HomeMy WebLinkAbout2512 DUKE PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626
Jab Address: 2512 DUKE PL
Suite No
Vicinity:
Parcel Nunmber: 14141244
Applicant: SZABO,KEVIN
Address: 2737 S CRODDY
STE D
. SANTA ANA, CA
Owner: YUEN, LAI HING
Address 2512 DUKE PL'
COSTA MESA, CA
PLUMBING PERMIT
Phone: (714) 241-1414
Zip: 92704
Phone:
Zip: 92626
Contractor: COAST ROOTER PLUMBING HEATING & AIR CONDITIONING
Address: 2737 S CRODDY
STE D
� SANTA ANA, CA
Arch / Eng : _
Address:
ISSUE FEE
Backflow irrigation
BackFlow Preventer .
Bathtub
Clarifier System
Connect pce,Soda,etc)
DenWl Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Ezpansion Tank
Gas Earthquake Valve
R 8 R WATER HEATER
AMT
$23.50
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
� $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Phone: (714)241-1414
Zip: 92704
License: 529127
Phone:
2ip:
License:
SCOPE OF PERMIT
FEE SUMMARY `
QTY AMT
� Laundry Tub / Washer $0.00
0 Landscape Irrigation $0.00
0 P-Trap $0.00
0 Pressure Regulator $0.00
0 Process Piping (per 10 fi) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
0 Sewer Cap for Demo $0.00
0 � Sewer Connect � $0.00
0 Sewer Pnvate Line $0.00
0 Shower $0.00
0 ' Sink, bar $0.00
0 Sink, commercial $0.00
0 Sink, Floor $0.00
�TY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Status: ISSUED
Applied: OS/19/2003
Issued: OS/19/2003
ISSUED BY:
SumpPump
Swimming Pool
Trap Primer �
Unnal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
AMT
30:00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
can
0
0
0
0
0
0
0
0
0
0
1
0
0
0
NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall eutomatically expire and become vold if work is not commenced within 180 days, or If work Is suspended or abandoned
for a period ot 180 days. �
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepectiona end flnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aas-ae�amo)
WORKERS' COMPENSATION DECLARA710N:
I hereby aXirm under penelry of perjury one ot t�e followinq declarations:
❑ I heve end will maintein a certilicate of consent to selFlnsure for workers' compensation, as proviCetl br Dy section 3700 of the Lebor Cotle, lor t�e peAormence ot Ihe
ork for whiCh Ihis pefmli IS issuea.
I have entl wlll malntain workers' compensetion insurance, as required by section 3700 of the LeOor Cotle, for the performance ol the work for which this pertnit Is Issued.
�y workers' compensatlon Insuranca carrier entl policy numbar ere: , `� t�Q �� U^O�
i 1
Ca _�TR'CE �llnill Po' Numb r.
rs secNon neetl nof be comp/efed il fhe permit is ve/ued et one huntlred dollers ($100) or Iess.J
tor which Ihi rtnit is Issu �rrohemploy eny person in any menner so es to becoma subject to the workers'
t ' ou me subJect tSttie'workers' compensaiion provisions ol Seciion 3700 of the Labor Code, I shell larthwlth
" ,v_""
tignature: � ate: �_� �� � ��� �
E TO SECURE WORKE ' CO PENSATV P� C/JVEPAGE IS UNLAWFUL AND SMALL SU&IECT AN EMPLO RVETiTO-C IMINPL PENALTIES ANDpVIL FlNES UP TOONE HUNDRED
DOLLARE (E100,000). IN ADDI ON TO THE COST OF COMPENSATION, DAA4IGES AS PFWIDED WP IN SECi1pJ 3106 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aMirm that I am Ilcensetl untler provislons of Chapter 9(comme cing with Sectlon 7000) of Division '��� iness and Protessions Coae, enC my Ilcense Is in lull
forc N SZ� �ClessJ�l' �G'� (�y�j
onVe gn ture: ' �0�8:� S"! 9• ,3
/ \
CONSTRUC710N LENDING AGENCV:
❑ I hereby attirm that there is a construction lentling agency tor the pertortnance ol the work for w�ich this permit is issued. (Sec. 3097, Civil Code).
