HomeMy WebLinkAbout2401 RICHMOND WAY - Building Permits .� CITY OF COSTA MESA
4 "
BUILDING DIVISION
> • ..,.r' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t. 1 ------- I
k . PERMIT B04-00154
44'0o
(714)754-5273 • Fax(714)754-4856 • www.ci.costa mr
esa.BLDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2401 'RICHMOND WY Status: ISSUED
Suite: Applied: 01/13/2004
Vicinity: Issued: 01/13/2004
•
Parcel Number: 41916553 Zoning:
Applicant: CHAVEZ, JUAN S
-
ISSUED BY:
Address: 3009 N SHERI ST
_ •Phone: 714-469-3915
ORANGE,cA , ; Zip: 92865-1622 -
Owner CHAVEZ, JUAN S
Address .3009 N SHERI ST
Phone: itt • ',A`
ORANGE,CA Zip: 92865-1622 Wm. ,
Contractor - • ' i' .� .
Address: -
i
Phone:.
Zip: License: '
Arch : - Eng: - . '
Address: - Address: -•
Phone: - - Phone: -
Zip: License: License:
SCOPE OF PERMIT .
.CHANGE OUT WINDOWS IN EXISTING CONDOMINIUM.WINDOWS WILL BE SAME SIZE/SAME LOCATION. '
FEE SUMMARY ,'
Plan Check: $0.00Calc Valuation: $4,000.00
Permit: $97.25 - . _ Claim Valuation: $4,o00.66
SMIP Res: $0.50 - . , /
SMIP Com: $0.00 . .
Other: . $0.00 - '
r
Inspection: ' $0.00
Total: $97:75
' -PLANNING &ZONING -
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0- Rear 0-0 Left 0-0- Right . •0=0— '
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES: -
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
2446-46(6/00)
DECLARATIONS �;
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have end 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.
❑ I 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'compensatio I nce carrier nd po cy number are:
Carrier: l Policy Number:
(This cfion need not be completed if the perm is valued at one hundred dollars($100)or less.)
I certifythat in theperformance of the work for which thispermit is issued,I shall not employ any~
rs y compensation
it my manner a ti to become subject to the,I shall f
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Seci`o�3700 pf the r Code,I shall forthwith
comply with these previ • ns. I t
Applicant Signature: ` Date: o
WARNING:FAILURE TO S E WORKERS'COMPENSATION COV GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOI-LARE($1 , ),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 I 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.Lic.a Class 4
Contractors Signature: Date:
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.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under pe of.perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Cale: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 s ned 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
Busin and Professions Code)or that he orshe'is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
u cts the applicant to a civil penalty of not more tliari)iGe 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 properly who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exe t under sec. Business and Professions Code for this reason:
Signature: Date:nse12)/0
Owner ID tied by drivers lice . ❑_ 0 No Drivers License No. Expir
Verificati 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 Code).
❑ 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? 0 Yes 0 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).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,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 II an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If 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 Califomia Health and Safety Code Section 42303 been made? ❑Yes 0 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 end city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION 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 represent fives of the City of Costa Mesa to enter upon the
above-described p operty for inspection urposes.I agree not to occupy or allow occupancy of any building authorized by th permit unyl final in action.
16 3/Il
Signature Of Legal ner(s) Date
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE RATE INTmALS CODE f INSPECTION TYPE, • CANE thermeLB
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
rillmilADDRESSE950FBUILdHG: 2401 RICHMOND WY aMr: CITY OF COSTA MESA — BUILDING PERMIT
NMI'IFINWN: CHAVEZ, JUAN S PERM NO; B 073604
ADDREss: 121 SUNNINGDALE CIR
ORANGE,CA 92668 PERMIT NO; B 073604 PLAN CHECK NO: N GOVT: N SUPP : N
ARING ADDRESS: CONSTRUCTION TYPE: VN PERMIT TYPE: STR - PURPOSE; OTH
CT ORENGNEER: UC.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 2, 999
ENG.'S ADDRESS: MT:
CLAIM VALUE; 2, 999 .00 CALC—VALUE: 2, 999 . 00 GROUP OCC: R-3 /
RACTOR'S NAME STOUT ROOFING INC ( 310 ) 923-6775
ACTOR'SMMUNG P O BOX 4309 COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 91 UBC
ADDRESS: DOWNEY CA ucND.: 402536 i69E1E1EPE1EdEfE1E#iEiEd6961F9ERE1EfE161EdEt6Pf9E1E16969Ed6RE9E 1t1t1ElE1EiE7EiririElE1L-1E1t1Fif1l1E1FxxiEiEir+Eikllftx-1EiFx1E1E** ir#iFlEifat#1r9E
90241 WIT: ZONING REQUIREMENTS
SED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
encing with Section 7000)of Dmsion 3 of the Business and Professio and my license is in full force and effect.
