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Home My WebLink About472 16TH ST - Building Permits�, FS < � 0 > _ = J .�� (714)754-5273 • Fax(774)754-4856 . CITY OF COSTA MESA � BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ,lob Addr@ss: 472 E 16TH ST Suite: Vicinity: AROUND POOL Parcel Nunmber: 42515104 BUILDING PERMIT Zoning: Applicant TRZECIECKI, JAROSLAW Address: PETER & ANNA 472 E 16TH ST " Phone: TRZECIECKI, ANNA Zip: 92627 Owner: TRZECIECKI, JAROSLAW Address PETER 472 E 16TH ST Phone: TRZECIECKI, ANNA Zip: 92627 ContraCtor. Addr�ss: Arch / Eng : Address: Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: Phone: Zip: License: d PEFMIT NUMBER 698-01979 L/ 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED `�� Applied: 11/02/1998 Issued: 11/02/1998 Phone: Zip: License: SCOPE OF PERMIT REPLACE COPING AROUND THE POOL IN THE REAR YARD AREA. COPING WAS DEMO'D BECAUSE OF NEW ADDITION IN PROGRESS. $0.00 $48.50 $0.50 $0.00 $0.00 $0.00 $49.00 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Ezistina: o 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 $1,500.00 $1,500.00 EXPIRATION: This permit shall automatically expire and become void 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 the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all required inspectfons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pe�mit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION OECLARATION: � I hereby aHirm under penalty of perjury one oi t�e following tlaciarations: ❑ I heve entl will meintain a cenificate o1 consent ta self�lnsure for workers' compensetion, es provided for by section 3700 of the Lebor Code, lor the peAortnance ot the work for which this pertnit is issued. ❑ 1 �ave end will meintain workers' compensetion insurance, as required by section 3700 of the Labor Cotle, tor Ne perfortnance ot the work for which this pertnit is issued. My workers' compensatlon Insurenca carrler end policy number are: Cenier. Policy Number. (This secfion need nof 6e completetl illhe pertnit is velued e! one hundred dollars ($100) oi less.J ❑ I cenify that in Ihe peAormance ot the work for which this permit is issued, I shall not employ any person in any manner so es to become sublect to ihe workers' compensation laws oi Califomia, entl egree thet if l shoultl become subjed to tha workers' compensation provisions of Section 3700 of Ihe Lebor Cotle, I shall torthwith comply with these provisions. Applicent Signature: Date: WARNINO: FAILUPE TO SECURE WORKERS' Q7MPENSATION COVERAGE IS UNLAWFUL AND SHALL SU6IEGT AN EMMOYEP TO CHIMINAL PENALTIES ANO GVIL FlNES lIP TOONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADOITIIXJ TO THE COST OF fAMPENSATION, DAM4GE5 AS PFOVI�ED FOF IN SECTIIXJ 3�O60F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CON7RAL70RS DECLARATION: I hereby aHirtn Ihet I am licensetl untler provisians of Chapter 9(commencing with Section 7000) oi Division 3 oi the Businass end Professions Code, and my license is in tull force ana eHecL Lic. # CI855 k Contractors SigneWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm Ihet Ihere is a construction lending agency for ihe pertortnance of ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Code). LendeYs Name: Lenders Address: Signature: �ate: OWNER-BUILDER DECLARATIONS: I hereby eXirm that untler penelry ot perjury that I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professians Cotla: Any ciry or counry which raqulres a permit to consimct, alter, improve. tlemolis�, or repair eny structure, pnor to its issuance, also requires ihe applicant for such permit to file e signetl statement ihet he or she is Ilcensetl pursuent to lhe provisions of the Contrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 of Iha Business and Professlons Code) or thet ha or she Is exempt iheretrom and Ihe basis for the alleged e:emption. Any violetion of Section 7031.5 by any applicant for a permit subjects ihe epplicaN to a civ,l penalry ot not more Ihen five hundred dollars (3500).): ❑ I, es owner of the property, or my employees with wages as iheir sole compensation, WILL DO TME WORK, antl the structure is not intendetl or oHered for sale (Sec. 7044, Business entl Professions Code: The Conlractors License Lew does not apply to an owner oi OroDerty who builtls or improves thereon, end who does such work himsetl or hereell or through his or her own employees, proNded that such improvements ere not intended or ottered for sale. II, however, the builtling or improvement is �soltl within one year o1 completlon, the owner-builtler will have Ihe burden of provinq �het he or she ditl not builtl or improve for puryose of sala.). I, as owner ot the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl ProFessions Code: The contractors License Lew tloes not epply to an owner of Droperry who builds or improves ihereon, and who coniracts for such project with a comractor(s) license pursuant to the Contractors License LewsJ. � � Ownar sec. drivefs license. ❑ Yes ❑ No Venficetian ol Ownership by (rype ol dwument, I.e. - properry tax bill or deed): Code tor ihis reason: Dnver's License No. oate: Expires: DIVISION OF INDUS7RIAL SAFETV PERMR CEfiTIPICATION: ❑ I hereby certify Ihat no excavatlon tive (5) or more teet in tlepth into which e person is requlrad to tlescentl, wlll be matle in conneciion with work authorizetl 6y this permit, entl that no building structure, scaflolding, falsework, or demolition or dismantling thereoi, will be mora then thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Celitornla Atlministretive Code). ❑ As owner-builder, I will not employ anyone to Ao work which would require a pertnit trom the Division of Industrial Satery, es noted above, unless such person has a pertnit ta da such work from the division. Signature: Date: Oivision of Indusinal Satery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORQATION OF ENTRY: I cenity under penalry of perjury Ihet I have read this application and state that ihe information given is correct. I agree to comply with all slate laws and city ordinances relaiing lo building constmction, antl euthorize representatives of the Ciry ot Costa Mesa to enter upon ihe �e/bp7ve-describetl pprope or inspectio/Lppurposes. I agree not to occupy or allow occupanry of any building authorized by this permit until final inspection. N ( i'.� �f�� /� Z �o �— Signature Ot Legel Owner(s) Date An0/Or Authonzetl Applicant Date CQ�E �. INSPECTIONTYVE 1616 Fixed System Final Fire Prevention 1266 Pool SDe Final pp0 Finel Re-Roo� 201 Final Block/Retaining Wall 202 203 204 2ddba6 Final Fectory Fire Place Final Sign Final Demolition �� GODE� INSPEC110NTYPE 206 Finel Mechanical 208 Finel Plumbing 210 Flnal Electncal 212 Final Fire PrevenUon 220 Final Planning Approvel 222 FinalSite 250 Final Building/Occupancy PA� Iti�AIS CITY OF COSTA MESA � BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT � P98-00458 PERMIT NUMBER '� (714) 754-5273 • Fa�c (714) 754•4856 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 472 E 16TH ST Suite No Vicinity: Parcel Nunmber: 42575104 Applicant: Address: Owner: Address Contractor. Address: ArchlEng: Address: TRZ�CIECKI, JAROSLAW TRZECIECKI, JAROSLAW PETER 472 E i6TH ST TRZECIECKI, ANNA ISSUE FEE Backflow irrigation BackOow Preventer Bathtub ClariBer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (1-0 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AM7 szz.00 30.00 50.00 50.00 so.00 so.00 30.00 $0.00 50.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 50.00 50.00 50.00 50.00 50.00 Phone: Zip: Phone: Zip: 92627 Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT connect prefab spa to poo� equipment, re:b98-00989 FEE SUMMARY AMT Laundry Tub / Washer 30.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen 50.00 Sink, servicelmop 50.00 Spa (private) $27.00 Spa (public) 50.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 06/09/1998 Issued: O6/09/1998 SumpPump Swimming Pool Trep Primer Urinal Vacuum Brkr BkFlow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater / vent Water Pipin9 (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 so.00 so.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 so.00 $0.00 $0.00 50.00 $0.00 50.00 so.00 so.00 $49.