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Home My WebLink About498 TRAVERSE DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 498 TRAVERSE DR Suite: Vicinity: Parcel Number: 41803109 Zoning: R1 R1 Applicant: KNOX BROTHERS CONSTRUCTION Address: 2931 GRACE LANE#H COSTA MESA,CA owner: BAOERMEISTER, KIRK D Address �498 TRAVERSE.DR , , � COSTA MESA, CA� Phone: (714)556-9910 Zip: 92626 Phone: Zip: 92626 Contractor KNOX BROTHERS CONSTRUCTION Address: 2931 GRACE LANE#H COSTA MESA, CA Zip:; �92626 Arch : - " Address: Phone:� (714)556-9910 � License: ' 580452� � Eng: Address Status: ISSUED Applied: 02/01/2001 Issued: 02/01/2001 � ISSUED BY: � " Phone: - Phone: , . Zip: License: License: SCOPE OF PERMIT CONSTRUCT A 420 SF GAME ROOM TO THE SIDE OF AN EXISTING SFD - �� Plan Check: Permit: � SMIP Res: SMIP Com: Other: `Irispection: , ��,� Total: $326.85 _ $502.85 $3.59 $0.00 $0.00 $0.00 $833.29 , FEE SUMMARY ., �, � � ' . . . SETBACKS,\ �'li ;; _ �� `�.,_ ,. MAIN STRUCTURE.Front "0- 0 � Rear � 0- 0 � �r;. �-.: , - ACCESSORY Front� b-0 � .' Rear 0-0 PARKING Existinqi �.o�\ ` Requiretl: o NOTES: �NNING & ZONWC Left . 0- 0 Left 0- 0 , Pr000sed: 0 Calc Valuation: Claim Valuation: % ��. � , :.-:�._ . �i�' ' ; . ;.i,� "�. $35,910.00 ; so.00 i ��. ,, ;'j� /,i � ;G ; / �Right �. �0 0'� �� . , �� RighC��,� "0-0' .�''. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Ca regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work for a period of 1 BO days. / INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with�� required Inspections and final epproval musl be obtained. Failure to obtain inspections and final approval will result in tlie ! FOR INSPECTIONS CALL: (714) 7545626 � 2446�46 (6/00) and related orabandoned �II applicable codes, and all expiration.of this permit. WORKERS' COMPENSATION OECLARATI�... � � - � I hereby aHirm under penelty of perjury one of the tollowing decleretions: '' ❑ I have and will maintain a certificale of consent to setl-Insure tor workers' compensation, es provided for by sec work for which t�is permit is issuee. I have antl will maintain workers' cOmpensation insurance, as required by section 3700 ot ihe Labor Code, for ihe � My workers' comp�nsatlon Insurence cartlar entl policy numbe� are: Carner: Policy (This section need not be completed it the permit is velue� one hundred dollars ($f00J ar less.) I certity t in �he pedO c tion lews of C ow: ant Signatur ING: FAILURE TO SECURF� iAND DOILARE (51C0.000}. V DCONTRACTORS h licen: end eflect. Lic. W� ihis permil is issued, I shall not employ any person in iould become subject to ihe workers' compensalion p COVERAGE IS UNLAWFIIL AND SHALL SUBJECT AN � CdAPENSATION, DAMAGES AS PROVIDED FOR IN 9(commencing with Sec�ion 7 ot Divjw of the � / lass Date: CONS7RUC710N LENDING AGENCY: / ❑ I here6y aHirtn that there is a cons�Nction lending agency tor the peAormance of ihe work for which this pertnit Lentlers Name: Lentlefs Adtlress: Signature: 3700 ot the La6or Code, for the peAormance of Ihe of the work for which this permit is issued. � so as to become subjecl to tha workers' Section 3700 ot tha Lebor Code, I shall torthwith � � l � � � JAL PENALTIES AND CIVIL FINES UP TOONE MUNDRED IABOR CADE, iMEREST, AND NTTORNEYS FEES. Professions Cotle, and my license is in full issued. (Sec. 3097, Civil Code). Date: OWNER-BUILDER DECLARATIONS: I here6y afrirm ihat untler penelry of perjury Ihet I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for iheifollowing reason (Sec. 7031.5, Business and Professlon: Coda: Any ciry or counry which requires e permit to constmct, alter, improve, demolish, or repair any sirucWre, prior to its issuance, also requires the applicant for such pertnii to tile e signetl stetament t�at he or she �s 1lcensed pursuent to Ihe provisions ot ihe Contradors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of Ihe Business and Professions Code) or ihai ha or sha is exempt iherefrom end ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permi� suhjects the applicant to a civil penalty of not more ihan five hundred dollars ($500).): ❑ I, as owner of �he property, or my employees with wages as their sole compensation, WILL DO THE WORK, anld ihe stmcture is not intended or ofleretl for sele (Sec. 7044, Businass and Protessions Code: The Coniractors License Law tloes not ap01y to an owner oi properry wlio builtls or improves ihereoq antl who does such work himself or herselt or through his or her own employees, provided that such improvements are not imended or ottered for snle. If, however, Ihe 6uiltling or improvement is sold within one year oi completion, the owneo-builder will have ihe burden of proving that he or she did not Duild or improve for purpose ot sale.). ❑ I, as owner of the propetly, am EXCWSNELY CONTRACTING WITH LICENSED CONTRACTORS to constru�ct tha prolect (Sec. 7044, Business end Protessions Cotle: 7�e coniradors License LaW does not apply ro an owner ot property who builds or improves thereon, an i who contracts for such project with e comracbr(s) licensa pursuant to the Conirector4 License Laws.). ❑ I am ezempt untler sec. Business and Professions Code tor this reason: Signature: I Date: Owner ID verified by dnver's license. ❑ �es ❑ No Driver's License No. E:pires: Venfication of Ownership by (lypa of documeni, I.e. � property tax bill or deed): � DIVISION OF INDUSTRIAL SAFETV P&RMIT CERTIFICATION: I ❑ I hereby certify thet no exwva�ion five (5) or more feet in depih into which a person is required to descend, will be made in connaction with work authonzed by ihis permit, and ihat no building stmciWa, scattolding, taisework, or tlemofdion or dismantling iheraof, wi110e more ti an ihiny-six (36) teei hlgh. (Chap. 32, Grp 2, Art 2, Sec. 34i, Ttle 8, Califomia Adminis�re�ive Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a