HomeMy WebLinkAbout763 CENTER ST - Building PermitsAODNRSOFBNlLWO: 76'3 CENTER ST
OWNEASNMIEIFIMOW�L HOLLY HAROLD W
'0°"�' 763 C�NTER ST
COSTA MESA CA
(714)642-3`/31
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MCXRECT OP ENtlNEEN:
AIICX.OR EIA'S IOOME55:
92627
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u"T CITY OF COSTA MESA — BUILDING YERMIT
PERMIT NO: M 081227 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: MEC
JOB DESCRIPTION : INSTALL TWO RECESSED WALL HEATERS
UNf:
CLAIM VALUE: CALC—VALUE:
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11CFNSED COMPACTOPS OECL�flATON: 1 hereby dlim uidx pauly d pajivy tlW I em IiceraW udn pvridau d CNqa B
(mmmentln0 xilh Sxtian JOW) d Oivbion ] oi the Buvimae aM Vmleeaion� Coda. end mY liwroe u in Idl brca W afletl.
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CONSTIiUCf10N LENMNO �OENCY: I hreby elfirm uMr peneEy d pe�jvy tM tAsa u e mW�uCion Wd'vq epenry la iM
perlormvx,e d �M1a xdk br xhid� ih'v O�i b eaueE (SWion �041. Ci+. G).
LENDEN'S NAAIE
LENDEP'S AODPESS:
I ttroly thm I hava reeC Nb nppfratim W tlete ihet IM ebow "udvmtlion o conetl.l rypes Iocanpy w'u� eA dlyaM mmry ad'nenca�
eM stets 4vn mlmYq to buJCM wmVwion aM hereh' eWwrue �epa+enietiwe W tNa rny io eMa upon iM ebwe�mwuiarE propMy
,a���.
HAROLD W. HOLLY
oma: f �
(5151�B.WP1 M/M1as-Bu�ldn08Se1ery:Qeeen+ia:Cemry-AppfraM:Pink-Haw�ue:OaMevo�Amv
PERM NO: M 08122
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: /
COMMENTS: REPLACE EXISTING WALL HEATERS WITH NEW ONES
ititititie*+tatatitit*�t*ititft**it�rit�r*�r*�**�r+r*+t+�+rx�x�*itit**itititit�t*�tit*etatx��x�atx*x�ititx�*���ratx��r*it**at*x *
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 42420308 ZNE: REF NO;
PLANNZNG Nd'TES>
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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
ZONING APPROVED BY .
HUILDING APPROVED BY :
ICATION I
DATE:
DATE:
itft+tit*x�x�**x�x���*��r****�rx�**�rx��rx�x�w *se�r�rrrw+r+r�r +r *�r�r�r�rx�***��*�*�r��x�**�r,�x��**��**�*
LEGALIZATION:N F E S U M R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 26.50
25t SMIP/NON—RES
PLAN
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 26.50 22.00 0.00 48.50 48.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 48.50 OVER/SHORT: .00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIp/TOT GRADING PLAN—CHECK
48.50
ik k k ik ik ik 1E iE 1f 1f 1E 1f 1E 1E it 1E ik 1E 1E 1E iF 1E k 1k 1k if 1E 1E if 1E 1E 1E iE k i! k 1F IE k k 1f !k If k 1E k 1E 1E 1E If if 1E 1k 1t 1f 1f 1k iflf 1E 1E iE iF iF 1f IE iE M If��1E iE 1E iF iE i! iE 1E iE IE
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
MEC 2 INST/RELOC RECESSED WALL HEATER 13.25 26,50
END OF FEES
EXPIRED
DATE � I���
�r
<.-��� .��
,, JAN171997 -�
CITY OF �CS'tA ME$A
CONSTRUCTION AND PLANNING P06L & SPk
APPROVALS Permit # - Date „Inspector qppROVALS Permitf# Date. Inspector
1. Temporary Electrical Service ar Pole - 52. Pool & Equipment Location �
2, Soil Pipe�Undrgrnd. "' . �� 53. Steel Reinforcement - '
;�3� EJ,Ectrical Conduit Utility�Undrgrnd. �_ � 54. Forms � - J-� ,
-��!�` �ettrical ConduibUndrgrnd. ' ' � 55. Elect�ical Bonding - '
5,�$teel Reinforcement - � 56. Rough Plumbing & Pres"sure Test . - '
z�'l
_��ectrical UFER Grnd. � � - � 57. APPROVAL TO COVEfl•GUNITE
-�7JF6otings � - , 58. Electrical Conduit�Undrgrnd.
