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Home My WebLink About2741 FREMONT LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��sCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 2741 FREMONTLN Status: ISSUED Suite No � Applied: 1 0/1 32 0 06 Vicinity: Issued: 10/132006 Parcel Nunmber: 14155603 Applicant: NAPPALLI, ANGEL A, Address: 2741 FREMONT LN Owner: Address ;'' // _ - Phone: 714-600-1145 COSTA MESA, CA , �� ;�!i"='��-Zip - 92626-5607' -_ �•' .,,�'. - � . .' . . / ,i, ,. ' ��- . � �,G'� .- � _ , NAPPALLI; ANGEL A,�, �� ' ; � � � , . . ?741 FREMONT LN, . ' � . _ . . ., ;t i ;�' �� `� � � _��Pfione: 714-600=1145 � �_ . �/ _ � � � ' , -' -' . COSTA MESA; CA/ ",% . ._ Zip: 92626-5607 - 1 ' //� \� � : //�� ',�i,�\ \ /i�/�/'� '� . . �, . . . Contractor: ��OWNER=6UILDER ��Address: '��j��' , � ' � � � �lY J�c� 1 � Phone.` ' . "/� , � . �,i � � , ' ' , .,, �.�. , � .. %' ,� �' Licen;e: 000000 , / _ /.; , � _ � . � ,% -, /,� ni� � � " � , i ' �` � SCOPE OF PERMIT . ' 4 � ��,' UPGRADE AND RELOCATE-SERVICE PANEL FOR A SFD. - �:i' ,� .. , , - � ;,i.� /- �A>� - " . ; •WORK�TOINCLUDE:1 SERVICET0200A. �� , � � ISSUED BY: ^t � �; Non Res � . . � � - � --- htt JUMMAKT i , �v;: ,--�,--� �- Y , ./� . , _ ( Quantity � i � � : =. . ' �,_�_� . � �. . _ _ ,, . . Quantity 1_ .�: , iSUE FEE ' � � � � $23.50'� �' �l� -� . . � . � Temp�Dist System / Lighling $0.00 0' emp service test $0.00 �� Busway /100 ft�. $0.00 0 ;es. a/c package, �. � $0.00 �, ` Standing Section � $0.00 0 Res (1-2 units) . $0.00 ...�^�0' �� f � � Res` 3+units �., ��.,'^, 'r--- - - - "= �`'�' �"_ir Misc Electrical Equipment $0.00 0 ( )' � $0.00 --0, ,:^-_ -_�-, _ � _ Transformers up lo _1 kva/kw $0.00 0 / SPa _,--�. ', -.: . � $0.00 '-�* .p_ - - � - - . �� - ................up,to 10 kva/kw - $0.00 0 ing FiiRs ,; .�� '�. $0.00 { 0 ................:up to 50 kva/kw $0.00 0 pt Outlets �� •, `' $0.00 � 0 ...........:.'.,up to 100 kva/kw $0.00 0 �.hes ,^• , ��,�� $0.00 " 0 ........,...: ...over 100 kva/kw $0.00 0 �2es Appl ��. �. ' $0.00 0 Low Voltage Equipment $0.00 0 4ppb \ \ � � � �� $0.00 � 0 «,=Low;Volt Wiring System / Ckt $0.00 0 Service to 200a �� ` �$ Service.to 7000a � ��`.� Service over,1000a '�' � ,\ Motorsto�1fip`., �,/� Motors to tOhp' \ /� Motors to 50tip �: A / �1 Motors to 100hp� �� !, � . Motors over 100hp�`��V " � Communicationdrops�ti`� �r, Sub panel to 200a �t�r\, Pole Light Pkg � � �� SignCircuits �� Temp Pwr Pole Intermed Pole � 1 ��J"'+>� ��MiSa Conduit $0.00 0 � 0 -� �'�{"�"."� �' � -� Misa Conductor � $0.00 : 0 0 ;'a.' %�''' . �., " . Cirws ( gen or Fide) . $0.00 � 0 j,�,::,:_.0�":: ' , �..i- ,.Cirws (mech.ride o� ligfits)"��. - $0.00 0 . 0 -� ^ � Christmas Tree Stand �$0.00 0 �� ,. Oz �� - " ' - Fireworks Stand - $0.00 . 0 \� ,�-0, ^= - � ° � Other Electrical Fee - - $D.00 ; � .c �� '��'p� ' _ " : . � _ > ,_ . . . ., ',� � �0'��=� ;�"��=� � InJesligation Fee � , ' �$0.00 / : - r0� � '- , - - -Plan Check Fee � - $0.00 � ��I �0 �'-�� ReinspectionFee , $0.00 i �p i- �7 _ '� �� 0`: �J/'� � � � � TOTAL CALCULATED FEES .554.00 -��.:..a�`-0 �.. _ . A ' . . " �, ,, - �. . ,. . - . _ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regWations. (Ord. No. 92-28, § 7, 72-27-92) 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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlona anq final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. � FOR INSPECTIONS CAL�: (714) 7545626 2aas-as�aroo) WORKERS'COMPENSAnON DECLARAnON: ' � I hereDy eXirm under penalry of per�ury one oi lhe following declaretlons: . ❑ I heve entl will melnteln e certlficete of consent to selt•Insure for workers' compensatlon, es pravided for by sectlon 3700 of the Labor Code, far the peAortnence of t�e work for which thls pertnit Is luued. ❑ I heve arM will melntein workere' oompensaUon insu2nce, es required by section 3700 of the Lebor Catle, for Me perfortnance of Me woAc for which this pertnit is issuea. My workers' compensetlon Insurence carder end policy number ere: Carrier. Policy Number: (This secUon need nof be com0/ete0 i! (he permit is valued ef one hundred dWlars ($100) or Iess.J � thet in ihe pertormance of Ihe work for which Ihis pertnit is issuaq I shall not employ eny person in any manner so as to become sublect to the workers' � isation laws ot Call i, en egree that it I should b cQme sub�ect to ihe workers' compensation provisions ot Section 3700 ot the Labor Code, I shall forthwith wiN these rovisi / ,p� rreNre; P � � Date:.-� !