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HomeMy WebLinkAbout1686 IOWA ST - Building Permits ' �� CITY OF COSTA MESA les..) BUILDING DIVISION • 1.•1 '•"�• DEVELOPMENT SERVICES DEPARTMENT 698-00949 arMI PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1686 IOWA ST Status: ISSUED Suite: Applied: 06/03/1998 Vicinity: Issued: 06/03/1998 Parcel Nunmber: 13906120 Zoning: Applicant: HURLEY, RICK Address: Phone: Zip: Owner: SOUTHALL, ERNEST TR Address 1686 IOWA ST Phone: COSTA MESA,CA . Zip: 92626 Contractor: HURLEY ENTERPRISES Address: 23251 PERALTA DR • UNIT R Phone: 714 951-6724 LAGUNA HILLS Zip: 92653 License: 314183 Arch/Eng : Address: Phone: Zip: License: • SCOPE OF PERMIT REMOVE TAR PAPER AND GRAVEL ROOF,2 1/2':12 PITCH, REROOF W/2 15LB. FELT 8 25 YEAR COMP.SHINGLE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,800.00 Permit: $99.75 Claimed Valuation: $4,800.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $100.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will this erm a certificatesued, of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number. (This section need not be completed if the permit Is valued et one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Ca' la,and agree th t If I sh Id become subject to the workers'compensation provisions of Sectio 3700 of the Labor Code,I shall forthwith comply with these pray' on ( c Applicant Signature: Date: r+/ 3�/ p WARNING:FAILURE TO SECURE WORKERS'COMPENSATI ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI PENALTIES AND CIVIL FiNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COS COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license• der provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N ' Class 4 Contractor's Signature: dirt-WAW Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with 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 himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a' permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Govamment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signet r Legal ner(s) • /One Dete An Or A dad Applicant 0 CI / Date ECT CODES INSPID1I TYPE DAM IO1mAL5 CODE( INSPECTION TYPE DATE 16/11EL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final // q 208 Final Plumbing 200 Final Re-Roof 19-0-If Dp 210 Final Electrical 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 2446-46 Applicant to fill in all spaces except those within heavy.border lines and sign all appropriate declarations. _ Tl Co CIYY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 951 EI I2�'� Project A dress /(Q 8(o _L-0 (..ma. P287`r (- ., TYPE OF CONSTRUCTION ❑ NEW ❑ ADD LJ ALTERATION ICY REPAIR Applicant's Mailing Address ff --11 Owner's Name 5fL,P�uQ - C+5 (-0.6 7A-G4.5 Phone<qO-Z'41? El CONVERSION ❑ DEMOLISH El OTHER A"P,# Zone DESCRIPTION OF WORK/USE OF BLDG. Address ��"vh�� rrrrf��''''lll'1I S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT El GRADING LI�FOUNDATION ❑ STRUCTURAL E Front G Address El TENANT ❑ ELECTRICAL -/PLUMBING ❑ MECHANICAL B Rear N Contractor's Name Etfo-- ..S ekt-t"LC Phone 646-II vS ❑ OTHER A Right N Add /S 39 MU nedva.I 3 4/3 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K - G City Liceness se (mailing/ CONSTRUCTION TYPE VALUATION$ S Left City License No. 17 ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - - Ping. Ref.# Parking Req./Provided E Q I hereby affirm 7 that0) I am licensedion underfprosiness f Charterro9i ns(commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and T my license is in fu fprce and effect. License ""i2r1� v L nse pJo. S Date �p- Signature 7 ---- ;"(-G.Llrl; PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers • I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Presenter Service Sink . \ 3800, Lab. C. / C,� L Automatic Washer Transformer 0 15-50 KW Policy No. �z�aZ—Yr` Company 5744 / aw -- Backflow Irrigation Sewer Cap - ❑ 50+KW Construction Pole Sub. ❑ Cutified copy is hereby furnished. ' ertifid copy is filed with the city ilei D sioq. Bathtubs Sewer Connection ' ' Cooking Unit Meter 0 u to 100 amps \ Date