The URL can be used to link to this page

Home My WebLink About786 NEWTON WAY - Building Permits�� I � Applicant to fill in all spaces exceot �hose within heavy eortler lines ana si9n all appropriate tleclaralions. Cir-Y OF COS7A M•�E/S�Qj CONSTRUCTION P/E��R`M,IT """ '""`�' "" ` """ NO � Project Address � /' n � � .�TON W 7 ' ' /�.� '�0� � • . . �� . ' � " ApplicanYs Mailing Address - ' ' t: �' TVPE OF CONSTRUCTION ' NEW'' �ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER' A P'# Owner'rName�� C��G' fLtLG �.•��+�- phone •Sa'��13 DESCFIPTIONOFWORK/USEOF-BLDG:'� - Address' - ��9"�'� - � � "� ' - � � 5 Main Building: Arch/Eng `License No. � TYPE OF PERMIT � � GRAOING . FOUNOATION - �STRVCTURAL „ . T Front - - �❑ TENANT � ELECTRJC�AL ❑ PLUMBING ❑ MECHANICAL Address = � /�+��p.�� , , � . - . � ' 8 Rear � ' COntfacroi'S Nam `� � % ' - Ph ne3_L7�.�J� �'OTHER . � ' ' � • �� ' � � �^ - ' A a2 �Iii�n�=,ni�!_t � L{//%( �.[:f'3 . PROJECT DESCRIPTION 5c1. Fr.� occuaANCv' - K Righc Address (ma I'na� � � - .: �, - ^��nu . CONSTRUCTIONTVPE � ' �VALUATION$ S Left' . City License No, 61 x. _, ZONE '� \ GRADING CU. VDS: 'ACRES - � p�ng. Ref. # • CICENSED CONTRACTOR DECLARATION i - - - I�hereby affirm that 1 am licensetl untle� provisions ot Cha�ter 9(commencing • Remaiks: �L� 3 _ V��i� ' - Planniny�NOtes: WIIh SECII00 J�DO) O1 ��V�5100 3 O} IhE BIlSIO255 dOtl GIOfC5510f15 COdE� dfld � my license is in full forc�?antl effect. . . ' . ; , ' � - ' � License Class `_'� � l%� Licen e Noi� .— ; Date ' `"7-k��i r��a� � � �� ' ' ' P UMBING'. � FEES � . WORKERS' COMPENSATION DECLARATION �T � . • 1 hereby�affirm tha[ I have a certificate o! mnsent to self= � Ba� Sink Showers � � insure or a certi�icate of Workers' Compensation Insurince or a certifietl copY thereof (Section ' a 3800, Lab. C.) � � . - " � , '�--- � - - " ', � " - - � Backflow�Preventer � - - -Service Sink � - -� „ � - Automatic Washer Policy No. Company ' Backflow Irrigation Sewer Cap� ' `�[ : Construction Pole Sub. 8 Certifietl copY is hereby (urnishe0. Certifietl copy is filetl with the city Buildinq Division. Bathtubs Sewe� Connection �% � Cooking Unit � Date � Applicant . � • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cla�ifi¢!5 SOIB! C0112Ct0�5 � Dishwasher (This section neetl not be completetl if tne permii is fo� one huntlr 00 � - less): . Dishwasher Solar Pipin9 ,' Dryers ❑Gas ❑Electric I certi(y tltat in the pertormance of tM1e work f ich [hi5 ln�t i5 i5 e I shall not emplOy any pefson in any manne! 5 to be me' b' to he D/iOkiOg FOUnt3in5 � $OIdI Tdnk � /.� I Fan Workers' qo nsatp w5 ot Califo�ni - , Date '�+ ��%�'�Si9nature - Floor Drains Swimming Pool w/Spa F.A.U. 