HomeMy WebLinkAbout662 JOANN ST - Building Permits�I
�DDNESSOfBVILpNO: �
awr+�raru�EiF�v�.'N: 662 JOANN ST
�o� PEARY, SARA A
662 JOANN ST
COSTA MESA,CA
�vr�. Yu�mo �no�ss: 5 4 8— 4 8 2 9
�qCNRECT011FNOMFFA:
MCR OH ENQ'S AODNESS:
UNT:
92627
uc. xo.:
urrt:
wxm�cTars wu�:
CWfR1Ci0R9Y41M0 ALL HOME REMODELING ( 714 ) 532-5380
�oox�ss 1403 N BATAVIA ucno:
ORANGE G CA 6uBi0501'^1 �
LICENSEU CONTXACTOPS UECLRNRTION: I hereby eflim �Air p�dX�d perjury thet I em licenaed uMer poviebnl��wwpm B
(cwnme�rq vnlh SsUion )OW) N Oiviaion 3 d Me Buairien enE Prdeecana CoEe, my licenee ia in full end eX .
cmuc.No.: y�G_f��jGCLf55: fe� LIC.NO.: � �
053613 B 00501 EX : 09/95
o,�,: comrea«:
OWNEN BUILDEP DECIAPATION: I hmeby d�um wEer penely d perjury �!W I vn ewnq han IM Caarmon licws lew la iM
Ybwip raemn (`�� ]0]1.5 &miau end Rdaveqne Code: Aery cIy w mumY �� AG� e pe�mil to mmbucl. Ms.'unpwa.
emd'eh, or ropei any evuciure, pria m na eauerica, ebo requiiu iM epplimnl lar azh pmnil �o fib e eqmd stetemen� �het he a eM
. i��.ee w�.m w in, nw�. a me com�aa. um�.a �. ICMqp 9(mmmentiM xil� Sedqn )OOO) d D'veion 3 d Ihe
Busrow vd Rtlaaiom COCeI a thel he «aha e uemq iMralmn uW iM Dem la IM albpad a�emq'v�. My vdmion d Satlion
)W 1.5 Ey eiry eppYrent Iv e psemn vdjxu Oa eppf t to a eW pmelry d iw maa tMn Ms hwWaE tlo0an �SSOOD.
� I.mowrwrdiM1epW�YamVamdW�xthwe9a+mtMiwNcomOMsetian.MPAOUaxork.eMtMevudunum�imeMW
a oflmed lor eeb (5eclnn IOM. Butlrma eM PMaeuwu Coda: The Comreaon lioriea law Eom ml xppyto an oxmr d papsry
vM buWs a inpaw� ihaean. aM Ma do» auN xak IcneeH a hasd a Ihraqh he a Mr own emOMws. pa'� tMl wN
'unprv.emmua me ew "vuendeC a a11ueE ta eab. tl. howewr. tM builtl'up a inpo.wnem o wIC wnhin ona Y� d mmplation. ths
owrcrbuiNs wiA I�m �M buMen d pwi�q M or eM d'd nd ddk a impow la iM qrtpms tl vb).
� 1. m oxner d ihe prtpem/. em utlwrveN �iree'vq wilh liceneed wnvectan m conetrutl IM pqetl (Setlion 10a1. Bueiroe� vd
Pmfevim� COEe: TM Conir+dwe lironx Law dros m� WWY b an onner tl pW�V xM buiNe a im0�'m tlw�son ud xfio
canUew br ocn pqw� wvh e meimaNa) lican�ed punuw to iM Comrm«e Liw�ue lawl.
� I em axemp uMer Seclion: B. 8 P.C., M Nu �meon:
Dele: ���:
I do Mreby cMity iM� I em awere W eM uMenieM IM reqWremanu W Cel/omu Ileellh eM Sdery Code Sediam 25505.15SU, aM
255�4, end ihei I a eny Muro WiMilp odupent will / wil na (rirtb one) neeE io comply wIh aeid Mte mdee eid tM'equiremenn br
epermillormnei�uciionormaCifiratianhaniheA'x e�i Siity enepemamDiwna.Ravidemialconelrud'anepptiraliomvseemp/mmNeea
yroN.bna.
Dme: �pP��:
WOFKEN'8 COMPEN9ATION DKLAN�TON: I MreEy eifi�m unEm penMy W pajury aa d tM IoOowi�q dedarmuro:
� I hew uM xY memian e eanArate d omsent io satl�inma br Mdkan' mmpawtion. m Mwidod b b/ SMion ])00 d iM taEar
coe.. io. iro v�+�s d m. wn� �«.n:�n w. v� e n.�»e.
� I heva eM xil meiNan �whse' mm�c�'vmneroe. m npu"vad by Saaion 9"!00 G Ihe LeEor Code. br iM pMamx�os tl tM
work la whiM ihia prmil o wsued. MY waMeie' canpommion imurerca cerrix ud pdiry number ma:
Ceerim:
awryr+�c« EXPIRES
rrn;,,��„�e.a�ww�de�eeim.w�e�m�2�?�rd�'4IdA�b!'�4 O1/O1/96
❑ i cenry ihm m the p«lormence M �M wark br xfiich �hie parmn ia mued, 1 ehdl ral ampiry vry paean in eny menner m n to
Mrnne w4� lo IM xo�ke�e' mnpe��ntion bwe d Caftlanie. W aprte Mel ! I MwM Eecame wbptl to iM worYan'
cwnpametbn provieam d Sedion 3]W o11M lebor COM. I tlWl lon��� �
, o„e 4� G—�r now�a�� ��9�/L� b
W�m/np: Fellun ro wcvn workeri rompruetlon rowrp� h vnlewNl, �ntl �N/l sW/�cf an employer ro cr/Miul p�n�ltlu end
Nvll flroi up ro m� h,nLrM thoua�ndlo/Mn /ff00,W0A /n sAsltlon ro M� rost ol rompaueWR ��W+� �i WovMM br In
SxOon 3)06 0l M� LeDorCorb, Irrtsisat, enAefromsy'a /w�.
