HomeMy WebLinkAbout439 GLOUCESTER DR - Building Permits�
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PFOJECT ADOflE55: �j ] 9 GLOUC EST ER DR i' uxiT:
owNeasxame: HOhtRIGHAUSEN THOMAS G 1� t�,
nooxess: 439 GLOUCEST�R DR
COSTA MESA,CA 92627
t�'
APCNIENGINEEX: ���i, � BEG.NO.:
AUOqE55: �. �ti UNIT:
PEHMITTEE: DIAL ONE SONSHINE PLMB, (714)523-9219
aoneess: 10537 UALE AV
STANTON r_A 92625
LICENSEU WNTHALTUH OECU�XFTION: I M1ereOy allirm �hat I am licensed untler provisions ol Chapter 9(commencing wi�h Section
7000) of �iv�sion 3 olihe Business antl Pwtessions COAe. and my license is in fulllorce and e�fect.
aTr uc.: 0 4 5 9� 8p 9 STpTE LIC.: S J O% S 6 cwss: C 3 6
Date:.�` ��� 1 � Siqnalure:. __ . _
WOflREBS' COMPENSpTION DECLABATION: I hereby afh �Aal I have a Cerii�iCate o� tonsen� Se n ure Or a te�i�iCate o� Workers'
Compensation W,s` y 9 j a/cert�t ed copy merem �Section 3800. Lab. ��l / O 1/ 9 S
roucvxo.: REPUBLIC EXP.OPTE:
COMPRNY: ,tt
� Cerlilie0 coOY is hereby �urnished. L'J Cerlifie0 caD is filed wil� Ihe ciry Buil - g �ivision.
�aie: �' � �� l � Applicanr
E%EMPTIONFqaMWONNEflS'LOMPENSATION�ECIANATION: isseclionneeAnolbecampleteEi�Ihe ermit' o nehunUreA�S100)arless).
I cetlify Inat in ihe pedormance of the work lor which this permit is issuetl. I snall not employ any pe a manner so as to become
suble�� �o the Workers' Compensa�ion Laws oi CaliPomia_
Date' Signamre:
NOTICE: I�, alier making thi5 Aeclaraiion, you 5hoN4 become sublec[ �o �he Workers' Compensalion provisions oi the Labor
CODe. you mu5lfo�hwiU comply with suc� provisions or�his permi� shall Ue OeemeA revoked.
CDNSTPUC710N LENo1NG RGENCY: I hereby aflirm that ihere is a constmction lending agency lor ihe Dertormance of Ihe work for
wnich Ihis permii is issued (Seciion 3WZ Crv. C�.
LEN�EB:
RODflE55:
OWNEfl BUIlOEfl DECLAflPTION: I here6y aflirm Iha� I am exempl irom ��e Comracmrs' Siate License Law br ihe following reason
(Section 703L5 Business an0 Pmlessional Catle: Any ci�y o� county whic� requires a Oermi� to con5imct, alier. impmve, Demolish, or
repair any slmciure, prior lo i�s issuance. also requires the ap0licant �or such permit �o file a signea s�a�ement that he/sne is licensetl
pursuam m ��e pmvisians ol �he Cantracmrs' S�a�e License Law (C�apler 9(commencing wi�� Section 7000) of Oivisian 3 oi the Business
and Pmlessians Gotle� or lhat �e/she is exempl Iherelmm and Ihe basis for the allegetl exemplioa Any violation o� Sectmn 7031.5 by
any applican� �or a permil su�lecis Ihe apPlicanl �o a civil penalty oi not more �han five hundre0 tlollars ($500).