Dermii from ihe Division of Industnal Safety, es notetl above, unless such person has e pertnit ta do such work from Ihe di�ision. Signature: Date: Division oi Intlustrial Safey Permit Number: 'ARDOUS MATERIALS AND EMISS�ONS CERTIFICATION: WIII ihe aOP�icant or present or fuN�e buildinq occupan� need to file and certify a Business Plan for emergency metenel? ❑ Ves ❑ No (Section 25505 of �he Califomia Healt� antl Safery Cotle requires, wi�h some exceptions, that a Business Pla business which has at eny ona timB during e reported year a quantity of hazardous materials equal to or greate or 200 cuhic teet oi compressed gas at stantlard temperaWre antl pressure). ................................................................................................................................................................................................................................................. Does or wi0 the applicent or present or tuWre builtling wcupant need to tila a registration form tor acutely hazarc (Section 25533 oi the Calitomia Health and Satery Cotla, with some exceptions, requires registration with the Cc one tlme has on hand a quentlty 0� ecu�aly hezerdous meterials equal to or greater �han e weigh� of 500 I compressetl gas at standara tampefature and presswe). ................................................................................................................................................................................................................................................. Does or will ihe epplirant or presenC or tuWre builtling occupant need to prepare an RMPP (Risk Management ai ❑ Vas ❑ No (Section 25534 of ihe Califomia Health and Safety Code pmvides that ihe Costa Mesa Fire Department may ri Department ot en RMPP by busine5se5 which ere required to register acutely hazardous materials with Ihe Fire ................................................................................................................................................................................................................................................. If an RMPP is presen0y required, hBs Section 25534 of ihe California Health and Satety Cotle been fully complis ................................................._.........................., ........._.......................... Does or will the applicent ar preseA or future Guiltling occupent require tor the work which is the subjed of �hls irom Ihe Somh Coest Air Ouality Menegement District or irom any other air pollution conirol district or agency7 (Sec�ion fi5850.2 oi the Celitornie Government Code requires that ihe requestetl information be furnished on ap� ................................................................................................................................................................................................................................................ WIII any part of ihe tacility to be con9tmctad untler this permit be within 1000 faet from the outer boundarias of a Qt'j�es", ihe tacili�y must meet the rBquirement of Sections 25534 and 42303 of the Calitomia Health and Safery ................................................................................................................................................................................................................................................ N e pertni� irom the South Coest Air Quality Management District or other eir pollution conirol district or egt applicetlon, have all of the disclosures prescdbetl by Californla Health and Satery Coda Section 42303 bean me� ................................................................................................................................................................................................................................................ Qf "yes", attech certificate of compli2�ce imm the appropriate air pollution control officer). GERTIFICATE OP COMPLIANCE: � cenity ihat under penalty of perjury the intortnation given above is correct regarding Hazardous Materials antl Emissions. Signature: Date: _ to release or ihreetened release of e hazartlous be filed with tha Costa Mesa Fire Depanment Dy every than a weight of 500 pountls, or a volume ol 55 gallons, materials7 ❑ Ves LJ No �Nesa Fire Depariment by each business which at any ds, or e volume ol 55 gellon5, or 200 cubic teet of Prevention Program tor acutety hazardous uire ihe preparetioq ceriification and filing with ihe Fire fparimenl. ........................................................................................................................ with7 ❑ Ves ❑ No ..... .................................................................................................................. ppllcation e permit for such constmction or motlification J Yes �J No :atlons for nomresidential hulltling permits). ie wark which is the No egree to comply with ell state laws and city ordinances CERTIFICATE OF COMPLIANCE ANU P�JTMORIZA710NAF ENiTiY: I certify under penalry oi perjury that I have reatl this application and s�ale thet Ihe intortnation given is correct. I to comply wlih ell state laws enJ� ciry ordinances relating to building construction, and authonze repiesentatives oi �he City of Costa Mesa to enter upon the ebo escnbe operty for insDection gy�pqakd. I egree not to wcupy or allow occupancy ol any building authorized by this permit until final inspection. COOE �. 1616 � 7266 200 201 202 203 204 INSPECTION TYPE Fixed System Final Fire Prevention Pool Spe Final Final Re-Roof Final BIacWRetaining Well Final Fectory Fire Place Final Sign Final Demolition � / -' m I pATE' I� CygF� INSPECTIONTYPEI 20fi Final MeChanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention I 220 Final Planning Approval 222 Final Site I 250 Finel BuilEing/Occupency (714) 754-5273 • Fax (714) 754-4856 • �+'�+�'��i.