HomeMy WebLinkAbout558 JOANN ST - Building PermitsPflOJECT FOOflESS: S S B JOANN S T
OWNFH'SNAME: MCBRIEN, SUZANNE TR
t aooeess: 1812 ANTIGUA CIR
NEWPORT BEACH,CA 92660
1
` 841-9956
AflLH/ENGINEEfl: NEG.NO.:
aone¢ss:
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UNIi:
uxiT:
PEPMITTEE: PRIMO ROOFING (714)841-9956�
aoonEss: 17066 PALMDALE ST
HUNTINGTON BEACH CA 94627
IILENSEO LONTBALTOfl OECLAXATION: I �ereEy a�lirm Uut I am IicenSeU unGer prmdsions o� CtuD�er 9(commencing wit� Seciion
7000� oi �rvision 3 oi I�e Business an� Pmlessions Cotle, anE my license is in lull force and elter.t.
ciTrucc-.: 007�j639 STATELIC.:33SSZO cuss: /C//� 37 �/��
DatP� '%' J y Si9naWre: / _ ' .)_�J-J—(L:k��i�.lY✓-�'
WOflKENS' COMPEPSATION OELNMTION: I hereby a�um itut I hyve a cenili[ale ol tonsem to selbinsure or a t¢rtilitaie ot Workers'
Compensalion �i �a�.aZaSa2ceju�ieQ3c$py tnerro� ISepwn 3800. LaD. �_1 / O 1/ 9 5
Poucv xo.: STATE FUND E%P. DATE:
LOMPANY: ,y
] CMdka COOY is he�eCy �umishe�. L'J Cen�fie0 woy ¢ itie0 ' � tAe ciry BuiltlingAqfwar. /�
' Da�e��G -9 Y Fpplicani: � i Y�%7W/'V✓✓�'1
E%EMPTIONFNOMWOflKENS'COMPENSf�TI0N0EClAMT�ON: (ilu55lClidlneMnolDeCa WetedilNepemmislorane�uMreC�5100�w1e55�.
I certily I�ai in I�e Dedormance oi t�e work fo� whic� 1�¢ perrttii i5 i55ue0. I stull noi employ any persan in any manner so as lo become
5u01e�� �o ��e Work¢rs' Campen5aiion Laws oi Califomu.
Oate: Siqnamrt:
NO7ICE: II, alter making this tleclaratian. you snoula �ecome suejecl to ihe worker5' CAmpensation orovisions ol Ihe Labor
Code. you must IonnvntA comply vnth such provisians or iks p¢rmit snall Oe aeemed revake0.
CONSTNUCTION LENOING RGENCY: I �erety aflirm Ihal t�¢re is i construction IenOing agency lor ihe Oedormance ol Ihe work lor
whicA inis permii is issuee (Sec�ion 3097. Civ. C1.
�ENOEq: REROOF TRIPLEX
aooness: REROOF TRIPLEX
OWNEB BUILOEfl OECLANRTION: I �ereby atlirm Ilui I am eRemp� �mm the Coniratmr5' SWte lice�¢e Law �or 1he lollowinp reason
ISeclion 7031.5 Business ana Pmlessional Cotle: Any cily ol county whicn repuirts a permi� to wnstmcl, alter. imorove, aemolisn, ar
i¢pai� any slNqure. pnot to its i55uance. also repuirM t�e appGtan� �p� 5uU permil lo lile a 9gne0 statemenl tlWt �Nshe R IicenSeG
pursuant �o i�e pmvisians ol ine Comranors' Sta�e License Law �CluDter 9(commencing wit� Section 7000) of Oivision 9 ot t�e Business
ane Pmlessions COae) ar tlu1 nUStie ¢ eRemO� �M�elmm aM ine qa5i5 lor IM aIICpM eKemo�b�. �Y ���ion ol Stttian 7031.5 ey
any apDlicanl lor a permit suEjecis t�e apDlicant lo a civil penally pl nat more tllan five nunOretl GollaR (f500).
