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HomeMy WebLinkAbout2021 CALVERT AVE - Building Permits r PflWECTADDRESS: 2021 CALVERT AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IB 066680 OWNER'S NAME: SHULMAN—BRUCE DEBORAH ADDRESS: 2021 CALVERT ST PERMIT NO: IB 066680 PLAN CHECK NO: N GOVT: N SUPP : Y COSTA MESA,CA 92626 • CONSTRUCTION TYPE: V—N PERMIT TYPE: OTH STR PURPOSE: ALT 979-1096 ARCH/ENGINEER: flEG.NO.: ADDRESS: UNIT: : SQ JOB DESCRIPTION T/OFF RESHT. REROOF W/FIBERGLASS SHINGLE FT: - CLAIM VALUE: 7, 200 .00 CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: ELLIS D R ROOFING (714 ) 759-5088 ADDRESS: 2012 PORT WEYBRIDGE COMMENTS: RENEWS EXPIRED PERMIT 859984 NEWPORT BEACH CA 92660 zt+r*********aEzk*zEakar**aL****z1**zk**N-*ac***zkzc*******+r*+r+tit***N-**zr-x*****arie*st**Ek********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect SETBACKS CITY LIC: STATE LIC.: 50494 ?�CpLASS: C39 ate:1(N/hfl Signature: ` ` ,&‘...___.— MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3804 Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING REQ: PROV: PARCEL: 13940419 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES> > • Date: Applicant. ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1170)or less). D E V E' L O P M E N T SERVICES R' EQUIREMEN 'T S 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 subie to h , kers'Compensation Laws of California. ZONING APPROVED BY : ppDATE: ;` te: - signature: NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY leDATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. C� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: -- DATE: �� / which this permit is issued(Section 3097,Civ.C). ***************************###******* ' ** ********************************* **** LENDER: ************************************** ' ************************************** ADDRESS: LEGALIZATION:N F E E SUMMARY , STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 30. 00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the BusinessPLS SMIP/NON—RES 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 penalty of not more than five hundred dollars(3500). ISSUL 1rE1di I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD I NC DIV ' PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 30 . 00 0 . 00 0 . 00 30 . 00 30 .00 • 00 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 30 .00 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 30 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon / and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *********************************.***.*.x.********. *. **.***.*.*.**.,**,**********,********* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: INS 1 BUILDING RE—INSPECTION FEE I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 30 . 00 3 0 0 0 END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit or construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant. I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned 01 00158393-00158393 TOT 30.00 property for i pe lion purposes. r.r L /� DATE: 04/05/94 TIME: 13.3D Date: N 'LN Signature: �/ "-------- Driver's License or Social Security a: 1641-46 Whim—Building:Green—Code Enforcement:Canary—Applicant,Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING ../OL & SPA e • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector • .1. Temporary Electrical Service dr Pole - 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement =-ai`Electrical Conduit Oiility-Undrgrnd. 54. Forms E.4 �Electrical Conduit.Uildrgrnd. 