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HomeMy WebLinkAbout178 BAY ST - Building Permits OWNERHFATH` Tra i. DATE 3-23;36 JOB ADDRESS 178 East Bay Street BUILDING PERMIT NO. 41451 itGENERAL CONTRACTOR Owner/Bl dr. DESCRIPTION of WORK Legal bye Room Addition AP No. 118-061- LOT TRACT FIRE ZONE VALUE $ 13,500.00 NSPECTIONS Signature Dote TYPE y GROUP I ZONE R-1 SOIL PERMITS ISSUED ' GAS SUBCONTRACTOR _ _ _ DoteNumberNumber Signori P JROUGHATER Otf-TOA_I/ bl p • '" ^' /M SGC./ ROUGH PLUMBING l��l�/•1 PROP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND [] POWER ❑ • ROUGH WIRING Heating and Vent. • TRENCHES E FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM fl STEEL REINFORCE R SHEATHING FRAME AND FLASHING - LATHING — IN ❑ OUT E PLASTER, BROWN COAT , STRUCTURAL, FINALEl + ` ectri HEATING, VENT., REFRIG. AND A.C.,yINAL �U 4&. (8� ^ • 3_a I4 4 3 .� PLUMBING, FINAL AND GAS TEST -✓-/I( LES* / -74 ELECTRIC, FINAL 7 --.3/e, BUILDING, BUILDING, FINAL 717 3>3/ .70 � / Applicant to fill in all spaces except those within`border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT PERM)NO. /- TRACT NO. LOT NO. UNIT NO. Project Address 178 E. Bay Ave. , C.M. 1� . c'b&o _ _ „yy,,,��� I 4604 10/07/86 15.50 TL Applicant's Mailing Address 126 Commercial, C.M. 92627 TYPE OF CONSTRUCTION U NEW LI ADD $2 J ALTERATION U REPAIR Wray 646-2388 ❑ CONVERSION ❑ DEMOLISH ❑ OTresidential - xemoYex A.P.#• I Zone Owner's Name Salm,Pl Phone DESCRIPTION OF WORK/USE OF BLDG. Address 2227 - 16th St N.B. 92663 alp, I)e e ; '� • O . .-_. e ' et_- e-, II- - S Main Building: Accessory Building: Z Arch/Eng. License No. • TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front0 Address CITENANT ❑ ELECTRICAL CIPLUMBING ElMECHANICAL B Rear N - Contractor's Name Crank Bros. Roofing Co Phone 548-5569 ❑ OTHER ____ _ A I PROJECT DESCRIPTION SQ. FT. 1.100 OCCUPANCY single C Right • N ' Address(mailing) 126 Commercial, C.M. 92627K G 005993 CONSTRUCTION TYPE reg VALUATION$ 1 375.00 S Left • R City License No._ ZONE GRADING CU.YDS. ACRES- - LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided - E O Q I hereby nr 70that) I am licensedion under provisions f Charterro9i (commenting Remarks: Planning Notes: _ . • M with sectione n hill of a and of 3 of the Business and Professions Code, and • - ilp my license is in full force and effect. T License CI s C-39 License 408677 $ 1.() Date Signature ` - . PLUMBING FEES �/ WORKE S' OMPENSATION DECLARATION Bar Sink Showers ELECTRICAL ' FEES f hereby affirm that I have a certificate of consent to self-insure or a certificate • ' if Workers' Compensation Insurance• , or a certified copy thereof (Section - Backflow Preventer Service Sink - ”' 3800, Lab. C.) Automatic Washer Transformer ❑ 15-50 KW Policy No. WP85362466 Company Fremont Indemnity Backflow Irrigation Sewer Cap ❑ 5Q+KW 9 Construction Pole Sub.' ❑i¢rtiferifiede copy is filed hereby ffth thehecitytl. [[�$ with the Building Division. i Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Dat Applicant Crank Rrns. Rofoing Co-. -- ' EXEMPT N FROM WORKERS'COMPENSATION DECLARATION Clarifiers ' Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($100) or " less). - Dishwasher • Solar Piping Dryers OGas DElectric Sub Panel : • I certify that in the performance of the work for which this permit is issued I - shall not employ any person in any mann o as to boo) subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP [)1A-8 ' Workers' Compensation Laws of Calif orni Date Signature Floor Drains Swimming Pool w/Spa F.A.U. - 09-15 HP ❑16.15+ 'NOTICE:If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith. Floor Sinks - Urinal Fixtures - - Microwave - - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets . Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performancePole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater e Outlets Ran Lender's 'Name - g Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-WashGarbage Disposal ;Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit Generator 00-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ' ' the Contractor's License Law(Chapter 9.(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt - , therefrom and the basis for the alleged exemption. Any violation of Section - . 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).. - $ 3 O I, as owner of the property or my employees with wages as,their sole Reinspection Fee $15 Issue Feb compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES License Law does not apply to an owner of a property who builds or improves DEVELOPMENT SERVICES REQUIREMENTS: thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ employees, provided that such improvements are not intended or offered for Zoning Approved By • nate • sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 pletion,the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose Of sale). LI I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dateq tractors to construct the project (Section 7044,Business and Professions Code: .The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑D-100,000 BTU ❑100,000 BTU SUMM Y OF FEES builds or improves thereon,and who contracts for such projects with a con- C� tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ .J proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT, 0 I am exempt under Section B.8 P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ • ENERGY P.C. $ I hereby certify that I have read this application and state that the above 1:10.100,000 BTU ❑100,000BTL - - , GRADING $ information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter Upon the above-mentioned prop. ty or • , inspection purposes) e`- �e L MECHANICAL $ ' TOTAL FEE $ is S-6 Signature (�-� s�"� Date �! Drivers' License or 5S Reinspection Fee $15 Issue Fee ' $ 3 PLAN CHECK 25% $' -`^•MF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor /(CONSTRUCTION AND PLANNING POO. ,SPA 1 •./ APPROVALS Permit Date Inspector APPROVALS 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 COVE R-GUNITE _7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines;P-Trap, 0 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 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-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# 21. Ducts,in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test .72. Underground Flush • .24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas El Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 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.t FOOD CERTIFICATE ISSUED 33. Final Electric Notes: J 34. Final Heating & Air Conditioning 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 Domestic-Final 42. Backflow Preventer . 43. Backflow Irrigation 44. .Landscape Irrigation System - - 45. Sound Attenuation ' - 46. Handicap Regulations I 47. FINAL STRUCTURE & BUILDING /B0V 48. Special Requirements Completed • O" ter 49. Electric Release to Edison I 50. Gas Release to Southern California Gas Co ' 51: CERTIFICATE OF OCCUPANCY � No Date IL _� PRQJELfil00RE55: 178 E BAY ST UNIT. CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064316 .A OWNER'SNAME: WRAY, SAMUEL S ADDRESS: WRAY, ELLENE B PERMIT NO: B 064316 PLAN CHECK NO: N GOVT: N SUPP : N A. 2227 16TH ST NEWPORT BEACH,CA 92663 CONSTRUCTION TYPE: V—N PERMIT TYPE: STA PURPOSE: ALT 646-2388 ARCNIENRESS: REG.NO.: ADDRESS: UNIT: : SQ JOB DESCRIPTION T/OFF REROOF W/FIBERGLASS SHINGLES FT: 3, 843 • CLAIM VALUE: 3, 843 . 