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HomeMy WebLinkAbout3141 KERRY LN - Building Permits PROJECT ADDRESS: 3141 KERRY LN UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: D 04977: OWNER'S NAME: JOHNSON ROBERT E TR • ADDRESS: 3141 KEfinY LN PERMIT NO:' B 049777 PLAN CHECK NO: • N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE; 5 -N PERMIT TYPE; STR PURPOSE: ALT ( 714 ) 545- 3349 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF W/"SIERRA" O/SHAKE ( ICBO#4361 ) SQ FT: 6,000 ADDRESS: UNIT: CLAIM VALUE: 6, 000 . 00 CALC-VALUE; 6, 000 . 00 GROUP OCC: R •3 /M-1 PERMITTEE: WESTERN SIERRA ( 714 ) 529-1019 ADDRESS: 450 APOLLO D COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. DREA CA 92621 ***** F+F9F**TFiF#?Fu-1F+FaFIFIFaF Fx{t1F1F1FYffiF ,****YY- -iF*iFiFTFiFYu4-$4444 Fry.aFi41fXIF+FY-Y-IFYi:iF#.7EY**Y!-*.w. 4Ya(-*iFY LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R E Q U I R E M E N T S 7000)of Division 3 01 the Business and Professions Code.and my license is in full force and effect. CITY LIC.: 039991 STATE LIC.:4 9 2 5 I CLASiSi MIL S E T B A C K S Date: 1( - 7—?O signature: U_ - --- - MAIN BUILDING - - - - - - - -- - --- ACCESSORY BUILDING ---- - - - --- WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN 'LEFT: FT IN RGIIT: FT IN POLICYND.: OIWCP120721 EXP.DATE: 04 /01 /91 -COMPANY: SUP. NATIONAL�.APARKING REQ: PROV: PARCEL: 14163214 ZNE: REF NO; J Certified copy is hereby furnished. yy Certified cop filed with the'cit B 'ding Di"ion. PLANNING NOTES> 9 U > Date: I /� -! Applicant: JLaFAFY'1F�FiFk'#AF1F3F1FdF#'****ipiF#1E1F1FK,****iFiF1FIFiFic****.****Y-ic***)4'if***X..****.141r,.'X-Y.iF.y'a{.')*1FiF'1F**XaFa *** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1001 or less). D E V E"L O P M E N T SERVICES REQUIR EM EN TS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE:if.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : • DATE: - Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. 7 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: �� / DATE: F// // /$ which this permit is issued(Section 3097,Civ.C). *{F{F***{F.7F{F)F***)F****-7F****1F F1F iF 1F31• - F 4** i F*Int*iF****k**Y.-Y.- 1945;•*41 �f if iF 65** LENDER: ***********tF**************lt*************** #*** 1F1FiF****IF**44-#.}FiFiFK-IFIF-K3!-Y.**** ** ADDRESS: LEGALIZATION:N F E E SUM ARY STRUCTURAL SEGMENT; Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM.I P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 81- . 0 0 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed „ pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 30l the Business .a M I P/NON -RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 81 . 50 0. 00 0. 00 81 . 50 81 . 5 0 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or • forptheepurpose oil saejhin one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE BLDG�T PMTOPLUMBING ELECTRICOMECHANIC FIRE1 SMIP/TOOVER/SHORT:GRADING PLAN -CHE• CK I.as owner 01 the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a Contractors)license pursuant 10 the Contractors'State License Law).I am aware aFY-iF4F#*jr-1F.1F1F{R1F****jF1(-y,1F{1.j(-jt{F**4F{Rj(-iF{F{F{R{F7F*{F IFaFiFY)(-{F IFaFjF*jEj(1F{FYY*jF1F{FYjLj4 K jFY-dFYY x-JF fF Y Y Y it Y yyy icy • that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date( Owner: SFR 6000 REROOF DY VALUE RESIDENIAI NOZONE 1 . 00 6, 000 , 00 I do hereby certify that I am aware al and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above•mentioned property for inspection purposes. 01 0 TOT 7366 Date et— 7=fo signature: r k ` DRTEC011/09 3620 90 ?TI E: 09:02 31.50 Driver's License or Social Security rt: 1641.46 Whrte—Dmldmg:Green—Codd Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor St a CONSTRUCTION AND PLANNING ' POt. . 