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Home My WebLink About2413 MINUTEMAN WAY - Building Permits(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 2413 MINUTEMAN WY Suite: Vicinily: ROOF Parcel Number: TPN98078 ApplicanC BLANKS, JERRY Address: Owner: MONTICELLO HOA Address 150 VALLEY FORGE RD Zonin9: Phone: Zip: Phone: COSTA MESA, CA Zip: 92626 Contracmr: PREMIER ROOFING AND BUILDING CO INC Address: 17501 NORWOOD PARK PL TUSTIN, CA Zip: 92780 Arth : Address: Phone: (714) 573-0155 License: 634404 Eng: Address: ISSUED BY: Status: ISSUED Applied: 08/16/2002 Issued: 08/20/2002 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF FOR 2413-2423 MINUTEMAN WY. INSTALL 1 BASE, 4 PLY WITH HOT ASPHALT THEN FLOOD WITH ASPHALT AND ROCK. "MONTICELLO" Plan Check: $0.00 Permit: $237.25 SMIP Res: $1.35 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $238.60 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 FEE SUMMARY PLANNING & ZONING Lek 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $13,490.00 $13,490.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under Califomia statutes antl related regulations. (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 if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this parmit to be considered legal, such work must comply with all applicable codes, and all required Inspectlona and final approval must be obtained. Fallure to obtain inspections and tinal approval will result in the axpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 '.ae�es lerool WORKERS'COMPENSATON DECLAFiAnON: � � 'r I hereby aHirtn under penalry of perjury one of iha tollowing declaratlons: ❑ I heve end wlll maintain a cenificate oF consent to sell-Insure br workers' compensatlon, es provided tor by sectlon 3700 0l the Lebor Cotle, tor the paAormence of iha 1 work for which this pertnil is issuetl. �heve antl will maintain workers' compensetlon Insurance, as required by section 3700 oi Ne labor Cotle, for the peAortnance of the work For whiU this pertnit is issued. y workers' compensatlon Insurance carrier and policy number ere: Cerder: PWicy Number: (lh/s section need not ba cromp/efe��/d il fhe permit is valued et one hundred dollars ($100) or less.) ❑ I ceni In the perform�e of the work for whic� thi permit Is issued, I shell not employ eny persan in eny manner so as to become subject to ihe workars' P c pe�nsetlon of Ce111 mle, antl agr ih �1 I s tl become subject to the workere' compensetlon provlslons af Sactlon 700 0l the Labor Code, I ahall forthwit� ss w' i s. -� `6 a� ��.� I Cant Si neNre: �L � /Dete: WAPNI ' E TO SECU WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SHALL SUBIECT ARERIPLOVER TO CRIMI PENAL ES AND CIVIL FINES UP TOONE HUNDRED SMlD OOLLARE (5100. ,, IN ADDITION TO THE CQST OF COMPENS4TION, DAAUGES AS PROVI�ED FOR IN SECiION 3708OF THE tABOR COOE, IMEflEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: of Chepter 9(commencing with Section 7000) at Cless M entl Projessions Code, end my license Is In full CONSTRUCTION LENDINCdAGENCY: ❑ I hereby eHirm that thera is a construction lending egency lor Ihe peAortnance ot the work for which tNs permit is issued. (Sec. 3097, Civil Coda). Lenders Neme: LentleYs AOdreu: Signature: Da�e: OWNER-BUILDER DECLARATIONS: I hereby etfirtn thel under penalry ot perjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe lollowing reason (Sac. 7031.5, Business entl Professlons Code: Any dry or wunry which requires a Dermit to construct, elter, Improva, demolish, or repalr any sWCNre, pdor to its issuanca, also raquires ihe epplicaN tor such pertnit to file a signed stetement that he or she is IicenseA pureuent to ihe pmvislons oi the Convectors License Lew (Chepter 9(commencing with Sectlan 7000) of Dlvlsion 3 ai the Business and Protessions Cade) or that he or she is axempt therelrom end the hasis for the flllegetl evemption. Any violetlon ol Sectlon 7031.5 Dy any eDP��m tor e pertnit sub�ects ihe epplicent to e civil penalry ot not more then Ilve hundred dollars (5500).): ❑ 1, as owner of tha properry, or my employees with weges es their sole campensatian, WILL DO THE WORK, entl the structure Is nat intended or oHereO tor sele (Sec. 7044, Business and Prolessions Code: The Conirectors License Law does not apply to an owner of property who builds or improves thereon, antl w�o tloes such work hlmsefl or herseli or through his or her own employees, provided Ihet such improvements are not intendetl or ottered for sele. If, however, Ihe bullding or Impmvemeni is sold