HomeMy WebLinkAbout544 CENTER ST - Building PermitsOwNER CIT7 OF COSTA MESA
JOBADDRESS 544 Center Street
GF'"RAL CONTRACTOR The WiZdr
A� �424-222-14 ��TPor. 16
INSPEGTIONS
soi�
G�5
W nTER
ROl1GH PLUM6ING
PROP. SWR. LINE r� MOUSE CON.
SPRINKIING SVSTEM
MISCELLANEOUS
POl1GH MERTING RNO NIR CON�ITIONING
TEMPOR4RV SERVICE OA POLE
UNDERGROUND [� POWEP �
ROUGH WIRING �
TRENCHES [ FORMS STEEI AEIHF.
FLOOR SYSTEM
80N0 BEeM L STEEL REINFOACE ❑
SMEATHING
FRRME AND FLRSMING (-1
LiTUING — IN r� OUT 1 �
P ER. BROWN COAT
STnvCiURAL FIN4L
NE1TiHG, VENT., REFHIG. AND �.C., FIN�L
PWMBING, FIN4L r1N0 WS 1E5T n
ELECTPIC.FiNAL
BUILDING. FIN4L
DATE 6-25-81
SUBCONTRACTOR
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
ADDRES�s/y� uc a�
T�ENANT�RC�iT'../ /JF C.�tSTA LY%%iA
CITV A �J�
CONSTRUCTION /p
IENDEF („� / T
BRANCH �-
ADDRESS ��
� ARCHITECT ���
OR ENGINEER
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ADDRESS�[ � � (/ �,E�
CITV. �LVQ N % � NEL. QS,/C
7
F STATE CITV
i LIC. NO� � LIC. NO.
,
{,�id SIZE NO.OF BLOGS, �
0. OF LOT NOW ON LOT
a USE OF
� E%ISTING BLOG. �
�
FSeparate permits are required for
Q electric, plumbing and heating work:
E,W,. USE OF BUILDING AND WORK TO BE PERFORMED
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� I hereby acknowledBe that I have reatl this eppllcation antl state
y� that tha ebova Informetion Is correct and agrea to comply with
d ell lews reBuletlnp building construction, a�tl I shell not employ
z any peraon fn violatlon of Me workman's compansation laws of
w Me Stace of Californla.
x
3 I heraby cenify that I am properly licensatl as a eonttecior untler
ihe Stata of Californie Businev antl P�ofeuions Cotle, Division 3,
Chepmr 9, and t�et such licenses ere in f�ll farce end effect, or 1
am exempi trom tha protlsions of t St , f�elitor eBusiness
antl Profeasion;j'i�Qa, � I 3
Slpnature of `'�L
Permlttea -
o. �—i� – �-/
Authorizatl A ant Date
7178 6/25/BI .50 TL
APPLICATION FOR STRUCTURAL PERMIT
R
A,P. NO.
BUILDING
ADDRE55�
UNIT OR
SPACE NO.
NEw I /�DD
ED
APPROVEDSETBACKS
PLANNING ACTION
� 227 _—
R
DATE
S
BLK.
n
'm
m
SQ. FT. �`+
J
THE AMOVNT SHOWN UNDER VALUATION IS OR m
THE PURP06E OF ESTABLISHING A PERMIT FEE LV: ey
VALUATION PERMIT FEE E �7
m
� PLAN CHECK E
$`D�4 TAX S �
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TOTALPAID E _�
, Sa
• c�
BUILDING PERMIT N0. Eiecvtwi Co
Tra<t B�ock Lot Pvmit No. c
{{�� vlumpin C.
Builtling L�� � i� p�rml: No. �,
AadlG55 f
,�
D
Crois Mec�an I W C
Mea $Vtet �� Permlt No. C
2
Owner /�/ V./) �, ✓ �/. TYPe oi RoiecL L New ❑ Altu LJ AOOition �
rv i
Aaaress � vCI �j �: ^' � � �� ❑ Reoair ❑ Convert ❑ Demo ❑ Occuoancy vmt i
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� SuD. Dii:./ �
Ciry :��r� �. S�z, Zi� 4/4/ PnOne A.P. ' ImG. ?rea �
A.cnitect/ I
Desiqne. �icansa No. Zone $D�. �Tt. NO.
Se[Oacks P/L Front UL St SveH wiatn
qCEresi
VarEs Left �9�t Nr
citv zlo Pnone
ave ro�. e i9 . .
En9���er l�cenfe No.
