The URL can be used to link to this page

Home My WebLink About632 BAKER ST - Building Permits. City of Costa Mesa Building Safety Deparfinent P. O. Box 3 V - Cosm Mem, California CERTIFICATE OF OCCUPANCY c �'The Building located at 6i� �8$�.' i�'�E'�• Witd A, �i � b� •' has been inspected and found to comply with the provisions of all City'of Cosfa Mesa Ordinances applicable-thereto . for a Gro�p � Occupancy. � , � � � • Use of B�ilding �� _ , ' _ .�Legal Description Q• p•' �l�ii�l�u � ' . � . . . :� . . � ' �� (Sau revane aide fo� Metes and Boundi) ' �,�Building�Permit No. Z�'a Eledrical Permit No. 1�� ' Plumbing Permit No. �1�" ' - _ n . � � �. , � . . '�Floor Load $igns have 6een installed as ": Room Capacity Signs have been�instaled� as ,;'required under Sec. 2308 U. B. C. . . required under Sec. 3301 (1) U. B. C. � . . 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or' lodging house shall be used or occupied 'until the owner or operaTor has been issued 'a� valid certifimte-of occupancy by the enforcement dgenry. -- ' -(b) A new certifimTe of ocwpanry shall be obtained whenever ihere is a change in: �� , . 1)� Occupancy classificqtion of� a.building or portion ihereof,,.,. ,,, . .._. � � 2) The number of apartments'or guesi rooms • � . 3) Ownership . � I{��Group H Occupancy, number of apariments and/or guesf rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. , � � ISSUED TO: Number of ry'. f• Ci .. t, Yc'a rR'+i and/or guest Building O{fficfal L.i, .'. l�_ � � This Cerfificate of Occupancy SHALL BE posted in a conspicuous place on fhe premises and SHALL NOT 8E removed except by the Building Official of The City of�Costa Mesa under See. 306 (e) U.B.C. aorm.sua�ta%�r-sa=.s_s r - CITY OF COSTA MESA _ "- � BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: 609-00019 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 41822206 DATE ISSUED: 01/2812009 ISSUED BY: RMD JOB ADDRESS: 632 BAKER ST"CM . Suite/Unit: Vicinity: ROOF - Squares: 800 • Valuation: $10,900.00 �' . - .. � � SCOPE OF WORK: TEAR OFF (E) BUR AND�INSTALL A NEW 4-PLY BUR ON A COMMERCIAL FLAT ROOF BUILDING, APPROX 28 SQUARES. ROOF TO COMPLY WITH T-24 COOL ROOF FOR COMMERCIAL BUILDINGS. � �.� OWNER: OTERO, KELLY� � . Address: P O 80X�2542 �'�'�i t. � Unit: PHONE: � . � 7 � � _ CitylState/Zip: HELENDALE, CA � '- � �� APPLICANT: HANSEN, DUKE ' . Address: N6646636� - ' Unit: : PHONE: . - ,- Ciry/State2ip: �� CONTRACTOR: ROSS AND BARROWS INC �.'. ,� Address: 260 E ALTON.AVEUnit: - - � �. - City/State/Zip: SANTAANA,CA 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspedion Fee: Bldg Std Admin Fund TOTALFEES -� License No. , - License No. � �;;.�,. $o.00 $195.25 : �$0:00'.-: . $1�.00':, �� _: . . $196.25 � .. PHONE: License No. 327802 714557-7440 CELL: PHONE: PHONE: , NOTICE: The work autho�ized 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must wmply with all applicable codes, and all required inspeclions and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the ezpiration of this permit. cODEt, INSPECTIONTYPE o�r i�� QDE� �MSPE�nONTYPE o� ixTm�is 1616 Fiaed Syslem Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �^ p � 200 Final Re-Root Z— 7"� l. 