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Home My WebLink About918 HYDE CT - Building PermitsAGO��ant to fill in all ipaces exceDt lhose wilhin �eavy �artler lines antl si9n all approp�iate Oeclarations. - GTY �F�COSTA M qIC, COj[�\ STRUpCT/I�O,�N��PERMIT / PER TRACT NO. LOT NO. UNIT NO. , � Project Address � ` a q 'v� �G` �1LN,,� .��^T,�, �,.'�-�o��p �� AppliCBnL�SMdilinyAdd�255 1S� �1J `�I�J�WV TYPEOFCONSTRUCTION ' NEW ADD ,ALTERATION REPAIR Oc-n n1� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p�p # ZOne Owner's Name `,UL�-�L-`f��E 2 Phone�_�2L"ld�� ' DESCRIPTION OF WORK/USE OF BLDG. � - Address �rr�- S Main Building: Accessory Building: • Z Arch/Eng. License No. TVPE OF PERMIT GaA�livG FOUNoaTiOiv ❑ STRUCTURAL T Front, - ' . O Addre55 ^ ] (� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � B Rear N ContreCtof'S NameT R� ' Phone a("J % � OTHER . - _ A . . . . _ - � PROJECT�DESCRIPTION SQ. FT. OCCUPANCV C Right N Addresslmailing) • � L K G CityLiCenSeNo. �� ZONETRUCTIONTYPE GftAOINGCU!YOSVALVATION CftEs g Left R I.iCENSED CONTRACTOR DECLARATION Ping. Ref. # � �Parking Req./Provided E Q I he�eby atti�m lhat 1 am licensetl untle� provisions of Chartei 9(commenGin9 Remarks ;: . � � Planning NOLeS: !�!f, M with section 7000) oi Division 3 of the Business antl Professions Cotle, antl ' � � T � my license is in full forc�} antl eftect. �l� �S � S Licens I yss C-J� . l'ce�{2�.N� � � Date' � I� 5'g t ��1Xf.P1l�Ml�, �j PLUMBING FEES WORKERS' COMPENSATION DECLARATION Bar Sink ShOWerS � \I hereby aHirm mat I have a certificate of consent to self-insure or a certificate . , ELECTRICAL . FEES of Workers' Compensation Insurance, or a certifietl copy thereot (Sectlon BackflowPrevenier �-ServiceSink 3800, Lab. C.) 1 1T Automatic Washer Transformer ❑ 15-50 KW PalicyNo. ��yv Company�aU�2 - eackflowlrriation SewerCa ' ❑50+KW 9 P Consiruction Pole Sub. ❑ Certifi¢tl mpy is heteby fumishetl. ' . - aCe fiet� co,P��j tiletl with the city BI'uSI m Di}� isi (� f\�`. A _-.w, Bathtobs Sewer Connection Cooking Unit Meter, �up to 100 amps Date �- i-K 3 Applicant r�• `��-�-�"�'� • . EXEMPTION FROM WORKERS' COMGENSATION DECLARATION Clarifiers SOId� Collectors . Dishwasher � Meter ❑Ov2� 100dmp5 (This section n¢etl not be completetl if the permit is to� one huntlretl ($100) o� _, less). Dishwasher Solar Pipin9 ` � Dryen ❑Gas ❑Eleccric' Sub Panel , � I certify that in the performan<e oi the work for which this perm�t is issued, I � shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan . Motors DO-1� HP 01 %- 8'. Workerz' Gompensa[ion Laws of Galifomia. Date Signature � Ploor Dreins Swimming Pool w/Spa F.A.U. � Inc. Solar �9-15 HP �16-15+ NOTICE: If, after makin9 this tlecla�ation, you shoultl become Subj¢ct to the — - Workers' Compensatlon provisions oi [he Labor Catle, you must for[hwitlt FI00� SinkS U�inel Fixtu�25 comply with such provisions or tM1is Oermit shall ba tleemetl.revoketl. Microwave CONSTRUCTION LENOING AGENCV GaSService OuUets WaterCloSet Device8oxe5 PoleLight I hereby affi�m that the�e Is a con5t�uction lentling agency for the perfOrmanGe n of the work for wnich this permi[ is issuetl (Section 309]/ Civ. CJ Interceptors ' Water Heater q Outlets Range LPntler'S Name LentleYs Atltlress Kitchen Sink - Water Service - -� Switches . Sign ' -� OWNER BUILDER dECLARATION . I hereby affirm that I am exempt from the Cantractor's License Caw for the Lavatories Auto-Wash following reason (Section ]031.5 Business antl Professional Cotle: Any city or Garhage Disposal Standing Sections county which requires a permit to wnstruct, alier, improve, tlemolish or repair P-Trap Laundry Trays Generator �0.5 KW 05-15 KW . Trash Compacmr any Structure, p�io� lo its is5uance, also requires the applicant fo� suth�permi[ [o file a signetl statement that he/sM1e is licensetl pursuant to lhe provisions of "Roof Drains � ' tne Contractor'S License taw (Chapter 9(commencing with Sectiori-7000) ot �Division 3 of Ihe Business antl Protessions Cotle) or that he/She is exempt . - the�efrom antl [he basis for the alleqetl exemption. Any violation ot SeCtion � 7031.5 by any applicanf for a permit subjects the ap011cant to a civil penalty of not more tM1an five huntlretl tlollars ($500). ' . ❑ I, as owner of the Property or my employee5 with wages as their Sole Reinspectl0� Fe¢ $15 � . ISsu¢ Fee $ 3 compensation, will tlo the work, antl the structure is not intentletl or offeretl qeinspection Fee $15 Issue Fee $ 3 tor sale (Section 7044, Business and Professional Cotle: The Contractor's . MECHANICAL PEES License �aw tloes nOt apply to an owner of a properry wM10 builtls or improvas • . thereon, antl who tloes such work