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HomeMy WebLinkAbout1271 CONWAY AVE - Building Permits • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. . 'CITY OF COSTA MESA - PERMIT NO: ' - TRACT NO. " LOT NO. 'BLDG.NO. • • CONSTRUCTION PERMIT ,C- 573 ' .. • •' 9'41''0 ' 12/ : 07182' 5.00 ":"L • , Project Address, TYPE OF CONSTRUCTION `• , Owner ` %"'��.J - . • - --Phonery�-3Ll t..D NEW _D ADD 9 ALTERATION- - t ..- " ' _ . . , Address y,i.F ' 1 - - .rq REPAIR ❑ CONVERSION ❑DEMOLISH y ~ . ' 'ZONING:REGULATIONS s 1 .. • Arch/Eng. •— License No: - ❑ OTHER • _ ,_ A.P. ' � '. Address - ' DESCRIPTION OF WORK` �1 `o _ - --Ca. \Lei +� ZONE - PLNG REF ')� -Contractor 'UGT • ‘S ,_:, v`•d31N V Phone z V -- BUILDING• •- - - - �.�'a4,tI TYPE OF PERMIT,. rp BUILDING . s SETBACK C/L ST, • PR OPE RTV LINE --.1. .. Address vet,-.2_ \N., Hn e,--$:_lt - `t('YN, f ' 0 GRADING ',D FOUNDATION- 0 STRUCTURAL ' , L D TYARD - , + ' - _ "- . • LICENSED CONTRACTOR DECLARATION '- D TENANT ❑ELECTRICAL MPLUMBING DMECHANICA SIDE YARD - - • - I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT ' "- ' 'mencing- with section 7000) of:'Division 3 f the -Business and -D.OTHER"-' - - .- - __ _ __ _ Professions Code, and my license is In ful rce and eff t. - - 'REAR YARD(TO P/L) ' ,., �-,_� ?rC ! PROJECT DESCRIPTION` - _ Licens�e7 Si ss}•7��p Lice •' PKG.SPACE REQ. - PROVIDED .Date{/ 1-07' Signature.. r.SQ.'FT: _ . . .. .. _ 'WORKERS'COMPENSATION-DECLARATION ,I OCCUPANCY`_CONSTRUCTION TYPE 'STREET WIDTH - .PARK FEE,$ .1 hereby affirm that I have a certificate of consent to self-insure.ora , - r ZONING APPROVED BY DATE '.certificate of Workers' Compensation Insurance, or a-certified copy VALUATION ZONE _ _I Y thereof(Section 3800,Lab.C.), • E IJDITIDN$: i GRADING CU.YDS. • ACRES •SP CI •Policy No, '- " Company - - -. .. . . ._ . _ . -.+ - , _. . , _ D Certified copy is hereby furnished.. -_ . REMARKS: • • - - +." - _ • ❑ Certified copy is filed with the city Building Division. - - "' ! - ��( _ EXEMPTION FROM-WORKERS'"-COMPENSATION'DECLARATION �•1.• s{�-\kt-..?\�'1.1��1- 'C^IYN1\--y ' ' - - " -" '- •'" -- (This-section need,hot be completed if the permit Is for one huntlretl •_ _ ($100) or less). • I �L-� .. .�.-''[+�l'r�� . , - _ - .. - . 1 certify that In the performance of the work for ••'ch this permit is - -issued, I shall not employ any person in any mariner �. -• become - PLUMBING ' • PLAN'CHECK •-- - -- ,ELECTRICAL ' -- -PLAN CHECK - " . ' subject to th W kers'Compensation La • Ca- - - . J7_ -.\[ �+ • 'BATHTUBS ' SHOWERS - uvvtLLING. -- rVAKAGt-- - - - - . • • ;Date - Signator: • •11Y SO FT NOTICE: If after making this declaration, you sho Id become subject TOILETS, , URINALS'- '- - •GENERATOR 0-1 KW_1-10 KW - to the Workers' Compensation provisions of the Labor Code,you must ,TRANSFORMER • ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - -APPL-IANCE . 