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Faclory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORK�25.' COR7PENSATION DECLARATION. I hereby aKrm under penalty ot perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure (or workers' compensation, as provided for by,section 3700 0( the Labor CoCe, for the peAormance of the vrork for which this permit is issued. ❑ I have and will maintain v,orkers' wmpensation insurance, as required by sectbn 3700 of the Labor Code, for the performance of the work for which this pertnit is issued. My workers' compensation Insurance carrier antl policy number are: �: S�li9 � �Ji� T�rs sMipn nee0 nol De cwnplefedlNepermrt is valueOaf orre �un0iM0o[ars (51001 wMuJ Po icy Number: FXj i, ��5 % ❑ I certify that in ihe pedortnance of [he vrork (or which this permit is issued, I shall not employ any person in any manner so as to bewma subject to the workers' compensation laws of Califomia, and agrea that if I shoultl become su6ject lo lhe vrorkers' compensation provisions of Seclion 3700 of [he or ode, I shall rt�with wmply with these provisions. � �„� �� / �A�piiW ' .Sigrialure _Dal� WARNING: FAILURE TO SECURE WORKERS' COMPENSATI�ON COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO iHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of lhe Business and Protessions Cotle, and my license is in tull torce and effect. �h-#.� (' d55.# � � � �=_ //7 R'/v 9 --Car's'Signalure �gpler� CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that Ihere is a cons[ruction lending agency for the perfortnance of [he v.ork for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Date OWNER•BUILOER DECLARATIONS: I hereby aRum that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Pmfessions Code: Any city or counry which requires a permit lo consWct, alter, improve, tlemolish, or repair any structure. prior lo 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 Contracbrs License Law (Chapter 9(commencing with Section 7000) of Division 3 of I�e Business and Pro(essions Cotle) or that he or she is exempt lherefrom and 1he basis for the alleged exemption. Any violation of Section 7037.5 by any applicant tor a permit subjects the applicant to a civil penalty o1 not more than fve hundred tlollars ($500).): ❑ I, as owner of the property, or my employees vnth wages as meir sole compensation, WILL DO THE WORK, and the s[mcture is no[ intended or ofteretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does nol apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her ovm employees, provided that such improvements are not intended or of(ered tor sale. If, however, lhe building or improvement is sold within one year of completion, the ovmer-builder will have [he burden of �proving that he or she did not build or improve for purpose ot sale.). . ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH IJCENSED CONTRACTORS to conswct the project (Sec. 7044, Business and Professions Code: The contractors License Law dces not apply to an owner of property who builds or improves thereon, and who cont2cts tor such project with a cont2cta(s) license pursuant to the Contractas License Lavrs.). ❑ I am exempt under sec. Business and Professions Code for this reason:� SignaWre Da�e JOSl�a6 (3I0]) Owner ID verified by Ariv, .,ense. ❑ Ves ❑ No � ` Driver's License No. Expires: Venfication of Ownership by (rype of document, i.e. - Droperty tax bill�or aeed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:� � � ❑ I hereby certify lhal no ezcaval'an frve (5) a mwe feel in depth into wfiich a person is requiretl to descentl, will be matle in conneclion with v,ork authorized by lhis permil, and that n0 building sWCWre, scaffdding, falsework, or demolition w tlismantling thereo(. will he more lhan thirty-sa (36) leel high. (Chap. 32, Grp 2, Art 2, Sec. 341, TM1Ie 8, Califwnia Administrative CoCe). ❑ As owner-builtler, I will not employ anyone to do work which vrould require a permit from Ne Division of IndusMal Safery, as notetl above, unless such person has a permil lo do such work (rom lhe division. Aod��'s SipnaWre Division of Indusirial Safety