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Home My WebLink About3004 HARDING WAY - Building Permits(714) 754-5273 • F�c (714) 754-4856 • WMnV.ci.CoSte-m85a.C��ILDING PERMIT n FAIR DFNE, GOSTA MtSA, GA 92ti26 ,lob Address: 3004 HARDING WY Suite: Vicinity: REAR PROPERTY LINE Parcel Number: 14113335 Applicant: MOHAMMED, NAZMOON Address: 3004 HARDING WY COSTA MESA,CA Owner: MOHAMMED, AMEER Address 3004 HARDING WAY COSTA MESA, CA Contractor: OW N ER-BU I LDE R Address: � Zoning: Phone: 714-751-2532 � Zip: 92626 Phane: Zip: 92626 Phone: License: 000000 ISSUED BY: Status: ISSUED Applied: Ot/27/2003 Issued: O7/27I2003 Arch : Eng: Address: ' Address: Phone: Phone: ZiP: License: License: � SCOPE OF PERMIT CONSTRUCT 116 L.F. BY 6 FOOT HIGH BLOCK WALL ALONG REAR AND SIDE OF PROPERTY PER CITY STANDARDS. 2/3/03 REVISION - ADD ADDITIONA� 6 L.F. AT THE REAR FOR ENTIRE WIOTH OF LOT AND 46 L.F. ALONG THE RIGHT SIDE . Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: 30.00 Other: $0_00 Inspection: $0.00 Total: $137.86 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: 0 Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposetl: 0 Calc Valuation: Cla'rm Valuation: Right 0- 0 Right 0- 0 $2,320.00 so.00 I NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under California statutas and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire antl become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlona and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 >.aaae �sroo) � -� WORKERS' COMPENSATION DECLARATON: � I hereby attirtn under penalry of peryury one of the tollowing Aeclarations: ❑ I heve end wlll meintain a certilicete of consent to sell-Insure for workers' compensation, es proNded for by section 3700 of the Labor Code,dor Ihe pertortnence of the work tor whlch Ihis pertnit is issued. ❑ I �ave entl wlll maintain workers' canpensation insurance, as requiretl by sectlon 3700 ot Ihe Lehor Catle, for Ne partormance of ihe wwk br wNch ihis pertnit is issuetl. My workers' compensalion Insurance cartier and policy num6er are: Cartier: Policy Number. (Th/s secfion need nat be comp/eted i! fhe permi( is ve/uetl et ane hundretl dollero ($100) or less.J ❑ I certily ihat in ihe peAormance of ihe work for which Ihis pertnit is issued, I shall not employ eny person in any menner so es to becoma subject to the workers' compansetlon lews of Califomle, entl egree thet If I shoultl become su0�ect to the workers' compensation provislons of Saction 3700 of the Lebor Code, I shall torthwith comply wi�h the5e provi5ion5. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU6IECT AN EMPLOYER TO CFIMIWIL PENALTIES AND dVIL FlNES UP TOONE HUNDRED T/10USAND DOLLARE (5100,OW). IN ADDfT10N TO THE CQST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTIIXJ J106 OF THE UBOR WOE. IMEiiEST, M!D ATTORNEI"S FEES. IICENSED CONTRACTORS DECLARATION: I hereby aHirtn t�et I am licensetl untler provisions ol Chapter 9(wmmencing with Section 7000) of Division 3 ot the Business and Pmtessions Cotle, and my license is in full torce end eflecL Lic. a Class M Comractols Signeture: Date: CONSTRUCTION LENDING AGENCV: ❑ I here6y ettirm thet there is a construction lentling agency for ihe pedormance of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lenders Neme: Lentler's Address: Signatura: Date: OWNER-BUILDER DECLARATIONS: I hereby aXirm t�et under penalty of perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu end Professions Cotle: Any ciry or counry which requires e Dermit to consWcL alter, improve, tlemolish, or repeir eny structure, prior to its issuanca, elso requires the applicanl tor such pertnit to lile e signed stetement that he or she Is Iicensetl pursuent to the provisions of Ihe Contrectore License Law (Chapter 9(commencing with Sectlon 7000) ot Dlvlsion 3 of the Business en0 Proteuions Code) or thet ne or she Is ezempt t�erefrom and the hasis lor ihe elleged exemption. Any Woletion of Section 7031.5 by any applicent for e pertnit subjects the epplicant co a civil penelry ol not more then tive hundred dollars (5500)J: ❑ I, es owner of the properry, or my employees with weges as their sole compensatlon, WILL DO THE WORK, and Ihe structure is not Intended or offeretl tor sele (Sec. 7044, Business end Professions Cotle: The Contrecbrs License Law does not apply to en owner of properry who builtls or improves Ihareon, antl who does such work himself or herself or ihrough his or her own employees, pmvided ihet such improvements ere not intentletl or oNeretl for sele. If, however, Ihe builtling or impmvement is soltl within one year of completion, ihe owner-builder wi�l heva the burtlen of proving tha� he or she tlid not build or improve for purpose of sele.). ' ❑ I, es ownar of the property, am EXCWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimct Ihe project (Sec. 7044, Business antl Prolessions Cotle: The contrectors License