I, as ownei of t�e pmDeM a� my employees wiiA waAes as ��eir mle compen5aiion. will Uo I�e work, ana I�e
❑ simcmre is not intenOeE or ollereE tor ule (SeCUon 70an. Buvneu an0 Prolessimal CoEe: The Contractors' Slate License Law
aoes n01 aOVN �0 an own¢r ol a pwperty wM UuiWs ar improvCS Ihereon, anG w�o tl0e5 5uth vrork himSelU�efS¢II or I�roUO�
�is or �er own emD�Wees, proviAeC ttut sucli imOrwemen�s aR nol inlenC¢E or offereA for Sale. II, �owever I�e buildinq or
impmvemem is sold wii�in one year ol compl¢Iion. Ine owner vnll Aave Ihe Eurden ol Dmving �e/s�e Uitl not builG ar improve
lor Ine puroose ol Sale�.
I, as owner ol I�e propetly. am evclusively coniractinq wil� li�ensetl conitactors to conslmci ihe pmjeci (Section 7044, Business
❑ anA Pmlessions CoOe: T�e Camraclors' State Licenu Law Ooes rwt a00N to an ovmer ol pmpeM w� buA05 or im0�oves Ihereon
and who coNracis lor sucA D�olecis wi�� a conVaclorlsl license pursuan� lo Ihe Coniractors' Slaie License Law�. I am aware
I�al D�ool ol Iheir Worker'S Compensalion insurantt s0oultl Oe prOviG¢A la me.
� I am exem0� under Setlion'. tl. 8 P. Q.
lor Inis reason:
Daie: Mmer.
I eo nere0y tenily Inat I am avrare ol ana unaerstana ine repuiremMis of CaOlomu Meatin ana Safety Cotle Sections 25505. 25533, antl
255Ja anG Iliai I or any lu�urt builOmg acupani wilVwill not (titUe one) need lo wmON "^�� �i0 s�a�e COGes anG Ihe iepuirtmenis �or a
perm�l br consimclion or modifiwtian tmm ihe Au Ouabty ManaAunent OiSlrici. FleSiGeniul consttu[�ion appliwtions are exempl �rom
I�eSe D�ovisions.
Dale: AppliWnl:
I hereGy cetlily Ihai I tuv¢ rea0 I�is ap0���a�ion and state Ihat ihe a0pv¢ inlarmdtion is tort¢ct. I agree Io camply � il� all ciiy antl counry
Of4i0dM¢SdfbSldi¢Idw5f2WIII19�0�NIG111gtM5INC11MdOGl1l�EEydYl110lItCICW=K�Idiivp ollhis �rywoenter n��eaGove�mentioneJ
pr�petly loi inSDeciion purposes.
DaR� SignaWre:
orivei's license or Social Securiry p:
t64��46 Wbile—BmlOing: Green—Coae En�orcemenl: Canary�Applkant: Pink—Revenue: GolQenrod—Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06707
PERMIT NO; B 067074 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: ALT
JOB DESCRIPTION : T/OFF, REROOF W/FIBERGLAS SHINGLES SQ FT: 4.730
CLAIM VALUE: 4,730.00 CALC—VALUE: 4,730,00 GROUP OCC: R-1 /M-1�
COMMENTS: SMOKE DETECTORS REQUIRED PER 91 UBC, REROOF 300,Q$��P�l��}�T�'!+'$�Q�'y
*�r*�**�rx�*�*�r*�r+rxx�r***+r*�**�rx*x�***�*�*�rw+�x******x***�rx �j��t �I�I_il*��i��in✓✓ � +t+t
Z O N I N G R E Q U I R E M E
SETBA�KS JREQUiRED
------------ MAIN BUILDZNG ---------- --------- ACCESSORY BOILDING ---------
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; 42216309 ZNE: REF NO:
PLANNING NOTES>
>
