HomeMy WebLinkAbout972 MISSION DR - Building Permits41
PXOJECT AOOHESS: 9% 2 M I SS I ON DR
�NEfl'S NAME: WAGNER GARY A
aooeess: 9322 L�, JOLLA CIR
HUNTINGTON BEACH,CA 92646
FflCMIENGINEEH:
FODflESS:
REG.NO.:
UNIT:
UNIT:
PEPMITTEE: SUNSHINE MAINT S REMOD ( 719 ) 848-0100
aoonEss: 17921 CARRANZA LN
HUNTINGTON BEACH CA 92647
LICENSEO CONTflACTOB OECUBATION: I here0y aliirm ��a� I am licensetl untler pmvismns � ChaD�er 9(commencing wii� Section
7000� ol Divison 3 0� Ihe Business and Pm�essions Coae. and my license is in �ull lorce elfeci.
ci c.: 5 8 3 61 srnre uc.: 6 2 9 6 S� �ss: B �
ate. �� Sgre�ureV //(/ y� � ��
EX$' COMPENSATION OECIAPATI�N: I here�y a��irmlhal I have a Cetlilitaie ol ton5eni �o Sel4insure or a terlifiw�e ol WDrkefs'
POLICY N0. n ns�apc� pr ��,e�UfleA GPpy thereol (Se���EXP. OATE b�7 � Q 1 4
1 1 V / 7 j
�o Y: STATE FUND
Certili capY �s �ereby fumis�etl. I� Cenilietl copy is ile wilh ��e ti�y il - g Oivi -
it¢: � � NpplicanL
,�3fE PTIONfBOMWOBKEflS'COMPENSIITIONOECIABATION: Q�i55et�ionnee0nolbetompletcdi�thepermi�i5�orone�undre0(4100�or1e55�.
1 ceNty that in the petlormance of ihe work for whic� Ihis permit is is5ue0, 1 shall not employ any person in any manner so a510 become
sublect �o Ihe Workers' Compensa�ion Laws oi Calilomia.
�ale'. Signa�ure:
NOTICE: If. af�er making Ihis tleclaration, you 5hou10 Uecome su�le�� �o the Workers' Compensa�ion pmvisions of Ihe Labor
Cotle. you mus� lotlhwi�h campty with such provisions or Ihis permit s�all be tleemetl revoked.
CONSTHUCTION LEN�ING pGENCY: I hereby a��irm tha� Ihere i5 a constmclion IenOing agency for t�e petlormante of the work �or
whic� Ihis permit is issuetl (Sec�ian 3097. Civ. C�.
LENOEfl:
ROONESS:
OWNEB BWLUEB OECLAXATION: I hereby aflirm �hai I am e�emp� iwm ihe Conirac�ors' Sia�e License Law Po� �he following reason
(Seclion 7031.5 Business antl Pmtessional Code: Any ciry oi coun�y which requires a Dermii b wns�mct, al�er, impmve. Uemolish, or
repair any slmcWre. prior to ils issuance. also re0uires Ihe applican� lor such permit to lile a 5igne0 sta�emen� ihat he/she is licensetl
pursuant lo �he pmvisions o� ��e Comracmrs' Sla�e License Law �Chap�er 9(commencing with Section 7000) ot Division 3 of �he Business
antl Pmiessians Code� or �hai �e/she is exem0< <here�mm antl ��e basis lor the allegeA exemp�ion. Any violatmn o� Seciion 703L5 by
any apPlicant for a permit su�iecls Ihe applicant to a civil Denally of not more ihan five nunOreO tlollars ($500�.
1. as owner of ihe pmDeny or my employees wit� wages as their soie comDenSation, will �o �he work, antl ihe
❑ simctureis notimentleU orafleredtorsale(Secnon 7044. Busmess ana PrafessionalCoae: The Conirac�ors' S�ate License Law
Aoes no� apply to an owner o� a propeny who builds orimproves ��ereon, and who tloes such work himsel�/hersetl or Ihmugh
his or her own employees, proviaetl ��at such imDmvemenls a�e no� in�entle0 or offerea br sale. I�, however ihe building or
impmvemenl is 5010 wilhin one year ot campleiion, Ne owner will have Ihe bur0en ol pmving he/she Oid not build or impmve
br the purpose of salel.
I, as ownerof Ihe pmpetlY. am exclusivety mNracting with IicenseG conlrac�ors to cons�rucl lhe pmlecl (Sec�ion 7044, Business
J antl Pw�essions CoOe: The Contractors' Staie LicenSe Law does no� apply Io an owner ol DmOeM1y w�o builas or improves thereon
and who conlracls for such pmlec�s wi�h a canVactor(s�license pursuan� to Ihe ConUaciors' Sta�e License Law�. I am aware
Iha� prool oi their Worker'S Compensa�ian insurance shoultl be pmvltletl �o me.
� I am exempt under Seclion B. 8 P. C.
