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Home My WebLink About913 OAK ST - Building Permits(774)754-5273 • Fau(714)754-4856 Job Address: 91$ OAK 5T Suite: Vicinity: Parcel Nunmber: 42249422 CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Zoning: PERMIT NUMBER B99-01246 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OS/09/1999 Issued: OB/09/7999 Applicant: BEVERLY SELBY ISSUED BY: `" Address: 307 CATALINA DR ` , � � - ' "� � -; Owner: Address --_� ,(. ,� - � , Phone: 949-5A8-5258 `--_r_- �.;;-�-� �., NEWPORTBEACH.-CA-,��L " Zip: 92663 �^�� "``.<'l_�,.... ' ""/-.� .-"� - � � , , i `-�-' � ! ii %- - � . '� � � ' � ;`. SELBIY'FRANK E,,BEVERLY SELBY , � � � � "�� 307�CATALINA DR _ - _ � � . � � �' �� i i _ . _ l t �' „ � � A� _� � �� V �. � � . , Phona: � �`-� . -, �:. . : � !V .� _ � �,��l" NEWPORT BEACH CA� � Zip: 92663 '�� . ` �.� � � � V1 fL/i�� %� _ ��V�. �<�� Contractor. � ��' ��/�� Address: � ��/ ��A� ` ��A�� r,�,, r j/ , . , f Pno�e_ �� `: � '� , .� :_, I � I �/ �� y �� : `� 1 t >_ �. � t-:� ^Zip�i 1/.�j License: '', �� l,�i�� ,1� � � - .. ' ' . �.� � t�� ,.Arch,;\ �/i�'.'� �*. '✓`,'.. -. � en9� ' � � ' ; i`�` �_ ' � �� \`, `, , �Addre'ss: ,, � f?� ` � ' ' . � jr > � ^'� � ' Address:, y �� , � � r` a' � . �` � i�` � ! � � � � Phone - - - - � ' , f•� � Phone � � � � 1k� -- �'�, l � � _, _- � —=-"ji��2 ��'�� _ " ��`� � 1,� �� l��,i � Zip: ��r��: J�✓`�� , License: . � .License: • ��'� . ,y'. ��. I "�� V �? '\ �� ' + 1 '�:� ' V'' � _ �' . �, _ SCOPE OF PERMIT � t, � . �}}} � i��' ;�REROOF WITH ONE LAYER COMP�. OVER EXIST.�2-LAYERS OF�COMP. SHINGLES �� ' n ' � ; �1� �f' -. _. _ .. _ .. _�..� . .. �_ _ � ,�: � ��'�� ' � � � FEE SUMMARY � ,' ' 1 ' � �i , `� Plan Check `� � $0.00 � �, _ _ - , ; � r� Calc Valuation �,�, ' _ gz,aoo'oo ; �c,�>— ��'�� , " Permit'� S�� $8325 " � � _ � � ,` � � ��v 61aim Valuation �, �, �-` $z,aoo.00� �� '� SMIP Res' ;: $0.50 _ _- , i f , � � � ; �' �SMIPCom��"" $0.00 _ ,� r,r ��'�` , �� - , � �,, l��: Other �.� � $0.00 � �Inspection , `.��\�$0.00 � � ! �;i' .`�� ;��t i� �'.�;,� � �_ „i, ; , � � � ��, �, /r . !� � � ��;�.Total� $83:75 � ,, � :� �. � . � . � �%. � ACCESSORY PARKING NOTES: e • r;;. . p ,, , }`'�' //,' �- , � �Front ,0=0 . �� Rear�..0-0``� C� - � � - � - �Front 0- D Rear 0- 0 Existin :� 0 � Re uired: � 0 Lek Left ONING.�.,•�� ,�:� " �: � .. � . . � .,�% /; r ' l� � , �; i� � 0-0 . :� Right �, �0;0,', /� ;�� . . � ., i, .i/, 0-0 _ Right ., 0-0 -�� + Proposed: " 0 . � ✓ . , > . �' ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regula�ions. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period ot 1 BO days. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wi�h all applicable codes, and all required inspectlona 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) 7545626 WORKERS'COMPEN9AnON DECLARAnON: I hereby aNirm under penelry ot perjury one ot the following tleclarations: ' �. ❑ I have anG wlll m&��ain a certlticate of consent to selFlnsure for workers' compensation, as provided for by sectlon 3700 of Ihe Labor Code, tor the pedormance of the wotk fOr whlch Ihis permii is issuetl. ❑ I have and will maintein workere' compensatlon insurance, as requiretl by section 3700 of the Labor Code, tor ihe perfortnence ot the work (or which this permit is issued. My warkers' wmpensation Insurance carner entl poliry number are: Cerder. Policy Number: (This sectlon neetl not tle comp/eted tl the permif is velued af one hundred dollers ($100J or less.) ❑ I certify that in the peAortnance of t�e work for which this pertnit is issued, I shall not employ any parson in any manner so as to become subject to the workere' compensation laws of Califomia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of ihe La6or Code, I shall fonhwith comply wiih these provisions. Applicant Signature: Data: WARNING FAILURE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TMOUSAND DOLLARE (51 W.