The URL can be used to link to this page

Home My WebLink About2242 MINER ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 2242 MINER ST REAR OF HOUSE 42219302 FLORES, KEITH 7835 S. MANCHESTER AVE ANAHEIM,CA SUITE 102 Owner: SPARACINO, JOSEPH Address 2242 MINER ST COSTA MESA, CA Contractor. BAY STAR ELECTRIC Address: ISSUE FEE Temp service lest Res. a/c package New Res (7-2 unils) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets SwitChes Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1hp Motors to tOhp Motors to 50hp MotorS t0 t00hp Motors over 100hp Communiwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole 1835 S. MANCHESTER AVE ANAHEIM,CA SUITE 102 ELECTRICAL PERMIT Phone: 714-778-1410 Zip 92802 Phone: Zip: 92627-2525 Phone: 714-778-1410 Zip: 92802 License: 754699 SCOPE OF PERMIT REPLACE EXISTING ELECTRICAL PANEL TO NEW 100 AMP PANEL. $23.50 $0.00 so.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 so.00 30.00 $30.50 $0.00 $0.00 $0.00 50.00 $0.00 $D.00 50.00 $0.00 50.00 $0.00 50.00 50.00 �uantiry 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System I Lighting Busway/t00ft Standing Section Misc Electrical Equipment Transtormers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Vollage Equipment Low Voll Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Ciras (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigalion Fee Plan Check Fee Reinspectlon Fee Status: ISSUED Applied: 02/23/2005 Issued: 02I23/2005 ISSUED BY: l � Quantity 50.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 ao.00 0 ao.00 0 50.00 0 $0.00 0 $0.00 0 50.00 $0.00 $0.00 $0.00 TOTA� CALCULATED FEES $54.00 NOTICE: 7he work authorized by this permN shall comply with all applicable handicap access requirements under Califomla statutes and related regula�ions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automaticalty expire and become voitl if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In ortler lor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlona and finel epproval must be obtained. Failure to obtain Inspections and finel approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5628 244Bd8 (BNO) WORKERS'COMPENSAnON DECLARAnON: �-/ I hereby eMirm untler penalry of perjury one ol the following dedarations: ❑ I heve end will meinleln B certilicate of consent to setl-Insure br workers' compensatlon, es pwvidetl for Dy saction 3700 of tha Lebor CoOe, tor Ihe pertormence ot Iha ,f�ark tor which Ihis permit Is issuatl. �eve entl will maintain workers' compensatian insurance, as reqNred by section 3700 of ihe Labor CaAe, lor Ihe pertortnance of �he work tor which this pertnit is issued. My workers wmp =setion ^Insurenca �er and pollcy number ere: —��'�^ ��j � errtl .�� /�\//l� Policy. "'Numtier. � (Th/s sectlon n tl not e com0/efe0!! Ne permifls veNed ef one hundred dW/ers (S I00J or /ess.) ❑ I certify thet in the perto e ol the wpk lor which ihis pertnit is IuueQ I shell nol employ eny person in any menner so as to Decome subject to tha workers' compenseilon laws ol I , pr�/ ap} Ih II I s�oultl Decome sub�ect to the workers' campensetlon provislons at Sectlon 3700 0l the Labor Cotle, I shell forlhwiN com I wit� t�ese s. �/ 1 /� A_ p cant.57gneture: � C7v-7 -� ��p`ate�.'