HomeMy WebLinkAbout1742 NEW HAMPSHIRE DR - Building Permits CITY OF COSTA MESA
BUILDING DIVISION
F••' ;�I$ 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • w.vw.ci.costa-mesa.ca.us
01.411 • FOR INSPECTIONS CALL: (714)754-5626 Y
PERMIT NUMBER: B08-00234
PERMIT TYPE B_ROOF2STATUS: ISSUED
APN: 13961119 DATE ISSUED: 08/13/2008
.--ISSUED BY: RMD
•
JOB ADDRESS: 1742 NEW HAMPSHIRE DR CM Suite/Unit:
Vicinity: HOUSE AND GARAGE ROOF
Squares: 3200 - "` Valuation '$8,500.00
SCOPE OF WORK: TEAR OFF-(E)ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A`4:12 PITCHED.ROOF AND REROOF
WITH 50 YEAR CERTAINTEED.PJRESIDENTIAECOMP SHINGLES ON AN ATTACHED HOUSE AND:GARAGE,APPROX
32 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED.
OWNER: PELLETIER"CHARLES , - Address`. ' 1742 NEW HAMPSHIRE DR' Unit:
PHONE: 714-422-901.1 City/State/Zip:-COSTA�MESA CA '
APPLICANT: CHAMBERS DARRELL}l a Address: 414 N SHATTUCK PL. •y "" �� Unit :
PHONE: 714-771-0307 - City/State/Zip: ORANGE,CA
CONTRACTOR: SONRISE ROOFING INC •• — " ' • 1 • License No. -860521
Address: 414 N SHATTUCK PLUnitr; - PHONE: - - 714-422 8011 •
I+-
City/State/Zip: ORANGE,+CA 14: ' :92866 • - CELL ' •
ARCHITECT: . ,r - License No. "- PHONE::
ENGINEER: �, License No. _ ',PHONE:`
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee: <<-
TOTAL FEES
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28, §1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE N. INSPECTION TYPE DATE INTITIALS CODEN INSPECTION TYPE DATE IMTmALS�
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final •t /'' �/ 208 Final Plumbing
200 Final Re-Root 8-2!q-O/ 4Ne'l_ 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
,
WORKERS'COMPENSATION DECLARATIOK Owner ID verified by do lice. 3 Yes D.No ,
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' . Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
• ❑ I have and will maintain workers'compensation insurance, as required by .
section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:•
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
� by this permit,and that no building structure,scaffolding,falsework,a demolition
-T
Carrier: tt tAnlit or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
C " (TN sseclar need not be completed/the permits valued atone hundred dollars(3lW)or less)
2,Art 2,Sec.341,The 8,California Administrative Code).
CP.olicy Number: Soo103")"" 200g
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of
the Labor Code,I shall
�forthv)y�th comply with these provisions.
Applicant's Signature Date
<��� w.'-' •/Ing g^13 - a g Division of Industrial Safety Permit Number:
G • Sr
Applicants gnawre ., Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEYS FEES. Department by every business which has at any one lime during a reported
year a quantity of hazardous materials equal to or greater than a weight of
UCENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force^land effect. a registration form for acutely hazardous materials? ❑Yes 0 No
Licr# �' �pri / 1 Class# �'' RC/ (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
f1 -� ��� each business which at any one time has on hand a quantity of acutely
c a ors ignature -Date t 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 at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑ No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No
thereon,and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for 8. (If"yes",attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
UCENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a-contracta(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. •
the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this u permi foal ins/feet' n.
.�(� ./� x-0?- of'
nature of Legal.pmt rT'' Date
Signature Date `- 1 is /I //' , Tr. f- 12—Os
309-46(3/0]) ��7 Vr Y1�L'/� ��/��ttlly I��Vr O 1
—And/or Authorized Appticant . Dale
- . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF M/E7SA C�iNSTR /C�TION..PE Ty-�,, PER T ,y/ TRACT NO. . LOT NO. • UNIT NO. 1
'Project Address •1•/ •
�a. 'V� ^U��irPi_//o' f� �" ��• r I rr � m�
Applicant's Mailing[q/dress (J `6 [/ TYPE OF CONSTRUCTION•
Li-NEW LJ ADD U ALTERATION lf?REPAIR
• Owner's Name ori UBZ- Phone a (�. . ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - • ' . Zone
�z • DESCRIPTION OF WORK/USE OF BLDG..
