The URL can be used to link to this page

Home My WebLink About2002 LEMNOS DR - Building Permits t`, ' 'S 9 CITY OF COSTA MESA ppp BUILDING DIVISION F DEVELOPMENT SERVICES DEPARTMENT /B03-01 RMIT NUMBER PERMIT 4 bePoRgiso 045 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2002 LEMNOS DR Status: ISSUED Suite: Applied: 06/18/2003 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 06/23/2003 Parcel Number: 13944232 Zoning: R1 R1 Applicant: MILLER, DAVID ISSUED BY: — Address: 2870 CHIOS RD Phone: (949)631-1924 COSTA MESA,CA Zip: 92627 Owner: BIRD, WILLIAM AND CATHERINE Address '2002 LEMNOS DR . Phone: COSTA MESA,CA Zip: 92626-3536 Contractor: ORANGE COAST ROOFING Address: 2870 CHIOS RD Phone: (949)631-1924 COSTA MESA,CA Zip: 92627 License: 434674 Arch : Eng: Address: - Address: Phone: Phone: Zip: - License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING WOOD SHAKE ROOF,7/16"OSB SHTG, 1 LAYER 15#FELT,APPLY"50-YEAR COMP SHINGLES"TO 19 SQ FT PITCHED ROOF AND 9 SO FT B.U.R.TO ALSO BE REROOFED, FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,618.00 Permit: $167.25 Claim Valuation: $8,618.00 SMIP Res: $0.86 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • Total: $168.11 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 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 clays. 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 end 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 2446-46(6ro0) DECLAMATIONS 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. 4:0‘2I have and will maintain wo ers'corn tion Insu{ ce,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers satin In uran 9grier and pbticy number are: _ Carrier: Policy Number: • ,.�J )_�3 (This section need not be comp ted if the emlit is valued at one hundr oilers($100)or less.) ❑ I certify that in the perform nce of t work fylr which t is permit' sued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of li rnla,a agree at If I sh uld beat subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provq s. Applicant Signature: IL 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 DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DE ARA ON: I hereby affirm that I am licensed er vl5lo05apr0f {)ler (co ncing with Section 7000)of Division 3 of the Business and Pailessiorer,s,and my license is in full force and effect.Lic.R• L Class N.', Contractors Signature: C Date: ; .t '3_o ' 9/ 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). Lenders 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 t0 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. ❑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,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: I 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 ❑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? ❑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 California Health and Safety Code been fully complied with? ❑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 Ouality Management District or from any other air pollution control district or agency? 0 Yes 0 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (II 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? ❑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 ••F ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comp with a state laws and city or• ances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describprope or insp ction pu ••ses.I agr:•not to occupy or allow occupancy of any building authorized by this permit until final inspection. C Sig afore Of egal Ow :'(s) Date �1/O fr 3—C),A rAulh•dze• pplicant Date ;ODE 0 INSPECTION TYPE DATE =Ma coos j85PECTION TYPt PATE 1NTff1ALS 1616 Fixed System Final Fire Prevention //�qL--� 206 Final Mechanical 1266 Pool SpaFinal 208 Final Plumbing 200 Final Re-Roof 1 ' 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 fir) CITY OF COSTA MESA 1 -- . �,I BUILDING DIVISION / r p2 "�!"