�' 2/e,L- 3//: �t� WAfiNINO: FAILIIRE TO SE ORKERS' tUMP PON COVEMGE IS UMAWFUL M1D SNALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES�AND CML FlNES UP TO ONE HUNORED THOUSAND OOLLARE (5100.000�, IN ADDRION TO THE O0.ST OF WMPENSATION, �AMAGES AS PROVIOED FOR IN SECTION 3�OB OF TME UBOF COOE. INiEREST, ANO ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATON: I hereby aHirm � at I em Ilcensatl lorce entl eHaci.Lic_M �� of Chapter 9(commencing wllh Sectlon 7000) of Dlvision 3.q�,�he,Business antl Professians CoCo, end my Iicense is in lull � . LGless�#� %� ^��i . CONSTRUCTION LENDING AGENCV: ❑ I horoby ettirm �hat there is e construction lentling agency lor the pedormance ol t�e work lor which ihis pertnit is issuad. (Sec. 3097, Civil Codo). Lentlefs Name: SignaWre: OWNER-BUILDER DECLARATONS: Lentlef5 ACdrau: Date: 1 hereby eHirtn thet untler penelry of perjury thet I em EXEMP7 FROM THE CONTRAC70RS LICENSE LAW tor lhe following reason (Sec. 7031.5, Business entl Protesslons Cotle: Any ciry or wunry which requires e permit to canstruct, elter, improve, demdish, or repair eny structure, prior to Its issuance, elso reQWres the eppliwnt for such petmit b flle e signed stetement �het he or s�e Ls licensetl pursuent to the provisions oi the Contractors lJcense Lew (Chapter 9(commendng wit� Sectlon 7000) ot DMsion 3 of the eusiness entl Pmfessions Code) or thet ha or she is eaempt therelrwn end tha besis for the allegeA axemption. Any viWation of Sectian 7031.5 by any eppliwnt far e permit subf ects the epplicant to e ciHl penalty oi nol more than frve huntlred Eollars (5500).): ❑ I, es owner of Ihe properry, or my employees with waqes es iheir sole wmpensatlon, WILL DO T1E WORK, antl the siructure Is not intentle0 or oHeretl for ule (Sec. 7044, Business and Professions Cotle: The Contractors LJcense Law tloes not apON �o an axner of properry who 6uilds or Improves iherean, entl who does such work himself or herself or through his or her own employees, proviaetl that such Improvements ere not intended or aHered tor sale. If, however, Iha builtling or improvement is sold within one year oi completion, the ownerbuilder will have the burden of proving that he or she did not build or improve for purpose oi sale.). • ❑ I, es owner of the praperty, am EXCLUSIVELV CONTRACTNG WITI LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The coNractors Llcense Lew tloes not appty to an owner ol property who �ulltls or Improves thareon, end who contracts for such prolect with e wNrector(s) litense pursuant to the Comracrors License Wws.). ❑ I em ezempi untler sec. Business and Professions Code for Ihis reason: Signetura: Date: Owner ID veritiotl by tlnveYs license. ❑ Yes ❑ No DAver's Llten9e No. Vedfication of Ownership by (type of documeni, i.e. � pmperry tea bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I hereby certify that no excevatlon five (5) or more feet in depth into which e person is required to descend, wlll be matle In connection with work auihodzed by this permlt, an0 that no huilding swcture, scaHdding, talsework, or tlemollUon or dismantling thereol, wlll be mora then thirty-sla (36) leet hig�. (Chap. 32, Grp 2, Ar12, Sac. 341, Tltle 8, Calitomia Atlministretive Catle). ❑ As awner-builder, I wlll not employ enyone to tlo wark which would require e pertnit Irom Ihe Divislon of Industriel Safery, es no�etl ebove, unless such person �as e pertnit to do such work Irom the tlivision. Signeture: Date: Dlvlslon