Address • J �i 'S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT C7 GRADING ❑ OUNDATION ❑ STRUCTURAL T Front O
Address ����////��r�� ❑ TENANT ❑ ELECTRICALUMBING ❑ MECHANICAL B Rear N
Contractor's Nam• Lie; _ ' J// ., / Phone 'no'4 • ❑ OTHER - . - C Right N
- yy�� PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) �� /) A enx.17/1 CONSTRUCTION TYPE • - VALUATION $ g Left G
City License No. ��
E
ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref:# • Parking Req./Provided E
I hereby affirm-that I am licensed under provisions of Charter 9 (commencing Remarks: �j Planning Notes: Q M
with section 7000) of Division 3 of the Business and Professions Code, and �/ 1 Y 11fOQ T
my license is in full./ c and effect. p ry.y,a. 11,1 v �70V S
Licenzla;' License No. (��p 7 PLUMBING FEES
Date / Signature .
WORKERS' COMPENSATION DEC I N Bar Sink Showers ELECTRICALFEES
I hereby affirm that I have a certificate of consent to self-Insure or a certificate
Dov: workers' Compensation Insurance, or a certified copy thereof (Section Backflow Piev¢nter •
Service Sink
'M)' Automatic Washer Transformer ❑ 15-50 KW
x:00, Lab.�C/Jn qpp,L,.p
r �::.''licy No. /Q193f ag Company( �� • Backflow Irrigation • Sewer Cap Construction Pole Sub. 0 50+ KW�e le Certified copy is hereby furnished.
.. certifie c��o'yp,Y is filed with the city g�iltli � Bathtubs Sewer Connection Cooking Unit Meter Dud to 100 amps
Date 4� Applicant ,
EXE( PT ON FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or • •-
less). / Dishwasher Solar Piping ••d' --- Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I • ,
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of California. Motors ❑0.1 HP ❑1%-8 •
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
NOTICE:If,after making this declaration, you should become subject to the •
Workers''Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked. _
CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance _
of the work for which this permit is issued (Section 3097'Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name
' Lender's Address Kitchen Sink - Water Service Switches ' Sigri
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories . Auto-Wash - '
following reason (Section 7031.5 Business and Professional Code: Any city or • Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap• Laundry Trays • Generator ❑0-5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor _
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section'7000) of - --
Division 3 of the Business and Professions Code) or that he/she is exempt
• therefrom and the basis for the alleged exemption. Any violation of Section ,
131.5 by any applicant for a permit subjects the applicant to a civil I '
tatty of not more than five hundred dollars ($500). $ 3
4 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not intended or offered — Reinspection Fee I $15 Issue Fee - ,$.3
for sale'(Section 7044, Business and Professional Code: The Contractor's MECHANICAL • FEES - -
•
License Law does notapplyto an owner of a property'who builds or improves DEVELOPMENT SERVICES REQUIREMENTS:
thereon, and who does such work himself/herself or through his or her own Boiler Hood or T ¢I D
' employees, provided that such improvements are not Intended or offered foryp Zoning Approved By Date
sale. If, however, the building or Improvement is sold within one year of com- - Canopy Type II ❑
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By ' Date
prove for the purpose of sale).
0 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
tractors to construct the project (Section 7044,Business and Professions Code: -
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating . 00-100,000 BTU ❑100,000 BTU ' SUMMARY OF • '
' builds or improves thereon, and who contracts for such projects with a con-
-
tractoi(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑' System Repair/Alteration - V - BUILDING PERMIT $ -,, SMIP $
proof'of their Worker's Compensation insurance should be provided to me. -- PLAN CHECK $ /�j���.. PERMIT
0 lam exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers' - • i PLUMBING $ freffr i 0DISSUANCE $
Date owner - Heating System&Ducting • Registers PLAN CHECK 25% $ _ ENERGY P.C. $
l 'hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BTL— • ELECTRICAL $ GRADING $
• Information is correct. I agree to comply with all city and county ordinances -
and state laws relating to building construction,and hereby authorize repre-- PLAN CHECK 50% $ MICROFILM $-
, sentatives of this city to enter upon the above-mentioned property for '
•
inspection pur.. • MECHANICAL $ TOTAL FEE $ ��
Signature /jej, - •
Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING • POOL & SPA
- Date Inspector Date Inspector
APPROVALS;, Permit# APPROVALS Permit#
1: Temporary) Iectricel-Service or Pole 52. Pool & Equipment Location
i
1X/
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement , ex
3. Electrical Conduit Utility-Undrgrnd. 54. Forms ao
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' •
5. Steel Reinforcement:- 56. Rough Plumbing & Pressure.Test
6. Electrical_IJFER Grnd: 57. APPROVAL TO COVER---GUNITE
7. Footingsr..: 58. Electrical Conduit-Undrgrn.:
d.
