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HomeMy WebLinkAbout2615 SANTA ANA AVE - Building Permits On 6 CITY OF COSTA MESA 4 D BUILDING DIVISION > : DECLARATIONS 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 work for which this permit Is issued. VI 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'compensation Insurance cards`and policy number are: A, Carrera-Fa rLMa 4 - u cA IXC 1A atm r�P Policy Number: /l t l oq- 2-54-00 (This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) ❑ I certify 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 subject to the workers' compensation laws of California,and agree that if I should become subject to the workertcompensation provisions of Section 3700 o the Labor Code,I shall forthwith comply with these=1st ns. / Applicant Signature:t �Sl • Date: 40 /7" 69 -yv WARNING:FAILURE TE(max), ),WORKERS'COMPENSATIONTCOT PENS IS UN.DAMAGAWFULES S A SHALL SUILDED FOR I N E EMPLOYER 3 6O CRIMINAL PENALTIES AND CIVIL A UP TO ONE HUNDRED THOUSAND DOLLARE(5100,0001,IN ADDRION 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 licensedunder� erprovisionsprof Chapter 9(commencing with Sectio 000)of Division 3 of the Business antl rofessions Code,and my license Is in full force and affect.g Lie.atu e--\'J✓' Classal : # C.1-3 So •� Contractor's Signature: 2 / Date: //^7-0 7. 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). Lender's Name: Lenders Address: Signature: Data: 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 t0 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 penr4t 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. 0 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(38)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: Data: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Wilt 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 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 a_pgermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D 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). o..._._.__.nstr.._..t_.._....__.._..__ within 1000 feet from the outer boundaries of a school? ❑Ves 0 No • (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code). _______......._......_t... _ __...i_ _..._.....__. c 7 If a permit athe South Coast rAir Quality cri ed Management Californiaeal or and Safety pollution control district3be or agency is required for the work which is the subject of this application,have allot the disclosures prescribed by Callfole Health and Safety Code Section 42303 been made? 0 Yes 0 No B (If yes",attach cortifcote 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 t0 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 abovr •: ri•:•p•;•rty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) © / Date/..111.014 �/ An�Authorized Applicant ( Date CODE a INSPECTION TYPE P.Aff, MALE MEI INSPECTION TYPE DAIS ILLS 1618 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 Bullding/Occupancy • ADDRESS OF WADING: 2615 SANTA ANA AV DMT' CITY OF COSTA MESA - BUILDING PERMIT ONNERSN4EIPKNOMN: PAVILLION PROPERTIES PERM NO: P 075739 ADDRESS: 12250 BRISTOL ST .. IR. CA PERMIT NO: P 075739 PLAN CHECK NO: N GOVT: N SUPP : N CA 252-0339 APPL.MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH ARCHITECT OR ENGINEER: Lit.NO.: JOB DESCRIPTION : GAS REPIPE FROM METER TO RESIDENCE SQ FT: ARMENG.'S ADDRESS: - CH. UMT: CLAIM VALUE: CALL-VALUE: GROUP OCC : R-3 / CONTRACTOR'SNAME: STEVE GUYER ( 714 ) 537-2021 CONTRACTORS MAKING 12091 DIANE ST COMMENTS: X • ADDRESS: G.G. CA uCNO.: 704238 *SE+t*SE+E*St4*******xxSESE****SE*St*SESE***SEStSE*+t **************Sr***x+ESEu*x*****SESE*Sk*****SESE 92640 um: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under peaty of perjury that I am licensed under provisions of Chapter 9 S E TB ACK S (commenting with Section 7000)of Division 3 of the Business and Profession,Code.and my license is in fun force and effect. C .NO.: UC.CLASS: C_39 UC.NO.: 704238 EXP : MAIN BUILDING ACCESSORY BUILDING Contractor: / FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN GLEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN P(Z7* 9C R BUILDER DECLARATION:I hereby affirm under perWy of per that I am exempt from the Contractors License Law for the llowng reason(Section 7031.5 easiness end Professions Code:Any city or county which requires a permit to construct,eller,improve. PARKING REQ: P ROV: PARCEL,:. 