HomeMy WebLinkAbout3257 IDAHO LN - Building Permits-+ CITY OF COSTA MESA I „ .
.
BYILDING DIVIS/ON �
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww�v.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754-5626
'�a„�m�m `�''
PERMIT NUMBER B08-00170
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 13906510 DATE ISSUED: 06IO2l2o08
• ' ' ISSUED BY:
, .
JOB ADDRESS: 3257 IDAHO LN'CM , Suite/Umt '
Vicinity: HOUSE & GARAGE ' , , ;, " ' '' ` : ° . ...
Squares: 2800 � � � Valuation: $10,000.00
SCOPE OF WORK: REROOF HOUSE & AT7ACHED GARAGE: T/O EXISTING COMP. ROOF, REPLACE SHTG. ON TOP SECTION AS
NEEDED, RESHEATH LOWER'SECTION W- 7/16" OSB, INSTALL 1 LAYER OF 30# FELT & 28 SQ'RS OF 30 YR.
GAF ELK COMP. ON 4:12 PITCH ROOF. ' . . „ �� .
OWNER: MILLER, EDRICK J TR -;�� „ , Addressi 3257 IDAHO LN � ,. Unit:
PHONE: - � . � � � City/State/Zipi- COSTA MESA, CA � - ,' � � �
APPLICANT: DEMPSEY, CHRIS . -- Address: 6154 OCASA DRIVE . , Unit:..:,� -,;
PHONE: 951 733-0371 , _ City/State/Zip: MIRAlOMA, CA . , • `- ' ! '�
CONTRACTOR: JORDAN ROOF COMPANY 6icense No. � 406783
Address: 915 W COLLINS AVUnit: �� � . PHONE: 714d44-6577
City/State/Zip: ORANGE, CA ,� ' � �92867 � . ' , � CELL•
ARCHITECT. . � License No. - - PHONE: '
ENGINEER: - � � � . License.No. — ..� �� ' PHONE:�
FEE SUMMARY :
, _
Reroof Plan Check: $0.00:._ .
Reroof Permit Fee: $181 25 '- , ,�,s �� �
Reinspection Fee: $0 00 `-- � .
TOTAL FEES $181.25 � � ' ' �� �
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia sWtutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applirable codes, and all
required inspections and Fnal approval must be obtained. Failure lo obtain inspections and final approval will result in the expiration of this permit.
c� INSPECTIONIVYE Qn� ixn� f�QQEt INSPECTIONTYVE on� ixnna�s
1fi16 Fixed System Final Fire Prevention 208 Final Mechanical
1266 Pool Spa Final � � 208 Final Plumbing
200 Final Re-Roof � 270 Final Electnwl
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition � 250 Final Building/Occupancy �
WORKERS' COMPENSATION DECLARATION�
I hereby a�rrtT untleS penal[y of perjury one ot �he ng declaralions:'
❑ I have and will maintain a certificate of consent to sel!-Insure (oF woikers'
compensation, as providetl for by section 3700 of ihe labor Code, for Ihe
pedormance of the vrork for which this permi[ is issued.
❑ I,have and vrill maintain workers' compensation insurance, as requiretl by
sec[ion 3700 0( ihe Labor Code, for the peAortnance of the vrork for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier ��y��[_��
(Tha sectun need nof be mmp�eted A fhe permrt is valucd al one hunOrcH dollars (St00) a less J
PolicyNumber: 6,;, /j�(]'7 %7/
❑ I certify that in the peAormance of the work for which this permit is
issuetl. I shall not employ any person in any manner so as to become subject
to the workers' compensation lavrs o( Califomia, antl agree that if I should
become subject to Ihe workers' compensation provisions of Section 3700 of
the Labor Cp shall forthwith comply wi[h [hese provisions.
