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HomeMy WebLinkAbout2959 FAIRVIEW RD - Building Permits OWNER JONES, KEITH DATE 3_13_78 OB ADDRESS 2959 Fairview Road BUILDING PERMIT NO. 45644 ENERAL CONTRACTOR Monica Res meant Exh. DESCRIPTION of WORK Dry Chemical System /,44P No. LOT TRACT FIRE ZONE VALUE $500. IN CTIONS Signature Date TYPE GROUP ZONE ol_ PERMITS ISSUED AS SUBCONTRACTOR I I Date Number Signature ATER Plumbing • OUGH PLUMBING OP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER El ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS IJ STEEL REINF. U FLOOR SYSTEM • BOND BEAM n STEEL REINFORCE n SHEATHING FRAME ANO FLASHING LATHING — IN n OUT in PLASTER, BROWN COAT STRIIrTURAL, FINAL Electric HE ;, VENT., REFRIG. AND A.C., FINAL PLU,.,aING, FINAL AND GAS TEST in ELECTRIC, FINAL A �A.. ,/.�� .may BUILDING, F IN ALL •/ V/Z //t OWNER Furniture DATES-j1-78 JOB ADDRESS 2959 Fairview Road BUILDING PERMIT NO. 45743 GENERAL CONTRACTOR Western Neon Co. DESCRIPTION of WORK Elec. Wall Sign AP No. LOT TRACT FIRE ZONE VALUE E 500. (7P CTIONS °" Signature Date TYPE GROUP ZONE SUBCONTRACTOR PEf2MIT5 ISS�ED AS Date J Number Signature ^TER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ED SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. . TRENCHES FORMS STEEL REINF. U - FLOOR SYSTEM^ BOND BEAM L STEEL REINFORCE in SHEATHING FRAME AND FLASHING LATHING — IN fl OUT fl PLASTER, BROWN COAT STR'"'TUBAL. FINAL Electric Co •HE ). VENT.. REFRIG. AND A.C.. FINAL (i./.d pti Y.tni o , 3-.?t(/ "4 3QV PLUmdING. FINAL AND GAS TEST fl ELECTRIC, FINAL it 7-il BUILDING, FINAL 71/- ) .0511 6 CITY OF COSTA MESA 4BUILDING DIVISION :j „„• ;.�i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �.nPERMIT �+ 601-00497 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2959 FAIRVIEW RD Status: ISSUED Suite: Applied: 04/13/2001 Vicinity: WHOLE BUILDING Issued: 04/13/2001 Parcel Number: 14120219 Zoning: Cl Cl Applicant: HANSEN, DUKE ISSUED BY: Address: 260 E.ALTON AVE ' Phone: (714)557-7440 SANTA ANA,CA Zip: 92707 , Owner RISCHARD, THEODORE E TR , Address . 18901E DODGE AVE . ", - , Phone: SANTA ANA,CA Zip: 92705 . ' p B�•,D Contractor: ROSS & BARROWS INC. DATE II b Address: 260 E.ALTON AVE Phone: -(714)557-7440 r SANTA ANA,CA Zip: ' 92707 'License: ,'327802 - Arch : , ' - Eng:, Address: - . - Address:• ' , - Phone: - Phone: r Zip: License: N License: - r-+ .,. - ' - SCOPE OF PERMIT , -- ' REROOF EXISTING COMMERCIAL BUILDING(40.SO).TEAR OFF EXISTINGROOFING'S,INSTALL NEW 4-PLY BUILT-UP \''• ROOF SYSTEM. - - S • 1 ' . -. FEE SUMMARY% 7 ' _I ,Plan-Check:. $0.00 „ . Calc Valuation: % ; , $8,892.00I Permit: $167.25 i/ Claim Valuation: ' $13.892 00 'SMIP Res:, $0.00 - , , - %/ r SMIP Com: ' $1.87 Other v.,$0.00 i�/ / ' /r Inspection:--' $0.00 % / �/ /, / , :Total: $169 12, i `a _� �,-.,' T /r � �� \s,A��, \*�� , ,`PLANNING&ZONING x �/�'U� 7)/ ii SETBACKS\\\-\,- �/<‘ —- , i�-) MAIN STRUCTURE'Front o-6:- /, ''Rear - 0 0 - Left 0-0- - Righty - 0-0' _,;- .1:\ \\":1-__77,6,/- ACCESSORY \"% ;('/ �' ACCESSORY Front -,�0-Cr-, �; Rear 0-0 -.Left -;, ,0.0 -�)1 �� \ � Right" ,0-.07 PARKING Existing: 0�-'Required: '0- ''. A-A-Proposed: -'0 _ . �� NOTES: ,_ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the _ work for which this permit is Issued. _p—I have a`nd will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'/ compen tion In ra ce carrier and policy number are: // Carder. ,C ��5 �/`� lose y.Number._ a�L C' – 0 ( 0006.3 0Z (Tis section need not