HomeMy WebLinkAbout2403 NARBONNE WAY - Building Permits�-. .
� CITY OF COSTA MESA
� BYILpIN6 p1VIS10N
� � DEVELOPMENT SERVICES DEPARTMENT RQR-0'I'I?R
� � � PERMIT PERMIT NUMBER
•�m �
(714) 754-5273 • Fax (714) 754-4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2403 NARBONNEWY
Suite:
Vicinity:
Parcel Nunmber: 43914342
Appiicant: HANSEN, DUKE
Address:
Owner. CARR, JAMES''� � � � -
Address 2407 NARBONNE:WAY " �
/��i. � ' �
COSTA MESA;CA '.� ` `�
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Contractor: !�ROSS& BARROWSJNC.`
. -i; - � ; �i. ._ -
Address: � i00260 E. ALTON AV"' .-'
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Status: ISSUED
Applied: O6/24/1998
Issued: 06/24/1998
Zoning:
Phone:
Zip: . , - ,. � .
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Phone: . " � " ' �
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. _Zip: - -92627 - � � �/' . �:��A=V�
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/'�- h SANTAANAAA'/� Zip: 92707 �� --,�`., � �`��.�'.
' " � License:�327802 � � ��-� ` �
Arch'/:Eng '\ / % .%� . i: �/, ' � .
Aiidress � „ , ' �� ��� i , - ' �
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. , .. ' . .. . / _ ... /� . _ License: - . . , .
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' � - SCOPE OF PERMIT
�'� �� � ' REMOVE EXISi BUR OVER THE GARAGE AREA & REROOF WITH BUR�� �
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ti FEE SUMMARY
Plan Check: � $0.00 �, �- � ;,', Calc Valuation: $i,aoo.00 �
' Permit: , � ' $48.50 _ ' : �-%`� :.� -'- ; '- ! � � % �- � Claimed Valuation:. $�,500.00 �
,SMIP Res: � $0.50 ' --- ; - i - ,
SMIP.Com:' ,' $0.00
� _„ Other: � $0.00 ''�- � ' �,`� � ,
Inspection: �. � � $0.00 � - - �';%� � � `
�,.�
i . -
;
� Total;� ' 54��00 � `_ _ �; � -
.
�., �, _ , i�.� . �
. . �� �; . .- ;PLANNING &'ZONING -
, - '�'
SETBACKS._ �. � > ' _ . �
MAIN STRUCTURE Front � 0- 0 - � � �Rear - 0 .0 , � � L'eft- � 0- 0 - - Right 0- 0 , '%
ACCESSORY Front ,0- 0- �'Reac 0. 0 Left 0- 0 � Right �0- 0 '
PARKING Ezistinq:� �0 �Required: o Pr000sed: o � � �
NOTES: � �
EXPIRATION: This permit shall automatically axpire 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 Ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred inepectlona entl final epproval must be obteined. Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARATION: .
I hereby effirtn under penalry of pe�ury one of ihe following declarations: � � ' .
❑ I heve end will meintaln e cenificete ot consent to self-Insure for workers' compensetion, es providetl for by section 3700 at the Labor Cade, for ihe peAartnence of Ihe
wOrk for whiCh this permi� Is issuetl.
�I have end vnli maintain warkers' compensalim insurerrca, es required by section 3700 ot Ne Lebor Cotle, for the peAortnence of �he wwk fw whiCi Mis pertnit fs issued.
� My worCkera' compensatlon Insurence cartier and policy number are:
Certiar. J i fiTj� '�il�✓ I'� . Policy Number.
(Thls sectlon need not be completed il the peimit ls valued ef one hundred dollers (5700) orleu.)
� I certify Iha� in the OeAortnance of the work for which ihis permit is issued, I shall not employ any person in any menner ao es to become subject to ihe workars'
compensatlon laws of Califomia,�yl egree that i1 I shoultl become subject to the workers' campensetlon provislons ol Section 3700 of the Lebor Cotle, I shall torthwlth
comply with Ihesa Wsions. � /
-ApplicenlS eWre: � � ae: Y'�y�F�
WARNING: FAILUR RE WORKERS' COfAPENSATION COVERAGE IS UNIAWFUL AND SHP11 SUBIECT E�1 CqIMJNq� pENp�TES AND qVIL FlNES UP TOONE MUNORED
E(5100,000), IN ADORIIXJ TO THE ODST OF �MPENSATIIXJ, DAMFGES AS PROVIDED FOR IN SECTION 3�W OF THE UBOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
1 hareby eflirtn Ihat I em Ilcensed under proWsions af Chepter 9(commendng with Sedion 7000) of DMsion 3 of the Business enC Professions Cotle, end my Iicense is in full
brce end eMect. Lia M Class»
Conirectofs Signetura: Dete:
CONSTRUCTION LENDING AGENCV:
❑ I herehy eMrtn Nat there is e construction lentlinp agency for Ihe perfortnance ot Ue work tor which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lend ma. � Lenders Atldress: �.
OWNER-BUILOER DECLARATIONS:
I hereby alfirtn that under penelry of per�ury thet I am E%EMPT FROM 7HE CON7RACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Business and Protessions
CoAe: Any ciry or counry w�lch requires e pertnit to construd, alter, Improve, demolish, or repalr eny structure, prlor to Its luuance, elso requires the epplicant for such permit
ro flle e signed atatement that he or she is Iicensed pursuant to �he D�ovisions af ihe Contrectors License law (Chepter 9(commenUnp with Sectlon 7000) of DiWsion 3 of the
Business and Protessions Cade) ar that he or sha is asempt ihereirwn end the basis far the elleped exemption. Any violation of Section 7031.5 by eny epplicant for e pertnit
suh�ects ihe epplicent ta e ciWl penalry ot nm mare Ihan five hundretl tlUlars (3500).):
❑ I, as owner of the properry, or my employees with weges es Ihelr sole compensatlon, WILL DO TIiE WORK, end ihe structure Is not intendetl or oHered for sale (Sec.
7044, Business and Protessians Code: The Contractors License Lew does not apply ta an owner ot propeny who builds or improves Iheraon, antl who tloos such work
himself or hereelf or ihrough hIs or her own employees, proNded thet suc� Impravemen49 ere not intentletl or ottered tor sele. Ii, however, Ne builtling or improvement Is
soltl wlthin one year oi completlon, lhe owner-builder will heve Ihe �urtlen o1 proving ihet ha or she Altl not build or improve for purpase o1 sale.).
❑ I, as owner ot iha property, am EXCLUSIVELV CONTAACTING WRH LICENSED CONTRACTORS to construct ihe prqect (Sec. 7044, Business end Professions
Code: The contwctors Ucense Law tloes not apply to en ownar of property who bulltls or Impraves thereon, and who coNrects br such proJect with a contrector(s)
license pursuant ro the Contractors License Lews.).
❑ I am ezempt under sec. Business antl Protessions Code tor t�is reason:
Signatura: Date:
Owner ID verified by drivafs license. ❑ Ves ❑ No Driver's License No.
Vedficetion o1 Ownership by (rype ot document, i.e. - properry tau blll or tleatl):
DIVISION OF INDUSTRIAL SAFETY PEHMR CERTIFICATON:
Eapires:
❑ I hereby certlfy thet no excevation fve (5) or more faet in depih into which a person is requlretl to tlescend, wlll be mede In connection with work authotlzetl �y this
pertnit, end thflt no bullding SWCNre, scaRolAing, talsework, or tlemolition or dismantling Ihereot, will be more than ihirty-siz (36) feet hlgh. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia AOmlNstratNe Cotle).
❑ As owner-bulltler, I wlll nal employ anyone to do work which would require a pertnit irom ihe Division oi Intlustriel Seiery, es notetl above, unlass such person hes a
permit to tla such work trom the diNslon.
Signature: Date:
DiNsion of InOustrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AllfliORIZA710N OF ENfAY: I certify untler penalry oi per�ury thet I heve read this applicetion entl stete ihet ihe intormetion given is
cortect. I egree to comply with all state laws and ciry oNinences relating to building consWction, and authodze represenietives of the Ciry of Costa Mesa to eNer upon the
above-described propeM �or Inspection purposes. I agree not to occupy or ellow occupancy ot eny building eu�horized by Uis pertnit uniil f nal inspeclion.
