HomeMy WebLinkAbout3066 CEYLON RD - Building PermitsAop�icant to flll In a11 spaces except tnose witnin heavy boreer Itnes ana sign all approprlate aeciarations.
CI7Y OF COS7A MESA CONSTRUCTION PERMIT
ProjectAddress �b�ai�o �CJ10�1
Applicani's Mailing Addreu �y��� �•�� = 5�
Owner's Name �� rv- A� � e `�C %�_�P_ r Phone751 -ZZ-S S
Address s� "�"�'��
Arth/Eng. ���-� LicenuNo.
Address
Convactor'sName�r-�•41.. .r+l�-ti2_ Lr.�s' Phone��� �;��
Addresslmailingl �4� �'�� �'`� 5�e. G�'��nl�'IESP
Ciry License No. 2�+ Z%!i—
LICENSED CONTRACTOR DECLARATION
i hereby aifirm tha[ I am licensetl untler provisions ol Charter 9(mmmencing
dh sectlon 7000) of Division 3 0l the Business�tl Grotessions Cotle, antl
.y iicense is in u tor1e ana elfect, o yZZ 47 L
Licens Class wi1V
Date -� Si9nature
WOfiKERS'COMPENSATION DECLARATION
I hereby afti�m that I have a tertiticale of consenl to SBILinSur¢ or a<¢�UfiCat¢
o/ Workers' Compensation In�y �rant¢, Or d Certliietl copy thereof (Section
3800, �ab. CJ �i.ti� ] t
Policy No. b�%_� i�.S i� company 5� ' nCl
❑ Certilietl copy �s nereby furnishetl. )
6 Certi �etl capy is t�letl with the city B� tl"rf /.�
Dale � �7 ' � � APOlicant ' v
EXEMPTION FROM W00.KER5' COMGENSATION DECLARATION
(Tnis section neetl not be como�otetl it lhe permit is for one huntlretl ($300) or
less).
I Certify that in IM1e per/ormanCe ot Ihe wo�k for whith thi5 p¢rT�t i5 issuetl 1
shall not employ any perzOn in any manner So a5 to bnCOm2 suDject to t�e
Workers' Compensalion Laws o! California.
Date Signaturc
NOTICE: If, alte� makin9 this tlCclatation, you ShOultl beCOTe zubject to the
Workers' Compensation provisions ot the Labor Cotle, you must forthwlth
comO�Y '�`���h such provlslon5 or th15 p¢rml[ Sball be tleemetl �evokCtl.
CONSTRUCTION IENDING AGENCV
I hereDy al(irm Ihat thero is a consVuction lentlin9 a9ency for the pertormante
of tne work 1or wp�cn'[�his permit is IiSueU (Sectlon 309] Civ. C.)
Lentler's Name /�
Lentler'S Atltlress
VNER BUILDER DECLARATION
!reby aflirm Ihat I am oxempt trom the ContractorY Licensa I..aw for the
iowing reason (Soction 7031.5 Bvsiness antl Protessional Cotlo: Any tl[y or
county wbich requirns a permlt to construtt, alte�, improve, Oemoliih Or �epair
any structure, prbr to Its issuance, atio reqWres the appliwnt far wcn permit
lo tile a si9nCtl stalement thdl Ile/Sh¢ IS Ilcen58tl DurSUant to the prOvlsiont of
� the Contractor's LiconSe Law (ChaD�er 9(commoncing witb Section 7000) ot
Division 3 01 �he Bu5ine55 and Pro1p55iOns Catle) Or that he/ihe i5 exemp[
' thereiwm antl the bails tor tho alle9ed exemption. Any vlolaUon of Section
7031.5 by any ap0litanl for d Permil SUDjettS Ihe ap0���dnt lo a Uvil
�enalty ol not more than flve huntlretl tlollars (y500).
1, as Owner ol Ihe p/operty or my Cmployees with wdgns as lhBir sole
CompenSd[ion, wi�l tl0 lne work, antl the strucWra I5 not inlentletl or ofteretl
lor sale (Section 7044, 8usines5 antl Protessional CoEe: Tha Con[ractor'z
License 1„aw tloes not aDP�Y �o an owner ol a property who builtls or improves
thereon, antl who tloes sucb work himself/perselt or thrOUg� �is o� her Own
employee5, prOvitletl tM1at su[h ImprovemCnts a!e not int¢ntlotl Or offeretl for
WIG. I/, hOweve�, th¢ bulltling o� ImprOVOment i5 SOItl wlt�in one year Ot com-
pletlon, ihe owner wlll havc the buracn ot oroving ho/sne tlltl not buila or im-
prove tor lhe purpose ot 5ale).