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 498 TRAVERSE DR 41803109 KNOX BROTHERS CONSTRUCTION 2931 GRACE LANE#H COSTA MESA, CA Phone: (714)556-9910 Zip: 92626 Owner:-' �BAUERMEISTER, KIRK D Address � 498 TRAVERSE DR Phone. COSTA MESA, CA Zip: 92626 Contractor: . KNOX BROTHERS CONSTRUCTION Address: 2931 GRACE LANE#H � COSTA MESA. CA Phone: (714)556-9910 Zip: 92626 License: 580452 Status: ISSUED Applied: 02/O1I2001 Issued: 02/01I2001 ISSUED BY: �_ SCOPE OF PERMIT REF B07-00151, ADD 420 SF GAME ROOM. , 2 UGHTS, 5 OUTLETS, 4 SWITCHES AND 1 UPGRADE SERVICE UP TO 200 AMP. Quantity ISSUE FEE " $23.50 Temp service test $0.00 Res. a/c package . $0.00 New Res{7-2 units) ' $0.00 0 New Res (3+units) , $0.00 0 Pool / Spa� � ` �� ` $0.00 0 Lighting Fixts . � . $770 7 Recept0utlets'� � �-� �$5.50 �_ � �5. � Switches � � � $4.40 -� ' 4 Non Res Appl� � � ;,/ $0.00 �_ A 0 . Res Appl �".. �, �, $0.00 ��.. : �, Service ro 200a � � � ' $30.50 � �1 -_� Service to 1000a � = `� � $0.00 � 0 Service over t000a . '� $0.00 - � � 0 Motors to 1hp , $0.00 �` 0 Morors to 10hp . $0.00 0 Morors to SOhp $0.00 - 0 Motors to 700hp $0.00� �,_ � 0 Motors over 100hp $0.00 0 Communication drops $0.00 0 Sub panel to 200a $0.00 0 Pole Light Pkg $0.00 0 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 FEE SUMMARY • � �. Quantity ,;; ' Temp Dist System / Lighting $0.00 0 ; � � � . , Busway /100 fl $0.00 0 � � � ' Standing Section $0.00 0 " � . � -Misc Electrical Equipment $0.00 . �0 - . � - � � � �Transformersuptolkva/kw $0.00 �0� � j � - _............�..up to 10 kva/kw $0.00 0 ' ' .� - '� ....:......:.....up to 50�kva/kw $0.00 - 0 ` ' � � _ ...:...........up to 100 kva/kw �- � $0.00. � 0 � � ' � � / / ........._.......over 100 kva/kw 50.00 , , 0 �, Low Voltage Equlpment . �,$0.00= . � 0 � % � Lovi VOIt Wiring System (Ckt',% $0.00 �� 0� �� , Misc.�Conduit , . . $0.00-� "0 /..% % � MisaConductor ".$0.00,�' ,0� '� Circus ( gen or ride) ,$0.00 � 0 � Circus (mech ride or lights) � � ' $0.00 .. � 0 Christmas Tree Stand $0.00 .' � 0 Fireworks Stand ' . $0.00 0 _� Other Electrical Fee . $0.00 .Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES 571.60 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under CaliA regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work is not commencetl within 180 tlays, or I( work is for a period of 180 days. and related orabandoned INSPECTIONS: In order for the worK authorized under this permit lo be considered legal, such work must comply with all epplicable codes, and all requlred Inapecliona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration.of this permit. FOR INSPECTIONS CALL: (714) 7545626 2b68�d8(W00) WORKERS' COMPENSA710N DECLAflATION: I I hereby eHirtn under penalry ot perjury one oi I�e following tleclarations: ❑ I heve entl wlll meinteln e certificate of consent to self-Insure tor workers' compensation, as provided for by saclion 3700 oi t�e Lebor Code, tor ihe peAormance ot ihe work for whlch Ihis permit is issuetl. ❑ I have entl wlll melntain workers' compensation insurance, as required by section 3700 oi Ihe L&bor Code, for ihe pertortnance ot the work tor which this pertnit is issued. My workers' compensation Insurance carner antl policy num6er are: . Cerder. PWicy Numbe[ (This secfion need co ed i! (Ae permi7js veluetl �/on undred dollars (5700) or IessJ tify at in the peAormanc f the wo tor whiol ' pertnit is issued, I shall not employ eny person in eny �menner so es to become sublect to ihe workers' p setion lews ot CalHori , ntl ag that Ii I Id become suh�ect to the workers' compensation provisions ol Section 3700 0l the Labor Code, I shell lorthwith y wlih ihesa provi5lon / � �--' - / —Z_"oe�� 2 `/ ` � /' FAILURE TO GURE W RKE0.5' ODMPENSATION COVERAGE IS UMAWFUL PND SHALL SUBJECT AN JAPL CRIMINPL PENALTES M1D dVIL FlNES UP TOONE HUNDRED (5100,000), IN ADDfT10N TO THE WST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR COOE, IMEREST, AND NTTOHNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I h�et I em licen ed under provisions at Chepter 9(commencing with Section 7000) ol orr ntl eMect. tJa B CONSTRUCTION LENDING AGENCY: ❑ I hereby eNirm that thare is a construction lending egency for Ihe pertormance of Ihe work for which ihis Lentler5 Neme: Lendels Address: Signature: Cotla, and my licanse is in full issued. (Sec. 3097, Clvil Code�. Dete: OWNER-BUILDER DECLARATIONS: I hereby aRlrm Ihet untler penalry ot perjury that I am E%EMPT FROM THE CONTHACTORS LICENSE LAW for Ihe foilowing reason (Sec. 7031.5, Buslness end Protessions Cotle: Any city or counry which requires e permit to construct, elter, improve, demolish, or repair any structure, pdor to Its Issuence, elso requlres the applicant tor such permii to lila e signed sletement ihat ha or she Is Ilcensed pursuant ro the provisions ot ihe Contracrors License Lew (Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business entl Professlons Cotle) or Ihat he or sha is ezempt thereFrom and the basis for Ihe alleged enemption. Any vlolalion of Section 7031.5 by any apP�icant tor e pertnii subjects the epplicant to a civil penelry af nat mare than live hundred dollars ($500).): i ❑ I, as owner of Iha propeny, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe structure is not intentled or oHeretl lor sale (Sec. 7044, Business end Professions Code: The Contrectors License Law does not aDPly to en owner of property who builds or improves theroon, antl who does such work himself or herseN or ihrough hls or her own emplayees, provided that such improvemenis are nat intended or otferetl for snle. If, hawever, the builtling or improvement is sold within one year of completlon, ihe owner-builde� will �eve ihe burden