HomeMy WebLinkAbout995 HARTFORD WAY - Building Permitsi •
PflOJECT AUUNESS: (� 9 S HARTFORD WY
�WNEP'S NRME: NELSON CONSTANCE T TR
noosess: 995 HA�tTFORb WAY
COSTA MESA,CA 92626
AflCM1ENGINEEH: S 4 O- Q J O 2 qEG.NO.:
aooness:
UNIT:
uxiT:
PEHMITTEE: NELSON CANSTANCE ( 714 ) 540-4902
nooxess: 9y5 iiAgRTyFORD WAY
LICENSEO CONTNACTOITdE�(IdilaxMli�e''CreLy atlirm t�at I am IicenseE unEer pm isio9n5 of�tu06� 9 kommencinp wiN Sec�ion
70W� ol Drvisim 9 0l t�e Business anG Pmi¢ssions C�e. anU my Ikense is in tWl lorce an0 elle[t.
LITY LIC,: STATE LIC.: CIASS:
�a�e: Signatur¢:
WONREHS' COMPENSATION OECLAXA710N: I Aereby alfrm �hal I bave a ceRdiCate o� tonsenl �o sel4insure a a ce�ilita�e o� WorNers'
CamOensatian Insurance. or a cerii�ied coOY ��ereof (6eclion 3800. Lab. C�. �
POIICY NO.: ' EXP. ORTE:
COMPANV:
❑ Cerlilietl copy is here�y lumished. ❑ Certilietl copy is IileA wilh ��e u�y BuildinB �ivision.
Date: ApDlicanc
EYEMPTION FHOM WOPNEPS' COMPENSATION OECIABATION: (This seclion neetl noi Ge comple�e0 if the permit is �or one hunAreA (S1IXq or less�.
I certity Ihat in t�e periormance ol Ihe work for w�ic� Ihis permit is issuea. I s�all not employ arry PerSon in any manner w as lo E¢come
Su�lect lo ihe Wo�kers' Compensation Laws ol Lalilamia.
Daie: S�qnamre:
NOTILE: I( afier making I�is declara�ion, y0u 5AOW4 Oecome SUEje[I to I�e Workers' Compensation O�ovisions ol I�e LaEor
Coae, you musl �ort�wil� comply wi�A suc� pmvisions or lhis permit s�all be deeme0 revoke0.
CONSTPUCTION IENUING pGENCY: I hereby a��irm �hat ��ere is a cons�mction lentlinp aAency �or �he pedormance ol Ihe work lor
w�ich Inis permit is issue0 �Setlion 3097. Civ. q.
LENDEB:
AOUflE55:
OWNEP BUILDEfl OECIAPATION: I hereby a�firm �ha� I am exem0� ��om the ConVacmrs' Sta�e Llcense Law �or �he lollowing reason
(SecliOn 703L5 Business ana Professional Code: Any �iiy of coun�y which requires a Oermit to cons�mct, alier, impmve, tlemoli5h, or
re0air any struCture, pr'ror toils issuance, also reQuires tAe aAb�nt Ia sutd permit to lile a siBnetl s�atemenl tlldl De/she islitense0
pursuant to the pmvisions ol ��e Contractors' Siate LicCnse Law (Chapier 9(commencing wit� Section 7000) ol ONision 3 oi t�e Business
anC Prolessions CoOe) or Inal ne/she is exempl inerefmm an0 ine 6asis Ior ine allegea exemo�ion. Any violation af Section 70315 Uy
any appliwnt lor a permit SUGIeciS the ap0licani lo a �ivil penalry 01 not mort t�an five �untlretl E011aa �5500).