Lentlers Neme: Lendef5 Adtlr855:
Signawre:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby ettirm Ihat under penalry oi perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lar ihe tollowing reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires e permit to construct, elter, improve, demolish, or repair eny structure, Onor to its iuuance, elso reduires the epplicant tor such partnit
to file e signed stetement t�at ha or s�e Is Iicensetl pursuant m the proWsions oi the Coniractors License Ww (Chapter 9(commendng wit� Sectlon 7000) of Dlvision 3 ot 1he
Business and Prolessions Code) or ihet he or sha is exempt thereirom end the basis far Ihe elleged exemption. Any violation ot Sectian 7031.5 by any epplicant for e permit
sublects the epP����� �o a civil penelty of not more lhan tive hundred dollars ($500).):
❑ I, as owner of lhe property, or my employees wiih weges es t�elr sole compensatlon, WILL DO THE WORK, and the siructure Is not Intentle0 or offered for sele (Sec.
7044, Business end Professlons Code: The Contractors License Lew does nol apply to en owner of properiy who huilds or improves ihereon, entl who does such work
himself or herselt or thmugh his or her own employees, provitletl that such impmvemems are not intenaetl or oHered tor sale. If, however, the building or Improvement is
sald within one year ot completion, the owner-builder will havedhe burden of proving Ihet he or she did not build or impmve for purpose of sale.). �
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sac. 7044. Business flntl Professions
Code: The comractors License Lew aoes not appry ro en owner ot propeny who bulltls or Improves Ihereon, and who comrects lor such project wlih a contrector(s)
Ilcense pursuant to the Camractors License Laws.).
❑ I am exempt untler sec.
SigneWre:
Owner ID verifietl by tlrivers license. ❑ Vas ❑ No
Business antl Professions Code lor this reeson:
Verification of Ownership by (type of document, i.e. - pmperty lex bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Drivefs License No.
Date:
Expires:
❑ I hereby cartity ihat no excavation five (5) or more feet in tlepth inio which e person is required Io descend, will be made In connection with work authorizad by this
permit, and Ihat no buildinp sWcture, sceHolding, talsework, or demolitlon or dismantling thereof, will be more than thirry-si: (36) feet hig�. (Chap. 32, Grp 2, An 2, Sac.
341, Title 8, Celifomia AGmINStretive Cotle).
❑ As owner-builtler, I wlll not employ anyone to do work which would requira e pertnit from Ihe Divlsion of Industrial Sefery, es notetl above, unleu such person hes e
pertnit to do such work Irom tha division.
Signawre: Date:
Division ol Industrial Salery Permit Numher:
CERTIFICATE OF COMPIJANCE AND AUTHORIZATION OF ENfRV: I certily under penalty of perjury thet I heve read Ihiq epplication and state Ihet ihe informatlon given is
correcL I agree to comply with ell state laws end ciry ordinences relating to building constructlon, antl euthorize representetives of the Ciry ol Costa Mesa to enter upon the
ebove-described property tor inspection purposes. I egree not m occupy or allow occupency o� any buil0ing authorized by this pertnit until final insDection.
cooe �, msaecnoxrrve
1616 Fixed System Final Fire Prevention
1266 Pool Spe Finel
200 Finel Re-Roof
201 Flnel BIak/Re�aining Wall
202
203
Final Factory Fire Place
Flnel Sign
204 Final Demoliiian
PAIF. 1tII�L6
S�i9-a
COOE 1 INSPECTION TYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Preven�on
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupenry
� �
�-10-Oi �
l '
��" �r AVD�icant to fill in all ipaces excepl those within �eavY borOer lines an0 si9n all a0Vro0/Iate tleclaratlons. �
��
CITY OF COSTA MESA CONSTRUCTION PERMIT PE�pRMIT NO. p TRACT NO. LOT NO. UNIT NO. � �
Projer� Address � 51a' L��! ('� i�L� �`" _� S 6 7 p� �$
ApplicanYs Mai �n Addr TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR R
� /_ (��' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P•# I I a� �' Z��a "��
Owner's Name ��,�� Ph^^" 6J� DESCR TION OF WQRK/USE OF ByD,G.
