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Home My WebLink About229 HANOVER DR - Building PermitsAoplicant to fi11 in all spaces ezceo� lhase within heavY borOer lines anG sign all apvravriate tleclarations. ciTY OF'coSrA nnE'SAQ CQ`lN STRUCTION PER MIT P�ojectAddress�� +�� K(� v'�� Applicant's Mailing Address �O�G � �G� l ye0 l In � Owner's Name ��g ��`Q f� U Q�phone �� 3 S Address `Z2 G «v- '^' c% J '? '(� � cg' � � Arch/Eng. License No. � Address ' Contracror's Name �'a�'p t��-RG r� C p neS U�o 7��3 Addresslmailing) ZOZR F`o�u.n,�wtnc� �j_ i�. (� �*'l� City License No. � � ��, � ' LICENSED CONTRACTOR DECLARATION � I hereby atfirm that I am licensed untler provisions of Charter 9(commencing with section ]000) of Division 3 of [he Husiness antl Pr syons Co e, 1an_a my license is in full force antl eftect. � Z�� p License Class Licen o Date�7 `ZZ��6� Signatur 'ORKERS' COMPENSATION DECLARATION iereby affirm�that 1 have a certificate ai mnsent to self-insure or a certificate ,i Workers' Compensation Insurance, or a certifietl copy thereof (Section 3800, Lab. C.) � � Policy No. � Company ❑ Certifietl copy is hereby furnished. � ��rtifietl co y is ' ' ' ' oivis Da � Appf t��-Pw EXEMPTION FROM WORKERS' COMPENSATION DECLARFTION (This section neetl not be completetl i/ the pe�mit is fo� one huntlretl ($100) or less). I certify that in [he performance of the work tor which this permk is issuetl, I shall not employ any person in any manner so as to b com@ subject to the Work��C¢mpensa(�o2 Law9of Calif n .��` „_ Date Z a F�1 si nature 4 -�cs-�r NOTICE: If, after making this tleclaration, you shoultl become subject to Ihe Workers' Compensation provisions of the Labor Cotle, you must forthwitn comply with such provisions or this permit shall be tleemed revoketl. CONSTRUCTION LENDING AGENCV � I hereGy affirm that there i5 a construction lentling agency /o� the performance Of the wark for which this permit is issuetl (Se[tion 3097 Civ. C.) LenAe�'S Name Lentler's Atltlress ' OWNER BUILDER �ECLARATION � ' I hereby affirm that I am exempt trom the Contractor's LicenSe Law for the followin9 reason (Section ]031.5 Business antl Professional Cotle: Any city or munty which requir¢5 a permit to construct, alter, improve, tlemolish or repai� any slructure, prior to i[s issuance, also requires the applicant for such pe�mit to file a signetl statement Ihat he/she is licensetl pu�suant to tbe provisions o! he Conhactor'S License Law (Chapter 9(commencing with Section 7000) of ivision 3 af the�Business antl Professions Cotle) or Ihat he/she is exemp[ - ierefrom antl the basis for the alle9etl exemption. Any violation of Section 7031.5 by any applitant for a pe�mit subjects the applicant to a civil �nalty of_ no[ more [M1an f�ve huntlretl tlollars ($500). , L.J I,. as�owner of the p�operty or my employees with wages a5 their sole mmpensation, will tlo the work, antl the sVucture is not intentletl or offeretl for sale (Section �044, Business and Profe55ional Cotle: The ConGactor'S License:l2w tloes�not apply to an owner of a oroperty who builtls or improves thereon, ana who tloes such work'nimself/herseit or throu9h his or ner own employee5, provitletl lM1at such improvemen[5 are not in[entletl or offeretl for sale. If, howeveq�tM1e builtling or improvement i5 Soltl within one year ot com- plelion, the owner will Itave the burtlen ot proving he/she tlitl not builtl or im- .prove for the purpose oi sale). ' ❑ I, as'owner of [M1e O�operty, am ezUusively contracting wttM1 licensetl con- lractors to construci tne Project (Section ]044, Business antl Professions Cotle: The Contratlor'S LicenSe Ww tloes nof applY lo an owner of property wh0 builtls or improves thereon, antl who,conVacts for such projects with a con- tractor(s) bcense pursudnt to the Contractor's License Law). 1 am aware�that � proof ot th¢ir Worker'S Compensation,insurance shoultl be provided to me.� ❑ I am exempt under Sectibn B. & P. C. for tnis reason , Date � Owner _ I hereby certify tlta[ I have reatl t information is correcL I aqree to�co antl state laws relatinq to builtling � sentatives of this city to eryter u in5pection pyt'qoses. �, /� tate that the above tl county ortlinances :by authorize repre- ionetl property fo� Daie��—�i i��'� ��..�3/ � 3�� .,�, ,.