within one year of com0letioq the owner-builtler will heva the burden of proving that he or she ditl noI buil0 or improve for purpose of sale.). � I, as owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business entl Profeuions Cotle: The cantractors License Law does not apply to an owner ol property wha builtls or Improves thereon, and who coniracts tor such pro�ed with e contrecior(s) liCenSe pur5uen� �o �he Contrec�ors LicenSe LewS.). ❑ I em exempt under sec. Business and Professions Code tor Ihis reeson: Signeture: Date: Owner ID veritiad by driver's Ilcense. ❑ Yes ❑ No Driver's License No. Vedficetion ol Ownership by (rype ol documem, i.e. - pmperry tex bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavetion tive (5) or more leet In depih Into which e person is required to descend, will Ge made in connection with work euthorizetl Dy this permit, antl that no builtling stnuture, scattoltling, felsework, or demolition or tlismantling thereol, will ba more than thirty-siz (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Calilamia Administrative Code). ❑ As owner-builder, I will no[ employ enyone to do wark which would require e pertnit irom the Division ol Intlustriel SeFery. as noted abova, unless such person hes a permil to do suth work Irom Ihe tlivision. SignaWre: Date: Division ol Intlustrial Salety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AIJTHORVATON OF EMAV: I certify untler penalry ol perjury thet I have reatl this application and state that Iha information given is correct I agree to comply wlt� all state lews end ciry ortllnances relating to building consWctlon, end authodze representatives ot ihe Ciry oi Coste Mesa to enter upon the above-tlescnbed properJy to� inspection purposes. I egree not to occupy or allow occupancy ot eny building euthonzetl by Ihis pertnit until linel inspection. CODE �, 1816 1268 200 201 202 203 206 Fized System Final Fire Preventlon Paol Spe Finel Finel Re-Raof Final BIocWReteining Wflll Finel Factory Fire Place Final Sign Finel Oemolition yOUE� INSPEC110N7YPE 206 Finel Mechanical 20B Finel PlumDing 210 Finel Elenrical 212 Final Fira Prevention 220 Finel Planning Approval 222 Final Site 250 Finel Buildinq/Occupancy Pdg Itl�Li PflOJECTADDNESS: 2453 MINUTEMAN WY OWNEN'SNRME: MC ILROY, GARY W aoon¢ss: 2256 CORNELL SR CASTA MESA,CA 92626 AflCH/ENGINEEfl: nec.xo.: UNIT: AOOflE55: UNIT: PEflMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 PDONESS: P � BD%t 4 3 � 9 DOWNEY CA 90241 ' LICENSE� CONTXACTOP �ECIANATION: I hereby affirm (hai I am Iicense0 un0er pmvisions o� Chapier 9(commencing wi�h Section 7000) ol OiNsion 3 of ine Business ana Pmfessions Cotle, an0 my license is in full force an0 eflect. ciTvuc.:( �059/377� }sTATEuc:902536/� cuss: C 39 EXP: 10/95 Oa�e�, ��L��_`4�_VI__ SignaWre� �/1 WOPNEPS' LOMPENSATION OECIAHRTION: I hereby a�f tha� 1 have a certilica�e o� consent �o sel4in5ure or a ce�ificaie ol Workers' Compensaiion I�c�o�e2�c �pSWien copy mereoi (Section 3800. Lab. �.S / 1 9/ 9 5 POLILV NO.: EXP. ORTE: COMPANY: �'IC' �/ ❑ Certifietl copy is here6y furni5he0. L? Certitie0 coDY is ti/led with �he ciry Building Division. iate: � NOPlicanL � �� E%EMPTIUNFP MWOfl EBS'COMPENSATIONOECUPATION: (ThiSuclionnee4not�ecom0le�etlil�hepermi�isloronehuiMre0�5100�orles5�. I cerlify Ihat in Ihe Dedormance ol lhe wark for which this permit is issued. I shall no� employ any person in any manner so as �o become suble�� o ine Workers' ComOensa�ion Laws o� Calilomia. . Date�. Signature: NOTICE: Ii. alier making Ihis declara�ion. you should Oecome suGleci Io Ihe Workers' Compensaiion pmvisions of �he Labor Code. you mus� �otlhwith comply wi�h such prov¢ions or this permi� shall be tleemetl revoked. CONSiflUCTION LENUING PGENCY: I h¢reby aflirm Iba� Ihere is a tonstmnion 1¢n0inp aAency tor Ihe pertOrmanCe o� �he wOrk tOr whlch Ihls permit I5 issuetl (Secllon 3097, Civ. C). LENDEfl: aooeess: OWNEP BUILOEX oECLABA�ION: I hereby allirm that I am exempt Irom ihe Comractors Stale License law 1or ihe following reason �Section 7031.5 Business an0 Pmlessional COAe: Any ciry of coumy whic� requires a permit to constmct, alter. improve. demolisR or repair any StmtNre. prior �o i�s issuance. also require5 �he apDlitan� fOr Such permit to �ile a Signed Sfatem¢nt Iha� he/she i5 liCens¢tl pursuam Io Ihe pmvisions of Ihe Contracmrs' Slaie L¢ense l.aw (Chapier 9(commencing wi�� Seclion 7000) ol Division 3 ot ��e Business an0 Prolessions Code) or ihat he/she is exempt iherefmm and the basis lor Ihe allege� exemplion. Any violation ot