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Home My WebLink About3020 HARDING WAY - Building Permits. JobAddress: 3020 HARDING WY Status: ISSUED Suite No Applied: OB/10/2005 Vicinity: REAR OF HOUSE Issued: 08/10/2005 Parcel Nunmber: 14113331 Applicant: HALL, ERIK Address: 3020 HARDING WAY COSTA MESA, CA Owner: Address � .. Contractoc�'' Address: Phone: 714-437-9295 Zip, .92626 PRESTI, ROBERT LEWIS 3020 HARDING WAY � � ;� ' ;� • ` .. ^ �Phone �' , • - CO$TAMESA,CA 3 R$` -" :'Zip 92626f .... � ' _� , , - _ y..',r . . . _ ,_ _ . . OWNER-BUILDER Phone: ISSUED BY: !'�� . , - Zip: .. . . License 000000 � - ' . . , .A . �;� ,. b, � ;.1 . ' .: � �„ .. � „ : , e-. �.. .�: . " �„SCOPE�OF PERMIT �x��="= �'{'� � � 'ELECTRICAL AND MECHANICAL PERMIT TO REPLACE THE EXISTING CONDENSING��UNIT WITH A NEW 9�.5 TON UNIT.��--� - " � ' � _' `�" `" � � �� ;,3. _ r V REF #MOS-00455 � '�-� � '�� . ` _. - -.-. .- -:-�. �:� - - � � i �: • WORK TO INCLUDE t MOTOR TO 10 HP' " ' � � ' � .� �g�' - � �� ,�.,, �, ., x - :� `_�-- � � ,. �. � rs- .. .4..-� � _ �. s�.;. . _ : < <a �-, _, , _f - " .. . .._ _i ` -- " FEE SUMMARY � ' ` �" ' "�� Quantity. - � - ! E, ' Quanhty� , ISSUE FEE �� $23.50 � � , -Temp Dist System / lighting, �, , ��$0.00 - 0 %�, Temp seryice test '�� $0.00_-- - � � � � � - " � Busv+ay"%100 ft r - - . , $0.00. :� , 0 Res. a/c package ,. $0.00.--_ Standing Section �� $0 00 ;'° 0 New Res (1-2 units) . ,. �... $0'.00 �� 0 Misc Electrical Equipment � $0 00 `Ii�A � New Res,(3+umts) �� $0 00 . 0 Transformers up to 1 kva/kw '$0.00 '� 0 Pool / Sps � . � `, $0.00 "-: -; 0 .............._up to 10 kva/kw $0.00 :. : s 0 , -., .�'' _°' ��__- .3F>f. Lighting Pizts : 3'' �$0:00 0 ....up to 50 kva/kw $0.00 :`., 0 Recept Outlet§ �'� �� '�$0.00 : � � 0 '" -.....up to 100 kva/kw „ 50.00 � �� ' 0 � . Switches �_ $0 00 �,: 0 , `� oyeb-_100 kva/kw �$0:0¢` e0 - Non Res Appl - � a. $0.00 ' 0 >� �Low,Voltage Equipment .. ��. $0.00 .0 '- Res Appl $0.00 •� 0':� r��c ,� s Low Volt Wiring System ! Ckl �.$0 00 0 Service to 200a ' $0 00 �,.�"-+.0_ � " � Misc: CondWt '' $0 00 ,.r�,� 0 ' � � Service to 1000a � �° $0.00- � 0 �, � Misc `Conductor'4,- � � <;� $0 00 ��- 0 - Service over 1000a , $0 00 0 �^�:t �' � Circu ( gen or nde) = " �� . �$0.00 � � 0 , • ��` Motors to 1hp - : $0.00, -` 0.. -„- - `�Grcas (mech-nde or lights)� $0 00 ;; -0� Motors to 10hp -:�=$12.30 ' 1 " •� �-�Ghristriias Tree SWnd '� $0 00 - `'�0 Motorsto50hp �-$0.00 0 <c.; - FlreworksStantl�; �^, ��' $0.00�.� 0 Motors to 100hp $0 OO�r �0 `�; - � ' `�"' Other,Elechical;Fee � �� . $0.00 Motors over 100hp $0.00 " 0 � -`- � � � ` � �' " Communicatlon drops $0.00 - 0��.,'��„- � ��Inves4gation Fee, • ' �"�� $0.00 Sub panel to 200a $0.00 0�`• ' �--PIan;Check Fee �:: $0.00 Pole Light Pkg $0.00 0 �'�� •.... s.,�. ' Reinspection� Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole 50.00 0 TOTAL CALCULATED FEES $35.80 NO710E: The work authorized by this permit shall comply with all applicable handicap access requlrements under California statutes and ralated regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended ocaband eon d for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all a licable codes, and all required Inapectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2446-4fi�N00) WORKERS'COMPENSAnON DECLARAnON: I hereby ettirm untler penalry of perjury one of the tollowing declarations: ❑ I have and will maintein e certificata of consent to self-Insure for workers' compensation, as pmvitletl for by section 3700 ot the Labor Cotle, tor Ihe pertortnance of Ihe work for which this permit Is issued. ❑ I have and will mainWin workers' compensation insurance, as requirad by sectlon 3700 of Ne Lebor CoOe, for ihe peAortnance ot the work for which this pertnit is issuetl. My workers' compensation Insurence carrla� end policy number ere: Cerdec Pplicy Number. (Thls section need not 6e crompleted i/ the permit is velued et one hundred dollers ($100) or less.) ❑ I certity ihat in the peAormance of Ihe worK �or which this pertnit is issueQ I shall not employ eny person In any menner so as to become subject ro Ihe workere' campensation laws of Celifomla, and agra0 thet if I should becrome subject to the workers' compensation provisions of Sectlon 3700 ot the Lebor CoCe, I shall fotlhwith comply with t�ese provisions. Applicant Signature: Da�e: WARNING: FAILURE TO SECURE WORKERS' COMPEN�ITIOPI COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED iF10USAND OOLLAFE ($100,000�, IN AODITIIXJ TO THE �T OF CAMPENSATIIXJ, DAMAGES AS PiiOVIDED WR IN SECTIIXJ 31O60F THE LABOF CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensetl untler provisions oi Chapter 9(commencing with Section 7000) of Division 3 of tha Business entl Professions Code, antl my license is In full ' forca and ettect Lic. p � Class N Contrector's Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm ihat ihere is a construction lending egency for ihe performance ot the work for which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penalry of perjury ihet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7037.5, Business and ProfesSions Code: Any city or counry which requires e permiC to constmct, alter, improve, demolis�, or repair any structure, prior to its issuenca, also requires ihe applicant for such permit to flle e signetl statement ihet he or she Is Ilcensed pursuent to the provision:c ot the Contrectors License Lew (Chapter 9(commencing with Section 7000) ot Division 3 of the Business entl Professions Code) or Ihat ha or she Is exempt iheretrom end the basis for the alleged asemption. Any violetion of Section 7031.5 by any e001icant for e permlt suD�ects the applicent to e clvil penelry of not mole than five hundretl tlollars ($500).): � ❑ I, es owner of ihe property, or my employe�s with wages as their sole compensation, WILL DO THE WORK, antl tha structure is not intended or ottered for sale (Sec. 7044, Business and Professions Cbde: ThB Conirectors License Law does not apply to an owner ot property who builds or improves ihereon, and who does such work himself or herseN ar through his or her own employees, provided thet such improvements are not intentled or oflered tor sale. If, however, tha builtlinq or improveme�l is sold within one year of complation, the'owner-builder will have the burdan of proving that he or she did not build or improve for purpose of sala�. ' ��s owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSEO CONTRACTORS to construct the prolect (Sec. 7044, Business entl Protessions �""��bode: The conirac�ors license Law tloes not apply to an ownar of propony w�o builtls or Improves thereon, and who coniracts for such project wlth e coniractor(s) license pursuant to the Contradors Licens6 Lews.). ❑ lam ventied by tlnvef5licensa. � re4 ❑ No Business and Professions Code for this reason: Vanlication ot Ownership by (rype of dwument, i.e. - property tax bill ar deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: ❑ I hereby certify thet no excavation five (5) or more feet in tlepth into which e person is required to descentl, will be mede in connection with woM euthorizetl by ihis permit, and that no building siruciure, scattolding, felsework, or demoll�lon or dismantling �hereot will be more ihan ihlrty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permi� from ihe Division of Industnel Sefery, as noted above, unless such person hes e pertnit to do such work irom the division. SignaNre: Date: Division of Indusirial Satery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUTHORW1710N OF ENiAY: I certify under penalry ot perjury that I have read this epplication antl staie Ihet ihe information given is correct. I egree to comply with a`state laws enG ciry ortlinances relating to building construction, end euthonze represantatives oi the Ciry of Coste Mesa to enter upon the above-described properry for'r�be� on s I egree not to occupy or ellow occupancy ot any building euthorized by this p�ertnit until final inspection. _.�„� O / �0.: ZQO� tSignaNra Of.LeBal Owner(s)'-` �;ID'ateJ COOE t. INSPECTIONTYPE 761fi Fixed System Flnal Fire Prevention 1266 Pool Spe Finel 200 Final Re-Root 201 Final Block(Retaini'g W alt 202 Final Factory Fire Place 203 204 Final Sign Final Demolition �g 0 � �d INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final ElecVical 212 Final Fire Prevenllon 220 Final Planning Approval 222 Final Site 250 Fina1 BuiltlinyOccupancy Data �g � C�TY OF COSTA MESA BUILD�NG D1V�S�ON DEVEL�OPMEN'T PERMIT � DEPARTMENT F�1��4%7��48� � "�'��'cosla•mesa.ca.us (714) 75�1'52�3 ' MECHANICAL PERM�T Job Add�ess: 302� KARDING W�' Suite Na VicinicY: REAROFHOUSE Parcel Number: 14h 13331 ppp�icant: HALL, ERIK pddress: 3020 HARDING WAY PERMIT NUMBER M05-00455 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED 6Y: ' Phone-.� 7�4-A37-9295 �� , . - ` - Zjp, 92826 _ . CpSTA MESA, CA . _ � , � Ownec PRESTI, ROgE,RT„LEWIS pddress. 3020 HARDING WAY�� -Phone..: "� ��' ' � : � .. Z�p. 92626 . COSTA MESA, CA' .. Confractor. OW NER-BU��fl�R Add�ess. .., , Phone. "�.. Zip: - • � - � � nse=000000 � ,'� - ; �-1 ? EU NE � y �RE LtCe Tf21CAL AND MECHADI�CAL PER �.3.5?ON WNIT( �� #M05-D0843 tKTO�fNC�UDE. � REPAIRIALT� S[atus: ISSUED qpplied: 0 811 012 0 0 5 Issued: OBl1012005 r.. - , , ,. � --� DPE OF PERM�7 � IIT TO RE�� XISTfNG CONDENSING UN 9T W�TH A, �� a' :� 7�., i 15T030HP,1?OOOKB - ,r,, , _ pOL11VGMEA7,A� 1 `.<,a,,, '.' z •� � QuanUty FEES� ,��: ,; $Qoo o ,� �� .. ,;� - f, , . ,� ' � � , � Quantiry . - Repair ! A1t Absorbtion�Unit �; $0 00 �. � � �* ;' Repair I;AIt ReEri9eration Unit . : . , $p.pp 0�, ` - ,� _ '�� 523 50 ��-` - � ba.�^ � �. stem $0 00 1SSUB'F,,EE -�.'$0.00 ; � 0 = ` ' " Vantillalloa Sy , , $0.00 --�%, lnst FAU'<10� k BT� �. $0.00 o Evaporative Cooler _ �-$p,00 � Inst FAU ?�00 k 8T� � - , ; $13.70 ' � Commerciat-Incine2tor RepairlARRe�s�S9Wa��aHtr . -- .> $0.00 � Domestic Incinerator Uon S stems�`. ,.,$� Q4 ;-�p Inst t Rep. . $p,pp 0 - Com ressors � Ab BTU � <100 k BN . :�p,pp 0 - Up to 3 hp 7 1D0 k Refrig SYS ,. $0.00 0 3 To 15, hp I 50� k BSU RePng Sys >�00 k BTW,;� � � �,000 k BTU Gas Pipin9 �" . $9 00 � , �`=. ` � ,�� ;- 55 To 3�:hP Fac1oN FirePlace ��$�.00., 0 3pSo�50 hP (�1,750 k�.BTU- $0 0� .. . � � Over 50 hp � Over 1`.750 8Tl Hood w�Mech EXhausl ' $� 00 �_ . ,.,_ ° Boif _ers` ; VAV Box �e.puct =. UP ro 3 hp �. "-�. Vent Fan ! Sing , ,$0 00 -. �:0 � _ ; .r � 0 ,..:«` _ ,a'x3T015;hP;';'- pppliance > $0,0� .- " p'iry Dampers - $� 00 _.._ � ..s `�' � 15 tot30 hp Smoke Dampers � gp,0� s.0 ,�a 30 to 50 hp�y ,__ r,a InstorRelocateApp�Vent` ___ g0`00 -0 ::-Aver�50,hp�- Air Handlers < 1��00°fm . $�.�Q 'p � , pther Mechan+ca� Fee } _ AirHandlers> 10�OOcim $�Q� _ p _ 'r_,�-<�nvestiganonFeer;=ti°._a� Floor Furnace $0.00,� �� plan Check Fee d Heater � .-. _ �Reinspe'ction Fes-� � " $0.00,.; 0 $3725� 1 $0.00 � $0.00 � .. . � ��5 � $0.00 � ° ` $0.00 0 50.00 0 � � �° $0.00 � $p.00 4 . `'� $0.00 $0.00 $0.�0 Floar or Suspen - � , . .. - '� - TOTALCALCULATEDFEES $74.45 1 wAh all app��cable handicap access requirements under Calitomia statutes and related this permii shalV comp Y ended or abandonec NOTICE: The Work authorized b2 21 92� S or it work is sUsp regutations. (��d. No. 92•29• 4 ire and beoome void it work is not commanced within 180 day , al, such wo�k must comply with a1� app�lcable codes,'an�d e EXPIRAT��N: This permit shaff automatically exp e�� tor a period of 180 daY$� ermit to be wnsidered �e9 d final approval will resull in the expiration of ��P ctlona ead final eDP�°val must ba obtatned. Fa��ure to oblain inspections a� ��/ INSPECT�ONS: �� ordar for the work authorized under th s p requtredlnspe 714 75M5626 FOR INSPECTI�NS CALL: l % WORKERS'COMPENSAnON DECLARAnON: I hereby a�rtn undei penalry of perjury one ot ihe tollowing declarations: � r ❑ I have and will maimain a certiticate of consent to self-Insure tor workers' crompensetion, �'s provitled�tor by section 3700 of the Labor Cotle, for ihe pertortnence of the work tor which ihis pertnit is issued. ❑ I have and will maintain workers' compensation insurence, as required by sectlon 3700 W the Lebor Coda, for Ihe pedortnance of the work Por which Nis permit is Issued. My workers' compensation Insurance carder and policy number era: Cerrier: Policy Number: (Thls sectlon need nof be completed i/ fhe permlt is valuetl at one huntlretl tlollars ($100) or less.) ❑'I certify ihat in the pertortnance o� the work tor which this pertnit is issued, I shall not employ eny person in any menner so as to become suble� io the workers' compensation laws of Califomla, antl agrae ihet ii I should becoma sublect to Ihe workere' compansation proNsions of Saction 3700 of t�e Labor Code, I s�all forthwith comply with these provisions. Applicent Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAW FUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED TFIOUSAND DOLL4RE ($100,000), IN A�DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOP IN SECTION 3]OB OF THE LABOR CAOE, IMEREST, AND ATTORNEY'S FEES. '�, LICENSED CONTRACTORS DECLARATON: I� I hereby aHirtn thet I am licansed under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 oi �he Business and Pmfessions Code, antl my license Is in full �� force and eNect. Lic. q Class q Contrectors SignaNre: Date: CONS7RUC710N LENDING AGENCY: ❑ I hereby ettirm thet there is a construction lending agency for the pertormance of the work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentler'S