�. I TYPE OF CONSTRUCTION rvEw 'ADD ❑ CpNVER510N ❑ DEMOLISH ❑ OTHER DESCRIPTION OF�WORK/USE OF BLDG. — ALTERATION TYPE OF PERMIT�y LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT CI EI.ECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 54. FT. - oCCUaANCv_ CONSTRUCTIONTVPE � VALUATION'$ 20NE GRADINGCU.VDS. ACRES— Remarks: Bar Sink Backflow Preventer Backflow Irrigation � Bathtubs� � Clarifiers � . Dishwasher Drinking Pountains' Floor Drains Floor,Sinks � Gas Service Outlets Interceptors Kitchen Sink ' Lavatories P-Trep Roof;Dreins � Reinspection Fee � $15 Boiler Duct - Under Ground Duct - SVuctural Duct - Ventilatinq Exhaust System ❑ Multiple Firepl/FacL BIL ICBO # Heatirig System & Ducting ❑0�100,000 BTU 0100,000 IDrivers' �icense or SS � I I Reinspection Fee • . I -$15 CMF 0865-46. /ev. ]0/84 VJhite - Builtling; Canary - ApO��cant; Pink - Acwunting: Goltlenrotl - As5Es5or � Showers � Service Sink Sewer Cap ; Sewer Connection Solar Collecmrs � Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays Issue Fee $3 A.P. # S Main Buildi E � T Front 6 Rear A C 'Right K g Left Ping. Ref. # � Planning Notes:' Automatic Washer• Construction�Pole Sub. Cooking Unit � � Dishwasher Dryers �Gas �lectric Fan F.A.U. F.ixtures Device Bozes Outlets SwitChes Garbage Disposal Generator �0-5 KW 05-15 k �1939 12/22/87 � , ' � Zone Accessory Building -. ' iParking Req./Provided ELECTRICAL . Trensfarmer -❑ 15�50 KW , -�.50+;KW Meter ❑up to 100 amps Meter ❑over�100 amps Sub Panel Motors � 0-7 H P Q 1 Y� - S� �Inc.Solar �9-15 HP �16-1 ' Micro�ivave; ' ' � Pole Light . , Jign ' • Standing Sections Trash Compacior ' Reinspection Fee ' $15' Issue Fee iANICAL � - � FEES DEVELOPMENT SEHVICES REQUIREMENTS: Hood or Type I ❑ Zoning Approved By Canopy ,Type II ❑ i - � , , , Building Approved By � /\ Refrigeration System . ❑0-100,000 BTU ❑100,000 BTL System Repair/Alteration Fire Damp Regisrers Issue Fee . ,$ 3 � : �a:Fn �TL Z O N I N G R E Q M T S FEES � SUMMARV OF FEES - ' BUILDING PERMIT $ -SMIP " $ ' � ' PLAN CHECK $� PERMIT � . � � - � PLUMBI�NG g-' ISSUANCE $ PLAN CHECK 25% $ -� ENERGV;P.C. $ _' � ' ELECTRICAL -$" b� GRADING - $ - PLAN�CHECK 50% $ � - MICROFILM ' S �� MECHANICAL $. TOTAL FEE $ � • � " PLAN CHECK '25% $ � � - ' , CONSTRUCTION AND PLANNING � -' - � ' APPROVALS Permi�tt#� 1i,Temporary Electrical Service or Pole �. , ',., 2��SoilPipe-Undrgrnd.� �i,� � 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. . ' 5. Steel Reinfarcement • ' ' 6. Electrical UFER Grnd. . 7. Footings ' .� � 8. Foundation ' '�� _ 9. Watei,Fipe-Undrgrnd. , . v� 10. Structural Floor SYstem � , i i. Property Sewer Line & House Connection 12. Sewer Cap , 13. Roof Drains � � 14. Rough.Plumbing 15: Rough Electrical-Conduit 16. Rough Electric Wiring • 17. Rough Wiring Sign � � -18. Rough Ele'ctrical-T Bar Ceiling '� 19. Rough Heating & Air Conditioning . 20. Rough Factory�Fireplace 21. DuCts, in Structure ' 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing 25 , Roof Sheathing . 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing - 28. Lathing & Siding � 29. Insulation . 30. Drywall Nailing � 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35.� Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final � _ 42. Backflow Preventer . 43. Backflow Irrigation -, - 44. Landscape Irrigation System � 45�. Sound Attenuation � 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48: Special Requirements Completed 49. Elearic Release to Edison - 50. Gas Release to Southern California Gas Co Date Date �% f-' POOL&SPA� t'.. � Inspector qppROVALS Permit # .- �ryi . . i ' S2. Pool &`Equipment Location' _ 53. Steel Reinforcement . 54. Forms 55. Electrical Bonding � � 56. Rough Plumbing & Pressure Test � ' 57. APPROVALTOCOVER-GUNITE ' 58. Electrical Conduit-Undrgrnd. .- 59. Gas Pipe, O Undrgrnd., Test ' •..•� 60. Backwash �Lines, P-Trap, � Undrgmd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final � 66. Solar System-Final 67. Fencing & Access Approval � 68. APPROVED FOR PLASTERING � 69. POOL/SPASYSTEMSFINAL � FIRE DEPT. REQUIREMENT APPROVACS Permit # _ 0 70. Underground Hydro 71. ProductPipingOGas ❑Oil 72. Underground Flush ' . 73. Undergrnd. Storage Tank O Gas ❑ Oil �74. Overhead Hydro 75. Dry Chemical� 76. Dry Standpipe 77. FIXED SYSTEM FINAL 7S. FIRE PREV. FINAL HEALTH DEPT.REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED . Notes: Date � Inspector HALE ELECTfiIC �1�29 flamingo Dr. COSTA MESA CALIF. 4�626 S�f6-'?61:' he: Fergeson Residence electi�ical load c�lcs. Mrs. Fergeson �29 Hanover dr. Costa Mesa, C:A. 7'0: Randv SucF: En�losed ai�e the load calc�al�itions and service reyuirements for the pro�ect located at �<9 Hanover dr. Costa Mesa DESCRIF'TI�N OF LOADS ----------- -- ----- 1,4�>G square {eet G 3watts per foot Electric �ven Electric F:ange , Electric Drier per N.E.C. Refridgerator Mir_row�ave r.