HomeMy WebLinkAbout2846 CHIOS RD - Building Permits�
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CITY OF COSTA MESA
CONST�iUCTION PERMIT
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Apv���ant to fill In all svaces exceo< those within heavy Doreer lines antl sign aIl appropriate Oeclarations.
Project Address a X`f� <' f7 i o 5 /ii,! I
Applicant's Mailing Address / 1�3� �.cJ ,�-/.J l�.a�.✓
Owner's Name �/ .✓ / i/S vhone?%1 -3 �7 D
Address• SAn" e
Arch/Eng. License No.
Address --�{� �7'�
Contrac[or'sName'1Lr' A✓�s !'�r/mG/N�� rA.%' Phone�%7��ju'7U
Addrr.ulmailing1�333 /.�/ /�/'c.a/.✓ An/,giie;m
City License No. S`7-j �
LICENSE� CONTRACTOR DECIARATION �
I herCby aflirm thdt 1 am licensetl untler provi5iOn5 of Charter 9(commenCing
wlth section 7000) ot Division 3 ot the Busine55 antl Professionz Cotle, antl
my Ilcense is in tull force ntl leff7 c�t. '
Licensq lass �` " `� % 'cen�e Nw���� �,�
oatc /�'/S' 3 ro�ar . /Y /"J �.l":L•�t-o
�WORKERS'COMPENSATION DECLARATION
I hereby aftlrm that I have a certiticate oi mnsent to selt-insure or a certl(Icate
of Workers' Compensation Insurance, or a certi(ied copy thereof (Soction
3800, Lab. C.) c,/ ' � .
Policy No. ��a TU Company(���C/� �!✓5
��..1y�ertitietl cooY is hereby furnishea. �
lH Certiii d cop is I tl with lhe city�}� Itling D�vi ion
Date ��'/,y-�� ApplicantN"`%L�'C�� ��
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl it the permif is fo� one huntl�etl (5100) o�
less) '
I certify that In tne Oe�fo�mance oi the work fOr which this pe�mit Is 155uetl, I�
shall no[ employ any Derson in any manner so as to become subject to the �
Workers' Compen5ation Laws ot Califomia.
Dato � Signafure
NOTICE: It, af[er making tnis tlecla�ation, you shoultl becOrtie subject to Ine
Wo�ke�s' ComOensation prOvizions Of the labo� Cotle, you must forthwith '
comply with such p�ovisions o� thls' pe�mit shall be,tl¢em0tl revoketl.
CONSTRUCTION LENDING AGENCV • ' '
I noreby atfirm that tM1ere is a consVuction lentling agency for fho performance
of the wark .for which this permit. is 6suetl (SecHon 3097 Clv. C.) .
Lentl¢r'S Namx -
Lentler's Atltlress
OWNER BUILDER DECLARATION ' � -
I hereby atflrm that I am exempc from tne Contractor'S Ucense l.aw for the
following reason (Sectlon 7031.5 Business antl Protessional Cotle: Any city or
[ounty whi<h �equire5 a permit to cons[ruct, alt¢r, improve, tlemOliSh or repdir
any structuro, prior [O its issuance, also reqWres tbe applicant tor such parmit
�to flle a.5ignad statement that he/she Is li[en5etl pur5uant to the provi5ions o/
the Contractor'S License �Law (Cbapter 9.(mmmencing wi[h Sectlon 7000) of
DivislOn 3 of lhe Bu51neR antl Prof¢SSions Cotle) m[hat he/she is exnmpt
thereirom an0 Ihe basis for the alleged exemptlon. Any violalion of Sec[ion
.]031.5 by any applicant tor a permit subjects the applicant to a dvil
� enalty of not more than five huntlretl tlollars (y5,00).
� I„a5 Ownar of the prope(ty o� my employees with wages as [h01� sole
compensation, will tlo the work, antl the�sVuctura is not intentletl or o(feretl
for sale (Section 7044, BuSiness antl Pmtessional Cotle: The Contractor4
Llconse Law tloes not apply to an owna� of a prop¢rty who bulltls o� imp�oves
the�eon, an0 who tloes such wo�k himselt/her5elf or through M1I5 0� he� own
employee5, provitletl that Suth improvements a�e not Intentl¢tl Or ofteretl for
Sale. If, however, tne Duiltling or imOrovement is soltl wlthin one year ot com-
Pletlon, tne owner will have tha burtlen of proving he/she tlitl not builtl or im-
�rove for the purpose of zale).