COpE I. INSiECTIONTYPE �,-
1816 Fixed System Final Fire Preventlon
126fi Pool Spa Flnal �
200 Finel Re-Root
201 Finel BIocWRe�eining Well
202 Final Fectory Fire Plece �
203 Finel Sign
204 Final Demolitlon
zasas
Qdg U�ALS
7 D-� �
CO�E� INSPECl10NTYPE
206 Finel Mechanical
208 � Finel Plum6ing
210 Finel Electncal
212 Final Flre Preven�on
220 Flnal Plenning Approvfll
222 FInelSiie
250 Final Bulltling/Occupancy
��
�r,�sso�eu��w+c: 2403 NARBONNE WY UNT:
wq,�'swpEjF,a�owx:BL'ACKMON, MARCIA
-•=- woeeu:.2;403 NARHONNE WAY
�e.''?;-�; COSTA MESA,CA 92627
� 6r42=3646
.��ca.wuw+c �ooeess:'...,.
t —
yi,ncxveiroa�ax�x:GAHLE ENGINEERING ��� C44917
'iecx.oee++o.•s�oox�ss: ,1706^NEWPORT . BL UNT: H
r C;.M. CA 92626
CONiNALTqI'4 NAYE: �
'camncroxs �uuxa
,e i; ' �ooxEss: � uaxo.:
UNT:
LICENSEG COMFRCTOPS DECLAFATION: I Mreby dl'rm uMw p�aly W perjury ihet 1 am licenaed uMer po.iebru ot Cheqer 9
(commancnp wnh &xtian J000) W DiWaun 0 d ihe Bueinep end Protmeiane Coae, eM my lipme ia in Iull brce vM aHed.
cm uc. r+o.: uc. cuss: uc. No.: EXP :
ode: com�.am:
OWNER BNIUEF UECLABATION: I hereW elfirm undx pendy d per�ury ihet I em examq Irom Iha Comreqps lJo�nse lew �w IM
Idbw'vp ieeaon (�� ]�1.5 Buaron erd Pmiwbne COE�: AnY c'ty a mumy wfiidi �puim s pertne m oomVucl. tllx. impove.
demolah, a npeir eny eVucWro, pnm to ile'saueMe, abo requirm Iha ep�Yiron� Iw wch prtmil lo fils e aiprwd eW ement IMI M or eha
is IiceneaE punuent lo Ihe provi�ione d ihs ConVec�an Liwnae lew [Chepdr e(mmme�np wllh Seaon ]000) d Divuion 3 M the
Bueinem end Profapiom COEe� or Ihel M a�he u uemq therehom eM ihe Eeau In tha eIIpW xempbn. My vbl�lion d 6aaion
]0�1.5 W enY WN�I Iw e permil abjeqs �M eppl'rsnt io a cnl penally ol rw1 mwa ihen fHa hunEnE EdW �S5W�1.,'.
❑ 1, m ovmar W Ihe properlY a my empbyroe wnh wepae ea the'v eole mmpametion, will do tha vrork, eM Ihe atfuclure i nd Inlended
or Merad br sale (Sac�ian ]a6, Businme end Proleeeions Code: The Contrepon Lkenne lewdo» ml appyto en ownxd propery
wlw bulde or'unprovea Ihereon. vd xM doea auch Mwk NmrM or Mnell a ihraqh he or Mr own ampb�eee, providad Ihe� vuch
impeovemems ere M intaMetl a diared lor ub. tl, however, ihe buiNiip a'vnpwemenl o edd wnhin wre yav d mmpb�ion, IM
�owrwrWiker will heve ihe buNen d pravinp M or eM dk mt builtl a im0� �a �he puryoee N ala�.
I, es ownx M tM propaM. � extlusrveM ����8 �h IicenseE conirectore io conavua ihe prol� ISeaion )Oid; Busir�ms eM
v�aes,�oo, c�: rna co�i,�aon u�� �. ao� oa �dv �o �, o�, a mowm •no wna «�v�« in«� �e ..no
convecia lw wM prqeda wilh a wnvmw�s) Icamed punuent io iM Coniradore Licensa Lawl. �♦
i.' '
� I em eeemq unda� Seci B. 8 P.C., lor ihis re �
o�,: 5-1��9�6 �,,:��.,+�ce �O.e.e1���-�
I do hereby cerliry thei l em ewem d enA unAersland tM1e requiremenis M CelAomie Heellh erd Sdery Cotle SeGbm 25505. 25593, enA
25534, eM thm I a vry lulure buikiip xwpeni will / will na (tlrcb one) need b compN w�h eeiE pete coEee eM ihe repuirementa br
e Deimil fwwnnvueiion a madifwion han ine �r�6T .TareBemenl OMrid. ResNen�id oxmewion eVG�'�iwnen axeenW fmn iMee
o.���a.
WONKEfl'S COMGEN4ITION DECIAPATION: I hereby etf�m urder penel�y d perjury aw d �he Idbvriiq detlareiiona:
� IheveandwillmeinlaineceNHcdadmnaenitosaH�inaurelarvrorken'compenaelbn,espovkediorbySedim�)OOalthaLebor
coda �« in� wrto�,�e w�n� .� io, �n m�. w�a �. ��ad.
❑ i neV. �a �;e meimen waxnn• ca�wrom� m��.a�,m... �ea��a M smia, a�ao a me �ee. caee. m, me w�ro.maMe a me
work lor whid� ihie partnn is iaueE. My wakers mmpensalion inaura�ce rartier eiM poliry number era:
c��:
rdcr N�mne,:
(This aMion rreed na Ee canplefed / fhe pa�mt a lw one hundrad Gollars (31001 w b.v.)
�] I canAy �he� in I�a perloimenca W iha wwk br whch thia parmn ia iaeueC, I sl�ell iwl ampby eny pxaon in eny menner w ea to
becana wMed to iM �wrFers' wmCemation lexs d Calilania. eM e6ree Ihm il I ehouk bacoma e�Med to tM xoM1ers'
compansmion panaars a/ Sed' 3100 d Ihe Lebor GOCe. I slWl /hwnh wmpy�vnh t 'aiore.
oem: .� �� � 9�+ nooikem: '�A(ri1 � ,>/l. �
Waming: FaOun ro weuro woAai eonpem�tlon rovenp� b unMwtil, �nd slvll np/�et m wv�pley.r ro WMmI peneMw eiM
clvll fines up ro ms �undrsE fhourrd Oo/Nr� (5100,000). M eddltlon ro M� casf ol romperwtbn, Senupsa �a provltlW br /n
Sxtlon 3]O6 0l ths Lebor COW, Inlerosq enJ attomsyY Iros.
CONSTRUCPON LENDING �GENCY: I M1ereby effiim �od« � a Po,Nrv �hm me� = a w��a� w�e�� �a�r i« ub
paAortnance d Ne xwk Iw which �ha permM is ssued (Sadion �09), Cv. C).
LENDEfl'S NNAE:
LENOEq'S AODHE55:
� cenity inel � nere reee �nm eyo�Ke�ion ene bve �nm me emre mr«mefon m w�ren. � epiee m campy wan el� dry d,d o,unry oNl�enms
enC sle�e lexs rela�ng lo GuiWmg consVupion erd hareby eulhwaa represanlelives ot Ihia dty lo enter upon Ihe ebove�maniqned properry
����P'�'�D�`0�"MARCIA F BLACKMON
/!/%/X.i-�e� e -S�
�� Dete:
'Signalula d O�metlApanVApplicenUGontratlor
(S�St-,fi.WPI Whne-Buikip 8 Selery: GrwmFle: Cuary-�ppiran�: Fnk-Pevenue: GdEenrod-Avaeaor
-- - � "^ " C'TTY•'OF COSTA MESA — BUILDING PERMIT
�", ` PERM NO: E 077685
PERMIT 'NO: E 07768,5, ' PLAN CAECK NO: N GOVT: N SUPP: N
�ONSTRUCTION,TYPE: V—N' PERMIT TYPE: ELE PURPOSE: ADD
• �ir,.,,.. •
JOB DESCR�`PTION : 1825F ROOM ADDTION INSIDE EXISTING ROOF S(J FT:
�LAIM"VALUE:`' -� CALC—VALUE: GROUP OCC: R-3 /
�OMMENTS:,ADD•2ND FL BEDROOM INTO EXISITING VAULTED CEILING / B-77684
�at***x�x�at�t'iyx�x��'at*�rat*�tie**+t*�t*ititit�at�rxititit�*ititio-*at*x�x *�r**x ie�it�ie*et*it�**it*�itiE�rx ifx k*it*at*�
Z 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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: E'T IN REAR: FT IN FANT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 43914340 ZNE: REF NO:
PLANNING NbTES>
i
IEillEiElEfEffiEiEiEiEiElEiEfElF1E1E1fifiEiElEfElElffEiflE1FlEiFiFiElEiElEfEfE1E1EfE1EkiFlElFIFiEiElf7fiF1E1FiE1E1E1E1E1E1f1ElF1E1E1EiEiFlEfFiE1FiE1ffE1Elkif
D E V E L O P M E N T S E�A V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY - DATE:
BUILDING APPROVED BY : '
7
APPLICATION ISSUED HY; �.i �
�,��*�����*���*�����**�
LEGALIZATION:N F E.'E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 9,00
SOY
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
15.00
PERMIT ISSUE PLAN—CHECK
9.00 15.00 0.00
DATE:
DATE: S � �
����*��,���������*
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
24,00 24.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00; ;
iElF if fF �f fF 1E IE iE iE iE iE 1ElF 1E 9E IE 1E If if iE if �F �E 1E fE 1E 1E 1E 1E af af 1f iF iF iE iF iF if iF 1E 1E if IF ik iF if iE iE IE iF if iE 1f iF iF iF iE iE iE 3E iE 1F 1E 1E iF iE fE iE jElE jE 1E iE �E iF iE 1E 9E
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
ELE 4 FIXTURES LIGHTING 1 ST 20
ELE 4 RECEPT/OEITLET 1 ST 20
ELE 3 RECEPT/SWITCH "' 1 ST 20
ELE 1 COMMUNICATION DROPS 1, ST 20
END OF FEES
EA. .75
EA. .75
EA. ,75
. - •( f_ ; '
i.Y. . _. � _" "
3,00
3.00
2.25
.75
\
�" CONSTRUCTION AND PLANNING � POOL & SPA
t*' APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporery Electricai Service or Pole 52. Pool & Equ�pment Locacion
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement �
'; �:3i. Ele�trical;�pn¢uit Utility•Undrgmd. 54. Forms
�_;:4: Hectrical:Conduit�Undrgrnd. 55. Electricai Bonding _
-~5: 5ieel Reit�Qrceme�t 56. Rough Plumbing & Pressure Test
; 6=,,�tectrieei:UFEEi Gr�d. 57. APPROVAL TO COVER�GUN4TE
:�?.:Pootings �� 58. Electricai Conduit�Undrgrnd. •
..m.'