'NOTICE: If, after making this tleclaration, you shoultl becom ubject o the ' , , Workers'_Compensationprovisions of the Labor Cotle, you must torthwith FloorSinks _ ._ . Urinal ' -- �. Fixtures � �� - comply with� such p�ovisions o� this permit shall be tleemetl rewketl. ' CONSTRUCTION � LENDING AGENCV Gas Service Outlets - WateF Closet � �- Device Boxes I hereby atfirm that there is a'mnstruction IenGing agency for the performance- ' of the work for which thi5 permit is issuetl (Section 309] Civ. CJ ' Lentle�'s Name � Intercepmrs . . Water,Heater _ Outlets Lentler's Atltlress ' Kitchen Sink Wa[er Service ' ' Switches OWNERBUILDER OECLARATION � , . I hefeby affirm'-that I am exempt from the Contratto!'s License Law tor thE Lav3LO1i25 � - �AUtO-Wash ' � Gdlbag¢ Di5po5al following reason (Section .7031.5 Business antl Professional Cotle: Any city or ' - wunry wnicn requires a permit to construct, alter, improve, tlemolish or,repair P-Trap ' � ' - Laundry TraYi= � � Generator 00.5 KW �5-15 1 th I� t t r Suth e�mit any structure, prwr to its azuance, a so reqwres e app ican o p �[o tile a si9netl statement that he/she is Ilcensetl'pur5udnt to the plovisions of � ROOf D(di(I5� ' � �� '-the Contractor'S License Law (Chapter 9.�commencing with Section ]000)bf-. � ' ' Division 3 of the' Business antl Profes5ion5 Cotle) o� that he/she is exempt - � - thevefrom antl the Dasis for the all¢9etl exemption. Any violation of Section � .. • ' - 9031.5 ,by, any applicant for a pe�mit subjects the appliGant .to a civll ..�enalty ot not more than five huntlretl tlollars (5500�. ' ' ' 3 1 ai owner of [he, property or my'employees with waqes as their sole � ReinSpeMioncFee $15 " � ISSue Fea � � _ $' _ 4412 6/07/B5 ____I�,p{7�„71 I i ��... .I _ , .�-- _ i d � ^ � � � ' � c" � ''i • - , _ ' . � C .'. i r_ , '. - - �; i i �" 1�. - ZOf18 - i,LL LL � : Accessory„Building �. � ' � �n I - ; c- - . . -• � � ' Z � - _ i� O _ ' � � � N I .. I .: � _ ' i ': � ; N � � � � �' G I - R Parking Req.)Provided , � ' - - E' � i i M ! L� j S t i • ' _ � � ' � - . ' ' I _ ELECTRICAL � , ' �FEES , i '� ` Trensformer ❑ 15-50 KW - ' -'�� - -- ❑ 50+KW � Meter up to 100 amps Meter ❑over 100 amps . ' Sub Panel � � �j (Jf Motors �0-7 HP �1'/: - B � ,Inc.Solar 09-15 HP 016-75+ - Microwave� - - Pole light � - Range Sign � i ; Stariding Sections V ', � . Trash Compactor ' n .comoensation, will tlo the work, antl the ztructure is not inten0etl or otteretl " Reinspectian F.ee !$15 � �ssue Fee� � '$ 3 for sa1e, (Section ��044, Business antl Professional Cotle: The Gontractor's � ' ' .. MECHANICAL FEES License �Law tloes not apoN to an owner of a property who builtls or improves ' '' ' DEVELOPMENT SERVICES REQUIREMENTS: ' ' ' lhe/eon, antl wM1o, Ooes such work himself/he�selt or through his or'he� own , gOilCf : • - � Hood o�� T E I� ❑ i ' employees, provitletl that such�improvements are mt intentle0 or otteretl tor . , VP ' � ! sale. It, however, the builtling.or improvement is soltl,within one year o� com- ' . ' Canopy . Type II ❑, '�' .