T���_ -�._ . . -
, 8. Foundation _ 59. Gas Pipe, � Undrgrnd., Test -
9. Water Pipe-Undrgrnd. � , 60. Backwash Lines, P•Trap, O Undrqrnd. .
10. Structural Floor System . 61. APPROVAL TO DECK � �
_. s
7 t. P,�operty Sewer Line & House Connection ' 62. Backwash & ReceplorFinal- ' -
12. Sewer Cap � 63. Heater & Vent�Final ' '
73. fioof Drains -' ' 64. Plumbing System • Final
' �1
14. flough Piumbing �, � 65. E�ectrical-Finai
15. Rou9h Electrica6Conduit _ . 66. Solar System-Final . �
16. Rough Electric Wiring '� � 67. Fencing & Accezs Approvai � • '
57. Rouqh Wiring Sign 68. APPROVED FOR PLASTERING -
18. Rough Electrical•T Bar Ceiiing � ' � 69. POOUSPA SYSTEMS FINAL .
� 79. Rough Heating & Air Cond{tioning - FIRE DEPT, fiEQUIREMENT�
" " C: T�-+xF � �- F �
20. ;Rough F34torY Fi�eplace � tc:•; r::� ?� O' S'K �• APPROV1tC�G P2tmit #* �T�
'C ": K <T (T�' K ,.k I'� �?:H(-'. 'C -
�. ^ Y �..n�'- �� Y L 1 r�•�. � r-•��•• �� •S( .li
21. QucL4,�n,$tr�tur�y �.... Hr � O,..�a: ' 70.�WntlergrQvrj,d Fjydro :h
22. Ducts; Ventilating-.� • fJ5 t� S ti_� % 71, product 'ping!L7��,as L�OiI
��. � � < rr .,:: r; i i � .� �:
23. 6as �pe-�oug� & T�st � ,_,$ .* n 0, s C{ 72. Undergreund F�yi"�i �.,
'24. f:SoofaFraming: �,i� i i--�. J•� 'y.'+ h m`c 7� Undergrnd.Sto� Tank'C;Gas O�OiI
I
25. RoorShPathing ? r Q N �;". '� ,_t*�,' C n' �' 7¢Y Overhead Hydro � R
26. .%-Bae;Ceiling (Strncwral) &�osoat a^ Q' t+lx� 7� Ory Chemical J y: `" � �
27.'Frameand Flashi �: 2' ^ * � "� ':-.' pi .�' ` T ,
39« aQ� r•^ >. :�, 7G-DryStandt�pet�6 x. E-.
_ 28.'Lathing �.Siding ��+� �; �e;�� ^ s c^. �• •�* 7E'.' FIXED�3VSTER'�FINAG � V �
n .� � r i-. :.. n n+
` 29. Insulati "� U �"' .. .. ' �� � 'r ' X -
� �x . R ( • '.; 78S FIRE PREV. F�l�{�L ,; ; s
� 30. Drywall f�ailing ��� �` x u ' ',� -H@ALTN DEP�'.-REQUIREMENT z
� 31. Plaster 8�wrrCo�.�; e �,,,.,�,., � � � "�'�,�' 79� FINAL kt+ISPECi`GTDN y�' �' � rQ R;
32. cElectricahPower Meter.=Final : �' �.� n; (•: '.� 8@� FOOD CERTIF.I�TE ISSt1ED s�
.�
.. 33. �in�EI�GIric,� m;� � � Q .r �:, I t ,',tt.^' f�tes: h �.'a * - ^ Cm _.
z
_i 34. �Fina�He,�d�, ing� Fj�p,�oriditiorii�� �-. r � I .�Fx ,r s C�N,.a. .. ,.. � � -�>'
- c„
35. �ina4�Ga`sPip��Tei[-'" ~ "y `� � � °" �� �� nS • �� t" '_G �F '
- r ^ x ... i :i _ 1: -� .:..- v ,v. -' m J'
36.'NooUor`GanoPv =.:.; 4 ;r-, � :,r, ! cK � C�o � ?c `� r.t*'
- w „- -,„-
37. �Kinat'Fac%ry Firep(�ct'� i �F � `-� � � . �' � �, ,: F-r
= I ..."
