HomeMy WebLinkAbout3119 MANISTEE DR - Building Permits .-
"'Fsy CITY OF COSTA MESA
4
0.0n4 BUILDING DIVISION
' wry�tr ' DEVELOPMENT SERVICES DEPARTMENT
b,fiNPERMIT P R UMBER
' mnnmm B99-00032
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3119 MANISTEE DR Status: ISSUED
Suite: Applied: 01/06/1999
Vicinity: Issued: 01/06/1999
Parcel Nunmber: 41801210 Zoning: R1 R1
Applicant: FAUBERT,BRAD.
Address: 24981 HON AV
Phone: 800-854-0011
LAGUNA HILLS CA Zip: 92653 •
Owner: LUBWICK,SINDI
Address
COSTA MESA,CA Phone: 562-481-4421
3119 MANISTEE DR Zip: 92626
Contractor: STAR COURSE ROOFING CO.
Address: 24981 HON AV
Phone: 800-854-0011
LAGUNA HILLS CA
Zip: 92653 License: 532778
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
, TEAR OFF WOOD SHAKE INSTALL 1/2"OSB&REROOF WITH 25 YEAR COMP.SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $6,250.00
Permit: $124.75 Claim Valuation: $6,250.00
SMIP Res: $0.63
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.38
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
NOTES:
EXPIRED
DATE a
•
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
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 Insurance canier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the pen.' : -.- : • e hundred dollars($100)or less.)
\
I certify that•in the perfo .- ce of the work for which t•s permit is issued, I shall not employ any person In any manner so as to become subject to the workers'
camp ' n laws of .Ifomia,and agree that if I sh••d become subject to the workers'compensa'•• ovlslons of Section 3700 of the labor Code,I shall forthwith
com ly with t pr••miens. ` o
Applicant Signature: I"✓� Date. / G r
• TO5 '.- '1_9Q' . 'S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJE • RTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE( 00,•.. ..DITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
here am fared under• =r ommencing with Section 7000)of D'•sloonn o =usin an.,;ofessiuns Code,and my license is in full
•
roe and effect Lia U
eek
Contractor's Signaturee: ' \/\ Date: — — y
CONSTRUCTION L •j r
❑ 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 civ,l penalty of not more than five hundred dollars($500).):
❑ 1,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.Ii,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. ❑Yes 0 No Drivers 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 at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
DSection 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
epartment 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 a ppermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? CI 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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? 0 Yes 0 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 undei,penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all stat ws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described prope ' pection purpos .I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
- .natu �•• Owner(s)
Date G , p p
• d/Or Authorized Applin- t — ( te)
�pe
CODE L INSPECTIONTYPE DATE MIALS CODE II INSPFcTION TYPE DATE IIi�ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall _ 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site _
204 Final Demolition 250 Final Building/Occupancy _
2446.46
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. 72,54; DATE /�%//y/,�
LOT NO. //
ADDRESS a //2--1ii7• /t.vf{i
0
The developer of the above entitled tract desires to sell the above set forth
e
lot prior to the time that the tract has been completed and its streets
accepted by the. City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that (he-she-they)
0
(was or were) ,---69GL rpm advised that this tract has
' not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
fox approval other than those conditions protected by surety bond.
/ a '
It
The undersigned agrees to indemnify and hold the city harmless from any claim
a
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
•
BY' OrILI' u
. ./ I
Ad age,
�I
Purchk2.1
RECEJ.NED BY II .
CITY OF COSTA MESA Developer and/or authorized
_ ° PLANNING 7.7
r r, representative
•
OCT ;1 II 1976 •
7 v10111t12i112i3i4i5P6 BY Lender
�DRESSOPSUILOINO: 3119 MANISTEE DR WIT: CITY OF COSTA MESA - BUILDING PERMIT
3WNERS NAME IF KNOWN: BERGSTROM, CRAIG STUART ERM NO: P 076088
ADDRESS: BERGSTROM, LINDA ANNE
3119 MANISTEE DR PERMIT NO: P 076088 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
APPL.MHUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : C/O DISHWASHER SQ FT:
ARCH OR ENS'S ADDRESS: UHT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
cONTRACTORSNAME NOCK PLUMBING ( 714 ) 895-1246
CONTRACTORS MMLDIG 11610 SEABOARD CIR COMMENTS: X
ADDRESS: STANTON CA uC.NO.: 511971 ***AEAE***AE*AE*AE*******x*********x*****At+t***********x* ***************************
90680 DHT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aline under penalty of perjury that I am(tensed under Provialon,of Chapter 9 SETBACKS
(commencing with Section 7000)ol Division 3 of the Business and Professions Code,and my lizense is in fun lace and effect.
