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Home My WebLink About361 LA PERLE LN - Building Permits: ._ • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Add�ess: 361 LA PERLE LN Suite: A Vicinity: DETACHED GAR4GE FOR UNIT A Parcel Number: 42531118 Zoning: npp�icant: ALEXSON, TROY ISSUED BY: .. �. Address: 1653 SUPERIOR AV � " -- - �� . � �i��i_ . "ph ` - _ - . �,' Owner: Address f i, rn / � Status: ISSUED Applied: 01/22/2001 Issued: 01 /22/2001 , . one. (949) 642-7222 COSTA MESA, CA�!�� -' ' Zip:' 92827 . � , ��%%�'!�.. '_" . � � � , !i� �'�•' . SARFATI!JEAN-JACQUES': � ' ' -_/- � �� 426 MARIGOLD, � , - ; � � - � � - - � -� \ ` ` �, , �fi��. `., _ �� Phone. _ i . �� CORONA DEL MAR CA �� Zip: 92625 , �;� -�� V� � /;��ir,i _. �� :� LEE ROOFING OF COSTA MESA �� ,�� . 1653 SUPERIOR AV � =�� ` - \ ,/�%_�� Phone:'�(949)642-7222 �'��-',. /� �,, ��,COSTA"MESA, CA � ��A �, �� - - - �,�' ;�. ��i'� ?� 926D' : License:-�349686 , - � � � , j .:��j-- -- � -•1 ' ' � . ' `�� ''� ��,bAfCh/:�'�, 1 '(rr,; �� ` . . � , , r Address: �� r�'( , . �i �' ; .- „ � �� I �, � _ _ -Phone: ; ��; ;�. ��. ��'.,.? i. 7 S� � `-�Zip: ��'% - '_ ' License: i (� - ! � U / i i �.� i ("• . :i^i= . Eng: - , � _ � _ -�� -�Address:'- =, � / � �. �. � i. ; / � 6%l � j' • +--�-'.y .' . SCOPE OF PERMIT- . , +�-: � � " REROOF EXISTING DETACHED GARAGE (UNIT�A): TEAR OFF EXISTING �SHAKES B�RESHEATH WITH PLYWOOD. INSTALL 1 LAYER OF 15# FELT UNDERLAYMENT 8 REROOF WITH 25 YEAR GAF SHINGLES (4 SQ). ' �.. 1 � . '�t��J�� I � . .. . . ACCESSORY PARKING \�nt�� +�r! � ` ' } '� ` \t?„---� Phone: �� -- " � �in�, � 1 cense:i �^� ; � ', i�'I' /'-\ �� : i _ �, : ' C�, � �CDX�� , �\,_ � '' ,y ': r____' i �f, � �� ,' b�lfj/ � , �� ; FEESUMMARY,' - ��(� $0.00 —�` . ` —` �_ ; � _ _ �� Calc Valuation: �'� $44.85 r � � =i Claim Valuation: 1'� $0.50 . 1` �` _ / . �\��,$�.�� `- _ ._ � � / � ��v�.�v �.- ' /, /, $0 00 e> � *� �' � � ' � 1� � \�� ' �/� v , ��a; � ';`tt' S'' Y / `✓� $45 35�` � � ya=-�- 4 . � , ; .s �.;-t^,::,r, t � � � \� �}�:, �� 4 n 1 � �.�'� ,l, �,. �" G% / ��. \� ��`?�\�� : PLANNING 8 ZONING �� C/� �,� o , � � � i ��- ' �'i .. �� l� � C / "�...� � ti � AY y- - ' / 2E�Fiont� 0- 0� !� � Rear 0 0�'' -.Left - 0 0- ` Right� !.0- 0 � \ � ��i C;`, r _ _� '�„� `��1�/��i� Front � 0�0�� ! /�Rear � -0-0,- ' , _� Left ii� 0 �0 '�,� � � � Right� 0-'0'�i� ��..�A� A�(��..i:. ,J� 1 �lJ�'i� � Exis[in 0V��-�Required: �0-� � � �A�: '� ��/'� �� . Proposed: ' `"0 - - � �� - - '- � -- � i: /!v/�� '"- .��i�i�i��' � `'_�.._" l'___`_.!- u 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, 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. � INSPEC710NS: 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 tha expiration. of this permit. FOR INSPECTIONS CALL: (714) 754-5626 24/6-d6 (8/00) WORKERS' COMPENSATION DECLARATION: � , I hereby eHirm under penalry of perjury one of the tollowing declarations: � ,� , ❑ I have antl will meintain a certtlicate of consent to selFlnsure for workers' compensetlon, as pmvitled for by section 3700 of the Lebor Code, tor the pertormence of the w tor which ihis pertnit is issued. I have end will maintain workers' compensatbn insurance, as requiretl by seqion 3700 of Ihe Labor Code, for ihe perfortnance of the wodc br w�ich this pertnil is issuetl. ��My workers' mpe% sation Ins ce er antl policy number are: /� 'Certie��/� �� Potiq.Number:--``%si�"l�f • �� (rhis secfion need not be camplefetl i/ the permif is velued ef one hundred dollars ($100) or less.) ❑ I certily t 'n the ert rmance ol the work for which ihis permil is issued, I shell not employ any person in any manner so as to become subject to the workers' com �nsa--�o e i omia, np d egrae that if I shoultl become sub�ecf to the warkers' compensation provislons oi Sectio 3700 0l the�bor Cotle, I shell lort�wlth wmpryw0hihesapr ions. //An _ l/i'�liy/ �'�--�� 'Appikant SI nature: � �V�( (.II'D—� Da� te:—�` 1 ��Z ' WAHNING: FFILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAWFIIL AND SHALL SUflIECT pN EMPLOYEii TO CRIMI PENALTIES AND GVIL FMES UP TOONE HUNDRED T}K%15AND DOIiME (5100,OW). IN ADOITION TO THE WST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECTION 3]O60F iHE UBOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSEU COMRACTORS DECLARATION: I hereby eflirm lha� am,llC B dey0n vi ic force end eHect Lia. U CONSTRUC710N LENDING AGENCV: ol Chapter 9(crommencing with Section 7000) of Division Code, antl my license is in tull ❑ I hereby affirm Ihat Ihere is a consiruction lending agency for ihe pertormance of ihe work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: Lender'S Adtlress: SignaWre: OWNER-BUILDER DECLARA710NS: Date: I hereby eHirtn Ihat under penalry of perjury Ihat I em EXEMPT FROM 7HE CONTFiAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Busineu end Protesslons Cotle: Any ciry or counry which requires a permif to construct, alter, improve, tlemolish, or repair eny siructure, prior to its issuance, also requires ihe applicant for such permit b flle a signed stalement that he or s�e is Ilcensed puBuant to ihe pmNsions ot Ihe Contrecrore license Lew (Chapter 9(commencing with Sactlon 7000) oi Division 3 oi the Business end Protessions Code) or thet he or she is exempt theretrom enA Ihe basis for the allegetl exemption. Any violation oi Section 7031.5 �y eny applicent tor a pertnit subJects the eppllcant to a civil penelry of not more than five hundred dollars ($500).): ❑ I, as ov.ner oi Ihe property, or my employees with wages es �heir sole compensation, WILL DO 7HE WORK, antl the siructure is not intended or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of propeny who builds or improves thereon, and who does such work himself or hersetl or through his or her own employees, provitled Ihat such improvements are not imended or oflered for sale. If, however, t�e building or improvemem is sold within one year o� wmpletion, the owner�builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, es owner of the property, am E7CCLUSIVELV CONTRACTING WIT}1 LICENSED CONTRACTORS to consiruct the prqect (Sec. 7044, Business and Professions Cotle: The contrectors License Law tloes not eppry to an owner oi propeey who builds or improves thereon, entl who con[racis lor such project with e contrector(s) license pursuant to Ihe Coniractors License Laws.). ❑ I em axampt under sec. Business and Professions Code tor this reason: Signature: Date: Owner ID verified by drivefs license. ❑ Yes ❑ No Drivefs License No. Vedfication ol Ownership by (type of daument, I.e. - property taa bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certity �hat no exwvation tive (5) or more Feet in dapih into which a person is required to descend, will be made in connection with work authonzetl by this permit, antl ihat no builCing sWcture, scaftolding, lalsework, or demolition or disman�ling ihereoC will be more ihan thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 345, Ttle 8, Califomia Adminisiretive Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit from t�e Division oi Indusirial Safery, as noted above, unless such person hes e permit to tlo such work trom fhe division. Signature: Date: � Division of Indusinal Selery Permit Number. CERTIFlCATE OF COMPLJANCE AND