HomeMy WebLinkAbout1726 NEW HAMPSHIRE DR - Building Permits �� MF CITY OF COSTA MESA
o aala A BUILDING DIVISION
F I .1.="'W ' DEVELOPMENT SERVICES DEPARTMENT
�• 4 PERMIT PERMIT NUMBER
'ter pgpj0fi \ E98-01294
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1726 NEW HAMPSHIRE DR Status: ISSUED'&JLJ7
Suite No Applied: 12/22/1998
Vicinity: Issued: 12/22/1998
Parcel Nunmber: 13961123
Applicant: CRUZ, JOE
Address: 1089 SAN PABLO CI
Phone:
COSTA MESA, CA ' Zip: 92626
Owner CRUZ,'JOE .
Address 1089 SAN PABLO
Phone: -
COSTA MESA,CA Zip: 92626 -
Contractor: -
Address: - _
•
. Phone:
, Zip:
License:
• SCOPE OF PERMIT
INSTALLATION OF NEW LIGHTS(7 KITCHEN&2 MSTR BDRM), 1 NEW SWITCH IN KITCHEN,2
OUTLETS IN KITCHEN&1 IN GARAGE. ,
FEE SUMMARY
• Quantity Quantity
ISSUE FEE $22.00 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 - Busway/100 ft / - $0.00 0• '
Res.a/c package $0.00 Standing Sectidn $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 - 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $9.00 9 up to 50 kva/kw $0.00 . 0
Recept Outlets $3.00 3 up to 100 kva/kw $0.00 0 '"
Switches $1.00 1 over 100 kva/kw $0.00 0 . •
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt - $0.00 0 ' .
Service to 200a - $0.00 0 Misc. Conduit $0.00 0
Service to 1000a $0.00 0 Misc. Conductor _ . $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride)" $0.00 0 i '
Motors to 1 hp - $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 . Christmas Tree Stand $0.00 0
Motors to 50hp $0.00 0 Fireworks Stand - $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection•Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $35.00
Intermed Pole $0.00 0
COMMENTS/SPECIAL CONDITIONS
EXPIRED
DATEt
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under 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.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS fl n
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to sell-Insure for workers'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 permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ 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 workers'
compensation laws of California,end agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES uP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS 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,and my license is in full
force and effect.Lic.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its 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 License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
`subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered 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 herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt• Business and Professions Code for this reason:
Signature: • r) Date: .1.72-Z1/47-zr
Owner ID verified by delve s license. L_../❑Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during 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 at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification end filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describl prop rty for insurp s I agree not to occupy or allow occupancy of any building authorized by this permityntil final inspection.
\ ./ o /7i/itZ L/l r
Sighaty'Of Legal Owner ( fc] Lr \ I r Date
And/Or Authorized Applicant 'a-' Date
CODE 6 INSPECTION TYPE DATE TEALS CODE! INSPFCTION TYPF DATE =ALA
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
2446-46
E e- �..�
ADDRESS OF NUM: 1726 NEW HAMPSHIRE DR WIT:
CITY OF COSTA MESA - BUILDING PERMIT
DMERSNAMEIFIGWtflI: WRIGHT, MAURICE E PERM NO: B 081203
ADmgEss 1726 NEW HAMPSHIRE DR
COSTA MESA,CA 92626 PERMIT NO: B 081203 PLAN CHECK NO: N GOVT: N SUPP: N
I
APPL.MAILING ADORES£ CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF WOOD SHING. RESTH & REROOF W/COMP . SQ FT: 5,130
ARCH.OR ENG.'S ADDRESS: BMT:
' CLAIM VALUE: 5, 130 . 00 CALC-VALUE: 5, 130 . 00 GROUP OCC: R-3 /
CONTRACTORS NAVE: TOM BYER ROOFING ( 714 ) 847-9332
CaDRACTORSMNLNO 17662 METZLER LN COMMENTS: X
ADDRESS: HUNTINGTON BEACH CA uc•No.: 575002 x x x x x x x x x x x x x X X X x x x X x x x x x x X X X x*****'**********st***************************.1t*****