himselt/herseit or tnrougn nis or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, proviEetl that such iinprovements a�e not intenCetl or offe�e0 for BOil2� HOOd O� Type I ❑ � sale. If, nowever, the builtling or improvement iz soltl within one year oi com- C2nopy TYPe I I ❑ Zoning Appraved By Date � pletion, the owner will nave the burtlen of provin9 he/she CiC not build or im- Duct - Under Ground Buildin9 Approved By Date - � prOva tor tM1e pur0ose of zale). �j . ❑ I, a5 ownel of the property, am exclusively mntracting with licensetl con- ' DuCt -Structuf2l REffigEl3liOn $y5t¢m Applic2tiOn ISsu¢d By T�(J D0t `�� tractorstd construct the O�olect (Section 7044, Business and Professions COGe: . , The Contractor's License Law tlaes not apply to an owner of property who Duct - Ventilating �0-100,000 BTU ❑100,000 BTU - SUMMARV OF FEES builtls or improves the�eon, antl who mntracts for such projec[s with a com . tractoi(s� btense pursuan[ to the Contractor•s License Law). I am aware that BUILDING PERMIT $ SMIP � $ Exhaust System ❑ Multiple ❑ System Repair/Alteration proof of their Worker's Compensation insurance shoum be providetl to me. P�AN CHECK $ PERMIT ❑ I am exempt untler Section B. & P. C. for this reason FirepVFact. Blt. ICBO � Fire Dampers ' pLUMBING $ �� ISSUANCE $ Date Owner Heating System & Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. $ - I hereby certify that � nave read mis appiication and state that the above ❑0�100,OOOBTU 0100,OOOBT i, ELECTRICAL $ � GRADING $ information is correcL I agree to comply with all tity and counry ortlinances . ' antl state laws relating to builtling wnslruction, antl hereby autharize repre- ' ,� PLAN CHECK 50% $ MICROFILM'- $' senlatives of this city to ente� upon the above-mentlOnetl property fo� ' . ' inspection pu e. �. -� G� (� � MECHANICAL $ TOTAL FEE $�'�� Si9nature� Date� ��_ Reinspection Fee $75 Iwue Fee $ 3 PLAN CHECK 25% $ ' IDrivers' LiGense or 55 � __ ^_`V V_` YVVv`+`- y "-V lmr utlbD-9b, rev. lu/tl4 wnne - eunalnq; Canary - Hppllcant; VInH - Accountln9f V��aenroo - Hssessoi CONSTRUCTION AND•PLANNING � POOL & SPA i-- ' Date Inspector AppROVALS Permit# Date Inspector APPROVALS Permit:# 1. Temporary ElectricaliService or Pole 52. Pool & Equipment Location �.. , 2.' Soil Pipe-Undrgrnd. �"� 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. , 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ��. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �' 7. Footings � 58. Electrical Conduit-Undrgrnd� 8. Foundation ' � 59. Gas Pipe, O Undrgrnd., Tes� 9. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, Ott �ndrgrnd. 10. Structural Floor Sy�stem 61. APPROVAL TO DECK �N 71. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final 12. Sewer Cap 63. Neater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar Sysfem-Final � 16. Rough Electric Wiring 67. Fencing & Access Approval � 77. Rough Wiring Sign - � �. 68. APPROVED FOR PLASTERING 18. Rough Electrical-T 8ar Ceiling �. � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro � 22. Ducts, Ventilating � 71. Product Piping O Gas ❑Oil 23. Gas Pipe-Rough & Test. 72. Underground Flush 24. Aoof Framing 73. Undergrnd.StorageTank L]Gas ❑Oil 25. Roof Sheathing � . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .. � 27. Frame and Flashing ,^ 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT i�' 31. Plaster Brown Coat 79. FINAL INSPECTION �' 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED - (�' 33. Final Electric Notes: /o/g$ GE�Caev. L.E� (Y� 34. Final Heating &�Air Conditioning � �� 35. Final Gas Pipe-Test � 36. Hood or Canopy , � 37.�Final Factory Fireplace , .� - 38.. Final Plumbing �p 1 � �� ' 39 � Water Service-Final � ' . " � � 40. Gas Service-Final ' - ' � 41. Solar pomestic-Final ' � , � 42. Backflow Preventer � ` _ , I ' �43. Backflow Irrigation . " "' , , � 44. Landscape Irrigation Systert� - `45. Sound Attenuation , ' . ' � 46. Handicap Regulations . .i , � • - r I 47. FINALSTRUCTURE&BUILDING - . • - ' � � � I 48. Special Requirements Completed . '• � I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co �. � . (.• 51. CERTIFICATE OF OCCUPANCY - . � . , No. Date • � r. . �PF6JECT AOUXESS: 9 1 II HYL E C T UNIT: .. � owecnsxame: SULLENGER, DAVID L aooeEss: SULLENGER, JEANNE N 918 HYDE CT COSTA MESA,CA 92626 pHCHIENGINEEB: �lLT WL�'�' �J�� REG.NO.: aooness: oja,�� v��qG'(� uNiT: �3g—i2c��P PEPMRTEE: anDntr n� .