Lew does not apply to en owner oi property who builds or Improves Ihereon, entl who contracis lor such project with e contractor(s) licensa pursuent m the Contracmrs License Lsws.). ❑ I am eaempt under sec. , � (,Business antl Professions CodQ tor this reasoy � Owner ID verilietl liy�/river's license. [�Yes ❑ No Driver's License No. Vedlicetion ol Ownership by (rype ot tlacumem, i.e. - propeny taz 6ill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certlfy that no excavation live (5) or more feet in depih into which e person is required to tlescentl, will be metle In connaction with work authodzed by this permi6 end that no building sirucWre, scaHoldinp, talsework, or tlemolition or tlismantlinp ihereoi, will be more Ihen ��irty-six (36) teet hig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Tl�le B, California Administrative Code). , ❑ As owner-bullder, I will not employ enyone to do work which would require e permit fwm the Division ot Industriel Sefety, es noted ebove, unless such person has e pertnit to do such work from ihe tlivision. Signeture: Date: Division oi Intlustnal Safery Permit Number: CERTIFlCA7E OF COMPLJANCE AND AUTHORVA710N OF ENTRY: I certity under penalry ot perjury that I have read this epplication and stata ihat the informetion qiven is correcc I egree Io compty with ell slate laws end ciry ortl{�ancas relating to building const cNon, end euthonze representatives of the City ol Costa Mesa to enter upon the ebove-describetl property for insDe�`ion purposes. I egr 9'not to occupy or allow occupa of eny building authorized by this per it until final inspection. nl01IJY1 / �2.�03 �C�s"i SianaWreOf eaalOwner ) Date GOUE �. INSPECTIONTYPE 1876 Fixetl System Final Fire Preventlon 1266 Pool Spe Finel 200 Final Re-Roof 201 Finel8lak/Retaining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demolition QejE - INTRIALS �,Z4-Q3 � COOE� INSPECiIONTYPE 206 Final Mechanicel 20B Final Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final BuiltlingiOccupancy �� PeIE I[4ID�Lfl •� k �'_ � � '1 •I'�1`j�c'1:d x�`; �, :ITI' �i�tiD. • :+u i. • 5. • af.�'. .. ;i • �'1!��•!!: � 'ara.� J i �� r y� r�'` ��1' ti �i S�.t • :'\.I�w� Iol��l�./_ J':' SUBIECT TO BLDci. llCe'l. iccu. NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROV$D BY THE PLANNING DIV. ' I' . • sow w,u.is�rt��;; estw�r r�• � s� na rmcrrr sfw.� BP SETBAIX AT 1FASI10' FROM FRONi PROPEIC[Y llNE • so� w,u.u�a�s sruia, Nar �c� r 6• w�carr wmm�r m oFnff �eorrr exo�rxrr � RaarcUxe ►�. • VERItY D6TAN� FROM CURB TO PROPER�Y [�NE AND 9tOW ON PL�N. VFRQ�7G7ION FROM TFtE Q[Y'S QJG�IIJG DIVBON 6 REQUIR�. CAIL (711) 75LSili PDR QQPORMAiION. �DATE: 2 �J "V'/ � ,pnlj(� I �!'��Y� -- --�_'}-o� -- I �� asx�a ' �� m _M 7 �oc�a 6 I� � M90ENQ i i � •""'"""""""""" � �--- n 1 � 1 RC90CMQ i i I � I j � I RC90ENQ i •-----GITY F OSTqjMF OQ� vIF-Q � M��a�u��a J J �p, �a oanma� J �o�� °��o BLOCK WALL LAY��t�'R'^�� PLANNING DIVISION � 31'� , �m,norWp��' -' ��c � �Dpmva r ��efe law i 18p daye o1 �s �u�� PICAL 6�� CONCRETE BLOCK FENCE 'i"FCIICEi'w ;- :-j �\ .� F�A? ^ '`' " 'X � i^ �r FenEef-5' or:leii : ' �„Vpn, Bars 378"¢at'�4';�0" O.C. .�y. ' � ..� ^ .T. � For Fences�ligheST1h'aii'S' � �en�Ban 3/8"�^t;3T`O.Q � : > -•'iill Celh'Solid YZ4RGtQu1 �wne`rtSieej;occai:-; t a.�cinlniiing' Steel;ShS1� '��onlorm lQ Sec7A� 15�39 A.S.T.M. T. �= w .. � AII Steel to 6e Lappec� 2A" or to Code > TWOLB"d8AR5 � CONTINWUS TOi 6 BOTTOM NOR�ZSTEEI MUST BE TIEO IN VLACE qT TIME OF TqENCM INSVECTION. WIDTH THICKNESS DEPiH OF �ARTHTOOTM SPACING OF' EARTHTOOTH GENERAL- NOTES MORTAR; p�a Part Plasfic Cement, and Three Parts Sund GROUT; One Part Cemenf TMee anG One Holt Ports S�and COPING: One Part Cement, TMee Ports Sand L'ONCRETE: Weil M�aed CZ-V2:3-�/2 Mc� of 7-I/2 Galicns of Wafar Per Sock of Cement GROUT MAV BE POUNED FROM THE TOP OF 7ME FENCE IN CELLS WHERE STEEL OCCURS. CELLS ANO AREASOF MOHIZONTAI NE�N FORCEMENT SHALL BE CIEAR, CLEAN 6 FREE OF p�L MOHTAR DEBR15, ETC. 'M CV' C4RLNTCOTH . . V! f��E NE�G7H Oi.�.ENCE �OW BO?70M OF �fOGT�NG , �CAL�E`.;I/2°= I' -�'� ', _ .. .-, .- - _ FOOTING REQUIREMENTSCHART 14� . . . . 14� . . . . . 12_. .. . . IZ- . I 0" 10" B"'' _ g r • 24" 20" 16" 12' 12' 14� . 16' 16' BUILDING DIVISION a:� . . . � �.:, i, . • 17-IIS Si�l'ai LS FOR INFORMA770NAL PURP066 ONLY. APPIJGNT LS RFSPONSIBLE FOR PROVIDIIJG AN ACNRATE REPRF5IN'fATION OF 77�IIt PROPERTY IIJ GSE 7HE StUPE AND SIZE DO NOT ODRRESPOND WIfH TFff IIJFORMAiION PROVmID ON hQS St�Ef. u • SOI]D WALIS/FENQ�S BEIWEII�12'6' h 6' IN F�IIGHf StIALL BE SEfBAIX AT LFASI' 10' FROM FROM PROPER'IY llNE. • SOI.m WAI1S/FENQ�S SHALL NOT IDC� 2' 6' IN k�IGHI WII7��I lO OF iHE fl20N7 PROPFRTY llNE �10T CURB 111dfj. • VEItR�Y DLSTAN� EROM NRB TO PROPFAfY UNE AND 4iOW ON ftAN. VERIflG1ION FROM 7}{E QIYS FNGP1E0tING D[V6fON LS REQUIRFD. GLL (I14) 7545344 A�R INPORMATION. r�°-! �3� �- �/ Z � � K � RE90Cwf2 � � �� m L �1�� 1 I PLAN INti DIVISION SUBIECT BLDG. DEP1: ] � N01'E: ADD ONS, DELETii I OR CORR ONS SHALL j APPROVED B�' THE PLANNIN � AE9DEMfZ I q[9DENfZ � �p[yp[N� I 1 � � '/ � '-----•-------------- --------- e: Ma_p�,oa_..0 Qr e.o�---•----- t �.._ -- - / �___ .