HomeMy WebLinkAbout105 THE MASTERS CIR - Building Permits Tut:. -1A- Cs-k..., ,- CITY OF COSTA MESA BUILDING PERMIT
ADOR Ss INMUM' KRISMAN, WILT 9 E TR WIT: PERM NO. H 084131
MEWS NAME IF KNOWN: 105 MASTERS l'__.
1 ADDRESS COSTA MESA,CA 92627 PERMIT NO: B 084130 PLAN CHECK NO: N GOVT. N SUFF . N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
ADPL.WANG ADDRESS:
JOB DESCRIPTION : T/O EXISTING INSTALL CAS SHAKE ICB0#4312 SQ FT: 11 , 400
ARCHITECT OR ENGINEER: DC NO.:
ARCH.OR ENG.'S ADDRESS: UPC: CLAIM VALUE: 11 , 400 . 00 CALC-VALUE: 11 , 400 . 00 GROUP OCC: R-3 /U-1
BRANDENBURG ROOFING ( 714 ) 586-4103
CONTACTarSWAo, 24242 MCKOY RD COMMENTS: X
CONmACTORSMMUNG LAKE FOREST CA 0668332 *******************************************************************************
ADDRESS: 92630 UC.NO.: ZONING REQUIREMENTS
UNT: SETBACKS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaky of perjury that am licensed under provisions of Chapter 9
(wmmenemwnl68tiS' 74Di„son3otheB rdPrdmaiona ®®y ie infEWEDedeWO/00 MAIN BUILDING ACCESSORY BUILDING
CITY LIG.NO.: UC.CLASS: UC.NO.: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
a� R BUILDER DECLARATION:I hereby affirm under penalty d perjury that I exempt from the Contrmae License law for he PARKING REQ: PRO V: PARCEL: 11939148 Z N E: REF NO:
4bbo nh reason Sion 703ure Goalless and to its ndu�essiioonns Code::Any or county MOS,requires a permit to construct alter.imp PLANNING NOTES>
applicant for such permit to file a signed statement that he or she
43,,:licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)ci Division 3 of the >
Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section ******************************************3**********•N*****3*********TE****{E*****
7031.5 by any applicant fore permit subjects the applicant to a civil Penally d not more than fire hundred dollars POO.
DEVELOPMENT SERVICES R E Q U I R E M E N'l $
❑ I,as owner of the properlyCr my employees will wages as their sole compensation,will do the work,and the structure is not intended
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of propend
who bolds or improves thereon.and who does such work himself or hersel or through his or her own employees.provided that such ZONING APPROVED BY DATE:
improvements are not intended or offered for sale.I.however.the building or inprovemen is sold within one year of completion.the
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). BUILDING APPROVED BY cif
o I.as owner d the propend.am exclusively oontradig with licensed contractors to construct Ne project(Section Mae.Dim ness andDATE:
Professions Code:The Contractors License law does not apply to an owner ci properly who builds or improves thereon and who CV
L /
contracts for such projects with a contrador(s)licensed Inman to the Contractors License law). APPLICATION ISSUED BY :
DATE:
❑ I amexempl under Section: B.A P.C..for this reason: ******************************* * ************************************ ****
Dale; Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAI' SEGMENT:Y
I do hereby certify that l am aware d and understand the requirements of California Health and Safety Code Sections 25505.pe'ne,and BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
35534,and that 1 or any Inure building occupant will/wit not(circle one)need to Compfy will said rote codes and the requirements ler
e permit for construction or modification from the Ak Quality Management Dismc.Residential oonsttucton appimtions are exempt from these PERMIT 187 . 25 1 . 14
provisions. SMIP/NON-RES
Date: Applicant: PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affimr under penalty
of perjury one of the following dedaratirs: ISSUE FEE
ElIhaveandMImantanamNlcateofconsenttoseelfinsureforworkers'compensation,as provideddvr
for bySe3700cithe ebur BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
M Code,for the performance ofthe work for whmmispent*isissued, . TOTALS----> 188 . 39 0 . 00 0 . 00 188 . 39 188 . 39 . 00
bI have and wil maintain workers'compensation insurance,as required Section 3703 of the Labor Code.for the of the
worktor whknthis pennuisSued-MYworkers€4021xEine .�ierandpagc,'numware, XP RES REVENUE DIVISION TOTALS--> COLLECTED: 188 . 39 OVER/SHORT: . 00
Canter: 1421R7H-97 04 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
, Policy Number: 187. 25 1 . 14
(This section need net be completed r the permit is for one hundred dollars I3t00f or less.)
