HomeMy WebLinkAbout407 GLOUCESTER DR - Building Permits. . _ _ _� ... _. ..- -. - . -�- - — --AOP�icantto fill in all spaces exceD� l�ose within heavy DorCer lines an0 si9n all aOP�aVriate Oeclaralians. �- � � - - , -. �-� - � - --• --- � ' " '.
ciTY 4F COSTA MESA ' CONSTR UCTION PEnRMIT PE IT NO - ' TRACT NO.; ' LOT NO. � UNIT N6. .' , , ' , ��` ': : �
�Project'Address � es �: �✓%�' � ��0� . . . . . . ; `� . . � x ' 1 _ '• � :
' Applicant�5 Mailina Addresc • C � I ', •' TYPE OP CON57'RUCTION �. rvEW • AOD ALTERATION_ REPAIR � ' 0944 �.]I.I 3I RFi .. S����
�� ������/}(? '❑ CONVERSION: ❑ DEMOLISH ❑ OTHER � p� p # , .. - ' ' _: Zoue
' Owner'sName�_�Lc��I�P��' � ' � -Phone.l27�Y_L17. -DESCRIPTIONOFWORK/USE�OFBLDG. - - � --
� Address . r . ' . ' ' I . � � _ � ' ` ; _ . . . r `' " . " � � - ; E Main Bwldmg ' � Accessory'Building�' I ' ` . Z' �
• Arch/Eng' � � • � License No. • � ' TVPE OF PERMIS � = GRADING�FOUNDATION � STRVCTURAL . T Fiont� ' - � � M - O. �
Addres5 � ❑O'TENANT ❑ ELECTRICAL PLUMBING �❑ MECHANICAL , �A Reai _ • - . _ _ - i - .. N 4
ConVactoCs Nam ^Phone� � �OTHER; � _ "' - ' � ' � . _ _ . . _
� • � � ' ___1�� � PROJEC7 DESCRIPTION SQ. FT. '.. . ' � OCCVPANCV C Ri9ht . , � c. . . " N
Addre55�mailing) � � CONSTRUCTION TYPE � VALUATION $ � g Left "� ' ' ' ' � � . e . G
City Licerise No �- l� /�.9 � ZONE - � GRADING CU. VDS. ACRES � , � ' h I� R
� Ping. Ref. # king eq' 'ded � ,� E
LICENSED CONTRACTOR DECLARATION . ' � . ' � � Q
I,hereby attirm lhat i am licensetl untler provisions ot Charter 9'(commencing ` Remarks: _. � � ' ' ' - � P.lanning Notes: � � - � ' . M.
� with section ]000) bf'Dlvision 3 of the Business antl Protessions Cotle, antl - T
my llGense.is in ful antl eitecL , ' � j�., � /�p� ' - • � . , ' " ' � — � . ' � - ' _ _ S
�License Class •� � irc.,..l.ry , ffV'Y d ' " . , - - . . �
Date ����' � g t � PLUMBING ! FEES � � � '
��WORKERS'COM�ENSATION DECLARATION ELECTRICAL � , FEES
� � ' Bar $ink ' • Showers � • �'
hereby affirm [hat I have a certificate of consent to zelf-insure o� a certiticate � �
�.� r Workers' Com ensation Insurance, or a'certifietl w thereof ' - ' " ^-- � ' ' ' " --" '�' ' ' - . � . , �- -
0 PY (Sectian'
�� BackFlow Preventer � Service SinK � � Automatic Washei� Transformer ❑ 15-SO KW , , �
l800, Lab. C.����F�� �N9-� YYI/Jrs
n� PoliGy No. Company /ll/ /A/ LIA Backflow Irrigation Sewer Cap� . • �Construction PoleSub. 0 5� � KW
, It7 ❑.Certified copy is M1ereby furnished. � ' � � . ' �
�� Cer fio3e pjV�1 iletl witn the city B n Div}¢ on.�J% Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date�-'l�"Z'j4+ ' AOPlicant ��{/�/S�%�/ i � . , � - . �
EXEMPTIONFROMWORKERS'�COMPENSATIONDECLARHTION - Cldfifi¢FS ... _ _ -_ .-5013�CoIlECLOIs � - --� -� - DiShwash¢� -- --�--- � Mete���Ove�-1002mp5�• - - - -
(Tbissection need not be completea if tM1e permit is for one�huntlr¢tl ($100) or � . ,
less). , ' Dishwasher - Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel ,
I certify [M1at in the perfo�mance of [he work tor which this perm�t Is issuetl 1 . � . , . . -
shall not employ any person in any manner so as to become subiect to'the � Drinking Fountains ' Solar Tank � Fan ' Motors �0-7 HP �7 ��8 �
Workers' Compensa[ion Laws of Calitomia. � • ' ' '
Date ' Si9nature � Floor Drains � Swimming Pool w/Spa • F.A.U.