�ven F.A.U. TOTAL WATTA6E G 100% First 1C��C�Ow e int�i Fem�ining 11,99C� G 45% Total Devided By <4�valts = 64 Amperes WATTAGE 4,200watts 4, 8.3C>watts 5,�9Uwatts S,i�ni�watts 920wat.ts 1,15Uwatts b0��watts 21,990 WATTS 1n,��on 5,�46 15,.?96 Watts E:;isting service si-<e; = 10�)amp. by General Electric. 0 AOC��cant to fill in all spaees exceot those within neavy bortler Iines ana sign all appropriate Oeclarations. CITV OF COSTA MESA CONSTRUCTION PERM�T . Project Address � z� �f�✓�U ✓ t� ,.��s„ � Q� Applicant'sMailingAddress �4-"�� - Owner'snlame J��e-* ��QV��L'"'` PhonesYv-033:� Address Sd� e Arch/Eng. � , License No. Address � c� ' � ' Contractor's Name -✓� �3� °'�-�^ � Phone 5�9'D27 Sj Addresslmailingl ZS'7S (r iA.,�,,.��Jtd� 1�+. C��"�• City License No. �� 9 z(oi LICENSED CONTRACTOR DECLARATION 1 1 hereby afflrm that I am licensetl untle� provisions of Charte� 9(commencin9 with section �000) of Division 3 of the Business antl Professions Cotle, antl my license is in II force antl effect. � License Class —� LicenSe N `1 Lrv'- $9 3 Date �- /9-�8 5iqnature � A--�._.� �z� � ��I� WORKERS'COMPENSATION ARATION � - 1 hereby aftirm Ihat I have a certificate of conSenLto Sel!-insure o� a Certificate ot Workers' Compensation Insurance, o� a certitietl copy theieof (Section 3800, Lab. C.) . . Policy No. " company eGertifietl copy is hereby furnishetl. Certifietl mpy i5 filetl with fhe nty Builtlinq DiviSiOn. Date - Applicant EXEMPTION FROM WORKEAS' COMPENSATION DECLARATION (Thissection neetl not be completetl if tM1e permit is for one huntlretl ($100) or less). I certity that in Ih¢ pertormance of the work for which this perT�t is issuetl, I shail not employ any pe�son in any manne� so as to becorr� subject to the Workers' Cor� pensation Laws of Cali/ r � Date ./- �"�� A � Signature n-.+�� rvoTICE: If, after making this declar on, you shoultl bewme subject to the Workers' Comp¢nsation provisions of th¢ Labor Cotle, you must torthwi[h compry with such O�ovisions o� this Oe�mit ,shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby af}irm that there is a construction lentling agency tor the per(ormanGe of the work for �which Ihis pevmi[ is issuetl (Section 3097 Civ. CJ . Lentler's Name - ' Lentler's Atltlress � OWNER.BUILDEH DECLARATION � , I he�eby'atfirm [haYl am exempt trom the Cont�ac[o�'s License,Law for [he followin9 reason (Section ]031.5 Business anC Professional CotleaAny city or county which vequires a pe�mit to consbuct, alter, improve, tlemolish.o� �epair any sVuc[ure, prior�to-its issuance, also requires ihe applicant for5uch permit to file a signetl statement that he/she is licensetl pursuant to th¢ O�ovisions of - tne Contractor's License Law (Chapter9 (commencinq witn Section ]000) of Division 3 of the Business antl Pw(essions Cotle) or tM1at M1e/she is exempt theref�om an0 the basis tor Ihe allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil � �enalty of not more [nan five M1untlretl tlollars ($500). LJ I, as owner of the property or my employees witn wages as their sole compensation, will tlo the work, and the sVucture Is not intentletl or ofteretl for sa1e.(Section �044, Buziness antl Professional Cotle: The Contractor's License Law tloes not appiy to an owner of a property who builtls or improves Ihereon,�antl who does such work himself/M1erzelt or through his o� her own employees, provitled that suclt improvemen[s are not intentletl o� offered tor sale. If, haweve�. the builtlin9 or Improvement is soltl within one year oi com- pletioq the owner will have the burtlen of proving he/zhe tlitl not builtl or Im- �rove for the purpose of sale). I, as owner of the property, am exclusively contractinq with IicenSetl con- tractorsto construct the project (Section 7044, Business antl Pro1e55ion5 Cotle: The ConVactor's License Law tloes not appry to an owner of property who builds or imp�ovez thereon, antl wM10 contracts for such p�oject5 with a con- t�actor(5I license pursuant to ihe ContractoYs License Law). 1 am awa�e that proof of their Worker's Compensation insurance shoultl be,provltletl to me. ❑�I am exempt untler Section B. b P. C. for this reason Date Owner 1 h¢reby certi(y Ihat I have reatl this application antl state that tM1e above information is correcL 1 agree lo comply with all city antl county o�tlinantes ana state laws relaling to builtling construction, antl hereby authorize repre- sentatives ot his city �tg enter on Ihe above-mentionetl Prope�ty fo� inspection p rp 5. �J O �� q Signature 1t��L Z Q-R //i� Oafe �'��%'�l� Drivers' License or 55 � � TYPE OF CONSTRUCTION LJ �NEW LJ ADD LI ALTERATION 'L� REPAIR ❑ CONVERSION ❑ DEMOLISH .