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Home My WebLink About1018 NANCY LN - Building PermitsADDRM OF BUILDING: 1018 NANCY LN UNIT. ONNEWSNAMEI1FIGNI :NICHOLAS DILGADO ADmus: 1018 NANCY -LN C.M. CA 92626 .t ADPL. NAILING ADDRESS: MCNWECT OR ENONEER: Uc. ND.: ARCH. OR M'S ADDRESS: UNT: CONTRAcrarsmur ISLAND PACIFIC ROOFING (714)637-2493 CONTRAcroasuuuNn 17762 CAMERON ST itoolm :H.B. CA uc.NO.: 631472 92647 um. 2 LICENSED CONTRACTORS DECLARATION: I hereby affirm under pwaAy of perjury Met I em limlmd uMv provbiorn of Creole, 9 (opmmendrp will, Section ]000) of Division 3 of the Susi. end Pmlosslarre Code, end my how. is in full force ard eHm. CWYLIC. NO.:0577 9 9 Lic.cLass:C 39 LIC. NO, 3147 EXP: 09/98 DO.: D.: Cmtrmm 1165C�ri� OWNER BUILDER 4LARAnON: I hereby affirm under penalty of perjury Ihet I am esempl ham the CoMredas Liceme Law for the lolbwig mswn (Section 7031.5 Business and Prde®pu Code: AM by or ootov which requires a perms to mrreUUd, after, improve, demol'reh, a repel wY wuo uss. prior b as areuenoe, also npu'vas IM eppli ma la woth parrot to fib a sigad sWemeN that M or art is Iican.ed Wnuwt to the promisee of the Co,ermas Licema Lew [Chaser 9 (comm.ncn9 with Section ]000) of Ovbiw 3 of the Businev end Prdeuims Code) or that he Or do IS memol therehcm and the Iamb for the Wiped memoliM. MY vioki of Bmion 7031.5 by wy applicant for a permit subjects the applicanl to a civil pemlty of m move then We huMred dollen [MI). ❑ I, as owmr of IM properf or my arnplolem wah vagas as their sole covnpenmtion. vall the work, end He suudum b nal intended or offered for "a (Sactic n ]Ou. Busirves vol Pmfineiau Code: TM Cmlredon License Law does ml appy low ownerd property such builds or improves Hereon, and efc dose suN se,k henatl or MnN or Walph M or her own employees. provMee call such improvemwts we rot idealec or offered fa 0111. If. ho vessr. the WeeN or anpmvernem is sold wfthin we year of complaim IM .wander will have the Wrdan of proving M or she cid nor affil or anprove fa the p r,me d sale). ❑ 1, as owner d the Property. On mcAranly cererectilp war ficen+ad owthesswe to mmtrud the protect (Section Ida, Bus. saw Prolemiare Coda: The Cmtram Liceme Law casae m appy to w owner of prop" who Wise or Yngwes thereon she who .t M such pr eerie with a mm,mor(a) Ibemed pursuer, to the Coaermon Limns. few). ❑ 1 fon sump ural-, Smbn: S. & P.C., for Mb .sawn: Data: 0.. 1 do Mnby mnify Ow I fon aware of erld uMmsMM the readromlmn of Cafaomie Hwhh and Scary Casale Sections 25505, 25551, vol 2553x, and Met 1 or vy Mun buikfmp ocmpanl vall / wR not (drds oat) need to comply wah said ewe codas art IM lepuiremede for . mane formmvudbn or modA'WbnhomlMAi My-Pliropement Curtis. Residwid mmnction eppiretimnero aumq Iran Meas provisions. Data: Appfram: WORKER'S COMPENSATION DECLARATION: I hereby cMmh under Penalty of Percy one of Me foil w'alg deeudions: ❑ I hat fort he mebten • 0 the si domed Io sep�maa for Issued. Wmpanwbn, n prodded la W Semm 3]00 d IM labor Cade, lathe padormanca d the wok la whfoh this pawl, b issued. ❑ k neva wd will mriaeb weak issue. . My asslo a, cowicav si nputred by Seamon 3 re d Ms labor Cods,W IM perlormerwa d IM work Ia which His pemW b hued. My worker' mmgauatin iawraahos wrier vaf paltry number era: Carrier: Pricy Number: (This amlay coed mr be tampered y the were is our was hwdnd doyen 15IWf v lima) ❑ I mnry Uw in He pedamenm d IM wok la whir Mb perms b baud. I awl m employ wy perm is any mmmr w m Io become subjm to IM rterY wecoom err al laws d Celdade. end agree Il, b become subject to 1M aarYnn' cemos t �n prcw'u' n d Section 3700 d the labor Cab, I Noll l h d h Mo 'sl e. Data: Applied: Wembp: Falun ro 1.ufas woKeri rompwsed rI coverall /a u 1, asltl atoll aum,*1 an ernPloyer ro cdMrrl P.M. and civil noes w ro one hundred thousand ddbn (SIO401)(11 In addificsl ro Me cost of rorrVweefbM1 damePs as ProvMM far In Section 3106 of Me Labor Code, InMml, and afomey i lees. CONSTRUCTION LENDING AGENCY: I hereby affirm wafer penaby of perjury that Ihen 1. e 0.Ylsllmbrl lershop agemy for Oro pedwrn.. of the wak for whits this puma is brood (Sec im 309]. Civ. C). LENDER'S NAME LENDER'S ADDRESS: I ceniy that I have