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Home My WebLink About185 YORKTOWN LN - Building Permits L J j omit, CITY OF COSTA MESA - 4 BUILDING DIVISION ;� P IT NUMBER DEVELOPMENT SERVICES DEPARTMENT k pica PERMIT B07-00504 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.a.UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 185 YORKTOWN LN Status: ISSUED Suite: Applied: 04/20/2007 Vicinity: KITCHEN Issued: 04/20/2007 Primary Occ: R3 Type of Construction: V-N Parcel Number: 41916539 Zoning: Applicant: HU, MICHAEL Address: NEWHOPE ST STEJ STE Phone: 714-444-2648 ISSUED BY: FOUTAIN VALLEY,CA Zip: 92708 Owner CHEN, HSIUNG-FEI Address 185 YORKTOWN LN Phone: 714-641-9016 COSTA MESA,CA Zip: 92626 Contractor ROVICS CONSTRUCTION INC Address: 17165 NEWHOPE ST UNIT J Phone: 714-444-2648 FOUNTAIN VALLEY.CA Zip: 92708 License: 800996 Arch : Eng: Address: Address: Phone: Phone: Zip: License: • License: SCOPE OF PERMIT INTERIOR KITCHEN REMODLE FOR A SFD.WORK TO INCLUDE:DRYWALL PATCH FOR ELECTRICAL WORK. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,000.00 Permit: $83.25 Claim Valuation: $3,000.00 SMTP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING &ZONING SETBACKS - MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 • .,Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) • 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. RIO I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance o1 the work for which this permit is Issued. 1 c My workers-co�rnp ensation Insurance carrier and policy number are: ((�� 77 Carder: E F4✓ Po tlicy.Number:, q; /V1- --(This > � (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) I El 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 workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisions. _ ////�� J Applicant Signature' a Dere: - ' /G"'�OWAR7- THOU AN: DOLL ET( SECURE ADD FIS' TO EN O • •VEPENS 11S UN,DAMA ES A SHROUDEDSUBFOR I AN SECTINEMPLOYER7 T600 IM/THE PENALTIES ANDFINES TO TO E'ONESHUNDRED THOUSAND DOLLARE($100,Dp0),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force end effect.Lic.# - 744' ambit P Contractor's Signature' Date: T \ 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: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,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 driver's 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(36)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: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has et 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? El 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 r will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yeo ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes El 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 armit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes El No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes El No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature OI Legal Owner(s) D- LI - nd/Or'Aut _ Date- r CODE# INSPECTIONTX g PATE JNTITIALS CODE# INSPECTIONTYPE PAIL INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roef 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign222 Final Site 204 Final Demolition 250 Final Building/Occupancy P/A' a / Etakfizatrit • - C • ! . �`On 9 CITY OF COSTA MESA BUILDING DIVISION t•ow) �1 a DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER F I ' '' IBL' 4 % PERMIT E07-00349 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaEct TRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 185 YORKTOWN LN status: ISSUED Suite No Applied: 04/20/2007 Vicinity: KITCHEN Issued: 04/20/2007 Parcel Nunmber: 41916539 Applicant: HU, MICHAEL Address: 17165 NEWHOPE ST STE J Phone: 714-444-2648 ISSUED BY: FOUTAIN VALLEY,CA Zip 92708 Owner: CHEN, HSIUNG-FEI Address 185 YORKTOWN LN • Phone: 714-641-9016 COSTA MESA,CA Zip: 92626 Contractor: ROVICS CONSTRUCTION INC Address: 17165 NEWHOPE ST UNIT J Phone: 714-444-2648 FOUNTAIN VALLEY,CA Zip: 92708 License:800996 SCOPE OF PERMIT ' ELECTRICAL PERMIT FOR AN INTERIOR KITCHEN REMODLE FOR A SFD.WORK TO INCLUDE: DRYWALL PATCH FOR ELECTRICAL WORK. REF#:B07-00504 WORK TO INCLUDE:4LIGHT FIXTS AND 3 OUTELTS. