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HomeMy WebLinkAbout1980 RAYMOND AVE - Building Permits 14 CITY OF COSTA MESA ` 4 - -' BUILDING DIVISION ri 4,-a r• DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT ,t,«a JB03-01012 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1980 RAYMOND AV Status: ISSUED Suite: Applied: 06/16/2003 Vicinity: ROOF Issued: 06/16/2003 Parcel Number 42630420 Zoning: _;21c.*#___± Applicant ERIC PETERSONISSUED BY: Address: 1653 SUPERIOR AVE - . ' . . ' Phone: (949)642-7222 COSTA MESA;CA- - Zip: 92627 -. Owner LANGDALE, HARRY J IR - Address /1980-RAYMOND AVE - - • - " V\ -y, , 7, .COSTA MESA,.CA ; - Zip: 92627 / Contractor: ' LEE ROOFING'OFCOSTA MESA \ :2/A , �,..\ v 'Address: 1653 SUPERIOR AVE /- > "/ Phone:' (949)642-7222 " ' ,COSTA"MESA,CA ' Zip: 92627' - ,License: 349686 . . ' Arch : Eng: ' Address:- - - • Address:, ' -- ' ` t. Phone:- - Phone: " /.: NN ' - . Zip: '.• License: -License: ' - • . SCOPE OF PERMIT- .- TEAR OFF EXISTING ROOF. INSTALL 30#FE_LT,_NEW METAL AL FLASHIN GS,TCLASS A,30:YEAR COMPOSITION SHINGLES.25 SQUARES • ' INCLUDES ATTACHED GARAGE. • v FEE SUMMARY ' ' m Plan Check:' ' $0.00 - - - - - . - - Calc Valuation: $s;000.00 _Permit: $111.25 - Claim Valuation: $5,000.b0 \SMIPRes: ', ' $0.50 , SMIP Corn: $0.00 Other",, °,,$0.00 Inspection: $0.00 ‘ .� :� � Vv', v Total: - $111-.75.: , vv• PLANNING&ZONING - SETBACKS ' MAIN STRUCTURE Front 0-0 ; Rear -. 0-0 Left 0-0 Right 0-0 ' / ACCESSORY Front - 0-0 -Rear 0-0 Left- 0-0 Right 0-0 " PARKING Existin : 0 Required: 0 Proposed:. 0' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) 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. • INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS rm , ,,--y WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the n/work for which this permit is issued. Y 'I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance�• carrier and policy number are: �7 �� Carrier: - S4rLaic{ , C.v.'SCA Policy Number 2©`i SS — f.-C..vJ3 (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performanc- - r which this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califo - r' should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision Applicant Signature: b. Date: b/• -/6-0 3 WARNING:FAILURE TO SECURE WORKERS'•• PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under_provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect.Lie.a 3'I N 6 6 Class k C...- Contractors Contractors Signature: Date: 6 — ( i — 0 3 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 penalty of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have.the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. _ Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): _ DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a_ormit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 8 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. • Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. s ._ s l V D^t�..J A d/Or Autho -• b•• - Date CODE I INSPECTIONTYPE PATE MALS CODE( INSPECTION TYPE DATE EOM 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final /' 208 Final Plumbing 200 Final Re-Root 13-"O3 its' 210 Final Electrical _ 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy — OWNER COMPTON, E. It.