� .1�j �l.. J 1 I� L � I C. �.0�� �/AL��'��(ZE S Main Building: Accessory Building:
Aildress •
E � Z
Arch/Eng. Licenie No. TVPE OF PERMIT ❑ GRADING ❑ FOurvDATION STRVC7URA T front � p
^— N
Address -�
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear �� �
❑ OTHER
Contractor's Nama ����� � Phone C Ai9ht Q� N
PROJECT DESCRIP710N S�S FT. oCCUPAN K G
Addreu�mailing) CONSTRUCTIONTYPE VALUATION$�� $ Left �
r-- p
Ciry License No. ZO�vE GRADING CU. VDS. ACRES E
IICENSED CONTRACTOR DECLARATION Ping. Ref. # Pd�king Req./P�ovid2d
I he�eby aftirm Ihat 1 am IicenSetl untlGr proviSlOnS o! Chart<r 9(COmmencing Remarks: Pl2nniny NOl¢5: �/ }� � �,�� ��Q ��� M
with section �000) of Divlsion 3 of the Busine55 antl Profession5 Cotla, antl T
my license is in full forte ana effect. . ►` T .{- �'�,y,�[ (` S
License CIa55 License No.
Date Signature PLUMBING FEES � I(tQ�
WORKERS' COMGENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
�reby affirm lhat I have a certilicate Ot Consent to self-in5ur¢ Or a CertHitate
Yorkers' Compensation Insurance, or a certifietl cooY tnereot (Settion gackflow Preventer Service Sink
�o, �ab. CJ . � Automatic Washer Transformer ❑ 75-50 KW
Policy No. Company Backflowlrrigation SewerCa �- ❑ SO+KW
P Construction Pole Sub.
BCeriifietl copy is hereby fumishea.
Certifietl copY Is filetl with [he City Builtling Division. BathtUbs Sewef Connection CDoking Unit Meter ❑up ro 100 amps
Date APPlicanl
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cla�ifiers Solar Collectors Dishwasher Meter ❑over 100amps
(Thissection neetl no[ be compleletl it Ihe permit is for one huntlr0tl ($300) o�
less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Eleciric . Sub Panel �
I certify that in the p¢rformance of th�ork ior whiph tytpermR i ssuetl, I �
shall not em loy ny person in any5idhner so aS.Co bE�+�R sub' t to the Drinking Fountains Solar Tank Fan Motors �0-1 HP �1 X- 6
workers' 6e s�y Laws of Calitprfiia. r/"el� � 1
Da[e d� Signature .(�.er �-'�-a 7�LfLiGI„KC( Floor Drains Swimming Pool w/Spa F.A.U. . InaSolar 09�15 HP �i6-15+
NOTICE: , at er makin9 this tleclaration, you shoultl become subject to the
Workers' Comp¢n5atlon provi5ion5 Ot [he ISbof Cotle, you must folthwitM1 FIoOI SinkS Ufin31 FixtulBS MicrOwdv¢
camply with such p�ovi5ions o� this pe�mit Shall bC tleemed revoketl.
CONSTRUCTION LENDING AGENCV GasServiCe OuLICis WatefCloset
I �e�eby affirm [hat there is a ronsi�uction Ientling a9¢ncy tor the perPormance D¢vic¢ BOx25 Pol2 Light
of the work tor which this permit i5 IsSuetl ($ection 3097 Civ. C.) �nt¢rCeptOrS Wat¢! H¢at¢r . ,.