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 - Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 .New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $4.40 4 up to 50 kva/kw $0.00 0 Recept Outlets $3.30 3 _ up to 100 kva/kw $0.00 0 , Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 t -- 0 Misc.Conduit ' ' - $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp '$0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee - $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 - Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $31.20 Intermed Pole $0.00 0 • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicablecand all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) 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. 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��/ Insurancencarrier and policy number are: Y 2 `Carrier: R 1 e �/ F.PolicyNurhber: - bf // 7 7 (This section eed no oe completed i the permit is valued et one hundred dollars($100)or less.) 55// ❑ 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 workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. /y// �7 / 2 Applicant Signature: ,_ Date: - NnL Lo/O `WARNING:FAIL -.TO SECURE WORKERS'COM•ENSATION IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER.TO CRIMI PEN,,,(((LLLTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1CO3COC),IN ADDITION 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 Ilcens�d�undrer rovisions of Chapter 9(commencing with Section 7000)of Division 3 of.the Business an rofessions Code,and my license is in full -force and effect.Lic.#--O " 0 7? "class#• ' -ContiectorsSignat`ur Date: V7n/a • 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). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 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: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the 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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application ePermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions, Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) 47/207 mate LA: Or.Authoriz•- t..n : _ 1—'Date CODE INSPECTION TYPE PAIS INTITIALS CODE INSPECTION TYPE PAIS INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /� 200 Final Re-Roof 210 Final Electrical FM. gL D t War 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 Building/Occupancy ti - i ,5� 'F 9 CITY OF COSTA MESA 4 BUILDING DIVISION F • 14111111• $ DEVELOPMENT SERVICES DEPARTMENT PERM T NUMBER 6p PERMIT P07-00246 R04. atio (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.P135MBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 185 YORKTOWN LN Status: ISSUED Suite No Applied: 04/20/2007 Issued: 04/20/2007 Vicinity: KITCHEN • Parcel Nunmber: 41916539 \/ Applicant HU,1 MICHAEL L`-1 Address: 1 17165 NEWHOPE ST ISSUED BY: _///�yy- �✓"�ll STE J Phone: 714-444-2648 FOUTAIN VALLEY,CA Zip: 92708 Owner: CHEN, HSIUNG-FEI Address 185 YORKTOWN LN Phone: 714-641-9016 COSTA MESA,CA Zip: 92626 Contractor: ROVICS CONSTRUCTION INC Address: 17165 NEWHOPE ST UNIT J Phone: 714-444-2648 FOUNTAIN VALLEY,CA Zip: 92708 License: 800996 SCOPE OF PERMIT PLUMBING PERMIT FOR AN INTERIOR KITCHEN REMODLE FOR A SFD.WORK TO INCLUDE:DRYWALL PATCH FOR ELECTRICAL WORK. REF#:607-00504 WORK TO INCLUDE: 1 DISHWASHER AND 1 KTICHEN SINK. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 - Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher . . $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0, Shower $0.00 -.0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service .. $0.00 _0 Spa(public) $0.00 0 , PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 • TOTAL CALCULATED FEES: $43.10 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandonetl for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) V 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. S3 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 carrier and policy number are: �� - /�� Carder: -ct7C FN JO Policy Number: (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) ❑ 1 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 workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signatur,- Date: /2e e WARNING:FAILURE TO SECURE WORK RS'COMPENSATION COVE-r •- MAW AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business an�rofessions Code,and my license is in full force and effect.Lic.a 8"0v N A 6 Class A Contractors Signature: _ Date: 17/'11/07 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). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,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 tor 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 driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 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: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑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? D Yes ❑No (Section 25cal 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 ❑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 ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? lYes 11 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No B (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) _ y/i's/G to And/Or Authorized Ap• • Date CODE t INSPECTION TYPE WiTE (FOULS CODE I INSPECTION TYPE PAL JMITIAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical p n 1266 Pool Spa Final 208 Final Plumbing P7/4n T pa � -1/Mehr- 200 5MeI' /V1 �-)titJ 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 Building/Occupancy I ADDRESS OP:WLDING 185 YORKTOWN LN tor: CITY OF COSTA MESA — BUILDING PERMIT OWNERSNAMEAiVIDwfI: CHEN, HSIUNG—FEI , PERM NO: B 073753 ADDRESS: CHUNG, HSUEH—CHIAO 185 YORKTOWN LN • PERMIT NO: B 073753 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92616 APPL.RARING ADDRESS: II CONSTRUCTION TYPE: VN PERMIT TYPE: SIR PURPOSE: OTH ARCHITECT OR ENGINEER: UC.NO. JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/ COMP SHINGLES SQ FT: 2, 999 ARCH.OR EIIO.'S ADDRESS: UMT: CLAIM VALUE: 2, 999 . 00 CALC—VALUE: 2, 999 . 00 GROUP OCC: R-3 / cONTRACTOWSK ADE STOUT ROOFING INC ( 310) 923-6775 CaNIRACTORS MAILING P 0 BOX 4309 COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRE55: DOWNEY CA =No, 402536 )E+E1fif+EdE****** ?IE*** x♦IEififfF****x*****iEdtdEi(-+t*iEif♦Ex3E♦E♦E**if+tdf-3E****♦EiEx-iE♦E*iE#)t-d***IEif-dEfEiAlE+E*** 90241 UMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty 'Ury std m!t I amunder pr. of- Chapter 9 SETBACKS (commencing with Section 7000)d Division 3 of the Business and Proles and m Bonne is it full . . effect. CITY LIC.No.: 059377 uc.c ss: C 39 uc. .: 402 / 6 E. : 10 ' S MAIN BUILDING ACCESSORY BUILDING 8 /f, FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: % Cathedra: '!, a LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN y OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors Lice._e Law for the following reason(Sedion 7031.5 Busiess end Professions Code:Any city or county whim requires a pend to cons ,alter.improve, PARKING REQ: PROV: PARCEL: 41916539 Z N E: REF NO: +!doh,a m repair any atnure,prim to as issuance,also requires the applicant for such permit to Be a signed statement that he or she PLANNING NOTES>: meed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 el the mess and Professions Codej or that he or she Is exempt therefrom and the basis for the alleged exemption.My violation of Section > '031,5 by any applicant for a permit subjects the applicant to a dvil penalty of not more than fire hundred dollars 155001). **************1*******************************************************'********** ❑ I,as owner of the property Or my empeyeea with wages as thea sole compensation,will do the work.and the structure is nol intended DEVELOPMENT SERVICES REQUIREMENIS or offered for sale(Section 7044,Business and Professions Code:The Contractor, ro License Law does not apply to an bwnerof propend .,, e who builds or improves thereon,and who does such work Nmaef or herself or through he or her own employees,provided that such / , r improvements are not intended or offered for sale.II,however,the building or improvement is sold within one yew of completion,Ue ZONING AP PROVED.BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,asowneroftheproperty.emexclusivelycontraaigwithlicensedcontractorstoconstructtheproject(Section7044,Businessand BUILDING APPROVED BY : DATE: Profession Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon and who contracts for such projects with a contracor(s)licensed pursuant to the Contractors License Law). ❑ lam exempt under Section: B.AP.C..for reason: APPLICATION ISSUED BY: DATE: '/�(/ **********************7E************ ** *************************** * 7FiE* ** Date: Owner, LEGALIZATION:N FEE S MMARY STRUCTURAL SEGMENT:Y I do hereby cenify Matt am aware of and understand the requirements of Caliomia Health end Safety Code Sections 25505,25533,and 25534,and that)or any future building occupant will/oil net(Crete one)need to comply with wad state coda and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modification from the Ai Quality Management District.Residential construction appicationsexe exemptMese from provisions. PERMIT 54 . 