HomeMy WebLinkAbout2209 MINER ST - Building Permits�l � � � �' ' � v .
CITY OF COSTA MESA
F B!/ILDING DIV/SIOIN
i` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
:
�. ` FOR INSPECTIONS CALL: (714) 154•5626
R''"°"'� PERMIT NUMBER: 609-00256
PERMIT TYPE B_ROOF2
APN: 42219214
JOB ADDRESS: 2209 MINER ST CM
Vicinity: RESIDENCE AND ATTACHED GARAGE
Squares: 2500
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
11102I2009
BJK
$4,900.00
SCOPE OF WORK: REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING WOOD SHAKE ROOF, 1/2" OSB SHTG, 1 LAYER
30# FELT, APPLY 30-YEAR GAF ELK TIMBERLINE COMP SHINGLES. 2500 S� FT PITCH 5:12
OWNER: DEPT OF VETS AFFAIR STATE OF CALIF Address: %ZIMMER, DOUGLAS W Unit: COSTA
MESA,CA
PHONE: City/State/Zip: 2209 MINER ST
APPLICANT: SERRANO, JUAN
PHONE: 714-076•5021
CONTRACTOR: SOUTHERN PACIFIC ROOFING INC
Address: P O BOX 3189Unit:
City/Stale/Zip: ANAHEIM, CA 92803
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
so.00
$111.25
$0.00
$1.00
5112.25
Address: P O BOX 3189
Ciry/State2ip: ANAHEIM, CA
License No.
License No.
PHONE:
License No. 925914
714-476-5021
CELL:
PHONE:
PHONE:
Unit
NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Califomia statules and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this pertnil to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to oblain inspections and final approval will resull in the expiration of this permit.
�OOE/, INSPECTIONTYYE D� INlinus �O�Et INSPECTIONTVPE ' OAL IN1111AL5
1816 Fized System Final Fire Prevention 206 Final Mechanical
1286 Pool Spa Final 20B Final Plum6ing
200 Final Re-Roof 270 Final Electncal
201 Final 81ak/ReWining Wall 212 Final Fire Prevention
202 Final Facrory Fire Place 22o Final Planning Approval
203 Final Sign 222 Final Site � /
7J 7l -/-
204 Final Demolition 250 Final BuildinglOccupanty � �0 �y�'y�
, . -, �
WORKERS' COMPENSATION DECLARATION:
� I here�y aKrm untler penalry of perjury one of Ihe following tleclarations:
❑ I have and will maintain a certificate af wnsent to self-Insure lor workers'
compensation, as provided for by section 3700 of �he Labor Code, for the
De ormance of the work for which this permit is issuea.
have and will maintain v,orkers' compensation insurance, as required by
.'sectwn 3700 0l the Labor Code, lor Ihe peAortnance ot the v.oM (or which this
pertnit is issued. My workers' compensation Insurance carner antl policy
number are: /"
Cartier7 i�)17�[�T
(Tnis secfio�rr(eeo rro� De �mmqdeOted�l1ine p.vm�a ut raNeo a� me nune.N nmars (Etool w ieu7
. PoliCyNumber: o�JilVO�V�q�
❑ I certify that in the peRormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to Ihe workers' compensation laws of California, and agree that i/ I shoultl
become subject to the vrorkers' compansation provisions of Section 3700 of
the Labor Code, I dal onhwith co 'th these provisions.
- �i z �
d�� s 5ignawre ' Dete
NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($700,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under Drovisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Code, and
my license is in lull torce and eflect.
Cic.-# � � Gass# �
' Z O
n racta's Sigremre _ Dai
CONSTRUCTION LEN�ING AGENCY: /
❑ I hereby affrm Ihat there is a construcibn lending agency for the
pedortnance of the work fa which this pertnit is issued. (Sec. 3097, Gvil Code).