-nn.naNy •�- • +n n�q0 FDOPESS: r t+ , ' — ' ' "E �; �TA1TT„J��::V . H CA 92649 LICENSE� CONTHRCTOfl OECLAHATION: I �ere�y afiirm Ihal I am licensetl un0er provisions o� Chapter 9(commencing wi�h Section 7000) ol �ivision 3 0� I�e 6usine55 antl Pwtessions Code, ana my license is in lull force an0 eflecl. cirruc.:�;;=51 STpTEH�3 S C 39 EXP; OS/95 Date'. ��a /a� SignaWre: WOFRE85' LOMPENSRTION UECNPp710N: I �ere�y aflir cendicate oi consent to self-insure or a cenificate oi Workers' Compensation Insurance. or a cetlifietl coDY �hereol (Section 3800, La�. C). POLICY NO.: S Z O O 3 S S E%P. DATE: O�I / U 1/ 9 S comrnNr: STATE FUND ❑ Certified capy is hereby �umished. Q. Certitietl co��iled with ' Buildin Division. �ale: ��/Q � Fpplicant E%EMPTION FPOM WOBNEflS' COMPENSPTION OECLABRTION: (This not �e compleleU ili�e Dermii is brone bundre� (Stql) o� less�. t certily Ihal in Ihe peAormance o� ihe work br w�ic� this permil is issueE. I shall no� employ any p¢rson in any manner so a5 io become suble�� la ihe Workers' Compen5aiion Laws of Califomia. �a�e� Signature: - NOTICE: II. after making t�is declaration. you shoWd become subject to t�e Workers' Compensation pmvisions of ihe LaAor Coae. you musi lonhwith comply with such pmvisions or this permit shall be tleemetl revoketl. WNSTflUCTION LENOING FGENCY: I here�y aifirm ��at ihere is a conslmciion IenOing aAency for �Ae pedormance ot �he work for whiCh Ihis permii is i<5ued (Sedion 3097. Civ. C�. LENOEfl: FOUHESS: OWNEfl BUILOEfl OECLAHATION: I bere�y alfirm Iha� I am exempt trom ��e Conirac�ors' S�a�e License Law for [he �ollowinp reason (Semion 7031.5 Business an0 Pmfessional Cotle: Nny ciry oi counry which repuires a permi� to constmct, alier, impmve, Oemolish, or repair'any simcWre. prior ta its issuance. alm repuires Ihe applicant for such permit b file a signeA stalement ihat he/she is licensetl pursuant Io Ne pmvisions of ihe Conlraciors' S�ate License Law (C�apter 9(commencing wi�h Sec�ion 7000) of �ivision 3 of Ihe Business an0 Professions Cotle) or I�at �e/she is exempi Ihereimm and Ue basis br ihe aliegetl exempiion. Any violalion ol Section 7031.5 hy any ap0lican� lor a permi� su�lecis the apDlican� Ia a civil penalry ot not more than five hundre0 Oollars (5500). I. as owner oi �he OmDerty or my employees with wages as Iheir sole compen5aiion, will do Ihe wo�k, antl ihe ❑ s�mmure Is noi inten0e0 or oflered br sale (Section 7044, Business ana Pmlessional Cotle: T�e Contrac�ors' S�ate License Law tlaes not apply Io an owner of a pmperty who builtls or impmves t�ereon, an0 wha tloes suc� work himsel�/Aersell or ��muAh his or Iler own employees. pmvide0 Ihal such impmvements are no� in�enJed or ofleretl lor sale. 11, �owever �he huildinq or impmvemenl is soltl wi��in one year o� comple�ion. �he awner will have the bur0en o� D�ovinA he/she tli0 no� build or impmve �or the purpose o� sale�. I, as owner of �he pmDeny, am exclusively contracting with licensed contraciors Io cons�mct the pmlect (Section 7(Wd, Business ❑ an0 Professions CoOe: The Contracmrs' State License Law aoes not apDty to an owner ot pwperry who bwltls or impmves thereon and who conlrazts �or Such prolecis wi�h a tOn(raCiOr(5) litense pursUant lo �he COnlfaC�ors' Sfa�e Litense Law). I am aware tha� pmol o� Iheir Worker'S Compensation insurance shoultl be pmvidetl �o me. � I am exempl untler Seclion: B. 8 P. C. for �his r¢ason: CITY vF COSTA MESA - HUILdING PERMIT PERMIT NO; B 068036 PLAN CHECK NO; N CONSTRUCTION TYPE: PERMIT TYPE: STR JOH DESCRIPTION : REROOF/T-O RESHEATFi & REROOF W/COMP, PERM NO; B 06803E GOVT: N SUFP: AI PURPOSE; ALT SQ FT: 1.100 CLAIM VALUE: 1,100.00 CALC-VALUE: 1,200,00 GRC�UP O�C; R-3 /M-1 COMMENTS: ** *��cx;�**�+�*«*+��**��*�*��r*�*��r�t*�*****�*x**�*�x �*�r**��rx��r*�r*x*�*x-**�r+�*�r**��tr�*** Z O N I N G R E� U I R 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 AEAA; FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGFIT: FT IN PARKING REQ: FROV; PARCEL; 41808219 ZNE: REF NO: PLANNING NOTES> ? �� 1E iE iE iF i(� iE iE i(� �k if # iF 1(� iF ik 1F iE ic �)E iE i!� iE ic 1E i(� #'r. iE ## iE it 1E if ie #�1F fF �tlE if iE # ik # iF # iE iE iFlElt i4 ik ik if !f iE iF # iF %iE k` iE �1f iE iE �14 k!F iE iE iM1 * iE it?E # 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 APPRO�'ED BY �= � naTE: BUILDING APPRQVED BY ; DATE: �''' APPLICATION ISSUED BY; �� DATE: �_,��(�'J� 3fi(�'k-fFiEi(�1E#?liElEiFiElEifiF1F')c#iEi(.iE YF ✓.,�:xiFfFiFifTttti ie�tiFiFiFF.itiFiFiE#iF-kiEiEiE#itifiT, i! 4:�ir"'e��'�(-j( if iE if �Y.- iE iE iE 1E f� IF iE �i !F 1R iG iF iF iE i%� iE iE iE # i! �k%ib if # �f % iE N- iF ik 9E #-# 1E;E 1E if iE i@ 9! if �K �IE iE iE N jE iE jE iElE iE iE iE 1F �)f �f ik iE �1C� i! i! ?E 3F i: !F 1f i! iE if iE lt JF iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMHTNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 27.00 50 PLAN SMIP/NON-RES ISSUE FEE BUILDING-DIV-> PERMIT IS5UE PLAN-CHECK TOTAL PAID DUE TOTALS----> 27,50 0.00 0,00 27,50 27.