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156 22ND ST - Building Permits
ADDRESS OF BUILDING: 156 22ND ST ulIT: I !CITY OF COSTA MESA — BUILDING PERMIT CW mEWSNAMEIFIwwm: KUBOTA, GEORGE s PERM NO: E 074906 ADDRESS: 156 22ND ST COSTA MESA, CA 92626 PERMIT NO: E 074906 PLAN CHECK NO: N GOVT: N SUPP: Y `9 APPL.MAtUNGABBRES& CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: REP ARCNIIECT ORENGNEER: UC.NO.: JOB DESCRIPTION : TEMP POWER PERMIT FOR UNITS B & C PROJEC SQ FT: ARCK OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / DONTACTO'SNAME: VANDENBERG PLUMB & CONST ( 714 ) 842-1781 cONTRAeroR ADDRESO 7285UNTI MURDGTON CI *O**E*******F**B*********B***5***********************************Rr Rt BFx-FE*arkx-St REat�E** ADw+Ess: HUNTINGTON BEACH CA mw, 521576 9264 . WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under pe at of.1.'jury th I am licensed under provisions of Chapter 9 SETBACKS Business(commencing with Section 7000)of Division 3 al the end Pn effect P. eons• •e, r y license in full force and effe CRYUc.NO.: 047178 =cuss: B L .NO.: 6 EXP: 12/95 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ow./a—Z8'9,-r Contractor: ,wut ,Lia! LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penal • .:'jury that I em•li rom the Contractors License Law for the following reason(Section 7031.5 Besoesa and Professions Cod :- y cry a county which requires a permit to mnsbuc,aha,improve, PARKING REQ: P RO V: PARCEL: 42606119 Z N E: REF NO: ' molSh,or repair any structure,prior to its issuance,also repo —the applicant for such permit to fib a signed statement that he or she PLANNING NOTES> iicensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the ...colons and Professions Coder or That he or she is exempt thaehom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars(55001). (.{(.{(.{(.{E{(.?t[.{(.{(. (. (.*?Ip{E{E{(.{(.{E{E.IE{E*{(.{E.K.{pip*{(.{E{f{p.****.7A{(..M.*.N..M.{E*{(..x.{F.)F{E.1f-{f{E.K.{E{E{(.{p{(.**{E{Elf.lFiFj(..IE#.1E.1h.lE.N,*if1f.K,*.K.* ❑ I,as ovmer of the PrOpeny or my employees with wages as their sole compensation,will do the work,and the structureisnotintended D E V E L O P M E N T . S E R V I C E S REQUIREMENTS or offered for sale(Section 7006,Business and Professions Code:The Contractors License Law does not apply to an Owner of propel who bolds or improves thereon, worka end who does such himself or herself through his Or her own employees,provided That such improvements are riot intended or offered for sale.It,however,the building or improvement is sold within one yea of completion the ZONING APPROVED BY ownad proving he or she did will have the burden not build or improve for the purpose of sale). _ DATE: ••t. ❑ I.as owner of the property,am esdusivey contradng with licensed contractors to construct the project(Section 7000,Business end BUILDING APPROVED B YDATE: Profession Code The Centred=License Law does not apply to an owner of property who builds or improves thereon end who , contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). t ❑ Iamexempt under secton: - ' B.AP.C..for this reason: APPLICATION ISSUED BY: DATE- \C7 i7"Diti' Date: ONTBf1 LEGALIZATION:N F E -d2 SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I em aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and • • 2553aand thal«any requirements BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit format I or construction or tune building Ouawy Management District.Residential construction epplcetiare we exempt from these provisions. PERMIT 15a 00 Data Applicant: 50% SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dadaretona: ISSUE FEE 4 . 50 ❑ Ihave and wil maintain acertificate ofcannot toself-insure for workers'compensato ,aprovided for bySection 3700of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ' Code,for the pedonnanae Awork kfar whish this pertnh is issued. TOTALS----> 15 . 00 4 . 50 0 .00 19 . 50 19 . 50 . 00 ❑ I have and soil 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 insurenc. 'er and policy number are: Cants,: STATE F. & EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 19 . 50 OVER/SHORT: . 00 Policy Number: WVICY,,'gli A 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,•his sectionneed not be completed Ithe permit iafor one hundred••tars 1St• f•r 19 . 50 ❑ 1 codify that in the performance of the work for which this• d is issu.+I shall` employ any person in any manner so as to become subject to the workers'compensation lawn d Cal• 1 fele become subled to the workers' ******************************************************************************* compensation provisions of Section 3700 of the Labor Code.I shall f. .rovietons. INDIVIDUAL F E E BREAKDOWN Dae:,[-. 1.•tea Applicant: a Awit• .. Warning:FllUn to secure workers'compensation cove /n/awM,,and shall • employer to criminal penalties as TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($100,r' n a clition to the cost of•• wtlon,damages es provided for in Secdon 3706 o the Labor Code,interest and attorney lees. ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15 . 00 15 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the wk for which this permit is issued(Section 3097,Civ.CI. LENDEWS NAME: LENDER'S ADDRESS: . I certify the I have read this application end state that the above information is correct.]agree to comply with all dry end county ordinances and state laws relating to building construction and hereby authorize representatives of this dtylo enter upon the above-mentioned Droned), r• favi iso purposes. FRANK VANDENBERG Print Name CiU 17 � :.-C31932E1 TOT 19.50 J Dae (6 � 9C ATE, lU/:LT/9 TThEI 12:04 reg idime of Owner/Agent/Applicant/Contractor (5151-46.WP) White-Building A Safety:Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POO WA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. til Pipe-Undrgrnd. -.1' 53. Steel Reinforcement .,Electrical Cond tiit.Utility•Undrgrhd. 54, Forms e -''24.Electrical Cond&R•Undrgrnd. 55. Electrical Bonding V5-.'Steel Reinforcemenj 56. Rough Plumbing & Pressure Test • -.6. '!Electrical UFE1fi' nel. 57. APPROVAL TO COVER-GUNITE c-_ ' J Footings .. -. 58. Electrical Conduit-Undrgrnd. -, -.8. Foundation •jinr-J ■. 59. Gas Pipe, 0 Undrgrnd..Test • 1c • r . 9. Water Pipe-Undrgrnd`, . - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - , 61. APPROVAL TO DECK 11. Property Sewer_Eine,& House Connection 62. Backwash & Receptor-Final 12. Sewer Capr' ) 63, Heater & Vent-Final T - 13. Roof Drains 64. Plumbing System • Final _ ' 14. Rough Plumbing. ry. 65. Electrical-Final 15. Rough Electrical-Conduit tr 66. Solar System-Filial. 16. Rough Electric wiring _ 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FO-Pt'PLASTERING 18. Rough Electrical'i Bar Ceiltnq 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning _ FRcrE DEPT. REQUIREMENT •T. - 20. tough Factor Fi i)lace `h �;u . '.• 'APPROVALS:t... Permit# ' '.` 21. Ducts; in;Strut'ture- •• 70. (Undergr'o'und I-&'dro ' 22. Ducts' Ver,Itilatin , - L' ¢�, 71. Produ HPjping ]�{ias GI Oil 23. Gas Pipe-Hough &Test • r ' 72. Undergroorid Flush . 24. Roofrpraming' .•T - ; 73, Undergrnd.Stolage Tank,O Gas 0 Oil 25. Root,Sheat sing ' 74, Overhead HVdro.� • - , 26. I--Bar Ceiling (Structtirai) & Monocoat 75 Dry Chemical F ' ': r- •/27. Frame and Flashing a 76. Dry Stan!pipe r-''. . 28. Lathing&Siding -L" ` _ `IE, :• 4; T ... .. .. 77.i FIXED SYSTE FINAL -. -, i• ,29. Insulation ' + - c 78 _ . FIRE PREV. FINAL - x 30. Drywall Nailing L.r . : r 1EALTH DEPT. REQUIREMENT 31. Plaster Brown-Coat, :: . t: n' ' - • 79. FINAL INSPECTION 32. E1ectricar?ow`er MeferFinal ' ( SQ. FOOD CERTIFICATE ISSUED l0 3/P' it ..-�, 33. rina4rElectric , '• otes: - 34. Finat.Heating'& Air Conditionir j -, y - t ' ' 35. Final Gas Pipe,-Test D .- ®' - C. 36. Hood^or Canopy '---. --' • - ;_., .• 37. Final Factory Fireplace • - 38. FinaPPlumbing n- -- W - 39. Wate7 Ser.vice•Final - . 40. Gas Service-Final - 4'' - : - - - ' - - - `' Cr - - 41. Solar Doniestic-Final' • �" ` I - 42. Backflow Preventer _ ' 43. Backflow Irrigation . a. . 44. Landscape Irrtgation.System�+`' - T ' _ 45. 'Sound Attenuations moi :. -- - ti :, .; • r 46. Handicap Regulations i*-,- - x 47. FIN, )_ STRUCTURE & BUIL'DING .. _ t - rrr w 48. El NAL PLANNING • ' + "' 49.'Electric Release to Edison ` - t - - 50. Gas Release to Southern California-Gas Co_r • •- - • - -• r - .i _. 51. CERTIFICATE OF OCCUPANCY • - ' - No. Date BUILDING PERMIT LOU A EMPLOYEE: ADDRESS: PERMIT NUMBER: TYPE OF PERMIT: VALUATION: SQUARE FOOTAGE: PERMIT FEES: DATE: TIME IN TIME OUT ACTIVITY eti is 9s q�as 9 6 / ; � .25" t -3 S //: jco /1: � Y Le `�,1 �.el��e ritdir„ his 4 rt- ONLY ONLY ONE ADDRESS PER SHEET-TIME IS TO BE CACULATED TO THE NEAREST 15 MINUTES PLEASE BE AS SPECIFIC AS POSSIBLE IN RECORDING ACTIVITIES . . . . . - . . . .- . . . . ' / I, . . COUNTY OF ORANGE - BUILDING DEPT. . Permit No..53-er'62-9- . 636 No.Broadway Application for Building Permit • Santa Ana,California Phone:KI 2-6211 AND FOR A • Certificate of Use and Occupancy Date 3 - • 1. OWNER'S NAME 1441.27. . 1 ' /11 d : . ., PHOADO - 7.64:k. MAILING ADDRESS 9LV‘V cc ... , a et...6? Name Name ............. ...' r--7--m_...---„. (Architect or Engineer) , Address Address 3‘y e (if .n ....'sr)4.,/z. City City el—Ze- State State Lic. No Phone Lic. No Phone& I,)--ire . . PROPOSED USE .fenf--Ae.-A-A—C.R-r Jr-, a 2. JOB LOCATION /St E -2- z. - der-Qx-et f (House No.) e , 62•Nantreet) (Town or School District) / 7 3. LEGAL DESCRIPTION: Lot -y- .40--7 / Block Tract...2 (Metes and Bounds Description—Use reverse side form) 4. CORNER LOTVoyczibTp.!..I0e2itt-,g.) THROFGH LOT ( ) SLOPE OF LOT 5. SIZE OF BLDG$ ( ) /eV 41-ear AREA- FS° SIZE OF LOT d ‘.C2212V37AREA- t 6. HEIGHT OF BLDG • // CEILING HEIGHT: 37 NO. OF STORIES 0-24-5-- 7. NO. FAMILIES .0.7isi.--L Size of mallest Bedroom- Size of Kitchen 8. EXTERIOR WALL CONSTRUCTION• INTERIOR WALL COVERING_ /24gera_ (Frame, Stucco, Etc.) (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard From Center Lin ),._Street CO Nearest Side Yard /0 Rear Yard Distance in Feet Between Bldgs. on Same Lot "174::)/1/14:- . 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. t t 11. For (a) Footing: Width / V Depth in Ground /2.- Width of Wall •<-74-Yr Accessory Bldgs. and Similar (b) Size of Studs:..7 )( I/ ...Spacing 7e, "CC Material of Floorille1/ 1- Structures: - X Ce. •(c) Size of Floor Joists- C.' Spacing / "CC • (d) Size of Rafters- 44- 5e 47 Spacing /e0 "CC 12. VALLI/0'10N OF PLIO,POSErORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $ col/...0. • • 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. . Signed: a7 Plans Filed- /Ae?rX:-./ 6--- ---......---- -- By• • (Authorized Agent) . FOR DEPARTMENTAL USE ONLY FEES: j , owes' CHECKING BY ../. APPLICATION Bldg. Permit • $ /41,....e. r HEALTH GROUP Plan Check • $ 7 TYPE ZONING -9-1 .-0' 1- FIRE Total - - - $ ` /7 DIST. --,;.. ....R. 9 SPEC'S PLANS AND MARSHAL Receipt No. • .....n......... MAR-Le edATE %...) Paid to • • ....ace........ SHEET NO r CORREC •1.1.t i GINEER Date 3 — r"")-D..757 VERIFIED .. AL PERM111SSUED BY: DATE /27 fre Ulf 5M-2.51 • 4 {/-1.id . . . t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. `CITY OF COSTA MESA CON%TRUCTI N PERMII,Tp /y PERMIT NO. TRACT NO. LOT NO. UNIT NO. 651 B B/I7/EL4 5e CQ ?l Project Addresi /�� J O Sj- CCCJSJ�+�L'/e d CIa. 13- 1 y 7� 8 LI REPAIR n/� Q Aq. 1/2Qd,. �� TYPE OF CONSTRUCTION LI NEW LI ADD U ALTERATION AOplicanf.'Mailin AddrAddress .F �/ Q,.... Grp•�/J6•�.G Owner'•Name �C� e,C.0.1 �+/.v- Pf�one 23/-ZL4 ❑ CONVERSION ❑ DEMOLISH ❑ OTH A.P.q(6 Zone g�+/ u�aa /A�q /I }� d DESCRIPTIO OF WO•K/USE OF BLDG. r - lDO .rS7'/'' Address 24C-, LQGuital-1716ic t&.Q•16T ( , - •+ we S Main Building: Accessory Building: i- Arch/Eng. License No. TYPE OF PERMIT I GRADING ll FOUNDATION L STRUCTURAL E Front 0 • Address ❑ TENANT El ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear / N f // ❑•OTHER • A Contractor's Name n UnY-1 �ci dole( PhoneR•,3 C Right / N Address • (mailing) PROJECT DESCRIPTION SQ. FFTT. OCCUPANCY K • G CONSTRUCTION TYPE •-M��N VALUATION$ S Left �� R ' City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref, # Parking Req./Provided E' LICENSED CONTRACTOR DECLARATION 0 jia I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M V with section 7000) of Division 3 of the Business and Professions Code, and T my license is in full force and effect. • iiLicense Class License No. S. Date Signature PLUMBING ' FEES WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW `8O0, Lab. ) - - ' - viicy No. ,e^8'9-y'•39-Y Compan rn Z H .C. M91 ' 0 50+KW 70�� -� Backflow Irrigation Sewer Cap Construction Pole Sub. Certified copy is hereby furnished. - Certif coD is with the city Bul 1 DI islon. Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps Date ( / Applicants %O EXEMPTION FROM WORKERS'COMSENSATIDIs DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed iflhe perms s for one hundred ($100)or I ce that in the perform/11a of theDishwasher Solar Piping Dryers Does ❑Electric Sub Panel shaft ' ,• pin the peof work for which this permit is issued, I anyin manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 0o-1 HP 011/2'8 Worker ' ti,% •.ws Of California. .. Date • Mi. Signature Floor Drains SwimmingPool /S a ' NOTICE: If,after makin• .is declaration,you should become subject to the wp F.A.U. Inc.Solar ❑g-15 HP 016-15+ Workers' Compensation pro • -ns of the Labor Code, you must forthwith Floor Sinks comply with such provisions or this permit shalt be deemed revoked. Urinal Fixtures Microwave - - CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - g of the work for which this permit is Issued (Section 3097 Clv. CJ Lender's Name Interceptors Water.Heater Outlets Range , Lender's Address Kitchen Sink Water Service Switches • . OWNER BUILDER DECLARATION - - Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any City or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Generator 00-5 KW 05-15 KW Trash Compactor any structure, prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt - - therefrom and the basis for the alleged exemption. Any violation of Section ; = 31.5 by any applicant for a permit subjects the,applicant to a civil Wnatty of not more than five hundred dollars($500). :'i:] I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business anti Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds Or Improves1.=1 thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees. provided that such Improvements aro not Intended Or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date �'� pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By r Date `S rove for the purpose of sale). 'SW A D I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Det 7 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating Do-100,000 BTU ❑100,000 BTU SUMMAI%16OF FEES builds or Improves thereon,and who contracts for such projects with a con- O ...CO tractor(s) 1lcense pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/AlterationBUILDING PERMIT $ I S— SMIP $ proof Off their Worker's COmpen I .nce should bo provided to me. VPY a�' , PLAN CHECK $ PERMIT -!]'I am exempt under Section P.C.for thi reason Firepl/Fact.BIt. ICBO# ISSUANCE $ �( qC.[l/er i t.,//.. `� PLUMBING $ '' . Date S4-�f-S Owner -N/ Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read 12 appli ion and state that the above Do-100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ • t. Information is correct. I agree to comply wall city and county ordinances and state laws rolati g to building Construction, and hereby authorize repro- CHECK PLAN 50% $ MICROFILM $ sentatives of this/ to enter u ton t • ab.ve-mentioned property for inspection purpo - 15. ,y_' . $/� MECHANICAL $ TOTAL FEE $ Signature / Date / Drivers' License or SS : . ' _ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865.46.rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor ' -• 1 CONSTRUCTION AND PLANNING POOL A APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Te p porary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. • I 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. • ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval• . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1.8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough&test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster 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 Fer InspectignS 37. Final Factory Fireplace Calk 38. Final Plumbing 39. Water Service-Final 754.56i.g. 40. Gas Service-Final I 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation _ • 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY _ • No. Date From the desk of . . . . BROOKS CAVANAUGH 1 - Z6 - 70 C0 Latc, -FLS 01a-- 1 Le_ vi# - S y/ ( L 8 ,X ZZ) etziTtL J zuutA, ?AA- ci ( guct cif,;:tia 2_ 4L. Lt. L2 uf w c 1 0 up s- [6„4_, CITY OF COSTA MESA PLANNIi._ DEPARTMENT - JAN 27-71g/100 788 z.4.+t**95.00 A. P. No. 118-081-19 Bldg. Permit No. 3 2 to 7/ PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 156 22nd Street Units B & C Owner's Name Norman Craig Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = $40.00 • 3 - Bedroom Units 1 @ $55.00 = $55.00 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = $95.00 Total Fee Total number of Dwelling Units 2 • Planning Department Approval Date 1-26-71 : i;ea No. 7 j/ By WLDPbc Applicant's Sign re L��� LAN 27-71000 78BRo Cfi50. ****95.GC CITY OFtCOSTA MESA PLANNING'DEPARTMENT A. P. No. 116•311 -1_r Bldg, Permit No. 3 2 6 j7 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt ProjectiAddress 15r, 23nd Strf2et Units r C Owner's 'Name Norman Cr•air. • Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = Q -0@ 3 - Bedroom Units 1 @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 or more Units @ $75.00 = �''•C%C 'Total Fee Total number of Dwelling Units Planning Department Approval Date 1';"•' '1 Park Area No. 7 By '1t '!` '• Applicant's Signature • TADDRESS OFBUILDING: 156 22ND ST UMT: B CITY OF COSTA MESA - BUILDING PERMIT mMEWBN:'EIFfl KUBOTA, GEORGE PERM NO: F. 074513 ADDRESS: 156 22ND ST a COSTA MESA, CA 92626 PERMIT NO: E 074518 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAIUNO ADDRESS: CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: REP ARCHITECT OR ENGINEER: HARTMAN ENGINEERING u"404 52434 JOB DESCRIPTION : FIRE DAMGE REPAIR SQ FT: ARCH.OR ENG.'S ADDRESS: 747 W KATELLA OMT: 203 ORANGE CA 92667 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTONSNAAIE: VANDENBERG PLUMB & CONST ( 714 ) 842-1781 CONTRACTOR'SMMUHG 7285 MURDY CI COMMENTS : REF: B-74516 ADDRESS: HUNTINGTON BEACH c '..: F21576 ***************************************-x-ir***TES-** -***ir****SE**SF******RESE****Tart*** 92646 MT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of•. t ended provisions of Cheater 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business end Profession • <:is in a end effect. CM(LIC.No.: 047178 lc.cuss: B LIC.NO. P: 12/95 MAIN BUILDING ACCESSORY BUILDING /961--//‘-' 'GL /" ✓U Contractor: �_1 � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN � — LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 'VNER BUILDER DECLARATION:I hereby affirm under penalty- •.fury that I am: empr from It License Law for the owing reason(Section 1031.5 Business end Professions C••- • y cry or county which requires a•- constmct,alter,improve. Z N E: REF NO: amoleh.or repel-any slrvcture,prior to its issuance,also r:• : the applicant far such permit to file :•statement that ha or eha PARKING REQ: P RO V: PARCEL: 42606119 is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with S:. 7000)of Division 3 of the PLANNING NOTES> Business and Professions Code[or that he or she is exempt therefrom end 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 fists hundred dollars IS50O1l. ****,*„********************************************************************.****** ❑ I,as owner of the property or my employees with wages asthe'o sole compensation.will do the work,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon.and who does such work Mmseff or hersel or through he or her own employees,provided that such , improvements are not intended or offered for sale.1,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and DATE: _ Professions Code:The Contractors License Law does not apply wh to en owner of properly who builds or improves thereon and o BUILDING APPROVED BY : .. contracts for such projects with a contmctorls)licensed pursuant to the Contractors License Law). ❑ lamexempt under Section: B.SP.C..for this reason: APPLICATION ISSUED BY: DATE:TE /' J/� ° a Date: Owner: ****** ***************************TETE** : ' 1F *.TETE ****************** ***3F**4 1FTFeFi **TE LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.7cc53.end 25534,and that I or any future building oavpant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Ai Oueimy Management District.Residential construction applications are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 3650 . Date: Applicant:__ 50% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN ❑ I have and will maintains certificate of consent toset-lnsure for workers'compensation,as•rovided for by Section 3700 of the Labor ISSUE FEE 15 . 00 Code,for the performance of the work for which this permit isissued. BUILDING-DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE o I have and will maintain workers'compensation insurance,as required by Sectioy • Labor Code.for the performance of the TOTALS > 3 6 . 5 0 15. 0 0 0 . 00 51 . 5 0 51 . 5 0 00 i%ork for which this permit is issued.My workers'compensation insurance . t.i:� number are: Carrier ST: . . ...../ EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 51 . 50 OVER/SHORT: . 00 Policy Number: 17R1R94-®/—fif 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (Thi section need nor be completed if the perms is for one hundred done /3100)or'� 51 . 50 ❑ 1 certify that in the performance of the work for which this permit is issued.I f /• any•. any manner so as to become subject to the workers'compensation laws of Celfom' ,end 'fl old -.blact to the workers' *************************************************************TE**TE************** 00/4 promssigns of 3103 of the Labor Code,I sh:Ifonh I N D I V I D U A L F E E B R E A K D O W N /,'7 /L ; ( Applicant: �i_ 4 . ,. 0 ' Warning:Fallon to astute tontera'compensation cover-yqt�lawful,and shall sub' criminal panaltiaa and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil tins up to one hundred thousand dollars(Slog.r., n addition to the cost of co - as provided for/n Section sloeoithe LaborCode,Interest,end attorney's tees. ELE 4 FIXTURES, LIGHTING 1 ST 20 EA. . 75 3 . 00 • CONSTRUCTION LEND • GENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the ELE 15 RECEPT/OUTLET 1 ST 20 EA. . 75 11 . 25 pedormarceMthe .• farwn t .permit eissued(Section 3091,Civ.c). ELE 5 RECEPT/SWITCH 1 ST 20 EA. . 75 3 . 75 NDER•s ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 L •DER'S AD END OF FEES I certify that l he:read this:•.l : • an ale that the above inf. •:ion is correct.I agree to comply with all city and county ordinances and state laws r Bring to bu t . sir -ion and hereby author¢: °presentations ot this city to enter upon the above-mentioned property for inspection• nooses • df. VAPiENT">✓RG C,”IT" LIN - •or Date: 16'7/—�� 01 00191323-00191825T! lt 51.58 1 &ATE: 10/11,95 TIflE: 10:39 `(5151-4e.WP) While-Building&Safety;Green- :;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor - J.' - PC e. SPA -s CONSTRUCTION AND PLANNING/ APPROVALS Permit # Date Inspector APPROVALS ( Permit Date Inspector' }-e 0.. 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location' • . .- - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding / -- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. _ 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation ," 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. , ,� 60. Backwash Lines,P-Trap, ❑.Undrgrnd. 