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CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B09-00248
PERMIT TYPE B_ROOF2
APN: 42236409
JOB ADDRESS: 2252 FEDERAL AV CM
Vicinity: HOUSE AND GARAGE ROOF � � �.
STATUS:
DATE ISSUED:
ISSUED BY:
Suife/Unit:
ISSUED
10/29/2009
RMD
Squares: 1700 �. - � . . �� � ;, �. -Valuation: �$4,936.00
SCOPE OF WORK: TEAR OFF (E) ROOF�MATERIALS, INSTALL 1 LAYER OF 15# FELT 4:12 PITCHED�ROOF AND REROOF WITH 30
YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 17 SQUARES. REPAIR AND REPLACE
SHEATHING AS NEEDED. : ' - . . �
OWNER: LOVING, ROBERT E � .Address: 2252 FEDERAL AVE -� � . Unit:
PHONE: � , - - � - � .� " City/State/Zip: COSTA MESA, CA _ . � -
APPLICANT: WHITNEI' ROBERT � �� �� Address: PO BOX 15396� . � ". � Unit: :
PHONE: 949-548-0769 � � ' City/State/Zip: NEWPORT BEACH , CA �.. �
CONTRACTOR: WHITNEY ROOFING License No. 406022
Address: PO BOX 15396Unik .. - � � - -- - �PHONE: � 949-548-0769 �
City/State/Zip: NEWPORT BEACH , CA 92659 �� �� , - CELL: . . ' �-
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
� License No. . .
License No. �
$o.00 � . . � ' _,
$111,25
$0.00
$1.00
$112.25 � . .. � . . ..:. .. ... : .. .
PHONE:
PHONE:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorizetl under this permit to be wnsidered legal, such work must wmply with all applicable codes, and all
required inspections and final approvai must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CO�E R. INSPEClIONTYPE �pTE INTITIALS COOEq INSPECTIONTVPE OATE IN1111AL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 FinalRe-Roof �r—����1 2W FinalElectrical �
�
201 Final Block/Retaining Wall � 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARA710N:
I hereby affrm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certifcate of consent to self-Insure for workers
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and wili maintain workers' compensation insurance, as requiretl by
section 3700 0( the Labor Code, for the performance of the wnrk for which this
pertnit is issuetl. My workers' compensa[i Insurance carrier and policy
number are: n //
g��� ���
Carriec
�(This secfron need noi 6e wmple(etl Athe peimif is valuetl al one hvntlretl tlollars ($100J or IessJ
Pol�umber:_. ��r �� �
❑ I certify Ihat in the performance o he work for which this permit is
issued, I shall not employ any pers � any manner so as to become subject
to the workers' compensati s of Ca � ornia, and agree [hat �f I should
6ecome subject [o th � rs' compensa6 n pmvisions of Sec on 37 0(
the Labor Code ith comply wi these provisions. �
g �
AP _ � i a� �� �+.�
WARNING FA URE TO SECURE WORKERS' COMPENSA ION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR W SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am licensed under ions of Chap[er 9(commencing
with Section 7000) of Division 3 ot siness and Professions Cotle, and
my license is in full force and e ct.
--'�yu„s.�,. �7
'Licr# � CC lass.#�.�..
L50
�-- ntract �. ignature� ��ate
t.i�'_— f �y .
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that Ihere is a construction-lending agency for the
pertormance of the vrork for wfiich Ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name�
Lender's Address:
S�gnaWre
OWNER-BUILDER DECLARATIONS:
I hereby affrm that under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any stmcture, pnor [o its
issuance, also requires the applicant for such permit to fle a signed statement
[hat he or she is licensed pursuant to Ihe provisions of ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or that he or she is exempt therefrom and
the basis for [he alleged exemption. Any violalion of Section 7031.5 by any
applicant for a permit subjects the applican[ to a civil penalty of not more �han
fve hundred dollars ($500).):
❑ I, as owner ot the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intentletl or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
ihereon, and who does such work himself or herself or [hrough his or her own
employees, provided that such improvements are not intended or oKered tor
sale. Ii, however, the building or improvement is sold within one year of
completion, the owner-builtler will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS [o construct [he project (Sec. 7044, Business and
Professions Code: The contractws License Law dces not appty to an owner of
property who builds or improves Ihereon, and who coniracts for such project with
a contractor(s) license pursuant to the Conhactors License Laws.).