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27.50 OVER/SHORT: .00 HLUG PMT PLUMfiING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN-CHECK z7,�� .5� il� 1E i! iE iE it iE it?E iE �)E iE ic 9E iE iE M� iE iE iF iE iE ib?i� iE #'1( iE i! %�!! it 9E iE iE iE �1E 1E iF if iF fi!E iE iF # �F iElE if 1F if!(� if fE iE iE # iE if if ##!k #' iF iE 1E iE iE 1E 1f iE fk iE 1t k iE iF Z N D 2 V I D U A L F E E B R E A K D O W N TYPE Date: Owner. I I tlo �ereby cetlify �hal l am aware ol and untlerstand the requirements of California Health an0 $afery Coae Secfions 25505, 25533, and $�R 25534 antl ��ai I or any INure huilding occupan� willlwill not (circle one) neeE ta comply with SaiU state codes and the requiremenis for a Oermi� lar constmctmn or motlihcalion imm ��e Air Ouah�y Management Oistricl. Residenlial cons�mction applicaiions are exempf �mm Ihese pmvisons. Oale: Applicant: I �ereby cenity I�at I have reaa Inis aDDlicalion and statethat I�e a0ove information is correct.lagree to comply witA all ciry antl counry ordinanws and stalelawsrela�ing�o builtling cons�mction antl hereby a erkw re5entaiives at�his ci�yto enteruponthe above-menlioned o�openy lorins ection purposes. Oal¢: �� S g � �riverS License or Social Securiiy x� ��-� .� 1641�46 White—Builtling; Green—Cotle Enlorcemenl; Canary—Applicant; Pink—Revenue: Goltlenrotl—Assessar QTY 1100 D E S C R I P T i O N REROOF BY VALUE RESIDENTIAL NOZONE ENL� OF FEES UNIT COST TOTAL COST 1.00 1,100,pp �1 00163977-OD163978 T O T 2�,�p DATE: 47/13/94 TIPIE: 13�05 , ii CONSTRUCTION AND PLANNING POOL & SPA APPROVAIS Permit� Date Inspector APpRQVALS Pecmit?k Oate Inspector 1. 7emporary Electrical Service.or Pole � 52. Pool & Equipment Location ��. ✓ 2. Soil Pipe�Und�grnd. %�, �" � /;� 53. Steel Reiniorcement 3. Eleai�cal Conduit Utility-Undrgmd. ' " 54. Forms ! 4. Elect�ical Conduit-Undrgrnd. ' 55. Electrical Bonding 5. S2eel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electr�cal UFER Grnd. � 57. APPROVAL TC COVER�GUNITE � I 7. Footinqs 58. Electricaf CanduirUndrgrnd. , � 8. Foundation • �� 59. Gas Pipe, O Undrgrnd., Test � 9. Water PiPe-Undrgrnd. j � l 60. Backwash Lines, RTrap, t�'� Undrgmd. i` , ��. 10. Structural Floor System y�. ; �• 67. APPROVAL TO DECK �', '. 17. Property Sewer Line & House'Connection� .�' 62. Sackwash & Receptor-Final �/) •_, 12. Sewer Cap '�.-' 63. Heater & Vent-Final .i � 73. Roof Drains 64. Plumbing System - Final , t4. Raugh Ptuc�bing 65. E{ectricat-Fina1 � 75. Rough Electrical-Condu�t 66. Solar Sys:am-Final 76. Rough Electric Wirin9 67. Fencing & Access Approval ' 17. Rough W�ring Sign 68. APPROVED FOR PLAS7ERING 78. Rough Electrical-T 8ar Ceiling 69. POOUSPA SYSTE�AS FINAL 19. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. OuctS, in Structure 70. Under9round HYdro 22. DuctS. Ventilating 77. Product Piping ^ Gas � Oil 23. Gas PiPe-Rough & Test 72. Underground Fiush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil I Z5. Roof Sheathin9 • ��Q�qG� �(,� 74. Overhead Hydro ! 26. T�Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpioe 28. La.hing & Siding • 77. FIXED SYS?EM FINAL 29. Insulation 76, FIRE PREV. FINAL 30. Drywall i�ailing HEALTH OEPT. REQUIREMENT 31. Plaste� B:oVvn Coat 79. FINAL INSPECTION 32. Elecvical Power MeterFinal 80. FOO� CERTIfICATE ISSUED � 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Finat Gas Pipe-Test ? ��. 36. Hood o� Canopy �� 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Serv�ce-Final 41. Solar pomestic-Final 42. Backflow Preventer � - 43. Backflow Irrigation , 44. Landscape Irriqation System 45. Sound Attenuation 46. Hand�eaP Regulations 47. FINAL STRUCTURE & BUILDING l�Y, �� 46. FINAL PLANNING �! 49. Elect�+c Re{ease to Edison j 50'. Gas Release to Southem Cafifornia Gas Co ` � 57. CER7IFICATE OF DCCUPANCY No. Dace Applicant to fill in all zpaees exeep� tRose-wyhin �eavy GorOer lines anE sign all a�prooriate tleclarations. . ' . CITY OF COSTA MESA �, 1� � � , .'� -i 1 �� PER T�. . � TRACT NO. LOT NO. � BL � � , i' - ' - - : -i'" , ^ --_ ._. _ _. _ �.. ..' CO�lSTRUCTION PERMIT. � : ,. �� i . =' j ,i � � �'3 � " , ,� � � , � i � -f% �-: +:a ;' , '' .,� ' ii <i � � � �i : �.- i c +�:: � ` , ''� i . ._ , • , . . ; - � ' .�; = `:' <. ' . , � ± "�' . � � "Hpplitent'9 Mai6n Addreu � �� ` / -y +� � "� 4 � � i : TYPE OF CONSTRUCTION ' ' iNEW ADD ' ALTERATION _ ' �REPAIR' . � � ' ' 1 �Y � � '�9�3 :BI� I FiI,83; � . Qjifl(]� '�L � AfOjeCtAddfeu. • •• '/ ,F'. `-� I � � � � : I ��CONVERSION �.❑ DEMOLI�S}I�TH�R.� ` ' - " � '' ' `!' � ' �� i � ' '� � ' ...1. � ' � i.