HomeMy WebLinkAbout423 16TH PL - Building Permitsi . '
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.B�LDING PERMIT 77 FAIR DHNE, GOSTA MESA, GA 92626
,lab Address: 423 16TH PL
Suite:
Vicinity: FRONT HALF OF RESIDENCE ONLY
Parcel Number: 42514116
ApplicanC ALMEIDA, CESAR
Address: 177 RIVERSIDE AV
NEWPOR78EACH.CA
Owner: JOHNSON, RAYNARD
Address ALEXAN�ER TR
COSTA MESA, CA
427 E 17TH ST #139
Convactor: NEWPORT ROOFING INC
Address: 177 RIVERSIDE AV
NEWPORTBEACH,CA
Zip: 92663
Arch :
Address:
Zoning:
Phone: (949) 645-0104
Zip: 92663
Phone:
Zip: 92627
Phone: (949)645-0104
License: 524454
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 11/17/2003
Issued: 11/17/2003
Phone: Phone:
Zip: - License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING SHAK� ROOF. INSTALL NEW CLASS C MEDIUM CEDAR SHAKES. FRONT HALF OF RESIDENCE ONLY.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$153.25
$0.74
$0.00
$0.00
$0.00
$153.99
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
�Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0•0�
$7,395.00
$7,395.00
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, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wNhin 180 days, or if work is suspended or abandoned
tor 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
requlred Inapectiona and finel approval must be obtained. Failure to obtain inspections end final approval will result in the ezpiratlon of this permit.
FOR INSPECTIONS CALL: (714) >545626
244&IB (B�W)
WORKERS' COMPENSATION DECLARA710N:
I �erehy aflirm under penalty o� perjury one ol the following daclarations:
❑ I �eve end will melntain e certiticete ot consent to setl-Insure tor workers' compensetlon, es provitletl for 6y 5ection 3700 of tha Labor Codo, for the pertormence af Ihe
work for which Ihis permit 15 Issuetl.
have end wiil maintain wor�c rs' comp nsatio ' nce, as require by sectlon 3700 of the Lebor Code, tor the petlortnance ol the work for which this pertnit is issued.
My workers' compeP'sa'atl'1 urance r(n�er antl po'c number er �
Carner: i y• r.. _ Policy Number:
(This sec(ion neetl nof be comP�eled ! the permit is velue ef one hundred dollers ($100J or /ess.)
❑ I ceritly ihat in the pertoR�ance of ihe work to� which this pertnif is issuetl, I shell not employ eny person in any manner so es to become subject to �h0 workers'
compensetlon laws oi Calllomia a i houla bacome sublect to Ihe workers' compensatlon provisions of Sec�Ion 3700 of Iha Lebor Code, I shall forthwith
comQly with these provi8ions.��— � �� I�� I��
Applicam Signeture: � �--� Date: /
WARNING: FAILURE T E qJ COVEMGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENPLiiES D CI NES UP TO ONE HUNDRED
TFKKISAND pOLLARE (E10p,00p), IN ADDITION TO THE CQST OF COMPENSATION, DAMAGE$ AS PflOVIDED WR IN SECTION 3'lO60F TME IABOq COpE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby eHirm that I am
torce end eflecL Lic. q
Comrectofs SignaWre:
CONSTRUC7ION LENDING AGENCY:
of Chapter 9(commencing with Section 7000) ot Division 3 of Ihe Business and Protessions Code, entl my Iicense is in full
Clau N
Da�e: � � ! -�1
❑ I hereby aflirm that there is a constmction lentling agency Por the peRormanco of the work br which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Neme: Lentler'S Address:
Signature:
OWNER-BUILDER DECLARAnONS:
Dete:
I hereby eflirtn thet unUer pen�lry of perjury Ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons
Cotle: Any city or county whicn requires a permit to consimct, elter, improve, tlemolis�, or repair eny strucWre, pnor ro its issuence, also requlres lhe eppllcant for such pertnit
to tlle a signed atatement that he or she is licensetl pursuant to tha provislons of the Conirectore License Law (Chapter 9(commenGng with Sectlon 7000) ol Division 3 of ihe
Business end Pmfeuions Code) or that he or she is e:empt therefrom end Ihe besls for the alleged ezemption. Any violation oi Sectlon 7031.5 by any epp��cant for e pertnit
subjecis ihe applicam to e civil penalry of not more Ihan five huntlred dollers (5500).):
❑ I, as owner ot the properry, or my employees with wages as ihelr sole compensation, WILL DO 7ME WORK, and the structure Is not imentletl or otteretl for sale (Sec.
