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HomeMy WebLinkAbout2402 NARBONNE WAY - Building Permits1\ r � ; JobAddress: 2402 NARBONNE WY Suite: Viciniry: ROOF Primary Occ: R Type of Construction: V-N Parcel Number: TPN007019 Zoning: Applicane DEBORAH SIMMONS Address: 9582 HAMILTON AVE SUITE 281 HUNTINGTON BEACH, CA.. Owner: Address Contractor: Address'. Zip Arch : Address: BACK BAY GARDENS HOA CIO OPTIMUM PROPERTY MANAGEMENT TUSTIN, CA 17731 IRVINE,BLVD SUITE 272' HIRSCHMAN, RP AND SONS INC 9582 HAMILTON AVE - SUITE 28'I � - HUNTINGTON BEACH, CA 92646 Phone: Phone: 714-960-8329 Zip: 92646 Phone: 714.508.9070 Zip: 92780 Phone: 714-960-8329 License: 781923 Eng: Address: Slalus: ISSUED Applied�. 04/12/2007 Issued: O4172/2007 Phane: Zip: License: . License: . SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 2 LAYERS OF 15# FELT, 50 YEAR TIMBERLINE COMPOSITION SHINGLES, AND REPAIR/REPLACE SHEATHING AS NEEDED FOR 4 UNIT CONDOMINIUM BLDG. � 48 SQUARES INCLUDES 2402 THRU 2408 NARBONNE,WY.- - , , - , � - . , -, FEE SUMMARY Plan Checli: $0.00 Permit: $37725 SMIP Res: $2.36 SMIP Com: $0.00 Other. $0.00 Inspection: $0.00 Total: $379.61 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Exislina: 0 Reauiredi 0 Left 0- 0 Left 0- 0 Pr000sed: - 0 Calc Valuation: Claim Valuation: Right 0-0 Right ' 0-0 523,670.00 $23,610.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 penod 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 requlred Inapeetiona end final approvel must be obtained. Failure to obtain inspactions and final approval will result in the expira�ion of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaa�ae �dao) WORKERS'COMPENSAnON DECLNRAnON: I hereby aHirm under penalty of perjury one oi the foliowing tleclarations: ❑ I have end 'will maimain e certificate of consem to self-Insure for workers' compensation, es provided for by section 3700 of ihe Labor Cotla, for ihe pertormance of the /^�ork for which Ihis permit is issuetl. ;e( � I-6e� entl will maintain workers' compensation insurence, as required by section 3700 of the Labor,Cotle, for the peAortnance of ihe work for which ihis pertnit is issued. sT'�_'My_workers' compensation I surance carner and policy number ere: , ��i /� /� �Carrier: T3,S%;L},rfi �GL/�.,l� (P.qlicy N�"lLU�O�o( d" / =f7iils section need nat be completed i! the permif is valued et ane hundred dollers ($100) or less.) �—�--�..y ❑ I certiy ihat in the performance of the work lor which this pertnit is issued, I shall not employ any person in any manner so es to become subiect lo the workers' compensetion lews of lifor ia, antl agree that il I,shoultl bacome subject to the workers' compensation provisions of Section 3700 of the Lebor Code, I shall forihwith comply withJhese_pro i o . // �J` A P ant Signature: _ 'Q %��%i1Wr/ f2'tia� � �ace: "' � "f���� � � ���_ ARNING:W FAILURE TO SECURE WORKERS' COMPE ATIqJ COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMP�OYER TL� O CRIMINAL PENAI.TIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND OOLLARE �5100,000), IN ADDITION TO THE CQST OF COMPENSATIqJ, DAMAGES AS PFiOVIDED WP IN SECTION 3106 OF THE LABOR CADE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: of Chapter 9(commencing with Section 7000) of Division 3 o1.tUe.Business and P�fessions Code, and my license is in full end�,ttect. Lic. q CONSTRUCTION LENDING AGENCY: ❑ I hereby aifirm that there is a consiruction lending egency for �he performance of the work for which ihis permit is issued. (Sec. 3097, Civil Code). I Lender's Neme: Lentlers Aatlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm that untler penelry of perjury Ihet I em EXEMVT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires e permit to construcL alter, imDrove, demolish, or repair any structure, prior to its issuance, also requires the epplicant for such permil to file e signetl statement that he or sha is IicenseC pursuant to the provisions of �he Contrectors License Law (Chepter 9(commencing with Section 7000) of Dlvlsion 3 of Ihe Business end Protessions Code) or