HomeMy WebLinkAbout3102 GINGER AVE - Building PermitsPflOJECT AODflESS: 3 1 O 2 G I NGER AV
OWNEH'S NAME: GORDON CANNON
RDONESS: Sjil"jE
549-5211
pPCNIENGINEEB:
AOOflE55:
flEG.NO.:
uxiT: B
UNIT:
PEHMITTEE: j�EE PLUMBING & HEATING ( 213 ) 759-9101
PDOflESS: SQS% CRENSHAW HL
LOS I�NGELES CA 90043
UCENSEO CONTFACTOH OECIAflFTION: I hereby allirm t�a� I am licen5etl unaer pmvisions oi ChaDter 9(commencing wiih Sec�ion
7000� ai Oiv��sion 3 of �he Business antl Professions Coee. antl ry license is in �ulllor , and e�feci.
cirvuc.:0302U3/� STATELIC.�O1 c s: /
oxle; � � �� `y � SignaWre: _ _ —_ _
WOHHEflS' COMPENSPTION OECLl�BRTION: I hereby aflirm Ihat I have a certihcate o� consem m sell�insure or a cetlifica�e of Workers'
' Compensa�ion I s a c cetlifiea wpy ��ereo� (Section 3800. Lab .
' n�ic. �o.: g� g���7 EXP. DATE: S I O 1 I 9 1
comraNr: STATE FiJND
❑ Certified copy is hereby furnishetl. � C/ery1ied copY is ed wi �he cny ilding Divisi
�ale: � � � � �L � / Apphcant: / � J
E%EMPTION FBOM WOflKEPS' COMVENSATION OECLANPTION: (This seclion n¢ed not be [ampleled if ihe permit i5 for ane huntlrea ($100) or les5).
I ce�ily Ihat in Ihe pertormance oi Ihe work for which Ihis permi� is issued. I shall not employ any person in any manner 5o as �o become
subject Io Ihe Workers Compensation Laws oi Cabbmia.
�a�e: SignaNre:
NOTICE: If, aller making Ihis tleclaraiion, you 5hou10 become 5ub�eci ta ��e Wofkef5' Compensalion pmvisions o� ihe Labor
Code. you must fonhwilh comply wilA such pmvisions or ihis permit shall he Oeemed revoketl.
CONSTHUCTION LENOING RGENCY: I hereby allirm Iha� lhere is a con5tmciion lentling agency lor Ihe pedormance ol �he work lor
whiC� thi5 permiii5 i55u¢0 (Seclion 3097. Civ. C�.
LENOEP:
FODPESS:
OWNEB BUILUEfl OECLAPRTION: I hereby aflirm �hai I am exemp� imm Ihe Coniracbrs' State LicenSe Law for the following reason
(Seclion 7031.5 Business and Pm�essional Code: Any ciry o� counly w�ich requires a permi� to cons�mcl, al�er, impmve, tlemolish, or
repair any slmcWre. prio� lo iis issuance. also requires �he ap0lican� Por suc� permil to �ile a signea 5tatemeni Ihat he/she is licensetl
pursuam to the pwvisions ol ihe Coniracmrs' S�ate License Law (Chap�er 9 �commencing wi�h Section 7000) o� Division 3 0� Ihe Business
antl Pm�essions Cotle) or �hat helshe is eMemp� Ihereimm anU I�e basis for Ihe alleged exemption Any violation oi Sec�ion 7031.5 by
any applicant lor a Dermi� suble��s �he applican� to a civil penaliy oi not more than �ive hundre0 Aollars (5500�.
I, as owner ol the O�oOeny or my employees wiiA wages as their sole compensation, wiil ao ihe work, an0 ihe
❑ simcture is not imenaed or offeretl for sale (Section 70a4. Business and Professional Cotle: The Contracmrs' State License Law
� Uoes nal apply �o an owner of a pmpe�y w�o Ouiltls or impmves �hereon, and who Ooes such work himself/herself or thmugh
his or �er own employees, pmvided tha� such impmvements are no� in�enaed or oifere� fo� sale. It, however �he builtling or
impmvement I5 sold wi�hin one year oi com0lelion, ��e owner wiil have the buraen of pmving �e/she tlitl not buil� or impmve
for ihe purpose of sale).
