The URL can be used to link to this page

Home My WebLink About2828 TABAGO PL - Building Permits PROJECT ADDRESS: L828 TABAGO PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; BMP 05141F OWNER'S NAME: BASKERVILLE, WALTER E TR ADDRESS: 2828 TABAGO PL PERMIT NO: BMP 051418 PLAN CHECK NO: . N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE; 5—N PERMIT TYPE: MEC PLU STR PURPOSE: ALT ( 714 ) 966-8404 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL FACTORY FIREPLACE ICBOlt3195 SQ FT: 4 , 000 ADDRESS: UNIT: CLAIM VALUE: 4, 000 . 00 CALC—VALUE: 4, 000 , 00 GROUP OCC: R-3 / PERMITTEE: WALTER & MARY BASKERVILLE ( 714 ) 966-8404 ADDRESS: 2828 TABAGO PL COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. �c COSTA MESA CA 92626 * *aE**.w. x. ******xx*x.xxa; Kxr. **E *)(-***** u****** :+r************-xux***>E*TrASE**Tt**TL** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cerlilicate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN ! Tompensation Insurance.or a certified copy thereof(Section 3800.Lab.C) LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN ' 'OLICY NO.: EXP.DATE: COMPANY: PARKING REQ. PROV; PARCEL : 13933209 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES> > Date: Applicant' **)E*****************IE*********x*lE*lE*************IE**********-TE***x-lc***'lf-**?F******* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES. R E Q U I R E M E N T .S 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. ZONING APPROVED BY ' - DATE: Date: Signature: - . NOTICE:II.atter making this declaration,you should become subject tome Workers'Compensation provisions of the Labor BUILDING APPROVED BY : 11- / DATE: Code,you must forthwith comply with such provisions or 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: « t�;�,:..a� DATE• 4k which this permit is issued(Section 3097.Civ.C). **********t**M********* rl ' w— ********1E* ;W** LENDER: ***************************************** ' '*************;.**************** ***** ADDRESS: LEGALIZATION: N F E E S U N A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'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 63. 00 2 00 6 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed '25% .";.!5% 50 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the BusinessSM 1 P/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 3 . 0 0 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— —> 72 . 00 18 , 00 > 0. 00 90 , 00 90. 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 is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 90. 00 OVER/SHORT• . 00 forme purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 . 00 5 , 00 -1 , 50 . 50 lXi 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 acontractor(s)license pursuant to the Contractors'State License Law),l am aware ****Ii-**************************%.****3(.*****FE.******FF.******************x-+f.*X...**.x.*at.*x. that proof 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 DESCRIPTION. UNIT COST TOTAL COST ' oate: r 2.1-2-- 7/ ownerifirdtitiH/a/ SFR 4000 ALTER BY VALUE RESIDENTIAL NOZONE 1 , 00 4 , 000. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 FAC TORY F I REP LACE 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 r 6 . 50 6-, J 0 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from PLU 1 GAS PIPING SYS OF , ' 1 TO 4 OUTLETS 2 , 00 2 , 00 these provisions. END, OF FEES Date: Applicant: 1 01 00083075— n -, TOT •n 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 ,'' DATE• DO_F�s07 ordinances and state laws relating to building construction and hereby authorize represe lives of cityto enter upon the above-mentioned 0�'n0.'91 T1nFS 3"'•2� property for inspection purposes. / Date: 3 — �`' --V Signature: , / Driver's License or Social Security #: V 164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue',Goldenrod—Assessor CONSTRUCTION AND PLANNING & 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 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 .y ' 12. Sewer Cap 63. Heater & Vent-Final 7 13. Roof Drains 64. Plumbing System - Final J 9 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 ❑Oil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage yank 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 - S-41( HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final /C.. 80. FOOD CERTIFICATE ISSUED 33. Final Electric r Notes: 34. Final Heating& Air Conditioning - •• • ? yr6�1� $ 35. Final Gas Pipe-Test' `j,rfiat ` c GGGCCC 36. Hood or Canopy R 37. Final Factory Fireplace , 14[n(4 -4Q 38. Final Plumbing L-j/-r(aI t :, 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 11(61 ti'1404-:-,c. .48. FINAL.PLANNING 'II 49. Electric Release to Edison ,r 50. Gas Release to Southern California Gas Co •j' 51. CERTIFICATE OF OCCUPANCY No. Date i ------ a . , A ,r) / /I /:-.7? 4 i, L„-, ,2--'/ 1 (10 K"ti 4.7.--4:-.' I tv -2.0 2 SP' -0?ISt'q 6:0 ?L C 01 q3646 / . l ----- I Ft1/2,41- -7 _______, I )\ 1 . 1H . 1 I -t- •.. ') '5al k ?fp i 1 . : 1 I ck RM I k i ! —,\fr„)ri r 1-t , i 1 : i i t f i Z • 1 . i 1 kk i I e t v-t--,- if 1 .? DiNtiv‘? .z i K r 1 in in •:,) H --C 1 V\.H 1 > : I 1 \ ' ...24 1 ` a ! \C•r.j . i ••,..." ^ . 1 \ 1 \ I , -- , ; ; Lu ; t . ._w_____—, ';1 7 ; 1 , , ;;;; W , . 1 ; ,,, , , C.1 -.. .1 Afr-it 7E- 33 1- a) _ceric.L.e? ' _ ! - cl -) ‘ , 3 - 7 A —II i I ‘4-) E. c8. It.....„, I i — 0 II-PL ki \ f 1 1 I ri:3-- /P/7- re) /0.57,46.2– , I 3 I act' Cz•–e.-Affirkir E- t ri 17.1.-_ 1:24 trli: 1 1 i 0 .... It 24 ti C 01. ‘4111C, cS- I i i N 1%'-`• , .c7 I ! 