HomeMy WebLinkAbout3071 PLATTE DR - Building Permits/
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PPOJECT AUOflE55: �6 ~
OWNEfl'SNAME: 3O%� PL�ATTE DR .�y�yC7'�(L�
POONESS: ASSAL, ELIAS D
ASSAL LILLZAN L
3071 �LATTE DR
COSTA MESA,CA 92626
RPCHIENGINEEH: 5 5 7— 7 1 5 1
nooa[ss:
PEflMITTEE: A—AMES PLUMHING & HEATING
aoosEss: ggll LARSON AI,T
UNIT:
FLOOD; X 97
flEG.NO.:
uxir:
(719)530-2440
B
��Ohapter 9 (commencing with Section
cirruc.:00 �6Q�p STATELIC.:2SO 07 �i55' � 3 � 06/95
Date: � � � ,/�� S Signa�u e: _ ' �
WOFNEPS' COMPENSATION DECIAXpTION: I hereby ' a� I h e a certitica�e o� consent Io self�insure or a cerii�icate ot Workers'
Compen5alion InSufanCe, ar a CerUfieO topy IhereOi (Settion 3800, lab. C�.
Poucr xo.: 3 9 0 3 2 61 E%P. DATE: O 3/ O S/ 9 S
comvnxv: REPUBL IC
� Cehilied copy is hereby lurnishetl. � Cetlilietl c y is �iled wi e ciry Builtli Di � io�
p �/ �{
�x�a�/s ADoncan ,C,.LJ �6'-CA-
E%EMPTION FflOM WOflREflS' COMPENSATION DECLABpTION: (This seciion neetl nai Ce complete0 if �he Oermit is br one hwdred (5700) or less�.
I ceriify Ihai in �he pedormanre oi I�e work �or which this permit rs i55ue0. I shall not employ any person in any manner so as �o become
subjec� Io Ihe Workers' Compensalian Laws of Califomia.
�ale: Signaiure'
NOTICE: II, alter making this Geclaration, you should 6ecome sublect to ihe Workers' Compensation pwvisians oi t�e Labor
Code. yau muSi �otlhwii� comply with 5uch pmvisions or Ihis Dermi� Shall Ue OeemeU reuoketl.
CONSTNUCTION LENUING pGENCY: I hereby alfirm I�at lhere is a constmc�ion lenaing agency �or the pedarmance of the wo�k lor
whicn �his oermit is i=sued �Section 3097. Civ. C).
LENOEfl:
AO�flESS:
OWNEN BUILOEP OECLABRTION: I hereby afiirm �ha� I am exempt iwm t�e Contraclors' S�a�e License Law to� �he followinp reason
(Section 7031.5 Business and Pmiessional Cotle: Any ciry of counry whicA requires a permi� b cons�mcl, alter, improve, tlemolish, or
reDair any slmclure. prior to iis issuance. also requires �he applicant �or such permi� �o �ile a signeJ s�a�emen� �ha� helshe is licensed
pursuant m the pmvisions of �he Convacrors State License Law (C�apler 9(commencing wit� Section 7000) oi Division 3 of the Business
an0 Prolessions CoOe) or ihai he/she is eKemp� Iherelrom antl Ihe ba5is tor the alleged exempiion. Any viola�ion ot Sec�ion 7031.5 Gy
any ap0licanl for a Oe�mit su�lects �he applicam ta a civil penalry of noi more Ihan five hunAred dollars (E500�.
I, as owner of �he pwperty �r my employees with wages as �heir sole compensation, wil� tlo the work, ana ihe
❑ s�mcture is no� intenAetl or oife�e0 fa� sale (Sec�ion 7044, Business and Pmfessional CoEe: The Conlratlor5' S�ate Li[ense Law
tlaes nai apply �a an owner oi a pmperiy who bui105 o� improves ��ereon, antl who tloes such woB himSelVhersel� or Ihmugh
his or her own employees, pmvitlea Ihat such impmvemenis are nat intendetl or oflereA for sale. If, however �he Euiltling or
, improvemeni is soltl wi�hin ane year at comple�ion. [he owner will have the bu�den of pmving he/she Oid no� builtl or improve
lor ��e purpose ol sale).
I, as owner oi ihe D�oDe�y, am exclusiveiy conlracting wiih Iicense0 wntractors b consimn t�e Dmlect (Sec�ion 7044, Business
'I ❑ antl Pmfessions Cotle�. The ComractoK State License Law Ooes not appry ro an owner of pmperty who 6uilAs or improves ihereon
� antl wha mnVac�s �or such D�olecls wi�� a conVacioqs)license pursuantto I�e Contractors' S�aie License Law),I am aware
�hal pmol at �heu Warkefs ComDensation insurance should 6e provlde0 to me.
