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HomeMy WebLinkAbout2212 MINER ST - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: :Z 221.a MINER ST HALLWAY CLOSET Parcel Number. 42`N9Y'f5 4'LZ- ��'�q T.a MECHANICAL PERMIT StaWs: ISSUED Applied: 72/OSl2005 Issued: 12/OS/2005 ilC.!/ ISSUED BY: � Applicant: ILDEFONSO RODRIGUEZ Address: 7059LAMPSONAVENUE �;r„'- a•-�^=r-- � Phone. 714-530 7320 -. . d' � , � GARDENGROVE CA• �' _ � Zip' 92841 • Owner: KEITH, JOE �r � _� � �� ^ � Address 2213 MINER�.ST , ,,.� ... ,� ,:� �,,;,, � „� `, � � = ;. � Phone 949-650-3436 COSTA MESA"CA Zip: 92627-2524 � � - . Contrector. EMPIREPLUMBWG �` , � � �_ Address: =4050 LAMPSON AV t � � . � ' Phone:-,714-530-7320 - ! .GARDEN GROVE, CA Zip: ; 92841 � . m ��"" . .� License 7-94154 ,,,, � -� � _ ` YFURNACE CHANGE OUT1N HALL , 1 INST FAU LESS THAN 100 K BTU. . . .'?." . , - _ ,,•": � _ � , � �.'e � � - � � r.. k' : £F� � ��: a - �. ai�, _ � ����,_FEE_SUMMARY ;,a,� � � �= � - ��_W� + �� . � � ,�%� ��e,, '- Quantity _ ' F _;� � . _ � -- ,. _ �.. Quanlr �, ISSUE�EEE �!", $23.50 ' - " Repair/AIt�AbsorbhonUni� " .$0.00 .0� �' + ,. Inst FAU <100 k BTU - €' � ;� $14�.80 1 - �- �� - -Repair /Alt Refrigeralion Umt '",�� : " $0.00 0 14? Inst FAU >100 k BTU r' $0.00- 0 Ventillation System � ': ' SO 00 0 , RepairlAlt Cooling/Heat �" -$0;00 0" s�� "' � -3Evapo�ative�Cooler " �. � � $000* 0 ��. Insl I Rep; Recess Wall Htr �" ; $0,00 0 � ..,.,CommerolaLincinerator �q �_ „� ,_ $0 00 0- . ; Refrig-Sys, <100 k BTU'� � � S0.00 � 0 ^ " ' ' -. _ y�-Domestic Incinere�or-'-. � �� SO 00._' 0- ' RefrigSys'>100k�BTU � -� $000-:- 0 Comoressors/Absomtion'Svstems � � Gas Piping �"' ., $0.00-- 0 Up-to 3,hp / 100 k BTU '- ,� �50 00 0,, Factory Fireplace, - "- a? �-�$0.00 0 3 To 1$'hp7 500 k BTU ? �:'^`$0.00 0��' Hood w/Mech Exhaust;; , $0.00 0 15 To 30�hp ( 1,000 k BTU �' � �.:50 00 .; 0 VAVBox . � --�$0;00 0 -;� 30To50hp/1,750kBTU � .:`50.00`�"0 Ven� Fan / Single Duct` �; -�"'$0.00 0 t",- Over 50 hp / Over 1,750 BTU ,, :. :` `�:;�50.00 �� 0 Appliance --� ,$0.00 0 � Boders � ' ` t� ," ' Fire Dampers % . ;� "��$0 00 0 -Up to`3 hp ,�„ $OAO 0 Smoke Dampers �. �.$0 00 �'0 � �3 To 15 hp� -,r�; �$0.00 0 Inst or Relocate Appl Vent . 50.00� a0 �`" ���75 to 30 hp - "§ - $OAO 0 Air Handlers < t0000cim - �}$0.00 �°•0 ,� , .�30 to 50 hp �S - �.$0.00 0 Air Handlers > 10000cfrn ,; ` . $0.00 ' 0 . � =0ver SO,hp, -- ,� � � �v � $0.00 0 Floor Furnace - �$0.00 0 '`�' Olher Mechanical Fee �s ' x Floor or Suspend Heater ' .::,,,;�a.._, ..$0.00 �, 0 ;•.., � �"`- � . -.� "`� g - � � • �� investi ation Fee ,,;���= � 50.00 _, . r ' � . � � � `°Plan Check.Fee � � 30.00 �� - y;�-' fs ' Reinspection Fee � �g,�.*� "' $0.00 • '�r;°� :, d. � �� �" � _ TOTAL CALCUCATED PEES $38.30 ,ws„' _ . _. . r`,�-'. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or ii work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlons and Iinal approval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zuase �eroo� WORKERS'COMPENSAnON DECLARAnON: ' � , , R I hereby aHirtn under penelry of perjury one of the following declaretions: � ❑ I have and will maintaln e ceeiticate of consent to self-Insure for workers' compensation, es provided for by section 3700 of the Lebor Code, �or the pertormenca of the wodc tor whiCh lhis pertnit is issuad. .,RI have and will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for tha pertormence of the work for which this pertnit Is issuetl. i—My workers' comqansation Insurance carder and policy number ere: �Policy Numtier:"` �?. n��Cn �,�n �,'� h s..