
7B. Rough Electrica��T Bar Ceiling ��69. POO VSPA SYSTEMS FINAL �
19. Rough Hea[ing & Air Conditioning F,I,RE,DEPTyREQUIREMENT �
r [i �t a.: � ri T �
I Y � • .n R I: �'�� ^� (��
� 20.'Rough factor.y P�sepiace , - _ _ � APPROVAL$;,r: Permit # � '� ~
27. �Duct,s, in Str�Fcture: + � ^ ^ - • ' `_�'� - 70.'Undergrouild I�jrdro '
,:, � . a
22..Ducts, V,entil tin . `� .- -�'- �;_ ` ^ '••.�. -
@„ 9- s� . s 71. Product,P,iPing�6Tas D Oi�
23. Gas�Pipe-Rough & Test , r� t^ '�' d: ' �� 72, Underground Fti�ih '' {"
. - c E• :
24.'Roof-Framing' r•'� -' � " _ ; � -1 C ,�,f: � 73: Undergrnd.StorageTank}�OGas OOiI
25. Roof Sheathing (-•t o• N+ 7q, Overhead Hydro _ '
26. T�Ba�'Ceiling IStruclural) & Monocoat .` ,_ �, r' r"�-.; 75: Dry Chemical �_ -` ,,.
27..Frameand Flashings +^ a�i 76. DryStan`dpipeF"7'- •
T
� 28. I..athing'&Sidingx��;'' •=�•� T y= . .. `� 77; FIXEDpSYSTE�,�M=FiNAL_ • �;
29. Insulation _.. _ • � � � 78: FIRE PREV. FINyAL - '-
� 30. Drywall Nailing h ��. _ '- ^ ' �; "" ' ' _ �HEALTN DEPJ.`REQUIREMENT
. 37. Plaster B owq"Coet o � - � K o 79. FINAI INSPECTtON +� � �
32. �Electrical;Powir Mgf�e'r-Final t''' �' SQ; POOD CERT,!F�CRTE I�SSUED
�i t -] ;s .
- 33. •Final Electric � , a � �: � Notes: u� * _ � �
� 34. FinaCHeating"& Air Conditionlrig� +` l ?� '` --='r '
:P ' p r :� rZ Z �S �- ` i / + � r � "'+
35.'Final'Gas Pipe-Test fi .. .. >. � ' � :�
k 36. Hood'or CanoPY - � '- � ' ' , �•. ' '`� - � .-� -
a i 1 ;r � • ; ^: C` .� [*+
37. �F.inzl.Factory fireplace � ,-F. �. . " � ` - >. �'
� 38. Final Plumbing --' ', � �, , . - _ '- �.
* ',- . �:
� 39. Water Service�Final ; ' . , , 4 � ` � ;_ J� �
'40. GasService-Final � �� . 'i :�l � j� _- c�r. '
�, I .. - :
�41. SolarpomesticFinal `- .. . -' '' �`" `'-" °
� t. . �^ `" o � ^ �
142. �Backflow Prevenrer. � + ��- �r ^ �
� v i� i �:
�43. Backflow Irrigation-� `^ � � � '� - * �" - ".
� � ' " .^� " - . n; .� c : 'n �' D' H. C. � ^'
44. landscape Irrigation System= . .. - ��
4 : ..r c.�: ' Y ,-i " r F
�55.'Sound At[enuation; �y"'';',. ' � �Y f, �, � j , � . ".�,
� - '
�6. Handicap•Regulations ' • � �k `� -� ` - = _ x
k7. FINAL STRUCTURE & BUILDWG ;, y � " ; i,
's.[F�NA�LPLANNING• F•�� .� :� � .*! �' �
' r - - + C
3.'Elecf'ric Release to Edlson � , = � -
,�
). Gas;Release to Southern Calitornia Gas Co � � � � � • •
,. � n •- -�:: i � . .
�. CERTIFICATE OF OCCUPANCY . �:'=• : -
� Date ____ . .....
.
