HomeMy WebLinkAbout2550 COLUMBIA DR - Building Permits�
CITY OF COSTA MESA
CALIFORNIA 92626 P.O. BOX 1200
FROM THE OFFICE OF THE PLANNING DEPARTMENT
December 17, 1975
The City of Costa Mesa wishes to advise you that in revising street
addresses, the following addresses have been changed:
OLD ADDRESS NEW ADDRESS
228 Princeton Avenue 2550 Columbia Drive
For your convenience we are listing the agencies below that we have
notified of the change. In addition to those listed, you are advised
to notify your correspondents of the change in order to avoid any
possible interruption of mail service.
Your cooperation in this matter is appreciated.
Very truly yours,
��, w. ���
Charles W, Roberts
Director of Planning
cc: Board of Equalization
County Clerk (4)
Orange County Tax Assessor
Pacific Telephone
Registrar of Voters
Southern California Edison Company
Southern Counties Gas Company
United States Post Office
Bond Department
Building Safety Department
Communications
Costa Mesa County Water District
Engineering Depar�t "ent
Fire Department ✓
License Department
Police Department
Public Works Department
Street Department
File
CMF 0064-26
s
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TESTING
Cwinanq Labos�tories �,f ���,i�tr�Z„ c��c�f�,z,Z«, �,z�.
P.O. BO% a] . 3?10 AIR"ORT WAY . LON6 BEACH. CALIF. 9080i . 1713� 4P6�3355 . ��I:� 636�2326 . p14� A1B-6a31
?nAYCN OGqCES:
�s .-o nen�.na,r.e�s�.,o�� .s�� No� o,.n,�n'.,r.��„o
Se.�a�vGa'�(o�,�evvo� 'r✓�-��°"- iv55a..da•ycn.e.oOR_.n
PI�� SJi8��5
�� ���� p� Lo�q 2ee:M1, Cel'�L Gpe01 �1p� a3a3]SE
�^, _�x
November 4, 1975
Examinaeion: SC]5-$123
COMPRESSION TESTS O�! GUNITE CYLINDERS
Mr. Erro1 F, Heesch
° 12g21 Aspenwood Lan"e •
Garden Grove, California 92640
PRo�ECT SIJIM POOL ^ DATJ McHENZ1E .
aDDRE55 2550 Lolumbla Drlve, Costa Mesa
SAMPLE FROM Po01
IUCXITFCT
ENOINEER
MIX
DATE CAST
DATE TESTED
CYIINDER NO.
COMPRESSION
TOTAI LOAD, t85.
POUNDS PER SQ. IN.
SIZE
COMPLIANCE
CYLINDERS
4.5 to 1
to/28/75
11/4/75
I
CONTNACTOR
California Piols
SUlCONTRACiOR
Grove Gy�nfte
SPECIFIED
SiRENGiH
SLUMP
7 Days 7 Days
72,500 75,500
2,365 2,400
6-1/4"x12-3/4�� 6-1/4"x12-t/2"
7 Day tests tanpty wlth speetfieattons.
�.uoe er
Jr.
DIST41�UfION:
E.f. Neesch - 2
Grove Guniet
Costa Mesa t31dg. Dept.
�
OEIIVFFFD !Y
2,00!1 psi
11/4/75
111
7 Days
82,000
2,670
IV "HOLD"
V "HOLD"
VI "HOLD"
6-1/4"xi3-1/4"
tFCFIVED ON
E. HeeSch 10/29/,)5
' Q�itd��,R� ..,�-��Y ,�t�'1.
4�uv � 1975
.,,...'o:a;i...�sr<:�:+�t„<,:,;.;,,, ,;,'r.t;r,.;;r.,�,,, ,
•ll MEVORiS �P{: SVOMIi}EO �5 TN[ CONfIOEMti�L PNOPERTV O� CLICNiS. 1l1TNOR12�T10M fOR PUOIIC�TIOM O� OVN REVORTS. COM�LUSIONS, OF EA� �
TP�CTS �ROM 04 RFG�RDING TN[M I$ ACSERVCO PENOING OVN WNITTEN �VVXOVAt.�S 1 MVTV�IL PROTECTION TO CL�ENTS,TME PUBLIC �ND DUPSELVCS.