AUTHORVJITION.OF ENfT7V: I certify under penalry of perjury ihat I have read this application antl sta�e that ihe intortnation given is ' wrrecf. I agree to wmply with ell state laws an0 ciry ordinances relating to building construction, antl authorize representatives of the City of Cwta Mesa to enter upon ihe above�described property lor inspection purposes. I agree not to occupy or allow occupancy of any builtling authonzed by ihis permit until final inspection. Of Legal Owner(s) COUE I. INSPELTIONTYPE 1818 Fixed System Final Fire Pravention 1288 Pool Spa Final 200 Flnal Ra�Rool 201 FIneI Block/Retaining Well 202 Final Faciory Fire Place 203 Final Sign 204 Finel Demolition ' Q[ij�,' IMRIALS �� 1 COUE� INSPELTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 final Site 250 ` Final Building/Occupancy D�TE INTITIALS s (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 361 LA PERLE LN Suite: B Vicinity: DETACHED GARAGE FOR UNITS B& C Parce� Number 42531118 Zoning: Applicant: ALEXSON, TROY , -- Address: 1653 SUPERIOR AV , , ,�l% "� - � � � � � - � " ;,- ., i, . - . . � _ __ -"�� , -- . Phone: (949)642-7222 � COSTA MESA, CA'� �"� � � . �, 2ip: 92627 ' � ISSUED BY: Status: ISSUED Applied: Oi/22/2001 Issued: 01/22/2001 ,��„-;, `.. , , _., . ,� .-,�' Owner SARFATI;'";IEAN-JACQUES. ' " � � - � � .� � ' � Address 428'MARIOOLD - - -- � � � � �%�\ � �� V �� _ � , � Phone' -�- . � -. � =. �.� ��CORONADELMAR CA " Zip. 92625 , � „ ��\�V� ' ' � \ /;.�. . , . . � �\�� niractoc �CEE ROOFING"OF COSTA MESA , � � � `��A ..,__ / � �` ' l��J,! 2 � 1653 SUPERIOR AV ir� �� r� Phone:=L (949) 642-7222 , /'.,i CA 1l f 'r/,'/ - - - , .Arch ;: � a'` . , Address: � � � �' � ; ' � � ' � ;�� - / .1 . : ' �� ; � i . - : Phone: i ,� '� � � \Zip: f -' , ' License: (�: � i . , PLYWOOD. INSTALL 1 �'� � � _ _ � i, 1 " ' � � , _--- � \ � i �, i ��PIanlChe� �� ,�� rPerrr �l �SMIP Re ,`SMIPCCoi \\,',, Othi ,..'License: `349686�...� � � ; / \ � \ � �- :� �� ', ,J \� v�" �� _,;A�F�A �-.:� Eng: _ ' Address:< � " � � / �� . : � � ��;� .- � � � ' �I.i, 1`.,__-• `� ,Phone:l 1 �� ' � \��z �,, : '� 1 �f License: t�' (�. � �. . �� , i ,� i, /" " 1 i ,�,_; ,� :._;_, _,.� ..�SGOPEOFPERMIT';.—•�-: �� :�� -�,� � �, ��_, , . �i , . . _ ... ,c �,� �.._J � OF EXISTING DETACHED�GARAGE (UNIT�B).-TEAR OFF EXISTING SHAKES &�RESHEATH WITH i/2"�CDX�� LAYER OF 15# FELT UNDERLAYMENT & REROOF WITH 25 YEAR GAF SHINGLES (4 SQ). ' ��' f��"- -- -� I 'i .I,i� � • , -- � � I,%1: � OI � ,, � �,�; . $0.00 � 1�.;$44.85 . , $0.50 � A'S$0.00 '�$0.00 � $0 ;00 ^ �� `✓-5 $45 35 '_E SUMMARY' - � % � �� Calc Valuation: � ' �' Claim Valuation: _ � :�.�' � � , � � � i \� ".r > :, x�;� ' ii \�-y- � ., � ,e j j y „ � , ' � � �.A� .. . . _ '"c, � � ��V L'�� , �o-pLANNING-&ZONING'�� / � SETBACKS�� "' � ��`�� , � ; °° r=�- - ,� �"�� MAIN STRUCTURE�•Front� 0-Oy �� %Rear �`0 0� `_- Left� 0-0-� Rgh�-':0 �� ,�. � ,�, -- � _ � . , , ACCESSORY Front� OcO�� .��,Rea� � O�,Oi— ��",1Left C��O-�0��1� �� Right 0; \ � �� l�; � . �, ' � � � "� i l i' PARKING ExiStinq: o��.Reauired: '0- �� L�.Pr000sed: ` 0 %,/"/ � - - .7`./ �-- - i NOTES: �-�� -� ��_ _ c �<i%-��-�_' - S� NO710E:� The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia 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 1 BO days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, s�ch work must comply with all applicable codes, and all required fnspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration.of this permit. POR INSPECTIONS CALL: (714) 7545626 2446�46(6/00) WORKERS' COMPENSATION DECLARATION: ' I hereby aflirtn un0er penalry oF perjury one oi the tollowing declarations: � ❑ I heve end wlll meintain a cerlHicate of wnsent to self-Insure for workers' wmpensation, es provided for by section 3700 of the Lebor Code, for the peAormenca of the ` /work for which this pertnit is issued. �{ i have�entl will maintaln workers' compensation insurance, as required by section 3700 oi the labor Cotle, for the peAortnance oi Ihe work for which ihis pertnit is issuetl. `My.wark rs: ompensatlon Ins ce carrier and policy number are: } q a )� Cercier:�� _ �'�_(�ie� Polity Number:_ 1 7�U- l� � QV (Tiiis sec(ion need not be comp/efed i/ the permit is velued at one hundred tlollars ($100) or Iess.J . �—�"� ❑ I certity ihat in the pertortnanca oi tha work for which this permit is i�sued, I shall not employ any person in any manner so as to become su6ject to ihe workers' compensation laws of elitomia, a d agreep ihat if I shoultl become subject to the workers' wmpensation pmdslons ot Sec/uon 3700 ot Ihe Labor COCa, I shall fotlhwith �py-with. ; ions. v�,n,�_ ��/ APP��a��.SignaNre:` e (1/� �XXqKGi%-- -Date:_ -' .-,C^'n''_z �/�O � WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIry�rvLL PENACiIES AND CIVIL FlNES UP TO dJE HUNDRED T10USAND DOLLARE (E100,000). IN P.ODITION TO THE COST OF COMPENSATION, DPM46E$ PS PROVIDED FOR IN SECTIIXJ 310fi OF THE LABOR COpE, INTEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn t al,l.am.lic5j�setl under rovisions of C�apter 9(commencing with Section 7000) ot Division 3 of4he larce end eHect�Lic p�..7L%g �i� �` L.Gess Cotle, and my license Is In full CONSTRUCTION LENOING AGENCY: � I hereby aHirm Ihat Ihere is a consiruction lentling agency tor the perfortnance oi �he work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentler's Address: Signawre: OWNER•BUILDER DECLARATIONS: Date: I hereby effirtn that under penalry oi Derjury Ihat I am E%EMPT FROM THE CONTFiACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Profeuions Code: Any ciry or county which requires a permit to constmct, alter, improve, demolish, or repair any stmcture, pnor to its issuance, also requires the applicant for such permit to flle e 51gne0 statement that he or she is Ilcensed pureuant to the provisions ot ihe Contrecroro License Lew (Chapter 9(commencing with Section 7000) ot Divislon 3 of the Business end Protessions Code) ar thet he or she is e:empt therefmm end the basis for the alleged exemption. Any violation ot Section 7031.5 by any applicant for e pertnit subJects the ep011cant to a civil penalry of not more than five huntlred dollars ($500J.): ❑ I, es owner of the O�operty, or my employees with wages es Iheir sola compensation, WILL DO THE WORK, and the structure Is not intendetl or otlered for sale (Sec. 7044, Business and Protessions Code: The Contractors License Lew does noi apply to an owner ol property who builds or improves thereon, and who dces such work himself or hersetl or through his or her own employaes, provided that such improvements are not intended or oHeretl for sale. If, however, ihe huilding or improvement is sold within one year ot completion, ihe owner-builtler will have the burden of prodng that he or she did not build or improve for purpose of sale.). ❑ I, as owner ol the property, am E7CCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business and Professions Code: The comrectors Ucense Lew does not appty m an owner of pmperty who builds or improves ihereon, antl who comracis tor such projea wit� a coniractor(s) license Dursuant b the Contraaors License Laws.). ❑ I am exempt under sec. eusiness and Prolessions Code for this reason: SigneWre: Date: Owner ID verified by dnvels license. ❑ Ves ❑ No Dnver's License No. Expires: Vedtication at Ownership by Qype o1 document, i.e. - properry tax bill ar daetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFIGA710N: ❑ I hereby certily Ihat no excavetion fiva (5) or more fee� in depih into which a person is required to descend, will be made in connection with work authorizetl Dy this permit, and that no builtling slrucNre, scaHolding, falsework, or demolition or dismantling Ihereoi, will be more than thirty-sia (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 34i, Title 8, Calilomia AtlmlNstretive Code). ❑ As owneo-builder, I will not employ enyone m tlo work which would require a permit irom the Division ol Industnel Safery, as noted above, unless such person has a permit to tlo such work from the division. Signature: Date: Divislon of Intlustnal Salety Permii Number: CEHTIFlCATE OF COMPLUWCE AND AUTHORVJ1710N.OF EMRY: I cenity under penalry of perjury Ihat I have read this application and state that the infortnation given is wrrect. I egree to comply with all state laws end clry ordinances relating to Duiltling consWction, and authorize representatives ot ihe Ciry of Costa Mesa to enter upon t0e above^_descnbad property tor inspection purposes. I agree not to occupy or ellow occupancy ot any 6uilding authorized by ihis permit until tinal inspection. CQOE �. INSPECTIONTYPE 1616 FIxeC System Final fire Prevention 1288 Pool SOa Finel 200 Finel Re�Root 207 Final Block/Retaining well � 202 Final Fectory Fire Placa 203 Finel Sign 204 Finel Demolilion ' Owner(s) Appliwnt_�--=%� P�' INIITIRLS --26-01 � � %-2-� :a Da COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 270 Final Electncal 212 Pinal Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy P9IE 1[�fl (714) 754-5273 • Fau (774) 754-4856 � www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 361 �A PERLE LN Suite: ~ Vicinity: Parcel Number: 42531118 Applicant: ALEXSON, TROY Address: Zoning: Phone: 949-642-7223 Zip: Owner: SAR�ATI, JEAN-JACQUES Address 426 MARIGOLD Phone: CORONA DEL MAR, CA Zip: 92625 Contracroc LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AV COSTq MESA, CA Zip: 92627 Arch : Address: Phone: (949)642-7222 License: 349686 Eng: Address: Phone: c� Status: ISSUED Applied: 09/27/2000 Issued: 09/27/2000 � ISSUED BY: Phone: Zip: License: License: SCOPE OF PERMIT � REMOVE EXISTING MEDIUM SHAKES, RESHEATH, INSTALL 25 YEAR COMP. � � , FEE SUMMARY Plan Check: $0.00 Permit: $9725 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $�.00 Totai: $97.75 SETBACKS MAIN STRUCTURE �Front 0- 0 ACCESSORY Front 0- 0 PARKING Existin : 0 NO7ES: Rear 0-0 Rear 0-0 Reauired: 0 PLANNING & ZONING Left 0- 0 left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: �R�yn� b- o �� - Right 0• 0 sa,000.00 sa,000.00 NOTICE: The work authorizad by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1 BO days, or if work is suspended or abandoned for a period ot 180 days. � �� `' - INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such wo�k must comply with all applicable codes, and all required Inspeotions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2dd6d6ICV00) WORKERS'COMPENSAnON DECLARAnON: � I hereby eflirm untler penalry of Derjury one of the following tlaclarations: ❑ I have end will maintain e cetliticate of consent to self-Insure Por workers' compensalion, a5 provided for by section 3700 ot the Labor Code, lor the pertOrmance of Ihe work tor which Ihis permit is issuetl. � I have aritl will maintain workers' compensation insurarice, as required by section 3700 ot Ihe Lebor Code, for the peAortnance of the work for whic th'��s pertnit is issuetl. My workers' wmpensation Insurante cerriar and pollcy number are: Carrier: Pdicy Numher. sectlon need not be compleretl iI (he pe�mit is valued at one huntlred dollers ($100) ar less.) I certiy Ihat in the peAormance of tha work lor which this permit is issued, I shall not employ any person in any manner so as to bew subject to ihe workers' compensatlon laws of Ilfomia, anC egree that it I should become subject to ihe workers' compensetion provisions of Section 3700/of the Lab r Code, I shell lorthwith comply with th v . �/,,�,� � /� /� f�� jlpPlican� e_� Q�(y `�iflf�7�. Date: �� ( WARNIN(3: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I$ UMAWRIL ANO SMALL SUflIEGT AN EMPLOVER TO CRIMINAL PENA�TIES AND GVIL FlNES UP TOONE HUNDRED T/qUSAND DOLURE (E100,000), IN ADOfTION TO TME COST OF COMPENSATION, DAMAGES PS PFOVIDED FOR IN SECfIqJ 3%O60F THE IABOP CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am licensed under provisions oi Chapier 9(commencing with Sedion 7000) of Division 3 of the Business and Professions Code, antl my license is in tull force end eflect. Lic. M--ir— n Class N �, / __.. .. CONS7RUCTION LENDING AGENCY: ❑ I hereby affirm Ihat there is e construqion lending agency for Ihe pertormance oi �he work for which ihis permit is issued. (Sec. 3097, Civil Code�. Lentlefs Name: LentleYs Adtlress: SignaWre: OWNER-BUILDER DECLARA710NS: Date: I hereby attirtn that under penalry of perjury that I em E%EMPT FROM THE CONTHAC70RS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Busineu and Professions Coae: Any ciry or wunry which requires e permit to constmct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, also raquires ihe applicant for such permit to file e signed atatement thet he or she Is IlcenseC pursuent to the pmvisions of the Contractors License Law (Ghapier 9(commencing with Section 7000) oi DiWsion 3 ot Ihe Business anA Professions Code) or that he or she is axempt therefrom and the basis for Ihe allegetl examption. Any violation of Section 7031.5 6y any applicant far a permit subjects Ihe epplicant to a civil penalty of not more Ihan five hundred dollers ($500).): ❑ I, as owner of the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe structure is not iniended or otlerad for sala (Sec. 7044, Business and Prolessions Code: The Coniractors License Law does not apply to an owner of property who builds or improves thereon, end who does such work himselt or herseN or Ihrough his or her own employees, providetl ihat such improvemenis are not intended or ottered lor sale. If, however, t�e building or improvement Is soltl wi�hin one year ot completion, the owner�builtler will �ave the burden of proving ihat he or she did not build or improve tor purpose of sale.). ❑ I, es owner oi the Oroperty, am E%CLUSIVELV CONTTiACTING WITi IICENSED CONTRACTORS to construct the prolect (Sec. 7046, Business and Protessions Cotle: The wntrectors License Lew does not apply to an owner of pmperty w�o Duil�s or improves thereon, antl who conirects tor such project with e conirector(s) license pursuant to the Contractors License Laws.). ❑ I am exempt untler sec. Business antl Professions Code for this reason: SignaWre: Date: Ownet ID verifietl by drivef5 license. ❑ Ves ❑ No Dnvers License No. E:pire5: Verification of Ownership by (type oi �ocument, i.e. - proDerty tax bill or deetl): UIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity �hat no exwvetion five (5) or more feet In depth into which a parson is required ro descenq will be matle in connection with work authorized by this permit, and ihal no builtling structure, scatlolding, falsework, or demolition or dismantling thereof, will be mora than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Celitomia Atlministrative Cotle). � As owner-bulltler, I will not employ anyone m tlo work which would require a pertnit from ihe Division of Industnal Safery, as noted above, unless such person �es e permit to da such work irom the division. Signawre: Date: Division ot Industriel Salety Pertnit Number: CERTIFlCATE OF COMPIJANCE /WD AUTMORIZATON OF EHTRV: I certify untler penalry ot perjury that I have reatl this application and state that lhe infortnation given is correct. I egree to comply with ell state lews entl ciry ordinances relating to building wnsiruction, an0 authorize represen�atives of the Clry of Casta Mesa to enter upon ihe ebove-descnbed properry for inspection purposes. I agree not to occupy or allow occupancy ol any building authorizetl by this permit until final inspeqion. [r]a��I:F97xN I!P.