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 EXPIRA710N: This permit shall eutomatically expire and become void if work is not commenced within 180 days, or il work is suspended or abandaned for a period of 180 days. INSPECTIONS: tn order for the work eWhorized under this permit to be consideretl legal, such work must comply with all applicable codes, end all required Inapeetlone end flnal approval must be obtained. Failure to obtain inspectlons and final approval will result in the expiration of this permlt. FOR INSPECTIONS CALL: (714) 7545828 �' c. WORKERS'COMPENSATION DECLARATON: I hereby effirtn under penalry af perjury ane ot t�e iWlowinq dedaretions: ❑ I heve erM wlll melntein e cerUlicate oi consent to setl-Insure for woAcers' compensetlon, fls prwitleC tor by sectlan 3700 of the Labor Code, tor the pertortnance of [�e work lOr whkh �hia pertnit Ls IssueC. ❑ I have errcl wlll melnteln vrorkers' compansetlon insurence, es requiretl by section 3700 01 the Labor Code, for the pertoimance of t�e woflc fw which thia permit is iawed, My workers' compensation Inwrance cartier end pdicy num6er are: ,� Cartler: Pdicy Number. (fhls secNon need not be comp/e(etl il the peimit Is ve/ued et one hunEretl dollars (S 100) or /ess.) ❑ I Certtly t�et In Ihe peAormenco ol t�e work tor whiCh this pertnit Is issuetl, I shell not employ eny por5on in eny menner so as to become 9ubjeCt to ihe workers' compensetlon laws of Celifomie, end e8� �hat tl I should became suD�ecl to the workers' compensetlon proNslons ot Sectlon 3700 of the Lebor Cotle, i ahall fonhwlth wmply wilh Ihese provlslons. Appllcant Signeture: Date: WMNINO: FAILUFE TO SECURE WORI(ERS' OOMPENSFTION WVERAGE IS UNLAW FUL AND SNALL SUBJEGT AN EMPIOVER TO CRIMINAL PENALTES PND CML FlNES UP TO ONE HUNDRED T10USrW 0 DOl1ARE (f100.000), IN ADDITION TO THE WST OF WMPENSATON, DMNQES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEREST, M!D ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtn that I am Ilcense0 untler provisians of Chapter 9(commenclnp wllh Sectlon 7000) ol DiNsion 3 of the Business end Prafessians Code, end my Iiconse is In tull torce entl eflect. Lic. p Cless # Contrectors Signature: Date: CONS7RUCTION LENDING AOENCY: ❑ I here6y ettirtn thel there is e constructlon lendinp agenry tor t�e peAormance ot iho work tor whic� this pormit is issued. (Sec. 3097, Clvil Catlej. Lentler's Name: Lentlers AOdreu: Signature: Data: OWNER-BUILDER DECLARATIONS: I �ereDy eHirm thet under penelty of perjury Ihet I em El(EMVT FROM THE CONTRACTORS LICENSE LAW lor Ihe tollowing reeson (Sec. 7031.5, Busineu anE Prolessbns Cotle: Any ciry or counry w�lc� requires a pertnit to wnstrud, alter, impmva, tlemolish, or reDelr eny structure, pdor to its Issuance, elso requires Ihe applicam tor such pertnit to flle e slgnetl stetement that he or she Ls Ilcense0 pursuant to Ihe D��s ot the Contractors LJcense Lew (Chepter 9(commencing with Sectbn 7000) of DMsbn 3 of the Business end Proteulons Cotle) or ihet �e or she is exempt therairom entl the Desis tor the elleged axemption. Any violation o1 Section 7037.5 by any epplicant for e pertnit suh�ects ihe epplicant to e civll penalty oi noi more than five hundrad dWlars ($500).): ❑ I, es owner ot the properry, or my employees with wages as their sole wmpensa�on, WILL DO THE WORK, entl t�e siructure is not IntentleG or ottered lor sale �Sec. 7044, eusiness entl Professlans Cade: The Contractors License Lew does not eppty m en owner of property who builds or Improves thereon, enA w�o tloes such work hlmselt or hersetl or through hls or �er own empiqrees, provitled that such Improvamants are not Intended or oNeretl for sale. If, however, t�a hulltling or improvement is soltl wlthin one year of completlon, I�e owner-builtler vnll �ave tha Durtlen oi proving ihat he or she ditl not build or improve for purpasa of sele.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct Ihe projact (Sec. 7044, Business end Protessions Cade: The contractors lJcense Law�oes not appty to en owner at pmperry who bulltls or improves Ihereon, and who contracts tor such project wlth e conireMor(s) license pursuant to the CoNraStorSl.icensa laws.). ❑ lamt s�g�am�e: Oaner ID v Veriticatlon � Busineu and Professions CoOe lor thls reason: 7liR%� C Date: license. ❑ Yes ❑ No Driver's LJcensa No. Explres: by (lype of doamenL I.e. - propBM � blll or deBd): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFlCATION: ❑ I hereby ceNfy Ihat no excevellon iNe (5) or more leet in tlepth into which e pereon I5 requlred to tlescenQ will be mede in connectlon wlth work euthoAzed bj Nis permit, en0 thet no bullding atructure, scettdtlNg, falsework, or Aemdition or tlismentlinp thereof, will be more than thlrty-six (36j leet high. (Chep. 32, Gry 2, M 2, Sec. 341, Title 8, Celifomia AtlminisiretNa Cotle). ❑ As owner•bullder, I will not employ enyane to do work which woulA require a pertnit trom the DMsian ollndustnal Sefery, as noted ebove, unless such person hes e permil ro do such work trom Ue Civision. Signetura: Date: Division of IndusMel Safery Permlt Number: CERTIFICATE OF COMPUANCE AND AUTHOR¢ATON OF EMAV: I ceniy under penelry ot per�ury that I have read this application end state that Ihe information given is correct I egree to comply with all stete laws end city ordinences relating to building construction, and euthonze representetives of the Ciry of Coste Mese to enter upon the above-descrl�ed properry for inspectlon purposes. I egree no� to occupy or ellow occupancy of eny bulldinp euthorizetl by this pertnfl until tinel inspection. COOE 1. INSVEttION TYPE 7678 Flaetl System Finel Fire Prevantlon 1286 Pod Spe Flnel 200 Flnel Re-Root 201 Flnel BIocWReteinlrig Wall 202 Flnel Fectory Flre Race 203 Final Slpn 204 Flnel Domolitlon 2a4&a8• . Qd¢ ��,5 j�QpEj MSPECTIONTYPE 208 Flnel Mechenicel 208 Flnal Plumbing 210 Flnal ElecMcel 212 Final Flre Preventlon 220 Flnal Planning Approval 222 Final Site 250 Flnel Building/Occupenry �%9/9� oe�e � � / t: • i -� � . � CITY OF COSTA MESA - � BUILDING DIYISION Y � � OEVELOPMENT SERVICES DEPARTMENT 898-00989 0� °•��; PERMIT PERMI� (774) 754-5273 • Fau (714) 7543856 gUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 V� Job Address: 472 16TH ST Status: ISSUED Suite: Applied: 06I0811998 Vicinity: NORTH REAR OF YARD Issued: 06/09/1998 Parcel Nunmber: 42515104 Applicant: TRZECIECKI, JAROSLAW Address: PETER 472 E i6TH ST TRZECIECKI, ANNA Owner: TRZECIECKI, JAROSLAW Address PETER 472 E 16TH ST, COSTA MESA TRZECIECKI, ANNA Contractor: Address: Zoning: Phone: Zip: 92627 Phone: 714-548-8186 Zip: 92627 Phone: Zip: License: Arch I Eng : Address: Phone: Zip: License: ' SCOPE OF PERMIT INSTALLATION OF AN EXISTING SPA RELOCATED TO THE REAR NORTH CORNER (SEE ATTACHED DETAIL FOR LOCATION), INGROUND SPA 6'8"X6'8". SET BACK REQ. ARE OK � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $36.89 $56.75 $0.50 $0.00 $0.00 $0.00 $94.14 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fmnt 20- 0 PARKING Existinq: o NOTES: Rear 0. 0 Rear 5- 0 Reouired: 0 FEE SUMMARY PLANNING & ZONING LeR 0- 0 Left 6- 0 PropoSed: 0 Calc Valuation: Si,eoo.00 Claimed Valuation: st,eoo.00 Right 0-0 Right 0-0 EXPIRATION: This permit shall automatically expire and become void il work is not commenced within 780 days, or if woik is suspendetl or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell requlred Inepeetiona end finel epproval must be obtained. Failure to obtain inspedions and final epproval will result fn the e�iration of this permit. FOR INSPECTIONS CALL: (714) 7545828 � � a WORKERS' COMPENSATON DECLARATION: I hareby affirm untler penalry of per�ury one ol Ne Iollawing declaretlons: � ❑ I heve antl will melntein e certllicate of consem to sell-Insure br workers' compensation, es proviCetl for hy section 3700 01 ihe Lebor Cotle, Por the pertormence o1 the work for xTich ihls permit Is issued. ❑ I have aritl wlil malnteln vrorkers' compensatbn Inwraxe, av raquireA by section 3700 W Ne Lebor Code, for the peAortnarice af the vrork for which this pertnit is issued. My vrorkers' compensation Inwrence cartier and poliry number are: Certler. Poliry Number. (Th/s sectlon need not be canpleted 1! rhe perm/f Is va/ued et me hurMretl dWlers (S 100) a less./ ❑ I cenify ihet In tha pertartnance ot Ihe work for whkh t�is peimit is issuetl, I shall not employ eny person in eny manner so es to become suD�ect to Ihe workera' compensation lews o1 Celllomla, enA egree Nat II I s�oultl Eecome suhJect to tha workers' campensetlon provlsions ol Section 3700 oi the labor Code, I sha0 fortMvlih compy with these provislons. ' Applicent Signeture: Date: WARNINO: FAILURE TO SECURE WORKERS' CIXdPEN5AT10N COVEqAOE IS UNUWFUL PND SHML SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND pVIL FlNES UP TO ONE HUNDRED TVpUSANO DOLLARE (Et W,OW). IN FDORION TO THE COST OF Wf.IPEN$ATION, DAMAGES AS PROVIDED F-0R IN SEGTON 3IOB OF TNE UBOR WDE. INfERESf, AND ATTORNEV'S FEES. LICENSED CON7fiACTORS DECLARATION: I hereby eHirtn thet I am Ilcensed under provlslore ol ChaD�er B(commendng with Sectlan 7000) oi Dlvision 3 of the Business entl Professions CoOe, entl my Iicense is in full larce end ettect. Lic. x Class N Comractots Signeture: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby eNirtn Ihal there is e constructlon lending egency lor Ihe peAortnance of the work lor w�lch t�is pertnit Is issuad. (Sec. 3097, Civll Cade). Lentlers Name: Lentlers Address: Signatura: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirtn Ihet untler Denelty ot perJury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Buslness end Prolesslons Code: Any clry or counry which requires e pertnit to consWM, elter, Improve, demollsh, or repair eny siructure, pdor