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Home My WebLink About349 MAGNOLIA ST - Building Permits'r (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 349 MAGNOLIA ST Suite: Vicinity: DE7ACHED GARAGE ONLY Parcel Number: 11725123 Applicant GqODGAME, JACK Address: 16831 KETTLER LN HUNINGTON BEACH, CA Owner: VALENSTEIN, RICHARD J Address 349 MAGNOLIA ST � � COSTA MESA, CA Cootractor: �SI�RRA-ROOFING CO � Address: 16831 KETfLER LN Arch : Address: HUNINGTON BEACH, CA Zip: 92847 Phone: Zoning: ISSUED BY: Phone: (714)847-1773 Zip: 92647 Phone: Zip: 92627 Phone: (714)847-1773 License: 511172 Eng: Address: Status: ISSUED Applied: 05/16/2002 Issued: 05/i6/2002 . Phone: Zip: License: License: SCOPE OF PERMIT . - � REROOF DETqCHED GARAGE ONLY: T/O 2 LAYERS OF COMP SHINGLES, REPAIR SHTG AS NEEDED,'I LAYER 30# ASTM FELT, REROOF WITH "25-YEAR TIMBERLINE COMP SHIGNLES. 11 S�UARES � Pfan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $83.25 $0.50 $0.00 $0.00 $0.00 $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 52,oi 2.00 s2,oiz.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) 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. . , � i" - INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and Final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 . 244E46 (fil00) WORKERS' COMPENSA710N DECLqqp7lON: I hereby attirtn under penalry oi perjury ona ot the tollowinq tleclarations: ❑ I heve end will maimain a certifica�e of consem m self-Insure br workers' compensation, es provided for by section 3700 of tha Lebor Code, lor tha pertortnance ot ihe work for which Ihis Dertnil is issu�p. . I �eve and will maintain workers' G�pe��lon insuranca, as required by sectlon 3700 of the Labor Cotle, for iha peAortnance of Ihe work tor which this permit is issued. My workers'�inp�sation Insurence carrier end pollcy number era: be comp/etetl one PolicyNumbe,: �o� �QZ� ar less.) ❑ I certity Ihet in t�e peAormance ot ihe work for which this Oermit is issued, I shall not employ any person in any manner so as to becoma suhject m Ihe workers' compensatlon laws ot Califomia, and agree that shoultl become subject to the workere' compenution provisions of Sectlon 3700 ot the Lebor Cotle, I shall fotlhwith wmply wilh Ih s provisio \ppRcent Si�r� . . . ��-Q `'Oatej � — ��— � z— WRRNING: FAIIURE SECURE WORKER6' COMPENS ION GUVERAGE IS UNLAWFUL AND SHALL SU61ECi PN EMPCOVEflTO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSAND �OLLAFE (5100.000). IN ADDITIQry TOTHE CQST OF COMPENSATION, DFAMGESlS PROVIDED FOR IN SECTIqJ 37060F THE LABOR WDE, INT�REST, AND ATTORNEVS FEES. LICENSED CON7RACTORS DECLAqpT10N: 1 hereby eMirtn Ihat I am licen d nde pJovisions of Chapter 9(commencing with Section 7000) ot Division 3 01 the Busines and Professions Code, and my license is In full torce end eHect:�LicT� � / e2 �Cless # � — � /�' �ContrectWs�Signature: ` � �� y-b,(� Date� C--'/� ^� Z i v CONSTRUCTION LENDING AGENCY; ' ❑ I hereby aMirm Ihat there is a conswction landing agency tor Ihe pedormance