HomeMy WebLinkAbout2256 AVALON ST - Building PermitsJobAddress: 2256 AVALON ST
Suite No
Viciniry:
Parcel Nunmber: 41908406
Applicanc FERNANDO JARA
Address: 2929 CRAPE MYRTLE CI
Owner:
Address
Contractor:
Address.
- ��Bhone: (951)202A540� -
CHINO HILLS, CA � � � Zlp_ 97709 �_ � - -
- �� _ � ,
PEREZ, L`UCRECIA ` , '
2256 AVALON ST �• . - �
� � � � � � � phone
�;COSTA�MESA,CA � � � Zip:
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�FERNANDO MARTIN IRIARTE JARA
2929 CRAPE-MYRTLE CI
0
92626-6447 ' �
Status: ISSUED
Applied: 04/12l2007
Issued: 04I12/2007
ISSUED BY: v
,.
I
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. - , i, ` Phone:' (951) 202-9540 � `�� . , � : � '�
� �� . CHINO,HILLS, CA Zip: . :91709 - �
. '�.Licen5e;869308 ,: � . � � � - �
, " SCOPE OF PERMIT �
- � UPGRADE SERVICE PANEL TO 200 AMPS LOCATED ON SIDE OF�PROPERTI'.��' �
� �',
, FEE SUMMARY �
� Quantily._ - - � - - � � , � . . . �
Quantiry � .
ISSUE FEE - $23.50 ' - � �-+ . � Temp-Dist System hLighting� ' � $0.00 0 � � - � �
7emp service test $0.00 � , , � , � �' F , _ Busway /10D ft � , ; � � , $0.00 0 � � ;, , � ` • �
Res.a/cpackage $0.00 � . . �
WOHKERS' COMPENSATION DECLARA710N: �� ' � � ;,
I hereby aNirtn under penalty of perjury one of the following tleclerations: , .
❑ I heve end will meintaln a cenificate of consent to self-Insure for workers' compensation, asprovided for by section 3700 of the Labor Code, br the performance of ihe
work tor which.this permlt IS issued. , ,- � � ' � � . „
❑ I heva end will maintain workers' compensetion insurence, es required by sectlon 3700 of Ne Labor Code, for the performance of the work for which this permit is issued. �
My workero' compensation Insurence cerrle� antl policy number ere: " '
Carrier: Policy Number:
(%his section need not be camplefed if fhe permit is velued af one hundretl dollers ($700) or less.)
q�-bceqlty that io the peAormance ot the work �a which thi pe�mit is issued, 1 shal! not employ any person in any manner sa as to become subject to the workers'
���compensation laws of Callfornla; end ag�ee thet it I s Itl become sub�ect to the warkers' compensetlon proNsions of Section 3700 of the Labor Code, � shell forthwlth
comply With these provisions.
AbpliceMSlgnature:"—"-�- � Dete:--�.- � '�z�07
t r�.::.. �
W�pNING.'FAICURE TO SECUfiE WORKERS'CQ�7 ION CAYEHAOE IS UNLAWFUL AND SMALL SUBIECT AN EMPLOYFA.70 CAIMINAL PENALTIE AND CIYIL FlNES UP TO ONE HUNDRED
ThqUSAND DOLLARE ($100,000), IN ADDITIONi07HE COST 05 COMPENSATION, DAMAQES AS PROVIDED FOR IN SECTION 3�Ofi OF THE LA00R CADE, IN7EflEffi, AND ATTpflNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
Chepter 9(Commendng wlth Sectlon 7000j o( �fvision 3 of the Buslness aGntl P�r�ssions Code, end my license Is in full
� �r.iwe<a-�...
CONSTRUC710N LENDING AQE�: -
❑ I hereby atFirtn thet ihere is e construction lending agency for the peAormance ot the work for which this permit is issued. (Sec, 3097, Civil Code).
�entler's Name: � Lendefs Atldress:
9igneture:
OWNEH-BUILDER DECLARATIONS;
Date:
� hereby attirtn thet urnler penelry o1 perjury thet I am EXEMP7 FflOM THE CONTRACTOAS GCENSE LAW tor the tollowing reeson (Sec. 7031.5, Business ertd Protessions
Code: Any city or counry which requires a permit ro construct, elter, impmve; demolish, or repair any structure, prior to its issuance, elso requlres the epplicant for such pertnit
to file a signed statement that he or she Is Ilcensetl pursuant to tha provfsions of the Conlractors License Lew (Chapter 9�commencing with Section 7000) of Division 3 ot ihe
Business entl Prafeulons Code) o� lhat he or she is ezempt therefrom and the besis for the elleged exemption. Any vloletion of Section 7031.5 by any epplicent for e permit
subjects Ihe applicant to e civil penalry of not more then five hundred dollers ($500).): � �
❑ I, as owner o( the properry, or my employees wlth wages as the(r sole compensalion, WILL DO T}1E WOfiK, and the siruclure fs not Intentletl or oflered for sale (Sec.