G'' / -Y Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors ` Dishwasher Meter Dover 100 amps t. (This section need not be completed if the permit Is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel `� I certify that in the performance of the work for which this permit is issued, I V shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan Motors 00-1 HP 01'/ -B Workers' Compensation Laws of California. — Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE:Compensation makingthis ions ofi h,you should becomesubject to ite comply Com such ipr provisions of the Labor Code, you et forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service ff -- Outlets Water Closet • 7j 0'0 Device Boxes I hereby affirm that there is a construction lending agency for the performance W Pole Light of the work for which this permit is issued (Section 3097. Civ. C.) ' Interceptors Water Heater Outlets Lender's Name Range i Lender's Address Kitchen Sink Water Service Switches ' Sign OWNER BUILDER DECLARATION , . I hereby affirm that I am exempt from the Contractor's License Law for the - Lavatories Auto-Wash • Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays any structure, prior to its issuance, also requires the applicant for.such permit y Generator KW.❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt - . - - • therefrom and the basis for the alleged exemption. Any violation of Section / 7031.5 by any applicant for a permit subjects the applicant to a civil I _ penalty of not more than five hundred dollars ($500). $ 3 ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure is not intended or offered — - Reinspection Fee J $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I 0 - sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II -❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Approved ey Date • prove for the purpose of sale). ' 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By lv{O Date 6-12-8" tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU ❑100,000 BTU builds or Improves thereon,and who contracts for such projects with a con- tractor(s) SUMMARY OF FEES license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration • BUILDING PERMIT $ SMIP $ . proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT / PE 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ 6, CoRMIT ISSUANCE $ Date Owner Heating System& Ducting RegistersPLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- sentatives of this city to ntgr upo the above-mentioned property for inspection pur s. Gr O��; S'7 MECHANICAL $ TOTAL FEE $ 6- � DSirivers' ` Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS� CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL& SPA 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-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL 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, D 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 Drains 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 Electrical-T Bar 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 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil i 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 4 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test (,j-/2-i2 1.40 36. Hood or Canopy • 37. Final Factory Fireplace 38. Final Plumbing b72- -i? C' 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final • 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date OWNER SOUTRALL, ERNIE DATE 7-24-78 • iBUILJOB ADDRESS 1686 Tnwa Street DING PERMIT NO. 46445GENERAL CONTRACTOR n&, id G Fartke DESCRIPTION of WORK gFIF7 to Fami1yrnnm IstAP.No. .3.39_01_2n LOT 9A TRACT 37 2 FIRE ZONE VALUE $ 71800.00 INSPECTIONS Signature Date TYPE rT GROUP V ZONE R-1 SOIL PERMITS ISS ED GAS SUBCONTRACTOR Date I Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. E SPRINKLING SYSTEM MISCELLANEOUS �f-��, ROUGH HEATING AND AIR CONDITIONING 5ba, 5 • TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING lJf�/7 Q� Neofi pnd yr. • TRENCHES FORMS STEEL REINF. L !l- B �(Oj7�f' D(}- t -�'` t6�vs-- FLOOR SYSTEM r-� BOND BEAM (� STEEL REINFORCE l l A pl n SHEATHING �YAKJ[�// P/727/ . �(�/2 CH.VCCLLED FRAME AND FLASHING +AH'e�r�"!"