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HomeMy WebLinkAbout3148 MANISTEE DR - Building Permits CITY OF COSTA MESA - t BUILDING DIVISION >• „;, `1 DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER t• t �w�a Plita • PERMIT B03-01595 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.'{'ALDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3148 MANISTEE DR Status: ISSUED Suite: Applied: 09/18/2003 Vicinity: RESIDENCE AND ATTACHED GARAGE issued: 09/18/2003 Parcel Number: 41801225 Zoning: R1 R1 • Applicant: GALISTKI, GUY Address: 19792 POTOMAC ISSUED BY: Phone: (714)965-2387 HUNTINGTON BEACH,CA Zip: 92646 Owner: SCHAEFER, BIRGITTA Address 3148 MANISTEE DR Phone: COSTA MESA,CA Zip: 92626-3124 Contractor G G ROOFING CO INC Address: 19792 POTOMAC Phone: (714)965-2387 HUNTINGTON BEACH,CA Zip: 92646 License: 364151 Arch : Eng: Address: • Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISITNG SHAKE,INSTALL OSB, FELT AND COVER WITH 30 YEAR COMP SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,200.00 Permit: $139.25 Claim Valuation: $6,200.00 SMIP Res: $0.62 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.87 • 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: 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(6120) DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: I hye 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 1..0159 rk 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed i/the permit is valued at one hundred dollars($100)or less.% ❑ 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 shoo .ject to the workers'compensation provisions of Section 3700 of the LLLaae��bor ode,��GI shall forthwith comply with these provision/s.��////////J����� /7t _ i g-- Applicant Signature: _t� or- Date: (/' XU WARNING:FAILURE TO SECURE WORKE COMPENS' •' COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADD ION 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 licensed und. .rovisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.k r mss— Class N _ Contractors Signature: ����—� Date: al —NC. CONSTRUCTION LENDING AGENCY: El 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,Califomia 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? ❑Yes ❑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 (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'? U Yes U 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 ❑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 ❑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 0 t•- r(s) /�I/ (j -ora or•� ized Applicant " , O (Daatls ) PODS• INSPECTION TYPE PATE 1NTIALS CODE! INSPECTION TYPE RATE INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final q-24-p3 208 Final Plumbing 200 Final Re-Root of�/� 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 CITY OF COSTA MESA REQUEST FOR OCCUPANCY r� / TRACT NO. �� �j CQ DATE f6 LOT NO. / 457/ ADDRESS t3/ 4/2 //(4,1/57 f /Y�i The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The under: 9:ned, by executing this agreement , acknowledges that (he-she-they) /-d...41_2... , (was or were) a advised that this tract has ir not been riven final inspection nor has it been accepted by the City of Costa Mesa as havinghhcomplied 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 for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. /� )20-da-Z-- RECEIVED BY- / -,�}�.�,/6per CITY OF COSTA MESA BY ��1�//P�//!