10. Structural Floor System , - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & ReceptoreRinal 12. Sewer Cap _ 63. Heater &qen[-Final, - 13. Roof Drains - - _ 64. Plumbing System-Final • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - 16. Rough Electric Wiring - 67. Fencing & Access Approval 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-? Bar Ceiling 69. POOL/SPA SYSTEMS F IN AL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro • 22, Ducts, Ventilating 71. Product Piping ❑Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas :]Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Ba' Ceiling {Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Merer-Final BO. FOOD CERTIFICATE ISSUED 33. Final Electric 5,(31 6 _-a Notes: • 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test 36. Hood or Canopy ' 37. Final Factory Fireplace 38. Final Plumbing 39, Water Service-Final 40. Gas Service-Final 41. Sclar Domestic-Final 42. Backflow Preventer 43. Backflow lirigation 44, Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50.'Gas Release to Southern California Gas Co r.-- 51. CERTIFICATE OF OCCUPANCY No. Date F '4- R AOORFN9 of SNlDNO: 156 22ND ST u"r' B , ` CITY OF COSTA MESA - BUILDING PERMIT 0MER'SNAME I KNOW KUBOTA, GEORGE -..--, PERM NO: E 074524 ADDRESS: 156 22ND ST 1 COSTA MESA, CA 92626 PERMIT NO: E 074524 PLAN CHECK NO: N GOVT: N SUPP : Y APES-MAILING WDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: REP ARCNDECTORuwl m HARTMAN ENGINEERING uc."G: 52434 JOB DESCRIPTION : SUPPLEMENTAL TO E-74518 SQ FT: ARCH ORENC:S ADDRESS: 747 W KATELLA WIT: 203 ORANGE CA 92667 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTCRSNAIIE: VANDENBERG PLUMB & C,"ST ( 714 ) 842-1781 CONTRACTOR'S YAWNS 7285 MURDY CI COMMENTS: REF: B-74516 ADDRESS: HUNTINGTON BEACH II • uc521576 ************************************iEat*REiEAEit*ft*****RE**RE*�E+E�EIk*************�t-AE****+r 9264 ) WIT: Z ON I NG R EQU IR EM EN T S LICENSED CONTRACTORS DECLARATION:I hereby aflim under pe 'y 01 Perlin' : am I. •..•under provisions of Chapter 9 S E T B AC K S (cont ng with Section 7000)of Division 3 of the Business and Proles:'•a C1.. licen.• lull force end effect. C L1C. 0.: 0471782uccuss: B sic. D I ; 76 EXP: 12/95 MAIN BUILDING ACCESSORY BUILDING ��••T' Contractor Alba FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ER BUILDER DECLARATION:I hereby affirm under pan ry4 at I em exam m the Co rectors License law for the alowig reason(Sedonlo31.5 Business and Professions -. ny city or wantywtidlreeviree a•. doconstruct,all improve, PARKING REQ: PROV: PARCEL : 42606119 ZNE: REF NO: 'demolish,or repair any swcture.prior to its issuance,also uiree the applicant for such permit to file a ign•statement that he or she is licensed pursuant to the prevision of the Contractors License Law(Chapter 9(commencing with 11 7000)of Di.eion a of the PLANNING NOTES> Business and Professions Code)or that he a she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7o3l.5 by any applicant for epermit subjects the applicant toe evil penally dnot more than love hundred dollen(S500II. ******************************************************************************* ❑ I.as owner of the prroeny Or my empmyees with wages as their sole compensation,will do the work,and the structure i not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License law does not apply to an owner of properly who holds a improves thereon,and who does such work himself or herself or through he or her own employees,provided that such improvements are nal intended or offered for sale,If,however,the building a improve/nem is sold within one year of completion, ZONING APPROVED BY - DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ "I,as owner of the property,am ertluuvdy contracting with licensed contractors to cmmnud the project(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE: contracts for soda projects with a wmrada(s)licensed pursuant to the Contractors License Law). /+,y� ❑ Ism exempt under Section: B.a P.C.,for thireason: APPLICATION ISSUED BY: ` DATE: J — 1I —Tr Date: Owner: ************************************k,r aF t_*************************** ********** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N I do hereby candy that I am aware of and understand the requirements of Celgada Health and Safely Code Sections 25505,25533,and 25534.and that I or any future building occupant will/Wit nor(dare one)need to comply with said slate codes and the requirements for a perm)for constnaton Or modirmtonhan the Ai aB�Te ly ereparcnt Diauid.Residential contusion ° are exempt Iran BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 11 . 0 0 Date: Applicant: 50% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby am under penalty of perjury ate d Mowing lowing declarations: PLAN Nu ❑ Ihave and will alm manacerdid edemwdifor consent to provided for byrmd Section 3700 ISSUE FEE 7 4 . 50 Code,for the prdamancedlrowork fowlrichthis permiisissued. BUILDING DIC > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE Ihave end wit meotan waken'comperuate.bn insurance as required by- he ••• •, • the performance of the TOTALS----> 11 . 00 4 . 50 0 . 00 15. 50 15 . 50 . 00 work for which the permit is issued.My workers'compensation Matrons. .: umber er Carrier: CTA Tr rt- r EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 15 . 50 OVER/SHORT: . 00 Policy Number: 1 '161 GOD ArIMM)— 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (The section need naeeconieredAthe pemr.efaone hundred••,: (5W a l 15 . 50 ❑ I catty that in the pedamence el the work for with this permit i issued.I 1 •• • ••in any manner so as to become subject to the wakes'compensation laws d CacaN ,end age - . subject to the workers' ******************************************************************************* ism/ sun P/reweisn y}�' len 3700 d the Labor Code.I she fothw;l I N D I V I D U A L F E E B R E A K D O W N ! I/ /V wean: ' . . 1 inning:Faure to secure workers' w conperdpn cow end shell I �t e—to criminal Melanin end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil flews rpt to an hundred thousand bolters($104,,, Mn to the cost of compnstioe.dangles se provided for In Section 3705 of the Labor COM,IntsreaL and attorney' ELE 1 SUB-PANEL 11 . 00 11 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there i a construction lending agency for the END OF FEES performance or the nark for slidn this penny is issued(Section 3097.Ce.C), LENDER'S NAME: LE DDRESS: I tangy that p ration and state that the above information is coned.I agree to compN with all tit and county ordinances and stale , gmnWadion end hereby adhorUerapeeentathes d this city to enterupon the above'mentioned properly porins...... !A9K VANDENBERG Pont Name Delis: /e / 9V/ , i \ C. GJ191 '. i(1f1uO 5 Tail .0 ',nature of er/AgpnVAppE lredor r. r r /CiTE: J 1.1_ '_r f:'fE: 1C..5 _ (5151-46 WPI White-Buildvq&Safety:Green-File;Canary-Applicant:Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING , l . & SPA f APPROVALS Permit# Date Inspector APPROVALS Permit#` Date Inspector • 1. Temporary Electrical Service or ()Ole 52. Pool & Equipment Location i 2. Soil Pipe-Undrgrnd. f 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd..Test 9. Water Pipe-Undrgrnd. , 60. Backwash Lines, P-Trap,0 Undrgrnd. 10. Structural Floor Sy;tem 61. APPROVAL TO DECK 11. Property Sewer Lin//e & House Connection 62. Backwash& Receptor-Final 12. Sewer Cap - - 63. Heater & Vent_Final - 73. Roof Drains __ _ 64. Plumbing System - Final 14. Rough Plumbing65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final /J 80. FOOD CERTIFICATE ISSUED 33. Final Electric 5/3,5, /L!K„/ Notes: 34. Final Heatirig& Air Conditioning �/✓` , / r 35. Final Gas Pipe-Test 7� 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date til (gip qq••��� 8l OTES SUBJECT: ja y7p fi `�( - 2N,r YL4 Z . JOURNAL/ INSIGHT —74/5--17 07/61; Rni to W > -a ,�.,. ! Gi/G ow e-in- �uut� 4"eiI11r�/7 ,�roi�y�1- nvl 1-efrtI?z# ca yy -lviaicci&- - 2PJZ?+l ,<�eZtal orrli& latel i e e,n of ✓�/�L� z-23-76 (iotcecians AA) x& • 1871-46 k r0I 156 22ND ST fMT: C CITY OF COSTA MESA - BUILDING PERMIT KNOWN: KUBOTA, GEORGE PERM NO: E 074521 156 22ND ST COSTA MESA, CA 92626 PERMIT NO: E 074521 PLAN CHECK NO: N GOVT: N SUPP: N DDRESS:I CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: REP ARCHITECT ORENaNEET: HARTMAN ENGINEERING Ucxoa S2434 JOB DESCRIPTION FIRE DAMAGE REPAIR SQ FT: ARCH.off ENG.'S ADDRESS: 747 W KATELLA DMT 203 - ORANGE CA 92667 CLAIM VALUE : CALC-VALUE: GROUP OCC: R-3 / CONTRACTOR'S NAME: VANDENBERG PLUMB & CONST ( 714 ) 842-1781 CONTRACTORS11MMNG 7285 MURDY CI COMMENTS : REF: B-74516 ADDRESS: HUNTINGTON BEACH .. UC 21576 ********************�F->E�F�F�x�F**�F**�x*** +EBF*t�***�x**+E********* -**�F**i��F********sF****** • 92646 � MT: Z ONI NG R EQU IR EMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm order penalty• .njury 1 : r•, sed u • provisions of Chapter P S E T B ACK S (commencing with Section 7000)of Division 3 of the Business and Prcfessi• Code, •.n A is4P: :and effect. CITY UC.Na: D47178UC,CLASS: B UC.Nr,: 52-1 . 6 12 /95 MAIN BUILDING ACCESSORY BUILDING /40 ")/A--.7-5- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN contred« ` LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ER BUILDER DECLARATION:I hereby affirm under penall�y�•,!}�,I�/,„, ern•awl from the r• ars License Law for the &lowtg reason(Section 7031.5Busiess and Professions Cod my which requires apo : ..mer,improve. PARKING REQ: PROV: PARCEL: 42606119 ZNE: REF NO: demolish,or repair any structure,prior to its issuance,also repo' 'cent for such permit to file a ,emend that he or she is licensed pursuant to the provisions d the Contractors Licen - .w[Chapter 9(commenting with Seth( r r r)of Division 3 of the PLANNING NOTES> and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exempt'. .Any violation of Section > )31.5 by any applicant for a permit subjects the applicant toacivil penalty of not more than five hundred dollars is50oI)- ******************************************************************************* ❑ I.as owner of the property or my employees with wages as their sole compensation,will do the work,and the structures not intended D E V EL OPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,end who does such work himself or herself or through hs 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 ZONING APPROVED BYDATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,as owner of the properly,am exclusively contracting with leaned contractors to construct the project(Section 7044.Business arid Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE: contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). ❑ lamexempt under Section: B.&PC..forthhisreaon: APPLICATION ISSUED BY: / DATE:/0A //Q1^Date: owner: fff****** LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: N I do hereby certify that I am aware of and understand the requirements of Caliomt Health end Safety Code Sections 25505.25533,and 2a 534,permit thatlorionrmny buidinnfoc theAiOsryMa gementme thee)need a.Re&o ornplyconeth udstalewdesnsaexempt requirement,forBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2purmit fndthatIorr an«moe'bui iinho occupant t/w otMimeo e) rid. to Residential mMradisnepcodes and eremgementeee provisions. PERMIT 55 . 60 Dale: Applicant: 5 0% S M I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: P LAN ❑ have and will maintain a certificate o consent to seffcinsure for workers'compensation,ars provided for by Section 3700 of the LaborcjiISSUE FEE T- 15 . 0 0 Code,for the performanceoftheworkforwhichthispermiisissued. BUILDING DIC > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE Ihave and wit maintain workers'compensation insuranoe,esroquired by� �. ;lf�T�'•d,,[[..Labor ..,f«the::nprmance Of the TOTALS----> 55 . 60 15 . 00 0 . 00 70 . 60 70 . 60 . 00 work for which this permit is issued.My workers'compensation insurance.. •• um••.r: a: Carder: CTATF FT PIRES REVENUE DIVISION TOTALS--> COLLECTED : 70 . 60 OVER/SHORT: 00 Policy Number: 11R1 A7Ca/ ff 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK -s section need not be completed y the peri o for one hundred doll .151001 or 70 . 60 I certify that in the performance of the work for which this permit • issued,I •• pe-• n any m ner so as to becomesubjecttotheworkers'compensationlaysofCalifomm.:,and . 4. ..at4 d•:.•. . subjectttheworkers' ******************ic************************************************************ mpematloesofSecto3700dtheLeh«Cade,I f•• h Ut. & " .