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HomeMy WebLinkAbout1859 ORANGE AVE - Building Permits 'PROJECT ADDRESS: UNIT: 060218 •" owxNRsxaME: 1859 ORANGE AV A CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B ADDRESS: VILE, JUDD MASON VILE, DOLORES E PERMIT NO: B 060218 PLAN CHECK NO: - N GOVT: N SUPP: N 1859 ORANGE AVE #A COSTA MESA,CA 92627 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR OTH � 695-0983 ARCH/ENGINEER: flFC.NO.: JOB DESCRIPTION : REROOF 0/1 LAYER W/FIBERGLASS SHINGLES SQ FT: 1, 075 ADDRESS: UNIT: CLAIM VALUE: 1, 075. 00 CALC-VALUE: 1,075.00 GROUP OCC: R-3 / PERMITTEE: JUDD VILE (714 ) 645-0983 ADDRESS: 1859 ORANGE AVENUE COMMENTS; SMOKE DETECTOR REQUIRED IN ALL ROOM PRIOR TO FINAL COSTA MESA CA 92627-2845 ***;PSP***;E****************** ********SP;ESP**************************************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sen-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab. C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ; PROV: PARCEL: 42523309 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > 'ate: Applicant: ********************************************************************,*********** .XEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E M E "N<T.. S 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. ZONING APPROVED BY DATE: 'f ..'r Date: Signature: ll ,NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: I:i� Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / ([,.��/ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: • ( DATE: l1 ` L/ which this permit is issued(Section 3097.Civ.C). **********************7E* ******** ****************4************** ******* LENDER: *******************************************************************Rk*********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y - OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 27. 00 . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES pursuant to the provisions of the Contractors'State License law(Chapter 9(commencing with Section 7000)of Division 3 of the Business f i and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN - - <_ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE ,,, BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the I , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 27. 50 0.00 %: 0.00 2 7. 50 2 7. 50 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through G,, ' his or her own employees,provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED: 27. 50 OVER/SHORT: 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG27PMMTT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL ,.-,FEE BREAKDOWN K) I am exempt under Section:BP7044 B.SP.C. -4 lorthis reason: ALL WORK BY OWNER �F/ I �L� ,/ //� TYPE QTY D E S C R I P T I O N,.-• UNIT COST TOTAL COST Dale •V FAC.1. 1't v V LI.Y.• �— ���y�� Z� owner: SFR 1075 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 1 , 075 . 00 do hereby enify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ' END OF FEES I25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a I. permit for construction or modification from the Air Quality Management Dislr ct.Residential construction applications are exempt from these provision/J ` , /� er Date: It if /f Z Applicant: (7(J# t'� I hereby certify that I///have read this application and slate that the above information is correct.I agree to comply with all city and county . ordinances and state laws relating to building construction and hereby authorize representatives f this city to enter upon the above-mentioned property for inspection our / o5e5. \Date: I 1 7+Z Signature: e"--‘111 12 // / -D„( \ �p �•, - _ _n _ Driver's License or Social Security#: 1641-46 Whee—Building,Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor .4 - - , - - POOL & Si ,.r - ' CONSTRUCTION AND PLANNING s ' 'APPROVALS Permit'# Date Inspector APPROVALS Permit # Date Inspector • 1.