�eli� i616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition �g �� !i i ' 9 a -�a,� �� Da e CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 2tt Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinyOccupancy J. J. VAN HOUTEN & ASSOCIATES JOHN J� VAN HOUTEN, PE Consulting Enginrer in Acoustica February 25, 1977 Robert F. Hollingsworth . 1115 W. Bay Avenue Balboa, California 92661 Subject: Reference: Gentlemen: % 61P 50. HARBOR BOULEVARD, ANAHEIM, CALIFORNIA 92805 � (714) 635-9520 Report No. 471-77 e Plumbing Inspection for Noise Control - Apartment Complex, 361 La Perle Lane, Costa Mesa, California Noise Insulation Requirements, subject project, ltr, rept. by J.J. Van Houten & Associates, Nov. 29, 1976 The Plumbing Installation of the subject apartment complex, has been in- spected by the undersigned. The plumbing in party walls was found to be in compliance with the recommendations of the referenced letter and the State of California Noise Insulation Standards (CAL ADM CODE: TITLE 25, Section 1094). Very Tru1y Yours, J.J VAN H TEN . ASSOC TES� �� John J. V outen, P.E. Consulti Engineer in Acoustic JJVH/cag Copy to: Ed Shafer � Building Dept. City of Costa Mesa 77 Fair Dr. Costa Mesa, CA 92626 � No. 16233 �j' � ' �HAN��Pv �� \F�F CA�\F�� ; October 10, 1994 CITY OF COSTA MES�A CALIFORNIA 9262&7200 P.O. BO% 1200 DEVELOPMEN7 SERVICES DEPARTMENT Dear Costa Mesa Property Owner: In reviewing past permits, we find that work has been done on your property located at 361 La Perle Lane, Permit No. B64899, for a roofing permit. The permit is valid for 180 days from issuance or your last inspection, per Section 303 (d) of the 1991 Uniform Building Code. Should we not hear from you within l0 days, your permit will expire as stated herein and additional fees will be required to finalize the permit. Failure to final a Building Permit could possibly impact the future sale of your property. To activate the above permit, please follow these steps: 1., Telephone (714) 754-5626 or 754-5627. 2. Request an inspection; state address, permit number, and type of inspection. 3. Be sure to have working smoke detector's as required per Section 1210(a) of the 1991 Uniform Building Code. 4. Have an adult present at the property at the time of inspection to provide us access. Should you have any questions regarding this process, please contact me at (714) 754-5273. Thank you for your cooperation. Sincer,�ly, � 0.�(�yIC,�Q' ��i�,��^^�',�'" o anda Huapaya v e mit Processing Specialist 77 FAIR DRIVE BuilOing Division (71d) 754-5273 � Cotle EnforCemen� (774) 754-5623 • Planning Division p14) 754-5245 FAX (714) 5564508 • TDD P74) 754-5244 PqOJECTpODXESS: j�1 LA PERLE LN OWN>P'SNFME: SARFATI, JEAN—JACQUES _' nooness: SARFATI, FAMELA 426 MARIGOLD _� CORONA DEL MAR,CA 92625 AflCH/ENCINEEN: AUOPESS: flEG.NO.: uxir: CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 064899 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR UNIT: PEflMIiTEE: LEE ROOFSNG (719)642-7223 FDOHESS: L�S3 SUPERIOR COSTA MESA CA 92627 LICENSEO CONTflACTOP OECLFPATION: I �ere6y allirm that I am licensed unCer pmvisions ot C�apter 9(commencing with Sec�ion 7000) o� Divis�on 3 0� ��e Business and Pmfes5ion5 Code. anC my license is in Iuil farce an0 eflec�. ciTr uc.: 0 2 B 7 51 srnre uc.: 3 4 9�� c�� u 5�3� Oale:.�� SignaWre � �l WOflNENS' OMPE SATION DECIANATION: I here6y a��irm Iha� ave a cenificate o1 consem to sell-inmre or a cenificale of workers' ComOensabon I sw 0 a c ified copy thereoi (Section 9 0 Lab C roucvNo.: ��`��—y� oare: �6/30/99 � comraxv: STATE FOND,s, ❑ Certitied coOY is hereby lumishetl. L'1 Certilie0 coDY is ilea � e � B'Iding Division. Oate: � AppliCanL E%EMPTION flOM VOBHEF$'COMPENSNTIONOECLAflATI�N: (Thi55et� nnee4nd�beCompletetli�theDermi�i5�oronehUnOretl�$100)orless�. I cehity Na� in Ihe petlormance o� the wark for which I�is permil is � ueq I shall not employ any person in any manner so as �o become ' sublecl lo t�e Workers' Compensa�ion Laws of Calilomia. Date: Signature: NOTICE: If, a0er making Ihis tleclaraiion, you should become sublec� Io the Workers' ComOensation provisions o� ihe Labor Cotle, you mu5t fort�with comDly wiih suc� pmvisions or this Dermii shall be tleemed revoketl. CONSTPUCTION LENUING RGENCY: I hereby affirm that there is a constmciion lentling agency for tAe De�ormance of ihe work for ' whicM1 Ihis permii is i=.suetl (Sec�ion 3097, Civ. C�. LENDEP: aooqess: OWNEN BWLOEB OECLAFATION: I �ereby allirm that I am exempt imm the Conirocrors State License Law lor tAe following reason �Settion 7031.5 Business an0 Professional Code: Any city ol county which requires a permit to consimc6 alter, improve, tlemolish, or repair any simcture, prior to its issuance. also requires the aDPiicam for such permit to lile a signed statemem that he/she is IicenseA pursuani �o tAe O�avisions ol �he ConVaciors' Slaie License Law (C�apter 9(commencing wilh Section 7000) ol Division 3 0� �he Business an0 Pm�essions Cotle� or Ihat helshe is exemp� �herefrom and the 6asis lor the allegeU eeemption. Fny violation o� Sec�ion 7031.5 by any aOPlicant tor a Oermii subjects Ihe apDlicani to a civil penal�y o� nol more I�an five huntlred tlollars (E500�. I. as owner of ihe pmperty or my employees with wages as their sole compensation, will tlo ihe wodt, and ihe ❑ stmcture is not inten0ea or onereU tor sale (Seclion 7044, Business and Pmlessional Code: T�e Cantractors' Sta�e License Law tloes not apDly �o an owner of a pm0e�y who Ouilds or impwves ��ereon, antl wAo Ooes such work himsell/hersetl or �Amugh his or her own employees, pmvitletl Ihat 5uch impmvemen�s are no� intentletl ar oHereU Por sale. If, �owever the 6uil0ing ar impmvement is soltl within nne vear ol comple�ion, ine owner will have t�e huraen ot pmving he/sne aia nol build or improve �or �he purpose oi sale). I, as owner oi ihe pmpeny. am excNsively conVacting wit� IicenseG contraciors to conSlmci Ih¢ pmject (Section 7044, Business ❑ and Pmfessions Cotle: The Conirac�ors' S[ate license Law Uoes w� apply �o an owner ot Dmpeny who builtls or impmves Ihereon and who conlracis lor suc� pmlecis wi�� a contraclor(s�license OurSuani to lhe ConVaclors' Sla�e Litense Law�.l am aware �hal Omol of Iheir Worker'S Compensalion insurance ShOultl be pmvitletl �o me. � I am exempt under Section: B. 8 P. C. �or I�is reason: PERM NO: B 064895 GOVT: N SUPP: N PURPOSE: OTH JOH DESCRIPTIUN .; 'T/OFF 6 REROOF W/COMP.SHINGLES SQ FT: 2,200 CLAIM VALUE: 2,200,00 CALC—�'ALUE: 2,200,00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS ARE REQUIRED 1991 UHC +��**�******�c**��****�t+��r��c*��****��r*�*�*��*�*a��*x*�c�****�c*��c*?