I. as owner ot �he pmpehy. am excWsrvely con�mcting wil� licensetl conlractor5 ia cons�mcl �he D�olec� (Section 7044, 6usine55
❑ antl Pm�eSsions COAe' The ConVac�ors' S�aie License Law tloes no� appry m an owner oi Dmperty who builOs or improves lhereon
antl w�o tOntrac�5 �or 5uth prole��s wi�h a ConVattor(5� litense pursuant�o �he Con[racior5' S�ate LiCense Law�.l am awar¢
��at pmo� o� their Worker'S Compensation insurance 5hou10 be pmvitletl �a me.
� I am exempl under Seclion. B. 8 P. C.
for Ihis reason:
�aie: Owner
I do hereby cetlity ��ai I am aware o� and untlersland ihe requirements o� Cali�ornia Heal�h antl Sa�e�y Cotle Sectiore 25505, 25533, ana
2553a and Uat I or any lumre buitding occuDant will/will not (circle one) neeU to complY wiih sai0 state codes and ihe requiremenis for a
permi� �ar consimclion or moddica�ion �mm t�e Air Oualiry Managemeni OisVict. flesi0emial consimciion applicaiians are eKempt fmm
these provaions.
Oale: Fpp6canl _
I hereby cer�i�y Ihal I have reatl �his apphcation an� slale Iha� 11
ordinanc¢s antl 51Alelawsrelaling�a builtling constmciion antl hei
properlY �o�inspetlion purposes.
Date: � � � �' � � � Signalure: _�
oriver's License o� Socia� secunty q�
above intarmation is correci. I agree to comply wi�� all city anU coun�y
ly�Wpqnze re���ves af this ciiy m enter upon �he a0ove�memioned
' / �—/-� —��\
164va6 Whne—Builtlmg; GreCn—Cotle Enlomemen�� Canary—ApolicanL Pink—Revenue: Goltlenmtl—Assessor
CITY OF COSTA MESA,— BUILDING PERMIT PERM NO; M USU50
PERMIT NO: M 050509 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPc: PERMIT TYPE; MEC PURPOSE: OTH
JOB DESCRIFTION ; 60000BTU FAU CHANC;E—OUT SQ FT: �
CLAIM VALUE: CALC—VALUE; GROUP OCC: /
COMMENTS: NO 5TRUCTURAL WORK AUTAORI7.ED
*�a�*x�a**���****�*******�**�cx**�x*�*���r*�x-�*���*xx***�*����*��**�xxx*x�***�**�*
Z O N I N G R E Q U I R E M E N T S
sETBAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT TN REAR: FT IN
LEFT: F'I' IN RGHT; FT IN LEFT: FT IN RGFIT: FT IN
PARKING REQ• PROV: PARCEL; 13956902 ZNE; REF NO:
PLANNING NO'i'ES>
�
if 1f * if?4 if 3f !F * if if iF If af iE iE �IF 3F if 1F if 3E ii iE 3E IF 1E if !f �f iE �F �1F iE �lf- iE if if �If �1h 1f �E iE iE �IEiE lE Ih N-iE 3F iE iF iElE �lE 3E iE iE If iF iE �1F N� 1E �E if �lf iE 3E jf IE iE �f R 1F if ?f
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:
BUZLDING APPROVED BY : DATE;
APPLICATION ISStJED BY: '� DATE: � �
3FififlEiflE�ElfiEiFiE1E�FdE1EiFiflEiEiEifiF iEiflfiEiE3f�EjEiflk � #Eif
3f if iE dElF 3F 3E if 1E iE jf 16 iF fE jFlF iE iE )f !E iE iFlElt 3E if iE if jE iE if if 1F iE dFif jE if iE 7E �E iE iF iE if lf !f iF iF iF iE dF iE IE iE iE If #f!f!F id IE iE if !E �E iE 3f iE iF iE 3F iE iE iE iF iE if iE
