HomeMy WebLinkAbout3296 GEORGIA PL - Building PermitsOctober 2, 1994
CITY OF COSTA MESA
CALIFORNIA 9262&1200 P.O. 80% 1200
DEVELOPMEN7 SERVICES DEPARTMEN7
Bear Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 3296 Georgia Place, Permit No. B65442, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 (d) of the 1991 Uniform
Building Code. Should we not hear from you within l0 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit could possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627.
2. Request an inspection; state address, permit number, and type
of inspection.
3. Be sure to have working smoke detector's as required per
Section 1210(a) of the 1991 Uniform Building Code.
4. 'riave an adult present at the property at tne time of
inspection to provide us access.
Should you have any questions regard'inq this process, please
contact me at (714) 754-5273.
Thank you for your cooperation.
Sinc�y�
Y�dlanda Hua a �����L v
P Y
Permit Processing Specialist
77 FAIR DRIVE
Builtling Oivision p1a) 75a.5279 • Cotle Entorcemem p14) 75<�5623 • Planning DiviSion pla) 754-5245
FA% Q1a) 5567508 • TDD (71a) 754-5244
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PNOJECT AOOflESS: 3 Z 9 6 G EORG IA PL
OWNEN'S NAME: MARCHAND PAUL P
aoonEss: 3296 GEO{tGIA PL
COSTA MESA,CA
PflCH/ENGINEEX:
AOOflE55:
UNIT:
92626
PEG.NO.:
UNIT:
PENMITiEE: PAUL PIERRE MARCHAND ( 714 ) 557-4817
aooeess: 3296 GEORGIA PL
C.M. CA 92626
LICENSEo LONiNACTOB DEGUNaT10x: I neie�y alfi�m Inal I am licensea unaer v�ovisions ol Chapter 9(cammencinp wiln Seclion
7000) ol Omsion 3 0l Ihe Bu9n[SS an0 Proleuions CAtle. ana my hcense is in full force anG eflttt.
LITY LIC.: ST�TE LIC.: CIASS:
Oate: Signalure:
WOHKEBS' LOMPENSRTION OECLAMTION: I her¢by aflirm Itlai I have a t¢rliliwie 01 cOnsenl Io SeIlJnsure Or a C¢tlilicale at Wark¢�5'
Comoensation Insurante, ot a ceniliee copY ��ereof (Secuon JB00. La�. C�.
POLICY NO.: EXP. OATE:
COMPANV:
-] Cenilied copy is Aereby furnis�e�. ❑ Certilied copy is IileA vnth t�e cily Building Oivisian.
Oa�e: ADDlicam:
E%EMPTIONFBOMWOflNFBS'fAMPENSPTIONOECUMTION: �ThiSSecfianneetlnalU¢compleleCilNeperm1i5l0ronehunOreO(51W�orl¢55).
I cerlify �Iwl in the pedormance ol t�e work tor w�ich this permil is is5ue0. I shall not employ any persan in ny manner so as �o become
suble�� �o I�e Worker2s' fAmpenSalion laws ol Calilomia. n�� � y(���
�ale: I� / ZT /� Signature: _f� � "��
NOTItE: II. a�let making Illis Aetlaralion, you SOou10 hetome 5ubjeC[ �o Ih¢ Waficefs' Campensation provaions al tAe La�or
Caae, you musl fontrvntn comDN ��� sucn pmvisions or Ihis ce�mit snall Ee EremeA revOkeO.
CONSTBUCTION LENOING AGENCV: I OereOy allum ��at ��er¢ is a tonslmt�ion IenGing apenty �Or lhe Detlurmance 01 l�e work lof
wnicn mis permii ¢ issuetl IStttion 3W7. Civ. CI.
