HomeMy WebLinkAbout2420 SARATOGA WAY - Building Permits II CITY OF COSTA MESA
6 BUILDING DIVISION ,'
>:� � DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMB R
jj 4 r PERMIT
M04- 544
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
. MECHANICAL PERMIT
Job Address: 2420 SARATOGA WY Status: ISSUED
Suite No Applied: 10/18/2004
Issued: 10/18/2004
Vicinity:
Parcel Number: 41916277 - ISSUED BY: "yr
�'�
Applicant: YENULONIS,LORA- '
Address: 422 JENKS.CI • - . - •
• Phone: 714-9984300 - N
CORONA,CA - • " Zip: - 92880 • ' ,
. ,
Owner',r PARKER, BOB _ � �
Address. ''2420 SARATOGAWAY •
- - Phone: 714-545-5036 '
. ' COSTA MESA,CA Zip: 92626-6543
•
Contractor: -ALLIED PLUMBING - HEATING -AIR CONDITIONING -
Address: 422 JENKS CI -" • _ ' ..• :
' Phone: 714-9984300 - - �
CORONA,CA - - 'Zip: 92880
- License:610780
SCOPE OF PERMIT , ,
' CHANGE OUT OF FAU TO A NEW<100 KBTU FAU. _ .
,"� - •- . . - �. ;r�_. _ - - ,
. ' - � FEE SUMMARY 1
Quantity . Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit . '$0.00 0
Inst FAU<100 k BTU • $14.80 1 ,, Repair/Alt Refrigeration Unit �. $0.00 '0/
Inst FAU>100 k BTU. $0.00 0 ' _ . Ventillation System . $0.00 0 '
Repair./Alt Codling/Heat' $0.00 -0 '- ' Evaporative Cooler '- •' $0.00 0'
Inst/Rep'Recess WalFHtr $0.00 0 Commercial Incinerator $0.00- 0
Refrig Sys<100 k BTU $0.00 0 , Domestic Incinerator _ f ' $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems ,
Gas Piping , '' ' $0.00 0 - ;
_.Up to 3 hp/100 k BTU , • $0.00 , 0,. r,Factory Fireplace -
$0.00 0 �'_ • '3 To 15 hp/500 k BTU � '' c- .$0.00' 0" /
Hood w/Mech Exhaust �" ' $0.00 0 r-^_- � 15 To 30 hp/1,000 k BTU (. ! $0.00 0 i
VAV Box' ' - $0.00 0 30 To 50 lip/1,750 k BTU /- " $0.00• --0,
Vent Fan/Single Duct, $0.00 - 0 - - Over 50 hp/Over 1;750;BTU j i. $0.00: ,0
Appliance . •'. $0.00 0 , • Boilers - //" - '
Fire Dampers /' $000 0 " "Up to3hp ' �/ $0:00 0
Smoke Dampers " .$0.00 0 , - '" _ ' 3 To 15 hp /> c/ /$0,00 0
Inst or Relocate Ap -= �pl Vent, ,/, $0 00 -0'='-- - ,15 to 30 hp. --__•;;;---"2""'""" < -/ "- $0.00 0
Air Handlers< 10000cfn"A- $0.00 .,0 ' _ _ _,30 to 50 hp_ '..- ' . (--1' \\-/„;',/ ,/ '$0.00 0
Air Handlers> 10000cfrn $0.00, .0 - • Over 50hp `. ( -. /, !'/' $0.00 0
Floor Furnace ' ' - $0.00 ' 0 = Other Mechanical Fee ' ''
Floor or Suspend Heater $0.00 0 ' - , , ,- Investigation-Fee ' -'> $0.00
Plan Check Fee . ' $0.00
Reinspection Fee . / �,, $0.00
' - - - - - TOTAL'CALCULATEDFEES $38.30 i
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
2448.48(8/00)
DECLARATIONS ( ) ( l
WORKERS'COMPENSATION DECLARATION: '
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
,,�1.,�,w7�work for which this permit Is Issued.
L sy I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cale,for the performance of the work for which this permit Is issued.