❑ I, az Owner ol th¢ PropCrty, am exclusivaty COnlracting with li<¢nsetl con-
lrattofs to conSVuct lM1e prOjecl ($ettlOn 7044, Bu5ine55 antl Pro1¢SSions Cotle:
The Contractor's License Law <loes not apply to an owner of pro0erty who
builtls or imoroves thereon. antl who contracts for such oroiects with a con-
tractor(s1 license pursuan[ to [ne Contractor�s Ucense Ww�. I am aware that
proof of [h¢ir Worker'S Compensatlon insuranca ShOWd be provltletl to mG.
❑ I am exempt untler 5ection B. & P. C. for this reason
Date Owner .
I hereby certify [bat I hav¢ reatl
in/ormallon is correct. 1 aqr¢e t c
antl statc laws rclatln to i n9
SEOSdIH¢5 01 2 C� ¢�
inspection pur o
Slqnature
Orivars' ucense or 55 �f �
0865-46,rev. 5/ee
eoy aumonze repre-
Ionetl property fo�
oate .S' Z o 4
TYPE OF CONSTRUCTION LJ NEW u aDo LJ ALTERATION
❑ CONVERSION ❑ DEMOLISH ❑ OTH�j R
DESCRIPTION OF WORK/USE OF BLDG.- ^ �-�� �� �
TVPE OF PERMIT�RADING LJJ'sOVNDATION 1(, STRVCTURAL
❑ TENANT ELECTRICAL L�PLVMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION 5a. F7. OCCUaANCv _�
CON STRVCTION TYPE VALUATION S T. U 7�_�,T ���v
ZONE GRADING CV. VDS. ACRES
Remarks: i' _ _ �. _ � _-�- "'��._i_. p " �'" l.r.� � ` _ Mw�..
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathcubs
Clarifiers
Dishwasher
Orinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fae � $15
Boiler
Duct-UnderGround
DuCt - $tfucNfdl
Duct - Ventilating
Ezhaust System ❑ Multiple
Firepl/Fact.6lt. �CBO #
Heating System & Ducting
❑ai oo,000 eTu O i oo,000
fleinspection Fee � $15
White - Builtling; Canary - Applicant: Pink - Accounting: Goltlenrotl - Assessor
Showers
Service Sink
Sewer (:ap
Sewer Connection
Solar Collecwrs
Solar Piping -�
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Waeer Heater
Water Service
Auto�Wesh
Issue Fea
Hood or Typet ❑
Canopy Typell ❑
Refrigeration Sysiem
Oaioo,000eTu ❑iao,000sTu
System Repair/Alteration
ire Dampers
Registers
Isue Fee
g 3
FEES
$ 3
A.P. 3W
S Main Buildi
E
T Fron[
B Rear
A
C Right
K
g Left
Ping. Ref. #
Planning Notes:
Auromatic Washer
Construction Pole Su
Cooking Unit
Dishwasher
Dryers �Gas ❑E6
Fan .
F.A.U.
Fixtures .
Device Boxes "
OIILI2L5
Switches
Garbage Disposal
Generetor �0.5 KW
Zone
Accessory B
Parking Req./Provided
ELECTRICAL
Tronsformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel '
Motors 061 HP � 1 h- 8
Ina Solar �9�15 HP 016-15+
Microwave �
Pole Light �-
Range
' I Standing Sections
15 KW' I Trash Compactor
� Reinspaction Fee �$15 � � luue Fea
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approvad By
Building Approved By � _�i
O
N
I
N
G
R
E
�
M
T
S.
FEES
SUMMARY OF FEES�
BUILDINGPERMIT $ 3S.-OCi SMIP $ �S�
PLAN CHECK $ PERMIT
PWMBING $ r �� ��UANCE $
PLAN CHECK 25% $ ENERGY P.C. 5
ELECTRICAI S /S•%�GRADING 5
PLANCHECK 50°.6 $ MICROFILM $
MECHANICAL $ TOTAIFEE $
PLAN CHECK 25% $
r - � lS-
..... . _i'._. •v ,., ' '
4 �l `� \\. � . .