LENOEP;
noon¢ss:
OWNEB BUILOfB OECLAMTION: I h¢r¢Gy allirm Iliai I am exempt Imm I�e Conlratlors' State Lkense Law lor �Ae lollowinp �eawn
(Seclqn 7Q37.5 Busioe55 anG Proleiti0nal CuUe: Any city of toun�y wNcn rCpuire5 a pefmil �a mmtrutt, altet, imprOve. aem0lish. ar
re0ai� any Siruclure, prio� IO ils isSW�Kl. alsa repuire5 ��e applitani lor Such Defmii to lil¢ a Siqnetl Slalemeni Ilui �dihe is litensed
pursuanl to Ine D�m+s�ons ol me Conuador5' State License Law IChao�e� 9(�ommentiilg wit� Seapn 70001 ot Oirisron 3 0l ine eusiness
anU Professions LWe) or I�at �Us�e i5 exempl I�erefmm anG t�e Oasis for t�e alleg¢C exemptian. Any vidalian ol SEttion 7Q7L5 Ey
any apPlicanl lor a peemi� 5Wj¢CIS l�e aOD�itanl to a civil penally of noi more ��an five �unGr¢G EMlars (5500�.
,y 1. as owner of ine oropeny or my employees vnih wages as iheir So1e compet5alion. vntl Ao Ihe woM1, ane Ine
❑ s�mclure is not intenUeO ar aflerea for sale (Section 7044, Business anG Pmlessional Coae: T�e Controcmrs State License Law
Uoes n01 apply Io an awner 01 a Orop¢riy who �uilas or impmv¢S thereon, ana wh0 Uoes SUth vrork him5¢I�lA¢rsell Or IhroUph
�is ar �er own employees, D�ovitleC t�at such imDrovemenis are not inten4e0 or offere0 lor Sale. II, �owever Ihe huilding or
impmvement is So�C vnRlin one yeat of tompletion. ihe owner vnll �aue ihe GurGen of proving ne/s�e tli0 not OuiIG or improve
for tne purpose ol salel.
I, as owner of ine D�openy. am e�clusivelY conirac�ing with Iicense0 conlractors to constmct the pmlect �Section 704a. Business
❑ antl Pmfessions COUe: T�e tamractors' Staie License Law Eoes not aODM �o an owner of properry wlio GuiiGs or im0�o�es I�ereon
anC w�o coniracls lar suc� pmle��s wil� a conlracim�s) license pur5uanl to I�e Conlrociors' S�ate License Law),I am aware
I�a� O�uul ol Iheii Worker's ComDensation insurance s�oultl be provided Io me.
� I am eRempt untler Section: B. 8 P. C.
lor ��is e,aZson: � �� � , � I '
�, p 1 A
oaie: � Z J3 Ovmer: � a'-'C 4....��•� .
I tlo nereoy ttnity Ilat I am aware ol ana unaerslana Ine reQuirements ol Cahfamu Mealtn ane Sdiety Coae Sections 25505, 25539, ane
2553d an0 itut I or any tulure OuilGmy acupant wilVwill nol (circle one) nee0 to compty witA SdiO state totles anU t�e Rpuiremenis lor a
permii lo� ConSirutlion Or moCiliWtion Irom I�e Au ualny Management Oistricl. Pevaemul constmction appliwlions are erempt Imm
I�eSe DrOvbi0n5.