92647 UNIT B ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force end effect.
C 732 Lie.CLASS: C39 IX.NO.: 575002 .5X12� 04 /97 MAIN BUILDING ACCESSORY BUILDING
6'}. c«Hnd« _� <1 t � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
°' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under penalty of perjury thatI am exempt m the Contractors License Law ler the
following reason(Sedbn 7031.5 Business and Professions Code:Any city or county which requires a permH to construct,alter,improve, PARKING RE PROV: PARCEL: 42545218 Z N E: REF NO
,olsh,or repeir any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he Or She t
ensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the PLANNING N TES> •E
APES and Professions Coded or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section - > •
.05 by any applicant for a permit subjects the applicant to a civil penalty of notmothan five hundred dollars M5001). '^**************:******************
ElI.as ovmer of the property or my employees with stages a their sole compensation,will do the work.and the stmclure is not intended D E V E' L O P M E N T SERVICES R V I C E S R E Q U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not applyto en owner of propend -
^
who bids or improves thereon,andy
who does such work himself or hereof or through his or her own employees,provided that such 7/ �'.-
improvements are not intended or offered for sale.If.however,the building or improvement is sold within one year of completion,the Le'
owrwr'buiier will have the burden of proving he or she did not build or improve for the purpose of sale). ZONING APPROVED fHY DATE:
❑ Proessions Codde:the TheCntt�radtads Li ennseively eLiaww ooees not aappplyo anownerof property whtors to consuva io be uilds i�mproothereon annd whoiness BUILDING APPROVED BY : DATE: ..7
contracts for ash projects with a contractor(s)fcenaed pursuant to the Contractors License Law). '/
Ellamexempt under Section: B.aP.C.,rormereason: APPLICATION PISSUED BY: � **********************4*DATE: ..
*************,************************** * * * **
Date: ower: LEGALIZATION:N F E E S U M'44-A-R Y STRUCTURAL EGMENT:Y
I do herebycertify that lam aware of end understand the requirements of California Health and Safety Code Sections 25505.nein.and
25534.and that I or any future building occupant will/wit not(circle one)need to comply with said stale codes and the requirements for
a permit forconstmdion or modification from theArOwlty Management Diana.Residential mrmnxlioneppirelnne are exemptfrom these BLDG PMT PLUMBING ELECTRIC' MECHANIC • FIRE SMIP/RES GRADING
provisions. PERMIT 112 . 25 ✓1 ' q'. i `+ 51
Dale: Applicant: U! 9 •t is SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the blowing declarations: PLAN �� �r %` Fr,
[have and a certificated content le self-insure for workem•compersation,es provided for by Sadiron 3700 of the Lebon ISSUEFEE
❑ BUILDING
ING-DIV > PERMIT ISSUE PLAN`CHECK 2.-.
TOTAL PAID DUE
Code,for the performance of the work for which this permit is issued.‘Ti(
/
(nava and wilt maintain workers'oompansaticn inawanro.mrequirod by Salim 3]00dthe Labor Code.f«the ped«menro of the TOTALS----> 112 . 76 0 . 00 ) 0 .00 .r 7 112 .76 112 . 76 . 00
carie:work for w ''s issued.hich this permileued.My workers compensation insurancecard
carrier end policy number are: -
STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED:: q .).112 .76 OVER/SHORT: 00
Policy Number: 2AS-96 CHAUT ?SS 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC ,FIRE SMIP/TOT GRADING PLAN-(`HECK
.section need not be completed l rhe plume is for one hundred dollars aloof«less./ 112 . 25 h. ei r U r ,?" . 51
❑ I certify that in the performance of the work for which this permit o issued.I shall not employ any penin in any manner so m to `%r / "Y /
become subject to the workers compensation lawn d California,and agree B I should become subject to the workers' *******************************************.***.****************************Nip***
panaation Drove alta of Section 3]00 of the Labor Cad�Arrdk(epbwdh.. .ply "•t •;
C 3- JJ INDIVIDUAL Fc`E�•E BREAKDOWN
•
req:Failure rosecureworkers' w
conpatlan coverage Is unlawful,and shall subject toyer rocriminal penalties and TYPE QTY D E S C R I P T I O ,N� .-„ UNIT COST TOTAL COST
CIO fines up to one hundred thousand dollars(3100,000A In addition to the cost of co damages es provided for in xs
' Section 370GoyMe Labor Coda Interest,and atromey'sfees. SFR 5130 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 130 . 00
CONSTRUCTION LENDING AGENCY: t hereby affirm under Penalty of perjury that there is a Construction lending agency for the END,. OF, FEES
performance of the work for which this permit is issued(Section 3097,Cis.C). n
LENDERS NAME:
I LENDER'S ADDRESS: / ,,� 1
I certify that I have read this application and stale that the above information is cared.I agree to corn*with all thy and county ordinances D!
and elate laws releting to building construction and hereby authorize representative°of this city lo enter upon the above-mentioned property
for inspection purposes.
(�`�
BRYAN WOLSKY ' T,.� rT,IAN 16 199) I
J Prim Name �, l�
°a1 CITY OF COSTA MESA
Signature d• ^n •• red« �j�
(5151-46.WP) White-Building&Safety;Green-File:Caney-Applicant:Pink-Revenue:Goldenrod-Assessor 'a�/
f APPROVALS Permit#- 'CONSTRUCTION AND PLANNING POOL.„-,,,SPA
- ,
Date Inspector ?�-`_ Date Inspector
• APPROVALS, Pe Ailt#•
.
