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Home My WebLink About208 CECIL PL - Building Permits.' 2 58 �.. _ .� � 00� eOMESA BUILDTNC+SAFETY DEPART �NT Po� App11mM fo Fill In CompbMly TYPE OR PRINT �uao�na ADOR800 COSTA MESA, CALIFORNIA T�. STATH Tm.. LIC. NO N . s�ze Ho, o� e�ow. OF LOT NOW ON IOf USE OP EXI6TIN� BLDO. � e¢nweK une �nor � c6HTeR OM 9TR6R NSAR Y G1D Y L6F� ��` RIOIfT DESCRIPTION-OF WORK I N[R6pY ACNNOWL[DOt TIIAT.1 MAVt 11fAD AND OT�T6 TNAT TI� /�GOV[,�! COM6CY A� PLY WITM �LL CIiY OROIlWIC[� A�IO TAT[ nw�oir�ocoHsrpurnv. ! / 816NATURE . � � PBRMITYH �urHon�zeo woirir C6TY (�� C.S�t� �1 OCT 4 1965 for Cffin U» Only R[C[IIT NO. , un ieeuio r [ NO.0/ I U�[OI�NRr • � 'LAqI �YILDINO '� ,t9 o Lv CIIIRIO �. No. � � ��- 7 —� Y '8i NOlAVCOVeRHANOBMALLDeLl88THAN TO BIDH O RBAR P. L ee aweo cu. e. c. neouineMcrrr� VARD�MPROVED YARDBAPPROVeD MAIN BUILDINO ACCHBHOHY BUILDINO v�. # DATB / // ' Oi � � �. �. � iN� AYOY/R �XOWry UND6fi VALUATON IG IOR TH8 � ►URP06[ O! YiACUDNINO A P6pMIT I[1 ONLY. vwwwT�oN mo 30 � � PERMIT FH6 = 8j 2 6C� � oa € �� w �� TOT1tL P68 .. �51�� :"-�`_��p COiTA MESA BUILD�IN'G-SAFETY DEPARTMENT P.O. BOX`31� COSTA MESA, CALIFORNIA FOR APPUCANT TO f/LL /N COMPLETELY TYPE OR PRINT BUILDING p /� ADDRE55 �O(! C,Oi1 / � 'CG �' �COSTA MESA, CALIFORNIA LEGRL LOT ^/ % OESCRIPTION NO. e —� / E A.P. NO. /"I d _. J�O ' OFEOT .S D X��L� TEL. NO.OF BLOGS. NOW ON LOT SET9ACK LINE FROM CENTER OF STREET S REAR VAF SIDE YARD ILEFT i� IRIGHT J DESCRIPTION OF WORK REPAI S Z'E DING� n�,/�j 6� ROOMS Q EXTERIOR WALL 1 ROOF COVERING J/G'CCO GOVERING USE OF BUILDING AND WORK TO BE F ,�� c�tC�l�lE� cn^" JUN 1 19�� FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR Off/Cf USE ON[Y ' I RECEIPT NO. I fl[�IT pGC/ J¢ IIVE%6� I D� ./ E/ F��,'/ I�A'TE/ �. BU COSTA MESA. CALIFORNIA I ) FIRE ZONE BY ��_�-��r ��/Jlil ��DATE � ZONING ' 20NE INO.OF IUSE OF NEW. PLANS Z BUILDING APPROVED � BY OATE '/ YARDS EVES REQUIRED ALLOWED ICENTER LINE ST.) L. SIDE S� Ff. -- - ^ " - IN. . O� • � 1 HENEBY ACNNOWLEOGE THAT I HAVE READ THIS APPLICATION THE NMOUNT SHOWN UNDER�VALUATION IS FOR THE AND STRTE THAT THE;RBOVE IS COflFECT AND AGREE TO COM- pUqPOSE OF ESTABL�SHING A PERMIT FEE ONLY. PLY WITH ALL TY OHDINRNCES 6NU STATE LTWS REGULFTING e�i�oinc corvs auCiion. VALUATION �j SIGNATURE OF � PERMIT FEE $ � / PERMITTEE � �J .[ —VY./� J�� $ /"/ "•%^� / PLAN CHECK $ / �.� � v AUTHORIZED AGENT TOTAL FEE S S�j� � OWNER fiERTZ� S.M. DATE k-17-7�+ �' JOB ADDRESS Cec _ Place BUILDING PERMIT N0. �1 GENERAL CONTRACTOR Hertz Masonry DESCRIPTION of WORK Block Wall �AP No718-12�-1? LOT TRACT FIRE ZONE VAWE 51.072.00 r.Fi�xa�i W RTER ROUGH HEATING AND AIF CONDITIONING IINOERGROUND U POWER Lf ROUGH WIRING TRENCNES FORMS STEEL LATHING — IN � I � PLASTER. BROMN COAT HERTING. VENT oare SUBCONTRACTOR JOB ADDRESS GENERAL CO] � � DESCILIPTION OF FIftE ZONE VALUE $ 8,250.00 _ GROUP i TYPE p ZONE R-2 SUBCONTRACTOR I r_. P�'R'n*1TS�ISSUEDrt^^' ^n (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 BUILDING PERMIT c Job Address: 208 CECIL PL Suite: Vicinity: Parcel Number: 42607325 Applicanr. GOODGAME, JACK Address: '16631 KETTLER LN HUNINGTON BEACH;, CA