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.•Electrical Condujt-Undrgrnd. 55. Electrical Bonding S..Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6: Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE ` -- 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 4- 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 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 _ tEr 1 - 20. Rough Factory Fireplace �`; -• - t--' .. APPROVALS_; 'Permit # ' 21. Ducts, in Structure r •• '.: ti •_ .-....v * X70. Underground Hydro 22. Ducts, Ventilating - r _ T•? ' .71, Product'Piping 0 Gas 0 Oil 23. Gas:Pipe-Rough&•fest , tI 47. ._; `._72. Underground Flush^o. - 24.'Roof_Framing• r,. ' '- ^1 • a i 73 Undergrnd Storage Tank 0 Gas 0 Oil 25. Roof,Sheathing `, .�'--�0- �(�t/, �.. 74. 'Overhead Hydro 1, 26. T-Bar Ceiling (Structural) & Monocoat r v '� It] ; 75.JDry Chemical , ' - " '- - - 27. Frame and Flashing' ` - , t 76. Dry Standpipe ' : 28. Lathing'& Siding • .s )' -•I e 77.:FIXED SYSTEM'F.INALi 29. Insulation 4 y 78sFIRE PREV. FINAL - :r 30. Drywall Nailing - aI --I. HE_ALTH,DEPT.REQUIREMENT '31. Plaster Brown Coat'. . ,- , .- I. s r 79.'FINAL INSPECTION I 1.- 1{I 111 32. Electrical Power Meter-Final I '3 .'1F I.• + t80OOD CERTIFICATE ISSUED .33. ,Final Electric - ' I - '' "Notes: :�_. _ 34. Final Heating& Air:Conditioning- - 1 '� r - • -- - 35. Final Gas Pipe=Test F I j I� , • ;:r. - ; •• .: 36..Hood or Canopy t, -' (' I _. 7 oo • Y t1 •37.`Final'Factory Fireplace ' - p4: _ . . to ,.' t 'rt- -38. Final Plumbing nr " •i •p1. . - ., • 39. Water Service-Final • • • ( i4' ' C ,' ' - '40. Gas Service-Final - I , ; . - :41. Solar Domestic-Final - � - 42. Backflow Preventers • .; ') 1+ ' r ' • •- , ;� 43. Backflow Irrigation' - ' = ) '- • 44. Landscape Irrigation System • _ - _ - _ 45. Sound Attenuation . .. .. __t. . _ 46. Handicap Regulations Ir - 47. FINAL STRUCTURE & BUILDING - f'J�` sc , • _ _ 1 48.'FINAL PLANNING; . - t. r I j, t• • .I • 49. Electric Release to Edison - • j_ 50. Gas,Release to Southern California Gas Co ' I 1'I"J: - r. - , 51. CERTIFICATE OF OCCUPANCY t ' i •; - ,. - • , No Date • PROJECT ADDRESS: 3141 KERRY LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 049518 OWNER'S NAME: JOHNSON ROBERT E TR V ADDRESS: 3141 KERRY LN PERMIT NO: B 049518 PLAN CHECK NO: N GOVT; N SUPP: N • COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: ALT ( 714 ) • i ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL 4 SKYLIGHTS (NO CUT RAFTERS) SQ FT: 2 , 150 ADDRESS: UNIT: • CLAIM VALUE: 2, 150 . 00 CALL—VALUE: 2, 150 . 00 GROUP OCC : R-3 / PERMITTEE: MINI CONSTRUCTION ( 714 ) 272-9199 • ADDRESS: 364 PALOMAR DR COMMENTS : SMOKE DETECTOR(S ) REQUIRED IN HOME. CORONA CA 91719 ********************)f***************+P**********+r**********+E********>t*>E>E******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R E Q U I R E M E N T S 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T 'B ACK S CITY LIC.:051641 STATE LIC.:5 9 6 3 71 CLASS: B Date:_tCJr / Aga_ Signature:..._"4:411/4147 (4—01_ I� MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affirms I v acertificate ofc sent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN -ompensalion Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ILICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL : 14163214 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> Date: Applicant: ***********************************************************************.******** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1001 or less). DEVEL OPMENT SERVICES R E Q U I R E M E W T. S 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'Compensation7.