CONSTRUCTION AND PLA...�aING POOL & SPA
APPROVAL$ Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary"'Electrical Serviceor Pole 52. Pool & Equipment Location
2. Soil-Pi�Se-Undrgrnd. 53. Steel Reinforcement
3. Elecvical Conduit Utiiiry-UndrgPnd. 54. Forms .
4. Electrical ConduibUndrgrnd. ., 55. Electrical Bonding
5. Steel Reinforcement � :•.� 56. Rough Plumbing & Pressure Test
6.. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
�-
7. Footings ' . 58. Electrical Conduit-Undrgrnd.
8. Foundation � � • 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe-Undigmd. ' � 60. Backwash Lines, P-Trap, � Undrgrnd.
70. �Structural Floor System � ' 61. APPROVAL TO DECK
11. Property Sewer Line & House 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 Electriral-Conduit 66. Solar SYstem-Final
r -
1.6. Rough Elecrric Wiring 67. Fencing & Access Approval
,17. Rough N/iring Sign ��-� 68. APPROVED FOR PLASTERING
'�18. Rough Electrical-T Bar Ceiling ! 69. POOL/SPA SYSTEMS FINAL
19: Rough'tieating & Air Conditioning FIRE DEPT. REQUIREMENT
��
�20. Rough.Factory Fireplace APPROVALS Permit #
21- Ducts, in_Stfucture ' 70. Underground Hydro
22. Ducts, V,entilating � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe:Rough & rest �, � 72. Underground Flush ,
,
� 24. Foof Framing ' _- ' 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing '• 74. Overhead Hydro
26. T-BeqCeiling (Structural) &�Monocoat 75. Dry Chemical
27. Frame and Flashing •��• ' g� 76. Dry Standpipe
� ..
28. Lathing,& S�ding ' • q� 0 77. FIXED SYSTEM FINAL
29. Insulation -- ' PJ 8�' ��(,�' 78. FIRE PREV. FINAL
�
30. Drywall; Nailin9 . , HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � - �j ��� 79. FINAL INSPECTION
32. Electr�ical Power Meter-Final-� � 80. FOOD CERTIFICATE ISSUED
33. Final Electric I �O Y- q Notes � /(/�j /rj/rA� '
34. Final Heating & Air Conditioning J� � K
35. Final Gas Pipe-Test
36. Hood or Canopy .
37. Finat FactorY Fireplace
38. Final Plumbing $=7� L�D
39. Water Service-Final
40. Gas Service-Final ���"
L
41. Solar pomestic-Final .
42. Backflow Preventer � �•
�
43. Backflow Irrigation � ' • -
44. Landscape Irrigation System �
45. Sound Attenuation �
�'i.
46. Handicap Regulations � .✓'
47. F1NAL STRUCTURE & BUIIDING �
48. Special Requirements Completed
49. Electric Release to Edison ,.
50. Gas Release to Southern Califomia Gas Co � ' �
51. CERTIFICATE OF OCCUPANCY '
�
No. Date - ,`
rxaecraoowess: 3066 CEYLON RD
owxea�sxune: BILL REELER
�oowEss: SAME
751-2299
uxiT:
NIENGINFFR: NEU.NO.:
ROONESS: UNR:
rex�nmEe: RAINPROOF ROOFING ( 714 ) 536-8702
'• nooxess: 369 P.O. BOX
HUNTINGTON BEACA CA 92648
110ENSEO CONTMCTOfl DELUMTION: I �ereOY altirm Inat I am ticensM unUer D«o�+af Ctupter 9(wmmencinp wit� Sectian
7000) ot Oivision 3 0l the Business antl ProleuiUns CaOe, antl my license is in tull force anU ellect.
cm uc.: 0'1 '1 A STFTE UC.:S 57 c nss — 9/�
Oata: ��l�a Ipnat - iLe^�
WONIfENS' MPEN ATION OECLAIUTION: I re�y anirm Inat I nave a certilicate ol consent lo sall�insura or a cen�wte oi Workers'
Compensauon �sYr�r� �r a�niti� �py tnereai (Secnon 3800, tao.61A / O i/ J S
roucv no.: STATE FUND �P• o�re:
�OMPINY:
Certifi a y is he eby IumisheU. ❑ CertilieE cop IileO ith the ciry BuiIE p Divislo �/
Date: ���� �N � Applica ' ��/.l���l �
E%EMPTION FAOM V/OBNERS' fAMPENSITION OECU ON: (iAis se�tion nee0 not �e mmpleteU ii ihe permit p lor one huntlre0 (E700) a less).
