HomeMy WebLinkAbout1202 PARNELL PL - Building Permits - . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CO STRU 10 PERMIT PERM O. TRACT NO. LOT NO. UNIT NO.
.Project Address ,. 0 n 'A I . ' • � ��
• Applicant's Mailing A•dress A . I s .. it / 0-- TYPE OF CONSTRUCTION NEW U ADD U ALTERATION f REPAIR
4.� .1 Phone 57,_. Ell CONVERSION El DEMOLISH El OTHER A,P.# Zone
Owner's Name - DESCRIPTION OF WORK/USE OF BLDG.
Address 1../AL1 � 1 • S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ALJ FOUNDATION U STRUCTURAL T Front Z
Address ❑ TENANT ❑ ELECTRICAL IQPLUMBING ❑ MECHANICAL B Rear N
Are
�_ ,.n,� ❑ OTHER A I
Contractor's Nam / • -� '� / ' PIgo e uw C Right N
7777 777 /44-
��11 (py1j+�� PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) ! .5$ al W , /! K G
9 CON STRUCTION TYPE VALUATION S Left
City License No.
R
ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and 7 s;.r T
my license is in lull fo S e • effect. / �� RECEIVED U C I !'JJU
License lass �d' , i e •, 5
Gate • Signature fen/ . �—a __ PLUMBING FEES
ORKERS'COMPENSATION DECLARATION Bar Sink Showers ■ ELECTRICAL FEES
nereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink ,
Automatic Washer Transformer 0 15-50 KW
1 3800, Lab. C Q `/n T �j�� , , 0 50+KW ,
Policy No. �9�g3�l-�9 Campany( 7"� • r(�1(,!/t Backflow Irrigation Sewer Cap Construction Pole Sub.
rtified copy is hereby furnished.
Cert' ed y Ijed with the city BlI g i Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date /0 1pJ Applicant
EXEMPTION FROM WORKERS'COMPS SATION DECLARATION Clarifiers Solar COI¢Ctorg Dishwasher Meter Clover 100 amps
(This section need not be completed if the permit is for one hundred($100)or
less). ,Dishwasher
■ Solar Piping �� I Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued I
shall not employ any person in any manner so as to become subject to the ,Drinking Fountains Solar Tank ■,■ Fan . Motors 00-1 HP 011/2-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar_ 09-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith .Floor Sinks IIIUrinal ■ Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCYII
• Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION •
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW 05-15 KW
any structure, prior to Its Issuance, also requires the applicant for.such permit Trash Compactor
'o file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
ie Contractor's License Law(Chapter 9(commencing with Section 7000) of
/vision 3 of the Business and Professions Code) or that he/she Is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
LIenalty of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves ..
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date /D/149/gr.for the purpose of sale).
0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date V
tracors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that ■Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT
0 l am exempt under Section B.& P.C.for this reason I. Firepl/Fact.Blt. ICBG# IIFireDampers PLUMBING $ 5-- ISSUANCE $ '��/
Date owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000BT ELECTRICAL $ GRADING $
information Is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for PLAN
inspection purpos: /2/�- r, MECHANICAL $ TOTAL FEE $ `'71/ V
Signature / .��i �L/ Date ,J/O
Drivers' License o SS#
CMF 0865-46.rev.10/84 White - Building: Canary -Applicant; Pink - Accounting: Goldenrod - Assessor Ul UVUI(2(U-UUU1/2/U I U 1 :.UU
DATE: 10/18/88 TIME: 09.01 •
CONSTRUCTION AND PLANNING POOL &SPA
APPROVALS.- Permit# Date Inspector APPROVALS Permit# Date 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
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER;GUNITE
fes.
7. Footings i��- 58. Electrical Conduit-Undrgrnd.
8. Foundatio59. Gas Pipe, CIUndrgrnd., 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-Final
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
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 Permit# - -
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT ;.%
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED `.
rL.