of the work for w�ich ihis permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lentler's Atltlress: signamre: Date: OWNER-BUIIDER DECLARATIONS: I hereby etfirm that untler penalry ot parjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Busineu and Professions CoOe: Any ciry w counry wNcb requirey a permil to conSWc( alter, improve, demdish, or repair any struWure, pnor t� its iswance, also reqbires the applicant tor such permit to flle a signed statement ihat �e or she Is IlcenseC pursuant b the pmvisions of ihe Contraclore IJcense Lew (Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Code) or that he or s�e is exempt thereirom and the Desis for ihe allegetl eaemption. Any violation of Section 7031.5 by eny applicant for a pertnit su6jects tha applicant to e civil penalry ot nat more than tive hunAred dollare ($500).): � I, as owner of the pmperry, or my employees with weges as their sole wmpensation, WILL DO 7HE WORK, and ihe strucWra Is not intentletl or otterad for sala (Sec. 7044, Business and Professions Coae: The Contractors License Law does not applY to an owner of property who builtls or improves thereon, and who does such work himselt or hereelf or Ihwugh his or her own employees, proviaetl that such improvemenis are not Intentlatl or ottered for sale. If, however, ihe building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that �e or sha did not build or improve for purpose of saleJ. ❑ 1, es owner of the pwperry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business antl Professions Code: The coniractors License Law tloes not apply to an owner ot propeny who builds or improves thereon, antl who contracts for such pmject with a comrector(s) license pursuant to ihe Contractors License Laws.). ❑ I em exempt untler sec. Signaiure: Owner ID veritietl Dy drivef5license. ❑ yes ❑ No Business and Pmtessions Cotle for this reason: Veriticetion ot Ownership by (type ot tlp�ument, i.e. - pm0erty taz bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivers License No. Date: Expires: � I heraby certity iha� no excavation tive (5) or more feet in depih into which e person is required to deuend, will be made in connection with work au�horized by ihis permi6 and that no building siructure, sceflolding, talsework, or demolition or dismantling ihereoi, will be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, TUe B, Califomia Adminisirative Code). ❑ As owner-builtlar, I will not employ anyone to do work which would reQuire a pertnit from the Division of Indusirial Safery, as noted above, unless such person hes a permit to do such work from Ihe tlivision. � Signawre: Date: Division ol Industrial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND pl7T}{ORIL4710N OF ENTRY: I certiy untler penalty of perjury that I have read ihis epplication and state ihat ihe intortnation given is correcL I agree to comply with all state laws and ciry ortlinances relating to building consWction, and euthorize representatives ot the Ciry ot Casta Mesa to enter upon Ihe