HomeMy WebLinkAbout279 BROADWAY - Building Permits�
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Applicant to fili in all spaces except tnose witnin heavy Coraer lines ana si9n all aoo�ovriate Eaclarations.
CITY OF COSTA MEnSA� CON�nSaT�RUC`T_I,ON PERMIT PERMIT NO.. ._, , TRACT NO. LOT NO. UNIT NU.
Project Address Z��1 lJ��x—�.DyY��,/
Applicant's Ma�il�inj Addreu Z Sz ' T�
Owner'sName`n�N�EI�� I�IARQU�phone I B�
Address �—r1 M�' � C�3SiA ML�A� C/2[e�(,�
Arch/Eng: License No.
Address �.,C
Contracto N � '�'� I�i�-t� Phor �
Addreulmailingl�%�Z�UIi� -�'�, GM� �l�a�y
City License No. �(O�J'
LICENSED CONTRACTOfi DECIARATION
I hareby ailirm thdt I am Ilcensetl untler provlslon5 0l Chartor 9(comm0ncing
with section ]000) ot Divlsion 3 oi tne Business antl P�oleSsions Cotle, ^n�
my Ilcense Is in full {prco antl ettect. ��� _�
]ate(�1' �'= '+ _ Signature — �
WORKERS'COMPENSFTION DEC AR I N
I nereby ailirm lhat I have a certilit te of co �sent to sel -insure or a cerUfiWte
Of Wotke�s' Comp¢nsatiOn Inw�ance, o� a certlfietl copy the�eof (SectlOn
8 0 a ) �./
I � � ��1� ComPanY �JgL?V'
Certi(ietl moY �s hereby tumishetl.
rtife cf� ii file0 with thG city B�ui�ltlin9, Io � r
Datc ��Y�� Applican�)�i^���� ��
EXEMPTION FROM WORKERS' COMPENSqTION DECLARATION
(This zeclion neeC qot be completad if [he permit is for one M1untlretl (5300) or
less).
I certi/y thal In the pertormance of IhC work fot which [hIs perm�t is isiuetl I
shall not employ ¢ny pe�son 7n any manner so as ta Docome subject to the
Wo�ker5' COmpens9(lon Laws Ot Callfornia.
Daro Si9naturo
NOTICE: 11, after making thls tloclaration, you shoultl bacome subject to the
Workers' Compensxtion Provisions oi tne Labor Cotle, you mus[ fortnwith
comply wilh such p�ovisions ot 1h15 p¢rmit shall be tlCCmetl reyoke0.
CONSTRUCTION �ENDING AGENCV
1 hernby afiirm tha� �pere is a construction lenaing a9onty lor the pertormance
01 lh0 wotk ior which lhis parmll is issuetl (Seclion 309� ❑v. C.)
Lontler's Name
Lentler's Hdtlte55
OWNER BUILDEp DECLARATION
I hereby afflrm that I am ezampt lrom the Contractor's License t3w for the
following reason (5¢ction 7031.5 Business antl Professional Cotle: Any cify or
Counly whlch reqUireS a Oe�mit lo construct, alter, imProve, tlemolish or repair
any s[ructu�e, priOr to Iti iSSuance, also reqUireSlhe applitant for Sucn permit
to file a signetl ztdtement that he/She is licrnsatl pur5uant lo lha Provisions of
he ContractorR �icense Law (Chap[er 9(commencing wiN Sectlon ]000) of
Jivisian 3 0l tne Business antl Professions Cotle) or that �e/she is exempt
Iher¢IrOm antl lnp basis tor [he alleg¢tl exemption. Any violation ot $ection
]031.5 by any ¢pplicant to� a petmit Subjects the aoo���ant to a civil
�enalty oi no[ more [nan five huntlretl tlollars (5500).
I, as owne� of the property or my ertlploy¢es with wa9e5 a5 th¢i� zole
compcnsatlon, wiry tlo Ihe work, antl [he struc[u�e i5 nOl Intentletl o� off¢retl
for wle (Section 7044, Business antl Protessional Cotle: Tne Contractor'S
LlcenSe l.dw aoes �ot apo�Y to an owner ot a property vaho bulltls or improves
lhormn, antl whp tloes such work himself/hers¢If o� th�ough his or he� own
employeez, proviCetl that such improvnments are not intentlotl or otferetl tor
581C. It, however, the builtling or ImprovemEnt is Soltl wllnin ono year Of com-
p10UOn, the owne� will havc [ha burtlen of provin9 M1e/she tlItl no[ builq or im-
prove 10r Ihe pu�pos¢ ot salo).