4 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. �M PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTlA(�//I((�//��yy$$]JAy'1. • + j�J TI e f'P MIT 3 �] A.P.qW Zone . Project Address l'�+s'` •e. a, /� " 7 3 7 I Project - • I S Main Building: Accessory Building: �� ) LSTYPE OF CONSTRUCTION U NEW U ADD Li ALTERATION U REPAIR E Z Applicant's Mailin• ..ss / ❑ OTHER T Front O rr +• I- ❑ CONVERSION ❑ DEMOLISH Owner's NNn�f l' l I G1l.L'��_��I111.G• e /' /1 r DESCRIPTION OF WORK/USE OF BLDG. A Rear N Address Irby_ U I U L/i,lllA. Arch/Eng. License No. TYPE OF PERMIT U GRADING LI FOUNDATIO 0 STRUCTURAL I C Right G Address 1 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL $ - Left Contractor's Nam.- 01'I( 1. 1 I ', 1 Ay a 5,1/753 53 ❑ 'OTHER i Ping. Ref.* Parking Req./Provided RE Pr ►T 1p' III 1 , /I PROJECT DESCRIPTION SQ. FT. OCCUPANCY PlanningNotes: Q Address(mailing • LM 6/L . } • CONSTRUCTION TVPF VALUATION$ FF '. �� ' City License No. / ZONE GRADING CU.YDS. ACRES frD II. LICENSED CONTRACTOR DECLARATION _.•cSau5• 1' CCL B I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I [9F with section 7000 of Division 3 of the Business a(tl Professions ode,al�tl my license is in ful oj}9 . d effect. • t _\�71- ELECTRICAL FEES Lice .I - � i 4% Date — IL Signature zrr', -.-4 4 fe PLUMBING FEES Automatic Washer Transformer 0 15.50 KW WORKERS'COMPENSATION DECLARATION COn$Lf UCtIOn POI¢Sub. 0 5O+ KW I hereby affirm that I have a certificate of consent o self-insure or a certificate Bar Sink Showers of Workers' ompensa io Insurance, or a certifi••c••I thereof (Section CookingUnit Meter 1 3800, Lab. )?i3/�1) i71 Backflow Preventer Service Sink up to 100 amps Po icy No.. v�w Company M. - IT - Backflow Irrigation Sewer Cap — Dishwasher Meter Cover 100 amps v Certified co isclay y furnished. P �P - Dryers OGas ❑Electric Sub Panel Cert fi i �Q with the city B- • I• , / / Bathtubs Sewer Connection • a e I s Applicant alt AV -y�FS i��L Fan Motors❑0.1 HP 018-8 EXEMPTION FROM WORKERS'COMPE SATION IECLARATION Clarifiers Solar Collectors (This section need not be completed if the •ermit is(tr one hundred($100)or - less). Dishwasher Solar Piping - F.A.U. Inc.Solar 09-15 HP ❑16-15+ 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 te 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, you should become subject to the Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYSwitches $i n Gas Service Outlets Water Closet 9 I hereby affirm that there Is a construction lending agency for the performance Garbage Disposal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9 P Standing Sections Lender's Name . 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 Treys I 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 therefrom and the basis for the alleged exemption. Any violation of Section $ 3 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LII, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offeredZoning Approved By Date for salese (Section Business and f aProfessionalprCode: The Contractor's MECHANICAL FEES Building Approved By Date erLaw does not apply to owner f a property or who builds or improves thereon,empland who does such work ovehimself/herselfpts ot through tende his or ere own Application Issued By Dat employees,II, ho eprovided rthat such or improv eves are not inwithin or year oftd m- Boiler Hood Type I ❑ sale. II, thethe owner building improvement opro i sold within one your im- - Canopy Type II ❑ SUMMARY OF FEES pletion, r th owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose he pope). BUILDING PERMIT $ SMIP $ ❑ t as owner the project am t7 44, contracting ing with licensedioncon- Duct-Structural Refrigeration System • PLAN CHECK $ PERMIT �...,/.� hetors tactorsconstruct the project (Section 7044, to and Of property Code: • -e The Contractor's License Law does not tract to an owner le property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $ }'� \'.j. builds or Improves thereon.and who contracts for such orolects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ [" System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. GRADING $ 0 I am exempt under Section B. & P.C.for this reason - Firepl/Fact.Bit. ICBO dk Fire Dampers ELECTRICAL $ / PLAN CHECK 50% $ _ fjOFILM $ Date Owner Hating System& Ducting Registers 01 MECHANICAL $ {moi+_se 77% I hereby certify that I have read th .pplication and state that the above ` f`-(i 100,000 BTU 0100,000 BTL ID 1' ""' OTAL FEE $ 24 information is correct. I agree to co •p y with all city and county ordinances u./ PLAN CHECK 25% $ and state laws relating to building c•+ truction, and hereby authorize re re- sentatives o thi cit • .enter up• the above— entione p o e t inspection p rp..as I i ignature `.a. A ..patieJIJ `✓ Dat s �/ Pink -Accounting; Goldenrod - Assessor OAT,:- B2/O6/t1 i It.: CC"'4 _ , I 'CONSTRUCTION AND PLANNING POOL & SPA • A/PROVALS . Permit# Date Inspector APPROVALS Permit# Date Inspector r. Temporary Electrical Service or Pole _ , _ 52. Pool & Equipment Location 2. , P 9 Soil Pipe-Undrgrnd..,.rnd. _ -. 53. Steel Reinforcement i3. Electrtical Conduit Utility-Undrgrnd. 54. Forms • • .4:iElectncal Conduit-Undrgrnd. - 1 ,- . , r 55. Electrical Bonding • 5. Steel Reinforcement- • - 56. Rough Plumbing & Pressure Test •. , • '6. •Electfical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. iFootings• , • i - i_ 58. Electrical Conduit-Undrgrnd. 8. ;Foundation ; 59. Gas Pipe, 0 Undrgrnd.,Test - ' ••9.•-Water.Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.• ,o• 10. :Strluctural Flo• or System ' ' • 61. APPROVAL TO DECK t 11. Property Sewer Linel& House Connection 7 ' 62. Backwash & Receptor-Final ,. 12. Sewer Cap 63.-Heater 8.1 Vent-Final 13. Roof Drains - - ( 64. Plumbing System - Final I 14. Sough.Plumbing , 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final _ 1.6. Rough Electric Wiring 67. Fencing & Access Approval 17:Rough Wiring Sign 68. APPROVED FOR PLASTERING 16? Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT J ?Or 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 PREV. FINAL -" 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED " • E 33. Final ElectricNotes: t • >/// 34. Final Heating & Air Conditioning u(a'4 069 35. Final Gas Pipe-Test ``ll l 36. Hood or Canopy 37. Final Factory Fireplace - - 4 -- • - ' - - - 38. Final Plumbing 39. Water Service-Final ;y; - 40. Gas Service-Final �51 41. Solar Domestic-Final . r • 42. Backflow Preventer i , t.. 43. Backflow Irrigation .0 rI ' 44. Landscape Irrigation System • i �- • is 45. Sound Attenuation - 7 4 • 46. Handicap Regulations,?. 47. FINAL STRUCTURE & BUILDING 1 , , a48. Special Requirements Completed NS' ll -t: :09. Electric Release to Edison 1/ • i 1 p, • 50. Gas Release to Southern California Gas Co 1 51. CERTIFICATE OF OCCUPANCY No. Date 1• 4.A Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 111111111rOSTA MLA PERMIT NO.7-,4846., TRACT O, LO'T NO. BLDG.NO. t, r" .2,- :, T es& • CONSTRUCTION PERMIT RM� Hi(5,4"" 4a7 Ai0 c- - Project Addressee Rig7-,4846., mace TYPE OF CONSTRUCTION (7� Owner DmIV Sc i_i-t Itp 4 C. Phone(( 7221 0 NEW 0 ADD *ALTERATION 1�" - • I Address d €17 74,14 Go 0 REPAIR 0 CONVERSION ❑DEMOLISH •00 D �� TL s Arch/Eng. • License No. 0 OTHER' I -. Address - - - ,_ . . • DESCRIPTION •F WORK�L../f G / L1'd�'-21r _ • 1. i I Contractor a,acne Cry -flit g4 Phone:Z 761' • . ' w cm-11471CCe�,�•��3�/1�I1�•••P IRTVNG �,.. !�M Address .....#r+Z. �. a L -- 4 •"a• - 19 ■ •I t: • • • A SED�YARDL�ia2) man . - LICENSED CONTRACTOR •DECLARATION. - ■ ■ ELECTRICAL OPLUMI9ING OMECHANICA SIDE VA-I- -ll-- - 1 hereby affirm that I am licensed under provisions of Charter 9 (corn- _ RIGHT �� , menclng with section -7000) of Division 3 of the -Business'and ■ • rn' • Professions Code•••,000 and my license Is In full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) l71U , Cd -- �, License Class ^� "f License No.�y4•U�l PKG.SPACE REO. ' ' PROVIDED' Date 7-� ZSignature (_. �__r,y,`(,_( - + WORKERS'COMPENSATION DECLARA N • • STREET WIDTH i-� ( PARK FEE$ 1 I hereby affirm that I have a certificate of consent to self-Insure or aY-135407 --ZONEUATION ZONING APPROVED BY Ir P. DATE i 1 certificate-of--Workers' Compensation Insurance, or a cerrtllfff ed copy thereof (Sect] y i�p0-if- C $r--e FUN(% rceftlo icy fieo. /)c 15•S / f6 i hed. • - ' ert ifietl copy is hereby furnished. REMARKS: . 0 Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed if the permit is for one hundred _ • - - -: - - v \-+ __ _ _ ' ($100) or less). - - ._ . I certify that in the performance of the work for which this permit is issued, I shall not employ any perso any manner so to-become PLUMBING - - PLAN CHECK ,ELECTRICAL - - PLAN CHECK- - subj¢ct to the Workers'Compensdti0 ws of Calif or ni _ ` ,- BATHTUBS SHOWERS UWtLLINta .. ._ t'MHM aE. Date BATHTUBS l-Q- • 1 • - 0 - - - '• NOTICE: If after making this declaration,yOpdu should become subject TOILETS - URINALS - GENERATOR- 0.1 KW_1-10-KW -- - to the Workers' Compensation provisions df the Labor Code,you must .TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS' APPLIANCE- - 10-50 KW_50+KW revoked. -. _- - - KIT.SINKS" - - -- -DISHWASHERS - - -MOTORS-- 0-1 HP_1-30 HP - .CONSTRUCTION LENDING AGENCY .. 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS '.SUMPS-- -- (INC.SOLAR) 10-50 HP 50 + HP ' formance of the work for which this permit is Issued (Section 3097 - ' - • 1 ,Ci v. C.).` . 10 if C- FLOOR SINKS - - FLOOR DRAINS'e• FIXTURES' 'vc. OUTLETS le SWITCHES 3 1 Lender's Name A/ _ • �Lender•s Address DRINKING FOUNTAINS ;1'" - 'GAS TUBE SIGNS - - - ,, - -- - OWNER BUILDER DECLARATION'-- - INTERCEPTORS • ,• CLARIFIERS - - ,POLE LIGHTS' - ' - • - - j I hereby affirm thati am exempt from the Contractor's LicenseI.Law for _ - - the following reason•(Section -7031.5 Business and Professions Code: SWIMMING POOL`"' P TRAP -- - • . • _ • +- _ _ - -Any,- city:or county which .requires,a permit to construct, alter, - 'POLES METERED SUB Improve,demolish or repair any structure, prior totitsissuance,also re- WATER SERVICE ' ALTERATION -_ • 'PANELS- -- MAIN -SUB - quires the api licant for such permit to file a signed statement that hex ' is-licensed pursuant to the provisions of the Contractor's License-Law GAS SERVICE _ OUTLETS SERVICE - -- AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that-he is exempt-therefrom and-the WATER-HEATERS- '- BTU OUTPUT-- ' - - - - - - - -- basis for the alleged exemption. Any violation of Section 7031.5 by - - - - any applicant for a permit subjects the applicant to a-civil-penalty- SEWER-CONNECTIONS"- -.1- - - - - - - - - - •- - of not more than five hundred dollars ($500). -- ❑ I, as oWner bf the property,or my employees with wages as-their - SOLAR TANK - - 'COLLECTORS - -- ' -- --- • - - - •_ -- ' sole.compensation, will do the work,and the structure is not intended -- - I or offered for sale. (Section 7044, Business and Professions Code:'The SOLAR PIPING SYS. • ISSUE FEE "-' - - -- - - 3 co-1 Contractor's License Law does not apply to an owner of a property • ;who builds or improves thereon, and who does such work himself or ISSUE'FEE __ __ • .- 'APPLICATION APPROVED BY 7 -/_, -DATE - 3-VL through his-own employees, provided that such Improvements are not intended or offered for sale. If, however,the building or improvement MECHANICAL -PLAN CHECK _ - is sold within one year of completion,the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING • Y r -D I, as owner of the property, am-exclusively contracting with AND DUCTING - - licensed contractors to construct the project (Section 7044, Business 100,000+ BTU _ PERmiT and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who Con- REFRIGERATION 0-100.000 B)•TsU tracts-from-such projects with•a contractor(s) licesned-pursuant to SYSTEM • - 100,000+g�.