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Home My WebLink About449 FLOWER ST - Building PermitstG�� MF 9 o � > _ : J .�"' �� _,�.a (714) 754-5273 • Fax (714) 754-4856 Job Address: Suite No Vicinity: . CITY OF COSTA MESA ` BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 449 FLOWER ST Parcel Nunmber: 11734210 Applicant: GERLICH, JEFF Address: Owner: ELLIS, JAMES D TR Address: 2272IRIS AVE � SAN DIEGO,CA contractor: MC KENNA'S AIR SUPPLY Address: 761 n richman MECHANICAL PERMIT Phone: Zip: Phone: Zip: 92154 - Phone: 714-879-4444 � fullerton, ca. Zip: 92832 License: 626029 ArchlEng: Address: Phone: Zip: ' License: SCOPE OF PERMIT REPLACE EXISTING FAU UNIT IN HOUSE. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Dud Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000dm AirHandlers> t0000cfm FloorFurnace Floor or Suspend Heater $22.00 $13.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY PERMIT NUMBER � M99-00014 77 FAIR DRIVE, COSTA MESA, CA 92626 Quantity � . Repair / Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System 0 Evaporative Cooler 0 Commercial Incinerator 0 Domestic Incineretor 0 Compressors / Absomtion Svstems 0 Upto3hp/100kBTU 0� . 3 To 75 hp / 500 k BTU 0 15 To 30 hp / 1,000 k BTU 0 30 To 50 hp I 1,750 k BTU 0 Over 50 hp / Over 1,750 BTU 0 Boilers 0 Upto3hp 0 3To15hp 0 15to30hp 0 30 to 50 hp 0 Over 50 hp 0 Other Mechanical Fee 0 Invesligation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED i�v-/ Applied: 01/14/1999 Issued: O1/14/1999 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 so.00' o $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 E35.25 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 1 BO days. . INSPECTIONS: In order tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSqT10N DECLARATION: I hereby ettirm under penalry oi perjury one of the tollowing tleclarations: ❑ I have and will maintain a certificete of consent to self-Insure for workers' compensation, es provitled for by section 3700 of ihe Labor Code, for the peAormence of ihe work for which lhis permil is issued. ❑ I have and will maintain workers' compensation insurance, es required by section 3700 of tha Labor Code, for ihe pedormanrs of the work tor which ihis permit is issued. My workers' compehsation Insurance cerrier end poiicy number are: Carrier: Policy Number: (This section need nat be completed i! the permif is velued at one Aundretl tlollers ($100) ar less.) ❑ I certify that in the peAormance of ihe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomis, and egrea thet if I shoultl 6ecome su6ject to the workers' compensetion pmvisions of Section 3700 ot the Lebor Code, I shall torthwith comply with ihese provisions. � g �1 p ApplicantSignature: �� ,i.J ��i1.P . Date: �—�7-7� WARNMG FAILURE TO SEC R OR ' CAMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIE$ AN� CIVIL FINES UP TO ONE HUNORED THOUSAND WLLARE ($100,ppp�, IN A�THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O6 OF THE LABOR