330q2
,1
�:�,
'�ITY 0•F COSTA M�S,B
'ProjectAddress _��
.:.a> -
Appiicant's fvtailing Addret
-OwneF's Name �
'Address 7S� CQ�-Ef�
UCTION PERMIT
Applicant.to fill in all spaces exceD� those within neavy bortler Iines ana zign ali aooropriate tleUarations.
-"PERMIT NO. TR CT ' LOT NO. UNIT NO.
Arch/Effg. - • • License No. : "
Address ' p
J �
Y Contractor's Name O p "�' �'�Phone ��
Addresslmailing) �� ` -' � � � /:.
City'License No. � ' ' ' +`' ' t�-�
f� LICENSED CONTRACTOR DECLARATION `', � �-• _ : "
�y I hereby affirm lhat I am licensetl untler provisions of Cliarter 9(commencing
v with section �000),ot Division 3 ot the•Business antl Protessions Cotle, anCt.
CiL my license is in full force antl effect, f
�� License Class •' license No.
1 6 Date Signature � ` `� J
� WORKERS' COMPENSATION DECLARATION �. � •�
� I hereby affirm tnat I have a certificate of consent to self-insu.e or;a certiticate�.
of Workers' Compensation Inmrance, o� a certitietl copy;thereof ($ec[ion.
3800, Lab. C.) ' � 2 ' !
licy No. Company� -
Certifietl coOY �s hereby furnishee. . .- . ,. • r�
J Certifietl copy is tiletl witM1 the city Builtlinq'DiviSion. ' �
Date - ' Applicant � '� `�`•
EXEMPTION FROM WORKERS' COMPENSATION,DECLARATION /: �
(TM1i55ection neetl not be completetl if the permit Is for one huntlretl'($300) or
less). _! ' ' �.� ' �, .
I certify that in the perto�mance of tlte work tor�which this p¢rm�t is i55uetl, I
shall not employ any person in any manner�so as-to become subject to the ,
Workers' C�o{+�pensation Laws of California. - < -.
k Date _�/.f.�.l..�'�—Si9nalure �� �� � - '
NOTICE: rf; atter.makin9 this'tleclaration, you"shoultl become subject to tne
Wo�ker5' Compensation 0/ovlsions of the Ldbor Cotle, you must forthwitn
comply with such provi5ion5 or'. this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby atiirm-that there is a construction lentlin9 a9ency for the per�ormance
of tne work for which this permif is issuetl (Section 3o9�.•Civ. C.)
lender's Name
. l_entleCs Aatlress _ �
OWNER BUILOER �ECLARATION
I hereby atfirm that I am exempt trom the Contractor's License Law tor the
following reason (Section ]031.5 Business antl Professional Cotle: Any ciW or
counry which �equires a permlt to cansttuct, alteq improve,'Oemolish or repair
any st�uctu�e, ptlor to its issuance, also requi�es the applitant for such petmit
to tile a Signetl statement that he/she is licensetl pur5uant to [he provisions of
the Contractor's License Law (Chapter 9(commencing wlth SectionJ000) of
Division 3 of the'Business'antl ProfessiOns Cotle) or that M1e/stte is exempt
lberefrom antl the basis for the'alleqetl exemption. Any violation of Section
]03L5, by any applicant fo� a�pe�mit subjects the appliGant to a civil
' �enalW of not more than five huntlretl tlollars ($500).
