HomeMy WebLinkAbout198 BUOY ST - Building Permitsr�� ._�i. � -
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� CITY OF COSTA MESA �
B!/ILDING DIV/SION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856
PERMIT TYPE
APN: 42619308
Zoning: ,
FOR INSPECTIONS CALL: (714) 754•5626
PERMIT NUMBER:
B_MISC STATUS:
DATE ISSUED:
ISSUED BY:
wv+w. ci.wsta-mesa.ca. us
VBX08-00163
ISSUED
05/28/2008
RMD
JOB ADDRESS: 198 BUOY ST CM .. ' ' �= � � � " :Suite/Unit:
Viciniry: KITCHEN ENTRY Primary Occ �; -� ;� � Const Type :??
SQ. FT: 0 . Valuation .S1 20000,�„� -
J �Arr + r
SCOPE OF WORK: '''t,e s " �'``
REPLACE REAR ENTRY DOOR Al'.KITCHEM(REPLACE FRAMING)�FOR A SFD� "�"�
OWNER:
City/State:
Phone:
APPLICANT:
City/State:
Phone:
Address:
City/State:
Zip Code:
ARCHITECT:
Phone'
ENGINEER:
Phone
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RENFRO, CARRIE,A TR Address:: 198 BUOY ST ,�i;
COSTA MESA CA .-� �'` �:'� Zip Code: 92627 2103 �;
949-646-8223 .c�F � { .
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STEVEN-JANOSIK �: ' Address: CDL D6923436 _' + 14 n",`
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'14349-2182 �;F+,.'
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_ DOW REPCACEMENT�SPECIALISTS � License'No pi�523043 ;'.
17032 MURPHY:AVE ' z .' �; - _ '� � � " , -
IRVINE CA i� a --,. . .:..;�:_-..�. . _ '.' . :'
92617 - -;:!� � -- ` . .. .:--.. ..----Phone.-:' 714-259=5120 �� -_�:� -Cell:
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s: FEESUMMARY ��! i,
Building PIan�Check ` '` $29'�:15 � � ,� ;!.'�
Building Permd �''w ' x `�` $44`85 �
Electncal Permit:' ti � $Oi00 � '
SMIP Residential `� • �`} ' r� :,.� � ,$0.50 . ,��"t�,�
� �SMIP Commercial `` ;+�„,� s �:."�- - .$0.00 -�''�` ' ::'
TOTALFEES � �r., $74.50 �f��,�
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Unit
Unit
Unit:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) � � . � . �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. �
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable' wdes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
CODE /. INSPECTION TYPE
7616 Fized System Final Fire Prevention
1268 Pool Spa Final �
200 Final Re-Roof '
207 Pinal BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
DAIE INTITULS
CODER INSGEL710NTVPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site �
250 Final Builtlincy0ccupancy P/il_
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WORKERS' COMPEN$A710N DECLARATION:�
I hereby affirm under penalry of perjury one of [he owing declarations: '
❑ I have antl will maintain a certificate of wnsent to self-Insure for workers'
compensation, as provided for by seclion 3700 of the Labor Code, for the �
pertormance ot the vrork for which this permit is issued.
� I have and will maintain workers' compensation insurance, as required by
sectbn 3700 of the Labor Cotle, for the peAormance of the v,�rk for which this
pertnit is issued. My'workers" compensation Insurance carner and policy
number are: �
:.carrier �E:�`�KILS'E-� �
(This secfbn need rrol Ce comdete0 � Ihe pe�mA is valuetl al one hunOretl Nllars (St00) orless )
PolicyNumber.�� �������
❑ I certify that in the pertortnance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as lo become subject
to ihe workers' compensation laws of Califomia, and agree that if I should
become subject to the workers' compensation provisions ot Seclion 3700 of
the La or Cotle, I shall forthwith compl with these provisions.
_ S.2B-�8
Ap iwm SignaWre Dale
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000). 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 full force and effect.
