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Home My WebLink About910 HOLLOW BROOK CIR - Building Permits� CITY OF COSTA MESA � BY/LDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT �98-0055'I vPERMtT NUMBER (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 910 HOLLOW BROOK Suite No Vlcinity: Parcel Nunmber: 93506131 Applicant: NOCK, RON Address: Owner: Address �{: - ..Phone:" ; - } -_, - � . . - - ;%/i', ' � _ , Zip: I i : Y� �C� , � . RBARA JEAN i '� ' � _� f�L JR�% -- .,� � -t r�.=r.-=�..,, i � - ��Phone )K i �' Zip 92626 Status: ISSUED Applied: 07I07/1998 Issued: 07/07/1998 `` . � `��///,\ ��\ \��\ �-�i i � � � � � \ \ ��\ � �\� . 1 \ � �/ �� \. �� V� i � � �,��`��V�\ \�\�� / \ \` \\ \ �/ �/ � i \ \` �\� �. \ ; �, i� V`�� , _ ,.� �/n___",/// /' �O� � ��, � Address:'J�11612 KNOTT ST �i�' � n�VA � / - ui ' 1�� 'il � Phone:��714885-7246 _ _ _�'�� . ti � r J / �� _ , . ; � ..,,,:. ��. i ��' GARDEN GROVE,.CA ::' Zip:+"9284] ' " ! � ' VJA�� ' � ' i i i i i ,' V'� . � � � .i , � �� 41� � S � %� License 707775 ' . , � _, � , , � �� i ,� - i ,h .._i a. � „ , . �� ' ' � �� . � --- ;� �. / kl �. � /� � ' / - ----' %' �� s ` / � +Arch I Eng� , r`� � `,,� �� f "� - .!�`�/� / � ... � Address: ,",.�a� /��'\ ' - �V -• . � ��, _ � , . � ' ; ' % ' � �. :> Phone: A . �` % f __': _--..Zip�. _-_-. _? � `� � ,.". ��.� f� �1 ♦r�, i�'1. �\ i �� . � � - - ':� � � ,_.0 <-•�; � .License:�i,r�lj0, o /�`� % i�� 4. � . � ' . � � . _ . " . �.:1-• 'i� C '. . . � . AA P . _ �. . 1 _ - �' �, DI �� " � ISSUE FEE. ', � BackBow,irdgation � �� Backflow Preventer � Bathtub ��" �, � ' Clarifier System\ Connect (Ice,Soda,etc) Dental Units ':� ��, Dishwasher � Drein, Floor � � Drain, Rainwater � Drain, Roof Drinking Fountain Ezpansion Tank Gas EaAhquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) ` -SCOPE OF PERMIT � / HVJASHER � -��./ '�, � -�_„�-1� / % �i� _ i =,.� - ��'.. �N'_ i'�.\ _ ' _ - . r �'�'. . - � `. ^ 1 ^ FEE SUMMARY✓/� � .:AMT QTY� =AML./ QTY i22.00 j Laundry Tub / Washer `-50.00 _ �0 ,$0:00 0 . Landscape Irrigation $0.00 0 $0:00, 0 � P-Trap �, , $0.00 0 $0.00�� 0 �� PresaureRegulator'�^` �;%��$0.00 0 $0.00; A�, 0 Process Piping (per 40"ft) � ��$0:00 � 0 '$0 00� ��0 Receptors � ��,� ��, $0.00 ;" 0 $000 ��0\\ � � �'SephcTank�;_� � � � � $000�','0 � $8 75� � �1V�� ,Sewer Cap for Demo � �� .SO 00 �-,=0 $0�00 '� 0 ��SeweuConnect � =� �f( $0.00 .� 0' . $0.00 //0�� ,Sewe �Private�Line.��! Q :$0:00 � 0 , $0.00� �i 0 / _�� Shov+er � � -. ._ �';, -< .:50.00- � 0- �� $O.OD �0 i�, ��' Sink, bar � � - _ $0.00 � 0 $0.00 �� 0��" � �- Sink,.commercial $0.00 0 �, $0.00 �"_�'0 � �� Sink, Floor ' ' � � � '�50.00 �- 0 $0.00 � � .0- � � Sink,�kifchen - � . $0.00 0 � $0.00 0 - � Sink, service/mop�, `. . "'.-$0.00 0 $0.00 0 � � Spa (private) .,- . . , ., „.; , � $0.00 . ,0--' � $0.00 0 Spa (public)' � . - _ -$0.00� 0 "� $0.00 0 - " � �� $0.00 0 COMMENTS / SPECIAL CONOITIONS Sump P Swimmi Trap Pri Urinal . Vacuum Vacuum <Wasti B � Wash B � �Waste a � Water C ,� � Water H Waler P � WaterR Water S � � �. ';^, ,`� nMr' Qrv �� $0.00% 0 o � ��, i $0,00 0 $0.00 0 ' �� $0.00 0 r Bkflow(1-0) � �� $0.00 0 r BkFlow(5+) � : $0.00 0 ,�, i /., ' $0.00 0 Set /, �, ,% $0.00 0 !ent System 50.00 0 t(Toilet)� $0.00 0 r % vent $0.00 0 � Qnst or RepJ $0.00 0 �e $0.00 0 :e $O.00 O ier $0.00 0 ',-OTHER $0.00 �� VIOLATION $0.00 PLAN GHECK $0.00 REINSPECTION $0.00 0 TOTAL CALCULATED FEES: $30.75 EX1-;_�:ED DATE I Zv �' � EXPIRATION: This pertnit shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a pariod of 180 days. INSPECTIONS: In order for the vrork aulhorized under this Dermit to be considered legal, such work must comply with all epplicabla codes, and all required inepeetlons and flnal approval must be obtained. Fellure to obtain Inspections antl final epproval will result in the expiration of this permk. FOR INSPECTIONS CALL: (774) 7545628 WORKERS' COMPENSATION DECLARATION: , , — � , I hereby aRirm under penelty ot par�ury one of ihe following declarations: , '' � ❑ I heve enC wlll mainteln e ceniNcete oi consent to selFlnsure for workers: compensetlon, es DroNdad tor by sedlon 3700 oi ihe Lebo� Cade, for Ihe pedortnence of Ihe Ol whlCh �hi9 pertnit I9 issuBd. I heva end will mainteln workers' campensalion insurance, as required by seclion 3700 of Ne Lehar Code, for ihe perfomience of ihe work for which Ihis pertnil is issued. My warkers' com{��n�7nsw�e� certlergf�d policy number ere: ( /—�O� /�r! Cartier. � � ��-��YL %�'S �/ Policy Number. __ 7//� Y Y �� (This sect/on neea not complete0!! the permit ts velued t one hundred dollars (5100) or less.) ❑ I certify ihet In Ihe peAom�ance ol the wotic for which this permi� Is issued, I shall nat empby eny person in any manner so es to