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Home My WebLink About912 LOMBARD CT - Building Permitsvr IECT 0.�BE55: J 1 Z LOMBARD CT NEN'SNAME: D'ARNAUD—GUERRE, � �aooqcss: C 912 LOMBARD CT COSTA MESA,CA AFCHIENGINEEN: pU0flE55: UNIT: CYNTHIA 92626 flEG.NO.: UNIT: PEflMinEE: DILT—WELI. ROOF AND MATERI ( 714 ) 739-1288 aooeess: � 310 C�ERDUGO R(?AD LOS ANGELES CA 90065 UCENSEO CaNTBACTOF OECLAXpTION: I herehy atfirm Ihat I am licensed untler provisions of Chapter 9(commencing wi�h Section 7000� ai Orvision 3 of �he Business antl Professions Code, an0 mV license is in Iull farce and e�fect. ciTruc.: 0340�6 STqTELIC.:QSBOOS �'S' C 39 EXP; OS/95 �ate: �,j//Q{C- SignaWre: _ WOflNEHS' COMPENSFTION DECLAPATION: I hereby aHir ave a ce�ilicaie of consem m setl-insure or a certilica�e of WorkeK Compensation Insurance, or a ceni�ie0 copy Ihereol (Section 38W. Lab. C). Poucreo.: W937102489 ezr.onre: 07/13/99 COMPANY: CAL COMP � Cetli�ietl copy is hereby fumished. Q Cerlilie0 copy is �ilBtl with ihe ciry Builtling Division. �a�e: ApPlicani: EXEMPTIONFqOMWOflREPS'COMPENSRTIONOECLAflFT10N: �ThiSSeclionnee4noib¢wmpl¢Ietli�ih¢permiti5�oronehundretl�E100)arle55). I ceriif Ihal in I�e peAormance of Ihe work �ar whiCh IhiS ermil i5 is5ued ot ¢mpl any p¢rson in any manner So a5 �o beCame sublett �o ihe/�A rker ComOensa�ion Laws o� Calilomia. Y P Oale:__C�" � 519namre: � NOTI E: If, alter making t�is tleclaration, you should �eco ect to the Workers' Compensa[ion pmvisions of the Labor CoAe. you must fonhwith comvly wiU sucn pmvisions or thi5 Dermit shall 6e 4eeme0 revoke0. CONSTBUCTION LENDING RGENCY: I hereby alfirm ihat t�ere i5 a constmc�ion lentling agency for the Oe�ormance of ihe work for w�ich Ihis permit is i=5ue4 �SeCiion 3097. Civ. C�. LENDEN: AOOPESS: OWNEN BUILOEB OECLl�BATION: I hereby allirm �hat I am eaemPt tmm Ihe Con�ractors' S�a�e License law far the following reason (Sec�ion 7031.5 Business and Pmfessional Code: Any ciiy ol cou�ry w�ich requires a permit �o con5imct, atler, improve, demolish, ar �eoair any simcture. prior Io its issuance, also requires ihe applicant for such permit to lile a signetl statement �nai he/she is licensed pursuanuo Ihe pmvisians ol Ihe Comracrors' S�a�e License Law (Cnapier 9(commencinq with Seclian 7000) o� Oivision 3 0l ��e Business anU Pmfessions Cotle) or ihat helshe is e�empt inerelrom ane the basis for che alleged exemption. Any violation ol Section 7031.5 by any ap0licanl for a Dermit subjec�s Ihe applican� to a civil penalry ol no� more t�an five �unOred tlollars (5500). I. as owner of ihe proOe�Y or my emplayees with wages as t�eir sole comDensation. will tlo t�e woB, anE ihe ❑ slmqure is noi imen0etl or ofieretl for sale �Section 7044. Husiness antl Professional Coae: The Coniractors' State