Dam: Applicam:
I�ereOV ttr0�yl�all�ave�ea0 1�5 a0�litali0n and State��al IM1e a�ov¢intormalion 6 COrr¢LI. Ia0Ret0 COmply vnlA aA tiiy atM toUn�y
orGinan[¢SanO 51ateWwSie�dtinqloDWlEinp c0�5lmciion anU �ereby aut�anxerept¢untaliveSaftlti5 tiryloentefupOn�h9abOve�menlione0
D�o�eitY �onnspeclwn ipo5e5. � �
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/\ i6<n<6 Wnne—Bm10vg: Green—Goea ENorcement: Canary—ApO�icanp Pink—Revenue: GWCenroE—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 065442 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE; STR
JOH DESCRIPTION ; REROOF W/COMPOSZTION SHINGLES
PERM NO: H 0 44
GOVT: N SUPP;
PURPOSE: OTH
SQ ET: 3,000
CLAIM VALUE: 3,0OO,OQ CALC—VALUE: 3,000.00 GROUP OCC; R-3 /M-1
\
COMMENTS: REROOF 2900SF W/COMP SHINGLES, SMOKE DETECTORS+ �RnE+�Q�UIR+�ED +P�+E�R 91UHC �9
+r+e+e+r+r+r*�r�rirx*+�+r+r+rrx*�r�r�rx*x�r�r�r*x�**+r�t�t�r�r�t�r�**�ir**+t*�t*+rrx�+�** `9fVIVi��UL.. I �,.�1!!1`j
Z O N I N G R E U I R E M E N T
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BL]'t'LLYTICG'.��----
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 AEQ: pROV; PARCEL; 13904102 ZNE: REF NO:
PLANNING NOTES>
>
1FMif if lkftfkkMflif 1t1k1tit4ltitiFkiFlFi!!FlkM1E1F1fM1FftM1f 1f 1f1f MiF1F1fit1EiF1ElkitMkiEitif MiFMM1f 1E1E1fMif iEMM1F1t1f iE1f MkiFiFiE*lf41t
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: '•
HUILDING APPROVED BY ; DATE; '
APPLICATION ISSUED BY; DATE: �� 2� rl�
1tM%M1fiEltiEk1E1k1fiflklEMftflMlkilM kitMMkMMfEifit !fk
MitMMiEMitiEMiEkifiEiElfM4fFMMiFMiFlfMlfMiEiffFMMMIfifMlfMlflfMiFitiEiFitiFMiE1FiFMiFitMMMKiFiEMiEiFMfEifMiFiFKlflEiFitif�FMifiF
LEGALIZATION:N F E E S U M M A R Y STROCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 54.50 0.00 0.00 54.50 54.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 54.50 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00 .50
itiFkif4MitiflfkifiEkifififiFiliflllfllitMkkiflEifkititiFMiFifiFkitlFlfiFifiEiFikffkiEiElfkifkkMiF1E1E1fitlfiEiFMitlEiEfEiEifiFifiEkififitiE
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
SFR 3000 REAOOF BY VALUE RESIDENTIAL NOZONE 1.00 3,000.00
END OF FEES
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S%� - P RMI Nc�� TRACT NO. LOT NO. BLD . .
PERMIT c:rr «,.._....... �E��i�fl i(i.�{ � �
AppliCant'sMeilingAddrea �-8C"C" 3oHF. R�6+� CouRT — _
Projeci Address �2q�� y����j i A PL •
�'Y�YL 4 Y�'1G1.,$ W ESTJh%�145
Owner's Name hone
Addreu -324� �iE�'�i �.�
Arch/Eng. �'!,_=_ . . License No. �
Address
ConRactor'sName N��*EI.+oG.tt �hone QR�^'3SSz-
Addreulmailing) I'�� Jcti� REEo �w+cr c�r5 qF lrn.,,rrty
�icente Na: 34A 9 �`1
LICENSED CONTPACTOR DECLARATION .
�1�hareby affirm that 1 am IlcansaG untler provislons at Chartar 9(cammencinq
with sectlon 7000) of Division 3 01 tna Busineu antl Vrofessions Cotle, anA
Q my'licansa,is In full force antl affect.
1 Llcenx Clau Llcense N. 7� �
� Date.s'2•::1 5�9�ature �
�'ORKERS' COMPENSATION D6CLARATION'
C` nereby affirm that I have a certlficata o/ consent to SelNnsure or a certltifate
� of Workevs' Compensatlon Insuranca, or .a- certlllatl copy tnereof (Sactlon
�� 3800� Ldb. C.) � , ,/ •
PolicY No1n•A-CO-t]S}2Q'l COmPanY ��Au I�o
�Certl/letl coDY is �areDy turnishatl. ' . � :
Cartltied ca y iz fllatl wlth tha Gty gullding OIvlzion. a
Oate s. Z. �� AOPliwnt O� dic^' "� "� ^`i"'^-�` .
EXEMPTION FROM WORKERS' COMPENSATION DECLAR TION
(Thissactlon neea not be completetl if t0a permit iz tor one hunEretl (5300) or
iess).