CADE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirtn thet I am li�ensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 0l lhe Business and Professions Cotla, and my licensa is in tull force and eHect Lia # Cless # C Contrector'sSignatura: � � Date:� /—%�—�L� GONSTRUC710N LENDING AGENCV: ❑ 1 here6y aHirtn ihat ihere is a construction lending �agency for the perfortnance of the work for which Ihis permit is iuuad. (Sec. 3097. Civil Cotle). Lender's Name: _ Lenders Address: SignaNre: OWNER-BUI�DER DEC�qqpT10NS: Date: I hereby aHirtn that under penalry of perjury that I am EXEMP7 FROM 7HE CONTRACTORS LICENSE lAW tor the foilowing reeson (Sac. 7031.5, Business and Protessions Cotle: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repeir eny stmcture, prior to its Issuance, also requires the applicent for such permit to file a signetl statemem that ha or she is licensetl pursuant to Ihe provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business end Professiong Codej or that he or she is e:empl iherefrom and Ihe basis !or Ihe atleged exemption. Any vioiation of Seclion 7037.5 by any applicant for a permii sub�ecis Ihe applicant b 8 ciml penalry ot not more than fve huntlretl tlollars ($500).): ❑ I, as owner of the property, or my employees with weges as their sole wmpensatlon, WILL DO 7ME WORK, and iha stmcture is not intendetl or oNeretl tor sale (Sec. 7044, Business and Protessions Code: The Contrectors License Lew does not apply to en owner ot properry who builds or improves thereon, and w�o does such work himsell or herselt or through his or her own employees, provided that such improvemems ere not intended or otlered for sale. H, however, [he building or improvement is soltl within one year of completion, the owner-builder will �ave the burden ot proving Ihat he or she did not build or improve for purpose of sale.). ❑ I, as ownar of tha property, em EXCLUSIVELV CON7RAC71NG WITH IICENSED CONTRACTORS to construct the prqect (Sec. 7044, Business and Professions Code: The conVactors License Law does not apply to an owner ot property who builtls or improves thereon, and who coMracts for such project with a coNractor(s) license pursuant to ihe Conirecmrs License Laws.). ❑ I am exempt under sec. Business and Professions Code tor this reason: SignaWre: Date: Owner ID verified by tlrivpr's license. ❑ Yes ❑ No Drivers License No. Ezpires: Vanlication of Ownerehip by (type o1 documanC i.e. - pmpeny Iax bill or deed): DIVISION OF INDUSTRIqL SAFETY PERMR CER7IPICATION: ❑ I hereby cehity ihat no eacavetion five (5) or more teet In tlepth into whlch e person Is requiretl to descend, will be made in connaction with work euthorized by ihis permit, and that no builtling stmcture, scaHolding, felsework, or demolitlon or dismentling thereot, will be more than thirry-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Celifomia Atlminisiretive Cotle). • ❑ As owner-builder, I will not employ anyone to do work which would require a permlt trom the Division of Industrial Safery, as noted