HomeMy WebLinkAbout950 CHEYENNE ST - Building Permits�
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PN0.IECT AD�HESS:
UWNEX'SNRME: SSO CHEYENNE ST
nooaess: 9�ONCHEY�NN�ST w
! COSTA MESA,CA
PflLHIENGINEEN: 5 4 f1— 2 5 a 6
aoosess:
UNIT:
92626
flEG.NO.:
ux�T:
PENMITTEE:
aooness:LYNCH 6 PIKE ROOFING (714)871-8103
p�7T4�T3�p4pW(E�S��T AMERIGE AV(E�N�UEq a9
LICENSEU CONTflRCTOP OECCAflR11�NTT1RTeGy aflirm lhat I am licensed unOeryrtRvisioM1��IMptEr 9(commencing wilh Sec�ion
7000� o� Oivisian 3 oi Ne Business antl Pm�essions Code. and my license is in tull force ana ellec�.
cirvuc.: �3 soreuc.:403576 Cc� l��
I Oa�e'. L SignaWre: � i
�� WOPN 5' COMP NSRTION OECLANpTION: 1 here�y allirm Ihal I have a cert�ficate o� consent to I�insure or a ceriificate ol Workers'
. Compensalion Insurance, or a ceniliea copV �hereoi (Section 3800. Lah. C).
I roucr No.: 0675650-91 E%P. DRTE: O9IO1 �9Z
comrnxv: ST.�T� FtINi�
� Ceei�ietl copY is ere y furmsnee Certilietl copy i5 filea ' Ihe ciry Builtling Divisian.
oaie: Z2 Z ppplicant: LGC�����-� _
E%EMPTION FBOM WOPI(EBS' fAMPENSATION OECLAHRTION: (This sectian nee0 no� be complelea ii the permit is far one hunOreJ �$100� or Iess�.
I cenity thal in ihe oedormance of ine work for which this permit is issued. I shall not employ any person in any manner so as to become
suble�� �o tAe Workers' CamOensalion Laws oi Cali�omia.
Dale: Signature:
NOTItE: Ii, aller making this declaration. you shoNU become suble�� �o Ihe Workers' Compen5ation pmvi5ions oi Ue LaOor
Cade. you mu5i forlhwil� compty wilh such pmvisions or t�is permi� shall be tleemetl revake0.
CONSTflUCTION LENOING RGENCY: I here�y altirm that Ihere is a conslmc�ion lending agency �or Ihe pedormance oi lhe work tor
which Ihis Dermil is issuetl (Seciion 3097, Civ. C�.
LENDEN:
AOUHESS:
OWNEB BUILOEfl DECLRflRTION: I here�y affirm Ihat I am exempl lmm tAe ContraGlors' State License Law for the tollowing reason
(Section 7031.5 Business an0 Pwfessional Cotle: Any ciry o� counry which reQuires a De�mit �o cons�mc�, alter, impwve, demolish, or
reDair any slmcWre. prior lo its issuance, also requires ihe apDlicant for such oermit to file a signeJ statement that Ae/she is licensetl
pursuam �o Ihe pmvisions ol the ConVactors' Slate License Law (C�apter 9(commencing with Sec�ion 7000) ot Division 3 of �he Business
an0 Professions Code) or ��al he/she is exemp� �hereimm an0 Ihe basis lor Ihe allegetl exemp�ion. Any violatian oi Section 7031.5 by
any aoPlicant for a permit subieds ihe applicant to a civil penalty a( nol more ihan five nundretl dollars ($500).
I, as owner of Ihe pmpeny or my employees with wages as iheir sole compensation, will Oo the work, and tAe
❑ Slmciurei5 no�intended oroheretl lorsale (Seciion 70EA, Businest anU Pmfe55ionalCotle: The Contrac[ors' State License Law
- �oes not apply lo an owner of a propeny who builtls or impmves thereon, antl wno Ooes such work himself/herseli or ihmugn
�is or her own employees, provitletl ��a� such impmvements are not in�en0etl or oiteretl �or sale. I�, �owever �he 6uiltling or
improvement is so10 wiihin one year ai completion. ��e owner will have Ihe Uurtlen of proving �e/she ditl no� �uiltl or impmve
lor Ihe purpase ol sale).