LEGALIZATIOi�I;N F E E S U M.M A R Y STRUCTURAL SEGMENT;N
BLDG PM'P PLUMBING ELECTRIC MECHANIC FZRE SMIP/RES GRAllING
PERMIT 9 00
'15Y SMIP/NON—RES
PLAN-
ISSUE FEE 15.00
BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15,00 0.00 24,00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT: 00
HLDG PMT PLUMBSNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
z4.00
iE iE 3f iF iE �f 3E ik if 3E aE �1F iF iF aE iE 1k iF 3t if IE 3ElE �E aE iF 3t if if !E iE jE iE �E IF if �F if IE jF if if iF 3k if if if iE iE ik 3f iF 1E iFif aF 3E iE �F aE i4 3f iF iE �E iE iF 3E iE �E 1F iE iE 3F jE iE if �E aE
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 2 O N UNIT COST TOTAL COST
MEC 1 INST FORC—AIR/GRAV FURN <= 100 R BTU 9,00 9,00
END OF FEES �
Gi QOp77y'�,5`�fl�I���a.3 .r :" i .:lm
OAiE: 0�;�..i9f 1IiE: t3tig
V
CONSTRUCTION AND PLANNIN6• r�dL & SPA
- APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
� i. 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
5. S[eel Reinfo�cement 56. Rough Plumbing & Pressure Test .
� 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
•' 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test '
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-Pinal
12. Sewer Cap � ' 63. Heater & Vent-Final
73. Roof Drains = 64. Plumbing SYstem - Final
14. Rough Plumbing - . 65. Electrical-Final
15. Rough Electri�cal-Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical�T Bar Ceiting 69. POOL/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace -. ' � APPROVALS .Permit #
21. DuCts, in Structure. ' . � ,70. Underground Hydro
22. Ducts, Ventilating � ' .`� •. :�_77, producCPiping O Gas O'Oil
23. Gas Pipe-Rough & Test , ,, � 72. Underground Flush _ �
24. Roof Framing - � " �•73�. Undergrnd.StorageTank �Gas OOiI �
25. Roof Sheathing ' _ � � , �' '74' Overhead Hydro
26. T-Bar Ceiling �Structuraq &�Monocoat - � 75. Dry Chemical
27. frame and Flashing , 76. Dry Standpipe ", � ' '
28. Lathing & Siding �� . ., � �, > � � � 77. FIXED SYSTEM� FINAL' -
29. Insulation - _' , � � � �` ; 7$„ FIRE PREV. FINAL . �
� 30. Drywall Nailing �• + � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown CoaC � � '' 79`'FINAL INSPECTION �
32. Electrical Power Meter-Final .. � � �.�80..F000 CER?IFICATE ISSUED
33. �Final Electric ' � I; _' Notes: '� -
34. Final Heating'& Air Conditioning, ,� Z(�3 9J L� , • ' - - �
�35. Final Gas Pipe�TefY . - � � � i� ' • ', , � -
r 36. Hood or Canopy I �- ' . �
37.�Final FaMory FireplaCe � • • � � -
�: �.
38. Final Plum6ing . � � .� I� � . . . �
' 39. Water Service-Pinat' � �• • -- - - - �
40. Gas Service-Final ; � , � � . . � �
41. Solar pomestic-Final _ � • � �
42: Backflow Preventer ' � '
� i l� ,
43. Backflow Irrigation� • � - � � � �
.
