HomeMy WebLinkAbout2425 MISENO WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 2425 MISENO WY
Suite:
Vicinity: ROOF
Parcel Number: TPN00143
Applicant: HANSEN, DUKE
Address: N6646636
Zoning:
Phone:
Zip:
Owner: BACK BAY ASSOC/ WEBB PROP. MGMT
Address 960 CALLE AMANECER .
Phone:
SAN CLEMENTE, CA 92673 Zip:
Contractor
Address:
2ip:
Arch :
Address:
Zip:
Phone:
License:
Phone:
License:
Eng:
Address:
BCOPE OF PERMIT .
' REMOVE OLD B.U.R. AND INSTALL A NEW 4 PLY B.U:R. ON UPPER FLAT ROOF ONLY.
FEE SUMMARY •
Status: ISSUED
Applied: 04/29/2002
Issued: 04/29/2002
ISSUED BV:
Phone:
License:
Plan Check: $0.00 Calc Valuation: Sz,aoo.00
Permit: $83.25 � . ` Claim Valuation: S2,3oo:oa
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.50
$0.00
$0.00
$0.00
$83.75
SETBACKS
MAIN STRUCTURE Front 0- �
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Right 0- 0
Right 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mu'st comply with all applicable codes, and all
requiretl Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
oawo Itiw�
WORKERS'COMPENSAnONDECLARAnON:
I hereby eflirm undar pAnelty ot perjury one of ihe following tleclaretions: ' - � ' .
❑ I have and will maintain a cetlificate oi consent to self-Insure for workers' compensation, as provided for by section 3700 of ihe Lebor Cotle, for ihe peAormence ot the
work for whiCh �his permit is issued.
�I have and will maintain woAcers' compensation insurence, as required by section 3700 ot the Labor Cotle, for Ihe peAortnance of Iha work for which �his pertnit is issued.
My worke compensation Insuranc�arner and policy number are: U
Carrier. _���.�'''Pi %`CJ�Ii PolicyNumber: �/�-- � z-C�OI � S(T
(This section neetl not be completed il the pemrit is velued af one hundred dollars ($ f00) or less.)
❑ I cehity thai in the pertormance of ihe work for which �his pertnit Is issued, I shall no� employ eny person in eny manner so as to become su6jec� to ihe workers'
compensation laws of ornia, and egree ihat if I should become subject to the workers' compensation provisions of Section 3700 ot Ihe Labor Cotle, I shell forthwith
comply with these pr isi s. / (� p
Applicant Signature: _�l� / ��— Date: / z ! —�-
WARNING: FAILURE TO SECURE WORKEPS' CAMPENSATION COVERAGE IS UNL4WFUL ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TOONE HUNDRED
TFK)USAND DOLLARE (510p.000), IN ADDITION TO THE COST OF fAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�O60F THE LFBOq CADE, INiEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirm that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Cotle, and my license is in full
force antl effect. Lic. a��� y Cless a C- —.S `(
CONrac�or's Signature: Q 9b � Date: �-( -?_ �— o �
CONSTRUCTION LENDING AGENCY:
❑ 1 herehy atlirtn that there is a construction lending agency for ihe peAormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Cotle).
Lender's Name: Lenders Address: '
Signature: � Date: �
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that under penalty of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Cotle: Any city or counry which requires e permi� to construct, alter, improve, demolish, or rapair eny sirucWre, prior to its issuance, also requires �he applican� tor such pertnit
b file a signad statement ihat he or she Is licensetl pursuent ro Ihe provisions of the Contrectors License Law (Chapter 9(commencing with Sec�ion 7000) of Divlsion 3 of ihe
Business entl Protessions Code) or thet he or she is ezampt thereirom and ihe basis for ihe aliegetl e:emption. Any violation of Section 7031.5 by any applicent for a permit
subjects the appliwnt to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of ihe property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the stmaure is not intended or otteretl for sele (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner ot properry who builds or improves thereon, and who does such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not intended or ottered for sale. Ii, however, ihe building or improvement is
sold within one yeer of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose ot sele.).
