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Home My WebLink About469 18TH ST - Building PermitsF COSTA IT AOP��cant to }ill in all sDacas axca0� tnosa wllhin �aavy OorEer Iines an0 sign all apProO��ate tleclarations. PE�C01T Nq� � TRACT NO. LOT NO. UNIT NU. c o�iS '-�_ � I�p.ppl Cant'S Mailin Addf2u � .S . TYPE OF CONSTRUCTION NEW AOD ALTERATION REPAIR b�Isa�o�S � CONVERSION ❑ DEMOLISH ❑ OTHER q.p,.h6 ' Owner's Name /– Phone DESCRIPTION OF WORK/USE OF BLDG. I AdAress� E�St' %BHl . �Jl."" �'j57�1 /1/%_i4� ��0�.% Arch/Eng. License No. Address Contrnctor's Name Phone Address (mailing) City License No. UCENSEDCONTRACTOR OECLARATION � I he�eby atfirm Ihat I am litensetl untlar prOvislons of Cha�t¢r 9(commencin9 with section 7000) of Divislon 3 ot the Business antl ProteSsions COCe, antl my licen5e is in full force antl eftect. License Class License Na. — Date Si9nature WORKERS'COMPENSATION OECLARATION ereby aHirm that I have a certlflcate oi consent to salLinsure or a cerHficate Workers' Compensation Insurance, Ora certlfietl copY thereof (Section .00, Lab. C.) Polity No. Cornpany ❑ Ceriifietl copy is hereby furnishetl. ❑ Certifietl capy Is filetl witn tne tlty BUiltling Divlsion. Date APolicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl no[ be compleletl ii Ina p0rmit is for one huntlretl ($300) or ICSS . I c rtity tha[ in the perlormadca Ot the Wo�k (Or which thls pe�m�t is i55uetl, I S II not em0loy any pe�sorj�ln any m8nner so, as to becpme sy{>ject to the `NOTICE: H, atter makin9 thls aeclaraElon, you 9houla become subjett to the Workers' CompensatiOn P/ovl5lon5 Ot Ihe Labor Cotle, you mu5t tOr[hwith comply witM1 such Provislons or this permit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCy I he�eby a1fl�m that [nere is a conSVuctiOn Ientling dgGncy to� the perto�mdnt¢ oi the work for which [ni5 p¢rmit is IsSu¢tl (Sectlon 309] Civ. GJ Lcntler'S Name Lentler's Atltlress OWNER BUIIDEN UECIARATION 1 neroby alflrm [hat I am exBmpt trOm [he Contraclor'S LIC¢nse L.aw fOr t�e following rcason (Section 7031.5 Business anU Profe55ional Cotle: Any city or county which r¢quire5 d permit l0 cOnSfrucq altaq improve, tlemOlish or r¢pair any structure, prlor to its issuance, also requtres the applicant tor suth permil to tilo a sign8tl stdtlmenl [hdt be/Sh0 IS IIC<n58tl DurSuant to the prOvlsion5 of tne Contractor's License law (Chapter B(commontlng with 5ection 7000) of 7lvislon 3 Oi [he Businass antl ProlesYionS COEe) o� lhal he/ihe (s ezempt e�eirom antl lh0 basii f0/ Ihe allegetl OxemptlOn. AnY vlolaUon o( Sectlon )31.5 by any applieant br a pereqll subjeets the applieant to a eivil endlly ot not mote than flva huntlr¢0 tloliars (E500). � I. as owner ot the oroPertY . _ . . . . . . . ..,_._, or thelaon, antl wn0 UoeS sucn worK mm5Ci1/�ersert or cnrougn nn o mm � emv�oyoes, proviaetl that such Improvements are not Intentletl or otteretl for sale. If, howevor, tha bulltling or ImPro�ement ii soltl wlthin one year of com- pletlon, Ihe ownn� will hava th0 bu�tlael Ot prOving he/Shrt tliC not builtl or Im- proveforthe purooso of salu). ❑ 1, as owner 01 the prOperty, am exCluSivGry COnitacting with IlcenS¢d con- traClo�s to ConsVuct the Oro�ecl (SlCHOq ]OG4� BOSIO855 dOG PlOfC551005 COCC: The Contracror's Licensa Law doas nqt apply to an owner ot property who builtls or Improves thereon, antl wno contracb tor such orojects with a con- tra<[or,(5111cense Dursuant�to the�Contractor'i License Law). I am aware that prool o( their Worker'S Compensatlon InSuranca shoultl be prOvitletl to me. ❑ 1 am exempt un0er Sactlon B. & P. C. for this reason n Y!� �. A5 n,.,�a� Mnc Ao-.i i M C� /Our 1 hereby certiry that I have reatl tnis application antl state that the above informatlon is correcL I agree lo comply with all cily antl coun[y ortlinances antl state laws relatlng to bulltling tonatruction, antl hereby authorize repre- SBntativei of lhis pity O en[Br up q[he bov¢-mentionetl Property fOr inspection pur os �/_Q.