Lic. #. - - - � class # � p
.� 2� IOrJ
ntra lor'sSignalure Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a constructbn lending agency for the
pedortnance of the work ta which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Atldress:
OWNER-BUILDERDECLARATIONS: � -
I hereby aKrtn ihat under penalry of perjury that I am EXEMPT FROM 7NE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Pro/essions Cotle: Any city or county which requires a permit to
constNct, alter, improve, demolish, or repair any shucture, prior to its
issuance, also requires the applicant for such permit to fle a signed statement
that he or she is licensetl pursuant ro the provisions of the Contrecrors
License Law (ChaDter 9(commencinq with Section 7000) of Division 3 of the
Business and Protessions Code) or that he or she is exempt therefrom and
the basis for the allege0 exemption. Any violation of Sec[ion 7031.5 by any
applicant for a permit subjecls the applicant lo a civil penalty of not more ihan
five hundretl dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and ihe structure is not intended or
oRered for sale (Sea 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
theieon, antl who does such vrork himself or herself or through his or her own
employees, provided that such improvemenls are not intended or offered for
sale. If, however, Ihe building or improvemenl is sold within one year oi
completion, the owner-builder will have the burden o( proving that he or she
did not build or improve for purpose ot sale.). � - '
❑ I, as owner of the property, am EXCLUSIVELY-CON7RACTING WI7H
LICENSED CONTRACTORS to construct the projecf(Sec. 7044, Business and
Professions Code: The contractws License Law dces not apply to an owner of
property who builds or improves thereon, and who cont2cts for such project with
a cont2ctor(s) license pursuant to lhe Cont2ctor5 License Lavrs.).
❑ I am exempt under sec.
Business and Professions Code for ihis reason:
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Da�e
Owner ID verifetl by driv, ise. ❑ Yes ❑�No e
Driver's License No. Expires:
Verification ot Ownership by (rype of document, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATIONi �� .
❑ I hereby certdy that no excavation (rve (5) or more feet in depth',into which a
person is required to descend, will be made in connectbn with vrork authorized
by this permit, and that no builtling structure, scafidding, talsevrork, or demolition
or dismantling thereof, will be more ihan ihirty-siz (36) feet high. (Chap. 3.2, Grp
2. Art 2, Sec. 341, Title B, Calitomia Adminisl2tive Code).
❑ As owner-builder. I will not employ anyone to do vrork which woultl
require a pertnit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
ApOhcanl's Signalure Dale
Division of Induslrial Safety Permi[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neetl to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safely Code requires, with some
excep[ions, Ihal a Business Plan be filetl wilh the Costa Mesa Fire
Department by every business which has at any ona time dunng a reported
year a quantity of hazardous matenals equal to or greater than a weight of
500 pountls, or a volume of 55 gallons. or 200 cubic feet of compressed gas
al slandard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to fle
a registration fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Heallh and Safety Code, wi[h some
exceptions, requires registration with the Costa Mesa Fire Department by
each business whic� al any one time has on hand a quantiry of acutely
hazardous materials equal lo or greater than a weight of 500 pountls, 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 (or acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides ihat the
Costa Mesa Fire Departmem may require the preparalion, certification and
fling with the Fire Department of an RMPP by businesses which are required
to register awtely hazartlous materials with the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of [he California
Health and Safety Code been fully wmplied with? ❑ Yes � No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of [his application a permit for such conslruction
or motlifcalion from [he South Coast Air Quality Management District or from
any olher air pollution conlrol tlislrict or agency't ❑ Ves ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requesled
infortnation be fumished on applications for non-residential building pertnits).
6. Will any part of the facility to be constructed under this permit be vrilhin
1000 feet (rom the outer boundanes of a school? ❑ Ves ❑ No
Qf'yes", the facility must meet the requirement of Sections 25534 antl 42303
of ihe California Health and Safety Code).
7. If a permit from tha South Coast Air Quality Management District or other
air pollution control district or agency is requiretl for the vrork which is Iha
subjecl ot this application, have all of the disclosures prescribetl by California
Heal[h and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air pollution
control oKcer). , . . ��
CER7IFICATE OF COMPLIANCE: I certify;that under penalty of peryury the
information given above is correcL I agree to comply with all state laws and
city ordinances regarding Hazardous Matenals antl�Emissions. • �
SignaWre ' . Dale ,
CERTIFICATE OF COMPLIANCE-AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read Ihis application and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the Cily of Costa Mesa to enter upon the above-describetl property for
inspection purposes. I agree not to occupy or allow occupancy o! any building
authorized by this permit until final inspection.
