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Home My WebLink About3093 KLONDIKE AVE - Building Permits 111 ' CITY OF COSTA MESA Y BUILDING DIVISION F• � . DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 0PERMIT + P01-00532 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 3093 KLONDIKE AV Status: ISSUED Suite No Applied: 09/06/2001 Issued: 09/06/2001 Vicinity: / ISSUED BY: �-/ V Parcel Nunmber: 41806304 - • Applicant: NOCK, RON -- _-- � Address: _, - - Phone:, 714-895-1246 - / . \ \\� Owner /, NOUHAD, YOUSEESAMI /► �� Address '3093 KLONDIKE.AVE t ,- 'v, Phone: x� - COSTA MESA, CA Zip: 92626 Contractor: NOCK PLUMBING Address: 11612 KNOTT ST , - - �- - - • Phone: (714)895-1246 ` GARDEN GROVE, CA Zip: 92841 _ License: 707775 ' Arch / Eng : " - - - . Address: - - ` Phone: - , Zip- _ • • __ License: . - / - . SCOPE OF PERMIT ' • WATER HEATER CHANGE OUT. . . --FEE'SUMMARY , AMT QTYAMT QTY - '-AMT QTY ISSUE FEE - , $23.50 - - :.1.,.,.,.. Laundry Tub/Washer $0.00„ ';0.:.:':',111-•/;:-• Sump Pump _ - $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 - Swimming Pool .$0.00 0 Backflow Preventer $0.00 (i-- P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 - ' 0 " Pressure Regulator $0.00 ' 0 : -- Urinal - - - $0.00 0 Clarifier System . . $0.00 , 0 - Process Piping(per 10 ft) $0.00 0 - Vacuum.Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc)- $0.00/ 0 . ' Receptors • , " $0.00 0 ' Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units " '$0.00 - 0 - Septic Tank $0.00 0 Wash Basin; - - -- $0.00 0 Dishwasher 4$0.00 0. Sewer Cap for Demo $0.00 - 0 Wash Basin-Set $0.00 0 Drain,Floor $0.00 - 0 Sewer Connect' $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00- 0 ' Sewer Private Line $0.00 0 7 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 -0„,- - Shower , • , . $0.00 0 . .. Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 - - - Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 ' Sink,commercial $0.00 -''0 . Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor - $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 • COMMENTS/ SPECIAL CONDITIONS • 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 fora 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(6/00) DECLARATIONS (") (Th 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 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 Ls Issued. My worke compensation Insyrance carrier and policy number are: p O Cartier: /ON Policy Number: Gf�// ).Oo (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 :Ilfomie,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr• 'si• '.. aa Applicant Signature: Date: e -/D ' a / WARNING:FAILURE TO SECURE •- ERS'COMPENSATION COVERAGE IS UNLAWFUL + r SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under•rovisi•isC er ( ommencing with Section 7000)of Division 3 of the Business and Professio Codd my license Is In full force and effect.Uc.q / 7 Se icClass p G Contractor's Signature: Ul� Date: —ill -/9/ • • CONSTRUCTION LENDING AGENCY: ❑ 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: Lenders 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 porn*. 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 Ucense 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 contrector(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 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,Califomla 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 ❑No (Section 25533 of the Califomla 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❑Yes or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? 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 Califomia 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 a plication aEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 1U Yes LJ No (Section 65850.2 of the California Govemment 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? 