Owner: DEATS; DOUGLAS Address .21902 VACATION LN HUNTINGTON BEACH, CA Contracror. SIERRA ROOFING CO Address: 16631 KETTLER LN HUNINGTON BEACH, CA Zip: 92647 Arch : Address: Zip: Phone: License: Zoning: Phone: (714) 847-1773 Zip: 92647 � � Phone: Zip: 92646-8242 Phone: (714) 847-1773 License: 511172 , Eng: Address: ISSUED BY: Status: ISSUED Applied: 02/06f2004 Issued: OZO6/2004 Phone: License: _ _ SCOPE OF PERMIT . REMOVE AND REPIACE ROOF. FLAT AREA APPROX 27 S�. FT. - BUILT UP ROOFING. PITCHED AREA APPROX 7 SQ. FT. COVER WITH 30 YEAR COMP SHINGLES. REPAIR AND REPLACE SHEATHING AS NECESSARY. Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.59 SMIP Com: $0.00 Other: $0.00 Irispection: $0.00 Total: $125.84 SETBACKS � MAINSTRUCTURE Front 0�0 ACCESSORY - Front 0-0 PARKING Existina: o Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Lek 0= 0 Lett 0- 0 Proposed: 0 Calc Vaivation: Claim Valuation: Right 0- 0 Right 0- 0 $5,938.00 $5,938.00 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, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work Is suspended or abandoned for a period of 7 BO days. _. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, end ell requlred Inspeetiona end Iinal approval must be obtained. Fallure to obtain Inspections and final approval will result in the expiratlon of thls permit. FOR INSPECTIONS CALL: (714) 7545626 26d&68 (fl�00) WORKERS' COMPENSATION DECLARATION: � I hereby aHirtn under penelry ot perjury one oi the following declarations: ❑ I heve end wlll maintain e cetliticete at consent to sell-Insure for workers' compensatlon, es providetl tor by section 3700 of ihe Lebor Cotle, lor Ihe peAortnence oi Ihe Ork fOr whith this permit Is IssueA. 1 have end wlll malntain workers' compensation insu2nce, as requiretl by section 3700 0l Ne Lebor Cade, for Ihe peAortnance of Ihe work for which this pertnit is IssueO. My w ers�' w/mpensatlon Insurence carner and poliry number ere: .+� �7 [ Cartier: �T/TT� �U/v%i PoliryNumher. ��S �dO v�� (This section need no( be completetl il the permit is valued at one hundietl tlollers (5/00) or /ess.) ❑ I certify that in �he peAortnance ol the work for which Ihis pertnit is issued, I shall not employ any person in eny manner so as to become subject to tha workers' compensation lews of Calllomia, end egree Ihat if should 6e�ome su��ect ro the workers' compensetion provisions ot Sec[ion 3700 of [he Lebor Code I shall forthwlth comply wilh �ha;,�brow5ion5.A . / / / ��c., � ` Applicant Sipneture:l�f/I,F'�T , O//i1�'�— ' Date: ` \P � WARNING:FAIWRE ECUREWORKERS'COMPENS COVERAGEISUNLFWFULANOSNALLSUBIECTANEMPLOVEFTOCFIMINALPENALTIESANDpVILFlNESUPTOONEHUNDRED TFIOUSAND OOLLA (E100.000), IN ADDITIqJ TO THE COST OF COMPENSATION, DAAMOES AS PROVIDED F-0R IN SECTION 31O60F THE LABOR CO�E, IMEREST, AND ATTOHNEY'$ FEES. LICENSED CONTRACTORS OECLARATON: I hereby aNirm t�at I am Ilcensetl under provisions of Chapter 9(commencing wit� Section 7000) ol Division 3 ot the Business and Profauions Code, entl my Ilcensa is in lull force entl ettect. lic. # Class q Contrectors SlqnaNr � 1— Date: � ��Z CONS7RUCT10N L�NDING AGENCY: ❑ I hereby aHirtn that there is e wnsiruction lending