Lender's Name:
Lenders Address:
SignaWre
OW NER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty Of perjury Ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW fOf lhe lolloWing fea5on (SCC. 7031.5,
Business and Professions Coda: Any city or county which requires a permit to
conslruct, alter, improve, demolish, or repair any swcWre, O�or to its
issuance, also requires me applicant tor such permit to file a signed statement
that he or she is licensetl pursuant to the provisions ol the Contractors
License Law (Chapter 9(commencing with Section 7000) ol Division 3 of the
Business and Professions Cotle) or that he or she is exempt therefrom antl
the basis for the alleged exemption. Any violation ol Section 7031.5 Dy any
applicant !or a permit subjecls Ihe appliwN to a civil penalry o( nOt more than
five huntlretl tlollars ($500�.):
� I, as owner of the pmperty, or my employees with wages as their sole
compensation, WILL DO THE WORK, antl the strucNre is not intended or
oflerea for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law tloes not apply to an ovmer of property who builds or improves
Ihereon, and who does such vrork himselt or herself or through his or her ovm
employees, provided that such improvements are not intentletl or offeretl for
sale. I�, however, the building or improvement is sold v.ithin one year of
completion, the ovmer-�uilder will have the burden ot proving thal he or she
tlid not builtl or improve for purpose of sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CON7RAC71NG WI7H
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Pmfessions Code: The contractors License Law dces not appy to an owner of
property who builtls or improves thereon, and who Gontrad5 (or 5uch project with
a cmt2ctor�s) license pursuant to the Contractors License Laws.).
❑ I am exempi �nder sec.
Business and Professions Cotle for Ihis reason:
� ' .
Ovmer ID verifed by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifica�ion of Ownership by (rype of document, i.e. - propeny tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N:
❑ I hereby certify that no ezcavation (ive (5) or more feet in depth into �.4iich a
person is required to descend, will be matle in connectbn with work authorizetl
by this pertnit, and that no building strucWre, scaFfdding, lalsewoAc, or tlemolition
or dismantling thereof, vrill be more Ihan Ihiriy-siz (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Calitomia AdministrdWe CoOe).
❑ As owner-builtler, I vnll not employ anyone to tlo work which vrould
require a permit from the Division of InOustrial Safety, as noted above, unless
such person has a permit to do such work from the tlivision.
Appliwnt's Si8^���re
Division of Intlustrial Sa(ety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
t. will the applicant or present or tuture building occupant neetl to file and
certily a Business Plan for emergency response to release or threatened
release of a hazartlous material7 ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Salery Code requires, vrilh some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous matedals equal ro or greater t�an a weight of
500 pountls, or a volume o( 55 gallons, or 200 cubic feet of compressed gas
al standard temperature and pressure).
2. Does or will the applicanl or present or luWre builtling occupant need to �le
a registration form (or acutely hazardous matedals? ❑ Yes ❑ No
(Section 25533 0! the Califomia Health and Safety Code, wilh some
eaceptions, requires registration vrith the Costa Mesa Fire Department Dy
each business which at any one time has on hand a quantity ol acutely
hazardous materials equal to or greater than a weight of 500 pounds. or a
volume ot 55 gallons, or 200 cubic teet ot compressed gas at standard
temperature and pressure).
3. Does or will ihe applicant or present or future huilding occupant neetl to
prepare an RMPP (Risk Management and Prevention Prog�am for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that lhe
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses whic� are reQuired
ro register acutely hazardous matenals with the Fire Departmenl.
4. II an RMPP is presently required, has Section 25534 of ihe Cali(omia
Health antl Salely Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fWure building occupaN require for
�he work which is ihe subjecl of this application a permit for such construction
or modificalion from the South Coasl Air �uality Managemenl District or !rom
any other air pollution control tlisirict or agenty? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that lhe requested
in(ortnation be lumished on applications la non-resbential builtling pertnils).
6. Will any part o( lhe facility to be constructed under this permit be within
1000 leel from the outer boundanes o( a school? ❑ Yes ❑ No
pf �yes", the taciliry must meet the requirement o( Sections 25534 and 42303
of the Cali(ornia Health and Salety Cotle).
7. If a permit (rom Ihe South Coast Air �uality Management DisMct or other
air pollution control district or agency is required (or lhe v.ork which is the
subject of this application, have all of the disclosures prescriGed by Calilomia
Health and Safety Code Section 42307 been made? ❑ Yes ❑ No
B. (If yes", attach ceni(cate of wmpliance Irom the appropriata air polWtion
control oKcer).