CONSTNUCTION LENOINO AGENCY: I Mreby �rm urder penelry d perN'Y �� �Mrt b e mnm�ueion bMi�q epancy M iM
paAamarce W iM wk la xfiiN �he osrmi o ea�wC (Seaion �09). Crv. CI.
IENDEP'4 NMIE:
LENDEN'S100NE%:
I eeniN �� I Aew eetl Nc eppliee�im aid uela tMl tln ebws'v�tarmatian o eanM. I ep�r lo mnyy xrt� e0 dy end wunly adieu�w
9M C�81G IBM IBWMi b �III��N taW1uOIM B�d MM�t�NMf¢! A�XMM�MIM1M d �M1i!!LY b MYaf YV� lM BbdG.mM�IMlE pIOpBlly
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(S15tJe.WP) WM1eo-Buld�q 8 Salery; GrwmFb: Cenery-Appicem: Rnk-Rwmue: Goldmro�/asavn
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 071806 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE; PLU
JOH DESCRIPTION ; INSTALL NEW RECPTACLE FOR GARAGE DOOR
CLAIM VALUE:
CALC—VALUE:
GOVT: N SUPP; N
PURPOSE: OTH
SQ FT:
GROUP OCC; R-3 /
COMMENTS; REPLACE WATER HEATER, RE:RE71805
ititir�r+r+r:ir�-frxirir�rrir*�r*rv***ir*ifw*+r*+r***ir+rr�r*+r*r***r*�r***r+r.+rr**r��t*�*r�+Fr*r*ic-*r�ir�t��
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 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
PARY.ING REQ: PROV; PARCEL: 42215107 ZNE; REF NO:
PLANNING NOTES>
%
it M if if iF ik iF if 1� jf if if iE iE �t if it 1E M if if if if it if iE if 1f i! iflf if if 1f if 4 M M iF M iF i! iF if 1F 1F K if 3E iE Y i4 if jF iF if if ff 1f 1F jf M 1f i4 iF i! A4 ii !f iF iF K iE if 1f if iE 1f 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 T S
20NING APPROVED BY ___ _ DATE:
BUZLDING APPROVED BY : DATE;
APPLICATION ISSUED BY: DATE:
ifififififlEif�1(�iEififififif%ifiFii4M�lEiE iE 1EifiF iF ifiM1afMi4i:jfit�R 1R1FIRiElfiFifMif�K Mi4�*{{{FjRiE
LEGALIZATZON;N F E E S U M M A R Y STRUCTDRAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7,00
25E SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7,00 20.00 0.00 27.00 27,00 .00
RE��ENUE DII,�ISION TOTALS--> COLLECTED; 27.00 OVEA/SHOAT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK
27.00
K'1f Y 1F if if if'N' M-1f if 1F')E'IF'IF 1f'IF 11' if If ik if if if'N' if iE i(' iI' If iE iE if IE �E'N' 11�lf'M 1f if k' If ii N' il� iE 1E iE �f'If iF iE 14 if if iR if 1R iR if K 1F iF Y 141L M-iE ii % M if iF 1F #' 1E'If if
I N D I V I D U A L F E E H R E A K D 0 W N
TYPE QTY
PLU 1
D E S C A I P T I O N
WATER HEATER AND/OR VENT
END OF FEES
UNIT COST TOTAL COST
7.00 7,00
Of D�Jii947i—Q0179477 �'t=�� �7.��
�iATE: C4./O6/95 TZhE: 13:34
C(SNSTRUCTION AND PLANNING PO y SPA
APPROVA4S Permit # Date Inspector qppROVALS Permit # Date Inspector
i
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2, Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduii-Undrgrnd. 55. Electrical Bonding
5. Steel Fieinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UPER Grrtd. 57. APPROVAL TO COVER�GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd. '
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Uhd;grnd.
10. Svuctural Floor System 61. APPROVAL TO DECK .
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor�Firsal
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final , '
