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Home My WebLink About400 BRIGHTON SPRINGS - Building Permits(714) 754-5273 • F2Jc (714) 7543856 • Www.Ci.COSte-fn038.G�sUMBING PERMIT n FAIR OFIVE, GOS IA MtSA, GA 9261ti JobAddress: 400 BRIGHTON SPRINGS Status: �SSueD Suite No � Applied: 07/27/2006 � Issued: 07/27/2006 Vicinity: q � �' ��' o� Parcel Nunmber: 93786021 �� ,��a� App�icant: RODRIGUEZ, ILDEFONSO 9�s'�' ISSUED BY: Address: 7050 LAMPSON AVE . . . - - -. Owner: Address � %,;'Addres3:_ ; / i i,�`, ' ( � , . ._ , � ` _. . - � � -�;� ,��-Phona:'714-530-7320 - - GARDEN GROVE,.CA;y/l!--_,.- . �'Zip,-�92841 � , - ��" � '�,�; _ , , , _ -�c `. . i�� - � � / ' � � KOCDING R rMARJORIE STOVALI TR! '� '� �'`�'; � i , °%CERNAK; THEODOREI j - _ _ � ; � � � � , ` � �� ` COSTA MESA�CA�� / � ,_ Phone � - `�- �� : �-. �, \ � A) _�� 400 BRIGHTON SPRINGS�j � Zip 95819�148 �� / �� ; �� \ / C .�,-- %�s' ��j-�� .' i �� % �' � \� _ i � � � `��' \ �EMPIRE�PLUMBING � -��`�� ,' �� \ \ _. . 7050.CAMPSONAV �� . �" �. � �' ``• � j� Phone� 714-530-7320 � � �� . � ��;�' •, GARDEN GROVE, CA , Zip: � 92841 . , _ ��, � � '•License: °-794]54,.. j / ' �\ 1 .%'f � . . ' „ � . . , . , �; �� W TER HEATERJCHANGE OUT _ / y r _• AMT ISSUE FEE � -i.;' �� $23.50 Back9ow irrigation! � � $0.00 Backflow Preventec ;; , $0.00 Bathtub .-- '�'� �� $0.00 ClariferSystem � $0.00 Connect (Ice,Soda,etc) �. $0.00 Dental Units '- . $0.00 Dishwasher � 50.00 Drain,Floor .� .� $O.OD Drain� Ralnwater ��\\�'-} $0.00 Drain; Roof�, �J` \ � $0.00 Drinking'Fouritain�,� ��$0.00 Ezpansion Tank� � ��$0;00 Gas Earthquake Valve �50.00 Gas (1=4 outlets) .� $0.00 Gas (Over 4 ou0ets) � � $0.00 Gas Repipe�� " $0.00 Gas Service'-� �� /$0,00 Interceptors (Grease, Oiq'/$0.00 Interceptors (Sand'Auto )� � $0.00 - �r.` �-. /��.. : �' , � ✓ � % FEE SUMMARY � QTY-- �'- .-- - - . .. ,.- AMT QTY�- - 0` /��.�r✓_�La"ridseap'e�lrrig too r�.1..�_$0.00 .��O:f':�� 0°--� - "- " P=Trap ` � - $0.00 '0 - 0�� PressureRegulator $0.00 `'O;j 0� ��.Process.Piping (per 10 fi) $0.00 �A�, 0 ,� _ . � Receptors � ' /, ��, <:$0.00 '7`.0. �c.z, • 0 �: -'-"SepticTank-'-`" " '°--$0.00' �'0' �- ' � 0 �, "'' SeweiCapforDemo� -- $000 0 --" � 0 ' Sewer Connect $0�.00 � � 0 O,i Sewer Private Line �$0.00�_ 0 0 Shower :.:$0.00'�„,0 0; Sink, bar $0.00 0 Oi Sink, commercial;�"`��•?�:%� �� $0.00 0 0� Sink, Floo�.?� �:�� `� �. 50.00 0 0; Sink,'kitchen `- �$0'.00�,•,0 0:. _Sink'service/mop - �i. ,� $0.00 =�-�0..,; _< �- 0 J?�^-:�i,� Spa (private)� %, - $0.00 � "0 `� �'b-� � 0� - '', Spa (public) �_ ` � � ��' $0.00 0 � v � AMT `•�SumpPump $0.00 ��SwimmingPool�� ', � $0.00 - �TrepPrimer -� - $0.00 ' Urinal . $0.00 i Vacuum Brkr Bkfiow(t-4) ' $0.00 ^ Vacuum Brkr Bkflo�v(5+j >- ; �$Q00. � Wash Basln � ; $0:00' Wash Basin Set;' , $0.00 � � Waste and Vent System -; $0.00 `- WaterCloset (Toilep �, - $0.00 � WaterHeater./vent;�'- -$12.30, Water Piping,(Ins�t or Rep.) ; $0.00� WaterRe,pipe� � ��%$0.00 Water Seryice „ : $0.00 Waler�Soflener % $0:00 OTHER � ' , � �$0.00 �'-�VIOI:ATION ' _ � i .$0.00 .�" FLAN CHECK ��.� $0.00 � 0 ;�� C0 0 0 0 0 0 0 0 1 0 0 0 0 � 0� � c�. -; . . � ,REINSPECTION $0.00 0 �0 \ � �\��` o . . �', ' . ..� _�� , �'. / �%f ,� \ \.� �` ` - � � �� i ,� - TO `AL CAL � ATED`FEES: 535.80 � i % / V�J� L60MMENTS / SPECIAC CONDITIONS �V '/ /,� ,� - ., , _ ,..` / ` , �- , ,. � ��,`` - � � - -.