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 IF1-J8 LCD
39. Water Service-Final • .
40. Gas Service-Final
41. Solar Domestic-Final _ .
42. Backflow Preventer
• ti
43. Backflow Irrigation .W
44. Landscape Irrigation System - 1-`1
45. Sound Attenuation •
46. Handicap Regulations a7
O
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
•
No. Date , l
January 12, 1967
Bankers Mortgage Company
1505 East 17th Street
Santa Ana, California
ATTENTION: Lou Harrison
Dear Sir:
On November 29, 1966, Bu ding Permit No. 26417
was issued to David King to add a pat o cover to the resi-
dence located at 1202 Pa ell Place wi n the City of Costa
Mesa.
Structural Inspec or Francis J. Mahoney inspected
this structure o January 11, 967 and found it to comply
with all requir nts of the Uniform Building Code.
Enclose is the standard job card with the in-
spector's signed ap oval.
Yours very truly,
RICHARD HANHART
Director of Building Safety
by
Secretary
OWNER COLLEGE-MESA COMPANY DATE 10-11_56
JOB ADDRESS 1202 Parnell Place BUILDING PERMIT NO. #3825
C 'ERALCONTRACTOR The Hale CO. VALUE $ 10,218.00
LOT 169 BLOCK TRACT 2671 Single dwelling w/att. gar.
GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 3855
PERMITS (3SUED
INSPECTIONSDATE SUBCONTRACTOR DATE NUMBER
II--
Footing Trench ;LT ifrt_____ - ,r
Foundation Forms and Grade to Garage ---...1-7-27F
Rough Framing Yee z t �/� `� � limit,
Plumbing, Rough to Slab SVf 1 I11 r b nn/ lim.M /0- 0 -,5 4 7a?<f L-
Plumbing,Rough Complete /At t.,� 1-y 3h
Temporary Pole ,,((�7 ,o/� h
Wiring, Rough 4 20 '7 r re IU).....,,.J CJce-C- . /h&c--S7 ,3/ 27 a�
Heating,Rough yvt e%5 /i-M-6-6
Heating, Final 44/7S ./ -S .a4t-elY1'- ' •+'...., /- /1 - C . 7.f0 c' [�
ewer,` House Sewer,St.41/i-c triers? Y`-5 .Cr^N1n.o_i2L-may 1�- e ,-��, 1.7 G4
c Tank or Cesspool �r��L "-CC
Lathing, In( Out gLi.---4 ) -s$
Plastering , k -i a b ." -'S 7.
Plumbing,Final,Fixtures CompleteMbeS -iv s7
Plumbing,Final Gas Test/,r /H/74S , _/ - - \ - -/e </ 1l+' )ft,71.-•
Wiring,Final JUN 1 rp., �� f , -- p
Occupancy /yiis 6-26-S7
Wsta Mesa Building Department APPLICATION FOR PERMIT
At
111 EAST&OSTA MESA, CALIFORNIA h STREET •`�3�.fi D ��
FOR OFFICE USE ONLY
` FOR APPLICANT TO FILL IN Receipt No. I Permit No.
Building I 1612/52- C
Address 1202 Parnell Place
Costa Mesa, California Received by Date Recd./// Date Issued
Nearest _ /Q M /0—St'/a --// -J
Cco
_Cross St. Loren Lane __ _ __ Building
- Address
Owner College Mesa Company Costa Mesa, California
Mall -
Address 1777 W. Lincoln Avenue Nearest
Tel. Cross St.
CityAnaheim NoKEY 3-3161 zone No.of Type
l Grou /Jir
I Plans I y p
Architect or Lia \
Engineer Davis & Quigley No. C-1790 Approved
by Date
xes443 Malaga Cove Plaza,Palos Verdes CORRECTIONS
City Lic.
Contractor The Hale Company No, 3422
Address 1777 W. Lincoln Ave. , Anaheim
Legal I Lot I
Description I No. 169 I Block I Tract 2671
(Attach Metes and Bounds)
I No.of Bldgs.