�*�*�*�+c��*�cu*s� Z 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 BOILDING --------- --------- ACCESSORY BOILDING -------- FRNT: FT IN REAR; FT IN ��FRNT; FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN P.GEIT; FT IN FARKING RE�• PROV; FARCEL; 42531118 ZNE: REF NO: PLANNING N 'tE5'> j .. fE ff jf # �E iE iE iE �f'.c 1t If f! il±f'fE �)t 1k iE iE 7! 1E ff �lf if �E iE �}f ik k 1f 1f it iE iE if ik jE iE fE iF fE iF iE ih �IE iE it 1f �lE if jE iE 1f iE iF iF if 3E?E if 1E iE 1E 1E iE iE iE �)E i'r �1f if ?k it # 1F i!� iE if D E V E'L v P M E N T S E R �' I C E 5 R E Q U I R E M E N T 5 ZONING APPROVfiD HY ;_ _ ____ _ . _ DATE: BUILDING AP�ROVED HY ; DATE: APPLICATION ISSUED BY: � DATE: `�1�,5_I�� tatar**+ti�-*�-+t+r**�*�ti�***�r*�titi��c-��t*�tx-*atitir�r�r,r�t�*******rt**��***fc**+�***��*;Y*�.��i'*.*�:a�t*** �r***��*ie*�-jt*�**i��-tt**��t�****�r�*�***-�i�x*****�r***+�***it�*�+��***�:+�*+�****at?t*****�*�+��c�,:, LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y"=-:;,;.,, BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIF/RES GRADING � PERMIT 5q,0U .50 SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 54.50 0.00 0.00 REVE�7UE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 54.�� TOTAL PAID DUE 54.50 5a,50 .00 54.50 OVER/SHORT; ,00 FIRE SMIP/TOT GRADING PLAN—CHECK .50 -?: if if if 1(� it iF i(� jE iE �lE !f !E if iE if if *% 1E it iF iE �lE �Y if fF if if -%iE iE 1E 4-k iE iE aF if i! if iE k i=1h 1t i: iE �E if #f- if iF ff iE ic �}F 1f Yc jf iE iE iE dF if aF iE iF if �)f dF iE jh-k IE iE i4 �IE -%- I N D I V I D 0 A L F E E B R E A K D O W N TYPE Da�e: Ownec I -r„{FR I do �ereby [ertify �hat I am aware o� antl untler5ian4 Ihe repuiremenis of Calilomia Heallh antl Safery Catle Sections 25W5, 25533, an0 25534 and mni i or any IWure OmlOmg occupant will/will nol (circle one) need to comply wi�h 5ai0 sta�e codes an0 �he requirements lor a permii lor consimqion or modificatmn irom Ihe qir Oualiry Managemen� �isirict Re5i0ential conslmc�ion application5 are eK¢mp� imm ill¢SC pfOvi5i0f15. Oaie: ADPlicanl: _ I hereby cer�ily��a� I have reatl ��is applicaiion and sia�e Ihai�he ortlinances antl statelawsrelaiinglo 6uilding construc�ion antl hprpt pmpetly for inspe ion purposes. �� , Da�e: SignaWre/� Oriver's �i se o Socia� Security v: QTY 2240 Ll E S C R I P T I O Pd REROOF BY L'ALUE RESIDENTIAL NOZONE END OF FEES comply wi�� all city antl counry I S MOK�E D ETEC 1��0 R emer uDon the ahove�meniionea REQUIREp 16aL46 While—Boiltling: Green—Code EnlorcemenC Canary—Appl¢an�; Pink—qevenoe; GolOanrotl—Assessor UNIT COST TOTAL COST 1.00 2,200.00 n+_ oo�,as��-on7��soe -rj�z- ' :�;.;�, �R�i% 1.1li:/i5 �i17C. Q,v";1;; ✓� , , % � ` PO� 5 SPA � r CONSTRUCTION ANDPLANNING , �qPpROVALS Permit # Date Inspector APPROVALS Permit � Date Inspettor 1. Tempo�ary Electrical Service or Pote �� 52. Pooi & Equipment Location � 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Eleccr�cat Conduit Utility-Undrgrnd�. 54. Forms 4. Elect��cal Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & P�essu�e Test 6. Electrica� UFER Gmd. � 57. APPROVAL TO COVER�fiUNITE i 7. Foot�ngs - -��' �- 58. Electrical Conduit�Undrgrnd. 8. Foundation " 59. Gas PiPe. O Undrgmd., Test 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. 14. Svutturat Floor SYstem 6t. APPROVALTO DECK 17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final � 12. Sewer Cap - 63. Heater & Vent-Final 73. Root Drains � � 64. Plumbiny System - Final 14. Rough Plumbin9 65. Electrical-Final 15. Rough Electrica6Condurc 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wlring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricai�T Bar Ceiling 69. POOLISPA SYSTEPnS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 24. Rou�h Factory Fireplace APPROVALS Permit # 21. Duczs, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping O Gas ❑Oii 23. Gas Piqe�Rough g Test 72. Under9round Flush 24. Roof Framing 73. U�dergrnd.StorageTank OGas C70i1 25. Roof Sheathing ��(p-q? � 74. Overhead Hydro 26. 7-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �" 27. Frarr�e and Flashing 76. Dry S2andpipe +"'� 28. La[hing & Siding 77. FIXEO SYSTEM FINAL : i L`-• :-. 29. Insu�ation 78. FlRE PREV. F�NAL �}� � 30. Drysvali Nailing HEALTH DEPT. REQUIREMENT �-�"'.-� ,.,�',_.� 31. Plaster Brown Coat 79. FINAL INSPECTION �" ! L 32. Elecxricai Po�ver MeterFlnal 80. F006 CERTIFICATE ISSUED �±�''� i i i� 33. Fina� Elec;ric Notes: 34. Finai Heating & Air Conditioning f ' 35. Final Gas Pipe-Test 36. Hood or Canopy ' 37. Final factory Firepiace 38. Finai Plum6ing 39. Water Service-Final 40. Gas Service-Final 41. $olar pomestic-Final 42. Backflow Preventer 43. Backflow irrigaiion 44. Landscape Irrigation System 45. Sound Aitenuation 46. Hand�cap Regulations 47. FINAL STAUCTURE & BUILDING `O `G) 1, 48. PINAL PIANNING _ � 49. Eleccrie Re�ease to Edison ,� 50. Gas Release to Southern Catifornia Gas Co J 51. CERTIPICATE OF OCCUPANCY No. Date CITY OF COSTA MESA PARK ES Fee Payment Receipt Project Address �/� / LG� /'F'l`/Y_ ! A. P. No. � � ��(o � �� i Building Permit No. �$��T.�� Owner's Name vz;u No - - - 22i3 � rn�:�-,r�-7lr�,�r-r{71�t5�F7 ;x�,t�r��li7.o�! Mailing Address � / FEE Single Family * No. of Units Multiple Family '* No. of Units �� Planning Department Park Area @ $455.20 = @ $321.32 = .,�/ �tal�ee J�� ApplicanYs Signature U �/ 0"w�' � � • Clty Ortlinance 72-44 � '• Clty Ortllnance 72-45 � **' Clty Resolutlon 74-124 , White - Plannln9; Canary • Planning; Pink • Finance; Goltlenrotl - ApP��cant CMF 017426 � CITY OF COSTA MESA SE6 .E REQUEST & PUBL[C ASSISTAN� ORM Date � / — �� Time Caller's Nature of Request: (location, type, severity) �� . - � -�, .��= � �� ,�,o a ,.�-�-- .� �. . �� _ /�� / � �! , / L Person Receiving ,�� p/77 Call back � � �'�"^'� � Service Only � /�, --,t', / o � i ' Information Only� O�OWNER HOLL NGSWORTH_ �JOB ADDRESS � 1 L�i a Perl �OGENERAL CONTRACTOR � �AP No. 117-2 —24 LOT INSPECTIONS \501 L 3 GAS W ATER ROf1GM PLUMBING p PHOP. SWR. LINE Q NOUSE COH. � ` SPRINKLING SVSTEM MISCELLANEOUS ROUGH ME�TING ANO A�p �pN01ilONING TEMPORRFY SEPVICE OR POLE UNOERGROIIND �I >OWER � ROU6N WIRING TRENCNES FORMS STEEL RE FLOOR SVSTEM BONO BEAM � ST�EL REINFORCE [ SMEATNING FRAME AN� FlRSHING LATHING - IN �J OUT n PLASTER, BROWN CORT STRUCTUR�L. FIN>L NEATING, VENT., REFqIG. ANO �.C., FI PLUMBING. FIN4L ANO GAS TEST (� ' ELECTRIC. FINAL BUILDI FINAf DATE SUBCONTRACTOR 42 F � 6w. a � h H C W F a O � a > � � � w a Q 0�. P+ W "� 3 . �c3�2 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use lnk Only BUILDING Q% i r �_ . ._ _ .� � OWNER MAI l ADDRE: CITY BRANCH ADDRESS CONTRACTOR ADDRESS CITV STATE LI0. NO. SIZE /� OF LOT 0 TE�. NO. CITV LIC. NO. /Q V(�� 00. OF BLDCS. / OW ON LOT EXISfiNG BLDG. •T/ V VJ r. 