ebove-descnbetl propeny for inspection puryoses. I agree not to occupy or allow occupancy of any building authonzed by ihis permit until Final inspection. �OOE 1. INSPECTIONTYPE 1616 Fixed System Final Fire Pravpntion 1288 200 201 202 203 Pool Spa Final Final Ra-Fooi Finel BIocWRetaining Well Final Fectory Fire Place Finel Sign 204 Final Demolltion PAI& INrmp�s . � � �/l� L�i �. — � 6 �aU Z COOE � INSPEGTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Final Fire Pravention 220 Finel Planning Approval 222 Final Site 250 Final BuiltlinryOccupancy P�l€ 1t�91� l{ .. � vn�ecraooxess: 399 MAGNOLIA ST owxen�snarnc: VALENSTEIN RICHARD J noosess: 349 MAGNOL�A ST COSTA MESA,CA 92627 APCHIENGINEEN: 6 7 3' S 7 3 4 flEG.NO.: aooness: UNIT: uxiT: PEPMITTEE: COASTAL ROOF DESIGN ( 714 ) 583-9038 aooxess: z q 2 36 LARKWOOD LN EL TORO CA 92630 LICENSEO CONiflACTOfl DECLAflPTION: I hereby a��irm iha� I am licensetl under pmvisions of Chap�er 9(commencing with Sec�ion 7000) of Division 3 of the Business antl Prniessions Code. ana my license is in �ul orce ail eitect. ciTvuc.:04845E1.�TATEUC.:S%O3OZD cu�ss: � n�--`g—i2^ Y Signature.— �� WOBKEBS' COMPENSATION UECIABAT10N: I �ereby aflirm that I have a certilica�e o� consent �o sel4insure or a cerii�icate ot Wo�kers' ComDensation Insurance. or a cenifietl copy Ihereot (Seclion 3800. Lab. C). POLICY NO.: EXP. ORTE: � SOMPANY: Certih¢tl tOpY is hereby tUmishea. ❑ Certilietl cOpy i5liled wilh Ihe Ciry Builtling Divisian. Da�e'. Applicant: EXEMPTION FBOM WONNEPS' COMPENSRTION OECfABATION: (This section nee0 not be completeA d Ihe per d is lor one hunareA (5100) or less�. I certily ��al in I�e pedormance ol �he woB �or whic� Nis permi� is issuetl. I s�all nal emplo ny pe m any manner so as lo become 5ub�etl lo �he Workers' Compen5aii0n Laws ol Califomia. ��'�2' 7'2 Signa�ure:�o ig NOTILE: II. airer making ihis Ueclaration, you shoul0 become suDlect to ihe WOBers' Campensation provisions oi the Labor CoOe. you must forlhwitA comply with suc� D�ovisions or Ihis permit shall be tleemetl revoketl. CONSTflUCTION LENDING RGENCY: I her¢by aflirm Iha� Ihere is a ConS�mc�ion lenaing aAenCy fof �h¢ perlormante of fhe vrork �or which Ihis permii is issuetl (Section 3097. Civ. C�. LENDEX: AODflESS: OWNEB BUILOEB OECLAflAT10N: I hereby aliirm tha� I am exempi �mm Ihe Cantractors' State License Law �or �he �ollowing reason (Section 7031.5 Business an� Pmlessional Code: Any ciiy ol coun�y which repuires a Dermil to cons�Nc[, al�er, impmve. Uemolish, or reoair any simcture. prior to its issuance, also requires the applicant for sucn permii m file a signed statement that he/she is Iicense0 pursuant to the pmvisians al the Contracmrs' State License Law (Chapter 9(commencing witA Section 7000) of �ivision 3 of �he Business and Prolessions Code) or Ihai he/she is exempt Ihere�mm antl �he basis �or ��e allegetl exemption. Any viola�ian o� Section 7031.5 6y any apPbcanlfor a permit sublecis ihe apPlican� to a civil penalty o� not more ��an �ive huntlrea dollars ($500�. I. as