HomeMy WebLinkAbout3328 WYOMING CIR - Building PermitsPflOJECT p00flESS:
�WNEP'SNAME: �3ZH WYOMING CI
nooness:ROS5, GROVER
3328 WYOMING CIR
1 CO'�� MESA,CA 92626
i i
PNCNIENGINEEN: S AEG.NO.:
RUOflE55:
UNIT:
UNIT:
PEflMITTEE:
, aooeess:ISI�AND PACIFIC ROOFING ( 714 ) 637-2493
V1�94R�12Tn�M/�CL/�A�7RpENp LrNV (�n o ^
I LICENSEO LONTflACARFOtGlTAR11T10N:T1`fR1P0ylIIiVm�2hFdm IicenSeE un0erq�ovi�6� � Gl
� 7000) ol Orvivon 3 al Ihe Business anA Pmfessions CoOe. and my license is in lutl lorce anG eVei
� CITY UC' I VqI STRTE LIL.6 3 1 4,� Z CLASS:
Oate: �!`� 1� 9gnaWre:
9 (commenting wiih Seciion
� WOBREPS' COMPENSATION UECLAflRTION: 1 A¢re�y a��irm �hal I llave a cetlilitale I c sem io sen-insure or a cenilicate of Workers'
ComDensalion Insurance. or a ceNtieE copy thereol �Setlion 9800. La�. C�.
POLICY NO.: EXP. OATE:
COMPANY:
i ❑ Certtliea capy is �ere�y fumi5he0. ❑ CeNIieO copy is lil¢G vni� t�e city Builainp Division.
�
�
�ale: ApDlicant:
E%EMPTIONFBOMWOHHENS'COMPENSFTIONOELUflATION: Q�i55eclionnee0nolbecample�eUillAepermili5�arone�unEreO�SiW�orla5�.
I ceriily ihat in ihe perbrmance ol Ne work for which I�is Dermit' 'ssued, I shall no� employ an per5on in any manner So as �o Gecome
sublect�yr @e�Wor�Yqj 5_Compen5aiion Laws ol Cali�ornia. �
Date: �7 I � 1 � S.
NOTICE: Ii, atler making �his Ueciara�ion, y 5h 4 betome SuOjeti lo llle WOrkerS' fAmpenSaiion D�ovisions ol Ihe La�or
Cade. you musl fo��with com0ly wit� Suc sions or I�is permii s�all �e 4eemeA revoke0.
CORSTHUCTION LENDING AGENCY: I �ere�y allirm thai there is a constmctian lentling aBe��Y �o� �he Dertormance ot tAe work for
which ��is permil is issued (Sec�ian 3097, Civ. C).
LENOEP:
PODNESS:SMOKE DETECTORS ARE
REQUIRED PER 1991 UHC!!!1
OWNEfl BUILOEN DECNFATION: I hereby a��irm t�al I am exemp� �mm IAe ConiracloR' Slale License Law lo( I�e lallowinp feason
(Seclion 7031.5 Busine5s antl Pmfessional CoOe'. Any ciiy oi county which reQuir¢5 a permi� lo consimcl, alter. impmve, tlemolish, or
repair any slmqure. prior lo ils issuance, also repuires ine aDO�icant lor such permit lo lile a signe0 statemen� t�at he/she is licensetl
pursuant m the pmvisians ol �he Contraclors' Stale License Law �Chapter 9(commencing wi1A Section 7000) oi �ivision 3 0l �he Business
anU Pmiessons Gotle) or �hai �elshe is exempt iherefmm ana Ihe basis lor Ihe allegea exemp�ion. Any viola�ion o� Section 7037.5 by
any ap06cant �ar a permi� su�lects �he applicanl �o a civil penally ol nol more �han live hunAred dollars ($500).
I, as owner ol ��e pmDeny or my employees wi�h waAes as Iheir sole compensa�ion, will Oo �he work. anA Ihe
❑ slrucWre is nol intenaed or ofieretl lor saie (Section 70aa, Business an0 Pmiessional CoOe: iAe Coniractors' Staie License Law
does not aOVty lo an owner o� a OroDeny w�o �uiltls or improves ��ereon, and wM1a Joes suth work himseli/herse�� or ��mugh
his or her own employees, pmvide0 ihai such imD�ovemenis are nai intendeG or o��¢reG lor sal¢. IL Aowever Ine �uilding ar
improvement is SOIG wi�hin one year ol completion, �he owner will have �Ae burGen ol provinp he/she Gia no� �uiltl or impmve
�pr Ih¢ pufpOS¢ 0� Sal¢�.