- Za�ing Approved By Data oletion,�the owner will' have�tne buraen of proving ne/she tlitl not builtl or im- Duct - Under Ground � � -� � Building Approved By ' � � Date � � prove.tor [he purpose of sale). ' ' � ' %�/�/) � Dete�� ❑ I,'as,owner of the property, am exclusively contracting with licensetl con- Duct -Svuctural ' Refrig¢ration System � ;�: � � Appliption Issued By � tracto�s to construct the project (Section ]044, Business antl Professions Cotle: I � - The Convactor's License Law tloes mt apply to an.owner oi property who : ' Duct - Ventilating . ❑0.100,000 BTU ❑100,000 BTU � . SUMMARV OF FEES ' � � "builtls-or'improves thereon,'antl-.who contractsto� such projects with a con--� � - Y � - � � - '- - '- -- -- -' � �- -- � ---- - � - i -- � ' I � I �I � tracror(s) license pursu5nt�to�me�ConVactor's License Law). I am aware that � � ' � BUILDING PERMIT ;$ � SMIP. �$� prOof oi their Worker's Compensafion insurance shoultl be provitl¢tl to�me.� ; E%h3u5tS St¢m ❑ Multlpl¢ �� SystemRepair/Alteration 1 r• � 1 � � i � ! i � - � I PLAN CHECK , $ PERMIT ' � ❑�I'am exempt untler Section � B. & P. C. for tnis reason � i Firepl/Fact Bit. ICBO�# ' Pire Dampers � � i � . � i 1 ! ISSUANCE '$', '� � � ! ' ' � � ' PLUMBING ! $ I Date � � owner� 1 �� I Heating System & Ducting i Registers , � , � � � pLqN CHECK �25%' $ � ENERGY P.C. $ ' Iaws rel u rto bufltlf ig conz n Cuo { nd of{ fhi ' y'� to ente � upon �e ve- Pur . � i � � 1 � icense ar�55 � � , rev. 10/84 White - Builtling; Canary�Ap �- �0-100,OOOBSU�O�100,OOOBTI � � t ' f ' 1 i i . � i '�� I 3 I Reinspection Fee � h Pink - Accountin9: Golaenrotl - Assessor .._ _... — ,_'.i � � ! i 1 � 1 I � , Issue Fee � i � ELECTRICAL , � $ ' � ��OD GRADING 1 $ ' � I � ^ . I I � MICROFILM I $ I , PLAN CHECK 50%' $ , : � ' ; � 1 j � i � MECHANICAL �, $ � TOTALFEE $ � �S�OD I $ 3 I PLAN CHECK 25%; $� � . i � i � � r � . � , CONSTRUCTION AND PLANNING ' � POOL & SPA i.APPROVALS �Permit# � Date Inspector � AppROVAIS -Permit# Date Inspecto� . • 1. Temporary Electrical Service or Pole �' �� 52. Pool & Equipment Location � �2. Soil Pipe-Undrgrnd. � � �. •' 53. Steel Reinforcement � ' � 3. Electrical Conduit`Utility-Undrgmd.� ' � i• 54. Forms - 4.�Electrical Conduit'Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcerrient , � � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.' � � 57. APPROVAL TO COVER-GUNITE � 7. Footings ' 58. Electrical Conduit-Undrgrnd. " i' 8. Foundation , � I . . � 59. �Gas Pipe, O Undrgrnd., Test � . I �� 9. Water Pipe-Undrgrnd. � � � , 60. Backwash Cines, P-Trap, O Undrgrnd. � � � 10. Structural Floor System �. 61. APPROVAL TO DECK ' � 17. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final -' �12. Sewer Cap . .' • ' � ' �63. Heater & VenbFinal . � 13. Roof Drains � , ,�. �' - , 64. Plumbing System - Final " � 14. Rough Plumbing�� .' � 65. Electrical-Final - � 75. Rough Electrical-Conduit 66. Solar System-Final �16. Rough Electric Wiring 67. Fencing & Access Approval ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. �Rough Electrical-T Bar Ceiliqg � 69. POOUSPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# � 21. Ducts, in Struaure � 70. Underground Hydro � 22. Ducts, Ventilating ' � 71. Product Piping O Gas ❑ Oil � . 23. Gas Pipe-Rough & Test ��% 72. Underground Flush � � 24. Roof Framing ;"` '. - 73. Undergrnd.StorageTank �Gas ❑Oil � 25. Roof Sheathing � 74. Overhesd Hydro " 26. T-Bar Ceiling (Structural) & Monocoat . 