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Home My WebLink About1878 MAUI CIR - Building Permits • r 1 CITY OF COSTA MESA 4� D@ BUILDING DIVISION > ni • to tli•Irge• , 8 DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER F I in • PERMIT 4%, 61 B01-01807 (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1878 MAUI CI Status: ISSUED Suite: Applied: 11/13/2001 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 11/13/2001 Parcel Number: 13941102 Zoning: R1 R1 Applicant: COOTER, LYLE ISSUED BY: Address. 12812 VALLEY VIEW ST Phone: (714)897-1780 GARDEN GROVE CA Zip: 92845 Owner: BARNES, JACK CLARENCE TR Address 1878 MAUI CIR Phone: COSTA MESA,CA Zip: 92626 Contractor: MCCLAIN ROOFING INC Address: 12812 VALLEY VIEW ST Phone: (714)897-1780 GARDEN GROVE CA Zip: 92845 License: 625013 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF:T/O EXISTING SHAKE ROOF,REPAIR SPACED SHTG AS NEEDED, 30#FELT SHAKE LINER, INSTALL"CLASS B WESCO SHAKES."35 SQUARES FEE SUMMARY Plan Check: $0.00 Calc Valuation: $11,000.00 Permit: $195.25 Claim Valuation: $11,000.00 SMIP Res: $1.10 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $196.35 - 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 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized 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: This permit shall automatically expire and becomevold 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 244648(8/00) DECLARATIONS 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. 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: Carrier: U.e0�11-7/7 F Pen i,P'n — 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. / Z�v Applicant Signature: Date: WARNING:FAILURE TO SECURE W SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN PITON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under rovisions of Chapter 9(comm 'ng with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and effect.Lie.# h75n r / class a C- ? 71747/ Contractors Signature: /� Date: /( 17 7n a, 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). Lenders Name: Lenders 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 perr+' subjects the applicant to a civil penalty of not more than five hundred dollars($500).): Cl 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 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 Drivers 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(38)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 ❑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 ❑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 Califomia 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? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? I0 Yes LU No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan 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 6 (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 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 Ow (s) 7/ Date A And/Or Applicant Date CODE P INSPECTION TYPE Prig IH71TMSL5 CODE# INSPECTONTYPE PAM INTmAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / 208 Final Plumbing 200 Final Re-Roof 11.—Z t� C (Q '6" 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 ! June 1, 1973 • Mr. Robert Mc Curdy 1878 Maui Circle Costa Mesa, California 92626 Dear Sir: A building permit has been issued to Beach City Swimming Pools to construct a private swimmi pool on your property. In order that your pool will be safe one and for the purpose of advising you of your responsibility regarding the requirements of ' the Costa Mesa Municipal Code, we refer you to Section 8107, a copy of which is ached. This letter is direct to you in order that you will be aware of our ordinances and can make a complete safety check of your pool area. .Sincerely yours, RICHARD HANHART Building Safety Director RH:cb • s- ,dl6 Twining Laboratories of ccouLI£¢2 cLz<<fovz„,, -ti e4 P 4f LI P.O. BOR 47 • 3310 408008 WAY . LONG BEACH CALIF. 