I, as owner of �he Dmperty or my employees with wages as Iheir sole compen5aiion, will tlo Ihe work, anA the
❑ slmcWre is nol inlende4 or oflered lor sale (Section 7W4, Business and Pm�essional CoOe'. The Con�ractors' Slaie License Law
Uoes not apply lo an owner o� a pmDeny who �ui105 ar improves ��ereon, antl who does suc� wark himSelHherself o� Nrough
hi5 or her own employ¢es. provitlea Iha� SUCh impmvemen�5 are no� imentletl or ofleretl for sale. IL Aowevef Ihe Uuilaing or
impmvemen� is 5010 wi�hin one year o� comple�ion, Ihe owner will have Ihe burden of pmving he/she did not builtl or impmve
for ihe Durpose of sale)
I, as owner a� I�e pmpetly, am exclusively conVacting wrth hc¢nsed ronVac�ors �o con5imc� �he pmjec� (Sec�ion 71144, 9usiness
❑ antl Prolessions Cotle' T�e Contraciors' Slale License �aw does not apply to an owner at pmDehy who Euiltls or impmves ��ereon
and who coniracts lor such prolec�s with a coniractor�s)license pursuant ta t�e ConVacbrs' Sta�e License Law). I am aware
thal pmoi oi �helr Worker's Componsatian Insurance should �e pmvided �o me.
� I am exempt under Semion: B. 8 P. C.
br Ihis reason:
�ale', Owner
I do hereby cenity �hat I am aware ol ana undea�antl �he requiremenls o� Calitomia Heal�� an0 Sa�ery Catle Seciions 2550.5, 25533, and
25534 antl Ihal I or any tulure builtling occupanl willlwill no� (circle one) need to comply wi�h saitl state cotles antl �he requirements lor a
peimit for constmction or moddicalion Imm Ihe Air �ua6ry Managemen� Disiric�. Residen�ial conSlmciion applica�ions ar¢ exemp� irom
IhpS¢ pf0V151005.
Date. ApplicanL ,
I hereby cetlity Ihal I have reatl ��is application ana s�ate
ortlmdnces and siale laws relaiing �o �uilding consimclion ;
pmperly for inspectian purposes.
oaie: �—� S '� � Si9namre�
oriver's License or Socia� Securi�y a: �
ihe above
�
is correcL I agreeio comply with all city and
ntalivesofthis ciryto enterupanihe above�me
I6aL46 Wh'ne—Buildmg: Green—Code Enlorcemen��, Canary—Applicant Pink—Revenue; Goltlenrotl—Assessor
CITY OF COSTA MESA - BUILDING PEP,MIT
P E R M I T N O: P 0 6 6 4 0 9 P L A N C H E C Y. N O: N
CONSTROCTION TYPE: PERMIT TYPE: PL❑
JOB PESCRIPTION : ELECTRICAL WATER HEATER CHANGE-OUT
CLAIM VALUE:
CALC-VALUE:
PERM NO: P 056405 /i\1C
GOVT: P] SOPP: N `
PURPOSE: OTH
SQ FT:
GROUP OCC: /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
�*��c**�c*��**�**�**�*��**�ac��c�e***�����*�*��c****�t*��+�**�����**�**�a ��*�a�*�**��*��-
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 BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RCHT: FT IN
PARKING REQ; PROV; PARCEL: 42624421 ZNE: REF NO:
PLANNING NOTES>
>
# iE iE iE tE i1� �E iE if i! ik ih i! iE iE if f4 if �)f iE iE iE iF iE �It iE iE iE iE k jE �%j4 ie if iE iE 9E iF i(�!F iF iE-lE il� iE -fE i; 3E # iE ic �E iF iE 1E 1E * if if it ii� �1E 9E iE i� i: 'lE �)E iE iE !f iE iF 9f iF 1E 1t-k
D E V E L O P M E N T S E R V I C E Sy R E Q U I R£ M E N T S
