HomeMy WebLinkAbout1056 VALLEJO CIR - Building Permits PROJECT ADDRESS: 1056 VALLEJO CI UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05094 =
• . OWNt"'S NAME: SIAW, MARTIN
SADDRESS: SIAW, MARTIN FARP EE TR PERMIT NO: B 050943 PLAN CHECK NO: - N GOVT: N SUPP: N
1056 VALLEJO CIR . •
COSTA MESA CA 92714 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
714 241-189
ARCM/ENGINEER: REG.ND.: JOB DESCRIPTION : T/OFF & REROOF W/HEARTY SHAKE SQ FT: 2, 200
ADDRESS: UNIT:
CLAIM VALUE: 2, 200 . 00 CALL-VALUE: 2, 200. 00 GROUP OCC: R-3 /
PERMITTEE: CONSUMER SERVICES ( 714 ) 754-1533
ADDRESS: 17450 MT HERRMAN COMMENTS: TEAR OFF & REROOF W/HEARTY SHAKE
FOUNTAIN VALLEY CA 92708 ***T ******* *LEAH*UE***+t*****�E*�ESE�E>E+E*S6* **sE�Ex********TE***** * ATE***Tr *****x**>E *+G***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY LIC.: p 4 4,8 STATE LIC.:424349 cuss: C_ , 9.
Date:_9 Signal MAIN BUILDING ACCESSORY BUILDING
\ WORKERS'COMPENSATION DECLARATION: I reby aft ix that I have acertificate of consent to self-insur$certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy the eol(Se• on 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 1105091-90 EXP.DATE: 10/01 /91
COMPANY: STATE FUND PARKING REQ• PROV: PARCEL: 41205214 ZNE: REF NO:
0 Certified copy is hereby furnished. Certified copy is filed with the city Builtlin• r ision� re PLANNING NOTES>
•••;_c___ >
4...../ Date' Applicant ' i. _.-. *****************************************N-*************************************
EXEMPTION ROM Wo ERS'COMPENSATION OECLAR , This section need not be completed if the permit isnoe hundred($100)or less), DEVELOPMENT SERVICES R E Q U I R E M E N-T S
I certify that in the performance of the work for whit • unit is issued,I shall not employ any person i manner so as to become
subject to the Workers'Compensation Laws of Cali• •.. ZONING APPROVED BY .
DATE
Date: Signature:
NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ,/ DATE
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ,,,,J/ / �^,( -7
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: `, - �� DATE• r%— 4E—7(
which this permit is issued(Section 3097.Civ.C). ******.****.************ *. *. .**.*.
LENDER: ********************************************* ** ******************************
ADDRESS: LEGALIZATION:N F E 'E SUMMA Y STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERM I T 54 . 00 . 50
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensedSMI P/NON-RES
pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($510). ISSUE FEE
I, as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID , DUE
1 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 . 0 0 0 . 00 54 . 50 54 . 50 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ,
his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING. PLAN-CHECKimprovement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 0 0 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ********************************************************************V**********
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.A P. C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST "TOTAL COST
Date: Owner: SFR 2200 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 2, 200 . 00
I do hereby certify that I am aware of and understand the requirements of California,Health and Safety Code Sections 25505,25533,and END OF FEES - _
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Dale'. Applicant: ' -
I hereby certify that I have read this application and state that the above information is a est I a• r a to omply with all city and county
ordinances and stale laws relating to building construction and hereby authorize represe r .Neil)?I. ci enter upon the above-mentioned
property for nspe Ion our ses. 01 000$0142-00080143 TOT c; `G
Date: v , Signature': / GATE: 02/07/91 TIME: 11:07 ` /
/Driver's Lic sefi a or So ial Security a: / \ `a
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
•
--1 - -
CONSTRUCTION AND PLANNING rOOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd. 54. Forms
4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement t 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE
7. Footings • - 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final .
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final
16. Rough Electric Wiring - - 67. Fencing & Access Approval .
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling L 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . • 'APPROVALS ' Permit# •
21. Ducts,in Structure . . 70. Underground Hydro
22. Ducts, Ventilating . ' 71. Product Piping OGas OOil
23. as Pipe-Rough & Test
G 9 72. Underground Flush •
24. Roof Framing ' 73. Undergrnd.Storage-Tank 0 Gas 0 Oil •
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - - 75. Dry Chemical '
27. Frame and Flashing: • 76. bry Standpipe
28. Lathing& Siding - - • - -i• • 77;•-FIXED SYSTEM'FINAL' '
29. Insulation .. • . I f 78. :FIRE PREY. FINAL
30. Drywall Nailing I i. ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - "_ ,l` 4 79. FINAL INSPECTION
32. Electrical-Power Meter:Final . 1 I -1' • 80. FOOD CERTIFICATE ISSUED
I
33. Final Electric ' I �, Notes: -
•
34. Final Heating & Air Conditioning , I I' - . ,
35. Final Gas.Pipe-Test' i p ; ' ' '
36. Hood or Canopy
37. Final Factory Fireplace - ' '
38. Final Plumbing . " - - / k .
39. Water Service-Final
-
' 40. Gas Service-Final � i ; '
41. Solar Domestic-Final. I
I 1 ' '
V.
42. Backflow Preventer - �
43. Backflow Irrigation
.44. Landscape Irrigation System - • . -.
45.- Sound Attenuation '
46.':Handicap,Regulations
47. FINAL STRUCTURE & BUILDING d q_ft6.14.1 „ S B 4� �i< � `- 6�at
48.-FINAL PLANNING ( !
49. Electric Release to Edison , , -
50. Gas Release to Southern California Gas Co '-!
51. CERTIFICATE OF OCCUPANCY - .
No Date
•
PROJECT ADDRESS: 1056 VALLEJO CI UNIT: CITY OF COSTA MESA — BUILDING 'PERMIT PERM NO: BME 050211
OWNER'S NAME: SIAN, MARTIN
ADDREs,s SIAN, MARTIN FARP EE TR PERMIT NO: BME 050216 PLAN CHECK NO: 06773-90 S GOVT: N SUPP: N
1056 VALLEJO CIR
COSTA MESA,CA 92714 CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC STR PURPOSE: ADD
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 316SF 1ST FL RESIDENTIAL ADDITION SQ FT: 316
ADDRESS: UNIT:
CLAIM VALUE: 12, 000. 00 CALL—VALUE; 21 ,804 .00 GROUP OCC: R-3 /
PERMITTEE: CONSUMER SERVICES INC. ( 714 ) 754-1533
ADDREss: 17450 MT, HERRMAN{4 B COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME,
FOUNTAIN VALLEY CA 92708 ******�E�F�E+E*SE* ¢�ESF*�6*>F**+FSE**************QHS¢**�F+r�E****** FSE**SF*SH*+PS¢*****Sr**+F******EE**
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETH ACK S
CITY LIC.: 044683 STATELIC.:4 4349 /�/•' B
Date: Signature: l�fe�' 2 ��� MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: Thereby affirm that Ihave acenif .,e of consent to -u insure oracertificate of Workers' FRNT: 20 FT IN REAR: 20 FT IN FRNT: FT IN REAR: FT IN
Compensation ii•rs•r�eµp 77,, nilir tiny thereof(Section 3800.Lab. ) LEFT; 10 FT 8 IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
POLICY N0.: 110 5 a 7Y—9 V UP.DATE: 10/01 /91
' • COMPANY: STATE FUND /3 —07-90,...„...„/PARKING REQ PROV: PARCEL• 41205214 ZNE: R1 REF NO:
❑ Cemredcopy ishereby furnishd. LX Certified copy isfiledie^ Buildm wsioPLANNING NOTES> 322 SF ADDITION OF A FAMILY ROOM TO AN EXISTING SFR
� > LOCATED IN FLOOD ZONE BUT ADD, LESS THAN 50% OF TOTAL,
2-07-990 • *******************************************************************************
Date: App cant D E V E • L 0 P M E` N T S EARVICES R E U I R E M E N •'T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TNN section need not be completed if Me Int is for one hundred(5700)or less,. Q
I certify that in the performance of the worVor which this permit is issued.I shalt not employ any person in any manner so as to become • r!-