---- - - DATE 5-13-g . I JOB ADDRESS 1980 Raymond Avenue BUILDING PERMIT NO. 1313 GENERAL CONTRACTOR Owner-Builder VALUE $ 5,627.00 LOT 6 BLOCK TRACT 278 Dwelling relocation (Same lot) / and add garage GROUP I a J ` i) TYPE V ZONE R4 FIRE DISTRICT 1328 1T y,� 3� PERMITS ISSUED INSPECTIONS /��7s DATE SUBCONTRACTOR 1, DATE NUMBER Footing Trench c �.,f L7 SS_— , .` Foundation Forms and Grade to Gaar'age 4 -j0'� Rougl}Frami Rg� �J 6--.Z Sp- N a/' - /l- f� PlumbitTt3g`ugh teaab ?f i-iL._.�'a z', -.a t& liWat40.�) F./- a-3//fo./,4)t -ric Plumbing,Rough Complet-,,,� sr 7,/ 1-T T T 7-1(--I: �-/ 6 1/ /A_ne r Temporary Pole G ) if J L.t.J, Ccv.c; (p1WUR& -k1'-fl' / 0 S 10 .sem Wiring, Rough _ QLur».�tl-, �A- 2-(n -S.S /l '�-b.i- Heating,Rough cr-/.j5 Heating,Final 20- CL. 3 3 .'Sewer, House Sewer,St. Sr /7- 9- S5 I p ' Septic Tank or Cesspool % / ia dt i % i G Lathing, In Out • • ^' t Plastering Plumbing,Final,Fixtures Co .IeteGL� 7'41-1 f Plumbing, Final Gas Test , -- 5_ I-ser �� AY Wiring, Final Cyt/ es�-e.C.<......• 7.-cit ."'pa-J Occupancy /1)13 - (._a---RA Wnrm 9111 C.-T4 15011 1-5N atti a o 714 iii sta Mesa Building Depa a ioyAP CATION FOR PERMIT n CESTA ME A, CAL TORN 134 ' D N G 1 -FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY _ Receipt No. Permit No. Buildingea / 31/3 , Address � /(/0 /ea yMG/YQ ^Zee. Costa Mesa, California Received by Date Recd. 'ariI tugs Nearest Cross St. EST ea A - Building • , /�� Address , Owner E., ( 3 AelPT o h, Costa Mesa, California Mail / Address 3.s7 ,E 2.o a SA' • Nearest ''A TeI4/.7 6_// Cross St. City ri, >rta S A ' No. v Zoned ' I No.of I Type,v ,/ I Group,1 y� Architect or Lic. f �- Plans/// V ..���(�7I'd Engineer No. - Approved /- DateD..rw'l Address (� CORRECTIONS �n City Lic. Contractor - CctCiNo. Address / Lel Lot* De crption I No. P' I Block I Tract 27! (Attach Metes and Bounds) . Size of Lot/,Ztx/u44w Now onL tldg� 0 Use ofNo.of ` -No.of -- - -- 71 Existing Bldg./),.V5LG i wwe=I 'Families Rooms I) ' Setback Line fromRear Yard ,2,-.5- ) 2 Center of Street JVD Side Yard 3- -- i///� y DESCRIPTION OF WORK. i/ly U New I '•f I Alteration I I Addition I V Repair I I Moving I ^ I Demolish I u 'Building ,/ No.ofEI'r / , Sizet / X 7 Rooms Stories / Op- M7Coterie Wall Roof .2. Covering ff$'�,f- STnS`s CoveringFY,,Sp,(/ytJ-S,(/. fi APPROV S Use of New ///214at' Location Inspector Building //l�,cLL /- - arms,Materials, 20 )C2 "*.- .1-- .tr Under-Pinning I/ • Frame: Fire Stops, Bracing,Bolts '7Lecu•i- -� _ i I hereby acknowledge that I ha e r•.d this Application Lath.Int. and state that the above is correct and agree to comply Lath.Ext. with all City Ordinances and State Laws regulating building construction. �.�. Signature of rte"• ,ed/ 6/1 Plaster, Int. ' Permittee h •/�(/ l �f �w.a Authorized Agt. V Plaster,Ext. Masonry Reinforced Valuation / � Permit Fee $ t 4 �/Pgl., plan Check $ S. o a I Bond Beam $ �/ Total �- Fee $ If p c ! r FINAL FORM 204 0-R 2M 5-54 I' ___ . .. ii • c al c �! o. _ .. 'G J• - - ' co ti - 'i • - .s, t. -- - a a MAY 12-55PD,cosra * u 1`9.00 MESA- tIv2C: - - -� - _ . . - - \ _ - CI' v .