.44. Landscape Irrigation SYstem � - � ' . • . -
-45. Sound Attenuation � � �� �
46. Handicap Regulations � � � ,
47. FINAL STRUCTURE & BUILDING � -
48. FINAL PLANNING ' �� , � . .
� 49. Electric Release to Edison I ' I �
50.. Gas Release to Souihem California Gas Co � � i� ,
51. CERTIFICATE OF OCCUPANCY � .
No. Date
L
Aoo���ant to fill in all spaces exceot ihose witnin neavy bortler linas antl si9n all approDriate tleclarations.
iCITY OF COSTA MESA CO STR/U�CTIO/N�y �P RMIT
ProjectAddress ��0� ��NC7� ""�
�" ��S/ N� %1-N �
roolicant's Mailina Address
Owner's Name i�` " � rno�rye-�" •
Address 3102 �%/NfJ�2 £'• � Co9/�74 KE$A'
Arch/Eng. License No.
Address �
Contractor's Nam �" 9---3.�i�
Addresslmailing) � �/C�7,G/�,)7'Ti� �E'hone � L1
City License No. ' � � (�
LICENSED CONTRACTOR DECLARATION
I nereby af}irm that 1 am Ilcensetl untler provi5ion5 ot Charter 9(commencing
with seclion ]000) ot Division 3 0/ the �usiness antl Professions COUe, antl
my ucense Is in 1 �Q and errect. ^ n �p/
, LJcenseq� ��j1`���yy'y �� ( /, L���'rt /-v� `
Dale n� �'^^�—�� �
WORK RS' COMPENSATION DECLARATION
I hereby atfirm tita[ I hava a certi(itate o( consent to self-insure or a cerUficale
of Workers' Compensation InSurance, or a certifietl copY Ihereot (Saction
3800, La�. I'�1
. Policy No. Company � �V'V�
bfie copy �s hereby furnishetl.
Cer ' �� p� sy�f Iletl with the city ByilOw+➢-9��Isio�/� �/ /D
Date_1��Y � AP�Iicant ric�ziv ri.r� cm
EXEM TION ROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl il the permit is for one huntlretl ($300) or
less).
I certify [hat in the pertormance Of Ihe work for which this perm�t i5ls5uetl I
snan not employ any oerson in any manner so as to become subject ro t�e
Workers' CompenSaHon LawS of Cali/ornia.
Date $i9nature
'NOTI[E: Ii, aiter making this tleclaration, You snoultl become subjett to the
Workers' Compensation provisions of the laEor Cotle, you must tort�witn
Comply with such O�ovisions o� this pe�mit shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV �
I hereby atfi�m that tnere IS a construction Ie�tling agency tor the performance
of the ,work tor whlch [his permit is issuetl (Sectlon 3097 Civ. CJ
LRntler's Name
Lentler's Atltlress ,
I OWNER BUILOER DECLARATION
j I hereby, atfirm that I am exampt from the ConVactor's License Law for the
I lollowin9 �eason (Seclion 7031.5 Business antl ProTessional Cotle: Any cily or
i county wnich requlres a pe�mit to construGt. alter, imp�ove, tlemolish or repal�
any structuve, p�io� to Its IsSuanc¢, also reQuires the appllcan[ tor sucit po�mlt .
to tile a signetl statem¢nt that he/sM1e is IiLensetl pu�suant to tM1e provision5 0(
the Contractor'S License Law (Chapter 9(commencing with Sectlon 7000) of
Division 3 of the BuSiness antl ProfessioPs Cotle) or that he/she is exempt
thereirom antl the basis tor the allegetl eXemption. Any vlolation of 5¢ction
]031.5 by any. appliCanl for a permit zubjects the applicant to d Civil
�ndlty of not more than tive huntlretl tlolld/5 (E500).
I, as owner of the oroperty or my employees with wa9es as lhelr sole
comoenzation, will tlo the work, antl the structure is not Intentletl or otieretl
for zale (Section 7044, Bu5ine55 antl PrPfessional Cotle: The Contracto�'S
LicenSe Law tloes nol apply to an owner of a property�wM10 builtl5 or imprOves
thereon, antl who tloes such work himself/herselt or through his or her own
employeez, provltletl tM1dt Suth improvements are no[ intentle� o� offered tor
wle. If, however, the builtling or Improvement is soltl wlthin one year of cOm-
pletioq tne owner wi11 nave Ihe burtlen ot proving he/she tlitl not builtl or im-
� prove for Ihe pu�Dose o1 sale).