90801 • 12131 42b-3355 • (2 13; 636-2386 • (114) 828.6432 - BPANCY, OFFICES • TESTING 151•D:.ulh l-. .s..�' ra Sarna A-a Cartic.4 ??31 ^ i ta55 P8d88d8 Ave P.O B°.a, 17141 531 3045 ¶¶¶¶CCCCd '070 t,4? 1°^g Beach Cal.. ROBCP 12731 535-2185 June 25, 1973 Examination: SC73-4167 COMPRESSION TESTS ON GUNITE CYLINDERS Mr. L. E. Sprague 5041 Roanoke Avenue Irvine, California 92705 PROJECrSwimming Pools for ROBERT McCURDY Permit! 36732 )VY� —Maui Circle, Costa Mesa SAMPLE FROM 1-2 Bond Beam: 3-4 Shallow End: 5-6 Dee End ARCHITECT CONTRACTOR Beach City Pool ENGINEER SUBCONTRACTOR Coast Gunite Co. SPECIFIED MIX Verdugo • STRENGTH 2 ,000 psi DATE CAST 6-18-73 SLUMP DATE TESTED 6-25-73 6-25-73 6-25-73 2 "HOLD" CYLINDER NO. 1 3 5 4 "HOLD" 6 "HOLD" COMPRESSION 7-Day 7-Day 7-Day TOTAL LOAD, LBS. 74,000 90,000 98,000 POUNDS PER SQ. IN. 2,412 2,935 3,327 SIZE: 6-1/411 x 12-1/2" 6-1/4" x 12-1/2" 6-1/8" x 12-1/2" COMPLIANCE 7-day test complies with specifications . MADE BY DELIVERED BY RECEIVED ON CYLINDERS L. E. Sprague Dave 6-19-73 DISTRIBUTION: ' -Costa Mesa Bldg. Dept. �, �? • __. . Beach City Pools Coast Gunite Co. L. E. Sprague - 2 ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AUTHORIZATION FOR PUBLICATION OF OUR REPORTS. CONCLUSIONS. OR ES- TRACTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES 330-12 JOB ADDRESS 1878 Maui CircleBUILDING PERMIT NO. 23508 GENERAL CONTRACTOR George Demery DESCRIPTION OF WORK Res.w/att.Gar. P- No. 1�9-1+11-02 LOT - TRACT FIRE ZONE VALUE $ 28,515.00 1 ECTIONS 1 Signature Date GROUP V TYPE I & J ZONE R1 SoilPERMITS ISSUED Gasme-4;166- SUBCONTRACTOR I Date i Number 1 Signature Water y y frifl,c-6,-,5- r _ - ,_ - Plumbing Rough Plumbing / _ - ` / • -� .- .- - - -Gs 4.5.--266 a Prop. Swr. Line ®'House Con. 0- J7 , -L ,, , -a -.77-65- 47/ e s Sprinkling System / Miscellaneous - Rough Heating and Air Conditioning 9•,� I/mr., Temporary Service or Pole rt 67-[x- Underground ❑ Power 10 Rough Wiring rye -04i) Heating and Vent. TrenchesW norms p- Steel Reinf.� s�jai r� -- p. i A .S 3iti'� Floor System .f/Y,rr . _. �!? t'1 (o-I�-� S Bond Beam 0 Steel Reinforce 0 Sheathing , 1 / '050 Frame and Flas,,�sg(,ti� ^') rA LathingIn,611 Out iC PIP'ter, Brown Coat J� "i i 0 r ural, Final Electric Hcaang, Vent., Refrig. and A.C.,-Final r - / may.„_ p. • ,ZC4-.2?-6.5-(290417Air Plumbing, Final and GasTest / {/--a 5/-.,15=--65 , 'e(d PC Electric, Final liraYC 9-`�- Building, Final Kral 12- -6- Rnarial Ranniramante s FEE RECEIVED 23508 FEB 1 1965 CpSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING 44 Alf/ et For Office Use Only ADILDI � � OREST.a4- T'9i e- T fS9 RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA s o 8 RECE E 5Y Am REytIVSD DATE ISSUED OWNER ace Gc �t: v-el? �! p�j / (�JA 3',S-_4i MAIL `/ / //J ADDRESS ) O ( � A /�U i °- ADDRESS &. tV. PI/ �'_/'I 4 E 4 4 dB ,411 TE '/ �y/ ZONE FIRE 3 TYPE GROU cm,' F i L c.-S/C Ton/ NO __ ___ (� ARCHITECT TEL. BYAP ATE 3 OF -VGINEER N9. O INCADL.HES // CONTRAS • NE NO.OP BUUEOFNEW f /'I�O�� E. T� l / )/ I PNS I BUILDING CONTRACTLORR l/B+ 0/ in °E./G.7 E R/ '"'nil, ---- ...ADDRESS / 5 it I•(/ C Hog t de it _DESCRIPTION ILEGAL (-iTi J r� /-IJLn CITY LE/QToni C -4t, r A.P.NO. / .] 