I, dz Own¢r of the property, am exclusively mntracling wi[h Ilcensetl con-
tractors to construct tne oroject (Section ]044, Business antl Pro(essions Cotle:
The Contrattor•s Llcense Law tloes not apP�Y lo an owner of properry who
bulltls or Improves thereon, antl who contracts for suth orojects witn a con-
tractor(5) Iic¢nsa pursuan[ to the Contractor's License �aw).
❑ I am exempt untler Section B. & P. C. tor this reason
Data Owner
1 hereby certlty that I have reatl tNs applicatlon antl state that tne above
informatlon is correct. I aqree to comply with all city antl county ortllnances
antl 5[ate laws relating to builtling constructlon, antl hereby authorize repre-
sentatives oi this cily to enter upo �the aEove-mentionetl property tor
Inspaction purp �t
Siqnature ( Date� )'�� �
-�a�o9
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p.�6
DESCRIPTION OF WORK
S Main Building:
E
TVPE OF PERMIT GRADING FOVNDATION STRUCTURAL T FfOnt
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL A Reaf
❑ �OTHER
PROJECT DESCRIPTION 5(l. FT. OCCUaarvCY ' C Right
K Left
CONSTRUCTIONTVPE � VALUATIONS S
ZONE GRADING CU. VDS. ACRES ping. Ref. #
i
Remarks: Parking Req./Provii
' ' Use of Building:
' . ' - PLUMBING FEES P�anning Notes:
Sink Showers
cflow Preventer Service Sink
cflow Irrigation Sewer Cap
nubs � Sewer Connection
ifiers $plar CAllectors
iwasher ' Solar Piping
iking Fountains � Solar Tank
x Dreins• ' Swimming Pool w/Spa
x Sinks � Urinal
Service
Outlets
Kitchen Sink .
l:avarories '
P—Trap
Roof Drains
Reinspec[ion Fee. $25
Boiler
Duct-UnderGround
Duct - Svuctural
Duct - Ventilating
Exhaust System � Multiple ❑
Firepl/Fact. Blt. IC80 #
Heating System & Ducting
❑ ai oo,000 sTu O i oo,000 er
Drivers' License or 55 �
� - I I Reinspection Fee I $25
CMF 0865-46 rov. 7/83 White - Builtling; Canary - Applicanq Pink - Accounting; Gol�enrotl -Assessor �
Water Heater
Water Service
Issue Fee
Hoad or Typel ❑
Canopy Type I I' ❑
Refrigeration Sys[em
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
luue Fee
Automatic Washer
Construction Polef
Cooking Unit
Dishwasher ..
Dryers �Gas Of
Fan
F.A.U. .
Fixtures
Device Boxes
OuHets
Garbage Disposal
Generetor 00.5 KW �5-75
$ 3 ';
Reinspection Fee
FEES '`
� PUBLIC SERVICES REO
"� Zoninp APProved By_
'-� APPlication APProved 8y
'� Appliption Issued.By—
$ 3
BUILDING PERMIT
P�AN CHECK
PLUMBING
PLAN CHECK
ELECTRICAL
PLAN CHECK
MECHANICAL
PLAN CHECK
/
Park.Fees $
�
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
' Meter Dup ro 700 amps
Meter poveri00amps
Sub Panel
Momrs O0.1 HP O1 X- 8
Inc.Solar �9-15 HP �1E75+
Microwave
Pole Light '
Range
Standing Sec[ions
Trash Compactor
$25 � Issue Fee
0
$ 3
SUMMARY OF FEES
S SMIP $
$ PERMIT ��.�
$ � ISSUANCE $
� ENERGV P.C. $
g GRADING $
$ MICFOFILM $
$ TOTALFEE $ .5 C"J
$
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CONSTRUCTION AND PLANNING �• POO� d SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
d,� Temporary Electric8l Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. " 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
'�4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. , 57. APPROVAL TO COVER�GUNITE
,7. Footings � . 58. Electrical Conduit-Undrgrnd. .
. Foundation 59. Gas Pipe, O Undrgrnd., Test
��9. Water Pipe-Undrgmd. � � 60. Backwash� Lines, P-Trap, O Undrgmd.
