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HomeMy WebLinkAbout2057 GOLDENEYE PL - Building Permits CITY OF COSTA MESA _ ie BUILDING DIVISION > DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1 /� o' !'o PERMIT • 1B03-02006 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2057 GOLDENEYE PL Status: ISSUED Suite: Applied: 11/19/2003 Vicinity: ROOF Issued: 11/19/2003 Parcel Number: 13954406 Zoning: R1 R1 Applicant: JOEL ISFELD ISSUED BY: Address: 8941 MINT AVENUE Phone: (714)847-7663 WESTMINSTER,CA Zip: 92683 Owner: LEFAVE, JOEL Address 2057 GOLDENEYE PL Phone: COSTA MESA,CA Zip: 92626 Contractor: CALIFORNIA ROOF LIFE CO INC Address: 8941 MINT AVENUE Phone: (714)847-7663 WESTMINSTER,CA Zip: 92683 License: 509623 Arch : _ Eng: Address: Address: Phone: Phone: Zip: - License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1/2"OSB B PLYWOOD,15#FELT,AND 30 YEAR COMPOSITION SHINGLES. 18 SQUARES INCLUDES ATTACHED GARAGE. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,500.00 Permit: $111.25 Claim Valuation: 54,500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • Total: $111.75 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) 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 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 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate 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: 3717/7-62.- ree- /) Policy Number: /0.7//3 S' - ao-c,3 (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) ❑ 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 Calif.• ia,an. If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,1 shall forthwith comply with these pro l:'• Applicant Signature: Date: /7–/q–O� WARNING:FAILURE T• ECU; WOR ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA '($100•••),IN AD• • •• • COST OF 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 licensed under 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.# 090 Class# C 3 7 Contractor's Signature: _ /!\��� Date: l///9/4'3 CONSTRUCTION L- D AGENCY: ❑ I hereby affirm at there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lenders 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 end 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 properly 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.It,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.). O 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑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 WIII 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? ❑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 a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Wit any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 Nes",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 penalty 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, Signa a al Owner(s) Date 4' A r t onzedA ' nt Date q_O.; CODEI SPEC••NTYPF . Qdg MAU CODE( INSPECTIONTYPE PATE thaws 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof //–t—o3 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 I IADDRESS OF BUILDING: 2057 GOLDENEYE PL LINT: , Zb CITY OF COSTA MESA — BUILDING PERMIT g4NERSNAYEIF IWonOfIN: LEr AVE, JOEL FLOOD: AE-46 PERM NO: B 08524E wss LEL AVE MADALYN SHAFFER 2057 GtLDENEYE PL PERMIT NO: B 085298 PLAN CHECK NO: N GOVT: N SUPP: N ` (esCOSTA MESA,CA 92626 appL.mum,mo s: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH I, ARCHITECTORENGNEER: LIG ND.: JOB DESCRIPTION : T/OFF SHEATH & REROOF W/COMP SHINGLES SQ FI : 2, 500 ARCH.OR Exit's ADDRESS: 0N7` CLAIM VALUE: 2, 500.00 CALC—VALUE: 2, 500. 