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Home My WebLink About121 THE MASTERS CIR - Building Permits t 5041 9 CITY OF COSTA MESA 4 BUILDING DIVISION > • •n.• ,i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER I PERMIT 11302-00218 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 121 THE MASTERS CI Status: ISSUED Suite: Applied: 02/14/2002 Vicinity: LEFT PROP LINE Issued: 02/14/2002 Parcel Number: 11939144 Zoning: • Applicant: GUTIERREZ, JESUS ISSUED BY: 7$',� Address: Phone: 714-667-3977 • ' Zip: Owner: MONTAPERT, ANTHONY Address /41 ROYAL ST GEORGERD Phone: NEWPORT BEACH,CA Zip: 92657 Contractor GUTIERREZ CONSTRUCTION COMPANY Address: 1636 ELM ST Phone: 714-6673977 ANAHEIM,CA Zip: 92805 License: 719696 Arch : - - Eng: Address: Address: ' Phone: Phone: • Zip: License: License: SCOPE OF PERMIT• 35 L.F.OF 5 FT. HIGH BLOCK WALL ALONdTHE LEFT SIDE OF PROPERTY LINE PER CITY STANDARDS. FEE SUMMARY Plan Check: $19.24 Calc Valuation: $700.00 Permit: $29.60 Claim Valuation: $0.00 SMIP Res: $0.50 - SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 ' Total: , $49.34 • 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 NOTES: 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 2446-46 WOO) 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 tris 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 at one hundred dollars($100)or less.) [C} 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,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 provisions.)/J � Applicant Signature: ��( //L - sr Date: �(/tl 70 2— WARNING:FAILURE TO SECURE WO S'COMPENSATI COVERA IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN A[5DITION 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 of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full fforce and effect.Lic.# '�( Qh. Class rl Contractor's Signature: Date: 17,///It 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 properly,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 0 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 Califomia 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? 0 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? 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? I�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 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 COMPUANCE 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 And/Or Authorized Applicant �,/J4 Date 2//y th 9i CODE C. INSPECTION TYPE DATE (/f"1NTIRALS % !/ CODE f INSPECTION TYPE PATE YOTIALS 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 V—Z7"V� (/)C 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 •THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN 21fi•6:6'IN HEIGHT SHALL ONLY. APPLICANT IS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 101 FROM FRONT PROPERTY LINE. AN ACCURATE RiPRFSENTATION OF MEM PROPERTY IN CASE 7HE SHAPE AND sin DO NOT CORRESPOND •SOLID WALLS/FENCES SHALL NOT EXCEED 7 V IN HEIGHT W1771 THE INFORMATION PROVIDED ON THIS SHEET. WIDEN 10'OF DIE FRONT PROPERTY LINE(NOT CURB LINE). •VERIFY DISTANCE FROM CURB TO PROPERTY LINE APPROVEDAND SHOW ON PIAN. VERIFICATION FROM THE GINS ENGINEERING DIVISION IS REQUIRED. CALL(714)7545343 TTY a sit)-c••R INFORMATION. ,OF; ;.Y TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping optional -- -- GENERAL- NOTES Channel Stock With 1,3/BO . ..'I ., _� Horizontal Top of all _ - Forces `k II ' , I MORTAR; �hreeert Plastic Po is Sand Cement, and 0� ��'� II One Part PaThree and For Fences 5'or Less ISI I`� GROUT: One Half Parts Stand Ven.Bars 3/B"¢-ii e' 0"O.C_. d o COPING: One Port Cement, Three For Fences Higher Than 5' - ! 