I, as owner ol Ihe D�oDe�y, am exclusively contrac�ing with licensed conimc�ors lo consimc� Ihe pmleci (Seclion 7044, Business
❑ antl Professions CoOe: T�e ConVactors' Stale License �aw aoes no� aDP�Y �o an owner al pmDeny who huilOs or impmves �Aereon
antl who conlratls �or such prolecis wil� a contractor�s) license pursuanl lo t�e ConVa[Iors' Slaie Lic¢nse Law�. I am aware
Ihai prool oi I�eit Worker'S Compensalian insurante ShoNU be pwvidetl IO m¢.
� I am eeempt unCer Stttiw: 8. 8 P. C.
�Or IhiS r¢d50n:
Date: Ownec
I do �e�e�y cen�ly ��ai I am aware oi an0 un4erslan0 ine requiremenls ol Caldomia Heall� anE Salery Cotle Sections 25505, 25533, ana
25534 antl��at lo�anyfulure builUing occupanlvnlVwilinat (cir[le one� ne¢Ct0 comply vni� SaiA s�ate cotles antl Ihe�eOuirements�or a
permil lor consimctian or moAilica�ion imm I�e Au Ouahty Management Oistrict. Revaential conSlmciion a001icaiions are exempt tmm
IAese pmhsfons.
Dale: Ap0licanl:
I nere�y cenAythat I nave reatl Inis avDlication antl statetnal ihe ahoveinlormationis correcl. I agree lo comply vnlh allcity and couniy
ordinancesantlsiatelawsrelaling�abuittlmgconslmctionantl�ere �aut� erepresen�5liv¢sy 1' ci� IoenteruDonlhea0ove�mentionetl
pmp¢rly for inJpec�io��e5. ��
J �
oa�e: � ^ _ „ u�,_ .. .
Onver's Gcense or Saial Securiry a: �
t6aba6 Whne—BuilOmg;
Pink—RBVBlIUB; CiOId20l�—A552590�
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; H 061177
PERMIT NO: B 061177 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; RESHEATH S REROOF SLOPED ROOF W/ASPH SHI SQ FT; 4,000
CLAIM VALUE: 4,000.00 CALC—VALUE: 4,000,00 GROUP OCC; R-3 /M-1
COMMENTS; REROOF FLAT ROOF W/HOT MOP, REROOF 21005F RESTD 6 GARAGE �^p
rt*�it�t�t�t�t�t�t***it**it*�t�t*ft�r*x�x�*x+rit�rit�tit���rirx-rt�t**ir��*x�**fr***�*�x�***it�t**i� ���' vr�
2 O N I N GS ERT�B�AUCIxRSE M E N T S S'������
���UIRED
------------ MAIN BUILDING ---------- --------- ACCESSORY BUIi i --------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARRING REp • PROV: PARCEL: 13961113 2NE: �REF NO:
PLANNING N(51'ES>
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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
�Z71QI7d6 APPROVED BY DATE;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY: DATE:����
iEifiElElEiEiEiFikififlEi6if•%1EikiEN�ikiEif iEiF3E�EiFifihiFilif�� � fEif
iE if iE 3E if if iP �1f iF 3F ik 1F 1E iF it iE iF it if iE !E 1E iF ik if !E iE 1k iE �F �k iE 1E if �! iE iE 1E jh 3F iE 1F iFiF 3k if jF iE if iE iF �F iE ik iF iE i! ik if 3F it iF iF iF if * iE if jh i4 3E it 3ElE iE 3E �1E if iP
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRI,C MECHANIC FIRE SMIP/RES GRADING
PERMIT 63.00 ,50
SMIP/NON—RES
PLAN -
ISSUE: FEE '
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63.50 0.00 ''"0.00 63.50 63.50 ' .00
kEVENUBLDGVPMT PLUMBING ELECTRIC�MECFIAN�IC` FIAE3�£MIP�TOT/SGRADING PL�AN—�`HECR
63.00 ,50
1! �k it iE iE �k if jF jE iE iE if !! * iE iE ik if ik iE if if �f * ik fk it iE i! if iE 3E jf iE �E ik 3f �f �k iElf jE it it * iElk 3E 1E �E iE iF 3f iF jE iE �k if i! fE iE k� jk iE iE iF?F iE iFiFik iE iE iE #E iE iE iE jE
I N D I V I D U A L F E E B R E A IC D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 9000 REROOF BY VALUE RES�IDENTIAL NOZQNE