�� _ -- .. „ . :_. '% �.. � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become vold if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for �he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepections end final approval must be obtained. Failure to obtain inspections and final approval will resull in the expiration of this permit. FOR INSPECTIONS CALL: (7/4) 754-5826 3GL:3F1J7 WORKERS' COMPENSATION DECIARATION: I �ereDy eNirtn untler penelry oi per�ury one oi t�e lollowing tleclaretlons: ❑ I heve entl wlll meintaln e cenlficate at consenl to setl-Insure for workers' compensetion, fls provided tor by sedion 3700 of the Lebor Code, for the pertortnance of the work for w�ic� t�is permit Is IuueC. � I have entl will maintaln workers' compensation Insurence, es required by seclion 3700 ot Ne Le6or Cotle, for I�e peAortnance ot the vrork tor which Nis pertnit I5 Issued. Mv worknre' mmoensntlon Insurancw rartler.entl oolicv numhnr xre� CoIlryNumber. �IQQl1 � F��r ar IeSsJ ❑ I cenify that In Ihe pertortnence af ihe work tor w�ich ihis permil is Issued, I shall not employ eny person in eny menner so es to become subJect to 1he workere' compensetlon laws ol Caqfomia, antl egree Ihet If I shoultl become suD�act to Ne workers' compensetion provisions of Sactian 3700 of [he Lebor Code, 1 shell torthwNh compty with Ihesa pm bns � G AppOca`nt SlgneWre: I' �-� �� Date: � �J��' �ii i WARNINO: FNLURE TO SECURE WO (E0.5' OMPE AT COVERACE IS UNUWFUL rWD SFIALL SUBJECT PN EM%.OYER TO CRIMINRL PENRLTIES Ml� CML FlNES UP TO ONE HUNDRE� TFKKISANDDOLLARE(SI00,000),INAO�RIONTOTME OFCOMPENSATIqJ,DAAAAGESASPROVIDEDFORINSECTION3]O60FTHEIABORCODE.IFrtEREST,ANDATTORNE'I'SFEES. LICENSED CONTRACTORS DECLARATON: I hereby ettirm ihat I am Iicen39dyP d¢�r p�raWs1'Pns ol Chapter 9(cammencing with Section 7000) oi �ivlslon 3 ot Ihe Business�end Pratesslons Cotla, entl my license Is in full lorce.antl aXect.Lc _x /Y YY,T� `/� �dlass�a� ConlrecibYs�Signewre:-1� �%a�G��% Oete:. Z`��— A CONS7RUC710MLENDING AGENCY: ❑ I hereby ettirtn Ihat t�ere is e conslruction lentling agency for the peAortnance ol the work For which ihis pertnit Is issued. (Sec. 3097, Civil Cotle). Lenders Neme: Lendefs Address: SigneWre: OWNER•BUILDER DECLARATIONS: Date: I hereby eHirtn Ihet under penalry of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Cade: Any ciry or counry which requires e Oermit to construcl, alter, impmve, demolish, or repelr eny strucWre, pnar to its issuenca, elso requires the eODlicant 1or such pertnit to file e signed stetement thet he or she Is Ilcensetl pursuent to the provisions of t�e Coniredora License Law (Chepter 8(commencing wlth Sectlon 7000) of DlWslon 3 of ihe Business end Professions Cotle) or t�et �e or she Is e:empt Ihereirom end the besis tor Ihe allegad exemption. Any vloletian of Secllon 7031.5 by eny eppllcanllor e pertnN subjects the epplicent to e civll penalty a� not more then fiva hundred tlollars ($500) J: ❑ I, fle owner of the praparry, ar my employees wlth wages es iheir sole compensetlan, WILL DO THE WORK, antl the structure is not In�entled or oflered for sele (Sec. 7044, Business and Protesslons Cotle: The Contrectors LJcense Law tloes not apply to en owner ot properry who bullds ar impmves thereon, entl who tloes auch work himsell or herselt or through hIs or her own employees, providetl