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Home My WebLink About1883 MAUI CIR - Building Permits • ,�,�?t �' CITY' OF COSTA MESA 4pp BUILDING DIVISION :t_' . ,1 DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER PERMIT B05-01504 itbkftutrneo 04. ID (714)754-5273 • Fax(714)754-4856 •. -me is !m, DINPER T 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1883 MAUI CI Status: ISSUED Suite: Applied: 09/06/2005 Vicinity: ROOF Issued: 09/06/2005 Primary Om: R-3 Dwellings/Cony Res<10 Type of Construction: V-N Parcel Number: 13941108 Zoning: R1 Applicant: RON SELL Address: 18032 LEMON Phone: (714)528-1758 ISSUED BY: _ YORBA LINDA,CA Zip: 92686 Owner BOWEN, JOSEPH B III AND DIANNE S Address 1883 MAUI CI Phone: COSTA MESA,CA - Zip: 92626 Contractor SELL ROOFING COMPANY Address: 18032 LEMON Phone: (714)528-1758 YORBA LINDA,CA Zip: 92686 License: 323842 Arch : Eng: Address: Address: Phone: - Phone: Zip: - License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL 2 LAYERS OF 30#FELT,7/16"OSB,EAGLELITE#4660,CAPISTRANO 5.5 LBS/S.F.AND REPAIR/REPLACE SHEATHING AS NEEDED.29 SQUARES INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,900.00 Permit: $167.25 Claim Valuation: $6,900.00 SMIP Res: $0.89 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.14 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 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 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 2446-46(6/00) 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. lD: )'Rave and will maintain workers'compensation insurance,as fired by section 3700 of the Labor Code,for the performance of the work for which this permit is iss. My workers'cpm�p-e–nsatiop nsurance Carder d policy nu dee •r,_ /f (� •arrier•.'� S / !! �—L� 'AZ�'`6'� Pol' NumDer.. ✓ 6�✓ saecffin need not be completed if the permit is valued et one hunelehpilers($100 f or less.) Ipo ,- T ,r ❑ I othai in the Performance the work for which this permit is d,I o hnot ee s' p on in revision err so as to become t subject to the,I half compensation lawseof California,,end a at If I shou become ubject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. '�� / 6 ^O App ic�ant 9 :f" lgheture:�� "•+_ _�(. � Dale: -+ WARM f3WILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN MINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DO(.LARE($t00,000),IN ADOmON 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 provisions of Ch:'ter 9 rencing with Section 7000)of Divisio 3.of.the.Business and Profe Ions Code,end my license Is in full 16oC Oa'-a:a`.�'�" '�—"^r. - a Class w v--,ig ? ntractors.Signature:---'i "�-+ A / ➢ate:— —r 6 D - iii CUCTION 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 1 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 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 drivers license. ❑yes ❑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,TIUe 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 greeter than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standardtemperature 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 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? ❑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 apemit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). _..-WEI any p___of the _ .._._.... 