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Home My WebLink About2298 FOUNTAIN WAY - Building PermitsPflOJECT AOONESS: z Z 9 8 W FOUN TAI N WY awxess r+nme: SCHROEDER MGMT aooaess: z q 11 E COAST HWY CORONA DEL MAR CA 92625 (714)675-4900 ABCHIENGINEEfl: AOUXESS: flEG.NO.: UNIT: UNIT: PEflMITTEE:aLI�—COAST ROOFING ( 714 ) 650-2244 ADOPESS: z1O% WALLACE AV COSTA MESA CA 92627 UCFNSED CONTPPCTOfl �ECLAflP710N: I h¢re�y aliirm thal I am lit¢nsetl unaer pmvi5ion5 <i �ap�er 9(commencing wilh $ection 7000) ol �rvision 3 0l ihe Business antl Pmlessians Coae, antl my license is in lull lorc I ecl. - ciTruc..05)i92 , srnrcuc.:598440��) cuss:C' � „ Dale' __ � ��GI� Signamre' �/ WONNEBS' COMPENS TION OELIAflATION: I �ereby a��irm tha� I �ave a t �iwi¢ O7 ConSent t0 SeI6in5Ure Or a cetlilicale ol Workers' ComDensalian Insurance. or a ceni�iea coDY �hereol (Section 3800. Lab. POLICY NO.: E%P. OATE: COMPPNY: � �� Cenifiea copY is hereby lurnished. ❑ Certilie0 mDY is filetl vnih the ciry Builtling Division. Daie: Aoo�icant EEEMPTIONfPOMWOflREflS'COMPENSATIONOELUBATION: Q�i 5ectionneeano�becOmp tNi perm,itisioronehunOrtN�$100�arless�. I certity �hai in the pedormance ol �he work lor w�ic� this permit issue0. I s�all not em ny erson in any manner so as to hecome sublecl Io I�e ork 5' jGompensation Laws o� Calilomia. �ale: � • Signaiurt: � NOTILE: 1, afi r making t0is aeclaraiion, rou shoula hecame subject o �e WaM1ers' ComOansation pmvisions of Ihe �abor Code, you must fotlhvnth comply vnth suc� pmvisions or Ihis p¢rmit I be AeemeO revakeG. CONSTHUCTION LENOING AGENCY: I �ere�y aliirm Ihat ��er¢ is a cons�mc�ion lending agency lot ��e perlormance ol Ihe wo�k lor which ��is permi� is Issued �Section 3W7. Civ. C�. LENOEP: aooecss: OWNEB BUILOEN OELLAFATION: 1 hereby aHirm Iha� I am eKempt Irom Ihe Con[ractors' $taie License Law far �he following r¢ason �Semion 703t.5 Business and Pmiessional Cotle: Any city ol coumy wt�ich repuires a Oermit �o cons�mc6 alter, impmve, Oemolish, or repair any Stmclure, p�ior lo ils issuan[e. atso requires ��e applicani lor such p¢rmii �o lile a sipneC slalement ihat he/she is licensea pursuant to I�e pmvisions ol �ne Comractors' S�aie License Law (Chapter 9(cammencing wt� Seclion 7000) of Oivision 3 0l t�e Business antl Pmfessions Code� or I�al he/she is exempt therefmm ana ihe hasis lor t�e allegeG eMemplion. My violation of Section 70.31.5 by any apPlicantlor a Dermit suGle[I5 I�e aD�licani ta a civil O¢�aliy ol nal more than �ive hundre0 aollars �5500). I, as owner ol the pmpeny or my employees vnin wages as Ineir so�e compensalion, will tlo ihe work, and Ine ❑ stmcture is nol inlenaetl or olleretl lor sale (Seclion 70E4, Business antl Pmlessional Coae: The Contractors' State Lit¢nse Law tloe5 nol apply�o an owner o� a O�oOerty w�o �uilAs orimproves l�ereon, and wha d0es SUt� wOrk him5ell/Aersell orlhrouAh his or her own employees, providea ��at suc� imDmvemems are noi imenAM ar allere0 lor sate. Ii. however ihe building or imDmvement is solG wilhin one year of comD�elion, t�e owner will have ihe burAen of DrovinA he/she Gitl not hui10 or improue lor ihe purpose of Sale�. I, as awner ot ihe property, am