ZONZNG APPROVED BY _ UATE;
BUILDING APPROVED BY : '� DATE:
�
APFLICATION ISSUED HY: .` DATE: �J� '���ll,�
***x��r*�-**�-***x.***�*�tf� � �, �i���**u�if**+�'iF"3F'3Fr�'��'iF'�3C��*-�
�1! jE if if iE # 1E iM1 iF if i4 iF iF i( # if �lE aE iE 1E iE iF if fE if iF+F �1E iE iE 1f i(� iE 1E iE iF 3f ff itlF iE K if iE if iE iE'�1F iE 3(-iE �)f if +f if if # iE iE 1t %iE?@ iE iF 9E iE Y� #f ?f it if �N.-iE it if ?f iE fE
LEGALIZATION;N F E E ✓S�U M M A R Y STRUCTURAL S^cGMENT:N
BLPG PMT PLUMHING ELECTA,ZC' MECHANIC FIRE SMIF/RES GR�}ING
PERMIT 7.00 � ' �
25R ' �' SMIP/NON-RES
PLAN ;- „ ,
ISSUE FEE 20.00 .a-"
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 7.00 20.00 . 0.00 27.00 27.00 .00
REVENUE DIVISION TOTALS--> COLLECTEU: — 27,00 OVER/SHORT- 00
BLDG PMT PLUMBING ELECTRIC MECH;ANIC� FIRE SMIP/TOT GRADING PLAN-C$ECK
Z%. U� _'
, �
fE # iE fE iE 1ElE 3E af if iE?E iE iE �' iE%iF 9E iF iE iF i6 ii� iE �)t it jE iE #• if �E iF iE iE iF 3F'i�-ff #: �E iElE �1E 3E iE 3f 1E iE �:1E if jf iE?E 9f iE �E 9E if if if if iE i! iF if 3F iE jE iE iE fi 1F �F i�` 3f �F jE
I N P I V I D U A L -�F E'E B R E A K D O W N
TYPE QTY U E S C R I P T I O N� �� UNIT COST TOTAL COST
PLU 1 WATER HEATER
AND/OP. VENT
END OF FEES
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7.00
Oi �Oi57%1E-001.572EE T�] T
OATE: �3%SS/95 7IhfE: 13:49
�.00
27.6E7
CONSTRUCTION AND PLANNING POO SPA " -- -`�
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
��
1. Temporary Electrical Service_r Pole _ 52. Pool & Equipment Location -
2. Soif Pipe-Undrgrnd. � 53. Steel Reinforcement �
;
3. Electrical Conduit Utitity-Uqctrgrnd. - 54. Forms .-�
4. Electrical Gonduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesi
6. Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Foo2ings 58. Electrical Conduit-Undrgrnd. .
8. Foundation �� ~�' � 59. Gas Pipe, O Undrgrnd., Test �'
9. Water Pipe�Undrgrnd. .'S . i 60. Backwash Lines, P-Trap, � Undrgmd. t•
10. Structural Ploor System '-� "' 61. APPROVAL TO DECK � i�
11. Property 5ewer Line & House,Connection i 62. Backwash & Receptor-Final )
72. Sewer Cap � ,� 63. Neater & Vent-Finat �\
73. Roof Drains , � 64. Plumbing System - Flnal '
74. Rou h Plumbin , = �'
g 9 r- 65. ElecTrical�Final r'" �
�i _
-15. Rough Electrica6Conduit ' � �� 66. Solar System-Final -�
16. Rough Electric Wiring 67. Fencing & Access ApP��val
17. Rough Wiring Sign 68. APPftOVED FOR PLASTERING
18. Rough Eiectricat-T Bar Ceiling 69. POOI/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Condicioning � FIRE DEPT. REQUIREMEN7
20. flough Factory Fireplace APPROVALS Permit 4'-r
21. Ducis, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipinc� O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-8ar Ceilin9 (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe.