❑,OTHER A p �t . DESCRIPTION OF WORK/USE OF BLDG. �� - GA4y a r3ect��.s� . 11/ l ' �S�"tl�✓—� .S MainBuilding: TVPEOFPERMIT GRADING FOUNDATION l�JSTRVCTURAL � •T Front ' ❑ TENANT ❑ ELECTRICAL �LUMBING ❑ MECHANICAI �B Rear . ❑'OTHER � C Right ' PROJECT DESCRIPTION 5Q: Fr. � occuPANCv � CONSTRUCTIONTVGE VALUATION$ S�J•O� S Left� ZONE Gi2ADING CU.YDS. ACRES P�ntJ. R¢i. ik Remarks: � � ^ � Planning Notes: . , i � PLUMBING � � FEES ' Sink Backflow Preventer Backflow Irrigation Bathtubs . Clarifiers Dishwasher Orinking Fountains Floor Drains . Floor Sinks GasService Outlets Interceptors Kitchen Sink � Lavatories P-Trap. Roof Drains ReinspeMion Fee � '$15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFact Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU O 100,000 BTi Reinspection Fee I $75 CMF 0865-46, rev. 30/04 White - Builtling; Canary - qppllcanh Pink - Accoun[ing; Goltlenrotl - AS5e550r $howers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater� Water Service Auto-Wash Laundry Trays Issue Fee iANICAL Hood or Typel ❑ , . Canopy Type II ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers �Issue Fae ' Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher - Dryers ❑Gas ❑Elec Fan F.A.LL Fixtures Device Boxes Switches Garbage Disposal � Generator �0-5 KW �5-15 [i390 !/P9/85 2one Parking Req./Provided ELECTRICAL . Transformer ❑ 75-50 KW ❑ 50+KW Meter LJup to 700 amps Meter ❑over100amps Sub Panel Motors �0-1 HP O7 h- 8 ', Inc.Solar �9-15 HP.016-15+ Microwave Pole �ight . . Sign �Standing Sections Trash Compactor $ 3 I J Reinspection Fee $15 luue Fee FEES DEVELOPMENTSERVICESREQUIREMENTS: Zoning APProved By Building Approved By � Applintion luued By $ 3 33e25 TL Z O N I N G R E Q M T S FEES $ 3 ' SUMMARV OF FEES � � BUILDINGPERMIT $ �p'�.OD SMIP, $ 'SV � PLAN CHECK � $ 7 '7 � PERMIT � PLUMBING $ 'I• 0 �G ISSUANCE $ .PLAN CHECK 25% $ �• `�C7 ENEFG�' P.C. $ � ELECTRICAL� $ GRADING $ PLAN CHECK 50k $ MICROFILM $ - MECHANICAI., $ ,TOTALFEE $ 33.zS . PLAN CHECK 25% $� � � �. CONSTRUCTION AND' PLANNING � � _ _� POOL & SPA APPROVALS �Permit# �Date �;Inspector pppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion � � � 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 -i �� ' ' 59. Gas Pipe, 0 Undrgrnd., Test � 9. Water Pipe�Undrgrnd. - • 60. Backwash�Lines, P-Trap, O Undrgrnd. 10. Structurel Floor System 67. 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 i 6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T 8ar Ceiling � ' r� 69. P00�/SPA SYSTEMS FIN'AL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT �J ' � 20. Rough Factory Fireplace ' APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. .Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing � . 73. Undergmd.StorageTank.OGas ❑Oil � 25. Roof Sheathing - � 74. Overhead Hydro � �� . 26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical " � � . 27. Frame and Flashing • Z� ��.� • 76. Dry Standpipe � '� 28. Latfiing & Siding � 77. FIXED SYSTEM FINAL `� 29. Insulation . 78. FIRE PREV. FINAL "� " 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat � • � 79. FINAL INSPECTION ;_ 4 � .�� -32. Electrical Power Meter-Final ' 60. FOOD CERTIFICATE ISSUED - - ` 33. Final Electric - Notes: . . � � � 34. Final Heating & Air Conditioning � , -• 35. Final Gas Pipe-Test � 36. Hood or Canopy _ � ' 37. Final Factory Fireplace � ' � � � ' ' . 38. Final Plumbing . 3fis�'ff LE� ", -� ', 39. Water Service-Final • ` -r 40. Gas Service-Final � ' � 41. Solar pomestic-Final • • ' � 42. Backflow Preventer - - � � � . 43. Backflow Irrigation ' � ,'1 . - 44.; Landscape Irrigation Sysiem � � ' - � . �, 45. Sound Attenuation � � � � 46. Handicap Regulations . �; -. � � 47. FINALSTRUCTURE&BUILDING 8 qp �. ,;� � - ' 48: Special Requirements Completed , �. 49. Electric Release to Edison � _ _ . ' ' • , 50. Gas Release to Southern California Gas Co - � 51. CERTIFICATE OF OCCUPANCY " ' - No. Date ' AGD��ant to flll in all spaees except those wit�in heavy bortler lines ana sign all appro0��ate tleelarations. CITY OF COSTAn�S� ,CpNSTRUCTION BERMIT PERM NQ.