1- y/,� /2 , NO. O / ,J p NOTE: NO EAVE OVERHANG SHALL BE LESS THAN Erg,.0.33 / LL/ Z p>/- z7 ' O 6 30•TO SIDE a REAR P.L. SIZE 3 118 )I 8'0 EAVES OF LOT _l NO.orLOT "V 4 ALLOWED (U.B.C.REQUIREMENT) USE OF (� I�il ��•�' YVED MAIDN BUILDS ING YARDS APPROVED ACCESSORY BUILDING EXISTING BLDG. /( (FROM C/L STREET/ SETBACK OLFINE FROM $....12 cg..._ REAR YARD .LxN FRONT pFT. c / / FT. SIDE YARDI LEFT S'OII I RIGHT //IO II R.SIDE 1/ FT. FT. DESCRIPTION OF WORK L.SIDE ` '`9. FT. NY x ALTERATION_ ADDITION REAR 1_f ,:FT. FT. DISTANC BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.SLOGS. BUILDING /) NO.OF O VAR.# DATE SIZEy'3y6$.,(�-5!'d.'3jy STORIES a_ C.U.P.B APPROVED EXTERIOR W L Liz., //JJ APPROVED // / f COVERING**-0C(.n t3/Ai VERING&aft 5N4 It'e� BY ^ IATEN 2 -/ l�q I /t USE OF BUILDING AND WORK TO BE PERFORMED IWI/ IRI Cs ( Q ) C &/L„J� 9.2.23-0:Q.n.... , e3 f0 6,-1 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE t AND STATE THAT THE A:• E IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. D PLY WITH ALL CITY 0 NCES AND STATE LAWS REGULATING BmLa NG CONSTRUCT YALUATION ��.•— a SIGNATURE OF //� _40, PERMIT FEE $ -D SIGNATUR $pG 15/O __PLAN CHECK $ 9 J O11 AUTHORIZED AGENT Oma• g /3,7- - -- . 'J� L TOTAL FEE 7 OWNER MCCURDY, Robert DATE 5-31 -73 C\' JOB ADDRESS 1878 Maui Circle BUILDING PERMIT NO. 36732 fl NERAL CONTRACTOR Beach City Pools DESCRIPTION of WORK Pryt. Pool ,-.,- No. 13q-411-02LOT 25 TRACT 145g3 FIRE ZONE VALUES 8.000.00 INSPECTIONS Signature Date GROUP ,T TYPE TFT ZONE R1 `; , Pool Location if7/12 4/673 SUBCONTRACTOR PERMITS ISSUED Date Number I Signature Forms Main Drain • Steel Reinforce Elec. Bond Electric ,�� / Approval to Cover ME /P&Z3 4 Li,L/I� 4„,0 v'3/n3 - Wf Underground Electric I'l /Me-75 ✓ Gas Piping Test /r i g-73 Plumbing ��//11 Filtering System Lines /r/W is-t6-73 �fa�/Ift-��/� (y�.e.6/ 53/.73 6360f — Backwash Lines and Recep. Mad (/ Electrical Final 140 7/3475 .er and Vent Final 1'1'5 7 2-f?) Filter System Final /� 7.1-75 Backwash and Recep. Final /220 () . a u\ //h 726-7 PAID �� MAY 31-73-00 1 70s A>}**57.56 MA • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING nn f/�/� p �i /�'3 c ADDRESS 1� ix ' , nut CI RCA._a. Q u d �. r3 �/�(\ C /� 'I A,P,NO.'3 1 - II%-OZ - PERMITNO. OWNER 0 plct_--c- 1 ' 1 l UR t BUILDING /6(2227 Cie ADDRESS MAILs 5 AME1 RS A $OVt ADDRESS t/ AU Ciao dZ TRACT '5 fl LOT02S U CITYCO$TA r ES Ft NO. 54:SOS C BLOCK ZZ < CONSTRUCTION NEW ADD AL,TER REPAIR MOVING OFMOI ISH O N LENDER am _17 BRANCH ///J /may Jrn OWNER /Z ell./1/- . C ADDRESS '"� VALUE (7 j ARCHITECT R.L-. TE-BF1 ocrNo.5 32gI __USE 0Ldi/JT 404- $ 47 et' Q OR ENGINEER rt L CJ N ex FIRE W CC ADDRESS 13031 Tr20SPtC_T Sf kiii ZA ZONE TYR GROU // aw Q X0015 APPROVED / /'23 JO CONTRACTOR P Cti Ci11 SW)mMfNG- BY DATE J 19 4 1 • 2RCM lop J ADDRESS ZW W TEL. / h'I�( ZO NO.OF�j USE OF N F CITYNV1 Ttri II v eo&ND. 7t0 O'17�� - -( PLAN$ C� BUILDING �pL APPROVED YARDS APPROVED N¢ LIC. NO. a L 4 ? 8 LIC.NO. ilia YARDS- 0 STATE CITY MAIBUILDING ACCESSORY BUILDING _ 7O (FROM C/L STREET) t SIZE NO.OF BLOTS. OF ) / e6 _� LOT NOW ON LOT FRONT FT. l9 FT. Cl.l"3 USE OF EXISTING BLDG. B.SIDE FT. / FT. I- SIZE OF NO.OF �s Z NEW BLDG. ROOMS STORIES L.SIDE FT. 2-2.---FT. UEXTERIOR WALL ROOF I COVERING COVERING REAR FT. ' I FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS.BLDGS. Q /yam VAR.# DATE O ,Oei0Sn rICAilini t?v NG C.V.P.