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Home My WebLink About2884 MONTEREY AVE - Building Permits(714)754-5273 • Fax(714)754-4856 CITY OF COSTA MESA evno�N� o�v�s�oN DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT Job Address: 2884 MONTEREY AV Suite No Vieinity: Parcel Nunmber: 14156308 Applicant: NOCK, RON Address: �i/" , _ �/ ' Owner: �SMITH; WILLIAM GARNER JR �� Address�!SMITH,CAROLJEAN , - � '"�COSTA MESA,CA --. - " i,:i - n-�% �2884'MONTEREYAVE /i�, / � , � �:/ `� �./i: � „�;r Phone: Zip: Phone: Zip: 92626 �,� ,/ Contrectoc�, NOCK PLUMBING ,.. - -��Addr es:-�11612KNOTTST i;� , �� / � � ,,.;�� ' . , " Phone: 714895-1246 - GARDEN GROVE , CA � � _. -. Zip: 92&41 � ' , � � ' / � � . � Liaense: 707775 ' �� „ � + A�chlEng: � � . ' Address: , / i � � i � • , . . . INST DISHWASHER.- _ � .'AMr Qrv �. - ISSUE FEE � � �$22.00 ' BackBow iingation �: � $0.00, 0 � BackFlow Preventer $0.00- ,� 0 Bathtub - � $0.00�� 0 Clanfier System ,� $0.00 �� 0 „ Connect pce,Soda;etc) $0.00, - 0; ; Dental Units � �$0.00 �, 0'�. �� Dishwasher � $875 , 1. � � Drain, Floor � � $0.00�- - 0-, Drain, Rainwaler � $0.00 ` � 0 ' Drain, Roof $0.00� 0 �" Drinking Fountain $0.00 0 �. Expansion Tank $0.00 � - 0� , Gas Earthquake Valve 50.00 0 Gas (1-4 outlets) $0.00 0 Gas (Over 4 outlets) $0.00 0 Gas Repipe $0.00 0 Gas Service $0.00 0 Interceptors (Grease, Oip $0.00 0 Interceptors (Sand Auto ) $0.00 0 Phone:� . . ZiP�.. . . ,. license: SCOPE OF PERMIT , _ - �i .' . . ��.,.,�., -..nnnr Qrr Laundry Tub / Washer , 80.00 0 Landscape Irngation � , � $0.00 0 P-Trap �, ,��$0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 ft)' ,$0.00 0, ; Receptors -. � $0.00 0 SeplicTank; � �� $0.00 0. ,�� Sewer Cap for Demo . 30.00 0 -SewerConned_ , �, , $0.00 0 Sewer Private Line � $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 � �Sink, wmmercial � $0.00 0 Sink, Floor - $0.00 0 Sink, kitchen , , , $0.00 0 Sink, service/mop $0.00 0 Spa (private) $0.00 0 Spa (public) $0.00 0 COMMENTS I SPECIAL CONDITIONS �-/ PERMIT NUMBER P98-00606 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08I03/1998 Issued: 08I0411998 SumpPump� � � Swimming Pool . Trap Primer Urinal ' Vawum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin � Wash Basin Set ' Waste and Venl Syslem Water Closet (Toileq Water Heater / vent Water Piping (Inst or Rep.) Waler Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION . AMT $0.00 �$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $30.75 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepaetlona end flnal epproval mus� be obtained. Failure to obtain inspec�ions and final approval will result In the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 WORKERS' COMPENSATION DECLARATION: I herehy e8irtn undar penelty oi perjury one oi Ihe follovnng declaretions: ❑ I heve end will maintein a cenificete oi consent to selt-Insure tor workers' compensalion, as provided for by sectlon 3700 of lhe Lebor Catle, tor the peAormance at t�e work tor which �his pertnit Is issuetl. ,y..,� ✓�eve enE will maintein workers' compensetion Insurence, as required by sectlon 3700 of Ihe Lebor Code, tar the performence of Ihe work fa which �his pertnit is issued. � My workers' /c�om`per11seti9n Insur nce carrler entl policy number are: � / �} V(� Certier: �L�1 `if � ��%'�l � � Policy Number. "'i � / � li `� �� (lhis sectlon neev�t be com0�e(e0!