HomeMy WebLinkAbout752 SCOTT PL - Building Permits City of Costa Mesa 2005 C
Building Safety Department CERTIFICATE OF OCCUPANCY N?
P. 0. Box 317
Costa Mesa, California
The Building located at 752 Scott Place, A, B Cs C
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for Group II 8a J Occupancy.
Use of Building Triplex Residence _
Legal Description A. P. jI116-101-11
(See reverse side for Metes and Bounds)
Building Permit No. 21306 Electrical Permit No. 22172 Plumbing Permit No. 42380
floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments Three (3) and/or guest rooms
ISSUED TO: BuildingiO�fficial
NEIL MONTGOMERY
OMflW by 'ng2/ !etc"--/�l/i2,-i—s--""
Date June 11. 1964
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bu3e-1M-11-e3—s-a P
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
-��.,I2-2- A.P.
# Zone
Project Address 752 Scot* Pl Place - Garage .7ti� • I (�'f' S Main Building: Accessory Building:
Applicants ;^ling Address 324 S. Far]hant TYPE OF CONSTRUCTION U NEW Li ADD ® ALTERATION LI REPAIR
FSC X R al t0 N�I �tt-1'tF- TM.1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front 0
Owner's'Vame .._Re75(�-2505 DESCRIPTION OF WORK/USE OF BLDG. Tear off and re-roof i B Rear N
Address 18022 Cans Suite 202 R Tnrine 92714 Ca rage nsinr,A Rni1t-lig Asrlhalt Rry9t/gran11ar siirfac-2,/fra& Right N
Arch/Eng. License No. TYPE OF PERMIT _ GRADING FOUNDATION LJ STRUCTURAL K G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 5 Left R
Contractor's NamPF.I1frit RY1F MRi17t'PfLgvg Phone 997—d938 ❑ OTHER �,^ I Ping. Ref.# Parking Req./Provided E
PROJECT DESCRIPTION SQ. FT. 800 OCCUPANCY M J` PlanningNotes: Q
Address(mailing) 324 So Farl ham, Oranges, CA 97b69 CONSTRUCTION TYPE Re-roof117QIs1f,JVALUATION$ 1 ,000 00 M
City License No. 039965 ZONE GRADING CU.YDS. ACRES
S.
LICENSED CONTRACTOR DECLARATION
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 full force and effect. ELECTRICAL FEES
License Class C-39—Al/cense No. 465344 - -
Date 6-28-89 Signature fP.Gi� PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATION Construction Pole Sub. 0 50+ KW
•
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter Dug to 100 amps
3800, Lab. �,y1,785 Dishwasher Meter Clover 100 arri s
Policy No. / Company StateFund Backflow Irrigation Sewer Cap p
❑ Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Certified copy is filed with the city Bo'ding Division. Bathtubs Sewer Connection
•
Date 6 27 89 Applicant vJ/"r+wt!—br rdle 2 Fan Motors❑0-1 HP ❑1'6-8
EXEMPTION FROM WORKERS'CO ENSATION 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 016-15+
less).
I certify that in the performance of the work for which this permit is issued I Fixtures
shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE: If,after making this declaration,yob should become subject to the Outlets Range
es, Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
_ comply with such provisions or this permit shall be deemed revoked. Switches
(re' CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign
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. C.) Interceptors Water Heater Garbage Disposal Standing Sections
- Lender's Name
( Lender's Address Kitchen Sink Water Service J Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
r. I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business anti 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 requites 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 exemptReinspection Fee $15 Issue Fee $ 3
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS:
Ll I, as owner of the property or my employees with wages as their sole Reinspection Fee i $15 Issue Fee Zoning Approved By Date
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 Date
License Law does not apply to an owner of a property who builds or improves ® _ _._ — / O.e
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Date L'7 l.O—08
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II ❑ SUMMAIAVF FEES
diction, the owner will have the burden Of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). - BUILDING PERMIT $ 2 $MIP $ h\
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - PLAN CHECK
tractors to construct the project (Section 7044,Business and Professions Code: . $ PERMIT
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 oro facts with a con-
ENERGY P.C. $
tractors) (,cense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration I PLAN CHECK 25% $
proof of theireirWorker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers • MICROFILM $
PLAN CHECK 50% $ _
Date owner Heating System&Ducting Registers MECHANICAL $ TOTAL FEE $ 21 ��
I hereby cert(ay that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL PLAN CHECK 25%
information is correct. I agree to comply with all city and county ordinances $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for
Inspection purposes. jj��
Signature ,/�7r�',',,
) Reinspection Fee $15 Issue Fee - $ 3 DATE: UM/C.9 TIt Z: :I:63
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
I.
