Loading...
HomeMy WebLinkAbout218 16TH ST - Building Permits . ' - CITY OF COSTA MESA ,y' %. BUILDING DIVISION PERMIT NUMBER ".4. r. ,., DEVELOPMENT SERVICES DEPARTMENT. �� PERMIT it)r.,,,am BOO-00423 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 218 E 16TH ST Status: ISSUED Suite: Applied: 04/03/2000 Vicinity: HOUSE&GARAGE • Issued: 04/03/2000 Parcel Number: 42520116 Zoning: ' Applicant: AUSTIN HAN ISSUED BY: --- -----' Address: 1022 W ORANGETHORPE Phone: (714)871-9923 FULLERTON,CA Zip: 92838 Owner OVERBY, RICHARD L TR Address P O BOX 7605 •S 4 Phone: _�'(� • BRECKENRIDGE, CO Zip: 80424 o • gI . Contractor: ACE ROOFING 9O' Address: 1022 W ORANGETHORPE Phone: (714)871-9923 FULLERTON,CA Zip: 92838 License: 679543 • Arch : Eng: • Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF-PRE ROOF INSOPECTION REQUIRED. INSTALL 1 LAYER OF 30#FELT AND 25 YEAR COMPOSITION SHINGLES OVER 1 LAYER OF EXISTING COMPOSITION SHINGLE ROOF. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,500.00 Permit: $83.25 Claim Valuation: $2,500.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 (DECLARATIONS 1 WORKERS'COMPENSATION DECLARATION: ,.,1 4 I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ...p..4 have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: , Carrier: Policy Number: (This section need not be completed II toe permit Is valued at one hundred dollars($100)or less.) ❑ 1 certify that in the pertormanthe for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cantor / . agr at if I should become subject to the workers'compensation provisions of Section 3700 thebor Code, I shall forthwith comply with these provisions _ • Applicant Signature: I Date: /`// ,.9,f/aU WARNING:FAILURE TO SECURE W. i-S'COCOVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE rJAL ES ANC)[ IVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE 15103,000),IN ,.PRION TO COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un. r pro;sion�1 ap a 9(commencing with Section 7000)of Division 3 of the Business and Professions.e,and my license is in full Ili r force and effect.Lic.N � Class a L Contractors Signature: • iii Date: _ CONSTRUCTION LENDING AGENC . O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OW NER-BUILDERDECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end Professions Code:Any city or county which'requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)'or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors license Law does not apply to an owner of properly who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit.and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feel high.(Chap.3.2,Grp 2,Art 2.Sec. 341,Title 8,Califomia Administrative Code). O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). - _0 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 II an RMPP is presently required,has Section 25534 of the California Health and Safely Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes j�No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: _ CERTIFICATE OF COMPLIANC AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply wit tate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for lion•rp. es.I agree not to occupy or allow occupancy of any building authorized by this permit until final/inspec/ctt/bion. �r aura u/ :vale .- I �pbl� /Oa •r •ut'.rized Applicant ((l Date CODE r INSPECTION TYPE PATE ynm*LS CODF( INSPFCTION TYPE PAIS MEALS 1616 Fixed System Final Fire Prevention _ _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing tf),A' 200 Final Re-Roof l� 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition __ 250 Final Building/Occupancy 204646 - tat) NF CITY OF COSTA MESA tat) BUILDING DIVISION I DEVELOPMENT SERVICES DEPARTMENT �• arreat. PERMIT P IT NUMBER • B99-00157 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 225 E 16TH ST Status: ISSUED Suite: IA (4;5 Applied: 02/02/1999 Vicinity: Issued: 02/02/1999 • Parcel Nunmber: 42533413 Zoning: Applicant: ALEXON,TROY Address: 01653 SUPERIOR AV Phone: 949-642-7222 COSTA MESA CA Zip: 92627 Owner: BALDWIN, ALAN R TR Address 437 PRINCETON DR EXP ED Phone: COSTA MESA,CA Zip: 92626 DATE �I Contractor LEE ROOFING OF COSTA MESA Address: 01653 SUPERIOR AV Phone: 949-642-7222 COSTA MESA CA Zip: 92627 License: 349686 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF ROCK ROOF&REROOF WITH SAME. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,226.00 Permit: $137.25 Claim Valuation: $7,226.00 SMIP Res: $0.72 SMIP Corn: $0.00 • Other $0.00 Inspection: $0.00 Total: $137.97 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • DECLARATIONS - WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'cora enation I urance rrier and policy number are: //� 9!/ /'. Cartier: 57/3-/e r'� Policy Number: 900 T,'I (This section need not be completed i/the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Ia, sTM�H/ "'•'(and a ee that if I should become subject to the workers'compensation rovlslons of Section 3700 of the Labor Code, I shall forthwith pplicant Signature: Date: -• • . - - •SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I h' ,. . "' Azioiensed under provisio s of Chapter 9(commencing with Section 7000)of Division 3• •= Bust ' •nd Professions Code,and my license is in full orce effect.Uc.# _ 9 . - Class# I — Contractor's Signatur:" i ♦- a. .. ' - 9 -a/ n �%irLUSG7• CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: _— OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that lam EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requiresa permit to construct,alter,Improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation live(5)or more feet In depth Into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If ryes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 es 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /.1.nature Of ••.I Owner(s) C And/Or Authorized Applicant �— CODE_L INSPECTIONTYPE DATE Di1IDASS CODE! IBSPFCTION TYPE DATE IMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final —/�� 208 Final Plumbing 200 Final Re-Roof `• • 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 YJOWNER OVERBY, RICHARD L. DATE 5-8-78 ?JOB ADDRESS 218 East 16th Street BUILDING PERMIT NO. 45972 tENERAL CONTRACTOR Overby & Son DESCRIPTION of WORK Trash Enclosure 3�AI 117-151-05 LOT TRACT FIRE ZONE VALUES 500. ST cCTI0N5 Signature _ Data TYPE V GROUP J ZONE R-2 SOIL SUBCONTRACTOR PERMITS ISSUED AS Date I Number I Signature \y WATER Plumbing 'ROUGH PLUMBING PROP. SWR. LINE n HOUSE CON. U SPRINKLING SYSTEM MISCELLANEOUS • ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICE OR POLE UNDERGROUND n POWER ED ROUGH WIRING Heating and Vent. • TRENCHES u FORMS Li STEEL REINF. U FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n • SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLP-A, BROWN COAT ST URAL. FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL / /� B n BUILDING, FINAL \_J_ # (_4/i. 4537,4 0556 5/08/78 5.50 TL S0SOCKTIJ CUOAME2BUILDING-SAFETY UNSAA DEPARTMENT 0556 OOU04459 72 I A f P. BOX 100CO TAME ,CIORNIIA 9626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING ADDRESS '\ .S f - \.�\ / C 1 C \ ^� -76-( //I ERMIT NO. j OWNER��r .\'�G\C{� �. \ )� �C`�:� A.P. NO. MAIL -r BUILDINGS^—,?/ rte' /�]I ADDRESS ')`"1_'�jC ' j`tt.SO \O P\O)TG ADDRESS/ Y L� �Ce TEL. TRACT r G, l LOT BLOCK CITY LO�rSh V`1\�S , NO.v11��0 CONSTRUCTION` A\ `eO NEW ADD ALTER REPAIR MOVING DFMOLSH LENDER ` I ry/�/��j�� / I /��/�� BRANCH C.OS�A �V >QS� ,fed_C�aS� �LW A '/Pit e. ✓/ OWNER / ADDRESS '�'`pc •<\EiNS c,DC •ca,\ O VALUE ARCHITECT Lt'V SNKIaL'<\G'J TEL $ OR ENGINEER O'NC S r'CS NO ��0+"Crk\\ _ U ` ' p ZONE TYPE V GROUP p/ ADDRESS \rj may?. �.A\ ����Q , \�G�(,gn��Jv \''� ` APPROVED '//.1/ 5-4-y(/ CONTRACTOR O��Q.