4 'i �� Parts Sand Ven. Ban 3/8"� at 32" O.C. _ > W — — CONCRETE: Well Mined 1:2-1/2: 3-1/2 r In a z Moa of 7- 1/2 Gallons of Fill Cells Solid With Grout ICI > Z i „ Water Per Sack of Cement Where Steel Occurs r�Be� ). - - Reinfnrcing Steel Shall — .Bpl 2 to GROUT MAY BE POURED FROM THE TOP �IIIYYYY dee■ OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A1539 I,I o r OCCURS. A.S.T.M, - • IBI I" —' 1� CELLS AND AREAS OF HORIZONTAL REIN All Steel to be Lapped 1 w pi FORCEMENT SHALL BE CLEAR,CLEAN& N 4 I FREE OF ALL MORTAR DEBRIS,ETC. 24"or to Code - al NATURAL GRADE III x_11 I TWO 3/B"0 BARS , �t o� CONTINUOUS TOP " " &BOTTOM . 111 IF WIDTH li TO 16' 0 C MAX e SEE CHART • HIaRSZSTEEL MUST BE TIED IN BELOW p[cTH (.F [eRTMiCOTM PLACE AT TIME OF TRENCH • I , •/., tilt HEIGTH OF FENCE INSPECTION. _ L -MOW BOTTOM OF FOOTING t-0- 1 O 2,.j SCALE: 1/2" = 11 FOOTING REQUIREMENTS CHART f WALL HEIGHT 6' $ 4' 3. 1 WIDTH 14" . 14" . 12". 12" THICKNESS • 10" 10" 8 " • 8 " yr,. DEPTH OF EARTHTOOTH 24" 20" . . 16" 12" SPACING OF EARTHTOOTH 12' 14' . 16' 16' 1' l BUILDING DIVISION ) ) ! p CITY OF COSTA MESA (__- BUILDING DIVISION et rj4. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1. 1 PERMIT `°�ro� B02-00113 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 121 THE MASTERS CI Status: ISSUED Suite: Applied: 01/23/2002 Vicinity: - Issued: 01/23/2002 Parcel Number: 11939144 Zoning: Applicant: MONTAPERT, ANTHONY ISSUED BY: Address: 41 ROYAL ST GEORGE RD Phone: 949-644-7036 NEWPORT BEACH,'CA • Zip: 92657 Owner: MONTAPERT, ANTHONY Address 41 ROYAL ST GEORGE RD Phone: NEWPORT BEACH,CA Zip: 92657 Contractor: Address: Phone: • Zip: License: Arch Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT - INSTALL MASONITE SIDING IN PLACE OF CEDAR SHINGLES ON THE GARAGE IN-FRONT OF THE RESIDENCE.APPROX. 300 SO.FT. ICBG#2319 AND 3567 • FEE SUMMARY Plan Check: $25.19 Calc Valuation: $1,000.00 Permit: $38.75 Claim Valuation: sl,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $64.44 • 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 NOTES: • • 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 2446-46(6/00) 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'compensayo/n III s ance caro r and policy number are: Carder. �y7 (- Policy Number: (This action need not be completed it t e p it�alued 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' (�1(\ compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Se tion 3700 f the Labor Code,I shall forthwith comply with thes/e provlsio�7s. � Art1 n O 2-- WARNING: :Applicant:Signature:-Ar- a4��./ '. Date: 3 d� WARNING:FAILURE TO SECURE YPOR RS' PENSA7 COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DDI I ARE(5100,000),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 DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my lidense is in full force and effect.Lic.II Class# Contractors Signature: Date: 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: 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,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 i:� -,sfness and Professions Code for this reason: (Signature:— '-``a'. i i . Date: ( 7-4 0 Owner IOvedfied by driver's license. ■ Yes 0 ,o Drivers License No. : 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 B,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 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? 