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Solt Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
•
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test
•
6. Electrical UFER Grnd. i 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
•
8. Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
187 Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
26. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 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 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ///
33. Final Electric Notes: KZ Air S/'h'C-- /r�O-e/4 9/27/l�
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System •
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 4� dy
48. Special Requirements Completed /7 /
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No- Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. TRACT NO. LOT NO. UNIT NO.
\OF
COSTA MESA CONSTRUCTION PERMIT A.P.vW son¢752 Scott Place S Main Building: Accessory Building:ct Address -
U ADD ALTERATION U REPAIRTYPE OF CONSTRUCTION U NEW
-antSalling Address 324 S. Earlham E Z
's Name 1 � L, Trr' -Phone 756-7405 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front 0
DESCRIPTION OF WORK/USE OF BLDG. Tear off & re-roof I B Rear N
cac
Address 18022 Coaanc Suite 202 R , Trvine 92714 3-Tab Fiber Glass Asphalt Shingles.
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL C Right G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left R
Contractor's Name E11Jott W0f Phone 997-4938 ❑ OTHER n_ $
I Ping. Ref.#` Parking Req./Provided E
Address(mailing) 324 So. Farlham, Orange, CA 92669 PROJECT DESCRIPTION SQ. FT. 1900 OCCUPANCY R Planning Notes: M
City License No. 039965 CONSTRUCTION TYPE re—roof V h) VALUATION$ 2,000.00
T
ZONE GRADING CU.YDS. ACRES $-
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing ng Remarks: ' Vail Cll `�
with section 7000) of Division 3 of the Business and Professions Code,and II ^^l_ chatJslh'-`-i.--^('L�- et a
my license is in full force and effect. e ELECTRICAL FEES
License Class e-39 License No.465344 \lH l 1'
Date 6-98-89 Signature At f1.4T� PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
'WORKERS' COMPENSATION D LARATION Construction Pole Sub. 0 50+KW
— I hereby affirm that I have a Certificate of Consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Cup to 100 amps
Polis Lab. C.) Dishwasher Meter Dover 100 amps
Policy No 5717R5 Company State Fund Backflow Irrigation Sewer Cap
R.Certified copy is hereby turnished. Dryers ❑Gas ❑Electric Sub Panel
L9-Certified copy is filed with the city Buil Ing Division. Bathtubs Sewer Connection
Date 6-28-89 Applicant �. yre ra,,,, b Fan Motors❑0.1 HP ❑L'h-S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred($100)or F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is issued, I Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
rNOTICE:If,after making this declaration, you should become subject to the Outlets Range
V Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal g
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
of the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections
I Lender's Name Interceptors Water Heater
�' Ler'tler's Address • Kitchen Sink Water Service Generator ❑0.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that 1 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
anystructure, 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
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REOUIREMENTS:
1J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zoning Approved By Date
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 A Date
License Law does not apply to an owner of a property who builds or improves _ _ YA /_ ^�rr; �./t
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ Application Issued By 7 �'T Date 10 CJ V
employees, provided that such improvements are not intended or offered for
sale. It, however, the building or Improvement Is sold within one year of com- Canopy Type II 0 SUMMA V OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground - O
prove for the purpose of sale). - BUILDING PERMIT $ � SMIP $
LJ I, as owner of the property, am exclusively Contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ 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 $ IS$UA NCE $
builds or improves thereon. and who contracts for such oroiects with a con- '— ENEflGV P.C. $
tractor(s) license pursuant to the Contractor's License Law). 1 am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $
proof o// their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO dk Fire Dampers MICROFILM $
HeatingSystem PLAN CHECK 50% $
Date Owner y em& Ducting Registers MECHANICAL
$ TOTAL FEE $I herebymacertifysthat I have read this application and state that the aboves ❑0.100,000 BTU 0100,000BT
information is correct. I agree tocomply construction,
ost with all dy and countyh rite repre-
sentatives
PLAN CHECK 25% $
and state laws relating it tobuilding Constr utti b,andhereby authorize yfor
sentatives of this city to enter upon the above-mentioned property for
Inspection purposes. g 2 7 '
Data 01 1003653..-00333533 -r_' T ,°,
Signature Reinspection Fee $15 Issue Fee $ 3 0�ilt: 116!23/89 TIitE: 11:.7
Drivers' Li erase or 55 7F
0865-46,rev. 5/80 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
-
. .T . .. ..