�Ooy /'�tin� fSION OF Bf3iI.i3[�G SAFETY _ CITY(1F{]C4STAlu7F�A STREET A�PROVED I . ��,��. - ----- "--------- i i -- � -�e u.Nv � FOR BUILDING PERMIT DIVISION 0 TYPICAL 6�� CONCRETE BLOCK Cement Coping Op�ional — Channe10bck With 1�3/8� Hori:ontal Top oi all Fenca For Fences 5' or Less Ven. 8ars 3/8" yS at 6' �0" O.C. For Fences Higher Than 5' Ven. Ban 3/8"� at 32" O.C. � Fill Cells Solid Wi�h Groul Where 51ee1 Occurs Rnnimcing $�eel Shall Cunlorm to Sec.A�15�39 A.S.T.M, All Steel to he Lapped 24" or to Code NATURALGRADE TWO 7/8"O BARS Li CONTINUOUSTOP I B BOTTOM y_� HOQIiSTEEI MUST BE TIED IN PIACE AT TIME OF TRENCH INSFECTION. z 0 a x LL F a e �KI � SEE L BEL( 0 FENCE: : _ ; GENER�AL= NOTES _ ._ ` MORTAR; p�e Pa�t PlosliaCament, and Thiee•Paris Sand GROU7; One P_ort Certient Tluee� ana One Holf PaNs'-S�ond• COPING: One',Port Cement, Th�ee . Parts��5and - � • � CONCFETE: Weil.M�xed I.'2-,.I/2:.3-i/2, Mati�� ot 7-I/2 Gol;cns of. Waler•Per Sack•of CemenL, GROUT MAV BE:PO`URED FPOM THE TOP ' OF THE FENCE IN CELLS WHERE STEEL ' OCCURS. ' ' � � CELLSAND 11REASOF NORIZONTAL qEiN' FORCEMENTSMALlBECLEAR,CLEANd, ^ FREE OF ALL MORTAR DEBR15,'ETC. �a ; WIDTH 14" THICKNESS 10" DEPTH OF EARTHTOOTH 24" SPACING OF EARTHTOOTH i2' FOOTING REQUIREMENTSCHART 14� 10" 20" t4' BUILDING DIVISION 8� 16" 16' H CV C4RTHTCOTM �/' fHE HEiGTM O� FENCE �LOW BOTTOM OF fOGTiNG SCALE: I/2�� = I� i2„ 8'� 12" i6' " . .. L''�i � C''.o�ta ��2e�a �u�:��ur� D�i�o�. OWNER-BUILDER VERIFICATION A city or counry, which is required to give notice pursuant to Section 19830, shall auach to such notice, and, as a condition precedent to issuing a building pertnit, require the comple[ion and require the retum of, an owner-builder verification. Attention Property Owner. An `owner-builder' building permit has been applied for in yuur name and bearing your signature. Please complete and retum this information in the emelope pruvided at your earliest opponunity to avoid unnecessary delay in processing and issuing your building pertnit. No buildine permit will be issued until this verification is received. I. 1 personally plan [o provid the major labor and materials for conswction of the proposed property improvement. Yes ❑ No 2. 1(have/have not)-Z hG�� signed an application for a building permi� for the proposed work. 3. 1 have contracted wilh the following person (firtn) tu provide the proposed construction: Name �� Address ^ Phone ( ) City — Contractor's Lic. No. 1 plan to provide poRions of the work, but I have hired the following person [o coordinate, supervise and provide the major w�rk: n N�me _�, Address � Phone (��G� ) Contractor's Lic. No. 5. 1 will provide some of the work but I have contracted (hired) the following persons ro provide the work indicated: Name t0a2a6 �REV.958) Address Phonc Typc of Work 1 hereby affitm [ha[ I have received a copy of the information set forth in Sec[ion 19830 of the State of California Heal[h and Safety Code and have comple[ed the above information to the best of my personal knowledge, in compliance wi[h this State law. (Prinmd or Typed) C.D.L. # OR S.S. #� Date: 2. D For more information call City of Costa Mesa Building Division at (714) 754-5273. 1002J8 (REV.9/98) CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fex (714) 754-4856 JobAddress: 3004 HARDING WY Suite No Vicinity: Parcel Number: �4��3335 Applicant: PENSO, JOHN Address: 4522 EISENHOWER DR CA ANAHEIM Owner: MOHAMMED, AMEER Address: 3004 HARDING WAY COSTA MESA, CA contractor: ECONO AIR Address: 4522 EISENHOWER DR CA ANAHEIM ArchlEng: . Address: MECHANICAL PERMIT Phone: (800)503-2666 Zip: 92809 Phone: Zip: 92626 Phone: (800)503-2666 Zip: 92809 _ License: 445220 Phone: Zip: License: SCOPE OF PERMIT INSTALL 1 75000 BTU FAU. AND 1 A/C 4 TON UNIT. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refriq Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers . Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 70000cfm Floor Furnace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $14.80 50.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 so.00 so.00 50.