00 . 50 Dia: Applicant: SMIP /NON—RES PLAN • WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE ❑ 'I have and wilmaintain acertificate oconsent toself-insure for worker,'compensation.asproviedforbySecion3700ofthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I Code.for in.penna oatethewokfaw:hmpermit TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 R !have and ori maintain workers'compensation insurance.as required by Section 3700*fibs Labor Code,for the perfomence of the work for which this permit Is issued.My workers' insurance caner end pnumber we: Carrier: evpoky EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00 Port'Number: v4494u0004687 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK .section need not be completed 1 the peon]is for one hundred dollars(51001 or less.) 54 .00 . 50 ❑ 1 certify that in the performance of the work for whip the permit e' • shall not employ any person in net so as to become subject to the workers'compensation tare el CaMomie .. ...that if sitcom become to IM • ******************************************************************************* compensation peps e(Sad 3700 of Ne labor Code, //��/y Non pro iso / INDIVIDUAL F E E BREAKDOWN feats: VrX 1J 1 " Applicant: / L/' ✓ Warning:Falloff to secure workers'contperssdon coloragt It unlawful,and shall ndlect an employer to cranked ones and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000).in addition to de coalof conpetars damages sided tor In Section t on37o5oftheLaborCode,Menaendelromeyefeet neaa SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 999 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there isa cmnnd'jn lending ageny for the END OF FEES pedprma ce of the work for whim the permit is Issued(Section 3097,Cu.C). LENDER'S NAME: LENDER'S ADDRESS: . I certify that I have read this application end state that the above information is cared.I agree to comply with all city and county ordinances and state laws volati a to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property f°`maper'"7-. D LpENPriE B ORD �,// / ....41,..r.' /� mNw�' Y Dale /^�/� 01 D0188166-091E8167 OC:45 54.50 l Signature d Owner/AD. I/Applc°ndContra,or DATE: 06/11/9` TIME: OC:45 (5151 d6.WP) White-Building&Safety:Green-File:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor POO I IPA '• t CONSTRUCTION AND PLANNING . APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspeptor 'CY 1. Temporary Electrical Service or,Pole 52. Pool & Equipment Locatio'rr' 2. Soil Pipe-Undrgrnd, : -- 53. Steel Reinforcement 3. Electrical Conduit Utility-UndrgrnP. 54. Forms r - 4,.Erectrical Conduit.Undrgrnd. 1 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test , '6. Electrical UFEB Grnd. 57. APPROVAL TO COVER•GUNITE "7g.'Footings • .- 58. Electrical Conduit-Undrgrnd. A. 8. Foundation - - 59. Gas Pipe, 0 Und?grnd.,Test 9. Water Pipe-Undrgrnd.: 60. Backwash Lines,P-Trap, 0 Undrgrnd. ' t 10. Structural Floor System _ 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -"r-42--Sewet•_Cap - 63. Heater & Vent-Final - . 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit ' 66. Solar System-Final . ` • • 16. Rough Electric Wiring67. Fencing & AcCess Approval 17. Rough Wiring Sign 68. APPROVED FDR PLASTERING 18. Rough Electrica(T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning _ FIRE DEPT.REQUIREMENT , 20.-Rough Factory Fireplace . ti : APPROVALS • Permit # . 21. Ducts, in Structur% - -- , -- - _ 70. Underground Hydro 22. Ducts, Ventilating - = • 71 . Product.Piping OGas ❑Od 23. Gas Pipe-fioUgh& Test - T,. t 4 _ 72. Underground FiusM ' ' 24..Aoof Framing c-- - -. 