Ic.NG.®59377 pLIC.CLAS : C 39 UC.x 025 6 E 10/ 5 MAIN BUILDING ACCESSORY BUILDING
L1 '' / Catndo �/� RNT: FTIN REAR: FTINFRNT: FTIN REAR: FTIN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
R BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors Lice law for the
II, vdng reason(Section 7031.5 Business end Professions Code:Any city or county which requires a permit to const .alter,improve, PARKING REQ: PRO V: PARCEL: 41916553 Z NE: REF NO;
_s'f.3moleh,or repak 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 Deision 3 of the PLANNING NOTES>'
Business end Professions Code)or Ihal he or she is exempt therefrom and the basis for the alleged exemption.My 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[$5001).
**************;*.****SEW W*iflEiFHE1E*iE1EiEBE1E9F****iEiE W W***BE*!E**9E 1E**i6W**********************
Elt,es owner of the property or my employees with wages es their sole compensation,wig do the work,end the etnctum is not intended D E V E'.L OPMENT SERVICES R E !1 U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License law does not apply to en owner of properly M
who builds or mproves`hereon,and alio does such work himself or herself or through he or her own employees,provided that such
> vl_
improvements are not intended or offered for sale,H,however.the building or inprovemenl is sold within one year of completion,the ZONING APPROVED/ BYDATE: ''°
owner-builder will have the burden of proving he or she did not build or improve I«the purpose of sale). -
❑ I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7004,Business and BUILDING APPROVED BY DATE: i'‘''
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). en
❑ I are exempt under Section: B.A P.C..for this reason: APPLICATION ISSUED BY: DATE;
Date: Owner: *****SITE*BER'*PE*16**********BE**1E****$EBE* * *4'e***************iEiElttEl ***
LEGALIZATION:N F E E SAMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I an,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 end the requirements for
a permiforconsbuction ormcdificationfrom the Air u�6eTMregement District Residential construction pp$caare exempt ionetionefthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 54 . 00 . 50
SMIP/NON—RES
Dae: Applicant: •
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury w of the following declarations: ISSUE FEE
❑ Ihave and MImaintain acertificate dconsent osell-insure for workers'compensation,as provided for by Section BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,tor the pedorma«aofmwork whiten this permit is issued.
TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 .00
r, I have and coil 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.