❑ I canfy that in the performance of the work for which this permit is issued.)shell nal employ any person in any manner so as to *******************************************************************************
ecom
be subject to the workers'compensation laws o Califon- , agree tme subject f I should becobject t the workers'
1 mpg se on provisions s n d Secton 3700 of the LaborCode,I ran •es t ore INDIVIDUAL F E E BREAKDOWN
Datta:/ //-1 7 APpl L- �� TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Waning:Failure to secure worker.compensation coverage Is unlawful, d shall subject an employer to criminal penal n and
civil fins up to one hundred thousand dollars 01040001 in addition tothis cost 0lcompennt/on,damagse as peal forin SFR 11400 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 11 , 400 . 00
Section 3706 of the Labor Code,Interest,and attorney's feet
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permi is issued(Section 3097,Civ.C),
LENDER'S NAME:
LENDER'S ADDRESS:
I candy that I have read this application end stale that the above information is=red.!agree to comply with at oily end county ordinances
forrii staleylawsnrenosses.RORER BRA ENSU G of this city to enter upon the above-mentioned property
iflJr, f f r- r✓ci - 08-11-1997/11:34 Ar/4186.39
ROT4:01a01K1r
ryA � •
Pt--- ' — PERMIT:084130
rre
of Owner/AgeneAppicant/Conuaa•
(5151.46.W P) White-Building&Safety;Green-file;Canary-Appicant;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING PO ti SPA
APPROVALS •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-Undrgend. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . '
6. Electrical UFER Gr.nd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
'"r-' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
•
�' . 9. Water Pipe-Undrgrnd, 60. Backwash Lines,P-Trap, D,Undrgrnd.-
10. Structural Floor System - 61. APPROVAL TO DECK
- 11..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 I l
16. Rough Electric Wiring 67. Fencing & Access Approval 1
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 3 • 1 APPROVALS: Permit#
21. Ducts,in Structure - , . 70-.. Underground:Hydro
22, Ducts, Ventilating- ` _, f i '" 71• product Piping Q Gas : 0 Oil
23;,Gas Pipe-Rough & Test - ° -7,:.• - 72. Underground.Fljesh a
r
24. Roof Framing - - _ . 73. Undergrnd.StAege'Tatik DGas 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 i . .. 79. FINAL-INSPECTION : "
32. Electrical Power Meter-Final , B0. FOOD CERTIFICATE ISSUED
,
33., Final Electric ' - Notes: ,
34. Final Heating& Air Conditioning - r I - '
39. Final Gas Pipe-Test J I. i -
36. Hood or Canopy .r - ,
37. Final Factory Fireplace . ' -- ! ` 1 '- `
I .
38. Final Plumbing - : i
39. Water Service-Final i
40, Gas Service-Final . I _
s
. 41. Solar Domestic-Final - if
42. Backflow Preventer x -' - + •.- , • _
-43, Backflow Irrigation - '
44. Landscape Irrigation System ', ;: . - � '
-
: 45. Sound Attenuation
46.', Handicap Regulations - - ' •'
47. FINAL STRUCTURE & BUILDING ( `_ 46.4,---;
48..FINAL PLANNING [
49'. Electric Release to Edison . - . •"
50. Gas Release to Southern California Gas Co , . -- -
51. CERTIFICATE OF OCCUPANCY -
No. Date
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
/ 77 /=c /fir .t . • .. �Jep7
TRACT NO, (� �o,Y DATE 5/�14l _
LOT NO.
��
ADDRESS /6K //'/ ki `i s
cat
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-they) 2_ (was or were) (w-a--5/ 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 condition;
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.
BY
Pure aser
B& AY . / AcilLat
Devels /er and or authorT ec
representative
BY
Lender.
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA M)ES C.NST' UCTION PERMIT — PER I NO. TRACT NO. LOT NO. UNIT NO.
Project Address / 2) 4a5 s J ae -� r3 v/ sip
•
� J �
Applicant's Mailing A.cress / e, _ e ,i'de ' g // TYPE OF CONSTRUCTION LI NEW U ADD LI ALTERATION L4' EPAIR r
Owner's Name Ai IAA A Phone - J1/L.� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
- DESCRIPTION OF WORK/USE OF BLDG.