License Law Does nol apply to an owner of a pmpetly who builUs or imP�oves �hereon, and who tloes such work himsel�/herseli o� ��mugh his or �er own emDloyees. pmvitletl iha� such impmvemEn�s are no� intentletl or oflered for sale. I�, however I�e huildinp or improvemeni is solU wilhin ane year of comple�ian, the oWner will have �he Eurden af pmving he/she tlitl noi 6uild or improve for Ihe Durpose af sale�, I, as owner ol �he pmperty, am exclusively coniracting wi�h licensed conVac�ors �o cons[mct �he D�oleci �Sec�ion 7044, Business ❑ and Pmlessions Cotle: The Contracmrs' State License Law Uoes not aD�ly lo an owner oi pmpeM w�o bwlds or im0�oves t�ereon antl who coniracls lor such pm�ects with a coniracim�sllicense pursuant to �he Contractors' Stale License Law). I am aware Ihal pmoi of Iheir Worker'S Campensa�ion insurance shoUld be pmvitletl Io me. � I am exempi untler Section: B. 8 P. C. �or Ihis reason. �ale'. Owner I oo hereby cenify Ihat I am aware o1 ane un0erstantl ihe requiremems oi Califomia Health ana Safery Cotle Sec�ions 25505, 25533, antl 25534 antl Ihal I or any fuWre building occupanl willlwill nol (circle one� neetl to tomply with said s[ale cotles and the requirements �or a Oermit for consimction or moddica�ion �mm �he Nir Oualiry Managemen� DiSVic�. flesitlential constmc�ion applicaiions are exemp� from Ihese pmvisions. �a�e: AppliCani:_ I hereby ceritly ihal I have reatl �his apphcation antl slate Ihat Ihe ortlinances an0 sla�e laws rela�ing lo bwltling conslmctian antl �erel propetly forinsp�cban}�urpases. Oa�e: --��'-/!� (X� Signaiure:� priv¢(5 Lit¢nS2 or $acial Secuniy k� � is correcl. I aAree b Gomply with all city anU county ni�jves ai [his ciiy to en�er upon the above�meniianetl 1641 n6 Whne—Builtling; Green—Cotle EnlorcemenL CanaN—APPlicant; Pink—Revenue; Goltlenrotl—Assessor CITY Of' C05TA MESA — BIIILDING PERMIT PERM NO; B 067966 PERMIT NO: B 057966 PLr1N CHECK NO: � N GOVT: N SUPP: N CONSTRUCTION TYFE: V—N PERMIT TYPE: STR PURPOSE: OTx SOB DESCRIPTION ; T/OEF & REROOF WITH COMP, 6 HUR IN BACK SQ FT: 1,1U0 CLAIM VALUE: 1,100.00 CALC—VALUE: 1,100,00 GROUP OCC: R-1 /M-1 COMMENTS: SMOKE DETECTORS ARE REQUZRED IN EVERY BEDRQOM & HALLWAY ****�r�**��*�*�rx#tr�r�r�***�*�*�**�**x***��r**�#*****x�r#�r**�+��r��x*x*��rfr«�x**+��**�r�r*� Z O N I N GS ERTEBS�AUCjKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------' FRNT: £T IN REAR: FT IN FRNT; FT IN REAR: FT IN LEET: ET IN AGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV; PARCEL: 41808241 ZNE; REF NO: PLANNZNG NOTES> , 1 et*ieit**�r+tstie�r�rit�+tititit+�it�rie*ir�*�x*it�e*��r**�*��r*it�ret�r*��r�r�xit�*it*��*it**�+�*?rtt�-�a#**��.**�ie�arx D E V E��L O P M E N T S E R 4� I C E S R E Q U I R E M E N�:T S ZONING APPROVED'HY DATE: ry' BUILDING APPROVED BY : DATE: ': APPLICATION ISSUED BY: /�'�_ PATE: � p1 ��i.iEiFiE*itio-��*�*iE#+k�iEiEiEitiE*it�."'