'NOTICE: If, after making this tleclaration, you shoultl become subject to the '� - ' Inc Solar �9-75 HP �16-75+ .
Workers' COmpenSdtion provision5 Of the' C.dbor Cotle; you must forthwith �'� �- FIOOf SiOkS � � � � Ulindl � FixLufeS MiCIOwdVB �
compty with such provision5 or•this p¢rmlt Shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCK � ' � Gas$eNiCe -IOutlets WaterCloSet ` DeviCeBOxes PoleLi hi � �
I ItereCy affirrn ihat there is a conitru[tion I¢ntling agency for the performance � - ' 9 '
of tne wark for whicM1 this permit,is�issuetl.C(Section'309� Civ.'CJ ' ' ' "- ' , � .
Lentler's Na'me " ' Interceptorv Water Neater - � _ �- � � Ouilets � � Range , i
Lentler's Atltlress ' � � _ - - Kitchen Sink ., ' ' � Wa[er Service' � � � . Switches� ' Sign ' '
OWNER BUILDER DECLAR/iT10N � - � ' ' ' -� � � . , , ' �
1 hereby affirm tnat I am exempt trom the Contractor's License Law for the � Lavatories� ' ' -A'uto-Wash ; . •. Garbage Disposal ; Standin9;Sections �-'
tollowing reason (Section ]031�.5 Buslness antl Professional Cotle: Any ci[y or �
county wnich requires a permit to construct, alter, improve, tlemolish or repair P-Trap �' � - Laundry Trays' � '� � Generator �0�5 KW 05-15 KW �. Trash Compactor
any StruGture, prio� to it5 issuanCe, al5o �equireS:tM1e applicant for Such'pe�mi[ , { �
to file a si9netl statemenKthat he/she is licensetl pursuant fo Ihe provisions of Roof Drains y � � � � . i
the Contractor's License Law (Chap[er 9(commencing with Section ]000),of - ' ' �
�ivision 3 ot the Business �antl Professions Cotle) or that he/she is ezempt , .�,- __ - ' �
�erefrom antl the basis fog the alleqetl exemption. Any violatiOn ot Sectlon �_ -' _ , ' � ' � ' F
J31.5 by, 5ny applicant fo� a permif subjects'Ihe applicant to.a civil - ' - ' -
� �nalty of not more Ihan fivc huntlred tlollars ($500)., • ' ' � " , + ' . : . . , ' ', '
LJ I, as owner or tne property or my employees with wages as their soie . , Reinspection' Fee ' $75 � Issue Fee $•3 ' '
�compensation, will do the work, antl the structure is not intentletl or ofteretl - ' ' Reinspection Fee $15 Issue Fee � ' � .$ 3
tor sale �Section{7044, Business and Pro(essional Cotle: The Contractor's' _ - • • - + , ��� �MECHANICAL � � FEES ' -
� LicenSe.Lawltloes nOt apply to an owner ot a property who builtl5 Or improve5 � - ` ,
chereon, antl wno Goes sucn work himselijherselt or Ihrougn his or-her own , �- . � � ' DEVELOPMENT SERVICESREQUIREMENTS: , , ' ,
employees, provitletl [hat such improvements are not In[entletl o� ofteretl to� ' BOiIE� .. ' HOOd O� Type I� ❑' ��� . . , ,
sale. If,�however, the building or improvement is soltl witbin one year of com- . ' Canopy Type II ❑� 2oning Approved By _ . Date
pl¢tloq,tne owner will have the burtlen Of proving he/she tlitl mt builtl or, im- Duct - Under Ground � �• Building App�ovEd By ' � Ddte���__r
prove for the purpose of sale). . � � � , ' , ' . . .