b �
Apphcanl' ignaWre ate
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOlLARS
($100,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions Code, and
my license is in tull to(�rce and effecl. C
Lia # d 3 Class # C— 3 1
s 6/0 2/0�
o ract ature � Date �
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn ihat there is a constructbn lending agency for the
perfortnance of the work f« which this pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name:
Lender's Atldress:
oa�e
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that untler penalty of perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reasOn (Sec. 7031.5,
Business and Pmfessions Code: Any ciry or counry which requires a permit to
conswct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to fle a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom antl
[he basis for the allegetl exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applican[ to a civil penalty ot not more than
five hundretl dollars ($500).):
❑ I, as owner of the property, or my employees vnth wages as their sole
compensation. WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himsel( or herself or through his or her ovm
employees,'provided that such improvemenis are not intended or oRered (or
sale. If, however, the building or improvement is sold within one year of
completioq the ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as ovmer of the �pmperty, am EXCLUSIVELY, CONTRACTING WITH
LiCENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Pmfessions Code: The contractws License Law dces not apply ro an ovmer of
property who builds or improves thereon, and who contracts for such project with
a cont2ctor(s) license pursuant to Ihe Contrac[ws License Laws.).
❑ I am exempt under sec.
Business and Professions Code for [his reason:
SignaWre Date
305]-O6(3/0➢) - '
Owner ID verifed by drie nse. ❑ Yes ❑ No
r . .
Dnver's License No. Expires �
Veri(ication of Ownership by (rype o( document, i.e. - pmperty tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: -.
❑ I hereby certrfy that no excavation frve (5) or more feet in depih into which a
person is required to descend, will be made in conneclion with work authonzetl
by this pertnit, and that no building stmcture, scaffolding, falsework, or demolilion
or dismaniling thereof, will be more �han thirty-six (36) feet high. (Chap. 32, Gry
2. Art 2. Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which vrould
require a permit from Ihe Division of Induslrial Safety, as noted above, unless
such person has a permit to do such work from [he division.
Apphcanl's SignaWre
Division of Industrial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupant need to fle and
certi(y a Business Plan for emergency response to release or threatened
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Safety Cotle requires, with some
exceplions, lhat a Business Plan be fled with the Cos[a Mesa Fire
DepaAmem by every business which has at any one time during a reported
year a quantity of hazardous matenals equal to or greater Ihan a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperaNre and pressure).
2. Does or will the applicant or present or (uture building occupant need to fle
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( the CaliFomia Health and Safety Code, with some
exceptions, requires registra[ion with [he Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic teet of compressed gas al standard
temperature and pressure).
3. Does or will the appliwnt or present or fuWre huilding occupant need to
prepare an RMPP (Risk Managemen[ and Prevenlion Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of ihe Califomia Health and Safery Code provides that the
Costa Mesa Fire Department may require the prepara[ion, certifcation and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous ma[erials with the Fire Department.
4. I! an RMPP is presently required, has Section 25534 ot the California
Health and Sa(ely Code been (ully complied wi[h? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
ihe work which is the subject of this application a permi[ for such conshuction
or motlifcation fmm the Soulh Coast Air Quality Management District or fmm
any other air pollution control district or agency? ❑ Ves ❑ No
(Section 658502 of the Califomia Govemment Cotle requires that ihe reques[ed
infortnation be fumished on applications fa non-resitlential building pertnits).
6. Will any part of the facility to be consiructed under this pertnit be wilhin
1000 feel from [he outer boundaries o( a school? ❑ Yes ❑ No
(If'yes", the facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safery Code).
7. If a permil from the South Coasi Air Quality Management Dis[rict or other
air pollution control district or agency is required for the vrork which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8: (I( "yes", attach certificate of compliance from the appropriate air polWtion
control officer). . � ,
CERTIFICATE OF COMPLIANCE: I certify that.under penalty obperjury the
information given�above is coriecL I agree to comply with all state laws and
city ordinances regardinq Hazardous Materials antl Emissions. -� �
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
cehi(y under penalty of perjury Ihat I have read this application and state that
the information given is correcL I agree to comply with all state laws and city �
ordinances relating to building conslruction, and authonze representatives of
the Ciry of Costa Mesa lo enter upon Ihe above-described property for �
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit until fnal inspection.
