HomeMy WebLinkAbout481 BROADWAY - Building Permits�
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PPOJECT ADOPE55: Q� 1 B ROADWAY
OWNEH'SNAME: TURNER RICHARD E
AOOHESS: 481 E �R�k�j°)a�(
COSTA MESA,CA
646-1837
APCH/ENGINEEF:
AOOPESS:
_ ^` UNIT:
(i i i
92627 ,
flEG.NO.:
UNIT:
PENMITTEE: A—AMES PLUMBING & HEATING (714)530-2440
nooness: 10922 TRASK AVENUE
GARDEN GROVE CA 92 2
LICENSED CONTpACTOR OELLAPATION: I �ereby allirm Ihal I am lic ea unaer t r 9 �commencinp witn Sec�ion
7000) ol Orv�sion 3 of the Business anA Pm� ssions Cade. and m ense i' ul rce el�eci.
ciTruc.:0066 S T � 25030�"' �^ 6
Date: � SiBnat . _ _ —
WOPNEBS'�COMP NSA IOND TION: Iher aAirmihall eace ificaie nitoself-insur enificateoiWorkers'
Gompensa�ion Insuran[e. or a ceri �ie0 co0 ��e�eof �Seclion 3800. La .
aoucvNo.: PC941094,9�3 EXP.DATE: O3/OS/99
corneaxv: REPUBLIC
❑ Cehi�copy is AereOy lu nis e� .� CertilieE coDY is ' tl with the [iry n,
�/
Uaie: � Applicani: -
E%EMPTION:BOMWOBNEflS'fAMPENSNT10N0ECUBATIO. (TN55edionnee0n10ecomp ilUepermali5lorme�unUre4�5100�or1e55).
I wrtily Ihai in Ihe pedormance o� the wark far whic� t�is permit is issued, I sAall not em0�oy any person in any manner so as �o become
I Subleci Io Ihe Workers' Compensaiion Laws o� Califomia.
Oale: $iB�aWre:
NOTICE: II, after making t�is declaraiion, you shoulG Eecome sublect �o t�e WarkeK Compensa�ion prwi5ion5 0� Ihe Labof
Coae. you must lonnwtin mm0ly with such v�a'/�sions or Inis permit snall oe deemetl revokeC.
LONSTPUCTION 1EN01NG ACENCY: I hereby allirm t�a� ihere is a ton5�mtiion IenGing aOenCy lOf Ihe periormante Of Ihe wOrk �or
which Ihis permil is i55vea (S¢tlion 3W7. Ci¢ C�.
IENOEfl:
AO�NESS:
OWNEH BWLOEB OECIABATION: I �ereby allirm t�at I am eeempt Irom �he Coniracior5' Siate �icense Law �or ihe fallowing reason
(Secuon 703t.5 Business anA Professional CoOe: Any city ol county which requirts a permit to constmct, alter, im0�ove, tlemalish, or
ieoair any stmctme. v�ior io its issuance, also repuires �he a0olicant lor sucn permit to file a sipne0 statement Itut nelshe is Iicense0
pursuam io �he provisions ol the Comracmrs' Sta�e License Law (Chapter 9(commencinA wi�h Section 7000� of Divivon 3 of lhe Business
anA Pmlessions Cotle) or tha� �e/she is ecem0� lh¢relrom and itle Oasis lor Ihe allegeE exem0�ion. Any violation ol Seciian 7031.5 hy
any ap0lican� �or a permil suble«s t�e aDPlicanl to a civil penaliy ol noi more Ihan five hunAreO dollars (b500).
I, as owner of Ihe pmpetly or my emplayees wit� waAes as their sole com0ensa�ion, will tlo l�e work, antl �he
❑ stmcWre is not imenGeO or oifered for sale (Sec�ion 7044, Business anC Professional Code: The Coniractors' S�ate License Law
, tloes not appty to an owner ol a pmperty who Cuilds or impmves I�ereon, and who does such work himself/herself or Ihmugh
' his or �er own employees. provide0 tlrat suc� improvemenis are not intentleE or oifereA for sale. If, however t�e �uiltling or
�. impwvemenl is wle vninin one year ol completion, ihe owner will haue the Euraen ol pmving Ae/sAe tliA not Ouiltl or improve
' for @e purpose ol sale�.