// Developer and/or authorized NOV 9 i975 representative AM Ni 71819110111112111213141516 BY 1 Lender ADDRESS OF BUILDING: ME R — ©0 1 ) 5BUILDING: 3148 MANISTEE DR ' CITY OF COSTA MESA - BUILD,ING POMIT OWNERSNAIIEIFQC*N: BROWNLEE HARRY D TRERM NO: P 086226 A°DREss' 3148 MANISTEE DR • COSTA MESA,CA 92626 PERMIT NO: P 086226 PLAN CHECK NO: N GOVT: N SUPP: N 939-0114 AWL.MMLDIO ADDRESS: CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU N— ` PURPOSE: ADD ARCHITECT ORENmNEER: UC NO.: JOB DESCRIPTION : DISHWASHER CHANGE-OUT SQ FT: ARCH.OR ENO:S ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONDIACTOR9NAa APPLIANCE INSTALLERS, INC ( 562) 986-5511 CONTRACTORS MNLING 3299 E HILL COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADm+ES&SIGNAL HILL CA UCNo: 594282 ***********************RERE****sr**RE***+E*SEr,E***+r+r+E+Ex+rsE*+rRE****sE******se******SE+r**+r*** 90804 uta. 306 ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby elfin under penal,/of peRey that I em licensed under dovisirs of Chapter 9 SETBACKS (commencing with Section 7000)d Division 3 d the Business and Professions Code,and my Boerne is in full tome and effect. CITY UC.NO.: UC.CLASS: C 36 u^ _ c.NO.: 594282 EXP: MAIN BUILDING ACCESSORY BUILDING 9 Date: \y2—\es-4rwa —7 car AUxa7- -i; .Zinn -C• 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 penalty of perjury that I am exempt from the Correctors License Law for the • 'dldwig reason(Section 7031.5 Bunten and Pi is Cade:Any ay r tansy which requires a permit to cambia alter,irnProve. widish,or repair any structure,prior to is issuance.also requires the applicant for per such mit to file a signed statement that he or she PARKING REQ• PROV: PARCEL: 41801225 Z NE: REF NO; a licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES> Business and Prdessicns Code)or that he or she is exempt therefrom end the basis for the alleged exemption.MY violation or Section > 7031.5 by any applicant for a parfait subjects the applicant to a obit penalty of not more than Rre hundred dollars[MOOD. ******************************************************************************* ❑ I,as owner d the property r my employees with wages as thei vole compensation.MI do date work,and the stardom a not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of propeM • D E V E L O P M E N T SERVICES REQUIREMENTS who bolds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such provements are not intended or offered for sale.If.however.the building or improvement is sold within one year of cmpalon,the ZONINGAPPROVED BY DATE: owner-builder will have the burden d proving he or she did not build or improve Ir the purpose d sale). ❑ I.as owner of the property.sat exclusively conlradi g with licensed contractors to connrud the project(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon end who BUILDING APPROVED BY : DATE: contracts for such projects with a contractors)licensed pursuant to the Contractors License law). / ❑ I am exempt under Section: B.AP.c„for this reason: APPLICATION ISSUED BY: DATE: \'2_ ( ********************************************** * * ******************* **** * Dale: Owner. I do hereby certify that I ern aware dand understand the requirements of CaliforniaHearth and Safety Code Sadism 25505,cat+4 and LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N 25534.and that I or any future building occupant will/will ret(dale one)need to comply with Said stale Codes and the requirements for e permit tor arstn/dlen or modification from the AilanagenwMDishid.Residential appWtbmars exempt from Nese PERMIT BLDG PMT PLUMBBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. Date: Applicant: 2 5% SM I P/NON-RES WORKERS COMPENSATION DECLARATION:I hereby affirm under penally d d the one blowingdeclarations:declarations: PLAN ISSUE FEE 22 .00 o I ha,.and will maintail a eenilicate al con:ten]to sell-insure kw workers'ccothensation.as provided tor by Serdion 37C0 id the Labor BUILDING-Div_> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,fpr the performance d the work for which this permit is issued. ❑ haveIrmdMImaintawalkers'compesatinisurance,asrequ:ed byBedit3700dLabor theeam thepancedthe TOTALS - -> 8 .75 22 . 