7044, Business end Professions Code: The Coniractars License Lew does not apply to en owner of property who builds or improves Ihareon, antl who does such work
himself or hersell or ihrough his or her own employees, provitled ihat such improvements ere not Intentletl or oflered lor sale. It, however, Ihe huilEing or improvement is
soltl wit�in one year of completion, the owner-builder will have t�e burtlen of praving that he or sha did not build or improve for purpose of sele.). �
❑ I, a5 ownar of tha propedy, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construd the pmjeci (Sec. 7044, BuSiness and Pmfessions
Code: 7Te wntrectors License Lew tloes not eppty to an owner ol property who bulltls or Improves ihereon, and who coniracts for such pro�ect with a contractor(s)
Iicense pursuam to the C�iraaois Licanse Laws.).
❑ I em ezempt under sec. Business end Professions Code tor this reason:
Siqnature: Date:
Owner ID vorlfied by tlnveYs liCense. ❑ Ves ❑ No Oriver's License No.
Vedflcetion oi Ownership by (type of tlacument, i.e. - propeny tez bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Explres:
❑ I hereby certity thet no e%cavatlon tive (5) or mare teet in tlep�h into which e parson Is required ta dascenq will be mede in connection with work euthoMzed by this
pertnit, antl Ihet no building siructure, scaHoltling, falsework, or Cemolition or dismantling ihereoi, will be more Ihan Ihlrry-sia (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, Title B, Callfomia Adminisirative Cotle).
❑ A5 owner-builder, I will hot employ enyone to tlo work which woultl require a permit trom Ihe Division ot Industrial Sefety, es notetl above, unless such person hes e
pertnit to do such work fNm the division.
Signature: Date:
Division ol Indusirial Selery Permil Number:
CERTIFlCATE OF COMPLIANCE AND AIfTHORIZATION OF EN7RV: I cartify untlor penalty ol perjury that I �ave reaa this epplication and slate Ihat I�e intormetlon given is
corred. I egree to wmply wit� ell stete laws end city ordinances relating to bullding construction, and authorize representatives oi the Ciry ol Coste Mesa to enter upon the
above-descnDed properry for inspection purposes. I eqree not to acupy or ellow occupancy of any buildinq authonzed by this pertnit until tinal inspection.
COOE �. INSPECTONTIPE
1616 Fi:eC Syslem Final Fife Prevention
7266 Pool Spe Final
200
201
202
203
204
Finel Re-Rool
FIne181ocWRetelning Well
Flnel Fettory Fire PIaGe
Finel Sign
Final Demolition
� 1. .1111_
Q r _.��'�
� � f.�/ r��oeca
V
Dato
CO�E I INSiECTION NPE
206 Final Mechanical
20B Finel Plumbing
210 Finel ElectnCel
212 Flnel Pire Plevenllon
220 Final Planning Approvel
222 Final Site
250 Final Building/Oaupancy
pAg UiiID�L$
� {�Jt�T110DNE58: qzj E 16TH ST
OWNEB'S NAME: RAY JOHNSON
11DOflES3: SAME AS ABOVE
714/548-0739
�HCHIENGINEEfl:
ROOflESE:
flEU.NO.:
UNR: Q
uxrt:
PEHMITTEF: CRANK BROTHERS ROOFING ( 714 ) 548-5569
aooeess: 126 COMMERCIAL WAY
C.M. CA 92627
OCENSED fANTMCfOfl OECUMTION: 1 �ereCy atllrm lhai I licemed unEer provisions ol CAaO�er 9 cin ' Sec�bn
7000� ot Division 3 0l the Business antl Proleuims CaOe, anU 6unse ¢ in tull forcz anE elfed.