❑ I, as owner of the D�oper[y, am exclus��ely contractin9 witM1 Iicensetl con- �
Vactorsto mnstruct the prqect (Sectioo ]044, Business antl Protesslons Cotle:
The ConVactor'z License Law tloes mt aPPly to an ownet o/ property who
builtls or impwves thereon, ana who confracts for such projects wlth a mn-
: tractor(s1 Ilcense pursuant to the Con[ractor's License Law). I am aware that
proo( o( [heir Worker'S Compensation insuranc¢ shoultl be provitletl to me.
. L7 �I am exempt untler Sectlon B. & P. 0.(or this reason '
Date � Owner
I hereby certify [hat I bave reaE tnis ap0���ation antl sta[e that the above
iniormatlon is correct. I a9ree to comply W�th ali city antl county ortll ances
antl'state laws elating lo b iltling ConStrticHon, antl hereby authorix repr -
senta[ivez o is i [ n r upon t above-menlionetl Orop rty
insoection p ce5.
Signature • � Date
Drivers' License or 55 �
TYPE OFCONSTRUCTION LJ NEW U ADD LJ ALTERATION �L]+REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p#
DESCRIPTION OF WOR1� USE OF B�.DG. �� oFF EkIS%. 6�MJ �
p (L _ /e �v �( 'L-PL �� {r ���y' E Main Building:
TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL T Front
❑ TENANT ❑ ELEpC TRICAL ❑ PLUMBING ❑ MECHANICAL 8 Rear
p �OTHER F`�. h�9'� A
PROJECT DESCRIPTION 5�. FT. oCCVPANC �/— C Right
CONSTRUCTIONTVPE VALUATION$ ��J/ S Left
ZONE GRADING CU. VDS. ACRES Ping. Ref. #
Remarks: 7j � -� �� P�anninq Noies:
Sink
Preventer
Irrigation
athtubs
rinking Fountains
loor Drains
loor Sinks
asService OuUets
Lavatories
P-Trap
Roof Drains
�
Reinspection Fee $15
Boiler _
Duct - Under Ground
Duct - SVuc[ural
Duct - Ventilating
Exhaust System ❑ Multiple
FirepVFact. Blt. ICBO #
Heating System & Ducting �
❑ P7 00,000 BTU � 100,000
Reinspection Fae .� 815
CMF OB65-46, rev. 30/84 Wnite - Bulltling; Lanary - Applicant; Plnk - Accounting; Goltlenrotl - Assessor
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Type 1 ❑ '
Canopy Type I I ❑
Refrigeretion System
❑aioo,oaoeTu ❑ioo,000
System Repair/Alte�ation
Fire Dampers
Registers
� Issue Fee
$ 3
FEES
$ 3
2135 8/27/86��
Zone
Accessory Building:
ELECTRICAL .
Automatic Washer Transtormer ❑ 15-50 KW'
Construction Pole Sub. � 50 + KW
r
Cooking Unit Meter ❑up to 700.amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Elecvic Sub Panel .
Fan � Motors �0-1 HP � 1 h- 8
F.A.U. Inc. Solar �9-15 HP 016-15+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches
Garbage Disposal
Generator �0-5 KW �5-15 KW
$tanding Sections
Trash Compacmr
Fee �$15 � � luue Fee
DEVEIOPMEN7 SERVICES REQUIREMENTS:
Zoning APProved By
Building Approved By
Aoolication Issued Bv .4 (.J�
SUMMARV OF F
BUILDING PERMIT $ �3�00
PLAN CHECK $
PLUMBING , $
P�AN CHECK 25%,$
ELECTRICAI $
PLAN CHECK 50% $
MECHANICAL � $
PIAN CHECK 25% $
,.