Address '�� S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ElGRADING ❑ OUNDATION ❑ STRUCTURAL E Front • 0
Address ❑ TENANT El ELECTRICAL 'LUMBING ❑ MECHANICAL B N
r/� ❑ OTHER A Rear
Contractor's Nam. Au' .. r•7 -0 / Phone aq.06s C Right - N
/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) -I n L/p� I_ L�� H' K G
/ u? CONSTRUCTION TYPE VALUATION$ Left
City License No. ' $ R
LICENSED CONTRACTOR DECLARATION ZONE GRADING CU.VDS. ACRES Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and P2444111arge
RECEIVED JUN — 8 5988 T
`e i .
my license is in full f/..ma�y a d effect. �/_J L_4
License Class
ice se No. i7IC 4 JO' $
Date ,--_. .1Z Signature g�f� _"_ _ PLUMBING FEES
"'ORKERS'COMPENSATION DECLARATION Bar Sink Showers
Cr- ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
60 Workers' Compensation Insurance, or a certified copy thereof (Section
Backflow Preventer Service Sink
3800, Lab. C. �y�r Automatic Washer Transformer ❑ 15-50 KW
Policy No , ,/9.3 V-' p Companyi 4 Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
ertified copy is hereby furnished.
Cert' c y is fled with the city B In v on� Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps
Date s Applicant / �
EXEMPTION FRO WORKERS'Co EON DECLARA 0 Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps .
(This section need not be completed if the permitpermit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountains Solar Tank Fan
Motors❑0-1 HP ❑i'h-8
Workers' Compensation Laws of California. _ -
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. -
Inc. 09-15 HP 016.15+
NOTICE: If,after making this declaration, you should become subject to the —
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY /-', Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light
of the work for which this permit is issued (Section 3097" Civ. C.)
Interceptors Water Heater Outlets
Lender's Name � Range '
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION 9
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code:Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW❑5.15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
`?Contractor's License Law(Chapter 9(commencing with SectionJ000)of
ision 3 of the Business and Professions Code) or that he/she is exempt
;efrom and the basis for the alleged exemption. Any violation of Section
.31.5 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 Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES .I
License Law does not apply to an owner of a property who builds or improves _ ____
thereon, and who does such work himself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. if, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner se have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved BY Date_ _
rove for the purpose of sale). �/uL,
LI I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
Ar
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating . 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration I BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ /� PERMIT
IDI am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ .7/_DO ISSUANCE $
Date owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BT GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of t $ cit enter upon the above-mentioned property for e
i
inspection our s
Signature Date 9F CT 0 MECHANICAL $ TOTAL FEE $ S•
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or SS#
CMF 0865-46,rev.10/84 Pink -Accounting; Goldenrod - Assessor IJ1 UUUUGY6&-UUUU6Y8, 19 I )0J
CONSTRUCTION AND•PLANNING POOL &SPA
Date Inspector - Date Inspector
APPROVALS Permit# APPROVALS Permit#
1'. TemporarwiElectrical',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-Undrgmd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
•
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,O�Undrgrnd.,
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Flna'I
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 D Oil
23. Gas Pipe-Rough & Test 72. Underground Flush ;'
24. Roof Framing 73. Undergrnd.Storage Tank D 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 •
c,
•
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED '
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test • •
36. Hood or Canopy
37. Final Factory Fireplace
38, Final Plumbing /J/Sta Z
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 & BUILDING
48. Special Requirements Completed - -
49. Electric Release to Edison • •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY • - -No. Date
• 1 I .
OWNER UNITED SAVINGS & LOAN DATE 4-27-70
JOB ADDRESS 105 The Masters Circle BUILDING PERMIT NO. 31734
GE'RAL CONTRACTOR Ryness A Smith DESCRIPTION of WORK Residence W/Attached Garage
AF - LOT 2 TRACT 6508 FIRE ZONE VALUE $ 32,133.00
INSPECTIONS Si nature Date GROUP I & J TYPE T ZONE R-1
SOIL 1144 2 -k'-7G SUBCONTRACTOR PERMITS ISSUED
GAS
Date I Number I Signature
WATER (.iq4J SS'-8-70 Plumbin• •
ROUGH PLUMBING AL .--2-6 -70 A� afi �W `r/ P ��j}�� .,�
PROP. SWR. LINE r HOUSE CON. rI'i+"f/ -f. Ade�/L:ll�nr�:�p�/ti/.r
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING A•45.C./-94.!-7 Q
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER ❑
ROUGH WIRING ‘la & 2G-.2e Heati nd e t.