r�
����� Foundati0n,.. 59. Gas Pipe, O Undrgrnd., Test
� flr� Weter Pipe-Undr9rnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. St:uctural Ploor Svstem ' 61. APPROVAL TQ DECK �
7 7. eeoperty Sew�r, Line & House Connection 62. 8ackwash & Receptor-Final
12. Sewer Cap " 63. Heater & Vent�Final
:J
73. Roof Drains T. 64. Plumbing System � Final '.
74. Rough Piumbing � " 65. Electrica!-Final �
15. Rough ElectricabCondult ', fi6. Soia� SYstem-Finai
16. Rough Electric 4Viring K/�/1.. 1- 67. Fencing & Access Approval
- - �SZ�1�16 ' ll td�w°�
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18. Reugh Electrical�T Bar Ceiling � 69. POOL/SPA SYSTEMS PINAI
19. Ro�gh Heatin�g.& Air,Conditlo g. �, .� �; �.�; ; b, FIRE EPT.-fiEQU1REMEN7
`H�' _ #2 -� c. r . �_
� � _ ,; - � _ �...-.
20. ��oug� Factor•�FirEplace .��*� x,� :v S �-+ � � C�APPR�OV�ALS �� Pet'mit# _ � �`
21. Ducr_� in'a�tructure::�. �� �� S._ � .�., ;j: .. 70. �lJnderyrcwnd F{9dro
22. Qucc6� Ventilating..;a� � �� •' C' � . �- -<; 7�, producT i?iping O-Gas OOii .
.
23. G'as P�pe�$oug„h & j st r'= r� °' � �.� � 72. Undei rrisir.id F+ush - .
g r• .-.- >: cc � - .% 9 .
24. Roof'Fsaming � �s �~ �c �� r r++' � 7$.' Undergrnd.StocacyeTank�"flGas ❑Oil
r �,- n -
25. Roo�;$he`ething �* ' �` X'., - m; .� i 74: Overhead Hydro' �
26. f-BaF.'.CeiGng {Structeral) & P71oItaSoat ._ , C7.� 75; Dry Chemical .- � -�"' �
27. �rarrie arid' Flashin '�* '�Sc: x c . o:� � ^n� =-� � E- _.; _
,L tt ,.,..r,�. � w �;� 76. DryStandPipe'_ .
�., 28. Latfiing �SySiding �;j'; �� �r;t- � �: � • �* 77; FIXED SYSTE�q�FWAl� - � .
w
29. Insulatio4 � x� �, .. r � , �r 7� PIRE PREV. FIJ�IA� r
�.
�. x
� 30. Drywall tdailing :�- i y- r S �'HfALTH DEPT. REQUIRlEMEN7
. 31. Plaster Br_pwn��;oa :;r = 'n,r �. � + 7g. PINAL 1Y9SPECTIDN ` � : -
: �- - �,,: � ' - � - -
�� 32. ElectricaFPower Mecer�-Final . :.: ` : 8d-� FOOD CERTIFLCATE ISSUED '-
- 33. �na�leCIric=r r:t h� � �-_.-� � 71i•:�j f� a Note,s: i.�,-��'QZ -�OGP��7 ���_ry
� � �
' 34. �inajJiea'Cing.Bc Air Co�ditioning �r �` - , ; � � ` z' "
= - � 4=1'6'4_ZGoi�sul%ifia�►-
35. Fina� Gas`Pipe=Tesr' � •• ` �" � � �- rv'" . ,
,r n' Tl . --'.
=: 36. Mood,or GanoPY ,-;i. ` . � �.�, �., � � � .r� m :. _
� 37. Finai�Fectory Fire�tace,. � � ` ' ' M: � '
i F�' a �� c� i I� �' .� �
-38. FinaF�Plurqbing ='.. �r,�' � .a .. � h: �. . . ` -
� 39. Water Service-Finat7 � F ' � � � � "• ' "-'�'C
,._, r .� � . I +r. F�.. � - ! �
'40. GasService-Final .� �'y ;'�.�_ m : - ' x • - .
- 41. So1ar por,restioFinak -' + � � "� �' "� �'" . _
`� r r
� t. ^ 4V A� � � i�' •
42. Backflo+N,j,'reYanter � �� ;�„..�.. x � r Cr "� ' -�
43. Backflo�v Irrigation� K y �•'`• ` � � - � '
ryr_❑ �k :K - "2 :
"�. .. ;� _..-". X�:i � ._ .i��. u �t :. �• .� � �
94. it,andscape; Irripatig,n�System � ��-; - ._ ,r �'>� - �. v � m = --
45. Sound A'[tenuatio� z �`� .:'.. ' � ~ t"� '-'`�+' �� 'J' 'J' `r . `'�� ,:
' .r1. / F' .. K
46. HandiFap'Reguiation5 - - �`� ^ � � r �, � �. . .
47. FW,l61STRUCTURE&BUILDWG � !- �" �
t � �_
48. F_INAL PLANNING : � � � � �, � �- - ¢
�'.
49. Elsctric Release to Edison � r. i a K •�- '
', O G' ' ,
50. Gas fYelease to Southern CaliforqsGas Co � '' .;S �� ` LL � -
5i. CERTiFlCATE OF CCllPANCY
No. Date �
� _ � •-
CITY OF COSTA MESA �
� BYILpING pMS10N
� � DEVELOPMENTSERVICESDEPARTMENT ggg_p��pq
� PERMIT PERMIT NUMBER
�� P
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92826
BUILDING PERMIT
JobAddress: 2403 NARBONNEWY
Suite:
Vicinity:
ParcelNunmber: 43914340
Applicant: HANSEN, DUKE
Address:
Zoning:
Phone:
Zip: .. .
Status: ISSUED
Applied: 06I24I1998
Issued: 06/24/1998
Owner: BLACKMON,,MARCIA F TR" ' '
Address 2403 NARBONNE WAY ".- -� � � � , "
��,i�-' - _ ' _ _
/i��-, _ � ' ' Phone: _. , .
COSTA MESA;CA � � � ,� � Zip: 92627 � - � �'��
.�� % � . � � ; -�" - �-- � ' =�
%/ -. . A � ' _ . : ��AA
Contractor ,�ROSS & BARROWS INC. � �-� � � ��
�
Addressi "00260E.ALTON�AV��'- ������` ' ' �����
, .
� , -� ✓ . � i� �' Phone: , ` /
ii,��. �.
�„�%� SANTAANA-CA� Zip: 92707 ' � �A ' �- �,,
i �
,�.:� /� /�/-� License:p327802 � . :�� , , �.
Arch'/ Eng : �" � '„� . ` � . .
�
� �
� 'Address � � �i ' . i � � ' , _ �
�', / �"%�" ::�ne�. -.:. � , .
� � ' - `Zip: , t . . - �.�
. , --� . _ - , �, jA � . � `License:�- � .. . .
, . '� . .i , - -- � � - -
��
� � `� �� SCOPE OF PERMIT � , � � � '
� , � ' ,_ .;
, ',, •� "REMOVE EXIST BUR OVER THE GARAGE AREA & REROOF WITH BUR. �`. . �
�` / � � . �
i . _ � ���.�� , . . �
\ .� , � . � ' � . . ' � � . . •. , ' , .
.