agency for the pedormance ot Ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lenders Nema: ___ . _ LentleYs Atltlress: _ . _ __ Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aXirm thet under penalry oi perjury that I em EXEMPT FROM THE CON7RACTORS LICENSE LAW far ihe tollowing reason (Sec. 7037.5, Business antl Pratesslons Code: Any ciy or counry which requires e pertnit to construct, alter, improve, tlemalish, or repeir eny strucNre, pnor to its issuance, also requires tha epplicant tor such permit ro file e signed stetement that he or she is Iicensetl pursuant to the proNsions oi lhe Conirecbrs Llcense Law (Chapter 9(commencing with Sectlon 7000) ot Division 3 of the Business entl Professions Code) or that he or she is exempt therefrom enA the besis tor Ihe elleged exemption. Any violation of Section 7031.5 by eny epplicant for a pertnit subjects t�e epplicant to e cidl penalry ot not more ihan five hundred dollers ($500).): � I, as owner of Ihe proparry, or my employees with weges es Iheir sola compensation, WILL DO THE WORK, antl tha structure is not intanded or oflered lor sale (Sec. 70a4, Business and Protessions Code: The Contractors License Lew does noI apply lo en awner ot property who builds or improves thereon, antl who tloes such work himself ar herselt or �hrough his or her own employaes, pravided thet such Improvemenis are not Intentletl or otteretl for sele. It, however, Ihe bulltling or improvement is sold within one year oi completion, ihe owner-builtler wiil heve ihe burden of proving t�at he or she tlitl not build or improve for purpose of saleJ. ' ❑ I, es awner ol ihe properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct fhe project (Sec. 7044, Business entl Pmfessions Cotle: The contractors License Law tloes not epply Io an owner of propeny who builds or Improves �hereon, antl who comracts for such prolect wilh e contrector(s) license pursuant to Ihe Contractore License Laws.). ❑ 1 em exempt untler sec. Business antl Professions CoAe lor this reeson: Sl9nature: Date: Owner ID veritied by dnvers license. ❑ Yes ❑ No Drivels License No. Venfication at Ownership by (type ol document, i.e. - properry tea �iil or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expire5: ❑ 1 he�eby cenify Ihat no excavation five (5) or more feet in depth into which e person Is required to descand, will be matle in connection with work euthodzed by Ihis permlt, and that no building siructure, swNoltling, falsework, or demolillon or dismantlinp ihereof, will be more than thirty-six (36) feet Nqh. (Chep. 32. Grp 2, Art 2, Sec. 341, Title 8, Celifomia Atlminisirative Code). ❑ As ownar-builder, I will not employ anyone to tlo work w�ich would require e pertnit trom the Division ol Indusirial Safery, as no�ed above, unless such person hes e permit to tlo such work tram the division. Signeture: Date: Division at Industnal Satery Parmit Number: CERTIFICATE OF COMPLIANCE AND AIJIHORIZATON OF ENfAV: I certify untler penalty of Deryury that I heve reatl this applicetlon entl state thel lhe informatlon given is correct I agree to comply with all stete laws end ciry ortlinances relating to building construciion, end