Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1810 TANAGER DR - Building Permits
CITY OF COSTA MESA o:Alw kiss BUILDING DIVISION •.�0 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us v CIPNI FOR INSPECTIONS CALL: (714)754-5626 Rs.ti PERMIT NUMBER: BX10-00219 PERMIT TYPE B_MISC STATUS: ISSUED APN: 13963209 DATE ISSUED: 10/14/2010 Zoning: R1, ISSUED BY: JOB ADDRESS: C1810-TANAGER DR7CM-`77 Suite/Unit: Vicinity: FRONT EffTRYWAY Phmary Occ: Const Type :7? SQ. FT: 0 Valuation: $6,000.00 SCOPE OF WORK: • ADD GABLE ROOF OVER AN EXISTING FLAT ROOF AT FRONT ENTRY WAY. OWNER: DONNELLY, FRED D TR Address:: 1810 TANAGER DR Unit City/State: COSTA MESA,CA Zip Code: 92626-4848 Phone: APPLICANT: FARTHING, SCOTT Address: Unit: City/State: Zip Code: Phone: 949-645-9325 fi 9 CONTRACTOR: FARTHING DEVELOPMENT INC License No. 560875 Address: 904 DOGWOOD Unit: City/State: COSTA MESA, CA Zip Code: 92627 Phone 949-500-2870 Cell: ARCHITECT: License No. Phone ENGINEER: ALEX WHITE PATTERSON License No. 24968 Phone 714-875-1589 FEE SUMMARY Building Plan Check: $81.41 Building Permit: $125.25Fr-zr tl„i, Electrical Permit: $0.00 SMIP Residential $0.60 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 I-,nil, TOTAL FEES $208.26 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Satrudays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal Holidays: New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day 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/. INSPECTION TYPE DATE INTTALS CODE/ INSPECTION TYPE DATE • INTIMLS 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 ICI �� ,•J 204- Final Demolition 250 Final Building/Occupancy 7. I VZ--- t b WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0 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. `o I have and • maintain worke compensation in ranee, as required by `section 370 o e Labor C the performar the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is i ed. y workers' mpensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This section need not be completed if the permit is valued al one hundred dollars($100)or less.) 2,Art 2.Sec 341.Title 8,California Administrative Code). 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division 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 permit to 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 corn • ese provisions. DDivision of Industrial Safety Permit Number: App awre 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No c`tf#_ / - •. s# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by z/ each business which at any one time has on hand a quantity of acutely Contr6aw$trstgnat 1. , -Dae 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 fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 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 Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 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 Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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 0 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 Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 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: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read [his application and state that 0 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. Signatur gal ) Date /a/7'W/0 Signature Date 305746(3107) Anhnw-N.etn+m y'0.0*+icagi Da CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. &C 6 a DATE /0 ' /-90;72 LOT NO. eS la ADDRESS /A/a fl. oceeC 'O2 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 streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement , acknowledges that (he-she 1M (was orig.', 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 harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. B122 flft i / Purchaser BY SLICJCOGO Cdaa Developer and/or auYYorized representative BY ' /" /Grv,eal9Vadal Lender PROJECT AODflESS: 1810 TANAGER DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 056531 OWNER'S NAME: CURTIS ROBERT A ADDRESS: 1810 TANAGER DR PERMIT NO: B 056534 PLAN CHECK NO: N GOVT: N SUPP; N COSTA MESA,CA 92626 CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: OTH ARCH/ENGINEER: �57-5077 REG./10.: JOB DESCRIPTION : REROOF 3000SF RESID & GARAGE W/ASPH SHIN SQ FT: 5, 900 ADDRESS: UNIT: • CLAIM VALUE: 5, 900. 00 CALC—VALUE: 5, 900. 00 GROUP OCC: R-3 /M-1 PERMITTEE: ROBERT CURTIS ( 714 ) 557-5077 ADDRESS: 1810 TANAGER DR COMMENTS; X C.M. CA 92626 ************************************R•***kir********>:** u•****3E*x********4****+i # LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS \ CITY LIC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING • - ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: Ihereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT _N POLICY NO.: EXP.DATE: COMPANY: PARKING REQ. PROV: PARCEL: 13963209 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOtES> > Date: Applicant: *************k****3E****Bi****************iE***k***********?Lii*)8-14-Y.