that he or she is esempt thereirom and the basis for the elleged exemption. Any vioiation of Section 7031.5 by any applicant for a permit subjects the applicant to e civil penalry ol not more ihan five huntlred doilars ($500).): ❑ I, as ownar of Ihe pwperry, or my employees with wages as Iheir sole compensation, WILL DO TME WORK, end ihe siructure is not intended or ottered tor sale (Sec. 7044, eusiness antl Professions Cotle: The Coniractors License Law does not apply to an owner of properry who builds or impmves Iheraon, and who does such work himSeN or herself or through his or her own employees, provided that such improvements ere not intentletl or oHerea tor sale. IF, however, the building or improvemenl is soltl wit�in one year of completion, the owner-builtler will have t�e burtlen o� proving ihat he or she did not build or improve for purpose of sale.). ' ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo construct the projeci (Sec. 7044, Business end Professions Code: The contrectors License Lew does no[ apply to en owner of property who builds or Improves ihereon, and who contracis tor such project with e con�ractor(s) license pursuant to ihe Contractors License Laws.). ❑ I em exempt under sec. Business and Professions Code for this reeson: SignaWre: Date: Owner ID venfied by dnvefs liten5e. ❑ Yes ❑ No Orive/5 License No. Verificetian of Ownership by (type of document, i.e. - propeny te�c bill or deed): DIVISION OF INDUSTRIAL SAFETY PEHMIT CERTIFICATION: Expires: ❑ I hereby certiy that no excevetion five (5) or more feet in depih into which a person is required to descentl, will �e matle in connec�ion with work authorized by Ihls permit, and Ihat no building stmcture, scaHoltling, falsework, oi damolition or dismantling ihereoi, will be more Ihan thitly-sia (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341. Title B, Califomia Adminisirative Code). ❑ As ownervbuiltler, 1 will not amploy enyone to tlo work which would require a pertnit fmm the Division of Intlustrial Satery, es noted above, unless such person hes e permit to do such work from ihe division. Signature: Date: Division of Intlustrial Satery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORI7ATON OF ENTRY: I certify under penalry of perjury that I hava read this application and state that the information given is correct. I agree to comply with ail state lews entl ciry ordinances relating to builtling construction, entl euthonze representatives of Ihe City oF Costa Mesa to enter upon ihe above-describad properry for inspedion purposes. I agree not to occupy or allow occupancy of eny building au�horized by this permi� until final inspection. COUE �. INSPECTIONTYPE 1616 Fixed Sys�em Final Flre Prevention 1266 Pool Spe Finel 200 Final RB-RooF 201 Final Block/Retaining Wall 202 Final Fectory Fire Place 203 Finel Slgn 204 Final Demolition �g ��S wlc-a- �,r� �/ COOE 1 INSPECTION TYPE 206 Finel Mechanical 208 Final Plumbing 270 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approvel 222 Final5lte 250 Finel Building/Occupency P9IE INTIfIRLS (714)754-5273 • Fax(774)754-4856 CITY OF COSTA MESA � BUILDING DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 2402 NARBONNE WY Suite: Vicinity: Par�e� Number: 43914350 App�icanc GREG PETERSON Address: 260 E. ALTON AV CA SANTA ANA Owner: TOMPKINS, ROBERT W TR Address 2a23 VISTA NOBLE7A NEWPORT BEACH, CA Contractor. ROSS & BARROWS INC. Address: 260 E. ALTON AV CA SANTA ANA Zip: 92707 Amh : Address: Zip: Phone: License: BUILDING PERMIT Zoning: PhOne: 714-557-7440 Zip: 92707 Phone: Zip: 92660 Phone: 774-557-7440 License: 327802 Eng: Address: PERMI7 NUMBER � 99-01648 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 10/12I1999 Issued: 10/12/7999 Phone: License: SCOPE OF PERMIT REROOFING 2402-2408 NARBONNE VJY - ALL ONE ROOF PER APPLICANT. TIO, USING EXISTING SH7G, INSTALL 3 PLY BUILT Up ROCK ROOF. Plan Check: Permit: 5MIP Res: SMIP Com: Other: Inspectian: Total 50.00 5181.25 $0.93 50.00 50.00 i0.00 $182.18 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0-0 Rear 0. 