oi Intluslnal Salety Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I cehify under penalry of perjury ihat I have read ihis application end state thet ihe intortnetion given is correct. I egree to comply wlth ell stete laws end ciry ordinences relating lo bullding construction, end authoAze representatives of ihe Clry ot Casta Mese to enter upon ihe abave-descnbetl propeny tor inspection puryoses. I agree no� to occupy or ellow occupency of any huilding authorized by this pormit until finel ins0ection. COOE �. INSPECTION �YPE I616 Fizetl Syslem Final Fire Preventi0n 1286 Pool Spe Final 200 Finel Re-Rooi 201 Final BIxVJReteining Well 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolition . �� : . Dare Pdg 1NI�6S CO�E 1 INSPECTION TYPE 206 Finel Mechanical 208 Final Plumbinq 210 Final Electrical 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Finel Building�Occupency P� It1�Lfl '�-1-e S -� JobAddress: '1'141 MINtKJI Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 42219302 Applicant: BILLINGS, ANDY Address: 14262 ALLEMAN PL SANTA ANA, CA Owner: SPARACINO, JOSEPH Address 2242 MINER ST "„ COSTA-MESA, CA Contractor: COVER RIGHT ROOFING Address: 14262 ALLEMAN PL SANTA ANA, CA Zip: 92705 Arch : Address: Zoning: Phone: (714)832-0113 Zip: 92705 Phone: Zip: 92627-2525 Phane: (714) 832-0113 License: 615852 Eng: Address: Phone: ISSUED BY: amws. iaau�v Applied: 09/16/2004 Issued: 09/16/2004 Phone: Zip: . License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING WOOD SHAKE ROOF, 1/2" OSB SHTG, 1 LAYER 30# FELT, INSTALL "GAF 30- YEAR COMP SHINGLES:' 21 SQUARES . .� �� ' - . / � FEE SUMMARY Plan Check: $0.00 Calc Valuation: Ss,ieo.00 Permit SMIP Res: SMIP Com: Other: Inspection: � Total: $125.25 $0.52 $0.00 $0.00 $0.00 $125.77 SETBACKS MAIN STRUCTURE ,Front 0. 0 ACCESSORY �-Front 0-0 � PARKING ' Existinq:, o ; �' . � Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Claim Valuation: Ss,iso.00 Right '0- 0 . ' RIgRt 0-0 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 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for tha work authorized under this permit to ba consideretl legal, such work must comply with all applicable codes, and all requlred Inspections end final epproval must be obtained. Failure to obtain inspections end final approval will result in the ezpiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5626 >aas-ae ldao� WORKERS'COMPENSArON DECLARAnON: � ' . �� ' I hareby affirtn untler penelry ot perjury one ot ihe fallowing declaretions: ' ❑ I have end will main�ain e ceniticate of wnsent to sel(-Insure for workers' compensation, as provided tor 6y section 3700 oi Ihe Labor Code, for the pertormance of the work for which t�is pe�mit Is issuetl. ��l I have end will mainteiP workers' oompensatbn insurance, as reQuiretl by SecGon 3700 of Ne Labor Code, tor Ne pedortnance ol Ihe work Por which Ihis permit is iuuetl. My worke sI' compensatlo nsurapce cartier and policy number ere: Cartier: V�TA�Q. f.1nL{ PolicyNumber. I�ZC%S�Z ��%%� (Ihls sectlon need no( be c0 p/efed i! he permit is veluetl e( one hundred tlollers (S 100) or IessJ � . ❑ I cenity Nat in the perlo anca ot the work tor which Ihis permit is issue4 I shell no� employ eny person in any manner so as to become subject to the workers' compensatlon laws of Ilfomi grea Ihat it I should 6ecome D�ect to the workers' compensalion