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Home My WebLink About424 BAY ST - Building PermitsApplicant to fill in all spaces exce0� [hoze wit�in heavy ooraer lines ana sfgn all avv�oPriate aeUa�ations. PERMIT MIT NO. TRACT NO. LOT NO. UNIT NO. A P GTYOF-COSTA ESA C NST UCTION Project Address �� . Appiicant's Mailuing Ad ress Owner's Name 11 Q L•�• _ hone ��'�� Address ��"� Arch/Eng.�� License No. Z Address £ ��7 Contractor'�Nar.,a��NG�- � ' Phone �� Address (mailing) �~�'� City License No. IICENSED CONTRACTOR �ECLARATION I hereby all' m tha[ I am licensetl untle� O�ovlslon5 ot men mg wilh seclion�OCi-ei-DWisind3_Of th antl Protesslons Cotle, antl my 1 f 11 f Licens�Cl� _ Date Si9nature WORKERS' COMPENSATION OECIARATION I hereby aftirm thal I have a certificate of consent to self-insure or a certlfiw[e of Workers' Compensation InSurance, or a certitietl copy thereof (SeCtlOn z800, Lab. C.) licy No. Company Certitietl copy is hereby furnisnetl. � Certitietl copy is filetl with the city Bulltling Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION '(This section neetl not Oc tompletetl if the permit ls for one huntlretl ( ) or � less). I certity that in the oeAormanta o1 Ihe wor� whi Is per is suatl I Shall not em0loy any Oe�Son in any ma � o as eco Sub" t(O t�e WOrker C e� n Lawz Ot Cal a. Date Signaturc NOTICE: II, alter dking this Uecla�atlon, you shoultl bOCOm¢ Subjecl [o [he Workers' Compensation provisions o( the Labor Cotle, you mus[ fortnwith como�Y with sucn provisions or tnis permit shall be tleemetl ravoketl. CONSTRUCTION LENDING AGENCV I nereby af(Irm that there is a con5truction lentlin9 agency for [�e pertormance of tne work for which this permit is iszuetl (Section 309� Civ. C.) LPntler'S Name l.entler's Atltlress OWNER BUILDER DECLARATION 1 hereby affirm ihat I am exempt from the Contraclor's License Law for the following reason (Section ]031.5 Bu5lness antl Professional Cotle: Any city or tounry which requires a permit ro tonSVucq alter, improve, tlemolish or repair any scructure, orior to its Issuance, also requires tne applitant for suth permit to tile a sign¢C Stdt<menl that he/She i5 IIC¢nsetl pur5udn[ to the provl5ions of tne Coniractor'S License Law (Cnapter 9(commen<in9 wi[h Section 7000) o� DiviSion 3 0/ the Business antl Professions Cotle) or tnat ne/she is exempt tbere/rOm antl Ih¢ ba5is (or Ine allegetl CzemptiOn. Any violatiOn of $ectiOn ]031.5 by any applicant for a permit Subjec[5 the appliGant to d<ivll eenalty of not more than five huntlretl tlollars (5500�. LJ I, as owner of the property or my employees with wages as their sole fumpensation, will tlo the work, antl Uie structura Is not In[entletl or otferetl � lor sale (Section 7044, Business antl Protessional Cotle: The Contractor'S License �dw tloes not apply lo an owner of a property who builtls or Improves tnereon, antl who tloes such work nimseH/herseli or throu9h his or her own employees, provitletl tnat such imorovements are not Intentletl or oiteretl tor sale. II, however, [he bulltling or improvemant is soltl within ona