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Home My WebLink About234 HILL PL - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 234 FIILL PL Suite: Vicinily: RESIDENCE 8 ATTACHED GARAGE Parcel Number: 11910122 Zoning: Applicant: MOORE, DERRELL A Address: 234 HILL PL � - - - " � � -� � �� '� �� -Phone: 949-642-4102 COSTA MESA; CA�? � . � Zip: 92627 7 . , Owner MOORE; DERRELL A Address 234 HILL'PL' � -, .� " - /, ` . � -_ . _ � Phone: � ".COSTA MESA; CA - Zip: 92627 Contracmc �OWNER-BUILDER Address: i.'.. � . , , Phone: Arch : Address: Zip: Zip: " License: 0 i , ' �_ , , Phone: ' � . License: Status: ISSUED Applied: 09/18/2001 Issued: 09I18I2001 t ISSUED BV: - �. ,' r. � / ,'� � -� ' - � �. ��, \ � � �.�. Eng: Address: , . , , Phone: , �` � - License: SCOPE OF PERMIT ` , - -,� - � � i REROOF. T/O EXISTING ROCK ROOF, REPAIR SHTG AS NEEDED, FELT�PER MFGR'S SPECS, APPLY COMP SHINGLES. � APPROX 70 SQUARES � � � � � - � � - � � � � � � Plan Check: ' $0.00 Permit: $69.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 lnspection: , � $0.00 � TotaL• � � `$69.75 �. i� :� SETBACKS ' • � MAW STRUCTURE'Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: FEE SUMMARY , , � , -- - - - = - ' = Calc Valuation: sz;000.00, ' � ' � � %� " Claim Valuation: � � . �2,000_00 ,';, � " - 1.� i: , .. . , . � . _, . .'_ . ,., �,, , PLANNING&ZONWG . , _ �, ;,, , � � � . � Rear 0. 0 �� eft 0- 0 Right � 0. 0 � . � Rear 0- 0 Left 0- 0 Right " 0- 0, ;- � Required: 0 Proposed: 0 NOTICE: The work authorized by ihis permit shall comply with all applicabla handicap access requiremenis under California statutes and related Iregulations. (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 1 BO days. � IINSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2d46-06 (&00) WORKERS'COMPENSAnONDECLARATON: �" I hereby eflirtn under penelry oi perjury one of t�e following tleclarations: ❑ I have end will malntaln e certillcate oi consent to selt-Insure for workers' compensation, es provitletl tor by seclion 3700 of tha Lebor Cotle, for the pertormence of ihe work tor which this pertnit Is issue0. ❑ I have end will maintain workers' compensatbn insurance. fls required by sectlon 3700 of Ihe Labor Code, for ihe peAortnance of the work for which ihis pertnit is lswetl. My workerg' compensatlon Insurence certier end policy numbet a�e: Cerder: Policy Number: (This section need not be comp/etetl i!!be permit is velued et one hundred dollars ($700) or less.) ❑ I certity ihat in Ihe peAormance af �ha work for w�ic� this permit is issued, I shall not employ any person in any manner so as to bacome subject to the workers' compensation laws ot Celitomia, antl agrea that If I should become subject to t�e workers' compensatlon provisions of Sactlon 3700 01 Ihe Lebor Cotle, I shall forthwlih comply with these provisions. Applicant Signeture: Dete: WARNINO: FAILUFE TO SEWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHPLL SUBIECr AN EMPIOVER TO CRIMINPL PENALTIES AND GVIL FlNES UP TOONE HUNDRED T/IOUSAND OOLIAFE (5100,000). IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE UBOR CO�E. INTEREST, AN� ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm Ihat I em licensed under provisions oi C�apter 9(commancing with Section 7000) of Division 3 of the Business antl Profeuions Cotle, antl my Iicense Is in full force and effect. Lic. # Class A Comractofs SlgnaNre: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby afflrtn t�at ihere is a wnswction lending agency for Ihe pedormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's AOdress: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby eflirtn Ihat untler penalry oi perjury that I am E%EMPT FROM TME CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or wunry which requires a permit to wnstruct, elter, improve, demolish, or repair any structura, pnor to its Issuance, also requires Ihe epplicant for such pertnit to flle e signed statement Ihet he or she is IicenseE pursuant to the pmWsions ot the Conirectors License Lew (Chapter 9(commencing with Section 7000) of Dlvision 3 oi the Business and Professions COCe) or t�et �e or she is eaempt theretrom end the basis for the allegad eaamption. Any vlolation of Section 7031.5 by any applicant for e pertN1 subjects Ihe applicant to e civil penalry of not more Ihan five hundred Aollars ($500).): �� I, es owner of the properry, or my employees wlih wages es iheir sole compensation, WILI DO TME WORK, and the slrucNre is not iniendetl or oflerad 1or sale (Sec. l 7044, Busineu and Professions Code: The Contractors License Law dces not apD�/ �o an owner of properry who builds or improves thereon, and who does such work himself or hereelt or Ihrough hls or her own employees, O��tlea ihat such improvemenis are not Intended or oHered lor sale. If, however, the building or improvement is �solC wiihin one yeer ot completion, ihe owner-builder will have ihe burden of proving Ihat he or she ditl not build or improve lor purpose of sale.). I, es owner at tha property, em EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the pmject (Sec. 7044, Business and Professions Cotle: The crontractors Ucense Law tloes not eppry to an owner of propeny who bullds or improves thereon, and who wntracts for such pmiect with a contrector(s) license pursuant to the Contractors License laws.). ❑ I am_axemp� under sec. ID venfietl by drivefs license. Business and Profeuions Cotle for this reason: .�in o-c.vc [ oa�: —%— 1(f— � l ❑ V85 ❑ No DnvBYs LicenSe N0. ExpireS: Varilicetion of Ownership by (rype ot document, i.e. - properry tau bill or deed): DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTFICATION: ❑ I hereby certily Ihat no ezcevation five (5) or more feet in depth into which a person is required to descend, will be made in wnneciion with work euthodzed by this permit, antl that no building sWcture, scallolding, talsework, or demolition or dismamling thereof, will be more than ihirty-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Ttle 8, Calitomia Administrative Cotle). ❑ As owner-builder, I will not employ enyone to tlo work which would require a pertnit trom the Division oi Intlustnal Safery, as noted ebove, unless such person hes e pertnit to do such work irom the division. Sipnature: Date: Division oi Industrial Sefery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUTMORVATION OF EMRV: I cenify untler penalty of perjury iha� I have reatl thls application end state t�et the intortnation given is correct. I eqree to compty with ell stete laws and dry ordinances relating to builtling construction, and euthonze representatives ot ihe Giry ol Costa Mesa to enter upon t�e ebove�descnbed roperty for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until (nal inspection. ��o�p a-.