- 1. Temporary Electrical Service or Pole • - . - 52. Pool & Equipment Location ' -
2. Soil Pipe-Undrgrnd. - .. 53. Steel Reinforcement -
::-C37'Electrical ConduTi,Utllit Un rnd. - _ 54. Forms s- : - - - t
4-Electrical Condu i-Undrgrnd. • 55'. Electrical Bonding i
...... 1-5;;;Steel Reinforcertient - 56. Rough Plumbing& Pressure Test';•• - r
4 :_6t�{�iectricalUFER'Grnii. ' - . . •• - 57. APPROV_AL.IDCOVER-GUNITE- • :
t:7 =Footings �.�� n - -58. Electrical Condp_itYUndrgrnd, - - x
=, I i •
I - [JFoundation ."„. '-2, - ; Sb 59. Gas Pipe, 0 Urldryrnd.;-Test a -
F I :_-9:::
Water Pipe-UndFgrniirl7; 7 60. Backwash Linesf P=Trap,.O Undrgrnd. .
, 1d Structural Floor System - ;61: APPROVAL TO:DECK
i 11.=Property Sewer Line & Hotise.Connectiort - - - 762. Backwash & Receptor-Final -
12. Sewer Cap - i ' 63. Heater & Vent-Final
Y •
•13. Roof Drains . - - 64. Plumbing System - Final •
14. Rough Plumbing; _ 65. Electrical-Final -
15. Rough ElectricatCopiiuit. ' = I • .
66: Solar System-Final -
16. Rough Electric Wiring,, o , - - '• ' -67', Ferieing & Acces.7.Appproval ,
17. Rough Wiring Sign : ;, `-68. APPROVED FOR-PLASTERING
-
18. Rough Electrical_T Bar Ceiling , . i 69. POOL/SPA SYSTEMS FINAL _ •
19. Rough Heating & Air Conditioning • • - - ' - FIRE DEPT. REQUIREMENT
- - - G c tr.-�4 c r -• r:
20. Rough Factory FiC place rii.--..i .
* ^ - cN > T
±»' APPROVALSDO Permit# * •
r_ .D kr :;:c, 't S tr W. Cl t; C CJ ti 47 t a
21. Ducts, inrStrueture. .. .. ;_I s _ s O ,-'.* '-t 70.Aindergrourtd ljvdro
22. Ducts, Ventilating- - 5 * S e; r1 71.•Produft,{,Piping't_•FGas 4 Oil
n c, t_it' c" 1
23. Gas Pipe-Rough &Test ° .`°n' `r"* F' ' ' -i-"' ` ? '�
,.- r•:_ z MI •:, .�t 72. Underground Fru*, ..-,
24. Roof Frarning l . . • D C r 752 Undergrnd.Sto�'ag2 nanl D Gas OVil
25. Roof Sheathing E^ J - r'hr '
C J vs/-/�7,1 : .- . . 74?-0verhea HYdro v�
26. T-Bar Ceiling (Structural) & Monocoat r m `7 tit 75; Dry Chemical r_ =: a '- el 5
. 1
27. Frani and Flashing , __N Y' `„ . y,* 76 rOry Standpipe�� - "�' C1 G
.' . J- ..-i, ,---: i.
: 28. Lathing&Siding ^K" r * 5-• •• • ••� 7T FIXED S^STE $INAJ tr
29. Insulation - t x m r5 78 FIRE PREV. FINAL ri r, ti
' 30. Drywall Nailing •• L.. * ' lHEALTH DEPT
+ ' � r -REQUIREMENT
31. Plaster Brown-Coat .. - + 1 Y - 79' FINAL RNSPECTTON '" C ' 72
, 32. Electrical Power Meter.1inal . * co l : 80t FOOD CERTIFICATE ISSUED
_ - - k , '- Cr u ID
J 33. FinatElectric; ' tr.; I : " Notes: ir =,i• * ,._. 0 r:r
ni 34. ,Fina Heating$ Air Conditioning i, * 1 r- /`L2 p e -/ rC G�
l i - N `f-m CO
35. 'final Gas'PipetTest• r r•C ti 't, ^ a .1.
