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Home My WebLink About1712 MINORCA PL - Building PermitsCITY OF COSTA MESA ! t F, BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 wv,w.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00209 - I, PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13933102 DATE ISSUED: 09/25/2009 ' ISSUED BY: CAC JOB ADDRESS: 1712 MINORCA -PL CM Suite/ Unit Vicinity: •- Squares: 0 Valuation: $8,600.00 SCOPE OF WORK: T/OFF EXSITING WOODSHAKEINSATLL 7/16 OSB AS NEEDED 1 LAYER 30 LB FELT AND 30 YR COMP. SHINGLES OWNER: LEE, HENRY M TR Address: 1712. MINORCA PL Unit: PHONE: City/State/Zip: COSTA MESA, CA' . APPLICANT: LEU FERGUSON Address: 1260 N HANCOCK Unit: :SUITE 107 PHONE: 714-7774040, City/State/Zip: ANAHEIM CA' CONTRACTOR: MC CORMACK ROOFING AND WINDOW CO . License No. - 643700 Address: 1260 N HANCOCKUnit: - SUITE 107 PHONE: 714-777-4040 City/State/Zip: ANAHEIM, CA` ,92807 --- -- - CELL: 949-347-1400 ,;: ARCHITECT: _- License No. PHONE: ENGINEER: - - - - - License No. - 'PHONE: FEE SUMMARY Reroof Plan Check: - $0.00 Reroof Permit Fee: >$167.25^ Reinspection Fee: $0.00, - Bldg Std Admin Fund $1.00 ` TOTAL FEES $168.25 - - .., Ihoit. 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. OC DEN. INSPECTION TYPE DATE INTITIALS CODED INSPECTION TYPE DATEINTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical . 261 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 DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -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. have and will maintain workers' compensation insurance, as required by sectio 3700 of the Labor Code, for the performance of the work for which this p issued. My workers' compensation Insurance carrier and policy u err ar,��j _ r'' j�1f17AJfVa� oicYN.mi eed riot be wmpetetlANe permx is valveegatone nundrpdpcbnars(sloocrless.) P MSS S/P 0007 / —O /❑at 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Lab YL` de, I sh tfirrthwith comply with these provisions. L3`1 09 pphranr ure ate WARNING: FAILURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with S 70 00) of Division 3 of the Business and Professions Code, and In e I m full force and effect.2S4C� 22 y ��a s# C3 / 6 �--� ontr dors Si a 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: 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 under sec. Business and Professions Code for this reason: Signature 3057-46(3/07) ' - Owner ID verified by tlriiver's license. Driver's License No. ❑ Yes ❑ 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, a 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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 and 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? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ 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 feel from the outer boundaries of a school? ❑ Yes ❑ 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 ❑ 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 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-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si�gnalure a al ,rls) Dat �/c D And/cLAuthonzed Appl' ate 44 '`gyp Mssp CITY OF COSTA MESA BUILDING DIVISION ERMIT NUMBER � DEVELOPMENT SERVICES DEPARTMENT °• PERMIT P99-00700 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 1712 MINORCA PL Status: ISSUED Suite No Applied: 12/17/1999 Issued: 12/17/1999 Vicinity: Parcel Nunmber: 13933102 0A �/ ISSUED BY: Applicant: LORIE GLOVER _ Address: AMT - _ - - Phone_ (714)241-1414 Phone: SANTA ANA, CA Zip: Zip: Owner LEE, HENRY M -. License: Address 1712 MINORCA PL - - Backflow irrigation - Phone: - COSTA MESA, CA Zip: 92626 Contractor: COAST ROOTER PLUMBING HEATING & AIR COND Address: 2737 S. CRODDY #D _ AMT - _ - - Phone_ (714)241-1414 QTY SANTA ANA, CA Zip: 92704 Laundry Tub / Washer $0.00 License: 529127 Arch / Eng.. - Backflow irrigation $0.00 Address:, Landscape Irrigation $0.00 0 Swimming Pool $0.00 Phone: Backflow Preventer $0.00 0 Zip: $0.00 ' Trap Primer ,License:._ 0 Bathtub _ $0.00 0 Pressure Regulator $0.00 0 SCOPE OF PERMIT $0.00 WATER HEATER CHANGE OUT. Clarifier System _ ` '$0.00 AMT QTY AMT QTY AMT QTY ISSUE FEE, $23.50 Laundry Tub / Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P -Trap $0.00 0 Trap Primer $0.00 0 Bathtub _ $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System _ ` '$0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect (Ice, Soda,etc) $0.00 0 Receptors - $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher - $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 '0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater / vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 0 TOTAL C CULATED FEES: $35.80 COMMENTS / SPECIAL CONDITIONS DATE % O D 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: 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 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -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 work/erra. cpm enation Ins._u1r_an�c�e carrier and policy number are: y �O�q Carrier I 1I Ir l 0 I VY�I Policy Number: NOI UUV) / (This section need not be completed If the PeVnit is valued atone 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, and agree that it 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: /;;L 7 WARNING: FAILURE TO SECUR RKERSCOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLIARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION W06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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. Lia M 5 'z Class k C3 u Contractors Signature: Date: 1- 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). Lenders Name: Lenders 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 contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ 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: ❑ 1 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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 Cade provides that the 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. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Ves [I -Wo 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aZrmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U 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 ❑ 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 ❑ 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-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ?-FF --Signature Of Legal Owners) Date And/Or Authorized Applicant Date CODE A. INSPECTION TYPE DATE INL I`L$ CODE INSPECTON TYPE DATENI TRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing J4 _,L _ Off_ 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 OWNER LEE, MR. -& MRS. HENRY DATE NOV 1 5 1963 ..1 JOB ADDRESS J� GENERAL COS y APNO-39-33 LOT TRACT FUR alffwd VALUE $ 1,3b0-00 FIRE ZONE 3 DESCRIPTION OF WORKAdd Den to RCS. INSPECTIONS Signature DATE_ GROUP I TYPE V ZONE R1 SUBCONTRACTOR PERMITS ISSUED 6 DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line ❑ House Con. ❑ St. Swr. ❑ S rinkling System _ Construction Pole Underground El Power i❑ Rough Wiring Trenches E7 --Forms Elk -Steel Reinf. ❑ J� -(�- Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing Frame and Flashing Lathing — In ,l' Out Plaster, brown coat Re'-ig. ❑ Air Con, ❑ Final I Ig, Final Pl,.,.lbing Fixtures, Final Final Gas Test Electric Fixtures, Final Buildin Final _ 27p - i -S- f, OCCUPANCY VlC9H1U' 2-09 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS CA L . COSTA MESA, CALIFORNIA CITY ARCHITECT TEL OR ENGINEER O. 0 LIC..TE O Ne. PLANSnS NEL0.• 6,34 +� 11 lll1 cNirtlon/� t/- b .moi SIZE_ F NO EAVE OV ERHANG SHALL BE LESS THAN TO SIDE a REAR P. L. NO. OPBLDGS. / I OF LOT r .OWED Now ON LOT USE OF I YARDS APPROVED MAIN BUILDING I EX I ST I NGBLOG. I��SI GKLC SETBACK LINE FROM 0 CENTER OF STREET REAR YARD O r0 SIDEYARDI LEFT - RIGHT DESCRIPTION OF WORK BUILDING NO.OP 312E ROOMS' (��ST( EXTERIOR WALL STUtW l COVOERING "MM COVERING X71 i HEREBY ACKNOWLEDGE THAT 1 HAVE.READ THIS APPLICATION AND STATE THAT THE ABOVE 1E CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. AGENT ' FEE oRECEIVED FINANCE DEPT.. APPLC7OInFFQQIM SA BUILDING For Office Use Only I RECEIPT NO. I RERMIT I. BY DISTANCE BET. BET. MAIN d MAIN SLOGS ACCESS. BLDOS. VAR.* DATE /er rJ SQ. FT. TXE AMOUNT SHOWN UNDER VALUATION IE FOR THE 2 PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION u PERMIT FEE S / 3,?'0- , u $PLAN CHECK ¢ Ne. PLANSnS US lll1 cNirtlon/� 1. NO. Jay-33J-� F NO EAVE OV ERHANG SHALL BE LESS THAN TO SIDE a REAR P. L. 'ES .OWED (U.S. C. REQUIREMENT YARDS APPROVED YARDS APPROVED MAIN BUILDING I ACCESSORY BUILDING DISTANCE BET. BET. MAIN d MAIN SLOGS ACCESS. BLDOS. VAR.* DATE /er rJ SQ. FT. TXE AMOUNT SHOWN UNDER VALUATION IE FOR THE 2 PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION u PERMIT FEE S / 3,?'0- , u $PLAN CHECK ¢ t ,30 ' �0 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS %Ikr)_ Elk• COSTA MESA CALIFORNIA FE C,QVED FINANCE DEPT. APPLICATICRFM AftU111 MESA BUILDING For Office Use Only Investors Marine Inc. RECEIPT NO. 1,77J'500 I OWNER MAIL ADDRESS 1600 W: Coast Highway RECE VED BY GATE RECEIV€ D OATE18BOED.. I -TrZ r' R �/y/�� wa CI,n, Newport Beach,Calif. No: le BUILDING 71.2- AUILDINDDRES/ ARCHITECT same TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. FIRE ADDRESS ZONE TYPE tl GROU APPROVED Mesa Verde Builders, Inc. CONTRACTOR BY DATE ADDRESS 1653 Mlnorda Drive ZONING ' Costa Mesa, Call f . ZONE NO.OF U8¢ OP NEW JrfJ 9 CITY PLANE I I BUILDING.1 STATE 181269 NOL. Ki 9-0395 LEGAL �(� G -� / - J.. �f O B DEHCRIPTION 1 :J iiF-- V SIZE 501 ii 1001 NO. OF SLOGS. 0 OF LOT NOW ON LOT A. P. NO. USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LIN. PROM1 25 1 45 ICENTBR LINE ST.) / FT. CENTER OF STREET REAR YARD FRONT 4( 5 1N. 51-61, i I 6 6 SIDE YARD LEFT RIGHT R. SIDE FT. IN. DESCRIPTION OF WORK 5_ _FT. L. SIDE L5IN. NEW I X II ALTERATION I (ADDITION IREAR FT. IN. APPROVED'A I / T� ` REPAIR i MOVING (DEMOLISH I BZLDINGIc^�Sq.tNO. OF SWP.ROOMS6STORIES O1 in pJIERING COVERING t1CCOg USE OF BUILDING AND WORK TO BE PERFORMED — 4/SIV r3 single fat residence and garag Model 20-A / Attached garage 462 Sq.Ft. '1 HEREBY ACKNOWLP GBrAT 1 HAVE READ THI APP CATION AND STATE THAT THEIA O 8 IB COR tt AND A REE O COM- PLY WITH ALL CITY oR I NCEB AND TE LlW E ULATING BUILDING CONBTRUttI THE AMOUNT BROWN UNDER VALUATION IB FOR ONLY. PURPOSE OR ESTABLISHING A PERMIT FEE ONLY. VALUATION �j �7 PERMIT FEE $ 3 / — SIGNATURE OF I` �L/L� / ' PERMITTE // d�oi��D $ / PLAN CHECK $ / d ,5 -6 I AUTHORIZED AGENT TOTAL FEE -5-5-,5-0