-******#***3E*li**** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is fee one hundred WOO)or less). DEVELOPMENTSERVICES REQUIREMENTS 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. ZONING APPROVED BY DATE: Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; DATE; Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: ereby affirm that there is a construction tending agency for the performance of the work for APPLICATION ISSUED B Y; — fy— DATE. 3I (t (%i._ —�~ L which this permit is issued(Section 3097. v.C). *********************k-**k************* ***************sr**************£fir* k*kk LENDER: ************if*********************************aE******************************** ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT; Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 . 00 - . 59 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business — and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN _ , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE I. as owner of the property or my employees with wages as their sale compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 81 . 59 0 . 00 81 • 59 81 . 59 • 00 •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.II,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 REVENUE DIVISION TOTALS——> COLLECTED:. 81 . 59 DV ER/SHORT• . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIFl.. SMI /TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 . 58 © 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 acontractor(s)license pursuant to the ContractorsState License Law).l am aware ****k-***iE*************k-*********k' ;.***+.d(.*****k**********aI*************j=*******7i.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. -• for this reason: / TYPE QTY DESCRIPTION UNIT COST TOTAL COST Dale: 3�(t�9� �^Sr"`eirG' 6SFR 5900 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 900 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and eeND OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a —1 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from . ( these provisions. Date: Applicant: I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county ry ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. y� �,, 12;19 I _ _ _ Date: 3—//- 9z /Signature: �L'Wa'K. a. Cab- 7 1/ � /' a/ 9 �� !11TCi.' 1:3; -t It'.r r, . _ Driver's License or Social Security A 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APP°,OVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. 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. Electrical UF ER 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, ❑ 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 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 7 tett 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 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. FINAL STRUCTURE & BUILDINGf) / /y044, 48. FINAL PLANNING E 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date • 440 sits CITY OF COSTA MESA v A. BUILDING DIVISION F i ... .. i PER IT NUMBER sk �.�, DEVELOPMENT SERVICES DEPARTMENT Brox PERMIT E00-00007 on le (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1810 TANAGER DR Status: ISSUED Suite No Applied: 01/04/2000 Vicinity: KITCHEN&DINING ROOM Issued: 01/04/2000 Parcel Nunmber: 13963209 ISSUED BY: Applicant: CHERF, PAT Address: 949 AZELEA Phone: (714)546-0318 COSTA MESA, CA Zip: 92626 Owner: LEE, TERRENCE MICHAEL Address 1810 TANAGER DR Phone: COSTA MESA,CA Zip: 92626 Contractor: CHERF CONSTRUCTION Address: 949 AZELEA - Phone: (714)546-0318 COSTA MESA,CA Zip: 92626 License: 362537 SCOPE OF PERMIT INSTALL 8 FLUSH LIGHT FIXTURES. FEE SUMMARY Quantity _ Quantity ISSUE FEE $23.50 - - Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $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(3+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 $8.80 8 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over.1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $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 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 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. 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 workers'compensatiorkinsurance carrier and,policy number are: Carrier: -S�o7- T �usi"' ) Policy Number: COO (This section need not be completed i/the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in tri erformance 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 law alifornia,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these // Applicant Signature: Vim" Date: //era WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COV RAGE IS UNLAWFUL ANO 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 COOE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provi 'ons �oftChapter 9(commencing with Section 7000)of Division 3 of the Businps and Professions Code,and my license is in full force andeffecg atuLic.e -( Z Classat : N / Contractor's Signature: Date: %low 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: Lenders 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,after,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 driver's license. 0 Yes ❑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: Cl 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,Gm 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 ❑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). ..._.. the applicant present or building egs.t,ration..fom.