The URL can be used to link to this page

Home My WebLink About3410 MEADOW BROOK - Building PermitsPHOJECT AOOHE55: j Q 1 O �Jr,��[•j BRQQF( UNIT: owr+en•sxame: VILLAGE CREER AOMEOWNERS aooness: ASSOCIATION 3429 TIMB�.R LAKE CM VA 92626 APCH/ENGINEEfl: CHESTER CARVILLE XEG.NO.: CIS3OS aooxcss: 79zz AFtMOUR ST UNIT: S.D. CA 92111 PFHMITTEE: PHOENIX ENTERPRISES INC, ( 213 ) 690-9559 noonEss: 411 COMERCIAL WAY LA HABRA C 90631 IICENSEO CONTPACTOP �ELNflFTIUN: I hereby aflirm tha� I am licensetl un . p isio I Chapter 9(co ncing wil� Sec�ion 7000� nl Diviainn 9 oi �ha PusinPse and Prnlessions f,ntle, antl my licanse i' I orca ef�ec�. ciTvuc�5078 s ic.:376639 � Da�e: _ � � Signature: — . — WOBREPS' COMPENSA ION DECIAPATION: I �er¢�y ailirm I i have a cenilicaie a consem ro selt-inmre or a cenilicate orkers' Comoensalion lnyuaAc� o� �cendietl coov mereol (�ction 3800. Lao. G17 � O 1/ 9 1 'OLICY NO.: W� U � 4 E%P. �ATE: U �omvaer. CA CONP 6 FIRE Cerlilie [o0Y �s �er by lurn��ea ❑ Cetli�ietl copy is filetl � city �Ainq ivisian. � Daie: _� a �� AP�licant: EXEMPTIONFROMWOBREPS'COMPENSATIDNOECUNPTION: (Thi55ec1ianneeUno�Getomple�edi��hepermi�isiorone�u (511p�orle55�. I cenily Inat in Ihe perlormance of Ihe woB tor which ihis permit is issue4l shall not emDloy any person in any manner so as to become sublecl lo ihe Worker5' ComDensation Laws ol Cali�omia. �aie: Signature: NOTICE: II, alier making I�is OeClara�ion, you s�oNA Getome Subjeci l0 Ihe Workers' Compen5ati0n D�ovisi0n5 0l IAe LaUOr Cotle, you musl lorihwi�h comDty wii� Such pmvisions or Ihis p¢rmil SAall be 0¢emed revoke0. CONSiPUC7lON LENOING pGENCY: I hereby aitirm that inere is a consimction lentling agency for ihe pedormance ol the work for which Ihis permii is issuetl (Sec�ion 3097. Civ. C). LENDEB: aooness: OWNEP BUILOEB UECIABATION: I �ere0y aifirm t�at I am e�empt imm Ihe ConVactors' State License Law lor tAe lollowinp reason (Seclion 7031.5 BuSiness anA Prolessional Code: Any city o� counry which r¢qui�es a Oermit �o con5lmci, alter. improve, tlemolish, o� iepair any slmciure. prior to ils issuance. also requires ��e applican� lor suc� permit lo lile a 5igne0 staiemen� llul Ael50e is licens¢tl pursuan� to t�¢ p�ovisions ol the Caniractors' Sla�e License Law (CnaD�er 9 �commencing vnth $ectwn 7000) o� Division 9 0l 1�e Busineu ana Pmlessions CaEe) or Ihat he/she is erempt Iherelmm antl Ihe oasis for Ihe allegea exemption. Any Nolation of Sxibn 7037.5 ey any ap0��nt lor a Oermii 5ubjecB Ihe aD0litan� to a tivil penalry of nol more IIWn five �un�retl tlolWrs (5500�. I, as owner al Ihe pwpeny or my employees wit� waAes as t�ei� mle compensation, wi0 ao ��e work, anA Ihe � stmcture is not imen0etl o� offereG for ule (Sectian 70aa. Busineu anC Pml¢ssional Cotle: The Coniracmri Slate License Law Ooes no� apply lo an owner oI a property who 6uiltl5 or imprOveS i�er¢an, anG wh0 d0e5 SUCh waM �imsell/her5¢II or ��wUAh his or her own employees, pmvi0etl t�at suc� improvemenis are nol intentled or oflere0lor sale. If. �owever ihe huiltlinA or impmvement is sold wilhin one year of completion. Ihe owner will have Ihe Dureen of pmving he/she ditl not buila or im0�ove lor Ihe Ourpose oi sale). I, a5ownerolihe DmDetly,am exclusivel9 conlracting with IicenSeU comracmrs m constmc��he proleci(Sec�ion 7044, Business ❑ and Pwlessions Code: The Contraciors' Staie License Law tloes nol apply to an owner oi proDe�y who �utlds or imD�oves thereon antl who conVac�s lar sucn prolecls with a conirac�or�s�license pursuani �o ��e Conirac�ors' Sia�e License Law�. I am aware Ibai Om01 0l �heir Warkei 5 ComOensation insurante ShOWd �¢ DmviUetl Io m¢. � I am exempt untler Section: B. 8 P. C. lar �Ois reason: �ate: Owner. I eo hereDy cenilV thal I am aware ol antl untlerslan0 the requirements of Calilomia Healih anJ Safety COde Sections 255Q5, 25533, anA 2553A and Iha� I or any lutWe �uil0ing occupan� wilVvnll not �circle on¢� nee0 io comply with saitl s�ate co0es ana ��e reQuiromenis �or a permil �or conslmction or modilicaiion imm �he Air Oualiiy Managemeni Dislricl. fl¢siAential cons�mction apDlica�ions are exempt �mm IhCS¢ OrOvi5i0n5. % Oale: ApD�icani: I �¢r¢Dy C¢rlilyi�al I havet¢a0�hi5 a001itaiion ana slaiethalihe aUove ' rr tionis r recL lagr¢e to ly with all city and nty ordinances antl Stale lav5 relaling t� uilEing fbn5lmclion an0 �ereby a� ,�' .v