❑ I am exempt under sec.
Business and Pro(essions Code for this reason:
SignaWre Dale
3�5]-46(3/0])
, - .
Owner ID verified by tlrive� � ucense. ❑ Yes ❑ No
Driver's License No. Expires:
Verifica[ion of Ownership hy (type of document, i.e. - property [ax bill or deed):
�IVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify [ha[ no excava[ion frve (5) or more feet in tlepth into which a
person is required to descend, will be made in connection with work authonzed
by this pertnit, and Iha[ no building structure, scaffolding, falsework, or demolition
or dismantling thereof, will be more than [hirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 347, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safe[y, as noted above, unless
such person has a permit to do such work from the division.
ApPlicanfs Signature Dale
Division of IndusVial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neetl to fle and
certify a Business Plan tor emergency response to release or threatenetl
release of a hazardous material? ❑ Yes ❑ No
(Seclion 25505 of ihe Califomia Health and Safety Code requires, with some
exceptions, Ihat a Business Plan be (led with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume o/ 55 gallons, or 200 cubic feet of compressed gas
a[ standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file
a registration form for awtely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safery Code, with some
exceptions, requires registration with the Cos[a Mesa Fire Departmen[ by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
[emperature and pressure).
3. Does or will the applicant or presen[ or fu[ure building occupant need to
prepare an RMPP (Risk Managemen[ and PreveMion Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 0/ the Califomia Health and Safety Code provides that [he
Costa Mesa Fire Departmen[ may require [he preparation, certification and
filing with the Fire Deparlment of an RMPP by businesses which are required
to register acu[ely hazardous materials with the Fire Department.
4. I! an RMPP is presently required, has Section 25534 of the Califomia
Health antl Sa(ety Cotle been (ully complietl wi[h? ❑ Yes ❑ No
5. Does or will the applicant or present or (uture building occupant require for
the work which is ihe subject of this application a permit for such constmction
or motlifcalion from the South Coasl Air Quality Management District or fmm
any other air pollution con[rol district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires tha� the requested
information be fumished on applications (a noo-residential building permits).
6. Will any part of the facility to be constructetl under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qt'yes", Ihe facility must meet the requirement o( Sec[ions 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air polWtion contml district or agency is requiretl for the work which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certi�cate of compliance from the appropriate air pollution
control offcer).
CERTIFICATE OF COMPLIANCE I certify that under penalty of perjury the
information given above is correcL I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penalty of perjury that I have read thi application and state that
the informalion given is correcL I agree to ith all s[ate laws and city
ordinances relating to building con�tr�n d authorize representatives of
the City of Costa Mesa t Cer u the above-described property for
inspection purposes. I e not to cupy or allow occupancy of any building
authorized by this mit until f inspection.
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�noaessaeuioua: 2252 FEDERAI, AV
o,v�xsru�eica,ar'+: LOVING ROBERT E
wonrss: 2252 F�DERAL AVE
COSTA MESA,CA 92627
548-6687
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YICNIfECTOflFNtlNFEP: IIC.NU.: �
MCH.Ofl Otl.'S ADURESS: 1 1 1 9 9 '�f�t�l--�=iv UMf:
`��`T�� ft1424 EEBORCHARDMBING INC (714)550-9358
caNm�cro �� SANTA ANA CA ��, 495929
9 2 7 0 ,,,,,:
LICENSEU COMRACTOfl4 OECLAR�TION: I MeeW elfr'r� uiEer pe pw�ury Net I mn lieeved ivdx pra�'vim+ d Cheptr B
(mmmmdn0 MI� SMion )0001 W qMebn ] d Ne Busliwes eM PM GOM. vd mY limnee u in hA lau aM efletl.
cmuc.No.: uc.cuss: C—�6 uc. . 495929 EXP;
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OWNEN BUILD UECLRNRTON: I hmsb� etFmi undm ps�Wy d perjivy tMt I em eumq han �M Gammaae L'vama lew la IM
Idbxiq reem� (�ion lW t.5 Buaiiro� eM Prolea+bna C�e: Arry cry a aountY �� �Vuime e pertnu to oonsVucl. epx. impow.