Size of Lot 78 x 125 I Now on Lot None o
Use of I No.of I No.of A
Existing Bldg. I Families I Rooms Ill . GS
Setback Line from Rear Yard 34.4 2
Center of Street 52 SldoYard 8.8/10 D
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I '
Repair I I Moving I I Demolish I g
'ding No.of w
1181 Rooms 5 Stories 1 0
exterior WallRoof —
Covering Stucco I Covering Shake APPROVALS I
Use ifnNew Foundation Location Inspector Date
Building Single family dwelling with Forms,Materials,
attached garage, Under-Pinning M
Frame: Fire Stops, .o
Bracing,Bolts b
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int. G
with all City Ordinances and State Laws regulating Al
building construction. Lath. Ext.
Signature of THE HALE COMPANY
Permittee Plaster, Int.
Authorized Agt. Plaster,Ext. 0
Valuation Permit Fee $ 26.00 Masonry Reinforced 4-
Plan Check$ 13.00 Bond Beam
$ 10,248.00 Total O
Fee $ 39.00 FINAL o
FORM 204 S-BP 2M 6-55
I. 1111.
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- Street t - .,
PLOT PLAN _
Show location and distances from
o property line and between buildings. - •
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UWNER Davi.0 A. Hing DATE 11=29-bb
JOB ADDRESS 1202 Parnell Place BUILDING PERMIT NO. 26417
GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Patio Cover
P" No.141-046-08 LOT 169 TRACT 2671 FIRE ZONE VALUE $ 700.00
'ECTIONS Signature Date GROUP V TYPE ,7 ZONE R-1
Soil PERMITS ISSUED
Gas SUBCONTRACTOR I Date Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con. p _
Sprinkling System
Miscellaneous _
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing—In 0 Out 0
Placter, Brown Coat
tural, Final Electric
Vent., Refrig. and AC., Final
Plumbing, Final and Gas Test 0
Electric, Final /I I !��-r
Building. Final `I.E 07).44 I 7AA %r ►roti 's•`
W 7***aa6.00
' _ 26417 NOV 29-66 001321 _
, COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 42ca Rgm,oEu_ >DL . C f i • For Office Use Only
ADDRESS
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA in A
/ RECEIVED BY DATE RECEIVED DATE ISSUED
OWNER 'D/ I,/1D A . k_1116 . //- L.9-66 i/-zi-G'C
MAIL yy�� QQ n /�/ I pt , BUILDING /20 z // P
ADDRESS /L 0 2 �'7`Nf-�-L r L- I ADORQ98 q/^//e i
FIRE
_ .
CITYCo r6 Alps
4 . TXOl-S4r-3.2J2 ZONE ----TYPE GROUP ...7—
TEL.
APROVED/ //' DATE /^4/
6
LINGII NEER NO.
ZONING
ADDRESS
rota" No.or USE Or NEW ,/
^W / .�/2--
T / PLANS BUILDING k„ 6�/�/B
CONTRACTOR�s�.IO,,,./ A. L ` (N W Y
ADDRESS J r7Y / DESCRIPTION h)[),//)i6 y'l-/ T -/2 6 7/
A.P.NO. /7/ . O4'/r OO
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL Sr TO SIDE B REAR F.L.
LIC.NO. / NO.
SVES
I LOT 78 "x Its ! NO OF BLDG/. / ALLOWED (U .B.C.REQUIREMENT)
MOW ON LOT
. YARDS APPROVED YARDS APPROVED
USE OPrr II 11 '' 11 /�. MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. DW_E� J N(T — (FROM C/L STREET)
)I '/
SETBACK LINE FROM FRONT ST .y T{�����
CENTER or STREET REAR YARD I/• -
SIDE YARD I LEFT RIGHT
R.SIDE.-57 pT. PT.
DESCRIPTION OF WORK L.SIDE .S Fr. FT.
- e I
!.-n/ ALTERATION ADDITION / REAR ZO FT. Fr.