year of com- pletion, the Ownm will have tne bU/tlen Of proving he/sh¢ tlitl not bulltl o� im- prove tor Ihe purpose oi sale). ❑ I, as owner ot the property, am exclusively contracting with IlcenseA con- tractors to mnstruct the project (Section 7044, Business antl Professions Cotle: . The Coniractor's License Law does not apply to an owner of property who �� builtls or imoroves thereon. antl who contracts for sucn oroiec[s with a r.on- traclor�51 Imense pursuam m[ne Contractor•5 Litense La ). I am aw at proof o( their Wo�ke�'s Compensat� n Insu� oul e p�ov' t me. �.I am exempt untler Sec[ion—� P. C. r reason / � _ D te � nw,,,ar . � _ _ I hereby cer[if�have r ad lhis application and state [hat the above Information is correct. I agre comply w II city antl county ortllnances antl State laws �ela��to b 1 ing Cons n, antl he�lby autho�iz¢ �epre- sen[atives of thj/ to [er u e above-mentlonetl property for Si9nature iC _ �.7 �rivars' License or 55 $ � 3 S30 � TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTFIER DESCRIPTIONOFWORK/USEOFBLDG. , � TYPE OF PERMIT LJ GRADING LJ FOUNOATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL �PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.F7. oCCUParvCY- CONSTR TI�TVPE � VALUATION$ 20NE � GRADING CV. VDS. ACRES Remarks: �xF�I7f � O•`� b r �J¢S I�G(�"�� '�-rnu�.t f�bt+l5 R E•_ R E��4 �S- 3ar Sink 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers Dishwasher Drinking Fountains Floor Drains F-�laor Sinks • �s Service 2 Outlets Interceptors Kitchen Sink � Lavamries �- P-Trap Rooi Drains �� Reinspection Fae $15 Duct- Under GrOund Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. �C80 # Heating System & Ducting ❑6100,000 BTU 0100,0 OBT Heinspection Fee I $15 - 0865-46, rev. 5/88 White - Bulltling; Canary - Appllcant; Pink - Acmunting; GOltlenro0 - Assesmr Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Wate! CIOSeS Water Heater Water Service Auto-Wash Laundry Trays laue Fae Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑o-ioo,000eru ❑ioo,000 stem Repair/Alteration Fire Dampers Registers Issue Fee ..# S Main Building: E T Front 8 Rear A C Right g . Left Ping. Fe(. # Planning Notes: FEES Automatic Washer Construction PoleSub. Cooking Unit Oishwasher ' Oryers �Gas'DElectric Fan F.A.U. Fixtures Device Boxes " OUtI¢t5 Swicches Garbage Disposal Generator �0�5 KW �5�� Zone Accessory Building: Parking Req./Provided ELECTRICAL Transtormer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors �41 HP �i'f, � 8 Inc.Solar 09-15 HP �16-75+ Pole Light Range Standing Sections 5 KW Trash Compacror � Reinspection Fee !$15 � I Issue Fee S 3 DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By FEES Building Approved By Application Issued By I $ 3 SUMMARV OF F BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ =��_00 PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ P�AN CHECK 25% $ FEES $ 3 SMIP $ PEfiM1T ISSUANCE $ ENERGV P.C. $ GRADiNG $ MICROFILM $ TOTALFEE $ ' �0 O N 1 N G E Q M T S. �� nn7zl;io_:�JOiisji' -��r. T .:,�i: D�,TE: Cr.'26!"4 7IfiE: iG:3i -. �,.. ' : CONSTRUCTION AND PLANNING � POOL & S� ,�� APPROVALS Permit# � Date Inspector qppROVALS Permit# -Date Inspector ► '1. TemporarylEle trical Service or Pqle �. 