'�nd'eh, u npei eny svicwre. pia io na'veuence, ebo req�irw tM epplinm Ip vuc� pemin lo fib e eipmd tlelemani Mm M ar eM
'mrosd punueM to tM prowiam d Ihe Cuurraws Limn�s �w �Chepx 8(comme�q rrilh Setlion ]000) d Di�'sbn 3 d tlr
m�av eM Prdwiuu Codel a tAn he n eM b azemq Ihrdvn end Ihe bsm la IM eAeO^d ssemWu�. My vulmion d Setlun
�,UD1.5 Ey vry eppliunt la e pxmi� abptls �he epplirem lo e d�il pmelly d nal mas Ihm fns hunEretl EOAen �f500¶.
� I. es owrer d tM pope�Y or mY emplv�eee xiih wep» b Ihei wle mmpeneetion. rrill do tM vrork. eM iM nWCNre e ml in�aMad
n oflareA br eeb (`siion ]aa, BusmeeeM Pmlaeaiap Code: TheComreaae Licerue Lew Eoee not eppF/ ioen owrcrd propeMy
who buide «inD�+e ihe�ean. end Wc doee �uM wak IimaNl a Mne1 a M�auW he or hm ovm emMPMa. po+�ded �hn ach
improudnmua ere nol iNeMad aWereE lu eab, tl. lwwmer. iM buitli�q «inpwemem w wN vrilhm arYau d mmpbion. Ihe
pwmrbuiHm will heve iM Wrdan M pw+iq M or Ne Dy �p WiM a impwe In tM W�s d mb�.
� 1. es awrer M �M P�oGeM. em exduen'M' aonVecM M'nh liceraed conVeMon b conqruq iM pMed (Seuion )OM. Bus'viwc end
Pmleeeione COCo: Tha Conlreclon Licenee Lew doee r�q epp�y W� owner d pmpany who builde « impovm thereon end who
conVecb la wM prqed� wnh e comrapor�e) IcemeE p�n�un� to the Gom�mae lirome law).
� I em uemp �Mu Seciian: B. 8 P.C., la Nb �esvm:
Dele: �^+bc
1 Eo Iwreby cenily Ihet I am ewere M enA undententl ihe ropViremamv of Caliomie HeeXh eM Salely Code Sediw 2550a, 25593, enE
255J1, enE tlut I a eny Murt Wikiiq arupenl vnll / wtll r�a (rircb aw) neeE to wmpty wih enid ume oodae enE tM nqu'uemWs fa
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aow.�..
ome: �va� an:
WONKER'S COMVEN9ATION UECL�NATION: I hareby dfym wds penWy d parjwy one d Ihe IODowieq dedeim"vu:
� I Ma eM W mein�en e centliula d mwnt to �etlimiva Ior xchen cdnpenwon, n pwitlod fa by Saeion 31W d tM lebar
Gods. ta tM prrlwmsncs d IM xarM ta wlir.n inie pq��p y�p��.
