HomeMy WebLinkAbout322 CABRILLO ST - Building Permitsd
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(774) 754-5273 • Fax (774) 754-4856 � www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626
Job Address: 322 CABRILLO ST
Suite No
Vicinity: KITCHEN
Parcel Number: 42501306
Applicant: MARSEILLES, CHRIS
Address: 999 OAK ST
COSTA MESA, CA
owner: HUDSON, ROBERT L
Address: 41864 JENNIFER AVE
HEMET,CA
Contractor. G AND S CONSTRUCTION
Address: 999 OAK ST
COSTA MESA, CA
Arch / Eng :
Address:
MECHANICAL PERMIT
Phone: (949)642-9204
Zip: 92627
Phone:
Zip: 92544
Phone: (949)642-9204
Zip: 92627
License: 369762
Phone:
Zip:
License:
ISSUED BY:
Status: ISSUED
Applied: 11/13/2000
Issued: 17/13/2000
SCOPE OF PERMIT
INSTALL NEW HOOD WITH VENT IN KITCHEN OF EXISTING SINGLE FAMILY RESIDENCE, PER
CODE ENFORCEMENT NOTICE.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair / Alt Cooling/Heat
Inst / Rep. Recess Wall Hir
Refrig Sys <700 k BTU
Refrig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers � 10000cfm
Air Handlers > 10000cfm
Floor Fumace
Floor or Suspend Heater
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
510.65
50.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
Quantity
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Re(riqeration Unit
Ventillation System
Evaporetive Cooler
Commercia l I n cinerator
Domestic Incinerator
Compressors / Absomtion Systems
Up to 3 hp I 100 k BTU
3To15hp/SOOkBTU
15 To 30 hp I 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15to30hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
ouantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00
50.00
50.00
534.15
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis untler California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 7 BO days.
INSPECTIONS: in order for lhe xrork aulhonzed under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
246646 (NW)
WORKERS'LOMPENSAnON DECLARAnON: '
I hereby eNirm u0der penalry ot perjury one ot tha following tleclaralions:
❑ I have antl will maintain a certifiwte of consent to sell-Insure for workers' compensation, es providetl lor by section 3700 of the Labor Code, lor the pertortnance ot the
wark for wnich ihis permit is issuetl.
I.liave and wlll
My workers' c
❑ I cBRify ihe� in
compenseUon
comply witn Ih
ApOlicent SlgneWra:
T/qUSAND DOILARE
LICENSEDCONTRACTORS
1 hereby aHirtn tha��l�em lice'n)�
force and eNecL.�-M��
CONSTRUC710N L
❑ I hereby aHi�
Lentlets Name: _
Signature: �
irence, es required by section 3700 of the Labor Code, br Ne perfortnance of the work for which this pertnit i5 Issuetl.
G �/.�I /ti/// �PalicyNumber.— �6 � 3.5 b �
ip/eted i/ the pertri 1s u ef onThuntlred dWlars ($700) oNess.) ZZ y
ance ol iha work fo Ich ihis pertnil is issueQ I shall not employ any person in any manner so as to become subject to Ihe workers'
'fomia, and egree if I shoultl �ecomo subject to the workers' compensation provisions ot Seclion 3700 ot the Lebor Cotle, I shall Iorthwith
" //-/3- ��
�Dete: ---
WORKERS' PENSATION COVERAGE I$ UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOqED
IN ADDITION TO TNE COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SECiION 31060F THE LPBOR CODE, INiEREST, AND ATTORNEY'S FEES.
with Section 7000) of Division 3 otthe Business3� Profes ions Cotle, end my license Is in full
Giazs 1 �% �
Date:- �%/'�/ �
construction lending agency tor the peAormance of iha work lor whic� this Dermit is issued. (Sec. 3097, Civil Code).
Lentler's Atldress:
_ Date:
OWNER-BUILDffR DECLARA710N5:
I hereby ettirtn thet under penelry of perjury that I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Profeuions
COCe: Any ciry o! counry whic� requires a permit to construct, alter, improve, tlemolis�, or repair eny structure, prior to its issuance, also requires the applicant for such permit
ro file a signad stetement ihet he or she is licensetl pursuant to the provisions ot t�e Contrectors License L.ew (Chepter 9(commencing with Section 7000) of Division 3 at Ihe
Business and PrO�essions Cotle) or �hat he or she is exempt Iherefmm antl the basis for t�e alleged exemplion. Any violation ot Saction 7037.5 by any applicant for e pertnit
subjecis the applicant to e civil penalty of not more Ihan five hundred dollare ($500).):
❑ I, as owner ot Ihe pwperty, or my employees with weqes as Iheir sole compensation, WILL DO TME WORK, and the siructure is not intended or oNered for sale (Sec.