au�horize representatives oi the Ciry ol Casta Mesa co enter upon the above-described property for inspection purposes. I egree not to occupy or allow occupancy of any building authorized by this permit until �inel inspection. cooe.. ixsvecnoxtvre 1618 Fixed System Final Flre Prevention 1266 Pool Spa Finel 200 Final Re-Rool 201 FIneI BIocWRetalning Well 202 Final Fectory Fire Place 203 Finel Sign 204 Flnel Demolition PdIE It�1dLfl ►�4 ! %1�� 7 — �e�fU� Date cooe� ixsvernoxTrae 206 Finel Mechanical � 208 Finel Plumbing 210 Final Electrical 212 Finel Fire Preventian 220 Final Planning Approvel 222 250 Final Site Final Buildingi0aupency � It�fl AOD��ant to fi11 in all zpaces except those within heavy bortler Iinos ana sign all approprlate aeclaratlons. �' CITV OF COSTA rMLESA ,�O,IVSTRIJ�TIOfV PERMIT � Project Address � ��' ►�4e.�� Applicant's Mailin Address zva �' � �� Owner's Na e �N � n ^ P one � Addreu � 2-�� E �� M 'y'� Arch/Eng. ' License No. i_ti Address �,��I Contracto�•� Nx „a _/ � +�� + �oIle �i1 —'�l Address (m 'I' g) � / n 6 A�"��_ Ciry License No. � �b 34 � LICENSED CONTRACT00. DEC ARATION 1 he�eDy affi�m tha� I am Ilcensetl untle� p�ovislOns ol Charte� 9(commencing �wiih se[tion 1000) ot DiviSiOn 3 01 the Bu5ine55 antl PrOfeSSiOns Cotle, antl my licens i in jQll i�c antl effecl. �,� Zv ( License ��` LI ET o � Da[e ignature � WORK S'COMPENSATION DECLARATION �, lereby atiirm that I have a certiticatu of consent to selt- ure or a certifiwte Wo�ke�s' Compen5alion Iniuranc¢, Or a certifi¢tl <Opy [hereof ($ection ..800, Lab. C) ) /^.� �fry1 C ^ �' Policy No. 1� �, L} � U , Comp `�+�� N� Certifie co is �ereby tuTiShCtl. Gertifi o ileU with lne city Bu ivisi Date Applitdnl EXEMP ON FROM WORKERS' COMPENSATION ECL ATION (This sec mn neetl no[ be com0�eleG if the parmit is for one h nCratl (§300) or less). I certify thal in the pertorman<e Ot Ihe work fOt whlcM1 [hls p¢rm�t Is issuetl, I shall not employ any person in any manner so as to become subjecl [o the Workers' Compensation Laws ot California. Date Signature NOTICE: If, after making this tleclaration, you ihoultl becoma subject to the Worke�s' Compensation provisiOnS Of th0 Labor COtlC, y0u mu5[ �Ortltwilh compry with Such proWsions or Nis Dermlt shall ba tleeme0 revoked. CONSTRUCTION LENOING AGENCV 1 hereby a/tirm that there is a constructlon lentling a9ency lor tne verformante of Ihe wark � for which in15 plrmll Is ISsuntl (SettlOn 3097 Civ. CJ L.entl¢r'S NamC Lentler•s Atltlwss OWNER BUILOEN UECLARATION I M1ereby dfflrm [hat I am axempl irom [hC Cont�aclor'S LIC¢n5o Law fo� lhe 1 following reazon (Sec[ion 7031.5 BuSiness antl Professional Cotlo: Any tity or <ounty which reqWras a permit lo construtt, alter Improve, tlemoliih or wpalr any struclure, prlor to its issuance, also reqWres t�e applicant tor such permit t0 file a signetl Sta[eiflent [Ilal ho/sh0 is IlcenSBtl pWSudnt t0 th8 Provlslon5 of the Contractor'S License Law (Chapter 9(commoncin9 wlth Sectlon 7000) ol '.