00 0 . 00 30.75 30 . 75 . 00 i, work for which this permit is issued.My waken compensation insurance�inruance artier and policy number re: Carrier GOLDEN $ L EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 30. 75 OVER/SHORT: . 00 Policy Numbr. NWC-34177 - 3 01 /30/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (chis section need ma be competed i the persist a for one hundred*Oars POW or teas) 30 .75 . ❑ I certify One in the performance d the work for which this permit is®red.I shag nor employ any Penn in any manner so as to become sudad to the werkes'cempewMldn len Of res dmq d I ehrdd beton subject to the wadas' ******************************************************************************* `prnmia "'a°"° �S°di°nr Apptcem rovi'bav' I N D I V I D U A L F E E BREAKDOWN —1 Dale: -0_--19,— 7p Warning:Failure be secure workers'conpenasdan Coverage I• nrawdd,and shrill stablest an employer to criminal pananles and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST CIM fines up to one htndred thousand dollars($104000A h eddldon to the cost of compensation,damages as provided lot In Section 3706of the Labor Code,Interest,and attorney's ors. PLU 1 DISHWASHER 8 . 75 8 . 75 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES performance el the work for with this penny is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS:I certify thatt I haw rad this application and state that the above infrmation is correct.I agree to comply with all dry and county ordinances _.and sate aws relatig to Wiling construction and hereby authorize representatives of this dy to entr upon the above mentioned property Cjjn--1�/E e�WQ(for inswdte Purposes.DANE MCNEALY _ _Print Name 0), 12-18-1937/1©:44 FN/93(1,73 1L� Date:C2--� RC,T I:Cl 341i i Signature al Owner/AgenVAppliant/Cont o W4).(11C11141b/916,e ‘I ‘I �'ERi=iIY:0E622fx v (5151d6.WP) While-Buildig&Safety:Green-File:Canary-Applicant Pink-Revenue:Goldenrod-Assessor 114 O 1 CONSTRUCTION AND PLANNING POI. _ & SPA ' APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location T2. o Pipe-Undrggd.n, 53. Steel Reinforcement r}I . "..!..N:.E,estri cal Pond gttT'-c'[lt� ty-Undrgrnd._ 54. Forms ' GS-Y, s '-s4. Si trical Condui�4.1rSigrnd. 55. Electrical Bonding r gel ReinforcerliFt t 56. Rough Plumbing & Pressure Test ri S . e�'lectrical UF ER &rad. r,• 57. APPROVAL TO COVER-GUNITE et 1. 7 C � ]��Ftootings N� w 58. Electrical ConctdrrG�Undrgrnd. • ▪- -- ....i ;7: - >13,77 Foundation '•C o ' 59. Gas Pipe, 0 Undrgrnd.,Test ' . .. _, ._ 1. :V:9. Water Pipe•UndrrBrnd. a 60. Backwash Lines trTrap, 0 Undrgrnd. A0. Structural FloonSystem ,n. 61. APPROVAL TC .DECK 11. Ptoperty Sewer Linee& House=Connection 62. Backwash & R2"Ceptor-Final 4 12. SLwer Cap > z 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System • Final r.. 14. Rough Plumbing nj _' . 65. Electrical-Final 15. Rough ElectricabConduit •• 66. Solar System-EXcta4 16. Rough Electric Wiri tgc67. Fencing & Acces Approval 17. Rough Wiring Sign 68. APPROVED FOR-PLASTERING 18. Rough Electricaf-T Bar Ceiling 69. POOL/SPA SYST'fMS FINAL 19. Roughs Heptingl& AicConditioning:: -.i-+ vi C 'ZX 7 F.IRE!DEPTc 7REOUIREMENT ' _„ C 0 `. .j.. ..._ ce n m -i.co0 r1 itY '-7 20. 