Atldress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm ihat under penalry of perjury ihat I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Protessions Code: Any ciry or county which requires a permit to conswct, alter, improve, demolish, or repeir any strucNre, prior to its issuance, elso requires iha applicant for such permit to file a signed statemant that he or she is Ilcensed pursuant b Ihe provislons of ihe Contractors License Lew (Chaptar 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and tha basis tor the elleged exemption. Any violation oi Sectlon 7031.5 by any flpplicant for e permit subjects the applicant to e civil penalry ot not more than five hundred dollers ($500).): ❑ I, as owner of the property, or my employees with weges es iheir sole compensation, WILL DO THE WORK, antl ihe structure is not intended or oHered tor sele (Sec. 7044, Business and Professions Code:.The Contractors License Lew does not apply to an owner of propeny who builds or improves Ihe�eon, antl who does such work himself or hersell or ihrough his or her own employees, provided ihat such improvements ere not intendad or oHered tor sele. If, however, ihe huilding or improvement is _solrwithin ona yeer ol completion, Ihe owner-builder will have the burdon of proving that he or she did not �uild or improve for purpose ot sale.). � ��j� I'as owner of ihe property, em E7(CLUSIVELV CONTRAC7ING WITH LICENSED CON7RACTORS to construct the prolect (Sec. 7044, 8usiness and Professions Code: Tha contrecmrs License Law tloes not apply to en owner of pmporty who bullds or Improves ihereon, end who contracts for such project with e contredor(s) license pursuant to the Caniractors License LawsJ. ❑ I am exempt � Business antl Pmfessions Cotle for ihis reason: _ �SlgrretTu,re:--- . �Owner ID venfied by driver's license. es ❑ No DrivePs Ucense�No. Verificetion of Ownership hy (type ot document, i.e. - propeny tax blll or deed): ��_,�� DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certily thet no excavation five (5) or more feet in tlepth into which a person is required to tlescend, will ba made in connection with work euthonzetl by this permit, and tha� no building sWcture, sceflolding, falsework, or demolition or tlismanUing ihereof, will 6e more Ihen �hirry-si: (36) fee� high. (Chap. 32, Gry 2, Ar12, Sec. 341, Ttle e, Califomia Administrative Code). . ❑ As owner-builtler, I will not employ anyone to do work which would require e permit from ihe Division of Industnal Safety, es notetl above, unless such parson has e pertnit to do such work from the division. Signature: Date: Division of Industnal Safery Pertnit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certify under penelty oi Oerjury that I have read ihis application end stete that the infortnation given is correct. I agree to comply with all state laws and city ordinances releting to building construction, and authonze representatives ot the Ciry of Costa Mesa to enter upon ihe ebove-descnbed property for i ction purpo s. I agree not to occupy or allow occupancy ot eny building euthorized by Ihis pertpnit until finel inspection. L� �� O `�D—ZGZJS�_ �Signa ur t Legal Owner(s) Date �—� And/Or Authorized Applicant Date CODE t. INSPECTONTYPE 1616 Fixed System Final Fire Pravention 1266 200 201 202 203 204 Poal Spe Final Final Re-Root Final Block/Retaining Wall Final Faciory Fire Place Final Sign Final Demolition p�TE �f� �Qpjt INSPEC110NTYVE 206 Final Mechanical 208 Final Plum6ing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy l�jf, IMIMLS �dH�P�/7SOl� G��1!'lye-Dt.t7� %�r�mJ%" R�N21� + t a s �da s�� h La �af/a r, a � .�C Lt,ti'/T' CITY OF COSTA MFSA PLANNING DIViSION ECT TO BLDG. DEPT. REG. I•IOTE: ADDITIONS, DELFTIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. f'Si pA�;Q/o 05 /dyo ty• ��, --- - - ��'� - ---- .�-- H�k9,ti�s- wA y --� 0 Ei�/,e /�fa / � 30� ,��,�y w�y C�rTq M Es�} � c,[�. �z6 2.6 PHOJECT PDDflESS: j O 2 O HAAD I NG WY � UNIT: OWNEN'SNAME: SALADEE HEVERLY A FLOOD; X 47 aooness: 3020 HA�2DZNG WAY COSTA MESA,CA 9<626 540-9497 AHCN/ENGINEEN: AOOXESS: flEG.NO.: UNIT: PERmiTTEE: HUFFMAN CONSTRUCTION ( 714 ) 540-9497 AOOPESS: 1 S S S ATLANTA WAY C,M. CA 92626 UCENSEU CONTBALTOP UECIAflATION: I �ereGy a�lirm thal 1 am Iian5e0 unaer pmvisions al Chapler 9(commencinp wi�� Seciion 7000� ol Omsion 3 0l i�e Buvneu ana Pmlessions Cotle, anG my license is in tull iwce and etiect. STpTE LIC.:Q 2% z 9 5 .// cus/$:�� ate: � 14 N� Signa�we: /� �• � 1� REBS' COMPENSATION OECIAflFTION: I �ereby atfirm that I have a certitica�e o� consenl lo sel4insure or a cehifica�e ol Workers' Compensation Insurance, or a cenified coDV Ihereot (Secuon 3800. Lab. C�. POLICY NO.: EXP. OATE: COMPANY: ❑ Cerlilie0 copy is �¢reby Wmishetl. ❑ CenifieJ coDY is filed with the ciiy Building Oivision. Oale: Applicant: ENEMPTION FAOM WONKEHS' COMPENSATIUN DECLAPATION: (This section neea na� be completea if �he Dermit is �or one hunOreO (51W) oNess�. I I cerlily Ihai in Ihe periormance ol �he work lor which ��is permit is i55ue0, I shall no� employ any person in any manner so as �o become SU�IQLI �0 IhC WOMClS COIIIpCOShciOfl L2W5 01 CdIi�0�0id. � / � ate: � � ; �5`�� Signa�ure: /tLiiiiiv '� . � TICE: II, afler making inis aeclaration, you snoultl betome suUject to ihe WOBers' Compensation provisions of Ihe LaOor otle. you musl �orl�wiih compty wit� 5uc� O�ovisions or Ihis permit shall be tleemeE revoke0. ONSTPUC710N LENOING FCENCY: I hereby atfirm ihal ihere is a consimction lending aBency lor ihe De�ormance of the work lor which Ihis permit is issuea (Sec�ian 3097. Civ. C�. LENDEN: nooness: SMOKE DETECTORS REQUIRED OWNEB BUILOEB OECIAflATION: I �ere0y a��irm Ihai I am ezempt �rom ��e fqnVatlors' State License Law lor t�e lollavnng reazan ISection 7031.5 Buvneu an0 Pwfe55�onal Coae: Any ciry ot couniy whic� requires a permii Io conslmci, alter. imD�ove, G¢moliSA, or reDair any S�rutlUr¢, pri0r Io iis issUante. alSo re0uir¢5 ��e appliwni lOr 5uth permil to lile a 5igne0 S�alemeni I�al heJshe is lit¢nsetl pursuam to ine O�ovisions ol t�e Comracmrs' Staie License Law (Chapter 9(commencinA �� Section 70W� of Division 3 0l tne Business ana Pm�essions COGe� or I�al �e/she is exemD� Ihereimm antl �he basis lor �he allegeG eremD��on. Any violali0n o� Seclion 7031.5 Gy any apPlicantlor a permii suCl¢cis I�e aOD�icant �o a[ivil penalry oi na� more lhan �ive huntlreU tlollars (E500�. 