HomeMy WebLinkAbout3359 NEVADA AVE - Building PermitsCITY OF COSTA MESA �
o�""'E9 BYILDING DIVISION
Ft�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wiw.ci.costa-mesa.ra.us
°���� FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: P09-00062
PERM�T TYPE PLUM
APN: 13957237
STATUS: ISSUED
DATE ISSUED: 0511312009
ISSUED BY: CAC
JOB ADDRESS: 3359 NEVADA AV CM Suite/Unit:
Vicinity: � "
SCOPE OF WORK: CHANGE OUT OF WATER HEATER AT SAME LOCATION
OWNER: HUNDLEY, HENRY R- Address:
PHONE: " City/State/Zip:
APPLICANT: VENTI DRAGON � � Address:
PHONE: 800-898-0008 City/State/zZip:
CONTRACTOR: CALIFORNIA DELTA MECHANICAL INC
Address: 1235 GRAND AVENUE
City/Stale: SPRING VALLEY, CA ZipCode: 9197Z` - - .
ARCHITECT: License No.
ENGINEER: License No.
3359 NEVADA AVE -
COSTA MESA, CA
1235 GRAND AVENUE �
SPRING VALLEY. CA
License No. 817174 ` -'%-{1�a�.�
PHONE: 800-898-0008
CELL: 866-692-5273
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
PHONE:
PHONE: �
. ^'f� 9,.Y i.+ :.� s:.
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order foi the work authorized under this permit to be considered legal, such work must comply with all applicable wdes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval vrill result in ihe expiration of this permit.
CODE/. INSPECTIONttGE ORTE INTITIRLS LOOEC INSPELTIONTYPE OATE IN1111AL5
1676 Fizetl System Final Fire Prevention 206 Final Mechanical -✓� �`
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electncal
201 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning App�oval
203 Final Sign 222 Final Site ':"�'r;- r,
204 Final Demolilion 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATIbN:
I hereby affrm under penalty o( perjury one o( the following declarations:
❑ I have and will maintain a certificate of consent [o sel4lnsure for workers'
compensation, as provitled (or by section 3700 0( [he Labor Code, for the
peAormance o! the work for which this permil is issued.
\�[� I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the peRormance o( the vrork for which lhis
permit is issued. My workers' compensation Insurance carrier and policy
numberare: �T�
Cariier: / � vN�
` (This seGion neetl not De cum,pt�le(etl A lhe permd is va�uetl at one nundmtl dollars (St00) or less )
Policy.Number: �6�1 ���3
❑ I certify that in the performance of thy work (or which this permit is
issued, I shall no� employ any person in any manner so as to become subject
to ihe workers' compensation laws of CalifOrnia, and agree that if I should
become subject to the vrorkers' compensation provisions of Seclion 3700 0(
[he Labor Code,�I�n all lorthwith comply wilh these provisions.
l�Eiv 7i �.2/1G�s+' O✓`//3/09
AOPllcam's SignaWre 'Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT qN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS 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, antl
my license is in (ull (orce and eftect.
Lic. # `' o ����y class # ' %�3 �
ENT�� ;%��Ga.� Ds/i,3/09
Gonvaciw's SignaW�e Oale
CON57RUC710N LENDING AGENCY:
❑ I hereby aKrm that there is a constmclion lending agency (or the
per(ormance of the vmrk fa which ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
SignaWre
OWNER-BUILDER OECLARATIONS:
I hereby affirm that under penalty o( perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for lhe following reason (Sec. 7031.5,
Business antl Pmfessions Cotle: Any city or counry which requires a permit to
cons[ruct, alter, impmve, tlemolish, or repair any stmcNre, prior to ils
issuance, also requires the applicant for such permit ro 51e a signetl statement
that he or she is licensed pursuanl lo �he provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the
Business and Professions Cotle) or that he or she is exempt therefrom antl
[he basis for the alleged exemption. Any viplation of Seclion 7031.5 by any
applicant tor a permit subjects the applicant to a civil penalty of not more than
five hundred dollars (3500).):
❑ I, as owner of ihe pmperty, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the slmcNre is not intended or
oftered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or hersel( or through his or her own
employees, pmvided that such improvements are not intended or ofteretl for
sale. If, however, ihe building or improvement is sold within one year o(
completion. Ihe ownerbuilder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractws License Law does not apply to an owner of
property who builtls or impmves ihereon, and Who cont2cts !or such pmject with
a cont2ctor(s) license pursuani to the Contrec[ws License Laws.).