00 GROUP OCC: R-3 / CONTRACTORS NAYE: CONTRACTORS YOUNG COMMENTS: RERPPF 1350SF RESIDENCE W/COMP, SMOKE DETECTORS REQ PER '94UBC -a ifM>tkiiatM3flFifiFMiFiFiF•IF1FjFff3FiF3F'1f3FRFiFiFiFiIF****i13F#itik'743F3r3F#iF9EiFlflfiFif3E3i***k1hM'1k#1e3FiF****fhieif9f%iFiiifiii**lei I ADDRESS: UC NO.: .:./d LINT, ZONING REQUIREMENTS .L. UCENSED CONTRACTORS DECLARATION:I hereby slim under penal),of perjury OI am licensed under provisions of Chapter 9 . — S E •I B A C K S J d RED(commencing((commencing with Section 7000)of Division 3 d the Business end Professions Code.end my MoverMoveris in hg force and egad. J,l U . ..:.u Cm LIC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT - IN REAR: FT IN FRNT: FT IN REAR: rT IN Date: Cocteau: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penal),el p°rjoy that I am exempt from the Contractors License Law 1«the following reason(section 7031.5 Business and Profession Code:Any sty or county which requires a permb to construct,after,improve, PARKING REQ• PROV: PARCEL: 13954406 Z N E: REF NO: owlish.or el repany elmature.prior to its issuance.also requires the applhmnt for such permit lo fib a signed statement that he or she PLANNING NOTES> lensed pursuant to the provisions al the Contractors License Law[Chapter 9(commencing with Seam 7000)of[Melon 3 of the n'vwa and Professions Coder or that he or she is exempt therefrom and the basis to the alleged exemption.My violation of Section >. • 7031,5 by any applicant fin apence subjects theepploan to a civil penally of nil man than fixe hadred dollars[5500]). *********iEfFdfifiiifiF-ifiF3Eftsf#ii%if3Fif3fsfllikiF3f3f#3fiFiFiF3eifsf3fiF1F3f•ffif3kiFifitiFif M9FifiFiF3f•if#ifiFif#if#iFlFifiF1F#iFieiFitie r1 I. ofthe Prawn),«my emptb/eee with warn:Ulli ale compeoerion,will do the work and the.adore is net intended D E V-'E 'L O P M E N T SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors Licensee apply law donot ply to an loner properly -- operly who bulds or e°.', *noimproves therand wdoes such work Firmed or his« .'al or fiendthrough hher own em iloyaa,Providedthat such rot w improvements are rot or offered Ice sale.I,however,the building or isprovemera is sold within one year of compkam.the ZONING APPROVED BY DATE: oww-bu kter will have the burden of proving he et she did not build or improve to the papas of Ile). ❑ I.in owner of the property.ernexweive ronhadi.g with Rearmed contractors to construct the project(Section 7044.Businessand BUILDING APPROVED BY : DATE: .c. Professions Code:The Contractor.License Law does notapply to en ower or improves properly who builds improves thereon and w -- - contracts for such propels with a cunrector(s)licensed pursuant to the Contractors a Lae . I em exempt under Section B.AP.C.,ler lits ..'. : / APPLICATION ISSUED BY: DATE:'efI �< U.0( 9 i * ' ***************************** *****st***se********. * *******3f********.****ort iter w* UmAca- �7 cera LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby cenily Ins I em aware a arc undramnd the requiremesb / da ' Health Safety Code Sections 25505,25533,end .. . 25534,and Nr l u any Mure building occupant wY/wil n°I(dcle•y up comply wt aid rote code ed the requirements f« BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e pant for mroauctian or modacaionfrom the Alt yes y red.Residanid radian applosSaart exempt from these 79 75 50 Provisions. Dale: Applicant: PLAN SMZP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm urderpeaiy Or peeNy one Or the blowing decimations: ISSUE FEE ❑ Ihave and MImaintain crtil eoconsentloed+nen«workeraco°prwdi .,asprovidedf«WSeddon 3700ofUmLabo BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE code.f«the p°d«mar.ced « the work permit is issued. TOTALS----> 75. 25 0.00 0. 00 75. 25 75. 25 . 