1. as owner ol i�e Dmpeny or my employees with wages as their sole compensation, will Go �he work, anE ihe ❑ stmcture is noi imenaea or offereU far sale ISection 10aa, Buvness and Professional CaOe: The Conlraciors' State License Law Eoes nol apD�Y io an own¢r 01 a pmperiy wtq builtls or improv¢5 Ihereon, antl w�o GoeS suctl woA �im5ell/II¢rsell of lNough his or �er own employee5. pwvitleE I�at suc� imprwemenis are not in�en0etl or ofler¢E lar 5aie. Ii, howaver I�e huilUing or impmvemenl is 5a10 vnt�in one year 0� complelion, Ihe owner will have Ihe buraen o� pmvinp �elshe tli0 noi OuilU a� improve tor Ihe Durpose ol salel. I. as owner ol ihe pmDeny, am exclusively contracting wilh licensetl contractors to construci ihe pmiect (Section 7044, Business ❑ and Proie55ion5 Code: TAe Conlracior5' S�ate Li[en5e Law Aoes no� appty to an owner 0� prop¢rly who �w105 or imprOveS Nereon ana wM10 contrads br such prolecis wi�� a wnVactor�s� license pursuant to Ihe Cantraciors' S�at¢ Litense Law�. I am aware Ihat pmol af IAeir Worker'S Campensation insurance shoultl be pmvitletl �o me. � I am exempl wEer Section: B. 8 P. C. lor i�is reason: . Dale'. Owner I tla here�y cerlily Ihal I am aware oi antl untlerstana Ihe requiremenis o� California Health ana Salely CoOe $eclions 25505, 25533, and 2553d and Iha� I or any Iuiure building occu0an� willlwill noi (circ�e one) need to compty wiN saitl sta�e codes and the requiremen�s for a permit lor consimction or moUilicalion Irom I�e Pir Oualiiy Managemen� OiSirict. flesi0enlial cons�mction applica�ions ar¢ ¢xempt imm �hese pmvisions. �aie: Applicanl: I hereby cerlily I�ai I �ave rea0 t�is apPliCatiOn antl Siale Ihai �he above in�ormation is correcL I agree l0 comply wil� all ti�y and t0unry ortlinancesantlstatelawsrelalinglobuiltlmgconstmclionandherebyauthorixerePre5en�ative5oft�isciry�oenlerupaniheaUove�mentionetl pr forinSDeCiiOn purpo5e5. � n // �� J �wr r..-�- a Oare: r.--. 1'7 ,j9go Signamre: ,�� s �icense ar Sociai Searny x: 1601�46 While—Builtling; Green—COOe Enlorcement; Canary—Applicanl; Pink—Revenu9: GOlpenr00—Assessar CITY OF COSTA MESA — BUILDING FERMIT PERM NO: B 070870 PERMIT NO: B 070B70 PLAN CI-IECK NO: 00272-95 L GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: CON JOB DESCRZPTION : LEGALIZE ENCLOSED 172SF HREEZE WAY SQ FT: 6,360 CLAIM VALUE: 6,360.00 CALC—VALUE: 6,360.00 GROUP OCC: R-3 / COMMENTS: LEGALIZE ENCLOSED 172 ADDED TO LIVINING ROOM **r*+�**�r****��r*+r**r*�*r�r**�r*****+�*****�r**�c*******rr*+rr*x***r*rr***�*****�x-�*+��c* Z O N I N G R E Q U T A E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT ZN RGFIT; FT IN LEFT; FT IN RGHT; FT IN PAAKING REQ• PROV; PARCEL: 14113331 ZNE; R1 REF NO: PLANNING N(3'I'ES> ENCLOSE EXISTING HREEZEWAY AREA TO EXPAND LIC�ING ROOM i +r***�r+e*+�rr*�r*�r*r,rr****+t�r***�r****+t*+t***�r+�**,c+r****+r**�r*r+r*****�r+�r+�*x�*****�**�r*�- 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 BY �t� DATE: SUILDING APPROVED BY ; �Stly-� DATE; � S APPLICATION ISSUED BY; �-� D AT E : if�IflFkMif4YlEiFil4ifiFiF{kiFMitififif3F�iFiFil�iFiF�iF�iF�FiF 3FPiFiF�Sf3F�i�{f�'i��FifMMMifMitYilR lfif r if ifif iFiE if if if iEifk iFlfif k1FiE 1f M itit i!M if ifif M1f if if iE if ifiE if4lfiE if if if �f if if 1f 1E iFif M iF �fit ii if �Filif Y riF1f if it1F if 1f ir if 1: ac ifif if iFif if at aF LEGALIZATION;Y F E E S U M M A R Y STRUCTURAL SEGMENT;Y 6LDG PMT PLUMBING ELECTRZC MECHADIIC FIRE SMIP/RES GRADZNG PERMIT 180.00 ,64 SMIP/NON—AES PLAN 117.00 . ISSUE FEE BUILDING—DIC�—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE - TOTALS----> 180.69 0,00 58,50 239,14 239,14 ,00 REVENUE DZVISION TOTALS--> COLLECTED: — 239.14 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 180.00 ,64 58,50 M lflf if rt �f if jf if iF 1f ifiE ifif 1f 1f 1f 1! if M if 1f ifif !f k!F M if if !f if ff it if if41f �f 4 if if 1t if iE 1f iE 1EM M M ifiE iFif ik if ff 1fif4 1fiF r i4�)f �! if Y M iF ifiEif iF ifif iE I N D I V 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 TOTAL COST SFR 6360 ALTER HY VALUE RESIDENTIAL NOZONE 1,00 6,360.00 END OF FEES ^! ovirssss-ooi7ss�o r��-r za,.io �JS1E: �1�2�/9G 7I!'!E: il:i's CONSTRUCTION AND PLRNNING F _& SPA APPROVAIS Permit# Date Inspector APPROVAIS Permit .�t` Date Inspector 1. Temporary Eleciricai Service or Pole 52. Pool & Equipment Location 2, $oil Pipe�Undrgrnd.. 53. S[eel fteinforcement 3. Etectrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit�Undrgrnd. '55. Electrical Bonding • S..Steel Reinforcement ,56. Rough Plumbing & Pressure Test 6. Electrlcal UFER Gmd. � �57. APPROVAL TO COVER�GUNITE ' . 7. Footings �58. Electrical Conduit�Undrgrnd. B. foundation 59. Gas Pipe, O Undrgmd., 7eu - 9. Weter Pipe�Undrgrnd. 60. Backwash Lines, P•Trap, � Undrgrnd. 10. Structural Floor System "67. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Recepior-Finai 12. Sewer Cap 63. Heater & Vent-Fina� ' 73. ROof Drains " 64. Plumbing System - Finai 14. Rough Plumbing 65. Electricai�Final 15. Rough Electncal•Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approvai 17. Rough Wiring Sign 68. APPROVED FOR P�ASTEFING 78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEb1S FINAL 19. ROugh Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ..' - , � APPROVALS Permit # � 21. Duccs,inStructure � .• _ _ • 70. Underground�Hyclro 22. Ducis, Ventilating • .71. Product�Pipi�g C�Gas ❑Oii 23. Gas Pipe-Rough & Test - . 72. Underground Flush 24. Roo� Framing' ' � , 73.�Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing � :i " 74. Overhead Hvdro 26. T-Bar Ceilinq (Structural) & blonocoat ' � 75.'Dry Chemical 27. Frame and Flashing� • 76. Dry StandPipe �" � 28. Lzthing&Siding . "•-�� ' ' " 77..�FIXEDSYSTEMFINAL � 29. Insulation . , •� 78.�FIRE PREV. FINA'L 30. Drytivall Nailing ' . , � FjEALTH DEPT. REQUIREMENT 37, Piaster Brown Coat •�„- i�.79. FINAL INSPECTION 32. Electrical Power Meter�Finai ' �'� ''80. �FOOD CERTIFICATE ISSUED 33. Final Ele�iric • �Notes: . 34. Einal' Heating & Air Conditioning_ � � ,Z_ /_g S - 1-'f_ �. � �..� � �� l f/-� � 35. Piiiai Gas PipO�Test ,. _ . , � ��. 36. Hood or Canopy , � � � _ , 37. Finai Factory Fireplace , � ,. � 38. final Plumbing , , _ 39. Water Service�Final ` ' - � • ' . i � 40. Gas Service-Final • ' � 41. So�ar�omesticF�nal �� ' . � ,� . . , 42. Backtlow Preventer � � � - � 43. Backfiow Irrigation � , . . . 44. Landscape Irripation System � .� ' ' � � ' � - 45. Sound Attenuation ', ., „ . , , 46. Handicap pegulations . � ' • 47. FINAL STRUC7URE & BUILDING 2-� ..Ct�"'� ,� . 48. FINAL PLANNING � ' _ � ' , 49. ElecYric Release to Edison ' � �� 50. Gas Release to Southem Califomia Gas Co - • �� 51. CERTIFICATE OF OCCUPANCY � No. Date PNOJECTROOflE55: 3OZO HARDING WY OWNEH'SNRME: SALADEE BEVERLY A PDUflE55: 3OZO HA{2DING WAY COSTA MESA,CA 590-9497 ANCHIENGINEEN: ADONESS: 2� � �N�T: FLOOD: X 47 92626 flEG.NO.: UNIT: PEpmiTTEE: HUFFMAN CONSTRUCTION ( 714 ) 540-9497 nooxEss: 11 S 1 ATLANTA WAY C.M. CA 92626 LILENSEO CONTflPCTOfl OECLAHpTION: I �ereDy aHirm IAat I am licensetl unaer pmvisions of ChaD�er 9(commencing with Sec�ion ]000) o� Orv�sion 3 oi �he Business an0 Gmiessions Cotle. and my license is in lull lorce anE eilect. CITY LIC^.: STATE LIC.:Q 2% 29 S ss: H. EXP : oate:.