ebove, unless such person has a pertnit to do such work irom the aivlsion. SignaNre: Division of Industnal Safety Pertnit Num6er: Date: CERIIFlCATE OF COMPLIANCE AND AUTHORVATON OF EMAV: I certify under penalry ot perjury iha� I hava read ihis application and state that Ihe infortnation given is corred. I egree b comply with all stete laws and ciry ordinences releting to building constmction, and authorize representatives ot ihe Ciry of Costa Mesa to enter upon Ihe ebove-describetl property tor inspection purposes. I agree not to acupy or allow acupancy of any building authorized by ihis permit until final inspection. COOE f. INSPELTION TVPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Ra-Roof 207 Final BIocWReteining Wall 202 Final Fectory Fire Place 203 FinalSign 204 Final �emolition 2646 46 �� LQUE� IXSFECTIONTYPE 206 Finel Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Finel Planning Approval 222 250 Dete / - >y- S9 Date Final Site Final Builtling/Occupancy `�LAil-LL 31�L � ./ , CITY OF'COSTAIYIESA .�(,"ON�TRUCYION PERMIT � �� ProiecS Address Applicant to fill in all spaees exeept tnose within �� Owner's Name �� han�" -" �`�' � � Addreu , A�h/Eng. Licen NoC"� I Address ^ � I Contractor's Nam hone Address Imailing) 0 W h� City license No. LICENSED CONTRACTOR DECLARATION ' I hereby affirm that I am Iicensetl untler Orovisions of Charter 9(commencin9 wi[h section 7000) of DIVISion 3 0l tne Buslness antl Protessions Cotle, antl � my license is in full (orte antl eftect. • ' License Class License No.• � Date Si9nature WORKERS' COMPENSATION DECLP.RATION � ' ' 1 here�y�aHirm that I havo a certiflcate bt mnsen[ to selbinsure or a certificate .-of Workerz' CompensaUOn Insurance, Or.d C¢rtl(ietl' mpy Thereof (SeCtlon . 3800, Lab. C.) , ' - ! Policy No. ' Company eCertifietl copy is hereby furnishetl. � - , � � , � � ' Certifietl copy is filetl with the city Bulltlin9 Division.• Date APPIiGdnl � EXEMPTIONFROMWORKERS'COMPENSATIONDECLARATION ' (This section neetl not bo completetl if ttie perml[ is for one M1unaretl ($100) or less) ' ,�.. ' `: ' 1 certify�that in the parformance ot the work �or'which this perm�t is�issuetl I shall not employ any pe�son in any manner so as to ecome Subject o the Workers' Co p �j a lo ws of Califernia'' � Date __ �%Si9nature�-� ' NOTICE: It fte� aking this tlecla�ati0� YOu ❑OWU become subject to h0 Wo�ke�s' Comp¢n5atlon O�ovi5ion5 Of the t2b CoAe, you must Porthwith comply with� such orovlsionz or tnis p r shall be tleemetl revoketl. CONSTHUGTION LENDING AGENCV� . - ' I hereby alflrm tnat there is z mnstrucUon lentlin9 a9ency for the oeriormance of the work tor, vOhicn his per!