00 ❑ I have and sal maintain workers'compensation insuranoe,es required by Section 3700 of the Labor Code.for the performance a the work for which this permit ed.Myer«kat: wrh adnem«h insurancinsurancerae wriernd apolicynumberar.: REVENUE DIVISION TOTALS--> COLLECTED: 75, 25 OVER/SHORT: . 00 Policy Carrier BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,.itis section need not be completed d The pend is for one hundred dollen IStOOl or Mn) 74 .75 . 50 ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any pinyon in any manner so es to become subject to the*rockers'compensation lawn of California.and ages that l l should become subject to the workers' ***********************************ff***************if**************le M*********** compensation provisions of Seai«n 3700 of the lab«Code,I shall forthwith comply with those provisions. INDIVIDUAL F E E BREAKDOWN Dare: APpliant: Warning:Failure to secure workers'compensation coverage la unlawful,and sheand subject an employer to criminal pensides TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines se to one hundred thousand dollar.($700,OOO),In addition te tee Pear of eon,anseDOn damages as provdad for In Secton3706 of the Labor Codernfrasl adafornsy's fess. SFR 2500 REROOF BY VALUE RESIDENTIAL NOZCNE 1 . 00 2, 500.00 CONSTRUCTION LENDING AGENCY: I hereby arm under penalty of Perla),that tore is a canmwion landing agency for the END OF FEES performance of the work for whirl,the permit is issued(Section 3097.Cr..C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state the the above information is coned.I agree to comply with all city and county ordinances and slate laws relating to building constzuction and hereby authorize representatives of this city to enter upon the above-mentioned properly or ins solo Porno"- JOEL LEFAVE Porn Nae 11: NM25 Date: (6 O y'97 PIB-16ERM997/1ITP 685248 11 /f75 erlApenUAPplcant/Conlraa«(5t51-48.F/?A Safety:Gran-Fle:Canary-Applcant:Pink-Raonw;Goldenrod-Assessor CONSTRUCTION AND PLANNING • POO SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement m31•£IEctrical Conduit Utility-Undrgrnd. 54. Forms !- ':j,4 Ely,'Ctrical Conduit-Undrgrnd. 55. Electrical Bonding - . :5r:-.-$tgel Reinforcement 56. Rough Plumbing & Pressure Test n r ' • ' fectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE i:r , -:7< optings 58. Electrical Conduit-Undrgrnd. , 8:iFoundation 59. Gas Pipe, 0 Undrgrnd., Test -di,'Dater Pipe Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. ti ' 10: Structural Floor System 61. APPROVAL TO DECK Jr 17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12 Sewer Cap 63. Heater & Vent-Final j3. Roof Drains 64. Plumbing System - Final -14. Rough Plumbing n 65. Electrical-Final '75. 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 .....-TI FIRE DEPTtREQUIREMENT ,j 20.i'',Bottsh Faktorr F.1,.•r ce ' 'r.1 r S �, 'S -1 T r lj APP.HOV.f1 Syr= Pejmit # ;' >` n.. 21. ucta,in$trpit;turti 1 •• •• 5 r S _ '- 70rtinder-Iglu:�d 1 dro t S . ,y 22. Quct#, Ve\}tti4tinZ 4 i 7. j R l' t ;� 71. Prod u!?t„ping'CSGas J Oil y , ,i. . .d• :-4.. - .i , . 23.-basMipe,5-oglgh & T.r est 'r„S + +n .r < r - 72. Undergfauh d Fa- D ._ r . - _r - l- _ . r 24.cRoo. Framing* Il1 '(' ' `' ., 4 Z . Undergrid.St0aeJan D Gas boil1. 2E- Roof,Sheathing v f' IT .St i v it 7 f �� e 7'C,-Overhead HydrD 1 v 1; _ 1 CfT 26.0T-B0 Ceiling (Structural) & WlaitU oat ,q in q, Dr emn Chical + 4 - 1 27.;Frame and Flashiegk •Ds,x r r >, n . 76. Dry Staadpipe.-•.x' , - ' 0 28. Lathing & Siding-10 -1 -i,r : £ ••1 •'IK 7 . FIXED 'STEiv FINAteL,y n ,n ,r .D t. .'1 -4 .. .. '> K n I Ir ) 1 .. -L 29. Insulation • tr.. ,.. rr 72. FIRE PREY. PAPAL k •> 'Z N # .: .i _ i f: e -Y " 30. Drywall'INail.-ti g 'V I, y I _ I I: ,S ,`tI�EALTV DEP+T'.1REdUIQEMENT ' 31. Plaster BibwniCod r .c• .