� r ' Signafure Date rl J �rivarz' Licanse or 55 � � TVPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRVGTURAL ❑ TENANT � ELECTRICAL ❑ PLVM9ING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sp. FT. OCCUPANCY— CONSTRUCTION TVPE VALUATION 5 Remarks: Backfiow Preventer Backflow Irrigation Jrinking fountains Floor Drains Floor Sinks Gas Service Outlets Inrerceptors Kitchen Sink Lavatories GRADING CV. VDS. ACREi i_ � . i I 1_ . . Roof Droins Reinspec[ion Fee $15 Boiler Duct- Under Ground Duct � Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO �W Heating System & Ducting ❑ ai oo,000 eru O i oo,000 peinspection Fee � $15 �F 0865-46, �ev. 30/04 White - Builtling; Canary - Applicant; Pink - Accounting; Goldenrotl - Assessor l�LW Showers Service Sink � Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater water Service Auto-Wash Issua Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑6100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers Registers • laue Fee S 3 $ 3 S Mam B� E T Front 8 Roar A C Right K Left $ Ping. Ref. # Planning No Automatic Washer Construction Pole Sub. Cooking Unit D ishwasher Dryers ❑Gas ❑Electric Fan F.q.U. Fiztures Device Boxes Outlets Switches Garbage Dispoul Generator 00.5 KW 05-1 3858 II/08/85 zone Accessory Building: Parkin9 Req./Provided ELECTRICAL - Transtormer � 75-50 KW ❑ SO+KW Meter �up to 100 amps Meter ❑over 100 amps Sub Panel Motors �67 HP �7'rS - 8 IncSolar 09-15 HP �1615+ Microwave - Pole Li9ht � Range ; Standing Sections KW Trazh Compactor �060 TL FEES 2 O N 1 N G R E Q M T S � Reinspection Fee �$15 � � Issue Fee � $ 3 � DEVELOPMENT SERVICES RE�UIREMENTS: ZoninB Approved By nata 8uilding ppproved By !� Date Application Issued By yy Date �� SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING $ ISSUANCE $ PLAN CHECK 25% $• �� ENERGY P.C. $ ELECTRICAI $ b�`! GFiADING $ P�ANCHECK 50% $ MICfiOFILM $ MECHANICAL S TOTA�FEE $ � PLAN CHECK 25% $ � � . ,COiSlSTRUCTION AND PLANNING POO SPA � %APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspec4or '1.'Temporary Electrical Service or Pole 52. Poof & 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 Reinfor,cement 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnii. 57. APPROVAL TO COVER�GUNITE '7: Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 _ �4 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush� 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Ftoof 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. F�NAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster 8rown Coat 79. FINAL INSPECTION , 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. �Final Electric � � 7 7�D Notes: . - � � 34. Final Heating & Air Conditioning � - 35. FinalGas�Pipe-Test - 36. Hood or Canopy 37. Final Faaory Fireplace � .38. Final Plumbing 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomesticFinal � 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 �� C AOPlicant to till in all spaces except those within heavy Garticr lines ana sign all approoriate tleclaratlans. CITv OF COSTn MESa CONSTRUCT/ION PERMIT ' Project o,ddress u-%9 �. /t1 �y S/ ' Applicant's Mailing Address vSa rw e ' Owner's Name �- �' � c,(o w phone�o�/S-.2GG S Address y� 9 E ��= S T• Arch/Eng. -- � l License No. Address Conirac�or's Nam< �� i✓i �54/� E" �O � Phone 6y(-�7yO �Addresslmailing) Y85 _F. /8th $�� eOF,fd'%i�BSQ City License No. 3%% 4�8 7 LICENSED CONTRACTOR DECLARATION I h¢reby affirm [hat 1 am litensetl untler provisions of Charter 9(commencing with sectlon ]000) of OiviSion 3 of'the Business antl Professions Cotle, an0, my Iicense Is in full force antl eifect. ' License C as " �jcensg Ny ! H8 7 Date �" S Signature eY LU WORKERS' COMPENSATION DECLARATION - I hereby atiirm that I have a certificate ot tonsent to selt-inzure or a certificate �( Worke(s' Compensation InSurance, o� a c¢rUfietl coOY thereOT (Section 3800, Lab. G19Yy87- 8S �� F. �( Policy'No. b Company S� �i �'� Certilied copy i5 hereby Fumishetl. Ce�ti/i¢tl co y i5 filetl with the city Bu' in Div i �'�, �a[e �� ApPlicant � � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neednot be mMpletetl if [he permlt is for one huntlretl (5100)br less�. % ' • I certity that ln the performance ot the work Por which this peimit is issuetl, I� shall no[ employ any persqn in any manoer So as to become subje<t to the , Workers' Compensation Laws of California. '�. Date Siqnature 'NOTICE: If, aiter making this tleclaration, you Shoultl become subject to thB Wo�kers' Compensation p�ryyisions of tM1e Labor Cotle, you must torthwith tomply wilh such provisions �A� thii permlt sM1all be tle¢metl revoketl. CONSTRUCTION LENDING AGENCV � I hereby afBrm that [here is a construction lentling agency for the performance of the wark br whicn this' permit is issued (Sectlon 309] Civ. C.) Lentler's Name — -- Lentle�'s Aatlre55 ' ' ' OWNER BUILpER OECLqRATION I he�¢by aHl�m lha[ I am exemo� irom the Contractor's License Law tor the �nnnwina reazon f5ection J031.5 Business antl Protessional Cotle: Any city or i county which requires a permit to construct, alteq Improva, aemollsn or repau any structure, prior to itz issuance, also requirez the applicant tor such permit to file a siqnetl s[atement that he/she Is licensetl pur5uant to the provisions of the Contractot's License Law (Chapter 9_(comm¢ncing with SeCtion-7000) ot DiNsion 3 ot. the Businesg antl Professions Cotle) or Iha[ he/5M1e'is exempt theref�om antl lhe ba5i5 for.the allegetl exemptiOn. Any�vlolation o} Sec[ion 7031.5 by any applicant tor a permil subjects tne applicant to, a civll �enalty ot not more than fi�e huntlretl tlollars (E500). I, a5 owner of the P/Operty-o� my employea5 wittt wages ds tM1ei� Sale compensation, will tlo the work, antl the structure Is not intentletl or otferetl lor sale (Section 7044, Business antl Pro(essional Cotle: •The Contractor's License Law tloes not apply to an owner of a property who builtls or improves thereon, antl who tloes such work himselt/herseli or through his or her own employees, provlCetl that such improv¢ments are not IntentleE or oiferetl f0/ uie. it, nowe�e�, cne builtl�ng or improvement Is soltl within one year of com- pletlon, the owner will hav¢ the burden of oroving he/she tlitl not builtl or im- �/Ove fo�the purpose of sale). I, as owne� of the property, am ezclusively contratting with lic¢nsetl con- tra<tors [b mnztruct [he Drojecf (Section ]044, BuSiness antl Protessions Cotle: The ConVactor's Llcense ��y tloes mt appty ro an owne� ot property wno ' builtl5 or Improvez tbereon, antl who conttac[5 for such project5 witb a con- traCto��51 I)cense Oursuant to the Gont�actor's LiGense Law�. I am aware [hat proot o( [heir Worker'S Compensation insurance shoultl be ptovitletl to me. ❑. I am exempt untler Sect�on B. & P. C. for Nis reason Date owner I hereby certify that I ha�e reatl tnis apo��ation antl'state tnat th¢ above informatlon Is correct. I agree to comply.with all clty antl county ortlinances antl 5[ate lawz relating to huiltling COnstruction, antl h¢reby authorize re0re- zentatives of thiz city [4 enter upon tM1e above-mantionetl property for in5pection purpose � Siqnature �� i9 L-�-+' - Date �� S Drivers' �Icense ar 55 # <��- TVPE Of CONSTRUCTION LJ NEW � ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. �s o�+�r-� i 2„�^ TVPEOFPERMIT�y IJGRADING LJFOVNDATION L�'lSTRUCTURAL ❑ TENANT L7 ELECTRICAL ❑ PLV BING ❑ MECHANICAL ❑ �OTHER 2O�Q�PfiT�O CO✓EQ- PROJECTDESCRIPTION Sn.FT- /GG 7bAZA4'Enrriionnirpv� / CON STRUCTION TVPE VALUATION $ �e' ZONE GftAOfNG CU. V05. ACRES_ Remarks: BarSink - Backflow Preventer Backflow Irrigation Bethtubs Clarifiers Drinking Fountains Floor Drains � Floor Sinks Gas Service Interceprors Kitchen S�nk � Lavatories Roof Drains Reinspection Fae Showers Service Sink Sewer Cap • Sewer Connettion : Solef ColleCtOrS � Solar Piping � Solar Tank . � Swimming Pool w/Spa Urinal • - �UIICtS H/aLC! C�OSCI � Water Heater Water Service $15 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating ' ' Exhaust System ❑ Multiple Firepl/Fact Blt. ICBO # Heating SVstem & Ducting ❑ a i oo,000 sTu O i oo.000 Rainspection Fea I $15 CMF 0865-46, rev. 30/84 Wh�te - Builtlin9: Canary - Appllcant; Pink - Accouniinq; Goltlenrotl - Assessor Issue Fee Hood or Typel ❑ Canopy Typell ❑ A.P. �p � — S Main Buil ing: E ^ � T Front ��q A Rear C Fight K g Left Ping. Ref. # Planning Notes: p Automatic Washer I '� ConstructionPoleSub.' ✓ Cooking Unit � i Dishwasher � Dryers ❑Gas ❑Elecn . /l Fan ti ! F.A.U. - � Fixture5 -- � Device Boxes Outlets Switches Garbage Dispoul Generator �0.5 KW ❑ Re6igeretion System ❑0.100,000 BTU ❑100,000 BT System Repair/Alteration Fire Dampers Registers Issue Fee $.3 $ 3 1550 10/07/B5 Zone Accessory Building: Parking ReqJProvided : ELECTRICAL . Transformer ❑ 15-50 KW' ❑ SO+.KW Meter ❑up to 700amps Meter ❑over100amps Sub Panel ' Motors O0.1 HP O i%- 8 Inc.Solar �9-75 HP �16-1 Microwave Pole Li9ht ,. � Sign ; Standing Sections 5-15 KW Trash Compactor � Reinspection Fee ' $15 DEVE�LOPMENTSERVICESREQI Zoning Approved By Building Appraved By Issue Fee I�5o02 TL' FEES �� $ 3 2 O N I N G R E Q M T S SUMMARV OF FEES BUILDING PERMIT $ � SMIP $ 0•`5O PLAN CHECK $ �.