HomeMy WebLinkAbout660 CENTER ST - Building Permits! 1
� CITY OF COSTA MESA
BIIILDING D/VISION
77 FqIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • v+ww.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT TYPE: B COMBO
Sub Type: RES_ALT
JOB ADDRESS
APN: 42421237
Vicinity:
Const iype: V-B
660 CENTER ST CM'
SQ. FT:
PERMIT NUMBER: BC09-00370
STATUS: ISSUED
DATE ISSUED: 1010112009 .
ISSUED BY: BJK
Suite/Unit:
Zoning: , ,
Primary Occ:
0
Valuation: 5140,000.00
SCOPE OF WORK: FIRE DAMAGE REFAIR TO REAR UNIT. WORK TO INCLUDE DEMOLITION OF FIRE DAMAGED AREA,
REBUILD ROOF ON 2ND STORY, REPAIR BALCONY, RAILING, REPAIR ALTER/COOLING/HEAT, ELEC: 17 LIGHT FIXTS, 35
OUTLETS, 24 SWITCHES, 1 SVST0200A; PLUMBING: 1 BATH TUB, t DISHWASHER, 1 LAUNDRY TUB/WASHER, 1 KITCHEN
SINK, 2
WASH BASINS, 2 WATER CLOSETS, 1 WATER HEATER; MECH: 1 REPAIR/ALT COOIJHEAT, 1 HOOD WIDUCT MECH
EXHAUST, 1 VENT FAN SINGLE DUCT
APPLICANT ADVISED TO CONTACT AQMD.
OWNER: KtPPER MICHAEL J AND JOLIE R
Phone:
APPLICANT: HERG, DANNY
Phone: 714-553-9314
Address: 77861 SAN CLEMENTE ST
City/Stale2ip: FOUNTAIN VALLEY, CA
Address:
Ciry/State/zZip:
coNrancroR: EXCELSIOR CONSTRUCTiON AND DESIGN INC License No. 767126
Phone: 714-758-1153 Address: 2430 N GLASSELL STUnit:
Cell: CirylState: ORANGE, CA
ARCHITECT: JIM QROWN AND ASSOCIATES License No.C9475
ENGINEER: � License No.
COMBINATION PERMIT FEE SUMMARY
Building Plan Check; $791.54
Building Fees: $1,217.75
Electrical Fees: $130.57
Mechanical Fees: $55.10
Plumbing Fees: $111.70
SMIP Residential: $14.00
SMIP Commercial: $0.00
Bldg Std Admin Fund $6.00
TOTAL FEES: $2,326.66
"Ratar lo fee receipts fol all feas pald /or proJect
Unit:
Unit: :
UNIT E
ZipCode 92865
PHONE:909989-2441
PHONE:
NOTICE: The work authorized by this permit shall comply vrith all applicable handicap access requirements under Califomia slatutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be oblained. FaiNre to obtain inspections and fnal approval will result in lhe expiretion of this permit.
CODEt. INSPEC710NTYPE Ij�A¢ I� �QO�F/ INSPECIIONTYPE _ I�, Q/y��1 IN7I71pL
7876 Fixetl Sys�em Finel Fire Prevenlion 206 Final Mechanical ' I 1' (� � d
1286 Pool Spa Final 208 Final Plumbing
200 Final Re-Rool 210 Final Electncal _y�
201 Final Blxk/Retaining Wall 212 Final Fire Prevention
202 Final FaGory Fire p�aca 220 Final Planning Approval
203 FinalSign
204 Final Demolition
222
250
Final Site � —V�W=`
Final Building/Occupan�y (3
�' M
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm untler penalty ol perjury one of the following declarations:
❑ I have antl will maintain a te�i(Gale o( con5ent to 5elf-Insure (or workers'
compensalion, as providetl for by section 3700 of the Labor Code, for Ihe
�rmance of the wvrk for v+hich this permit is issued.