❑ I, ds owner of the D�operty, am exclusively cont�actiog with licensetl con- ; DuCt -St�uC[u�dl ;� � R¢ffigCfdtiOn $y5t2T � � � Application Issued By ' � � � Dat���ij �L�
tratto�s to consbuct the projec[ (Section ]044, Bu5ine55 antl Professions Cotle: ' �
The Contractor's.�License Law.does not apply to.an owner.of properry who � - Duct - Ventilating - - r --, DO-100,000 BTU ❑400,000 BTU --.- ' �' • SUMMARV OF FEES ' �
builtls or improves thereon; antl�who�contract5 for such projects with a con- - , � � � � '
tractor(s} license pursuant to the`Conbacior's License Law). I am aware that Exhaust System ❑ MWtiple �, System Repair/Alteration ' BUILDING'PERMIT �$� SMIP �$'
proof of tneir Worker's Compensation insurance shoultl be provitletl to me.� . _ ' � PLAN CHECK . �$ � PERMIT � ' .
❑ I am'exempt untler Section . B. & P. C. for ttiis reason } Firepl/Fact. BIL ICBO # Fire Dampers PLUMBING ' �$� �SSUANCE $
Dale � ' ' Owner i Heating System & Ducting , Regizters � ' � ' ENERGV;P.C.. $ '
� - PLAN CHECK .25% $ '
I�tiereby certify that I'have�reatl �this appVicatio`n'znG staie thaf tne�above� ❑0.100,OOOBTU �t00,000BT ' � � ' GRADING $� '
. information is correcL I agree to comply with all dty antl munty ortlinances ' � ' ' ELECTR ICAL � •$ , i
�� antl,state lawz relating to builtlinq const�ucHon, antl hereby authorize repre- t ' � ' '$ MICROFILM $ �
sentatives of t is cit to enter upon the above-mentionetl property for , . � PLAN CHECK 50% ,
. inspection pu 5es � / / !l ' � � • MECHANICAL $ ' � �
Si9nature DateJ,�[31"f¢ ' � � � �TOTAL FEE , $
Drivers' ��icense or 55 � Reinspec[ion Fee $15. • Issue Fee � $ 3 PLAN CHECK '25% $
CMF 0865-46, rev. 10/84 White - Bulltling; Canary - qpplicant; Pink - Acroun[in9: Goltlenrotl - Aszessor
CONSTRUCTION AND PLANNING . � , POO >PA _ _ �
APPROVALS Pe�mit# Date Inspector AppROVALS �Permit# Date Inspector
1. Temporary ElectriCal $ervice or Pole 52. Pool & Equipment Location � �
: 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � _
. 3. Electrical Conduit Utility-Undrgrnd:, 54. Forms. � �
4. Electrical 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 Undrgrnd., Test
9. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, � Undrgrnd. .
10. Structural Floor System _ ' 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final
12. -Sewer Cap � � 63. Heater & Vent-Final �
73. Roof Drains � . 64. Plumbing System - Final � � -
14. Rough Plumbing � � - � 65. Electrical-Final � ' , - � .
75. Rough Electrical-Conduit - - . 66. Solar System-Final - � - .'
16.,-Rough Electric Wiring . . , � � � 67.-Fencing & Access Approval - . � �
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING •
18. Rough Electrical-T Bar Ceiling � � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT. -- , �
20: Rough Factory FirePlace ' APPROVALS Permii #
21. Ducts, in Struc[ure .. � � 70. Underground Hydro � �
22. Ducts, Ventilating 71. Product Piping O Gas ❑�Oil ' ,
23. Gas Pipe-Rough & Test , � ' � 72. �Underground Flush ' y �� �
24. Roof Frami�g ' � 73. Undergrnd. Storage Tank O Gas ❑ Oil
�
25. Roof Sheathing � .' ' 74. Overhead Hydro , .'
26. T-Bar Ceiling (Structural) & Monocoat .� 75. Dry Chemical �
'27. Frame and Flashing - 76. Dry Standpipe , ,
28. Lathing & Siding � � 77. FIXED SYSTEM FINAL � ' r
29. Insulation �� 78. FIRE PREV. FINAL �
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT , �
31. Plaster Brown Coat •' ' �79. FINAL INSPECTION �.
�
32. Electrical Power Meter-Final ' � " 80. FOOD.CERTIFICATE ISSUED � �
33. Final Electric • � Noies: ' , �
34. Final Heating.& Aif Conditioning . ,
35: Final�Gas Pipe-Test � � � � � . �
36. Hood or Canopy , - � . � ' , � �
37. Final Factory Fireplace � � - � � � - � �
38. Final Plumbing � 7�-�'J-�b (�ED � ' � �� � �
39. Water Service-Final . � ~ '� ' � • . . - � ,� '
40. Gas Service-Final ' ' ' � � , . • �
, �..r. .