subject to the Workers Compensation Lawsof California. —ZONING APPROVED BY • CL.,3 DATE: 12 f y ( C1 0
•
•
Date: Signature' -,BUILDING APPROVED BY
NOTICE:If.atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must forthwithG comply with such firm t or this permit shall bedeemed revoked. •
,�, � I DATE: 1•L r'l J �j
CONSTRUCTION LENDING AGENCY: heRby affirm that there is a construction lending agency for the p¢rorrnant¢of the work for /APPLICATION ISSUED BY• ' � 11E 9F 91FF y�**!7 TF
which this permit is issued(Section 3097.Civ.C). • *********************************** * ** * * *****************{(.** * * * *.{p
LENDER: '*******************************************************************************
ADDRESS: LEGALIZATION:N F E E S U M MAR Y • STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of •i• which requires a permit to construct,alter,improve,demolish,or PERMIT 225 . 00 9 , 00 18,00 , 1 . 53
repair any structure.prior to its issuance.also requires the arm•"_•such oermil to file a signed statement that he/she is licensed 5 0 t • 25% SM I P/NON—RES
pursuant to the provisions of the Contractors'State License L i ire��arAririy,nein with Section 7000,of Division 3 of the Business
and Profession Code)or that he/she is exempt there're.. Oa TE- ill d •n.Any violation of Section 7031.5 by PLAN 146 . 25
any applicant lora permit subjects the applicant t. • civil p Jai ly 5 ouar s500). ISSUE FEE 15 , 00 15. 00
�sac.,1 • \W BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I, as owner of the property or my employees with , .v•�'y. . i' p. will do the work, and the TOTALS----> 253 . 53 30 . 00 146 . 25 429 . 78 429 . 78 . 00
❑ structure is not intended or altered for sale( ton 71 •,Business an.Pru anal Code •0 Contractors'State License Law
does not apply to an owner of a propeny who builds or improves thereon. . d who doe�r ' work himself/herself or through
his or her own employees,provided that such improvements are not intend •or offer or sale.II,however the building or REVENUE DIVISION TOTALS——> COLLECTED: 283 . 53 OVER/SHORT: . 00
1 improvement is sold within one year of completion.the owner will have the b den of proving he/she did not build or improve
tor the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 225 • 0 0 2 4 , 0 0 3 3, 00 w 1 . 53
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon 'w
and who contracts for such projects with a contractor(sf license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof 01 their Worker's Compensation insurance should be provided to me. IND I V ID UAL F EE..,- B' R E.
AK DOWN
o I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY . DESCRIPTIO N • . UNIT COST TOTAL COST
Date: OwnerSFR 316 DWE—TYPE V—WOOD FRAME —GOOD• , 69 . 00 21 , 804 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533.and ELE 4 FIXTURES, LIGHTING 1 ST 20 EA. . 75 3. 00
25534 and that I or any future budding occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 6 R EC EP T/OUTLET 1 ST 20_ EA. . 75 4 . 50
permtese fo construction or modification from thes. Air uafity Management District.Residential construction applications are exempt from ELE 2 RECEPT/SWITCH 1 ST 20' r EA:: . 75 1 . 50
MEC 2 REPAIR/ALT HEATING UNIT/SYS• W/CNTLS 9 . 00 .18 . 00
Date: Applicant: END OF FEES
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county •.
ordinances and state laws relating to building construction and hereby am' ire representatives of this city to enter upon the above-mentioned a
,
•
Property for inspection purposes., (/yam— / ,r 01 000757E2-0007579:: 1:37—,
2 �
Date. / —07=S/ Signature: f 2. 3� DATE: 12/07/90 TM: 11:`.•1.