❑ I, as owner of [he prooerty, am exclusivaly contractlng wlth Ilcensetl ton-
tldCtOR l0 COOSV4Ct Ih8 pfOjCCI 15CCti0l1 7064, BuSi0055 dntl ROf855i00S CO�O:
The ConVactor's License Law docs not apply Io an owne� ol pw0erty who
builtls or imD�ovQs theroon, antl who contracts for suth Orojocts witn a mn-
traclor(51 Ilcen58 pursuanl to tb8 ConVattor'S Llcen58 Ldw). I aT awdfe [bdt
prOal o( thnir Wptker'S COmponsaUon inSUran<0 shoultl be prOvitleO to ma.
❑ I am ex¢mpl untler SectiOn B. 6 P. C. lor thi5 reaion
Date Ownar _
I herCby ttrliiy that I have redG lhis
Informatlon is correce. I aaree lo como
Signature
Driverz' U<e 5
CMF 0865-46, rev. 30/84
TYPE OF CONSTRUCTION LJ NEW LJ AOD LJ ALTERATION LJ REOAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT IJ GRA�ING �J FOUNDAT�L1 57RUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5O. FT. oCCVPArvCv_
CONSTRUCTION TYPE VALUATION 5
ZONE GRADING CU. VDS. ACRES_
Remarks:
above �
nan<es
repr0-
b fo.
Sink
Preventer
I rrigation
Drinkin9 Fountains
Floor Orains
Floor Sinks
GasService Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspec[ion Fee � S15
Duct- UnderGround
Duct - Strucmral
Duct - Ventilating
Exhuust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
,H�e1_eting System & Ducting
pir700,000 BTU 0100,000BT'
��,�" I I Rainspettion Fee I S75
� � �—_
Whit¢ - Bulltling: Canary - Appllcan[; Plnk - Accounting; GOltlenrotl - Assesso�
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Hester
Wate� Service
Auto-Wash
Laundry Trays
laue Fee
Hoodor Typel ❑
Canopy Type I I ❑
fietrigeration System
Oaioo.000eTu ❑ioo,oao
Syscem Repair/Alteration
Fire Dampers
Registers
Issuo FeA�' S
A.P. #
S Main Building:
E
i Front
B Pear
A
C Right
g Left
Ping. Ref. qW
Planning Noces:
Accessory Bui
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction PoleSub. � SO+KW
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Bozes
Outlets
Switches
Garbage Disposal
Generator �0�5 KW �5-15 KW
Zone
Meter L1up to 700 amps
Merer ❑over100amps
Sub Panel
Mo[ors O0.1 HP Q t'/h - 8
InaSolar �9-15 HP �16-75+
Microwave
Pole light
Fiange
Sign
Standing Sections
Trnsh Compactor
5�Reinspection Fee 515 Issue Fee
FEES
�DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning ApProved By
Building Approved By
Applifation Issued By
S�
BUILDING PERMI7 5
PLAN CHECK $
PLUMBING S
PLAN CHECK 25% 5
ELECTRICAL S
PLAN CHECK 50% g
MECHANICAL `�
�?�1t "'�6 S�
SUMMAHV
Z
O
N
I
N
G
R
E
�
M
T
$
fEES
$ 3
ES
SMIP S
PERMIT
ISSUANCE $ �
ENERGV P.C. $
GRADING $
MICROFI�/�e��1
TOTAL FEE $
GANSTRUOTION AND PLANNING POOL & SPA
•��PPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
, 1
.1..Temporary�ElectricafService or Poie 52. Poo� & Equipment Location
2. Soil Pipe-l/ndrgrnd. 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."Foo[ings 58. Electrical Conduit-Undrgrnd.� ;
8.,�F.oundation 59. Gas Pipe, O Undrgrnd., Test�
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
1� Structural Floor System 61. APPROVAL TO DECK �'
7� . Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap 63. Heater & Vent-Final
�� 3. Roof Drains 64. Plumbing System - Final
n
74. Rough Plumbing 65. Electrical-Final
1�5. 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. POOUSPA 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. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �`'