Plan Check: � $0.00
' Permit: $34.75
SMIP, Res: $0.50
SMIP Com:'. , . $0.00
, �th0f: $�.�0
Inspection: $0.00
,�, �
� 'fotal: _ ' $35�25,
,��
FEE SUMMARY
. _
^. � :
.. . „ ---_ i •�
-
��
' / !
p _�
`
� �. � ����.' , : "PLANNING�,BZON
� ::� � � " - ":�,<
SETBACKS�� � , , �- �
MAINSTRUCTURE Front 0-0', , � Rear= 0-0 �`� LeB� �-0-0
ACCESSORY Front 0- 0�� �'Rear 0- 0 Left 0- 0
, �� _
PARKING Existing: �� 0� - Required: '0 ' Proposetl: �
� ,,
NOTES: - ; . . . �
Calc Valuation: Ssso.00
Claimed Valuation: 3eso.00
� . � ,���'.
i��,
����';
G� � i.. ,
�_ Rigni ao � � ,� �
Right 0- 0 � -
0 �' � � �
0
EXPIRATION: This permit shell eutomatlrally expire and become void if work is not commenced withln 180 days, or if work is suspended or abandoned
for e perlod of 180 days. ' '
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all epplicable cales, and all
requlred Inspeetlons end flnel epproval must ba obtained. Feilura to obtain Inspeclions and Flnal approval will resutt in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARATION: .
I hereby etlirtn untler penalry of perjury one ol Ihe following tleclaratlons: . ,
❑ I heve end wlll meinlain e certificate of cansent to setl-Insure for workers' campensetlan, as provltled for by section 3700 of t�e Lebor Code, far the peAortnence ot the
�wOrk lor whiCh IhiS permit Is Issued.
I have end wlll melntein workere' compensetlon insurence, fls required Gy sectlon 3700 of Na Lebor Code, for �he peAortnanca of ihe work for which this pertnit is issued.
My workere' compensasti n Insurence cartler enC policy number ere:
carder. : S% l9 �iC I�ivJD Policy Number: 0�i� — F�Y' U ti'o 6.7oZ
(This sectlon need not be completed l/ the permit fs velued et one huntlretl tlollars ($100) or /ess.)
❑ I cehify Ihat in the pertortnanca oi the work for which ihis pertnit is issued, I shall not employ eny person in any menner so es to become sublec� �a ihe workers'
campensetlan laws at Celitomia, end egree that if I should became subjed ta the workers' compensetion provlsians oi Sectlon 3700 of the Lebor Cotla, I shall fonhwith
e p�rr/�/ ions. � �/ q,/
ApPli nt Sign : �%� l� —I—De e. �— 2 (�! o
WAANI : FAILURE TO SEWRE WOPI(ERS' WMPENSATION OOVERAGE IS UNLFWFUL AND SNALL SUBJECf AN EMFLOYE NAL PENALTES AND CML FlNES UP TO ONE NUNDRED
THOUSAND OOLURE (5100,000), IN ADDRION TO THE GOST OG COMPENSATION, DAhL1GES AS PROVIDED FOR IN SECfION 3IW OF iHE IABOfi CODE, INTEREST, PND ATTORNEI"S FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereby effrm thet I em licensed under D�ovlslons ol Chapter 9(commencing with Section 7000) ol Dlvision 3 ot Ihe Business end Professions Cotle, end my license is in full
force end ettecl Lic. a Cless n
Cantrectars SignaNre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I herehy effirtn thet there is a conslruc0on lending egency for the pedormance of the work tor which Nis Oermit is issued. (Sec. 3097, CIWI Cotle).
Lendefs N e: Lenders Address:
Si�( ��i�..�. Da � — Z —
OWNER-BUILDER DECLARATIONS:
I hereby eMirm Ihet untler penalry oi perjury that I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry or counry which requires a permlt to construct, elter, Impmve, tlemolish, or repelr any structure, pnor ro its issuance, elso requlres the epplicent for such permit
to tlle a slgned stetement Ihet he ar she Is Ilcensetl pursuent to Iha provisions of Iha Cantrectors License Law (Chapter 9(cammencing with Secibn 7000) ol Division 3 of the
Business entl Professions Code) or thet he or she Is exempt Iherefrom antl ihe basis for Ihe alleged exemption. Any vlolatlon ot Sectlon 7031.5 by eny epplicent for a permit
subJects the epplicant to e civil penalry of not more ihan five hundred dollers ($500).):
❑ I, ea owner of the properry, or my employees with wages as thair sole compensatlon, WILL DO TNE WORK, entl ihe structure Is not intentletl or oltered for sale (Sec.
7044, Business entl Professions Code: The Contractors LJcense Law does not apply to en owner of property who builds or improves thereon, and who daes such woAc
himseN or herseli or ihrough his or her own employees, provlded that such Improvemenis ere not intendetl or ottered for sale. If, however, ihe building or Improvement Is
soltl within one year ot completion, the owner-bullder will heve the buraen oi praving thet he or she did not build or imprave tor purpase ot sale.).
❑ I, es owner of Iha properry, am E%CLUSIVELV CONTHACTING WITH LICENSED CONTRAC70RS to construd the project (Sec. 7044, Busineu end Prafessions
Cotle: The contrectors lJcense Law does nat epply to en ownar of propeny who bullas or Improves �hereon, end who contrects for such project with e coniractor(s)
license pursuant to ihe Contredors License Lews.).
❑ I em exempt under sec. Business anC Professions CoCe tor lhis reason:
Signeture: Date:
Owner ID verifietl by drivefs licensa. ❑ Yes ❑ No Drivefs Llcense No. Expires:
Veriiication of Ownership by (type oi document, I.e. - property tex bill ar deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certiry t�at no excevetion live (5) or more feet in depth into which e person Is requlrad to descand, will be made in connectlon wlth work euthorized by t�is
permit, end ihet no bullding stmcWre, scettolding, felsework, or tlemolitlon or tlismentling Ihereof, wlll be more than thirty-sia (36) feat high. (Chap. 32, Grp 2, An 2, Sec.
341, Title B, Celifomla Atlministretive Coda).
p As owner-builder, I will not employ anyone to tlo work which woultl require a permit tmm the Dlvislon of IntlusMal Satery, es notetl ebove, unleu such person hes e
pertnit to do suc� work from �he division.
Signature: Data:
Division of Intlustnal SafeN Pertnit Number.
CEHTIFlCATE OF COMPLIANCE AN� AllTMORQJITION OF EMAV: I certify under penalry ot pe�jury that I have read ihis applicetion and state Ihet the infortnation given is
cortect. I egree to compty with ell stafe laws end dry ortlinances reW6ng to building construdion, end authonze representetives of the Ciry of Cosla Mesa to enter upon t�e
abovadescribed propBrty for inspection purposes. I egree not ta accupy or allow occupenq oi any 6uilding authorizad by ihis permit until final inspedion.
FQQEy INSPECTIONTYPE �� PA¢ IiR�96S
7616 Fixetl System Finel Fire Prevention
1266 Pool Spe Final
200 Final Re-Root
201 Final BIocWRetaininq Well
202 Final Feclary Fire Place
203 Final Sign
204 Finel Demolition
2AAW8
CODE� INSPECTIONTYPE
206 Flnel Mechanical
208 � Final Plumbing '�
270 ' Final Electnral �
212 Flnel Fire Prevention
220
222
250
Flnfll Planning Approval
Finel Site
Pinal Builtling/Occupency
�a�a
�--�._ �. — 2 �-(-`t {�
oeff u�a�s
�
'`►j
�
7
iwonesso�em�ou�c: Z403 NARHONNE WY
an*+Easru�EiFaamiBLACKMON, MARCIA
� /i00PE55:2403 NARBONNE WAY
�� COSTA MESA,CA 92627
642-3646
uri. �wuxc �oo�ss:
urcxrrecrax�r«ai�nn:GABLEc ENGINEERING
RCN.OqEHf..'S�DORE55: 1%OO NEWPORT BL
C,M.
cartmAaars wu�:
carm�crorrs�uia+c
�DDRE55:
UNT:
�.�: C44917
UNT: B
CA 92626
UC. NO.:
I ur�r:
LICENSED COMRRCTOpS DECL�HATION: I Mreby eRim uMx peraly ol pe�ury ihm I em IcensaE wMer prariaions W CM1eqar B
(mmmervirp xilh SMnn ]000) ol pivuion � ol lho Bugirop erq Pmimfipiy CpEe. yq mY ��b ia ln lull Ipce and eiletl.
cm uc. No.: uc. cuss: uc. No.: EXP :
oe�e: com�nu«:
OWNEN BUILDEN OECLAP�TION: 1 hereby elfirm uMer penely d perlury �Mt I em uemq Irom IM Coniredas Lironae Law la �M
fdbxap iae»an (Setlian )Q'f I.5 Buaroaa eM Rolxvare Code: Arry e1Y a" �nty whirh nVuima e peem� lo eanstniel. eltar. impova.
demolah, or roper eny ewclura, prbr m nn 6auenco, ebo repuime Iha epDlirant Ior eucM1 permX lo fle e aqnad nmamenl �het he m aM
ia liceneed W rsuan� lo Ihe provisian of Ure Conlreeon liqnae lew �Chepter 9(oommerc'vq wnh Seaion )000) d Drvsion � ot iM
Bumnav erd Vrdea'ais Codal w Ihel he a ehe a eaemq ihereham eM IM buia la �he elbOeE esempion. MY vidmion d Seeun
)031.5 Ey eny ep0licenl la a parmn wbjede tha epplireni io e dvil penelry d na moro Ihen iNe huMred dollen �$SOOj).