to its Issuance, also reqWres We epplicant br such pertnit to file a sipned stetement that he or she is Ilcensetl Oursuant to Ne provislons ol Ne Contrectora Llcense Lew (Chepter 9(commencing with Sectlon 7000) ol DlWsion 3 of Ihe Business end Prolessions Cotle) or thet he or s�e is exempt Iherefrom and ihe besis for the allegetl exemption. Any vloletion oi Section 7037.5 Ey eny epplicent for a pertnit sub�ects ihe appllcant to a civll penelry ot not mora Nan Me hundred dollars ($500).): ❑ I, as owner ot the property, or my employees with weges es their sole compensetion, WILL DO 7HE WORK, end the structure is not intentletl or otteretl for sale (Sec. 7044, Business and Prolessions Cotle: The Contredors Llcensa Law tloes not eppty to en owner ol property who 6ullds or improves thereon, anG w�o does such wwk himsetl or �erselt or t�rough his or her own employaes, proNded Ihet such Improvemenis are not Intentletl or oHeretl for sale. If, however, t�e bullding or improvement is soltl within one year ot completion, ihe owner-huilder will have Ihe burden at proving ihet ha or she tlitl not build or improve for purpose of sale.). ❑ I, es owner of Ihe properry, em EXCLUSIVELY COHTRACTING WRH LICENSED CONTRACTORS to wnstruct Ihe D�oJect (Sec. 7044, Business antl Professions Code: The coniredors Llcense Law daes'not eppty to an owner ol properry who builds ar impmves iherean, antl who contrecls tor such project with a conirector(s) license pursuant to t�e Contr ers"Gcense Lews.). ❑ I em exempt Business and Prafeuions Cade tor this reasan: Signature: ��/G�/Ll_— -Pi Date: Oaner ID ve " y drivefs license. ❑ Yes � No Drivef5 LiCense No. Explres: by (type oi Aocument. I.a. - pmperty teu WII or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIflCATON: ❑ I hereCy certlty thet no excavatlon INe (5) or more leet In tlepth inlo which e person Is requlred to descend, will be made in connectlon wit� work euthorizetl by t�ls pertnit, entl Ihat no bullding structure, sceHdtlinp, lelsework, or tlertalitbn ar tlismentling thereoi, will be more t�en thlrty-aix (38) feet hlph. (Chap. 32, Gry 2, Art 2, Sec. 341, Tllle 8, Celifomla Atlminisiretive Cotle). ❑ As owner-Duiltler, I wlll not employ enyone to do wark which would raquire e permit from the DMsion of Indusirlal Safery, as nated ebove, unless such person has e permit to tlo such work Iram the divlsbn. Signeture: Date: DhAsion of Indusidal Satery Permil Number. CERTIFlCATE OF COMPLIANCE {WD AIJfHORVATON OF EMRY: I ceRily under penalry of perjury �hat I have reetl Ihis application flnd stete Ihet the Infortnetlon given is correct. I egree lo comply with all slete laws and ciry ordinances relaGng to building consWction, and authorize represenletives of the Ciry ot Coste Mesa to enter upon t�e ebove-dexrlDed proparry for Inspection purposes. I egree not lo acupy or ellow occupenty oi any building authorized by Ihis permit uniil linel Inspection. i. ' yi•, �.. �ff �� 1616 Flxetl System Finel Fire Prevention e 1288 Pool SOe Final /��L G H. b 200 Final Re-Roof 201 Final BIocWRetalning Well 202 Finel Fectory Fire Plece 203 Final Sign 20a Flnal Demdl�lon 2aa8de CO�E I INSVECTION TYPE 206 Flnel MBcheNcal 208 Finel Plumbinp 210 Flnal Electrlral 212 Fnal Fire Preventbn 220 Finel Plenning Appravel � 250 Final Site Flnal Bulltling/Occupency G%9/�� oate � I�� i� • 6�'�u��` � �l–btl -- A -�, �U– I..... i � - _ ._ : NEW s!'i( /.A'u7ir�n1 472 EAS T lG � 5%�CET GOSiN NESA � C.�LlFtarN/q (E� lICS/DC4JCG i� r (E�poOL__-_ _ llIVISION OF Bli1Lll]NG SAFE7'Y CITY OF COSiA MESA AP3'RpVED �Y � l � Date ��_ This set of ptans ard speci(rcatip�s MUST be kept on this job al all times arM it is �aw(ul lo 'nako any ct�ges aa4era(ion on same x3,lqu1 x�t� �� D�� ol Builtle;g and Safely, CrTy of Costa �Aaa. K c r� a _n�_ �.. _ . .. . _ ,,�a � ��' •� �-.,� � e� �opemu or o anapprovzl � c Lhe vioL:lion ot a�ry �;ovisioo; e'�;,;; ,-•�p ;f !,nsia ';esa lhdin�nce anNcr Sate latir. � t� ^�r.�arti,-,a,r,ris�a'�;r.r•:n�,��.,i�,itr,r:�cr c�:�^ie:,u9a� ! dvoidi i�ebuildinrcr ..........,:-:r:�,..,....._�..,. _. .InB�r ::F� .y, ,� ' .' . .. .• T•;J 1� �cV5Gi:5.977f5:. ��J�L ADDITIONS, DELETIONS, OR CORRECTIGYS aNAll. BE APPR�VE� BY TkE fL1t;i;l;;G D!�ltS�v(1 -...,�,y �.� UBJE �NNING D1V.ES � � �T �� BLD�, p� RE � —OqTF �if�10 � ` n..a.. o..d. �.p'.. o' �� p -- //<��'//��` / .• • , �- � - y ,�;6.�,�5�� . I ' / � I % i I \� - i j . .- ! - .��\ • i �i : �,:•�/l - -j ' NCFI ciP :r/Si7!LLn'70N �72 c�sT �G T'� sr�cec% — C0= �+ N[".rYt , rj!/ i�t'n�is1 ---'� -� .D�r� iL _; o� M' I � �� ! i ,� I / 'I � r �� 5/`hu� -- \ � - - --- - -- � -•—�— --- // \\v/,�.� ,i \ , ;,�:/ :.�`�.; , — � _-- _..�--�----- -- ,l� . _�/ / i �j i�,ytyVDl \�`t ,/ �v�a,:CF;-,oFG�siNn�t�M � - - ttPYROV�:D � � � Date� � --- df�cafro� MUSi he kepl on ihis p at atlttrnes endi��.u�a� _'--- � ' , '• ,• • • IheDiv�s�onotBv�Ng 1Qssetolplansaae�ratinnonsama�uF+��P��ionhom -- -- - nake am� cha� e rov21 � �nd Sa!ety, C'dy ot Costa Mesa• [heslamPingofthisplanar�sp�fipfw�sSHAL1NOTheheWlopertnilortobed' P el ;h^ violation ol any provis'ions ei zny Ci1y ct Ces:a tleso Ordin�nce andlor 5tate lar:. � � � 6 Imi!�`�'n and becomo r.� i ar•d,;a^d�l lhe b Si` u�, cr r �C3 <<r..:::'Ptn 1,., .x rs o _:a�. ^„se olans and pa,�m.. �t ail exGir Y w.ae r.:; l•ri� ,. �i�Ur�i: �.. �ri•�M ^,r,nv'o^...,n�.t3.1..'+� CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (774) 754-4856 Job Address: 472 E 16TH ST Suite No Vicinity: Parcel Nunmber: 42515104 Applicant: Address: ow�er: Address Contractor. Address: ArchlEng: Address: CZAPLA, CHRIS TRZECIECKI, JAROSLAW PETER 472 E i6TH ST TRZECIECKI, ANNA CHRIS CZAPLA PLUMBING 20219 LONDELIUS ST CANOGA PARK, CA PLUMBING PERMIT Phone: Zip: Phone: Zip: 92627 Phone: 818 772-0553 Zip: - 91306 � License: 623768 Phone: Zip: License: SCOPE OF PERMIT PLUMBING FIXTURES FOR NEW ADDITION: 3 BATHTUBS, 1 SHOWER, 5 WASH BASINS, 2 TOILETS, 1 WATER HEATER Q��; �C� $��(�S� ISSUE FEE Backflow itrigation BackFlow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1� outlels) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease. Oil) Interceptors (Sand Auto ) AMT $22.00 so.oa $0.00 52625 $0.00 $0.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 30.00 $0.00 50.00 $0.00 $0.00 $0.00 QTY 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Laundry Tub I Washer Landscape Irrigation P-Trap Pressure Regulator Process Piping (per 10 ft) Receptore Septic Tank SewerCapforDemo SewerConned Sewer Private Line � Shower Sink, Car Sink, commercial Sink, Floor Sink, kitchen Sink, service/mop Spa (private) Spa (public) AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.75 50.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 Qn 0 0 0 0 0 0 0 0 0 0 i 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS P98-00456 r/ PERMIT NUMBER 77 FAIR DRIVE. COSTA MESA, CA 92626 Status: ISSUED �� Applled: 06/08/1998 Issued: O6/08/1998 Sump Pump Swimming Pool Trap Primer Urinal Vacuum Brkr Bktlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater I venl Water Piping pnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 ao.00 $0.00 $0.00 $0.00 $0.00 $43.75 50.00 50.00 $17.50 $11.00 50.00 50.00 So.00 50.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $'129.25 QTY 0 0 0 0 0 0 5 0 0 2 1 0 0 0 0 EXPIRATION: This permit shall automatically explre and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a per(od of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all required Inapactiona end finel approval must be obfained. Failure to obtain inspeclions and final epproval will result in the expiralion of this permit. FOR INSPECTIONS CALL: (714) 754-5826 WORKERS' COMPENSATION DECLARATION: „ I hereby ettirtn under penalry of par�ury one of the fdlowlnp tledaretions: i� ❑ I heve entl will melntein e certificete at wnsent to setl-Insure for workars' compensetion, es Drovidetl lor by sectlon 3700 of the lebor Catle, for Ne pertortnence of It�e work for whic� thls pertnit is Issued. ❑ I �ave arM wlll meintein workers' canpensetion Insurence, fls requiretl Dy section 3700 oi Ne LeOor Code, tor Ne peAortnanca o1 Ihe woAc for which this petmit is issued. My workera' compensation Insurence certler entl polky num�er ere: Certler. Pdicy Number. (ThIs secNon neetl notOe canpleted7! Me permlf fs valued at me huntlretl dollars (3100) or Iess.) ❑ I certity Ihet in the pertarmance ot Ihe work for which ihis pe�mit is issued, I shall not employ eny person in any menner eo es to become subJect to the workers' compensation laws ol Celllamla, entl egree Ihat II I should bacome su6�ect to the workers' compensatlon pmNsions ot Sectlon 3700 01 the Lebor Cotle, I shell forthwith compy wllh these ProNsions. Applicanl SlgneWre: Date: WARMNO: FAILURE TO SEWRE WOPo(ERS' CaMPENSATION OOVEMGE IS UNLAW Fl1L PND SHALL SUBIECT PN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNE$ UP TO ONE HUNDRED TIqUSAND OOLLARE (E100,000),IN AUIXiION TO THE COST OF COMPENSATIIXJ, OAMAGES AS PROVIDEO FOR IN SEGfION 31O80F THE IABOP