❑ I, as owner of the property, am EXC WSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmd the project (Sec. 7044, Business and Professions
Code: The contractors License Law tloes not apply to an owner ol property who builds or impwves thereon, and who contraas lor such project with a contracror(s)
license pursuant to the CoMractors License Laws.).
❑ I am ezempt untler sec. Business end Professions Code for ihis reason:
Signature: Date:
Owner ID verified by dnvar's license. ❑ Yes ❑ No Driver's License No.
Veniication of Ownership by (type oi tlocument, i.e. - pwperry tau bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION:
❑ I hereby certify ihat no excavation five (5) or more feet in depth into which a person is required to descen4 will be made in connaction wi�h work authonzed by this
permit, and ihat no builtling swcture, scaHolding, falsework, or tlemolition or tlismantling thereof, will be more ihan thirty-sia (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, THe 8, California Adminisirative Code). . �-'
❑ As ownar-builder, I will not amploy enyone to do work which would require a permit from the Division of Intlusiriel Safety, as noted abova, unless such pereon hes a
permit to do such work from ihe division.
Signature: Date:
Division of Industrial Safery Permit Number.
CER7IFlCATE OF COMPLIANCE AND AUiHORVATON OF ENTRV: I certity under penalry of perjury Ihat 1 have read ihis application and state ihat ihe infortnation 9iven is
correc�. I egree to comply with all state laws and ciry ordinances relating �o builtling consWction, end authonze representatives of the Ciry of Costa Mesa to enter upon Ihe
above-tlescribed propeny for inspection purposes. I egree not to occupy or allow occupancy of any building authorized by ihis permit until tinal inspection.
- �Signature Ot Legal Owner(s) Date
�/�'�-- L/� Z � —r.� � _
Antl/Or Authonzetl Applicant Date
LOpE 1, INSPECTIONTYPE
1616 Fiaetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel Blxk/Retaining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Final Demolition
Q�jF INTRIALS
�Z �
COOEN INSVECTIONTYPE
206 Final Mechanical
208 Final Plumbing
270 Final Electtical
212 Final Fire Prevention
220 Final Planning ADP�o�al
222 Final Site
250 Final Building/Occupancy
PdTF INTfMLS
,� PHwADOHESS: z9ZS MISENO WY
� OWfl�fl'SNRME: SARVIE CAROL
aooness: 24z5 M'ISENO WAY
COSTA MESA,CA
AflCHIENGINEEP:
92627
flEG.NO.:
UNIT:
AO�XESS: UNIT:
PEPMITTEE: BRAHMA AEAD ( 714 ) 649-2976
RDONESS: z 8 B 1 S MODJESKA CYN RD
SILVEAADO CA 92676
UCENSEo CONTNACTON oEClANa710N: I nereby allirm inat I am IicenseU unCer o�ovisions o� ChaD�e� 91�ommencinA with Section
7000) ol i I usiness anG Pmi si n . nE my litense is in � II lor e nE efleci.
°'�g�8��f �8i��� �-� EXP: 12/94
CITY LIC.j: GS�T]RTE LIL.: � �
�Dale / � � � 1 l Signalure: _� '�� �
WONRENS' COMPENSATION OECLANATION: I nereby alfirm t�at I nave a cehiticate of consem m self-insure o� a cenificate oI WOM1ers'
Compensation Insu�ance. or a cendieA capy t�ereol (Section 3800. Lab. C�.
POIICY NU.: E%P. ORTE:
COMPANV:
❑ Cetlilied CaOY is here�y �umiSheC. ❑ Ceniiietl copy�is /file�0 with tt�e city Builaing Divi n
lat l L _ L"� _ � � AODiicant: /� " � � �—
E%EMPTION FpOM WORREPS' COMPENSATION OECLAflATIUN: (T�is seclion need not he camplete0 il �he permi� is lor one �unOretl (5100) or less�.