Permit Number: _ HA2/1RDOU5 MATERIAIS AND EMISSIONS CERTIFIGATION: 1. Will the applicam or present or (uture building occupam need lo file and certify a Business Plan for emergency response to release or threatened release of a hazardous matenal7 ❑ Yes ❑ No (Seclion 25505 0( the Calitomia Health and Sa(ety Code requires, with some exceptions, tha[ a Business Plan De filed with the Costa Mesa Fire Department by every business which �as at any one time during a reportee year a quanlily ol hazardous ma[erials 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 temperaWre antl pressure). 2. Dces or will the applicant or Dresent or future builtling occupant need to fle a regislration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Cali(omia Health antl Safety Code, with some ezceptions, requires regislration vrith Ihe Costa Mesa Fire Departmenl by each business which at any one time has on hand a quantiry of aculely hazardous matenals equal to or greater Ihan a weigM of 500 pounds, or a volume ol 55 gallons, or 200 cubic feet of compressed gas at stanCard �emperaNre and pressure). 3. Does or will the applicaN or present or future building occupaN neetl ro prepare an RMPP (Risk Management and Prevenlion Program for aculely hazar0ous matenals)7 ❑ Yes ❑ No (Section 25534 of the California Health and Safety Cotle provides that the Costa Mesa Fire Department may require lhe preparation, certi(cation and filing with the Fire Depanment of an RMPP by businesses which are required lo register awtely hazardous materials with Ihe Fire Departmenl. 4. If an RMPP is presenlly required, has Section 25534 of the California Health and Safely Cotle been fully complied wilh't ❑ Yes ❑ No 5. Does or will Ihe applicant or present or future building xcupant require tor the work which is ihe subjetl of this application a parmit (or such consWction or modification from the South Coast Air Qualily Managemenl Disirict or irom any other air pollulion control tlislrict or agency7 ❑ Yes ❑ No (Sectbn 65850.2 of tha Califomia Govemment Code requires lhat the requestetl infortnation De fumisheA on applications for rron-residential building permits). 6. Will any part of the facilily to be constructed under this permit he within 1000 feet from lhe outer bountlaries of a school7 � Yes ❑ No Qf yes", the faciliry must meet the requirement of Sections 25534 antl 42303 of the Calitornia Health and Safety Code�. 7. If a pertnit from the South Coasl Air Quality Management District or other air pollution control district or agency is required for Ihe work which is the subjec� of this application, have all of the disclosures prescribetl by California Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No 8. pf yes", auach certificate ot wmpliance from the appmpriate airpollution tontrol oHicer). - • �� ' - CERTIFICATE OF COMPLIANCE: I'certify that under penalty'of perjury.the infortnation given a6ove is correct. I a9ree to comply vrith all state laws antl city ordinances regarding Hazardous Malenals and Emissions. ,� Signalure Dale � � CERTIFICATE OF COMPLIANCE /1ND AUTHORIZATION OF ENTRY: 1 certify under penally o( perjury that I have reatl this appliwtion.and sWte that the inlormation given is correcL I agree to wmply with all state laws and ciry ordinances relating lo building wnstruction, antl authorize representatives of the Cily of Costa Mesa to enter upon the above-descrihed property tor inspection purposes. 