-/A .Yr Applicant ` IND IV I D •U A L F E E BR EAKDOWN .- Warning:Failure rosecure workers'compensation covarag 1,Ind s•Isubject anernployertoannnnal.mettles and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($100,000A Ilion to ma coat of compensation,damages ea . .vlOM for In section 3706 of th Labor Interest,Cods, and attorneys./en. ELE 7 FIXTURES, LIGHTING 1 ST 20 EA. . 75 5 . 25 CONSTRUCTION LEND.0 AGENCY: I hereby affirm under penally of perjury that there is a con melon lendin, agency for the ELE 20 RECEPT/OUTLET 1 ST 20 EA. . 75 15 , 00 performance or the • for ich this permit sissued(Section 3O97,cin.C)' ELE 3 RECEPT/OUTLET ADDITIONAL EA. . 45 1 . 35 ENDER-N ' E: ELE 10 RECEPT/SWITCH ADDITIONAL EA. . 45 4 . 50 L DER'S •rD as: ELE 1. SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 Icertiy that : :reed this tion •date that a above infmretion is conect l agree to comply with all nay and county ordinances ELE 1 SUB-PANEL 11 .00 11 . 00 and state laws .int to• antro. and he.• authorize representatives of this oft to enter upon the abovementloned property for inspection.•rposes. END OF FEES • FF eNK VANi,ENHERG ae/7"-t.) � oata� n' nR_101,Jr-nn 9 9'+ y- T t 1._I Y J 7J.60 / 41'.n: :of PvnerlhgenVApW: V-./•r « u, r r.: (5151-4(. P) White-Building 8 Safely:Green-File:Canary-Appecant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING./ POOL 1 5, ti APPROVALS Permit# - Date Inspector APPROVALS Permit#` Date Inspector. 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ` 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test `• i 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-rap, 0/Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line House Connection 62. Backwash & Receptor-Final 12. Sewer Cap : - 63. Heater & Vep[<Final/ 13. Roof Drains 64, Plumbing System Final - r 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit /. 66. Solar System-Final 16. Rough Electric Wiring .2 T _� .L(.w�" 67. Fencing & Access Approval - - - - 17. Rough Wiring Sign '���lll���""""`__"" 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil t23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil !25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27, Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning .i 35. Final Gas Pipe-Test 36. Hood or Canopy ? ^' 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING , 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date �� �p 9 1 NOTES [SUBJECT: / &P r -'-orf JOURNAL/ INSIGHT 1,//71/41 - v(�r, y off' f ria , a J, 04M11-- 3-y-1.6 fccjteq' o sb, • 1871-46 ADDRESS OF WILDING: 156 22ND ST UMT' B CITY OF COSTA MESA - BUILDING PERMIT ON - NERSNtMEineimN: KUBOTA, GEORGE PERM NO: B 074515 ADDR 156 22ND ST COSTA MESA, CA 92626 PERMIT NO: B 074515 PLAN CHECK NO: 03822-95 A GOVT: N SUPP: N APPL.FAWNS ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE; REP ARCHITECT ORENGINEER: HARTMAN ENGINEERING DD'MD'` 52434 JOB DESCRIPTION : FIRE DAMGE REPAIR SQ FT: 35, 000 ARCH.OR ENO.•s ADDRESS: 747 W KATELLA WIT: 203 ORANGE CA 92667 CLAIM VALUE: 35, 000 . 00 CALC-VALUE: 35, 000 . 00 GROUP OCC: R-3 / CONfRAC70ASN°0` VANDENBERG PLUMB S CONST ( 714 ) 842-1781 CONTRACTORSMARJC 7285 MURDY CI COMMENTS: FIRE DAMAGE REPAIR ADDRESA HUNTINGTON BEACH T lIC1l0-: 521576 ******' ***�E*a:- f-***�E******If********** - f-***IE*�E*SEx-SE�E�k**�t* -irSE*SEK-RE***#St*RE;E***i�-IE•****** 9264C4 ' w. ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under.. y of perjury Ised under provisions of Chapter S SETBACKS (commencing with Section 7000)of Division 3 of the Business and Prof-sons Code, y • ( is in full force and effect. C .No.:047178 LIC.CLASS: B UC. o.: t EXP ; 12/95 MAIN BUILDING ACCESSORY BUILDING ��_/�_ �S Contractor: - ' .) FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ale: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN P NER BUILDER DECLARATION:I hereby affirm under pe , ..rjury that I am exempt from t trades License Law for the dfowig rotten(swim 703t.s Business and Professions Any ctv«manly which nqubasepennh to masmn.alter.knprove, PARKING RE 'PROW PARCEL: 42606119 ZNE: R2-M REF NO: demolish,or repair any structure.prior to A issuance.also requires the applicant for such permit to fib a signed statement that he or sh Q 4ficemedl.n temtotheprod*r,edmeCndradesL «,eeLaw(Chagers(comm.wngw;thSedim7ooO)dDiaidonadthe PLANNING NOTES> REPAIRS TO UNIT AS A RESULT OF FIRE DAMAGE. NO CHANGE TO EXI Rosiness end Professions Code(or the he or she is exempt therefrom end the basis lot the alleged exemption.Am/violation d Sedan > STING FLOOR PLAN. )31.5 by any applraot for a permit subjects the applicant to a civil penally Olin more than five hundred dollars j$5001). ************************IE*******************************************3(406******** tJ I.as owner al the proper o my=abyss,with wages es then sole compensation.will do the work,and the structure is notintended V or off mei for sale(Section 7044.Business end Professions Code:The Contractors License Lew does rn apply to en owner of property DEELOp' M E.-N;.T S E R V I C E S R E Q U I R E M E N T/S who busts or improves thereon,and who does such work himself or herself or through he or her own empbrws,presided that such "unprwemeea are red"ended a olleredfor"M.I,law�ver.th&althea a ieprawnere'm aunt whim Deeyen el mnpbt e'gr ZONING APPROVED BY OP DATE: _/i _[/ _9.s-. owner buitler till have the burdd pr en oving he a she did w build or improve forthepurpose of sale). r ❑ I.as owner of the prapeny.em exclusively contradiig with licensed cantreUes no construct the pnjed(Section 7044,Business end - - ��y ) / 7 r Professions Code:The Conti does threw Law does rat appy to an owner a property who builds or impewes them and iota BUILDING APPROVED B Y : f// DATE: /O 5 contrwe lot such projects with a coaradors)Icemen pursuant to the Contractors License law). - ��AA ❑ •Iamexemptunder Section: B.aP.C..rormisreason: APPLICATION ISSUED BY:'' V� DATE: /� 4e Date: • Owner: *******************************************************************77rhf3E��E***** Ido hereby certify thaton Nat I em aware of and understand the requirements of Gallos Healthand Safety Code Sections 25505,25533.end LEGALIZATION: N F E E SUMMARY STRUCTURA , SEGMENT:Y 25534,and the I or any future building occupant will/wit!not(time one)need to comply with said stale codes end the requirements for a permit la construction o modification from the A'kDisthiy Management District Residential oonerudionappicaions are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING prpNSiOns, PERMIT 317 . 00 3 . 50 Doe: Applicant: S M I P/NON-RES WORKERS COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the foewi ong declarations: PLAN 51 . 51 o I have and owl mn aintae certificate of consent to self-insure tor workers'compensation,as provided for Section 3700 d the Labor ISSUE FEE Code,for thepedomumeedmeworkfowhchthispermitismped. BUILDING-DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE /AL I have and MI Maintain ntaworkers'cotio mpensan insurance.as required bySedimn 3700 of the Labor Code, the performance of the TOTALS----> 320 . 50 0 00 51 . 51 372 . 01 372 . 01 . 00 \work for Mich this ret poi is issued.My worker,' compensation insurance• al n .iter e: Carrier: CTaT FTih1 41 EXPIRES REVENUE DIVISION TOTALS > COLLECTED: 320 . 50 OVER/SHORT: 00 Pricy Number: 1 . • 11:170-?13Wifa 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK kis section need not be completed it the panne is for one hundred dole -(5100)or 317 . 00 3 . 50 I certify that in the pedonnence of the work for which this permit is issued,I sn in any manner aid as e .me subject to the workers a mPensation laws of Calhone end agree 7.to e"hiedtothewhari *********************************************************************3e********* c. pensoion provisions of Section 3700of the Labor Code.I shall onhwhh./ • • .. INDIVIDUAL FEE BREAKDOWN a ,e ` •e Applicant: . jr—I Ing:Failure to scurewwera•compensation coverage/,,and sNl•ubject an , •lo tocdMnal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST c WI tines up to one hundred thousand dollars($100,000), /tion to the coat of component• , images ss provided for In Section 3706 of the Labor Code,Interest,and attorneys fees. SFR 35000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 35, 000 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury the there is a construction lending agency for the END OF FEES performance of the work for which this perms is issued(Section 3097.Civ.CI. LENDER'S NAME: LENDER'SKESS: I certify that I have re.• I.. .ion end stale that the above information is correct.I agree to comply whh all city and county ordinances and stale laws retro.. • .con r •on and here• authorize representatives d the dry to enter upon the abowe.mwfoned progeny for inspedicn Pur.. ��A diKI VAn. ENBERG a Dae: O— ) )-9s 01 Go±`Y�.7sT-I)t'L1 t3JG T'CD Ti ;''iJ. p �r. eaowoeri-•ensu.. . � I GnTE: Iir1�I/';$ lir": u•..;, . (5151-46 WPI White-Building&Safely:Green- .. anay-Appecanl:Pink-Revenue:Goldenrod-Assessor - CONSTRUCTION AND PLANNING ) PPOL & - APPROVALS Permit # Date Inspector APPROVALS \ Permit # - ) Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -- , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • I ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 11 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test /' ! 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, O Uridrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final--- 12. Sewer Cap 63. Heater& Vent-Final - 13. Roof Drains • - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing z f-C- '6 _4e 76. Dry Standpipe 28. Lathing& Siding 31(_,G /a-C1.4 77. FIXED SYSTEM FINAL 29. Insulation a-{27-76 78. FIRE PREY. FINAL 30. Drywall Nailing 31( 9$ Cu/le HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat '311c"`S, -F&l) 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 F 37. Final Factory Fireplace r! 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING �r_7/f.` - - 48. FINAL PLANNING ! 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY l No. Date ADDRESS OF BUILDING: 156 22ND STUMT' C CITY OF COSTA MESA - BUILDING PERMIT ONNERSNNE IF 100N11; KUBOTA, GEORGE BERM NO: B 074516 ' ADDREss: 156 22ND ST COSTA MESA, CA 92626 PERMIT NO: B 074516 PLAN CHECK NO: 03821-95 A GOVT: N SUPP : N APPL.MMLDC ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP ARCHITECT OR ENGINEER HARTMAN ENGINEERING ucxo, S2434 JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: 35, 000 ARCM.ORENG.'SADoRESS: 747 W KATELLA mm 203 ORANGE CA 92667 CLAIM VALUE: 35, 000 . 00 CALC-VALUE: 35, 000 . 00 GROUP OCC: R-3 / CONmAcwrsNWE VANDENBERG PLUMB & CON T ( 714 ) 842-1781 CQ4TRACTORS MARINO 7285 MURDY CI COMMENTS: FIRE DAMAGE REPAIR ADDRESS: HUNTINGTON BEACH l 1110.: 521576 **************{c-*SF***#1F*RtK-IF�t**N•x-titer*�E*******N** *****RF*+ciE*it**********f�****N•-,E***�E�E 926 . . uMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under•- -- y d ped . I -•.under provisions d Chapter 9 S ET B ACK S (commendre with Section 7000)of Division 3 of the Business and Prof- Works Code r-cin fun force and effect. CITY,LIC.NO.: 047178 UC.CLASS: B UC NO.: c ) 7(�. EXP: 12/95 MAIN BUILDING ACCESSORY BUILDING D . p— I- ' Canvador . FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWN.- BUILDER DECLARATION:I hereby affirm under petWy Nmhaty II ant exam%1• the Cadrad• License Law for the .reason(Sedion 7031.5 Bushels end Professions •.• nycty or county whichmqu .<a permit lo,. .:cod,seer,improve, PARKING REQ: • PROV: ' PARCEL: 42606119 ZNE: R2-M REF NO: demolish, or any Rrtrprc"prior maisdAte Comredorssuance.sLLiittneLaw(CChhapter icant 9(coommenncinpermg l•heSed.000)of Division he that or the PLANNING NOTES>• REPAIRS TO UNIT AS A RESULT OF FIRE DAMAGE. NO CHANGE. TO EXI s sines and Professions Code]or that he or she a exempt therefrom and the basis for the .: :5:...on.Any violation of Section >-. STING •FLOOR PLAN. - 131.5 by any applicant lora permit subjects the applicant toe civil penally Snot more than the hundred dollars 135001). fEjElE9fiEiElF3EiEiE#IEjf******df1E#*1Ei(-IEiE*****1E1E3Eff3EiEiflEifiEi(iE* *iEl ****1EIEiE1ElliEif*1E1E#iflfiE**-M3E*.