7044, Business antl Professions Code: The Conirectors License Law tloes nm apply to en owner of properry who bullds or improves ihereon, and who does such work
himself or herself or through his or her own employees, providad that such improvements e�e not Intendetl or oHered for gale. If, howaver, the builtling or Improvement is
sold within one year of completion, the owner-builder will have the burtlen of proving that he or she did not build or Improva for purpose ot sale.). �
❑ I, as owner of the properry, em EXCLUSIVELY CONTHACTING WITF1 LICENSED CONTRACTORS to construct ihe prqect (Sec. 7q44, Business end Professions
Code: The conirectors License lew does not epply ta en owner of property who builds or Improves thereon, end who can[recis tor such pro�ed wlih e contractor(s)
licensa pursuant to ihe Contrectars License Lews.). .
❑ I am eaempt under sec.
3ignafure: �
Owner ID veritied by tlrivers license. ❑ Ves ❑ No
Business and Professions Code for this reeson:
Verlficetion of Ownarship by (type of tlxument, I.e. - properry tex bill or deetl):
41VISION OF INDUSTRIALSAFETY PERMIT CERTIFICATION:
Dnvers License Na.
Date:
Expires:
❑ I hereby certify thet no ezcevation five (5) or more feet in depth imo which e person is required to descend, will be mede in connectlon with work authonzed by this
permit, and ihat no buildinq swcture, scaRolding, (alsework, or demolition or dismentling ihereof, will be mOre than thlrty-six (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Titla B, Celifornla Adminisirativa Cotle). .
❑ As owner-builder, I will not employ enyone to do work WhiGh would require a permit from the Divislon of I�tlustrial Safety, es noted ahove, ualess such person hes e
permit to da such work from the division.
5ignature: Date:
Division of Industrial Safery Permit Number:
CER'T�FlCATE OP COMPLIANCE AND AUTHORIZATON OF ENTHV: I cenity untler penalry of perjury that I have reatl this epplicelion and stete thet the infomiation given is
correct I egree to comply with ell state lews and city ordinences relating to bullding construction, entl authodze representatives of ihe City ot Caste Mesa to enter upon the
above-descnbetl property for inspection purposes. I egree not to oCcupy or allow occupancy of eny huilding euthorized by ihls pefmit until finel inspection.
COUE N, INSPECTIONTYPE ,
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Finel .
200 Finel Re-RoW
201 Final BIocWRetaining Well
202 Finel,Factory Fire Place
203
20
Finel Sign
Finel Demolition
�
PAI€ 1�9F�
cooe� INSPECTIONTYVE
206 Flnel Mechanical .
208 Final Plumbing
210 Final Elecidcel � � � .
212 Finel Flre Preventian
220 Final Planning Approvel '
222 Final Slte • � ' -' � ' ' "
250 Finel BuiltlinglOccupency ' ' �
DAIE I[�L9
- � � �!/:w'
�,�ooxEssorew�ou+c: 2256 AVALON ST
owxeasruxeir1o+avx: pALMER, PATRICIA E
�ooness 2z56 AVALON ST
COSTA MESA,CA 92626
645-0322
nar�. xuuno noo�ss:
1pCNRECT OP ENf�NEEA:
MCX.OH EN4'S MUXE55:
catmncraesru�:
ea+m�crarsxuuNc
AUDHESS
ue. rro.:
uara:
urR: CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 072735 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
UNT:
UNT:
LICENSED CONTPACTORS DECLIINRTION: I Mreby aRvm uMx penaXy of pajury ihet I em licensed uMs Ortiviaiona of Cheqx 9
(mmmendrg vrilh Seclion ]000) d Oiviaion 3 al iM Busiirem vM Pro(esaiona Code, erd my lioarea u in full torce eM eHed.