—I0 ' Laws of California. ZONING APPROVED BY . DATE: • Date:f-/ /' f0Signature: NOTICE:If.after making this declaration,you should co a ublect to the rkers'Compensation provisions of the Labor BUILDING APPROVED BY '/// ,/ DATE: p' Code,you must forthwith comply with such affirm that or this permit shall be deemed revoked. i'Rs L/ �F� %N If�F It X**iF iE CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: O which this permit is issued(Section 3097.Civ.CI. ************************ * ** ** A******************S&A)*** ***** LENDER: *************************************** ** *********************************** ADDRESS: LEGALIZATION:N F E E SU MARY STRUCTURAL SEGMENT :Y OWNER BUILDER DECLARATION: I hereby affirm that lathexempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 . 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed :• pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN arty applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(SSOO). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING D1 V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ) structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 Does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT; 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contraclor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL - F E E BREAKDOWN ❑ I am exempt under Section: B.g P.C. tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2150 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 150 . 00 l do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END' OF FEES 25534 and that I ar any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ..4- these provisions. r ' Date'. Applicant: • I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly far inspection purposes. J} , Date: • —art/2.— rr U Signature:_ _QU4i Driver's License or Social Security x: 01 00072294-00072295 TOT 54,50 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor DATE: 10/17/90 TIME: IME: 14:58 CONSTRUCTION AND PLANNINt, ,L& SPA P PROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -1 2.. Soil Pipe-Undrgrnd., i 53. Steel Reinforcement 3:• Electrical Conduit Utility-Undrgrnd. 54.'Forms 4. Electrical Conduit-Undrgrnd..'• 55. Electrical Bonding / .5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6' Electrical UFER.Grnd. 57. APPROVAL TO COVER-GUNITE 7., Footings - _- I' 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test i/ ' 9? Water Pipe-Undrgrnd. , 4..-•, , 60. Backwash Lines,P-Trap, 0 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 .x 13. Roof Drains - 6- 4.64. 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 t. 20. Rough factor' Fi 'eblace ; :!rl is r •"4 t 1APPROVALS: "Permit # t". 311 f4'. :. . f• i r-, • 1 -� . 1j. 21,:Ducts,inStructure4 • •• .x +4 a x'70. UndergrouridlHydro 22.-Ducts, Ventilating,. I s. ' .-., ` 't-':,` e `,11, Product:Piping O Gas 00i T i.,.,,.F t, 23. Gas Pipe i M Rough &Test M. • y ;1 , t 7 .t, k .� , 72. Underground Flush' + , 24.'iRoof•Framing' ' T i .:. i. y p . -, y � ,�., J3. .Undergrnd:Storage}Tank O Gas ❑Oil 25. Roof Sheathing ,..-6 :r t , � - 7 > as :I: 74,?Overhead Hydro. , 26. T-Bar Ceiling (Structural) &Monoboat 'r• ~' r-' -� 'rr'r A. 75., Dry Chemical .r 27. 'Frame and Flashing a',,,,a1 I Z,/,�,, a' t 7 ''' �' `t �.31 "IV '(/�,t(i�i: 76. Dry Stand Pl Pe F•'-' -28. Lathing& Siding'- `, -' , n •'//j, l 771.''FIXED SYSTEMJ'FINALt , a .. .. .1'. lu , iii :t J t '29. Insulation .i `- :e I t 78. FIREPREY. FINAL ' 30. Drywall Nailing - is; s ' j l'''.'j.t a. ' „ t HEALTH'DEPT+REQUIREMENT t3 : rp. 1. Plaster Brown,Coat1 , 4 ' rt79.FINAL INSPECTIONi. ' v :i ,32.rElectrical,Power Meter;Final I '- 't I.e`.11, 180.''FOOD CERTIFICATE ISISUED, t 1.0.✓11• 1 1" ,' r, 71 ,33."Final,ElectricI, , :� ifft-p, r Notes: ' 1 .I , - ..,, 34.,Final:Heating Air ni Conditiong - :, + '�• 11, �` _ / -g- q , i :2.°4L-Wee. s°4L-W _ 35.`.Final'Gas.Pipe,-Testi ,��' •; i, 1-1i ,fes,j...•::./T Yaradji .