---..-! ❑ I certiy ihet in the perfortnance of the work for which this pertnit is issuad, I shall not employ any person in any manner so as to bacome sublect to the workers' compensation laws of Californla, and egree that if I should become subject to tha workars' compensetion pmvisions of Sectlon 3700 ot the Lebor Code, I shall fonhwith comply with these provjsipns. � 4Applicant�Signetuie: .� � ��$,, ' Date:�• � � WARWNG:FAIWRETOSECUREWO RS'COMPENSATIONCAV RAC ISUNLAWFULANDSHALLSUBIECTANEMPLOYEFTOCRIMINAL NALT ANOCIVILFlNESUPTOONEHUNDRED TMOUSAND DOLURE (510D,000), IN ADDITION TO THE COST OF WMPENSATIIXJ, OAMAGES AS PROVIOED FOR IN SECTIIXJ 3%OB OF THE LABOq COD , INfEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm that I em licens� ynQer pfovisia CONSTRUCTION LENDING AGENCY: of Chepter 9(commancing wit� Section 7000) ot Divislon 3 of Ihe Code, and my licanse is in tull ❑ I hereby eNirtn Ihat there is a conswction lending agency for the pertortnance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Nama: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hareby aHirm ihat under penalry of perjury thet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7037.5, Business and Professlons Cotle: Any ciry or counry which requires e pertnit to construct, alter, improve, demolish, or repair any sWCWre, pnor to its issuance, also requires t�e epD�icant tor such permit to tile a siqned statement ihat he or she Is Iicensetl pureuant m t�e provisions of the Conirectors Licanse Law (Chepter 9(commencing with Sectlon 7000) of Division 3 oi the Business and Professions Code) or that he br sha is axempCtheretrom and the basls for the alleged ezemption. Any violetion ot Sectlon 7031.5 by any applicent for a permit subjects the applicant to a civil penalty of not more ihan�five hundred doliars ($500).): ❑ I, as owner ol ihe properry, or my employeas with.wages es their sola compensetion, WILL DO THE WORK, antl ihe siructura is not intended or oHeretl for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does no� apply to an owner of property who builds or improves thereon, and who does such work himself or herseli or Ihrough his or her own employees, provided Ihat such improvemenis are not intended or oNeretl tor sale. N, however, the buiiding or improvement is soltl within one year of completion, the owne�-builder will heve the burden of proving Mat he or she did not build or improve for purposa of sale.). ' ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTiNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions Code: The coniractors License Law does not apply to an owner oi propeny who builds or Improves thereon, and who contrects tor such project with e coniractor(s) license pursuan� to t�e Coniractors License Lews.). ❑ I em e:empt under sec. SignaWre: Owner ID verified by drivers license. ❑ Yas ❑ No