HomeMy WebLinkAbout934 HOLLOW BROOK CIR - Building Permitsw
PNOJECT AOOHESS: (j 3 q HOLLOW BiZ0�1(
OWNEH'SNAME: HUBERT WAKEHAM
aooaEss: g34 HOLLOW BROOK CIR
C,M CA., 92626
pqtHIENGINEEfl:
aoosess:
PEG.NO.:
uxir: CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 064572 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU
uxir:
renmirrcc: pROGRESSIVE DESIGNED PLMH (714)580-3500
aooaess: 6 VANDERBILT B
IRVZNE CA 92718
LICENSEO CONTBACTOP OELLAIIATION: I hereGy allirm thal I am Iicense0 under prov¢ions ol C�apter 9 �commencing wii� Section
7000) ol DrviLon 3 0l t�e Business antl PtoleSsions Co�e. an0 my license is in �ull lorce antl effect.
CITYLIC.:Oq 4 sTaTcuc.:334799 / ��'ss: C-36
Dale'. � SignaWre: _(.�,.<S �
waBNEBS' CO PENS ION OECLAflATION: I �¢re�y a��irm I�al I �ave a tetlilitaie 01 COnsenl �a s¢II�inSure Or a ce�ilicai¢ o� Workers'
Compensa�ion Insuran or a renilietl copy Ihereol �Seciion 3800, Lab. C).
voucrxo.:WC120717046 E%P.ORTE: lO/O1/9�i
comraxr: VALLEY FORS�E IN
] cemren coov � �ereoy i r��snee. Ud Ceriilietl copy is IileG wli`A I�e city uiltlinp Divisron.
Oaie: C 3 AODlicanC L��"�
E%EMPTIONfB WOPNE 5'COMPENSATIONUECIANATION: �ThisseclionneeenotGewmplete4il11ieperm�isloranehmMre0�5100�orless�.
I Ceriify I�al in Ih¢ peilarmante ol Ihe work l0� which thi5 DQ�mii is issUetl, I 5�all nai empl0y any person in any mannee w as �0 became
su01e�� �o ��e Wotkeri fAmpensalion laws of Cdlilamia.
Date: SignaWre:
NO71LE: If, afte� making ihis tleUaralion. you snoultl eecome su0ject to ihe Wodters' fAmoensati0n provisions ol the labor
Cade. yrou musl fanMnl� campN w��� suc� pmvisions ar IN5 p¢rmii 5�all �e aeeme0 revokeG.
CONSTXUCTION 1EN01NG RGENCY: I hereUy alliim I�al ��ere is a conslmciion lenainp aqency lar Ihe pedormante of Ihe work �or
w�ich Ihis pe�mil is issued (Seclion 3W7. Civ. C�.
LENOEfl:
AODHESS:
JOB DESCRIPTION : RELOCATION OF WATER HEATER
CLAIM VALUE: CALC—VALUE:
PERM NO: P 06457
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: NO 'H' PERMIT INVOLVED.
r*+t**�**�r****�*+r****�r+t�+r****+�**+�*ae*�r***�e�z*�-**�-�-ir**�r�r+r�r�r�r-�+�r��*+r�t�r**�r+rir�r�r�*�**-�rx-
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
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; 93506125 ZNE: REF NO:
PLANNING NdTES>
>
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D E V E L O P M E N T S E R V I C E S;� R E Q U I R E M E N T S
ZONING APPROVED BY C� DATE:
BUILDING APPROVED BY : DATE;
'
APPLICATION ISSUED BY: ��'_ "r�
�t�t*it*ic�iti��tir*ir*ic��t**�t�r�t�r*�riFiFiFiF3F3F3F�FiriF#x�"3f'�r�F3F'i��f�iFitiFiF,iF�r�iF*�t**Di�t***f� � � �
k k if 1E 1F if 1f 1E 1E 1t it 1E 1E 1E 1E if 1f iE iE if it 1E 1f 1f 1k 1E k k if 1t fE 1E iE fl� k k iE if k tf 1E it if 1f 1E 1F 1f if !F 1f iE it!! if M!f iE iE iE iE 1f 1f iF iF iF if if if 1E af if iE af if iE 1E 1E N� �!
LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
OWNEBBWLOEBOECLAP�TION: I�er¢Oyallirml�allamexemptlmml�eContrac�ors'StateLicenseLawbrt�elollowingreason $LDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Sec�ion 70.?7.5 Business and Pro�essional Catle: Any [i�y of coun�y w�ic� repuirts a Dermil �o constmct, alter, impmve. Oemoli54 or p EAM I T 7, 0 0
iepair any 5lmtlur¢. prior Ioiis i55uant¢. also repuir¢5 Ihe applitant lar SUGh p¢rmi� �o �ile a 5ipnetl 5latemen� Iha� �rJshe i5 licen5etl
pursuam m Ihe pmvisions ol the ConVaaors' Slate License Law (Chapter 9 �commencing wi�h Seclion 7000) a� Division 3 ol ��e Business 2 5 R SM I P/ NON—R ES
ane Pmlessons Code) or Ihal he/she is eMemp� Iheie�rom ana Ihe basis lor Ihe allegea ezemplion. Any violation ol Seclion 7031.5 by pLAN
any applican� lor a permit subjects �he apDlicant �o a civil penally ol no� more Ihan live hunerea Collars (8500�. I SSUE FEE 2 0, � 0
I, as owner ol Ihe pmpeny or my employees wiN waqes as ineir sole comoensa�ion, will do ihe work, antl me BUILDING—DIV—> PERMIT ISSUE PI.AN—CHECK �1'O'I�AL PAID DUE
❑ simcNre is not inienaea or ollerea br sale (Secuon 70aa. 8usiness anG Pmlessional Caae: The Contracmrs State License Law TOTAL S-- --> 7. 0 0 2 �. � � 0. 0 0 2 7, 0 0 2 7, 0 0 , 0 0
doe5 nol appty to an own¢r a� a pmDerlY wh0 builas ar impmves ��ere0n, and wtro AoeS Such wOB him5¢I�/�ersell 0! Ihmug�
his or hei mvn employees, proviaeA I�al such improvemenls are nol in�entletl or o��ere0 lor sale. I�, �owever tlle huilding ar
' impmvement is sole wilhin ane year of completion, ihe owner will have the burtlen ot pmving he/she ditl not �uila or impmve REV ENU E D I V I S I ON TOTAL S--> COLL EC TED • 2 7, 0 0 OV ER / SHORT ; 00
mnnepwPoseo�saieL BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I. as owner ol �he propeny. am exclusively canlracting wilh licensed coniraclors �o conslmc� �he pmlec� (Seclion 7044, Business 2%, � Q
❑ and Pmfessions Code: The Conlraclors' Stale License Law tloes noI apDly Io an owner o� propeny who 6uilJs or impmves t�ereon
antlwhocomraasbrsuc�proleclswil�acomracior(s�licensepursuamlol�eConiracbrs'SIa�eLicenseLaw�.lamaware .K.,�**.�.*..�,**,.K,*�„�*„�*,�„�*,�,�,*,�*,**„K„K,*,*,*,*,***,**„�*,*******,�***,*,µ********************�******
�hai D�oof ol I�eir Warker's Compensation insurance s�oultl be pmvide0 to me.
� I am exempi unGe� Section: B. 8 P. C. I N D I V I D U A L F E E H R E A K D O W N
mnnareason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Oate: Ownor.
I tlo hereby ceniry �hat I am aware ol antl untlersiantl ine requiremems ol Calilomia Heal�h antl Sale�y Code Sedions 255�5, 25533, antl P LU 1 WAT ER H EAT $R AND /OR V ENT '] . � Q 'j . Q Q
25534 ana Iha� I or any luture builtling occupanl will/will nat (circle one) neetl �o compty wilh said s�a�e cotles antl the requiremenis for a
p¢rmi� to� consimction ar modibcation Imm I�e Air Oualily ManaBement �istricl. ResiGenlial con5�mciion apDlicaiions are exempi imm
I�eSe pmvisions.