CERTIFICATE OF COMPUANCE: I certify that under penalry of perjury the
information given ahove is correct. I agree to comply with all state laws and
city ordinances regarding Hazartlous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certity untler penalry of perjury that I have read this application antl state that
the information given is correcL I agree ro comply with all state laws and city
ordinances relating to building constmction, and authorize representatives of
the Ciry of Costa Mesa to emer upon the above-described propeey for
inspection purposes. I agr cua-cccyey or allow occupancy ot any building
authorizetl by this permit niil final ins n.
a10.. r(s) Daie
SignaWre �'ale � Z �f
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/
�ooncssa eunowo: Z 2 0 9 M I N ER S T u��
w�xeasruYeir'wowrc DEPT OF VETS AFFAIR STATE
"0°"E8A OF CALIF
RZIMMER, DOUGLAS W
:209 MINER ST COSTA MESA,CA 9262
uv�. �,uuNo �omrtsa
NIqIREtfON FNfd1EfN: 11C.W:
nex on exo.•s �ooirtss: uNt:
��*��NOCK PLUMHING (714)895-1246
Cpllq�tTOR5Y111M011612 KNOTT ST
"D°^�sg GARDEN GROVE CA 1GN0' 707775
92891 uxr: 17
UCENSEU COMPACTONS DECIAP�TiON: I hereby � �My prely d pmjury Na I em I'Kenwtl uMa pm'vioru d Cliepter 9
(wmmenaeq rm� SecYan ]000) d Oiwion 9 af tlro Bus'vem md PMesnaa Cods. W mY limrue b m Iu0 brca vM ellen.
cmuc.No.:� a uc.cuss:C_36 uc.No�.: `�� EXP: 02/99
o�a: �_ c�e.a«:_p�/� �
OWNER BUILDEN DECLA ATION: I hneby effiem ivder pwly tl ihet 1 em aumq Imn �M Com�eum liroree lew la ihe
iea�m (5xfion )M1.5 Bufiwas eM PmtmeiWu COEe: MY uY a aouNY xfiidi iaVu'va� e De�mN �o canfbucl. Mx. MWave.
amdeh, v rapi eiry al�uclive. piar b m c�uence, eqo �� �Ip eppGa�q Ip euch pemW lo fib a vyned �tmameru Nm M a ehe
. u��..e w� �o me nw�+ d u. com�m«s u�� �. �cn.a. s(�«�,o .nn s.a:� mool a o:d� a a in�
uaineea ard Rdeaiom Lodel � ihet M a ehe u esamp �haehvn ud �M bess la ihe albpod vemqun. My videtion d Sedion
�W t.5 by ary epplcw la a prmu ribleR+the epplcep to e dN pe�uYy d nal mwe Nm Iwe hund'ed EaYu� �5500�.
� I.nowwd�MD�W�YanH�Obl�wahw�mNxWemmD�+�. YdoM'�akeMtMMxlu�seia'vaeMed
a Mred W ub (Sa �im )Os,. euzron eM PMaamnaCade: TM Coeuream limiue lew mu not wdYto en owner a pweM
Ma buWa a inD�+e� �Mraon. end Mn dom �uch xak In�tl a lwad a Wwqh he a Mr wn amobwm. Pa'�d �hm wch
imprnqnptls ma M iNsdeE a a1lraA ta taM. tl. howv:er. Ne hiltip a inpaanM e wtl r.alun me Y� a�PMion. Ns
owrw-0uAJw T M1ew tM Mndan d pw'vq M w Me Sq np puid a'vnpma la Ne p�vpwa W atls�.
� I.mmnwrdiMPWMY.emssrkmvWwr�rea�pwvhbwtlmWstmbcanNwNep9�lSaa'vnMu.&n"v�verd
PNmion Code: TM Ca+eenm Lka� law 4oes m� wN/ m a� wner d PW�Y Me duW rc nww'M tl+ason md rAn
eoniraets la �uN o�4�+� WiN e meer+Ms) ��naed w�+� m �M Comrma� Limme lewl.
