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Home My WebLink About3016 JEFFREY DR - Building Permits�r Landscape, Irrigation & Design Proposal Property Address: 3016 Jeffrey Dr. Costa Mesa, CA Che� 222- (v3�3 321 - 02l b Please see the attached diagram for details on the installation of the following landscape, irrigation & design at the above referenced property. Scope of work: � y�-g) C�a'' � �x P�¢v` � • Install a 15' x 4' planter along the driveway adjacent to the existing fence. Materials (Please refer to diagram for location of materials): A— TREE: 24" box Evergreen Tree Eriobotrya deflexci - Bronze Loquat Rhus /ancea - African Sumac B— SHRUBS: 5 gallon size Phonnium cookianum - New Zealand Flax Ceanodiu.r g. `Ynrikee Poii7t" - Cnlifornia Lilac Strelit;in reginae - Bird of Paradise \� • C — GROUND COVER Ltuitano montevide�isis - Lavender Lantana Coprosma kirkii - Mirror Plant Cephnlop/ryliun speciosum - Ice Plant Bark Mulch will also be used in 2' diameter surround tree base per city guidelines. • D— IRKIGATION: Underground piped water lines with low water flow drip or � trickle irrigation system will be installed with an automatically time-controlled sprinkler system. { R� �Q1._l t �� J o E �u�;n� -(n' Curvr.� CohCrL��, PlANNlNG APRROVAL cnr a co,� Me.o we�,u� oa. �s�o�,��8. Reyuked Prior to 8uudn,n Fb�at �VES �NO ZaMnp Inspealo� OVES ppp Trafid Perk Feea BY��O�e:IU IZ� �� s iQrkan9 GaYaa�es ' '�'°�`.� '�• a e � . o a ' • • 00 @ e �' •� . e . • �. .. . . .• • Y ..�� . e� . ' � . �� • � .�� 6 0 �� a . � � • .; . . \� . � I \`fl' . � •� • : � � 1360 Jeffrey Dr. Costa Mesa, CA - Google Maps Address Jeffrey Dr GOO� e ma ps Costa Mesa, CA 92626 Page 1 of 1 Save trees. Go green! � DownloadGoogleMapsonyuur � phoneatgoogle.com/gmm o http://maps.google.com/maps?hl=en&q= I 360+1effrey+Dr.+Costa+Mesa,+CA&ie=UTFB... I 0/25/2010 � ��3 ��`._ �' f +'�"�.} �� —�sc � ..�. , � 8,i; � ` _{ A ��, c.-..� ��..�,� � 1"'s,�, tt . � ?` - � _�i� . . .. '� �'.�f .. � . . �, ^ "_ . . . .. a � _ .. � `,sd ..u_. ��ce.5-y a. .. ..v' _ . .4i f ,,� � � >,�"-'� �- ; i � >r' �; � . . �.r �� ~ y.�5 N ,�� 1 �� . � 5 � „�� ..�.. �- �, . _ _ ._ '� -..�....��'"�z _ .. � . � �[/� �' °�y�� ,�.,+. _ f � � _ � ... , , - —J . 'a ,� .�"` E� f �..,.a .�,� . h � 9 � � '�'a�, 'E �'n . � �� ' c- tT a b FI. (�, 1�2 4s�2 � . t.Z3 4'°'-�^W S F � �e :. � �� k:.�, i ji�}��.,,�ri'�-w y ' t. �d qa � : �vit i;`' y"Y�,x'`°�i'��w�� +� �5 �3 - 7 � a�� ..+.:, i" .l 3�� ,�� , p Kd e -+ss� '�, 4 i�,3 � �` �, u,- ,� � i: ��, E y ,;._ ..� _;:.� r .Y� =` . .)� y�c..a r ..� ,:. . .. .�--•,mt�... ..... � h �:,1 _ F " d . r" �' ++� ' i�.. 5 _ } � �. . n � � � �"✓'4!.}. . ... :i.� -. ... '-. ' . -' . ...._ i�y+ T` , �'! �`�+_ > i ��1�� iL �'t�' �1 4� Y � �� _ . � a}�14 � §�I� � . _ �`�!eX.?� ��F�s_,— R'� Yai[(�� (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3016 JEFFREYDR Suile: Vicinity: Parcel Number: 41812109 Applicant: GURNEA, SEAN Address: 1013 WALNUT ST SANTA ANA, CA Owner: HORIO, KEN S Address 660 BAKER ST STE 405 COSTA MESA, CA Contractor: WEATHERLINE ROOFING INC Address: 1013 E WALNUT ST SANTA ANA, CA Zip: 92701 Arch : Address: Zoning: R3 R3 Phone: 714-737-3425 Zip: 92701 Phone: Zip: 92626-4411 Phone: (714) 7313425 License: 729560 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 10/01/2002 Issued: 10/01/2002 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL SHEATHING, FELT AND 30 YEAR COMP SHINGLES. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Fron� 0- 0 ACCESSORY Frant 0-0 PARKING Ewstinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 sa,000.00 sa,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements untler California statutes and related regulalions. (Ord. No. 9248, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred inapections and final approval must be obtained. Failure to obtain inspections and final approval will resufl in the expi�ation of this permit. FOR INSPECTIONS CALL: (714) 7545626 � 2448.48(fi/00� WORKERS' COMPENSA710N DECLARATION: ` '� I hereby eflir fider penairy of perjury one o� the following declarations: ❑ I e entl wlll maintein a cenificate oi consent to self-Insure for workers' compensetion, as provitled tor by seciion 3700 0( ihe Lebor Coda, tor the perfortnance ot the ork for which this permit is issuetl. 1 have entl will m i workers' co � tion insur nce, as required by section 3700 of �he Labor Code, for tha pedortnance ol Ihe work for which ihis permit Is issuetl. My workers' co s tion I ance c'er and p'� numb r are: � r �, ^�� Carrier. � , ' Policy Number. \L` J (This section neeU no e completed i/ the rmif is va/ued et one huntlred dollars ($100) or Iess.J ❑ I certity ihat in the peAormance oi tha work for which ihis permit is issued, I shall not employ any person in any manner so es to become subjecl to the workers' compensetion laws of C 'a, and agree ihat if I should becoma subject to the workers' compensation provisions ol Section 3700 oflthe La�or Cotle. I shall forihwith comply with ihese D�a sions. � O / O� ApPllcentSigneWre: �� . �� Date: � WARNINd: FAILURE TO SECURE KERS' CAMP ATION CAVERAGE IS UNLqWPUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES A D CIVIL FlNES UP TOONE HUNDRED iHOUSANO DOLLARE ($100, , IN ADDITION TO THE COST OF CAMPENSATIIXJ, DAMAGES AS PROVIDE� FOF IN SECTION 3]Ofi OF THE LABOP COOE, INTEREST, AND ATTOFNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm Ihat 1 am licensed force and eflect. Lic. a ContractoYs Signature:� CONSTRUCTION LENDING AGENCY: 9(commencing with Section 7000) of Division 3 ot Ihe B� Class # � Data: _ and my license is in full ❑ I hareby affirm that ihere is a construction tending agency for ihe peAormance ot the work tor which Ihis permit is issuetl. (Sec. 3097, Civil Code). Lendar's Neme: ___ Lenders Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby ettirm that untler penalry of perjury Ipet 1 em EXEMPT FROM 7HE CONiRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a pe�mit to wnstruc6 alter, improve, demolish, or repair any siructure, prior to its issuance, elso requires the applicant for such permit b tlle a signetl stetement ihat he or she is licensetl pursuant b[he provisions ot the Gontrectors License Law (Chapter 9(commencinq wilh SeMion 7000) of Divislon 3 ot the Business entl Professions Code) or ihat he or she is exempt therefrom and the basis for Ihe elleged ecemption. Any violation oi Section 7031.5 by any apP�� or e Dertnit su6jects Ihe epP��ent to a civil penalty of not more than five hundred tlollars ($500).): ❑ I, es owner of the properry, or my employees with weges as their sole compensetion, WILL DO THE WORK, ana Ihe strucNre is not inte�tletl or ottered br sela (Sec. 7044, Business and Professions Cotle: The Contractors License Law tices not apply to an owner of properry who builds or improves ihereon, antl who does such work himseN or �erself or through his or her own employees, provitled that such improvements ere not Intended or oMered for sale. Ii, however, the builtling or improvement is sold within one year of completion, ihe owner-builder will have the burden of proving Ihat he or she did not build or improve for purpose of sale.). ❑ I, as owner of lhe property, am EXCLUbIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professions Cotle: The contractors License Law do0s not epply to an owner of pmpetly who builtls or Improves thereon, antl w0o contracts tor such project with a conirector(s) liconse pursuant to ihe Contractors Licanse Lews.). ❑ I am eaempt under sec. Business and Professions Coda for this reason: Signature: Date: Owner ID verified by tlriver's license. ❑ �es ❑ No Driver's License No. Expires: Verificetion oi Ownership by (type of daument, i.e. - property tax bill or deed): DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certify Iha� no exwvation tive (5) or more feet in depth into whic� a person is required to tlescend, will be mede in conneciion with work authorized by thls permi�, and ihat no builtling slrucNre, s�Holding, falsework, or demolition or dismantling thereot, will be more ihen thirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Atlminisirative Cade). ❑ As owner-builtler, I will not employ anyone to do work which would require e parmit from Ihe Division ot Industnel Sefery, es noted abova, unless such peraon hes e permit to do such work from ihe divisio�. . Signature: Date: Division oi Indusinal Safety Permi� Number. CEHIIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I cetlity under penelty ot perjury that I have read Ihis applicetion and state Ihat the intortnalion given is correcl. I agree to comply with all state laws and ciry ordinances relating to builtling construction, antl authonze reprasentatives of t�e City of Costa Mesa to enter upon the aDove-descnDetl property for inspection Duryoses. I egree not to occupy or allow occupancy ot eny building authorized by this permil until tinal inspection. COOE �. INSP[CTIONTVPE 1616 Fixetl Sys�em Final Fire Preven�ion 1266 Pool Spe Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 203 Final Factory Fire Place Final Sign 204 Final Demolition AppliCant �_ �i�m�. �li^Ili"ffZ � � ��,a Data COOEt INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecincel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy PdIF II�IELS ADo��cant to flll in all svaces except tnose wilhin heavy boraer Ilnes ana sign a11 aDoropriate tleelarations. CI7Y OF COSTA M�E/SA� CON-�S—�TRU�.C�.T�I,/ON PERMIT•• P MIT NO. TQRA�C(T NO. LOT NO. UNIT NO. Project Addreu -�/�� 1E:1�"G�`-'� ` � �� TlT�� — ApplicanYs Mailing Address.J,/�3D/r(� Q��i TVPE OF CONSTRUCTION NLJ EW LJ ADD ALTERATION REPAI R Ownef'S Name s� �"��`�� hone � CONVERSION ❑ DEMOLISH ❑ OTHER. Address �� Arch/Eng. License No. Address Contractor's Name � /1 �,,/ p�Phon �7�'7�/'3,,J' Addreulmailing) �/��/L cfi�1�EIL��/�' /«C1�� .� �C/n Ciry License No. L%D p�%� IICENSED CONTftACTOR DECLARATION I neteby affi�m inat I am licensetl untler provi5ion50/ Charte� 9(commentin9 with section 7000) of Division 3 ot the Busines5 antl Profes5ion5 Code, antl my Ilcense is in IWI fo� antl effecL �fj• �%•x) licens�e CI� s • - - tr' nsa No.� Date L//.9 .l�% ca„a� .a , �/C/��_ WOR ER COMPENSATION DECLA0.FT10 hereDy afiirm tnac I �ave a certi/iwte ot consent to selPinsure or a certlticace Warkers' �q mpensation Insuranc¢, or a cert/i�ti/etl copy thereof ($ecUon ,d00, Lab. CiY G�(�/ L� ComPanY Tw��"bN ! Pnnnolicy No. �� 0 O`7 �Certitietl copy is hereby fumishetl. GerY 'e cop �5 filetl wifh the city Bui15�j�i '�� Dale AOPlicant -�—� --�� EXEM IOq FRO A WORKERS' COMPENSATION`OE LARATION (Tbisseccion neetl not be completetl if tne permit is for one huntlreC (E300) or less). I certlty that in lhe Oe�to�mance o/ Ih¢ work fOt which Ihis pe�m�t Is Issuatl, I