END OF FEES
EXPIRcD
fncomplete Inspections
i�lC _.._ -. $Ig �-------
1,00
4:000.00
�
�
�CO?JSTRUCTION AND PIANNING
APPROVALS Permit #
1. Temporary Electrical ServicB or Po�e
2. Soil PiM-Undrgrnd.
3. Elec�il Conduit Utihty•Undrgrnd.
4. Electr. �I Condwt�Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe�Undrgrnd.
70. Struc[urai F�oor System
11 . Property Sewer Line & House Connection
12. Sewer Cap
73. Roof Drains
14. Rough Plumbing
75_ Rough Electrical-Conduit
16. Rough Electric Wiring
.77. Rough lViring Sign
1 S. Rough Electrical-T Bar Ceihng
19. Rou9h Heating & Air Cortdit�oning
20. flou9h Fattory Fireptace
21. Ducts,in Structure
22. D�cts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Celling (Structural) & Monocoat
27. Frame and Flashing
28. t..athing & Siding �
29. Insulation
30. Drywall Nailin9
31. Plaster Brown Coat
32. Electrical Power MeterFinal
33. Final Electric
34. Finai Heating & Air Conditioning
35. Finai Gas Pipe�Test
36. Hood or Canopy
37. Final Factory fireplace
38. Finai Plumbing
39. Water Service-Final ,
40. Gas Service-Final
41. Solar pomestic-Final
42. Backfiow Preventer
43. Backflow Irrigation
44. lar,dscape Irriqation S;item
45. Sound Attenuation •
_ �..
46. Handicap Regulation� ; ;
47. FINAL STRUCTURE-� BLI,ILDING
48. FINAL PLANNING <Y' "�
49. Electric Release to Edison �,
: � , r
50. Gas Release to Southein"California Gas Cc
51. CERTIPICATE OF OCCUPANCY
Oate
POOI �PA
Date Inspector qppROVALS Permit#
52. Pool & Equipment Locatlon
53. Steel Reinforcement
54. Forms
55. Electrical8onding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Elecirical Conduit�Undrgrntl.
59. Gas Rpe, O Undrgmd., Test
60. Backwash Lines, P-Trap, � Ur.drgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor-Finai
63. Heater & Vent-Finai
64. Plumbing SYstem � F�nal
65. Electrical-Final
66. So�ar SYstem�Final
67. Fencing & Access ApP�ovai
68. APPROVED FOR PLASTERING
69. P00�/SPASYSTEMSFINA�
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
� 70. Under9round Hydro
71. Product Pipinp C7 Gas ❑ Oit
72. Underground Flush
73. Undergrnd.5torzge Tank � Gas :� Oil
Z/9� �� 74_Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
� 77. FIXED SYSTEM FINAL
� � 78. FIRE PREV. FINAL
� HEALTH DEPT. REQUIREMENT
' , �� J9. FINAL INSPECTION �
I I ' 80. FOOD CERTIFICA�TE ISCUED
a
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fncomple!� lnspectiors
�-�9I�l3 �:.. h,�
Date � �nspector
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.
r
� 2
� 2��2 I .o�,�.`
,
��� °ti
TESTING
baboratories ��f ��«E����,� c��°��"_,�«_, �,u.