- • a the Contractor's License Law). _ „ 0 I am exempt under'Section -- ' -' ' -B.& P.C.for this- ' - . -BTU TU reason- - • - - - - Date Owner SYSTEM REPAIR,ALTERATION Itr , 'r • • MECHANICAL.$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE information is correct.'I'agree to comply with all city and county ordinances and state laws relating to construction,and hereby authorize 7T` �J' . 'C'. O 227( 1P representatives offthis city- to' out- upon the above mentioned property for my-ction purp• es. Signature -*-Z-ei - - 4-(4--:- Date _11 t '• , ' - ISSUE FEE ®c� Drivers' License or SS —//' \ CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor -- • to____1111, CONSTRUCTION AND PLANNING a POOL&SPA - L Date Inspector - Date Inspector APPROVALS Permit# APPROVALS Permit# _ 1. Temporary Electrical Service or Pole 43: Pool & Equipment Location _ - - S 2. Soil Pipe-Undrgrn _ _ 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn , - _ - -_ _ _ . _ _ 45. Forms - -- - . 4. - Electrical Conduit-Undrgrn _ . - 46. Electrical.Bonding - - • - ` 5. Steel Reinforce _d�4-„v,aa4t) 3_17_$) S 47. Rough Plumbing& Pressure Test - - ' - - - _6.- Electrical UFER Grn ' • . . • - l 48. APPROVAL TO COVER-GUNITE - - - 7. Footings .__ „ --. •• - . -fg_$Z 49. Electrical Conduit-Undrgrn 8. -Foundation- . _ . _ 50. . .Gas Pipe, ❑Undrgrn,Test • • 9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap, ❑ Undrgrn ' - - . 10. Structural Floor System (' a.Q„J,__} g -tit-gam.• P 9~7 52. APPROVAL TO DECK . • ' 11. Property Sewer Line & House Connection_.-_.. - . 53. Backwash & Receptor-Final • 12. -Street Sewer.Connection _, _ - - 54. Heater & Vent-Final 13. Rough Plumbing 55 Plumbina System -Final - - 14. Rough Electric-Conduit ' ' - -56. - Electrical-Final - - ,• 15. Rough Electric-Wiring g- /5 c3 Cc 57. Solar System-Final , - 16. Rough Heating &Air Conditioning - - b8. Fencing&Access Approval 17. Ducts, in Structure • -- 59. APPROVED FOR PLASTERING . 18. Ducts, Ventilating - -- - - . _. . . . _ - . 19. Gas Pipe-Rough &Test -- - - 60. POOL/SPA SYSTEMS FINAL 20. -Roof Framing- - - -I 21. Roof Sheathing - - - - - 22. . Frame and Flashing _'r'_ /..0“:-.5 7 Z5153X - .IL_93 - -P . -NOTES:- - - • • 23. 'Insulation - - $_/&-g3 0'1 C--10-w3 D.W'n0,/:w O(( in Gars o or)!y -J.t 24. Lathing & Siding - y.2'1_9'; "C- .7-/T-fl -U u.5sr,e-r9r o .v n. 25. Drywall Nailing 62k no'fe, - t-29-fl _80'7 7 /2r/?J' Fre , :n a F}C Pe,,d e1 rl 4 oh.�7i1 :` 1 C';1 . 1°ociph lei,. 26. Plaster Brown Coat - 1!-?0-cr-v -e '7i-,- 1i-Li-1534.2.....3-#-/y-,`- _ _ J G-4c✓w�%.y . _a�-7a�e 27. Electrical Power Meter-Final • - - o - ,•.j /vJ (f 26•. Final Electric t,cq/fit( (tr` - II 29. Final-Heating & Air Conditioning - 6j'"Z'i1 t7 C.EA - - - 30. Final Gas Pipe-Test - - •- - - • . _ - 31. Final Plumbing - _ - - - -- - , .32.-.-Water Service-Final - • . -- - 33. Gas Service-Final - - - a - - 34. Solar Domestic-Final .. - n,� • • . - - - 35. Landscape Sprinkling System - • 36. Sound Attenuation - - 37. Handicap Regulations �{ • - . 38. FINAL STRUCTURE & BUILDING `2 w 1_V�� _ _ 39. Special Requirements Completed �" 7 t • 40. Electric Release to Edison - - - ! 41. Gas Release to Southern California Gas Co. _ - - ' 42: .CERTIFICATE OF OCCUPANCY _ .- • �"' N'o. Date - . - - .- k '4 111.111111111.111"1"1.1r-1 LATION d CERTIFICATION ka iS1. east. es4.. Ora n Number an Street City Cmey / USRtreedc. -- 900r T3- Suborvl.ion Lot Number • • DESCRIPTION OF INSTALLATION ROOF Material Brand Name Thickness (inches) Thermal Resistance IR Value) EXTERIOR ALL Mai trial f/pitl LES /ISM(SOU_ Brand Name esterta1SttenA• 11 Thickness )inches) b Thermal Resistance IR Value) CEILING • r I hr Batt or Blanket Type €r !RSC T.YY'I�C. Brand Name C6 ,,J�A1NtCe 0_ GA" G Thickness !inches) Thermal Resistance (R Value) Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb Area Covered (ha) Thermal Resistance (R Value) FLOOR, ELEVATED Material Brand Name Thickness(inches) Thermal Resistance (R Value) FLOOR,SLAB Material 'Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL • Material Brand Name Thickness (inches) Thermal Resistance (R Value) DECLARATION I hereby crnify that the above insulation was installed in the building at the above location in conformance w,th the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 74 of the California Administrative Code). o ,e _/n/ /I a %S General Contractor (■uIder) License Num,uer Signature and Title Dale Sub Contiector (Insulation AppI.calor) License Number Signature and Title Date Figure 4 -1 Example of a compliance certificate 4-9 \2C� 2sA �/' (' Fri Twining Laboratories of a tithn e 1--"Cunni _ (, fine' PO 90V 41 . 33.0 .`,:Poor •.V., . LONG BEACH Cl,Llc 9080i • .7.3) 42P 3355 . .2.3) cat.238o • 1714) 8288432 - •,:cOlt CO TESTING 7 • Si•20•E August 7, 1978 Examination: SC78-3459 COMPRESSION TESTS ON GUNITE CYLINDERS Mr. Errol F. Heesch 1292i Aspenwood Lane Garden Grove, California 92640 PROJECT Pool for KARL GIBBS POOL ADDRESS 2828 Tabago Place, Costa Mesa SAMPLE FROM Gunite Swimming Pool ARCNIIEC1 CONTRACIOR South Coast Pools ENOiNfI; SURCONIRACIOR Grove Gunite Co. SPECIFIED MIX 41 to 1 STRENGTH 2,000 psi DATE CAST 7-27-78 CYLINDER SIZE 6" x 12" DATE TESTED 8-7-78 8-7-78 C' LINDER NO 1 11 3,4,5,6 "HOLD" COMPRESSION 11-Day 11-Day TOIAL LOAD, LeS 88,000 101,000 POUNDS PER SO IN 3,115 3,575 COMPLIANCE 11-Day test complies with specifications. ,BADE SI QUIVERED Nr RECEIVED ON CYLINDERS Ray Hoesch 7-28-78 DISrRIeul,ON RECEIVE" E. F. Heesch - 2 b y South Coast ?ools A1/435 - Grove Gunite Co. ,.Costa Mesa Bldg. Dept. _ yam _ IMF ' PROJECT ADDRESS: 2828 TABAGO PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 055034 OWNERS NAME: BASKERVILLE, WALTER E TR ADDRESS: 2828 TABAGO PL PERMIT NO: B 055034 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESHT.REROOF W/DURA LITE ICB0#2093 SQ FT: 7, 800 ADDRESS: UNIT: CLAIM VALUE: 7, 800. 