�rTe3fx��rTri'r�i'exir�� ie�ri'r�i�r�rx�rxx� ir, itkx�irfEiEititiEtEk�;-�r"'x�. r,e. **� 1E it� jF 3(� iE iE iE iF i�- iE iE iM1 iF iF ## iF iE ff iE i(� iE iE if iF k iE iF ic iF if if �lf iF if 1M1 9t i(� It iE iE if jF j! iE iE iE iE 3f iE iE if iE iF iE �(-iF iE iE i! iE iE lE ff jF i@ iP iE ih iE *+rlf iE fE *�lE iE 1E LEGALIZATION;N F E E S U M M A R Y STRUCTGRAL SEGMENT;Y BLDG PMT PLUMBING ELECTRTC MECHANIC FIRE SMIP/RES GRADING PERMIT 27,00 50 SMYF/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PASL� UUE TOTALS----> 27,50 0.00 0.00 27,50 27.50 ,00 REVENUE DIVISTON TOTALS--> COLLECTED; 27,50 OVER/SHOAT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIF/TOT GRALING PLAN—CHECK 27,00 .50 iF iE i41! iE iE i!� iF IE iE iE fE iF iE iF iE �! iF �IE if 9E iE if 1E 3E!! 1f f! # iE iE if it it �)F'N� iF iE it 1E iF 1t iF ff iF iF iE 1E �l(-fFlE # iE ih iElh 1e if if i� iP jt iE 1E!!!F i! 1E iE �lE iE iE ic iE iF i:- �k it # I N D I V I P U A L F E E H R E A K D O W N TYPE QTY SFR 1100 D E S C R I P T I O N REROOF BY VALUE RESIDENTIAL NOZONE END OF FEES UNIT COST TOTAL COST 1.00 1,100,00 Y ol 001b3752—OO1b3763 T�7 T 27,SD DATE: Q7/11/94 TItIE: 11:21 �C.ONSTRUCTION AND PIRNNING POO iPA �APPROVALS Permit� Date inspector APPROVALS Permit# Oate Inspector i 1. Temporary Electrical Servicear Poie 52. Pool & Equipmen: Locaticn 2. Soil Pipe�Und�gmd. 's /' 53. Stee� Rzlnforcement �r; 3. Electrical Condu(t Ut�lity-Undrgrnd. 54. Porms .'- 4. Electrical Conduit-Undrgrnd. 55. Electrical 8onding 5. Steel Reinforcement 56. Rough Plumhing & Pressure Test 6. Electrical UFER Grnd. 57. APPAOVAL TQ COVER-GUNITE � 7. Footings � 58. Electrical Conduit-UnJrgrnd. t! 8. Foundation � j 59. Gas Pipe, (7 Untlrgrnd., Test �•�� 9. Water Pipe-Undrgrnd. ��+ � � 60. Backwash Lines, P�Trap, �J Undrgrnd. � .� ��' � ' 7 t...� 10. Structural Floor Sys[em ,:- ��/ 61. APPROVAL 70 DECK i t. Property Sew¢r Line & House Connection �` 62. Backwash & Receptor�Final ��' �` ` . 12. Sewer Cap ' 63. Heater & Vent�Pinal 13. Roof Drains 64. P;umbing System - Plnai �; � 14. Rough Plumbing � 65. Electrical-Firai .` 15. Rough Electrical�Conduit 66.- Solar SYstem-Final r^; r 16. Rough Electric Wiring 67. Fencing & Access APProval 77. Rough Wiring Siyn 66. APPROVED �OR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEh45 F�NAL 19. flough Heating & Air Conditioning F1RE DEPT. REQUtREMENT 20. Rough Pactory Fireplace APPROVAIS- � Permit � 21. Ducts,in Structure � 70. Underground Hydro � 22. Ducts, Ventilaiing 77. Product Piping u Gas � Ofi ( 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergmd.StorayeTank uGas �Oii 25. Roof Sheathing '7 �q 4/L �� 74. Overhead Hydro I �T 26. T-Bar Ceiling (Structural� & Monocoat 75. DrY Chemical i 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sid�ng 77. FIXED SYSTEAI FIiVAL . 