HomeMy WebLinkAbout3105 JEFFERSON AVE - Building PermitsCITY OF COSTA MESA
O�pMFS ' ' BUILDING DIVISION
t q
F�, �&g 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 •
� � p - " � FOR INSPECTIONS CALL: (714) 754-5626
• O4'OIITIt�
PERMIT NUMBER:
PERMIT TYPE B MISC STATUS:
APN: 14165233 DATE ISSUED:
Zoning: R1,
ISSUED BY:
C� oOp�
wv+w. ci. costa-mesa.ca. u s
�
BX10�00226
FINALED
10/18/2010
CAC �
JOB ADDRESS: 3105 JEFFERSON AV CM ,.: Suite/Unit:
s, � .. � yp ;��?
Viciniry: � PnmaryOcc _,; � E ��; ConstT e�
SQ. FT: 0 �' � _ - Valuation. � +S3 100 00 ;' " � - _ �
� ' �
SCOPE OF WORK: 2 , ' �= � - - ''�' `��� I
REDUCE WALL OPENING SIZE BETWEEN DINNING I200M AND LIVING ROON1 FROM 12FT TO 10 FT REPAIR DRY WALL AS
NEEDED. NO STRCUTURAL WORK IS INVOLVED WITH THIS TYPE OF WORKr ''
�
.� � ,
,�. � ',. �
OWNER: ROGER XAVIER- r�� r°�� Address:: 3105 JEFFERSON �AV �, �� Unit
City/State: COSTA MESA CA, � ,__„ ' Zip Code �92626, �_ �
Phone: �•w. , �.;�
- s
� i'!',' ' . '. ''�4 ^]t.
APPLICANT:
City/State:
Phone:
CONTRACTOR:
Address:
FLOOR
City/State:
Zip Code:
ARCHITECT:
Phone
ENGINEER:
Phone
Monday thru
�ENBECK JOHN � , '" r ;`. Address: . � �' ' ` � � +; Unit:
r '. _ = ` Zip Code , � :
89-1410 ryy `- , `'�...,i F ; .,s ,
T L�,C HOME IMPROVEMENT INC --- - -�� L�cense No p 2991�61,�=�
.. -. .r. , ._ _
333��S GRAND AVE :,. ,..' .�� s '�-�� .: . . . � ._.' . - �;-_ � :�� � Unit 25TH
LOS'ANGELES °CA �� � , � � �' -' � �� �
90017 - '- Phone ._800 989-1410 r� Cell:
�, �.� . � . ..�, .. . ._ , y,.
r. F _
� _ f License No.'
_
�`- « _. . ,� ��`
' � .��ri . �� �_-�I
,,�, ,. - �� _ License No .
t: �
FEESUMMARY � '� ° ' � ° , �
Building Plan`Check �' ���' , $0.00 r � ' � - �
.: ", .
Building Permit: ; `` ` ��� .- $97.25 `` : .' '
Electrical Permit: � •,. e � „ _, $0.00 �, _r``'' �
SMIP Residential '��; ` "!.$0.00
SMIP Commercial ' � ' $0.00 j
- ,. �.>,r
Bldg Std Admin Fund _ _ -- - $1-.00 �',�:�' � � �� �
TOTAL FEES 598.25
HOURS FOR CONSTRUC710N ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
1ay - 7:00 am thru 7:00 pm. Satrudays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the tollowing Federal Holidays:
NOTICE: The work authorized by this permit shail comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92) I
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. �
i
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable wdes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CODE t. INSPECTION TYPE
16t6 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roaf '
201 Final Biock/Retaining Wail
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
UATE INPTIALS
GOOEk INSPECTONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Finat Fire Prevention
220 Final Planning Appmval
222 Final Si�e
250 FinalBuilding/Occupancy
' onre ixnna�s
x',,1_z-,�
WORKERS' COMPENSATION DECLARATION:
I here6y affirm.under penalty of pgrjury one of the following tleclaralions: -
\ � ///� ! I�\ /r.�
❑ I have and�will maintain a certifcate of consent to selt-Insure (or workers'
compensation; as pro�ided'`for�by section 3700 of the Latior` Code,-for the
performance o( th'e work for which �his permit is issuetl. . , -
❑ I have and will maintain wviM;yrs' compensation insurance, as requiretl by
section 3700 of the Labor Code, fpr the performance of Ihe work for which thi§
pertni[ is issued. My vrorkers' compensation Insurance carrier and policy
number are:
Carrier.