75. Rough Electrical�Conduit ' 66. Solar SYstem-Final '
76. Rou9h Electric Wiring 67. Fencing & Access�Approval
17. Rough Wiring Sign �. 68. APPROVED FOR PLqSTERING
18. Rough Electrical�T Bar Ceiling � 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. ftEQUIREMENT
20. Rough Factory Fireplace APPROVALS . Permit #
21. Ducts, in 5tructure � � 70. Under9round Hydra
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test. 72. Underground Flush
24. Roof Framing ' 73. Undergrnd. Smrage Tank O Gas ❑ Oil
25. Roof Sheathing - 74, Overhead Hydro
26. T•Bar Ceifing SStruceural) & Monocoat � 75. Dry Chemical
27. Frame and Flashing _ 76. Dry Standpipe .
28. Lathing & Siding .• " 77. FIXED SYSTEM. PINAL
29. Insulation � 78. FIRE PFiEV. FINAL
30. Drywall NB���ng ' � HEALTH DEPT. REQUIRE(41ENT
31. Plaster Bro�vn Coat � 79. FINAL INSPECTION
32. Electrical Power Meter�Finai 80. FOOD CERTIFICATE ISSUED �
33. F(nal Electric � Notes: "-...4 � �� o
34. Final Heat�ng & Air Condit�oning ,
35. Final Gas PiPe-Test � � �
36. Hood or Canopy • ' . .
37. Final Factory Fireplace � �• -
38. Flnal Plumbing � 5"_� •-�S
39. Water Service�Final .
40. Gds Servite-Final �
41. Solar pomestic-Finai ..
42. Backflow Preventer '
43. Backflow Irrigation
44. Landscape Irripation System • ' '
45. Sound Atcenua[ion . . '
46. Handicap Regulations -
47, FINAL S7RUCTURE & BUILDING
48. FINAL PLANNING � �
49. Electric Release to Edison �
56. Gas Release to Soulhem Catifornia Gas Cn �
51. CERTIFIC%1TE OF OCCUPANCY
No Date
�I
�
RODFESS OF BUILdNO:
OWNENSN.WEIFIWOWN: �jGZ JOAP7N ST
wontss PERRY, SARA A
— 662 JOANN ST
� COSTA MESA,CA
�vv�. iuiuxc �oo�ss: 5 4 8— 9 8 2 4
RPCNRECT OA ENf1NEEN:
MCX. Ofl ENG'S �UOPE55:
UNT:
CITY OF COSTA MESA — HUILDING PERPIIT
92627 PERMIT NO: E 071805 PLAN CHECK NO: N
uc. r»:
uNr:
coNrn�craas xu¢
CdPPACTOP'SMNIJNO ALL HOME REMODELING ( 714 ) 532-5380
�oo�ss: 1903 N BATAVIA ucra.:
ORANGE �'J CA EyQr05011
LICENSE� COMflACTOFS DECI�pATION: I hereby eRim ��r19ry d perjury tlW 1 am licenaed uMm pavroM�x 9
(commena�p wil� Saclian 1000) W Orviaion 3 W Ihe &nineas end PManaiona Gode, eM my lioenae o in lull lorce entl aMed.
CITY LIC. NO.: L1C. CL1�55: 11C. NO.:
�361� H 600501 EXP; 09/95
o�e: � �1 �,�� c�um«:
vp�
OWNEN BIIILUEN DE�UIPRTION: I haiaby elfiim unEx paraly d perjury ihm I em azemq tmn �M Contrecwn Liceiva Lew la Me
'dlowiq reawn (�� ]03t.5 Buairess eM Prdessons COEe: A'ry cily a oounlY +M�+ �Qui�ee e permX lo mmtrua. ellx. impove.
emoleh, a repeir eny ewciure, pna lo ile eauence, e6o reQuirea tha epdicent la euch pertnil lo file a eipneC ele�ameM thel M a she
a IioereeA W�s��e�� to tM pwaiona d IM Conlreqon Licenae Lew ICheqm 9(oommend�p xilh Sedion 1000) d Orvebn 3 d IM
Buriiwaa vM PrWessiwa Codaj w ��m Ire a sM ia eKemq ihselrom arM ihe bnie /a the elbpad ssemqun. My vulmun d Sed'an
)031.5 by eny epplicenl /or e parmn euqMe Ihe wWicanl lo a civil penelly W iwt more Ihen tNe huMreE dollere �5500��.
� 1. ea owrwr o/tM P�PanY a mY a^WW� �h we0� %+tM1ei ede campenaelbn. will Eo Ne wwk. enA tM al�ucture c nd intendeA
w oNared br sele (Sedion ]010, Buvmsa eM Profeasbu Cotle: TM ConlretYac Laensa lewdwa nm eppyto en ownerd propany
wM WiM a in Wm'es iherom. md who doee autli wak FimseX or henN ar ihmqh he a har own emdM�e. p�eE Ihet awh
improvementa ere rot inleMaE a dle�ad lor cele. tl, haxever, iM buikifq or'unprovemem ie eoN wilhin om yeer d mmWa�nn, �M
owrer-0uiqer will heva iM WMen d pa+iip he or she d'd m� Wild a improva lor iM WT�e d eele�.
� I. m ovmer d �he propeM. ��duarely contretlin9 �h lioenaed convectwe to canavue iha pmjetl (5epun )614. Buaireca eM
Prdesvone Code: The COMrepae L'rense law doas na epply lo en owrrer d popaM ��iWe w impwp tharson erd wfio
conirecu for s� prqeea x+�h a canlretlor�e) licanxtl W�e�l lo �ha CaNretlan lioeme lawl.
❑ I am eumq uMar Seclion: 8. 8 P.C., la ihie reeaon:
Dma: Owner.
i ao ne�ev anM md i em aware a a,d �wers�,e ine �ea���am a cd���e H..nn m,d smmv code s.a�. nws. zssx�..m
55
25530, eM ihel I a eny Mure WilEi�p omupani will / wil nd (axb wie) need to comply wIh eeiE atete mEee aM Ihe reQuiremenb fa
eD��lamret�uclionamotlifrationhamtMRi�y enepamemDiCritl.Rmideniidcmm�urfianeGG�'voenuemqhaniheea
o,��m��.
Deta: APW�I:
W OPKER'3 COMPENS�TION DEC WiAT10N: I M1ereby eMim ueder penelly d pa�jury aro d Na idbrriiq Eetlaraznns:
� i neV„�e �e mdm� e ronnkma a�m �o.en-��,uro ro� woM� ���.m�, m aw�aee ia ny sm� a�oo d m. �n«
Cotle, iw the perlarmence d Ihe xoek la which thie parmn in ivuatl.
I�I heve aM wil meintan xvMare' oompenselion inaureMe. av �uireE by Setlim 3J00 of Ihe lebor Cada. lor iM pailormenro d the
wark lor xfiich ihie peimn ia ivued. My warkers mmperiee�ion imurence urrier erd pdiry number ua.
Gemer
voiwy rv�mn«: E X P I R ES
m�;=�«.���a�wo-e�aa��+��va+����2�2 ��73�TwT 4 O1 /O1 /96
� I mMtly Nel in iM perlormarice d Ihe work lor whch �hie paimM is iaeueE, I ehell iwl empby arry perem in eny men�wr eo m to
bacoma wbiea fo ihe xorMms' camv��bn bwa d CelEanie. erd qns �M� d I dwuN becwn9.A�M� m �he xvM1en'
Oaie: �-' L� Z J AvWeeiv: o fL� / ����
v
Weminp: Fa/lun ro aacun woikr�'romyxuatlon cavxry� ls unbwNl, �ne �Mll �ub/xl �n wmploysr fo crlMiul pxieM/u �ntl
c�vn nns. w ro on. nunerw trouuna daMn (sraa,aoal, �n sa+�aon ro aro m.r or ronwerua�an, dams�ps o wovwed ror �n
Srotlon ��f16 oI fhs Labo� Code, Infereq antl ettomey'c /ww
CONSTHUCTION LENdNO �GENCY: I hereby elfiim unEer penetly ol perjury ihm ihere ie e mnalmd'an bMinO e0ency Im IM
peAormenca d ihe xwk fa whiM thu paiml re awed (�� �). C'v. CI.