-Temporary Electrical Service or Pole • 52. Pool & Equipment Location • 2. SoiltZpe-Undrgcnd.. 53.Steel Reinforcement �`� k - - -3;-EIt:4dical Condp�t . ility-Undrgrnd. 54. Forms r';r A: t4: Elgct l ConduiFUndrgrnd. • 55. Electrical Bonding p r n ; ; StLa6f einforcem8fifd 56, 'Rough Plumbing & Pressure TE>L o _6:Z•Qac(rlcal UF CA Grad. 57. APPROVAL TO COVER-GUNifE r- r�-.r • . . - a ..• mf -� ings `•' 58. Electrical Conduit-Undrgrnd. y �.. >t thoundation j _ 59. Gas Pipe, D Undrgrnd-, Test c '.;' - `4- •Y 7- . 9. W%ter Pipe-UndrgEtd. 60.:Backwash Lines, P-Trap, 0 Unditrnd. J .r - 10. Structural Floor System _ 61. APPROVAL TO DECK - . 11. Property Sewer Lin & House Connection 62et < . Backwash & Receptor-Final - . 12. Sev&r CaP y 63. Heater & Vent Final 13. Roof Drains 64. Plumbing System - Final . • 14. Rough Plumbic 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electricifyirili'g - 67. Fencing & Access Approval • ` 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING n• 18. Rough Electric-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT C "--i vc C" :r o r+s= ^,, 20.rtoCS9h gct! Itlace i stn �'"' Z �. E In':!. r •PPR Vd 0`9erTitit# '',,K, 5' tr 5 $ 7 SM x'v K: S 7x Ar V,•JY - 21.Duets,irrStrgcturg* l .• -• `.:S * S C -+- * .70. ULndergtoimttHy&ro c �•� 22.1Dus�s, VdntWtirti"-F I r� x tr . ,15 -='I1. Product • iItg 0t D JiI 23.`-Gatlipalo�h &• est I ir5 r..en tT 4 p> x 72. Underground Flush:N c F C 24-cRodt Flamingn z ' F=ig v1-• x > C s r r `,73F_Undergrnt Storig4k ]Gas D CH 25. Roc1:,Shriathin x,: x ,:; ^ O N* x ct vQE^c-, x 9 r, % v :04 r 74,;Q.verhead HY dro• x 26^T-Bar Ceiling (Strootural) &S'Iettocoat x td - tnx .s 75- Dry Chemical - "'. C ;C 27. rarj'e a9d F,lashiriga :7._-. XIn, >. wx x 76.`rdry Stand.p pe :-s ntrj q 8.--‘1..atfzing 5sin , YS •• -- • * x 77FIXED Sn7p NAL"- y "rx =2� � -. • .. x'29. Insulati J M"` _ JI) 9n *" S -• •• '� Vit`' R x 78ZFIRE PREY. FIfUFyp- > ,� y 590. Drywall.�aitttg n* HE�ALTH'OEPT:REQUIREMENT c.,31. Plaster �ovvn,Ccie: .r.P.T. �` 1r79 r"FINAL IN CTI f'J M ` ' r-- -32.trElectricai Power Metett•Final' J i v . -?80.: CERTIFICATE ISSUED N .^ x h• • V _33?irlf Eictrit ' Tt X Nos 3 t.Np < - `r x:34;f inlr' HE$ting& At Conditioner i r_, UM I \ all S �� I x C• 35�TFinatGasPipe-Testi v y x ® x n 0 i> . tr 4 so i•. a CI .. x r L - =a t. :-T a: E-te :v X36 Hoed or;(anoPY )y I tTT 4• II In x : >., l•,o <rn Illa -n -37 rFinal Frit'ory Fir dlace� I 'r -, Y• r; { ; i z x - -T } learn n n.. `• T x N .. .. u) Y. lJ c �. ti .. .- C - :_38- Final Plyfnbing 7> N ..' * • x S `c K S C �C 9. WetBr Service=Finale -• x � * y n IA Cs? x w ,� G r••• >7. I s: -y f >. J, - # a `A0. Gas Sert~1pe-FnaF . Tt ,-y..- Co....- ^N x ' '=41. Solar Do- Flis-F-tal C_' •• * Ca * r BSc .# C r42rtackfloWPreventgr;; �; ;� 1 X j PPOJEC'�'AOORESS: 1859 ORANGE AV UNIX: B CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 059848 OWNER'S NAME: VIL2., JUDD MASON %> ADDREssVILE, DOLORES E PERMIT NO: B 059848 PLAN CHECK NO: N GOVT: N SUPP: N • 1859 ORANGE AVE • COSTA MESA, CA 92627 • CONSTRUCTION TYPE; V-N PERMIT TYPE: STR PURPOSE: ALT 645-0983 /.layer ARCH/ENGINEER: REG.NO.: JOBDESCRIPTION : i 70ri REROOF W/FIBERGLASS SHINGLES SQ FT: 1 , 600 ADDRESS: UNIT: CLAIM VALUE; 1 , 600 . 00 CALC-VALUE: 1, 600 , 00 GROUP OCC; R-1 / ' PERMITTEE: JUDD VILE ( 714 ) 645-0983 - ADDRESS: 1859 ORANGE AVENUE COMMENTS: SMOKE DETECTOR REQUIRED - ' • COSTA MESA CA 92627-2845 ***********-x** L******.**.Xx*.