� v`-' I y' �� '_URE TO SEWR ORKERS' COlAPENSATION COVERAGE IS UNUW FL1L lWD SMP115UBIECT AN EMPLpYER.TO RIMINAL PENN_TIES AND CML FlNES UP TO ONE HUNDRED N.LARE (E100.000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IIJrEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eNirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the eusiness and Professions Cotle, end my license is in full force end eHect Uc. # Clau # Contractors Signeture: Date: CONSTAUCTON LENDING AGENCV: ❑ I hereby affirm that there is a conswction lending egency tor Ihe perfortnance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentlels Neme: Lendefs Adtlress: Signature: Date: OWNER•BUILDER DECLARA710NS: I hereby aHirtn that under penalty oi Der�ury �hat I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Cotla: Any ciry or wunry which requires a pertnit to wnswct, alter, improve, demolish, or repair any siructure, Onor to its issuance, also reQuires tha epplicant for such pertnit to file e signetl statement t�et he or she Is Ilcensed pursuant to the pmvisions ot the Comrecrors Llcense Lew (Chapter 9(commencing with Secllon 7000) ot Divislon 3 of the Business entl Prolessions Code) or that �e or she is exempt t�erefrom antl Ihe basis tor Ihe alleged ezemption. Any violation oi Section 7031.5 by any epplicent for e permit sub cts the epplicant to a civil penalry M not more than tive hundred tlollars ($500).): ' I, as owner ot �ha proDerry, or my employees wlth weges as their sole compensation, WILL DO 7HE WORK, and ihe structure Is not intentletl or oftered lor sale (Sec. 7044, Business ana Professions Coda: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work himself or hersetl or Ihrough his or her own employees, provided that such impmvemenis are not intended or oflered for sala. H, however, ihe building or improvement is sold within ona year ol completion, ihe owner-builder will have tha burden ot proving tha� he or she tlitl not build or improve for purpose of sale.). �gs owner ol the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions Cbde: The contrectors License Lew does no� apply to an owner ot property who builds or Impmves thareon, and who contracis for such project with a comractor(s) I license Dursuant to the Contractors License Laws.). lem Busineu and Prolessions Code for Ihis reason: Ownar.ID venlled�by drivefs li%nse. ❑ Ves ❑ No Vedtication ot bwnership by (rype of document, i.e. - proparty tan bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certity Ihat no excavation five (5) or mora feet in depth into which a person is requiretl to descen4 will be made in connection wi�h work authonzed by ihls permit, end Ihat no builCing sWciure, scaflolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle B, Califomia Atlminisiretive Code). ❑ As ownar-builder, I will not employ enyone to do work which would require a permit from ihe Division oi Industnal Sefery, as noted ebove, unless such person hes e permit to tlo such work fmm the division. Signeture: Date: Division of Industrial Sefery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUiHOROATION OF ENTAY: I certiy under penalry of perjury that I have read ihis application and state that ihe intormation given is corract. I egre comply with all state laws end ciry ordinences relating to building construction, antl auihodze representatives of [he Ciry ot Costa Mesa to enter upon the ebove-Cescn r ins c ion u os . I�gree nol to occupy or allow occupancy of any building authorized by ihis permit until fnal insp ion. � /.3OG% 1�� -p -� ture Of Legal Owner(s) Data COUE �. INsvECTIONiYVE 1818 Fi:etl System Final Fire Prevention 1268 Pool Spa Final 200 Finel Re-Raot 201 Final BIocWRelaining Wall 202 Final Factory Fire Place 203 FinelSign 204 Final Demolition � It� COpEt INSPEC710NTVPE 206 Final Mechanical � 20B FinalPlumbing. . 270 Final Elec�rical 212 . Final Fire Prevention 220 Final Planning Appro'val 222 Final Site 250 Final Building/Occupanry PAIE l51 ' .ulf' nl.l�? Aoplicant to fill in all spaces except those within heavy eorGer lines ana sign all apo�opriate tleelarations. ci7Y OF coS7A MESA CO�NST,RUCTION PERMIT ' ProjectAddress Z7�) ��L%mOnT � • _ Applicant's Mailing Address S7/M/1!� Owner's Name �� rY��-na Phon�iQ�� Address Arch/Eng. License No. � - -' Address Convactor's Nam • `^^ •'�1-�,�, Phone�'�"�s'� Address (mailing) �ZZ /w�•fRNJ��. S' A • Ciry License No. �Z� �"1 LICENSED CONTRACTOR OECIARATION 1 hereby affi�m lM1at I am licensetl untle� provi5ion5 of ChartEr 9(commencing , with section 7000) of Division 3 of tne Business antl Protessions Code, antl my license is i full Porce dntl eftecL .Z�y A Licen Class iCe 5 No�:/r�0��' Daie � � Signature WORKERS'COMPENSATION DECLARATION '`?reby affirm that I have a certificate of consent to self-insure or a certiticate �Vorkers' Compen5ation Insurante, or d certifietl cOpy thereof (SeCtiOn ), Lab. C C N- r-�iicy No.