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HomeMy WebLinkAbout2479 ELDEN AVE - Building Permits W-C11.1-.4'.., CITY OF COSTA MESA f i� ,1� BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT 4 PERMIT PERMIT NUMBER / B98-01870 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2479 ELDEN AV Status: ISSUED Suite: A Applied: 10/15/1998 Vicinity: UNIT A Issued: 10/15/1998 Parcel Nunmber: 43928125 Zoning: Applicant: ELLIOTT, JAMES Address: Phone: - Zipt Owner: WENDLER;.HARRY ENIS TR /i Address 18472 DURFEE CIR - . �% - . A � ' � \ � J ' Phone: - ,, - �" :N.:: ; ,,VILLA PARK,CA Zip: 92861 "\ .- ' 7 K _A _ _/�/ / A , Contractor:, ELLIOT ROOF:MAINTENANCE Address: 324 S EARLHAM-ST ' ''\ .%� Phone,714-997-4938 ` ' �; OR CA!,,// Zip:,4 92669 License:-..465344 I Y. 'Arch/Eng. : ; a Address: r/ -Phone;'; : - A /... - _ - Zip: - License: ' / ' SCOPE OF PERMIT / .T/O EXISTING ROOF ON UNITS A, B-E,AND F-G OF-AN EXISTING MULTI-FAM.RESIDENCE. ` ' REROOF WITH CELOTEX.PRESIDENTAL SHAKE(COMP._SHINGLE).ROOF CERT ATTACHED TO PERMITS. FEE SUMMARY ;'/. , Plan Check: $0.00 , Calc Valuation: $3,015.00 Permit: $87.25 — l/ Claim Valuation: $3,015.00 SMIP Res: $0.50 .� / . SMTP Corn: :$0.00 _____ Other: '$0.00 • , ' Inspection: . $0:00 - Total: • $87.75 .;v ' - PLANNING`&ZONING , _ - SETBACKS ' ' , - / / MAIN STRUCTURE Front" 0-0 ' ' 'Rear 0-0 " Left 0-0 Right 0-0 , ACCESSORY Front 0-0 Rear 0-0 Left i 0-0 ' ' " Right, "0-0 PARKING Existing: 0 Required: 0 Proposed: 0 ' - NOTES: ' • 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 DECLARATIONS a _ 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 perform-Nice of the work for which this permit is issued. ❑ I have and 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'compensation Insurance canter and policy number are: Cartier: Policy Number. (This section need not be completed if the permit is valued at one hundred dollars($100)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 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. • Applicant Signature:- flyr� �ete: ,o/)1C/fl WARNING:FAILURE TO CURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE(SI C0,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.tit#� Class M Contractor's Signature: Date: 0 / 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: Lender's 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(commenting with Section 7000)of Division 3 of the Business and Professions 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 to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or 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 Lew 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 Driver's 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 five(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: 1 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 Callfomla 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 end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Li a plication a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes ❑No (Section 85850.2 of the California Govemment 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? ❑Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 11 a permit from the South Coast Air Duality 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? ❑Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty 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 AUTHORIZATION 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Si nature re Qf Legal Owner(s) Date ,! And/Or'AUthonzed Applicant rDate— gong L IBSPFCTION TYPE DATE IfIImAIS COOE1 INCPEPTION TYPE DATE DMUS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final nC 208 Final Plumbing 200 Final Re-Roof `/f f 6 L 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Anal Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-48 ?fir CITY OF COSTA MESA y ..