cmucj:'005 93 C/sur�uc.:408677 cuss:C39
Date: _/� J � `� / O Sipnatum:
i3' COMPENSATION OECWNITION: I �erebyatl' � I Aave a cetlificate ol wnsent
utian s rt ieE coDY ��ereo� (S io 00, Lah. �.
xo.: �������� o�Te: 1 /O1 /91
Workers'
❑ Certified Wpy i5 Irereby �urtusAeO. � CeM1iliN Wpy is il � � Ue al� BWdinq �
% a
Oaro'�6� �� v pppliwnt
EIIEMPfIOX FIIOM WOHKENS' WMPEXS1710N OECUM7ION: (This suuan nee0 not Oe mmDleteO il Ihe permii a la are hun re0 �f100) m ba).
I ceriiry tAat in ihe pedormanca ol tAe xrork lor wAich tAis Oe�mit is iuue0, I slWl not emD�oy any persan in any manner so az to Eecome
suEjed lo IAe wo�kers' ComDenution Laws of falitomia.
Date: Sipwture:
NOTILE: II, atler maMinp IAis Oedaation, you stwulE 6ecome subl� �o Itre Wo�kers Compe�sauon provisiom ol the LaOor
CoOe, you must IorthMi� comDly wIN suc� Dro�nsions ar Ihis permit SAall Ee deemeE revoked.
CONSTBUCTION LENDINO �OENCV: I heraby amrm that t�em is a consWc[ion IentlinB a0ency lor [ha peRormance of tha wark lor
wAich Ihis Dermit is issue0 (Satbn 3097, Civ. C�. �
LENUEX:
1100PESS:
OWNEP BUIL➢EB OECUMTION: I �ereDy amrm that I am exempt Imm the Contractors State lkense Law for Ne tollawin0 �euon
(Section 7031.5 Business anC Pmleuional CoOe: My cfty at counry which reQuires a De�mit to wnstruct. aRer, imD�a�e, damolish, or
re0air any stmcture, pnor to Its issuance, also requias Ne aDPlicant /or suc� permit to file a siOneC statement tlut he/she is Iicense0
pursuant to the pmvisions ol the Contnctors' St�te Licensa Law (Chapter 9(commencinA with Section 7000) af Oivision 3 of ihe Business
an0 Pmlessions Coda) or �hai ha/she is arempt tAeretmm antl ihe Uasis for Iha allaped exemption. My violatian oi Section 7031.5 by
any applican[ lor a permit subleqs Ihe aD711cant to a ciril penalry of nol mare t�an frve huntlre0 tlollars (55U0).
I, az owncr ol Na property or my employees witA wa0es as [heir wle compensatlon, vnll do ihe work, an0 Na
strucWre is imt inteMeO or oHereOlor sale (SeCtron 7094, Business anU Pmfessional Cotla: T�e Caniractas' State llume Law
��. � Eces not apDN �o m owner ol a pmperry wlro Cuil0.s ar imprwes tAereon, and who aacs sucA xrork Nmself/�ersell or Nmuph
�, h¢ or hu oxn empbyees, Drovitle0 ihat sucA imprwemen6 are not inten0e0 or ottereE tar sale. If, �awever t�e Oui101nO or
� improvement is sdtl witNn one year al comDletron, Ne owner will Aave t�e WrOen ot proWnO ��s�e Oi0 not Dw10 or improve
br Ihe purpose ol ule�.