75: Dry Chemical � � 27.'�rame and Flashing „ 76. Dry Standpipe � 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � - i 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � 33. Final Electric Notes: , 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 pomesticFinal � . . 42. Backflow Preventer � ' . I 43. Backflow Irrigation , _ , , 44. ,Landscape Irrigation System � 45. Sound Attenuation . • � � 46. Hand(cap Regulations -. , J _ , � � , 47. FINALSTRUCTURE&BUILDING � , 48. Special Requirements Completed . 49. Electrie Release to Edison , -• --� . 50. Gas Release to Southern California Gas Co ' � ', i 51. CERTIFICATE OF OCCUPANCY �� 7 , � No. ' Date ' � I . ". � � � , ' ' AOP��ant to fill in all spaees except tltose wilnin heavy bortler Ilnes an0 si9n all appropriate Oeclaralionz. onn�r n�n TRACT N[1 . I f1T N!1 i inii'r niY. � CITYOFCOSTAMES CONSTRUCTIONPERMIT . Project Atldress -7 �9 iGVew-j�w �.. �-` e Y,.� , ' ApplicanTs Mailing Address � Owner's Name �N`"'�+v""<+�.� �."Qr�t��i Phone 7 31 s`/:b ` Address \, 3�1� S'1��= ' �5�.��, �lo� Arch/Eng, License�No. � �� Address �� Contractor's Nam °�� " �� • Phone� ��x3K� .. Addresslmailin9) `��q�� ^`� '-� Qk GwK�.etiG. ^� City Licen�p No. I 5 lg� � ' � � LICENSED CONTRACTOR DECLARATION I hereby af�{rm that I am licensetl untle� p�ovislon5 ot Charfer 9(tommencing with sectio� �000) of Division 3 of the Business antl P�o(es5ion5 Cotle, antl . my license iy in full force antl etfect. LicenseCiass � 3L Licen No?SSyO� Da[e � ��_' $i9nature �—�'�^� WORKERS'COMVENSATION DECLARATION 1 hereby atfirm that I have a certiticate ot consent to self-insure or a certlticate . of Workers' Gompen5afion Inw�ance, Or a�-ce�tlfietl copY thereof (Section 3800, lzb. �,)�s-� �jr (�, �y� J ' PoIItY No. -T'� -� �-1 J ComPanY �L � `^.{�(l� eCertifietl topy I5 hereby furnizhetl. Certifietl �op� flletl with che city Building Di�jsian. � �ate 2 Applicant =� 1 �'' � EXEMPTIO FROM WORKERS' COMPENSATION DECLARATI � (This section neetl not be completetl it the oermlt is tor one huntlred ($300) or . less). , I certity that in the performance ot the work tor which this permit i5 is5uetl, I shall not employ any person in any manner so as fo become su0ject to the Workers' Compensatlon Laws ot California. . Date Signature 'NOTICE If, after makinq this tleclaratlon, you shoultl become subject to the Workers' Compensation provisions ot tbe Labor Cotle, you must forthwith romply wilh such provisions o� this permi[ Shall be tleemeE revoketl. CONSTRUCTION LENDING AGENCV , I hereby afll�m that there is a con5tructlon lentlinq a9en[y to� the OerformanCe � of the work for which this permit Is issuetl (Section 3097 Civ. C.) . Lentler's Name � OWNER BUILOEN bECLARATION - I hereby aftlrm thai I am exempt from the Contra�tor's License Law for the following reason (Section 7031.5 Business antl Protessional Cotle: Any city or county which requires a petmit to construci, alte�, Improve, tlemolish or repai� any