^: ' DEVELOPMENT SERVICES DEPARTMENT �,� 4� PERMIT PERMIT NUMBER "baenm E98-00756 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2516 KINCAID DR Status: ISSUED Suite No Applied: 07/17/1998 Vicinity: CARPORT NEXT TO 2516 KINCAID' Issued: 07/17/1996 Parcel Nunmber. 42004101 Applicant: CUMMINGS, TROY Address: �_��, ^" Phone: 71'4=938-1100- Owner: STATE OF-CALIFORNIA - i �' ',`c Address °�VICLAGE'INVESTMENTS; - \I, IRVINE CA .„,,,,,,,,„.±:_ - Phone: /7J/P O BOX C-19611 i_ E; Zip: 92713 /, i . A /j/ii" -' �u \ % ce ' �\ � Contractor/ Address: 1,7 /7,/,';','/. j '` � , i,'2 Phone:' - I/,- _ • /Zip:" - ' - ,l '"`C- License: SCOPE OF PERMIT 'INST 4 LIGHT FIXTURES IN CARPORT. - . • • FEE SUMMARY ., -. - . - \Quantity - ,,J Quantity ISSUE FEE -• $22.00 � . t`:, ---Temp Dist System/Lighting $0.00 0 - 1. _ � Temp service test• ; $0.00 - ~-^ .7 ,Busway/100.ft A'-'--- ' ' $0.00 0 . Res.a/c package $ " $0.00 " - -- ' - - Standing Section . $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical'Equipment $0.00 0 ' New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 ' Pool/'Spa $0.00 - 0 -up to 10 kva/kw $0.00 /0 Lighting Fixts C., \\\.l\ $4.00 4 up to 50 kva/kw $0.00 i s 0 , Recept Outlets-,`-' ` \'\$0.00 0 up to 100 kva/kw $0.00, ' 0 Switches., ,`,, \ .- ‘;',X,$0.00 0 -- over 100 kva/kw $0.00 ; 0 . Non Res Appl, $0.00 0 ' "•`r Low Voltage Equipment $0.00 - 0 1 Res Appl .,..\, � $0.00, 0 - Low Volt Wring System/Ckt $0.00 0 Service to 2001 \'‘ / . . $0.00�.‘,:.- '0 - =,Mist.Conduit ' ' $0.00 . 0 Service to 1000a7.\,\ .',/,$0.00 .‘..` 0.. - 'Misc.-ConCuctor. '_ - " $0.00 0 Service over 1000a / $0.00 ' ,'-0 " Circus(gen or ride) - $0.00 0 Motors to 1hp $0.00;, '-0.- - - ' , Circus(mech ride or lights) $0.00 '' 0 Motors to 10hp "y '$0:00 - , 0 _ , Christmas Tree Stand $0.00 -"0 Motors to 50hp , . , $0.00. , ' 0 Fireworks Stand $0.00 0 Motors to 100hp . =$0.00 ‘ 0 Other Electrical Fee $0.00 Motors over 100hp .$0.00_, 0 Communication drops $0.00 0- . Investigation Fee - $0.00 Sub panel to 200a $0.00' - 0 .Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 - Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $26.00 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS EX? LLED DATE_ _312/o r 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 • • 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 wo hich this permit is Issued. 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 workers'compo on In wants Mar and, number ad : Cartier: Policy Number /�111 7//?(ri WO 00/ Pe? C- (This section need not be mp/emd it the permit s 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 C mia,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 pro sio s. 'An pplicant Signature: /J. T Gr 1 , Date: WARNING:FAILURE TO SECURE WORORS'COMPE COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDITION TO THE••. OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37C6 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un. r 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.Lic.A , /C Class q ( .x Contractor's Signature: "" , C�ft-, Date: /L--( '7 —Pc �/ 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 properly 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 driver's license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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? 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? 