I. as owner of tne pmDeny, am exclusively comractinp wit� licensetl comracmrs m consimcl lhe pmlect (Section 70aa, Business
❑ antl Pmtes5im5 CoOe: i�e Contracbrs' S�ate License Law tloes no� aOGly to an owner ot OmPeRy w�o bwlEs or impmues Ihereon
ana w�o contrazts lor such pmlems wi�� a comracmr(s) license pursuant to �he Comractors' Stale License Law). I am aware
thal pmo� ol Iheir WaBer's Compensalion insurance 5houlU be pmviaetl to me.
� I am exempt unaer Seclion'. 8. 8 P. C.
lor Ihis reason:
�aie: M+neC
I do �e�eoy cetlity I�al I am awaie ol an� untlerstantl t�e reQuiremen�s ol Calilomia Healih anC Salety Cotle Sectians 25505. 25539, anE
2553<antl t�at I or any tuture �uilGing occupant wiltlwill not (ci¢le one) need to comply vnlh saiG stale cotles ana ihe requiamenls lor a
Oermil lor conslmdion oi modificalion Imm �he Air �uali�y Manapemen� Oistric�. fleSiUeniial wnSUuction appliwlions are exempi �mm
iAese o�ovisions.
�ate: Applicam:
1 �ere�y cetlify Ihal I have read Ihis applica�ion antl state ��at Ihe above information is wrrecL 1 aglee to camply with ali city antl counry
or0inance5antlslatelawsrela�inglo�uildin conSUuciionan0herebyautoriierepresenlativesof�hiscy�oenieruponitlea�ove-mentionetl
D�operty torinspeciian Durposes. /
Daie. _ Signalure:
���
Dmer's uce�se or 5ociai Secur �: �
t64t�a6 W�ne—BuilEing; Green—Code EniorcemenL Canary—ApplicanC Pink—Revenue; GOltlenro0—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: M 066104 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE; MEC
JOB DESCRIPTION ; CHANGE OUT FAU
CLAIM t'ALUE: CALC—VALUE:
PERM NO; M 066104
GOVT; N SUPP: N
PURPOSE: OTH
SQ FT:
GROIIP OCC: R-3 /
COMMENTS: WATER CHANGE OUT ONLY
*+t+�*�r�r**�t-+�+rx�*#�r*�r***+r�r+t�r+t****�x�r**�r�t�r�r-x-�r�-*�r�r��e�**�x��r�r*�r�r*�r-**�r*�r�r���-*�*�-�t-�#*�r�-***
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV: PARCEL: 11733117 2NE: REF NO:
PLANNING N TES>
i
iE iF it if it iE if iE iE if if iE iF i! if if it 1t iE if iE iE it iE it it if it it iE i! M if it 1E iE �fE iE iF'k iE iE iE if iF iE iE if iE iE if rt iE iF 1f if iE iElf ik 3E fE?E iF 3E if iF if!h it %it it iE iE iE 1f jf iE
D E V E L O P M E N T S E A V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ,
DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: �l�ll� ��_
*****+t***�r*�r�r*�t�x-**x�i�+�**x�*�+t�r+�*+�**��iE"�r�'t��r**+r+.�i.'itTE*'�*�r e'i **x�*x-*x�*****x���*******�
it 4 iE 1t iE if 3E iF ie iE iE i! aE if i(� it 1f if if if iE if iE if it #'k iE if iE ik iE iE iE if i!� it iE iE ik iE'k if iE iE iE jE iE fh ii iE ff iE if it 1E if iE M if iE i(� iF if if it if iE if iE ic� iF iE iE it iE iE i!� iF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLIIMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9,00
25� SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15.00 0.00 24,00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 29,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CHECK
24,0�
if iF iE iE �E if iP if iE iE 1E if if it it k 1! if iE %jt it ik iF iE if if ff 1E iE iE iF it ff i! iE iE iE it iE if iE it i! ik i! if it 1f iE 1E iE if iF if iF 1E iE iE if if 1E iE if k if if 1t iE iE �E if iE iE fE af if rt if
I N D I V I n 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
MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9,00 9.00
END OF FEES
01 001,5598-001u�598 T C�T
OATE� 02/17/94 TI%E= 11:22