�] I lura erd wi� meimen woiken' wnpenmlun ineurence. � rpuired Ey Seabn 9100 M IM lebar Cads. far �he parfarmenca d iM
�x�a�.nw�umv.�nme.�e.Mv.«���'m�°�[.z.�.,�ewu�r��ca�e: EXPIRES
c�«:
rdrym,mw: 03/27/97
. sMion rieed rro16e canWsroC / fM P�{ u la one huMieJ ddbrs �3 Of bw.1
� I centy Ihel m �he pMamerce W ihe work la whkh t�ie pemi4 b ww d, dWl m� m�pb� em� pason n uy menMr eo o t0
bxmie abjw lo �M xoM1 �e' mmpeneelcn la�++ tl CefEmtie. ne ttel tl 1 JvJd bsmr r�bjz! lo iM wabn'
�ompen�e(ion pm ..on� d 5 aon ]]00 d iM leEa �ey. I du010 mnpy tiA Rma pmw'vm.
oma: � � � q ��:
Waml�p: pNun ro wc wortxi rorrparustlon roverp� l� un/awNl, �ntlWII �uDJec� m wmployw ro olMrel pwWtlu uM
emi niv. ,q m am nu+er.a trouaw ed�.n lf�al000A �n wNdon ro m� eo.t or rort�oawuon wnw u povrwa ror �n
Sxtlm J1P6 0l tlh 1.�4or Cob. lirtrpt. uM eRamry i/wa
CONS1PUCf10N LENOINO RGENCY: I Mreby ��m urcb penMy d perjury �het �Mn u e ouutewon bnd"vp epe�.y lor tha
paAmnenc! d IM v.pM IOf WM1iCh �11P VSm�1 If 68uBd (laetl{�MI'J09). Civ. L�.
LENOEP'3 N�IIE:
LENUER'S MOPESS:
1 cenity thm I hma �mE ihu epplicNbn eM sWe �hm tM ebmro iNamuion u oonop.l epne iocamply vrilh e0 dry eM wmtyad'mmus
ard ewa kv.s ralmip lo buikiq connrudion eM MreEy eut�e iepeeanimrvee d ihie dy io entu upon tM ebo.e�meMiond pvpeny
'«'"'°°°'°" 'v °° RALPH LERMAN
PnN Nemo
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s�a �ao..bneye�vnocs� Mrea�
(5151ap.WP)
wnaa-a��b�ro a sat.n: o�Fia: c�w-Aov�c w,ka,."��,: oouoo�oa�..�
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 078643
PERMIT NO: P 078643 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE; OTH
JOB DESCRIPTION : HOT 6 COLD WATER REPIPE SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1
COMMENTS: REPIPE RESIDENCE
*�x����rx *�***+�+rx���+r�r���*��r******���r��r�r***�**+�x�+r�r**�rx �r*��r*x **x�***x �r�r*�r� *�r�r*x��r+�*� x
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 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
PARKING REQ• PAOV: PARCEL; 42236409 ZNE: REF NO:
PLANNING NdTES>
% „
�E i! 1! 1E 1E 1k 1E 1E 1F 1k 1f 1E 1(-1f 1E iF k!E i! IE 1E 1k �E ik iE ik 1k 1E 1E iE 9f iE ik 1h iF 1E fE 1E If 1f 1E if iF ik 1E 1F 1E.lE iflE 1E 1E 1E 1! # 1f 1F 1k 1E 1t 1F 1E 1E fF 1E 1E iElf 1k 1E iF 1E IF 14 f! iE 1f 1E 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
ZONING APPROVED HY �a DATE:
BUILDING APPROVED BY : �'A\ DATE:
APPLICATION ISSUED BY; � �� DATE; �
*******��*��******�*** �*����****���*
LEGALIZATION:N F E E S U M M A A Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
8.75
258
SMIP/NON—AES
ISSUE FEE 22.00 �
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8,75 22.00 . 0.00 30,75 30.75 .00
REVENUE DIVISION TOTALS--> COliLECTED: 30.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30,75
k iF if 1E iE k 1E k 1E iE 1E i! 1E 1! 1f if i! 1k fE 1t 1E 1E iE k iE 1k ik 1f 1k 1f iE iE iE 1E i! 1E 1E i! iE if iE iE k 1k iF iE 1E iE 1k tE1E 1E 1E dF if 1f iE 1E iE if 1f 1E 1E 1k 1k 1E 1E 1E iF ik 1E 1F if iE 1E 1F 1E fE if
I N D I V 2 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 WATER RE—PIPE 8.75 8,75
END OF FEES
/ .� �
�� �1�
CONSTRUCTION AND PLANNING POOL °� SPA �
APPROVALS Permit # Date Inspector qppROVALS P� ,rt # Date inspector
i. Temporary Electriwl Service or Pole 52. Pool & Equipment Locauon
2. $oil Pipe�Undrgrnd. . 53. Steel Reinforcement ,. �
-3. El,�ctrica4 ¢njip'rt lhility-Undr�rrid. 54. Forms � - " `1
,' '�: • ' , ' ,
_ � : 4; Electrica4� ¢ �luit�U'odrgrnd. .� 55. Electriwl Bonding . _
;: 5. Steel Re;itfOr+� ment 56. Rough Plumbing & Pressure Fest
�. n� ..