* ..x-*************-**** r****-x ***ac-*******x*************rE* • LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S - ' CITY LIC.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN F'RN1`: FT IN REAR: FT IN ' ` • ,Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT. IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV; PARCEL : '4252 -9 G E: REF NO: 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > • nate: Applicant: *************************************************-*******BP***********nL*****BE**!ti* • :MPTION FROM WORKERS'COMPENSATION DECLARATION:. (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENS -edify that in the performance of the work for which this permit is issued,I shaft not employ any person in any manner so as 10 become • subject to the Workers Compensation Laws of California.; ZONING APPROVED BY DATE: ,<y Date: _ -Signature: r. NOTICE:n,after making this declaration,you should become subject to the Workers'Compensation provisions of the labor BUILDING APPROVED B Y 4 —t DATE , 1. Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 'r _ , /ir 1 72?' _G '� / CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y' / I�- DATE:: / f v • which this permit is issued(Section 3097.Civ.,Cl. ******************************x* *****' *ft*************************** * re<*,r*** LENDER: ***************************iE*******-]E**********!(-!E****iE********1-***!t* E********* ADDRESS: - LEGALIZATION: N F E E S U M M A Y • • STRUCTUFfS.) SEGMENT;Y ..., 52 • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANLC\ \' .FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 37 , 00 ,50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SNIP%NON-RES ' pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ' and Professions Code)or that he/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). ISSUE FEE " ' I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS----> 37 . 50 0 . 00 _ 0 . 00 37, 50 ' 37 . 50 . 00 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or 'REVENUE DIVISION TOTALS--> • COLLECTED : 37. 50 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the.burden of proving he/she did not build or improve for the purpose ofsale). • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 37' 0 0 - • - . 50 • ' r • and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). l am aware *****->t***************')F***%7F*fE********* %'**********'k'**#f'*********H'****K*****3p*9(•kE* that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L . ' F E E BREAKDOWN ❑ I am exempt under Section: B.A.P.C. • for reason: TYPE QTY DESCRIPTIO N' UNIT COST TOTAL COST ^, --wle. fi (C�/f 7 ahadSafeoedS SFR 1600 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 1 , 600 , 00 .1 do hereby c�y that I am aware of and understand the regwreme rnia Hections 25505,25533,and ;END N]0 OF FEES ..\ /25534 and that I or any future building occupant will/will not(circ) e)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Manage t District.Residential construction application are exempt from these e: provision GD , / / �� Date: I rJ / /7- L ApPlicam: ��[ /fy( — L/�/(�eI I hereby cer�fy that I read this application and state th a above information is correct.I agree to comply with all city and county 'ordinances and state laws relating to building construction hereby authorize representatives of this city to enter upo the above-m ned - property for inspection p rposes. ///) ® 1y/� //lam/�/L/ • - ,Date: �4 Signature: / / -7Y`�l4 .4 < _ Driver's License or tial Security a: � I u i• ', ' 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor IIIIPF i CONSTRUCTION AND PLANNING POOL & Sr 'APPROVALS Permit Date Inspector APPROVALS Permit;, • Date Inspector n 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. •Forms • 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 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 ' 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 • - • 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 0Oil 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing& SidingI I 77. FIXED SYSTEM FINAL t ' 29. Insulation I 78. FIRE PREY. FINAL . 