lor Ihis reason:
�ate'. Ownec
I tlo hereby cenily Ihat I am aware oi antl untlerslana the requiremenls of Calilomia Healih anJ Safery Code Sections 25505, 25533, anU
25534 ana Ihai I or any iWure �uiltling occuDanl willlwill not (circle ane) neetl �o comply wi�� saitl state cotles and ihe reQuirements �or a
permil �ar cons�mction or mo0dicalion Imm �he Air Ouality Managemenl DisVicl. Resitlential consimc�ion applications are exemp� �mm
Ih¢Se prOviSions. /j
Oale: Applicanl:
I hereby ceriity I�a� I have reatl ��is applicalion an� sla�e Ihat ��e ahove inbrmation is rre . I agree to c mply wi�� ail cily antl counry
ortlinances antl sialelawsrelalingta �uiltling constmc�ion antl r �y authorizerepreseni iv ollhis cily�o n upon�he abave�menlione0
propetly forinspeclmn purposes /
�ale: —/ � �__ Signature: �
Driv � �icense or Sociai Security u:
t64Fa6 White—Builaing; Green—Coee EnlorcemenC Canary—ApPlicanl: Pmk—Revenue; Goldenma—Nssessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 06572'
PERMIT NO; B 065722 PLAN CHECK NO: N GOVT: N SCiPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; T/O RESTH 6 REROOF W/COMP. SHINGLES SQ FT: 3,800
CLAIM VALUE: 3,800.00 CALC—VALUE: 3,$00.00 GROUP OCC: R-3 /M-1
COMMENTS: SMOK DETEC REQ'D PER TAE 1991 UBC
*x-x�x�+t+�**�ri���r*�rx��r�rx��r�r******x��rx�x�**x��*�r*+t+�+t*�rx�*+�*�t*�r***+�****�c-********+r****x��r+r��t*�r*
Z 0 N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR; FT IN FRNT: ET IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 14166217 ZNE: REF NO;
PLANNING NOTES> —
`5
if �E if 1E 1E iE if iE if if if iE 1E 1ElE iE iElE iE iE iE if 1k iE if 1E 1E 1E 1f if iE iE 1E iE fE 1E �E 1ElElf fE 1k 1f if 1! �E iElElflE iflf iE iE fElf !E iE iE 1E ik df !E K ff jf 1f if iE jf 1E if if iE iE if �E jE 1E
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 APPAOVED BY DATE:
HUILDING APPROVED BY : DATE: ��
APPLICATION ISSUED BY: DATE:
+t*****xx*x*�r*�t,x��t�t+t*�tx* *�**���r�r** *�
*+�xx******+t*+t*+t**�r****�r�t�r**�******�****x�******�t**��***�+r**�*�******** *�******+�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES" GRADING
PERMIT 63,00 �����p�E D�TECTOR SMIP/NON-RES
PLAN ;
HUILDINGEDIV—> PEAMIT ISSUE PLAN—'C'F[ECfC���� �'
TOTAL PAID �-� DUE
TOTALS----> 63.50 0.00 0,00 63,50 63.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: r,` ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING-:P,LAN—CHECK
63.00 .50
1 •
�F 1E if 1E �k �f 1E iE iF 1E iF fElf !E k if iF iE jF ik ik 1h iE iE if fE IE aE'lE iE if if 1ElE iElf 1E iE iE iE 1E �F iE 1E iE 1E iE 1E if !t!E jf 1E if 1ElE i1 iF 1F �F jE iElE if 1f !f iE if��F iF'if 1E if iE it fE if iE iE
I N D I V I D U A L F E E H R E A K D O W N ,
4
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
fr:
SFR 3800 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1.00 3,800.00
END OF FEES '
,�r
.�
+Ji oQ:`3?75—(i01S377fi T C�T .�;.50
6ATE� Fli114/94 TIi1E= ?2:i7
.
CONSTRUCTION AND PIANNWG.
'`APPROVALS Perm�j#__T
t, TemOorary Electrical Service'or pole ,-
2. Sod PiPe-Uodrgrnd. -"�'� � .
3. �fectrica� Cqnduit tit���tY�Untir�rnd.
.A. E�ectrcalCqndul2-Und�grnd. -
5. Steel Reinfo�cement .
&. Elettr,ca! UFER Grnd.
�. �Foot�ngs .�
i�
8: Foundation �
9: Water P�pe-Undrgrnd.
'-�
10. Str�ctural Ploot System �
it. Prope�ty Sewer �ine & Ho.
� 12.�$awer C�p .. i. i �
73 fioof Drains � �
� 14. R� bing .� �-
75. Rough Electriral-Conduit �
�
� 16. Rough Electrit Wiring
�17. Rougb Wiring Sign
18. Rough Electri�l•T 88r Ceiling
79. Rough Heating & kir Cor.di±ioning
20. Ro�gh Faaory Fireplace • - ,
21. DuCts, in Structure � '
22. Ducts, Ventdating
23. Gas P�p:•Rough & �ast
24. RoDf Framing
25. Ro4t Sheathing
26. T�Ba� Ceihng (Strattural) & Monocoat
27., F�ame � rd Flashing
28. LaThing � Sid�ng - .
.-
29. insuiat�pn ' ..
"30. Dryv:ali NaJing
31. Plaster Qro:•:n Coat _ -
32. Elertr,ct! Porier A^.eter�Pical
33. Fi�a� E:::ctnc
34, Final Heatmg & Air Co�drtionmg � �
35. Final Gas Pipe-Test
� 36: Hocr� o� Canopy .. � �
37. ��nal P;ctorv Fireplace ' �
38. Fin:i Pt;rmbing ..
39. 4Vater S..�rv�ce-Finai -
'40. Gas Service-Finai
47. Solar pomesiic-Final
42. 8ackflow Preventer
43. Backffow Irrigation �
� 44. Landscaoe Irriyation System .
- 4$� Sound Attenuation � • �T
46. Handicap Re6uiations -
A7. fINAL STRUCTURE & BUI�DING l
48. FINAL PLANNING
A9.�Electric Release to Edison
50. Gas Release to Southern California Gas C
51. CEftTiFICATE OF OCCUPANCY
No. Date
a
Date � Inspecto
POQL &
� APPROVALS Permit # Date inspector
52. Pool & Equipment Location
53.�Stee1 Reinforcement
54. Forms
55. Etectrical Bonding
56. Rou9h Plumbing & Pressure Test
57. APPROVAITOCOVER�GUNITE
58. HecUical Cq�tluit�Undrgmd. �
59. Gas Pipe, � Undrgrnd., Test
� 60. Backwash �ines, P-Trap, � Undrgrnd.