� I, as owner of the properry or'my employeez with wages as their sole
.mpensation, will tlo the work, antl the structure is not intentletl or offeretl
�or sale (Section 7044, Business antl Pro(essional Cotle: The ContractoYs
Llcense Law tloes not apply lo an owner Of a property who builtls or improves
Ihereon, antl who tlaes such work himself/herself or througn his or her own
employees, provitletl tha[ such improvements are not intentled or offeretl for
sale. If, howeveq the builtlin9 or imOrovement is soltl within one year of com-
plEtion, fhe owner will have the burtlen of proving he/she tlitl not builtl o� im-
prove tor the purpose Of sale): ,
� I, as owner ot the property, am exclusively contracting with licensetl con-
tr2ctorsto construct the project (Section ]064, Business antl'Protessions Code:
TM1e Contractor's License Law does not apply�to an owner of property who
� builtlz or improves.thereon, antl who contracts for suth projects witn a con-
tractor(s) �¢ense pursuant to the Contractor's �icense Law). I am aware that
proot of their WorkeYs Compen5ation insurance shoultl be provitletl [o me.
❑ i am eicemPt under section ���`�`� B. & P. C. for thi5 reason.
� Date Owner '
I M1ereby certify that I haJe reatl tM1�s application antl state that the above
information is mrrect..l agree to compty with all city antl county ortlinances
antl state laws relating to builtling wnstruction, and hereby authorize repre-
� sentatives of thi5 ci[y [o_enter upon [he dbove-mentioneA propetty fo�
inipection purposes. , ' 4
.Signature� l�/wA/1S � Data �Q`87
y� orivers'Licenseor55� �/ � =}•
B E A 3 a3 3 S .�vl �3p .,
TVPEOFCONSTRUCTION NEW 'ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER 'f� ' A p # / /-.�
DESCRIPTION OF WORK/USE OF BLDG. �� C+Gl -/�-•! S� -
� � S Nlain Buiiding:
7�PEO�PERMIT GRADING FOVNDATION STRVCTURAL � T Front
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL A Rear .
❑ O�THER � ' - .
PROJECT DESCRIPTION St�. FT. ' OCCUPANCV C Ri
CON;STRVCTION�TVPE VALUATION S /%�C7O• ��� 'S Left .
�ZONE � '' GRADING CU. Y�S. � ACRES Ping. Ref. #
Remarkv. _ ' � Q(� - , : PlanningNotes: �
J � ` .
V'
� � Bar Sink - � � � —
Backflow Preventer - ' ��
� 6ack�flow Irri9ation � . .
� Bathtubs ' ' � �
� Ciarifierv . `
Dishwasher�
� Drinking Fountains �
Floor Drains . � '
Floor Sinks
ice Outlets ,
[Of5 f j `�
Sink , . . .�1
es � 'C
ains '�.=-.-��. '
Reinspection Fee � $15
Boiler
Duct- Under Ground .
Duc[ - Structural
Duct - Ventilating
Exhaust System ❑ MWtiple ❑
Firepl/Fact.8lt. ICBO #
Heating System & Ducting •
❑aioo,000 sru Oioo,��
cion Fee �� � $15
CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicant Pink - Atwunting; Goldenrotl - Assessor
PLUMBING � -
Showers
' Service Sink
Sewer,Cap
'SewerConm
Solar Collec
Solar Piping
� Swimming�Pool w/Spa
Urinal
Water Closet
Water Heater
. Water Service . -
' Auto�Wash
Issue Fee
Hood or Typel ❑
Canopy Typell '❑
Refrigeration System
❑0-t00,0006T 100,
System air/Alteretion
Registers.
luue Fee
$ 3
FEES
$, 3
Automatic Washer � .
Construction Pole Sub.
Cooking Unit �
Dishwasher
Dryers �Gas ,�Electric
Fan '
F.A.U. '
Fixtwes �
Garbage.Disposal
Generator �0-5 KW
t.^
5559 9/18/�7
Accessory Building:
�
� /1 /
/Prov
0
ELECTRICAL �. , ,
Transformer ❑ 15-50 KW
•. ❑50+KW
� Meter ❑up to 100 amps
Meter ❑over700amps
� Sub Panel � - .