, I
NRUCTION AND PLANNING POOL& SPA
Date Inspector Date Inspector
VALS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.• 53. Steel Reinforcement ••
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE
7. Footings •
58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
•
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
•
12. Sewer Cap 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16: Rough Electric Wiring 67. Fencing & Access Approval
11. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . , APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 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 I 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:,4jay- S??.Z( � ;0;
34. Final Heating &Air Conditioning '�
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound .Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 0:4
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
•
51. CERTIFICATE OF OCCUPANCY •
No. Date
- Z00.6-
(OWNER MONTGOMERY, NEIL & JANET DATE JAN 2 1 1954
(OWNER
ADDRESS 352 Scott Place, A, B & C BUILDING PERMIT NO. 21306
\{ GENERAL CONTRACTOR Atlas Builders VALUE $ 29,159.00
AP No1.16-101-11 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Triplex Res.
INSPECTIONS _ Signature DATE GROUP 'H&J TYPE - H�T� ZONE R' 3
Soil q. /- 371'-L PERMITS ISSUED
Gas 3'�/�il/ SUBCONTRACTOR DATE NUMBER
Water de / -.,,r-64` x„ ./. .-2±5_,_
_.
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating ! 33-6-9' eC 't C@ l:e 'a-, I-ld-, P QCT —
Rough Plumbing ,1--$ '313-LL .- -.4---- C-,.d i a 3-cje .e, 3 /a o (3)
Miscellaneous
Prop. Swr. Line : House Con. if, t. Swr. 0il.-17‘-s -21-,7-2.es RteeiQn"tz 'Ft! t•_alllr+-1 _I. 1 5n
Sprinkling System f•6 4
Construction Pole / ‘,11°1
Underground 0 Power 0
Rough Wiring Sklit 7 q_(l•P Cl l k P 14 !c l'G9-[ ( c"4.1-1"-e-..
Frenches 0 Forms 0 Steel Reinf. 0
V
Floor System 11 !
fjL V `T
'.•x , iv -
Bond Beam 0 Steel Reinforce 0 ,_\li 4
Sheathing Ri¢(ry 3-2-V/ I/UO ! ✓ +-•
Frame and Flashing 1,/�ryx P 3 6, I LI' r/
•
Lathing — In,� Out k(1 �� ��ff�- V26,/,y lir
Plaster, brown coat 'r err Sq-1-2/91 _ r¢�
'Refrig. 0 Air Con. 0 Final /
Heating, Final
Plumbing Fixtures, Final ,S s 2c'—
Final Gas Testa--..; 6 y�y
Electric Fixtures, Fin _ S-27
Building, Final
I
OCCUPANCY C ;o
Form BU4-5M-3-63—S-8 P R(1T.Tl TYIR RPFDTAT. RR.LITTTRPMT'WM Pl 'if1ri
•
21306 FEE RECEIVED
.. COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 9 1964
P.O.BOX 317 COSTA MESA.CALIFORNIA - ((''II77FIIN��AFFNCEpp$$DEPMMT.
•
For Applicant to Fill In Completely APPLIaT1 NCPNAPEk.c
TYPE OR PRINT BUILDING
�'J' //l( - / C For Office Use Only
BUILDING
ADDRESS $5.._
! �d O \/ RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA d/t..90
Al_ syn RECEIVED BY DATE RECE ED DATE ISSUED
MAIL �"7�/ BUILDING
ADDRESS /T).? '�L-(//�', ///mac' / ADDRESS •
FIRE
CITY t -Iz-- _ 7 a.o.'1- VOL...P/4 giz-4 ZONE TYPE GROUP %`/•
ARCHITECT apQ7/�_ L �/,}//A ,_ '` > / APPROVED • Ana
OR ENGINEER / j/61 ^'�+ NO.(„% / 1�•` BY _
Lear i
ADDRESS �r3 .-u /`7 ^ ° WI. •NTNG
ZON .°I NO.OF USE OF NEW
I '- PLANS -2— BUILDING
CONTRACTOR �'TL X/ •A i L- T IZ S _ T �
ADDRESS 19�` SY/ / FIE ' _ -
�'c�
CITY A.P.NO. '
Cryo NICCA 1/ %/o 1/
ti�/ ` NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE
LIC.NO. 2.---1 7 `t 1-5' NO. ‘77
90'TO SIDE a REAR P.L.