� I em ssemq under Soeiim: B. 8 P.G.. far tlo eeevi:
oa.: o.�«:
i eo nenM wnav ow i.m..ere a w�.wn.�w ms �.mm�.0 a cwomi. �wm�.�w sdwv we. swne uws. nsa�..m
Y55�1. ard IIW I a vry Mun buitivq omqe�u. WI / wii nM (�b wa) neeE to mnply wYh aid Yele aoEa� uM tM �apuirememe M
e parmn Iw oombucliana moEi6mtionhdnNOM�y�p�bp D'mtria. Raetlrtlel amn�ion eGG�iam en momp hom Noa
w�.�,..
om.: �oor.w:
WORKER'8 COMVEN9�TON DKUN�TON: I MWj yrym Nqy p�py d pMjW aw d Ns idbvrirp Mtive�iom:
� IMwvdwilmeinte�ecantliutedoauemioaW{�y��yYyky�'oompanW'v�.apo.idMtnbySeaian�)OOdtMleEn
Cotle, lw �M pMwmeza d Ne wak Ia Mich Ihu pwme u ivued,
� � new.�d xi� mmmen .omm�• oomwromon ina,rano.. m�.w�ee M seam a�oo d N. �.n« coe.. �« ine w�«m�m a me
r work lar xhidi Mu pamn b o�ued. MY wa4as' canP�ion muvuic� urt's cM DdiY �+mEr u�:
■[ Qen1r �OLLLEAI EItCLE EXPSRES
■ Po1� Niniba P��47T34" ^�� 0 9/ O 1/ 9 8
F'ihia asaian roM mrW candMed I w o�1 e ror u» huMna edW� Rrool a 1wJ
� I oul/y Yw N i� pM eerw d Ihs rak br rAiiU� We pvm4 e uawd. I NeE a mipb� erry pavan in ury men�r p u lo
bcmie �ub'� � o tA waM1ar�' mnqanu�lan kr� tl Cedonie, na el �MJd Eecmr wAjad to iM worka+'
mmponWl i owi • I wion 91W tl tM lqya �oy, I o it o�mpl� wV� w� prw'e'
Dna: I�ppfuK:
W�mliq: F�Nun fo ueun woikw+' mmpru�tlon Mrapr l� w1�M�, W LWI r!/�ef �n �mployr ro eMr/iW pwvltluW
u.n n�.. w ro a» n�e�.e w�,.�e eorw. (t�oqama a.mno� ro m..�o.i o� �a��an w�.w � aoMe.e ro. i�
S�ctlon 91G6 0l M� l�Dor Coi. InroiuS �����Ny� I�u.
CONSTNUCIION LENqNO ROENCY: I MreEy elf n urds pe�Wiy d pajuy ihel IMn b e mm�ion bM'vq epxwry br Uw
paAormvo d iM wak br xAiM Om D�� e eausd (SW'v� �. CH. CI.
LENOEN'S NAME:
IENDEP'S �DDPESS:
� CM�h' I�W � �1YY! 1lY� �110 G�I�SNOI YY� W10 ��1tl 1�M GbW! Y1�IXRb�0119 CIXIW. � y' fM IO COIII�/ ME�1 GO �' YIQ WIIN)' OIdOVII�
erM �iete lewe raWiq io Eutld'vq canMtlion end hereby auUv¢a npimumivm d Ihu tlty to emw upon �M eEave.meMioneE popeM
Iwimpeqion purpovee.
RO NOCK ��
Prvn Name
Dma:
Sqnetum �G^��
(S151d6WP) Whae-&ddiq8SelelY•G�ee�fie:CaneiY-�W�^�:Pink-Rownw:(3dEsuoa-Aauva
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CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: P 087535
PERMIT NO: P 087535 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRZPTION : INSTALL DISHWASHER SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT
******�***�****+�***���*****�**�x**��r**+r�r****�r***+��*rt**�+��******�**�**�*�+�**�**+�
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 HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 42219214 ZNE: REF NO:
PLANNING NOTES>
i
fE iE if 1E ik it if if 1Elk k ff 3f 1t iE iE fE iE iE �ElE iE iE iE iE 3f iE iE iF iE 1F 3F ik ik iF �F if iE iF iE iF 1F if iE iE iF iF i!'.if IE iEif iE jE iF �1E IE �E if iF iE iE iE iE af 9f iFlk if if �E iF �F iE iE �E iF iE iE
D E V E L O P M E N T 5 E R V I C E S .•R E Q U I R E M E N T S
ZONING APPROVED HY . ' DATE•
HUZLDING APPROVED HY :
APPLICATION ISSUED HY:
LEGALIZATZON:N F E E S U M M A R;Y
I
bLDG PMT PLUMBING ELECTRIC MECHANZC
PERMIT 8.75
25%
PLAN
ISSUE FEE 22.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 8.75 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
30.75
DATE:
�iF*i�*�***w**�iF£�r�t
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
30.75 30.75 .00
30.75 OVER/SHORT; 00
FIRE SMIP/TOT GRADING PLAN-CHECI(
iElF 1t 1f iE if iE if if if !F �f fk �E �E 1E iE �k 1k jE 1F ff iF if iElE iF ik it if if 1f iE K R if iF 1f iE if it if iF iE 1f iE 1f if 1f if iF if K if 3E iF if 7F if IE iE if �f 1k iE if if if ik iF 3E if ak iE 1k �E aE iE IE
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 P T I O N UNIT COST TOTAL COST
PLU 1 DISHWASHER 8.75 8.75
END OF FEES
D
E ��� �
v� r
84-02-1998/11:51 NA/530.75
kCDT�:�l-c1"t1812
PEkI'iIT e 087535
�
CONSTRUCTION AND PLANNING � - P�'�SPA t �
APPROVAIS 7ermit � Date Inspector qppROVALS Permit # Date Inspector
1. 7emporary Electrical Service or Pole 52. Pool & Equipment Location .