��J�� Company '�'r' 'wW�� - �Certifietl copy is hereby turnishetl. Ce ifietl c is filetl with tbe cit � n Div' on Dale�-� Applicant��L� . EXEMPTION FROM WORKERS' COMPENSATION DECIARATION (Thisseciion need not be compietetl ii the permit is for one huntlretl ($300) or less). I certity thal in the performance of the work tor which this perm�i is Bsuetl, I shall not employ any pe�son in any manner So a5 to b¢come subject to the WorkerY Compensation Laws o( Califomia. Date Signature NOTICE: If, after makinq this tlecla�ation, you Shoultl becom¢ SubjeCt to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such orovisions or this permit shall be tleemetl revoketl. CONSTRUCTION IENDING AGENCV � I nereby affirm that there is a consVuction lentling agency tor the pertormance of [he work tor whicn this permit is i55u¢tl (SeCtion 309] Civ. CJ Lentler's Name Lentler's Atltlre55 OWNER BUILDER DECLARATION 1 hereby affirm ihat I am exemp[ from the Contractor's License Law tor tne following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a permit to construCt, alte�, improve, tleTolish o� r¢pair any sVucture, prior to its issuance, also requires the applicant for such permit to file a si9netl statement that he/she is licensetl pursuant to tne provisions ot the Contractor's License l.aw (Cbapter 9(wmmencing with Section 7000) of Division 3 of the Business antl Protess�ons Cotle) o� that he/she is exempt -efrom antl tM1e basis tor Ihe allegetl exemption. Any violation of Secfion !.5 by any ap0lican[ for a permit subjects the applicant to a civll alty of not more than five huntlretl tlollars (5500). LJ I, as owne� ot the prOperty o� my employee5 witM1 wage5 a5 th¢i� sole compensation, will tlo the work, antl the structure is not intentletl or offeretl for sale (Section ]044, Business antl Pro(essional Cotle: The Gontractor'S License l2w tloes not apply to an owner of a property wM10 builtls or iTproves tnereon, antl who tloes 5uch wo�k himself/ne�self or throu9h his or h¢r own employ¢es, provitletl Ihat such imOrov¢ments are not Intentletl or Otferetl for sale. If, hawever, tne builtling or improvement is soltl within one year ot com- pletion, the owner will have the burtlen o( provinq he/she ditl not builtl or im- prove for the purpose of sale). � ❑ I, as owner o/ the property, am exclusivety cont�acting with licensetl con- [ractorsto const�uctthe project (Section J044, Busine55 antl Professions Cotle: The Contracto�'s �LicenSe Law tloes not apply to an owne� ot property who builtls o� improves the�eon. antl wha contracls for such oroiects with a r.on- tracror(s) license pursuant to me Contractor•5 License Law). i am aware that proo( of cneir Worker's Compensation insurance shoula be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason �ate Owner — I nereby certity thai I nave reatl th Slgnature T�Or.�_- .`Yi.. Drivers' License or 55 � tatE that the above ] munty ortlinances :by autho/ize r¢pr¢- ionetl prope�ty to� Date�� ?E OF CONSTRUCTION L1 NEW LJ ADD L�1'ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIOMOP WOFK/USE�OF BLDG. ,' �0.�, e{- Gb �. Q. TVPE OF PERMIT LJ GRAIYING LI FOUNDATIO LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING �MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq.Fr. _1 oCCUaANCv � CONSTRUCTIONTYPE 1Z�N - VALVATION$ ZQNE GRADINGCU.YDS. ACRES_ Rema�ks: � . Bar Sink Backflow Preventer Backflow Irrigation Bathtu6s Clarifiers Dishwdsher Drinking Fountains Floor Drains Floor Sinks GasService Outlets Kitchen Sink Lavatories P-Trap Roof Drains Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Au[o-Wash ' Reinspec[ion Fee � $15 I I Issue Fea I $ 3 I MECHANICAL FEES Boiler Duct - Under Ground Duct - Struciural . Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting � ❑0-100,000 BTU 0100,OOOBT Heinspection Fee I $15 0865-46, rev. 5/BB White - Builtling; Canary - APPlicant; Pink - Accounting; Goltlenrotl - Assessor Hood or Typel ❑ Canopy Typell ❑' Refrigeration System ' ❑o-ioo,000aTu ❑ioo,000 System Repair/Alteration F ire Dampers Registers , Issue Fae A.P. # S Main Buildi E T Front B Rear A C Right S . Lef[ Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Oryers ❑Gas ❑Eleci Fan F.A.U. Fixtures Device Boxes Outlets ' Switches Garbage Dispoul Generator �65 KW C Zone Accessory Building: N 1 N G R E Q M T S. ELECTRICAL FEES Tronsformer ❑ 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors �0-1 HP �1 %- 8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Light Range 15 KW � Reinspection Fee � $15 DEVELOPMENTSERVICESREQI Zoning Approved By Buitding Approved By yQ._— Standing Sections Trash Compacror Issue Fee SUMMARY OF BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ � PLAN CHECK 25� $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $' �-�•-� PLAN CHECK 25% $ $ 3 