reed this spplicetion east wo that the above inlorew. is correct. l -plea to amply with all dry and county adinwces and ewe Issue rows, b Wgdrq vM hereby aNhace repesanimisea dlhb my ro eche. Upm its Bbaamedbned property for Inspection purposes. FRANK MIRANDA e . IN Date: / V SigMum-o e,AgwVA oma (515146.WP) White-Buikliq d Soley: GrevFRle; Cwery-Applcent: Pink -Revenue: Goklenroa-Asamwr CITY OF COSTA MESA — BUILDING PERMIT y01 PERM NO: B 087712 PERMIT NO: B 087712 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : REROOF W/1LAYER COMP. OVER EXISTING SQ FT: 1,400 CLAIM VALUE: 1,400.00 CALC—VALUE: 1,400.00 GROUP OCC: R-1 /U-1 COMMENTS: < �-a C*'- ca'r p. Z 0 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 BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93530010 ZNE: REF NO: PLANNING NOTES> > ill iF iE iE i6 iE irk iF iE iE df de *irk * iE j6 iE 9E iE 3E iE of iE aE dE dE iE * iE 3F 9F iE iE *!F Hf df dE 1E iF aE dE dE d6 d6 9E dE ib 1E * RE iF HE HE 3E 9l, iE HE iF * iF dE 9f �)E ie 9E iE #E 3E 9E aE RE iF dE is iE iE iE 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 NIT S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: �•' q APPLICATION ISSUED BY: DATE: r **d6**9t aft 911 9E dP iE aft 9t 911 9E*aft*dr if if 3tiF'iF 3F3FiFiF iF+'F3F iF iF iF EtiF iFiF iF3F iFiFiF iF3F iF it dr 'iF3F3F if**iF d49b*Rt•Rt ..�fE �I *� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 45.75 ,50 PLAN SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 46,25 0.00 0.00 46.25 46.25 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 46.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 45.75 .50 d6 irk iE if irk dE ib )f iE dE iF d6 iE df irk d61E 9E ib dE dE de iE if iF irk irk i6 iF dE 1E He * * iE dE 9E irk iE dF if * i6 * * * ie irk ib dE 9E it if irk iR d6 ff * HE * iE irk * iE dE * iE iE de dE fir * dE !f Ht 9E iE iD df I N D I V I D U A L', F E E B R E A K D O W N TYPE QTY D E S C R I P T I O.N UNIT COST TOTAL COST SFR 1400 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,400.00 END OF FEES !/ 04-15-1998/10:35 AIVS46.25 KPT4:01-622445 PERMIT:08771ee C04JSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Z Inspector . Temporary Electrical Service or Pole • 52. Pool & Equipment Location " 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement "56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O,Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 4L- 20. Rough Factory Fireplace 21. Ducts, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough &.Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 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. 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 Notes:We-oCoa-l' 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 �. 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer .43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 16 48. FINAL PLANNING 49. Electric Release to Edison i - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date -' -- s VA PROJECT ADDRESS: 1018 NANCY LN UNIT: OWNER'S NAME: CANYON BLUFF HOMEOWNERS A Aoukius: 1003 NANCY LN C.M., CA 92626 650-0923 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: CANYON BLUFF HOMEOWNERS (714)650-0923 ADDRESS: 1003 NANCY LN C.M. CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a cuddled copy thereof )Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Cenified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. 'G Dale: • . Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: This section need not be completed if the permit is for one hundred ($11G) or less). I certify Ihat In the performance of the work far which this permit is issued. I shall not employ any person in any manner so as to became subject m the Work /s' Com De lion Laws of California. Data % Signam�e: NOTICE: If. after making This declaration. you should be a subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: 1 hereby affirm that, there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097.,Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that) am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant o the provisions of the ContractorsSlate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 