—. . - _ - __ _ _ . -. .. - T_ ' . _ . _ ._ _ - -..'i >'60':. - rico-r IQ _ ' to ni n.c+' Street - - - - bard_ ,.r*: _ -- r. - ' _ - PLOT PLAN ..~ _ . T' try, 1:-ms j�q .-���_. - J\, Show location•and distances from- • • •-n': ,^"^ ! property line and between buildings. ".' ' UWNtH DALE, JAMES LANG UAIt 8-2-79 JOB ADDRESS 1980 Raymond Avenue BUILDING PERMIT N0. 117393_ GENERALCONTRACTOR Net$gort Home Center DESCRIPTION of WORK Private Spa AP No118-215-26 LOT 6 TRACT 278 FIRE ZONE VALUE $2,000.00 _ 4 INSPECTIONS - Signature Date GROUP V TYPE J ZONE R-i \Pool Location SUBCONTRACTOR PERMITS ISSUED Dote I Numbcr _jgnature Forms • • Main Drain Steel Reinforce Elec. Bond �,E.l,�erctric &rndevalf, �mApproval to Cover 0 /4 L� oor �(9� yS238. -yy�±Underground Electr' �" l -"'ti"'�� Plumbi Gas Piping Test p Filtering System 'Mss. tad Zit �iii�J& "�74 Backwash Lines and 4- Electrical Final �' p Heater and Vent Final r. ;�' O - _ Filter System n Final 't� Backwash and Recap. Final ` Fencing Final \..N4 ('i /trj... 3 dl - . p?l66 2/08/79 30.50 TL • COSTA MESA BUILDING-SAFETY DEPARTMENT .01165 . 2/08779 30,50CKT0 4 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ' _ 66 00000473 93 I A N PPLICA IOIOR STRUCTURAL PERMIT l�f� For Applicant to Fill in Completely — Use Ink Only c E By DATE RECEIVED DATE ISSUED BUILDING 1_IT—7 e ! ADDRESS / O ��aQ ..4,4--"_ / ��� PERMIT NO. OWNER •Tar Af�/UL//.(.L A.P. NO. ' i �; Or MAIL ('�� BUILDI /�'�'� ADDRESS yy�r _ ADDRESSfie-� , fi707t- 'OF TEL. CITY rS7 ? �i 4$ NO a,.. c TRACT SPA BLOCK CONSTRUCTION NEW ADD •LTER REPAIR MOVING OFMOI ISH LENDER / /��y /�� �- //�)w BRANCH Z4/1 / /J//�� \/7//I BS ItGAL K/M� /V/ OWNE- ADDRESS G�/� VALVE .10.-- . ` ARCHITECT TEL. USE SOA- $ OrU�O OR ENGINEER /J/� NO. ., .. .. .'_-„ . . 7 L/ FIRE `,.'.—+ ADDRESS ������� ��//"" 7 ZONE YPE ��PROUP (J Qt t A $"e e' " I APPROVED / ` `4. elf CON A /Agr.ar Y�L�Arr BY •id_.� DATE 44 s bra ADDRESS 23/4.../.J//Crz ,42r• ZON NO.OF ^ USE OF N CITY ff$fl7 /, c4' NE9.1 96 # / PLANS / BUILDING.c �y•. STATE CC CITY' YARDS APPROVED YARDS OVED W LIC. NO. . 39'7(09' LIC.NO./j7/4 MAIN BUILDING ACCESSORY BUILDING LO SIZE u' / INO.OF BL (FROM C/L STREET) C. OF LOT • NOW ON LOT FRONT -" FT. FT. Q USE OFr sf � EXISTING BLDG. R•$ID£ a FT. (/ FT. U, FSeparate permits are required for L.SIDE `—FT.-- FT. Ci. ,electric,plumbing and heating work. REAR • FT,r2 nrj FT. [W. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ' A // n MAIN BLDGS. ACCESS. BLDGS. ' ✓/` (7/ VAR.+ C.U.P.# DATE Q / //r� APPROVED / APPROV _ E-7� � q .rl AP / IX 0 I hereby acknowledge that I have read this application and state in Q: that the above information Is correct and agree to comply with n m O. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of E W the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON43'; am exempt from the provisions of the State of Calitarnia Business a and Professions Code,Division 3,Gila.," 9 �� VALUATION PERMIT FEE $ Eli a Signature I ' e /A//� n ' PLAN CHECK $ / re Permltte•f ----J./Are----J./Are /' � $ *Jel.