sVucture, prio� to Its issuance, also �equires the appllcaM (or such permit to file a signetl statement that he/sM1e is litenzetl pur5uant to the provisions ot tM1e Contrador's License Law (Chapter 9(commencing witb Section 7000) of Division 3 ot tne Business antl Profezsions Code) or that he/she is exempt therefrom dnd the basis for the allegetl exemption. Any violation ot 5¢ctiOn ]031.5 by any applicant /or a permit subjects the applicant t0 a civil �endlty ot not more than five huntlretl tlollar5 ($500). 1, as oWner ot the propevty o� my-employe25 with wag¢5 as thei� sole com0ensation, will tlo the work, antl the structure is not intentleE or otferetl' tor sale (Section 7044, Business antl Protessional Cotle: The Contractor's' License LaW tloes no[ apply to an owner of a prope�ty who buittls or improves Ihereon, and wM10 tloes such work himself/herselt or through his or her own employees, Provitletl that such improvements are not Intendetl or offeretl for ��¢, �{� hoWeve�, the builtling or imp�ovement i5 Soltl within one yea� ot com- pletion, tne owner will have the burtlen oi proving he/she ditl not builtl or im- prova for the Purpose of sale). • ❑ I, as owner of tM1e property, am ezcluslvely cont�actinq with IlcenSetl con- tractorsto construct the praject (Section ]044, Bu5ine55'antl Proie55ions Cotle: Tbe ConVador's License Law does not apply to an owner of pwperty who builtls or imProves thereon, antl who contracts tor sucM1 projects with a con- tractor(s)'license pursuant ro the Coniractor's License Law�. I am aware tM1at proof ot [heir Worker'S COmpensation insurance shoultl be provltletl to me. ❑ I am exempt untler Section B. & P. C. /or this reason rS�i� TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER . ^ A p # DESCRIPTION OF WORK/USE OF BLDG. S Main Build E TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL % B Reaf ❑ �OTHER � J %� PROJECT DESCRIPTION SQ. FT. OCCUPANCY � C Right . K Left CONSTRUCTIONTVPE ' VALUATION$ $ ZONE GRAOING CU. VDS. ACRES . ping. Ref. �W Remarks: f�, Planning Notes Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher �rinking Fountains Floor Drains Floor Sinks s Servic Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee . $15 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL Blt. ICBO # � Date Owner Heating System & Ducting I hereby certify that I have �eatl tM1is applicatiOn antl StatE Mat lM1e above ❑0.100,000 BTU Ot00,0008T information is correct. I a9ree to comply with all city antl county orCinances antl state laws relating to builtlping const�uctiOn, antl h¢reby autho�ixe �ep�e- sentatives o� this city� e�upon the above-mentionetl property for inspection pu�Q ses. 1� �� Signature `�'�� Date/�' Drivers' Licen or 55 � � �� einspection Fee CMF 0865-46, rev. 30/84 White - Bulltling; Canary - Applicant Pink - Hccounting; Goltlenrotl - Assessor $15 Showers Service Sink Sewer Cap Sewer, Connection Solar Collectors � Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service AutO-WeSh