HomeMy WebLinkAbout3125 LIMERICK LN - Building PermitsPROJECTADDRESS: s 3125 LIMERICK LN UNIT:
OWNER'S NAME:. ^ISCHER, RAYMOND L
ADDRESSA125 LIMERICK LN
I? COSTA MESA,CA 92626
ARCHIENGINEER: REG,NO.:
ADDRESS: UNIT:
PERMITTEE: FISCHER, GAIL (714)549-0629
ADDRESS: 3125 LIMERICK LANE
COSTA MESA CA 92626
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed urrder provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect.
yWY LIC.: STATE LIC.: CLASS:
!`le: Signature:
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers'
Compensation Insurance. or a Certified copy thereof (Section 3800, Lab. C).
POLICY NO.: EXP. DATE:
COMPANY:
❑ Codified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not bemmpleted it the counties jargon hundred ($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 WorkersCompensation Laws of California.
Date: Signature:
NOTICE: It, alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or this permit shall be deemed revoked,
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 (Section 3097, Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason
(Section 7031.5 Business and Professional Cade: Any city of county which requires a permit to construct, alter, improve, demolish, or
,pair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
spent to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
J Professions Code) or that he/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 sate compensation, will do the work, and the
❑ structure is not intended or offered for sate (Section 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon. and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
as owner of the properly. am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code: The Contractors' Blate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
2; 1 am exempt under Section: 13P704 4 B. s P. C.
for this reason: ALL WORK BY OWNE�R.�7
Omer: L/
I do hereby Certify that I am aware of and understand the requirements of California Health and Safety Code S dig 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply with said stale c s and
a requirements for a
permit for construction or modification from the Air Outlay Mai earic�esidential conslr on a cationp are exempt from
provisions.
rovisions. ���
Applicant:
s/��' & —.—e&—.—e
1 hereby Certify that I have read this application and eta e'lt hat the above information is correct. I agree Io co wills all ci1Y and county
ordinances and state laws relating to building construction and hereby a representatives m this city to er upon the a bove-mentioned
property for inspection purposes.
aada � •— / � / Signature: /
Driver's License or Social Security p'
164146 White—Building; Green—Cone Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NOS B 054201
PERMIT NO: B 054209 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION EXTEND OVERHANG OVER ENTRY SQ FT: 200
CLAIM VALUE: 200.00 CALL—VALUE: 200,00 GROUP OCC: R-3 /
COMMENTS: PLANNING DIV APPRL NOT NECESSARY PER GE
Z 0 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 BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING R28: PROV: PARCEL: 14102310 ZNE: REF NO:
PLANNING N(STES>
>
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N; -T S
ZONING APPROVED BY. DATE:
BUILDING APPROVED BY,:. DATE:
APPLICATION ISSUED BY: DATE:
##k######k#########k#iF7FiF3FiF+•er3F3F3fACiF iFiF'iF kiF �iF iF7FiFiF iF3F3ciF iF3FiriF3FifiCf'F#########iFiF3S##
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES• GRADING
PERMIT 15,00 50
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 15.50 0.00 0.00 15.50 15.50 .00
r
REVENUE DIVISION TOTALS--> COLLECTED: 15.50 OVER/SHORT: .00
BLDG
PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOTT GRADINGePLAN—CHECK
.50
####################ie########k#k#################ia#9r####9(•########ka(###kit#####iE#
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 200 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 200.00
END OF FEES
a
CONSTRUCTION AND PL.- ANG
APPROVALS Permit =#1
Date
Inspector
POOL & SPA
APPROVALS Permit #
I
Date
Inspector
1. TNporary Electrical Service or Pole
52. Pool & Equipment Location
Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
'5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6.-ElectricalUFER"Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0 Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66, Solar System -Final
16. Rough Electric Wiring -
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18, Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
rAPPROVALS - Permit # -
20.. Rough Factory Fireplace
21. Ducts, in Structure_
70. Underground Hydro
22. Ducts, Ventilating
-71. Product Piping 0 Gas OOil
23.. Gas Pipe -Rough & Test r
72. Undergiound Flush r
24.• Roof Framing
.73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing -
74. Overhead Hydro
26.; T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical '
27. Frame and Flashing
�Q_'ll-w
76. Dry Standpipe '
28. Lathing & Siding
�f)""2""f"�
77. FIXED SYSTEM FINAL
29. Insulation "'
78, FIRE PREV. FINAL
30. Drywall Nailing
(
II
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
+
I
79. FINAL INSPECTION
32. Electrical Power Meter -Final,
I
F *
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning,
�
35. Final Gas Pipe-Test-
ipe-Test36.
36.Hood or Canopy.