be completed If the permit is valued at one hundred dollars(5100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if 1 should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these r visions. Cr -2 Applicant Signature:_ t i, ��� Date:_ _! — 7✓-0 7 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am.liceosed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and ProfessionsssCode,and my license is in full force and effect.Lic:x� 7 SO 'Class x/ L – 3 ContractorsS`gnature; e.4 ry as >L(- /3 - Of I CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and.Profe`ssions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant tee civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly;ar my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation live(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or wit the applicant or present or future building occupant require for the work which is the subject of this application aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penally of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHOR¢ATION.OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sl/g/r)ature Of Owner(s) DateAnd/Or Authorized Applicant Date - -- - CODE L INSPECTION TYPE PATE' EBBW SODS( INSPECTION TYPE 263 INIKILL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval . 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA • PERMIT NO. TRACT NO. LOT NO. BLDG.NO. • 2109 6/ 12/54 5800 TL CONSTRUCTION PERMIT /��p 3� • , . Project Address 295Q' Fa4r sly t RA C sta MAca 92446 TYPE OF CONSTRUCTION U NEW U ADD P'I'ALTERATION 'U,REPAIR - ApplicanYS Mailing Address " * 545/ • ; Crenshaw Bl. •L.A ❑ CONVERSION ❑ DEM ISH ❑ OTHER' A;P,,.i(6 I Zone Phone 557-7313 ' DESCRIPTION OF WORK DC-nangeout-Water.Heater _ Owner's.Name - Midori - - S Main Building: • Accessory Building: ,295Z Address - - - N 240186 TYPE OF PERMIT U GRADING ElFOUNDATION U• •$T RUCTU RAL T Front - N Arch/Eng. - License No. ❑ TENANT El ELECTRICAL © PLUMBING ❑ MECHANICAL _ B Rear - • ' I Address - - • ' -❑ OTHER . . A N ROJECT DESCRIPTION 5D. FT. OCCUPANCY C Right _ • , - G Contractor's Nam¢ A1ce. Plg•_fs Iltg.• Phone 213 789-91J� CON ST RUCTION TYPE VALUATION$ 4?S•U0 g 'Left - E Address(mailing) • 5657 C1eu5ltdw 81. L.A CA 90043 ZONE GRADING CU.VDS. ACRES City License No. 3020' • I - Ping. Ref.# Park:Fees $ 0• LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I • - . I hereby affirm that I am licensed under provisions of Charter 9 (commencing • - - Use of Building: - • • R with section 7000) of Division 3 of the Business and Professions Code,andE f� my license is in full force and effect. License Class r'•F /— se jvo. 9A0186 - • - PLUMBING FEES Planning Notes: M• I? Date__,_? .— Signature nn �' E -•CORKERS'COMPENSATION DEC • RAT1. Bar Sink Showers T •ereby affirm that I have a certifi•:fe of consent to self-insure or a certificate • Backflow Preventer Service Sink • S . Workers'-Compensation Insurance, -or a certified copy thereof (Section' - - 3800, Lab. C.) , , Backflow Irrigation Sewer Cap • ' • . ELECTRICAL . FEES Policy No. Tap-RL-(199$9/+' Comp ny . e.