HomeMy WebLinkAbout1789 ROGERS PL - Building Permits I
A pflpdkSTADDRESS: 1789 ROGERS PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 066662
OWNER'S NAME; BODENHOEFER, KENNETH R
as DRESS: 1789 ROGERS PL PERMIT NO: E 066662 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: V-5 PERMIT TYPE: ELE PURPOSE: REP
714 ) 642-1789
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT. JOB DESCRIPTION : INSTALL TWO BUTT SPLICES SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: KENNETH BODENHOEFER (714 )642-1789
ADDRESS: 1789 ROGERS PL COMMENTS : INSTALL "2"BUTT SPLICERS & INSULATE W/HIGH TEMP. HEAT SHRINK
C.M. CA 92627 * ****+P**aP*******+E*x**aE*** ******SE*****aP+r**+paP****+ESE+E************** ***********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code, and my license is in full force and effect.
CITY LIC.: STATE LIC.: CLASS: SETBACK S
Date Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-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(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 42539241 ZNE: REF NO:
' 'J Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
> 1.--
Dale'. APPlicant'. *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION; (This section need not be completed if the permit is for one hundred(5100)or less). D EVEL OP M E N T •S E;°R V I C E S REQU IR EMEN TS
I c ' 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
je to t^Wforl!kers'Compensation Laws of California. ZONING APPROVED BY
/o'e. `i'—�l y Signature: DATE:
NOTICE:If.after making this declaration,you should become subject to the Workers'C pensation provisions of the Labor BUILDING APPROVED BY : . - DATE:
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked.
.72
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:
(,$'�'L\ C DATE; Q`
which this permit isissued(Section 3097.Civ.C). *********************************!�.* 1E7E iE.1(.{E/f+.**********************4* * {_—
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I 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 22 . 00
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 five hundred dollars($500). ISSUE FEE 15 .00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 22 , 00 15.00 0 . 00 37 .00 37 . 00 .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
rptheepurpose of sszee)mn one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUBLDGDIVISION
PMT PLUMBING ELECTRICCOLLECTED :
IC 37 .00
SMIPO/TOT/SHORT: . 00
GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 37 . 00
❑ and Professions Code; The Contractors'Stale 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 ContractorsState License Law). l am aware **.{Eaf***4(.******.,*.x.************.*+!(.***qE*.********************.!(.****.*.****,x.*****,!(,.)(,*.****.![,
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
® I um exempt under Section:BP704 4 "RC-
or
.8P.C.or this reason: OWNER—BUILDER TYPE QTY DESCRIPTIO S C R I P T I O N
UNIT COST TOTAL COST
Date — V—/�V owner: 10-7,
ELE 2 MISC APPARATUS NOT LISTED REQ PERMIT 11 .00
I hereby certify that I am aware of and understand the requirements of California Health and Safety Code coons 25505,25533,and END OF FEES 22 . 00
534 and that or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Dale: Applicant:
I hereby 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 ofof this city to enter upon the above-mentioned
p/r/ofpeny for inspection lou/rposes, �C
a �4j` Signature:
river's License or SocialocSecurity#:
Applicant;Pink—Revenue;Goldenrod—Assessor
4 '
• GLdNSTRUCTION AND PLANNING POO' "�PA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1.j Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
2 3i' E.te-ctrical Condpii'Ufitity-Undrgrnd. 54. Forms
44 E ctrical Condtii,r<ilndrgrnd. 55. Electrical Bonding
51-Steel Reinforcknent 56. Rough Plumbing & Pressure Tesf- -
;�6.;Electrical UFER'6rnd. 57. APPROVAL TO COVER-GUNa'PE
is 1r Footings '1 i,' 58. Electrical Conduit-Undrgrnd.