iF 1f it 1E 1E if iE iE if it iF iE 1E 1E iE if M 4 if if 1E iE �E iE iE iE 1E it if if if fE iE k if 1E if iE 1f ff iE iE �E iF iE if if ff iE iE iE if iE if if if 1E if iE iE 1E if iF if #F #F f� 1f if iE 7E iE iF i4 iE iF it iE 1f
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 DATE;
BUZLDING APPROVED BY : DATE: �� �
APPLICATION ISSUED BY: DATE: �1 �(o ��
**it**�E***+��c*+r*******�*3F3F3F3F3F�F'iFiFiF�F7FiF'iF�F±F�FiFif 3F7F iF�f'iF3FiFiF�F3FiFiF�****�tt***ir ic*
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LEGALIZATIONiN F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING 6LECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 72,00 .50
SMIP/NON—AES
PLAN
ISSUE FEE
BUILDZNG—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
i2.50 �.�� �.�0 %2.50 i2,5� � ,��
REVENUE DIVZSION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
%2,0�
72.50 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
.50
if iF if 1E it iE if 1E iE 1E iE �f it iE iP it if ik it iE if if iE ik if iE iE iF if 1E iF K 1E if %iE iE iF aF 1E IE 1E if aF if iF iE iE if iF if if iF ic if 1E ik if 1E 1f iF it it if iE iE 3f iE iF iE iF iE fE i4 ip af iE if iF
I N D I V I D 0 A L F E E B R E A K D O W N
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
SFR 4730 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,730,00
END OF FEES
��i ��is��ia�-aa�o�io9 ro-r
OATE: OS/U6/94 TItiE: 12:03
41 00160108—Q015010� T�] T
DATE: p5/pG�g4 TItIE: 12:02
.50
��.�Q
I ��U��STRUCTIOi Ai� PLAMlItdG POOI & SPA
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; 1. `ompn�ary Ei-:encal Sa.r�ce or vo��o I � 52. Pool & Equipment Lucat on � i
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f�o---- - Date -I ,
AOOflF54 OF BNlpNO: Cj j a ,7'pANN CJ T
��E��� MCBRIEN, SUZANNE TR
�oopE%% 1812 ANTIGUA CIR
NEWPORT BEACH,CA 92660
; 642-1276
1]PL.M.UWq IOOPE39:
MCNrtEtT OR FlANEEP:
111CH OX FNO.'4 AD7XE59:
uc.xo:
cwmicraro ru�:
CONffl�CTORe YIIt1N0
AGDIIEW UG NO.:
uxr: CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 073922
PERMIT NO: B 073922 PLAN CHECK NO: 03400-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP
SOB DESCRIPTION ; REPAIR 20 SQ FT LANDING AT STAIRS SQ FT: 250
UNi:
CLAIM VALUE: 250.00 CALC—VALUE: 250.00 GROOP OCC: R-1 !M-1
uxr:
LICEN9E0 COMRRCTOR9 �ECL�NAT70N: I Mrotr/ ellim uMx panely d par�ury Mel I un Ik�nMd uMar pod�bns W Gheqx B
(cammoncbp xil� Sxtlon 1000) M Di+uon 3 d Ihs Buelnw enE Prolenions Cods, eM my Ilmnw i� In lull loms end aMeq.
cm uc. No.: uc. eusa: uc. No.: EXP :
Uela: ConVeam
OWNEN BIIII�EP DECLARITION: 1 Mnb/ elflrm undor psnely d prwry Ihel I un w��mq Irom Ihs Comroaon lloeriu lew Iv tM
'Mbwip neaon I�ion "lOJ1.5 &»iim� eM Prolmioro Cods: AM ciy a oouMy �Mkh rpuim e parmil lo mmbucl. ettar, imprwe.