1 agree not to occupy or allow occupancy of any building authorized by this pertni[ until final inspection. � gnature LegalOwner(sl Date � / - n —ElIX�Au ¢M'Appli�'anl D�I! w * � v R CITY OF COSTA MESA Bl/ILDINO DMS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT NUMBER. E08-00093 PERMIT TYPE ELEC STATUS: ISSUED APN: 41822206 DATE ISSUED: 04101I2008 : ISSUED BY: RMD '', � JOB ADDRESS: 632 BAKER ST;CM ��,' ' Suite/Untt ,�, Vicinity: INTERIOR OF SUITE TO;EXTERIOR ,' � �-�' SCOPE OF WORK: RELOCATE�METER INSIDE�OF BLDG. TO EXTERIOR 8 REFEED.EXISTING SUB,PANEL/LOAD TO REMAIN THE SAME. NO OTHER WORK AUTHORIZED Gj�� \r ?' �:+rp" ,- L'. ��{� ia �'i � , � � �af�� ;�n� j/.. ..�:,y�i` ,.TlA`-��• .;.�. i t7` � C�: ,1.� r+ ' :�': � . . . OWNER: OTERO, KEILY .-, �� '<��f Address: P O�BOX 2542'�Unit> �� ,".�. PHONE: ��i .� �.."� .�;!''��'�.~ , � � Ciry/State/Zip: HELENDALE, CA . � . . � ,. . - _ ',r.. � , APPLICANT: LOGAN, DENNIS r;',,� r �- Atldress: � Unit: �' , ' , . PHONE: 949 689-7778,,` � �: r"". - �" City/Slate/zZip: � . ' �. - , l.; . . .... , . , � CONTRACTOR: DENNIS LOGAN�ELECTRIO �� - - - -� . License No. 725011 � . Address: 300 SANTA ISABEL Unit: UNIT.A , � � � � . �- PHONE: 949-650!1303 City/State: COSTAMESA,CA-�; - ZipCode: 92627, :-CELL: , �. :../... - -- . ' ' . .. � -, . . . . _ . �.<�. '� , - - . ' � . � � � - , � ELECTRICAL PERMIT FEES Electrical Plan Check Fee:.. . � $42.25 Electrical Permit Fee: $84.50 Reinspection Fee �� • ' ' $0.00 : TOTAL FEES , $126.75 � - . -: _ � � - . - . . i;�. � . - _:'_ r.. . .. . _ , NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 obfained. Failure to obWin inspections and final approval will result in lhe expiration of this permit. COpE /. INSPECTION TYGE 1818 Fizetl System Final Fire Prevention 1268 Pool Spa Final . 200 Final Re-Roof 201 Fina181ock/Retaining Wall 202 Final Factory Fire Place 203 FinalSign 204 Final Demolition � INTIiULS CODE/ 206 208 210 212 220 ixsaecnox rrae Final Mechanical Final Plumbing Final Electrical P/�, Final Fire Prevention Final Planning Approval 222 Final Site 250 Final Building/Occupanc.y Q�g ix n i /i ! p _— � � t � �WORKERS' COMPENSATION DECLARATION: I hereby aRrtn under penalry o1 perjury one of ine tollovring deGarations: ❑ I have antl will maintain a cerfificate o( consent to self-Insure (or workers' wmpensation, as providetl for by section 3700 of the Labor Cotle, for the performance of the xork for which Ihis permit is issued. ❑ I have and wi0 maintain Hwkers' compensation insura�e, as requiretl by section 3700 M the Labor Code, !a ihe peAwmance of the work fa wfiich itns pertnit is issued. My workers' wmpensation Insurence cartier antl policy number are: Cartier: (T/us mtlm necd nd pe cpryYetetl l Ne perml u volue0 ef one nur�NeO Mars (510p) a ksa.) P_o�licy NumDer: .1� i cerG(y lhat in the peRormance of the work for which lhis permit is issued, I shall not employ any person in any manner so as lo become subject to lhe workers' compensation laws of Calitomia, and agree that il I should become subject to the workers' compensation provisions of Section 3700 of the Code, all forthwith wmply vrith these provisio . d �y lienCs SpnaWre D �e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AN� SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000�, IN ADOITION TO THE CAST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEI^S FEES. LICENSEO CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions o( Chapter 9(commencing with Seclion 7000) of Division 3 of the Business antl Protessions Code, and my license is in (ull force antl eHect. Lic D Gass # C � � Convaaa's SignaNre ale CONSTR CTION LENDING AGENCY: ❑ I hereby af(um that there is a wnstmction lending agency fa ihe performance of tha �wrk for wfiich tlris pertnit 's asuetl. (Sec. 3097. Civil Cotle). Lenders Name: Lentlers ACAress: Date OWNER-BUILDER DECLARATIONS: I hereby affirm that unCer