7044, Business and Protessions Cotla: The Comractors License Law dces no1 apply ro an owner of properry who builds or improves thereon, and who does such work
himself or Herself or through �is or her own employees, provided that such improvements ere not intentletl or ofleretl lor sale. If, however, �he builtling or improvement is
soltl wi�hin one year of completion, the ownerbuiltler will heve the burtlen of proving t�at he or she tlitl not build or improve lor purpose ot saleJ.
❑ I, as owner of Ihe property, am EXCLUS��ELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions
Code: The contrectors License Law tloes not aDG�Y �o an owner ol property who builds or improves lhereon, entl who coniracts tor such pwject with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I em exemp� unaer sec.
Siqnature:
Owner ID verified by dnvefs licensa. ❑ Ves ❑ No
Business and Professions Code tor this reason:
Varifice�ion ot OWnership by (ype of document, i.e. - properry tex bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Drivers License No.
Date:
Expires:
� 1 hereby ceM1��y Ihat no exwvation five (5) or more feei In depih into which a person is required to descen0, will be made in connection with work eu�honzed by Ihis
permit, antl that no builtling sWcture, scaflolding, talsework, or demolition or dismantling �hereof, will ba more ihan thirty-six (36) feet high. (Chap. 32, Gry 2. Atl 2. Sec.
341, Ttle B, Calitomia Atlministrative Code).
❑ As owner-builder, I will not amploy anyone to do work which would require a permit from ihe Division ol Intlustrial Sefery, as noted above, unless such pereon hes a
pertnit to tlo such work tmm the division.
Signature: Date:
DiviSion ol InduStfial Safary Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTFiY: I cenity under penalry of perjury ihat I have read this applicafion and s�ate �hat the intortnation given is
correct. I egre omply with all state laws d ciry ordinances rela�ing to Guilding construction, and aUthonze representaiives of Ihe City of Costa Mesa to enter upon the
above-desc � ed pr yerry for inspeqion pu es. I agree not lo acupy or allow occupanry ol eny building authorized by this permit until final inspaction.
CdIE 1NIID'!fl
Sysiem Flnal Fire Prevantion
1266 Pool Spe Final
200 Final Re•Root
201 Final BIocWRetaining Wall
202 Final FaGiory Fire Place
203 Final Sign
204 Final Dernolition
//-/ 3 - ���---
'Date��—
COOE� INSPECTIONTYGE
206 Final Mechanicaf
208 Final Plumbing
210 Final Elearicel
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupam
�.1711�L'il�ir,lci
� � T-
AVDlieant to fill in all soaces witnin heavy bortler lines ana sign all aooropriate aeclaratlons.
CITY OF COSTA MESA - aeg� IT ry,p �� TRACT NO. ' LOT NO. BLD(d. NO. � ' ' � -
CONSTRUCTION PERMIT r cS �.S � 5464 5/05I82' � ' 6•00 .'
Project Address 3 � ' TVPE OF CONSTRUCYION ' . � - ' � � � - �
OWnef , ' pho�e,� - 6 ❑ NEW ❑ ADD '0 ALTERATION - ` ' - � � � - ' �
Addf24 ' ' ' ' ❑REPAIR ❑CONVERSION ❑DEMOLISH
� ZONING REGULATIONS. -
ArchlEng. •� - License No. � o7t�ER - , �
AddfC55 -' " � ' ' - . _ DESCRIPTION-OF WORK A'P"� � � ' �
'ZONE PLNG. REF. �. � ,
�Contracror n Phone ,3 TYPE OF PERMIT ' � ' �SETBACK C L 57. a�o�����vNLiNE ' ' �
Addf255 - y, � - ❑GRADING ❑ FOUNDATION ❑-STRVCTVRAL �SIDEVARD �
LICENSED CONTRACTOR DECLAR ION � � LEFT
I hereby a�firm lhat 1 am licensetl untler provislons oi Cnarter 9�com- � SENANT O ELECTRIGAL �PLUMBING ❑MECHANICA 5iDE YA ,
menUng with section"]000) of •, Dlvislon-3 ot tna Buslness' antl � � OTHER - _ � RIGNT
Pro/e55ion5 Cotle antl my license is in full force antl eifect. - ' ' r ' REAR VARD (TO P/L) � r - 't
VROJEC7 DESCRIPTION
'Llcen e Class � Li<ensa No���9 '� ' ,
�-'�Q�jS � SQIFT. " L �PKG.SPACEREQ. PROVIDEDj
Date� r-d -�,,.,,,,�.a c� C�'�L - ' ; � . _ — . r
WORKERS' COMPENSATION��ECLARATION -- - . - OCGUPANCY_CONSTRUCTION TVPE ; STREET WIDTH PARK FEE §
�I hereby atfirm that I have a certifitate of consent to selhlnsure or a� ,' � �ZONING APPROVED BV • DAT,E , i
,VALUATION ' ZONE
,certiflcate of" Workers'�Compen5dtion Insuranca O a'certlfletl�copy 1
thereof Sec on 380p� Lab. C.). ; ' �SPECIALCONDITIONS: :
i � GRADING CU. VDS. ACRES '�" ia .)
