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Home My WebLink About2267 FOUNTAIN WAY - Building Permits� c CITY OF COSTA MESA BI/ILDIN6 pIVIS10N DEVELOPMENT SERVICES DEPARTMENT PERMIT 898-01211 70 PERMIT NUMBER (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2267 E FOUNTAIN WY Suite: Vicinity: Parcel Nunmber: 93074038 App�icant: FONTAINE, JIM Address: Owner: J(:F1KVt Address ASSOCIAT 2417 E CO i.in %SCHROE . � � %f�:'. ontractor. �FONSAIP Address: �/23075DEL !�j� � �i �� /�� /� LAGUNA'H : �� .�`%% ii�i _' �AGdress � i% � d` ��/� � �' �� , 1 ,' t �R - � i r i � !" � �- _ �' � .. � � BUILDING PERMIT Status: ISSUED �'a 6 Applied: 07/07/1998 Issued: 07/07/7998 Zoning: Phone: -- ZiP;:.� �, , __ _ _'- _ ERWILSON" X ;� .__.__ _` '` ' � �/% � ,- '' ' � f - , r- - � /�� j / � V � . i ' -1 � �� - ��; �A � � , �� T FNVY STE' \ �` Phone _ . /i � .\^. , ; �� \ R CO �' � � J . . -'- Lp � 92625 �� / ( r � ' i \ \ \ V A � � - . . , � -._"��.-�. 'l. �� `` � \ `�� AND ASS CIATES � � J � � � � � � V � ;,., �� -�• �•�_��_ i / ��\ ,GO#D2 ;% \�.;� -� �� \�� \ j% j� Phone: 714-598-8360 \�l\� ✓\`� / �, ��. SIC Zip: 92653 �� \,/,/ ��`� � License:�'708917 �� j � �. � �, (�� ' �...�. ;, �: _ '� ��•,; h�Y ! . � `�'��„` ` � " r-� ,� 'i'Phone�irv'� t � � � �� f- �. �� \ �1� 1 i. � Y Zip r� .. .i ; � �''% �_�-' l� �'License . - - - � "_ t:`-1 . �,,r � .,�� ,�\ � -�.,., ... _ �' , , . �� / ♦ ;,{; 'i��i�_ YO AND REROOF.2000SF �. . J -.. ` . � � PJan Check : ��,'�, $0.00 �, `��' Perm'it: i ,,'n, $9975 �SMIP Res ,; $0.50 �SMIP Com � r-$0.00 '� �, Other � ` ; `$0.00 Inspe`ction:,., ��`$0.00 ,�_ . , � �Total \ ; $100.2: \\ � � . \' �\��, SCOPE OF PERMIT FOURPLEX W/ BUILT UP 2267, 2269,2271 AND2273. �1 . _v. _ � t�Si.i>l 11n`".� , ` , �� i . .:-;,� _ � �,. FEE SUMMARY .� ..<.:'..; . ; \ -�: Calc Valuation: � "'"� ,y rt/� Claimed Valuation: ' : � 1x '�� _t {d JJI r__ .. .-+..1-2:3�'�- / � _ � J Fn 1 a � . � .�� ^� � ,' ''�—�,%_ �." . .. �'. � �� `' �VA�� ': �PLAN _� .AAA�� `Y'y�� n . �� r V A� ,� AVA ��-' �"� �� SETBACKS; � �/:�� \\�.�`� '= 2� �r, �;� MAIN STRUCTURE Front'= 0� 0' ��'Rear� 0 0'�,�'� 5 : /,�%'� � � \�� ` ACCESSORY Front 0-0� �/'�� Rear 0-0 - '�? i � !!.� ,,�� - - - < �� l � / " �. �,%�i � � -Left' 0. 0 , � `�.Left` 0 0' �� . ,.,: .. � ._ ,- . . PARKWG Ezistina:, ; 0. � �' Reauired' �� ,0� _� f -- � �Proposed: ._ 0, '- � , //� `,; , , �, � c%, �. $5,000.00� $s,000.00 ' t =// ' �� I �i . / ' /-�' %i '� � % 6 . - y� ��-� /,�i; Ri ht -0-�0 `� ' � T ; 9 � L��; i �/ Right � � 0- 0 ,' ;'� / NOTES: '- � _ � . _ A �. : . . � - _ 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. ' INSPEC110NS: In order for the work aulhorized under this permit to be considered legal, such woiic must comply with all applicable codes, and all requlred Inspeetlons and flnel approval must be obtained. Failure to obtain inspections and final appioval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 i� WORKERS' COMPENSATION DECLARATION: ' 1 hereby effirtn under penelry of per�ury ane at the tollowing Eecleretions: ' , , ❑ I heve and wlll maintein a certlficete of consent to setl-Insure for workers' compensation, es provlded far hy sectlon 3700 of ihe Lebor Code, for ihe pertormence o1 ihe work for which this pertnit Is luued. ❑ I have and will maintein workers' campenselion insurence, as required by section 3700 of ihe LebOr Code, �or ihe perFortnence of the work for which �his permll Is issued. My workers' compensetlon Insurance cartier end policy number ere: Certierr. / , Pdi�y Number. � 1 cenify that In the peA9r1�ance of iha work for which this pertnit is issued, I shall not employ eny person in eny menner so es to become