��6.;ElectricaJ.,l.� ERGrnd. 57. APPROVALTOCOVEft�GUNITE
_ �
7. Footings ;�! i� • ' S8. Electrical Conduit-Undrgmd.
�� S. Foundation� ;' �- ., 59. Gas Pipe, O Undrgrnd., Test
-9, Water Pipe'u ,dt9rnd. 60. Backwash L.ines, F-Trap, � Undrgmd.
10. Structural Floor System _ a--� 61. APPROVAL TO�DECK_ - .
11. Property Sev,�er�Line & House�Connection 62. Backwash & Receptor�Pinal �
12.� Sewer Cap �� ; - . 63. Heater & Vent-Finai
13. Roof Drains .� 64. Plumbing System - Final
14. flough Plumt��ng 65. Electrical�Final
75. flough Electrical-CQhduit ' 66. Solar System-Final _
16. ROugh E�eclric Wiring 67. Fencing & AccEssApProval �.
77. Rough N%iring Sgn�� 68. APPROVED FQFlPLASTERING �•
18. ROuyh ElectrirabT Bar Ceiling 69. POOUSPA SY57EPltS FINAL
79. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20,r:Rough Factory Fireplace - - - - - . APPROVA'C3.� _, P,ermit # *
21.•Duas, in_Structure - -, . _ _ _, . ' 70 rUndeFgfeu`nd �ydro �`,
22. Ducts, Ventilating � _ <� � _ 77. Product-Piping�CJGas -E7 Oil
23. GBs�ipe-Roligh & Test _ , ;t � ' - 72. Underground Flush � _
24. .�ROof. Framing - --- . - 7'3, Undergc�d. Storaqe Tank � Gas ❑Oil
25. Roof Sh`edthing - - Y� -" . ` 74. Overhead HYd�o �
26. T�Ba� Ceiling (Structurap & Monocoat � _ r 75. Dry Chemicai - t- '• '
27. Frame and Flashing- '_ "_ � ` i 7b. Dry Stditdpipe� r_ c ,' �
28.' LJtRing & Siding_ � , r :_ � - � �•�> 77. FIXED-SYSTfa'+tt51NAt
29. Insulacion - '" � -. " - � i 7$. FIRE PREV. FIGAL .� -- '�
- . - x .:
30. DrYwaIl�Nailing � r "' ' + - • � ��N�AITH DEPT, RE9UI)iEMENT
31. P18ster Binwo Coat' ' � ' 79: F�NAt INSPEC�ION ' - �
-„
. 32: Electrica� PovJer Meter•Final �� . .- 86. FOOD CERTIFICATE {SSUED
33.�Fina1 Electric ' y " " '� , Nates: �P
• - , s . _ �j & (� �`�i�Z-�-�+
34.-Pina� Heating & Air Conditionita� - '�y, :
35. FinaF G35 Pipe-7est - - - � - ' �_
36: Hood or-CanoPY � ' . - _ � � - �, � � -•
37.:Finel'Factory Firep�ace, , �•'' - "' " �
38. Final. Plumbing '. ' � . .• � Il'I� .fl'� _� - -
l
� 39. Water Service-Final � � - . - � ��
- r. . .