'Roup Fa2torc Fic`epiace 1 S ^,V s. S * rJ APPEO VA,J�S"e- Pee�?mit# t: c n £ U -. -.S.£M ' r+. ": K ,* 7'Q x M - 21. dlucfs;InStructuriix s -, t Cu ?--1 nX .. 70.e-Underground Hydro.. S .. S <4 • 7'LS ' 7:w t 22. Ducts VFntila£ing'I+4 • 0 x 7 C n F+ Ai 71. Produt6T['Piping.LThas OOil -1 A -7 i :7 x 01 x F. n. 23. Gas F pe•,Aou &� t LTS M T; K - 'Jx _ 7 + �-+:� i F j (XC _ x t^ 5e O 72. Underground Ffus r 24. Roof'Framing C ii '" Y r t~ 4M 73j Undergrrid.Stte Tens 0 Gas 0 Oil 1 * F ti *sT. n ti#: 25. RooPheathing * .-I x y r1 7r 74. Overhead Hydrr t D A..t -' 7 1' - 7 26. ••&Bas.Ceiling (Structural ) & Mcittdl:oat 'a 0 >• trx 7$; Dry CheiThical `"7 'r " ' ,A i• r v' m * rrt r]SW * S '; 27. 4arriclair Flash' i=ce=1 . : mx F•tao * . -, h .� i--71:J '1 a >4:r 76. Dry Starr Ptpe�..[ . a cl ni 3G ti J J.} . _ +e M JS✓ 4 28. Lathing&Siding :x ti-t a * I j 774 FIXEDES'QSTErFINA3." C 'U T * n . . . _ 29. InsulatiorZ• o* S ;; S , rt £ ` �t*t M ' a x I �: 7tJr_FIREREV. FFrcPL X x . Hr - _ 30. Drywall &Jailing =4' r+ �* I-' I S✓': ora4EALT,H DEPT. REQUIREMENT (`1,•a AN • F1 X7i 31. Plaster BrowniPtoaTix -- t HH t i ) 1 F. 79. FINAL [ EClI .��N * c., �, 32. E1lectrira ower Meter-anal _ s ' .x 88: FOOD CrERTIFJ'CATE ISSUJEDI • 7s •-' y� . ....' n 33. Fina'.EEleElric on _•rr'' ".. S * y k� Notes: G yin *�" 0 S 3; 34. `Fina 7ieating$ Air'toedrtioni g" --1 t> x r, .-i 7. ' X -• „s .., i-. 1 I X Cl om' =' * m n 35. Fina) Gas-Pipe=Testi* Q,a " M '-' I t* x ..'7 it m c:, . .. r I , t ,. r. t 36. Hoole` Canopy t: n r. '•1 xa M m 71 X 37. Final'Factory Firms a --' O * ' ES .. 4: O7 K� •• MSU ft 4 . it * > . -238. Finaff-Plumbing tix c.+ ✓. 4: L. ^ M ,.m y -. 39. Water Service-Final n E r X . _ r. M x ( r F-'I..' • % ..• r 40. Gas Service-Final * .n rir' S a• .Ti _ - . > n1� m 4 I Iw v£ rQ iC 741. Solar Domestic-Finals y It .r T '-it C' * C :1 '-. .CU * 7 'C I-I n/ k j * ^' x , ! .Y ♦r' .v _ F. 42. Backf low Prevsnter * [,j -cu.. ., 4: .y t r1 M^ ,; F X?`� .. 4. .� •.. 43. Backflow Irrigation >' t cc 1: r' '-, S n • r.. 1 r'10 is x F, t': ,. 3 ✓ T r T ��1., V 1 b' -u w V rA'i;. IJ�andscap>v'{;Irrlgatior*System =. � ' a; 41: _ E _� pi.� ,t: s. H • 45. eound Attenuation* ;_, •• '• - r1• r ;r;t `' Q' c "•. HO * ' r46. Handipap•Regulatiorls * eta Q ` q x - 417. FIN,At STRUCTURE & BUILDING i H I rt I c' t H n: .r, ,. X X , < ^l '7 a: 0 48. (kr I s ML PLANNING.;; "1 rK " ri .L * N +e • A. {EJec`ric Release to Edison 1 ' ve •n .- _ ,_ t._ -. ox x r1 3 X50. bas Release to Soutf ern Calif or atas Co y, * r. S ,7^Jo• ��C x r3 ✓ `51. CERTIFICATE OF OCCUPANCY No. Date 111111. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . i PERMIT NO' (// - TRACT NO. LOT NO. UNIT NO. ZO29 2IO9IB� 5od0 .TL • • CITY OF COST,1q�M,E7SA CONSTRUCTION PERMIT pIL7]1 Project Address lel/yg - ajj�'j�/55fel�_ pr - Applicent•s Mailing Address . /! fC kiv)2 1. TYPE OF CONSTRUCTION LI NEW LI ADD U ALTERATION 1.1.1,11-EPAI R. ' 5992 ?. ❑ CONVERSION ❑ DEMOLISH CI OTHER A.P.# . Zone •Owner's Name Phone / DESCRIPTION OF WORK/USE OF BLDG. Address r,I� S Main Building: Accessory Building: ' •UNDATI ON E Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ U STRUCTURAL T Front 0 Address �+�� �� ❑ TENANT ❑ ELECTRICAL• N •LUMBING ❑ MECHANICAL B Rear p . N Contractor's Nam- /I ii.'�.'S • ,1 , •ne tl►7r�i"I 00 ❑ OTHER C Right D `r ^'� - N ' PROJECT DESCRIPTION SQ. FT. OCCUPANCY RECEIVED } . Address(Mailing/ [?est`•�A CONSTRUCTION TYPE VALUATION$ S Left G City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION PIng. Ref. # Parking Req./Provided E •hereby affirm that I am licensed under'Provisions of Charter 9 (commencing Remarks: - Planning Notes: Q with section 7000) of Division 3 of ilia Business and Professions Code, and _ M my Ilcense'is In fur f• : antl effect. T • Ucen e a s " 1/. e" ' c•n . No. a) S.: 5 45 7 $ 'late • _.