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HomeMy WebLinkAbout700 VICTORIA ST - Building Permits (2)Job Address: Suite No Vicinity: 700 VICTORIA ST 6002 CONDO 6002 Parcel Number: 93778014 Applicant SCHNIERER, STEVE � Address: 22911 SAVI RANCFi PKWY YORBA LINDA, CA� Owqer: � MC DONALD, ROBERT E Address: 700 W VICTORIA ST #B-2 COSTA MESA; CA Contractor. SERVICE CHAMPIONS Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA MECHANICAL PERMIT Phone: 714-777-7777 Zip: 92887 Phone: Zip: 92627 Phone: 714-777-7777 Zip: 92887 License: 799170 ISSUED BY: SCOPE OF PERMIT CHANGE-OUT OF A 45,000 BTU FAU IN THE CIOSET OF OF AN EXISTING CONDO UNIT B002. . , -� - • 1 WST FAU < 100K BTU - � � - _ _ . ". . NO OTHER WORK AUTHORIZED WITH THIS PERMIT. . ISSUE FEE Inst FAU <100 k BTU . Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall HV Refrig Sys <100 k BTU Refrig Sys >,100 k BTU, Gas Piping Factory Fireplace � Hood w/Mech,Exhaust , VAV Box Vent Fan / Single Duct. , Appliance , Fire Dampers Smoke Dampers ' Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ` .$0.00� $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unil Repair / Alt Refrigeration Unit Ventlllation System Evaporalive Cooler � ..Commerciallncineralor � ' '� Domesticlncinerator Compressors / Absorption Systems Upto3hp/t00kBTU_ � 3 To 15 hp / 500�k BTU � � 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp . 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investlgation Fee Plan Check Fee � - Reinspectian Fee Status: ISSUED Applied: 11/18/2003 Issued: 11/18/2003 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0• $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspendeC or abandoned tor a period of 180 days. � INSPECTIONS: In order for ihe work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all requlred inspectlona and iinal approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2ane�ae �sroo� WORKERS' COMPENSATION D�CLARATION: � I hereby affirm untler penalry of Derjury one ot the tollowing declaretions: ❑ I heve and will maintein a certiticate ot consent b salf-Insure for workers' compensetion, as providetl for 6y section 3700 ot the Lebor Cotle, tor the pertortnance ot ihe work for which this permit is issuetl. ,� I have and will maintain workers' compensaGon insuranca, as required by section 3700 of the Labor Code, for the pertortnance oi the work for which ihis pertnit is issued. My wo ers' compensaf n Insurance carrier end policy numDer ere: .� 1 (�h Cerrier: (j �('�'Y�f �1' 1G.,� Policy Number. �t N 3nfon I 6lJ I (This sec(ion neetl nof be com�eted i/ the pe ls valued et one hunUred dollars ($700) or Iess.J � ❑ I certity Ihat in the performance oi t�e work for which this permit is issuetl, I shall not employ any pereon in any manner so as to become sublecN �o the workers' compensatlon laws Calitomia, d grae that it I should become sub�ect �o ihe workers' compensation pmvisions ot Section 3700 of lhe Labor Cotle, I shall forthwit� comply with the . ApplicentSigneture: / .