HomeMy WebLinkAbout2211 RALEIGH AVE - Building PermitsAop�icant to flll in all spaees except tnose within heavv bortler Iinoz antl sign all app�opriate aeclarations.
PER I NO. TRACT NO. LOT NO. UNIT NU. i33O I I/ I OIB]
CITYOFCOSTAMESA CO,IISTRUC�T�IO�NiPERMIT D � 7,00 TI
- Praject Address ?�1 � �L�Yt1
TYPE OF CONSTRUCTION NEW ADD P.LTERATION REPAIR
Applicant's Mailing Addiess �— ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # . Zona
Owner'sName ��;�A1 c' P�`^^P _l^ DESCRIP710NOFWORK/USEOFBLDG.
Addreu �—��� �+-�--�1�� �p �1J9-'� S Main Building: Acceuory Building:
Arch/Eng. License No. T �
TVPE OF PERMIT ❑ GRAo1NG FOUrvoATlorv 57RVC7URAL E Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL g N
Address A Rear �
�/� ❑ OTHER
Contractor'sNam �� �G,�` Phone _ISGTI C Right N
Addreulma'I" gl �L.Y'�`� ��Y ���.-►� PROJECTDESCRIPTION SQ.FT. OCCVPANCV K Left • G
��,� CONSTRUCTION TVPE VALUATION 5 S
City Lic¢n5C NO. ZONE GRADING CV.YpS. ACR[5 - R
LICENSED CONTRACTOR DECLARATION Plny. R¢f. # ., �� P2�kiny R¢q./P� vi E
� 1 hereby aifirm [hat I am Iicensetl untler provislons of Charter 9(comm¢ncln9 Remarks: Planning NOteS: M
with Seclion ]000) 01 Divl5lon 3 ot the Bu5ine55 antl Prof¢Ssions Cotle, antl T
my license is in (ull or e tl eii t
Licenze lass � 'cense o � S
N Date 4�' '��5'9 t S ` PLUMBING FEES
WORKERS' COMPENSATION DEC RATION Ba� Sink ShOwC15 ELECTRICAL . FEES
1 hereby a/firm that I have a certificate of cons¢nt to self-insure o� a certificate
of Workers' Comoensation Insurance, or a certifietl copy ehereof (Se<tlon Backflow Prevencer Service Sink ❑ 15-50 KW
3Boo, Lao. � �7 l �,f , Automatic Washer Transtormer
'` Polic No.1� F��=�/naoY�pany `� `'`��� Backflow Irri ation Sewer Ca ❑ 50+KW
Y ��—�--�T— 9 P Construction Pole Sub.
`!O �ertifietl copy is hCreby fumishetl.
��0 Certi ietl py i[le with the city N ivision.l Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
pate - Applica
1 E%EMP ION FROM WORKERS' CO SATION DECLARATION Cle�ifi¢�5 $Old� COII¢cL0�5 � Di5hwd5h¢� Met2� ❑OVC� 1002mp5
�(This section neetl not be completetl it the permi[ is fo� one huntlred (5100) or � ,
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
1 certify lhal in the performante of [h¢ work for which this perm�t ISlssuetl 1
snall not employ any person in any manner so as to become subject to t�e Drinking Fountains ' Solar Tank Fan Motors �0-1 HP �1'h - B
Workers' Compensation Laws o( California.
. Date Si9nature Floor Dreins Swimming Pool wlSpa ' F,q,U. Inc.Solar 09-15 HP �16-15+
'NOTICE: It, alte� making lbis tleclaration, you shOultl become subject to t�e
Workers' ComOensatlon provizionz of the l2bor CoOe, you mus[ tortnwith Floof Sinks Urinal Fixtures
comply wi[h Such provisions o� this permil Shall be tleemetl revoketl. MiC�owav¢
CONSTRUCTION LENDING AGENCV GasService OuU¢t5 WdtC�CIOSCt ' D¢vIC280%¢5 POI¢Light
1 hereby allirm that lhe�e is a construclion lentling aqency for [he perto�mance
of the work for which this permit is issuetl (Section 309� Civ. CJ Interceptors Water Heater Outlets Range
LenEer's Name
Lentler's Aatlress Kitchen Sink Water $ervice Swihhes Sign
OWNER BVILDEN �ECLARATION
I hereby aiiirm that I am exempt trom the Contractor's License Law for tne Lavarories Auto-Wash Garbage Disposal ; Standing Sections
tollowing reason (Section ]031.5 Businesz and Pmtessional Cotle: Any cily or
county which requires a permit to con5truct, alteq improve, tlemolish or repai� P—Tf3p L2Und� T�B s
any structure, orior to its issuance, also requires Ihe applicant for such permil Y � Generamr �0.5 KW �5-15 KW Trash Compactor
[o file a slgnetl Statement thdt he/she is licensetl Ou�suant to Ihe provisions of ROOi D�2in5
tne Contractor's Licens¢ Law (Chapter 9_(commencing with Section ]000) of
Division 3 ot the Busine55 antl Protessions Code) or that he/she is exempt
fherefrom an0 tne basis for the alle9etl exemption. Any violation of Sectlon
]031.5 by any applicant tor a permit subjects tbe aOP��cant to a civil
�endlty of nol more than five huntlretl tlollar5 ($500).