I, as owner of Iha DmDerly. am exclusNeIy coniractinq vnth licenutl contractors to constmct the Omlect (Section 70d1, Business
❑ anE Professions Cada: The ConVactors' SUte License Law Oces rot appty ro an wmer ot prope�rywAo 6wIQc or Impraves Nerean
aM who cantrads lor suc� Drol�� �it� a cmVacfor(5) license Dursuant ta the ConlraRors' Sute License Law). I am awam
Ihat prool ot tluir Warker i Compens.11on insuairce sAoulE Ee prmi0etl to me. '
� I am exemD� mMu Section: 8. 6 P. C.
iw Ih'a reazon:
Date: Umec
I Uo �ereby cerliy Nat I am awam al an0 wEerstan0 t�e reQuiremen6 0l Califomia HeaIN anE Safery Cade Sectiore 25505, 25533. anE
2553d anE that I ar any IUWm OuiWinp occupant xillhrill not (crde one) neetl to compry with sai0 state cotla antl Ue repuirements lor a
permd lor constmclian ar mo0ifiation Imm Ne ar Uualiry Manapemeni Distnct. FevAeniW canswction apDliwtars �re exempl Imm
lhese Drouisons.
Date: Applicanl:
I here�y certiry ihat I have rea0 ihis aDVlication a state t�at ih ove information is correct. I apree ro con I it all ' an0 counry
or0inances and state Wvrs rela11n0 �o Uuilainp uctlon antl he by Nhanze representatives af Inis ciry to p on Ine e�mantionaE
pmperry r insDeclion puryoses.
Oate: '� e '�Wre:
onver's �ianm or sacia� Secur�ry x:
.� 18Cb18 White—BUIIEinp; Grean—COEe Enlorcemont; Canary—Applicem; Pink—Revenue: GolOanrotl—Asaesaor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 049273
PERMIT NO: B 099273 PLAN CHECK N0: N GOVT; N.SUPP: N
CONSTAUCTION TYPE: PERMIT TYPE; STR PURPOSE: ALT
JOB DESCAIPTION ; REROOF W/ 3—PLYS HOT ASPHALT SQ FT: 1,633
CLAIM VALUE; 1,633,00 CALC—VALUE: 1,633,00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED
x� **�r*���*��+r��r�r�� ���x x �*��**�r*�*x *�*�r**x��r�r� �r�r�r+r**�*�*�*�*�*�*�rx ***�x��+r+r+r�r*��r��r*
Z O N I N G A E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN AEAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PAAKING REQ• PROV: PARCEL: 42514116 ZNE: REF NO:
PLANNING NdTES>
>
ik ik ik M i! 3t ik iF M ik if 1f if !t iF jf 3! M if if fF M�F iF iF if ik 1E 1E k%if ik 1E ik it if if iF iF k if ik k k M iF ff iF iE if �E if M ik if ik iF it iF if i! k iE iF iF %iF it iF 3f if i! if if 1F ik %1F
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N.T S
ZONING APPROVED HY .
BUILDING APPROVED BY ;
DATE:
DATE: -
APPLICATION ISSUED BY; DATE; ���
�kifikkM3t3FiFjtiEitiflEiFifikjklkiflfit�F itiE#MifikiEiFiF4 iEiE
iF if ik if 1k �k 1! ik it if iF if iE iF ik 1f ik ik iF if ik ik Ik fF ik M ik it it iF it ih jk if k M 1t ik iE iF 1f Ik iF if k if if ik fk iE iE i! iE ik k ik if ik M ik iF iF ik if iF k iE k it k iF iE iE M Ik iE iE iE if
LEGALIZATION:N F E E S.0 M M A R Y STRUCTURAL SEGMENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RSS� GRADING
PERMIT 39.00 ,
PLAN SMIP/NON—RES
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN�CHECK TOTAL PAID DUE
TOTALS----> 39,50 0.00 0,00 39,50 39.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 39.50 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
39.00 ,50
1t fk if if if iF ik 1k iF it ih if if 1! if it ih k it if ik it if if if ik ik k if k k ik if iF it ih ft ih it k k ik k M if 1t M iF it iF if iF M ik ik M if iE 3f M ik if k it iF iF i! 3f 1t k ik �)F it it iF iF i! ik it
I N D I V I D U A L F E E B R E A IC D O W N
TYPE QTY D E S C R I P T I O N-� UNIT COST TOTAL COST
SFR 1633 REROOF BY VALUE RESIDENIAL NOZONE
END'OF FEES
0
1,00 1,633,00
�7? 0007098J-900iD931 "� S"a'�' ;F.ii,
DATE� f0/G2/90 i1tiE� !'t��4
_�
� CONSTRUCTION AND PLANNI. OL & SPA
APPROVALS Permit# �Date Inspector p�ppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole�ti 52. Pool & Equipment Location
r�..�Soi� ?ipe•Undrgrnd: � � ._�p`, 53. Steel Reinforcement
--3�Electrical Conduit�Uiility-Undrgrnd?, � 54. Forms �
'"4.yElectrical Conduii Undrgrnd: - 55. Electrical Bonding
�'5. Steel Reinforce "m'ent . 56. Rough Plumbing & Pressure Test ' '�
,.r �
:�=ElectiicalUFEfi:Grnd. 57. APPROVALTOCOVER�GUNITE
�� 7.?Footings r- � 58. Electrical Conduit�Undrgrnd. -
'' 8. Foundation � • 59. Gas Pipe, � Undrgrnd„ Test '"