resen� .rves o� this ciry � upon t�e above� ione0 o�openv m� �;:;:�/.r ouroo `/ L � /1. �aie: _ /'— SignaWre: . Drivers License m Social Security M: $ 164L�6 Whi�e—Bulltling; Green—Gode EnlorcemenP. CanarV—ApplicanP, Pink—Revanue', Goltlenmd—Assessor CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO: B 050585 PLAN CHECK NO; 00135-91 A CONSTRUCTION TYPE: V—N PERMIT TYPE: STR JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE PERM NO: H 050585 GOVT: N SUPP: N PURFOSE: REP SQ FT; 193 CLAIM VALUE: 19,300.00 CALC—VALUE: 14,300.00 GROUP OCC; R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION +t*x��r***�r*�x ��t�r�t*� �*�*K �ra�**x x �r*�r�**�r**�r��e+�� u �*�**x�*�*�**x�*x *��*�*��*��**�tx �r*x Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: F7' IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT; FT IN pARHING RE • PROV- PARCEL: 93506124 ZNE: R2 REF NO: 'F�LANNING N�TES> FOUNDATZON REPAIR. i " �**��***�*�***�**�r*�r**+�*�**�*�***�*��*****�r�**�**��****xu*x***x�**�**�*****��* D E V E L O P M E N T S E R V I C E S R E Q U S R E M E N T S 20NING APPROVED BY ( � L-.�.... �, DATE: (�>> ( (�1 � BUILDING APPROVED HY ; !i-/lL—t� �� DATE: � APPLICATION ISSUED HY• DATE: lE�7flflfiE�IF�IEiElE�EiFiElkiE3fiFiF3F1FiFiE�if � ififlflfiEfEiElElEiF3�3F%i'riE iEiElEihiE3FiElfiEiFffiElFiF7EiFiFlf)EiEil�EiEi�iEiEiE3FiFiEiE iEiFiElfiEiFiElfiEiEiE1EiEX7F1FiE'IfititlElE�(�iflfiElPififiElflEaFifiF36jEiF)f)Eif I�EGALIZATION:N F E: E S U M M A R Y STRIJCTURAL SEGNENT:Y BLDG PMT PLUMBSNG EL 'TRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 162.00 1.00 SMIP/NON—RES PLAN 26.33 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 163.00 0.00 26.33 189.33 189,33 .00 REVENUE DIVISION TOTALS--> COLLECTED• iFi9.33 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIF/TOT GRADING FLAN—CHECK 162.00 1,00 ?6.33 1f iF 1f 1E iF it iF iE iE iE iE iE �E iE 1E iE * if 1f iF if iE if ik if if 1f iE iE iF iFiE iE iE iE If iE iFlF iE if iF 1E iE IE iE !F �E iE iF 1E 3c IE iF �lf if If If !f M iE 3(-3(� iE 3F 36 IE if if !F if iE lf if �1F if lf 3E if I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I F T I O 13 UNIT COST TOTAL COST SFR 143 STRUCTURAL BY VALUE PER 5100.00 100.00 14,300.00 END OF FEES 01 I1D07E733—�10u?3740 ?"C+"; C•ATE� Ol/23lFi i:i7;: P:39 ii.?..,_ CONSTRUCTION AND PLANNING ' '` 8' SPA APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Tempa�ary Electrical Servicebr Pole ' 52. Pool & Equipment Location '• . � 2. Soil Pipe-Und�gmd. " - " 53. Steel Reinforcement �� • �i- 3. Electriral Conduit UtilitY-Undrgmd. � 54. Forms �,� 4. Electrical Condui[-Undrgrnd,�-- <•' � 55. Electrical Bonding '� 5. Steel Reinforcement' � 56. Rough Plumbin9 & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation f �/ 59. Gas Pipe, O Undrgrnd., Test .� 9. Waier Pipe-Undrgrnd. /� �'� 60. Backwash Lines, P-Trap, Q Undrgrnd. ' i`�� 10. Structural Floor System ,f�/ � �!�% 61. APPROVAL TO DECK .' . i"'' 11. Property Sewer Line & Hou'se'Connection � 62. Backwash & ReceptorFinal � 12. Sewer Cap � / - � 63. Heater & Vent-Final � ,' 13. Root Dreins ' r1 64. PVumbing System - Final ' i�` 14. RoughPlumbing `% �i� i 65. Electrical-Fina� � �, . i 15. Rough Electrica6Condyfi ` � /� 66. Solar System-Final � �i 16. Rough Electric Wiring � � � � �� % ' � � �� ,� 67. Fencing & Access ApProval _. 17. Rough Wiring Sign .! `� r� 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT 20. Fough Factory Fireplace -' �� APPROVALS ' Permit # 21. DuCts, in Structure. . , •. 70. Undergrouncl Hydro � 22. Ducts, Ventilating � ' ,71. Product Piping OGas ❑Oil 23: Gas Pipe-Rough &-Test � 72. Underground Flush 24. Roof Framing •73. Undergrnd. Storage Tank i] Gas ❑ Oil � 25. Roo4 5heathi�g 74. Overhead �-4ydro 26. T�Bar Cei�ing (Structural) & Monocoat 75. Dry Chemical - � 27. Frame and Flashing � 76. Dry Standpipe 28. Lathing & Siding - � � � � i �- 77. FIXED SYSTEM FINAL �29. Insulation .' � ,' � I � 78. PIRE 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 Eleciric ` I ' Notes: " � 34.`Final Heating & Air.Conditioning � � �� / � � � // e i g 35.'Final Gas Pipe�Test � -' ��✓�� .�'// c� � 36. Hood 0� Canopy ' , I � � 37. Fina1 Pactory Fireplace , � � ` ' ' 38. Final Plumbing � � ' � � 39. Water 5ervice-Final I I _ � - 40. Gas Service�Finat . � , i . 41. Solar pomezticFi�al � � i �� 42. Backflpw Preventer � . 