C� I have an0 will maintain v.orkers' compensation insu2nce, as required by
section 3700 of the Labor Cotle, for the peAortnance of Ihe work fw which this
pertnit is issued. My workers' compensation Insurance carrier and policy
number are: rG��)/'J
�Carrier � �1 -l.i �V "v
(iNs setlpn neetl (�q�De amyeted ell�e ce�4 is ✓d�uetl al me hundetl tlo/ars (S �00) aless )
� �1 2 /'
<Policy,Number. I � � �70
❑ I cerG(y that in the performance of the vrork for which this permit is
i55ued. 1 Shall noI employ any person in any manner so as to bewme subject
to the vrorkers' ompensation laws of Califomia, antl agree that it I should
bewme subje t to Ihe ers' compensation provisions of Section 3700 0(
the Labor Cod . hall (o lh comply with these provisions,
- �m.( •o �
pplipnt�j nature -Daij' _'
C
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($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.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed untler provisions of Chapter 9(commencing
with Section 7000) of Division 3 0( ihe Business and Protessions Code. antl
my license is i t! r7ce�a eRect.
Lic'#�' �`� Class #�
�(� . �'_ �
mra ' S' aWre �a�e�
l
CONSTRUCTION LENDING AGENCY:
� I hereby affum Ihat Ihere is a consWction lending agency (or the
peAormance of the Kork la v.hich lhis permil is issued. (Sec. 3097, Civil Code).
Lender's Name:
LenCer's Adtlress:
Si8^aWre Da�e
OW NER-BUILDER DECLARATIONS:
I hereby aKrtn thal under penalty of perjury tha� I am ExEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Prolessions Code: Any city or county which requires a permi� to
wnslruct, alter, improve, demolish, or repair any strucNre, prior to its
issuance, also requires the applicant for such permit to file a signed slatement
t�at he or s�e is licensed pursuant to Ihe provisions o( the Convactors
License Law (Chapter 9(commencing wit� Section 7000) of Division 3 of the
Business and Professions Code) or lhat he or she is exempt there(rom and
Ihe basis (or the allegeC exemption. Any violation of Section 7037.5 by any
applicant tor a permit su0jects the applicant to a civil penalry ot not more than
five hundred tlollars (5500).):
❑ I, as ovmer of lhe property, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, and the slructura is not intentletl or
oflered lor sale (Sec. 7044. Business an0 Professions Code: The Contractors
License Law dces not apply to an ovmer ol property who builds or improves
Ihereon, antl who does such work himself or herself or through his or her ovm
employees, provided that such improvements are not intendetl or offeretl tor
sale. If, hovrever. the building or improvemenl is solC within one year of
compleGon, the owner-builder will have Ihe burden of proving thal he or she
did not builtl or improva for purpose of sale.�.
❑ I, as ovmer ol the property, am EXCLUSIVELY CON7RAC71NG WITH
LICENSED CONTRACTORS to construct �he prolecl (Sec. 7044. Business and
Prolessbns Code: The crnt2ctors License Law dces not apply to an owner ot
property wfio builCs or impmves thereon, antl who cont2cl5 for such project wi[h
a contracta(s) license pursuant to Ihe Cont2ctors License Laws.).
❑ I am exempt untler sec.
Business and Professions Code for this reason:
SignaWre Date
�OS]�a6(10])
�.
Owner ID verifietl by tlriver�se. ❑ Ves ❑ No
Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - propehy tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby Certify Ihal n0 excavalion frve (5) Or more leet in tlepth into wfiich a
person is requiretl to descentl, will be made in connxtion with vrork authorizetl
by Ihis permil, and thal no building sWCWre, scaffdtling, falsevqrk, p demolition
w dismantling thereof, will be more Ihan thiny-s& (96) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Ttle 8, Califomia Admini5t2tive Code).
❑ As ownervbuilder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safely, as noted above, unless
5uch person has a pertnit to Oo such work from the division.