OODE. INiERE$T, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARA710N: I hereby etfirm thet I em IlcenseC untler provisions of Chepter 9(commencing with Section 7000) ol Division 3 oi the Business end Professions Cotle, end my Iicense is In full torce end eMect. Lla a Class p Contrectors Signeture: Date: CONSTRUC710N LENDING AGENCY: ❑ I hareby eMirtn thet thera Is a consiruction lentling egency lor Ihe peAortnence of the wark lor which this portnit is Issued. (Sec. 3097, Civll Cotle). Lentlefs Name: Lendels Atldress: , Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby atllrm thel under penelty of Derjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Iho Iollowing reesan (Sec. 7031.5, Business antl Prolessions Cotle: Any ciry or counry which requires e pertnit to wnsiruct, elter, Improve, demolish, or repeir eny stmcWre, pdor to Ita Issuence, elso requlres ihe eppllcaN tor such pertnit to ille e sipne0 stetement thet he or s�e Is licensetl pursuent to Ne provislons of the Conirectors lJcense Lew (Chepter B(commencing with Sectlon 7000) of DlWsion 3 of Ihe Busineu end Professions Cotle) or thet he ar she Is exempt therelrom and the basis tor the alleged exemption. Any vloletlon ot Sectlon 7031.5 by eny epplicant for e pertnit sub�ecis Ne epplicent to e Gvll penelry al not more Nan five huntlred dollars ($500).): ❑ I, es awner of t�e property, or my employees wlth wages as their sole compensatian, WILL DO THE WORK, end t�e siructure Is not Intentletl or offared tor sale (Sec. � 7044, Buslness and Prolessions Cotle: The Contractors License Lew tloes not eppy to en owner of property who builds or impraves thereon, entl w�o does such work himseN or herselt or t�rough his ar her own employees, praWded thet such improvemants ere not intended or oHered lar sale. If, �owever, ihe bullding or improvement Is sold within one year ot compleUon, tha owner-builder will heve t�e burtlen oi proving that �e or she did not build or Improve lor purpa5e of sele.). ❑ I, as owner ot tha property, em EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS ta canstrucl the D�o�ect (Sec. 70a4, Business end Professions Cotle: The contrectore License Lew does not epDN to an owner of property who builds or improves ihereon, end who comracts tor suc� pro�ect wlih e comredar(s) license pursuant to the Coniraclors Licensa Lews.). ❑ I em exempt under sec. Business and Pralessions Cade for ihis reason: Signeture: ' Date: Owner ID verllletl Oy Arivers license. ❑ Yes ❑ No Drivefs Licensa No. Vedflcation o1 Ownershlp by (rype ot daumem, i.e. - properry tez bill or deed): Expir09: CERTiFlCATE OF COMPLIANCE AND AllTTIOR¢ATION OF ENfAY: I certify under penalry of perjury that 1 heve read Ihis epplicetlon anG stete that the Infortnation given Is correct. I epree to compy wich all slete laws flnd dry ordinences releting ta building construction, end authorize representetives ot Ihe Ciry o1 Costa Mesa to enter upon the abovedescnbed propeM for Inspection purposes. I eBrea not to occupy or ellow occupancy ot eny building euthorized by ihis pertnit until tinel inspeclion. Slgneture OI Legal Owner(s) An�UOr AUNorizetl Applicant CO�E L INSPECTIONME OAIE II{�LS 1616 Fixed System Flnal Flre Prevention 1286 Pool Spe Flnel 200 Flnel Re-Rool 201 Finel Block/Releinlnp Wall 202 Final Factory Fire Plece 203 Final Sign 204 - Flnal Demoliilon 2446d8 COpE1� INSVECTIONTYPE Qe¢ �64 208 Finel Mechanical �a 20B 210 212 220 Finel PIum6ing Finel Elecirlcel Flnal Fire Preventlon Finel Plenninp Approvel 222 Final Site 250 Finel Builtling/Occupancy • �' S� � � , � CITY OF COSTA MESA ' BI/ILDING DIVISION � � � � DEVELOPMENT SERVICES DEPARTMENT � .. 698-00654 �S PERMIT PERMIT NUMBER (714) 754•5273 • Fax (714) 754-4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 472 '16TH ST Suite: Viciniry: Parcel Nunmber: 42515104 ApplicanC CZARNOTA, STAN. Address: Owner: TRZECIECKI, JAROSLAW Address PETER 472 E 16TH ST TRZEGECKI, ANNA Status: ISSUED et� Applied: 02/2311998 Issued: OS/21/1998 Zoning: Phone: Zip: Phone: Zip: 92627 Contrector: WHITE EAGLE CONSTRUCTION M&S Address: 18993 BARROSO ST Arch I Eng : Address: Plan Check: Permit: Other: Inspection: Total: Phone: 626 964-1267 ROLLAND HEIGHTS, CA Zip: 91748 License: 647729 Phone: Zip: License: SCOPE OF PERMIT REMOVE 2 BDRMS & GAR4GE; ADD MAST BDRM/BA, & ENTRY; 400 SF GARAGE; REMODEL EX BATHRM, AND ADD 2ND STORY BDRMS, BA. TOTAL NEW IIVING SQ FT IS 1,277 SF. PC#737-98L. VALUATION ADJUSTED TO MATCH BIPS FEES FOR PC SUBMITTAL. PC FEES WERE PAID $62221, RECEIPT #98691 $0.00 $962.25 $0.00 $0.00 $973.70 SETBACKS MAINSTRUCTURE Front 20-0 ACCESSORY Front 0. 0 PARKING Existin : 0 NOTES: Rear 20. 0 Rear 0. 0 Required: 0 FEE SUMMARY PLANNING & ZONING Lefl S 0 Left 0- 0 Proposed: 0 CalcValuation: iia,5oo.00 Claimed Valuation: ��a,soo.00 Right S 0 Right 0. 0 EXPIRA710N: This pe/mit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a pedod of 180 days. INSPECTIONS: In order for the work authorized under Ihis permit to he considered legal, such work must comply with all applicable codes, and all required Inspectlona and flnal approval must be obtained. Failure to obtain inspections and final approval will resutl in the expiretion of this permit. FOR INSPECTIONS CALL: (714) 754-5826 WORKERS' COMPENSATION DECLARATION: I hereby effirtn unCer penalty ol per�ury one ol lhe Following declaretions: �/ � 0 I heva end wlll maintaln e certiflcate oi consent to self-Insure tor workem' compensetlon, es provltletl lor by 5ec0on 3700 0l Ihe Lebor Cotle, for the pedortnence oi ihe work for which ihis permlt is issued. � ❑ I heve end wIA meintain workers compensetlon Insurence. es requlretl Dy seclbn 3700 oi Ne Labor Cotle. tor Ihe peAormence of Ne work tw whkh this permit is Ixwetl. My workers' compensetlon Insurance cgrrler en0 pollcy number ere: Cartier. PWity Number. (71tls sectlon need nof be complered /! the Oermitls valuetl et ane huntlretl dollars (S 100) or less.) ❑ I cetliry thet In the pertormence ot the work for which Ihis pertnil is issued, I shall not employ eny person In eny menner so es to becomo eub�ect ro the workero' campensetlon laws o�ellfomla, end apree t�et It I s�aultl become subJect lo Ue worken' campensetlon provLslons of SecUon 3700 ot the Lebor Catle, I shall forihwlth compry wlth these pr ions. (� Applicent Signature:'6 Dete: C `�— 2�— �'d WARNINO: FAILURE TO SECURE WORKEflS' COMCENSATION dJVER4GE IS UNUVfFUL M1D SHPLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES MlD CML FlNES UP TO ONE HUNDRED T}p�$qND OOLLFRE R��•�I• �N ADDfTION TOT}�E COST OF COMPENSATION. DMA4CE5 AS PROVIDED FOR IN SECTION 7lW OF 7HE IABOfi COOE, IMEREST, AND ATTOHNEY'$ FEES. LICENSED CONTRAGTORS DECLARATION: I hereby effirtn that I am licensetl under provisions of Chapter 9(commencing with Sedlon 7000) oi Division 3 oi ihe Business flnd Professiau Cotle, end my license is in full torce antl eHect. Lic. x Class a CoNrectors Siqnature:; �. r� Date:e J— Z — CONSTRUCTION LENDING AGENCV: ❑ I �ere6y etfirtn thel there I5 e constructipn lending agenry tw iha peAormence ot the work for whic� Nls Oermit is issuetl. (Sec. 3097, Civil Cotle). Lentlels Name: Lendefs Address: Signeture: Date: OWNER-BUILOER DECLARATIONS: I hereDy ettirtn that under penelry ot perjury thel I am E%EMPT FROM TXE CONTRACTORS LICENSE LAW tar the fdlowing reason (Sec. 7031.5, Buslness entl Prolessions Code: Any dry or counry which requires e permit to consWct, atler, improve, demolis�, or ropalr any slrucWre, pdor lo Its igsuence, elso requlras Ihe epplicant lor such pertnit to lile e signeC stetement that �e or she is licpnsed pursuent lo Ihe proNsiwu al Ne Contrectaro License Lew (Chepter 9(commenUng wiN Sectlon 7000) of Divisian 3 ot the 8usiness end Professiwu Cada) or ihet he or sha is ezempt Iherefrom end Ihe DeSis tor ihe allepetl e:emptlon. Any vldeUon ol Sectlon 7031.5 by any epplicant tor e pertnil sub�ects the epplicant to a clvil penalry ot not more than tNe �untlretl ddlaro (E500).): ❑ 1, as owner at Ne Oroperry, or my employees with wages es their sole compensatlon, WILL DO THE WOFK, flntl t�e structure Is not intendetl or ofleretl for sale (Sec. 7044, Business and Professions Cade: The Contrectors Llcense Law does not appty to en owner of property who bullds or improves thereon, antl who tloes such work himsetl or herseN or through his or her Own employees, provlded that such imprwements ere not intended or oflaretl tor sale. It, however, the building or Improvement is soltl within o�e year ot completion, ihe pwner-builCer wlll heve Ihe burden ot proving that he or she did not bulld or improve for purpase ot sale.). ❑ I, es owner of Ihe property, em E%CLUSIVELY CONTRACTING WrtH LICENSED CON7RACTORS to consiruct the projec� (Sec. 7044, Businesa end Professions Code: The contredars License Lew Cqes no1 epply to an owner oi property who bulltls or Improves Ihareon, entl who conirecis lor such project wllh e contractor(s) Iicense pursuant to ihe Contractors Licanse LewsJ. ❑ I em exempt untler sec. Signature: Owner ID verifled by drivefs