,
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
-
40. Gas Service -Final _
- 41. Solar Domestic -Final
_
42. Backflow Preventer
43. Backflow Irrigation
- 44. Landscape Irrigation System
'
45. Sound Attenuation
46. Handicap Regulations
47,.FINALSTRUCTURE & BUILDING
48:,FINALPLANNING
49. Electric Release to Edison
,
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
LIMITED STATEMENT OF REST ,oNSIBILITY I Bldg. ,armit #
TO WHOM IT MAY CONGER
r,,ARIZATION I This Permit #
REQUIRED
3� �i" Li f1�2 icic L
Street Address
as Owner in Title of the above referenced
property, do hereby authorize:
G Z- f� � ys�
Street Address
edt
7/K-1 —06Z
Telephone No.
ay
to obtain permits in my behalf, as owner/builder, for o�C�oG D�/ E� j1�9 •�G�
at the above referenced property.
Should may -gem= become an'Emplayan engaged in the improvement of. the property, I shall
immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties.
Printed Name Date
01741411, SIX
Sim
' Signature COUNIN0
SUBSCRIBED AND SWORN
MY f , 1992
�
� TO BEFORE QE�S( 19� I ��
-h DAY OF NOTARIZATION
NAR PUBLIC REQUIRED
6y 12M�»d L, CiScLrer or%t'
w. arer J
PR'ElS: UNIT:
311
LIMERICK LN
FISC d RAYMOND L
3125• �AERICK LN
COST IESA,CA 92626
ARCHIENGINEER: 213 —4472 REG.Ij
ADDRESS: AL UNIT:
PERMITTEE:
ADDRESS:
: CROWLEYS- ROOFING (714)836-1966
ODRESS1016 E IST ST
SANTA ANA CA92701
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Cotle, and my license is in full farce and effect.
CITY LIC.: 3 a 0 STATE LIC.: 318521 CL. S. C3
Date: i- Signature:
-gORI1ER5' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consI to self- sure or a certificate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C).
POLICY NO.: 285-90UNIT 186 EXP. DATE: 01 /01 /92
COMPANY: STATE FUND
❑ Cement copy is hereby furnished. E� Certified copy is filed wj07 a /city Ruilcm, Oivis'
1 Applicant: [/�/ /r,)l..cLT._Y, E/.
EXEMPTION f OMWORKERS' COMPENSATION DECLARATION: (This section need not be completedyl per later one hundred($1DO) or less).
I certify that in the performance of the work for which this permit is issued. I shall not employ n on m any manner so as to became
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: It after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code. you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is named (Section 3097, Ci, C),
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the fallowing reason
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed
pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/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
El structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon. and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
1� and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors' Slate License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
far this reason'.
Date:
I d0 hereby certify that I am aware of and under
25534 and that l or any Injure building occupant
permit for construction or modification from the
these provisions.
Owner'.
stand the requirements of California Health and Safety Code Sections 25505, 25533, and
willlwill not (circle one) need to comply with said state codes and the requirements fora
Air Quality Management District. Residential construction applications are exempt from
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct. I
ordinances and state laws relating to building construction and hereby authome representative f1
property for inspection purposes. _ AI •
Slgnamre.
Driver's License or Social Security h:
to comply with all city and county
to enter upon the above-mentioned
164146 While—eudmng'. Green—Code Enforcement, Canary—Applicant: Pink a e: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05380
PERMIT NO: B 053807 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION T/OFF REROOF W/ COMP SQ FT: 6,000
CLAIM VALUE: 6,000,00 CALL—VALUE: 6,000,00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME
iF ile fit if if file kilefit ile ilefile if file ile ile ile file if filek ile ile fit kfilefiE fit file fit file kfile file kfile fiF�r�E �E�r�r�r+r���E���E*�r�E�E�E�*�e�r �E�E�e�*�e �r���**�r *�E��E*�t
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 14102310 ZNE: REF NO:
PLANNING N TES>
fiF**iF*iE iFif ilefitit file klE iE file kfile fiFfilek*fiF**iEkkMiE kit file ilefile iF itk iEit kiE*ile k1E*ile iE it ile**fit♦E file fit**it ilefiF *file ile iE *ile 1E*iF**ilefile *iF iFfile
D E V EA O P M E N T S E R V I C E S R E Q U I R E M E N'T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE;
APPLICATION ISSUED BY; DATE•
file****kfiF iF*file iirWilli file ile hill, iF* WIF
if fiF
ilefif ile file fiF ik file if ilefiFiF file *fit iE if fitfik ile ilefile iEk kit**fit *filek *ilefiE file*ile ile;E *file filefi fileile fit fitile*k*file file lE ilefiE*fitfiEfileilefiF ile iE*k*file *file kit kale*it*fit
LEGALIZATION:N F E E S U M M A R Y STRUCTURALISEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES/ GRADING
PERMIT 81,00 60:
SMIP/NON.-RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 81,60 0,00 0.00 81,60 81.60 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 81,60 OVER/SHORT: %%, ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING"PLAN—CHECK
81,00 ,60
*iF fiF fiF ile file kfilefit file filefile file iE ilefile*fileile ileile fileilefileilefilefiF file ile *iEfile filefile file fitile file * *fileiE ile ile*fileile**file fiFfile kiEilefileiEfiFiF file ile ileiF ile ilefit fit fiEile iE it iE ile ile iE * *9E iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST ,TOTAL COST
SFR 6000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 6,000,00
END OF FEES
IMF
1
NAND PLANNING
Permit # 1 1 .gate
Electrical Service or Pole
POOL& 4
Inspector APPROVALS Permlr#
52. Pool & Equipment Location
Date
- 1 ConduiIrlJallrgrnd. StD
55. Electrical Bonding
�2_ Soil Pipe-Undrgrnd. -y
n
53. Steel Reinforcement
-_
,3,.;•Elactric�al CondiiiLUlYlity-Uhdrgrnd'-n
54. Forms
�66;411e.ctricalLIFER-6nd.