**iFjEl ** 0 I.asownerofthepropendormyemployeeewithwagesastheirsoolecompensation.willdothework.andthestructureisnotintended D E V E L O P M. E N T S E R V I C E S R E U I R E M E N T '$ or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to en owner of proper y Q who bold,or inproves thereon,and who does such work/time or herself or through his or her own employees,provided that such - improvements are not imendederdleed ler eale.i,however,lM Wilding or kn%wemeMnadd within ane year dmmpblxtn.the ZONING APPROVED BY -2 DATE: 70 if /a/.,�r. ownsr buider wall have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,as owns of the property,em exclusively contracting with licensed conlrecto a to wtmud the project(Section 7044.Business and p, �• Professions Code:The Centred=red=license Lew does nappy to an owner d property ed y wbuilds or improves thereon end who BUILDING APPROVED BY !iti DATE: /0 _b 7 1 contracts foe itch projects with a codractor(s)Warned pursuant to the Contractors License Law). _ El ho lamexemptunderSecn: B.AP.C. this / for APPLICATION ISSUED BY:. CAN,- DATE: AJ' O Dale: Owner: *******************$**********************et**************if!(iE1ElEiElE3EfEi(-7-$FEV4fl=`- **ire 1(- Idahereby certifyant thatlewerof understandeendrequirementsof thaCallomaHealthatsfety Code Sections 25505.25533.and dS LEGALIZATION:N F E E SUMMARY STRUCTURA-., SECMENT:Y 25534.end that 1 or any future building occupant will/will not(circle one)need to comply with said elate codes and the requirements for a permit for conemctionor modification from the Air uatoranagement District.Residential construction applications are exempt from these BLDG PMT PLUM ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 317 . 00 3 . 50 Dee: Applicant: SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d s:perjury one of the following decrement PLAN 51 . 51 en ISSUE FEE o I have ode,fdwpertorenecarlilFsedmnwnnoeatl♦munMvorkon'wmpenuf.. ...fabySedbn3700dthe Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK-ticTOTAL PAID DUE hevee the nsdomnresof krMwrk for nsaliwhich Nanas required �� 320 . 50 0 . 00 51 . 51 - 372 . 01 372 . 01 . 00 �J �I ark w lie this en workers'edMy workers' insurance,' n oniiisur by and po r and,Ion led pademence d the ark for which thio permit is issued.My waken'compensation insurance• '.red poi ember are: Cartier: CTATV FT! EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 320 . 50 OVER/SHORT : 00 Polity Number: 1 "3 . 1 R7G //►vl 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 'Is section need nor be completed d the seine is for one hundred dollars[VOW or less) J p 317 . 00 3 . 50 I cenly that in the pedonnanca d the work for which this permit is' .ued.I shall /Or parson In any manner ser as to become subject to the workers'compensation lawn of California, , • agree I. ••one subject to the workers' ***,)F**,**,K,**3E*******,1E*****,Y.*,N,**,*,K,*.****************,N,****,7(,**N'***,#,7f*********!E****** (n compensation provisions of Section 3700 d the Labor Code.I shall 1•rthweh••, *• -. i.4A: /2,—// _ 9S ; INDIVIDUAL F E E BREAKDOWN V" Applicant: Wens/ng:Failure to secure warfricomperwuon coverage/ :. 1,and Wall subject an. Winne? and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Rhes up to ono Modred fhoulaed dellen(S100,000), n to the coat of compensation. • • • as podded for In Section 37aeolthe Labor Cods Interest,end anomay's SFR 35000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 35, 000 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097.Ca.C). ND•"'NAME: ENDER'S J.DRESS: I certify that ave read thi : c an stats that the above information is coned.I agree to comply with all sit and county ordinances end slate S relating to• • end hereby authorize representatives of this dry to enter upon the above-mentioned property for inspecti•n purposes NK VA DENBE . �5 I (\ /' /A Dere: 0' `•L 9/ • -um'd Dourer/Ag v ul u.919:tt9-C0191e20 x'1.73 7 '_G.50 DATES 1:. ¶1'45 ''Li:: 10:37 (515 -.,WP) While-Building A Safely:Green-file:Canary-Appicant;Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING- / POOL & APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pple 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement - • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms r 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - - 60. Backwash Lines, P-Trap, C Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap ---? 63. Heater & Vent-Final . _ 13. Roof Drains - 64. Plumbing System/Final 14. Rough Plumbing / 65. Electrical-Final t ) _ 15. Rough Electrical-Conduit - 66. Solar System-Final I 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing /) f.2_ 5,3 . 6A/A._ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat I 75. Dry Chemical 27. Frame and Flashing 2727--q6 aq,(i 76. Dry Standpipe 28. Lathing&Siding 3! S I a elimmii i ADDRESS OFMGM 156 22ND ST mt 1 /2 CITY OF COSTA MESA — BUILDING PERMIT QWNERSNAMEIPIOnSOt KUBOTA, GEORGE T TR PERM NO: B 073291 S'DDRES' 24841 LA VIDA DR LAGUNA NIGUEL,CA 92677 PERMIT NO: B 073291 PLAN CHECK NO: N GOVT: N SUPP: N APct.WCADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP ARCHITECT OR ENGINEER: UC.POI: JOB DESCRIPTION : DEMOLITION FIRE PERMIT SQ FT: 3, 000 ARCH.OR ENG.'S ADDRESS: UMT: CLAIM VALUE: 3, 000 . 00 CALC—VALUE: 3,000 . 00 GROUP OCC: R-3 / cONWAcToWSNAME: VANDENBERG PLUMB & CONST ( 714 ) 842-1781 CaNTRACTORSMNIDIO 7285 MURDY CI COMMENTS : X ADDRESS: HUNTINGTON BEACH CA ism: 521576 **iEN-*at****fE+ESESE*SE**x-Rt****** rt************RE*******************iE***REQ-****N- -*SE***** 92646 DMT: Z ON ING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of peµay IS I am leered under provisions of Chapter S SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code.and my licenses in lull force and sited. CITY LIC.NO.:047178 UC.CLASS: B UC.NO.: 591576 EXP : 12 ' 5 MAIN BUILDING ACCESSORY BUILDING 7��et?r convector / FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN °' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 0 ER BUIL ER DECLARATION:I hereby affirm under penally d perjury that I a n«_ �IM Contractors License Lew for the dowing reason(Session 7031.5 Beakless and Professions Code:Any city or°ounty em a permit to conawd.nar.Improve, PARKING RE PROV: PARCEL : 11721105 INE: REF NO: demolish,or repair any structure,prior to He issuance.deo requires the applicant for we • .b a signed statement that he or she p is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing wah Section 7000)of Dwain 3 of the PLANNING NOTES> Business and Professions Cab)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 apermit subjects the applicant toe owl penalty of not more than five hundred dollen RSCDIN ******************************************************************************* ❑ I.aeownerofthepropertyormyamWq«ewkhwep««their«kcompesaticsMIdothework.andtestructure'e notWended or offered for sale(Section 7044,Business and Professions Cade:The Contractors License Law does not appy DEVELOPMENT V E L O P M E N T S E R V I C E S R E U I R E M E N TS to an owner of property y Q who beide or improves thereon,and who does such work himself or herself or through his or her own employees.provided that such im"vamens we riotiniendad aoffndla sale.5,however,the butMip orinpmvtned is saki wi sold seryear(mnpSon,ithe ZONING APPROVED BY DATE : r-b owneuilder will have the burden of proving he or sat purpose MI build or improve for the puose of sale). ❑ I,aspen*:et the property,am exclusively mitradip with keened contractors to construct the project(Section 7044.Business end Professions Code:The Connectors License Law does not apply to en owner of property who Side or improves thereon and who BUILD I NG APPROVED BY : DATE: contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). (Ippi _ ❑ Iamexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY: — DATE: 11 Dole: Omar: ************************************** ************************** IF** I do hereby certify that rem aware of and understand the requirements of Caltomie Health and Safely Code Sections25505.25533, LEGALIZATION:N F E E SUMMARY STRUCTURAL S GMENT:Y and 25534,and that I or any future building occupant will/will not(circle one)need to comply with said nate codes and the requirements for e permit for construction or modification from the Ai Jsity anagemni Dideid.ResidentWeenstnMionappealione en extend from three BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 54 . 00 . 50 Cede: Applicant: SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of pe juy one of the blowing dedaratire: PLAN ❑ haveISImaintaacoeof mmentl0sedirwworks' 3700ofthLets ISSUE FEE andint� Code.for thpedarmraedthe wmfor whiae ahthispelmIssued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I have andwil maintain workers'compensation insurenoe.«required by Sedion 37C0 of to Labor Cods,for the performance of the TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 work for which this pemtt is Sued.My workers'compensation insurance Mbar and policy number we: Carder CTATF Fr1NTh EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: . 00 Policy Number: 11R1A')Q-95 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 'This section need not be completed I she pwme is for one hundred dollars(5100)or less.) 54 . 00 . 50 ) 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 became wiled to the workers'c°mpenedion laws of Cadania,and agree'hal if I should become PubPub*.ojto int workeri ******************************************************************************* ions ns of Section 3700 d IM Lobar Code.I shag forthwith pl�v' Natee e provu_ I N D I V I D U A Ir F E E BREAKDOWN drzempensat UNIT COST TOTAL COST ate: (V9 C Applian: rig:F.uur.roun workers'compensation coverage unlrerlu(and shall errplgerroandmlPerndd«.lee TYPE QTY DESCRIPTIO N fines up to are hundred thousand dollars($104000).N addition to the coat don,damages as provided for In Section Code,lamest, ro and. near«. SFR 3000 DEMOLISH BY VALUE RESIDENT. NOZONE 1 . 00 3, 000 . 00 ' CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty Of perury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is saved(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is coned.)agree to comply with all city end county ordinances end state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. KENNF H ASHMEYER. 01� —�'// `TiPATE: 07/19/95 4:47OT 54.50 / i� Date. C3L,lL_ �— (5151<e.WP) While-Suldip& .. ,r .- le:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor • . CONSTRUCTION AND PLANNING P.00L & • APPROVALS Permit# - Date Inspector APPROVALS Permit # Date Inspector Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrntl. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER.GUNITE • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap _ 63. Heater & Vent-Final 13. Roof Drains r - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL / 29. Insulation 78. FIRE PREV. FINAL / 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster 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 Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40, Gas Service-Final 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 577 6 48. FINAL PLANNING 49. Electric Release to Edison -. 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No Date f Post-itfFax Note 7671 Date r1.