1. as owner o� I�e pwpetly or my empI�yees wi�h waq¢5 as Iheir sole compen5aiion, will aa Ihe wo�k, and Ihe
❑ s�mcWre is not imen0e4 or o�leretl �or sale (Sepion 7044, Business and Professional Code: The Coniracmrs' S�a�e License Law
tloes not appty to an owner ol a pmperiy who 6uiltl5 or impwves thereon. antl who tl0¢5 such work himsell/�er5elf or �hmugh
his or her own employees. pwvitle� t�al such improvemenls are not intenOeA or ofleretl for sale. II, however the builtling or
improvemem is sold wilhin one year al completion, IAe owner vnll have Ihe bur0en ol proving �e/s�e OiA not bui10 ar impmve
lor ihe purpase af s]le�.
I, as awner ai ihe pmp¢rty, am exclusively mn��aciing vnth IitenseA conlraclors Io wn5imct 1Ae D�olec� (Sec�ion )p44, Busine5s
❑ and PmtesSions CoUe: T�e Conlraciors' Siaie �ic¢nse Law aoes not aDDly to an owner ot pmperty wha Uuilds or improves t�ereon
antl who coniracls for such pmjec�s with a cOniracioqs) license pursuan� Io I�e Conlraclors' S�a�e License Law�. I am aware
I�at pmol of Iheir Worker'S Compensalion in,urance ShoWa be pmvided to me.
� i am e.empi under Sectian: B P.� 0 4 4 B. 8 P. C.
�C �m� mrs � aso,n: / L WORK HY OWNER� � �
(�,� Qwner. � 1�1t Q iL
I da �eieny cenily Ihat I am aware of and unders�and �he repuiremenls ol Calilomia Healt� and Salery Cotle Seciions 25505. 25533, and
25534 and Iha� I or any future �widing accupanl will/will nol (circle one) neeG la Comply wil� SaiA slale cotles and I�e requiremen�5 tor a
permil lor consimclion or modilicalion Uom Ihe Air OUality Managemen� Oislrict. FesiOenliai Consimction aODlicalions are exempt �mm
Ihese pm/vis�ian�s � � � 1 )
�,,_. % / / /O / � ADplican� �%�Q ! � / �� 1% �fl /
I here�y cerli�at 1 have reaU Ihis applicatian an0 51die 1ha1 ihe above inlormalion is correcl.lagree to camply wiih all �iiy an0 counry
orainances ana Slatelav+siela�ingio �uil0ing cons�mctipn ana reby aullrorizerepreSenlaiive5 ol�his ciN�o enteru ponihe above-mentioned
o�o0etly lorinj peclion ourposes. ...�- � e (/�/^ 1
ale:_ /-�l�L,/ i i Signature�-Q^'� %� ` /A �L.-!J� /
D-ive�'s L�cense or Saiai Seariry n: �
t6fbaE Wpne-BwlEing; Green-Coae EnlorceTenl: Canary-Applicanl: Pink-Revenue; Goltlenroa-AssassOr
CITY OF COSTA MESA — HUILDZNG PERMIT PERM NO: H 053901 .
PERMZT NO; B 053901 PLAN CHECK NO; ,- N GOVT; N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : T/ OFF RESHT REROOF W/ COMP SQ FT: 5,000
CLAIM VALUE: 5,000.00 CALC—VALUE; 5,000.00 GROUP OCC: R-3 /
COMMENTS� SMOKE DETECTOR RE�UIRED IN THE HOME �
*�r�r�t�*�*ir�r�r�r��r�t*��r�*+r�r**�r*� ***�r�*�r�t*�r�r*�r�r�r�r�t�t+t�t�r�r�r��t�ex�r�t�t�t*�t***�r**�r�t�t*�t�*�t�t**x
Z O 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 BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT; FT ZN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 14105253 ZNE; REF NO:
PLANNING Nt7'I'ES>
�.
IF ik iF ik �F iF )f iF ik fF iE if iF �E'3E ik 3F if 1E 3f M if if iE if if iE if 1E if if if iF 3F �f iE iF �)f 1E 3F 3E iF if if iE iF �F if iE iE iF iE �f if 1E iF lE �E iE IF if iF fk if iE 1! �f iE k iF ik 3F iE if iF iF IF fE If
D E V E,I. 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
I.