# APPROVE I- / '/ �[ APPROVED �t� cn / CJ��-. AY IWC: r1.1 DATE '72 Z 1 VI hereby acknowledge thin I have read this application and state 0( D that the above information is correct and agree to comply with ' cc all laws regulating building construction, and I shall not employ I- any person in violation of the workman's compensation laws of (n the State of California, m to ZI hereby certify that I am properly licensed as a contractor under SO. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR g Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e Cr am exempt from the provisions of the State of California Business VALUATION tom' and Professions Cone, Division 3,Chapter 9. r to N PERMIT FEE $ 3X r D Signature of /9 G'O m Perm ltteey/ ///� '�z�Ts�/t.s�y{// $ ' OO ji PLAN CHECK $ E /600Authorized Agent �7Q_ Qtt ( t TOTAL FEE $ / U. OWNER McCURDY, BOB DATE 9-22-77 JOB ADDRESS 1878 Maui Circle BUILDING PERMIT NO. 44699 GENERAL CONTRACTOR Tim Mathews DESCRIPTION of WORK Replace window w/sldg. glass dr I ,. 139-411-02 LOT TRACT FIRE ZONE VALUES 500.00 INSPECTIONS Signature Dote TYPE Ty GROUP J ZONE R-1 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date Number umber I Sign afore WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. U SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING • TEMPORARY SERVICE OR POLE NDERGROUND 9 POWER 9 I `43 ROUGH WIRING Heating and Vent. TRENCHES 9 FORMS 9 STEEL REINF. 9 FLOOR SYSTEM • BOND BEAM ri STEEL REINFORCE Il ( SHEATHING �t.FRAME AND FLASHING Alta.._JO-/J27 LATHING -- IN n OUT R Po -ER. BROWN COAT - B rURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINALN' BUILDING. FINAL #/Y1 e/o -19.7 7 44699PAID SEP PAID *****5.50 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 RECEIVED BY DATE RECEIVED D E ISSUED BUILDING / Q .q" A /� pT /,t( ADDRESS / U /•7S � a e-R. W/- O� 6 ... _/ C�, PrPE OWNER 50,3 /I// - dug 0 Y A.P. NO. / ^ MAIL / BUILDING/A 44 H ADDRESS SA Mil Cr CITYef- I ADDRESS L, „/�7 v� L� TEL NO.. �S��S TRACT 9 rJ LOT 24,r BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLLSH LENDER •— 7 /' BRANCH �/ ,�rr}} OWNE gOfl � Cit Yr ,,e R /�6 IV/n�OO'4/AakUE ARCHITECT -._ TEL. USE_ " SL/OtvG pest" $ OR ENGINEER NO. FIRE ray{ ADDRESS ZONE TYPE L GROUP /r�/ 7� APPROVEDelae /// CONTRACTOR 7 7 MArP tsVS BY DATE 9 etin ADDRESS t 7Ai A e-Atbe•L,4 DR + ZONE '�J NO.OF USE OF NEW GCE y7,pr� /� TEL. /� -/ PLANS BUILDING ' CITY a- /y . TEL. yE`�yS� !! •• W/.ves✓rr i �A F STATE CITY YARDS APPROVED YARDS APPROVED! - s� LIC.NO. /.1.36,77 LIC.NO. MAIN BUILDING ACCESSORY BUILDING WA SIZE NO.OF BLDGS. (FROM C/L STR E,E /_ a OF LOT NOW ON LOT / FRONT F k++ ' t F�.I� Q USE OFa . ��'� .rte. EXISTING BLDG. ,0 -'IOL. G/44-7 IDS G�c�-I�^ �a�/T• C't.S FSeparate permits are required for E l 7?". \• F Cr electric,plumbing and heating work. 'C o��z�� '' �5,c1� FY 4J '7 _ RER 1- STT. r USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE4T. BET.MAIN NA G ba -L !Ant .- R Gtrp i-_f re. 2 te.//L e ft MAIN BLDGS. ACCESS. BLDG. / VAR.* DATE aC.U.P.#mAPPROVE / / !l1��1ED 7 APPROVC Ekn >-▪' ,BV Ce W 0 I hereby acknowledge that I have read this application and state o N IY that the above information is correct and agree to comply with m 0• all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of m d the State of California. -t I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business end 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 State of California BusinessVALUATION PERMIT FEE $ 6741/40v and Professions Code,Division 3,Chapter 9. u+ Signature of T '/A' +-/r r8.75 PLAN CHECK $ en '^ T ✓/lo �� LL Permittee ....-.• S TAX $ /927 2 � 6763 U ✓ Authorized Agent TOTAL PAID $ s 63