'Separate permiCs are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED 1 hareby acknowlatl8e that � have reatl this epplication antl state Mat the ebove into�matlon is corraci and apree io comply with all laws re9ulating buildlnB eonrtruction, end I shall not employ any penon in violetlon of the workman's compensailon laws of the State of Celifornia. I heroby certify that I am properly licensetl as a contrector und the Stete of California Business antl Profeuions Code, Dlvlsio Chapter 9, entl the uch lieans are in full force and effect, r I am exempt from i D�o� �lo ot the Stete of CaIlfOrnla Bu ness antl Professlona C Ni6i0 3� ha er 9. � �� d SlBnaiura of � Parmittae Autharizetl Agent Pdl�' I `r.T iz-tc�,�,JJ r�c2:* .,:-�;:i?5il POR STRUCTURAL PERMIi BUILDING % ADDFESS TRACT FIRE 20NE APPROVED VARDS APPROVED MA7N BUILDING FROM C/L STREET) BET VAR. # C.U.P. # J USE OF NE BUILDIN YARDS APP BET. MAIN & ACCESS. BLDi DATE 7 � n m i : SQ. FT. w /THE AMOUNTSHOWN UNDEP VALUATION IS FOR m THE PURPOSE OF ESTABIISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE § P ^ «� PLAN CHECK $ ^� �� o $ LL � TAX 8 � U TOTALPAID $ / � � �� COSTA MESA BUILDING-SAFETY DEPARTMENT . P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING ADDRESS / ' OWNER �, . , F � G Q h � `�i F� G W F Q � ..7 Q � } � a. W a O C 6. z W S 3 CITV BRANCH ADDRESS ARCHITECT CONTRACTOR ADDRESS CITV STATE LI4 NO. SIZE OF LOT USE OF TEL. NO. TE L. TEL. NO. CITV LIC. NO. NO. OF BLDGS. NOW ON LOT Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFOFMED �:ir�, � ��r,�d 3n-�5�7�,n��es1 ��*��:k2�a.(?� APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED DATEISSUED . � A.P. NO. BUILDING ADORESS TRACT lOT BLOCK FIRE ED ZONE NO.OF PLANS VARDS APPqOVED MAIN BUILDING VAR. # C.U.P. # APPROVED 1 hereby acknowledge ffiat I have reatl this application antl stare that the abova Intormation is correct antl aBree to comply with all laws regulaiing builtling construction, and I shall not amploy any person In violatlon of the workman's compensation laws of the State of Celifornla. I hereby cartify that I am properly Iicensetl es a coniractor untler S� the Suta of California Business antl Profassions Code, Division 3, THE AMOU Chapter 9, antl thet such licensas ere In full force antl ¢ftect, or I THE PURPOS am exempt trom the provisians of the State of California eusiness VALUATION and Professions Cotle, Diviston 3, Chapcer 9. Signatura of � Permittee $ �0 Authorizetl Agent � VALUE /J �If.P `�� GROUP DATE USE OF NEW BUILDING VARDSAPPROVEO ACCESSOPV BUILDING BET. MAIN & ACCESS. BLp DATE APPROVED n m i m m FT. N � SHOWN UNDEfl VALUATION IS FOR m OF ESTABLISHING A PEPMIT FEE ONLV: b PERMIT FEE $ a N m .PLAN CHECK $ ^ 0 TAX S LL F U TOTALPAID $ �� OWNER FLOLLINGSWORTH, Robert DATE 11-30- �`AP No. 117-264-24 LOT v~ \INSPECTIONS � SOIL �GAS WATER C ROUGN PLUMBING \PROP. SWR. LINE Q MOUSE COM. � SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEnTiNG RND AIR CONOITIONING TEMPON/.RV SERVICE OR POLE UNDERGRDUND � POWER � ROUGH WIAING TRENCHES FORMS STEEL REI FLOOR SYSTEM BON� 9EAM ❑ STEEL REINFOqCE [� SHEATMING FRqME RNO FLRSMING LATHING - IN n OOT PLASTER, BROWN COI.T � STRl1CTUARL, FIN�L NEATING. VENT., REFpIG. AN� A.C., FIN PLUMBING. FIN4L RN� GP.S TEST rI BUI FIRE ZONE SUBCONTRACTOR - ��` 423� � , COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comple[ely — Use Ink Only BUILDING •ry / � _ /�,._ _ _ ,_ FS PG W a a � H s F C �i F a c .�. a > r a a w a � a a z W '�' 3 OWNER ' � f MAII / ADDRESS TEI.` GTV /�G�. ' �. NO.�j — CANSTRUCTION A .. ._ . _ , � � ! i . , i ... .. .. BRANCH �IJE'/bL/J`f.P'I /jf��C� ADDRESS /� � r % D L AflCHITECT / T TEL. OR ENGINEER Q ADDRESS�I/ J/ /.. � ��/a �G[. CONTRACTOR ^ �A//✓L{. � �/'�J/L'p�-L AODRESS TEL. CITV NO. STATE CITV LI0. NO. LIC. NO. SIZE �/J NO.OF BLOGS. OF LOT � f �T/ Q� NOW ON LOT USE OF avr� EXISTING BLDG. , Separate permits are required for � electric, plumbing and heating work. USE OF BUI�DING AND WORK TO BE PERFORMED I hereby aeknowletlge thai I heve reetl this application and state t�at the ebava Informetton is correct antl apree to comply with all lews re9�letinp build(np consttuction, and I ahell noc employ any person in vloletlon of tAa workmen's compensatlon laws of Ma State of California. I he�eby certify that I am proper�y Iicensed as a eontractor under the State of Calitornia eusinesa antl Profauions Cotla, Dlvision 3, Ghapier 9, and that sueh Iicenzes a in tull torce and effect, or I am exempt from t�a rovl s tha State of California Businass and Profeszions C e � on 3 ap r 9. G,f / � Sipnature of �y Z Permittee N• f AuiharizaA Agent ,�� ;�.-.,�;:`�i10 Fio3" a:rs:,.:7=,(j FORSTRUCTURALPERMIT BUI�DING ADDRESS FIRE :0--��R///� � NO, pF � ,-�-�—� VARDSAPPROVED MAIN BUILDING FROM C/L STREET) BET VAR. # C. V.P. # USE OF BUILDI� VAR BET. MAIN & f� e i iOLD FOR SPECIi L REQUIREMEiVT n m i m SQ. FT. N T E AMOUNTSHOWN UNDER VALUATION IS FOR m E PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: b ,VALUATION � PERMIT FEE $ a N L'j/ � PLAN CHECK $ o � // � TAX $ LL F U TOTALPAID $ � , F�, �,�.,� F��- �� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. eOX 1200 COSTA MESA. CALIFORNIA 92626 ��,1 rnr:so-?F��:,e,DO��so ��*��=i��.0� APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Comple ly — Use Ink Only • RECEIVED BY DATE flECEIVED DATE ISSUED BUI�DING ADDRESS • PE OWNER A.P. NO. MAIL ' BUIIDING ADDRESS ADDRESS TEL. - TRACT LOT BLOCK CITV NO. CANSTRUCTION EW ADD ALTER P LENDER BRANCH OWNEF ADDRESS ' VALUE ` ARCHITECT ' TEL. SE S � OR ENGWEER N � , FIRE ADORE55 20NE TVPE GROUP APPROVED CONTRACTOR i BV DATE. ADDRESS TEL. ZONE NO.OF USE OF NEW CITY NO. P�ANS BUILDING ' STATE CITV �'ARDS APPROVED VARDS APPROVED IIC. NO. LIC. NO. MAIN BUILDWG ACCESSORY BUILDING SIZE . NO.OF BLDGS. (FROM C/L STREET) OF LOT ' NOW ON lOT ROM FT. FT. USE OF EXISTING BLOG. 51 E FT. FT. Separate permits are required for L SIDE FT. FT. electric, plumbing and heating work. � REAR FT. FT. USE OF BUIIDING AND WORK TO BE PERFORMED OISTANCE BET. 'BET, MAIN & MAIN BLDGS. ACCESS. BLOGS. VAR. #` DATE C.U.P.� - APPROVED . . APPROVED I hereby acknowletlge that I ha�e read this application and state that She above informaiion Is corract antl a8rea to comply with all laws regulating builtlinB cons«uction, end I shall not employ any person in violation of tha warkman's compensaiion laws of Me State ot California. . I hereby cartify thet I am properly Iicensetl as a contractor under 54. FT. the State of California Businass e�tl P�ofessions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOfl Chapter 9,-and that Such 17ronus ere In full force and effeci, or I THE PURPOSE OF ESTABLISHING A GERMIT F ONLY: am ezemp< fram tha provitions ot theState of California Business VALUATION antl Professlons Code, Dlvision 3, Chapter 9. � ' /// PERMIT FEE $ �,d ' / PLAN CHECK $ Signature of � / - Permittea � TAX $• AuthOrizedAgent TOTALPAID $ �� 17 OWNER O° JOB ADDR � GENERAL �AP No. 1] �INSPECTII 3 t�„ [iOLLINGSWORTH, Ro�ert F. W ATER ROUGM PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM � f- MISCELLANEOUS ROUGM ME�TING AND RIR CON�ITIONING TEMPORARY SERVtCE OR POLE UNDERGROUNO [� POWER � i10UGH WIRING TRENCMES FORMS STEEL REINF FLOOR SVSTEM BOND 6EAM � STEEL FEINFORCE ❑ SNEATMING FR�ME RNO FLRSMING ' LATHING - IN OUT PLASTER, BROWN COFT $TRUCTURAL, FINRL HEATING. VENT., PEFRIG. AN� �.C., FINAL PLlIM81NG. FINAL AND G�5 TEST I-I DATE 11-30-76 FIRE ZONE SUBCONTRA�CTOR F C W a Q � h 3." F G W F Q � .a a, > �- J .K� W a 0 fL 4 z W T. 3 4�8�p COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For App(icant to Fill in Completely — Use Ink Only � BUILDING �/��,.