0 Required: 0 FEESUMMARY PLANNING 8 ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0. 0 Right 0. 0 $9,261.00 $9,z61.00 NOTICE: The work authorized by this permit shall comply with all appliceble handicap access requirements under California statutes and related ragulations. (Ord. No. 9248, § 1, 12-21•92) EXPIRA710N: This permit shall automatically expire end become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell requlreq Inapectlone and flnel epproval must be obtained. Failure to obtain inspections and final approvel will rasult in the axpiration of this permit. FOR IN$PECTIONS CALL: (714) 7545626 WORKERS' COMPENSAnON DECLARA710N: I hereby ettirm under peMalty of perjury one ot t�e fallowing tleUeretlon5: ❑ I have antl will malntain a certificate of consent to selt-Insure tor workere' compensetion, as D�ahdetl tor by section 3700 of the Labor Cotle, for ihe perfortnance of Ihe �work for whic� this permit is issued. I have antl will maintein workers' compensa6on insurance, as required by SeMion 3700 of the LaDor Code, for the perfortnance of tha work tor which this pertnit is issued. My workars' compe�se�iwi Insurance carrier and pdicy number are: Carner. Policy Number. (This sectian need nat bB camp/eteU il the permil ls valuetl ef one huntlred dollers ($ f00) oi less.) ❑ I certify that in the GeRormance of the work tor which Ihis pertnit is issuetl, I shell not employ any person in eny manner so as to become subject to the workers' compensalion laws ot Celifomia, end egree that if I shoultl become subject to the workers' compensetion provisions ot Section 3700 of ihe Lebar Cotle, I shall torihwilh comply with Ihese p�a�v�/ wis. l n ApplicantSiqnaWre: _%/..-L�( - �G�i - Dete: � D� �2�7 � WARNING: FAILURE TO SEGURE WORKERS' PENSATION WVEMOE IS UNLAWFU� AND SIULL SUBIECT AN EMPLOYER TO CRIMINAL PENALiIES AND CML FlNES lIP TOONE HUNDRED THOUSAN� OOLLARE �St00,OW). IN AD�fiION TO THE CQST OF CpAPENSATION, DAMAGES AS PROVIDED FOq IN SECTION 31060F THE LABOF CODE. INfEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirtn that I em licensed under proNslons of Chapter 9(commencing with Section 7000) of Divlslan 3 at Ihe Business end Professions Cotle, flnd my license is In tull Iorce entl eHect. Lic. a -� 7� O Cless a L- 3� ComractofsSignature: � -s+ �---.� Date: � � - /2 -i� CONSTRUCTION LENDING AGENCV: ❑ I �ereby attirm Ihat there is a construction lending agency tor the pedormence ol �he work for which this permit Is issuetl. (Sec. 3097, Civil Cotle). Lendels Name: Lentlefs Adtlress: SignaWre: Date: OWNER-BUILDER DEC4AF7ATIONS: I hereby ettirm ihet under penalry ol perjury Ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe followinp reeson (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a pertnit to consirua, alter, Impmve, demolish, or repair any structure, pnor to its issuance, also requires the eppliwm for such pertnit to tile a signad statement I�ei he or she Is licensetl pursuaN to the provisions ol Ihe CoNrectors License Law (Chapter 9(commencing wi�h Sectlon 7000) of Division 3 of the Business antl Profession5 Code) or thet he or she is e:empt theretrom and the basis lar the alleged exemptlon. Any violation ol Seciion 7031.5 by eny eppliwnt for a permit subjects the ap0licant m� civil penalry M not more than (rve hunOred dollars (5500) J: ❑ I, es owner ol tha property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, end ihe slrucWre is not intended or offered lor sale (Sec. 7044, Business end P�o�essions Cotle: The Contracbrs license Law does not apply �o an owner of property who builtls or improves thereon, antl who does such woAc himself or herself of through his or her own employees, provitletl ihat such improvements are not intentled or oHered lor sale. If, however, the building or improvement is sold within one yee( of completion, the ownervbuilder will heve Ihe burden of proving �hat he or she did not builtl or improve for purpose of saleJ. ❑ I, as owner of the Property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct the pmject (Sac. 7044, Business