00 CALC—VALUE: 7, 800.00 GROUP OCC: R-3 / PERMITTEE: COASTRIDGE ROOFING ( 714 ) 557-6048 ADDRESS: 2480 FAIRVIEW RD COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME CM CA 92626 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N. G REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CITY LIC.: 049912 STATE LIC:541190 ��/ CLASS: C039 Date_f/ -- 1Z — ' i/ signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby after that I have a certificate of consent to sell-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 RE • PROV: PARCEL: 13933209 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES> Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E"L OPMENT SERVICES R E Q U I R E M E N :T S I certify that in the performance of the work for which this permit is i sued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. Y,, ZONING APPROVED BY DATE: / ( —\' r1/ signature: 1/ BUILDING APPROVED BY NOTICE:II.after making this declaration,you should become sub) 'lo J[he Workers'Compensation provisions of the Labor DATE: .. Code.you must forthwith comply with such provisions or 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: —Cr • DATE• I')'_) 2' t" which this permit is issued(Section 3097.Dv.C). *********************4******h** * • ***************************41F*****0*** LENDER: *************************************** **************************9E********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that lam 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 99 .0078 78 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 oe the Business PLAN SMIP/NON—RES,—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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 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----> 99. 78 0 . 00 0 .00 99 . 78 99 , 78 . 00 does not apply to an owner of.a property who builds or improves thereon,and who does such work himself/herself or through 1 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• 99 . 78 OVER/SHORT: ' 00 foror the purposea of sale).improvement 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 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 9 9 .00 .78 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon ). and who contracts for such projects with a contractorls)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* Nat proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL ' FEE BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason. TYPE QTY DESCRIPTIO N UNIT COST .TOTAL- COST Date: Owner. SFR 7800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 800 , 00 I do hereby certify 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 for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from these provisions. Dale: Applicant. I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county • i ordinances and state(avis relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes, L �Batc—�/ Ir ---2 Signature: / �� le ' • ' � • GI - DATE: 11%i. "'IL I , _ ' i` Driver's License or Social Security 0: 1641-46 While—Budding;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING / POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Servile or Pole - 52. Pool & Equipment Location 4. 2. Soil Pipe-Undrgrnd. .a. 53. Steel Reinforcement ;*_.' 4£lectrical Conditl3tility-Undrgrnd. 54. Forms (a;c z. - rk. Electrical Conc(ulbUndrgrnd. 55. Electrical Bonding dy 9.t iel ReinforcAni nt 56. Rough Plumbing & Pressure Test ,r r aTau•G-^tctectrical UFRi?iiernd. ..4-1-1. 57. APPROVAL TO COVER-GUNITE 'c 1 •T.-Footings �•-- 1 58. Electrical Conduit-Undrgrnd. tji foundation =a ' `" 59. Gas Pipe, 0 Undrgrnd., Test • -c :9. Water Pipe-Un82gi`nd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 4.- 71 11�. Structural Floor System 61. APPROVAL TO DECK ft. Rio pert), Sewer Line.& House Connection 62. Backwash & Receptor-Final H rt" irr r- t-2. SeWer Cap 63. Heater & Vent-Final . rt. a: a: 13. Roof Drains ^� 64. Plumbing System - Final 14. Rough Plumbing p 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough ElectrictWiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL A. 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20Yr,Ro h ctoe F e lace , i{rn " + ' U �M " t ' - r-`Lf- - -* 4. 1- Ol y b P •n+. C r tr'4 *APPRk9VALS;7OPet_mit # '++ "Y "C :r .1' S'.r i 'C"- rS:f 't' G ,-r _:f tt u cni -fit-. * ,r! 211Duc s,In_.Str ctuie, 1 •�F' T > ?: r- =r :t, Z s cr-'-,¢ �, a: n r3 r 1 •. .. I-S .v i !n a ,70. KTitde7graand H ro y 22. Ducts, Ventilating .I. 1 .'S a • ¢x; * '171. ProducY''Psping6te as DOil 23CGai-Pipe�Ro,ugh&'Test ! i S * s !fit w X72. Underg 4h F s1 o, x - - 24mRo'' Fcari`n •_: I :_, • .M , > u, ;:r. .1- .j r-ry ., w x .• R, ng , 0 er ** ;73:•:Undergrrb#.Storegt;Tank'C Gas ❑Oil J-a ••.4a--;": ••' .L ,.arc : .. fl g. 25. Ro'6f S Cathing �+ S v.4 F;•L q &' bp, �74-j 74.. -�No .t a t- .,. .�r�l� cn iJW- x U) .tea a 26,,T-( dr Ceiling (Structural) & jvlonocoat w L G tar* -4; 75:-.'Dry Chemical 7 a. + a cc 27-Frame and Flashing 'r * ri1 * g' 76-75-y StanUte '1� x It if `x g Ott ; r for K t r 'l �1 •> .~ , ; .rin:„ T a >44 .T S. • �t H le CO L ,_28. Lath ingf Skiing-4. „ -j<Io tg. -r s ••:. 77.,;' FIXED SYSTEM:rsINAUc tr t o a•�l �. .. 5,, c -"29. InsulatP%-t '� " C r. -- > : !1 ( I .;: 78y-'FIRE PREV. FINPr;L x -, ix 930. Drywaltavail ng if4. * I I * ,HEALYI- EIre: MEOW R MENT 31. Plaster 8 ow4 Coat' I a. I --' z 70FINAL Ig&ECTION ,327,Electric�i Poiyer, lg-i n-Finals x. o� I •t. :K n80rnF00D CERiIF(CATE IS'Sl7ED' 33'CFirtal ElectrL. I *: tr o ' i �- * 7Ndfes: i `=is *to T n S I-0 c,- rn I Q * * * 1 , ''ir- ^ITl * ': ti. talcs {;i340Fir"r�J_` Heating&'7/46'togditi4r74; r, . i I -it ? ;� s l^. :rs �C 35t*:Final Gas Pipe-Tfiztt- i _ a y 14(�',k n j ms <. tr' .,36. Hog`l1 ofCanopys± tC 1 lr'1 _. i n - S_ too •'1 . !r. Wit,. '-i37CFinal Factory Fi'Feplace I .