( �hrs seIXron neetl rrol0e mmpleted Alhe permrt rs valuetl af one �untlred dollars (5100) w less J
Policy Number
❑ I ceAify that in [he pertormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to [he workers' compensation laws of California, and agree that if I should
become subject to lhe workers' Compensation provisions of Section 3700 of
the Labor Code, I shall forthwith cbmply wifh these pmvisions.
ApPlitanl's Signalure Date
WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICFNSED CONTRACTORS �ECLARATION:
I hereby affirm that I am licensed under provisions ot Chapter 9(commencing
with Section 7000) of Division 3 Of the Business and Professions Code, and
my license is in full force and etteCt.
Lic. tt Class #
GonUactor's SgnaWre
CONSTRUCTION IENDING AG�NCV:
❑ I hereby aKrtn [hat there is a construc['an lending agency for the
peAortnance of the work (a which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
SlgnaWre Date
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty of perjury that I am EXEMPT FROM THE
CONTR4CTORS LICENSE LAW (or the (ollowing reason (Sec. 703t5,
Business and Professions Code: Any city or counry which requires a permit to
constmct, alter, improve, demolish, or repair any s[ructure, prior to its
issuance, also requires the applicant for such permit to fle a signed statemenl
ihal he or she is licensed purguant to the provisions of ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for lhe alleged exemption. Any violation of Section 703L5 by any
applicant for a permit subjects lh� applicant to a civil penalty of not more �han
five hundred tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the shucWre is not intended or
offered for sale (Sec. 7044, Business and Pro(essions Code: The Contractors
License Law does not apply to an owner ot property who builds or improves
lhereon, and who does such vrork himself or herself or thmugh his or her own
' employees, provided that such improvements are not iniended�,or oRered for
sale. If, however, the building or improvement is sold within one year o(
completion, the owner-builder wip have the burden of proving that he or she
did not build or improve for purpose of sale.). � ' ' -� -
❑, , I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construcl the pmjec[ (Sec. 7044, Business and
Professions Code: The coniractorg License Law dces not apply to an ovmer of
pmperty who builds or improves thereon, and who contracts tor such project with
a contractor(s) license pursuant tothe Contrectors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
Signawre _ Daie
JOS]<6�3I01) - - � � � '
Owner ID venfied by driver s license. ❑ Yes ❑ No
Driver's License No. Expires:
,Verification of Ovinership by (rype of tlocument, i.e. - property tax bill or tleed)-
DIVISION 051NDUSTRIAL SAFETY PERMIT CERTIFICATION:' ��
❑ I hereby certify that no excavation fNe (5) w more feet in depth into vfiich a
person is required to descend, will be made in connection with work auihonzed
by ihis pertnit, and that no building strucWre, scaHdding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) fee[ high (Chap. 32, Grp
2, Art 2, Sec. 341, Tlle 8, Cali(omia Administ2tive Code).
❑ As owner-builtler, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safery, as noted above, uniess
such person has a permit to do such work from [he division.
Appllcanfs Signature
Division of Induslrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupant need to File and
certi(y a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of lhe Califomia Health and Safe[y Code requires, with some
exceptions, that a Business Pian be filed wi[h lhe Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantiry of hazardous matenals equal to or greater than a weight of
500 poUnds, or a volume o( 55 gallons, or 200 cubic (eet of compressed gas
at standartl temperature antl pressure).
2. Does or will the applicant or presen� or future building occupant need�.to file
a regis[ration form for acutely hazardous materials? ❑ Yes ❑ No
(Sec�ion 25533 of the Califomia Health and Safety Code, with some
exceplions, requires registration with the Costa Mesa Fire Depariment by
each business which at any one time has on hand a quantity of awtely
hazartlous materials equal to or greater than a weight o( 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressetl gas at s[andard
temperaNre and pressure�.
