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HomeMy WebLinkAbout2420 LESPARRE WAY - Building Permits CITY OF COSTA MESA 4 BUILDING DIVISION F ,�I DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER PERMITS-01325 itlesIngral (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.B.WLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2420 LESPARRE WY Status: ISSUED Suite: Applied: 08/05/2005 • Vicinity: ROOF,4-PLEX AND ATTACHED GARAGES Issued: 08/05/2005 Primary Occ: R Type of Construction: V-N Parcel Number: 43914304 Zoning: Applicant: DEBORAH SIMMONS Address: 9582 HAMILTON AVE SUITE 281 Phone: 714-960-8329 ISSUED BY: HUNTINGTON BEACH,CA Zip: 92646 Owner: PANGGAN-. cX—MtI kkOk Address o424 6EiSPa E RWAY-`t7rtm V k\3 Z1 Z r" Phone <, , ,�/ C —,. ¶0511°1 Zip 9762'-t - C 27.16 Contractor HIRSCHMAN RP & SONS INC • Address: '9582 HAMILTON AVE .��..- SUITE281 ',:;; Phone: 714-960-8329 4, HUNTINGTOMBEACH'CA � Zip 92646 License: 781923 Eng: Address ; Address: Phone: s i ✓yam x€.r, License � » License: SCOPE OF PERMIT �?v xi TEAR OFF EXISTING:ROOF INSTALL 1 LAYER OF 15#FELT,40 YEAR COMPOSITION SHINGLES,AND REPAIR/REPLACE SHEATHING AS NEEDEI SQUARES FOR 4-PLEX.4 PLY BUILT.UP SYSTEM FOR ATTACHED GARAGES. 16 SQUARES. �� >,:: 2420 THRU 2426 LESPARRE WY ki ' '4 r\VI gr, FEE SUMMARY,`;.` �. ' ' Plan Check: ',$000 Calc Valuation $25,378.00 Permit $40185 Claim Valuation $25378.00 SMTP. Res: $2 54 fir' .,,; SMIP Com: 'r,-,$0.00 • Other: $0.00 Inspection: $0.00 Total:. $404133 xs P.LANNING BbZONING SETBACKS:4; z MAIN STRUCTURE Front 0-0 _0=-Orf Left t 0 0 = Right 0 0 ACCESSORY ,Front Lefl 0 0 " Right 0 0 �3 v' PARKING Exiahnq k a 0 Required 0 - " Proposed 0 ` � 0r s " • • 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 .2446-06(6/00) DECLARATIONS fl ( ) 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 ork 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 is Issued. My works editpensation I surance Trier and policy number are: /) }v1 Cartier. Jl —a.- e' n Ot Policy Number: 0 0 - Z�6 (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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply ig with these provjsion, / n Y1 ejS/D5 Applicant Signature: A6//uu��i{r J IX/irr/ Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND MI I ARE($1X,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licenssil upper provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Buslness?nd Professions Code,and my license is In full force and effect.Llc.# �''(// a 3 Class# (✓'ci Contractors Signature: 1cQIth-en ekit-140nVnla'LA Date: S'/5/DS 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 drivers 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,AR 2,Sec. 341.Title B,California 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 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 en 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 eggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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 pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 B (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.n. Aeop1 _ )(inure OfLegal O nve5J V /5725- ""And/Orr Authorized Applicant Date ;fief r, PISPEC11ONTYPE PEI IKTTALE CODES INSPECTION TYPE GATE 1143116121I 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 20 Final Plumbing 200 Final Re-RoofW 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 41011;f4 MF . Q CITY OF COSTA MESA F` ,I irtil d BUILDING DIVISION �\ DEVELOPMENT SERVICES DEPARTMENT J• • PERMIT . .. P T UMBER P98-00903 t (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2420 LESPARRE WY Status: ISSUED Suite No Applied: 12/16/1998 Issued: 12/16/1998 Vicinity: Parcel Nunmber: 43914304 Applicant: NOCK, RON Address: 11612 KNOTT ST . • Phone: 714 895-1246 GARDEN GROVE CA Zip: 92841 - - _ Owner PANGLE, WILLIAM L Address 2420 LESPARRE WAY . Phone: -, _ COSTA MESA,CA. Zip: 92627 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 (' FEE SUMMARY - - _ AMT QTY AMT - QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation ' $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 , 0 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 1 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 $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 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 . Shower $0.00 0 Water Heater/vent $11.00 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 WaterPiping(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: $33.00 COMMENTS/SPECIAL CONDITIONS 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 • DECLARATIONS 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 work for which this permit is issued. errhave 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 is issued. My workers'compensation Insurance carrier and policyponmber are: Carrier: �fl L,IQ�7-3 c(.Jt- Policy Number: GIU[-2C-4-7 2 3 (This section nee 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 California,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 provisions. - q� Applicant Signature: I \ i ` Date: �2 -77_ /o WARNING:FAILURE TO SECURE WOR RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE MST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed und° �^ n h g commencin with Section 7000)of Division 3 of the Business and Professions Code,and mylicense is in full force and effect.Lic.a 'v / Class* Contractors Signature: 77� �— 1 Date: / 1-may- 77 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: 1 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 drivers license. 