I certily Ihal in Ne peilormance 01 Ine wOrk �or w�ich Ihis permi� is issuetl, I Shall n0� employ any person in any manner 50 as �o b¢came
subleci Io IAe Workers' Compen5aiion Laws o� Calitomia.
Dare: SipnaWre:
NOTICE: II. aller making Ihis Oeclaration. you 5hou10 become Subleci to �Ae'Workers' Comp¢nsa�ion D�ovisions o� ihe La6or
CoOe. yau musl Iorthwii� comply wiih such provisions or Ihis permil shall be tleemed revoked.
CONSTPUCTION LENOING AGENCY: I here0y allirm that Ihere is a wnstmction lentling apency for the pedormance of t�e work lor
whicA Ihis permit is issuetl �Seaion 3097. Civ. C�.
LENDEH:
aooness:
OwNEA BUILUEP oEClANA7lON: I here�y affirm ihat I am exempt fmm ihe Conlractar5' State License Law for the followinA �easan
�Seclion 7p7L5 9usines5 antl Pmlessional Cotle: Any city oi coun�y whic� requires a permit lo constmct, alt¢r, impmve, tlemolisR or
repair any stmcNre, prior �o its issuance, also requires I�e applicani for such Oermil to �ile a 5igne0 s�a�ement that �e/sh0 is Iicen5e0
pursuant �o �he pwvisions of t�e Contractors' State License Law �ChaD�er 9(commencing wi�h Section I000� oi Oivision 3 of t�e Business
an0 Pmlessions CoOe) or Ihat �e/s�e i3 ¢xempi I�erefmm anG t�e Easis lor Ihe allegetl exem0�ion. Any violation of 5¢[tion 70.31.5 by
any applicant for a p¢rmit subletls Ille apDlicant to a ci'ril penatty al not more ihan five Aundre0 dollaR (5500).
1. as owner ol t�e pmpeny or my employees witll waAes as their sole comDensation, will tlo the work, and I�e
❑ s�mcWre is no1 inten4e0 or o�feretl �or sale (Sec�ion 70a4. Business anC Prolessional COJe: The ConVaciors' Siate License Law
tloes not appty to an owner ol a propeny wno builtls or improves Ihereon, antl who Eoes such work himselt/hersell ar tAmuph
his or ner own emoloyees, pmdtlea ihat such improvemenis are no� intentletl or o�fere0 for sale. II, however ihe euilAinA or
impwvemenl is SOIG vnt�in one y¢ar ol completion, Ihe awner vrill have Ih¢ burGen ot pmving hels�e Oi0 no� OuiIE Or imD�ave
tor ihe purpose of salel.
I. as owner af t�e oropeny, am exclusively coniractinq witb Iicense0 conlraclors to consiruct the pmlecl (Section 704d. BusineR
1� and Professions Cotle: TI�e Coniraciors' Sla�e L¢ense Law aoes na� appq to an mmer o� properry wM WilUs or impmves t�ereon
anU w�o conVa[I5 �or su[� pml��s wit� a cOniracloqs�license pursuant b the Contractors' Slate License Law�. I am aware
thal proai of Iheir Worker'S CamDensation insuran[e shoultl be pwviGetl �o me.
� I am exempl un0er Setlion: 8. 8 P. C.
tor Ihis reason:
Date: Owner.
I do hereby cenily �nat I am aware ol ana unEervand t�e reQuiremenls of Caldomia Health and Salety Coae Sections 25505, 25533, ana
25534 an01na1 I oi any luture buil0ing accuDant willlwill no� ([ircle one) neetl lo comply with said state coAes antl Ihe repuirements lor a
permit lor cons�mclion or moUilication Imm Ihe Air Oualiry Management �islricl Resitlenlial constmclian apDlications are exempi �mm
inese o�ovisions.
�ate: ADPlican��,
I hereUy cetlify ihal I have reatl I�is ap0lication an0 stale t�al lhe above inlormation is correct. I agree to comply wit� all city anA county
orainances ana slate laws relaling lo builainA conslmclion anU here0y authorize representatives ol this ciry ro en�er upon the a6ove�men�ioneE
prOp¢rly IarinSD¢CIiOn pufpOS¢5.