applicanl to a civil penalty of not more than live hundred dollars (5500). ,y, I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the L'I structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon. and who does such work himselftherself or through his or her own employees, provided loan such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). ','a owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: The Contractors' State License Law does not apply to an owner of proiaeny who builds or improves thereon and who contracts for such projects with a conlractor(s) license pursuant to the Contractors' Stale License Law),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason Date: 5xY43 Owner: i Ido 4 a dy cattily that am aware of and understand 4111 the requirements of California Health and Solely Code e Sections 2equir 25533. and 25534 and that or any future building occupant All Du not (circle one) tneed Dis to comply with said state codes and thus are requirements for a permit for construction or motldication from the Au ouahry Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct, Iagree to comply with all city and county ordinances and state laws relating to building construction and hereby outbound representatives of this city to enter upon the above-mentioned property for insp ion our used. Date'. Z i / Signature: Driver s License or Social Security e: 164146 While—Building, Green—Code Enforcement; Canary—Applicant, Pmk—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06422 PERMIT NO: B 064226 PLAN CHECK NO: 03768-93 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; 95LF CITY STANDARD BLOCK WALL SQ FT: 95 CLAIM VALUE; 1,900,00 CALL—VALUE; 1,900,00 GROUP OCC: R-3 / COMMENTS: PERMIT INCLUDES 1020 6 1022 NANCY LN Z 0 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 BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93530010 ZNE: R2 REF NO: PLANNING NOTES> APPROX, 95 LF OF 24 INCH HIGH BLOCK WALL ALONG RIGHT_SIDE PR > OPERTY LINE INSIDE IRON FENCE, ifiEiEiEiF***1f*lEiE it**k*�*it itffat**kiPititlEitlf*****1E**k*1P1EriH1Ek*1E**ifiPiE*1E1l�PJEk**KtiFfE%fflRiHiEiEiE*fEfEaPfffF 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 LC ZONING APPROVED BY �> — / DATE: � I BUILDING APPROVED BY : DATE: iI 1 q APPLICATION ISSUED BY: DATE: '? / ifkkkMik ff itit *1H Jf if ik Kt ae if it it It it* iP iP iE if iH iE iR it tE* *au ilitM*******iE iP al it fFk kiF iE*1f 1E it%ai 1E fE**kit iP Bli!**1E ik lE Ke iH iF*iE iE iE lE if if JflE*aE it iE lP iE fE iE aP MiEfk Kr iF lR iE 4 iE*KP aE 1P iE at aE *if iM1 LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC? FIRE SMIP/RES' GRADING PERMIT 43,00 50'- PLAN 27,95 SMIP/N0N�4RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 43.50 0,00 27,.95 (-•71,45 71,45 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 7,1,45 OVER/SHORT; �: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAD ING• PLAN—CHECK 43,00 ,50 27,95 fE ie at at*it*i!*ie if iE aE al lE iHM4iH i!lE if kitrt lk it it it Kt**ik iE iE Jf**it fE fE lf!l ft Kt if iE of KE*aEkie if iE iH iF ft kfe iP Kt ie k if al iH iE ie**4*M*iP aE ak 1E I N D I V I D U A L F E 'E B WE A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 95 RES—CONCRETE BLOCK WALL' /'FT, 20,00 1,900.00 END OF FEES v , t M 01 00143023-00145025 T O T 71.45 DATE: 09/30/93 TIME: 09:15 4 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement . A, Electrical Conduit Utility-Undrgrnd. 54. Forms "4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding eel Reinforcement `Q_(If_q G W# 56. Rough Plumbing & Pressure Test = -6:.Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE _ 7. Footings�tJH 58. Electrical Conduit-Undrgrnd. " 8. Foundation - 59. Gas Pipe, O Undrgrnd., Test .