3. Does or will the applican� or present or fuWre 6uilding occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous malerials)? ❑ Yes ❑ No
(Section 25534 0( the Califomia Health antl Sa(ety Cotle pmvitles [hat the
Costa Mesa Fire Department may require the preparation, certi5cation and
(iling with ihe Fire DepaAment of an RMPP by businesses which are required
to register acu�ely hazardous materials with the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of the California
Heal[h and Safety Cotle been fully complied wi�h? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or fuNre building occupant require for
the work which is the subject of this application a permit (or such construction
or modifcation from the South Coast Air Quality Management Disirict or from
any other air pollution control tlistrict or agency? � Yes ❑ No
(Sec�bn 658502 of the California Govemment Code requires that the reques[ed
information be fumished on applications for non-residential building permits).
6. Will any part of Ihe facilily lo be constructed under Ihis permit be within
1000 (ee[ from the outer boundanes of a school? ❑ Yes ❑ No
Qf "yes", the facility mus[ meet Ihe requirement of Sections 25534 and 42303
o( the Califomia Health antl Sa(ety Cotle).
7. If a permit from the South Coast Air Quality Management District or other
air pollu[ion conhol district or agency is required for Ihe work which is Ihe
subjec� o! this application, have ail of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance from ihe appmpnate air polWtion
control oKcer). ' � -� ' ' '
CER7IFICATE OF COMPLIANCE: I certify lhat under �penalry of perjury the
��information giJeo above is cdirecL I agree to comply with all'state laws antl
city ordinances regarding Hazardous Materials and Emissions., .
Signalure oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penaliy of perjury Ihat I have read this application'and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building cons[ruction, and authorize represenlatives of
the Ciry of Costa Mesa to enter upon the above-described propeny for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection. .
Signawre of Legal Owner(s)
And/or AulM1onze4 APPb�'anl
Aoolicant to fill In all spaces exeept thosa within heavY bortler lines antl sign all appropriate tleclarations.
CITY oP COSTA MESA CONSTRUCTION PERMIT ?E^^� NO. � T�p.� �q7, O. UNIT NO. � •
�n 1S S A.P. # ��+' Zone
, 'ProjectAddress ��1D� c���ZT{SJ'1� A��" - - '
1 S Main Building: Accessory Building: �
� SNm�� TVPEOPCONSTRUCTION NEW� �ADD .ALTERATION REPAIR . _
.AppliCanYSMailinCgIAddfe/55� � -❑DEMOLISH �OTHER � � ' ,'� FrOn[ . � � ' � - • �
pp1�, �.ryVp MO (,�'1��.Z7�� � �CONVERSION �
- Owne7s�Name ' ^ Phone� DESCRIPTIOry�F WORK/USE BLOG. B Rear � N
� Address . � -AWCi.rDSS, . ' fi'�jO'V8 �V2'7.t✓�--�r� �� O t- t A ,. �'
'(� �A - � � TVPE OF PERMIT • GRnDwG• � FOUrvo.anON LJ 57RUCT RA� ' � Right . � _ ` , ,� N
�. Arch/Eng. License No. _ t� ' K , - _ C+
� Addr¢ii ' ' ❑ TENANT L�S ELECTRICAL ❑ PLVMBING ❑ MECHANICAL S� Left ' _
❑�oTHER � . Ping. Ref. # ' Parking Req./Provided R
Contrector's Nam Phone • � � E
PROJECT DESCRIPTION SQ. FT._ ' OCCVPANCV�,:�_ planning Notes: n
Address (mailin9) ' ' . �iC - M --
y � . , �CONSTRUGTIONTVPE__, VALUATION$ q_l�n��' R ` _ , , T
CityCiCenSeNo. � __ ZONE� -GRAOINGCU:V.DS:- - ACRES � � S.
LICENSED CONTRACTOR�DECLARATION� - -'- '� ' - ' � . , , i � - - '
I�hereby�alfi�m Ibat I am licensetl untler provi51on5 ot Charte� 9(Commencing Remarkz: � � ' ' � �
with section 7000) ot Dlvision 3 of tM1e Business antl Protesslons Cotle, anG - . , . ,
� my license�is In full �orce antl etiecL , � � � ' ELECTRICAL • FEES
� �icensc Class � License No. . .