53.50 TL'
Z
O
N
I
N
G
R
E
�
S
FEES
$ 3
ES ' �-^
SMIP $ r�i O
PERMIT �
ISSUANCE $
ENERGV P.C. $ �
GRADING ,$
MICROFILM ,$ � �
TOTALFEE $ �3'��
�
-yC�NSTRUCTION AND PLANNING
APPROVAIS Permit#
7. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgmd. '��
3; Electrical Conduit� Utlliiy-Undrgcnd.
4, Electrical Conduit-Undrgrnd.
5. Steel Reinforcement� �
no
6• Efectrical UFER Grnd. �
7:.Footings � �, �
,�
� 8. Foundafion '
9. Water Pipe�Undrgrnd. i
10.�Structural Floor System .
11. ProPerty Sewer Line & House Connection
14. Se�rer GaP �, .
.� .�
13. Roof Drains , _/
14. Rough.Blumbing,'
15. Rough Electrica6Conduit -
16. Rough Electric Wiring
17. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
. 20. Rough Factory Fireplace ,
21. DuCjs, in Structure
22. DuCts, Ventilating
� 23. Gas Pipe-Rough & Test ' ,
24. RoOf Framing
25. Roof�Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing �.
�
31. Plaster Brown Coat , ,
32. Electrical�PowerMeter-Final
33. Fin�l Electric
34. Findl 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 �,•�.
4'4. Landscape Irr`igation SYsterr� � j
)
$5. Sound Attenuation . `.� �
:46. Handicap Regulations r�l '
�47. FINAL STRUCTURE & BUILDING
48. Special Requiiements Completgd
49. Electric Release to Edison �'�'
�50. Gas Release to Southern California Gas Co
�ln. Date
Date
0
0
POOL n �PA •
Inspector � APPROVALS Permit #
52. Pool & Equipment Location
53. Steel' Reinforcement
54. Forms
55. Electrical Bonding
56. Rough�Plumbing & Pressure Test
57..APPROVAL TO COVER-GUNITE
58: Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. .Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor-Final
63. Heater & Vent-Flnal
64. Plumbing SYstem - Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval -
68. APPROVED FOR PLASTERING
69. POOLISPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. ProductPipingOGas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas L] Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Nnies:
g�
u
s
Date InsFPctnr
, ,.
City of Costa Mesa
Building Safety Deparfinent
P. O. Box 717
Cos�c Mesa, California
CERTIFICATE OF OCCUPANCY rj� 26p1 C
The Building located at ju� ri�C.ZKmm2tIL9� s�11
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances opplicable thereto
for a Group .:H & a Occupancy.
Use of 8uilding � iB11C Ap�$�3 HStA ntt.R�CnEfl ggffig48 6T!$ 1�13t1dl4
Legal Description ��� � ItO� u
� (See roverte �ide for Mufat and Bounda)
Building Permit No. �� Electrical Permit No.- 2�9� Plumbing Permif No. g3�
Floor load Signs have been insfalled as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. . required �nder Sec. 3301 (1) U. B. C. —
17050, CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be �sed or occupied
until the owner or operator has been iss�ed a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupanty shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
�f Gro�p H Occupancy, n�mber of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Tifle 8, Chapter 9, Article 8.
Number of apartmenis '� and/or guest rooms
lSSUED TO: Building Official
� :� bY ��� ✓"„/. `lf �'� U �
Date • J1me 2'l, 19�
This CertificaTe of Occupa�cy SHALL BE posted in a conspicuous place on fhe premises and SHALI NOT BE removed
except by fhe Building Official of the Cify of Costa Mesa under Sec. 306 (e) U.B.C. Fo�m eua�tM—t�.ea--s-s r
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COSTA MESA BUILDING-SAfE7Y DEPARTMENT
P.O. 80X 7200 � COSTA ME$A� GALIiORN1A fR626
� For Applicant to Fill In Complefaly APPLICATION FOR PERMIT
TYPE OR PRINT �D BUILDIN�3
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PLY WITN A�L CITY ORDItUNCY At1p y{A}{ yWY PlOUL11TIN0 y�UATION �
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SIGNATURE OP PERMIT FEE
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