license. ❑ Yes ❑ No Busineu antl Professions Code for this reeson: Vedficatlon ot Ownershlp by (rype of dxumeM, I.e. - property tex �ill or tleed): DIVISION OF INDUSTRIAL SAFE7V PERMIT CER7IFICATION: Drivets LJcense No. Date: Explres: ❑ I hereby certity that no excevetlon five (5) or more faet In dept� into wNch e person Is reQulretl to doscend, wlll be made In connoctlon wlth work euthotlze0 by ihis pertnit, entl that no bulltling structure, s�¢Rolding, telsework, or demolition or dlsmentllnp Ihoroof, wlll be more then Ihiry-six (38) foet Idph. (CheO� 32, Grp 2, Arl 2, Sec. 341, Title B, Ce111am1e Atlminis(rellve Cpde). ❑ As owner-builder, I wiil not employ enyone to tlo work which woultl require e pertnit Irom Ne Dlvislon ot Intlusirial Selery, es notetl ebave, unlesa such person hea e pertnit to do such work from the divislon. • Signeture: Date: DiNsion of Indusirial Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUT}IORVA710N OF ENTiiV: I certify under penalry ol perjury that I heve reatl tNs epplication antl stete thet Iha Inlormetlon given is cortect. I egree to compty wltA all siete lews and Gry ortlinflnces rela6ng to building construction, entl authodze representetNes o1 the Ciry ot Coste Mese Io enter upon the ebwa•CescdCed pmperry tor inspection purposes. I epree not to occupy or ellow occupancy of eny buildinp euthodzed by thLs permit until final Inspection. Signawre Of Lagel Owner(s) �_�� —�n Date f t 7> � AndOrAuflwnzedApplicant Date CO�E �. INSVECTIONME 1616 Flxed System Final Flre Prevention 1266 � Pool Spe Fnal 200 Flnal Re-Roof 201 Finel Block/ReteiNng Wall 202 203 204 zasa+6 Final Factory Fire Place Final $Ipn Flnal Demdilion �� pFj INSPECTON TYPE 206 Finel Mec�enical 20B Final Plumbing 210 Rnal ElecMcal 212 Final Fre PravenUon 220 Final Plenning Approval 222 Flnel Slte 250 Final8ull0ing/OccuOancy � ��: �%�` l B� � � NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: ( Xl City of Costa Mesa ( } City of Newport Beach ( ) Counly of Orange Applicant: Address: � � 2508 District Receipt N�l �3Plan Check No. —' .., , . .- z�a:�=��:t TracUParcel and Lot Number(s): Location of Project Number of Square Feet of: Residential Space ResidentiaU Sr. Cidzen Space Commercial and Industrial Space CommerciaVlndustrial Project is: (Check One) _ Warehouse _ R8D _ Movie Theater _ Mini-storage _ Heavy Industrial _ Regional Shops _ Light Industrial _ This project is exempt because r� �, �� x $1.84 x $ .30 x $ .30 _ Motel Bank _ Neighborhood Shops _ RacqueUHealth _ Hotel _ MedicalOffice Office Park �4j Total Total Total % � v _ Preschool _ Auto Repair _ Hospital _ Large Office _ Office Bidg. _ Restaurant Fast Food This certifies that the above-named Developer/Appticant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building PerrrtiLs for this square footage in this proposed development may now be issued by your jurisdictlon. Checks are to be made payable to Newport-Mesa Unified School Representative The above representation as to square footage is true. Applicant agrees that if it is later d'eter ined that su� representafions are not true, then this certficate shall automatically terminate and the appropriate City/County �h be notified. Date: S�2 / � �/� �� Applicant CITY OF COSTA MESA � BUILD/NG D/VISION DEVELOPMENT SERVICES DEPARTMENT � P RMIT NUMBER ��. PERMIT E � E98-00792 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 472 E 16TH ST Suite No vciniry: Parcel Nunmber: 42515104 npp�icant: ZAPALE, KRZYSZTOF Address: .i �� - , Owner. TRZECIECKI; JAROSLAW � � -� Address RE7ER� V ` ��, ��.' �472�E�16TH STi ; ' �- - , , % : j TRZECIECKI, ANNA� �-� - � % _ ,' �,� ,� `�% ,; -!� " � : ../�%i i 7 %��% Contractor:� ,� „ �; ; � Atldress: � %� �. , // /. . � �, i - i � i , , i' -� �- r ELECTRICAL PERMIT ' Phone:� 878-368-8019 Zip: Phone: ��` � Zip: 92627 Phone: ZiP: � License: status: ISSUED Applied: 07/27I1998 Issued: 07/27/1998 � � ' �� SCOPE OF PERMIT � � REF B98-00654, INST36 fIXTURES, 28 OUTLETS,30 SWITCHES, 1 SUBPANEL AND 1 MOTOR TO 1.0 � / ' H.P . . - - . . . . � i ,. ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) � Pool / Spa " . Lighling Fixts , Recept Outlets Switches Non Res Appl , � Res Appl Service to 200a � - Servicetot000a � Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Morors l0 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pk9 Si9n Circuits Temp Pwr Pole Intertned Pole Quantlty • . 522.00 � _ .� so.00 $0.00 $0.00 � $0.00 $0.00 �� 830.40 525.20 $26.50 $0.00 80.00 �, $0.00 -, �� $0.00 50.00 $4.25 ". . $0.00 $0.00 $0.00 $0.00 - $0.00 $27.25 $0.00 $0.00 $0.00 50.00 0 0 0 36 28 30 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 FEE SUMMARY _ Temp Dist System / Lighting - - � Busway /100 ft,' Standing:Section Misc Eledrical Equipment Transformers uD to 1 kva/kw ................uP to 10 kvalkw .................up to 50 kvalkw .................uP to 700 kvalkw . ..................over 100 kva/kw Low Voltage Equipment ' Low VOIt Wiring System I Ckt . � Misc Conduit Misc. ConduIXor Cirws ( gen or ride) - Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Olher Eledrical Fee Investigation Fee Plan Check Fee ReinspeCion Fee Quandty so.00 0 80.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 80.00 0 $0.00 0 $0.00 0 50.00 0 80.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 5135.60 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work fs suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all requlred inepectiona and final epproval must be obtained. Failure to obtein Inspections and final approval will resufl in the expiretion of this permit. FOR INSPECTIONS CALL: (714) 7545826 WORKERS' COMPENSATION DECLARATION: I hereby eHirtn under penelry ot pe�jury one ol the �ollowing deGaretions: ❑ I heve end wlll maintein a cenificete of consent to selt-Insure tor warkere' compensetlon, es provitletl tor by sectlan 3700 of t�e Lebor Cotle, br the peAartnence ot the work tor which Ihis pertnit is issued. ❑ I hava entl wlll mainteln workers' compensalion insurence, es required by sectlon 3700 of ihe Lebor Cotle, for t�e pertortnarxe af Na work tor w�lch I�is pertnit is issuetl. My workers' compensetlon Insuwnce cerrier entl pollcy number ere: Certier. (7h/5 se Policy Number: nat be canpleted!! fhe pertn/t Is ve/ued vne hundred doflers (S700J or leu.) in Ne petlormence ot Ne work for ich this permit is issued, I shell not employ any pereon In eny manner so as ro Decome sub�ect to the workers' i laws oi Celtlomla, end egree the I should ec sub�ect to t�e workero' compensetlon provlslons of Section 3700 ot t�e Lebor Code, I shell lonhwith �ese provisions. —_ Date: � �� / � f0 SECURE WORKERS' COMP TIIXJ COVEMGE IS UMAWFUL M1D SHALL SUBIECT AN EMPLOVEF TO CRIMINAI PENALTES AND CML FlNES UP TO ONE HUNDRED i(E10U,OD0�, IN ADORION TO E Cp$T OF COMPENS4TON, DMWGES AS PiiOVIDED FOH IN SECiION 3IOB OF THE IABOR COOE, IMEREST. AND ATTORNEYS FEES. LICENSED CONTRACTORS OECLARA710N: I hareby ettirm thet I em licensetl unj�er prq � ic force antlAMect. Lic. k �-f 5 CONSTRUCTION LENDING AGENCV: ❑ I hereby aKrtn ihet there is e wns Lendefs Name: Signeture: OWNER-BUILDEP DECLARATIONS: vriN Section 7000) ot DMslon 3 of the Business ap� Prolessions Catle, enC my license is in tull _ Class M L Date: — egenty lor �he pBAormente of lhe work lOr whiCh �hi9 pertnll is IsSued. (Sec. 3097, Clvil Cotle). Lendefs Address: Date: I hereby eHirm that under penalry ot 0e�jury ihet I gm EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe lollawing reeson (Sec. 7031.5, Business end Prafessions Cotle: Any Gry or counry w�ic� requlres e pertnit 10 construd, alter, improve, Oemolis�, or repalr eny sWcture, pdor to ILq Issuence, elso requires Ihe applirant lor such permit to flle e slgnetl steiement thel he ar she is Ilcensea pursuent to the provisions oi Ihe Contractars License Lew (Chepler 9(cammendng wit� Section 7000) of DlWslon 3 ai the Business antl Professions Cade) or Ihet he or shg is e:empt iharefrom end the basis lor the alleped exemptlon. Any violatlon of Sectlon 7031.5 by any epplicant tor e pertnit sub�ects t�e appllceN ro e ciNl penalry ol not mor4 Nan five hundred dollars ($500).): ❑ I, es owner o1 the praperry, or my employees wit� wages as Iheir sole compensation, WILL DO THE WORK, end the siructure is not intended or oftered for sale (Sec. 7044, Business end Professians Code: The Contractors License Lew tloes not appty to en owner of property who builtls or improves thereon, end who does such work hlmself or hersetl or thmugh his or her own omployees, provided that such improvements ere not Intended or oHered for sale. tl, however, the building or Improvement Is sold within one year of completlon, the ownar-builtler will heve the burden ol proving thei ha or she did not bulld or improve lor purpose oi sale.). ❑ I, es owner af Ihe property, am EXCIUSIVELY CONTAACTING WITH LfCENSED CONTFiACTOHS b conswct ihe pro(ect (Sec. 7044, Busfness end Pm(essions Code: The contractors License Law does not epply to en owner oi property who 6WItls