Motors OO-1 HP O1 h- 8
IncSolar �9-75 HP �16-75a
Microwave
Pole Li9ht� •
Range •�
Slgn " --
Standing Sections
W TrashCompactor ;.�.
- ' I I _. =J
', I Reinspection Fee . ' I $15
bEVELOPMENTSERVICESREQUI
Zoning Approved By
Building Approved By ,
Issue�Fee � - --
FEES
�
�
�
' - - SUMMARV OF FEES Q
� BUICDING PERMIT - $ ��� SMIP " ;$. � :.��� � I
PLAN CHECK $ � 9• 9L • PERMIT �
PLUMBING $ C� - O b ISSUAIVCE •$
�. PLAN CHECK 25% $ Z- f�O ENERGV P.C. $ -
ELECTRICAL . $ _E�.� i��0 GRADING $
PLAN CHECK 50% $ � O�•�%'O MICROFILM' $
J. �
MECHANICAL $ TOTAL FEE S
PLAN CHECK 25% $r _ ' " . , ' . /�
'
, �CONSTRUCTION AND,PLANNING
�APPROVALS Permit# Date
,1. � �
Inspector
�,1.�Temporary Electrical Serwce or Pole
2. Soil Pipe-Undrgrnd. ' ' (�.�•� �p
3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement � �
6. Electrical UFER Grnd.~;" . .
�
7. Foo'tings �- - !� I6 g7 � f�'
. ,., ., �
8. Foundation � - -
- • ,
9. Water Pipe-Undrgrnd. - �
10. Structural Floor System (,(� (� d ��-
71. Property Sewer Line & House Connection �Z�u�� L�j
72. Sewer Cap
13. Roof Drains .
14. Rough Plumbing � SgG/rp1T 2•2,8Q [�jD
15. Rough Electrical-Conduit -
16. Rough Electric Wiring $Ct' -
17. Rough Wiring Sign � 4-,
18. Rough Electrical-T Bar Ceiling� . - �
�.
19. Rough Heating & Air Conditioning '
20. Rough Factor`y Fireplace'
21. Ducts, in Structure '
22. Ducts, Ventilating� .
23. Gas Pipe-Rough & Test
24. Roof.Framing �
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frameand Flashing 88 ��_
28. Lathing & Siding 1
29. Insulation 8�' �j�
30. Drywall Nailing �
31 Plaster Brown Coat �-
32. Electrical Power Meter-Final
33. Final Electric . �7.�
34. Final Heating & Air Conditioning
�35. Final Gas�Pipe-Test -
36. Hood or Canopy
3}: Final FactorY Fireplace
38; Final Plumbing ( � �� L�p
39. Water Service-Final .
40. Gas Service-Final
41. Solar pomestic-Final
*42. Backflow Preventer .
�
-43. Backflow Ir�igation ,
'44� Landscape I`rrigation System '
45.�Sound Attenuation
46_ Handicap Regulations �
47. FINALSTRUCTURE&BUILDING � � � 0
48.- Special Requirements Completed
49. Electric Release to Edison -
50. Gas�Release to Southem California Gas Co
Date _ _ I
i
. ' POOL & SPA . ,
APPROVALS Permit #
52. Pool & Equipment Location'
53. Steel Reinforcement ' � .
54. Forms � . . . .
55. Electrical Bonding � ,
56. Rough Plumbing & Pressure Test �
57. APPROVA�TOCOVER-GUNITE__,
a�
Date Inspector �
58. Electrical Conduit-Undrgrnd. ' �
59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines,-P-Trap, � Undrgrnd.
61. APPROVAL TO DECK •,
62. Backwash & Receptor-Final •
63. Heater & Vent-Final • � �
64. Plumbing System - Final �
65. Electrical-Final �
66. Solar System-Final � �
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
� FIRE DEPT. REQUIREMENT _�
APPROVALS Permit # � _
70. Underground Hydro
71. Product Piping � Gas ❑ Oil ,
72. Underground Flush ' .�
73. Undergrnd: Storage Tank � Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe -
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL --
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED,
Notes: �a -� "87 fc;t;c l, r� tr�'f r.
