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(714)754-5273 • Fax(714)754-4856
CITY OF COSTA MESA
BUILD►NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 977 DAHLIA AV
Suite:
Viciniry: REAR PROPERTY�LINE
Parcel Nunmber: 41218119
Applicant: TABOADA, FLOREAL
Address: 977 DAHLIA AV
COSTA MESAfCA
Owner:
Address
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LEGALIZE2'_RIGH LATT
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OK WITH\
.PLANNING BECAUSE AI
TO�BLOCK�WAIL AT 8' F
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"Ch ce k: U $13.65
Permit: $21.00
IIP�Res� $0.00
P Com'� $0:00
�Other: $2;.1k00
pection: $0:00'1
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Total: $55.65
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SETBACKS ���"
MAINSTRUCTURE Front 0=0
ACCESSORY Front 0- 0
PARKING Existina: o
NOTES:
BUILDING PERMIT
Zoning: R1 Rl
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hone:-714 540 �r � 6
�� P: 92626 �
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�,� Zip: 92626
TO COMMERCIALL
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77 FAIR DRIVE,
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MIT NUM
-01187
MESA, CA 92626
Status: ISSUED
Applied: 08/02/1999
Issued: OS/02/1999
ISSUED BY: c�-'
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Zip:
IROPERTY.(COULD BE PLACE�D�ON POST
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Calc Valuation: /�.�
- Claim Valuation: ��. )
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� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 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 penod 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
requlretl inspectlona and final epproval must be obtained. Failure to obtain inspactions and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION �ECLAfiATION:
I hereby eflirtn under penalry oi perjury one oi ihe following tleclarations: . � � . ..
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❑ I heve antl will melntain e certificate of consent ro selt-Insure tor wolicers' compensetion, as provitletl for by section 3700 of ihe Labor Cotle, for Iha pedormance of ihe
work for which ihis permit is �ssued.
❑ I have antl will maintain woikers' compensation insurance, as requi�ed by section 3700 of ihe Labor Code, for �he pedormance of the work for which Ihis pertnit is issued.
My workers' compensation Insurance carriar and policy numbar ere:
Carner. policy Number:
(This sectian neetl not be comp/e�ed 1! fhe permif is valuetl ef one huntlred dollars ($f 00J o� IessJ -
❑� I certiy that in the peAormance of the work for which this permit is issued, I shell not employ any pereon in any manner so as lo become sublect m the workers'
compensetion laws of Californie, and egree ihat if I should 6ecoma subject to Ihe workers' compensation provisions ot Section 3700 of Ihe Lebor Code, I shall forthwith
comply with ihese provisions.
Applicant Signeture: Date:
WARNING: FAILURE TO SECURE WOAKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNORED
THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED F-0F IN SECTION 3)O6 OP THE LABOR CAOE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensed untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full
torce and eflect. Lic. # Class #
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn thet thera is a construction lending agency for the pedormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lendels Address:
SigaaWre: Date:
OWNER-BUILDER DECLARA710NS:
I hereby aflirm ihat under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Protessions
��. Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any sirucNre, pnor to its issuence, elso requires �he applicant for such permit
to fila a signed statement �ha� he or she is licensed pursuant to ihe provisions of the Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Code) o< <hat he or she is exempt therefrom and the basis for ihe alleged ezemption. Any violation of Section 7031.5 by any applicant for a pertnit
subjecis the applicant to a civil pe�alry of not more Ihan five hundred tlollars ($500).):
❑ � I, as owner of the propeny, or my employees with weges as their sole compensation, WILL DO THE WORK, antl ihe structure is not Intendetl or oHered for sala (Sec.
7044, eusiness and Professions Cotle: The Contrectors License Law tloes not apply to en owner of property who builtls or improves thereon, and who tloes such work
himself or hersetl or throu9h his or her own employees, provitled Ihat such improvements are not intentletl or oRered for sale. If, however, the buildinq or improvement is
sold within one year of completion, ihe owner-builder wiil have the burden of proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CON7RAC70RS to constmct ihe projact (Sec. 7044, Business and Protessions
Code: The comracbrs Licanse Law does not apply to en owner of property who builds or improves Ihereon, and who conirecis for such projact with a coniractor(s)
license pursuan he Coniractors License Laws.).