�it �5 Issuetl (Secti� qn 309] Civ. C.), Lentler•s Nam¢' ��` �N "^ �- Kn pn N Lentler'S Atltlres y ✓ I nv .. e 12� ne �SLI- OWNER BUILDER DECLARATION I hereby atfirm Nal 1 am ¢xempt 1rOm the C6nVactor's License Law fOr the tollowing rea5on (Sectlom 7031.5 Business antl Prof¢zsional Cotle: Any ciry or � county which requires a permifto construct, alter, improve, aemolish or repair any structure, prior to Its lssuance, also requires the apP�icant'for such vermit .to file a signetl statement that'he/she is licensetl pursuant to the provisions of the Contractor's Ltcense Law (ChaD�er 9(commencing wi[h Section 7000) of Divizion, 3 ot tne Business antl Professions Coae) or tnat ne/she is exempt therefrom antl tne basis for the alle9etl exemption. Any violation of Section 7031.5 by any apo��t for a permit subjects� Ihe- aoP��ant to a civil �e,n� Ity of not more than five huntlretl dollars (E500). '�-. - ' id I, as', owner of tho pro0e[ty � � s�-ac-tPei�feb- .� m .•��n... �y7�� Co the work. antl the ztrucWre is not intantletl or offeretl License law tloes not apply to an owner oi a pro0erty.wno bWlas or Ymproves Ihereon, antl'whoitloes such wo�k'nlmself/h¢rsElf or throu9h hI5 or.he� own employeez, p�ovitl¢tl that such ImOrovamenl5 arC nOt intentletl or offe�etl tor sale. If, however, the bulltling or Improvament is solG within one year of com- � pletion owner will have•the bu�tlen Ot proving he/she tlitl nOt builtl or im- . �ro or Ihe purpose of sale). I, as owner of [he property, am exclusively contracting with licensetl con- ' tractors to mnstruct tha prqect (Section 7044, Busines5 antl Professions Cotle: � The Contractor's License Law does no[ apply [o an owner of property. who builtls oi improves tM1¢reon,.antl who cont�act5 (o� such p�oje<ts with a con- tractor(s) license pursuant to the Contractor's License Law). • � ❑�I am'exempt untler Section � � B. & P. C. for this reason Date Owner I hereby certity that I have reatl this appllcatlbn antl state that the above information is correcL I agree to'comply with all city antl county ortlinances antl�state laws relating�[o builtlin9 construcHon, and hereby au[horize repre- sentatives of this tlty tp ertter upon the above-mentionetl 'propefty�for Drivers' Lic CMF 0865-46 t�' 55 � i V " [ LL TYPE OF CONSTRUC ❑ CONVERSION DESCRIPTION OF borOer lines antl sign ali apvropriate aeclaratlons. IO ADD ALTERATION TVPE OF PERMIT LJ GitADING LJ FOUNDATION �a ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ ME � OTHER L ,rI t PROJECT DESCRIPTION Sa.Fr. o CONSTpR�CTION TVPE � VA UAT 20NE C�-I- GRADINGCU.VOS.� Remarks: _ �'� � � r{ � j. � • � Preventer Irrigation ing Founlains Orains ' Gas Service Interceptors' Kitchen Sink Lavatories � P-Trap Roof Drains' Reinspection Fea � Showers - F � ' Service Sink ` � - � SewerCap - �_,- SewerConnection � � Solar Collectors ' n� �, Solar Piping - � � . SolarTank .- ' Swimming Pool wJSpa , � Urinal Outlets 2 Water Closet Water Heater Water Service � � � , $25 , laue Fee ' Duct - Under Ground Duct � S[ructural Duct-Ventilating ' Enhaust System ❑ Multiple Firepl/Fact Blt. IC80�-/k � Heating System & Ducting , ❑ai oo,000 sru O i oo,000 -�� T�-�— I I Rainspection Fee Wnite -�Bulltling: Canary - AVP��ant: Pink - Accounting;.Goltlenrotl - Assessor $25 Hood or Typel ❑ Canopy Type I I ❑ �aioo,000sTu ❑ioo,000 SysPem Repair/Alteration� Issue Fee lJ REPAIR � A.P.