�
b
c.�.wsre � V�oac.� v��
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. , . } � . _ , ti� S� '`,. ,`" .��C:
CERT�F CATE .OF ,COMPLIANCE . . � ✓ � . �.
y ��,P`AYMENT,OF SCHOOL �FAC�L�ITY FEE � �\ ,.'� . -�- . ,_
1' `_;, . , �. 11 1 ".:.;; k i , ; , _�- ' ''"•_ �-, ,-�. , _ `
� -�l. � NEWPORT-MESA UNIFIE�DrSCH00L DISTRICT ' ��
_.... .'� _:_..l �� - , --� . z ��, � � � ��• _� /, i . ' ,
. :-e�,�+: ' 'ti� . ! �`, . tI t �... �+` �.y' " v . y ..� G �=� !' `� --e�� i '�-•�. �'' • • � � .
-..�.o'r . � '. � . a
i ` � _.
Developer/�A'p�g1-i'can�t�.'� .� �ir.. --��•%+"��a . . `+
, • ' ,i e . �-.r, v�jL,
' . , ' , , J: .F�. ` AT/f�L'
Ad�d;ress: ' "` i �SO �n�i...� 1��..
�'I'eLe'p}ione Numb'er: '%j'SyO-'.2��
' . � �,,,. � 1.., - 1 v . ; ",.9
Tract/Parcel and Lot Number(s):
� Location of ProjecC: � �) C
\
.�_ 1,x
)7�;E.o • . CbS� �
V . ��
J ^•,' M�,l' .
;�.;�. _ ' , ^� .
y . �.
'9�/'9! ,. . .
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� �� - ' �.»-. ! �:i1.�/.. ��L' � i'- _ '�e �1 .. •_
-' ..'1.:,��,lyt4.� ��....:+ 1 _ `�.1\ v�r:,r;�:..�, �d� , r.�✓'; , ; .......�' ,+,;i ;���
Numbe'r of .S uare Fee't of� S�`� ` '
4 1 �,rti �• — o o '�_;:.
� - ^ `�Riesid'eri.tia�l Space °` 3 ' `�"=�x �1 �50 Total ���5 "' '
._ .�'� �.,. � �'.; : �1 �: J ,- , +
� ,la� ' . s � � ��� �� -`� � ' �° rl, `I �� �A1�q .
� Num6'er of Square F,eet�'of� '�^"!,�`ti i IM1 �� � .,fi1�'?)�'•l `,-d '
�,.., ,. �� �'... , .���;, - v_
��pGo,mmeici�al"and � , �` . ' ' �:J' i�`
,i;�`I'i�dyu'striatl,,�S.Pac;e�y'�[� . _`�`z�':-��•l�tz $0.25� Total � ���-%l4.�'•i�s
. _`-__ ... A.�'�� � r,:,� _ ' k ��� .
' � � � , ,�rS �'irTit,;.�4 t � r �. >..� , ;,
=���TheJ,p,rovi.si!ons of Gov,ec,nmen}t Code•Section 53080�are not i -
J,':. applicable. i , ,� , �! �...Ct C'".'�.,'�.J�
- �.cw� �, Lt� � 2 �. V � 1 1,; ':�i l> ;�-i � �0 �. +% � a ' .
This certifaes that the above- a.med�Develope,r/Applicant hasr.p�a{id �;
.- � .-. �, _ . � � ., � �.-
� F scthool. fa'ci:l�i,ty:;,Vfees, in c�om.pl,iance wit;h �Government Code �Secl'i'ons`-T
a
530-870Fand� 6`599'S. � ,. : � r^` ..t ✓`y` ;`;��{ \..ir , ,.,i<i �' �� } +
' . ,1 l,.� � ��.t�l�, �.i'�1 v � � , ��� �i 1 �Q:'i� IY�U.T '�,�\ 1t'C�.X i . �'�.�,i1 ,...5�` :" . .