Outlets Range
Lender's Name
Lenaer's Atltlress Kitchen Sink . Water Service $witches ' Sign
OWNER BUIL�EN UECLHRATION
I hereby attirrn that I am exempl irom lhe Contrac[or's Llcense Law lor the L3vdtO�ieS AutO-Wdsh Garbage Disposat $tanding SeCtiOnS
followin9 reason (Section 7031.5 Business antl Professional Cotle: Any cl[y or
county which requires a permit to construct, alter, improve, tlemolixh or repair P-Trap Laundry Trays Generator �0-5 KW �5-15 KW 7rash Compactor
any structure, p�io� to its issuance, also reqWreSlha applicant fOr such permit
to file a si9netl slatement tnat he/she Is Ilcensetl pursuant lo the provislons of Roof Drains
the Contractor'S License Law (Gnapter 9(commencing witn Section �000) of
'�ision 3 of the Business antl Professions Cotle) or tha[ ne/she is exempt ,
efrom antl the basis for the alleqetl exemption. Any vlolation of Sectlon
1.5 by any applicant for a Pe�mll subjetts tne apPliGant to a Civil
ndlty ot not more than live huntlretl tlollars (E500j. $ 3
�I, as owner of the O�operty or my employees with wages as thei� sole Reinspection FBB $15 ISSue Fe9
compensation, will tlo the work, antl me structure is not intentletl or o(teretl Reinspection Fee $15 luue Fee $ 3
tor sale (Section 7044, Business antl Protessional Cotle: The Contractor's MECHANICAL FEES
License Law does not apply to an owner ot a property who builtls or improves
thereon, antl who tloes such work himself/herselt or throu9h nis or her own NOod or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS:
employees, prOvitletl that such Improvemenls are not Intentlotl or ofteretl for BOiI¢I ���-�
sale. I/, however, the builtlin9 or improvement is soltl within one year ot com- Canopy Type 11 ❑ Zoning Approved By ate
pletioq the owne� will have the bu�den Of proving hC/She tlltl not builtl o� im- DuCt - Unde! G�OUnd Building ApptovBd By natB
prove for fhe Ourpos¢ ot sale). /
❑ I, az awner of Ihe property, am exclusivety mntractin9 with Ilcensetl con- Duct - Structural Refrigeration System Applitetion luued By nat ��
traciors to conztruct the project (Section 7044, Businesz antl Professions Cotle: �
The Contractor's License Law does not apply to an owner of property who Duct- Ven[ilating ❑0-700,OOOBTU ❑100,000 BTU SUMMARV OF FEES
builtls or improves lhereon, antl who ton[racts for such 0/ojects with a con- - �
tractor(sl iirenze pursuant ro the ContracroCs License Law). I am aware that ��• BUILDING PERMIT $ l26•� SMIP $ 0•'S
Exhaust System ❑ Multiple ❑ System Fepair/Alteretion
�p oof o( thev Worker's Compenution insurance shoultl be provltletl to me. _ PLAN CHECK $ �0� 9S- pERMIT
I am ezempt untler Section 1 B. & P. C. fo this reason FirepVFact.6lt. IC80 # Fire Dampers PLUMBING $ ISSUANCE S
Heatin S 9 9� P�P,N CHECK 25% $ ENERGV P.C. 5
Dace - Owner 9 Ystem & Ductin Re isters
i hereby cer ity that i have read this appiicatlon ana state thae me above ❑6100,OOOBTU �100,000BT ELECTRICAL $ GRADING S
information is correcL I agree ro com0ly w�tn all city antl <ounty ortlinances
antl state laws relatin9 to builtlin9 constr ction, antl hereby authorize repre- PLAN CHECK 50% $ MICFOFILM 5
sen[atives of [his city to n[ on he above-menlionetl property /�for /
inspectlon pur es. � �� MECHANICAL $ TOTAL FEE 5 �
�Siqnature o- Date �a
Drivers' License or 55 � Reinspection Fee $75 laue Fee $ 3 PLAN CHECK 25% $
:MF OB65-46, rev. 10/84 Wnite - Builtling; Canary - ApPlicant; Plnk - ACGOuntln9: Goldenrotl - Assesso� , U� OOL1OSEO�I'OUJJS�Q? ���T 1_Q].¢°j
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector p�ppROVALS 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
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-Final ' '
12. Sewer Cap 63. Heater & Vent-Final j
13. Roof Drains 64. Plumbing SYstem - Final �
14. Rough Plumbing 65. Electrical-Final .
15. Rough Elecvical-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 77. Product Piping OGas ❑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 (Structuraq & 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:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test �
36. Hood or Canopy ,
37. Final Factory FireplaCe
i
38. Final Plumbing '
n.