Decome sub�ect to t�e workers' compensetlon laws of Celif , agree IheU1i-s uld become subJe the warkers' compensetion provisions ot Se lon 3700 of Ihe Lebor Cotle, I shell foMwith / comply wlt� these provislo s. � ''"7 �+/� AppliceniSlgnature: Date: �v / ��d WARNINO: FNLURE TO SECURE WORKERS' COMPENSATION COVERAGE I$ UNUWFUL AND SMALL SUfl1ECf AN EMPLOYEq TO CiiIMiNAL PENALTE$ MlO pNL FlNES UP TO ONE MUNORED TIqUSAND OOLLARE (5100.000), IN FDDfiION TO THE CQST OF COMPENSATION, DAANGES AS PROVIDED FOR IN SECiION 3%OB OF THE IABO{i CODE. IHfERE5T, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLAHA710N: I hereby ettirm thet I em Ilcensetl untler provislons af r 9(commencing with Section 7000) oi Divlslon 3 of the eusiness end Professions Cotle, and my Ilcense is in full torce and eHect. Lic. p �7i)�7 � v Class e �MracroYsSigneture: � Data: i•� %—�/k CONSTRUCTION LENDIN6 AGENCY: ❑ I hereby effirtn Ihet there is a consirucGon lentling epency for Ihe peAortnance of the wark tor which this permit is issuad. (Sec. 3097, Civll Cotle). Lentlefs Name: Lendets Address: SignaWre: Date: OWNER•BUILDER OECLARATIONS: I hereby eMirtn Ihet untler penelty of per�ury �hat I am EXEMPT FROM TT1E CONTRACTORS LICENSE LAW tor the tollowing reeson (Sec. 7031.5, Buslneu and Professions Cade: Any ciry or counry which requires e parmit to construcl, elter, improve, demolish, ar repair any siructure, pnor to ics issuance, elso requires the epplicant for such pertnit to flle a signed stetement Ihet he or she is Iicensed pursuent to the proNslans of t�e Contradora Llcense Lew (Chepter 9(commencing with Sectlon 7000) of Dlvision 3 of Ihe Business end Professions Cotle) or ihei he or she is exempt ihereiram and Ihe basis lor �he ellepetl exemplion. My vidation of Section 7037.5 by any applicant for e pertni� subjecW the epplicant Io e dvll penalry of not more than flva hundreA dollere ($500).): ❑ I, es owner ot the properry, or my employees vrith wages es their sde compensatlon, WILL DO THE WORK, and Ne structure is not Intentled or otteretl for sale (Sec. 7044, Business entl Professians Cade: The Contrectors License Lew does not epply to an owner of properry who builds or improves thereon, end who Coes such work himsetl ar hersell or Ihrough his ar �er own employees, proNtled Ihet such improvements ere not Intentletl ar oflereC for sele. If, however, the Eullding or Improvement is aold within one year of completion, Ihe owner-builder will heve ihe burden o1 proving that he or she tlltl not Dulld or imprwe for purpose of sale.). ❑ I, es owner of Ihe property, am EXCLUSIVELY CONTRAC7ING WIT}1 LICENSED CONTRACTORS to construct Ihe pro�ect (Sec. 76M14, Business entl Professions Code: The contrectors lJcense Lew does not eppty to en owner ol property who builds or improves thereon, end who conirects for such proJect with e contredor(s) license pursuent to the Coniractors Llcense Lews.). ❑ I em exempt untler sec. Business and Professlons Code lor this reason: Signetura: Date: Owner ID verified by tlAvers Ilcense. 0 Ves ❑ No Drivefs Llcense No. Ezpires: Vedficatlon of Ownership by (rype of tlaument, i.e. - properry tax bill ar tleeA): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certNy t�et no excavetlon five (5) or more feet in tlepth Into whic� e person Is requlred to descend, will be metle in connectlon wlth work euthorized by thls pertnfl, antl t�et no builtling structure, ScaRolAing, talsework, ar tlemolition or tllsmentling thereof, will be more ihan lhirty-six (36) feet Ng�. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomle AdminlstratNe Code). ❑ As owner-bullder, I wlll no� employ enyone ta do work w�ich woul0 require e permlt Irom Ne DlNslon o1 Industrial Setery, as notetl ebove, unless suc� person hes e pe�mlt �o Ao such wark trom ihe divislon. SignaNre: Date: Division ol Industnal Satery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTHOROJ1710N OF ENTflY: 1 cerlity under penelry ol perjury ihet I have reed this application end stete that ihe informetion given is cortect. I egree to comply with ell stete laws end ciry ordinances relating to building construction, end authorize representatives ot lhe Ciry ot Costa Mese lo enter upon the ebove-tlescdbed property ior inspection puryoses. I egree not to occupy or ellow occupency oi any builtling authorized by this permlt until finel inspedian. LQQEy INSVEClIONTYVE 1616 Flaetl System Finel Fire PrevenGon 1286 ' Pool Spe Flnel ' ' 200 Finel Re-Hoof ' ' 201 Flnel Block/Reteining Wall 202 203 204 2a46-68 Flnel Factory Flre Plece Finel Sign Finel DemolAlon � It�� '7 — 7 —`�S��a Date CODEI msrernoxTrve 206 Final Mechenical ' 208 Flnal Plumbing 210 Final Elecldcal 212 Final Fire Prevention 220, � Flnal Planning Apprwal 222 FnalSite 250 Final Building/Occupancy OAg . U17IDALS - 1 !