�6l�"^^ '1S r9S Signature: . ` _ _ r �_�� +� WOBNEBS' COMPENSRTION UFCIABRTION: 1 Aere�y ailirm I�a� I �ave a certi�itaie 0� to ¢n� l0 Sel4insure Or a certilica�e ol Workers' ComDensation Insurance. or a ceniliea cooY ��e�eol (Sec�ion 3800, LaC. CI. oOLICY NO.: E%P. ORTE: COMPPNV: ❑ Cetliliea CopY is hereby lurnis�ed. ❑ Ceriified topy is tileC wilh Ihe tily BUiltling Division. �ale'. PODlicant: E%EMPTION FHOM WOFREflS' COMPENSp710N OECLAAATION: (Thi55eciion neetl nol be comple�etl ii Ihe Dermit is br ane huntlre0 ($100) ar less�. I cetlify Ihal in ��e pedarmance of �he work for which ��is permi� is issuea, I sh�fI not employ an person in any manner so as to become s� ihe Workers' ComDensation Laws ol Cali�omia. - q /� �� r�J 4 / aie� 5 SiqnaNre:-,/v�i / 9^^�I� NOTItE: Ii. al�er making ihis Geclaraiion, you s�oula �ecome suble�� o t�e Wor� kers' C� pensation O�ovisions oi Ihe Labor COAe. you must tonhwitn camD�Y with such provisions ar ihis oermil shall ee aeeme0 revoke0. CONSTflUtTION LENOING AGENCY: I �ereUy aifi�m that t�er¢ i5 a conSlmclion lentling agency lor IAe p¢riormance 0� the work �or whic� Ihis permi� is issuetl (Set�ion 3W7. Civ. C�. LENDEN: ROONE55: OWNEB BWLOEB DEClAXA7lON: I here�y allirm ihat I am exempl Imm Ine ConlractorS' State ticense Law br the following reason (Sec�ion 7031.5 Business and Pmlessional Code: Any cily of counry which reQuires a permit Io constmci, alie�, impmve, demolish, or repaii any stNCWie, prior to its iuuance. aiso requires t0e aOD�icant for such permit to lile a signetl staiement tAat hPJshe is licensetl pursuant Io I�e provisions ol the Contractars' Siale License Law (Chapler 9(cammencing vnth $ection 70W� oi �ivision 3 0� �he Business anE Pmlessions CoGe) or �na� �eR�e is ezempl t0ereimm anA Ihe basis br t�e allegeJ exemp�ion. Any Nolation ol Seciion 7031.5 �y any aODlicant for a Dermii suble«s I�e appliUnt to a civil penalty of not mom ihan Ine �untlre0 Oollars (E500). I. as owner ol �he praperty or my employees with wages as ineir 5ole fAmpensation, will ao ihe walk, antl the 7 simnure is not intentleU ar allere0lor ule (Section 70a4. Business anE Proleuional Cotle: 7he Cantractors' State License Law tloes not appN �o an owner of a pmOerlY who GuilEs or impmves ihereon, anE w�o Joes such work himseif/�erself or tAmugh nis or �er own employees, D�oviQeA ��at such imprOvemenis are no� inlenGetl ar oflere0 �or sale. II, �owever t�e building or impwvemeni i5 5ald wii�in one yeat oi tompleiion. I�e owner will �ave Ihe burden o� pmving he/5he tli0 nOt Ouila or impmve for Ihe vurpose oi sate). I, as owner of ihe pmpeny, am extWsively contrac�ing wit� licensed caniraclors to conslmct i�e D�oleci (Setlion 7044, Business ❑ an0 Pmlessions CoCe: The Conlratlori Staie License law Coes noi apDty m an owner of property who �ml0s or im0�oves ��ereon ane who conVads lar sucn o�ojecis wiN a canVactorls)license vursuantto ihe Contractors' $tate License Law).1 am aware Inat pmof ol ineir Worker's Compensation insurance snoula be proviaea to me. Q I am e�empt untler Section: B. 8 P. C. �.jor ihis reason: aie�. Owner. o hereby cendy inat I am aware ol ana unaerstane tne requiremenls ol Calilomia Heaitn and Safery Cotle Sectians 25505, 25533. an0 2553C an0lhat I or anV �Wure building occupanl will/will not �circle one) neetl �o compty wi�h saitl state wdes an0lhe requirements for a permii lor conslmcUon or matlilicaiian Imm Ihe Air �uali�y Management Dis�ricl. Resitlential constmciion applications aB exempt �mm N¢5¢ pfOVI5i0n5. �ate: ApDlicanC I nereby certify thal I �ave reaa t�is aDDlicalion antl state that Ihe above inlormation is conect I agree to Wmpty with all city an0 county ottlinances antl slate laws relaling ta �uiltling conAruction antl �ere�y aWhorke represenlatives a� t�is city Io enier upon �he a�ove-mentioned p�➢p¢r�y br inspec�ion pwposes. � n /�� \ p .� Y/ / /1 1 S 1y57 ;c/-_v // L r—�l� Oale _, {�"'� Signalure: I�=�r odver's �icense or Sociai Security x: t64t�a6 Whue—Bulltling', Grevn—Coao EnlarcemenC Canary—Fpplicanl', Pink—Revenue; GOltlenroE—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 070872 PERMIT NO; M 070872 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: CON JOB DESCRIPTION ; LEGALIZE ENCLOSED 172SF BREEZE WAY SQ FT; CLAIM I�ALIIE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: AEF: B-70870 *x�*�rs+r****�***+t�r+r+t+e�x***+a**+r�-*�t*�t+t*a+t+t+t�t+r�t+t**+r+t*+r***�t+�***r**a�**�t+r«-*r�t****x�*+�+t� Z O N I N G R E Q U I R E M E N T S —• S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT; FT IN REAR; FT IN FRNT: £T IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKZNG REQ; PROV; PARCEL: 14113331 ZNE: REF NO: PLANNING NOTES> i - �ri�+�*,�**i�*�r**+r*�t*�«**�r**�r**�r*�r*�r�ririt�ric-�r�r+r****r********r+�r*****�****+r*»*********�c* D E V E L O P M E N T S E R V I C E 5 A E Q U I R E M E N T S ZONING APPROVED BY �• DATE; BUILDING APPROVED HY ; �. DATE; APPLICATION ISSUED BY; r'`��Qi'!"sF DATE: (�1 �+t�+r+�r�r�r�rit�r�r**�rr**rr***�iF��F'iF�FiFiF±F7Fir�F�r#'i tr ei �F7F*�i��**fr�****r�* * � ff 1f 1f iF 1f M iFa! M if1F if if if 1f if iEifif if if if 1f 1f 1F if if lfif ilififiE iFiF jfjE if ff i! iF if4 ?f +fif iEif �F iE M M r af M ii 1f if Y 1f M if +F +c iFiF it +f ic if iF ff �Eif if if if LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT;N BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE sMiPiaFs C:RAnTNf; PERMIT PLAN ISSUE FEE 9.00 — 25E 15.00 SMIP/NON—RES BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 9,00 15.OQ 0,00 24,00 24,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; � 24,00 OC�ER/SHORT: ,04 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24.00 if if if if if iEif 1t 1f'k if 1E if 1f if 1f 1! if 1f ih'lf 1� if 1f iF'lf 1f If if'If 1! if ifik il.if jf'If if if ik 1f if 1f'If if if if if'k'lf if ifY iFif if 1f ifif if if i(�if i4 if Y�if i4 M1M 1Rif if i4 M+f if if I N D I V 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 TOTAL COST MEC 1 INST FORC—AIR/GRAV'FURN <= 100 K BTU 9,00 9,00 END OF FEES O1 �017553�-00175537 Tt� T 2�.00 QATE: Di/3�/9:' TFI1E: 1::13 I � i � & SPA CONS7RUCTION AND PLANNING APPROVALS Permit# Date Inspector pPpROVALS Permit# Date Inspector t. TempOrary Eiectncal Service or Pote 52. Pool & Equipment 4ocacion ' 2. Soil Pipe-Undrgmd. 53. Steel Reinforcement � i 3..Electrical Conduit Utllity-Undrgrnd. 54. Forms � 4.,Electrical ConduibUndrgrnd: 55. Elecirical Bonding ' 5. Steel Feinforcement 56. Rough Plumbing & Pressure Tzst '� � 6. Electrical UFEF Gmd. 57. APPROVAL TO COVER�GUNITE � �7. Footings . 58. Etectricai ConduirUndrgrnd. . 