- / 36. Hood or Canopy_ '. . ., _a I .1. ti I-i .: t '1r .K, `i' '37. Final Factory Fireplace.. =r'' I. "1 I A ''II ;Az , '' ( ; . • .38. Final.Plumbing + I it I I tit; i • ,. i' 39. Water Se(vice-Final .4• I ,'- I :' ;- ,40. Gas Service-Final -ro•r • tr: ' x 1 v„' -I •41. Solar Dornestic•Final " 1 -' It r : Y '1 I; •` • 42.-Backflow Preventer. `, is �4 r o: - • i 43. Backflow Irrigation; - ;' ,c r 1 `44. Landscape Irrigation System,,..' - r ,:i i r t".• • t" . D =45. Sound Attenuation' ' ' • , '46. Handicap,Regulations hi ;:; •• ^• - r. 47. FINAL STRUCTURE & BUILDINGI � - I/ yr , 48.yFINALPLANNING ''.j;4 • .i t, ' 49.'Electric Release to Edison r. • - -' . I �f_t t :50. Gas Release to Southern California Gas Co ' t • - • 51. CERTIFICATEOF-OCCUPANCY 1 _t : No. Date • OWNER HARBOR HALL OF FAME HOMES INC. DATE '.OV 3 0 1962 JOB ADDRESS 3141 Kerry Lane BUILDING PERMIT NO. 18303 GENERAL CONTRACTOR Lifetime Residential Bldg. Corp. VALUE $ 19,055.00 AP No. LOTS3I&J TRACT V FIRE ZONE DESCRIPTION OF WORK Res/Att.Gar. INSPECTIONS Signature! DATE GROUP I&J TYPE V ZONE R-1 (,.i �J I2 01 SUBCONTRACTOR PEDATERMITSISSUED NUMBER Wever f,_1/ 20'6f Rough Com. Refrig. 0 Air Cond. 0 Rough Heating kte, - A.Y -0.„. _ -y . , i 043D / 6.7 //.4 '. Rough Plumbing Kea _246 .3 , ,� 49-4/-/2._ ga71. Si Miscellaneous ” �� "" Prop.Swr.Line%House Con. 4-St.Swr.GI 4.41- c 2-.24?-43 Zi C's taktr!,Tq a2-ov--es .3S/�/ , Sprinkling System l/ Lly1. Construction Pole Underground 0 Power ❑ _ Rough Wiring 'C .�.'/1J�c.. Pt (.Ci _f o?,�-/>_��%p� 'Trenches l� Forms Er Steel Heine. 0 ir n--3^-,YFloor System /a-if-42- Bond iBond Beam 0 Steel Reinforce 0 p Sheathing fail "l ,� (.-1S'-63 Frame and Flashinpett.-a) 4-0 2-4-0 Lathing — In VP'Out WJ/65 T'�r Plaster, brown coat Wit y-/d -61 Refng. 0 Air Cond. 0 Final _ P ''ng, Final 5`0 6? I ping Fixtures, Final QA ( t 63 Final Gas Test �/ I �/` Electric Fixtures, Final Si Building, Final 4ffer n c3 OCCUPANCY FORM BIM.5M — 7.61 1 R2l1Z 18303 Lot 53, T f Etl eEhl Via 30 I962 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLICATIth%T P 1 fr MESA ��// TYPE OR PRINT BUILDING ADDRESS ILDIN 3 /// /1'/Gtry ZgnL COSTA MESA. CALIFORNIA For Office Use Only RECEIPT NO. I PE T NO. OWNER Harbor Hall of. Fame Homes Inc. /x3 cS MAIL RECEIVE BY 77 81V8D DATE ISSUED ADDRESS P.O. Box 2066 Ee,�1�, /,� I , 6�(T yI hUV 3 9 7962 CITY Santa Ana TNml 9.2204.'.^ BUILDING ADDRESS ARCHITECT Jamison TEL.t/.8._0040 COSTA MESA. CALIFORNIA OR ENGINEER NO.JTT'�� ADDRESS 225 "D" St. , Tustin FIREh�int ZONE TYPE /�. GROUPbi✓ CONTRACTOR Lifetime Residential Bldg Corp.BYPROVED DATE ADDRESS 2131 So. Artesia St. ZONING '-,—, , /.� ZONE /� NO.OF USE OP NEW rt1 - CITY Santa M /!m I I PLANE )II BUILDINGiy t tlV ,.y�/ STA E T LIC.TNO. 208676 NO. KI 9-2204 LEGAL DESCRIPTIONs%(.5a)/ r2.. if3ST, SIZE 6000' I NO. OF BLOCS.O OF LOT NOW ON LOT A.p.NO. .1')L ' - -1 USE OF None YARDS EVES EXISTING BLDG APPROVED ALLOWED SETBACK LINE FROM 531 (CENTER LINE ST.) CENTER Op STREET REAR YARD3 3.50 FRONT -s-.3 FT. IN. SIDE YARD I LEFT 5' I RIGHT 5' - R.SIDE -5— FT. IN. DESCRIPTION OF WORK s— — L.SIDE FT. IN. NEW I g II ALTERATION I II ADDITION I REAR 3 3 FT. 4 IN. REPAIR I II MOVING I II DEMOLISH I APPROVED By evICil y> DATE to ')'Z--&)- SB Z LDING 1790 NO. OF ROOMS lO STORIES 1 COVEEXTERING OR WALL Plaster! INURING Shake USE OF BUILDING AND WORK TO BE PERFORMED Single Family residence _____;_0,:, , I HEREBY ACKNOWLEDGE T T I HAVE READ THIS APPLICATION THE AMOUNT SHOWN laER VALUATION IS POR THE AND STATE THAT THE E IS CORRECT AND AGREE COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY • D 4A CESCQ WE RE TINGBUILDING CONBTRUyVALUATION SIGNATURE oP '( 'G I. PERMIT FEE $ 3 NPERM ITTEF _''' (�// �•) L,�L , a_ $ / C/✓.J PLAN CHECK $ <. /.. •5 04: F AUTHORIZED AGENT TOTAL FEE97V..,cbD