Datc � Si9nature • � PLUMBING � FEES Automatic Washer Transformer ❑ 15-50 KW
WORKERS'COMPENSATIONDECLARATION Bd�Siftk $hOw¢!5 ConstructionPoleSu6. � �50+KW �
� M1¢reby aftirm lhat I have a certificate'of consent [o self-insure or a certlfiwte � ,
Norken' Compensation Inzurance; o� d certi/ietl cOpy'thereof (Section � ' COOkipg Unit M¢t¢f ❑up [O 100amps
J,'Lab. CJ " . � - � Backflow Preventer Service Sink - - - -
' Policy rvo. ' Compzny Backflow Irrigation Sewer Cap Dishwasher Meter ❑ovei 100 amps �
8 Certiiietl copy is hereby turnishea. � � Dryers OGas ❑Elecvic - Sub Panel
Ce/tilietl coOY �5 fil¢tl with the city Builtling Division. BdthtUbs $¢w¢� COnnCCtlO�
Oate Applicant � ' � Fan Motors �0.7. HP 01 Y� - 8
E%EMPTION�FROM WORKERS''COMPENSATION DECLARATION Clarifiers SOlar Collectofs ' - -
(Tnissection neetl not be completetl ii ehe permit is (or one huntlretl (g100) or Dishwdsher Solar Piping F.A.U. Inc.Solar �9-15 HP �16�15+
less). � . � � �
I c¢rtify.that In lhe performance ot the wOrk.t Ich thls pe�mk IS IsSuetl I , • Fixtures � ' .
shalL not e plo any person in any �� as me sub7ect to t�e Drinking Fountains Solar Tank Microwave
,Workers^ n tion Laws of Calitomia. • ' � ' � ,
te � Signature Floor Drains ' Swimming Pool w/Spa � Device Boxes . Pole Light
� NOTICE: II, after making this tleclaration, you shoultl come s ject ro the Outlets ' � '
� .Workers' Compensatlon provisions of the Labor Cotle, you.must forthwith Floor$inks . - Urinal - � • �w,, ange � _.�� ,
Comply with such p�ovisiOns o� tltis pe�mit, Shall b¢ Oeemed revoketl. _ , . .
, CONSTRUCTION LENDING AGENCV- ' ' ' � GaSServiCe �� Outlets ' � Water CloSet SwltChes Sign -! ,
I he�eby a/flrm [M1at there is a Construction lentling dgency fo� the p¢r/ormance - '
� of (h¢ work tor which thls permit ,is issuetl ($ection, .3097 Civ. CJ : i� Intercepmrs '- - Water Heater -� � Garbage Disposal $tapding $¢C['tOnS �
. Lentler's Nam¢ ' '
�ender's ntldress ' - � � _ _ Kitctien Sink �� �� Water Service • �' Generator �U5 KW �5-75 KW Trash�Compactor
OWNER BUILDER OECLARATION ' � � � • ' �' " •
I hereby affirm lha[ I am ezempt from tne Contracto�'S LIc¢nse Law f0/ the L3vdtOfi25 �AptO-WeSh - Q— 'i �,w' t
following reazon (Section ]031.5 BuSiness antl Professlonal Cotle: Any city or � , , - �
tlemoll5ho��¢pdir ��, F i�
wunty which requires a permit lo construct, alter, improve, P-Trap . .Laundry Tra'ys O �-.�. . i'i-
any slruGture, prior to ils issuant¢,'also requires lhe applicant Por such permit -�-. -
to file a'signetl stat¢men[ that he/she i5licen5¢tl pursuanl to4h¢ Pfovi5iOn5 0( ROOf DfdinS - '
the COMraclor's License Law (Cnapter 9(commencing with Sectlon 7000) of � �, f-� . _
n'vision 3 ot the Businesz antl Protessionz Cotle) or lhat he/she is exempt . - � . Reinspection Fee §75 laue Fee �'_' S
^�•efrom antl the basis lor [he alle9etl exemp[ion. Any violation of Section . � • .