Sign:�Wre: _
❑cense or soc�ai security M: $
16<F46 W�ite—Builamgl Green—COae EnloicemenC Canary—Applicanll Pink—Revenue: Goltlenrp(1—Assessor
CITY OF COSTA MESA — HUILDING PERMIT .
PERMIT NO; H 070565 PLAN CHECK NO; N , ,
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION ; T/OFF 6 REROOF W/BUR SQ FT; 800
CLAIM VALUE; 800,00 CALC—VALUE; 800,00 GROUP OCC: R-3 /
COMMENTS; SMOKE DETECTORS REQ PER 91UHC
w«+rwr*at+�+r*+t*+a*+��tx�x��x�«*+cx*+�*�rx�r�t*r�trarrr+F+r+�w+*�t*r*rr+rir+rx�r*rx�r*at*�rriritrjt+rar�-r�t*r*�t**
Z O N I N G R E Q U 2 R E M E N T S
S E T B A C K S
------------ MAIN BUILDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN AEAR; FT IN FRNT: FT IN REAR; FT IN
LEPT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING RE�• PROV: PARCEL; 43914321 2NE: REF NO:
PLANNING N TES>
i
itMftMMMiFffihMMftMifM1f447fkiflFlElfikiFiflfifMMififltififiFikMlfiFYiFififlFlflfifMMMiFiflfMifftKlfifMifiFiFitifM�IFM%iflfikltifjlillE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED HY DATE;
BUILDING APPROVED BY ;
DATE:
APPLICATION ISSUED BY; DATE;
1F 1f �k M M 1t ik M 1f ik if 1f 1f ft M 1F it 1h M 7f 1f 1E 1f 1f if M k 1k if M M M��F7FiE iE
ihlf%MkMltMitltifitMM1l�tiFlfMMffifif�tlfltillFiF�tlF1llFilMMiflfifMMlfifflMllMit7Fit1f1f1lMMiFNiFMMMM1kif1lit1FlF�tMltMit7fMMiFiflf
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 21,00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 21,50 0,00 0.00 21.50 21,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 21,50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21,00 ,50
MM1lili�ikitifMMMitffM4MifMifikMiFifMitk�fMMM�tMitlFitM1lifft4iFfkiFMMMififlFifMMififititMlfifMiFilifikRYiFltfFlfik4iElfifMYiFif
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
SFR 800
D E S C R I P T I O N
REAOOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
UNIT COST
TOTAL COST
800,00
oi ooi7a?a.-OQi74223 -r a �' 2z.;o
UATE: 12/'19f95 Til7c': 11:J7
�
CONSTRUCT40N AIVD PLANNING POOL 5 a '
� APPROVALS Permit # Daxe Inspector qppROVALS Permit � Date Inspector
t. Temporary Electriral SerVlceor Pole ' 52. Pool & Equipment Location
2. Soil Pipe�Undigrnd: � 53. Steel Reinforcement
� :, ..
'�3-�E�ectrical Corii�yh-FJtility`-Undrgrnd. 54. Forms
..�A. �lectrical ConduittUndrgrnd. 55. Electrical Bonding
r.'
� .., r
� 5;;��eel Reinforcerir,e�x 56. Rough Plumhing & Pressure Test �ti
J
•;�d:�fltectricaiUFiR%Gmtl. �• 57. APPflOVAITOCOVER-GUNITE �
.�. � . -i-:
� �],,F,botings �'' 58. Electrical Conduit-Undryrnd. �'