29. Insulation 78. FIRE PFEV. FINAI 30. Dry�vall Naiiin9 � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAI iNSPECTION ' 32. Electrical Powar A9eter�F�na1 80. F.00D CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test � '' 36. Hood or CanoPY • 37. Final Factory Fireplace " 38. Finai Plumbing 39. Water Service�Fina� 40. Gas Service-Final 41. So�ar pomesticFi�al 42, Backflow Preventer � � 43. Backflow Irrigation � . i 44. �andscape IrriGaiion System 45. Sound AitenUation 46. Handicap fiegulations � � 47. fINAL STRUCTURE & BUILDING g.��ft� �(�r� 48. FINAL PLANNING � �- . 49. Electric ReleaSe to Edison ,. 50. Gas Release to Southern California Gas Co .'"� 51. CEiiTiFICATE OF OCCUPANCY No. Date • AVP��:nt to fill in all spaces within heavy borCer lines anE.zign all appropriate tleclarations. CITY�OF�COSTA MESA � ceam�0i3�5 TRACT NO. LOT NO. �BLDG. NO. CONSTRUCTION PERMIT ` � Address 911 L:o Hgiq � n u T. ' Arch/Eng.- "- " " ' �Address � � � � �� ' Confract r ' �j� Address - ' � � LICENSE CONTRACTOR DECLARATIC I hereby affirm that.l am IlcenseC untler prt mancln9 wlth zectlon ]000�' of ' Dlvlslon Profaszions Cotle, z tl my I!c se is In Licen CI ss Date Si9natur WORK RS• COMPENSATION DECLAR I herebv atiirm that I have a certiticat 1 Y�;.�O �;6 TY E OF CONSTRUCTION Phone - 6 NEW �O.ADD ❑ALTERATION � " ❑ REPAIR ❑ CONVERSION ❑DEMOLISFi LiC2nse No. - 0 OTHER - - DESCRIPTION OF WORK � Ph�^e TVPE OF PERMIT� - = ❑ GRADING .❑ FOUNDAT,,I_O/{� ❑ STRVCT N � � ❑.TENANT ❑ ELECTRICAL VJPLUMBING ❑M �viilons of C�arter 9 (com- 3 ot tha Busirie55 antl ❑ OTHER � � ' fult torce -��n, effea. pROJECT DESCRIPTION- �� / en 8 o:�L'�a.r_ �b� �� d SQ. FT.'. . -' � ppT- OCGUPANCV_CONSTRUCTION TVPE� Consent to SelNniura or a ' � anca, or a cerHfletl copy VACUATION' � ZONE [hereOT (Settion 3800, Lab. C.). ' _ _ . , ]GRADING CV. VDS. � AGRES _ �6".'�.,�V No. � �omDany �:: �,r.g-�•rtltietl mpY �s hereby furnishetl. ' ' REMARKS: ' - xlrtifletl copy iz fllatl with the tlty Bulltling Diviilon. �EMPTION FROM WORKERS' COMPENSATION DECLARATION {E300)�or��¢uj eetl not be completetl H tha parmit is for one huntlretl ---- -� -- mrtNy thabin Ihe�performanca ot t�e work for whiclt tbis permit�i5 , I55ueE, I shall not emPloy any person In any manner so as to become PLUMBING . � PLAN CHECK subject to tha Workers W mpensation Laws ot California. - Date � Si9nature � BATHTUBS SHOWERS NOTICE: If after making this Oeclaration, you shoultl bacome su�ject TOILETS ��. URINALS to the Workars' Compensation Drovisions ot the Labor Cotla, you must forthwlth comO�Y M'��h such provislons or this permit shall be tleemeG LAVATORIES DOUBLE �AVS revoketl: ' - - � -- - � CONSTRUCTION LENDING AGENCV KIT.SINKS DISHWASHERS I hereby aTfirm that t�ere is a constructlon Iantling agenty for the per- SERVICE SINKS �`� SVMPS tormance ot the work tor which this permit is 155uetl (Se<[ion 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS Lentler's Name Lentler'S AtlAress ORINKING FOUNTAINS � OWNER BUILDER DECLARATION INTERCEPTORS CLARIFtERS 1 hereby afiirm that.l am exempt from.the.Contractor's.LicenSe.Law tor the following reason (Section 7031.5 Business antl ProteSsions Cotle: SWIMMING POOL PTRAP Any-tlty or munty whiGh r¢qulre5 a permlt.to ConStruC[, al[¢r, improve, tlemolish or repair any structure, prior to its Issuance, also re- yyqTER SERVICE ALTERATION quirez the applicant for such permit to tlle a signetl statement tha[ he is Ilcensetl pursuanl to the provisions of Ihe Contractor's License l.aw GAS SERVICE OUTLETS 1Chaptar 9(tommencing with Section 7000) of Dlvision 3 of the 8usiness and Prdessions Cotle) or that he is exemp[ therefrom antl the yyqTER HEATERS BTU OUTPUT b' hr the allegetl exemp[ion. Any violation of $ectlon 7031.S.by - . >Iiwnt !or a Dermit subjects the appliwnt to a civil penalty SEWER CONNECTIONS � mOr¢ than five huntlr¢tl tlollars (5500).. . . L as owner of the property, or my employees with wages as their SOLAR TANK C LEC O ,\ sole aompensation, wlll tlo the-work; antl the struchre Is not intentletl or ofiereU for sale. (Sectlon 7044, Business anC Rofesslons CoUe: The SOLAR PIPING SVS. Contractor's License Law Uoes no[ aOPly to an owner of a property who bulltls or improves theraon, antl who tloes such work himseli or ISSUE FEE through his own employees, provitletl that such improvemen[z are not intentletl or otferetl for sale. I(, howeveq the builtling or improvement MECHANICAL LAN HECK is soltl wlMin one'year of completlon, the owner will' have the burtlen of p�oving he tlI0 not bUilU o� intp�ove for the purpose of sale�. HEATING SVSTEM 0-100,000 BTU ❑ I, as owner� of Ihe pwperty, am excluslvely confrzcting with qND DVCTING Ilcensetl contraclors to mnstruct the project (Section ]044„ Business 100,000 + gTU antl Profe55loh5 COCe: The Cont�acto�'s Licensa Law tloes not apply to an owner of property who builtls or improves thereon, and who con- REFRIGERATION 0-300,000 BTU tracts from such projects with a con[ractor(s) Iicesnetl pursuant to SVSTEM tne Confractor's License Law).. .. . 