••r ii , x 'r 7•. FINAL:. 'PECTitON % j t 32-+£lectricai Power Meter.Final: ` '1 1 F 11 801. FOOD CERTIpE'ATE f5 UEp 33.11I14;Elesiri t o t n 3`i s In 5 z.:.. to S it Notes: 7 1tp7 k : Th I;.1 ' 34.-Fina HeaIingiSi AirsConekitioningC S f1. S •-);.:, S 07.7-:7 35.' inal'Ga ,PiP Te I is D l: -i ! ift Ir 7 _ _ '+.: r EIJ _ Y J ~ k or 36. Hood or,_£ anopy e D` l ,r-a .e l-, l II E IID r 4:C iv iv ,r ': D r n _ r :, 37. -EinEi,Factory FirX:4a s f_, ,vIle .. •.1 , 38. Finatl Plumbing :k .V c •1. r I IF. i s .Th v I It • -I 'r, t . 39. \Nater Saibice-1=ir? r1 7 t` i '' • "t ...--,T1 .: 'K a N t • L ' 1Z �r '1J 1' s ', 40. Gas Service-Fjnalr• r n y c•+r S t. .r, I it: • R-� Dry ,nn; r r - - - •-1 e • .us r Z 41. Solar Dor-'nest-Fa' ` .- g ric `kr d T A ' r r �• r r. -. u J .. .-1 - i 42.-Backflow Preventi<r o. •J r I IV R T. r 7 -• 43. Backflow Irr1jatit n „,15 y r ^ - -• r 0 r r 7 • r s 1 0 44. Landscape Irrtgat o5l Systems i; 3 x is n .- ' •7 k V 13 ._ ) r U D - T - ,-••. 5-,Tsound Attenuatioh' 'y r'4 r. r ;. ` ~i 1- n r H -, Q,1�• 'y .�i .. .-I , .7 1 r zt _ -46. }landicap•Regulations r t 471.:FINXtLSTRt7CTORE & BUILDING /L/��� , q & 15 r -- 48. FINAL PLANNING- . . . .v! I ` s4----- ..---.9 .. - • - I r L. _ y 49'. .fleceric Release to Edison . + ~ '' - .. -. " r ` i it •l r , ' '50. as fielease to Southern California.Gas Cc• k 1 i i r = • - s. RI - .51. CERTIFICATE OF OCCUPANCY • ' > 0 r D •x - r, No Date PROJECT ADDRESS: ' UNIT: OWNER'S NAME: 2057 GOLDENEYE PL CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067184 ' GARRETT, ROGER W TR I ADDRESS: 2057 GOLDENEYE PL PERMIT NO: B 067184 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA, CA 92626 . CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT ARCNIENRESS: REG.NO.: ADDRESS: UNIT. JOB DESCRIPTION : LEGALIZE WINDOWS & DOOR REPLACEMENT SQ FT : 800 CLAIM VALUE: 800 . 00 CALC—VALUE: 800 . 00 GROUP OCC: R-3 / PERMITTEE: ARLENE GARRETT (714 ) 545-3176 ADDRESS: 2057 GOLDENEYE PL COMMENTS : REPLACE WINDOW WITH A DOOR, REPLACE ALUM DOORS & WINDOWS W/WOOD C .M. CA 2 LICENSED CONTRACTORion3of DECLARs nI hereby affirm de cant I am licensedensei under provision ofel apler 9(commencing with Section Z O N I N G R E Q U I R E M E N T S 7000)of Division 3 of the Business and Professions Code.and my license is in full lone and effect. CITY LIC.: STATE LIC.: CLASS: SETBACKS Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab,C6 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL; 13954406 ZNE: R1 REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> LEGALIZE CHANGE—OUT OF 3 WINDOWS AND 1 SLIDER TO 2 WINDOWS > AND 2 FRENCH DOORS , Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the per ' is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the pertormanC'of the work for which this per issued.I shall not employ ny per in any as to become 2 subject to the Wor. rs'Corot'nsation Laws of California. �,, On n /L K� ZONING APPROVED BY Co l-J� DATE: �� �O Cl Date: Signature: T'J� NOTICE:If, Oh mak g this,'claration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: • Code.you ust fon ith comply with such provisions or this permit shall be deemed revoked. `� • DATE: Cl� 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(Section 3097.Civ.C). APPLICATION ISSUED B Y: < t(_ rl L1 ******************************************************************************* LENDER: ************************ ****iE****iE*iE****%i(-****************if-******************* ADDRESS: LEGALIZATION:Y F E E SUMMARY STRUCTURAL SEGMENT :Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'State License Law tor the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 42 . 00 5 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 42 . 