�by any avo��cant tor, a permit subjects. Iha a0�licant [o .a civll -
Ity oYnot more than tive hunaretl Aollars (55001. $ 3 DEVELOPMENT SERVICES REQ IREMENTS: = i � I
as owner o( the oroperty or my �employeei with wa9es as their sole Reinspec[ion Fee $15 laue Fee Zoning Approved By ' _ '; Date `
o p¢nsation, will �o the wO�k, antl [he SVUCtute is not InlenAGtl o�-ofteretl � � �J
. Yor sale' �Section 7044, eusiness ana Professional Cotle: The Contracmr's , MECHANICAL FEES Building Approved By _ � Date
License!Ldw tloes'nOl apply t0'an Owner Ot a property wh0 bulltl5 or'Improve5 - A Lc�tion IAued B
tnereon, ana who tloes such work�himself/herself or through his or her own goiler � Hood or Type I ❑ PP Y Dat
emplOyees, provitled lhal such�improvements a�e not IntenAetl O� otfe�etl f0/ -. . ,' , .
sale. H,,howeveq the bulltling or improvement Is sold witnin one year ot tom- . C2nopy Type I I ❑ ! $UM EES ,
pl¢[i0n,4�e Owne� will hdve the burtlen o/ proving he/she tlitl not builtl o� Im- DUCt - UndE� Ci�Ou�d ' " . , . 1,
. provetorthepurooseofsale). ' " BUILDINGPERMIT $ J• 'SMIP; $
' ❑ I, as owner o/ the property, am exclusiveiy mntractlng wlth Ilcensetl con-, Duct -Siructural � Refrigeration System .• pLAN CHECK $ � PERMIT ' '
bactorsto mnstruct the prolect (Section 7044, Business and Professlons Cotle:; ' . , .
,'Tne Contracror'z License,Law does not apply to an owner ot property who Duct- Ventilating ' ❑0-100;000 BTU ❑700,000'BTU PLUMBING $ ISSUANCE"-�'�$
• builtls o� improves lhereon: antl who,contract5 fo� such oroiect5 wilh a[on-: � ' � �
tractor s1 license punuan� m me Contractors License Law). I am aware that ' PLAN CHECK � 25% $ . ENERGV P.C. $
1 Exhaust Sys[em ❑ Multiple ❑ Sy,stem Repair/Alteretion m+� -
proof o( thev Worker's Compensation insurance shoWtl be provitletl to me.� =��RADING �\$
� . - - � ELECTFICAL � $ „�x � �� ,
• ❑�I am eaem t untler 5ection ' B. & P. C. tor Ihis reason FirepUFacL BIL ICBO # Fire Dampers ��'� ��^ MICROF.6LM1 1$�
. c . • PLAN CHECK 50% $ •
, DareK � ownerD� � • Heatin S stem & Ductin ' Re isters , a-��;�
� ' 9 � 9 9 MECHANICAL $ � TO7 Al FEE $' L,��
I hereby certity that I have reatl'this applicaU n antl ztate that the above - �0-100,000'BTU 0100,0006T � � -� �- (� Snpn �
intormation is correct. to tomply with all Uty antl county ortlinances ' P�N CHECK 25% $ �' J 17OJ �
antlstate laws relatin9 lo bu StructiOn, antl h<reby authoriie �epre- ,
zentatives o( to er o above-mentionetl. Property (or ' � ' � � �/'/
inspect pose . � � ' ' � ' ' ���� .
,Signature Date � ; . � . �L��� ,
orivers• ucense or 55 �#y Reinspection Fee $15 laue Fee '$ 3 , , ��.� ��j W��{�yy9 ;
OB65-46, rev. 5/BB White - Builtling; Canary - Appllcanp Plnk �/accounung: �ioiaenroa - qssezsor
`� . ' , _ .. . . . . . . " ' . . . .. ...