•.e • T. - •, kitecopy is hereby furnished. i • Bathtubs , Sewer Connection Automatic Washer Transformer ❑ 15-50 KW • 1F' Certified copy is filed with the city Elul ing Dlvl ion - • I ❑' 50+ KW •. Uate 5 23 8/1 Applicant Clarifiers • Solar Collectors _ Construction Pole-Sub. • EXEMPTION FROM WORKERS'CO ENSAT DECLARATION' ' Dishwasher Solar Piping Cooking Unit - • Meter Duo to 100amps (This section need not be completed ' he permit is for one hundred ($100) or less). DrinkingFountains I certify that'in the performance of the work for-which this permit is issued,I . Solar Tank I Dishwasher Meter Dover 100 amps shall'not employ any person in any manner so'as to become subject to te - - Workers' Compensation'Laws of California., Floor Drains Swimming Pool w/Spa • Dryers ❑Gas,❑Electric Sub Panel - , Date Signature • - — NOTICE:If,after making,this dediaration,you.should become subject to the Floor Sinks Urinal - - _ • Fan _ Motors❑0.1 HP ❑1'h:8 Workers', Compensation provisions of the Labor Code, you must forthwith ' 4 • - -' comply with such provisions. or this .permit shall be deemed revoked. - Gas Service • 'Outlets Water Closet - -' F.A.U. . 'Inc.Solar 09-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ' Interceptors. .Water Heater 2 00 ' Fixtures -• ., "Microwave . • • of the work -for which' - this permit-is issued (Section 3097 Civ. C.) , - Lender's Name. - Kitchen Sink Water Service , . ..- Device Boxes 1 • Pole Light i ' Lender's Address Lavatories r •� • OWNER BUILDER DECLARATION - - . •. . • Outlets bRange I hereby affirm that I am-exempt from the Contractor's License Law for the p-Tra following reason-(Section-7031.5 Business and Professional,Code: Any city or _ p - ' , . - _ Switches, - - , Sign • county which requires a permit-to construct,alter;improve,demolish or-repair - any structure, prior to Its issuance, also requires the applicant-for such permit Roof Drains • - • - . „ - •- : Garbage Disposal 1 . Standing Sections , ,to file a signed statement that he/she is licensed pursuant to the provisions of • _ - - 'he Contractor's License Law(Chapter 9(commencing With Section 7000)of -- Generator 00-5 KW ❑5.15 KW Trash Compactor vision 3 of the Business and Professions Code) or that he/sheis exempt - • .. . •refrom and the basis for the alleged exemption. Any,vlolation'of Section - . • J31.5 by any applicant for a permit subjects the applicant to a civil . Reins coon Fee $ 3 cpeenalty of not more than five hundred dollars($500). I pe - $25 - Issue Fee LLJI I, as owner of the.property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work, and the structure Is not intended or offered - FEES . l✓` I ---••••eir for sale (Section 7044, Business and Professional Code: The Contractor's - • PUBLIC SERVICES REQUIREMENTS:' License Law does not apply to an owner of a property who builds or improves Boiler , . Hood or Type I ❑ •- • • thereon, and who does such work himself/herself-or through his or her own Zoning Approved By '• Date ' employees, provided that such Improvements are not Intended or offered for Duct-Under Ground _ Canopy ' Type II' ❑ sale. If, however, the building or improvement Is sold within one year of corn- Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- r rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued,By 0 Date I. as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tracors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License'Law does not apply to an owner of property who _ PERMIT $ • SMIP builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration . $ ' tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK `- $ - PERMIT ❑ cam exempt under Section - B.& P.C.for this reason Firepl/Fact.'Bit. ICBG# • P•LUMBING ��' y`s�.00-$2-QQ ISSUANCE $ '4� - - - - - • PLAN CHECK ' $- - ENERGY P.C. ' $ • Date Owner Heating System& Ducting I hereby certify that have read thi .