I, as owner of tne property or my employees with wages as their sola Reinspection Fee $15 ISSue Fae $ 3
compensation, will tlo the work, and the structure is not intentletl or oiferetl Reinspection Fae $15 luue Fee $ 3
(or sale (Section 7044, Business antl Professional Code: The Contractor's MECHANICAL fEES
License Law aoes not apply to an own¢r Of a property who builtls or imprOves
thereon, anG who tlaes such work himself/herseli or ihrou9n his or her own goiler YPQ � � DEVELOPMENT SERVICES RE�UIREMENTS:
employees, provitletl tM1at such improvements are not intendetl o� otfe�etl tor HOOd O� T
sale. It, however, the bulltling or Improvement is soltl witnin one year or com- Cynopy Type I I ❑ Zoning Approved By Date
pletioq the owner wlll M1ave the burtlen of proving he/she tlitl not buim or Im- DuCt - Unde� Ci�Ound BUiiding Approved By DatP I�
p�ove for the purpose ot sale). .
❑ I, as owner ot the oroperty, am exclusively contracting witn licensetl con- Duct-Structural Refrigeration System APpliption Issued By / Oat
[�actori fo wns[�ucl lhe O�oject ($eclion 7044, Business antl Protessions Cotle:
The ConVactor's License Law tloes not apply m an owner of D�operty who Duct - Ventilating �0.100,000 BTU ❑100,000 BTU SUMMARV OF PEES
builtls or impwves thereon, an0 who conVacts for such projeGts wiN a con-
tracmr(s1 license pursuanl to the Convactor's License �aw). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof o( their Worker's Compensation insurance shoula be Orovitletl to me. .PLAN CHECK $ PERMIT
❑ I am exempt under Section B. & P. C�or this reason FirepUFact.8lt. ICBO # Fire Dampers PLUMBING $ ISSUANCE $�
Date owner He ing System & Ducting Registers p�p,N CHECK 25% $ ENERGY P.C. $
I hereby certify that I have reatl this apo���ation antl state that the above � 0.100,OOOBTU �100,OOOBT GRADING S
iniormation iz wrrect. I a9ree to comply with all ciry antl county ortlinances ELECTRICAL $
antl stare laws relaeing to builtlmg consiruction, ana hereby authorize revre- � PLAN CHECK 5046 $ j MICROFILM $
sentatives oi cily to e ter upon the above-mentionetl Proper[y lor � �
inspection pases 14 �� MECHANICAL $ 1�
5iqnatu o te TOTF�. FEE �
Drivers' cense or 55 � — - Reinspeetion Pee $15 Issua Fee $ 3 PLAN CHECK 25% $ J�
CMF 0865-46, rev. 30/84 White - Bullding; Canary - APPlicant; Pink - A<counting; Goltlenrod - Assessor
£ONSTRUCTION AND PLANNING ' POOL & SPA
'APPROVALS � Permit# Date Inspector AppROVALS Permit# Date Insper.tor
` 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � .
2. -Soil Pipe-Undrgmd. .53. Steel Reinforcement
3. Elettrical Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical ConduibUndrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �
7. Footings . 58. Electrical Conduif-Undrgrnd. . .
� 8: Foundation 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. . - 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor SYsfem - 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. Raugh 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.ProductPiping�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. DrYw'all 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 ����� L�
35. Final Gas Pipe�Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
A0. Gas 5ervice-FinaV `
L
41. Solar pomestic-Final ;� ��
,,�
42. Backflow Preventer • .
43. Backflow Irrigation .� j �
44. Landscape Irripation SystEik)
45. Sound Attenuation . � � , -
46. Handicap Regulations .
47. FINALSTRUCTUFE&9�11LDING - _
48. Special Requirements Completed .
49. Electric Release to Edison • - � � ;
50. Gas Release to Southern California Gas Co � � '
51. CERTIFICATE OF OCCUPANCY _ "
Nq. Date
ADo���ant to fill in a11 soaces except enose witnin neavy bortler lines antl sign ail approo��ate tleclarations.