52. Pool & Equipment Location t ��'� _ r � %'r )! '�2. Soil.Pipe-�ndigrnd. `i 53. Steel Reinforcement ';� .� - 3� flect�ical Cond �u i l}tility-Undrgrnd. °✓� 54. Forms - `.-"V � ,�., ,� � -��, � ;. 4�'Elec�cal4Conduit-ldndrgmd.'� � 55. Electrical Bonding V •�i 5-�Steel�ftelnf�orcement� ��' 56. Rough Plumbing & Pressure Test �� )irJ vi vi'� 1. �,A s�t Elecirical;UFER•Grnd. , � 57. APPROVAL TO COVER-GUNITE � � �;�(� �� 7,✓Footings,.5 �'V �'� � 58. Electrical Conduit-Undrgrnd. �,� I��-;� S:xFoundation -� �' �n% 59. Gas Pipe, O Undrgmd., Tes[ ,�'f -'j�, �• 9� Wa(ei PipsUndrgmd. ' , J 60. Backwash Lines, P-Trap, � Undrgrnd. �"� �� 10. Structural Floor System ; /�� 61. APPROVAL TO DECK �r' � (, 11. Property Sewer Line & Houie Connection �� 62. Backwash & Receptor-Final � h 72. Sewe�; Cap% �; � �, �� 63. Heater & Vent-Final j�,� + �'' 13. Roof,�Drains L i �/ 64. Plumbing System - Final % � ,� w e •v 14. RougF Plumbing� � 65. Electrical-Final � �`'' ' A.� 75. Rough Electrical-Conduit _,� 66. Solar System-Final ;L6. Rough Electric Wiring '� 6�.r Fencing & Access Approval �7�7� Rough Wiring Sign .; � �68.. APPROVED FOR PLASTERING v 18: Rough Electrical-T Ba{_Ceiling y� � 69: POOL/SPA SYSTEMS FINAL ... ,c - • �9�. Rough Heating & Air Condit�io`ipg iJ FIRE DEPT. REQUIREMENT it�. 20. Rough Factory Firepiace ,T� { �1PPROVALS Permit # 21�. Ducis, in Structure ? ;70. Underground Hydro ' 22. Ducts, Ventilating i ' �71. Product Piping OGas ❑Oil �` 23. Gas Pipe-Ro�gh & Te`st �T �� 72. Underground Flush �� 24. Roof Framing� �.- .�'J •. 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. F�oof Sheathing .i r_. 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) &�Monocoat 75. Dry Chemical 27. Frame and Flashing ' j'�� 76. Dry Standpipe , 28. Lathing & Siding �-. (,vl 77. FIXED SYSTEM FINAL 29. Insulation �� 78. FIRE PREV. FINAL 30. Drywall Nailing �*' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat n� 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED 33. final Electric Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test Y�gQ �p 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing (� 6 fjC{ (� .(� 39. Water Service-Final 40. Gas Service-Final 1 ,�4 41 . Solar pomesticFinal � � � � 42. Backflow Preventer ^'`"�'• �' �� . 43. Backflow Irrigation � � 44. Landscape Irrigation System ? 45. Sound Attenuation , "�� '' i, i. r 46. Handicap Regulations '••� .� 47. FINAL STRUCTURE & BUILDING `� � 48. Special Requirements Completed 49. Electric Release to Edison :- ., 50. Gas Release to Southern California Gas Co �': �, 51. CERTIFICATE OF OCCUPANCY v ._ No. Date jj - • � ADOlicant to fill in ilTi`�C� CllSTA MESA CONSTRUCTION PERMIT . Prol€ct ddress �� - �A�' • '�aT' - Applicant'sMailingAddress, v�`�"�� ,�y�' Owner's Name �� -�T—QCR��A-� Phone T'a�-' � -- Address -S/4M C ��`� Arch/Eng. �VI� �C—�Sorr+1 License No.G I Zo%% Address `��""'� �� Contractor'sNamP ��N'C�� PhoneSAM� Address�mailing) `��'"�� City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensea untler provisions of Charter 9(commencin9 with section ]000) of Division 3 of Ihe Bu5ine55 antl Protesslons Cotle, antl my license is in (ull force antl effect. License Clazs License No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affi�m that 1 have a certiticate of consent to selt-insure o� a ce�tlficate of Workers' CompensatiOn InSurante, Or a certlfietl cOpy fh¢reot (SeCtiOn 3800, Lab. C.) ' . 'olicy No. Company "'�� Certifietl copy is hereby fumishetl. .�� , � Certi(ietl copy is filetl with the city Builtlin9.Division. , Date Applicant �- EXEMPTION FROM W00.KER5' GOMPENSATION OECLARATION ✓ (This zection neetl not be completetl if tne permit I�for one huntlretl ($100) or / less). � /'. ! I certify ihat in Ihe perto�mance oi th¢ work'fOr which thi5 perm�t is i55u¢tl I shall.not employ any person in any manner-so as to bemme subject to t�e^ WOIk¢!5'�Cp rtl 2OSdilO Wy� s of Calitor d.{'� /� Date �i ��A�!�5'9nature /1�r1/�i -n NOTICE: If, after making this tleclaratlon, you sn ultl become subject to ttie Workers', Compensation provisions ot the Labor Cotle, you must (orthwith � comply with such provisions or this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby atfirm that there is a construction lentling agency for Ihe performan<e of tne work for which this permit is issuetl (Section 3097 Civ. C.) LPntleYs+ Name � - � Lentler•s Atltlress OWNER BUILDER DECLARATION � � I hereby affirm ihat I am exempc from the Contractor's License L.aw Tor Ihe followin9 reason (Section 7031.5 BuSiness anA Professional COEe: Any <ity or county whlch requires a oermit to construct, alter, improve, tlemoiish or repalr any SVucWre, prior to it5 is5uanc2, also require5 the applicant tov sucn pe�mit to tile a signetl statem¢nt that he/sM1e is licensetl pu�suant to Ihe O�ovision5 Of ihe Contractor's License Law (Chapter 9(commencin9 with Section �000) ot �ivision 3 of the Business ana Professions Cotle) or roat he/she is ezempt �Iherefrom antl the basis for'the alle9etl exemption. Any violation of Sectlon ' 7031.5 by any applicant tor a permit subjects the �applicant to a civll ;�nalty of not more than five hunGretl tlollars ($500). I„as owner ot Ihe property or my employees with wa9es as their sole compensatlon, will tlo the work, antl the structure is not intentletl or-ofieretl . jlor sale (Section 7044, Business antl Professional Cotle: The ConVactor's . License Law tloes not apoly to an owner of a property who builtls or improves Ihereon,:antl who tloes such work himselt/herself or through his or her own employees, provitletl that such improvemen[5 are not intentla0 or otferetl for sale. If, however, the builtling or improvement is soltl within one year ot com- pletion the owner will have the burtlen of proving he/she ditl not builtl or im- pro ortne purpose of sale). 