67. APPROVAl.TO DECK
62. Backavash & Receptor�Final
63_ Heater & Vent-Finat
64. P�urttbing System • Finai
65. El=ctrical-Finai
66. Solar SyStem�Fina1
67. Fencing & Access Approvai
68. APPROVED FOR PLASTEflING
69. POOL/SPASYSTEMSFINAI
FIRE DEPT. REQUIREMENT
.APPROVALS�� �Pertnit� , � ,"'
� 70. Underground HYdro .
77. Product Piping Cj Gas d Oii
72. Underground Fiush
73. Undergrnd. Stora'ge Tank C� Gas ❑ Oil
74' Overhead HYdro
75: Dry Cherrticaf �
76. DryStandp�pe ;�. .
77. FIXED SYSTEAI FINA�
7B, FIRE PREV. FINAL � . ^
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION ' _�
� 80.� FOOD CERTIFIGATE ISSUED �L
Notes: ` _ , � , .
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�M ���t; . iiii+ei�an. t�Ai�� S�+UtllideiY� a .•.1.a�� ei ', - � ' �' ,
f CITY OF COSTA MESA '�
z� �r� f° .
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`t �r �p CALIPORNIA 82828 ' .P:O: BOX,f200 • , L
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��+. �.;.'' �' � � � � " �-� FROM THE OFRICE OF THE DIRECTOR CF BU{L-DINO SAFETV , � '
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u" "�+A'M1 `�A �.,.� �Re ,,�9Z2 Mie'sion uY�Ve ' .
{ �
n-I;�we���`Ff1�ry ' 1 �t '; ' _ ..' , .' . . - _ .�
'r�iT r%t�' �.�,« '4 y' TO WHOM IT�:MAY CONCEBN. .
��{i�kMyf YA� .. . . � . '. �. . '' '' . I r..
f(3 S� �
�iRyE�y ��� 4����� � r _ ' t ! 'ls � i �,.� Ii � M:�i./�i -� ii� �ii �ie � S- �i�� �a AnJ _�'W ri��ai� : � '
��a���'������„�� �,rThe�com�lianceiinspection wae�made�for the'above,address 7�31 78''� r� �w w ���
,��,'�#r}�Y�;q„�i� �{Tiie followii�g liet is required ta bring the etruc`ture up 'to Uri�.foim ;` r, .
S+S.F^j \ e+�'1�� a Ni' � ` i.. � � fi � i... �� t�'i'�' � .�:. '� i
«� � * `� � t .�. Su1ldi$ Code. .Remove slieds and 'aEio ,co'vere whicl4 are .located . t �-:
' + �;}�y; �w ��y�x}�;�"4 � be`tween$970 snd 972 bii'seion Drivep �
' �',qlyre kUT, rte, i - ' � - . ' ; .}'
�ien�,�,�5 �tiR� -a � i �.�' { 4 ' . ii �.3, e �u;.i_ � 1 lfut �i: � W.� . �uL., l�� lt�t ' . ly� � '
� a� �.� ,` � Unit 1/1 Ven� oder rjange.is not working: . Remove all �torage in . �
� s,,,x �
uo ,� � ' �AU closet. , " f •
r , � u.� : � ,t^� * z . ,y � - . . . . . ,
Sl"♦;�n;'Y F1itt�Y1�1� t#'li 1-�i��.-.Il�' Il�.�l..u��:� I�a� f'�il. t�.�.. .-1
�-r,� ��, Ur�it, 113 Faucet leaka in �itchen eink, Repatr bathroom vent - t` � , :
� � �, rs, � . , ,
x �' .i - . � . - . .. - ,
�( �a.�.}�'i �f�'bn �[S tp li.� t1 .P - f� �♦ ��'Ia `l�il ii 1 '�1 � S'ullr.r�l �i ft� - ' 11�-P .:.�i i n � ��Il� u 3.i:.1}C � .�-.1
��"� �'+< <,Un�t 114 Bathxoom wash baein fauceti leekse The water Heater vent ' s� t"
tt�r� v�f-°i-�R. ' �7.: a �-� �I l�t' � u:�� �t tn �� il•� r �.'i a�A..,�� . ' .
i� ,,, 4� �� � wi-� �;,,. ;,. r, neede boxed in wall through upstaire iinit Water heater
,�„ �">� "t'`� ,+ � +` i neede P l�iid T Valve,oi drain on weter�lieatei and.ga� lines �^;' �
.� SSI�. Y�F� � '' {i tu. -It i ILt �• 1.+. I
, ��y, ,�� ,� i# ;, neei�; etrapped� to �he well , , . J .
� t f', � e ' �• : ; . t , , ', .
, j:
{ ��.� � � � ! /Jn� IZ 1. . � `- I1 �t 1 ' i.. .. u � lui�Jt �t .Y.- �� �Iu, r.�. . �P . .L. r � t.i ,
,, �;f: '4 }x y;� .I�epair deck' of tfie lialcony and pose`s tn gaYage wNeie d�maged� ` ,,
, : .�
I , ; _ <a
�1r."l t, ".1' , .':
r'+.��M,� ia �i �-t i' % i�� �u � f�.i �.iee.l ����1 l�u � a�F�,-ili ��� k�'
�, a, ,i Thede correctione sha11 ba�inad'eiafter appropriate permit�.hdverUeen
y �. �,� � � � � �., ,. �� �„� ��• �, � ,,,�, ,... � ,
iiu; `';.'� t, w co�leted•axid then inepecEion eha11 follo�i the ine'tallstian Ahy. ;� ,
i i s !� it�., l.n 1� i� � n.i ��b_.�c. - ua i fiu �,S' u� t -�i 1.
s�A;�: ,'t;�'�� further ijueseione regarding these correct�one ehall'be d�iected to
1 t Y� '[ 1� Il f 4' 1.� �'
�*`„ } � w4� ?�'fij, � the. Building.Depqrt�ent •�; � *' ` ''f
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�'�i.rt��j�i* i ��i�� �ls � tl�,� ' _ � ' � .