�i PEfiMIT , PLUMBING $ ISSUANCE $ PLAN CHECK 25% S ENERGY P.C. $ ELECTRICAL $ L�O GRADING $ PLANCHECK 50% $ MICROFILM $� ' MECHANICAL $ TOTALFEE $, �ZS•OZ PLAN CHECK 25% $ , i CONSTRUCTION AND PLANNING , _ POO SPA :� APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector � �1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemen[ . 3. Electrical Conduit Utility-Undrgrnd. ' S4. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electriral Bonding � 5..Steel Reinforcement g� 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, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap; O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property $ewer 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 1�6: Rough Electric Wiring �� 6 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, Vehtilating �' 71. Product Piping O Gas ❑ Oil ' 23. Gas Pipe-Rough & Test �� 72. Underground Flush , 24. Roof Framing - . , 73. Undergrnd. Storage Tank 0 Gas O Oil � 25. Roof Sheathing;-�;'•; , � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical i. .� 27. Frame antl Flasf�ing ' �� 76 � D'ry`Standpipe -28. Lathing €e Siding'' ��a 5. 77. FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE PREV. FINAL 30. Drywall Nailing , � HEALTH DEPT. REQUIREMENT 31. Plaster Brpwn Coat ;j �� -�j,^ 79. FINAL INSPECTION 32. Electrical power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric �a, � � 7� 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 pomestic-Final , 42. Backflow Preventer � ' " b 43. Backflow Irrigation . - ' '�� `�� • 44. .Landscape Irrigation System � . I ' 45. Sound Attenuation ' , y�r" 46. Handicap Regulations � 47. FINAL S7RUCTURE & BUIlD1NG � 5 � 48. Special Requirements Completed 49. Electric Release to Edison . � ' • 50. Gas Release to Southem California Gas-Co , � '� �-' 51. CERTIFICATE OF OCCUPANCY . " � ! ' '� , , � No. -Date �� - � ' A PERMIT AO011wnt to fill in all e:cept thou wit�in TRACT'. ' // � UorEar Iines anE si9� all aDD�oVriate Eecbntiuns�� `� '� � � �� LOT NO. 8 . . � y . , � 21 70 _ 7/ 1 3/B3 � I C5e 97 TL � ApplicenYaMaiPngliddress yXSh /d�'� J/• TYPEOFCONSTRUCTION L1NEW �ADD ALTERATION' REPAIR � _ - + ' Prqect Add�ess 69 � �4 ST ' ❑ CONVERSION ❑ DEMOLISM ❑ O7HER ' _ _ � � � _ ' . , ' � � � � ' . ' e u% ' � � hone DESCRIP7JD�(yF'yygRK Owner i Name p�[JiGDO Address I�//n % C /1�� ST' � - � . � . TYPEOFPERMIT GRADING FOUNDATION STRUCTURAL AfChlEng. � 1 _ _ LiCBnae NO. .❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MEGHANICAL ' Address '' - • ' ❑,OTHER � ' . .. Contrector's Name � � � �So � � , hone " y0 PR0.IECT DESCRIVTION Sq. F7. � � %�10 oCCUaAi � Addreu�Imeilin) �BS.LT ��.ST• � GONSTRUCTIONTYVE��'�=1'�MC VALUA710N§" �. sj � 7- y� +7 ' � . ' � ZON€ G RAD G CU. V D5. ' AC � License No. � � LICENSED CONTRACTOR DEC�,qRAT10N ' � , Ramarks: ,�H• 'EE ' � 2 ( I hemby aHlrm t�at 1 am Ilcensetl untlar praviilons o� Chartar 9(commanGng . . , \.. with section 7000) of Dlvision 3 of t�e Buslnass anA Professlons Cotle, ana ; �C C� ' X my Iltensa IS in full force e�tl ei1e�(, V l,lcense lau - can N. PLUMBING Date� V��3 5lqnature . s� �BKERS' COMPHNSATION DECLARATION � �• ' Bef Siak �� P � 4*,;�reGy afflrm that.l have a certitlwte of conient to selHnsuro or a certHlGie ' �- ' 7U�.'Workers' Compensatlon InsuranCe, or a•cerUflea,cov ��eroof ( tlon B�kflowPreventar - SeMRr.Conn2Ction 3800, LnD. Cr�� r �( , � � Backflow Irrigation �Soler Collectors � � . Policy No. "q �� d ��`� � Company • �� . �Certifletltopy IS hereDy furn14he0. : . BethtUb3 �So18��Piping ' ' � : -/- �� }I y Is fllatl wit� th0 Uty 8 I D��'�fSio • - . � , .: S� Date �� r�g.:__. AUPlle�nt � �'• �� . ' Clerifiers i SOIar Tenk _. . EXEMVTIO FROM WORKERS' COMPENSATION DECLARATION ', DiShVfdShef ' Swlmming POOI W�Spe . '(Thissectlan neetl not be comO�eLeA if the Oermit Is fof�one hunAratl (5300) or ' lessl. . ' . � .. . .. .— ' ',, . � 1 cartify�thet In the performante of the woik for�whith this perm�t 151TSuetl i � Drinking Fountains "Urinal �� ,_,.� � shall�not employ any person M any manner so as to bacome suDject.to the � workars' Compensation Lawt of �Iltorn7a., � FIOOr Diains; Wate� poSBt' Oate � � <�9�atura ' � NOTICE: If, after making�thii Oe��aration, you shoultl Decome subject to the � FIOOt SinkS- -� ._ __ _ WatCr HeatE� - Workers`. Compensatlon provislo�s of the Labor CoOe, you must /or[hwith , � comply with such O�ovisloni- or this �permit'ihall ba'tleemetl revokeC. . GaSServiCB , OutlBts WaterService .. CONSTRUCTION'IENDING�AGENCV '� - ' �� '� ' - i _ I hareby aifirm that there is a constructlon Ien01n9 agancy�for the erformance � Intercept0�5 _ � of the work }or which this� p�rmlt -is :issuatl (Saction 30�7 Civ. C.).