ACd����'s SignaWre Date
Division of Industrial Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future buil0ing occupant neetl to file and
certify a Business Plan lor emergency response to release or Ihreatenetl
relea5e of a hazardous material? ❑ Yes ❑ No
(Seaion 25505 of the Calilornia Health antl Safery Code requires, with some
eaceptions, thal a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reponed
year a quantity ol hazardous materials equal to or greater than a vreight ol
500 pounds, or a volume of 55 gallons, or 200 cubic feel of Gompressed gas
al standard temperaWre antl pressure).
2. Does or will the applicant or present or luture building occupant need to file
a re9islration form for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Salery Cotle, with some
exceptions, requires registration vnth the Cosla Mesa Fire Department by
each business which at any one time has on hand a quantity o( acutely
hazardous materials equal to or greater than a weiqht of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet ol compressed gas al standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevemion Progrem tor acutely
hazardous materials)7 � Yes ❑ No
(Section 25534 of the California Health and Sa(ery Cotle provides thal Ihe
Costa Mesa Fire Depanment may require the preparation, certification and
fling with the Fire Department ot an RMPP by businesses which are reQuired
to register acutely hazardous materials vriN the Fire DeDartment.
4. If an RMPP is presently required, has Section 25534 of the Cali(omia
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant Or present or future building octupant require (or
the work which is �he subjecl of lhis application a permil (o� such COnslruc�ion
or modification from the SoNh COast Air Qualiry Management DisMct or from
any other air pollulion control tlistrict or agency7 ❑ Yes ❑ No
(Secfion 658502 of �he Califomia Govemment Code requires that t�e requested
infortnation be fumished on applications fa ran-resitlential builtling pertnits).
6. Will any part of the facility to De wnsWctetl unCer lhis pertnit be within
1000 feet fmm [he outer bountlanes of a school? ❑ Yes ❑ No
Qf yes', the facili�y must meet the requirement o( Sections 25534 antl 42303
of lhe California Health and Safety Code�.
7. If a pertnit from the South Coast Air Quality Management District or other
air polNtion control disMct or agency is requireC for the work which is the
subject of this application, have all o( the disclosures prescribetl by California
Health and Safety Coda Section 42303 been maCe? ❑ Yes ❑ No
8. Qf yes", attach certificate of compliance from the appropnala air polWtion
contml oKcer).
CERTIFICATE OF COMPLIANCE: I certity that under penalty ol perjury the
information qiven above is cortecL I agree to comply with all slate laws and
city ordinances regarding Hazardous Materials antl Emissions.
SignaWre Daie
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify unaer penalty of perjury that I have read this application and state that
the information given is correct I agree lo comply with all state laws and city
ortlinances relating ro building constmction, and authorize representatives of
the Ciry o( Cosla Mesa to enter upon the abovedescribed property for
inspection purposes. I ag�ee not to occupy or allow occupancy of any building
authorizetl by lhis pe it uniil final inspection.
Slgnawre ai Owner Da�
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An V�onz¢tlAOGIi nl� �Dale�^
r'� mon�o�euRooa: 660 CENTER�ST
r� °N"'E"�"` VUKOVICH RUTH H
� "0°'�u' 665 PLOM�R ST APT C
. COSTA MESA CA 92627
714-6q2 26�7
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CITY OF COSTA MESA — HUILDING PERMIT
PEAMIT NO; P 086179 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PEAMIT TYPE: PLU PURPOSE: REP
JOB DESCRIPTION : REPLACE WATER LINE TO TRIPLEX SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 /
COMMENTS: REpAIR TO EXZSTING STRUCTURE PER NOTICE DATED 11-17-97
itititM�EMIkMMiflk�tklFNMMMMMMMMMffM1l1liEififMMMiFMifMMMk1f1llFkitiFlfifMiFiFMkMi!lFNNMMfF�tltifMiFMifMkMlflfitiflFMM
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN AGHT; FT IN LEFT: FT IN AGHT: FT IN
PARKING RE(� • PROV: PARCEL: 42421237 2NE; REF NO:
PLANNING NZSTES>
i
iFMififif�FikffMNifMififiFMifltftMilMMiflfMl(�ft1FMMififiFlfiFMiFiFlFklFMifMitlkiFMiFlhi('ftiEff1k1f1tkMMkiEMikkifkikMkMklfMlfMMM
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY .
BUILDING APPROVED BY :
APPLICATION ZSSUED BY:
MifkMMiFNNMMMifMMMM%MiiMMM
LEGALIZATION•N F E E S U M M A R Y
DATE:
DATE:
DATE: ���
MMNkiFKMM MiF
. _ _ STRUCTUAAL $EGMENT:N
BLDG PMT_ PLUMBING ELECTRZC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT --. BZSi SMIP/NON—RES
PLAN .
ZSSUE FEE 22.00
HUILDING—DZV—> �.�P.fiRMIT__ ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS---->..._ _.__.8.75. 22.00 0.00 30.75 30,75• ,00
REVENUE DIVZSION.TOTALS--> COLLECTED: 30,75 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.75
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I N D I V I D U A L F E E B R E A K D O W N
TYPE__ QTY D E S C R I P T I O N .. ,._. UNIT COST TOTAL COST
PLU 1 WATER RE—PIPE . _.._. _ 8,75 8,75
END,OF FfiES
- - - - EX,�I��D
DATE \ I�
1:-l5-1997/p4:17 P�/f38.75
RCPTR:31-9316863
RERMIY:08E179
CONSTRUCTION AN� PLANNING POOI & SisA
APPROVALS Permit # Date Inspector ApPROVALS Permit # Date Inspector
i, Temporary Electrical Service or Pole 52. Pool & Equipment Location '
,�2. hSo� il Pipe-Undrgrnd. 53. Steel Reinforcement '
�,�2Ctrical Condui[ Utility-Undrgmd. 54. Forms ^
F
�4^5122tricat ConduibUndrgrnd. 55. Electrical Bonding
..�- a
;. y.3�$}ee1 Reinforcement • 56. Rough Plumbing & Presmre Test �
�C�Y6btrical UFER Grnd. 57. APPROVAI TO COVER�GUNITE >
�?�6tings 58. Eloctrical Cqnduit-Undrgrnd. '�
�$� Foundation 59. Gas Pipe, O Undrgrnd., Test
9^ Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, C] Undrgrnd.
10.� 5tructural Floor System 61. APPROVAL TO DECK �
; 11. �flFoperty Sewer �ine & House Connection 62. Backwash & ReceptorFinal .
�
�2• 5`eWe� CaP , 63, Heater & Vent�Final
13. Root Drains ' 64. Plumbing System • Final
74. Rough Plumbing ``' '
,r, 65. Eiectrical-Fina�
15. Rough Electrical-Conduit. •• 66. Solar System•Final
16. Pough Electric Wiring 67. Fencing & Access Appro�al
17. Rough Wiring Sign , � 68. APPROVED FOR PLASTERING � _
18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI.
19. VRoug},i H�eting,& Ajt�Co�dition�g; :-� x � �,Q* -. F2R6tB�pTAREQUI&EMEIWT C
:.. �..... � �' .. �r ti��J�C ITl x � ']
20. �Fou§A Fa'2torQ� Fiu`e�late t �:" � �' s�+ =� APPp�7 r�iF' PC?�mit #' '='
:r. i� �» �.� � H r-. X S i� ti '7 ^: r' $- �'�JY'7'� C+7 ��`
21. �uc� in tru ur -�; ��� �� SH � r� H nx . 70.EtJndergraVifl�Y1 H�dro w
22. �utt� VeAtil3Eingtl%� � n y O � � H* , 71. Produ�`�i�ing`{�'ias �Oil �
23. �iasupe ou &.�'�'t ' mS �:n ^ a �� t t r
�j � �j � �r.�n p: * � c� Sa: 72. Undergreuad F�'�'us� � >.
� .