owner o� I�e pmpetly ar my emplayees with wages as �heir sole compensa�ion, will do Ihe woB, anE t�e ❑ s�mcWre is no� iNenGetl or afleretl �or sale (Sectian 70a4, Business and Pm�essional Cotle: The Contracmrs' Sta[e License Law tloes nol apply �o an owner o� a pmpeny who �uiltls or impmves therean, ana who does such work himsel�/hersel� or lhmugh his or her own employees, pwvitletl Iha� such impmvemen�s are nof intended or oflereA �or sale. I�, however Ihe builAinB or impmvemem is soltl within one year of completion, [he owner will have Ihe burCen oi pmving he/she Uid not build or impmve for �he purpose al salel. . I. as owner o� �he pmpetly, am exclusively conlracting with licensed contractors �o constNc� �he O�olecl (Sec[ion 7044, Business ❑ ana Pmlessions Code: The ConVactors' S�ale License Law tloes nol appty m an owner ol proDeM w�o bwl0s or improves �hereon and who conlratls �or sutA prole��5 wi�� a tOnfratloqs)IicenSe pursUant m �he ConVacmrs' S�ate LiC¢n5e Law),I am aWafe Ihal pwOf 01 �h¢ir Workei 5 Compensa�i0n insurance ShoNd be prouitl¢tl to me. � I am ezempt untler Seclion�. B. 6 P. C. �ar Ihis reason'. �ale-. Ownec I Ao hereby cenify ��at I am aware oi ana wderstantl �he requiremems of Calilomia Health and Safety CoOe Sections 25505, 25533, antl 25574 and iha� I or any IuNre builtling occuDani willlwill nat (circle ane) need �o comply wi�� uitl state cotles antl ��e requirement5 Por a permil lor con5imclion or motlilicalion Imm the Air Ouah�y Managemen� Oistric�. Resi�en�ial constmc�ion applications are exemp� �mm Ihese pmvisions Oale; ApplicanP I hereby cetlAy Inal I have rea0 t�is application antl slate ihal tAe above information is correcL I agree [o comply wilh all ciry and counry orainancesanOsla�elaw5relating�obuil0ingconsimc�ionandhe��r¢¢re�enla�ives IhiScily�oenteruDonlheabove�mentioned pwperly lar inspeclion purposes. 11 �y�-_►� ^ g 2 s�9�a��e: Y Oriver'S License or Social Seari�y x: tfi41-a6 WM1ite—BuilOinp'. Green—Code Enlorcemen��. Canary—Aooticanl; Pmk—Revenue: GolCenrotl—Assxccor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 05659 PERMIT NO: B 056593 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/OFF REROOF 13SQUARS W/COMP, SHINGLES SQ FT; 1,900 CLAIM VALUE: 1,900.00 CALC—VALUE: 1,900,00 GROUP OCC: R-3 / COMMENTS; SMOKE DETECTOR RE�UIRED IN THE HOME ****�r**x��e*�r*��*�r*�r****+r�*� **�r**��r�**�********��e******�r�r*��******��r+e*��r�r�r*r�** 2 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 HUILDING ---------- --------- ACCESSORY BIIILDING --=------ 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 REQ• PROV: PARCEL: 11725123 2NE: REF NO: PLANNING N25TES> i **�**�r*�e***��r*�r***�*�r********�**�*+��**�***�r****��r«��r**�**�«�*******�*�r**�x*�**�* 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: " BUILDING APPAOVED BY . DATE: • APPLICATION ISSUED HY: ' DATE; •�'—��_ MIfiElt3FiEkIFkM�F1kIFIfMitltlklEMlf�F 3k3tifiFiflfiEififif if�k MifMiFlFifiFlFiF�klfklFlf�flflfiFlflfkM�flflE�f3t�fiEk�filititifitifitiF