S¢ciion 7031.5 by any apphcant �ar a permi� suDlacts the applicani �o a civil penalry of no� more Ihan five huntlretl dollars ($500�. I, as owner oi Ihe propetly or my employees wit� wages as their sole compensa�ion, will do the woM, antl t�e ❑ slmcture is no� intentletl or oflerea for sale (Sec�ion 7044, Business an0 Pmtessional Cotle: T�e Contrac�ors' Sta�e License Law eoes not apv�Y �o an owner ot a pmpeny who builUs or improves ihereon, an0 wno tloes such wo�rc himself/herself or inroupn �is or �er awn employees, provided ihat such impmvements are noi inlenAed or ofleretl for sale. I�, however �he 6uiltling or impmvement is sold wilhm one year o� comple�ion, Ihe owner will have �he burtlen oi pwving he/she ditl nol 6ui10 or improve lor �he purpose o� sale�. I, as owner of ��e pmpeny. am exclusively con�mctinp wi�h license� contractors �o consimct the pmlec� (Section 7044, Business ❑ and Professions Cotle: The ConVacmrs' S�aie License Law Coes noi aDPty �o an owner of property who hmlds ot imD�oves thereon antl who coniracts lor such prolects wi�h a conVactor�s) license pursuantlo Ihe ConVaclors' State License Law). I am aware Ihal pmo� ot their Worker's Compensa�ion insurance shoultl be pmvitled m me. � I am exempt under Seaion: 8. 8 P. C, for Ihis reason: �aie: Owner. I do hereby cendy Ihai I am aware ol an0 unUerstantl Ihe reQuirements ot Cabfomia Healih and Salery Cotle Sections 2550.5, 25533, antl 25534 antl ��ai I or any lulure buildmq occupan� willlwill na� (circle one) neeA Io compty with said sta�e codes antl the requiremen�s for a permii lor cons�mtlion or modilication Irom Ihe Air Oualily Managemen� Dislnct. Fesidenlial cons�mction applica�ions are exempl tmm Ihese pmvisians. �ate: Applicanf. I hereby cer�Ay Iha� I have read Ihis applica�ian antl sta�e Ihal lhe above inlormation is correct. I aA�ee to comply wi�h all ciry and coun�y ordinances and 9a�elawsrelatinglo �uil0ing consimction and here�y authontereD�esenta�ives oflhis ciryto enterupon the ahove-mentioned propeny �orin5peclian prurp'osoi �ate: �O `"� SignaWre�.� ori�er s ucense or Sociai Securi�y n: i6Et�a6 Whne—BwlOing: Green—Cotle Enlorcemenq Canary—Ap0licant; Pink—Revenue; GolCenmtl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069558 PERMIT NO; B 069558 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRDCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; ALT JOB DESCRIPTION ; T/O RESTH & REROOF W/COMP 6 HOT MOP SQ FT: 2,508 CLAIM VALUE: 2,508.00 CALC—VALUE; 2,508.00 GROUP OCC: A-1 / COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE HOR SMOKE DET. REQUIRED ***r��r*�rr*�r«�r�r�-***�*****�*****��r�r*******�*********�r*�r�r*ic�*+�*+r*�r*+�****�rx�x�***�r** Z O N I N GS EATEB�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BOILDING --------- 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; 41916262 ZNE; REF NO: F+LANNING Nt5'I'ES> _ > iF if if iF �F if ik 1E iE if 1E k if !f 1tlk iF M ik iF if ik if iF 1f if f! 1f fk jf 1f 7f it if if 1f !E iF it iF �k iE if iF jF if if if k if �f if iF it if �f if if af ik if !f iF it if iE if 41f i! if ik ik ik M�k iF ik if D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N;:T S ZONING APPROVfiD BY DATE; BUILDING APPROVED HY ; _ DATE: APPLZCATION 1E if if fE af !F!f 1f 1f �f if if iE iE iE ik k a! k LEGALIZATION;N BLDG PMT PERMIT 54,00 PLAN ISSUE FEE HY: . • DATE: itatat�ritrir�ra � *�it�t t�rat��ret�rit**�r�r**ir�r*it*�r*it*******�tar*+tir+r�r �rr� *+t it* ikMjffkiEififlF iflffEfE1F1f1f1EiF1f4MkkifiEififlfifiFlkllkifiEltifiEif7flfiFikiflFiEififaFififitiE iEjEififiE F E E S U M M A R Y STRUCTURAL SEGMENT;Y PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING .50 SMIP/NON—RES HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 54.50 0,00 O.QO 54,50 54,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 54.SQ OVER/SHORT; ,00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK 54,00 ,50 k iF iE if if it %ik iE 1t it it i! fE 4 4 i4 ff 1f if it iE iF iElf 1f i! fE it ik if iE if it if 1E if 1f iE ik if iE i! ik iF iF iE if ih ff iE M iP iP it i! ik k it 1E iE iE iE if if if k�t it if iF ff if if iE jE if if if I N D I V I D U A L E E E B R E A K D O W N TYPE SFA QTY 2508 D E S C R I P T I O N REROOF BY VALUE AESIDENTIAL N020NE END OF FEES UNIT COST TOTAL COST 1.00 2,508.00 oi nei7os7a-�aa�rs�¢ -r�� T 54.;D DkTE: ±6/281�'ti Tif7E: 1?:`S ti CONSTRUCTION AND PLANNWG POOL & ,1 � ' APPROVAIS Permit # Date Inspector AppROVALS Permit # � Date Inspector i I 7. Temporary Electrical Service or Pole . 