10-50 KW_50 t KVO - - revoked. -_ ... -- - .. -CONSTRUCTION LENDING AGENCY - •KIT.SINKS' " ' DISHWASHERS MOTORS '- - 0-1'HP_1-10 HP - - -I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS-'-. SUMPS ' • ' -•ONC.SOLAR)_- 10-50 HP_50 +HP- - • - - formance of the work for which this permit is issued (Section 3097 •- - - -- Civ.'Lender's - � - "" FLOOR SINKS FLOOR DRAINS - FIXTURES ' OUTLETS -SWITCHES.", 'Lender's Name t•� • - ` r :Lender's Address - DRINKING FOUNTAINS- . ' - ' - ' - ^GAS'TUBE SIGNS ". - • - OWNER BUILDER DECLARATION - ' Cr " ' - . INTERCEPTORS ' CLARIFIERS • ' - 'POLE'L IGHTS' .. ' '1 hereby affirm that 1 am exempt from.the Contractor's License•Law for \ - - - - the following reason (Section 7031.5 Business.and Professions Code: ' -SWIMMING POOL P TRAP - LuNS I HUL i iuN _ ._ Any.. city or. county.which requires a,permit to construct, alter, POLES "METERED • improve;demolish-or repair any structure, priorto its issuance,•also re- 1 WATER SERVICE - 4jACTERATION 1 'e"te) 'PANELS ' - MAIN: 'SUB' :quires the ap,licant for such permit to file a signed statement that he - - - - - •- is licensed pursuant to the provisions of the-Contractor's-License Law- GAS SERVICE -.' -OUTLETS ' - - SERVICE '^^ .. .;'AMP ^-(Chapter 9 (commencing with Section 7000) of Division 3 of the • -- - IBusiness and Professions Code) or-that he is exempt therefrom and the WATER HEATERS -'- BTU OUTPUT' basis for the alleged exemption. Any violation of Section 7031.5 by • +- any applicant for"a permit Subjects the applicant-to a civil penalty `SEWER'CONNECTIONS - of not more than five hundred dollars ($500). LI ID-1, as owner of the-property,-or my employees with wages as their -SOLAR"TANK -COLLECTORS -.. .,. -. - - . , - sole compensation, will do the work,and the structure is not intendetl • - or offered for sale, (Section 7044, Business and Professions Code: The SOLAR PIPING SYS: " .. -ISSUE FEE. - ... :J' ' rk want builds License Law does not apply wh to as.such owner of a prims lfrty or _ - . - ; --� OLS APPLICATION'APPROVED BY -; _DATE-' + who builds or improves thereon, and who o a such work himself or ISSUE FEE • '' - 'through -his own employees, provided that such improvements are not _ _ O intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK 'SUMMARY OF FEES is sold within one year.of completion,the owner will have the burden I of proving he did not build or improve for the purpose of sale): - . - BUILDING. --. " - - --' with HEATING SYSTEM 0-100,000 BTU . PERMIT $ •� -,. 'SMTP-- -$ -- M r I, as• owner of -the property, am-exclusively contracting -gND'DUCTING -- -licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PERMITand-Professions Code: The Contractor's License Law-does not-apply to- -• ISSUANCE-$ _an owner of properly who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU = ------ PLUMBING $ •• -$'tracts from such projects with a-contractor(s) Itcesned pursuant to - SYSTEM - •• - - - •GRAGING. "VC the Contractor's License Law(. 100,000+BTU r PLAN CHECK$ - �D Iam'exempt under Section • "' 'B,& P,C.for this • BOILERS BTU ELECTRICAL $ $reason "_ .. PLAN CHECK S -:: - MICROFILM $-4 SYSTEM REPAIRALTERATIONDate - - - wner - ,TOTAL,FEE,$. -MECHANICAL $' - -1 hereby eertifythat I ha ad this application and state that the above EXHAUST SYSTEM MULTIPLE ,1 LE55 AD- a information is correct, o ply with all city and'county PLAN CHECK- - - ' - VANCE PC.'