�,) BUILDING DIVISION :, '"s�"i,. ' DEVELOPMENT SERVICES DEPARTMENT u `14y • PERMIT PERMIT NUMBER/ %%own ill B98-01872 V (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2479 ELDEN AV Status: ISSUED 1/v'l Suite: Applied: 10/15/1998 Vicinity: LiNIFS•Br e-D-E-4PEEM4,F/G DUPLEX J Issued: 10/15/1998 Parcel Nunmber: 43928125 Zoning: . Applicant ELLIOTT, JAMES Address: -,r - - Zip: - - _ t: Owner: WENDL'ER,-HARRY ENIS TR Address 18472-DURFEE CIR - -. _ 1 � \ \ //fVILCA.PARK,CA; :- - Zip: 92861 -r-Vv C N ' \.V•'\ t, / N ,, " �- // /A `.AA` ' Contractor:.' ELLIOT.ROOF MAINTENANCE -, i - 'NI-, -ivy' Address: 324 S EARLHAM-ST ' moi: v. A '/5'i <\ i Phone: 714-9974938 iOR CA Zip y 92669 / ,1 ` , ; //<' License:yr 465344 I "r _ _ ` Arch/,En9 ,%� v I � , Address f - f' i - <`� � ‘ _ ,-2 ' ,'Phone` �« Zip: License: / '`, ., SCOPE OF PERMIT --170 EXISTING ROOF ON UNITS A, B-E,AND F-G-OF-AN EXISTING MULTI-FAM. RESIDENCE. ' . t // -REROOF WITH CELOTEX--PRESIDENTAL SHAKE(COMP`SHINGLE).;ROOF CERT ATTACHED TO PERMITS. ` H t , : t.- •,r .v FEE-SUMMARY // 1 r Plan Check: .$0.00 - • _- ` '—Calc Valuation: •1 - $6,028.00 Permit: `$124.75 -j/�/ Claim Valuation ' $6,028.00 •SMIP Res: :$0.60 -c , - SMIP Com: , ,$0.00 Other , `$0:00 . Inspection: $0:00 Total: - $12535 /•//,/, N'7 '/> v• • " ; PLANNING/&ZONING -i.- '71 ' t v . SETBACKS . _ , - . , _ , . _ - ' MAIN STRUCTURE Front' - 0-0 'Rear , 0-0 Left 0-0 (Right -0-0 ACCESSORY Front 0.0- _ Rear 0-0' Left • 0-0 - Right, 0.0 PARKING Existing: 0 - Required: 0, Proposed: . 0 NOTES: 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 DECLARATIONS • e _ 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. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cede,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number (This section need not be completed i1 the permit is valued at one hundred dollars($100)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 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. //��/' ." Applicant Signature: �, Y,�1� /Date: l /5 / WARNING:FAILURE TO URE WO KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S 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 ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lt.# Class# Contra�Signeture: r 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: Lender's 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 Professions 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 to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or 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 properly who builds or improves thereon,end 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 Driver's 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 five(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: 1 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L]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? ❑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 penalty 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 AUTHORIZATION 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. v jeSign u e OLLega�Owner(s) J r Date And/Or Authorized Applicant rDate CODE I INaPECTIDNTYPE • DAIS MEALS =El INSPECTIONTYPE DATE IN MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final r / 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 2446-40 /4 ' > - - CITY OF COSTA MESA yt . BUILDING DIVISION 1. 1 ' :' , DEVELOPMENT SERVICES DEPARTMENT �• PERMIT PERMIT NUMBER 41/4431111T0'I B98-01871 V (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT • Job Address: 2479 ELDEN AV Status: ISSUED Suite: Applied: 10/15/1998 Vicinity: (,UMTS B,C,D,E 4 PLE PSO-DUPL-EX Issued: 10/15/1998 Parcel Nunmber: 43928125 Zoning: Applicant: ELLIOTT, JAMES Address: Phone: - - . Zip: Owner: WENDLER,'HARRY ENIS TR Address 18477DURFEE CIR - . A� , ,- VILLA PARK,CA . _ - Zip: 92861 I � .