9. Water Pipe-Undigsd. 60. Backwash Lines, P�Trap, O Undrgrnd. .
10. Structural Flooi.System - 61. APPROVALTO DECK
71. Property Sewer��Line:& House Connection � 62. Backwash & Recepior�Final
'• i
12. Sewer Cap ✓ ' - . 63. Heater & Vent-Final .' �
13. Roof Drains .. ; ' � 64. Plumbing System � Final .
14. Rough Plumbing �� � 65. Electrical-Final
15. Rough Electrical-Conduit ' 66. Solar SVstem-Final
16. Rough Electric Wiring . � 67. Fencing & Access ApProval
n
77. Rough Wiring $ign 68. APPROVED FOR PLASTERING
16. Rough Electriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19.�iough Heatin9 &�Air Conditionipg y FIRE;DEPT. REQUIR�MENT �
[" _ G' ^ h fi c„^ � .�. ' ! ^ y
20:�Rou h factor;Y Fire lace �" �; x � `� �'� '• � {�f �� �' X M
9 P St-' C :"f r, -APPRQVA S'��Per,mrt#
T c^+ �-I T i Y
21 '^Ducls, in'Structu�e�y ' •' •• "5 x = `� '"' "' * -�70. Under }'ound HYdro �
i SH x' �:. .-� Cl.t' *-� 9 J W
22:_Duc_�t;, Ventil�ting.i: �'C� �c ^ C (j 'i�-..r x. :71, Produc[�P.Lping OGas O�OiI M1 �
23.'Gas-PiPe�fiough &.Test Cns " r' �„�, ��* }�72. Undergrot�P� FI Sh'� � „ w
t-. . F-,;.J ..;-. ,a J v .d : .. _� .� . .-. - .
24.'RoofFraming ?± > .x �-x�. ••73.yUndergmd.Storag2y`'_TankOGas ❑Oil
25. RoofSHeathir�9 �"-� y �� '� � " _ �"K i' `74{`0'verhead Hydro��, i
c
- �• � r � .' v , �: s . .�
26.y �Bat Ceiling (Structural) &"Monocoat x C - �< e. 75.EDry Chemical [�J x r
27,-Frame antl Flashirtg � �-?�'=: +^ =� �;' x 761 Dry Standpi�;e F"� �^ ~ J
n � r. .-• n t: }. s: at -� 1� C7 'U :�
� >
�28. Lathing:& Siding= ,"° .y�ti � ;: i ��) ��� ��N * 77yFIXED SYSTEM�FINALi: �-: . �
�29. Insulation ' ' S " !` ` I �" * 78�FIRE PREV. FINArL �'� '' "�
r'. -� .'1 c c Vl: y: �i
'+ r� ^.tr ^ % i ' r! 1 a. r-� l
' 30. Drywall;Nailing � .� p- � � .�t x < HEALTIfDEPTx�REQUIRE�JIENT
�31. Plaster Bwwn Coat� 5 ^b" � x � � �' � 79.'FINAL INS�fCTI�N �i ^ T �
E � c., _.. 1 � t ..� � t� .7 �-
� _ . �. r � nN 1 Y.. _ ' i ,F �
�32=Electrical;Pow,erMetei"-F�nali * � I �,; 80.=FOODCERTIFI�ATEISSU�D�.