Issue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeretion System ❑0-100,000 BTU ❑ 100,000 BT System Repair/Alteration �� FireDampers � . laue Fee FEES Z �938 IQ/25/Bk 5,00 Zone Accessory Building: Z O N I N G R Parking Req./Provided ' E Q M T S ELECTRICAL . � Automatic Washer Tiansformer ❑ 15-50 KW ConstructionPoleSub. ' � 50+KW Cooking Unit Meter ❑up to 700 amps ' Dishwasher Meter �over700amps Dryers ❑Gas ❑Electric Sub Panel Fan � Motors�0-1 HP �1A-8 F.A.U. Inc.Solar 09-15 HP �16-15+ Fixtures Microwave � Device Boxes Pole Light � Outlets Switches Garbage Dispoul Generator �0-5 KW 05-15 KW Sign ! Standing Sections Trash Compactor $ 3 I _ � Reinspectian Fee $15 luue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: Zonin9 APProved BY . Building Approved 8y Application Issued By �iLiC $ 3 FEES $ 3 , , SUMMARV OF FEES � BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � � , PLUMBING $ �•CX� ISSUANCE S PLAN CHECK 25% $ ENERG�' P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $� S•�O PLAN CHECK 25% $ ' City of Costa Mesa Building Safety DepaAment P. O. Box 317 Costa Mem, Californio CERTIFICATE OF OCCUPANCY N� 2615 C The Building located at `.{�_'��Q �jQCii �t°[$i' has been inspected and found to comply'with'the provisions of all City of Costa Mesa Ordincnces applicable Thereto for a Group ��? Occ�pancy. Use of Building � 3 �t ��' � � � — Legal Description �u�%3o �Y� �' � . � '�' . ' ' " (See rever�e side for Me�es ond Bound�) Building Permit No._.�� Eledrical Permit No. �T—� ,�—' --�-�- �_ Plumbing Permit No. �}�� _ Flpor Load Signs have been installed as Room Capacity $igns have been instaled as� req��red �nder Sec. 2305 U. B. C. . required under Sec. 3301 (1) U. 8. C. . 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcemenf agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occ�pancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apariments and/or guest rooms as req�ired under Sec. 17050.1 (d), California Administrative Code, Title B, Chapter 9, Article 8. ISSUED TO: Number of apartments_ and/or guest : �t7"4t..i8 Building Official This Certificate of Occupaney SHALL BE posTed in a conspicuous place on the preni except by The Building Official of the City of CosTa Mesa under Sec. 306 (e) U.B.C. /� and $�iiAlL NOT BE removed Form HU34--1M-11-G9—$-g p OWNER J, JOB ADDRESS GENERAL COD AP No. 116-. INSPECTIONS SOIL GAS' W ATER ROUGH PLUMBING PROP. $WR. LINE SPRINKLING SVST MISCELLANEOUS ROUGH HEATING ANO AIR CONOITIONING TEMPORARV SERVICE OR POl UNOERGROUNO � POWER ROIIGH WIRING FORMS I I STEEL REINF. FLOOft SVSTEM BON� BEAM � STEEL SHEATHING FRAME AND FLASHING LATHING — IN � OUT PLASTER, BROWN COAT STRUCTURAL. FINAL PLUM61t ELECTRI BUIL�IN FINAL ANO GAS TEST FINAI F Date DATE 5_2• BUILDING PE N of WORK Paint : � VALUE $ l.' SUBCONTRACTOR C�Z�] S a � �� Z . a U Z ZQ � N d m J7 J � Q W ¢'] J J m Q U N ZQ W � a �! WZ J Q m Z J � W W 0 = Z F- w� N � 70 �0346 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. eOX 7200 COSTA MESA. CALIFORNIA 92626 rato 13.00 ;i1.Y7_S-6�?cr;sr,OO?643 �i.