� I am exemp� under Sec�ion: B. 8 P. C.
lor Ihis reason:
�aie: Ownec
I ao hereby cetlily Ihat I am aware ol antl unAerSlantl Ihe requiremems o� Califorma Heal�h and Sa�ery Code S¢clions 25505, 25533, and
2553a antl that I or any fuWre buiitlmg occupant wiiilwill not (circle one) need to comply wit� sai0 state wdes anA tAe requiremenis lor a
permit lor conslmction or modilication Irom t�e Air Oualily ManagemeN Oisirict. Fesidential consiruction apDlications are evempt irom
IhQS¢ pf�Vi5i0�5.
Dale: ApplicanL
I here�y ce�itly �nat I have read ihis aDPlicatian and e inat ihe ab e' formation is t. I ag ee lo compty with all ciry antl county
orainance5andstalelawsrela�ingtobuiltlingconSV lionantlherebya nzereprese tives is irytoen�erupontheabove-mentione0
propetly �orinspedion ppurposes.
�ale: � ~ � / �/ � Si aiure:
�river's Licenie or Social Securi�y x:
�6ab46 Whi�e-9uildmg; Green—Cotle Enlorcemenl; Canary—ApplicanC Pink—Revenue; GOltlenraE—Assessor
� CITY OF COSTA ME5A - BUILDING PERMIT
PERMIT D10: M 070747 PLAN CHECK NO: N
CONSTRUCTION TYPE; PERMIT TYPE: MEC
PERM NO: M 07�74�
GOVT: N SUPp; N
PURPOSE: OTH
JOB UESCRIPTIOPI ; FAU CHANGE OUT SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
if if it M if jt if �E if if 3f jf iE K iE 1f iE 1f jf if iE jf iE jf 3f jF if ik iE iF if iF iE 1f iE iF jf fE 3F if iF K if 1E iR jf if jf if iE if 1f if jE it ii iE if 3f 1F if iE if it if iE M �F iF iG * jf �f iF jf if jf ii iE
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BOILDING -----'---
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARI(ING REQ: PROV; PARCEL; 14151114 2NE: REF NO:
PLANNING NOTES>
>
*+t+t�t**fr**r�r*�t**v�**it*�t*�r*�t*it+t�r*ritatit**+e**ir�r�rr**�fir�r**�titit*rrarriF�-**�t*r+t+t�c*�ir�rr+t#ir*«�*
D E V E L O P M E N T S E R V I C E S R E Q D I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROC�ED HY : , DATE;
APPLICATION ISSUED BY; �}�Hr- DATE: �, �� �
i ifkiEifililififffiEiEffiEififiFiFiEititiijf�E�i�i���Eifi�Tf�F��l�f fi�F��iEiZr it i��ifitififiEifitifi�-iF iFiF �tit
�E �f iE if M if it if iE it iE it iE if if it 1E jf if iE 1f jt at jf �If if iE if iE iE iF it iF 1E if iE 1f fE it if i! i! if if if iE it if if M if if it if ic jE 1f r k%if iE iF 1F M if M Y if iP it if if if iF if 1f if aE
LEGALIZATION:N F E E S U M.M A R�Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTR�IC� MECHANIC, FIRE SMIP/RES GRADING
PERMIT '� 9.00�'=-
; � 25$ SMIP/NON-RES
PLar� ,,,� ..�
ISSUE FEE - -15,00 ,
BUILDING-DIV-> PERMIT ISSUE PLAN-CAECK� '� TOTAL PAID DUE
TOTALS----> 9,00 15,00 O.Od � 24.00 24,00 ,00
REVENUE DZVISION TOTALS--> COLLECTED: �.'"•29-.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE',SMIP/TOT GRADING PLAN-CHECK
2,4.00-'" � .F . �
" / .^ '
i! if jf k jf if if 4 jf if ik if 4 fF iF if it r if it iF if iE if 1E iF M s iE if i! if j4 if if jf iF if i! i1 iF it if if if it if iE it * jE iF iE it It at if iF jf if ik if if iF if i! 1E iE iE if if iE iF it tE iE if -1F it