2. $oil Pipe-Undrgrnd. 53. Steel Rei�forcement .
3. Electricel Conduit Utitity-Undrgrnd. 54. Forms
4. Electrica� Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgmd.
8• Foundation 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines,.P-Trap, O Undrgrnd.
10. Structural Flaor SYstem 6t. APPROVALTO �ECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
I
12. Sewer Cap 63. Heater & Vent•Final
73. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem•Final ,
16. ftough Electric Wiring . 67. Fencing & Access ApPro�al '
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Elettrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning _ � FIRE DEP7. REQUIREMENT
20. Rough Factory Fireplace - � APPROVALS � Permit #T-
21. Ducts, in Structure 70. Underground HNdro
22. Oucts, Ventilating 71. Product Piping O Gas O Oil
23. Gas Pipe-Rough & Test � ' 72. Underground Flush �
24. Roof Framing � 73. Undergrnd.StorayeTank �Gas OOiI
25� Roof Sheathing 74. Overhead Hydro,
26. T-Bar Ceiling (StructuraD & 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. RE�UIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
� 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUEO
33. Final Electric . Notes;
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test ' ' '
36, Hood or Canopy � +Z
37, Final Factory Firepiace • �r,
38. Final Plumbing y_� _ ��� `�' �-
39. Water Service-Final� �
40. Gas Service-Final . �
' t
41. Solar pomestic-Finat � _ '
42, Backflow Preventer
43, Backflow Irrigation '
44, landscape Irrigation System � •
45. Sound Attenuation � ,
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
4$. FINAL PLANNING ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
Date
or
SUBCONT1tACTOR
res.
� 26�L8
• COSTA MESA BUftDING-SAFE7Y DEPARTMENf
P.O. BOX 1200 COSTA MESA, CALIFORNIA V2820
For App11mM fo F(Il In Complo}�fy
TYPE OR PRINT
ouunuva 7/J
AGOREDD g (/ E i
COSTA MESA, CALIFORNIA
r eera�crc uns
no.o�
DESCWPTION OF WORK
BUILDINO
SIZE
EXTERIOR WALL
'1 HBRHpY ACR
wN0 eTwS6 Try
PLY WITN ALL
euuoino con.
� AUTHORIZ[O AO[NT
FEB 24-67PnIoOO 923 13.50
CHSA # ��`�4{
MPLICATION fOR PERMIT
BUILDING
For ONIc� U�� Only
11[C61I� NO. PI
��
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2209 Minor St.
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DATE I GROiTP �
DATE 6-10-59
BUILDING PERMIT NO.
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DESCRIPTION OF WORK Add. F3irt
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CdSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31� COSTA MESA, CALIFORNIA
FOR APPL/CANT TO f/lL /N COMPLETELY
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COSTA MESA. CALIFORNIA
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OWNER - O�CONNOR, Frank J. ' DATE 'j-9—K'j
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IhoPECTIONS I DATE
coat
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DESCRIPTION OF WORK
SUBCONTRACTOR I DATE
9,996.00
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535L
PERMITSISSUED
� NUMBER
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COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
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APPLICATION FOR PERMIT
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RECEIPT NO. PERMIT NO.
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COSTA MESA. CALIFORNIA
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