- ��/57 DATEj QY A1---- LATHING — INri OUT irr- Alpe_ ���(((J�¢r.�/ ���7�� PLASTER, BROWN COAT at O//c/'7t HEATING. AL, FINAL `( Y �p-' � �.?Hp �� Q7 HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST I t_may..`, 4�T,181 ELECTRIC, FINAL BUILDING, FINAL 4u X45 ' COSTA MESA BUILDING-SAFETY DEPARTMENT 0400 7/24/7866•55 - Uy�s', P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 0400 7/24/78 05C_K'.FD' PL AT N FCItrPMIOLLIITC For Applicant to Fill in Completely`—/JUse InkOnlyR E DATE RECEIVED to ADIDRESSG 7 478 4 a zi,u�A / q ' t-x i6 OWNER /`/J/6 . ,O7N/ZL L A.P. NO./_/9, /Otv,'- PERMIT NO. AMAIL DDRESS 5,9"77) BUILDING j! (/.� ZDI��`Jl) ADDRESS (�yt y / CITY a/ �l gigs 4 NO.TETRACT��j,-L LOT 9(�J BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEM/1115H LENDER tryte- BRANCH OWNER 2C-. /vJ o«TNntL ADDRESS ^ ;J� (}� � V,,AssLUE �// AT ARCHITECT / TEL. USE 'i4% pt) • "•'f E Item OR ENGINEER �O7t.. NO //�J FIRE ADDRESS ZONE YPE//GRIOOUP .t/�y' CONTRACTOR i (o p 1 • err BYPROVE• DATE //'4"!a ADDRESS gZ3 ©Cf,,O-CJ j4.14. Z NO.OF USE OF NEW�A si TEL �(. PLANS,Z, BUILDING CITY 0�-6TA 2 A No. W3 z ✓/ w/ /�/ Abbi r�aN .-1 STATE g LIC. NO. GI.y-2-, 77 W LIC.CITN O.wad YARDS BUILDING ACCESSORY BUILDING (( (FROM C/L STi$ET) w SIZE NO.OF BLDGS. �7 7' 4 OF LOT I NOW ON LOT r FRONT /Jr!/ FT. FT. _ Q USE OF / EXISTING BLDG. a,,,t/C e R,SIDE d FT. FT. F Separate permits are required for L.SIDE S FT. FT. - electric,plumbing and heating work. ,J[/�f - O REAR IJ FT. FT. IQ [.„ USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q� /1 MAIN BLOCS. ACCESS BLDGS. Apo J_) C.U.P. DATE �/ O /1c C.U. y� ///�/-s APPROVED yJ ly, ,.• �� 6" t Pr _B-Y Ri�Y� .Y� DATE 7/2/ / O a / CCC/// w oI hereby acknowledge that I have read this application and state in g4 that the above information Is correct and agree to comply with m 4 all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of o the State of California, h / I hereby certify that I am properly licensed as a contractor under "/'�Y� SQ. FT. N the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT E Nty 4 — am exempt from a provisions of the tate of allforni 8 sinew 1' cf VALUATION PERMIT FEE $ 'rte and Profession p , Division ,Cha er 9 lA " ', en ,P"--"PLAN CHECK $ i•S 2, Signature o gyro ) �....x Permittee $�y/ U TAX $ ..._,.R U. -U Authorized Agent TOTAL PAID $ Illitlir Sr' Lot 96 . Tr 3722 - - 13024 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT ga- I3-GO- ,ice P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely A1!RLI&ATIONLEOREPERMIT TYPE OR PRINT BUILBUILDING ADDRESSDING 1686 Iowa Street COSTA MESA. CALIFORNIA For Office Use Only OWNER K & E Development Co., Inc. I RECEIPT NO. IER IT NO. I302.4 MAIL RECE�I EO BY O TT��,,REC}IVHD DATE ISSUED ADDRESS 1555 PLA CENT IA AVE - - !/� I 7o' t'O_frA nCT1 4 7GRn TEL. , BUILDING CITY NFL PORT FIFArH NOMI A_32ADDRESS ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. , I FIRE v J./ - ADDRESS ZONE TYPE GROUP (/ CONTRACTOR K.W. KOI I APBYPROVED DATE 1 ADDRESS 1555 PI A CENT I A A VF ZONING ZONE NO.OF USE OF NEW 511 Pau,. CITY• NEWPORT BEACH R-1 I PLANS 2 I BUILDING Tril att gar STALIC.NO. 61195 No: LEGAL MI 6_3PP7 DESCRIPTION Tat 9 Tr»rt 3722 OF LOT 63X100 I NO. OF BLDG/. NOW ON LOT A.P.NO. none USE OF YARDS EVES EXISTING BLDG. NnkF APPROVED ALLOWED SETBACK LINE FROM (CENTER LIN[ BT.) CENTER or STREET 50 1 REAR YARD 20' FRONT FT. IN. SIDE YARD I LEFT 5' - I RIGHT 8 ' R.SIDE - ? FT. IN. DESCRIPTION OF WORK - /// L.SIDE IN. NEW I x II ALTERATION I II ADDITION I ./ l REAR •N D FT. DATE 10-10-60 IN. REPAIR I II MOVING I II DEMOLISH I APPROVED cid yt BY WW. LL. D. NO. OF SIZE BUILDING 1V .' ROOMS 7 STORIES I EXTERIOR WA L 3� ROOF Rock COVERING 0TUCCO I COVERING USE OF BUILDING AND WORK TO BE PERFORMED SINGLE FAMILY RESIDENCE and Attached Garage Plan 6-C _, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AN STATE LAWS REGULATING BUILDING CONSTRUCTION. • VALUATION �� SIGNATURE OF /�� y Cb PERMIT FEE $ T `--- � ' ^ X10 7/37 / N $ /"/ /' PLAN CHECK $ �/f I AUTHORIZED AGENT l /TOTAL FEE $ • D LL