�a�e: AOPlicant:
I hereby wr�ify Ihal I Aave reatl I�is apPlicalion and slate Ihal lhe above inbrmation is correci. I agree lo comply wi�� all cily and cowry
ortlmances antl stale laws rela�ing to bwltlmg conslmciion and her¢�y authariie representa�ives of I�is city to enler upon Ihe above�men�ionetl
propetly lOrinSp¢c n Vurpos . � � �
�aie: � Z SignaWre: S `"
Oriver's licen m 5ocial R
t64LC6 Whae—Builaing: Green—Cotle EnlorcemenL Canary—Applicanl: Pink—Revenua�. Goldenrotl—Assessor
END OF FEES
Oi �J024s'411-001<941: Tt� T 2i.Od
DA7E: 2D;32/93 TItlE� l0:24
CONSTRUCTION ANO PLANNING PG,... & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit � Date Inspector
i. Ternporary Electrical Service or Pole 52. Pool & Equipment Location
2. So I Pipe-Undrgrnd. 53. Steel Feinforcement
3. Eiectrical Conduit UtdrtY�Undrgmd. 54. Forms
4. Electrical Conduit•Undrymd. � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
J. Fontings 58. Electrical ConduibUndrgrnd.
8. Poundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor Svstem 61. APPROVAL TO DECK
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Orainr 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical�Fina�
15. Rough Electrical•Conduit 66. Solar SYstem-Final
76. ftough Electric Wiring 67. Fencing & Access ApProval
77. Raugh Winng Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & A�r Condit�oning FIRE DEPT. REQUIREMENT
20. ftough Factory Pireplace APPROVALS Permit ,$ �
21. Ducts, in Structure -. 70. Underground HyUro
22. Ducts, Ventilatin9 71. Product Piping � Gas ❑ Oil
23. Gas Pipe�Rough & Test . 72. Underground Flush
24. Roof Framing . 73. Undergrnd�.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-3ar Ceiling ISiructurall & Monocoat 75. Dry Chemical
27. Frame and Flashing � �6. 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. Fi�al Heating & Air Conditioning . .
35. Finai Gas Pipe�Test � ,
36. Nnod or CanopY
37. Final Factorv Fireplace '
38. Finai Plumbing ��76 j� lY�c�
_T`/ //• �
39. Water Service-F�nal
90. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer,
43. Backflow Irrigation
44. Landscape Irriqacion System
45. Sound Attenuation
46. Handicap flegulations
47. FINAL STRUCTURE & BUILDING
48. F�NALPIANNING ,
49. Eiectric Release to Edison
50. Gas Release to Southern Cafifornia Gas Co _
51. CERTIFICATE Of OCCUPANCY '
No. Date
�
PflOJECi FOOXESS: J 3 Q HOLLOW HROOK
OWNEH'S NAME: �(
aoonEss: Sp�g
uxir:
PflCNIENGINEEH: CHESTER CARVILLE flEG.NO.: CS83OS
ADOflESS: 79z% ARMOUR ST UNIT:
S.D. CA 92111
PEflMITTEE: QHOENIX ENTERPRISES INC. (213)690-9559
aooness: 411 COMERCIAL WAY
LA HAHRA CA 90631
LICENSEU CONTflpCTOP OECLAHATION: I hereby allirm Ihal I am b tl unAer pmvisions oi Chapter 9(commencing wiih Section
7000) o� Dimslun 3 0l ihe Business and Pmlessions Cotle, ana m e is in fullforce an� effecy�
c�Truc.: 50788 sTTe�ic.:376639 c �: � /��7�
Dale'. � � SignaWre'. �
WOFNEBS' COMPENSRTION OECLABATION: I hereby aifirm Ihal I �ave a ceN�icaie ol consen� to sel4insure r a certdica�e at Wo�kers'
Compensation �stta�cb o� �c�ureo cony inereo� �section 7eoo. �ae. �.� � O 1/ 91
POLICV NO.: E%P. OPTE:
�OMPANY: CA COMP 6 FIRE
Cerlifie0 copy is herehy /W'�mi/sheltl. � Cenilie0 capy is I i�h e ci�y BuiiAing Di � io
Date: /I ,�_ { v Applicam:
E7(EMPTIONFflOMWOBNEflS'COMPENSIITIONOECIABRTION: (Thisseqio neeana�becampletedillhepermiiisloronehunare4(5100�orless�.