# 1�1 -3 L S Main Building: RA� T Front /� ARear � � G�, C Right %y � g Leh ,S ._ /i � Ping. Ref. # • Parking Req./Provided L� Z] Q3 Uuof Building: F Fc Planning Notes: L� � GCl Automatic Washer ! Construction PoleSub. Caoking Unit +- � Dish'washzr � � Dryers ❑Gas ❑Elec Fan II V.cn�� .. Device Boxes Outlets.. Switches , . Ga7bage.Dispoul Generator �65 KW S 3 ` ' � Rein'speition Fee FEES �. PUBLIC SERVICES REQ Zoninp Approvad By� ApPlication Approved By Application Issued By_ $ 3 7720 I::/21/J- , � - fu Zone - - Accessory Building: Z O � N R- N Q!� � G R E � Park.Fees $. � n U I R I1 E � USG Res ' � �Or1 '� � � E K e t la �i N a u � T � ELECTRICAL �Transformer ❑ 15•50 KW � � SO+KW Meter ❑up to.100 amps . Meter ❑over 100 amps Sub Panel . , Momrs Oa1 HP O1 X- a � , Inc:Solar'�9-15 HP �16�15+ Pole Ligh Range �,_ �' $ign� � . - Standing 15�XW Trosh Co . •S25 Issue Fee E ENTry1Kw � -� :, : .� lfC.� � �"' '' su BUI LDING PERMIT $ -,�' -�� PLAN CHECK $ =' PLUMBING $-� . .PLAN.CHECK $�_ ;ELECTRICAL $'_� •� iLPLAN CHECK $� � _ MECHANICAL $ _ ,_P.LAN CHECK � $ _ FEES � $ 3 ��SMIP $ �•� PERMIT •, ISSUANCE $ ' � ENERGV P.C. � $ ��GRADING $ ' �';MICROFILM $ �J TOTALFEE $ `29 � .d, -,CONSTRU�TION AND PLANNING � � � � � ', POOL & SPA � APQROVALS Permit�k' � � Date �� Inspectoi qppROVALS Permit# � - ' Date Inspector i , �i. Temporary �lectrical Service or Pole � , 52. Pool & Equipment Location _ ', `2. Soil Hpe�Uadrgrnd. � . ' - . . 53. Steel.Reinforcement . _ ' � + 3. ElectricaLConduit Utility-Undrgrnd. � 54. Forms � . - � . �_ . -4�;Electrical'Cdndui;•Undrgrnd. � 55. Electrical Bonding � - r 5.�Steel Reinforcement . ," � , '56: Rough Plumbing & PressureTest . 6.�ElectricalUFER,Grnd. � • , _ _ 57: APPROVALTOCOVER-GUNITE - 7. Footings -, �- � � 58. Electrical Conduit-Undrgmd. � 8: Foundation �. • ' 59. Gas Pipe, � Undrgrnd., Test' ,_�, 9.`�Nater Pipe-Undrgrnd. � 60. Backwash Lines,-P-Trap, � Undrgrnd. � 10. Structura� Floor•System ' �_ _g3 M�. 61. APPROVAL TO DECK - 11. �property Seiver Line & House Connection � � 62. Backwash & Receptor-Final � 12. Sewei:Cap ;. ' , �63: Heater & Vent-Final 13. Roof Drains '; 64. Plumbing System - Final � � 14. Rough Plumbing '��/¢/ �9 � � 65. Electrical-Final .. 15. Rough Electrical-Conduit � � " 66. Solar_System-Final 7�6. � Rough Electric Wiring � �'2� 67. Fencing & Access Approval -� 17. Rough.�Jiring Sign � 68. APPROVED FOR PLASTERING - �18. Rough£lectriral-TBar.Ceilin9�'� � - 69. POOUSPASYSTEMSFINAL - 19. Rougli�Heating & Air Coeiditioning ��/�� FIRE DEPT. REQUIREMENT ., �20. RoughFactory�ireplace.�. ' , APPROVALS Permit# : � 21. Ducts, in,Strucfure ,��: •� 70. Underground Hydro - =22. Ducts,yentilaung, , �, �;� � 71. ProductPiping�Gas ❑Oil ." ' 23. Gas'Pipe-Rough & Test � . . ... t�� , ;�}2. Underground �Flush ' . 24.,Roof Framing .,• ��' ` 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof.Sheathing� ,.� , : . r� � -� ��? 74• Overhead Hydro � 26. T-Bar Ceiling (Structural�'J& Monocoat � 75. Dry Chemical '�7. Frame and Flas g f"�'"i "'"a�"' � � 76. Dry Standpipe � +• .