0 Yes 0 No (Section 25533 of the Califomia 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). ...oprose t future 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 California Health and Safely 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? Il Yes LJ No (Section 65850.2 of the Califomia Govemment 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 0 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 Califomia 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-describe• . "•:dy1or:ss/peclioonnn uurp I agree not to occupy or allow occupancy of any building authorized by ispermit uf�til final inspection. /�_gnaSi ature Of Algal Owner(s)� ' Y�1 JZ/ UDate And/Or Authorized Applicant Date CODE I INSPECTION TYPt allE &MAU CODE! INSPELTON TYPE PAM Mali 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 0Z�S"P,� 'k , • 4L,SAt CITY OF COSTA MESA r71� BUILDING DIVISION F ,IDEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER 4 PERMIT +�R"� B02-00080 Pomo'et (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 121 THE MASTERS CI Status: ISSUED Suite: Applied: 01/17/2002 Vicinity: Issued: 01/17/2002 Parcel Number: 11939144 Zoning: Applicant: PANGBURN,DEBI ISSUED BY: Address: 1007 W GROVE AV Phone: (714)997-9449 • ORANGE,CA • Zip: 92865 Owner MONTAPERT,.ANTHONY Address 41 ROYAL ST GEORGE RD Phone: NEWPORT BEACH,CA Zip: 92657 Contractor: FAIRWEATHER ROOFING INC Address: 1007 W GROVE AV Phone: (714)997-9449 ORANGE,CA Zip: 92865 License:- 770565 Arch : _ Eng: Address: _ Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT - TEAR OFF EXIST.WOOD SHAKE, INSTALL 7/16"OSB; INSTALL 30LB. FELT AND 25 YR.COMP.SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,992.00 Permit: $125.25 Claim Valuation: $5s92.00 SMIP Res: $0.60 'SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • • Total: $125.85 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 NOTES: • 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 2446-46(WOO) a. DECARA,TIONS ,.5 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 sell-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. !KT- My ave 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�Qrkers'compo anon Insurance carrier and polic nu bar ere:�y�� ,/ Carrier: A I Y)V Ou�Q CTC-'C� an S C5 r�-) 6%Y Policy Number: (This se io need not be completed if the permit is valued of 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 California,and agree that if I should become subject to the workers'_ nsation provisions pt Section 3700 of the Labor Code,I shall forthwith thes ;i ` s. pI InD• - rre: 11311k_...� t :17/ ate: l '•-UNG:FAILURE TO SECURE WORKERS'COMPENt TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CPI INAL PE ALTIES AND OVIL FINES UP TO ONE HUNDRED THOUSAND DO I ARE($100,000).IN ADDITION TO THE • T OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF T E LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED_,�•. :: ORS DECLARATION: I •", ., • am lice :d under.rovision of Chapter 9(commencing with Section 7000)of Division 3 o an r Sessions Code,and my license is in full l. Clas # C. tor's S.nature: I�K� `• 'II -.mit 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 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: ❑ 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,Gry 2,Art 2,Sec. 341,Title 8,Califomia 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 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? 0 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 a plication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ID Yes U No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Wilt any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑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 Safety Code Section 42303 been made? ❑Yes 0 No 8 (It'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. Ignature Of Legal Owner(s) _ L't� And/Orr rized plicant _ •. : ` CODE L INSPECTION TYPE, USE INTmALS CODE! INSPECTION TYPE PAIE IIW 1616 Fixed System Final Fire Prevention 206 Final Mechanical - 1266 Pool Spa Final 208 Final Plumbing .. 