73. Undergrnd.Storage:Tank ❑Gas ❑Oil 25. Roof-Sheathing - • 7 3O--q(GwL1r 74.Sverhead Hydrfl 26. T-Bar Ceiling (Struc4ura0 & Monocoat - 75._Dry•Chnical ,� 7 - 27. Frame and Flashing - :.. tap'dp 76. Dry Sipe - " 28. Lathing & Siding.: ` -- ' 77, FIXED SYSTEM FINAL 29. Insulation • _ v - 7$; FIRE PREY. FINAL 30. Drywall Nailing , - :HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • - - ' t -• 79. FINAL INSPECTION nr 32. Electrical Power Wye erFinal • ; BQ: FOOD CERTIFICATE ISSUED 33. Final Electric _ - t Notes: '- • ' 34. Final-Heating& AG Conditioning - tr, - .- ' 35. Final Gas Pipe:Test - . - 36. Hoo,Q,or,CanoPy - 1 .. - • n 37. Final Factory Fireplace .. - .- ' 0 ,. _ 38. Final Plumbing . ' c t „ - , ' 39. Water Service-Final - - 4 , 40. Gas Service-Final T ' .• - t - 41. Solar Domestic-Final - - i -1 - • -o - - 42. Backflow Preventer .-1 .. 43. Backflow Irrigation - - , • r44. Landscape Irrigation System "r;, _ _ . ti• 45. Sound Attenuation' -. .. . . 46. Handicap Regulations '1 - S _ 47. FINAL STRUCTURE & BUILDING 0,-31_gr a4 a 48. FINAL PLANNING' - - ( -. 49. Electric Release to Edison F • 50. Gas Release to Southern Calif orni3 Gas Co : - 51. CERTIFICATE OF OCCUPANCY ' No _ Date 1 OWNER SAN VT. TA BLiI _ao. DATE OCT 3 0 19S[ JOB ADDRESS T&5 Yorktown T.nne BUILDING PERMIT NO. 20658 GENERAL CONTRACTOR Ran Vista Thi1ding_CO.. VALUE $ 12,..635 00 AP No. LOT 174 TRACT 5 M FIRE ZONE DESCRIPTION OF WORK Res.w/att.gar I ECTIONS Si:nature DATE_ GROUP I&J TYPE V ZONE R-3 6�_ /j SUBCONTRACTOR PERMITS ISSUED Gas '_/ - / DATE NUMBER Wateryq/7y -/L 27-63 • Rough Com. Refrig. 0 Air Cond. 0 Rough Heating , rt._. -/D- 8 Rough Plumbing • ( 3-q...% �� H( \\ -lo. Miscellaneous l Prop. Swr. Line 0 House Con. p'St. Swr. 0¢4 3_4 4q e„,..„.....4. t .�� NOV 1 3 1963 09,7.'0 Sprinkling System - - re . /, Construction Pole _ -' Underground 0 Power -0 if 1‘ Rough Wiring ,'•C•0 C'_ \ .�zti� -zraicri i�� — Trenches 0Forms 0 Steel Relit ❑ ,`rje - 6 Floor System a� Bond Beam 0 Steel Reinforce 0 \\ Sheathing 67,1 0 2- - /7 Frame and Flaping / / !V_/o'-b(/ 44114.,LLathing — In Out• AF!4 j P' "ar, brown coat / i 7 /G cc riff' C / I, j. 0 Air Con. 0 Final '0 q b Heating, Final - 0 , ' Y Plumbing Fixtures,/ Final �/ �� Final Gas Test !�-# _ .� 47 l Electric Fixtures, Final 1 ti Building, Final - — 7,-kro(/ I _ OCCUPANCY • Form 13114—$M-3-63—S-B P HCUT) F(1R QDR(R AT ecnrrinre..:.....n X58 FEE RECEIVED CQSTA MESA BUILDING-SAFETY DEPARTMENT SGP Z 6 Wed P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE (� jjDppEPMMT..�Jp� \ For Applicant to Fill In Completely dP�LICA7161�SPaR PERMR TYPE OR PRINT Lot 174 BUILDING For Office Use Only BUILDING ADDRESS 185 Yorktown T1pP RECEIPT NO. 6Hf/�Td1¢•y.. COSTA MESA. CALIFORNIA _ P20S5B RECEIVE BY �/DATE RECEIVED DATE ISSUED • OWNER San Vista Building Co. / 2-5-G3 OCT 3 fly -e MAIL ,1166 E. 58th Street ADDRESS/Fs' I ADDRESS // CITY Los Angeles. l1 FIREl T,IL.AD 37187 ZONE TYPE (/ GROUP O ARCHITECT TEL APPROVED ORCHIENGINEER Raymond Levanan NGOR 37010 BY DATE AL 3a 3432 Via Oporto, Newport Beach �� ZONING///''�� TA /Zfsi�_ I NO.OF2 I USEOF N Y CONTRACTOR San Vista Building Co. VJ I{ FLANB BDILDC�/ �I ADDRESS 1166 E. 58th Street DESCRIPTION 77 Tract 5160 - Lo> 174 �e� 3 CITY Los Angeles 11, California A.P.NO. /41 - , L/ NOTE: NO SAVE OVERHANG SHALL BE LESS THAN SIC.STATEN192782 TEL.NOAD 37187 so-TO SIDE ft REAR P.L. EAVES SIZE 20 x 70I NO.OF SLOGS. 0 ALLOWED (U.B.C.REQUIREMENT) . OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. None (FROM C/L STREET) SETBACK LINE FROM 13 I n 7'10" FRONT FT. ' FT. CENTER OF STREET REAR YARD SIDE YARD I LEFT 0 I RIGHT 0 R.SIDE FT. FT. DESCRIPTION OF WORK L.SIDE FT. FT. NEW X ALTERATION _ ADDITION _ REAR FT. DISTANCE BET. BET.MAIN d IREPA.., M207%)ING DEMOLISH MAIN BLDQS. ACCESS.BLDG3. BUILDING NO.OP Plan #2 VAR.JF DATE SIZE 20 X ROOMS 5 STORIES C.U. '.�• APPROVED EXTERIOR WALL., ROOF ` �� COVERING -stucco ( COVERING Shingle = .,= DATE 9�/0� USE OF BUILDING AND WORK TO BE PERFORMED Residence and Carport "Th....1��, A O CO/ �// a/ ' nom//]it_ N /`N/y3Q.PI'. Y o c I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY •-DINAHCES AND STATE LAWS REGULATING VALUATION m BUILDING CONST-•CTI•'AN VISTA BUILDING CO. n SIGNATURE OF PERMIT FEE $ D PERMITTEE co • $ / e �� — PLAN CHECK $ �/ o AUTHORIZED AG-NT/ James N. Starbird �3 — TOTAL FEE $