HomeMy WebLinkAbout3406 LANTANA LN - Building Permits�'/�,� � �y
•7 7��� �'J CZTY OF COSTA MESA REQUEST FOR OCCUPANCY
� /�'I
TRACT N0. � %� O
DATE %�2G�%?
T�
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streeta
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he-she-they)_�s��(was or were) ��/�-�'.e,� advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harn�less from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uttcompleted condition.
`' . R E
�i�:,
;�,
: J�U
AM
0
�
,,. �7(/�uw�icw�-� w �r �--
�'�'— '�� Purchaser
�pp�Iu', U, E�'��' - 2� � �
bn/.dlr� Cr "�
;�yyA " BY
� T Developer and or authorized
� �
representacive
� � i�l�� � 4 (,�//-Lce-f"inti
�
� � PM `� � BY ' ,c.r,eG'C�
I�WZf3jQ�5�6 Lender
��' ,'� � �
OWNER 7,��N
JOB ADDRESS 3 La.ntan
GENERAL CONTRACTOR Ow
AP No. LOT 17
INSPECTIONS
SOIL
GAS
W ATER
ROOGH Pl.UM81NG �
PROP. SWR. LINE �'Fi0U5E CON. Q�
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CON�ITIONING
TEMPORARV SERVICE OR POLE
UN�ERGROUNO � POWER �
ROU6H WIRING
TRENCHES � FORMS � STEEL RE
FLOOR SYSTEM -
BONO BEAM � STEEL REINFORCE �
SHEATHING
FRAME ANO FLASHING
LATHING - IN OUT �
PLASTER, BROWN COAT
STftUCTURAL, FINAL
HEATIN6, VENT., REFRIG. ANO A.C., FI
PLUMBING, FINA� AN� GAS TEST ��
ELECTRIC, FINAL
BUILDING, FINAL
DATE
N of WORK Res
VALUE S
SUBCONTRACTOR
�bIW`Ha
359�2 ,
COSTA MESA BUILDING-SAFETY DEPARTMENT
401 AR P•O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
ADIDRESS 3406 Lantana Avenue
OWNER
'"�;,0 16255.Ventura Blvd.
z ..
«�
ww
d U
Z Q
o�
am
J �
J N
[� J
• 4]
J Q
U N
Z a
W �
aw
W Z
J Q
m Z
J �
W
� _
Z �--
w�
70
F
z
Q
U
J
a
a
Q
�
F
N
z
O
H
U
�
�
�"'
N
z
CITY
BRANCH
ADORESS
ARCHITECT
CONTRACTOR
AODRE55
CITY
STATE
LIC. NO.
size .
OF LOT
USE OF
E%ISTING BLDG.
WALI
Larwin So. Calif.
16255 Ventura Blvd.
Encino, CA
16255 Ventura Bivd.
TEI.
Encino CA NO 986-889C
191311 LICyNO. B��
67 X� I NOW ON LO S O-
NO.
E OF BUILDING AND WORK TO BE PERFORMED
Construction Single Family Residence
rrta f2.�
1'r.N2f-73cr��,�01711� ;m�a*11.
APPLICATION FOR BUILDING PERMIT
EIV�.b� DAjE%F�CEI�(,E3 D7T11$SUI
� / ��� / /9
BUIIDING
ADDRESS,3
TRACT
OWNER
FIRE
20NE
APPROVEO
LOT
20N� � IP�� 'i I gUILDING •�(..��
C1
VAROSAPPROVED VARDSAPPROVED
MAIN BVILDING ACCESSORY BUILDING
2 T
L. SIDE � FT.
IC REAR � FT. '
DI5TANCE BET. ' BET. MAIN &
MAIN BLDGS. ACCESS. BLD
VAR.# DATE
C.U.P.# APPROVED
APPROVE /�
�/
IIOLD FOR ECIA REQ IR
I hereby acknowletlge that I have reatl Mis application and state
that the above informaiion is correct entl agree to comply with
all laws regulating builtling consttuction, end I shall not employ
any person in viOlation of the workman's compensation laws of
tha State ot Califo�nia.
I hereby certify that I am properly licensed as a contractor untler
the State of Celifornia Business entl Professions Cotle, Division 3,
Chapter 9, antl thai such licenses are in full force and effect, or I
am ezempt from the provisions ot the Stete ot California Businass
end Professions Cotle, Division 3, Chapter 9.
Sipnatura%_d'//`////!�//.I//'/� _
Permittee �_ _ �. Downs
Authorized Ageni '
�
�
SQ. FT. ! � o
�
THE AMOUNTSHOWN UNDER VALUATION IS FOR j
THE PURPOSE OF E5TABLISHING A PERMIT FEE ONLV: m
¢
VALUATION �
PERMIT FEE $ �%4,00 j
$��/�� ��� PLAN CHECK s 47.00 O
/ ' � _) LL
TOTAL FEE $ ( �%��