1 I i - 43. Backflow Irrigation 44. LandsCape Irrigation System � . 45..Sound Attenuation � - 46. Handicap Regulations 47. .FINAL STRUCTURE & BUILDING � py' 48. FINAL PLANNING 49. E{ectric Release to Edison � 50. Gas Re�ease to Southern California Gas Co � � � � � 51. CERTIFICATE OF,OCCUPANCY , ' � .. - . No. Date I � � / PPOJECT ADONESS: 3l] i O MEADOW BAQOx owxenseame: VILLAGE CREEIC H.O.A. PDOXESS: 3Q�9 TIMBER LAKE COSTA MESA, CA 92626 553-1876 APLM/ENGINEEN: AUOPESS: HEG.NO.: UNIT: UNIT: aenminee: pETERSON ROOFZNG ( 714 ) 979-7111 nooness: 3006 ENTERPRISE COSTA MESA CA 92628 IICENSEU CONTBACTOP DECLANATION: I �ere0y allirm ��at I am licenseG untler pmvisions of ChaD�er 9(commencing wi�A Sec�ion 7000� al Divison 3 0l the Business and Pmleuions CoOe. and my license is in lutl �o¢e an0 eilec�. ciTruc.:045495 STRTEUC.:6O%S%Z cuss:C— � /� Dale' � � � � � � SignaWre: �N� IJ—�Y WONREPS' COMPENSRTION OECNHAt10N: I Aere�yalfirm �na1l have a 'fiwte at consent to self-insure or a cehificate of workers' POULV N0. n nsgra,qc� o� �yPJidiep pppY �hereof (SecGE%P. � TEab �,4 / O 1� 9 4 1VL .7 7 JJ cornrnxv: STATE FUND ❑ Certilied CODY i5 hereby IumiSheC. � Ce�i�ietl copy is �ileA wilA Ihe tiry 'Itlmg'Otvaie ate: C' ��'— �� APPliwn�: II.�W/ 4;Q�!%PcwCJCXJ E%EMPiION FRUM WOflKEflS' COMPENSATION OECIAPNTION: (Thit secU ee0 not be wmp�e0 if Ue pemn� is Iw one hundreA (4100) or less�. I ceriity Iha� in Ihe pedormance oi the work �ar whic� thi5 permi� is issuetl. I shall na� employ any person in any manner so as to Oecome sublect to the WorkerY Compensation laws ol Calilomia. Date: Signamre: NOTICE: II. a�ter making I�is Uetlara�i0n, y0u Shou10 Gecome 5uble�� o ��e WaM¢rs' Compensaiion provi5ion5 0� Ihe La�of CoOe. you musl Iotlhwiih comply with such Orovisions ar Ihis Oe�mit shall �e tleemeE revoked. CONSTflOCTION LENOING pGENLY: I herehy alfirm ttwt I�ere is a constmction IenOinq agency br ��e Oertormance ol IAe work lor which i�is De�m�t is issued (Section 3097. Civ. C�. LENDEH: FDDFlE55: OWNEN BUILOFfl DECUNRTION: I �er¢Oy aflirm IIW� 1 am eKempi �mm I�e CoNractors' Slaie License Law fof lhe lollowing reason (Semion 703t.5 Busineu anE Pmlessional CoOe: My ciiy al counry which repuires a permit to consiruct, alter, impmve, tlemolis0. or repair any s�mclure. prior Io i�s issuante. ais0 require5 ih¢ aOVlican� br sutA permi� Io �ile a 5igne0 Slalemeni Na� �elshe is licensetl pursuam to �he pmvisions ol i�e Contraaors' Sta�e Licenu Law �COaprer 9 �cammencing wlh $ection 7000) a� Oivision 3 0� Ihe Business ana Pmfessians fAae) or rt�at he/sne is eKempt Inerelrom an0 ihe Oasrs for Ne allegeE ezem0�ion. Any violation o1 Section 7031.5 by any aDOlicanl Ior a Dermit subiecls tne aODlicant to a civil penalry ot not more ihdn live hunUred tloliars (55001. I, as owner ol ihe pmDeny or my emyloye¢5 witn wdqCS as tAeir sole fAmpensdtion, vnll tlo the work, and ine ❑ s�muure is noi inlenEed or ollerea lor sale (Secuon 70a4. Business antl Pwlessional Code: The Comractors' State License Law does no� apply Io an owner ol a prop¢ny who builds or impmves Ihereon, antl w�o does such wadc himSelllAersell or �AmuAh Ais or her own emDlayees. DmviUeO ihat suc� imprwemenis are nol inlenAeA or oiferetl for Sale. If, howev¢r the huiltlinA or improvement is solA within one year ol compleiion, the own¢r will �ave the Uur�en ol O�ovinp hWshe ditl not bui10 or impmve lor Ihe purpose ol sale). I. as owner 0� Ihe pmDeny, am exClusively conlraciing with licensed tonlraclors Io con5imd �he O�oject ($ec�ion 7044, Business ❑ and Pm�essions Coae: ihe Contrac�ors' SIa1C LiCenSe Law Oces noi appty IO an owner 0� D�oDe�y �� 6uild5 of improv¢5lhereon antl who comracts for sucA D�ae��s with a comracmqs) Ikense pursuant to ihe Contracmrs' Siaie License Law�. I am aware Ihat pmol ol Iheir Worker's ComOensa�ion in5urantC shoultl De O�oviOetl to me. � I am exempi unGer S¢ction: B. 8 P. C. toi mis reason: Dale: Ovmec I do here�y ceNly I�a1 � am aware ol anU un0erslana Ihe re0uiremeni5 oi Califomia Healt� an0 Salery Cotle Sec�ions 25505, 25533, and 25534 ana Ihai I or any fulure builtlmB a�upani wilUvnll noi (circle one) nee0 to ComON ��h SaiG stat¢ coGes antl t�e r¢Quiremenis lar a permit for consimc�ion ar moAiiicalion �mm IAe Air Oualiry Managemenl �istncl. FEsiEeniul constmclion applicalions are eaempi �mm Ihese pmvisions. Oate: ADPlicanC