cm uc. No.: uc. cuss: uc. No.: EXP :
Dme: Gontreaw:
OWNEP BUILDEfl DECIANqTON: I hmeby elfirm under parety d perNrY ihel I em ezemq hom tM Comretlae Limnse Lew Iw Me
blbwmg reavm (Senion )031.5 Busineea vM Prolessbns COEe: Any c'sy or mumy whiM requ'uee e pe�mil to consWN, eller, improw,
nmd'eh, a repei any sVuclure, pia �o im oweMa. ebo reyuirea Ihe epplimM ta euch pxm'e to fib e aprwd etmemem Ma1 he or aha
a licensed W�+e^t to the provisbm d Ne Conlreciore Limnse law IChepter 9(mmmendip vrilh Sad'on ]OW) d Orv'sion 3 d Iha
Buei�sa eM Roiassbns Coda� ar thm he or sM e ezemq ihaelran end Iha beaie la IM dleped uemqbn. My vblmbn M Setlion
'l03t.5 by any applicent br e pemN aubjads Iha epqirant �o e irvil penelly of �al mwa �hen iNe hwMreE Adlers �5500��.
�] I. ea owner W iM pmpaM a mY �OM�a �h wegea u thei wb cwnpevelion. xill do iha+ork. end iha ehuclure u na inleMetl
«oMared im aek (SecGan ]aa. Buainesa eM Profeasiana Code: Tha Conireaas ticens.lewEms'al ePONto en ovmard o�M
who buiEs a improvee Ihereon. eM who Aoee eueh wwk NmeeM a heneY a ihrouph ho a har own employeae, peovided �hm aueh
impewemenls ere nd imeMad n oMereE ta sale. M, however, iM Wildi�p m inprnemem ie eok v�hin me yeer d eomqelion, tlie
owner-Wilder xill have tha WrEen d povinp ha w aM d'd m.a build or impmre Iw �he puryoae of mle�.
� I, aa owr�er d the prope�ty, em eRdusively oonlred'up v�h IiceneeE conirecton b mnsVud iM qqecl (Setlion ]0/4. Buei�a eM
Pmfmsiom Cade: Tha Contredae licensa lew Eaes iwl npply lo an ovmer of pmpeily xiw buiNs w imqwea IAereon eIM who
mnvena �w ww v�ims wnn a mmraaMe) �cenaed a�reuein �o �ne Gon�rea«e liwn.. tawl.
I em azemq under Se ion: , B.� .. tor N� `j ��
� ���J
areny �n�H ���+ ewere a�d u�wers�ene me reuu�remena a ce�aomie rfedin e�k seteri coda sea�a,a zssoe, zssv, e�e
25534. eM Nel I a e�ry Mure Wikirp oavpent will / wdl nd (aeM one) need to eanply wih eeid dele ootlee eM iM epuiremanb M
a pa�millorcansVucHm wmodif e�ion han IM Ai�iue iyi.�eregemam Diqrid. RawdeMid conehudion eppimiwuw exemp trom iMea
prwieons.
Deta: MM�:
WOflKER'S COMPENS�TION DECL1NA710N: I hereby alfi�m urdar penally d pmjury me d iM folbxirq detleretiona:
� 1 haw arM vril meinten a certilicqa W mnxnt lo aeltimum br v.a�ken' canperoelion, ro prwided la by Sedim 3]OD d tha lebor
Coie. fn tM pertortnarwe N iM work la which ihie pe�mil ie ieaued.
❑ � nave end wi� meimen vronere' cwna�aaon ireurenoe� m nauired M sxlim s'Iao a me Leb« Coae. ror �he wAamenm d �he
work tor which Mie pemiil'n iasued. MY ��' �^Pa^+mb^ imu�am.a umr erd pdky number are:
c�a,:
� Pdky Number:
(ihis sedion neeC iw! 6e cwnpleted % tM permk u fw ane hundred ddlun �St001 w kp.1 "
� I ceMdy ihet in IM pMormenm d ihe vrork tor which Ihia paimil q iswetl. I ahell mt ampby enY P�� m ury memis eo m to
becwna aubjea lo IM xa�kero' compenae�nn lewa d Celilwnie. arM prae UW � I ehouW berome eubjatl to tM xoMen'
compenution pmviaions o/5edion a100 d Iha Lebor CoEe. I shell lorlhxil� mmpN � �hma pwieiom.
Dele: AppliraM:
Wem)nD� FeNun N sxuro wortrers'romperuetlon eovsreps b unlawNl, enOalWl subJeet en employer ro�NMrW p�neltlu mtl
drll flnes yv ro ms huMrstl tMuasM eo/bn (S10q000A N eWltlon ro tlro croar ol romparuefbry demepu o provltlM ror In
SxXon ]l08 0l Ms LeboiCoM, Inlxuf, enE ettomsy'� Isa.