I N D I C� I D 0 A L 'F E E"1 B�'R'E A K D O W N
� '
TYPE QTY D E S C R I P T I O N ti .' �� :�. � � '�i UNIT COST TOTAL COST
MEC 1 INST FORC-AIR/GRAV FURN <=•lOQ�K B�TU 9.00 9,00
END"OF FEES,:
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Oi 0�27u103-aC17a30? T C�T �;,t�p
D4Tc: C1/17196 ?ZME: 13t�9
�
CONSTRUCTION AND PLANNING ��� °PA
APPROVALS Permit # Date Inspector APpR�VALS Permit # Date insnector
i, Temporary Electr�cal Service or °oie -� 52. Pool & Equipment Location ,
2. Soii Pipe�Undrgrnd.. ' �' 53. Stee1 ReSnforcement
__3. E�ectrjcil ConduFt�Ufility-Undrgrnd.n : 54. Forms
-4:'Electricai ConduiriCl�drgrnd. • 55. Electrical Bonding
-�7,•$tee{;RBinfOrcemen't 56. Rough Plum6ing & Pressure Test
-b."91ect�icalUFER,Grnd. � 57. APPROVALTOCOVER�GUNITE -
`7'.' Footings ' ' " 58. Electricat Conduit�Undfgrnd. �
:8. Foundation -. � 59. Gas Pipe, O Undrgrnd., Tesc
�9. Water Pipe�Undigmd. - 60. Backwash Linee, P�Trap, �7 Undryrnd. �
i�0. Structural FloorSvscem -� 67. APPROVALTO DECK
11. Property SewerCine & House ConneMio� 62. Backwash & Receptor-Final ,
12. Sewer Cap -- � ;. . fi3. Heater & Vent�Final �
73;� Roof Drains , 64. Plumbing System - Fina�
14:�floughPiurnbing, "' ;. 65. Electrical-Final �
15:�Rough Electrica!-Conduit �` 66. Solar System-Final �
16'• Rough Electric YViring � 67. Fencing & Access Approva�
17.. Rough Wiring Sign 68. APPROVED FOR PLASTEPING
18. Rough Electrica4T Bar Ceiling 69. POOUSPA SYSTEP;7S FINAL
19. Rough Heating & Air Conditioning ' FIRE 6EP7. REQUIREMENT
- - i = .
20. �Fjouyfi Fa�tory Fireplace � - : - , . ' A�PPRQ�VAI.S;;,,y _Perri{it # _
21. Ducts; in Struyture�� _ � .. .. - •� _� � * •7Q. Under9r8Un'tI-HYc?'o ' .
� ��
22. D.ucts; Ventilating"' � - ' ; � �.�'' ' �� +O
� :-� _' + � `71 . Product ��ping L� Gas ❑ 0��
23. C'ias Pipe•�iough & Test � � -_r, c.� �� �7p. Underground Flush i -
24. r'�oof Fram�ng ' `' ` ' "' "� � � - � ; ; •]3..Undergrnd: Storag� Tank C Gas ❑ Oil'
_� '
25. Roof,Sheathing _�� � : : �� . � � 74, Overhead Hydro •:� r
26. T--BaO�Ceiling (StruCturall & Monocoat �� " � � I5.fDry Chemical �
27. Frame and. Flashing � - �� �� � . ,�� ;n . '- 76. Dry Standpi`pe , � n - � �-
�28. Latfiing &�Siding �: � � � _ �. � �� "� "` ' 77. �FIXED Sl,'��EM,�:fNAL � .,
29. Insulatio�: ' . .. . -� ' '� i ' i' "� 78.'FIRE PREV. FINA�. : . -
30. Drywa�i Na�ling • • �; ' -' HEAITH DEPT. REQUIREICAENT
31. Plaster Brown CoaF �- � , � i � �� 7�9. �FINAI INSPECTION �
32. Electrical Pow`er A�€terFinal ' � �` -'SD,'FO00 CERTIFIC.aTE ISSUED ';,
33. Finai,Elec:iic=. . � � � 'Notes: 7 -,4i � , . �
34. Final:Heating & Air Conditloning • � Z4�5" " , ) . ' q� ' �"� �:' � - '�'.'
' , ' �, � ��F�4'.1 � ":'.. .I
35. Fina!�Gas Pipe;T'est.• , . • , t c�- . ` � � _ .
�. . ;3-%� a - C- :� ,G=>�{.
36. Hood�or Canopy �, � � �� - � '� : '• � - � ` �/_�
- � �' ��-�.��" W 1'1.�� �CfGt, ��
. . ' . ' .,. . I, . �� ,;'� � '
37. Final'Facto�Y Fireplace � . , _ . , . . _./,
i (`��
' = I. ' - �tSr7L.