—_—u 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑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 _ prepare 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? 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 01 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 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 Califomia 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 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. Sin re Of Legal Owner(s) / !7, e d — Y 620 And/ uthorized Applicant Dale CODE I 185PFCTION TYPE r111 INTIMAL$ CODE INSPECTION TYPE 1191E JNTmAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing n 200 Final Re-Roof 210 Final Electrical /-17 - on YUP- d 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 2446-48 J '9 q Mp CITY OF COSTA MESA o a'_t BUILDING DIVISION ,ti PERM NUMBER �r ' DEVELOPMENT SERVICES DEPARTMENT • PERMIT • 00-00036 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1810 TANAGER DR Status: ISSUED Suite No Applied: 01/13/2000 Vicinity: KITCHEN&DINING ROOM Issued: 01/13/2000 Parcel Nunmber: 13963209 pp Applicant: CHERF, PAT ISSUED BY: Address: 949 AZELEA Phone: (714)546-0318 COSTA MESA,CA Zip: 92626 Owner: LEE, TERRENCE MICHAEL Address 1810 TANAGER DR • Phone: COSTA MESA,CA Zip: 92626 Contractor: CHERF CONSTRUCTION Address: 949 AZELEA DR - • - - Phone: (714)546-0318 • COSTA MESA,CA Zip:- 92626 License: 362537 • SCOPE OF PERMIT SUPPLEMENTAL ELECTRICAL PERMIT-INSTALL 1 OUTLET AND ONE NEW CIRCUIT. • • REF:E00-00007 - • FEE SUMMARY . Quantity Quantity ISSUE FEE $7.25 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $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(3+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 $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $1.10 1 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $18.20 1 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $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 $26.55 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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 DECLARATIONS r ' • 0 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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 rk 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) O 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 alifomia,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 prov' / (49 (Jl Applicant Signature: Date: /l//3 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OVIL 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 ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions•f Chapter 9(commencing with Section 7000)of Division 3 of the Business ens"Professions Code,and my license is in full force and effect.Lic.k - - Class 0 f ' Contractor's Signature: NE -.4. - Date: e...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). 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.). O I, as owner of the properly, 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 driver's license. ❑Yes ❑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? 0 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 S00 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 ❑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 0N (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. ...._........ ...ispr.___. ctio f.the aHealt and . . -.fully .............. ...... ........ ....._ 4 If an RMPP is presently required,has Section 25534 of the California Health 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? IYes L-I No (Section 65850.2 of the California Government Code requires that the requested information bo 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? in Yes 0 No (If"yes",the faculty must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7..... r... .,.ro Quality m'__.- other pollution.... 7 Ifa a is tion fhav tae South isclos Air ri a by Calient is Heal hr nd fet Oecontrol 42303 district been 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 made? ❑Yes ❑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 end 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. •i Legal Owner(s) f at A fiAuthorized Applicant Date CODE r INSPFCTION TYPE DAA INTmAL6 CODEI INSPECTION TYPE Q> E INTITIALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 1_18'00 tk 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 1ST LOS Angeles Corporation DATE 3_13-72 JOB ADDRESS 1810 Tanager Drive BUILDING PERMIT NO. 34317 GENERAL CONTRACTOR The Buccola Co. DESCRIPTION of WORK Res.w/att.garage AP No. LOT 68 TRACT 6663 FIRE ZONE VALUE $ 42, 500.00 INSPECTIONS SignatureqDate GROUP Mt' TYPE V ZONE R-1 SOIL AOSV-,-7 J2. PERMITS ISSUED GAS SUBCONTRACTOR Date Number ' Signature W ATER j/Q44A-if_.7Y P lumbi n• ROUGH PL GG MB I^I NG ' ' - ]� ������%1ffalik /tfWe? 9-- PROP. /PROP. SWR. LINE El HOUSE CON. ❑ i •• r .V it .VrW-_i -. r SPRINKLING SYSTEM MISCELLANEOUS q � ROUGH HEATING AND AIR CONDITIONING /1/S6 -rO ;--,j- TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER El ROUGH WIRING � 9y/ toting and Vent. TRENCHES FORMS STEEL REINF. n- / ,� FLOOR SYSTEM ,-`o_ gC-/ J Q r rc' `�- � VZ BOND BEAM n STEEL REINFORCE � %"" I i; ,/fj �,•• • / 7( (Jp.