10. 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 �
74. Rough Plumliing � � 65. Electrical-Final .
15. Rough Electrical-Conduit 66. Solar System•Final
1'6. Rough Electric Wiring 67. Fencing & Access Approval
• 77. Rough Wiring Sign, 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning � FIRE DEPT. REnUIREMENT,
20. Rough Factory F'ireplace APPROVALS Permit9{
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � � 74. Overhead Hydro
26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemicai
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & Siding . 77. FIXED SYSTEM FINAL �
29. Insulation � � 78. FIRE PREV. FINAL
30. Drywall Nailing ' � . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: L¢�FT �i42O-�1 4�J�y L�
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy ,
37. Final Factory Fireplace � �
38. Final Plumbing /2�I�d�c� L%Ga
39. Water Service-Final
40. Gas Service-Final '
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation ,
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRU6TURE & BUILDING �
48. Special Requirements Completed �
49. Electric Release to Edison ' '
50. �Gas Release to Southern California Gas Co ' '
51. CERTIFICATE OF OCCUPANCY .
No. Date
rz +�.:.�t�'VU..-•`�/w� }'s L-.`;r�y: .� 9 N.. . ���r,{.�i� .L:V�L'�.���Y t.i:li,iL:�.-i,v..�1,:,n., �.y,f.i%__.,w;_p:..-.:.+t.,.
`�1 f.�Y�
CITY OF COSTA MESA
Developinent Services Department - Building Division
P.O. Box 1200, Costa Mesa, CA 92628-1200
PERMIT EXPIRATION FORM
i
To:
y��s, ��L��r �1�.�
,�/,•�� St/n ��GGot-:7/ s�'� .
( � !� 1L1`�s(_ �L P�.t. tL ���-�/�
c�
Date: ��-''� y ��
Permit� 1) ���� ��y 2)
Numbers 3) � 4�
Project Address: �� � �'��� �"��"L�'L `�"� '�'—"
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 �/� %�� � `'� .
Please be on notice that, without a valid permit and required inspections completed, you will have
encumbered your property with an illegal structure. �
ffi
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 correciing 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. 1 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 (7D) 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 Code�s�. All further contact shall be made with
that office until such time as resolution is decided by the Couri.
- C-1-33 -
Sincerely,
C'% � /'�
�l/I.C(/z.C-E�2J �? �%�1 G,•C,a? 4> �-�
RECORDS CLERK (/
754-5273
CMF 0985-46 (rev, 7/83) Wbite-Pe�mittee; Canary-Building,Div.
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OP a euim+u: 2 8 4 6 CH I OS RD uxr:
OfMER91UYEIFpqWN: MUNIICUS, JAMES L TR
wo�ss 2846 CHIOS RD
COSTA MESA,CA 92626
957-8344
�vr�. Yuin+o �ooxess
�PCNRECT OR QI@1H11: LIC IID.:
YKX.011 FHQ'S 1DOflE59: UNT:
ca+m�crarsru�: D&J ROOFING CO ( 714 ) 637-5609
����Ry�N� 2040 N SACRAMENTO
�oo�ss ORANGE CA ��� 366956
92667 �r
UCENSED COMRACTONS OECLGPATION: I Mreby elfrm uMn panaly d pe�ury iha� 1 un lice J uMx praieionv d Cheqs 9
(cpnmantlrp Mill} �J� 11(q0) a �^'uC^ C1A55: C ne u1CeeNonn C�� , d,yny,lisg e u I e eM e�e� / O O
CRY LJC. NO.: U t5 L 1 7 J b V V
Dme: S�/�'9� C r.
OWNEF BUILDER DECUINRTION: I he�eby elfiim uMr perely d per'Nry tlW I em apnq ho tM Co Ireaon licen�s Lew la Iha
IWox�q rseun (SWion ]031.5 Busiwsa eM Ndea�ionro CaAe: Arc�' M' or caunH/ wfiiN �Wu'vo e D�4 b mmwn. elr. inpo.a.
demd"eR a rpar mry nv.wie. pn b u'sauence. ebo reymm iM eppGram la ndi psme w fib e dprE petanM thtl M«4e
u IioeroaE Wnuani io �M P�+d Na CoMreqoea L«ame Lew ICAaqr O(mmmr�q Mit� Seaun )OOD) d Dii'sian J d ths
Buanw u,d Fan,ons ced.l «�nel ne «an. o eumN inere�mm aiw tne nnm lo. u�e albped eemq'vi. Mv violeton d s.eun
]031.5 by uy eppFa�u In e permil sibjxu ihe ppficW b a ad penMy tl rcn mon tAen fxa MaM�ed AWan �f500D.