00 CALC—VALUE: 3,843 . 00 GROUP OCC: R-3 /M-1 PERMITTEE` CRANK BROS ROOFING CO ( 714 ) 548-5569 ADDRESS: 126 COMMERCIAL WAY COMMENTS : SMOKE DETECTOR REQUIRED PRIOR TO FINAL COSTA MESA CA 926 7 *****xaraF+E*********+E***************TF*aF*.+E*+E*****+r**********+E yq� i R LICENSED CONTRACTOR DECLARATION: hereby affirm th licensed under provisions•• ,ter 9(commencing with Section Z O N I N GS ERT EBQAUC I KRS E M E N T 511E v ! `. 1030)of Division 3 of the Business and Professions Code,a • icense is in lull force • •••ti. CITY LI 005 STATE LIC.: 408677 , CLASS: .►�[ �� © (Cale O � 4.3 Signature:_ % - MAIN BUILDING ACCESSORY BU�SJTIG�' x WO 'COMPENSATION DECLARATION: I hereby hat I have a certificate of consent to serf-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof in 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY ND.: 285-93UNIT224 EXP.DATE: 01 /01 /94 COMPANY: STATE FUND PARKING REQ• PROV; PARCEL: 42619212 ZNE: REF NO: 0 Cemfied copy is furnished. 12 Certified copy,filed with the city B Dni-•.. PLANNING NOTES> a- J1 / / Applicant: yi�r� /� **************.*,*****************************************************3E********** 7 D �fL EXEMPTION FROM WORKERS'COMPENSATION OECLARAI (This/tion need not be completed it the permit is for one hundred($100)or less). D E V E I L O P M E N T S E R V I C E S R E Q U I R E M E N61T S I certify that in the performance of the work for which emit 7 slued.I shall not employ any person in any manner so as to become it subject to the Workers'Compensation Laws of Ca ZONING APPROVED BY • DATE: 1 Date: Sp azure: NOTICE:It.alter making this declaration,you sho • b come subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such pro sio . or this permit shall be deemed revoked. t �y CONSTRUCTION LENDING AGENCY: I hereby affir at there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: JkY-}-'— DATE: l0_(U L cjj which this permit is issued(Section 3097.Civ.C). *****************1h***{E**{h****.yE****ie.)E**i0.**#if�F{f iE iF if lF if iE if l!{f ie iE*iE iE if{F iiifff*1f if if if if if if if iE LENDER: ******************************************************************************* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT I T 6 3 , 0 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0 pursuant to the provisions of the Contractors'State License law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE i. I. as owner of the property or my employees with wages as their sole compensation, win do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE f ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 63 . 50 0 , 00 0 , 00 63 . 50 63 , 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTAL S--> COLLECTED: 63 . 50 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 , 00 , 5 0 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******,k****,************,******************************************************** that pmol of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. IND I V IDUAL FEE BREAKDOWN or this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: I do hereby cerlily that I am aware of and understand the requirements of Calilornia.Health and Safety Code Sections 25505,25533,and SFR 3843 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 843 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from I these provisions. � / Date: Applicant: • irti I hereby certify That I have read this application and slate ; e above information is correct o•comply with all city and county ordinances and stale laws relating to building conslmctio ereby authorize representalivya ly to enter upon the abave•mentianed ( property or inspection purposes. - 1 O 199 J Dat�G-S-93 5 — �.