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Home My WebLink About376 18TH ST - Building Permits' CITY OF COSTA MESA - • , � . BI/ILpING DIYISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wiw.ci.costa-mesa.ca.us �.` . FOR INSPECTIONS CALL: (714) 754-5626 " "�o.� � PERMIT NUMBER 07-00853 PERMIT TYPE B ROOF2 STATUS: ISSUED DATE ISSUED: 07/1112007 -- , < -ISSUED BY: BJK ,-�; ��" ! JOB ADDRESS: 376 C E 18TH�ST CM .`� '� '�: 'i� Suite/Uriif: �•.`•C Viciniry: UNITAC ,-� , ` • '� � - _ ' ,� r , ,ConstType�' ,?2>`•. SQ. Fr: 2000 ' % ' ` � � i ' Valuation � ,� $0.00 � ,�`i�i �, ::�� ,.f� �,'-'i`; . . !,l ti;�,.;. ,' I%r � ( �. ; ' /: �: f' � "��=u[:: �. r. ..�/ j �:. '-�t SCOPE OF WORK: REROOF,.UNIT�C,WITH�AT7ACHED GARAGE: T/O EXISTING COMP ROOF,`REPAIR/REPLACED SHTG AS NEEDED, FELT PER MFGR'S SPECS, APPLY,"30.YEAR`COMP SHINGLES:' ��5�'�''" �"' PITCH APPROX 3:12 2000 SQ FT r�� ,"s;i' ' . - _ .. ' 3 - - ' ' . . OWNER: PALMQUIST,`�DONALD TR y � ' � . � '�. Address: ' � � 105 VIA HAVRE��. Unit: ' ' PHONE: � � City/StatefLip:' � � ` NEWPORTBEACH;CA�,�'.� � �- � . , �.� ., � . - , APPLICANT: PALMQUIST, pON �� Address: 105 VIA HAVRE Unik � PHONE: 949-673-0884 � � ; - � City/State/zZip:.- -_NEWPORT BEACH, CA. � , . , ; :J' , _ , - � . , CONTRACTOR: OWNER-6UILDER License No. 000000; Address: Unit: � �� _ � PHONE: : - -- t, '� _ - City/Slate: � � ZipCode -�� _ -__'- - � . -: _.� CELL• - � � � _{ n �. . . . _ ' .,�.�r �-: � . ARCHITECT: - LicenseNo. -=— � . �;;;';•PHONE:.� ENGINEER: ' �.��`� ��i,_. � LicenseNo.,_ . , .;,-r ��,PHONE: r. � _ . . ,.�' .. , �� ; - Y- _ . , _ - . . ... . � r`. . . . � i /. . � :., -� � . FEE SUMMARY ��'- ` r.�. . ° Reroof Plan Check: � � �$0.00 �.�, � ,\ .. , - ... :. - t �'" .. •,� � {,� : �;.� Reroof PermitFee: � $8325..; - , i ��.,,.,, Reinspection Fee: 50.00' � . : �' ` _ . ., s . TOTAL FEES §83.25 � � �- � � - ' NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requirements under Califomia slatutes and related regulations. (Ord. No. 92•2B, § 1, 12-21-92) . EXPIRATION: PERMIT EXPIRES 160 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order for the work authorized under this pertnit lo be wnsidered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obWined. Failure to obtain inspections and final approval will resull in the expiration of this permil. CODEA• INSVECIIONTYPE y� INTIfIRLS CODE� INSPECTION7YPE Q]jE INTRI�lS 1818 Fized System Final Fire Prevention 208 Final Mechanical 1288 Pool SOa Final - 208 Final Plumbing 200 Final Re-Roof ��Ly� ) 210 Final Elettrical 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 �emolition 250 Final Building/Occupancy WORKERS' COMPENSATIUN DECLARATION: I hereby aKrm under penalty ol perjury one of t�e fon.,mng declarations: ❑ I have antl will mainWin a certificate of consent lo selbinsure for workers' compensation, as provitled for by section 3700 ot the LaDor Code, for the peAormance ot the work for which this permit is issuetl. ❑ I have antl will maintain wnrkers compensation insurance, as required by seclion 3700 of Ihe Labor Code, for Ihe pertwmance of the v.oAc for which this pertnit is issued. My vrorkers' compensation Insurance wrrier and policy number are: Carrier. (�fra seCm neetl nol0e arnplefeOlNa pnnv a rd�t.e0 at me nwMiNONars (S100J o'kss ) Policy Number: (�❑al certify that in the pertormance of lhe work for which ihis permit is issued, I shall not employ any person in any manner so as to bewme subject to lhe workers' co n ation laws o1 Califomia, and agree thal if I should become u ject to he rkers' compensation provisions of Se ion 3700 0( the La r C de, I ha forthwith wmply 'th Uese provisio . . �apC&Siq