I here�y certily Ihal I have read t�is applica�ion antl Slate Ihai the above inlorma�ion is correct I agree lo cam0ly wilh alt ciiy antl coun�y ordmances and siaie IawS relaiing to buiWing COnSirociqn anC hereby auttq�iie reD�esenWiives af t�is ciry Io enter upon the ahOve�menlioneJ propetly Iarinspeciion purposes. Oa�e'. �J � J�`� Signamre� oriver�s �icense or Socia� Securiry y: 16aL46 White—BUAEing; Green—CaEe Enbrcemem: Canary—Applica^I; Pink—Revenue; Goltlenrop—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; H 063405 PERMIT NO B 063405 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCT ON TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCR PTION : T/OFF SHEATH REROOF W/COMP SHINGLES SQ FT: 4,600 CLAIM VALUE: 4,600.00 CALC—VALUE: 4,600.00 GROUP OCC: R-1 / COMMENTS: SMOKE DETECTORS RE� PERMIT INCLUDES 3412 3414 6 3416 MEADOW BRO **�**x��**x*�*�r�*****�rx�***�r�r* f�x�*****��rxx�r�r�r*�#*�r��t*�r***�r�r*x��r***�r*��*x��r *** *+�* Z O N I N G R E Q U Z R E M E N T�MOKE DEY�C�OF� ssTSAcxs n ------------ MAIN BUILDING ---------- --------- ACCESSORY H1i.�S3.V;If�EQ---- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN lit T: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN ��PARK NG REO• PROV: PAACEL: 93506029 ZIdE: REF NU; PLANN NG Ni5TE5> li• � iE3EifiElE tEiEiEiEitiEiEiEjFiEiEiFfE3E1EillEifiFiEiFl6iEifiEiEiEitiFitikif3ElfiFiFitfFiF#iFifiEiFiEififiE#it�lF#iEi[��7[�!!�#ifiEi(�iEiFiEiEiEiFiF3tiEiE?F?f�lE \D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N��T S ZONING APPROVE`�D BY DATE: ' .` BUILDING APPROV,ED HY : DATE: APPLZCATION ISSUED BY: DATE• ,��,�,��**�**�,��,��*� *,�*�#��*��. �.l � * iF if if 1E if iE 1E iE if iE if iE iF iE i? iE iE if iE iE if if iE fk fE iE if i(� iElElE �t iE iE iE itlE 1k iF jf iE iE it iF it fE iFlE iE fF 1F iE if iE if if 1E iE if iE �E *iE if if #E iflElt # if iE iFit 1E iE if iE fE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72,00 ,50 SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 72.50 0.00 0.00 72.50 72,50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 72.50 OVER/SHORT: 00 BLD7zPM�T� PLUMBING ELECTRZC MECHANIC FIRE SMIP/TO�T GRADING PLAN—CHECK �1E iE jE if iE if 1t iE if iE if iE TYPE QTY SFR 4600 I N D I V I D U A L t E E D E S C R I P T I O N REROOF BY VALUE RESIDENTI END OF iE it iE if 1h iF if if 1E if iE iE iE iE ik iE 3( !! if iE # iE iE i! # iE if IE iElf !t it i! B R E A K D O W N UNIT COST TOTAL COST N020NE 1.00 4,600,00 \ 01 QO?44585-001445E6 T 4 T 7?.50 UATE: �lS/09/93 TItIE: 14:10 � /' � ,. , CONSTRUCTION AND PIANNING POOI' A APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspecto. 1. Temporary Electrical Service or Pole 52. �Pool & Equipmen[ Location 2. Soii Pipe�Undrgrnd. � 53. Steel Reinforcement 3. Elecirical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Piumbing & Pressure Test 6. Electrical UFEfl Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footinqs 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, O Undryrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Scructural Floor System 61. APPROVAL TO DECK 7 t. Property Sewer Line & House Conneaion 62. Backwash & Recepmr�Final 12. Sewer Cap . 63. Heater & Vent•Final 13. floof Drains 64. Plumbing System - Final 14. Rough Piumbing 65. Electrical�Final 15. Rough Eteccrical-Conduic 66. Solar System-Fi�at 76. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sig� 68. APPROVED FOR PLASTERING 18. Rough Electriwi-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, ftEQUiREMENT 20. Rough Factory Fireplace . APPROVALS Permit # 21. Ducts, in Structure . - � 70. Underground.Hydro � 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23..Gas Pipe�Rough & Test � • 72. Underground Fiush . 24. Roof Framing ' 73. Undergrnd.StorageTank OGas ❑Dil 25. Roof Slieaihing ��3_q�'�,(,i,i� 74, Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing . 76. Dry Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL ' 29. Insulation � -. � 78. FIRE PREV. FINAL 30. Drywall Nailing I � HEALTH DEPT. REQUIREMENT 31. Plasrer &�own Coat � ' 79. FINAL INSPECTION i 32. �Electrical Power Meter-Final � ' S0. FOOD CERTIFICATE ISSUED 33. Pinal Etectric , i , j Notes: . 34. Final Heating & Air ConditioN�9 � 35. Final Gas Pipe-Test � 36. Hood or Canopy . 