� ' Lenaer's Name , � , Kitchen Sink . - � • • Lentler's AEtlress . ^ � � �' � . , , - OWNER'BUILDER DECLARATION '• - ' y ' ' + ; Wvatories �� - I herebv.�affirm that I am'ezempt from tha Contractor'S,LI<ense Law ior the " • - Ich requlres a vermit to construct, alter Improve, aemoiisn or repair ue, prlar to lis IssuanCe,.alm reqWras t�e apPlicant for such permit ! 3netl slatement that ne/she I5 1lcensetl pursuant to [he provi5ions of ctor's Ucensa Law;(G4apter 9(tommencing with'Sectlon,l000) of of [�e .Business antl' Profeislons Cotla) br thaL he/she iz exempt ' anG the ba5is for the allegetl exemptlon.-My violatlomot SecUon , �- any aDPlicant tor e permit'sub7act5 [ne appliwnt to a civll notmore than fiva hurytlre0 Oollars (5500): • .� . wner oP the.property or my employees.with waQes.az their sole lon wlll Oo the work, antl the structure Is no[ Inten�eA o� off¢reA ie<�lon 7044, Buzina5s' antl ProfeSsional Cotla:f Tne' Contractor's � w Eoas not apply to'an ownar ot a property wha bulltls or Improves ntl who tloer such work himself/heriel/ or throu9h his or �er own � D�oviOeC tha[ zuch�IryiOrovement5 are not Intentlatl or oTteretl for �weverpthe Eulltling or improvemant I5 soltl within ona year,oi com- � a ��.,� r will M1ave the nu.nwn nf n.nv�na h¢/zhe tlitl not builtl or Im- ❑ I, as ownei of the proparty, am axtlusively contracting with Iicentetl Con- � tractors3o construct t�e pro)ect (5¢tUon 7044, Buslness antl Professions Cotle: . The Contratior's Llcense Law does not applY to an owner of property who ' builtls o� Impraves t�areon, antl who contractt tor such piojec[s with a ton- j � trac[or(s) II<anse pursuant to tne Contrac[or's LI<ense Law): . , ❑ I'am axempt untler Section _ B. & P. C. for thls reason � . . . � i Date ' Owner � ' ' �I hereDy '<ertity lhat I'have�reaC ihis application anG ztate�that the above `- Intormatlon is correct. I agree to comply with all cltY antl countY ortlinances antl state laws reldting to bulltling construction„antl haraby authorize repre- � �sentatives of:Ihlz�Uty'to entOr upon tha abova-mentlonetl pro0erty for Inspettlon DutDo�zeyi� � (� Signature � 7.70U- V ��/r� ' Date ? Drivers' License or 55 # / CMF OB65<6 rev. 12/82 Whlta - Bulltling; Canary - APPliwnt; Plnk - Actounting P—Trep Roof Dreins � � • Showers . � � Servite Sink � = ' ' � Duct - Under Ground Duct-Structurel � , � Duct - Ventila[ing . " Exhaust System ❑ Muitiple � Firepl/Fact. Blt. ICBO # Heating,5ystem & Oucting ❑a�oo,000.eTu �ioo,000sr� Hood or Tvoe 1 ❑ Fegisters � Goltlenrod - ASses� ; Reinspeetion Fee � � laue Fee' PLNG. .�� . "LEFTSIDEVARD " �f qc� PKG.SPACE REQ. (p � ^L 3 STREET WIDTH ; SPECIALCONDITIONS: � { Autometic Wazher � � , ��1 Construction Pole ' � � - Cooking Unit � � � ' �� , �� Dishwasher ' ' r t Dryeis ❑Gas ❑Electric f` -. Fan � � . y ; F.A.U. i � , � Fixtures � ' ' - . � 'p' Oevice'Boxps '� .��. D. o�iieci-� " _. � •� � Switthes ` � � �. •� Ga�bageDisposal i' �� t„ Generator OO-5�KW 'OS- - � Transformer.'�15-50 KW � ; ��eu�+Kw' •$15 " ❑4700,OOOBTU ❑100,OOOBTU � ' • Rein5Pec1 Issue Fee � BUIIDING � eeronr�r r�� eT � � PEAR VARD (TO P/L)' `7 - RIGHT�SIDE VARD� ' �7�� PROVIDED ' f PARK FEE�S , � � Meter Llover 100 emps , _ _ �Sub Panel ' ' ; �� ' �SubPole� ; � I�'' Moton OO-1 HP ❑lh$ - I nt. Solar� �9 ;1�5 HP �� 16-15+ �Microvuave . ;.:�';• � 'Pale�Light , ••' � ' .Range' . _ _ ' 'L __ � i � $CCSI005 ' t Trash � Reinapeetion '� Meter ��up,to 100 amps Issue Fae ' S 3 S 3 '' Zonin9 ?PProrad BY � %�' Dab Appliotion ApOroiied BY J `' ate 3 � Appli�ation Issued �By � ' • � Date '�� SUMMARV OF FEES ' r.. ;� � p • t� �.BUILDING PERMIT '$ ��SO �. gry��p ' .- , g . D•Q 7 . � PLAN�CHECK r • $ ' � PERMIT � 1 • �PLUMBING ' �$ � ISSUANCE . $ ;' � .• .'PLAN CHECK e $. , � ' '_ GRADING i $ ' � '� �ELECTRICAL. 'f',$ � � � • � $ , .. � PLAN CHECK. � '$ �.%O ' MICROPILM � $ , � , 'MECHANICAL �$ � � TOTAL FEE $ : ; � 1 iFee� .$15 . -,p�qN CHECK $ q qNCEDPC � $ � ' � , •S 3 ;'-' �'�. , ! � . FINAL FEE . $ � �� .. . . '�� .> ��.