imoloh, a repa'r vry �vucturo, pna lo ns ueuence, eYo reQuiroe �M eppliunl In �uc� parmil lo fila e u0�� ��amenl thel M or ahe
. �keiwe wnueni �o ins aowbu W uu conv.em. unm. lew Icheqn s(mnm«,dm wnn s.ao,'loao) a oH:im 9 a �ro
Buur�en uM Prdmiona Cods� a ihtl he a Me u ezamq iMeM1vm vM IM Eean la Ns eMpad mamqion. My videtion d Sedion
]W 1.5 by enY WVlimnl lor e permn wbjetls iM epd�� to a tivil penely d rol mon Ihen Ine Aundred ddlen �550011�
� I.uoxnerdlMpcW�Y«mYemdoR�whwapean�MisobmmWmtlion.xilldoNswuk.eMlheswcturoceMinteMeC
a oMe�ed lar ads (SMbn ]Ou. Butlroa eM Pmlmaiona Cotle: The Comretlan liwnea lawEom no1 epp�ylo en oxewrd popeM
W�p �II�� IX IIIW�� 1�1CIlql. dld'�ip � 6W�1 Nq� �1It119ly IX �1MN IX 1�1fp9h �b Of �1N OMTllf�ll��. P�� l�lq Wth
�wa�em. ve �a �m.�e «on«.a i«.�. u. nowa.�«. m. a,�u��ro «mw�en n.aa wnn�o oo. r� a�d�m. �
�o.�«a�aaar .;u neVe ma w�d.� d wwa'q ne o� ana ed �a n�b a �mww. i« ina wwo.• a..bl.
I. m o.*wr d IM pWeM. em mainrvelY oonirmM r.4h IinrtmE canirecton ro crosvua Ns i�l� l5enion tON. Bus'vise eM
Prolestims Gode: TAe CONratlan Licove law does nal aOV�Y �o en ow�w d VW�Y who dtilM or imV�'o Iharean and wM
mmram la wN qqMs wYh e meurerJoe(a) ficenaeE pusuaeu lo IM CoNrrJan Liwme lew�.
� I em eaemq wder Sectun: B. 8 P.C.. M Nie raemn:
Deta: ��
I do Mrtby cenEy Nei l em eware d vd uMersuM tlro rt�uiremeMa d Cellanu HmEh eM Selery COCe Setliona ?5505. 25533. eM
25530, enE �he� I a eny Mure WiMinp ocapeni will / will nrn (arcb one) nead to campty wih uid meie oodm vM iM repuiremmme br
ero�m�lumn�tructionwmodiRutnnhom�heAr�y wpemnuDmiia.Redtlentielwmeueu wG�iomenmemqivnthme
y,oWaia F(� C
om.: � � 1 �l S Md�:
WOPKER'S COMVE 9ATION DECL�H�TION: I hereby elfim ueder peneliy a a�ury ma d iM Idlovrirp detlervions:
❑ I heva vd ml meinle'm e cenil'cme d coneenl �o eeHinauro br �wrkme' wmpemelion, u prw'Med lor by bed'an �]00 d �ha lebar
Goda, lw t�e pe�mmence d the woh la wNch thia peim� u mued.
� i ne.�.�e w�e �m� �xe�• �w�� ��w,re�. n�c���a w s.u� a�ao a ms �co. coae. m. in� oa�,� d ma
wak lor which Mie permit u inued. MY ��� �mpenae�bn irourenca uirier eed pdiry number ere:
c�«:
aa�r ru�me�
i(n�hi: e«riw, �eed nor a. comWx.e � w w�. � ro, orre ww..e eoNers rsiool ai ha../
p� 1 cMN tM1et in iM pMaime�rw d �M wak la which Iho peimN n 6eueA. I ehell M empby eiry penan A anY m�� � es to
become wbptl lo IM xo�ke�e' mmpefuelion lewa d Ceftlomie. vW ep�es �htl tl I slauk becortw wEjetl lo IM r.wken'
�m waTMo�. d s.ay1^Qa�oCo d ma �.ro. coae. i.nmi ionn»nn comoN wnn � w�
Deta:Po� �. \ I 1� AVo�ram: � a...O�C�
W�mllp: FeNun ro s�cun wolkwi ronpenutlon rorerp� Is vn/nvNl, �n iIWI �u4Ncf �n xrployer ro alMlxl pmaltlw eM
elHl 9ros up ro aw hwCrM thouunC tlolGn (f104WJA �+�Itlon ro tln cwf o/ rompxuetbM1 tlemep� �+provlMe br In
s«non 9la or aro t�Do, cod., mM+,c ana.ttomer', �su.