24.OD
CONSTRUCTION AND PLANNING POOL & SPA
APPROVAIS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Elea�ical Service or Poie 52. Pool & Equipmen[ Locauon
2. Soil Pipe�Undrgr�d. 53. Steel Reinforcernent
3. Elecvlcat Condutt Utllity�Undrgrnd. 54. Forms
4. Electrical Condu�t-Undrgrrtd. � 55. Electrical 9onding
5. Steel Reinforcement 56. Rough Piumb�ng & Pressur< Tes. �
6. E'ectncal UFER Cirnd. 57. APPROVAL TO COVER�GUNITE
7. Footings . 58. Efectrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, 17 Untlrgmd., Test ;
9. 4"Jater Pipe-Und�g�nd. 66. Backwash Lines, P�Trap, C', Undrgrr.d. �
10. St�uctural Floo� Svsiem 61. APPROVAL TO DECK
77. Property Sewer Une & HouseConnection � 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent�Finai
�13. Roof Drains ' 64. Plumbing System � Final
14. Rough Plumbing 65. Electricai�Finat
15. Rough Electrical�Condurt 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Apuroval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrica6T Bar Ceilin9 69. POOUSPA SYS7E61S FINAL �
79. flough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Under9round Hydro
22. Ducts, Ventilating 71. Product Piping G' Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Underyrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro i
26. T-Bar Ceiling (Structuraq & AAonocoa: 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. Electncal Power Meter�F�nai 80. FOOD CERTIFICATE IS5UED
33. Finai Elec.ric Notes: �
34. Final Heating & A�� Conditioning �G� - j / _ �� ., /,
'Z_ rc ,_L - ``C':i '.i.�//l� n�%/ �✓....
35. Finai Gas Pipe•Test
36. Hood or Canopy
37. Final Factory Fireplace . (
38. Final Plumbing 1
39. Water Service�Final
40. Gas Service-Final
47. Solar pomestic-Final .
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDiNG
48. FINAL PIANNING
49. Electrie Refease to Edison
50. Gas Release to Southern California Gas Ca
51. CEF;TiFICATE OF OCCUPANCY
No. Date
�
AOOP650GBNLWIC: q 8 S BROADWAY '
°w'�"s"""E"'°�'": TURNER RICHARD E
"DOfl� 481 E �ROADWAY
COSTA MESA,CA 92627
646-1837
�vx. ��iuxo �ooneu:
APCXRECT Ofl E1MdlFFA:
RCIi OP EHG.'S dWNE55:
coxm�crarsw•�.
cam�croxs�uiwo
�nox[ss:
u"' CZTY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 086222
g PERMIT NO; B 086222 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTFI
"�ND JOB DESCRIPTZON ; T/O SHEATH 6 REROOF W/COMP SFIINGLES SQ FT: 5,800
UNf:
CLAIM VALUE: 5,800.00 CRLC-VALUE: 5,800.00 GROUP OCC: R-3 /
n;a�:.�n
uxr:
110EN5ED CONfPeCTOHS DECLANATON: I hareby ellim uMx pe�aly W peejury Ihel I em Ismad urMm >oAMam of GMqx 9
�oomme��o »nn s«i� �0001 a o�w� a d ine a��.. �d r�a...�,. coa.. �e mr �� s m mu io� �a enea.
cm uc. Ho.: uc. cuss: uc. No.: EXP :
ome: co�mwo.:
OWNER BUILDEP UEGLAFATION: I haeby alfirm uMx pmely d perjury thal I am uamq fmn ihe Caniraaae l'xxua law lor tlw
IdbwwO ienaon (Sapion )W 1.5 &piaaa ud Prdemia'u Coda: MY cIY rc couNY xfiich nQu"vee e D�! to canalncl. eker.'unCan.
demdYh. a repei ury at�ucluro. p'v b io hwierca. el+o repuime the epplim� la euc� pe�mE lo fla a epewd eteiemem Nm he a aM
n lironaed W�� �o IM povivima d Ne Conlredaa Licame lew �Chepr 9(oommencnp vrilh Setlion ]000) d D"vuion � ol tN
Buaimu vd Rdeaoro Codsl a thet M«�he u exemp iMrehan eiM �M Mm I« Ne albpad uanqion. anY vidmion d Seenn
�/0'�1.5 �' dl% 9DP�� �IX 9�10fIM WqY.lf ��IB B�CBI1� �O 8 OVa pB118��Y C� 1101 TOI� ��1BII �N! �1YIId1td ��BIB �$$L�%p.