+r b.s� A-i+gi d I 2 6 b' 28. Lathing &�Siditig ok �i`S S,7 �""""�'Y+ / 2_(_�ji 77. FIXED SYSTEM FINAL . - 29. Insu1ation��"d` ��` �2 Z2�� 7g. FIRE PREV. FINAL � 30. Drywall Nailing �?,�. • 1 Z-S'�3 �,Y ., � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coai'�� ' �Z_Z-2.' � 79. FINAL INSPECTION 32. Electrical Power� eter,-Final -' ' ': .80. FOOD�CERTIFICATE ISSUED ' �. . 33. Final Electric � ;j. . '<< � ;.Notes: _ 7 _� -� 34. Final Heating & Air Conqitioning _ �. � `1 35. Final Gas Pipe-Test ' , . O 36. Hood or Canopy • � , '.� . � /"/ '� , ' L 37. Final Factory Fireplace ll �l $�-g' ('7 K f'o e,rle�ior qth 38. PinalPlumbing �... � o ��., 39. WaterService-Final � ��'�' � p RS . -tJ• 40. Gas�Service-Final _ ��Z�1'�3 Fru.,;H �snd�'�a S"fqirl dDec +� , 41. Solar pomestic-Final • gy}her " fvo o W, � 42. BackflowPreventer �"� IZ-S-£�3 n�U'� (`{q� , r'�er.lor�� 'i�h , �S� bctto � ,.� 43. Backflow Irrigation _; ,^. � ` + - �`� '- ' �? 44. .Landscape Irrigation System . ', �� ' �45. Sound Attenuation � � 46. Handicap Regulations ' � _� , , � � 47. FI,NAL STRUCTURE & BUILDING„ . � 48. Special Requirements Completed� � � � . � 49. Electrie Release to Edison � � � . ' � . � � ` � � � 50. Ga�s Release to Southem Californie Gas�Co ;. . - ' i�-� 51. CERTIFICATE OF OCCUPANCY� . . ' � - �.!! �i ' � ,il ' � r � .j No. Date � ;'� ' ' ' " ` . � CITY OF COSTA MESA . BUILDING DIVISION OWNER-BUILDER VERIFICATION .. A i .. •. A city or county, which is required to give notice pursuant to Section 19630, 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-builder verification. � Attention Property Owner: An 'owner-builder' building 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 proposed property improvement. 1a' Yes O No 2. I(have/have not� �/�r.�.— signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name e��T�--� — Address City Phone ( ) Contractor's Lic. No.- 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name � /�'�� Address City Phone ( 1 Contractor's Lic. No -• 5 I will provide some of the work but 1 have contracted (hired) the following persons to provide the work indicated: Name Address Phone � Type of Work 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 personal knowledge, in compliance with this State law. Signe . Date: Name: �D�N �I-Q.2.N��11 ' (Printed or Typed C.D.L #or S.S. # ✓' CMF 304246 7545273 CITY OF COSTA MESA ��-�35� � � BUILDINGDIVISION PlanCheckNo. ' . or PLAN REVIEW CORRECTION LIST BuildingPermitNo.: ' lectrical Plumbing ❑ Mechanical r �i/%y %� �(A7�� 5 % JO8 ADDRESS ,��NN.DO/� OWNER %�� Y'd�i�i9-K CHECKED BV SUITE OR SPACE ii��%'iBN- /TrGv�oe,vc� JOB DESCRIpTION Zl i9GT�� DA7E CMF 0966-46 White - Bltl9. �iv.; Pink - AOO��ant JOHN E. WELLS ARCHRECCURB 8nd ASSOCIATES - ARCHITECTS A.IA. 3160CI�MPUSONIVE,HEWPORTBEACM,C<LIFONNI• BJl-11]I PLANNING ENGtN88R1NG 11-28-�3 G'�T Y a f Cr�s�-A NC � �d i�r,�i n� �5�.'f �r� �E�: 2nr� Sio�z�j Q corE-� o►� �vcanl li t.�z,n�1�1 �-�-� ��k.tZ S�. ��'� M�a. �°rZ S"2 � .