CONSTHUCTION LENWNO AOENCY: I hereby eff�m uMar penMy d par'puy ihei ihas n e conelrudion bMi'q epancy br tM
paAormence d iha wak In xfiidi the pemit n osued (Sed'on 309), Civ. C�.
LENOEN'S N�ME:
LENOEX'S �ODPESS:
I conity ihet I hevo reeE �his e001celion enE etete ihe� tM ebove inlameiion ia conen. I epree io canpy wilh ell dly eM munty oMinen�a
eM atele 4wa ielalip b WiMiq eanaVuqion eM MreEy eWwr¢e represenlelrvea d Ihu �ily Io enler upon Ihe ebwe�mmlionad qopeery
�����9P��P�rP%�� SUZANNE MC BRIEN
Pnm . ^ [
�CC.hI�/.Q— � C Dme: d 1 I
S� ne�ure ol Oxnar/RBe VRppticenVCOMradw
(5151d6.WP) WINe-Buildiq 8 Selery; GreerFle: Ceiwy-AppYrenl: Fnk-Rwenue; GoWen�aFMaesmr
COMMENTS: REMOVE AND REPLACE SHEATHING/ APPLY DECK COATING
iElE iE if iE iE 1E 1F iE 1E If !E IE !E!E 1E fE !E 3E fE 1E iF iE if iE 1E 1E 1E iE 1E If iE 9E fE iF 1E fE iE 1E iE 1E iE if iE IE iE 1E �E iE iE iE iE if if iF iF 1E IE 3f 3E iE iE iE 3E iE iE fE iE 1E iF 1E iE iE iF iE if 3E 1E �)E
Z O N I N G R E Q 0 I R E M E N T S
S E T B A C K S
------------ MAIN BOILDING ---------- --------- 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 RE9• PROV: PARCEL: 42216309 ZNE: REF NO:
PLANNING NdTES>
i�
1E �E 1E �E 1f 1f ik ik iE if 1f 1ElE fE fE iE fE iE *�E fE iE 1E aE 1E 3E iE �E k 3E 1E If 1E 3E iE iE IE 1E af �E iE 3E 3E iE 9E �)E iE 1E IE k iE jE iE 1F iflE 1E 1ElE 3E 1E 1E if !E �E iE IE iE iE iF iE iE iF 3E if 3E iE iE 3E
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 5
�
ZONING APPROVED BY %- DATE: "
BUILDING APPROVED BY': DATE:
APPLICATION ISSUED-BY: DATE: •2� S
iE iE iE iE iE iE if ik iE 1E if 1E iE iE iE iE IE iElE"iE 3E iE3FiF�iFiF3FTF3Fi�£3FiF�fiFiFiFiF��-Tf ��FiF�7F7FiF7FiE iE iElE iE IE iE iE 3E iE 1E jF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
�.
BLDG PMT PLUMBING ELECTRIC:; MECHANIC FIRE SMIP/RES GRADING
PERMIT 15.00 "„ , .50
PLAN 9,75 .� � SMIP/NON—RES
ISSUE FEE � i
HUILDING—DIV—> PERMIT ISSUE PLANrCHECK
TOTALS----> 15. 50 0. 00 •"r' .9 , 7.5
n, a �.