—m� �--a �_;�--o� Signature Ot Legal Owner(s) � "-� Date: `, AnNOr AuthonzeC Applicam Date COQE 1. INSPERIONiYPE 1618 FixeC System Final Fire Prevention 7288 Pool SOe Final 200 Flnal Re-Roo1 201 Finel BIacWRetelning Wall 202 203 Final Factory Fire Place Finel Sign 2oa Final Demolition �g �� ( —r v � LOUE 1 INSGELTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Flnal Elecinwl 272 Final Fire Preventian 220 Final Planning Approval 222 FinalSi�e 250 Final euilding/Occupency I. CIT-V OF COSTA MESA,- ��, — �� CONSTRUCTION PERMIT � Pioject Address, � G 7..5 � Applicant's Mailing Address. .� � i Owner s Name ' � Addrew � � �, . �G'L .' � L ' � Arch/Eng: � � � , ' � � � Add�ssj ' ' ' '' � �.. � . Contractor�sNa'me� � R"�Q ' Address.lmailingl � f . . . i�. : . . 1 City License No. � �. � LICENSED CONTRHCTOR DECLARATION I,hereby.aHirm that ! am licensetl untler p�ovi5i with section �000) ot Dlvislon 3 of the Busin my license is In fulLforce �a�yffecL - I /�oviicant to riu in au soaeei exeePt tnose w�tnin neavv ooraer iines ana siyn a�� aoorooriate aeciarations. � BBS I �/�B/84 ' I � �0 T�. - � PERMIT 0�.. � TRACT NO. LOT NO. BLDG: . � � - � - � � � � � , • � � � ��' .il�l'7�'� . . �, . , : . ' . • ; . �'f�� - ' TVPEOFCONSTRUCTION �NEW ADD ��ALTERATION• REPAIR /��(� F . � ' 0 CONVERSION �❑ DEMOLISH � OTHER q,p, # . ; � „ . - ,Zone. . ' ' - _Phone��q�,[� 'DESCRIPTION OF.WORK _ ��-F�"'—=� , � o�'�.Q. �, �,�� S�. Main Building: � �lccessory Building: , ' " " Z O . � �' TYPE OF RMIT � GRAOING.-_ F�(]S1L�DATION. STRUCTURAL - ' T Front � ' - � �- • , � - ' , � N 14� � ❑ TENAIVT ❑ EI.ECTRICAL L't PLUMBING ❑' MECHANICAL � � B Reaf � � - � � ` ! � I • ' p N ' O �OTHER ' ' '_ , 9 y _ . • � G _Phon , PROJECT OESCRIPTION SQi FT. �� pCCUaANCV C Ri ht K , R e�%J� • � CONSTRUCTION TYPE � � � VALUATION $ � g Left� � � � - _ E .- ' � ' ZONE ' GRADINGCU.VDS. ACRES PIng.Ref.# ! � � . - Park�.Fe¢5 $ , �;� - ' n � � _ u ' � � Remarks: � j . ' ' ' . 7 ' � ' . Parking�Req./Provided � • • � I � �arter'9 (commencing , , � ' ' - _ q 4ofessions Cotle, antl ' . � r � , ' ' • �� ! � Usebf Building: ' . ! � _' � '_ E � � . . .' �w'�..�-i...i5 ' ' -_._-__. .—._ � � .. � . . . . .. , ... . .._. __, . ..._"' _' " ".....__.- " _ �� of .Workers'-�Compensatlon..lnsurznce,j�or-a-certifietl CO thereof (Section ' - • � � � - ' � - �� ' 3800, Lab. CJ � ' � � - � I y Backflow Irr;gation � ' � Sewer Cap � � � . • � - •"' �- ELECTRICAL 1� �� FEES � � PolicY No ;/�\.�'2S\�i'jS�I' � comvanv ' � ' ' ' ' . � . . �,. '" � ,� . . , � \ Cer ietl copy Is hereby turNSFietl. � � . � Ba[htubs � � � Sewer Connecvon; ' '1 ' � 'Automatm Washe�r „„- �. �Transformer 0 15-50 KW � \rtifie qY i fil � wkh the citY B ' n9 �ivisi ' , � . . . , ; � � ; ' i � -� 50;+ KW . ' ; � oat �' '� � Applicant - . , Clanfiers '. � Solar Collectors : � Construcvon Poie Sub ..;� � _EXEMPTi N.FROM_WORKERS C ENSAT.ION.DECLARATION. .._ . - . � D6hWa5hC�' ' ' ' - � ' �• � - - � �(This section neetl not be,completeq the permlt is for, one huntlretl ($300) or � t '' � �� ; - ' "' CoOking Umt 7 �-. � '� •• � -^- �Meter �up•to, 700,amp5 - - - - SolarPiP�n9,t � i � , less): • � i . ' . � . . . . _ . . . , , , I certify�that'in the performance oi the work torwnich this perm�t is issuetl I i � Drinking Fountains Solar Tank � � �Dishwasher ' PI�� p{j' , � �Meter �over 100 amps �. shall'not employ any person in any manner so�as to become subject ro,t�e . , . � . , ' ' '' ' ' � Workerst Compensation! Laws ot California.