1, as owner of t�e D�opetly, am e�clusive�y contrading wilh licensetl conirac�ors to constmc� �he prolect (Sec�ion 7044, Business
❑ and Pwlessions CoOe: T�e ConVactors' S�a�e License Law tloes not apply Io an owner o� pmperty wha hutlAs or improves Ihereon
and who coniracis for such pmiecis witA a coniractor(s) license pursuant ro ihe Comracmrs' State License Law�. I am xware
ihal pmol of iheir Worker's ComDensalion insurance should be Omvitletl to me.
� I am exemp� unaer Sec�ian'. B. 8 P. C.
for Ihis reason:
ozte: - ownec
I do �ere0y cetlify I�at I am aware ol antl un0erslantl �he r¢quiremems o� Cali�omia Healih an0 Safery Cotle Sedions 25505, 25533, ana
25534 antl Ihat I or any luture butlding occupant willlwill not (ciicle one) nee0 �o comply wilh saitl s�ate cotles antl the requiremenis for a
permii for con9mc�ian or mo0ifica�ion Imm Ihe Air Ouality Management DisVict. FesiAen�ial conS�Nclion ap0lica�ion5 are exempt �mm
��ese pravisians.
Date: ADPlicant'.
I hereby cer�ity that I have Batl ��is applica�mn and state Iha� �he above in�orma�ion is wrrecL I agree Io comply wiih all ci�y and counly
ortlinances and 5lalelaw5reta�ingio builUing conslmcimn antl here0y authanze representaiives oflhis cilyio en[er uponthe a�ave-men�ioned
pmperiy lor i peciion pur ses. ^/�
Date: Fi 2`L � Si9namre: z�Gt-.� /��-C'�'�
Driver'S Lirense or Social Securily q'
t64i-46 WM1ile—Builtlina',
Pink—Revenue', Goltlenrotl—Assessor
CITY OF COSTA MESA - BUILDING PERMIT PERM NU; B 05788
PERMIT NO: B 057881 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: V-N PERMIT TYPE; STR PURPOSE: ALT
JOB DESCRIPTION ; T/OFF RESHEATH & REROOF W/COMP SHINGLES SQ FT; 5,000
CLAIM VALUE: 5,000,00 CALC-VALUE: S,OOU.00 GROUP OCC: R-3 /M-1
COMMENTS• REROOF 3000SF RESID & GARAGE � �,, p
***x******�x****x�*******�*�****�*�t+t+r�*x��t*�t+a*�r*�t+t*�t***�t�t*� ��j �x*���/`��f�
Z O N I N GS ERTEBQAUCZKRSE M E N T S�►�I►�l��—
QUIRED
------------ MAIN HUILDING ---------- --------- ACCESSORY BU�NG ---------
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; 19172311 ZNE; REF NO:
PLANNING Nt)T'ES>
' ii
ik iF iF IE if jf if iP if iF iE iE iE k jFiF if iE if IE ik if if iE iF if ik if� 3F 1E iE 3E if 1f jE iF iF iF iF �lf iF if if ik iF it it 3F i6 iF iF 3k iF ff 1f iE 34 iF if 3f If �F jE iE iF iF iE if iF if iF iF # iF it iE �E �lt� �f
D E V Ej'L O P M E N T S E R i� 2 C E S R E Q U I R E M E N T 5
���
7.ONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE;
APPLICATIOtJ ISSUED BY: ;n���FiE DATE: � 2�- �
1E#iE3F1EiEaEifaFlFlEik�EaEiF�F1FiEitiFIf�1E3F�FiFiF�iffTF�F7F�FiFSFiF�F3f'3F 3F iFTFiFiFiF7FiF7F7F�FiF�F�kiPitiEififiElfiF3E � 1E1f
iF if it iF iF iF 1E iF if iF If iE iE iE iE iF ak if iE iE iF iF if lFiE 1E jE iE iE 3t iE 3E k iE 3! ik iE 1E iF �F iFiE iE iE k iF if iE iE iFif iE jE �1t� iF iE if aM1 iF iE if it �f iE �E it aF iE �E if ik �lE 1E iE if iF iE-1F aF
LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES. GRADING
PERMIT 72,00 ,50 ,