or Improves Ihereon, entl who contrects lor suc� pro)ect with a conirector(s) Ilcensa pursuent m the Contrectors Licensa Laws.). ❑ I em e:empi under sec. Business and Prolessions Code tor this reason: Slgneture: Date: Owner ID verltletl by tlrivefs license. ❑ Ves ❑ No Drivefs License No. Explres: Vedflcetlon o1 Ownership by (ryDe of tlwument, I.s. - property tex bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMR CQpTIFICATON: ❑ I �ereGy cenity Ihet no excavetlon Ilve (5) or more teet In depth Into which e person is requiretl to tlescenA, wlll he metla In connedlon wlth work euthorized by this pormlt, enA Ihet no buildinp stniqure, sceMolding, felsework, or demolitlon or tlismantling t�ereof, wlll be mora t�en t�lrty-slz (38) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Ttle B, Caltlomla ACminlstretiva Cotle). ❑ As owner-bulltler, I wlll nat employ enyone t0 do work which wauld requlre e permli from t�e DlWslon oi Industrlel Sefery, es notetl ebwe, unless such person has e permil to tlo such work irom ihe divisian. Signetura: Dele: DlNsion of Industrial Safery Pertnit Number: ICERTIFlCATE OF COMPLIANCE /WD AUTMORIipTON OF ENTRY: I certity under penelry ot per�ury Ihal I heve read this epplicatlon and steto ihet the Infortnetion given Is I conect I eprea to comply wlth all siete lews and ciry ordinences relating ta building construction, end euthodze representetives at the CIry ol Coste Mese to enter upon t�e ebova-tlescnhed OrqpeM ior inspectlon purposes. I egrea not lo acupy ar ellow occupency ol eny building authorized by this pertnit untll Ilnel Inspection. � INSVELTON TYPE �¢ IIQID9L4 1616 FIxeA System Flnel Fire Prevention 1286 200 201 202 203 20C 2aa&4e Paol Spe Finel Finel Re-Roo1 FInaI8lock/Retaining Well Finel Fectory Fire Place Final Slgn Flnel Demolltlon 7 � 7 oB� Date CODE t INSPECTION TYVE 206 Finel Mechenicel 208 Finel Plumbinp 210 Final Electricel 212 Final Flra Preventlon 220 Finel Planning Apprwel 222 Finel Site 250 flnel Builtling/Occupency � � eonness a emwmo: 4/ L C 1 b�1 ri S-1 owNexswuieivaiovm: TRZECIECKI, JAROSLAW �ooxEss: PETER "PH#548-8186" TRZECIECKI, ANNA 472 E 16TH ST COSTA MESA,CA �vv�.wuuxo �oox[ss: � '. �PCNRECT ON F1M.INEEH: pC. NO.: APCN.OP ENO.'81DURES4: VNi: uxT: 9262" ' carim�crarsrun: PREMIER ROOFING ( 909 ) 674-7052 cam�croxswuuxc 13154 HROKEN BZT CI �ooxess: CORONA CA ��, 634404 91719 �,,,: UCENSEU COMHRCTOflS DECLAfl�TON: I Mnby aflim unEe� pero�y M peipuy Nm I em Icemed uMx pvrianns M Gheqx 8 ImmmendnB �1� Seciion )000) ol Division � d ilw Busron eM PMeavau Coda. vd mY lieiue is in lull lorce end eHeq. cmuc.No.:061266 uc.cuss: C-39 uy� 3 404 EXP; 03/96 o�, ��! l 5 � �o��11L �i-u.✓— OWNEN BUILDEfl OECIAHRTION: I henby dfiim wder penNy d perjury thm I am emmq hdn �M Convmav Liceree Lew la tha �lo'n^9 �eemn (Setlian ]Q11.5 &nreff eM Rdeuoiu COAe: RM W o counly whitli nW'vef e Oetmil lo ooneWCL eller. imAwe. mdon, u�ava: �r.wrn,�a. wKK w n s��. �to �a� �ne eoo�v ia �n o� m eb a ae� �+m�u uw ns «.na y',1 licenaetl pureueni m iM ywisians d iM Comredas Liceiue lew �Cheper B(commanrinp wilh SeUon )000) d DMsbn 3 M Ihe "'Busiriea eM Prdms'ms COEeI a Inm M a aM o ssamV thaeham ard ihe Wm fa Nw aDaY� ssemWion. MY violetion M Sed'an )031 S W eny applirent lor e parm� eubjem IM epplirani io e dnl paneXy d� mae �lan INa hwMred doAera �S50U��. � I.movmerdiMVWerIYnnNemGM�xvhwapa+mtheivobcvmC��.v�doNexoA.eMtMstrununum�inteMad w oRered la seb (��ion 10M. Bu9rou eM Profesvms COEe�. The Comrmon t'van�e Law droa iwt epplyto en owner W propeM wno a,wa «mw�s m�,. �d.ro ma..� .w� �.se a na.a «u�aqn ne «n« o�„ emvMe�. ao+� �nm.,�cn improvemenm ere rot inieMeE n dlued la ade. X, Aowaver, tM buikirq a inpv.•emeM ie aoltl wrhin aw yeer M mmpletun, the� o.��a�ad« w�u nab ma e�d� a wo�am ne « w� aa m e�ma «�� io, ina wm�. d..bl. � I, ea ovmar d �he propeM. � udutively mn�repiq wah lianud wnvaclan lo consUitl �he qopd (Sedion 1061. Buai�wsa end PMev'vie Code: The Caueaem lieeme faw Eroa na xGbY m en oxxpr d pW�Y wM10 bulG a'vnpw'ro thaean ud who comrern Iw euch pol�9 �h a caniredar(n) Icensed pursueM to �ha Conirmon lioen9e lew�. � I em ecemq uMer Section: B. 8 P C.. tar Yw �aemn: Dme: Oxror: I m MiaM eenM Nm I em ewara d eed �vMenteM Ue nmi�mu d Celfmia HeeAh W 5dW Coae Seaiau Y5505. a55�a. enE PSSM. aM �hel I a erty Mum drikiiq ooapent will / wil rwi (vrck an) � lo comyy Mt� eek elme oodm erd tAe reQuiremend Iw e perm� f«mruleuetion a moEifimlun ham�MAisw lyi'x(-v�epemen10istriC. ReeNxYul mMrWion appiutipq ye azemqlmm Neae pwi.ons. De�e: Appliau: WORKEN'S COMPEN4ITION DECUfl1TON: I Asraby dfilm wtiv pmetly M pe�uy dr d tM IoOow'up dsdermuna: � I heve vd xil meinten e cenEirate d mmmt lo eetl imun br wakeri canpawiion, m prwidad la by Ssqbn �100 d Ilw lebar Cade. la tAe peAormence d Rw wak lor Mvc� il�is pe�mC u ieued. ❑ I Mw eM xJ me'vven wM1nn' oomD�ion'vuuronce. n rcW"ved M Ssqbn �100W the lebor CoM. br IM Oe�ormence d �M .�ni«�.�,b,in�.o�nn��e.Mr.�wa.'�A�1��Rl��avm.v��n.a.: EXPIRES c�«: va� N�mea,: — 10 / 2 8/ 9 5 (Thia esdian rreed rwt M cand�b / tM Pa'mt e b aa hurMrsC LaEan ISIWI n lm.) � I canA' �� in ihe pMormerce d ihe wark Iw v.hich thu peimG p . I NeY mi emplq enY W� �Y mams w as �o Deeome wEjed to IM xaMere' eanpruetion lex+ d C en 1 E I ehwk bemme eubjea io iM warkees' canQpen Iqn qwiaionf d Setlian �]00 d IM LThor Cotle. I ql wYh �hoee pwiaon Oma: O��JI� I RDd'cen1: 9�� Wem/np: FeNun ro s�c✓n wroik�r�'romperuetlon rov�rep� li �ml�wNl, enCWll ydJ�ct en wnployw ro cNm'ne/ pm�tt/u enL c/vll Hroa �q ro ons h,nErW lhouurM JMYn (f1pq00pA M�tlEllbn ro M� cwf ol compsivatbrt d+�pu �i pnHdM br In Sxtlon JIOS of Me LeDor Cods, InHns4 ��S attomsy'� leu. CONSTFUCTION LENUINO AGENCY: I henby eMirm uMs pmelly d pmj�ry thm tMn e e omq�ueion Wdiip pm y lur rtn pe�amence d IM xvM1 lor xfiich IM1e permi u owed (Setlion �09). Civ. C�. , LENDEP'S NAME: LENUEP'S10DFE55: � ceniN �nel � nave reea �nc eodceibn ena Ad. mm me eeove mf«nwiw, u ronea. � ayree �o comdr wnli el� tl�r ene mumv aeinarice. arM etele le�n mla�iq lo buddiq conmvlan end IweEy eNfwrze iapasaNelna d Ihe tiy b eNr upon tM ebwe�man�'nned poparly �°��' �°°°�`D°�°'�ROBERT �DWARD JR i � � (5151-06 W P) De�e: ✓ , � Whne-BuiNvq 8 Selay; Greer�Fle; Cere�y-Appicent; Pink-Revenue; GOldenmA-Nseawr CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO: B 073881 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR JOB DESCRIPTION : T/O SHAICE 6 REROOF W/SHAKE, SPSF MAXWT PERM NO: B 073881 GOVT: N SUPP: N PURPOSE: OTH SQ FT: 3,500 CLAIM VALUE: 3,500.00 CALC—VALUE: 3,500.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 1700SF RESIDENCE **+��t*x��*x��rx�**x�***�t*+�*it***+�*+�***x��titi�**�r�t+�+t**x�*�tit*****+e+��*atxit*+e*+e�rfr**at***+�iE*�t�t*** ' ZONING REQUIREMENTSSMOKEDETECTOR S E T H A C K S p� �p� ------------ MAIN BUILDING ---------- --------- ACCESSORY BUI�L�NBl1L�G61-- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE�• PROV: PARCEL; 42515104 ZNE: REF NO: PLANNING N TESi> •- i. iE'lE iE')E �E �E �E 1F f(-iE iElE iE 3E * fE'lE'lE iE iF fE �E fE'IE %!(-iE iE iE'IF 1E 1F 1E'IE �E �E iF if if �f jF'N� �E 1f if 1E iE iE ih iE 3f 1flE �f 1E 1E iElE i4 3F �E �f if iE if if iE jE iE iE 1E �E iE iE 1E 1E �E 3E 1E 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'BY DATE: W:� �FJILDING APPROVED BY : DATE: APPLZCATION ISfiUED BY: DATE: 2 i�*iE*x�ititi�iti��titit*i�******�t�TF�F�'iF3F�F3'F'�F�F7F3F7F�F'iF3F3F'iF7F'iFT 5 3F'iFiF3FtF7�iFiFTF�F�FiF+tit�*rt*i�*�t**�F'�7(� ' I * LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 63.00 PLAN ISSUE FEE BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 63.50 0.00 0.00 FIRE �l i TOTAL ��'� 63.50 SMIP/RES GRADING 50 SMIP/NON—RES PAID DUE 63.50 .00 �'.' REVENUE DZVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TbT GRADING PLAN—CHECK 63.00 ,50 iE 1f i%'N- fE ii-1f 1f iE if 1E iE iE iE')f 1E 1E if 1E If 1f ii-if'If'IE iE iE �E'lE iE IE if if iI-ih'lk'If'IE 1E if 1f 1f'N-ih ii' ih iF iF 1E fF iE'lE i(' ik iF'!f if 1FifriE'IE 16 ih 1E IE iE iE i4 iF i4 iF i4 ih iE iF fE iE aE iE I N D I V I D U A L F E E B R E A K Ds0 W N TYPE QTY D E S C R I P T I O N UNYT CpST TOTAL COST SFR 3500 REROOF BY VALUE RESIDENTIAL NOZONE 1:00 3,500.00 END OF FEES �i • Y /�:i�� `�' r "% . � / �r OI O�ate?732—D313$732 T Cb'T DATE'' OZ�'?1{4s TICE: �]9:7: fi.]. s�� ._. ,. CQNSTfiUCTlON AND PIANNING POO� a SPA APPROVALS Permit # Date Inspector pppROVALS Permit # Date inspettor 1. Temporary Eiectrical Service or Po�e 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement � ' ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � . 4. Electrical COnduit�Undrgrnd. 55. E�ectrical Bonding 5. Steel Reinforcement . 56. Fough Plumbing & Pressure Test 6. Electrical UFER G.�d. 57. APPROVAL TO COVER GUNI7E 7. Footings 58. Electrical Concluit-Undrgrnd. 8. foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd. 60. Backwash Lines, RTrap, O Undrgmd. 