kiFiF�fifiFiFkiFikiFlEiflfiF3FiflE�klFlFif�lFiFifMiFiFiFiF1F�f*ififiF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES� GRADING PERMIT 43.00 50� PL� SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 93.50 0.00 0.00 93,50 93,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 43,50 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 43.00 .50 iE iF iE iE jF 3k if iF 1k iE if iE iF iF IF ik 1F if k iF iF k 1F M IE iF IFlF if iE if iFiF iF ff iF iF iF IFik M iE iF iE fF iF iFif !E iF IF�f M iF ii If IF iF3FiF iE iE iE iE M iF 1f ik iE iE iF1F iF if iF �f if iF If I N D I V I D U A L F E E H 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 1900 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,900.00 END OF FEES Cl �7JIIG�4i8—G011047� "'o:�T '�.5!, DATf: 03/2 :jDZ TI`tE= i��?d CONSTRUCTION AND PLANNING � " PO( SPA J- - � { Date � Inspector � � Date InspEctor � APPROVA�S Permit # - � - , APPROVALS Permit # _ � H 7. Temporary Electrical Serviye�or Pole �� , � � 52. Pool & Equipment Location LJ r � 2. Soil P1pe-Undr md. � 4-� . '; . �� 53.�.Steel Reinforcement : ,r �', .,•n - A: ��,`�.',Ei�ctriwl Condui�tility-'�Jn'drgrnd. ' 54. Forms , � '+'.4:�lectrical Conduitct�L�drgrnd. - - ' 55. Electrical Bonding � g:�.<<S'�el �einforcem�n�t 56. Rou9h Plumbing & Pressure Test �,Ci'�E�i@ctricalUFE�:�9rnd. tr � 57. APPROVALTOCOVER-GUNITE �i � � �,Z.`"�o�tings T'C � � � 58. �Electrica� Conduit-Undrgmd. ' ,8. �Foundation .; �` -. 59. Gas Pipe, � Undrgrnd., Test ' � '8',y Water Pipe-Undiymd. } �� % 60. Backwash Lines, P�Trap, O Undrgmd. `� 10�. Structural Floor SYstem 61. APPROVAL TO DECK .� 1 i. Property Sewer Li �& HansegConnection 62. Backwash & Receptor�Final _'�j 12_ S'e,wer CaP y.,�, �� 63. Heater & Ve�t-Final %'� 13. Roof Drains T � � ��' � �, �.; 64. Plumbing System - Final 14. Rough Plumbi� � � 65. Electrical�Final 15. Rough Electrical�Conduit , 66. Solar SYstem-Finai i6. Rough Electric-Wfring 67. Fencing & AccesrApProval 77. Rough Wiring Siqn 68. APPROVED FOR PIASTERING 78. Rough Electri Q-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' - " C .7 �-tIIr.-. G x ti 20�rfioGgh �ctory F.�eP�ace c�k�.T, �^ v: C C �� x*APPRDVA75D �perinit #^� �^ '" tc rD .f, y' �. r ¢ .c t- .�, X:r U: wtiH:-+ > f' t� 21 =DuCt's, ia�-Str±ictui �' ; `"� ''-' - � ^ �'� '. '�" ' ` " ��:: � f-;� . � G .s x -:70. Undergpoun � Hydro ;� 22. Dutts, Ventiktirig;s i t'�.S = � S ��' .R �^71. Produc�p ih �' ,r t n r- .-. c. �c ' 7 Y�Pt 9 Q?S ��il 23CGas Pipe`�Rou%h &'�est � :�,5 * ,�, _ �� 7z, Underground FI i�a � � a 24�Roof Fr2ming �^ M �°- r - *; O � �_ �� i73�Undergro�ic Srorr T hk � Gas' � 61 �� -* 5� , i :r r,1 ST! O CV x:i '- -4-o F 25. Ro� Sh�athing :{.�. � ,� , ,� � ., ,�,.� �; �74..jpverhead�iydrq]- � 26rT-B`ar Ceiling (Strtleturaq B�Monocoat :�� O��. � 75'�Dry Chemical J� r'-+ O +�'C 27:y rame a�d Flash�� 5 *,_ 7 �,. Y 76:`�Dry Stant�ppe FJ.,� �� M � i . t � . �:: -�i4t. . . . . .,,.-, '�8.-Wtging� Sidinq�x ca �-]1 z t� f F •-� ••x � 77^ FIXED S'/STER�{SINAL� y, �^ ' ' •�i I M .