.�.38. F(na�,flumbin9 m:K i' � .. .. � �J .� ��-'t S�-•� -. :.+ z G �.
`39.Wat��Service-Final>�� � x � � 's r,o�_ o a;r ,x
� r. i � �"' '. �X : G1 tr.
- 40. Gas ServiLe-Final n,.�� �, �,,,�;. � s,, �--* �,Q ��;,; x`•,
�� 47. Solar pomesticFinak = C' � •• r -? � ;� C'� *
Tt JI' M^ �- X �
"42. �ackflow Preventer �r �' �' r'� ' r,� � `-"' '� - �
.c� :
43. Backflow Irriqation>� �S �' G" ' .
• 2' A.i 1 t� '
� �C.� ,.. y. w s +: _ C7
A4. �andscape Irc7gatior��System�,;,,; N �:,; c,; z;. � n; _
115. �Sound Atteni7ation�+� ��+�^ �r . < <^ �"' `' � � . '-' -'e ^? - - d '"
�� n+Y: c '4 . ��� _- :7
9S. �HandicaP.Regulatiorjs y 5 r r'' .. .." - ,�',� < ` � . � I, ` _
_ ';� :-�
47. f.�INAL STRUCTUR�E & BUItDING � � � ' 'tx� .� � '" � � �i
t: K r, c. i .Y� t r .� �..
48. ,INPL PLANNING° � ''.`. ': � <: ' ' - `
F.: v j J �K rt �.'. fi ' �,ie.� i � "
� �(
.49. Electric Release to Edison � r '� '< : c, •" r � � '�
'nr� c .�. - av--...:'� ti
;50. .Gas Reiease to SoutHern Californ�zGas Co : , T ,:: .- . ;,= > ;� �. '.;�: �,-;,
:�1. CERTIFICATEOFOCCUPANCY' ;� �o . �. - c
No. Oate
AOOPF5.4UPLIYI�WQ 763 CENTER ST
�+�E�� HOLLY HAROLD W
�oo�ss 763 C�NTER ST
COSTA MESA CA 92627
(714)642-3`/31
i1PPL. WILPIO i1U0PEi4
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YMM.OP FNU.'S AOOf�54:
C I eG{ t, c;G.�
carimacrars wu�:
CONIP�CTORS YARRlG
ADDRESS 11C. NO.:
�
um: CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: E 081228 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE
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UCENSEO CONTflACTONS DECLAfl�TION: I MMy Nim utlx psWy d pe�vy Ntl I em livnesd wda praiMau d Chaqr 9
(commeruiM wilh Sec�ian ]OW) d Oiveion � d tM Bu�re end PM»iau CaM. uM mY 4oerm u m fu0 bm end afled.
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c lice�ued pu�vueM b ihe provivione d Ib Gont�anore Lioenx Lew �CMqr 9(aommenerp xilh Setlbn'l000) d DF+oion 3 0l the
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]U'l1.5 by enY aGDlicem lor a permit abja6� Ihs epplium lo e dN penehy d na mora then frvs huMmE tlaAen �f500�.'
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xho WiJe a inpwaa �M1e�mn. end Ww don eui� work 1'vnrL n tmM a Waq� h'v a Mr mm emWW+e�. pwidad ihel euch
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JOB DESCRIPTION ; SERVICE UPGRADE AND MISCELLANEOUS ELEC
PERM NO: E 081228
GOVT: N SUPP: N
PURPOSE; OTN
SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: /
COMMENTS: SERVICE TO REMAIN IN SAME LOCATION / UPGRADE TO 150 AMPS
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARKING RE(j: PROV; PARCEL: 42420308 ZNE: REF NO;
PLANNING NOTES>
i
iE 1E 1E iE �E 1E 1f 1E �IE 1E if 1f 1E iE 1E 1E 161k 1E iE 1F iE 1E 1E 1P 1E Ik 1E 1E if ik 1E 1E'lE iE 1E 1F IE IE IE 1f' 1E'1F 1E 1E 1E 1E k iE 1E ik 1f iE if IE ik 1k 1E 1f Ik 1f� iE i6 iF fE 1E 1E iE ik iE 1F 1E iE IE iF iE IE iE iE
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
ZONING APPROVED BY .