exclusively coniracting vnl� licen5e0 conVactor5 io constmcl i�e D�oiec� ($ection 7044, Business ❑ ana Pmiessions CaOe; t�e Coniracmrs' Stale license Law Ooes not aODN to an owner oi propeny who �uilUs or imDroves I�ereon ana who comracls for suc� pwl��s wii� a conlractor(s) license Dursuant �o I�e Con�rac�ors' Stare License Law�. I am aware I�al proa� oi I�eir Workefs Campensalion insurance s�oula 6e pmvitle0 to me. � I am exempl under SeClion: B. b G. C. lor �nis reason: Oale: Owner I tlo hereGy cenify I�at I am aware ol anG uneerslana Ihe reQuiremems al Calilomia Health an0 Safely Cotle Sections 25505, 25533, and 25534 anA ��at I or any W�ure buildmg occupani vnlVwill not (Ci¢le one) neetl �o comply vn�� saitl stale wdes anU ihe requiremenls lor a permii for con5tmcimn Or motlilicaiion imm I�e Air Oualiiy Management Ui5lrici. Fe5i0entul construction applica�ions am e�emp� irom Ihese pmvisions. Date: ADPlieam: I �ere�y certi�y t�ai I have reatl Nis a00�icaiion an0 stale ��at Ihe a�ove in�ormation i5 mrre[L I re Io c mpiy wi�A all cit ortlinance5anA51alelav5relalingtoOuiltlingcon5imclionana�ere au�IwrrzereDreSenlaiiveso is i toe leruponlheabo pmpeiry lar ins eciio purpose5. � Dale: Signature: Driver's Liwnse or Social Securiry 16av46 White—Bwlaing; Green—CoOe Enb¢emeni; Canary—Applicanl: Pink—Revenue: Goitlenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 061309 PERMIT NO; B 061309 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE; 5—N PERMIT TYPE; STR PUkPOSE; ALT JOB DESCRIPTZON ; T/O EXIST, LAY 1 BASE, TWO PLY 6 ROCK SQ FT: �� CLAIM VALUE: 2,800,00 CALC—VALUE: 2,800,00 GROUP OCC; R-1 / COMMENT5: SMOK DETEC PER THE 1991 ED UBC 3E df �lE iF iE iF if if it iE iE ��E if iE iF iE �16 # iE # if iE %� iE iE iE 9F�If �IE �It 9( iF iE �1Ei(-�1E if if if if iEiE �E �� 1(' iE �)h i(� if �X IF�IF �k iE 1f �k %��)F�)t i4iFif �lF�%� dE if iE iE iE 9F IF iC� �%iE �IEiF �)f� it Z O N I N G R E Q[7 I R fi M E N Z' S S E T A A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT ZN LE:FT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING kEQ • PROV; PARCEL; 42215407 ZN&; REF NO; PLANNING NG1'ES> i x��rit�trt�x��ritft*x�+��itvt*iritit*�xatit*��x�rit**iE*�+t�t*�*ie�aFiF*x x�iE��xie*iEit�r*i*�*�ieir*ie#jr�*�*�**r D E V�E':L �O P M E N T S E R V I C E S R E Q U I R E M E N T S iZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY• ' � DATE; `�1�� ikif�lFlfiEiEiFiEiEkkltkiE3l�lhifiFlEfEitiE�. iF� �ri 3fiF te3- 3r ��i"r'�FiF�FTE�FiFiFiEiFkif�xx�%�i(�IEft—it �r x i(-if iEN��fi(�iE�Eik!lfEiFikit#�1FiFilikiEiEiEiFifififiFkiEiEiEifitif3f?fiE3fifiEiEiEfElf lfikif3fiEkffifiEitiEfEiElklEiE�EiEiEiE�lEiElEiEiEiFifiEitiFiE3F36il�f LEGALIZATION:N F E E S U M M A R Y ST'RUCTURAL SEGMENT;Y HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIF�/RES GRADING PERMIT 54,00 SO SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DiIE TOTALS----> 54,50 0,00 0,00 54,50 54.50 .00 REVENUE DIVISION TOTALS=—> COLLECTED: 54.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIkE SMIP/TOT GRADING PLAN—CHECK 54.00 .50 � 1h iF 1k M- k iE il� fE iF ik If 1E �k it if iF iF iE i!