LENpEN'S NAME:
LENDEN'S ADONES3:
I caniry ihet I neve reed inis epplcelion end e�eb inel tne above in/ortnelion ia corted. I epree lo comoN �n ell dly ene munry aCinencee
erMstelelennl iploWiWvqcmriWion dh yeNhor�e�epeaemmrvead�hcarytommxupontMabon�membnedproperry
Iw inspmi �rpos �� �� r
P' le . , i /1 �.
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Sie�elur erlApenVRppGfanVConireaa
' �5151�46 WP) W�Ae-BuiWvp 8 Sdery:Oreerr-Fle: Carary-Applum; Fnk-Rsrenue; GdEenrod-Aeaeseor
CONSTRUCTION TYPE;
PERMIT TYPE: ELE
JOB DESCRIPTION ; INSTALL NE4I RECPTACLE FOR GARAGE DOOR
CLAIM VALUE: CALC—VALUE:
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS; REPLACE WATER HEATER
�+�+r�t+t*+r+�-��-**x-�-*��r****«x-�*�-*a�*�a�*x+s-*��-*+r�r w�-+r*�r+c-**�r�x��-**�+r***�r«�*�r*�r���x�+r�r x���+r�*+�*�c�-a.*�
Z O N 2 N GS ERTEB�AUCII{RSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRP]T; FT IN REAR: FT IN FRD]T; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IP7
PARKING REQ; PROV: PARCEL: 92215107 ZNE: REF NO:
PLANNING NOTES>
i
iE if iF 1f 1F iE jE if iE M �f if if !f if �f 1f �t 1f 1f iR if 1f �k iF jf jF fE jf if 7F jE iE �E �F iE 1F fF 1t 1F �F 1f iE �f if # K it if if �f j! iF iF 1E iR 1f if �c 1f 1E 1F if iF 1f if iF iE if iR jt- if if if if �f i4 aE jt
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:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: 5 DATE;
x�r+r-ir+r********�r****r*�f**��iT�*iF3F�3F�r���C�'��iF*��*��id'��T��**���ia«�+�***r* *3 �c* a* F* *ar-
LEGALIZATION;N F E E 5 U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT ,75
, SQ� SMIP/NON—RES
PLar�
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID D[JE
TOTALS----> 0,75 15.00 O,QO 15.75 15.75 .00
REVENUE DIVISION TOTALS--> COLLECTED; 15,75 OVEA/SHORT: .00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN—CHECK
15.75
1Fifif jE1f 1f1f if �f Maf if IfM if�l! ifif�lf 1f KiF1f iE�)f 1f if'1kiFifif it it 1f iE jflf ifiF 1f !F 1f 14it 1f ff if # M i6ffif 1M 1F iE 1f it if M1E M fflf'k�1t�1F-lf 1F�1F if�lf 1f 1f�X-1F iR if-i� 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 S C R I F� T I O A7 UNIT COST TOTAL COST
ELE 1 RECEPT/OUTLET 1 ST 20 EA, ,75 .75
END OF FEES
EXPIRED(�� f,,�'
DATE,�_,l,��l � �' V
et uC1�9y7b—CD3T94J6 -r aa�-
GATc": 4n/C6/95 7ifiEe 53:33
0
f�. /:�
w
GONSTRUCTiON AND PLANNING �'.Q� y SPA
Af'PROVALS Permh# Dete Inspecror APPROVALS Permit# Date Inspector
t. Temporary Electrical Service or Pale 52. Pooi & Equipment Locaron . '-
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Electricai Conduit Utll9ty-Undrgrnii. 54. Forms �
4. Electrical Conduit�Undrgrnd. ' 55. Elect�icai Bonding , �
5. S[eel Reinforcement : 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Gmc. 57. APPROVAL TO COVER-GUNITE •� •
i
7. Footings : � 58. Electrical Condult-Undrgmd.
B. Four.dation 59. Gas Pipe, 0 Undrgrnd., Test
9. FVater Pipe�Undrgmd. ' 60. Backwash Li�es, P�Trap, 7 Undrgmd.
10. Structurai Floor SYstem 61. APPROVAL TO �ECK �
11, Property Sewer L'+ne & House Con�ection 62. Sackwash & Rec=ptor�FL�I �
72. Sewer Cap 63. Fleater & Vent�Final �
13. Roof Dra;ns 64. Plumbing System � Final .
14. Rough P(umbing , 65. Electricai-Final .
75. Rough Eiectrical-Condui2 66. Solar SYstem-Final
16. Rough Electric Wfring , 67. Fencing & Access Approval
7�. Rough UUiring Si9n . 68. APPROVED fOR PIASTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEA4S FINAL
i9. Rough Heating & Air Conditioniny FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace : , APPROVALS Permit # �
21. Ducts, in Structure ��� • 70. Underground Hydro
22. Ducts, Ventilating - _ :_ 71. Product Pipin9 O Gas O Dii ��
K,
23. Gas Pipe-Rough & Test 72. Underground Fiush � i-s. "'
24. Roof Pramin9 � ., - � 73. Undergmd. Storaye Tank �7 Gas ❑ Oil �
25. Roof Sheathing - . ' '74,. Overhead Hydro � • ' --', �
26. T-Bar Ceiling (Structural) & ft�onocoat ' 75. -Dry Chemical ,
�
27. Frame and Fiashing ,� � • 76. Dry Standpipe . ..
28. l.athing & Siding � ' 77. = FIXED SYSTEAA FINAL
29. Insulation ' _ � • 78.�FIRE PREV. FINA� '� �� �
30. Drywall Nailing . ' � ' HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ' . •79. FINAL INSPECTION ..' �
32. Electricai Power Meter-Final ' 80.'FOOD CERTIFICATE ISSUED
33. Final Electric � � Notes:s - r-'j
���liE� �S � r;n�
34. Final Heating & �Air Conditioning �Q^�Q� _
. y
35. Final Gas Pipe�Test � - �' ' .
36. Hood or Canopy ' ,
37. Fir�al Factory Firepiace . � � � � � �
�38. Pinal Plumbing �
39. lVater'Service�Final � � .