0 Yes 0 No Driver's 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,California 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? ❑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 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 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 application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes O No (Section 65850.2 of the Calitomia 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 ❑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 ❑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. net re Of Legal Owner(s) / y /ate And/Or Authorized Applicant Date 00 CODE# INSPECTIONTYPE DAIE MEDALS CODE! INSPFt'TION TYPE DATE ,rrrr. . 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1 1266 Pool Spa Final 208 Final Plumbing i/o,�? 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 _ 2446.46 OWNER DOYLE & SHIELDS Development Co. ,Inc. DATE 6-3-63 JOB ADDRESS 2420 Lesparre BUILDING PERMIT NO. 19694 GENERAL CONTRACTOR Doyle & Shields Dev.Co. ,Inc. VALUE $ 16,790.00 AP No. LOT 110 TRACT 3433 FIRE ZONE • DESCRIPTION OF WORK REssw/att.g_ar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-2 Soil -----Al PERMITS ISSUED � _ Gas j� / l SUBCONTRACTOR DATE NUMB' Water �( � • Rough Com. Refrig. 0 Air Cond. 0 Rough Heating 4.1-/-$ O-24.36_ • • JUL 2 2 1963 .' a Rough Plumbing /A-f c / C s _ - �_/ .c. 6-/O-6 rife- Miscellaneous / _�1,). 'h Prop. Swr. Line Z Ho se Con. 0 St. Swr. 0 •0% /-5--G /���% thra-legr7,"s � n�:G - tafr7 Esvil o .3-.3-44L Construction Pole ° . ..i wL" Underground [l' Power 09 /Z.0 Rough Wiring- _V Al-.Z17"-- i 6, it__I e-,te, • 1-30-63 a0 3 - Trenches Forms ka' Steel Reinf. ❑ / Floor System 8h' G-.2.4?- -4 ,,, Y Bond Beam ❑ Steel Reinforce ❑ / . G"-- Sheathing 44, L' 0 G 3 1 - , , Frame and Flashing - z i--z Ai- al /lc Lathing— In l Out ate" '�� -7'1 �-3 / Plaster, brown coat txr- A - jy' G' Refrig. 0 Air Con. 0 Final Heating, Final -o•,/ i,to -bV Plumbing Fixtures, Final � C 2ye-ov / t.i Final Gas Test/s— / S z(a--Ov CJ Electric Fixtures, Final C Building, Final —raj Z_Z / � OCCUPANC Form BU4-5M-3-63—s-B P • HOLD FOR SPLCIAL ftEOUIREMENTS • • 19694 R F F V COSTA MESA BUILDING-SAFETY DEPARTMENT FEE R E C E I V ED P.O.BOX 317 COSTA MESA,CALIFORNIA V du H 3�p19963 For Applicant to Fill In Completely FIN lJ� aCKpFi'bN��FpOR PERMIT TYPE OR PRINT CITY OFFPPCNOST/Na m BUILDING ((�� {� ^ For Office Use Only ADDRESS ��LJ 'RECEIPT NO. PErIHIT�Rq-� COSTA MESA, CALIF NIA , ,,„Cly4, R EIVED Y DATE RECEIVED DATE ISSUED OWNER Doyle & Shields Dev.Co. Inc. A RESS ��// 5 - —`3 JUN 3 1.96-3 - III'/ B DING MAILyt . tc' ADDRESS :31 O. Manchester Ave. /\�� J� TE ZONE TYPE GROUP S.0FIRE 1- APPROVED Anaheim Calif Nol"PR 2802( ARCHITECT TEL. B1P'PROVED DATE OR ENGINEER • Hat C. Tan - NQL.871-2811. ADDRESS 4100 West Commonwealth ONING �. I �` ZOi� PNO.LA S USE DI NE • SGY " I PLANS I BUILDING / f� CONTRACTOR Same V I' El 4 DESCRIPTION Lot 110 Tract 343 ADDRESS same f� CITY Same A.P.NO. �J- I NOTE: NO EAVE OVERHANG SHALL BE LESS THAN Lc.NO.l51-2S0-B-1 no' PR 28020 30^TO SIDE BREAR P.L. e EAVES SIZEOF LOT 33 X S3.SO I NO,OF BUDGE. -- ALLOWED (U.B.C.REQUIREMENT) NOW ON LOT USE OF - YARDS APPROVED YARDS APPROVED• EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SETBACK LINE FROM CENTER OF STREET 20. 50 ,- REAR YARD-- 0 ,(7'�0 FT. - FT. SIDE YARD LEFT - - I RIGHT M-- R.SIDE 'LJ F7. FT. DESCRIPTION OF WORK L.SIDE © FT. FT. NEW - X (_ALTERATION ADDITION REAR FT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDQS. ACCESS.SLOGS. L VAR.# DATE SIZIEDING 33x53. 50 ROOMS 6 STORIES 2 C.U.P.# r \\.. APPROVED ,} COVERING LS tl1CC� ROOF H/ BY ee`` IIA..AA/V�� DATE J / USE OF BUILDING ANDWORK TO BE PEBFORMED (fix) Residence with attacnect garage Model 32-G 1558 5Q.FT zpio A. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SH UNDER VALUATION IS FOR THE S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF E LISHI NG A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING �/ BUILDING coNSTRUCTION. // /� //�� VALUATION • / ri ry SIGNATURE O (r1 D6 /• ll. )/ ^ PERMIT FEE $ co PERMITTEE ! C 99/�•�J t Z. 1,/ISD 7n'C ' $//1/O 7Q /d AUTHORIZED AGENT i - .{(!j,/q'✓'"�L1 . / PLAry CHECK $ t7 'J LL O ((!!!! Y TOTAL FEE $ dj FP