D & N INVESTMENTS
1733 So. Douglass Road, Suite I.
Anaheim, CA 92806
(714) 937-0501
October 30, 1980
City of Costa Mesa
Building Department
77 Fair Drive
Costa Mesa, CA 92627
Attention: Dave Schuyler
Regarding: Tract 10806
Palm Court
Dear Dave:
This letter is to notify you that D&.N Investments does hereby
accept all responsibility for the wood support post and wood
stair stringers that are in contact with concrete walkways and
patio slabs at 292 Palmer Street in Costa Mesa, Units C1 and C2.
Thank you.
�cerel�c,,
C/�
5� �
t (� •
R. E. Simington
Project Superintendent,
Authorized Representative for
D & N INVESTMENTS
RS/cn
i, . . . . .. . ' . . ' - ' , .. . ., �. �.� . .'. , " . . .,
� � �City of Costa Mesa ' � . ' � - . �
� . Building Safery Department C E R T I F I C A T E D F O C C U P A N C Y � i�,r� `� !� `� �. , '' `
- P.O. Box 1200 . . . . -
- � ' Cosia Mesa _California � . � - � .
�� The Building located at 9R9 Pa1mA"r ;traat f.l R, C9 ' ' -
, has been inspected and found to comply with the provisions of all City of Costa Mesa�Ordinances applicable thereto
o-
� for a Group � = Occupancy. � . _ . �
� - UseofBuilding frnn�ln•c � - � � �
� . Legai Description nPud�F_1�?r.nc - � � �
� ' (Sae reverse sida for Metes and Bountls) . '
- Building Permit No �QZ'����Qt'iF Electrical Permit No, d77i?Z/ARtr,7 plumbing Permit No.��acr.t�oh.:::
' � �, , - Number of aparfinents �" --3=--�-�and/or guest rooms'`—�r_->�� �- ---- � � � -, - _-.
ISSUED TO: Building Officia� ([�..,, � �
b�//��ca7/ � �'� a"l�,lt.. '
n r. ra itat�cc7r.�cnrrc .;_..- UICZDY' G. Ne���ton-Director Bu•iidino [�i�:i';i •
Date October 31 , "1980
. 7his Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by tFie
�� . - Building Official of the City of Costa�Mesa under Sec. 306 (e) U.B.C. � � - . " . , � � - .
Form BU 34 Rev. 11/70 - � � ' � ' �
1�� � . . - . . . , . . � � , ., .. . _. . , .. ' y
�j���Q}� • COSTA MESA BUILDING-SAFETV DEPARTMEN�
=i' _�' •P.O. BOX 1200 COSTA MESA, CALIFOFNIA 92626
For Applica o il 'n let - Use Ink Only
.BVIIDING- /
ADDRESS s
T NANT�R D�'N iNUES i MI�►� i S
nooRess �'7�3 ,5. �Ol16LnS$ ��.
TE L.
CITV �� NO. .(�. O
CONST(7UCTION ^
LENDEF G� �- V R C� � L
BRANCH
�
ADDRESS � �� ►Jew�Po� �� � QQ O�
ARCHITECT 1} p/�'SO � A .L'�1 NEL. �
OR ENGINEER �� `�F w
ADDRESS ��YS� "(aj' AIQ�RNAU@. C•�•
ADOFESS 17 33 � �• �o SS �'
, ^ TEL./'�
F CITV I{�-II 1 .NO."/��US
� LTC.NO. 3�IS�� 1 LICyNO.y' I�b �
W SIZE I C ��; NO.OF BLDGS.
a OF LOT J NOW ON LOT I
� USEOF �`; ��
EXISTING BLDG. V
y
FSeparate permits are required for
q electric, plumbing and heating work:
H USE OF BUILDING AND WORK TO BE PERPORMED
a
A.P. NO. 5/z
BUI LDI NGi
AOD RE55� � �
UNIT OR
SPACE'NO.
TR.NO.
NEW ADD
OWNER �/��
USE oO
ZONE R ^Z-
APPROVED
f� __ _ ,
♦ F� t
S -/!o •L-Uy}
°2 �L"ui �ItR�•.� ._
C ?�t �
LOT
LTER REPAIR MOVIN
t►tU�S 1 M�IJ i S
VALUE
TVPE GROUI
DATE
APPROVEOSETBACKS
REAR �O FT. O
PLqNNING ACTION
APPROVED � � � /
-•G� ..