Carrier: STATE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: .00
Policy Number: 044940000468 / 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed I the permit is for one hundred dollars/$100)or less) 54 . 00 . 50
o I pertly that in the performance of the work for which this permit is' •,I shall not ploy any person in.• anner so to
become subject to the workers'compensation laws C California,Ia nee Mai if should become to the . _ - 1EtE1E1E1E1E#1EiE##iE1�1EtE1EiE#iE#IEiEk1E1E1EiEfE1EiE1E#1EiE1EiElEiE1E1ElEiElElElElliEiE1E-0EfE1EiE1E1EtE1E1F1E1Eif1EiE1E1EiE3EifiElE1E)E1EiE'lFififfhlE
compansal'anX�rovisionnl orpeaion 3700 a e Labor Code,I shall I ham those pmvisi. .��` INDIVIDUAL F E E BREAKDOWN
Date: Applicant: —
Warning:Failure to secure worker.'compenseton coverage Is unlawful,and shall sub/et,an employer to criminal . aides and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($500,000),In addition to the cost of compensation,damages as • •vlded ler In
Seton 3703 of to Labor Corte,interest.and attorney's tees. SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 999 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that then is a cometnalion lending agency for the END OF FEES
performance of the work for which this perms is issued(Section 3097,Cu.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property
for inspection purposes
E
RLE imName 0R11 01 OO137630-001E7531 TOT :54.50
` fit' ire-r11---9,.<
1 9� 8 ^
0" 0
DATE: 08/04/95 TIME: :
Dale: / '
Signature of Owner/AgenVAppli Contractor
(515146.WP) White-Building&Safety:Green-File Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING F & SPA
APPROVALS Permit#- Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location
•
2. Soil Pipe-Undrgrnd. 53. Steel Reihforcement a ,
Lc3;,kiectrical Condtiii Unlity-Undrgrnd. 54. Forms ._
&
.7:4. Electrical Conduit-Urgrnd. .- 55. Electrical Bonding
, I •
S•••Steel Reinforceme0t} - 56. Rough Plumbing & Pressure•Test -1 ,
6;^Electrical UFEP-GInd, ' 57. APPROVAL TO COVE R-GUNITE a1
m y .
r,7:;Footings so 58. Electrical Condor Undrgrnd. -
C-
-.8:-Foundation o, -L 59. Gas Pipe, 0 Urfdrgrnd.,Test ?_
.-r .-:G o :nom
9.1Water Pipe-Undrgr,A'. a 60. Backwash Lines, J-Trap, a Urfdrgrnd. .
107:Structural Floor System - 61. APPROVAL-TO HECK. - ..
11. Property Sewer liner& Housetonnection 62. Backwash & Receptor -Final-
12. Sewer Cap 63. Heater & Vent-Final
rr,
13. Roof Drains 64. Plumbing System -Final
14. Rough Plumbing_' - - - ' 65. Electrical-Final ,
15. Rough Electrical-Cors'duit t7 - - - 66. Solar System-Final '
d v .
16. Rough Electric 4�jri •
67. Fencing & Access Approval`
•
17. Rough Wiring Sign .- '�.� 68: APPROVED F PLAS EKING .I
18. Rough ElectricaYT Bar Ceiling 69: POOL/SPA SYSTEMS FINAL
.� 19. Rough Heating & Air Conditionin( - - - F REEPT.t$EQUIFEMENT '
H-t rr- K rx T �ti r fJ
20. Rough Fa�torY FiMirpace : ._.7.L �c : S' n c' 'APPapv4.L r,`n.. Prumit# t ••:),-. M
.71' E =•••'-i E - :1
21. Duce,in'Strtmture^f. c ,-i y ; - n
�. R. S* 'cc-. t .'1_ ti, C,* tti 70. a.Inderg7olp71 Hydro ;,r .
22. Ducts:t VeritilalingNf r - < CJ E.:t' 71. Produmriping D as ( Oil
�' 23. Gas Pipe-F3ougEa & Test i �' Ms * C-t tr < p* •, 72. Underground Fttdds1r.- - -
-;
24. Roof-=Fraifiing7 Z 1 F''-' '•: * > O - .: 73 Under rnd Stoi a Tani 0 Gas ❑Dil
L : r g Oar _
25. Roof Sheithin r
y
9 ma g-7,095 o 74.rOverhead Hydro•7, 'I
26. T�BaF'",Ceiling (Strt f iral) & M,t oat .r C y rs jT. 7c Spry Chemical :., R 7 '' ;.,
27. Frame and.Flashirgitt L--' s: tr y Z.% 7• 6. Dry Stan pipe I--- Q
-428. Lathing 9Siddng G, ca `77 a:F- U ,' z •. •. . 72;• FIXED S�$TE&INAL F, ,
29. Insulation• •1• - s t: r tt 78. FIRE PREY. FrNAL K > r^ -
r." n.
r 30. Drywall Nailing cc4 r - I I _ �tr.aE ALTH•DEPt.REOUIREMENT
i 31. Plaster Brgwn.Coat c s I CrCe t j Fr " 79.E FINAL IDISPECTtON t• j
5 ! -+ '' Ir 8CE1 FOOD CERTIFICATE ISt6UED
- 32. Electrical=Pow`Rr MefErfiltal I • .. -
i 41- I rt i. I K T1 rn ?
s-33. FnahElectric; r-it tr -C N6tes: _ ^..T ✓t
* `I C ntTi
fT ,r w ,y n t.