, 1 cerUfy ttwt Ip the Vartarmance of tha work�taY whlc� this peYmit is isiuetl !
' s�all not employ any Oerson In any manner zo as to become suG,ect to t{�e
Worke�s' ComOansation Laws ot Callfornia.r /�
Date Signature ' �
NOTICE: If, after making thls tletlaratlon, you shoultl become �je<t t0 tha'
Wo�ke�s', COmpensatlOn provlslon5 af the Labor Cotle, you ust tort�with ',
comply wlih such provisions,.or this. pe�mit shall be tl metl revoke0.
CONSTRUCTION LENDING AC.ENCV �
I �ereby alflrm that t�ere Is a construction tentlin9 agert<y.t t�e pertormance
ot the work 1or whith' [his permit is 155uetl (SetH n 3097 Civ. CJ
�.entlar's Name
l�ntlar's Atltlress _
OWNER BUILOER OECLA
1 herebv affirm that I am e
7031.5 by � any apyu
�enalty o/ not more tt
I, a5 owner of th
fATpO�SdLIOn WIII tl0
for sale (Sectlon 70�
Ucense Law tloes not
tnereon.•ana who tloi
employ ees, provitletl t
�le, 1/, however, the
pletlon, Ihe owner wii
�tovaforthe ourpose
1, ai owner ot th¢
trattors to tonsV uct tl
Tne Contractor's Llce
butltls or improves th
traCtor(s) Ilcen56 puRl
❑ 1 am exampt untler
oat�
Dt t�Om the�COntlaC f'S 11c8n5e Ldw toI tha
5 Business antl Pro ssiona� Cotla: Any cicy ar
[o [onstrutt, alter mprove, tlemollsA or repali
ce,'also requlres e applicant for such permit
e/Sha Is Iiteflse pUrsuant to th¢ plOvi510�s of
�apter 9(com encing with'Sectlon 7000� oi
Roteszlons' otle) or that he/she Is�exempt
allegetl eze ption. Anyyiolatiodot 5ectlon
a�pflrmit. bjects tna appqcant to a Gvil
ntivetl tlal rs (E500). • �
� or my employaes with wages as thair sole
antl t structu/e I5 not intendetl or olfere0
ss an P.ofessional Cotle: The Contractor's
n o er of a pro0arty�wno GUIIEs or improves
�rk Imself/�ersel� or lhrough his or her own
m ovements are•not Intentletl or otferetl for
r provament Is soltl within one year o! com-
urtlen of proving he/she tlitl not builtl or im-
am aXcluSivaly cOMra6ting wfth liteni¢tl Con-
(Section 7064, Business and Professions Coae:
ioes not apply to an owner of DroOerty who
1 wno tontra<ts tor such pro]ecis wtth a con-
Contractor't Ucense 6.aw), ' '
9. 6 P-C, for tNs reason
. Owner '
hare �eatl thiz'application aritl state tM1at ttie abova
agree to comply with all city and county ortlinances
o builtltng constructlon,'antl hereby authorila repra-
to enter upon the abova-men8onetl Property tor
�-/9ti v�c-c�a. oata �' 2' `� 7
TVPE OF CONSTRUCTION U NEW Q� ADD U ALTERATION U REPAIR
O CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK "r
Stflu �IA2b C eu' . ���% (O/��
TVP^EOFPERMIT GRADING OUNDATION STRUCTURAL
LJ TENANT �ELECTRICAL PLUMBING ❑ MECHANICAL
❑ �OTHER
PR0.IECT DESCRIPTION 50. FT. OCCUVA �
CON STRUCTION TYFE V ALUATION $
20N� GRADING CU. VDS. ACRES
Ramark�: . .
Preventer
Floor Drains' �
Floor Sinks - �
GasService Outlets'
Inierceptors �
Kitchen Sink ' �
Lavaiories � '
P—Trap �
Roof Drains �•
Shower5 ' � ' �
Service Sink
Duct- Under Ground
Duct-Structural , �
Duct-Ventilating .