Ihat such improvemenis are not Intended or ottered for sale. If, howaver, iha bullEing or improvement Is sold within one yea� of completion, the owner-builder will heve the burden of praving that �e or s�e ditl not Gulld or improve lor purpose ot sale.). � ❑ I, es owner ot t�e propeny em EXCLUSIVELY CONTRACTING WITX LICENSED COMRACTORS to construd Ihe project (Sec. 7044, Business end Professlons Cotle: The contractora License law tloes not eppty to en owner ol properry w�a builtls or improves thereon, end who contracts lor such pro�ect with e contreqor(s) Ilcense pursuent to Ihe Contredors License Lews.). ❑ I em azempt under sec. eu5ineu antl Professions Code tor this reason: Signature: Date: Owner ID verified by dnvefs Iicense. ❑ Ves ❑ No Drivefs License No. Vedfirallon af Ownership by (rype ol0ocument, i.e. - property tex bill or tleetl): Eapires: DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATON: ❑ I hereby cenify ihat no excavetlon five (5) or more teet in Cepi� into which a pereon is required to descend, will be made In connectian with work euthorized by this pertnit, antl Ihat no bulltling siruclure, scettolding, telsework, ar demolition or dismantling Ihereat, will be more than thirty-sl: (36) feet �Igh. (C�ep. 32, Grp 2, Art 2, Sec. 341, Tiile 8, Celitomia Administretive Code). � Ae owner-builder, I wlll not employ enyone to tlo work which woultl require a pertnit trom the Divislon at Industdal Satery, es notetl ebove, unless such person has e pertnit to do such work irom the tllWsion. Signeture: Date: Division of Industriel Sefery Permit Number: CERTIFlCATE OF COMPLIANCE ANO AUTHORIZA710N OF EMAV: I certiry under penalry of perjury that I have read Ihis appllcetlon end slate t�at the intortnetion gNen is conect. I egree to compy wit� all sleta laws antl dry ordinences relating to 6uilAing construction, end aulhorize re0�esentatNes of t�e City of Costa Mesa to enter upon the ebove-described property tor inspection purposes. I agree not to accupy or ellow occupancy ot eny building authonzed by lhis permit until finel inspection. COOE t• INSVECPONTYPE 1676 Fiaetl System Finel Fire Prevencion 1266 Pool Spe Finel 200 Finel Re-Rooi 201 Final BIocWRetalning Well 202 Final Fectory Fire Place 203 Flnel Sign 204 Final Demolition Q� � i'� i —o%� � oa�a CODEt INSFECTIONTYPE Qd7$ �H 206 Finel Mechaniwl 20B Final Plumbing 210 Final Elecirical 212 Final Fire Preventlon 220 Final Planning ApDroval 222 Final Slte 250 � Final BuilUinp/Occupancy . . (714) 754-5273 • Fvc (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 400 BRIGHTON SPRINGS Suite: Vicinity: 400-410 Parcel Number: 93786021 Applicant: BATIOFF,JOHN Address: 17182 ARMSTRONG AV IRVINE, CA Owner: BRIGHTON SPRINGS HOA Address "412 BRIGHTO SPRINGS COSTA MESA,CXA Comractor. DAVEY ROOFING INC Address: 17182 ARMSTRONG AV IRVINE, CA Zip: ' 92614 Zoning: Phone: (949) 852-9955 Zip: 92614 Phone: 2ip: 92627 Phone: (949)852-9955 License: 700710 Status: ISSUED Applied: 04/23/2001 Issued: 04/23/2001 ISSUED BY: ,��%� Arch : Eng: Address: � Address: � Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXIST. CEDAR WOOD SHAKE AND BUILT ROOFING. INSTALL 30 LBS ASTM AND RERROF 38 S� W/ 40 YEAR COMP AND i6 SQ W/BUR. � Plan Check: � Permit: SMIP Res: SMIP Com: Other: Inspection: Total: � �- SETBACKS ACCESSORY PARKING NOTES: $0.00 $237.25 $1.40 $0.00 $0.00 $0.00 $238.65 Front 0- 0 Front 0- 0 Exi�: 0 Rear 0-0 Rear 0-0 Reouired: 0 FEE SUMMARY PLANNING 8 ZONING LeR 0. 