HomeMy WebLinkAbout167 MORRISTOWN LN - Building Permits A% DDRESBUILX :
167 MORRISTOWN LN °NT' CITY OF COSTA MESA — BUILDING PERMIT
EBS NAME IF MOWN: MC CAUL EY, BARBARA B ET PERM NO: B 073458
ADDRESS' AL
167 MORRISTOWN LN PERMIT NO: B 073458 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
APPL.MUJUNG ADDRESS CONSTRUCTION TYPE: VN PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 2, 999
ARCH.OR ENG.'S ADDRESS: DMT:
CLAIM VALUE: 2, 999 . 00 CALC—VALUE: 2,999 .00 GROUP OCC: R-3 /
wm'ACTORS""EI' STOUT ROOFING INC ( 310 )923-6775
CONTRACTORSMAJUNG P 0 BOX 4309 COMMENTS: SMOKE DETECTORS ARE REQUIRED PER 91 UBC
ADDRESS: DOWNEY CA uCNO.: 402536 ************Rt****************************'**********'*************le**$e**"E**4e*****
90241 uric ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under pe• of perjury that I em licensed under• • eons of Chapter 9 SETBACKS
(commenting with Section 7000)of Wilson 3 d the Busi end P• Code.and Ilan is In full l•. and elect.
CITY LIC.NO.: O c 9377 LIC.C/LA�'SS: 39 LI AA0 36 ' : 95 MAIN BUILDING ACCESSORY BUILDING
Dale: ."2/1-.I? Contractor:, �• /A� ' s� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under Andy of perjury that I am exempt from the Contractors Lica a Lew la the
flowing reason(Section 7031.5 Business and Profession Code:Any city or Aunty which requires a permit to pen ,alter,Improve, PARKING REQ: PROV: PARCEL: 41916 515 Z NE; REF NO:
demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to fib a signed statement Mel M or she
is licensed pursuant to the provisions of the Contractors License Law[Chapters(commenting with Section 7000)d Division 3 of the PLANNING NOTES;>y i'.'
Business end Professionssh Cole]or that he or she is exempt therefrom and the bafor the alleged exemption.My violation of Section "> '
7031.5 by any applicant for a permit sublede the applicant to a civil penalty of not more than five hundred dollen($5001). *********************************************************************it*********
❑ I,ati owner of the property or my employees with wages as their sole compensation,will do the work.and the structure is nolot intended D E V E L O P M E N T SERVICES R V I C E S R E �5 U I R E M E N T S
or tiered for este(Section 7044,Business and Professions Code:The Contractors License law does not appy le an ewers of properly M
who',tilde or improves thereon,and who does such work himself or hone,or through his
or her own employees,provided that such .. r!
provementaere rot intended or offered for sale.It however,the building or improvement is sold within ore year of completion.the ZONING APPROVED-'BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ..
❑ I,as owner of the property,em exdusivety contracting with licensed contractors to construct the project(Section 7044,Business and /
Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a conlrador(s)licensed pursuant to the Contractors License Law). �y,
❑ Iamexempt under S«don: B.&P.C..for this reason: APPLICATION ISSUED BY: f /`/ DATE:
Date: Owner: ********************************** * AAii ********************** * -* *
I do hereby certify that I am aware of and undersand the requirements of California Health and Safety Code Sections 25505,254.1.1,and LEGALIZATION:N F E E UMMARY STRUCTURAL SEGMENT:Y
25534.and that I or any future building occupant will/wit not(dreo one)need to comply with said ante codes and the requirements for
a permit for construction ormodificaton from theAi(Duality Management District.Residential construction applications are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 54 . 00 ,50
Data: Applicant: SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:1 hereby affirm under penalty of perjury one of the following declarations: PLAN
o I have and wmaintain a cell Sam of consent toseninsun for wake compensatowelded n.as ed for by Sedion 3700the Labor ISSUE FEE
R
Code,for the performance of the work for whihthis permit isIssued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I have and veil maintain workers'Compensation insurance.as required by Sedan 3700 d the labor Code,or the performance d the TOTALS----> 54 . 50 0 . 00 0 .00 54 . 50 54 . 50 .00
work for which this permit is issued.My workers'compensation insurance carrier end policy number are:
Carrera STATE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: .00
Policy Number: 0449400004S87 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(Ibis section need not be completed I the penult is for one hundred dollars'MO]or less) 54 .00 . 50
❑ l certify that in the performance of the work for which this permit is •,I shall s employ any peso,y en .as to
become sullied to rhe workers'compensation ley'(d Cali) agree t I should I?bled to t»/: s *******************************************************************************
\ compensation poria setlgyl�M1eJ.46or Linde 1: /•h those Prods
Date: 1 2 Pv . Applicant: �� r er ✓r i I N D I V I D U A L F E E BREAKDOWN
Warning:Failure to secure workers'compensation coverage isunlawful,and shell.object an employer to crime I penalties and TYPE ., QTY. . DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($IOP000),In addition to the cost of compensation,damages provided for In
s»tionmO6ofNinterest,
eL.borcode, andarcm
attorney's fees.
SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 999 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there S a construction lending agency ler the END OF FEES
performance of the work for which this permit is issued(Section 3097,Cit.Cl, - .
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and date that the above information is correct.I agree to comply with all city end county ordinances
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above'mentoned property
for inspection purposes
D ENE BURFORD /
PrintL f
(/ iii�/(7 01 0018710.5-00187107 TOT 54. n
/ e' Date; "�
SignataredowmeriAger,vApEoen • actor DATE: 07/28/95 TIME: 09:01.
(5151.45,WP) White-Building A Safety:Green-Ale;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING . R•OOL & SPA
APPROVALS Permit# Date Inspector APPROVALS'�t Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. J' 53. Steel Reinforcement
(-3rE}4cirical Conduu U ty-Undagrnd. 54. Forms
r
`e4. ENS rical Conduft-UrTirgrnd. 55. Electrical Bonding •
4. Sj,eel Reinforcem ne 56. Rough Plumbing & Pressure.Test
>6. Etettrical UFER. d. 57. APPROVAL TO COVEfl-GUNITE illi L.r+-n
CZ
7 tiioFings r= ; 2 58. ElectricalCondyryi',t )ndrgfnd.
'_`. . foundation cu 59. Gas Pipe, 0 Undrgvnd.,Test
S . t iater Pipe-UndrF, . 4 . I 60. Backwash Lines, %rap, 0 Uindrgrnd.
S10. Structural Floor System 61. APPROVAL TO DECK' " . '
III. Prorperty Sewer Line A House@onnection 62. Backwash & Recegior-Final
12. Sew r Cap _�� . " .
4 1 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final '
•
14. Rough Plumbing i:• 65. Electrical-Final
a
15. Rough Electrical-CortLuit 66. Solar System-FiR1 , .
16. Rough Electric Wirin 67. Fencing & Access Approval. •
17. Rough Wiring Sigta --- . 68. APPROVED Fq PLASTERING
18. Rough Electrica4T Bar Ceiling') iy
9 g� 69. POOUSPASY$CTEMSFINAL •
19, Rough Heating & Air Conditioning FIRE DEPT. REOUIREMENT
-, .. ,-,* , rt-ii-i -r, * f cf* U'H',QX
* E-• N
20. oug}iFgtor Firi4ace SI-I :: - 4. a* •PPf' lJV, Sg.L'Pecmi»it# * '" s
21. ft_ i- in 3truQureC' 1 -•• •• •< * S ! -1* ' 70. ndergit}•dr H.aafro
IT, _
22. �-ucti;Ve2itI!a ng at c' : �`. < S :Z* .'.71. Producil in Lm1Uas 0-0i I
23. aas Pape-Dough & Teat _ ' , i7 S 0* 72, UndergrdVntl Fldsfvv * •^ y
.- .-. Y � ' tt x ' -V `-. a. * 'T y
24. Roof rain ng" 6; I E" t7 2 m ,_,T ..73a;Undergrrt .Storla iI-jnk Gas ❑011 .
25. Roof;Shei hing ;r,m C A * 7t{2tdverhead Hydrin . .t _ -„
26. F,BarTl;eiling (Stru•• ral) & fv:o ' pat * O y �* 75.. , CherLti cal ~' " ..
n* CO * •.. z tri.. < ., L.