� I.s�ownerWlMMWa�Y«myamWvM^evAhwaW+es�MieobmmG��.vriIlCoNewak.eedtMevunununalinteMeE
«ofleraEa..w (sec�ia, )a.. emna. ene arofesaon. coa.: Tn. cw�.ca.lxen..ler me. nd eowv �a ��'^^«d o�wm
wln buid� a mpo�*s Iherean. W Wn doea sud� wark IimseX or henN a Waqh he or hm own employeu. pvrideA thet wch
impwanew ere nd intended a WxeU for eeb. tl. however. the Wiltlinp a inpwemeM u eotl xi�hin we Y� a�dbbn. the
�owo«�wue� wi na�a me w� a wW��a ne « db ed �a w�n a�po.�. i« ma wmo.� a.�1.
1. m ownx d iM V W�Y. em utluwM' aoniracteq wah 4anaeJ conuazmn m mMrutl Ne pM� (Sequn ]OM. &ninm� eM
araen�m. coee: rne cwnreaa. u�.ox �.. doe. �w acWr �o en ox�w d wwero •�no wam « Mwa.. inm.a, ene wno
convecu br wtli prqeea w'vh e mNredor�c) IcenaeE puc�enl to Ihe Ganirepan Liwma lew).
� I em ezemp uda Sxtbn: 8. 8 P.C.. M Nia eumn: ��
od.: / 2 �`7 %-1 o�,a ��Ct i.�=-=—�
I Ao Mroby cMEy Uw I em eware d W uMenleM �M reWiremmb N Cellomu /beEh enE Sdery Cods Sadiau 25505.255]�. enA
Y5530. eM Net I a enY �ure buikvq ompent will / wil ml (drcb one) need ro comply wih eeid mte ooEn aM �hs 1epuirememe br
e oe�m� lorewuvuction a modAcmionhanlMAiawTryl.ru�qpmeM Dielrid. Reeidsuiel mrM�utlian eGDk'�iwu ua exemq Imm tMn
Dme: MM�:
WOHKER'S COMPENSATION OECLARATION: I hxsby effirm under per�Nry d perjury ons d Ne ttlbwinp Mtle'etiom:
� � nme.�d.0 m�men a ronaiwe d ooneeo� io..n:�.,n �« waha: oomv«wwo... a� �o. w swion a�ao a m. �.n«
coae. ia m. v�o�� a n�..,� r« w�n inv v.� w w�.d.
❑ � neve ana.d meimen won`a.� wmv�� ��.z.. a+�.a��a M swion a)ao a un lan« coa. rw in. w�«meza a �n.
wak la wtiidi ihb pe�mM1 ia iaueE. MY'^'a�' �^W^�a^ Inwrarce wriu end pd'vry'wmEx era:
c�.:
Palcy Number:
�Th'v aedion mM rid 6e ttmvMfM ] rM 0>'mt u mr ms nwroea Edlen Riool n bn J
❑ � oenN u,m in �n. o��c. a �ne .mn ta, wnicn �M. o�n u:suea. �.ne�� na «roM �n w� � anv merv�e. n m m
Decvnie wEjse lo IM xorkxe' mnpenee�io� ler.+ tl CelAomu. enE epras Yw il I ahauN Decmn whjae to �M v.Wen'
comDen�elan pvneiom d Satlian �)00 d �he lebar Code. I ehell iathx'vh wmW wM iMu Vm+f�iam.
D4e: MO�N
W�minp: HYun h ucun woArwi rompxuetlon toverap� 4 unlewlN, uM �IWI am/aef en mrp/oysr ro cNMrW pwn�Mu en!-
dvll flnu �q b aro h,ndnd NouuM OVIMn /JIPqPOVA M edd/tlon ro N� awf ol rompru��bR ��p+ u provWeG br In
9�ctlon �)O6 0l M� Lebor CoO�, Inrw4 ��0 albmryi I�u.
CONSTtiUCiION LENDINO A4ENC1: I hwaby alfirm uMer penelry d pmjury �he� tMn b a cmpiudbn bd'vq epency br Ne
pxlormencs d IM wak Iw whiM Ihe De�i ia aeueE (Saqcn 309]. CN. C).