� �. � � � ,� ! Floor Drains� � - � Swimming Pool w/Spa �- i � I Dryers� �Gasi �Electric I ,Sub Panel � �, ' � Date ' - ' SigndtUr¢ ' ' ' ' ' , • ' ' ' ' ' " NOTICE: If, after makinq�this tleclaration, you shoultl become subject to Ihe � ; Floo� Sinks ', ( � Urinal � ; � I Fan� � � '� I �Motors O0.1 HP �1'/x- 8• � � . Workers'-Comp¢nsation-provisions-ot�!Ihe Labor-Cotle,�you�mu5t forthwith ' - . - -- - � -' �� - � � comply 3with; sucM1 .provision5., or �this.. permrt j shall be tleeinetl revoketl.- � i Gas S¢rvKC � , Outle[s � i � Wdier Closet' � _ � � � � . � • _ , . i-� . i I ^ ; F.A:U. I ;InaSolar��9-15 HP �1�6-15+ CONSTRUCT,IONILENDING P.GENCV�j I c� '. CJ ' �. 1 .� .'.! � v 1 ' . • . . . • .. • I bereby zffirm that there is a;construction'lentling a9ency'tor the performance' . Interceptors ri: �� - � Water Heater � �� Fixmres .. � � - � ' � ' { . . . G/J � �� Microwave � � ' ot the ,work ,(or which. this permit is' issuetl.r(Secbon�309J• Clv: CJi � � Lentler s Name� ' � • � ^ ' ' { � Kitchen Sink• ��Water,Service . - � � ' 6 - - ' ' - . 1 � Lentler'S "Adilress .' " . � ' � '^ �- �• � � _ � � . .� . . r _ � r � ^ � � DeviceBoxes , . � PoleiLight . . , OWNER BUILDER DECLARATION�„' � I 2 � > � � , '-. .Y : `- �Lavatone5' � Q � � � . �� Outlets ' � j � � Range �� j ' ' �� 1 hereby affirm'that I am�exempt irom.[helContractor's. License Caw for the ., -� . _ . � � ' i, -_ , � following reasori.(Section'7031,5'Business antl Profassional.Cotle: Any city or � P-Trapj � 1,;� �; �� q �� t`µ" _ �Switches' j ' ` Sign � � � county whlcti requires a Dermit:to construct, alter, improve', Cemolish or,repair i ,�� . .., � ' � ' �� ' ' 'any�structure; prior to Itz'•i55Uanc¢, a150 reqWr¢5 th¢:dpplicdnt tOlSuch pefmit �� 'RUOf Dfd105 Y� � � �� '? ' ' � ti � � � -' � ' � � - - � � !fo file a�signetl statement'that he/she I5 licen3etl puisuant to the prOvisions of � " '" 7 -�` r Garbage Dispoul. ; ;� � �, Standing Sections � . j �Divison��3�ofrtbe��ense�Law,(Chapter9(commencing,with�5ectionJ000)of'�„ - � - � � .r ' ;, - - � � � �� -� �• : -� Generator�0-5KW�5�15KW ; ,;TrashCompactor � � � • ;Business antl'Professions CotleJ, or that he/she_is exempt � - r �- � r: ' ',.' � � ; � ; • ; � S� � -� , , . therefrom'antl the basis tor tha allegetl exemption: Any violatiomof Sectlon ' ' ' - . . - � - . '703P.5 byiany-applicant for a' permit`sub�ects the_aOP��ant<;o a civil � - "`' �- ' - � ` � ' ' � ' ' � � � : ' r . � �' ' ' � enalty of�not more than five huntlretl tlollars ($500). � ' j �� - � • ; "' ; � � � Remspaction Fee > �$25� � u ! � ! Issue Fee. � -? ' ' $ �? � � � , , � ' `� I, as' owner of tlie�property oi �my �employees�_witli wa9es' as their sole Reinspection Fee ' $25 luue Fee i ; �$'3 � ''compensation, will Go the work, antl theistructure is not intentletl or ofteretl : ,-. �" , � ' MECHANICAL k : - FEES �, �or sale! (Section ,1044, eusiness antli Professional: Cotle:' The Contractor•s � , • � ., � � � PUBLIC SERVICES RE�UIREMENTS: ' } � � - � � � �' License Law tloas no[ apply to.an.owner of a property'who builtls or improves . 'Boiler , •= � � ; _ � Hood o�� Type I �� ❑ '' ; -� ' � ' � '' � '� ` � i Ihereon,�, antl �wholtloes such work,bimself/herself�or through his or her own � � -- �� t � R� - Zoning App�oved By � � - � �ate employees, provitletl th5t such'.imprbvements are not intentletl or otferetlifor ' � �� • Canopy : Type II O, .