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 Califomia 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes L I 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 part 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 Safely Code Section 42303 been made? 0 Yes 0 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. Signature Of Legal Owner(s) _ - - Date 7g And/Or�i lahad d Applicant Date coot t, IIISPFCTION TYPF DATE ItlimALS cnDF( laspFCRON TYPF DATE itcmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 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 244646 CITY OF COSTA MESA BUILDING DIVISION F �I 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us t. 11014 . FOR INSPECTIONS CALL: (714)754.5626 PERMIT NUMBER: BC09-00369 � s. PERMIT TYPE: B_COMBO /"' I( �1 t STATUS: ISSUED Sub Type: POOLSPA V\\��ijl DATE ISSUED: 09/22/2009 ISSUED BY: BJK JOB ADDRESS: 2002 LEMNOS DR CM Suite/Unit: APN: 13944232 Zoning:R1, Vicinity: POOL AND SPA Primary Occ: Const Type: SQ. FT: - 640 Valuation: $32,000.00 SCOPE OF WORK: INSTALLATION OF A 640 GUNITE POOL AND SPA AT THE REAR OF AN EXISTING SFD. ELEC: 1 POOUSPA; MECH: 1 FAU> 100K BTU; PLUMBING: 1 POOL, 1 SPA, 1 GAS OUTLET(1-4) FOR FIRE PIT NOTE: NO POOL CONSTRUCTION ALLOWED IN 6 FT PUBLIC UTILITY EASEMENT OWNER: BIRD,WILLIAM AND CATHERINE Address: 2002 LEMNOS DR Unit: Phone: City/State/Zip: COSTA MESA,CA APPLICANT: WALTERS,ANDREA Address: 2321 E 4TH ST Unit: :SUITE C601 Phone: 949-232-4779 City/State/zZip: SANTA ANA,CA CONTRACTOR: SHORELINE CONSTRUCTION POOLS AND SPAS License No. 742331 Phone: 714-449-8900 Address: 2321 E 4TH STUnit: SUITE C601 Cell: City/State: SANTA ANA,CA ZipCode 92705 ARCHITECT: License No. PHONE: ENGINEER: TODD L LACHER License No.C67656 PHONE:714-630-6114 COMBINATION PERMIT FEE SUMMARY Building Plan Check: $300.59 Building Fees: $462.45 Electrical Fees: $73.00 Mechanical Fees: $23.50 Plumbing Fees: $120.65 SMIP Residential: $3.20 SMIP Commercial: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $985.39 ^Refer to fee receipts for all fees paid for project 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE N. INSPECTION TYPE DAN INTI L CODES INSPECTION TYPE DA INIn1ALS 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 2/29-0 / 208 Final Plumbing 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code, for the performance of the work for which this t fl I herebycertifythat no excavation five(5)or more feet in depth into which a permit is issued. My workers' compensation Insurance carrier and policy •i p number are: 1, is required and that no building 1 bstructure,scaffolding,e made in ) alsewoon with rkk,, or demolitiork n Carrier �1b-. -of,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (Thfs section need not be completed ft the perm(is valued alone hundred dollars(8100)or less) T di •••,;,14 Ad ' 4 8,California Administrative Code). Policy Number: r ❑ A {t. . r '"�+.I not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require ape L1(:9C the el sion of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a • t i• do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. Signature of Legal Owner(s) Date Signature Date 3057-46(3/07) And/or Authonzed Applicant Date • • Applicant to fill in all spaces within heavy border lines and si• •all appropriate declarations. CITY OF COSTA MESA • PER IT NO- TRACT NO. LOT N'. BLDG.NO. - - - C*" CONSTRUCTION PERMIT B 50-352-4 I 6974 6/07/82 • 195.57 TL• Project Address / , ' 2002 L2.nNa3 • • • - - Owner -D04 fkkrts7 M c&1rT'n/ Phone 4'/,J D245 ■ . •• ■ • 4 Address --S...., . - ■ • ■ • • ■ • • .. Arch/Eng. 4:p.r License No. ■ • - ••t J _ •. ZONING REGULATIONS Address DESCRIPTION . O• ��'�+��/� ttt � u. IrIr ST C : 1 Contractor / Phone ' • =• • _LD Address '502'F �qa/a, &r ,t1,5 ■ GRADING ■ FOUNDATION 'g SITFTVARD SETBACK L ST. ' ••� / I LICENSED CONTRACTOR DECLARATION ■ OPLUMBINGAOMECHANICA IDE VAR• I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT „a"-, pie , -• ,t7 mencing with section 