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HomeMy WebLinkAbout615 KNOWELL PL - Building Permits,i Job Address: Suite: Viciniry: Primary Occ: Parcel Number: 615 KNOWELL PL RESIDENCE AND GARAGE R3 Dwellings/ Cong Res <10 42213211 Type of Construction: V-N Zoning: npplicant: LEMUS, RAFAEL Address: 2016 WALLACE AVE UNIT B Phone: 949-642-7057 COSTA MESA, CA � � _� „ ,� --. - -Zip: _ ,92,627- _ ,.-' �-.r.'..%-�--- "_ _ " /i�-�---.:� �. , � '. � - _ ' owner: BRAVO, BAUGIL'DO�' : --'' � � �_. � Address 615 KNOWELI Pl ; /i� � f � ' % .' ` f�' � ' � ;% � . j��i���. `,r"� � Phone: ' n ����` '�����A COSTA-MESA,CA��i,� ' .--'._ . 2ip:'�92627' � � ��%,�� � � ���..� � _ . -. . �-_ '���.A Contractor. ,% L'EMUS ROOFING, !" � �'� �:' "t, . � ��.,, Address��f 2016 WALhACE AVE=�= � ' =�'� "� �; � , % � ; ",� �UNITB�� i�%%� Phone: 949-642-7057 �`��` � � �� , �\ < � CO6TA MESA,=CA � .�� �V�� . ����'�/�/r 92627 j%j� License: 826813 �,\�\ ;\i ����,'� ISSUED BY: Status: ISSUED Applied: 12/29/2006 Issued: 1229/2006 �N�cn .L �.� //�,7� Address: �.,; /� /� f /i .-\/y: �'l�i� %; � 1 �ii ,'z�p: _' ; ,Illn;- " � , ' - . , , ,'�� . � , �, r�rJ; t. � '?EAR OFF COMP AND Phone: ' °' ' � ��� -License> ��<i'- . ,��.� �„ � _. � - . �i ,`� 1 � i �� el � �l P,lari Check ��_'$0.00 `'� Permif(j; �$111.25 {';��, SMIPRes� ` � $0.00 �y ;� � SMIP Com� �',`� � $O.00x � � ` Other ,�� $0.00 i �,', Inspectwn� � � �, $0.00 � �,� � ll . � ��, �,� � Total �`��, $111.25 �''� : � . v �. ��' • Eng: Address: V .-_ . � � i. �, .. I ... '""" '" SCOPE OF PERMIT � 30 YEAR COMP WITH #30 FELT UNDERLAYMENT. i �� ` � �', . . - a� ,', , �\�Phone, , Liiense:� �� '� ,. ',., . TACHED GARAGE. �_ FEE SUMMARY �! i� l_` .`.lYr( ;,'v/ : i! ''[L���l� �`.+!1���;` �;�-�,�Calc Valuation � . Claim Valuation. `�� = _`-� _ _ .. - _ ._ --_ �- = =. � �� � ; r _ i ' - ., ,,S �_ ��.' . � °,` �'� � - � i '_+--- — ..� � � l � - –�� .' � . � -��/ r, , �� /I J 1 � ; � � � �' � . , $5,000.00 � _$5,000.00 �., ti , PLANNING & ZONING �- �� / ,-- . . ,,, � � S� E Ff\t``\0�0 Rea� JO 0�,� � Left a0 0-��` Right 0�0 y` � � i'� � �..�� r - . . w..�_— i. l •. ` � 5 . "�Front_ 0.0�� � �' � Rear 0 0' . �, ,'Left �0-0 ''" �` "�Right �0-,0 . - J �� � � E�isli a /` 0\`' ��Re uired 0? �� � Pr000sed � d0 f r �� �� "� \ ' '' �� �vl 1, ,�, A _`-`� n ar� 6 - - . -; 4-i"�i v�/ /� % �� �f / j,��' . � � .�^:'ti .� , . \ � \� ��'.. ,"/� ,'� � �� \ : i � � i �� �, ; rl��� � --- �� �;�, „ ,. , �. ,. , � � .� � IJ� .1/ �1��j� > ` r �V � � , ;' � �. ( r^ � � � � � - ' � � v- _, `� � . � 1 . —� " . �;i: � i � ��\ �_�'L�.:;'.� -'�i ''\`_.�"_ _,,,..%: �i ,� '` , -- .- . _ -" .—,��'l�- - � � � � i� �;: _... . NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and relatetl regulations. (Ord. No. g248, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced�within �180 days, or if work is suspended or abandonetl for a period of 180 days. � � ' � INSPECTIONS: In order for the work authorized untler this permit lo be consideretl 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 ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446-48(fi/00) J. I .� /':� WORKERS' COMPENSAnON DECLARATION: I hereby aHirm untlar peqalry oi perjury one ol the following declarations: . ❑ I ve and wlll maiPtain a cenificate Of consent to sell-Insure br workers' compensa�ion, as providetl for by section 3700 of �he Labor Code, fot the peAortnance of ihe ork for whith lhis pertnit is is5uetl. 1 have entl will main�in workers' compensation insurance, as requirea by section 3700 of ihe Labor Code, tor the performance of the work for which this pertnii is issuetl. My workers' compe sa�ion I urence carner antl policy number are: � %(� ) �c �(� Cerrier: � ����, PolicyNumber: / �l iJ� �'I (This section neetl n�b0 comp/efed i/ the permit is valuetl al one hundred dollars ($100) or /ess.) ❑ I ceNty that in Ihe pedormance of tha work br which this permit is issued, I s�all not employ any person in any manner so as to become subject to the workars' wmpansatlon