and Profeuions Code: The contrectors License Law does not appy to a� owner of property who builds or improves Ihereon, antl who contracts tor such pmject with a comractor(s) license pursuant ro the Contrectors License laws.). ❑ I am exempt under sac. Business and Protessions Code for this reeson: Signature: Date: Owner ID verified by drivers license. ❑ V85 ❑ No Driver's License No. Ezpires: Verilication of Ownership by (rype ol document, i.e. � property �az bill or tlead): . DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby cenly thet no excavallon flve (5) or more taet in tlepih Into which e person is repuiretl to descend, will he matle in connection with work authonzed by �his permit, entl that no Duilding strucWre, scaHoltling, falsew0�k, or demolition or tlismentling Ihereol, wiil be more Ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle B, Californla Adminisiretive Code). ❑ As owner-builtler, I will not employ anyone to tlo work wNch would require a permlt irom the Divislon of Industrial Sefety, es notetl a6ove, unless such person has a permit to do such wark irom the tlivision. Signature: Date: Divislon of Industrial SBlely Pertnit Number: CERTIFICATE OF COMPU.4NCE AND AU7HORIZATION OF ENTRY: I certify under penalty of perjury ihat I have read ihis application and stete that t�e infortna�ion given is correc�. I agree to comply with all state laws entl ciry ortlinances relating to building consimction, end emhorize representatives of ihe Ciry of Coste Mesa to enter upon the ebove-tlescribatl property �o� inspection purposes. I egree not to occupy or ellow occupancy of any bullAing authonzad by ihis pertnit until linal Inspection. Signature OI Legel Owner(s) Dat �,�� G O -/2-`r@ �' And/OrAuthorizetl Applicant Oate 1fi16 Fixetl System Finel Fire Prevan�ion 1266 Pool Spa Finel 200 Final Re-Roof 201 Pinal BIocWRetaining Well 202 Finel Factory Fire Place 203 Final Sign 204 Final Demoliiion 2446d6 P9g lt{�1s66 CODE� INSPECiIONTYPE 206 Finel Mechanical 20B Finnl Plumbing 210 Finel Electrical 212 Finel Flre Preventlon 220 Finel Planning Approval 222 Finel Slle 250 Finel Building/Occupancy OSIE —L IN1IfIRLS � r` ' y��' i ::.�: I � ' CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 dobAddress: 2402 NARBONNE WY Suite: Vicinity: GAR4GE DECK Parce� Number: 43914350 Applicant: TOMPKINS, BARBARA Address: 2423 VISTA NOBLEZA NEWPORT BEACH, CA / -" j�: : owner: TOMPKINS; ROBERT W TR Address 2423 VISTA NOBLEZA"� � , - .- � ., �i, �� � _. i �.;�NEWPORTBEACH,�CA-''l - /;; � i/ � � i � ��. ' � / � : Contractoc rn - Address O � �'�` � . �/ i �� ,i � ',i � � • ' Zlp:� i i;�" Arch Address_ � , '�� Zip: BUILDING PERMIT 2oning: Phone:� (949)760.&404 . Zip: 92660 � 0 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: � , � Phone: - ' " � . � ,. Zip: 92660 � -� �'- � _- _ - � , � , � �� � � � ��\ ; � `.�� � � , . ,A `. Phone: � ,A.. ��� , � License:. Status: ISSUED Applied: 09/08/1999 Issued: 09/08/1999 .: �� ��`- _- ' � Phone: , , ! License: � `-�. � : : ' Eng: � , � �`� � � . _ � Address: � � � � � .- � Phone: � � ' .� �\�License: �_ - � � " SCOPE OF PERMIT � ' ' . , j REROOF GARAGE ROOF DECK -S/0, INSTALL 5/8" PIYWOOD; INSTALI NEW DEX-0-TEX ICBO #1338 ROOF. � . � . FEE SUMMARY ' , P�an Check: , $0.00 Calc Valua4ion: ' S�,2oo.00 . Permit: • .- $44.85 � � ' , . , - - - ,, `�: �� _:' 1 ,�; Claim Valuation: , � �3i,zoo.00 SMIP Res: � $0.50 — ' � � ��' � � � � + , � SMIP Com: ' $0.00 — j'/ ti Other: � $0.00 - � :Inspection: $0.00 � _ --_ ' ,�, � • ._ l � , ` . TotaL•, �-545.35 - �' � � � � PLANNING & ZONING - SETBACKS �. , � , � MAINSTRUCTURE Front �0-0 �'- Rear 0-0 Lefl� 0-0 � Right 0-0� � - � , , . , , ,. - v -. ACCESSORY � Front, 0-0 ,� Rea� 0,0 Left � 0-0 Right 0-0. -" PARKING ��Existinq: ' 0 R�equired: 0 Pr000sed: o �� NOTES: . ., . . . /. . , NO710E: 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, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a penod of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply vnth all applicabla codes, and all requfred Inapectfona and