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY Quantity _ PERMIT NUMBER I M99-00550 U 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/10/1999 Issued: 72/10/7999 ISSUED BY: � Repair / Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System Evaporetive Cooler Com me rcia l I n ci nerato r Domestic Incinerator Compressors / Absorption Systems Upto3hp/100kBTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up l0 3 hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $53.10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 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 780 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply vnth all applicable codes, and all required Inapections end (inel epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CAIL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby eHirtn untler penalty o/ perjury one of ihe following declarations: ❑ I have end will maintain e cenificate oi consent to self-Insure for workers' compensation, es Orovidetl for by section 3700 of the Lebor Code, lor the pertormance of the work for which ihis permit is issuetl. -- � I have antl will maintain workers' compensation insurence, as required by section 3700 ot the Lebor Code, for ihe pedormanca of tha work for which this parmit is issued. My work s' compey �tion Ins nce carriar and policy number are: / p Cerner. �Iv� - ��-C/ -� PolicyNumber. Lt�S� /O%8/�� (This section neetl no( be cromp/e(ed i! (he permif is valued et one hundred dollars ($100) or Iess.J ❑ I cenity that in Iha pertortnance oi th ork for which Ihis permit is issued, I shall not employ any person in flny manner so as ro become subjett to Ihe workers' compensation laws of Calif ia d g e ihat if I should bacome subject to the workers' compensation provisions of Section 3700 of ihe Lebor Coda, I shall forthwith �comply�wkh'these pron Q Applican ignature� T� �� 2��'9 / W�pIW RE TOS�Ct7fiE WOfU(ERS' COtdPEN$ATION COVERAGE IS UNL4WFUL PND SMALL SU61E EMPLOVE O CRIMINAL PEIJALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSANDDOILAFE($100,000),INADDITIONTOTHECOSTOFCOMPENSATION,OAMAGESASPROVIOE�FORIN 3]O60FTHELPBORCOOE,IMEREST,ANDNTTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I here rm th � ed under provisions of ce end c�. lic. k Contrea fsSiqnaWre: 9(commencing with Section 7000) of id Professions Code, end my licensa is in tull �d LORSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a construction lending egency for Ihe pertormance of Ihe work for which Ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: OWNER•BUILDER DECLARA710N5: Date: 1 hereby eNirm Ihat untler penalty ol perjury ihat I am EXEMP7 FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires a permit to constmc�, elter, improve, demolish, or repair any simcWre, prior to its issuanco, also requires tha applicant br such permit to file a signed s�atement Iha� �e or she is licensed pursuant to Ihe provisions of ihe Comrectors License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of ihe Business and Professions Code) or that he or she is exempt Iherelrom and the basis for Ihe allegetl exemption. Any violation ot Section 7031.5 by any applicant for a permit suhjeds the epplicant to a civil penalry ot not more Ihan five hundred dollars ($500).): ❑ I, as owner of lhe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe structure is not intended or oNeretl for sale (Sec. 7044, Business and Protessions Cotle: The Contractors License Law does not apply ro an owner of property who builds or improves Ihereon, ana who tloes such work him5elf or herself or ihrough his or her own employees, provided tha� such imprOvemenis ere not iniendetl or oHeretl for sale. If, however, Ihe builtling or improvement is soltl within one year of comple�ion, the owner-builtler will have the 6urden of pmvinq Net he or she ditl not build o� impmve for purpose of saleJ. ❑ I, as owner ot ihe properry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS b consiruct Ihe projeci (Sec. 7044, BuSinesS and Protessions Code: The contractors License Law tloes not apply to an owner of property who builtls or improves thereon, and who conirects for such project with a coniraaor(s) license pursuant m t�e Coniractors License Laws.). ❑ I am exempt under sec. Busineu and Professions Code lor ihis reason: SiqnaNre: Date: Owner ID verifietl by tlnvels license. � Yes ❑ No Dnver's License No. Expires: Ventication of Ownership by (type of document, i.e. - propeny tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in tlep�h into which a person is requiretl �o tlescentl, will be made in connection with work au�horized by ihis permit, end that no builtling structure, scaMolding, telsework, or demolition or dismantlinq ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 347, Title 8. California Adminisirative Cotle). ❑ As owner-6uilder, I will not employ anyone to tlo work which would require a permit irom Ihe Division of Industnal Safery, as noted above, unless such person has a permit to tlo such work irom Ihe division. Signature: Date: Division ot Indusinal Safery Pertni� Number: CERTiFICATE OF COMPLIANCE AND AUTHORVJITON OF ENTRV: I certify under penalty of perjury �ha� I have read ihis application and state Ihai ihe information given is correct. I agree to comply with all state laws and city ortlinances relating to building consiruction, end authorize represen�atives of the Ciry of Casta Mesa to enter upon the above-described propeny for