� � � ^ � � DESCRIPTION OF WORK � � � �A'"- ^--�"-I � 'Z�NING REGULATIONS=' � � Owne�'s Neme � OA1 f ��i (' � /� O�t Y S hone � ' s� � . I .� � ' - ` ' . ' . - ' i� � Addfess� ` � � _ ' . � ' 7yBEOFPERMIT ' � GRAOING�' �1 FOUNDATION � •STRUCTURAL A.P.s}�`�� t � ' �` i � � •ZONE �- � � -. ` �' I .� �. 1 I � Afth/Eng' ' � LiC2n5BNo. � ; � �'�(TENANT ❑'ELECTRICAL ✓�PLUMBING.��MECHANICAL' ' � � - � �BUILDING� .i ` � '� i- � � . -PLNG: REF yk •� a 1 ' '- - - . .. r,-, I Addf253� :' i � , � ' " �. ' ❑j07HER I = + - i '� . 1 ' . ° � u � .0 � „ . � � t) �� ' � PR PEIRTVNGINE� ' ' � 'REAR VARD (TO P/L) � , I '� . � ' Cont�ector's Nam O� � � u hone , � PROJECT DESCRIPT,ION $Q. FT. � ' ^ OCCUPANCV � � - - _ - I . . 1 • � ' _ . ' �. ' ' � ' -.. f , - � � 'r � -LEFT SIDE YARD . ; ' � � �RIGHTSIDE YARD � .� � �.�j I � ) ' Address�m2ilin9) � _ ��c , . CONSTRUCTIONT�VPE - VALU ION$ e:' _ ' � •�� ' j � ' 20N€ �r' f' ' � GRA�INGCU.V�S.�'ACRES �T ' � PKG.SPACE�REQ. � � . PROVIDED � - 1; , � � license No. ' � ' � � i' - � r i. • GCENSEO'CONTRACTOR DECLARATION : � ; ' �' � � � � ' ' � � ; '� ' � � STREET WIDTH � ' �� . . , , -�� 1 , . Remarks: .. 5 - � � C i � 1 . - � r . ' ' '� � . � E �' . PARK FEE S � . �{' � I;hereDy;affirm that I am Iicensetl'�untle� provi51on5 oT Charter�9 (commencing ' ' - �� , , � , � � ` . � L ' wltti sectlon 7000) oi. DIVISion 3� ot the Business antl Profesilons Cotle, antl ' i ' �� t .t � � ( � � � r� f �_ ( , �. ' SVECIAL CONDITIONS � � ; [' ( c� . � ' my�llcense��ls In full force antl�ettect. ! : � � � � • - ' ' , � ' i `; , - f - ' r License Ciazs ' � , i ' � � � . ! i� L'icense No � � � , � : , , t � � . � � 1 PLUMBING I ; I ; �' I � ' I , , ' � � . ' ' . ! � i � � �, ; � j v ��'" t � � Date 1 � t 1 519nature � . � � � � r'' i S � BarlSink � �1 � � �' ��r�P' � .i i � � I ' : ! ELECTRICAL ' ! � i I � . � WORKERS' COMVENSATION DECLARATION ; ; { ! � • ' ' � � ° � i I,herBDy affirm,tha[ I have a,Certifiwtepf tOnSent to.581f:In5uYe ol.a CeYtlfiWte, �. . � BeCkflow�PreVentef---' -- -SBWB1-COnneCtiOn�. -�,� --' -�• --.�f-- .... . AUtOmatic Washer I_�„L __ jMeter ❑Uvef lOT) amps ; y� �.j � I of Workers' Compensatlon Insurance„ or a certitietl' copy t�eieof (Sectlon : � . . , - r—� �_ , - , . _ _ . � _�,�, _'_ _ . � 3800, Lan. C.) � j ' �. t ,�' i , � Backflow Irrigation � j � Solar Collectors , ' i Construction Pole � �%� i ; $ub Panel� � i ; PoIICY No. ' ' , ' ComPanY � ' ' � ' � ' 1 .I - . . . _ .. �� _ � � Cooking Unit ' t ' .L7j 1 ,Sub Pole i '! � � 1 � , eCertitietl copy is hereby furnishetl. ' i, ; � ' < i , f , i Bathtubs Sol'ar Piping ; �. . . . , , . � Certifietl copy is fiietl witn tne city auutliny Dfvislon. • � � i � � � Dish�vasher "'. Motors �0-1 HP �1'/:-8 �- . i � (DT� s section neetl n APPlicdnt � Cla�ifie�s < < Sotar Tank � � � � . : . t . � EXEMPTION�PROM WORKERS' COMPENSATION DECLARATION I - �"-'- �rye'rs`OGas'�, OElectnc � d'nc:Solar �9-15HP' 076=15+ !- -� ot be comDletetl if the permit is tor'one hunGrea (5100)�or � ' Dishw25h2� �� :' Swimming Paol w/Spa i i . V � i less):• . � . - � ! � ' � i t f . � . . � , - . . . � Fan { � � e � ' �Microwave � � i � � ' I certity�t�at In the pertormance of the work for whic� t�is perm�t i51s5ueE I� � Drinking Fountains � ; � Urinel � � ; I � : � ' shall no£ amploy any Oerson In any manner so'as to become subject.to t�e , , . � i .. � � . i F.A.U. � F '�p�f �Pole�Light �• . ' Workers',Compen5ation�.LawSof Calitornia.� � � � � �- ' � FIOOrDrains� 't , � ; . WaterCloset� ! -i I ' I Date' ' ' '� ' Signature �� ' • • , , . . . � ,-NOTIGEeI(,aftenmaking-thls�tledaration,.you.sfioulQbecame-suDjectiothe j - .FloorSinks.� ..:._._�_._y. .� .. _.Water,Heater�-�_� '.:_ ..�._ _ _.;. __�� Fixtures � ( � :Rang2 � � , 'i � 1 Workers'� Gompensation provisions of the Labof Cotle„you'must forthwith �` ;_;, � . � , � f�- Device Boxes 1� � �<omply with sucli provislons-or�thi5;�permitlShalP be�tleemetl'revoketl:' �_ GasService , `tOutlets� C: i� WaterService � t.� _� g�� t Sign� � , 'I I CONSTRUCT�ION •LENDING "AGENCV� � ' � � � " ' ' '- �� - OUtlets � I 1 ' � � F ' ' I � ; I nere�y at(irm that there is�a mnstruction IenCing agency,for ihe�performance. � � Int2�cCptoro � y, > - `, - � � I,n . . � � e � Standing Sections � � �of tne work tor� whmh,.this, permit is ,issuetl u(Section 3097, Civ. Q)� �Trash Com acto� � L.enaer•s� �Name:: ' = .' . � . : ^ 'c Kitchen,Smk ; i. r � - : � f ; . ; Switches . .' � ; ' � . P , ' ? � � ; LenCei's AdGress . '' � � ' = ' + � ^ � ' • v ' Y � -� �� Lavatones - � ,�-j T �.f-! (! � f Garbage Disposal ! ! j ' � � � ' � ( �OWNER'BUILDER OECLARATION :2 .i . -. ' `" � ;; ' . �. � i. , • I - .. .t . �' � y ' I . � 1 , . . . , ` � I