� Ik �IE fE iE iE K� if IF �K� if iF if it if iE �E IF fE 1F #%i6 �16 it If k ik i4 if �h i(� # i! if �lt ft %� iE iF ik il� iE 1E K� iF i(� � IEiE iE'iF N� # 1t ihlE 3i� N- fP if I N D I V Z D U A L F E E: B R E A K D O W N TYPE QTY D E S C R I P T I O N SFR 2800 REROOF BY VALUE RESIDENTIAL NOZONE � END OF FEES , � EXPIREO fncomplete Inspections Uate �_ � Sig UNIT COST 1 , 0 � ', a '. 'I'OTAL COST 2�8��„00 � i - I CONSTRUCTION AND PLANNING � APPROVALS Permit#r i. Temporary ElectriWl Service or Pole 2. Soi� Pipe-Undrgrnd. . 3. Electrical Conduit UU�ity•U�drgrnd. 4. E!eclrical Conduit�Undrgmd. 5. Steei Reinforcement ' 6. Elec[ncal UFER Grnd. i � 7. Footings I8. Foundation 9. Water Pipe•Undrgrnd. 10. Structural floor System it, PropertySewer Line&HouseConnection� 12. Sewer Cap 13. Roof Orains 14. Rough Plumbing 15. Rough Electrical-Condu�t 16. flough Elettric Wiring 17. Rough Wiring Sign 18. Rough E�ectriwi-T 6ar Ceihr.q 79. Rough Heating & Air Conditbning 20. Rouqh Factory F�rePiace 21. Dutts, in Structure 22. Ducts, Ventilating 23. Gas Pipa•Rough & 7est 24. Roof Framirtg 25. Roof Sheathing 26. T•Bar Ceding (Structurall & 7�tonocoat 27. Frameand Flashing 28. Lathing & Siding 29. InSulaUon 30. Drywall Nailing 37. Plaster Bro�vn Coat 32. Eiectnwl Power Meter�F�nai 33. Finai Electric 34. Final Heating & Air Condition�n9 35. Finai Gas Pipe�Test 36. Hood or Canopy 37. Finai Factory FirepiaCe 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Oomestic-Final 42. Backflow Preventer 43. Backfiow Irrigation 44. landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulationz 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Oate Date � Inspector �� 0 m POOL �PA APPROVALS Permit � Date 52. Pool & Equipment Location 53. Steel Reinforcement 54. forms 55. Electrical Bond'ing 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, � Undrgmd., Test 60. Backwash �inos, P�Trap, i 1 Undrgrnd. 61. APPROVAL TO DECK 62. Backwash 6� ReceptorFinal 63. Heater & VenbFinal 64. Plumbing SYstem � Final �' 65, Electrical-Final ' 66. Solar SYstem•Final 67. Fencing & Aceess Appr�val 68. APPROVED FOR PLASTERING 69. POOVSPASYSTE�b15FINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. UndergrOund Hydro 71. Product Piping O Gas U Oil 72. Underground Flush 73. Undergmd. Stora�c Tank C Gas ., 0�1 74. Ovcrhead Hydro 75. Ory Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIqE PREV. FINAI HEALTH DEPT. REQUIREM1IENT 79. FINAL INSPECTION I 80. FOOD CERTIFICATE ISSUED -�- Notes: ncomplete E Inspector � � --i Applicant to fill in all spaces ezcept tM1ose wit�in �eavy OorGer lines antl si9n all apP�aDriate Oeclarations. CITY O'F COSTA MESA CONSTRUCTION PERMIT Project Address � � 1 � Applicant's Mailina Address 4+'� l AGI. V,� i� �Y. Owner's Name •�– �CL(� Phone I Addreu � � Arch/Eng. Licenu No. M Address W y��\,��'!�t'_f�R\�1�,�Z.}'�—PhoneSyl,;Y�L.R �/� Coniractor's Nam � �,�r�� . T n �� 1 Address (mailingl lflCl�l^�'L��V �� 1(I . 1�\� l..l J�Z�n �____� N City License No. LICENSED CONTRACTOR DECLA0.ATION A� I M1ereby affirm [ha[ I am licensetl untler provlsions of Charter 9(commencing 1 � with zection 7000) ot Division 3 of the Business antl Professions COCe, antl [ my licenze is in fu Por-c�e aIn�tl effect. License Class �� ✓` �' L/i�cense No � �� f Dale `1'��–% 5'9 l �i..