33. Final Electric Notes:
34. Final'Heating & Air Conditioning 2�s' (fiv L�� ,�'
35. Final Gas Pipe-Test
36. Hood or Canopy
37,. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final . �
41. Solar pomestic-Final • .
42. Backflow Preventer .
43. Backflow Irrigation
44. Landscape Irrigation System
45. $ound Attenuation
46. Handirap Regulations
47. FINALSTRUCTURE&BUILDING ,
48. Special Requiremen[s Completed �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY
No. Date
. '
Pfl0.1ECTR01!pE38: z']9 BROADWAY
OWNEN' 91ME: WINN MARQ UET�
� s�ess: z'7g BROAISWAY
� �OSTA MESA
.71 A 92627
(714)646-6181
�NCNIENGINEEfl:
RODPESS:
d �
flE0.N0.:
UNIT:
b �c
�
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UNR:
PENMITTEE: MCARTHY ELECTRIC � ( 714 ) 241-1946
aooxess: 3100 SUMATRA PL �
COSTA MESA CA 92626
LICENSED CONTMCTOB OECLAMTION: I Aertby afiirm that I am Iice�aeU unGer pmvisians ot CAaO�e� 91�mmenUnA ��h Section
7000) of Division 3 of f�e Business and PrOfessians CoAe, antl"p license is in full brca and effecl. .
cinuc.:03568299sTnreuc.:461872 ( �ncuss: C—�1J0 � l
Date: ��� p � SignaNre: _���w�� g - �
WOPI(EBS' COMPENSRiION OECUMTION: I �eaUy attirm ttiat I Iwve a certifiwte ot rnnsent ro stlbinsure or a ce ifiwte af Workers'
Campensatian Insurance. ar a certi(ietl copy thereof (Section 3800, LaC. C�. '
POLICY NO.: El(P. O�TE:
COMPRNY:
❑ CertifieE wDY �s �ereby fumished. ❑ CeNiieO wDY � f�eO vnth t�e ury BuilEinp Division.
Date: ApPlicant:
IXEMFfION FlIOM WONI(EHS' COMPENSATION OECWUTON: jiltis sectim neeU not Ce canpete0 if Ue perrtN is ta one huMrM �E700) ar less).
I certiry t�at in the petlormance af the vrork for wNch t�is Derrttit' ue0,1 sha11 no� employ any persan in any manner sa as ro become
suble�� �o, J[he Workers' pCo�mpensation Laws of Calitomia. � � � (/'��
Date: '�/ — � D � � � 519natu2: • �,`L_--?r�6 .�-�I. -
NUTICE: If, atler maknA �his Ceclaration. ynu SAouIU hecame suhject to the Workers' Campensation proNs ns oi Ne La6or
Cotle, you must brt�with comply wit� SucA provisians or ihis Dermit shall be OeemeO revoked.
CONSTNUCTION LENOING �GENCY: I hereby affirm ihat t�ere is a conswction Ien4inB aAency tor t�e peAormance of t�e work for
whichthis Dermitis issue0 (Section 3097, CN. C).
LENOEN:
RUONE88:
OWNEq BURUEP OFCIAMTION: I AereEy aKrm that I am ezempt from t�e Contractors State License Law for the I011owinA �eason
(Section 7031.5 Busineu antl Pmlesslonal CaUe: My ciry ol counry whiU rryuims a Dermit to constmct, alter. impmve, tlemolish, or
repair any simcture, pnor to its issuance, also aquires t�e aDO��nt far suc� permii to file a sipneG statement t�at hUshe is IicenseA
pursuant to the OmNsians ol the Cantroctori State License Law (Chapter 9(crommendn0 ��� Section 7000) oi Divislon 3 of tha Business
antl Pmfessions Cotle) ar I�at hUs�a is eMemO� �herefrom antl ihe Oasis lar t�e alleAea exempiion. Any violation ol Section 7031.5 Oy
any appliwnt lor a De�mit su01e� t�e appliunt to a civil penalry oi not rtwre than 1Ne hundretl dollars (f500�.