I certiy Ihai in I�e pertormance at the wark for whic� Ihis De�mit is issuetl, I shall not employ any person in any manner so as to Gecome
SuEject m the Workers' Campensation Laws of fAlifomu.
Oate: SIp�aNre:
NOTICE: II, atler makln0 ��is tleclaratian, you slwultl Oewme suEjec� to tAe Workers' Compensation prodsions of t�e LaOor
CoEe, you must torthmih mmply vnt� suc� pro�sions or tNs Dermit SAall Ee EeemeE revokeE.
CONSTPUCTION 1EN01NG �CEXCY: I AereEy am�m Ihat tAere is a canslmclion IenOinp a0ency lor I�e perto�mance al Ua work lor
wnicA this permit is iuuea (Section 3097, Gv. CI.
LENDER:
RODflE33:
OWNFB BtIILOEB OECIAMTION: I Aereby affirm Ihat I am axemp� Imm the Contracmrs' State Licanse Law lar t�e followinq aason
(Section 7031.5 Business anE Professlonal CoUe: �Y ciry ol counry whic0 requias a Dermit to consiruct, alter, imprave, Eemolis�, ar
repair any struclure, Dnor lo its issuance, also reVuires Ihe aD7��ean1 for SucA permit ro lile a SiA�ed statement ttut hNshe u IlunseE
Pursuant to tAe OroNsions of t�e Contractors' Sta1B License Law (C�apter 9(commencinA ��� Section 70W) of �ivision 3 oi t�e Business
;s?0 Piolessions Cotle) or I�at he/she is exempt therairom anE tha 6asis for the alleped exemption. My violation of Section 7031.5 by
^7y aDPlicant lor a Oermit suUjects the apD�icant ta a ciWl penalty oi no� mom t�an fiva �undreO Oollars (5500).
I, as owner ot t�e D�oDeM ar my emDloyees with wapes as IAeir sole campensatlon, will Eo t�e work, anO t�e
❑ simcture is not imen4e0 or atlerea for sale (Section 7074, Busmess an0 Pmiessional Cotle: The Contractors' Slate License Law
Aoes not aDOty ro an owner of a proparty who bullAs or Improves t�erean, anA who aoes suc� wark himseltl�erselt ar I�rouAh
his ar her own emDloyaes, pmvldeG tAat such impmvements are nat intenAetl or atteretl lar sale. It, Aowever t�e builtling or
impmvement is sold wil�in ona year ot compleiion, the owner will have the EurOen ol provinA ��she 4iU not �uila or improve
lor t�e Durpose of sale�.
I, ss owner oi Ihe Dioper1y, am excNsively contrac[inp with IicenseE contractors to constmct Ihe pmlect (Section 7044, Business
❑ and Professbns CoEe: The Contractors' S��e Liunse law Cces not appry ro an owner ot propeiry who Em105 or improves tAe2on
an0 wA0 cOniratl5 lor Sut11 D�alecis �i�� a cOnlfacial�S) litense pursVani �o Ihe CAnlfaCiors' State license Law). I am aware
ihat proaf ot I�eir Worker's Campens:tw� �nsurance shoWE be O�ovitled to me.
� I am axempl untler Section: B. 8 P. C.
lor IAiS rea5on:
Date: Owner.
I Eo nereby cenity tAai I am aware ol anE unGerstanOlhe reQuiraments ol CaliPomia Heatlh an0 Safery CoOe Saciions 25505, 25533, anE
2553C anA t�at I or any future EullAinp acupant ��II not (drUe one) nee0 to comDN ��h SaiA state coAes anC Ihe requiremenis for a
permit tor con5iructian or mo4ilicaGon Irom Ihe �� ualiry Manapement DiSIncL ResiEenlial wnstmction applications ara exempt tmm
t�ese provisions.