300,000 + gTU ❑ I am Gz¢mpt unaer S¢ction B. & P. Q fo� thi5 . . . . . - , , BOILERS ' BTU^ reason - ' Date Owner SVSTEM REPAIR, ALTERAT.ION fherebycer[iTythatl�averea thisappli t�onantlstate haCtheabove EXHAVSTSVSTEM MULTIPLE_ . intormation is wrrecL I�gr e to comply�with all Ci� antl�county orElnantts antl state laws r atf a to�construcBon. antl he�ebv a horize - - -� upon 0865-46 White-Builtling; Canary-Applicant; Pin r\� ISSUE FEE ; GOICenrotl-Assessor 0 0 0 � . � . � � __ . ' ' 6486 IO/07/81 . ZONING REGULATION A.P. ilt ' ' . . •ZONE PLNG. REF. � �' :9.0� TL. REAR VARD (TO P/L) PKG. SPACE REQ. PROVIDED •STREET WIDTH "' ' PARK FEE S ZONING APPROVED BY � ' DATE� SPECIALCONDITIONS�n..rh. . � ELECTRICAL PLAN CHECK e GENERATOR 0-1KW_1-lOKW � TRANSFORMER •APPLIANCE 10-SOKW_SO+KW� - MOTORS 0-1 HP_3-30 HP �(INC.SOLAR) 10-50HP SO+HP � � FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ' 'POLE LIGHTS PANELS MAIN SU8 I_ SERVICE AMP ' 0 ISSUE FEE • )O APPLICATION APPROVED BV DHTE , SUMMARV OF FEES , BUILDING - .PERMIT - S ' �SMIP � E PLAN CHECK E PERMII''� ISSUANGE .§ _ VLVMBING E 9.00 . GRADING .S 'PLANCHECK E` y. . _ .. . . _ . _ _ s 'ELECTRICAL E - ` �� PLAN CHECK § -� MICROFILM s MECHANICAL E � " TOTAL FEE §, PLAN CHECK E -- "LE55 AD-'- VANCE PC § - - ' FINAL FEE 5 • � � � .. ' R. � . . .. 9 ' ' ' ' . " " _ " " ' _ _ � " _ _ ' ' . .� , - _- . . _' ' '" " _- , OWNER BIPDLE DEVELOPMFJdT, INC.' JOB ADDRESS � 1 �,�],4 Tnmhai GFtiERAL CONTRACTOR Same 418-081-42 LOT 4 Z T � CTIONS ' soi� � GAS WATER ROUGN PLUM9ING PROP. SWR. LINE ❑ MOUSE CON. � SPRINKLING SYSTEM MISCELLRNEOUS ROUGH HEATING qND AIR CONOITIONING UNOERGROUNO '�� POWER ROUGH WIRING TRENCHES FOFMS FLOOR SVSTEM 1 80ND BEPM I^I STEEL RE SHEATHING FRAME RNO FLASM�NG LATMING — IN f Ol1T - PL" -'R.BROWN COAT IR4L, FINAL G. VENT., AEFRIG. AND IHG. FiNn�. 4N0 GAS TE INF. DATE 7-13-79 BUILDING PERMIT N(l 4R42R SUBCONTRACTOR inlsc�Qat;�;J �S a-��-40 p� >c��l rJa:iw� DS 3-�-q.� r ag- �o 7`�(� ea�D �� M�,� � b �,� e�.,��P,�� ',-ea,.l � �l A�z� , ��Z �(�A:,�� Z c�eee�ta� � ,_j a/� �.��:,-._.e¢� . �.> A-,�cq r�.�n�e-. Rt ��b s�`�St. , R f� v: S •�-� �� C6-r1�oR.J� waec_Q�Q'If2 � L�e j'f �� .�iHr�''�-IV '. �.L %�iL2e`�: `i-� . /z� �-t�.. .¢�� ,�i�w� a��, �,.�,.~-. �.5 �,��• �: �J 5 s�; , 80w'q � ` tt � �,n �r .�-� � � � �`= F � W 0. a .�. y rT+ F C V] F G .� Q � a x w O a o. z W 2 3 T 6869_ 7/ 13Y79 251'.Otl TL� BLDG. �k 14 ",',2..--' - "- '- - ... .. _ 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 fiECEIVED DATE ISSUEC �.BUILDING OWNER MAIL CITY NeWD( CANSTRUCTION BRANCH A�DRESS nacNrinEiccr�+add�KelSEy�WoOdElaYd N��' ADDRESS 180 Newport Center Dr. NB CONTRACTORBI(Ldl2 Development Inc. ADDRESS 3848 Campus Dr. Suite 116 cirv Newport Beach, CA No�'S40-5505 STATE CITV _ uc. No. g2g6614 LIC. NO. SIZE __ NO.OFBLDGS. _ OF lOT NOW ON �OT USE OF EXISTINGBLDG. �-ocirlanti�l electric, plumbing and heating work. UILDING AND WOflK TO BE PERFORMED nit -0k 41 (D) 1740sq.ft. 4k 42 (C) 1603sq.ft. -0� 43 (B) 1450sq.ft. -rcxP.L 4'fq3s4•Fr. I he�eby acknowledge that I have read this epplication antl state that tha above Information is correct antl agree to comply with all laws ragulating building construction, and 1 shall not employ any person In violetion of the workman's compensation laws ot tha State of California. 