•
.' 36. Hood:or Canopy = O� a . 'fie
-.Fra-p_ -'!%Q-/ '"r.-
vc _
-' 37. FinaVFactory Fireplace_ '`' • ii 4 ~i:
teg
1. 38. Final Plumbing _ _- •,- c 1 I x
39. Water'.Se/pica-Final '- i ix ,l r r - v_,... S S
n
_r 40. Gas Service-Final ,: 7) ,c.?- _ :4 ,., (i LI
C.3
41. Solar Domestit-FinaE = i.- '4 1 t r, aT `.1
x
-- 42. Backflow Preventer - 'r * i ' 1- ix ?E- • * q '"
- - .. ,ti:-,,._•
.-
i-
43, Backflow Irrigations >S Jr x`'"' '` O. -
Iv
:14. Landscape Irr7gatiori-Systemtz=,n p i7 - n e ry ,, _•
• - _ ^•' -- ^i. _ ,_. _ ; L. . -
;15. Sound Arttentiation* - i '• r ,-.••J
^46. Handica p,Regulation; r. •,-
..... = a cr Ci-, :S 1-
,J >-
,-
47.
47. FINAL STRUCTURE& BUILDING 2).-.41.7.-17 7-"-'S J l.• N.
48. FINAL PLANNING; - -_ . t* L_ L'n p-
49. Eieciric Release to Edison * . Jv c -c17, o,
l I 1
"50. Gas Release to Southern California-Gas Co - I l r; _, r • it;7.1 ,••-; ` nY
51. CERTIFICATE OF OCCUPANCY • K N
No. Date - t°
/b/ c� .,1TY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. l / S DATE 5-09 -7/
LOT NO. /8-
ADDRESS
8-
ADDRESS / 72 4 ,?w i44 .- 'S2';e a .
J
crit i,
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)
X.-�\R'�/ s 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.
BYv ' i/ eer i �Y
rchaser
0
we/�
B /
L.�.A.i.k.%ter
Developer an. or a•thorized
representat' e
Lender
?_n 7g Way -4-70crogO0 119* ***159.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIV /�% DA:1-5,R IVSD DATE ISSUED
BUILDING /' /V1"7
ADDRESS 1 726 New Hampshire Dr. PERMIT N6.)D
OWNER Modular Technology, Inc. A.P. NO. .. 'e..."='3
MAIL BUILDING 1726 New Hampshire Dr.
Z ' ADDRESS 1104 E. 17th St.
a 0 CITY Santa Ana TEL
)47-9673 TRACT 669 I LOT18 BLOCK
H Z
Z Q CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMOLISH
H LENDER U. S. National Bank
Oct •
X
J 0 BRANCH Main Office
cn OWNER Modular Technology, Inc.
ADDRESS 190 S. Broadway, San Diego
m-CO ARCHITECT TEL. USE Residence VALUE 17,700
J N OR ENGINEER Kermit Dorius NO. 675-1164 bili /��
UV) FIRE C
wCC ADDRESS 3111 2nd St. Corona Del Mar ZONE TYPE GROUP (///-�
aw
W Z APPROVED
J O CONTRACTOR Owner BY DATE
CO 2
J cc ADDRESS Same c(.
W w TEL. 7-�ZO E NO.OF qUSE OF NEW r
zCITY ''Same NO. 1 PLANS ' BUILDIN ist t c o,
W 0 STATELIC.NO.Y X690 YARDS
co LIC. MAIN BUILDING ACCESSORY BUILDING
NO. 252549 N
D O - (FROM C/L STREET)
SIZENO.OF BLDGS.
OF LOT 50 X 98 I NOW ON LOT -- FRONT .5--FT. FT.
USE OF
EXISTING BLDG. __ R SIDE O FT. FT.
H SIZE OF 2100 sf NO.OF 9 2
2 NEW BLDG. ROOMS STORIES L.SIDE 0 FT. FT.
Q EXTERIOR WP,�L ROOF (� -
U COVERING rer Plans COVERINGWOOd Shingle REAR ? 0 FTL _ FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
n'
a MAIN BLDGS. ACCESS. BLDGS.
O - VAR.#` I , a S `� r�DATE r
Construct new residence with attached VAR. # ...car-APPROVED S-�u'G
H APPROVED ���/
f/1 - garage. ABY 62_____A__,....7
Jr �/ / DATE / �- 2_ '70
z HOLD FOR SPECIAL REQUIREMENTS _
O
VI hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
H any person in violation of the workman's compensation laws of
V) the State of California.
✓J g v m
Z O`l SO. FT. 5J(y 1.9I hereby certify that I am properly licensed as a contractor under o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
m
Chapter 9, and that su�'lictenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the/pro miens of the Stat f California Business CC
and Professions Co , vision 3 C apte VALUATION / 0 N
azi PERMIT FEE $ /e9.e/ xJ
Signature of ��rl /� S
Permittee ` �.6/ ('.L�Qi(/ $ �,/� b / PLAN CHECK $ ,� �� E
Authorized Agent /// o
TOTAL FEE
$ /5-9;7,5 LL