Oate: pppliwnC
I hereGy cenity tAat I Aave reaG this applicatlon and state that ihe aEwe information is mrrect I apree to wmply with all ciry and counry
OfdlOdflC25df1ESIdIeIdW5f812Wp�00011GII1QfAfI5INC10 er yauth (itn� 1�hisci� beMer��heabove-men6oneA
propeM lor in5peciion p r�� �i
Date: .�/r� Si;^��' � ! � �
_��—
Dnver's Ltcenu or $ocW SecuAry N: �
�Bn��e Whl�e—Buibirg; Gree�CaOe EnbRamant; Cenery—Appllcan�; Pink—Revenue; GdUenroE—Atxsso�
CITY OF COSTA MESA — BUILDING PERMIT PERM NO:.B 048380
PERMZT NO: H 048380 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: OTH
JOH DESCRIPTION : REROOF 2800SF RESID W/COMPOSITION SQ FT: 3,788
CLAIM VALUE: 3,788,00 CALC—VALUE: 3,788.00 GROUP OCC; R-3 /
COMMENTS: X
+��r�r�r�x��rx**�*�*+r***�x*****��r**�**�r�r**��r�r**�**�r�+r�r�*��*�r**+r+r�*�r**�r*+r�r+��r****�
Z O N I N GS ERTEB�AUCIKRSE M E N T S SMOKE DET���OR.
------------ MAIN BUILDItdG ---------- --------- ACCESSORY BUIL�6ut�f-FF{��—
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 REQ• PROV: PARCEL: 13916513 ZNE: REF NO:
PLANNING N6TES>
>
iElEikik�Fififik!litiEiFikiEiElFkiElfkifiFitlFitiEiFititlllEkikifkitifftiliEkik%itifkikiF7Ekifk%kikM1ElEMkiFMiFlEifiFlFikiFiFititiEfEiEiE3liEiF
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 .
HUILDING APPROVED BY :
DATE: '
DATE: "
APPLICATION ISSUED BY: Yi� DATE: ^ —�c
iEiF�kiElEiFiPiFifkiFiFitiklFitlFMiEiEiFiE MiFiF3iiFiFlFiEiFiE ikiE
ik iF iE iE iF ik iF * ik 3t iF iF iE �E iE �! ik �E iE iF iE iF iE k iF if ik if ik k iE i! iflk iE iF iF if it if it fF ik iE ik iE iF if k M 1F k 1E it 1E if it it K M if if 1F ik iE iF if M 3k iF iF iF iF iE if iF iF �f if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
r
BLDG PMT PLUMBING ELECTRIC',MECHANIC FZRE SMIP/RES GRADING
PERMIT 63,00 ' .50
, �`; ,. , SMIP/NON—RES
PLAN
ISSUE FEE ' �
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK - TOTAL PAID DUE
TOTALS----> 63,50 0.00 . 0,00 �-. 63,50 63,50 ,00
REVENUE DIVISION TOTALS--> COLLECTEDc 63.50 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63,00 ; �� ; .50
i! iE ik ik if it if 4 3F iF i! i! ik iE ik �1! Ik k dk iF �F fF i! f! ik ak iF i! if iF ik M if iE iF ik iF %fk k it ik f! 1f if if ik iE k iF iE ik iF if k �F iE iF k 1E 1E if iF iF ik �t ik if if ik iklk �E iF ik ik �E iE ik
I N D I V 2 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 R�1,'• '� ' UNIT COST TOTAL COST
SFR 3788 REROOF BY VALUE AESIDENIAL NOZONE 1.00 3,788.00
END ^OF., FEES :
.. r �. .
r,• '.
O1 O�QbE59S-U0066.45 'U't�'�' 63,56
DATE: 07/31/90 TICE: 16:p5
CONST TIOfjAND PLANNING � `P�OL & SPA
APPROV LS Permit # Date Inspector qppROVALS Permit # Date Inspector
.