M workers'compengatlon Inrence carder and policy number are: �/� �/
0-C his a/a Zl1X%CI'% —C�(YpP 1C t C OA", --.aorto ymmb- 00,—U'3 p11Jg3-0 i
(This section need not be complet If the permit is valued at one hundred dollars($100)or less.) .
❑ I certify that in the erformance of the wo or which this permit is issued,I shall not employ any person in any manner so as to becom subject to the workers'
compensation la :of California,and agr:: hat if I should become subject to the workers'compensation provisions of Section 3 O oo[f he L(abor Code,I shall forthwith
.1111.° 10
zApp'caii gra um: Aji I♦1 . 411- Date:
WARNING:FAILURE TOS ..URE WO'I' RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND MIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS(Mose),IN•Ci.ION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION SOS OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affi Kat f m.Icensed tray'v' '• hapter 9(commencing with Section 7000)of Division 3 �ntYProfe Ions ode,and my license is in full
forciand of ec. Ic. ItlV1 l� P•11 FClass t.(J LTJ
Co tractgfs tura: Noi r • I b at : -Ln
CONSTRUCTION LENDING AGE
❑ 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).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 6,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:
I 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? 0 Yes 0 No
(Section 25533 of the Califomia 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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the Califomia 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 apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 ❑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 California Health and Safety Code Section 42303 been made? 0 Yes ❑No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND 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 representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
k.e\ A gnature Of Le.. • ner(s) la+ ate
utG,o
Or nzed{Appllcant% —• °_'°�
CODE I INSPECTION TYPE CC����� DATE JNIRIALS CODER INSPECTION TYPE WIQAATEINTIAL$
0-241-0.-4.
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 Sign222 Final Site
204 Final Demolition 250 Final Building/Occupancy
•
PROJECT ADDRESS: 2420 SARATOGA WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069626
„ OWNER'sNAME: BLEDSOE, ALBERT A TR
ADDRESS: 5412 LAKEVIEW • PERMIT NO; B 069626 PLAN CHECK NO: N GOVT: p:11:::::SUPP ; N
YORBA LINDA,CA 92666
'•..` CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH & REROOF W/COfM & HOT MOP SQ FT: 2, 508
ADDRESS: UNIT:
CLAIM VALUE; 2, 508 , 00 CALC—VALUE; el:M2, 508 . 00 GROUP OCC ; R-1 /
PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775
ADDRESS: P 0 BOX 4309 COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
DOWNEY CA 90241 ****************************************7P********yE**BFBEar******B6**at**BE+t****BP->t****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
cITyuc.: 259 77 sTATELIc.: 40253 • LAss: C 39 EXP; 10/95
Date:IQi Signature:_ _ _ I MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPE An0x DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT I N
Compensation l5Nrapeeagr/eddied copy thereof(Section 3800.Lab.R.5/19 /9 5 LEFT; FT I N RGHT; FT IN LEFT; FT I N RGHT; FT IN
POLICY NO.: o L L O 7 EXP.DATE: ,
' COMPANY: AIG ,��(( • PARKING REQ: PROV; PARCEL; 41916277 ZNE; REF NO:
❑ Certified copy is hereby furnished. L1 Certified copy is filed with the city Building Division. PLANNING N TE$>
Date: LD[, 6I lU/ Applicant:� ************** *****************************************************!t*****IE****
l D E V E'L OPMENT SERVICESRE `-
QUIREMENT $EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred 800)or less).
I certify that in the pertormance of the work for which this permit is issued,I shall not employ any person in any manner so as to become
subject la the Workers'Compensation Laws of California. ZONING APPROVED BYDATE;• ' _
Date: Signature: BUILDING APPROVED BY ; ; /'
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor _ DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 1 � 11 r�/!��`
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y Y V• •
DATE; YD.�`_
which this permit is issued(Section 3097.Civ.Cl. *********************4***** F* ************************************ **
LENDER: ************************** ****************************************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT :Y
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 54 . 00 • 50
repair any structure.prior to its issuance.also requires the applicant tor such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE
any applicant ler a permit subjects the applicant to a civil penalty of not more than five hundred onars (5500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 54 , 50 0 , 00 0 , 00 54 . 50 54 , 50
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law00
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 REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sale).