0 Lefl 0- 0 ProDosed: 0 Calc Valuation: Claim Valuation: ` $13,957.00 $13,957.00 � �i � �� % : / � � � .. �' Right 0- 0 � Right 0-.0 � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or ii work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona and 8nel approvel must be obtained. Failure to obtain inspections and final approval will result in the expirationot this permit. FOR INSPECTIONS CALL: (714) 7545626 2b6&66 (6N0) WORKERS'COMPENSAnON DECLARAnON: I hereby attirm under penalry oF perjury ona of the following declarations: ❑ I have and will maintain a cenificate of consent to selFlnsure for workers' compensation, as provitletl tor by section 3700 of the Lebor Cotle, for the pertormence of the �work for which this pertnit is issued. '��I�have arW will maintain workers' canpensation Insurance, as required by sectlon 3700 oi Ne Labor Code, for �he pertortnance ol t�e work tor which this pertnit is issued. My workeJr�,' co—m�pensation urance carri r and poliry numbar are: �7y� Certier: J�� PolicyNumber r�Z3I /VI (ihis section neeb not be comp/eted il fhe permif is velued af one hundred dollars (5/00) or Iess.J ❑ I certify that in the performance ot ihe work for which ihis pertnit is issueQ I shall not employ any pereon in eny manner so as to become subject to t�e workers' compensation laws ot Caltlomia, and egree Ihat il I should become subject lo tha workers' compensation provisions ot Section 3700 ot the Labor Code, I shall torthwith comply with [hese pmv�sions. n \ aoori��.sianawre: ��`� ..rr� �oa�e:. Ll r-2 --G` f WARNING: FAILURE TO SECUR ERS' PENSAi1pN COVERAGE IS UNLAWFUL AND SHP1L SUflIECT AN cMPLOYER70 CRIMINAL PENALTIES AND CML FlNES UP TOONE HUNDRED THOUSANp DOLLARE (5100,000), IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SELTION 3]OB OF THE IABOfl COOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby attirm thai I am Ilcensetl und�er provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the force and eflect Cic. M_.. `% OL� '� I(J� Class Coae, end my license is in tull CONSTRUCTON LENDING AGENCY: ❑ I hereby aHirtn that ihere is a cronstrudion lending agency tor the peRormance of the work lor which this permit is issued. (Sec. 3097, Civil Coae). Lendels Name: Lentlers Address: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby affrm t�at untler penalry oi perjury ihat I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professlons Cotle: Any city or county which requiras a permit to construct, elter, improve, tlemolish, or repeir any structure, pnor to its issuance, also requires the applicant tor such permit to tile a signed statement Ihat he or she is Iicensed pursuam to the provislons of ihe Contractors License Law (C�apter 9(crommenGng with SecGon 7000) ot DlWsion 3 01 t�e Business antl Profeuions Code) or that ha or sha is ezempt therefrom end the basis lor Ihe ellegad ezemption. Any violation of Seciion 7031.5 by eny appliwnt for e permit sublecis Ihe epplicant to a civil penalry of not more ihan five hundred dollars ($500).): ❑ I, as owner of the pmperty, or my employees wilh wages as Iheir sole compensation, WILL DO THE WORK, entl the structure Is not intentletl or oflered for sale (Sec. 7044, Business and Professions Coda: The Conirectors License Law dces not appty to an owner of property who builds or improves thereon, and who does such work himsetl or �erself or through his or her own employees, provided thet such improvements ere not intendad or offered for sele. II, hawever, �he building or improvement is sold within one year of completion, the owner-builder will heve ihe burden of proving that he or she did not build or improve tor purpase of sale.). ❑ I, as owner of tha propeny, am EXCIUSIVELY CONTRAC7ING WI7H LICENSED CONTRACTORS to construci the proleci (Sac. 7044, Business and Professions Code: TTe contractore License Law does not appty to an owner of pmpeny who builtls or impmves t�ereon, end who conirects lor such pmject wiih e contrac�or(s) license pursuant to the Contraciors License Laws.). ❑ I am exempt untler sec. Business end Prolessions Code tor this reason: Signature: Date: Owner ID verified by tlnver'Slicen58. ❑ Ves ❑ No Dnvefs Licensa No. Expires: Veniication ol Ownership by (type ot tlocument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hareby certify that no ezcavetion tive (5) or more feet in tlepth in�o which a person is required to descentl, will be mede in connection with work authorized 6y this pertnit, end that no building structure, scattolding, lalsework, or demolition or tlisman�ling �hereot, will be more than ihirry-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 34 i, Ttle B, Califomia Administra�ive Code). ❑ As owner-builtlar, I will not employ anyona to do work which woultl require a permit Irom the Division ol Industnal Sefery, es noted ebove, unleu such person �es e pertnit to tlo such work trom the tlivision. Signature: Date: Division oi Industnal Satery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N.OF ENTAV: I cenily under penalty oi perjury thet I have read this epplication entl stata Ihat the information given is correct I agrea to comply with ell state laws entl ciry ordinances relating to building construction, and euthonze representatives of Ihe Ciry ot Cos�a Mesa to enter upon Ihe ahove-descnbed property tor inspection purpases. I agree not to occupy or allow occupancy oi any building authonzed by this permit until final inspection. yODE �. INSPECTONiYPE 1616 Fixed Sysiem Final Fire Pravention 7266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 FinalOemolition Owner(s) AppNcant. o�re� ItIIIILLS - 2-Of � yQOEt INSPELTIONTYVE 206 Final Mechanical 208 Finel Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Builtling/Occupency �7\I� � CULLIF --�unrv[rt—�-U.—JHIYCJ l:Q�� JOB ADDRESS 400. 02 _ 04 _ 0 SWA. LINE I UNOEAGFOUNO S�STEM GIR COM�ITIONING OR POLE POWEA r AS STEEL qEINF. SMEPTHING FRAME AND FL/SHING LAiHING — IN r� < PLASTER.BAOWN COnT STRUCTUR4L, FINRL HE�TING. VENT., REFpIu. n PLOMB�HG. F�H4C aNO GA5 TESi nf1 EIECTRiC, FINnI BUILOING, FINR� S�ECIAL AEOUIREMENT� 1� m SUBCONTRACTOR N'L7'/7 ?ERMIT N0. 0 � �ar �0 i i- � , �-i� ��: � ��` y�>,� ��. vhncK--M-'17_ . �pATE___—_ -i�-c�-i� JOB ADDRESS 40� Brlahton Sorinos BUILDING PERMIT N0. Part ESCRIPTION of WORK IRE ZONE V cj SUBCONTRACTOR PROP. SWR. �INE I J NOUSE CON. SppINKLING SVSTEM MiSCEIL�NE0U5 ROOGH NEFTING ANO AIR CONDITI M WIRING INF. BONO BERM � j STEEL AfIN SHEATNING FqqME >ND FLnSMING iEFRIG. ANO A.C., FINAL 4N0 GRS TEST n 9UILOING, FINnL SPECIaL REpU�REMENTS ..�.. .�.. ...��.�.