r.
57. APPROVAL TO COVER-GUNITE
- 1 ConduiIrlJallrgrnd. StD
55. Electrical Bonding
'5L.St;F;g tforcem�rtt C1
56.- Rough Plumbing & Pressure Test
-_
Y
�66;411e.ctricalLIFER-6nd.
r.
57. APPROVAL TO COVER-GUNITE
o�ti rigs ;r .,t
58. Electrical Conduit-Undrgrnd.
Foundation j`- -
59. Gas Pipe, ❑ Undrgrnd., Test
.1
-g_ Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
10. Structural Floor System _
61. APPROVAL TO DECK
_
11. Property Sewer Line-& Hoose.Connection
62. Backwash & Receptor -Final
12. Sealer Cap °` y
63. Heater & Vent -Final
13. Roof Drains v
64. Plumbing System - Final
11. Rough Plumbing;
65. Electrical -Final
15. Rough Electrica -Conduit
66. Solar System -Final
16. Rough Electric iring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electricgtj Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
• -
FIRE DEPT. REQUIREMENT
•7 r M I l7:-, M F •- . f
- -
-
...
20.rRo S1t �' cto Firreplace I tr, t-.1 <,i
x •?
p lT y: .*
IAPPROVAL'S'!J3 Perrrt'it # °
4 11
V
Lg
21..Ducts, i ti5tri�etu e* ;�S
S
C I E x'-10.
idergr 'ri_ ydro
x
22. I ^n
+
A.
W 1. ProductPipirig 0r%'s OOiI
_Duc^,VRhtilating-;e
:<
23.-�as-PiperRough &'test I u;
;;
I -.y :r
i_ .,i - I uj
Underground; Fl"sh�
.>, I M ;
11
:x . Z7
J* -.k
;-72.
.EI
24.:Roo� Framing. F>• F:-` J:�
a ,
V VuUndergrnd'Stora9PYjgk T Gas OP
25, Roo Sheathing
54,;�Xerhead Hydro'
26. 'T -Byre Ceiling (Structural) &,$Oonocoat
:? Lr
Z, 7+a x
75.�Qry Chem'cal � 7 a + 0 rt•
27.E rade and Flashing�,K
1i
76.'Z7Fy Stanc{.'x.
�
1c tT
�; r
.L28.~Lat n Sidin I
9c$1 9 -' P'! .et.^.J' u:
r� .'F
..
•1 •tea �
-
77.7FIXED SYSTEM=�F3NAL:?;
_ �
I
r
29. Insulation
78.�j=IRE PR EV. FItJAL
x x
30. Drywall ailing iT1 a: •
ff :
HEALTHrOEPTY-REQUIRE1v1ENT
,31. Plaster �wn Coag'
I
+ ./f;
'
79.`'FINAL lWdP..ECTIkN ' -
'f`
Z32.�Electrical Po4er 44er:Final i
'! ?J
I
x:
,180. +_FOOD CERTIFICATE ISSUED
..
Electrics I a
s t'!
`n'LI ?
733.�ina� I.a w: tr,
w -1
4. I -F i n aL, H ea t i n g -.N P;IrFCondationi�g;
y�
^
_
35.'Tinal'Gas Pi;3-Tesif`
.>r
•t`f'
C Ic:� ' �r• .S:%
,86.'Ho0d
or Cano *G
IQ I In
_�inhllFactory FirPfke' I :SW
I
[11 .Y :': 1 [-t•" O
-Y
(7 >:
A it
38. Fin@t Plumbing
39. W0e7 Service-finaluz,
to
I: 40. Gas Service -Mal x_
* (rl
to �
I",t x
r;;N .K
1. Solar Domestl>;-Final "; C1-
'�- CT
! •
�4•u 11 X
142. Eackflow Preventer`.°
�
It
a'
.v
*
:r
7 - _• .r �' -
43. Backflow Ir ri§ationt
r v
�; '�;
v e
:•1 i ?