41. Solar pomestic-Final =� -
e.n � . . . . . .
42. Backflow Preventer l�1 �" ' � ' - , ' �
i ��
43. Backflow Irrigation � � �a �' � , � -
44. Landscape�Irrigation�System „ � � ' ', ,
45. Sound Attenuation `%� ' � � ' �
46. Handicap Regulations , { � �;�_ � ,
47. FINALSTRUCTURE&BUILD`ING .
48. Special iRequirements Completed ' ' .
49. Electric Release to Edison � � - � � � �
�
50. Gas Release to Southern California Gas Co '. , � . +
.51.,CERTIFICATEOFOCCUPANCY _ _ _ _ , _ � �
N'o'�� -Date � • . �
. :. -
-_ F ,
\
ApD��cant to iill in all soaces except those within neavy Eoraer Ilnes ana sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT
Project Address �� ��fN�('PSf'PI^ nst� N1esa Ga 92627 �.
Applicant's Mailing Address
Ownei's Name ThP NTbYOS C-0 Phone7�4'�—��
ndd�ess. P.O. BOx W)f,4 IarnTna Hillc, C� 9�6rir1
Arch/Eng. License No.
Address
Contracior'sName�Itl4lC2_� A�crr Rrvrfir� Tnr Phone 7t4-64F-3911
Address (mailingl P.(� E�c 10456 Costa Npsa, �(� �627
City License No. �q'(,�
IICENSED CONTRACTOR DECLARATION
I M1ereby aHi�m that 1 am licensetl untler provisions of Chart¢/ 9(commencing
with seclion ]000) of Division 3 of the Business antl Professions Cotle, antl
my license is in full torce antl efiect.
License Class Li�se No. �
Dale� ture
WORKERS'COMPENSATION OECLARATION �
•reby af/irm that 1 hav¢ a certititate of consent to self-insure or a certiticate
vorkers' Compensation Insurance, or a certifiea copy thereof (Section
.0, Lab. CJ i
Policy No. ����1010'2���.�'�mpany I i�rh�i M_hii�l__t�?��^�Fl�`
8 Cer[ifietl mpy is hereby furnishe0. �r����
�ateertifietl copy i�ited �PPhCa^i`y Builtlir,tg����&iates Roofirg Inc
ic uanc.e
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This sec[ion neetl not be campletetl ii the permit is for one huntlretl ($100J or
less).
I certify that in tM1e perto�mance of the wo�k for whiCh thls pe�mit id issuetl, I
snall not employ any person in any manner so as to become subject to the
Wo�ke�s' Compensation LawS of CalifOrnia.
Da[e Si9nature
NOTICE: If, afler making thi5 tleclaration, you shOultl Cecome 5u0ject to tha
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply with such provisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV �
I hereby affirm that there is a wnstruction lentling agency for the perfoimance
of the work for which thi5 permit is i55uetl ($ectiOn 3097 Civ. CJ
Lentler's Name � -
Lender's AtltlreSs
OWNERBUILDEft OECLARATION
I hereby atfirm lhat I am exempt from the Contractor's License Law tor the
tollowing reason (Section �031.5 eusiness antl Professional Cotle: Any city or
county which �equire5 a permil to con5truct, alte�, improve, tlemolish o� �epair
any s[ructure, prior to its issuance, also requires the applicant for such permit �
to file a signetl Stdtement that he/she is licensetl pu/Suant [o tne p�ovi5ion5 ot
�the Conlractor's License Law (Cnapter 9(commencing witn Section �000) of
•ision 3 of Ne Business antl Professions Cotle) m that be/she is exempt
efrom antl the basis for [he allegetl exemption. AnY violation of Sec[ion
1.5 by any applicant (o� a permit subjects the ap0licant to a civil
,alty of no[ more than five huntlretl tlollars ($500).