❑ I am exe � ec. Business and Professions Code for this reason: '� -�
�SignaWre: � ��/h�i 0 ��%� Date: er�. -t� Y- �y Q
Owner ID verified by tlriver's hcen9e. ❑ Yes ❑ No Dnvers Licanse No. Expires:
Verification of Ownership 6y (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFEn' PERMIT CERTIFICATION:
❑ I hereby certify Ihat no exca�ation tive (5) or more feet in depth into which a person is requiretl ro tlescend, will be matle in connection with work authorizetl by ihis
permit, antl that no building 9lrucWre, scaflolding, falsework, or demolition or tlismentling ihareof, will be more than thirry-six (36) tea� high. (Chap. 32, Grp 2, Art 2. Sec.
341, Title B, Calitornia Administrative Cotle).
❑ As owner-builtler, I will not employ anyone to tlo work which would require a permit from the Division of Industrial Safety, as noted a6ove, unless such person has a
permit ta do such work from the tlivision.
Signawre: Date:
Division of Industnal Safery Permll Number.
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAY: I cenity untler penalty ot perjury that I have read this application and state that the information given is
correct. I e to comply with all state laws and ciry ordinancas relating to builtling constmction, end authorize represeNatives of ihe Giry of Costa Mesa to enter upon ihe
ab e- (/�g� d pro�p�erty ior inJsp�dio,/n p�rposes. l agree not Io occupy or allow occupancy ot any building aulhorizetl by this permit until flnal inspec[lon.
� ALit��G'��GA/9'LYI/i O�-�2_ Q L%'
Siqn&ture Ot Legal Owner(s) Date
AnNOr Au�horizetl Applicant Date
COpE N, INSVECTIONTYPE . �
1616 Fised System Finel Fire Prevention
1266 Pool Spa Finel
200 . Final Re-Root
201 Final BIocWRetaining Wa�l
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
ew�o co
� Qdjf, NI TRIALS
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LOOE N, � INSPECTION TYVE
'; 206 � Final Mechanical
208 Final Plumbing
210 Finel Eleciricel
212 Final Fire Prevention
220 Finel Planning Approval
222 Flnat Site
250 Final Building/Occupancy
INTRIALS
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C17Y OF CQS7f; �A�SA
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This sef of plans xnd spec�!!cations tdUS�i be ke�t on this joC al all iimxs and fl s unl�v,9ul to
make any changes or aNe�ation on same erlhoN vri:'2o azrtni:sbn from lhe Division of Buiidinq
y�d Safety, Cityof Cos!a A"�<x.
The stamping of this ol��i a�d s�cificaiiens SHP.LL NO i be heW to pertn:t er lo ba y� approv;I
of ihe violafion of any pr,visiocs ef zny Ci!y ef Cosie h!ea3 Or, irarcz and!er S�ata iati�.
il;e;: plan; and pamit shali ea�ire by fm;la;ioa eij tzcone nuli and void if iha huilding or
l!'C�; IS 001 C7f!ITBO:Ed df!d f!12nlainod ,r�p,f E1°_r U�C g�C9 (A,) !Y'[hi�: l@0 d"1G Of 1=51�?!!C^_.
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�oonEssoFem�owa: �977 DAHLIA AV- � � -- �uxT:
wmexswuieiFaiavw: TABOADA, FLOREAL FLOOD: AH-38
mowEss TABOADA,- NORMA ' �
1068 SAN.PABLO CTR
_OSTA MESA,CA 92626540-3167
WPI.IWIING �DDPESS: . . .
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urcxrtecT ow �+cu+�+: � . . uc. xo.: , .
1NCX.OXENC.'SdWRE53: . - . � UNf:, . .
. caem�crarsxu�: PRIMO ROOFING � , � � ( 714 ) 841-4456
c«+m�croxs�uiu'c 17066 PALMDALE ST '� �
_ �onqEss: HUNTINGfON BE92647 ._ CA uaao: uxr:1120
IJCENSED COMH�CTOfl3 DECIAXATION: I hereby � uMx penely d perjury thel I am licemed uMx povaions d Cheqar 9
(mmmena�q wnh Seclion ]000) d Orvuion 3 d Ihe Bueimm eM Prdeaeiaro COEe, eM my Icenee m in lull lorce eM efl
cmuc.no:0 7639 uc.cuss: C=39 uc.No.: 31120 {FJ` 3/98
', o�, ��,�� sr�y �-�UL1
OWNE BUIL fl DECLANATION: I MmW elfirm under penelly d perjury �he� I em eRs Irom tM Coniredae Licenae Lew fa iM
/olbxin0 �eesan (S«fbn 1a+tS Busiieae aM Rolmaions Code: Am cb «muMV Mhirh rt9uiree e V�il �o canvud. el�a.'unarava.