�I� IN ADDRION TO iME COST OF COMPENSATION, DAMAGES A$ PROVIDED f-0R IN SECTIIXJ 3]O6 OF THE LABOR CODE. INTEREST, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby attirm Ihat I am licensed undar provisions of Chapter 9(commencing with Section 7000) of Division 3 ot the Business antl Professions Code, and my license Is in full force and eflect. Lia A Class N Cuntracbfs Sigaawre: Date�. CONSTRUCTION LENP�NG AGENCV: ❑ 1 hereby attirm tha� there is a construction lantlinq agency for tha peAormence of the work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lendels Atltlress: Signature: Date: OWNER-BUILDER DEC�AnONS: I hereby ettirm that und�r penalry of periury ihat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any city or county which requires a permii to construct, alter, improva, demolish, or repair any stmcture, prior �o its issuance, also requires ihe applicant for such permit to file a signetl statemeN ihet he or she is licensed pursuam to Ihe provisions ot the Contraciors License Law (Chapter 9(commencing wit� 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 ezemp�ion. Any violation ot Section 7031.5 by eny applicant for e parmit sub�ecls the epplicant to e civil penalry of not more Ihan five hundretl dollars ($500).): I, as owner of the p�operry, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 44, Business and Professions Cotle: The Contractors License Law does not epply to an owner of property who builds or improves t�ereon, and who does such work himself or herself or thmugh his or her own employees, provitled that such improvements are not intentletl or oRered tor sala. tl, however, the builtling or improvement is sold within one year of completion, ihe owner-6uiltler will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of ihe Property. am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business entl Professions Cotle: The contrectors License Law does not eppty to en owner of property who builtls or improves thereon, and who conirecis for such project with a contractor(s) license pursuant to the Contractors License Laws.). p �-, � � ❑ I am exe under sec. Business antl Professions Code for this reason: Sig Wre: � enfied by dr'rvers cense. ��(es ❑ No rivar's License No. Verification of Ownership by (type oi document, l.e. - property tan blll or deed): DIVISION OF INDUSTR�AL SAFE7V PERMIT CERTIFICATION: Expires: ❑ I hereby certity tha� no excava�ion five (5) or more �eet in depih into which a person is required to descenq will be made in connection with work eutho�zetl by this pertnit, antl that n0 buildinq structure, scattolding, talsework, or tlemolition or dismantling thereot, will be more ihan thirty-six (36) leet high. (Chap. 32, Gry 2. Art 2, Sec. 341, Title B, Celitornia Administrative Cada). ❑ As owner-buil0er, � wl�l not employ anyone to do work which woultl require a permit trom the Division of Intlus�rial Safery, as noted above, unless such person has e permit to da such work irom the tlivision. SignaWre: Data: Division ot Intlusirial Safety Permit Number. CERTIFlCATE OF COMPUANCE AND AUTHORIZA710N OF EMAV: I cenity under penalry of perjury that I heve read this application and stete Ihat the informa�ion given is correct. I agree to comp�y wiih all state laws antl ciry ortlinances relating to building construction, and authorize representatives of Ihe Ciry oi Costa Mesa to enter upon tha above- � scnbed property �or in ection purposes. pree not to occupy or ellow ocapancy of any builtling authorized 6y this permit until final inspection. a —Q— SigneWre Of L I Owner(s /� e �� AndLOrAuthonzed Applican � Date CQOE a. INSGECTIONTYGE � 1816 Fizetl System F�nel Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Finel FeCtory Fi�e PIaCB 203 Final Sign 204 Final Demolitian 2448d6 - ✓ i • i COUE� INSGECTIONTYGE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 250 Final