SiB at eatLepal 5) (/, Dale�p
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� la AulhonzeE ppli m � Dale
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Window And Door Rep(acement
1 All Windowa Muat Meet IBC Sect 2406 For Safety Glazing.
The Following Locations Require Safety Glazing,
Tempered or Laminated, To Be Etched Marked
A. Glass In Dows
B. GI2es Ir LNir.dowe Within 29' Ot Coa .famb &< 6C' Hi^yh
Q Glass WiNin 5' Ot Pod Oe Spa Watws Edge
D. Glass A1 Shower, 8athtu6 Or Stair Landing � 60' Of Floor
2 All ConsWction Shall Comply With The 2007 CBC
( Califomia Building Cale ) �
All Windows Are Rated With 20Ibs. Of Wind Load
All Windows Musf Meet IBC SecL 1203 For Light (.08)
And Ventilation (.04)
All Windows Meet 2D05 Energy Code :
U- Fac[or = 0.67 Or Less .
S.H.G.C. = 0.40 Or Less
3 Smoke Alatms ln All Bedrooms
4 Egress -
NI Bedrooms Must Have At Least One Window Or poor
Opening Directly To The Exterior Meeting This Criteria:
Mia Clear Width = 20' Min. Clear Height = 24'
Min. Area = 5.7 Sq. FL ( 5A Sq. FL Grade Floor Residential )
Max. Sill HL = dd"
5 French Doors • Outswing Doors
Doors That Swing Outward Must Open Over A landiag That ls
Not �tore Than 1' Lower Than The Intenor Finished Floor Level.
7he Exfenor Landinq Must Be As Wide As The Door(s) Md
Extend Out A Minimum Of 3 Feet
APPROVED ANDERSEN INSERT. WINDOW
AND�PSEN PATIG� DOOR DETAIL
n+aNuxnaear n,+EnnaknNe
STULCO F�ASI'IING TUCKfO UP
BEtiIND WqTFR M2�ABRAtJE
AAIWIMWNOF �'
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twm rrxr to
ACCEPT PIWSHING 1RIM
PND2RSEti INSCR7 WINOOW
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Renewal � •��'' �
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W7ndow Replaceme�t Speela/isfs
- BUOY ST
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Name CARRIE RENFRO Dial One WRS
Adress � 98 BUOY ST. 1621 E. St. Mdrew Place
Ciry, Zip COSTA MESA, 92626 Santa Ma, 92705
Phone 949-6468223 7142535210
Drawn By: Steve Janosik
ALL NEW WINDOWS HAVE OtJAC GL4ZE, LOW E4 HP G(ASS UNLESS OTHERWISE N07E0
J�B:19825 ja
LEGEND:
XX SLIDER, SLIDER
XO SIIDER, FIXED
GW GARDEN WINDOW
CST CASEMENT
PiX PICTURE WINDOW
AWN AWNING WINDOW
DH DOUBLEHUNG
SH SINGLE HUNG
RBA RenewalByMdeisen
PD PATIO DOOR SLIDER
SCOPE of WORK:
REPLACE KITCHEN REAR ENTRY DOOR WITH NEW STEEL CLAD DOOR WITH TEMPERED GLASS
INSERT.
NO OPENING MODIFICATIONS
NO HEADER CHNAGES
1
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Pfl0.1EC7 AOUHESS: 1 9 Pi $ UOY S T
OWNEfl'S NFME: CAIVNINGf� SALiY M
AOOHESS:19S B[�Qy 'JrT
� COSTA MESA,CA
(714)646—A?.23
ABCHIENGINEEP:
AOONESS:
UNIT:
92627
flEG.NO.:
uxir:
� PEflMITTEE:CONSUMER SERVIC:ES {714)754-1533
� nooAess: 1260 LOGAN AV A-3
COSTA MESA CA 92626
LILENSEO CONTHPCTON OECLABATION: I hereby aHirm Ihat I am licensetl unaer pmvisions oi Chapter 9(commencing with Seciion
7000� of Oivision 9 oflhe Business antl Pmlessions CoOe. antl my license is in fullforce ana eflect.
ciTruc.:049683 sraTEuc.:42434///9 1 cu�ss:C,39
oa�e: _3�`1�� 3 SignaiUre:�
WOflNEHS' COMPENSRTION OECIAPAiION: I hereby a�hr a� I have a certili e ol conSenl �o seli-insure or a certifica�e ol Workers'
Compensalion Insurance, or a certilied copy �hereof ($eclion 3800. Lab. C).