Driver's License or Social Security e:
r
1641-46 white—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor `
CONSTRUCTION AND PLANNING PO(,_ a. SPA
APPF}OVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. 'toil Pipe-Undrgrnd. •C _ 53. Steel Reinforcement
c .3. Electrical Conduit,Utility-Undrgrnd; ' 54. Forms
1 4C Electrical Conduit=Undrgrnd. 55. Electrical Bonding
•..5.,Steel Reinforceineent, ' /L L7-qo jj6r 56. Rough Plumbing & Pressure Test
6.-ElectriwlUFERGrnd. I i 57. APPROVAL TO COVER-GUNITE
•-,7-.-Footings 58. Electrical Conduit-Undrgrnd.
c
B.,'Foundation 59. Ga e Undrgrnd., Test -
9. Water Pipe-Undrgind. 60. Ba //aa�6 Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 1 c (2.-t7--q DW 61. APPi• TO DECK
11_Property Sewer'Line & House Connection 62. Backllwas�s:4`7-ceptor-Final
12. Sewer Cap c 63. Heate\l.*)nt-Final
13. Roof Drains 64. Plumbirst tr - Final
14. Rough Plumbing • 65. Electrical4inal
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 2-CS-ii C C 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 Z-sZ..ttf i.Cp FIRE DEPT. REQUIREMENT
20.rRough Factory Fireplace - r _ - , :. ' 1 --• 'APPROVALSr2 CPermit# .'
- r Sa . _- : _ * . t • , • .
21.,Ducts,in Structure. ., 'r a . - - -:70. Underground Hydro •
22. Ducts, Ventilating - - - _ - ` - • -r71. Product Piping 0 G_as 0:0 1
23.-Gas PipetRough&lest `: _ 72. Underground Flusfi .,
24..Roof Framing •., - - ' r ?73?'Undergrnd:StorageTank OGas 0011 t '-
25.'Roof Sheathing r' I-fl-W it , • '74.:b'verhead Hydro_ -
26TT-Bar Ceiling (Structural) &:Monocoat • i 7 '•• 752 Dry Chemical - -• • _ '," ,.
27- Frame and Flashing. 1 ' • Z--?,/-4.1 '.3gA , 76. Efry Standpipe
28.`Lathing•& Siding _ _ 3_7.j-j ail. 77. FIXED SYSTEM FINALk _ ''• ?
'29. Insulation . _.. ' " _ 7-12J-qt 0 !s y - - • -
�- P 78a-FIRE PREY. FINAL _ t�'
30. Drywall Nailing -• : _• - 3-(Y1( 6:444 : ., HEALTH�DEPTL REQUIREMENT
31. Plaster Brown Coat r -: . :fa t(-4( gp {{ ,79: FINAL INSPECTION• -
. /' t. r -
32.-Electrical Power Meter-Final, . . . 1 (: • �r80..FOOD CERTIFICATE ISSUED'
33.:Final Electric s ' '.
o.
34;-Final Hating & Air Conditionin ,-
r..
35:'Final Gas Pipe-Test' tr 'C _ ' • = "- - '• - • ■ b'
36.rHood or.Canopy` J.r t >: z fi,.a � ,
-37.-.Final Factory Fireplace '`•rL.. r ' le2reqa ' 5Cab;‘ /.S fC" A`
'38. Final Plumbing ,. " :AC, + • ' i_.
' •39. Water Service-Final i . -� ' � .• > -a'• a ' r . r, 's-
•
• r. -
40. Gas;Service-Final • i ' / >--hi-Ser-e• t • t nz
41.:Solar Domestic-Final.: _ ' : x
42'Backflow Preventer, 1' ,i. - _ -.•
•
43. Backflow Irrigation, - .�` .-• - ' • _ - _ .
a . • L'
X44. Landscape Irrigation System;-'_ a, - • y. ` „
45._Sound Attenuation ., - .- • . ,rd •
-46:-Handicap Regulations - • • =
47. FINAL STRUCTURE & BUILDING (-211t2 6. ' '' • .&
48.1FINALPLANNING 1 • -
-49.-Electric Release to Edison >
•
•• 50.:Gas Release to Southern California Gas Co • I - ,
51. CERTIFICATE OF:OCCUPANCY _
No. Date
City of Costa Mesa
California 92628-1200 P.O.Box 1200 i
Insulation Certificate 1
• 7 Q 2
• Permit Number F / / J 3 Al
/06 C V'19i'Ccffb Ot N1,nz,
Number and Street City
v.A•
County Subdivision Lot Number
Description of Installation
ROOF /�n
Material 'r t&X/ /'t& Brand Name /) iPt?‹
Thickness (inches) Thermal Resistance (R-Value) .