24. Aoof Fra�ing e�R �K �-' � ,�� 7� UndergrnfJ. S[o?a�e Tan(� O Gas ❑ Oil
25. ooLShe�thing '"�'
•.vx �
� c,� N * ti ;�7 px 7. Overhead Hydrgc+ r
26..�i-Bat�Ceiling (StrWtdral) & M�4?Coat � v %� �7� 7� Dry Che'llical �"'�� * , < � '
Z7. �6ram� a�i Flashi K �Q� �` � �' �� -o t+mo �: t*7
.]� 't•': �7�h: Hn7:? T � ;�y 76. DrySta�P�Pe¢� .�t..'7 CJ x
�� 28. Wth ng �n5iding :. Y Ca;S- l �� � r 7 FIXED�SY•STEfU �'INP;�"' n S
n c-•� s �� •• �: � �, ' «. '�
29. Insulation� ,y* � � ;� S � � 7�;���RE�P.REV. F�NmAL *
� 30. Drywall Nailing :Jw �-+ � x(-� � ` r S�^� onHEALTJi DERff REQUIREMENT
� 31. Plaster B`c�'wr�,Coatr�,'K'' i FF x � x' 79. FINAL t{U�ECTfDN � J �.,,
' I IV I \'1
� 32. �Iectrical ower Meter [aal i t � � �^ 80a FOOD CERTIFtiCATE FS�tJED'
> Fw n i � * �y �n J '7m �-� O m
' 33. �ina�'E�c�c ric,�. �a. x ��H � s: G ( k rvsues: � n'J[1 � S
� 34. ind7}ieatin9� AK7 itionin9 p+ .� 7 � r c �+ i e-tt * ,�
35. ��na�Gas=Fipe=Tesm� �� " * �'" � i .�� �� .��, n �
n 36. Noo�or no �� _ � 6 ��
PY .� C'� i Qtn .� s m �o �: m ia
� 37. FSnal'FaQ�ry Fire��C�z i F"�"' � * v � ( 4 T' f N
Hti �v i
38. Fina���Abin9 c�y-.:n i w x � � t. � x
39. Water Service-Final x E � * � ' ' 'K = `� * •^
px r.� x i � fR �w a tTl
�40. GazService-Final ��'`' ��Fn � ;� ' j-� • NE s i
y�
. 41. So1ar pomesticFi�v� m x � y � t�' �v � z x �
x c. a: � r� O i * S
42. Backflow Pre�nte,�"[,:� � p;,�`,,,� �;,� * C,j M�; .; ` �..
a
.� M3. Backflow Irriytiotr�� >' y � x � F N +' 3 O %
2Aq. ,l�andsca� IrrYAat � *S stem ��' � ;;; � ,c!, � s � '` ' T
IQlk Y ��2 X� Q et *. £ -r J� � 5 F
.�. �
45. �und Rttenu�tion.r '7 ..'.. ' * �'7 ^i t�f* � u '� . `'p ,�'
. C �-r '� 'k (" .. »: 1 / / H ✓ �
' �4„6. Nanci�ap'Regulatior� s .. � S ; � � ' n O y !J �
; �47. IN�1. STRUCTURE & BUILD��G � E� ' :� x Q' * J
�; >,:
48. �Nk,}.PLANNING,y, � F�" , I t� C� N S * �t
:qg, �Elecir�c Release to Edison i � I �,*� � �s � n v
` 50. 9as E,?elease to Southem Califar�a'"'.,-Gas Co ,� � *. s .�o (i •t cu �-
" 51. CERiIFICATEOFOCCUPANCY '"
No. Date
� '.