37. Final Factory Fireplace � � 38. Final Plumbing I � i 39. Water Service�Final j � � 40. Gas Service-Final � � i 41, Solar pomestic�Final � ! � 42. Backflow Preventer � i � 43. Backflow Irrigation � 44. Landscape Irripationl$ySterr�. 45. Sound Attenuation �P ��`-� 46. Handicap Regulatio��. ;._,� 47. FINALSTRUCTUR�!$ BCpLDING 3�3-q,� �� 48. PINALPLANNING.--, � ' , �. ' 49. �Electric Release to F$l�spn� � 50. Gas Release to Soutlierp California Gas Co ' 51. CERTIFICATE OF OGCUPANCY No. Date PHOJECT AOOXESS: 3 q 1 O MEADOW BFi04]( OWNEfl'QNRME: �OLLER VICTOR L, ' ADOHESS: 3910 M�ADOW BROOK COSTA MESA PflCHIENGINEEN: AUGHESS: HEG.NO.: UNIT: UNIT: PEpmiT'EE' ELECTRICAL SYSTEMS TEST. ( 714 ) 898-5113 naoness: 15573 COMMERCE LANE HUNTINGTON BEACH CA 92649 LICENSEo CONTPACTOX oECtABATION: I hereDy alhrm iha� I am licensed untler Omvisions ol Chapter 9(commencing wi�� Sectian 7W0) 0� Oiv�sion 3 0l t�e Business antl Pm�essions CoOe. antl my license is in lull torce anC efiec�. cirr uc.: �2 � 3 Zr Te uc.: 311709 Io/UUU//yyySSS$/J�f(y��/�1� Q//�/,� —Date. ' Signamre: _P_�X�" ' ✓� �` // I ' `WOPRERS' COMPENSFTION OECIAflATION: I here0y allirm ihat 1 Aave a ce�ilicale ot consent �o self-insure or a certibcate of WOBers' Cam0en5aiion Insurance. or a ceniliea copY ��ereof (Sec�ion 38110. La�. C�. PaucrNo.: 1042904-90 E%P.OATE: Q7/OII9Z comrnNr: STATE FUNLL ❑ Lerlilied copy is� /hereby t/um�i5hed I_}[ C¢tlitied Copy �5 fileU w,(h �he u�y Bu/ild�{p�� DiviSion/ ♦�e. �� / � / / A�PlicanC04�!/✓' W" /.'( ¢ �C��dil/W `� EXEM11PfI0N FROM WOBKEflS' COMPENSAPON OEQAPATION: (This satqp nee0 not be completeE il @e perml is fa one hwMreU (5700) or less�. I cehity Ihat in Ihe pedormance o� �he work for whic� t�is permil is issued, 1 shall no� employ any person in any manner sa as �o become subie�� o ine workers' Compensation laws ol Califomia. Daie: SignaNre: NOTICE: II. aiter making I�is tleclaration, yau StwulG be[ome spblec� �o ��e Workers' ComDensa�ion O�oWsions o� the Lallor Code. you must Ioriliwith comDty wii� suc� pmvisions or this Oe�mii s�all b¢ deeme0 revoked. . CONSTBOCTION LENOING RGENCY: I �ere0y attirm that there i5 a �pns(ruciion IenEing a0ency Por the peAormance at the work for whic� �his permi� is issued (Sectian 3097. Civ. C�. LENOEP: AUDflESS: oWNEB BIIILDEN �ECIANpTION: � here�y aflirm ina� I am erempt imm �ne Comracmr5' State License Law for the following reason �Seclion 70.31.5 Business an0 PmteSsional Coae: Any ci�y ol COuniy wAich repuir¢5 a p¢rmt to [onstmct, atler, impmv¢. �emoliSh, or repair any simclure. D�iar lo i1s issuance, als0 reQuires Ihe aODlicant �or 5ucb Dermii Io file a sipne0 s�a�emenl t�at he/s�e is licensetl Oursuant io ihe pmvisions of t�e Coniracmrs' SUte License Law �CnaDter 9(wmmencinA m�� Section 7W0) ol 0ivision 3 0l the Business and Professions Code� or Iha� �e/she is exempl thereirom ana ��e Easis lor I�e allegetl exemption. Any violaiion oi Sec�ion 7031.5 by eny applicanl lor a De�mii suEle�ts t0e a001icant la a civil De�aliy af not mote ihan live IlunEreG Aollars (5500). I. as owner ol t�e pmpeny or rtry emplay¢es wiih wapes as lheit sole com0ensation, will Go the xrork, an0 ihe ❑ s�mcmre is not intentled or ollere� �or sale (Section 70aa. Business and Pmlessional CoOe: T�e Contraciors' State License Law Ooes no� apply lo an awner of a pmpeny wh0 buitds ar improves iherean, anA w�o does SucA wafk Ilimsell/�ersell or ihmugh �i5 or �er own employee5, O�ovitleG I�ai Suth impmv¢menl5 ate nol in�en0ea af o�lereE lOr Sale. II. however �he bUiltling or impmvemeni is solE wil�in ane year of COmpletion, t�e own@r mil have I�e �urUen al proving �els�e AiA not huiltl ar impwve lor ihe purpose of sale�. I, as owner ol ihe pm0etly, am exclusively contractinp wilh Iicense0 conlractors lo constmct ihe D�aiect (Section 7044, Business u an0 P�olessions CoOe: 7he Coniractors' Staie License Law Go¢y nat aDDN �a an ovmer o7 propeny wno �uilds or imD�a�es ihereon antl wno comracls br suc� pmle��s wilh a contrac�oqs�license Dursuant Io IAe Conirac�ors' S�a�e License Law�. I am aware Ihat pmot oi I�eir Worker'S fAmpensation insurance 5�oulU be pmviAetl io me. � I am exempl untler Seclion: 0. 