BuildingiOccupancy Idd1�I:ii1il15j L'� � C''�ta ��eda �c�r�c�ur. y Diuidio� OWNER-BUILDER VERIFICATION . �. . . . , . A city or county, which is required to give notice pursuant.ro Section•19830, shall attach to such notice, and, as a condition precedent to issuing a building pemiit; require the completion and requi�e the re[urn of, an owner-builder verification. Attention Property Owner. � ' An `owner-builder' building permit has been applied for in your name and bearing your signature. Please comple[e and retum this information in the envelope provided at your eadiest opportunity to avoid unnecessary delay in processing and issuing your building permit. No buildine permit will be issued until this verification is received. 1 personally plan to provid the major Iabor and materials for conswction of the proposed property improvemenL �Yes ❑ No I(have/have not) yQ/J� signed an application for a building permit for Ihe proposed work. I have contracted with the followin� person (firm) to provide the proposed conswction: Name Address Phone ( City _ Contractor's Lic. No. 4. I plan to provide portions of the work, but [ have hired [he following person to coordinate, supervise and provide the major work: Name �/ Name 1042-46 (REV.9/9B) Address _ Phone ( ) City _ Contractor's Lic. No. 1 will provide some of the work but 1 have c�eeted (hired) the following persons to provide the work indicated: Address Phone Type of Work t -�2C/-5o 7 R' /�c.a -�.�� r� Applicant to fill in all spaees except l�ose wilnin Iteavy Eortler lines antl sign all appropriate Geclarations. CI7Y OF COSTA M SA C NST UCTION PERMIT OFRN(�T Nll TRACT NO I(1T N(1 ��T .�.. Projeet'Address / },� _ ApplicanYs Mailina�A)�dAr�ess �� 3 voZ ! 'L!� Owner's Name. 1.LW1..:� � Phone �� Address ,,Ly� p� , . Arch/Eng. License No. Address Contractor'sName ' Phone!—�)�, Addresslm �I' g) � � y�Q�� G / �i' • / Ci�y License Nq / t LICENSED CONT0.ACTOR DECIARATION 1 hereby atfirm that I am licensetl under provisions of Charter 9(commencin9 with secfion ]000) of Division 3 of the Business antl Professions Cotle, and my license is in ❑- rce antl etfect. / License Class License o. Da[e Signature WORKERS'GOMPENSATION D L A 1 N I hereby affirm that I have a certificate o( consent to seli-insure or a certlficate oi Workers' Gompensation Insurance, or a certifietl copy thereot (Section 3800, Lab. C �} /� '/ q�i � Policy No. ��'1�N�U �� Company rl/� � ertiTiea copy is hereby fumishetl. Certifietl py' tl with the city BW ing Division. Date � APD��cant ��! EXEM TION FRO WORKERS' COM 5 TION OECLARATION (This section neetl not be com0�etetl if the permit is for one hundretl ($300) or � less). 1 certify that in the performance of the work for which this perm�t is iszue0 I� snall nol employ any person in any manner so as to become subject to t�e workers' Compensation Laws ot Calitomia. Date Si9nature NOTICE: If, after making this tleclaration, you shoultl become subject to the � Workers' Compensation provisions of the Labor Cotle, you must (orthwith tomply with such p�ovi5ion5 or Ihis permit shdll b¢ tl¢¢metl revOketl. CONSTRUCTION LENDING AGENCV . . I hereby aftirm that there i5 a constru<tion lentling agEncy for the per(ormdnc¢ of the wOrk tor which this permit is i55uetl (Section 309] Civ. C.) Lender's Name Lentler's Atltlress OWNER BUILDER DECLARATION I hereby affirm Lhat I am exempt irom the Contractor's License Law for the following reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or county which requi�es a pe�mit to con5truct, altei, improve, tlemolish or repai� any structure, o/�or to its issuance, also requlres the applicant for such permit to tlle a siqnetl statement that he/she is licensed pur5uant to the provisions of the Contractor's LicenSe Law (Chapter 9(commencing with Section 7000) of Division 3 of Me Business antl Professions Cotle) or that he/she is ezempt therelrom anG the basis for the allegetl exemp[ion. Any violation ot Section 7031.5 by any applicant fo� a permit subjects the aOPlicant to a civil �enalty of not more roan five huntlretl tlollars ($500). I, as owne� ot the property o� my em0loyee5 with wd9es as their sOle mmp¢nsatioB will tlo the wo�k, antl the Structure i5 not intendetl or-offeretl tor sale (Section ]044, Buziness and Professional Cotle: The Cont�acto�'S License Law tloes not apply to an owner ot a property who builOs or improves [hereon, antl who tlocs such work himsel!