I, u owner ot tna praperty or my employees with wa0es as �t�eir sale campensatlon, will tlo ihe work, and Ina
❑ stmcture is not intendetl or otlerz0 1or sale (Section 70a4, Business antl Pmlessional Cotla: T�e Contraclors' State License Law
dces not apDN �o an owner of a pmcehY � �uilGs or ImOrmes tAereon, anE wlro Oces suc� wod himsel�/herself ar ihroup�
Ais or her own emDloyees, D�o�detl t�at suc� impmvements are nat inlende0 or atlereE for sale. If, however tAe huilAinp ar
impmvement is mld wiihin one ywr ol mmpletlon, IM wmer will hava t�e EurCen ol pmvinp �Us�e diE not Euild or impmve
, lorthe Ourpose oi sale�. ,
I, as owner of ihe property am exclusively conVacGnp wii� IicenseE contraciors to wnstmct t�e pmlecl (Sectian 7044, Business
❑ enG Pmfessions CoOe: The Coniractors' SWte Licrosa Law Eces not apDN �o an mmer al properry wlw Em10s ar improves Ihereon
anE w�o contracis lor suc� pmlec6 wIN a cantracror(5) license pursuant to t�e Caniractars' State license Law). 1 am aware
t�at D��� of t�eir Warker's Compensatlon insuance sMu10 Ge pmhAed ta me. ,
� I am exempt unCer Section: B. 6 P. C.
lor Inis reawn:
Oate: Ownec
I Uo �ert6y cetliry t�at 1 am axare al antl un0erstanU the reQuiremen6 0l Califomu Health anA Satery COEe Sections 25505, 25533, an0
25534 anE t�at I or any luwre buit0ing occupant will/vnll not (cirGe one) neeA to comply wit� saitl state cotles an0 i�e requirements for a
permit for canstfuctbn or motlifiGtion fmm the Nr Uualiry Manapement Usirip. HPSidentlal tonSWttion applications are exempt Irom
Ihese pmvisions.
Date: Appticant _
I h¢r¢Ey tertity ihat I Aave r¢ad I�a applicaGon anC 5tate t�
ordinances antl stale lavrs relatinp to OuilNnp conswc6on ani
Dmp¢rry Ior in5pet0on Durpose5.
Date: -( � � ^ / � SiOnature: _
oriver's �icense or saia� securiry x:
mation is cortece I aqree to comply with all ciry ana counry
2pre5entalivesofthiscdyto enterupont�e a�ove-mentioned
1661�06 W�ite—BuilEing; Green—Cade Enlortemenl; Cenary—Applican�; Pinh—Fevanue; GolEenroE—Assessor
CITY OF COSTA�MESA — HUI,LDIN� PERMIT PERM NO: E 047022
PERMIT NO: E 047022 PLAN CHECK NO: 1 N GOVT:.N SUPP: N
CONSTRUCTION TYPE; S—N PERMIT TYPE: ELE �, PURPOSE: OTH
JOB DESCRIPTION : ELECTRICAL SERVICE CHANGE OUT' . SQ FT: '
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS:
**�rxx*x�r+r�r**�r�r*�rxx*�r�*�rxx�xx**�r*�r�*xx�rx�rx*�**x****+r*+r�r+r�r��*+r��r��r+r�e*�****+rx�**�r�x
Z O N I N G R E Q U I R E M E N T S
5 E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAA; FT ZN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT ZN
PARKING REQ• PROV: PARCEL: 11721218 ZNE: REF NO:
PLANNING NCSTES> ' •
. . . 7 . ' . � . . -
!f i! if !F it it iE iF if iE i! ik iE iE it it it 1t iF iE 1f 1F 1! iF it iF 1F iE if !f !f i! ik 1E it iE if 3E iE 1ElElf !f iF 1k fE iE iF ik it iF iF iElk iElE iF iE ik �k 1F if iF iF iE if iE if ik i! i! 1E %it it 1k �E iE iE
D E V E L O P M E N T S'E R V I C E S R E Q U I R E M E N T S
.