#7141 Signature c�dLre. PLUMBING FEES RECEIVED J�tS RS' •OMP I have N DECLARATION Bar Sink • Showers ' 1 hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensa n Or a certified copy thereof (Section s}yp g�I y,,q `�-.(S Backflow Preventer Service Sink �7-0 / �/Z / S n Automatic Washer Transformer• ❑ 15-50 KW • 3800, Lab. sf . Policy No. - Company ft/nf Backf low Irrigation Sewer Cap Construction Pole Sub. 0 50+KW • 1 ..Certified copy Is hereby furnished. ``��j Car die • ire h ,city i•• 1•n/ - Bathtubs Sewer Connection Cooking Unit • Meter ❑up to 100 amps is Date / q Ifcant _f`�- -A i• E%EM ON OM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps' (This section need not be completed if the Permit is for one hundred ($100)or iShwasher less). Solar Piping 2 Dryers ❑Gas ❑Electric Sub Panel I certify that in.the performance of the work for which this permit is issued I - �• shalt not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan - - Motors❑0.1 HP ❑1'h-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains • Swimming Pool vv/Spa — F.A.U. NOTICE: If,after making this declaration, You should become subject to the Inc.Solar 09-15 HP 016-15+ . .. Workers' Compensation provisions'of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet • I hereby affirm that there is a construction lending agency for the performance • Device Boxes Pole Light • I of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater ' • Lender's Name - ' Range , . Lender's Address - Kitchen Sink -Water Service - - OWNER BUILDER DECLARATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sectio• ns county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays • Generator ❑0-5 KW ❑5-15 KW Trash Compactor ',y structure, prior tom nt hat.he/, also required the tcto applicant for rovi ionspermit p file a statement that,he/she is licensed pursuant to provisions of Roof Drains , A a Contractor's License Lawss (Chapter 9(commencing with Section 7000)of • , on 3 of the Business and'Professions Code) or that he/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 - coenaltyof not more than five hundred Sellars($500). ' I, as owner of the property or my employees with wages as their sole Reinspection Fee I. $15 Issue Fee $ 3 • compensation, will do the work, and the structure is not Theintended or offered - Reinspection Fee I $15 Issue Fee - $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES ' ' License Law does not apply to an ownerof a property who builds or improves ' thereon, and who does.such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUI REMENTS: ,• employees, provided that such improvements are not Intended or,offered for Boiler Hood or Type I 0 •• sale. If, however, the building or improvement Is sold within'one year of com- Canopy Type II ❑ Zoning Approved By • Date prove the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By • Dat Prov¢for eo purpose of sale). ❑ I,as owner of the property,(Section lusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By /`/s' • Date - 'tractors to construct the-project (Sectio7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU • SUMMARY OF FEES builtl5 or Improves thereon,and_who contracts for such protects with a con- . tractor(s) license pursuant to the Contractor's License Law). I am aware that, Exhaust System 0 Multiple 0 System Repair/Alteration- BUILDING PERMIT $ SMIP $ proof oftheir Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT • ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ CC ti V ISSUANCE • $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ 'I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BTU - $ GRADING $ .information is correct. I agree to comply with all city and county ordinances ELECTRICAL and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of is,city to en er upon .the above-mentioned propirt hi- . t- _ MECHANICAL $ 6 O 'inspection P• r, , . ' �� TOTAL FEE . $ Signals' ���� `.