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 76. FIRE PREV. FINAL
30. Drywall Nailing HEAITH DEPT. REQUIREMENT
31. Plaster Bro�vn Coat 79. FINAL INSPECTION
32. Electricai Power Meter�Final 80. F000 CERTIFICATE ISSUED
33. Final Eiectric Notes:
34. Finai Heating & Air Conditioning _ i
"Z .�4=A/ 6b���. ���,_z�, -
35. Final Gas Pipe-Test � _o :
�-�L4- (i [i �c-
36. Hood or Canopy
-g'_`� `�-T- - - ,-
37. Final Factory Fireplace
38. Final Plumbing � -?5,C/ �
L
39. Water Ser�ice-Final
40. Gas Service-Final
41. Solar pon�estic-Final
42. Backfiow Preventer ;
43. Backflow Irrigation - •
44. Landscape Irripation System , •
45. Sound Attenuation .
46. Handicap Re9ulations ,
47. FINAL S'fRUCTURE & BUILDING . �
48. FINAL P4ANNING - " _
49. Elec[ric Release to Edison - '
50. Gas Release to Southern California Gas Co -,
51. CERTIFICATE OP OCCUPANCY
No. Date
ADP��cant to fill in all spaces exceo� tnose within heavy boreer lines antl sign all aDv�opriate tleclarations.
PERMIT NO. � TRACT NO. LOT NO. � UNIT NO.
cirY OF COS7A S�} CON ST(� UCT�Q N PER I�T n.P. #
Fro�ectAddress �"•�C25t2Y'� COSTd r'�ESa� Ca 6Z� � � 3�,� '
1 - S Main Buildi
Applicant'S Mailing Addre55 TYPE OF CONSTflUCTION NEW ��ADD ALTERATION REPAI R E
�y,,, ❑ �EMOLISH ❑ OTHER T Front
IIIc F�roS `�.O - ����_� ' ❑ CONVERSION'
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. �A Rear
Address �,� �
� � C Right
Arch/Eng. License No.� � TVPE OF PERMIT GRADi(vG FouNDATIorv srRucruan� � �, �� K.
AddrCsS ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . g� Left
Contractor's Name VdIICP Ri ACSOC ROnP1f10 IIIC �.'Ph�o�ne 714-646-3211 �'�THER' � . ' _ Ping. Fef. #
Address Imailing) P' n �1X 104rifi Cns A �d .�LEZ7 PROJECT DESCRIPTION SGi. F7: OCCUPANCV i Planning Notes:
CiryLicenseNo. ��9�.� • CONSTRUCTIONTYPE VALUATION$ 3703.00
20NE � GRADING GU. VDS. ACRES
LICENSED CONTRACTOR DECLARATION '
I M1e�eby affirm [hat I am licensed untler provi5ion5 of Cha�te� 9(commencing
with section 7000) ot Divislon 3 of the BuSiness antl Pw�¢ssions Cotle, dntl
my license is in full force�antl effect.
License Class ic nse No.
Dale� iq��ynture �
WORKERS'COMPEN��_TTON DECLARATION
.',�hereby atfirm that I bave a certifica[e of consent to self-in5ure o� a certificate
'':,�;�:,Workers' Compensation Insurance, or a certifletl copy thereof (Section
!-.`�0, Lab. CJ
��6oiicy No. �v,��Q���Q�mpany �+b�'a'�� Mrh al Tnc ir,
eCertifietl wpy is hereby /umishetl.
Certifietl copy isiil�N�y{jEj�Phcdni[yHuiltlj0g&Dy'�S� f�ofing Inc
Date � L—ifyp VdIR.0
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be mmpletetl if tne permit is for one hundretl (5100) ar
less).
I tertify that in tM1e pe�fo�mance of the wO�k for which this perm�t is issuetl, I
shall not employ any pe�son in any mann¢r so as to become subject to the
Workers' Compensation Laws ot Cali/omia. •
Date Si9nature "
NOTICE: If, attet making this tlecla�ation, you Shoultl became subject to tM1e
Workers' Compensation provisions of Ihe Labor Cotle, you must forthwitn
comply wilh such p�ovisions o� this pErmit shall bC tleemetl revoketl.
CONSTRVCTION LENpING AGENCV
1 hereby af(irm Ihat the�e is a con5truction lentlinq agency far the perfo�mance
of the �work for which thi5 permi[ is issuetl ($ection 3097 Civ. G.)