SMIP $ PERMIT ISSUANCE $ ENERGV P.C. $ GRADING � $ � � MICROFILM $ TOTAL FEE $ Zg. �� C1 OQ039565-aG03�586 �'i1'� -_„��. GAT�: p$/n4;E9 Ti�1E: 09:37 . _ _ __ . _�'�\\> . . CONSTRUCTION AND PLANNING \ POOL 'PA Date Inspector Date Inspector APPROVALS Permit # - i�7 APPROVALS Permit # 1. Temporary Electrical Service or Pole � �• 52. Pool & Equipment Location ��. n, 2. Soil Pipe-Undrgrnd. ��D ;� 53. Steel Reinforcement �- .r. 3.' ElecCrical Conduii Utility-Undrgrnd. �� 54. Forms f 4.:Electrical Condurt-UndNgrnd. �� 7 55. Electrical Bonding ;�- � 5. Steel Reinforcemenf ✓ '' � 56. Rough Plumbing & Pressure Test "� �� i , �- •r _i\ .i 6._ Elecirical UFER:Gmd'.' �.'' __i_ 57. APPROVAL TO COVER-GUNITE '\: � 7._Footings ,,� � '� '" 58. Electrical Conduit-Undrgmd. C`�N� 8' Foundation ��;,._ �'� ,_� 59. Gas Pipe, 0 Undrgrnd., Test �` �� . � � ti 9'�Water Pipe-Undrgrnd: �, y �Z 60. Backwash Lines, P-Trap, O Undrgrnd. r, 10:�iStructural Floor Sy4tem � '; �'� 61. APPROVAL TO DECK 11'. Property Sewer Line'& House CoN`n_nection -� �,� 62. Backwash & Receptor-Final �2. SQ°"?!.CaP '1� _� j ^• 63. Heater&Vent-Final �� 13. Roof•Drair; p„ �� _� 64. Plumbing System - Final + 14. Rough PlumbingJ/+ i 65. Electrical-Final G' 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring ' 67. Fencing & Access Approval l7;' Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19� Rough.l-leating & Air Conditioning FIRE DEPT. REQUIREMENT 20 � Rough Factory Fireplace APPROVALS Permit # 21. Ducts, i� Structure 70. Underground Hydro 22. Ducts, Ventilating �,: 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-'Rough & Teat 72. Underground Flush 24. Roof Framing -J 73. Undergrnd. Storage Tank O Gas ❑ Oil ��T- .: � 25. Roof Sheathing �74. Overhead Hydro ; C 26. T-Bar_Ceiling (Structural) & Monocoat 75. Dry Chemical � c� • 27. Frame�and Flashing 76. Dry Standpipe ��. �.� r � 28. Lathing & Siding 77. FIXED SYSTEM FINAL � � 29. Insulaiion 78. FIRE PREV. FINAL ' � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � 31. Plaster,Brown Coat 79. FINAL INSPECTION 32. Electrical Power�MeterFinal 80. FOOD CERTIFICATE ISSUED , ' r-�t• 33. Final•Electric � Notes: .'� "� " .'-� • 7 34. Final Heating & Air Conditioning r8!` L� 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing . 39. Water Service-Final . 40. Gas Service-Final ,�4 r 41. Solar pomestic-Final �,� 42. Backflow Preventer jl 43. Backflow Irrigation . "'� �� 44. Landscape Irrigation System : f j. 45. Sound Attenuation `��`�� °.� 46. Handicap Regulations i 47. FINAL STRUCTURE & BUILDING � 48. Special Requirements Completed 49. Elearic Release to Edison �J (/, 50. Gas Release to Southem California Gas Co !�� . • 51. CERTIFICATE OF OCCUPANCY �" No. Date `� - � J CI7`YOF COSTA nnESA+ .CONSTRUCTION PERMIT "ProjectAddress � z�41 Fremont 'Lane , Applicant's Mailing Address . Sdme Owner's Name J02 Moreno � � � ano�e Address � 2741 Fremont� Lane - 'Arch/En9. ' License No. Address � ' Convactor'sName A11 Amaricdn P1llTR1]��e 541=975 Addresslmailing) 3t7%% 'NOYtYl Hesgerian.iaay, #101 City License No. � �Q9 � 9 � 'UCENSED CONTRACTOR DECLARATION � , I herebY af(irm that I am licensetl untler provi5ion5 ot Charter 9(comm¢ncin9' with seclion 7000) ot Division ] of.the Business antl Protessions Cotle, antl my IiCense is in full force antl effecL � A ., n... � , �" oate �i / J�., u /�x _F+ Signature �l,kL/n C� �pJLC�/ . ?I WORKERS' COMPENSATION DE RATION I hereby affirm that I have a certific e of consent to ielf-insure or a certificate of Worke�s' Compensation' InSurance, or a cer[ifietl.cOpy thereot (Settion _ 3800, Lab. ��`OZ�LSZ9 Zenith Iris. Policy No. V Company �Certified copy is hereby fumishetl. Cer �tietl'cop s filetl with th¢ cit 'Idng Divi. io Date AOP��ant - EXEM TION��RKERS' COM NSATION DECLARATION (Thissection need mt be com0�etetl it permit is tor one huntltetl (E300) or less). I certify tbat in the performance of th¢ work for whith this perm�t is i55uetl, I shall not employ any pe�son in any manne� so as to become subject to tM1e Workers' Compensation Laws of California. . Date $i9natur¢ ' ' 'NOTICE: If, atter making this tlecla�ation, you shoultl become subject to the . Workers' Compensation provisions o( the Labor Code, you must forthwi[h comply with such provisions or this permi[ shall bE tleemetl revoketl. CONSTRUCTION IENDING AGENCV ' � 1 herety aftirm that there iz a construction lentlin9 agency for the'performance of [he work for which this pe�mit is issuetl (Section 3097 Civ. C.) , Lender's -Name Lentler's Atltlress � - � OWNER BUILDEH bECLARATION ' � � I hereby affirm that I am exempt from the Contractor's License Law (or th¢ � following reason (Section 7031.5 Business antl Professional Cotle: Any ciry or county whith