8. �Foundation 59. Gas Pipe, �7 Undrgrnd., Tes[ 9. VMater Pipe-Undrgrnd. 60. Backwash Lines, P�7rap, � Undrymd. 10. Structwal Floor SYstem 67. APPROVAL TO DECK ' i t. Rvperty Sewer Line & House Connection 62. Backwash & Receptor�Finai 12. Sewer CaP 63. Heater & Vent-Final . 73. Roof Drains � 64. Piumbing System - Final 74. Rough Plumbing 65. Electricai�Final 15: flough Elec:rical-Conduit 66. Solar S•/stem�Final 76. Rough Eiectric Wiring 67. Fenci�g & Access Approval 77, Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricai-T Bar Ceiling � 69. POOUSPA SYSTEMS FINA� 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factor.y Fireplace �'; �, � , , APPROVALS. Permit # 21. Ducts, in Structure •• � � _ 70. Underground•Hydro 22. �ucts, Ventifating � ' , 77, product.Piping OGas OOiI 23..Gas Pipe�Rough & Test i . �72. Underground Flush 24. Roof Framing' ' ' " - ,73. � Undergrnd'. Storaye 7ank O Gat ❑ Oif 25. Roof Sheathing �.' � 7q, Overhead Hydro 26. �T�Bar Geiling (Structural) & Mohdcoat 75. Dry Chemicai 27. Prame and Flashing � . 76. Ory Standpipe � 28. Lathing & Siding ' ' �� . ' ' � 77. �FIXED SYS7EM F�NAL� 29. Insulation - � �- 78,-FIFE PREV. FINAL ' 30. Drywa�l Nailing � � _ HEALTH OEPT. REQUIREMENT 31. Piaster Brow�n Coat � �. - 79. FINAI INSPECTION � 32. Electrirai Po�ver MeterFinal ' 80. 'EOOD GERTIFICA7E ISSUED 33. Finai Electric Notes; l_ �,��- ��'_ 34. Final Fleating:& Air Conditioning" ' !�/^ . ' ' C 35. Final Gas Pipe=Test ,. . . �- -� - � . � 36. Hood or Canopy ' � � � - �, _ . � 37. Final Factory Fireplace � � . �. � � • . 38. Final Plum6in9 � ' ' - � 39. Water $ervice�Final . . ' 40. Gas Servfce-Final - • � � , ' - 41. Soiar pomesticFinal .,� � , • ', - �� . _ I 42. BackfloW P�eventer ' • ' 43. Backflow Irri9ation . ,• ' � 44. Landscape irriqation System -' � ' � , 45. Sound Attenuation . , , � � � 46. Handicap iiegulations � , 47. F�NAlSTRUCTURE & BUII�ING . 48. FINAL P�ANNING - ' 49. Electric Release to Edison ' 50. Gas Retease to Southern Califorrtia Gas Co , 5L CERTIFICATE OF OCGUPANCY No. Date PflOJECTAU0PE55: 3OZO HARDING WY uNiT: OWNEfl'SNPME: SALADEE, BEVERLY A FLOOU; X 47 aooeEss: 3020 HARDING WAY COSTA MESA,CA 92626 540-9497 APCHIENCINEEH: AODNE55: flEC.NO.: UNIT: PEflMITTEE: HUFFMAN CONSTRUCTION ( 714 ) 540-9497 aoonEss: 1181 ATLANTA WAY C,M. CA 92626 LICENSEO CONTHACTOP UECLAXATION: I hereby atlirm Ihai I am licensed unUer pmvisions o� ChaD�er 9(cammencing wilh Section 1000� ol orvision 3 at the Bvsiness antl Pmlessions Code, antl my licansa is in lull lorce and eilect. C Y LIC.(:� STATE LIC.: Q 2% Q 9 r'j ClA S: , .��-� ��,� zt _�'I�+ '3�7 � �%.5 signamre: _ e_ _ wOPREHS' COMPENSATION DECLABA710N: I here0y affirm Iha� I have a cenilica�e of consent to self-insure or a cenificate ol workers' ComOensalion Insurance. or a cenilietl copy ihereof (Sec�ion 3800, La�. C�. OIICY NO.: E%P. OFTE: COMPANY: I❑ CeN�i¢tl copy is hereby lumis�¢tl. ❑ Certified copy is tile0 with ihe ciry BuilOinA Division. Oale: ApDlicanf. E%EMPTION FNOM WOflNEPS' COMPENSNTION OECLAflATION: (This section need not be campletetl il ihe permit is lor ane hunaretl ($100) or less). I cenify Iha� in I�e pedormance o� Ihe wark tar which Ihis permil is lssued, I shall no� employ any person in any manner 5o as �o become �Ip Ihe Workers' Compeos� � Laws of Calilomia �� ., I/ , o .i�X ii - - - al ��. 1� y Signalure: �MN'— � NOTICE: If, ai�er making ihis Aeclaralion, you should ecome suble�� o the Workers' Co pensalion pmvisions of Ihe Labor Code, you must lonhwilh camo�Y'^'��n such pmvisions or this permit snall Ue deeme0 revokea. CONSTflUCTION LENOING AGENCY: I here6y ailirm �hat ��ere i5 a ConSitUt�ion I¢n4inA aAenCy lor Ihe OeMarmante o� Ihe work for w�ich Ihis Oermn is issued (Seclion 3W7. Civ. C). LENDEfl: PDONESS: OWNEfl BUILOEN DECIANATION: I here0y aflirm ihat I am enempl Irom Ihe Coniractors' State License Law for ihe following reason (Section 7037.5 Business and Prolessional Code: Any m�y oi counly whicM1 requires a permi� to cons�Nc6 alleL imOmve, demolish, or repair any slmcNre. pnar to ils issuance, also repuires the aDPlicant for suc� permil to lile a signetl statement Nat he/she is licensetl pursuam ta the pmvisions of t�e Contracmrs' State License Law �C�apier 9(commencing with Seclion 7000� ol 0ivision 3 oi �Ae Business an0 Pmlessions Code) or Ihat he/she is exem0� �hereimm antl the basis lor t�e alleAed evemption. Any violalion af Section 7031.5 by , any aoPlicant for a permit subiecis Ihe apolicant lo a civil penalty ol not more ihan five huntlred tlallars (5500�. I, as owner ol ihe pmDeny or my employees with wages as t�eir sole compensation, wiil Oa ihe wark, and the 7 slmaure is no� intenUed or ollerea lor sale (Senion 70a4. Business an0 Pmfessional Cotle: T�e Coniracmrs' State License Law aoes not apply to an owner of a prooerty wno euiles or impmves Inereon, ana who Ooes such work himselllhersell or throupn his or he� own employees. pmvide0 I�at suc� impmvemen�s are nol intentle� or o��ered lor sale. II, howav¢r Ihe �uil�ing or impmvemenl is sole wi�hin one year oi comple�ion, t�e owner will have Ihe �urden o� provinA he/s�e tliU not �uilJ or impmve �or ��e purpose ol sale�. I, as owner of �he pmDerty, am e�clusively conVac�ing wil� licensea contrac�ors �o cons[mc� �he pmjec� (Section 7044, Business ❑ antl Pm�essions CoUe: The Conlractors' Siale License Law Ooes nol apDly Io an owner of pmperty who 6mltls or improves Ihereon anA wh0 tontratts �or suc� pmjetls wiN a tontrac�or�5� IicenSe pur5uani �o Ihe Con�ratbrs' State License Law�. I am aware I�at Omof of iheir Warker'S Compensation insurance shoultl be pmvided lo me. � I am exempt under Sectian: B. 8 P. C. br ihis reason: CITY OF COSTA MESA — HUILDING pERMIT PERM NO; E 070871 PERMIT NO; E 070871 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: CON JOB DESCRIPTION ; LEGALIZE ENCLOSED 172Sf HREEZE WAY SQ FT: CLAIM VALUE; CALC—C�ALUE; GROUP OCC: R-3 / COMMENTS; REF; B-70870 +�+r+r�r�*+r*�r+t*+�*+t-�x�+r**�r�r+r******�+t**+�*-�r**+r*�r+r+rr+r***��r*+t�r�r+r*+r*+�*-�«**�r*+******+«r+r*+r+e Z O N I N G A E Q U I R E M E N T 5 S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT ZN FRNT; FT IN REAA; FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGEIT: FT IN PARKINC REQ• PROV: PARCEL; 14113331 ZNE: REF NO: PLANNING NdTES> i ****+r�r*�rt��rir********+r�r�r*+r�r*+�w*rr**�t�t*r�r*w**r�r*s�r«**r**�.