0 Yes 0 No (It 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 Califomla Health and Safety Code Section 42303 been made? ❑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 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. ature Of Legal Owner(s) Date ^D` And/Or Authorized Applicant Date ODE L )NBFECTION TYPE PATE INTMALS CODED INSPECTION TYPE PEE tNTTIiALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing S S'-O 4' bQ (r/ZD 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 • in ` No. r s WILLIAMS INSULATION COMPANY O,F CALIFORNIA 1201 E. Hunter Ave., Santa Ana, California 92705 (714) 547-5148 THERMAL INSULATION CERTIFICATION THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITI CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE,TITLE 24 STATI OF CALIFORNIA, IN THE BUILDING LOCATED AT: Tract Name: Lot No. /11- /Tgract No. . I�nt,q Block No. J Street 'l `-i3 $22(,/��9r�2-kt City EXTERIOR WALLS: R— . mfg. �____ a____.__ Thickness/Type err Value 19 Ceilings: Batts: R_ Mfg, Thickness/Type - Value 11 w - Blown In: \ R_ Mfg. IL\ Thickness/Type Value k t R— Sq. Ft. Covered _ No.of Bags Used Value Floors: R_ `y Mfg. Thickness/Type Value Other _ R— Mfg. Thickness/Type Value General Contractor California Contractors License No. - Date Signature Title Williams Insulation Co. of California California Contractors License No. 267522- Date 9—An—aa Signature t Title JOB COPY-WHITE BUILDING DEPARTMENT-PINK GENERAL CONTRACTOR-YELLOW FILE COPY-GOLD , CITY OF COSTA MESA oBUILDING DIVISION h a) . DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER tIPPNIPERMIT • +� % B05-00596 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDINGJob Address: 3093 KLONDIKE AV - Status: ISSUED Suite: Applied: 04/13/2005 Vicinity: ROOF Issued: 04/13/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: ‘ 41806304 Zoning: R1 Applicant: FERGUSON, LEW ISSUED BY: Address: 4091 E LA PALMA ,. . • SUITE D - Phone: (714)630-5543 ANAHEIM,CA Zip: 92807 . - Owner NOUHAD, YOUSEF SAMI 7 Address ,3093 KLONDIKE AVE - , . Phone: COSTA MESA,CA - Zip: 92626 - , Contractor: MC CORMACK ROOFING Address: 4091-E LA PALMA ' • SUITE D.' , Phone: (714)630-5543 , ANAHEIM,CA Zip: 92807 -License: 643700 _ Arch : - - Eng: .. Address: - Address: , Phone: Phone: • Zip: - License: License: SCOPE OF PERMIT ' TEAR OFF EXISTING SHAKES, FILL IN SPACED SHEATHING; INSTALL 2 LAYERS OF30#FELT UNDERLAYMENT,&REROOF WITH EAGLELITE CAPISTRANO ICBO 4660-5.7 LBS(22 SQ). • - • , FEE SUMMARY Plan Check: $0.00 -- - - Calc Valuation: • 56,400.00 Permit: $139.25 • Claim Valuation: / 56.400.00 SMIP Res: $0.64 - SMIP Corn: $0.00 _ - Other: $0.00 Inspection: $0.00 ., • Total: $139.89 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 - , 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(WOO) ') DECLARATIONS U ( ) It WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I haw d 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 for which this permit is issued. I have and will ma�r�a in workers'compensation Insurance, s required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'co/r��o��nsation Insurance carder and Ilcy mber are: saw--73 - I w t�tvfr44aoCt.' (C2 IPS umN ber: �C.O 7ocD y0 -mal (This section need not be completed it 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 Call la,and a• .e th. if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr. r.- �/(3e 0 /o5 e ,OP:. - t Bet __ WARNING:FAILURE TO SECURE WORKERS'COMPENSATI• • OE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COSTA S. .ENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm th*rLiapLllcensed under pro siory5 of-C118pter 9(commencing with Section 7000)of Division 3 pt.the.Bu mess and Prof sioo Code-and my license is in full force and effect.LfcM...I / 1 �I�(J _ (Cfass-e (� 3 7 /J ContrpctodsSignature.,_ ae_`-7"^- /7 q/ / 3/04115--- — CONSTRUCTION LENDING AGENCY: ❑ 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 Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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 Coda). ❑ 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,ora 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 (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? 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 aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes 0 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? 