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7,{xm"J�* ri�� }5� i 1fv�.t li l�,�ifi-.� t .. .�' . .. '+ ', ' � .` '
�� y s�s�{�` i�' WIL'LIAM S: KUMER �
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a `��+'Ywog, i��``!��} � ; .Ase�t $i�il��,ng Di,reEtoX. , '
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... .. ....._. e .r ... .. ..... . .. .. _. . .. ..s . .
s c
Z I � Applicant to fill in all spaces ezcep[ those wi[hin heavy bo�der lines an0 sign ail approp�iale tlecla�ations.
� Ci7Y oF COSTA MESA CONSTRUCTION PERMIT
Project Address �7 � M 1 SSI Oil
Appl ican�'s Mai I ing Address
Owner'sName ��-Ar� wA[�n?r � PhoneS"70-AR79
_ �_ , I
. Address Q�� a- �.4 c�p (( b I�tJ n� � OaLI�
Arch/Eng. �`%y.Z Licenu No.
Address C
Contractor's Name_slt�ci�� �kp('2 �N 5 i Phone �3� `��� 3
Address (mailing) 8� � W� � �TM ��_'� M�A
City License No. 'Z.�� � r
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I' am licensetl untler provisions of Charter 9(commencing
wit� section 7000) of Division 3 oT the Business antl Profeszions Cotle, antl
my license is in fu force antl eftect. (� 2�Z l 7 Z
Y �License CIa s � ' en e No.
� Date Signature ' '
1 VORKERS'COMPENSATION DECLARATION� . .
hereby affirm that I have a certiflcate ot consent to self-insure or a certitiWte
Worker5' Compensation Insurance, or a certifietl copy thereof (Section
D, Lab. C.) I
cy ivo.G"�b UA�i ZIjFj' Company y4 � F�
� Certi(ietl copy Is hereby (urniSheC.
❑ Certitietly� y i fil tl with ttte city iltl' q i n.
' Date � Z r � �� Applicant .
� EXEMPTtON FROM WORKERS' COMPENSATION DECLARATION
� (This settion need not be Completetl it the pe�mit is to� one huntlretl (5100) Or
less).
I certi(y that in the perPormance ot the work for which this permit is issuetl, I
shall not empioy any person In any manner so as to become subject to the
Workers' Compensation LawS of Cali(omia.
' Date Si9nature
. NOTICE: If, after making this tleclaratlon, you snoultl become subject to the
Workers' Compensation provisions ot the Labor Cotle, you muzt forthwith
comply w�th such provisions or tnis permit snall be tleemetl revoketl.
� CONSTRUCTION LENDING AGENCV �
I hereby affirm that tM1ere is a constructlon lentling agency tor the pertormance
of the work for��.vhicp this permit is issuetl (Section 3097 Civ. C.)
Lentle�'s Name Nf'��
I Lentler's Aaaress ' '
� OWNER BUILDER DECLARATION
� I hereby affirm that 1 am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business antl Professional Cotle: Any city or
tounty which requires a pe�mit to con5truct, alte�, Improve, tlemoli5h o�'repai�
�'any structure, prlor to its issuan<e; also requires the apo�icant tor such permit :
� to file a signetl statement that he/She is licenzetl puRuant to th¢ provi5ion5 of
the Contractor's License Law (Chapter 9(mmmencinq with Section 7000) of
Division 3 ot the Busine55 antl Professions Cotle) or that he/She is exempt
th=.efrom antl the basis for the allegetl ezemption. Any violation of Section
.5 by any applican[ to� a permit Subjects Ibe applicant to a Civil
ty oi not more than five huntlretl tlollars (§500).
� i a5 owner o( the�properb or my emploYees with wages as their sole
comp¢nsa[ion, will'tlo the,work, antl the structure I5 not intentletl oqoft¢retl
, for sale (Section ]044, Business antl Prof¢Ssional COtle: The COntractor'S
License Ldw tloes not apply to an owner of a property who builtls or improves
. thereon, antl who tloes sucn work himself/herself or through his or her own
employees, p�ovitletl thal Such improvements a�e not Intentletl o� ol�eretl fo�
sale. If, however, the builtling or improvement is soltl within one year ot com-
pletion, the owner wi11 have tha burtlen of proving he/she tlitl not builtl or im-
• �rove for tne purpose of sale).
I, as owner of the property, am exclusively rontracting with licensed con-
tractorsto construct the project (Section �044, Business antl Profe55ions Cotle:
The ContracM= License Law doe5 nOt aDPly to an owner ot pro0erty who
builtls or I:.L� the�eon. antl who contracts for Such oroiects wlth a con-
' tractor(s1 Lcense qursuant to cne Con[ractor•s License Law). I am aware that
proof of tneir WotkeYS COmp¢nsation insurance shoultl be provitletl to� me.
❑ I am exempt cder 5ection B. & P. C. tor thiz reason
Date Owner
I he�eEy certify Ihat 1 have reatl this appliwtion antl State that the above
information is correct. I agree to comply with all city antl county ortlinances
antl state laws relating to builtlmg constructlon, antl hereby authorize repre-
sen[atives of thi5 City'to enler upon the above-m¢ntionetl prope�ty fo�
in5pection pu�pose5.
SlgnatUre Da[e
�rivers' License or SS �
....._. __. __. .._. .,,.,, ,.... A.P.#
��
S Main Building:
TYPE.OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
�❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front
DESCRIPTIONOFWORK/USEOFBLDG. A�T - 6 qear
A
TYPE OF PERMIT�q GRADING FOUNDATION STRVCTVRAL I C Right '
❑ TENANT IC4ELECTRICAL � PLUMBING ❑ MECHANICAL � ! g� Left
❑ �OTHER . P,Ing. Ref. #
PRQIECT DESCRIPTION 5Q. FT. �Ob ([7 OCCUVANCv
Planning Notes:
CONSTRUCTION TVPE F�o.�nF VAIUATION $ F"I I Z S
ZONE GRADINGCV.VDS. ACRES _
Remarks:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors .
Kitchen Sink �
P-Trap
Roof Orains
Reinspaetion Fee � $15
Boiler
Duct - Under Ground
Duct - Structurel
Duct-Ventilating '
Exhaust System ❑ Multiple
Firepl/Fact. BIt. iC60 dk
Heating System & Ducting
❑ ai oo,000 aru O i oo,000
Reinspec[ion Fee � $15
0865-46, rev. 5/88 White - 8uiltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
Showers
—r—
ServiceSink "•. -
Sewer�Cap � � -
Sewer Connection �-
$O�df COIIQC[Of5 J�
Solar Piping `. .
Solar'Tank '� � �`
Swimming Pool w/Sp2
Urinal
Water Closet
Water Heater
�Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
Canopy Type I I �
�
Refrigeretion System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES Automatic Washer
Canstruction Pole Sub.
Cooking Unit �
D ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
$ 3 '
FEES ,
�
$ 3
Garbage
e
Zona
Bui
Parking Req./Provided
ELECTRICAL
Trensformer ❑ 75-50KW
❑ 50+KW
Meter Uup to 100 amps -
Meter ❑over100amps �
Sub Panel � "
Motors DU7 HP O1X-6
Inc.Solar �9-75 HP �16-15+
Microwave � �p�
Pole Light . � i i ;
Range r�. �
Standing Sections
KW 05-15 KW Trash Compactor
FEES
N
I
N
G
R
E
Q
M
T
S.
; I Reinspection Fee !$15 I ' luue Fee I $ 3 I
DEVELOPMENTSERVICESFEQUIREMENTS:
Zoning App�oved By Date
i:
Building Approved By Date
Application Issuad By - Dat��2��'-�i
`v SUMMARY O�EES �
BUILDING PERMIT $ �O'� —� SMIP $ �_
✓ PLAN CHECK $ PERMIT
� PLUMBING $ ISSUANCE , $
PtAN CHECK 25% $ ENERGY P.C.� $
"„ ELEC7RICAL � � $ GRADING $
PLANCHECK 50% $ MICROFILM $ `�
• MECHANICAL $ �
TOTAL FEE $ �3 -
J PLAN CHECK 25% $
t'i OQu2i'S24-OIIO�SJZS i'�J'� b„JC
�ASE: #.:'IDGti38 i'IIiE: I�:S7
. " . , . . .. . .. : -rv ��.n �C �Dr :. rll�i-rnc.?t._ : 1�: ...�.A'�g.... - -. . ti r ..
1 �Y
� , 1 ` W�
CONSTRUCTION AND PLANNING .T � POOL? '4
ate Inspectoi Date Inspector
� APPROVALS Permit # � APPROVALS Perm�. #
1. Temporayy Electrical Service or Poleti a ,�� , �, 52. Pool & Equipment Location
r.
2. Soil Pipe �Undrgmd. "d i - �;� ��' �� � � j � � �53:�Steel Reinforcement
3:�Electrical'Conduit UtilitY-Undrgrntl. . �` j 1`54. Forms - �
4: Electrical Conduit=Undr rnd. _ ' �
g �� •�� �55. Electrical Bonding
5,•Steel Rei�forceme�L `� -. 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 Undrgmd., Test
9. Water Pfpe-Undrgrnd. � � ,• 60. � BackwasFi Lines, P-Trap, � Undrg'rnd.
10. Structursl Floor System ' ��--� 61. APPROVAL TO DECK
11. Property Sewer Line & House Co �nection � 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
1�6., Rough Electric Wiring � 67. Fencing & Access Approval
17.�Rough Wiring Sign �� 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Cei�ing•� 69. POOL/SPA SYSTEMS FINAL �
19.'Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT
20� Rough Factory Fireplace .� APPROVALS Permit#
�' 21. Ducts, in Structure � 70. Undergraund Hydro .
22. Ducts, Ventilating � � 71. Product Pipirig OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 � g 2� _ 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: .l�_/C-�b Qit �v GtJ����T�%��<d
34. Final Heatin9 & Air Conditioning �4� Q� �w,p�� •7-O �S/�t ��
35. Final Gas Pipe-Test .
36. Hood or Canopy w`�� �1 �
37. Final Factory Fireplace -
38. Final Plumbing , � "
39. Water Service-Final� � „ . _ _,
40. Gas Service-Final � �
41 . Solar pomestic-Final
42. Backflow Preventer , ,
43. Backflow Irrigation , �.
�
44. .Landscape Irrigation System � :i
C
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 . �
�1
._ 4
Fzaming
Roof ing
insulation
Electrical
Plumbing
Stucco
Painting
'\ �
a
Construction
_r.
9
�
�; �
$ 300.00
300.00
300.U0 `
850.00
900.00
325.00
1,150.00
I
$4,125.00
�
894 West 18tn StreeL Costa Mesa, CA 92672 �(7ta) 531 �??73 � Llc. Na 42?37"<
I
4 L� 1 �, � SS ��h `�+ 3� p L�, Applroant to fill h({II SD C�es exeept thoi! with Y �or0er lines antl sign all approp�iate Eeelarotions.
Cl�v nF r-oSTA MESA CONSTRUCTION PERMIT
ProjectAddress ��. �'�'<<55 o.n
Appiicant's Mailing Address �+-�' �'� q���
Owner'sName �''� �q�t// /� n Pho'ne-➢1�L�!
Address 9�+2Z �+4 �6��u l'�-'+eR' ,�7-�pc�l
Arch/Eng. License No.