10. Structural Floor SYstem � 61. APPROVAL TO DECK - 11. Property Sewer Line & HousA Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbinc� System � Final 14. Rough Plumbin9 65. Electrical�Final - 75. flough Electrica6Conduit 66. Solar SYstem�Final 16. Rough Electric YViring 67. Fencing & Access Approval 77. flough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heat�ng & Air Conditioning , FIRE DEPT. REQUIREMENT 20. Aough FactorY Fireplace - APPFiOVALS- � Permit# 21. Ducts, in St�ucture 70. Underground Hydro 22. Ducts, Ventilating � 71. Product Piping 06as OOiI 23. Gas Pipe-Rough & Test � 72. Underground Flush ' 24. RoofFraming" �� 73. Undergrnd.StorageTankOGas ❑Oil 25. Roof Sheathing . 8� g� (�..�,�/�/ 7q, Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical � 27. frame and Flashing ' 76. Dry Standpipe ' 28. Lathing & 5�ding' � �� 77. FIXED SYSTEM FINAL 29. Insulation �• 7$„ FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Piasrer Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric . . Notes: � � 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe•Test 36. Hood or Canopy . • ' ' 37. Final.FactorV Fireplace . 3$. Finai Plumbing , 39. Water Service�Final 40. Gas Service�Finai ' - 41. Solar pomestic�Final � � � 42. Backflow Preventer ' � Z�_.. ` -� -� 43. Backflow irrigation ' �� ` Z�� 44. Landscape Irriaation S?ttem � . 45. Sound Att¢nuation �'"� ;Z 46. Handicap Regulations�`j'i f�. - 47. FINALSTRUCTUR6'&,Bl7iL�DING 8 Z�-�j �C,�6L • 48. FINAL PLANNiNG ' �' " 49. Electrie Release to Edjson tT 50. Gas Release to Southe?n Cafrfbmia Gas Co '' 51. CERTIFICATE OF OECUPANCV No. �te � ,woness a em�pxo: q � z E 1 6 TH S T u"T: �e""'Ei°'°'°'m': TRZECZECKI, JAROSLAW �� PETER TRZECIECKI, ANNA l72 E 16TH ST COSTA MESA,CA 9262 I�PPI. M�NNO ADURE54: - ARCXRECT Ofl F1M�NFfA: ANCN.OR FNO.'S /iWNE53: PERMIT NO: M CITY OF COSTA MESA - BUILDING PERMIT 075364 PLAN CHECK'NO: N CONSTRUCTION TYPE: PERMIT TYPE; MEC � � IJOB DESCRIPTION . FAU CHANGE-OUT UNf: CLAIM VALUE: CALC-VALUE: cowm�cTarsruxe:KEMNITZ A/C S HEATING (714)453—B500 COMNACTORSM4l1N0 188 TECHNOLOGY �ooxess: IRVINE CA uc.eio.: 695874 o� 9 2 718 urir: C LICENSED COHfNACTORS UECLAF�TION: I Mrtby ellim uMx pmely d perjury Ntl I em Icm»E imEs pmisione d Claqer 9 (mmme�np xilh SecWn'l000) d Diviaun 3 d iM Buairon enE Prdeaama CoEe. enE mY ��+a a in full lace erd eHea. cmuc.No.:06^3�392 uc.cuss: C-20 �� 874 EXP: 10/96 oare: / / -�Y— '��_ caveao,: OWNEH BUILDEF DECIAFATION: I hereby efirm uMer pmely W ' em uemq Imm the Contretlwa Liceme law Ia I�e folbwig iaeson (�� )�1.5 Buarou eM PNmione Code: Rrc� eiY a oouniy r.fiirh �puiree a peemd to wrebun. elier. improve. damoleh, or repai eny sVuclure, prior �o ts cauanm, elso requiree �ha epplimnl for wc� peimil lo fib e sproE etatement Net M u eM ia licensad W�I lo iM porivona d Ihe Cuurmna Lirama Lew �Chepler 9(��Y �h Sed'on NW) d Divuion 3 d ihe Busnesa arM PrMessions Code� w thm te a she u uemq iharalrom ard �he besis fa Na ellepeC a�emqion. My volelon W Seaon J031.5 by e�ry eppliraN fa e perm0 wbpGa Ihe eppfieW �o a crd penelly ot rp1 more Ihen live huMead ddWs �S;A0�1. � I.mawrerdtMpropenyamyemplvyeeaxihwapeamlhsxlemmpavstion.xitldothaxak,endthesiiucwreemtiMeMad or ollareE fa eale (5eciion )Oda. Business eM PMasvmaCoda: The ConVeporo lironse LawEoes iwt eppy�o en ownm W popeM who bulda a in0�s Iherem. end wM Coes such xvrk FcnaeE a hene� a Wwqh he v har own emPMa+=. p�ed thet auch o'mpovemema are mt imendaA a dlmaG Ia eab. H, Ipwever, �M Wildinp or inpevmmaru u vold wnhin ap year d eompbtbn, iM w�«a�uea, �;n new me w�� a v�ro ne a xb eu m dnu «�o�+e �« ma wm�e a�l. ❑ t m e.m., a �ne wwain. an eswmwr mn�imne �.;�n w�me eanue�.,on w mnmw Ne wdw (seaion �o... amie�. ane Prolaseam COEe: TM CaNntlas L'erua Lew dow rid apply b an owner d peopeity Hw buiFb a"unpavev ihareon erd who conlracla Iw mxf pqeaa wnh e mmredor(e) IKemeE pursuem to tM Conireqore Limue Lew�. � I am examq uMer SMiar�: B. 8 P.C., br Nu ieeson: o�a�, o..,b� I do heraby cMity Ihel l em ewara d ard wdersieM iha repuiramemn d Lellomie HaeAh eM Setety COEe Seaiau 25505. 25533, arM 255J0. eN ihm I u e�ry Mun Duikbp omqefu xitl / wil rM (acb aa) roed io canply wih mid mne mdn ud the rpuimmenia fur e paimn lormnawcwn w modAre�ion homlM Ai�ty . enepertwm pixnn. Reaideiyiel canq�upnn apqiy�iom e�e ssemq irom Neae proviaione. � De�e: Appfra�n: WOFKER'S COMPENSATION DECL�N�TION: 11wreW elfiim uMx perany d pwjury ma d the bllowiip dedvmons: ❑ I have vM vnl maimen e cenM' �e d oonaeni io �ellinwro br xwkan' wmpeme�on, e� poviCed lor by Sedion �100 d IM LeCor GaEa. iw the peAm�wice d Ne v.a�k la Mih Nb pemd'e roued. 1"l inewd,e�;��w�.omm�a�v�o��.�.m,.m�:aeMs.n�a�ooame�n«cme.ro�inero�+«�o.din. R' wak lar whiM thie pam'il n iaueE. MY waken' compeneqbn imurence umar ud pdiry number ere: c�: STA7¢' F_ FUND EXPIRES Pd'ry Numbr: �� / � — Q z� � 1� 9[ (This eeubn rieeC ml be romdetM / uro P�t u M aro hurMrM ealen R�m/ n Iw 1 � 1 m�ey Ilut in IM1e p«Imnarica d �he wak lor v.TkA �Au pamntly�N'�iid amdW �Y Va� in anY mennm eo m lo nx� .�q.a m ine wnen canoe�+mc� e.. a ceiaomb. a i enwb n«m�e w4ea io ine .,awa,• �oa�w;� o��. m seeion aroo d ine �ebor Coee. � nynn .an NO.. powion.. L•��—�t��.:L�9 Weminp: F�Nun b ucuii'GoKai campawtlon eov�rep� Is ✓nMiI�J..eeWlGll rtlJ�cf �n smplqp ro cr/Mnl p�n�M�� erM clvll llros up ro wa I��ndrsd HnuunJ Collan (JtpqOppA M Wltlon b M� cwt ol romysnutbrt ��ps� is provltlstl br In SxHon J106 0l Ms Lebor COW, /ntawS ��d ettomsy'i fw. CONSTNUCTON IENUINU AGENCY: I Mraby �rm uMer peneXy d perjury iM1m iMn ia e conslruqion IeMiip epency lor �ha perlormaMe d iM wa�k tar whiM �he D�� u ueuad (Seaion 309). Cv. G). LENDEH'S N011E: LENDEN'S ADDNE55: I ce�ity �MI I 1 011E B�B�BIBNt (St51d6.WP) Y M to canply xnh dl vry uM couMy ordirencee lo enter �pon Iha ebwe.mentuneE qopeM Date: 8 Selety: GmerFle: Canaiy-RPGkeni: Pink-Aarenue: GdEenroE- Mxaaor PERM NO: M 075364 GO�'T: N SUPP: N I;�ij;i • • , SQ FT: GROUP OCC: / COMMENTS: NO OTHER WORK AUTHORI2ED BY THIS PERMIT �**�*****�+�x+�**at*��****+��x*x+�+e��**it+��+�***at��*�*it�*�t*�*********if*it**�*itiEit�*�*ar�� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCE5SORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42515104 ZNE: REF NO: PLANNING NOTES> --' � ' i 1E iE iF �E 1E jE iE iE 1E iE 1E jE iE �E 1E iF iE if jE iE 1E 1ElE 1E 1E 1E 1E 1E if iE jE iElE 1E 1E if 3E if ik *!E 1E 3f 1E if iE iF.iE �E �E 3E 1E 1E 3E fE 1E �E iE iE 3E 1E if 1E iE jE iE 3f iE iE 1E iE iE iE �E �E iF aE iE IE 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 �i ZONING APPROVED BY . " DATE: BUILDING APPRO�'ED HY : �� DATE: C_ _�^ �t APPLICATION ISSUED BY: 215�� DATE: �� **�-*+�****-�*ie�****�-***�iF'iF'iFiF'iF'iFiE"iFiFiF�F�F7FiFiF3F7F'i��FiFiF�F;�'R'3A�3F7F;FiF�F?Fi��F�F*�******** �iF*+t LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMHING ELECTRIC`�'MECHANIC FIRE SMIP/RES GRADING PERMIT i 925t SMIP/NON-RES PLAN � J ISSUE FEE � ^ 15.00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 9.00 15.00 ,.- 0:00 24.00 24.00 .00 REVENUE DIVZSION TOTALS--> COL�ECTED; 24.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHP;NIC FIRE SMIP/TOT GRADING PLAN-CHECK 24•, 00 � if iE'lE 3E iE IE if iF if 1F IE jF iE if M dE iE iE iE IE aE aE aE iE IE aE iF iE 1E 1f iE 1E iE 1F ii:df'1E iE if iF 11E 1E iE if iE if ii' i6 ik 1E if if')E'IE iE jF 3E if iE i( if iF iE iF ih ii- if if iE'7(' iE iE IE iE if iF if aE 1f I N D I V I D U A L�% F'E E B R E A K D O W N � � 4 TYPE QTY D E S C R I P T I O/N�y� � UNIT COST TOTAL COST MEC 1 INST FORC-AIR/GRAViFURN <= 100 K BTU 9.00 9.00 END OF FEES /� i�; C�C1��:�- -_ic':�� rr:-C ^.,,' i "•'.__ '. - .� .rj .c; i�� .� , . _ ! CpNSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspe4tor 1. Tamporery Electrical Servfce or Pole 52. Pool & Equipmen[ Loca[ion.. Z. Spil Pipe•Undrgrnd. 53. Steel Reinforcement 3. ElecVical Conduit UU4ity•Undrgt�d. 54. Forms " • 4. Electrical Cond�it�Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UFER Gr�d. 57. APPROVAL 70 COVER-GUNITE 7. Footinqs 58. Electrical ConduibUndrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash lines, P-7caA, O Undrgrnd. 10. Scructural Floor Svstem i 61. APPROVAL TO DECK' •.! 1 t. Property Sewer Line & House Conrtection 62. Backwash & Receptor�Final 1 12. Sewer Cap 63. Heater & Vent-Finat 13. Roof Drains 64. Plumbing System � Pinal 74. ROugh Plumbing 65. Electrical-Final 15. Rough Electrica�•Conduit 66. Soiar SVstem�Final i 6, ROugh Elearic Wiring 67. Fencing & Access Approval �� 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. RJugh EleCtricai•T 6ar Ceiling 69. POOLISPA SYSTEM$ F WAL � 19. ROugh Heating & Air Cond�t�oning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permi[ # 21. Duccs, in St�ucwre 70. Underground Hydro 22. Dutts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe•Rough & Test 72. Undergro�nd Flush ' 24, Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashi�g 76. Dry Standpipe 28. Lething & Siding ' 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PfiEV. FINAL 30. DrVwall Nailing HEAITH DEPT. RE�UIREMENT 31. P18ster Brown Coat 79. FINAL INSPECTION 32. Electncal Power MeterFinal 8Q. FOOD CERTIFICATE ISSUED 33. Fina4 E�ectric Notes: J2-/ -S S- �� r.