� I.mowrorallaMOP�vanNomCbr+ear.ihwa6mmlheieoleaomDemmian.villAotlrwA.vdtMewmin:ml'vitmMeE
a aReredfor aele (Section )pu.8usiiwee vd Prdeaebm Cotle: The Coniracbn Lioenae law tlaea rwt epqyto en owiwr W qope�ry
who WtlOa w inproves iherean. erd who doee eurh wk NmeeM n heneC rc Mrwp� lib a her orm empbyres. prmided �MI wcli
impurw^mis are M intaMad a d1aaE la eab. tl, howewr. �M builMM n unpo.vnml b edd wnh'u� one Yev d mmV�ion. Ns
�owmr-0uiker hill heva iM buNen d povinp M w eM d'd rol WiM a imqo.e Ia IM puryosa d aele).
I. n ovmer d iM propeny. em exrl welY mnlretln0 �Kh tironed mNreebee io eonmW IM IX9� (5saion )OU. Busm�a eM
Pedesvau Coda: Tha GaNrauon Lieense lew Eou m� eppy ro en owwr d pW�Y Mn buiNs a'vnAa'm thweon ud xfio
mn�earn M mM poja ta wnh e muraqor�e) IieenaeC punuem to iM Comeeq«s limnse lav�.
� I an uemq uMer Seciun: B. 8 P.C.. M Nu
o�,: 5-/� -9l� �,,,�.:�Q�tcc2 �'�P,a,r� .,-,, ,
� eo n«eM �.nM u�m � am aw�e a.�a �ro.rs�ene ma nc��«ro d cmaomie H.enn w sde�v wee seeon. usos. zssxa..�a
?5530. vq tlw I a erry Mun Wiltliry oc�pe'u will / wa nd 55
(rircb me) IreE io'mply wN �eitl pete mdee ud tlr repui�mnenb Ior
eV��lacantrurtionamoEifiwionhantM�r�t e�emwy0iurip.RwkaraielmmrveioneVV�iaroueuemPlmntMM
qwivone.
Deie: ppq�yy:
WOPKEF'S COMPENSATION OKL�N�TON: I Mrety ellum undr pxupy d pMjuiy on� W tM Idbwiiq deyyetiom:
� I have uM xil meiniein e cenAicme d mneent io eett�inwn In xpkari canqnW ion, ro prwMed Iw by Saqion 3)00 0l ths lebar
Code, lar iM partarme�e ol Ns wak /w which ihie permn i� heued,
❑ I neve vd wJ meinlaF haken• oomw��ion iro�renro, m na�imE W Swim 3100 d iM Lebor code, br the w�lormence a iM
woM la which Ihia pe�mii ia inued. My warkeis' mmqnealion ineurance cemer eM poliry number are:
Certiar
volcY Number:
(ihis sMrcn nesd nw W compbfe✓ / fM1e pvrmi n la om huMred ddlen /S1PD/ n.Wa.)
�] I cenA' �het in ihe pMormence d the wark Iw whkh inie permtl ia ieeued, I�hell na emplay eny pe�wn in eny mennx eo m io
becane wbjeU io tM waMen' wmpenytion levn d Celilanie. uM yrm Na 11 eMuk beconn wbj«f lo iM hoMn'
eompenulion pewiaion� d Seaion 3]0p d IM labor Code. I dWl lal mmply xilh Nwa qmie'vu.
o�a: 5-//-�-9�� ��,�:: �/a����t.��.m,��..x�J
W�minp: F�llvn ro a�cen woAxa'rompNu+tlon mv�rp� 4 unMwNl, en0 �Hll aub/�cf m�mp/oyx ro ctlMiul p�n�ttlu enO
c�va nn.. w ro on� nura..e tnouw,d aw4n lJroq000A �n .ee�wn ro �M ewt or rompxuarron d+m.w u pnv�wr ro. �n
3�ctlon Jla6 0l tM Libor Cotls. Imwr, nM ertomry'� t1u.
CONSTpUCT10N LENDINO �GENC�: 1 MnW effirtn uMer prWry M pmjay thm �Mn u e mrutrua'an bMiip apezy b tlw
o�«merce a m...� �« wn� me w�r u ewed (seab, aw�. civ. cl.
LENDEN'S NMIE:
LQlOEN'S RDDNE59:
1 eerlily Ihel I Mw read Nis applicatbn eM p¢u irym iM ebwe inlomatipi o emW.l ap�r io eanpy xilh ell dry W oouNy orEinenro�
enE atete lexa ieWiq ro MriN�q m�mwia� eM MesW eWarrsa �w�te�i.ea W ihe M'�o ems u0� �M ebma�maaurd papeny
����,°'°°�P�`0�"''MARCIA F HLACKMON
K��"� /\X.��'I-�-B%V Ume: .5 — �
s�e��,a a o».bnnvaounvo�vcom�a
(SlStde.WP) WhGe-BuiWip d Selery:Green-FIe:GenW-AppYcenl: Pink-Revenue: Oddenro�Asaeamr
��— .
CITY OT.' COSTA MESA — BUILDING PEAMIT
. PERM NO: B 077684
PERMIT NO: B 077684 PLAN CHECK NO: 01410-96 L GOVT: N SUPP: N
t:00N��RUtCT�ONiYKP.E: NP.HHIftTT'I'YPE: STR PURPOSE: ADD
JOB DESCRIPTION : 182SF ROOM ADDTION INSIDE EXISTING ROOF SQ FT: 182
CLAIM VALUE; 15,000.00 CALC—VALUE: 14,177.80 GROUP OCC: R-3 /
COMMENTS: ADD 2ND FL BEDROOM INTO EXISITING VAULTED CEILING
it+�+tat*itiF�tft�tit�x�*�*�**�***ieitit*it*ft�**x�it*it*ititieatftatxet�ft���t*�**at*it*atit�tatetitet�ririt**it*�t�r*x **
Z 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 BUILDING
FRNT• FT IN REAR•
LEFT: FT IN RGHT:
PARKING REQ: PROC�:
PLANNING NOTES> ADD FOURTH:H
> NOT AFFECT P
1E 1E iE 1E iElE
-------- --------- ACCESSORY HUILDING ---------
FT IN FRNT: FT IN REAR: FT IN
FT IN LEFT: FT IN RGHT: FT IN
PARCEL: 43914340 ZNE: R2 REF NO:
DROOM (UPSTAIRS) TO EXISTING CONDOMINIUMj�DOES
RKING RE�UIREMENT. BDRM TO REPLACE OPEN CEILING'
1E1E1E�E1EiE1Eif iklElFiFlf1llEiFiE1EiE1E1f1E1Fik1f1f1EfElblElFiF1F1k1EikiEiflFiE,ifiklElEkftriflElE
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 APPROVED BY KCCi� DATE: �- 1�=9�ij
HUILDING APPROVED BY : S�'4'� DATE: S I %{p
APPLICATION ISSUED BY: r+ DATE: C/�J
iE iE 1E 1h 1E fE iE 1E 1E 1F 1k 1E IE 1E if 1E iF 1f If 1E 1f 1E 1E 4 iE iE 1k IE iE 1E 1E 1E�{F�1F 1F
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 224.75 ' ,� 1.42
-�` � SMIP/NON—RES
PLAN 146.09 � ✓
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN-CKE�K�. TOTAL PAID DUE
TOTALS----> 226.17 0.00 146:09 372.26 372.26 ,00
REVENUE DIVISION TOTALS--> COLLECTED:�"�. 226,17� OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC' FIRE rSMIP/TOT GRADING PLAN—CHECK
224.75 " , , ' 1.42
� /.
IE if iE IE IE iE 1E if if 1E 1E iE if iE 1E if 1F 1E if iE iF iE iF iF if iF if if if ib if iF iF iF iE.1F iE iF iE iF iE iE 1E iE iE iE 1F iF iE iE iE if 1f IE iE iE IE fE iE iF iF 1E fE IE iE if if iF iE iF iE iE IE if if iE if K IE
I N D I V Ii 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 182 DWE—TYPE V—WOOD FRAME • —GOOD 77.90 14,177.80
END OF FEfiS �
�. '
� ,.