sub�ect to the woAcers' compensetion laws ot p fifomia and egree det1f I should becoma sub�ect lo Ihe workers' campensation proNsions ot Sectlon 3700 of the LeCor Cotle, I ahell forthwlth wmpry with these pm t ao �-/ �Applicant Slgneture: Date: � � � ^ �a WAfiNiNG FAILURE T� WORKERS' COAIPENSATON COVERAGE IS UNLAWFUL AND SIULL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVII FlNES UP TO ONE HUNDRED T/KKISAND�OLJ.ARE 100,000),INADOITIqJTOTHEGUSTOFOOMPENSATION,UAMFGESPSPROVIDEDWRINSECfION3lOfiOFTHEUBORODOE,INfEREST,rWDATTORNEI^SFEES. � LICENSED CONTRACTORS DECLARATION: I �ereby eitirtn ihet I em licens� unQsr pr� ons f Cha (commendng with Section 7000) ot Divlslon 3 of Ne Business end Professlons Code, and my Ilcense is in full brce anC eHect. LJc. N �. Class M L�� Contradafs Signeture: _T� �� Dete: 7— 7'-- 7� CONSTRUCTION LENDING AGENCY: ❑ I �ereby atfirtn that thare is a construction lentling agenq for the pertortnanca of Ihe wark for which Uiis pertnll is issuad. (Sec. 3097, Clvll Coda). Lenders Neme: Lentlers Atldress: SignaNre: Date: OWNER-BUILDER DECLAPATIONS: I hereby ettirtn that under penfllry ot per�ury Net I am EXEMPT FROM THE CONTRACTORS IICENSE LAW tor the following reason (Sec. 7031.5, Buslness end Protesslons Code: Any ciry or crounry w�ich requires a pertnit to consiruct, elter, Improve, demolish, or repelr eny siructure, pdor to its Issuance, elso requlres ihe epplicant for such pertnit to file a sipned stetement t�at he or she is licensed pursuant to the proNsions of the Cantractars License Lew (Chepter 9(commencing wit� Sectlon 7000) of Division 3 of Ihe Business and Professions Code) or that he or she is exempt therefrom entl the basis tor the elleged esemptlon. My ddetion W Section 7031.5 by any eppliwnt for e pertnit subJects Ihe epplicant to e civil penelry ot not more ihen five hundred dollars (5500)J: ❑ I, es owner ot t�e property. or my employees wlth wages es thelr sole campensetlon, WILL DO THE WORK, end the siructure Is not intended or ottere7 for cale (Sec. 7044, euslness antl Professions Code: The Contractors Licanse Lew does not eppry to en owner of property who �ullds or Improves thereon, end who Ooes such work himseli or herself or through hls or her own employees, Orovlded Ihat such Improvements ere nat IntentleA or offered for sale. II, however, the Eulltling or Improvement Is soltl within one yeer ol completlon, the owner-bulltler wlll have Iha burtlen af proving ihet he or she ditl not build or Improve far purpose of sele.�. ❑ I, es owner of ihe pmperty, flm EXCLUSIVELV CONTBACTNG WRH LICENSED CONTRACTORS lo construd the pro�ect (Sec. 7044, Business anC Protessions Cotle: The contrectors LJcense Lew does not epply to en owner ot properry who builOs or improves thereon, end who wntracts tor such pro�ec� wilh e contrector(s) license pursuent to the Contrectors License LewsJ. ❑ I am exempt untler sec. Signeture: Owner ID verifed by drivers license. O Yes ❑ No Business and Professions Code tar this reason: Vedfication of Ownership by (type of doamenL i.e. - properry tae bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATON: Drivels License No. Date: Ezpires: ❑ I hereby certly that no excevatlon Ove (5) ar more teet in depih into whlch e person is reqWred to descend, wlll �e matle in connectlon wlth work euthatlzetl by this pertnit, and that no bullding strudure, sceftolding, felsework, or demolitlon or Gismentlinp thereof, wlll De more then thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tiile 8, Cfllifomie Atlministrelive Cade). ❑ As owner-builtler, I wlll not employ enyone to tlo work w�ich would requlre e pertnll irom Ihe Dlvislon at IntlusMel Sefery, es notetl ebove, unless such person has e permit to do such work irom t�e tlivision. SlgneNre: ' Dete: Division ai Industrial Satery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTFiORQATiON OF ENTAV: I certily under penalry ot perjury Iha� I have read this epplication antl state Ihet Ihe Inlortnatlon given is correct. 