DISTANCE err. BET.MAIN B
REPAIR `MOVING DEMOLI4H MAIN BLDGS. ACCESS.SLOGS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES C.U.P.# APPROVEDEXTERIOR //
COVERING ALL I COVERINGROOF APPROVED WIJ DATE //�ay
y�/
USE OF BUILDING AHD WORK TO BE PERFORMED T D,
D
P r,o eolvc� 1
•
SQ.PT. X
I HEREBY ACKNOWLEDGE TMAT.I HAVE READ nos APPLICATION THE AMOUNT SHOWN UNDER VALUATION Is FOR THE D
AND STATE THAT THE ABOVE,IS CORRECT AND AOREE TO COS PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE N REGULATING VALUATION
BUILDING CONSTR//uUCTI�O1N. \SIGNATURPERMIT FEB , . O-D E
PERMITTED OF �/ ` mB (�
' $ 700 PLAN CHECK S r— r2
AUTHORIZED AGENT
TOTAL FEE $ I 00
4OWNER LIBOLT, John DATE 9-5-75
013 ADDRESS 3202 Parnell Place BUILDING PERMIT NO. 40525
GFNERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Blackwall
R A 1.141-046-08 LOT TRACT FIRE ZONE VALUE $ 750.00
4 INSPECTIONS Signature Date TYPE III GROUP J ZONE R-1
�t SOILPERMITS ISSUED
As SUBCONTRACTOR
Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING N •ting a d Vent. • r
TRENCHES ❑ FORMS ❑ STEEL REINF. .. � A p ,L .��
FLOOR SYSTEM InarairaMINI
BOND BEAM L STEEL REINFORCE n ♦ I•( I /, T •2,4
SHEATHING
FRAME AND FLASHING
LATHING - IN n_ OUT n
P' 'ER, BROWN COAT
S .TURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST in
ELECTRIC, FINAL ^p
RIIILDING. FINAL
•
PAI
Pry 52qEP -5-75cgs�00 278' ^***x8.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A PLI TI N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Inl my
L RE IV a DATE RECEIVED® np=EIS UPD r
ADBUIDRESS LDING I OJ V �■I}'jQ/J 7S
// A.P. NO. /-D5'/ DR ERMIT NO.
OWNER `fnhn Li /� I �^ 8
MAIL G _- . BUILDING ' IIO2 gs rna' PL_
ADDRESS Grp ADDRESS / /j �� Y
TEL. TRACX II LOT BLOCK
CITY C. KL--x. NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING. nEM01 ISH
LENDER /1
BRANCH
OWNE^{VI JtPJ L' h0 /-/-T
ADDRESS
ARCHITECT TEL. USE I • Ck '' ,l' /A//('LUE
✓WL i / $
OR ENGINEER NQ
FIRE
ADDRESS ZONE TYPE V OUP
AYPROVE. 7.6-----z<CONTRACTOR ��-.`��csC �` � ',L. BV �/ /�� DATE.ADDRESS S VCS (((t����1111gggg s —
TEL. ZOg I PLANS / BUILDINGUSE OF GW/CA 7Qr/.
CITY C i-v-� NO. oZ Iib
- STATE CITY YARDS APPROVED - YARDS APPROVED
LIC. NO. LIC. NO. ' MAIN BUILDING _ ACCESSORY BUIL pI G Q
$6 SIZE NO.OF BLDGS. (FROM C/L FREE-11
�I 1- �L/Q_u w.J C�
0. OF LOT NOW ON LOT FRONT N
FT.
USE OFLa //^^��
EXISTING BLDG. R.SIDE 0. FT.
rA
S Separate permits are required for L.SIDE FT FT.
i electric,plumbing and heating work.
REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q // MAIN BLDGS. ACCESS. BLDGS.
G 731-
OG �A �L VAR.# APPR
Q '�r � C.U.P. A/, ` APPROVED ''y`J
ePCr-
i.
I:6
e ft l`
g-
Cl. I hereby acknowledge that I have read this application and state v.
n
$6 that the above information Is correct and agree to comply with m
41 all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of m
.�.'Wthe State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and Profe 'ons Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR at
Chapter 9, and that such licenses are In II (erce and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the pro dons of th. to - of Callfornia Business // y
VALUATION PERMIT FEE $ ]'
end Professions Code Sion 3, C.:ptei=. [� In
m
orb PLAN CHECK $ "I
Signature of �' `' o
Permittee i a t.
art / $ /6-0 �- Li.