hareby;affirm that I am�exempt Trom tfie�Contractor's License Law tor the � • - � r ,u� �• Gen¢rator �0-5 KW �545 KW . F � � � ' following reason-(Sectlon�7031".5 Buslnass antl ProTesslonal Cotle: Any dty or � � P-Trap� �' a ,;i ' � ,�, � ' � " I ! � ' '- I�county which� requlres a permit to construct, alter, Improve' Oemolish orrepair �. �� , . . �_ � � ._ �. TransfOrm2r 015-50 KW � 1 ' � I 1 �any structure, prlor to its�issuance,.also requires the applicantltor such permit Roof;Draini' ' �. � � � ^ ' "� ' m � ' ( j ' 1 ' � ' � ' �' to file a signetl statement that Ra/she is licensetl pursuant to the:provisions of' ' '• ! ❑5U+ KW � ! ' � the Contractor'i License Law;(Cnapter 9 (commentlng�with'Se<Uon-7000) of f ' u. ; - � F - � , F � i , � . � :Reinspection Fee ' $75'� Divlsion �3 �ot the'Business antl Professions Cotle)' or�• that, he/she� isiexempt � ' � ShOw¢�9 ..� � , Reinspectian Pre'; - � : $15 .' : .. ' � � thereTrom�antl thej ba5i5 (or the allegeC exeinptlon. Any. vlolatiod of Sattlon '� ' ' �' - ' Metef ❑up [0 100-3mpa ��155ue P88 � �$� 3 �;7031:5 Cy,.any applicaM tor'-a;permit-subjects the�applicant to a•civil ' ; � '�" - � 'y � ! 1 ' z ��j � F � , enalty of not more than five'hunOretl tlollars ($500)'. � T�.;. 1 �'. . 3' � Servite Sink �- ! i , � i ' . � ��ue Fee C� .$ 3� Zoning Approvad By � ' ' � � Date I�I,eas'owner ofi the,property�or.�my employees;with wages�as thei� sole • � � � � ; ' ' � ' i � ' ' � t � ' ' � 1 � � . compensabon wlllltlo the work; antl�the'structure is not intentled or ofteretl � r� . ,��! 'j !, MECHANICAL � ! . �_� '�'� qppj��tion Approved By ' Date � � tor sale;(SecEton 7044', Business!antl�Piofe551onal,Cotle:�Tha}Contractor's.� , .' � t �, � ILlcense �Law tloes not apply to;an owner of a property.who builtls or improyes � - - �- I , Refrigeration System .. �' I •' � j � .� � ; thereon,yane ,who'tloes�such work nimself/herselt or through hls or her own� � � BOil2�, � 1 �' �; . � , � � � 5, qppliration Issued By 1 � ` �DatB � � Iemploy eas, provitletl that such�improvements are'not Intentletl or otlerea for � f � ' � ' ❑a100,0006TU ��100,OOOBTU, �i � • � . � � � sale. If, how¢var, tho bWming or Imorovement is soltl within oneyeadoi com- .� Duct Under,GrUund � � .i t,, � , , ; ,; ' I � j SUMMARV OF FEES f I ' '� �� ipletion,'the owner!will have [he Durtlan of proving he/she tlid not builtl or Im- ! . � ; . . � � �. � ' ' � ' 1 � . � � roveforthepurpose,ofsale)'. �� -� .� 1 .±� -` ,� � . � ' � Duct-Structural � � � Syst2mRepair/Alteration � .BUILDINGPERMIT $' ; � ' � SMIP �' � � $! • � � ., � �� I, as owner oi tfie piaperty, am exclusively 6on[retting�with9lcenietl com � � � ' , � � � � � � � - i�, � � � ' � V � ' Ira<tors to construct the�project (Section 7044, Business antl Profezsions Cotle: i Duct Ventilating_ �_i _ � �_ � � 1 . A 1� �� ' jPLAN CHECK� �� $. � '� i ' PERMIT . ; I' The Cont�actor's Llcensa Law does not apply to an owner of property who�� - � �' - -'� � ' � ISSUANCE $' � � �i builtls or improves [hereon, antl who <ontracts for such projatts with a con � ., Exhaust System ❑ Multiple � � `I ` < < � j ' � �.� ;PLUMBING i $' � I ' � � , � tractor(s) Iicense pursuant to the Contractor s Llcense Law): � � � ` � � ' ' ' ' � ( � , GRADING � 1 $ � � � � - � . � � ' i ' � � � � PLAN CHECK� $ � : 1,\ ❑�Yam exempt un0er Section ' ` B, 6 P. C. Tor this reason , � Firepl/Fact. Blt. ICBO #-� � I � , � /:� f ' i f � } � ±$ �.'. i aL' �- ` � : � : . r 1 � . . � ; , ; � 1ELECTRICAL' � $� � � j � . ,�� , � �ate � � ' � Owner!' �� -' { ' � Heating�System & Ducting }. ; ! , � ' i 1 �� {. � , 1 � . � ' � � ' � ' ' � ' � ;PLAN CHECK! i $; i ' MICROFICM � $ . r �'-1-�ereby certify_fhat Ishave-reatl-4hi5-appllcdtion-aptl��6tate�thdLthe•above.- - �OIOOOOOjBTU�lOO,0008T'•. - _ .,.�... .�.F- � : � 'L. 1 � � � ' 1 ; Information is mrrect. I a ree to mmply wich all clty,antl county ortlinances ' . t� i � I t !� ! .I .1 '� � � , TOTAL FEE !$ � � f ' antliscate laws rela g.t bull construction„antl hereby authoriza repre � � .i � � . � � ; y, MECHANICAL $ � ; , � I j � y" i Hood or T� e I ❑ i �� LESS � ' sentatives ot,t� dty er;upon the above-mentlonetl o� oert for , r �P , �� RemS ection Fee� -$15� � � ' � � , . � ( , / � ; ' . . , , t i_ ; P � " �PLAN CHECK� � � i � � ADVANCED PC $ ( I.In5p0<tlon pur se5. j 1 CanOp . T� e II ❑ � f } i � 4� $� � j . � Slgnature i � . i Date , , ! � � - � ! ' Re isteis i � Y Issue Fee I � � ' � ! � -1 I � � � i , Drivers• LI or 55 � � � 9 t ( - � � t . � � � � ' $ 3. t 1 1 ' � � FINAL FEE j r $ ;� . . . . . . . - . . � , .. . _ _'_ ...... "_ ' _ . _.'__' ' "'... �. _.._ ".._ . . � �...-.__. . . _ . . ` _..._ "' " "_"_. . ..:.._ .___ -.. . . .