PL� SMIP/NON;RES
ISSUE FEE �' �''
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID •'e DUE
TOTALS----> 72.50 0.00 0.00 72,50 72,50-.�.� ,00
REVENUE DIVZSION TOTALS--> COLLECTED; 72,50 OVER/SHORT; -' ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING:.PLAN-CHECK
72,00 .50 '
3E 1E if iF IE 1E 3ElE iF iP �k iE iE ik iF �F IE iE �t iE iE�FiE iE iF �E �lt iE iF �F �E �E 3E �E j! �1E iF �f iE iF aF IE �! iE jE iE �F3E iF if jE if iP iF iF af i! �F �F jF iF iF jE 3F iF �! 3F jF IE'iE �lk �E if lFiF �f iE �F iE
I N D I V I D U A L F E E B R E A R D O W N
.:�:
TYPE QTY D E S C R I P T I O N
SFR 5000 REROOF BY VALUE RES1IC5ENTZAL NOZONE
t� h�IVD OF FEES
� j
EXPIRED
Incomplete Insp�t��s
�at� e Sig --
�,,J��q3
P +� I
UNIT COST TOTAL COST
1,00 5,000,00
01 OQS1?S?�:-�C7.li:?7 �,- ;- ;.,
DATE: 0'0,'?.2 �r: i :! : . � „
�
CONSTRUCTION AND��PLANNING' , : � : PO. b SPA _ - �
' APPROVALS Permit,# ' Date �Inspector qppROVALS Permit# .� Date Inspector, �
1. Temporary Elec[rical Service o� Pole - �' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ;_ : I � _' - � 53..Steel Reinforcement � . �
.3: Ele4trical Conduiy UtilityUndigrnd. `�- 54. Forms �
4. Etec.trical Conduit-Undrgmd. ;. � 55. Electrical Bonding �
-,6-: ,Steel Rginforcemerit " � . _ , 56. Rough P.lumbing & Pressure Test -
c
_6. EleCtrical UFER Gmd. �_ , 57..APPROVAL TO COVER-GUNITE -
-7:.Footings . � � 58. Elec2ricat Conduii-Undrgrnd.
,� ;
� 8.'�Foundation - - 59. Gas Pipe, � Undrgmd., Test
9>-Water Pipe�Undrgmd. 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Sv�ctural Floor System �" 61. APPROVAL TO DECK
11. Property Sewer Line �& House�Connection ' , 62. Backwash & Receptor�Finai
12. Sewer Cap � � � . 63. Heater & Vent-Final
�
13. Roof Dreins - . � � ' 64. Plumbing System - Finel�
14. Rough Plumbing 65. ElectricabFinai
15. Rough Electrical-Conduit 66. Solar SYstem-Finai � .
� 16. Rough Electric Wiring 67. Fencing & Access.ApProvai
77. Rough 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 �
20. RoughFactory.Fireplace �� �� ' _ APPROVALS�:'.�Permit# -
, .� - ,i. -
21. DuGts, in Structure'; ., ' - � "� � � "
. - .. - 70. Undergiownd�Hydro .
22. Ducts; Ventilating y� � � � t. �''71, Product Pip�ng O Gas OOii
23. Gas Pi'pe-Rough & Test ' ' � . _ - , 7.z. Underground�Flush' " " - _
24. Roof'Fraining.. h �� . -� 73. Undergrnd:StorageT'ank OGas OOiF �
25. Roof�Sheathing ' ' �' �- �-�r-? . j4, �pverhead Hydro "
26. T-Bar, Ceiling (Structuraq & Monocoat � ir . . 75. Dry Chemical • •- �' "- .
27. Frame and Flashing' � i - _ 76. DrY Standpipe ` • �� - �
�. _ . _
28. LathiP9 & Siding � ,. - � .. . • 77, -FIXED SYSTEM FINAL '
29. Insulation` -' _ � - ' t �� 78.-FIRE PREV. FINAL . - '
:r.'. _
30. Drywall Nailing � - � .a �� � , � HEALTH D,EPT. REQUIRffMENT � ,.
r i
31. Plaster Brown.Coat ' ' " 79. •FINA� INSPECTION - ' � �
32. EleCtricalPower MeterFinal ' _. '. 80. F000 CERTIFICATE ISSUED
33. FinB� Electric' � " ' � � �
r _ � Notes: , .