requires a permit to construct, alter, improve, tlemolish o� �epai� - any sGucture, prior to its issuance, also requires the.applicant forsuch permit to file a signetl statement that he/she is licensetl pursuant to tM1e provisions�of �the Contractor's License Law (Chapter 9(commencing wi[h Section 7000) of Division 3 ot the Business antl Professions Cotle) or tha[ be/she �is exempt the�efrom antl the basis for tM1e alle9etl ex¢mptiOn. Any violation of Section 7031.5 by any applicant tor �a permit subjects the applicant to a civll eenalty ot not more than five huntlretl tlollars ($500�. � , , LJ I, as owner ot the property or my employees with wa9es as.their sole com0ensation, will tlo the work, antl the structure I5 not intentletl or offeretl for sale (Section ]044, Business antl Professional Cotle: The Gont�acto�'S' License Law tloes not apply to an owner ot a property wno builtls or improves thereon, antl who tloes Such wo�k him5el(/herselt or tM1�ough his or her own employee5, provitletl that such improvements ate not intentletl or otte�ed tor Sale. If, however, the bulltling or Improvement is soltl within one year of com- pletian, tM1e,owner will have the burtlen of p�oving he/she tlitl not builtl o� im- prove for the purpose ot sale). � � ❑ I as owner of the property, am exclusively contracting ith licensetl <on- tractorsto conslructthe O�oject (Seciion ]044, Business antl Profes5ions Cotle: The Contractor's License Law tloes.not apply to an owner of property who builtls or imoroves thereon, antl wno conera<Is for such,projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Wo�ke�'S Compen5ation in5urance shoultl be provltletl to me. ❑ I am exempt untler Section B. & P. G. �or this �eason• /i� n[ to fill in all 50aees except t�osa within �eavy bortler lines antl sign atl apurovriate tlectaralions. TYPEOFCONSTRUCTION '�LINEW UADD �ALTEf3ATION IJREPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � ' p� p # � _ � DESCRIPTION OF WORK/USE OF BLDG. RPS1C12rit.131 installti '�� - S MainBuildin9:' E TVPEOFPERMIT GRADING�r FOUNDATION � STRVCTURAL r T Front ' ❑ TENANT ❑ ELECTRICAL'LdPLUMBING. ❑ MECHANICAL , A Rear ' � ❑ �OTHER -' � - . PROJEC7 DESCRIPTION 5Q. FT. � oCCUVArvGv C Right K Left CONSTRUCTIONTVPE � VALUATION$ � -$ ZONE GRADING W. VDS. � ' ACRES 'Ping. Ref. # Remarks: ' � " , - Planning Notes: Sink Preventer Irrigation Dishwasher Drinking Fountains Floor Drains - Floor Sinks Gas Service � Outlets I ntercepmrs P-Trap _ ' • � - ' RoofDrains• . . � Reinspection Fee $15 Boiler Duct-UnderGround Duct-Structural • ExhaustSystem L7 Multiple FirepVFact. Blt. ICBO # , I uwner - � Heating System & Duc•�� `�aertify that I-have�reatl this-application antl state that the above� ❑P100,OOOBTU 01 — -�is Correct. I agree to c Oly with all city antl county ortlinances', �� '�s relating to builai onstruction, and hereby authorize repre- � is city to nt upon the above-menUonetl properry for '. . �� ' � ' _ _ Date'=3/2� ` �v55� � Reinspection Fea �B4 White - Builtling: Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor � , a Showers Service Sink � � Sewer Cap Sewer Connection SolarCoilecrors� ' Solar Piping Solar Tank ' � Swimming Pool w/Spa Urinal Water Closet � Water Heater WaterService ' Auto-Wash . Issue Fae $ 3 Hood or Typel ❑ Canopy Typell ❑ � Fefrigeration System � � ❑aioo,aoo'sru ❑ioo,000eTu System Repair/Alteration FireDampeLi ' Registers � � $15 I� I Issua Fee � . Automatic Washer Construction Pole Sub. Cooking Unit � Dishwasher � � Dryers ❑Gas ❑Elec� Fan F,A.U. ' Fixtures � - - Device Boxes Outlets Switches Garbage Disposal. Generator �0-5 KW C 2��8 3�J��UC ,,�w�.�.�.�001� 1L Zane Accessory Building: . ELECTRICAL Transformer ❑ 15-50 KW ' ❑ 50+KW Meter �up to 100 amps Meter ❑over100amps Sub Panel Motors 00.1 HP �1 %- 8 ' InaSolar �9-15 HP �16-15+ Microwave--' � - -- Pole Light . Range ' ', Standing Section� KW Trash Compactor 1 — Rainspection'Fee � $15 Issue Fee � DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approvad 8y � Building Approved By � P �� $ 3 i Z O N I. � N G R E � M _ T S FEES . SUMMARV OF FEES , � � BUILDING PERMIT $� � : SMIP $- PLAN CHECK � $; ' PERMIT � � • i PWMBING $ S F�O � ISSUANCE ' $ , PLANCHECK 25% $� ENERGVP.C; $ E�ECTRICAL • $� � ' ��GRADING $ PLAN CHECK�50% $� � � � MICROFILM $�-��-y}�#/}-- MECHANICAL $� � � TOTALFEE; $�.iC—._ P�AN CHECK 25% $:. "" � � � � I � , • � , CONSTRUCTION AND PLANNING . L APPROVALS Permit # _ 1. Temporary Electrical Service or Pole _ r � 2. Soil Pipe-Undrgrnd. � . 3. Electrical Conduit Utility-Undrgrnd. � � 4. Electrical Conduit-Undrgrnd. � - � 5. Steel Reinforcement "6. Electrical UFER Grnd. 7. Footings � ' 8. Foundation - . � - 9. Water Pipe-Undrgrnd. � 10. Structural Floor System � �,11. Property Sewer Line & House Connection 12. Sewer Cap , 13. Roof Drains " 14. Rough Plumbing 15. Rough Electrical-Conduit . . 