EXTERIOR WALL ) — /�/�n
Material ' ��� Iv kee.nt B'` Brand Name ci(5MOW^� Li/GC-
fi
Thickness (inches) Thermal Resistance (R-Value)
CEILING �A
Batt or Blanket Type .-- Brand Name cf b /1494.. f),{_
Thickness (inches) CO " Thermal Resistance (R-Value)
Loose Fill Type Brand Name
Contractor's minimum installed weighUft2_ lb. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value)
SLAB FLOOR
Material
CO 11/41-2
n Ce—AgBrand Name
Thickness (inches) Thermal Resistance (R-Value)
Width (inches) '
FOUNDATION WALL
•
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value) •
• Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Adminstrative Cod-
c ' C,4!&" P 3
Gener. tra •r(B '•er) icense Number
/ISiggnatur�e and ' /4/ S/ Date
to'^`P�
Sub-Contractor(Insulation Installer) License Number
\ Signature and Title Date
190746
29582
JAN -7-69P�7000 214* ****99.06
COSTA MESA COSTABUILDING-SAFETY DEPARTMENT crlsn
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92686
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING
ADDRESS 1056 Vallejo Circle
RECEIPT NO. 2PE15 2
COSTA MESA. CALIFORNIA - — �lll (YV�(�L/
CEIVER
TE
SUED
OWNER Heltzer Enterprises-Costa Mesa l iV Ia- 24, -6a J, :? -07
BUILDING /���j/ //.,__n. , Oy
MAIL ADDRESS /W& !/O Mir {.(1CGCf�
ADDRESS 144 South La Brea Avenue /
CITY Los Angeles 90036 ;R7936-1104 ZONE TYPE r.. GROUP Z*I
ARCHITECT 1' TELL,,„�,, 714) DYAPFROVED DATE
OR ENGINEER PrAnkjinn7al PC NO.112-6878
1336 E. Chapman Avenue ZONING
ADDRESS ()ran California 92668
ZONE NO.OP BUIL DI HEV/ Res. w/
CONTRACTOR George S_ Meltzer & Assoc. Rl I PUN. 2 I Bwtm/GAttnrh rnrnpe
ADDRESS 144 South La Brea Avenue DESCRIPTION Lot 57, Tract 6637
CITY Los Angeles , California 90036 A.P.NO. None
NOTE: NO[AVE OVERHANG SHALL BE LESS THAN
STATE 201098 No 936-1104 BO'TO SIDE O REAR P.L.
LIC.NO.
SIZE NO.OF SLOGS. VES
ALLLOWED (U.B.C.REQUIREMENT)
OF LOT I NOw ON urn 0
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
-I -(FROM C/LL STREET)
SETBACK LINE FROM
CENTER Or STREET REAR YARD 20 I
FRONT 5 PT. PT.
SIDE YARD I LEFT 18 1 I RIGHT 51 R.SIDE FT. FT.
DESCRIPTION OF WORK L.SIDE II FT. FT.
NEW X ALTERATION ADDITION REAR __>11 FT. FT.
DISTANCE BET. BET.MAIN&
REPAIR .1 MOVING DEMOLISH MAIN BLDQS. ACCESS.BUMS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES 1 C.U.P.# APPROVED
EXTERIOR WALL ant ROOF APPROVED /I .. ,,
COVERING 5LUCO:y COVERING wood shingle eY WTE /1p
USE OF BUILDING AND WORK TO BE PERFORMED ��11 � �• 104
Dwelling and Attached Garage T
Plan 407R - T.nt 57
J/991eO. a o
PT. 7cg
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION TME AMOUNT B N UNDER VALUATION IS !OR THE j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. ,DNJ,
PLY WITH ALL CITY ORDINANCE/AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. / —
91
SSIGNATUREERMITUEE OF ab PERMIT FEE 5 IYYC///l�
/�/�J f da 377 PLAN CHECK S '. ' - 1`
AUTHORIZED AG[ G(f_2 j�}ij ' TOTAL FEE $
v