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Home My WebLink About1973 ALISO AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT ,lob Address: 1973 ALISO AV Suite No Vicinity: CORNER OF GARAGE Parcel Nunmber: 42632223 Applicant: MILLER, KEVIN Address: 933 RASHFORD DR Phone: (714)579-0952 PLACENTIA, CA Zip: 92870 Owner: WEST, GEOFFREY T TR Address 1973 ALISO AVE Phone: COSTA MESA, CA Zip: 92627 Contractor: K R M ELECTRIC INC Address: 933 RASHFORD DR Phone: (714)579-0952 PLACENTIA, CA Zip: 92870 License: 473148 SCOPE OF PERMIT UPGRADE ELECTRICAL SERVICE TO 200 AMP ISSUED BY: Status: ISSUED Applied: 10/18/2001 Issued: 10/18/2001 COMMENTS / SPECIAL CONDITIONS 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 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646(6/00) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool / Spa $0.00 0 ................ up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 ................. up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 .... up to 100 kva/kw $0.00 0 Switches $0.00 0 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $30.50 1 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $54.00 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS 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 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646(6/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ['have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carded /—, S,a4G r-L �l� Policy Number: 111U,t 0/ 2.7Z Z—Gy (This section need not be cothp/eted if the perm" is valued atone hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with these provis�'� Applicant Signature: T2� r _.Gt, Date: 1,57 —/(i— V/ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($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 affirm that am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect: Lia N J G— L J1 Class #I /-to Contractor's Signalure: ` l�..iL Date: [e CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a peri subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Cade). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......................................................................................_............................ildin..............................................................istr.......................for..t-c-................................................................................-..................................................................... 2 Dces or will the applicant or present or future builtling occupant need to fila a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Cade, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .. .....................................................................................-.......................... ......... .... ............................... .............................. ................................................................................................................................................................... .... ........................ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ....................................................................................................................................................................................................................................................................................................................................................-.................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ......................................................................................................................................................................................................................................................................................... .....................I.............................................. ........................... 6 Will any part of the facility to be constructed under this pennit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................ .......................... I......................................................... .....................................................................................................................................................................-..................................................................... 7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZAT10N OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S=f Legal Owners) Date And/Or Authorized Applicant Date CODE t. INSPECTION TYPE GAIE INTRIALS CODE I INSPECTION TYPE DATE IRIQIBL@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing Ie� 200 Final Re-Roof 210 Final Electrical aT� 201 Final Block/Retaining Wall 212 Final Fire Prevention �/ If 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy iAOIECT ADDRESS: 1973 ALISO AV UNIT: OWNER'S NAME: WEST, GEOFFREY T TR ADDRESS: 1973 ALISO AVE COSTA MESA,CA 92627 631-7511 ARCHIENGINEER: REG.NO.: ADORES$: UNIT: PERMITTEE: BRENT OWENS ROOFING (714)978-2075 ADDRESS: 12901 BUUBBLING WELL ROAD SANTA ANA CA 92705 LICENSED Cgq11PPT E 'AAT 10 N: hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70041 of Dlvltpnyt f I e mess and Professions Cotle, and my license Is In lull tort n e11ecl. CITY JC. 