8. Foundation; 59. Gas Pipe, 0 Undrgrnd.,Test '
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O:Undrgrnd. •
10. Structural Floor System 61. APPROVAL TO DECK ' .
11. Property Sewer Line & House Connection , 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
1 13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final . '
15. 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 Ceiling . 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ,' FIRE DEPT. REQUIREMENT
v
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank OGas O Oil
25. Roof Sheathing 74. Overhead Hydro ,�,I
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical [Iii.
27. Frame and Flashing 76. Dry Standpipe 'I1'.;t i S
28. Lathing & Siding 77. ,FIXED SYSTEM FINAL '[ •
29. Insulation ' 78. FIRE PREV. FINAL ' 1'? -
30. Drywall Nailing -. HEALTH DEPT. REQUIREMENT '
i -
31.-Plaster Brown Coat 79. FINAL INSPECTION
32. ElectricalPower Meter-Final 80. FOOD CERTIFICATE ISSUED .>✓
( r:
33. Final Electric Notes: •
34. Final Heating & Air Conditioning • . r�
• 35. Final Gas Pipe-Test - _ .
36. Hood or Canopy
37. Final-Factory Fireplace . . e, ' _ r/) ,
38. Final Plumbing 7•/q,Yk LED ;� -. .v ;y
39. Water Service-Final - - s 0
.
40. Gas Service-Final - -....3-,...
41. Solar Domestic-Final • O -
42. Backflow Preventer
1}_
43. Backflow Irrigation ' • ,,' i .., f�(�
. 44. Landscape Irrigation System , f!r
45. Sound Attenuation
46. Handicap Regulations - IV
47. FINAL STRUCTURE & BUILDING .: �,
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -.
51. CERTIFICATE OF OCCUPANCY
No, - - Date _ , r ' -
// / CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. D 6 � DATE -7 (
LOT NO. Z Z �J �/ ///J
ADDRESS / 711 Z `i /T�z a4 2, OA_
The developer of the above entitled tract desires to sell the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that (he-she-they)
(was or were) advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
BY
Purchaser /
B
Or 1r�
Developer and/o adrifarized
representative•
OWNER RODRIGU]EZ, Teresa DATE. 8-2-71
JOB ADDRESS 1742 New Hampsl : Drive B ING PERMIT NO. 33479
GENERAL CONTRACTOR D. W. Mc. arren DESCRIPTION of WORK ratio Cover
-AP No.139-611-19 LOT TRACT FIRE ZONE VALUE $800.00
INSPECTIONS Signature Date GROUP J TYPE 1V ZONE R-1
SOIL PERMITS ISSUED
SUBCONTRACTOR
\cAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE fl HOUSE CON. n
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CONDITIONING
• TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER n
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. 0
FLOOR SYSTEM ^
BOND BEAM n STEEL REINFORCE in
SHEATHING
FRAME AND FLASHING
LATHING — IN FT OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING. FINAL /7 _ do
-: 33479 A 30-71-EA1DO63023 v $,QO
COSTA MESA BUILDING-SAFETY DEPARTMENT - .
II P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 -
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECE I V� ey7 DATE RECEIVED • .
TE• r
BUILDING rj A " —�-7 •
ISSUEDJ
ADDRESS •�
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OWNER T�FS.r4 �� ��l+/!!« Ilfi➢anSt —��'
MAIL / 7y{ �„,k /0 /%/nc,wn .
z ADDRESS ••• I CEIP 'MVAIWAI . .
0 U CITY (43' 77,9 �J�, q NOL LOT x BLOCK
Z , In _. ..
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m J . ADDRESS VALUE •
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• WCL . ADDRESS gjjS' Gt)r /fiSa T4t5 S-�/ `%'•NE ///�TYPE1/y' GROUP - �J
J Z0 - CONTRACTOR der ( )C ���/ ,s 7&/ [♦j4 � BVPROV ED DATE 7� O�/ ..
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JCC ADDRESS -._H2 J "��� r
W-F PLANS USE ON N • /
0= •' - TEL. NO.OF� BUILDING
z �. , CITY NO. 3- ,/ 1 i/ -Lri
w 0 $ STATE / •
CITY YARDS APPROVED • YARDS APPROVED
rn Fc LIC.NO. c2c A 6 Y - LIC. NO.02:20 MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/L STREET,/SIZE - NO.OF BLDGS.