52. Pool & Equipment �ocation � � 2. Soil Pipe-Undrgrnd. � �. . � 53. Steel fleinforcement - 3. Eiectrical Conduit Utility-Undrgrnd. � 54. Forms 4. Electricai Condurt-,FJndrgrnd. ✓ 55. Electrical Bonding .. 5..Stie! Reinforcerrient 56. Rough Plumbing & Pressure Test � - 6., Eiectrical UFER Gmd. , 57. APPROVAL TO COVER�GUNITE � � - 7. Footings � 58. Etectrical Conduit�Undrgrnd. ! � B.:Foundation . " 59. Gas Pipe, (� Undrgrnd., Tesc i �3. Wa.er Pipe�UnCr9��'� � 60. Backwash Lines, P�Trap, C� Undrgrnd. ' � 10. Svuctural Floor System � 67. APPROVAL TO DECK I � 1 t. Pfpperty SBwer Li�e & House Connection 62. 8ackwash & Receptor�Fina! ' � iZ. Sewer Cap � 63. Heater & Vent-Finai i � 13. Roof Drains . 64. Plumbin� System - Final � 14. Rough Plumbing ' 65. Electrical�Finai 15. Rough Elec'.Gica4-Conduit 66. So�ar SVstem-Final 16. Rough Eleccric Wiring 67. Fencing & Access Approvat � � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING f 18. Rough Elecuical�T Bar Ceiling 69. POOVSPA SYSTEMS FIiVAL � i�. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEN7 I � I _. � 20.:Rough Factory FjreP!ace - - ^APPROVALS _.� �Permit # 21. Ducis, ia Structute; ' . . - � �� ° ' �' - �l y '� , .. -. - . =70. Undergeoun� Hydco 22. Oucts, VentBating-. • ��': �, - ': � 77. Producf Pjping CiGas I.JOiI � r 23.�Gas PiqeiRough,?i Tes. ' �„ :_ _ ' ` � ,7z, Undergrbund FIusM �_, �. -. � 24.;�Roof Fra�m(ng r . � � � •• . - � - �-73:'Underyrnfl.5toraye:Tank OGas ❑Oii + 25. flo0f Sheathing '; ,�l z%..qY/ 6wli '� ' 74.- Overhead Nydro ;�� . � �Z 'Y 26.`S'-3ar Ce(4in9 iScructurall &_:41�onocoat � �� '� �� • • 75V'Drv ChemicaV 'f ^ � � ��. � 27.�Frameand Flashing '' ' , �° . 76.�Dry Standpipe � � - � 28. Lathing & S�ding�;. - � •� : � �� R � 77:' FIXED SYSTEM'FINAL " -29. Insulation ' - � " " � . ' � � �; : 7$ti FIRE PREV. FI�lA�L � . . y .' f� � �30. Drywaii Na��ing r � _, i' + HEALTHrOEPT•. REQUIREMENT 3?. Plaster Brown Coat i,,, , � I y �. „79.�- FINAL INSPECTION "' - - f.32. Electrical Power MeterFinal� <-, _3,�� y�.80r�FOOD CERTIFtGATE ISSUED � 33:-�i^al Electric - ' � � � i., ` Noies: , � � � ' � � , . � 34.�FinalHeating;&Air.Cood�tion��g� , � � i �F � .. - • � . �35. Final Gas PiPe�Test' � ; .x „ ;-,, - _ .. . 36. Hood or�CanoPY�,�, . ' � .r. , . � ' I �; � ' �. . _. r 37. �Fir.ai Factory Fi�eplace: ! �'� ' � � �, ; ' __ � 38. Final Plumhing , ' .. . r - . I � � .. ! 39. Water Service�Finai �� ' • � � � , 40. Gaz Service-Einat � •�, ; �, ,,. . � �h . � � � �41. Soiar OomesticFinal ' ' •• :. i � � � ' , , ' 42, `Backflow Preventer � ,' � �, . . . - I 43. Backflow irrigatiom �' _ '• " '� " --� � • 44. �andscape irr.igation System. : rc, . .� �45. Sound Attenuation � �� • -' - ' ' _ - � � � r, � . � 46. Handicap Ragulations . - , " � � �� . ,• � �_ � � �� ._ I 47. -FINAL STflUCTURE & BUfLDING � `y , �W�� " ' - . , _ 48. FINAL P�ANNING ` .. i �'�- ' .�, �' �. 49. Electric Release to Edison � � � -•�-= : � ' , � 54. Gas Reteasa to Soufhesn Caiifocpia Gas Co � :_1_ :� - _ . ' • 5i. CERTIFICATE OF OCCUPANCY . , � � No. Daee Pfl61ECT ROONESS: z q 1 3 p7INUTEMAN WY owxex�sx�Me: MERLE MCILROY. nnoaess: 7413 MINUTE MAN WAY 1"*' COSTA MESA CA 926T.6 .p9CN/ENGINEEP: . eooxess: pE0.N0.: UNIT: ux�r: PENMITTEE:MERLE MCZLROY (71A)G41-6964 nooaess: 2413 MINUTG MAN WAY 0 COSTA MESA CA 92626 UCENSFU CONTMCTOP OEClAN�710N: I heahy atlirm tAat I am IicenseA untler pmvisions af C�aD�e� 9(commencinp with Section 7000) ot DiNsion 3 of t�e Business antl Prolessions CoOe, anG my Ilcense is in IM lorce anA etlect. CITY LIC.: � ST�TE UC.: LU58: '. Oate: Siqnature: WOPKENS' COMPENSATION �ECLAMiION: I �ere6y attirm Itut I have a certiliwte dl cansent to self-insu2 or a certliiwte of Workers' Compensation Insurance, ar a cenifietl copY �nereoi (Sectlon 3800, LaE. q. YOUCY NO.: E%P. ORTE: COMPRNY: . � ❑ CeNfieE croOY is here6y Iumishetl. ❑ CeNfieA wpy is file0 with Ne dry BuilCinq Division. te: ppDticant: � . IXEMFIION FlIOM WOHKEAS' COMPFNSATON OEIXANITIOX: (11us ucuon nttd (at be canpleteA tt Ihe pemut B ta are hundre0 (5700) w less�. I certiTy that in the pedormance oi t�e xrork tor wNch this permit is issueE, I shall not employ any person in any manner so az to 6ecome su�ject [o �he Wofners' CAmpensa�ion Laws ot Californu. ' . , Date: ' SiAnamre: - � � NOTICE: It, after makinA �his Oetlaratlan, you slioulA Eecome suEject lo t�e Warkers ComDenution O��sions ol tha Labor CaOe, you must farthvnN comply wi[� such provmons ur tlris permtt shall be Oeemetl revaketl. � CONSTBUCTION 1FM01NG AGENLY: I heaby aKrm ihat ihere is a consvuctbn lendinp apency lor tAe