40. Gas Service�Final - _ �
47. Solar pomestic-Finai '. „ �
�
42. Backflow Preventer � � � � �
43. Backflow Irrigaiion , �
44. Landscape Irripation System � . . �
45. So�nd Attenuation , ' . �
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison '
50. Gas Release to Southem Califomia Gas Co
51. CERTIFICATEOFOCCUPANCY .
No. Date
il
�I
�
PflOJECT AUDflE55: 6 6 2 JOANN J�'T '
OWNEB'S NAME: PERRY SARA A ^''"
aooxEss: 662 JbANN ST
COSTA MESA,CA
AHCHIENGINEEfl: S 4 8— 4 8 Z 4
aooness:
UNIT:
92627
HEG.NU.:
uxir:
'E""u'TEE' G.L.M. CAPITAL (213)429-7663
noosess: 487zp CA]�ND{�jLEBERRY AV
UCENSEO CONTXPCTOAOECG1fAT121FlElheCre3y a��irm iha� I am licensed unUerCpr�ovisio9ns0o�h�apOr 9(cammencing with Seclian
7000) ol �ivision 3 0� ��e Business antl Pmlessions Code. antl my license is in full lorce and e�fect.
cirr uc.: Q 5 STRTE LIC.: 4'� Z 56 cuss: ,�,p
Oate: 9gna�ure: ���
WOflNEflS'COMPENSRTION�ECNFATION: I�erebyallirm�hallha ceeihcateo�consem�oself-i�Ysureoracenilica�eolWorkers'
Compensa�ion Insurance. ar a cenified copy Ihereal (Section 3800, la C).
voucveo.: Zg5-93UNIT171 E%P.OAiE: OiIOlI94
cornraxr: STATE FUNI}_�
❑ Certdietl copy i5 hereby lumished. �,3L Certilie0 coppy �s �iletl wi�� Ihe ciry BuilOing �ivision.
Daie: Npp�iCani: / � tp �� �r� �
v
E7(EMPTION FHOM WOPREBS' fAMPENSATION OECLRPATION: This 5� on nee0 no� be completed i e permii is for one hunOred (51W) or less�.
I cerlity tha� in �he Detlormance ol the wark �or whic� this permi� is issuetl, I s�all not employ any person in any manner so as Io �ecome
suDiect m Ine warkers' Comvensation Laws ol Calilomia.
Dale'. Signa�ure:
NOTItE: If, atter making IhiS declara�ion, you should become subjec� �o [he WOBers' ComDensa�ion provisions oi the La�or
Code. you musl �otlhwi�� comply wit� such pmvisions or Ihis permi� shall be aeeme0 revoked.
� CONSTHULTION LENUING AGENCY: I hereby affirm t�at �here is a conslmc�ion lentling agency for �he pedormance of the work for
whlch Ihis permit is Issuetl (Sectlon 3097. Grv. C).
LENDEP:
ADOXESS:
OWNEfl BWL�EB OECLFPPTION: I here�y a0irm �ha� I am eKemD� ��om ��e Contractors' Siate License Law lor ��e following reason
�Section 703L5 Business ana PmfeSsional Code: Any ci�y of counry which requires a permit �o consfmc6 al[er, improve, demolisA, or
repair any SlrucNre. D�ior �o its issuance. also requires the aDD�ican� for such permit ta �ile a signed 5taiemen� �ha� he/s�e is licensed
pursuam �o I�e O�ovisions ol the Coniractors' Slate License Law (Chapter 9 �commencing vnM Section 7000) al Division 3 of �Ae Business
anU Pmfessions CoOe) or �ha� he/she is exemp� �herelmm and Ihe basis �or Ihe ailegea exemp�ion. Any violalion ol $ec[ion 703t5 by
any applican� �or a permi� sublec�s �he apDlican��o a civil penally of no� mote �han live hundred tlollars ($500�.
1, as owner of t�e O�oOeny or my employees with wages as iheir sole com0ensation, will do ihe work, an0 the
❑ slmcWre is nol inrendetl or offeretl for sale (Section 7044, Business ana Pmlessional Cotle: T�e Contracmri Stare License Law
tloes not apply Io an owner o� a pmperly who Duilds or impmves thereon, antl who tloes such work himsel�/hersel� or fhmuBh
his or her own employees, provitlea Iha� such improvemen�s are no� intentle0 or ofiere0 for sale. It, however Ne building or
imDrovemen� is sold wi�hin one year ot comple�ion, Ihe owner will have �he 6u�Aen of pmving he/she did no� 6uild or impmve
lOr �he purpose o� sale�.
I, as ownerol Ihe pmpetly. am exclusivery conVacting wi�h Iicense0 con�rac�ars to consimct �he pmlec� (Sec�ion 7044. Business
❑ and Pmlessions Cotle: The Conirac�ors' State license Law aoes nat apply to an owner of pmpeny who huilOs or impmves thereon
antl w�o contracis tor such pmle��s wilh a conVactor�s� hcense pursuan�ta Ihe Contra[�ors' S�aie LicenSe Law),I am aware
�hai proaf al �heir WorkeYs Compensa�ion insurance shoultl be provitled lo me.
� I am exemp� under Seclion: B. 8 P. C.
lor Ihis reason:
Daie�. Owner.
I tlo hereby cenity Ihai i am aware ot an0 unaerSlanA I�e requirements ol Cali�omia Healfh antl Salery Code Section5 25505. 25533, and
25534 antl Ihat I ar any Imure Ouildmg occupanl willlwill no� (cirde one) nee0lo comply with said slaie cotles and the requiremenis for a
permi� for consimction or modification from �he Air Ouab�y Management �iSUic�. Residential cons�mction apDlica�ions are exemp� irom
ihese pmvisions.