:8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. •
-n
10. Structural Floor System 61. APPROVAL TO DECK
11: Pigperty Sewer Ling•,& House Connection 62. Backwash & Receptor-Final
12. sewer Cap 63. Heater & Vent-Final I
.L•
13. Roof Drains 64. Plumbing System - Final ,
14. Rough Plumbing 65. Electrical-Final I
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
I- 171
20. lough Factory Fireplace i t `.r 3 > k _APPROVALSC J.Perm_ it # -
CN,-r
21. uc_;,in Strilbture' ' i-•r- s'3 c -
.. .. .�<_ -, r •]O. lUadergrour. Hyc'•ro in
22. Ducts, Ventitating. - 1.-•: rr •77 1: i .71. Product Pilling l7t s 0 Oil
23. Gas Pioe-Roujh&'T,est r -;
<- q `•F'12. llndergrou`_id Flush-
24. .Root Framing:il `, 0 •-,E r• ") , .1:73.=Undergrnd.Storage"-Tank n Gas 0 Oir
_
25. Root Sheathing r ' - s 14.-Overhead Hydro-
26. T'Bar Ceiling (Struptural) & tyonocoat - IT; ' 75.•�Dry Chemical 3 - =
27.,FraLpeand Flashing` ", 76.` Dry Stand/40 ?_ . •
•:28. Lat n `
h) 9&siding:T..,. "41 . 77 - FIXED IXED SYSTEM:F'INAL
29. Insulation • ^• " :. I 1. r 78.;FIRE KIEV. FINAL : - at •
30. Drywall Nailing 0r I i' . iHEALTH DEPTkREQUIREMENT
X31. Plaster Beiswn.Coat 1, - 1 i 1. v ,T79.'FINAL INSPECT 14":r1i '.`; --1.;
I • ,�..
:'32. _Electrica l:Po+Ker Meyer-Final - x u i 1 l'i > r80.'FOOD CERT IFICATEs ISSUED J
33.-troarElectric' '' ` ,, ' -- C//2 yia '-'Notes -y _ .. • - - ii.,
.:.'34.,FinaT'Heating'& Air�onditioning__ _1- . _ i... _ - �.j
35. Final Gas-Pipet-fest •, y y I 't .- it y. `. .. > e, �. _ n •;
,36. or_Canopy 1;1 t, c 0 0 1 1. .
'_37. Final:Factory Fireplace• •, ! ;:i: '2 ;f r"i � ii� , - _
38. Fina1-Plumbing is7 ., l .. .. 1 IY - r - c
39. Water.Service-Final • - • - " ' . -
. • - i • i• ; a -
•.
r . c. •,
40. Gas Service-Final:_ ,.c„ __ • , , l r ,,,
41. Solar Domestic-Final '' •• - 'I ' ` <c•
.1 •. .
a.
42. •Backflow Preventer_ ` - _ - 1 I J -. - -. ,
43. Backflow Irrigation : - ` 0- - -
4 ;4. Landscape Irrigation System - . . - _ . ^ ,- • .
. _
A5. Sound Attenuation ' 4 t*' * ;n fn.
_ _
46. 'Handlcap,Regulatior�s '. . ,, .: S. '10 -
47. E;IN.l STRUCTURE & BUILDING - i II
r^ t r, , - x
46. FINAL PLANNING', , r•
49. Electric Release to Edison i ! -
50. Gas Release to Southern California,Gas Co i - _ _'.' :
51. CERTIFICATE OF OCCUPANCY . - -
No. Date
FILE
Randy Buck
77 Fair Dr.
754-5244
den- tame q
Lc/L•477'6e-S
I
Lo✓I-t7
AMIE
As pictured above,the radiant heating is embedded in the brown coat of the ceiling plaster. The roof c
V dept. deemed it necerssary to open the master bedroom ceiling. In so doing,they cut two conductors o
I replaced the missing buttonboard with 5/8 drywall,spliced the conductors together with 22-18 gaup
number 50.02886. The butt splices are enclosed with Heatrax high tempeerature-Kynar heat shrink to
manufactured by ICO-Rally corporation, Palo Alto, Ca.,telephone No. 41.5-856-9900.
The original radiant wiring is #E 25612 rated at 90 degrees centigrade.I checked with Briggs electric u
1963.when the house was built.He concurred with my repairs as being consistant with what they woi
may call Bob Briggs-Briggs Electric at 714-863-9901.
This is in reference to Costa Mesa permit #E066662 at 1789 Rogers Place. Please respond at your-earl!
so that I can get on with this work.