1 he�eby cartify that I am properly Iicensetl as a contracto� under tha State of California Business and Profeuions Cotle, Division 3, Cnap�ar 9, entl that such licenses are in full ce antl effect, or I am exempt from t�e provisions of the of Califo usiness antl Profassions Cotle, Division 3, � 9. SIOna Pe Auihorizetl ABeni (,� -U('f - �/ S�3Y PERMIT NO. A.P. NO. BUILDING � /� / %� ADDRESS ( TRACT LOT BLOCK W ADD ALT R PA M I OWNE � L� • � r UE 8 FIRE /��".. ZONE T P � / GROVP ��T �\ APPROVED BV DATE �N � D PLANS uU1LDING EW YAR�SAPPROVED YARDSAP ROVED MAIN BVIIOING ACCESSOR BUILDII �FROM C/L STREET) FRONT FT. I FT T. FT. REAR FT. FT. DISTAN E BET. BET. MAIN & �IAIN BLDGS. ACCE:S. BLDGS. VAR.�#��-,��n� DATE..^^�IJ��i..- .......,.� � ,- i-��-/f � lOLD FOR SPECIAL .�.�lu�xcm �.. � �n � �p� ' V" . � SQ. FT. N THE AMOUNTSHOWN UNDER VALUATION IS FOR m �` THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: � VALUATION PERMIT FEE $ d M``� PLAN CHECK $ �! o V i �� ` $ �a0 TAX $ � `U TOTALPAID ��m� COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION F9�/91'Rid�`l'$R�, PERMI'I369.50 r.u.oun�icw GUJIAMtSA,GXLIYVMIV1AtlLb[b �-� - �' ' RECEIVEDBV P T � For Applicant to Fill in Completely — Use Ink Only - � BUILDING A,P, NO. AODRESS BUILDING T�E AN �RBl�e DC'V. IRC. %�DDRESS UNIT OR ADDRE s 3848 Campus I%i�. .Sjllte ilb SPACE NO. TR.NO. LOT BLK. ewpor , eac � S. TEL. -S CITV NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUClION LENDER BRANCH OWNER Biddle �i7. IIlC. ADDRESS VAIUE ARCHITECT TEL. USE $ OR ENGINEER AODRESS ZONE TVPE GROUP APPROVEO CONTRACTOR BV DATE ADDRESS TEL. CITV NO. STATE CITV %rPPROVEDSETBACKS LIC. NO. LIC. NO. � SIZE NO.OF BLDCS. (FROM C/L STREET) OF LOT NOW ON LOT ROfYT FT. USE OF EXISTING BLDG. F . Separa[e permits are required for L. SIDE FT. electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED I hereby aeknowletl8e that I heve read this epplicaiion and state that the ebove info�mation is correct antl a0ree to comply with all Iaws reg�lating building construction, antl 1 shall not employ any person in violatlon of the workman's compensetion laws of the State of Californie, I hereby certify that I am properly licensed as a contractor under SQ. FT. the State ot California Business entl Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that sueh licensas are in full force antl effect, or 1 THE PURPOSE OF ESiABLISHING A PERMIT FEE ONLV: em exempt trom ihe provisians ot the State of Calitornla Business VALUATION PEi3MIT FEE $ and Professlons Cotle, Division 3, Chapter 9. SiBnatura of P�AN CHECK $ _�_ Permiitae S _Q_ TAX �$ or - ' Authorized Agent oa<e TOTAL PAI D a 369. 50 TI.