27. ame,antLFla31`aing;* : r >, cox 76. Dry Stan..'• e •-...e... * O
.
=28. Lathing CSiding HA i -i<z * £ 77Y FIXED $1'.5'TEr:PINA(r' _ n ;r
:, x "..a.f-. ., x 7. tI J
t-t
'29. Insulation- . PJ.:: S •• 78£FIRE PR EV. FIN�L * p .� 4
30. Drywall ffiiling ** rr 1 v" F, - 1LTIFI,,DEP-*.IR'EL701R-$MENT
E.1 '+1* I x to LU • r• * v
j31. Plaster Breyvn1Goatt 1c c I FIT # 179. FINAL I 8 ECTIeN * • D
V •
32. Electrical=Powe+�rv14' ln.l * "•' j Y '•80FOOD CERTIF QTE I`�xS,�,lED� Q
I
_33. keina Electi is 1 -.2.
*,t to 1 •; Mai Notes: -;< "- 0 .'i;'1
"Lf FlnarHe3[ing 8i Ai,T•Qonditionln.T.Sa i t* m S :1T -lcS OC
-- y C* to ;r- * ti u r. H,C * tr1C
35. tinar Gas ipe es CxD * I-. ' rr t o O-' Hv'"
36. How: of Canopy E.:.::* ..71 tt
I " 4. * it • r n
• nor * ¢^
--,•• us * l 1 str: e i t* ..- * 1-Ti "![r
r� •
a, t- S' * h I r* .1 * :•,
:37. F]nal'facrry Fire pI ce x I E•. * k rs.. x ^;
38. Finan Plumbing .r* n% rilli- 1 . S .y s w U -_
<4_ - ti h F is
Y rV * I P l I ...•4 -* 7.
39. WateF•Serieice,ina11� £ * c. i x a >i -e.S
• -
„40. Gas Serviee-Final v ^ C:'ir S r. t^. I 4. Oa nidi *
< x te: O * c
J
�41. Solar DorilesticFinal' S r'~... "' ** 4: 2 a .+ Hi *
* Zr) 1: •f* ?' -iO Y m .-,
42. Eackflowreventer * cu * I S ,..-,E- • * a r
r- et r t-1 i-: t- - * Cr) CI'C i. * h.
43. Backflow Irrig;ion * >SS * t o -ro * n •
--
,� r Qa * " o- *• Z :O
44, Landscapalrrtpationitiystem ecru) t * cli O t7* • rJ ri xt7 * c e-
n r '-Id- Ili * -. & -* 0 £ £ :v O1 * S
-� -t: •--i CC^ ir * 2 . L cJ* H H ...4. H' *
. . Spund Ageneation 1 * m tr1* . ' • Fa
t, '' Y * to 'l v . .t .._
( . Imola ndicap Regutationt H U * * •- t4 .S Co
-p c .. I . r* - mru i, 5
g. F"?Nt2.STRU"TUR & BUIL%ING
* NOS
48. 1.NAL PLANNING * 1 :-F+ I. na I I la , tri d 'r F
49. E?ect?tc fjfeas€to Edison * * 4;I* T x a•
a< a - I. r r -
50. Gas li¢lease to Southern Califdretiw-Gas Co * i ti IT.: --i< € O •
< * - * • S SO r * p; o.
51, CERTIFICATE OF OCCUPANCY * r 1 n no 12 r r _•
No. Date
•
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•
CITY-OF COSTA MESA• - -' • PERMIT NO. TRACT NO. LOT NO. BLDG.NU. - -
CONSTRUCTION PERMIT • • ,/v7/g0
Project Address 1,67 Mnrt{Atnetp TYPE OF CONSTRUCTION. ❑ NEW El ADD U ALTERATION Li REPAIR • • .