Lentler's Name -
Lentler's Atltlress -
OWNER BUILpER DEGLARATION
I hereby affirm lhat I am exempt from the Contractor's License Law tor the
following reason (Section 7031.5 Business antl Pwfessional Cotle: Any city or
counly which requires a permit to wnstruct, alter, improve, tlemolish or repalr
any sVuc[ure, prior to its issuance, alzo requires [he applicant for such permd
to file a signetl stalement that he/She is licensetl pursuant to the provi5ions of
the Cantractor's License Law (Cnapter 9(commencing wi[h Section ]000) ot
�ivision 3 oi the Business and Profess�ons Cotle) or that he/she is exempt
�efrom antl the basis for Ihe alleqetl exemption. Any violation of Sectlon
�1.5 by any applicant for a permit subjects the applicant to a civil
.ialty of not more [han tive huntlretl tlollars ($500). '
❑ I, ai owner ot the Oroperty or myemployees with wage5 a5 Iheir sole
compensation, will tlo the work, antl the structure is not intentletl Or o(teretl
for sale (Section 7044, Business and Professional Cotle: The Contractor's
License Law tloes not apply to an owne� Of a Property who builtls o� improves
t�ereon, antl wM10 tloes such'wo�k himself/herself or through his o� h¢r own
employees, provitletl that such improvements are not intentletl or affe�etl for
sale. It, however, the builtling or improvement is soltl within one year o� com-
pletion, tne owner will have the burtlen of proving he/she tlitl not builtl or Im-
prove forthe purpose of sale).
� I, as owner of tM1e properry, am exUusively mntracting wi[h licensed con-
bactorsto construct the proje<t (Section �044, Business antl Professionz Cotle:
The Contractor's -License Law tloes not apply to an owner of property who
builtls or improves thereon. ana wno conVacts tor such oroiects with a�on-
tr ctor(s1 license yursuan[ m me ConVactoYs License Law). I am aware that
Pr�of o1 [heir Worker'S Compensation insuranGe Shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date
I hereby certify that I
information is wrrect.
antl 5tate laws relating
sentatives of this city
inspeCtion purpO5e5
Signature __�
Drivers' License or 55 �
0865-46, rev. 5/88
Owner
have read this apPlication antl state that the above
agree to comply with all city antl county ortlinances
o buil0ing construction, and hereby authorize repre-
to e r upOn tlte above-mentionetl-prope�ty fo�
� oate 7-1 -�
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Baihtubs
king Fountains
r Drains
�r Sinks
Service Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspac[ion' Fee
$15
Boiler
Ouct-UnderGround.
Duct - Structural
Duct - Ventilating
Ezhaust System 0 Multiple ❑
Firepl/Fact. Blt. iC80 �
Heating System & Ducting
❑0-100,000 BTU 0100,OOOBTi
Reinspection Fee I $15
White - Builtling; Canary - Applicant; Pink - Atcounting; GoltlenrOtl - AzsessOr
Showers
Service Sink -
Sewer Cap
Sewer Connection .
Solar Collectors
Solar Piping '
Solar Tank .
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
WaterService '
Auto-Wash
Laundry Trays
FEES Automatic Washer
Construction PoleSub.
Cooking Unit �
Dishwasher '
Dryers ❑Gas ❑Elec[ric
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL ' '
Transformer ❑ 15-50 KW
❑ SO+KW
Fan
P.A.U.
Fixtures
Device Boxes
�Utl¢t5
Switches
Garbage Disposal
Generator DO-5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over 100 amps
Sub Panel � ! �
nnoto�: Oai HP Oi i- a
Inc.Solar 09-15 HP �16-15+
Microwave '�'
Pole Light . .
Range ,
Standing Sections
Tresh Compactor
� ReinspeMion Fae I$75 luue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Issue Fee . Zonin9 Approved By
' FEES Building Approved By
Hood or Typel ❑
Canopy Type I I ❑�
Refrigeration Sys[em
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
O
N
1
N
G
R
E
�
M
T
S.