— TAX $ • C.O V L Authorized Agent - TOTAL PAID $ �✓3• 57 Wil/ 7�/ . OWNER COMPTONT-F,7=W __ DATE 1-7-57 JOB ADDRESS 198O-Raymond Ave. - BUILDING PERMIT NO. #11182 GENERAL CONTRACTOR Owner Bldr. VALUE $ 336,00 AP118-213-25 LOT Por. 6 BLOCK TRACT 278 Cement Block Fence GROUP J TYPE III ZONE Rt, FIRE DISTRICT 4225 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench 4j /-'#0-C�� n Foundation Forms and Grade to Gaa l_1 fl ... () 4440 av 4*1 oi Rough Framing Plumbing, Rough to Slab _ ar Plumbing, Rough Complete ,' ,(i( Temporary Pole ,� A / Wiring, Rough / �(,'� /`ta A Heating,Roughinal � .� many Heating, Final Sewer, House Sewer,St. 7 • Septic Tank or Cesspool _ Lathing, In Out Plastering Plumbing,Final,Fixtures Complete Plumbing,Final Gas Test Wiring,Final p� _ Occupancy /v d ?(_L. FORM 210 3M 10.55 4182 .- ,,j,ic\i„. .--)____)q u / • ." d7.25 0614 q� 9:_j COSTA MESA BUILDING DEPARTMENT ` f • P.O. BOX 317 Ilk COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ABU I DDRESS `ry Q f�/�y AP)oAi b /7703BUILDING COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. ERMIT/, O.� OWNER 6. W. / n,\ yr ' ,/,. / o 7 7 """��, �l --nu/22 BY// DATE RECEIVED DATE ISSU`EQ, MAIL ADDRESS /fee, /f gyiil1O niOJ �/..., ♦ u /' /- 7- 7 /D 7-V 7 EL. 9 BUNG CITY �t M, TNO.� _7„5.7 � ADDRESILDIS - ARCHITECT LIG. EN OR ENGINEER NO. . COSTA MESA. CALIFORNIA • ' FIRE ADDRESS ZONE ZONE HOOF TVP GROUP .1.— CITY LIC. Iyn{ PLArvS CONTRACTOR / / NO. V / p//RC 6'• TEL. APPROVED •1�� _ADDRESS NO. • BY DATE LEGAL ry �/o ('('�{�RF� DESCRIPTION/)NOT,T /6 BLOCK TRACT 4/O I� f�it ITS\,Ty. `,An A.P. NO. ( / s �J� 1 . _. jn{11 18S✓ `PLYµ _ SIZENO.OF SLOGS CITY UI- Cu:,r IV'L5A I DF LOT S E.,a1.7- Dalin ON LOT 0 pi.ANNING DEP V. _ USE OF I �n /// / SUBJECT TO G. OCPT. REG. EXISTING BLDG. out Ail /f/�S Y C/{/v.Tt l� SETBACK LINE FROM CENTER OF STREET 1 SREAR YARD /n�✓J '{�, </ D /C /� BY ii DATC7.../-7---ST SIDE YARD ,fes • LEFT O./ S / , PI�'N TE4fv/' - 9/ DESCRIPTION OF WORK NEW ALTERATION II ADDITION . REPAIR MOVING IfI DEMOLISH BUILDING NO.OF SIZE ROOMS STORIES EXTERIOR WALL ROOF COVERING COVERING USE OF NEW BUW.1NG Pas • I,HE BY ACKNOWLEDGE E THATI HAVE READ2C-,THIS fe--34 TION STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL • CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC• TION. r /1 VALUATION SIGNATURE OF T l/ YsT•C� PERMIT FEE S `— PERMITTEE �o $ 3.3 lfr/ PLAN CHECK $ •AUTHORIZED AGENT TOTAL FEE 93 COSTA MES BUILDING—SAFETY DEPARTMENT 3 i 67 �i;h,;;;7 12.1). P. O. BOX 1200 3167 _'.T.. Costa Mesa, California 31 ;r7 C c' ! '+ n , '-ryhELECTRICALaPERMIT. APPLIGMION - q TRACT NO. ,/� PERMINO. ELECTRICIAN ,J/7 '7. �j?,ef r LOT NO `, ADDRESS�/"4!/J1J'}"_'. BUILDING USE, •'- „, D//A/TE ISSUED CIlY,' yr-9 / �f'y TR. NO. /v • rIg r STATE LICENSE NO. OP , CLASS. i 14 (' - - - CITY LICENSE NO. ADDRESS X94 7 ,C2/Ar1U9 - ' NO. ITIM EACH PEES COSTA MESA, CALIFORNIA ' Dwelling. Sq. Ft. f NEAREST CROSS ST. id d /t�`, Q "*' _ IV/Yr i UJ Garage, Sq. Ft. OWNER roaeriti .2./4/�1(fA C • Q First 20 Outlets, each ADDRESS ,., Z IL c'°/l'y - J Outlets, Additional ,p��' /{/ Q cln�CiST11-.res?