200 Final Re-Roof 2'S— Z61E-- 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 OF BUILDING: 121 THE MASTERS CI UNE _ CITY OF COSTA MESA — BUILDING PERMIT NAMEIF IolCWN: MONTAPERT, ANTHONY PERM NO: B 077059 _. ADDRESS: 41 ROYAL ST GEORGE RD NEWPORT BEACH,CA 92660 PERMIT NO: B 077059 PLAN CHECK NO: N GOVT: N SUPP : N APPL.SWUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH ARCHITECT OR ENm4EEn. uc.NO.: JOB DESCRIPTION : T/OFF SHAKES SHEATH & REROOF W/COMP SHIN SQ FT : 4 , 000 ARCH.OR ENG.'S ADDRESS: U -: CLAIM VALUE: 4, 000 . 00 CALC—VALUE: 4,000 .00 GROUP OCC: R-3 / CONTRACTDITSNAME WHITNEY ROOFING ( 714 ) .48-0769 coNTRACTORSMutmG 15396 PO BOX COMMENTS : REROOF 1900SF RESIDENCE W/COMPSMOKE DETECTORS REQUIRED PER 94UB ADOBESS: N.B. CA . .No, 40.022 *+t1f+11f1fiE+E+Ei(-♦E♦E+r+E+E♦E1EIk♦E♦E♦EfE****IE♦E*iF%'if+riEiE*****4*fE#IE+r+F+Elk♦E****+E+t1E+E1E**R*p1E^�E *C�E pp 92659 u : Z ONING REQUIREMENTS LczIVIuKtz t1tR LICENSED CONTRACTORS DECLARATION:I hereby Nim under penalty of pe' •that am licensed u •.•.envisions of Chapter 9 SETBACK S (commandnp with Section 7000)of Division 3 of the Business and Professions ••e,end y license is in list . e and effect I"'�r�/'1 Ii I —— clrruc,No.: 028035 LIC.CLASS: C 39 LIC.NO- 40 '0 • XP: 07/96 MAIN BUILDING ACCESSORY BUI \ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 7 Dae ^��l Contra •ctor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Ir r OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury t •) . exempt from the Contractors License Law for the following reason(Sedon7Wt.5Buaimss and Professions Code:Anycly oesu . which requires a permit to combed,after.improve, PARKING REQ: PROV: PARCEL: 11939144 ZNE: REF NO: '.mdaany h,or repair structure.odor ID Es el"issuance,erequires the applicant I«Kith permit to tie a signed statement that he Or she licensed pummel to the provisions of the Contractors License Law(Chapter 9(cornmendrg with Section 7000)of Division 3 of the PLANNING NOTES> .usinen and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemprion.Any violation of Section > 703t.5 by anyappitent forapermit subjects the applicant to advi penally of notmore than Ire hundredddlan POOR. ******************************************************************************* ❑ I.asowwer o thepropenyomy employees wages as tihe/sob compensation.wig do ihewcM,end theswdure is not intended D EVEL OP MENT SERVICES REQUIREMENTS or offend ler sale(Section 7044,Business and Professions Code:The Contractors License Law does nor apply to en Corner of property who buids or improves thereon, or ho and who does such work himselferself through his or her own employees,provided that such improvements are not intended or offered for sale.1,however,the building or improvement is sold within one year d compelon,the ZONING APPROVED BY DATE: owner-boike will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY DATE: Professions Cade:The Contractors License Law does not appty to an owner of property who builds or improves thereon and who contracts for such projects with a onntrector(s)licensed pursuant to the Contractors LIcense Law). ❑ Iamexempt under Sectiom: B.AP.C.,for this reason: APPLICATION ISSUED BY: DATE: IIIII *********************************************** ***************** ** Date: Owner: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby candy that I am aware of and understand the requirements d Calioni Health end Safety Code Sections 25505,prrn3,and a; mdI building occupant (circle oneede`° dwthe perms for o Iran thAi-oanag marict.BakedngxtkeapplcatkaaesamfromBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING prgvisicne. PERMIT 63 .00 . 