final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of lhis permit. FOR INSPECTIONS CALL: (714) 7545626 'WORKERS' COMPENSATION DECLARATON: � I heraby ettirm under penelry at perjury one of the following tleclaretions: ❑ I heve antl wlll meintein a cenificate ot cronsent to selt-Insure tor workers' compensatlon, es provided for by section 3700 oi ihe Labor Code, for the peAormance ot Ihe work tor which this pertnit is issued. ❑ I have entl will mainteln workers' compensation insurance, as required by section 3700 of Ihe Lflbor Cotle, for ihe pertortnance ot Ihe work for which this pertnii is issued. My workers' compansetlon Insurance carrier end policy number ere: Carrier. Policy Number: (This sectlon need nof be crompletea i/ the permit is velued et one huntlretl tlallers ($100) or less J ❑ I certify that in the pertormance of Ihe work for which this permit Is issued, I shall not employ any person in any menner so es to �ecome subject to the workers' compensation laws of Celifornia, antl agree ihat It I should becoma subjact to the workers' compensation provislons oi Sectlon 3700 of the Le6or Cotle, I shall torthwith comply with these provisions. Applicant SlgnaNre: Date: WARNING: FAILURE TO SECURE WORKERS' WMPENSATIIXJ GUVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (Sf 00,000�, IN ADdTION TO THE WST OF CQNPENSNTIIXJ, UAh1AGES A$ PROVIDED FOR IN SECTION 3)O6 OF THE LABOR CODE, IMEFEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirtn that I am licensed untler provisions of Chapter 9(commencing with Section 7000) ol Division 3 ot ihe Business antl Professions Code, antl my license is in full force antl eMect. Lic. p Class a ComrectoYs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirtn thet there Is a conswction lendinq egency for tha pertormance ot t�e work for which this pertnit is iuued. (Sec. 3097, Civil Cotle). Lender's Neme: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm Ihat under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit to cons�mct, alter, improve, demolish, or repair any structure, prior to iIs issuence, also raquires Ihe applicant for such permlt b file e signed statemem the� he or she is licensetl pursuant to iha provislons of ihe Conirectors License Law (Chapter 9(commencing wlth Sectlon 7000) of Division 3 ot Ihe Business end Protessions Cotle) or that he or she is exempt therefrom entl ihe besis for the allegetl exemption. Any violation ol Sectlon 7037.5 by any applicant tor a permit subjects the epplicant to e civil penalry oi not more than tive hundretl tlollers (5500)J: � ' ❑ I, es owner of the property, or my employees with wages as their sole compensetion, WILL DO THE WORK, end the structure is not intendetl or oHeretl for sale (Sec. 7044, Business antl Professions Code: The Coniractors License Law does not apply to an owner of propeny who huilds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, provided thet such improvements are not intended or oHared for sale. If, however, Ihe building or Improvement is �sold within one year ot completion, the owner-builtler will have the burtlen ot proving that he or she did not build or improve for purpose of sale.). I, as owner of the property, am EXCLUSIVELY CONTRACTNG WI7H LICENSED CONTRACTORS to conswct the pro�ect (Sec. 7044, Business and Professions Code: The conirectors Licensa Law tloes not appy to an owner at property who builtls or improves ihereon, and wha cantracts for such prolect with a contractoqs) license pursuant to ihe Contractors License Lews.). ❑ I em exe t u er sec. Business end Professions Code for this reason: Signature: �_�'�....s Date� — Owner ID veritietl by tlriver's license. ❑ Ves ❑ No Driver's License No. � Expires: Venfication of Ownership by (type of document, i.e. - property tax bill or daed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity that no ezcavation five (5) or more teet in depth Into which a person is requiretl �o tlescend, wfll be mede in connection wlth work authonzetl by �his permit, and thai no GuilCing structure, scafloltling, falsework, or