••licat and state that the above ❑o-100,000 BTU 0100,000 BTU ELECTRICAL $ GRADING $ information is correc agree to c• ply ith ity and county ordinances - and state laws relay o building co • ructlo- d hereby authorize repro- PLAN CHECK $ MICROFILM ' $ ' sentatives of this, to enter ••n the a•• -mentioned property,for - 7 Inspection purpos MECHANICAL $ . TOTAL FEE $ 5.00 Signature ►/�! Elate Reinspection Fee $25. Issue Fee $ 3 PLAN CHECK $ - Drivers' Licens. •r Sap • • - CMF 0865-46 ev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - CONSTRUCTION AND PLANNING • P00 'PA APPROVALS Permit 4k 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 , s 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 . 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 ❑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: Mo wq-rru . l4-€.4TFR.. IK BU{LD flS. 34. Final Heating & Air Conditioning 141117C C.E.D. 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace . /J 38..Final;(?IWWmbing _ �s'1g4�1 "` r 39. Water Service-Final �,_, �y�y J20 7 1� ,�+i __AL"11947 40. Gas Service-Final ✓ 4 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• . • a,. &yr / 016 / 963 *** AUG 19-770001751* 214.45 44519 s .- COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP I AT ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only _ RE DATE RECEIVED DijTE ISSUED BUILDIN -1IS' i . Anal �' 0.- 5-- -74 ADORES // .'yr �H� C. �I S ChliCZD �/ p ERMIT NO. OWNER CA.P. NO.I//� &°Z-// BUILDINGMAIL �s 7-Cr? �//fQ y/e W /Q0A11 ADDRESS ADDRESS Z.I f ^ A TEL /r/F.0 2 I./Y- //'Z_ 8 CITY,J�\/VT14 014, NO.,544374, TRACT LOT BLOCK CONSTRUCTION J`EW ADD ALTER REPAIR MOVING fFMOI ISH LENDER !�\7 ;"� BRANCH 9` - i - OWNER�F� J�,(s GFfALUE f ADDRESS �,/JT VALUE ARCHITECT YLc`//� 1. FAVEZO..A47G/f16 OSS *`-'�dIL S,f Pc $ ��`dlJ OR ENGINEER 7 ^ ' lNr��C 2027 N. /�AIta FIRE ADDRESS rTANr� �^I/A ZONE TV GROUP F.- 2- ��\ ByPROVED DATE/O"-S 7� CONTRACTOR / wr"\��fl N ()t LjX-2S l{JC ADDRESS /S7Z $ C-7/2A1\3 (? ZONIE NO.OF USE OF NEW R 4'Z - CITY IjANT✓� !-� //ss,,`� TEL 714-l�l✓� NO.647 93 17 C-/ PLANS a BUILDING COnMt'alL SrCCES f' STATECITY YARDS APPROVED YARDS APPROVED LIC.NO. 736O �} LIC.NO.636/ MAIN BUILDING ACCESSORY BUILDING [al SIZE U NO.OF BLOCS. ��++ (FROM C///LL STREET) /� �/y L OF LOT 25764 I J NOW ON LOT V FROM/ '9 FT. (Z 'FTY r Q USE OF I ,! /VI / /��/ l�//, EXISTING BLDG. A/A. B-SIDE qi FT�'J'(I C,/` /l/(�jf, q cn 9 Separate permits are required for L.SIDE /L/FT. Yr, r/6ik'F/[!/73-( electric,plumbing and heating work. ( /r D REAR `/FTC/ FT. USE 0 Lon I�D VSOt I TO PERFORMED DISTANCE 9S. BET.MAIN& !/��j{, W.0 TO S MAIN_ BLDGS, ACCESS.BLOCS./ 7.1 �k^�-/POr(�///?' .� of / G2�/�� C.U.P.g167�%/7ç/ ATE7e -q--gd APPROVED/ .. 777 )1. £i= I /'T"/L (/�/TS //C L1VW . BY APPRO��6E, CCCIII7/W 0 I hereby acknowledge that I have read this application and state n g that the above information Is correct and agree to comply withce C. all laws regulating building construction, end I shall not employ s' Z any person In violation of the workmen's compensation laws of W the State of California. ��////f I hereby certify that I am properly licensed as a contractor under gift)SO. FT. tmv (t the State of California Business and Professions Code, Division 3, T E AMOUNT SHOWN UNDER VALUATION IS FOR m \ Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions f the State of California Business y VALUATION PERMIT FEE $ and Professions C da,D Vitali 3, haps 9. v+ f PLAN CHECK $ 264;04 m Signature of /at� /rp , Permittees TAX $ g, o U Authorized Agent ` TOTAL PAID S .2/ (/o- tf.5 i • 514/2 OCT —5-77PF1000 211 0*** p� PAID 317.01 •- COSTA MESA BUILDING-S ETY DEPARTNTENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP C T ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECE DATE RECEIVED BUILDING �Q/� / fJ /.y�i�js DP/JAE ISSUE ADDRESS QC—�.7 / �I 1i�.3 II`yILIW •`r/ / ✓�O 1� Q ERMIT NO. OWNS Rare e A,C/0 A.P.NO. MAIL ADDRE SWIG/ 13 S ADDRESS ADDRES�� CITY NOL TRACT LOT BLOCK CONSTRUCTION NEW ADD I ALTER I RFPAIR I MOVING OFMOLISH LENDER BRANCH OWN E R' OWN E Rerlen IE ch 42D ADDRESS `VALUE ��� ARCHITECT TEL. i USE �� e�.7 $ OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW CITY NO. PLANS BUILDING *.. STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING (y SIZE I NO.OF BLOCS. (FROM C/1_STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF Cn EXISTING BLDG. R.SIDE FT. FT. V) FSeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS. BLDGS. ��J VAR. DATE ', sirC.U.P.9W APPROVED Q APPROVED }..l _BY DATE C4 La O0 I hereby acknowledge that I have read this application and state o h. cc that the above Information is correct and agree to comply with m 0. all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of e the State of California. - 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses ere In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business PERMIT FEE E3/ /.y y and Professions Code,Division 3,Chapter 9. VALUATION —H w AN CHECK $ nt Signature of o Permittee $ TAX E n ✓i-U �Authorized Agent TOTAL PAID $ /' i y . - St J44 • COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 7187 r/I'/7P 5o5L. Th APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only D$ i 1 �� ��J��,i i. ( RECEI� DATE RECEIVED' gTE IS U. rt ) BUILDING [ / 11 ((S Z/V1y ADDRESS K... { 4 J P• 1h / PERMIT NO. OWNER A.P. NO. MAIL // A BUILDING ADDRESS //r �%r \ -J3 .g_cc a_) �.s; ADDRESS CITY ,m cT/y M c N(3, /'6iSt 'S✓ TRACT LOT BLOCK CONSTRUCTION NEW I ADD ALTER REPAIR MOVING nFMOLISH LENDER • BRANCH ' OWNER " ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER NO. FIRE ADDRESS ZONE {� TYPE GROUP AA APPROVED /)�0/C/�1,�]�J CONTRACTOR XA(�r<� I( ,(J � Qi Y-11, BY DATE ADDRESS e.� Tl \\J P4rN\. ^ , '' TEL. ZONE NO.OF USE OF NEW CITY C Pk) / ,/,4. NO.3'/7, PLANS BUILDING iw STATE ) CITY �} YARDS A 'ROVED YARDS APPROVED LIC.NO."5/ 7 C1. % LIC.NO. / 7/ MAIN BUI• •ING ACCESSORY BUILDING WI SIZE NO.OF BLDGS. (FROM C/L STR' T) n. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF 4 EXISTING BLDG. _R.SIDE FT. FT, C/) (–• Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. O REAR FT. FT. W USE OF BUII-DING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAI & MAIN SLOGS. ACCESS B .t.. /� ''11,, �/� / VAR.# DATE Q (.'oe \ AA C1 .L.ttb — \I�. >1? i C.U.P.* APPROVED j. t. /hi�M. 'll r�1 /�Y� -I gAk BY APPROVED DATE bd /t`( t-kc0 7 w o. O I hereby acknowledge that I have read this application and state in n I$$ that the above information is correct and agree to comply with m M all laws regulating building construction, and I shall not employ Zany person in violation of the workman's compensation laws of y, the State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, 3 THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business to VALUATION PERMIT FEEv and Professions Code,Division 3,Chapter 9. $ 5i �� in 00 m PLAN CHECK $ �– ^ Signature of - it o Permittee �V_-LJ6�1a'tt` J,` $ �O TAX a LL Authorized Agent • ` TOTAL PAID $ .' e 5-0 V