laws of Califomia, and agree that it shoultl bewme su6jecl to ihe workers' compensation provisions of Section 37p0 of Iha L or Cotle, I shall Iort�wilb comply with these p�a�i ' s. I 1 jQ /1� ( � AppliceNSignaWre: �Qp„ L- Date: I�// � OV/ WARNING: FAILURE TO SEGURE WORKEPS' COMPENSAiION ERAGE IS UNUWFUL AND SHALL SOBIECT AN EMPLOYER TO CFIMINPL PENAL IES AND CIVIL FWE UP TOONE HUNDRED TFIOUSAND WLURE (510p.000). IN ADDITION TO THE C0.ST OF COMPENSATIqJ, DAMAGES AS PROVIDED WR IN SECTION 3]O60F THE LABOR COOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby aflirtn that I am licensed untlar provisic force entl ettect. Lic. k_Y-��„ no/� Coniractors SignaWre: of Chapter 9(commencing with Section 7000) of Division 3 of the BuSiness antl Prolessions Code, end my license is in full Class k G � � e nti oate: I 2� 29 [D(� CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm Nat �here is a consiruction lending agency for ihe performance of the work for w�ich this pertnit is issued. (Sec. 3097, Civil Cotle). LenCafs Neme: Lender's Adtlress: Signeture: Date: OWNER-BUILDER DEC�7AT10NS: I hereby ettlrtn Ihet under Penalry oi perjury ihat I am E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry w�ich requires a permit to construct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit to lile e signed statement that he or she is licensed purouant to lhe pwvisions of the Coniracrore License law (C�epter 9(commencing with Section 7000) of Division 3 0l tne Business and Professions Code) or thet he or she is ezempt theretmm and ihe basis for the alleged ezemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil Qenalry oi not more than five hundred dollars ($5�0).)�. ❑ I, es owner of ihe p�operty, or my employaes with weges as their sole compensation, WILL DO THE WORK, end the sWdure is not intendetl or offeretl for sale (Sec. 7044, eusiness and Professions Code: The Contrecbrs License Law tloes not apply to an owner of pmperty who builds or improves t�ereon, and who does such work himsetl or herself or thmugh his or her own employees, provided thet such improvemenis are not intendetl or oHered tor sale. II, however, ihe builtling or impmvement is soltl within one yee� o� �mpletion, the or.neo-builtler will have the burden of proving ihat he or she did not �uild or improve tor purpose ot sale.). ❑ I, as owner ol the p�operty, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the O�oject (Sac. 704d, Business and Professions Cotle: The con(ractOrS Litensa Ww does noi epply to an owner of pmperty who builds or improves ihereon, antl who Con(racls for SUCh project wilh e coniractor(s) licanse pursuant to the Contractors License Laws.). ❑ I am axempt under sec. Business and Professions Cotle for �his reason: Signature: Date: Owner ID verified by tlnvar5liten5e. ❑ Ve5 ❑ No Driver's License No. Expire5: Veriliwtion ol Ownership by (rype ol documem, i.e. - properry taz bill or deed): DIVISION OF INDUSTRI�L SAFETV PERMIT CERTIFICATION: ❑ I hereby cenity that no excavation five (5) or more fee� in depth into which a person is requiretl to descend, will be made in conneclion with work authonzed by this permi6 and Ihat no building stmcture, scattolding, falsework, or demolition or dismantling Ihereof, will he more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Tttle 8, CalltorPia A�minisirative Cotle). ❑ As owner-6ulltlar, I will not employ anyone m do work which would require a permit hom the Division of Intlustrial Safery, as noted ebove, unless such person hes e permit to do such work from lhe division. SignaNre: Date: Division oi lntlusinal SafeN Permit Number: CERTIFlCATE OF COMPUN�ICE AND AUTMORIZATION OF EMRV: I cenity under penalty ot perjury thai I have read this ap0�ication end state that the iMormation given is correct. I agree Io compy with all state laws end ciry ordinances relaling to building consiruction, and authodze representatives of the Ciry of Costa Mesa to enter upon the ebove-tlescribed propeny tor