��j C\ AP (Y Ltd DATE /11 ADDRESS ' L"\t, 9::n- e z -t- TEL. ZONE/� NO.OF USE OF NE CITY l .OS Rr� \Z•e'G So NO.t \h \YAK • /f� PLANS 7 BUILDING ret s4 r STATE CITY YARDSLAPPROVED YARDS APPROVED LIC. NO. 2_,c-A,\"•Jca"]� LIC. NO. MAIN BUILOING ACCESSORY BUILDING IR SIZE _ I NO.OF BLOCS. (FROM C/L STREET) L OF LOT.O''/� \-2,1 _j Q FRONT FT. FT. Q USE OF c„ EXISTING BLDG. R,SIDEj L. FT. r L an F Separate permits are required for L.SIDE fl c 7.Z-, P/11—% 6r0 rtntf electric,plumbing and heating work. REAR ------Fc,- FT. {i7 F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QMAIN BLDGS. ACCESS.SLOGS. n VV�f'-s'70`C„,C`,\ `--c'�G\S� VAR.tW AATE PPR \ _VAR.+ APPROVED 7 s / n //A, P�J C'G\J C-\DSU� '� lQ APPROVE //404— DATE (� / 3 Cg w 0 I hereby acknowledge that I have read this application and state N Q! that the above information is correct and agree to comply with m L all laws regulating building construction, and I shall not employ Z any person in violation Of the workman's compensation laws of e Wthe State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 am exempt from the provisions of the State of California Business VALUATIONPERMIT FEE E.� •1�,�j,Qt, and Professions Code,Division 3,Chapter 9. ms" Signature of \ QD PLAN CHECK $ o Permittee c \• C 'c $ fD� TAX $ V 019 Autharizetl Ageni \ v, TOTAL PAID E w • _ I -� `, _ -- — —__ - ._ _ — -__ _ ._ -- _ _r.- I IT - J—/. 'i _ — :t___ _ 1 'VI i"•' ...::). 44A A,-, .T ,J ,....:. EOR: ' 1� VII • 1_ JII'_ 4r.,7,— .i✓-JN j_— `.W11t1 .-ILvI I/ C.Oi .i i -- . r,-,LJ: .r ri., _.— — — _ I_ 1 - --: T • 1 ,1I (. , •i 1 '11 1,f, _ .. is :- I ' :�, n.EC 14-77F❑ISAgrB00 729* *****5,50 45225 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in CompletelyJJ��—Use Ink Only RECE^IV`khJm BY DATE RECEIVED DATE ISSUED�/ BUILDING ADDRESS 7.,,,\S. E, �t S1• V ,� � H- / Z--I 7 L?) ` ` A.P. NO. /72—/P-- O PERMIT NO. BUILDING al- MAIL OWNER C��Lw�O�QO fir. �JL«y ADDRESS 1 C O -. ADDRESS 3,„. c , i s TEL 4v4 • . 1 H S CITY GtSs . "(\�CS . NO.5>A,0go3d TRACT !-r LO BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING D BL{ LENDER c9NN- c¢9 v/ BRANCH ( ,Ob' t., 'I.t546%, • ADDRESS 'l.. toc�y i>\C'tt�C " s.)c. OWNER ��C i}�tl ✓[�CJC7?Y ARCHITECT C_eOASP'cc.3 %A .) -e/ytn VALUE OR ENGINEER .�p C.o\vctcfrCS NOtn$3. OZ\\ USE / r Tis/ _ E \JZa3 V'1 CDA�\t. CZ\�JLwI�M ZON _ ADDRESS _` ZONE TYPE GROUP ©.4,t<�� \ Sb� APPROVED CONTRACTOR BY DATE ADDRESS -1).1/46 •tiocze\Sega< talc, Olt N,, TEL. ZONE NO.OF USE OF N .1� 2 E CITY LO'�\O� ��e5 % NO.S�Q -1 PLANS ' BUILDING 9 .--. STATE Q CITY YARDS APPROVED YARDS APPROVED /�..��30 LIC.NO. 2„.. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO. BLDG (FROM C/L STREET) C, OF LOT b \ NOW ON LOT O RONT F . / FT.Lye/ Q USE OF /J// llQ> cosEXISTING B • .SI•- '� F . FT. ca (-0 76 Separate permits are required for L.SIDE F27./ , , .1/4- FT. O electric,plumbing and heating work. REAR F V` iT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. v BET.MAIN& \-.) C 1 _ MAIN BLOCS. ACCESS.BLOCS. "a � NZ.M*40\\S\^ VAR..W DATE Q C.U.P.qW APPROVED '7APFROV / � t,.•••\•S \�cJo� L�2S�O CN• Cr.... BY Pt_ DAT9/2e-/ J/'!7 ,7 -4 CC IN 0 I hereby acknowledge that I have reed this application and state N eg that the above information Is correct and agree to comply with m C. all laws regulating building construction, and I shall not employ Zany person In violation of the workman's compensation laws of o x the State of California. m I hereby certify that I am properly licensed as a contractor under SO. FT. N tho State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: _ am exempt from the provisions of the State of California Business 1O VALUATION PERMIT FEE $ z m Y end Professions Code,Division 3,Chapter 9. V N re Q�) PLAN CHECK $ N Signature of - -`___ , \ - U. Permittee ��a- �+ S TAX $ SO LL C,� U Authorized Agent U TOTAL PAID $�`,. /¢� 3j DEC lfl-77a;s° 452 24 00 730 jA***86.00 COSTA MESA BUILDING-SAFETY DEPARTMENT J P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely—Use Ink Only RE�C[FyJV ED BV DATE/ RECEIVE `D� DATE ISSUED BUILDING rIW /3 �L-1/ /2---/7•77 ADDRESS. 9,...\<4, V:-. �C•`n�` � ��C . (JJJ r -L7I '�\'��CCL \. C•J et<'CS.