16. Rough Electric Wiring •17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20: Rough�Factory Fireplace 21. �Ducts, in Structure . � 22. Ducts, Ventilating � 23. Gas Pi{ie-Rough & Test 24. Roof Framing . 25. Roof Sheathing : 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation � 30. Drywall Nailing 31. Plaster Brown Coat - 32. Electrical Power Meter-Final � 33. Final Electric � 34. Final Fleating & Air Conditioning 35. Final Gas Pipe-Test . � 36. Hood or Canopy 37. Final Factory Fireplace . 38. Final Plumbing , , 39. Water Service-Final ' � 40. Gas Seniice-Final � 47. Solar pomestic-Final ��:j . 42. Backflow Preventer ' 43. Backflow Irrigation' ' 44. Landscape Irrigation System' � 45. Sound Attenuation 46. Handicap Regulations '„ a ^ 47. FINALSTRUCTURE&�BUILDING 48. Special Requirements Corripleted ..� � 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co ` 51. CERTIFICATE OF OCCUPANCY No. " Date Dafe POOI �PA Inspector p�ppROVALS Permit # Date � . 52. Pool & Equipment Location . - 53. Steel Reinforcement � 54. Forms 55. Electrical Bonding ' � 56. Rough Plumbing & Pressure Test - � 57. APPROVAL TO COVER-GUNiTE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. � 61. APPROVAL TO DECK 62. Backwash & Receptor-Final � 63. Heater & Vent-Final " 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final � 67. Fencing & Access Approval � _ � • 68. APPROVED FOR PLASTERING � - - 69. POOL/SPA SYSTEMS FINAL FIRE DEPT. REQUIREMENT ' APPROVALS Permit# ' 70. Underground Hydro- 71. Product Piping � Gas ❑ Oil 72t Underground Flush - 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical � � � � 76. Dry Standpipe , 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL � HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: /s-C/-fl�, i ds-Yi nn,� il•�u i� 0 � Applicant to till in ali spaces exceot inose within heavy eortler Iines ana sign all aporopriate aeclaretions. ITY OF COSTA MESA CONST.RUCTION PERMIT PERMHf Nfl.. _ _� i TRACT NO. LOT NO.� i�rvi7 Nn � a�oj c[Address 2�4� D433K34D6�S Fremont Ln. .'Appiiwnt;s Mailing'Address 126 (:ommer� i a l lh'ay C.M.� 9262 Owner'sName Inaanh Mt�rano phone � 545-635 Address � z�4� Fremont Ln., C,M, a ' Arch/Eng. License No. Address Contractor's Name Crank Bf O5. ROOf 1 flg phone �48-556 Addresslmailingl 126.Commercial� Way, C.M. 92627 City License No. 005993 LICENSED CONTRACTOR DECLAf1ATION ' I-hereby atfirm tnat I am licensetl untler provisions oi Charter 9(commencing !� with section ]000) of Division 3 of the Business antl Professians Cotle, antl `V my license is in /ull fo�ce antl effect. , �icense ciass — �mense io. 408fi77 oate 6/ 1 /89 signature WORKERS' COMPENSATION DE ION � `ereby attirm tnat I have a certitic of consent to self-insure or a certificate � Workers' Compensation Ins ce, or a certitied coOY tnereof (Section oo, �ab. c�85/224-89 State Fund �' Policy No. Company ❑ Certitietl copy is hereby furnishetl. ( � m' �[eertlfiecLcq�y/j�AleC wAPPM1c ^iLy B' i on. b/ tlN � ' EXEMPTION FROM WORKERS' CO PEN ION DEGLARATION (Thissection neetl not be completetl if the rmit isfor one huntlretl ($300) or ' less). + I certify.thai in the performance o( th¢ wqi)lc for which this p¢rm�t is is5uetl, 1 shall not employ any person in any m 6$er so as to become subject to the ' t Workers' Compensation Laws o( Califo � �Date Si9nature NOTICE: If, afte� making this tlecl ion, you Shoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with suth provisions or'thi5 pe�mit sball be tleemetl revoketl. �- CONSTRVCTION LENDING AGENCV ' I M1ereby-atfirm that thEre is a const�uction lending agency for the pe�fo�mance of the work tor wltich this permit is issued (Section 309] Civ. C.) l.entler'S Name /-' Lentler's AtlOreSs , OWNER BUIL�EH OECLARATION - .I hereby affirm that I%2m exempt from the Contractor's License Law.for [he followin9 reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires'a permit to construct, alte�, improve, tlemolish or repait any st�ucture, prior [b%it5-issuance, also requires Ihe applicant for such permit to fiie a signetl statement that he/sM1e is licensetl pursuan[ to [he p�ovi5ions of the Contractor'S License Law (Chapter 9(commencing with Section ]000) of nivision�3 ot tM1e Business antl Professions Cotle) or that he/she is ezempt =refrom and the basis for Ihe alleqetl exemption. Any violation of Section 31.5 by any appllcan[ for a permit subjects the applicant to a civil ;nalty of not more [M1an five huntlretl tlollars ($500). ❑ I, as owner of the property or my employees with wages as their sole com0ensation, will tlo the work, antl the sVucture is