demolition or disman�ling t�ereof, will be more than fhirty�siz (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 347, Title 8, Celifomia Administretive Code). ❑ As owner-builder, I will not employ enyona to tlo work which woultl require e permit trom ihe Division of Industdel Safety, es notetl above, unless such person has a permit to do such work from �he tlivision. Signature: Date: Division at Industrial Sefery Pertnit Number: CERTFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I certify untler penalry of perjury ihai I have reatl Ihis epplication anC s�ate Ihat Ihe information given is corract. I agree to comply with all state laws and ciry ortlinances relating to 6uilding conswction, and authorize represematives of the City of Costa Mesa to enter upon the ��ve-tl cribetl property for inspectio purposes. I egree not lo occupy or allow occupancy of any huilding authorized 6y this permit until final inspection. .� C? _�o,..a�.� 9- 8- 9 9 Sianatu Ot Leael Owner(s1 Date AnNOr Au�horized Applicant Date GppE �, INSPEC710NTYPE 1616 Fizod System Finel Fire Prevention 1266 Paol Spa Finel 200 Final Re-Rooi 201 Final Blcek/Reteining Wall zoz 203 204 241E4s Final Factory Fire Place Final Sign Final Demolition P�IE INi1f1AL5 � � CODE� INSPECTIONTYPE 206 Final Methenlcel 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Site Final BuiltlinglOccupancy D�TE INTffIALS . C'',�;t�y o� C,'oQta ��2eQa �'u,;��uuy Du�i�ia�s OWNER-BUILDER VERIFICATION A city or couniy, which is required [o give notice pursuant to Section 19830, shall attach to such no[ice, and, as a condition precedent to issuing a building permit, require the completion and require [he retum of, an owner-builder verification. Attention Property Owner. An `owner-builder' building permit has been applied for in your name and beadng your signature. Please complete and retum this information in the envelope provided at your eazlies[ oppoRunity to avoid unnecessary delay in processing and issuing your building permit No buildine permit will be issued until this verification is received. L I personally plan to provide the major labor and materials for conswction of the proposed property improvement. ❑ Yes � No 2. I(have/have not) �.t 2. signed an application for a building pertnit for [he proposed work. 3. I have contracted with the following person (firm) ro provide the proposed conswction: Name ��I' q.�K B+bs � e c c� i r�� Address City C�"�'4 U�IcS� Phone ( Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contrac[ed (hired) the following persons to provide the work indica[ed: Name Address Phone Type of Work 10a2i6 (REV. BIBB) JOB ADDR GENliRAL ent Co.,IriC. DATE �_q_6� BUILDING PEAMIT N0. 1a71 VALUE SUBCONTI2ACTOR ��?�o COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 91] COBTA MEBA, CALIFORNIA For Applicant �o Fill In Completely TYPE OR PRINT ■ ARCHITECT COSTA MESA, CALIFORNIA �le & Shields Dev.Co TEL. NO. TEL. Fullerton NO: OI BLOOl. � USEOF EXISTIN6 BLDR. 6ETBACK LINe PROM � 0• C O � C¢NTEROPSTHEeT J REARVARD �� 81OETARDI LfiFT �� I RIQHT –� DESCRIPTION OF WORK � EXTERIOR DING ANO WORK TO BE Ca w�attat�h[pi 42G 1 HENBBY ACKNOWL6DOQ THAT 1 NAVB qCAO TN�B 1ppLICATION AND BTATH THAT TH8 ABOV6 IB COqRfiCT ANO AORE6 TO COM� PLV WITH �LL CITY OPDINANCHe AND BTATH L�WB q6OULATIXO BUILDINO CONB UCTION. �/ PERMITTEEO� �e� �f„� � AUTHORIZiDAOfiNT Y� - //LII'/ ���— F�RECEIVED JIJN 3 1963 FINANCE DEPT. APPLICAT16FLYF�� �f� (y�E$f{ BUILDING For Office Use Only flCCCIPT NO. � PE�i I N0. n P 1 HOO I OM1THP6CHIy$D `I_ ��� IBBOH�� L3 3 A° Ess a��a � �.����� Fi e ZONE TYPE QROUP APPROVED BY DATE ZONIN(i N NO. OP UBH OF •urve au��o�rva L80AL Lot� 156, Tract 3433 'E: NO EAVE OVERHANG 6HALL BE LES9 TMAN TO HIDH ft REAR P. L. E8 .OWED (U. B. C. REOUIREMENT YARD9APPROVED YARDSAPPROVED MAIN BUILOIN6 ACGESSORY BUILDING IOM C/L STREET ) DISTANCE BET. MAIN BLDGS. VAR. �C 1833 so.�, THE �MOUNT BH N PIIRPO58 O! H VALUATION � � l�/ �y� � DATE ,^ Y H ra+ o VALUATION �9 FOq TH8 = A PEqMIT FH8 ONLY. 0 °a � IT FEE $ ' �� j --D m CHECK S �/�S 0 _ FEE $ � Sa "