TRENCHES 5g FORMS 7 STEEL RE INF. U vel,. -/^70 Imo/ i WIZOW-RIJt aA0 -
FLOOR SYSTEM ^ ��� r.,�-t0 IF Grp/ ar r -17-/a 26 /
^
BOND BEAM STEEL REINFORCE l l /
SHEATHING ' /. in
FRAME AND FLASHING J// (/)-jC
-
LATHING - IN Al OUT RI' rrrra�t'' 74 /to
PI 'R, BROWN COAT 4. 7 fr.//r70
ST._...TURAL, FINAL n ElecYtric
7/ /�
HEATING, VENT., REFRIG. AND A.C., FINAL A/a 2- vezez n/r&./.ae• 7-,q8 ,_f//i7.-
PLUMBING. FINAL AND GAS TEST n 443T'/' 47 )
ELECTRIC, FINAL i{ /r 3"--.26.7/
BUILDING, FINAL M 7 %
/. //S/ r- o
2a j31. PAID
APR 29-7rE�Si 001 671* ***163.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEI9V DA � E SSUED_BUILDING 027-7a
ADDRESS 105 The Masters Circle
PERMIT/Mt
OWNER United Savings S. Loan Assoc. A.P.NO. — .-k i 1.14
—
MAIL BUILDING
ADDRESS 9800 S. Sepulveda Blvd. ADDRESS �0//S )14fLc- O
al La L
CL U CITY Los Angeles, Calif. NO.670-7550 TRAC'QSO LOT BLOCK
- CONSTRUCTION NEW (ADD ALTFR REPAIR (MOVING DEMOLISH
)-- LENDER Owner
am
J D BRANCH
J N — OWNER
CO J ADDRESS VALUE
m ARCHITECT TEL USE $
JQ OR ENGINEER R.J . Marvick No.839-3840
U co —
FIRE
W M ADDRESS 1538 N. Century, Santa Ana ZONE TYPE GROUP
d W APPROVED
LLI J O _CONTRACTOR Ryness-Smith Co. BY DATE ti,,3
fS
JCC ADDRESS 140 E. Industry Ave.
w W Z E
TEL
NO.OF USE OF
CITY La Habra, Calif. N0. 879-3111 (- / IPLANs s........ BUILDIN )4.-
O STATE CITY YARDS APPROVED YARDS APPR,VED
LU
¢ LIC.NO. 167538 LIC.ND. 1964 MAIN BUILDING ACCESSORY BUILDING
70 (FROM C/LST EET)
SIZE NO.OF BLDGS.
OF LOT 45 x 115.50 NOW ON LOT FRONT C FT. FT.
JUSE OF
EXISTING BLDG. R.SIDE 3 FT, FT.
I— SIZE OF NO.OF 1
2 NEW BLDG. 2165 ROOMS 7 STORIES 2 L.SIDE FT. FT.
Q EXTERIOR WALL ROOF / j
V _COVERING Stucco COVERING Wood Shake REAR 11 4' FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 - MAIN BLDGS. ACCESS. BLDGS.
Q VAR.#7E/5-- le .,1 (e DATE B-t 7-
Single family dwelling 8 two C.U.P.gq-�w fj- 69 APPROVED / -b-/ay
Z car attached garage APPROVED tut-0 fa'/--II c//n v
—gVATE n /
O
Lot 2 Plan 4-A QW IM
VI hereby acknowledge that I have read this application and state
D that the above information is correct end agree to comply with
CC all laws regulating building construction, and I shall not employ
I— any person in violation of the workman's compensation laws of
fA the State of California. Q m
/ O
Z I hereby certify that I am properly licensed as a contractor under �/� SO. FT. ✓ 0
the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN 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: a
cc
am exempt from the provisions of the State of California Business
VALUATION %O
and Professions Cod Division 3,Chaptr
9ry
•b PERMIT FEE $
Signature of
m
Permittee $ 3r� /33 PLAN CHECK $ ��S E
/ a
/13 s '21-
...
Authorized Agent f TOTAL FEE $