� � � � � � �ii�� q�� i �.:.,•::: ; : ��, (714) 754-5273 • Fax (774) 754-4856 Job Address: Suite No Vicinity: CITY OF COSTA MESA � 6UILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 910 HOLLOW BROOK IN GARAGE Parcel Nunmber: 93506131 Applicant: BELL, RALPH Address: 11801 MAC ST GARDEN GROVE ELECTRICAL PERMIT Phone: 534-2593 Zip: 92641 Owner.'� �WAKEHAM, BARBARA JEAN Address , °hMILLER, ROBERT L JR -- � COSTA MESA,CA Phone: � 910 HOLLOWBROOK Zip: 92626 Contractor. CRYSTAL AIR Address: 71801 MAC ST GARDEN GROVE . "� , INSTALL MOTOR FOR A/C UNIT. / - REF: M99-00334 Quantity ISSUE fEE Temp service test Res. a/c package New Res (i-2 units) New Res (3+units) Pool / Spa LigMing Fixts Recept Outlets Swilches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 700hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $11.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Phone: 534-2593 Zip: 92647 License: 655036 SCOPE OF PERMIT FEE SUMMARY Temp Dist System / Lighting Busway I100 R Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kvallcw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low VOIt Wiring System I Ckt Misc. Conduit Misc. Conductor Circus ( gen ar ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/75/1999 Issued: 07/15/1999 ISSUED BY: Quantity $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 30.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 533.00 NOTICE: The work authorized by this permit shall comply with ell applicable handicap access requirements under Californie statutes and related regulations. (Ord. No. 92-28, § 1, 12•21•92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this parmit to be considered legal, such work must comply with all applicable codes, and all requlretl Inapettlona end flnal epprovel must be obtained. Failure to obtain inspections and final epproval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (774) 7545628 WORKERS'COMPENSAnON DECLARATON: � ' I heroby aHirtn untler penalry of perjury one of the following deGeretions: ❑ I heve end will maintain a certificate of consent to self-Insure for workers' compensetlon, as provitletl for by section 3700 of the Lebor Cotle, tor the perlormance of the work lor whlch thls permi� is issuatl. ❑ I have and will maintain workers' compensation insurance, as requiretl by section 3700 of ihe Lebor Cotle, for the perfortnance of the work for which this pertnit is issued. My workars' compensation Insurance cerder and policy number are: Cerrier. Policy Number: (This section need not be complefed il the permif Is veluetl at one huntlred dollars ($100J ar less.) ❑ I certiy thet in the pertormance of ihe work for which ihis permit is issued, I shall not employ eny person in any menner so es to become subject to tha workers' compensetion laws o I' ia, antl agree that if I should bewme subject to the workers' compensation provisions oi Section 3700 at Ihe Labor Code, I shall torthwith comply with these p' i ^_/S �� ApplicantSi9neture: Date: �< < WARNINO: FAILURE TO SECURE WORKEFS' COMPENSATION WVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPIOYEfl TO CRIMINAL PENPLTIES ANO GVIL FINES UP TOONE MUNDRED TMOUSAND DOLLARE (5100.000�, IN ADDff10N TO TME CQST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECfION 31O60F THE LABOR ODDE, INfERE$T, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm ihet I am license¢ under provisions of Chapter 9(commencing with Section 7000) ot Divlsion 3 ot the Business antl force and eHect. Lic. a_ �9 5� a✓? 6 � Class x C' Contrectols Signature: r Data: % - Cotle, antl my license is in full CONSTRUC710N LENDING AGENCV: ❑ I hereby eflirtn that there is a consiruction lending egency tor Ihe pedortnance of the work tor which Ihis permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: LentleYs Atltlress: Signature: Date: OWNER•BUILDER DECLARATONS: I hereby affirtn thet untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a pertnit to consirucL alter, improve, demolish, or repair eny siructure, prior to its issuance, also requires tha epplicant for such pertnit ta fila e signetl steiement thet he or she is Ilcensed pursuent to the provisions of the Contrectors License Law (Chapter 9(commencing wlth Section 7000) of Division 3 0l the Businoss entl Protessions Code) or ihat he or she is exempt thereirom and ihe basis lor ihe ellegea e:emption. Any violation oi Sectlon 7031.5 by eny applicant for a permit sub�eds the applicant to a civll penalry oi not more Ihen five huntlretl tlollars ($500).): ❑ I, as owner ol the pro0erty, or my employees wit� wages as their sole compensation, WILL DO THE WORK, entl the structure is not Intentled or oHered tor