. . . � .= ; . . _ ' ,
34. Final;Heating&Air�Conditioning� �- � r - _ . - , - , •
�
35. Fin8lGa.s�Pipe�Test ' • " ' ir • _ ' -
36. Hood or Canopy � ` , . - , - � y . . ��
37. Fina�`Pactory Fireplace � ^•. ^� � � - � � � `
t.
38. Finai.Pluinbing ', " , � � � _ " , � ' . '. . .,,;.
39. Water•Service�Final � � ,� � ' - � . --
- ,
40. Gas Service-Final � . , , � .. : , . ��
41. Solar pomestioFinal� ,. . • � _ - ' - "
,r ,
42. 6ackflow Preventer , � - ' ; � . .
43. Backflow Irrigation � • - ' - =• "' ��
44. �andscape Irrigation System . � � - . ,. " :'' -- �
45. Sound Attenuation • . ._ � -� - E.X p � R;E ��
46. HandicapRegulations •.- � ; •� mp�1�'
47:. FINAL STRUCTURE & BUILDING ; J � sjg _� -�
48. FINAL PLANNING �' ' ' , " ' '
49. Electric Release to Edison'.. . , . '� �x
50. Gas Release to Southern;Califomia Gas Co ;��' '� _- ,. `
51. CERTtFICATE OF�OCCUPANCY ,- - ;
No. Date
� � ' Applicant to till in all spatts within heavy borGer Iines ana sign all aDGropriate aeclarations.
CITY OF COSTA� MESA" ' ' PERMIT NO. TRACT NO. - LOT O: , BLOG. NO. � - - • _ - - - �. ._ , _ _
��--; CONSTRUCTION,PERMIT E " 3� � ' � �J'lj � , � ' 6297 _� 5/24/82 "'� 2p I .O5 �Tl.�
Project Address U G HE' EIVNc - • � �� TVPE OF CONSTROCTION �� �� �� � � � �' ' ' ' ' ' � - --
• Owner ' ' ' ' - ' 'Phone ' f ..__ . ..-_ = :+t.'P.' ". . .�
. U � S4:i Z ❑� NEW' �iDD 'O P,LTERATION - �
fAddres (�'`�' t C--• � � � - - - - -�-REPAIR.�CONVERSION.�DEMOLISH_ , _ . ' . ,_„ �t � �� � ', �- }� �� �
, . . , ; ��• I i �ZONING'REGUL'ATIONS '
. �...
!"Arch/En9.--%i � N L/��x��L•iCenSe�Nor....' ' ". _O.OTHER_ ' .. � . A:P:9f "' ' .__' �„_,_ -�
" _
AddiE55.•. ` . . . -'- -"'- _"" �. _DESCRIPTIONOFiO'RK. . �' _._' , "" - �ZONE'�Q " -' ' - PL'NG.-RE :��'.- ' - "�
i 2 Ail ��ilS�' d' ,��
'-ContFacto}...0\N N� /G:.' � . _ ' Phone' ._ .. ' . _ „ _�.. ' _ "_-..; �. ._ . _ ,e o __ .. . a . i ..oiNc . ' �
- TYPE�OF P,ERMIT • � � - �-- i
�_ �. •• �j SETBACKCLST. OP TV.LINEI
i ABBre55 � " � �-"' " �" ' " "- '-�-'„- � —� �,GRADING' ;O FOVNDATION-�STRVC;URAL- - �(LEFTVARD- - a� - ,� _ / �
�GCENSED-CONTRACTOR-DECL'ARATION -- �_ - .� ❑ TENANT ❑ EbEGTRICAL OPLUM�ING ❑MECHANICA 5 � !
IDE-VA �/�
;I hereby affirm th:,t I am Iicensetl untler provisions of Charter 9(com-, � r�ot ; (+�l , . �� RIGHT '3I CJ � .' ry/ �
mencing"with-settion^7000)-rof �Division--3-ot the-Businezs antl =O�OTHER -- �, i v
Protessions Cotle,'anG my I¢^e�nse is in full torce antl efiect,opROJE PTI N'._ '^ ' ' �� �.__TREARVARD(TO'P/l) -_' -' ''
Lite�n�seClas,_ i _._. -Lice�h No� ; ���• �OO. I� V `� ' . '.PKG:SPACE"REQ. ' ' -PROVIDEO �
Dat� alyll3'fa e ._. i . � ; SQ F_T. JI' .. _ Y.�'"' _ �' - > >. _ _ _ .