provislans ol Section 37W ot the Labor Cotle, 1 shall lorthwith comply with ihese pro ns. I ,/ Applicant Slgnature: Dete: � q �lD /� V � WARNWG FAIIURE TO SECUFE WO KERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FWES UP TO ONE HUNDRED THOUSAND OOLLARE (b100,0001. �N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED F-0R IN SECTION 370G OF THE LABOR COOE, INTEREST, AN� ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm ihat I an farce and eflecL Llc. M`, CanlractoYs Signeture: of Chapter 9(commencing with Saction 7000) of Divisio� 3 0l ihe Business antl Professions Code, antl my license is in full ciass a _ C � 3�1 '� -- Date: � �i/,� �G � CONSTRUC710N LENDING AGENCY: ❑ I hereby attirm that lhe�e is a consWc6on lending agency for Ihe performance of the work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Neme: Lentler's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I heraby aHirm that untler penelty of perjury ihat I em E%EMPT FROM TME CONTRACTORS LICENSE LAW lor the tollowing reason (Sec. 7031.5, Business end Professions Code: Any city or counry wh�ch requires a permit to constmct, eltor, improve, demolish, or repair any strucWre, prior to its issuence, also requires the applicant tor such permit b tile e signed stetemeN t�a� he or she is licensed pursuent ro the provisions ol the Contractors License Law (Chepter 9(wmmencing with SecUon 7000) of Oivislon 3 of Ihe Business and Professions Goae) or ihat ha or she is e:empt iherefrom end the basis tor the alleged exemption. Any violatlon oi Section 7031.5 by any appiicant for e permit subJects the epplicent to e ci�il penalty of not more than tive hundred tloilers ($500).): ❑ I, as owner ol the property, or my employees with wages as thair sole compensation, WILL DO 7HE WORK, entl the s�rucWre Is not in�entle0 or ottered tor sale (Sec. 7044, Business antl Plofessions Cotle: The Contractors License Law does not apply lo an owner o� propetly who builds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, providetl Ihet such impmvemenis are not imentle0 or oflered lor sale. If, howaver, the building or improvement Is soltl withln one year of complation, the ow�er-builtler will heve Ihe burden of proving ihat he or she did not �uiid or Improve for purpose ot sale.). � ❑ I, as ownor ot Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Professions Catle: Tho contractors Licensa Lew does not epply to en owner of property who builtls or improves thereon, end who coniracts br such project wlth e contractor(s) license pursuant to the Comractors license Lews.). ❑ I am exempt under seG� Busineu and Professions Code for Ihis reason: Signeture: Date: Owner ID vanfied by tlrivers license. Yes ❑ No Dnvar's License No. Ezpires: Venfication af Ownership by (rype af a ment, i.e. � properry ta: bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby coM1ity ihat no axcavation five (5) or more leat in tlepth Into which e person is �equired to descen4 will be made in connection with work euthonzed by ihis permi�, and thei no buildinq s�ructure, scallolding, talsework, or demolition or dismamling ihereof, will be more Ihan thirry-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Calibmia P.dministretive Cotle). ❑ As owner-builder, I will not employ anyone to do work whlch would require e permit iram ihe Division of Intlustriel Safety, as noted