" �CONSTRUCTION AND PLANNING POOL & 5FSA
APPROVALS Permit# Date Inspector qppROVAIS Permit# Date Inspector
1. Temporary Electricai Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcemenc � �
-� F.�ectrical�Conduit Utiifty-Undrgrnd. 54. Forms -
�`4. Electrical�Conduit-Undrgrnd. 55. Electrical Bonding ' �
. 5. Steel Reintorcement 56. Rough Piumbing & Pressure Test
- 6� Electrical 11FER Grnd. 1 57. APPROVAL TO COVER�GUNITE
-Z Footings'_ F, 58. Electrical Conduit�Undrgrnd. �
- �, \
; 8: Foundation� �/ i 59. Gas Pip€z CJ Undrgt�id., Test
9. Wa(er Pipe�Undrgrnd. • . 60. Backwash Lines, P�Trap, O Undrgrnd. -
10. Structural floor System 67. APPROVAL TO DECK � �
17. Properxy Sewer Line ffi House Connection 62. Backwash & Receptor-pinal
12. Sewer Cap 63. Heater & Vent-Final '.
13. Roof Drains . 64. Plumbing System - Final �
14. Rough Plumbing • 65. Electrical�Final ,
15. Fo�gh Electrical-Conduit : 66. Solar SYstem-Final � .
i6. Rough Electric Wirine ' 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 & A�,� Condnioniru, - - - FtRE'DEATY2EQUISEMENT '
- . �r " JG . LT'
20. ttouqh Factory FiY�slace �� �x :'" S _ APPFjOV7��5'`-" P�,imit #"
;\ � �i' K
21. pucFs, in$tNEtufe �r � �� � - y ; ; � - r� . 70.EUndergreiuid F]�dro "
22. nucfs. V2ntilating� � � q -. !_:* 71. ProduLI'Piping,�.Gas ({70i1 `
23. Gas Pipe-Rough &_Test __ - � S ='; 72. Undergreund F}ush.. : :
24. �Roof Framing _ � T ^ �, � 7�; Under9rnd. Stoiag'z:Tanf�' O Gas ❑ Oil
25. ooi'Sheathin `. '' _ ,'' f � • �
� 9 ,., r; -�+ 74.�verhead Hydrp - .
26. �7-Bar�Ceiling �StrucFural) & Monncoat � " - -= ` 75:�,Dry�hemicat �� = ° �_ r �.
. 27. Krame ar(d Pf$shiny* _ _ 7 : , ' �� r � 76. Dry StartT_dp�pea .J * .-� .
- 28. Lathing & Siding,- < y� - . �- � x ��� ' 77: FIXED$YSTEM�FINAL � � • �t .�
29. Insulation � ;`. ;� "- ' , � ' �', 7� FIRE PREV. Fli�`+{�L � .
30. Drywail Nailing ° -- y�^� 2„q,.,C� ��(. S :JiEALTA DEP�T. RcQUiF�EMENT
_ 7�
.31. Plaster Browq Co�I'.� = , : , _�Y � ' 79. FINAL G�V�PECTTON j - r., �--
32. Electriwl=Power MEier�Final __- � � • BQ[ F000 CERTIFJC�ATE FS3UED ._
�.' ~r' .r � �'- •
-33.FinalElectric, !�`�-` � � tes: / �_ � ��.�
� � :.- s _ . _ nia s 23 gG_ ���1 ' �� `t- �
34. Final Healing&Air�onditionirig" �-;� , � �
_ _ . _ _ �. - ' �i/'d !/ < --��.�'�' £�f.��>-C
35. Finat Gasi'�pe�Test � � 'j'- _ ' ' ' - - ^'
- ._ .: - � - `' , E_• L/-�C,1;6 ..L1 e.a,-�•-� /l e-e�!/
= 36. +lood or Cenopy ' _ ` " � � �
_ �..'" rr. �*_ ;a `� Zrl�G=� 1Q1� - GCv
y37. Final Faclory Pire�`I$ce. ' 'r" ` --�� � ��� T _ - - -
E.. � ti� . ,:r .
-38. Final Plumbin8 'x [.: .wi� � � i',' =/G/ p'7� � hO�� ,�v �
39. Water Service=Final '" " • m C� t� � � - � / -��"-'
: r- � �� s. _ ;+ F ����( ` U/�
..40. Gas Service-Final � � ��`' , ' -7
. - * �'.., � :, n� _ ' ' �.` y IS-RI �-.� `�''�,c s� �'a,oj ��G,--
a ��-
- 41. Solar porsiestic-Finaf� - ��'" , '+ �� '. "� - x�. - ' ^�� ��.
_ -:� - R; < _ - ._ r
, _ �e�N _
42. Backflow:Preventep, . . �''" -' ' � ` � .,
' � '*� . � r. i-: �_ � * � �
- ' , ..�-�
43. BaCkflow Irriyation 4 . "i � r. ," i ti� � �, �
•a - . r • -
Od. Landscape� Irrigation,SYstem _ :�;- r: ; ir i �� . ._ ` r � G ;� r ' -
- ^r
45. Sound Attenuation' - •� �� =�-}� ` tT.' Q c' � � ^ � �•
- - ^. ;� .. ... . � . .,�.: .•�,
Q6. Handicap Regulations � ;; `. '- ' ' -,
_ 4 �, ,
47. FINAL STRUCTURE & BUILDING �_�.�.�/7 •� , �, � -
a
48. F_INAL PLANNING> � i ', i;, �; ; �; w,
48. Electric Release to Edison - � i K ,.
50. Gas Reiease to Southern Calitornia:GasCo . � - _ � "= ' �
51. CERTIFICATE OF OCCUPANCY }
No Date
CITY OF COSTA MESA
BUfLDING DIViS10N
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. � Yes O No
2. I av ave not) signed an application for a huilding permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name _
Address
Phone (
City
ContractoPs 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
Phone (
City
Contractor's Lic. No..
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Address
Phone Type of Work
'="' I hereby aNirm that I have received a copy of the information set forth in Section 19830 of the State
of California Health and Safety Code antl have completed the above information to the best of my per-
sonal knowledge, in compliance with this State law.
Signed: _, ^i' � �/1�-��-Fn� �ate: 5—/�— �I�._
Name: ��C/A $_hcKMON
(Printed or Typed)
,o.: �
C.D.L. q or S.S. # �
754-5273
ORDINANCE N0. 65-zo
AN ORDIIdAAiCB OF T�a' CITY COUtICIL Or THE CTPY OF COSTA hIESA
AMENDING THE i•fUNICIPAL CODE OF THE CITY OF COSTA I�'SA
TO PROVIDE FOR Thr, ADOPTION OF THE 1964 EDITION Or THE
DNIFORM BUILDING CODE AND AhiENDMENTS THERETO.
The City Council of the City of Costa ?iesa does hereby ordain as follows:
SECTION 1. Section 8100 of the Mnnicipal Code of the City of Costa Mesa is
hereby amended to read as follows:
"Those certain documents, three copies of which are on file in the
office of the City Clerk, being marked and identified as Volume I
of the Uniform Building Code, i964 �dition� as amended and as the
same shall be herea£ter amended, and Volume III, entitled UniForm
Building Code Standaxds, 19FJ+ Edition, as published by the Intex�rtional
Conference of �zilding Oi£icials, are hereby adopted as the Building
Code of the City of Costa i4esa, including the Appendix to 'Joliune I thereof."
SECTIOid 2. This Ordinance shall take effect and be in full force thirty (30)
days from and after its passage, and prior to the expiration of i'ifteen (15) days'
from the passage thereof shall be published once in the ORANGB COAST DAILY PIIAT, a
newspaper of general circulation, printed and published in the City of Costa Mesa,
together with the names of the members of the City Council voting for and against
the same. �-'
PASS� AND ADOPTc."D this �% r� day of
ATTFST:
�/`- • Vi+'�-�� .
City Clerk of the City of Costa iKesa
STATE OF CALIFO?2NZp )
COIINTY OF 0?tAtiGE ) SS.
CITY UF COSTA i��SA )
v � 1965.
��.���
Ma • of the City of Costa T1esa
I, C. K. PRl-EST, Citq Clerk of the City of Costa Mesa and ez-officio Clerk of
the City Council of the City of Costa Mesa, hereby certify that the above and foregoing
Ordinance $o.65-zo was introduced and considered section by section at a regular meeting
of said City Council held on the 21st day o£ June, 1965, and therea£ter passed and
ad,,o,�ted as a whole at a regular meeting of said Council held on the /� r4 day of
uv�, i965, by the following roll call vote:
.
AYxS: COUt:CILt�.V
NOES: COUIdCILi�.N
ABSENT: COtTb;CIL1�2fE�v
IN WTfNz'.SS TAH�tEOF, I have hereunto set my hand and affixed the Seal of the
Citp of Costa ^fesa, this 2D r day of /�/'y�_, 1965.