1, as owner of the property, am exclusively contracting with licensetl con- ' tractors lo construct the project (Sec[ion �044, Business antl Professions Cotle: The Contractor's License Law doe5 not apply to an owner ot pro0erty who bui fs or improves ihereon. antl who contracts for such oroiects with a con- traa� � Lcense pursuan[ [o [ne Contrattor�s License Law). I am aware thac proof theiv Worker's Compensation insurance shoultl be provitletl to me. � L7 �Ibm exempt untler Section _ B. & P. C. fOr [his rea5on ' Dat � " Owner — ` � SO I hereby certify that I have reatl this application antl state that the above informa[ion is correct. 1 agree to comply with all tity antl counry ortlinances . antl state laws relating to builtling construction, and nereby authorize repre- 5¢ntatives of this city to ent¢� upon the above-menfionetl property �for Inspection py�P oses � /-� 1 � ezQ Signature/�1 /� fHSU� Date 1 E' d�T/CJ Drivers' LI<ense or 55 �-A s0ace5 ezcept thoso within heavy bortler Iines antl sign all apP�opriale tleelarations. TRACT NO. LOT NO. UNIT NO. q,p, # a� ��05 ?�,�7- ',�r' _ TVPEOFCONSTRUCTION NEW ADD ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER <7� DESCRIPTION OF WORK/USE OF BLDG. - � TVPE OF PERMIT LJ GRADING LJ FOVNDATION LJ STRUCTV ❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICA ❑ pTHER PROJECT DESCRIPTION 5�. FT. � 7 Q oCCUa Ncv_ CONSTRUGTION TYPE Q� VALUATION $ Ha ZONE �� GRA�ING CU. VDS. . ACR Remarks: �)Go�o,NS�OIJ OP Z (�F�-�S�f�C� 1017tS�7/ 3ar Sink " 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers Dishwasher � � Drinking Fountain! Floor �rains ' Floor Sinks Gas Service Interceptors Kitchen Sink � Lavatories - P-Trap .. Roof Drains . Reinspec[ion Fee Showers �, Service Sink Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outlets � Water Closet � Water Heater Water Service Auto-Wash , - Laundry Tra'ys .. $75 Boiler Duct--UnderGround Duct - Structurol , Duct - Ventilating Exhaun System ❑ Multiple Firepl/Fact. Blt. ICBO dk Heating System & Ducting ❑0.100,000 BTU �100,000 Heinspection Fee � $75 0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Aszessor Issue Fae IANICAL Hood or Typel ❑ Canopy Typell ❑ . i _ 9 Refrigeratlon System 00.100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers � Registers laue Fee S Main Building: R�VAIR � E � � !� I T Front /Z�,p B Rear \ I C Right � S. Left �� v� �, Ping. Ref. # Z PlanningNotes: p��n Automatic Washer Construction Pole Su6. Cooking Unit Dishwasher Dryers as ❑Electric Fan F.A.U. Fixtures "' QS Zone . % . f . Accessory Building: (�A �,t� O Si ._ yi N V �/ � .. / N � . G R Parking Req./Provided E � n M T 5. ELECTRICAL � Switches -1 Garbage Disposal�,. " ' � ,Generator �0.5�KW 05-15 KW ' �� $75 Transforifier LJ 15-50 KW ❑ 50+KW Meter ❑up to 700 amps Meter �over100amps Sub Panel Motors �0.1 HP 01 h- 8 Inc.Soiar �9-75 HP 076-15+ Microwave � Pole Light � � Range � N Sign Standing Sections � Trash Compactor . � laue Fee EES Ei1 - DEVELOPMENTSERVICESREQUIREMENTS: n $ 3 r ,Zonin A �p�- . g pproved By • �� Date �/- � T� FEES' � �Building Approved 8y � C, Date._.�� ..� $ 3 _ � ' ' SUMMARY OF � ;.BUILDING PEAMIT $ ., � ,,�, S=' ,tPLAN CHECK \ $ � !:PLUMBING . ; $ Z( � • 'PLAN CHECK 25% $ ,_ -' ELECTRICAL , $ �I 2� , '?,PLP.N CHECK 50% $ ,.MECHANICAL $ . �'PLAN CHECK 25% $ i J ca . SMIP $ O�� PEFiM1T ISSUANCE $ ENERGY P.C.