7000) of Division 3 of the Business and LJ OTHER C e e /`y Professions Code, d my license is in full force 3nd fect. PROJECT , REAR YARD(TO P/� 1 License Class - License)1.19or r PKG.SPACE REQ. C� : • PROVIDED Date RS'COMPENSATION O ' Signature /�•' 'f a STREET WIDTH PARK FEE$ . W ORKy RS'Cm MhEN SATIO N DECLARATION • • • ,A I _`_r.R . hereby affirm oke have a iof consentto self-insure or a VALUATION20o,ZONE ZONING APPROV:••t „SA DAT($/O certificate of Workers' Compensation Insurance, or a certified copy thereof(Section 8Qq0 Lab.C.). SPECIAL CONDItIONS: s Policy"No. .Ttfs L'fV - Company S rah- /•4•✓D rin- a.�1T/�irlr ❑ Certified copy is hereby furnished. - - ' �a r hi / / _I 7 ��iZ_l tia Certified copy O fit W with the city Building Division.NDECLARATIONI� '�-f/� �1Sar'�i� EXEMPTIONion Fe n WORKERS' a if the pATION ndr J i, (This section need not be completed if the permit.Is for one hundred . - - - ($100) or less). S. it�.bi-,' "mom _ ' A.,µ-. - - ' 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 PLUMBING • • • PLAN CHECK1 ., j- ELECTRICAL - PLAN CHECK subject to the Workers'Compensation Laws of California. - - - BATHTUBS SHOWERS UWE�.LIrvb 2 i (��RAV E Date Signature - - NOTICE: If after making this declaration, you should become subject ,TOILETS _ • URINALS GENERATOR -0-1 KW 1:10 KW to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE - 10-50 KW-50+ KW revoked. - KIT. CONSTRUCTION LENDING AGENCY KIT.SINKS - DISHWASHERS MOTORS _ 0-1 HP 1-10 HP 1 hereby affirm that there Is a construction lending agency for the per- n SERVICE SINKS ' SUMPS •) --(INC.SOLAR) s10'50 HP_50 +HP - formance of the work:fortwhich this perniit'is,.lssued (Se_ctlon.3097 • • - - - Civ. C.). - FLOOR SINKS FLOOR DRAINS; FIXTURES OUTLETS SWITCHES Lender's Name • ' ` _ _ - _ - • - -Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS - ' OWNER BUILDER DECLARATION - "- -- INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for 4s the Tbllowing reason (Section 7031.5-Business and Professions Code: SWIMMING POOL P TRAP ' - LUNS I NULI ION Any_city or county which requires a permit to construct, alter, POLES METERED SUB improve,demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE- ALTERATION PANELS MAIN SUB quires the a pilicant for such permit to file a signed statement that he 'is licensed pursuant to the-provisions of-the Contractor's License LawGAS SERVICE OUTLETS SERVICE - ' AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code)-or that he is exemputherefrom and the' WATER HEATERS BTU OUTPUT � •MI - basis for the alleged exemption. Any violation of Section 7031.5 by • ' any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS' ' of not more than five hundred dollars ($500). O I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and.the structure is not intended - ' ' or offered for sale. (Section 7044, Business and Professions Code; The SOLAR PIPING SYS. ISSUE FEE .-_ -Contractor's License Law does not apply to an owner of a.property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not Arg5 intended or offered for sale, If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold-within one year of completion,the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING _HEATING SYSTEM 0-100,000 BTU O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 + BTU and'Professions-Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- REFRIGERATION 0400,000 BTU PLUMBING $ tracts from such projects with a contractor(s)' licesned pursuant to SYSTEM - - the Contractor's License Law). 100,000 +BTU ❑Tam exempt under Section B.