-+ -� . .i'1 Y r. �'29. Insulati'�n o cC�� G r-+ ^�.. � * Ta I � F� w D � +: b] s � i��. 7&�.FIREPREV.FINAi x� �� :� r30. DrywalFNaiing �r,.K �� x� u I � j4c k .MEALTH�DEPT: R�EQHIRL'iVIENT � �..;31. Plasier p��own, Coat�` ; ' � J ` 79S"FINAL If?iSPECTI�N �`" ' F-j �"� i ;� . ;r:r .r. f ;s - r rp rz. ' c 1 HF x � S r. � 1 - t' _32.lElectrical Power.��4,ete(;Final, �c L i �'Y�. �Y r80�F00D CERTIFLCECTE ISfiUED� Y . � - • ' 33�FinalEl in y�,� j �'T '�'; `'�"�:i *:No,2er. a -s_ :c p, � �r. gi 'i H:: rr, t !' Rt:. yT ?c' � p:ir �• `,";3arpin3 Hean�y & Af�y�gdicio"�'s; n .Y � � r y� z 5 �x Y s a^ 'Y n �35•';final GaF PiPe-T�£7' � - t I '�: I f,<�r. n C: �*.'s >:*' Sv n- .. w-. i a:.s � :.o .-.�- :� ,u36xFIo4d or�-CanoPY„�.+„r J� i h••- �� *: C1 I �� ,�;{ * 3: Cic �� Qt� ` .. �37CFin31 Fa�tory FiFeplacA � 'K T � * �ti � t i � T �` ~-r rr � 1.'- c.� :t � L� T Y ,�. .r. lC i•. •• Z� l� N - " `38. Finaj Pl�mbing v: , + � u s } � �-' � 5 �-� * n7 � .. :39. Waief Service-Finah i _.+ -:: k' " n �+-'*i *� G .�� . rz � I k_v � c., +' S 'T40. Gas Seri�e��fnal ' � � Y � � " x .� x� r•=� �•� ,m, a ,7 it t,+h+ , :i: r : �±. - C w• ��::. :: M . I � • . �}41.SolarpomestirFinal� ;� •� �:,;,,; i < �L"� - z� s � %. -k ,r � -� C �- +� ^42.�ackflo� Prevente { '� U ;; '' � , �Z a :c j � • .� j ' ; 43. Backflow Irriyatio�r 'T. �'S �+� `� x^� � J '- . i e- v r'T x S: 1 / ' x r44. Landsczpe I'rjigatio`P Syste«�in� ,� � "x ;� � ::� ; + x� x j � �� w i, V .. �,. _. ... -. .... ._ � ,� _ 5.45:=Sound lltterivation: -:cr �? y i F :- h��: �� - c�. �.cG •: .> > rt1 r� 1 t 7 '-� (-. � r �46!*iandicap, Regulations i � ti `'� ,; � x -:� _ _'i,' ..� , �47;¢If�L STRk1CTU�E & BUt DING � � Q � w - +•• �s � � m 1 ir�Cr :K ' � � � -f '.� t . ^ . t. as:� iMAL PLANNIN� i . y; R� ' �. �. 7 ,� �,� � _ „ �49�E1e`clric Relgase to��dison i �: E ' �.' ' „ � • ' a, I :,.. n '; .r� o ;`50. Gas�iel�ase to So�2hern Cal�forrf2la Gas Co x i �;/�: � i G o�. K � a i t. r �Y..: t, • J r K � • '�51. CERTIFICATEO.fiOCCUPl�f�fCY � x ^ , �;� _ , ,_ � No. Date � �m��rt JOB AC GFtiER i. _c SOIL Gn5 WRTER ROUGH PL UMB I NG !�(„�'+y� `�L�{-- PROP. SWR. LINE � NOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGM HEATING AND AIR CONDITIONING TEMPORARY SEfiVICE OR POLE UN�EFGROUNO � POWER � ROUGM WIRING TRENCHES [ FORMS STEEL REINF.� FLOOR SVSTEM �� BONO BEFM �� STEEL REINFORCE I� FqAME AND FLASHIN OS�L, LATNING — IN OUT P' .'TER. BPOWN COAi '11RAL, FINAL R�. .�NG, VENT., REFRIG. ANO A PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL Bt11L01NG. FINAL CGFfIGI GGf1111fiFMGNTC iINAL R. D. UAIt FIRE ZONE VALUE SUBCONTRACTOR ✓ � .- � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUII.DING AODRESS � OWNER � MAIL � /, Z ADDRESS // waU� TEL. Z CITV �; S NO. � Q CONSTRUCTION Y � . � .� BRANCH AODFES: ADDFESS CONTRACTOR TLT�.—�1v/' o(��.'�—�—P— AODFESS CRV STATE IIC. NO. SIZE OF LOT USEOF ��i�� EXISTING BLDG. S12E OF � /_, NO. OF NEW BLDG. S �� ROOMS EMERIOq WA� ROOF COVERING C COVERI USE OF BUILDING AND WOFK TO BE TEL. NO. CITV LIC. NO. INO.O IBF� NOW ON LOT ED PAl� +rit'�w� '!OV -9-73r?