ZONING APPROVED,BY DATE:
BUILDING APPROVED BY : DATE; ��
APPLICATION ISSUED BY; DATE; �^( 6—
aEififiEiE#FiE1EiEiElf±EihlEiEafaFiElf�kiElE�iF il�if�flfiFiEiE3E7fiE 3EiE
iF�lEafifklFlFaElEaFif�EiEiFiFifif�141EikikiFlfiFlEiE3fiEikiE3EififjEifiFiEiEiEififiE FIFiFiFiEifif3Fifif�iFiEiElElFifiEkjFiEiFikiFiEiEif3fiFiEif�3EiEiFiF3fiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RHS GRADING
PERMIT 72,00 „50
SMIP/NON—RES�
!
ISSUE FEE '''
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID,� .DUE
TOTALS----> 72.50 0,00 0,00 72,50 72,50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 72.50 OVER/SHORTa - ;,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-6HECK
72.00 .50 -• ,
if if iF if iF If iE if !E �E iE iE iElf IE iE iP �f iE iE ik iE iF iE if ik lF ik k iF iE iE if If if if iF iE 1E 1E if iFlf 3F IE �! iE 3E±E it �E *�f �E iF 1E IF iFiE iE IE iE fE 1E !f �lE iF 1E iE 3F IE if iF iE iF if 3F iF If
I N D I V I D U A L F E E B R E A K D O W N
�
TYPE QTY D E 5 C R I P T I O N UNIT COST '' rT.OTAL,COST
SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 .�"5;000,00
END OF FEES �' ; , �
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�CONSTFUCTION AND PLANNING POO� & SPA ' I�
APPROVALS Permit# Date Inspector pppROVALS Permit# ' Date Inspzctor ��
� �
1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location �
2. Soil Pipe-Undrqrnd. 53. Steel Reinforcement , � '
i3��Electri'cal ConduityU�i;lity-Undrgrnd. 54. Forms �
� 4: EleStrical Conduii•1lndrgrnd. 55. Electrical Bonding
�'5. Steel Reinforteme �t�� 56. Rough Plumbing & Pressure Te"3t��"
��6..£iectricalUFEF��G�nd. 57. APPROVALTOCOVER�GUN��'� "
: 7�>�Footings _ 58. Eiectrical Conduit-Undrgrnd. '-'
`8: ,Foundation "��- 59. Gas Pipe, O Undrgrnd., Test -
; 9: Water Pipe�Undrgr�id. 60. Backwash Lines, P-Trap, O Undrgrnd. � �
t
10. Structural FIUor System 61. APPROVAL TO DECK �'` ' .�
114• Property Sewer Line-& House Connection 62. Backwash & Receptor-Final �
r
12. Se�er Cap L ' 63. Heater & Vent•Final � �
13. Roof Drains .r 64. Plumbing System - Final �
14. Rough Plumhing � 65. Electrical-Final . "
15. Rough Elec2ricaf=Condui[ 66. Solar System-Final � '
16. Rough Electric Wiring 67. Fe�cing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica{=T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - i � -
20. Rough F3ctory Fqeplace i �.0 . �y ; a_ .^ - :. .APPROVALS��. �. Permit # - �
n .��i: � <... ��� r � , - r
21.'buctd,inStruc[urg ` , ,.-.. : =' , - '' � �JO. lJndergroundLHydro ;, �
22. Dutts, Ventilating- � .: �: � � • • � � -77, Product'Piping OGas QOiI
�
23.�Gas�Pipe�f;oqgfi &'T�st '��, � , _ ; _ �.72. Underground FIusFF ,. - �
24.RooC_Framing�. ��� _� � a � ` - `73.'Undergmd..Storage`TankOGas ❑Oil
25. Roof,;Sh�athing ��; � ?: ., q�%�„Lj� �'� � �'74,�Oyerhead Hydro - ' '
``' � L
26.-.f-Bar Ceiling (Strvctural) & Monocoat � '� " �� x. 75.=Dry Chemical � • - _ �i'
27. _fra�ne and Flashingi '� l,� ' � �. .n T 76. D�y StandQ��e � S� . �
'28., Lathjng & Siding; ~ v.� �;�:';c �r t >' • • , � 77._ FIXED SYSTEM EJNAL .!