50 Date: Applicant / SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:thereby affirm under penalty of perjury one d the foowing declarations:I h 0 I haus end willmaintain a certificate of oonsent to sef'insure forworkers'compensation.as provided for Section or by S 3700 of the LabB U FEE Code,forthepedonnancedtheworkforwhichtispemhisissued. BUI LE LDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ Ihave and win maintanworkers'compensaloninsurance,as required bySectima00othe •./ ....for the performance othe TOTALS — —> 63 . 50 0 . 00 0 . 00 63 . 50 63 . 50 . 00 work for which this permit u issued.My workers'compensation insurance carrier end poi ITL .-r are: Came: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 63 . 50 OVER/SHORT: 00 Polity Number: 1:Iaananu S c3i•/:W 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,This section need nor be completed it the permit is for one hundred dollars($1.. . less.) 63 . 00 . 50 ❑ I certify that in the performance o the work for which this permit is'v ••,I shell .. any.- • m any manner m as to become subject to the widen'compensation leve,d CeMonde ylrse B Mubled to the waken' ******************************************************************************* d 3)W d the App Code.)= ./onhwbh.• �/ IND I V IDUAL F E E BR E AK D 0 14 N 1 Date: � r/ App am: 7 Warning:Nnlluro xvera secure workers' coge/suniawhd,end. t lu )ecr an''loyr to cr/miWpenamw and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Ones rpt to one hundred thousand• is(Sf04000),In rHldon to the • of conpw.tbrt damages as provided ler In srdon 3705 of the Labor cod,carver :red .•m.yY fen. SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 000 . 00 ' CONSTRUCTION LENDING AGE. • .reby afh under penalty of perjury that there is a const rdton lending agency for the END OF FEES performance of the work ler wh'• this is issued ...on 3097.CN.C), LENDE' NA . LENDE"ADDRv Icertiy that)have -•this and stale the, .infomaticn is coned.)agree toc«npty"eh dldty: •onu ordinance, and state laws . lip to• lid; .construction and here• authorize representatives of this sty to enter upon the -meal'• ed property f«inepeapn•.. ...- . i B../RTT�(�HS 'THEY �i EXPIRED DATE ` _ ;34 / NMI" Data. r 1 DATE - oC 1 �V`/ .i.T . .fl'.rl rvAppicanuContrad« (5151.4E.WP) hits-Building A Safety:Green-Pile:Canary-Apptcent:Pink-Revenue:Goldenrod-Assessor' f Ptt CONSTRUCTION AND PLANNING P00. SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector . 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 UFER.Grnd. 57. APPROVAL TO COVER•GUNITE L. 7:- Footings sr- 58. Electrical Conduit-Undrgrnd. .. -8.,Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. .-; 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL Tt3•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 .r - ,''•' is .y . 20. Rough Factory Fire4iace - r, y APPROV?LL.'- Pe mit # . 21. Ducts_in Structure:i . t F• 70. Underg�ou&i Hydro 0, 22. Duds-, Ventilatin9 r- -' a a r r" c' 71. Product Piping Cites °Oil 23. Gas Pipe-Rough & Test _ ., T. C 72. Underground Flush - ` - v 14 24. Roof Framing' • - '• r - L. _ ..• ' 73. Undergrnd.Storage Tank OGas Obit " 25. Roof Sheathing - v : - Fri - -r- 74; 'Overhead Hydro- : i I . 26. --Ba:Ceiling (Structprall & Manocoat i, e 7r�L.Dry Chemical T i _ t - t. J 1 27. ;F•rame and.Flashing c �'�_ 76. Dry Standpipe • _ �� 28. Lathing&Sidfng r -.a'r. L : a '• .. .. 77. FIXED SYSTENI=FINAi d 29. Insulation -. S + ci. 78. FIRE PREV. FINAL 30. Drywall Nailing ,. ;� HEALTF DEPZ. REt U1REMENT - 31. Plaster Brown Coat'- : ' 79. FINAL INSPECTION . - 32. Electrical Power Meter-Final 1' -.I r ' 80: FOOD CERTIF.-It-ATE ISSUED 33. Final:Ele iris - - 4 ? 4 h Notes: tin" -*-1- 34. Final Heating_& AJ Conditioning" - r, •S i - m . 35. Final Gas Pipe:Test. -• V: - . ' 36. Hood or Canopy • x -= - I • • . _ • 37. Final Factory Fireplace - - -, - 38. Final Plumbing r''" 39. Water Service-Fina(.;. , �• • ' Th . - - 40. Gas Service-Final '- - s :r�-r 5 it - . - .o_. + e r • 41. Solar Domestic-Finals - .. - 1, • _ i 42. Backflow Preventer. r 1 . 