•z�ivision 3 O( Ihe BUSIne55 antl PrOfessiont COtl!) or Inat he/sne is azampt `.terefrom an0 tne basis for Ihe allegetl exempHon. Any vlolation ot Sectlon � i`�931 5 by any applicant for a permit subjeGtS lh0 applitant to a clvil �"pendlty o1 not morO lhan five buntlrcU tlolldr5 (E500). ❑ I, as owner of tne oroparty or my omployees with wages as thoir sole compensation, will tlo Ine work, antl tM10 structuro ii not IntanEetl or oHeretl for ule (Section 7044, Business antl Prolessional Coao: Tne Conbacto.'s License Law tloes not aoPly to an owner of a property who bulltls or Improves the�ean, antl who tloe5 Such work M1lmself/hBr501f or thrOugh hi5 or ho� own emplOyees, provltlatl that such improvamOnts ate not In[entled o� oii¢re0 /0� sale. If, however, Ihe builtling ar improvement Is soltl withln one year of com- --pletion, Ihe owner will havo lh0 bmtlon 01 prOving hC/Sha dIU not builtl or im- - p�ovefo�tM1e purpose olsale�. , ❑�1, as owner O/ the prOperty, am ez<luslvely contracting wlth liG¢nsetl con- t�actor5 [o cans[�uct Ihe pwject (SeCtiOn 7044, Bu51n855 antl Protesslon5 Cotle: The Contractor's Llcense law tloes not apply to an owner ot property who builtls or Improves thereon, ane who contracts for tucn projects with a con- tfacior(s1 bcen5e pursuant to lhe COnlrattOr'S LICBnie Law). I dm aware tF1at prooi o( (heir Worker's Compensallon insurance snoultl be provltleC to me. ❑ I am e%empt un0¢r 5¢CtiOn B. 6 P. C. tor lhii reason Date Owner I hereby certi hat I hava r his apD��<aU intormation is cor c[. I agr o m01y with a antl sta[e iaw rela ing to �� onstruction sentatives ol h' ity ro e e pon the ab inspection pur s Signature Driverz' LicenSe or 5 � _.._B .2 g o 37 ...... ...,. TVPE OFCDNSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p *, DESCRIPTION OF WORK/USE OF BLDG. S Main 8� E TVPE OF PERMIT GRA�ING FOUNDATION STRUCTURAL T Front TENANT ❑ E�/ C�T^R_IC—AL ❑ PLUMBING ❑ MECHANICAL B Reef � OTHER (�./(WG A P OJECT DESCRIPTION 5�. FT. 7�'pO oCGUPANqCv C Right CONSTRUCTIONTVPE VALUATIONS�C(iD� g Le(L ZONE � GRADING CV. VOS. ACRES p�ng. ReL # Remarks: �� S�1�6 � F PlanningNo � (� D 2 k � S—r— PLUMBING FEES Sink Preventer Clarifiers � Dishwasher' Drinking Fountains Floor OrainS Floor Sinks GasService Qlltl2ti Interceptors • Ki[chen $ink Lavamries P—Trep Roof Dreins • i Fee � $15 Ground Dutt - Ventilating � Exheust System� � Multiple Firepl�Fact. BI[. IC80 # Heating System & Ductin ❑P700,000 BTU ❑ ,000 Fee � S15 `\865-46, rev. 10/B4 White - BuilEing; Canary - Appllwnt; Pink - Accountin9: Goleenro� - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Heater .SEfVICQ Isue Fee g 3 1ANICAL � FEE Hood or Typel ❑ Canopy Type II ❑ Refrigeration System 00.100,00 ❑100,0008TU S m Repair/Alteretion Fire pers Regizters laue Fee I S Washer m Pole Sub. �ishwasher � Dryers �Gas I Fan ' F.A.U. Fixtures Device Boxes Outlats Switches Garbe9e Disposal Genereror �0�5, .:.� Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW � ❑ SO+KW Meter ❑up to 100 amp Meter ❑aver 100 ps Sub Panel 75 KW Light Standing Trash Co "� Feinspeciion Fee �$15 � � Issue Fee DEVELOPMENT SERVICES�RE�UIREMENTS: Zoning Approvad By Buildin8 APP�e�d By �� AppllWtlOfl IStUBd BV al HP �1'h-8 �9-15 HP��16�15+ FE 5 3 SUMMARV OF FEES BUILDING PERMIT $ 2.A .00 SMIP s �' S� PLAN CHECK $ PERMIT PLUMBING S ��UANCE $ PLAN CHECK 25% $ ENERGY P.C. 5 ELECTRICAL $ GRADING - $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL . $ TOTAL FEE $ 2 g• SC PLAN CHECK 25% $ 2 O N 1 N G R E U M T S CONSTRUCTION AND PLANNING _ POOL & SPA � APPROVALS Permit # Date � Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings ' 58. E�ectrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � ' 9. Wa[er Pipe-Undrgrnd. - • 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System . 