�O BOS <%. 3i10 P.1-�ORi wP� . LOi.G BEACH CAiIF. �9�Ci .,?�31 .�-'°55 . R'?� 6362360 .'1ia) f2E5432
6ven0� o==CES
..or.. .,s.. n�-', . ..-
S,. in�a G eova? '•. pagyv an.. ?C E...:
']Iq 5J 10•5�( d V~��' � t� i.re. n Ce.. e0vpl 1:�3: eit4]f0
• ��4tr�`wY�
February 1, 197z
Examinafion: SC]2-$16
COMPRESSION TES75 ON GUN�176� CYLINDfRS
Jos. M. Ne�ley N32
1973 ilewport 61vd,
Losta t�lesa, Callfornia 92627
PROJECT
ADORE55
SAMPLE fROM
ARCMITFCT
fNO1HlER
Lester Palley
MIX
DATE CAST
DATE TESTED
CYLINDFR NO.
COMPRESSION
TOTAL tOAD, LBS.
POUNDS PER SO. IN.
COMPLIANCE
CYIINDERS
Swim Pool for G. ROSS
33�$ 4lyaming, f.osta flesa
Cylinders: fl1: Dottom: 82: Side wall at light:
,N3: Bond beam at skimmer
CONTR�CTOR
Sunse[ Pools.
SU6CONT��CTO�
Ceniury Gunite
iPECIFIED
1-25-7z
2'1-]7
1
7 Days
95,000
3�B2o
2-1-72
2
7 Days
57>5�0
2 ,�20
STRENGTH 2 000 pSI
$IZE: �2: 5-1/$���x �2,�1/2��
k3: 5-1/2" x 12-3/4"
2-I-72 lA "HOLD"
3 2A "HOLD"
3A "HOLD"
7 Days
59 ,500
z ,,05
7-Oay test compties with specificatlons.
py�p( �y DEl1VF0.ED or , liCflVfD ON
Jos. M. Henley Jos. M. Henley I-26-72
OIS/RUUfION: / _ J - -
Jos. N. Nenley ��'/'%-�/ /� �'fZ--���/ ' `• " -
Sunset Pools / l.l���.-.�.0 ..�,• �� a ��i'i.
Century Gunite �EtS 2 �`��2
Clint Jackson
Costa riesa Bldg. Dept. /
f -{/ ;,
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... ��..u��a •o� s.n.,�.co .s n�� co.,.�or>: .i e�n r� . n cu.�is ..�a.�i•��on .�v >�ei�u� ow or o��n w aovrs eoNo�oain�s on r.
�..< a •» . o vr.. r �.. ..r.. + � .. o ... . . �. •e.. .�=.na i .s . r.,r,,.�. ..�.o..ci�ov .o « c.�is roe eau��� .�n o.wse,ves
ROSS, G. 1-5-72
OWNER DATE
3 JOB ADDRESS 33 WYo�� Gircle BUILDING PERMIT N0.
�� =RAL CONTRACTOR Sunset Pools DESCRIPTION of WORK Swim Pool
.�n, ,ao. 39- -13 LO7 TRACT FIRE ZONE VALUE $ 3,�•00
INSPECTIONS Si nat�rc Da�e GROUP TYPE ZONE
Soi� SUBCONTRACTOR PERMITS ISSUED
�GAS Datc Number $i nature
W ATER P�umbi
RW6H PLUMBING . .i %�i 9 /i,in _.� _ /—� .S �
MISCELLANEOUS
ROUGH HEATING FND AIR CONDITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUN� � POWER U
ROUGN wIRING
TRENCHES � FOftMS �]/ STEEL REINF.
FLOOR SYSTEM ,
FRAME ANO FLASHING
L' 'NG —
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. � 34008
i,��a —s-77�� :"00 � r, � � .... � 3~.SC
COSTA MESA BUILDINGSAFETY DEPARTMENT -
'. P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completety
RECEI BY DATE RECEIVED DATE 1 UED
BUILDING � / � %� �� 7
ADDRESS
3 — _ / PERMIT NO.
OWNEfl A.P. NO /�
MAIL BVIIDING �� /�/
ADDRESS ADDRESS C.G(/
TEL. TFACT (� LOT� �+ BLOCK
CITV NO.