inspection purposes. I egree not to occupy or allow occupancy of eny builtling authorized by this pertnit until linal inspeclion. LOpE �, INSPECTIONTYPE 7616 Fixetl System Final Fire Prevention 7266 200 201 202 203 Pool Spa Final Finel Re-Roof Final BIocWRetaining Wall Finel Fectory Fire Place Final Sign 204 Final Demolition 2446 <6 INTRIALS CODE 1 INSPECTION TYPE 206 20B 210 212 220 222 250 Final Mechanical Final Plumbing Final Electncal Final Fire Prevention Final Planninq Approval Final Site Final BuiltlinyOccupancy . •� T r1s �ili a �p MFS9 o. � > _ r J �'`��+F (714)754-5273 • Fax(714)754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: CITY OF COSTA MESA BUILDING DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT 3004 HARDING WY 14113335 npp�icant: PENSO, JOHN Address: 4522 EISENHOWER DR CA ANAHEIM Owner: MOHAMMED, AMEER Address 3004 HARDING WAY COSTA MESA, CA ELECTRICAL PERMIT Phone: (800) 503-2666 Zip: 92809 Phone: Zip: 92626 Contrecror. ECONO AIR Address: 4522 EISENHOWER DR CA Phone: (800) 503-2666 ANAHEIM Zip: 92809 ' License: 445220 SCOPE OF PERMIT INSTALL 1 75000 BTU FAU. AND 7 A/C 4 TON UNIT. ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 7000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 700hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to i kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Invesligation Fee Plan Check Fee Reinspedion Fee PERMIT NUMBER E99-01175 77 FAIR DRIVE, COSTA MESA, CA 92626 SWtus: ISSUED Applied: 12/10/1999 Issued: 12/10/1999 ISSUED BY: l '^" L Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 80.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 50.00 50.00 $0.00 TOTAL CALCULATED FEES 535.80 COMMENTS / SPECIAL CONDITIONS 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, § 7, 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 penod 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 requlred inapectlone and final approval must be obtained. Failure to obtain inspections and tinal approval will resufl in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby afllrm under penalry ot perjury one of the lollowing tleclaretions: ❑ I heve antl will maintein a certificata of consent to self-Insure for workers' compansation, es provided for by section 3700 of the Labor Cotla, tor the peAormance ot Ihe work lor which t�is pertnit is issuetl. � I have end vnll mainWin workers' ampensation insurance, es required by seclion 3700 of the Labor Coae, tor the pertortnance ot Ihe work for which this pertnit is issuetl. My worke/rg' compens,�y/�o�n Insur ce�cg� ^er antl policy number are: Cerner: / �S - w �c `�' � Policy Number. � � � � 6 y 8 �� (This section need nof be complefetl i! fhe permi( is veluetl et one huntlred dollars (5100) or /ess.) ❑ I certity that in the pertortnance of,tha o i r which this permit is issued, I shall not employ eny person in any manner so as to become subject to the workers' �mpen�ws of Califomia, Rd th t if I should become subject to the workers' compensation provisions of Saction 3700 0l Ihe Labor Cotle, I shall forthwilh visions. (7Q ApplicantSiqnaWre: !�' Dete: �Z'�O" 7 / WARNI � SE ORKERS' COMPENSAiION COVERA�E IS UNLAWFUL AND SHALL $lIB1ECT AN E YER TO RIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED T/IOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECiI OF THE L4BOR CODE, IMEREST, AND ATTOFNEI^5 FEES. DECIARATION: 7firm ihat I am ettect. uc. a _ t5 Slgnatura: Chapter 9(commencing with Section 7000) of Class k Date: Cotle, entl my license is in tull CONSTRUCTION LENDING AGENCV: ❑ I hereby alfirm that there is a construction lantling agency tor ihe pertortnance of the work for w�ich Ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lentlers Atltlress: Siqneture: OWNER-BUILDER DECLARATONS: Date: I hereby affirm ihet untler penal�y of perjury ihat I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit �o consiruct, elter, improve, demolish, or repeir eny structure, prior m its issuance, also requires the epplicant tor such permit to lile e signed statemem that he or she is licensed pursuam to Ihe provisions of the Contractors License Law (Chapter 9(commencing with Sec�ion 7000) of Division 3 of the Business end Pmfessions Code) or ihat he or she is exempt therefrom antl the besis for ihe ellagea ezemption. Any violation of Soction 7031.5 by eny epplicant for e permit subJects the epplicant to e civil panalry of not more then flve hundred dollars ($500).): ❑ 1, as owner oi the pmparry, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe siructure is not intantletl or oflered for sale (Sec. 7044, Bu5ine55 end Profes5ion5 Cotle: The Contrettors LicenSe Law dces noi epply to an owner of property who builtls or improveSlhereon, antl who tloes such work himself or herself or thmugh his or her own employees, providetl thai such improvemenis ere not Intended or oHered for sale. If, howaver, the builtling