�j ��// ''7 (� EAVES
OF LOT / S/< / 9 �� I NO. DN LDTB 0 ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OFv.--------•-• - MAIN BUILDING ACCESSORY BUILDING 4.4
EXISTING BLDG.
(FROM C/L STREET (n F
SETBACK LINE FROM I 1�J /� Z
CENTER OF STREET v3 REAR YARD 3/ FRONT�� FT. L .' . n/Imo'
/ 6�/Q y01
SIDE YARDI LEFT S- i.- RIGHT tn' /,/LC rit R.SIDS DFT. �L�K�-PS's P I
DESCRIPTION OF WORK L.SIDE/2SFT. 'cai r. dF
/ L'
v' REAR ) FT. /_ - , • / q . QNEW ALTERATION ADDITION
DISTANCE BET. BET.MAIN B „]
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. <
•BUILDING )) y'.,.,/ NO.OF ` VAR. DATE Q
SIZE ' SZ.M/I 2O ROOMS iS STORIES 7.---
z— C.U.P•4 APPROVEDth
/' / \(\�\\
EXTERIOR WALL UCCe I COWERING C/L BTPR¢l/EO / ��/,, DATE /may - (�47 /li J
COVERING 4/` 6
USE BUILDING D WORK TO BE PERFORMED /1 y., �y
'Y�( d _//V L�-Yll .' l V.
cr
99,-4-) rite. . /-�� . i •xG
4 197.5-172
_a ,�`�`'` 71- Gro/' '
�w-i z
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE A •UNT =6•WN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION ' r0 0
BUILDING CONSTRU •N. (//�' J N
1 SIGNATURE OF/ PERMIT FEE $/D D
PERMITTEF
/ %'= • f.q
. { , �i/sy°-° PLAN CHECK $ 4s, 0
AUTHORIZED AGENT ,/�6 �J `.`.�• '{/�L
��m� TOTAL FEE $/�`+ ' / ✓
r
CAVA MESA BUILDING-SAFETY DEPARTMENT a . "AY -5-75�YS,00 129 cJ.+*****5.00
P. O. BOX 1200
• Costa Mesa, California
IP
IlI
I k I ; IT APPLICATIONPERr/1TO.
TRACT NO. RECD. BY 6 77MI230
CONTRACTOR ,
,/�/] gj �c' a eic LOT NO. DATE ISSUED
Address M1' BUILDING USE
at), l?a rda/2 Ord(Ie Tel* N°1-39073 BUILDING ADDRESS 175 T. VW ti
State License No. el...,// ?9S'Class. 8 -I NEAREST COSTA MESA. CALIFORNIA
ww City License No. Vag CROSS /
i- OWNER, J. q/ in Tey _ , ..
< NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL
ADDRESS SoU �
i
rset(Toilet)
—I Bath Tub
CITY /Y/ /3/6
Shower I hereby acknowledge that I have read this application
Lavatory(Wash Basin) and state,that the above is correct and agree to comply
>' Kitchen Sink with, all ,City Ordinances and State Laws regulating
"'I Laundry Tub or Tray plumbing.
CC I certify that I possess the above valid state of Cali-
x Service Sink - fornix classification or I am the legal owner of the resi-
O Floor Sink - - I) :dential property described above.
Floor Dishwasherh ^ ge�
CCG{J�
CL - ��Y Signature of
Permittee
2 Drinking Fountain
w Urinal '
= Garbage Disposal -� ��- > INSPECTION RECORD
Automatic Washing Mach. '
I-
- Water Softener. I ' - �t
2 / Water Heater d'VJO
Or/
cc Lia
Receptor
a. Swim Pool Filter System
CC Gas System . . . Outlets
7 Lawn Sprinklers
O Installation or Alteration
Water Piping APPROVALS
Back Flow Preventer
N Prop. Sewer—_ ft.
INSPECTOR DATE
= House Sewer Connection U/G Soil
I- Cesspool, Septic Tank U/G Water
Services—Water 0 Gas 0
Miscellaneous Rough Plumbing
Sprinkler System
Gas
Property Sewer
Pool Receptor
Filter System
Pool Heater
Miscellaneous
Issuing Permit 00•
I TOTAL FEE Cl/�,,[ Gi Final Gas
I{D - Plumbing Final
cf U Utility Co. Notified rR.4 5:-.7..1 C.
FORM SU•24 1/3-2,71BLDG. PERMIT NO