sale (Sec. 7044, Business end Professions Code: 7Te Conirectors License Law tloes not apply to an owner ot property who builtls or improves thereon, and who does such work himself or herself or thmugh his or her own employees, pmvided Iha[ such improvements ere not intended or ottered for sele. It, however, the bullding or improvement is �old within one year of completion, the ownerbuilder will have ihe burden of proving ihat he or she ditl not buii0 or improve for purpose of sale.). ❑ I, as owner oi lhe property, am E%LLUSIVELY CONTRACTING WITH LICENSED CONTFACTORS to construct the project (Sac. 7044, Business antl Professlons Code: The contractore License Law tloes not apply to an owner of propeM who bullds or improves thereon, antl who contracts for such pro�ect with a contractor(s) Ilcense pursuant to Ihe Contractoro License Laws.). ❑ I am exempt untler sea eusiness end Pmtessions Cotle lor this reason: Signewre: Date: Owner ID veritietl by tlriver's license. ❑ Yes ❑ No Dnvafs License No. Ezpires: Veriticatlon of Ownership by (type ot document, i.e. - properry tax blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certlfy thai no excevation tive (5) or more leet In Oepth into whlch a person Is requiretl ro tlescend, will be matle In connection with work authonzetl by ihis permit, end ihet no building stmcWre, scaHolding, falsework, or demolition or dismantling thereof, will De more than ihirty-six (36) feel high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, California Administretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit Irom the Division of Intlustrial Safery, as noted ebove, unless such person has a pertnit to do such work from the tlivision. SigneWre: Date: Division of Industrial Safery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUfHORVA710N OF ENTAY: I certity under penelry of perjury that I hava read this application and state that the infortnation given is correct. I agree to comply with all state laws end ciry ordlnances relating to builtling wnslruction, antl aut�orize represeniatives oi Ihe City of Costa Mesa to enter upon the above�descnbetl pwperry tor inspedian purposes. I egree nat to occupy or ellow occupancy of any bullding euthorized by this permit unHl Ilnal inspection. Si n ur Of Leg� Owner(s) � �5 /// � � -�/• ! nd/ A t�� 6 AOPlicant -� Date �QOE �, INSGEC110NTVGE 1616 Fized System Finel Fire Preventlon 1266 Paol Spa Finel 200 Final Re-Root 201 Final BIocWRe�aining Wall 202 Finel Fectory Fire Place 203 Final Sign 204 Final Demolition z4aaee COpE 1 INSPECTION TVPE 206 Final Mechenical 20B Final Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Final Planning Appraval 222 Final Site 250 Final Builtling/Occupancy • • AJ�� PNOJECT NOUflE55: 9 1 O HOLLOW B ROOK C I ,owxentearne: VILLAGE CREEK H.O.A aooness: 3429 TIMBER LAKE �� COSTA MESA ,CA., 92626 AflCHIENCINEEB: 5 5 3— 1$ 7 6 aooness: NEG.NO.: UNIT: uxir: PcemineE: pETERSON ROOFING (714)979-7iil nooxess: 3006 ENTERPRISE COSTA MESA CA_.92628 LICENSEU CONTNACTOfl OECLANATION: I here�y attirm �hal I am Iicense0 unGer pmHsions o� C�apier 9(commencing wi�� Seclion 7000� of Oivrsmn J al I�e Business antl Pmlessions Cotle, anE my license is in full lorce ane eilect. cirvu��45 4'��y�3 STATELIC.:607872_ n ss�_�� Daie: / $ignamre: %`� ..� 9 wOPRE COM NSATION OECLANATION: I here0y atlrtm ihat I have a cenificale of c sent to self-insure or a cenificate of workers' Compensalion Insurance, or a cenified copy Ihereof (Sectmn 3800. Lab, C). voucrxo.: 1021355-93 E%P.DATE: O4IOLI94 comrar+v: STATE FUND ❑ Cetlilied copy is �ere6y Wmis�ed. � Cehilied mpy is �iled wiih �he ry 8' ng �ivi�n / % i7 Oaie: ApDlitant:7� b 7 E%EMPTIO FNOM OPREHS'COMPENSATIDNOECLIflATION: (T�iSsectionnee0no10ecom0�eteGi eDermitisloronehuMrea�S700�orless). I tertify Ihal in Ih¢ petlormance Oi I�e work for w�ith this permit is issuetl. 15�a11 not empioy any persOn in any manner 50 as lo b¢come su�ject to t�e Workers' CAmoensalion LaxS ol Calitomia. Oate: Signamre: NOTICE: II, ailer making inis Oeclaration. you shoule become suDie[t to ihe Workers' Compensa�ion omvisions ol ihe Labor Code. you musl lort�wil� comply vn�� suc� provisions or �his permi� shall be EeemeO revoke0. CONSTflI1LTI0N LENOING RGENLY: I hereEy a��irm Ihat �here is a[onSlmtiion 1¢ntling ap¢ncy lar �he peAormance ai Ihe work fOr w�ic� Ihis Dermii is issueU (Sec�ion 3097. Civ. C�. LENOEH: ROONESS: OWNEP BUILOEP OECLAHRTION: I hereby allirm Iha� I am exempt Irom the Conlraciors' $lale License Law for the following reason �Seciion 7031.5 Business antl Professional CoOe: Any city ol county w�ich reQuires a permii lo consimct, aller. improve, tlemolish, or repair any slmclure. orioi to iis issuance. aiso requires ine applicant