$8. Finai PlumUing 3 k •.." . . . - � , �y . � :' � �A �
39. Water Service�Fina�. ' � � ,.�� �� �.- -� , -
; . . u: � � i'1 � �'' "C'/.5 Li1--rY� �
,40. Gas Service-Final >> � � ,�; + j- a. + � :,
. ' ' . I ^ 2.4- ` j �r-• ; � : �I /�-[�_
41. Solar pom2sticFinal: � " " � '- � k � . �_j'j, , y �
, i _.
42. Backflow Preventer . . � �, f �: -. •
n I
43. Backflow If�igation ` • , . , . � , ''; -�
�
,44. Landscape IrrigationSystem � _ � " " '��� • '' :
r .�
45. Sound At enuation , . , . , . '- � `-� � � `- _ : `;•' .
�S . �, •r r.� � E., r-� �'
46. NandicapRe9ulations � � �' ��' : ���� -
r
47. GIN4L STRUCTURE 8. BU/LD/NG ' + '�' � ' - , �
.. �. . �I �J' • _
46. FINAL PIANNING � � � ''� ;,i
' 1- ,: �
49. Eiec�ric Release to Edison ' 1 �1� '� ' ' -�
, �. .j „
50. Gas Release to Southem California Gas Co ' -� � -. _, :; • .
51. CERTIFICATE OF OCCUPANCY _.: ,- r . �
No. Date
CITY OF COSTA MESA `
BI/ILpIN6 DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
698-01137
PERMIT NUMBER
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address:
Suite:
Viciniry:
Parcel Nunmber:
Applicant:
Address:
3071 PLATTE DR
14151114
OWENS, CHARLES
Owner: ASSAL,
Address ASSAL, L
Slatus: ISSUED
Applied: O6/25/7998 r%� ('�
Issued: O6/25/1998 v��
Zoning: R1 R1
Phone:
� � �.�=_:%tZip '�+ p`.` . , �
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�1 � `� Phone:�_ !.(��i/j1 /{ �����
�� � �' � _Zip_-`92626_-�; ��l / � =�
�' � �" -_"c � �A � /
�"�`_= - - -�' �`�. � � � � \
G%'/�;-. __.-- --_��� �, �.
i'ROOF.ING� � � z
���ri� �
NECLRD ` ��l\\\ O
% ��`�
� Phone: \�\\
Zip: 92705 � ;,
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9 k�,, ,'. _ �,.
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i�I � (�1J�� ,,slr,,'*� -` SCOPE OF PERMIT
�il ��« � ���T/r0 EXISTING AND`REROOF WITH COMP�SHINGIE-'CERT CATTACHED�
��, t
�I . /'' i��4'i� ! i��iL9to� .-,� �-,. , [ln�'�`i,Tfi�rnl�'7 �'�.hf=-tn
""• `�` ° `°='FEE-SUMMARY
���� � '����-� 1� �dLU.,a_ ' _'_ __'___ =:ftiliL�ifi
P,lan`�Check � 1 �1� $0.00 � - -I
��, �Permit �� ,���$99.75 � , �� � l
�SMI,P Res ����'•�� $0.50 � '"��LZ'��'- -- �� �� �i �t, ���r=t
c�- � - --- � ` ;
`SMIP Com: t���� $0.00 — - � _ _ �/
SETBACK:
MAIN STRUC
ACCESSORY
PARKING
NOTES:
'���`��$0.00 !
. V�$o.00 ��
)���::. ,
, $100�s25 �
��� �
,� ,, - ' . \
, , �
�•' r ^` ���i�
\ � � I�' 1 � J\ I
Calc Valuation: �; . $a,soo.00 � �� �
Claimed Valuation: Sa soo.00 � t'';�
; �, , !
'� /,�� r � ����
� /!�/� , � J '�V�
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�`t ��R �PLANNING & ZONING / /j,"
��-1 �> \ . ti� r fi
� f \� s ' y����:�� //rr���,� k'���� , /�� � 1
��/` � �� �y, < // � ,:, � � �/
�Front�i0- � ���`�Rear �°�0 d„" �i�>�'eft%�'}ji0 Os�U��`,%Righi 0-01v�
� y �.,,,'^ �l „�c .�1 n �f � i� �A i _ � t . � ,/r' ,. )
� %/ �i _, �'-, �"^.... ��'C�. C ,n ..y � � G / / �-� �// �
� Front„ 0 0� ��"�4 Rear 0 0� � ` Ceft. 0�0 -_'� �� Right .^, 0= 0 L
� �. 11: : - -- _ - -_ .. i�.�
w .� A / �> � _ _ - � . �_`� t. ' /'i i�
Existinq -.p� Required ��0 � _� i .__� �Pr000sed r'0� � ��V � ,r /1',�
r� �' !i � . ��'•�
. ( . . - - -�i .�
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�c��C7
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In orcler tor the work authorized under this permit to be considered legal, such work must comply wilh all applicabla codes, and all
requlred Inspectlone and flnel epproval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of ihis parmit.