- . , � , - - ? c<CONSTRUCTION�.ANDSPLA NING, � ,� ..' � ��..N = ;�_ o ,` _ '; _ POO'. - �PA � ._ < �� ,.,- �„ , _ :, � �� ' '' " ` � y �' ,Date � � '�Inspector � ' � " ' _ �� Date ' -Inspecto�, ° APPROVALS,- Permit;# .p . �APPROVALS,, �Permit# h) ' _ t N N ; � ' � 1 - � P � 1 _ '. 3 i ' Tempoiary�Electr�ical Service or,POIO � �' �J 4n� �� T ^ ' �.�52: -Pooi &�Eguipmenf Location'i ' - ' > - � � , - 'V � _ n - _ � n ' S . - � - - - c - i� 2! il Plye-Undrgrnd� a�� S rgg i :'� '; � �� - o?' ;; ` �,53 � Steel Reinforcement�, , ;" � � ; � _ 1 `• �3! `fiectricel �'i�ondwtjUtiiitV Undrgmd � � ; ' i �- zO ,;>� � �54� Forms ° � ` F'. - - � �, '�. - ' "i' `° ^ �,. �- : . Q 4:� ElectFical ConduibUn;�1�9r0� � >. � „1 t � ` - �' � '� c ° 3 .55. Electrical� Bondirig- � , ; ,? - _ . � - � ; � .' � .•' - 5: Steel"Reiriforcement , i n k � � ! ; �: 7 � l5'S3 °p � ��-56 Rough Plumbing & Pressure Test � � - ' ' - � �• � �,� .r: - 6:�Ele'ctrical�UFERGrnd:� �a'OT �t� °1 ' x'�`� - _- .57;`APPROVAL`'TO;COVER-GUNITE- ''�*�� .I � � °,: r;.� �, ; ,. _ �� _ - - - - �. Footings . ' � � F '.�� a c� �,`,i < i ` �'` " '58:, �Electrical Cqnduit=Undramr{:- . . ` - i �. `. � �. . � , � . . , :. 8. F,oundation- � �� A � ,' 1 �- .' r . � , � � � � - . . , ^ i i i� � IC1^ o g �� - �": �- ? � ' 59. Gas�Pipe,�O Undrgmd Test °' : � � 9. Water Pipe-Undrgrntl. � � ; - �'� � =, � � s� .,' ' ��60. Backwasfi Lmes :P-Trap,`��Undrgmd �- � :"- � ..�• � 10. SRuaural Floor Sy�terim � ; o �o- ; : o �, j � �:; �� .61. APPROVALTOiDECK T � � . 11. Property Sewe;r Line &�Ho,use Connection; : � . �;; '�` � 62. �Backwash� &�Recep(orFinal' ' _ ' . ; j 72. Sewei Cap' �!'� I � f�. I � I ' �. '63. Heater&',UentFinal_ �`, .. " �,' 13. Roof�Drains � i ;:� � � �a I i : �" , ,: 64. Plumbing:SYstem-�Final . -'�.� - ' � - > ''.: . 14. �RoughRlumbing '�i ' i �c I � ' ° : ° - ' 65. Electrical=Final� • -= ^= �-- �� ` ' ' - � ' -' +,�15. �Rough'Electrical=ConduitT`''-a'-'Ii 1 �--� �"' ' ' �66J�Sola��System-Final Y - - � - � � � ' "- - ' '-� � ; _ ,. . ; 16.;`Rough�Ele6fnc�Wiri'n9, s � n h '- � .-/e'--'-'� i- 9 '- �-- ;- - - - ' - -' � . � ,,, m� ., , n . . ( �� ,�t�;;:� ;. ,.LD �. 67" Fencin &�Access�Approval� - . : �- --t'� , � ='t17. �Rough.Wi�ing!Sign"' ;� ;� � � � y �" � � t=� � '' ' � ` . 68 • APPROVED FOR,PL.4STERING� ' �' � U � ' - � i i� � � -; ! � � f , � . � , t !ict$.1Rough'Elec[ricalT�Bar,Ceiling��.11 �, I �}:f I �� -+ �69;POOL/SPASYSTEMS;FINAL .., � � ' ��' �- , Ni i >� h � � � ,� 19. 4Rough Heating &�Air�Conditioning � ; ' I o � i i �� i � . �FIRE DEPT.�REQUIREMENT ' � � - � �' � � � � � . , �� 0. y�RoughrFactory Fireplace � � � -�� ' � � � � � � � APPROVALSi � Permit # �� ' ` � ' , � � n"� i��i � - v . v..; " ' 2, �� { f. "'1 i t 1 I � . � . . � . . , . � 21. !Ducfs; m;Structure4 ,, ,{ rl�,.' �� I� ! � � i �!jp,i Underground Hydro �� ' P. r . !:; � � p . � . � � ! � ' . ! t � ' 1 '��.22;�Ducts, Ventilating F• c �.+•' {i �; �, I , , � � � �71 � product Piping OGas OOiI '� ��23- Gas Pipe-Rough & Test o �- j � i v �; � � i � j72! Undeiground Flush, �� J� {� v . - ! ( � ,- - -l�i ,4.. � `24. 'Rpof Fram ogt i:.! �' � �; ..� �� ,� f�;7 �2 g3 ,�1?, •- ,73 � Unde'rgrnd. Stoiage Tank O Gas: � Oil � � � � � ? 25. �Oof SReatM1mg I � � • � � : � I{n u ' !�' '� ,� .� �. �74! O'verfiead Hydro ' '� _ .- i ' j i � � i � u -" . T � . - ; ' ..„ � . � . , - , - . - � 26. ;T-Bar Ceiling (StructuralL�& Monocoat' i �, �� _� � �j '� n ; � �� 75 � Dry Chemical 4 ' : � " . ; j � , , ��, �� ,, r,. c i . � ,i u �-2'Y,:•wFrameand'Flashingii i��'�. �j � � �� ' 8'��;1, + �76JDryStandpipe� t � - � � � . - -' �`28. ��L'athing &�Siding� j ',�j � � + � li � �! � g � -� ,�•P i J7.' FIXED SY$TEM'F.INAL �� I � � . i � � „ � t 29. �'Irysulatiori ¢ - =Q - �?f.l j� � II � � � �' � I �78.' FIRE PREV. FINAL � � � � ' � ,. , , _ � '�'-�30.!Drywall Nailing ��'�;il �+ �' '1. C �I I�!g 3 �� i �Notes: ' 1 � I - O� �.�';X � 4t I �;-. ; � ; . ;F ,'; ; i,.;� I' ii -Ig-fs3 �� T �-�--,--- ., -. _ .1 _ - -,- J31. �Plaster Brown Coat ,� •� ! I 0� �n � hr' ' a• / � AfC� ING e� � 4 l i i � i �• �. i j. � � � � i � � � � I 32 �Electrical Power Meter-Final� �; � � � � � � � , , �I � � �.r , .� � n, � O� t ; � � ! f , : ; _ .y : ' .33. �Final Eleotric � � ' �_ �� i� ;�_ 1 / /_$� � � 26,'-8'3 �IhsGIR��an'0 n' � f ��y$GGII�C :�. __,. �� 34. Pinal Heating &�Air Gonditiohing � �'� � � � � ' � � ��}` - � A� u llrRlmlr:li-1 vi �f � � I ' �«<li�l V'� Q2 O � '1 i . ' � �� u.l i o �❑ C,7 � � - ,a� - ] . - . 