-MIICY Nd. �0396// " ComPSnY .S� . . ' - . . . .
'ertltietl copy-Is bereby furnishetl. � � • REMARKS: - �-
.ertl8etl copy Is tiled wi[h the city Builtlin9 Divislon. . �'�� , � �
E%EMPTION FROM WORKERS' COMPENSATION DECLHRATION - � � � - - �
(This 5ection neetl not be completetl if Ihe pe�mit I5 fo� one huntlretl _ . . . . . _ . . . . . . . .. ' . . . . 1'
{§100) Or Ie55). � • � v .
.C¢rtify tha[ In [he perfOrmance of [he wo[k fot whiph [nis pCrmit I5 _ . . _ . _ _ . . _ .
ISSuetl, I shall not employ dny per5on In dny manner So as to betome . PL•UMBING . PLAN CHECK � ELECTRICAL PLAN CHECK �
SUDjett [O�the Wo�kers' CAmpensation ldws ot UlHornid.. " �
Dale Signature � BATHTU85 SHOWERS
NOTICE: It after making this tleclaration, you s�oultl betome stibject �. TOIL'ETS' • ' � VRINALS GEfJERATOR 0-1 KW_ 1-lO�KW,
lo the Worker5' Compensation provi5ions of the Labor Cotle, you mus[ _. _ .TRANSFORMER. _ .. � _
forthwith comply wi[h such provizions or this permit shall be tleemetl LAVATORIES DOUBLE LAVS � �APPLIANCE 30-50 KW_50 + KW � •
ravoketl.. . .. ' - - - . _
CONSTRUCTION LENDING AGENCV KIT. SINKS DISHWASHERS MOTORS 0-I�HP_7-30 HP -
. 1
I hereby aiilrm that there is a construclion lentling agGnty for the pGr- SERVICE SINK$ SUMPS ' .(iNC.50lAR) 30-50 HP '=50 +.HP '
.formance ot the work for which this permit is issuetl (Section 309� �
Civ. C.). "' ' -" - � FLOOR SINKS FLOOR DRAINS �FIXTURES OUTI_ETS SWITCHES ,
Lentler's Name
Lentler'S Atltlress DRINKING FOUNTAINS . � ' GAS TUBE SIGNS � • � • �
OWNER'BUILDERDECLARATION'-� � � - � INTERCEPTORS CLARIFIERS POLELIGHT$
I h¢r¢by affirm Ihat I am Gx¢mpt from th! Contrattor'S LicenSe Law for ��
Ihe following reason (Section �037.5 Business antl Professions Cotle: SWIMMING POOL � PTRAP - - �� -
Any city or county which requires a permit to <onstruc[, alter, VOLES METERED SUB �
improve, tlemolish or repair any structure, prior to Ils issuance'also re- yyqTER SERVICE ALT.ERATION - %PANE�S MAIN�:. —-.SUB � j� �
qWres the ap'.liwnt tor such permit to ti10 a signetl statem2nt that he
is Iitensetl purzuant [o the provisions of the Contractor's'License Law' GASSEftVICE OUTLETS � �� 'SERVICE � � AMP. �
(Chapter 9(commencing with Section 7000) ol Division 3 of tne '�
6ustness antl Professions Cotle) or that he I5'exempt therefrom antl lhe' y�ATER HEATERS � BTU OUTPUT �
b@�515 for the alle9etl exemption. Any violatiOn Of SeCtiOn 7031.5 by _ Y _ ;�� • '�� ����- �- ' �
`;•appllcant for a permit subject5 the applicant to a clvil'penalty - SEWER CONfJECTIONS ���
{.,�"""t mo�e lhan five huntlr¢tl tlollars (§500). �- � � �+"
... "__�_ ' ' ' _ ' _ ' """ ' . _"'__ _. "_ , ' '"__'.. '
.�`:3'!; as owner of tne properiy, or my employees with wages as their SOLAR TANK COLLECTORS� � � •.•��. � , - � � ,�,�.� ,.,.�. � � . �� ' ,
sole_compensation,.will tlo the wo�k,.antl.the.5t�ucture Is nol Inlontletl �
or ofteretl lor sale. (Section ]044, Business antl Professions Cotle: The SOLAR PIPING SVS. � ISSUE FEE �
ContraGtor'z_License t.aw does no[ apply [o an owner ot a p�oper[y - �
wno builtls O� improvez [hereon, antl wno aoes such wo�k M1lmSelf or ISSUE FEE '� 1 d •AVPLIGATION APPROVED BV� � � pqTE {
through.M1is own.employees, pmvitletl thal sucli improvements a�a nof
Intentletl or ofleretl for sale. If, however, the builtling or improvemeni MECHANICAL PLAN CHECK �� " �
is sola.within. one year oi.compietian, the owner wlll have tna Guraen � _ SUMMARV OF FEES Y�. .
o� proving he tlitl nol builtl or improve tor lhe purpose of sale). � rBUILDING' - �
� I,- as owner �oh-the property, am exclusively-contracting�wi[h HEATING SVSTEM 0-300,000_BTU � , _ PERMIT E �� �SMIP - E'
IlcenSetl mn[rattors to consVuct Ihe r0'eCt Settion 7044, BuSiness ANO DUCTIIVG ' PLAN CHECK E 7ERMIT �
P 1 ( 300,000 + 8TU �
antl Profes5ions Cotle:�The Contractor's Ucense Law tloes not apply�to '- --- - ' a� � ISSUANCE S
an owner of Oroperty who builtls or improves theraon, antl who con- REFRIGERATION 0-]00,000 BTU PI.UMBING §
(ract5-f�om zuth projec[5 with�a contrdCtor(s) IICGSn¢tl pur5uant [o- -SVSTEM' - ' ' - - " ' ' ' " _ GRADING E - '
[he Contractor'z License Law). 100,000 + BTU PLAN CHECK 5 • • � ..
❑ I am exempt untlei Settion B. & P. C. lor this BOILERS BTV • �ELECTRICAL S ' E �
rea5on' ' - �PLAN CHECK E - �MICROFILM E
SVSTEM REPAIR,ALTERATION i •
Date - - pwne� - ' 'MEGHANICAL 5 TOTAL FEE S-
I,hereby certitythat I have reatl this appliwtion antl state that the above. EXHAUST SVSTEM MU�TIP�E - . '"LE55 AD- ' -
inlormation is mrrecL 1 agree to comply with all city antl county PLAN CHECK E VANCE PC �/ �
ortlinances and state laws rela[ing to construction, antl hereby authorize , �j � ,
repr¢senlatives� of this city ta entCr upon [he aDOve mentlonetl � - y a
property foy�inspec�tlop purposes. _ _ -� �y�2 . I "
Signa[ure yC �� r���1/L Dat¢ FINAL FEE S��� ��
Drivers' License or 55 � ISSUE FEE � - - - -' . ' ' , � , - �
CMh UbbS-4b WryItC-6WI0109; Cdndry-AppIICdO[; YIIIK�HCCOUOtlng; GOIO¢nl0a-Hssessor
�
CONSTRUCTION AND PLANNING � . � POOL & SPA ' , ; �
APPROVALS Permit # P-3yw Date Inspector ' p�ppROVALS Permit # ' Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location- � � -
Soil ipe-Undrgrn 44. Steel Reinforcement --
3. Electrical Conduit Utility-Undrgrn 45. Forms '
4. Electrical Conduit-Undrgrn 46. Electrical Bonding - -
� . tee em orce - 47. Rough Plumbin & Pressure Test--
6. Electrical UFER Grn ' 46. APPROVAL TO COVER-GUNITE �
7. Footings ' . � - ' 4y. Electrical ConduiDUndr rn � � � �
6. Foundation - - � � 50. Gas Pipe, ❑ Undr rn, Test � �
9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn ' -
10. Structural Floor SYstem 52. APPROVALTO DECK ' •
' 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � �
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing � - •
14. Rough ElectricConduit - - - - �56. Electrical-Final ' � �
� 15. Rough Electric-Wiring- � � � 57. Solar SYstem-Final - � ' ' � � ' '