&P.C.for this BOILERS BTU reason - ' - - - - MICROFILMPLAN CHECK *$ Date - Owner - _ SYSTEM REPAIR,ALTERATION i ,575-7 MECHANICAL $ .1 hereby.certify that 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ - AD- information is correct. I agree to comply with all city and county ) - ordinances and state laws relating to construction,and hereby authorize /0/(n.t. 7eyLer representatives of this city to enter upon the above mentioned FINAL FEE $.Sroperuy fd�r )-qsp�eqctioys ou��r��°o�s. - _ oo El ' Signature "/ •� Tsui Date 1-7-,2— .. ._ . . Drivers' License or SS 40 ISSUE FEE • CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING U •`.-\ • . POOL&SPA . - r - -,�; APPROVALS Permit# Gari, 381'1 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location • - - 2. Soil Pipe-Undrgrn . 44. Steel Reinforcement 3. . Electrical Conduit-Utility;Undrgrn , , , - - - - 45. Forms . 4. Electrical Conduit-Undrgrn 1,.. - - 46. Electrical Bonding • • 5. Steel Reinforce - 47. Rough Plumbing & Pressure Test . ' - 6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE • - - • - 7., 491 Electrical Conduit-Undrgrn • . 8. Foundation . - 50. Gas Pipe, E Undrgrn,Test • 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap, ❑'Undrgrn 10. Structural Floor System • 52.'• APPROVAL TO DECK .11. .Property Sewer,_Line & Housie Connection 53. ,Backwash & Receptor-Final s e12. Street Sewer Connection , , _ -. • 54. Heater &Vent-Final • 55. Plumbing Svctem- Final •, . - - 14. Rough Electric:Conduit - " " - . - - 1 56. •Electrical-Final . 15. Rough•EIectric-Wring - - - - . " " ` - 1 '`]-I'L$2 -abs C. - - "57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing &-Access Approval 17. Ducts, in Structure - • '7_/z .&t_ C. `L 59. APPROVED FOR PLASTERING '18: Ducts, Ventilating . . . . . 19. Gas Pipe-Rough'&Test • 60. POOL/SPA SYSTEMS FINAL . 20. Roof Framing - . - 21. Roof Sheathing AS • _ 22. Frame and Flashing • - 7-11{-ga 7 y,. - x NOTES: ro_oas C c e..on) ,,,,¢ e /ejs c -113 5 t%r � 23. Insulation 7-/ii-n- R n•--1 Aa, o,✓E A4,A4- 0- C . -7--Cs---Fs-Z- ' 7-Cs-Fs-Z jJ_--- _ U' ' 24. Lathing & Siding - - 25. Drywall Nailing 7-/5'--'3a (9 26. Plaster Brown Coat ' 27. Electrical Power Meter-Final ' . . 08. Final Electric i-7-SL )9& • - _ 3. Final Heating & Air Conditioning 9.7-'g2, .oO 30. Final Gas Pipe-Test . 31. Final Plumbing ' 32: Water Service-Final - . -33. Gas Service-Final- _ 34. Solar Domestic-Final • ' 35.• Landscape Sprinkling System . 36" Sound Attenuation _ _ . - . - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 4_/p-Qle_ D 39. Special Requirements Completed . 40. Electric Release to Edison - -" 41. Gas Release to Southern California Gas Co. . . 42. CERTIFICATE OF OCCUPANCY - . ` . -No. Date OWNER DEARING1 BALD L. DA'.--»- JUN 2 5 JOB ADDRESS 2002 Lemnos Drive BUI .'YiiNG PERMIT NO. 225dr. y-GENERAL CONTRACTOR Owner-Builder VALUE $ 200.00 `. AP No 139-442-32 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK ' . Det. Patio INSPECTIONS Signature DATE GROUP .T TYPE V ZONE R1 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water • Rough Corn. Refrig. 0 Air Cond. ❑ . Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line ❑ House Con.❑ St. Swr. 0 . Sprinkling System Construction Pole Underground ❑ Power ❑ Rough Wiring Trenches ❑ Forms 0 Steel Reinf. ❑ y( %t' e-1(6-6/ Floor System Bond Beam ❑ Steel Reinforce 0 Sheathing Frame and Flashing Lathing— In ❑ Out❑ Plaster, brown coat Refrig. 0 Air Con. .0 Final Heating, Final Plumbing Fixtures, Final • Final Gas Test Electric Fixtures, Final Building, Final X DS- ,Q,A/6r/ OCCUPANCY Form BU4—SMS-63—S-B P oognh 22504 FEE RECEIVED rill) 1��u� II1 ,J Q COSTA MESA BUILDING-SAFETY DEPARTMENT Fi(�AIYCC ��1 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 • CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING ./f� '�'yY�� 17 _ ��l�/ ADDRESS T�/1J../ F.