`, / , v, � 'iii Contractor ' ELLIOT,ROOF-MAINTENANCE , Address: 324 S EARLI-IAM ST ' ' < Phone: 714-997-4938 ,`, _- 'OR CA:- ' Zip::...92669 N. Licenser.465344 - , 'Arch/Eng: - •. . •. • , Address: v ' - -Phone: . Zip: - - - License: SCOPE OF PERMIT T/O EXISTING ROOF ON UNITS A, B-E,AND F-G OF,AN EXISTING MULTI-FAM. RESIDENCE. / REROOF WITH CELOTEX PRESIDENTAL SHAKE(COMP.SHINGLE).,ROOF CERT ATTACHED TO PERMITS. FEE SUMMARY Plan Check: $0.00Calc Valuation: $12,057.00 Permit: $199.75 O j Claim Valuation: $12,057.00 SMIP Res: $1.21 i SMIP Corn: $0.00 `- _ • Other: $0.00 Inspection: $0.00 , Total: • $200.96 , , ' PLANNING'S ZONING . SETBACKS . MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 , Right 0-0 ACCESSORY Front '0.0 ' ' ' Rear 0-0 Left 0-0 , Right ", 0..0" PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work Is suspended or abandoned lora 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm •under penalty of perjury one of the following declarations: -•• ❑ I have end 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. ❑ I have and 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'compensation Insurance carrier and policy number are: Cartier. Policy Number. (This section need not be completed ll the permit Is valued at one hundred dollars($100)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 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith • comply with these provisions. / D�/�/q� ApplicantSignature: h7s2� �cilei Date: f WARNING,FAILURE TO SREWORJERS 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 3708 OF THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.LIc.#-/ Class# ' - � C -- Contrectofs Signature: .h.. 1 P Date: _,,/_574pp 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: Lender's 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 Professions Cale)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 to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,br my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sate(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of property who builds or Improves thereon,and who does such work 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 Driver's 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 five(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? ❑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 Are Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 penalty 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 COMPUANCE AND AUTHORIZATION 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. Signature"Of,Legal Owner(s) y Date �2- 7 D / cv g And/Or At thorized Applicant �Date� roes L 184PFCTinH TYPF DAIS WEALS GOQEF INSPEC�,JYEN) PE DAM g1)IDELB 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final G 208 Final Plumbing et-s---5et-s---5•1200 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 2446-48 c • 44320 /o► CITY Q G1'e �� M254\ ao► COSTA MESA BUILDING-SAFETY DEPARTMENT ;� J V L 14 07 7 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 .i 6 / ^y APPLICATION FOR STRUCTUURA ER/MIT For Applicant to Fill in Completely— Use Ink Only 0 <- — � _ t RECE�11/ED BY IDATE'RECEIVED ISSUED BUILDING 2ir9 FG,2E� % C ADDRESS �E/B/ I/ /� ,sr OWNER .L.