-err 0- l 1n 1 Y z Ci , r •CI _ .. .. -� r 'r 1 i-r-, 't' a. I ' * ..- - CU ''38. Fink Pl4lmbin , -c - , - -- I- x Iv .4 'Q a• S I Y r t ._ s .v .139. Water Service•Fina11 I as I la t n o)al 4. 1i; Q Y cc I Ea 7,a4 a S `' t * 01 •rt"40. Gas SerWce-knal * to in LCIT (r S te pj bet) L-1-0 s a F - - �. -t >41. Solar Domestic-Fir-Cals. n •• _. ;ti I ' .t. <l� .-+ •--42?Backflorl Preventer '' x C. I t ` Y :J ,k -7 • C I-. V - 43. Backflow Irrigation .X�;.� :r; -t a. »- C ,4 r ,t ,. * ii ,- 4 n • ;7:7,44. Landsc a lcti_anon SYste °' " ' r x 0.1 ` Q e Landscape q rrrA. zZ tr. .>: El I., Ca: a: X .Lr ICC :C;1 �: Pi a ±45i'Sound Attenuation •-'-J - .r _ S H Hn ` I- C o. .; 4 -. - .. .. in M Ir.l: • -- 1- Cr, • .-n �461-Handicap Reeiulatidns ,0 •"'1 •''i x 4g ,:S 7 S t• . •47sFINAL STRUCTURE & BUCLDING / ` �']]/ j e •'✓•= tr. tr 48i',FIN'ALPLANNING ' " •" ( T1-I".. ' `t ;e `6 .;�491TEle�trili release to.Edison I e 1 jr Y. % ,, _ (i I/` •)1141:1;_. .^C -be: /.r....4____-, . OP ---4044,. ''',50 Gas h�{{ ppelease to SouIhern Ca Gas Co . ktP '# :7. L'' _ • "''r a' :'51. CERTIFICATE OF:OCCUPANCY "` .• No. Date ..1 : •.i .'4r _ _ :rY:. Ir_ ' .� : ..,.,r.: o . is . - . . CITY OF COSTA MESA 2 7,10 %fd8,fa, 2)2.. Building _ , ! ' - DEPARTMENT. Address OF - ,,// _ n _ BUILDING SAFETY .CA,v/ 4865 Owner ,g . . S• 6A sr Poe t Contractor' Registered Deputy Building Inspector -. /� �• - - Certificate of Compliance • (.D374 /fes9 Address • 7-J7- 9, PermitDate '• Date of this Certificate 49,943 Number 07 Issued- To the Director of Building Safety: . I hereby certify that the following portions of work on the buildings at the above address which required continuous inspection and which I was • employed to inspect, were inspected by me and comply with the provisions -of the Building Code applicable thereto. . 1) Concrete -3) Welding 5) Special Cases 2) . Masonry , 4) Reinforced Gypsum Swimming Pool Size /.S /30 Gunite Hand Pack Sacks Cement /94/0 Tons of Sand 41f Approximate % of water in aggregate 5Z ' This report covers work completed during week ending . 7-.2 9 - 79 REMARKS: _ � 1360 L 00— c I �/ p ( a.1 l..A` REGIST rr 'EP Ti BUILM-N& INSPECTOR • ' ' Name ' E.¢°L F 4 eseN Address 4,71/2,000 6/200e • Laboratory Iuiminu Telephone 97/- 39J_ 7 _ Form BU 6 '..(oen4c ' 1:.:.x'..•.... J___Je. ::,,,:g ik-pz_z.'wi:.i:�u., a�5.:w r:.....�:�.:a+:...—-,--.�s _---_,-.-.,c.„-;;,..„ OWNER THORSEN, JACK / DATE 6-6-62 JOB ADDRESS 2828 TabaQo P7.. Lot #4B BUILDING PERMIT NO. 1720_ GENERAL CONTRACTOR Walter r . Kenrich VALUE $ 1014.00 AP No. 139-332-09 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Plk Wall INSPECTIONS Signature DATE GROUP J TYPE III ZONE R-1 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power 0 Rough Wiring trenches Forms U Steel Heinf. Floor System Bond Beam 0 Steel Reinforce 0 Edf Sheathing Frame and Flashing Lathing — In 0 Out 0 Plaster, brown coat Tieing. 0 Air Cond. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final IrMAQ.-qt.-6)) OCCUPANCY FORM BIM-5M - 7-61 17205 17205 FEE RECEIVED JUN 61982 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT Vd Y &'- pg OR PRINT �/�/ , BUILDING ADDRESS a(J ` /� 7-44-----a--e 4/ (/ COSTA MESA. MESA. IC'ALIIFOR / 'o\ For Office Use Only OWNER 3;4-G. K -r U R S F/N I RECEIPT NO. I PegMl,_,;�+oC 7 MAIL RECItet BY DA RE/G,a,IVE 4 9 I OAISSUED/ ADDRESS 7-S-14--A� TA R AR O I -(�_E/TEL. (Y ^f/T'F^� CITY C O 1 7,T MES/}- NO. BUILDING r' 2 g /J� ADDRESS ar7 J �� ARCHITECT TEL. — COSTA MESA. CALIFORN OR ENGINEER NO. ADDRESS r FIRE //�� C it cAl n �L ZONE TYPE ((J I GROUP G I Y CONTRACTOR W44 - T EA F, yry PG // APPROVED DATE j/j ADDRESS 12-33 StRA4/C PL- ZONING CITY G O S 74 114 /� ZONE /) / I floor �I U88 OF NEW,Lr��i� Op S�/ p �j /A/l PLANA p BUILDING i .... STATE LIC. /( 7 2 I TNO. lei x/31 '- ! `LEGAL I1/ O T V y DESCRIPTIO Y" I TR, 4 O 0 0 SIZE V Q NO. OF BLOTE. l / 9—ttt �l� 7—— 0 y OF LOT 7.l X NOW ON LOT / A.P.NO. USE OFiYARDS EVES ��- EXISTING BLDG, A _ APPROVED ALLOWED SETBACK LINE FROM 0 (CENTER LINE ST.) CENTER OF STREET REAR YARD FRONT FT. IN. ce SIDE YARD I LEFT I RIGHT d R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE FT. IN. NEW L/I N ALTERATION I II ADDITION I REAR FT. ON. /P /ON./ REPAIR I II MOVING I II DEMOLISH I APPROVED %,�/ �� /T DATE C. `f, -6, BUILDING NO._OF__--__ ('(f /�r/ SIZE ROOMS --STORIES- EXTERIOR WAIS _ROOF--- .. COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED CONT CREE fyc.oCK W,4L-( rte., EAST, P/L I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. J �T VALUATION SIGNATURE OF ✓7 i�l1y"e't".4-- ` \ .j PERMIT FEE $ 3 -� PERMITTER $/� / G/(/ o 7 / PLAN CHECK $ °k AUTHORIZED AGENT /�[ �' E K TOTAL FEE $ u OWNER GBs DAIL 7_17_7 JOB ADDR SSS 28828RTabago Place BUILDING PERMIT N0. 46403_ GENERAL CONTRACTOR Soli-Coast--P-00-16-DESCRIPTION of WORK Pvt. Swimming Pool x/Spa_ APNa139-332-09 LOT TRACT 4008 FIRE ZONE VALUE $ : :.0,00 INSPECTIONS Slgnoture Dote GROUP J TYPE III ZONE %j-1, i PERMITS ISSUED Pool Location Q_ °` 1-1.•716 SUBCONTRACTOR Dote_il N„rnb,,_ 1Siv_noture orms 2 Main Drain Steel Reinforce Elec. Bond ,E{lectri�c/ ,// �Q ,J GJ� Approval to Cover C, C 7.2r7t Asca L esztf” asi 7-1771 //. .., Underground Electric C.. t" A'fo IS 9 Gas Piping Test C.� 7,k5-.115. Plumbing i L 7/7-7, 74,3E Filtering System Lines Backwash Lines and Recep. Electrical Final - J.... Heater and Vent Final Filter System Final C A N i C E LE' Backwash and Recep. Final Fencing Final r R-2.4.75 Gam/_ . _._ u_n I \ • . 