�r� r�c r� CI CfT �� tfpo�oZ�O�f� aG� O8� IU �'� t� 2� �/ I f� 79 ,� I 6.84 T4' � COSTA MESA BUILDINGSAFETY DEPAflTMENT APPLICATION F TR CT RALPERMI -��- �^ P.O. BOX 1200 COSTA M�SA, CALIFORNIA 92626 � RECEIVEDBV PERMIT� � F � m a ¢ y h S F G F � J a > �' ..i � m a 0 C a Z W S 3 For Applicant to Fill in Completely — Use Ink Only BVILOING A.P. NO. �S� IO� ADDRESS BUILDING °ENApRj �R M.D. Janes Co. , InC. Aooaess UNIT OR ADDRE55 2g50 Airway Ave. , D-9 SPACENO. Tg.NO � LOT ' c�Tv Costa Mesa 92626 No`979-337 / NEW ADD ALTER CONSTRUCTION I FNl1FF N/A � BftANCii Y' ADDRESS y� ARCHITECT S,dm leT OR ENGINEER P ADORESS 179�+�+ SkY CONTRACTOR OWll2T ADORE55 CITV STATE LIC. NO. size Irre OF LOT K' USE OF /Ilg No`549-252 Park. Irvine 9271 NO. CITV LIC. NO. NO. OF BLDGS (/� NOW ON LOT Y Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO 8E PERFOFMED I haraby ecknowledBa thet 1 hava reetl thia epplication ontl siate that the above information is eorraet end aB�ee to eomply wlt� all laws regubtinp building construction, end I shell not amploy any person in vlolation of the workman's compenmtion lews of the Stata of Californle. I hareby certify thet I am propar�y ��cenfetl as a contractor untlar Ma State ot Californla Busineu ehtl Protauions Code, Dlvislon 3, Chepter 9, entl thet such licensas are In tull forca and ofiect, or 1 am exempt fro Ne provisions of t�e Steta of Callfornia Buainass entl Protessions otle, tyislon 3, Chepter 9. Sipneture of Perm(ttee or Autho�ized . i DatG ROVED APPROVEDSETBACKS (FROMC/LSTREET) „ PLANNING ACTION DATE DEMO �RWV/C P~ I DATFIU �v � ROL9 FOR SPECIAL REOLIIREMENT� VALUATION � � C 'm m N J JN UNDER VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONLV: � PERMIT FEE E q n PLAN CHECK § 6v ^ 0 �5,2� � TAX E A� u TOTAL PAIO E : {//_. LZ "/ v - COSTA�A BUILDING-SAFETY DEPARTMENT P.O.BOX1200 COSTAMESA,CALIFORNIA92626 t For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS T� NANT�R M/D. ( ITI II�I F�+ C W 6. Q � y T F O � F Q G .� 6 � �^ ..7 C � a O a a z W 2 3 CITV BRANCH ADDRES: TEL. CONTRACTOR ( �Ci1,�C,� ADDRESS TEL. CITV NO. STATE CITY LIC. NO. LIC. NO. SIZE NO.OF BLDCS. OF lOT NOW ON LAT VSE OF EXISiING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowledBe thet 1 have reetl this epplication antl state that the ebove information is correct antl agrae to comply with ell laws reBulettng builtling ctl�struction, antl I shall not employ any penon in violation ot Me workman's compansation laws of Me Stete of California. I hareby certlfy that I am proPerly licansetl as a conttacior undar ihe State of Californla Businets antl Professions Cotle, Division 3, Chapter 9, and thet s ch licensas ere in full force end eftect, or I em azampt from the rovisions t the Steta ot Celitornia Buslnens entl Professiona Cotl Divl on 3 Chepier 9. SlOnet�ra of Permittee or Authorizetl Age Date , 5691 10/29/79 464,00 TL APPLICATION FOR STRUCTURAL PERMIT f�4].��(� PERMIT 'l0 � �� Z �� A.P. NO. BUILDING ADDRE55 UNIT OR SPACE NO. TR.NO. LOT NEW ADD ALTI OWNER USE APPROVEDSETBACKS PLANNI REPAIR MOVING DEMOLISH VAWE S / E GROUP DATE u �`` � THEAMOUNTSHOWN UNDERVALU THE PVFPOSE OF ESTABLISMING A PERP VALVATION PERMIT FEE E � PLAN CHECK 5 § TAX S TOTALPAID E C� m C > : m N J IS FOR m ONLV: _ m 0 f U F C W a a H � S F G,�" �`'j� �/�jc�'� � Q._ 46.70 TL 7 "� COSTA MESA BUI DINGSAFETY DEPARTMENT pPPLICAT[ON F R STRUC RAL PER,IIIT P.O.BOX1200 COSTAMESA,CALIFORNIA92626 V PERMIT N° 49045 For Applicant to Fill in Completely — Use Ink Only BVILDING / � A,P,NO. �S-«-3-�2 i�i 43 ADDRE55 ///�� Cp OWNER OR �� _ 1_ u� ADDRESG TENANT 1 Q(, MAILING UNIT OR ADDRESS�� Q SPACENO. TR.NO. LOT BLK. TE 7 y CITV �j NO NEW ADD ALTER REPAIR MOVING OEMOLISH CONSTRUGTIO LENOEF BRANCH M .