1� P � " 35. Final �ias PiPe=TeSt� � t � ^ � _^� r� I ; i ° � � � ' I ` ` I ' : � = e � ` a.�. � . - _ . . ic •iry r�j 36.Hoodor`CanoPV��n�¢��Inl IiI-��"i��Jl I I �ZB-g��CV I- ��i7•Z•.'Q.' �! _�J. 37. Final Fac[ory Fireplacem ' 1 r I� � j '. ' ' ��n� u�: / _�¢ �`-1 I' �' In �' ' I � I P['' o'��CG.. C�O P '�I �O' '7 'f � 38. Final Rlumbing I.'�I .� I � :f !I I �` I T � I � : I 1 � � � - ` � ' � {� NG � � - 39. Water�Service-FiryaP � �I I �I h. � � � �' � i � .g=( (� �) / � � �` ii �I �� i,vn � � !.. � I i I- I C.�7e[�� ,ol �5 K h..LI�h 40. Gas Se vice'Final�;:i�t� � � ' ' !� � ( � � 1 � � i � � ' � " , • � � �i . � , I i ' �: I � I � I i , �� _ 41. Solar pomesticFinal,� ' � � � � �-J-� � � � '� i � ; � _•�f � � .� .� .�� , i • . o.-n+ n � � -� - -' ;-""' -- - -? r � - -- - � 42. Backflow, Preventer' �, � ) ! ��,, � i � � _ i `f � � �'�' �_� . - � - . . r� v� „i i �� _ t � ti_,I- �.-i---E"-� � -�-`- • � . hU0 i.. 4 e .a � ��q C� �C i� c<1T G�J� -� � 43. Backflow Irrigation � �. , ' I _ _ I �; � � o I S � � - � � � � � �, c:�� -� t� t�. �"-- .� � i: �� , � ..1� ,o� .. m�u. � ..i` ,'nl� �til 'I � �",�� - - � � ' . - _ 44. Landscape:l�iigation Syytem � I� �?;� � s � --' . I � = 1 y i '? � � � �� ,.. ylrt�4� la,�i Ini,-�� i: i � , .'. . ` �] � 45. Soundi:Attenuation � � I � _ i . �' _ _ ' � r. � , ur-U�--�fa'r • � Q �.. � 2 _ � i� � � ' � ?�� Y.R- I`1' ' .� I �f I..I { j�) p� ' I :i i I j� i�;f. ' � _ �� 46. Handisap� Regulatfons 4 �,,- i� �`v �, � � " i � �� - 47. FINALSTRUCTURE�&BUILDING'� ; � � ,� � j � i ; � �,` � „ � �� u �,- � � � I� I 9� -$"3. ..� i. i..... ' �. i �-��,� � � f �-� n�. -��: 48.,SpecialReqmremenisCompleted �, I I ( � ,:� � � � � . ��,.: �.� � ' �- � ' n i ir i ,49.' Electric Release,to�=Edison � � i� ' � , ;�,� � 1 � ' _ , . . ..' ' , ' � �, � 1...i i i 1 � ii f' `I�'"-1 -� -- ��_�': _ �"`�._'I"' i I ' ry 11 � -'J � I. 1, I � 1 1=�� ,.. 50. Gas Release to'Southern Catifomia Gas Co � � � ( , � ' � � ; t, � .:, �-'�� r ' � ! � � ' • �� , � � x I � I I � � � 51. CERTIF CATE OF OCCUPANCY {I. �._ �...�. f �� --�-1- � I I �� i I j4 � ! . � I � , - No. !� �� Date I �' � � I� II �1 i,� ' � . �� , . . , :.rk.� Y..Y:P��.� �-.J.� -� 1.�� •�� . 1 i�.� . � J-� ' / �/ • .;--;.. 8 �� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA. CALIFORNIA For Applieani to Fill In Complefely TYPE OR PRINT au��oiNc ��I _ Cc , A/U ADDRE63 � COSTP.,MESA CALIFORNIA � MAIL � 6BTBACH EXTERIOR WALL COVERING USE OF BUILDING I H8H6BY ACRNOWLB[ AND BTATe TM�T TH8 PLY WITH I1LL CITY BUILDINO CON9TR BIGNATURH OF n . � AUTNORI2ED r� 18 TEL. FIRe ZONE APPROVED � � �� W �� : �� iw�r �� t� � APPLICATION FOR PERMIT BUILDING For O#iee Use Only aece�rr Ho. r,Rrynr2no. ( � / 7 BV I /,�/�°�zl--�/.J�a�`�.1. COSTA MESA. CALIFORNIA �.-,^9� ZONING �� O/� �I I PLANB � I 8 LD NO HW I�� '� - �o•� _ 3�7 Z _!7 � oescp�prioN �� NO. OP BIDOB./ . G. P. Nf]. L/� � //I �/�� l� NOW ON LOT /� (CBNT[R 4N6 6T.1 REAR YARD _y �" FRONT � � Fl IRIGHT �/ R. SIDE � 7 � F1 OF WORK L.SIDE S_fi F"i II _IIADDITION I _ wcee �� c� APPROVED — BY HOLli rOk Jrt�itiL TO BE PERFORMED VEO �� "v�Cr, IN. — IN. � IN. IN. arF �1��'�CL 'HA� THI9 MPLJGTION TH6 AMOUNT BHOWN UNDER V�LUATION 1! POR TX6 �ND AGflBE TO CON• pUliP088 OP 68TABLA9HIN0 w PeRMIT P86 ONLY. A LJ�W9 p80ULATINO � VALUATION J PERMIT FEE $ /� N ��{{{ � _' D , $��D� `� PLAN CNECK $ Z GL� TOTAL FEE � n - - 34221: COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BU�LDING /I/ � ,j X �' \ � AODflESS 7(� �/ � .J' OWNER //J/i%1/ji�.-� / P. �/��.CJ/1/ F918-72�AIcOO 876 n****11.50 APPLICATION FOR BUILDING PERMIT IiEC�.IVE,{'�BY DgT�REC�ENED nnT&Issul AODRESS �`F' � — . �� e7-r . />ODRESS 6 � � Z . d U C17V �fS �¢ !��5 �C� NOL�j��] � TRACT ZZ W ADD A Q OONSTRUCTION O N LENDER am ,J � BRANCH J N OWNER m J ADDfiESS J m ARCHITECT TEL. S a O ENGINEER N . V � FIRE Wa ZONE � T � AUDRESS APPROVED J O CONTRACTOR �/ G �� ' O BV m . T JQ ADDfiES �,r�,'3 /� ✓ �+1 W /�--� � 20 NO.OF ZF CITV�I�'l/// PLANS W � STATE �� CITV �'ARDS APPROVED N� LIC. NO. LIC. NO. MAIN BUILDING 7 O (FROM GL STREET) 512E �j(13�1 NO.OFBLDGS. y OF �pT NOW ON LOT � ROM ` USE OF � � � EXISTING BLOG. H SIZE OF y NO. OF' Z NEWBLDG. � � /•��IOOMS STQRIES / L.SIDE FT. �% COVEEROING/ �'�� N�D/ w COVOERIN - LX-�� . REAR FT. a USE OF BUILDING AND W K TO BE PE FORMED pISTANC� BET. a MAIN BLDGS. Q /� �� r�/ VAR.