`� . A.P.BUILDING. /7 /4--/ 4-�_O PE NO. / OWNER C�_� MAIL a�✓) J ADDRESS 2 I - L . /6 ADDRESS-,.....n.'leg \Ji Sr`.Kee C CITY t; NO.%i...\,... 04$;....„ TRACT LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER C_cR\. 5-cc:. BRANCH L_ce`SsC4\ --e4\0:_St,,,, !Th ' p `, OWNER `•C„LC4.Q.�4 fl n JT.,/•.-b/ ADDRESS 2,21C f_` MC p�C CC \V'b• ARCHITECT 1..4w41/4CVL•`C\O4S TEL L e..4t..Rf #VAsLUE S boo OR ENGINEER frete)f,etCelt', NO. .Lee (Ste r ` y FIRE ADDRESS \ 5c; �� 7'.��\`( XR\V.L,C`N\\S- ZONE ��^^// TT PE PE�G RO UP�r�- Xr� APPROVED �`' DATE�^(J ZU CONTRACTOR �",•.:;'�'C-'Qf v.S. �b'� ADDRESS `� ��� "��‘C - TEL. ZONEJP NO.OF USE OF NE CITY ; -fj�q Ny �S'� NO.Se.‘o \vr't' - es PLANS r_ BUILDING ' - - STATE CITY YARDS APPROVED YARDS APP-OVED gLIC. NO. nc'\\jC3-,z, c.,••\ LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOTS. FRONTM 60 F . CI ! i, 5VL 6r LOT Ss� }( \��e�j'/ NOW ON LOT O FRONT FT. ,.� FTJ/ y - USE OF / eI EXISTING BLDG. I R SIDE‘,23 FT.() FT. y / etF Separate permits are required for L.SIDE 5 FT.O FT. electric,plumbing and heating work. REAR,.�/5 F/I)) FT,/• N W FT, USEOF BUILDINGAND WORK TO 8E PERFORMED F DISTANCE BET. BET.MAIN D �Q MAIN BLDGS. ACCESS BLDGS. ( p ••--� `` VAR.# DATE Q \Il.�,,SN<•J t4 \ •t\C\CC s �� S\C 1G C.V.P.#0'l!! 3/\c)( APPROVED —^ �/ ; > >\ •'h..�gra.G�-Nr- C- cSCC'�. �APVPROyjiitet _/l_/- DATE tS �/ (/ W I - - - 0 1 hereby acknowledge that I have read this application and state 0 N. b eg that the above information is correct and agree to comply with a Q e all laws regulating building construction, and I shall not employ ,a_t�_.S. 'I" Z any person in violation of the workman's compensation laws of �OL� If012 SPECIAI. REQUIREMEN__'� a ri the State of California. `,17,2e) rr /o / �I�, m n X SO. FT. tel( c`i{•OL'CJ n N. I hereby cenSfy that I am properly licensed as a contractor under \ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are in full force and effect,or I THE PURPcSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ v and Professions Code,Division 3,Chapter 9. 4424 u+ ` Signature of PLAN CHECK $ 12 no Permittee \t�\'1,\. \�•a1.\C'-\a jcitaa P7� �••.• LL IMX E f /) aiC U Authorized Agent a TOTAL PAID $ Ct/t/O_ L/ ����� 0555 5/08/7S 175015 TL COSTA MESA BUILDING-SAFETY DEPARTMENT 05:'5 5/08/78 1750150KT0 / P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 055': 011654;.5224IA APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill i Completely— se Ink Only /1�} RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING /� ��A[� — ADDRESS ` ((,,,jj�,(j�1� T' .01..4 r.I//�J / J// ��o./'�,�/ Si-- RMIT NO. , OWNER /�r ���iYsflrlri L� L/1/�/��Q���C'�`fir/!/ r A.P.NSir/ MAIL — V�/ BUILDING / (� / /L—/lyliy'— ADDRESS ADDRESS d TEL. CITY NO. TRACT ' LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING f IFMOl ISH LENDER �t BRANCH / i 1 / / OWNE- / / ADDRESS VE i _• . ARCHITECT TEL. _fir ', A/ /• _'Pe ..$ OR ENGINEER NO. ' FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE I NO.OF USE OF NEW CITY NO. PLANS BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLOCS. (FROM C/L STREET) g. OF LOT NOW ON LOT FRONT FT. FT. a USE OF •. EXISTING BLDG. R SIDF FT. FT. CA F Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR FT. FT. [W.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& I\_) 0 MAIN BLDGS. ACCESS.SLOGS. Mi VAR.tW DATE a ulitte earew C.U.P.4' APPROVED APPROVED --BY DATE IX W 0 I hereby acknowledge that I have read this application and state n g„ that the above Information is correct and agree to comply with co g• all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 2 m Z the State of California. a 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. H the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR co Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION MIT FEE $ / `J and Professions Code,Division 3,Chapter 9. /7p7.Pe m (� \� \ PLAN CHECK E / "' Signature of go S U Permittee `v $ TAX $ Authorized Agent \ TOTAL PAID $ /7J./6