-9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Urdrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbirfg 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS - Permit # 20.,Roogh Factory Fireplace 21. Ducts, in Structure. i i , 70. ilndergiapnd Hygro 22. Ducts, Ventilating - - 71 . Produci Piping O C1as ❑ Oil 23. Gas PipfO Rough & Test- 72. Underground FIus1' c 24., Ratif Framing 73. Undergrrid. Stoeap.e Tank O Gas O Oil 25. Roof Sheathing • 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashind -; 76. Dry Standpipe _28. Lathing& Siding 77; FIXED SYSTEM FINAL 29. Insulation I 78; FIRE PREV. FINflL 30. Drywall Nailing ) HEALTH.DEPT. REQUIREMENT 31. Plaster Brown Coat I .791 FINAL INSPECTION ' 32. Electrical Power Meter -Final 80..FOOD CERTIFICATE ISSUED 4 Final Electric .. I Notes: -. X34. Final Heating &Air Conditioning B -lz-R_3� ew, lam, L �� r a r-Lip-i1GQ"-G / /l AZT - �a , 35: Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace '1 - 38, Final Plumbing •� ._- - 39. Water Service -Final ` Dee Y 40. Gas Service -Final .'41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation• •?�' - - i , 44. Landscape Irrigation System - 45.: Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 1� 48. FINAL PLANNING �y_s13 6(,� C-'•./ - �L_-__ 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date Unn LK ^ -••lo m rivavr ni UnIC 4-Zb "(( JOB ADDRESS 1018p 1020, 1022 Nancy Lane BUILDING PERMIT NO. 43575 GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Triplex w s AP No. 115-023-11 LOT TRACT 9691 FIRE ZONE VALUE $ _ 120,200.00 INSPECTIONS et al Si nater.222� TYPE GROUP ZONE SOIL SUBCONTRACTORPEr T SU ED GAB Dat. Number Si nature WATER • J 2$ ] PI..bin ROUGH PLUMBING PROP: SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING' TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING N atin and TRENCHES Le FORMS STEEL REINF. lent. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING J b FRAME AND FLASHING LATHING - IN n OUT -/0. ).', � PLASTER, BROWN COAT STRUCTURAL,FINAL irt,"12 _ _ HEATING. VENT., REFRIG. AND A.C., FINAL?..0- -YTi I PLUMBING. FINAL AND GAS TEST '71 ELECTRIC, FINAL BUILDING, FINAL •ia- Q Cai!'ia CFIV iIaLYFYTC1 u/ eo l CI- sv� iys lz.- -.;t9- 77 43575 WCOSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING AnnRF �A/ I/r7/i- /s 72 [.d,vLY LR.v OWNER g4L,04Lli MAIL _ TEL. CITY/I/Ctr,t✓ "r gr*H NO.�73-ZO CONSTRUCTION BRANCH ADDRESS ARCHITECT 4� TEL. j _799 ARCHITECT TE 'rb CONTRACTOR ��- /�.'� Q_�� ADDRESS TEL CITY NO. STATE CITY LIC. NO. LIC. NO. W SIZE NO. OF BLOGS. 6, OF LOT NOW ON LOT USE OF EXISTING BLDG. y FSeparate permits are required for G electric, plumbing and heating work. iW. USE OF BUIN ILDG AND WORK PERFORMED `c vNi r ,Imo Q 7 .a �i W Q1 hereby acknowledge that I have read this application and state d! that the above information is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ Z any person in violation of the workmen's compensation laws of Sthe State of California. 3 I hereby certify that 1 am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the p visions of the State of California Business antl Professions Coa . ivislon 3, Ch e ter 9. Signature of Permittee Authorized Agent Fr r5 77LA" 0813 __ w' 215.41 APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV I DATE RECEIVED ..r OWNER ROVED DATE F NO. OF USE OF N -� PLANS BUI LDING� Q RDS APPROVED YARDS APPROVED AIN BUILDING I ACCESSORY BUILDING DISTANCE BET. MAIN BLDGS. VAR .+ C.U.P. 16t f_ -7/e BET. MAIN & ACCESS. BLD DATE Ii�ss �.0 THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE E LAN CHECK E o /' $ / r TAX E s (� W TOTAL PAID E afl 143-575- LA Lo Pl?n-77cm Qo'/'�- c 51 i. COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED DATE ISSUED SS lol—102-0 I✓� L N /J 1 CfJG/s I/ /�. �3'� FADDRESS A.P. NO. PERMIT NO. ZOp� � �AUfaA �iz ADDLDING n / RESS 11DOBa6�-2a /ye TEL. CITY f.—• a NO. $% _Z TRACT LOT BLOCK CONSTRUCTI LENDER BRANCH OWNER ADDRESS //AA VALUE S c-�t / $ ARCHITECT / TEL. OR ENGINEER t N FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BV DATE ADDRESS TEL. CITY NO. ZONE NO. OF PLANS USE OF NEW BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO- OF BLDCS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT. FT Separate permits are required for L SIDE FT. FT. REAR FT. FT. electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLOCS. VAR. qW DATE C.U.P.46 APPROVED APPROVED DATE I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: em exempt from the provisions of the State of California Business end Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE $ .31% JVD PLAN CHECK $ Signature of TAX $ Permittee $ TOTALPAID $J� fZ% Authorized Agent