�/ A Date .:�"�` - 3 Drivers' License or SS � <=— Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit Date Inspector APPROVALS Permit# -Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms •• rY. 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement( 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grrd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undfgrnd. jJ 8. Foundation 59. Gas Pipe, 0 Undrgrnd.;Test -' - r± 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap;0 Undrgrnd',-: 10. Structural Floor System 61. APPROVAL TO DECK=; 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Frinal 12. Sewer 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 Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# • _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing • 4/4204W7 • L 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERM NO. TRACT NO. LOT NO. UNIT NO. CITYOF COSTA MESA Co NISTA CTIO PERMIT I A.P.# Zone ' Project Address • I ��/, I C II 3 7 ` 9/ ' F�G r I�1 S Main Building: Accessory Building: • Applicant's Mailing Addressrrrir 1- TYPE OF CONSTRUCTION Li NEW H ADD LI ALTERATION LI REPAIR �1/^1 51110/_•1 / I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front D Owner's Name �1r1 1`P' Phones `i"I AL^!T'�I DESCRIPTION OF WORK/USE OF BLDG. B Rear _ N Address J� Arch/Eng. _License No. TYPE OF PERMIT ❑ GRADING LI FOUNDATION ❑ STRUCTURAL C Right - N Address 'fffn���I///���1�����...n///ill �/ ` ❑ TENANT ❑ ELECTRICAL LJ PLUMBING ❑ MECHANICAL S • LeftR Contractor's Na9me O� N jr10.p1. Phone y�/�-7 ❑ OTHER ping. Ref.# Parking Req./Provided _ MAddress(mailin h �� /I d # C/ / 1 1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY Q ��//���1 CON ST RUCTION TYPE VALUATION$ Planning Notes: II--11ec^C ,ILL qy' City License No. a:/(J // � ZONE GRADING CU.YDS. ACRES RECEIVE❑ ; �. O1 i j% gA T LICENSED CONTRACTOR DECLARATION RtCE� � IJCD .- s. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: R1 .0 with section'7000) of Division 3 of the Business and Professions Code, and 'Q my license is in full o+�p_antl effect. '/C�y�7 ELECTRICAL FEES ktLicense las - ��/ Lic se g� UO4✓D / _ Automatic Washer Transformer 0 15-50 KW �ate_g__ '.___ Signature � j�l� PLUMBING FEES O RKERS'COMPENSATION DECLARATION Construction Pole Suh. 0 50+KW 1 .Hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter Dug to 100 amps 3800, Lab. /n1 (; �� / Backflow Preventer Service Sink Policy No. /4,N,-5y gq Company `JIC1tfr_,.. ' r2.11—CA Backflow Irrigation Sewer Cap Dishwasher Meter Clover 100 amps ertified copy is hereby furnished. Dryers ❑Gas '❑Electric Sub Panel ert"fie copyya filed with the city Bu' in • Bathtubs Sewer Connection Date Y Applicant Fan Motors❑0.1 HP ❑1%-8 EXEMPTION nFROM d WORKERS'COM ATION DECLARATION( Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher Solar Piping F.A.U. Inc.Solar 09.15 HP 016-75+ I certify that in the performance of the work for which this permit is issued, I - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fixtures Microwave Workers' Compensation Laws of California. DiCe Bd%e$ Date Signature Floor Drains Swimming Pool w/Spa Pole Light