mie //� WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLIARS ($700,000), IN ADDRION TO THE CAST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST. AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that I am licensed under provisions of Chapter 9(wmmencinq with Section 7000) of Division 3 0( the Business and Prolessions Code, and my license is in tull force and eHecl. Lic. # Class # Canvanor's Sipnawrc Da�e CONSTRUCTION LENDING AGENCV: ❑ I hereby affum that there is a constructbn lending agency fw the perfortnance W lhe v.ork ta wfiich this permit is issueC. (Sec. 3097, Civil Cotle). Lender's Name: LenOer's Address: Da�e OW NER-BUILDER DECLARATIONS: I hereDy affrtn that unde� Denalty of perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor ihe lollowing reason (Sec. 7037.5, Business and Professions Code: Any ciry or counry which requires a permit ro construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicam for such pertnit lo fle a signed statement Ihat he or she is licensed pursuant to the provisions ol tha Contraclors License Law (Chapter 9(commencing vrith Section 7000) ot Division 3 ot lhe Business and Professions Cotle) or that he ar she is exempt therefrom and 1he basis for ihe allaged exemption. Any violalion of Section 7031.5 Dy any appliwm for a pertnit subjects the appliwnt to a civil penalty of not more than five hundred dollars ($500).): I, as ovmar of the property, or my employees vrith vrages as Iheir sole co pensalion, WILL DO THE WORK, anA Ihe struclure is not intended or oRered lor sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an ovmer of property who builds ar improves thereon, and who dces such v.ork himself or herself or through his or her own employees, provided Nat such improvements are not intended or oHeretl for sale. If, hovrever, the building or improvemenl is sold within one year of completion, lhe owner•builder will �ave the burden of proving that he or she tlid not build or improve lor purpose of sale.). � � I, as ovmer of the pmperry. am EXCLUSIVELY CONTRACTING WITH CENSED CONTRACTORS to construct the projecl (Sec. 7044, Business and Professions Code: The cmtractors License Law dces rrot appy to an rnmer of pmperty who builtls or impmves thereon, anC v.ho contracts for such prqect wiih a contracta(s) license pursuant to the Contraclors Ucense Laws.�. ❑� I am exempt under sec. Busine nd Protessi s Code for this reason: �� Sqrromre` -,. � D ..� 9059 .61Y0]) �� Owner ID verified by drivE ise. �yes ❑ No �— Drive:s;License.No� �p'ves z Verifcalion of Ownership by (type of document, i.e. - property tax ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation frva (5) or more feet in depth iNo wfiich a person is requiretl to Oescend, will be made in connection with v,ork autlarized by Ihis pertniC and that no builtling stmclure, scaffdCinq, falsev.ork, or tlemolilion or tlismantling thereof, will be more Ihan Ihirty-six (36) leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Calitwnia Administrative Cotle). ❑ As owner-builtler, I will not employ anyone to do vrork which wnuld require a permit from the Division of Industrial Safety, as noted above, unless such person has a pertnit lo do such work from the division. ApPlitanl's SipnaWre Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or preseN or fuWre buildinq occuDant need to file and certity a Business Plan for emergency response to re�ease or threatened release of a hazardous matenal? ❑ Ves ❑ No (Sectlon 25505 of tha Califomia Healih and Safety Code requires, wilh some exceptions, Ihat a Business Plan De fled with the Costa Mesa Fire Depanment by every business v+hich has at any one time during a reported year a quanlity of hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at slanaard remperature and pressure). 