Eamolivh, n repei eny avuciure, pn b �a aaiarv e, eho requim iM epplimnt la wch pemiu to fib a egrcd atatement Net M a ehe
if IKeroed pursuen� lo �M pwieions d �M Lan�redoro Littnae law [Cheple� 9(commerci�p w�lh Setlun J000) d Divnion 3 d IM .
Buainea enE Prolevions COEe� w Ihat M a ehe ie ezemq �herehom eM Ihe besie Iw,the elbped exemqion. My viulelon d Setlnn '�,
]031.5 W enY eDDlirant tar e permn auEjeife Ihe epd�l lo e crvil penelry d ml more Ihen Me huMred ddlen �550011. .
❑ �.mmme.a�newore�r«mr�v��••nwepmesinei.deoomro��.wY�eomewoek.endu».uwureena'uneMee
w dlareE lor eeb (Secwn )ae. Buvrcas eM Vrdassiona Gode: Tha Conireewe Liwrea lewEo» �wt eOpYto en ow�wr ol pmpeny
wM Wdda w inproves Ihereon, e�M who Eoen euch wvrk Iemeetl or MneX or Ihrouph ho w Mr oxn employeea, provideE Ihel wch
impravemema ere not inleMad v dleieE �m ede. M, Mwever, lha buidiip a'vnqwemem u eoN within wr ymr d oompblbn, tlw
o.�«�w�n« �;n ne� ma w� w wd+��e na «� ed �a w�a o. �mv� �� �ns wm�e a�l.
❑ t m ovma, a �ne o�rom. � exautivtiv ��neiro wun �icenaea emvectore m canmue m. wM� Iseaon rose. a,a�mm ena
Profaanro Code: The Cantrecon Licenea lew doea na eppty b en owmr d qopeM �o buiNa a impaves ihereon end w1w
conlrecb iw wd� propds xilh a convedorls) Icenmd Wnuem to tha Conveaas l'xenae lewl.
❑ I em emmp uMx Sed'an: B. 8 P.C..Ia Nis rea+on: . ,
Dam: Owner: � '
i eo ne.eM Pon�y inv i em ewme d e�d ��we�siene me �w��:m. d c.ieo�,�r H..im ene smmr coee sea�. ssws. ass3a..ne
usN. end �nm �«enr nnuie nuikvq aowv�� �.;�� � wil �wl (arcb me) neee ro canoN �•'vn mid .�m. mdm ena �ne nm+��m ro.
epeimAlormnavunionamotlifiraiianhan�MAi ue�ty eMpamemDimria.Pevdaruielmnct�udioneppiratiom�e�eexemqfmmtlrove
prwisione. . . . .. _ . ' .� . ,
Dete: � ADd�eM: , ' 1 .
WOHKEN'S COMPEN4ATION DECL�N�TION: 1 MreEy etfirm uMm penelry d perjwy�ar d Me folloxiep Jetluetau: .
� I heve eiM Mil mdnten e ceNfcele W cmmni to setl�inauie M worken' mmpamelion, n prwided lor by Seaim �'!00 d Ihe lebar
Code. ta IM parlm�ance af Ua xwk lor wlich ihia permil w iaued. . - .
�] in...�ew�i�m,:�.,on�•�o�����.mroa��esrs<a�e�oo'dme�.no.ceaa.b,in.vaea�orm. �
wort �« whkh mie uermA �a reawe. My w«ka�e A�Geuon inaurer�ce ramu e�k pdic� numear are: ��� E X P I R E S
t.mer:
. Pdiry Numb«: ' 1 1. � 0 1� 9 7
(ihissedianrreednabecompleteJ)l�epmntis/aonehuMieJtlollars/5100/mbse.)'. � ; .