for such oermi� to file a signe0 sia�ement ihat helshe is Iicense0 Dursuam to t�e pmvisions ol ��e ConVactors' Slale License Law (Chapter 9(commencing wi�� Sec�ion 7000) ol Division 3 of the Business antl Prolessions Cotle) or t�at hels�e is exempi Iherefrom antl ��e basis for Ihe allc0etl eKemplion. Any violation ol Seciion 7�31,5 by any aDPlican� br a permil 5u01e��5 I�e aDPlicani �o a civil penally ol no� more Ihan live hunOreO tlollars ($500�. I, as owner ol Ine pwoeny or my employees with wages as ineir sole compensation, will ao the work, antl Ihe ❑ s�mcture is not intenUetl or ollerea lor sale (Section 70a4. Business an0 7rofessional CoOe: T�e Coniracmrs' State License Law does no� apply to an owner of a pmpetly who builtls or impmves Ihereon, an0 who does SucA work himsel�lhersel� ar Ihmug� �is or �er own employees. O�ovidetl t�at such imD�ovemenis are not intentletl or oflere0 for sale. If, however ttle builJing or impmvemenl is solE wilnin one year o� compleiion, I�e owner vrill have I�e burtlen ol proving he/she Oi� noi Euiltl or impmve Ior Ine ourpose ol salel. I, as owner ol Ihe pmpen . am exclusively conVacling wi1� licensetl conVactors Io consimct Ihe Dmlect (Seclion 7044, Business ❑ anE Professions CoEe: TKe Comrac�ors' S�ate License Law tices no� appty Io an awner ol pmperty w�o hm105 or improves lhereon ane w�0 tonlrat�s Ior 5uth D�Ojetls wi�� a wntratlar�s) litense OurSuani l0 I�e Conlratlors' Slaie License Law�. I am aware t�at pmoi of Iheir Warker'S Compensatian insumnce 5hou10 b¢ pwvitle� la me. � I am eMempl un0ei Secliun: 0. 8 P. C. lor I�is reason: Da�e: �'ner. I Oo �ereby cenity I�al I am aware al ana unGersiand t�e requiremenls ol Califomia Health anA Salery Code Sections 25505, 25533, ane 2553< anG I�al I or any Iuiure OuilGing acuDanl vnlVwill nol (ti¢le onq need to tnmOM �^�h sziG slaie co0es an0 the iepuiremenis lor a permi� loi consimtlion ar mo0iliw�ion Imm I�e Air Dualily Managemenl Distriq. Nesidenlial cons�mction apDliwlions are e�empi imm Ihese Dmvlsions Da�e: Applicam: I �ere0y certilythal I have reaa t�is aDPlica�ion antl stalelAal Ihe aboveinlormationis correci.lagree to comply wiih allciry an0 counly o�tlinance5anO5la�elaw5ielatinglobuiltlingcon5imcuonantlherebyauthoriz represe alivesal��i ci�,�oenierupon��eabove-menlioneA pmpeny ioi inspedian vurposes. Oaie. �� Signalure � � - �river's L¢ense or Social Security r: i6a�-a6 W�ne—BmlOing; Green—Cotle Enlarcemem: Canary—Appl¢anC Pink—Revenue: GolAenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064529 PERMIT NO: B 069529 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/O RESAT 6 REROOF W/COMP. SHING SQ FT: 9,600 CLAIM C�ALUE: 4,600.00 CALC—VALUE: 4,600.00 GAOUP OCC: R-1 / COMMENTS: SMOKE DETECTORS REQ. INCLUDES 914,912,916 HOLLOW BROOK CI r*r�r*�c******�t***�r**�t***�rx�it*�tititir****+t�r***+f+t+�***+t��****+t*��►*+a*+t*r**+c**rc***�-*��c*+��- Z O N I N GS ERTEBQAUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGFIT: FT IN PARKING REQ: PROV; PARCEL: 93506117 ZNE: REF NO: PLANNING NOTES>' �' � it if �f iE 1f if !t!E if k!E iE if !f 1f it k M k M k ik 4 if !f iE 1f if iE if 1E 1! i! if if fF # if 1E 1E �f iE jf �f !f if it 1E if 1f 1E Ik iE %if 1E fE if �F if iF 1F iE it i! M 1f if if If af 1E iF if it 1F 1t 1f fE D E V E L O P M E N T S E R V I C E S R E Q U T A E M E N'T S ZONING APPROVED BY DATE: HUILDING APPROVED BY : DATE; ' APPLICATION ISSUED BY; F��i� DATE: �' 3 ifffiflEifiEiE*ih�kMkihitlfiflEifiFiEifif��iF�'if'iF3F��F Tf� F7FiF��FiFTFiFiFiF3fTif3F3FitiEiEifkififiEMit iEif �fiflFiElEiflEiE1E1E1EfEit!lkiEififMMlElEiEiEiEififiEifiklkkiEifiEltiFlElffEkiEMitiElffFifiEifitik'1FiflElfjfiflEifkikiEfElfiflEiE1E iflffEffiEK�4ifiE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADING PERMIT 72.00 ,50 SMIP/NON—RES PLAN ZSSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL pAID DUE TOTALS----> 72.50 0,00 0,00 72.50 72.50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 72,5 OVER/SHORT; 00 HLDG PMT PLUMHING ELECTRZC MECHANIC IR MIP/TOT GRADING PLAN—CHECK 72.00 ,50 iF iE if 3f if if k k 1E k!f 1f i! iE 1F fk 1t it dk k iE iE fE iE if 1f if iE if if !f 1f iE k if if if if it if ik if if if if fE iF %If 1k fF K if 1f if iE ff ff if iF 7f f! ff Y 1E iF IF iE 1E M!f 1f it iE R 1E 1t 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 5 C R Z P T I O N UNIT COST TOTAL COST SFR 4600 REROOF BY C�ALUE RESIDENTIAL NOZONE 1.00 4,600.00 END OF FEES SMOKE DETECTOK u.. REQUIRED ,_ 4! 00l49234—Q0149235 T 4 T i2.i0 G'n?t: 14.'?0/i3 TIIiE: 23:5q . �,ONSTRUCTION AND PIANNING POOL & SPA �"'� Date Inspector Date Inspector APPROVALS Permit # . APPROVALS Permit �k ��. Temporary Electrica� Service or Pole . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � ; 53. Steet Reinforcement 3. Electrical Conduit Utd�ty�Undrgmd. � 54. Forms 4, E ectrical Conduit•Undrgrnd. 55. Electricai Bonding 5. Sreel Reinforcement 56. Rough Piumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAI TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation � . 59. Gas Pipe, Ll Untlrgrnd., Test 9. Water Pipe-Undrgmd. -. � 60. Backwash Lines, P�?rap, O Undrgrnd. � � 70. Structural Fioor Sys2em . � 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap : � . 63. Heater & Vent-Final 13. Roof Drains � " 64. Plumbing System - Finai 14. Rough Plumbing • 65. Electrical-Final 75. Rough Electrical•Conduit 66. Solar System-F(nal 76. Rough Electric Wiring 67. Fencing & Accese ApProval � 77. Raugh Wiring 5�9n � 68. APPROVED FOR PLASTERING 18. Rough Electric5l-T Bar Ceiling 69. POOVSPA SYSTE?AS FINAL t9. Rough Heating & Air Condicioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit � 21. Duc{s, in Structure . � 70. Underground Hydrp 22. Oucts, Ventilat�ng " � 71. Product Pipin9 �G��s ❑Oil 23. Gas Pipe-Rough &' 7est 72. Underground Flush . - i 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing `�„Z�..�(,� �� 74. Overhead Hydro � 26. T�Bar Ceilin9 (Stractural} & Monocoat � 75. Dry Chemical 27. Frame and Flashing � 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYS7EM FINAI 29. Insulation � . 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH OEPT. REQUIREMENT 37. Plaster Biown Goat 79. FINAL INSPECTION 32. Electrical Power Meter�Final $0. FOOD CERTIFICATE ISSUED 33. final Eleciric . � Notes: 34. Fir.al Heating & A�r Conditioning ' 35.'Final Gas Pipe�Test • 36. Hood or CanopV 37. Fina1 Pactory Firep�ace ' . 38. Final Plumbing 39. Water Service-Final 40. Gas Service-F�nal � 47. Solar pomestirFinal 42. Backflow Preve�ter 43. Backflow Irrigation 44. Landscape Irripation System � � 45. Sound Attenuation 46. Handiwp Regulations 47. FINAL STRUGTURE & BUILDING 3�L (,rClc( G(4� 48. FINALPLANNING / 49. Electric Release to Edison , 50.'Gas Release to Sout�ern California Gas C4 51. CERTIFICAT� OF OCCUPANCY No. Data PBOJECT pUGHESS: 9 S O HOLLOW B R��Yi OWNEfl'SNAME: VILLAGE CREEK HOMEOWNERS nooness: ASSOCIATION 3429 TZMBER LAKE CM VA 92526 UNIT: FflCHIENGINEEH: (;HESTER CARVILLE nec.r+o.: C18305 nooxess: 7922 ARMOUR ST uNiT: S.D. CA 92111 PEHMITTEE: SOIL ENGINEERING CONST. ( 619 ) 560-7645 aooxcss: 7922 ARMOUR ST SAN DIEGO CA 92111 LICENSED CONTFACTOH OECIAflPTION: I here6y allirm Iha� I am licensetl under pmvisions ol C�apler 9(commencing wilh Sec�ion 7000� o� Oivision 3 0l Ihe Business and Professions Cotle, antl my I 'e i in full force an/d ef�lea. ciTruc. 5099 sraTeuc.:26808�s�✓�C/�� Oaie: SignaNre: WOBKEPS' COMPENSATION OECLABATION: I hereby aifirm a� 1 hav a certilica�e o� consenl to sel4in5 re or a ceni�icate ot Worke�s' Compensation N.cy�apF�Gc�cwtupd copy t�ereof (Section 3800, la�. �) O IO S I9 S POUCY NO.: � U U � � L E%P. OpTE: � COMPFNY: BEAVER INS,y ❑ Cenifietl py is/h eby lumis/�e`a. L'T Certifie0 ropy is ' ci�y Builtling Divi' Oaie: /� / `� ApplicanP E%EMPTION FflUM WONREXS' OMPENSATION OECLABPTION: Qhis sectian need nol be completetl if �he permil is lar e AunAreU ($100) o� less�. I certify Ihat in Ihe petlormance of Ihe work lor whic� this oermit is issued. I shall not employ any person in any manner so as to become 5ub�ectio Ihe Nlorkers' Campensation Laws ol Califomia. Date: Signature: NOTICE: II, a��er making Ihis declara�ian. you shoul0 become subject ta the Wolkefs' Compensalion pmvisions of Ihe Labor Gode. you musl Iorihwi�h camply wiih 5uth pmvisions or Nis p¢rmil 5hall be Aeemea revoketl. CONSTBUCTION 1EN01NG AGENCY: I hereby af�irm Iha� Ihere is a cons�mction lentling agency fo� Ihe performance o� Ihe work lor which ihis permn is issued �Sec�wn 3097. Civ. C�. LENOEfl: aooaess: OWNEfl BUILOEB OECLABATION: i here�y a��irm �hal I am exempi Imm Ihe Contracbrs' Slate License Law for the tollowing reason (Section 7031.5 Business an0 Protessional Cade'. Any ciry o� coun�y which requires a Dermit to cons�mc�, alter, impmve, demolish, or repair any sim[lu�e. Orior �o its i55uance, also repuires �he a001icanl lor suc� permit �o �ile a 5igne0 statement tha� he/she is licensetl pursuant la �he pmvisians of �he CanVacmrs' S�a�e License Law (Chapler 9(commencing wi�h Section 7000) ol Division 3 0l �he Business antl Pmie55ion5 Cotle� or thal he/she is exempt there�mm an0 ihe basis lor �he allegetl exemption. Any violation ol Section 7031.5 by any aDP��cant br a permil su�lecls Ihe applicantlo a civil penal�y oi no� more Ihan �ive hunOreO tloilars ($500�. ' I, as owner oi ine v�openy or my employees with wages as their sole compensation, will do the work, and ihe ❑ Slmc�ure is noi imenaed or oflered for sale (Section 70a4, Business an0 Pmiessional Cotle: The Contracbrs' S�ate License Law does no� apply Io an owner a� a pmpeny who builtls or impmves Ihereon. an0 who tloes such work himsel�/herself or �hrough his or �er awn employees, pmvidea �hai such impmvemems are noi iniende� or ofleretl �or sale. II, however �Ae buil0ing or , impmvemeni is 5010 within ane year o� complelion. �he owner will �ave Ihe hurtlen oi proving helshe tlid no� build or imD�ove lor ��e purpose ol sale). I, as owner o� ��e pmOehY. am eKclusrvely contrac�ing with licensetl contracmrs �o cansimc� I�e pwlec� (Sec�ion 7044, 8usiness ❑ and Pm�essions Cade: The Contractors' State License Law tloes not apply lo an owner ol pmDeM w�o builtls or improves ��ereon antl who conlracts for such prolec�s with a conlractor(5) license pursuanl ro Ihe Canirac�ors' Slale License Law�. I am aware I�al proof o� Iheir Worke�'S Compensation insurance shoNU be pwvidetl to me. � I am exempl under Section: B. 8 P. C. ' lor ihis reason: Date. Ownec � I tlo hereby cenity tha� I am aware ol and underslana ��e requiremems of Califomia Healih antl Safety Catle Sec�ions 25505, 25533, and 255JG antl Ihal I ar any lu�ure builtling occupani will/will not (circle one) neetl to comply with 5ai0 s�ate cotles antl �he r¢quir¢men�s �or a permi� lor consimction ar modihcation �mm the Air �ualiry Management �isVict. flesidemial constmciian applica�ions are exempl fmm �hese pmvisions. Oa�e: Applicanl: I hereby certily Ihal I have reatl this applica�ion antl sta�e �ha� Ihe a�ove informa�ion is correcl. I agree to comply wi�h all ciry a aun�y ordinancesantls elawsrela�ingtobuiltlmgconsiruc�ionantlher ' tho erepresenla�ivesofthi ' Ioenlerupon�heab -men�ionetl pmper�y lo •i eclioR urpase � /� Daie: � � v Signalure: Dd�er's ucense ar 5ocia� Seadtv a: Green—Cotle EnlorcemenL Canary—Applicanl: Pink—qevenue: Goldenr0�—Assessor CYTY OF COSTA MESA — BUILDING PERMIT , � PERMIT NU: H 049856 PLAN CHECK NO: 06939-90 A . , CONSTRUC't7:ON TYPE: V—N PERMIT TYPE: STR PORPOSE: REP JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143 CLAIM VALUE; 14,388.00 CALC—VALUE: 14,300,00 GROUP OCC; R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION ******�*�ra�-*�r****��r�r*�*�*x �r�*�r****�****��r**+r�r*��rx****�t*�r***�r*�rr*�r�*****+t�t**+�*�r Z O N I N G R E(j U I R E M E N T S sETBAcxs • ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN I,EFT: F'I' IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARK2NG REQ• PROV: PARCEL: 93506124 ZNE: R2 REF NO; PLANNING Nt5'CES> REPAIR EXISTING FOUNDATION. p!1f11 p��pp p� � afTFiFYFifi�#9f1F R��`7P�k if-�R'1EM^iPM� !F i! 3E k�t iF if if if it iE if k IF iF it if ie k it iE �kltlF !f iE k �f iE IF aF it If iE it it if if k iF if iE ib iF if;f iF it fE iE#it it 1t 1F 3F D E V E L O P M E N T S/ E R V I C E S R E Q U I R E M E'�N �T,; S. ZONING APPROVED HY : �� /� �f—i— DATE: .I-I.O BUILDING APPROVED BY : i.-�LLf7Pcl`J DATE: � � ,. APPLICATION ISSUED HY: DATE; 1f �k iFiF �F )E if iE �IF iF �hfF jf k I!�!f if IF if iF If if dF dk 3E 1E IF �F if aF IE iE�i'F'�FiFiF iF iEif3kkfEjElflFif�EffiE3E1E1flE3E�flf3f�fiflfiFifikiElEiliEiFikiFiE 1EiklFifiEifiFkiFkifiE3fiEif3EiElfif�flEiElElk�EifiFN3flfiEdkltlEi!lf�FjfkkiEil�kif LEGALI7.ATION;N F E S U M M A R Y STRUCTURAL SEGMENT;Y HLDG PMT PLUMBING E ECTRIC MECHANIC FIRE SMIP/RES�� GRADING PERMIT 162.00 SMIP/NON—RES PLAN 26.33 , 2,15 ISSUE FEE • . BUILDING—DIV—> PERMIT TSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 164,15 0.00 26.33 190.48 190.48 "' ,00 REVENUE DIVISION TOTALS--> COLLECTED: 190.48 OVERISHORT; .,00 BLDG PMT' PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 162.00 2.15 '.26.33 IF If�iF �)f 1:lF i61E if �lF if �k ff �If if iF if- ik if k iFlf if !E if iF �F if iF if iFlf if iE iF iF if iF ik k IFlF if �lE 1F k if If M 1F 3f iF 1f �E iF IE iE if lF�E 1! if IF iF1! k �! iF �lf �If if IE iF iF 1! If Ik iF 3k I N D T V I D U A L F E E H R E A K D O W N TYPE (jTY D E S C A I P T I O N UNIT COST TOTAL COST SFC 143 FOUNDATION BY VALUE PER $100 100.00 14,300.=00 END OF FEES '. 41 Q0074'o9—OQ�J7�401 Y��—d' I90.i8 DATE: il/S6/90 TI}1E: 11:5g CONSTRUCTION AND PLANNING �� ` SPA APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Po�E,_ 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _ o�'� 53. Steel Reinforcement 3�'Electrical�Coridufi�Utility-Undrgrnd:y • 54. Forms � •A�Electrical ConduibUndrgmd. 55. Electricai Bonding ;'5:'�Steel Reinforcement " 56. Rough Plumbing & Pressure Test `� r.. = 6.- Efectrical UFER•.Gind. � 57. APPROVAL TO COVER-GUNITE �O =�7. Footings�"= T« �= 58. EleMrical Conduit-Undrgmd. - - c, Y$. F,oundatfori .'