'y n TATE LIC.: 60040 GLA �C Date: i Z 3 Signature: _ WOO :ERS' COMPEN ATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a certificate of Workers' Compensation IppssgI�iap�y,qr. RXc%%j�Iifie coppy thereof (Section 3800. Lab 8. POLICY NO.: 6"tl L !t` LE EXP. DATE: 2/01/95 COMPANY: STATE FUND RR Certified cop is hereby urnished. L'T Certified copy iissht Ih the cny titling 'Ston pate: Applicant: / 66 EXEMPTION 401101 WORKAS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less(. I cerudy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date: Signature: NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cotle, you must forlhwilh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState 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). 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the El structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law 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 awn 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 for the purpose of sale). 1. as owner of the property. am exclusively contracting with licensed contractors to construct project (Section 7044, Business Eland 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). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. Im this reason: Data. Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 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 permit for construction or modification from the Air Oualily Management District. Residential construction applications are exempt from these provisions. Date'. Applicant: I hereby certify that I have read this application and state that the above information is correct. I ordinances and slate laws relating to building construction and hereby authorize represen atives of 11 property for In eclmn f rpas(es/. Date' � I 4q• Signature'. Driver's License or Social Security a: in comply with all city and county 3o enter upon the above-mentioned 164b46 White—Building: Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 066556 PERMIT NO: B 066556 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : T/OFF RESHT, REROOF W/COMP SQ FT: 8,510 CLAIM VALUE: 8,510.00 CALL -VALUE; 8,510,00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS ARE REQUIRED IN BEDROOMS 6 HALLWAYS " 1991 UBC " Z O N I N G S E T B A C K S R E Q U I R E M E N T 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: 42632223 ZNE: AEF NO: PLANNING NOTES> > RE 1E 1!*iF 1F%1f 1klFlfRElP7E*%!f***lkiE*iEfE 1FM*4*1l if 1t 7k iE RE iF 1ElF*7ElflFk lF Bf*1f***!f!Flik*****iE*f!!F**it iE Bf*MiP**it it 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 /"% DATE: BUILDING APPROVED BY APPLICATION ISSUED BY: !Ek***M!F *RE 1E**!l1E 1F M1E***1E 1E 1E LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 108.00 STRUCTURAL SEGMENT:Y FIRE SMIP/RES GRADING 85 SMIP/NON-RES PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 108.85 0.00 0.00 108.85 108.85 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 108,85 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 108.00 .85 *4M*!E**IE 1k*lE 1E 1E 1F**1F*1klE**iE 1E 1E****BEfE 1f 4lE iE 1E 1E 1F M1F *!!lF Rt**!k*M*1f iE41E*1k iF iE le!!lE 1E iE ff*iF *Bf 1E 7l iF ie ll•iF 1E iE iE 1E 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 SFR 8510 REROOF BY VALUE RESIDENTIAL NOZONE END OF FEES UNIT COST TOTAL COST 1.00 8,510.00 01 00157836-00157837 TOT 108.85 DATE: 03/28/94 TIME: 11:07 .0 CONSTRUCTION AND PLANNINGPOO. . SPA ,Inspector APPROVALS Permit # Date Inspector APPROVALS Permit +_ Date 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. :? - �;:-� 53. Steel Reinforcement f r3?tE. ctat Con¢yJt1lF y t ndrgrnEi T :A. Forms 6ectry'cal Conea4:4ndrgrnd. 55. Electrical Bonding =; -5. b'£ el'Re nforct -' 56. Rough Plumbing & Pressure Test - r.• 116 'E+ectr. ca' UFE 94�rd. ,- 57. APPROVAL TO COVER GUMTE Footings = 58. Electrical Conduit-Urdrilmd. - J _8. Foundation 59. Gas Rpe, �_ Undrgrrc., Test 2. Mater Pipe-Und?gtnd. 60. Backwash Lines, P -Trap. 10, Structural Flo&:SYstem 7 fit. APPROVAL TO DECK 11. P%operty Sewer , & House Concoction 62. Backwash & Receptor -Final r r .r 12. Sewer Cap y ;• - 63. Heater & Vent -Final 1 13. Roof Drains 64• Plumbing System - Final 14, Rough Plumbitra 65. Electrical -Final 15. Rough Electrical -Conduct 66. Solar System -Final 16. Rough Electri'rWiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceding 69, POOL/SPA SYSTEMS FINAL 19 Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 'APPRj0VAYLS' -,:Permit # 20; f4o;yh Pactcny I'hioplace : xta 21 `4u is Stillct I.sWf fi ._ •� r� * G • , r -370. (Inder`grn�rdl Hro r 22. Ducts, 4entuatu-4 sa71. Produc }pi g C s s O`Oil y . _ 23.aS.Pipe'Roµgh&'Test c' -" - -- - Cnlahx Undergrogpd F. -t , a'�- r .72. , 24::fioczf 'Framing , ,_ r. J r^ » 73.;-•Undergrnd atoragSf:Tank Gas ❑Oil 25. Pint Shgathmg M 3i - '•74. -Overhead �lydro--- ,� 26. •T Bar Ceding (Sir-vaturah &-t4anocoat 75= Dry Chemical ^• ^�- - 27 -Frame and Flashht . -` " - 76.D'ry Standj3ie ,`}: �xx > r_ �. s . 