❑ I cenAy Mm in �ha pe�lormerce W ihe wak for xfi'nh ihie pemfi u iaeued, I eheN m� ampby eny penon in eny me!� er eo m to
bxame auEjee �a tM wahere' wmpenmtion lewe d Celilame. ard��pp ree IIW tl I ehoul bavn� iq'IM xwMn'
wmW�s 'on Ma om ol Setlion 3]00 d Ihe Labor Code. I eypLLJmE�M1 cwnV�/ xiN tlpe
� r w-
oma: - nooik�c /� 'vF
Warrilnp: Fellun ro sx�n worken'rompwuatlon ewsrepe l� unlewNl, entlWxll rb�se en employer ro eNmIIW pmeMs, enJ
c/vll llro� uy ro ans MndiW tMuund dolkn fffOQ000A M MCltbn ro M� ewt ol rompwuetbM1 danwp�� u provWeG ror In
Sxtlon J106 0l M� La6or Cotle, Intxsst, erb efromsy'� Iwx ,
CONSTHUCTION LENOINO �OENCY: I MreEy effirm uMer penelly d perNrv �� �M1�n u e mnm�uaion bMiip epeM.y br Ne
yen«meMe a �ne wo�k e« �.niM �ne oe^^� a�uee (seeon xe). cn. cl. _ .
LENDEP'S NAME: � � .
' LENOEWS ADUNE55: . ' ', � �
I eenM �� I hew rtad tho epplce�ion end aele t1iM IM ebove iMame�ion ia wnea. I piee lo mnply xil� all ory eed mumy adirerioe�
eM s�ete kwe �eleimB �o buiMiq consteudian eM Mreby eiNwrrza repesantetivea ot Ihu viy to enter upm Iha ebwe-meMioned qopnry
�°`�°s°°"�o°P°`0°"` TOM LIEBHERR
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(S151dfi.WP) Whne-BuiWiiq85alety;Oreen-Fle:CanW-ApPFcenCPink-flerenue;OoldenraHAsemwr
9
- CITY UF COSTA MESA - BUILDING FERMIT
' _ PERM NO:.H 08313
PERMI.T NO: B �083134 � PLAN CAECR NO: N GOVT: N SUPP: N
CONSTRUCTION 'PYPE: V-N' PERMIT .'PYPE:; S'PR PURPOSE: OTH �
JOB DESCRIPTION� : T/OFF SHEATH 6 REROOF W/COMP SHINGLES SQ FT: 5,884
CLAIM VALUE: 5,88,4.00 CALC=VAI;UE: 5,884.00 GROUP OCC; R-3 /
COMMENTS: REROOF 2900SF RESIDENCE W/COMP, SMOKE DETECTORS REQ PER 94UBC
�1f7E7t�it�klEiElEitiEfEiklE#�7EikiEifiE3flEiE�)FiFiE7EiEklEifiEiFifikikjE#if�k�lEIE�Ik�E3E�E�lEiEiFif�j(-iF��1f�k�%�ifiklE E{�p�y�+ �{ p9
2 O N I N G: R E Q U I R E M E. N'f S��i/!<Jf�� U���j�l'�
S E T B A C K S
_ _ _ _ _ _ _ _ _ _ . � ��_ _ •
- MAIN BUILDING .--------'-- --------- ACCESSOR�%BLT.I���
FRNT; ' FT IN REAR: FT ' IN� ' FRNT: FT , IN REAR: - FT IN
LEFT: FT IN_RGHT: '� FT ; IN LEFT; FT IN'RGAT; FT IN '
PARKING REQ:, ` PROV: ' PARCEL: 91218119,ZNE: REF NO'; '
PLANNING NOTES>.
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iF 3f iF iF �k 3k �f �f ik if ik iE if'if ik �k it df if ik �f if jE iF if jt iE iE if iF iE 3F 1F if if i! 3! i! iE ik if'k i! if iklf !E iF it k iE k iE iE lE �E iE iE if iE if if �%* i! if IE,�'i! k� ff if !E if iF if if k if
D E V�E'•L O P' M E N T S E R V I C E S R E Q 0 I R E M E�Ni'I' S
� ' ���/ . . - � �Y; .
20NING APPROVEDjBY ' DATE:
/
BUILDZNG APPROUED BY : � � DATE:/`�,•^
�df, .