Oe�ormance of t�e work for i which t�is Dermit is is5ue0 (Sectlon 3097, Gv. C�. ' � , LENOER: PUORESS: � ' ' � � � OWNEB BUIIDEB OECIAMTION: I Aereby alfirm t�at I am exempt from tAe Contactars' State Lkense Law for the lollowinp reason (Secibn 7031.5 Busineu mtl Pmfessbnal Code: My tiry al munry wAic� requires a Dermit �o wnsimct, alter, impmve. Eemolish, or re0air any simcture, pnor to tts Lssumce, also reQuires t�e applicant for SucA permii to file a si0ne0 statement t�at he/sAe is licensetl pursuant to t�e D�ovisians of Na Comracrors' Sute Licenu Law (CMpter 9(wmmencinA �� Section 7000) oi Division 3 ot the Business anU Pmlessions CoEe) or Ihat �e/s�e is aKempt t�erelmm anG tAa Casis for tAe alleped exemptlon. My Nalalian oi Sectian 7031.5 Uy any apD�icant lor a Dermit subjmis IM appliwnt to a civil penalry ol not more t�an iNe hmkreE Eollars (5500). I, az owner of Ihe proDe�Y or rtty emyloyees vritA waqes as ��eir Sole campensation, will tlo t�e work, antl ihe ❑ slmciure is not inlentleG or oflereA /or ula (Secuon 700O3 Buvneu an0 Pmlessional CoEe: T�e Contractars' State Licanse Law Gces not aDDN �o an wmer ol a properry who EuilCs or ImDrwes thereon, an0 wlro tloes suc� woM himself/herself or thmupA . �Is or her own employees. prwiUetl flut 5uU improvements am not intenaetl or otlere0 lar ule. II, however t�e bulldinp or impwvement is salA w�ihin one year of wmplation, I�e ovmer will �am tAe 6urtlen of Drovinq he/she tli0 nol �uild or impmva for IAe purpose al sate�. , � I, as owner of the Dmperry, am exUusively contractinp wit� IicenseA contractors to wnsimct the D�oject {Sectlon 7004, Business J an0 Pmlessions Cotle: The Contactars' Siate License Law Goes not aDDN ro an owner oi properry who huAas or improves ihereon and who contracis for SucA projec6 wiN a mntractoqs) ticense pursuant Ia9Ae Contnctors' State License Law�. I am aware tAai D�� ol t�elr Worker'S Compensatlon insurance shoNO Ce DranOeE ro me. ' � I am exemD� untler Section:-� � 4 4 B. 8 a. C. mrinisreuon: �qORK BY FAMILY MEM ER Oate: _.E/ ^ � ^ g � O+me I do here6y certity ihat I am aware of an0 unUerstand ihe requiaments al Calit nia Heatt� anE Sa�ery COde Sections 25505, 25533, nA 25534 ana t�at I or any future buil0inq occupant wilVwill not (urde ane� neetl ta compy wit� sai0 state catla antl t�e repuirements or a. permit for wnstmction or moEifiutiw imm the tir �ualiry Manapemem OislncL ResiOential consimctlon apDlications are exempt /mm tAese provisions. . Date: � ' ppvlicant: 1 here6y certiy t�at I luve reatl t�is aDPlication antl state that the above intormation is correct. I aqree ta comD�Y with all city an0 county orainances anE state laws relatmq to buildinp construction anE IrereGy autlar@e aDreSentatNes af t�is cfty to enter upon t�e a0ova�mentione4 pmperry for inspection Durposes. Daro: �� " � � $ 9 S9natur�l[ � � � �� `-""�'^^"'� �� oriver's �icense or Socia� Secunry x: 1661<8 White—BuilCing; Green—Code Enforcemant: Cenary—Appikant; Pink—Revanue; GdEenroO—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: H 044834 �PLAN CHECK NO: N CONSTRUCTION 'PYPE; V-N PERMIT TYPE: STR tilil:i�1�.Y4� f:7i �i �Ll CLAIM VALUE: : ADD 4'0"XS'0" WINDOW TO EXT WALL 200.00 CALC-VALUE: 200.00 PF.RM NO: B 0448J4 GOVT: N SUPP: N PURPOSE: ALT SQ FT: 200 GROOP OCC: R-3 / COMMENTS: SINGLE ST STRUC, NO ROOF OA CEILING LOAD *��r�e�r�*�*�**+r+�*****��cr*x�*** *« �***�r�*�r+r**�r�*��+�**+r�**�rx ��rx�+�***+r**�*�r*��r�***+��*�� Z O N I N G R E(a U I R E M E N T S S E,T B A C K S � - ----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT TN FRNT: FT ZN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQUIRED: PARKING PROVIDED: � PARCEL; 41916262 ZONE: R3 PLANNING NUTES> APPROVAL TO INSTALL ONE ALUMINUM;SLIDER WINDOW . � . iElk iE iE 3E # 1! �f ik ik iE iE if iF iE iE iE 1E iE.iEiElf iE iF iE iE iE iE iE 1E If iE iE iE iE fE f! fklElE iE if if fF iE 1f iE iE �E iE iE fE if fE iF iElf 1F %�IE if ff Ik iE 3E if if iE fE iE iE �flf �k iE iF i! �F iE D E V E L O P', M E N T S E R V I'C E S R E(J U I R,E M E N• T'S ZONING APPROVED BY � ' G T �___:j�� • DATE: _// =G, ��g BUILDING APPKOVED BY�: DATE: __/l—G—� APPLICATION ISSUEll BY: DATF; /I/ �� 3f ih 1f if �f iE 4 if IE i@ K 1E ii M ib ik if if if iFlk �k ��F IE If IE if k ik iE iE 1E ifiFi�Fi.