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 0 O S O
❑ and Professions Code: The Contractors'
with License Lowden pursuant
ot apply to to the er of property who icensorimproves thereon *******************************************************************************
and who cls for such projects with a State License
Lal license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. IND I VIDUAL F E E BR EAKDOWN
0 I am exempt under Section: B.&P.C.
for this TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner. SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 508 , 00
I do hereby certify that lam aware of and understand the requirements al 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 for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with alt 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 nur,pose/`s, '/
Date: ��J��vl''—t' Signature: _ /�/E�
Driver's License or SocialLLLLLLSecurity x: 01 D0ATE:
"00170649 TOT 19 5j4,,50
DATE: 10/28/44 TIME: 13:19
164646 Wnne—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor _ _
•
CONSTRUCTION AND PLANNING POOL 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
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
Electrical
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
S. Steel Reinforcement 56. Rough Plumbing & Pressure Test
• ...'Electrical UFER-Grnd. - 57. APPROVAL TO COVER-GUNITE
y
: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 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 1' 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
- u
t
20::Rough Factory Fireplace , n1 •. t 1 • _ • ! -APPROVALS : •Permit # '
21. Ducts, in Structurl?; , F. - } •i70. Underground Hydro
22. Ducts, Ventilating • T r L. , ' .171. Product Piping 0 Gas 9 Oil
23.-GasPipe.,Rough&Test r ; : .472. Underground Flush
24:t.Roof Framing •. • ' -•-• • • _ : ' i:73,„1-..,Undergrnd.Storage-'Tank 0 Gas 9 Oil
25. Roof Sheathing 4' - 71_iq` Z.. etvGpj�. -74a Overhead Hydro '
!l .
26.•Y-Bar Ceiling (Structural) & Monocoat ro 757 Dry Chemical -
27.'Frame and Flashing ri r r 76' rD'r Standpipe .:-) `- 7 r'
4.
28. Lathing & Siding-. . , -;�' ;.• - • i * 77• c:• FIXED SYSTEM-FINAL '•
29. Insulation ' - - rt 7.1i I r 78 FIRE PR EV. FINAL
-30. Drywall-Nailing ,. • t I HEALTHrDEPT•. REQUIREMENT
. 31. Plaster Brown Coat' _ r ,n, I j,-., ,79 'FINAL INSPECTION : r' -'
32. Electrical Power Meier:Finals '-"It t r,80.11FOOD CERTIFICATE ISSUED
- -
33. Final Electric " • T - ' +' ' h , `-Notes: .,.;
-34..Final Heating,& Air, nditioning, j. . +
.Co - : - ",
n.
135. Final Gas Pipe-Test- %' V ' I " .
36:Hood orCanopy •, ' - _ -
_ i .. • . +
37. Final Factory Fireplace ! �• ,. ` : •.
38. Final Plumbing - •. •• ' ,• : -_
_ - -•
•
'39. Water Service'Final• - i ' - -
.
40. Gas Service-Final .•.,.,, '• „• �
41. Solar Domestic-Final •: -
42. Backflow Preventer ' ,1• . - , - .
' 43. Backflow Irrigation • - ' - - -
,44. Landscape Irrigation System- -. , r,
45. Sound Attenuation - ;
- ,l
146.- Handicap:Regulations ', - . ; r; • _ _
,47. FINAL STRUCTURE& BUILDING a ll...th 1 aW%/_' ' •" is
48, FINAL PLANNING .� + . i !_.._ r ? - • •
49. Electric Release to Edison ' - ,
.. .. r ..
'50. Gas Release to Southern California Gas Co . - ..
51. CERTIFICATE OF OCCUPANCY - -
No. Date
OWNER SAN VISTA Building Co. DATE 7-21-67
JOB ADDRESS 21i20 Saratoga Way BUILDING PERMIT NO. 27329
F TRAL CONTRACTOR San Vista Bldg. Co. DESCRIPTION OF WORK Res.w/att gar.