�a�e: Applicant:
I hereby cerlily Ihal I have reaa Ihis applicaiion antl 5taie I�a� Ihe a�ove iniorma�ion is correcL I agree lo comply vn�h all ciry ana counry
ortlinances antl sia�elawsrelatingto �uilding conslmc�ion an0 ereby authorizerepresenla�ives ol��is ciryto en�eruponihe a6ove�mentioneU
pioper�y for ins eclion purpases. f
1� .p-t.rr�J ,.
Oale: ' � SignaWre: � �/�
Driver's License or Social Securiry q:
CanarV—!oolicanl: Pmk—Revenue: Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 06358
PERMIT NO; B 063589 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : T/OFF & REROOF W/COMP SHINGLES SQ FT; 2,800
CLAIM VALUE: Z,B00.00 CALC—VALUE: 2,800.00 GROUP OCC: R-3 /M-1
���**+�e*�r�r**�**�rD*�***���**�F****D�*�*�r**�r***fr�r***��********�e�***D�r***�**��r�r��*
ZONING REQUZREMEN��OKEDETECTOR��
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY �iD1(�l-C��-----
FRNT: FT IN REAR; FT IN FRNT; FT IN R ; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV: PAACEL: 42215107 ZNE: REF NO:
PLANNING Nd1'ES>
i ''
�e�e+e+e�r *+r�**�r**�e�e�r�e,r�r,e**�e�e�e�r,e,r�rr�*�r,r����e�r«�r�r*«�e�r�r�r**�r�r�r*�r�e�r�e*�e�r �e**�r***+ex�*�r�r***,r�r*
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 HY DATE:
BUILDING APPROVED BY : DATE: ��
APPLICATION ISSLTED BY; DATE: 8�'Zo
iFkif�fiEifiE�k�fkiflk�FlFik�klF�fif�fk�f �flFiFiflF�Fikif�FiF ikif
�E �f �f �f �flt �k �f 1F1f 1f k�Fik�E1f iklf �F if �f It �f �f if iF �f 1F1f 1f 1f 1F IE1F �k�F �F Iflt�f if 1F if if �f �t i! kiF if if If if if 1E �E 1t �f �k �f k ik iF ik if if 1f ikif 1f 1f If �k�FiF if �t �k �F
LEGALIZATION;N F E E S U M M A R Y STRUCTURAI. SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54,00 ^ 50
' SMIP/NON—RES
PLAN '•
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID � DUE
TOTALS----> 54.50 0.00 0.00 54.50 _ 54.50 ,00
REVENUBLDGVPMT PLUMBING ELECTRIC�MECH�D� FIRE4�SMIP%TOT/SGRADfNG PLAN—�HECK
54.00 .:50
k k ik if if if iF k iF k k it k it it it it iF i! k if iFiF k iF k if if �f if k iF if �F �f iF iF if if k ik if Iflf k ik if *1! ihif it iF itlf if iFif k if if if �F i! if �f if 1F itlf �f iF 1! if!! iF iF it if
I N D I V I D U A L F E E B R E A R D,,O W N
TYPE (aTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2800 REROOF BY VALUE RESIDENTIAL N020NE ' 1,00 � 2,800,00
END OF FEES
i
01 00145376-00145377 Tl] T
DATE: 08/2Q/93 71ftE: 1�:13
54.50
-.. - -----
CONSTRUCTION AND PLANNING - P�G� d SPA
APPROVA�S Permit# Daie Inspector AppROVALS Permit# Oate Inspector
1. Temporary Electriwl Servioeor Pole - 52. Pool & Equipment Loca[ion ��
GS VI(
'� �
2. Soil Pipe�Undrgrnd. -��•� r.;q `�' 53. Steel Reinforcement � .„
,.-�
T3`„�HQ�t�i�IConduii��ity-191idrgrnd�r ��, 54. Forms _
. �
o=�:Eleytrical.Condu#Iil.�ndrgmd.�• Sp 55. ElectricaiBondi�g
��.� 4��5�1 H�inforcerpc4yrr F"�„ � 56. Rough Plumbing & Pressure Test :
.�
� r'Ele;�trical UFEgr r`yd�. � 57. APPflOVAL TO COVER GUNITE �
_ 7. Ftfatings :-ty � 58. Electrical Conduit�Undrgrnd. .� �
�. Foundation �� � 2_" 59. Gas Pipe, O Undrgrnd., TeSt •
9. Water Pipe-Undrg�cl. �.. 60. Backwash Lines, P-Trap, � Undrgmd. _.'
70. Structural Floor Sy�tem .-�-(� � �,�,. 61. APPROVAL TO DECK �,
i t. Prflperty Sewer Ling-& Ho4+se�onn�ction ; 62. Backwash & Receptor�Pinai `�J,
12. S�er Cap �� ,1 i 63. Heater & Vent-Final ��-
13. Roof Drains V `'� " 64. Plumbing System � Final -
�
14. Rough Plumbin'2^ � �'•' 65. Electrical-Finai
75. Rough Electricai_'-Conduit 66. Solar System-Final
16. Rough Eiectric�iring 67. Fencing & Access Approval
77. Rough Wiring Si�n 68. APPROVED FOR PLASTERING
18. Rough Electricaf•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Condi;ioning FIRE DEPT. REQUIREMENT
't*'ix-[r .. l b' .T�-+!UE� '.L x: H Ci
20. ;Rough Fqytory F'Vyplace � QtTt K'"� r O� a'a� � diPPROVA'[S'35�eritfit # �� �' `�'
- i �� crx f n c:, o��� > : �r
21. . uC i� in; Tr. tu��` i FH ?:S a: :-� '7 '7 �' x C, .� �'_. (. '. �' �il
� � $ � �•.* i . •+S' * S !J �,- • 70. ndergraurrtl�-IYfia ...
22. �Ducts�, Vemtilating+x. � f��S �.l� S C� x t�t. P�oduct�Pigir}g Q'G�',s O��ii
n�- H .4 .t�.