� Date: �L�ig�Q3 WARNING: FAILURE T SECURE W�p�(ERS' GJIdPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND pVIL FINES UP TOONE HUNDRED T110USANDWLLAR ($100,000),INADDITIONTOTHECOSTOFCOMPENSATIIXJ,DAMAGESASPROVIDEDFORINSELTION3IO60FTHELABORCODE,INTEPEST,ANDATTORNEYSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I am licensed under provisions of Chapter 9(commencing with Sectlon 7000) of Division 3 of tha Business and Professions Code, end my license is In tull force end eNect �ic. u� i class a C.ZO ConlrectoYs Signemre: Date: � lj,I 1 ii' �� CONSTRUCTION LENDING AG�NCY: ❑ I hera6y aNirm that there is a consiruction lentling agency for the peAormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lender's Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I �ereby affirtn thel under penalry of perlury Ihat I am EXEMPT FROM THE CONTPACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires a permit to consWct, alter, improve, tlemolish, or repair any sirucWre, pnor to its issuance, also requires the applicant tor such permit to file e signea statement thet he or she is licensed pursuant to the provlsions of the Contrectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 oi the Businass and Professions Code) or that he or she is exempt Iherefrom and the basis for the alleged e:emption. Any violation oi Section 7031.5 by any epplicant for e permit sublecis the applicant to a civil penalry of not more ihan five hundred dollars ($500).): ❑ I, as owner of tha properry, or my employees wlth wages as their sole compensation, WILL DO 7XE WORK, and ihe struciure is not intentletl or oHeretl for sale (Sac. 7044, Business and Professions Code: The Contractors License Law does not apply �o an owner of property who builds or improves ihereon, and who does such work himselt or herself or through his or her own employees, provided ihat such improvements are not intended or oHered for sale. If, however, the builtling or improvement is sold within one year of comple�ion, Ihe owner-builder will have.lhe burden ol proving that ha or she did not build or improve for purpose ot sale.). � ❑ I, es owner ot the properry, sm E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5truct the project (Sec. 7044, Busines5 end Prof055ion5 Cotle: The contractors Liceqse Law does not appty to an owner of pmperty who builds or Improves ihereon, and who contrads for such project with a conirector(s) license pursuant to ihe Conlractors license Laws.). ❑ I am exempt under sec. Business an0 Professions Code tor this reason: Signeture: Date: Ownar ID venfied by drivers license. ❑ Vas ❑ No Driver's License No. Vedfiwtion of Ownership by (type of documeni, i.e. - property tex bill or deed): Eapires: DIVISION OF INDUSTRIAL SAFE7y pERM1T CERTIFICATION: ❑ I hereby cerli�y ihat no excaVation five (5) or more feet in tlepth in�o which a person is requiretl to tlescend, will be made in connection wiih work euthorized by ihis permit, end that no building siructure, scallolding, talsework, or demolition or tllsmanUing iheraof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomia Adminis�raiive Cotle). ❑ As owner-builder, I wiil not employ anyone to do work which would require a permit from the Divlsion of Industrial Safety, es notetl above, unless such person hes a permit to tlo such work trom Ihe division. Signature: Date: Divislon oi Industnal Safaty Permh Number: CERTIFlCATE OF COMPLIANCE pND AUTHORVA710N OF EHTAY: I ceniy undar penalry of perjury Ihat I hava read this application and state Iha� tha information given is wrrecL I egree to comply with flll state laws end ciry ortlinances relaling to bulltling construction, entl authorize represeM2tives of ihe Ciry of Caste Mesa to enter upon ihe ebove-descnbed properry for inspection puryoses. I agree no� to occupy or ellow occupancy of any building authonzed by this permit until final insDection. COOE �. INSYECTIONTYGE 1616 1266 Fixetl System Final