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Home My WebLink About1730 NEW HAMPSHIRE DR - Building Permits • CITY OF COSTA MESA • .4. BUILDING DIVISION Fi �, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 '• www.ci.costa-mesa.ca.us �, FOR INSPECTIONS CALL: (714)754-5626 Sgt.cent ia>'F PERMIT NUMBER: B08-00339 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13961122 DATE ISSUED: 12/11/2008 ISSUED BY: BJK . JOB ADDRESS: 1730 NEW HAMPSHIRE DR CM -Suite/Unit Vicinity: PORTION OF REAR ROOF ' - . Squares: 500 - I ;Valuation [$1;500.00 SCOPE OF WORK: REROOF-PORTION OF.THE REAR OF AN EXISTING SFD ONLY:T/O-COMP,ROOF, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 15#FELT,APPLY.30-YEAR COMP SHINGLES."PITCH 4:12 500 SO FT - - - OWNER: ALEXANDER,STEVENB. . . Address: 1730 NEW HAMPSHIRE DR Unit: PHONE: -I ,•- ., -City/State/Zip: COSTA MESA,CA ii,, :i. . APPLICANT: VERANO IFAT Address:" Unit: : PHONE: 818.941.5305 . .�, "'" City/State/Zip: " CONTRACTOR: R L BUILDING AND CONSTRUCTION:INC - " License No: :'' 907956 • . - Address: 6340 COLDWATER CYN BLUnit: SUITE 208- PHONE: . 818-941-5305 City/State/Zip: VAN NUYS;CA 91401 - -CELL '.` sl ARCHITECT: License No - - PHONE ' • ENGINEER: License No. PHONE�::' FEE SUMMARY Reroof Plan Check: $0 00 r.=. -. Reroof Permit Fee: •'.$54.00 - . ' Reinspection Fee: $0.00 - ::, TOTAL FEES $54.00 4 . . . . . . , • 0 . • . 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 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/ INSPECTO T7PF DATE INTITIALS CODE/ INSPECTION TYPE D INTIIULS 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 to , WORKERS'COMPENSATION DECLARATION: . Owner ID verified by driv 'cense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Drivers License No. Expires: 0 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 foe(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,or demolition Carrier or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Th deco need rot be completed a the peant is valued at one hundred dollars($100)or leu) 2,Ant Sec.341,Title 8,California Administrative Code). Poli Number: ❑ As owner-builder, I will not employ anyone to do work which would C> I certify that in the performance of 81- •rk for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any.r rson ii . y manner so as to become subject such person has a permit to do such work from the division. to the workers' compensatio I. .f California, and agree that if I should become subject to the worke s':••mpensation provisions of Section 3700 of the Labor Code, I shall forth h t•mply with these provisions. Applicant's Signature Date SA Applicant's jo? Division of Industrial Safety Permit Number: Appliram's Signature 1 47_ te^ 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? El 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 ATTORNEY'S FEES. 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 LICENSED 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'he Bus''ess 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 and eff:ct t a registration form for acutely hazardous materials? 0 Yes ❑ No cCic..#} 01 / Class,#_- ) (Section 25533 of the California Health and Safety Code, with some �' 1.2 in , exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signal a l. -Date • 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 i5 issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lenders Name: hazardous materials)? 1:1Yes ElNo (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 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested 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 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 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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 thatunder: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 .city ordinances regarding Hazardous Materials and Emissions. ❑ l;'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 - ' Signature Date • property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMP IANCE A AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). , , certify under penalty of perj ry hat I •-ve read this application and state that the information given is co -c. I a. ee to comply with all state laws and city ❑ I am exempt under sec. ordinances relating to buildi • o .truction, and authorize representatives of Business and Professions Code for this reason: • the City of Costa Mesa •11'j : upon the above-described property for inspection purposes. I a•re ';. k.