Si r! Legal Owner(s) Da�e -
6 �.
AntllorAW�onze AO -an� D�1
322�1 � ►�C 11��
Applicant to fill in all spaces except those within heavy border lines antl si9n all appropriate tleclarations.
CiTY OF r,OST ES CO S RUCTION P RMIT
�
Project Atldress
Apyalicant's Mailing Address � p
Owner's Nam � ' `,1 Phone {
Address � , Q�� {r�V
Arch/Eng. License No.
Address
Conuacror's Na/� �on
Address (mal" �y
City License No. � � �� �
LICENSED CONTRACTOR DECLARATION
I he�eby affi�m that I am licensetl untl¢� provi5ions of Char[er 9(commencing
with sec[ion 7000) of Division 3 ot the Business antl Professlons Cotle, a tl
my license-is in tu�l fo�rj e tl ettect.
License lass �= �+� ' LicenseAN�
Date���9nature ��
WORKE 5' COMPENSATION DECLARATION ' �
I hereDy affirm [M1at I have a certificate of mnsent to self-insure or a certificate
of Workers' Comp,,e/nsation Insurance, or a certifietl copy jhereof (Section
3800,' L-�i �.�)1'/�L��lLlv� ' l� ��i.�T_ / �=L�-l-
PalicYn�h-�I� �rTPnY_-.r/i�JY�I
C ifietl copy is hereby fumishetl.
ertiffi%��fo�'.I� fi1G(1 y(jth the city '' ivision.
Date "'�-Lf����J�oOPlicant ' � .
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thi55ection neetl not be completetl if the permit is tor One huntlretl (E300) or
less).
I certify Nat in the performance of the work tor which ihis perm�t is issuetl, 1
shall not employ any person in any manner so as to become subject to the
Workers' ComOensdtion Laws of Calitomia.
Dat¢ Si9nature
-NOTICE: If, atter makinq this tlecla�ation, you shoultl become subject to [M1e
Worker5' Compensation provisions of.the l.abor Cotle, y0u must forthwith
mmply with such provisions or this permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 M1ereby affirm that [here is a conSVuction lentling agency !or the performance
of the work for which this permit is issuetl (Section 3097 Civ. C.)
Lender's Name
lentler's Adtlress
OWNER BUILDEH �CCLHRATION
I nereby aftirm that I am exempt from the Contractor's License Law for'the
following reason (Section 7031.5 Business anC Professional Cotle: Any city or
counry which requires a permii to construct, alter, Improve, tlemolish o� repai�
any structure, prior to its'issuance, also requires the applicant for such permii
in Ii�e a zionetl statemen[ that he/she is licensetl Oursuant to the provlsion5 ot
herefrom antl the bazis tor the allegetl exemption. Any violation of Sec[lon
)031'.5 by any applicant tor a petmit subjects the applicant t0 a civil
eenalty of no[ more than five nuntlretl dollars (g500). �
LI I,- as owner of the property or my employees with wa9es as their Sole
�mmpensation, will tlo the work, antl the structure is noi intentled or offeretl
tor sal¢ (Section 7044, Business antl Professional Cotle: The Contractor'S
License Law does not apply to an owner of a property wno builtls or improves
thereon, antl who:tloes such wo�k himself/herself o� through his or iter own
employees, provitletl that such improvements are not intentletl or otieretl tor
sale. I/, howeveq the builtling or improvement is soltl within one year of com-
pletion, the owner will nave Lne burtlen of proving ne/she Oltl not bulltl or Im-
p�ove (or the purpose of Sale).
❑ I, as owner of the Droperty, am ezclusivety contractinq with liG¢nsetl con-
tractorsto construct the project (Section ]044, Business antl Professions Cotle:
The Convacror's �icense Law tloes not appry to an owner oi property wno
builtls or improves Ihereon, antl wM10 cont�acts fo� such projects witn a can-
trac[or(sl license pursuant to the ConVactor's Licenze Law). I am aware that
proot o( their Worker's Compensation insurance shoultl be provitletl to me.