/ tbe pe it /s velued et one bundred dollars ($100) or less.) ❑ I certlly that in the peAormance of Ihe work for whic� this pertnit is issued, I shall not employ eny person in eny manner so as to become subject to the workers' compensetian laws of Celitomia, entl egree Ihat N I should become sub�ed ro the workers' compensetion provislons oi Sectlon 3700 af the Lebor Code, I shell fotlhwith comply with these pr '' ns. Q� (� � �'(/ ApplicamSigneture: �� — Dare: (J � L V WARNINO: FAILURE TO SECUFE WORNER$' COMPENSFTION COVERAGE IS UNLAWFU� AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND pVl� FINES UP TO ONE MUNDRED TqUSAND Dp1ARE (5100,000), IN ADDRIIXJ TO THE COST OF WMPENSATIOfJ, DAMAGES AS PROVIDED FOR IN SECfION 3]O60F THE LABOq WDE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirtn that I em Ilcensetl underp�ovjsic force and eflect. Lic. p ��1 Cantractors Signeture:—� 9(commencing with Section 7000) ot Division 3 ot the Business end Professians Cade, end my license is in tull Class» —�l Date: '� '" CONSTRUCTION LENDING AGENCY: ❑ � hereby eifirm thel there is a wnstruction lentling egency for the pertortnance ot the work for wNch Nis pertnll Is iuued. (Sec. 3097, Civil Code). Lenders Name: Lenders Atldress: Signature: Date: OWNER-BUILDER DECLARA710N5: I �ereby eHirtn Ihal under penelty Of per�ury ihei l em E%EMPT FROM TME CONTRACTOHS LICENSE LAW for Ihe following reeson (Sec. 7037.5, Busineu end Professions Cotle: Any ciry or counry w�ich requires e pertnit to construct, alter, improva, demalish, or repair eny structure, pdor lo its Issuance, elso requires Ihe applicant ior such pertnit to tile e slgned statement that he or she Is Iicensed pursuent to ihe pmvisions of the Conirectors License Lew (Chapter 9(wmmencing with Sectlon 7000) oi Olvision 3 of the Busineu end Pmteulons Code) or thel �e or she is ezempt iherefrom end the basis for the allegetl exemption. Any violetion ol Sectlon 7031.5 by any applicent for a permit subjects the epplicant ro e civil penalry of not more Uan five huntlred tlWlars ($500).): ❑ I, as owner of �ha proparry, or my employees with weges as iheir sole compensatlon, WILL DO TME WORK, end the structure is not intended or otteretl tor sale (Sec. 7044, Busineu entl Prolessions Cotle: TOe Contrectors License Law does not epply to an owner ot property who builds or improves thareon, entl who does such work himself or herselt ar through his ar her own employees, proNtled ihat such Improvements ere not intendad or oHeretl for sale. It, however, the builtling or Improvement Is sold within one year of completion, t�e ownar-6uiltler wlll have the Durden oi proving ihat he or she did not bulld or Improve lor purpose of sele.). ❑ I, es owner of the property, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro consWct the pro�acl (Sec. 7044, Business end Professions Code: The cnntrectors License Law tloes not appty to an owner of properry who builtls or Improvas