CONSTRUCTION W
IENDER
BRANCH _ ' ' /
OWNER a'�Q�CL/
ADDRESS VALUE
ARCHITECT TEL. 5 g
OF ENGINEER
FIFE
ADORE55 � ZONE TVPE GROVP
APPROVED
CONTRACTOR BV DATE S� �
ADDRESS 0
� TEL. Z� NO.OF �J USE OF NE
CITV NO. "' P��ry` BVILDING
STATE CITY �'AROSAPPROVED VARDSAPP OVED
liC. NO. �1 � LIC. NO. MAIN BUILDING ACCESSORV BVILDING
SIZE NO.OF BLDGS. (FROM C/L $TiiEET)
OF LOT NOW ON LOT FflOfYT FT. FT. �
USE OF
EXISfING BLOG. FT
SIZE OF P NO. OF /�
NEWBLOG. O � ROOM$ STORIES L.SIDE FT. .7 FT.
EXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT.
USE OF BUILDING AND WORK TO BE PEFFORMED DISTANCE BET. BET. MAIN &
MAIN BLOGS. ACCESS. BLOGS.
�. VAR.� �ATE
C.U.P.# APPROVED
APPROVED � /��
V
I hereby acknowletlge [ha[ I have reetl this application entl state
that [he above informe2ion iz wrrect antl oprea to comply with
all luws regula�inp b�ildin8 �onstruction, antl I shall not employ
eny person in violation of Ma workman'z compensatiOn laws of
tha State of Califomie. °
4
I hereby certity that I am properly licensetl es e contractor untlor SQ. FT. �
the State of Californie Businesz antl Protezsions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl tha[ such licensez are in full torca antl effoct, Or 1 TME PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: i
am exempi from Me provisions of the Sce[e ot Calilornio Baslness �
antl Profeszions Codo, Division 3, Chapter 9. �A.LUATION ��{ a
!/' PERMIT FEE S��/ O O �
signamre of �.��J� / — ^ / .S Cf a
Parmirtee ,�L�� G(/O/wf/l $� �O� P�AN CHECK $ E
l '
n�mo�t:ee aea�t 3 , � � °
TOTAL FEE $
J
OWNER ROSS� GROVEit
JOB ADDRESS �_3328 Wyoming �
ERAL CONTRACTOR �
�.. ��o,� 9— 11-13 LOT
INSPEC710N5
SOIL
GAS
WATER
ROUGN PLUMBING
PROP. SWR� �INE ❑ HOVSE CON. �
SPRINKLING SYSTEM
MISCELLPNEOUS
ROUGH HEATING AND AIR CONOITIONING
TEMPORAPV SERVICE OR POLE
UN�ERGROUNO � POWER �
ROUGH WIRING
TRENCHES ❑ FORMS � STEEL REINF.
FLOOR SYSTEM
BONO BEAM ❑ STEEL REINFORCE �]
SHEATMING
FRAME AND FLASHING
L^"'iNG - IN n OUT n
i ER, BROWN COAT
STnUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., FINAL
PLUMBING. FINAL ANO GAS TEST n
ELECTRIQ FINAL
Auil niur FINAL
DATE 3-24-72
SUBCONTRACTOR
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PAl1J *�*�*
i .. •. '?,A 7'i-77cii:,�Q7699 u 5.0�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOx 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
ForApplicant to Fill in Completely REc e v DATE REC vEo
� �/ S� � �� � DATE ISSU D
ADIDRESS LA� . / l� ��•
��/ �//f PERMITNO.
OWNER /a A.P. NO. �.J
MAIL �� � �•r BUILDING •
ADDRESS ADDRESS
CITV e[J NO. TRACT �j/S LO B OCK
CAI�LSTRUCTION P
LENDER
BFANCH
OWNER
A DD R ESS VAI.UE
ARCHITECT TEL. S S
OR ENGINEEP N
FIRE
ADDRESS ZONE TVPE GROUP
��� Y APPROVED
CONTPACTOR BV DATE
ADORESS
TE� ZO NO.OF VSE OF NE •
CITY NO. � P�� BUIIDING
STATE CITV VARDSAPPqOVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSOFV BUIIDING
512E NO.OF BLDGS. (FROM C/L STREET) ��
OF lOT NOW ON LOT R NT FT. FT.
VSE OF
EXISTING BLOG. ��r
512E OF NO. OF
NEWBLDG. ROOMS STORIES L.SIDE FT. -�i'� i
EMERIOR WALL ROOF
COVEFING COVERING REAR FT. ��M�-�
USE OF BUI4DING AND WORK TO BE PERFORMED OISTANGE BET. BET. MAIN &
MAIN BLDGS. ACCE�. BLDGS.