� i co•si r_ 1pJJt C Driver's License or Social Security a: • _ COSTA MESA 1641.46 White—Boiltling'.Green— anC Pink—Revenue:Goldenrod—Assessor • cm c. • . ., � � i , , CkISTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# }date Inspector APPROVALS Permit # Date Inspector It 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location i 2. Soil Pipe-Undrgrnd. ." 53. Steel Reinforcement 3: _Electrical Conduit Utilitydfndrgrnd. , 54. Forms - 4, Electrical Condurt=Undrgrnd. - _ 55. Electrical Bonding 5.'Steef'Reinforcement56. Rough Plumbing & Pressure Test 6. .Electrical UF ER Grod. _ 57. APPROVAL TO COVE R-GUNITE ••7.'Footings ....... - 58. Electrical Conduit-Undrgrnd. 8.''Foundation - - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 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 13. Roof Drains 1 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-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 l 20. Rough Factory Fireplace i - APPROVALS- Permit# • ' 21.Ducts,in Structure 70. Underground,Hydro 22. Ducts, Ventilating _ • . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test -, - _72. Underground Flush • , 24. Roof Framing -• • - 73. Undergrnd.StorageTank 0 Gas 0 Oil 25. Roof Sheathing ' - /614_13 6 4 j he. 74.Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75._Dry Chemical ' 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 j 80. FOOD CERTIFICATE ISSUED 33. Finh1 EleFtric " I i" 'Notes: 34. Final Heating& Air Conditioning- r ' - • 35. Final Gas Pipe-Test 36.-Hood or Canopy. ' • - 37. Final Factory Fireplace 38. Final Plumbing I ! I. r' -_ 39. Water Service-Final 40. Gas Servide-Final . I - 41. Solar Domestic-Final . - ' 42. Backflow Preventer . 43. Backflow Irrigation ' . 44. Landscape Irrigation-System - .. . - - '45. Sound Attenuation --t-'• t ' - 4As 6. Handicap,Regulatio '"I 4 i- • . 47.-fINAL STRUCTURE,& 1LDING 7.-24 re d' /- .. 48. FINALPLANNINGl, ' - - 49. Electric Release to Edison • • 50. Gas Release to Sou0e.rn California Gas Co 51. CERTIFICATE OF'OCCUPANCY • No. =-Date • '' 4145 'IAR ?3-76EF7OO1171* 16Z.rt** 9 A 5 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only ADDRESS t // • RE E DBV []... 4.IVED D, p 14,4.Ryv,/ BUILDING �/ f Q J /■ PLS /�S�jf !7L OWNER _MAIL //. - ��7/r ��•JJ�JJ _. ,•'f A.P. NO.IIV/-�06I- PERI( IT, • - ADDRESS / / L r / ABDDRE S // �/( 6„ ' d� CITY i�y N0.3-4p z... TRACT.3/ Oj• I LOTp�4� BLOCK LENDER ONSTRU ION /'Nf>'NOL�ti NEW ADO ALTER REPAIR MOVING DEMOLISH BRANCH ; OWNER ADDRESS -Y�JI� VALUE I�yJ /�]� ARCHITECT TEL. , 71E [a 5/./ x7171 OR ENGINEER N / FIRE ADDRESS ��//////�� ZONE , TYPE ROUP �E CONTRACTOR gizzo�J(�jty_ fe e , BYPROVED iS DATE 0" ` ADDRESSPiebAL • S TEL. ZO K NO.OF /� USE OF NE CITY NO. P't^ ' PLANS / BUILDING I- STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF SLOGS. ILI 0 (/[J(FROM CP-yffE . OF LOT NOW ON LOT FRONT /J/ I LJIll FT, Q USE OF C� CR EXISTING BLDG. R.-S1DE ( EL FT. U, F Separate permits are required for L.SIDE SOFT. FT. electric,plumbing and heating work. FT. W - REAR / FT. a lapr,e,p BUILDING AND WORK TO BE PERFORMED"� � • DISTANCE BET. BET.MAIN& ��V 0LUf/✓J Roc", -&'C1 /,9r/, MAIN BLDGS. • ACCESS. BLDGS. A VAR.• DATE L,9s.wpny R pd ezy - - Ratter /e/apfl C.U.P.e• /��y APPROVED�S )., Pe:•B2 70 x420. 