thareon, and who contrects for such prolect with e contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code tor this reason: SignaNie: Date: Owner ID verNied by tlrivers license. ❑ Ves ❑ No Drivers License No. Expires: Vedticatlon of Ownership by (rypa at dwument, i.e. - proDerry ta< bill or deed): DIVISION OF INDUSTRIAL SAFETY PEFMIT CERTIFICATION: ❑ I hereby ceNiy thet no excavatlon five (5) or more feet in depih Into which a person is requlred to tlescend, wlll be mede In connection with work authorized 6y this permlt, entl thet no builtling structure, sceHolding, falsework, or demolition or dismantling thereof, will be more then thirry-sin (36) feet hiph. (Chep. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomle ACminlstretive Catle). ❑ As owner-builder, I wlll not employ enyone to do work which would require a pertnit from Ihe Divislon of Industdel Sefery, es noted above, unless such person has e pertnit to do such wark tmm ihe divlslon. , Signature: Date: Division at Industdel Safery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AllTMORVATON OF EMRY: I certity under penalry of perjury that I have read this application end stete that ihe information given is wrrecL I egree to compy with all stete laws and ciry ordinances relatinq to building construdion, end euthodze representetives at the Ciry of Costa Mesa to enter upon the above-tlescnbed property for Inspectlon purposes. I agree not to occupy or allow occupancy ot any building euthorized by Ihis permit until final InsOection. s'p�eture a �e� qal Owyc s) �_� oe�� A Or Authonzed Applicant , Date COOE t. INSVECTIONTYPE 1616 F:ed System Flnel Fire Preventlon 1266 Pool Spe Finel 200 Finel Re-Rool 201 Finel BIocWReteining Well 202 Finel Fectory Flre Plece 203 Finel Sign 204 Finel Demolitlon 2666I8 QSg �{$ j�p�� INSPECTONTYPE _ 206 Finel Mechenical 20B 210 212 220 Final Plumbing Final Electricel Final Fire Preven�on Finel Plenning Approvel 222 Finel Si�e 250 Finel Building/Occupancy PAB � � AVP��ant to fill in all spaces wilM1in heavy Eortler lines antl sign all aOV�opriale tleelarationi. CITY OF�COSTA MESA - �P RMIT NOl � j TRACT NO. LOT NO. BLDG. NO.' ' Cft7NSTRUCTION PERMIT � y';�`1�} Address Address O Contractor �� Lrnone�' p� TY,PE OF PERMIT ' ' � Addfe55 ' - ❑'GRADING' ❑ FOVNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION � Q TENANT ❑ ELECTRICAL ❑PLVMBING ❑MECHANI( I hereby affirm th;.t I am licensetl untler pwvi;ions of Chdrter 9(com-' �c, mencing with section 1000) of Dlvlslon 3 of [he Business antl -LI OTHER- R@SOOP -�4 8Q8 - Profe55ion5 Cotle, a tl my Iic¢ns¢ is in full force f,( t. ' � U PROJECT D,�SCRIPTION \ 'Licen CI � C3� � _ License No. 9� �- 4W � � - � �j Dat¢_ ��,� Si9nature � SQ. FT. � : . . . � WORKERS COMPENSATION �ECLARATION .