� Checks are to baes made payable,.,t�o���(N�ew�ort-MesatiUnified Schlool � ��
�� .- . D s:til t{,_�r�;.. �'�C�11=.1.. `,; i_'1�..�'•.J�`-� ` „�' ..,1i ���tnJy� 4_� 1�iti �
��. � �v i � � (:
� { C�
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� ` �.-'�--?j . t,� 1�..' ''` 1 � �) ^ l� n , Ci;;7• �cy�t�% /�'. ':L����� �11. �;<ll •� � „ .
� • .�'� � � , l -1- j � i 'J � d � � �� - ' - .`� . l." I . . �
� �� �'{� , .j.1.11 �`B.uslin ss Manager C -i-7•��� `(,� FJ ��'
� � ti_\. � Newport-Mesa UnifiedCSchool District' '
.^s��hw."..Y-��-•�Cr...�� G��i4�''�� �t �,{�w �l�{���.\`�
�
, � „�,_ �r, �
1. �' � L .
T.}i,e__ati_ove r,e.pr�esen'tation 'as�:to�sq�uare footage is true. ' ,
Develotpe��Applic.ant agrees�tha.C�if�'/iE is later.determi��d that.
�su�ch`�represen�t�at:ions,are�ntot��rrueVth'en this certificate.Lh,a31��
automaYically terminate and bhe"Ea.p,propri�ate Cih'y/County sha11�• be
no•bi?fii�e,d.�-��i•, 1��C7 �.�.ri��,, �/'1'"((;�:C'�1��(�`±.-;
, �ac::.i�, ���:..�r ;� ... � • � �31��a �- _ �-� ��,n�-z�`
r�� . �- ,,-/ ��f. , ,
� ����'�_:.�C;i•i ��`�<:�. ;-,�-Ji� iJ �� �//� LGt9�z_�---:%�i�==,�*�. ^�
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- D`a•te':k�, \g������ �� ��1V �Per 'A'PPlicant �, . ` l 1
. � � � . , ,..., . , �,, . C� �, -�, �.�n�e� ,r�t,-_
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To .� cv�,�., ,+.�,a y �o.��.�.�ti �s/89 . --
2 E: Per..,, t# �3 EP 3 0 3 3 g
4' : ZS.So C'o(u,.�l,iu ,����ue - -
f nucf. 3 i S 7 /07'' 3 0 _ . _
Subj: p�a�Naye .-
- -- -- -- - � �")� _,QrUPor _C��^ai�vaye /7Cc5 �ee..J �+a�.✓'rarved an. /vn✓J.^oue� -
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_.tlU2 rp CO+�S-I�ruc'��o.v COr..�pl-e7�.-Pe{ a� a(jov,¢ AdriSS• �Cc.. p� _
.. .. _ p� 2JCCeSS R.4�v U^ .Lu�'�'2� �,.r .. /S ��B//t..T. _ - - _ -
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OWNER Dan McKenzie DATE 10-1-75
JOB ADDRESS 2550 Columbia DLiVE BUILDING PERMIT NO. 40627
GENERAL CON712ACTOR California Pools DESCRIPTION of WORK Pvt. Swim Poo w pa
APNo. 1_ q5-35 LOT 30 TRACT 3187 FIRE ZONE VALUE$ 5 000.00 _
n` INSPECTION$ $i nature Dvte GROUP TYPE ZONE �RL
` Pool Location � +Q � b-,�-�� SUBCON7RACTOR PERMITS ISSUED
� Date Number Si naeure
� Forms
� Main Drain
\
Steel Reinforce
Elec. Bond
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines 8nd Recep.
Electrical Final
Heater and Vent Final
Filter System Final -
Backwash and Recep. Final
Fanrinn Final
Electric
Plumbing
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' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING � CO'LU�ry��
ADDRESS
OWNER l 1H-N /�/G.C�r��F/7 %eC
ADDRESS p�ry��D
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TEL.