shall not employ any per5on in any mannet so as to become subject to the Workers' CompenzdtiOn Lnws oi Calltornia. Date Si9nahre NOTICE: If, a(ter makin9 this tleclaration, you shoultl become subiect to the Worke�s' Compensalion provi5ion5 Of the Labor Cotle, you must fortnwith comply with suth prOvisions or tbis pe�mlt snall be tleeme0 revok¢tl. CONSTRUCTION LENDING AGENCV � I he�eby affirm thal lh¢re is a const�uclion lentling agenty (o� the perfOrmanC¢ o( [he work for whlch this permit i5 issuetl (Section 3097 Civ. G.) Lentler's Name �Lenaer's Aatlress OWNER BUILDEH DECLARATION I ttereby af/i�m that I am exempt from [he Can[�acto�'S Licenze Law for the followin9 reason (Se<[lon 7031.5 Business antl ProfeSsional Cotle: Any city or county which requires a permit to construct, alter, improve, tlemolizh or reoalr any struciure, ptlor to its issuance, also requires tne apo��cani for such permit to file a signetl statement thai h¢/ShC Is Ilcensetl pursuant to [be proviSiOns of Ihe Contractor's Li<ense Law (Chapter 9(commencing with Section 7000) of Oivision 3 of tne Business antl Prolessions COtl¢) or tnat he/she is ¢xempt heretrom antl the basis tor the allegetl exemption. Any violation of Seclion 031.5 by any dpplicant fo� a permil subjects th¢ applitant to a civil �enalty ot not more [han five huntlretl tlollars (E500�. LJ I, as owner of the property or my employees wltn wages as their sole mmpensation, will tlo the work, antl the 5[ructure is not intentletl o� ofte�etl for sale ($ection ]044, Business antl Grofessional Cotle: The Contrac[or's LicenSe Law tloes not apply to an owner of a properry who builtls or improves [hereon, anG who tloes sucn work him5el(/ner5¢It Or through his o� her own employees, prOvitletl lhat such improvementz are nol Intentled or Ofleretl to� sal¢. It, howlveq the builtlin9 or improvement is soltl within one year Of com- pletion, the owner will have the burtlen ot p�oving he/She tlitl n0[ bui1C or im- prOve for the purpose ot saleJ. ❑ I, as owner ot the property, am ezclusively concracting with licensetl con- lractorsto construct tne project (Section ]044, Business antl Protesslons Cotle: The ConVactor's �icense Law tloes not appty to an owner ot property who builtls or imoroves tnereon, antl who contracts for such orojects wlth a con- l�ac[or(s) pcense pu�suant to the Con[ractor'S Lit¢n5e Law). I am awdra that proof of their Worker's Compensatlon insurance shoultl be proviaetl to me. ❑ I am exempt unEer 5ection B. 6 P. C. for thi5 reason Date Owner I hereby oertity that 1 have reatl lhis applica[iOn antl statC Shat the above information is correcL I a9ree to comply with all city antl county ortlinances antl state laws relating to builtlin9 construction, antl hereby authorize repre- sentatives of this_ciri to enter uoon the above-mentionetl orooerb, for Signature / V/�� Drivers' LicenSE Or 55' TVPE OF PERMIT I.J GRA�ING FOVNDATION, JC STRVCTURAL ❑ TENANT �ELECTRICAL PLUMBING�MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sc�. FT, oCCUPANCV ' CON�STRUCTION TYPE �- VALUATION 5 ZONE GRADING CU. VDS. ACRES Remarks: � Bar Sink Back,flow Preventer ' 8ackflow IrrigatiOn Bathtubs rinking Fountains loor Dreins loor Sinks as Service Outlets rterceptors ^ - itchen Sink avatories . -Trap ,. Roof�Orains Reinspection Fea $15 Boiler Duct - Under Ground Duct - Sttuccural Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL BIL IC80 # N,,�e�a g System & Ducting L]f0-100,000 BTU 0100,000 BTI Reinspeclion Fee � 515 CMF 0865-46, rev. 10/B4 White - Builtlin9: Canary � Applicant; Pink - Accounting; Goltlenrotl - Assassor 7 Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Warer Heater Warer Service Auto-Wash 9 ES . laue Fee $ 3 1ANICAL FEE Hood or Type I ❑ Canopy Type I I ❑ Retrigeration System ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee � $ 3 A.P. # S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: Auromatic Washer Construction PoleSub. Cooking Unit Dishwasher Dryers OGas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generoror �0-5 KW C 2644 Bu Zone Parking Req-�./ProIvitled GO N G I Y i�i.T ��. ELECTRICAL Transformer ❑ 15-50 KW ❑50+KW Meter ❑up to 100 amps Meter ❑over100amps � Su6 Panel Morors �0.1 HP �1 X- 8 Inc.Solar 09�75 HP �16-15+ Microwave Pole Light Range I I Standing Sections 5 KW I ' Trash Compacmr 20Bo50 TL FEES I Reinspection Fee I$15 I � Issua Fee I $ 3 I DEVELOPMENTSERVICESREQ4IREMENTS: ZoningApprovedBy ��-/�� Date2��' � Building Approved By Date Appliwtion Issued By Dat Z O N I N G R E Q M T 5 S MM RV OF FEES BUILDING PERMIT $ � :� SMIP $ �� 8 PLAN CHECK $ � %Z PERMIT PLUMBING S �O ISSUANCE 5 PLAN CHECK 25% S__� lP _L ENERGV P.C. $ ELECTRICAL $ GRADING 5 PLANCHECK 50% $ `7 � �O MICROFILM S MECHANICAL 5� TOTAL FEE $ a8,'�� PLAN CHECK 25% $ "' POO L & SPA ��CONSTRUCTION AND PLANNING ' �. . APPROVALS �Permit# Date Inspector AppROVALS Permit# Date Inspector 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' � 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgmd. 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. S. Foundation . '- 59. Gas Pipe, 0 Undrgmd., Test � ,. 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. � 10. Structural Floor SYstem � 61. APPROVALTO DECK � - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � • 12. Sewer Cap 63. Heater & Vent-Final i; , 13. Roof Drains 64. Plumbing System - Final � ' 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring �_.3 �7 ,� ,,,67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough•Electrical-T Bar Ceiling �, 69. POOL/SPA SYSTEMS FINAL � 19: Rough Heating & Air Conditioning Zj,}/-jj� (,�n � FIRE DEPT. REQUIREMENT '' . i •.' : 20. Rough Factory Fireplace APPROVALS Permit # '_ '� r 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil �� 23. Gas Pipe-Rough & Test 72. Underground Flush ' `S --� , 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical i , 27. Frame and Flashing 76. Dry Standpipe ' . � �.�., � ' 28. Lathing & Siding 77. FIXED SYSTEM FINAL ' �" 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing G � HEALTH DEPT. REQUIREMENT ( � 31. Plaster Brown Coat 79. FINAL INSPECTION �� '� ,'. 32. Electrical Power Meter-Final ,7 80. FOOD CERTIFICATE ISSUED � , � , 33. Final Electric �, Notes: ^�,-aS'�-�_ �"�Rc /2c...� c� w!2 34. Final'Heating & Air Conditioning /_ � �lV /Y / w.0 � 35. Final'Gas Pipe-Test 36. Hood or Canopy , . '>, 37. Final Factory Fireplace ' ' ,. 38. Final Plumbing �� ' � r� - 39. Water Service-Final � - � � ��' � 40. Gas Service-Final ,' .� "' 41. Solar pomestic-Final � � � r , � i� 42. Backflow Preventer • ' • ` ' � 43. Backflow Irrigation �� ; • . ' -'44., Landscape Irrigation System ' "� , -%- � � 45. Sound Attenuation �� 46. Handicap Regulations " ' • ' � `" ' .. . 47. FINALSTRUCTURE&BUILDING � �4 � ,'�� . -' ' ! 48.�Special Requirements Completed . � ' � 49. Electric Release to Edison • ' �. 50. Gas Release to Southern California Gas Co , � 51. CERTIFICATE OF OCCUPANCY � , No. Date - ,� ; — . . A�ii�� - - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALtFOqN1A 92626 ��r,-��7;FR'°oa ,zz� �ts155.50 �r�. APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only FECEIVEDBY DATERECEIVE� ..nrc�cc�i« ADDRESS 3016-A,B C Jeffr �YlV@ (.'