- , , . OCCUPANCY_C(�OpNSTR/�VCTION TYPE � I ber¢by atti�m that 1 hdve a certificate Of consent to Self-insure.o� a VALUATION '� 7y�+V5��PpNE � certiti�ate of Worker5' Compensation Inzura�ce, or a Cerlifietl copy , . -. [hereof (Section 380p��,ab. CJ. GRADING CU. YOS. ACRES 'cor�ynoRC.S7;�i7t5t5b Company��. �9. �ri0. ❑ Certifietl copy is�herEby fumiShetl. ' ftEMARKS: ' - . - - ' � Certified cOpy is tiletl with the cliy Builtling DivisiOn. EXEMPTION FROM WORKERS'COMGENSq710N DECLARATION " ' ' ' (This section neetl not be completetl if the permit is for one hundretl _ � � . ' .. ($100) or less). , . �"� � I certifylhat in [he perto�mance of IhE wo�k (p� which [hiz pe�mit Is . issuetl, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK - subject to the Workers' Compensation Isws of �ylitomia. Date Signature . BliTHTUBS �.SHOWERS � NOTICE: If after making.this tleUaration, you shoultl betome subject TOILETS . � URINALS " � to Ihe Wo�ker5' Campensation p�ovisions ot ihe Labor Cotle, you must - . torthwith comply with such provi5ions or this pe�mit sM1all be tleemetl LAVATORIES DOVBLE LAVS � �evoketl. . _. _ . .. CONSTRVCTIONLENDINGA6ENCV �KIT.SINKS - DISHWASHERS 1 hereby affi�m thai Ihere is a const�ucHon leqtling agency for the per- SERVICE SINKS SUMPS � ' �� ' tormance of th¢ work for which th{5 permit is Issuetl (Section 3097 Civ.C.)'. - ' " ' FLOOR�SINKS FLOOR�DRAINS" - Lentler's Name Lender's�Atltlress � � � � ORINKING FOUNTAINS ' ' ' ' � ' � OWNER BVILDER DECLARATION' '- INTEi3CEPTORS '- CLARIFIERS I hereby ai(i�m tM1at I am exempt trom the Contracto�'S License Law for the following reason (Section �031.5 BusineSS antl Professions Cotle: SWIMMING POOL � PTRAP ' ' Any� city or county whith reQuires a permit to construct, alter, improve, tlemolish'or repair any sVucture, prior to its issuance, also re- yypTER SERVICE � ALTERATION � �� quires the ap� licant for Such-permi[ to file a sign¢tl s[atement tha[ he' is litensetl pursuant to the-provisions of-the CbnVac[or's License Law GASSERVICE � OUTLETS ' (Chap[er 9(commencin9 with $ection 7000) of Division 3 of Ihe - Busmess antl Prolessions Cotle) or that he Is ezempYtherefrom antl the yyqTER HEATERS BTU OVTPUT basis for the allegetl exemption. Any violation of Section ]031.5 by any appliwnt /or a permit-sublects [he appqcan[ to a tivil penaliy SEWERCONNECTIONS ' � �� of not more than five M1untlretl tloilars ($S00), ❑ I, as owner of [he property,-or my empioyees with wages as their SOLAR.TANK . COLLECTORS � sole comoensation,'will do tne work, antl Ihe Structure is not intentled _ o� offeretl for sale. (Sec[ion ]044, Business antl Professions Cotle: The SOLAR PIPING SVS. Contractor's License Law tloes no[ apply to dn owner of a property _, „_ wh0 builtls or improves thereon, antl who tloes such wo�k himself or ISSUE FEE - through his own employees, provitletl thal such improvements are not intendetl or offeretl tor sale. If, M1oweveq lhe bulltling or Imp�ovement MECHANICAL PLAN CHECK is soltl within one year of complelion, the owner will have the burtlen ot proving_.he. tlitl not builtl or improve foY the purpose of sale). HEATING SVSTEM 0-300,000 BTU ❑ I, ax owner- of tha property, am exclusively contrac[ing with qND DUCTING � ' - � licensetl contractors to construct the project (Section ]044, Business 300,000'> BTU antl Professions Cotle: The Contractor's Litense Law tloes not apply to _ an owner of property who builtls o� imp�ove9 the�eon, antl who con- REFRIGERATION 0-300,000 BTU ' tracts irom �such pwjects witb a contractor(s) licesnetl pursuant to SYSTEM - . [he Contractor's License Law). 