I cetlity Ihat in Ihe pedormance of the work lor whic� ihis permi� is issuetl. I shall nol employ any person In any manner so as �o become
sublec� to Ihe Workers' Compensa�ion Laws ol Califomia. -- —__ '
Dale'. Signature:
NOTICE: I�, ai�er making I�is tleclaraiion, you 5h�u10 become suhlect �o Ihe WOBers' Compensa�ion Dmvisions of the Labor
Catle, you mus� lohhwrth compty wiih such pmvisions or �his Dermi� shall be tleemed revoked.
CONSTPUCTION LENOING RGENCY: I Aereby aflirm thal lhere is a constmc�ion IenAing aAency lor ��e pedarmance o� Ihe work for
which this permi� is issue0 (Sectmn 3097, Civ. C),
LENOEX:
aoosess:
OWNEP BWLOEH oECLAflRTION: I hereby affirm Ihat I am exempl irom ihe Contracmrs' State License Law 1or ihe following reason
(Seclion 703L5 Business ane Pmlessional COAe: Any ciry ol counry which repuires a permi� lo cans�ruct, alter, impmve. demolis�, or
repair any 9mcWre. prior �o ils issuanc¢, also reQuires Ihe apPlican� lor such Oe�mit to �ile a signed Sla�emen� �hat he/she is Iicense0
pursuant lo Ihe pmvisions o� �he Coniracmrs' Slale License Law �Chapter 9(commencing wit� S¢clion 7000� of DiviSion 3 0l �he Business
antl Pmlessions Cotle� or I�ai he/she is exempl ��erelmm and Ihe basis for the al�eged exemp�ion. Nny violation ol Section 7031.5 by
any applicant �or a permit sublecis Ihe appliwni to a civil penalry of not more ��an five huntlred tlollars ($500).
I, as owner of the pmpetly or my employees with wages as Iheir sole compensalion, will tlo the work, antl the
❑ stmc�ure is noi inientlea or o��ered �or sale (Sec�ion 7044, 6usiness antl Pmlessional Code: The ConVacmrs' State License Law
Ooes no� apply to an owner of a prapetly who builds or impmves ��ereon, and who does such wo�k himSelUherself or thmugh
his or her awn employees, proviUetl �ha� such impmvemen�s are no� intentled or oflereU �o� sale. If, howeve� �he building or
improvement is soltl wi�hin one year ol comple�ian, �he owner will haue �he burden o� pmving he/5he did no� build or improve
for �he purpose o� sale).
I, as owner of Ihe pmpeny, am exclusively conVacling wi�h licensetl conlrac�ors �o con5�mci �he pmle�� (Seclion 7044, Business
❑ and Pm�essions COde: The Con(rac�ors' State License Law does not apply to an owner ol Droperty who builtls or impmves thereon
an0 who contrads for such prolecis wi�h a canVactoqs�license pursuan� ta the ConUaclo�s' S�a�e Licenre Law�. I am aware
Ihai pmo� o� their Worker'S Compensa�ion insurance 5hou10 be pmviaetl to me.
� I am exempl uneer Sec�ion: 8. 8 P. G.
lor Ihis reason:
Oate: Owner
I Oo �ereby ceNty t�at I am aware of anU understantl ��e requiremenis ot Cab�arnia Health and $aleiy Code Sec�ions 25505, 25533, an0
25534 antl Ihai I or any �ulure butltling accupanl willlwill not (circle one) need �o compty wi�� saiA Slaie coAes and Poe requirements lor a
permil lor wnsimction or motlihca�ion �mm Ine Air �uahty Management OiSirict. Fesitlential cons�mclion applica�ions are exemD� �rom
Ihese pmvisions.