�-r i s n�T �x � +�zrzs � i p R��t'LS �}�� SI�� n��A�zY ro � n5�� U. t�� F3LE AT T+1 � i►1��►2.s�� c7 n�'�'�-I E 1 Y� `iilE R.G�F �'l2AM IY?6 . 2X (o M a� v� 12d�- ��.�, I S Sl�1�Ti G��. OWNER \e�{ AP No. ].17-3�F2-10 �0T 10 �INSPECTIONS soa G AS W �TER ROUGH PROP. 5'NA� LINE U HOUSE SPRINNLING SVSTEM AIR CON�ITI�NING UNOERGROUND U ; POWER ROUGM WIRING REINF. BONO BEAM LJ STEEL REINFORCE SMEATHING FRAME PNO F�AS� LATHING - �N OUT PlASTEp. 6ROWN COAT HEATING� VENT., REFRIG. AND A.C., FINAL TEST BUILDING. FINAL DATE SUBCONTRACTOR il .. � 27438 ' COSTA AAESA BUILDINGSAFEfY DEPARTMENT p.0. BOX 1200 COSTA MESA� CALIPORNIA OZ62E For ApplicaM fo F(11 In Completdy TYPE OR PRINT COSTA MESA, CALIFORNIA . ..- 1 1 � 8rT I�y / (7 RIOMT DESCRIPTION OF WORK BUILDINO � .r 1 X6P6pY ACKNOWL�DOi TIAT.1 HAVI IIUO TNI� A�►LIGTON AND BTAX[ TNAT TX[ /�lOVi ID CORq[R ANO AOR6[ TO CAY- PLY WITN ALL CITY OROINANCp A�(D R�1[ tAW{ �[6YMTtN6 OW�DINOeoNBTpyC�ION. , � _ n AUTM011�=�D AOtNT � rnm r...;.::,�' L'�G 15-G7cr;;�OO 855:> ..I?.5L ,4rPLICATION FOR PERMR BUILDING for Offlc� Us� Only eccivr no. �i s��:'-,;�, ZONING ��v ��, — �� `- /c� iHANO 6NALL OB L688 THAN YApD6 MPROV [D MAIN 6UILDINO v�n. # TXl AYOYNT RIRlO![ O► s/(v7� �— YARDBAPPROVHD ACC6880RY BUILOINO � ��/O�/ "�_ �. e owrs ' a m � � � v��u�noN ie ron TMi � /. P6pYli I68 ONLY. � � � IT F88 ' � �`o eHeeec S w � � . . - _- ��L i �s�4 FEE RECEIVED COSTA MESA BUILDIN6-SAFETY DEPARTMENT �� 15 �ggy P. O. HOX 917 C08TA M68A. CALiFORN1A fIPfANCE OEPT. {�`� For Applicanf fo Fill In Complefely C�TAPPLICA'fi�N� PER ��f 7 TYPE OR PRINT BUILDING BUILOING ' � ADDRESS GOSTA MESA. CALIFORNIA For Office Use Only (^ RECE�PT NO. PEPMIT NO. OWNER tr MAIL t` RECEI D 9Y I D RE I E� I D'j£��- D ADDRESS � � � TEL. BUILDING .(�/_ dTY NO. ADDRE65 �T �/ ' � ARGHITEGT TEL. �� COSTA MESA. CALIFORNIA OR ENGINEER NO. A�DRE55 FIRE ZONE TYPE � GRO/U�P CONTRACTOR � APPROVE X // � / Y BY 0 OATE V (O �O C•i ADDRESS �' ZONING �'��' �' ZONE NO.OF �+� � U8E OF NEW �-�/Lf c• /�� ',�'jy I PIANB �J�1 BUILDINO �� T W�-I ✓ l 0. .J� STATE TEL. LeoAL � I I-, �� K� LIC. NO. NO. o68crtiriiaH " / 6� 1 1 BIZE �P � � NO. OF BLD08. OF LOi I NOw on �Ot A p NQ '! _�! �, _ Q USE OF YARDS EVES EXIb71NG BLOG ^ APPROVEO ALLOWEO SCTBACK LINB Ffl�M �p�.�`O ICCNT6F LINe eiJ �_ �NieA OP BiPeET REAR YARD • FRONT �� 1 ' IN. SIDE YARO I LEFT I RIG R. SIDE � SFT. I IN. DESCRIPTI OF WO L.61DE �FT. IN. � NEW I IIALTERATION I IIADDIT�ON I X gEAR O FT. I�W, REPAIR I IIMOVING I IIDEMOLISH BYPROVED ��' U�E� BUILAIN6 /�/ NO. OF SIZE D✓ ROOMS ST IES I EXTERIOR W IROOF COVERING COVERING USE UIL ING AND WOAK TO BE E FORMED _ • D pi 1 HEReBY ACKNOWLeDG¢ THAT I XAVE READ TH18 MPLIGTION TMg AMOUNT BHOWN UNOER VALUATION 18 FOq THE ANO BTATE THAT TH8 ABOVC 18 LOPNECT AND AGAeE TO COM- pVpp08E OF ESTABLIBHING p PEftNIT FCE ONLY. PLY WITH ALL ��TY ORUINANCEB �D BTATE IAWB IiEODUTINO Bu�Lp�Ho coHBTRUCT1oN. VALUATION ./ � SIGNATURE F PERMIT FEE $a{ 6 PERMITTE . / X/� /n v S/!� ��D � PLAN CHECK S V 3� F AUTHORIZED AGEN v� � � O TOTAL FEE LL