❑ i.mo.mmdmewoo�v«mv.mWoros+wm�e.me:.d.mmw��..;nmm.wax.eneub.m,aun:�aw.�aee
«M«aE br eeb (Seaion )oM. Bimma uk PMudan COCs: TM Contreeon limme Lawtlom nd roVN �oen oMnard qapeny
M�1D b11�J V�IIV� Ihlllpl. BM� wip DOB! 9Uf�1 Mq�. �VIIfOd IX �IOTO� R I�YMI�1 �1b IX �1M G1H1 MIqO�lM, pM'1.� ��W Pll�1
imprv.emeMe na ew imaMed a dlsed la eeb. tl, hows.er, �M WiNi�p a inpm.wnem u edd Milhin ons yser d aompblion, tla
ox+w-0uitler xill heve tM Widen d po+iiq M or sM Etl M Euik a improro ta iM purpwa d vab).
❑ �. ro mmx a �he wuwro. em mc�lY caMreano ..m� �immsa cono- ,a. ro ca�w �n. waea cs.ao, ra.. eu.;... w
Pmimeione Goae: The Conlreaan Licenea Lew Eoee nd epqy �o on ownr d popeny v.Rw Witle ar impwm theraan vM Ma
convecte lor wM piqaes wnh a mMredo�s) IcemaE WnuaM lo Ihe Conlretlora Limme lew).
� 1 un a�amp uMar Sectim: B. 8 P.C., lar thu iaewn:
nm. Ownx:
I do hereby cenily Na� I em ewere d vM �vdeieieM ihe reQuiremenro d Cellomie HeeXh xd Sdny COEe Setliwn T5505. 25SU. eM
25531, W tlW I a ury Muro buYEvq ocwpent xiY / wil nd (drcb ms) nseE b oomqy wth veid pma oodee W tM ipWnmwh br
ow: �ovr�:
W ONNER'S COYPEN4�TON DECLAii�TION: I heroby eH uMv penMy tl prjury oro d tM IOAowi�p ErLrtlba:
❑ � nm..iw .a me'vuan. �anCrae a mro«N �o..n;mue a..vrk.: camponmian... a� �a W s.eid, aloo a ue LeEa.
coe.. i« m. oa+�� d u».� i« w�n mb w�a 4 4.�.d.
❑ �na..�e.ummaen�Wae•canre����.�...�.m�e.aMs.aanarooam.�.e«cm..wu»o«�«m.rc.am.
work la whirh Nu D� u ueueE. MY wvtera mm0a�ion iiuurercs wrier eM P�Y mimbr ms:
c��:
rdry N�me«
''�I.,.�� �..e,�a e. �o�ee i me w�+a ro. o� n�mm.e daw. �s,00/ w w.�
I wnLy ihm in Ne pMamence d �he woek far v.fich thu parmn I� ueustl, I Mall nol empbye9 non' menrw eo n to
becaro aMb to �he woM1an' comGe��un levnpLCc41p�n erd nG�ea Ow il I eMu 7 bx m ' p io IM haM1re'
wmpeneetion O�pna W Sedan 9)00 d iM Lebor�GoEe. I efi21� nhwnh mDN A hoe provie m.
�
ov,: �{ � i G_ 9� ,wwra�,. -
Wemllp: F�llun ro�Icun woilrsn'ronperwtlon rovenp� l� vnbwNl, �ntl NWI /ecf �n /oysr to ulmiml pwrltlp mM
uM� nno w ro am nu�e..e �rouw�e dww, !s+%awA b���n ro m. co.r o� mnpruenon �w u povaw ror in
Sxtlon ]l06 0l M� LMa�Cods, lirt�m4 � etfomay'� Isa.