00000600 Z N E: REF NO: demolish,or repel any structure.prior to its issuance,also requires the applicant for such pemhn to fib a signed statement that he or she .,is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)d Division 3 of the PLANNING NOTES> Business and Professions Code]or that he or she is exempt therefrom and the basis for the dipped exemption.My violation of Section > `,5 7031.5 by any applicant lore permit subjects the applicant toewit penaity of not more than five hundred dollars]5500]). ***************************************,*******!E******************************** o 1,as owner of the property or my employees with wages as their sole compensation,will do the weds,and the structure and intended D E V E L O P M E N T S E R V 'I C E S R E Q U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contractors license Levidoes not applyto an owner of property /� Q who builds or improves thereon,and who does such work himself or herself Cf through he or her own employees,provided that such (y- improvements are not intended or&farad for sale.If,however,the building or inprovement is soldwithin one year of completion,the ZONING APPROVED BY v DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose d sale). ❑ I.as owner of the property,am esdusinly contracting with licensed contractors to construct the project(Section 7044,Business and Professions Coda:The Contractors License Law does not ato rel owner of propertyor who builds improves thereon and who BUILDING APPROVED BY : - ,., 5 DATE: contracts for such projects with a contrador(s)licensed pursuant to the Contractors license Law), ❑ exempt under v ! r� )� IamexemuerSetan: B.aP.c..fothis APPLICATION ISSUED BY: ' . DATE: Dae: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am 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/we not(circle one)need to comply with said stale=des and the requirements for aper .for construction or modification horn the Ai °�uTMananagment District.RdantelcostWionappLcen liae° exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 7 . 00 Date: Applicant: 25% `/' SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaralaes: PLAN 00 1 ❑ Ihave and wilmaintain°certificate&= prby consent self-insure for workers'compensation,as provided forSedan3700oftheLabor ISSUE NG- 20 . Code,for the perforanceof the work for whissued. BUILDING-DIV-> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ andIhave MImaintanworkers'compensationas insurance. mquirdcattle Code, of the TOTALS > 7 . 00 20 . 00 0 . 00 27. 00 27 . 00 . 00 work for which this permit is issued.My workers compensation insurance canter and policy number are: Carter: REVENUE DIVISION TOTALS--> COLLECTED : 27 . 00 OVER/SHORT: . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK '(Thi section need not be completed r the permit is for one hundred dollars($1001or less) 27 . 00 I certify that in the performance of the work for which this permit is issued,I shall not employ any parson in any manner=as to subject to tis the workers'compensation laws California.aced agree e ill thI should become=bled to 1M ha van' **************************************_***************************************** puse pcorne nlan provisionsof sadism 3700 of the Labor Code,t.haft forthwith�n with those provisions, INDIVIDUAL F E E BR EAKDOWN Date. I Z- 21 ." ....0 / ApplApplicanta Warning:Failure to secure workers'compensation coverage is ,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N ,, UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(51040001 M addition to the cost of compensation damages as provided for In Section 3706 of the Labor Code,interest andaffomey's fess. PLU 1 GAS RE—PIPE 7 . 00 7.00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END-OF FEES performance of the work for which this permit is issued(Section 3097.Civ.C). ��JJ' V1 ,l /'\ LENDER'S NAME: Z.