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 73. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing � 65. Electricel-Final 15. Rough Electrical-Conduit 66. Solar System-Final . 16. Rough Electric Wiring � 67. Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # _ 27. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71 . Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Unde�ground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof $heathing 8 7 O� 7q, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemiral . 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: .34. Final Heating & Air Cond'tioniny � 35. Final Gas Pipe-Test ' - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - ' 39. Water Service-Final �� 40. Gas Service-Final � ' 41. Solar pomestic-Final ' 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation System 45. Sound Attenuation ��'� 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 NO. Date i Z . d U ZQ ON am J � J N Q W m J J m Q U � Za 2 aw wZ J Q m Z J � W w O= Z F w0 � Q F Z Q U J a a Q � � � z 0 F U � � r N Z � 38295 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For App/icant to fill in Completely 6VILDING OO •/ n� //, M ADDRE55 Q .0 f/ l� "/ OWNER ,s �. ,y��z MAIL �� AODRESS CITV /QS%�i ///E..JI% NOLf!/�� BRANCH AODRESS ARCHITECT ADOFESS CONTpACTOR ADDRESS (� 8 , ,� P� • a /�/FsSF� TEL�a CITV NO. STATE CITV Ij LIC. NO. � �� LIC. NO`'j O SIZE � K /�a iNO.OFeLDGS. OF LOT NOW ON LOT EXISTING BIDG. ��G .y OE�K� SI2E OF NO. OF NEW BLOG. ROOMS �STORIE: EXTERIOR WALL ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED ��n/_ .� . .. . i i. _.. ,i _. _ I hereby acknowledge Nat I have reatl this appltcntion end stete that the abova information is correct antl agree to comply with oll laws ragulatinq builtling consttuction, and I shall not employ' any person in violation of the workman's compensallon laws of . the Statt of California. I hereby certify that I em properly licensetl as e contractor under [he S[ate of Celitornia eusiness antl Professions Cotle, Dlvislcn 3, Chapter 9, antl t�at such licenses are in full forca antl effecx, or I• am exempt from the provisions of the Stete o( Calilornia Businass antl Protessions 6e, Division 3 Chapt� r 9. SiB�ature of ///� Permlttee �� Au2h rizetl Agant P,PR 17-74�A�;'00 671 ''17.00 �� r,ra.. �N FOR BUILDING PERMIT OATE RECEIVED nnsc issui srs� BUILDING ADORESS OWNER FIRE DATE rT % / NO.OF USE OF N PLANS BUILDING VAROSAPPROV�p VARD: MAIN BUILDINY-0 � ACCESS DISTANCE BET. I BEf. MAIN MAIN BLDGS. ACC6S. Bl VAR.# DATE ILDIN // . j� �, b SQ. FT, o THE AMOUNTSHOWN UNDER VALUATION IS FOR � THE PURPOSE OF ESTABLISHING A PEFMR FEE ONLV: Q VA�UATION � W PERMIT FEE $ � ------777n � 5 m $ /D / / � PLAN CHECK $ E � '� � � ' LL TOTAL FEE 5