8 P. C. lor I�is reasan: Da�e: a«ner. I tlo nereby ceruty Ihal I am aware ol antl untlerSlanA ihe reQuiremems ol Calibmia,Healih antl Sa�ery Coae Seclions 25505, 25533, and 2553G and ihal I or any luture Ouildmg otcupanl wilVwill not (tirGe one) neeA lo comply wilh 5ai0 state toaes ana �Oe reQuiremenis tor a permit for consimction or motlJication Imm I�e Aii Ouably Managemenl Di5lrici. Revd¢nlial consimclion aOPlicalians are exemp� imm mese pmvisions. Oate: APD�itanl: I here�y cerUty �Aat I have rea0 �his aDPlica�ion an0 slate I�at I�e a�ov¢ inbrmaiion is correcL I agree lo comD�Y'�^�h all city antl caunly artlinanres antl state laws rela�ing �o builtling consimclion an0 �ereby ay�nor¢e represen�atives ol Ihis city to enier upon Ihe above�men�ioned pmpeny loi insp dion pur Oses. ��lf /��/,,� � �yy/y/� '��C� �ale: / �/ Signaiure' `4"iV/fi�/` /' / • oriver's License or Sociai Secun�y n: 164L4fi Wmte—ewltling: Green—Coee Enlorcement: Canary—qpplicanC Pink—qevenue'. Goltlenroa—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052924 PERMIT NO: E 052929 PLAN CIiECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMZT TYPE: ELE PURPOSE; OTH JOH DESCRIPTION : INSTALL SWITCH FOR AC RADIO CONTROL SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: SMOKE DETECTOR RE�UIRED IN THE HOME *****��r**�****x�********�r*� �+��******x+�**�r+�*�r�r**�*�r�r**�r**x**+�x+��***✓***��r*�*�*�r 2 O N I N G R E Q U I R E M E N T S S E T B A C K S �---------- MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT ZN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING RE � PROV; PARCEL; 93506029 ZNE; REF NO: PLANNING N�1'ES> J M iE iE iE !F 3F iF 1E if 3F 1E 3E iE iF iE #F 3E iE iF iF if k if 1E iFir if iF iE iE iE iE k 3F if 3E �E if iE 3E �F 3f if if k iE 1f 3f iF iE �f iEiF 3E if if 3F iE IE 1E 3E �f 1E if iF ie if % iE IF 3E iE IF jf if iE iE �E 1E D E V E L O P M E N T S E.'.R V I C E S R E Q U I R E M E N T S 20NING AFPROVED HY '• DATE: HUILDING APPROVED HY : _ DATE: APPLICATZON ISSUED BY; DATE: �'—�� ifiF1F1E1k3kiEiFiEiF1E1ElEiEiEiE�EiElfiFiElF . IfiE1fKlFaEiF�FiEiF ikiE f43FiF1E1FfFifiEfE3E1f1EifafiflEifiEiEiE3E1FiFfEffft3EiElFiEiE1FIFiEfl�r iEiiiEif-3ElfifififififibjEifikiEiflflfiflf�llflhiEiFiEiflii"riE3fifiFlE!flf3FiFiEaE I�EGALIZATION;N F E.iE'1 S U M M A R Y STRTJCTURAL SEGMENT:N BLDG PMT PLUMHING ELE�TRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 11.00 SOY SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 11.00 15.00 0.00 26.00 26.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 26.U0 OVER/SHORT: .UO BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 26.00 1E iE iF iF IF?F 1F if * iF ik * iP if iE iF iF iE iF if iF if if iE k 1E iE �E if iE aE 1f iF aE iF if 1f #�F !E 3f )f af 3E 1F iF i41E iE iE iE iE if iF if if iE iE iE iE IE aF af If 1f if �f 3i� ie IE iF iF IE if if #!E if # I N D I V I D U A L F E E H R E A K D 0 W t3 TYPE QTY D E S C R I P 1' I O N UNIT COST TOTAL COST ELE 1 MISC APPARATUS NOT LISTED REO PERMIT 11.00 11.00 END OF F'EES �'. 1". .'�' ' . . "e ' t � �. ..i:.. . ..l � Li : _ ...._ � . i'b �CONSTRUCTION AND PLANNING i P�� A . APPROVALS Permit # Date Inspector AppROVALS Permi� # Date Inspector `l. Temporary Electrical Service or Pole 52. Pool & Equipmen[ Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemeni 3. Electrical Conduit Utility-Undrgrnd. " 54. Formt 4. Electrical Conduit�Undrgrnd. 55. Electrical Bond�ng „5. St¢el Reinforcemenc 56. Rough Plumbing & Pressure Test ,�6. �Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings ' ' 58. Eiectrical Conduit-Undrgrnd. � 8. Foundation ''` - 59. Gas Pipe, O Undrgrnd., Test 9: Water Pipe�Undrgrrid. • 60. Backwash Lines� P-Trap, O Undrgrnd. 10. Structural Floor System l 61. APPROV.AL TO DECK 11. Property Sewer. Line & House Connection 62. Backwash & ReceptorFinal 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains � 64. Plumbing SYstem - Final � 14. Rough Plumbing � 65. Electrical-Final 15. Rough Electricai-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Reugh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica�-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • � • 20. Rough Factory Fiieplace • �-.APPROVALS � Permit # ., 21. �Ducts, in Structure . � , , ' � �70. Undergrounc} Hydro � 22. DucTs, Ventilating • - 77. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test � - 72. Underground Flush � 24.RoofFraming • � � �73.�Undergrnd.StoragaTankflGas❑Oi1 25. Roof Sheathing . • - '; � 74. Overhead Hydro � 26. T�Bar Ceiling (Structural) & Monocoat �� - 75. Dry Chemical � ' 27: Frame and Flashing . ; 76. Dry Standpipe . . 