4.. , r�
l
.'29. Insulatio� �" �'�r `, ' '"' - }. �'� . 78 �:�FIRE PREV FINAI � .� :'
.�30. Drywall.Nail�g ., ' , � l_. . HEALTH,6�EPT, REQUIREMENT
4 . '._
�37. Plaster Browr�,Coaf � , � � .�. .{ ' < _. ', �79: FINAL 113S2ECTION � ' � -�
;�32. Electrical Poirer Me.ier�Finai , � . � t• � �SO.:FOOD CERTIFIEFTTE ISSUED � _
,33.-Pinal Electric ` '� ; � � `' Z��; �� ��Notes ,,r y : " .�.', '�,
�' ` l� , ,'f 1 � l.l • . -S. � 1 ' �\1� �'` ��` ' ''J ..i'3 •
.34. -Fin�l. Heeting"g� AiF Conditioning� ._ , .� � (�; - , t _
35.'Final Gas Pipe'-TeSt � _ - '^ �� �•' • �� ' -
o �
. � �. : � � �
,36. �Hoo� or"Canopv . . - ,j'. - , �,.:� �
«
37.�Fina1 Fa�tory Fireplate � � �" ' �" � " ?- ' 1,
� ,� t - �� _
�38. Fina�Plumbing � � � , . . w - � � � �t _
: 39. Water Service-Final � � • � ' ' � �� -�
' � Y
'40. Gas Service-�Snal '" ' � �' �. f� ` " n � �
u� .�� 5vu .�.. , C;: .,�t. •
'41. Solar pomesticFinal ;-, �� � , � � � "' � ,
.� �� > >
.,
42.��Backflow Preventer', � � , , _ . _
43. Backflow Irrigation'� '�� � '� • - � - _ "
. � i
. � i � y .
.44. Landscape Irrigatiop System�,',j;� ,•� � � ,� � �.� ' - j
s45.^Sound Attenuatiom '-. . ' '. � , � * ' �. _ - _t 7
. � �
�.46.� Handicap Regulatiops � ' ; �'`' � � � � �� �
, : �m� -'rri ! �� D
�47. •FINAL STRIiCTURE & BUI'LDING " ' �'�" `• ' ��-.,-�
� . ' � � :� • ` �a�y z`'�
48.`�FIN7>L PLANNING� '� � � "�. � �• +�, • i
in• - -
;A9..�Elee{fic Release to fcdison * :� � � _ �
�, , So 4 ,v- I
' 50..,Gas Release to Southem California Gas Co ''�'' ' `� �' f . I
, _ �:
51. CERTIFICATEOP�OCCUPANCY , ,. ;. _-, ._
No. Date
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 995 HARTFORD WY
Suite No
Vicinity:
Parcel Nunmber: 14105253
Applicant: SZABO, KEVIN
Address: � � �
Owner: NELSON, CONSTANCE T TR
Address 995 HqRTFORD WAY
COSTA MESA, CA
Phone:
Zip:
Phone:
Zip: 92626
Contractor: COAST ROOTER PLUMBING HEATING & AIR CONDITIONING
Address: 2737 S CRODDY
STE D
_ SANTq qNA, CA
Arch / Eng :
Address:
Phone: (714) 241-1414
Zip: 92704
License: 529127
Phone:
Zip:
�icense:
SCOPE OF PERMIT
CHANGE OUT WATER HEATER
ISSUE FEE � -
Backflow irtigation
Backflow Preventer
Bathtub
ClariferSystem �
Connecl pce,Soda,etc) �
Dental Units
Dishwasher
Drain, Floor
D2in, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
AMT
$23.50
so.00
30.00
$0.00
86.00
50.00
$0.00
30.00
$0.00
so.00
so.00
$0.00
$0.00
$Q.00
FEE SUMMARY
QTY � AMT
� Laundry Tub / Washer $0.00
0 � Landscape Irrigation $0.00
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 ft) $0.00
0 Receptors so.00
0 Septic Tank $0.00
0 Sewer Cap for Demo $0.00
0 Sewer Connect $0.00
0 Sewer Private Line 50.00
0 Shower $0.00
0 . Sink, bar $0.00
0 Sink, commercial 50.00
0 Sink, Floor � $0.00
Qn
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Status: ISSUED
Applied: O6/11/2003
Issued: O6/11 003
ISSUED BY:
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Sel
Wasle and Vent System
water Closet (Toilet)
Water Heater / vent
Water Piping (Insl or Rep.)