2. Dces or will the appliwnt or preseM or tuture building occupant need to file a registration form for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Healt� and Safery Code, with some exceptions, requires regisiration with the Costa Mesa Fire Department by each business which at any one [ime has on hand a quantiry of acutety hazartlous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of wmpressed gas at slantlartl temperature antl pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management anC Prevention Program for acutely hazardous materials)? ❑ Ves ❑ No (Section 25534 of the Califomia Health antl Safery Code provides Ihat Ihe Cosla Mesa Fire Department may require the preparalion, certification and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Sec[ion 25534 of lhe Califomia Health and Safey Code been fully complietl with? ❑ Yes ❑ No 5. Dces or will the applicant or present or fuwre buil0ing occupant require for Ihe vrork which is the subject of this application a permit lor such wnstruclion or moaification from ihe South Coast Air Quality Management District or Irom any other air pollWion control districl or agency7 ❑ Yes ❑ No (Section 65850.2 of Ihe Califomia Govemment Cotle requires that the requesle0 intortnation be fumished on applications fa rron-residential building pertnits). 6. Will any part of �he facility �o be constructetl untler this permit be within 1000 feet from Ihe outer bountlaries of a school? ❑ Ves � No (I( yes", the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Sa(ery Code�. 7. If a permit !rom the South Coast Air Dualiry Management Districl or other air pollution control dislrict or agency is required for lhe work which is the subject of this application, have all ol lhe disclosures prestriDetl Dy Califomia Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No, 8. Qf'yes", attach certificate of compliance from the appropriate air poliulion control officer). CERTIFICATE OF COMPLIANCE: I certify Ihat untler penalty of perjury Ne infortnation given above is cortect. I agree to wmply wiN all sWte laws antl city ordinances regarding Hazardous Materials and Emissions. � SignaWre Qaie CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify under penalty of perjury that I have read this application and state that the infortnation given is correct I agree lo comply with all s[ate lav5 and tiry ordinances relaling to building construction, and authorize representatives ol lhe Ciry of Costa Mes lo enter upon the above-tlescrihed propeny for inspection p oses. I zgr not to occupy or allow occupa cy o any building authorize t is er ii , til final inspecGo . SienS�' of_Leeat. (s.3' /� �e' Anp/M Pu1�MZP0 AppliG3n1 �dIB ADP�icant to fill in all sDaees exceot those within heavy Dortler lines anE sign all appropriate aeclarations. CITYOFcoSTAMESA CONSTRUCTIONPE,RMIT Project Address -�� 1 �T� �J� • ANplicant's Mailing Address '7a l"'�T+ t�E�in.l�+� 1'��-� Owner's Name ��-.��.1��``�7 �� , `�,,I �e(l�1��`y� Address ��"J �y�'�'e '�-ld`v�� NGW � V� Arch/Eng. License No. Atltlress ' ` '! 5� Contractor's Nam r .( Pho YP Address (mailin9l � %�' G�/� { �P''�'�� City License No. ��(O 3 LICENSED CONTRACTOR �ECLARATION I hereby aftitm that I am licensetl untler provisions of Cnarte� 9(commencing wit� section ]000) ot Division 3 of the Business antl Professions Cotle, antl my license.is in fw�torce ntl eitect. Licen C s G� License��Q� Q � Date `�' ' S 9 t ' � WORKERS' COMPENSATION DECLA0.ATION I hereby aifirm tnat I have a certificate ot consent to self-insure or a certificate if Workers' Gompensation Insurance, or a certified copy tnereof (Section 800, Lab. C�) i `��- ' �olicY Nc�� 0�7��anY �.T'^�� ifietl capy is hereby tumishetl. (� /� ertifieQ cc}�yj@.ylptl with�the city.B[�if0lirg,Division.