34. FinahHeating'& AL•Eonditiorfing= n ' ..,--i, ` s --'
F• r 1 _ K n h.] . �'3' I ..< I. ^i
35. F!naEGas�fipe:Te n* cr.. •• 4 ;-+ , p _i zo C'ri. t Fir
CT ..r • .. z :.. _.
• 36. Hood or CanoPY ' D i n :• i ^r <?`
It rh -o x „- -
-137. FinaLFact_o-rY Fireplace T - E.s •
s N r ca
- 38. Fina PPlu nbing t rn) x -i . !o C.
. LP R rrt IJ K , t r i. t+.' _ cz
L :k. .1, : f _ , : 4. H. V
'
'39. Wate%'Sekicejina'-I1' T t; x P,: •• a ,
r40. Gas Service-Final r :r e.:•, .-r S t .7 rt _ -+C•%
, .i- 1-, rn -i :A: .- C.T t try'
41. Solar Domestk-FinafK -' rr 4 r., <
- - -'
42. Backflow:Preventer - v * ri h: c Cr H -
S 5,. r ..,-. . " _ _
43. Backflow Irrigation ; * 1. K ,-, .
44. Landscape IrrigatiorPSystem cum0 a: * C "7- C � n3 Cu C. .n t,'. ti
r_.
-47.-•--- T r a. l_' t.-' Int : • c - f- !. ,
45. Sound Auenbation - rl -q 7.-.4. _ 4, • E-•t� t
^ter eJ _ t fn. • u y
46. Hendicap•Regulations - 0 • m �- x .s Jo s t' r
r c,
47. FINAL STRU TORE& BUJ L'D(NG !l,�Y xgS64,-,41:,.. r+•3:> s • 1
v. ..
48. FINALPLANNINGI' ' - :4 Xty , ytxrt C t. Hl
* r. r.! i .: _. .4
49. Electiic Releafe to Etlison * _-- * ' y
50. Gas Release to Southern California-Gas Co x '. ' `-' D ' or,, r 0 ,
54. CERTIFICATE OF OCCUPANCY * 1 4. - or. , r
No. Date I
OWNER SAN VISTA BUILDING COMPANY DATE 6_1_64
JOB ADDRESS 2401 Richmond Way - BUILDING PERMIT NO. 22279
GENERAL CONTRACTOR RAMP VALUE $ 15,735.00
AP No. LOT 230 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK - - 1At'
INSPECTIONS Signature 71/2-/-..
D T_ GROUP TRo.T TYPE v ZONE
Soil e I� .. SUBCONTRACTOR PERMITS SUED
Gas _ DATE NUMBE1
Water
Rough Corn. Refrig. 0 Air Cond. 0 _ ',`'�>'�r"
Rough PlumbingHeatib �e 7 -k?E�e-L—rt/ /.��%F-i � t , S ? G— A,
Rough G'' `% " , O /—� ./ I-
�•
Miscellaneous � m /�_��
Prop. Swr. Line ❑ House Con. P�'St. Swr. ❑p!f i/ (f:e��+t- C::K-..'-� DEC 9 1963'11 ' Y•
rinkling
SpSystem - -
Construction Pole S
Underground 0 Power ❑ �,1I6
Rough Wiring per. 4,0 'h-7 S -SEP—Fris'4 $ 6 8
Trenches ,l /Forms9, y
y1' PX� Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce D Flannm-"n''
Sheathing alt :1�E3ar =' r c
Frame and Flashing :an 2 • 4� " r n,,,
Lathing — In 12.----Out L eQ 3 C51-•n1°°'
Plaster, brown coat _
Refrig. 0 Air Con. ❑ Final
7i//� �
Heating, Final .. . a
Plumbing Fixtures, Final AP r .a`ffer
Final Gas Test/51L' IS ,�f/
Electric Fixtures, Final / _�_�
Building, Final ,f1/' //� S ��
OCCUPANCY • ,
Form BU4-5M-3-63-5-B P HOLD FOR SPELIAt RCQUIItElM4LNTC
22279
COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED
P.O.BOX 317 COSTA MESA,CALIFORNIA 9 tem
For Applicant to Fill In Completely APPLICRWINOLibrawArr
TYPE OR PRINT //AJJ - CITl- ptign AAFsp
BUILDING 2 viol et],
t • / - f FS) U /Ce YS /Ay17�)77
ADDRESS 7 �J RECEIPT NO.