� �a 1 . . �� , sale. It, however, the bulltlin9 or Improvement Is soltl withln one year of com- � � DucG- Under Ground : � , , ; , qpplication Approved By t � Date � plelion, the owner will have dhe burtlen of proving fie/she tlitl not builtl or im- � � �- . . . . . � � { • • �rove for Ihe purpose of saleJ. . : ( � : , i : ; � � � Duc[ - Struclural � � � � . Refrigeration Systein ; � �.' ! Appliption lisued By • ' � � � Dat ! I, a5 owne� of the property, am eztlusively contracting�with.licensetl con �O-�IOO 000 BTU ❑lOOOOO BTU � ' tractorsto construct the project (Section 70a4, Business antl Profeszions Cotle: ' Duct Ventilating ;� � j , � � i� �' � � � �SUMMARV OF FEES �• � _The. Contractor's License. Law,does_not apply to.an.owner.of property who .� . . - - - �- - - BUI LDING PERMIT , $ SMIP ' $ � bulltls or impwves thereon, antl who contracts for such projects wim a con- ' Exhaust System ❑ MWtiple 0� System Repair/Alteration . . � � �� ' ' tractor(s) license oursuant to'the Contractor's License Law): � . ; � ' ' ' PLAN CHECK i$ � ' PERMIT i ❑ ,I;am exempt untler Section � � � B. & P. C. tor this reason � 'Firepl/Fact.8lt. ICBO�k � � � . , � ' I � � iISSUANCE ' � $ � � � � ' ' ' ` ' � ` PLUMBING � '$'� - oate � Owner• � � Heating System & Ducting � � i � � ' PLAN CHECK . ; $ � � � ENERGV P.C. . $ I hereby` certify that f have reatl this application aritl state tliat ttie abbve ' �❑0-100,000 BTU �100,OOOBT� - - � �_A`+ �. � , � '. ' ' , ' GRADING $ � ��intormatiomivcorrect-.�I a9ree�to�comply with au city antl;county�ortlinances- � - - -�r -�r - � . . ; ELECTRICAL � $ � . , . ; � antl-state laws r ting;to builtling constru ion; ntl hereby authorize repre- � � � � • � � MICROFILM $ ' sentatives o i � city. to' enter upon e a e-mentionea oroperty {for , • � � � � ' � ' . � � ; ! PLAN CHECK � $ ' � . , Inspection urp es. ' � � � ` ' - i I ' � MECHANICAL � � $ � � TOTAL FEE i $ � � U��% � Signatur � G� a� ` � � j � $25� f Y , Issue Fee � � $ 3 PIAN CHECK � $ } � � � � ' • Q� Drivers} ' erise or 55 � � � Reins ctia�n Fee , . . � i � CMF.0865-46rev..7/83�'---N/nite-Builtling;Canary-.AppliwnqPink-Accountirig;Goltleniotl.-Assessor__. ' ' � ` � " " '" � .. . .'_ . ._ ...__ _.._. . _-�...... � _._ _.. _ _ , _ , � � 1 � ' � 4 1 :. . � . . . .�. _ .._ �. ...�.. . .�_. _. � ' . �_ .� ' . . . . . � �v.;�" CONSTRUCT�ION AND PLANNING � �' ' - -' .. . -POOL�& SPA, . . • � � �' Date � Inspector � � ' . . Date Inspector� APPROVALS. Permit # APPROVALS Perinit # _ . 1. Temporary Electrical Service.or Pole - ' � 52._ Pool & Equipment Location - . - � ' 2. Soil Pipe-Undrgmd. . �� ' . ��53. Steel Reinforcement �- � � . - 3.'Electrical-Conduit.Utility-Undrgmd� " � - � ' 54. Forms . � � . ' ' ' 4.' Electrical Conduit-Undrgrnd. .��. ' ' 55: �Electrical Bonding � - . � - � � � 5. Steel Reinforcement • � � ' � � 56.. Rough Plumbing & Pressure;Test � • 6: Electi,ical UFER'Grnd.,' ` -� � � ' �57: APPROVAL TO COVER-GUNITE � _ • ' 7.�Footings, -� � - � .� . 58. ElectricalConduit-Undrgrnd. . ' 8.. Foundation � � ', • , , 59.. Gas Pipe, O Undrgrnd., Test � � ' 9. Water Pipe-Undrgmd. . � �. 60.- Backwash Lines, P-Trap, O'Undrgrnd.� �' 10. Structural Floor System . - �61. APPROVAL TO DECK � ' � - � � ' . 11. Property Sewer Line�& House Connection .� 62.� Backwash & ReceptorFinal � � ,r 12. Sewer Cap ' •" � � �'� � � 63: Heater & Vent-Final � • 13: Roof'Drains . �, � � . ,64. Plumbing.System'- Final � � 14. Rough Plumbing•• � �`' ' ` ' � 65. Electrical�-Final. • - �- - . 15: Rough Electrical=Conduit . ' 66. �Solar System-Final ` ' - ' . 