$_•_- • _ ordinances and state laws relati nstructton,and hereby authorize - i ' f r representatives of this ter upon-the above mentioned ' vb property for insP _ - -s 1 - "• •` • S © Q • Signature Date/2-t—bZ _ • FINAL FEE $_ • i Drivers' License or 55 - 'ISSUE • - - --• - .. - - ._ . . - . . CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor ' .CONSTRUCTION AND PLANNIN POOL&SPA, - - - APPROVALS Permit# ���� ..-4 - ,• ir• �;,, Date Inspector -- .- Date= •- Inspector � APPROVALS Permit# _..... 1. Temporary Electrical Service or Pole v 43. Pool & Equipment Location - - - --- - -- 2. Soil Pipe-Undrgrn . • _ _ 44. Steel Reinforcement - • - - - - - - ' 3Electrical Conduit Utillty-lJndrgrn _ - - -_ _ _45. Forms - - - - - - - - - - 4. Electrical Conduit_Undrgrn_, ,_ _ .. . • - - . ±: _ 46. ,Electrical-Bonding ' - - - . • .. - - • _ 5._ Steel Reinforce _ 47. Rough Plumbing& Pressure Test '• - •- - • - 6. Electrical UFER Grn . . " 48. APPROVAL TO COVER-GUNITE • . - - - 7. Footings _ - _ ' . 49. Electrical Conduit-Undrgrn • 6. Foundation_- '� /` 50.; :Gas Pipe, CI Undrgrn,Test . .9.. Water.Pipe,-Undrgrn_- __ _ . ' . - .- . /2 7 -ftz .(�'�' /s 51.- Backwash Lines.P-Trap. ❑Undrarr "''•- • - -- •• _ . 10. Structural Floor System _ ' 52. ' APPROVAL TO DECK ' 11. Property Sewer Line & House Connection _ _ _-_ 53. Backwash& Receptor-Final- ' •• •- ' ' - 'I , 12.. Street Sewer Connection , • 54. Heater &-Vent-Final • • 13._ Rough Plumbing _ __ •_ .. •-- 55 Plumbing System'-Final r . - � 14. Rough Electric-Conduit . • - - - • - 56.-: •Electrical-Final- .. - - 15. Rough Electric-Wiring -"" ' -- "- "-" - - - - - - -57.-- Solar System-Final ' - 16. Rough Heating-& AirConditioning - -- - _- . _ • - - 38.- Fencing&Access Approval • •, . • . 17. Ducts, in Structure59. APPROVED'FOR PLASTERING , 18: Ducts, Ventilating r., _ _..A_ . . . . . __ '_ .. .- _ _. _. __ _ __ __ .. - 19. Gas Pipe-Rough&'Test • - . _ . . . ."..60._ POOL/SPA SYSTEMS FINAL-, 20:- -Roof.Framing _ ._ - _ _ . _. . - .I 21. Roof Sheathing - •-. -- .. . . - . .�. . ,:• .:.. J 22.. _Frame and Flashing-- :'_. __ . _. __ L _. . . . NOTES .. - - . • ---,56-8-p ,. 23. . Insulation _ " I- - HP-:7.-c--:-HP-:7.-c--:- . . 24. Lathing&Siding " - - 25: Drywall.Nailing-- - _ "- - - .a/7-f2.- .A i'Xi.-2.,:;-S-, -A/ "i .a.ec/ , ' 26: -Plaster-Brown Coat _ _ - _ - .. .. _ - �.Q _ •. . - i , ,s.. - ' i i 27. Electrical Power Meter-Final - _ . L ' _. _ . _. _ - __ . . _ . ' i • • . . • L 28'. Final Electric: - - . i . - - &. 29. - Final Heating Air Conditioning - '- `• • ' 30. Final'Gas Pipe-Test_ . • " 31: ._Final'Plumbing 4/7-17-et- Ackkj.,' i. 32:-- Water Service-Final_ . ___ " - - 33. Gas Service-Final . __ . . 34. Solar Domestic=Final f •' •0"' •"' " ' ' 35. -Landscape Sprinkling System. .. • i . , _ . .r . - ; 36. Sound Attenuation . _ _. .r 1. - - - . .'• ; 37. Handicap Regulations .. . i. ' , i _ _. . , ,• , -•. .. ..