REVENUE DIVISION TOTALS--> COLLEGTED':
BLDG PMT PLUMBING ELECTRIC MECHANIC
15.00 �
TOTAL PAID DUE
25.25 25.25 .00
25,25 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
,50 9.75
iE 3E iE 3E iE 1FlElE 1E iE iE iE 1El6 if iE IE 1E 1E 1E 9E fE 3E iE iE iElF 1E iE 1E 1E �E if iE iE iF iE.1E iE iE iE 1E IE iE IE iE iE iE �E fE iElE iF 3E if IE 3E iE iE jE iE k!E iE iE iE iE iE 3E 3E iF �E iF �)E!E 3F 1E iE 1E
I N D Z V I D U A L � F'� E H R E A K D O W N
TYPE QTY D E S C R I P T I O N� � � ONIT COST TOTAL COST
SFR 250 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 250.00
END''OF FEES
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1^ � �
COh�'l'RUCTION AND PLANNING � POG� 6 SPA
'! APPPOVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Elecvical Service or Pote 52. Pool & Equipment Location
2. $pit Pipe�Undrgrnd. 53. Steel Reinforcement
� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms
A. Electrical Conduit-Undrgrnd. 55. Electricat Bonding
5. Steel Reinforceme�t 56. Rough Plumbing & Pressure Test
6. E�.earical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical ConduirUndrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9�. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
1 i. 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. Electrica6Final
75. Rough ElectricabConduit ' 66. Solar SYstem-Final
t6. Rough Electric W1�in9 67. Fencing & Access Approvat
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Ro�gh Heating & Air Conditioning FtRE OEPT. REQUIREMENT
20. Rough Pactory Pireplace . APPROVALS Permit #
21. Ducts, in Structure �� - 70. .Underground Hydro `
22. Ducts, Ventilating 71. Product Piping � Gas � Oil
23. Ga5 P�Pe-Rough & Test 72. Underground Ftush
24. Roof Framing , 73. Undergrnd. Srorage Tank O Gas ❑ Oil
25. Roof Sheathing � 74. Overhead HYdro
26. T�Bar Ceiling (Structural) & Monocoat 75. DrY Chemical
27. Frame and Flashing -. Q�� �� 76. Dry Standpipe "
!/
28. I.athing & Siding � " 77. FIXED SYSTEM FINAL
29. Insulation _ • � 78. FIRE PREV. FINAL
30. OrVWall Nailing - HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat . 79. FiNAL INSPECTION
32. Elec[rical Power Mec�rFfnal 80. FOOD CERTIFICATE ISSUED
33. Final�Electric , � Notes:
34.FinalHeating&AicConditioning ' .�J�L[�,,,L�S...-� (��r� (��,��(�
d t -- T
35. Final Gas Pipe-Test � . �.�/s � �(,� 5� �.� ��.f,� �� b
36. Hood or CanoPV " �yy� � k,�y �� o.� T� ��L� - 6��
37. Finat Factory Fireplace � - �
38. Final Plumbing .
39. 1Vater Service-Final . �
40. Gas Service-Final
q}, �{ar pomestic-Finat •
42. BaGkflow Preventer : '
43. BaCkilow Irrigation
44. landscaQe Irripation Syscem ' '
45. Sound Attenuation , '
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -�Q.q �w�
48. FINAL PIANNING �
49. Eleccric Release to Edison • �
50. Ga5 Release to Sou[hem Ca�ifornia Gas Co 1
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builtler verification.
Attention Property Owner:
An 'owner•builder' buiiding permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. ❑ Yes [�No
2. I(have/have not) ,.�[� signed an application for a building permit for the
proposed work.
3. I have contracted
Name L�Rk
Address ���
Phone (']/c� �
the
s mou
(firm) to provide the proposed construclion:
3 OY dJit( City _�
Contractor's Lic. No. � 4"
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide Ihe major work:
Name
Address
Phone (
City
Contractor's Lic. No..