Address ' C
Contractor's NamP ��+-+'G'� J�r2 Cr... �„ Phone 6x� �31 �
Addresslmailing) 8��� W �lg�� �oS�a d'iDSA
Gty License No. —Z.�C % �% 3
LICENSED CONTRACTOR DECLARATION
I hereby aftirm ihat I am��licensetl untlen O�ovi51on5 of Chart¢r 9(commenCing
with section ]000) of �ivi5ion 3�of the Business ntl Professions Cotle, antl
my license is in full forc� antl etfec[.
LicenseCiass `'� ' E I nseNo.��-Zk�'L
Date � "T- � 5 R $ Siqnature _
WORKERS'COMVENSATION DECLARATION
1 hereby a(firm thal I have a certiticate ot consent to self-insure or a certlficate
�of Wo�ke�s' Compensa[ion Insu�ance, Or d certitietl copy tne�eof ($ection
�� Lab. C.) f -"
y No. O�L (irt1�F Z(ZA ComP nY `� �� L .!��
I��Gertified copy is hereby turnishetl. J� ^/'
LlC�ti��cA.opy�Qetlwithth¢tityB i ' < I I�
Date qp� Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION =t
(TM1issection neetl not be <ompletetl ii the permit is far one huntlretl (5100) oi
less). '
I certify tha[ in Ihe perto�mance of tM1e wo�k fo� which this pe�T�t is Issu2tl I'
shall not employ any person in any manner so as to become subject to t�e,�.
Workers' Comp¢nsa[ion Laws of California. "
Date Signature �' ^
NOTICE: If, after making this tleclaratlon, you shoultl become subject to ehe
Workers' Compensa[ion provisions of the Labor Cotle, you mus[ fortnwith
comply with such provisions or this vermit snall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV •
I bereby affirm that there is a construction lentling agency tor the performance
of the work for which this permit is issuetl (Section 309� Civ. C.)
Lentler's Name -
Lentler'S AtltlreST
OWNER BUILDER DECLARATION -
I hereby affirm lhat I am ezempt from the Contractor's License Law for the
followinq reason (Section 7031.5 Business antl Professional Cotle: Any city or
tounty which �eQuires a permit to construGt, altCr, Improve, tlemOlish o� �epair
any struclure, prlor lo itz issuance, also requires the applicant for such permit
to file a signetl StdtemCnt that he/sh¢ I5 licensetl pursuant to the p�ovisiOns ot
tne Coniractor's License Law (Chapter 9(commencin9 �+�<h Section 7000) of
Division 3 of the BuSiness antl Professions Cotle) or that he/she is exempt
therefrom antl Ihe basis for the allegetl exemption. Any violdtion o( $ection
'"''.5 by any applicant for a permi[ subjects the applicant to a civil
ty of not more than five huntlretl tlollars ($500).
a5 ownet ot the prope�ty or my employees with wages as thBi� sole
<ompensation, will tlo the wo�k, antl Ihe structure is no[ intentletl o�mfferetl
for sale (Section ]044, Business antl Professional Cotle: The Conbactor's
License Law tloes not apply to an owner of a property wha bulltls or improves
[hereon, antl wno tloes such work himself/herself or through M1is or her own
employees, provitletl that such improvements are not intenCetl or otferetl for
sale. Ii, however, the builtlin9 or improvement is soltl within one year oi com-
pletion, the owner will have the burtlen ot proving he/she tlltl not builtl or Im-
�rove to� ttte purpose ot sale).
I, as�owner of the p�o0erty, am ezclu5ively contracting with Ilcensetl con-
tfactor5 t0 COnstruct the projett ($ectiOn 7046, Business antl ProfeSSiOns Cotle:
The Contractor's License Law tloes not apply to an owner ot prooerty who
builtls or improves tbereon. antl who cOntractz for such oroiects with a mn-
t�actor(Sl license pursuant co tne ConVacto�'s Litense Law). I drn awa�e that
proof o{ their Wo�ke�'s Compensation in5urance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date / I Owner
a reatl tnis application antl scate that the above
:e to comply with all City antl county o{tlinances
uiltling construction, and hereby authopze re0re-
enter upon the above-mentionetl prd0erty for
L% r
�= 36$�2J
TVPE OF CONSTRUCTION NE
❑ CONVERSION ❑ DEMOLISH
- DESCR�PTION qF WORK/USE OF
ADD LJ ALTERATION
TYPE OF PERMIT� GRADwG �LJ �VrvDnTlorvJt7�iFaucfiU�
❑ TENANT ELECTRICAL L�6LUMBING L�J"MECHANICAL
O OTHER
PROJECT DESCRIPTION Sq.FT oCCUPANCv
CON STRUCTION TVPE VALUATION $ �
ZONE GRApING CU. VDS. ACRES_
Remark5: Y✓Y ���
/ �
Bar Sink
Backflow Preventer
� Backflow Irri ation i'
( Bathtubs o,
� Clarifinrs /.�
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee
Outlets
$15
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt �CBO �k
Heating System & Ducting
❑P700,000 BTU 0100,000BT
Si9nature AL7 V ' -` ' Date � �.f
Drivers•�Lice se or 55 � `�� I I Reinspection Fee
0865-46, rev. 5/BB White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
$15
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
laue Fee
Hood or TYPeI ❑
Canopy Typell ❑
6
liefrigeration System
❑aioo,000aTu ❑ioo,oaoaTu
System Repair/Alteration
Fire Dampers
Registers
laue Fee
R
FEES
A.P. #
S Main Building:
E
T Front
ARear
C Right
S . Left
Ping. Ref. # ,
Planning Notes:
Automatic Washer
Cooking Unit �
�ishwasher '��
Dryers ❑Gas DElectric
Fan '
F.A.U. �
Fixtures "/
Device Boxes ��
Outlets �
Switches
Garbage Disposal
Generator �a5
Reinspectian Fea
2one
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps �
Sub Panel
Motors DO-1 HP O1 %- 6
Inc.Soiar �9-15 HP �16-15+
Microwave
Pole Light
Range _.__
KW LJ5-15 KW I I Trash Compa<
��
$ 3 DEVELOPMENTSEflVICES
Zoning Approved By
FEES Building Approved By
� Aoolication luued Bv�
$15 � �"Issue Fee,
SUMMARYOF.