ZONING APPROVED BY DATE:
HUILDZNG APPKOVED HY : ' DATE:
APPLICATION ISSUED BY; DATE: #�{�����
ikifik�FiEffafjt�fi!ltfEkiliiilifikiElflF�! iEifiFlEiElFiFifikik iEif
ifiEifikififiEif�ffFiklEiEiF3tiEikiEiElfiflk�FifklFifit�tiFilitikikikif%itiEiElEikitif 1fiEiEifiFiFifiEiEltltiEitif%ifiEifiEiFifiE3fiFifiFiEiEiEKiEifiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 20.00
SOY SMIP/NON—RES
PLAN '
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 20.00 15.00 0.00 35.00 ; 35.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: . 35.00 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
35.00
if if if iF �f ik ik if �F dE if 1F �k iE if it if if if ik iklF �f if if if if iE if it k if ik 1! it 1E if if 1k if k!f !k 1E 1f iF iF if if !f 1E if iF iF i! 1f it k if if ik iE i!!k 1! k iF k �f ik if iF if �F 1E if fE iE if
I N D I V Z D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 RECEPT/ODTLET 1 ST 20 EA. .75
ELE 1 RECEPT/SWITCH 1 ST 20 EA. .75
ELE 1 SERVICES BELOW 600 V& BELOW 201 AMP 18.50
END OF FEES
.75
18,50
ui oaossvsa-aflasassa rE1r �1.�1�
DATE: �4/;3i4d TiI�E: i1:24
\
� CONSTRUCTION AND PLANNING POO� b SPA .
APPROVALS Permit # Date / Inspector AppROVALS Permit # Date Inspector
�
7.� �porary Elec[riral Service qr Pole 52. Pool & Equipment Location �
,
�`2. �I�P,ipe-Undrgmdl � : 53. Steel Reinforcement � .
- �'3^ Electrical Cond"uit�Utility-Undigrnd. . 54. Forms � �
- : �-," -
" 4SElectrical Conduit=Undrgrnd.' '� 55. Electrical Bonding �,'
rz'c5c$teel �ReinforcertSent' 56. Rough Plumbing & Pressur�4e,
-��nr -.�r-�
�;6;CEI�ectr cal UFER,_`Grnd. ' 57. APPROVAL TO COVER�GIINITE 0.'
•�;�7. Footings � �-`; �� 58. -Electrical Conduit�Undrgrnd. -
8. Foundation �� °' 59. Gas Pipe, O Undrgrnd., Test a
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structurel Floor System 61. APPROVAL TO DECK
11. Property Sewer Lirie�& House Connection 62. Backwash & Receptor-Final
12. Sc�er Cap :u o 63. Heater & Vent-Final
13. Robf Drains ., ,� 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical�Final
15. Rough Electrical-Conduit - 66. Solar System-Final
;
16. �Rough Electric N/iring 67. Fencing & Access ApProval
17. RougFi 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
n c • x� � �- -, t tr - �a ;+ � > . �-- . :n r, "
�; �. �' '� - �.�: 'Q.^- .ti V .: C^a . r. -yn17r - '7" -
20.-qRoUgh �actwy Fireplace s;� r.�,� ;; c.� a�: x�„APPROVA[5;;��Permit # ---
21;-Du�s, iz;Structu�e,*� �"" s� * n C �;* M�70. Onderg ou d Hydro ,
22.-Ducts. Ventlyati r"�` • `"'� � ' `' �. ' ' `�... �
a �?9•rc . . � � 7 �; i, �7� �:77. ProduchP.iping OGas O�OiI
23 �Gas Pipe-Rough & Test ?7� % 7 '::' 'Q Cx � ;72, Underground Flush+ '�
r. > rs' : fYr: �c C T c a: L �n v s
T o ' jr r.r �v .. (-. x; �. �� r' X x "' _ 1 ^. . _. y .
24`'Roof Framing � m ,� � ...r. � :73^Undergrnd.Storag�Tank OGas ❑Oil'
25.Ro"of Sheathing i �h � � 7? �L �� �qCOverhead Hydro;:�
n ,r -' �.. �- _�� T.. Q P � > > "' \ " y, � _ r: �: "
26�T�Bar Ceiling (Structural) &'Merwcoat T;,� `.r �.. 75sDry Chemical �-.,� �. ' m,� .�
27.iFrameand Flashinq� .�r� * � -z . 76. DryStan�pipe 'n " � �''» �
ti rn �. r• Y �:'t � r
:`26. Lathing & Siding * �' jxc; � .'y 5' "� ��� '�,,�. ;� 77 j FIXED $YSTEM;F��INAL _. - �� n