FEES
$ 3
SUMMARV OF,�FEES . f� ��
BUILDING PERMIT $ ��i . SMIP $ x__
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE ' $
PLAN CHECK 25% $ � ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �/��_
MECHANICAL $ lD7jl
TOTAL FEE $
PLAN CHECK 25% $ '
0.100037745-00037?kb T�7T �;�,;fl
DATE: 07/13I84 'iS11E: iQ:TS
_ ' C' - _.. ; . . .
CONSTRUCTION AND PLANNING POOI '�PA
Date Ins ector "
APPROVALS Permit # P APPROVALS Permit # ��ate Inspector
1. Temporary Electrical Service 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 4' ;
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ( j�
h
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNiTE %
;
v
7. Footings ��f � 58. Electrical Conduit-Undrgmd. �%'
8. Foundation _� 59. Gas Pipe, O Undrgrnd., Test �,1�
9-. Water Pipe-Undrgmd. "� 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor System (J ' 61. APPROVAL TO DECK
11. Property Sewer Line & House Conne�ion 62. Backwash & Receptor-Final
L2. 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
16. Rough Elec[ric Wiring 67. Fencing & Access Approval
1J'. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
18. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
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 � 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. Electrical 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. FINALSTRUCTURE&BUILDING rf��'�
48. Special Requirements Completed
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co ' '• �,'
51. CERTIFICATE OF OCCUPANCY �` � . ; �
No. Date �-• '
2,C7�
COSTA MESA BUILDING-5,4FETY DEPARTMENT
P.O. BOX 3f7 C08TA M88A� CALIPORNIA
For Applicant to Fill In Completely
�� TYPE OR PRINT
BUILDINQ f//j0 GLovcCsiE,� ,7% JL
ADORESS �
� COSTA MESA, CALIFORNIA �
504 No. Newport Blvd.
o,�r,- Ne ort Beac
ARCHITECT grent S.
Oc -�iGINEER
A. _s81320 Carmelita, Laguna Bea
CONTRACTOR Ca e Series Inc.
wooaesa 504 No. Ne oTC Blvd.
•c�rr Newport Beach; Galif.
;;�TNo. 221233 No • 646-9341
s!zE,._ 48. 83 x 44. 33 � NO.OP BLOOS.
6P7' /Z -V- I RIGHT'
DESCRIPTION OF WORK
X II.._�_._._..I II ._�
"° 1269
S'� S
7. OF l
JOMS BTORIHB 1
ROOF
COVERINB cedar Sr
'TOBE ERFOf2 ED
'residenua`�
FEE RECEIVED
HOV. 2'7 1963
FINANCE DEPT.
A��A�fo���a� �T
BUILDING
For Offlce Use Only
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LeO"` LOT
D88CRIRION
A. P. NO. �
NOTE: NOEAVEOVER
30" TO SIDE 8 REAR F
EAVE3
ALIOWED
,YAR�BAPPROVED
MAIN BUILDING
( FROM C/�
FR NT Ff.
R. SIDH ✓'S FT.
L. 9106 � %— FT.
REAR O Ff.
DIS7ANCE BET.
MAIN BL�G9.
VAR. �L
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BHALL BE LE89 THAN
(U.B.G.REQUIREMENTI
YARDSAPPROVED
ACCESSORY BUIL�IN6
i �_�ry
��'� 6'(]
1269 6q. �.
I HEqEBY ACKNOWL6OO8 THAT 1 XAV6 READ TN�B APPLIC/�TION TNH AMOIINT BHOWN IIND6R VALUATION IB FOR'TXE
AN� 9TATE TMAT TXR ABOVH 18 CORNECT AND AOqEE TO COM- PUHP088 OP 66TABLI9HIN0 A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANC88 ANO BTATH LAWB RHOULATINY yALLIATION p
evi�oirvo<OrvsTrtuci�on. pERMiT�FEE $ JH. ZI
SIGNATURE OF �11, 738. ZS
PERMITTE I�S QiG
� ' '$ , . PLAN CHECK $ OO
AUTHORIZfiD AGfiN p
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