POLICY NO.: EXP. DFTE:
COMPNNY:
� Cerlilied capy is �ereby �umis�etl. ❑ Cetlilied copY is �iletl wilA �he ci�y BuilOing Oivisian.
Date'. Applicant'.
E%EMPTION FBOM WOflMEflS' LOMPENSATION OEClAPP710N: (This section neea not Oe campletetl if t�e permit is lor one hundretl (310�) or less�.
I cetlify Ihat in I�e peAormance oi I�e wark lor which t�is permit is is5ue0. I shall not em0loy any person in any manner so as to Oecome
sublet� Io Ihe Workers' Campensation Laws of Califomia.
�a�e'.3 � SignaWre:
NO CE: I�. after making Ihis tleclara�ion, you ShoWa be m su�lect Io �he WOBers' mpensation Dmvisions of ��e Labor
Cotle. you mus� foMwilh compty wilh such promsions or is permil shall be deemeU evoketl.
CONSTBUCTION LENOING pGENCY: I Aereby aifirm IAai Ihere is a constmction lentling a ency for ��e pertormance o� ihe work for
which I�is permii is issuetl (Section 3097. Civ. C).
LENUEfl:
FDUHE55:
OWNEfl BUILOEfl OELLAflRTION: I hereUy aliirm Ihal I am exempt imm Ihe Coniracmrs' Staie License Law for Ihe following reason
(Seclion 7031.5 BuSlnesS ane Pwlessional Code: Nny ciry oi counry whic� requires a permi� �o cons�mcl, aller, impmve. Eemoli5h, or
r¢pair any slmc�ure, priar lo ils issuanCe, alm requires Ihe apPlicant lor such permit to tile a Signed Slaiemen� Ihat he/She is litensed
pursuanl Io ihe pmvisions oi t�e Comractors' State License Law (ChaD�er 9 �commencing with Section 7000) oi Oivisian 3 oi Ihe Business
ana Pmlessions CoDe) or Ihai he/she is exempl lherelrom and Ihe basis �or the alleged exempiion. Any violaiion oi Sec�ion 7031.5 by
any apDlicanifor a permit sublects Ihe apDlicant to a civil penalry o� noi more (han �ive Aundre0 Jollars (E500�.
I, as owner ol @e DroDeny or my employees with wages as iheir sole compensation, will Oo ihe work, antl ihe
❑ s�mcmre is noi imenAeO or offere0 for sale (Section 7044, Busmess antl Pmiessional CoOe�. The Comractors State License Law
does no� apply to an owner o� a pmpe�y who builtls or improves �hereon, antl who does such woB himself/hersell or �hrough
his or �er own emplayees, pmvided �ha� such improvemenis are no� inlentleU or o�feretl for sale. I�, however Ihe huilding or
improvemen� is soltl wit�in one year of complelion, �he owner will have the bur0en o� proving he/she ditl no� builtl or impmve
' br ihe purpose oi sale).
I, as ownerot Ihe Ompeny. am evclusively conirac�ing wilh licensetl contractors �o consimct ihe pmlect (Section 7044, Business
❑ antl Pm�essions Code: The Conlraciors' S�a�e License Law Ooes no� appty to an owner o� pmpetly who �utl�s or impmves �hereon
and who cantrac�s �ar such pmlecis wiih a conVacior(s) license pursuan� lo �he Coniractors' Sta�e License Law). I am aware
Ihat prooi oi Iheir Worker's Compensation insurance shoultl be pmvided to me.
� I am exempt unaer Section: B. 8 P. C.
lor I�is reason'.
oa�e ow�ec
I tla hereby certify ��ai I am aware o� antl undersland the repuirements ol Calilomia Heal�� and Safety Code Sec�ians 25505, 25533, and
25534 ane ��at I or any future building occupant will/will no� (circle one� neetl �o comply wilh saitl s�a�e cotles antl �he �eQuiremen�s for a
permil lor conslmction or motli�ica�ion Imm Ihe Air Ouali�y Managemenl DisVict. FesfOen�ial cons�mction aDPlications are exempt tmm
IhQSC pfOVI5i0115.