'r - 43. Backflow-Irrigation .- , - . ' , 44. Landscape lrrigation:System ,_ - t " ' -tet - ' . - w - -a S 'c'. ;S x ; 45. Sound Attenuation[ _ - -. .. 7 • 46. Handicap Regulations - . + r = ' 47. FINAL STRUCTURE& BUILDING I 48. FINAL PLANNING - *ir , 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date A OWNER UNITED SAVINGS & LOAN DATE 4-27-70 JOB ADDRESS 121 The Masters Circle BUILDING PERMIT NO. 31.738 GENERAL CONTRACTOR Ryness & Smith DESCRIPTION of WORK Residence W/Attached Garage AP No. - -LOT 6 TRACT 6508 FIRE ZONE VALUE $ 31,566.00 INSPECTIONS Signature Date GROUP I H J TYPE y ZONE R-1 SOIL fiq tr•4�7er PERMITS ISSUED GAS SUBCONTRACTOR WATER L4 4 /L� Date Number I SignatureROUGH PLUMBBINSJ'-�-JCt /4$C l2(j X70 Plum.i nq • PROP. SWR. LINE 014.1 HOUSE CON. I( 4tsg -'1--->e) a • • /Pre."% •- /_7a - r SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING MSG-t-C-70 TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER J ROUGH WIRING if d-Z4-7Q Hearin. a •i Vej t. TRENCHES Z1 FORMS ® STEEL REINF. 0 / - �I 1 . -7i / L• • d---ia 7--- FLOOR SYSTEM R, St S -q-ro/, '_' "' r Z�r-%T�jv ��Nr BOND BEAM rl STEEL REINFORCE n / SHEATHING rl f'f C•437129J. FRAME AND FLASHING ^ `4 1� LATHING - IN K OUT \ I (I-fn PLASTER, BROWN COAT - • h k e. f10 __ __ _ STRUCTURAL, FINAL EI ctrll, HEATING, VENT., REFRIG. AND A.C., FINAL )�/■��/,/,�S5-?L'7/ /".,/7/zaiceet? L`p• oY-.71?-7o .3/21/ PLUMBING, FINAL AND GAS TEST n �v/>�)/2�Zd ELECTRIC, FINAL /7l�7�/V- ,5-/,/•7/_ BUILDING, FINAL 1 >Thri- 7/ 1 31738 AM 29-7cc s7001675* ***159.75 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE,I ty�/ D• E,,,EIT DA I SUED ra) BUILDING 121 The Masters Circle I`��[ . !�� O7/� ADDRESS PERMIS, O OWNER United Savings 8 Loan Assoc. A.P. NO. --- 0 I r _ BUILDINMAIL ADDRESS 9800 S. Sepulveda Blvd. ADDRESS 121// The Masters Circle z Lu ui tLU CITY Los Angeles, Calif. TEL TRAC4 0g LOT 6 BLOCK I- Z Z Q CONSTRUCTION Owner NEW ADD ALTER REPAIR MOVING' DEMOLISH — I- LENDER CL m J D BRANCH ' Jin OWNER Untted Savings & Loan Assoc. mtil J ADDRESS VALUE JN OR ENGINEER R.J . Mary ick TEL. 839-3840 s $ U FIRE W 2 ADDRESS 1538 N. Century, Santa Ana ZONE TYPE GROUP a_ ( APPROVED J O CONTRACTOR Ryness-Smith Co. BY DATE mcint fan re- w/ J ADDRESS 140 E. Industry Ave. 9 W W TEL. ZONE NO.OF USE OF NEW zF CITY La Habra, Calif. NO. 879-3111 R-1 PLANS 2 BUILDINGatt. 2 car g. rage WCC STATE167538 LIC.No. 1964 CITY YARDS APPROVED YARDS APPROVED N Q LIG.IC. BUILDING ACCESSORY BUILDING NO. D SIZE NO.OF CLOGS. (FROM C/L)LI/ OF LOT 46 X 90 NOW ON LOT RONT •'7 / FT. FT. USE OF • 3 EXISTING BLDG. R.SIDE FT. _ FT. l— SIZE OF NO.OF C� Z NEW BLDG. 2100 ROOMS 7 STORIES 2 L.SIDE / FT. FT. • EXTERIOR WALL ROOF /, V COVERING StUCCO COVERING Wood Shake REAR /v FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 3` a a MAIN BLOCS. ACCESS. BLOCS. Q VAR�iy� / S-tv DATE 3—/ -7_ (; O Single family dwelling R. two car c.u. 9/—‘,. APPROVED/0 -x, -.67 i— ca garage APPROVED y attached W. L. D. DATE 4-24-70 Z Lot 6 Plan 6-A ami/Q14rJ O C-) I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with Cr all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of CO the State of California. g; //C ��^ mi- the z I hereby certify that I am properly licensed as a contractor under SO. FT. /tj/ O State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from the provisions of the State of California Business and Professions Code 'vision 3,Chapter 9. VALUATION /O / S° n PERMIT FEE $ 4'• D Signature of ,, '' V , /J __ a] Permittee ✓/ •V i `"� $3//��0 PLAN CHECK $ .2 E .r?� p Authorized Agent ` 7 a TOTAL FEE $ -