. Applicant's MailingAddress. 677 T ❑ CONVERSION ❑ DEMOLISH ❑ OTHER (sq.4l, j/OI /p1, c n
PP 10 cask AvP A.P. •# Zone
Owner's Na Mc all Phone 545-5442 ' DESCRIPTION OF WORK Replacement of Water Heater - IL
rme7Mr, S Main Building: Accessory Building: ^z
Address' 1 MOTr1S own rr � E O
TYPE OF PERMIT L I GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front N
Arch/Eng.' _ - License No. ❑ TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL - A Rear 1
Address . CI OTHER N
A-ames Plumbing-Htg, 530-2440 PROJECT DESCRIPTION. SQ. FT. OCCUPANCY C Right • G
Contractor's Name PROJECT K R
10422' Trask Ave'. Garden Grove CONSTRUCTION TYPE ' VALUATION$ S Left •
Address(mailing) • E
6664 • . i ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ ' G
' City License No. -FOR INSPECTION
U
LICENSED CONTRACTOR DECLARATION • Remarks: READY FOR IIV ! Parking Req./Provided 1
I hereby affirm that I am licensed unde ' Ions of:Charter 9 commencing SPECTION R
with section 7000) of Division • .nd Profess' s ode,and Use of Building: E
my license is in full force and
License Class- - • Licens41 2 e] - PLUMBING FEES Planning Notes: E
Date 3 17 84 Signet. .• I/ .- • N
/ WORKERS' COMPENSATION D CLARAT Bar Sink I Showers
I hereby affirm that I have a certificate of fent to self-insure or a certificate T
i Backflow Preventer Service Sink S
of Workers' Compensation Insurance;o a certified copy thereof•(Section - •
3800, Lab. C.) . Backflow Irrigation Sewer Cap • ELECTRICAL • ! FEES
Policy No. WP84076419 Company Fremont
,y.•.r Certified copy Is hereby furnished. Bathtubs Sewer Connection Automatic Washer, •
Transformer 0 15;50 KW
Certified copy is filed with the city Building Division.
Date 3+17+8l. Applicant a+Braes P1iirnbing- tb',. Clarifiers Solar Collectors Construction Pole Sub. .•
❑ SO+ KW
• EXEMPTION FROM WORKERS'COMPENSATION-DECLARATION- - Dishwasher •- SOlar'Piping- '- 'Cooking Unit ` Meter ❑up to 100amps -
(This section need not be completed if the permit is for,one hundred($100) or
less). •
-
I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank I • Dishwasher '-‘:
„ Meter Dover 100 amps, •
shall not employ any person In,any manner so;as to become subject to the •
Workers' compensation Laws of California. • • Floor Drains Swimming Pool w/Spa • Dryers ❑Gas DElectric Sub Panel
Date Signature '
NOTICE: If,after making this declaration,you should become subject to the : Floor Sinks Urinal Fan ! '
Workers'. Compensation provisions of the Labor Code, you must•forthwith-' - - . . . .. Motors❑0-1 HP 01%-8 ,
• comply 'with, such •provisions or .this permit shall be deemed revoked. • - Gas Service ' 'Outlets Water Closet' . F.A.U. • Ina.Solar ❑9-15 HP 016-15+
CONSTRUCTION LENDING AGENCY S ' - -
I hereby affirm that there is a construction lending agency for the performance • Interceptors - 1 Water Heater - 2.00 Fixtures 'Microwave
of the work •for which this permit is issued (Section 3097 Civ. C.) '
Lender's Name - • - - Kitchen Sink . - Water Service Device Boxes Pole Light
Lender's Address :Lavatories
OWNER BUILDER DECLARATION . , ' Outlets I Range '
I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap -
following reason (Section 7031.5 Business and Professional Code: Any city or . - - . Switches • ' ' Sign
county which requires a permit-to construct,alter,improve,demolish or repair • '
any structure, prior to Its Issuance,also requires the applicant for such permit Roof'Drains ' ' ' Garbage Disposal Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of • - • •
the Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW ❑5.15 KW Trash Compactor Division 3 of the Business and Professions code) or that he/she is exempt P '
therefrom and the basis for the alleged exemption. Any violation of Section .
7031.5 by any applicant for a• permit•subjects the applicant to a civil Reinspection Fee . $ 3 •
'malty of not more than five hundred dollars($500).• _ Pe $25 Issue Fee .