16. Rough Heating & Air Conditioning � encing & Access Approval
17. Ducts, in Structure APPROVED FOR PLASTERING
' 16. Ducts, Ventilating ,�
79. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL � �
20. Roof Framing �- � � � ' � �
21. Roof Sheathin � ' , . _ � • ' -
22. Frame and Flashin ' NOTES:
23. Insulation � ' ' � � �
24. Lathing &.Siding , ' � - �
25. Drywall Nailing .
26. Plaster Brown Coat • � ' - -
27. Elecvical Power MeterFinal ' - � � � "
� 28. Final Electric ' - � � � � �
29. Final Heating & Air Conditioning � • .
30. Final Gas Pipe-Test - "'
31. Final Plumbing JZ Q1- - ' • ' � �
32. Water Service-Final � " � �
33. Gas Service-Final � � '
� 34. Solar pomestic-.Final � i ' ' � � �
35. Landsca e S rinklin S stem � � � �
� 36. Sound Attenuation � • � � � -
37. Handicap Regulations � � - - , � � �
' 38. FINALSTRUCTURE&BUILDING � � � � ' �
39. Special Requirements Completed � � - �
40. Electric Release to Edison � - -- -� -
' 41 . Gas Release to Southern Califomia Gas Co, i � � � � - -
42. CERTIFICATE OF OCCUPANCY �- �
� No. Date
OWNER pI,qTTE, PATRICIA DATE 5-4-70
JOB ADDRE55 322 Cabrillo Street BUILDING PERMIT N0. 31789
- .. . nocr-oioTinr.i _t wnov . , . .... . . .. . .. ..
GENERAL CONTRACTOR p�er-
AP No. 117-245-06 LOT 6
INSPECTIONS
soi�
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE � MOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOIIS
ROUGH MEATING AND AIR CON�ITIONING
TEMPORARV SERVICE OR POLE
UNOERGftOUND POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BON� BEAM ❑ STEEL REINFORCE �
SHEATHING
FRAME AN� FLASHING
LATHING — IN OUT n
PLASTER, BROWN COAT
STftUCTURAL, FINAL
HEATING, VENT., REFRIG. AN� A.C., FINAL
PLUMBING, FINAL AN� GAS TEST �]
ELECTRIC, FINAL
BUILDING. FINAL
SUBCONTRACTOR
r"
� :� I ��39
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
for Applicant to Fill in Completely
PAIL
aAY -4-7[�cHs;,00 101'� *t
APPLICAT�ON FOR BUILDING PERMIT
RECEIVEDBV DATERECEIVED DATEISSUI
��'�C .S'f�7o .r d
OWNER' A
MAIL +J BUIIDING
Z .
ADDRESSO � � � ADDRE55
w W TEL.
dU CITV NO.� '�� TRACT
Z Q CANSiRUGT�ON
W A A R
O � LENDER
a m
J � BFANCH
-� N OWNER
m J AODRESS
_j m ARCHITECT TEL. SE
a OR ENGINEER Z N '�
V N � FIRE
Wa / 20NE T
� AODRESS �
aw
APPROVED
W Z COATRACTOR - BV
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W w TEL. ZON NO.OF
ZF CITV NO. P��
w� STATE CITV VARDSAPPROVED
y� �IC. NO. LIC. NO. MAIN BUII,DING
_� SI2E . �L% .�Q7 NO.OFB�DGS. (FROMGlST�
OF LOT NOW ON LOT � FRONT
VSE OF
EXISTING 9LDG. ' , -�( S FT.
� SIZE OF /p NO.
Z NEWBLDG. � ROOMS STORIES / L.SIDE FT.
EXTERIOR AL ROOF
V COVERING KCE COVERING REAR FT.
J USE OF BUILDING AN� W RK TO BE PERFORMED , DISTANCE BET.
a �!� MAIN BLDGS.
a
Q U VAR. �W
O C.U.P.3W
� APPROVED
N �
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VI hereby acknowletlge that I have reatl this application antl ztate
= that the aba�e information is correct antl aB�ee to comply with
� all laws re6uletin8 builtling consvuction, antl I shell mt employ
F any person in violation ot the workman's compensation laws of
(/� the State o� Calitornia.