❑ J am exempt untler Section . B. & P. G�or [his reason
Date Owner _
I hereby certity that I have reatl this
intormation Is correcL I agree to mmp
antl state laws relating to builtli�q con
sentatives of [his citY to ente( LWoi
Siqnat J(�y ci '
�_
Drivers' License or 55 � —
� SDSD '
TYPE OF CONSTRUCTION NEW ADO ALTERATION REPAIR �
❑ CONVERSION ❑ DEMOLISH ❑ OTHER p�p #
DESCftIPTION OF WORK/USE OF BLDG.
S Main Buildi
TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL T Front
❑ TENANT O ELECTRICAL ❑ PLUMBING �ECHANICAL B Rear
❑ OTHER A
C Right
PROJECT DESCRIPTION 5a.F7. occuPANCv K .
CONSTRUCTION TYPE VALUATION S S Left' -
ZONE GRADING CV. VDS. ACRES Ping. Ref. #
Remarks: � Planning Notes:
Sink
Preventer
I rrigation
Drinking Fountains
FlOor �rains
Floor Sinks
Gas Service Outlets
Inierceptors� �
Kitchen Sink
Lavatories � . �
P-Trap '
Roof Drains �
Reinspection Fee
Boiler � �_ .
Duct-.Under Ground
FEES
$hOw¢f5
Service Sink
Sewer Cap �
Sewer Connection '
Solar Collecmrs
Solar Piping �
Solar Tank
Swimming Pool w/Spa'
Water Closet
.Water Heater
WaterService . �
Auto-Wash
Laundry Treys �
r
�
$15 Issue Fee $ 3
MECHANICAL FEES '
� Hoodor� Typel ❑
Canopy Typell ❑
Duct - Ventilatin9
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
IHe3� ing SYstem & Ducting
P(0-100,000 BTU O 100,000 BT
I W�,-i- �"�. ,
Reinspection Fee $15
CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenrotl - Assessor
Flefrigeration System
❑0�100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
Automatic Washer
Construc[ion Pole Sub.
Cooking Unit •
Dishwasher -
Dryers ❑Gas ❑Electric
Fan.
F.A.U.
Fixtures
Device Boxes
Outl¢t5
Switches
Garbage Disposal
Generator DO-5 KW OS-15
6363 9/30/87 ��,pp' TL
Zone
Accessory Building:
ELECTRICAL
Transformer ❑ 15-50 KW --
❑ 50+ KW
Meter ❑up to 700 amps
Meter ❑bver 100 amps
Sub Panel
Motors �0-7 HP Oi %- 8
Inc. Solar 09-15 HP �76-15+
Microwave � - '
Pole light � � �
Fange
Standing Sections
Trash Compacror
Fee �$15 � � Issue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By '
Building Approved By _..��—
Aoolication Issued 8v � � �
FEES
5 3
Z
O
N
I
N
G
R
E.
Q
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S
� SUMMARY OF FEES � -
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
' PLUMBING $ ISSUANCE .$ �� .
� PLAN CHECK 25% $ � � ENERGV P.C. $:
ELECTRICAL $ GRADING $
4� PLAN CHECK 50% �g7 p�— MICFOFILM $ -
MECHANICAL `$' ^� TOTAL FEE � $ �
$ 3 PLAN CHECK 25% $ �
'�.
�c ..
� `
CONSTRUCTION AND PLANNING PL� - Se S�A
�- Date Inspector Date Insper.ror
APPROVALS - Permit# APPROVALS Permit#
,}. Temporary Electrical Service or Pole ' 52. Pool & Equipmeni Location .
2. -Soil PipC-Undrgmd. 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� Electriczl UFER Grnd. 57. APPROVAL TO COVER-GUNITE �
7. Footings 58. Electrical Conduif-Undrgrnd. .
8' Foundat�on 59. Gas Pipe, 0 Undrgrnd., Test '
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System _ 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer CaP ' 63. Heater & Vent-Final
13. Roof Dr2ins � 64. Plumbing System - Final
14. Rough Plumbing - ' 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 Electriral-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT . .
20. Rough Factory Fireplace APPROVALS� Permit # �
21. Ducts, in Structure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � 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
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:Z�/-ge L�/CT �'�pE� [,•F:�
34. Final Heating & Air Conditioning � ! 6U Gneu. f� ,�iE.�3d3•J �,tie. G.i%.O
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final ,�, '
40. Gas Service-Final
i
4l. Solar pomestic-Fi�al 1"• (��� ��
42. Backflow Preventer ���;-: �
«_.
43. Backflow Irrigation ��
r �
44. Landscape Irrigation Sy��Sy'rn
45. Sound Attenuation �"'�� �
46. Handicap Regulations �
47. FINALSTRUCTURE&BLILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Souihern Callfornia Gas Co �J �
_�
51. CERTIFICATE OF OCCUPANCY -
No. Date ' �
OWNER MILLER�IDRICK . Dp SEP 1 5 196!
JOB ADDRESS 325% IdenO I8II0 BUILDING PERMIT N0. 22937
�GENERAL CONTRACTOR Owner-Builder VALUE $ 6�380-.00 Add
INSPECTIONS
�...d-
P
DATE
ZONE 3 DESCRIPTION OF WORK I
tOUP I TYPE V ZONE
PERMI'
SUBCONTRACTOR nnmc i
l 9-
• � . � w 22937
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 - COBTA ME9A. CALIFORNIA
For Applicant to Fill In Complefely
TYPE OR PRINT
BUILDIN6 3a5� I A� � ur
ADDRESS
COSTA MESA, CALIFORNIA
OWNER ^M�I` 1 V� MI��
Ao RE88 3�5� ^DAH� ►- ut
�,r c� s� M r-'SA N��� KI 9�1'
��E RECFiV�-�
_S �p 11. 1964 �J`�
fll�AiVCE DEPI.
C�PLI�ATIONr FOR �PERMR
BUILDING
For Office Use Only
RBCfiIM NO. - � PEqMIT NO.
ZONIN(i
/� PLM1NB ��I BYILOINO W
ow -�- a��� c� �� �Y
t.Eaw�
oeecairt�ox
A. P. NO. CI�
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
■ BETBACK LINE FROM
DESCRIPTION OF WORK
BUILDING �'1 \. '1 ROOM9
SIZE •C /t �C
EXTERIOR Wp�� � ROOF
COVERING 7I U CC d C�VE'
U11� ovG �kIS1IJ
6 C
1 HEFEBY ACKNOWLEO02 TXPT 1 H V8 READ TH
FNO BTATE THAT THE ABOVE I8 T ANO
PLY WITH ALL CITY D�NANCEB D AT6
BUILDINO CON9TPY I N' C L I
SIGNATURE OF
PERMITTE
AUTHORIZEO AQENT . .
YARDSAPPROVED
MAIN BUILDIN6
�
VAR. #
RIES � C. U. P.
I N G �L. APPRO�
BY
VAR�SAPPROVED
ACGESSORY BUILOIN6
DATE
a
N
HQ.FT. �
-�WTION THE AMOUNT eHOWN lINOER VALUAT�ON I6 FOR THE �
TO COM- PURPOSE OP EBTABLI6HIN� F PERMIT FEE ONLY. Q
UL�TINO ypWAT10N
m
PERMITFEE $ � �
]
m
$ �/ ��Q " PLAN CHEGK $ � � �� F
¢
36� `
TOTALFEE $
oWNEA MTf.i.F'R. EdZ'ick J.
n� 8-6-62 �_
BU�..ilING PERMIT NO.
GEN�RAL CON1'RACTOR OWIIeT-B1dT. VALUE $ 100.00
AP No. 149-OE)5'? LOT TRACT I'IRE 'LONE DliSCRIPTION OR WORK COIIV.W1T1d.tQ
INSP�CTIONS �Signature� DA7'E GROUP I TYP� �/ ZONE R-j.