� LL�� 34. Final Heating & Air Conditioning C/4-/t-/ 35. Final Gas Pipe�Test � rz� �'S-F�.c�fi�- _ 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � %�� S 39. Water Service-Final 40. Gas Service-Final 47. Solar pomestic�Final 42. Backflow Preventer 43. Batkflow Irrigation q4. LBndscape Irrig2[ion System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. EleMric Release to Edison 50. Gas Release to Southern California Gas Co 51. CEfiTIFICATE OF OCCUPANCY No. Oate a�p 1 1 1957 � OWNER CAR20LL� D. �` DATE 7_��_[{/� JOBADDRES3 1y�2 E. 16th St. BUILDINGPEHMITNO. #j3%E� GENERALCONTRACTOR Corson & Muntean VALUE 5 5(7�.00 AP 11�-361-04 �or 5 BLOCK 7RnCT l'7l� Work room add. to dr�Plling TVPE INSPECTION$ Foundation Forma and Grade to G Rough Framing Plumbing, Rough to 31ab ` Plumbing, Rough Complete j Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer, House Sewer, St. SepticTank or Cesspool lathing,ln Out f bing, Final, Fixtures Co Plumbing, Final GasTest DATE SUBCONTRACTOR PERMITS ISSUED I NUMBER Wiring, Final �^�v 1 0 � ol Yb6 I I I \ Occupancy JAN15 19 7 �t,i! FOFM 310 9M �o.,� - 3378 , Costa Mesa Building Department APPLICATION FOR PERMIT . COSTA MEOSA,�CALIFORNIA ''��'4n6 B U I L D I N G ' FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. n,aar�ess % 2 �/(r7�. �e� � 3 P Costa biesa, California Receivetl by Date Rec'd. I Date Issue� � Nearest ' ^ 0�3 % CrossSt. /lnr+�....! Building Address Own . Mail �s �� /�� CostaMesa,Ca�lifornia Address `i Nearest /� A �1 Tel. Cross St. City li r iv �� No. Zone I No. ot I Type Group Arohltector Lic. P�a^s Engineer No. Approved b Date Address /� � ��1 City LIC. �traeto�n+`�iu..�,/ /�� l. No. Z Y1 Addross 4' � L �''K. /��n � Legal �ot I �/ GITY O� Descriptlon I No. I Block � Traet�7� 1 Tt af @E��— � REG. (AttaehMetesand8ound9) � 1'��G/�D� a$'f�E` TB-�L �^ y No. of Bldgs Size of �ot �d7 V I Now on Lot � �'S— 0 l�seof No.of No.oT �ji a Existing Bldg. � I Families I Roo�t]a � Setback Line from � Rear Va� -� �= 1 - — Centerof8trxt 3idaVard' ��. �;i�1" " '�'�, D DESCRIPTION OF WORH _ . � . - � ;, _ _ New I I Alteretion I I Atldltion I � .. �� ' !� J ( . ! �_ Repair I I Moving I I Demolish I Building �1 � Q No. of / Size l. � Rooms � Stories -��teriorWall Roof m��, �� h��' f��:�"nn �ering S, t-j— I Covering ��f6t "y �� u �'e APpROVAi:S�� ..se oT New �" � Foundation Location Inspector � Date Building �V ' Forms, Materials, � Under-Pinning Frame: Fire Stops, Braeing, Bolts I hereby acknowledge that I have read this Application and state that the abme Is correct and agree to mmply Lath. Int. wlth all CIty Ordinances and Sta[e Laws regulaling building COnstruction. �_ Lath. Ext. Signature of L �J�, �� f(�� Permlttee Y /v/ "^' -"-� Plaster,lnt Authorized Agt. �l. /V ' Plaster, Ext ValuaUon Permit Fee $ �� Masonry Reinforced S� O� Plan Check $ " Bond Beam $ Total Fee � FINAL cowrn zoa �oas o. r. e s. � '� A CO$T� ��iL 23 �SPDnEsc 11 C¢ t•..: �•:li,�� . , �.� . 1 � � ti • � _ i �1 f '. � . \� ;" � ' rinJl tLt�l�l &how Iowtlon and distancea from ^ property line and between bulldinga � • . � i \ "� ' .. . �. , . , i�•� . . .� ' OWNER �A�QI,j,� DI(�,j{ � DATE 9-11-56 JOBADDRESS (172 �'. lbth Place BUILDINGPERMITNO. #3C>T$ GENERAL CONTRACTOR CO2'3051 & Muntean VALUE $ 270.00 �oT 5 BLOCK TRACT 1714 Wardrobe AS PER U. B. C. INSPECTIONS � DATE I SUBCONTRACTOR I DATE PIRMITS�NUUMe Footing Trench Foundation Forms and Grade to Rough Framing _ Plumbing, Rough to Slab Pole Sewer, House Sewer, St./ Septic Tank or Cesspool � Lathing,ln Out� � � Plastering , �y" � P hing, Final, Fixtures Complete P��..ibing, Fin.al Gas Test D, Wiring, Final ' Occupancy � _ t�— FOFM 210 3M 10�95 Costa Mesa Bailding Department APPLICATION FOR PERMIT COSTA MEOSA,�CALIFORNIA :;rJ�O._2 B U 1 L D 1 N G ' FOR OFFICE USE ONLY FOR APPLICANT TO FII.L IN Receipt No. Permlt No. nda e� L17.� fi1./U� �c�.2_ I.3lo 7� Costa, Mesa, California Re e' d by /� Date Rec'd. Date Issued Nearest ' y�//—s � �—//"J � Cross St .y�l Build ng �� Address � Owner Mail / �y ,T Costa Mesa, California Address u � �:. %(o �r.�l �'I ' Nearest �� p Q Cross St. Gty `�'�'yiC.n yi.ai No.�7 �.S ., Zon I Plans I TYPe // GrouP � /� Architect or Lic. � Engfneer No. Approved b Date Address CORRECTIONS . Pi _ . /In ?— CitY Lic. . ` ■ Ad Size of Lot l�se oi Existing BI Setback Li Center of S � New �.ae oT New y y /6�s-C�e Lot r I /-� No. 7 Block I Trac( / ind Bounds) � INo. of Bidgx Nowan Lot , , , _ � No.oi � No.of I hereby acknowlet and state that the : with all City Ordi building constructit Slgnatureof � Permittee Authorized Ag6 G Valuatlon $ .�,5 � Alteretion Moving No. of Rooms Addition Demolisl Stories � Frame: Braci that I have read this Applicatfon ie is correct and agree to comply Lath. Ir Sces and State Laws regulating ,..�r o �/ i i ��..�cry Permlt Fee $ -- Plan Check $ " Total / Fee $ � � ■ Ext �F CU�IsPecsor � aN 'YrG ��., c.i.�; n PLOTPLAN - Show locatlon and distances irom property Ilne and between 6uildinga � w. ci i . C ^ . n }., � r � � OWNER CORSON Sc MIINTEAN CONST. C0. / DATE 1�_�9—rir, l% JOBADDRESS iJ7Z Zbt}7 S{',. BUILDINGPERMITNO. 2],$9 GENERALCONTRACTOR Owner-hnildPr VALUE $ ��npn nn L�— S BLOCK TRACT ].%].I.J PV}, SL773R POOI. GROUP 'J TVPE 1 ZONE cvy FIRE DISTRICT Z18S PERMITS ISSUED INSPECTIONS �DATE SUBCONTRACTOR I . 7 Footing TrenCh t� �,� �Foundation Form9 and� Rough Framing _ Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer, House Sewer, St. . Septic Tank of Cesspool Lathing, In Out f ±ring —�^ � Piumbing, Final, Fixtures Complel Plumhina. Fin�al Gas Test Wiring, Final I I I I_ Occupancy. v,....., oi n r._u i Fnn i_Ss Losta Mesa Bnilding Department ' 111 EAST 20th STREET COSTA MESA. CALIFORNIA Y FOR APPLICANT TO FILL IN BWlding � �7 // y�/ Address �• �9/��r1 Costa Mesa, California Cross St Owner Mail Address 'Size oi Use ot ■ New 3 xn . _< ot I Bloek s) , p rv� N� Ni F: � I No. �PLICATION FOR PER � BUILDiNG FOR OFFICE IISE ONLY _ Receipt No. I Permit No. � �/ �• — Reeglyed by Date Rec'd. Date IasuW r // 7� .l �/ - �� / � i — � Buildin " �Addre� • Costa Mesa, California ' Nearest _..! Cross St. siags, 2 I hereby arlcnowledge that I have rnad this Application and state that the above is mrrect end agree to comply Lath. I nt with all City Ordinances and State Iaws regulating bWlding ConstruCtion. Lath. Ext Signature of Permittee Plaster,fnt Authorfzed Agt. ��.L'f.�t0.7 Y", �� Plaster, Ext Valuatlon Permit Fee $ �`� � Masonry Rei 2� Q O�'� Pian Check $ .� � Bond Beam $ Totai � 6 Fee S �.+� • FINAL FORM 204 S-6P 2M 6-35 CORRECTIONS ✓ �',-"�', 1 �_-�.. _' APPROVALS � O a � Z D r Show Iocatlon and distances from property Ilne and between buildinga � , coSTn K . �'r t �rS�QD�eesz '•^.�;z t',;•i t 1.r� .�F�o r�.�\ S� � `��.*�.� . r , a �� _ . . . j „ . + " .l c OWNER CORSON & rNNTEAN � DATE 10-ZIl-SS JOBADDRESS �72 E'. Zbth St, BUILDINGPERMITNO. ZOOLI GENERALCONTRACTOR COI'SOR & Mur�an VALUE $ 13�360•OO j."-5_ _ _�7 BLOCK _(, � TRACT j'7j�i Sinvla �aollino _ ria4._ vmrnoo � ,�. VFN r INSPECT ONS , �—� Footing TrenCh Foundation Forms and Grade to 7emporary Pole Vliring, Rough ,L �G. Haating, Rough Heat�nB, Final Sawer, House Sewer, St. Septic Tank or Cesspool Lathing,ln %, Out i :ring �� 7�' P�,.�nbing, Final, Fixtures Co le1 Plumbing, Final GasTes W(ring,Final � e Occupancy F'orm 210 G-H 1500 7-55 I• 7_\ ��-PI; Zdd: Y l: LL�1 i UP FIRE DI PERMITSISSUED I NUMBER Mesa Building Department APPI.ICATION FOR PERMIT 117 EAST 20th STREET �2013 B U I L D l N G 7 COSTA MESA� CALIFORNIA FOR OFFICE USE ONLY •" FOR APPLICANT TO FILL IN I Receipt No. Permlt No. Building ./ Addrese �� T CiOStB� MC88�� Cia�1fOPII18, Recei by Date Rec'd i I Dato Iasued Nearest � �0 — � ^� �l I O — �' Cross St. Building Address owner Costa Mesa, California Mail �J 2- r Nearest Address 7 � Tel. Cross St. City %Y) No. Zone �'Jr/ No.of Type � Group , Arohitector Lia � y- I_ Plans I G yi� � En 'Size of Use of � �R�7J N o. City i \ �/�? No. . �� G.�I� �. , "�j `S Block � Tracq/� Bounda) . Y�Q I No. of Bldgs ,r'� �• Nowon Lot �� No.of No.of — Famllles �t / RearYard ci Side Vard ' ON OF WORH IAlteration I I Addition I I�Moving I I Demolish I No. of / � Rooms Ci� Sto�ies �^rior Wall � Roof _ .riny Coverin�' APPROVALS �se of New /j Building . ,��G��.� �j�- Foundation Location Inspector -�—�'-- Forms, Materials, � Ai . A// �!O Under-Pinnina -� I hereby acknowledge that I have read this Applicatlon i% and state that the above is correct and agree to rnmply Lath. Int 's with all City Ordinances and State Laws regulating building constructio Lath. Ext. �I Sfgnaturaof �/��/v' ,�A�h�' `� Permittee �"��"��Fis. Plaster,lnt �� i ca Authorized Agt. Plaster, Ext �F Valuation Pe�mit Fee $ ��-� �� Masonry ReinTorced ': � !3 � � Pian Check $ � � Bond Beam $ � � a Total �. o d � Fee $ FINAL � � Date O 9 G) Z D r PLO� PLAN Show Iocation and distances from Property iine and between buildinga.