—'7 pages f - CCI'�VZ p • Co. ! Phone k Phone N Fax k Fax k - Date: 7� 'S-9S NOTICE ❑ Stop Work ISCorrect Work �,Q Job Address /5 6 ,'i 2-2 -"' S Permit Number 004110 Q 7 3 2-41 - VS IC,' re b., 14-0 ]L ® k-Pw s4L �. h ,r 15>` ,lj%. elect l� tre ""nh 9 r .5lte2 0 7 y. 5 ✓ A y Etter . P14,.6 ,� ckc". s Inspector's Telephone Hours: 7:00 - 7:30 a.m. 3:00 - 4:00 p.m. 0 Correct & Proceed Inspector's Office Hours: 3:00 - 4:00 p.m. Inspection Request: 754-5626 yD���j/ r 754-5627 Division Inspector ._% l� w �''/ y CMF 0363-46,rev.4-1.57 Tel. T�` y-y�y� '-V6/7 ADDRESS OF BUILDING: 156 22ND ST 'Pr: B CITY OF COSTA MESA - BUILDING PERMIT ONNERs NAME IF MOWN: KUBOTA, GEORGE t PERM NO: P 074520 ADORERS' 156 22ND ST , COSTA MESA, CA 92626 PERMIT NO: P 074520 PLAN CHECK NO: N GOVT: N SUPP : N APPL.WALING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: REP ARCHrrECTOREaatiELt HARTMAN ENGINEERING Ii"40, S2434 JOB DESCRIPTION : FIRE DAMGE REPAIR SQ FT: ARCH.OR ENC.'S ADDRESS: 747 W KATELLA umT, 203 ORANGE CA 12667 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / comnuoRINAIt VANDENBERG PLUMB 6 CONS' ( 714 ) 842-1781 CONTRACTORSWGWG 7285 MURDY CI 1. COMMENTS : REF: B-74516 ADDRESS: HUNTINGTON BEACH ND. )21576 ******************If**+f)f**********I **************1fxRt***IE*************iE*+f**#****iE 92646 NT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Slim under peaty. '. . .. . . t 7. . of Chaplet e SETBACKS (commencing with Section 7000)d Division 3 d the Business end Profu in 1 face• .effect. • C'1411' 047/] 78 di `0"V uc.cuss: B u`' Contractor:: EXP: 12/95 MAIN BUILDING ACCESSORY BUILDING P� � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I heeDy affirm under - /jury than em thereat from the �- Law f«Ne >' Imowingmaon(Swion]m1.5Busies*and Pmessiors ` W«mtwywt rea�aeeaPeonslomewd.alter.im«oe. PARKING REQ PROV: PARCEL : 42606119 ZNE: REF NO: lemoleh,or repo any structure,prior bus issuance.also the applicant for such pent to Mee signed Bate ant that he or she Q licensed pursuant to the provisions of the C«.tae«a License Law(Chapter 9(commencing with Swan 7003)of Division 3 of the PLANNING NOTES> casinos and Prdessbre Code]or the he or to is tier=therefrom and the bath for the alleged exrnpldon.Any violation al Section > - 7031.5 by any ethic=for epanne stied,the apPiura toe del penally ort not more than love hundred dollars 15500p. ******************************************************************************* ❑ I.as owner d the property cc my employees wehwages as thea We compensation,wi do me wort end the swf«e is not unemeed or offered for sale(Section 7044,Business and Professions Code:The Camtd property DEVELOPMENT V E L O P M E N T S E R V I C E S R EQU I R E M E N T S ra o License Law does not apply to an owner prope wig buts or improves thereon.end wen does such work tinsel or herself or through his or her own employees,provided that arch , o r'butders.ighh'aaveth burden olmokr inngheoa�ediddrefbbildeverjhe�oimp«roveelprrrteOp'pu.�agala,: '«awhn°Ietan'the ZONING APPROVED BY DATE: ❑ I.as ewer of the properly.em exclusive')contractWg with Boned contractors to=mann the project(Section 7044.Business end Professi=w Code:The eontndm License Law does red cooly a an owner d property who bahils«improves thereon andeho BUILDING APPROVED BY : DATE: .7:_t____ contracts for suchprojects with a contractors)reeled prsura to the Contractors Liens Law). j• � ❑ lamexempSection: N n: B.AP.C.,krereason: i APPLICATION ISSUED BY: DATE: JO / l Date: Owner: * **** I do hereby certify tm at I aaware of and understand ts of Cameliathe requireCameliade Heath and Safety CoSect 25505.Pcs=.and LEGALIZATION:N F E E SU -M,.A R, Yr ), • STRUCTURAL SEGMENT: N cassis'and that l«any r=Menai=omtheA �] foraagRte«e)needka«m"wmesidmteondesendNerempifromtsBLDG PMT PLUMBING ELECTRIC' MECHANIC, FIRE SMIP/RES GRADING ▪Par=l«mseurtan«t=builiin occupant tare Iallntr anepemeotei ne. to comply ars aid dte odds ns ends eremplemet r P rovisions- PERMIT 7 . 00 " - Oafe: Applicant: 258t SMIP/NON-RES WORKERS COMPENSATION DECLARATION:I hereby affirmed m under paty peay One d d to following edefoliels: PLAN r ❑ IhawerdwSmaitaa a certitude of consent tosedirwe tor workers'compensation.es provided for by Section 3700 of the Labo ISSUE FEE ] 20 . 00 Code,for the wnormanceof the wr kforwhichthispmtisissued. BUILDING-DIS > PERMIT ISSUE PLAN-C11'ECK •TOTAL PAID DUE I haw end MI maintain waiters'compensation insurance,as required by Section 3700 of e,k •• Code theped«manced the TOTALS----> 7 . 00 20 . 00 • '' 0 .00 27 . 00 27 . 00 . 00 work for which this permit S®lid.My wanns workers'compensation insurance.. r lee: 'r canter c'rn'rr FET TEi EXPIRES REVENUE DIVISION TOTALS--> COLL$CTED; 27. 00' OVER/SHORT: 00 Policy Number: m " lila— analfl01 04 /01 /96 BLDG PMT PLUMBINGNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK a swim need not be completed 1 the puma a for one hulled dodgers - wl« n / ❑ canN Ow in ted xrfamrce d the aro k b which thb Prete e'.: .,I A any manner so as to f w become iso ed to the workers'compensation laws d Cessna. . • erg .«' w to ted w=krs' **********************************i�************'******************************** mompenseli= ion f kat 3700 a the Labor Cede,I Karg f• nw m -. .. Asi. I N D I V I D U A L F E E % BREAKDOWN =Dan^ /e54- Applicant: . �� a - Ing:Failure to secure workers'compensation coverage Is t�a �ublecf an lover tocrl.nal penalties end TYPE QTY DESCRIPTIO N +• UNIT COST TOTAL COST wr civil fines w fo one hrbred thousand dollars(51040D0F m the cost of comprise•. danwps as provided ler In Section 3706 of the Labor Coda,Inrrsatand afromey's PLU 1 LAUNDRY TUB OR WASHER01. 7 . 00 7 . 00 CONSTRUCTION LENDING AGENCY: I hereby aff -- penalty d perjury the there is a conafn.ion lending agency for the END OK. FEES _ performance d the work for which the perms a issued(Section 3097.Cit C). _ NDE NAME: ' v r ,:R'S DRESS: .r ' t •I certify that this ami•n end sate that the above information is cones.I agree to comply with all city and county ordinances •and state . •k •• -.• -;• rd hereby auUgnce represenetrs of this city lo enter upon the ebove.mentioned propend •v �/ - J OKs: Ga'1/'95 lit.; grata. . • .1 ._ olOanU06ntradgn _ _ ._ - V ."'•vP) Whim-Build g& .. :Green-File:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor ) •. �. - n BOOL PA CONSTRUCTION AND PLANNING/ / APPROVALS Permit# Date Inspector APPROVALS 'Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location" - . 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement ' _ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE " 7 Footings 58. Electrical Conduit-Undrgrnd. t S. Foundation 59. Gas Pipe, 0 Undrgrnd.. Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap - - - 63. Heater & Vent-Final_ - 1-3. Rbof Drains - -- 64. Plumbing System - Final - 74. Rough Plumbing _ it -if • 65. Electrical-Final .15. 4ough Electrical-Conduct ^�c� 66. Solar System-Final • 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Corditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough&Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: f-Cc-- Si Cern/2 C,-creJ Ar✓ 34. Final Heating & Air Conditioning l e viertnrz, erg;_ 35. Final Gas Pipe-Test - , r -19 -7-t con -rljJ7c.c3 �Q �I•' 36. Hood or Canopy I I -2if-,4 Lc - if tea• 37. Final Factory Fireplace Lc 38. Final Plumbing St37 / FM 7._Z-Z It ! 11---4-0t4:4---1 _ i. 39. Water Service-Final /-- LL--tO� 40. Gas Service-Final c_ / -5 P2 Fes.•) 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 1 48. FINAL PLANNING 49. Electric Release to Edison --- 50. 50. Gas Release to Southern California Gas Co • • ' 51. CERTIFICATE OF OCCUPANCY No Date 41 I ADDRESS OF WILDING: 156 22ND ST *um B CITY OF COSTA MESA — BUILDING PERMIT OWNERS NAME IF MOWN: KUBOTA, 1?EORGE 4ERM NO: M 074519 ADDRESS: 156 22ND ST COSTA MESA, CA 92626 PERMIT NO: M 074519 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAIUND ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: REP ARCHITECT°}I ENGINEER: HARTMAN ENGINEERING sac.Pa: S2434 JOB DESCRIPTION : FIRE DAMGE REPAIR SQ FT: ARCM OR ENG.'S ADDRESS: 747 W KATELLA UHT: 203 - ORANGE CA 92667 CLAIM VALUE: CALL—VALUE: GROUP OCC : R-3 / CONTRACTdfSNA1c: VANDENBERG PLUMB 6 CONST ( 714 ) 842-1781 CONTRACTORS IMIg30 7285 MURDY CI COMMENTS : REF: B-74516 ADDRESS HUNTINGTON BEACH CA 521576 ****************'*+E********+E********#*******+ESE*****+ESE*+E+E*****+ESE***+ESE***+t Rt******* 92646 1 ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby/Arm under tamely• perjury that I '•ensed • •- pr• • ,of Chagx 9 SETBACKS (commencing with Section 7000)of Division 3 d the Business and Proles:• -Code and mS i lull force and. ed. C. u• NO.: 047178 UC.CLASS: B uc.NO. 521' 3 EXP: 12 /95 MAIN BUILDING -- ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN - -.9Co"tBdOr 7 --a:14 , LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN •• PIER BUILDER DECLARATION:I hereby affirm under penally of• em exempt from the•• - •e Law for the fdlewig reason(swion Trots Buskess and Professions Code: • .. � which requires ape alter.improve. PARKING REQ: PROV: PARCEL: 42606119 ZNE: REF NO: demolish,or repair any structure.prior to its issuance.aiso reyw. .-..-_ for such permit to Swig ig •., .ement that he or she ' is licensed pursuant to the provisions el the Contractors Lioelt . ' Chapter 9(commencing with Swan 7003)of Division 3 of the ' PLANNING NOTES> ft, Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the appfrat to a dvi penally of not more than We hundred dollars($5001). ****************************************************3y********irk**irk************** ❑ I.as ownadthe POW'?a my emplwee ewith wages as Nei sots compensation.pug do the wok,and the structure is ltd bnendee DEVELOPMENT S E R V I C E S REQUIREMENTS or offered b sale(Section 7044,Business and Professions Coda:The Condos License Law does not apply to an ower of property --- , who bolds or inpeoves thereon.and who doss such work lensed or heeN a through his or her own employees.provided that such 1', improvements are ltd intended or offered for sale.I,however.the building a improvement is sold within one year d completion.the ZONING APPROVED BY �� DATE: owner-builder will have the burden of cawing he a she did w build a improve for the purpose of sale). ❑ I.as ower d IM property am acnsi,dy mmrwing with lirorsed conuedoes le eqnmud the pmjed(Swop 7041,Busbms and ! , Professions Code:The Contractors License Law does ltd apply mnowner dpopeM who builds or thereon and who ,,$�TILDING APPROVED BY : '-1 DATE: contracts ler such projects With a contractor(s)firmed pursuant to the Contractors License Law). ❑ I am exempt under Section: S.8P.C..brNbrmaon: APPLICATION ISSUED BY: ^ DATE: /S /�/QC ********************** k******„x********************7734.;:****** Data: a'A1°r LEGALIZATION: N F E E S U ,M M o R Y STRUCTURA... SEGMENT: N I do hereby certify tont d I am aware and understand Colonistwoe d the requirements of Colo Heath and Safety Code B25505,2'c' ,end 25531.and that 1 or arty Mune Wilding occupant will/we not Icmle one)need to cony with sad state codes and the requirements for / I•v t `- apermit tor construction ormodifimtionfG3�y al from District.ReSfl construction n ionapicatiome exemplfmm these BLDG PMT PLUMBING ELECTRIC ' MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT .• -•r 12 AO Done: Aperient!: f 2'54 SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of the following detlambn: ISSUE FEE r 1.... 1.5 :001' ❑ Ihave and will meirMnantra*domwmtosod-insure brwaken'mperrtion,oprovidedtorbySwion]TOOdtheLabo BUILDING—DIV—> PERMIT ISSUE PLAN4CItECJl • 'TOTAL PAID DUE Code,for the performance of the eat for vitich this pen i.issued. TOTALS----> 12 . 00 15 . 00 ''' 0". 00 I' 27. 00 27 . 00 . 00 1'�I I have and Mil mental woken'compensation insurance.a required by Swim 3700 d!e Labor Code,for the pafmmance d the Vt;\work for which this panne'u Sued.My wakes'compensation Snufflecarrier. . ..P numbere: Cather: ST,TF PION A I are: EXPIRES REVENUE DIVISION TOTALS--> COLLtCTED : 27, 00 OVER/SHORT; 00 • Poky Number. 11R1R90-QSSIfi 4I, 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANICIC FIFES SMIP/TOT GRADING PLAN—CHECK (This section sed not be competed f to derma s for one hist doers Mir. r ' ❑ I tarty that in the parlormenee d the work ler which this penes u'.. ,o any manner n as to f v ,� become subjed to the waken'copersation Laws d Catmda, to the workers' ****************** ***************3B**********ib*3F�E****************************** Dentsatipn pnwtslem ion])00 d lM Leber Cods.I shall l APPlicara: � I N D I V I D U A L , F ,E E •' B R E A K D O W N Warning:Failure to secureworkwa'compensation coverage b . adahsllsubjectsn ••loyertoctlnS'- panaidusnd TYPE QTY DESCRIPTIONx } UNIT COST TOTAL COST Seq• civil fines'to one of the Lebon Cob,thousand !MeresanteiRom��l odldonro the roar of compass •Rdamsgu sprovbW for In v ` MEC 1 INST/RELOC RECESSED WALL HEATER CONSTRUCTION LENDING AGENCY:I by effuse ander penally perjury that then construction e ron lending agency'lee4 r the MEC 1 GAS PIPING SYS 1 — OUTLETS Mosby f 3 . 