TAX $ 2
U
Authorize• •1•nt TOTAL PAID $ 6i)
OWNER LIROLT,. John DATE 11-17-76
JOB ADDRESS 1202 Parnell Place BUILDING PERMIT NO. 43054
C 'RAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK R1 nrlaual 1
At .40.141-046-08 LOT TRACT FIRE ZONE VALUE $snn nn
INSPECTIONS Signature Date TYPE V GROUP J ZONE R-1
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR Data Number amber I
Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE❑ HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS U STEEL REINF. ( ,c /f _4
FLOOR SYSTEM
BONO BEAM II 'STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
L 'NG - IN n OUT n
F ER. BROWN COAT
STRUCTURAL. FINAL Electric
HEATING. VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST f]
ELECTRIC, FINAL .
_ . - _
.. 430554 :ri17-76:#:00i 013:4- .. 5.5C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APL 'AT ON FOR STRUCTURAL PERMIT
For Applicant to Fill in\7C000mpletely —Use Inkk Only
REG EA Y DATE RECEIVED D ISSUED
BUADIDRESS II Q-L \�ijlctlie c r `.' U/ rU/! IT?OWNER �� . 1 ,LT+I�Q� B NO..rV 1 AUIDDIEG IMAIL
ADDRESS QIV ADDRESS 1 /I Z._,. /y
CITY ,3--)q I /L� NOTEL S TRACT ,.2..A. LOT/�7 BLOCK
CONSTRUCTION s3/3.
��� NEW ADD ALTER REPAIR (MOVING• DEMOLISH
LENDER
BRANCH
O // �er
WNER (�
ADDRESS
If ii i VALUE a/.��/��'/�
ARCHITECT TEL. USE Le KM4 $ �(l!/
OR ENGINEER NOFIRE.
ZONE YPE el.......:-GROUP ADDRESS ✓ (((/ /w
CONTRACTOR C;4 BYPROVED DATE (q /// '76
ADDRESS QWl�ti� �(J/L�rc-.'�, ZONE�JI NO.OF --r .USE OF
111�W�!!!�`�
TEL. �R\ PLANS ✓/ BUILDING
CITY NO.
STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLOCS. (FROM C/L STREET)
L OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
so
... EXISTING BLDG. _ SIDEB. QE FT. FT.
VI I
FSeparate permits are required for L.SIDE l — /L FT.
1 electric,plumbing and heating work. REAR rr. FT.
n US_ ..131F BUIL M NG AND ORK TO R P rIF MED
Cr' A IZT Fi nG / DISTANCE BET. BET.MAIN&
d -Ci .) / !Q/ ' MAIN BLOCS. ACCESS.BLDGS.
VA
DATE
a oir
�//ej b/- UA� VU_aL�#1 C.U.P.#,,//)/'//�/y/J'//� APPROVED` �J
..1 V . . U ' __ay A ROVEJ'!G - DATE / /'-/7-7‘
ce C
W /
O. I hereby acknowledge that I have read this application and state 4.)4"7,44 N Vr,rett l�/21
(yv that the above information Is correct and agree to comply with „eat;
S ��IIG7 7/ /7i m
Z alln laws regulating building eworkman's construction,
and I ensl not laws employ / _ /O� /v j/ J r
{Cil any person in violation of the workman's compensation laws of ,iaJC'gy- �r- t ( m
,s the State of California. m
I hereby certify that I am properly licensed as a contractor under S FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR as
Chapter 9, and that such licenses are In fullce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to
am exempt from the provislorlqs of the Sta ••.lifornia Business VALUATION PERMIT FEE $ <
and Professions Cod 0 visl.n(3,Chapter en
r .n
/' !� PLAN CHECK $ o
Signature of /I' ,,
Permittee $J(/(/ U
Authorized ; • t U
TAX $
- TOTAL PAID $ �..��
s