OF LOT NOW ON LOT i . FRONT (IA% `I FT.
USE OF
EXISTING BLDG. - r R SIDE d IFT.
I— SIZE OF NO.
•
/ OJ n A
Z NEW BLDG. ROOMS STORIES U
L.SIDE FT. FT.
Q EXTERIOR WALLROOF `�
O COVERING I COVERING . REAR /5 FT. FT. .
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& __ V
- . MAIN BLDGS. ACCESS. BLDGS.O.
_ •
o • /A X 3 3 ♦ ,966,7,77. Di .14 C U.P# APPROVED
/J -
APPROVED 0 J J// 7/ A /fir /
CON lt�� 4� •ATE U// `
/
U I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ •
CC
F any person in violation of the workman's compensation laws of
Co the State of California. b
I hereby certify that I em properly licensed as a contractor under • C
the State of California Business and Professions Code, Division 3, , THE AMOUNT SHOVVN UNDER VALUATION IS FOR $
Chapter 9, and that such licenses are in-full force and effect,or I THE PURPOSEOF ESTABLISHING A PERMIT • mm
cc
am exempt from the •rovisions of the State of California Business
and Professions Co.- •vision 3,Ch.•ter 9. VALUATION • n
• S
Signature of ///
• .. Permittee ., Ski ►� , , E
111 LL
Authorized Agent i ,
An, TOTAL FEE $
•
'3—. ami -Ii-7oP- OU 123* ***120.00
�?,U COSTA MESA
XE 200 CIOSDTING-SAFETY A MESA,CALIFORNIA A 9 626 DEPARTMENT
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECEQ��DB V DATE RECEIVED DATE ISSUED
BUILDING cVV� Aai -7D
ADDRESS 1742 New Hamshire Dr. PERMIT NO.
OWNER Modular Technology, Inc. A.P.NO. '7'].'.o7
I.
BUILDING
MAIL ADDRESS 1742 New Hampshire Dr.
Z ADDRESS 1104 E. 17th St.
d 0 CITY Santa Ana
TEL
547-9673 TRACT 6695 I LOT 22 BLOCK
1- Z
Z ct CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMO!ISH
-m LENDER U.S. National Bank X
J 7 BRANCH Main Office
-IN OWNER Modular Technology, Inc.
ro ADDRESS 190 S. Broadway, San Diego VALUE
J < ARCHITECT EKermit Dorius NO.L.675-1164 E Residence $ 13 300
5 C FIRE
WIZ ADDRESS 3111 2nd Ave. Corona Del Mar ZONE TYPE GROUP
al+
W Z APPROVED
J O CONTRACTOR Owner BY DATE
m z Same . ` , /tJ��_.
J cc ADDRESS A I - '
W W TEL. ZOit NO.OF USE OF
Zz CITY Same NO. 'J" \ 1 PLANS � BUILDING I
W- O STATE 252549 CITY 1690 VMAIDS N BUILDINGD ACCRD •SORV BUILDINGOVED
to CC LIC. NO. LIC. NO.
7 O (FROM CR.STR E ET)
SIZE OF LOT 53 x 91 I NO.OF BLDGS. --
NOW ON LOT FRONT •)✓FT. FT.
USE OF ///'��/
EXISTING BLDG. -- _R,SIDE t FT. ^ FT.
I— SIZE OF 1440 sf NO.OF 7 ] c ,{�
Z NEW BLDG. ROOMS STORIES L.SIDE /b FT. Wt.' FT.
EXTERIOR WAUL ROOF
V COVERING rer Plans COVERING Wood Shing$e _BEAR SFT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
1 MAIN BLDGS. ACCESS. BLDGS.
G-
Construct new residence with attached C U.P# �S G( gppROVED� L,
APPROVED � �� �//)
CO garage. By
C/-�v// DATE ` I— �'- / `�
O \ HOLD FOR SPECIAL REOUIREMENT5
V I hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
¢ all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
CI) the State of California. m
/Pyo 3
Z I hereby certify that I am properly licensed as a contractor under SO. FT m
the State of California Business and Professions Code, Division 3, THE AMOUNT OWN UNDER VALUATION IS FOR 5
Chapter 9, and that su icenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the r visions of he S f California Business m
VALUATION
and Professions Co ivisl �Q N
/7 a er of PERMIT FEE $ D
Signature of / �j �f m
Permittee C.V. y,i4.- $ pl fT PLAN CHECK $ 4/O E
ToO
LL
Authorized Agent TOTAL FEE $ / v-