FOR INSPECTIONS:CALL: (714) 7545826
WONKERS' COMPENSATION DECLARA710N: . ' � - -
I hereby etfirm untler penalry of pe�ury one of the fdlowing tleclaretions:� . � , _
❑ I heve entl wlll mantain e cenificete oi consent to setl-Insure for workers' wmpensalion, es provitletl for by sectlon 3700 of the Lebor Cotle, for the pertortnence of ihe
work tor which Nis pertnit is luuetl.
❑ I have entl w��� meintain workers' compensallon insurence, es requiretl by section 3700 of ihe Lebw Code, for Me pertortnance oi ihe wwk fa which Mis permit is issued.
My workere' compensation Insurance certler end poliq num�er ere:
Certier: Pdicy Num6er
(Thls secNon need nof be completetl i/ Me perm/f fs ve/ued ef one hundred dW/ers ($700) or /ess.)
❑ 1 certity thet In the pedormance of tha work for which this pertnit is issuad, I shall not employ eny person in eny manner so as to become subject to ihe workers'
wmpensetlon laws af Calito and gree thet H I shoulO Decome sublect to t�e workers' compensetlon proNsions of SecNon 0 oi ihe or Code, I shall Iorthwith
compy�wltl�,Nese provisi
Appl�— _ ��,,e O�_ Da�:�--- z �
Signeture: C
WAFNINO: FAILURE TO SECURE WOflKERS' OOMPENSATION COVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE TIES Ml� CIVIL FINES UP TO ONE HUNDRED
THOUSANDOp1ARE(E100,OW),INADDRIONTOTHECOSTOFCOMPENSATIqJ,DAMA6E$ASFROVIOEDFORINSECfION31060FTHELPBO CODE,II�frEREST,ANDATTORNE`fSFEES.
LICENSED CONTRACTORS DECLARA710N:
I �ereby eHirtn ihet I em licensed under provisions of Chepter 9(commencin9 with Section 7000) of Division 3 ot the Business entl�Profeuions Code, end my license is In full
torce end eHect. Lic. a �-. � qau N /'/ �
GONSTRUCTION LENDING AGENCY: ,
❑ I hereby effirtn Ihat ihere is a constructlon lending egency for Ue peAortnance of the work for which Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lentlers Address:
Siqnature: - ' Date:
OWNER-BUILDER DECLARATIONS:
I hereby aMirm thet undar penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires e permit to consiruct, elter, Improve, tlemolish, or repalr any strucNra, pdor to its Issuance, also requires ihe applicant for such pertnit
ta flle e slBnetl atetement ihet he or she is licensed pursuant to ihe proNsians of the Coniractors LJcense Law (CheD�er 9(commancing wlih Section 7000) of Divlslon 3 of ihe
Business and Proiesslons Code) or ihat he or she Is exempt therefrom and Ihe basis for Ihe alleged exemption. Any vlolatlon ot Section 7031.5 by any epplicant tor e permit
subjects the epPlicent to e civil penalry of not more Ihan flve huntlretl dollers ($500).):
❑ I, es owner of Ihe property, or my employees wlih weges es Iheir sole compensatlon, WILL DO TME WORK, and Ihe structure Is not intended or oflered for sala (Sec.
7044, Business and Professions Coae: The Contredors License Law does not apply to an owner of property who builds or Improves thereon, and who tloes such work
himself or herself or ihrough his or her own employees, proNtletl Ihet such improvements are not Intentled or offered for sele. It, however, the building or improvement Is
soltl within one year of completion, the owner-builder wlll heve the burden of proving that he or she tlitl not buIIC or Imprrne for purpose of sele.).
❑ I, es owner ot the properry, am EICCLUSIVELV COHTiiACTING WRFi LICENSED COMRACTORS to consiruct the project (Sec. 7044, Business and Professions
Cotle: The conirectore License Lew does not eppty to en owner of property who builds or improves ihereon, entl who comracis far such proJect wlth a contrector(s)
Ilcense pursuaN to ihe Con�rectors License Lews.).