� ��,E.�/ _ ' EXEMPTION�FROM WORKERS' COMPENSATION DECLARATION � �(Tnissec[ion neetl nal be wmpletetl if the permlLis for.ane hunOred ($300) or less). • i I certi(y Iha[ in the pe�tormance of ihe wo�k (o� wttich this pe�mit is issuetl, I sball no[ employ any person in any manner so as to become Subject to the Workers' Compensation Laws ot California. � � Date Si9nature 'NOTICE: If, after making this tleclaration, you sM1oultl become subject to the Workers' Compensation provixions of the Labor Cotle, you must forthwith � �comply witM1 such provisions o� this permit Shall-be•tleemetl �evoke0. � CONSTRUCTION LENDING�AGENCV� � � 1 herety aifirm tha[ there is a,construction lentlin9 a9ency for the'performance of roe work for which thi5 permit is.issuetl (Section 309] Civ. 0.) Lentler's Name OWNER BUILDER OECLARATION - - - ' ' I hereby affirm that I am exempt from tne Contractor's �Icense Law for tM1e following-reason (Section 7031.5 Business antl Professlonal Cotle: Any dty or county whicn requires a permit to consiruct; alter, improve, demolish or repair any structure, prior to its�issuance, also requlres the applicant for such permit to file a si9netl Statement that he/5he is licensetl putsuant to the provislons ot the Con[ractor's License Law (Chapter 9(commencing with Section 7000) of � Division 3 ot the�Business antl Pro(essions Cotle)-or that he/she is ezempt •herefrom antl tM1e ba5i5 for the allegetl exemption. Any violation of Section '31-.5 by any applicant for a permit subjects the applicant to a civil ialty o� not more tnan five huntlred tlollars ($500). _.J I as owner oT the, propertY or my emploYees' with wages as their sole `compensation, will tlo the work, antl thc sVucture is not intentletl o� offeretl for saie (Section 7044, Business antl Protessionai Code:' The Contractor's License Law tloes not apply to an owner af a property w�o builds or improves thcreon; antl who tloes such work himselt/nerselt or through his or her own employees, pravitletl that such improvements are not intentletl or ol�eretl fo� Sale. If, howeveq the bulltlin9 or Improvement is soltl within one yeav of com- pletion, Ihe owner will bav¢ the burtlen of proving he/she tlitl not builtl onim- prove forthe purpo5e of sale). . ❑ I, as owncr oi the proDerty, am exclusively contractin9 with licensetl con- Vacrors to construct the project (Section 7044, Business and Pwiessions cotle: The Contractor's License law tices not apply to an owner of property wha builtls or improves thereon, antl who mnt�acts for Such project5 with a con-. tractor(511icense �pursuant-ro the Contractor's License,�aw). I am aware that proof o1 tM1eir Worker'S Compensation insurance shoWtl be provided to me. ❑ I_am exempt untler Section , B. & P. C. for tM1is reason Date Owner � � ' • I hereby certiry that I have read this application antl state that the above information is cOr�ect. I agree [O comply wrth all city antl county ortlinances antl sta[e laws relating to builtlin9 construction, and hereby authorize repre- sentatives city to ent up [he above-mentionetl O�ope(ty for inspecti Oose , 11',y3,f".k� Signatu Dafe� �� Drivers' cense or 55 � � � �— �� Nl 3/ y�8 - I I I _. TYPE OF CONSTRUCTION NEW � ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH�❑ OTHER DESCRIPTION OF WORK/USE OF BLDG_ TVPE OF PERMIT L-� GRADING U FOUNDATION LJ STRUCTV RAL ❑ TENANT ❑ ELECTftICAL ❑ PLUMBING -v1ECHANICAL ❑ �OTHER- - ' PROJECT DESCRIPTION SQ. F7. oCCVParvCv_ CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES_ ear Sink Backflow Preventer Backfiow Irrigation Bathtubs � Clarifiers Drinking Fountains Floor Drains' Floor Sinks Gas Service P—Trap ' Roof Drains Showers . . . Service Sink Sewer Cap Sewer Connection ' - Solar Collecrors Solar Pipin9 � Solar Tank � Swimming Pool wlSpa Outiets Reinspection Fee t � $15 Boiler �. � _ Duct - Under Ground ' Duct-Structural � Duct-Ventilating . . � Exhaust System ❑ Multiple ❑ � FirepVfact.Blt.IC80� . ` He ng System & Ducting l� 0.100,000 BTU 0100,000 BT Reinspection Fee � $75 CMF OB65-46, rev. 30/B4 Wnite - Builtling; Canary - Applicant: Pinli - Accounting; Goltlenrotl - Assessor Uririal . Water Closet Water Heater Water Service � Auto-Wash � Issue Fee Hoodor Typel � ' Canopy Type I I. ❑ ' Refrigeration System ❑o-�oo,oaoaTu ❑ioo,000s System Repair/Alteration � Fire Dampers Registers � Issue Fee FEES � A.P. # S Main Building: E T Front ' ARear C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer � Construction Pole Sub. Cooking Unit ' Dishwasher � Dryers ❑Gas ❑Elecvic Fan F.A.U. Fixtures Device Boxes � Outlets Switches Gar6age Disposal Generator �0-5 KW $ 3 Reinspection Fee P $ 3 iaai i.aio�iei � - i,oa TL Zane Accessory Building: 2 O _ N I � N G R 7 kir�g R , ed � � � " 'E � _ Q - M • T . _ _ S ELECTRICAI ' � Trensformer ❑ 75-50 KW � � 050+KW , Meter ❑up to 100amps� ' Meter ❑over 100 amps � Sub Panel Motors DO-1 HP �1 % - IncSolar 09-15 HP �1 Microwave - Pole Light • 15+ Si9n ; Standing Sections � ' 15 KW Trash Compactor � DEVELOPMENT SERVICES R Zoning APPmved BY . Building Approved By — APplltetiOn 15uBd BY ' �FEES $15 � � Issue Fee - I•$ EQUIREMENTS: ' � Date � _ . / � � � � ' SUMMARY OF PEES r �BUILDING PERMIT $ SMIP - � $ �� PLAN CHECK $ PERMI7 � �,/�,�� PLUMBWG � $ : �ISSUANCE � $ �p.-�1� PLAN CHECK 25%' $ ENERGV P.C. $ ' ELECTRICAL $ _�__ GRADING � $ • � °P�LAN CHECK 50%,$ � MICROFILM '$ ' � MECHANICAL $ TOTALFEE $ � . PLAN CHECK 25% � $ . �� " , �, -yCONSTRUCTION AND PLANNING � POOI PA 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7. Footings � 58. Electrical Conduif-Undr9rnd. . $' Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe�Undrgrnd. . 60. Backwash Lines, P-Trep, � 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 . � � .1.6: Rough Electric Wiring ' 67. Fencing & Access Approval �17', Rough Wiring Sign ' 68. APPROVED FOR PLASTERING i v 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. Storage Tank O 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE 1SSUED 33. Final Electric Notes: , � / � 34. Final Heating & Air Conditioning , � � 35. Final Gas Pipe-Test 3 a0 �QA�L, � tp!•jD � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final :�� ;, 40. Gas Service-Final � � i� q1, Solar pomestic-final ' �� :; + 42. Backflow Preventer i.: !�� ;`l .; 43. Backflow Irrigation � 7 44. -Landscape Irrigation System 45. Sound Attenuation �.._ 46. Handicap Regulations �y � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed . 4g, Electric Release to Edison �s „ 50. Gas Release to Southern California Gas Co '�=�' �� i -�� 51. CERTIFICATE OF OCCUPANCY � '"' .. � No. Date � Costa Mesa Bnilding Department APPI.ICAriuN ruK r�nmrr ' � 111 EAST 20th STREET n��',� g U I L D,� N G � " COSTA MESA, CALIFORNIA ��s � FOR APPLICANT TO FILI. IN FOIt O&'FICE USE ONLY �� Receipt No. Permit No. s�na��9 3� Cso�%� ox 3� Address Costa Mesa, Ci&�OTll18� Received by Date Rec'd. Date IssuW Nearest "��'� � I '1 �O - Cross St. Building Address Owner ! �/ � ��` Costa Mesa, CiB��OPII18� Mai� �7/ p� -r� Address � / (p G. ��J y"fj � /� .. __ _ . . . . Nearest City Lic. ntractor C) �V N"e � No. Idress egcrption I No. �a �O I Block � I Traet ,tiach Metesand Bounda) Use oi �� Existing Bldg. /TB/!