• occupy or allow occupancy of any building authorized by this permit'\n tib- pection. , , a�/l Signature of Legal 1•-r('• Dat Signature Date ��,\ 1110 �305]G6(3/07) And/or Authorized A•pli:.• t .Dai .1 4 ., i , . Y, CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 fj #1 II 1 y$; DEVELOPMENT SERVICES DEPARTMENT • BUILDING DIVISION ��-1pgPJ1RGR��\9, COURTESY NOTICE OF PERMIT EXPIRATION January 11, 2010 PLEASE DISREGARD PREVIOUS LETTER WRONG PERMIT NUMBER WAS PROVIDED! Steven B. Alexander 1730 New Hampshire Drive Costa Mesa, CA 92626 PERMIT NUMBERS: B08-00339 1730 New Hampshire Dr., Costa Mesa, CA FOR: Re-roof Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of the last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on January 22, 2010.. Additional fees will be required to finalize expired permits. Requesting an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requesting an extension -If you wish to request an extension, requests must be made in writing addressed to Bill Nunes, Chief of Inspection at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. n^ ^ Sincerely,� Barbara J. wart Office Specialist II cc: RL Building & Construction Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 LAY l7i A\TSA ARSE . Trun(71 A\7Fa.c a4 • ,AAAA,ri rncla.mnca ra ac 44014*- CITY OF COSTA MESA F�fj e 6 P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 j . G IF fig.Ji' 2,i y)7 , -.D. DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION . January 11, 2010 Steven B. Alexander 1730 New Hampshire Drive Costa Mesa, CA 92626 0 PERMIT NUMBERS: BCSS-f� 1730 New Hampshire., Costa Mesa, CA FOR: Re-roof • • Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of the last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have • they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on January 22, 2010. Additional fees will be required to finalize expired permits. • Requesting an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requesting an extension -If you wish to request an extension, requests must be made in writing addressed to Bill Nunes, Chief of Inspection at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, 04,1 1 Barbara J rt Office Specialist II cc: R L Building & Construction Inc. Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD H141759-5244 • www.ci.costa-meso ca.us CITY OF COSTA MESA �, ' �� BUILDING DIVISION • :1,.:,-t. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa:ca.us P.1 n. FOR INSPECTIONS CALL:(714)754-5826 PERMIT NUMBER: BC08-00567 • • PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 12/11/2008 - : - •, ISSUED BY: BJK • JOB ADDRESS: 1730 NEW HAMPSHIRE OR CM SuitelUnrt:,; � . • APN: 13961122 Vicinity: FAMILY ROOM - - "PrimaryOcc: 'R-3 , - Const Type: V-B -SQ. FTi 322 - Valuation':. ' $22,000.00. . SCOPE OF WORK: INTERIOR'414SF REMODEL OF AN EXISTING FAMILY ROOM TO CONSTRUCTW'ALLS TO REPLACE GLASS WALLS, REPLACE SLIDER DOORS WITH FRENCH DOORS &WINDOWS. ELEG3 OUTLETS- OWNER: ALEXANDER,,STEVEN B Address:. - 1730:NEW HAMPSHIRE DR Unit: Phone: City/State/Zip:.,'COSTA MESA,CA APPLICANT: VERANO, !FAT :AO -- Address: t''�1 Unit • Phone: 818-941-5305 - City/State/zZip: - CONTRACTOR: R L BUILDING A ND CONSTRUCTION INC ` License Na. 907956 `. Phone: 818-941-5305 v - Address: 6340 COLDWATER CYN BLUnit:- SUITE 208 Cell: City/State: VAN NUYS, CA ZipCode 91401 ARCHITECT: ,: , + License No. - - PHONE 'Cr ENGINEER: License No. .- . PHONE:'- COMBINATION PERMIT!FEE SUMMARY Building Plan Check: $227.01 . • Building Fees: ..._$34925 .. " Electrical Fees: $3:30 Mechanical Fees: $0:00 Plumbing Fees: $0 00 - SMIP Residential: - Is)$2 0 : - - . . SMTP Commercial: $0 00 TOTAL FEES: $58116. . - ••Refer to fee receipts for all fees paid for project - - 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 II. ermit.-CODES. INSPECTIONIYPE Drt INTIMLS CODES INSPECTION TYPE - PL& IN11TIALS 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 • 2O" (XJ(/t6 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive..-ncense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 0 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,or demolition Carrier or dismantling thereof,will be more than thirty-six(36)feet high.(Chap. 3.2.Gm (Thlss need not be competed the permit is valued at one hundred dollars($100)w leu) 2,Art 2Sec.341,Title B,California Administrative Code). Polio umber: 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performan.