• . , i-- - 38. FINAL STRUCTURE & BUILDING - - • - -- '•r ""'• 39. Special Requirements Completed "" " ' ' • �-. "" - �- - " - -• - ;l. • ' 40. Electric Release,to Edison - . ' ' ' . I i r.a:, .._ -- - _ _. • 41. Gas Release-to Southern California'Gas Co." ' I -IAA,. _ . • F. ,. l, - I 42. CERTIFICATE OF OCCUPANCY . . ..1 - _ ._ _ _ _____ . .. .Nd - ,.a r Date -i - - 'i - -- - - _ _ . _ - - .- . V. - c CITY OFCOSTA MESA ,. . BUILDING DIVISION b. ' ' DEVELOPMENT SERVICES DEPARTMENT " argi A. PERMIT PERMIT NUMBER B98-01662 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1271 CONWAY AV Status: ISSUED Suite: Applied: 09/16/1998 Vicinity: Issued: 09/16/1998 ParcelNunmber: 14115505 Zoning: R1 R1 Applicant: TRIBOLET, ROBERT Address: . "Ptione:" 435-0248 .`r./' Zip: • Owner LOZONNE GARY W JR Address LOZONNE;RONDA - . / COSTA MESA,CA ', - Phone: - _ - ,/,,1271,CONWAY AVE. ' _ - Zip: 92626 ��. Contractor: ' RT CONTRACTING Address: 908 MAGELLAN ST , Phone: 714-549-0305 =� > ' k C.M. CA Zip::: 92626 '�-' - License::- 374368 - - -•� Arih/Eng: ' - -.' - Address: ` - ! -`' • "Phone: - , - _ . N -/ Zip: .t: License: SCOPE O_F PERMIT /TEAR OFF&REROOF WITH COMP. . ' - 1, FEE SUMMARY ; ' .. . `- Plan Check: ' $0.00 _ -• .,,i--iii. - ,/,/,.., - Calc Valuation: • $2,700.00 Permit: i,$74.75 . jClaim Valuation:,, $2,766.00 SMIP Res: .$0.50 / SMIP Com: :$0.00 Other: ' • $0.00 - -- . Inspection: $0.00 1 Total: . $75.25 ,, -PLANNING &ZONING. , ,. SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left - '0-0 Right ' 0-0 '' .' ACCESSORY Front 0-0 Rear 0-0 Left 0-0 ' Right 0-0 - PARKING Existing: 0 Required: 0 Proposed: 0 " / ' NOTES: 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 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections 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 y WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number (This action need not be completed if the permit is valued at one hundred dollars($100)()doss.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' coBon laws of California,and agree that if I should become subject to the workers'compen ions of Section 3700 of the Labor Code,I shall forthwith corn wn ase pro ' to s. ❑ �, p / /: Applicant Signatu 'LLIZr 3 Zk Date: Ci- A0 —Z WARNING: E TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED D DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSE RACTORS DECLARATION: I he y affi tha I am licensed under provisions of Chapter 9(commencing with Section 7000)of Divi ' Mess and Profsissions Code,and my license is in full ce and effect. c.1r 3Z`{3(r+% Class# 8—( Contractor's Si ature: Qait Date: 5--/i. -rf / CONSTRUCTION LENDING AGE f Y: O -:retry. nn n t there is - •nstruction lending agency for the perfo ce of -- • for which this permit is i .:•, -:c.3097,Civil Code). L defs Name: ' .41.111111111P-A.- Le .ers Andress' _ W Ignature: Marr �.