inspection puryoses. I agree not to occupy or allow occupancy of any building authorized by Ihis permi� until final inspection. A Si �Of LABaI Owner(s) �� � �atqe ��� d � % An Or Auihorizetl Applitant Date COOE �. INSGECTONTYPE 1616 Flxetl System Final Fire Prevention t266 Pool Spa Final 200 Final Re-Roo� 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition p� IN R L �—� � CODE I IN$PECTION TYPE 206 Final Mechanical 208 Firtal Plum6ing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sile 250 Final Builtling/Oaupancy RT � INiRI�LS ��ia� �sa-sz�s • Fax (714) 754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 615 KNOWELL PL 42213211 PYLE,JOHANNES E 615 KNOWELL PL COSTA MESA, CA PYLE,JOHANNES E 615 KNOWELL PL COSTA MESA, CA Contractor: Address: i � ; ISSUE FEE . Temp service test Res. a/c package New Res (1-2 units) , New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Molors to 1 hp Motors to tOhp Motors to SOhp Motors to 100hp Molors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ELECTRICAL PERMIT Phone: 949-722-7078 Zip: 92627 Phone: Zip: 92627 Phone: , ... � �,'�'.'1�.' � ` - Zip: License: REPLACE EXISTING SUBPANEL. $23.50 $0.00 $0.00 $o.00 $0.00 $D.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 ao.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 Quantity SCOPE OF PERMIT FEE SUMMARY Temp Dist System / Lighting Busway/100ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................uP to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee NUMBER 77 FAIR DRNE, COSTA MESA, CA 92626 Status: I SS U E D Applied: 07/20/2000 Issued: 07/20/2000 ISSUED BY: ��^ Quantity $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 554.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis 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 wo/k is suspended or abandoned for a period of 780 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 requlretl Inapectlona end final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: � � I hereby atlirm untler penelry of perlury one of the following tleclarations: ❑ I have and wlll maintain a certifiwte of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for Ihe peAortnence of the work tor which this pertnit is issued. � ❑ I have and will mainfaln workers' compensation insurance, as required by section 3700 of the Labor Code, tor the peAortnance of ihe work for w�ich ihis permit is issued. My workers' compenution Insurance carrier end policy number are: Carner: Policy Numher: (This section need nof be comD�efed il the pertnif is velued el one hunOretl tlollars ($100J or less.) ❑ I canify that in the pertormance of fhe work lor which this permit is issued, I shall not employ any person in any menner so as to Decome subject to the workers' compensation laws of Celifomia, and agree t�at ii I should become subject to tha workers' compensation provisions of Section 3700 of ihe Lebor Cotle, I shell fonhwit� comply with these provisions. Applicant SignaWre: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL PND SMALL SUBJECT PN EMPLOYER TO CRIMINAL PENALTIES FND CIVIL FINE$ UP TOONE HUNDRED iHOUSAND DOLLAFE (510D,000). IN ADDITION TO THE COST OF CO!dPENSATION, DAMAGES AS PROVIOED FOR IN SECiION 31060F THE LABOR ODDE, IMEREST. AND ATTORNEV'S FEES. LICENSED CONTRACTORS OECLARA710N: I hereby attirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) oi Division 3 ot ihe Business and Professions Cotle, antl my license is in full force and ettect. Lic. a Class # Coniractofs Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn ihat there is a construction lentling agency for the pertormance ot the work tor which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentler's Address � Signature: Date: OWNER-BUILDER DECLARATIONS: I hereDy affirm Ihat untler penalry of perjury thai I am EXEMPT FFiOM THE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a permit to consWct, alter, impmve, demolish, or repair any s[rucWre, prior to its issuance, also