penalty o1 peryury Ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW (Or the follovring reason (Sec. 7037.5, Business and Protessions Cotle: Any city or county which requires a permit to wnslruct, alter, improve, tlemolish, or repair any slructure, prior to its issuanca, also requires the applicant tor such permit to file a signed statement that he or she is licensetl pursuant to the provisions of Ihe Contreclors License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of t�e Business and Professions Cotle) or that he or she is exempt there(rom and t�e basis for the alleged exemption. Any violation of Seclion 7031.5 by any applicant br a pertnit subjects the appliwnt to a civil penalty of not more ihan five huntlreC dollars ($500).): ❑ I, as ovmer of the property, or my employees vrith wages as their sde compensation, WILL DO 7HE WORK, and the structure is not intended or oKered for sale (Sec. 7044. Business antl Professions Code: The ConUactors License law dces not apply to an ovmer of property who Guilds or improves thereon, and who dces such work himself or herself or ihmugh his or �er ovm employees, provideC that such improvemen(s are nol intended or offered tor sale. If, however, the builCing or improvement is sold wit�in one year ot wmpletion, the owner-builder will have lhe Durden of proving that he or she did not builC or improve for purpose of sale.). ❑ I, as owner of the pmperry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct [he projecl (Sec. 7044, Business and Professbns Code: The contractars License Law does not apply lo an avner of property v+ho builds or improves thereon, antl who cont2c15 for such project wilh a contractor(s) license pursuant lo the Contractors License Laws.). ❑ I am exempt under sec. � Business and Professions Code for this reason: SgnaWre Date JOSI<6(101� 4 Owner ID verifed by driver n, � Yes ❑ No Driver s License No. Expires: Venfication of Ownership by (rype of documenC i.e. - property Wx bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetlify that rro excavation frve (5) or mwe leet m depth into which a person is required to descend, will be made in conneclion with work authwized by ihis pertni�, and Ihat no building shuclure, sc�(dding, lalse.wrk, a tlemolition w tlismantling lhereo(, will be more lhan thirty-sBc (36) teet high. (Chap. 3,2, Grp 2. Art 2, Sea 341, TiUe 8. Califomia lWministrative Code). ❑ As ovmer-builder, I vrill not employ anyone to do work which would require a permil from Ihe Division of Industrial Safery, as noted above, unless such person has a permit to do such wvrk from Ne division. Appli�nfs SianaWre Division of Intlusinal Safety Pertnit Number. _ NAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicaN or present or future building occupant need b file antl certify a Business Plan tor emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Seclion 25505 0l Ihe Califomia Health and Safety Code requifes, with 5ome exceptions, that a Business Plan be filed vrith the Cosla Mesa Fire Depanment Dy every business which has at any one time dunng a reponetl year a quantiry of hazardous materials equal to or greater lhan a vreight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas al stantlard temperaWre and pressurej. 2. Dces or will the applicant or present or fulure building occupant neetl to file a registration form for acutely hazarCous materials? ❑ Ves ❑ No (Section 25533 of ihe Califomia Healt� anA Safely Cotle, wilh some exceplions, requires reqislration with the Costa Mesa Fire Department by each business which at any one time has on hanE a quanlity of acutely hazardous matenals equal lo or greater Ihan a v.eight of 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressetl gas at standartl temperature and pressure). 