Exhaun System ❑ Multiple �'
Firepl(Fact.8lt.ICBO�k '
Heating System & Ducting
❑P7 00,000 BTU � 100,000 BTl
�
Hood or Type I ❑' .
� -.�.----. - -- - .
Drivers' License or 55 � ���` Registers
�� �`CMF 0865-46 rev, 12/82 Whita - BUIltling; Canary - ApPlitant; Pink - Accountin9� GOltlenroG -Assessor
Solar Collectors
Solar Piping .
Solar Tank �
Swimming Pool wl5pa �
Urinal •
Water Closet � -
Water Heater
Water Service �
RKe4+T@ Mo+�
Reinspection Fee
Issue Fee
❑a,ioo,000eTu ❑ioo,000sru
System Repair/Alteration •
$ 3
ReinspeQion Fee $15
Issue Fee S 3
PLNG.REF.�W
LEFT SIDE YARD ,�
PKG.SPACE REQ.
STREET WIDTH
SPECIqL CONDITIONS:
Wazher
Unit
F.A.U.
Fixtures
Device.Boxes
o�4T ,�/�;;/'
REAR VARD (TO P!U-/ �
RIGHTSIDE VARO ���6��
PROVIDED
PARK FEE'$
'Meter IJover100amps
Sub Panel � �
Sub Pole
�Motors OO-1 HP ❑1'hE
lectnc Inc.Solar �9-15 HP 016-t
� .Microwave . �
Pole Light -
� . Range . . � _
�� i
Generatbr LJ0�5 KW LJ545,
Traasformer ❑15bOKW -
� osu+Kw •�
Meter ❑up to 100 ampi
2oning Approved By -
ApPlication APGroved By
StandingSections �
Trash Compactor �;.
i '
t
\pPtication Issuad,BY.. • \/T �Data J-�L�6�S
• ' UMMARY OF FEES � . ,. Q� S6
BUILDINGPERMIT $ - • '���SMIP •r'' $
PLAN CHECK �. $. �2- PERMIT � ,.
PLUMBING � . � $ '�O , ��UANCE � $ �
PLAN CHECK $ OO !�' GRADING �� $ � �
ELECTRICAL� � $�� �, . � � '�� $ �
PLAN CHECK , $ �%- D . N1�CROFILM �� $ � �
'� • ' TOTAL FEE $ '� �
MECHANICAL , $: • •
PV.N CHECK . $ � �� - LESS ' ,' ,
. ADVANCED PC $
.' � , ' /37• 88
' � FINAL FEE� ' $
�
. ��CONSTRUCTION AND PLA If�j(;
APPROVALS . Permit#� �f� � � I
,, .
I. Temporary Electrical Service or,Pole .
2: Soil Pipe-Undrgrnd. _ F - � , ,
3. Electrical Conduit Utilitv-Undrgrnd; `�.
4. Electrical Conduit-Undrgrrid� �.
S
5: Steel Reinforcement- � <
�. _
6. Electiical UFER Grnd. . �;
7. Footings ' � � '
R
8. Foundation �I �� '
r 9. WatecPipe-Undrgrnd. �
�
10. Structural Flo`or System
11. Property. Sewer Line & House Connection �
12. Sewer CaP ' � . .. '
13. Roof Draini � � � �
�
74. Rough Plumbing - �
15. Rough Electrical-Conduit ' -'- - I
16:• Rough Electric Wiring- � � � '� ��
�.