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Address
Phone Type of Work
��?�?��48
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State
of California Health and Safety Code and have completed the above information to the best of my per-
sonal knowledge, in compliance withn t•his State law. (� `
Signed: �/.�c._Q.4ih2, 1Y\�'��,. Date: �a3� ��95
Name: � u ti1i !/u c�2� Etil
(Printed or Typed)
C.D.L. N or S.S. # �
754-5273
City of Costa Mesa
Duilding Safety Deparlment
P. O. Box 317
Costa Meso, California �
CERTIFICATE OF OCCUPANCY N�' 1$i9 C
The Building located at � J���"�fl�J �d �
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances aoplicable ihereto
for p Group � ffi ti Occupancy. �
Use of Building ��Sil . ReesidxccA wSlh attnr�£'1 Lt�roart Pi [fn�'�
Legal Description �' 4'�s �t' ��, _
' (Sae raver�e �ide fo� Malo� ond Bounds)
Building Permit No. �1 Elecirical Permit No.� Pl�mbing Permit No.�6
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
requ�red under Sec. 2306 U. B. C. . req�ired under Sec. 3301 (1) U. B. C. �
17050. CERTIFICATE OF OCGUPANCY. (a) No apartment house, hotel, or lodging house shall 6e used or occupied
until the owner or operator has been issued a valid certificate of occupancy by ihe enforcement agency.
(b) A new certificate of occ�pancy shall be obtained whenever there is a change in:
1) Occupancy classification of a bvilding or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apaAments and/or guesf rooms as req�ired under Sec. 17050.1 (d), California
Adm�nistrative Code, Tifle 8, Chapter 9, Article 8.•
Number of apartments_�— and/or guest rooms
ISSUED TO:
�r r Ii<M' A�iU"t+y�'�t`A�11KTi � F3'�vr
•
�/ ' � i
� ����
t.. i /
�. �.��.,,.i�,..�y, . �,.
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by fhe Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fo�,,, aus+—�r.+—�i_��a r
41
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX ]f] GOHTA MEHA. CALIPORNIA
For Applitant lo Fill In Completely
7YPE OR PRMT
�.�oiNa r ..�
1RE58 .� � eAti/-� S� ,iC
COSTq MESA. CALIFORNIA
wo'Resa 7900 Pacific Bl
c�n �i�tin ton Perk
OR ENGINEeR D SI TS A880C •
ADGRE83 g02� E• 2IId SL•
f'fINTRA('Tl1R Oaner
■ 6TATE
�
USEOF
EXISTIN6 BLDO.
BHTGACK LIN6 FROM
YiY�I
DESCRIPTION OF WORK
% ��-�-----•--.� ��.--
FEE R�CEIVED
�nJ'; r � 9L�
I PERMR
CI o��F�Pu�E�,�y
11[et�P� No. /'1(111
FIRB
ZON{,.� I ouNe�v I pUILOPNO {�/�..1 �
V ' W
��„� � � r'i 1 (j
DBtCRIR10N Q��OlG� ,�1/VI�C.{ T
/A� �, V
A. P. NO. "�J •�I �� /
NOTfi: NO BAVH OVHRHANG SHALL BH LE93 THAN
90' TO BIDB Q RHAR P. L,
PJ1VE8
ALLOWfiD (U.B.C.REOUIREMENT'
VARDBAPPROVED VARDSAPPROVED
MAIN BUILDIN6 ACGESSORY BUILDING
( FROM GL STREET L,
oisrwn
� MOVINO DEMOLI6H MAIN 9
IN6 30001 NO.OP I1 z VAR.}i
ROOMB HT RIHB C. U. P.
IOR WALL SfrC • ROOR -^ �%, � eYPRO'
� �i�6�.✓ f/ -
1 H8R8BY ACKNOWLEqpg THAT � NAV! HEAD THIB APPLICATION
AND BTATH TNAT THH ABOV 19 COHNECT ANG AOR88 TO COM.
PLY WITH ALL CITY OkD NC88 /1N 9TAT[ LAWp q60YLATIN4
BUILOINa CONBTPYCTIp
SIGNATUREOF /� ��'
PERMITTEE
AUTHORIZHD A66ti7
r1ULD
C:e l�.
DATB
� �80. �.
0
THE AMOUNT 9HOWN UNDlH VA �TION 18 POR THe F
PUNPOBB OP 88TABLI9HINa A PBRMIT RHH ONLY. Q
VALUATION �{ /� m
PERMIT FEE $ U 1 `� �
s3�y�— �a^� _
O