above, unless suc� person hes a permit to do such wark from Ihe division. Signature: Date: Division of Industriel Satety Pertni� Number: CERTIFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I cenity under penalry of perjury that I have read Ihis epplication end state Ihat the intormation given Is correcl. I eg�ae lo comply wi�h sll state laws end ciry oMinances relating to builtling construction, and authodze representetives ot the Ciry oF Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occuDancy of any building authorized by ihis permit until tinal inspection. Sign e Of Legal Owner(s) �/��ate , l �� And/Or Authonzetl Applicant a Date J CODE t. INSPECTIONTYVE 1616 Fi:etl System Final Fire Prevention 7266 Paol Spa Final 200 Finel Re�Roo� 201 FInaI Blak/Reteining Well 202 203 Final Factory Fira Place Finel Sign 204 Finel Demolition Q� �$ �1�3-��l �wr�- � CODE� INSPELTIONTYPE 206 Final Mechanicel 20B Final Plumhing 270 Finel Electricel 212 Finel Fire Preventlon 220 Final Plenning Approval 222 Final Site 250 Final Bulltling/Occupancy P9I€ It�IELfl UWNER W ATEN PL ROUGX HEPTING 4N0 AIR CONOITIONING UNOERGROUN� U POWER U ROUGH WIRING TRENCHES � FORMS � STEEL REINF. FLOOR SVSTEM FRqME PNO Fl.qS LFTMING - IN [ PLASTER,BROWN 5' 'URRL, FI! FINRI RIIII OING. FIN1L i DATE SUBCONTRACTOR � 4f;73& COSTA MESA BUILDING-SAFETY DEPARTMENT P.0.60X1200 COSTAMESA.CALIFORNIA92626 �T , �,-�s�a�'-on eaa : ::;: � ;�t �sc Ar� A ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only R V DATE RECEIVED D TE SSUED ADDRESS �oZ /NL� S �- �� OWNEF G,�� A.P. NO. 'O 3�O PERMITNO. BUILDING M`u MAIL ADDRESS ADDRESS M � �7�^] TEL. TRACT3G�S� LOT Z BLOCK CITV U NO. lJ CONSTRUCTION W A A LENDER BRANCH OWNER O%YI ADDRESS A UE AFCHITECT TEL. S AC' �O�vt�§ � D—' OR ENGINEER N FIRE Ij''' ADDRE55 ZONE VP GROVP J APPROVED CONTRACTOR BV � OATE ADDRE55 �L TEL. Z NO.OF USE OF NE CITV NO. PLqNS BUILDING STATE CITV �'ARDSAPPFOVED VAROSAPPROVED LIC. NO. L�C. NO. MAIN BUILDING ACCESSORV BUIIDING SI2E NO.OF BLDGS. (FROM C/L STREET) OF LOT �Q J� �, S NOW ON LOT � ROM FT.� FT. USE OF //�� r � _ EXISTING BLDG. �i �l � ��'`"' / `�r�"�`^� e FT Separa[e permits are required for L. S�DE FT. FT. electric, plumbing and heating work. REAF FT. FT. USE OF BVILDING AND WOflK T BE PERFOFMED � � DISTANCE BET. BEf. MAIN & E' Cc � E ?�i. A J MAIN BLDGS. ACC6S, eLDCS. , VAq.9W DATE C.U.P.qe APPROVE� APPROVE / � I � J I hereby acknowlatlpe thet I have reatl this application and rtete that She above Informetlan Is corraci antl eprae to comply with _ ell laws repulBtlnB b�IIAInB conrtruc[ion, entl I shall not employ any person In violation of t�e workmen'e compansation lawe of ihe Siaie ot Celifornle. I hereby certify t�at I am properly Iicensetl es a conTrecior untler SQ. FT. tha Stata of Callfornia Bucinasa and Protesalons Cotle, Dlvlsion 3, TNE AMOUNT SHOWN UNDER VALUATION IS FOF Chapter 9, end that s�ch Iicenfes ere In full torce entl effeci, or I THE PURP06E OF ESTA PERMIT FEE ONLV: em exampt from the provisions of the Staie of Celifornie Businees VALUATION entl Professlons Code, Dlvielon 3, Chepter 9. P IT FEE y Q �— SiB�eture of / $��D PLAN CHECK E Permlttae -v�- TAX E � Authorizetl A0 �t TOTAL PAID 5 Q�(�j�% OWNER O�CONNOR, FTank J. � DATE %-9-5% JOB ADDRESS 221i2 Miner St. BUILDWG PERMIT NO. 5j99 DESCRIPTION OF PLAN NO. INSPECTIONS I DATE I gUBCONTRACTOR I DATE ` vNUMBER E.._..