�. OWNER / / � ES ADDRESS VALUE ,` ARCHITECT TEL. VS � S y�(/ OR ENGINEER 7 AODRESS ZONE ` TVP�� GFOUP� APPROVED CONTRACTOR BV DATE ADDRESS TEI. CITV NO. STATE CITV APPROVEDSETBACKS LIC. NO. UC. NO. SI2E NO.OFBLOGS. (FROMC/ STREET) OF LOT NOW ON LOT RONT FT. USE OF EXISTING BLDG. T Separate permits are required for L. SIDE J FT. elec[ric, plumbing and heating work. aena Fr. USE OF BUILDING AND WORK TO BE PERFOFMED PLqNNING ACTION � � �O �l✓ I APPROVEDI'�'�✓—� NPPROVE� . D� S C AL R OUIREMENTS I haraby acknowletlpa thet I have reatl thla eppllcation entl stata thet tha abova Intormetion Is eorrect antl apree to comply wiN all laws re8uleting builGinB eonsttuetlon, entl I ahalt not employ any parcon in vlolatlon of Me workman'a compentation lewa of the State of Celltornle. I hareby certify that I am properly Ilronaetl as a contrector untlar SQ. FT. the Staro ot Callfornia siness entl Proleulons Catle, Divialon 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR Chaptar 9, entl that a Iicenws are in (ull forca antl etfect, or I THE PURPOSE OF ESTABLISMING A PERMR FEE ONLV: em axempt from tha rovisions of the Srote of Callfornia Buslnass VALUATION untl ProfassionaCo 'vialon , Cheptar 9. PERMIT FEE S 28/ O� Sip^ntura of eO PLAN CHECK E / � 2O Permittee � TAX E �sQ 5 ar � AuthorizedAg Date TOTA�PAID E �j� � �� F � W a a h h F G W L-' G � > J � W 0. O a a Z u� 7. 3 . �2i�5fi C-T— � � COSTA MESA BUILDING- FETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 For Applicant ro Fill in Completely — Use Ink Only BUILDING AODRESS OWNER OR TENANT MAILING ADDRESS /� TEL9 CITV (J7()rj �il��(� NO.= 7I. BRANCH ADDRESS ARCHITECT TEL. CONTRACTOR ADDRESS TEL. CITV NO. STATE CITV LIC. NO. LIC. NO. SIZE NO.OF BLDGS OF l0T NOW ON LOT USE OF E%ISiING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUIIDING AND WORK TO BE PERFOflMED � � 9.�� APPLICATIO `OR STRUC RAL CERMIT ,7 """ N° 49046 A.P.NO.�IS�I�- �Q1 � �� BUILDING /�_ ___� / � iiODRE55 (,(�j/J1Ci L� VNIT OR SPACE NO. %/R`�f`j�a � LOT BLK. NEW ADD ALTER REPAIR MOVING DEMOLISH Z APP APPROVEDSETBACKS ►� PLANNING ACTION 2� �8-Is9 APPROVE(��.�J � ' 1 E O �%0 �S I heraby ecknowletlBe thet I heva reotl thls application entl smte � thet the above informetlon is correct antl aprea So comply wlth ell lewz reBuleUnp buildlnB eonetruetlon, entl I ahell not amploy � any par�on in violatlon of tha workmnn'e compansatlon law� of :' tha State of Californle. ' 3o m I hereby certify that I em prope�ly Iicansetl ae a eontractor untlar Z SQ. FT. �`+ the SSeta of Californie sinesa antl P�ofeulona Cotle, Dlvieion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Cheptar 9, end thai su licenses ere In fuil torce antl eftxt, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � em ezempt from t�e visl the Stata of Californ(a Businese VALUATION PERMIT FEE 5�B � end Protezsions Co iv on 3, apter 9. � � n PLAN CHEGK 5 �D a SIB�at�re of Perm�fttee S�/tQ�� TAX E s u r ♦ AuthoNzed Ba Date �� TOTqL PAID S�q_ 77