,. �r�
�&:� Foundation - 59. Gas P�pe, � Undrgmd., Teu
9. Water Pipe-Undr,�rnd. � 60. Backwash Lines, P�Trap, C7 Undrgrnd.
10. Structural Floor_SYstem � 67. APPROVAL TO DECK
i i. p�operty Sewer Line & H�iuse Connection 62. Backwash & Receptor�Final
•o
12, S�wer Cap �� 63. Heater & Vent�Final
13. Roof Drains - 64. Plumbiog System � Final
74, Rough Plumbfng r� :. 65. Eleclrical�Pinal
t5. Rough Electrical-Condui�- � 66. Solar SYstem�Finat
76. Rough Electrii'Wiring �: � 6�. Fencin9 & Access Approval
17, Rough Wiring.Sign 68. APPROVED FOR PLASTERING
18, Rough Electricai�T Bar Ce�ling � 69. POOUSPA SYSTEAAS FINAL
19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREM1ENT
i .. r.. C. _. `, p _ .7�
20'!;RoighFacto}Y�9�'?-Place � y;� � •� J '�� � �aAPPi'��V�L�$,�'�?Pc�init# `��" `',_�-
21;.�D�:ts, � Scryctu�a i .. .. - �+�� Y � J0. �t3nderg+lo`�7n'FJ H§iiro ` •
2z,.0i�ts.}�entJating; ! �� i �` - �.,;y >�'. 77. ProduC,��jP±ng U��as i;,lOil
' H,� -. � .. �� 4 ; -I '� A P ' � • , .
23:.G�s�P�qe-Roqgh &,Test � p�<; ,; �n '� s . . 7Q, Undergro7)nd Flnst��: �+ - n
24x'Roof Framin9 =� . � �-' � �' �n � =. ,��� ,yy ; " 73�; Underyrn�f.Sto �i�Tjin{S",CJ Gas ❑ Oil
25. R6of Sheaihing ,. , �� �/i rp/�/� + 74:+Dverhead+Hydrqi �
- +:
26rT�b6r Ceiling (Sfrvcturalj &�41or�fpcoat F � -� m�' 7�s' Ory Cherajcal c" '"' `•' j•
i' � L.1 F�J 1 C+7
27T� Frame a� d Flasti;i�y T� ;-.,; �,�. u; b: 78. Dry Starrc.'p�ipe H ci : ��')
_ '
-,28� Lathin'.1� Slding,+ -� '��ts .x i s- •..r ' 77,:' FIXED �Y$T[{��,�INA�� ^ "�
�2, �a�=. . : �r t .� � ;
"29. Insulation `'. ii, ` t �.... :. : �� � + 7� PIRE PREV. FIN.AL + �• -. .
�'30. Drywa�l,NaFtm9�?; , , : � I f ; A ','�'IEALTH�DEP�. REQlliF#�MENT
-;3L Plaster'.�t`rown Cb�a;, _, ; ��p. + � a �79' FINAL 1�3ECTt1?N � ,��'
., . t-i-.�n . � : ' _�., - : . --
-•32:'Electriea�iPb�lver.^MBti�'r_Fina! ��-�% I i ,����SQ.'�FOODCERTIFI�dTEI�SUED r
..; 33�:FiCai EJQctriL .,,. � '; ♦ r' � � t � NqSes:? ^' ",Q t .
_. . . . ::: . , f� . � 9�9s ;' : � , c�=..
�»34:iFir�l Haating &Ais Conditiorffi�4 � i ! � ` � . <- - , `� -:-�
- •n �. ;r r • � t + 'i r+ 1 --+ ' t r
^35��Firi�i G�s Prpe•Test �� : .y ( t' : . � � �:a -;', . n F•t�
v36. �Hdmd or CanoPY � ' :^ -1 .s s n + i ; 'i _, . . . . . *,..