or improvement is sold within one yaar of complation, the ownerbuilder will heve the burden of praving ihat �e or s�e tlitl nm builtl or improve for purpose at sale.). ❑ I, es owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct t�e project (Sec. 76M14, Business antl Professions Gode: The contrectors License Law tloes not epply to an owner of preperty who builds or improves Ihereon, and who conlrects tor such pmject with a coniracror(s) license pursuant ro the Comractors License Laws.). ❑ I am exempt under sec. Business and Professions Coda for Ihis reason: Signeture: Da�e: Owner ID verilied by driver's licanse. ❑ Yes ❑ No Driver'S LicenSe No. Venficalion ol Ownership by (type of document, i.e. - property taz 6ill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: E:pires: ❑ I hereby certify thai no excavation live (5) or more teet In tlepth into which a person Is requlred to descentl, will be made in conneclion with work authorized by Ihis permit, entl Ihet no building sWdure, scaHolding, talsework, or tlemolition or dismantling thereol, will De more than t�irty-si: (36) leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, California Atlminisirative Code). ❑ As ownerbuilder, I will not emD�oy anyone to tlo work which woultl require a pertnit trom the Division ot Indusirial Safery, as noted above, unless such person has a pertnit to tlo such work from the division. Signature: Date: Division of Industrial Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EFRAY: I cenify under penalry of perjury that I have read ihis application and state that ihe information given is correci. I agrae to compty with all siate I ws and ciry ordinances relatinq to builtling construction, and authorize representatives ot ihe Ciry of Casta Mesa to enter upon the above-described propeny for inspectio�rposes. I egree not to occupy or allow acupancy ol any Duilding authonzed by this permit until linel inspection. COpE y, INSPECTIONTYPE � ' � �A�F INTRIALS 1616 Finetl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Root Final Block/Retaining Wall Finel Factory Fire Place Finel Sign 204 Final Demolition 2aa8�48 CO�EM INSPECTIONTYGE 206 Final Mechanical 208 Final Plumhing 210 Finel Eledrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy pRTE INTRIRLS ' �l_�l �i�1 � CITY OF COSTA MESA (,��pMFsq BUILDING DIVISION i4�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax p14) 754-4856 • w�wv.ci.costa-mesa.ca.us � � FOR INSPECTIONS CALL: (714) 754-5626 �"°°"""fi PERMIT NUMBER: BC10-00468 PERMIT TYPE: B COMBO STATUS: FINALED Sub Type: RES_ALT DATE ISSUED: 1 011 812 01 0 ISSUED BY: RMD �os nooResS: 3004 HARDING WY CM APN: 14113335 Zoning: , , Vicinity: THROUGH OUT HOUSE Const Type: SQ. FT: 0 Suite/Unit: Primary Occ: Valuation: $500.00 SCOPE OF WORK: HOUSING REHAB PROJECT. WORK TO INCLUDE THE REPLACEMENT OF 1 VENT FAN, 10 LIGHT FIXTS, 6 OUTLETS LOCATED IN DINING AREA AND KITCHEN, UPGRADE SVC TO 200A, 1 KITCHEN SINK, 1 WATER HEATER, 2 SHOWER VALVES AND 2 WASH BASINS WITH MINOR DRYWALL WORK. ELECTRICAL MANDATORY MEASURES ATTACHED TO JOB CARD AND CITY PERMIT. OWNER: MHC NSP LLC Phone: APPLICANT: CARMODY, R4Y Phone: 714-870-5640 Address: 3004 HARDING WAY City/StatelZip: COSTA MESA, CA Address: City/State/zZip: CON7RaCTOR: CARMODY CONSTRUCTION COMPANY License No. 399097 Phone: 71q-870-4640 Address: 1240 BIRCH TREE COURTUnit: Cell: City/State: LA HABRA, CA . ARCHITECT: ENGINEER: COMBINATION pERM1T FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees; SMIP Residential: SMIP CommerCial: Bldg Std Admin Fund TOTAL FEES: "Refe� ta (ee ret2ints for all /ees oaitl for oroiecf License No. License No. $0.00 $23.50 $54.00 $30.75 $62.70 $0.50 $0.00 $1.00 5172.45 Montlay thru Fritlay - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. F New Years Dav, Memorial Dav. Indeoendence Oav. Labor Unit: Unit: ZipCode 90631 PHONE: PHONE: ��_ � i�.; ,J: PER CMMC Sec. 13-279 3- Sundays and the foilowing Federal holidays: a Dav and Christmas Oav 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 (inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOEO. INSPECTIONTYPE DRTE INii11R15 COOE� INSPECTIONTYPE pATE INT11AL5 1fi16 Fixed System Final Fire Preventlon ' 206 Final Mechaniral X �— �o� �oZ Yr1�._ 1266 Pool Spa Final 208 Final Plumbing �(g —�_� ,�,.�_ 200 Final Re-Rqof 210 Final Electrical x�� "I �– /Yl�_- 201 202 203 204 Final8locklRetaining Wall Final Factory Fire Place Final Sign Final Demolition 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy -I(� ' .