NOTICE: II,after making this declaration,you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - Switches Sign Gas Service Outlets Water Closet 9 I hereby work that there is a permit ssue agency for the 97rfCly. nce ,C.) of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors I Water Heater �7 Garbage Disposal Standing Sections Lender's Name P Lender's Address Kitchen Sink Water ServiceGenerator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Tra's - 'fly structure, prior to its issuance, also requires the applicant for such permit file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains Contractor's License Law(Chapter 9(commencing with Section 7000) of .vision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit supjects the applicant to a civil penalty of not more than five hundred dollars($500). I 3 DEVELOPMENT SERVICES REQUIREMENTS: LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ compensation, will do the work, and the structure is not intended or offered Zoning Approved By Date /_ for salee (Sectionwe Business and Professional Code: The Contractor'smproveMECHANICAL FEES Building Approved By Date License Law does not apply to an owner if a property who builds or improves — _ -thereon, and who does such work himself/herself or through his or her own Application Issued By Date employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type I I ❑ SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground prove for the purpose of sale). . - BUI LDING PERMIT $ SMIP $ O I, as owner of the property, am exclusively contracting With licensed con- Duct-Structural Refrigeration System PLAN CHECK $ �ERMIT tractors to construct the project (Section 7044,Business and Professions Code: n The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU PLUMBING $ V ISSUANCE $ - builds or improves [Hereon. and who contracts for such oroiects with aeon- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $ _ proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers • PLAN CHECK 50% $ MICROFILM $ Date Owner Heating System& Ducting Registers MECHANICAL U `� I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTI... - $ TOTAL FEE $ Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter/ pon the above-mentioned property q for i59 atue .tnpun /s.i44 _ Date '/ -81 falfr - Reinspection Fee $15 Issue Fee $ 3 01 00026461-00025461 TOT 5.00 Drivers' License or SS DATE: 02116/$9 TIME: 12:04 0865-46,rev-5/88 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor V t t CONSTRUCTION AND PLANNINC L& SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1.'Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3..,Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Elecvical Conduit,Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. .8. Foundation 59. Gas Pipe, Q Undrgrnd., Test 9: Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. • 10.,Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection • 62. Backwash & Receptor-Final 12:Sewer 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 Wiring 67. Fencing & Access Approval ,)7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 201 Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping LI Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing Vain La'7 39. Water Service-Final C^ rc•. 40. Gas Service-Final 01. rc .•n 41. Solar Domestic-Final�<"j 42. Backflow Preventer cr.. '•21 /( may„I 43. Backflow Irrigation ;-,-C-J r•; 44. Landscape Irrigation Sem � e' 45. Sound Attenuation . CC' 46. Handicap Regulations A.., - 47. FINAL STRUCTURE'&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • - 50. Gas Release to Southern California Gas Co ..