- 20/ A.P. NO.J/9 Ot �L DEQ PER "20 MAIL ��/J r���/ / !, J� BUILDING /� G�,J/A — h ///Q/ ADDRESSZ /f2 /74 Yl /r-Oae (/'!' ADD RE LY`7 air �J� �/ TECITY N�--r/c I /ft /f_ NOL3TS�7yt1 TRACT 3OO I /`�JK /� BLOCK CONSTRUCTION/ ,,{r N� IADD ALTER REPAIR MOVING IIFMOI ISH e LENDER r e-- f—•C=U BRANCH / OWNER 1(�. /n' ADDRESS �,�{///�� s( P.J' $ ARCHITECT ,,,rr TEL.,-,..z., USEV\II All ''//T�fj�,{. OR€NGINEER(/r_yrd. OEc•GTii/=/= NO./. •�Sy — FIRE ADDR ESSI2. N /1,,e ,oe/l1L./�,(7 ,44 ZONE TYPE GROUP APPROVED CONTRACTOR� (j,e4Pe,JCIN 5-74 Co. BY DATE ADORES/2/7 ADOREALUA A- 771--14&TEZsL E NO.OF USE OF .W CITY c . /8 Ns F.• --.Cr PLANS BUILDINe - '4)-C I STA E CITY YARDS APPROVED YARDS APPROVED / LIC.Nycc---7•2''J•',l7 - LIC.NO. 709 3/ MAIN BUILDING ACCESSORY BUILDING 0.1 SIZE T� / NO.OF BLDGS. (FROM C/L STREET) O. OF LOl X CJ S I NOW ON LOT FRONT /0 FT. A r FT. Q USE OF c •�--� r.• EXISTING BLDG.. fie /29:4,,,.(/f/7 R ma J / FT---8 A, FT. en (—• S Separate permits are required for L.SIDE FT, FT. Ct electric,plumbing and heating work. REARFT./-^� fal 25 FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ' �Q MAIN BLOCS. ACCESS BLDGS. /� ` VAR. . DATE Qv�ls�./ /Y-ry 64-4 C.U.P.qp �] APPROVED a IbLU F �.'�' ',�`ktR191R�N1�NTS .1 A. I hereby acknowledge that I have read this application and state n 00 that the above information Is correct and agree to comply with m all laws regulating building construction, and I shall not employ 0 Z any person In violation of the workman's compensation laws of o 0 the State of California. IMO 3 I hereby certify that I am properly licensed as a contractor under 1571‹. FT. dw N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR a, 1�. Chapter 9, and that such licenses are In f 2 yrce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: s V am exempt from t •rovia •ns •f,thPt tPo99 f California Business VALUATION PERMIT FEE $ N and Professions •de P Signature of a PLAN CHECK S 1 39i7 S' c Permittee , - $ w4 e o 0 TAX $ x/0�J6 f Lb Authorized Agent / TOTAL PAID $ /91¢sZ3 U • /`/ h �O SEP 12 77cnsn00 488 0 **215. 0 . a COSTA MESA BUILDING•SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only //I� RECEIVED BY DATE RECEIVED DATE ISSUED BADDRESS 2$79M.D�� a� dip// - PERMIT NO. OWN MAILER a ' / ADIDRESSQ?6179' i/ / �eIO/, // ADDRESS TEL. TRACT LOT BLOCK CITY NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH LENDER BRANCH / / OWNER L,•, 7 '' ADDRESS SAL. ARCHITECT TEL. USE E OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP /lJ���,�� ''7J� APPROVED CONTRACTOR �� 't&2!!tl/ are, . / BY DATE ADDRESS wrr TEL. ZONE NO.OF USE OF NEW CITY NO, PLANS BUILDING F�+ STATE CITY YARDS APPROVED YARDS APPROVED C. LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLDGS. (FROM C/L STREET) 0. OF LOT NOW ON LOT - FRONT FT. FT. Q USE OF ,�. EXISTING BLDG. R.SIDE FT. FT. rA FSeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. W REAR FT. FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q I� �' (J/ MAIN BLDGS. ACCESS. BLDGS. > ` //•SAA//"LLAAss`IjL/J¢'//// ��'��C� APPROVED DATE Q " C.U.P. APPROVED APPROVED } BY DATE CCW O. I hereby acknowledge that I have read this application and state N p(, that the above information Is correct and agree to comply with as 6, all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of 2 xW the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. co the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ra Chapter 9, and that such licensee 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 VALUATION PERMIT FEE $ a!� - I' a and Professions Code, Division 3,Chapter 9. s /�/ J� m PLAN CHECK $ ce o Signature of c Permittee $ TAX $ u.2 U Authorized Agent TOTAL PAID $ . 3 4432 I. �� (02 — ,, CO Qy COSTA MESA • COSTA MESA BUILDING-SAFETY DEPARTMENT I P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 II II I 14 1- -' I a PPILICAturi FOIZ STRUCT ' L ' er For Applicant o F' in Completely —Use Ink Only "t _ L R CEMED BY DATE RECEIVED I ATE ISSUED ADDRESS Ii L..DE /i G/ O 20/ 202 ' RMIT O. OWNER r,2, Sy/Q A.P. NO. ' -- _ J I _ MAIL BUILDING y�y p• \ /r/0// '2, ADDRESS ADDRESt:T//.3 'Z TEL. TRACT 3o0 PP.Tt BLOCK CITY NO. CONSTRUCTION NEW I ADD ALTER I REPAIR MOVING DEMO'ISH LENDER �/yVp 111 BRANCH OWNER Ie,L. / /) ADDRESS /�VA:UE ARCHITECT 1,s ^ TEL. S_ //, .