' LJ I, as owner of the prooerb or my employees with wages as their sole
� compensation, will do tne work, antl the structure is not intentletl or ottered
, fo[ sale (Section �044, Business antl Professional Cotle: The Contractor'S
Lihense Law tloes not apply to an owner of a property who builtls or improves
�� the reon, antl who tloes 5ucn wo�k himself/herself o� tivou9h hi5 or he� own
'' eMployees, provitletl tha[ such improv¢ments ate not intentletl or otteretl tor
� Sale. If, however, She builtling or improvement is 5oltl within one year of com-
pletioq the owner will have the burtlen oi provin9 he/she tlitl not builtl or im-
prOVa for the purpose of sale).
❑ I, az owner of the property, am exclusively contracting with licensetl con-
tractors to wnsfruct the project (Section 7044, Business antl Professions Cotle:
The ConVactor's'License Law tloes not appty to an owner oi property who
builtls or improves thereon. antl who mntracts fo� sutn oroiects with a r.on-
tractor(s) hcense pursuan[ to me Contractor's License L.aw). I am aware that
p�oof ot tneir Worker'S Compensation in5urance Shoultl be provitletl to me.
❑.1 am exempt untler Section B. & P. C. for this reason
Date Owner
1 h¢rEby certify that I hav¢ reatl thi5 applica[ion and siate that the abov¢'
information is correct. I agree to comply with all city antl county ortlinances.
anG state laws velatin9 to builtling wnstruction, antl he�eby autho�ize rep�e-
Sentatives oi tnis <ity to ent upon th above-men[ionetl property for
inspection pu�po5e5. /'` �_�r�_pn
Signature C�( � Date � ��
Drivers"License or 55 � �
._....2...G...t.. _._._..-- -- .........,.
� J . 1 � O . . � . . A.P.
S Main Buildi
TYPE OFCONSTRUCTION NEW ADD ALTERATION REGAIR' E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T' Front
-0ESCRIPTION OF WORK/USE OF BLDG. I A Rear
TVPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL I C Right
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � g� Left
❑ �OTHER - n.� '' P�ng. Ref. #
PRQIECT DESCRIPTION 5o. FT. OCCUPANCVR:7 - Planning NoteS:
CONSTRUCTIONTVPE ' VALUATION$�03��._
ZONE GRADINGCU.VDS. ACRES _
Remarks:
Backflow Preventer -
Backflowlrrigation •
Bathtubs
Clarifiers � �-
Dishwasher '
Drinking Fountains
Floor Drains '
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fae ! $15
Boiler � ' ' _ �
Duct - Under'Ground
Duct - Structurel
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iC80 dk
Heating Sysrem & Ducting
❑0-100,000 BTU 0100,000
Reinspection Fee � $75
oe65-46, rev. 5/Be wnite - Builtling; Canary - Applicant; Pink - Accounting; Goldenrotl - Assessor
Showers
Service Sink
$ewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank �
Swimming Pool wlSpa
Urinal'
Water Closet �
Water Heater �
Water Service �
Auto-Wash
Laundry Tra'ys
Issue Fee
Hood or Typel ❑
Canopy Type II ❑
Refrigeration Sys[em
❑0-t00,0006TU ❑100,000
System Repair/Alteration
Fire Dampers
Regizters '
Issue Fee
FEES
$ 3
FEES
$ 3
2ona
Accessory Building:
Parki
ELECTRICAL
Automatic Washer Transformer ❑ 75-50 KW
Construction Pole Sub. ❑ 50 + KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel � •
Motors �0-1' HP �1 % ?8
Inc.Soiar �9-15 HP �16-15+
Microwave ' � .
Pole Light �
Range
Sign �
Standing Sections
W Tresh Compacmr
Cooking Unit
�ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
�Utl¢t5
Switches
Garbage�Disposal
Generator �0-5 KW �5-75 K
I Reinspection Fee �$15 ' I Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS: �
Zonine APProved By
Building Approved By
Applicatian Issued By
a
FEES
$ 3
n
N
I�
N
G
R
E
Q
M
T
S.
SUMMA V O�EES /�� ,�
BUILDING PERMIT $ _� � SMIP $ _y1=
PLAN CHECK $ PERMIT
PLUMBWG $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ /
MECHANICAL $ TOTAL FEE $ —SQ��
PLAN CHECK 25% $
�ii �e�a�;��-oc�a�»�,� -t'����- ;�.,,�
�AiE� �7:13/Sy TICtE: ?�7:?3
_ ,
� � �.__''� � .