� �arking pdces equi�etl ovi e Overe
2 Atltlress
ia Sir�ct No. ol N0. of '
m City Zip Phone Height StO��es Pamily
� LICENSED CONTRACTOR'S DECLARATION aark Fees � ves F�e
A Requiretl No GT. q�«ipt I
m I pareby aHirm thai l em licrosetl untle� provisions of C�aptar 9 (
Icommencin9 wit� Saction ]000 af Division 3 ot t�e Business antl
�Zonlnq ADD�oveC By: Date
Professions Cotle anC my license is in iull lo�ca antl attacil.
?� Litanse Clasz !�-` `�� Licensa Numbar I
T DateG �rl�l Connactor�/U��/lG<1/L�6'F�IC� /.�/G Misc.
E nadross ` C l�h�Q� ��' aropozea Use I
y Ciry ana Zio.,AA/ f/M �lJ, p�a� 1/ � o/ Svvctvre
� CONS7RUCTION LENDING AGENCV I
� I �erebv affirm chat t�ere is a consi�uc[ion Isntling agency lor ihe I
L oerformance of ine wo�k far wnich xnis permit is issu�d ISec. 3097, �CO' Tyoe Coae
' Clv. C.1. Ciass Conit. �'ear �
y Lenae.'s Name USE/OCCUPANCY SiZE 5�. FL �
� Lenaer7 Atltlress �
� OWNER-BUILDER DECLARATION I
Y I �ereby afiirm c�ac 1 em aaempt irom the Convactor's License Law 1� "
� fo� tbe following raasOn:
� L� I, es owner o/ x�e prooerry, o� my �mpioy�as wit� wages es t�el� 2.
tple cOmpen30t�On, will tl0 ille wOlk, antl the �buClul! i5 nOt
� inientleC o� offaretl forsgl¢. 3 �
- L� 1, as owner of t�e prooeriy, em teclvsivNy cOnvactinp with
i
� licensetl coniracto�sto constructt�a D/olect.
.v, _� I am aiam0� vntler $ec. , B&PC �O� t�is reawn 4' I
Y_ I,y Dav Owner
E WORKERS' COMPENSATION DECLARATION Tmai valuation � �
3 '
I n�reoy affirm inat 1 have a cUtilicate oi consvnt lo selbinsure, � G �
or e c!/iiticdt! Of WOrkers' COmD��ution Insurant�, O� 0 C��tilietl Encroac�ment Permit itecuireC V!S NO
[ LOOV Lflf�lOt. '
A Gnaing Gmt Graainy i
vorc rvoyZ /%U�79 - � UC' ❑ ❑rao vmt.r+o.
4i at Y tompany ��- qppulreC Yet �
� {�.Cxr:i!i�C opv i: �e.opy'u: ni:�atl. �� � Rou9n Gratling �
_ ❑ Certifiw coov �sfi1W witn O� pou E a
/ / APD�oveO by: Date
DatelO �`�I APPlican� � � 3
CERTtFICATE E%EM ION �
FROM WORKERS COMPENSATION INSURA 'E Z
(This section neatl not Da comD�atetl i1 permit is ta� 5100 or lassl. �
I cxiify i�ai in t�e p�rlormanca of t�a wOrk 1or whiU t�is parmit is 3
issued, 1 sl�ell not �mploy eny person in sny mann�. fo ef io Dacome PERMIT FEE$ R
subleci to t�e Work�rs' Gomo��setlon L�wa o1 Califo�nia.
Dau Applicant i
NpTICE TO APFLICANT: H, efte� mskinQ t�i� Certificna oi SVuctural S PlanCneck { �
Eaempaion, you ��oultl become wCjecc to th� Wo.kery' Compansation
orovisions of t�� Lebor Cotle, you mvs[ forMwi�� comply wi[h suc� ElecviWl S Soecial s �
provisions or t�is Ormic s�all pa O�amatl nwketl. Invest �
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE i
THAT TME ABOVE INFORMATION IS CORRECT. I AGREE TO �umbing f
COMPLV WITH ALL COUNTY ORDINANCES AND STATE LAWS 1
RELATING TO BV�LD�NG CONSTRUCTION, AND MEREBV AVTM� Mecnanical S I
ORIZE REPRESENTATIVES OF TMIS COUNTV TO ENTER U�ON �
T�� V��� Epi�CRO� FOR INSPECTIO AGU(i� pre.Gratle s i
�� InsOe<Hon
d Re-Gnae Permit
�S�ip/net�re ApD��u i or Apeni ace Rec. No. s Issue f j
�[G-GY�A.r/DF�' .f �fI�P-L!.! � I
Print ADDi�cent's/Apen�'s Neme
Plan IsSuanGe i
All speces within t�is box muri Da compinad to process Cneck Br: Aoo�ovea:
cmF o3ss�ae (eu-zn7 rev. e/no