. . �u � o ./o� utlES.n= - � _�,
I � • ; . - 3 fE61�•SSP�reEsnk544a eutr:,.'�4.5Qw
=�
COSTA MESA BUILDING DEPARTMENT �
P.O. BOX 31]
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL fN APPLICATION FOR PERMIT
qooR'ss 660 Center Street � BUILDING
COSTA mEsn. cnuFORNin � FOR OFFICE USE ONLY
' ' RECEIPT NO. P�plO.�_
owr,eR �raeburn Consttuction.Corp. vv
qECENEO BY OATE RECEIVED �wTE ISSUEO
ADDRE55 3404 Via Lido �� —'� FEB 2 1 1956
CITV Newport Beach �No:QR 3-1240 qDDRE55
ORC NIGENEER Ray Levanas Np, C 747 COSTA MESA. CALIFORNIA
nooRess 3432 Via Oporto, Newpoit Beach ZONE
CITY LIC. e ZON NO,NS TYpE � / GROVP
CONTRACTOR L1C10 COR$LS• NO. LJ%915 //
AD�RE55 3404 Via Lido N�OR 3-1240 BVPR � � DATE �/' S �
oEs�a�P.�orv No 15 eLocK TRACT 3287 CORRECTIONS _
A.P. NO.
$RE CO X 1'L%� NO.OF BLOGS. O
OF LOT J NOW ON LOT
USE OF
EXISTING F1LDG.
SEtBACK LINE FqOM '/ TO`�p--
C[rvrea oF 3TREEr 45' '" REAR YARd=+ �
SIOE YARD RIGHT S� LEFT �� 3�� v
DESCRIPTION OF WORK
NEW X ALTERATION I ADDITION
REPAIR MOVING DEMOLISH
SU�IE DING 3124 9(j. ft. ROOMS 13 STORIES Z
EXTERIOR WALL WOOd ROOF �
COVERING COVERING WOO(� shin
BUELD NGEW Multiple Dwelling
i 703 sa.ft. attached ¢aa�e & carport
f�7.r � ��-
6 5� 5' - -�.._._
STPTE THAT TME RBOVE IS CORRECT AND wGREE TO COMPLY WITII iLL
CITY ORD�N>NCES TNO STATE 1�W5 REGULATING BUILOING CONSTRIIC�
iiON. VALUATI N
SIGNATURE OF � PERMIT FEE S �"'O
PERMITTEE �
PLAN GHECK $ p��, �S Z%
$ a3,a�y- // /,
AUTHORIZED AGENT TOTAL FEE S �'y' �`� �M�
CO3TA MESA•BUILDING DEPARTMENT �U 463 C
Lit East 20th Street
Coeta Mesa, California /1 ���.
Date......-- r.�._---..�-"..l....r..._�...._�r/. /'�.
CITV OF COSTA �ME8A /� ��,
CERTI�F�CATE OF��(kG��G�iJPANCY���/t/'
�fy �..,�.i
Building Permlt�N/R.� ..............Eleetrieal Per itNo....��..�,.�.:.Plumbin PermitNo........�
i1�'�! .+_._.. /1 �-/� /�
ux or aufmlog..._.....�...�.�..:..,'i:..._L.. ._� l.l.=._�.:.•:..��r..[.:._'. ....f...�..�..:�:,.F'.. .
.�.. .
_. . .... ._ _ . . � � G �i„ %, _� �
—�...r- �- c r•1
� � .
Lot................._�............"........ Bloek.._....................................... Tract......Q�.....�.'��.....�........_.._..."""
(See reverse side Tor Metes and Bounda)
has been inspected end found to comp�y with the provistons of all City ot Costa Mesa Or-
dinances applicable thereto for a Grou ..�...p.......................Occvpancy.
�� �SUEDT)p� J/`/'•�T� / (/j/� A.J�V�OL2 �
Tf1 ?.GI7__'r=.1>.!--.._�:'rt1y�i • �-�'� City k�6�dir�elal • /%•
...... _ . .. .._ ................ . // ���/%/Ge^� � l/ ;s�
� (Owner oT Building) By ................................_%.. .........GT.:.... F.-._.......
CC: ❑ Ori�nal—Owner ❑ lst mpy—Gas Co. ❑ 2nd copy—Edison,C�o. ❑ 3rd copy—F'ile
Form 206 G-0i IM 1&69