�r**r�rr***+r+c*+�****�*�t�r**** 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; �� ifMiffflk�fifafiflfifMifkififYMifififM ifilififlfMYlFi1+f riE iflffEiFiEifffiElflfififififi�iFlfif�fMififiEfkiflfM1t1f1tMMiEifMififlEMMM1F4ifi4ififjfif�FiFififif�fftil�lfkiE�FlElf!l�iFififlMiE �fiEiE iFjFi!iE LEGALIZATION:Y F E E S U M M A A Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIPlRES GRADING PERMIT 31.00 SOt SMIF/NON—RES PLAN ISSUE FEE 15.00 BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAIU UUE TOTALS----> 31,00 15.00 0,00 46.00 46,00 ,00 REVENCTE DIVISION TOTALS--> COLLECTED; L46,00 OVER/SEIORT: ,00 HLDG PMT FLUMBING ELECTRZC MECHANIC FIRE SMZP/TOT GRADING PLAr7—CHECK 46.00 if ififif�! if ilit iF if if M M if if Mif jf 1t if it it �f if M M k 1f !fM if tf ih if if itM if M M 1F ftll-Mif if if if k IfY iFif if if M iFif if iF if ifiF it iF iF ft iE M M if iE iE if iE jEaf 1E N I N D I V I D U A L F E E B P. E A K D O W N TYPE oate: �'""ef� EL E I tlo �ereby certi�y iha� I am aware o� anU unUerSlanU �he repuiremen�s of Calilomia H¢ali� an0 Saleiy CoOe $ection5 25505, 25533, antl I EL E 25534 anA �hat I or any INwe building occupam willlwill not (circle one) nee0 io comply with saitl sia�e cotles antl Ihe reQuiremems �or a EL E permil lor consVuction or modificalion imm ihe Air Ouality ManaAement Dislricl. Residential consimction apDlications are exempt Iwm Nese pmvisians. Dale: Applicanl: I �¢reby t¢rtify I�al Ihave reatl IhiS aDDlita�ian and 5�ale thai lhe above in�armation is tarret�.l agre¢ to comply wii� allCily and wUnty orainances and sla�e laws relaling to GuilUing con5imction antl �ereby aui�oriie repreSenWtives o� Ihis ciiy �o enier upon Ih¢ a�ove�menlioneE O�opeity Iorins0ecuon purposes. �ate� �..n— , 2 S � Signamre: �.�� 'I- �� S ..b6vei's License oi Safal Securiry +: tfiaba6 While—Builtling; Green—CODo Enbrcemen�; Canary—ApplicanC Pink—Revenue; Goltlenrod—Agsessor QTY D E S C R Z P T I O N 5 RECEPT/OUTLET 1 ST 20 EA i RECEPT/SWITCH 1 ST 20 EA i SUB—PANEL END OF FEES UNIT COST TOTAL COST .75 3.75 11.00 11,00 O1 Q0175S36-0017553h TO T 4b.Q0 D�TE: �ll2ti/95 7IhiE: 11:?2 CONSTRUCTION AND PLANNING � �& SPA �APPROVALS Permit # Date laspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Gipe�Undrgmd. 53. Steel Rein'orcement 3. Electrical Conduit Utility-UndrgrnC. 54. Forms " 4. Electrical Condnit-Undrgrnd. 55. EYectrical Bonding � 5, Steel Reinforcemenc 56. Rough Plumbing & Pressure Test 6. Electncal UFER Gmd. 57. APPROVAL TO COVER�GUNlTE .• 7, Footings �, 58. Electrical Cr,nduit�Undrgmd. . 8. Foundatfon � • 59. Gas Pipe, G� Undrymd., Tesc 9. Water PiPe-Und�gmd. . 60. Backwash Lines, P�Trap, L� Urdrgmd. 10. Structurel Floor System . . 67. APPROVAL TO DECK it. Pvope{ty Se�,ver Li�e & HouseCoanection 62. Backwash & Receptor�Finat 12. Sewer Cap 63. Heater & Veni-Final 73, Roof Drains � 64. Plumbing SYstem - Finai 14. flough Plumbing ;. 65. Electrica6Finai 15. Rough Electrira6Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 18. Rough Etects(caI T Bat Ce�4inc� 89, POOL,''SPA S'fSTEMS Ff NAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace , � � ; � � - ' APPRQVALS, .Permit # ' 27. Ducts, in Structure .. .. � - ' 70. Undergro�rid HVclro 22. Ducfs, Veniiiatin4 � _; 71. Product Piping (� Gas ❑ Oi� 23. Gas PiPe�.Rough & Test - • � , '� 72, Underground Flush 24. Roof Framing• � � ' ' � 73. Underyrnd. Sioraye Tank � Gzs ❑ Oil 25. Roo4�Shehthing �� - . �. . 74. Overhead HYdro � ' 26. T-Bar Ceiling (Structuraq & Monocoat °_, - '' 75. Dry Chemicai I 27. Frame and Fiashing � _, , � �. 76. Dry Standpipe 28. �athing & Siding�� • - .� ; _- _ , " � : ' 77. ��FIXED SYSTEh9 FINAL . . " `� 29. Insuiation ' � �� • - � �. � 7g, FIRE PREV. FINAL 30. Drywa�� Naiiing ' � ` HEALTN DEPT. REQUIREMENT 31. Piaster Brown Coat � i - 79. FINAL INSPECTION � 32. Electr�cat Pn«:es hleterfinal " 8�.'FOOD CERTIFtCAT[ iS$UED 33. Final Electric � , � -�j-fi � Notes: - � - , ^ 34. Final Heat�ng & Air Conditioniny ' � � - i . 35. Final Gas Pipe-Test ,. , . _ � 36. Hood or.Canopy ' �' � - 37. Finai Fac.ory Fireplace : '�� . 38. Final Plumhing � - ' � J � 39. Water Service-Pinal ' �, � . , . . 40. Gas Se�vice-Final . � � - - 47. Solar pomesticPinal ;r ' � , - , 42. Backflow Preventer � ' 43. Backflow Irrigation ' � . , � 44. Landscape Irrigarion System ' ' - ' . •- 45. Sound Attenuation ' . � � ' � 46. Handicap Regulations _ �� 47. FINAL STRUCTURE & BUILDING ' � 48. FINAL PLANNING � � � � 49. Electric Release to Edison � ' ' ' ' 50. Gas Release to Southem California Gas Cn � � - � 51. CERTIPICATE OF OCCUPANCY No. Dare ; G � T� O i- �'l.+r 7�- M 6��- `� J 1 L0[N Co S�Fr'iT% �I VI�"J(pN + - - R£:- '�� l-F�DLNc� W�� _ �-8 � 19`'r5' l7�-e__ _ s�t�-`� ; - - - - - � - - � - �r� ��c.os�a _ �rz�.��wR� A-D�� -no� <r7 ; �+L l�.► ✓.f N c� _ �o�/ . _ N-�5 �-T 2� ��. wop.k : TN-8�T wfl� - t� i-- l NSP&c-T�D t�-T Z-t+� �N' i _ _S i �E . TN-F-i)..t �r2,�. . .�- C�� [ _ '�v�G� E=1�-S , . . 'g�N _ lN �/��-(.ED A-T �-1+� �RDtNT . m� NEW � � � �L`►-`�1 C�'i> L. . � cv _ ��ILDT�4� , . � � . 'IJAV ( N �` �C�1 � . -r�-�--�- A.r� J `t� vEvi� ��,— p-�'#1.,4�� ---1 NSTl�LL6D Fd/L _ Tt'i"� . L-1-IF� �� T�� OJ� , ��-y , �� ,�� . � Y $r._13M —.. 3 9 x 3 � .----- 0 ��.'1N� L1Cb ___}�R� �ivr _N_�_ RM ._ _ ,_ �n �� J /_ �; � - HE•+v_ G_x_I� _BEAt�'J _O. n � 'yU r1��v� �'xisr�vva��, � �� , a ��, � C��; ' _ ty�sT v se��wAy .° oX • or ��c ro' � � � _� a � ev � � . '�� /y„ ,DFr�w/�LL�f , x � "� �`i 7��,� \ �A� / f� L i ; �� \ / � S6�TaN � � .' . � , �' � ' R i ;,N fF i '`,� � � ' / ; .� ✓; 26. 5.�._ oocv, „ � _SELrGI.[9bfh/(� 5�31 Ty1)G�)(�'D0.��WA�-L �-; New �,w��LS AaD�D E�,�+vEEN- ; �ARqG@ �ND liv�1�£ VNOBE 67lST� � u'x 9� H�A�e2S Rr e� �ND � ; �o.i�c.H 8v.�s�w Ry ; � . _. G�S�A.�� W � 2� �� t �� <�� t� 1\�� R � �. 4�= G-.► � l'�� fJ-0�� H-�o��r�,.� I I. -�I ., � / Sl�-l_/�D�� R�->> D-= r�� i , � � `�`'� N.�-Jl,c� � n� t. �� % -� �,=�; 2 � �sA- �.��I ; ' ; . -- - --�-------� .----_ __ _ _ --- - - - -bn `� SC•�A Lb' I�y �� - I �- a' ` _ _ ... L� Cb�?�� : �x� ST' is WA4L - ' NFw �,rAu: . _ _.�.�� ~ �- _ . 5 i . : _ ��`rl� ° v,�E �rYALL - _ - _. , ..,� ...V _ � r-s_ t '`��a' -' ._...s:.i �W]M�,-i'v..:.�.„.uL:.a�._i.x�.s �:.:tv.�. .��..—e._,_�z..�c...e...�i_a.�......._..