.M. own,ea '�y�d Secaell Inc. � MAIL 8 ADDRESS 136 F�chestes Street P' TEL. cirv ('Asta Mesa No.642-4905 BPANCH AD�RE55 ARCHITECT OR ENGINEEF ADDRE55 OWNER O��L „�=�2i FIRE 20NE APPROVED 7 VALUE DATE R ADDRE55 TEI. E NO.OF USE OF N CITV NO. P�� BUILDIN F STATE CITV �'AR�SAPPROVED VARDSA PROVED LIC. NO. IIC. NO. MAIN BUILOING ACCESSOFV BUIL�ING W SIZE NO.OF BLOGS. (FROM C/L S ETfj(., �. OF LOT NOW ON LOT RONT T. FT. a USE OF � E%ISfING BLDG. S T. FT. h � Separa[e permits are required for L. SIDE FT. FT. 0 electric, plumbing and heating work. REAR �I, FT. FT. w USE OF BUILDING AND WORK TO 8E PERFORMED F DISTANCE BET. BET. MAIN & �Q MAIN BLDGS. ACCE�. BIDGS. V/\R.# DATE � C.V.P. — lj APPROVED — � ` P� APPROVED rj r a a I-IOLD Fd; S� ` F['y �!nr�n�en�T w � I haraby acknoWlatlga that I hove reatl thif application antl ctnte � N a thet Na aEova I�formetion ia eorract entl eprea to comply with m a ell lewa reguletin0 bulltling conrtrucNon, antl 1 ahall not empioy Z any peraon in vialation ot Me workmnn's compensetion lews of m � the State of Culifornia. ^; 3 I hereby certffy tAot I am properly Ilcensetl as e contractor untlar SQ. FT � � w tha Stete oi Celife��e Busineu entl Profenionz Cotle, Divlalon 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chopter 9, entl t�et such Iieanms era In fuil forea enE affeet, or I THE PURPO6E OF ESTABLISHING A PERMIT FEE ONLY: � nm axempt from tha provisions of tha Smm of Cellfornie Buziness VALUATION PERMIT FEE 5 ' antl Prafeuions Co a, Divislon hepiar 9. J+ 64 PLAN CHECK E ` 1O SIO�nmra ot � R /� .� � J LL Permlttae S Q2 L� TAX 5 QS f Q � � ' c, Authori ABant TOTALPAID § �` Q � 7`.� �� COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 ':tft-9-"I7�,��QO 61h ��•233.�C APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completety — Use Ink Only qECEIVED BV DATE RECEIVED DATEISSUED AOIDRESS 3016-A B C Jeffre Drive C.M. PERMIT NO. OWNER �CY17i'Cl SC'YWell IRC. A•P� NO. ADI RIESS�' Q V� ADORESS 136 Roch t2i $ 22t TEL. TRACT LOT BLOCK CITV Costa Mesa 92627 No�642-4905 �NSiRUCT10N W A AL P LENDER BRANCH �"` OWNEfl L) �ELL ADDRESS ��{ � P VALU$ /�(�D ARCHITECT TEL. S � OR ENGINEER 53111 A}Rl—Dd PI'1 N. �I — FIRE ADDRESS 136 Rochester St. Costa Mesa ZONE TVPE GROUP APPROVED CONTRACTOR �1 BV DATE ADDRESS TE�. Z�NE NO.OF USE OF NEW CITV NO. P�� BUILDING STATE CITY �'AFDS APPROVED VAFDS APPROVED LIC. NO. 28]_61H Bl �IC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BLOCS. (FROM C/L STREET) OF LOT NOW ON LOT FROM FT. FT. USE OF EXISTING BLDG. SI FT Separate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED p�$7ANCE BET. BET. MAIN& MAIN BLOCS. ACCESS. BIDC�.S. VAR.qW DATE `IY'1 �.2X Wl}�'1 d C]7 did 2 C.U.P.qp APPROVED APPROVED I heraby acknowlatlge thet I heye read this eppllcation antl state 2 � '^ that the above Informetlon is cp�rect entl aBrae to comply wlth v � all laws re0ulating bulltling construction, entl I sha�l not employ l m i eny parzon in violailon of Me Wprkmen'z compansation laws of 4 m ihe Stata of Gelifornie. I hereby certlfy that 1 em pro0e��y ��ensetl aa a controctor untlar SQ. FT. N ihe State of Californle B�elness entl Profasslons Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl thai such Ilcense5 ara in full forca and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � am exempt from the provislons 6f the State of Callfornia Business a VALUATION PERMIT FEE $ antl Protasslons Code, Dlvislon 3, Chapter 9. ♦ �n � m / PLAN CHECK S �^ Sipnaiure of {' _//J �—� � Permlttee b/�� /w�1 5 rAx a � U Authorizetl A t TOTAL VAID § �