( � STREET WIDTH"' ` "PARK'FEE $ . � f
�WORKERS'COMPENSATIO ATION ��__ _.,.. OCCVPANCY- CQjV RVCTIONTVPE _ i^_ "
I heraby affvm tha[ I have a r[ificate ot consent to self msure.or a L j ,�ZONING APPROVED'BY ���}, -DA7E -'
'certiflcate'o�'Workers"Compensation-Insurance-oi a certrtietl'copy �VALUATIO�� �6ZONE _ ___
... .
thereof (Section 3800, L:ab. C.). � � �GRADING�CV: VDS. � ACRES' �SPECIAL`CONDITIONS " 'k
L'__ "
cY No.�i:1._..�.-ComFanY ��. '�"' ' _�.. ' _ �" ' " _ ' _ " _ _" ' ._. _. _ ._ _ . _-_ �
�Certifietl�copy�is�h¢r¢byturnishetl.�.�--��- �._ _.._.._� ._._,8:u '_REMARKS: �-^y-�J..."�: y _ . � "�"�� •c ••_' r••� t
Certifi¢tl cOpy is filetl with the city Builtling DivisiOn. � � � �- ' " -"� � .-`� .; '�; �_`,^ ��j , "' ,�'. �� '�
EMPTI'ON FROM WORKERS"COMPENSATION�DECL"ARATION' ' -"" '-- ' ' - � -- - - - �
. . ..... . _ . . . .
- ..: _ .�_. _ ...�...... . •
. � �..._
.4 P _ . tl '_"__.' "'' "' ' ' :.._.... _ ' L ... ^.' ' 1 ' ^.11��l_ f. '�.r
� � ,:
This.section neeA_not.be.com letetl,if.the.permitis,for,one_huntlre
� :� � .. � __' ��'_.
'(5100) or Iessl. j . . .. _'...' �'. f.. ' _ _ _ _ _ ' ' F _ ' ' ,�
I..certity_thdtin.the performanc¢.of. th¢ work for whiCh this �pevmit is. . ^ �'� u' . j,,,, , �, �
IssueG, I shall not employ any person in any manner so as,to�become �," PCUMBING����nc;� ,lS�PL"AN CHECK-""'� -� ""- �ECECTRICAL '- - --`-' PL'AN CHECK�-- -- ----- L
bubj¢Ct�tO-the.Work¢rSLComp¢n5ation.LawS.of Cdlito�nia. ' . ' - ' �
'Date � � Signature � BATHTUBS�l�'SHOWERS' ` - �' `j" ""' ' "� '- ' -" " _
�NOTICE: If after making this tleClaration, you shoultl become-Subject yTO1LET5:�� �_ g• �.�URINALS'- "-" -r'� -- �'GENERATOR�-0-1 KW_1--30"KW'�-�- -•�' '� 1
to the Workers' Compensatlon provi5ions of the Labor Cotle, you must � '� }TRANSFORMER � r' i, p-� �, ~,r.,_�} �
,forthwith comply with such.provisions or [his permit Shall be tleemed LAVATORIES DOUBLE L'AV$-- - '? '- - --'�'APPL-IANCE--" 30-50 KW_50-+.KW-- - � � �' -_ `..,_�' : �
revOketl.-...____.i�.�_�__'_"_ -. ._<__ ` � �. 3MOTORS- � . ..... ... •
KIT:SINKS --`--'-"DISHWASHERS -'- -� -0-1-HP-_1-lO.HP�--�='- - � �
�CONSTRUCTION'LENDINGAGENGV � � - ��� " ' "-- '-- '
jl hereby atfirm that there is a construction lentling agency for the per- SERVICE $INKS�- .,SUMPS"' '�"-';"-!"'''V� _. L- .�pNC..50LAR) �.10-50.HP 50 + Hp:'��'�'�,,'� :=,��� _ p^
,formance of the work fonwhich Ihis�permit is"Iwuetl (Section 309� - � � � ^ - �� � - - �
'CiJ. C:)-"-'-""' • - "- ' '-' ' ' - ' " �,FLOOR'SINKS ` '- FLOOR'DRAINS �- '- �' -'-"f,FIXTURES��--OUTLETS--SWITCHES-��=- � - — - a
._.._ -- . ..,.. � �� . ...