• $ GFADING $ . MICROFILM $ _� TOTALFEE $ � #�}V�'`t_�G�F�� '�Z��-��Ti'�' Oi �1002Q�i3-OD�2!}816 i�!T ±I�.��. CAiE: 11/'a�/83 TiiiE: 14:§i ' . �. . Y . V . -' . . . . . . . . . . . ) � '�1� r � ' � '��' POOL&SFs�}� . ' . CONSTRUCTION AND PLANNING� ' � ' ; �� Date Inspector �� , Dat�y} Inspector . �.i '.,APPROVALS Permit # , J APPROVALS� Permit # . - i ��i�. Temporacy�Elect�ical Service or Pole � 52. Pool & Equipment Location _ s� � I.r ' � 1 l t� r/ / ' � �2. Soil�Pipe-Undrgrnd. � ('l,yy-kE' (iE� 53. Steel Reinforcement . -',l � �,- i) r.�� _ � P/. f - '�3�Electrical Conduit Utility-Undr9rnd. � �� 54. Forms �� - '% �`�r ' �.: � � u� - �i �o � r� �'� . 4:� Electrical,Co duit-Undrgmd. % 55. Electrical Bonding �• /� n. � �n u -t v � � -,5T Steel�Reinforcement , � 56. Rough Plumbing & Pressure Test � vj�'�� e l.r .c. . ,�. / - 6.E qlecirical�AFER��G�nd. �, 57. APPROVALTOCOVER-GUNITE ;�'i ' � m' ii � . /i, � . . . ,- a . ' . ; . . 7�� F,�ootings -� .� 58. Electrical Conduit-Undrgrnd � i� � y �_ � � L� w t. a � �r _ � .. - 8.. F�ou ;dation � �� 59. Gas Pipe, � Undrgmd., Test •�; �.�, :� �� 9-:-Wat�P ipe-Undrgrnd. / 'itF �9�'j` 60.. Backwash Lines, P-Trap, O Undrgrnd. , T_ ' V .10:�StructuralFloorSYstem U'. . 61. APPROVALTODECK � �i �,� � 11,-Pr'operfy.Sewer Line & House Connection ^ �'� 62. Backwash & ReceptorFinal � � - `! �� _�,� 12! �e�wl� Cap�', (:�. . _ . . .1 � . 63. � Heater &-�Vent-Final : . . _ _ ��' : �/ 13. Roof �Drains � �` 64. Plumbin S stem � Final � � .`- �� , t . . i,_ . 1 . . . . . i . 9 Y . � 14. Roug`h Plumbing�3- 1��9 65. Electrical-Final �� _ �� 15. Rough,Electiical,Conduit •:.z_v.. �h � `66:' Solar System=Final� " � �� "�' 6_! Rough Electric Wiring , 1� _, ��O_89 � 67. F,encing.& Access Approval . ,�1�7! Rough Wiring Sign .,�J ;,� 68. APPROVED FOR PLASTERING _ �' 18l Rough Electrical-T Bar,� eiliKg�/�� ' � '+ 69. POOUSPA SYSTEMS FINAL � � ' 19. Rough Heatin9�&•Air Condivio`1 i1g� �q (�p.u.. �� ' FIRE DEP.T. REQUIREMENT � , , 20. RoughFactory�Fireplace �J;�}!�`��.•- , „•'� • APPROVALS . Permit# _ _ , �t��.� . 21.. Ducts, in Structure )�T j 70. Underground Hydro � � -- - 22. Ducts; Ventilating '�. "'.� � f- � ^_ 71. Product Pipi'ng QGas OOiI ' 23: Gas Pipe-Rough & Test �I i_ j ±� � � 72. Underground�Flush , - - � � �� 24. RoofFraming � �r�� 73.,Undergrnd.StorageTankOGas ❑Oil - ' �25�Roof Sheathing � -.� � � �� - � � , � 74. Overhead Hydro t 26. T-Bar Ceilin9 (Structural) &�Monocoat � 75. Dry Chemical . � -�f ��' � ' ,� ._- ' 27. -Frame and Flashing + v f� � _ � 76.' D 'ry Standp�pe ' � �' � � . ni [4 1.�1 ;- � . / 28. �L�thing &�Siding . �y� �r , � 77. FIXED.'S�'STEM FINAL ��„ � � � `. 29: Insulation ' j 1� � 78. FIRE PR . FINAL p ��30: Dr w"a11 Nailing.�'�( � �� :li rT _(r HEALTH DEPT. REQUIREMENT' ' ' � . ` `- r. � 31. �Plaster�Brown Coar �f'(�y ��-�� ,j�� 79� FINAL INSP.ECTIOro � ' .� , 32. E�trica�'PowerM�terF,inal I�!� ! � � '1 ( 0,. F000'CERTIFICA ISSUED � . 33. Fi al� Electric �� p ��' �� :��,. - . s' � Z� �f' .