LJ I, as owner of the pro0erty or my employees with wages as their sole • Reinspection Fee , $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES _ • • - ■ -MI
•for sale (Section 7044, Business and Professional Code: The Contractor's : PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 •
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date '
employees, provided that such improvements are not intended or offered for - Canopy Type II 0
sale. If, however, the building or improvement is sold within one year of corn- Duct- Under Ground Application Approved By
diction, the owner will have the burden of proving he/she did not build or im- Date
•
rove for the purpose of sale). Duct-Structural Refrigeraiion System Application Issued By 1 J Date'3f�y/99
I, as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions code: Duct-Ventilating SUMMARY OF FEES
The Contractor's License-Law.does not apply to an owner of property who - _ -. .
builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
tractor(s) license pursuant to'the Contractor's License Law). PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for thi• s reason Firepl/Fact.Bit. ICBG 4 PLUMBING $ �'00 ISSUANCE $ triz�''
Date Owner Heating System& Ducting
PLAN CHECK $ ENERGY P.C. $ •
I hereby certify t . . - read this applic. io and state that the above 00.100,000 BTU 0100,000 BTL—fir _ ELECTRICAL $ GRADING $
information irc• ect. I awe. to co • wi city and county ordinances -
and state law elating to bu' ding_ I. ,and hereby authorize repre- • PLAN CHECK $ MICROFILM $
sentatives o t s • -nter abo --mentiong4proppper y f •
inspection'•• bo s .-/ - / _ MECHANICAL $ TOTAL FEE $ 5.00
Signature . �•:/ —a. •- - ` 444
Drivers' L' ense or 5$ lava
CMF 0865-46 rev. 7/83 • White-Builtling;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor • . - -
•
• ' CONSTRUCTION AND PLANNING - POOL& SPA
APPROVALS Permit# Date Inspector- APPROVALS Permit# - Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement ,
.3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding - .•/
5. Steel Reinforcement' - - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 1 57. APPROVAL JO COVER-GUNITE
7. Footings - - . I ;v 58. Electrical Conduit-Undrgrnd. ��
8. Foundation , - ' 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd•. r' - - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. is
10. Structural Floor System - -_. 61. APPROVAL TO DECK - ' ir.
11. Property Sewer Line & House Connection '62. Backwash & Receptor-Final
12: Sewer Cap 'y 63. Heater & Vent-Final i.- X..
13. Roof Drains 64. Plumbing System - Final •',
_,
14: Rough Plumbing 65. Electrical-Final
- 15. Rough Electrical-Conduit - , ' 66. Solar System-Final r
- 16. Rough Electric Wiring - - 67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
. 19. Rough Heating &Air Conditioning . . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ;';:3 APPROVALS Permit#
21. Ducts, in Structure c'''' 70. Underground Hydro
22. Ducts, Ventilating -r, • 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test Cry . . 72:-Underground Flush
• 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing +� 74. Overhead Hydro
26. T-Bar Ceiling (Structural) ez /lonocoat - 75. Dry Chemical
f
27. Frame and Flashing76. Dry Standpipe
28. Lathing & Siding � 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:
34. Final Heating & Air Conditioning •
35. Final Gas Pipe-Test
36. Hood or Canopy -
•-
37. Final Factory Fireplace 4/07447,
/
38. Final Plumbing y�'� G�Q
39. Water Service-Final . ' '7 - -
40. Gas Service-Final
41. Solar Domestic-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 -
49. Electric Release to Edison , - .
50. Gas Release to Southern California Gas Co - ,
51. CERTIFICATE OF OCCUPANCY
No. Date - • -
OWNER aAN VIota fU11a1ng 1:V. DATE i-“-kit'
JOB ADDRESS 167 Morristown Lane BUILDING PERMIT NO. 27291
GENERAL CONTRACTOR San Vista Bldg. Co. DESCRIPTION OF WORK Res.watt.gar.