100,000 + BTU 0 I am exempt untler Sec[ion g. & P. C. for this BOILERS BTU�� reason ' Date Owner SYSTEMREPAIR,ALTERATION I hereby certifythat I have reatl this application antl state that the above EXHAUST SVSTEM MULTIPLE information is correcL I a9ree to mmgly with all ciry antl county .. _ ortlinances antl state laws �elati➢9 to coD'nqLctiqn. �ntl herebv authorize - � � TYPE OF CONSTRUCTION Phone 5 5 ❑ NEW ❑ ADD ❑ ALTERATION�� REPAIR ❑CONVERSION ❑DEMOLISH License No. � ❑ oTHER DESCRIPTIONOFWORK � �epr¢SEntauve5 � nis a o e e upon e above meniionetl- � property for ' t" rpo5e 0�5 82 Signature Date � " Drivers License or 55 � ISSUE FEE � CMF 0865-46 White-Builtling; Unary-Applitant; Pink-Acmunting; Golaenrotl-Assessor � H.P. qf ZONE 029:a I I /Qd/: '. PLNG. REF. � � � 34ac1 'Ti REAR YAR� (TO P/�) � PKG.SPACEREQ. PROVIDED STREET WIDTH ,PARV( FEE 5 ZONINGAPPROVEDBV ' �.�ATE_,- .. -; SPECIALCONDITIONS: „ ELECTRICAL PLAN CHECK � I GENERATOR' �0-1 KW_1-10 KW ' 'TRANSFORMER - APPLIANCE 10-50 KW_50 +�KW -"' � � � �MOTORS ' ' 0-1 HP_1-301-1P (INC. SOLAR) - 10-50 HP 50 + HP ' " FIXTVRES ` - �OUTLET$ '�SWI7CHE5 � � GASTUBE'SIGNS "' '' ' "��'- "" ' � POLE LIGHTS - ' ' ' ' - POLES METERED SUB � �PANELS� �� MAIN � "'SUB ' SERVICE ' ' AMP� ' � I 55 U E F E E' - " � . � �� - APPLICATION APPROVED BV" '. ' ' DATE - SUMMARV OF F.EES BUILDING �� PERMIT $� ' SMIP: � ' $ -,�O . �PLANCHECK $ PERMIT � � ' ISSUANCE $ - ' PLUMBING $ ' ' � " Gf3ADING $_. PLAN CHECK $ � " . . � „ ELECTRICAL $' $' . PLAfJ CHECK 'E .MICROFILM-E MECHANICHL $ � " ' .TOTAL.FEE S� PLANCHECK g - � LESSAO-."_ . ._ , VANCEPC $_ _ � - FINAL FEE R._��•� a CONSTflUCTION AND PLANNING � � . POOL & SPA � - ; - ~, ��"' , s Date ' Inspeetor - � � � . - - -� '^ � • Date - Inspector_ APPROVALS Permit #� APPROVALS . • Permit # :;,,.tt_' . � 1. Temporary Electrical Service or pole � ' 43. Pool & Equipment Location � - � - - � " � - � i ipe- n rgm � � 44. Steel ReinforcemenE � - - - Electrical Conduit Utility-Undrgrn - 45. Forms � � � �- 4. Electrical Conduit-Undrgrn ' f �r �- "- "'�46.�� Electrical Bonding . . tee ein orce � 47. Rough Plum6in & Pressure Test • " •'' -. . `� . �- � 6. Electrical UFER Grn 48. APPROVALTO COVERGUNITE �'��' =' •• i 7. Footings ,,49. .,,Electrical Conduit-Undr m - � � 6. Foundation _ 50. Gas Pipe, ❑ Undr rn, Test � '' � 9. Water Pipe-Undrgrn • 51.� Backwash Lines P-Tra ❑ ndr rn ' -- � 10. Structurel Floor System 52. APPROVALTO DECK " '- 11. Property Sewe� Line & Houie Connection �� .53F�Backwash & Rece tor-Final • � 12. Street Sewer Connection � � � 54. Heater & Vent-Final 13. Rough Plumbing - � ' ' � ' ' � -"' ' 14. Rough Electric-Conduit - � - - � �56. Electrical-Final � 15. Rough�ElectrioWirin ' '-- - �- - 57. SolarSystem-Final ' - � 16. - Rough Heating & Air Conditioning - - - - • encing & Access Approval �� •� � 17. Ducts in Structure '' • APPROVED�FOR PLASTERING' ' 18. Duc[s, Ventilating - � -� - � . _ ._ � 19. Gas Pipe-Rough &Test - 60. .POOL/SPA SYSTEMS FINAL ' � 20._ Roof Framing � � � � �' 21. Roof Sheathin ' ? � - . . ' � ' � � ' ' 22. Frame.and Flashin " NOTES: ' 23. Insulation � ' 24. Lathin & Siding - ' � - - � - � � 25. Drywall Nailing. � - 26. Plaster Brown Coat � ' � � � - 27. Electrical Power Meter-Finat � � � � 28. Final Electric ' - � � � � . 