Kenneth R.BodenhoJer
714-642-1789
FILE •
•
PflOJECT A08RESS: 1789 ROGERS 'PL 0NIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067012
•OWNER'S NAME: BODENHOEFER, KENNETH R
ADDRESS: 1789 ROGERS PL PERMIT NO; B 067012 PLAN CHECK NO: N GOVT: N SUPP ; N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT
• 714 ) 642-1789
ARC"/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/O SHAKES, RESHEATH W/1 /2"CDX,APPLY COMP SQ FT: 7, 000
ADDRESS: UNIT:
CLAIM VALUE: 7, 000 . 00 CALC—VALUE; 7, 000 . 00 GROUP OCC : R-3 /M-1
PERMITTEE: TOP QUALITY ROOFING ( 714 ) 858-9194
ADDRESS: 27758 SANTA MARGARITA PKWY 273 COMMENTS ; SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC
+6�E�E
MISSION VIEJO CA 92694 *st***k6*iE•dr+E+E+t+r>,t***xie****** ********a6+Ex*****ic****x*****dr*****f6******ar+t*dE******
LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section ZO N I N G R EQU IR EMENTS
70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect.
SETH ACK S
CITY LIC.: 3 6 STATE LIC.: 6171 7:i_ CLASmSA —39 /
al 5" L 4 Signamr••_ /"l • (/� �^�/ MAIN BUILDING ACCESSORY BUILDING
WORKERS'C PENS TION DECLARATION: I hereb•affirm at I have a cenilicale of consent t self Ins a or a tenlhcate ol47orkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy mereol .ecti,• 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ; PROV; PARCEL ; 42539241 ZNE; REF NO:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> , .
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This ection need not be completed if the permit is for one hundred(8100)or less), DEVELOPMENT SERVICES R E U I R E M E N 'T S
I certify that in the nce of the work for which this permit issued.I shall not q"pl�oy any person in any ner so as to become SMOKE DE1gECT0 R
ct to the Vj(or rs'C mpensation Laws of California. I_ /A/J p ZONING APPROVED BY , t 'IYAT E
k. the
4-1/ Signature: a vel ' ' � REGUIRE�
�No r, n.aver r eking this with you snou a subject to the Workers'Cpmpem sign pr. Bions of t . .or BUILDING •
APPROVED B Y DATE:
Code.you must forthwith comply with such provisi:: 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 APPLICATION ISSUED B Y: /� �' DATE: 2
which this permit is issued(Section 3097.Civ.C). ************************************* * *1F iE************************** T.:
which
LENDER: *********************************************************************** *******
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Slate 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 90 . 00 . 70
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 Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 90 . 70 0 . 0 0 0 . 00 90 . 70 90 . 70 . 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. II,however the building or
pesold
eninone year ofcompletion.the owner wnhave mebuwengfproving he/she did not build orimprove REVENUEDIVISION
ELECTRICOMECHANFIRESMIP/TOT
DIC 90 . 70
OVER/SHORT:
forthe puposeolsale). GRADING PLAN—CHECK
I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 90 . 00 . 70
❑ 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 ***********************************************************************,*.****,***
that drool of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: •
TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner' SFR 7000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 000 . 00
I do hereby cenify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
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 lot construction or modification from the Air Ouality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this apPlicahpn and state that the above information is correct.I agree to comply with all city and county
ordinances and stale laws relating to budding construction and reby authorize representatives at this citytO enter upon the above-mentioned 01 00159824-00159825 TOOT 90.70
ty for insp don/.trrposes. DATE: 05/02/94 TIME: 03:33
Date: 5/�i 7 Signature' • e
river's License m Social Security f.:
anary—Applicant;Pink—Revenue;Goldenrod—Assessor
.4, CONSTRUCTION AND PLANNING POOL . PA I( _
APPROVALS Permits
Date Inspector APPROVALS Permit ;'% 1 Date Inspector
°t 1. Temporary Electrical Service or Pole 52. Poo; & Equipment Locat.on
2. So . Pipe•U-orgmd. ' • _ 53. Sre-- Reinforcement _
3. E'. Icu-cal Conduit Utility-Ugdrgrnd. 54. Fr ns
4. E t!ctipa, CnnduT-Undrgrnd 55. Electrical Bnnd-ng
5. St_ei Reinforcement _ __-- 56. Rough Plumbing & Pressure Test I,
S. E. -. Ui ER C--.d. 57. APPROVAL TO COVER GUNITE
I - - - - - --+- - i
1 7. Footings 56. Electrical Cordu;t-Undrgrrd. • _ I
Fount:.;,]n - :; , 59. Gm P pe, ❑ Undrgrrrl . est H.