1-7 28. LaFc ing,& Siding- 77:- FIXED SYSTE"FINAL_ '29. Insulation i 30. Drywall- G a « ; t HEALTH.DEPTt REQUIREMENT Plaster Brown Coat I * y 79' FINAL II`2P-�CTIC7'N ~ t'- -31. ,r., _ .32._Elactncal Pa_yzreart�Final� 1' - l .I< ,r -80. -FOOD CErRTIFIC<TiE ISS D�-� r ir.--1 Elt iris „33. _i ^ - R .uy 34..fmge Heating& A.ir Con[jitioning- 35. Final Gas Pius -Test` 'd 'r i I' F •h = ' '' - - s36.lHoc4 or'Canopy-' . i - m 'J37. -Find Fatiory Firgplace .38. FmoF Plumbing - '39. Water Service-Fi fal+ * ' _ _ r A _ .240. Gas Service-c~.inal, tT. -. l.r D- - 'T% �• r .;,x _o{ s ' '--41. Solar Domestic-FUia" I M • I - I IT F - .42. -Backflow Prever.ter• 43. Backflow Irr�atiar,s r_S y S r ,'u F44. Landscape I Rgaiion Systems-- ;1 Or_ i5.'�§ound Attertttation �xr• > I, F- -�+ •� '"c; T a -46. handicap Reguladops � � f '" :: 47.1IN!kL STRUCTURE & BUILDING 7� Ef Gw - 48.�INtyrr �L PLANNIfle _49._�Ie62(ic Release to Cdlson - _�0._Gas,Rele4e to Soui�ern CaliloLpjAGas Co .St. CERTIFICATE OF CCUPANCY NO. Date Property Address �_ Owner 55 Contractor CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION 4 l i,So I Permit No. '13 to 655, State Contractor License Number '?f'(000 ye,72 Classification I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner -Builder permittee only). ❑ I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company tmited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: e 0990-46 White.Building Dry.; Canary -Contractor; F nor Company or Corporate Name izgoi /3u[3&1"'v (.IQL-ll Addr S,, 7� 4 Signatyr �I✓lf/•� ate Printed or typed name COSTA MESA BUILDING DEPARTMENT NU 44 s 111 East 20th Street Costa Mesa, California _ Date.......... f `Y.v j ti CITY OF COSTA MESA CERTIfFICATE OF OCCUPANCY Building Permit No._.'y...r Electrical Permit No.... "�.Plumbing Permit No... Useof Building..............-S.�Y..•.t":C..3.... ..,......... ................ .------- _---------------------------- --------- The building located .........................................................................................-............-.._...--*---------...__._.. Lot... Y.r:�&-........................ Blocic ........................................... Tract.....I..� ..... .......... _._...........: (See reverse side for Metes and Bounds) has been inspected and found to comply with the provisions of all City of Costa Mesa Or- dinances /pplicable thereto fora Group....... Occupancy. ISS TO " y% A. J. VOLZ ��%(� ...... Ci Buildtag- b / !/ (Owner of Buildin 8 CC: ❑ Original—Owner ❑ 1st copy—Gas Co. ❑ 2nd copy Edison Co. 3rd rnpy—Ftle i Form 206 G -H Iia 12-53 I Costa Mesa W'ng Department APPLICATION FOR PERMIT 4 4 111 EA. .h STREET 34 'U. .G.�N.G COSTA MESA, CALIFORNIA ' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY - Receipt No. ' Permit No. } / ✓✓✓111FFF�� Building Address 191 Aliso Avenue Costa Mesa, California /Receiv d by i Dat Recd. Date Issued ✓ v// �� S Nearest Cross SL Esther StreetBuilding Address Owner Mr - & Mrs -_ Rohe t_A,. Eastman Costa Mesa, California Mail Address 123 Broadway Nearest Cross St. Side Yard or Address Contractor (Attach Metes and Bounds) _Repair I I Moving I I Demolish Building No. of Size _L9Q_S_ft�Rooms Stories Exterior Wall P Lis gar 1 Roof Ccvering_�.j Coveri tUeee ng bak Use of New I hereby acknowledge that I have read this Ap] No. of Bldgs. Size of Lot 70X120 Now on Lot No Use of I No. of I No. of Existing Bldg. Families Rooms Setback Line from Rear Yard 61 Center of Street KK f Side Yard ,ids _Repair I I Moving I I Demolish Building No. of Size _L9Q_S_ft�Rooms Stories Exterior Wall P Lis gar 1 Roof Ccvering_�.j Coveri tUeee ng bak Use of New I hereby acknowledge that I have read this Ap] and state that the above is orrect and agree to with all City Ordinance nd State Laws r I building construction. Masonry Reinforced Signature of Bond Beam Permittee Authorized gt. Valuation Permit Fee $ ^' �� Plan Check $ .'. $ Total �^ APProvetl h l�.,l r� / Date i ].,..4 CORRECTIONS I APPROVALS Foundation Location Inspector Date Forms, Materials, Under -Pinning Frame: Fire Stops, Bracinc. Bolts j1atlng Lath. Int. Lath. Ext. Plaster, Int. Plaster, Ext. Masonry Reinforced m® Bond Beam O� FINAL im PLOT PLAN Show location and distances from property line and between buildings. u c i J c c 6 J P 6 a a Street PLOT PLAN Show location and distances from property line and between buildings. i SR Robert A.Eastman ✓ DATE 12 JOB ADDRESS 1973 Aliso Ave BUILDING PERMIT NO. 29 GENERAL CONTRACTOR Construction Sales VALUE$ 12,000.00 • LOT 26 BLOCK TRACT 1663 // t GROUP 1 TYPE v ZONE Rei FIRE DISTRICT IL S-LG� INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED Y DATE 'j -- NUMBER Footing Trench / j' Foundation ForuLQ yj G e to Garage Rough Framing . Plumbing, oug to Slabtl,) Plumbing, Rough Complete / • La fIr1/ Temporary Pole 'ring, Rough �`1 =�� C SROs '3V S L sating, Rough Heating, Fi Ina] _ Sewer — _ 2.-21-5 Septic Tank or Cesspool Lathing /'V Plastering Plumbing, Final, Fixtures Co fete -/ / a- Plumbing, Final Gas Tess l� J / `� .$'-/ — Wiring, Final _ _ /2 C c Occupancy Fbrm 210 GH 1M 12.68 /