� � � � _� j OWNER MAI l AD�RE CITV , %%�Z �/V BRANCH ADDflESS A�OR � L� TEL. NO. 1 TE ADDRESS�/I .(// / J}' � '(.,. CITV //L/fU/le Ui NOLG�r, STATE -� GTV LIC. NO. � ' LIC. NO. OF LOT �/(/[FG �`� �O (�/Q � INOWONLO USE OF /` USF EXISfING BLDG. , �7 Separate permits are required for electric, plumbing and heating work. � USE OF BUILDING AND WORK TO BE PERFOR�7ED � I hereby 3cknowletlge that 1 have reatl ihis appllcation antl state that the above information Is corract and agree to comply with all laws reBulating building consiruction, antl I shall not employ any person �� olation of the workman's compansation laws of the Stata ot Calitornie. . I hereby certify ihat I am proparly.licansatl as a contractor under the Stata at Calit Business antl Professions Cotle, Dlvlsion 3, Chapter 9, antl at s ch Iicen es are in tull torca antl affect, or I am exempt tro the ro ifi s of the Siate of Celifornia Bu ' s antl Profes6lons� otl , Jisi n 3, ChaPte� 9. ' i Stgneture Pt � Permlttee ° Authorizecl A9ent �f7 ?..;i PkiL ��;: % �'i ,. t�;.,o� �,;; . �n�.>� FORSTRUCTURALPERMIT R BUILDING TRACT FIRE ' ZONE APPROVED VARDS APPROV ED MAIN BUILDING (FROM C/L 9TAEE DISTANCE BET MAIN BLDGS. VAF. # QU.P. �k VALUE YAROS BEf. MAIN & ACCESS. BLD DATE /J/ � BLOCK n m . v eDSQ. FT. N THE AMOUNT SHOWN UNDER VAIUATION IS FOF m THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE $ `� N m IK PLAN CHECK $ "� $ �� TAX 5 '3 (�Z, V l TOTALPAID $ a �, � CI 0 8la � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFOFNIA 92626 F � W o. Q � � 'S' F G fa7 F Q G ..1 Q � i' � a w a O R.' a z W x 3 For Applicant to Fill in Com tely — Use Ink BUILDING ) AODRESS � I I IJ/ / � OWNER rc� MAI l ADDRE55 CITV CONSTRUCTION LENDER BflANCH ADDRESS ARCHITECT OR ENGINEER ADDRESS CONTRACTOR �L•� ADDRESS TEL. CITV NO. STATE - CITV LIC. NO. LIC. NO. S I Z E I NO. OF BLDGS. OF LOT � NOW ON lOT USE OF EXISTING BLDG. Separa[e permits are required (or electric, plumbing and hea[ing work. USE OF BVILDING AND WORK TO BE PERFORMED I heraby acknowledge ihat I have read this applicatlon and state that the above information is correct entl agree to comply with ell laws regulaitnB builtling construciion, and 1 shall not employ any person In vlolailon of the workman's compensetion laws.of ffie State of Califomie. - I hereby certify that I am properly Iicensatl as a contractor under the State of California Businezs end Professions Code, Division 3, Chapter 9, antl that such licenses ara in full force and affect, or I am exempt from ihe p�ov(5ions of tha State of Californla Business antl Professions Code, Division 3, Chapter 9. SiBnature of Permittea AuihoNzetl ABent 3 '. 'v GA:;; ��',� 3�-7s�,,:�: 0016u9 ��:; *� 97.Of; APPLICATION FOR STRUCTURAL PERMIT ECEIVED BV OATE RECEIVED nnTF ISSUFn BUILDING ADDRESS OWNEfl S FIRE ZONE T APPROVED BV ZONE NO.OF PLAN$ YARDSAPPROVED VALUE VSE OF NEW BUILDING VARDSAPPROVED ACCESSORV BUIIDING DISTANCE BET. BEf. MAIN & MAIN BLD('�S. ACCFSS, gLDi VAR.� DATE C.U.P.�p • APPROVE� APPROVED n m i m SQ. FT. rv THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ES"fABLISHING A PERMIT FEE ONLV: "' e VALUATION PERMIT FEE $ • a / ♦ �� in / PLAN CHECK $ M � � o $ TAX $ LL f U TOTALPAID E � OWNER HOLLINGSWDRTH, JOB ADDRESS 361 La Per] GENERAL CONTRACTOR Owr AP No. 117-264-24 LOT INSPECTIONS SOIL GFS WATER ROOGM PLUMBING PROP. SWR. LINE Q NOUSE CON. � SPRINKLING SYSTEM .NISCELLANEOUS ROUGH HEPTING ANO A�IR CONOITIONING TEMPOR4RY SEPVICE OR POLE UNOERGROUND � POWER � ROUGN WIRING TRENLHES FORMS STEEL RE FLOOR SVSTEM BONO BEAM � STEEL REINFORCE � SNEATHING FFAME RNO FLASHING LATXING�- IN n OUT ��J� PLASTER, BROWN CORT STRUCTURAL, FINAL HEATING. VENT., AEFRIG. �ND A.C., FI PLUMBIN6. FINAL �ND GAS TEST (.] ELECTRIG, FINRL BWLOING. FINRL FIRE DATE SUBCONTRACTOR PERMIT F � a Q y � x F G W F Q Q � Q 7 �+ �i W 4 � a 6. Z m '� 3 � �285`� COSTA MESA BUILDING-SAFETY�DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVIIDING 'rf �L ADORESS f OWNER t // �L � MAIL / ' ' //� �� ADDRESS �% CITV %%/%l/.Q � NOL�.71./� BRANCH TE ADDRESS �/r J� JL i //�/t.L'.f.' L.///_./�� CONTRACTOR 0�� F�_ �U/L�J" G/l AODRESS TEL. CITV ' • " NO. STATE CITY UC. NO. . LIC. NO. SIZE /�ID/� NO.OF BLDGS. OF LOT /��-f � NOW ON LOT USE OF ��, , . � i . Separate permits are required for elec[ric, plumbing and heating work. USE OF BUILOING AND WORK TO BE PERFORA I hereby acknowletlge tnat I have rea0 this applicatlon antl state that the above informetion is correct antl agree to comply with all laws regulating buildi�8 construction, and I shall not employ any person in vtolat(on of the workman's compensetion laws of the State of Californla. I hereby certify that I am Properly Ilcensetl as a contractor untler the State ot Calitornla Business antl Protessions Code, Division 3, Chepter 9, antl thai zuch Iice as ar in full force and ettect, or I am exampt from th �is ns ot e State of California Business antl Professions Co e, Ivi on 3, ha [er Signatura of C Permkiee L � � tr Authorized Ageni R BUILDING ADORESS ��Plii.: ,�� i2-,rr�.i- �i� hr�,�: ,:•�i�;.::;;.r,r FORSTRUCTURALPERMIT VALUE � AIT NO. N NO.OF/� USE OF NE / PLANS_/ BUILDING �7 (yb VARDS APPROVED VAflDSAPPROVED MAIN BUILDING ACCESSpRV BUILDII DISTANCE BET MAIN BLDGS. VAR � THEAMOUNT THE PURPOSE C VALUATION s��ya ' FT. DATE I� N n m i : m N VN UNDER VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONIV: � PERMIT FEE $ a �7� M PLANCHECK $ f J✓ o TAX ' g `'T LL � �� U TOTALPAID $ � Q O / \ �� i--- / � 1 �� N�, �; ��1 � ��---O(?ts�a�; �::�::�,:15.QL' .10- t��.;�. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 . � APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BV DATE RECEIVED pqTE ISSUED BUILDING ADDRESS �r PEFMIT NO. OWNER i A.P. NO. � MAIL - , UILDING �j� / A � ADDRESS ADORESS � � `�, TEL. TRACT LOT BLOCK CITY NO. CANSTRUCTION W ADD ALTER P LENDER BRANCH • OWNE ADDRESS VALUE ARCHITECT TEL. US 3 l�%' OR ENGINEER FIRE ADDRESS � ZONE � TVPE GROVP APPROVED CONTRACTOR BV DATE ADOIiESS TEL. ZONE NO.OF USE OF NEW CITV NO. ' PLANS BUILDING . STATE CITV YAROSAPPROVED YARDSAPPROVED LIC. NO. LIC. NO. MAIN�BUILOING ACCESSORV BUILDING SI2E ' ND.OFBLDGS. (FROMC/ISTREET) OF lOT � NOW ON LOT RONT FT. FT. USE OF EXISTING BLOG. SI FT. FT Separate permits are required for � �. sioe FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILOING AND WORK TO BE PERFORMED DISiANCE BET. BET. MAIN & MAIN BLDGS. ACCE$$. BLDCaS. . VAR.# DATE C.V.P.# APPROVE� APPROVED 1 heraby acknowledge ihat I hava reatl this application and state �^ n that the above information is correct entl a8ree to comply with m all laws reguleting builtlinB construciion, antl I shall not employ any penon In violation of Me workman's compensation laws of m the Stata ot Californ(a. , � I hereby cartify that I em prope�ly Iicensetl as a contractor untler SQ. FT. w the State of California Business antl Professions Code, �ivisian 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR m Chapter 9, antl that such licenses are in full force and effect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE ON�V: — am exempt from the provisionz ot the Staie of Callfornia 8usiness p entl Prafessions Cotle, Division 3, Chapter 9. VALUATION PERMIT FEE $ ��,.