V ���
�,��'�..��-
City Clerk and ex-officio Clerk of the
City Council of the City of Costa r±esa
_. _. _�___---_._.._ �______—_
�_�_....__,__—_._._,_-------� ,T._._.______ �: -
annwEssaew�aw: 2403 NARBONNE WY
wn+exsnu+e�rroa�vr+: BLACKMON, MARCIA
.100PE49: ZQO3 NARBONNE WAY
COSTA MESA,CA 92627
642-3646
.vvi. y,uiwc .00�u:
IAfKXREttONFN6'NEFN:
�NCIlOA ENO.'4 ADURESS:
u�
I�-T
IlC ND:
UNT:
COMPACTpfB u�u�.
CONfRACT0ASN41W0
1DORES9: 11C.Np.:
UNT:
LICENSED COHfRACTOR4 OECUNATION: I hareby ertem ukar pemYy d porjury tM 1 em IiwnwE uMr poriebm d Cheqer D
(oommerid�p rniA Seciion )000) d Di+uun J d Ne Bua"uru enA Pmfutiona Cods. ud mY �� e in IW krts ud e(lea.
cmuc.No.: uc.cuss: uc.r+o.: EXP:
Oaie: Caweer.
OWNEfl BUIL7EN OECIAP�iION: I haeb� eRum �uMa pmuly d perjry Net I em emmq Imn ihe Caqredm Lim�se Lew la iM
IdbwnV eaeeon (Sed'an )O��S Busiru end PNaabns Cods: MYW a wuNY whirh nGu'uv s Wrmu m mnuup. eEer.'unqaro.
Mmofi�. or rapei ury ebucMs. prior m Ia e.w�m. e6o raQiva Ns epp6nm ta arJi psmd to Ne e aproE mtamaN Nel M a�he
u �k.n.w wmiem m �ne wovifiau a ne can..a«s Li as le. �chaqa e(mnun.ndnu w'vn seacn �000) w Dneim � a ilr
BuaiMo end Pralmiwu CaMI or IM M a ehe e ssunP �heMmn eM IM Eaa tn Ne eAeO� memqun. MV videtun d Swion
1W t.5 by eiry eppli eiu lor a prmn vibjw+ Ihe epdke�t lo a wi peneliy d nal mas �1un fvs hundrad da�vs �5500�.
� I,uownrdiMqapMyamyemDbymwlhwapsanNwu4mmpnWim. TEOlhsxak.eMtMaruM�s'siMWoMW
a MereO br eeb (Sar�ion 10u.8uww� ud PeWm�ionaCOEs: Tha Caa'eem liowa law Eoes nd ePdY to en ow'wrd pope'Iy
who buiM ar inM� �Mnan. end Ma don eudi wh fimwll a haaN a Wu9h he a hm orm amDbY�. P�� thet euch
�mwwemau. ae �a w�eee «m«.d io,.d.. n. no..w. m. wu��m « mwa«�.m m.od wnnm oo. r� a�,dnm. me
�owro..hualer vAp Mn iAa buNen d pw'vp M« eM did na bdd «unpvw la �ha wmde d We).
1. m owMr d �M D�W�Y. em u huivalY mMreuYq MVh 4camsE mWeclm b ooMrutl IM P�9b (SWbn ]Ot�. Bwiro�� W
Pmteveime Code: TM CoMratlae liemas Law Eom nd ropy b en ovmer d prapMy w1w Wilde a'unqww therson eed wM
eonirula br wM WNxv wLh e evNemple) Icerued O�uem io �M Coruremn lloeeue lawl.
� I em axemq uMe/r 'Seclbnn:/ B. 8 P.C., br Nrc , �/% n�
Deie: ,5���-F' IYJ O.mer.'�/�.I�.[A �J!/IiiL�+A�A_.JI'/��
I Eo MmW ceniN �hel I em ewus d W uMenwM Hr mVuiramaro d Cdianie INMh W&elatY COEe Satliom 25505.255�. uM
955�. end ilw I u�nY Mwa WiWaq omD� xi9 / wa nd (ac4 ans) Mad ro m^dY xiA uiE mte oodm W iM nV��rro br
ePrmnlamrutruclionamodiRmbnhaniAsAi�t wpenrmObtrie.RpidervielampiudioneVC�iomusexamNlmmNms
a�.
Deie: Mp���
WOHKEP'8 COYVEN9�ilON OEC WI�TION: I Mr�by a1(vm W�r pxrtly d pMuy w N Ms 1a4rAiq dedveian:
� 1 hew ud wil meiNew e eenJi�au d miwn� io �sOtimm br xakan' oompormlian. m prwfdsd la by BMian �]00 M iM leEu
God�. t> iM DMmwin W tlw M ta Wicn Nu CMro o bwE.
� I MM vd wil m�im�n wkon' cwnM�ion vuu�vo. n npu'v�d b/ BWbn �100 d iM LeOa Cods. br iM D���* M tM
wak la whitli IM V✓mn u iau�E. MY ratn�' mm0�ion Na�uic� umr W O�Y wmbx vs:
Curier.
Pdiry NumMr:
(TAIs roaM neW rw� M mnnhtW I �lw Oa'ml 'o M aro nuMrsd daLen It�WI a ka.J
}� 1 centy IMt in ihe prlamencs d tM wark far whkh tAi� permu b WueE, I Wtl nd empby erry pron In eny mennu o m to
becans �ubjse io iM MwFen' canpenxtion bw� M Celilanie, eM ep�w Uut G I�hould becans wb�ap lo IM worka�i
compenWbn D�bbn� d Sadion �]00 d �M labar Code. I JWl lon�oomply xiN tMu pmw �
�'-//�4�i- '' �
Oeis: �Vdiunl: �%/i!�-!A. A LI?lfl
W�minp: F�Nun b �Icun rork1r�'romp�nutlon rov�rry� l� unNMu4 �� �wl �ulJ�el �n �mplo�w ro crlMnl p�n�ltlu �nE
clMl Ilir� �q ro m� MndrW flwus�rd JWbn (JIOq000A h M1tbn b IM cmf ol mr�vw�uWM1 tlarrvp� u prvvlLM br In
9xtlon J108 0l Ih� LeEor COW. Infxut ��d aRam�y'� Iw�.
CON9TIIUCf10N LENDINO �OENCY: I heMy elfrm uMer pneEy d parjuy ihel �Mn e e cvnq�uCbn bMi�p apercy br IM
psAamanp d tM Mak M xAIN tM puml u'vwW (Satlion �OD]. C'r+. C).
LENDEX'S NAME:
LENDEP'8 ADDRE44:
I<MiIY Ihtl I luw netl thu WO�Ketim eM tlata �1� Ne ebwa iNonwion u oonM. I qyw �o oomW vril� e! M' end awM' adi'unw�
eM �wa lews iMmip to buJdiq mMrWin� erd hmebY uGlvcs �apewLLe�ma d thu tltyto eNx upon tM ebwe�mmtionW popeM
�°""'0°"�°°w�°°"'MARCIA F HLACKMON
vm� w�»
C7i1.GC2 Ld71� oms:_�5—/�—�rQ
Sq un dO�nee/�penVAppkant�GON'ma
I�
`; (515�<a WP) W�ne-Buikvq 8 Sefery: OreeMFb: Cenery-Appfunl: Pink-Rwewe: Oddanro�Maeswr
�_ _
�— CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: M 077686
�ERMIT NO: M 077686 PLAN CHECK NO: N GOVT: N SUPP: N
:ONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: ADD
JOB DESCRIPTION : 1825F ROOM ADDTION INSIDE EXISTING ROOF SQ FT:
:LAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
�OMMENTS: ADD 2ND FL BEDROOM INTO EXISITING VAULTED CEILING / 8-77684
f iF if 1F 1E if 1h if 1E iF �I-1h 1E 1E IE 1E iE 1k iE 1E iE 1F 1F if 1f 1E 1F 1f 1E iE if' 1E 1E' 1E 1E M' IE 1E 1f IE If 1! 1k 1F 1E iF if 1E 1E 1f If� 1E 1E IE 1E 1E If if 1E if iF 1E iE ff IE 1E iE i(� if iE If iE iE 1E f(� iE iE i[-iE
Z 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 BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
?RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
�EFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
?ARKING REQ: PROV: PARCEL: 43914340 ZNE: REF NO:
?LANNING NOTES>
i
f 1E 1E 1E iE 1E iE iE 1E if iF iE �E 1f 1f 1F 1f !f if ii 1E ik 1E IE 1E iE fE iE iE 1E 1E 1E ff if� 1E 1! i! iE 1E 1E ik iE iE iE if 1E 1F IE i! i! iE 1E fE 1E 4 iE 1E 1f 4 fE iE �E 1! 1E iE iE �! iE iE 1E if iE it IE 1E �E iE �E 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 N T S
LONING APPROVED BY .