LenCer's Name ' - � � � ' �- - �
_..._�._�_" " � _""___-`-_' . - . .-.. ..:...�.. �.- t
Lentler's Atltlress � � _T � `�DRINKING'FOUNTAINS"",�" (- - - �� iGAS-FUBESIGNS---- ---- --- -- - __
I� e eby aBfi�m�that IDam exempt hom.the Contractor's �icense Law (or ��NTERCEPTO�RS ' - CLARIFIERS�� i�� � � q ;��`+ �POL-E'LIGHTS---------- �- --==i'---�-` +_�^ 1'
ihe'iollowing"reason'(Section'7031C5 BuSinesrantl^Prote55ions Cotle:- -$WIMMING'POOL "" ""'P TRAP "-�' -- ' • ' - - J` � " T �
Any _ci[y or county which requires a permit to construct, alter, � �'�� ��POLES METERED--�SUB` -' ' ' 0
iinprove, tlemolish'or repalr'any5tructure,- prior to'its'Issuance; also�re-� 'yyqTE0.'SERV ICE-"' - ALTERATION'-"""' f""',- - l'-' tPANELS" - - ^-MAIN --j_ - - SUB��-�--=- - - - - -
quires the apFlicant for such pe�mit to file a signetl'statemeni that M1e �+ • � -
is'licensetl"pursuant"to the provisions"of the'Contractor'S"'License'Law� --�^ �-- ' - �•- v - - ,.. ,_ � '
(Chapter 9(commencing with.5etiion 7000) of Division 3 of the GASSERVICE ��" OUT�ETS i' '."'•`L •�' � SERVICE—^�- - -�qMP- -.�
BuSiness'antl'PrdessionsCotle) or thaYhe'is ezempTtherefrom-antl�the� -y.�qTER HEATERS"` ' BTU'OOTPUT �-'-'-'}-- J , - ---.. - . _.__ _ __ _ _ ,�
basis for the allegetl exemption. Any violation of Section 7031.5 by
any'applicanYfor"a'permiYsubjects'the-applicant to-a-civil-penalty- -SEWER"CONNECTIONS'-'-�. -"�" "' " ^ --- ���-- -- --- —�----+�--�---�— - -
.not more lhan five huntlretl tlollars ($500). � W �
I, as owner of the property, or my employees witF wages as tBeiP 'SOCAR'TANK"""""' COLCECTORS^ -• :�-�--- - - � ------- __.._ _� _ _ .,._ _ __ __ ' _ _ _, f
e.compensation„will tlo the_wark„antl.the_sVUGture is not intentletl - � ' -� "-
or ofteretl for sale. (Section 7044, Business antl Professions Cotle: Tfie SO�AR PIPING SVS.' "'r -�--�— - � ` - �" '-'�SSUE'PEE'•----- --- - - - - - � O�fl� � .
Conlractor:s_License.Law.tloes.not_apply to_an owner_of_a property .,qPpLICATION/aPRROVED� •^ . �
'who builtls or improves thereon, antl who tloes sucM1 work himself or � ISSUE�FEE ' : �j '--"' ''1— 0 � B�'^ �- - -�- -DAT.ES Z
through_his.own employees, p�ovitlCtl,[hdLsuch_irtlprovements are not - � ' ' ' - �
Ilntentletl or oHeretl for sale. If, however, the builtlinq or�improvemenf� MECHANICAL PLAN CHECK - '- �-� "-"" �
is.soltl.wilhin..one_year_oi_wmpletion, the owner will have the burtlen � . I ^ SUMMARV�OF FEES ,��, V,�{ 5:�� «�
of proving he tlitl not .builtl or improve for tM1e purpose of-sale). - - -- -' -- BUI6DING -- - ._ . /
HEATING SVSTEM 0-100,000�BTU V PERMIT y- O�� ~ SMIP� r r- E,'-`, OO�' �
,O'I;'^as-'owner-of--the-property,-am-¢zdusivety-cont�aGting-with- _ -__ _ _ _ _ _..I _.__.'_� -T_ _ �1'.�_�� � � Sw �� �
licensed contractors to construct the pro ect (Section ]044, Business AND-DUCTING '- � i'- � t � pLAN CHECK y-��' PERMIT.. ,-" -' "'" 1
1 ' 100,000e gTU '
antl"Pro(essions-Cotle:-The�ConVactor'sLicenze-Ldw�tlo¢snot�apply�to� ' '�ISSUANCE._S�'� �� �� . �
an owner of pro0erty who builtls or improves inereon, ana who con- REFRIGERATION 0-100,000 BTU � ' PLVMBING�!, $^ OO-'�� �� , .� �.