1 egree to comply wit� all stete laws and ciry ordinances releting to building constructlon, and authorize representetives of the Ciry ot Cos1a Mesa ro enter upon the eDove-descdbeC property for inspeclio�puryos`es. I egrea not to acupY or allaw occupency ot eny building authodzed by this permlt until flnal inspection. CQOE � INSPECiiONME 1fi16 Fixed System Flnel Fire Prevention 1266 Pool Spa Flnal ' 200 Final Re-Rooi 201 Finel BIxWReteining Wall 202 Flnel Fectory Fire Place 203 Final Sign 204 Finel Demolition 2646d8 �g �� /1LlL � Date � �— %�� Date COOE� INSPERIONTYPE 206 Finel Mechenical �208 Finel Plumbing ' 210 Finel Electrlcal 212 Final Fire Prevention 220 Flnel Plenning Approvel 222 Flnal Site 250 Flnal Bullding/Occupency OAg . VIfIDlLS �� ApPlican� to fill in all sDaces excepl those within heavy borGer Iines anG si9n all apDropriate Geelarations. CI"fY OF COSTA MESA CONSTRUCTION PERMIT ProjectAddress Z267�,�.�69�2z��zz7� Fori�rainrI�/Jai�AST ApplicanYsMailingAddress �� n�*�7J CiQC/_C IT� !3- Owner's Name ��' ��'6C Phone Address Arch/En9. License No. Address /1, ConVacmr'sNam �hone 4-ry-7�36� Addresslmailing) ��-7�� T-1nG�.P i-i�� City License No. (1 O�33 i LICENSED CONTRACTOR DECIARATION I hlreby a(fi�m Ihat I am licensetl untle� provi5ion5 of Charter 9(commenGinq with Section ]000) ot DlviSion 3 af the Business antl Professions Cotle, antl my license is In full for e antl eftett. l.icense Class �� Li nse o. � Date Si9nature WOH ERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of mnsent to self-insure or a tertificate ! Workers' Compensztion Insurance, or a certifietl copy thereot (Section �aoo. iao. �� ;�0 �F5/�a4T Pnolicy No. � Company LJ Certifietl Copy15 filetlbwithrthehctly Builtling v�y`)� %�/ Date�=�=,�� APpllcant � ///�/ L/K�lG , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Tnissection neetl not be mmpletetl i/ Ihe permit is fot on¢ huntlretl ($100) ov less). I certity tnat in th¢ Performance of the work for which thi5 perm�t is issuetl, I sM1all not employ any person in any manner so az to become subject [o the Workers' Compensation Laws of California. �ate Signature NOTICE: If, after making this tleclaration, you snoultl become subje<i to the Workers' Compensation provislons of lhe Labor Cotle, y0u must forthwith comply with Such O�ovisions o� th15 p¢rml[ zhall b¢ tleemetl �evoketl. CONSTRUCTION LENDING HGENCV 1 hereby afFlrm that there is a mnstruction Ientlinq agency for tne pertormance of tne work far which thiz permit is issuetl (Section 309� Civ. C.) Lentler's Name Lentler's Atltlress OWNER BVILDER DECLARATIOfJ ' 1 hereby a(ilrm that 1 am exempt irom the Contractor's License L.aw for the f011owing reasOn (Section �031.5 Business dntl Proiesslonal Cotl¢: Any city or county which roQuires a permit to ConStruct, al[er, imprOve, tlemolisb o� r¢pair any s[rucWre, prior to its is5uan<e, also reqWres the applicant Por such permit t0 file a sign¢tl 5[a[ement that he/she Is IIC¢n5etl pw5uant to ih¢ prOvisiOns of the Contractor's License I�w (Chap[er 9(commencing witb Seclion 7000) of Olvision 3 of [he Business antl Profes5ion5 Cotle) or tna[ he/she is exempt hereirom antl tha basis for tne allegetl exemptlon. Any violation of $ectlon '031.5 by any applicant for a permit sublects the applicant lo a civil ��enalty of not more tban