6 WIII any pan tfacility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑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? ❑Yes ❑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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signe Of gal Own s) �at mdtO7Autho --zed d Applicant r ODE 1 INSPECTION TYPE LAIE 111010,ELI LODE t INSPECTION TYPE • 2Am =AU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final0 d 208 Final Plumbing O 200 Final Re-Roof / �-w� 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 10 -9-71t200 00 330Ro****7C "C CITY OF COSTA MESA PLANNIN, EPARTMENT A. P. No. 139-411-02 Bldg. Permit No. .i(M7 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 1883 Maui Circle Owner's Name Lisle !filler Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units 1 @ $70.00 = 70.00 5 - or more Units @ $75.00 = $70.00 Total Fee Total number of Dwelling Units 1 Planning Department Approval Date 5-13-71 Park Area No. 12 WLD:pd By Applicant's Signature CITY OF COSTA MESA PLANNING 2PARTMENT NN -971�NSgdO- 330 0****70.00 A. P. No. 139-411-08 Bldg. Permit No. Alp 7K PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 1883 Maui Circle Owner's Name Lisle Miller Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units 1 @ $70.00 = 80.00 5 - or more Units @ $75.00 = $70.00 Total Fee Total number of Dwelling Units 1 Planning Department Approval Date - _ ;irk Area No. p By .WLD:pd Applicant's Signature`s T / rgn ellOpe. l7th . • Earth Sci•nc•s a Foundations 3847 BIRCH STREET • NEWPORT BEACH. CALIFORNIA 92660 • (714) 540-9760 • Construction Mat•riol REPORT OF COMPRESSION TEST CONCRETE TEST CYLINDER JOB NO : 71-304-B PROJECT: 1883 Maui Circle, Costa Mesa SAMPLE FROM : E. Wall, Top Lift ARCHITECT: Dusatoff - Jamason CONTRACTOR: L. C. Miller Company SPECIFIED STRENGTH,PSI: 2000 Cylinder No: LM 2 A Mark No: LM 2 A Size: 6" x 12" Made by: Thorne • • Date cast: 7/28/7.1 Date tested: 8/4/71 Age of test, days: 7 Max. load to destruction , lbs: 73 ,500 Compressive strength, psl: 2,600 Slump REMARKS: HOLD CYLINDERS NO. LM 2 B & C REPORTS TO: COSTA MESA BLDG. & SAFETY L. C. MILLER COMPANY BUILDING SAFETY DEPT. 611i X9-3- 7/ ;;Ei' 31971 Respectfully submitted, Terra Laboratories; Inc. By' 4. Miami reir !P /y 3. finFes[./® • Earth Sci•ncu LVq•1�3y� • Foundations 3547 BIRCN STREET • NEWPORT BEACN, CALIFORNIA 92660 • (7741 540-5760 • Construction Material REPORT OF COMPRESSION TEST CONCRETE TEST CYLINDER JOB NO: 71-304-B PROJECT: 1883 Maui Circle, Costa Mesa SAMPLE FROM : N. Wall, Top Lift • ARCHITECT: Dusatoff - Jamason CONTRACTOR: L. C. Miller Company SPECIFIED STRENGTH,PSI : 2000 Cylinder No: LM 1 A Mark No: LM 1 A Size: 6" x 12" Made by: Thorne Date cast: 7/28/71 • Date tested: 8/4/71 Age of test, days: 7 Max. load to destruction , lbs: 61,500 Compressive strength, psi : 3 ,420 Slump 41" REMARKS : HOLD CYLINDER NO. LM 1 B & C REPORTS TO: COSTA MESA BLDG. & SAFETY L. C. MILLER COMPANY BUILDING SAFETY DEPT. C�hi�� 93 7/ SEP 31971 Respectfully submitted, Terra Laboratories, Inc. By' 41 Mira.; OWNER MILLER, Lisle DATE 6-9-71 JOB ADDRESS 1883 Maui Circle BUILDING PERMIT NO. 33078 '. 'ERAL CONTRACTOR Same DESCRIPTION of WORK Res.w/det.garage /. lo. 139-411-08 LOT TRACT FIRE ZONE VALUE S 34. 548.00 INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-1 SOIL /OS(•-(h-7/ SUBCONTRACTOR PERMITS ISSUED GAS/,f ((/C' ks 4c ,-7/ Date I Number I Signature WATER A4 , e4)/ 'Plumbi ROUGH PL MBING 44 ( , - � �r �-' / `' ��..,E,OO}}}}��• /�_7 -I PROP. SWR. LINE HOUSE CON. 2 Alc% t ---7/-7 / _2' .. • b-i7-7/ 55'8/6 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING 42 -- -.7/ TEMPORARY SERVICE OR POLE n •Z r. 7fy UNDERGROUND POWER 0 •C.1•3•R�n‘ I. 7/ .