•'W'��if iF ik iF fF iF iF iF �lE iE ik ik if if if iE ik iF if iF:iF iF IF 3f iE iE iE k M iE iE iE iE iE iE k if iE ik if iP iE 1E 1E ff iE 3E if i! 1f 1E 1E iE iE 3f �F iflE fE 1f if 1E iE iF iF iE �F iE if if if i! iE iF �E iF iE M iE IE iE LEGALIZATION:N F E.E' S U'M M A R.Y STRUCTIJRAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES� GRADING PERMIT 15.00 ,5p SMIP/NON-RES PLAN ' ISSUE FEG BUILDING-DIV-> . PERMIT. ISSUE PLAN-CHECK TOTAL� PAID DUE TOTALS----> 15.50 0.00 0.00 15,50 15.50 .00 REVENOE DIVISION TOTALS--> COLLECTED: 15.50 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 15.00 ,50 !E if if iE if 3f if if k ik if it �f ik if k it iE ff if iE �f fE 1f k iF iE if 7f it iE ik M IFlf if if 1E IE iF if k 1E IE iF M ik if if iE if it ik iE iE if IE k�F k k ik iF iE iF if iF if iF iE �f iF jf if iF 1E 3! 1F ik � I N D I V I D U A L F E E B R E A K D O W N ' TYPE QTY SFR 200 D E S C R•I P T I O N ALTER BY VALUE RESIDENTIAL NOZONG END OF FEES � 0 UNIT COST TOTAL COST i,00 ioo,00 J� -;�i`i�.�3;'r i •-r � . i '��'•--�" -'vL. �:f�~.. :� CONSTRI�CTION AND PCANNING P�� $ � ' � � ' A�ROVALS Permit# Date .Inspector p�ppROVALS Permit# Date Inspector i. Temporary Elec[rical Service or Pole � 52. Pool & Equipment Location • , Q.� Soil Pipe-Undrgrnd:� � 53. Steel Reinforcement �� 3:'Electrical ConduiTUtility-Undrgrnd. 54. Forms � ,� 1 4.�Elect}ical Conduif�Undrgrnd. .' 55. Electrical Bonding �" � ` �- 5-Sfee4 ReinforcemenT� 56. Rough. Plumbing & Pressure Test- • �• -� ^,tii - ,'_;�6F'Electrical UFER;G nd. . 57. APPROVAL TO COVER�GUNIT.E �-,P7,:^Footings � 58. Electrical ConduibUndrgrnd. _ � < � 8-'Foundation , ' 59. Gas Pipe, O Undrgrnd., Test � � :ti 9.yWater Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. '- 10. Structural Floor System 61. APPROVAL TO DECK = 1 i. Property Sewer Line & House Connection 62.' Backwash & Receptor�Final � � . 12. Sewer Cap 63. Heater & Vent-Final � 13. Roof Draint �_ � 64. Plumbing System � Final � 14. Rough Plumbi` 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar SYstem-Final ' � 16. Rough Electrie-Wiring 67. Fencing & Access Approval ' . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &-Air Conditioning �FIRE.DEP_T. REQUIREMENT_ �• �-+ . i C _-+ %. r.: � .R .n � �V l ^� i� �y � 2Q-„Ro`ngh Facto,ry F,9�ieplace u' � _ r �, �APPROVACSi� �Per,mit # - ;� :. . , ,-. ''� .... �� y� ` =�.t. � �70. Undergiound;Hydro . 21 -Ducfs, in Structuie� , �,� * � , 22 -Duc`ts, Ventilating � �'_ ._ c; rj �� r�. y71. ProducCRiping O�Gas O'Dil 23.�Gas:Pipe-Rough & Test r'=� "'�' " � �" * "7z, Under round Flush „ � -' -' �- m •�'i lt 7 S s': � 9 c 24: Ro`of Faming - �' :-�r; t� '-� �' �-.k� ,� 73'7Undergrnd. S[orage:Tank O Gas � Oil ��. 25. Roof Sheathing ^ ?i �� .%,J � �� 13'� 7q�0'verhead Hydro��_ � 26�,T�Bar Ceiling (Structural) &'Monocoatr ,; - u - � �; � 75^Dry Chemical - � ^�-,' 27. Frame and Fleshmg _;_ ^ T�, '� ` 76. Dry Standpipe � � _� '�28. Lathing'& Siding ,•,, ` �'�`-'� �; ` �� . ��y � 77= FIXED SYSTEM� FINALY -• _. 29. Insulation _' � ' � ` ,,., _ w _ • ^� ; .* 7g=FIRE PREV. FINA� ". � � �30. Drywall Nailing -__ - - r' , _ � ' ! - � , HEALTH�bEPT� REQUIREMENT . � �31. Plaster Brown Coat � ;F ` ' � I•-�. �i", ,,;; K T79.�FINAL II�SP)ECTION " .,�� 32.�Electrical Power'Meter�Final - ' ii"•�y'� ''80=��FOOD CERTIFI'CATE ISSUED- - t.33='Final Electric ' � - '' � x � No`ter. '� `�� '� - - ` . i. � -, y. . � •. �-. �. ; C'. H - i34t1Final Heating:& Air Conditioning � F�.-. i: ,., � � . '`'� � c `" � ' �- ' �'� f V' :K ' �-1 .-�el� � :'7 35::Final Ges Pipe-Test � :r� � i<.. v�.is k_ ="-� �7!-� ^'- '}.' -:.r . � - ..n .-+ _�36aHood or CanoPY_ ` � r,; ••� y�, ! � j „� �� c ,�; �cc � t� ; i -37��Final Factory Fireplace : � �-E '-+ � � � "��*� _� �' -.� i �^ �38. FirialPlumbing - - " � �`�- Y .J� � � � �; ,,�-, . -� ri �39. Wa(er Service:Finzl,: Z, � -: =•.; �-j- ( Ck a '� v� � * _ „_ e �, y ;..,,... i .-� �40. GasService-Pinal " � �� " �^ � � �` � �'' "" :� l'�..{ �: �'. �'1 • 7 i - _`,41. Solar pomes`ticFinal-- � � ;�r.� � " � +: �:c. T ,. '� '� � 42 Backflow Preventer: , " y * ` 1 ,M1 � r ::7�� k ' ~ . � O._, t, ,- K _ V. • M � -��.� i� �. �.- - 43. Backflow Irrigation :�J -�7 � . '� *' ' % _ - • - • ci �,�44.�Landscape I�iipation System �`� 'J� ' •'� 7 C 7+ < :� n+ .=:G� * � :_ c�' ,� y; �;, ^1 C, r� ef, x. '.X ' �G '-+ ._l�: `45=�Sound Attenuatio� =,V•� • 7 � � �� - C c: • -y + � Y 4+n1 .•4.y -��46."Handicap Regulations � �. � ` �' �' G �� ' �.. ;: y,47'FINALSTRUCTURE&BUILDINGc % -LL , � `� �' � .: �: 48^FIN'AL PLANNING E"'r " •' �"" 11� ��I �F' "r j � �� i� { ,_49:',Elec'tric_Release to Edison � }. y ' � r; 4 *� `s • , � -; '50-GarRelease to $oufhem Califomia Gas Co " v^ !� '� ` � " _ _ ' �R' �` - -' � _ c r, s , .-� 51. CERTIFICATE OF OCCUPANCY " ' " " ' - ' ' No. Date m � r i� mc.T��y ��/ 1- =�� u 1'� YY�� v�ae J'nay Ww� _ � "_oy+� �'Y1�s✓�� .