50 0 , 00 0 . 00 42 . 50 42 . 50 , 00 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 42 . 50 OVER/SHORT: , 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7D44,Business 42 .00 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law),I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. o lam exempt under Section: B. S P.C. INDIVIDUAL F E E BREAKDOWN for this reason, //}} ,/ , , TYPE QTY DESCRIPTION UNIT COST TOTAL COST his Date: /WI 7 Owmec . . Si �_.f / I do hereby certify On I am w are of a understand the requirements of California Health and Safety Code Sections 25505.25533,and SFR 800 ALTER BY VALUE RESIDENTIAL NOZONE 1 , 00 800 , 00 25534 and that I or ny future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit lot construe ion or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and R -by authorize representatives of this to enter upon the above-mentioned property for IP _Ies. TOT it Dale: A/_It Signature: _� .- _ _ - AT I DATE: 05/16/94 TIME: 11:09 42.50 Driver's Lice a or oci I Security r: Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permits Date Inspector APPROVALS Permit I Date Inspector 1. Temporary Electrical Service or Pole I ++ 52. Pool & Equipment Luc..ton 2. So,i Pipe•Undrgrnd. 53. Steil Reinforcement 3. Electrical Conduit Utility-Undrgrnd. L I 54. Forms 4. Elactricai Conduit•Undrgr;id. � I 55. Electrical Bond•rg j I 5. Steel Reinforcement 56. Rough Plumbing & PrLssure Test 1 I 6. Hifi-cal OF ER Grnd 57. APPROVAL TO COVFR.G1ruiTE I ' 7_Footings 58. Electrical Cor_nu�t•Und•_•nu. L f.-_ I p 8. Fr._,rdation 59. Gas F.pe, -: tlru;n- 1 . -'E;: L9 ';,,iter Pipe•Undrgrnd. Y- - I 60. Bac::nash L.c-;, P•Tr,.1=, 7 ., arra j 10. Sr-ictural Floor System 61. A°FROVAI TO CEC'�( 11, Pr-pe ty Scorer Line F• House Correction 1 62 . Bae:cr:ash & Receptor F,� - _- - 1 12. Sever Cap 63. Heater & VenlFina • - --_ 13. Root Drains I • 34. Plumbing System FeralI . . .. 14 Raa'r Plumbing -_-- 65. ElectricalP rai ---__ 15 Px.gh. E,ectrical-Cond..'t j - _ 66- Solar Syster-. F r.vi j -- - -- - - -- -- 16. RaLah Electric Wiring II 67. Fencing & Acc rs Ano 0..:4L 17. R s,:gh!': rig Sign 9B. APPROVED OR n; i,STERI:t;G , 18. Raugh Electrical-T Bar Ceiling 39. POOL/SPA SYS"E"•S FINAL 19. ROuah Beating & Air Cor.dit-on ng FIRE DEPT. HEOUIFtEitlE"T 20. Rough Factory Fireplace r APPROVALS Permit ___ 21. D-CS, n Structure - ---- - ------- - ---- - ? -- -i--- - --- 70. Unn.•rgrcanr. '1y . 22. Donn, Vmtiiattng _ -_-_- -- I 71. Prcciuct P'P,rh, '.G'i; 'O t- -1-- -_-^ O. l.:7-...r sro1 - rm. 24. Roof Framing a• I I 73. hr1 rrgrnd S i Cr' 25. Pc,.: Srcatn,ng I j i'4. Cv, -reap Hy. , 26. T-Bei Ceiling (Structural) & Morocoat i 1- " 1 / rvChernrc.. f' 27. Fl ame and Flashing 7 b. Dry ..tom c andt�ia. i � 28. ltth,ng & Siding I 17. FIXED SYSTEM%',,s:.AL t 29. 'owulet:on I 78. FIRE PREV. :`;'!A _ • 30. Dr y.tiall Na:Iirg --_----___ - __-_� __ HEALTH DEPT. REOUIRE'.'.ENT SI. '.stn• 3•ar,n Coat 179. r;r:AL INF":•"' I I 32. Electrical Power Meter-Final 1 TI80. FOOD CENTi°ICA: F. ISSUi 7 l_ 1__ 33. F.. al Elrctrc iVotes: r( 34 F,n,a Heating & Air Coi.d,tiomeg , i 35. Fir,,; Gas Pica-Tea 36. Hcod or Canopy +! i. 37. r.•„I Facts v Fireo .c. _ 38. F,nat Plumb,,.gi ---�- I- 39 :?nti.r Service-Final -�-- - i-- -- �- - --- ---- ----- --- - - --- - -- -- j -1_,40 Gas 5ervpzF,nal j 41. So Domestic-Fine' -- - - --- { r2 6 _'tic,:' Presenter .___ -- -I --j- - --- - - ---- - - - ---- r43. Bc.zt:or: Ir gat`on -~ 1 •,4. L. ndicepe lir:gatin^ SystrrrL 1 45. S and Attenuation 46. Ha td:cap Regulations 47. FINAL STRUCTURE & BUILDING 0-W &'(art-' j 4$. Fit AL PLANNING -- ---- - ---- -- _-_ I 49. Electric Release to Edison - 50. Ga., Release to Southern California Gas Co ; 51. CERTIFICATE OF OCCUPANCY I No. Date 2 -12€A2 (sou--rw) \&IALL CF_ , stir lac... .. • wQ 5 I L_ 5 5-- . a / . D '_' 1 ,. , ,, [rte rfo X3 i�P v1-to t 5 fa°_x3- ALUAA. StlDlu�',.? iNDA‘4•3 .