��" ��' 59. Gas Pipe, O Undrgrnd., Test �`" -"9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. r,: 10. Structural Flodr System � 61. APPROVAL TO DECK 1�1. Property Sewer-Linz & Hopse Connection 62. Backwash & Receptor-Final 12. Sewer Cap . � 63. Heater & Vent-Final 13. Roof Drains� �- 64. Plumbing System - Final 14. Rough Plumti(ng " � 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric-Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL(SPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT - ' :^ C�-„n - u: - iU 20-Rough �Eactory Fireplace r;�� •*,'_ �� _ . �APPROVALS -.:-� Permit # > `� '� <- - : e' � �•o�,- : •- ,� .� ^. � _�. �.-� � - . .... 21.'.'DuCts, in Structu',ce' . � =' • � r � ' �'� `� ,`, _F i .. .. S _. � � �, 70. �Jnderg�oqnd Hydro 22. Ducts, Ventilating:• � �"� � - �• -71. ProducfPiping OGas �Oil ,�. 23-Gas Pi �e-Rou h &;7est ' ' "'' ' ��' - P 9 �<- ,�. r• ,t �, , r 72. Underground FIGsI�„p , .. 24: Roof Fiaming p:r . - C : 73e- Undergrrid. Storage Tank'O Gas�O Oil � 25. Roof Sheathing i i � t� � o- T' ' ^ 74?� O�erhead'Hydro `�� . 26:_T-6ar Ceiling (Structurel) &-Monocoat:, : � - :� i .:. 75:' Dry Chemical � ' 1 � � � ��' 27-. Frame and Ftashin 'i ` 11 � ` ' � "' � � ` ` :, 9 .x.c �* �r ;�T >. 76- �Dry Stani�pipe '_,y '_28.'Lathing& Siding.�� i,� �.��:; ri. U; ._ �•�! r 7lc FIXED SYSTEM.FINAL' y . ..t .,� n ^29. Insulation '� _��' '= - ' •• ''`r ' �`; � � � 7g: FIRE PREV. FINAL : 30. Drywall.Naifing r�� ~ �` ii. � � + �t �� -MEALTHiDEPT-.iREQWIREMENT . 31. Plaster'Bro�n Coat ' _ x - � ' . 79r'FINAL INSPECTION � �� ' c r,r � i. t . 32, Electrical PowerMeLerFinal �" -, :�, _; ��.��'Y. �80:iPOODCERTIFICATE ISSUED y 33�Final Electric "'- _ � �.� ' • � y��' � f .* � Nu'[es: f �'� " _ _ �? � ,y;:. -j34: Final Heating &,Qii C'onditiorung S' "' � `' �:�;; ' _'-' � :r . .� �'- - � ,� r � �35 'Final Gas Pipe-l`est � �� ' •` :) �� ' " `• 'r � r � T � � r .. ; : . ' "�^ �` ' i �, '4 �� . � x [ f � 36� Hood or, CanoPY_. <� � � - i � n s - +. �• - - - .- -- ,. _ , �37= Firfal FaMory Fireplace ' -'�' `• '.'T ' � ' C�•+ f• � �.� - 384Final Plumbing :,": .� �� .. � ; � � � r ,i �39 -Water Service-Final � � � � � «� �' * � �s �. � , a_ ' � .�. 40�'Gas Service=Final ; . ,.,,, ,� , "�n ..� �,ti � s,41-� Solar pomesticFinatc - � •� _ . 7 2<� - � c - c � - 42.rBackflow Preventet �.. "' ` ' �' � •�" � ` � _. �z - .� .- 43. Backflow Irrigatiow , _ . r , � - - .� � C c ' 44. Landscape `rripation System r =; �z ; µ ,- '� > i _ ,,t � ;;j,-, L ,'1 %" ^_45.`.�Sound Attenuation . �'� � �- `-. ` "- '�,-' ; " - - 1 - 346.�"HandicapRegulations - � �~ '� j`', :�- ��S , ��47:.FINALSTRUCTU.RE&BUILDING� ,� . � ' � _ ,. 48; � r :> � F�. �i� - � �.� -, ( n . - .r --49=�Electric Release to�Edis n � i�x . . ' � ' ::; -` . � r.r ' 50,.Gas Release to SoUthem California Gas Co �= � '�' � � '' rr` ' I � � . � Y . _ . 51 �CEBTIFICATE OF OCCUPANCY ; �_ , , ;� " ` '" � . i7�o �:.. .� �-. No. Date � owNtrz STATE-WIDE DeveloAers, Inc. DATE 4-28-76 JOB ADDRE55 g10 Aollow Brook BUILDING PERMIT N0. 4iRei TRACT ROUGH PWMBING PROP. SWR. LINE U HOUSE CON. U $PRINKLING SYSTEM MISCELLRNEOUS ROUGH MERTING ANO RIR CON�ITIONING TEMPORARV SERVICE OR POLE UNDEFGROUNO � POWER � ROUGN WINING TRENCHES � FORMS � STEEL REINF. FLOOR SYSTEM FRFME AND FL SUBCONTRACTOR � ,4.1.84 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fil/ in Comp/etely ADIDRE55 910 Hollow Brook :�b.V 13-76�A�`•OQ 646'� *':::}?6�.E� APPLICATION FOR BUILDING PERMIT :EIVED BV DATE FECENED ...x ��o��. OWNER StBLP— Wl(IP D2VP_�OD2M5 Inc. A�°•NO� —c cirv BRANCH ADDRESS AqCHITECT m BUILOING q ADORESS / �b No.`826-4550 TRACT d"8 CONTRACTOR State-Wide �PvelopQrc, Inc ADDRESS q461 6rindlay TEL. CITV Cv�ress N��826-455 STATE CITY LIC. NO. 'Z2(�� LIC. NO. oF �or 12.093 dt1'ES INOW ON LO O VSE Of EXISiING BIDG. S12E OF NO. OF COVEERINGALL�OO��er ICOV�EFING Sfiak VSE OF BVILDING AND WORK TO BE PERFORMED 1 Residence w/att I he�e0y acknowletl8e thet I have reatl this apPlication and state thet the above intormation is correci antl aB�ae to comply wit� all laws re0ulating buildinp conrtrucNon, and I shall not omploy any Oerson in violation ot Ma workmen's compensation laws of the Steta of Californie. � hareby cartlfy that I em proparly IleantBtl ea a contraetoi unCar tha Staio 05 Col{fornfe Buslness entl Proteasbm Code, D{Wsicn S, Cnepter 9, end that such liconms are in full foree antl eifeet, or I em ez¢mpt from the p�ovlcions of tha Smte of Cali ornie Business entl Proteaslona Code, Dlvielon 3, Chapter 9. S�aneLUfOO ate-Wid� p Inc. Permlttae AuthorizedAgan� Vice President OWNER VALUE FIRE 20NE APPROVEO Z CP IPLANS z I BUILAING EW VARDS APPROVED VAPOS Ai VAR. qW ^] C.U.P. �p� '/ APPROVED �A 11 THEAMOUNTSHt THE PURP06E OF E VALUATION � � $ � � BEf. MAIN & RV 3A ,Si � 0 ON IS FOR ' FEE ONLY: Q � m • n � � m ,a o � • LL 1 