cm UC.NO.: 050386 UC.CLASS: C-36 LIC.NO.: 5 1971 EXP: 02 /96 MAIN BUILDING ACCESSORY BUILDING
0 /- W —46 commdo: (. Pt /e/.JC , 400_- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of penury That I am exempt from the Contractors License Law for the
Business PARKING REQ: P ROV: PARCEL: 418 01210 Z NE: REF NO:
demolish,or repair any structure,prior to u issuance.also requires the aopsrom for such permit to file a signed statement that he or she
t licensed ausuant to the provisions d the Contractors License Law(Chapter 9(commencing wth Section 7000)01 Division 3 of the PLANNING N TES>
lssines and Professions Code)or that he or she is exempt therefrom and the basis far the alleged exempton.My violation of Section > 1n
yogi.5by any applicant for a permit subjects the applicant to a del penalty of not more than five hundred dollars(S5031). *******************************************************************************
❑ I.as 98ner of the doPerly or nY emPiclees Mb wages as thei sole compensation.will do the work.and the structure is not iraended DEVELOPMENT V E L O P M E N T S E R V I C E S R E
or offered fow
sale(Sectio,7044,Business emitProlessnsCode:TheCommradesLkenseLawdaorlwgMm
aanOwner ofpropern r Q U I R E M E N T S
who buds or improves thereon. ds end who does such work himself or honied or though his or her own employees.provided that such
improvements are not intended or offend for sale.II,however,the building or improvement is sold within as year a completion,ms
w,ner'builder will have the bud.,dprovingheorshedidnalbaldorimpm»torthepurposeofsale). ZONING APPROVED BY DATE:
❑ I.as owner of the property.am examvely contracting with licensed contractors to construct the project(Section 7044,Business and
Professions Code:The Contractors License Law doesro appy to an Owner dprapenyvele builds a keen:Nee thereon endwho BUILDING APPROVED BY : .' DATE:
contracts for such projects with a catrector(s)licensed pursuant to the Contractors License Law). Nair
❑ lamexempt under seaon: B.aP.c.. oNbreason: APPLICATION ISSUED BY:
9t(E i. —7_i DATE:
Date: Owner:
I do hereby certify that l am aware ofrequirements understand the requiremeof Catania Health and Safety n Code Sectio25505.25533,end LEGALIZATION:N F E E SUMMARY STRUCTUR• SEGMENT : N
25534,and that I or any hese building occupant will/wit not(circle one)need to comply wih said sae codes and the requirements for
e permit for constriction or modification horn the Ai tayManegemem District.Residential omumdioneppiratiames exempt fromGme BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 700
Date: Applicant: PLAN 25* l SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of pequy one dine following dedamione: ISSUE FEE 20100
❑ I have end W maintain a certificate d consent to se5irsrre b waken'compensation,as Provided to by Section 3700 d the Labor
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
9 Ihave and wImainsail workea
workers' r
ninsura .asrequiredbySeaon37DodtheLaboa
Code, thepedamanceathe TOTALS----> 7 . 00 20 .00 1 0 . 00 27. 00 27 . 00 . 00
7C work for which this permit is issued.My workers'compensation insurance carer and policy number are:
Carrier: STATE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED' 27. 00 OVER/SHORT: . 00
Poky Number: $1WC32113100 09/30/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
this section need not be completed if the penal is for one hundred dollars 151001 a kat) 27. 00
❑ I certify that in the performance of the work for which this permit is issued,I shall nor employ any person in any manner so as to
become subject to the workers'compensation laws d California .ree that I should become abject to the waken' *******************************************************************************
compensation provisiong.of Seaton 3703 d the Labor Code.I comply 'h t provisions.
IND I V I D U A L—.• FEE BREAKDOWN
Warning:Failure to secure workers compensation coverage is unlawful,and Biwa subject en employer to atm'nal penalties and TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(5104000),In addition to the cost of compensation,damages as provided for In j.
sectien 3704 of The Labor cont,interest,and attorney's fess. PLU 1 DISHWASHER 7 . 00 7 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097.Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and ase that the above information is correct,I agree to comply with all city end county ordinances I'//--,
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above•mentoned property
1".4)14
•
for inspection purposes.
RON NOCK `h
rent Name .24
Q//
Signature
� Date: /....
I+ua� _
i.