�': h IV/ 51. CERTIFICATE OF OCCUPANCY -;• i � No. Date A-' :,)i Vel\Ln race. rieba nuwco WAIL JOB ADDRESS 11/ 7„�a� n lopment Co. DESCRIPTION of WORF ,g gnictaa A.'-rp DING PERMIT NO. 41663 GENERAL CONTRACTOR ' - "" Residence w/att garage AP No. 61R-011-01 LOT 14 TRACT 9036 FIRE ZONE VALUE $ 35,900.00 INSPECTIONS Siature Date TYPE V GROUP I & J ZONE R-1 ,--, SOIL af''S r'"•74 SUBCONTRACTOR PERMITS ISSUED GAS Dote I Number I Signature WATER Plumbing_ '/ ROUGH PLUMBING fa �� -J�4-?' 4VV a--/ PROP. SWR. LINE ❑ HOUSE CON. yy "`� )-i .?6 .. r `•a4-k 4 I 4 g✓ SPRINKLING SYSTEM y,y,�, ys fp Zo;7e pC��( � 4.`•ZG 702 9e MISCELLANEOUS *\Li 7-2,}5.94 V C7 ROUGH HEATING AND AIR CONDITIONING [2 •s "7-144')6 . TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING 77j2(i Heating and Vent, TRENCHES Li FORMS STEEL REINF. �,e_�er�� ✓n/e._1 "kat / -1 74 iQ s8 C� FLOOR SYSTEM a 7 U.4-/g-" /.263y / BOND BEAM [i STEEL REINFORCE n '/ SHEATHING - C•47, /a-'j FRAME AND FLAyING ./ d'- / - L LATHING — IN 1__I OUT 4.... . PLASTER. BROWN COAT '. Z-9-- .26-2 STRUCTURAL, FINAL /�• HEATING. VENT., REFRIG. AND A.C., FINAL a� 0.i t u ej,I,;'PA lin. PLUMBING, FINAL AND GAS TEST El sr 5 /0.M3 '7 ELECTRIC. FINALa. -/Qyy//Q-IFly BUILDING, FINAL . a - /T-AG eagle. -------- 13 41 Pain 1PR ?0-76 n01020* **t215.51 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A A ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only R BY DATE TE IS BUILDING h/�." -j�,� ADDRESS��� r Yw-� �7(�. i }/�� 1 �(�.( 3OWNER Park Mesa Homes A.P. NO. di PER 1 1 O 1t l SDI I 'OI �` MAIL ADDRESS R ADDRESS (`�1451 Quail Street BUILDING 01 ct , CITY Newport Beach No`'833-0018 TRACT 9036 LOT 14 BLOCK CONSTRUCTION DiegoNEW ADD ALTER REPAIR MOVING DEMO!ISH LENDER Federal S & L x BRANCH Sari Deigo _ __. �Q 2L1f_ . _ 4ged ADDRESS 600 B StreetARCHITECT OWNER 'sem/ ,/��1�/�/�ur� . --- /A ALUEJgQ ei OR ENGINES Craig CiOmbe b Aaeot: No`'645-8040 USE /^J/'y'/ 5 .7 FIRE T ADDRESS 1535 Monrovia, Newport Beach ZONE 44/11E (/ GROUP1 3417CONTRACTOR Lucas Development Corp. BVPROVED - DATE # /lf ADDRESS 1451 Quail St. TEL. 0aE NO.OF USE OF NEW��• CITY Newport Beach NO. 833-0018 h .-LD PIANS Z BUILDING rAt/Mt 6431 1"' STATE CITY YARDS APPROVED YARDS APPROVED gLIC. NO. 257064 LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLOCS (FROM C/L STREET) p+ 4 OF LOT 55 x 90 NOW ON LOT non. FRONT S FT. FT. Q USE OF none (13 EXISTING BLDG. _H.SIDE v FT. FT. t/] FSeparate permits are required for L,SIDE .5 FT. FT. c electric,plumbing and heating work. REAR 20 FT. FT. [a:7 USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& AMAIN BLOC'S. ACCESS.BLDGS. 3 single family residence g,L VAR.# DATE / Q C.U.P.#26-75—97 / APPROVED/1-3-?5- APPROVEL��% !�/Ii��/ .-.1 ....BY U DATE V"- 1 l.0 CC TOLD FOR SPECb L REQUIRED Nrc Lai Pr A. 0 I hereby acknowledge that I have reed this application and state n C4 that the above information Is correct end agree to comply with m 0• all laws regulating building construction, and I shall not employ Z any person in violation of the workmen's compensation laws of o the State of California. ���eJ)�(//^t �0 It a 3 I hereby certify that I am properly licensed as a contractor under ""Y ' SO. FT. T. �/ ry the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such Ile nses are In full fo •a and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt from the provlsi ns of t • .tate o .elifornie Business VALUATION PERMIT FEE S ���� and Professlo f Ctia,DI it n 3,p ter 9. be m f / / rid PLAN CHECK S YYY 2 Signature o /t/J� 7/1 2 Permittee ' TAX E 2.5! u Authorized Agent TOTAL PAID jr/ N!� s 7