Business antl Pmtessions Code for this reason: Verification oi Ownership by (rype ot dwument, i.e. - properry tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Driver's License No. Date: Expires: ❑ I hereby cehity �hat no ezcavation five (5) or more feet in depih into which e person is raquired to descend, will be matle in connectlon with work euthonzed by Ihis permit, and ihat no building swcture, scettolding, falsework, or demolition or dismantiing thereot, will be mora than Ihirly-sis (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Celifornia Administretive Code). ❑ As owner�6uilder, I will not employ anyone to do work which would require a pertnil from the Division oi Industnel Sefety, as nated a6ove, unless such person hes e pertnit to do such work irom the division. Signature: Date: Division of Intlusirial Satety Permit Number: CER71flCATE OF COMPLIANCE AND AUTHOHIZATON OF EMRV: I certify under penalry of perjury that I have read this application and state that the information given is corred. I agree to comply wit� all sta�e laws and ciry ordinences relating to huilding construction, end authorize reD�esentatives of the Ciry oi Costa Mesa to en�er upon �he above-descnbetl property for inspection purposes. I agree not �o occupy or ellow occupancy of any buildinq authorized by this permit until finel inspection. [�] 7�7�IiFii�ilFPifl93 7616 Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition . jj�jE INRilALS COOE� INSPECTIONTYPE 20fi Final Mechanical 20B Final Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final,Building�Occupancy PHOJECT ADDFESS: 2 z 1 Z M I NER $T OWNEH'SNRME: KEITH, JOE aooeess: zz12 MINER ST COSTA MESA,CA PflCMIENGINEEfl: AUDflESS: ) l l�/ �N�,: 92627 sec.No.: uxiT: PEPMITTEE: NOCK PLUMBING (719)895-1296 aooRcss: 11610 SEABOARD CIR STANTON CA._906B0 IICEN5E0 LONTflACTOP OECLAPATION: I �ereEy aHirm Itwl I am IicenSeG unEer pmnsions oi C�aO�er 9(cammencing with 5¢ciion 7000) ol �ivision 3 of Ihe Business and Pmfes5lan5 Cotle. an0�"*� nse is in �ull �orce and eitect. cirvuc.: 0.03�ST^� 51197}' / c�asr. �_ ia � ale. _� ! SignaNre: _`f� EFS' COMPENS TION U CLAHPTION: I hereby aitirm �hat 1 �ave a certifiwte al consent �o sell-insure or a cehificate ol orkers' ompensalion Insurance. or a certilied copy tnereol (Seclion 3800. La�. C�. roucrNo.: 1167992-94 E%P.DATE: O3IOZI9S comaaxr: STAT E � CertilieA co is � e�y �ur '6�ed. [� CeNlied topY �s e mlh the ciiy Bu I i avision. a�e: � �� � AP�licant. �l � PTION FNOM WOFKEBS'COMPENSRTION OELfANATION: (i�isseclian neetl no�becompletedi�tAe permi�is�orone huntre S1AC less�. �I I certdy Uat in Ne peAormance oi the work lor �vhic� ihis permii is issuea. I shall nol employ any person in any manne� so as lo beco subleq Io Ihe Workers' Compensalion Laws ol Cahbmia. Date' SignaNre: NOTICE: II. alier making Ihis Eeclaraiion, you shoultl become Subje[t Io I�e Warkers' Compensation pmvisions ol �Ae Labor Coae. you must lonhwitn compty vnin such provisions or this permit shall Ue Aeemetl revokea. COh$TPIILTION 1EN01NG AGENCY: I �ereCy afiirm I�al there is a conitmciion lending agency for �he Oehormance ot Ihe work lor which I�is permit is issue0 (Sec�ion 3097. Civ. C�. IENDEN: AOOHESS: OwNEB BUltoEfl oELLAflRTION: I hereby affirm inat I am exempl imm ine CAniractor5' State License Law lor the lollowing reason �Semion 7031.5 Business antl Prolessional Coae: Fny ci�y ol county which repuires a permit �o consimct, alter, impmve, demolish, or repair any simtlure. prior lo iis issuance. also re0uires I�e apDlicanl lor suc� Oermi� b �ile a siA�eU slaiemen� �hat �e/she is licensed pursuant �o ihe provisions ol the Comracmrs Staie License law (C�apter 91�ommencing wilh Section 7000) ol Division 3 0l ihe Business dntl Prolessions Coae) or inal ne/sne is enempt tnerefrom ana Ine UaSis for Ihe alleqee eKemption. Any violation ol Section 7037.5 by any appl¢anl lor a Dermit Suble��i the ap0litani lo a civil Denaliy oi noi more ��an Iive hunAred dollars (5500�. I, as awner ol I�e D�operiy or my ¢mGloyees with wages as Iheir sole compen5aiion, will do �he work, antl �he ❑ stmcmre is not imenae0 or offerea Iar sale (Section 70aa. Buvness anU Pmfeuional CoEe: T�e Comracmrs' State License Law does nol aDDly Io an owner ol a pmpetly who builCs or impmves IAereon. an0 who tloes 5uch work himsell/hersell or �hrough . his or �er own employees. provi0e4 ihat such impwvemenis are not inlenAetl ar offeretl for 5ale. II, however ihe 6uilding or impmvemenl is 5010 wi��in one year a� compielion, t�e owner will have I�e UurOen ol proving he/s�e aitl nol �uild o� imOmve Ior ine purpose ol Shcel. I, as owner ol IAe pmperiy, am evclusively comracling with licensetl ronVacmrs m wns�mc� Ihe pwlec� (Section 7044, Business ❑ ana Pmiessions CoUe: Tne Convacmrs' Siate License law aoes nat apoN �o an mmer ol pmDeny vAo builUs or improves t�ereon an0 w�o coniracis lor such pmjetls wil� a conlractor�s) license Dursuanl lo I�e Coniracmrs' State License Law�. I am awam Ihal O�ool ol I�eir Warker'S fAmpensa�ion insurance shoula �e pmvide0 �o me. � I am exem0� unaer Seciion: 8. 8 P. C. lor Inis reason�. �a�e: Owner. I Oo nere0y cerlily Ihat i am aware ol anG unaersiantl ��e �eQuiremenis of Caiilomia Heatlh antl Safery Cotle Seclions 25505, 25533, and 2553a and Inat I or any future �uiltling acupant wilUwill not (cirGe ane� neetl to compty vnih saia state cotles antl I�e repuiremen�s lor a permit for consimclion or moadicalion �mm I�e Air �ua6iy Managemeni Oi5lricL FesiCential constmc�ion apPlicalions are eeempl Imm these pmvisions. Daie: Npplicant: I hereby cenity Ihat I have reatl Ihis apDlication antl 5taie Ihat Iht a0ove inlormaiion is correct I agree lo comply wiih all ci�y and counly orainances and s�ate laws relaling to buiiDing cansimctian and here�y autMr¢e representatives ol this ciry lo enier u0on the above�mentionetl OfOp2tly �4� in5 .G�i00 �p0525. ate Signat ��� Oriver's License oi Social ecurity t64t�a6 W�ne—BuilEing: Green—CaCe EnforcemenC Canary—Ap0licanL Pink—Revenue; Goltlenro0—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 0662'78 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU JOB DESCRIPTION : INSTALL WATER HEATER CLAIM VALUE; CALC—VALUE: PERM NO: P 066"l7 GOVT: N SUPP: N PURPOSE: OTI-I SQ FT: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT �rrx�u�r�r+t�r****x�**�r�r*x�****�r*ir�r+�x�t+e�r�r+r�r�rx�***+r�t�r*�r*****�+r*�r**�r******�r*�rx�+r**�r**�r�r*�** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BDILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGFIT: FT IN LEFT: FT IN RGiIT: FT IN PARKING REQ• PROV: PARCEL: 42219309 ZNE: REF NO: PLANNING NOTES> > if �E iE iE iF if iE if iE it iF iF iE iE iE fE iE rt iE iE iE iE it * iF if iE iF if iE if it iE iE if if if iE iE iE if if iE iF iE #:9E 1E #!f iF iE iE K iE iE if iE if iE iF iE iE iE iE iE if jF jf 3E 1f 9E iF if �)f iE if 3E iE D E V E L O P M E N T S E R V I C E S R E Q O I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED HY : ,,/�" � DATE: � APPLICATION ISSUED HY: �� 4: �,+I DATE: � � iEif�14if9fiEiEitiEiElfjfifffiE%iFiEifiEifiF C iF*iFiEifi:ifiEiE1E iF �{F� I�iF9E iF1EiF3fifiE9EifiElEiEiFiEififiEifiEifiFifiEitifiEffifififiElE9tiEif�fikiEififiElFififrtiElEitjEiEififiFif�EififiEifiFiFiFiE*iFK+fiEiF ifif iFiciFiFiF�YiF LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7.00 25$ PLAN ISSUE FEE 20.00 � BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 7.00 20.00 ' 0.00 REVENUE DIVISION TOTALS--> COLLECTED: HLDG PMT PLUMBING ELECTRIC MECHANIC 27.00 TOTAL 27.00 SMIP/NON—RES PAZD DUE 27.00 ,00 27.00 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN—CHECK it it if ih iF if if if K iF it if iE iE 1! r if i! if it ft 1t if iE if if iE M�f 1E it iF iE iF i: iF �f iF 1f iE if if if i(� iF 1f iF K iF if if K iF 1E 1E iF 1f iE iR iF if ii iE 1! if if if N� 1E iF jF �f if if iE �f jf M iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLO 1 WATER HEATER AND/OR VENT END OF FEES 9 01 0015568S—OO1S6685 TU T OkTE: 03/07/94 TItIE: 09:48 27.00 CONSTRUCTION AND PLANNING P��� '' SPA � APPROVALS Permit # Date Inspeetor ApPROVAIS Permic # Date inspoc2or i. Temporary Electriral Service or Poie 52. Pool & E4uipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electricai Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Eloctrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPPOVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. -� 60. Backwash Lines, P�Trap, � 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 Oreins 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical�Final 15. Rough Electrical-Conduit 66. Solar System-Finai i 6. Rough Electric �Viring 67. Pencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rougfi factory Fireplace APPqOVALS Permit #-'r 21. Ducts, in Structure 70. Underground Hydro 22. Oucts, Ventilating 71. Product Pipiny O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashin9 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM F�NAL 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 i - 33. Finai Electric Notes: ..G �,--¢e� V'�`�� �y�' � , � j-�- 34. Finai Heating & Air Conditioning . � 35. Final Gas Pipe-Test "' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � -� �'f, R : 39. Water Service-Finai 40. Gas Service-Finat . 41. Soiar pomestic-Finai 42. Backflow Preventer � '•� 43. Backflow Irrigation . ' 44. Landscape Irriqation System 45. Sound Attenuation . 