�r_� • - - OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. _ _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ es 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 4 C7 /6 ri S n ,t , Signetule L al ner(s) _D7 — r And/Or Authorized Applicant Date CODE L 9tl.UPE DATE Ui1mALS QQQEI INSPECTION TYPE DATE INTMALS 1616 Fix d System Final Fire Prevention 206 Final Mechanics 1266 Pool Spa Final 208 Final Plumbing p7$200 Final Re-Roof -I 2 5-- 6.,--k- 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-48 • OWNER - COLLEGE MESA COMPANY - DATE 11-20-58 JOB ADDRESS 1271 Conway -Avenue BUILDING PERMIT NO. #7999 GENERAL CONTRACTOR The Hale Company VALUES 12,890.00 - - AP. No. LOT 10 TRACT2671 FIRE ZONE DESCRIPTION OF WORK . Res. Watt. gar. GROUP I & J TYPE V ZONE R1 PLAN NO. INSPECTIONS DATE PERMITS ISSUED SUBCONTRACTOR DATE NUMBER Trenches Forms Steel LAG-' // �t,-6e ' Floor System \ L-E-4 / -5-.VW - - Steel Reinforce \ Chimney Re-Rod 66 • Bond Beam 1 t.-5-t _t ,. - O 1..:3 7 1 Frame and Flashing 1 74,4fl* - /J /S_(-4: /t` Lathing, In Out ( ,- S7 i-, ZI'd''isr Y/ Plaster, brown coat 41 '2 - to ---,If ' Underground soiVL-no'W/G Pipe Test/,./y/,7,-4•-S'If _t Top Out (Z•74? ' /- i Furnace C,Mi /—/ -� ,Tr7A ��Ti .re,v-e✓i 3ist ii2y /1-3.6=-th- to Jr it .'•-•'�• Gas Vents - / V) Rough Plumbing fri, /-.2• AV . //I4)r0°?f_ ' NUV 'ji--01-950 1 (4b4-V Cesspool Septic Tank ... jh 1 Prop. Swr. Liget Hour, n. St. Swr. 3r c /y't( r,�.,,-4-- GA„,_"--- /21;c0,1 LS y4 f ,1 Sprinkling System Heating Final J /n/ 7 -í6W 7 I Plumbing Fixtures, Final ,i,. /n/V 3. •i, / Final Gus'Test /A14,4-4, 2• /A. 44 3 ./ Construction Pole ' Underground . Power p Rough Wiring (1-4-7 f_ S`'-f / -M r~'. -C�i. .., - /a , 3t'-� 7 f�.S-� Fixtures, Final /2/)2'. ?�(r q-C/ - f t OCCUPANCY . /., W .?./0.64 U �t Form 2to-5M—I-57 - _ 7999 COSTA MESA BUILDING DEPARTMENT /i/�oJr £= P.O. BOX 317 FIC>1�ttiCe DEPT: COSTA MESA. CALIFORNIA CM OF E"RSTA Cid FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING BUILDING ADDRESS 1271 Conway Avenue i. COSTA MESA. CALIFORNIA FOR OFFICE US Nity,„v RECEIPT111499g..... 9g'r OWNER COLLEGE-MESA COMPANY J Vv MAIL RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS P.0.Box 2277, Brookhurst Station ---,a-7e/ // i9-(7.- NOV 2 0 195 CITY Anaheim TEL.NICE 3-3161 ADDDRESS ARrHITECT Bulot, Quigley LIC. G GINEER and Clark NO. RE 7191 COSTA MESA. CALIFORNIA III ADurtESS 1102 W. 17th St., Santa Ana ONE E ZONE NO.OF TYPE GROUP CITY LIC. PLANS / CONTRACTOR The Hale Company NO. 7350 { ADDRESS 1777 W. Lincoln,AnaheTik: KE 3-3161 APPROVED BY DATE LEGAL LOT CORRECTIONS DESCRIPTION NO 10 BLOCK TRACT 2671 Plan No. 1-A • . ' A.P. NO. SIZE 1 No.OF SLOGS. OF LOT 62 x 100 NOW ON LOT None O USE F r USE EXISTING BLDG. -- • L,L SETBACK LINE FROM CENTER OF STREET 501 REAR YARD 301 SIDE YARD RIGHT 71 LEFT 71 DESCRIPTION OF WORK N. x ALTERATION ' ADDITION • 4 REPAIR MOVING DEMOLISH BUILDING 4 0'-Gar. NO.OF . SIZE 12531-Liv. ROOMS 5 STORIES 1 EXTERIOR WALL ROOF • COVERING Stucco COVERING Compo USE OF NEW BUILDING Single dwelling w/atta rherl cAraaf I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL , CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. b CO LEGE MESA COMPANY . VALUATION PTEE ERMITO U ' THE HALE COMPANY, Gener 1 PERMIT FEE X30 QO C/ r PLAN CHECK S ]5. 00 $ 12,890 AUTHORI-•02 -P/ �� 27? TOTAL FEE $45.00 `EMF