�� TRACT NO. LOT NO. UNIT NO. A P# . Zane ,(� �) t� Project Address GY LS��/(fQUE� �d/ ��j -_ S Main Building: Accessory Building: /�33 l�1 L�ivR[x�) TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR E Z AppiiCant'S Mailing ddfess ❑ CONVERSION ❑ DEMOLISH' � OTHER T Fron[ - p Owner's Name �£rG'USOiU Phone� DESCRIPTION OF WORKNSE OF BLDG. I A Rear . N Address C � Right . - N ArCh/Eng. LiCense NO. ' TVPE OF PERMIT GRADING�-�/ FOUNDATION ❑ STRUGTVRAL K G Address • ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL S� Left _ ❑ OTHER R Cont7actor's Name � � � Phone � Ping. Ref. # � � Parking Req./Provided E PROJECT DESCRIPTION Sa.FT. oCCuaqNCv a Addre55�mailing) 'r � �/�� --� CONSTRVCTIONTVPE VAIUATION$ PlanningNotes:, M T CityLicen5eN0. " ZONE � GRAOINGCU.VDS. ACRES $, LICENSED CONTRACTOR DECLARATION . l� C �{' I hereby affirm lhat I am IicenSetl untle� provision5 ot Charter 9(commencing Remarks:/�S�H� Q TC.IY �%� ' with section 7000) of Division 3 of the Business antl Professlons Cotle, antl /Q my license is in (u -fo 'e antl eftect. n ELECTRICAL _ FEES Licen�sS�yl�ass " LIq� ns No��/�S Date��L�7� 5'g t ,.(, �/ �„Qtye,� PLUMBING FEES Auromatic Washer Trensformer ❑ 15-50 KW WOR KERS� COMPENSATION DECLARATION ConSt�UCtion Pol2 Sub. � 50 + KW I hereby atfirm that I have a certiticate of COns¢nt to Self-in5ure o� a certlficate � Bd� Sink $hOW¢�S , ot Workers' Compensation Insurance, or a cer "' tl copy thereof (Section � Cooking-Unit Metet ❑up to 700amp5 3800, Lab. C.%.� Backflow Preventer Service Sink � q aoiic No. �/�� Com an �+ Dishwasher '� i� Merer ❑over 100 am s � v p Y , Backflow Irrigation Sewer Cap P C tifietl mpy is h¢reby fumishetl. Dty¢Is ❑Gas�„OElectric Sub Pd0¢I ert't' i iletl with the city gQ ilpybg D'vis� n. Bathtubs Sewer Connection Date_ �� AOPlicant f� Af �.(. �6�///�iri2d Fan Momrs �0-1 HP �1'h - 8 EXEMP ON ROM WORKERS' COMPENSATION DECLARATION Clafifiefs SOlar COII¢ctofs (Thissection neetl not be completetl if the permit Is for one huntlretl (g100) or . F.A.U. ' Inc.Solar �9-15 HP ��6-15+ iess)�. Dishwasher � Solar Piping I certity that in the performance of the work for which this perm�t is issuetl, I Fixtures shall no[ employ any person in any manne� so as to become subjeGt [o the Orinking Fountains $OId1 T3Ok MiclOw3v¢ • Workers' Compensation Laws of Califomia. � ' Date Si nature Device Boxes �. Pole Li ht . . 9 Floor Drains Swimming Pool w/Spa 9 . NOTICE: If, after making this tletlaration, you should become subject to the Outlets .Workers' Compensation provisions o( tne LaCor Code, you must torthwitn FloorSinks Urinal Range comply with such provisions or this permit� shall be tleemetl revoked. CONSTRUCTION LENDING AGENCV' ' G25$2NIC2 �ut12i5 W2L¢�CIOS2L $witch¢5 Siyn I hereby affirm that there is a consiruction lentling a9ency for the pertormance � ot the work tor which this permit is issuetl (Section 3097 Civ. C.) Interceptors / Water Heater . a Garbage Disposal Standing Sections Lentler's Name , �ender's Aaaress � Kitchen Sink Water Service �n Generator �0.5 KW �5-15 KW Trash Compactor OWNER BUILDER DECLARATION I I hereby affirm ltiat I am exempt trom the Contractor's License Law for the LavatOries Auto-Wash r�� followin9 reason (Section 7031.5 BuSiness and Professional Cotle: Any tity or munry which require5 a permit to <onstruct, alter, improv¢, tlemolish or repair P-Trap . LaUndry Tfe'y5 . any strut[ure, priOr ta its is5uance, also requires th¢ applicant for Such pe�mit ' to file a siqnetl statemenYthat he/she is licensetl pursuant to the provisions ot Roof Drains r the Contractor'S LicenSe Law (Chapter 9(commencin9 with Section ]000) of Oivision 3 ot the Business antl Professions Cotle) or that he/she is exempt � Reinspection Fee $15 luue Fee $ 3 the�efrom antl the basis fo� th¢ allegeG exemption. Any violation of Section . � 7031:5 by any applicant for a permit subjects the aOP��ant to a civil �� . . enaity ot not more than tive hundretl tloilars (3500). - DEVELOPMENT SERVICES REQUIHEMENTS: '� I, as owner of the properry or my employees with wages as their sole Reinspec[ion Fee $15 laue Fee $ 3 �; compen5ation, will do the wo�k, antl the structu�e is not intentletl or o�feretl . 2oning Approved By DetB for sale (Section ]044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES''.� Building Approved By Date�� License Law tloes not aOPty to an owner o( a praperty who builtls or'improves / tnereon, antl who tloes such work him5elf/herself or throu9h his or her own Applitation Issued By— Dat � employees, provitletl tha[ such improvements are not intenOeG or ofteretl for Boilef - Hood or Type I ❑ � sale. If, nowever, the builtling or improvement is soltl within one year ot com- Canopy Type II ❑ t" ' SUMMARV OF FEES pletion, the owner will have the burtlen ot provin9 he/she tlitl not builtl or im- Duct- Under Ground prove tor ehe purpose ot sale). ' BUILDING PERMIT $ SMIP $ ❑ 1, as owner ot me proverty, am exciusively convactin9 witn iicensetl con- Duct-Structural Refrigeratfon SyStem PLAN CHECK $ PERMIT tractors to con5truct tM1e project (Section 7044, BuSiness and Protessions Cotle: The Contractor's License Law tloes not apply to an owner of oroperty who Duct- Ventilating ❑0�100,OOOBTU ❑100,000 BTU _ PLUMBING $ ��U� ISSUANCE $ builds br improves tnereon. antl who.conVacts for such oroiects witn a con- � - tractor(sl license pursuanc io me convattors License Law). 