{�r ��l�y/ ml�� : 34� Final Heating & Air Conditioning�u �,._ , p; y�� j-/(o �� 1�� - 35. Final Gas Pipe-Test '�� '- � ,i'� � � 3 k9 S�¢2 PaK �oK 36. Hood or Canopy � � �� - -� `' � �37. Final Fec�or,y_Fireplace-, . � , 38 fF.i al Plumbing '� i� - �s 1N» � C�µ��l� � 39: Water Service-Final ' ^ � �bT- /�F//�ni � f, , �40. ,Gas Service-F.inal �- 6 6!� �9' L r v� � 41.'Solar pomestiaFinal • _ � T� - � 42. Backflow Preventer � �- - - � •- � ' ' •,i � t� _ '43. Backflow Irrigation ' ' . „j � ' �„� , 44. Landscape Irrigation System - ' � 45. Sound ;Atterivation � � , ,� _ _ � 46. Handicap�Regulations � y � � . � ' . 47. FINACSTRUCTURE&BUILDING �� p . 48.'Special-Requirements Completed , �� 49. Electric Release�to Edison � � � - � - , � -� 50. Gas Release to Southem California Gas Co ' _� � ' ,i•� p�:1 �i � 51.:CERTIFICAT.E OF OCCUPANCY l� 1{ � lV �{� U�J .'.t� - , . � � ' � � �' � . � No. ' Date 4 •> � - ? , .�� ' •i t \ � p 2961 I I/ 17/80 5:5fl Tl�. COSTA MESA BUILDINGSAFETY DEPARTMENT APPLICATION FOR STRUCTURALPERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � RECEIVED Y PERMIT For Applicant to Fdl in Completely — Use Ink Only ° BUI�DING G LZA�/ A.P. NO.� �� 243 � ADDRESS C �C��7/ BUILDING OWNER OR � �OSE � ADDRE55 TENANT UNIT OR MAILING� �. �� 57ACEN0. ADDRES TljR.�0.2� LOT� BLK. TEL. CITV � � NO. CON5iqUCiION NEW D ALTER REPAIR MOVING DEMOLISH LENDEF BRANCH OWNER i ADDRESS VALUE ARCHITECT TEL. USE � $ OR ENGINEER / N . �%� ADDRESS ZONE � TVPE GROVP -�..J APPROVE CONTRACTOR r BV DATE ADDRESS2�, e,W TEL. CITV .M. - NO. � — �, STA'f�E � CITV APPROVEDSETBACKS �IC. NOp� I � LIC. NO. SIZE NO.OF BLDGS. (FROM C/LSTAEET) OF LOT NOW ON LOT NT � FT. USE OF Q EXI5TING eLDG. ' Separate permits are required for � sio � FT. electric, plumbing and heating work. REAR � FT. VSE OF BUILDI RyVD K BE PERFORMED PLANNING ACTION / 'I r Q . �nt..�,_ r APPROVED � QYC S A�`c.°� tl � � I hereby acknowledpe that I have �ead this application and s[ate that the abova informetion is correct antl agrae to comply with all laws reBuleting builtling consttuction, antl I shall not employ any person in violation of che workman's compensation laws of tha Stete of Celifornie. � 1 heraby cerilfy ihat I am p�ope�ly Iicensetl as a contractor untler SQ. FT. the State of California Business antl Professions Cotle, �ivision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force antl effect, ar I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt from the provlsions of the State of Californta Business �p,LUATION end Profassions Cotle, Division 3, Chepier 9. {i b PERMIT FEE $ Q � Signeture of n �/� �j� /�p i�y ,/ p � O 7�AN CHECK $ Permittee ��// /L(I y./l�t'/L( oAA'//1�17� $ �� TAX § � Authorizetl AOent Date �/��7�n �/ TOTAI PAID S i �• 2 . d V �- Z ZQ am J � J N 0] J J m Q U Q Z� w aw J 0 m z J � W ly� � ZH w� 70 os�2 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFOHNIA 92626 iICT -1-69�NSp00 004 0*****5.00 ForApplicant to Fil/inCompletely APP��CATION FOR BUILDING PERMIT REC IVED BV D TE RECEIVED DATE ISSVED BUII.DING E ,� D�i- /a- - ADDRESS c /� OWNER 0 � � � A.P. NO. II(J 'V( I� � P N.