3. Does or will the aDPliwnt or present or future builtling occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous malerials)? ❑ Yes � No (Section 25534 of the Califomia Health and Safety COCe provides thal the Cos[a Mesa Fire Department may repuire lha preparation, certification and filing with Ihe Fire DepaAment of an RMPP by businesses which are required ro register acutely hazartlous malerials with Ne Fire Department. 4. I( an RMPP is presenlly required, has Sectlon 25534 of lhe Califomia Health and Safety CoCe been fully wmplied with? � Ves ❑ No 5. Does or will the applicant or present or tuture building occupant require tor the work which is the suhject of this appliwlion a pertnit tor such wnslruction or motlificalion from me SoWh Coast Air Quality ManagemBM Dislritt or (rom any other air pollution contml district or agency? ❑ Yes ❑ No (Sectbn 65850.2 of Ihe Cali(omia Govemment Code requires that the requested in(ortnalion be lumished on applicatbns for non-residential building permit5). 6. Will any paA of lhe facilily lo be consWcted untler this permit be wilhin 1000 feet from lhe ouler poundaries of a school? ❑ Yes ❑ No (If yes", tha faciliry must meet l�e requirement of Sections 25534 antl 42303 ol [he Califomia Health antl Safety Cotle). Z I( a Dertnil from Ihe South Coast Air Qualiry Management Dislrict or other air pollution conlrol GisMcl or agency is required for the work which is the suDject of Ihis application, have all of the disGosures prescribed by Califomia Healih and Safery Cotle Section 42303 been made? ❑ Yes ❑ No 8. pf yes", attach cenificare ot compliance from ihe appropriate air polNtion wntrol o�cer�. CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the information given above is cortect. I agree to comply with all state laws antl ciry ordinances regaraing Hazardous Materials and Emissions. . , SignaWre CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have reatl mis appliwtion antl state that lhe intormation given is wrrect. I agree to comply with all state laws and city ordinances relaling to building construction, and authorize representalives o( Ilie Ciry of CosW Mesa lo 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 inspecfion. $ig re oi Legal Owner(s� � / ri X lor Au1l�mze0 Appli�nl IC , 19042. ; � ��`� COSTA MESA BUILDING-SAFETY DEPARTMENT MA R 1 2 1963 P.o.Bo=9,� �o�AMgaA.��.�FORN�A FINANCE DEPT. For Appllcanf to Pill In Completely ��L�ATr�N �e ��irMESA TYPE OR PRINT � BUILDING / 1 For Office Use Only BUILDIN6 ADDRESS �� S ✓ �� . REC8IPTNO. PERMITN COSTA MESA, CALIFORNIA � ` xecerve er o ne mveo owre �sa� OWNER .J C � � �/ � MAIL w ' � BUILDIN6 ADDRE6$ {/ ADDRESB }� � ..L �ii_. _ re�../%li✓iaiA FIRB �..e� f1I ,.e..��e r. DESCRIPTION OF WORK � • ZONING NO.OF UBEOPNI PLANB OUILO�NO LlOAL A.P.NO. I �� I NOTE: NO EAVE OVERHANG BHALL BH LE83TMAN 80' TO SIOE @ REAR P. L. EAVES ALLOWEO (U.B.C.REQVIREMENT: YARDSAPPROVED YARDSAPPROVED MAIN BUILDIN6 . ACCESSORY BUILDIN6 O. O �— 'a, � R. s�oe.� �w'r. F-r L. SIDE �IFf. � �FT � N REAR FT. FT DISTANGE BEf. BET. MAIN Q �H MAIN BLOG9. ACCE55. BLDf -� ' VAR.# DATE lIEB G.U.P.JF APPROVED ?�-.� APPRO� �O n "__ � �, I HEREBY ACKNOWLBO68 TXAT 1 X�Ve REAO TNI9 APPLIC�TION AND 8TAT2 THI1T TNe Ae VE �8 CORReCT AND AOREB TO COM. PLY WITH ALL CITY OA N AND 9TI1T8 LAWB q80YLAT1 6UILO�NO CONBTRUCT /%� SI6NATUR80R / l PERMITTE AUTHORIZHD T iS � .<d, � 64.FT. � TXE AMOUNT 9HOWN UNOeR VALUAT�ON 18 POq TNe � PtIRP09E OF 88TABLIBXINO 11 PEPMIT F88 ONLY. o VALUATION p � PERMITFEE S ,� / �� j $ //L/ m r �� — � `J'� ¢ � _ P