Date'. Applicam:
I �ereby cetlily �ha� I have reatl Ihis aDPlicalion ane s�ale Ihal the above iniormation is correcl. I agree lo camply with all city and counry
or0inance5 antl Slale laws relaiing to �uiltling consimction an0 hereby aNhorize representative5 0l Ihis ciry ro enler upon the above-men�ionetl
pmper�y lar inspeciian purposes. �
Oate: �/K�� 3 Signamre:
oriver's License or Social Seariry x:
I6at G6 W�ile—Bmlding; Green—Cotle Entorcement; Canary—Applsant;
Goitlenmtl—Assessor
CITY OF COSTA MESA — HUILDING PERMI'f PERM NU; B 061263
PERMIT NO; B 061263 PLAN CHECK NO; N GOVT: N SCiPP; N
CONSTRUCTION TYPE; 5—N PERMST TYPE; STR PURPGSE; ALT
JOH DESCRIPTION ; T/O, RESHEATH W/1/2" CDX S REROOF W/COMP SQ FT; 5,300
CLAIM VALliE: 5,300,00 CALC—VALUE; 5,300,00 GROiiP OCC: R-3 /M-1
COMMENTS; SMOK DETEC PER SEC 1210 '91 UBC
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Z O N I N G R E Q U I R E N, E N T S
sErsacxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAk; FT IN FkNT; FT IN REAf1; 'r'T IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARRING RE - PkOV; PARCEL; 4261930R ZNE; REF NO;
PLANNING N 'I'ES>
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D E V E I, 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; "
V.
BUILDING APPROVED BY : DATE;
U
APPLICATION ISSIIED HY: DATE•,���
3Ei4iEiEiFiEitlEiEl4itiE1fiE3E3FiEitit3kit3E � i e'fe ��r t - r � e t �.� i � � i43Fit��7E-1f�7f�%3E3Ei6 #iE
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LEGALIZATION;N F E E S U M M R Y STRUCTURAL SEGMENT;Y
� , �
BLDG PMT PLUN,BZNG ELECTRI,C.: MECHANIC fiIRE SMIP/RcS GRP.DING
PERMIT 81,00 �.,'i; SMSP/hiON—RES
PLAN "%
ISSUE FEE " '
BUILDING—DIV—> PERMIT ISSUE PLAN,—,CHBCK TOTAL PAID DUE
TOTALS----> 81.53 0,00 ' 0,00 81.53 81,53 .00
REVENUE DIVISION TOTALS--> COLLECTED;; 81.53 OVER/SHORT; ,00
BLDG PMT PLUMBING E:LECTkIC MECF3ANIC FIRE SMIP/TOT GRADING PLAN—CHECFC
81.00 �''. ,;, � .53
iE jE iE 3F if iE 3E iE iF 1f iE �1f iE �lF it if if� lE K 3f �1E 3F 1h iE if-%�)t 1E 1F ih 3E iF �E iE'if iE iE iE iF �F;IE iE IF iE 3F iF K� iE 3f iE )f jF If iE if' )f 3E i4 #%� iEif 3f 3E ih iE iE # K� if !k �7f 1f if -1f il� �E 3t iE
I N D I V I 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
SFR 5300 kEROOF BY VALUE RE.`S,iDENTIAL NOZONE 1,00 5,300.00
,END OF,:FEES
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CO'��TRUCTION AND PLANNING
APPROVALS Permit#
1, Temporary Electrical Service or Pole
2. Soii Pipe-Undrgrnd. '
3. ElecVical Conduit Utility�Undrgrnd.
4. Electrical Conduit-Undrgmd.
5. Steel Reinforcement
6. Eiectrical UFER Grnd.
7. Footings
8. Foundation `
9. Water Pipe�Undrgrnd.
10. Structural Floor System
11. Property Sewer Line & House Connection
12. Sewe� Cap
13. Roof Drains
14. flo�gh Piumbinq � .