23.'6as;�'Pe��} o44�h&'1`�st i c:. t. m ��.a:.;p. -, i r,�7 .r: •-, �i
.-� �7 „� c*1S �t M � pa k� i-�2. Undergroiii�diFlus�'�.� * [. m
24. t$oo,f•�Framing. �'x � Ft�- ••(-� �> r� t�` �'�� a i�3.' ndergmcGStoraqeQank EJGas ❑04D
_ %' b S '� 4 [ c .. .. �
r !�ti S n} � i b c � �-J[_�. yf
25. Roo�,SheaYhing h;>. �y .� „�� -�� �.'�.; �. 74.�v_erhead NYdro J _�
26. fb�Bae,Ceiling �Str�jvralE & pjioapcoat � G ra# = 75.�DrY Chemical �'7 x� �• ^ �
- H, .i
2Z �Frame and Flashi' * �^�� x x x x �6.°D�y Stand I' C� '� S'' L`
c.� ,�.x �a:'-C w tr' ;a. ::7�.. x E.P.� c.,:: x ��
" t r. r�.--7. F r. �
(2.8. �athing R Sidgng �..x r.,i '7 ta: � x� �i� .. 77.u'FIXED SN�S`fEM7?iNALx n"
r � �f 1
�29. Insulaticrn' � ' �� U S "" ' n �'� �'t 78.�IRE PREV. FII�yA�i; : -, �
r i N O �. ^. � l J �. . w ' .^.
r'30. Drywall NailiDg r,x ��� K x �-- N�AITH,QEPTrAfiQUi,RE�MENT
.
t31. Piaster 6 w Co r" � " �`� 79.�INAL IN'��}',�F.CTIO:N _* � M�
� ��?, c � r t k.,4 n ,7
.i � n .., t 1 F+ t. - c r, � �� ^ � r i
:32.�lectrica�fowgr fy�seP;Final i' t-cv � a�80..�F000 CE `iIFIQiA'T,E IS9UED
33. •f6ina!'Ele tri .� �F� '. � m a: iv " � !`No�€'�: ...: �.y�� * .` . ���
s .- n. �S ,c i .. r . c "7 `i:*: r ^7 �J .�`^
/. ' I.r--i1-i G� %y > h I� l �t : r. '.-�
,34. �ina[.He�jing�& R',},l�o'`i�ditioqi��- n * « r. � S i�x � t�^
35.'RinalGav7'ipe7TeSF �' d '7 x. x: � Ct C�5 a T ^s�7
i ,'1 r.� -.x �� w. 7 :to 'Ji-� f(:'
,. A � •• � x ` .:: � n
-36.'Noo�'or.CanoPY ,�,y � i ry n Y �l x}_ r t�G � , <t;.�
��37.'Einal.Factory FirepFace� ' �'� `�' * �" k � ` � , r •
-. f = f %�
.. .. .� . a � i . .. �� r o t< x ., .� � .
_38. Final Plur�bmg xx ,,i -� x r„ S ' x.: p
:39. Water.Service-Finatt � � � �- * ': � : . '-�,T7 r � J
_ a. .- a i. � a � S
�0. Gas Service•Rmal �' ` :� ': \ Y ` , ` • , . . ,
yT: T,i 1'� .7 ?♦ YY �j # T :: k. L14
}7. Solar pomesricFirral � !'�� ^ �* O� x t ��v � "
�n ' JG !T ¢ "
F'#2. �ackflow Preventp'� �"" ; � '� y. ` j.� /} " /� # � /� ��
��. � a: r. -�7;��Z �- Gt,fCOr S' `�G'+.�2 dR2-�_-�,
l., r . .. . . ... . . ' ' '
43. Backflow Irri�q2tiun. �. QaS x � x Sf- � w G �
.: i , ,., � i•�
rx f > <:= � _ � .
��44. Landscape Ir�tgat�q'�SX.stem;�th�j � �� d � �y :� p; v �O x' n� �
.,
�'1 ' J „ . . � � .
. 5. �ound A�tenuatiom= �� i-.�:r r o: ?' F�� =��- t Ct N H T� :C�y t^
.� r X �+ h' �-�< .k �� a' J 2 • -�0 ?
� n i �. ti 0' l': . .. ...r � � / -� ' .. ,� ac
�46. liandicap;Re�ulaYiNo�s� "• . ,� J x � �. 2 :.;, •� .;�q .� .k
47. �FINqL STRI}.GT�RE. & BUi:CDING ..+1 y� y (,� � +'-� =�sG �,� ' � cv
.,� ;, U /�
48.',Tr'INl�LPLANNIIVfi';i• '-<<^[r z r;r;� �, ' .
-.� .- �'F` Y N #< Ri L�! G t`..
� i
�99. ;�lectr,ic Releyse tajEdison .. � .� y :' .[ � i: = cr
� o
;50. Gas Rele�e to Southem�Califorrr�iaiGas Co ' � ;. � '" ry . '.�r �; ,� `:
;51. CEF�TIPICATE OF;,OCCUPANCY' � %:; y .� ,,� � .� ;� ,_ �
No. --------._ __._. Date
�
Mr�IN JFFICE
Ifi35 WEST GAYLOPD ST.. - P.O. BO% 9065
LONG BEACH 10, CAL�FORN�A
HEMLOCK 5-%GP3
SPFUC6 5�20�I
�9Rr�111"QLif
Lxamination No.
Samplc from
Architect
� �
Contractor
Alix
\Vater, gal./sk. cement
BRANCH OFFICE
1314�� NORTH XARPER ST.