% N m Signature of PLAN CHECK $ M 0 Permlttee $� �� TAX $ LL f / U Authorizatl ABent TOTAL PAI D $ � OWNER AOLLING JOB ADDRESS 361 GENERAL CONTRACT AP No. 117-264-5 INSPECTIONS sm� c�s `W ATER �ROUGM PLUMBiNG PROP. SWR. LINE � MOU! SPPINKLING SVSTEM MISCELLANEOUS ROUGH MEr1TING AND RIR I TEMPORARV SERV�CE OR I UN�ERGROUN� � PON HOUGN WIFING TRENCHES FORMS FLOOR SVSTEM BOND BE�M � STEEL SHEATNING FRRME ANO FLRSHING LATHING - IN [� OU' PL�STER, BROWN COr1T STRUCTURAL, FIrypL HEPTING, VENT., REFRIG. PLUMBING. FINR� ANO GA ELECTRIC, FINAL BUI�OING, FINAL Lane DATE SUBCONTRACTOR �:c,u�cn�.yl;if:� , " —i . \ � �- � � 428J�S� � '�T 1��-7;'�,T�.'n!J 66�r:� „.. ..:.�.50 COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 A P C ION FOR STRUCTURAL PERMIT For Applicant to Fill in Comple[ely — Use Ink Only RE i v TE RECEIV TE ISSU BUILDING . . ADDRESS � �C �� O, � A' � PERMIT NO. OWNER � � Z (�' (�f P..P. NO. — C , MAIL BUILDING ' . ADDRESS y v� ADDRESS 6/ � CITV :/f NOL(�J"GL�/ TRA�T" � �� BLOCK . IENDEq�ION L/�GX • Vrr�G f EW ADD ALT P BRANCH' r' �� ADORESS / OWNER CL��J � "n� / ' VALUE � ORENGINEEFl TF'(, TEL, u_/�p0 S $ 7 7 /,/�I FIRE �% T ADDRESS _y .�,� L,i2CL '/V/ ZONE vE • GROUP � p APPROVE D• A ' CONTRACTOR NL� ' YOC a�' DATE L ADORESS TEL. ZON NO.OF USE OF NEW CITV NO. _ PLANS BUILDING .F-i STATE CITV �'ARDSAPPROVED VAFDSAPPROVEO � LIC. NO. .LIC. NO. MAIN BUILDING ACCESSORV BUILDING {,c� SIZE �� ' NO.OF BLDGS. (FROM GL STREET) . G� OF LOT L NOW ON LOT FROfYT FT. FT^. � � EXI5TING BIDG. U(/J ' S E .FT G4� � FSeparate permits are required for L SIDE T. FT. q electric, plumbing and heating work. REAR FT. PT. W USE OF BUILDING AND WORK TO BE PERFORMED I'� DISTANCE BET. BET. MAIN & Qn MAIN BLDGS. ACCESS. BLDGS. a�, /� � � C URP. # APPROVED >. �7�/sCd1f .°`PRo" ., x � w 0 I hereby acknowledge thet I have reatl this application and sta<e � � <het ihe ebove information is carrect antl aprea to comply with m a ull lews reguleting builtling construction, antl I shell not employ Z any.pereon in violaiion of the workmen's compansaiion laws of � the Stata of Calitornia. � 3 I hereby certlty that I am properly licensatl es a contractor under SQ. FT. a , the Stata of California Business and Professions Code, Division , ! THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl t uch sen s ere in full force antl ettect, r I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: " am exempt tra th pr )£io of the Stete of Californla Bus' ess a VALUATION PERMIT FEE $ and Professions 6 a, iJsio ha't � � � � + � PLAN CHECK $ "� Signaturo ot � Permittae �` �� S 5��.. TAX $ � U Authorizatl ABent TOTAL PAID S ,� OWNER �g JOB ADDRESS GENERAL COP yAP No. 117-i INSPECTIONS Dsoi� �GAS W ATER ROUGH PLUMBING PflOP. SWR. LINE SPRINKLING SYSI MISCELLANEOUS HOUSE CON. ROUGH HEATING ANO AIR CONOITIONING TEMPORARY SERVICE OR POLE UNOERGROUNO � POWER � ROUGH WIRING Q,�_L TRENCHES � FORMS � STEEL REINF. � FLOOR SYSTEM BONO BEAM STEEL REINFORCg SHEATHING FRAME ANO FLASHING d DATE g-3-75 BUILDING PERMIT N( RIPTION of WORK Interior Al ZONE VALUE $ 3,�.00 PE V GROUP I SUBCONTRACTOR PE �•: r � 405U COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. eOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comple[ely — Use Ink Only BUILDING -9i ) _ _, 1 �� F � a Q F ci F � .d > a x w a LK 4 W S 3 OWNER MAIL CITV BRANCH ' ADDFESS ' ARCHITECT TEL. ,_— OR ENGINEER ' NO ADDRESS � CONTRACTOR LL[�l.V%L(,�(,/�L-(�i�-C� �„ ADDRESS ��y.0� `� `.C�(jy. CITY �.L/'�- f �� TEL.. ��'E No.b STATE CITV LIQ NO. �.�L�F'�T/�� LIC. NO. �� SI2E • � ��y � NO.� OF LOT � NOW ON LOT USE OF �� --� EXISTING eLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDINf,a AIJD �^10gK,T0 qE f.ERFOFf�'ED N�� S:?-3-75�;i5-0D t32 4Z.50 FOR STRUCTURAL PERMIT r BUILDING ADDRESS TRACT FIRE ZONE APPROVEI DATE% 7^ VARDSAPPROVED � VARDSAPPROVED DISTANCE MAIN BL� VAR. �k I hereby acknowletl8e thetY have raatl this application and siate � � that ihe above Informetion Is corract antl agree to comply with � all laws regulatin8 building consttuction, entl I shall not employ any person in vlolation of the workman's compensation-laws of the State ot California. � � � I hereby cartify that 1 am proparly Iicansetl as a contrector untl¢r SQ. FT. the Stete of Califo�nia Business and Protesstons Cotle, Division 3, THE AMOUNT SHOWN UNDER VALU Chapter 9, and that such Iicenses are In full forca antl etfect, or I THE PVRPOSE OF ESTABLISHING A PERI am exempt from the provlsions of the State ot California Business VALUATION PERMIT FEE $ end P�ofessions Code, Divislon 3, ChePter 9. yyy�� z— LAN CHECK $ Slpnature of , I/,�, — ,- „^ � N�,,,� Permittee V___ . . �v°(XA�1.TV•••'•"-' S �/`�F/��1 TAX , - � $ T` �� . Authorizatl ABent TOTAL PAI❑ 5 h m � : m IS FOR " m ONLV: � r 'pn m m 0 � U / .� � ER HULLINGSWORTH� Robert F. DATE La Perle Lane BUILDING PERMIT N0. 4�i s� AP No. ili-�b`+-�� LOT INSPECTIOHS SOIL c�s W ATEF HOUGH PLUMBING PROP. SWR. LINE [] NOUSE CON. SPRINKLING SVSTEM MISCELLANEOUS ROUGN MERTING ANO AIR CONOITIONING TEMPORRFY SEFVICE OR POLE UNOERGROUN� � POWER � ROWH WIRING TRENCHES FORMS STEE� RE FLOOR SYSTEM BON� BEAM ❑ �STEEL HEINFORC� SXEATMING FRRME RN� FLASMING LATMING - IN ❑ OUT G�j PLFSTEP.BROWN COAT STRUCTURPL, FINAL HE�TING. VENT., REFRIG. AND A.C., FI PLUMBING. FINRL ANO WS TEST n fY13�'{�l: SUBCONTRACTOR / ,. . � ' 43154 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only sui�owc -a: i .. ivr.. .. / ,. F � W a a � h .'S.' Ey C W F G � a > � x w a. O a a z W x 3 MAI l ciTv ..UHL, CANSTRUCTION BRANCH ADORESS ARCHITECT CONTRACTOR ADDRESS CITV STATE �I4 NO. SIZE OF LOT USE OF N ✓ ' A.P. NOJ BUIL�ING �^ � ADDRES: NOL, J�IC�I II� TR � �i ✓ w n \ OWNER TEL. NO FIRE 20NE _ J� APPROVF � BV TEI. Z E NO. CITV V LIC. NO. NO.OF BLDGS. � (FROM Ci NOW ON LOT _FROfYT. i Separate permits are required for electric, plumbing and heating work. US OF� yBUILDI/ry G AND WORK TO BE PERFOR� �a/C L�{rl/1�dn i iLL�(1/N c��rry r�� .F�v� � DISTANCE BET MAIN BLDGS. VAR. # NA1U .,��.-�-�r,�:,� Ot� 399+� ::��:•i8.50 FORSTRUCTURALPERMIT )' NO. NO.OF /j USE OF PtAN$ � / BUILDIN I hareby ecknowletlBe,that I have reetl this application anE state that the above Information is corract antl agree to comply wlth all laws regulatin8 building consttuction, antl I shall not employ any person in vlolation of the workman's compensetion laws of the State of California. I hereby certify ihat I am properly licensed es a coniractor under Sn' ffia State of Califo�nle Business antl Protessions Cotle, Dlvisio THE AMOUN' Chapier 9, antl that auch licensas are in full torce and affec or I THE PURPOSE am exempt from t provisio of the State ot Celitornia 8 iness VALUATION andProfessions o D isi 3,.Chapte 9. /' Signatura of �J ��J J, �J / /� Pe�mittee �` �'� r ['� "�` % � $ / { � /� ��JS v i i Authorizatl Apent . VAFDS BET. MAIN & ACCESS. BL� DATE n w i x � N VN UNDER VA�UATION IS FOR m 'ABLISHING A PEflM1T FEE ONLY: e PERMIT FEE $ a PLAN CHECK $ M 0 TAX $ LL E U TOTALPAID $