1,44. Landscape Iri:Igatiou. System.trn:, ',Z
'. �1 i7
C7 L �. �
'� N ?: ;..^.; «.- n7 C
J.
%45.,Sound Atten.uatiorr -tv Ir
?
136.` Handicap Regulations
r,
y
a
is u: t:7
,47.+IN'ALSTRU7CTURE&BUfLDING
s/.7
'?r IrA,,`-�, ,✓%� t �C-��.-,pC
Kw9
48."' INAL PLANNING;
:A9._Electric_Release to Edison
'-,50.Seas,Rele'asetoSoutternCaliforniaGasCn
-51. CERTIFICATEOF;OCCUPANCY
; x,•,
do ,
No. Date
vvv i�un -�--
JOB ADDRESS
GENERAL CONTF
Ar' No. LOT 69 TRACT 4355 FIRE ZONE DESCRIPTION OF
L ECTIONS Signature
DA,rE
GROUP I&d TYPE V ZONE RI
Soil
SUBCONTRACTOR
PER ITS ISSUED
Gas
DATE
NUMBER
Water
,
Rough Com. Refrig. ❑ Air Cond. ❑
Rough Heating <
.J
10 -az-
gp —
Rough Plumbing
_
_
Miscellaneous
Prop. Swr. Line p'Flouse Con. St. Swr.
$
�/rP,.,A. Com`
d •� -
__.�!
Sprinkling System—
Construction Pole
Underground ❑ Power ❑
Rough Wiring
Trenches E?- Forms ZY Steel Reinl ❑
C3
_
Floor System
Floor
Bond Beam ❑ Steel Reinforce ❑
Sheathing ofm
f --,:r Cx
Frame and Flashing
_?(
Larl+ing — In Out [�-
I �r, brown coat§ /
r( j'.-n
fte,g❑Aa on . L]FinaHeating,
T')
FinalPlumbing Fixtures, Final
Final Gas TestFinaElectric
Fixtures, l
7W G'9
1845
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING 2-s
3/—BUILDI1ADDRESSL
COSTA MESA. CALIFORNIA
FEE �JCEIOD
Lot 69, Tradt 430-, P1 4
XFINANCE DEPT.
APPLICATION%PIP&OhA MESA
BUILDING
For Office Use Only
Harbor Ball of Fame Homes, Inc.
RECEIPT NO. PERMIT NO.
OWNER
I
�[
P.O. BDX 21/06
RECEIVED BY TATE RECEIVE DATE ISSUED
AMAILDDRESS
Santa Ana NEoLKI 9-22
BUILDING
CITY
ADDRESS
ARHITECT
Jami E 4-0040
COSTA MESA. CALIFORNIA
ORCENGINEER
-225 I'D"St., Tustin
FIRE
ADDRESS
ZONE TYPE / GROUP 1��y
CONTRACTOR Lifetime Residential Bldg Co
APPROVED
BY DATE
ADDRESS 2131 So. Artesia
ZONING
Santa Ana
ZONE O
I
NO. OF
I
USE OF NEW
CITY
^ -?
PLANS
BUILDING
ST No. 208676 TEL x1 9-22o4
LEGAL y.- 7l<' y.
DESCRIPTION O 9
SIZE 60001I N0. OF BLDGS.O
OF LOT NOW ON LOT
A. P. NO.
USE OF None
YARDS EVES
EXISTING BLDG.
APPROVED ALLOWED
SETBACK LINE FROM c
1
50331
10ENTBR LINE 8T.1
CENTER OF STREET REAR YARD .5
FRONT .So FT. IN.
BIDE YARD
I LEFT 131 -
�1
I RIGHT I 1
R. SIDE / FT. IN.
DESCRIPTION OF WORK-
13
L. SIDE FT. IN.
NEW I x I ALTERATION I II ADDITION
REAR 33 FT. IN.
REPAIR I II MOVING I I DEMOLISH
APPROVED a DATE
OF
6441
ZE�ING
8 ROOMS 9 STORIES 2
EXTERIOR WALLP18S ROOF
ter) Shake
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Single familysidence
1 HERESY ACKNOWLEDGE TH I HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE OV E CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLYWITH ALL CITU N S AND ST W REGU NG
VALUATION
�^
Bu1LD.No COXBTRU o
SIGNATURE O
PERMIT FEE S �J
PLAN CHECK S �f_b
PERMITTE
$ / / ' /
AUTHORIZED AGENT
l//7/0
5-'
TOTAL FEE