15. Rough ElectricabConduit
16. Rough Electric Wiring �
17. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rou9h Heating & Air Conditioning
20. Rough Factory Fir�P!ace
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21�•Ducts, in Structure
22. Oucts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structurall & Monocoat
27. Frame a�d Fiashing
28. Lathing & Siding' .
29. Insulation
30. Orywail Nailing
31. Piaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Finai Heating & Ait Conditioning
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 �rtipation System
45.-Sound Attenuation
46. Ha�dicap Regulations
47. FINALSTRUCTURE&BUILDING ��
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE 0� OCCUPANCY
Jo. � __ Date .
Date I Inspector
�
�
�
POOCiLSPA
AAPROVALS Permit # Date Inspector
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas PiPe, O Undrgmd., Test
6Q. Backwash Lines, P-Trap,� Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System : Final
65. Electrical-Finai •
66. Solar System-Finai
67. Fenciny & ACcess Approval
68. APPROVED FOR PLASTERING
69. POOLISPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
� 71 . Product Pipinc� O Gas � Oil
72. Under9round Flush
73. Undergrnd. Storage Tank C� Gas ❑ Oi!
74.� Overhead Hydro
75. Dry Chemical .
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. F�NAL INSPECTION
80. FOOD CERTIFtCATE ISSUED
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OWNER �rrF�wnnn Fnz�FST nFv_ I� `G
JOBADDRESS 198 Buoy�Street I� BUILDINGPERMITNO. #LL(�(O
GENERAL CONTRACTOR j,1CI0 CORS'tT'llCtlOrl VALUE $ ZZ�3OII.00
�OT 1 BLOCK TRACT ,31OC) R65. W�3tt, �az'.
GROUP I& J TVPE V ZONE RI1 FIRE DISTRICT l�573
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
Trench
ion Forms and Grade to
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Plasterinq
FixturesComnleteYY,G�i I_<=/6-S
Plumbing,Fin,alGasTest/S" (�YIESI5=�6'yi
Wiring, Final �A� ]. �l��957�i�'
Occupancy � � � Id =l6-5"7
FOflM 210 3M IO�iS
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COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31]
COSTA MESA. CALIFORNIA �
FOR APPLICANT TO FILL IN
ADDRE55 /7 X I..J UUV " Si
COSTA MESA. CALIFORNIA
OWNER,_J cicU� aa r E
MAIL
ADDRE55 � ���,n, (I
TEL.
CITY N " �/ NO.
ARCHITECT A e� � �t/ LIC.
OR ENGINEER �� �
ADORE55 / � y yy �77 � r
i . . /1 . . . CITY LIC.
LEGAL LOT
oeSCeiPnorv NO. BLOCK ' TRACI
A.P. NO.
SIZE `' � � NO. OF BLOGS.
OF LOT T NOW ON LOT
USE OF �
EXISTI4G BLDG.
SETBPCK LINE FROM /' �
CENTER OF STHEEi ^� � REAR YARD�
SIDE YARD RIGHT LEFT �
� DESCRIPTION OF WORK
NEW ✓ qLTEFATION ADDITION
REPAIR MOVING DEMOLISF
BUILDING/ NO.OF
SIZE ' ROOMS STORIF
E%TERIORWALLWDOV �'
COVERING �i'IUGCLi COV�ERINGLEpf1'R
BUELDFNGEW (/(//'�I. II,G '�
1
STATE TXAT TXE A�OVI
CITY OROIN/NCES ANO
TI ON.
SIGNATURE O� v
PERMITTEE�T
AUTHORIZED AGENT
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TO COMPLT�WITH ALL
BVI///LUING CONSTRVC�
�� 1 A
FEE RECEIVED
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FINnANCE DEPT.
APPL`Tf:ATI�NT'F�F7"PERM IT
BUILDING
FOR OFFICE USE ONLY
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZONE ^ I
�,�
APPROVED
CORRECTIONS
E'$ '� -: L1 `, g..s y �.. .�.-
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1 �.: .�,::�; . �': _.
� u: u;: i'I U �LLG. :iEPT. REG.
i;Y
PERMIT FEE � ,7 C/ ^
3O �f-'� PLAN CHECK $ � S �
� /� / �
v� �
TOTAL FEE $ S�S —
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