LENDEF'S NMIE:
LENOEH'S ADDHESS:
I ceniry �Mt I Nce nad ihia eppliwion uk ens thel Ne ebova iMametion u coneC.l qiae iocanpy Mn� M tlry erd cauMy adirorcm
end ewe levn rNmfq io builAvp canmueian eM hereby euFwrrss npraeemeura d tAe aly lo enls upon IM ebow�mwuiard propeM
��`��°"`��°�'D�"`AICAARD TURNER
(� �
\� � s� i .. � �—_ _� Dme:
�ipnm d rllpenU�ppimn✓Cmtreaor \
(5151d8.W�) Whils&ntlM6SelelY:4�aemFJe:CenW-AGV�'eN:Rnk-Revenue:OaNm�o�Reessv
COMMENTS; REROOF 2000SF AESIDENCE W/COMP SMOKE DETECTRS RE�UIRED PER 94UBC..,_
r***�t***�r�r�r�t**r*�+r+tx��t�r�tit�rit�t�t�tx�*�t�t+tf��t�t�t�titftx�ft�t�r�t***+t*�titititatit�tF� , �t.�t�t+t+t+t �t�fE�j �!*�t
Z O N I N G A E Q U I R E M E N"Ti`SSi�l�� _��� •�..'Lp d'�
S E T H A C K S �iE- '
` �������..
------------ MAIN BUILDZNG ---------- --------- ACCESSOR
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING AEQ • - PROV: PARCEL; 11733117 ZNE: AEF NO:
PLANNING NdTES>� �
�•.
�('*'***�'***�'*'�'******�'*�'�'�'**�'*�'**�'********'�*�'***�'*�'*'*�'**�{'*�{'*�{'�'�***'****�'�'*'�{'�'*�'�'**'�'*
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
i
ZONING APPROVED'BY DATE: �
HUILDING APPROVED BY : DATE: '
APPLICATION ISSUED BY: DATE: C2- 1'l� �
�r*+t*****��e****�e*��*�ex��e ********+r+r �r
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL'SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 112.25 58
SMIP/NON-AES
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 112.83 0.00 0.00 112,83 112.83 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 112.83 OVER/SHORT: .00
BLDG PM�lT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOTp GRADING PLAN-CHECK
112.L5 .SU
1FMiFIFMk1E1FiE1FiEikifKififiFififMiFMKMKKIF1FIfiFikMK1F1EM1FMikMlFikMMM3F1F1FiFiFlFkiF%MiEifiFMlfikifMKiFiFifi('iFaFMklFikiEiFffKM
I N D I V I D U A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 5800 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 5,800.00
END OF FEES
12-17-1937/�73:1� P�I/iii@.o.i
k�DT9:31-Ca17�31
PERI'7IT: F,8E222
s
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit �h Date Inspecior pppROVALS Permit # Date Inspector
1. TemOorary Electrical Service or Pole 52. Pooi & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
�_.�.
r G �
PJ-^3;,,�lectrical Conduit Utiiity-Undrgrnd. 54. Porms �
� ^[�4c7'qectrical ConduibUndrgrnd. 55. Electrical Bonding
:�.�eQl Reinforcement 56. Rough Plumbing & Pressure Test
�-6i;.@Iectrical UFER Grnd. 57. APPROVAI. TO COVER•GUNITE ']
,�_
L`T-,{.'Ppotings 58. Electrical Conduit•Undrgmd. 5
-.. �
:$� Foundation 59. Gas Pipe, O Undrgrnd., Test �
'`9. Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Structural Floor SYstem 61. APPROVAL TO DECK
: 11.�Properry Sewer Line & House Connection 62. Backwash & ReceptorFinal
12. 5�ewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final
74. flough Plumbing � 65. Electrical-Final
15. Rflugh Electriwl-Cqndui[ .. 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
16. Rough Electrical-T Bar Ceiling 69. POOVSPA SYSTEMS FINAL