9.te 6y egreLE ,7— —fly APPROVE DATES_02 3 --7.46- -a 0wofra f /.1. yen'RS 'eo . co I hereby acknowledge that I have read this application and state n N lY, that the above information is correct and agree to comply with m 0. all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of o RI the State of California. r n m I hereby certify that I am properly licensed as a contractor under 'J1 0S Q' FT. ry the State of California Business and Professions Code, Division 3, THE AMOUNT SHO UNDE LUATI ON IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF EST B I ERNy 0NI Y3 p am exempt from the provisions of the State of California Business i V t✓ VALUATION RMIT FEE S ... and Professions C e, Division 3,Chapter 9. � I �n �, 0° PLAN + L,/.j/ A. 0 Signature of PLAN CHECK E p( ^ U. Permittee � Q o TAXTOTAL PAID - h � Authorized Agent . O X° 4 ,X` -It ►I 4592 FEE RECEIVED COSTA MESA BUILDING DEPARTMENT a.n.to I c` r —5., P.O.BOXFINANCE DEPT. COSTA MESA., CAL IFORNIA pp MMFF���� FOR APPLICANT TO FILL IN APPLIIY CAOf CCppl�716NT"run-PERMIT ABUILDDRESDINSG ) 7 g F.451- 6,4v S/ BUILDING 11 r COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY OWNERS/[J7GR(�N.)OODFoecsf plc;d.e(u RECEIPT NO. ,E4.619ADDRES� Y( N1 AI eat, RECEIVED.BYDTE RECEIVED 7M4/ 1S UED ,MAIL ......-74.-1,00- 3. • c 79 5 7 CITY A flys/ TEL. NG./( . LtS / BUIL EISS ORCHITECT AyMANO )-EV/4NAS LIC.0 7 y, OR HITECTE,^LL1 1 / /� cc no. COSTA MESA. CALIFORNIA 1 ADDRESS ///q w / li(/fJf/ /Lle FIRE ZONE L CITY LIC. ZONE PLANSNO.OF TYPE G_ROU/P)J CONTRACTORL I flA Cows r NO. (j 4 ,i" / WI V Y}� �rT� / TEL. CC tt�� APPROVED ///T '.ADDRESS // V'5. �.1 N ColAt NO.I(y J l/sl BY DATE (/ LEGA` LGT CORRECTIONS DEscRIPnON NO. fV BLOCK TRACTS/A� A.P.NO. ^ ^`T (_ SIZE `v w g NO.OF BLDGS. V � . e V OF LOT,J /� CI RI NOW ON LOT AFP O Y D USE OF (:ti"I'/A MESA EXISTING BLDG. CITY • C SETBACK LINE FROM q / pt, aNc, ute r CENTER OF STREET H REAR VA RDA) Tn BLDG. DEV(. REG. /' 3UDJfC' SIDE YARD RIGHTS/4. LEFT 5 4. DESCRIPTION OF WORK BY----�,— DAT::-� PLMIf co. NEW v ALTERATION ADDITION REPAIR MOVING 1IIpI DEMOLISH BUILDING .1 NO.OF SIZE . ROOMSLo. STORIES/ EXTERIOR WALL WOOL ROOF CEA A4 5/14K5 COVERING SI•/IG�I� COVERING Sw,NGh; . USE OF NEW D �r BUILDING L (� rI,L. IA/( l /b I • . 1 THAEFEBV ,ACNNO ED E THAT HAVE—RES PTION STE THAT TME AB V 15 CORRE AND.AGRAD EE THIS TIO COMAPPLLICAY WITHN AA LDL CITY ORDINANC SCAN TATE L S'REGULATI 0 BUILD( G.CONSTRUC- TION. //l n(�/� '7� /////f1� VALUATION SIGNATOR OF / (._ AI�.�IiL/ I 1.'1'T / I61� ,J PERMIT FEE S PERMITTE /`/Y� T /./(3' r/'•' F fG.`A 1 II ✓,y��//'J /(�/f� /�/ izoToif_.. PLAN CHECK $ Lj / X . 7„, S AUTHORIZED AGENT tom. -N • , / TOTAL FEE S �----- %frF y . v OWNER SRFRWDOD FOREST DEV. DATE 3-13-517 JOB ADDRESS 178"E. Bay Street - BUILDING PERMIT NO. #11679 GENERAL CONTRACTOR Lido Construction VALUE $ 12,304.00 LOT 20 BLOCK TRACT 3106 Res. w/att. gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 11592 PERMITS ISSUED INSPECTIONS � DATE SUBCONTRACTOR DATE NUMBER u Footing Trench - �Il 3 . -' Foundation Forms and Grade to Garage C.�[ 7 Rough Framing �i1.�V4 6'- Plumbing,RoughtoSlab cS— a' , T�.�c/., a, CCY'�oi 3-/3-57 Ri // f� Plumbing,Rough Complete 111 65 5/,/O%YJ // Temporary Pole V Wiring, Rough ^ APR 1 6 2 L '4 C -/' -S7 `// 37 h Heating,Rough q��te-s -/S--s- if/ ,. / ,. _ 1,3 1//- �, // Heating,Final //LL$ 6',0-j'-47 • e...--Sewer, House e.A Sewer,St./fle5 --4,'S , , . " ( . //-/S-57 A /.Z 2 Septic Tank or Cesspool C /L Lathing, In Out)( #,s z;�li `'1�-f�� Plastering CE 5`9-5- ' r Plumbing,Final,Fixtures Completelne5 .2-9 ,57 _ —al \\ Plumbing,Final Gas Test/S'� fjtL� 6* S9 .6:7 �� J Wiring,Final �/MAY 22195( Y If Occupancy 77) e 6S� sly.-0 FORM 210 3M 10.53