❑ I am exempt untler sec.
Business and Professions Cotle for this reasOn:
Owner ID verified hy drivei s license. ❑ Yes ❑ No
Driver's License No. Expires:
Veritication of Ownership by (type of document, i.e. - property lax bill or deed�:
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby cetlify Ihat no excavation frve (5) or more (ee� in depth in[o wfiich a
person is required to descend, will be made in connectbn vrith work au[honzed
by ihis permil, and that no building sWCWre, scaf(olding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) teet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administ2tive Code).
❑ As ownerbuilder, I will not employ anyone ro do work which would
require a permit from the Division o/ Industrial Safery, as noted above, unless
such person has a permit to do such work from [he division.
App�iwnt's Signatore oate
Division of Industrial Sa(ety Permi[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to fle and
certify a Business Plan for emergency response to release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Sa(ety Cotle requires, with some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time tluring a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
al standard temperature and pressure).
2. Does or will the applicant or present or fuWre building occupant need to file
a regislration form (or acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 0( �he Califomia Healih and Safety Code, with some
ezceptions, requires registration with lhe Costa Mesa Fire Departmen[ hy
each business whic� al any one time has on hand a quantity o( acutely
hazartlous materials equal ro or greater than a weight o( 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas al standard
temperalure and pressure).
3. Does or vnll the applicant or present or fuNre builtling occupant need to
prepare an RMPP (Risk Management antl Prevention Pmgram for acu[ely
hazartlous materials�? ❑ Yes ❑ No
(Section 25534 of Ihe California Health antl Safety Code provides that the
Cosla Mesa Fire Department may require �he preparation, certification and
fling with the Fire Departmen[ of an RMPP by 6usinesses which are required
to register awtely hazardous materials with the Fire DepanmeN.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Cotle been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre building occupant require for
lhe work which is the subject of this application a permit (or such constmction
or motlifcation (rom �he South Coast Air �ualiry Management Distric[ or irom
any other air pollution conlrol tlistrict or agency? ❑ Yes ❑ No
(Seclan 65850.2 of the Califomia Govemment Cotle requires that the requested
information be fumished on applications fa non-residential building pertnits�.
6. Will any part of the facilily lo be constmcted under Ihis permil be within
1000 (eet from the outer bountlaries o( a school? ❑ Ves ❑ No
Q( "yes", Ihe facility musl meet the requirement of Sections 25534 antl 42303
of the Califomia Health antl Sa(e[y Code).
7. I( a permit from Ihe South Coast Air Quality Management District or other
air pollWion coMrol dishict or agency is required for the work which is the
subject of lhis application, have all of Ihe disclosures prescribed by Cali(omia
Health and Sa(ety Code Section 42303 been made? ❑ Ves ❑ No
8. Qf "yes", attach cenifcate of compliance trom the appropriate air polWtion
control oKcer).
CERTIFICATE OF COMPUANCE: I ceAify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws antl
city ordinances regarding Hazartlous Materials and Emissions.
Signawre Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury lhat I have read this application and stale that
the information given is correcL I agree to comply with all state laws antl city
ordinances relating to building conslruction, and aWhorize representatives of
the Ciry of Costa Mesa to enter upon the above-tlescribed property for
inspection purposes. I agree no� to occupy or allow occupancy of any building
authorized by �his permit until (inal inspection.
Sig�n/atyre ot legal Owner s) Dale
Signalure Date //��(/%/ ��ijQ'G.�p,✓ Q�T/�.3/09
!%
3�5]-46 (3I01) Antllor AWhonze0 Applicant' .Date. /
� I�ecT�ooeess:, 3359 NEVADA AV u"�T I CITY OF C05TA MESA — bUILDING PERMIT PERM ?d0: B 048070
� awNee•sxune: HENRY R. HUNDLEY
�4 aooeEss: S�E AS ABOVE PERMIT NO: B 043070 FLAN CHECK NO: N GOVT: N SUPP: N
714/557-5127
�.fflCNIENGINEEfl: .