❑ I am e:empt under sec. Business end Prafessions Code tor this reason:
Signeture: Date:
Owner ID venfied by drivefs license. ❑ Yes � No Drivefs License No. Expires:
Vedficatlon of Owners�ip by (rype of document, I.e. - properry tex blll or tleetl):
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION:
❑ I here6y cently that no eacavatlon fiva (5) or more feet In tlepth into which a person is requiretl to descend, will be metle In connection with work aut�odzed by this
pertnit, and Ihat no building structure, scettolding, talsework, ar demolition or dismantling thereof, will be more then ihirty-six (36) feet �igh. (Chap. 32, Grp 2, Art 2, Sec.
341, Tflle 8, Celifomia Atlministrative Code).
❑ As owner-bullCer, I wlll not amploy anyone to do woAc which would require a permit from Ihe Dlvision of IndusMel Satery, es notetl ebove, unless such person hes e
pertnl� to do such work from Ihe division.
Signeture: Date:
DMslon of Indus[rial Safery Permit Number:
CERTIFlCATE OF CAMPLUWCE AND AUfHORIZATON OF ENTRV: I certity under penalry of parjury that I have read this appliwtion end state that the infarmetion qiven is
conect. I egree to comply with all state lews and city ordinences relaiing to building construction, and authorize representatives W the Ciry of Costa Mesa to enter upon the
ebove-desc�ropgqyfor insp§ctior�yryoses. I agrea not to occupy or ellow occupancy of any builtling authorized by this pertnit until fnal inspection.
COOE I. INsveenaxTrve `
1616 Fixed System Finel Fire Prevention
1268 Pool Spa Final ' ' '
200 Flnel RaRoot ' �
207 Final BIocWRetaining Wall
202 Finel Factory Fire Place
FZ�k�
204
f�LS �Gf•!
Finel Sign
Flnel Demolition
�g ��
iQQF2 INSPECTION TYPE
206 Finel Mechenical
208 ' Finel Plumbing '
210 Flnel Electdcal
212 Final Flre Prevention
220 Final Plenning Approval
222 Final Site
250 Final Builtling/Occupancy
�g
��
V�AlS
owrrEx NOR79iGATE
JOB ADDRESS 307]_ P:
GENEAAL CONTRACTOR
Ap No.
ECTIONS
S`--
DATE ��� 5 �963
VALUE
SUBCONTRACTOR
!4[�ll
., - �• ! 9973
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COHTA M86A, CALIPORNIA
For Applicant fo Fill In Completely
. TYPE OR PRINT µS94�Z
BUILDING 2� ,1 q ���-�
ADDRESS ✓ i'F
-COSTA MESA, CALIFORNIA
OIR' N ER C� H1�.�.9T
ADDnc53 B� 7-7. Ana
oT ' 60 x
OF
TING BLO6.
�CK LINH FROM
ER OF HTREET
�
REPAIR I
BUILDIN
SIZE 0 x
EXTERIOR WALL
C�iY
A6ENT
�
INO. OP OLDOB. ��
NOW ON LOT
REAR YARD 31 I
IRIQHT 7 �
ION OF WORK
RATION _ ADOITION
N6 DEMOLIHH
NO. OF
ROOMB '6 BTORI68 ].
I ROOR
PEAO TX�B APPLIGTION
CT ANO AGFEE TO COM.
TATH L�W9 REOULATING
� EE RECEIVED
JAPPLIC�r I���� R PERMR
FINANt,�ui�.��
CI1Y F9P 96f��4 ��nly
RGCEIPT NO. I PI
ZONINCi
ZO NO.OF I USEOINE
PI.�Ne BYILD�N� ,(
LHOAL T- �j t,
D88CRII�TION Q �1 �lr ry—
A. P. NO. �
NOTE:NOEAVEOVERHAPo68HALLBELESSTHAN �
90' TO 81Ofi 8 REAR P. L.
EAVES
ALLOWED (U.B.C.REOUIREMENT;
YARDSAPPROVED ' YARDSAPPROVED
MAIN BUILOIN6 AGGESSORY BUIL�ING
V AR. SC
DATE
7 e_�1� pi
�..3 S.A ea. Fr.
TX8 AMOUNT BHOWN UNDER V1
PURPO6E OF fi6TABLI6HIN6 A
VALUATION
, . PERMIT
�13���- A ,
TOTALF
/7—G
0'