30. Drywall NailingL + HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION i 32. Electrical Power Meter-Final I - j 80. FOOD CERTIFICATE I. UED ear Jq /-/ t l� 33. rElectric i' Notes: // / t,� �/ �c.e� I� o 34. Finallieating & Air Conditioning 35. Fina✓Gas Pipe-Test I ' 36. Hood or Canopy • I 37. Final Factory Fireplace ! I I 38. Final Plumbing • - 39. Water Service-Final I I Y • 40. Gas Service-Final - I I 41. Solar Domestic-Final i 1 42. Backflow Preventer . I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations / - � 11 47. FINAL STRUCTURE& BUILDING • ZI a"- 48. FINAL PLANNING II L 49. Electric Release to Edison I 50. Gas Release to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY o No. Date PIPPr !, CoSZ- jos a 1355 ?zit f ! 7S, DrGolQ A-fQ K 3 60 .21 ,r- A- l yr? a ?aA-1-re (k_,�� ?/,7A-7/Lg- �-L 7 ► c ci,vxceac - -I- (A--17z � j 2. sz,i), lac l I� 1I lA A ) 2 s it e DAivtp I;I 'I II SEWER PERMIT APPLIC 7N PERMIT COSTA MESA SANITAR STRICT '''' iii 4/S - ti P. O. BOX 1200 -jii N° 1 I21"3 COSTA MESA, CA 92626 Contractor OW A Na RTh`I I l i) a_ Address LPS Cr)PAS 1 ( c`c_ A V-L_ Du State Zip w Building Address '5 Owner OWvs N it C— I- 0< Phone No. (r42.-h' State License No. City Business License No. J > I hereby acknowledge that I have read this application and state that the above is correct and agree to >- comply with all State laws, City ordinances and Sanitary District regulations pertaining to sanitary sewers. I ¢ certify that I possess the above valid State of California cla i ti or am the legal owne of the property w described above. (x' O t cc _ Signature of Permittee O. OFFICE _USE ONLY = Street Connection Fee $ J� Date Issued / gar) House Connection Fee $ - er. Received by - e►! «_ F Processing Fee $ cc Lu TOTAL $ 5---- ra cc 0 INSPECTION USE ONLY Q } DATE OK'D BY U) Street Sewer Y Sta 0 M. H. Sta = House Sewer F- No. REMARKS: AN "S" MUST BE PLACED ON ALL SEWER CONNECTIONS MUST BE CURB BEFORE CALLING FOR INSPECTED. -,,s-5/ INSPECTION. CALL 5156-53U7 PERMIT N2 114 3 CMF 0706-68 CITY :OSTA MESA PARK FEES p�q FeemmPayment Receipt Ne 404 4 • Project Address le)el vl:i+dc .-e A,P. Number 111 — 123 —«� CFA Park Areaif Building Permit Number hieo'a.J Owner's Name S&Xi7, C4-4'2\S VII—Cc. Mailing Address 1A °WANCay:- Age--• FEE: Single Family * Number of Units 2-Bedrooms or Less @ $ 702.70 = 3-Bedrooms @ 983.13 = 4-Bedrooms @ 1,260.33 = • 5-Bedrooms+ @ 1,476.32 = Multiple Family ** Bachelor or Studio @ 386.81 '= 1-Bedroom @ 467.38 = 2-Bedroom 1 @ 718.80 = 7/&,80 3-Bedrooms+ @ 1,135.66 _ Q p Total Fee *** 712.80 Planning Department veF.Date 9'2278 By ii Applicant's Signatu YY�Jtih__c� * City Ordinance 72-44 *• City Ordinance 72-45 *** City Resolution 77-89 CMnF 0174-32 Rev.7/77 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant I VI figs • im ch 343 agggl:oab COSTA MESA BUILDING-SAFETY DEPARTMENT 3-p43 QOQO446663 t' hwi P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 .: - •- ; ti; APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BY DATE RECEIVED J DATE ISSUED • BUILDING +e, / CC ADDRESS \ �1 S r�' Z.\./1= GG ....-.,. ,.. I -. .,,,. 'J.-.,.....a.... .