CONSTRUCTION AND PLANNING P��� 'P'4
Date Inspector '°" � �„ Date �Inspector
APPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. . . 54. Forms n
4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding t��
%'1
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. - � 57. APPROVALTO COVER-GUNITE ;,�
7. Footings 1� � 58. Electrical Conduit-Undrgrnd. �
8. Foundation ' U� 59. Gas Pipe, O Undrgrnd., Test V�
9. Water Pipe-Undrgrnd. �)� � . 60. Backwash Lines, P-Trap, O Undrgrnd. ���
10. Structural Floor System � . 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
Y. ,�
12. Sewer Cap �� 63. Heater & Vent-Final
13. Roof Drains '� 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
18: Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
�i
20, Rough Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � , 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & 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. REQUIREMENT
31: Plaster Brown Coat � � • 79. FINAL INSPECTION
32. Electriral Power Meter-Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test .
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final ,
40. Gas Service-Final
41 . Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation � '
•; ,
44. Landscape Irrigation System • ' ' '�, � •
45. Sound Attenuation -
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING B ,�Soti•� /��T at
48. Special Requirements Completed �
49. Electric Release to Edison �- �
� 50. Gas Release to Southern California Gas Co � _�� '"
51. CERTIFICATE OF OCCUPANCY `
;' �',
No. Date _,. �
.. . � e o��
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX i1] C08TA M66A, CALIPORNIA
For Applicanl. /o � Fill In CompleTely
TYPE OR PRINT
AODRE58 �a / V"/oNG��G'Y D�'/K
� COSTA MESA, CALIFORNIA
�.Rr�� j�.jE6g Brent S:
Series
221233 No•646-9341
��X.S�_nRXan_��' � �e.oPe�ooa.�
ew ox � er
G BLDO. n�11e . . ' �
LINB P110M .1 A,�q_�'I 12
F 6TXEET z^�TZ�/ O REAR YARP' ^� O
RDI LEFT �ro �•��`�I RIGHT �� I�
DESCRIPTION OP WORK
_I X ALT6RATION _ ADDITION _
IMOVIN6 DEMOLISH
16 1425 sq, ft�$oM$ 5 �oRi fi$ 2
IRWALL�,«..,,.,_I ROOF __�___ _�__�
I XEREBY /�CKNOWLEOOC THAT 1 H�VB PEAD THIB APPL�CATION
AND BTATE THAT THE ABOVB I6 CORIiHCT ANO AOpEfi TO COM.
PLY WITH ALL QTY ORUINANCCB AND BTAT[ LAWB H80YL�TINO
BU�L�INO CONSiRUG}ION. '
SIGNATURE OF �� s'����� �N G�
PERMITTE `
AUTHORIZHD A6HNT
rtt Ktc;��vtu
NOV 2 7 1963\�
fINANCE DE�T. �
_ , CITY OF COSTA MESA �
APPLICATION FOR PERMIT �
BUILDING � -
For Office Use Only
I RlCHIpT NO. � E_ 1,
iseueo
ZONINCi
zpNp no. or� use or rve
�i /� I I PLAN9�J�� I BUILD
x,
�:°":,_,.... Lot 5 Tract 5212
SHALL BE LE55 THAN
YARDSAPPROVEO YARDSAPPROVED �
MAIN BUILDIN6 ACCESSORY BUILDING
(FROM GLSTREET)
FRONT FT. ' F�. ' �J
R. SIDE , .��FT. PT. µ1
�
L.91�E � FT. FT. . a
RfiAR � FT. FT. P=,
OI9TANCE BET. � BET. MAIN 4 :}
MAIN BLO68. ACCE96. BLDG . �
VAR. $R OATE - I71
C. U. P. � APPR V D C.
BYPROV A.LVy DATE ��� - �
�3 �
�
{1.
1 A
1425 so. Fr. = 5
TN¢ /�MOUNT SXOWN IINDEP V�LUATION IB FOq THE F
PIIRPOeE OP H6TA9LI6HIN6 '♦ PEFMIT FEE ONLr. p
VALUATION ) ' - . m '
�1`3� 1g1.'G5 PERMITFEE s42.54 � .
m
� A C oo �
TOTAL FEE $4Z. S4 6