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 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. Sig Onat 1..; -Cal Owner(s) Date £a O`/// 3�� 5 An ®i a leant- C.,- tem. CODE I INSPECTION TYPE DATE 1IfMg& CODEC INSPECTION TYPE PAIS INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final �/ a208 Final Plumbing c200 Final Re-Roof %9 r 4 210 Final Electrical 201 Final BlockiRetalning 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 n4.7 19 COSTA MESA BUILDING-SAFETY DEPARTMENT 14 3332 2/.13/.79 9977 T� P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 3332 `2/13/79 I2 )g7 APPLICATION F l' S RUIPCII tlatEl9MIT" -1 A __KC _ For Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED a. BUILDING JJ�� 0 ADDRESS V.9..4. . r laA •` ae ..r ...,_,...„ .. �� /�/�t PERMIT NO. OWNER Foley Construction Co. , Inc. A.P. NO.`7/Q=Q�/- 2- AMAIL DDRESS 2101 E. Fourth St., #100 BUILDING Dl RIE S/ tf,3 k , I i1 CITY Santa And TEL 543-947] TRACT 10 11 LOT 10 BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH LENDER X BRANCH OWNER Foley Construction 0. , Inc. ADDRESS ARCHITECT .�. 1 tO �L_�n AVALU$ Q, OR ENGINEER Hales-Langston NOL 547-0860 USE1 [('�T' wl �V /O4• ADDRESS 777 S. Main St. , #105; Orange Z // GROUP 1:4 1ppL�L FONE TYPE (/ .T APPROVED CONTRACTOR Owner/Developer BY DATE ADDRESS Same TEL. ZONE cg PLANS BUILDING NEW Aye5 }I CITY Same NO. I-. STATE CITY YARDS APPROVED YARDS APPROVED 5 LIC.NO. Same LIC.NO. MAIN BUILDING ACCESSORY BUILDING . W SIZE i NO.OF BLDGS. 0 (FROM C /REEL) p/ °11614/14/C.IO. II A.m CU OF LOT NOW ON LOT FRONT pls..-1 L- I^ Y1G F /r��- a USE OF n rn EXISTING BLDG. N/A R.$113FS FT, (J FT. CAI FSeparate permits are required for L.SIDE 5 FT. 0 FT. electric,plumbing and heating work. REAR " G FT. �O O FT. [LI USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ¢ MAIN BLDGS. - ACCESS.BLDGS. Q VAR.# DATE Development of 4]. s nal e-family C.U.P.# APPROVED adetached residence units. ,AP ROVfeDvr DATF 3—I6-7� x - �L' w Qv I hereby acknowledge that I have read this application and state HOLD FOR SPECIA,. REQUIREMENT tn N. IX that the above Information is correct and agree to comply with m p4 all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of m LV the State of California. sit / d - 3 .3 I hereby certify that I am properly licensed as a contractor under 2,549 SQ. FT. ,(JLC' C��S w(`w& the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m J' Chapter 9, and that such licenses are In full farce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from the provisions of the State of California Business a VALUATION PERMIT FEE $ and Professions Coda, Division 3,Chap 9. tit 7411 /0/ a PLAN CHECK $ ! aA I) Inns. Signature i7t��/r t/7/I $ vvfv�vrver C, Permittee �/ TAX $ M� 2/Q Authorized Agent TOTAL PAID $,a ti 74.//g 734 3/27/79aS:�BCK#fF 734 3'/27179_ _. COSTA MESA BUILDING-SAFETY DEPARTMENT ' 734 00004474 19 la - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATIO OR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only RECEIVED BY DATE RECEIVED " " ' DATE ISSUED BUILDING-z r7 ADDRESS �Q a.! ic1 (2)A 114-C I Pry ry PERMIT NO. OWNER 1 /I oil_A7 - I • 'II A.P. NO. y MAIL BUILDING 30g3 k(o+vatkCe. ADDRESS ADDRESS TEL. TRACT/05 31 LOT /0 BLOCK CITY NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER BRANCH OWNER /. '291e.41 c/ en! J ADDRESS r--ti maVALUE ARCHITECT TEL. USE $ OR ENGINEER NO. .-...: .. ...... ..:... .,- -... .. FIRE ADDRESS ZONE TYPE GROUP I APPROVED CONTRACTOR 0G BY DATE ADDRESS {{" TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. F+ STATE • CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 1.1.1 SIZE 'NO.OF BLDGS. (FROM C/L STREET) C. OF LOT NOW ON LOT FRONT FT. FT. a USE OF . c./). EXISTING BLDG. R.SIDE FT. FT, ca F-. Separate permits are required for L.SIDE FT. FT. O electric,plumbing and heating work. REAR FT. FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCESLOGS. BET. BET.MAIN& 0 MAIN BLCX>5. ACCESS. BLDGS. VAR.# DATE ,-.1 C.U.P.# APPROVED 7 APPROVED _HY DPIE ma I:4 W O I hereby acknowledge that I have read this application and state N Ln CC that the above information is correct and agree to comply with Ow all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 2 the State of California. "c I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE �/� c and Professions Code, Division 3,Chapter 9. $ Tn J, en PLAN CHECK $ Signature of `//"'T-- o Perm Vitae $ TAX $ K2 F -U Authorized Agent TOTAL PAID $ a 4"/S et