ZI hereby cert(fy that I am properly licensed as a contractor untlar SQ, FT.
Me State Of California Business ontl Proteszions Cotle, Divisicn 3, THE AMOUNT SM01
Chapter 9, end [ha[ such licenses are in tWl /orce antl effett, or I THE PURP�E OF ES
am ezempt from t�e provisians of the Steta of California Business VALUATION
antl Protes4bns Cotl�slon� 9i��
Sig^atura ot �j �O
Permittee . 5 �S/ �f DO
b�
Auffiorized A9ani
LOT
APPROVED
FV BUILDI
FT.
BET. MAIN &
ACCESS. BLDGS.
DATE
APPROVED
nn-rv .."Y../�-%�i
�
0
!N UNDER VALUATION IS FOfl '
ABlISHING A PERMIT FEE ONIY: ¢
PERMIT FEE $ � �'�� j
PLAN CHECK $ I I �� O E
0
TOTAL FEE S
� �So LL
OWNER. NeedB �O rp DATE 12-1�-�R ,_
JOB ADDRESS 322 �3bP1110 Street BllILDING PERMIT NO. 82(9
GENERALCONTRACTOR
AP. No.
GROIiP
INSPECTIONS
mat
VAL[IE
DESCRIPTION OF WORK
TYPE V ZONE
DATE I SUBCONTRACTOR I DATE
s. w aet/gar
�
ERMITS ISSUED
I NUMBER
e J� -_ v �-_ "-� �.
` ) '�� _ __ " _�� . _
; -'.. . ' "� ' . '
$269 I�i �/ u?�
COSTA MESA BUILDING DEPARTMENT "� �� VA�CH`_I t1 �61'
p.p.BOX 31l �+�^-
COSTA MESA. CALIFORNIA � 3I ( S ��
G1�11A�11i'C � CDT
FOR APPLICANT TO FILL IN APPLICATION .'OR PERMIT
ADORE55 �� � ,�J�,Q �Y c���
411BUILDIN�GA
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
//y� PECEIPT NO. pp}w(���
OWNER �,E��ETh A L m.� /� o L3fb�
IMAIL
ADORE55 JO�,
QTY ,�'
ARCHITECT
OR ENGINEER
ADDRESS
� �� A.
CONTRACTOR
ADORES '
LEGAI LOT
OESCRIPTION NO.
A.P. NO.
TEL.
NO.
LIC.
NO_
� � CITY LIC. ����
_S�'L• NO
/��/�� ��IOSNOf..L—��NDB
BLOCH TRACT(/�%.�
OF LOT � 3 a i��o �
USE OF
EXISTING BLDG.
SETB>CF 11NE iNOM ��.�/
OF BLDGS.
ON LOT
REAR VARD
SIDE YARD RIGHT /J LEFT �7
DESCRIPTION OF WORK �
NEW ALTERATION I ApDITION
REPAIR MOVING DEMOLISH
BUI�DING NO OF
SIZE 9 ( AOOMS Ij STORIE$
EXTERIOR WALL ROOF
cnvcwiur. COVERING
/'-'��'r� I/ L ry.S 1� D�
BIJILDING
ADDRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZONE {.�
/ t
HOLD
� S
DATE
CORRECTIONS
-�� - � a- ` ('3-
-.� 6'; /� �S- a ';
i _ — '��i- . /> Q �
r' l�TC�' �`f� i6�A �/�oi O '
�Y�/ '-!Y � �–�"
I HEREBY nCNNOWLEOGE TXnT I H4VE PETO THIS APPLIC4TION �Np
STATE TNRT TNE /�BOVE Ij�ljf�CTf�plp�/�f�(t�T� Q�LL.Y WITN ALL ��//'1
CITY ORpINRNCES AND $IY ROf aZW6.Mi l�idb��C CONSTRVG rL�
r�orv. pq3p NEWPORT BLVD. vnwnrroN
SIGNATURE OF COgTA ME$A. CALIF. PERMIT FEE S i�I �
PERMITTEE o ONH LI. B•9388
S I� S�/ PLAN CHECK S / S —
AUTHORIZED AG �!<2=�f�� TOTAL FEE 5 SL,�
v��
a.