<• i n�„ =� �:c + n� -in,
. �'l. Y-y � s.�t' �L '(�7 F" � � - 1
�y37:;�Fin�l Fac.ory PireglBce- � `.�, _ � . � �; . ..j
-�38. Fin31 Plumbing . i . t`� i l e+ <,' � �F 7' O
� ,i' � �
t'39. Waier Servic��Final . " ' � ' � ..:�*7 � u: ,�
� :x � �-�
"i46. Gas Service-F.inal = . ,-�n� s � sn � (i . 0-� ',^% • . ..
r x '-+ +
�41. Solar pomeS��'icFin"aN� ` ; ' �` �`" " ^
C h
_� :"! •• I I �. fi ;r• '"76 �C^ + 3;
r�42""Backfiow Preventes � �: k � ! n: �E• • t_' ��
t � 1� h
43. Backfiow Ir�gatiort `�"=' ' t % Y' �" `� - .
� . �r k » i
.,
=.44. Landscave Qrigation Systemi,�;:� a: �r G U p�• y m ro 'C�7 �~ :•! .•
.-. .n .. n �. U' r `"' F
:-�T::-� n� + i; F• F. p-.. . �.� �,...� a,•r i
`'�45;�Sound nfjttenuatio� ..� .. .. * r.� ;�7 �;, # t� ,S - F,q +
";46�.Handicap Re�ulations �:. ri +�� � r` n; _ �ci S
I 16 `
47�PINALSTRUCTURE&BU4l.DING Grj�o , ` �3='�� ; �
� '
'46��If�AL PlA?JNING i F�: .v ! I �+ r ,t :1 �
i , ,
a49r'E4eCtric Release to�Edison � ' , , + ? " �;, Y ; ��� u;
N T .t ` Y t] .�. Y li
jr. .. .i : 1 � { � v ._ . -
.50..GasReiEase to Southem Califor�nia Gas Co r.- � Ci •�7 �T' � C� �
- -i f i
51. CEfi3TIfICATE OF OCCUPANCY - � �� ^' =� -- � -� �'
No. Date
OWNEft DOYLE & SHIELDS Devel�rnnrnt f:n._Tnc. DATE
TRACT FIRE'LONE DLSCRIPTION OF WORK Re&<x/att_gar.
I Sianatm�e DATE I GROUP 7R.7 TYPE V ZONE R_9
SUBCON'1'1tACfOH
F.
. .. ��s���
COSTA MESA BUILDING-SAFEf'( DEPARTMENT
P.O. BbX 81] C09TA MEBA. CALIPONNIA
For Applicant to Fill In Completaly
TYPE OR pRINT
■ MAIL
COSTA MESA, CALIFORNIA
F E. RECEIVED
FINANCE DEPT.
A P P L I C.(�; j� NO FOFt�� I T ES A
BUILDING
Fo� �(�I[B USB Onty
IONING
Z 16 NO.OV I U680F
�� — �uNa eu��nu
�;e�;,.,,,,� Lot 127. Tr
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
ryEL PR 2-8020 90' TO SIDE @ REAR P. L.
I—_ EAVES
No.oRBLOGe. ALLOWED /U.B.C.REQUIREMENT
NOW ON LAT
YARDSAPPROVED YARD9APPROVED
MAIN BUILDINO ACGESSORY BUILDINO
( FROM GL STREET ) -
ICENTER OF'BTR@eiM ZO � SO �
6FT l� � RI(iHT �—
DESCRIPTION OF WORK
WALL
Model 42G
NO. OP
�ROOM�S
I ROOF
01
2
�I HEHEBY /�CKryOWL8D08 THAT I HAVB PBAO TH�B APPLICAT�ON
AN� 8iwT8 TMAT TH6 wBOVt 1➢ COHHBCT AND AOq6H TO COM•
PLY WITH wLL <�TY ORDINANCHi AND BTAT[ LAWB RBpULATING
BUILD�NO CONBTRUCTION.
e AUTHORIZED AGENT �� �
VAR. SC
�1833 �so.Fr.
TMH AMOUNT SNOy
PYRP096 OR EaY�
VALUATIOPI
$/�S yo �
DATE
T� � , N
0
UNDER VALU�TION 19 FOR THE �
IBHINQ A PEqMIT FE8 ONLY. 0
QYj m
N
PERMIT FEE S j
'7 � � m
PLANCHECK S .-7/• o
9� S� LL
C