� __ _ _. ",.' _ " _ _'" _" "___ _" ' _' _" ' CMF 0865-46 rev. 12/82 e - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor . , � - ' '- -' ' "-�"""' "-'^"-"'�" •'-'-""- "'-'- ^---�^ ---^ -t \ 1 '_'_ _'____ '_ __'__..__ ____._-_._____.. __ __ __.._ __ ' ._.' . _ _ __.__ _ _ _' ___ . ..'• i� , - - ._ . .,-. - _..,_ POOL&SPA'. . � .. . -- ' ' ' � �CONSTRUCTION AND PLAN I G� /"% - - . . � ; �. n � � � � � , - .� � ' ��j�/��/�� -Date �luspector� - ` � '� Date �� Inspector �'APPROVALS- Permib# �{� � .: �' APPROVALS `�Permit# - r:. . ___��: ` ' • /� , . . . _ � `7•.' � emporary Electrical Service ouPole . � ; _ � � - ' � 52� Pool & Equipment �Location � :- , � � � �., ". � �2d �Soil�Pipe-Und�grnd.; � ! � V � ' �4' �,53. �Steel Reinforcement � . ' � ' � .a_. ' %i' '. �i � �3. �Elec`tiical Conduit Utilitv-Undrgrnd: - � _ - ^ �54r �Forms' . ->'�- _ , '.` . , .; ' ' �� • `r 4. Electiical Conduit-Undrgrnd. f - ' •-` � � ' • �55. 'Electrical.Bonding � - ' • ' �-�� • .� . � . 1 . . ��' � . �5�. Steel!Reinforcem-ent � � � :; -�: ' �,� - ! -- � �56. 'Rough�Plumbing &'Pressure Test.. •� ' :�� - '6. ,Electrica� UFER Gmd: � � ; � � � r� , ?= � � -57. APPROVAL TO;COVER-GUNITE' -- ' 7. Footings ' - ; ; � -� � � ; ` � = ��58.� ,Electr�icai �nduit-Uhdror��i? � . � ' � 8. Foundation � ' , ' � � � : ` " � � .' � , �r59. GastPipe, O�Undrgrnd., Test';.� ' :�. � .'� � ' . ri- 9. Water Pipe=Undrgrnd. :� o� �' �: - 60. Backwasti Lines, P: Trap, O�Undrgmd.: `� � y 10. Structural Floor System � = • • •61..APPROVAL'TO DECK '-: ;_ _� ✓ 11. Property Sewer Line & House Connection =. ' � '; : '�62. BackwasH &:Receptor-Final._' i rv' . " ^ � � 12. Sewer Cap , � _ ` � . �` � 63. Heater & Vent-Final -� - � = r 13.-�Roof Orains � , "' � - � �. ;64. Plumtiing System: Final�' , 74. ,Rough Plumbing - � � - � � - � 65. Electrical-Final� ' . v _ 15. Rou fiElectrical�-CooduiY" �""".-" " ''`-' �---'- �'-�' '�' - ' 9 . � , i _ � �- � � � �'66: Solar Syst`em-Final� � " �-f' `i6�Rough Electric Wiiing � , , :. ? ; � !.,-� ; � -''-"*;-'`-,' -�67; �Fencing &.Access Approval � ' . � ' �� ' � 1.7<�,Rough-Wiring�Sign_,' i'? � �'`�:�' � � '� . ,'`��' 68.APPROVED�FORFLASTERING . - , ',' e - - 18.`'Rough Etec[rical-T�Bar Ceiling ,� �' -_ ', � 69. POOUSPA SYSTEMS FINAL ^ ' � � 19. Rough'Heating & AirConditioning ; � _' I ; • y FIRE DEPT. REQUIREMENT � . . � . �20.� Rough.Factory Fireplace ' ' � -�� ' ` , '� � � ARPROVALS � Permit # ' ' l � � , � �. i t' 21.�Duc[s;inStiucture . � � �� , � ' t !70.' UndergroundHydro i • ' - ,..22.'Duct�Ven'tilating� - { �. � � � 71, Product Piping OGas ❑Oil , � ' - . . � - - '- ' - . � �- �- •- - -- -- � -- - . - _. _ _.. . -- - - - - - _23. Gas�Pipe-Rough & Test `c ': .' � �; � � ' � � 72. Underground Flush , . , � 24.: Roof F..raming � � �° � � � : ;�:.; � � ` �� :+ •^ � � . 73. Undergmd. Storage Tank � Gas �0 Oil � . � ' . 25_'Roof Sheathing � ' � . '• '-� - }, , 3 _ � ; ' � .74: Overhead Hydro � - � " � �- , .,�26. �T.-Bar Ceiling (Structuralh & Monocoat � -, � � 3. � ; �Z5: Dry Chemical . � . � i 27. ;Frame anil-Flashing � ' ; ' � ; 76. Dry Standpipe . � ' - i . , 28. ,Latbing & Siding � . j t i , ` J. j77: FIXED SYSTEM'FINAL. � . ' . � . 29.' insulation . ; ' �• � � � ' � , 78. FIRE PREV. FINAL . � � i , ' � •, . V � . . . , . 30.'Drywall Nailing * �� r � Notes. . - . � , � 3L� Rlaster•'Bcown Coat ` � ' !� '� j ' j ; . _ 3 . ._ � . -.._.. � 32. Electrical Power MeterFinal ' � + � � � � 'L i � _. � � ' . .. 33. �Final Electric ' ' � j� � ; 1 - ' � � � ' � � ' 34. Final Heating�& Air Condlt�oning , � � . , i . + _. ,� . _ � .. • � r . ' 35. Final Gas Pipe=Test - � � : • � - - ` ��.- - . �, , - -� . � � . . � � < <� 36. Hood or CanoPY ' '�' ' � _ ' . _ � � • .. ; ' . - � . i�� i �� . _ . 37. Final Factory�Fireplace'�. � �� • , '� � �T � � . ' � .. ' � � _ , 38. Final Plumbing' �.. . � , � . � ' . . "' - 1 - ` . .. '39. Water.Service-Finai � ; , , � , ' � � � ' " . �� 40. Gas Service-Final � � � � ; �. - ' i ` ' 41. Solar pomestic,Final ' " ___ _ � _ '_ _ _ . , _ _ _ � , � , . ... . �� : � � � • . . 42. Backflow Freventer . , � 1 � - � . �, ' _ _ 1 ,_ . � _' , _ .� ' ' ' .' , - � 43. Backflow Irrigatiori = � _ j � � ��_" ;= � '• : �'� � ' . . . ,' z �� - �a; � v - � • �. �-: . ' � ; � i 44. Landscape Irr,igation,System � � r ; : � -_ ._ • � • � � -. ,� � � . 45. Sound Attenuation� �� . ' ''_ � ' ' • �" � � ` ' � ` � • cr �. ,i^ i , , . . 46. Handicap Regulation's � F �': ' � j � . . ' � _ . , � � • � � � 47. FINALSTRUCTURE&BUILDING � + � � i ' , .' � � 48: Special Requirements Completed � � I � � � ' , , : : . � ' ' ��?'' . 49. Electric Release to�Edison ' " '_ ' _ � _. _ _' ... . _ ! .'