1. TemporarY Electrical $ervice or Pole � 52. Pool & Equipment Location �
-2.; Soil Pipe�Undrgrndo � � 53. Sreel Reinforcement
��3. Electrical Conduit Utiliry�Undrgrnd. 54. Forms
- r
',4. Electiical Condui[-U.ndrgrnd. - . 55. Electrical Bonding
�-5. Steel�Reinforcement _ 56. Rough Plum6ing & Pressure Test �-
--6. ElectricalUPERGmd. . 57. APPROVALTQCOVER�GUNITE -,
7. Footings � " 58. Electrical Conduit-Undrgrnd. -
� 8. Foundation - 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor Svstem . 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final .
�2• Se�^'e� Cap . `�� ' 63. Heater & Vent�Final
13. Roof Drains .- . 64. Plumbing System � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough EI¢ctrical�Conduit 66. Solar System-Final
16. Rough Electric�Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79` Rough Heating & Air Conditioning .., � r _ . -; FI_RE;DEPT. B•EnUIREMENT �
• " '' _ ' .. T T
20i: Rough Factory F,�replace - .� • ;AQPROVACS-- �= Peimit # x - -�
2L�'Ducis, in Structure - �- _ � 7p. Underground HV�1ro -
2277Ducts, Ventilating � � .� 4 " -� �.77. Product�Piping O,Gis ❑�Oil
23.'Gae:Pipe-Rough&Test �-� � ' ^�' � ' , ' =
_ J2. Undergro`und Flush � ,
24. Roofi Framing �: ?: > �73vUndergmd.Storage-Tank OGas ❑Oil
.
25. Roo] Shedthing - � ' � - ' ' ' 7q,'Overhead Hydro=-1 .
,y. . _
26�T�Bir Ceiling (Structural) &'Monocoat � � � 75'Dry Chemical -� ..
_ 27, Frame and Flashing' . x� Y'� �� 76. Dry Standpiqe �',
,28. �athing&Siding ; ' -��ic:: ;� ' - 77.�FIXEDSYSTEMFINAL' `'
,�29. Insulation � i--, � . ,� 7� FIRE PREV. FIN.4:L -� � �
r .
�30. Drywall Nailing -•- � r � HEALTFI�DEPT: REQUIREMENT
,<31. Plaster Biown Coat� " ' ' x �79.�FINAL IN$PECTIO,N ;.] �
�32:�Electrical Power Meter�Finaf � {� � -�SO.:FOOD CERTIFICAi'E ISSUED�y
_.
=33.'�Fina! Eleetric' �� ,M "� 'Notes� �J'� � �
.'34;Final Heating_& Air ConditioniAg" ;= ; � -
`35: �Final Gas Pipe-Test " ^ ' " � - � ��% �� 7 �
z�
� ..c.
��36., Hootl or Canopy ;� � ' �' w ' � r � = -. -. �� ,
37.•Final Factory Fireplace" � �� � : •. _ ��` _ °`
ti �
38. Final Plumbing ', � _; �.�. . % D�
�39. Water Service-Final� •: " z ' - � :.. 6��,�
- �
'_�,40. Gas Servite-Final "' � , � F ; � • . ' '. " � _
�--47. Solar pomeeticFinal� . . :'� '
42. Backflow Preventer' ' � _ � �
_._ ,�'� ..
43. Backflow Irrigation � � - _
•_d4.-Landscape liripation System - � ' ,' _ - � ,
�45. Sound Attenuation • � " �� " � ' • - -' �-
-46.'Handicap Reg'ulations _ ` " ,
47 FINAL S7RUCTURE & BUILDING g-�b �(,,� :
48.. FINAL P4ANNING . � � - . ^ � ' . .
-_49. Elec(ric Release to Edison �
; 50: Gas Release to Southem Califomii Gas Co �"� ,
51. CERTIFIGATE OF OCCUPANCY
No. Date
:
j� t. 9���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31'] GOSTA MESA. CALIFOftNIA
fOR APPC/CANT TO F/[L /N COMPLETELY
TYPE OR PRINT
BUILDING
AD�RE55 ��
COSTA MESA. ALIFORNIA
iOWNER .7 CdIIIOI L �
IMA�� 10835 Santa Monica Blvd.
AfIIIRFGS
�ARCHITECT L.C. Maior NfO.
OR ENGINEER
� LEGAL
d SIZE
Const
. _r•: - ' - ' �
� t.:J�-f �b.l��'
�,�'- rAaY Z � i�s�
,:,�!,?r�CE DEPT.