� , BUILDING PERMIT $ �'g• ��
PLAN CHECK $
' PLUMBING $ � �.�v
�' PLAN CHECK 25% $ �U �
5__ ELECTRICAL $ �`��C%
PLAN CHECK 50% $
MECHANICAL $ �'"y• �D
. PLAfiN CHECK 25% $ ____ .. _
O
N
I
N
G
R
E
�
M
T
$.
FEES
SMIP $ � 5�
PERMIT
ISSUANCE�-' $
ENERGV P.C. $
GRADING ' $
MICROFILM $
TOTALFEE� $ �,�
D, ��022563-000325b7 "T�s!'
Or�7"c: 1�/�5/E£ TitIE: i2�54
�
55.SC
�
�! e4�;�� . . .. : _ ._ _ _ _. . . . .
� CONS,T.RUCTION AND PLANNING = POOL &'^A
„i �APPROVALS Permit# �ate Inspector AppROVALS Pern...# Date Inspector
"fj i. Temporary Electrical Service or Pole . 52. Pool & Equipment Location ..
� _<r
g� 2. Soil,Pipe-Undrgrnd. ' �' 53. Steel Reinforcement --.
a. "
���i 3�'Electrical ConduiE Utilijy-Undrgrndt � • � 54. Forms _
'J 4.:Electiical Conduit-Undrgrnd.- � 55. Electrical Bonding -• '
�%� 5., Steel�Refiforcement ' - -; 56. Rough Plumbing & Pressure Test
t 6::Electtical UFER Grnd � '� � 57. APPROVALTO COVER-GUNITE '
�
7. �Footings . �' �} 58. Electrical Conduit-Undrgrnd.
�� B. Foundation , � 59. Gas Pipe, � Undrgrnd., Test ••
� r 9. Water Pipe-Undrgrnd. _ � 60. Backwash Lines, P-Trap,�0 Undrgrnd.
�, 10. Structural Floor System � . �� 61. APPROVAL TO DECK '
"' 11. Property Sewer Linef& House Connection 62. Backwash & Receptor-Final
�
��'' 12. Sewen Cap ,� • " 63. Heater & Vent-Final •
i '
;/� 13. Roof Prains •� � 64. Plumbing System - Final •
14. Rough Plumbing•, 65. Electrical-Final - �
15. Rough Electrical-Conduit 66. Solar System-Final
y'"
16_ Rough Electric Wiring . Z.Z� � 67. Fencing & Access Approval
r;•
� .1i7! Rough Wiring Sign � 68. APPROVED FOR PLASTERING
• ��8. Rough�Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
• �19. Rough ��ating & Air CondiHoning �� '� FFRE�bEPT. REQUIREMENT
�
I� 20. Rough �F�ctory Fireplace '�,"`�,' ' �, APPROVAL�' Permit #
h 1�
211 Duc[s, inStructure � 70. Undergr6und Hydro
22. Ducts, Ventilating ._y !�,� ,,;t_ 71. Produ�{�Piping OGas ❑Oil
I23. Gas Piper'Rough & Test `I 72. Underground Flush �..
� 24. RoofF�aJnipg �_ 73. Undergrnd.StorageTankOGas ❑Oil
25. RoofShQathing �f 74. Overhead Hydro
.�;
26. T-Ba�C'ei.ling (Structural) &�fNonocoat 75. Dry Chemical '
27. Frame�afid F�lashing ✓'� 76! Dry Standpipe .
28. Lathing�&%Siding '� � 77� FIXED SYSTEM FINAL
i ✓. � �
29. Insu a i n• i/=3 78"FIRE PREV. FINAL
�
30. DrywalLNailing � �j HEALTH DEPT. REQUIREMENT
�/ . 1 0
�_.� .�
31. Plaster�Brown Coat,'�i �l1 79. FINAL INSPECTION
i
32.!Electrihal:Power Metef-Final��° G' 80i FOOD OERTIFICATE ISSUED �" �.�
.i
33. FinaUElectric �� 2 N`g'tes: �� �% �
�I n
34. Final Heating & Air Conditioning
G1 I� �'� �. �m+, �
35. Final Gas Pipe-Test
36. Hood�or Canopy ,
37. Final Factory Fireplace �•• _
38. Final Plumbing - � . � ' -
39. Water Service-Final � .
f'<�
40. Gas Service-Final � '
41. Solar pomestic-Final . � . -
C! . � r .
42. BackflowPreventer � ����� �' �'� i �.
43. Backflow irrigation E X P I R E D � � � 6' �.
44. Landscape Irrigation System � -•�� " �
45. Sound Attenuation 172t8 ,,,,_ $Ig _ '
r
46. Handicap Regulations ' , }
47. FINAL STRUCTURE & BUILDING _
48. Special Requirements Completed • �
49. Electric Release to Edison , ;f � r.;�,
50. Gas Release to Southern California Gas Co • �� ��
.,� _ ,
51. CERTIFICATE OF OCCUPANCY �' " P' `:, r'< < `%� �,.� �,
.:� �
No. Date '' j i `� I„� i nt . ,
� � � �
' City of Costa Mesa
; Building Safety DepaAmenT
P. O. Box 317
Costa Mesa, California
CERTIFICATE OF OCCUPANCY N� IH3S B
The Building located at 972 M:'tSsiOn Li•ive� A� B� C 8: D
has been inspected and found to comply with ihe provisions of all City of Costa Mesa Ordinances applicable thereto
for a Gro�p x&� Occ�pancy.