�- Qacoa�,. /� � �j �,u✓�^��^^' yr ,�,c6 (�-�"�"L N0� g 1969 /�. �� ( ( / �. ; o,�, 1-1.¢�"Y ��L i CITY OF C057A MESA PLANNlNG DEPT. 3UlJECT TO BLDG. DEPT. RE0. ��1-L�.��_ DATF (I-�-i 7 D!lCfO! O� ►UNNINO 33 �"' `�'�""" _ `� Permet .# `('-( g 3,� THIS NUMBER MUST ACC0�1PANY ALLINSPECTION REQUESTS G t AVClicant to /ill in all soaees except tnoze within heavy eoraer Ilnes antl sign all aoVroDriate tleclarations. CITV OF COST esa CONSTRU TION PER Project Addres Applicant's�Mailin Atldres �� Owner's Narr�e � _ hp ArchlEng. License No. (� Address .e � Convactor's Nam `--t� Phon� �SS� Addres's (mailin� S City License No. � -j LICENSED CONTfEACTOR DECLARATION I hereby atfl�m that I am lic¢nsetl untle� Orovislons ot Charter 9(tommencing .with section 7000) of Division 3 0( the Business antl Professions Cotle, antl � Q my license is in fy{�tq/r,p�ane effect. � .� p„ q/Q ucens �i I Dal - ' Signature WORKERS' COMPENSATION DECLARAT \ I hereby a(firm that I nave a certifitate oi co eni o seli-insure or a certiflcate 1 of Workers' Compensa[ion Insurance, or a cer i tl copy the�eot (Settion �. soo. �ab %.�10377—�� _'� � ' l�licy No. Compan �y,� Cer[ifietl copy is hereby fumishetl. 2�1 Cert� ietl py is f with the it uiltling pivision. Date �� 0 � APPlica EXEMPTION FROM WORKERS' COMPENS ON D RATION (Thissection neetl not be compleletl if Me per t is tor e huntlretl ($100) or less). I certity lhat in the performance ot the work fo� whicb this perm�t i5 issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Lawz o/ Calitornia. Date Signatute 'NOTIGE: If, afte� makin9 Mis tlecla�allon, you Shoultl become subject to thB Wo�kers' Compensation Provisions of the Labor Cotle, you must forthwith compty with such D/ovi5ion5 or tttis permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby attlrm tnat there iz a constructlon lentling agency for tne pertormance ot me work for whicn this permlt is issuetl (SecNon 309� Civ. CJ tentler's Name Lentler4 Atltlress OWNER Bl11LOEH DECLARATION I nereby atfirm that 1 am exempt from tne Coniractor's License Law br the following rea5on (Section ]031.5 Business antl Prolessional Coac Any city or wunty whith require5 a permit l0 constru[t, alt2/, Improv¢, Oemolish or repalr any structure, orior to Its issuance, also requires the applicant for sucn permlt to ti�e a si9netl 5W[ement tha[ he/she is Iicensetl pursuan[ ro Ihe provisions ot the Contractor'S License Law (Chapter 9(commencing with Section �000) of Division 3 of the Busine55 antl Pro/e55�on5 Cotle) o� that he/She is exemp[ theretrom antl the basis /or the allegetl exemption. Any violation of Section �031.5 by any applicant for a permit subjecls the aoo��cant [o a civil e0dlty of not mor¢ than tive hwtlretl t1011ars (5500). � I, as owner ol the property or my employees with wa9es as their sole � cOf[lpensation, will tlo th¢ work, antl the StNctule i5 nOt In[entletl ot ofteretl for sale (Secfion 7044, Businesz antl Professional Cotle: The Contractor's License Law doe5 nOt apply to an Owne� of a property wit0 builtls or imp�oves thereon, antl wha tloes sucM1 work nimselt/nerselt or tnrou9n hls or ner own employees, prOvitletl that suCh ImOrovements are not Intentlatl or offered tOr 5ale. If, however, the builtling or Imp�ovement is soltl within one year ot com- pletion, the owner wlll have Ihe burtlen of orovin9 he/sne tlIC not buiitl or im- p�Ove fo� the Ourpose of sale). ❑ 1, as owne� of the O�oper[y, am extlu5ively contracting with Iicensetl Con- tractors to construct the pro�ect (Sectlon ]064, BuSiness antl Protessions Cotle: The Contractor's License l.aw tloes not appty to an owner ot property who builtls or imOroves th¢reon, antl who contract5 for such prOlects with a con- tractor(51 license pursuant�to the Con[ractor's License Law). I am aware tbat proof o( their Worker'S Compensation insurance Shoultl be provitletl to m¢. ❑ I am exempl untler Section B. & P. C. for this reason Date I hereby cettify t information IS COI! � dlld SId�C Id ICIt sentatives this inspeGtl n Pose rivers' License or CMF 0865-46, rev. — Owner I have reatl this application antl state I agree t0 comply wilh all city antl co to builtling nstruction, antl hereby � to enter on the above-m ntione [ ite - Builtling; Canary - Applicant; above 1 a a 7s� �___ � �_..._. )FCONSTRUCTION NEW .qDD .qLTERATION REPAIR CONVERSION ❑ DEMOLISH ❑ O R iCRIPTIONOFWORI$/USEOFBLDG•-��" "'- - 't'-L�� • �E OF PERMI� L/I�GRADING LJ FOUNDATIp� qN Ll STRUCTURAL ❑ TENANT LILECTRICAL ❑ PLVMBING 1�1 MECHANICAL ❑ OTHER ' \ �.IECT DESCRIPTION SGi. C O N ST RUCTI ON TYPE— Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs �rinking Fountains Floor Drains Floor Sinks uas Service OuNets Interceptors Kitchen Sink Lavatories P-Trap Foof Orains Reinspection Fea 'T. OCCUPANCV VA�UATION 5_ GRADINGCU.VDS. ACRE$_ $15 Boiler Duct - Under Ground Duct - SVuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL Blt. ICBO # Heating System & Ducting �4100,000 BTU O 7 00,000 BT Showers Servite Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Pipin9 Solar Tank ' Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays laue Fee Hoodor Typel ❑ Canopy Type I I ❑ Fefrigeration System ❑0.7000008TU ❑100,OOOBTU Sysrem Repair/A Iteratio n Fire Danpers -�� `i�� i Fee $15 I Issue Fae Accoun[inq; Goltlenrotl - Assessor $ 3 $ 3 A.P. �WW S Main Building: E T Front ARear C Right K Left S Ping. Ref. # Planning Notes: Auromatic Washer ConsVuction PoleSu6. Cooking Unit � Dishwasher Dryers ❑Gas ❑Electr Fan F.A.U. Fixtures Device Boxes O utlets Switches Garbage Disposal Generator �0-5 KW �! Fee 9385 2/14/Bo Zone Accessory Building: ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW , Meter ❑up to 700 amps Meter ❑over100amps Sub Panel Motors �0�1 HP � 1'h - 8 Inc.Solar �9-15 HP �76-15+ Microwave Pole Lighc Range ; Standing Sections 5 KW Trash Compactor $15 luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approvad By Building Approvad By � :�r, FEES $ 3 Z O N I N G R E Q M T S SUMMARV OF FEES � � BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE $ � PLAN CHECK 25% $ � ENERGY P.C. $ ELECTFICAL $ GRADING $ PLANCHECK 50% MICROR�M $ MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ ..1-�1' �� O v— � CONSTRUCTION AND PLANNING POOL f 1 APPROVALS Permit# Oaie" Inspector qppROVALS Permit�k Date Inspector '1. •Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe•Undrgrnd. � - . 53. Steel Reinforcement 3.+.Electrical Condu't Ufil�ty-Undrgrnd� ' 54. Forms � 4:� Electrical Conduit-Undrgrnd. ` • � 55. Electrical Bonding � , � 5. Steel Reinforcement. ' � 56. Rough Plumbing & Pressure Test ' 6•� ElectriCal UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings� - 58. Electrical Conduit-Undrgrnd. S; •�Foundation � �, � 59. Gas Pipe, O Undrgrnd., Test 9., Water Pipe-Undrgmd. �' . 60. Backwash Lines, P-Trap, � Undrgrnd. 10...Structural Floor System � 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final 12. Sewer�Cap .� , �� , 63. Heater & Vent-Final 13:��RooYjbrains . � ' � - ' 64. Plumbing System - Final 14."� Rough�Plumbing ' . S � 65. Electrical-Final 15. Ro'u9h Electrical-Conduit � 66. Solar System-Final , 16. Rough Electric Wiring 67. Fencing & Access Approval 77;_ Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough El�ectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 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 O Gas ❑ 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 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL � 30. Drywafl Nailing HEALTH DEPT. REQUIREMENT �31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: -34. Final Heating & Air Conditioning �i�f..�(� �� 35. Final Gas Pipe-Test 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomesiic-Final � {:' 42. Backflow Preventer � � ' � 43. Backflow Irrigation • - 44. Landscape Irrigation System`� � 45. Sound Attenuation . 46. Handicap�Regulations � � , _ 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed � ]l 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co '�'}, 51. CEFTIFICATE OF OCCUPANCY • No. Date '„ V YY1VL' 11 �t{j� 1 JOB ADDRESS , Gr;NERAL 1N�PECTIONS� or SUBCONTRACTOR 27478 COSTA MESA BUILDINCrSAFETY DEPARTMEM P.O. BOX 1200 COSTA MESP.� CALIFORNIA 9262E For AppI1rnM to Ffll In ComplNaly TYPE OR PRINT i�o�Na � . oRw �-�� 3'W��-M a«__ 9 4ii COSTA MESA. CALIFORNIA —f BTATH LIQ Nd 6IZE OF LOT U9E OP �� xea[er I�ND OTAI PLY WITX euac�Ha O� iXAT.i AGOV�.�6 � �, . � eu�� ADDR FIR[ NO. . .��S�I ZON6 T6 APPRI N . I� �.j BT' iON 180AL OOC111 A. P. ! NOTE: 80• TI EAVEE NO.OIlLOO ALL01 OF WORK »iu wr�uunox 10 110p6[ M COY. L11W N[OYLATINO r�aio StP -ES-67cnsr,00 178::' :'::`:`t'fi 1.�0 ArPLICATION FOR PERMR 6UILDING Por Offin Us� Only ZONING NO.OF ^� U�[OINtY/� bIl �LAN1 [' � lYILDINO U/ �{� �,7� (,!P�rrep�'�''/G� � �30 �- 03 — a'7y 'E OVERHANO BNALL EH L6B8 TXAN YARDH APPROV ED MAIN BUILDIN6 tOM GL fTR6[Tl INT O RT_ U VAR.$ n'¢ �rourrr •YRPOlI O! s/ `.' o�� YARDS APPROVHD ACC6880RY BUILDIN6 �AT6 MPROVED OAT[ ✓ �/ a w � C�?Q� � vwtuwnox �e vox rn¢ � A PlRMIT R[6 ONLY. 7 IT FHB � E GHECK 4�� W 3v _PEfi r