of proving that he or she did not builtl or improve Por purpose of sale.). ❑ I, as owner ol the property, em E%CLUSIVELY CONTRACTNG WITi1 LICENSED CONTRACTORS to consiruct the pro�act (Sac. 7044. Business end Professions Code: The contractors License Lew tloes not appty lo an owner oi property who builds or impmves Ihereon, end who contracts lor such project wlth e coniractor(s) license pur5uant to ihe Contrectors LiCen58 WwS.). ❑ I am exempt under sec. Business and Protessions Code for this reason: ' SignaWra: � Date: Owner ID veritiatl by Crivers licanse. ❑ Ves ❑ No Drivers Licensa No. E:pires: Verllicatlon ot Ownership hy (type of tlocument, i.e. - property taa hill or Deetl): � DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: , ❑ I hereby ceriify that no excavatlon tive (5) or mora feet in depth into w�ich a person is required to descend, will he made in connection with work authorized by Ihis pertnii. and Ihat no 6uilding structure, scaflolding, falsework, or demolition or tlismantling ihereof, will be more than thirty-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Tille 8, Celitomia Administretive Code). i ❑ A5 ownerCulltler, I will not employ enyone to tlo work whic� woultl requira a permit fmm tha Division ol Intlustrial Safety, es noted aDove, unless such person hes a permit ta do such work from �he tlivision. I Signature: , Data: Division oi Industrial Safery Permit Number. 1 Will Ihe apDlicant or presant or fuWre building occupent neetl b file entl certity a 8usineu Plan tor emergency'response to releese or Ihreatenad release ot a �arartlous malenal7 ❑ Y85 � No ' I (Section 25505 0l tha Califomia Health and Safery Cotle requires, vnt� some eaceptions, that a Business Plan be filetl with t�e Coste Mesa Fire Depertment Dy every business which has et any ana time Cunng a reported year a quantiry of hazartlous ma�enals equal to or greater ihan e weight of 500 pountls, or e volume of 55 gallons, or 200 cubic teet oi compressed gas at standard temperature and pressure). ......................................................................................................................................... ................................................................................................................................................................................................................. 2 Does or will ihe epplicent or present or tuWre builtling wcupant need to file a regisiration form for ecutety hazardous meterials7 ❑ Yes ❑ No i (Sectlon 25533 0l Ihe Celifomia Heal(h end Safery Cotle, wlth soma exceptlons, requires registratlon with the Costa Mesa Fire Department by each business which at any one time has on hantl a quantity at acutaly hazeMous meterials equal to or greater Ihan e weigM of 500 pounAs, or a volume ol 55 gellons, or 200 cubic feat of comoressed 4as at stentlartl �emoaraWre antl pressura). I or win tne eppucant or presem or prepare an (Section 25534 of ihe Calitomia Heellh and Safety Code pmvides that ihe Costa Mesa Fire Department may require I Depertment of en RMPP by businesses which ere required m register acutely hezardous metenels with the Fire Depeni .......................................................................................................................................................................................................................................................................... 4 It en RMPP is presently required, hes Section 25534 of ihe California Heelih end Satery Gotle been fully complied with i ..........................................................................................................................................................................................................................................................:............... 5 Does or wlll ihe epplicent or present or fuwre buliding occupent require lor t�e work which is the subjec� ot �his e pllu irom �he South Caas� Air Qualiiy Menegement Disidd or fmm any o�her eir pollution conirol disirict ar egency7 I� Ve: (Seclion 65850.2 ot t�e Californie Govemment Code requires �hat the requested information be fumished on applicatloi .............................................................................................................................................................................................................................................._.......................... 6 WIII any part of the feciliry to be constructetl under this permit be within 1000 feet from the outer bountlanes ol a school QI "yes", the lacility must meet the requirement ol Sections 25534 antl 42303 oi the Califomia Healt� and Safery, Cotle). .......................................................................................................................................................................................................................................................................... 7 If a permit irom Ihe Soulh Coest Air Ouelity Menegement District or other eir pollution control dislrict or egency is eoolicatlon. hava ell of Ihe dlsdasures orescnbetl �v Callfomla Health anA SalaN Cotla Saction 42303 bean metle? C B Qt'Yes", etlech cetlifi CERTIFICATE OF C regartling Hazerdous Signawre: certilicetion end filing with ihe Fire � or for nomresitlenlial building permits). ,��,..,��..��..�,,..vv...v....,,.....� .................................