I6. ti..tar P pe-Undrgrr.d. ` SO. 8ac!rc✓ash Lines, P•Trgp, T. Urvrnrro
10. S•uctu'a' Fluor System •I 131 . APPROVAL TO DECK
I
11. Preperry Sever Line & House Connection I 62. Back- ash & P.eceptor-Firal , 1
12. Sewer CaP 63. Heater & Vent-Final f`
r- - - -'r-- - -1
13. Pito' Drt-ns 61. Plumping System • Fn.l �--
1 -4. f+nuen Plumbing - �ES. Electrical-Final j
-I-'r--
.5 P- :r-".c'rG11-Coro u�t�- _ t___,
. -. Gu. Sol,;- Sistem•t-mal I I
16. fin .oh Electric Wiring { G7. F acing & Access Aocrosal -
it Rccgh :'rung S.yn1 - ? gg. APPROVED FOR PLASTERING
18, Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEMS f- 'NAL I i'
19. RI uttdF. Heating & Air Condit on.nq FIRE DEPT. REGUIHENEN i
20. Rough Factory Fireplace APPROVALS: Permit ;k
I - -- ---1_
--- -- -
21 C. r S..r_cture ( +
•: 70. �cdag-o..rC Hydro
22. D ...Ls, Ventilating I 71. Product Piping G.i, H Ori I I I
-__ I - -_-__ - -_ - -__I -^
I 23. G..s rip_'-Ro;.gh & Test 72. U- ce•g'o..^ci F ,;;'•
I
- _ qt
_ 1 73. 1Jndernrnd.Storage Tank L G.,, 0;' I
o5 Root S"'athxtg 5 7-1 LI 6Wbt 74 C:ennead Hyu,o -{'
(Structural) & Monocoet 75. Dry Chemical I ._L26. TB.irGd'lIn9
2 F ^e • I_
atBashing I 7E. D•-, 5ta^d;.n:e --_ --- - -
n6. ::.th.r & Siring ---- I - - 77. FIXED SV STr_i:c Ft^;AL - -- I
I_~-- --- - -I
22. . :., ct.r.,. _I 78. .'-IRE PREV. FI>:P.'
I 33. D %maii _.n:Lng -- _ _- + HEALTH DEPT REOUiRE E2F- '
31. P.r¢r o,o.vn Coat 1 79. FI' sL INSPECTI'H' --- --- . .-
4.
I 32. Elrctnr.:• Poyser Meter Final ! PO 7000 CERTIFICA1 L. IS;UFD-_ I
_1-- _ L ,
33. Frog; S ctuc !I Nutes:
34. F, 4,; Hc;,ng& Air Conditiorri,g
, 35. F - Gas Papa-Test - - --1- -�
-- --- ---- _ - --- - - - ----
.I _. __ � - �
37. F Factory' Fireoiace r..,t j -
I ,..-0 , -, - -- --
38. F ni' P t'mbi ng ___ __ . _-_._ _ _._- _ __.
_ 1
39. Water Service-Final ,•.--) --_- ^.- _---_-
40. Gas Sers ce Final > ---
I_ _. - ----- -- - 1
I41. Solar Domestic-Final 1---117.- --• l
.,2. 3. Kf
c !o-.: Preventer 1--c.• '
'ii3. P'd;flo.: Irrigation
_�
44. I a^7supe Irngat:Cr. System f .�-
45. Sound Attenuation
4E. F'ar.dicap Regulations
'I 47. FINAL STRUCTURE & BUILDING s.bp.qy t ccit7 - ---- - _�
43 FiNAL PLANNING _t -
I
4+9. ctodric Release to Edison
1-5 Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY I
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
MIT NO. TRACT NO. LOT NO. UNIT N _
CITY OF COSTA MESA CONSTRUCTION PERMIT ('�_ A.P.# x•12 Zone
Project Address /717 ,PDP' RS PAAee - � 3$�`� �� Tar. I�� S Main Building:��� Accessory Building:
Applicant's Mailing Address .S Rene TYPE OF CONSTRUCTION U NEW Li ADD kt ALTERATION LI REPAIR
/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front O
Owner's Name KEN r�O.D 'yO 7Z Phone (ar/2 nil
ESCRIPTIO OF WORK/USE OF�LDG. ! L' E'utT SP/J- I B 'Rear N
Address -S/'Fm t A I
�'�—II -}. T� —l rn''I �- +n4h... I C Right N
Arch/Eng. License No. TYPE OF PERMIT L GRADING LJ FOUNDATION LJ STRUCTURAL K - G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING El MECHANICAL S • Left R
Contractor's Name e-Sertne Ir9/8 Phone ❑ OTHER Ping. Ref.# Parking Req./Provided E
Address(mailing) PROJECT DESCRIPTION SQ. FT. N OCCUPANCY_r R. p r �P �K /� S M
PlanningNotes: �pl �o, T
CONSTRUCTION TYPE `� VALUATION$ ('yQ
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions Of Charter 9 (commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in f for e and effec ' ELECTRICAL FEES
License lass *Cr T=
='1�atr_iIyJCw PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
D. - .. r s> m.��_._. _
WORKERS' COMPENSATION DECLARATION
Pole Sub. 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate• Bar Sink Showers
Workers' Compensation insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
00, Lab. C.) .
Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
8 Certified copy Is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection jr,G // !�
Date Applicant Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors — Motors 00-1 HP �1 h-8 7 S'D
(This section need not be completed if the permit Is for one hundred ($100)or F.A.U. Inc.Solar 09-15 HP❑16-15+
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is Issued, IFixtures Microwave
shall not employ any person In any manner so as be ome subject to the Drinking Fountains Solar Tank
workers' or*}Pen Ion Laws of CaliforDea. Device Boxes ,.
Date e Signature f[./� • Floor Drains Swimming Pool w/Spa Pole Light
NOTIC 1 after making this declarat on,you should beco subject to the e Outlets Ran
Workers' Compensation provisions of the Labor Code, yo must forthwith Floor Sinks Urinal g
comply with such provisions or this permit shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY / DQ Switches Sign
Gas Service Outlets Water Closet
I hereby work that there is t is permit ssue (Section
for the performance C.)
of the work for whicp�_athis permit is issued (section 3097 Civ. C.) Interceptors Wat¢r H¢at¢r Garbage Disposal Standing Sections '--
Lender's
Lender's Name W/'/-
•
Lender's Address Kitchen Sink Water Service ' .Generator ❑O-5 KW❑5.15 KW Trash Compactor •t r-
OWNER BUILDER DECLARATION — e
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
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
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 • Reinspection Fee $15 Issue Fee 4t 00
'refrom and the basis for the alleged exemption. Any violation of Section
11.5 by any applicant for a permit subjects the applicant to a civil
.laity of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
L] I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered — Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By AN .e Date
License Law does not apply to an owner of a property who builds or improves 1 i�/-l�.0..� e 6
thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 Application Issued By _ iL _ Dat
employees, provided that such Improvements are not Intended or offered for Boilerl
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground !, SUM ARV a F F'
rove for the purpose of sale). BUILDING PERMIT $ SMIP $
X-1, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System
tractors to construct the project (Section 7044,Business and Professions Code: PLAN CHECK $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑O- 00,000 BTU 0100,000 BTU PLUMBING $ — . O0 ISSUANCE $
builds or Improves thereon.and who contracts for such oroiects with a con- , ENERGY P.C. $
tractor(s1 license pursuant to tree Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration PLAN CHECK 25% $
proof off their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ �• GRADING $
0 1 am exempt under Section _ B.& P.C.for this reason Firepl/Fact.BIt. ICBG 4k Fire Dampers • MICROFILM $
PLAN CHECK 50% $
Date owner - Heating System & Ducting Registers MECHANICAL $ 35
V •SO
hereby certify that I have read this application and state that the above 00-100 000 BTU ❑100,000 BT - TOTAL FEE $
Information is correct. I agree to comply with all City and county ordinances PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city • - ter pon the above-mentioned property for
inspection �,,.poses ` 6$
Signature ) r_ I Date F9'f1
Reinspection Fee $15 Issue Fee $ 3 Cl GDG3334ia—[1i 3Z4Y97 — 1 _ _
Drivers' License or 55# . _
p DATE: :a/07/7 jLjti; �',J I
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor
s
CONSTRUCTION AND PLANNING POOI PA
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
dj;Electrical Conduit Utility-Undrgrnd. 54. Forms
4/Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5: Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings / 58. Electrical Conduit-Undrgrnd.