BUILDING ApPROVED BY ;
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LEGALI2ATION;N F
BLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
E`£� S U/M MI,A R Y
ELECTRIC MECHANIC
2�.25
SDY
22.00
FIRE
DATE:
DATE:
DATE: LQ/.�
iflklEiflFlkitik /�F�lE1E
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
❑ in,...,�ewu�o,:a.n.anr�.woo�..aio.w�.e,..on..�m�w.e�...aow.eeo�nysw�a�ooau.tma HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
`°"°.'«"1D"'°"'"""°""°"°""`1iNitivipsviY"bpwd TOTALS----> 27.25 22.00 0.00 49.25 49,25 .00
� Iha.aeMwilmeiNenwM1�n'oomD�onlmwenw.mn�adM6wim�)OodNel�EarCOM.btMP�dtM
�����'�����•���������� REVENUE DIVISION TOTALS--> COLLECTED: 49.25 OVER/SHORT: ,00
c.�:.:
r�rmmw HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CFLECK
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uH� rtnu w ro an nu�ene mowma awan (na4aooA �+.enwn m a. cwe o� mna«u.ran �.w • wova+.e ror �n �'
s�ee�smsorm�t�eoieoe�,��r�t���my���u. ELE 1 SERVICES BELOW 600 V S BELOW 201 AMP 27 S �'� 2S
A
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pMwmenm d IM xak br MJrh ihe M^^� u ewed (9wbn ao�. Cb. CI.
LENUER'S NM1E:
�v�oen•s �ooness:
1 unM �hm I hew meE Ne wqicetian eM mta tM Ns ebws'vdomwion e oortw. I eWw �o comW wtln m mY W�MY atlmvwe�
eM ata�e levn releLLq W buikip tmaVud'pn ud IixaEy aNhaae repatenlativa� d �his cly lo anler upon IM abwe�mentionaE propeM
����'P"�""°�"' HAROLD W. HOLLY
i, np � � �B�B: � ' 1 /
��qretu�e d Pnw/Apru/��funMantim
(St51�aB.WP) WINs-Buikiqd5elW:OreerFla: :Rnk-flmnw:OddenmFbuemr
END OF FEES � ''. 1
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CITY OF COSTA MESA
i
CONSTRUCTION ANO PLANNWG � POOL & SPA - �-
APPROVALS Pecmit # Date �Inspector qppROVALS Permit # Date Inspector
� 1. Temporary Electrical Service or Poie 52. Pool & Equipment Location ,
2. Soil Pipe•Undrgrnd. �. - - ��53. Steel Reinforcement �
4 ?3r Electrical Conduit UtilitytUndrgrnd. - . 54. Forms � - '
� ;4' El�ctricai Conduit-Undrgrnd. � � . ' 55. Electrical Bonding �
5� �,teel Reinforcement 56. Rough Plumb(ng & Pressure Test ' .
; T�,j��lectrical UFER Grnd. 57. APPROVALTO COVER•GUNITE
i�C7� Footingi 58. Electrical Conduit-Undrgmd.
,1-8:' �o`undation , . � 59. Gas Pipe, O Undrgrnd., Test _
�9. Water Pipe•Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.. '-
10. Structural Floor Sysiem � 61. APPROVAL TO DECK � �
71. �Property Sewer Line & House Connection � 62. Backwash & Receptor-Final �
12. Sewer Cap • 63. Heater & Vent�Fina�
13. Hoof Drains ' - 64. Plumbing System - Final •
74. Rough Plumbing : t„ , - . 65. Electrical-Final
15. Rough Electrica6Conduit . - � 66. Solar System-Finai : , -
16. Rough Electric Wiring , 67. Fencing & Access ApP�oval '�
17. Rough Wiring Sign 66. APPROVED FOR PLASTERING
18. Ro�gh Electrical�7 Bar Ceiling .69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Rir Conditioning FIRE DEPT. REQUIREMENT
20. rRouqh factory Fitepiace �-�� r� %'• - �, c APPROVAIS� � Permit # x � -
_ .- x _ �, e' x. � .r - c � -, .....