�-h�_ WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certifiqate o( consent to self-Insure for vrorkers' compensation, as providetl for by section 3700 ot the Labor Cotle, foi Ihe performance of the work for which thia permit is issued. ❑ I have and will maiNain vrorkers' compensation insurance, as required by section 3700 of the Labor Code, for Ihe perfortnance ot the work for which this permit is issued. My workers' compensation Insurance carrier antl policy number are: Carrier (TM1is seclion nee� no( be mmple(etl i/fhe peim� is valuetl at one hundietl dollars (5100) or IessJ Policy Number: ❑ I certify that in Ihe peRormance of the work for vfiich lhis permit is issued, I shall no[ employ any person in any manner so as to become subjecl to the workers' compensation lavus of California, and agree that if I should become subject [o Ihe workers' compensation provisions of Section 3700 0( Ihe Labor Code, I shall forthwith comply with these provisions. ApPlicanfs SlgnaWre Dale WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FMES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR W SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm ihat I am licensed under provisions of Chapter 9(commencing with Sec�ion 7000) o( Division 3 of [he Business and Professions Code, and my license is in full force and effect. Lic. # Class # ConVactor's SgnaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn Ihat there is a construclan lending agency for the perfortnance ot Ihe v.ork fa which this pertnit is issued. (Sec. 3097. Civil Code). lender's Name: Lender's Address: SignaWre oate OWNER-BUI R TIO S: I hereby aFfirm r' t I am EXEMPT FROM THE CONTR4C70R C t vnng reason (Sec. 7031.5, Business antl Pr sions c ty which requires a permit to construct, alter, prove, m any s[mcNre, prior �o iIs issuance, also requires the applicanl tor suc permit ro fle a signed statement that he or she is licensed pureuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pmfessions Code) or that he or she is ezempt Ihere(rom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tor a permit subjects the applicant to a civil penalty of not more than fve hundretl dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the strucwre is no1 intendetl or offered for sale (Sec. 7044, Business and Professions Code: 7he Contractors License Law does not appty to an owner of property who builds or improves thereon, and who does such vrork himsel( or hersel( or through his or her own employees, provided that such imprOvemenis are not intended or o(fered for sale. If, however, ihe building or improvement is sold within one year of completion, the owner-bu'tlder will have the burden o( proving tbat he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTR4CTORS to constNct the project (Sea 7044, Business and Professions Code: The contractors License Law does not apply to an ovmer of property who builds or improves [hereon, and who contracts for such prqect with a cont2ctor(s) license pursuant to the Coniractors License Lavrs.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: SignaWre Date 305]-.fi (3I0]) Owner ID verifed by tlriver s license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type o! document, i.e. - property tax bill or deed): DiVI510N OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certAy that no excavalion frve (5) or more feet in depth into which a person is required [o descentl, will be made in connection with work authonzed by Ihis pertnil, and thal no building sWCWre, scaHdtling, falsework, a demolition or dismantling thereof, vrill be more than thirty-six (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Califomia Administrative Code�. ❑ As owner-builder, I will not employ anyone to do vrork which would require a permit from Ihe Division of Industrial Safety, as noted above, unless such person has a permit to do such vrork from Ihe division. AppLwnl'S SignaWre Date Division o( Industrial Safety Permit Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will �he applicant or present or future building occupant need to fle and certify a Business Plan for emergency response to release or threatened release of a hazartlous material? ❑ Ves ❑ No (Section 25505 of the Califomia Health and Safety Code requires, wi[h some exceptions, tha[ a Business Plan be Bled with [he Cos[a Mesa Fire Departmen! by every business which has at any one [ime 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 feei of compressed gas at standard IemperaWre and pressure). 2 Does or wili fhe applicant or presenf or (uture builtling occupant neetl to file a regis�ration (orm for acWely hazardous materials? ❑ Yes ❑ No (Section 25533 of lhe California Health antl Safery Code, wi[h some exceptions, requires registration with Ihe Costa Mesa Fire Department by each business which at any one time has on hand a quantity o( acutely hazartlous matenals equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet oF compressed gas at standard temperaWre and pressure). 3. Does or vnll the applicant or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazartlous materials�? ❑ Yes ❑ No (Section 25534 0( the California Health and Sa(ery Cotle provitles Ihat the Costa Mesa Fire Department may require the preparation, certifcation and fling with ihe Fire DepaAment of an RMPP by businesses which are required to register awtely hazardous materials with the Fire Department. 