�. � I certity that under penalry ot perjury the infortnation given ebove is correct I egree to comply with ell state laws entl ciry ortlinances Emissions. I DatB: i CERTIFlCATE OF CO ANCE AND AIJiHORIZATION.OF EMRV: I cenify under penalry of perjury that I �ave reatl this epplication and stete ihat the information given is correct. I agree to mpty w e stete laws entl ciry ortlinences relating to bullding consWctlon, end authonze reD�esentatives ot Ihe City ot Costa Mesa to enter upon the above-described roperry for in ection purposes. I agr�e f+ot to acupy or ellow occupancy of any 6uiltling authorized by this pertnit until finel inspection. CQOE I. INSPECTIONTYPE 1616 Fixed System Final Fire 1266 Pool Spe Finel 200 Finel Re-ROof 201 Final BIocWRetalning W ell 202 Final Factory Flre Place 203 Finel Sign 204 Finel Demolition Q�j�' 7NTffIALS C�pg,: INSPECTIONTYPE 20fi Final Mechanical 208 Final Plumbing 270 212 220 222 250 2 Finel Elecirltal Finel Fire Preventlon Final Planning Approval Final Site Final Bulli Z11 I:1WLL4. v � .�� (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 498 TRAVERSE DR Suite: Vicinity: Parcel Number: 418�31 �9 Applicant RASOA, ODILLA Address: , Owner. BAUERMEISTER, KIRK D � Address '498.TRAVERSE�DR � �..i. ,� ' � - / . �'- / COSTA MESA. CA. ' ' � � � �- i Contracror: #1-BEST ROOFING COMPAN 'Addiesa:i 939 SERRA WAY ' , COSTAMESA,CA , _ Zip: ' � 92626% ' - , �i�., -_ Arch': �� '� . Zoning: R1 R1 Phone: 714-434-2525 Zip: Phone: Zip: 92626 Y Phone: (714)434-2525 License: 722805 " Eng: Status: ISSUED Applied: 04/02/2001 Issued: 04/02/2007 ISSUED BY: , . �'� . ��_ . � � ��,`. , A'�� '� � �V A _ � � ; � � ��`� �A � � � Address: � � ' � .Address: ^ . . �� .� ; Phone: Phone: - ,� � - . ' . . •�� .Zip: ' License: , License: ' � ` � � \� / � � � - ' . SCOPE OF PERMIT . � � �� , ROOF OVER EXISTING COMP ROOF WITH 30 YEAR COMP. �� -- ��-- -� � � � i � PIan,Check: $0.00 _ _ 'Permit:' $97.25 • ��SMIP Res: - $0.50 �� SMIP Com:� � . $0.00 � '� Othec' �,$0.00 lnspection` , '�$0.00 `� �i� ., `; �Total: ` -$9775.� � � �.� ' � } .� �� . ,� �� \.�-. . � SETBACK: MAIN STRUC ACCESSORY PARKING NOTES: �\� � l � % , � ��.\,." . , �,�� / /;';�; ��:>�; "URE�Fiont 0-0 � � Rear�, 0-0 —�A�� -; j �!�- Front �-0; 0�� "/� Rear�� 0- 0 �� _ . � . - � i � .°_\ Existinq: � �0, `-� � _ Required: 0 ��, . FEE SUMMARY � Calc Valuation: ' � �- Claim Valuation: %-r �� ' % �' -_ ///,, ,�,/ % % ti'/ , •- , -ir i", �'. . , , -. Left� ,. p- p Left � 0- 0 . i : .; 1 � Proposed: .� - . � ; . c �`� �/'�/ � ' . i � / NG j i, � ,,� i � ,;�</ - ' Righf � : 0- 0' / � i - �_.� .��. %�i - Right„ "0- 0 �,, �� :, � � \ � .�/� �=j 0 "� �'�" , _ �\ j, � � i'�/ � 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 it work is not commenced within 180 days, or if work is suspended or abantloned � 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 requlretl Inapectiona end tinal approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration.of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2446d81fl�00) . . WORKERS' COMPENSATON DECLARATION: . I I hereby aRirm under penely ot perjury one of the following declarations: ❑ I h ve'end wlll meintaln e certilicata of consent to self-Inwre for workers' wmpensetlon, es pmdded tor by sectlon 3700 of ihe Labor Coda, for the peAormanca of the ork for whiCh thi5 pertnit is issuatl. A i I have end will maimain workers' co en9AGon Insurance, as requiretl by section 3700 of Ne Lebor Code, lor Ihe pedortnance of ihe work tor which ihis pertnit is issuetl. My woMers' compensetlo renc Yriar a licy number are: I Certier. Policy Number: (This sectlon need nof be comp/efed il the p mi is valued a( one hundred dollars ($100) or less.) ( i ❑ I certity Ihat In t�e pertortnance ol t�e o for w�ich ihis pertnit is icsueQ I shall not employ any person in any manner so es to become subjact to the workers' compensatlon laws oi Celifomla, end r e ihat if I should become suD�ect to Ihe workers' compensatlon provisfans of S�ec/tio/p' 3700 0l the Lebar Catle, I shell forthwith comply with theae prov/l5 �' Dete: �I I/—� �/l l 1 Applican� SlgneNre: � WARNINO: FAILURE TO SECUR RKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINPL PENALiIES PND CIVIL FWES UP TOONE HUNDqED T}IIXISPND DIX.LARE (5100.OW�, IN AD�IiION TO THE COST OF �MPENSNTION, OAMAGES AS PROVIDED FOq IN SELTION 31W OF THE LABOfl CODE, INTEREST, AND AiiORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I I hereby eHirm tha� I em Ilcensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of �he Business and Protessions Code, end my license Is in full fofCe entl BMBCI. Lla M CIe55 # � Contractoh Si9naWre: _ � /Q.6'X�/ Date: � � � � CONSTRUC710N LENDING AGENCV: � ❑ I hereDy aifirtn Ihat t�ere is e cansiruction lentling egency for the Dertormance of Iha work tor which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender'S AAdress: ! SignaNre: I Date: OWNER-BUILDER DECLARATIONS: I I hereby aHirtn thet under penelry ol perjury ihet I am EXEMPT FROM THE CONTRACTORS LIGENSE LAW tor Iheifollowing reason (Sec. 7031.5, Business end Prolessions Cotle: Any ciry or counry which requires e permit to construc6 alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires the epplicant lor such pertnit to file a signed sletement Ihet he or she Is Ilcensed pureuent to the provislons of the Coniractors License Lew (Chapler 9(commencing with Settlon 7000) of Divislon 3 of the Business entl Professions Code) or thet he or she is e:empt ihereirom end the basis for the alleged eaemption. Any violation oi Section 7037.5 by any appllcenl for e permit subjecis ihe epplicent to e civil penelty of not more than five hundred dollars ($500).): ❑ I, es owner of Ihe property, or my employees with wages as iheir sole compensetlon, WILL DO 7HE WORK, a Id ihe siructure Is not in�endetl or oHeretl tor sele (Sec. 7044, Business and Professions Catle: Tha Contractors License Law tloes not epPly lo en ownar of propeny wfio builds or improves thereon, and wha tloes such wark himsetl or herselt or lhrough his or her own employees, providad lhet such impmvemenis are not intendetl or oHered tor sale. If, however, �he building or improvemeM is soltl within one yeer oi completion, ihe