19.,RoughHeatir���&AiFConditionjng� �; n ,� y�; �, y{���FpT:REQUIFTEMENT .�
� �T1 `7.^J :O A n v
20. �Rougr FaCto��? Fiteplace i st-' "� � 5 � �'a � qpp{}OV�A�C-'Sy-^ Permit # " �' -'
s' �: �-. � T. S 7� i--! - '-1 x i S-' t s�i. j-
21. ;I�uR�, in;$trJctur�f� �� �� S�, v� �;..� r#. 70.;11ndergrouod hrydro rr
22..�ucCs': Ve,ntilafingJ�� . .T". * V S.� [-+'� F 77. Prod �� i inc,�.�as �]Oil �
'- �PP
23. Gas F-jpe�Fiou� B�Ten ��,,,;. C� *"'• � d; S��'., �, 72. Undergr�d fy.is ,� * j. o
24. Roof Framing �a � t+7 a� � : -' �--+� • 7� Undergrhd.Sto?#y4�7anKOGas OOii
l� r' ^ '1 R1 � S J�-1 V '�-IL4 RI -K
25. �oo��hesething �h � /� � �'� �, �x 74:..O�erhead Hydr3-. ,'�e
26. �-Bar'Cei�ing (Struciural) & ��Loat = O r = �• 7g pry ChemiCal ;�� * T � '
.� -� Y' - .r �-
� 27. f�rameartB FI'aihir�,�'� H�i;� 7, � T ?' �� 76. Dry Sta�ipipef� Y p N�
• 28. Lathing &�Siding �n�� 7m � p x` � c 77i FIXED�BY�TEM�FINA�L�" �
29. Insulatic(� � . j* S �� �' A S � 'x 7{i FIRE PREV. F}I�ipL *'\ � �
30. Drywall Nailing -��• •-� �:- � j '� S tiH£ALT.RI DERT. RE�UIREMENT
n n�
. 37. Plaster B�w oa�." y ��'�T, K ' � �,� ' 79. FINAL �EC�DN �� H.;�
� 32. Flectriptrpower M1Jt�ter`�Final i y f+ � ^� � 80� FOOD CERT�F�CATE t6SUEF3�
33. �ina�El�tric� ir �� ' r,., � k� I ' 'r (�,�tes: ,Q ��.'.,? �` y C H�
i
34.'.inal.,lie04ing� A'*,r�Co�ditionin`g' �.; i�. ; ,� � .. .' i-.v, ic �r�V
!l C' - T "� .'�1
35. �Final Ga's�ipe-Teff �' �J� " `�'J ` h� " ^o o� x. i-.T
^ � .F /' Is7 • r * [T:
� 36. Moo�or'Cano � ` ' m � �" R " ' `' •
- - Pv r.�rt :� 'F:tr �� K I r ` :n �cc x m, -:n
r.
� 37. PinaYfactory FirG�pl cG„�" � �"�"' " '� � ��' � h _C3
. . � /� � • J .Y �/ {�` � T � .�
( '-1 i'
"- 38. Fin�:Plu�bing r* .. . � ,� � � � . �; •--x .
y 39. Water Secilice?FinaY+ E ' N «'� Fy �? #'� �
' 40. Gas Servi -Fitjal'�x` � `, :•;' � .': ; , � '' '
�F :� s c,� �, _, t�; v � i • � i A C
41. Solar pomen7mFinek 'r � � *^ "w _ * � -
x ir 1: ^ � I ,i .i
42. Backflow Preventec� � ''` ' `;�.-, � ' ^
� QNH fi �-� 1: .T. ["
43. Backflow Irriqation'� "a,7 a. � * • � r .� `'
�
�ikd. ;l�andscap8 IrPfQati�i System�`'� �.j � � r Z s;. , g � � %ii; �� � � V
�45. �ound Attenuati6dt '� •• •• tn '� T! ^ t • -7 y'
.- � <- w i r�� -•.. :
4'6. Hand�cap'Regulatf�d�s `-" �, ': • - •' `� „
: �� � ! � T �=ti.0
�7. FINA�L STRUCTURE & BUILD�TG L�Q� ! ;� _ y k
48. E;INk�L PIANNIhI�' .`"" s~� I � r• r' .
;, , � � r_ .. � � ¢
,. �
q9. Electuc @elease to=Edison t ! I <� •�� �
,- ,� ' - .e o
i Y: F� .-� '. . J;"i7 n ^J �_
'S0. �Gas �Rele'a�e to Souttjem Califofi}Gas Co F x . � � � ,�
51. CERTIFICATE OF CCUPANCY ' �� " -
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until Ihis verification is received.
O
�
4.
I personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. ❑ Yes ❑ No
I(have/have not) _
proposed work.
I have contracted with
Name —� e.�
Address
Phone ( )
signed an application for a building permit for the
person (firm) to provide the proposed construction:
c�cy
Contractor's Lic. No..