%t Setback Line from O� � Cen2er ot Street Q DESCRIPTiON New I I Alteratfon Repair I I Moving Building ,/ �No.[ Size �� Jl �� Roor Er•'rior Wallp I � '�^9 d T�'CCO � l,_ df New n / I hei'eby acknowled; and state that the a with all City Oid'u building rnnstructio� Signatureof '%A./� PermRtee /rU Authorized Agt. Valuation s �3, 600. FORM 2�4 p-H 2M 5-54 v'� 3tories � I:� � a 1�1i�/:\ i�.y (�O� Jr.� �' / �/�GOy reunuauen �ecaua Forms, Materials 9P .�.�a'/,,f�. Under-Pinning Frame: Fire Stopa, . Bracing, Bolls thaf I have read this App]icaUon Lath. Int. ✓e is rnrrert and a ee to comply Lath, Ext ices and State s regulating _� _ n � Plaster, Int. Fee , o 0 r o eond B A o FINAL O A � 2 D r .. : � • 7' : . �� , _ - ` . . . _. , , ' . . . ... . - : r , . �`_\ ._: .. . _ � �' ' • - c�Ee t n-ScP.Du�sr.^-,��Sa . � �t�t }�5.�� c , i ! , � Show_ locatlon and distances Trom � � " _. - - - . , � property Iine and between buildings. � �:� - .0 r � �. . - ' � � ' . � _ " .' .. _ . - . .. _ .._ . . ' - . ' . _ � i -_ _.. t •u...i, .. .. � . . . . . " .. . . . . . . , ' . .. Ji.. . . ' . , �� .. _� i�., U , - - v . . . � . � , ��a:'' ' � , • � LI' ... . . .. . ' L��. • __ '. '_ _ ' _.' . . _ . ' , i., : �'= � �-�-��° FEE RECEIVED CC�STA MESA BUILDING-SAFETY DEPARTMENT f.� �! —�o � P.O. BOX 31] COSTA MESA. CALIFORNIA fINANCE DEPT. �`�` +?' 7� fOR APPUCANT TO F/LL /N COMP[ETECY A�'k.1�1'L(�N1 AA�$� PERMIT ' y Cs ' TYPE OR PRINT BUILDING BUILDING � ��j�{{ , AODRESS +�� t� t �U COSTA MESA, CALIFORNIA /'VR OFFICG USE ON�.I OWNER �I� \ ��AJ�V I PECEIPT NO. I P ftM NO. ADDRE55{1 / 6 �� I V� > � l AECEIVE� BY I OAT¢�/C�EIVED� I/[�ATE I6 E9/ w I / s / � U CITYC.1=S�A N7� TNO.UCIY�I p�DRESS •l�� IO �� ARCHITECT � 1� No: � COSTA MESA, CALIFORNIA OR F" :INEER C � �+� ADG__sS FIRE o � ZONE TYPE GROUP S�A O CONTRACTOR a� � LR- LIC.NO. BYPROVED �, DATE /�� VD nooRess ONING � LEGAL � LOT %' I �, ZONE 1 NO. OF USE OF NEW �(` OESCRIPTION N�. � �/ BLOCK ACT. � - (P�ANS ��I BOILDING � �il V �J ,� � � _ ��.) APPROVED J' � ` A.P. NO. BY .V - �yOATE — I � OF LOT fJ�" � �'�`�'d �' I rvow oH tors I REQU RED ALLOWED � USE OF n� y� (CENTER LINE ST.1 !� EXISTING BLDG. 1"�SI�✓F�G FRONT V�FT. IN. ��i/ � f SETBqCH LINE FROM � CENTER OP STREET REAR YARO R. SIDE � FT. IN. SIDEYARD I�EFf IR�GHT L.SIOE � ITFT. IN. DESCRIPTION OF WORK � � � �, � � � IN. NEW � I�II AITERATiON I II ADDITION I REPAIn I IIMOVING I IIDEMOLISH I ty, p .i 5 Z'E D'N D�X � D 1 R OMS I � STORIES �• - E�t �` ` �v � ' I�c 5 � i� bt "� EXTERIOR WALL��p ROOF OQ b � COVERING ICOVERING ��1_ � J . � / USE OF BUILDING AND WORK TO BE P�RFORMED , -- - v ,�7 . � � :4s�T. E` A�'PRCVED � �'O�S' � �� R�Q ��FME ,� I HEPEBY ACKNOWLEOGE THqT 1 HAVE READ TNI6 APPLICNTION ` ANO STATE THAT THE RBOVE IS CORFECT qND qGREE TO COM- THE AMOIINT SN WN UNGEN VALUATION IB FOR THE. PLY WITH ALL CITY ORDINAN S FND STATE LAWS R A G PIIRPO6E OF ESTABLISNINO A PEIiMIT FEE ONLY. BUILDING CONSTftUCf10N. VALUATION SIGNATURE OF � PERMIT FEE $ �� PERMITTEE � $%�!1 a 9 0� PLAN CHECK $/7'� AUTHORIZED AGENT v� " TOTAL FEE S�� COUNTY OF ORANGE • BUII.DIIVG DEPT. 636 No. Broadway Santa Ana, CaliEomia P6one: KI 2-6211 I. OWNER'S MAILING Application for Building Per-°t AND FOR A Certificate of Use and Occupancy Name........................_�n!e.��(_ 1................................... (Archicec[ or Engineer) Address........................................................................... .....'--.... City......------ .............................. State Lic. No .. ........... �- ................. PROPOSED USE: Permit No. ��..Z...