28. Lathing & Siding ,� � 77. FIXED SYSTEM FINAL _ 29. Insulation , 78:_FIRE PREV. FINqL •30. Drywall Nailing � � � - HEALTH.pEPT. REQUIREMENT � '.31. Plaster Biown Coat ' .; i79. -FINAL INSPECTIQN ; - . 32. Electrical Power Metar�Final ' �-' - s,. FOOD CERTIFICATE ISSUED .33. Final ElectriC , �l'Q� ._rJ-, No�.s: � ' _ ,�34: Final Heating & Air•Conditioning - , • • . � 35: Final Gas Pipe�Test' � � ' � �� • . , r- ,36. Hood orlCanopy . � . „ . . . 37: Final Factory Fireplacc • � : 38. Final Plumbing . � f '.39. Water Service-Final - ' 40. Gas Service-Final � . , , , ' I _ . , �41. Solar pomestic-Pinal • • . � 42.�Backflow Preventer, ` i . " � 43. Backflow Irrigation - � - 44. Landscape Irrigation SYstem, . � . •- 45. Sound Attenuation � • � 46. Handicap Regulations � � � . , ' 47. FINAL STRUCTURE & BUI.LDING � � • • 48. FINAL PI.ANNING � !. � 49.� Eleitric Release to Edison � � � r . 50. Gas-Release to Southem Califurnia Gas Co , j , � . 51. CERTIFICATE OF OCCUPANCY No. Date � A�Plieant to fill in all spaus except t�ou wit�in CITY OF COSTA MESA, � _ CONSTRUCTION PERMIT ' ' . .., . _ . . ApplicanYs Nlailing Address � "" ""� , TVPE OF CONSTRUCTION� Ll raE PlOjett Addfess � ❑ CONVERSION ❑ DEMOLISH �� .hOne � ^ ^ DESCRIPTION OF WORK Owner's Name - � Address � � n . . � - TVPE OF PEHMIT GRnowc Afch/Eng. LiCen58 No. ❑ TENANT ❑ ELECTRICAL C Addrea� ' � {( ❑.�OTHER Contrectoi s Nam r -� tfurfe S . ,; ' PRQIECT DESCRIPTION 5�. FT.— i J ADD OTHER Iines intl sign all aOD�oDNata Oeela�itions. ' �T No. s� , �CGCGfJZGl7�� r �/%ZL� . %CC�L�' � �� L�L� �� ALTERATION REPAIR � � IB6�1 %�{J��a3 �' RJo�rl� T� � FOVNDATION ❑ STRUCTVRAL A.P.� PLUMBING ❑ MECHANICAL� P�NG. REF. # Addresslmailing) � ��6.,.J`, , CONSTRUCTiON7VVE � VALUATION$ ' 1EF751DEVARD _ ZONE GRADING CU.VDS. ACRFc PKG.SPACE�REQ. Cicense Na — LICENSED CONTRACTOR DECLARATION Rema�ks: -' , STREET WIDTH I hereby aHirm that I am IlcenseG untlar pravlilons aT Charter 9(commencing , , . with sectlon 7000) o� Divlslon 3 of the Buzlness antl ProfeSsionz CoEe, antl . . • SGECIAL CONDITI my Ilcensa Is In typ fqrce antl effect. , , ��i p� o te �° `l��` � is i , ^ , �",��t"� �,�xe C � , �7— 51g t Bar SH1k WORKERS'COMPENSATION DECLARATION '�pereby atflrm Mat I have a certitirate ot con9ent to Self-Insuro or a.tertHicata . Beckflow Preventer �*,.;3Worken' ComDensatlon Insumnce, o� a Fertlfletl copy thereof (Sectlon � - "io, Lab. Cf1 /� ^ Backflow Irriga[ion LSOUty No. !'l,/ �� rT COmDany �rtifietl-copY 15 hereby fu�nishetl. 82thtUbS rti le y Is flletl wlth tha city Bul tl�n D is' . Date • ADP��Ent • � � Cla�ifi¢�5 EXEMPT ON'FROM WORKERS' COMPENSAT�ON DECLARATION DIShW25h2f ��Isze<tlon neatl not be tomD�eteO It She Derrrilt I5 for one huntlretl (5300) or IcA) tlty [hat in [he De�fO�mtnce Of the wo�k fo/ whlch this pe�m�t i5155u<tl I Drinking Fountains shall ot employ any perwn In any manner to as to bacome subject. to t{�e . Worker'COTpensatlOn,lawSofCalifomia.. � � , FIOOfDreinS . Date �Signature ' NOTICE: H, er making this tleclaration. You'shoultl become suEject [o Me Workars' Comp tlon Drov�slons of tha Labor Cotle, you must Torthwith ; comply with suc rovisions• or •[his`perm�t shall ba tleemetl revoketl. CONSTRUCTION L ING AGENCV � 1 here�y aftirm that there constructlon lend��9 agency for the performance ot the work for . which t c_ permit is ;i4suatl :(Sactlon 3097 Civ: CJ' • Lander'S� Name � ' Lentler'S AtlCress � �- � OWNER BUILDER DECLA0.ATION � ' �' I hefeby affirm that I am esempY from tne;Contractor's,License Law for the ; or as bulltls of Imploves [heleon, and who tractor(5) Iicense pursuant to the Cont ❑ I'am exemp[ un0er Sectlon— Date � Owner — upon utllects.tna applicant to a tiv11 s (E500). . � - �p�oyees with wa9es a5 th01� So18 ru<ture is not IntenCetl or offered � �esslonal Cotle: Tne Contractor'S j property who builtls or improves ' nerself or through hls or her own ; [5 are not intentletl or oiferetl for . !n< Is soltl wlthin one year oi com- ir0��ng he/she tlitl not Duiltl or im- ' elY contracting�with,lic¢n5¢tl con- fiA..Business.ana Rotassions Cotla: . ply to an owner of property who � acts for such piojects with a con- 's License Law): � ! ' B. & P. C. fo� thli �eason 1 lication antl state that tne above- Itn ali city anC counly or0inances :tion, antl hereby authoriza repre- g above-mentlrooeA p��p�r�Tor � noor ainKs � - � - . - � Gas