I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name _
Address
Phone (
City
Contractor's Lic. No. _
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name
Address
Phone Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State
oi California Health and Safety Code and have completed the above information to the best of my per-
sonal knowledge, in c�lian�e w� this S` t�w. �
C1
Signed: \`Y � _ (�_o � �. Date: /�.- � � %
Name: �y�'�(,�� I� � �C � �F(1
(Printed or Typed)
c.o.�. � o� s.s. a
754-5273
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION
Permit No. 1�" b 2- 2- Z—
Property Address W$ � 4'�Qe7� \.(.� �,/
owner 1Zl (' l.I:.AR-1� �' .`YC� 1����-- -- � Ll_�'Al W � L� �(./ �T.
contractor � �� n.�✓l c_t �► e�L
State Contractor License Number
Classification
I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform
Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of
the manufacturer.
[� I further certi(y that I am the owner of the property. (Owner-Builder permittee only).
❑ I further certity that I am:
[t]� Owner of sole proprietorship company
❑ Fuli partner of the company
❑ Limited partner of the company
❑ Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this
certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
Received by Building Division
By:
. \ � � 1 � l l � �
Initial Date
0990-46 MW95� N/�ite-BuiltlingDiv.;Cenary-ConVaIXorPink-Oxner
Company or Corporate Name
Atldrass
��
� �, SignaWr�° `�'b Date
Printetl or Typed Name
NIXON. Arthur &
JOB ADDRESS
A ONTRAC
AP. o. LOT
GROUP I
INSPECTIONS
Trenches Forms
Ploor System
Stecl Rcinforce (
Bond Beam
Framc and Plashing
Lathing, In Out
Plaster. browa coat
Ocmer�uilder
TRACT 11SIt FIRE ZONE
TYPE
DATE
DATE
DESCRIPTION OF WORK
PLAN NO.
SUBCONTRACTOR I .DATE
NUMBER
�
.
. �
60'75
COSTA MESA BUILDING DEPARTMENT
P.O. BO% 31�
C65TA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING � QJ / i. _ � _ _�.� . _
���-vnii+ � . �-r.urvni.�n
OWNERV(/I�(/W��� � /`��'Y'
MAIL �G 1 ��P
ADDRE55 O /
�l�% � TEL.
CITY -, -- v� NO.
ARCHITECT —T LIC.
OR ENGINEER NO.
AODRE55
ADDRE55 a �
LEGwL LOT
DESCRIPTION NO,
A.P. NO. � _
SIZE ��'
OF LOT
i / IBLOCK �T7RAC
� � _""� � /
K / � � NO.OF BL�GS.
t'IOw ON LOT
0
L
E%ISTING BLOG. •"�""��'� ' �.�
SETB.�CK LINE FROM �� /f
CENTER OF STREET � REAR VARD� A
- � Y
SIDE VARD qIGHT S�� LEFT S
DESCRIPTION OF WORK .
NEW ALTERATION AODITION
fEEPAIR MOVING DEMOLISH
SIZE DING D X �,J ROOMS STORIES �
EXTERIOR WALL� �� ROOF ,y�s�
COVERING /'7 COVERING
USE OF NEW /'�_ T/ � %i �_ j ��
BUILDING i � ��/� IU }-��---�Il�^�- -
%l' ' - - l.C.�el�� � t'o !� a.u1�+_r
�'.�� e�C���l��
rr-,�--5�
FIP�!ii�!CE DEPT. �� �
CIIY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
PECEIPT NO. PERMIT NO.
�O 5c1�
RECErvED BV DATE RECEIVED OPTf ISSUEO
COSTA MESA. CALIFORNIA
FIFE
20NE
BY OATE
CORRECTIONS
TA MESA
i�3
✓'/
I)
/ O
STATE TNPT TME �90VE IS CONRECT ANO tGREE TO COMPLY WITM 4LL
CITY OROIN>NCE$ FND $T4TE L�WS REGVLRTING BUIIOING CONSTRVC�
T�O�. \ VALUATION D
SIGNATURE OF ��.[/L PERMIT FEE 5 YJ /
PERMITTEE
�t�/ PLAN CHECK $
$ /O �/ —
AUTHORIZED AGENT
TOTAL FEE $ �j? — �°iMi