CITY OF COSTA MESA C S RUC ION PERMIT PER NO. TRACT NO. LOT NO. UNI'r N6.
4662 I I/2� /0� �oG TI
. Project Address, ��T
Applicant'9MailingA dress TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
� ❑ CONVERSION ❑ OEMOLISH ❑ OTHER p,p, # zone
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Acceuory Buildin9:
E Z
Arch/Eng. License No. TVPE OF PERMIT GRAOING� �FOUNDATION STRVCTURAL T front p
Address ❑ TENANT ❑ ELECTRICAL LId'PLUMBING ❑ MECHANICAL A Rear N
COnt�actO��sNdrT P one �'�THER
///yyy� p� y_�* �/ PROJECT DESCRIP710N Sq. FT. OCCUaANCv C Right N
Addreu (ma�����1 � � c 1��J6N K Left G
CONSTRUCTIONTVPE VALVATION$ $
CityLiC¢nwNo ZONE GRADINGCU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. R¢1. # PetkiOg R¢q.�P�Ovid¢d E
Q
I bereby affirm Ihat I am licensetl untler prOvislons of Chdrter 9(commencin9 Remarks: Planniny NOtCS: �� ry�
with section ]000) 01 �ivi5ion 3 Ot the Bu5ine55 antl Protezsions Cotle, antl
my license is in lul antl ef(ecL O _ T
LIC8052 CI 5 2 C O Q S
Date Signature PLUMBING FEES
�WORKERS' COMPENSATION OECLARATION BarSink ShOwers
1 hereGy affirm lhal I have a certlticate oi consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compen5dtion Insurance, or a certifletl copY thereof (Section BackflowPreventer SeNiceSink
\3800, Lab. ��Q p/� Automatic Washer Transformer ❑ 15�50 KW
1 Policy No. v�l�� I n`, Company _ Backflow Irrigation Sewer Ca ❑ 50 + KW
P Construction Pole Sub.
\�er[ifietl copy is he�eby turnishetl.
U¢erti i p is flletl with the city tli i//ys . Bathtuhs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date��r!�.� APPlicant��(d
E%EMPTION FROM WORKERS' CONfP�NSATION DECLARATION CI3�iFi¢f5 $Ola� COIICCt0�5 Di5hwd5h¢� M¢tE� ❑Ov¢/ 1002mp5
(This section neetl not be completetl H Ihe permit IS for On¢ huntlr¢tl (§100) or
iess). Dishwdsher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel
I certify thal in th¢ perfOrmance of the wo�k for which thiz perm�t i5 issuetl, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan � Motors �O7 HP �1'h- 8
Workers' Compensation LawS ot CalifOrnia.
. oate 5iqnature Floor Orains Swimming Pool w/Spa F.A.U. � Ina Solar �9-15 HP 016-15+
. 'NOTICE: Ii, after making this tloclaratlon, you shoultl bemme subject to the
Workers' Compensatlon provisions of the Ldbor Cotle, you must folthwitll FI00� SinkS UflnBl FixtUf¢5 Mic�Owdv2
comply with such p�ovisions ot thls pe�mit snall be tleemetl revoketl.
CONSTRVCTION LENDING AGENCV GasService Ou[IEfS Wdt¢iC1052t DevicCBOx¢s
I hereby aftitm that there is a wn5t�uctlon lentling agency for the performance POI¢ Li(Pub
ol the work far which this permit is issuetl (Section 3097 qv. C.) �
Lentler's Name
Interceptors Water Heater Outlets Range
Lentler's Atltlress Kitchen Sink Water Service � Switches Sign
OWNER BUIL�EN OECLARATIOfJ
1 heleby aftirm tha[ I am exompt trom Ihe ConVactor'S License Law for the LavatOfiCS A�uLO�WaSh Ga162gC Di5pO5dl ;$tanding $¢CtiOns �
tollowing reason (Sectlon 7031.5 Business antl Professlonal Cotle: Any city or
county which requires a permit to construct, alter, Improve, tlemolisti or reoair P—Trap Laundry Trays Generetor �65 KW 05-75 KW Trash Compactor
any st�uctu�e, prbr [O its issuance, a150 reqWres Ne applicant f0� such permif
to tile a signetl stalement that he/She I5 licens¢tl pursuant to tne provisions ot ROOf D�ainS
[he Contractor's License Law (CnaD�er 9(commencin9 �+'��h Section 7000) of
Division 3 of the Businesz antl Professions Cotle) or tnat he/she is exempt
tberetrom anC the ba5i5 fOr [he allegetl ¢x¢mptlon. Any violatiOn ot $ection
7W1.5 by any applicant for a permit sub7ects the applicant to a civil
�enalty of not more tnan five huntlretl tlollars (E500).