CONSTqUCl10N LENqNO �GENCY: I hereW elf uMer peneM1y d perjury Ihtl IMn u e mrutvfion Mndinp epercy fa tlr
peAamenro W IM waF la �fiirh tM pamY u eaued (SsUun 3041. Cw. C).
LENDEP'S N/JIE:
LEN�EF'S ApDPE55:
� Clf1�Y I�Itl � hBVBlBBd I�1M B�ICB�YMI LId 519�81119� 1�18 BbMOI��IXIIIG�MII O CORlL�. � B01M IO ttY11V�V WI1�18� OIl' Yld W1Nl' OId11WMIf
YW 6W! kv/� �0�9(�q b bNN�q MW I�YI BM11 �IMGq' 91R�1OfR0 tOpwn�6NM tl lhlf flly b MpBf UpM IM 9EMB�IIMM911lE p1OpM�y
'°""'°'°'°"0"`°°'°' HILL JO,[y�S
o�a: b� � i� —9
(5151�B.wP) WhnrBuiknp 8 Se1ery; Graer�File: Ce�ary-�ppiranl: Pink-Revenue: (3oldenmd-Irnw
CITY OF COSTp MESA — BUILDING PERMIT
PERM NO: B 079103
PERMIT NO: H 079103 PLAN CHECK NO: N GO�7T: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF RESHEATH W 1/2"CDX / ICBO 5121 SQ FT: 7,400
CLAIM VALU£: 7,400.00 CALC—VALUE: 7,400.00 GROUP OCC: R-3 /U-1
COMMENTS: NATURE GUARD BY LP ICBO #t5121
1E 1E if iE i63E �E iE 3E aE 9E �E iE iE iE if !E iE iE 1E 1E iE �E 1E 1E �)E �E iE �E 1E jE jE fE jE 1E IE iE iE ik iE iE iE df iF iE iE iE iE if �E iE 3FlE fE iE iE fE iE iF iE �E �E �E ik jf 3E iE iE-1E iE if iF iE �E iE if if iE iE
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT ZN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGFIT: FT IN
PARKING REQ: PROV; PARCEL: 13943195 ZNE: REF NO:
PLANNING NOTES>
� _
�E 1f �E if ff fE iE iE iE iF �E If if if j(-iE If if iE iE fE iE iE �E if iE iE 1F iF jf iE 1f 1E iE if if if if if iE 161E iF 1E iE 3E if !E iE if iE if 1E iE if iF iF if if 1E 1E ik ff if 1f iF 3E iE fE �E if !E iE fE �F �f iE IE 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY . DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: �_�—�-=; /�
jlifiEiEiFiE�f-iFiE�If141EiEiE�[-lEiEfEiEif7kfETF3F{FiF�F3FIFTF�F3FTF�E3F3F�iFTF3Fi�iF3FTFTF�;F3F EiE�TFTF3F3FifiFififif-1EifikifiklE9fiE �EIE E E�F1fiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 137.25 .74
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 137.99 0.00 0.00 137.99 137.99 .00
REVENUE DIVISION TOTALS--> COLLECTED: 137.99 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
137.25 .74
iE i!!E iE 1E �E iE 1E if 3E 1! if iElE 1E iE 1E iF 1E 1E 1E aE IE �E fE �FlE �E if i! iE df iE ik ik i6 if 1E if �E ik i6 if if iE iE if if �E jf iE iF iF iE 1E �E if If 1f if iFlElE �)E iF iflE iE fE iFlE *�E fE fE iE fF �E ib
I N D I V I D U A L F E E H 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 7400 ALTER BY C'ALUE RESIDENTIAL NOZONE 1.00 7,400.00