� /// $ OR ENGINEERf_•$" l/c >A-/ci 1/c NO. i FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR �� 0�,� ( ONS /n '�.>o+- BY DATE ADDRESS TEL. ZO NO.OF USE OF E CITY NO. PLANS BUILDIN ��*A. I-. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE INO.OF BLOCS. (FROM C/L STREET) 0. ' OF LOT NOW ON LOT FRONT �t) FT. A. A. S FT. Q USE OF y EXISTING BLDG. R.SIfF 37 FT. 'I 1 FT. V) ! 'E - Separate permits are required for L.SIDE J FT. FT. G • electric,plumbing and heating work. REAR /0 1 l0 FT. 37 s FT. Iz7 • USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& G . ,lam/ [• I, / ,s MAIN SLOGS. ACCESS.BLDG& Q ¢ OA, /r',/ /t/'I (p l�iC/VLES VAC URP.qW DATE APPROVED A . a '.l _APPROVEDc&$ 9 p DATE 9/r//7 7 - Ix 'OLD /FOR SPEC - L RE•U •e iiw . 0 I hereby acknowledge that I have read this application and state �^ c4 that the above Information is correct and agree to comply with mC 0 all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of /J / u the State of California. 371J,SQ. FT. /92a s iz_t__- rr 0 m 3 I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE 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 of the Stem o Afornia Business VALUATION PERMIT FEE $ d and Professions Code, Div Ion hap 9 n • Signature of /� in PLAN CHECK $ Z/3•//65 0 Permittee - -. . $ /G4 QOo TAX $ 8-94 2 U SAuthorized Agent TOTAL PAID $ 227.8 a• //lL r/ / SEP 12-77 ,00 492 = *329.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only ///4 ���,y����/ �/fJ� itch it"z RECEIVED BY DATE RECEIVED DATE ISSUED BUADIDRESSp2� / / A��%YFiivl(/'r" , 4444iz /�_w[ /�/ ///PERMIT SE R MI�Ta[/N�O. �y� MAILER ' `/ ADORES4/ L /� �'Tw�`i age tire- ADDRESS fe�ery� ADDRESS ` 4 e TEL. TRACT LOT BLOCK CITY NO. CONSTRUCTION NEW ADD I ALTER I REPAIR MOVING DEMOI ISH LENDER III BRANCH OWNER if . J. . ADDRESS AL ARCHITECT TEL, uSE $ OR ENGINEER NO. _ FIRE ADDRESS ZONE TYPE GROUP CONTRACTOR¢ J ��=/f tt2*" p( APPROVED • DATE ADDRESS "��//YYCC ZONE INO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED gLIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING ly BLOCS. INO.OF BLD . (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. R.SIDE FT. FT. to (-1 Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. WREAR FT. FT. I.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q BLOW. BLOCS. ACCESS.BLD . / a /� lar VAR,# DATE '--� j,t( K C.U.P.# APPROVED 7 APPROVED 3" _BY DATE a w 0. I hereby acknowledge that I have read this application and state N ;C, that the above Information Is correct end agree to comply with me 0. all laws regulating building construction, end I shall not employ Di Z any person in violation of the workman's compensation laws of E SW the State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. tv the State of California Business and Professions Code, Division 3, THE 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: to am exempt from the provisions of the State of California Business VALUATION1L� o and Professions Code,Division 3,Chapter 9. PERMIT FEE $ /��M-�� N t� PLAN CHECK $ me Signature of U. Permittee $ TAX $ f ✓� U Authorized Agent TOTAL PAID $ �� . ' y, ., P WV OF COSTA MESA ,. 4 4322 COSTA MESA BUILDING-SAFETY DEPARTMENT J U L 14 197 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 � 9/79 APPL CATION OR STRt7CTURAL,PEPMIT For Applicant to Fill in Completely — Use Ink Only© �s 7� 15 BUILDING att., fl. /n] �/ RECEIV DBV DATEI ECIIVED�OAT.EJ1 SUED ADDRESSazy ftGDEd/ /')"(t(i \/7 //. OWNER fret . S yj/2j0 A.P.NO.