- 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 •ers. in a .nner so as to become subject such person has a permit to do such work from the division. to the workers' compensatio a • alifomia, and agree that if I should become subject to the work. s', pensation provisions of Section 3700 of Applicant's Signature Dale the Labor Code.I shall fort 't• omply with these provisions. ,r �70 /D p Division of Industrial Safety Permit Number: Applicant's Sig /ure Dai 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? 0 Yes 0 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 ATTORNEY'S FEES. 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 LICENSED 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 and -ffect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# / ! -/ ' lass#c exceptions, 25533 re the CaliforniatiHealth a SafetysaCode, with sometb J�/ n exceptions, requires registration with the Costa Mesa Fire Department by w- r Z /DY each business which at any one time has on hand a quantity of acutely Contractor's Signal e Date I/ 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)? 0 Yes 0 No (Section 25534 of the Califomia 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 Califomia OWNER-BUILDER DECLARATIONS: • Health and Safety Code been fully complied with? ❑Yes ❑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 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 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? 0 Yes ❑ No thereon,and who does such work himself.or herself or through his or her own 8 (If"yes", attach certificate of'compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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 properly, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. ' El I, as owner of the LICENSED 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 contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building co struction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to entz upon the above-described property for inspection purposes. I agree no ti occupy or allow occupancy of any building authorized by this permit until f r al •eclion. Signature of Legal Own. 11 Dat Signature Date 151 )2 O O 3057-46(3E07) And/or Authonzed Arca' - D e • CITY OF COSTA MESA REQUE. FOR OCCUPANCY TRACT NO. it.; 65-1 DATE LOT NO. / g n ADDRESS / 7 30 by DA . • 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 holdthe city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the, aforementioned uncompleted condition. • .43 BY 4, 6e-4-• r,/. ; P chaser // B& Developer a /or authorizes represents ive • 'Len er .-"em2qi3 -0C 4 L'':._.,,. PA Nov -IA-705E-0o 120* ***141.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely gECEI D B DATE RE^CEIVED DATE ISSUED BUILDING /( /�.–ad-7� ADDRESS 1740 New Hampshire Dr. PERMIT N OWNER Modular Technology, Inc. A.P. NO. "�r7,R^O MAIL BUILDING Z ADDRESS 1104 E. 17th St. ADDRESS 1730 New Hampshire Dr. 0- 0 CITY Santa Ana wiii TEL 5j47- 9673 TRACT 6695 I LOT 19 BLOCK. I– Z Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH Q- N LENDER U. S. National Bank X a m J N BRANCH Main Office w 190 S. Broadway, San Diego OWNER Modular Technology, Inc. a CO J ADDRESS / y) VALUE ' -CO ARCHITECT J Q OR ENGINEER Kermit Dorius TEL.. 675-1164 u5 ence $16,000 Z< FIRE v 1✓ w 2 ADDRESS 3111 2nd Ave. Corona Del Mar ZONE TYPE GROUP LY" // d W APPROVED V W Z CONTRACTOR Owner BY DATE J O m 2 Same E J Ir ADDRESS Ill w TEL. ZONE NO.OF USE OF NL / 0= CITY Same NO. (PLANS „` – BUILDING r Zi– cn O LIC.STATE o. 252549 LIC. NO.Y X690 YARDSMAIBUILDING YARDS ACCESSORY BUILDINGD – SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT 50 x 98 I NOW ON LOT -- FRONT 3 SFT. FT. USE OF EXISTING BLDG. -- R.SIDE O ET FT. – I– SIZE OF 1770 sf NO.OF 7 1 /O Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. Q EXTERIOR WALL ROOF V COVERING Per PJ arts _ COVERING WoQ_d Shinglg REAR � FT.±– FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL MAIN SLOGS. _ACCESS.SLOGS. GS._ Q Construct new residence with attached VAR.#V-mss &(D APPROVED TE c_.----____)4_& —�KJ 0 N APPROVED � – _ CO garage. BY [T vim/ DATE / I –? 7v Z HOLD FOR SPECIAL P,EOUIREMENT. 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 F- any person in violation of the workman's compensation laws of – fA the State of California. /7�� 4/f3 eo B zhereby certify that I am properly licensed as a contractor under SQ. FT p the State of California Business and Professions Code, Division 3, THE AMOUN OWN UNDER VALUATION IS FOR Chapter 9, and that'tic /licenses are In ful force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from th' p ovisions the St of California Business g: VALUATION and Professions C de Nish, ,Chap r . p,.i/ co PERMIT FEE $ /7 D Signature of / ��/D �/^7 m Permittee fw / fipg/J $ 076 / PLAN CHECK $ ! / - E 0 Authorized Agent u TOTAL FEE $ //141/—