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING `� 48. FINAL PLANNING • � 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Cv � 51. CERTIFICATE OF OCCUPANCY No. Date 1 COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only OWNER OR / TENANT Q� MAI LI NG � ADDRESS TE L. CITV ` ���J NO. � CONSTRUCiION �ENDEfl BRANCH ADDPESS ARCHITECT � .. /I.f� 1 TEL. ADDRE55 CONTRACTOR / 6 v ��N� ADDRESS Q TEL � CITV NO. F STATE CITV LIC. NO. I y LIC. NO. � SIZE NO.OF BLDGS. I d OF lOT NOW ON lOT a USE OF � EXISTING BLOG. � h FSeparate permits are req ed for � electric, plumbing and heating work. � USE OF BUIIDING AND WORK TO BE PERFORMED F Q ' � � r � � a w 0 I hereby acknowledge thai I heve �eatl thls appllcatlon and stete � y� thot the ebove intormation is corract antl agrea to comply wlth a all lews ragulating builCinB construcNon, antl � shell not employ � > Z any pe�son In vlolation of tha w0�kman'a compensatlon lews of � � the State of Californla. ' 3 I hereby cortify that I em properlY Iicensed es a contractor untler SQ. FT. N the State ot Californla BuSlnass entl Profauions Cotla, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licances a�e in tull force and effect, or I THE PUflPpSE OF ESTABLISHING A PEFMIT FEE ONLV: � am exempt from the proviciOns ot the Stata of Calitornia Buslne83 antl Profezsiana Cotlo, Divizlon 3, Cheptar 9. VALUATION a PERMIT FEE b �(� � Slgneturaof /'� \B LANCHECK E _D(� o Permlttee � $��[ �(%� LL or ���� rAx S � f U AuthorizetlAqent Date TOTALPAID S �� . APPLICATION FORSTRUCTURALPERMIT RECEIVED B� . S - . �„ _ � J. :, � A.P. NO. `� ' ��J —' � BUILDING �� � ` „^� ADD0.E55 ��� UNIT OR SPACE NO. TR.NO._� LOT � �. I�I�J57 OWNER APPROVED REPAIR MOVING DEMOI L � VALUE � S E ROUP �T` C DATE� /L�� APPROVEDSETBACKS (FPOM �C//L REET) FRONT / � FT R. SI�E �O' FT L. SIDE L-�-` FT. REAR � FT. PLANNING ACTION DATE G APPROVED l ` 'f�{'. 50 TLt OWNER ��COTTAJ�R. Frank J. � DATE ']_9_57 JOB ADDRESS 2212 Miner St. BUILDING PERbSIT NO. 5�06 � GENERAL CONTRACTOR S2m2 VALUE $ 9.996.� AP. No. LOT 9 TRACT 3Q3q FIRE ZONE DESCRIPTION OP WORK .�att• "pgp. f 'lIP I& J TYPE V ZONE PLAN NO. 53�y$ INSPECTIONS I DATE I SUBCONTRACTOR I _ PERMITSISSUED I' L .- -' � � -' S348 C0.;TA MESA BUILDING DEPARTMENT P. O. BOX 31� _. COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN ADDRE55 � �� � ,�( /��� �� COSTA MESA. CALIFORNIA OWNER /—I�A'v%G �. ..� e { % J /� MAIL (Y�L� l f! Py i AODRE55 CITV G� ARC' '.CT OR VEER ADDRE55 CONTRACTOR �/�'�t E ADDRE55 LEGAL LOT OESCRIPTION NO. I A.P. NO. SIZE �+,X l�� OF LOT J � ! USE OF EXISTING BLOG. SETBRCN LINE FHOM ��J� CENTER OF STREET �1V NEN FEE RECEIV�D � �, � t9s1—� Q . F ANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIpT NO. pERMIT NO. ECEIVlD BY D4TE FECEIVEO pP/�SSVEO ��% � — �c�4r7 7 — f -s� TEL. //� �'L''l�IBUILDI NO �� /[) Y-� ADDRE LIC. NO. CITY LIC. � NO./ TEL. NO. TRAC NO.OF BlDGS. RIGHT `�' LEFT S DESCRIPTION OF WORK ALTERATION I ADDITION SIZ'EDING �O�r''Y C ROOMS � STORIES / /w / E%TERIOR WALL ROOF : n /_� COVERING �� COVERING «�� USE OF NEW iJ_ � J B.L% .i� _� _ COSTA MESA. CALIFORNIA APPROVED BY DATE CORRECTIONS $TATE TMAT TME ABOVE 1 CORRECT �ND �GREE TO COMPLV WITN /�LL CITV ONUINFNCE$ ANQ 4TE L>W$ REGUL ING 9VILOING CONSTRUC� T�o�, v VALUATION // —� J� PERMIT FEE S i' � SIGNATURE OF „r�� _ PERMITTEE �e-� ///���///��� s yY `/� PLAN CHECK S � L r ��� L AUTHORIZED AGENT TOTAL FEE $ ��+ vM� �;.