t�acts`hom`such`projects^wrth� a-contractor(s)�-I�cEsnetl-pursuant-to- -SVSTEM------- - ���-=- - - -- - � � y ' \ � GRADING �$ r <<i r�
IIIC COIIbdCLO�'S LIC2lISC LdW). SOO OOO + BTU . PLAN CHECYC $� � ��- � " - ��
'� I am exemPt uritler`Section` "' ' "- "B:'&'P'Cior this' - - � --- "' ' �1 "- \li p. . ' 's � � l y �� i �� �
j BOILERS BTU C}ELECTRICAL $� - - .
reason"'--""'^ � . _,_ _ _ _ _ " '_ '�MIGROFILM'S
� +� �- SVSTEMREPAIR,ALTERATION PLANCHECK��S" --�- r - - -,�•t
.Date '- " - '-' ' Owner ' . . . � � � t,l.\ '-♦ '`.•F TOTAL FEE E - ��,^`_ i ,
i . � - 'EMECHAIVICA6'S""'.. - ^- .•-•--- �. • -
�Lhereby cer,tifythat I have reatl this application antl state that the above � EXHAUST SVSTEM MULTIPLE 1 r l r'� g,�.•p•, ��;,j f,LE55 AD ..';: 1
informa6on is correcL 1 a9ree to comply with all city antl "cbunty" - � 4PLAN�CHECK y- - - VANCE PC �$_•��-�-- -
'o[tllnances antl s�ate laws relating to construction, antl hereby autho�iZe 1� � 1 . ��,I , n„� �
�represen[aC s- of� this �city Eo enter� upon � e above" mentionetl' { • j �•� •-� �� �+' �• .i �
prope�ty o� ' spe tion u 5. ]� �t � e O �
- �Signatur _Dat2�'�� - _ . _ _ . . _. _ _ FINAL FEE 5 ��' -
� �river �censeor5S9f ' �' " 'ISSUE�FEE--_.."' _' ' ' "" _,_. .1...., .. ... ___""_ " "'""' "' . .-..._. ., ._ .. .__. . � i
h t1MF OBfi5�46 White-Builtling; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor
�\"�
CITY OF COSTA MESA ,
Development Services Department -'Building Division
P. O. Box 1200, Costa Mesa, CA 92626
PERMIT EXPIRATION FORM
.,,
To: ��,c-;.v� /sLf's�U7"L�/L,a�c.c��
•U��� ( � 70:.,f;%7�1-Y>D .
� UZr:Ci �1i���i�? �? �?,r�:��
�
ti:
Project Address: —�— ��-»'r-� �
Date: � ��d���—�
Permit 1) �� � �e 2)
Numbers 3)
4)
Our records show that the listed permitls) was obtained for property improvement, or alteration, at the
above project address.and the project was not properly completed.
This permitls) expired on ��—��� ��-�j .
Please be on notice that, without a valid permit and required inspections completed, you will have
encumbered your property with an illegal structure.
1. ; �� Please call 7545273, giveJthe permit number�s) and request a"deadwood"
inspection within ten days. An inspector will visit the site with the .
pertinent records and advise you of the necessary steps in correcting this
situation. If no,work was performed, please sign and date, and return to
the Building Division.
I hereby certify that no work was performed. I understand the permit will be cancelled.
SIGNATURE
DATE
2, ❑ No contact has been made. An� Inspector will make an on-site inspection within
ten (10) days of date shown above to verify status of project.
3. ❑ Deputy Building Inspector denied entry onto property for inspection purpo5es. -
Documents will be forwarded to CitY Attorney's office with request for Inspection
Warrant from court to access property for inspection. �
4. ❑ Request inspection within ten (10) days and verification of Code compliance (see
attached sheet�.
5. ❑ Project is completed. Remove or expose areas checked in attachment (No. 4 above)
for verification of Code compliance within ten (10) days of date above.
r
� 6. �❑ Owner,refuses to complete project by required inspections and said property is
potentially hazardous to any who enter thereon. All documentation has been forwarded
to City Attorney's office with request for prosecution for violation of adopted Code�s�.'�
All further contact shall be with that office until such time as resolution is decided by Court.