//9-025-02 PERMIT NO. MAIL BUILDINGNyi " a ADDRESS ADORES 7..--/ aiTEeeT�,, ,,__ A CITY NO. TRACT 3or1) P2 ,46/p BLOCK CONSTRUCTION NEW IADD ALTER'REPAIR MOVINrING DFMOI ISH LENDER 4 BRANCH OWNER kiet. ADDRESS '� 1 VAL E ARCHITECT TEL. VSE Anti w 5 OR ENGINEER/t./L.. JJOS..IT/Cl NO. FIRE ADDRESSZONE TYPE GROUP APPROVED CONTRACTOR 1*2 OCA.0 Cc/1'frty Cs_ BY DATE ADDRESS TEL. Z yr INO.OF USE OFrola �� _ / CITY NO. O/ PLANS BUI LDIF NEW 7�//a/+JJtt/ —+ STATE CITY YARDS APPROVED YARDS APPROVED 7 LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING {yl SIZE NO.OF BLOCS. (FROM C/L ST/FgV) ET) CI. OF LOT NOW ON LOT FRONT . S6/FT. FT. et USE OF EXISTING BLDG. R.SID4F ` 2-FT.'844 FT. VI F (�Separate permits are required for L.SIDE FT. a FT. electric,plumbing and heating work. ' D REAR /0 FT.7/177i FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. I BET.MAIN& Q / MAIN BLDGS. ACCESS BLDGS. Q Q�e ON/I- Iii,Ail iI4Q . VAC URP.qy. OATE APPROVED 7 APPROVED//„� w� G��--7 10LD FO SPL K C/ It t`MtN'IS cgw oI hereby acknowledge that I have read this application and state CC that the above Information Is correct and agree to comply with m a. all laws regulating building construction, and I shall not employ Z�y any person in violation of the workman's compensation laws of o S the State of California. (� /` . = Li 3 I hereby certify that I am properly licensed as s contractor under a vo 50. FT. 4+O .+'� a: 0 the State of California Business and Professions Code, Division 3, THE 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: a (nam exempt from the provisions of the State of C. o Isla Business e \ and Professions Code,Div n ter 9. VALUATION PERMIT FEE S v, / ri /O r, PLAN CHECK S /00e G Signature of i' ?Qgoo LL Permittee $ 7o. TAX S 2s 7j. u Authorized Agent TOTAL PAID $/D f in 2 ..10 770 • SEP 12-77D 493 d***154.00 443 �� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION•FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — se Ink Only RECEIVED BY DATE RECEIVED' DATE ISSUED BUtLDING�,LrJ/, 1 //s / A- ADDRESS TKh/[rte' I PERMIT NO. OWNER /Lr / 0 A.P.NO. MAIL / BUILDING Cc4L7e y4 ADDRESS ADDRESS T TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEW I ADD I ALTER I REPAIR MOVING DEMOI ISH LENDER BRANCH Rf /i s OWNER .0 Alf ADDRESS j/• UE / ARCHITECT TEL. USE E OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR ,., fi BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 9.1 SIZE INO.OF BLOCS. (FROM CA.STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. a USE OF EXISTING BLDG. R.SInF FT. FT, Cl) 12 F Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. D REAR FT. FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& C MAIN BLOCS. ACCESS.BLOCS. VAR.# DATE ..l 41 C.V.P.# APPROVED a a 7 U APPROVED ' _BY GATE GC 0 I hereby acknowledge that I have read this application and state n 04 that the above information is correct and agree to comply with as d all laws regulating building construction, and I shall not employ Z any parson In violation of the workmen's compensation laws of 2 IW the State of California. . m I hereby certify that I am properly licensed as a contractor under SQ. FT. Iv the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR as 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 /sfs�r I '.I d and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ V1 PT/ 'a m PLAN CHECK $ co 0 0 Signature of Li. Permittee $ TAX $ U Authorized Agent TOTAL PAID $ is4,4> Q • . - 44953PAID NOV -1-77c7/17,00 016* ****«5.