✓_VVN V11�1 (r/L1 RECEIPT NO. PERMIT N COSTA MESA. CALIFORNIA 'ZaS lit NKr Sr 11:711;0710 c M (o/ i IBS e 1 A ` l� OWNER ban n l (. . I Ono- I In MAIL 5� f ADDRESS 2 cc 2 La4,ij1/0S. biz ADDRESS 9,00,)- LP VNr\ noc., I E T // _ ,� } TEL. `' ZONE 2 TYPE GROUP �+ CITY \ (7�I (A 1�'' SLI NO. . t.19..fli ' APPROVED //�� - '/ ARCHITECT TEL BY .O /DATE �Z.71' ORENGINEBR C"`a.:..V.P r NO. C' Y_ ._ ZONING ADDRESS n '' -•' � / ONp / I NO.OP 2 I ROVED _.IX CONTRACTOR ��lA/VA 2 _ / /p�� ADORES/ DESCRIPTIONII---0-(/' I-, 1T 'la lig CITY .--.--__ A.P.NO. / 3 7— Y.D 3 NOTE: NO SAVE OVERHANG SHALL BE LESS THAN STATE - TEL. SO'TO SIDE&REAR P.L LIC.NO. NQ, VES SIZE O X I L I NNO.OF OW ON LAT . I ALL WED (U.B.C.REQUIREMENT/. OF LOT USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. p C2- I C Al a) MAIN BUILDING ACCESSORY BUILD/ G (FROM O/L STREET/ `, SETBACK LINE FROM `/'� �t{�'J FRONT FT. X FT. CENTER OP STREET J // REAR YAD'J / (((JJJ -I- SIDE YARD I LEFT ? / I RIGRIGHTi R.SIDE PT. D ,-FT. DESCRIPTION OF WORK L.SIDE PT. D. 337 Fr. �' NEW I>C II AI.TERATIQN I ADDITION REAR PT. / / Fr. I'll DISTANCE BET. BET.MAIN Q REPAIR MOVING �PEMQLiSH MAIN BLOOD, ACCESS.BLOCS. BUILDING NO.OP VAR.* DATE SIZE �� ROOMS `i STORIES_J C.U.P.# APPROVED EXTERIOR WALL ROOF ,2 APPROVED I / / //. COVERING "-� I COVERING ��S -G-Y DY u //gI,�ff �DATE VJ (O y SE O�F)BUII�DpIRS AND WORK TO DE PER r ED lYv� G' ' Y rr% 1 7 r o i l-e r V w Del' 1 I HEREBY ACKNOWLEDGE.THAT I NAVE READ THIS APPLICATION THE MOUNT SHOWN UNDER VALUATION 18 FOR THE AND STATE THAT THE ABOVE IS CORRECT)AN'D AGREE TO CON. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. 113 PLY WITH ALL CITY O DINANCES AND ST /LAWS REGULATING BUILDING CONSTRU O� �� / /1' VALUATION C) �� IQ 1/AI1 $ 07 SIGNATURE OF 1 PERMIT FEE E PERMITTEE r/U1 c /. /%.[...M /`� o • $ OvPLAN CHECK S AUTHORIZED AGENT ) f TOTAL FEE 5 OWNER PAPFSflvppR WF.RP TNT VENTURE DA" 3-22-63 JOB ADDRESS 2002 Lemnos nri.v, BUJ- ANG PERMIT NO. 19098 GENERAL CONTRACTOR Andros Land Company VALUE $ 22,592.00 AP No. LOT lit TRACT 4348 FIRE ZONE DESCRIPTION OF WORK res att gar INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE HI Soil Pb' V.76-/! PERMITS ISSUED Gas - SUBCONTRACTOR DATE NUMBER Water ' i -/' 3 a. i Rough om. Refrig. 0 • it Cond. 0 - Rough Heating '' '.."--,41-4., /,x/42 _ I' Rough Plumbing fl'ae . 7-43 .lJ�l - 1< 1 ,-/, 164, 9-;-G J ec8o,'o ' ' id Miscellaneous �� - �7 —=7\-... /�. _\_I�f' Prop.Swr.Line [04ouse Con. Tr St.Swr. 0 g .f7. I,- J.}_�j f%/_ / .. r/ z-42-�_,..� �9 \ (�I Sprinkling System / p1 Construction Pole _.? ce �Pp 2 iql�L±_z 1 Underground 0 Power ❑ _//�� a_ Rough Wiring /4"047 / ,2 63 e/.irNnf �r�c..n„/! /4-4z-G3 o%GC,o..„ Trenches fa" Forms Ifd gteel Heinf.N] r•(rrld- y-f'Y. Floor System '.16� p, r t -6 Bond Beam 0 Steel Reinforce 0 Sheathing ,pt+y- ('3 Frame and Flashing I (-Pr-G3 Lathing — In Is— Out _ Plaster, brown coat FF fel 'f '-(,� lefrig. 0 Air Cond. 0 Final Heating, Final Q, / g-/ �y Plumbing Fixtures, Final / Final Gas Test AS - i / • Electric Fixtures, Final /i.,. ', /I ,� �e Building, Final y j' -Me-r.j .' OCCUPANCY • mom MIA.FM _ ].fl 19098 FEE RECEIVED 1COSTA.MESA BUILDING-SAFETY DEPARTMENT V MAR 2 2 tQ•' P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLICATION Fc�iRtRA&COSTA MESA -2A,, ^.) y ay TYPE OR PRINT `-Ai!� BUILDING BUILDING /� �) n_ For Office Use Only ADDRESS 30 ,ri a'",R l4..ltagc2 �Ovj RECEIPT NO. PE p9r9 Y/ COSTA MESA, CALIFORNIA _ / (i /�' �� J // [ // REC81V8(De/.HY DATE RECEIVED DATE ISSUED OWNER egovez W tZ.4a./ � [fit Le„ "- �3'.0 MARL 2 I9B. BUILDING / MAIL / l / ) ADDRESS ADDRESS G ,7227C--0-1- c,c. �K�/1✓ TEL. Y‘.4- FIRE ZONE TYPE GROUP 4 rDCTY p_A- La //2„..,- NO. p 3 7 s ARCHITECT �// TEL. 7 722AAPPROVED Y DATE OR ENGINEER�C�V NO. 43G! ZONING ADDRESS 997//,/a /WWVS�CyLp✓ l ///1 t,[A.tL-Gti. ZO�g/ I rvo.OF ' /I USE oP rvp(�\J�( - it. /Tb Ll �.ce•-ad s( , it c +VEL PU