«. .. � ._ . ..s.w –�a�_ :a.w R '.ICATION FOR A BUILDING PERM' Elactrical � Tract eiock �ot BUILDING PERMIT NO. Po�m�t rvo. � n / Plumbing Atl'd�ieu ♦ I r`j ((/, Pcimif No. � ` � jl V CIO55 � Methanical 6 qrp,a Street ° � Permit No. � Type of Roject: ❑ New ❑ Alter � Owner ❑ Atltlitlon AGtlress �i% . ❑ Repair ❑ Convart ❑ Damo ❑ Occupancy Pmt. tt !i'-� CItY �ZL¢L.L Z�p G� 4 Phon 9yq 7 A.P. uP. Disl./ Insv. Area Archltect/ Zone Spl. Gmt. No. Oesigner Uce�se No. Setbacks P/L Front C/L SL Street Witlt� AGOre55 VarUs Le g ear CItY . ZIP PhOn¢ ave ro . e 9 . . « En9lncer Licenu No. c arkm9 Paces equ re �ov e overe a ACtlress m �� Zip Phone Siruct fJo. o/ No. of y Heigh[ $to�le5 Family Y ' LICENSED CONTRACTOR'S DECLARATION Park Feet Ves / Fee U � Requiretl No G•T. Raceipt m I hereby atfirm thet 1 am licenaed under provisions of Chepter 9 L (commencinB w�«� Section 7000 of Division 3 of [he Business antl Zoning Approvetl BY: / Oate Profassions Cotle, entl my license Is in full torce antl effactl. � �icense Clas License Number / ? Date Conttactor Misc. E naa.oss Proposetl Use / of Structure jy, City und Zip Phone N CONSTRUCTION LENDING AGENCY / d I hereby aftirm that [he�e is e conatruction lending agency tor tha a pe.formance of rha work for which this permit is issued (Sec. 3097, Occ. ' Type Cotle , C� � � Class Const. Vear y Lender's Neme USE/OCCUPANCV SIZE SQ. FT. � Lentler's Atltlress � '� OWNER-BUII.DER DECLARATION � y 1. I horeby affirm thet I em exempt (rom the Conttactor's License Law � f r the tollowinp ruuson: � � I, az ownar Ot the prOperty, or my employees with wages as their 2. \ � sole compensetion, will tlo the work, antl [he struct�re is not �t„ intendetl or ofturetl for sale, 3 \ � ❑ I, as owner of tha proporty, am excl�sivaly connacting wit� licensed contractors to construcc t�e project. \ � ❑ I um eKempt nder Se . 8&PC f r this ea n 4' _ ` y De[�'_/'�. —�il Owner �(q�-t(��C / � ��4-�-1 ( '' -\ E WORKERS' COMPENSATIO�CLARATION 7otal Valuation I �ereby aHtrm that 1 �ave e certillcate of consent to self-insvre, � Na or a certificate of Workeri ComDansaxion Insurenca, or a cer2ified Encroac�ment Permit ReGuireC ❑ Ves c copy thereof. Gratling Pmt. Gratling r� Policy No. Compony Requiretl ❑ Ves ❑ No Pm[. No. � ❑ Certified copy is horeby turnished. a Rough Gratling 'O 6 ❑ Cartitied topy is filed with OranBe Caunty, EMA. qpprovetl by: Date f0 a Date Applicant 3 CERTIFICATE OF EXEMPTION � FROM WORKERS'COMPENSATfONINSURANCE Z (This settion neotl not ba completotl if permi[ is for $100 or IessL � I tertNy that in [he pertormance ot tha work for which this permit is 3 issuetl, I shall not employ any person in any manner so as to become PERMIT FEES � sabjact ro ihe Workeri CompenwUon Laws ot Califomia. Detu Applican[ NOTICE TO APPLICANT: It, etter making this Cer2ificate ot Struttural S Plan Check E Exomption, you shoultl become subjeet to the Workars' Compensation SOeeial provisions of the �abor Cotle, you mus2 for[hwith comply with such Electriwl E E provisions oi this pormit shall be tleemetl revoketl. Inves[. 1 CERTIFV THAT I HAVE READ TNIS APPIICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO Plumbinq 5 COMPLY WITH ALL COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBV AUTH- Mechani<al S ' OR12E REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE ABOVE MENTIONED PROPERTV FOR INSPECTION PUR- pre-GraEe POSES. Inspection E Signatura Ot Applicant Or Agant Dece Pre-Gratl! $ Permlt s Rec. No. 155ue `Print Applicant's/Agon['s Name vlan Issuance All spaeea within this box murt be completed to proceu Check By: APprovetl: CMF 0335-46 (BU-28) rev. 6/80 OWNER g� JOB ADDRESS GENERAL CONT AP No. 141— INSPECTIOHS SOIL G45 WATEP ROUGH PLUMBING yJ SPRINKLING SVSTEN � MISCELL4NEOU5 ro ROUGH ME�TING �NO F] TEMPORnRV SERVIC�i FUNOERGROUND � '�• ROUGH wIRING y TRENCHES � 1 FOR � F100R SVSTEM aBOND BEAM �1 SHEATHING PRAME PNO FL45MING l ATHING - IN I � F FIN4L 4N0 FINAL CONDITIONING POLE VER � STEEI REINF. .REINFORCE n DATE FIRE ZONE VALUE SUBCONTRACTOR RMIT ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR'STRUCTURAL PERMI'f I 0.50 TL •.V.yV^ "VV VVV•^•••cJ^•y^` vn,••^a'V'V R CEIVEDBV PERMIT �� D For Applicant to Fill in Completely — Use Ink Only BVIIDING A.P. NO. ADDRESS , BUILDIN O OWNER OR ADDRE55 TENANT UNIT OR MA1 LI NG SPACE NO. ADDRE55 TR.NO. LOT � BLK. TEL. CITV NO. Q��y CONSTRUCTION NEW ADD LTER REPAIR MOVING DEMOLISH LENOER BFANCH OWNER � ADDRESS VALUE O ARCHITECT TEL USE E D O OR ENGINEER N ADDRESS ZONE � TVPE GROUP APPROVED CONTRACTOR O B BV DATE ADDRESS TEL. GTY NO. STATE CITV APPROVEDSETBACKS LIC. NO. LIC. NO. SI2E NO.OF BlDGS. (FROM C/L STREET OF LOT NOW ON lOT R M USE OF EXISTING BLDG. Separate permits are required for L. SIDE electric, plumbing az1d heating work: REAa T. VSE OF BUILDING AND WORK TO BE PERFORMED PLqNNING CTION ' DATE APPROVED APPROVED � C+� Jz—�Q �c/ / LJ I hereby acknowledBe thet I have reatl this applicetion antl stata °i n Mat ihe ebova Informaiion iz correct anC og�ea to cOmply wlih all laws reguletlnB buildin8 connructlon, and i shall not emp�oy any person in violation of Me workman's compensation laws of m Me S<ete of Calitornia. m I hareby certify that I am properly Iicansetl as a contractor undor SQ. FT. n ihe State of Calitornia Business e�tl Professions Code, Division 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR m Chapter 9, antl t�et such licansas ere In full force antl effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � am ezempt trom the provisions oi tha Stete of Californla Businasa VALUATION PERMIT FEE S � and Professlons Cotla, Division 3, Chapter 9. � �. �� m Signature of � �� P�N CHECK 5 ^ 0 Permitt¢e ��f� � / ! .Q § I LL o, � � � TAX E , �O f Authorizetl ABant Date TOTAL PAID E Q S U a ° ,9 TRA` �2 2 FEE RECEIVED .�- � � �; �=o stP Z�,ssr .COSTA MESA BUILDING-SAFETY DEPARTMENT �FIIVANCE DEPT. P. O. BOX 9fi COBTA MEBA. CALIFORNIA CITY OF COSTA MESA For Applieant to Fill In Complefely APPLICATION FOR PERMIT YYPE O R� T. _� r,,,, gUILDING BUILDING 3 c � .� 90.�` A�DRESS COSTA MESA CALIFORNIA For Offite Use Only _ _ . .._..._ _ ___ RHCCIPT N4 q f[RM�T NO. OWNER A �"�:"�I If MAIL . ReCelv D!Y I pAjB�RE !IV$� SEPe �ssueo nooeess —'7-555 P7�acen�ia Ave. - •••� C Y S '1 'Y nDa TEL. BUILDING � CITY :.i n N0714' 7 qDDREbb ARCNITECT TE�. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS ^ FIRE � ZONE TYPE GROUP CONTRACTOR -' '��t'I�-KOZ].-. . ___ APPROVED BY DATE ADORESS r. �F ZONING l�eT OP V BQciCh ,,, , ION6 e I NO.OP I UBE OP NEW TI cITY � – n— ruxe � eulLo�No W STATE TEL. �[awL � aL / 9 T� N L 3 2 LIC. NO. F NO. '�'� o58CnlriloH tv/ SIZE /1 NO. OP BlDGB. OF LOT O 1� X 1 OO � NOw ON LOT O A. P. NO. USE OF EXISTING BLDG i^ APPROVED ALLOWED BfiTBACK lJNB PROM 11 � � p f�MT6H LIHB BTJ �� NiEH oP BT1es8T `�O REAR YARD O H FRONT �� FT. IN. SIDE YARD I LEFT � �� I RIGHT � �� R. SIDE ��' FT. / IN. DESCRIPTION OF WORK L. SIDE S FT. � ,N. NEW I IIALTERATIONI IIAOOI710N I REAR �� FT. `�' IN. I II MOVING I II DEMOLI6H I' ByPROVED (N /� DATE "/�' 6/O � ftEPAiR ti BUILDING - " NO. OF SIZE ROOMS STORIES EXTERIOR'WA�, ROOF 7/�fpSHINGLE COVERING �LUCC� COVERING � Q USE OP UILIiING.pN0. ORK TO BE ERFORMED S�ir.g_e ra�i y rtesid�ence and i �6ftatch Crara�e 5 PLAN No. B I H6flHBY ACNNOWLBDG6 TMAT 1 HAVB pHAD TNIB APPLIWTION TMQ �MOUNT BXOWN UNU6q V�LUAT�ON IB FOp TMH ANO BTATE TXAT TXE ABOV6 18 GOPAHGT AND A6p8H TO COM- pYRP09E OP 89TABL18NIN0 A n¢qMIT PEE ONLY. PLV WITN ALL CITY O��NANG¢8 AND BTATB La�WB Ii80ULATINO Bu1LDINo coNeTRUGTION. VALUATION �7L 81GNATURE OF �� /`�/ //� PERMIT FEE S� 7�J / PERMI7TE $��// �// pLAN CHECK g /��D n AUTNORIZED AGENT J!'"7�� p TOTAL FEE J' y