4. If an RMPP is presenlly required, has Section 25534 of the Califomia Heal[h and Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or Wture building occupanl require for the work which is the subjeci of lhis application a permit for such construclion or modifcation from the SoWh Coas� Air Quality Management District or from any o�her air pollution control districl or agency? ❑ Yes ❑ No (Sectbn 658502 of Ihe Califomia Government Code requires Ihat the requested information be fumished on applications (a non-residen[ial building pertniis). 6. Will any part of the lacility to be consWcted under Ihis permit be wi�hin 1000 feet from the outer boundaries o( a school? ❑ Yes ❑ No (If "yes", the faciliry must meet the requiremen[ of Sec[ions 25534 and 42303 of the Califarnia Health antl Safety Code). 7. If a permit from the South Coast Air Quality Management Disirict or other air pollution control district or agency is required for Ihe work which is Ihe 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 trom the appropriate air pollution control officer). CERTIFICA7E OF COMPLIANCE: I certify �hat under penalty of perjury ihe information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signalure Dale CERTIFICATE OF COMPLIANCE AND AUTNORIZATION OF ENTRY: I certify untler penalty of perjury Nat I have read this application and s[ate Ihat the information given is correct I agree to comply with ail state laws and city ordinances relating to building construciion, antl 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 aWhorizetl 6y this permit until (nal inspection. Signawre oi Legat Ovmeqs) Wte Andlor AWhor¢ea AOPlican� ra�r.n •-4 �") """ o`- LA7.1'i Y Gl V � JOB ADDRESS 300 H2TCi1Clg W3y BUILDING PERMIT NO. Q�9�_ :GENERAL CONTRACTOR Owner-81dr. DESCRIPTION OF WORK AAA Familv rm_tn raa_ SUBCONTRACTOR or , - 2ssss COSTA MESA BUILDING-SAFETI' DEPARTMENT P.O. BOX 7P00 - COSTA MESA, GALIFORNU Y2l36 For Applirnnt fo Fill In Completely TYPE OR PRINT COSTA ME3A, CALIFORNIA II� MAIL STATE LIC. NO. BIZE oF LOT USE OP EX16T�N0 BL csrewcK un� NO. DESCRIPTION OF WORK �IOR WALL COVERINO uae or em�.otn �1 H6xleY ACKNO ANO BTM1TH TXAT PLY WITX ALL CI BUILOINO CONBiI � AYTHORIZGD AO[NT TM�T 1 NAV[ 11fAp iNl/ MPLIGTION IV6 It CORR[GT�AND AhR6[ TO COM• UNC�/ AND RAT� LAWY R[OULIITINO .r�� G d�n'ui n��21-6�P"1°OQ��c�� 13.5G cnsr. • �f�'`t. APPLICATION FOR PERMR BUILDING . f0� Offit9 {ISO �ri� 116C[IMI'HO. PEHMyTN�� / (o '� - M n�� v n owT �egu o . / J 4 � O // T C 6RO-U/Pq '/ I ' DATE / _`/' V � ZONIN(i MO.O� UY[OIN[W •uru emtowo �yyi �z3 , Y�3 - L// /.� o --� �s� \V6 OV[RHANO BHALL DH LE88 THAN VARD/ MPROVHD MAIN BUILDIN6 tOM GL 1 )NT � / oiorwNcc err. MAIN BLD61. VAR. # VAROSAPPROVfiD ACGELSORY BUILDIN6 esr. M�w a ACCFS➢. BL[ DAT6 _ . _ , � a w � �� eo. vT. ~ � a TH6 AYOUNT OXOWN UND6H VALUATION 16 IOq TH6 j ■UPPOB[ 01� [fTAGLI8HIN0 A PCPMIT P8H ONLY. .�J�. VALUATION �„� � PERMIT FE8 Sz' G'. s �p°O .` � TOTALFEC $ �� J ° 2�t FEE RECEIVED " ! �_�^-��-� �,,/ SEP 271961� COSTA MESA BUILDING-SAFETY DEPARTMENT r FINANCE DEPT. P. O. BOX'377 C08TA MEBA. CALIFORNIA CITY OF COSTA MESA For Applieanf fo F111 In Complefely APPLICATION FOR PERMI7 TYPE OR PRINT ' �i�t. BUILDING BUILDING �^ N^ _ /� �� (� A��RE68 t L� �..-.. P ✓ CO�'aTA MESA. CALIFORNIA For Office Use Only RECEIPT NO. �j CRMIT NO. oWNER K Sc K VE OBMENT CO. I NC, , i7 r'� MAIL rtec rveo er oe/r,¢ n�ec/�q�y� u/ o�re issueo� ADDRE55 K P C E I '7 � V✓ TB �CP '� 7 10� CITY B NO. ri7. 6– BUILDING ADDRES6 ARGH�TECT TE�. COSTA MESA. CALIFORNIA OR ENGINEER NONE NO. ADDRESS FIRE ZONE TYPE GROUP APPROVED CONTRAGTOR W. gy DATE ADDRESS a. P cent' A ZONING Tuewpor+, Beach zorven rvo.oc use ov nsw>µ %J+�%�B cin w� �, I PI.AN6 � I BUILDING y� � iic No. 611 No: Mi 6- 2� �ca"� ,�Je,�-Z3 �if �/L 3Z DEBCPIPTION SIZE NO. OR BIDGB. O OF LOT O� X O � NOW ON LOT p, p, NO. USE OF YARDS EVES EXISi1NG BLOG None APPROVED ALLOWED 88TBACK LINE PROM fC6NT6P LINe BTJ atNTex Ov sincai � � REAR YARD � FRON7 �� FT. �� IN. SIDE YARD I LEFY � �� I RIGHT � �� R. SIDE � d FT. � IN. DESCRIPTION OF WORK �.S�oE /o FT. / ,„. NFW I X II ALTERATION I II ADDITION I �_. _ I �_ _.. REPAIR I IIMOVING I IIDEMOLISH I° BYrrcovtu ��f'�Q OATE J�y6 p f't �/ BUILDINp� NO. OF p ' SIZE 1`fOOSQ.FT. ROOMS U STORIES ], EXTERIORWALI.� IROOF P„pD SHINGLE �I�D, COVERING J COVERING 7 USE OF BUILDING AND WORK TO BE PERFORMED � p N Sl P G2rage '� ' PLAN O. I HEREBY ACKNOW�D6E THAT 1 HAVB NBAD TN�B APPUGTION }M6 AMOUNT BXOWN UNU6R VpLUAT�ON IB FOR TME ANO eTATE THAT YMB A90VE IB CORRELT AND AGHHB TO COM• pURPOBE OF ESTABLIBMIN6 A PFRM�i FeE orvLY. PLY WITX AI.L CIi7 OHOINANCH9 AND BiAT¢ LAW9 R60ULATIN6 OmLoixo coNBTRU��ox. VALUATION SIGNATURE OF PERMIT FEE $ � � � PERMI7TE $ /5� 39/— PLAN CHECK $ � ]��j/ AUTHORIZEO AGENT ['�; � � TOTAL FEE V