owner-builder will have the burtlen of proving that he or she tlitl not build or improve Por purpose of sele.). ❑ I, es owner oi ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constnict the prolect (Sec. 7044, Business end Professlons Cotle: The conirectors Llcense Lew tloes noi appty to an owner oi pmperty who bulltls or Improves thereon, end who contracts for such prolect with e con�ractor(s) license pursuant to Ihe Contractors License Laws.). � ❑ I em exempt under sec. Business and Professions Coda for lhis reason: SignaWre: I Data: Owner ID vedtietl Cy tldvef511cense. � Ves ❑ No Dnvafs Licensa No. Expires: Verifiwtion of OwnersMp by (type of tlaument, i.e. - property tax bill or deed): � DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify that no exwvation Nve (5) or more feet in depth into which e person is requiretl to descend, wlll pertnit, end that no building siruciure, swttolding, lalsework, or demolition or dismantling �hereol, will be more 34 i, Tltle B, Celifomla Adminisirative COde). ❑ As ownerbuilder, I will not employ anyone to do work which would require e permil irom the Oivisian of Ina permit to do such work Irom the division. Signature: Division at Intlustnal Salery Pertnit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: t WIII the eppllcant or present or future bulltling occupant need to file end certlty e Business Plan br emergency ma�edel7 ❑ Ves ❑ No (Section 25505 0l Ihe Celifomia Healih and Sefery Code requires, with some exceptions, thet e Business Pla business which hes et any one time dunng a reported year a quan�iry of hazardous meterials epuel to or greab or 200 cubic teet ot compressetl ges et stendard IemperaNre and pressure). ......................................................................................................................................................................................................................................................... 2 Does or will the epplicant or presenl or fuNre building occu0an� need ro file e registration torm for ecutely hazari (Section 25533 0l Ihe Califomie Healih end Safery Code, with some exce tlons, requlres reglslretion with Ihe G one time has on hentl e quantiry of ecutely haeardous matedals equaPto or greeter than e weight of 500 compressed gas at standerd tempereWre and pressure). ......................................................................................................................................................................................................................................................... 3 Does or wlll the ePplioent or presant or fuWre builtlinq occupant need to prepare an RMPP (Risk Menegement a made in connec�ion with work authorized by this n thirty-six (36) }eet high. (Chap. 32, Grp 2, A� 2, Sec. Satery, es notetl above, unless such Oerson has e Date: to releese ar ihr0aienetl releasa of e hezardous be filed with ihe Costa Mesa Fire DeOartment by every than a weight of 500 Dounds, or e volume o155 gallons, erials7 U Ves U No a Fire Depariment by each business whlc� at any or a volume of 55 gellons, or 200 cubic feet ol for acutely (Section 2553a ol Ihe Calilomie Healih and Safery Code pmvitles thet tha Costa Mesa Fire Department may require the preparatioq ceNtication end filing wi�h the Fire Depertment oi fln RMPP hy businesses which are requiretl ro register ecutety hezardous matedels wilh the Fire Department. .........._.......__..._ ......................................................_............................................__........................__..................._.................._..__.._...................._....:............................................__........._.............__.............._................................ 4 If en RMPP is presently required, hes Sec[ion 25534 ot Ihe Califomia Heellh end Safery Code been tully complietl with? ❑ Yes � No ......................................................................................................................................................................................._......................._..............................................................................................._.................................................................. 5 Does or will the applicenl or present or tuture builCing occupenl requlre for the work w�ich I5 lhe subject of ihis a pliwtion a gertnit tor such conSVuciion or motlificallon trom the South Coest Alr Oualiry Management Disidct or from any other eir pollution control disidct ar agencyt �� Yes LJ No (SecNon 658502 0l Ihe Calilornie Govemment Code requireSlhel the requested Information be IumisOetl on epplications for noo-resi0entlal building permits). .........................__......................................................_.......................................__.._......................._......................_._...................."'.........................._..._....................._.................._..._........_.......__.........................................__........ 6 Will eny part at t�e Iaciliry to be consiructetl untler this pertnit be wilhin 1000 feel lrom l�e outer boundanes ot a school? ❑ Yes ❑ No (It yes'. the faciliry must meet the requirement of Sections 25534 antl 42303 of the Celifomia Heelth antl Safety Cotle). ........................................................................................................................................................................................................................................................................................................................................................................................ 