39. Water $ervice-Final '
40. Gas Se?vice-Final
41. Solar pomestic-Final
. 42. 8ackflow Preventer
.43. Backflow Irrigation ' �
i 44. Landscape,lrrigation SYstem • � ,
45. $ound Attenuation -� � ,
46. Handicap Regulations �p y� 8 i
47. FINALSTRUCTURE&BUILDING -� _ . �� �� � ,
48.-.Special Requirements Completed o,� o Q�(� 8� '
49. Electric Release to Edison ' ,
50. Gas Rclease to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY � ,�
No. Date �
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Coping Optional --
Channel Block With 13/8�
Horizo�tal Top of all
Fences
For Fences 5' or leu
Vert. Bars 3/8" � at 4' -0" O.C.
For Fences Higher Than 5'
Ven. Ban 3/8"� at 32" O.C.
Fill Cetls Solid With Groui
W here Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-1539
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURALGRADE
TWO 3/8"$ BARS ,
� CONTINUOUSTOP �
-.� & BOTTOM .i �
:A � � •
{ �..' - �...r..
i1OR1i5TEEL MUST BE TIED IN
�P.LACE A7 TIME Of TRENCH ��
INSPECTION: � :
F
>
�
� ` . • `� �
' � �- • .
4
� oe :_L_L
n
D '
�WIDTH
� SEE CHi
' �v � BEI.OW
�.I e
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: pne Part Plastic Cement, and
7�ree Parts Sand
GROUT: One Port Cement Tlvee and
One Half Parts S�and
COPING: One Part Cement, Three
Parts Sand
CONCRETE: Well Mixed 1:2-I/2:3-i/2
MaY. of 7-I/2 Gallons of
Wafer Per Sack of Cement
GROUT MAV BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL BE CLEAR, CIEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H OF EARTNTCOTH
i/3 THE HEIGTH OF FENCE
�OW �BOTTOM OF FOGTING. ,
� SCA�E: I/2�� = I'
WIDTH . . . . . . . . . . . . . . .14�� . . . . . . . . . . .14�. . . . . . . . . . . i._I2��..__.. � : 12���'=
THICKNESS . . . . . . .-. . . . .10'�. . . . . . . . . . . .10" . . . . . ' . .'. . . 6°. . . . . . .'. . . . 8,.
DEPTH OF EARTHTOOTH . . . 24�� . . . . . 20�� . . . . . . . . . . . 16". . . . . . 12��
SPACING OF EARTHTOOTH. . 12� . . . . . . . . . . .14� . . . . . . . . . . . 16�. . . . . . . . . . . 16�
City of Costa Mesa, California
Building Department
„'.. � ...-,•�_,_.; (ZEVl9ED NOK82
OWYERS NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _
JOB ADDRESS: ._ _ _ _ _ _ _ _ _ _ __ _ _ _
FERMIT NUMBER:_ _ _ _ _ _ _ _ _ _ _ _ _ _
SIGNATURE: _ _ _ _ _ _ _ _ _ _ _
�lOTE
ADDITIONS, DELETIONS, OR CORRECTIONS SHALL
BE APPROVED BY THE PLANNING DEPARTMENT
� AppR� .
a� �N`° "�D �
�ESA
.� �
-�T ��.
1 1 . � y�� �r R!a
�Yl/��,{�
�I.,R,»�"a pA � (�,
►�uav�8,
_,
�
��_�+r u;
�•�r��,ui ���f
:�� _..s,�
City of C Mcsa �Ut�G�ftg ept.