` CONSTRUCTION�AND�PLANNING� � "' �i! , . POOI '�PA _ �� .�;'„-',_.•�
. Date ��Inspector � ' � . ��. ��Date . Inspector� '
� APPROVALS Permit # � - . ' APPFiOVALS Permit # � y '
�,1. Temporary Electrical Service or Pole - .-. 52. Pool & Equipment Location � ) .
t._�
��-2. Soil Pipe-Undrgrnd. � . - 53. Steel Reinforcement - - � -
cn. _
�3. �ElecVical Conduit Utility-Undrgrnd. 54. Forms . . �,��,.
� �4.� Elettrical Conduit-Undrgrnd. � , ' . 55. Electriral Bonding , �� .
•5.�Steel Reinforce4ent. , ; � 56. Rough Plumbing & Pressure Test - , -�; �,, �
�fi. Electrical UFER Grnd. _- � • � 57. APPROVALTO COVER-GUNITE 1'��!
; 7� �Footings . - , t , 58. Electrical Conduit-Undrgrnd�. ' � '•"{`} .
�.:8:- Foundation � � � � • � 59. Gas Pipe, O Undrgrnd., Test . ��
��
• ..��9� Water Pipe-Undrgrnd. - � � 60. Backwash Lines, P�Trap, ��Undrgrnd. . � , ,
'� 10. Structural Floor System -� � i � ��.61�. _APPROVAC TO DECK.�- , _ _ _ _ �
71. Property Sewer Line & House Connection . 62. Backwash & ReceptorFinal � - �
12. Sewer Cap' •- � - � 63.'Heater & Vent-Final - . - �
13. Roof Drains 64: Plumbing System - Final - �
. 14. Rough Plumbing ." 65. Electrical-Final - ' ,
c F
- �15. Rough Electrical-Conduit - � 66.� Solar System�Final - - � � �� . � ,
�,16'. Rough Electcic Wiring , , . , �67. Fencing & Access Approval � - , . - �
� 17 Rough Wiring Sign ,�-, � -
= (;;;'. � . � , " 68: APPROVED FOR PLASTERING � . .
1��Rough Electrical-T Bar Ceiling ' � , '69� POOUSPA SYSTEMS F.INAL �� �
19} Rough,Heating & Air Conditioning ' �� FIRE DEPT.,REQUIREMENT ��
t. .
20.' Rough'Factory Fireplace � APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro -
, 22.�Ducts,-Ventilating �f � � � 71. Product Piping OGas ❑Oil � -
�- �
. ��23:•Gas Pipe'-Rough & T�st . - ' , "' 72. Underground Flush '
�,�4�.' Roof Framing ' � j 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing - 74� Overhead Hydro - �
26. T-Bar.Ce`iling (Structural) & Monocoat -�. 75. Dry Chemical
��27. Frame and Flashing - � � 76. Dry Standpipe � �
.- '28.�Cathirig:& Siding � � ; � 77. FIXED SYSTEM FINAL �
- 29.. Insulation ' .. • ' 78. FIRE PREV. FINAL
- 30.'DrywalhNailing " � i�. 'HEALTHDEPT.REQUIREMENT �
' 31. Plaster Brown Coat ��� � n � � � 79. FINAL INSPECTION - � - -
32. Electrical Power Metei�Final � ' 80. FOOD CERTIFICATE ISSUED
� 33. Final,`le�tric ' '� � , � � Notes: - � � �
34. f-inal Heating &�Air Conditioning ' . � � � � � �
35. final Gas Pipe-Test � • � � t - � � �. � � ` ' ��
' B6: HOod or CanoPY � . . ' . I -� � . . , • �rT. j , . , . �
37. Final Factory Fireplace ,f ' • i � ' ' �
�38. Final Plumbing' , ' � � � �� �
�.