� 17. Rough Wiring;Sign � � ,
16:� 1Rough Electrical-T Ba�.Ceiling � �
19.� Rough Heating & Air Conditioning
20. Rough Factory Fireplace ' � ' �
21. Ducts, in Structure � ,
, � �'22. Ducts, Ventilating �� , '
23. Gas Pipe-Rough & 7est � _, i'
24. Roof Framing � I , i
25. Roof Sheathing �, � � � , �� �
26. T-Bar Ceiling (StructuraQ� & Monocoat � �
27. Frame,and Flashing - � � -
_,
28. Lathi��.&Siding � _�
29. Insuletion '� ' ` _a
-30. Drywall�Nailing - ' - � �_�
31. Plaster Brown Coat- - ' � '
32. Electrical Power M�terFinal � ,
33. Final Electric ' � � %.
34. Final Heating & Air. Conditioning -
35. Final Gas Pipe-Test � � '
36. Hood or Canopy . ' ' �
37. Final Factory Fireplace ,� '
38. Final Plumbing � , „ i ' �-
39. Water Service-Final � � �
40. Gas Service-Final � � .
41. Solar pomestic-Final
42. Backflow Preventer' . �
. - - _' POOL .. SPA -
. ' 'Inspector� �-_APPROVALS Permit#_
� - � � . .'52: Pool & Ecjuipment Location
- ' • 53. � Steel Reinforcement �
= -� : -54. Forms'_ ��' � �
� .; , 55� Elecirical Bonding �
', � 56.. Rough Plumbing.�& Pressure Test �
- • 57.� APPROVAL TO COVER-GUNITE.
�
;.. � �58, Electrical:Conduit-Undrar��1.
� ` � 59. Gas Pipe, O-Undrgrnd., Test
�• -�60. BackwasFi Cines, P-Trap,�� Undrgmd.
� � 61. APPROVAL TO DECK �
- . . 62. Backwash.& Receptor-Final
�-� .'63. Fleater & Vent-Final .
_ . 64. Plumbing"Systein - Final -
• 65. Electrical-Final
� � � � 66. Solar System-Final -
� --67."Fencing & Access Approyal � -
- • 68. APPROVED FOR PLASTERING
' �69.�POOL/SPASYSTEMSFINAL -
� �' ' FIRE DEPT. REQUIREMENT �
� ' i
� � � APPROVALS � Permit #
i
70.� Underground Hydro
� , 71.� Product Piping O Gas ❑ Oil
� 72.f Underground Flush
�' - 73.' Undergrnd. Storage Tank � Gas ❑�Oil
� � Jr,� � � 74. Overhead Hydro -
- .' ' �� � 75. Dr�y Chemical 1 �
76.. Dry Standpipe .
77.� FIXED SYSTEM FINAL
�j �/Z`�v�� 78.� FIRE PR_EV. FINAL �
�
� • . . q
� ' • �� ' v tL'TuZi:JL'I
■� - �. �.� .
��J u .. _ . � _�,�
�. �� �
.=e^ �J ..
�� .
� �.1 _=-/.
� , � _ • i
��
���
43. Backflow Irrigation - - , � �' ' �
44. Landscape Irrigation System ' �
45. Sound Attenuation � � � �
46. Handicap Regulations
47. FINAL STRUCTUFE & BUILDING , ; 7
48. Special Requirements Completed • �
49. Electric Release�to Edison1 , .
50. Gas Reiease to Southern California GasCo
51. CERTIFICATE OF OCCUPANCY .
� No. ' � � _ Date '
m
F
�
- - i - �.;�' -,
Date �nspector
It\lSULATI�DN CER�IFICATION
3Z`j� �P�Rto� 1� P I. Ct>STF� VV�ESd� OR�AN(,�
NYmDC/ an0 SUt[t CIIY COUnIY
SuOEirldOn ' 101 h�mDe�
DESCRIPTION OF INSTALLATION
ROOF r _ .