END OF FEES
CONSTRUCTION AND PLANNING
ApPROVALS Permit #
i. Temporary Elec[rical Service or Pole
2. Soil Pipe-Undrgrnd. �
3. Electrical Conduit Utility-Undrgrnd.
4. Elecirical ConduirUndrgrnd.
5. Steel Reintorcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation '
9. Water Pipe-Undrgmd. �
10. Struttura� Floor System ' .
11. Properry Sewer Line & House Connection
12. S¢wer Cap .
13. Roof Drains , ' -
14. Rough Plumbing -
15. Rough Electrical-Condurt � -
16. RoughElectricW��ing
17. Rough Wiring Sign
18. Rough Electricat-T Bar Ceiling
19. Rnugh Heating & Air Conditioning
20. Rough Faciory Fireplace
27. Outts, in Structure
22. Oucts, VentiVaxin9
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheatfiing �
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Wthing & Siding
29. Insulation
30. DrYwall Nailing
31. Ptascer Brown Coat
32. Electriral Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe•Te:t
36. Hood or Canopy
37. Final FactorV Fireplace
38. Pinal Plumbing
39. Water Service-Final
40. Ges Service•Final
4�. $plar pomesticFinal
42. Backtlow Preventer
43. Beckflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING �
46. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas G
51. CERTIFICATE OF OCCUPANCY
No. Date
Date
Z
PO . SPA
Inspector AppROVALS Permit # Date
52. Pooi & Equipment Locat�on "
53. Stee� Reinforcement
54. Forms
55. Electrical Bonding �
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, Q Undrgrnd., Tes4
60. Backwash Lines, P-Trap, i� l�ndrgrnd.
61. APPROVAL TO DECK .
62. Backwash & Receptor�Finai `
63. Heater & Vent-Final �
64. Plumbing SYstem � Final
65. Electrical�Final � �
66. Solar System�Final � " ��
67. Fencinq & Access ApProval ;�
68. APPROVED FOR PLASTER NG
69. POOL/SPA SYSTEMS FINAL
FIREDEPT.REQUiREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Pipin� O Gas � Dil
72. Underground Flush
73. Undergmd. Siorage Tank O Gas ❑ Oil
�j�v� 74. Overhead Hydro
75. Dry Chemical
76. Dry Standp�pe
77. FIXED SYSTEYI FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
inspeCtor
JOB ADDRESS 2�46 Chi
GENERAL CONTRACTOR
AP No. LOT
INSP�CTIONS
OCCUPANCY
'ORM BU4 � SM —
naT� 3-22-63
BUILDING PERMIT NO.
Q TRACT l}3l{$ rIRE ZONE DLSCRIPTION O1P WORK T06
Signature DATE - GROUP TYPE "^mZON� `.
SUBCON7'RAC7'OR pER�1ITS I;
B�'
• � 19G86
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 9f ] C06TA M69A. CALIFORNIA
For Applican� �o Fill In Completely
� TYPE OR PRINT
BUILDIN6
ADDRE59
COSTA MESA. CALIFORNIA
� ,u n . , ./
L
CITV
STATE
LIC. NO
SIZE
OF LOT
USE OF
V b.
FHOM _
1 HEREBY ACKNOWLEo�
ANO 6TFTE THAT THE
PLY WITH RLL CITY O¢
BUILO�NO CON6TRUCp1f
!
SIGNATUREOP �
PERMITTEF ���
AUTHORIZED AGENT
s^��gq—�
�
%�) 7. .�
LEDAL
FEE RECEIVED
MAR 2 z 1963
FINANCE DEPT.
�CITY OF COSTA MESp
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
R8C81P�N0. P�H�TJiO �
� b.
a: �re%3,�� 3 @�I�T�'u "f�563
ZONING
NO.OF lI6EOF
PLANB � . euaou
NOTE: NOEAVEOVERHANGSHALLBELE3STHAN
90' TO SIDE @ REAR P. L.
—O
EAVES
rvO.onaLpae. pLLOWED �U.6.C.REQUIREMENT
NOW ON LOT � "
YAROSAPPROVED YARDSAPPROVED
MAIN BUILDIN6 ACGESSORV BUILDING
_ (FROMC/LSTREET)
OF WORK
NO. OP
ROOMS
I fi00F
TXAT 1 NAVE NEA� THIB APPLICAT�ON
�8 CORFECT AND NOREE TO COM�
IA P8 AND 9TATE LMYB RE611LATINO
r
DISTANCE BET. I BET. MAIN @
MAIN BLDGS. ACCE55. BL[
VAR.iC DATE
>� /a � so. Fr. � 5-06 � " _
�,
TXE AMOUNT BHOWN UN�EP VALl1ATION 19 POH THE F
FIIpPOSE OF E9TABLIBHINO A PERMIT FEE ONLY. �
VALUATION �� _— m
PERMITFEE $ �
§ a� S/a � LA C ECK � —' 0
¢
/ v a
TOTAL FEE $ � � O —