1 ~P P • /Mlle / ,-.1 COSTA MESA BUILDING-SAFETY DEPARTMENT V96` 7/17778 776 66.62 TL P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink O y T/J/J /j/ RECEIVED BY DATE RECEIVED DATE ISSUED/ ADDRESSBU LDING OWNER '/�, ?r?t ///[y�(J/7Co /t, r la1/' OWNER /�4TeL (�-r 6qs A.P.NO. 139 -332 —o1 —J2? S 3 I BUILDING r�s AMAIL DDRESS get i? TgaG° ADDRESS / Bag I /i " i' �r CITUiQ A /rj-SSR TELTOTRACT YDg LOT // BLOCK CONSTRUCTION NEW ADDI ALTER REPAIR MOVINf; OFMOLLSH LENDER BRANCH / /OWNER 0 ADDRESS .. .-"------------- ARCHITECT 1/ y __-• , / ,, UE nen�i TEL. I/'rY/y�S .{'(((�LI(G .'� S ��"' OR ENGINEER NO. FIRE ADDRESS 1 /O ZONE TYPE ROUP / CONTRACTOR SCCA'} ��7/�W +4 Oe/S APPROVED DATE ADDRESS 6Y9 j 9nEL- -CT. CITY Se) '{/9- !/, ta6./7 TNOL S5 0465 ZONA --1 PLANS NEW BUILDING fret' F STATE // CITY YARDS APPROVED YARDS APPROVED LIC.NO.0 JOU O/ g) LIC.NO. MAIN BUILDING ACCESSORY BUILDING id SIZE 7S- x /O O INO.OF BLOCS / (FROM C/L STREET) /� Sat 0. OF LOT NOW ON LOT FRONT FT. FT. USE OFF EXISTING BLDG. if—A5 W.-5i R SIDE FT, /3 FT, ' s& [/ 9 Separate permits are required for L.SIDE FT. / / FT. ^ L1 electric,plumbing and heating work. REAR FT. /d W FT. (.., USE OF BUILDING AND WORK TO B PERFORMED DISTANCE BET. BET.MAIN& Q /� / ` 1 / / MAIN BLDGS. ACCESS.BLDGS. T/////A/�_r//J� VAR.# DATE ', r C.V.P.# APPROVED /J�/J } APPROVED i[ ///.// DATE 7// 7/76Q 12 0 I hereby acknowledge that I have read this application and state 'n N a that the above information is correct and agree to comply with as 0' all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMITy9 ONLY: n am exempt from the provisions of the State of California Business 6J6 es VALUATION PERMIT FEE S f/ N and Professions Code, D vision 3,Chapter 9. 00 es �' aa•, PLAN CHECK S m Signature of //'� Permittee $ gybe) TAX $ A. V •0 Authorized Agent TOTAL PAID E COSTA MESA`BUIlDINO—SAFETY DEPARTMENT 9598 7J17/78 12,6D } P. O. BOX 1200 Costa Mesa, California ..4LECTRCICAL_PER?MIT :APPLICATION,..: TRACT NO. RECD By 4 " X2J ELECTRICIAN nLet h ` CJ JS7 atV'S LOT NO DATE ISSUED C=.4/•: ADDRESS 4 9d/7/Z,('GZBU NG USE CITYC�SAy1 /7jp /4 Tit. NO. S%6—d6:° / // Y , STATE LICENSE NO.0 36 FT/O CLASS �L �.) CITY LICENSE NO. / AOIDRESSLC7o2J at 4. .I a 4.17 '.' \t L NO. ITEM EACH FEES COSTA MESA, CALIFORNIA Dwelling, Sq. Ft. S NEAREST ^\ '` CROSS ST. k ` Y \ Vag;IW F'Garage, Sq. Ft. I OWNER KARL •6% )34\ ' i 0 First 70 Outten. each ADDRESS 2??S' ag;AC C) J � Q Outlets, Additional CITe � �ry TEL. NO. First 20 Fixtures, each I HEREBY ACKNOWLEDGETHAT I HAVE READ THIS AIPII- ";Yj )" OPB CATION ANIATE THATHATTHE ABOVE IS CORRECT MID AGREE —I Fixtures, Additional TO(TOOMPLY"WITH ALL CITY ORDINANCES AND STATE LAWS RfG- .;?. &LAT__ING ELECTRICAL WIRING, `` LLE mi ', CERTIFY THAT I POSSESS THE ABOVE VALID STATE Of ..; O. Dryer ,. fl \ LIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER Of ;'1: v THE SINGLE FAMILY RESIDENTIAL PROPERTY DESCRIBED ABOVE. 0- Fan rt )Y Z Heater Slenotsms e _ �a EU r (5...:} tr'4 PERMITTEE ri Oven. Domestic CI Y MO, ITEM EACH FEES ' I— Pole, Constructione{.2�' Sign S 1 Irons. 2.00 Range, Domestic�1 ` Transformers KW W • • CCgt) .......... . .... . 0 -;6 9-47 6"'y G rOtani\ p !W.7% v t trsf IL,--, '•+S! - Motors IS.. Schedule) cn L I-- HP YIkp! C HP q` ey/ n D r C 1 HP T ¶3 oAF 7J 11J-APPROVALS I1 G. DATE Melon, en. TEMP. POLE I» IMDERGROUND CONDUIT I l_ +/6- Permit Fee 3 00 ROUGH I Sub-Total fees FIXTURES I I _ POWER I I Total Fees UTILITY CO. NOTIFIED II T FINAL C re ._ e. CMF 0313.46, rev. 705 , tot For items not listed refer to Fee Schedule BLDG- PI O"IT "n • COSTA MESASD!LD4NG—SAFETY DEPARTMENT 9597 ,J/17/7p 6.00 TL h . - — P. O. BOX- 1200 . Costa Mesa, California ,a. .. v ;. IPERMIT N0. r . 1 r II UMDin a rypRECD. BY - CONTRACTOR ..... ..tel–i, (Ofp4 tJOO/S LOT NO. DATE ISSUED Address 9 Q�eegt ST. BUILDING USE 7f / i, City COS/A /1)rig Zip Code 907‘74, Building �8a� i��p�0 v Address ?. State License No.0 e>08 Class. Owner pia. 67; a4 s ww City License No. Tel. NI>Syd—(&-6, Address 28c9 o Mg AC a I- Q NUMBER TYPE OF FIXTURE OR ITEM FEE Cot14 /Ih"�4 . c-5-/6_C667 o Bathtub City Tel. No. J Laundry Tub or Tray I hereby acknowledge that I have read this application and Q Automatic Washing Machine state that the above is correct and agree to comply with all City Ordinances and State Laws regulating plumbing. Shower I certify that I possess the above valid State of California classi- J Sink, Bar fication or I am the legal owner of the residential property de- ':•1 Q Sink, Kitchen scribed above. W Wash Basin(Lavatory) I certify that I have obtained a permit from the State Division of `V Cl. Industrial Safety fore cavations,other than swimming pools,five Water Closet(Toilet) feet deep or deeper a into which a person is required to descend. CC Drinking Fountains St d Fluor Drains Signature of Permittee Z Interceptors 1s.i rilL Receptors = INSPECTION RECORD `.y Sinks,Commercial or Industrial Sinks, Floor . "na Sinks,Service �^a s willi ';'% 2 i Swimming Pool ' Urinals �� .t� �� W WPM'S Jr a. Dishwasher CC Garage Disposal Water Softener • Water Heater and Vent p rAaaI ' - 4 Y Gas System ...Outlets. .. Ue y Roof Drains L !A Water Piping Alteration INSPCQVR DATE = Backflow Deventer I U/G Soil . F lawn Sprinklers(Res or Non-Res) U/G Water Property Sewer... Feet Services—Water 0 Gas 0 House Sewer Connection. Rough Plumbing G.tv 1- 2S- 7 r Cesspool,Septic Tank Sprinkler System Sewer Cap Gas Z, C "7-2.s_ 7 v Miscellaneous Property Sewer Pool Receptor C. C. T aJ-'1 y Filter System 1 l Sub-Total • . Pool Heater L C ,.