55. Electrical Bonding r.5;•Steel Reinforcem-eht-• 56. Rough Plumbing& Pressure Test ''6:'WjectricalUFER;Gnd. _ 57. APPROVAL TO COVER-GUNITE `� 7: Footings _ " - 58. Electrical Conduit•Undrgrnd. - 8 ;Foundation �' " - 59. Gas Pipe, 0 Undrgrnd.,Test }9: Water pipe-Undzgrnd. 'I 60. Backwash Lines,P-Trap, 0 Undrgrnd. • 10. Structural Floor System -• i 61. APPROVAL TO DECK 11:1 Property Sewer Line--& Hoare 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 Electric2`j-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricaf-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT y r - 20..Rough Factory Fireplace - - 3 o t^= t :APPROVALS 1.--<Permit 21.-0ucu, inStructurg' 0 „x :f- .-70. Wdergroundi'HYdro t 22. Ducts, Ventilating�r# :�_ - '- r. _ r�- • - r~ ,•71. Product:Piping ,�Gas 0:,Oii 23`Gas ipe-dough &"rest _ t ',72. Underground, Flush • �' 24. Root Framing. p- •. , -f • _ 73.? geT . 1t73. -Storaank 0Gas • Oil 25. Rodf'Shethhing . - -- '• -, ' , ; ,:c. 74.Overhead Hydro, „ 26. j-Bars Ceiling (Structtural) & Monocoat J _ 75'Dry Chemical + - t rn 27. Fram:.e and Flashin, • y m.. . 76.'-0ry StandPsfpe 2r ° _ a- :-4-1-: -: - i.28. Lathing &Siding' : ;: -. -• • ^+ r 77 t• FIXED SYSTEM'FINAL* 4.--1 •29. Insulation --' It" C - . "- f.+ .. 1 IA ,,, 78.=:FIRE PREY. FINAL x 30. Drywall NailingLHEALTH:OEPTIR•EQUIREMENT :31. Plaster Brown Coat ' ; i n•- i j FF < r79.' FINAL Ih1SP,ECTION j7-2 -' a 4. -;32.-Electrical Power Meter-Final ; _ I i 4 :80.`FOOD CER�TIFICAT�UED ^ m I l e � : .,33.'Final -'riL. > _ -„ w _ I, „ 47 .> y ,� ..-i,n -34. :F,ina7T Heating& Air,Conditionings I \,1. . t-T 35.tEinal`Gas Pipe'-Test 1\1 ^ c C. Cr: 0 36.TIoo 'or.CanopY _ ,r• . -. • C. I 4 }' . 1 fl''' `37. .Finai-Fact'ory Fireplace,.• i `;r :- Yrt I h' im y 38, Final,Plumbing j .. .. " x I I " ' 39. Water 5ervice-Final:: . i I i -k - . r' 'A,n' x T I Is r -- o t r '40. Gas Ser vice-Final , , II 6 - - ' .41. Solar Domestic-Final i'-; •• I I rt K i- '42. •Backflow=Preventer . '4; '' - I I, '. ;� t-.41 al �, -..r. 43. Backflow-Irrigation - - - - t '-. •J - . • .44. Landscape Ir`.igation System;o",t_ . , • ., -• C c: ,; cj :45. Sound Attenuation • 71 r... - •-,' - c' :F..< '- -746. Handicap,Regulations ° ••• 7 47. 'FINAL STRUCTURE & BUI,LDING '(_5t eil 6,,,,,....- ' a -,'i -- 48. F'IN&L PLANNING' ,.L I 49. .Elec$,ic Release to Edison �_ . i c :- -- , .- ,_ . I . \ ,5 - 50. Gas Release to Southern Califorrnia Gas Co :' ` - ` Ill51. CERTIFICATE OF OCCUPANCY ,; �., �� 'to ;r P - o _. No. Date I r JECT ADDRESS: 2021 CALVERT AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 059984 wxER;S�nME: SHULMAN—BRUCE . DEBORAH ADDRESS: 2021 CALVERT §T PERMIT NO: B 059984 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 :ONS,TRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH 979-1096 ARCH/ENGINEER: REG.NO.: OB DESCRIPTION T/OFF RESHT, REROOF W/FIBERGLASS SHINGLE SQ FT: 7, 200 ADDRESS: UNIT: LAIM VALUE: 7; 200, 00 CALC—VALUE: 7, 200. 00 GROUP OCC; R-3 / PERMITTEE: ELLIS D R ROOFING (714 • )759-5088 ADDRESS: 2012 PORT WEYBRIDGE OMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME NEWPORT BEACH CA 92660 ***iP�r Est*�rsr *�r***�E�E *>t *�Ex +EBF +PiE�E****�P�P�r** *+E****�e*irs6�r�r�rsr�r**** t �r************I ,: ENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with SectionZONI N GREQUIREMENTS - 0)of Divi(siioon 3oat the usiness and Professions Code.and my license is in hill force and effectS E T B A C K S YLIC (�:� /57 $TATELIC.:SO494C39 * e:Jl ' Signature:_ MAIN BUILDING ACCESSORY BUILDING ORKERS'COMPENSATION DECLARATION: I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN • 'ompensation Insurance,or a certified copy thereof(Section 3800, Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN . 'OLICY NO.: EXP.DATE: COMPANY: PARKING REQ' PROV: PARCEL: 13940419 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANN ING NOOTES> ' • >• Date: Applicant: ***************************************************************•**************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V 'E"L OPMENT SERVICES REQUIREMENTS I cemty 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 lie Wgkers'Compensation Laws of California. ZONING APPROVED- BY - DATE; ate: i''l fl--(({Itt t-- Signature: _ NOTICE:It.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - _A DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. I A� ]`!/ (`/ _—( �7 CONSTRUCTION LENDING AGENCY: hereby afrm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; '__ DATE• (, ( ` ( `_ • which this permit is issued(Section 3097.Civ.C). *********************3E*** iii!!! *********** .s,4 iFitititiFil3F******c*lk NBklE1FiE�FiEit*** 1tiF#iF* l�iE LENDER: ******************************************* '*********************************** ADDRESS; • LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y • OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ' ELECTRIC MECHANIC • FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 99 . 00 , 72 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed • - SMIP/NON—RES pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 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 PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE • I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ., DUE structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> .99, 72 0, 00 0 , 00 99 , 72 99 , 72 , 00 ' 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 employees,provided that such improvements are not intended or offered for sale. If,however the building or REVENUE -DIVISION TOTALS--> COLLECTED: 99. 72 72 OVER/SHORT: , 00 improvement is of sallee)hin one year pl completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusive) contracting with licensed contractors to construct the project(Section 7044,Business 9 9 . 00 72 "? ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' • and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ****•*************lt************3******************W******************{E***BP**{E*** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE -.BREAKDOWN J - - ❑ I am exempt under Section: B. 8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST •Date: Owner: • SFR 7200 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 • 7;200, 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and' END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a . . �' _. :Ti r„ permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • . these provisions. EXPIRED . Date: Applicant: InGomPldle Ills 'tt{OILS I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ; • ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned . Sig �___-'r property for coon purposes. �� a • - 1111 —� Date:I, t— Signature: Li Driver's License or Social Security e: • t .0 1641-46 While—Bmlding:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor - • 4 I ,OL & SPA I ., STRUCTION AND PLANNINIt Date Inspector Date Inspector ` APPROVALS Permit # APPROVALS Permit#_ f;. Temporary Electrical Service:•vr Pole . 