&,---„Wa.A.gd...., ••••• 2c. (7 .. rk .T t--• e t ran:, /4—z��2.1(4•:STt-,DDE.D .v.(ALL. ,al :, .r u Ar•ofr �'r:' J ( X 68 �LUM . SL1D&2 loe7C Le NAII�A. u, 1o.Da� *40 CUAs.J6f:.. . . s ! trap .p;o.:s ni ntlY UV '�� " tT7id,tf,,,,e e'+l G,7e,} _ I ' I {c T (p4 I!-' (o� - 38 —� I- 26 IY (off • , E Z�^ Z • r -1,.a,�I'frr�tionna—Cocan rn t -_3� IIY f l :Vey1. ort N yr.a, y,�man n ,: . work 1snotc utfomen _ ----- 'R --PL.,6,c_f_•:_ikek•E"..rr-s 07 _ ,.- , 41TCs,e.n( F4MiLY_2oolA _ _.. c,ED4ZooM 7 �, ti - � ' (i�1 s1�G tdi�!TIiI4.,�: '+.,• 1 .' ....+ ,,p,•� pA �,11 1•'.:;.d il'Ls�.T. SWILL : (o' X6% V�OOD SNGt-; In LAZIz--O`-sfz Xfli.. FRFa 4C4 '000es ' .' �.s`r� �4 T , --.2"----,, tfr t ,t, 5 :),( 95:::489 5 i . 2 5 cGl . w CI 1119, nr/�n, 1 A • - • 6`^X3`- Y��O 5,>,Gt�6bZ6 '~t�. _sr: •f. .4Co 't/ c to'x3y wmo st�,.e_ G.Lc�zrz oati L,T� ,A.)(=cc, wt00ot- �. ; :: :44 - , ) owz.t_t•rr WIUDt..i /\./ NI V — NOTrL: ALL STIQUCT aa.L. 1..-ItMB CS 7 UEAtE2S cSTI.OS , To 2B:MAtto , too ckl:aoce.5-, villnlTu .r�xrsor,o.� WIMBUW DOO ��L�CE IEI�TS r oF; Rt=,-kouAj,oe s,LL op--.7„., t..3Do�- "d" -co � o mg § MRs R. GARRErT ACCoMMOtSA.Tt-L- FQ1-ae4.1,__DcotS . ' Z051 GOLD a N.EYE PL . scta,r- y2:= l ' CostA MESA SCA 92!26 • ' -`� p Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. L°ITY OF COSTA MESA• 'CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. pi 7565 11 /20/B6 21a95 IL Project Address a• '�_��11 • . _ , a — • 8- 26 3CPD 344 C„ — - • ApplicanYs Mailing Addressdrn� _LL /-(0 S 'j � 4 1Q,1� • TYPE OF CONSTRUCTION U NEW U ADD ALTERATION Li REPAIR f • Owner's Name'G�,C�'1� Phone?4 s'-3, ❑ CONVERSION ❑ DEMOLISH ❑ OTS,{ 'lU (J' UV�,# t.3 _ 544—a& I Zone • �' 2 -•1 GOLD., . l� DESCRIPTION OF WORK/USE OF BLDG. )) // s Main Building: - Accessory Building: Address UtYVt �v�,,� _ Z Arch/Eng. ^ License No. TYPE OF PERMIT ❑ GRADING LI FOUNDATION I��S'TRUCTURAL E Front i 0 • Address • /1 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name_•�kir, 5/t1I IGIt.Tti Phone SSi ' /Y� ❑ OTHER C Righ N C� -p6 - PROJECT DESCRIPTION SQ. FT. - OCCUPANCY G Address(mailing) get/-0 SKyf •'I�t CONSTRUCTION TYPE VALUATIONS 7VV'0' s Left �� R City License No. /9� ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION /' 0 • I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: T/'/2D -s6 Q 946 9. Planning Notes: e A M with section 7000) of Division 3 of the Business and Professions Code, and - TC/50 it T my license is in f orCe and effect. �' _ License Cla s 1 enae No. �A U��S . - $ Dated/tea;U �Signature PLUMBING FEES , • WORKERS' COMPENSATION DECLARATION Bar Sink Showers ' ' hereby affirm that I have a certificate of consen to self-insure or a certificate ELECTRICAL FEES Workers' Compensation insurance, or a certified copy thereof (Section Backflow Preventer Service Sink eoo, Lab. C� Q Q Automatic Washer Transfdrmer ❑ 15-50 KVV Policy No. .`.�_L�.-b.L�J Company STK COH'n Backflow Irrigation Sewer Cap _ 0 50+KW • C Certifietl opycIs hereby furnished. • Construction Pole Sub.- I Dale a/1led.4opy-sl%d with the city Bu'O10hg 'sin.' ` Bathtubs - Sewer Connection • Cooking Unit Meter 0 u to 100 amps LIUJ la Applicant (� 1 - �. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _ Dishwasher Meter Dover 100 amps ' (This section need not be completed if the permit Is for one hundred ($100)or - I less). Dishwasher Solar Piping • Dryers ❑Gas ❑Electric . Sub•Panel I certify that in the'performance of the workfor which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan • ' • Workers' Compensation Laws of California. - i Motors❑0-1 HP ❑1X-8 Date Signature I Floor'Drains Swimming Pool w/Spa i F.A.U. _ Inc Solar ❑9-15 HP ❑16-15+ .NOTICE: If,after making this declaration,you should become subject to the - - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks comply with such provisions or this permit shall be deemed revoked. Urinal Fixtures • Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets . Water Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes • , Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) - Lentler's Name Interceptors ' Water Heater Outlets Range - Lender's Address Kitchen Sink Water Service - - - ' -- - OWNER BUILDER DECLARATION - Switches- Sign • , I hereby affirm that I am exempt from the Contractor's License-Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections - i ' following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - Generator 00-5 KW ❑5-15 KW � any structure, prior to its issuance, also'requires the applicant for such permitTrash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains l 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 -- - ,erefrom and the basis for the alleged exemption. Any violation of Section - i )31.5 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 Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee - .$ 3 • for sale (Section 7044, Business and Professional Code: The 'Contractor's MECHANICAL I 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 Y s pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale). Building Approved By Date ❑'I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date _ tractors 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 ❑0-100,000 BTU ❑100,000 BTU - SUMMARY OF FEES - builds or improves thereon,and who contracts-for such projects with a con- / tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ 3.00 SMTP - $ �• Sip proof oftheir Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ 4'•44C PERMIT- 0 i am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $' Date Owner • Heating System& Ducting Registers - PLAN CHECK ' 25% $ ENERGY P.C_ $ I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100.000 BTU GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ - - and state laws relay b i con ruction,and hereby authorize repre- CHECK PLAN 50% MICROFILM $ sentatives of this cit t en upo the above-mentioned property for $ inspection purposes. ,/` MECHANICAL $ TOTAL FEE $ 2/• q. Signature /�^ O Dain L Drivers' License or $5# -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING. POOL &SPA - APPROVALS Permit# Date Inspector APPROVALS Permit# _-- Date Inspector 1. Temporary Electrical Serviceor 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, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final- 12. eceptor-Fina-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 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 PREY. 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: e 317 ' 34. Final Heating& Air Conditioning '[!V 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace • 38. Final Plumbing • . 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 y �J 47, FINAL STRUCTURE & BUILDING 4/z�/�� Qt , 48. Special Requirements Completed • 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No._ Date • • SKYLIGHT THROUGH R'0i4 CATHEDRAL CEILING C ., ii • 37 x1•S Bristolite Skylight Metal Flashing Q I.C .B. O. 2469 & Waterproofing COD U = W 37'1 tt E 2"x4" Curb U 71:1 o 75 .1 � t v Str C) W �/ x 8 " Roof Rafters- 5 "O.C. ICXJ cr STztAc-r1.Iefa1- ISE,q-pi/S = 6 = Y 2 Q � -- C=A0c SKYLIGHT ADDITION FOR : ... TT -2057 ao, o tigyE PL . O95fl? fie-5.g Se/S-317lo 4441 No