�f.� ��=q� i WORKERS' COMPENSATION OECLARATION ' \ ' hereDy atfirm that I have a certificate of consent to selt-insure or a certificate � f Workers' Compens5tion Insurance, or a certitied coOY thereof. (Section J800, l.db. C. P iGy No. � � Company _ Certi(ietl capy i5 hereby fumBnetl. y p � I (� Datee� �tietl cOPY is £�,�,APPhcantY�a�i9� i V�A� V�� l D/i /'J, � / EXEMVTION FftOM WORKERS' COMPENSATION OECLARAT�ON (This section neetl not be comple[etl if the permit is to� one huntlretl ($100) or less). I certify that in the OerformanGe of thG work fonwhich [bls perm�t is issuetl, I shall not employ any person in any manner so as [o become subject to the Workers' Compensation �awi of Califomia. . Date S9�ature NOTICE: If, aiter makin9 this tleclaratlon, you spoultl become sub�eGt to the Worke�s' Compen5ation pwvisions of the Labo� Cotle, y0u must fOrtbwitM1 compry with suc� provi5ion5 or [ttls Oermit spall be tleemetl revoketl. CONSTRVCTION IENDING AGENCV • 1 nereby affirm tnat tnere is a constructlon Ientling a9ency tor the performance ot Ihe work tor �which LhiS permlt is i55u¢tl (Sectlon 3097 Civ. C.) LenOer's Name Lentler's Ailtlress OWNER BUILDER DECLA0.NTION I heroby affirm that I am ezempt trom the COntractOr's LlcenSe �aw fot th¢ tollowing reason (Settion 7031.5 Business and Profes5ional Cotle: Any city or county whlch reqWres a Dermit to construct, alter, improve, aemolish or repalr any sbucture, prior to its i55uan<e, alw reqWres lhe applicant for SucM1 permit [o fiie a signetl slatement tha[ he/sbe fs licensetl pursuant to the provisions of the ContraClOr'S licen5¢ Law (Chapter 9(commencmg with Seciion ]000) ot �:`��vi5ion 3 of tlle Busine55 antl Profes5ion5 Co�e) ol thal he/shC ii ex¢mpt herefrom antl the basis tor the alle9etl exemption. Any violatlon of Section °"031.5 Dy any applicant for a permit subjetts t�o apo��ant [o.a civil ��"''�¢�alty of nol mo�e Ihan Ilv¢ huntlretl tlollarz (5500). U I, aS owner of the prop¢rty or my employee5 wl[n wage5 a5 Ihelr TOIe compensacion, will tlo tne work, antl [he structure is not intenqetl or offeretl for sale (Sectlon ]044, Buziness antl Professlonal Cotle: The Contractor's License l.aw tloes nol aOP�Y �o dn owner oi a property who builtl5 Or Improves thereon, antl who tloe5 such work bimself/hers¢It o� tM1rou9h hi5 or hOr Own em0�oy¢es, proviaetl that such improvemen[5 a�¢ not Intentle� or o�feretl tor sal¢. If, M1owever, Ihe building cr improvement Is Soltl wi[hin one yea� of com- pletlon,•the owner will have the burtlen ol proving ne/she tlltl not builtl or im- �rove for the ourpose ot sale). 1, as owne� ol the property, am excluslvely contrdGting wi[h licensetl corv Vac[O�5 [o cons[rucl the Droject ($ectiOn 7044, Bu5ine55 antl Profession5 COtl¢: The Contractor'S Lic¢n5e L2w tloe5 not apply tQ an owner ot propmty who builas or improves thereon, antl who contrac(s for such projects with a con- Vactor(s1 license pursuant�tb the Coniractor's License �aw). I am aware tnat proof O( Iheir WO/ker'S Compensa[ion Insu�ance shoultl be provltletl to me. ❑ I am exempt untler 5¢ction B. & P. C. for this reason Date Owner _ I �ereby certity that I have reatl this intormation is correct. I a9ree to compl antl state Iaws relating to builain9 con! Sen(dtives of tM1is city [o en[er upOn Inspectlon oses. Signature ' � � Drivers' License or 55 � � aEove / 3�� ....._. .