/herself or Ihrough his o� her own employee5, provitletl that such improvements ar¢ n0[ intentletl or ofteretl for sa�e. I(, however, tne builtling or improvement is soltl within one year of com- pletioq the owner will have the burtlen ot proving he/she tliG not builtl or im- prove for the purpose o1 sale). ❑ I, as owner ot Ne property, am exclusively contracting with licensetl con- tractors to cons[ruct the project (Section ]044, Business antl Professlons Cotle: The Contractor's License Law does not apply to an owner of property wh0 builtls or improves thereon. antl who contract5 far such oroiect5 with a mn- tractor(sj Lcense pursuan[ ro cne Contractor�s License Law). I am aware that proof oi their Worker's Compensation insurance shoul0 be provitletl to me, ❑ I am exempt untler Section B. & P. C. for this reason TYPE OF CONSTRUCTION LI NEW LJ ADD LJ ALTERATION, � REPAIR' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' � DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRADING FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANIGAL ❑ OTHER PROJECT DESCRIPTION SQ.FT. oCCUPANCY CONSTRVCTION TVPE VALUATION $ ZONE GRADINGCV.VDS. ACRES Remarks: 0 Backflow Preventer ' Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Serviee � Outlets Kitchen Sink Lavatories P—Trap Roof Drains - Reinspection Fee , $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFact. Blt. iCBO dk Date Owner Heating System & Ducting I hereby certity that I have reatl this application antl state that the above ❑0100,OOOBTU �100,OOOBT information is correcL I a9ree to comply witM1 all city antl Wunty ortlinances antl state laws relating to builtling construction, antl hereby autnorize repre- sentatives of lhis city to en[er upon the above-mentionetl property for InSpecUon purp J_� `,,,}(� Signature � DateL_,_=� peinspection Fee $15 Drivers' License or 55 � 0865-46, rev. 5/Bg Pink - Accounting: Goltlenrod - Assessor ShOWers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank ' Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fae Hood or Typel ❑ Canopy Typell ❑ Refrigeration Sys[em ❑aioo,000aTu ❑ioo,000eTu System Repair/Alteretion Fire Dampers Registers laue Fee �a.r. �P . S Main Buildi E T Front B Rear A C Right . K . Left S Ping. Ref. # Planning Notes: FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher- ,✓� Dryers ❑Gas ❑Electric Fan 1� i• F.A.U. • Fixtures .�y� Device Boxes f // i OutIeLS' � , ., Switches Garbage Disposal .� ' Generator �0-5 KW �5-' $ 3 FEES $ 3 � zone � Accessory Building: � . , Z O N I N G R •- Parking Req./Provided � E Q M $. F� RFGQ _ e .ww., ELECTRICAL - Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel Motors �0.1 HP O7 Y� � 8 Inc.Soiar �9-15 HP �16-15+ Microwave Pole Light Range Standing Sections KW Trash Compactor I Reinspection Fee !$15 I I luue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By Appliption Issued By n ";1 SUMMARV OF FEES BUILDING PERMIT $ SMIP :� PLAN CHECK $ �'�� PERMIT >; PLUMBING $ �=iJ_..LL� ISSUANCE PIAN CHECK 25% $ ENERGV P.C. ELECTRICAL $ GRADING � PLANCHECK 50% $ MICROFILM � MECHANICAL $ TOTA�FEE PLAN CHECK 25% $ FEES S 3 oi oo�?sac�-c�ozssaa Tc�r oa�c: azio�fa� TTnF. s;:s% . . - 1\ �� , . . . . . ,n.. . _-� _ _ _. . . .r. .. . :�T.. - C.CINSTRUCTION AND PLANNING ' POOL & SPA �APPROVALS Permit # Date � Inspector ' qPPROVALS Permit # Date -Inspector 1. Temporary Electrical Service or Pole , 52. Pool�& Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement - ,�P 3. Electrical Conduit Utility-Undrgmd. �� ._�. 