29. Insulation Y r, '• i� � �,i 78fFIRE PREV. FINF�;L Y� �:��� .
'`30. Drywall Nailing �� � � �� r t �H,EALTH�DEPT,. REQUIREMENT
i }i=,
J31. Plaster Brown Coat� =. � .T^' '� �� � �+ � *79. FINAL IN,SPECTION• - � �
_ � ._
':32TElectrica''I Po er Mete�FUnal *`'� � �`•iK ;� '80:rP00D CERTIFICATE ISSUED �
�33�Final Electrio- � -. ' S /] � - �� �NoYesa •-+^ :t i . ' V
./� iN /'� �^
'��34r.FinalHeating�&Aii°COnditionirig� r• �` I �' �� }� � •�� '•- C�]j ' S r'
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-�37�Fin�al Factory Fireplace ^ , �r'•[-. v �' � � ��%,�: �' : �' � i
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� 42. Backflow PreventerK � N * ^ � � * = `, � � •�
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43. Backflow Irr�gation� y.�` * r + x v a� i' ••�
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-51. CERTIFICATE OF�OCCUPANCY ' � '� `" � • ' `' '- ' '
No. Date
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PLUt
SWR.
MARQUET, W.D.
ROUGH HEATING ANO AIR CONOITIONING
TEMPORARV SERVICE OR POLE
UNOERGROUNP I-I POWEP n
FORMS I I STEEL REINF.
FLOOR SYS"
BON� BEAM
SHEATHING
FRAME ANO KLASHL
LATHING - IM n
PLASTER, BROwN G
STRIICTIIH>L. FINAI
IT., REFRIG. ANO A.C., FINAL
INAL AND GAS TEST I-I
LD
T
DATE 2-20-69
E
SUBCONTRACTOR
NG PERMIT NO.�
�r. l�t. to Gar.
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29773
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
6VILDING 'I � � Q' �C
ADDRESS �- �/
OWNER w 'N. M/r/�Q (�{E /
MAIL C�MR
ADDRESS �
CITY
CasT� �SA NOLGv6Gi�
CANSiRUCTION
IENDER
BRANCH
ADDRESS �—
ARCHITECT �� TEL.
Ofl ENGINEER N .
ADOFE55
CONTIiACTOR OwN��\� �J U1LPcI�
ADDRESS �— S/J M �
p TEL ��
CITV //M � NOF
STATE CITV
LIC. NO. LIC. NO.
512E NO.OF BLDGS.
OF LOT d NOW ON LOT
USE OF
EXISTING BLDG.
SI2E OF NO. OF
NEW BLDG. POOMS STORIES
EMERIOR WALL ROOF
COVERING COVEFING
USE OF BUILDING AND WOf1K YO BE PERFORMED
/ O x 1 � .Xn/�� �-o-o�+-> �.
fE6 21-69�p5A00 568 �**'' *�9.00
APPLICATION FOR BUILDING PERMIT
FECE�VjE BV DaT�E VED pp`qT'��SU�
� �% �
R I O
A.P. NO. '
BUILDING q.
ADDRESS �L
TRACT � LOT BL K
W ADD A P
/
OWNER
V LUE
SE 5
FIRE
ZONE TVPE GROqUP �+
APPROVED � � "1 �c ,� � �[q
) — NO.OF�
PIAN$
VARDS APPROV ED
MAIN BUILDING
ROM GL STREET)
VAR. �{'+
I hereby acknowletlge that 1 have reatl this aOPlication antl stare
that the above intormation is corfect antl agr¢n to comp�y with
all laws regulating builtlinB consirUction, and I shall not employ
any person in vlolation ot xhe workman's compensation laws of
ffie State of California. ��
I hereby certify 2hat I am properly licensed as a convactor untler SQ. FT.
the State oi California Business entl Professions Code, Divisicn 3, TME AMOUNT SH
Chapter 9, and that sac� licanses are in full forca entl eftect, ar I THE PURPOSE OF I
am e.empt from the provisions ot ihe State of Callfornia 8usiness VALUATION
antl Profezsions Code, Division 3, Chapter 9.
Sipne[ure of � pa i�/(� ///JJJ` . /1�
Permittee $ //j Ml�
Authorizetl Agent / � v
USE OF N Vt�'YL[P�GC'
BUIIDIN
VAR�S APPROVE
ACCESSORV BUILDING
BET. MAIN &
ACCESS. BL�GS.
DATE
APPROVED
m
0
JDER VAWATION IS FOR �
iHING A PERMIT FEE ONLV: m
¢
�^ N
AIT FEE 5 / �
m
v i
TOTAL FEE $ �