5.33.=Finat Electric" r' �' � r � � `� �� Notes: �' 7� X'_ `� Ri"'
,(' �.. �-+ k� Y 1 h+ Y l`: / H.i
>' � " `C r `i � , TC ): C. - . t
:�§4:µfinat Heating;& Air,�Conditioning- h �; � � i �. � ; • � Q , � � � - _
35.:final Gas Pip¢-Testx ,^.. � � +: r: ����'g K yp O.-+ W T H,r G_.�i/_
�.r �r; x rt+ � t^ .:. �{c� TT
136 ,.Hoad or Canopv '' ` �'' �� `s '�� �� ' � "� r ' r, � x;
?� c'. i�z r•. :� * I ��r• � ra x o + m
^37. •Final•Fattory FirePyac=:^ --e-� � «'._ ' � Y � � '�
�; c�
.`38. Finai'Plumbing a ��� ti y��, � � * ,� f -.� � � �
� 39. Wate� ServicecFinal�� g �•� ' '" �>: y� u� S
r� 1 I�• x .-w ; lT7 M
:�40. Gas Service-Final � '""" � ` �" ,: � ��"' •''. . "
. .-.:-. x i .. F- • o= x c
�G7. Solar pomesficFinal' =.; � .� r ;r+ �=-o T � ^ �
�s � i-.. : 7 i « �
,42. Backflow Preventers�• ' � ^ I � �'' ' = r" • * '"
.) x: J .7 H t-+ a: rt s. 1. R', D'i V'J * 9r
` M.>.� . .. �.. .. l. .
43. Backflow Irrigation�.; ;� t: �: �% �� �.i � '* �, •
r x>. :. N *.i U O
* ",' �' �LT:✓ x ��' �7 C'� Y:�x Ri tU w(J X t:. v
G44.,Landscape Irripation System_;y� ,y. � `' � r� �; � � O� � � F,
i.� ✓ � �-�.. .-- .
45.:Sound AttenuationN ••• i: �:� ;+� R±M w�• r� a �• �-�d �:
.� ..a�.>.:� i,..�.,J ..�-i t
�46.,Handica. Re ulations �' � � ~ - �� �' i � �`�1 J7 � '"
P� 9 � .. �: ^ ; i '� x K [*i�.p ("� x
-47."PINALSTROCTURE&BUILDWG o-Q � � .* � �VV�.� � � F
x r !it G "' � �l
48.'fIN•AL P_L'ANNINGK � `•`" * �u � .7'v: i:: m 'c • r^ ^
i. � ti: � i� � if` � f7 C) CG S x C,
.:99. �Elec4iic Release to Edison ' a: �', :� a: Cj c •; , � �
.�1. '�- r. �^ x u
,-50. �Gas;gelease to Soutfiem Califoinia;Gas Co � -�'�.'P" k `-' ~' ` • JR` �� " •
.s . .i_. :i. „X # •• S �O W. :ti
�51. CERTIFICA7E OF�OCCUPANCY " � ' " " "' '
No. Date
� 2 237
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOx 7200 COSTA MEBA� CALIFOFNIA 9Z620
For Appl7cant fo F(U In Comp/eroly
TYPE OR PRINT
ADDfl �9Y Z3 T� `'{�/}L �
COSTA MESA, CALIFORNIA
s 3366 Via Lido ADDR88G
FIR6
Newport Beach Na�6733130 zoNe
.�Burton Romberger Te sYrRovci
NEBR NO`'540 8833
B 4501 Birch St., Newport Beach
zox�
�R Fabre Construction Corp. -
uo.�t
i 4501 Bii'ch St, oucmrnc
Newport Beach A.P.NO.