54. Forms � 4:,Electrical Conduif-Undrgrnd. � 55. Electrical Bonding � � 5. Steel Reinforcement - " 56. Rough Plumbing & Pressure Test � 6..ElectricalUFER.Grnd. ' 57. APPROVALTOCOVER-GUNITE � � 7: Footings . �- ' � 58. Electrical Conduit-Undrgrnd. � $. Foundation � . 59. Gas Pipe, O Undrgmd., Test � 9. _Water Pipe-Undrqind. ' � 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor Svstem '' ? 61. APPROVAL TO DECK i l. Property Sewer Line & House Connection ,� . � 62. Backwash & Receptor-Final 12.� Sewer Cap ,. . �� _ ' 63. Heater & Vent-Final � 13. Roof Drains _, i ' 64. Plumbing SYstem - Final 14. Rough Plumbing� � 65. Electrical-Final __ 15. Rough Electrical,Conduit � 66. Solar System-Final 76. Rough Electric Wiring 67. Fencing & Access Approval . r.- '�17. Rough Wiring Sign 68. APPROVED FOR PLASTERING " �16. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT in ; ;ZQ. 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 & Sirling 77. FIXED SYSTEM FINAL , . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31.�Plaster Brown Coat 79'. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notesr'j, //� 8R L�� L.E',(� 34. Final Heating &'Air Conditioning � ' 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plumbing . . � � • 39. Water Service-Final� T � 40. Gas Service-Final �..� ('� 41. Solar pomestic-Final � �� 42. Backflow PreventeriT'1 � � � • �'J%- r-j �.� � 43. Backflow Irrigation_� r'- r:� j .1 ,:: 44. Landscape Irripation'•System ' . . �!;) ,C' 45. Sound Attenuation"� �� , 46. Handicap Regulations_ �; • 47. FINALSTRUCTUFtEi&B�UILDING 4R. Sper.ial Requirements Completed � �____�_ ` 49. Electric Release to Edison � � ' ��_, I � � , I Q3'C 50. Gas Release to Southern California Gas Co - �" � 57. CERTIFICATE OF OCCUPANCY _/;�� . I No. Date �=-' 1 � I OWNER f 'JOBADDRESS 913 oAx ST. BUILDING PERMIT NO. 839 `� GENERALCONTRACTOR Qp7ngr-Bll11d0T VAWE $ 1�200.00 LOT pp� BLOCK � TRACT 1712 _Garage and stora�8 TVPE V ZONE R-1 INSPECTIONS Footing Trench (�,/G�, Foundation Forms and Grade to Garage Rough Framing � Plumbing, Rough to Slab Plumbinq, Rough Complete , Wiring, Rough .Heating, Rough -Heating, Final ' Sewer Septic Tank or Cesspool-' Lathing � ,.�-C� t" Plastering Plumbing, Final, Fixtures Plumbing, Final Gas Tesy Wiring, Final py c Occupancy „ Form 210 G-H 1M 12-69 DATE I SUBCONTRACTOR FIRE DISTRICT 6U6 PERMITS ISSUED DATE I NUM - �asa� . Costa Mesa Building Department „ _ 711 EAST 20th STREET � + COSTA MESA, CALIFORNIA FOR APPLICANT TO FILI. IN B��ia��9 J�� C�'� /s J7`: Address Costa, Mesa, California Cr ss St. vc7r� �/ ��//0�7d � Owner �Of7 P/�/ L. • f h7��ry Address �%/,.� Dr7/f �/'%`, ' ta /�PJa. Ov or Ot.vvi er r i.r•a Address Lega7 Lot Description No.� UV Block%-� (Attach Metes and Bounda SizeofLot /jry,}��SYI Nowogl New � vl Alteretfon I I Addition ZY,S APPLICATEON FOR PERMIT �� BUILD�tNG '� � FOR OFFICE USE ONLY ; Receipt No. Permit No. � 8� ,`� ,�3 Received by Date Rec'd. Date Issued /— i91J Costa Mesa, California Date CORRECTIONS uunamg ��) rvo. or / Size ,�c (/.{`.�0 Rooms � Stories ExteriogWall� y- I Roor g� �° ��/ AppROVALS Coverin / [iCNd Coverfn � �� Use of New 1- �c Building �a g(-c� �/ e f SL.U('d c/-p FoundaUon Location Inspecto -E Forms, Materials, Under-Pinning Frame: Fire Stops� Bracing, Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State I.aws regulating _ building construcU�on/./ ,, ��% Signature of �ii�i' /, /. � -'/�%/v" ' Plaster� Int. Permittee �� 1 Plaster, Ext. Authorized Agt. Masonry Reinforoed Valuation O Permit Fee $ $ � O T talCheck $ , O D Bond Beam /� Fee $ /. V � FINAL FaRM 204 G•H 2M 9-54 Date O 9 G> Z D r ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT � 636 North Broadway � ' � ' , � SANTA ANA, CALIFORNIA ,� . � � � � �. �•� —� ,