LJ I, as owner of the proper[y or my employees wiln wages az their sole Reinspection Fee $15 Issue Fee $ 3
compen5ation, will tlo the wo�k, antl the st�uctura IS not intentletl o� ofteretl R¢inSpeCtian Fee $1$ Is1ue FBB $ 3
tor sale (Se<tion 7044, Business antl Protessional Cotle: The Contracmr's MECHANICAL FEES
License Law tloes not apO�Y to an owne� oi a property who builtls o� ImprOves
thereon, antl who tloes such work hlmsel(/herselt or tnrougn his or her own DEVELOPMENT SERVICES REQUIREMENTS:
¢mployees, D�ovitletl (ha[ SUCh improvements a�e not intentletl or otte�etl for BOil2� HOOd O� Typ¢ I ❑
sale. It, however, the builain9 or improvemeni is soltl wlthin one year ot com- Canopy Type II ❑ 2uning Approved By Date
pletlon, the owner wlll nave tha burtlen of provin9 he/sne aitl not bulltl or im- Duct - Under Ground Building Appraved By Date
��ove tor the purpose ot Sale).
I, as owner oi me property, am ezclusively contracting with IicenseC com Duct -Strucmral Refrige�ation System Appliption Issued By y Dat �
L(dCLOlSSO COlISIlUCI Ih2 OfOjCCI (SCCHOO �044. BUSI0055 dfld PfO�C5510lIS COdZ:
The ConVactor's License taw does not apply to an owner ot property who Duct- Ventilating ❑0.100,000 BTU ❑100,000 BTU - SUMMARV OF FEES
builtls or imDroves lhe�eon, antl who contracts for such projects with a con- -.
tractor(s) llcense pursuant to the Contractor's Llcense Law). I am aware thac Exhaust System ❑ Multiple ❑ System Repair/Alteration - BUILDING PERMIT $ SMIP $
prooi oi their Worker's Compensatlon insurance shoultl be provitletl to me. " P�AN CHECK $ ,, !1 PEFiMIT
❑ I am exempi untler Section B. & P. C. mr thiz reason Firepl/FacL BIL ICBO �k Fire Dampers PLUMBING $�(,G_(�_ ISSUANCE $
Oate Owner Heating System & Ducting Re9isters ' ENERGV P.C. $
PLAN CHECK 25% $
i hereby certity that � have read this appiication and state that tha above ❑0.100,000 BTU �100,OOOBT ` ELECTRICAL $ GRADING $
in(ormation is correcL I agree to como�Y �'��h all dty antl munty ortlinances
antl state laws relaling to builtlin9 consVuction antl hereby autnorize reore- PLAN CHECK 5096 $ MICROFILM .$ �)
5entatives o/ [his city to enter upon the above-mentlonetl property tor TOTAL FEE $�OL/
inspeciion pu� se
Signature Date���.�_ MECHANICAL 5
Drivers' License a Reinspection Fee $75 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865�46, rev. ]0/84 Wnite � Builtling; Canary - Applicant; Pink - Accountinq; Goltlenrotl - Assessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Telnporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
�. 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-Undrgrnd.
8. Foundation 59. Gas Pipe, � 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-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
79. 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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:3��-f('j L�T Cq2lJ_ L.�/�
34. Final Heating & Air Conditioning ('•t�•8`, C��� � f�R �3 U� L•E.D
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final �
40. Gas Service-Final i �
41. Solar pomesticFinal ��
42. Backflow Preventer
43. Backflow Irrigation `�
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER MFSA MANOR,--INC DATE Q—Q8—S7
JOBADDRESS 2211�Ralei�h Ave. BUILDINGPERMITNO. #1}(ili
GENERAL CONTRACTOR R1CI73CC� H3SL VALUE $ ZO�OIZ.00
LOT j2 BLOCK TRACT 29(17 $j.ri�10 res, a/det. �ar.
INSPECTIONS ry_� ^wA I,/ y�T�.nl SUBCONTRACTOR I DATE P IRMITS �NUMBI
VY �YIF/'" H /
Footing Trench (/
Foundation Forms and Gra
Rough Framing
Plumbing, ftough fo Slab
Plumbing, Rough Complete
Temporary Pole
Wiri�g, Rough
Heatina. Rough
St.