CITV NO._
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A.P. NO.
BUILDING
ADDRES:
t1CT -1-75cra�n�Q 014`•' '�:r:^f,*Li8.50
FORSTRUCTURALPERMIT
DATE RECEIVED DATE ISSUE❑
' /A_ �� �'�
BFANCH
OWNER � �
AD�RESS yALUE �r�,/
ARCHITECT TEL. S OOG— $ ���UU
OR ENGINEER N .
FIRE �
ADDRESS ZONE TV GROUP
APPROVED �
• CONTRACTOR � � BY DATE � '
ADDRESS '2� �� ��p . � '
TEL. Z�N NO.OF USE OF N
CITV NO."f�'�I6 PLANS BUILOIN��I
rF. STATE CITV �'APDSAPPflOVED VARDSAPPflOVED
� LIC. NO. `� LIC. NO. MAIN BUILDING ACCESSORV BUILDI
(y SIZE NO.OFBIDCS. (FqOMC/LSTREET)
iL OF LOT NOW ON LOT RONT FT.
a USE OF
.�. EXISTING BLDG.
� `
FSepara[e permits are required for L SIDE FT.
0 elec[ric, plumbing and heating work. qEAR FT. �
W USE OF BUIIDING AND WORK TO BE PERFOR ED
F DISTANCE BET. BEf. MAIN &
qMAIN BLOGS. ACCES"i. BLD
VAq.qW DATE
'� / , (� C.V.P.$ APPROVED
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� I hereby acknowledpe thai I have �eatl this application antl state
p�. ihat the above information is corract and aerea to comply with
a all laws re8ulating building consttucNon, antl I shall not employ '
W any parson in violation of the.workman's compensation laws of
� the Stata ot California.
3 I hereby certify that I am properly licensetl as a contrector untle� SQ. FT.
the State of Califomia Business antl Professions Cotla, Division 3, THE AMOUNT SHOWN UNDER VA�U
Chapter 9, end ffiat such licenses are In full force and effect, or I THE PURPC6E OF ESTABLISHING A PERI
am exempt from the p ovisions of theSiate of Callfornia B�Slness VALUATION PERMIT FEE $
entl Protasslons Cotla ivision 3,,Chapter 9. '
, d:% PLAN CHECK $
SIB�atura Of J
Permittee $ �'��9 TAX $
� Authorized Agent ✓ TOTAL PAID $
ON
FEE
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OWNER C. E. PHIId;IPS
JOB ADDRE55 2550 Co1u
GENERAL CONTRACTOR G
AP No. � k7 _�q5-�S LOT
INSPECTIONS
SOIL
GAS
WITER
ROUGM PLUMBING
PNOP. SWR. LINE I-I MOUSE COH.
SPRINKLING SYSTEM
MISCEILANE0U5
ROUGH HEATING AN� AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNOERGROlINO � POWER �
ROU6H WIRING
�TRENCHES FORMS STEEL REINF.
FLOOR SYSTEM
Bj]H� BEAM � STEEL REINFORCE ❑
�MERTMI G
FRRME/.NO FLRSMING
LATHING - IN ❑ OUT n
PL�STER, BROWN COAT
STRUCTURRL, FINAL
HEA7ING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINA� RN� GAS TEST ❑
ELECTRIC, FINRL
BUILOING, FINAL
DATE
SUBCONTRACTOR
9-7-77
PERMIT N0.
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' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
ADDRESS L, UI I • �
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OWNER r• `� �� �I I I ^
MAIL �1C � �.�...,.�..... /1.�_
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CITY
BRANCH'
ADDRESS
ARCHITECT
ADDRESS
CONTRACTOR
ADDRESS �
CITV `
STATE
UC. NO.
SIZE
OF LOT
USE OF
EXI5TING BLOG.
NO.
TEL.
CITV
ll0. NO.
NO.OF BLDGS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating wock.