7 II e permit Irom ihe South Coest Air Oualiry Manegement District or other air pollution contml distnct or egency is requiretl for the work which is the sublect of this eppllcelion, have ell ot the disclosures prescribetl by Calitomia Health an0 Salety Cotle Sectlon 42303 been matle7 ❑ Ves ❑ No .................................................................................... ....................................................................................................................................................................:............................................................................................................................. 8 Qf yes', ettach cetlificate of compllance trom the appropnate eir pollution contml oHicer). � CERTIFICATE OF COMPLIANCE: I certity ihat under penalry ot Derjury ihe inbrmetion qiven ebove is correcl I agree to comply with all stete lews antl ciry ordinances regarding Hazardous Matenals and Emissions. I SigneWre: Date: I CER7IFICATE OF COMPLIANCE AND AU7HORIZATIONOF EMRV: I cetlity under penalry of Oerjury that I have read this appliration and state Ihat the infortnation given is correct. I agree to comply wlih ell stete laws end ciry ordinances relating to building consiruction, and euthonze representatives ol the City of Cosle Mesa ro enter upon the above-described pmperty br inspection puryoses. I agree not to occupy or allow occupancy ol eny building authorized by this permit until iinal insDection. /)p.f7Signature Of Legal Owner(s) A �"7/Le,yJt� ��`MAnd/Or Authorized Applicant CQOE �' INSVECTION TYVE � 1616 Fixetl System Flnal Fire Prevention 1266 Pool Spa Finel I 200 Final Re-Fooi :!01 FIneI BIocWRetaining Wall II S02 Final Fac�ory Fire Place Flnal Sign Final Demolition Qdjf' IN�TLQ �Qyf,! INSPECTIONTYPE 206 Flnal Mechanical 20B Finel Plum6ing 210 212 220 222 250 Final Electnc2l Flnal Fira Prevention Final Planning AOP�oval Final Site Final Buildinp/Occuoan� o�re r i i' BUILDING PERMIT JobAddress: 498 TRAVERSEDR Suite: Vicinity: Parcel Number: 41803109 Applicant: RASOA, ODILLA Address: Owner: BAUERMEISTER, KIRK D Address 498 TRAVERSE DR COSTA MESA, CA Contracror. #1 BEST ROOFING COMPANY Address: 939 SERRA WAY COSTA MESA, CA Zip: 92626 Arch : Address: Zoning: R1 R1 Phone: 714-434-2525 Zip: Phone: Zip: 92626 Phone: (714)434-2525 License: 722805 Eng: Address: i �� 01-00423 Status: FINALED Applied: 04/02/2001 Issued: 04/02/2001 Phone: Phone: 2ip: License: License: SCOPE OF PERMIT ROOF OVER EXISTING COMP ROOF WITH 30 YEAR COMP. FEE SUMMARY Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: PLANNING & ZONING Rear 0- 0 Left 0- 0 Rear 0- 0 Lek 0- 0 Required: 0 Proposed: 0 Calc Valuation: $3,�so.00 Claim Valuation: gs,�so.00 Right 0- 0 Right 0-0 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT lob Address: 49S TRAVERSE DR Suite No Vicinity: Parcel Nunmber: 41603109 Applicant: KNOX BROTHERS CONSTRUCTION Address�. 2931 GRACE LANE#H � � - Phone: (714)556-9970 C05TA MESA, CA � Zip: 92626 / � �. ' i � � � Owner: BAUERMEISTER, KIRK D Address 498 TRAVERSE DR Phone: C05TA MESA, CA Zip: 92626 �, Contractor. KNOX BROTHERS CONSTRUCTION Address: 2931 GRACELANE#H . Phone: (714) 556-9910 � -,-005TA MESA, CA Zip: 92626 � " " License: 580452 Arch / Eng : � - � - - � - - Address: , ' Phone: _ Zip: License: SCOPE OF PERMIT �� REF 801-00151, ADD 420 SF GAME ROOM. �;� � `� 1 GAS REPIPE AND 1 GAS METER. ' '�. .AMT ' gTY � - ISSUE FEE �� A �$23�50 � Backflow Irrigalwn� ��;� $0.00 ,� 0, � Backflow Preventer . � � $0.00 -� � 0'. Bathtub , � �$0.00 � � 0 � - � Clarifier System �� $0.00 0 Connect (Ice,Soda,etc) $0.00 ,�': 0 �- � Dental Units $0.00 � � 0� � Dishwasher $0.00 � - 0 Drain, Floor $0.00 0 Drain, Rainwater $0.00 0 Drain, Roof $0.00 0 Drinking Fountain $0.00 0 Expansion Tank $0.00 0 Gas Earthquake Valve $0.00 0 Gas (1-4 outlels) $6.15 1 Gas (Over 4 outlets) $1.10 1 Gas Repipe $0.00 0 " Gas Service $0.00 0 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 FEE SUMMARY AMT Laundry Tub ! Washer $0.00 ��-Landscape Irrigation $0.00 � P-Trap� � $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 � Receptors $0.00 Septic Tank � $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line .$0.00 Shower � � " $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 - 0 0 " 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 02/O7/2007 I ssued: 02/01 /2001 ISSUED BY: I �J. _� �: , � -a-.:,;_ - � , ' " _ � /, �'�AMT .- �= SumpPump� �� "/ $0.00 � Swimrfilng Pool j ; ' $0.00 � ,�TrapPrimer i %// $0.00 � ` Urinal'�'� ' $Q00 � Vacuum.Brkr�Bkflow(1-4) $0.00 Vacuum Brkr Bkflow(S+) $0.00 ' Wash 6asin $0.00 - Wasli Basin Set $OAO - Waste and Vent System $0.00 Water Closet (Toilet) $0.00 Water Heater / vent $0.00 Water Piping pnst or Rep.) $0.00 Water Re-pipe $0.00 Water Service $O.00 Water Sokener $0.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK $0.00 REINSPECTION $0.00 TOTAL CALCULATED FEES: 530.75 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C NOTICE: The work authorized by this permit s a compy wi a appica e an icap aocess equirements undei 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 tor a period ot 180 days. INSPECTIONS: In order fof the work authorized under this permit to be considered legal, such work must comply with� requlred inspectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in�he FOR INSPECTIONS CALL: (714) 7545626 2C46-48(fl�00) orabandoned 311 applicable codes, and all expiretion.ot this permit. WORKERS'COMPENSATON DECLARAnON: . I here6y afFirm untler penalty of perjury one oi the following declarations: ❑ I have end will melntain a cenificate of consent to self-Insure for workers' Compen58lion, as provided tor by section 3700 ot the La6or Code, br the pedormance of the work for which Ihis pertnit is issuatl. ❑ I have and will maintain workers' compensatlon insurance, as required by section 3700 0l ihe Labor Cotle, tor the pedortnance of the work for which this pertnit is issuetl. My workers' compensation Insurance carrier and policy numbar are: Cartier. (This section ne ot be a (� I certify ih t in ihe per � COffID8f13 tiOn IBw3Of pe/mit is ihat Policy Numher: e hundred tlollars ($700) or /ess.) ertnit is issuetl, I shall not employ any person in any manner so as to become sublect to the workers' become subject to the workers' compensatlon provisions ot Section 3700 of the Labor Coda, 1 shell forthwiih Si ure: ' . � ��/ , � �— �—'Data� ?'