— ctn-l4 O3- r • LENDER'S ADDRESS: I certify that l have read the application and dare that the shove information is coned.I agree to cont y with MI city and county ordinances /fin/ ,n , e stale laws relating to building construct/al end hereby authorize representatives of the cry to enter upon the above-mentioned propend "` �i ! h i r , d for inspedton purposes. /i • STEVE GUYER l ,-::)J Print Nene v -�, � ,ft Data rz'.994'ST"'&Owner/ApentiAppec n e 7.7. .1 '- -. • _. -_ -_ - i ^_1 (5551-46 WP) WhiteWhite-Building , -.White-Building&Safety:Green--° -Appicent:Pink-Revenue:Goldenrod-Assessor C• _ �c CONSTRUCTION AND PLANNING it POOL .. 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 Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . I 4: Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' • 5.,Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grad. 57. APPROVAL TO COVER-GUNITE In 58. Electrical Conduit-Undrgrnd. B. 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 1 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 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 0 Gas 0.0i1 23. Gas Pipe-Rough & Test - '. -72. Undergrdund Flush - 24. Roof Framing'• -- •-- " - :73:-Undergrnd.StorageTank 0Gas 0Oil 25. Roof Sheathing a �- 74: Overhead Hydro •, 26. T-ear Ceiling (Structural) & Monocoat75: Dry Chemical , _ 27. Frame andFlashing - : 76. Dry Standpipe c .,, 28. Lathing & Siding - • 77: FIXED SYSTEM P`NAC ' 29. Insulation 78.. FIRE PREV. FINAL 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - - 79. FINAL INSPECTION - 32. Electrical Power Metei-Final ' `'80 FOOD CERTIFICATE ISSUED . 33. Final,Electric - - Notes: - . - 34. Final'Heating& Air Conditioning: + 35. Final Gas Pipe-Test .1'��- C`-� -9S- ,�,fl . 36. Hood or Canopy l! 1 tt�� 37. Final Factory Fireplace - - _38. Final Plumbing • r ]2L2Z 5 ed ' 39. Water Service-Final - ' . 40. Gas Service-Final .. - _ - - - 41. Solar Domestic-Final _ - 42. Backflow Preventer r _ 43. Backflow Irrigation $ -: - 44. Landscape Irrigation System '- c .- _ • - 45. Sound Attenuation .. 46. Handicap Regulations - 47. FINAL STRUCTURE& BUILDING . 48. FINAL PLANNING .. 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No Date OWNER SUNDBERG, Soren J. DATE 2/27/73 JOB ADDRESS 2615 Santa Ana Ave. BUILDING PERMIT NO. 36134 GENERAL CONTRACTOR Owner Bldr. DESCRIPTION of WORK 1 Gar. Space NAP No. 119-163-24,25.0T TRACT FIRE ZONE VALUE $ 1,000.00 INSPECTIONS Signature Date GROUP F-1 TYPE V ZONE R-2 SOIL PERMITS ISSUED GAS SUBCONTRACTOR WATER Date I Number Signet Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER fl ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS ❑ STEEL REINF. ILL.'i mh FLOOR SYSTEMle I -C7-13 BOND BEAM n STEEL REINFORCE n SHEATHING 95-'7/ FRAME AND FLASHING f LATHING — IN n OUT �.41" PLASTER, BROWN COAT T r 3a STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL �f BUILDING, FINAL - S A0 ' 2S 7 a --n rn PAIL 3b � 5 + 27-;3En-.0010, 1 . r:::.. *10.50 if.. - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA•CALIFORNIA 92626 i L CATION FOR BUILDING PERMIT For Applicant to Fill in Completely RE E BY DATE RECEIVED lam+ �/ DATE ISSUED ADDRES z�!S tS eicco, 7` /v(�{/• nt 6 °Q 2 -�o=J3 -27-7 3 • c7VKA9C/c. • S'c //Wit A.P.NO. IN l-Ilea 2 f'1-`� PERMIT NC:1 OWNER fie, / � ,r c �� � /' r ��,1�At ,— ADDRESS Z 3 a 0/4 /'/.. ADDRIE S OT>/. /J� A Yl ii J' NYS tral K.) CITY �/ �v NDLfJ/��6c TRACT I77p OT 71 BLOCK CONSTRUCTION Sc 6#1r NEW AD Q AI TFR REPAIR MOVING DEMfll ISH 0 LEL m LENDERJ�\ J D BRANCH , OWNER � V U NQ�b'1GCr Q U.1 W ADDRESS fmVALUE m ARCHITECT TEL. USE I G*I2-A&cSPhCC$ /" Jv Q ORIENGINEER NO V Q FIRE //' wM ADDRESS ,L,� ZONE I TY'E 1l/ GROUP I W Z CONTRACTOR /g'/ •C APPROVED /,// / / DATE 1, -2.7'....7.5r CO J EE ,ADDRESS y� w w TEL. ZONE��jj NO.OF USE OF NEW pi pow a V Z 2 CITY NO. l�"'� PLANS BUILDING f «.oR-Y �Rvcrci Z~ LII 0 STATE Z 7 9 C /• CITY YARDS APPROVED YARDS APPROVED to Q LIC.NO.'SIZE (FROM(� ? 7 77•t LIC.NO. MAIN BUILDING ACCESSORY BUILDING O OF LOT r+ ] / LoA✓7)4/1 NOW ON LNO.OF OT FRONT CIL STREET) ,JT. O FT. .USE OF EXISTING BLDG. ]]yy/49/77 c'/�A-,€AR SiflF FT. 3 C2 FT. I- SIZE OF Z NEW BLDG./LI )1Zb ROOMS q��STORIES L.SIDE FT. 0 F�T..