Fire Prevention Pool Spe Finel 200 Flnal fie-Rool 201 Finel BIocWRetaining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolition �.11���I:IIiYI� � �' �S�Q3 �a.e Date tOpE� INSPECTONTYPE pa¢, 206 Final Mechanical �9 - 03 208 210 212 220 Final Plumbing Final Elecirical Final Flre Prevention Final Planning Approval 222 Final Sita 250 Final Builtling/Occupenq '�oonEssavsm�ou�c: ']00 VICTORIA ST °"'"E""""'E"'°'°'''": pACIFIC CREST VILLAS '' "D°"�u' 700 VICTORIA ST C.M 929626 �vv�. �uuxc wo�ss: 642-1722 IAIICHRECTORFINiNEEX: u�cx. on v+o.•s �oo�a: uxr: B _ 2 uc. xo.: UNT: carm�crarsx�ue: LEE ROOFING ( 714 ) 692-7223 carn�croxsMuuxo 1653 SUPERIOR �o� COSTA MESA CA . ueno.: 349686 92627 uNr: �ICENSED CONfPACTOp9 �ECLAflATION: I hemby eflim uMer paneXy d perjury Ihet 1 em licewetl uMer qoNslone ot CMipter B 'wmmeridnp xilh Section 1000) d Divieion � ol ihe Bueinen enE Proleeebn� Coda, enE my Ilams N In lull loru end oHad. rruc.No.:028751 uc.cuss: C_39 uc.No.: 3 686 EXP: 03/96 a�, — Contreaor IEfl BUILOEF OECLAXRTION: I Mreby e/firtn uMu pe�W y d N�Y �� I em uemp Imm IM Cont�aqOn Uteme Lew Ia �M tolbwinp reavan (SeGbn ]W 1.5 Busnees eM Pmfepiom Code: A ciy a oounlY �id� rpuiiee a partne m mmwct. eller. imwow. demolhh, a ropei xry eWclure, prior io na'vwarKa, ebo reQui�ee Ihe epplirant lor euch permil lo file e epned etalemenl Ihel M or ehe u licemad Wnuenl lo Ihe prmisiona d Ihe Cantrepon Limnae Lew jCheplx B(mmme��p wilh Sad'pn )OW) d Diauion J M tM Bueinsa end Prdeaioru Cadel a thet he a ahe i� usmp �hvehwn erM IM bstia la Ne dbped az�mqion. My v'delion ot 6etlion 1W t.5 by enY eVW� lar e permn subjetls iM eppliceru Io e d.il parielty d ml mae ihen INe hunEred ddlen �55001). ❑ I. m ovmer M the propenY w rtry empbyees wIh wepes aa tAei ede mmpon�ion. will do iM xnM. eM ihe evuqu�e a not inleMeE a oilereE lor aele (Seetion JOu.Buvrbee aM Peoleasiona CoEe: The Contreqwa Lieenee LewEoee ml eppty loen owner ol prapoM wlw buide « inpewea iMrean, eM who does suM wak h'unwX w henN or iheouph he a hm oxn ampbyee�, povideE IMI we� impwemema me � imaMed a WmeE la eab. tl, Iwwewr, iM buiNinp a inpavaenem e wM wnhin me ymr d mmplelun, IM owrorbuiltlar WI heve ihe buNm d prwiip M m eAe did rwi buiW a imqae Iw tM pvpua M ub�. � I. u owwr d I�e D�M. em exdinively mntrediq wnh liceneed conlreclwe to mnqrud ihe D�I� (�� ]�. �einme aM Prolessione Cotle: TM Contraqm L'eenae Lew doea mi eppry b en owrcr d popenY M� b�iM� or impovm ihxaon eed who convma 1« mrh pqaee wnh a arqredar�a) IienseE qvauem to tM Comrenm lioerue lewl. � I em examq uMer SM'vi: B. 8 P.C.. lor Nu �aemn: Dele: Ovmu: I do Mmby cendy Net I em ewue d eM uMe�siard the rpwremanb d Cellanu Heetlh end Sefely CoEe $etlioru 255p5. �SVJ. vd 25S3a, ud thm I a erry Mure Wik'uq mapeM vrill / wil �(acb an) naeC ro cpnp�y wYh eeA uaie oodm erd tM rpuimmsnb br epertnnlawmwnionamodifireiianhwntM�r i�iy enepament0iatrid.Rwidm�elmmiueuneppicatiwnvsexemptimmtheee paisions. Date: �pplcem: 'OPKEF'S COMPENS�TION DECLAN�TION: I hereEy elfvm unEx penMy d peijwy aw W the Idlowinp dederuiom: �] 1 hera ud wJ meimen e cenAiaie W mnmt �o aatlimuro br xvrkm• mmpemetion. m>o.ided tu bY Sed'an 9)00 d IM leEor Cade. la iM pMormerce d tha xak la wFicM1 Nb pamu b usued. �i n�.