00 3 . 00 pedamercedlM work forwhichw µNAME: is Spied(Section aoeT.Civ.C). END OF FEES i* .�.y • L' DE"S DDRESS: y 1...: • 1 certify that I : -read h' . ..- �f Me thio the above information is coed.I agree to comply with all cityeb and county ordinances /' / • '.i , and aWak. relmrg •• -NCI•• ^ay• and hereby adlvc.representatives d the city to over upon the abovemervoned property "� • :: .• "'1 f rina..-' pun..: / . VANDES'dERG �' Jr "7 i .M Date •• /— p - - jw ignature d Owner/ .-W.: • . +T : . .t .. (5151-48 W P) White-Buidng 8 Solely;Green-Re;Canary-Appicant;Pink-Revenue:Goldenrod-Assessor fI CONSTRUCTION AND PLANNING PO. di SPA APPROVALS Permit# - Date Inspector APPROVALS Permit# • Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 13. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test � i 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Uptlrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final_- 12. Sewer Cap _ 63. Heater & Vent-Final 13.-Root Drains 64. Plumbing System-.Final 147,Rough Plumbing - 65. Electrical-Final _ • 15: Rough Electrical-Conduit - 66. Solar System-Final 1€. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' Z27_% FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: !�/G , /_ L z(�` aPIj 34. Final Heating& Air Conditioning P3 6 7-I O IC wet 35. Final Gas Pie-Test /- 36. Hood or Canopy 1 73-7 37. Final Factory Fireplace z-z)� 6 38. Final Plumbing / 4--7A 39. Water Service-Final 40. Gas Service-Final 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING J 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF WILDING: 156 22ND ST. . . 1mm C CITY OF COSTA MESA — BUILDING PERMIT r OWNER'S NAME IF IOCVfl4: KUBOTA, CEORGE •9 PERM NO: P 074523 ADDRESS: 156 2 2ND ST COSTA MESA, CA 92626 ' PERMIT NO: P 074523 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: REP ARCHITECT OR ENGINEER: HARTMAN ENGINEERING UC.NO.: 52434 JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: ARCH OR ENG.'S ADDRESS: 747 W KATELLA DNT: 203 ORANGE CA 92667 CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / CONTRACTOR/SNUME: VANDENBERG PLUMB & CON ST ( 714 ) 842-1781 CONTRACTOR'S MARINO 7285 MURDY CI COMMENTS : REF: B-74516 =mss, HUNTINGTON BEACH CA ' 21576 **********************************iE+Ex*************x* x*******ii***************** 92641 :at ZONING REQU IR EMEN TS LICENSED CONTRACTORS DECLARATION:I hereby affirm under pe ;, of perjury t et - .. provisions d Chapter 9 SETBACKS (.. ....rlonc vrh Section 1000)d Obison 3 d Me Buiness and P. ..... Code.:.• area a. .i . ..end effect. .NO.: 047178 LIG.CLASS: B uc. 5, lP /6 P : 12 /95 MAIN BUILDING ACCESSORY BUILDING se: O ' .� canrsd«: , ,� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 0 ER B • UILDER DECLARATION: Business and Professions Y License Law for the �y city or county which requires a gahe I arn ex pl from the mins t�. .Irw, ars improve, lemdsh,or recti any structure.prior tone issuance.abo r.••es the applicant for such permit to Be a signed statement that he or she PARKING REQ: PROV: PARCEL : 42606119 INE: REF NO: is licensed pursuant to the provieiore ol the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES> : "r.' Business and Professions Code)or that he or she is exempt therefrom and the basis tor the alleged exemption.My violation of Section > • r, 7O31.5byany applicant for a pennueuNects thapWiam to a cilia penalty ol not more than live hundred draarsrS`+DOp. **************-IE*****************************if*iF1N******************************* o I,esownsofthepropertyormyemployeeswithwagesastheisolecompensation,willdothework,andthestructurebestintended DEVELOPMENT S ERV IC ES REQUIREMENT S or offered for We(Section 7044,Business and Professions Code:The Contractors License Law does not appyto an owner of property who bids«improves thereon.end who does such work himself or head or through his a her own amnoyees,provided that such • improvements are not intended or offered for sale.II.however,the building or improvement is sold within one years completion, ZONING APPROVED BY DATE: owner-bulkier will have the burden of proving he or she did not build or improve for the purpose of sale). dI ❑ I.as owner of the Properly,ant exclusively contracting with licensed contractors to construct the project(Section 7044.Business and ii+' Professions Code:The Contractors License Law does not apply to an owner d prowills or i geny who mpres ovthereon end who BUILDING APPROVED B Y : _ t DATE: contractscontrafor such projects with a oorarectods)licensed pursuant to the Contractors License Law). ❑ lama=emptunder Secton: B.6P.C..l«thisreason: APPLICATION ISSUED BY : DATE: /7_J/ 17 * *** �i ************************************ **** €******************* ****i€****** Date: Owner: LEGALIZATION: N F E E SUMMAR Y STRUCTURAL SEGMENT: N I do hereby certify that I ens aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ,e C' 1 /1 25534,end that I or any future building occupant will/wit not(circle one)need to comply with said stale codes and the requirements for BLDG PMT PLUMBING ELECTRIC . MECHANIC�1 FIRE SMIP/RES GRADING a permit for constnalonor modifiationfrom the AkGu n Dania.sria.Residentialconstructioconstruction applications ere exempt from these provisions. PERMIT 42 . 00 / i' lit ': Data: Applicant: 25% , - . I, . SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: PLAN . 't' have andwii maintain acenfiate a consent to self-insure for workers'compensation,as• • '•ed for by Section d n 31the Labor ISSUE FEE 20ISSUE . Code,l«the ad« a mcedthe w«el«wNpermit which this BUILDING—DIV—> PERMIT PLAN CHECK TOTAL PAID DUE /,yy�Ji/�\I have and will maintain worker compensation insurance,as required by See, 700 TOTALS----> 42 . 00 20 . 00 ': r 0 . 00 62t0O 62 . 00 00 •• (work for which this permit is issued.My waken compensation insurancetier end A number are: _ Comer. c'r 'r ' b'ii+,t'y r EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 62 . 00 OVER/SHORT: 00 Ploy Number: 1 ']N 1 ' 90—®///% MM► 04 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANrC FIRE SMIP/TUT GRADING PLAN—CHECK (This section need not be completed I the pemi<ie for one hundred dollen '1001«less less, 62 . 00 ❑ 1 candy that in the performance of the work for which this permit is t- ued,I*MIA to any manner so as to i become compensation�pwgo the workers' compensatione ol tLabe(laws epdsiwai..h agree • '. ....• . subject to the workers' *************************************r*iEIE***********3f"************************** 555 �� INDIVIDUAL:. • F ..EE . BREAKDOWNN Applicant: ili e Ing:Fa0untsecureworkerscompensationcoverage j1 "Tienmy.cranW.csln*SUIP.nsWn.nd TYPE QTY D E S C R I P T I O• N ^2 UNIT COST TOTAL COST I dnes n9 to erne htndred thousand do/bn(5104000), ' Won to ' cost of tempensessprovided ler InSection 3705of the Labor Coda Interest sed attorney'Th' PLU 1 SHOWER 7 . 00 7 . 00 CONSTRUCTION LENDING AGENCY:I hereby arm under penalty of perjury that there'e a • lending agency for the PLU 1 SINK, KITCHEN 7 . 00 7 . 00 perf«manadthe work for elicit this penniis issued(Secton3097.CN.C), PLU 1 WASH BASIN _ i .✓{� 7 . 00 7 . 00 LENDER'S NAME: PLU 1 WATER CLOSET (TOILET) • Y.� 7 . 00 7 . 00 + D "'S ADDRESS: }•rti PLU 1 REPAIR/ALTER DRAINAGE/VF,NT PIPING, 1 7 . 00 7 . 00 Icenifyl .. have read I1 ••icationerdsteetheteaboveinformatiniscorrect.IagreetoampywAhalcityandcountyordinances PLU 1 WATER RE—PIPE „ 7 . 00 7 . 00 and state •we reletitg •• •• ..• • and hereby authorize representatives of this drytenter upon the ebevesnantonW property END OF FEES —,. / purpoeea� I , ; r J R kN1 VANDENBERG / /AJ �`• "i• i Awa ff, Pritt Name Ome: /O�G�T ul :,.):*7' - u. • _ __s 71Trsd,.VAPPbean 1�iTE: i. .. �• ;,y (5151-ca.WP) While-Oink/ sy Green-File: wry-Appian:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING �% PO. : SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location. .7/ 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding --- � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test n. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test , 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Lite & House-Connection 62. Backwash &Receptor-Ficial 12. Sewer Cap 63. Heater & Ve1iOFinal - '13. Roof Drains -_ 64. Plumbing System"- Final - . 14 .Rough Plumbing t:17--c16a 65. Electrical-Final , • 15: Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts,Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test tr/ 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing&Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80, FOOD CERTIFICATE ISSUED 33. Final Electric Notes: Fig .0 L C 211- artate 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test !�/, e a 12th`• ierSt1 =a 36. Hood or Canopy 37. Final Factory Fireplace ,yj 9t n`l 2:77.3:27‘. 38. Final Plumbing `Qr Qr29 . rig-d am 39. Water Service-Final c Com✓ 40. Gas Service-Final `G' to LiGel 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BMLDNO: 156 22ND ST UM-T: C CITY OF COSTA MESA - BUILDING PERMIT I ONNERSMAMENIIOWN: KUBOTA, GEORGE. • • PERM NO: M 074522 ADoxEss: 156 22ND St COSTA MESA, CA 92626 PERMIT NO: M 074522 PLAN CHECK NO: N GOVT: N SUPP: N MPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: REP ARCHITECT OREI ?LEER: HARTMAN ENGINEERING UQNOc 52434 JOB DESCRIPTION : FIRE DAMAGE 'REPAIR SQ FT: ARCH.OR ENO'S ADDRESS: 747 W KATELLA DIT' 203 ORANGE CA 92667 CLAIM VALUE: CALL-VALUE: GROUP OCC : R-3 / CONTRACTO'S NAME: VANDENB ERG PLUMB & CO'-T ( 714 ) 842-1781 =MARGIN'S MNUNO 7285 MURDY CI COMMENTS : REF: B-74516 ADDREst HUNTINGTON BEACH c ...: 157692646 : Z O N IN G R E Q U I R E M E N T S LICENSEDCONTRACTORSDECLARATON:Iherebyatlimunderpenalty• • . • dChapterg SET B AC KS CITY LIC.N wish 4 7n 17 d Dinsw C d She BBnesa and Pmt»u. 4j _A: • b Ieche. crrYuc."o.: 047178 sacclass: B uc. 12/95 MAIN BUILDING ACCESSORY BUILDING ata. �� � FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OW BUILDER DECLARATION:I hereby atfum under penalty�•that 1 em es exempt hot .COOMICI Lice Law for the ., • wing reason(Section MI5 Business and Professions •'d city o courtly which requires a• d to.. .wd.alter.improve. PARKING REQ: PRO V: PARCEL : 42606119 2 N E: REF NO: •olah,or repel any suuclure.prior a its issuance,also - : the appicant for such permit to foe-signed a•,emote that he or she .posed parsuad to the provision.of Ba Contnadas License Law(Chapter B(commencing with •.on •••)of Divbinn 3 of the PLANNING NOTES> ..•niness and Professions Code)or that he or she is exempt therefrom and the basis for the alleged axe pian My violation of Section > 1031.5 by any appliCaril for apermit subjects the applicant toedwi penalty anot mate then rate ...• ($5aDD' TFiElEifiE7EiE9ETEiFIEiF****If#'1F1Eif#1E1EiE1E1E1E1E#)fi(-3Eif#'Ifif1F1E***3E1fiflE'1E'If#iE3fyEi ******iE*****1EiEjE****iE***iE#lf 0 Lproperty mpw as owner of the my eoyeesh wages as thee sole compensation w will do the ? structure isna intended DEVELOPMENT V E L O P M E N T S E R ,V I C E S R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:TheContractors License Law does not apply to an owner of properly Q who bolds or improves thereon,and who does such work himself or here or trough M or her own employees.provided that such impwemens are rat intended«Sind t«salt I.however.to baMkg or enpmmsni b scel wahines year d odnplabn.to ZONING APPROVED BY DATE: owner-bilder welt have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as owner of the property.an,exclusively ndradig with lapsed contractors to cersaud the project(Section 7044.Business and Professors Code:The Contractors license Law does m appy to an owns property who boils or improves thereon see who -BUILDING APPROVED BY : - DATE: contracts for such r suprojects with a ccrrate: tor(*)licensee pursuers to the Contractors License Law). pp ❑ lamexempunder Section: B.AP.C..for bbreason: • APPLICATION ISSUED BY: DATE: /07/// 12 Dee wn.n: aE *#*# Ido hereby candy that hem aware lend understand the requirements of California Health and LEGALIZATION:N F E E S U M M A R Y STRUCTURAL NT:N Safety Code Sed ate 25505.2x5••1,and / 25534.and I or anyur headingheadingwed=opera /we not(circle one)need to comply wsaid an e codes and the reau'aernenb la ' that M - a permit construction omodJrationfrom the arpmwd District ResidaaEdmMrWion apple io n eexempt from BLDG PMT PLUMBING ELECTRIC MECHANtiC( L FIRE SMIP/RES GRADING pry PERMIT ( ''' •20 : (�0 Date: Appfaad: r i/ c�?$ SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby cone under penalty of perjury of the following(federations: PLAN IhaveanewImaboa curd.meocorwerntosel;naoal«wakricanpemaim.esprovkbdf«MSeaioS10DathLeb« BUILE FEE 1'S ' o . Code.fortheperformanceoftewwfowichtaspanabissuw. BUILDING-DIV > PERMIT ISSUE PLANrCFi CK' ' �OTAL PAID DUE /� Ihave and wSmaidanwrkrs'company/On insurance.esnadnd by A -• Code.•• the performance oflM TOTALS----> 20 . 00 15 . 00 " 0 : 00 '1 ' •35 .00 35 00 00 l/ `work 1«w4,15 this perms is issued.My workers'compensation insurance. bar are: Carrier: aTATr PIT' 1� EXPIRES REVENUE DIVISION TOTALS- > • COLLECTED: 35. 00 OVER/SHORT: . 00 Polley Number: t 'Snda/G.CUMMI/V )4/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC • FIRE SMIP/TOT GRADING PLAN-CHECK vat ., section need not to completed Athe s M perm/ one hundred .(slot/« r 35 . 00 I „ ❑ I certify that in the performance of the work tor which this game is 1 . . manner o as to 1 become subject to the workers'conperaMleb«of CaSdoisde.I shall and.are.P. '.• Io the"flume' ***#1E******1t1t#1tlt**dEdEdt#3EftatdEdt#IETt)t M-*eE 1�**#oft*rfEdt)E#It*#L`WE dept*it*iE*dE#dtdti(-*itit******itdtdt**it*** //�� pe%psi/p/a,� 'M' INDIVIDUAL: 'F E E' K13'112 LL�TVyltr-�..IJnp:F.Nun to secure wortae'rocryauaton- aMSIW�aC(ect an aryloya •atlnYw penalties aha TYPE QTY D E S C R I P T I O; N h UNIT COST TOTAL COST Il fines rpt to one hundred thousand dollars(5104•• ••• •,•n to the coat of compensation. • •• a as provided for In s.aton3rzcatm.Labarcods,lme+stad.dm.r: MEC 1 INST/RELOC RECESSED WALL HEATER „ 9 , 00 9 . 00 CONSTRUCTION LENDING AGENCY: I hereby slfnn under penalty of perjury that then b ry le a •• - •an lending egenr the MEC 1 INST HOOD W/DUCTS FED BY MEC. E&HAUST 6 . 50 6 . 50 performance athe work for which this permit is issued(swan3on.Cir.q. MEC 1. VENTILATION FAN CONN TO SINGLE 'i'( 4 . 50 4 . 50 LENDER'SN E: END OF FEES•, ' i LEN•"'S 0 • ': • „' I candy that I : • ead tis... 1• - stale .above idonnalbn b coned.lagree to can ply wh at dy and county ordinances w l,t ` fir ; -; SV hI ed state lees illus. .. end byeWwbe nepneeeNaiaasdlkesayasnter upon led abwa.nad'oned property 4 .-t V , «mod«•• .•.- F���TJAP�NBERG mow////)� /�///� • •- ' .•. Dae/2 iG ✓�/ - - .1•.; ` . 1:''1 (5151-46.WP) Weddig A Seamy;G atham :Cy-Appio:Pink-Revenue;Goldenrod-Assessor M - CONSTRUCTION AND PLANNING POO' SPA - APPROVALS Permit# 1 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location/ 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE - - 7.tFootings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap - - 63. Heater & V.er -Final ' 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final _ - - 15. Rltugh Electrical-Conduit - 66. Solar System-Final • I 16. Rough Electric Wiring 67. Fencing & Access Approval 17. ?lough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling ,�� 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 7�At ,7-�{iA,f FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace L ` ��• APPROVALS Permit 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas D Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATEIFISSUED 33. Final Electric Notes: F./ 9 '- � Qout!Qa93%/ _�Z�l 34. Final Heating & Air Conditioning g - q-` 74 c,( • S/ 35. Final Gas Pipe-Test .' 1.:±24 - z '- iA 36. Hood or Canopy23-7-6/ .�'► 37. Final Factory Fireplace Z-2t2:5 ies_ 38. Final Plumbing ` .-'>X 9 t_ ctiyug. Gam` 39. Water Service-Final _ ."L -�C- C-4721.1Chard, 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date • City of Costa Mesa • California 92628-1200 P.O.Box 1200 Insulation Certificate Permit Number .6 73°R / . • iso E . adnd 5!• Ccihz 197esa._ Number and Street City • t qc C� fy /County Subdivision Lot Number Description of Installation ROOF C% G� Material � �?/79� 77G�� 0/7 .2-� y/' Brand Name ( eiXS %� Thickness (inches) Thermal Resistance (R-Value) EXTERIOR WALL Material a/(AXO Brand Name Thickness (inches) Thermal Resistance (R-Value) CEILING II • Batt or Blanket Type N��a-/i/n7 Brand Name 47 cui i', i/e Thickness (inches) g." Thermal Resistance (R-Value) _/2 -tea Loose Fill Type Brand Name Contractor's minimum installed weight/ft2_ lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR • Material Pie - in 9 Brand Name Thickness (inches) Thermal Resistance (R-Value) • SLAB FLOOR Material /arc - tXi31-in9 Brand Name • Thickness (inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Material Pre - Ex/-s71/In 5 Brand Name Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adminstrative Code. VP( /1 eLS-lDrQ fi&1 Co/7717,o cbLk c • Sa/ 5 7 CG Ge oral Contractor(Builder) License Number j c (4u40 5—/c27(//9 Signature and T e Date Sub-Contractor(Insulation Installer) License Number Signature and Title Date • 1907-46 St ECT PROPERTY INFORMATION O 1) Property: 156 22ND ST, COSTA MESA CA 92627-1737 C016 APN: 426-061-19 Use: TRIPLEX County: ORANGE, CA Tax Rate Area: 15044 Total Value: $89,880 Census: 632.01 Prop Tax: $1,585.90 Land Value: $41,550 Map Pg: 31-E1 Delinq Tax Yr Impry Value: $48,330 New Pg: 889-B2 Exemptions: Assd Yr: 1997 Phone: % Improved: 53% Owner: KUBOTA GEORGE T/TR Mail: 24841 LA VIDA DR; LAGUNA NIGUEL CA 92677-1917 SALES INFORMATION IMPROVEMENTS LAST SALE PRIOR SALE Bldg/Liv Area: 2,820 Transfer Date: 08/27/92 05/17/76 # Units: 3 Sale Price/Type: #Bldgs: Document#: 569833 1173801632 #Stories: Document Type: $/SF: 1st TD/Type: Yrblt/Eff: 53 Finance: Total Rms: Junior TD's: Bedrms: • Lender: Baths(F/H): Fireplace: Seller: Pool: Title Company: Bsmt Area: Transfer Info: Construct: SITE INFORMATION Flooring: Air Cond: NONE Improve Type: Lot Size: 60 X 127 Heat Type: Zoning: Lot Area: 7,655 Quality: County Use: 2 Parking: ATTACHED Condition: Bldg Class: Park Spaces: Style: Flood Panel: 060216-0047E Site Influence: Other Rooms: Phys Chars: Legal: L1 TR269/SELY 60 FT Comments: 2-2BD,1BA;SFR 1966#. Copyright© 1996-97 Experian Page: 1 of 1 OWNER KSERSEY,—Albert DATE 9-20-62 JOB ADDRESS 156 E. 22nd St. BUILDING PERMIT NO. 17851 GENERAL CONTRACTOR Owner-Bldr. VALUE $ 125.00 AP No.118-081-19 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Det.Carport IN°PECTIONS Signature DATE GROUP J TYPE V ZONE R-2 PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous _ Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power Li- t/Rough Wiring • Trenches U Forms U Steel Remi. U _ Floor System Bond Beam 0 Steel Reinforce 0 _ • Sheathing Frame and Flashing Lathing — In 0 Out 0 Plaster, brown coat • g,J'"4 ^,. 0 Air Cond. 0 Final FSS--,:,i°ng, Final Plumbing Fixtures, Final • Final Gas Test Electric Fixtures, Final Building, Final '1,/r /l_ yo-L?- OCCUPANCY m rst r 4T Fua 1 7RSl ---" ` t 17851 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT SEP 201962 P. O. BOX 317 COSTA MESA. CALIFORNIA TTFIINppAF�NCEOp����DppEP11E�.��pp0 For Applicant to Fill In Completely AP9LICATIONTOR PERMIT TYPE OR PRINT BUILDING BUILDING rt/ / ADDRESS COSTA MESA. { CCALIFORNIAFor Office Use Only OWNER(24124 4 (- (�C'/ji-,1)..y. RECEIPT HO. I '1765 I MAIL f/r/ „ /me- RECEIVED Y -_TE_ RELBIV/gq� L�pAITE-IBI}3JlU�EV1D ADDRESS/ 7 G .��"� • �B/y.�T//JJ) CN (// �p�J/�!OL�II /V^/ '1i/-i /Fi�CL- TEL/y) / r'/CDDREIBS I ��f0 C� - 2 i_ CITY e- ✓/,�{ NO/1/,tom_3 RROOOD ARCHITECT --- -- TEL. COSTA MESA. CALIFORNIA OR ENGINEER NU. FIRE v/ ADDRESS �� ,. ,( /J� // ZONE TYPE GROUP /�' CONTRACTOR' (�.i2/7- e-e. ( _c.-1.-- ��*,fi APPROVED DATE UUU� ADDRESS /M ^ZONING &P IA" E _I/ PLANS / I B8 LDING BW [ `" CITY STATE TFL. LEGAL /� 169 9 LIC.NO. NO. L/( i / �•\ �6 / / A + ?/� ( }�{7 DESCRIPTION / y/+ OF ELOT 10 � J'J /• J li I NOW ON LOTNO OP S A.P.NO. I / 7-c S 1 ` %/- USE OF YARDS EVES EXISTING BLDG. APPROVED ,,(( ALL��O^^WED TE CENTER OF SETBACK INE STRETTM #7 / REAR YARD / FR NT LINE BT.) /_ FT. )..}:f IN. .{ SIDE YARD I LEFT I I RIGHT ?t R.SIDE .�5 IN. DESCRIPTION/ OF WORK L.SIDE LC FT. i IN. VII II ALTERATION I II ADDITION I REAR p FT. l' IN./ REPAIR 1.2 MOVING I II DEMOLISH APPROVED (A/C�4) DATE 9'-' )0-1p SBUILDING Xy Xa0) / NO. OF ROOMS STORIES 64/17) EXTERIOR WALL---ROOF Q COVERING I COVERING Al /p USEPF BUILDING AND}WORK PERFFP MED l ,C.../i./ 4 2- ezi r r/ • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION �' 61GNATURE OF _ PERMIT FEE Si ' � ' PERMITTEE ^ P G�.✓ W B 1 $ /�� PLAN CHECK S `K AUTHORIZED AGENT / I3 ' TOTAL FEE $ y TOWNER CRAIG, 'Norman DATE 1-27-71 Ctt JOB ADDRESS ` 156 E. 22nd Street BUILDING PERMIT NO. 32671 cam.GENERAL CONTRACTOR, Eason & Sons Const. DESCRIPTION of WORK Dplx.w/att.gar. & storage PJ /`' 'o118-081-19 LOT TRACT FIRE ZONE VALUE $10,900.00 v 0) ECTIONS Signature Date GROUP I & .T TYPE V ZONE R-2 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing . ✓ A ROUGH PLUMB I NGPQ -2•n -u�, 'iii,- , .l PROP. SWR. LINE HOUSE CON. SA ./r 1d SPRINKLING SYSTEM MISCELLANEOUS ' ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 /,,t/ +y ROUGH WIRING /rjL �23•// Heating and Veer. TRENCHES [ FORMS © STEEL REINF. © /1,:•ItyK•, i-rt-l// FLOOR SYSTEM p/f(, i_st•-r/ BOND BEAM n STEEL REINFORCE n SHEATHING 7/ FRAME AND FLASHING t°,:ciatTer //// LATHING — IN OUT /7� I PLASTER, BROWN COAT II S 'URAL, FINAL i,• 9N it 1 HEn.ING, VENT., REFRIG. AND A.C., FINAL ----see 7 7y � ,(U se,97—LOlytei, PLUMBING, FINAL AND GAS TEST n /-1 --.7--ze ELECTRIC, FINAL _�•=11r 77 BUILDING, FINAL • 41 °- 7-7y ' 3267I1Nl 27-71PAIDoo 785* ****70.5C [LISA COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely r� gECEI, D B DATE RECEIVED; DATE ISSUED7 `7 BUILDING l' / Z.Z L,A <'/ Il -L �2 ---W / �.I `L• '- // ADDRESS LO /.' OWNER ,(I•1RIA" AAI Cita tat C.+ A.P. NO. Ilfi-o81 - 19 PERMIT uMITS /MAIL ( \ BUILDING ADDRESS ISL, - Z2/vd ADDRESS /�C� ZZLD �I q_c Z !� 0.U CITY Ccs All ra, NO`S 74 La TE . TRACT 0 LOT / BLOCK Z Z Z CONSTRUCTION I'1 NEW ADD ALTER REPAIR MOVING DFMOIISH O LENDER X X COCL r J D BRANCH '. // JN OWNER Aln2diet NA! 62.A./6 Q W ADDRESS del 03 J - VALUE / p m ARCHITECT TEL. USE S/O, P7!l J Q OR ENGINEER NO. - - Z CC FIRE in-. LL ADDRESS ZONE TYPE GROUP •+"' O. 971 — - /J APPROVED BY A� 27 ATE/� 7/J CONTRACTOR 2�ASc7QSO.4_/S �-Q/iSZ CO W W ADDRESS L� // izi ZONE NO.OF USE OF NEW 1-SroeY �� / TEL �/7 K-Z PLANS Ca BUILDING / Z r clry ,Uq� G! NO.'f O !09 7 t1Nln w .FTrHrµ - O STATE CITY YARDS APPROVED YARDS APPROVED 64-'-6• coLLI ¢ LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O e (FROM C/L STREET) SIZE NO.OF BLOCS. L / -yl-- 1.-- OF LOT J NOW ON LOT FRONT �'/ FT.ioe a.. 4 T.L=rct) USE OF Laid/ EXISTING BLDG. R.SIDE /0 FT. EC sr FT, I- SIZE OF NO.OF �7 Z NEW BLDG. ROOMS 3 STORIES 2 L.SIDE Ir FT. 4t d____ FT. / VEXTERIOR WALL ROOF /LJ/ /� ' _ COVERING COVERING REAR FT. /L� FT. J USE OF BUILDING AND WORK TcliBE PERFORMED�(JDISTANCE BET. r7 t BET.MAIN& d /- i F4/4-1 IZE� Anti GoaMS MAIN BLDGS. .j/ ACCESS.BLOCS. `tea i �/- 2-�7/ 2 T gaDoi7N .V�- ''2E-91 -70 APPROVEDSepi 21 (??a V to �( A� / APPROVE W / 'i co LA.i rel Itirkcdtc"yy7 2- (dr oarLtw� ABY DATE /-76,-7/ �' O cF- Srof4o -gammy 5-doe. 0 j. ,n �� 1 hereby acknowledge that I have read this application and state C a !r) P4oU� 2H' /=/ 2 -9t-'/U that the above information is correct and agree to comply with J l. `.2 all laws regulating building construction, and I shall not employ 4 any person in violation of the workman's compensation laws of the State of California S2 9s9y m I hereby certify that I am properly licensed as a contractor under ✓ SO. FT. / a the State of California Business and Professions Code, Division 3, TH AMOUNT SHOWN UNDER V DATION IS FOR m Chapter 9, and that such licenses are in full farce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: [a am exempt from the provisions!thP State of California Business VALUATION / �] Mt and Professions Code, Di i-i• ,Chapter 9. /f / PERMIT FEE $ t' Si0, 7 4 Signature of /r/� 3 J n m Per•• �� $ PLAN CHECK $�✓ E Authorized •Beni ��O vz TOTAL FEE $/ Se LL