`39. Water Service-Finaf'� l � ' - � �
� i - �
40. Gas Service-Final `^. � , ' ' . i . `,� r �
� 4,1.. Solaj`DomesticFinal � � � , � � � . ' /-y ,/ � ' �` � ,
42. Backflow Preventer �. ' � : � � , � :{� � ���, j.
43. Backflowlrrigation��- - � �: ' - '`"^� 't':`„ n
44.',Landscape,Irrigatio��System � . . �: gCtlOfiS' �{:�-%' �
45.-Sound Attenuationf� , -•� � , ��" ' � . . -.
i i
1 46.=�Handicap Regulations . +� - . . - � .j
Lh
47. FINALSTRUCTURE�& BUILDING _ � � ' � � , • ' � �
� 48. Special Requirements,Completed � � � • �
i ��
� ., �49. Electric�Release to Edison ' � _� _ � �� J;
.50: Gas Release to•Souttiern California Gas Co � � �� ��"'� ' �� �
�'^ : .,c'
,--i 51. CERTIFICATEOFOCCUPANCY ' i� ;�j' !�: �;��- , '� ,
No:. ._ � Date � � . • . � / ��
., r
.._. �... - - �' : � ; _ --
;a , �
. . ,8�5� FE REC�I�'ED
COSTA MESA BUILDINGSAFETY DEPARTMENT FE8 1 y 1963'
P. o. Bo, s,� COBTA MEBA. CALIFORNIA FiNANCE DEPT.
For Applieanf fo Fill In Completely APPLICAT10PiljFOR�PERtv11T' MESA
TYPE OR PRINT gUILDING
BUILDING
A�DRE66 �0 e e�eon V p%Z�e � .
COS7A MESA. CALIFOFiN1A ", FOr Office Use Only _
�CCCL�.��� LOQR OR! Q/I, 'AQCEIPT rvo. I e n r y f
OWNER �
hiAll. p / RECEIVED 9Y �ATE RECEIVEq OATE I66UED
ADDRE55 ' 22 Ha�.bo� U�CV�. ���� 1 u 1`�B. F�� � R teC �
n� TEL. /.CO O BUILDING / � � '
crrr � UA.ta II�P..02 No. Yo qDDRESS
ARCHiieci �' � � ie�. 7.. � COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRE55 ' FIRE
/� �J^ J�/ ZONE TYPE G/ GROU �
CONTRACTOR 71� �ell I7• QCA-�OOi'a• BYPROVED DATE �
ADDRESS � O� F�Q�.��� Q R U/L4.V2 ZONING
QeVQ/� 77�4 �L O/LRCQ ��NE I NO. OP I use oc New s.� �d,.,,r�y
CITY R�� PL.hNB � BUILDINGf✓/q Qr.
STATE 7/.' ' TE�' R�VO9 �O Lee�� '�^' {
LIC. NO. Y NO. • DEBCRIPTION �� � `� ✓�/ l�� 'i 6og
SIZE NO. oF Btucs.
OF LOT NOW oN �oi p, p, NO.
U6E OF ' YARDS � EVES
EXI6TING 9L�G APPROVED ALLOWED
86TBACK LINB FROM �; �� lGlNTER LINH 6T.1
ceNien ov aTrteer REAR YARD FRONT SO FT. IN.
SIDE YARD I IEFT I RIGHT R. 61DE �r FT. -- IN.
� DESCRIPTION OF WORK ,5 _
L. SIDE FT. IN.
NEW ' I X II ALTERATIaN I II AD�ITION I REAR 3� -�FT. 3 �N.
REPAIR I IIMOVING I IIDEMOLISH I BYPROV � OATE �-� ��C'Z
8 ZIELDING 2 X� ROOMS O STORIE6 �
I
E%TERIOR WALL �. IROOF ip / p n /
� / �o . a- <or� `6 p _-a3k/� °
I HEREBY ACKNOWLED68 TM�T 1 X�VE RG� THt9 APPlJCATION TME AMOUNT BXOWN UNOEp VALUAT�O� IS FOR THE
'ANO BTATE THAT TH8 ABOVB I6 CORRER AN� AGREE TO COM- pURP09E OP, 88TABLIBHING A veqMlT FEE oN�v.
PLY WITH ALL CITY �INANGE9 AND BTA WB ULA O
Bu1LDINa cONe . VALUATION � ',.,�)
61GNATURH O > - PERMIT FEE $�� V�
PERMITTE n . /-A �
� $ . / � O� [( �"' PLAN CHECK S �O•�O_ F
� �! / /
AUTHORIZED AGE �p�.Jd o
TOTAL FEE LL
/%��J