-- ROUGH ROUGH WIRING 7 7 Heati g Vent. / TRENCHES f...PO%MS STEEL REINF. � ' ' r �^ ,�! (jar I_/'• i lth_*t/ 7-6-7` go 7i FLOOR SYSTEM /fern e �/ ��// � W'�"" ,-//- S/ ,Q//O dzct' BOND BEAM n STEEL REINFORCE n SHEATHING 11< 7 -77/ FRAME AND FLASHING /'/// "t� 7 ;�J.ir LAT aING — IN YI1 /•( OUT }' ,J" �7417/I}i P ER, BROWN COAT STnuCTURAL, FINAL gt ' HEATING, VENT., REFRIG. AND A.C., FINAL M Q•i•/o-7/ i � t ) 6,21-7/ ;V' PLUMBING, FINAL AND GAS TEST n q ^//�j Li�Ai�-- /'Jl' i 6,an 253 ELECTRIC, FINAL )/ illy c1/7/ �Y N w �. cam//...•f/ • .. 23078 PAID hY 13-71F. C., 51^ a COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely �' y / o �j 1/� //J,�r RECr;YJ /$Y DIE R6D61VEQ� DATE ISSUED/ BUILDINGDDRE8 U _J /! c-a / (ir i'4/6 '. �J / / ,�'t/y ADDRESS j _ / CJ /� �J MIT 'y�{r/ OWNER 14,5 / i-- /17/4 L Li? A.P. NO. /3 - il-4Cl P /M-4e/V MAIL V /��/ ,( / BUILDING Zwill ADDRESSSSJ� cs I�/,// 4-�-N c"/J /at-/; ADDRESS /773 - �Q(,(��6,4,4 la- (-) CITY /"Q (n /'/Miff NOTEL //,YI' TRACT ea LOT// BLOCK z Z6NEW ADD ALTER REPAIR MOVING DEMOLISH Z Q CONSTRUCTIONE /. O N LENDER ,{)�/v/'� D /- J}� / I 0- w ( f/ 1 • J u BRANCH -fix I-/f /rP I' ei.I.�GA/ • J n OWNER mJ ADDRESS /,1//9 cis J r -CO VALUE : ./ (� UOR ENGINEER(///Fr1�/♦ry-/�F/t////Y//rSd t/ NOI./y�i/�II USE $•�• Q/ W M ADDRESS IZ// lr fm-i 4wA 421,4/711/..-7-- FIRE ,/ ZONE TYPE /J GROUP �j °- w its- APPROVED (/ �./s.ATE �� /'� J O CONTRACTOyR GGjj 4 is /e " /'f,.j/-4or! r/ter BY llll ,.. L L - ADDRESSC 7 /J ,6;/n/./r•/ it •/ / i W W ZO NO.OF USE OF NE CD= TEL. yam/ Z JK - PLANS BUILOI Z CITY�jI/''�/Aver e�� NO.S7`+I.J�� "` I '�• Q' ��/' I W O STATE / CITY YARDS APPROVED YARDS APPROVED �Ir cn O LIC. NO. 1S7/o �� LIC. NO. MAIN BUILDING ACCE Of W. ILDI SIZE P r NO.OF BLDGS. (FROM C/L STREET) ♦ Q OF LOT 90 0 0 I NOW ON LOT 0 FRONT Cc/ FT. / L 2 FT. , '1 USE OF I/ EXISTING BLDG. R.SIDE a ry FT. FT. el I- SIZE OF NO.OF 1 n Z NEW BLDG. ?2 7 ROOMS // /STORIES / L.SIDE FT. / J ( FT. C.) COVERING RIOR WALL Jjt/IG Q TCOVVFERING (/9��f y� REAR s3/ FT..Z FT.4 a- I/ -I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& CL MAIN BLDGS. ACCESS.BLDGS. 0 /�/^/7' DATE O tit's.'tit's.' s/4.-li Ip //' /y /Lis VAR.# APPROVED '/ /,��I APPROVED /� Li) rif..tw'^�r"-'t I/Mi / �Y /CA DATE S� �/3-7/ O (ll s- HOLD FOR SP 1 • REQUIREMENTS UI hereby acknowledge that I have read this application and state �4GARic.-277;L- ' O that the above information is correct and agree to comply with J �� CC all laws regulating building construction, and I shall not employ r any person in violation of the workman's compensation laws of V) the State of California. 11 " ��7 �� t 0 I hereby certify that I am properly licensed as a contractor under JV- aL SO. FT. ` o the State of California Business and Professions Code, Division 3, THE AMOUNT SH WN UNDER VALUATION IS FOR 5 Chapter 9, and that such lice ses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; 0 ti am exempt from the prov'.i.ns of the State of California Business and Professions Code,Di si-n 3,Chapter 9. VALUATION ,e N PERMIT FEE S Signature of /� �L]/�� ` I Permittg �. i' ✓ $ /l PLAN CHECK $ C5 7 / Authorized Agent TOTAL FEE $ .T :% 3 3 0 71 )� _9'71LNSFPAIDOO 328 offi:8 1L.G� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECtdddVED BY Db TFt�j RV.fIVED DO TA IS/TED BUILDING 1883 Maui Cr.ADDRESS Lisle Miller PERMIT NO. OWNER A.P. NO. MAIL BUILDING Z ADDRESS ADDRESS a..to U TEL.CITY NO. TRACT LOT BLOCK ▪ z 2 Q CONSTRUCTION NEW ADD ALTER REPAIR MOVINf; DEMO!LSH O m LENDER 0- m J J BRANCH —I co OWNER co J ADDRESS VALUE J CO ARCHITECT TEL. USE_ $ < OR ENGINEER NO. V to FIRE ADDRESS ZONE TYPE GROUP W Q< O. Ill APPROVED JZ CONTRACTOR Same BY DATE O CO Z J m ADDRESS W W ZONE NO.OF USE OF NEW O r TCITY TEEL. PLANS BUILDING 2F — O STATE CITY YARDS APPROVED YARDS APPROVED NCL LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING J0 SIZE NO.OF BLOCS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R SIDE FT, FT, I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. VEXTERIOR WALL ROOF _ COVERING COVERING _REAR FT. FT. —I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL. a MAIN BLOCS. ACCESS.BLOCS. Q Res.w/ett.Gar. VAR.