3UILDING APPROVED BY :
4PPLICATION ISSUED HY: �
k it 1! 1f f! 1f 7f if iE if 1f if fE if if k iF iE ik 1E 1k 1E
LEGALIZATION:N E E E S U M M A R Y
BLDG PMT PLOMBING ELECTRIC MECHANIC
PERMIT 9.00
DATE:
_ DATE:
� DATE: �
��3FfkiEiE1E1k1f1f1fiflF iE1E
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
25Y SMIP/NON—RES
PLAN -
ISSUE FEE � � 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15.00 ,0.00 24.00 24.00 .00
ftEVENUE DIVISION TOTALS--> COLLECTED: 24,00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
:24.00
If 1f 1f 1t 1! 7ElE iElk 1F 1k if If 1E fE 1F 1E if 1E 1E 1E IE �E if i! M 1f fE �E iE M 1E M iE 1E 1E 1t fE 1E ik 1E 1E 1E 1F iE iE 1k 1F 7k 1E ik 1E M 1E 1E 1E iE 1! 1k 1f 1E i! Ik IE 1E iE 1! 1E 1E 1E 1E 1i 1E iE 1E 1f IF 1F 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 P T I O`N UNIT COST
MEC i REPAIA/ALT HEATING UNIT/SYS W/CNTLS 9.00
END OF FEES
\�.i :� �'� ... -
� , .'
TOTAL COST
9.00
CONSTRUCTION AND PLANNING � POOI & SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1, Temporary Electrical Service or Poie 52. Poot & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
Q,3�;EIeGtriwl Conduit Utilitv-Undrgrnd. 54. Forms � `_'
�`- d: �leetrical ConduibUndrgrnd. 55. Electrical Bonding �-
�,-= 9: �[QBl Reinforcement 56. Rough Plumbing & Pressure Test �
•�:.Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
���ootings 59. Electrical ConduirUndrgr�d. a
�&i Foundation 59. Gas Pipe, O Undrgrnd., Test i.
�6r Water PIpe�Undrgrnd. 6p. Backwash �ines, P-Trap, O Undrgrnd.
10. Structural Floor Svstem 61. APPROVAL 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 �
75. Rough Eleccrical-Conduit 66. Solar SYstem�Final
16. Rough Electric Wiring 67. Fencing & Access Approval '
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electricat-T Bar Ceiling 69. POOL/SPA SYSTEh9S FINAL
19. 6ouc�h Heating & Au Conditioning -- - - py��-BEpT?REQUIREMENT F �
- - " _ - - - t*:
20..Rougn Factor�Firxplace �� _ ' > - _ • APPqOV�1LS�" Perr,mit#�� �-
21. �uCti, in $tNCtu�: � .• .• . �_ _ ,� � .. ^` - ^� •a
i 70. �Jndergroim'd kydro
22.D�rts,Ventils4inc�,¢'.x� � ' " �� - 7�, Produf`�,t�Piping,.G�as (QOi� �
- - r
23. Gas Pjpe:RoUgh B�Tgst _ =' � ' T 7 72, Undergruupd F}ush . .
24. �oo� Freming C* ' r V "(„ �; �; 7�: Undergr�fd. SI �ag�e Tanf� O Gas ❑ Oil
25. Aoot"Sheathin ' � * '4 " � � = � '�
9 �- v _ .� .� w 7�4: Overhead Hydr`g. r^
26� T-Ba6:Ceiling (StruceLraq & M�fptoat + � - -�: 7�: Dry Cheihical �� - r_ '
2). Ereme aRa Flashing � -� ff .` r x� 76. Dr Starjdpipe �;r .- -� �
� R.: Y
28. Lathing &'Siding r : �- R � � � , �+� 77; FIXED�3lP�TE�M�FINq},` ��
29. Insulation, �_ � " y� 7�i FIRE PREV. FIf�AL % r � -
30. Drywall Naihng r - '^ +� 5 'HEALTH DEPT,..,REQUIiiEMENT
,. 31. Plaster B wn Coat ��' �; � I �4 ' 79. FINAL tN�PECT�ON r-- � _
r e t.. - -
. 32. ' IectricaEPoyter MererFinal , + ! 80. FOOD CERTIFICATE ISSIJED
�. �-
33. Finaf'Eleelric� �' , _ '� Ptqtes:�`�G�_q r`r . � " Q�/
h{ � -- ' i�:Ho��tccc"SS �.�
• 34. Fnal Heatin�$ Av,CQnditioning' _ �� �j'1 � .I �� �--1 .. '
- -92 - nt_��/�cecss��- 6_N
35. finaJ Gas-PipB-TeSt " - .. ', . . - =•ti _ - c. d. r^
i n, ,_, _
, � _ .. .
' 36. Hood_�or£anoPY r;i ' . � �.r. r 't. .� � . T �_.
r -
37, Final'Factory Firgg�cP. 7' F ^ -' .', , ° - -' `
. �. � ^tr ; _ �:
- 38. Fina�Plumbing -, r . { ' � . � _ Y _' _ ,� r � -
: -�.'. - s- .� c
39. Water Service�FinaT�� _ � . �. � ^ � � -`_
r 40, Gas Serviee-Final � ' ' :. ° . �' . _ . = ,: :_ �
- - y.
41, Solar pomesticFiaal ' ' � � _.- e +� z �
y � �� . � i ' _<_'
42, Backflow�Preventer•, - - . _ ; r, ' � � . i.
43. Backflow Irrigation ; >' � "` � � ;. .'
.� :
� - ' � i, . . - �- ,_ .
�34, ;6andscape IrripatioaSysrem- : �.j .* r F � � c v : -
45. Sound Attenuation• •• ' !r r.. •- �r • c-.r. -
� . _ . ..w - - � ..r i
46. Handicap�Regulatior� �. � , �. � J ^
� r•
ri7. FINAL STRUC7URE & OUILDING - �° - -
- r. - r i a ' _
48. FINFSL PLANNING: � � '�� ; c: ... <•
49. Electric Release to Edison * � "• "
� Y V - � 1
50. Gas �elease to Southem California�Gas Co : - _ - -
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER DOYLE & SHIELDS Development Co.,Inc. DATE 6_3�3--
JOB AbDRESS 2�+Oi NBTbOrine BUILDING PERbiIT N0.
GENEkAL CONTRACTOR Dovle & Shields Dev.Co..Inc. VALUE S 19.417.00
DA
SUBCON'L'KtiCTOR
. � � ��_ ���
COSTA MESA BUILDING-SAFEfY DEPARTMENi
P• O• 90X 91f COBTA MHBA. CALIFORNIA
For Applican� to Fill In Completely
TYPE OR PRINT
eui�oiHo �,Q (l
ADDRE59 IV
COSTA MESA. CALIFORNIA
�,r, Anaheim
ARCHITEGT Hai C. Tan
ORENGINEHN
FIRE
20 zoni
Fullerton, '�C
LHOAL
ADDR656 Same
CITY `Same
LIrG.TNO.ISI�GSO—B `�1 NO. PR Z�OOLO
OFLOT 3 X S3 SO I NowoNtuTD�
USE OF
EXISTING B�DO. —�
eeie�cK une pqoM 'LO. SO � REAR YqRD
CENTEP OP BTpH[T �
81DHYARDI LEFT R16HT
DESCRIPTION OF WORK
EXTERIOR WpL ROOP S � NE
COVERIN6 �tUCCO COVERINO
'U9E OF BUILDINC AfiD WORK TO BE P6RFORMHD
Residence w/attached aaraae
32C
'1 NEREBY 11CkNOWL8O06 THI1T I MAVH RBAD TNIB APPLICAT�ON
♦ND 6TPTB THAT THB AOOV[ IB COpqHCT ANO AOflH6 TO COM-
PLY WITH I1L� CITY OPO�NANCV AND YTATt LAWB R[ODUTING
BUILDINO CONBTwVciION.
� AUTNORI2HD AGiNT
FEE RE�EIVE�
`FINANC�E.n C�tE�PMESA
APPLI��ICQ� ROR'7ERMIT
BUILDING
For Office Use Only
R[C[IIf NO. PYPIT
isaueo
ZONING
NO. OP Uet OP N
�LANB 9UILDINO
Lot 146, Tract 3433
�—
JE OYERHAN6 SHALL BE LE59 THAN
! REAR P. L.
(U.B.C.RFCUIREMENT:
YARDSAPPROVEG YARDSAPPROVED
MAIN BUILDINO ACCESSOkY BUILDING
eEr.
VAR. $R
DATE
1824 sa. �. Q N ^".
THE M1MOUNT 9 1 UNOlR VALUATION 19 pOq TH8 ._
PIIRPOB[ OI BL�BNINO A PBflMIT F88 ONLY. �
VALUATION '] m
PERMITFEE $ G(J�`y j
$>g, w�- °' A 3 s� �
0
a