ROONESS: '
xEa.xo.:
UNrt:
� PENMITTEE: CHEIMPION RUOFS ( 714 ) 898-8600
' eooeess: 3257 VERDU7G0
ORAMGE ' CA 92667
110EN5E0 CON7MC70R OEClAIL1TI0N: I �eahV attirm tlut I am Iicense0 un0er Dmvisions ol C�apter 9(wmmencinp vnth Section
7000) oi �ivision 3 of ihe Business and Pmfassions CoOe, anG my license is in tulllorce and eflect.
cm uc.: 0 4 2 7 2 5 sTnie uc.: 4 2 9 4 81 cusg: C 3 9
oate: 7'� 0' q � Siqnature: ��_��
WOBNEHS' COMPEN&1TION OELUMTION: I hereby affirm that I have a certiliwte ot wnsent lo ulbinsure ar a ceniliwte ot Workers'
Campenutiw Insurance, ar a cmife0 coDY �hereol (Section 3800. Lah. C�.
bucrxo.:WP062819-90-04 uv.onr�: 06/02/91
COMPANY: PAC' COMP .
❑ CeNfi¢E coOY is here�y tumishe0. 0 C¢tlilleE coDY is tile0 wit� ��e dry uil0inq UiNsbn.
Date: � � �0' �%D qpWicant:—�r '"�"'�'��� �"�"�-+„L��
IXEMPf10N FIiOM VIOflNENB' CONPEN&TIOM OEGAMTION: (ilus se�tian rieeE not Ee mmqeteU il Ihe permi ¢ la arc �unOreE (570� a las�.
I cenity tAat in the pedorm2nce ol t�e work for wAich t�is permit is issuetl. I s�all not employ any person in any manner sa az to Eecome
su6lect to the Workers' Compensation Laws ai Calitomia.
Oate: Signature:
NOTICE: If, atter maldng Ihis GeUaration, you sMu10 become subject ro t�e Workers ComOensation Dro�� of ihe Labor
COEe, you must /ah�witA compty wit� such Dravisions ar itus perimt SAall Oe EeemeE rawketl.
CONSit1UC710N LENOING �GENCY: I hereOy�aMrm ttut there is a constructlon IenEinp apenty lor t�e pedormance ot the work tar
wtiicA this permit is issuetl (Section 3W7. Civ: C).
LENOEfl:
R�OHES&:
OWNEN BURDEH OECIAMTION: I AereEy aifirm thal I am exempt Imm t�e Cantactors' Sute Lkense Law Iw Ihe lollowinp reason
(Section 7031.5 Business anU Prolessianal CoEe: My ciry oi wwry whic� rtquires a Oe�mit ta cansiruct, atter, ImDrove, Eemolish, or
repair any structure. pnor ro ils issuance, also requiros the apD�icant lar suc� permit to lile a 51pneU statement that Ae/she ¢ IicenSeE
pursuant to tAe Orovisians oi Ihe Contacrors' State Licansa law (ChaD�er 9(cammencinA with Section 7000) ot DiNsion 3 0l the Busineu
an0 Pmlessions Code) ar that he/s�e k exempt theretrom an0 Ihe basis lor the allepeU eKemption. My NOWtion ol Section 7037.5 by
arry applicam tor a permit suEjects tM aDWicant to a rivii penalry oi not more Wn frve �untlreC Oonars (SSW�.
. I, az owner of t�e Droperty or rtry emVloyees wiN wapes az their sole camperrsafion, xi0 Oo �M work. ariE tM
swctura is no� intenUeA ar otleretl for sale (Seclion 7044, Business anA Pmfessional CoOe: T�e Contactors' SWte Lkense Law
Oas nat apDN �o an owner ol a O�aperty wtw Uuiltls or impmves thereon, anE wAo Eas suc� vroM himul0�ersetl or e�roup�
' his or her own employees, O�deA that suc� imD��'emenis are nol inlen0ed or offem0 lor ule. I/, Aowever Ihe builCinp or
impmvement is soltl witAin one year oi comDletion, the owner will �ave Ihe OurEen oi Drovinp �e/she OiA not Uui10 or imDmve
for Ne purpose of sale�.
I, az mmer oi t�e property, am aGusiveN canlraNnp with IicemeE convactars ro wnsWct Ne projecY (Seclbn 7041, BuUness
❑ an0 Prolesdons CaEe: The Contractors' �tate liceme Law Oces rqt appy ro an a+mer ol Dmperry wtq EWEs ar Improv¢5 Nereon
and wAo caniracts for such D�al�� �h a cantactor(s) Gcense Durswnt to the Coniractors' Stah L¢ense Law�. I am aware
that proal ol Neir WOMer's Compensanon inwrance sMNO he pmn0e0 ro me.