Sincerely,
n
'-i� � ..% ' � o
i . �_.
'�?-J7�l�:l��L� �F''� ic✓''A�QJ
RECORDSCLERK
C-133 754-5273
CMF 0985-46 (rev. 5/83) White-Permittee; Canary-Bulltling Div.
.< ,.:
CITY OF COSTA MESA -
Development Services Department - Building Division
P. 0. Box 1200, Costa Mesa, CA 92626
PERMIT EXPIRATION FORM
To: �G,7-f/YYJ C4Lf�'t�(J-'7,2d2.P/yCGY �
�'g',�O L�'�zPcr�/ytlrLe�
�.,�-,� �.�r ca 9�6,�6
Project Address: --����Z-e-
. , -r .' �-';_�
Date: �/�/�<�; o'i9. �•3
� u �
Permit 1) �i'J��p ���� 2)
Numbers 3)
41
Our records show that the listed permit�s) was obtained for property improvement, or alteration, at the
above project address and the project was not properly completed.
This permitls) expired on .
Please be on notice that, without a valid permit and required inspections completed, you will have
encumbered your property with an illegal structure.
C-1-33
7. ❑ Please call 7545273, give the permit number�s) and request a"deadwood"
inspection within ten days. An inspector will visit the site with the
pertinent records and advise you of the necessary steps in correcting this
situation. If no work was performed, please sign and date, and return to
the Building Division.
I hereby certify that no work was performed. I understand the permit will be cancelled.
SIGNATURE
DATE
2. �� Owner refuses to comply by responding to the City's request to correct an illegal and
potentially hazardous project. If no response is made within ten (101 days of the date
� above, all documentation will be forwarded to the City Attorney's office with a request
for prosecution for violation of adopted Codels). All further contact shall be made with
that office until such time as resolution is decided by the Court.
Sincerely,
( �K1X�ivC� t'��i2-P�J
RECOROS.CLERK
754-5273
CMF 0985-46 (rev. ]/83) White-Permittee; Canary-Builtling.Div.
' 239�4 -
COSTA MESA BUILDING-SAFEfY DEPARTMENT
P. O. BOX 91] C087A M28A� CALIFORNIA
For Appl7canf fo Fill In tompletely
TYPE OR PRIN7 �,'
"o�"G 9Jr� Cheyenne Street
�RESS
, � COSTA MESA, CALIFORNIA �
� ARCHITECT
STATE
��c. No. 19
SIZE /
OF LOT lY �
USE OF
EXISTING BL�6.
68 E. 4th St:� Tustin
Brattain Contractors,
4 Vf. Commonwa+n 1 t.h Ava _
erton� Calif.
417 No' 871-2710
�i . _ .. ' I NO. OP BLOOB.
� y � kEAR
EFT S ' I RI(iHT
DESCRIPTION OF WORK
� ROOM9 O BTORIEB 1
� ( COV�ERIN� Shinele
��
1 HEREBY RCKNOWLED�B THAT 1 XAYe RBAD THIB �LIC�TION
ANO BTATE TH�T THE ABOVe IH COppECT��NO AG E TO COM.
PLY WITH ALL QTY OROINA! 89'AND 9TAT6 W8 REOOLATINO
BOILDINO CON9TROCiION �
SIGNATURE OP'
PERMITTE ��
AUTHORIZfiO AGENT � ✓
CITY 0� CDSTA ME�
'A�YLI�ATIO96FOR PE
���U�ING
f i�lse O
n¢ce�rr no.
3
ZONING
NO.OPI U8[O�
YARDSAPPROVEO
MAIN BUIL�IN6
�ISTANCE BET.
MAIN BLDGS.
V AR. SC
BE LESS THAN
YARDSAPPROVED
:CESSORY BUIL�ING
OATE
� 6S
/6�zsa.�.Aba'"'� n
THE AMOUNT SHOWN UN�EH VALUAiION 18 ROP TH8 F
PUPP08E Op E9TABLI6HIN0 A PERMIT FE8 ONLY. + Q
VALUATIOIJ O /' Q m
PEPMITFEE $ ��� �
l �
�� f��� - LA CH C � �/�^ O
�\ / ! // �% n