* uR. * O APPROVED I— APPROVED CO —SY DATE z 0 UI hereby acknowledge that I have read this application and state 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. n 2 I 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 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b am exempt from the provisions of the State of California Business I, m and Professions Code,Division 3,Chapter 9. VALUATION 114.00 n PERMIT FEE $ D Signature of m Permittee $ 00.00 PLAN CHECK $ E `o Authorized Agent 114.00 u TOTAL FEE $ OWNER MILLER, Lisle DATE 7-8_71 JOB ADDRESS 1883 Maui Circle BUILDING PERMIT NO. 33241E 'IERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK pyt. Swim Pool No. 139-411-08 LOT TRACT FIRE ZONE VALUE $ 2,000.00 INSPECTIONS Signature Date GROUP J TYPE III ZONE R-1 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date Number Signature WATER Plumbing S ROUGH PLUMBING 7 7 J / L/ �� 4' PROP. SWR. LINE ❑HOUSE CON. C Y / SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER C ROUGH WIRING Mff)de,7.11'1 f Heating and Vent. TRENCHES FORMS REINF. II -nj KF�57c27 7/ FLOOR SYSTEM '-_� � BOND BEAM R-.-STEEL REINFORCE Ph"- /fr73'7 -27-?i SHEATHING FRAME AND FLASHING LATHING - IN nOUS( q Sl,•uCTURAL, FINAL Electri ,.. �/ HEATING, VENT., REFRIG. AND A.CI.,,I FINAL ) 4 q a,( Q-e/-� .[� 7 4,9-I/ j�5/ ,A'9 PLUMBING, FINAL AND GAS TEST ` 1 �i/', p� ( """L` ELECTRIC. FINAL 1/75 � � �,"/� - 33244 PAI D COSTA MESA BUILDING-SAFETY DEPARTMENT JUL -9-71�„ �� 637 • � :�30 �� P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI `/•�'1' D{�TE R'CEi DATE I$$VED/ BUILDING [, VJ `/` (/ 7/ /7— I UE ADDRESS i S p 5 /*CI I 1;77 G`IS •/ OWNER J/IS/ c /7/LL C� A.P.NO. 3 - //.- DPk •�, _ BUILDING �^�� MAIL 4 ADDRESS (/ • Z • _ ADDRESS �t i// I /��.0-t- �t.S 4...--4 /y II ELL CITY ca Jryt r(tjr NO.,TELM1 qc TRACTf373 LOT/9 BLOCK f– Z CONSTRUCTION 77 � s W A . A • • s O� LENDER a �/�sil -EIM . m S4r-7t-r�1- A-N ' J BRANCH / • / _iv) OWNER <LU ADDRESS Lade. VALUE 113 J m ARCHITECTr I TEL. S_ $ J Q OR ENGINEER ST6/A"Rj// / E N . U Q FIRE 7//� WCC ADDRESS ZONE TYPE /// GROUP1 0- W APPROVED 7 J 2 CONTRACTOR /t,Sj, ///i1/7 C BYArr DATE m Z n/ �'L J EC ADDRESS ,7l-_ epiR 4 ,5c Al"aid I h W •i NO.OF n USE OF NEW /� W= TEL. 7 PLANS prC BUILDING +r"r Z1– CITY .fri✓/E//.r lam/ NO. Z . : 7Q .I tit STATE zy �J/,Q / CITY YARDS APPROVED YARDS AI-ROVED to O LIC.NO. .L JZ 5 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) / OF LOT I NOW ON LOT FRONT FT. [ FT. ' USE OF �j C EXISTING BLDG. /f /- R SIDE FT. tri-FT a' I— SIZE OF NO.OF Z NEIN BLDG. ROOMS STORIES L.SIDE FT. 3 UFT. ✓ EXTERIOR WALL ROOF // �' _ COVERING COVERING REAR FT. �FT.& J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d 0 MAIN BLOCS. ACCESS. BLDGS. Q VAR.• DATE O �D /�-,S 7-71rI L( z r P// )r� -I/ C.U.P..91s APPROVED I— APPROVED 7-/7/ l;q oo L A••TE Z / UI hereby acknowledge that I have read this application and state ✓ 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 CO the State of California. m zI hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Cr am exempt from the provi ••ns of the State of California Business VALUATION ,�) Co?and Profession Code,DD on 3,Chapter 9. (/� PERMIT FEE $ 0 m N Signature of / / �.,/�000 B m Perms ,i &%�z PLAN CHECK $ ,d E L. Authorized Agent 3 O u. TOTAL FEE $