•)-5--'1 f! — Reinspection Feen Miscellaneous P-rt4p t ,C 7 'L{-'7 �- Processing Fee C L Final Gas LI d_ 53 _�� 71(TOTAL FEE / I 11,e Plumbing Final (Q Utility Co. Notified CMF 0450.46 BLDG. PERMIT NO. 14f0.g COSTA MESA BUILDING—SAFETY 'DEPARTMENT 9596 7/17/78 12.01i r.: P. O. BOX 1200 Costa Mesa, California ., ELECTRICALJPER�MIT,:APPLICATIONS s. TRACT NO RECD BY AP NjlTgp•�, ,T✓/re ELECTRICIAN -Soli} PA `UHS7 gly00 -5 LOT NO DATE ISSUED ADDRESS b1/9 Orner EZ SI CITYeIjSf /7/PS/4 TES, NO. S/'d C0 6 `51 / NG I / �Y STATE LICENSE NO.C$GO 0/p CLASS. CITY LICENSE NO. ADIDENSGZga �/3-�O NO. ITEM EACH i FEES COSTA MESA, CALIFORNIA \ Dwelling, Sq. Ft. $ NEAREST CROSS ST. o HGarage, Sq. N. OWNER KAeL. G'' ea p '� o O First 20 Outlets, each MAIL�Si e')/ 7.i Outlets, Additional CITY�LT.t'r9 _ 0; FiestaTEL. NO. First 20 Fixtures. eat)1 I HER VMilli- )" THAT I HAVE READ THIS PA- } CATIONTE THAT THE ABOVE IS CORRECT AND AGREE i PL WITH ALL CITY ORDINAACES AND STATE LAWS REG- CC nip Additional TII ELECTRICAL WIRING. Wt CERTIFY THAT I POSSESS THE MOVE VALID STATE OF O Dryer -Wk IFORNIA CLASSInuTION OE I AM THE LEGAL OWNER of CC Fon4�'�yl� �' IHE aINGIE FAMIIV REa10ENTIAL HtOI'ERTY DESCAISED ABOVE- ME Heater Y WFERMI Signature Oven, Domestic ^ NO. RW LAOS FEU I— Pole, Construction ^W" Sign& 1 Trans. 2.00 ccRange, DeJge ic) / Transformers KW W 1 (�A/. 1 0- - � CC lair' I T L N t Mo an See Schedule) , • mrd cn F HP( atO ( 0 (MTh P HP .� eN 1'2-3-APPROVALS . NOFECTOE OATS Meters, ea. TEMP. POLE /1 Permit FeeUNDERGROUND CONWC_IT I -1T5. 300 ROUGH I Sub-Total Fees FIXTURES POWER I Total Fees . /R0767 UTILITY CO. NOTIFIED I )� S� 40•01•11S- Itl FINAL I V TX--- aa -11 CMF 0333-46,rev.7/75 BLDG. PERMIT NO. I 11/ For items not listed refer to Fee Schedule • "A COSTA MESA BUILDING-SAFETY DEPARTMENT 9597 7/17/78 F 6.00 T P. O. BOXY 1200 . Costa Mesa, California I_ II r I . I _ 1 'APERMIT NO. P I UCATION- TRAcr NO RECO. BY ,p� :.. CONTRACTOR a. '/4 Wns%) abots LOT NO. - DATE ISSUED AddrOSSG99 ' rnp,9 eeet Sr' BUILDING USE 1�.,r,', 71 City eosig mei', Zip Code 9�6zb Andress n( er• ii9a4 0 // f��L/ te, Stale License No.0 &OO18CIan. Owner Katt 6; 4aB S wCityLicense No. Tel.Nn `[U/// 7 Ma l n p Q 1 /fes Addie//ss��f o//� TACE A� C D o QO NUMBER TYPE OF FIXTURE OR ITEM FEE City`^'674 47e 4' ' ` .4-Tel.No.,-596-4566/ Bathtub J Laundry Tub or Tray I hereby acknowledge Mat'! have read this application and C AutomaticWashingMachine state that the above is correct and agree to comply with all 1City Ordinances and State Laws regulating plumbing. ' i Shower I certify that I possess the above valid State of California classi- J Sink, Bar fication or I stn the legal owner of the residential property de- ¢ Sink, Kitchen scribed above. ILI Wash Basin(Lavatory) • - s I certify that I have obtained a permit from the State Division of d Industrial Safety fore cavations,other than swimming pools,five O Water Closet(Toilet) 2 feet deep or deeper into which a person is required to descend. K Drinking Fountains fl a - . Signature of a )) 3 ^ J Floor Drains - 1. t t Permittee ' •y Z Interceptors _ e E" \ w 3 Receptors i _. .)1. INSPECTION RECORD Sinks,Commercial or Industrial' Sinks, Floor .1 ) t 1. . - q Sinks,Service;l t.f" � n —, I. a� � Swimming Pool' ?a'lp Imitslitit a. Dishwasher J 2 Garage Disposal D Water Softener O Water Heater and Vent �O sa • - A ' Gas System ...Outlets... e V) Roof Drains _ H Water Piping Alteration INSPECTOR DATE ✓ - Backflow Preventer U/G Soil I I I-- Lawn Sprinklers(Res or Non-Res) U/G Water - I Property Sewer... Feet Services—Water 0 Gas 0 Q House Sewer Connection. - Rough Plumbing. G.F .{ -2.S- 7 f[ Cesspool,Septic Tank C. -• . Sprinkler System Sewer Cap - Gas C. C '7-I S- 1 Miseellaneoui• t '- I"- 14,.VI' `-. ` - F Property Sewer Pool Receptor C.C. $-:"1.i'-"1 Y Filter System L Sub-TotalPool Heater C C. g.)-5C 1 S Reinspection Fee - Miscellaneous QiQ4p L ,C -7 '1..c-'7 Processing Fee O/1 I .74,.,. _. I ._ Final Ger Plumbing Final C`e' TOTAL FEE _ 49. Utility Co. Notified CMF 0450-46 BLDG. PERMIT NO 41/CA5 .` Lot. 48i . ,_3968 / E RECCEIVED�ja- - COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 6 1141 P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLICATION 01R $ERrKY{�I7TA MESA TYPE OR PRINT F� BUILDING BUILDING ADDRESS ‘ 4bTnc,O r ‘• COSTA MESA. CALIFORNIA For Office Use Only OWNER Investors Marine Inc. RECEIPT NO. I 115N9z6 ] MAIL L^ RECByyY�D BY DA RECEIVED DATE ISSUED ADDRESS 1600 W Coast Highway !/C% I —(o/I van R 196' CITY Newport Beach,Calif. NO. 1¢ ADDRESS rt �� ARCHITECT Same TEL. Epi/COSTA MESA. CALIF IA OR ENGINEER NO. ape /COSTA FIRE // ZONEIRTYPE / GROUP jilt CONTRACTORMeSa Verde Builders, Inc. APPROVED 1653 Minorca Drive BY DATE ADDRESS ZONING CITY Costa Mesa,Calif. ZONE A II PLANS y I BBELDINGf.. ':4 II STATE NO. 181269 NO. Ki 9-0395 LEGAL PITON _ 1• C r_79#-LI TZ9#—/z/ k' 741 I DESCRIPTION rQ� V SIZE x 98 NO. OF BLDGS. 0 OF LOT I NOW ON LOT A.P.NO. USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE PROM 01 l l 1 (CENTER LINE ST.) /�I ,, Q CENTER OP STREET 4 REAR YARD .Yi FRONT //OFT. {J�-' IN. SIDE YARD I LEFT 5,-6. I RIGHT I R.SIDE / / FT. . DESCRIPTION OF WORK SFT. ( IN. L.SIDE NEW I 4 ALTERATION I II ADDITION I REAR / J FT. - IN. REPAIR I II MOVING I II DEMOLISH I APPROV BUILDING1700 Sq.Ft.NO OF 7 1 BY DATE - �/ SIZE ROOMS STORIES EXTERIOR WALL tiding ROOF Sh 3?n ffe (I _- aJ / �- COVERING (� SUCCO I COVERING "G k ( �Q USE NG ANI)WORK TO PERFORM D / family resi ence an garage 9 — Ley p Model 750-D Garage not attached 462 Sq.Ft. I HEREBY ACKNow GE THA I HAVE READ THIS PLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT TH ABOVE S CORAL AND AG T COM- PLY WITH ALL CITY ORDINAN S AND ST TE LAWS G TING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. / I VALUATION SIGNATURE OF 1 177(1 �,/��- it 11 tit-c CPERMIT FEE $ �� N - PERMITTEE J $ 2 J 946- PLAN CHECK $ a D.SC AUTHORIZED AGENT /-/ s6 E TOTAL FEE C.v - is.