7l
APPLICATION iSS'OfiD BY; ! � � DATE�: I�o
�tifiEdEif3t3f3FikikiEi4iFififiF'kiE3fiE�fdk3Fi�iFiF3F7F3FiFiF3FiFiFiF3F3F'iF3FiF3F#SFSf3F3fTFiF :'�Fif3fiFiF3FiEiEaEfEif767fikifik , �t 1Elf '
LEGALIZATIUN�,N �� F E E S U M.M A R Y � STRUCTUR-AL SEGMENT:Y
N � i
BLDG PMT, PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRAL7ING
PERMIT 112.25 , 59
' ' SMIP/NON-RES _
PLAN- �. . . .
ISSUE FEE ; ' � '
BUiLDING-DIV=i PERMIT ISSUE PLAN-CHECK 'COTAli PAtD DUE
TOTALS----> ,112.84 0,00 0.00 112,84 112.84 ,00. .
REVENiI£ DIVISION TOTALS-->' COLLECTED: 112.84 OVER/SHORT: .00
' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
112..25 ,i`:59 .
jf if iE iE jE iElk �E �E af �F 3F jf aE �1E �E%iE 7E �f �E 3E �E 3E �E if iE 7E �F � iF 3E if �E ff 3E if if iE iE iE �k iE �lf if ik iE iE iE iE 1E if �E k� iE Jf if iE fE if i! �E iE �F �E k fE iE 3k IE 3E iE k� if ik �1F it
, � 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'� T I O N UNIT C�OST 'TOTAL COST
SFR 5884 ;REROOF BY VALUE RESIDENTIAL NOZONE ., 1.00 5,884.00
• END OF FEES
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- APPROVALS Permit #^�.' � '- � °�? ;�' . ".:APPROVA�S Permit.# � � ? , "
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-"1. Temporary�Elec�ri'c'a�Serviceor.Pole Y ,s ��P yz, _ � 62' Pool & Equipment L:ocation�; '. , ,'s - •� f� �
.'.2. So8 Pipe;Undrgind�. �t � r ' - � - z , 53•.� Steel Reinforcement� � +�, �; � , � , � �
J �
3. Electrical Conduit UtiftV�Undrgrntl.zN1�:'' � Y � ' ' � '545 Form's� � ' , � �`���: - , : �fE;
.. _. � s
4. Electrical Conduit-Undrgr4d. � i � y � Y "; � �55r Electncal,Bonding� � ' �' � _ f ,� 'j
- 5. Steei Reinforcemer.t � E�� j •- � ; s;} t j-�56�� Rough Plumbing & Pressure T,est-. � ~- �`1;
�
6. ElectricalUFERGmd. ��'� `"` �';;"" "•' • �57? APPROVALTOCOVERzGUNITE . � .Fi` ��= '�
� � ::ii' i�.t' 1 � � � �fv
7: F.00tinqs ,_ �a . �58`� Electrical Co EduiFUndrgmd:. •X - � .h'��"i.
S. Foundation ' ` ' r�- � n =�' '', L59i� Gas Pipe O"Undrg'md- Test9 ' y��t� "
' I k � i . � t- 1 . � �. y t. l r� i
�9. Water Pipe-Undrgrnd'. - s'y n� � z�"�' �- , .'". � . > � - ' - '� �� � . � �� �
,60i Backwash;Lines,'PTrap;O Undrgmd.� � i
/ I :'e �.- 1 ..-X � L � r
10. Structurel FloorSvstem. >�-! �j -';9; 3` '�" 9� � 1�.61; APFROVAL'TODECK.�I��� ' � �
.r. _sJ � r• '
i t. Property Sewer Line & Hq�se Connection} ^: ; € ;g �: ` � T62. Backvvash &'ReceptorFinaly,� � _ ' ' _ ' � ;;'-,