"� , ,'I�`^1!1 Pj-(`p
i
APPLICATION FOR PERMIT
BUILDING
FOR OFF/CE USE ONCY
IRECEIPT NO. I �jT
✓EIVEp BY , I (_A E�� S�' MAYE (�
� /� � J
FIRE
ZONE
COSTA MESA. CALIFORNIA
anta Monica Blvd ZONING
ZONE NO.OF USE OF NEW
1 IBLOCK ITRqC �' IP�wrvs Ieui�oiHc
APPROVED � y/��
RV /�H/: OATE .�
NO.OF BLOG6.
SEiBRCK LINE FROM (
cervrew ov slAecr Q� �j � REAR YARD
SI�E YARD I LEFT 5� I RIGHT S�
DESCRIPT,ION OF WORK
NEW I X II!�YERATION I II ADDITION
REPAIR I II MOy�NG I II OEMOLISH
BUILDIN NO.OF
SIZE 746 ROOMS ii STORIE'_
AND
YARDS
REQUIRED
�CENTER LINE ST.) �
FRONT ,�
� _ R.SIDE il
1 HEFEBY ACKNOWLE�GE THRT 1 HAVE RE/�D TMIS PPPLIC�TION
•NO STATE THAT THE AB4VE IS CORRECT /�ND FGREE TO COM�
PLV WITH ALL CITY OflDINANCES PNp STqTE L1W5 REGULATING
BUILOING CONSTRUCTION. q
SIGNATURE O ,/� /C/ /—
PERMITTEE , .,J�ri1 O,« Li9>s�_(y �
AUTHORIZE� AGEN��,i�'�C�
REAR
FT
THE AMOfINT SHOWN UNOER VALUATION 19 FOR THE
PUrzPOSE OF ESTABLISHING • PEflMIT FEE ONLY.
VALUATION Z �J
PERMIT FEE $ ✓ /.
$ / // 3 � 7i PLAN CHECK $ / � �
TOTAL FEE $ S f� 3
� ;;;;��� ..��i'i�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNIA
Fo� Applitanf to Fill In Complefely
TYPE OR PRINT
BUILDING ".� A / � �.-. . I
COSTA MESA.
� MAIL
FE� RECEIVED
Qr.— JUN 2 8 �;;�1
FINANCE OEPT.
APPLICl�4(�t� �QJ���itA+f��SA
BUILDING
For Office Use Only
� O�+Zi
3066
CASTA MESA,
A�DftESS !�Y! ��i. .f/. ZONING
\/�/y�� 20 NO. OF /l�UBE OF NEW
�',�Ty �J� / /Yl / '� I PI.ANS �' LI BUILDING
!r
STATE � TEL. +-� Leaw�
LIG NO. �� , NO. !R a/ OE6CRIPTION i�
SIZE I NO. OF BLpGB. �
OF LOT NOW oH LOT A. P. NO.
USE OF YAROS EVES
EXI6TING BLDG. � �//"n � APPROVED ALLOWEO
SETBALK L�NE FROM fCCNTHX LINC 9TJ
CeNTER oP eTHeeT REAR YARD "—� FRONT '--FT--��
SIDE VARD I LEFT ���C� I RIGHT R. SIDE
DESCRIPTION OF WORK
BUILOING
size
EXTERIOR WALL
COVERING
U88 OR BUILDING
NO. OF
_Z
1 HEREBY ACKNOWLEDRB THAT 1 NAVE READ THIB APPLIGTION TXC AMOUNT BHOWN UN�ER VALIIATION 16 FOR THE
AND BTATE THAT THE ABOVE I8 CORREGT AND A6REC TO COM- pURP09E OR EBTABLIBHING • P¢RM�T FEE ONLY.
PLY WITH ALL CIiY OI��NANCEB ANO BTATE LAWB R80ULATINO
BUILOINO WN9iFtUGiGN. VALUATION �}�
SIGNATURE OF `� PERMIT FEE $ �
PERMI7TE !�� a
/ �� $ ��. ' PLAN GHECK $ `—
`/ F
AUTHORIZED AGENT �vj %'`����( � _ __ _ 7 O'r �
�
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