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP �N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE E DATE RECEIVED BUILDING D TE�SU � ADDRESS2 Y9 E4-/r, /.VE / p fit/ .. JC PERMIT NO. OWNER 0,r �8 SAI/pig A.P. NO. // _ Oa/'N �/r ^/3 ✓ ADDRES'�y2f C�� / MAIL ADDRESS Z 7 t {A,. r%c/[ra C/� �}/� /y CITY per 27 Bco t NO.TETRACT 300 `LS `/y BLOCK CONST UCr1ON F� NEW ADD ALTER REPAIR MOVIF71G DFMOLSH LENDER BRANCH J OWNER g .SQJ ,47 ADDRESS od VALUE ARCHITECT TEL. L.ii D $ OR ENGINEER FIRE ADDRESS / AP ZONE T PE f�GROUP CONTRACTOR ii/R7- "awl �LyC n BYPgOVED / ......JJJJJJ DATEll- r� �� ADDR 1 G. - a L �G ZO NO.OF USE OF NE 22Jolit)/ ] _/ TEL 96e6.-0 ` P BUILDING /[/ CITY � y6/`� � NO. / _ F STATE Yui CITY YARDS APPROVED YARDS APPROVED gLIC. NO.0 / VO L" 0'S' LIC.NO./354/5 MAIN BUILDING ACCESSORY BUILDING Ia SIZE NO.OF BUDGE (FROM C/LREET) d OF LOT NOW ON LOT / FRONT Cate /��FFT. Q USE OF .N. EXISTING BLDG7".aiZ//sQ R SURF EL FT. rA F Separate permits are required for L.SIDE �p p� ey FT. electric,plumbing and heating work. (� "tom REAR FT. FT. 1.9 I.., USE OF BUILDING AND WORK B PE RFO MED DISTANCE BET. BET.MAIN& Gr/f .12A0 O. MAIN BLOCS. ACCESS.BLOCS. DATE a C U * APPROVED/ /n ROV_ay � DATFb• ' /... CC IQ 3. aI hereby acknowledge that I have read this applicatIon and state O m CC that the above information Is correct end agree to comply with m O. all laws regulating building construction, and I shall not employ i Z SSS anyparson in violation of the workman's compensation laws of thee State of California.ifo m I hereby certify that I em properly licensed ase contractor under SQ. FT. (Id the State of California Business and Professions Code, Division 3, THE 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 OA, " am exempt from the provisions of the State of California Business �� m VALUATION PERMIT FEE $ and Professions Code,Dlvislonr3,Chapter 9. `— n PLAN CHECK $ 1p Signature of �+•' o Permittee .... /d .�•..- SrTAX $ ,6 O LL U U Autho ze• •pant TOTAL PAID $ ;4-/ S-2) 047106 COSTA MESA BUILDING-SAFETY DEPARTMENT ► 9614 11/28/78 23.0 Tl. P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEI D ECEIVED DA IS BUILDING /1 if 71 .,L 0La r /� .1e , —27-7-- ._ > _ ADDRESS h/� / /� Yn�`vQ,�t� f^7 V .p !/_ G `OWNER 1F sS' i[�S l",smq ?�II�I A.P.NO. PERMIT NO. N►. 4 2A F p� Jin I/ 9—Q.za- /y�3 ��I MAIL II"'JJ Z- pftvt..7�rr/FYi 00—. ADDRESS a y7 /n fre ADDRESSTEL /��( 9 �I" CITY MP&PCPT &mem NO. TRACT ,3 �� I LOT G BLOCK CONSTRUCTION CA c,-' 0-/� NEW ADD ALTER REPAIR (MOVING nFMO1 ISH LENDER BRANCH 4451" n X.Yr in' OWNER ADDRESS /Gn�W�/, ARCHITECT TEL. USE '/ cec VALUE$(1 /b OR ENGINEER NO. s'� FIRE ADDRESS ZONE TYPE GROUP CONTflACT�OtR�1yS'� R- �WpScAIOf c!o APPROVED DATE ADDRESS 9'57 7 3 ORT-m& J f gm /+� TEL. ZONE NO.OF USE OF NEW 610 C h CITY Co STh ` .cs4 NO. 4'79-7413 RZ PLANS 2, BUILDING W fq L` i-• STATEnCITY YARDS APPROVED YARDS APPROVED LIC.NO. 2_O �/7 / 7S LIC.NO/ � MAIN BUILDING ACCESSORY BUILDING W I SIZE /_ NO.OF BLDG& ''r (FROM C/L STREET) 0. OF LOT 60 ,(✓oo ) NOW ON LOT / FRONP /Z FT. FT. N EXIS11NG BLDG. of PAPr EJ�1� R.SIDE FT. FT, in p� L F Separate permits are required for L.SIDE 0)\. r FT_ FT. C electric,plumbing and heating work. REAR err FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& , QMAIN BLDGS. ACCESS.BLDGS. a ✓0"/� VAR.bs DATE 6 �l bN J C.U.P.# APPROVED / / Q_'/ } 290 L,G, ARPPROVED�1 R-'4' DATE /If Z r170 .., ce GU 0. 0 I hereby acknowledge that I have read this application and state N O N (Y that the above information Is correct and agree to comply with m a' all laws regulating building construction, and I shell not employ Z any person in violation of the workman's compensation laws of - e 44 S the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR n 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 /5:00 �OO �a VALUATION PERMIT FEE E v and Professions Code, Division 3,Chapter 9. '^ Signature , ��OO PLAN CHECK S 75O 6. U. Permf $ TAX E U Au orizetl gent TOTAL PAID eg OD