� Q T' c.u.P. # � ,�C1•o�r1F 5'i�`u O.r1LY "�' E �n ; z O UI nereby acknowletlge that I have r0atl this aDP��ation and state � thet the above intormation is corract antl agree to comply with � all laws reg�latin8 builtlin8 construetion, antl I zhall not employ F eny person in violation ot the workman's compensation laws of y [h0 Sta[e ot Califomia. ZI hereby certity that I am properly licensed as a contractor under SQ. FT. ing State of California Besiness antl Professionz Cotle, Dlvisicn 3, THE MOUN7 SNO' Chapter 9, antl ihat zuch licenus are i full force entl effact, or I THE dURPOSE OF ES am ezampt trom the visions ol t ete ot Calitor ia BusJnocs VALUATION entl Protessions e er 9. � oc S�Bnatura Permittee Authorizetl Agent - �_��f1 I �i/I�1 0 USE OF NEW ¢�% � BUILDING Q�—A'-� VARDS APPROVEO ACCESSORV BUILDIN �'Oi cr BET, MAIN & b 0 VALUATION IS FOR � A PERM(T FEE ONLV: Q = S —_ N 0 m �.K $ � •--�. E `o �� LL $ _ ` 3422i COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Fo� Applicant to Fill in Completely EB 28-7?_cNSF°001105 U****23.00 APPLICATION FOR BUILDING PERMIT FECEIVEOBV DATEftECEWED nnrr�ccw ADDRESS `�9 F+. 18th Street � L OWNER Thom&5 A. GieloW A.P. NO. 1�.7�372—• MAIL BUILDING Z . ADDRESS 693II8 ADDRESS d U CITV COStiB. Mesa �� No�� 64 -266 TRACT Z Q CONSTRU(,TtON W ADD AL7 O � LENDEIi - � a m J � BRANCH J N OWNER m J ADORESS m ARCHIT�CT TEL. S J a OR ENGINEEF � N. U N FIRE Wa ZONE T � ADOFESS a w APPFOVED w Z CONTRqCTOF United Remodeling BV �O mZ J � AD�RE55 ' w W TEL. ZONE � NO.OF Z� CITV NO. P�� w 0 STATE CITV , VARDS APPROVED (n CL UQ NO. LIC.'NO. MAIN BUILDING' 7� SIZE NO.OF BLDGS. (FROM C/lSTREET) OF �OT NOW ON LOT FftONT ' FT: USE OF EXISTING BLDG. T8S1C�.eIICQ F � SIZE OF NO. OF Z NEWBLDG. fi00M5 STORIES L.SIDE FT. U EXTERIOq WALL ROOF COVERING COVERING REAR FT. J USE OF qVILDING AND WORK TO BE PERFORMED DISTANCE BET. a MAIN BLOGS, a � add bedroom and bath � �RP # ~ APPROVED ' � z � ' V I hereby acknowledBe thet I have reatl this application antl state � that the above information is correct antl agree io comply with � all laws regulating builtlin8 consiruction, and 1 shall not employ F uny persOn in violation of the workman's compensetion laws of y the State of Caiifom'ra. , Z I hereby certif that I am SQ. FT. y properly licensetl as a conttactor under the Stete of Califomia Business entl Professions Code, Oivisicn 3, THE AMOUNT SHO' Chapier'�, and tha[ such licenses are in tull force and atfect, or 1 THE PURPOSE OF ES am eaempt from the provisionsof the State of California Business VALUATION and Profassions Cotle, Division 3, Chapter 9. Signatura at ' Pe�mltteg $ �� Authorized ABent ' �� PE VALUE USE OF NEW BUILOING �'ARDS APPROV BET. MAIN & TOTAL � ' f� b 0 VALUATION IS FOR � A PERMIT FEE ONLY: ¢ W E S Z . � � m K 8 E ____ o 23.0o LL S - 3458.8 COSTA P.O. B For Applicant to Fill in Completely BUILDING / // /f �S� ��{�,� ADDRESS `TFJ7 OWNER T�a,ma.s f/�f..G��loc,� MAIL lT'?l �� IO �� • Gf1f1RFSS crrv LGl`�Ti CANSTRUCTION BRANCH ADDRESS ARCHITECT CONTRACTOR ADDRESS CITY STATE LIC. NO. SI2E OF LOT USEOF EXI5TING BLDG. SIZE OF NEW BLDG. EXTERIOR WALL COVERING USE OF BUILqI TEL NO. TEL. TEL. NO. CITV LIC. NO. INO.OF LB�DGS. . NOW ON LOT NO.Of ROOMS 5' ROOF COVERING AND WORK,TO BE PERFORM 'ap i9-7ivaro60 806� ��** «,�• 34.68 APPLICATION FOR BUILDING PERMIT RECEIVE„�BV DATERFjCEIVED nnTciecu A.P. NO.I� BUILDING ADDRESS OWNER FIRE ZONE T APPROVED /// BY /�J ZONE NO.OF PLAN$ VARDS APPROVED FOM C/L STRE DISTANCE BET MAIN BLDGS' VAR. #` C.U.P. # APPROVED � � USE OF NEW BUILDING VARDS APPROVED BET. MAIN & I hereby acknowledge that I have read ffiis applicaiion antl state � " J �� that the above intormation is correct antl agree to comply with all laws regulating builtling construction, and I shall not employ any person in violation Of [h¢ workman's compensation laws of - the State ot Calitornia. ' .1,� m � I hereby certify that I am proparly licensetl as a contractor untler SQ. FT. o the State ot California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR Chapter 9, antl that such licensas are in tull torce antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m am exempt from the provisions of the State of Calitornia Business � VALUATION antl ProfessiOns COtle, Division 3, Chapter 9. � • �� N PERMIT FEE $ ] SiBneture t ./�y'� �,/��/� �S�p O m Permittee SL�• :N�%�'L'T�!/UY $ PLAN CHECK $ � 5 E 0 Authorizetl Agent 1Q LL TOTAL FEE $