AP No. 930-03-238 LOT 238 TRACT 5160 FIRE ZONE VALUE $ 17,6110.00
INSPECTIONS I Signature Date GROUP I & J TYPE V ZONE R-
Soil A%ltr -2/-(e PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
Wate, •/wwr-S -2 P umbin•i
Rough Plumbing Ira.. t�7AWM/P. . i.
rin cwg r lite p House Con. !? I 'Ti7 i==
Sprinkling System Ian
Miscellaneous
Rough Heating and Air Conditioning F Slree b
Temporary Service or Pole
Underground 0 Power 0
Rou:h Wirin_ ���/� - .6 Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0 V`/Mfl 3.11.24) ._,....n.94,Zry ,Q-/?--a7 „ri/t
Floor System r,(ITEIy ]g
Bond Beam 0 Steel Reinforce 0
Sheathing r�/�% ► a7 .1
Frameand Flashing. � ( 6
Lathing- Ind1---- SrOut
Plaster, Brown Coat / ,
Structural, Final �,+jr//'�j� _M -ctric,
Heating, Vent., Refrig. and A.C., Final � �, - (i�f�/ ;, %ainekennrtos.
Plumbing, Final and Gas Test r-
arev).. ��--
Electric, Final •
Building, Final hi a /, , c.
271291 )UL 25-67cfi OO1663'- ****85.5C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92020
qFor Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
��/�.40-411-14 g For Office Use Only
ADDRESS 7� Tyi1v,
7
R[Ci1PT NO. JYEERM`IT HO_�_
COSTA MESA. CALIFORNIA iC!
I RZC[I ■ pATi/�[CEl [D DATE ISSUED
OWNER OCA A4 ✓ CAA.1)14.444111.7 64 . /'/t 7 7-•-1(-‘7
MAIL �I '/ (� BUILDING
ADDRESS 2a W(4,Ly�Qr�Oa LJtiLI1-a ADDRESS FIRE
o.L
TEL ZONE TYPE V OROUF J`/
CITY �/k^^ No. �3? X54 I
ARCHITECT /71 NO/,/ ,�1 L•�' BYPROVQD /�� DAT E/ /7
OR ENGINEER L1� 7 <'Y
. ^ ZONING
ADDRESS / pis /v L . �iitame
06.40244
ZONE NO.Or USE OP NEW
Sing
0` a R-3 PLANS 2 DUN.DING Sing ROB.
CONTRACTOR -`}/ .q,Dp
`', '' ' LEDAL La-�'S f6- Sr b 0
ADDRESS '. oncRlmoN
C)(y.-L'.?
A.P.No.
CITY 930-03----238
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. QO•TO SIDE a REAR p.L.
LIC.NO. NO.
SIZE �1 �/ NO.OFNLOGI.-�j ALLOWED (U.B.C.REQUIREMENT)
OF LOT /�O /� 1 O NOWo. ON Loo
YARDS APPROVED YARDS APPROVED
ESE RINOPO B MAIN BUILDING ACCESSORY BUILDING
EXI
(FROM C/L STREET)
SETBACK LINE PRO FRONT 0 PT. pr.
CENTER OPP GI1T-R REAR YARD
SIDE YARpf LEFT RIGHT R.SIDE 0 pT, per.
DESCRIPTIONIALTERATIOj
OF WORK L.HIDA 0 rr. FT.
NEW I ADDITION REAR Rf. !T'
DISTANCE B . BET.MAIN e
REPAIR MOVING DEMOLISH MAIN BLDGH. ACCESS.SLOGS.
BUILDING NO,OP A+�( /J VAR.>S DATE
SIZE ;LO X7O ROOMS ��/, 1��, .,��-��,ST.ORRRRIES 2- c.v.p.# /� APPROVED
EXTERIOR WALL.i/ALc I ROOF i --L' APPROVED /m7arA�(J 7-7-67
COVERING / P��(�/ I COVERING SY LY9"1 DATE
USE Og1�lILDlflg_AND WO R ITirjlittPLIIRFSR MED. y
n
0 /c23 .Fr4/400 `'e 1
0 I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICACOTION THE AMOUNT SKO UNOW VALUATION IS FOR THE O
AND STATE THA THE ABOVE II CORRECT AND ACRE[TO N. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL' ITV,ORDINANCES AND STATE LAWS REGULATINGOMR.BUILDING CO CN. VALUATION r�J
SIGNATURE OF ^ is PERMIT FEE $ .J / E
PERM ITTBF �/A A A 1^ N ` !/•'
s/7, 6X° -1 PLAN CHECK S aeg.S"0 L
AUTHORIZED 011 TOTAL PEE S ._c7