CONSTAIICTON LENDINO /10ENCY: 1 Mreby dfirtn uMer pen+ly W parjwy ihel �hae c a mnnruaun kMi�q apancy for tM
parlormence d Iha v.vh br wf�ich ihw pemd ia vsueA (Sadbn 309]. CN. C).
LENDER'S N4ME:
LENDEfl'3 AODNE55:
I canM �nm I heve reaE tnis e{qlicelion vW atme inm �he ebove imammion o correa. I epree lo comply xilh ell dry eM counry wdineMee
arM slete lewe relmip Io buiNiip cona4Wbn erd hereby eulFwrixe mpreaenietiree dthe dry W entar upon tM ebove�meMoiwd propeM
r«ms��w�o�.PATRICIA PALMER�
oma:� /7/�
(5151d6.WP) While-B�iMmg 8 Selely: Oeean-Fb: Cenery-AppFraM: Fnk-Ravenue: Gdtlenmtl-Avseamr
PERM NO: B 072735
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : T/OFF & RE—ROOF W/COMP. SHINGLES SQ FT: 2,300
CLAIM VALUE: 2,300.00 CALC—VALUE: 2,300.00 GROUP OCC; R-3 ./M-1
COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVETRY HEDROOM 6 HALLWAY, 1991 UB
*it***iEat**ieit*���itit�r**itieit*ititatitieatir�rieie�ie�r�*ieirititie***at***�rit*ieie+e+�*+�irieieieieieitie�ieit*�*�atitieie
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 HUILDING ---------- --------- ACCESSOAY 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: 41908406 ZNE: REF NO:
PLANNING NOTES>
% ' -
'N"!h iF'!f' i("If iE iE'N' 1h 1E 1F'K' i("1f' iE'If it iE iE'K"!f 1E 4 aF 1E 1f' iF'N' iF'/F ik iF iE �If iF 1E iE iF if iF iE if� 1F �lE iF �E iE 16 iE 1(� 1E iE iE �lE'IE iE i6 iE �1F 1f if 9f 1f iF 1ElF iE'N"!F iE 1E'IE 1E 1E 1f if'1E if
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 HY DATE:
BUILDING APPROVED BY ; DATE: ��
APPLICATION ISSUED BY: �;� DATE: /J
iliFikiFiElEiFiFiEiEiEiEiEiFiE�IFiE1F1E�Ik�1EiEiFiE3F�Fif3F77F�3FiF�i�if'ifiFiF'�F �F 7f'if'iF'�F7FTF�iFiF7F3E�FiE1E�IkiEiliFiEifiEiF iE�E
LEGAL22ATION:N F E E S U M M A R Y STRUCTURAL'S GME :Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 50
PL� _ SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 54.50 0.00 0.;00 54.50 54.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00 - .50
1E fE 1E 1h 1E iE iF!! iE 1E'lE')h ik 1E iE i! iF 1k'lE 1E i! iF iE iF jE 1E 1E 1E 1E iE dI� �E ik 1E 1F iE 1f 1E iE 1E 1h'X' iE 1h i! 1("lE iflF 1Fif �E 1F 1E tE 1E �E IElE ih i! 1E ih 1E'lE 1E ik i6lE 1k �E 3E iF 1E 3! iE 3E i63k
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
SFR 2300 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,300.00
END OF FEES
�i �fL�14�f'��_R��fSS77% �iA.i . . .
�ar�� �E.n�:S; rrr��: ..:,s
CONSTRUCTION AND PLANNING ` ' P(7 ,y SPA `
APPROVqLS Peimit # Date Inspector , APpROVALS Permit # Date Insp�ctor
�
S. Temporary Electrical Service or Pole 52, Pool & Equipmeni Location '
i +
2. Soil Pipp-Undrgrnd. 53. Steel Reinforcement �
�3.�.ElectricalConduit�Utility-Undrgrnd. � 54. Forms ��
� ,;;4: �Electrical Conduit-Undrgrnd. 55. Electrical Bonding
t:V 5�:Steel Reinforcement 56. Rough Plumbing & Pressure Test
.�
,`-'6�~Electrical UFER Gmd. 57. APPROVALTO COVEft GUNITE �-°
�.u�.