water Re•pipe
Water Service
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
orv
0
0
0
0
0
0
0
0
0
0
1
0
0
0
N0710E: The work authorizetl by this permit shall comply with all applicable handicap access requirements under Califomia stafutes and retafed
regulations. (Ord. No. 92-28, § 7, 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 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (774) 754-5626
244&d816/00)
WORKERS' COMPENSATION DEGLARATION: �
I �erehy effirm under penalry ot perjury one ot Ihe following declerations:
❑ I have entl will maintain a certificate of consent to self-Insure lor workers' compensation, es providetl for by section 3700 0l the Lebor Code, for the pertormance of the
work tor whiCh this permii is issuetl.
� I have and will maintain workers' compensation insurance, as required by section 3700 0l Ne Lahor Cotle, br ihe peAortnance ol Ne work tor which this permit is Issuetl.
My wo�rkers',c�om,p..e.nsation Insurence cerrier enC poliry numEer ara:
Carner: �1! �l+`t.�tl�./� PolicyNum�er: L��Z�O—Q�
(lh/s secfion need nof be cromp/etetl i! the permif is velued a! one nundretl tlollars (5700) or less.)
� I certify that in the performance of the work for which this permil is issued, I shall not employ eny person in any manner so as to become subject to ihe workers'
compensetion laws of C�to(nle, end eg �ellyat i I should 6ecome subject to Ihe workers' compensation provisions oi Seclion 3700 of the Lebor Code, I shall torthwith
Comply with ihese provis � i4 �
Applicani Signeture: Dete: b— < < � �
WARNINp: FAIWRE TO SECURE WORK R OMP ON COVERAGE IS UNIAWFUL ANp SHALL SU&IECT PN EMPLOYEP TO CiiIMINAL PENALTIES AND CIVIL FlNES UP TOONE MUNDRED
TFKKISAN�DOLLAHE(5100.000),INAD TIONTOTHECOSTOFCOMPENSATION,DAMAGESASPROVI�EDFORINSECTIqJJJO60FTMElA80RCODE.IFIrEREST,PNDATTORNEI^SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I am
force end eHect. Lic. N_
Coniractor s Signature:
ot Chapter 9(commencing with Section 7000) of OlWsion 3 ot the Business entl Professions Code, antl my license Is in tull
c�ass x C3 6 N 1 G
oate:__(7 -l�`y3
CONSTRUCTION LENDING AGENCY:
� I hereby aNirm ihat ihere is e construction lentling agency for ihe Oedormance ot the work for which this permif is issuetl. (Sec. 3097, Civil Code).
Lendels Name: Lendels Atldress:
Signature:
OWNER-BUILDER DEGLARATIONS:
Date:
I hereby ettlrm that under penalty of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or counry which roquires e permit to construct, alter, improve, demolish, or repair any atmcNre, prior to its issuence, elso requires the applicant for such permit
to file e signed statament that he or she Is Ilcensetl pursuant to Ihe pmvislons of Ihe Contractore License Lew (Chapter 9(commenGng with Sectlon 7000) of Dlvision 3 of Ihe
Business end Prafessians Co�a) or ihel he or she is exem0� �herefrom antl tha besis for the elleged exemption. Any violetlon of Sectlon 7031.5 by any epplicant for a permit
sublects Ihe epplicant to a civil penalry at not more then five hundred dollers ($500).):
❑ I, as owner of the property, or my employees with wages as I�elr sole compensation, WILL DO THE WORK, and lhe structure is not intended or oNered tor sele (Sec.