1 am aware that ExhauSt System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $ proof oi their Worker's Compensation insurance shoula be provitletl to me. ELECTRICAL $ GRADING $ ❑ I am exempt untler Section . B. & P. C. tor this reason Firepl/Fact. BIG ICBO # Fire Dampers � ' MICROFI LM $ � . PLAN CHECK 50% $ r Date - � owner � Heating System & Ducting Registers ' MECHANICAL $ I hereby�certify that I have reatl mis application antl state that the above ❑0-700,OOOBTU �100,OOOBT _ TOTALFEE $`'�'� Information is correct. I agree to compty with all city antl county ortlinances PLAN CHECK 25% $ � antl'state laws relating to builtling construction, antl hereby authorize repre- . Sentatives oi. this city to en er upon the above-mentlonetl P� pe ty to� �. � � ' �� . • ` In50ectlon pu� s ' , ' '-� ' Slgnature ' f' Date % � � _;�� .. ReinspectionFee ' �$75 IsueFee $ 3 " pUF��ICATE �.`E��Z[--"Y3P� ' Drivers'!Li<ense or 55 � �� - � i4 0065-46, rev. 5/88 White - Builtlinq; Canary - Applicanq Pink - Accountinq; Goltlenrotl - Assessor v+ ow.�t��U-UUYJ�l1V ��J � �,p(j DATEc �1/26/9D TIME: t,5:15 'T . a . . " . � ..z .� . ,._.� � .... ...� . .. . . . . , .. . T.x _ _ ,-s a..+.r ,. . . � 6 \ , \ (•� CONSTRUCTION AND PLANNING � POOL & SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 7. 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 i. � � 58. Electrical Conduit-Undrgmd. `� 8�•Foundation . 59. Gas Pipe, � Undrgrnd., Test � 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd. � � 10. Structurel Floor System - - " 61. APPROVAL TO DECK 11•:-Property Sewer Line,&"HouseConnection ; . 62. Backwash & Receptor-Final 12. �Sewer Cap -^ � ,�� - � � 63. Heater & Vent-Final , 13.�'Roof Drains ' - , . 64. Plumbing SYstem - Final � � � 14. Rouyh Plumbing'� �� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final i6. Rough Electric Wiring 67. Fencing & Access Approval �.'17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ,1:8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 719. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT :� 20. Rough Factory Fireplace APPROVALS Permit # � r.�. �47j Duc[s, in Struccure , 70. Underground Hydro � � 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing � 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding . 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL . 30. Drywall Nailing � • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:�(o/qtj J�q/ pkEfi�ON�"E- LEF�Gq/'lw�- L• t�. D 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test ' � 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing Q ql�d L�L/� � 39. Water Service-Final �t? . 40. Gas Service-Final �r� � 41. Solar pomestioFinal � � - - . . „ -.� pf 42. Backflow Preventer � '�-'' �-' nr � 43. Backflow Irrigation '�� .' ;�: << 44. �Landscape Irrigation System . , ' �� ic 45. Sound Attenuation � � , � � � � ?° 46. Handicap Regulations �,i � , ' �� . >s 3P �i�47. FINALSTRUCTURE&BUILDING ' ' 48. Special �Requirements Completed � � �� 49. Electric Release to Edison ' '��r i ii �. �50. Gas Release to Southem California Gas Co � �� 51. CERTIFICATE OF OCCUPANCY � I'� ' � �, No. Date ' ` r� . �c7 � �� PRQIECT ADDflESS: Z z(j HANO��ER DR .� OWNEN'S NAME: FERGUSON, JANET � aoosess: 2 z g HANOC'ER DR COSTA MESA,CA AHCMIENGINEEP: nooness: UNIT: 92626 XEG.NO.: uxrt: venminee CLAYTON ROQFING ,__ ( 714 ) 543-6515 ADDNESS: z 3 1 4 N WR ILCLH T � SANTA ANA CA 92701 4CENSEO CONTHPCTOB OECUINRTION: I hereby affirm Ihat I am licensetl under O�o�isions a� Chapter 9(commencing with Seciion 7000) ol �iv��sion 3 af Ihe Business and Pmfessions Code. anA my license is in full �orce antl eflec�. CITY LIC.: O S Z/-Z 2,," j/`'sTaTe uc.: 6 012 2 6/� �cu�ss: C_ q� Date: —�,(l��3�-�— Signature: _/!