27.�uct'S in_Stru u�'�' `-'` �� '� = � ��e ` '-'y'". t-. � r.1
r. � p . 70.=UndergrQun_d Nydro ,x
22.Ouc¢,Ventilatin¢� ;S ` S `*H 77,�produM't�iping-C3�Gas OOiI
� 23. Gas?ipe-�ougfi &"f�st � V' r r ,77, Q GT - 7g• Unde grqund FJH� � F
! 24. Cyoo��,-'Framing: n o � r.l, ••' . _ T �e ; 7$ Undergrrld�Stora� Tank_ O Gas C}Oil
f �
25. RooTSh¢ething � ��' - , r', � �? :, ��'; ` 74. Overhea� Hydro � i
26. ?-Bar; Ceiling (Struciureq & Nlonocoat i: _� r;r 73'. Dry Chemical � -� -
r, � �
27."•Frameand Plashinp` T^ " ^ '_ �" ��', p� T ' '�� � = �� '-T'
i. _,x., , T r �x YStaadeiPeF�, .
' . 28. `Lathing & Sidinga = -- � ��`= � : E •• � � 7��. FIXED�YST@M�FINAt � +�
�
"29. Insulation; E`'- -'' " ; ;.'� � �' 7g, FIREPREV.F,INAL '„••,
� • 30. Drywall Nailing 5 �� � �� ' ' ' � �r -� �-,HEALTH DEP�rREQU1REMENT
� 31. Piaster B2own.Coy�' �.,_ ` i �• �i7 79: PINAL tNSPEC7.JI3N t= �� �
� _ . _ .. . . _ .
i���. 32. Electrica[Powe� Meiec;Final �`^ - ' 80; FOOD CERTIFICA3E ISSUED '
33.;�ina'r�,Electric� ` r ' / ' �' ` y< �
v ' ' : �/ r' r, - ' z'
'1 � ' 1--!r F .. � , r14; �'.1 � v J
• 34.,Fina�-He�ing:& Air,Conditionirtgy �-; x ' }x . •,� i .x .r, � -,
35.!Final�Ga�Pipe�Test � - i ^ , F� � -. - - �_ � ' J
r. '�Y '_ C r
.. _ � � .. Y _ t �
..� 36. Hood or`.CanoPY � - � - � �� ' - �: " �' -
� 37.'Final�Factory Fireptace ^ -'� •i '-'� � � �' ` � ' ~ �
ti L w
� 38. Pinal-Plur�j�bing ' � '� .... � F � . � s(u�c. � ,x _+ p� -
- ...
i 39. Water 5etvice-Finai* - � ' i � , ; ^.
' i * -
40. Gas Serv"tce-Final « _ "' "'` � � - � " �
. _ . r 5 x n • :�� ..
r. - _
: 41. Solar pomestioFinai � ^ +: ��< '� :: - <•
�� J
C p< ''t
' - 42. BackFlow �Preventer' E ,. - � : r, , '- ,
43. Backflowlrrigation} ._- ' ' `�- -
t ' Y _ - ; ��.- ;� : ;
.�;
;A4. Landscape Irt'iparioq System�,�,J r -. C, - _• � � . � . � .;.
.. - ., , _ __ - ._ _. - ,' .
:45. �Sound Attenuation'. _ [*' z � E. F 6- = ` - - c -• : C " Cin ` ,-�
x m - [- - -1
r46.'Fiandicap`, Regylatio�s ` S ;. " � ^ �. � ' � - _ � � .. '
�� � c :7
t i-
47. �EINAL STRUCTURE & BULLDING y -�' � � '" " •'� : � � 'D �- ti
. r r ' ti: i ^ .: - '-=�
48..FINAL PLANNING, ^,'FK. * -: ' s r ir , � - � �.
i.
�19. �lectric Release to Edison � �� � � ��' � � � � ir N
r j !',',.+ -. -� Q
"50..Gas Release to Southem CaliforOidGas Co ; � • ,_ �. a� ; r `
51. CER.TIPICATE OF;pCCUPANCY � ,; - =�c-. T : _
No. Date
UWfVtK ULLLL\VGII� vuruia..+
JOB ADDRESS Center�
� GENERAL CONTRACTOR C
�AP No7.l -0 j- LOT
INSPECTIONS
a SOIL
\� GAS
WRTER
ROUGH PLUMBING
PROP. SWR. LINE �
SPRINKLING SYSTEM
ROUGH HEATING ANO RIR CON�ITIONING
UN�ERGROUND Lf POWER
ROUGH WIRING
STEEL REINF.