16. Rough Electric Wiring . ' -.- 67: Fericing'& Access Approval ' - ' 17. Rough Wiring Sign _ � - � 68..APPROVED F.OR PLASTERING � - � 18. Rough Electrical-T Bar Ceiling . � '69.%�POOL/SPA Sl'STEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT . � - 20. Rough Factory Fireplace � � ' APPROVACS � Permit # �' 21. Ducts, in Strucwre ' ' 70. Underground Hydro 22. Ducts, Ventilating. . 71. Product Piping O Gas ❑ Oil � , � 23. Gas Pipe-Rough & Test � ' • 72�Undarground Flush � � 24. Roof Framing " ' � . �� • 73. Undergrnd. Storage Tank O Gas ❑ Oil, . � n, , 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. Drywall Nailing , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � � 79. FINAL INSPECTION - 32. Electrical Power Meter-Final. ,' . � ' 80; EFOOD CERTIFICATE ISSUED � 33. Final Electric � . � � Notes:�-' �• ' - 34. Final Heating & Air Conditioning� . �' � 35. Final Gas Pipe-Test • - _ . ' __ . � 36. Hood or Canopy ' . . . . '. � . 37. Final Factory Fireplace � � � ' . � ' � ' � - 38. Final Plumbing � � �. (/( � (�Q � � �� '� - 39. Water Service-Final , . ��/�f (�Q � � ' . � 40. Gas Service-Final � . ' . � 41. Solar pomestio-Final ' � 4 ..' ' ` _ ' � � 42. Backflow Preventer . �� ." � . . 43. Backflow Irrigation � � � � . � � . : ' 44. ,Landscape Irrigation System � • - � . 45. Sound Attenuation � • , . 46. Handicap Regulations � � � . . 47. FINAL STRUCTURE & BUILDING � 48. SpeCial Requirements Complered � t ' f � _ � � _ . � . , ;e 49. Electric Release to Edison � � - - . - - - � , � � '� . ,' 50. Gas Release to Southern Califoinia Gas Co � � � � � , , ' � � � , ' r- 51. CERTIFICATE OF OCCUPANCY� . _ _' , _ _ � " �, . � . � � �, No. Date �� ' � � � . , � - � . �', � � ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT . ' 636 Noreh Broadway _ . . .• • � � I • �- � p . +- SANTA ANA, CAUFORNIA . -- � I � FOR APPLICANT TO' FILL IN ' POR OFFICE USE ONLY � RECEIPT NO. PERMIT NO.� BUILDING � ` � � . � .. G � 9 � ��i� , nooaess �_� /LL L aRHTOWN �ST��T� ��5� �REC�E/I�VEO'BV DATEREC'D. DATE ISSIiED NEAREST �,�sr�ri�iSrEk /�L� �,(f// �. � ��V �� 6 �"�� :J� CROSS ST. OWNER ��T I"F �!!LS EN BUILOING ; � 7// � � ' ADDRE55 1 ,JT / . r i Sre AD RE55�,�� Z^T T� P� SCHOOL OIST.�� MAn .+s • •yO�'_%j ( OR TOWN . CITY �p.� % �(+... �/I �� NEO(� �7J� J NEAREST GRO55 ST.f ARCHITECT OR �r„�� LIC. ZONE - I ENGINEER NO. � H . ADORESS APPROVE � . _ � LIC. BY 000Ress DESCRIPTION I NO. �/'�j BLOCK I TRACT/j'T� (ATTACH METES & BOUND51 SIZE OF LOT �� /�Q I NOW ON LOT Ci USE OF NO. OF NO. OF EXISTING BLDG. Q Fnu:��ies ROOMS a SETBACK LINE FROM� / REAR YARD � � CENTER OF STREET � SIDE YARD _�; DESCRIPTION OF WORK NEW I I ALTERATION I I qOO1TION I�'^ REPA�R I MOVING I I DEMOLISH I 9UILDING a�y�� NO. OF L•�" SIZE CJ Vl ROOMS .J STORIES EXTERIOR WALL/' !� ROOF J�N %' f!]VFRINC �fTUC[_l/ . COVER�NG L USE OF NEW BUIL�ING FOUNO. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FO APPLICATION AND STATE THAT THE ABOVE IS CORRECT UN AND AGREE TO COMPLV WITH ALL COUNTY OR�INANCES FRAME: BR AND STATE LAWS REGULATING BUILDING CONSTRUCTION. AUTHORIZEO AGT._ VALUATION S PERMIT FEE $ , �� 'f� " U1�I �� 'I�FEEA� �� SM 9-30�59 IONS APPROVALS s'.LOCATION I�� q� IATERIALS, / NNING /) � /. � O I A � 2 D r � - PLOT PLAN Show location and distances from property line ond between buildings. \` ; , 1,1\ ,i' `` . _ i ' _ �� _1�::i '��. .. � ' ' -• . . 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