�5;00 413" �.50 , I A.P. NO. TRACT OWNER FIFE ZONE APPROVED lN NO.OF PLANS VARpS APPROV E MAIN BUILDING ROM GL $.yfiEEy) VAR. # C.U.P. a1� APPROVEO FOR BUILDING PERMIT �'E,fiEC�V�D DA7E ISSUI �fi i ti / /i LOT DATE BLOCK USE OF NEW BUIIOINGB� ��/ VARDSAPPROVED BET. MAIN & I hereby acknowledge that I have reatl this application and state S1r" that ffie above information is mrrec[ and agree to comply with all laws regulating building consvuctian, antl I shall not employ any person in violation ot the workman's compensstion laws ot the State ot California. � m � I hereby certify that I am properly licensed as a controctor untler SQ. FT. T o [ha State of California Business antl Professions Code, Divisicn 3, THE AMOUNT SNOWN VNDER VA�UATION IS FOR ^ m Chapter 9, antl thai such licenses are in full for<e antl effeci, or I� THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: ¢ am exempt from tt:e provisions ot the $ta[e Ot California Businass VALUATION and Professions 'e, Division 3, Chapter 9. / N ? �ERMIT FEE $ ` r � SiB^atureot V/QA) .� m Permittee S Q v I� � PLAN CHECK $ E �' , � a LL Authorized Agent i TOTAL FEE $ OWNER KIb1Y0DI, R. D. � DATE q_9q_Kq JOB ADDRESS 3lt9 Magnolia St, BUILDING PERMIT N0. 101i31 GENERAL CONTRACTOR �wner- Bldr. VALI7E S 2r.LIiO_00 AP. No. 11 -2 1-11 LOT � TRACT FIRE ZONE DESCRIPTION OF I ECTIONS �p _1 y� DATE I GROUP "[ TYPE V L_ .ergtound Soil U.G. Water i..,a,...,,�_.._a .._.. �5 —I SUBCONTRACTOR I . � -i-.rc i ��,cr...� V �' �hfng—� � j ��'/ �e and Flashing �V f� La��une. Tn :✓ Ont �/ ex. `: �r.- � 10�� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA fOR APPUCANT TO f/LL /N COMPLETELY TYPE OR PRINT BUILDING�" �y � � ADDRESS ( � , COSTA MESA, CALIFORNIA MAIL � G / /7 ADDRESS r /T CITY �y'�OST � �d // TNO. ae� �<cr G'r�i r uc. ..c�a.i:r�Y= LEGAL I LOT � I I R/� ne5cniviioH NO. 6LOCK T C' A.P. NO. � � �/ — /I OF LOT %/ �]� �� I NO.OF BLD65. NOW ON LOT SEfBACK LINE FROM :+' � CENTER OF STREET ' REAR YAI SIDE YARD ILEFT IRIGHT DESCRIPTION OF WORK NE' I II ALTERATION I II ADOITION I/ ftEPAIR I II MOVING I II DEMOLISH I BUILDING NO.OF � SIZE ROOMS STORIES EXTERIOR WA `� I OOF �{ COVERWG (�C ICOVERIN /,i USE11F BUILDIIyG ANQ WQRK TO 9E,PF�RFORt.�EL\ ,� 1 HEREBY ACKNOWLEDGE THAT I XAVE FEAD THI6 PPPLICpT10N AND STATE THAT THE ABOVE IS CORNECT ANO AGREE TO COM- PLY WITH ALL WTY ORDINpNCES ANO STATE LAWS NEGULATING BUILDING CONSTftI1CT10N. SIGNATURE OF _ � AUTHORIZED AGENT / L�.%�/(/Lf�� rEE RECEfVED � y-��--J--� FINANCE DEPT. APPLICATIOISTFF�R�FpERMIT BUILDING foR officF usE oH�y IRECEIPT NO. I IO R`r 3 RECE)V BT I �T��S^J /I DA� � 3yJ � COSTA MESA, FIRE ZONE ZONING ZONE �� ,/ I P AN9 /� BU�ILDIN� �I ��./// / I APPROVED//) � � C�A BV ��/ DATE L ��7 ) VARDS �VES „ REqUIRED ALLOWED (CENTER L�NE STJ / FRONT .�P�. FT�C y R.SIDE .�FT. �Y- fi � THE AMOUNT SHOWN PURP09E OF ESTAB� _UATION � �/S'D � / �n�Fr�nvFr1 a5-` 1 � �_".'_ DER VALIIATION IS FOR THE 19HING A PERMIT FEE ONLY. PERMIT FEE � $ F [/ ! PLAN CHECK $ �� TOTAL FEE $ �J �"