8., Foundation I 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 ! " I 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
.i6. Rough Electric Wiring
67. Fencing & Access Approval
1%. Rough Wiring Sign 68. APPROVED FOR PLASTERING
8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 12./C1 frpi 611-.
1.d.
-
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating I r 71. Product Piping 0 Gas 0 Oil
•23. Gas Pipe-Rough &Test • 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 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 Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall;Nailing HEALTH DEPT. REQUIREMENT
31. Plaster drown Coat 79. FINAL INSPECTION
,32. Electrical Power Meter-Final 80! FOOD CERTIFICATE ISSUED
33. Final Electric Nates: /// �\I� > p
34. Final Heating & Air Conditioning ®/C/c7 < tL a /•calf/-
35. Final Gas Pipe-Test �"/ I Y vi
36. Hood or Canopy
37. Final Factory Fireplace
'38. Final Plumbing
39. Water Service-Final •. ,
40. Gas Service-Final ' •
41. Solar Domestic-Final I,
42. Backflow Preventer. �- I
43. Backf low Irrigation
44. Landscape Irrigation System -
45. Sound Attenuation / '
46. Handicap'Regulations r,
47. FINAL STRUCTURE & BUILDING t
48. Special Requirements Completed
49. Electric Release to Edison - •
i
50. Gas Release to Southern California Gas Co /- i /' , '-
51. CERTIFICATE OF OCCUPANCY 1- '1
No. Date
t - "r
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. x 9-SSW
PERMIT NO. T ACT NO. L T O UNIT NO.
CITY oF,CbsT/� �O T, CTPION PERMIT .�3� a� � 7� � ?) �• . A•P.# `{�S=gq2 — LI zone jzZ
Project Address �f'� f.f�)NJ S Main Building: Accessory Building:
Applicant's Mailing Address 17194 rS TYPE OF CONSTRUCTION EW U ADD U ALTERATION U REPAIR E . Front Z
y / r/o !� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ - • - T O
Owners Namel n.al�l �n Phone 6442 DESCRIPTION OF WORK/USE OF BLDG. IA Rear j7f N
Address .041-...b-2-tr. aft-21-17g Vdr f0TZ/O Cf let C Right S N
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING 1_1 FOUNDATION ❑ STRUCTURAL J G
CI TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $- Left q
j44J1e.4
Address "�I R
Contractor's Namp �/'9h's fs (-9N Phone ❑ OTHER .0 Ping. Ref.# Parking Req./Provided E
PROJECT DESCRIPTION SO. FT. 19.o OCCUPANCY Q
�• Planning Notes: ®G 'I'D [OW'r
Address(mailing) CONSTRUCTION TYPE ?/ -IJ VALUATION $ (0� 1t' M
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION L ^ ,/J7 S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Re ma rks:SM0 ss ,C 1 /_ Ors a-crc �S f p J 1 (JC
with section 7000) of Division 3 of the Business and Professions Code, and sss"'��� JJJ���� C
my license is In full force and effect.
ELECTRICAL FEES
License Class inse o. eyDw�Qr
•
Date 6.-
PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION
Bar Sink Showers Construction Pole Sub.
❑ 50+ KW
I hereby affirm that I have a certificate of consent to self-Insure or a certificate
• Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
00, Lab. C.)
policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant Fan Motors 00-1 HP ❑1%-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100)or Dishwasher • Solar Piping F.A.U. Inc.Solar 09-15 HP ❑16-15+ +
less). /
I certify that in the performance of the work for which this permit is Issued I Solar Tank Fixtures Microwave I
shall not employ any person in any manner so as to becomesubject to the Drinking Fountains —
Workers' C pe sa on Laws of Calif Orn'
` pay 1g. Device Boxes
Date B l L� Signature /t-� Floor Drains Swimming Pool w/Spa Pole Light - ,�
NOTICE:If,after making this declaration, you should become sub' t to the - e Outlets Ran
Workers' Compensation provisions of the Labor Code, you mus Ortnwith Floor Sinks . Urinal 9
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service • Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance Garbage Disposal of the work for wi this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9 P Standing Sections
Lender's Name H
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05.15 KW Trash Compactor
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
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
-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 Reinspection Fee $15 Issue Fee $ 3
-refrom and the basis for the alleged exemption. Any violation of Section
11.5 by any applicant for a permit subjects the applicant to a civil
.laity of not more than five hundred dollars($500). 3 DEVELOPMENT SERVICES REQUIREMENTS
''LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ Zoning Approved By (Q Date L7�7
compensation, will do the work,and the structure is not Intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By
License Law does not apply to an owner of a property who builds or improves Date `_
`"
thereon, and who does such work himself/herself or through his or her own Hood or Type 0 Application Issued By Date r2 e_�
f
employees, provided that such improvements are not intended or offered for Boiler
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
gee� L ,
for the purpose of sale). BUILDING PERMIT $ _��'Da SMIP $ . V�s.�
, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System _ PLAN CHECK $ 3 S- �� PERMIT
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. 00.100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $'
builds or improves thereon. and who contracts for such oroiects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof o// their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers
PLAN CHECK 50% $ MICROFILM $ 4 /
Date owner . _ is. .on ._ Heating System& Ducting Registers MECHANICAL $ S! (�0
I hereb certify that I have read this application and '• that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $
information is correct. I agree to comply with all city an. county ordinances PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of tq i city t en r upon the above-mentioned property for
inspection pupyqryppss����'vs� /
Si nature l"[/\ Date e -2„--el
r - ��
Drivers' License or SS#
-Applicant; Pink - Accounting; Goldenrod - Assessor
1P001 POOI PA
} AP InIOVALS 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
57. APPROVAL TO COVER-GUNITE
6. Electrical UFEfi Grnd. ^ :'
77 Footings I ' 58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd.,Test
t ..
9. Water Pipe-Undrgrnd. .y 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System •I 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 ill 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace :1 APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilatin
9 1.,1 •} r 71. Product Piping 0 Gas 0 Oil
23?Gas Pipe-Rough &TEst .4.1 C 72. Underground Flush
24. Roof Framing r� t 73. Undergrnd.Storage Tank O Gas 0 Oil
25. Roof Sheathing{,' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) &,Nlonocoat 75. Dry Chemical
27. Frame and Flashingr. 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing t( HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat tU ^. 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
. 1'.Y
W4•0
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
3/436. Hood or Canopy
37. Final'Factory Fireplace
'38. Final Plumbing 1
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
.
42. Backf low Preventer '
43. Backflow Irrigation': ?
44. Landscape Irrigation System
45. Sound Attenuation,
46. Handicap Regulations `)f , )
47. FINAL STRUCTURE & BUILDING pleligGI /vy. r
48. Special Requirements Completed I
49. Electric Release to Edison ' $,
I
.50. Gas Release to Southern California Gas Co • '7-
e 51. CERTIFICATE OF OCCUPANCY .-�-'•� •�
No. . Date • -
19787 FE RECEIVED
COSTA'MESA BUILDING-SAFETY DEPARTMENT JUN 7 1963
P.O.BOX 317 COSTA MESA,CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely APPLICATIOt6 FWRJPEE198TA MESA
BUILDING
BUILDINGW'P.E047
T (Rt For Office Use Only
ADDRESS RECEIPT NO. gE9rrr ct
COSTA MESA, CALIFORNIA / Y C�/
�/ RECEIVED ST DATER CEIIV(� `IBSUBD��
OWNER d ,. vvgr P .a.), 6-Aidac-FF.Q Jr "--7<3-7:"'
--� ( / �� /�C�
BUILDING
MAIL �e'� �j ADDRESS
ADDRESS (- Lam• kiO r V 7FIRE
/ n
TEL. y ZONE TYPE (7 GROUP �)/- �T'
cITYre.cTA /1lse4/. No.S.Y8-iY.7p (,/J
TECT �r APPROVED /
OAR ENGINEER EER KCAO} 57RAsch/L No6`>1V'YVY BY �i �, _® IN DATE
ONING „kits
REss i irE fie sr. Cns1A OA �-`-( rl
:NitNo.oP� I ueE or NEYA.7 Vv. �+ le •
1 Pune BUILDING 1 ��
CONTRACTOR (jL41/JEr.. D ,1/DT+ ''}-` L ^ _,
Q DESCRIPTION�/ r J . ����J ) �^
ADDRESS SCC BAG+t_� /'j 1 Cg-I .2
A.P.NO.0— J63_45 SuSD . $49K
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. ---. SO-TO SIDE @ REAR P.L
LIC.NO. NO.