Materi�l F�heR�l.AsS�' f��� �A�kEP� grantlName QWeNS ��D'RI��1��0
t' i 6
TAickous �inctros) � Thermal Res�s:a�ct IR Vi�ue) � 1
EXTERIOR WA�L, �
M�terid �� beeGc�ss �61 ( Br�nd Name C��� �JS C 61� � l A7(O
�. � `'
TAicknen (inche9 3�Z T�ermsl Resiste�ce �R V��ut) ' K�, �
CEILING � ��
BattorBlantetTvo�� �'ATT BnnONeme O�+�KIS� �O`t/q11J
7��ckness f���hesl ��� Tnerm�� Res�sta�ce (R Valuel �–� 9
loote Fiil Type
Brand N2me
Min�mum Thickness (��c�es) _ Nurt�ber o� bsgs Weighi per Cag �D
Area Coveretl Ifi=1��$ a 5�_F T 'fAermal Reslsta�ce (R Va�uel
FLOOR,ELEVATED ►�env'�-
Naterial
Tnickntss linceesl _
FLOOR,SLAB —
A:atuial
Tnicknn: (inchnl _
Wltlin linc�es� __
FOUNDATION WALL
Maier�a�
Tn�<kness I�nchesl_
–NOA+�– '
Bony Name
T�ermal Resisw�ce {R Va�ue)
�
1
'Brsnd Name
Tnerma� Res�s�n�ce l9 Va�uel _
Brand Name
Tnam.�l Res�sta�ce fR Va'ue)
DECLARATION
1 AtrtGp eerti�y lhai t� e a�ove' insulatio� was ��ztalletl m tl+[ building at the above lou�ion in conlorma�ce vsrth fl+r
cw.rne .rqvla�ions xlling E�eijy Conservatnn S+a�tlartls Io� new resitlent�al bvild�ngy �Io[0",e0 in T�Ue 7C ot Ibe
Ghio��la 4dmirisVary'vr Code7.
�.
I� �A►.,ey ����-. Co . 3'-l�i � 3 �i
Ganeui Contractor IBu;ioeq Licrnse hu�n�e.
_ Q� �. �I(��ouryl�, ' � - T-83
s�snn�,. a Trt�. o,��
Sun Cont�+c�o� �inwiaiwe c,00��u�o�� liceme taumpe+ .
'"' ' S�q�ulwe �na Tiue —' Jate
F�gv�e G-1 E+�mRle ol a eomO��+�ce crnil�ute
4-9
.. _ �.���2
COSTA MFSA BUILDING-SAFEN DEPARTMENT
P. O. B07( 917 COSTA MEHA. CALIPORNIA
For Applieanf fo Fill In Complefely
� TYPE OR PRINT
ADDRH68 2 6 Geor ia Place
COSTA MESA, GALIFORNIA
■ MAIL
C3T].SOIl RC TEL.
0
TEL.
BIZE No. oP BWae.
" ' __ st9 1 v 09I "_'"" "" " __ _
FIRE
ZONE
APPROVED
ZONE
�
teau.
FEE R�ECEIVED
��,�� MA`f t 6 i960
FlNANCE DEPT.
CiTY OF COSfA MESA
APPLICATION FOR PERMIT
BUILDING •
For Office Use Only
nece�rr Ho. � r�`IF� .,�
av I o�sneceiveo I oer¢ �su¢�u_
COSTA MESA. CALIFORNIA
ZONING
NO. OF U8fi OF NEW
PUN9 q BOIIDINO ��
3L�6 TnT1P YARDS
APPROVED
3Ti188TM 48' REAR YARD 19� ���reR L1Ne er.�
FRONT
� I L�F7 �.0� I RIGHT ZS � R. SIDE
DESCRIPTION OF WORK
gB=1ELDiNG1 c^ S .Yt..ROOMS
W
EXTERIOR WALL IROOF
COVBRING COVEF
U9E OP BUILDING AND WORi( TO E
1 HH0.8BY ACNNDWL8D06 TXAT 1 HAVE ReAD THIB MPLIUTION
•ND BTATe THAT THH ABOV6 IB CORPECT AND AOPLB TO COM-
PLY'WITX �LL G��'Y OIipINANCE9 AND 8TAT6 LAW6 R60Ul.�TNO
BUILDINO CONBiRUGT10N.
81GNAiURE OP � �
PERMITTB
AUTHORRED APENT Dike � Calegr.nve� �Il(J�
EVES
iHH AMOUNT BXOWN UNDBR VALUAT�ON 18 IOq TH6
PURP08H OP 88TABLlBNING A PBRMIT REH ONLY.
5 �.6�10�.• I P�N CHECK