not intentletl or offeretl fo� sale (Section ]044, Business antl PrOfessianal Cotle: The ConfractoYs License Law tloes not apply to an owner of a property wna builtls-or improves tbereon, antl who does such work nimseli/herself or tnrou9h his or her own employees, provitletl that such improvements a�e not intentletl or offeretl (o� sale. If, however, the builtling or improvement is soltl witM1in onc year of <om- pletion, the owner will have the bu�tlen of proving he/sne tl10 not builtl or im- prova for tlte purpose of 5ale). ❑ I, as owner of the property, am exclusively conGacting with licensetl con- tractorsto mnstruct the project (Section ]064, Business antl Profe55ion5 Cotle: The Contractor'S License Law tloes not apply to an.owner of property who Euilds or improves Mereon; antl who �ontracts for such projects with a con- tractor(s1 iicense pursuant to the contractor's �icense Law). I am aware tnat proof of IM1eir Worker'S Compensation insurance Shoultl be provitletl to me. ❑ I am exempt untler Section B. & P, C. for this reason Date certify n is cc _ Owner liave reatl this application antl state that the above pgree to comply wi[h all city antl county ortlinances o b Itling conSVuction, antl hereby authoriie repre- �nter u on the above-mentionetl property for oa�. 6/ 1 /89 )F CONSTRUC710N 'LJ rvEw � LJ a.Do ❑ TEftATION, LJ REPAIR LJ GONVERSION ❑ DEMOLISH OTHER A p# DESCRIPTION OF WORK/USE OF BLDG.RP.moVP PX i�t I f19 fosk .r��{_, �' - � 2-30# 8 CLASS A f i ber I ass sh i n I es. New meta I. s Main Building: TVPEOF�pERMIT GRADING ❑.FOUNDATION ❑STRVCTURAL T Ftont ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear y 'O OTHER . I A ' ;PROJECT DESCRIPTION 5q. FT. � occuParvcv 51 �q e� K Right - �,CONSTRUCTIONTVPE residential VALUATION$ 4•�29.QU g Left ' � rZONE � �GRA�ING CU. VDS. ACRES p�ng. Ref. # � Remarks: � Planning Notes:� . i . - Sink Irrigation ing Fountains Drains Gas Service Outlets Interceptors Kitchen Sink "' Lavatories � ] Roof Drains Reinspection Fee � §15 Duct-UnderGround Duct � Struciural Duct - Ventilating , Exhaust System ❑ Multiple Firepl/FacL BIL ICBO # Heating System & Ducting ❑0-100,000 BTU 0100,000 � �„_.n. _ _ _ _ _ � i heinspection Fee � $75 _�""��o:_Canary - Applican[; Pink � Accounting; Goltlenrotl - Assesm� —� PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collecmrs � - Solar Piping � Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater � Water Service A uto-W ash Laundry Treys laue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,000 BTU ❑100,000 BT System Repair/Alteration Fiie Dampers Regis[ers � Ixsue Fee FEES $ 3 FEES $ 3 I � � � ' � ' . � Zone ' . �Accessory Building:� � ELECTRICAL Automatic Washer � Consvuction Pole$ub. Cooking Unit • � ' ' �ishwasher' ' Dryers ❑Gas ❑Electric . Fan F.A.LL ' FixtUf25 Device Bozes • Outlets Switches Garbage Disposal Generaror �0-5 KW �5-15 KW � Z O - N 1 - - ' . N � . G R ./Provided � E Q M T 5 . FEES _ Transformer ❑ 15-50 KW � - ' �' ❑ 50+KW � Meter' �up to 100 amps ' Meter ❑over.100amps ' Sub Panel Motors OO-7 HP O1'/:- 8 Inc.Solar �9-15 HP �16-15+ Pole Light aign ^ Standing Sections Trash Compactor � Reinspection Fee �$15 � � Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By 8uilding Approved By Application Issuad By /� $ � SUry/�p,� �' OF FEES � � � BUILDWG PERMIT $ I �� ' SMIP $ :� �, PLAN CHECK $ PERMIT � - PWMBING $� � � 'ISSUdNCE $ � I • PLANCHECK 25% 3 ENERGV.P.C. $.�� ' �- II ELECTRICAL $� :GRADING _ S ' PLAN CHECK 50% $� MICROFI LM .$'�^7� �/� - MECHANICAL $ TOTAL FEE $ � PLAN CHECK 25% $ " � . r,� (�un3€��a3-Uao3440a TL"�T � ;;,5c, DA?F: ,^,blil�.e9 TrM.. n�_ .. CONSTRUCTION AND;PLANNING POOL & SPA . „ Date , Inspector + Date Inspector APPROVALS .Permit,#" . APPROVALS Permit�r` , 1?„Temporary Ele�trical Service or Pole ' S2. Pool & Equipment Location' � V 2. Soil Pipe-Undrgrnd. � 53. Steel Reintorcement ' 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. 8. Foundation �� 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undfgmd� :' _. 60. .Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' 61. APPROVALTO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � 72. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final . 15. Rough Electrical-Conduit 66. Soler SyStem-Final 16. Rough Electric Wiring � 67. Fencing & Access Approval ' � � 17. Rough Wiring Sig� - 68. APPROVED FOR PLASTERING � ' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & A�r Conditio�ing FIRE DEPT. REQUIREMENT 20.' Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Undergraund Hydro • 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil , 23. Gas Pipe-Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd.StorageTank OGas ❑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 r� 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED _ �;�, 33. Final Electric � Notes: > ' (J 06 O 34. Final Heating & Air Conditioning � � � � �� O 35. Final Gas Pipe-Test - � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Fihal � . 40. Gas Service-Final . - 41 . Solar pomestic-Final : ' i 42. Backflow Preventer � � ' ' 43. Backflow Irrigation � � � � i 44. Landscape Irriqation System � .° . � 45. Sound Attenuation 46. Handicap Regulations . � � 47. FINAL STRUCTURE & BUILDING ` a� �y � ' � , 48..Special Requirements Completed � 49. Electric Release to Edison _ - 50. Gas Release to Souihern California Gas Co . � - 51. CERTIFICATE pF OCCUPANCY . �`� o. ' Date • i • .` • \ •. •> - Lot 30 Tract 4285 P1a��A � E�E V E D .,,. ''r''r--,��;G.)�ri �Q.a.v. S��SE�6" , COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 977 �o�A MeeA. �.�ao��A � � CITY OF COSTA MESA Fo� Applieanf fo Fill In Complefely APPLICATION FOR PERMIT COSTA MESA. CALIFORNIA esa.Del Mar Develonme� ��TM Corona del Mar ARr""�HCT OA 'NEER PS3CC0 C noowwae 3800 E. COHSt TEL. NO. TEL. BUILDING ADDRE55 3800 E. Coast Hi hwa cirr Corona del MaY zoNe iicTNo. 98808-SB-1 No: Oriole 3-4220 oescn` SIZE No. of BIDGe. OF LOT 6603 S F NOW ON LM none A P � USE oF None YARD EXI6TING BLDG. pppg� SeTBACK LINC PROM � � «�'�T cENTeR oP BTRaer 4S REAR YARD ZS FRON SIDE YARD I LEFT S� I RIGNT S� 3�� R. SIC DESCRIPTION OF WORK L SIC NE' I X II ALTERATION I II ADDITION I REAR REPAIR I IIMOVING I IIDEMOLISH I BYPRi SIZE'NG 61�9��X53� ROOMS � STORIE61 EXTERIOR WALL StllCCO ROOF 4700d - COVERING GOVERING shin LeS USE OF BUILDING AND WORK TO BE PBRFORME� BUILDING For O#Iee Use Only, HECEIPT NO. tPHRW1bN0.�'� BY COSTA ZONING INO. OP `�UBH OP N6W .. �L.V��('�� PLANB { BUILD�NO �� —`� �17_ .; L NC� La *-:.�D YN6 6T.1 � �_ � s �y � EO 411� A_ rea. � � 5 S F etc., Area. 68 S F 1 HBP6BY ACIWOWLEDOH THAT 1 XAYH RGD T119 MPLIGTION THE AMOUM BXOWN UNDER VALl1ATION 1! POR TX8 AND BTATE TXAT THC ABOVE i6 GORRECT AND I16R86 TO CON• PUflPOBE OR E6TABL19HIN0 A PERMIT P6E ONLY. PLY WITH ALL CITY OIiDiNANCEe ANO BTATB U1W8 REGULATNO eu1tDlNa coNBrnUCnON. � VALUATION V SIGNATURE OF e a. Del ar Develo ID2Rt CO. PERMIT FEE $ { d / PERMITfE By: $ IB��L�LJ.00 pLANCHECK $ /�J AUTHORIZED _ , _____ ___ _ �j],OO F 0 4 - � �'�.'%'•rir� COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING �,�` F2.�MOnI � LAJ ADDRESS OWNER fj Q� NO MAI� q ADDRESS F/�L Od.J ! L� ` TEL./'�� CITV D T t. '• `•� •,. 'NOJ TJ-'G3S! CANSTFUCTION - LENDER � \ BftANCH'.. . . . —.;' , . ._ . .a . 's"+ i ,. � �.. . \: . .' � ADDRESS`2. . - � _�. . A�ORESS � CONTRACTOFi ADDRESS%. ( ; RE' E 'V V, �A •E RECBV Dv `Ay• L`u•,, I O TL D TEI�$UE i � A.P. NO. � � —O BUILDING ADDRESS p� 7�� F,�E'�1Lo�uT 'L / ' ,•TRACTy� S .�^LOT_�O \ BLOCK N W ADD ALTER R P I V �. _. .`\'� . . . �'. '^, A f.� FIRE ' � � ' ZONE T i APPROVED i A. �. r i .r7EL i�E� � ` - ' EL. s �. 'ZONE / NO.OF '. USEOF,N �/ �(/ 0 NO. 3�� ! PLAN$ BUILDINCt � U��• •.1 , r .� F STATE ' p p CITV �'ARDS APPROVED VARDS APP OV � LIQ NO. 3 c.p ps� - LIC. NO. � �� - '` MAIN BUIIDIN '� ' AC ESSORV UIL (y SIZE � NO.OF BLDGS. (FROM C/l TR 0. pF LOT � NOW ON LOT FFONT F. FT. � USE OF � /¢ / EXISfING BLDG. �t% LE G ��«� SI FT. l/ Fr. � � FSeparate permits are required for L SIDE FT.� FT. electriq pl�mbing and heating work. � � REAR FT. FT. � USE OF BUILDING AND W O BE PERFORMEO DISTANCE BET. BET, MAIN & MAIN BLDGS. ACCESS. BL7GS. ¢ O ^ O E� :� NLGOSU [—�• � C URP.�p APPROVED � -/ � APP ED �., /1 � � W � I hareby acknowletlga that I have reatl this application and stata O p: that the above information is corteci and agree to comply with �^ all laws regulating building construction, antl I shall not employ z any person in violation �of the workman's compensation laws of W the State ot California. �/ /�� 3 I heraby certify xhat I am properly licensetl as a contractor untler SQ. FT. �/"�(,� � tha State ot California Business antl P�ofessions Code, Dlvision 3, THE AMOUNT SHOWN UNDER VALUATION Chapter 9, antl that such licenses are in full force and eftact, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE am ezempt from the provisions ot the St e of C lifornia Business VALUATION PERMIT FEE $ antl Professions Code, Divi on 3, hap �. Signature of //JJIj� �, � P AN CHECK $ / Pelmlttee � ,5 ` /L[Y/1 TAX $ ��fici V Authorizetl Agent � TOTAL PAID $ n ro u' 7 m e a N M m 0 � U P 0 .- , � . \. . �. � . . ;� �. � C:_ - .,' GGC/fZ�9�! i%�° //-��d�o��Gc/ Za ��zd'7 ..-P/�G2eGi�/ //�Zz �jr/zGT //� �+�(o7�ciYc� �T� /!�Fl�,�� c:Pi,�'!�(ii`D'Cc ' . / � �%� �-p"� .�`t'C(.. � �E�Gc / �r�0 � � . . .. .Gvz: :.i%�6�_ �� ' i�o � /�° . `�o �2�ec�% GUzl�oz�Gc ��'`r�—e _ - � : ... ', . t . -.. , �. _:, �.'`','..s