52. Pool•& Equipment Location !3 Il Pipe-Undrgrnd. - - 53. Steel Reinforcement 1 :tR'fl . -.:3.c`El ctr,'xal Condi ility-Undrgrnd. . - 54. Forms -IC. El`ectrfcal Cond'uit•4'lddrgrnd. ' ' 55. Electrical Bonding' • n ax �(j * _ .•<S, el ,einforcePi@� - 56. Rough Plumbing & Pressure Test u: >tV Efectrical UFERiGtrld. 57. APPROVAL TO COVER-GUNITE err, ,z =r 4- - s .- _ F2.t-P, tings 03x `F'_' 58. Eiectrical Conduit-Undrgrnd. G; C `1 l I- nJ <8.rFz ; oundation r-,t ( , t 59. Gas Pipe, 0 Undrgrnd., Test -..--t --r r V rig. Water Pipe-Linggi{rd. \4 - Li 60.-Backwash Lines, P-Trap, 0 Undrgrnd. • 1t. Structural Floor System .1 / , 61. APPROVAL TO DECK rl 14. Property Sewer Ling,& HdOse'Connection 62. Backwash & Receptor-Final 12. S Iver Cap �. "+ ; ; 63. Heater & Vent-Final 1 .s 13. Roof Drains rn I 64. Plumbing System - Final o ' ( 1 14. Rough Plumbi Sg 1 65. Electrical-Final 15. Rough Electrical-Conduit I 66. Solar System-Final 16. Rough Electri&jviring- 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING C- 18. Rough Electril:1-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT • •- C 17 ' 7" -*• .7 -•C. =173 .o C,`7-a'E- 7Z x H tU 20pRoi0h gctqy Ff lace i ' 17,1, x4 * S "I 7.r* ?PPR9VA :i4":7-. er it# �*, >• v IU !--� 7 X 1 .......1'..a. x r- J .*. 4 )1. J i 4 .'r7 ?7 21: Durrts,iQStlg�cturex I •• •• HS x S O I-X * -70. bndergrofnd Hydro x 22.puGsfs, $ntrT�tirJx f CJS * S 6* * -171. Produci.P i�rg CT:as O`Oil 23't3as`'.�, ti ip4R h & est I ": ?. 7 r�+: Iv - :T. I I c17, * Cn oe� 1 CC r 7 Q0* * -t72. Underground Flt+slpcv x E-' :n 24013o5f F amirtg O* I r-E- -it,- x > O H* * 73°Undergrn Stor c. nk ID Gas OCytl - 25. Rod} Stilathing Els; < y •Y //� �• �jyx - 740@verhead Hydro_ ;: ' r----t- T-BFdr Ceiling (Stt3otural) &SAonocoat , Cf' t1/4;.3::. x 753-., y Chemical .73 .. .. rnx _1� x x Sb - x x1 27�Fra a and Flash. C.DXo: ar 7 - cc xr a 76: Pry Stan x�e ox S tq n I i - .....9 r-,.,,1:. u y,.> .l- 1--28. Latbin�& Sidings✓ -1¢x x z •• •• •?: x: 77� FIXED SSYSTEIIS. -INA cr r7Z:. ; _ -U. tuso lc 1.-1 n :"+ 'r 7 x CDFi •• •• > * M , X r x I ui 29. Insulation ' * x x 785 FIRE PREV. FINAL :5 > u: w 0 A S 3 ' -- '730. Drywall Naiting tttl* * c- - 'k x - HEEALTHrr'DEPT REQUIRAJVIENT X31. Plaster o ` * x x• 1 x cI P 2- '4.- .- P31. viva Cate S crit * a * r79:`FINAL IIgBECTI.QN x .; i-327Electrical PoevercMet&Final * to _,R ' '180tiFOOD CERTIF MATE ISSUED rr e• C.Lit n. x * X x et' I- cc 7.33KFir l El ctr�I k ,.ix rl 7 t Cr) 6 x --_ ." x '* 17 rri :x r. NqI�sC `-g * 1-1 Tx O t[ru (r . .u. ., :1;341Firtgi Hg3tin & >irDOEdltlOriQgCx VP.:x „ S (lm x S GG 16- er •-r __ rr •'n .-,-r. rr, +r. _ * 7 r X > U I r-i? -r: to C- 35MFirSal G Pie ^ -TTS u7 y * x * Cl 0 m" ?: =r SG I i .•+ . ... •• x H •••• ;C4 ^:-+ .% F--cc- r' 1, ,-"C . .z , , - ••CI tc36. Hood otrCanopyxx = 1 (r'•1 x ;1 i x + no * n .Q,r c? r -ix r P ' m x 1r * Irl CO * -rn rn _ �37`01Firi F 'tory Fi riOe•.t I z n x to * „! g x 1 h7 ~ - •J r J tl # .+. , .. .. "'a ., .V t * _ -E , S _ ,-+38. Final PUtmbing .: O. I s • .+ * S �-.1 : PIT O n it .t C ,--t t[ = •/+ X39. Wa4"er S4viceFinaR _ 1 ' o-' * -5 * na:tr7 `sc O " , u, 1 +r u > 0) S s wJ x,40. Gas Ser-v`ice-Kinal ,. tri r`toEr S * of * * Oa- t-cu .* -� t _^ t - .. . rsr L, iY xCr :'41. Solar Dome„'slt'c-FiriIS Cr •• :C5 x,, x lit 4.-- r- .iC ry • •-I >-I ., x ill x 3: * Er -1n l• CC. .". S S *: :_, !Xi '. :-J ' '" F' / 'c •1 ' 42. Backflow! Preventers .5 * j FEE RECEIVED 17909 OCT 1 1%2. COSTA MESA BUILDING-SAFETY DEPARTMENT YFINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF-COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT - BUILDING �J� A / y� /J/ BUILDING ADDRESS (/V id �" /L.