(/ WOflRENS' CO PENSNrION DECL4flAT10N: I here�y al�irm Iha� I have a cetlitita�e 01 tOnsen� to selFinsure Or a tetli�ita�e o� Workef5' Compensaiion Insurance, or a cerli�ieA copy thereol (Seclion 3800, Lab. C). POLICY NO.: ' � E%P, OATE: COMPIINY: ❑ Ce�ified copy is hereby tumishetl. ❑ Cendie py is tiled wi[h Ihe ci�y BuilOing Oivision. Oa�e'. ROP��canC E%EMPIIONFflOMWOPKEflS'COMPENSA NUECIAPRTION: (Thi55tt1iannee0no16efAmpl¢IedilUepermli5�atonehundreE($100�or1e55�. I cerlily Ihal in the petlormance of Ihe ork lor which t�is permil i5 issuetl. I s�all no� em0loy any person in any manner so as Io become sublect to I�e, Work/er_i C,�ompensalion Laws oi Califomia. Da�e'. L12�L_t�rq L Signa�ure', �� NOTICE II. �iler making this 4eclaraiion, you 5hou10 Oecome subjec� b the Workers' Compensaiion pmvisions oi the labor Co�e. you mus� tart�wiih comply wi�� such pwvisions ar �his permi� shall 6e OeemeO revoked. CONSTNUCTION LENOING FGENCV: I hereby aHirm I�a� Ihere is a conslmction ientling agenCy for lhe pedOfmante Oi �he work br w�ich Ihis permi� is i=sued (Seclion 3097. Civ. C). LENOEN: AOONESS: OWNEF BUILDEH OECLAHNTION: I hereby aflirm �hat I am exemD< <mm �Ae ConVac�ors' S�a�e license Law �or �he �ollowing reason (Seciion 7031.5 Bu5ine55 an� Profe55i0nal COae' Any tiry 01 toUn�y which requires a permit IO cOnstmCl, al�er, improve, tlemolish, ot re0air any simclure. priar �a i�s issuance, alsa requires Ihe applicant for such permil to file a signetl sta�emeni t�at he/she is licensed pursuam m �he pmvisions o1 t�e Coniracmrs' State License Law (Chapter 91�ommencing with Section 7000� oi Oivisian 3 of the Business ana Pmlessians Code� or Ihai he/she is exempt Iherefrom anE ihe hasis for ihe alleged exemption. Any violation of Section 7031.5 by any applicanl �or a permit subiecis ihe applicant to a civil ve�alty of not mare tAan five hundretl dollars 13a`00). I. as owner oi the pmpeny or my employees with wages as iheir sole compensation, will Oa ihe woM, and the ❑ strucWre is nm intendetl or afieretl for sale (Sec�ion 7044, Business antl Protessional CoOe'. The Coniractors' State License law tloes not appry m an owner oi a pmpe�y w�o builtls or impmves ��ereon, antl who does such work himsell/�erself or ��rough his ar her own emplayees, pmvitle0 ihat such impwvemen�s are no� intended or oifere0 for sale. I�, however Ihe builtling or impmvement is sold wilhin one year of completion, Ihe owner will have �he burden oi Droving he/she di0 not builtl or impmve lor Ihe purpose ol sale�. I, as owner o1 Ihe pmperty. am exclusively contraming wit� Iicense0 coniractors ta constmct the Dmlect (Section 70d4, Business ❑ and Piofessions Cotle: The Conlracmrs' State License Law tloes not ap0y to an owner ol pmperty w�o builEs or improves the2on and wAo conVacis �or such prole��s with a coniractor(5) license pur5uani �o IAe ConVac�ors' S�a�e License Law�. I am aware Ihal proof ol �heir Worker'S Compensa�ion insurance shoultl be provided lo me. � I am exemp� untler Section: B. 8 P. C. for ihis reason: Daie: Owner: I tlo here�yaehify �ha� I am aware ol ana untlerstantl �he requiremenis ol Calilornia Heal�� antl Saf¢ry Cotle Sec�ions 25505, 25533, anA 25534 antl Wi 1 or any IUWre building occupan� wlll/will noi (circle one) neetl �o comply wii� sai0 s�a�e cotles an4 i�e reQuiremenis �or a permil lor con5imction ar motli6caiion Iwm Ihe Pv Oualily Managemen� O�strict. Fe5i4eniial consimction applicalions are exempt irom Ihese pmvisions. Date'. ApplicanC I here�y ceAdy that I have read �his application antl Sla�e �hal �he a0ove informaiion is correcL I agree to compty wiih all ciry antl counry ortlmances antl slaie laws relating Io building conslmc�ion antl hereby aulhorrze represen�aiives o� this ciry �o enter upon the abov¢-mentionetl Oropetly Ia n5pec�ion purposes. �aie: __�2,[� Si9nalure: �4l L —�-�� nver's Li�¢nse or Social Securiiy n.' [` 164L06 WhAe—Builtlmg, Green—Cotle Eniorcemen�; Canary—Applicanl', Pmk—Ravanue; GolCenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMZT PERM NO: B 06967� PERMIT NO: B 064672 PLAN CHECK NO; N GOVT: N 5UPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/OFF REROOF W/COMPOSITION SHINGLES SQ FT: 3,950 CLAIM VALUE: 3,950,00 CALC—VALUE: 3,950.Q0 GROUP OCC: R-3 / COMMENTS: PERMIT INCLUDES DETACHED GARAGE, SMOKE DETECTORS ARE REQUIRED ***�*�***��*�r***�r***��*��«**��*+�a�+�*�r***�***�***�**�c**�*+�********�*+�*�***��*�*x Z O N I N GS ERTEBc�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PAACEL: 19139522 ZNE: REF NO: PLANNING N TES> _• .