requires the applicant tor such permii to file a signetl statement ihat he or she is licensed pursuant to the provisions ot ihe Contrectors License Law (Chepter 9(commencing with Section 7000) of Division 3 oi the Business and Protessions Code) or that he or she is exempt therefrom antl the basis tor the elleged exemption. Any violation of Section 7037.5 6y eny applicant for a pertnit sub�ects ihe applicant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employaes with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intended or ottered tor sale (Sec. 7044, eusiness antl Protessions Code: The Conirectors License Law tloes not apply to an owner of properry who builds or improves Ihereon, and who does such work himseN or herself or through his or her own employees, provided ihat such improvements ere not intentletl or oHered for sale. If, however, the building or improvement is sold within one year of completion, ihe owner-builder will have Ihe burden of proving that he or she did noi builtl or improve tor purpose ot sale.). ❑ I, as owner of the propeny, am EXCLUSIVELV CONTRACTING WI7N LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pwfesslons � Cotle: The coniractors License Law does not appty to an owner ot property who builds or improves ihereon, and who contracts for such project with a contractor(s) license pursuant to the Contractore License Laws.). ❑ I am ezempt un e. �� Business and Professions Code for ihis reason: Signature: / �"'`���� Date: �O� Owner I venfied . Ves ❑ No Drivets License Na. Expires: /e .-9 j—O� Verifiw�ion ot Ownership by (rype of daument, i.e. - pmperty �au bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity Ihat no excavation five (5) or more teet in depih into which a person is requiretl to descand, will be matle in connection wi�h work authonzetl by ihis permi�, antl that no buildinq simcNre, scaftolding, talsework, or demolition or tlismantling ihereof, will be more than ihirry-siz (36) taet higR (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Celitornia Adminisirative Cade). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require e permit trom ihe Division ot Industnal Safery, as notetl above, unless such person has a permit to tlo such wark from t�e tlivision. Signature: Date: Division of Industrial Satety Partnit Number: CER7IFICATE OF COMPLIANCE ANO AUTiORIZA710N OF ENiRY: I certity under penelty of perjury that I have raad ihis application and stata ihat the informetion given is correct. I agree b comply with all state laws and ciry ordinances relating to builtling construction, and authorize representatives of the Ciry ot Casta Mesa m enter upon lhe above-described pwperty for ir��p7ey� tipon purposes. I agree�t to occupy or allow acupancy oi eny building authorized by this pertnit until finel inspection. � � /�^^ % �l /�� L %—• �O_ L7C7 � neture Of Legal Owner(s) Date And/Or Authorized Applicant Date COQE �. INSGECTIONTYPE 1616 FineO System Final Fire Prevention 7266 Pool Spa Final 200 Final Re-Roof 201 Final 81xk/Retaining Wall 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demolition 2408�66 UATE IN(ITIRLS COUE 11 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �: t uu %' Zb '�U �'7^ � a :, , L'� � C'o�a �zleQa �u�r�� ?���s OWNER-BUILDER VERIFICATION .,,. . . � . .. . . . . - . � . . A city or county, which is required to give notice pursuant to Section 19830, shail a[tach to such notice, and, as a condition precedent to issuing a building permit, require the comple[ion• and require the retum of, an owner-builder verification. Attention PropeRy Owner. An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and remm this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building pertnit. No building pertni[ will be issued until this verification is received. l. 1 personally plan to provide the major labor and materials for construction of [he proposed property improvemen[. ❑ Yes ❑ No � I(have/have not) signed an applicution for a building permit for the proposed work. �. 