UILDING AND WORK TO BE PERFORMED
�
I hereby ecknowledge ihat I hava reatl thla eppllcetion antl state
thai the above Informetlon is co��ect antl agrea to comply wiih
all laws ragulatinB bulitling constructlon, and I shell not employ
any person In violatlon of Me workman's compensetion laws of
the State of California.
I he�eby ceriify that 1 am prope�ly Ilcensatl es a contractor unde�
tha State ot Celiiornie Business and Protessions Cotle. Division 3,
Chaptor 9, entl thec such licenses ere In full� force and effect, or I
am exempt tram the provlslons of the State of California Business
and Professlons Cotla, �ivisl Fhapte .
Signetureof / /� �` /\7
Permltiee _CV � /�
Authorizad ABent
PAIO
SEP-7-77�nsAQO 277� ****Z0.50
APPLICATION FOR STRUCTURAL PERMIT
RECEIV50 DATERECENED neToiccimn
A.P. NO�/j/
BUILDING
ADDRESS
TRACT
FIRE
ZONE
APPROVED
N � NO.OF ,
PLAN$ �,
VARDSAPPROVED
MAIN BUIIDING
VAR. #
C.U.P. �
USE OF NE
BUILDING
VARDS API
ACCESSOflV
BEf. MAIN &
accEss. e�o�
DATE
APPROVED
9_
THEAMOUNTSHOWNUNDERVALU
THE PURPOSE OF ESfAeLISHING A PERI
VALVATION PERMIT FEE $
�a PLAN CHECK S
$ /DOO ' TAX S
TOTALPAID $
T
BLOCK
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COSTA MESA BUILDING DEPARTMENT
P. O. 60% 3 I �
COSTA MESA. CALIFORNIA �
�=EE RECt{VED
, SEP i s is5�
INANCE DEPT.
�� '�I GTY OF COSTA MESA
FOR AP LI NT TO;FIL N, APPLICATION FOR PERMIT
BUILDING O BUILDING
A�DRE55
COSTA mEsn. cnuFORNin ' FOR OFFICE USE ONLY
FECEIPT NO, p �/�
OWNER COLLEG E PARK NO. � vZ
RECEIVEO BV OtTE RECEIVEO OnTE ISSVEO
MAIL ' r C�
ADORE55 2 � �-(� S0. ���A I N'ST, —/ v
TEL. BUILOI G �
CITV ({ e� NO. K � .ADDRE55
ARCHITECT � uc. COSTA MESA. CALIFORNIA
OR ENGINEER NO,
FIRE .
ADDRE55 ZONE
CI IIC, ZONE �LANS � TYPE ,/ GROUP
CONTRHCTOR NO. v Y
TEL. APPROVED
AODRE55 - NO. - BY DATE �
�E�a� �or (J CORRECTIONS
oESCRIPiION NO. � O BLOCK . TRACT � I(J
A.P. NO. . � '
SIZE / NO.OF BLDGS.
OF LOT ( �IOW ON LOT
USE OF �
E%ISTING BLDG. � �
SETB/.CI( LINE FROM �
CENTER OF STflEET REAR YAR
SIDE YARD RIGHT LEFT
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
�REPAIR MOVING DEMOLISH
BUIIDiNG NO.OF
SIZE ROOMS STORIES '
EXTERIOR WALL ROOF '
COVERING COVERING '
BUELDFNGEW RESIDEDICE EC DETACHED
G R A G F
I MEREBV ACKNOWLEDGE THPT I HAVE REAO THI$ APPLICATION ANO
STATE TXAT THE ABOVE IS CORFECT ANO FGflEE TO COMPLV WITH wLL
CITY OROINPNCES AND STATE LA�NS REGULATING 9IJILOING CONSTPIIC-
riorv. � VALUATION '
SIGNATURE OF PERMIT FEE 3 �
PERMITTE COLLEGE PARK NO• �
' PLAN CHECK $ l .�
AUTHOR ED� $��� 200. TOTAL FEE 5�
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