`.�...� % Date..----/�f.-.�-��Y ............... 7.%!-��------------- - �---- PHON QIGA�Go:r�--5�i3'le L.._.....--�� .....-- ...... CITY.��Q.�,�.-----,��Le%L��f.LeC!� Name ....:....................(�tic.--ru°�C�....... - - �--- - ....._.....- (Contractor) Address. -----------� ..... .........................----------� --....------------ -�-- City State Lic. 7 2. JOBLOCATION...:�..��=�-------..:.-----�--:.....--------�-_O.:r?:!i.F4f.r ............._.........-�-------.(,%°:N.^.-.a..-.---li_r�a�,--_.-----�---�-� (House NoJ (Name o( 5[reet) (�'own r Sthoo� District) � ' iil NAME OF AND DIRECTION FROM NEAREST CROSS STREET...�. a'«�.... ..... `��a��Yl.�.�:a.. o.T......._�. .......... 3. �LEGAL DESCRIPTION: Lot.-�-� �----/ 3� - ..............�-----�--Block .............._. ... -........ -- ........--- ract.._..!..Y...��..�:---�O.S� (Metea and Bounds Destription—Use reverae side of form) / 4. CORNER LOT ( ) INTERIOR LOT (G2��j%�-'�'d_d✓•UGH LOT (✓) SLOPE OF LOT ( ) //` �+ vG i. SIZE OF BLDG.:..�T./l.�.Zr.---AREA:...sl...��_�?..R......SIZE OF LOT:..-3.%.�il.'/....2.6.AREA :.................................. . .� . 6. HEIGHT OF BLDG .:..............._-----.._................CEILING HEIGHT:....... �....�._.........._ NO. OF STORIES------ -.---.--------.....------ / i � � � 7. NO. FAMILIES ..............�---..............-----Size of Smallest Bedroom:--._L..�---X--I �-._-..._ Siae of Kitchen..._��. �!P......-'---- 8. EXTERIOR WALL CONSTRUCTION:._S.T_t�O ..................INTERIOR WALL COVERING__._..a�%�I.��G G_.. (Arame, S[ucm, Ete.) / • (Plazter.Drywall, Pm.) iI // ROOFING COVERING.........-�..r�-�.....i�2�uc��t�'!,LrYxA.._.:E]C....'"" '"""_"""'""_"_'""""_ ..............""""...... 9. STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EAi .....�r�- ..��,�,�_- .. ��.�.� 10. SETBACKS: Frorh�Yard From Center Line bf�5treet.........._ �..�..��.........`...�Q..� � ' �- ��' Nearest Side Yazd...__..�..........Rear Yazd----... ..,j�.........Distance in Fee[ Between Bldgs. on Same I.ot-_•--____..-_ ......................... (Proper:y Line) (PropertY Line) 11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. i 12. (a) Footing: Width.-----/��/� .............Depth in Ground....... ��...I..._....Width of Wall---___`��. .�_--........ (b) Size'of Smds:......11..�Q..�.........Spacin ---...�.c..�._�.�....:'CC Material of Floor-----�P._!:�.c.�7e..T.2.....__. . ��. yx �. �6,, (c) Size of �Joists :.............-�--' -- -- Spacing....----........_............-.._._....:'CC a �'� (d) Size of Rafters:........---�..r2%....� ................_Spacing.....------.....-�--.._... .......:'CC � ��-// � /f'� �1 h 13. VALUATION•OF P SED ��RK: Including all labor, plumbing, electrical wiring, heating, fir� sprinklers, painting and sewage disposal $-.... ��-:�-�-�. �.....-----• 14. 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 THEI�ETO.� f' �. . . _ n �' �� ,/.,.s Y .............. Signed: Plans Filed:..........�--. ..-_ � - - By: r (Owner) (Au[horized Agent) FOR DEPARTMENTAL USE ONLY FEES: Bldg. Permit - $......��.i�!Q GROUP...... ............. .. ........ Plan Check • �----�:_�-.Q...--.-:. TYPE ... . ..... ......---�-- ....... Total . , /� , $....-- --..:.Q.. DIST. �o �/ Receipt No. /" lG � � �.. . MAP...--_--.S..G....._.......�..%.. ... ... ..... ..----.. Paid co . . SHEET NO ........ ............-- ��...- - ---�-- Date I..Y......-�,2..�J1- PERMIT DATE----�. [�,/..�..)..{....��-��---- --� ................... sooa--�-sa � / ZONING ........... ...!!_.... PLANS AND SPEC'5 ..... ...........-�� --- CORRECTIONS m FIRE MAR SHAL--_------.......---- STATE................................ ENGINEER JN7Y C�,,P .o v