� TEL. raEyl-7 .27. First 20 Fixtures, each 1 HEREBY'ACKNOWLEDGE THAT I NAVE READ THIS A PLI- • CATION AND''.STATE THAT THE ABOVE IS CORRECT AND AGREE Fixtures, Additional 1O'COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REG. CC QGkATING ELECTRICAL WIRING. W . {�; o. 1`. YI CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF CL. Dryer .„(--ssCALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF Q '• L THE SINGLE FAMILY RESIDENTIAL PROPEij DESCRIBES-ABOVE. CC Fan ■ Z Heater a { Si/0P LY 8 5—• _ I /:FERMI at"..--Ss Xa Oven, Oomasti< + I+._. ti 4 c r k. R w RMPEES _1". Pole, Construction ^ .. C Sign& 1 Irons. 2.00 37-et Ra ,is {j ' '/ DC nge. Dome ) ATF / •I ti' a.1 Transformers KW a. Misc. , cc n / �U Generators KW Q 2n Motors ISee Schedule/ 0 — • . I HP I— HP Sub-Total Fees HP • APPROVALS INSPECTOR I DATE Meters, so. TEMP. POLE Permit fax UNDERGROUND CONDUIT 3 00 ROUGH Sub-Total Fees FIXTURES - J _, POWER Total Fees ,r E/ e) UTILITY CO. NOTIFIED FINAL CMP 0313-46,rev. 7/75 BLDG. PERMIT NO. �� 7-(�- For items not listed refer to Fee Schedule COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 1200 3168 2/0 %75 6.00 Costa Mesa, California 1k k,-.1j.sib: r•6 a.=ra s ..,x,K s .,s �• w.�' - -.�,_...: _ :. P MIT -, PLUNBNG PERNIT'APPLICATI�! � NO. RECD. BY ple I X4 •6 r1 - .Lz .. :TW-Lir: :' sCtWi5.3+1c�.re t'itiry ' 7t9TRACT1 CONTRACTORyinf/TZ'r/I/'1T • LOT NO. DATE ISSUED BUILDING USE �j� Address / /4w-en- &? 2-`�J�-7l I City( cy / ,silr Zip Code Build Addrress inj O A/,w..e'a State License Na.339,719 Class., / Cf - rer .7,-.41.4'nJ44 Cw2e'Ae . w City License No. Tel. Noj)//-9c9e.�s�Mad s��, Address Q NUMBER TYPE OF FIXTURE OR ITEM FEE //�� y� . .• (/ _0 Bathtub ' Cityl rTAr/iE,S-4 Tel.No. y� l J Laundry Tub or Tray I hereby acknowledge that-I, have-read this application Q Automatic Washing Machine state that the above is correct and agree to comply will City Ordinances and State Laws regulating plumbing. Shower 1 certify that I possess the above valid State of California classi- Y Sink,Bar . - - - fication ox I am the legal owner of the residential property de- J � Sink, Kitchen scribed above. • W Wash Basin(Lavatory) I certify that I have obtained a permit oily the State Division of d Water Closet(Toilet) I Industrial Safety for excavations,oth/ an swimming pools,five Cl ' feet deep or deeper and into whic ' e in is requir•d to descend. CC Drinking Fountains - ___.-- CI. Signature / / Floor Drains Permi ! _ Z Interceptors _s w i Rece tors Sink Commercial or Industrial I N S P E C T I ���:� Sinks, Floor ' ; , 'SJ t Sinks,Service ri "itk. tura cc Swimming Pool I , _ —_��� i t •aur wUrinals + ■r. - d ' Dishwasher . 1 ' CC ' Garage Disposal Water Softener c �-• oWater Heater and Vent ` tTE�68, Stu . ' Gas System...Outlets... - , . �• P P R Cf V A L S N Roof Drains •_ ' Water Piping Alteration INSPECTOR DATE CD U/G Soil b ackflow Preventer I=- Lawn Sprinklers(Res or Non-Res) _U/G Water Property Sewer... Feet ' Services--Water ❑ Gas 0 House Sewer Connection _ Rough Plumbing Cesspool,Septic Tank Sprinkler System Sewer Cap Gas • Miscellaneous - Property Sewer Pool Receptor .. . ' • Filter System • _ Sub-Total Pool Heater Reinspection Fee ' . Miscellaneous Processing Fee I 61 `)-1'1 Final Gas TOTAL FEE _ Plumbing Final Utility Co. Notified CMF 0450-46 BLDG. PERMIT NO. ci?' J4j.