—�—�� FAILURE TO SECURE WORKERS' CO PENS ION COVERAGE IS UNLAWFUL AND SHALL SUBJE _ TO CRIMINAL PENALTIES AND pVIL FINES UP TO ONE HUNDRED i OOLLARE (5100,000), IN ADDITION TO iHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR W SECTION 39060F TME LABOR WDE, INTEFEST, AND ATTORNEV'S FEES. LICENSED provisions of Cl�ter 9(commencing with Section 7000) of Divisi he Business ap�ofessions Code, and my license is in full A %/ —�� i � oa 2—/— CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a constmction lending agency for the pertormance ot the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lender'S Name: Lender'S Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: 1 hereby afFirtn ihet under penelty of perlury thet I am E%EMPT FROM TME CONTRACTORS LICENSE LAW tor the Following reason (Sec. 7031.5, Business end Professions Code: Any city or county which requires a permit to construct, alter, improve, tlemolis�, or repair any structure, prior to its issuance, also requires Ihe epplicant for such pertnit to file a signed statemenl thet he or she is Iicense0 pureuanl to the provisions of t�e Contrectore License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cotle) or that he or she is exempt therefrom end the basis for the alleged exemption. Any violalion oi Section 7031.5 by any applicant for a pertnit subjects the applicant to e civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of ihe propeny, or my employeas with wages as iheir sole compensetion, WILL DO 7ME WORK, and iha structure is not intendetl or ottered tor sale (Sec. 7040, Business end Professions Code: The Contractors License Law aoes no� apply to an owner of propeny who 6uilds or improves ihereon, and who does such work himsetl o� hereelf or ihrough his or her own emploYees, provided that such improvemenis are not intended or oHeretl 1or sale. If, however, Ihe building or improvement is soltl within one year of completion, the owner-builder will have ihe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sac. 7044, Business and Prolessions Code: The contrectors License Lew tloes not appty to an owner of propeny who builtls or Improves ihereon, and who contracis for such prolect with e comractor(s) license pursuant to the Contrectors License Laws.). ❑ I am exempt under sec. Signature�. Owner ID ventiad by driver'S liCenSe. ❑ Ves ❑ No Business and Professions Code for lhis reason: Verification ot Ownership by (type of dwument, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Oriver's License No. Date. Ezpires: ❑ I here6y ceriity that no excavation tive (5) or more feet in depih into which a person is required to descend, will be matle in connection with work auihonzed by this permit, and ihat no building slrucWre, scaHolding, falsework, or demolition or dismantling fhereof, will 6e more �han ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 345, Title 8, Califomia Atlministrative Code). ❑ A5 owner-huilder, I will not employ anyone to do work which would require e pertnit irom the Division of Industnal Safery, as noted ebova, unless such person has a permit to da such work from tha division. Signa�ure: Date: Division oi Industrial Safery Pertnit Numbar: CERTFICA7E OF COMPLIANCE AND AUTHORIZA710N.OF ENTAY: I certify under penalty of perjury ihat I have read ihis application and state that the informa�ion given is wrrect I a reec; to comply with all stateJaws and yy� ortlinances relating to builtling constmction, an0 authonze representatives of ihe City of Costa Mesa to enter upon the above-de8bribedalopa�y for inspectior/{nryose�J%gjee not to occupy or allow occupancy ol eny building authorized by this permit until final inspection. �ODE t. INSGECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReteining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition nt C� jl�' I L QQQ[( INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fira Preven�ion 220 Final Planning Appro�al 222 Final Site ' 250 Final Building/Occupancy P1I€ INTRIALS � 2797 I DEC 27-63��—°�(i 930+� *+►* *SS.SO COSTA MESA BUILDINCrSAFE'fY DEPARTMEPIT P.O. BO% 1200 GOSTA MESA. CALIFORNIA YT640 - For Appllcanf ro Fill In Completaly APPIICATION FOR PERMIT TYPE OR PRINT BUILDIN(i euiwiNo (� -�' �� For Off(ce Ute Only ADDRE89 R[C[IIT HO. NO. COSTA MESA. CALIFORNIA �'^��%� 11[U�V[ �d1T[RtG[IV6D OAT[108/O6D/ OWNER -�4' 1�-l� ��--\... _� ' ' 07 �!0-10 MAIL � 1-� . ADO EIBG /L�t�. �% . wooRseO 1�� T8L FIRB J� // CITY NO. ZON! ��J . TYPB Y OROUP MPROV[D • ARCHITEGT T6L BY DATH ORENOINERR NO. ^� , S ZONING ADDRE88 �J sona wo.or ucsorx�w cor�rn�cron 1 / ,�—�p�J C �T �. �uHs 2 eu�lolNo 8CC 8L. O `� � u�cmmox LO f� ' I �l .S �"� AD R88� ��T, � �. r. Ho. 141-031-09 N0T6: N06AV60V[RMAN08HALLOELH88TMAN STATH 2�!1 TB4 HO• TO 81DH a RBAR P. L � LIC. NO. V NO / 8R8 � No.oI�LDw. �LOWHD (U..B.C.REQUIRHMENTI. OF LOT Now N U9E OP / O YARDB MPROVHD �'AROS APPROV HO EXISTINO BLDa. MAIN BUILDINO ACCHS80flY BUILDINO <PROM G/L R[[T1 ocrewcec une rnor ��. � p�. cBNTHR O� �TR[[T R[A1l YA D HIDHYARDI L[PT `�/ RIOlfT R.YID[ RT. FT. DESCRIPTIpN OF WORK �. ama 6 rr. rr. � NEW '�t7�/�TI N ADDITI N RHAR RT. FT. '�� DIiTANC[![T. BR. MAIN a REPAIR IN aM � MAIN BLD D ACCESS.BLDO9. BUILDINO l NO.OR V�•� DATB IIRE \�� R�MB q� C. U. P. 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