�d w�me:,..onas• amw�mon i�,re�,ce. m�c�d M s.uo, a�ao d m. �e« coa. mr m. ro��. d in. wak /a xfiidi Il�n pami� is iasuad. MY workan' canpanation imurerce rarer ud pdiry numbor ua: c�.,: STATE FUND EXPIRES PofryNumber. � ao a- 06/30/96 /INs aMion mea rw be ewnP'ared % �heO�M is b are huMied ddlers /51001 a Ix�.) � I cenJy Nei m Na pMamence d IM wak M xfich �hia pmmd'n iaueE. I eMY na empby erry q�am in enY menrw m n to hpc ta tAa xaknn' canperemion lewe d CalEmiie. enE yr thm - uW Decpne wbjeC to IM xoM1en' �IM/O��Wq M SBtlOn'J]N af IM �B�f �rOd! tM C D � r e V�'��b . eta: "(fl `"� � APNicaM: w. O:FaYunrosscunworten'ro�aewtloncovenp�l�unYMN4 e.w�.�e�r.�.�my..rocd.mwo.�.m.,.�e nroa iy ro om n,narM thouune dwwa lslo4aaaA M seatlon e M• eosr or ronpsiwran �m+w� u povMM ror /n Sxtlon J]G6 0l Ms LaDo� Cob, infenat, �nE ettomsy'a lsea. CONSTflUCT10N LEN�ING RGENCY: I hxeby �rm uMer penelry d perFvy ihm thpa u a consl�upbn bMiip epercy br ihe peApmeMe d tM xork for wh'rh the pemiY e bwed (�� �]. Cw. Cl. IENDEP'S NMIE: LENOEP'S �ODPE55: I cMity �lat I heve reeE ihh epplicetion eM qele Ihet Ne eEove iNamuion is wnsp. I pree to compy wnh dl cry enE muNy pdinuv.ae ard eiere lews nlmip to buiu.q m�uvufion erd hareEy aWwaa repasenietivas d tiva dIY lo eM« upan iM eEwa.monfmM propeM laimqdion purposes. MI�CHAEL HURRE o�e: //—/,� —9 5 (515H6 WP� Whne-Buildiq 8 Selery: Green-Fb: Cenery-Rppirant; Vink-Fevenue; Gddenro�Aneaw CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 075042 PLAN CHECK NO: N PERM NO: B 075042 GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : ROOF 1LAYER COMP OVER EXIST 1 LAYER COMP SQ FT: 1,528 CLAIM VALUE: 1,529.00 CALC-VALUE: 1,528.00 GROUP OCG: R-:i /M-1 COMMENTS: SMOKE DETECTORS ARE RE�UIRED AS PER U.B.C. 1991. �***+t+t+�+t*+�*�*x*�*******x+�+�***�x�t �t�**�t�tx******+�**�r*��*�x�x��x��r�*�r�t**���+t*****�r**� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE(]: PROV: PARCEL: 93778014 ZNE; REF NO: . PLANNING NOTES> > ar��s��rx��ca�cw�c��+��r��c�c�� u+�*x�+r*+�*x*�*�**��****+r�c**x�+�*�c*****x�**+�+�***�*�*�*��+����r* 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 ZONING APPROVED BY DATE; '• i� BUILDING APPROVED BY : DATE: APPLICATION ISSUED HY� � nnrF. I�-•� ��1" LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 37,00 ,50 ' SMIP/NON-RES PLAN ISSUE FEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL �- PAID DUE TOTALS----> 37.50 0.00 0.00 37.50 r 37,50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 37.50 OVER/SHORT: 00 BLD37P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT� GRADING PLAN-CHECK 1k1EfEiE1EfE3E�EiEIEiEiE1EIE1E1E1F1E9EiEfElEiEiEiFiFifiEiFlEiEiflflEiE1EIEIfiE1EiE1EfEIEiE1E1EIfiFlEiEifiEiflElEiFiElElfiEiElE�EiE1E1E1EiEiE�EfEIEiEIElFiEiEiE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT-COST TOTAL COST SFR 1528 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,528,00 END OF FEES � � iJ�.1 JClt�i ?-:i.I4�7�0 �'�C"Y u�i�C.: �LL ��i�'� Iit�f� j��l.� �-..� jlCONSTRUCTION AND PLA, .NG � POOI & SPA . •�APPROVALS Permit # Date Inspector pppROVAIS Permit # Date Inspector � 1. Temporery Electrical Service or Po.te 52. Pool & Equipment Loca[ion - � 2. Soil Pipe•Undrgrnd. ' S3. Steel Reinforcement 3..Electrical Conduit UtiiitY�Undrgrnd. 54. Forms i . 4. Electrical Conduit-Undrqmd. 55. Elecvical Bonding ' 5. Steel Reinforcemeqt� 56. Rough Plumbing & Pressure Test 6. �Electricyl UFEfl G�nd. 57. APPROVAL TO COVER-GUNITE - - 7�. Footings ',y � 58. Electrical Conduit�Undrgmd. ^� 8. Foundation - _ . 59. Gas Pipe, O Untlrgmd., Test . �. Water Pipe�Undrgmd. ' • -60. Backwash Lines, P:Trap, O Undrgmd. � 10. Structural Floor Svstem ' 61. APPROVAL TO DECK • i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' � 12. Sewer Cap ; 63. Heater & Vent•Final �' - i 7 3. Roof Drains . 