SANTA ANR. Cf�LIFORNIA
JEFFENSON L2044
JEFFEFSON 1�209fi
June 15, 196� ' �,
GUNITE ^ �rC�
REPORT OF TEST CYLII�,'DER � �UN j
sC61-3�97 ���' ot
�' Buildi B D
For - Blue Haven Pools �
1221 N. Palm, Anaheim, Calif.
✓ �
L. RAK�I RESIDENCE - 662 W. JoAnn St., Costa Mesa
Gunite Swim Pool
Blue Haven Pools/4-Star Gunite, Inc.
size 5-3/� x 12
Date cast � 5-18-61
Dace tested 5-25-61
cy�;na��• No. 3-A
C0,14PRLSSIOI�' TEST 7 Days
Total load to destruction, Ibs. 30�000
Pounds per square inch 1,322
Cylinder made by Al Betmner
C}�linder deli� ered by Brad
Cyluider received on $-19-61
cc: Rakow
Blue Haven POols
Costa Mesa Bldg. Dept.
SA Lab
6-?5-61
3-B
23 Days
6i,o0o
2.350
3-C "Hold"
�nc.
��� � /�- ��,
ALL REPORTS rlkt SU�MRTED AS THE CONFIDENTIHL PROPERTY OF CLIENTS, qUTHOqIZI�TION FOR pUBLICATION OF OUF PEpORTS� WNGWSIONS. Oq E%�
iRPQS FROM OR REGAROING T,HEM IS qESERVED PENOING OOR WRITTEN APPROVAL AS A MUTUAL PFOTECTIOI� TO CLIENTS, TNE PUBLIC AN� OURSELVES.
OWNER Santa Ana Ranchos DATE 9-"i0-K8
JOB ADDRESS 662 W. Joarm StT22t ' B[IILDING PERMIT NO. 7C�B%
GENERAL CONTRACTOR D1ke & Co1B�T'OV2 VALUE $ 13,919.00
AP. No. LOT j4 TRACT 2215 PBtE ZONE DESCRIPTION OF WORK S1II le Res. Att. G3i'.
C '1P T� J't'YPE V ZONE PLAN NO.
INSPECTIONS I DATE I SUBCONTRACTOR �___ PERMITSISSUED
co�t
F inq Pixtu
Final Gas Test
` .. � '7�8'J
µ �,%
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
ADORE55 �� �� v0�1 St•
COSTA MESA. CAUFORNIA
OWNER y$Tjy$ � [4dtiChOB
MAIL y�q E. 17th St.
nnnrxcsc
ARC' :T
OR 1 JEEft
�'
CONTRACTOR
LEGAL
oesceianorv
A.P. NO.
5'zE 60 x 100
OF LOT
USE OF
E%ISTING BLDG.
rNo`T.i. 8—].15�
LIC.
NO.
rv uc. g�
A.No.
NoI.i. &-]15'
TRACT �F.1S
;� °F a�°�� none
IOW ON LOT
$ETBACK LINE FROM ^� 281
CENTEw OF STREET S� REAR VARD
� St
SIDE YARD RIGHT S LEFT
DESCRIPTION OF WORK
NEN p ALTERATION I ADDITION
REPAIR I IIMOVING I I OEMOLISH
5 ZE DING 1365 sY `�OOMS V STORIES 1
EXTERIOR WALL L ROOF
COVERING SVUCCO COVERING . GOIII�i•
USE OF NEW
BUIL�ING � �Q faadlv residence
wi.th attached garage.
�EE RECEIVED .
�-�O-S�
itNANCE DEPt.
CI11f OF COSIA �A
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. �}T�$Q
lJ I
FECEIVlD BY L1PTE RECEIVEO O4TE ISSVE
-- - �/ 9_ 30 -.i SEP 3 0 1'
BUILDING
AD�RE55
COS7A MESA. GALIFORNIA
DATE
CORRECTIONS
Plan 110A
I HEFEBY ACKNOWLEDGE THqT I HnVE FEAD iH15 APPLICl�TION AND
STATE TMAT TME ABOVE IS CORR CT PND AGREE TO COMPLY WITH 4LL
CITY OROINANCES AND STATE NS REGVIAiIN6 BVILUING CONSTRUC-
iion. VALUATION M
SIGNATURE OF
PERMIT FEE S 32�'JV
PERMITTEE n/� [ /��
� ' T,,, g 13,919�W �'LAN CHECK $ lp�y�/
AUTHORIZED AGENTylke & Colegrove� lllC• TOTAL FEE 5�o�oo
GENERAL C0.
Blue
AP.No. 115-61S-O% LOT
I ECTIONS
.0
Pools
DATE
SUBCONTRACTOR
0
.00
Pvt, Swim Pool
° � .�' ���1j
�OSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 C08TA MEBA. CALIFORNIA
For Applicanf fo Fill In Complefely
TYP OR PRINT
BUILOINGi / �
AOORFf.R (�
CALIFORNIA
� MAIL
� AR�
�
�' TEL.
, NO.
� SIZE
■ 96TBACK LING
NO. OP BIDGB.
DESCRIPTION OF WORK
BUILDING NO. OF
SIZB V ROOM6
EXTERIOR WALL ROOF
COVHRING ICOVEF
U6E.0P'BUILDING AND WORK TO 6
1 HHRBBY ACKNOWLEOGE THAT 1 HAVE ReAD THIB
AND BTATH iNAT�T�T A00 / 8 COPR6CT AN�G
PLY WITX ALL CI'�Y OND BTATe E
BUIIDINO CONB 1
AUTHORIZED
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C FII�AIL'CE D PT•
CITY OF COSTA iNESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
necervec
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
ZON6 NO.OF UB! OP NHW
� �� PL11N8 � OUILDINO �OO'
QBCRIPiION / VI �`�� �ha�Z` �`�'
A. P. NO. II3 � �/� —a /
YARDS EVES
APPROVED ALLOWED
(C8MlR LIN6 BT.) [� r
FRONT Q �FT�./ I
R. f:1nF � �T� �
S
�
TXE AMOUNT BHOWN UNDER VALUAT�ON Is FOR THE
PUPPOSC OP EOTABLI8H�N6 A PENMIT PE6 ONLY.
VALUATION /%
PERMIT FEE $ �V ^
l ,/ A'� C o
$`/ y' o-'O�/ PLAN CHECK $ J
0� / E
70TAL FEE /S .� 0
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