(515ta5WP) Whte-Buikig 8 Slay:Green-Rte:Canary-Applaun:Pink-Revenue:Goldenrod-Assessor
.1- 'CONSTRUCTION AND PLANNING POOL ,PA
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 '
r3:- .Electrical Conduit UtilityUntgrnd. 54. Forms •
- rAl.-7E1ectrical ConduiS-tjridrgrnd. 55. Electrical Bonding '
�Wit•ee( Reinforcement;= 56. Rough Plumbing & Pressure Test -
t 6ZElectrical UFERtInd. 57. APPROVAL TO COVER-GUNITE
_ ,J,_.Fooiings se 58. Electrical ConduitiJndrgrnd.
f7�
r. ,..Poundatlon u - 59. Gas Pipe, 0 Un'drgcnd.,Test
--) rt 4'
9?'"Water Pipe-Undrgr . - 60. Backwash Lines, RTrap, 0 Undrgrnd. '
.
G0.-Structural Floor System _ 61. APPROVAL TO DECK ,-
1'J:*-Property Sewer Line & House'Con'nection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final `
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing_. Ti 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Fi,4aL
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign -. 68. APPROVED FtW,PLASTERING
18. Rough Electrical-T Bar Ceiling' 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
r - ** r-, r'r- r Nr r r,..r 'T' !_. c-
20. Rough Fa[3tory:Firetlace •_ T' t _ "D `rx t 1PPRRVA1 .,Perrnit# : " .
• A
21. Ducts,in Structure a µ� • F-• y -170. UndereJrd-i7rJ;d HRro
r.22. Ducts, Ventila;Ing �. * ct F,F ,, 71. ProdugEQi'ping utas L�Oil
1 - at• 70J .-
23. Gas Pipe-Rough & Test -i'. -
.7 3* r-72. Undergrond Ftus6 * i-
-.
24. Roof Framing - - - - s ^4 ..7 °UndergrrII.Stovall jTank,O Gas 0 fail
z.25. Roof She hin + t' �`1 C r G r
s� g : ! - v < t" n'* 74C.Overhead Hydro. '
, . - ... > .. _t-
26. T'Ba r,Ceiling (Structural) & Mo xDCoat t - cChemical F. ',
27. Flame and Flashing . ., - 7+ % 76'. Dry Stanctpipe - •
.. ).•-
g r r ^T
•-28. Lathing &Siding „:: A ;,rt,�, "IA 774 FIXED Sn'TEREt.FINAL .. _ d
29. Insulation- fr. v. .- 7$5FIRE PREV. FIN/SL- * l> - _,
' 30. Drywall railing _ 4`. I:, 6. c1_ c�HEALTI•`PDEPT REQUIREMENT
31. Plaster Brown,Coat r S - * lX
rr r79.FINAL-IINSEECTION 4'
74- _c_.
;32. Electrical;oyl r Meter-Final ' a r; r '80 ;FOOD CERTIFINTE I'ESL�IEDr
• 33. Final_Electric, -; q C 1 - Notes: _ r.
34. Plnal'-Heating &Air &onditionin§ = _• t 7." LI eC 1' * -
35. FrmallGas Pipe.Test r -.'x i
r36. Hoodor Canopy : - r - r c
s • -f = .t
-. 37. Final Factory Fireplace.^ i%_ e t !r x t'
4 2
38. Final.Plumbing R -' r,! `
_ A , I 2-i rJ-�C� .,
• 39. Water Service-Final ' I - 1`
I p1 .