'~T�.footings �� ' 58. ElectricalConduit-Undrgrnd. - �
��8: Foundatio� 59. Gas Pipe, O Wndrgrnd., Test ���
�� �
� 9. Water Pipe�Undrgrnd. 60. Backwash L,ines, P�Trap, O Undrgrnd.
10. Structural Floor System - 61. APPROVAL TO DECK
11.'Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12,. ewer Cap - 63. Heater & Vent-Final
.
13. Roof Drains � � 64. Piumbing System � Final
14. Rough Piumbing fi5. Electrical-Final �
15. Rough Electrical-Conduit - • � 66. Solar System-Final •
i 6. Rough Electric Wiring . 67- Pe�cing & Access ApP�oval •
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-7 Bar Ceifing 69. POOL/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditiorting � a �, FIRE pEPT.,jiEQUIREMENT „
20.�Rough F,acto�y F�eplace '�•T � a , � APPROVALS;. � P�Cmit #T.; ?,
21. Ducts, i �Structue�'� •• •� -+5 � _ ' � 70:H ndergrou;�d Hydro '
22.,Ducts, Ve�tila'ting�� � ��= " . i, � `; 7}. ProduciPipi���OGas �70i!
23. Gas Pipe�Rough &;T�est ! � �� • � =�1 � 72. Undergreund Fldsif� � �
24. -Roof Frsming' J� '�'� "r� ; .;� 73. Undergrnd. Storage,-iank O Gas O bil
25. Roof•Sheathin9 �;�. � Le f 74�." Overhead Hydro '
26. T-Bar Ceiling (Str��cKuraq & Monocoat ; ' � ,� 7�5:,-0ry Chemical �,,.- " �i ' .'
27. Frame and Fiashi,rri�g..- �i.' y• ; �- � '.�. 76. Dry Sta�dpipe�-4� ±�� ' ��
; 28. Latfiingr& Siding �� � : :�� ;� �; � ' 77� FIXED=SVSTEM-FINAL� �T
29. Insulation �• `;j � - .. .. � • 7•B. FIRE PREV. FINAL + -
' 30. Drywall�Nailing ;� �^. ' �, ^ ' `SHEALTH DEP.T.�REQUIREMENT
�� 31. Plaster B�owm�Coat.: ;, � rr rt r 79 FINAL tNSPECTUON - �
_ �,
� 32. Electri�al Power IN� feF-Pinal � ' a� 80? FOOD CERTIFYEATE I�SSUED
: , , . � ` , :. -,..-
� 33.�Fin@L�lectric� C�.�� � i �� � �i � Notes:� p, ��'�_g/ff�• Q!f ./
, 34.:Final:Heatin�& A9,�'CorxiitioningS i •� "'� - -� '-�7
L F. I r �-" t� F i IT:
, 35. Final'GaS=Pipe!Test;, ,- - .. j V _ � � � � ��' � /
�O /S��J" .A,/ v.f�! � /fJ�
c' 36. Hood Or GanoPY A t^ �;,1 ' • • y' �- t•: �� �
37. Final:Fac�ory Firepiace. .:r � . � ' " --
- 38. Final�Plumbing �tt+ ' ' ' � =� '' ' � -
n -w +� r. i r-� � [:
' 9- ' I '. I-1 il
39. WateY Ser,vice�Fina��., ' ,; . �� y .
�
; -. -
• � 40. Gas Service�Final :7�-. r. �C-;:+ ' �� ' �+ - .•� '
-�. _c. :.� *.
41. Solar pomestiC-Firia1 �� " ' ' i '' :' �
�
� � 42. 'Backflow Prevente� �- •• � = "' '
,� .
43. Backflow Irrigation,. ? ��`' . . .. - -' � .,
V�
,44. Landscape Irripatinn System �-� �.. 'T: ht 7 - - �� - '� � � �
��'*' `if �' -
`45. Sound Attenuatio ` ' �" . .- �. �-� - �Z ' �' '
�, - ... - - -
46. Handicap�Regulat�ons . r� � " • ''' y _.
: �„�
47. FlNAL STRUCTURE & SUILDING .'�' � i ��� �- �, " �,
r
48. FINAL PLANNINiit � F•� - � . 3 ' '* ' - '
.�
49. Electric Releate to(Edison �. ' , � �'
r ..