� I am eRempt urMer Section: ' B. a P. C.
for I�iS reason:
Oate: Owner
I Uo Mrehy ceNy WI I am axare ot anE unUerstan0 tAe reQuiremenis ol Califomia Healih ana Sa/ery CaOe Sectbns 25505, 25533, an0
25534 an4lAat I or any fu[ure builtlinp acupant wilUwill noI (cirde one) neeA to comDN ��h uiE state co0es an0 t�a reyuirements lor a
permii tor construction or mo0ification Irom Ihe Air aliry ManaAement District. NesiGential consimction apDliutions are eKempl Irom
t�eu Orovisbns.
Date: ApDlicani:
I here�y ceNN tAat I have reaE itus appliwGon an0 state ttui tAe aGwe intormation a cartect. I apree to comDN w+ih all dry anE wunry
orGinancw anC SGie laxs relatin0 �o UUWinp cor¢wciun anG reby aulMriza represenlaiives o� fAiS dry �o enter upon Ne aUove�menibrretl
prop¢fiy lar inspection purpoSCs.
Date: 7—( D� 96 Sianawm: � ��'�'"'�—'
Drroer's Licenu or Saiai Sewriry �
161146 W�ite—BuiWing; Graen—COEe Enlorcamang Canary—Applicant: Pink—Revenue; GdEenroE—Avesnor
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION : T/O WOOD SHAKE S REROOF W/DURA—LITE SQ FT; 9,000
CLAIM VALUE; 9,000,00 CALC—VALUE: 9,000.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED
*�t�x-****x�***��t�t*+t�t+�*+r��+���t�t*****#-�t*��*it��r�-�-�r�t-�-�***��-�-�****��i��x*-�-�t�c �-�**�t�**-x�***��t*�
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
------------ 14AIN bUILDING ----------
FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN
--------- ACCE550RY BUILDING --------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 13957237 ZNE: REF NO;
PLANNING Nd'I'ES>
> '
iE iE ?E iE iE # it iF 3E iE it it dt it ik it it it it iE it iE �)h it iE it it it it if ii iE if iE if it it i6 iP i6 it it iE if it it iElt it jE iE �)E 9t iE iE iE?E if it iE iE jf i6 iF iE iE ie±f iE iE ic it �lE it if ii �t if 3E
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
r
20NING APPROVED BY DATE:
BUILDING APPROVED BY ; DATE: •
APPLICATION ISSUED BY: �, DATE: .�" I�'/ LJ
it iF it iE 1f iE iE it if if if iE it if if it if iE iE iE iE it iE iE iF jE jE aE iF �F!E if�g"�FiE if
iE it if 1F iE 1k ik 1f if fE ik i4 # it 1f iFlE iE iE iF iE �E �1E �E iE if k iElf ik jElE �k iE it iE ie jE 3f iE if 1f IE iE iE iF �lE 1E?f iE iF 1t jE iE if iE fE 3E iE 9E 1! fE 1F fFlE 1k �f iklElE if iF jE iE iE iE 3E if 3f
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 108.00 :fi3
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID' DUE
TOTALS----> 108.63 0.00 0.00 108,63 108.63 .00
REVENUE DIVISION TOTALS--> COLLECTED: 108.63 OVER/SAORT:'• .00
bLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
108.00 .63
1F it ik i! 1f it!!!E if !t if ik if % 3f ff iE i(� k ff 1f ik if i! iE iE K it it iF iE iF 1t±t+t'1! fE iE �f iE iE iE af jE if IE iE iE if iE 1f iE iE iE itif iE?f if 7E iE iF ik iE iE 3E �E iE jE df 3E iE if iE iE dE?E K �E
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST � TOTAL COST
SFR 9000 REROOF HY VALUE RESIDENIAL NOZONE
END OF FEES
1.00 � 9,000.00
01 OD06��52—OOOb.E53 �4]� 108,6s /
OA?E: D7/10/90 TIt1E: li:Q9 V
_.