12. SewerCaP .. .. -e � � t.:.i�'-' _ _. � , ,. . ' F_. , " . .
,., � -63: Heatei & Vent-Final - � �! �
13. Roof Drains � . ����j k -=7'�' �� - ` _ � �64, Pluinbing SYsterri yFiriaT�%'� 'F - .
14. Rough Plumbing �, _ ; L• , =' � � .65 ElectricabFinal � ! `,�y'� _ '
15. Rough Electricai-Conduit;r !^ ; - `: ' ' ; '�66. Solar SYstem-Final � ��� ; ; - " y�
76. ftou h ElectricWirinB �� n:"7� - ;,'=� • ' � � � ' � �J',.� - � �' ' �
. 9 �:. ,i ;� �� „67z Fencrng;& Access ApProqai .� � �
`t7. Rough Wiring Sign � s'i '. �-"- � " � %'gg; qppROVED FOR�PLASTERING � - (,� �
- 18. Rough Electricai�T 68r Ceiliny � !. r ;-; � . , � -69. POOVSPA SYSTEMS�FINAL ' "'� I - i
' S9�.•ftough�Heating & Air Conditiooing=- -- -- - � . - �- ' FIRE DEPT: REQUIREMENT-' - - - � �-� - �
20. Rough Factory Firepiace r � APPROVAIS Permit # - �
Yc
�21. Duots, i� Structure ' � ° �
, . 70.� Undergro�nd Hydro �
22. Ducts, Ventilati�g . . ' 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � _ ' 72, Underground Flush , �
24. Roof Framing �� -, � �� � 73. Undargrnd.StorageTank L�Gaz OOiI
25. Roof Sheathing "�, ' � 7.���?�74. Overhead HYdro '� �
26. T-Bar Cei(ing (Svucturail & Monocoat � • ' 75. DrY Chemica4 . �
27. -Frame and Flashing - 76. Dry Standpipe � '
28. Latfiing & Siding �, • 77. FIXED SYSTEM FINAL �
29. Insulation ' � 78, FIRE PREV. FINAL .
30. Qrywall Nailing . � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . . 79. FINAL INSPECTION ' ,�
32. E�ectrical�Power Meter-Final ' � 80. FOOD CER7IFICATE ISSUED
33. _Final Electric .� ' ' Notes: ' � , �
34. Final Heating & Air Gonditioning , � � � , �-
35. Pinal Gas Pipe-Test- ' - '
, 36. Hood or Canopy , - , � � _
37. Final Fac2ory Pireplece
38. Final Plumbing ' ` �
39. YVater Service�Final
' 40. Gas Service-Finai . .' : , ' �
. 41. Solar pomesticFinal � . � ,
' 42. Backflow Preventer � � .
43. Backflow Irrigation � . - ' -
44. Landscape Irriqation System � - -
.45. Sound Aitenuation ' � - � - ' '
-46. Handicap Regulations ., ,. � �
�47, fiNAl STRUCTURE & BUI.LDING � �p �
48. FINA� PLANNING � . ' , - ' .
49. Eiectric Ralease to Edison : _,
50. Gas Relea'se to Soutbern California Gas Co �" -
51. CERTIFICATEOFOCCUPANCY ,
No. 6ate
OWNER
JOB AC
GEN ER
AP No.
INSPEC
SOIL
GAS
PROP. SWR. LINE � HOVSE CON. �'
SPRINKLING SVSTEM '
MISCELLANEOUS
ROUGH MEATING AND AIR CONDITIONING
TEMPORARV SERVICE-OR�P06E^
UNDERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS � STEEL REINF
FLOOR SVSTEM
BOND BEAM ❑ STEEL REINFORCE ❑
SHEATHING
FRAME ANO FLASHING
LATHING - IN /J�' � OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
MEATING. VENT.. REFRIG. ANO A.C.. FINAL
DATE
BUI�DING PERMIT N0.
SUBCONTRACTOR
s2. 4 . � .
r. _ :�
: . � . . - � r�;l � � _ � .. , ,
, - . `3� , , �. . : . - ; vArc
. > >n� z5-,3���,;OOi rya,� *:« i �{2:85
. � �COSTA MESA BUILDING-SAFETY DEPARTMENT � " ' � ' . � � . - � . ' �
' SOZA• P.O.80X 1200� COSTAMESA,CALIFORNIA92626 � � . . , . . . .
,. • - � � -� - � T , PLIC TION FOR BUILDING PERMIT ���
. .� -. ForApplicantfoFill,inCompletely� � . ' �RE ive V ..DATERECEIVED
DA7 E ISSUED
' . BUILDING•. . - ; �. . . ... y. -- � Z / .