1 have contracted with the following person (firtn) to provide the proposed construction: Name �n�C` G 6� � L E�'T/� �� Address �.67/ CC�/B r%6sA T� City �oslN l'��Jq Phone (c+��j �� �/ 7T � Contractor's Lic. No. a� 67�84 8 � 4. I plan to provide portions of the work, but I have hired the following person [o coordinate, supervise and provide [he major work: Name Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) [he following persons to provide the work indicated: Name Address Phone Type of Work 1042�d6 (PEV.9/98) . ..... . . _.,:. ... , OWNER ROGERS� K. K. � DATE %-2(-5tj 6 �.i � JOBADDRE88 --6�12 Knowell Place BUILDINGPERMITNO. I1ZZ GENERALCONTRACTOR Owner VA WE $ 9 SZO.00 � LOT 2�j BLOCK � TRACT 2],(�(j Dwellin� GROUP I TYPE V ZONE R�l FIRE DIS7RICT #433 INSPECTION8 II DATE SUBCONTRACTOR I PERMITSISSUED DATE I NUMHER FoundaYlon Forms and to Slab Heating, Rough /_-/rd�G //—/G—d9- �1 7n(, f:�..<�a.s.Yl�`.�.... ,V—/9 Heating, Final . '" � Sewer ��l�A� �'f K+.._... �r�GC /�"/C cl� Cl `2/. � �...�.p��SnJ i/- (�—. or Final, Fixtures Final Gas Tesf`, Form 1I0 GH lM 1E-68 � Mesa Building Department A�• � 111 EA&T 20th STREET �,.�� ' COSTA MESA, CALIFORNIA FOR APPI.ICANT TO LL IN Building ' Address j � ;L b /t� G'OSt'd Z , � CiB� & Nearest CroSs S / ' Owner Mail Address . Z�%!� O .�— Size of Use of t�C-L�7 I hereby acknowl and state that the with all City i building const Signature of Permittee Aulhorized Agt. Valu,a,t�iro�n $ C � FORM 204 G•H 2M 5-54 No. City LiC. No. � Block � �1fct`�� L No. of Bldgs. !J t' Now on Lot No.of I No.of Familles Roorgs, Rear Y� Moving � � Demolish � No. oT Room Stories I Roo Coveri s � ;e that I have read this Applii bove ' rrect and agr��te� � s and SLate �,,t:c�eu Plan APPLdCATdON FOR PEdi11ZIT ��3 � t9 I L D,t R9 G '� FOR O�'%+'ICE iJSE O1�TI.Y j _ _ Receipt nNo. _ . ._permit No, j i ��� / � ��a � Received by Date Re 'tl. Date Issued i ' � %�G,S $uilding .,6iS� . Address Costa 11�esa, California Nearest , i .A / � ♦ __- � //Dn __ I . .. �.t;� nrrRova�.s fation Location Inspectoi �ms, Materials, fer-Pinning e: Fire Stops, cing, Bolts Int. Ext. :r, Int. �/ �FINAL rerr p+ . ..:S��k'�., • ' .. .: � . � . ._. �.• �f�.. ` . ` 1j:f. � 1y�- \� . .k�. _. � ." .`�'y� -.�'_ '� „ . L �•._ _\ •_�s �. .., , � '... . .. � .�� � . �n ti . , _ :A . 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'r" ' . _ , _ _ '�. �' ` �. � .. , ... - t , `.� � : .1'. .�. . �, • . , . � � ., • . .. - _ _ .. . � " _ _ . � . i ' ry.,';:.. 4 � t � � . . ''.1 � . . . . . .\ - . . ` ; � ' _ . _ _ _ ._ _ _ . �^. `_ . . . . . ._ .. � . � .:H-JL].;afOi ii�O���Id.SS.E � �iti� �� ` m'*.F. H. A. v FIRE ZONE j DESCRIPTION OF WORKAd.Q ll@ri tC 3. SUBCONTRACfOR YdtlCl�l 71h57 _ , 2145i ;.. �STA tiIESA BUILDING-SAFETY DEPARTMENT P. O. BOX 317 C08TA M88A. CALIFORNIA For 'Applicani fo Fill In Completely � TYPE OR PRINT � eu��oir+o - •� d ,L-L� ADDRESS COSTA MESA, CALIFORNIA TEL. � CITY NO. ARCHITECT ' " - TEC.' - .--�_ OR ENGINEER NO. ADDRES$ —�.' CONTRACTOR � �( ADDR6S8 l� � � O CITY STATE TEL. `� LIC. NO N . V+ SIZE -� . ' NO.OP9L�09.� OF LOT NO' USE OF EXISTING BLDO. FS • BETBACK LINH FROM ' CENTER OP eTRE6T REAR SIDE YARDI LEFT ' RIOHT DESCRIPTION OF WORK WALL I1 HEREBY ACKNOWLEDOE THAT 1 HAVE HEAD THIB APPLICATION wNo 6TATE iHAT THE �BOVE Ie CORRECT ANO AOREE TO COM. PLY WITH ALL CITY ROINANCGB ANO BTATQ LAWe REOULATINi BUILO�NOGONBT ION. O AUTHORIZfiD A6ENT FEE. RECEIVED� JAN, 1 7 1964 FINANCE OEP1. ���������R . BUILDING For Office Use Only fl6C81PT NO. . I g�q�//N. / ��....... NO.OF I/I1660FNE VLAN9 y X BUILDINO A P.NO u J ,GJ�' � � NOTE: NO EAVE OV ERHAN6 SHALL BE LESS THAN 30" TO 61DE 8 REAR P. L. . EAVES ALLOWED (U.B.C.REQUIREMENT; YARDSAPPROVEO YARDSAPPROVEO MAINBUILDING ACCESSORYBUILDIN6 �, YAR.# �ATE G.U.P.# p APPR APPROYHD I/I . ��3 � o 80. �. THE AMOIINT 6XOWN UNDER VALl1AT10N 19 FOR TH8 , F PYRPO6E.OP EHTABL�6HIN0 A PERMIT FE8 ONLY. Q VALUATI N !�� m n PERMITFEE � � �'%�D,� ` �'r.t, 4