SUI3CONTRACTOR
r
;
� 17643
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO7( 917 COBTA MEBA. CALIFORNIA
For Applicani fo Fill In Complefely
TYPE OR PRINT
BUILDING , / �
A�DRE68 I. N
C05TA MESA. CALIFORNIA
� MAIL
■ AI
■ STATE
k
TEL.
NO.
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TEL.
NO.
( I NO. OR BLOGe.
9HTBAGK LIN6 FROM � ' =
C8ef1'ew oF BTReET � REAR YAR�.
Q- � I
SI�E YARD LERT � O E_ RIGHT
DESCRIPTION OF WORK
■ BUILDING
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I HEREBY AGKNOWI-BOOC TNAT 1 MAVE READ TH18
ANO 9TATfi THAT TH8 RBOVE I6 CO��AND AG
PLY WITH ALL CITY O INANC£8 AN AT8 LAWB
9WLDINO CON9�U�� r ^ ` I
11
AGENT
�
�EE REC�IVED
AUG 6 1�2
fINANCE DEP1. �i �--
APPL�CdT'IONSFOR PERMIT
BUILDING
For Office Use Only
HECEIPT NO. IPp�gMIT��
RECEIVEO !Y I D/�TE�RECE�CEO � DeTe 1asueo
COSTA MESA. CALIFORNIA
inR�� �J /�� T..e� // .-e..��e
ZONING
ZON�NO.OP �l USE OF P
I� I vlAN9 // I BUILD�NG
f v
LEOAL
DEBCPIPTION �� � E�_
A. P_ N�_ I.� �/ �' O(Ol 7-
(CENTER LINE 8TJ
COM- TMB AMOUNT 6HOWN UNDER VpLUATION 16 FON THE
,,�NQ PURP08E OF H9TABL18HING A nERMIi PEE ONLY.
VALUATION �p
� PERMIT FEE $ r��
$ / (J D � PLAN CHEGK S
TOTAL FEE �- �,
LoT 22 ,
TR �]22 �' 1�� `a3J�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 C09TA MEBA. CALIPORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
ADORE6s 3257 �DAHO LANE
COSTA MESA. CALIFORNIA
.......�., K R� E DEVELOPMENT CO.� INC.
BUILDING
ADORESS
PIRE
ZONE
APPROVED
BY
ZON[
R-1
LfiGAL
6�X � Q� I NO.OR B1D08.
Now eu �or
FEE REt,t �TG�
�QCT 24 ,...
FINANCC �A MEs�
CITY OF
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. (+J'8�!!(�[�NO.
BY I DATE RECEIVED � I OATE 188UED
COSTA MESA. CALIFORNIA
ZONING
Ho. on use ov new
pLAne 2 I euitolNG W/ a't't
Lot 22, Tract 372
6ETBACK LINC FROM �Q � 'ZOI ICeNTCR LINH BT.I
eeNTeq op aTAE6T REAR YARD FRONT
SIDE YARO I LEF'f �S ' I RIGHT S/ R SIDE
DESCRIPTION OF WORK
,�t
IROOF WOOD SHI
COVERING
WORK TO BE PERFORMEC
PLAN E)-BR
I H6ReBY ACNNOWLeDG¢ THAT 1 HAVE READ THIB APPLIGTION
ANO BTAT¢ THAT THe ABOVE IB CORREGT AND AOqHB TO GOM-
PLY WITH ALL CIT' ORDINANCEB A ATE 8 RBOULATN6
9U�LDINO CONBiR/U�/(�ON/.//� �
SIGNATURE OF/ y//a � ,. _ /� __�ti�
IAUTHORIZED AGENT
THE AMOUNT 9HOWN UNDER VALUATION IB FOR THE
PIlRPOBE OF E9TABLI6HING � PEPMIT FEE ONLY.
VALUATION /
��f'j � PERMIT FEE $��/G
/� / � ��
S � PLAN CHECK $
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