Lath
lumbin9. Fin.al Gas TeSt
Occupancy
FOFM RIO 3M 10�•v5
���
�sta Mesa Bnilding Department APPLYCATION FOR PERb
P.O.Box3�� 4326 BUiLDING �
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOY� APPLICANT TO h'II.L IN Receipt No. Permlt No.
a���d��9 442�
Address 2211 Raleigh Avenue
Costa Mesa, California Received 6y Date Redd. Date Issued
Nearest _ 3p . FEfi 2�' 195]
c�oss st. Victoria B,,;ia;,,9
Address
owner Mesa Manor, Inc
Mail Costa Mesa, California
Address 1.7fi49 Vannwan Rt Nearest
or
CrosS St.
Zone
Approve�
Address 4253 Coldrvater, No Hollvwood CORRECTIONS
cicY u`l'15286
Contractor Richard Hart N,.
nddress 17639 Vanowen� Van Nuys
Legal lot I
Description I No. j2 I Block � Tract Q91L%
(Attach Metes and Bounds)
No. of Bldga
Size of Lot 137X5�L Naw on Lot �tTORQ
O
Useof I No.oi I No.oi �
Existfng Bldg. Families qoqms �
Setback Line trom Rear Vard �
CenterolStree2 55� SideVar.1 ri� min ?
X
Repatr I I Moving I I Demofish I
Building ll5o S No. of 6
Size Q �Raoms Stories �-
Exterior Wall I Roof
APPROVALS
-- - -- -- '-- � Forms,Materials,
Under-Pinning
Frame: Fire Stops,
Braein9� Bolts
I hemby acknowledge that I have read this Application
and state that the above is correM and agree to rnmply Lath. Int.
with all City Ordinances and State Iaws regulating
building construction. Lath. E.:t
Signatureot�e5& Man02' II1C
Permlttee Plaster, InL
1
Authorized Agt. plaster, Ext.
Valuatlon Permit Fee $ �— Masonry Reinforced
$ /O/ O�a TI��ICheck $ / 3— gond eeam
Fee $ � — FINAL
e.. ��. ��..e o. n. e s_
iLUl i�'q N
6how locatlon and distances from
property Iine and between buildinpa
, , 1
J `
8
OWNER �q�N �pg�y DATE 10-4-68
706 ADDRESS o��� R�iA; �s, a..o,,,,o BUILDING PERMIT N0. �oiRv
AP No.
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE
ROUGH HEATING AND AIR�CON�ITIONING
UNOERGROUNP (J POWER
ROUGH WIRING
REINF.
FLOOR SVSTEM
BONO BEAM � STEEL
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT
PLASTER, BROWN COAT
FINAL ANO GAS
FIRE ZONE
SUBCONTRACTOR
� 29187
COSTA MESA BUILDINGSAFET! DEPARTMENT
P.O. BOX 12pp " COSTA MESA, CALIFORNIA Y2l10
For Appllmnf �o Flll Jn Complefaly
TYPE OR PRINT
MAfL
COSTA MESA.
Sz k i37. i/
USE OR
EXI6TIN0 BLDO.
Y6TDwCR LIX[ InON
Ho. or ■�.no,.
DESCRIPTION OF WORK
NO.Or
ROOMB
WALL ROOF
OCT —4-68�hs0.�� 1S4 o****aS.00
AYPUCA710N FOR PERMR
BUILDIN�i
FOr Offln Ux Onfy
eanrt no. �i
IG
ZONING
NO.O� YYtOIN[W� 41ryn�,
� � �ux� Z eu��oixoAwti.,��
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GENERAL CONTRAC70R �,,,,,pr.
AP No. 115-551-10 LOT 14
INSPECTIONS
SOIL
GAS
W AT ER
AOUGH PLUMBING
PROP. SwR. LINE Q HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROtIGH HEATING ANO AIR CONDITIONING
TEMPOftARY SE0.VICE OR POLE
UN�EftGR0UN0 � POWER �
FOUGH WIRING
TRENCHES FORMS STEEIfiEINF.
F�OOR SVSTEM
BOND BEAM ❑ STEE4 REINFORCE ❑
SHEATHING
FRqME ANO FLASHING
LATHING - IN n OUT n
PLASTEF, BFOWN COAT
STRUCTURAL, FINAL
NEnTING, VENT., REFRIG, AND A.C., FINAL
PLUMBING, FINAL PNO GAS TEST n
ELECTRIC, FINAL
BUILOING, FINAL
DATE 6
BUILDING
E ZONE
SUBCONTRACTOR