50.•Gas�Releaseto.SouthemCaliforniaGasCo - �- � • - -
51. CERSIFICATE OF OCCUPANCY � � �
No. Date
owNEu KEAtDON HOP�fES, IIQC. �AT�i_ 5-58
JOB ADDRESS ��� Ac.al nn S+,rA�t � BUILDING PERMIT NO. 7n� �
GENERAL CONTRACTOR � �—
. K_ W. Knll _ VALLIE $ �T ,� n�_
AP. No. LOT (�6 TRACT 31Ej$� ZONE DESCRIPTION OF WORK Sin�rea. w at+_gar
GROUP I&,1 TYPE V ZONE �RJ� PLAN NO. �����_
PERMITS ISSUED
1. !ECTIONS " I DATE I SUBCONTRACTOR I DATE I NUMBER
�
. , ;+�
�` � , '7���
COSTA MESA BUILDING DEPARTMENT
' P. O. BOX 31]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING ,.,.�i .___. ___ .0
COSTA MESA. CALIFORNIA
OWNER %endon Homes, Inc,
ADDRE55 2026 NBW�iOT�i �9d�
. `. �`'�[�LLM'�':fa
6- 2c�_sg- � �.
FIN�f�CE QEPT.
APPLICP��TION �FrORNFE�RMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PEFMIT NO.
cirr N oI't BeBCh Cal'No: OR 36601 nooRE�s"s �
.g W SO�.�. COIISt.'CO N�p; COSTA MESA. CALIFORNIA
CONTRACTOR t1 W ff�11 C�nBt "`� No: g534
LEGAL LOT
pESCRIPTION NQ,
A.P. NO.
SIZE �
OF LOT
USE OF
EXISTING BLDG.
SETBA<K LINE FROM
NO.OF BLOGS.
NOW ON LOT
EAR YAFD �4H
FT 6
DESCRIPTION OF WORK
NEW B ALTERATION ADDITION
REPAIR� MOVING DEMOLISH
BUILDING � NO.•OF
SIZE I ROOMS 6 STORIES
EXTERIOR WALLy ROOF �t�
COVERING HYiiCCO COVERING TOliB
USE OF NEW
BUILDING aingle Pam residence & att @
FIRE
ZONE
�O� Y �
I HEREBY FCKNOWLEOGe Tnw1 i nnv[ ncnp THIS APPLICATION ANO
STATE THAT TME RBOVE IS COflREQ AND AGREE TO COMPLT WITH FLL
CITY ONOINPNCES RNp STI�TE L�WS REGUTATIryG BUIL4ING CONSTFl1C�
riorv. ' VALUATION
onTe
CORRECTIONS
SIGNATl1RE OF PERMiT FEE $ ,�Q �
AUTHORIZED
/�,�'J cj//� PLAN CHECK � J .�
!�!/
TOTAL FEE $ (�� ���
� !
, COSiA MESA BUILDING—SAFETY OEPANTMENT �x
P.O. BOX 1200
Coata Mesa, California
Address
State License No. '1 Clau.
wCity License No.
r
Q NUM1IBER TYPE OF FIXTURE OR ITPM
0 N'ater Closet (Toilet)
� Ba[h Tub
� Shower
Lavarory (N'ash Basin)
JKitchen $ink
� Laundry Tub or Tray
w Service Sink
a Floor Sink
� Floor Drain
n' Dishwasher
Z Drinkin Fountain
= Urinal , t -. �
� Ga�bage Disposal � ��_�ti`_�
AutomaticWashin�.Mzch. � "
~ Water Softenei� r ' }
� Water Heetei &'�Veni
wRece tor�`..) �
d Swim'Poal Filter System
� G5s Sysrem . . Ou[le[s
� Lawn S rinklcrs
� Installntion or N[cration
Watcr Pi in
_ Back Plow Preventer
y � Pro . Sewer (t.
S `
F,. Cess aol Se ne Tonk
TO'I'AL FEE
lONM eu-a�
FEE
6�
�!AY 30-75cMs�OO1278 ���`�`*��.0�
TMCT NO. REGo. BY 6738�
LOT NO. OATE IB6UfiD
BUILOING USE ��� /p
cr
V
BUILOING
ADORE55 �
COSTA MESA, CALIFOftNiA
NEAREST
I hereby aclmowledge` that I have read this application
and state,Uiat the:above is correct and agree to comply
with, all��.�City Oidinances and State Laws rngulating
plumbing., � -
�� I ce'rhfy that I possess the above valid state of Cali-
fornia classification or I am the legal owner af the resi-
dential praperty des�cribe�d above�//�"/`/�"
Signature of / // � ��
Permittee (�.�'
INSPECTION RECORD
APPROVALS
INSPECTON �be