Service� Outlets � � , Interce{itor5 : Kitchen Sink ' ' � �' , Lavatories � - - � P,—Trap r.: � Roof Drains � • � Showers �. - ' • � Boiler. : � • � . Duct - Under'GrOund ' Duct-Structural � .. Duct - Ventilating . . .. , Exhaust System ❑ Multi{ile ❑ Fiiepl/Fact. Blt. ICBO # , Heating System & Ducting � �4100,OOO,BTU 0100,000 BT , Hood or Type I ❑' � j Drlvers' Llcense or 55 � - / � Registers CMF 0865-46 rev. 12/82 White - Builtlin9; Ca�ary - APplicant; Pink - A<counting; Goltlenrotl - Assessor Mairvu � Sewer Cap $Bwef Connection Solar Collectors � Solar Piping • � � Solar Tank Swimming Pool w�Spa � Urinal Water�Closet -Water Heater - �WaterService . , Reinspaction Fee laue Fee netngeravon System + . - oa,00pooeru ❑,00,000eru System Repair/Alteration Reinspection Fee Issue Fee ! $15 $ 3 $15 $ 3 Automatic Washer Construction Pole - Cooking Unit Dishwasher (- Fan F.A.U. . Fixtures Device eoxes REAR VARD (TO P/L) ' RIGHTSIDE VARD PPOVIDED PARK FEE § . � Meter LJover 10b emps � _ ' Sub Penel' ' Sub Pole ' � Motors ❑04 HP ❑7'h� � - Inc.Solar.O9_75HP �i6-15+ Microwave ' � 'Pole Light ' ' - Range Sign StandingSections . � � Trash Compactor )ial � )-5 KW �5- ❑ 15-50 K W ❑5U+ KW 0 100 amps Zoning APProvad BY ApPliotion Approved BY � � Application Issued By _. !._._. . � { ' �SUMMARV �BUILDINGPERMIT $ � PLAN CHECK� ' $ ,PLUMBING �� $ �_ —"�' .'P�AN CHECK� $ EIECTRICAL $i PLAN CHECK � $' MECHANICAL � $ �PIAN CHECK' $. . � 0 a .painspaction Fee � � $15 � \ laue Fea . � $ 3 ` t l Date �I—Date / �2 �/' `L.cr�,' _Date Lo ' % � ` !� � i )F FEES � , ' ' SMIP . ; $ . � PERMIT I ISSUANCE � ' $ � � GRADING I . $ � � • � $ I � MICROFILM � $ � � TOTALFEE � $ � � � LESS ' ' � .� : ADVANCED PC � $ �� ,y�� FINALFEE � $ f�L'��L. OWNER JOB ADDRESS GFNERA� ��J � �. YE6 t GAS STATE-WIDE �� W ATER ROUGH PLUM9ING PROP. $WR. LINE � HOl15E CON. SPRINKLING SVSTEM MISCELLANEOUS UNOERGROUND AOWH WIRING TRENC� BONO BERM $HEATHING FRAME ANO FLASHI LATHING - IN � Pl 'EF, BROWN C S' fURAL, FINAI iIR COHDITIONING OR POLE POWER � 5 � STEEL REINF. EEL REINFORCE �J TRAC1 s�a�.� Inc. y i DATE BUI c FIRE ZONE VALUE TVPE GROUI SUBCONTRACTOR � PE w . gar �ag �+50.6D— ti �, —" PaI� COSTAMESABUILDINGSAFETYDEPARTMENT �u^Y?3-?e�ps•OO 758^ ^��''ZC�r�.JB P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT HECEIVEDBY DATERECEIVED DA EIS UEO ADIDRESS3 0 �4 d Bro k � �v �IIZ-1//�0/ 02. ^ PER . .l .. OWNER State-Wide Develo ers, Inc. A.P.NO. -0� �Q �G/ __ MAI L BUIlD1NG / z . aooAess9461 Grindla ADDRESS 34�o L'(/�Cl� �UO�C a v ciTv C r255 No�264550 TRACT �or e�ocK Zz Q CANSTRUCiION W ON LENDER d m J 7 BRANCH J tn OWN m J ADDRESS VALVE O ' �a e„�`,"no�� Lohrbach Pulanski TE`556-6610 � V N FIRE W� ADOFESS P Blvd Irvine �ONE TVPE GROUP — a W APPROVED J O CONTRACTORStatC�I'��CE DQVQ�O er$ INc. eY DATE m �� AooAess9461 Grindla w w TEL. Z�NE NO.OF VSE OF NEW /(�' V% ZF ciTr Cy CeSS No.826-4550 22�V P�^� Z BUILDING w O STATE r� CITV VAfl�S APPROVED VARDS APPRO ED y� LIC. NO. ZG4%�O LIC. NO. MAIN BUILOING ACCESSORV BUILDING � O (FROM C/L STREET) OF LOT 12.093 acres NOW ON LO 5 � FqOM � FT. FT. USE OF �� EXISTING eLOG. FT. F� SIZE OF NO. OF Z NEW BLDG. ROOMS STOFIES L SIDE FT. FT. U E%TERIOFN1F�l_ a� er RO�F �%` COVERING COVEfiING Shake REAR FT. Z: FT. J USE OF BUILDING AND WORK TO BE PERFORMEO D45TANCE 9ET. BET. MAIN & a MAIN BLOGS. ACCESS. BLDCS. pa �7— onstruction-Condominiud�s CURP.qW�r(� �7 APPROVED �� APPROVED � _22-7G � HOLD FOR S ECZAL E UIRF.Mr� �� UI hereby ecknowletl0e that I have reatl this avv�icaUon e�a aate � ^S � thet xh¢ abova informetion is correct antl aptea to comply with � ell laws repuletlnp bu�ltling consnuctlon, antl � shall not employ � any perso� in violatio� of t�a warkman'a compenseNon laws of _ y the State ot Celifornia. p m ZI hereby certify that I em properlV 1(censetl as a conttactor untlar S�. FT. J� p3 O the State of Cal(fornle Business entl Profecsions Cotla, Dlvisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR Chepter 9, and thet sueh lieanses ere In tull toree and effaet, or 1 THE PURPOSE OF ESTAeLISHING A PERMR FEE ONLV � b em exempt from Ma provisions ot t�a State ot Iitornia Businasa � VALUAT ON entl Professlons Code, Divizion 3, Chaptar 9. , I J � H l�T � PEflM1T FEE $ ] S�a a� tate-Wide D ve o , Inc. �,�� m Permlttee $ PLAN CHECK $ � E AuthorizetlAgant Vice Presiden � LL TOTAL FEE S � �