146423 Na�• 540 8833 90TTOH�1
swvea
-' G n t I No. o� n.no.. wLlowio
DESCRIPTION OF WORK
x � .� �......,w � � ..,..
euaniNo 1984 No.o� 7 I-1,
6128 ROOMB Y RI
EXTHRIOR WALL ROOP
COVERINO StUCC COVBRINO shake
UY6 OP GUI LDIFIG AlID WORK TO G6 P[RPORMtO
Family dwelling w/attached garage
O� _s O�
1 XCHBOY ACKNOWLEDO[ T11AT 1 MAV[ R�AO 1NIY APPL�G ON
I�ND BTATH TXAT i116 I1COV[ 1� CORR[R�AHO AOp68 TO COM.
PLY WITH ALL CITY Oppyl4tpG 1�TA I,AW/ R[OULATINY
BUILO�HO CONBTR QTION t
SIGNATURP P 1 \ �
PERMITTbiC � - � ��7
AUTHORIZiD Aa[NT
OCT 16-68vAIo00 885� ***1?_4.5C
CHSA
APPLICATION FOR PERMR
BUILDING
FO� ��M �/f0 �II�
ZONINf3
8NALL D8 L[88 TMAN
YARDDAPPROVHD I YARDSAPPROVBD
MAIN BUILDINO ACC6YSORY BUILOINO
S
oirr�ne[ err.
MAIN BLDOf.
vwR.� V-40-68
TN6 AYOYM
rUHP00H OI
err. Mwin e
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DATH
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VALUATON �e ron tHs �
A PEHYIT P88 ONLY.
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IT FEE �
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APR -2-69�NSA00 098 �***�*7.00
ForApplicant to Fill in C mpletely APPLICATION FOR BUILDING PERMIT
RECEIV��BV DATERECEIV� D TE�UED�
BUILDING �� ' � . � l.%L4% p O
ADDRESS '
�/�� P Fjf�
OWNER �� N S yi � A.P. NO. 1/7
ADDFESS 3 IyuQ � O /aD RIESS L/�7 'C' �b *y • L�E'
CITV � NOL �� / TRACT��(J / �OT /(O BLOCK
CON5TRUCTION ��� �� W P
LENDER ✓�
(
BRANCH
OWNER RtiY �0��!S�n
ADDRESS
OR ENGINE R � T� hoa /t NEL. g�. VALU$ �/ O (1Q
N
FIRE j�
ADDRESS N' ZONE #ti) TVPE GROUP �
CONTRACTOR /,1 �/�I� Vvb BVPROVED � � DATE �
A DO R E55/�J OV J � • �oY I� ✓�' A [•
TEL. ZON6 P�� Z BUIIDING EW �TK�h/�f
��T� S�, Ci,t, No. p�6a K— I .�
UC. NO. � J S Z/G LICYNOI�� vMA NSBUI DOING ACCESDSOFV BU�ILDDING
SIZE NO.OF BLDCaS. (FROM C/L STREET) /��/� `1 T�`
OF LOT NOW ON lOT FRONT FT. �T" � Q�FT: ,O "'�fT•
USE OF 1 —,
EXISTING BLDG. / FT. � FT.
512E OF NO. OF
NEW BLDG. ROOMS STORIES L. SIDE FT. � FT.
EXTERIOR WALL ROOF .�
COVERING COVERING REAR FT. � FT.
US F BUIIDING AN WORK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BL ^.
� ` VAR. # DATE
C.U.P.� APPROVED
APPROVE � � /iw �— � —� /
I hereby acknowledBe Ihat I have reatl this application entl state
chat the ebove informafion is correct antl apree to comply with
all laws rogulotinq builtling consvuction, and I shell not amploy
any person in violation of the workmen's compensation laws ot
the S[ate of Califomia. �
I hereby certify that I am properly licansatl as e cOntractor �ntler SQ. FT. '
the Scute ot Calitornla Business entl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VAIUATION IS FOR
a
Chapcer 9, antl that s icenses are in full force antl effact, or I THE 7URPOSE OF ESTABLISHING A PERMIT FEE ONLV: Q
am exempi trom t Pr i ions of the State ot CalHornia Business VALUATION
antl Protessions d, vi on 3, apter 9. � �-- �
J C PERMIT FEE $
Signatura of ^/ � �� a
Permittee � 5/)� PLAN CHECK $ E
Au[horize gant � � O LL
TOTAL FEE $ ��
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