I. J. 930-03-259 LOT 259 TRACT 5160 FIRE ZONE VALUE $ 13,240.00
INSPECTIONS Signature i Date GROUP I & J TYPE V ZONE R-3
Soil vC-&? PERMITS ISSUED
Gas > iff` -,'cc' SUBCONTRACTOR I Date I Number I Signature
Waugh Plumbing
/e1 7 ��� g �J 7 ' 71!
Rough Plumbing y p-- d /� p ar7
Prop. Swr. Line 0 House Con. G.-- 4.ts- 7-2?-4-`)
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning 9Yy--7
Temporary Service or Pole
Underground 0 Power :0
Routh Wirin_ - Heating and Vent.
Trenches + Forms Steel Reinf. i' ,04 Q— 17_ -pat--7;m7 � 7-//-47 N/-aZ,d7
Floor System _ - ir f4 d7 `4?
Bond Beam 0 Steel Reinforce 0
Sheathing _
Frame and Flashing - / t 9 L i
I'"-'ng — In.M.--- Out in..........„--
±� e 9/le(6_,7
t1
I .r, Brown Coat c Structural, Final ���yyy��'y{y{y{ctectriHeating, Vent., Refrig. and A.C., Final 7 '��` j trip/t- .� /-e7 ,�7,791
Plumbing, Final and Gas Test f/ ZicC -$ 7Electric, Finali7/7/f/j' j-7
Building, Final _ yyt a N/7/C 7
•
P,
2'j 3`29 JUL 25-67cris„ .J1685-` ****67.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 •
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT , BUILDING
BUILDwo //�� q •
For Office Use Only
ADDRESS c2_4 2 (J 4 /
RECEIPT NO. PERMIT NO.
COSTA MESA, CAL) ORNIA� /J1 C/�/q9 D�.9'1'117.r.3(`
OWNER OL41,f 1 �I ) L `J�y��-apie I/, ` 7 BUILDING NL!_ 'y /
ADDEESS.{a ('� �C1C'�-u-I�LLA(lj PAA-4,10 ADDRESS /
^f 7/�J� ,�,� I� TELQ�., stet FIRE �//A,J/
CITY)`/G',I A 1GJ��LL/(-Y/ NO.Q4�l et ZONE TYPE GROUTS/7r
ARCHITECT �:�Q TE� APPROVED U
OR ENGINEER / /S(/�V�7.t� NO. t3�3- I.L7-1 BY DATE
/ S• l ZONE NO.or ZONING USE Or NEW
ADDRESS U 7`.� 1 Pei-Adria
� � O R3 PLANS 2 I BUILDING Sing Res.
CONTRACTOR O,�lLt �7 rq
DESCRIFNox 1--1,÷a S L ./1-0-60- 5i6 v
ADDRESS � ��
A.P.NO. 930-03-259
CITY 0-/CILl/V&-1^—
STATE TEL NOTE: NO[AVE OVERHANG SHALL BE LESS THAN
80'TO SIDE a REAR P.L
LIC.NO. NO,
SIZE /J �'I EAVES
OF LOT 2-'17 L I NOor N "C ALLOWED .(U.B.C.REQUIREMENT)
USE OPS -T
YARDS APPROVED YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
d FROM C/L STREET)
SETBACK L'INWFROM FRONT 0 FTFT
CENTER OP STREET REAR YARD
SIDE YARD LEFT RIGHT R.SID) 0 FT. FT.
DESCRIPTION OF WORKL.EDI 0 FT. PT.
NEW T[RATI N 1 ADDITION
REAR 0 FT. FT.
DISTANCE SET. BET.MAIN&
MAIN BLD ACCESS.BLOCS.
,
REPAIR MOVING DEMGLISN
DATE
SIZE NG2S C'7 0 ROOMS 4 STORI I APPROVED
EXTERIOR 512E WVy7-7-67
COVER!NG L.Q�ai1 I COVERING - DATE
USE OF BUILDING• ND WORK/TO B [RFORM - P.
CA A IIS( - i(-Q.Q i _
/� / 960 °
4 ��-) //// a1 ?
'Wiest Fr. �1 7� o
i HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
.ZAS
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CO UCTION. PERMIT FEE $SIGNW� N
PE ITTEF OF
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SIUDSG®.. (i/ TOTAL FEE $ /
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