-- -- — .,..,, ...,. TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p. *, DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TVPE OF PERMIT GRADING FOVNDATION STRUCTURAL T Front ❑ TENANT ❑ ELEGTRICAL PLUMBING ❑ MECHANICAL B Rear ❑ OTHER p` C Right PROJECT DESCRIPTION 54. FT. OCCUvnNCv K CONSTRUCTION TVPE VALUATION $ S Left ZONE GRADING CV. VDS. ACRES Ping. Ref. # Remarks: , Planning Notes: Sink Preventer Irrigation king Fountains r Drains ir Sinks Service Outlets Kitchen Sink Lavatories P–Trap Roof Drains Reinspection Fee � $15 Boiler Duct - Under Ground Duct - Structural Duct - Vencilating Ezhaust System ❑ Multiple ❑ Firepl/Fact Bit. IC80 # Heaiing System & Ducting ❑ ai oo,000 aru O i oo,000 sr Reinspection Fee � $75 CMF 0865-46, rev. 4/84 White - Builtling: Canary - Applicanh Pink - Accounting; Goltlenrotl - As5e55or Showers Service Sink - Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Warer Closet Water Hearer Water Ser�� Isue Fee Hood or Typel ❑ Canopy Type 11 ❑ Refrigeration System ❑aiao,000aTu Oioo,000eTu Syscem Repair/Alteration laue Fee $ 3 $ 3 'Automatic Washer,: � Construccion PoleSub. Cooking Unit • D ishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Pixtures Device Boxes Outlets $WILCh25 Garbage Disposal Generator 00�5 KW e�se II/21/B4 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15�50 KW � ❑SO+KW Meter ❑up to 100amps Meter ❑overt00amps �' Sub�Panel nnom�s�ai Haoih-a InaSolar �9�15 HP �16-15+ Microwave Pole Li9ht Range Standing Sections 5-75 KW Trash Compactor � Reinspection Fea I$15 � � Issue Fee DEVELOPMENT SERVICES REQUIPEMENTS: Zoning Approved 9y Building APProved By � � Appliption luued By 5.00 TL FEES $ 3 Z O N I N G R E Q M T S. SUMINARV OF FEES � � � BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ S-C`�O �SSUANCE $ PLAN CHECK , 25%' $ ENEFiGV P.C. $ ELECTRICAL $ GRADING 5 PLAN CHECK 50% $ MICROFILM $ �/�/� MECHANICAL $ TOTALFEE $ �1 PLAN�CHECK 25% $ CONSTRUCTION AND PLANNWG POO� aPA APPROVALS Permit# Date Inspector qPPROVALS Permit# Date Inspector 1. Temporery Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemeni 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Elecvical UFER Gmd. ' 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 & Recep[or-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. 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 78. Rough Eleccrical-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, Veniilating 7i. Product Piping OGas ❑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 (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FI�RE 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 �r �/G!J 39. Water Service-Final � � 40. Gas Service-Final ' 41. Solar pompstic-Final . � 42. Backflow Preventer 43. Backflow Irrigation . . . 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations a7. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date By'YLDIIILG SAFETY DEPARTMENT N� 13 0 4 � P. O. Box-No. 317 Costa Mesa, Ca�ifocnia Date l��A ij � ^ /! ,� : r � � CITY OF COSTA MESA CER7IFICATE OF OCCUPANCY Building Permit N7 r� `� � Electrical Permit No Plum6ing Permit No. Use of Building `"/ - The building located at - ��_ I,egal llescdptio� (See �verse side for Metes and Bounds) na� p�n inspected and found to comply with.the provisions of all City of Costa Mesa Ordin- � ; aPplicable thereto for a Group �� Occupancy. ISSUED TO: ! - � � - �� City Building Official ' l u,i,� Yr" 1nti,:,-'.�40:1� f , (Owner af Building) By 7.�titi+�t-G-r `, �ZI/( �,: .�„ryr..( f� CC: p Original—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison' Co. ❑ 3rd copy✓File Fo� zos as r iaa i-so V v � , - �� so��a , .. � COSiA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA fOR APPL/CANT TO f/LL /N COMPLETELY TYPE OR PRINT eui�oiNc oZo2 % Q— � COSTA MESA. CALIFORNIA ER ITECT INEER 61 LEGnL I LOT ` 69Y�a LIC. � .. ,��. �I� � ��J—��T �=Y�'��i��sp�P� shv �l APPLICATION FOR PERMIT BUILDING FOR OfF/CE USf ONLY I nece�vrno. �1I E�.e.ayh o. ISSUEU COSTA MESA, CALIFORNIA STATE APPROVED � �iQ. NO;{�n(j(� BY DATE/ ta Mesa ZONING I�/,�� ZO IPANS ,�IBUEILDNGEC �A � � APPROVED �//� BY A. DATE No. oF etncs. ypRDS E now oN�oi REQUIRED ALLOWED (CENTER LINE 6TJ � / FRONT IS . �CY FT. . O /Ai SETBACK LINE FROM ^O • �� CENTER OF STflEET y REAR YARD ZS SIDE YARD I LEFT $•6 I RIGHT 16.6 DESCRIPTION OF WORK NE�' I X II ALTERATION I II ADDITION REPAIR � I II MOVING I II DEMOLISH SIZ'EDING ZZ X 4O ROOMS STORIES EXTERIOR WALL IROOF , ,�_ % ,. I HEFEBY ACKNOWLEDGE THAT 1 HAVE REAO TMIS APPLICATION /�NO STATE THAT THE ABOVE IS COPN ANO AGREE TO COM� THE AMOUNT 6HOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY OROINRNCES ANO TE LAWS REGULRTING PUNPOSE OF E6TABLISHING q PENMIT FEE ONLY. OUIL�ING CONSTNUCTION. VALUATION SIGNATURE OF /' PERMIT FEE $ /Q� PERMITTEE �q/� ��/t $Qc� O�OD'� P�%N CHECK $ � �� AUTHORIZED AGEN TOTAL FEE $ /CJ � .. . _ � �0�'�2 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 GOSTA MESA. CALIFORNIA FOR RPPL/CRNT TO f/LL /N COMPLfTELY TYPE OR PRINT f,e,-C eui�oiNrn�o�y��'r� r ADDRE55 Y COSTA MESA, CALIFORNIA OWNER Paul E, Robertson, Inc. I [NY�� IEGnL I LOT DESCRIPTION NO. A.P. NO. �I 9ETBACK LINE FFOM . . ,,,;_�,,,_,, ,� (o—i�e—s`�� FI11!;I�CE DEPi. v �� V�i' .�� !`(1Cii� �;-C{� APPLICATION FOt2 PERMiT £� � / ` BUILDING �fe ' FOR officE usE aNcy I NECEIPT NO. I� lPERMI,TN< ED fEL.MI(IWH}' I BUILDING NO. 'IIi ppDRESS No: C-1449 STATE NO, OF eLOG9. ILEFT ZZ.f) IRIGHT ZO.S DESCRIPTION OF WORK I X II GI TFRATION I II AbOIT10N BUILDING NO.OF SIZE 3Z x 55 ROOMS ' EXTERIOR W L IROOF COVERING �YUCCO COVERING USE OF BUILDING AryD WORK TO BE F I NEREBY ACKNOWLEDGE THAT I HAVE NENO THIS APPLICRTION qNO STATE THAT THP� pBOVE IS CORRECT AND qGREE TO COM� PLY WITH ALL QTY qRU1NANCES AND ST TE LqWS FEGULATING BUILOING CONSTFUCT�ON. SIGNATURE OF PERMITTEE AUTHORIZED AGENT � APPROVED BY A PROVED BV COSTA MESA. CALIFORNIA % NO.OF USE OF NEW PLANS 1 BUILDING � L =D LINE ST.) 3. s �� THE AMOUNT SHOWN UNDER V�LU�T�ON IS FOR THE PUHPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION -,/ � PERMIT FEE S � C.�� t�!/ � �/ PLAN CHECK $ � 7 � S- TOTAL FEE 5 73 ,