�.';'� - APPLICATION FOR BUI DING PERMIT ForApplicanttoFillinCompletely RECEIVEDBV oqg ece e >p' DAT SUE ADIDflESS / p � � � 7 I �_ ' PER �r�NO. OWNER A.P. NO. MAIL /� BUILDING � ADDRESS / �G �( �+DDRE55 �' TRACT LOT� BLOCK. CITV ��/ NO. CONSTRUCTION y/� _ _ W A� T P LENDER �l (��1 [i BRANCH OWNE ADDRESS ' VALUE Y4 ARCHITECT TEL. S $I3�' � OR ENGINEER N . FIRE � ADDRESS 20NE TVPE GR P APPROVED CONTRACTOR BV DAT Z � ADDFESS TEL. ZON NO.O USE OF NEW CITV NO. �L� P�' BUILDING STATE CITV VARDSAPPROVED VAROSAPPROVED LIQ NO. LI0. NO. MAIN BUILDING ACCESSORN BUILDING SI2E NO.OF BLDCS. (FROM C/L STREET� OF LOT NOW ON LOT FRONT T FT. USE OF � - EXISTING BLDG. E 'FT SIZE OF NO. OF NEWBLOG.. ROOMS STORIES L.SIDE F FT. � EMERIOR WALL ROOF COVERING COVEFING REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLIX'aS. ACCESS. BLDGS. VAR.# DATE C.V.P.� APPROVED 1' r l � APPROV C�? 7�-C / \ 't J I hereby acknowletlga that I have read this application antl state that th¢ above information is correct antl agree to comply with all laws regulatinB building consttuction, antl I shall not amploy any person in violaiion of the workman's compensation laws of the State of Califomia. m b 1 hereby cartity ffiat I am prop¢rty licensed as a contractor untler SQ. FT. p the State of California Business antl Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR � Chaprer 9, antl that such licenses are in full force and effect, or I THE PURP�6E OF ESTABLISHING A PERMIT FEE ONLV: m am eaemp2 trom the provisions of the State of California Business VALUATION ¢ and Professions Code, Division 3, Chapter 9. . � � m PERMIT FEE $ �I .�� Signatura of / qN m Pefmittee .��{[�M l .(/�'N��'�� §% 2 �/„�� PLAN CHECK $ E / �U� � L,.v `o Authorized ABent LL TOTAL FEE $ � �' �Q322 ,! �_ . COSTA MESA BUILDING-SAFET7 DEPARTMENT P.O. BO% 7200 � COSTA MESA, CALIFORNIA 92lSE For Appllcanf fo FIII In Completoly TYPE OR PRINT ADDRE'88 �,7/V G'� � COSTA. MESA, CALIFORNIA n[ A �6_ � L.,L� � ��oOs . X CITY t'jw v K 1 f�) �j�=N ' uc No. �Z� �7v`t rTieL' J`id'9�i%b OP LOT I��+ � �� noW rn �� V U88 OR E%I6TIN0 BLOO. pETpACK L�Ni IROY � ceerten or cTRCR RiAR Y D� 6 � ... � . �.. / r�� 1 H!RlBY ACKNOWL6DI wno eiwT6 TXAT TNe PLY WITX ALL GITY BUILOINO CONBiRO IC SIGNATURE OP PERMITTEfi AUTHORIZQD AC[NT OF WORK � t�v -q-6ePA1D00 0�6# *�A CMSA 11Z.SC APPLICATION FOR PERMR BUILDINf3 For Offlce Um Only ZONING zan[ no. o� uca or Hsw t. FNOt3 �L Rzci' �un� Z euaoixa MhN��K -M-1 "°"` �rs 3� S�-G_ le. �l° 43�38 cucnimon A. P. NO. I I�- Z I I /� Tt s J- � NOTl: NO HAV6 OV[RNAN6 SHALL B6 Ll88 THAN DO• TO 8ID6 4 RBAR P. L. 8AVE8 ALLOWBD <U..B.C.R6QLLINHMENTI YAROHMPROVHD YARDSMPROVED MAIN BUILDINO ACCB9HOHY BUILDIN6 {PROMC LSI'R[LT) ' ��% PRONT FT. L%GJ�Gl W Rf. - -•-- —.-4-4a-69 � vwn.# RI / C. U. P. M b � APPRO' TN�B APPCIGTION IO AOPB[ TO COM- U1WD q[OUL/�TINO HOLD FOR SPECIA DATB ' Tf1C AMOUM BXOWN UHOBR V/ �UHPOBH OP 68TABL18HIN0 A VALUATION � / M,\ PEPMIT � / V s TOTP.L i a MENT'a � i L�rr � ? � IB FON TH8 j F86 O� N�Y. � S�• � � / V D iv �� r