F100R SYSiEM
BONO BEAM � ST
SHEATNING
FRAME AND FLASHING
PT
IEFRIG. AND A.C., FINAL
RNO GAS TEST I—I
SUBCONTRACTOR
15
��osta Mesa Building Department
111 EAST 20th STREET
� • �� � - COSTA MESA, CALIFORNIA
FOR APPLICANT TO FIId. IN
Bulldfn9
Address 763 Center St.
Costa Mesa, California
Nearest
c,.,s, sc Wallace Street
owner Sorensen Corp.
Mail 19 E. 17th. St. �
Address '4
Tel.
cicr Costa Mesa No. Li. 8
Archit�tor __ . ____. Lic.
Contractor Dike & Cole�roneao" � 1,
nddress 419 E. 19th. St.. Coste Mes
Descr�ption � Not 6 ' Blxk I Tract
(Attach Metes and Bounda)
Size o1 Lot 6� X�.3� No. of Bidgs
Now on Lot NO
Uee of No.of No. �
Existing Bldg. Famillea Rooi
CenteYo Streetm 55� SiderVard ct
New
��
I Demolish
6 Stories
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to rnmply
with �11 City Ordlnances and State Iaw latlng
buitainB construc�E AND COLEGR��
SlgnatureM GEN�.R�LCONTRACTORS
PErmittee n e A
Ai'PLICATION FOR PERMIT
BUILD,�NG '�
FOIL OFFICE USE ONLY
_ Recefpt No. Permit No.
/i 3 3
;eived by Date Rec'd. Daffi Issued
5�-!("�
Butlding
Address
Costa Mesa, California
Cross
io.or I �YPe � I �
lans
Date
CORRECTIONS
APPROVALS
Forms, Materlals
Under-Pinning
Frame: Fire Stopa�
Bracing, Bolte
Lath.int.
Lath. Ext
Plaster.lnt
Valuation Permi�ee $ «•W
Pian Check $ � _�_ Bond Beam
$ 8,500 rota� 25��
Fee $ FINAL
cnvu �ne 0-N 2M M1-M19
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PLOT PLAN
Show Iocation and disYancee from
property Iine and between bulldfnga
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COSTA MESA BUIIDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For AppJicant to Fi(I in Completely
BUILDING ��J��7 /> . .- =n C / ,�a_
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CONSTRUCiION
BRANCH
ADDRESS
CONTRACTOR
ADDRESS
CITV
STATE
UC. NO.
S12E t/j
OF lOT „J jj �
TEL.
TEL
CITV
IIC. NO.
SIZE OF � �I NO.OF
NEW BLOG. O fi00MS STOf
EXTERIOf7 WALL FOOF
COVEFING COVERING
USE OF BUILDING AND WORK TO BE PERFOAMED
i ne.onv e�k�owiaao. :nez � na�a reatl tbis epplicaUon antl state
thet [he above informetion is correct entl oproe to comply with
all laws reBuletin8 builtlinp consxruction, antl I shall nox employ
eny parson in violation of Me workmen's compensation laws of
the State ot Celiforn(a.
1 hereby certity that I em properly Ilcenaetl asa contracto� untlar
tha Smte of Celiforn(a Business antl Profassions Cada, Dl�isicn 3,
Chaptar 9, antl that sueh Iicensas are In full force antl affect, or I
am azampt from the provisions of the State of Californla Business
antl Protessions Coda, Diviflon 3, ChaO<er 9.
Signatura of S
Perminee
a�cnori:ea nea�
N���
,.m, iz-���,,5.00 3��:: ;.;�t�}0.50
N FOR BUILDING PERMIT
DATE RECEIVED nnrF iccum
BUILDING
ADORESS
FIRE
ZONE
APPROVED
�'ARDS
MAIN
BET
THE AMOUNT SHi
THE PURP06E OF E
VALUATION
�� �
$
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BET, MAIN &
4 PX �
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VALUATION IS FaR �
A PERMIT FEE ONLV: m
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