DEMOLI
F -i4-11
DATE
APPIiOVED
I hereby ecknowledga ihat I have reatl this apP��cation antl sta2e .riN,D FOR SPECIAL
that the above intormation is correct antl agrea to comply with
all laws ragulating building cons[�uction, antl I shall not employ
any perwn in vtolation of tPe workmen's compensation laws of
the Stata ot California.
I hereby cartlfy ffiat I am p�PPerly Itcensed as a conttector untler Sn•
the Stata of California BusinOss antl Professions Code, Division 3, THE AMOUN'
Chaptar 9, entl that � lice�ses are In full force and effect, or I THE PURPOSE
am exempt from e rovisia�s of the State o Calitornia Business VALUATION
and Professiona C d, Divisio� �te�
Signature of �� ( �
Permlttae � � $ �ii-9-'9'�4A�
i7b�'hM�YL�
0I !
AuffioAzetl Ageni Date
f SHOWN UNDER VALUATION IS FI
OF ESTABLISHING A PERMIT FEE ONL
PERMIT FEE $
�� PLANCHECK $ //3� �
TAX § �I �J
/G
TOTAL PAID e � + ^ -
� [ �P�
TL
. . �► /� �
.� COSTA MESA BUILDINGSAFETY DEPARTMENT APPL[CATION OR?STRUCTURALPERMIT� �5.00 TL
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
RECEIVE BV PERMIT
For Applicant to Fill in Comple[ely — Use Ink Only C. ��
BUILDING A,P, NO.
ADDRESS �
BUIIOING /'�_�+f� _,
, OWNEROR � � ADDRE55 C .�r
TENANT
UNIT OR /� H
MAILING .2�� � SPACE NO. '�
ADD RESS
T .N LOT BLK.
♦ TE }�j�,� ' '
CITV _�i�� NO. .)j<t/�
� NEW DD ALTEP REPAIR MOVING DEMOLISH
CONSTRUCT
IENDEH ' C ` �` �-
BRANCN ��—
.�
OWNER
ADDRESS p VALUE
OflEN INEE � �Q . � TEL.My-_p.�+ USE �/� a � $
/L.V DO�/
ADDRESS � p /� '� /YL� I _ �iK ' ZONE � VPEV GROUP - 3
APPROVED n
CONTRACTOR �' BV DATE 3—/�O^ a
ADDRESS 33'5, � Q cl��
TEL.
CITV ��y� NO —Q��J
F STATE CITV `�� APPROVED SETBACKS
�` �/�'F� �7 ���.NQt6/iG.sa-
IIC. NO.
SIZE ..� NO.OF BLDGS. (FROM C/L STflEET)
6. OF LOT f� � �� NOW ON lOT / FROM FT.
a VSE OF
�.�. EXISTING BLDG. $�
�
FSeparate perrrilts are required for �. sioe FT.
0 electric, plumbing and heating work: REAR FT.
�.W„� USE OF BUILDING AND WORK TO BE PERFORMED �
PLANNING ACTION
Q
\ ,
� , � v DATE
t�LPx1 k APPROVED
� APPROVED
r
.a
� i
w
� 1 hereby acknowletlge thai I heve reatl this application and staie
0
y�, ffiat the ebova Intormation is correct antl agree to comply wiffi r
� all laws regulatine buildine aonstruction, antl I shall not employ
Z any person In violation of tl�e workman's compensation laws of �
. � tha Stata ot Celifomia. +�
3 I hereby certity that I am prePeNy Iicensetl as a conbactor untler SQ. FT. �,705 '
the Staie of Celifornle Business antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl that such lice��s are In full forca antl effect, or I THE PUfiPOSE OF ESTABLISHING A PERMIT FEE ONLV: j
am ezempt from the provisians of the State of California Business �
,� VALUATION PERMIT FEE $ / � . �
antl Profe ' ' j I
PLAN CHECK E �_ '
Signa �I �
Perm $ TAX S �— (
or �
Authori d genS D e TOTAL PAID $ � j
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