EAVES
SIZE OT &Q I ZC!Ay' y I NO.OF BLOTS, /� ALLOWED
NOW ON LOT {/ B.(U.S.C.REQUIREMENT)
OF L
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. (FROM C/L STREET)
CENTER
SETBACK OF carveSTREEPROM T .J /� REAR YARD,S' 06".# FRONT S/FT. FT.
/'�
SIDE YARD I LEFT 3 G I I RIGHT f 0 I R.SIDE I OFT. FT.
DESCRIPTION OF WORK L.SIDE /`/4 FT. I Fr.
Nr' - X ALTERATION _ ADDITION REAR �1 FT. 10 FT-
DISTANCE BET. BET.MAIN a
RtrA1R MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS.
BUILDING37 M4t9 0 es.
NO.OF p VAR.S DATE
SIZE .23'K 34# ROOMS p STORIES Z• C.U.P..}l i APPROVED
EXTERIOR WALLROOF /,�^ APPRO G -7-C'
COVERING I COVERING c 414 C BY DATE
USE OF BUILDING AND WORK TO BE PERFORMED ((���� .At� � en J
It ES I P c iu C_i-' e /St 77-44-A4r-,) \:B�vo l c- �6 �t4Atc u 7 11)
6.•;.eIt9tc t 33``%33``.. ✓a,Ain
X -PcR 5-6.
1. 7r .Cs- et,-e . p G/ 1
/IAC-F7+SQ.FT. pn!4 5,- / n- �N-lo
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AllOUNT SHOWN UNDER VALUATION IS POR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. f O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /c
BUILDING CONSTRUCTION. �/p ., Q..Q G
nn '�/L`. PERMIT FEE $/0 . N
SIGNATURE OF �J R� // (�q `/ ,t
PERM ITTEPnL-f �S,• (..1/s��+i/fA��1A_ �. 7�
/J' $ '� PLAN CHECK $ �• a
AUTHORIZED AGENT V / O� P%jo
-.7,-
£
d S (IP, TOTAL FEE $ lv�1
OWNER BODENHOEFER, Kenneth R. DATE 6-19-63
JOB ADDRESS 1789 Rogers Pl. BUILDING PERMIT NO. 19787
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 24,658.00
AP No. 117-163-45 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res.w/att.Rar.,
INSPECTIONS S'gnature �A E GROUP MrTYPE V ZONE A & P
° �,,�y1 PERMITS ISSUED
V iln �trr_� .� a ��' JL'763 SUBCONTRACTOR DATE NUMBER 3r•
wate�ff'i�r-r-sa t-� 'i 70 43
Rough Com. Refrig. 0 Air Cond. 0ir
Rough Heating /'faz. 16 C3 �p ��,
Rough Plumbing /Vb?S —7-G3 0e ri6.� 7/P/63 3 a'2-/ —
Miscellaneous /) '-U
Prop. S . Line 21/House Con uyst. Swr. ❑ 7-3G-C7 f����„/ ^r� . 7/;5 3 .3._s-5e) 6 -
Sprinkling'System
/
Construction Pole
Underground 0 Power
Rough Wiring 67/11Th ¶ 2 C3
,sC" f�z�-9, \/___J p— -c 3 a o i< Y/
--
Trenches Forms 0 Steel Reinf. 0 M 7- CFloor System HBond
Beam 0 Steel Reinforce 0
Sheathing Aka 4-74'63
Frame and Flashing t?
Lathing— In ❑ Out 0 Wit -a —AnPlaster, brown coat .0".4.4.,› 4/2-7b it ail ;B
Refrig. 0 Air Con. 0 Final -
I ig, Final tkr-C /2,4-C'Z
Pi,...,bing Fixtures, Final I ////343
Final Gas Test /541. 0 _ ii-/7-6.?
I
Electric Fixtures, Final (¢r?--C \
Building, Final Mf.S /1.243
OCCUPANCY
Form SU4-5M-3-83-5-B P 1 07A7`.•.