� BUILDING ; %�/� r' ��' MAIL AODHESS `id C�• ADDRESS � 7 �7 TEL. SYP TFiACT p( �rt � LOT BLOCK CITY C NO. � CONSTRUCTION P � LENDER O � BRANCH OWNER . �� ADDRESS VA `(,(� ARCHITECT TEL. S OR ENGINEER FIRE ADDFESS ZONE � TVPE GROUP APP VE u � DAT �((� CONTRACTOR ,F �q.�(� 1 f B�' ADDRESS C f '� 20N NO.OF USE OF NEW L CITV NOL �— P�� BUILDING �� 7�i STATE CITV /,'Z(�� VARDSAPPROVED YARDSAPPROVED LIC. NO. a 2 Q LIC. NO. MAIN BUIIDING ACCESSOflV BUILDING �j (FROMGLSTREET) / C� /+Y ST� OF LOT �J5 X a D NOW ON LO ` ROM FT. USE OF � � EXISfINGBLDG. NC/r S FT. �I' FT SIZE OF NO. OF [� � NEW BLDG. ROOMS STORIES L. SIOE FT. � J FT. EXTERIOR WALL ROOF �— COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. eET. MAIN & MAIN BLDGS. ACCESS. BlDGS. � VAR. # DATE C.U.P.# qpPROVED L^� � � APPROVED� , /�i_/_ / �J V e� I hereby acknowlatlBa thet I have reatl Nis epplicetion antl stare thet ihe ebova Information la corract entl a9rea to comply with all laws ragulatinp buildi�B consvuction, entl 1 shall not employ eny person In violation Of che workmen's compensatlon laws of tne Stete of California. m 1 heraby cartify Mat I ain properly licansatl es e eontroctor untlar SQ. FT. o the Stnte of Celifornin BNsiness antl Professiona Cotle, Dlvislcn 3, THE AMOVNTSHOWN UNOER VALUATION IS FOR ' Cheptor 9, antl that sut� licanses e�e In full force entl Bffect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE ONLY: a om exompt from the pro+�sionz of [he Stete of Cellfornia Business VALVATION ena Protesslons Cotla, Div�ston 3, Chaptar 9. �� H �,�f PERMIT FEE 8 ] SIB^et�ra o/ _ / � }/' � D ✓ _ m Parmlttoe ��6�'!A �� g� j� P�.qN CHECK S �—� E `a Authorizetl ABant ,p �) LL TOTAL FEE $ ��/—v . . � +••, , . - '74_J3. COSTA MESA BUILDING DEPARTMENT - P. O. BOX 31� ' COSTA MESA. CALIFORNIA BUILDING ADDRE55 FOR APPLICANT TO FILL IN F axio� ++o,r vwcc� COSTA MESA. CALIFORNIA OWNER yxy$t$T}�'j]try yu10Y01♦O MAIL �,9 y� lly�y Sy• ADDRE55 CITV C�'gta Cuc'9a! C�1J1• NO. ARCHITECT C�S� � LIC. OR ENGINEER (j e OOk No. AODRE55 7v�>,y'�'.yQQI'1 �OPB CONTRACTOR VVle�,iOVe� �C�C'TY N'O. ADDRE55 T� �• �I�tl JU• NO. �Ec^� LOT OESCRIPTION NO. � BLOCK A.P. NO. NO.OF BLOGS. OF LOT ��rJ USE OF EXISTING BLOG SET6wCK LINE FHOM CENTEfl OF SiREET REAR YAR[ SIDEYARD RIGHT7� LEFT p� DESCRIPTION OF WORK � - �llL� IAP 1'�'� B V REPAIR a MOVING ION � DEMOI SH 5 ZIE DING 1647 9 1 V�OOMS / STORIES COVERIINGWALvyuCCO COOVERING V�� BUELDFNGEW Single fandlp residence with attached garage. � 1 � � e� � � 1� �1 :� d� IL. l�.v .F_ � ' a-� _ �toSTp �Aa �t{tA�.�� FI�!^,�:CE DEPT. .. nr n11CTA nqCC. APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY w COSTA MESA. CALIFORNIA DATE CORRECTIONS Plan x76oC i MEREBY wCNNOWLEOGE THnT I HnVE RE�D iH15 �PPLIC�TION AND STaTE TN�T TNE /.BOVE IS HflECT 1ND �GREE TO COMPLY WITM �LL CITT ORDINANCES �ND 5 A flEGUL�TING BUILDING CONSTNUC� T�� VALUATION SiGNATURE OF � PEFMITTEE � �j Ai AUTHORIZED AGENTa�1k8 &�/018��t%e� Ll1C• g 16,59g.�0 PERMIT FEE $ ��W PLAN CHECK S i9�OO TOTAL FEE g S7�OO ��