29. .Final Heating & Air Conditioning . ' ' � � ' � 30. Final Gas Pipe-Test - � � 31. Final Plumbing ' ' 32. Water $ervice-Final � - ' . 33. Gas Service-Final � � ' � 34. Solar pomesticFinal � ' ' � - � " � - . 35.� .Landsca S rinklin S stem'-'� - ' " ' - • 36. Sound Attenuation � � � ' � � - ; 37. Handicap Regulations " � � � � • � 38. FINALSTRUCTURE&BUILDING � ' 39. Special,Requirements Completed � � � � -� �� -"' � � � ' 40. Electric Release. to Edison � �� - 41. Gas Release to Southern California Gas Co. - � 42. CERTIFICATEOFOCCUPANCY i •No Date - - '' - �� ,�,�� t 9�, Tract lt204, �E�€� R E C E I V E D COSTA MESA BUILDINGSAFETY DEPARTMENT ,d'J SEP 1 1 l�ul P.'O. 60% 817 ��A M�,,. �,.t.�Ro�� ffNP.NCE �EPT. For Applieanf fo Fill In Completely APPLICATION��OR�EI�iSiTA MESA TYPE OR PRINT BUILDING BUILDING z$81t �onterey Avenue ADDRH58 GOSTA MESA CALIFORNIA For Offite Use Only __ R8Ge1PT NO. PEPHIL NO. 3800.E. Coast ARCHITBCT �yCCO COi OR ENGINEER p ADDRES�B� F' • CO'dS'�'. . CONTRAGTOR �CCO COT ADDRE55 3�� F+• C08St an Coxrona del ar 6TATE no[1n0 n,. . BUIIDING y ', I ��.I�_`G/I StYe COSTA MESA. CALIFORNIA � ay ZONING ZON5� NO. OF UBE OP N ♦ '_ I PLANB BUILDING LEGAL v � 3 3—�.{22� oescRia�iox � � NO. OP BLD08. B6'l�ACK LINe FRON 1 �1 CENi6R oP eTR[¢T S� REAR YARD 2 61DEYARDILEFT/F�/'I�J 1O�1�ERIGH7 1�-�lln' D6SCRIPTION -OF WORK � � BUILDING,.1. �X�I 612E uu EXTBRIOR WA4� COVERING 9'fU US8 OF BUILDING AD oF b MS 1 1 H81i8CY ACKNOWLHDOi THAT 1 XAVE RGD THIB MPLIGTION AND 9TAT8 TNAT TXH ABOVE I6 COIIAER ANO I13R8H TO COM- PLY WITN ALL CITY OI�INANCEB AND 8TAT8 IAWp RBGULATINO BUILDINa cONtl�UCTION. SIGNANRB OF Mel3�.De1. Tdax Develonment Co AUTHORIZED AGEN_1'L� b ICHMEq YN8 BTJ L. SIDE �O R�R ! 3 APPROVED BY � �n . Living area 12711 S F Garage areg t,45 s F Covered porch, etc. 159 S F TH¢ AMOUM BHOWN UNO6p VALUATION 18 FOP THH PUM08! OP lBTABLIBHING • PEqMIT FEE ONLV. VALUATION '/ PERMIT FEE $ '] ` $ �1.�1.01•� PLAN CHECK $ / �� 14 4 TOTAL FEE g SI'�O� � � ' COSTA MESA BUILOING—SAFETY UEPAHTMENT ""'"r`• P.O. BOX 1200 ' Ca:ta Mesa, Cali}ornia CONTRACTOR �aG��, - � Address � � Cty �j, n IQ,TeI. N Sfate Licensa No. 2 g q Class. City License No. \U\16ER TYPEOFFI\TUNEORITE:\I N'ater Closet (Toileq 8ath Tub m Pool Fiiter Sys[em ; System . . OuJets x�n $prinAler.c tallacianor Vteration H�atcr Pioine rk Flow Prevcnmr ng FEE D(� TRACT LOT N rm ,' � PAiU J*M1�A:( d, 73•75�H5;00 525 0 5.00 ftECD. BY I •� DATE I66U./6o BUiLDwG USE �r/� �� COSTA MESA. CALIFORNIA NEAREST CFO55 ST. /( n OY/NERS// //� I � ' MAIL' ^ � A NVI�O� i _ ' UTY �• 1: � TEL. NQ.�%tJ �Y�i/ I hereby acknowledge that I 6ave read this application and s[ate that the ebove is correct and agree to rnmply with all City Ordinauces and State Laws regulating plumbing., ' • I certify Nat I possess the above valid state of Cali- fornia classification or I am the legal owner of the resi- .dential property de///s:::cribed above. Signature oJ � � � �� Permittee � �'� INSPECTION RECORD APPROVALS ronr eu.a� BLDG. PERMIT 3