BY _ � ---•. ^ATE �o (0 19 �� �
TH'cSE FL 4NS P.ai1Si CF O�' JCH �T all TiMES An»Y.E �
NU CriANGES H'li'ttOUl Fi<lCP. l�PPkGVAL O'r D"PT •
THqISSUANCE GR GFANDi•:G O' C: Sh11! QP <%7iG`/:• O'
PlAP15 A�� SPCCI=1CAfIG:.S `uAIL N�): JG C O:JSTHUEU TC. 3E ' ,
PERMIT fOR. OR FN SPP70VRL O�. ANY \'IQ� 4110N CF A:,i C
THF PROVi510N5 •')F THi:, ::ODF..:JO PERMI7 PRES�MII:G T: C b. p
AUINORI'.Y TO \'ICini_� UH CnNCE! 'H6' i';OViS!Oh5 U' '!
CODESHAILdEVniID,E::f.fPI1N50F:RA57N:WC•R%i'�`� �OR INSPECTIONS
wNICH IT AUIHOHIZES IS lA'��i'Ui.
THE ISSUANCE OF A FcriM1T ,ASED UPO�� PLANS ':
SPECIFlCA?ICN$ SHAII NOi PfiEVEN( IHE B�ILD�NG C�'�` - �
FROM THERE::FIER REQUIlWG IME ::OPP.ECTION GF f.^F,: "' . �
$AID PiANS PND SPECIFlCATIGNS OF. FV,O�A D2c� °' •: !
BUIIDING OPERATIONS 9EWG CPFF'2L�� ON iHEREI�NGEit '/ �. 3
IN VIOLAiION OF THIS CCDE OR OF ::ri! CInE0. OFDINAI .� �' �
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RESID[NC[ R�EIG[MCE � qEe1DENC[
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_ STREET � _
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CALL
754-5626
or
754-5b27
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COSTA MESA BUILDING DEPARTMENT
P. O. BO% 3I]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
OWNER
MAIL
ADDRE55
cirv N2i�rF
ARCHITECT
OR ENGINEER
AODRE55
,� inute riac:n
COSTA MESA. CALIFORNIA
BeBCLL� C81. TNO. a'4
same ��o.
NO.
LEG�I ILOT 70
OESCRIPTION �.jQ, JV
A.P. NO.
SIZE irre
oF �or g
USE OF
E%ISTING BLOG
$$iQ0
- _•. , :6Lod
��h ✓ i�.,.
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�Il1;"�t^� D�P�
l'.'17 c'•" ��r,cr,: o:-c,
.�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
COSTA MESA. CALIFORNIA
FIRE
r���y ZONE
CO CITY LIC. ZGl l� �ONE I
NO.
S�e TEL. s8� BYPROVED
NO.
BLOCK TRACT 20�
no. or' e�oqs.
NOW ON L6{
6ETBPCN LINE Fl10M �/� n
CENTEF OF STFEET JV REAR YARD �+�
SIDE YARD RIGHT / LEFT 7
DESCRIPTION OF WORK
NEW � ALTERATION �Ij ADDITION
REPAIR � MOVING IIDEMOLISH
SiZELDING 1611 � �20 ROOMS 6 STORIES
EXTERIOR WALL ROOF
COVERING gtuCCO COVERING hO�I
BUEIDFNGEW Residence & att. garage
m _.,, i vn
CORRECTIONS
I NEREBY AC1t('IOWL[O4L Inwl i n�VC wCwV in a wrr�ia_n��Vrv wrvU
STPTE TNaT TME ABOVE IS CORRECT �rvO sGREE TO COMPLY WITH �LL PurpoSe o er� 8 is ing a permit fee only.
CITY OROININCES • STATE LAW$ REGVLATING BUILOING ONSTRUC-
T�o�. q VALUATION nn
SIGNATURE OF ���� t PERMiT FEE 5 �jS�W
PERMITTEE y5,967��� 1�� 50
PLAN CHECK S
5 n
AUTHORIZED A NT TOTAL FEE 5 S<�SO ���
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