•-* � , � ' ' , • . � i • I -�- --�"---- � - . ; :. . � � � i . , 50. Gas Release'to Southe�n California Gas Co ' � � j � � -� i .. ' ` ''� � , � ' 51.CERTIF,ICATEOFOCCUPANCY .�. ._�__ . 7_-�_ _ ..____,_:._ :,: , t No � �: ' � � � Date + �A � � ' - , � . � � �::-_:_. � .1,-:-_:�_.�_ _' _ _'._.�.Tt��_ .._..--- - -'-- --'-�' • OwNER BIDPLE DEVELOPbIEvT, INC. JOB ADDRE55 , , e ourt AP No. `+lu-val- INSPECTIONS�= soi� c�s W RTER ROUGH PLUMBING SPRINNLING SYSTEM MISCELLANEOU< � nJS Q {- ROUGH MEnTING FND PIP CONOITI TEMPOR4RV SENVICE OR POLE ❑N�ERGROUN� � POWER � ROUGH wIRiNG TRENCHES I FONMS STI FLOOF SVSTEtn BONO BERM [1 STEEL REINF( SMEFiNING FR4ME FNO FLASMING LFTHING — IN `I Ol PlRSTER 9ROWN CO/T� REFRIG. ANO A.C., F RNO GAS TEST I�I � � DATE �_iz_ FIRE ZONE VA� SUBCONTRACTOR .� ` � GI r� !i � 0 � �€;-�e..r s�r �+'N.,;�9N 1�arn�;�� F � a Q .�. h � H O W F Q C a ¢ 7 � a 0.' W O R' L Z 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. eOX 7200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use Ink Only BUILDING ADDRESS OWNER giddle Development, Inc. MAIL AD�RESS 3848 Campus Dr. Suite 116 CITY Newport Beach, CA No�' S40-S CAN5TRUCTION . BRANCH ADDRESS ORENGI�IEEFiT+ddd, Kelsey,Woodyary�o�. aooaess180 Newport Center Dr. N.B. CONTRACTOR giddle Development,�Inc. ADDRESS qR4R cam�nc Dr,. Suite 116 cirv Newport Beach, CA No�540-5505 �ic No. BZ86614 �icyNo. -- SIZE NO.OF BLDCv. OF LOT I NOW ON lOT -- USE Of E%ISfINGBLDG. T251dEi1t181 e�S'epara�e per�a� z�2erequ40d�t�og. ft.. electric, plumbing and heating work. USE OF BUII�ING AND WORK TO BE PEFFORMED nnir {p �9 {� 1740sq.ft. �k 20 (C) 1603sq.ft. �To-rP.l_ 4�1D2`I B4 � I hereby acknowletlge that I have read this application antl state that the above information is corract and agree to comply with all laws re9ulating building consvuction, antl I shall not employ any pe�son in violation of the workman's compensation laws ot the Staxe ot California. I hereby certify ihat I am p�operly licensetl es a conttacto� under tho State of California Business end Protessions Cotle, Division 3, Chepter 9, and ffiat such licenses are in tull torca a ect, or I am exempt from the provisions of the State o if ia Business and Professions Cotle, Division 3, Chapter . Signatura ot i9�f,� � _.�yi, � Authorized � � �. *��d `7713/79 243.b5 T�,� BLDG. �r�7 APPL[CATION FOR STRUCTURAL PERMIT RECEIVEDBY DATERECEIVED r.�r��o�ii« <//f/–VfJ/'yf�Y'�Y`� I PERMITNO. A.P. NO. /'UO��a... jn �YB BUILDING ADDRES � .?O TRACT ' LOT BLOCK ��//i7/%% 111�/%l� FIRE ZONE APPROVE� �NO.OF USE OF NEW � �� M PLANS BUILDING — YAROSAPPROVE� APOSAPPROVED MAIN BUILDING A CESSORV 6UILDING IOM GL STREET) & C URP�,�-/$�('�(rf��.'//� I AP ROVED �//��i( ' APPRO�Lem_ �� '� � � �� C�r� IOLD FOR SPECIAL EOUIREMENTS Q � �� m > �a SQ. FT. w � THE AMOUNTSHOWN UNDER VALUATION IS FOR m� THE PVRP0.SE OF ESTABLISHING A PERMIT FEE ONLV: b VALUATION PERMIT FEE $ p m ^. PLAN CHECK S o 1\- i' L j LL ` $ /4 TAx $ D. � � U TOTALPAID � fiP.`�iB --i41�37�@t � g COSTA MESA BUILDING-SAFETY DEPARTMENT pPPLICATION FOR'STRUCTURAL`PERMIT=59� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECENED BV P Q "� For Applicant [o Fill in Completely — Use Ink Only - BUI�OING A.P. NO. ADDRESS BUI LDI NG T� NANT�RBl�.le DEVelO ent an ADDRE55 UNIT OR ADDRE s 3848 C j]$ ]h'. Sj]tle 116 SPACE NO. TR.NO. LOT BLK. c�Tv Newport Beach, Ca No` 540-5505 NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER Bld�e Develo ment ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER N . ADDRESS ZONE TVPE GROUP APPROVED CONTRACTOR BV DATE ADDRESS TEL. CITV NO. STATE CITV APPROVEDSETBACKS LIC. NO. LIC. NO. SIZE NO.OF BLDGS. (FROM C/l STfiEET) OF LOT NOW ON LOT RONT FT. USE OF EXISTING BLDG. Separate permits are required for �. si E FT. electric, plumbing and heating work: REAR FT. USE OF BUILOING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED S APPROVED I hereby acknowledge that I have read this application and steie that the above intormation is correct and agree to comply with all laws reB�lating builtling consttuction, and I shall not employ any person in violation ot the workman's compensation laws of the State of California. I hereby ceRify that I am p�operly licenud as a contracior untler SQ. FT. the State of Califo�nia Business and ProfeSsions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR Chapter 9, antl that such licenses are in full force antl effect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: am ezempx trom th¢ provisions of the State ot California Business VALVATION PERMIT FEE and Professions Cotle, Division 3, Chapter 9. $ ' Signat�re of PLAN CHECK $ -�- Perm(ttae � -� TAX $ ot - - Authorized Agent Da[e TOTAL PAIO a 359. -- )9 Tl