-... _ i OWNER 4, On 1`x. �l V I LC_ i A.P. NO I l/ -tZ.. -act P /✓i •/ �� MAIL ` BUILDING I� �e /' , fr.UN1T ADDRESS 1 r 't��// nit'�Y,�,�� rrr���II s_ 4' 0G^ ADDRESS �j `(l / ,/ y CITY GDP-St-V:4 Q ' / -;yam t�tp-'�-L�� TRACT �'.S7 • LOT ll' BLOCK I• - CONSTRUCTIONA yin. C-- \ NEW ADD ALTER REPAIR MOVING r1FM01 , LENDER 1W•lCr Kilo - BRANCH OWNER ADDRESSAO G VALUE •�. ARCyH�ITr�r�C�T�� 1 LL Lt 4---\--.. TEL. S ✓ -/^A ./ft a[ S� /�, / FIRE ADDRESS L. Sic\ �U• ZONE TYPE , GROUP kit APPROVED CONTRACTOR ' C> -7"n\1 'o BY DATE - ADDRESS S R-11\4?-- TEL. yt�t Z . OF-ACT NO.OF USE OF NEW C1Atm' CITY S l� NO. 4 r\-- t(._ PLANS 2._ BUILDING' a _F F+ STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING rp, SIZE NO.OF BLOGS. (FROM C/L STREETII 0. OF LOT ( S3 x�� I NOW ON LOT ' FRONT' I I FT./ I-pit, FT. Q USE OF 1azi-c - �• EXISTING BLDG. B.SIDE *' FT.` /,LL FT. 4 F Separate permits are required for L.SIDE I FT. 'FT. • G electric,plumbing and heating work. REAR 2-5-FT. _ FT. W USE OF UI LDING AND WORK TO BE PERFORMED F DISTANCE BET. / ®Il BET. MAIN& - OS ty/ MAIN BLDGS. If ' ACCESS:BLDGS. / 1�f� a L� / I�( C U.P# -I�-ill APPROVED J 't/'j7a >' .QUI yi Ai ytciQCr,Cn'-L&, r Pin ail... —By ROVE J OATF C�`� (V ••1 Gid /o. I hereby acknowledge that I have read this application and state tIOLD FOR SPECIAL REOUIREINETqtoz. C4 that the above Information is correct and agree to comply with 0 a. all laws regulating building construction, and I shall not employ live �/ Z any person in violation of the workman's compensation laws of �� / �Q (Q • m FR the State of California.I ✓f�// C:--- .--r/3 m I hereby certify that I am properly licensed as a contractor under / SO. FT. i- / N O� the State of California Business and Professions Code, Division 3, THE A/MOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: \ am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ V �\ and Professions Code,Division 3,Chapter 9. in J PLAN CHECK $ . o w Signature ✓ / Permittee • ` S[^ " " [/ TAX $ `z /�f Authorized Agent T/ U TOTAL PAID $ 53.6` w • - 4 -63 - - 6536 9%22/78 .104.00. _TI . COSTA MESA BUILDING-SAFETY DEPARTMENT 5536 9/22/78. . f04.000KT1 P.O.BOX 1200 COSTA MESA,CAL?FGRNIQ92626 .. - .�. 5 0000 -'I •P"PL AT ON F ,STRUCTURAL PERMIT R T fi For Applicant to Fill in Completely — Use Ink Only (f(,, .n �/j. BUILDISS /!///���gr64446.`1 Ave_ RE .'.... .,. • - -,..,.�.. • f: 1r���%�SL �z r OWNER '2oC ru.s YILc A.P. NO. PE-I tGs ✓ MAIL • BUILDING obioft" ADDRESS ADDRESS .�j(`tA1-t_[Y�II C. TEL. TRACT LO BLOCK CITY NO. - CONSTRUCTION NEW ADD ALTER REPAIR MOVING - OFMOI ASH LENDER BRANCH OWNER (LL ': ADDRESS - ARCHITECT TEL. USE 3cAGa�ALUg�+ (2114 OR ENGINEER NO. _.r...->..� ..._..,_..m._..-..F..._-.....--•.,,..:.....�,r-.,.a.,. ......,_.,�_.. , FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. - MAIN BUILDING ACCESSORY BUILDING I•4 SIZE I NO.OF BLOCS. (FROM C/L STREET) C. OF LOT NOW ON LOT FRONT FT. FT. @ USE OF V) EXISTING BLDG. R.SIDE FT. FT. FSeparate permits are required for L.SIDE FT. _ FT. electric,plumbing and heating work. G REAR FT. FT. _ L USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& AMAIN BLOCS. ACCESS. BLOCS. VAR.# DATE J C.U.P.# APPROVED APPROVED ›.. BY DATE F4 a O I hereby acknowledge that I have read this application and state in N Ig that the above information is correct and agree to comply with a+ all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of .WW the State of California. a co I herebycertifythat I amSQ. FT. N properly licensed as a contractor undera the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE O yue., _ am exempt from the provisions of the State of California Business /1 VALUATION PERMIT FEE $ / and Professions Code, Division 3,Chapter 9. J m Signature of - PLAN CHECK $ re o Permittee $ TAX $ IL U Authorized Agent TOTAL PAID $ /OV (1