{A� SHEATHING FRAME AND FLASHING to • LATHING - IN i OUT Or &11��!7/f1 'T PLASTER, BROWN COAT /� 54117 -- PLUMBING, SFTRUCTURAL, REFRIG. GASATEST nFINAL �1 � )/ CO �54-4 (_ .7-21-p 5119/ —• ELECTRIC, FINAL ./ /�r']01-- // _ r •' PLAN NO. 11B 3431 7PAID ' ',R 2?-72cri;,,00 940* ***203.58 LOT NO. 68 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely r RECEI lofyi DATE RECEIVED DATE ISS D BUILDING dc] ('t / ADDRESS /��C Tanager Drive 7 PERMIT NO. OWNER 1St Los Angeles Corporation A.P. NO. 3/131 BUILDING MAIL �t ADDRESS /WO ADDRESs#1 Wilshire @ Grand ��/OTiv�ys.2/,rQ,e/ vc d U CITY Los Angeles NO`'625-7341 TRACT-4'13 LOT f�G BLOCK Z CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH 0k LENDER 1st Los Angeles Corporation ✓. am J r BRANCH ) /y JD) OWNER rT Z.,47C.O/CP. •_ aJ ADDRESS#1 Wilshire A Grand 1.0,7i.„ I VA/LUE / J Q ARCHITECT TEL. USE `�[.W $ H'�SdO OR ENGINEEppREaTl G. Kaltenbach NO. 547-8046FIRE `/ �� W m ADDRESS1823 E. 17th, Santa Ana ZONE TYPE GROUP d- 11 APPROVED LLIJ Z CONTRACTORThe Buccola Company BY DATE 03 J ccADDRESS4501 Birch Street wuJ TEL. ZONE NO.OF USE OF NEW/Ctrs w/i/rr Z I- CITY Newport Beach NO, 540-8833 ,C-_/ PLANSZ BUILDING CRS GRR• W O STATE CITY YARDS APPROVED YARDS APPROVED rn CC LIC, NO. 146423 LIC. NO. 21011. MAIN BUILDING ACCESSORY BUILDING D 0 (FROM C/L STREET) SIZE NO.OF BLDGS. OF LOT 6 t x 100 t NOW ON LOT 0 PONT 0 FT. FT. USE OF EXISTING BLDG. R.SIDE 3 FT. FT. I- S1ZE OFcc NO.OF 2 NEW BLDG?)9W sq ft ROOMS 12 STORIES 2 L.SIDE l FT. FT. < EXTERIOR WALL ROOF /' _o COVERING COVERING Shake REAROZ�J FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Ct. ��/yam. MAIN BLOCS, ACCESS,BLOCS. Q / '/ r v(/" i C UVAR. P.# APPROVED 0 I— APPROVE '/ co RY Ydco6yP� DATFrel -a2 V-70 - p POLO FOR SPECIAL REOUIREMEN^TSS UI hereby acknowledge that I have read this application and state STAO� /10ID D that the above information is correct and agree to comply with xt CC all laws regulating building construction, and I shall not employ 9; V/(/`y' / 1- any person in violation of the workman's compensation laws of G (O co N the State of California. m zI hereby certify that I am properly licensed as a contractor under SAia'FT. o the State of California Business and Professions Code, Divislcn 3, THE AM HOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e cr am exempt from the provisions of the State of California Business and Professions Code,7i ions3,Chapter 9. VALUATION /a ' co Crffik /" ion PERMIT FEE $ 1 j Signature of l..fA�— u,/ b m Permittee �' $ /��� PLAN CHECK $ 7— E o LL Authorized Agent ` TOTAL FEE $ C9-O/r r OWNER LOWE, Jere, W. DATE 2/21/73 ` � JOB ADDRESS 1810 Tanager Dr. BUILDING PERMIT NO. 36111 GENERAL CONTRACTOR Owner Bldr. DESCRIPTION of WORK Patio Cover Q APNo139=632-09 LOT - TRACT FIRE ZONE VALUE 3,000.00 Y INSPECTIONS Signature Date GROUP 3 TYPE IIT ZONE P-1 k SDIL PERMITS ISSI4ED AS SUBCONTRACTOR Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. I:I SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS El STEEL REINF. LI /Trim¢ 1 J-1.4, FLOOR SYSTEM BOND BEAM [1 STEEL REINFORCE [1 SHEATHING • FRAME AND FLASHING LATHING - IN [1 OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST f ELECTRIC. FINAL BUILDING, FINAL __ /f'/ 7-Z-7. • 3 6 I I I „ .,c- WI eo9 - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING/ �JPERMIT RECEIK ,BV DATE RECEIVED a-tv-/ f aTE�1_75 ISSUED BUILDING // p -T T L� ' ADDRESS` / pi� /AN f16BK Vz\�/L �C� /2 /meq / OWNER S�� W,4._oleic A.P.NO./J /�E.7,JZ�V/ PEFill N7// BUILDINGMAIL .// J(Es ADDRESS SAwv Z.11.1 Lli ADDRESS O r t //� a 0 CITY �S7r7 M of; NO.S`FO_O/9r TRACT 3 LO et BLOCK Z CONSTRUCTION NEW ADD LTER REPAIR MOVING OWs1OLLSH O< LENDER am �� ��it/ � J BRANCH J CO OWNER L.G'�tiL < LLI J ADDRESS 7LLUE //////��//��ssqq � ARCHITECT r TEL. USE �/ r $ Y/v�T J < OR ENGINEER 014 rt.__ L/GNA NO. U Q FIRE / �� W Cr ADDRESS ZONE / ��( 6ROUP a W APPROVED ' - mO CONTRACTOR (/l/Z{ .sY _A ��Y BY GATE 1 )1 Z •I J cc ADDRESS . W Liz Z01:72 ZONJ�/6J.� / NO.OF USE OF NEW/4'72e 0= CITY NO. tc. (/ IPLAfS'7/ BUILDING ham/ Z I- w O STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZE NO.OF BLDGS. /(�J� OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. �2.LZSl ts( U�Iii _a.SIDE FT. S FT. I- SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. 3/ `� FT. o 7 eEXTERIOR WALL ROOF COVERING I COVERING REAR FT. .5 FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a O. MAIN BLOCS. ACCESS.BLOCS. /�/ QDATE ��� 1 �-t CURP.# APPROVED 0 _ // APPROVE L�._t 73 V) —B_Y �r1 DATE / Z / O FQTATC U I hereby acknowledge that I have read this application and state r that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ r F, any person in violation of the workman's compensation laws of C to the State of California. TAX Z I hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses ar In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: R am exempt from the provisions of t e State of California Business VALUATION n and Professions Code,Division 3,Ch pter 9. _//, // ./ PERMIT FEE $ VL sG -C/ gi Signature of ///jjj /� Permittee L) / $ n w /`� PLAN CHECK $ /V I E /��/"V 37 d Authorized Agent u TOTAL FEE $