64. Plumbing System � Final 14. Rough Plumbing - 65. Electrical-Finai ' • 75. Rough Electrical-Conduit ' 66. Solar SYstem-Fipal i 76. Rou9h Electric �ring' 67. Fencing & Access Approval . 77. Rough Wiring Sign 68. APPROVED FQR PLASTERING ' 18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning pIRE DEPT. REQUIREMEfVT 20. Rough Factory FirEptace . -� � �,,, , . „ � .APPROVACS�=�,'Per'init# , - 27. DuctS�, in'$tructure• � • � - _ _ _ - ' 70. Underground Hydro 22. Ducts, Vehtiiaiing_.; � ' "• ,-� 7�, Produci Piping OGas ❑Oil 23. Gas Bipe-�.puyfi & Test �• �� 72. Undergroun� Flush�� '� F- ` 24. Roof�Framing "-- � , , , _ 73: Undergmd. Storage Tank,O Gas ❑ dil 25. Roof-Sheathing - �� �. � - � ' � 74; Overhead Hydra $ x 26. T�Ba'r Ceiling (Structural) & MorSocoat � - . 75. �ry Chemiral _ _� 27. Frame and� Flashing, ` _ • - .� 76. Dry Stand_pipe -= 28. Lathing & Sidfig ' ' - . , " "� 77.� FIXEO �YSTEnA FINAL ^, � - '�29. Insulation � � �� 7$, FIRE PREV. FIA1Rl ' �� � 30. Drywall Nailing r: _ � `HEALTH DEPT. REQUIREMENT 31. Plaster BrownrCoai� .. c � , � 79. PINAL INSPECTtON - 32. E�ectrical Power Met€i=Fina1 80.. FOOD CERTIF4�ATE ISSUED � 33. Final Eleclric--. .. � � • Notes: - , 34. Finaf Heating & Air Conditioning - � - �•� . .35. FinatGasPipe•Test ,' ." .. . � �,,� � �� ' -� � 36. Hood•or fanopy - - - .. ' ' . � � 37. Fanal��Factory Firepiace ; , . . � , �.. -' - 38. Pinaf Plumbing - - " - - ��39. Watel Service�Final„ y � ' ; � � �-40. Gas Service-Final - � 41. Solar pomestic,Final ' . - �' � ' � � 42. Backflow Preventer-,x � -' 43. Backflow�lrrigation • ' //_ �7 p �T�. �..1� i � ��� _ _L-[=L Lc. 44. Landswpe'IrrtgationSystem �`- - . ' ' . ' �,� a , - /_ e .�� < ��a.� 45. Sound Attenuation _ , . ; - ' � . d6. Handicap Regulations � • ' 47. PiNAL STRUCTURE & BUILDING � ��.1��'��,�( ' 48. F:INAL PLANNING " - - • ' "' ' � - 49. Electric Release to Ee�ison , -� �•� ; 50. Gas Release to Southem CalitomiaGasCo � - " = 51. CERTIFICATE OP OCCUPANCY No. Date PACIFIC HOMEOWNERS ASSOCIATION 700 West Victoria Costa Mesa, Ca. 92627 November 30, 1995 Attention: All Members � Subject: Roofine Addition and Citv Requirements for Final lnspection Our roofing contractor has finished his work in providing new roofing. However, in order to get the work OK'd(signed of� by the City Inspector for the City of Costa Mesa, per 1991 Uniform Building Code "UCB" Section 1210,.....each condo is required to have smoke detectors in each bedroom and in anv adioining hallwavs. Each hallway should already havc a detector, but new ones need to be installed in the upstairs bedrooms. Tliis means hvo new detectors in most of our units(if not all). Buck informs mc that these can be bought for a minimal cost at Price-Costco, etc. Buck and Cathy say the laspector has been very helpful and is able to answer any questions in regard to this or any related matter. You can reach liim at the following: Gary W. Hook (714) 754-5617 Building Inspector (714) 754-4856 FAX City of Costa Mesa 77 Fair Drive / P.O. Box 1200 Costa Mesa, Ca. 92628-1200 We also need to schedule another meeting concerning monthly payments for the roof, as we were unable to secure a loan for such a small amount. Should the monthly payments be $1,000/12, or contain some small additional fee? lf there are any questions, please do not hesitate to contact ac� etherell HOA President _, �\ �'lury�� COSTA MESA BUILDING�SA � DEPARTMENT D P.O. BOX 1200 COSTA MESA, �,nLIFOFNIA 92626 For Applican[ [o Fill in Completely — Use Ink Only ADDFESS `O�' �Z ���+�2�/� J / - T�ENANT R G y/174LJ� S� NG�✓2. MAILING ^S /U///��}N%%S L�� ADORE55 « /�/�6 ciTv S.SON �/E.JO N o�'7 JD- S. CONSTRUCTION / i. . u . . _ . . _ . F�+ 5 W 0. Q h y 2 F L1 v� F C ..1 Q 7 i' � � w a O a a z W i 3 BRANCH AD�RE55 ADDRESS � � CONTRACTOR ADDRESS CITY STATE �IC. NO. SIZE OF LOT T TEL. NO. CITY LIC. NO. NO. OF BlOCS. NOW ON LOT BLDG. Separate permits are required for electric, plumbing and heating work. IUILDING AND WORK TO B� PERFOR� I �ereby ecknowladpe that I havd read ihls application entl stata that the ebove information is coRact antl agree to comply with ell laws reBulatinB Cuiltling consttuc2ion, end I shell not amploy any penon in violaiion of the workman's compensation iews of tha Smte of California. I hereby certify t�at I am properlY licensetl as a contractor under tha Steta of Californla Business a��tl Pro(essions Cotle, Division 3, Cheptar 9, entl that such licensas are in tull torca antl oifeet, or I em exempt from the provisions of the Stata ot Celifornia Business end Professiona Co ivision 3, hapiar SIB�at�re of Permlttee or Authorizad Agant Oate 328$ 3/14/80 g1o27 T� TION F 3SRUCTURAL PERMIT A.P. NO. I S Y�7�I �G� 3 Z ADDI7E55 U/G��//} ST VNIT OR SPACE NO. I�' _ Z� TR.NO. / LOT BLI �Ola-I NEW ADD ALTER REPAIR MOVING DEMOLI OWNER USE � HPPROVED SETBACKS (FROM mYl STREET) C PLANNING ACTION VALUE E DATE.7 �� DATE APPROVED APPROVED //��/� �erc �' ! AULll FOK SYECIAL REQUIREMEN"l'� m C > m Z S SQ. FT. �+ � THE AMOUNTSHOWN UNDER VAIUATION IS FOR m THE PURPO6E OF E5TABLISHING A PERMIT FEE ONLV: � � VALUATION PERMIT FEE E ,a'� PLAN CHECK E ?B.SO o � $ �SW TAX E .%7 V �/'� TOTALPAID § \ .Qi�r.Z% COSTA MESA BUILDING-SfF�F ' Y DEPARTMENT APPLICATION : STRUCTURAL PERMIT P.O• BOX 1200 COSTA MESA; �LIFORNIA 92626 RE 1 BV PERMIT For Applicant to Fill in Completely — Use Ink Only JC%J � 4/�� I 5i I BUILDING'�J�/- � ?� Q- �/` q.p,NO. ADDRESS (Vta '�- OWNER OR � � � ApDFE55 �G 'L TENANT MAILING UNIT OR _� ADDRE55 SPACE NO. TR.NO. LOT BLK. TEL. GTV NO. CONSTRUC�ION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDEP BRANCH OWNEF L S ADDRESS A E ARCHIYECT TEL. VSE E OR ENGINEER ADDRESS ZONE TVPE v GROUP� � CONTRACTOR BVPR�VED DATE Z /3 V�+ ADDRE95 TEL. CITV NO. STATE CITV /�PPROVEDSETBACKS LIC. NO. LIC. NO. SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT q ry7 FT. USE OF EXISTING BLDG. � Separa[e peratits are required for L SIDE Fr. elec[ric, plumbing and heating work. FEAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION 0.4TE APPROVED APPROVED I horaby acknowletlge that I hpve �aatl this applicat(on entl stete that the ebova Info�metion is correct entl aprea to eomply with all lews fepulailnB builtlinp conrtrucNon, antl 1 shell not employ any DareO� �� ��olation of the workman'c compan5ation laws oi the Stata of California. �f I hereby canify thaT I am properly Iicansetl es e<ontrector untlar L�� SQ. FT. � 7d [ho Stata of Calitornla Buainess antl �foteuiOns CoAe, Dlvis(on 3, THE P.MOUNT SHOWN UNDER VALUATION IS FOR Cheptar 9, entl i�at such licanses are In fuil foree antl effect, or 1 TNE FURPOSE OF ESTABLSHING A PERMIT FEE ONLV: em exempt from i�a provisions of the Stete oi Celifornla Busineu yqLUAT10N PEFMIT FEE 5 ana Prof9saione Cotle, Division 3, Chapttr 9. �� Sipnetura ot PLAN GHECK S r Parmlttae S � TAX E l or / — Authorizetl Agont Date TOTAI PAID E IIl Tl,