�a�e: ApplicanL
I hereby certily ihat I have reatl �his applicalion antl Slate Iha� Ihe aba m rm �ion 75 correct. I agree �o complV w��h all ciry an0 county
ardinances antl sia�e laws relaling lo bwltling conslmclion and hereb U� rze r eSenlaiive5 0l this ci en�er upon Ihe above�menii
pmperty I. i pec0 n purposes. �/' � �
�ate'. f � Signature'. ' V`�
Driver's License or Socia� Securiiy x:
tfiai�n6 Whne—Bwlding; Green—Cotle Enlorcement Canary—ApVlicanl; Pink—Revenue: GolOenrod—Assessor
CITY OF COS7'A MESA — BUILDING PERMIT E M N; �
PERMIT NO: B 099823 PLAN CHECK NO: 05693-90 A ��t7�`-fTS[71��J
CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: REP
JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 15,038
CLAIM VALUE: 15,03$.00 CALC—VALUE: 15,038�.00 GROUP OCC: R-3 /
COMMENTS: X
***�t�r**�x*�r�r�t�t+t*�t�t*�t*�t�t�t�t*******�r*�**�r�r****��r�r�r�r�r+e*�*�t�t�t�r*�r�***�*+��t**��t�+t***�r*+t
7. O N I N G R E(a U I R E M E N T S '`.�
S E T H A C K 5
=----------- MAIN HUZLDING ---------- --------- ACCESSORY BUILnING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT TN LEFT: FT IN RGHT: FT' 'IN
PARKING REQ • PROV; PARCEL; 93506125 ZNE: R2 REF NO;
PLANNING NlSTES> FOUNDATION CORRECTIONS —
' ifk� *iF{E3(�iE�Fif�F�Fi(�7E9F�if�
7kiflfifiFiFiFiEififlf9flFlkiFlflEifkkiEiElflfiFiE�fiFiflE�fltiEiEltiFkikiFklFiflFiFiF1F3E�f1F1E�EitiFIFIf1E if
D E V E L O P M E /N T S E R V I C E S R E Q U I R E M E N 1` S
20NING APPROVED BY : (� �� DATE; / I O��%O
BUILDING APPROVED HY ; /�J 1 L%Ji�'�� DATE; �
APPLICATION ISSUED BY: DATE: � �
iF If iF �If it if 1F iF 1Flf d4 ik iE k �F �E 1k if if if Ik3E If iF ik if IE if �! �F iR fF�iFiF�FiF ik �k
iFik3kifiFlFiFlFifiFiFiflEklf�E�lEfklf7ElE�t16iE1FiF�EfkiElEiElE�kffiF iFiFiFlfikififlElEifiElEfEffiE1f1E1f1fkiFiFifiFiFlElkIf1E�E�IEi(�iE,dfklf�fifif±fiEiE3F
LEGALIZATION:N F E - S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING E CTRIC MECHANIC FIRE SMIP/RES. GRADING
PERMIT 171,00 r 1,05
SMIP/NON—RES
�
PLAN 27.79
ISSUE FEE
BUILDING-DTV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 172,05 0.00 27.79 199.84 199.84 .00
REVENUE DIVISION TOTALS--> COLLECTED: 172,05 OVER/SHORT: ,00
HLDG PMT PLUMHING ELECTRIC MHCHANZC FIRE SMIP/TOT GRADING PLAN—CHECK
1%1,�� 1,05
9F if if ik iF iF 1f 3k 3f 1E if iE �1k iE 1f iF iE if if �F iF iilk 1E iF M iE iF iE if 1f iF iF iF iP iP if 1E if if if iF iE iF If �k if 1F iE iE �If if IE iF if iE IE iE iE 1FiE if IF aE if 1F iF iF if ik iF iF if iP If if iE 9F 3f
I N D I V I D U A L F E E B R E A K D O W N
TYPE (JTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 15038 STRUCTURAL BY VALUE PER 51.00 1.00 15,038.00
END UF X'EES
�'
Qi QD07443=—�L'074425 "0'i� + :7?.�JS
L�RTE: i1f16i4LT Ti�tE: i2:J7
CONSTRUCTION AND PLANNING - POOt & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # �ate Inspector
1. Temporary Electrical Service or Pole. - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd._ v = 53. Steel Reinforcement
, 3.•Elec[rica('Conduit_Utility-Undrgrnd;i�' 54. Forms
-' 4. Electrical•Conduit-Undrgrnd. 55. Electrical Bonding
'� 5. S[eel Re nforcemerif .,� 56. Rough Plumbing & Pressure Test t.�
�. -
= 6. Electrical.UFER Grnd. 'T. 57. APPROVAL TO COVER-GUNITE
� ,
Y 7. Footings'_'' �, 58. Electrical Conduit-Undrgrnd. ��'
.� 8. Foundatipii x` L 59. Gas Pipe, O Undrgrnd., Test `
r9. Water Pipe�Undrgisd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor SYstem �- 61. APPROVAL TO DECK
11 . Property Sewer_ Li �& Ho�se Conrrection 62. Backwash & Receptor-Final
12. Sewer Cap _' � 63. Heater & Vent-Final
13. Roof Drains- • 64. Plumbing SYstem - Final
14. Rough Plum6ing � 65. Electrical-Final
75. Rough Electrical-Conduit � 66. Solar SYstem-Final
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
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
' - - - - - - ���-,.ya- s -
20?Rough Factocy F.ireplace t=.m �2 � " _� Y � AppROVA'LS =�permit #� T
a,n E* - �c �, .:: a c - c •.c
s .,� _: ,-' i . r . .� - - � <. >�_� -� ;; `.
21: �DucIs, in Stwctu�e; . .. . ,.� S - -� r ;70. 1Jndergropnd Hpdro -�
22. Ducts, Ventilatingx ' CS �> '?�� �- -'77, ProducfPiping O'Gas QOiI
- n,- - r
I .: i IT .�;:� i,_ r�� '
23CGas_Pipe`Rough&'7est , ns .� ,; - .1 `,. -. _72. Underground Flu"sh�;. ,� '
._,�. . ., . . . � .. _
24�.rRoofFraming � �:--.� ••,- --7 G -r ��-�. 73DUndergmd�.StorageTank�OGas ❑Oil �
25. Rci-f Sheathin ° S Oi x. t�7 b? " C�r. :Y � � �. .-,a.G :
2 9 y „f � , , ��� ;,; �, , 74= Ove ,head Hydrov �
26.:T-Ber Ceiling (StructurAl) 8c�lvlonocoat.� : [r'� `� 75yDry Chemical * �-� - �l%
�� .�
27."�Frame and Flashincj ? ^ � ,S �D �, � L _� � 76. Dry Stand�e � `,' ; � '
u: i '
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No. Date
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicanf to Fill in Completely
IILDING___ .. .� _ .
pyJNER
CITV
gpANCH
ADDRESS
ApDRESS 77R48
CONTFACTOR Q}a
ADDRE55 9461 G
cir� Cypres
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APPLICATION FOR BUILDING PERMIT
RECEIVEDBV DATERECEIVED nnrciemu
BUILDING G
ADDRESS /-
No`826-4550 TRACT
TEL.
No`.826-4550
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UC. NO.
NO. OF BLDGS.
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OWNER
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20NE
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3�OLD FOP. �PECI , RGQU
I �oreby acknowledBa tha[ I �eve reatl [his epplicetion and stete
tha2 the above infarmeNon iz correct antl apree to comply with
ell laws regulatinB buildinp consvuction, and 1 s�ali noc amploy
any Oerwn in violatlon af Ma workman'z eompensetion laws af
tha Stata ot Californie. o
I hareby certify ihac I em proparly Iicensetl as e contractor untler ��o� 50. FT. �-534
tha State of Californie Businesa entl Professions COtla, Dlvlsicn 3, THE AMOUNT SHOWN UNDER V
ChaPter 9, antl that such licencas ere in full forca anC effect, or I THE PURPOSE OF ESTABLISHING A
em exempt from the provisions of the Stete of CaIHo nla Business VALUATION
antl 7rotessions Code, Division 3, Chapter 9.
S��a� ao Stat -Widem Develop r Inc. ,�$' �a^ PERMITFEE
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Permittae -- � PIAN CHECK
AvthorizatlAgent Vice President
TOTAL FEE
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