� if ?f iE if if iE iE if iE iE 1E iE ik jE iE if iE M it iE if iE if 1F if 1f i! it i! if iE jf iE iE �Elt 1F iE i! k iF 1E if iE if if iE k iF i� if if Tf if if if iE iF iE it� 1E 1F ic iE %iF ii iE if iG iE �E iE iF iE i! aE aE iE 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 ZONING APPROVED HY DATE: � HUILDING APPROVED HY ; DATE: APPLICATION ISSUED BY; DATE: � 2 p� ifiFiEiEifiEi4lEifiFiFiFfE3E.3FiEififi6iEifiE��iklEiEiEiPiE�f�)h�f;F�ifiE �;F kiFlft�jEiEiEiEif#EjfiEifjElEif 1E jEif' 9E-IE �1E it iE 1E it it±f 1t i! fE it 1F ff aE #'� if if 1E iE iF if iE iE if if 1E iE if iE ik # 1E 1Elf iF it ik iE i(� 1f # if iE if 1h iE iE 1E jE �)t iE �lE iF M!E 1f iE iE fE �)F!E iF iE if it iF 3F if jE iE if iF fi if fE if !E �lE if LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG PERMIT 63.00 .50 SMIP/NON—RES PLAN ' ISSUE FEE " BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 63.50 0,00 0.00 63.50 63,50 ,00 REC�ENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK 63,00 ,50 M if iE iE iE 1E if if if iE iE if 3E iE iE k iE 1E if iE 1f ff iElt iE 1E iE if iE 1f iE iE if iE if if TF iF if if if if ik if if iE 1(� iE iE �f jf if iE 1tlF iE if iE fF �E 1E af if 1F if 1E 1f iF iE iE if # iE if if jE iE �E iF I N D I LI I D U A L F E E B R E A K D O W N � TYPE QTY D E S C R I P T I O N UNIT COST 'I'OTAL COST SFR 3950 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 3,950.00 END OF FEES ....:�.��.�: �� i �C'��"OR REQUIRE� �, oi 007<s763-0014?7E4 T�7 T ��,�[� C�4TE: iC!^3l9: TIhE: :0:46 � - CONSTRUCTION ANDPLANNING APPROVALS Permit # 1. Temporary Electricai Service oF Pole 2. Soil Pipe-Undrgrnd. � 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Scee! Reinforcemenc 6. Eiectrical UFER Grnd. 7. Footings 8. Foundation 9. Water Pipe�Undrgrnd. � t0. Sxructu�al Floor SYsiem 7 7. Property Sewer �ine & House Connection 12. Sewer Cap � 73. Roof Dra�ns . 74. Rough Plumbing � 15. Rough Eiec!rical�Conduit 76. Rough Electric�Viring V. Rough Wi�ing Siyn 18. Rough Electrical-T Bar Ce�ling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, VBntilating 23. G;s Pipe�Rough & Test 24. Roof Framing Z5. Roof Sheathing /, 26. T-Bar Ceiling (Structuralj & Monocoat 27. Frame and Flashing 28. Lathing Fi Siding 29. Insulation 30. Drywali Nailing 31. Piaster Brown Coat 32. ElecVical Power MeterFinal 33. Final Electric 34. Pinal Heating & Air Cond(tioning 35. Finai Gas P��e-Tesi 36. Hood oi CanopY 37. Final factory Fireplace 38. Final Plumbing 39. Water Servite-Final 40. Gas Serviae-Final 41. Solar pornestic-Final 42. Backflow Preventer 43. Backfiow Irrigation 44. Landscape Irri9ation System 45. Sound Aitenuation 46. Handicap Reguiations 47. FINAL STRUCTURE & BUILDING � 48. FINAL PIANNiNG 49. Electric Release to Edison 50. Gas Release to Soutfiern Catiforn;a Gas Q 51. CERTIFICATE OF OCCUPANCY No, Date Daxe � Inspector POv� & SPA APPROVAIS Permit?� Date �Inspector 52. Pool & Equipmenc Locaiion � 53. Steel Reiniorcement 54. Forms 55. Electrical8onding 56. Rough Plumbing & Pressure Test 57. APPROVRL TO COVER-GUNITE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, �7 Undrgmd., Test 60. Backwash Lines, P�Trap, C Undrgrnd. 61. APPROVALTODECK 62. Backwash & Receptor-Final 63. Heater & Vent�Final 64. Plumbing System � Final 65. Electrical-Final 66. Solar SVstem-Final 67. Fencing & Access Approvai 68. APPROVED FOR PLASTERING 69. POOUSPASYSTEP.4SFINAL FtRE DEPT. REQUIRE141EN7 APPROVALS Permit # 70. Under9round�Hydro 77. Product Piping �Gas OOii 72. Underground Flush 73. Undergrnd. Storage Tank � Gas O Oil "74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXEDSYSTEMFINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIRENtENT 79. FINAIINSPECTION 80. P000 CERTIFICATE ISSUED Notes: t'. %�i /h v .i� . ;•; :1 '��? ..YiO� , �OWNER COLLEG� PARK IQO, Ll DATE 9_26-57 )OB ADDRESS �2o Hanover Dri�re BUILDING PERR3IT NO. 57%7 GENERAL CONTRACTOR Harbor Construction VALUE $ 11,200.00 r ��p I & J . cCTIONS 3as 1'est / <'� U ZONE Rl DA7E � gUBCONTRACTOR Y�� PLAN NO. PERMITSISSUED � �. �� ". � COSTA MESA BUILDING DEPARTMENT P. O. BOX 31� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN eui�oirvc COSTA MESA. CALIFORNIA ADDRE55 s rnA N s� n TEL. CIT' ��ITA M�IA NO. AR0. .:T LIC. OR ENGINEER NO. AODRE55 i _ � / QTV LIC. ` 6=EE R��`�'� D SEP 1 3 1957 FiNANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDWG FOR OFFICE USE ONLY RECEIPT NO. P RECEIVfO BV OATE RECEIVE� pATE ISSUEO iv�xr/ 9- ia7-c-7 SEP 2 6 1957 / IFIRE ZONE BY COSTA MESA. CALIFORNIA LEGAL LOT I p CORRECTIONS DESCAivnON NO. (� 9LOCK TRACT I U A.P. NO. SIZE / rvo. or' e�ocs. OF LOT p X I I now oN �01 USE OF EXISTING BLDG. - SETB�CK LINE FROM CEVTER OF SiREET O ftEAft YAR� � SIDE YAR� RIGHT I O LEFT - DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPAIR MOVING �EMOLISH BUILDING NO.OF ' SIZE I ROOMS STORIES � EXTERIOR WALL ROOF COVERING � COVERING ' USEOFNEW ,_, _ o _____„__ I HEREBV nCKNOWLEDGE TMf�T I X4VE flEtD THIS I.PPLICRTION /.ND STATE TNAT THE ABOVE IS CORRECT l�N� AGREE TO COMPLV WITH iLL CITY OR�INLNCE$ /NO STATE Lfi�NS REGl1LPTING BIIILOING CONSTRIIC� T�o�. VALUATION SIGNATURE OF COLLEG E �ARK NO. L� PERMiT FEE $ �— PERMITTEE / � , � PLAN CHECK $ � — l ��, �/ $ � � �2��• / nuTHORi A6�[Wf /� V TOTAL FEE S T'� —`g'��