/ /� � C URP.SW APPROVED
2
APPROVE
1 �ereby acknowletlga that I �ave reatl this application antl stnta ,�
than tha ebove intormation is correct antl aprae to comply with ��
all laws reguletlng buildinB consvuc[ion, antl I shell not employ
any person In �iolat(on of Me workmen's compensaHon laws ot
the Stata of Califprnia, r. m
a �
I hereby cartify that I am proparly Iicensetl es a connactor untlor v� � �
tha Stem o( Gali(ornin Buslnass ontl Profeszions Cotlo, Olvision 3, THE AMQUALLB' OWN UNDER VALUATION IS FOR �
C�npter 9, end thet such licanses ere In full fOrca antl atfeet, or I THE PURP06E OF ESTABLISH�NG A PERMIT FEE ONLV: m
am exempt from tho provlsionz ot t�a Stnto of Celiforn(a Bus(nass ¢
VALUATION
antl Professio�s Co e, ivision 3, Cha r. „J� �,� �
UV PEfiMR FEE S c'
$Ip^etura of 7
m
Parmlttea $ � PLAN CNECK $ E
i `o
AUNorizad Apant J � LL
TOTAL FEE $
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�� - �� �JSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
1:OV —4-7�sn00 � 9� *** 141.00
APPLICATION FOR BUILDING PERMIT
For Applicant to Fil/ in Completely
REC�Eq�V Df1�iRE� IVE� DATE ISSUED
BUILDING / � �� �
AODRE55
PE1iMl"f` Pt01
OWNER M dular Tec olo Inc. "�P• NO� '-` "-""'
BUILDING ,
MAIL ADDRESS `z8 W OIR1T1 ClY'Cl8
ADDRESS Yl S
ciTv Santa Ana No`.�547-9673 TRACT6695 �or28 gLOCK
CONSTRUCTION W ADD E P
LENDEF U r] ional Bank X
BRANCH Main Office
OWNEP Modular Technolo Inc.
aooaess 1 0 S. Broadwa San Die O VALUE
ARCHITECT TEL. �- l� USE Residence s 15 700
Oft ENGINEER K 1 1 N
FIRE �
ADDRESS 11]. 2nd Ave. Corona Del Mar Z�NE TVPE G
APPROVED
CONTRACTOR OWY10Y' BV DATE
ADDRESS ''S�e /
TEL. ZO NO.OF USE OF 4�/
PLAN$`�/ 6UILDING
CITV 'S�e NO.
l C No. 252549 UCVNO.�-�/0 vMAIDN 8U L�ING ACCESDSORY 6U LOING
SI2E NO.OF BLDGS. ( n
(FROM GL STREET)
OF LOT 6O X IZO NOW ON LO�-- FRONT IRT. �S FT.
USE OF /�
EXISTING BLDG. --- ID V FT. FT.
SIZE OF 1'78'z Sf' NO. OF S 1 A
NEWBLDG. ROOMS STOFIES L.SIDE U FT. FT.
EXTEFIOF WALL ROOF /J
COVERIN COVERING W I11R ZE REAR / FT. � FT.
USE OF BUILDWG AND WOPK TO BE PERFORMEO ' DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLOGS.
Construct new residence with attached C.0 P� � PPPqOVED �-�cY�7
�, e APPROVED / ���/1
u
IiOLD FOR SPECI L - F
I hereby acknowledge ffiat I have reatl [his application and state
thai the above information is correct and aBree to comply with
all laws regulating builtling consttuction, and 1 shall not employ
any person in violation ot ffie workman's compansation laws of
the State of California. / �7 �j� �
I hereby ce�tify ffiat I am p�o0e�ly licensetl as a contta<to� unde� �� SQ. FT.
the State of California Busines5 antl Professions Code, Divisicn 3, THE AMOUNTSHOWN I/NDER VALUATION IS FOR
Chapter 9, antl that s licen5es are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt trom H ovision4 ot the e of Califo�nia Businnss VALUATION
antl Professions C', DiviSi n, Ch) tB i'' _
/ �y PERMIT FEE $
Signature ot � /'
Permittee G✓ � 5 p�� //� � PLAN CHECK 5
Auffiorizetl Agent TOTAL FEE 5 ///—
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