five huntlretl tlollars (y500). I, as owner of the property or my emplOye¢s witb wagei as [hei� sola COTpensation, will ao the work, antl ihe SVu<turc is not fnten�etl o� of(e�etl for sale (SeCtion 7044, BUsiness antl Professional COtle: Tha ConirdciOr's License l.aw tloes not aOPly to an owner o1 a property who builtls or improves tnaraon, antl who tloes such work himsel//herself or through hls or her own ' employees, proviaetl tM1a[ zucM1 improvements are nol intentletl or offere� Po� sale. I(, however, the bulltling cr improvement i5 soltl within on0 yaar ot com- pletion, tne owner wi11 have the burtlen ot proving he/sh¢ tlitl not bulitl or im- �/Ove tor the pu�po5e of sale). ' LJ I, as owner oi the prooerey, am ezclusivery contractin9 with licensetl con- tractorsto construct the project (Section �044, Businessantl Professions Cotle: TM1e Con[racror's License l.aw doez mt apply to dn owner of pmperty who i, builtls or improves tnereon, antl wno contracts for such projects with a con- ' Vactor(SI licenze pursuant �to the Con[rac[orY �.icense Law). I am aware tha[ proof o/ tnei� Wo�ker's Compensation insurance ShOultl be prOvitletl to me. ❑ 1 am eaempt untler $eciion B. & P. C. tor [his rea5on Date Owner _ I hereby certify tnat I have reatl tnis information iz mrrect. I a9�ee to comp antl state laws relatin9 to builtling con sentatives o! tM1is ci y t en e upo� in5pec[ion p ose5. �J Signahre u Drivers' �icense or 55 � tlon antl state that the above all city antl county ortlinances �, antl he�eby authoriie repre- bove-menlionetl property for � Da[e 3-�-rfJ TVPE OF CONSTRUCTION lJ NEW lJ ADD Ll ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p.�6 DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi E TVPEOFPERMIT GRADING FOUNDATION STRVCTVRAL T Front ❑ TENANT ❑ E�ECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rea1 ❑ OTHER PROJECT DESCRIPTION 5�. Fr. � oCcuPANCV C Right K CONSTRUCTIONTYPE VALUATIONS g Left ZONE GRADINGCU.YDS. ACRES PIng.Ref.# Remarks: Planning Notes: Sink Preventer Irrigation Drinking Fountains � FIOOI �fdlfl5 Floor Sinks - Gas Service Outlets Interceptors Kitchen Sink - Lavatories P—Trap Roof Drains Reinspaction�Fea � $15 Boiler Duct � Under Ground Duct - S[ructural Duct - Ventilating Exhaust SYstem ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0� 100,000 BTU O 100,000 BT� Rainspectian Fee � $15 CMF 0865-46, rev. 4/84 Whi[e - Builtling: Canary - Appliwnt: Pink - Accounting: Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service � Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration Sys[em ❑o-ioo,000sru ❑ioo,000 System Repair/Alteration laue Fee Auromatic Washer Canstruction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00�5 KW OS-'. 8891 3/07/85 2ana Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over700amps Sub Panel Motors OOl HP O 1 X- 6 Inc. Solar �9-15 HP 016�15+ �Microwave ' Pole Light Range • � I Standing Sections 5 K� Trash COmpactor �°on TL FEES Z O N I N G R E Q M T S. � 3 I � Reinspectian fee $75 Issue Fee $ 3 FEES DEVELOPMENT SERVICES FEQUIREMENTS: Zoning Approved By Date Building Approved By ' Date Applitation laued By � � Dat� SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT P�UMBING $ .S , � ISSUANCE $ PLAN CHECK 25% $ ENERGY P.Q $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM 5 MECHANICAL $ TOTAL FEE $ S �� $ 3 PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POO. SPA • APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 7. 