� ,, U EXTERIOR WALL Cf eOI COVERING CO ng REAR T. et. �atz{'.L.,4.r � COVERING LJ 1 • J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. B .MAIN& OF S MAIN BLOCS. ACCESS.BLOCS. Q "AaG7//i/4 / X99-#2 etc VAR.# p DATE % O J C.U.P.# 7E-73--3 APPROVED '''-r°-JD-. I- APPROVED P/) _BY DATF NATE IJ UI hereby acknowledge that I have read this application and state <Pt l'�tu,... e� u, MFN that the above information is correct and agree to comply with Sr�.Ls w (�lqa CC all laws regulating building construction, and I shall not employ HOLD FOR like TAxv ,frany person in violation of the workman's compensation laws of �o-J o co the tate ofCalifornia. I hereby certify that I am properly licensed as a contractor under SO. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, end that s • 'censes are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a: am exempt from : provis ,ns of the 5 : .f California Business VALUATION / and Professions ode,O axon 3, ' .• ,r 9. PERMIT FEE $ /Q' coN !!! D Signature of I i m Permittee • $ //OTD PLAN CHECK $ E !l //O� LL o -r- Authorized Agent TOTAL FEE $ OWNER SNYDER, G. D. MAR 2 1959 DATE 10-15-58 _ JOB ADDRESS 2b15 Santa AnaAvenue APR 6 1SRta BUILDING PERMIT NO: 7783 / GENERAL CONTRACTOR Owner-Builder VALUE $ 11,034.00 - 14-4431-15-lb LOT 71 TRACT 376 FIRE ZONE DESCRIPTION OF WORK Duplex & Gar. GROUP I & J TYPE V ZONE R-1-1 PLAN NO. PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR - DATE NUMBER - Trenches Forms Steel -Z- /D-/7- S—,,E rip ,...,..:-„,...,..:-„LetO - ..,...,..:-„Let ia•---1.-4.--.1-s'-- --• Floor System r$1 � y' &-/A/,C�/ i tr Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing Pr 1102Efra-W _- Lathing, In .• Out 0/ 1 ✓b- ., 'w -1' - Plaster, brown coat✓G A * ie . I,L/ I` -'rni., Underground soil/J/4c- /G Pipe Test4}45 '- - V 'I tr t Top Out 44^)-51 Furnace I-V 14 f5l-4'Y 04A 9—yu&— ALL, J 3'Yo'XI Iib /`(,g.� �'/ Gas Vents �7_ Rough Plumbing i„�/(p-Ye-s-+ rst-4/0-ylA/>/- �i 3 ->11-:51 / 7 / Cesspool Septic Tank I est Prop. Swr. Ijna- Ho�I(on. St. Swr. 3/ci too ,-E.e-0-.-r.✓�• 7//olbo XI 2�'" Sprinkling System _ _ /' 66 Heating Final 4.1 •.2r .cnk!j-1'. R`ofJ-1/ 2j � Plumbing Fixtures, Final // `/> q..t9. B 34 5-b o R l Final Gas Test , b_^/�al!� 1.-Ice 7- -i4*o 4A �� - Construction Pole Underground Power p� -'G Rough Wiring %4! / 6_J,ff�14;/.[2.4.tt-wt 4 .&r/ /e -.77- .1% /07f44jZ Fixtures, Final ,Joe 1/49.4 I , -OCCUPANCY he.." 0_29.64 - Form 230--obi-1-57 7783 f > � � tEL � ���� • j49-7_ se VL-. 4COSTA MESA BUILDING DEPARTMENT MIANCE DEPT.CM OF MA P.O. BOX 317 COSTA MESA. CALIFORNIA . FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING 2G4N y_ z! /J,A� actsa, BUILDING ADDRESS / -¢wt/f 1^/"`/ COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY � � �� RECEIPT NO. PERMIT NO. MAIL '%%�C`ryryryy////Jy(// �( MAIL )641- E�� '' // Y BY hE /SCE ♦ DATE ISSUED ADDRESS ) Li C I /D 7 J /A .y' �/ TEL. //'/ BUILDING CITY V �� ��[(� NO. `.� g(�J 7Q ADDRESS .76/57.4.46244 ARCHITECT / LIC. COSTA MESA. CALIFORNIA ' OR ENGINEER C. ADDRESS ZONE CITY LIC. ZONE POA O -z TYPE UP CONTRACTOR (�lfn NO. R G...- I{ TEL. APPROV D ADDRESS LOT "?OST NO. BY DATE LEGAL //_ CORRECTIONS DESCRIPTION NO. �/� 1 BLOCK / TRACg 740 A.P.NO. //• - I l /S-cr. J cr ( ir - OSIZEFLOT ;10Xao NO.OF LOTL NOW ON APPROVED USE OF Aeon/ CITY OF CTA MESA NG BLDG. r PLANN DEPT SETBACK LINE FROM 1 �� SUBJECT TO B G. DEPT. REG. CENTER OP STREET cp(� ', E REAR YA/R�D /� SIDE YARD RIGHT S , LEFT J ' BY�,i /( ) / Q-�y� DESCRIPTION OF WORK LH. -771DA` T - — f PLAN�jTECH.�j1/ Y/ NEW /• ALTERATION ADDITION 6/• • O'`�/o-_() .7 r REPAIR MOVING DEMOLISH . I- SIZELDING]9eA, eft /d n0. _v STORIES P EXTERIOR WALLt. ROOF y / /D i, _COVERING , COVERING 5 USE OF NEW77- , / B Q/� BUILDING a/ �f 17 / d,,z2 7c / J 0 ' 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND / WITH ALLV STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY /-0 CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CITH C. !/ V SINN Q VALUATION rT SIGNATURE OF ` / �}//� PE MIT FEE $ �X -- PERMITTEE /v �EN� L _ $ //j0311- PLAN CHECK $ / AUTHORIZED AGENT TOTAL FEE $ Vc?., - r