� Gas / � �. �/ ; � � � 5341 ` COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILDING �` ��N�/Q, S� nooaess Z 2`f 2 COSTA MESA. CALIFORNIA OWNER ��.fI.�L/� �/' D �CO %�NQ MAI�,�r G �. � ! �� ADDRE55 ��T� C, .2J, ARCHITECT � OR ENGINEER AODRE55 CONTRACTOR ADpRE55 LEGAI OESCRIPTION A.P. NO. TNa:Li,�'jd k LIC. NO. G CITY LIG /��I`� NO. (1 J TEL. NO. SIZE �O � /�� INO.OF BLOGS. OF LOT S rvpw oru �or E%iSTit�G BLOG. SETBRCI( IINE FROM r'� l�%J ccnren or' srneer S O REAR VARD roT�o SIDE YARD RIGHT S+ LEFT � DESCRIPTION OF WORK NEW ALTERATION pADDITION FEPAIR MOVING IIDEMOLISH BUILDING � NO.OF ! SIZE � X �0 ROOMS � STORIES E%TERIOR WALL 's vuA ROOF GUpOP COVERING COVERING USE OF NEW �/i rs �/ Ai� / �� BUILDING (�«`� g� I��I P4vQ �R [j_ E/�✓ � FEE RECEIVED � �,�.,,,..a. � uy �� S7 -� � � FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY pECEIPT NO. _PERMI�No � 3 ' ..� i ECErvf� OY [�PTE nECEIVEO O�TE ISS/UE'D %7t/1P� L i �CL{( �- rJ'J � COSTA MESA. CALIFORNIA APPROVED� BV DATE CORRECTIONS ST�TE TN�T THE �BOVE IS CORRECT �ND eGXEE TO COMPLV WITX �LL CITV ORDINaNCES /.NO ST�TE LewS XEGULeTING BVILUIN(. CONStPUU i�oN. VALUATION SIGNATURE OF PERMITTEE g � ^�� y AUTHORIZED AGENT PERMIT FEE S Z � � PLAN CHECN 5 � Z � TOTAL FEE 8 �6 � 'M� WNER�, AURK� Tom �JOB ADDRESS 2p42 Miner St� GENERAL CONTRACTOR ��er�j A� . ��5-pBq_ry? LOT '\�IN, _CTIONS !� SOIL `GAS W FTEF ROUGM PLUMBING PROP. SWR. LINE Q HOUSE CON. � SPRINKLING SVSTEM MISCELLANEOUS ROUGH MEATING ANO AIR CONDITIONING TEMPORaRV SERVICE OR POLE UN�ERGFOUNO � POWER � ROUGH wIRING TRENCHES � FORMS STEEL REINF. FLOOR SVSTEM BON� BEAM ❑ STEEL REINFORCE � SHEATMIN6 FRqME AN� FLASHING LATHING - IN ❑ OUT n _ PLACTER,BROWN COAT 5' 'URAL. FINAL DATE SUBCONTRACTOR IT N0. L F G4 a Q y r y "S'� F C W F � a a > r J CC W a � a a z 3 4ti73 � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING a ya ��/ ^p ADDRESS G/� OWNER � M B U�/` MAI l CITV CONSTflUCTION BflANCH ADDflESS ARCHITECT CONTRACTOR ADDRESS CITY STATE LIC. NO. SIZE OF lOT USE OF TEL. NO. TEL. CITV LIC. NO. NO. OF BLDGS. NOW ON LOT Separate permits are required for elecVic, plumbing and hea[ing work. E OF BUILDING �+ND WORK TO BE PERFORA I here0y acknowletl6a that I hava reatl thif application antl steta thet tha ebove Intolmatlon Is corract entl aprea to comply with all lews re9ulating bulltlinp consvuction, entl I shall not employ any penon In viole4�on of Me workmen's compansetion laws of the SSaSe of Californle. I �areby certify thai 1 em properly Ilcensetl es e contractor untler Ma Stem of Callfornia Businesa antl Profaulons CoAe, Division 3, Chapter 9, end ffiet such Ilcenses era In full forca antl eftect, or I am axampt from Mo P�ovlsionz of the Steta of Calitornla B�slneca entl Protessione Cod Dlvialon 3, Chaptar 9. Sipnat�ra ot �J Parmlttee � � A�thorized ABant A.P. NO. � BUILDING AODRESS TRR r: R ROVE r �PAi� x A�ir:':..� ,�T,h-,:��s,on 6��.. �- .50 ,TION POR STRUCTURAL PERMIT BV DATE RECFIVED neTc ieciie� NO. LOTZ I BLOCK �I Wjs� , �NO.OF�USE OF NE�TOJV I` ��PLAN$ BUILDING rF�� VAROSAPPROVED YARDSAPPROVED MAIN BUILOING ACCESSORV BUIIDIN DISTANCE BET. I BET. I MAIN BLDGS. ACCE: VAR.q� DATE � � n m i 0 SQ. FT, a T E AMOUNTSHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMR FEE ONLV: � VALVATION PERMIT FEE s O� � n m �( P�.AN CHECK E ^� � o LL $ � TAX E � U TOTAL PAIO S ,�SD