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 UFER 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, O 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 i 6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrica6T Bar Ceiling R 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 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 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing /�S L�� 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation . . 44. -Landscape Irrigation SYstem 45. Sound Attenuation � 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date : A�G SAFETY DEPAR.TMENT N° y� S J ` P. Box No. 317 Costa Ikesa, Calitornia Date •� �j K } �- f �'7 /4iG r1 CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No�/''r/'� Electrical Permit No Plumbing Permit No. Use of Buildin� =J u;.i �� .� r> >—" /f „ � The building located Legal Descrlption (See reverse side for Metes and Bounds) h-- been inspected and found to comply with the provisions of all City of Costa Mesa Ordin- ; applicable thereto for a Group �� Occupancy. {SSIJED TO: � City Buildine Ofiicial 1-'ai:� r� �i.n� r. •LT_ � � (Owner of B�ilding) By ' � � � . CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison Co. ❑ 3rd copy'—File, Form 208 SB P 1M 1-60 • _ .�•- 10��:� COSTA i�AESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA f0R APP[/CF1NT 70 f/LL /N COMPLETELY COSTA MESA, CALIFORNIA Paul E RHiertson Inc - • .��„� . - ..,f� _��i-a yv� i-�(��',;:CE DFaT. , ,,:�.. APPLICATION FOR PERMIT �� BUILDING e '''.— � fOR OFf/CE USE ONLY PECEIVED CITY C08C$ I'iCB8 NOF�� BUILDING ADDRESS ORC TENEER W. JoLdaA No`:C-1449 ADDRESS 771 West 19th floata i'JEBd FIRE ZONE P8u1 & RoheiteQ�No 1�060 BYPROVEO CONTRACTOR e,,,,wF« 771 West 19th Coeta Mesa :`I_�1.'��[ ] NO.OF BLDOS. � USE OF E%ISTING BLDG. SETD�GK LINE FFOM DESCRIPTION OF WORK NE' I g IIALTERATION I IIADDITION I REPAIR I IIMOVING I IIDEMOLISH I BUILDING�2 B SS NO.OF (� 'L SIZE ROOMS STORIES E%TERIOR WAS`11CC0 IROOF BU�LL U COVERING COVERING USE OF BUILOING AND WORK TO BE PERFORMED 1 HENEBY �CKNOWLEOGE TMAT I ANO STATE THAT THE ABOVE I6 pLY WITH /�LL LITY OHDINANCES BUILOING CONSTRUCTION. SIGNATIJRE OF PERMITTEE AUTHORIZED AGENT o�re issueo io -/G-: COSTA MESA. CALIFORNIA L/'i/ /tYDATE ��O/� ZONING NO. OF � I USE OF rvEW- / PLANB BUILUING u � � ICENTER LINE STJ FRONT � FT. R. SIDE � FT. `%- L.S�DE ,/ ' FT. REAR .� S - � I FT. ��- -- - -- -- THE AMOUNT BNOWN UNDER VPLURTION I8 FOH THE '�D AGHEE TO COM� pUFP08E OR EST18lISHING A PEFMIT FEE ONLY. LAw9 FE6ULATING VALUATION '/ PERMITFEE $ 7SI-� g�y ��/ � PLAN CHECK $ �y'� � S TOTAL FEE $ .� � 10�33 COSTA' MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPUCANT TO f/CL /N COMPLETELY /TYPE OR PRINT BUILDING �/pJ5 �� ADDRE55 — GG��a ej.�R� COSTA MESA. CALIFORNIA IEGAL LOT L OESCFIPTION NO. LU BLOCK A.P. NO. OF LOT V,/ X L3S I NOw ON USE OF EXISTING 9LOG. SETBACK LINE FROM cEnteq oF sirseer 9O REAR VAI SIDE VARD ILEFT 16.6 IRIGHT DESCRIPTION OF WORK NF` I X II ALTERATION I II ADDITI SI�EDING ,12 EXTERIOR WALL GOVER W G USE OF BUILDIN NO.OF ROOMS I HEflEBY ACKNOWLEDGE THFT I AND STATE THAT THE ABOVE IS PLY WITH ALL QTY ORDINANCES BUILDING CONSTFUCTION.^ SIGNATURE OF / l . AUTHORIZED ��i� ��CEe'J'=0 ( o- 1 �( �5-`'1 FINANCE DEPT �� CITY OF COSTA M�SF APPLICATION FOR PERMIT BUILDING fo,e officF usF orocy I RECEIpT NO. I PEHMIT N BUILDING -1449 COSTA'MESA. CALIFORNIA � FIRE � ° ZONE TYPE GROUP APPROVED �� 'DATE /� � BY :ey ZONING �(y' ZON NO.OF USE OF NEW %� ZAC;.� - I pLANS � I BOILDING ` �/I V� pPPROVED � � f) nerr //i-��, F-�ca:n�y REAR LINE � �D THIS �PPLICATION THE AMOUNT SHOWN IINDER VAtUATION IS FOR THE pND AGREE TO COM- 'E L�WS REGULATING PURPOSE OF E9TABLISHING A PERMIT FEE ONLY. VALUATION �1 � PERMIT FEE $ / O — n� $� ��` �' PLAN CHEGK $ � � TOTAL FEE S .,1j /