40. Gas Service-Final rr- - d. Y v e _,
- 41
41. Solar Domestic-Final `� ; „ ::c C1; 4 X _,
_ 4 -
-42. Backflow Preventer t - r _
en
. ,
43. Backflow Irritfation r' z y ., _
44. Landscape IrrigationSystem _=7117 4 it -7. e7 tit z r77 cu 2_':.
- 1 4 T r X r" c e: ✓ r ' i
45. Sound Attenuation ' • * r r t- r - cr, a
- ,
46. Handicap Regulations _ + - t- - =c x
T .. r
47. FINAL STRUCTURE & BUILT3ING E- ..-1 -.1-.1 '•
-
'.-w: _ .•-•48. FINAL PLANNING IL i t-4•- - - +' r=i - F'
49. Electric Release to Edison 4 n ;
a
50. Gas Release to Southern California Gas Co * he - - - '
- -r, t
51. CERTIFICATE OF OCCUPANCY - t n
No. Date
OWNER park Mesa Homes DATE APR 1 9 p72
JOB ADDRESS 3119 Manistee Drive BUILDING PERMIT NO. 41678
GENERAL CONTRACTOR Lucas Develonment Co. DESCRIPTION of WORK Residence w/att garage
A x. 47R-oil-0i LOT 29 TRACT 9036 FIRE ZONE VALUE $ 38,100.00
INSPECTIONS Signature Date TYPE V GROUP I & J ZONE R-1
SOIL •1 �j �'‘74PERMITS ISSUED
GAS �' 4, SUBCONTRACTOR
Date Number I Signature
WATER Plumbin•
ROUGH PLUMBING _/ - J .A. !AVO .AIIE`1 _ MMr
PROP. SWR. LINE n HOUSE CON. (
SPRINKLING SYSTEM . _ a r1 ,
MISCELLANEOUS �A ``1�'- n
ROUGH HEATING AND AIR CONDITIONING !3 2S. d
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER 0
ROUGH WIRING Heatine and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. _, 4�;Qs�1: _ T, + !/ � _ • /
FLOOR SYSTEM :0,- O -r- ew �".0War x/ b/ i 24 417 '
BOND BEAM n STEEL REINFORCE n
SHEATHING G- t 4-et'7
FRAME AND FLASHINp- / O 6.
LATHING - IN, OUT Ho- 4"i V 6
PL 'R, BROWN COAT + LC. ..-LA'[lb
Sl URAL. FINAL w �(, Ele riC ��7 J
HEATING, VENT., REFRIG. AND A.C., FINAL 5 r �e " ?4 c Cat. �0-t•7G 4/64425
PLUMBING, FINAL AND GAS TESTri
ELECTRIC, FINAL L
mu, num r,uni i '1
41618 'SPR 20-7 #OU1005< n=*233.67
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A C ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
Q ,A. ,, ETT- RE I E BY DATE RECEIVED DA EIS UED/
ADIDRESS 2I I \ ({/{a(�IS�ET✓ - • - / (�/ {/� �y;(y/Jr
OWNER Park Mesa Homes A.P. NO.. IQ 'OI1—O‘ P.1A"7"'
MAIL 1451 Quail Street BUILDINGS -1 31iq
ADDRESSADDRESatL \, a.
CITY NewportQBeach
TEL.
CITY TRACT 9036 LOT 29 BLOCK
L�ENDERCTIOJan Diego Federal S & L NEW ADD ALTER REPAIR MOVING DFMf/1 lSH
xx
BRANCH San Diego _ /tet i 11`.
„)A
ADDRESS 600 B Street OWNER 1!i i • i�IYa`I(1/K//�'Qy.'/'!'/`L,1
Dir ' VALUE j�
AREHARCHITECT Craig Combe b Assoc TEL. USE P . i / $gel/R.ro
NO, 645-8040
FIRE T
ADDRESS 1535 Monrovia, Newport Beach ZONE YP I GRO47'
APPROVED /, DATE
CONTRACTOR Lucas Development Corp. _ r _
ADDRESS 1451 Quail St.
-TEL. �psZONNID `
E NO.OF USE OF NEN/14a
CITY Newport Beach NO. 833-0018 11PK-1-13 PUNS 2.- BUILDING/N GAT
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. 257064 LIC.NO. MAIN BUILDING ACCESSORY BUILDING
IR SIZE NO.OF BLOCS. (FROM CIL STREET)
L OF LOT 50 x 90 NOW ON LOT none FRONT 3S FT. FT.
USE OF
en EXISTING BLDG. none R SIDE SFT. FT.
rA
F Separate permits are required for L,SIDE SFT, FT.
W
electric,plumbing and heating work. //rr
REAR �FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
JMAIN SLOGS. ACCESS.BLOCS.
'Zi single family residence C 'L VAR.all•C U.P ql 7$-cJ7 AATE
PPR /1-3-75
APPROVED /J
.'.l APPROVED�j � DATE ��I7—263
iu
#OLD FOR $PFCI RFQLltncae`t�
0O I hereby acknowledge that I have read this application and state
N
p: that the above Information Is correct and agree to comply with
m
0. ell laws regulating building construction, and I shall not employ ti
Z any person In violation of the workman's compensation laws of 1
{x7 the State of California. 'j,Jy/ a}t�'/r
S
1440 SQ. FT. 4-7 /O N
1 hereby certify that I am properly licensed as a contractor under i
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON V:
am exempt from the pro isions . a State . California Business - r ft
VALUATION PERMIT FEE $ V
and Profession hada, D sio `r CT' purr 9. in
en
U 2
Signature of PLAN CHECK $ %.� n
3g 0
Permittee 1� _ $ I /` TAX $ 2
U
Authorized Agent J TOTAL PAID $ •