a
' CONSTRUCTIOIeI AND PLANNING �' -
APPROVALS Permit # Date
1. Temporary Electrical Service�or Pole .
2. Soil Pipe-Undrgmd. �
3. Electrical Conduii UtilitY-Undrgrnd. '
4. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation '
9. Water Pipe-Undrgrnd.
10. Structural Floor System •
11. Property Sewer Line & House Connection ,
12. Sewer Cap .
13. Roof Drains
14. Rough Plumbing
15. Rough Electrical-Conduit '
16. Rough Electric Wiring �
�
77. Rough Wiring Sign ,
18. Rough EIeC[riCal-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Struciural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING
49. Electric Release to Ediso�
50. Gas Release to Southern California Gas Co
51. CERTlRCATE OF OCCUPANCY
No. Dace
JL & SPA
Inspector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical8onding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�7rap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor•Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem�Final
67. Fencing & Access Approval
66. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank � Gas O Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
�
�
viQir�
a
�
Date Inspector
OWNER ppOLLO DEVEOLOPMENT DATE 4-20-70
JOB ADDRESS 3359 Nevada Avenee BUILDING PERMIT N0. �� ���
GENERAL CONTRACTOR gy�e DESCRIPTIONofWORK Residence W/Attached Garage
APNo. _ LOT t4 TRACT 6694 FIREZONE VALUES37_764_00
SOIL
ROUGH PLUMBING
PROP. $WR. LINE
ROUGH NEATING ANO AIR CONOITIONING
TEMPORARY SERVICE OR POLE
UNOERGROUND � POWER �
ROUGH WIRING
TRENCHES �J FORMS � STEEL ftEINF.
FLOOR SYSTEM
60N0 BEAM � STEE� REINFORCE ❑
SHEATHING
FRAME ANO FLASHING
LATHING — IN n OUT n
PLASTER, BROWN COA �
HEATING. VENT.. REFRIG. AN� A.C.. F
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
�PR zz-,cP�'°ao� s6# *�* 159.75
CNSA
For Applicant to fill in Completely APPLICATION FOR BUILDING PERMIT
RECEI D� DAT RECEIVED DgT� ISSUED
ADORESS 3359 Nevada Ave. "� �� 7—a�` �
�� PERM{T.W
OWNER Apollo Development Corp. A.P. NO. .� !��%Li
MAII BUILDING
ADDRESS 1104 E, 17th Street ADDRESS 3359 Nevada Ave.
cirv Santa Ana nTio� 547-9673 TRACT 6694 �or 19 e�ocK
LENDER�ION U. S+� National Bank W ADD
X
BRANCH Main Office
ADDRE$$ 190 S, Broaclwa San Diego �WNERA ollo Develo ent Cor
VALUE
ARCHITECT Kermit Dorius rE�675-1164 S Residence s
OR ENGINEER N .
FIRE }y.
ADDRE55 3111 2nd Ave., Corona Del Mar 20NE TVPE GROUP r
APPROVED
CONTRACTOR [, 01.10 De el0 m nt C.OT BV DATE
ADDRESS 11O�F E,17th 5t. Z E NO.OF USE OF NE
cirv Santa Ana NOL547-9673 � P�-4N' � BUILDING w
STATE CITV �ARDSAPPROVED VARDSA PROV
LIC. NO. �I.SZS�FJ LIC. NO. 1�790 MAIN BUILDING ACCESSORY BUII ING
SIZE NO.OF BLOGS. (FFOM C/LSTREET)
OFLOT SO X LOO NOWONLOT �— ROM FT. FT.
VSE OF
EXISfING BLOG. �' S FT
N WBLDG. Z1OO S.F. R� MS 9 STORIES 2 L.SIDE ✓ FT. FT.
EXTERIOR WALLPianSr RO�F Wood Shin le
COVERING COVERING S REAR � FT. FT.
USE OF BUILDING AND WORK YO BE PERFORMED DI5TANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
Construct new residence with cuP # �aoveo
attached garage. aaaRoveo a
Q% �
I heraby acknowletlge that I have reatl this application antl state
t�et the ebove informetion is corlact entl agree to comply with
all lews regulatinB buildin8 constr�ction, and I shall not employ
any person in violation of the workman's compensetion laws of
xha Stata ot Celifornia. a !/ p a
I hereby certity thet 1 am proparly licansed as a tonttector untler
� ��� SQ. FT. � � J C
Me Stata of Calitornia Business entl Professions Cotle, Dlvislcn 3, THE AMOVNTSHOWN UNDER VALUATION IS FOR
Chepter 9, antl that such licansas Bra In (ull torca antl a�fett, or I TNE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLY: <
am ezempt from ffie provisions of the Staxe at Californla Businesz a
VALUATION /a j'rO �
antl PrOtassions Cotl iv�sion 3, Chepta� . J a
PERMIT FEE 5 C�
SIg^eture of �/ � a
Parmittae ��� 5 3/ /� / PLAN CHECK 5 ��i� E
/ G C
Authorizatl Ageni TOTAL FEE §/�/', �� u