A0. Gas Service�Final . _ . . " - ,
47. Solar pomesticfinal, � • � ( � - - _
� 42.`�Backflow Preventer � . , . -
43. BackFlow irrigation . _ _ � r ' ' -
F �'
i � _
_44. L.Bndscape Ic{igation Systerr� = . � -� - . � , - .
-45. Sound Atte2uation - - � - " '= e
� �-
46.� Hgndiwp Regufations - - � 'y f' _- �- - �
47.:PINAL STRUCTURE & BUICDING
�48.�FINAL PLANNING . , - . �
49._E18ctric Release to Edison �` 4� � � '
�
50. Gas Release to Southern California Gas Co � � �- _ "
51. CEftTIFICATE OF OCCUPANCY , : = - --
No. Date
��
COSTA AAESA BUILDING DEPARTAAEIVT �'
---- P. O._ BOX _ 317^^....
4 FT. FENCE MAY BE PLACED ON DOTTED LINES ------
8 FT. FENCE MAY 8E PLACED ON SOLID LINES
I 6525 I �'�� ��C����
, �
FOR APPLICANT TO-�,; 3 . 22 .��v
5 Z � • �HP �[
BUILDING 1�pI�RES5 z � :.. _. __�?:: -..��"
Mail Addr s� 2 Z'S�Z �/�A�/��„�_
tuy
City_ �-G/�/ Ph. No.��+�
Contractor ��k- Ph. No �6�
City Lic. No. _ State Lic. No.
Size of Lot %S%/ Da AP No. �af y Ttif2 p�3
Setbacks: C/L Streef .S`D Rear ��� �
Side Yard - Right � Left �
I Type of Fence �A�ad� �5 � �`., /(1 � � �
�
� ��c
I�� I hereby acknowledge that I have read this application and state
� ihat the above is correct and crgree to comply with all City Ord-
Iinances and S/ta �� ws regulating building construction.
'I Signature // �� n
°of Permitteg ( � �e--`�/ -Z2.� 2�
� ��; � ' , �-
I Agent ``
r � '� �
c I '�' FOR' OFFICE USE ONLY
� � .: 6 . � �
° � Permit No.
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� � C"p (� :G'Vl�l.- �. �i� S`.�� �
I,
� � � VALUATION
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� p/ 7
? I:,j e � P_ $ �
I C�
.
- a.�'- s �i '3 as-
� Permit Fee
�, Plan Check
TOTAL FEE
USE REVERSE SIDE FOR DETAILS
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Cross
esa Bnilding DegartmenE
P. O. Box 3!7
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
%g o2 .i-, S:1 �'.Ccic �i .a L �i
Costa Mesa, California
or "
Attach Metesand
Existing Bldg. ^
Set6ack Line from
Center of Street .�
New
Use ot Ne�J-
Buildinq �/w,
�
I Block �' � Trae��
No. of Bldga �
9l! Nowon Lot
No.of No.of
F,amilies Rooms
� RearVard d'�'
Side Yard i �
Rooms
I Roof
Demolish
APPLICATION FOR PERMIT
�R1.9 BUILDING �
FOR OFFICE USE ONLY
Receipt No. Per�m^it oNo.
V J Q S
�Rece've by D,a/te Rec'd./ D/a'te Issued
'" % � c.5 C '7i .�� S
Builtling
Address
Costa Mesa, California
Nearest
Cross St.
CORRECTIONS
APPROVALS
in Location Inspector
Materials,
�Inning
ire Stops,
I hemby acknowledge that I have read this Application
and state that the above is correM �nd agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building rnnstruction. Lath. Ext.
Signatureof � Q
Permittee �/3'v������� Plaster, Int
Authorized Agt Plaster, Eut
Valuation Permit Fee $ q� 02 —�— Masonry Rei
$ �d ��C� Plan Check $ � / -- gond Beam
o �G— ' Fee I $ �� � FINAL
coam zoa �o.ee o. e. e s.
Date
O
A
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2
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PLUT PLAN
Show locatlon and distancea fram
property Iine antl between huitdinge.
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