-�E/�a T"^"E ww COSTA rMESA. �CALIFORNIA �'//� .-/�.�BE7ya. For Office Use Only /@lM�{1S'INJp ///TR�'/ /(/'G g iV .C7�/(�- '�I _/�vex - -_- I RECEIPT NO. I I I�.l IJV. MAIL E UED ADDRESS - 4 /,/ya/412:,c("Iy�t�et� �j� RECEI ,Bre/ ( 7 /RE ///�/// MrTr,/IR//B11i^��2 CITY 4---4 41n,4 NES.j (4'393-ADDRESS GCU27/// l ��oa6 ..'v'.vl - OR HITECT �/� Jr ,a �IC�EL. _ COSTA MESA. CALIFORNIA OR ENGINEER 441-h N [rN L - o ADDRESS /�V // w ,�(n a ZONE TYPE y GROUP lY �, CONTRACTOR Aeon 1441 1 APPROVED DATE ADDRESS /6 ;---3 Ails ,c bet ZONINGJ I CITY (/+� ,{ f 14 ZONE _l ( PLAO.NS L BUILDING E OF NEW/ �� STATE /gel /� NO. k, 4o 34f X ` • . LEGAL v./� LIC.NO. �f DESCRIPTION ) (�/C/ ��l" 7 SIZEF �L( X [ A ] I NO. OP SLOGS. /3 7— /0 — / 9 OF LOT CC�' {J--(�• NOW ON LOT A.P.NO. ESEOF ��-4 Jnent'er APPROVED ALLOWED YARDS EVES EXISTING BLDG. SETBACK LINE FROM / /� (,,J(CENTER LINE ST.) CENTER OF STREET ( REAR YARD 2(L FRONT /� FT. IN. SIDE YARD I LEFT 7 I RIGHT d R.SIDE FT. IN. DESCRIPTION OF. WORK L.SIDE S �_ FT. IN. X NEW I '\II ALTERATION I I ADDITION I REAR "c FT. �'� IN.N. REPAIR I I MOVING I DEMOLISH BBYPROVED _Gt.7/�Q�� DATE 2/ZLY/b 1• BUILDING NO. OF '` SIZE / �© ROOMS STORIES TTORIES CEXTVEEORRIIONRGW .-V`WAICOVVRING 5 1-64 k eU-OF BUI/LDiINGJ4D( ORK Br3t. _ g m . O/ 7loeivc 3 E /of QL0- iiiiinOQ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF. ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE OF,jAf [ ID PERMIT FEE $ Si bra PERMITTEF {/PSV J - • , /p1 fry u_ //,J/�f� /,I /� $ /S1 O./ PLAN CHECK $ D?S .S O 'w AUTHORIZED AGENT /'• 4 `4 �0 f x TOTAL FEE $ 7 6• `� O O n ' COSTA MESA BUILDING—SAFETY DEPARTMENT - 4.,Y —5-75P ` 00 130 *****5.00 P. 0. BOX 1200 Costa Mesa, California PERMIT NO. PLUMBING PERMIT APPLICATION TRACT NO. RECD. BY . 67229 CONTRACTOR %az //1 .45.//�/ e / LOT NO. DATE ISSUED Address 75L// ea !!(/ BUILDING USE �5— 7 /� �I�,,� � f� 77 p�z /req 7 /� 7 / City Qa,r• i f)C.(re VC. Tel. No.: 1/76 BUILDI s 2g L� ( .z/v� �&'e State License No. //(/ 98 Class. ce '/ COSTA MESA, CALIFORNIA /, [,/ NEAREST ww City License No. �V / CROSS ST. 4 I— OWNER co, A6 r trt7., IM N41 Q NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL /' �� Y 11yj '" Water Closet(Toilet) I• ADDRESS / +�/. ti �r// ,f'7A J Bath Tub CITY ✓/ �` tom+. TEL. NO.g o O�.6Z- Q Shower I hereby ackuowledgel that I have read this application Lavatory(Wash Basin) and state,tlfat thelabove is correct and agree to comply ? Kitchen Sink with. al14 City Ordinances -and State Laws regulating CCLaundry Tub or Tray plumbing., ' w service Sink -11 I certify that I possess the above valid state of Cali- o_ forma classification or I am the legal owner the resi- O Floor Sink -esis ` %'dential property described above. 2 Floor Drain -47 C\i fY /1 r d \�`�r Signature of e Dishwasher t �l Permittee Z Drinking Fountain '.f Ld' Gabage Disposal ,.F . k INSPECTION RECORD Automatic WashingAM'ach. X. ' HWater Su ftenerk it, g .i' �r 2 1 Water lleetei&`Vent ,�[q QQ WReceptor.-) ' _ r a.. Swrn1`Bo`ol Filter System IL Gas System . . . Outlets D Lawn Sprinklers O Installation or Alteration N Water Pining APPROVALS Back Flow Preventer N Prop. Sewer ft INSPECTOR DATE iHouse Sewer Connection U/G Soil t" Cesspool, Septic Tank U/G Water Services—Water ❑ Gas 0 Miscellaneous - Rough Plumbing Sprinkler System Gas Property Sewer Pool Receptor Filter System Pool Heater y Miscellaneous I uing Permit 'X on _ I TOTAL FEE 1-da-1151R— Final Gas Plumbing Final L 0 SF_1 ^) [7�f Utility Co. Notified If p FORM OU-24 'Or raS BLDG. PERMIT NO.