Use of eoilding— FoUZ'plex Residence f�ith aztached Garage
Legal Description �� 7� `Pr• 5011
(See raverae side for Metes and Bounds)
Building Permit No. Z9a31 E�ectrical Permit No. �O�F61 Plumbing Permit No. 38�0
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. . required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever There is a change in:
1) Occupancy classification of a b�ilding or portion ihereof
2) The number of apartmenis or guest rooms
3) Ownership
If Group H Occupancy, n�mber of apartmenfs and/or guesf rooms as required �nder Sec. 17050.1 (d), California
Adminisirafive Code, Title 8, Chapter 9, Article 8.
N�mber of apaAments_ 4 and/or guest rooms
ISSUED TO: Building Official
HYCROFT 'FEFR11Ci�� II'iC. bY --
Date Fr�l�in�flr� l'j��,9E1�
This Cerlifieate of Occupancy SHALL BE posted in a conspicuous place on The premises and SHALL NOT BE removed
exeept by The Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fo=rn svs�.im—ii-sa-s-s r
- � �9��� FEE RECEIVED
COSTA MESA BUILDING-SAFE7Y DEPARTMENT
P. O. BOX 31]' CO6TA M89A, CALIPORNIA �N .j 0 �aa
FINANCE DE�T.
For Applicanf to Fill Ih Completely ���Pf�jC.�j� ��ERMR
TYPE OR PRINT BUILDING
ssion ive For Ofiice Use Only
ADD EI59 O{: SC't SQ]_].
. R6C6�PT NO.
COSTA MESA, CAI.IFORNIA
,. R[CfiIV O!V O.yl=fl[p 81VH ��,.pAT� I^�Sy¢q�
OWNER HYCROFT TERRACE rNC. � v/ a.- !�Un +s iyti
MAIL BUILDINO
ADDRESS F % ADORES9
FIRE
TEL. ZONE � TYPE GROUP �
cirr h A No.646- 4
L� APPROVED
-OR EN'GENEER 1 lep NE.,t'R 2OO BY ' DATE
ZONING -
ADORE58 2 uite N. uclid Anh.
. ZON�`�I I NO.OF USEOpNEW - '�L�
�t PLANH '� lYILOINO��
CONTRACTOR TO ' % 1� (�-- I
ADDRE88 58111e BYCRIrt10N � U � 5/ ��l� �% ��
. . A.P.NO. �
CITY
NOTE: f�10 EAYE OV ERHAN6 6HALL BE LE55 THAN
STATE NEL, Same 90" TO 91D8 @ REAR P. L. .
LI0. NO. 2 6
EAVES
SIZE � � �� No, oF eLGan. ALLOWE� (U. B. C. REQIJIREMENT)
OF LOT HO X - rvoW on T
YAR�9APPROVED - YARDSAPPROVED
USEOF - , � MAIIJBUILDINR AGCESSORYBUILDIN6
EXISTING BLO6.
_ (FROM C/LSTRE6T1
SETBACK LIN6 FXOM �.f � j G11
cErvTex oF BT0.Eei ,.T>a! REAR YARD �-� / FRONT L FT. FT.
SIDE YARD I LEFf ' � RI�HT ].O � R. SIDE I l� FT. Pf.
DESCRIPTION OF WORK �. sioe I. Fr. F-r. y f
1
NEW Y.� ALTERATION ADDITION REAR I� Ff. � Ff. z
� 'DISTANCE BET. BET. MAIN E �f�
REPAIR MOYIN6 ^— DHMOLISH MAIN BLOGB. ' ACCESS. BLDGS. L
BUILDIN6 � NO.OF ' V'°'R.�Y DATE [G
SIZE � 4� ROOMS � 8TOR169 2 C. U. P. APPROVED ��
EXTERIOR WALL I ROOF AryPROV �,�, DATE C �
GOVERING +i COVER�N6 E �� `�+ �
C
USEOFBUILOINBAdDWORKT BEp FO BD
t 4 nlex -z
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s4. Fr. o v;
I HEREBY ACKNOWLEDOfi THAT 1 HAVB plAD THI6 APPLICAT�ON TNE AMOUNT BHOWN UNDER VALUATION �9 FOR TH8 �
ANO BTATE THAT iHt ABOVe IH CORR6Ci AND AOqEE TO COM� YUFP09E Or 88TABLISHIN6 �l PEFMIT FEE ONLY. 0 O
PLY WITH ALL qT' OqDINANC88 ANO BTATH LAW9 q[OULATING yALUATION '
BWLDINOCONBTqYCiION. ^� m O`
SIGNATURE OF /� . PERMIT FEE $�/�Q1i S O j �
PERMITTE , �� S/J� ��� LA CHEG (!�V � rJ ¢ T
AUTHORIZEDA6fiNT -. �• '` � TOTALFEE � $//JU��j LL
City of Costa Mesa
Building Safety DepaAment
P. O. Box 317
Coste Mesa, Califor�ia
CERTIFICATE OF OCCUPANCY N� ig3g C
The Building located at �'(2 A4isaion 1T_•�.VL�31_TBg C& D _
hos been inspected and Eound to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group H@s J Occupancy.
Use of Building �'�rnlex Residence Hi��.li attached Garage
Legal Description �� r� `�• 5��'1
(See reverse eide for Matas and Bound�)
f
Building Permif No. 198��- Electrical Permit No. ��'�G�- Plumbing Permit No. 3 �
Floor Load Signs have been installed as Room Capacity Signs have been insTaled as
required under Sec. 2308 U. B. C. . required under Sec. 3301 (1) U. B. C. —
77050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupanty classification of a buiiding or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupanty, number of apartmenTs and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapfer 9, Article 8.
Number of apartments—�_ and/or guest rooms
ISSUED TO: Building Official
_ ItYCROIT ^tE7'iRACi . IkC. bY���' �_� -
Dafe xP '�Tw � �1
This CeMificate of Occupancy SHALL BE posted in a conspicuous place on ihe premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under SBC. 3OG (2) U.B.C. Form BU34-1M-11-G3—S-B P