7044, 8usiness and Professions Cotle: The Contractors License Law does not apply to an owner oi pmpeny who builds or improves t�ereon, and who does such work
himself or herself or �hrough his or her own employees, provitled Ihet such improvements ere not intended or oHered for sale. II, however, ihe builtling or improvement is
soltl within one year of completion, the owneo-builtler will have�lhe burden of pmving Ihat he or she tlitl not build or improve tor purpose ot sele.). �
❑ I, es owner oi the properry, am E%CLUSIVEIV CONTRACTING WITH LICENSED CONTRACTORS m consiruct the projecl (Sec. 704a, Business and Protesslons
Code: The contractors License Lew does nol flpply to en owner ol property who 6uilds or Impmves Ihereon, end who coniracts lar suc� project with a contrecror(s)
license pursuant to the Coniractors License Laws.).
❑ I em exempt under sec. eusiness end Prolessions CoOe for this reason:
Signature: Date:
Owner ID ventie0 by dnver's license. ❑ Yes ❑ No Dnvers License No. Expires:
Verlfitetion of Ownership by (�ype ot tlacuman�, i.e. � pmperty tez hlll or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify Iha� no ezwvation five (5) or more fee� in depth inio which e person Is requlred to descend, will be made in conneciion with work euthonzed by Ihis
pertnit, antl ihat no builtling siructure, swttolding, falsework, or tlemolition or tlismanUing Uereol, will be more than thirry-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Ttle B, Californie Administrative Cotle�.
❑ As owner-builder, I will not employ enyone to do work w�ich would require e pertnil Irom the Divislon oi Indusinel Sefety, as noted above, unless such pereon hes a
pertnit to tlo such work irom t�e division.
Signe�ure: Dete:
DiviSion of IntluSirial Sefety Permi� Number:
CERTFICATE O COMPLIANCE M D AUT}IORVA710N OF ENTRY: I certi(y undar penalry of perjury that I heve read this epplicalion and state that the infortnalion given is
correct. I eg e o comply iitfi &II ata laws and ciry ordinances releting to 6uiltling construction, end authorize representetives of t�e City of Costa Mesa to enter upon the
ebove-tlescn propeay f� mspe tion Ouryoses. I agree nol to occupy or ellow occupancy ol any building authonzed 6y this permit until finel inspection.
Si ature Of Le I Ow er s) Date
✓W �'�u G'll -D�
And/Or Authorized Applicant Data
�OpE I, INSPECTIONTYPE 2Ag �
1616 Fixed System Final Fire Prevenlion
1268
200
201
Pool Spa Finel
Finel Re-Roo�
Final BIaWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 -FinelDemolition
COUE I INSPECTION TYPE
206 Final Mechanical
20B Finel Plumbing
210 Finel Electrical
212 Finel Fire Prevention
220 Final Planning Approval -
222 Final Site
250 FinalBuiltling/Occupency
PAIE U�ELB
Lot 6 Z8�33
COSTA MESA BUILDING-SAFETY DEPARTMEPR
P.O. BOX 121N COSTA MEeA, CALIFORNIA 926YE -
For AppllcaM lo F711 /n Comploroly
TYPE OR PRINT
�ut�oiNa ('� [J �
ADDRHDD
COSTA MESA, CALI RNIA
�aan Constructors, Inc.
5 Front Street
nieao. Calif. w�'' 234791
2949 Randolph Ave.
Costa Mesa, Calif. 82626
234399 0' S40-0960=
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For Offlc� Us� Only
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