^ADDRESS . -• D8I1118 �EiV2.Rll2 � "/ � /�—�
,. - ._:- , . � -.. . . . PERMYT ..I I
OWNER LarwinSouth'ern Calif:, I11C�: �', �A•P•NO. �
, � ' " � ' . BUILDING / '/`/ '
nooRess 16255 Ventura BZVCl. �. ADDFiE55 ���..
Z . ' ..
a �" : ciT,v �Encirio, Calif. NOL9HFJ—Hsg '' TRACT 7/ , �o � BLOCK'
z ' .
ZQ' CON5TRUCTION �� W ADD A T P
oN LENDER LdYW1R Southern Calif. ,
a m '
�^ J N- � BRANCH 16255, ventura_ slvd: � � . ' 2w�� � SC _ � /l1 �
� -" y ' OWNER
Q W '
� ADDRESS Encino, � CaTif: �� • � � . us
d] J � - �� VALU$�/
m ARCHITECT'� � TE � � SE ��
�- ((%
J a OR ENGINEER ��LaTWln � N�7�3'4464 _ _
.. V Q . . . . �.. ,FIRE ., �,% �
, W� ADDRESS 9100 Wilshire,- Beverl fHl'1 ZONE� � TVPE • GROUP �
a W . . ' • � ' ' APPROV �J
,. J O CONTRACTOR� L�dYW1T1 �SOUt112YR- Cd11P. � BV�, DATE /��
mz � , � . � . . . . ' � .. .. . � . . . . .
�� nooaess 16255 VentuYa Blvd.
w W ' TEI.� ' 20NE � NO.'OF VSE OF NEW Cj. �/v �fi� �JU
Z� cirv ETlCi.np, Calif. No9$6-8890 � P�-^^� � BUILDING ti✓/ 2
�, STATE � � CITV � �. �'ARDS APPROVED' VARDS APPROVED
� N CC LIC. NO. : 19131�. '( 'CIC. NO. B-1 - MAIN BUILDING ACCESSORV BUILDING �
.� O - • (FFOM GL STqEET) . -
OIF �OT 6O X LOO � � � NOW ON LOT O` RONT FT. PT. -
' USE OF � ' -' ' � ' . �
_ EXISTING BLDG. ' I E � FT: ^ FT.-
� SIZE OF � NO.OF � ' '
Z NEWBLDG.174O ' . qOOMS STORIES �1 LSIDE S FL � - . FT. ' �
� a EXTERIOR WALL '- ROOF �, ' � . �
� V COVEFING S'tUCCO COVERING Wd. �Shin 1 REAR FT.-• FT. •
J USEbF-BUILDING AND WORK TO BE PERFORMED � DISTANCE BET. �- � BET: MAIN & � - ' �
' �n' ' � � MAIN BiDGS. ' - ACCE55. BLOGS. �
a
Q . . � � - �, VAF.,$ � ' DATE - . . •.
O. ' . . C.U.P.# � ^ • qPPROVED�7 � �
. '� . APPROVED ' , ,\. .� - / �77� " . ,
VJ CORS WJi" ' "
� � �itOLD FOR SPECI L RE IRE
' �~` . I hereby acknowletlge ffiat�'I have raatl ffiis application antl state ', '
� �� thai the above. intormation �is rorrect antl agroe-to comply with �� , ,
• � ell laws regulating building consvuction, antl, I shall not employ, , ' Tqk
F any person in violation of tha workman's compensation laws ot '
� y the.State of Califortiia. � � -� � . � °�
� �.
zI hereby certity ffiat I'am properly licensed as a contractor untler Q. FT, o �
the State o£California Business and ProfezsionsAode, Divisicn 3, HE AMOVNTSHOWN UNDER VALUATION IS FOR '�g
Chapter 9, antl ffiat such licenses are in full force and eftect, or I THE�PURPOSE OF ESTABLISHING A PERMIT FEE ONIv: ¢
,, � am ezempt from Ne provisions of the State of Calitornia Business VALUATION � '
antl Professions Cotle, Division 3, Chapter 9. � ' , ' � �
� . . -PERMIT FEE 5 �
, . . , _ , � •.' : / .7
' Signamre of' " . "�� ' . ' �7 .,L � m -
• ' Perminee ' /D. DOWIIS' �$_/�7�% � PLANCHECK$ E �
P ` � `o
� Authorizetl Agent �' � � � � � � / LL
TOTAL FEE $