7,279
COSTA MESA. CALIFORNIA
��'`` 1 1 .`p1� [\^\�,�M '/RV_ RHC BY DAAj .RREIt EIIVE/q�� DATE ISSUED
OWNER S(.L! U.2L Y�XX S •% i'`7 JIM 1 1964
r 1(/_ 6.Z•
O 'cell BUILD NG /
AD RESS )I G V (/`•• f� ADDRESS
FIRE
CITY ' ' fir / / NO //a Win ZONE TYPEV GROUP,L. 4a3
ARCHITECT f + TEL.) /I APPROVED
OR ENG INEE' A ' .�. - - NO. d ♦ BY DATE
Lk
L tr"1 3 a ZONING
ADDRESS 3 Z� 1k6. a• 11 A _ .ori I�
�S ZOI�, NO.OR USE OF N W , 'III,,jr
('l /I an,
PLANS I BUILDIHO. �`1l •
CONTRACTOR /\n A.A. •`(. )/::act r�Q(9O LX I -
LEGAL S-1100 I A�I ) •/ S v
ADDRESS //-L I, `• Ls--p-,� s/ / DESCRIPTION C �"• v-
CITY . fi T // . . A.P.NO. f T./ ,; CI:3
NO?Jr/L.
TATE n n LIVID,
EL, l / /7 OTT:SOEAVE IDE a REAR PHANG SHALL BE LES THAN
LIC,NO. J ]Z `/`t�/}� NO. J/+ � FJ/� /
O l� / 0 I NOW ON LOT O
EAVES
( �•
SIZE NO.OF BLOCS. ALLOWED . (U.B.C.REQUIREMENT) 1
OF LOT .
YARDS APPROVED YARDS APPROVED
USE OF ( MAIN BUILDING ACCESSORY BUILDING +�
EXISTING BLDG. 11 A1``
/ (FROM C/L REET) Cr •
01,
SETBACK LINE FROM / Q FRONT /�/gI'FT. ( FT. `Y�
CENTER OF STREET REAR YARD C, lT
SIDE YARD I LEFT 0 I RIGHT 0 R.SIDE D FT. FT.
DESCRIPTION OF WORK L.SIDE /q/ FT. FT. VI
NEW XI ALTERATION ADDITION REAR (/ FT. FT. t.
•
DISTANCE BET. BET.MAIN& j
MAIN BLDQB, ACCESS.SLOGS.
REPAIR MOVING DEMOLISH f
OM1Y VAR.lC DATE LU
BUILDING^ �A c/ NO M "'T ES /�
SIZE Q[�/+ Y• ROOMS STORIES .L. C.U.P. APPROVED
EXTERIOR WAilf-�7�_ I ROOF • BPPRO' ,/L DATE /( a
COVERING y(.iA..C,Cl COVERING BY ill [ /'J - � a
U8 UI /ORK TOB ERFORMED -
/ L ^_ Q
• In/ •
u
9'/ /( SQ.FT. �/(1 420 o 0-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN DER VALUATION IS FOR THE T
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTAB HINO A PERMIT FEE ONLY, E re
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION0
BUILDING CONS UCTION. .✓, H IL
PERMIT FEE $ 5/ V V
SIGNATURE OF _'��/..//�f/�/I�1 ��J m
PERMITTEE • $/A•f 7.55.ff PLAN CHECK $ LY��Q c O
AUTHORIZED A O'/ / _',-,I/ i T
TOTAL FEE $ %t L