Final Inspection Will Be Made UNTIL COMPLETE BY CITY US NESSSLICENSE DIVISION. LISTUBCONTRACTORS IS APPROVED AL7 CAUTION ELECTRICAL LINE CLEARANCE REQUIREMENTS 1 -- IN ACCORDANCE WITH STATE SAFETY REGULATIONS, IF '\ CONSTRUCTION REQUIRES WORKERS, EQUIPMENT, CRANES OR HOISTING DEVICES TO BE IN PROXIMITY OF OVERHEAD ,'` ELECTRICAL LINES, OR UNDERGROUND ELECTRIC FACILITIES, CALL SOUTHERN CALIFORNIA EDISON COMPANY IMMEDIATELY (714) 895-0244 rs . wi. APPROVED .. STRUCTURAL APPROVAL ONLY Cift of C Mesa Building C Vit. SEPARATE PERMITS ARE REQUIRED DATE IC AO 1:861 FOR ELECTRICAL. PLUMBING, THESE PLANS MUST BE ON JOB A ALL TIMES ' HEATING E TING. VENTILATING AND MAKE NO CHANGES WITHOUT PRIOR APPROVAL' OF DEPT. ' THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL Petr. it o B 263&o OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION THIS NUMBER MUST a.CL'DMPA.NY OF ANY Of THE PROVI_:ONS OF THIS CODE. NO PERMIT PRE. SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE ALL INSPECTION REQUESTS PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO --------- FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAW$1L. • THE ISSUANCE OF A PERMIT BASED UPON PLANS AND ' I FOR BUILDINGS WITH( PERSONS ARE TO BE SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICLAC EMPLOYED WE SUGGEST THAT THE STATE OF FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS CALIFORNIA DIVISION OF INDUSTRIAL SAFETY IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING I BE CONSULTED FOR ADDITIONAL BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WNW REQUIREMENTS. IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINA'1CBi -`111E CITY. 28018 COSTA MESA BUILDING-SAFETY DEPARTMENT Al2-64E500 430* ***135.75 P.O.BOX 317 COSTA MESA,CALIFORNIA f is6 For Applicant to Fill In Completely APPLICATION FOR PERMIT Tr . 5492 TYPE OR PRINT P1 . 65-A BUILDING BUILDING For Office Use Only ADDRESS 2057 Goldeneye Place RECEIPT NO. 713018 COSTA MESA, CALIFORNIA RaVBD BY DATE RECEIVED DATE ISSUEDED OWNER Mesa Verde Builders /`/% ^�� JAN 1 61968 MAIL BUILDING F/J//k;� (IO) ADDRESS 2850 Mesa Verde Drive FIRE ADDRESS 0/ FIRE CITY Costa Mesa NQ 5490395 ZONE TYPE GROU ARCHITECT TEL ABYPROV EO DATE ORFNGINEER Kaltenbach ND.5478046 - ZONING- AD_ __ss 1823 E. 17th St . S .A. ZONE No.OF BEOPNEw5ingl tam. PLANS BUILD' CONTRACTOR Mesa Verde Builders RI 2 T*/ att gar. LEGAL ADDRESS 2850 Mesa Verde Drive DESCRIPTION Lot 6, Tract 5492 CITY Costa Mesa, California A.P.NO. - none NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE 181269 TEL 549-0395 90'TO SIDE O REAR P.L. NEAVES SIZEOT 64 .x 108 I NO.OF SLOGS. 0 OT TE. ALLOWED (U.B.C.REQUIREMENT) OFL NO. ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET) SETBACK LINE FROM 541 39 ' FRONT 5 /y FT. FT. CENTER OF STREET REAR YARD //// SIDE YARD I LEFT 8 ' I RIGHT 6 1 R.SIDE C., FT. FT. DESCRIPTION OF WORK L.SIDE jj7FT. FT. NE" X ALTERATION /ADDITION REAR / / PT. FT. . DISTANCE BET. BET.MAIN B REPAIR MOVING DEMOLISH MAIN BLDQS. ACCESS.BLDGS. BUILDING 2172 S I NO OF 8 2 VAR.# DATE SIZE q ROOMH STORIES 2 C.U.P.# APPROVED EXTERIOR W wood I ROOF Wood APPROVED COVERING LILUCCO COVERING - BY W.L.D. KATE 1-3-68 USE OF BUILDING AND WORK TO BE PERFORMED F/J Single Family Residence &ra pt, 1/4,902l70 SQ.FT. 444/4/ /9111;34; I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SH N UNDER VALUATION IS FOR THE S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF E ABLISHING A PERMIT FEE ONLY. O PLY WITH ITY ORDINANCES AND STATE LAWS�+REGULATING VALUATION m BUILDING ONST TION. �/J/�j//��//��v�4 r Cl � iILGEa�Cy PERMIT FEE $ p/ SU D SIGNATU '' (( PERMITTEE C ry G $029 73� PLAN CHECK $4J��^�/X�/l��OI, AUTHORIZED AGENT \ O(/7/ TOTAL FEE $/�V . 5