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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 ' ... Plombirto r Z . aU F2 Z � O v� am J � J N 0] J m J Q U N Za W � aw WZ J 0 m Z J � ww 0 z �._. w� N � � � ;� � e;7!� 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