HomeMy WebLinkAbout2258 PAMELA LN - Building PermitsCITY OF COSTA MESA
BIIILDIN6 D/VISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754•5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.
. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER BX07-00034
PERMIT TYPE
JOB ADDRESS:
Vicinity:
SQ.FT: 0
B_MISC
2258 PAMELA LN CM
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Primary Occ:
Valuation:
ISSUED
07/23/2007
BJK
Const Type:??
$14,000.00
SCOPE OF WORK: REMOVAL OF WOOD SIDING & APPLICATION OF STUCCO TO THE ENTIRE 2-STORY SFD. WORK TO
ALSO INCLUDE WINDOW CHANGE-OUTS OF 16 WINDOWS (LIKE-FOR-LIKE) PER �
CURRENT CODE AND REPLACE 2 SLIDER.
OWNER: ESNARD, R PAUL � Address:
PHONE: City/State2ip:
APPLICANT: POMERO, ROBERT Address:
PHONE: 949-054-1938 CitylState/zZip:
CONTRACTOR: DEL SOL CONSTRUCTION AND ROOFING
Address: 27106 PACIFIC TERRACE ORUnit:
City/State: MISSION VIEJO, CA ZipCode: 92692 �
ARCHITEC7: License No.
ENGINEER: . License No. -
MISCELLANEOUS PERMIT.FEE SUMMARY
Building Plan Check: $0.00
Building Permit: $237.25
Electrical Permit: $0.00
Other Fee: $0.00
SMIP Residential $0.00
SMIP Commercial $0.00
TOTAL FEES $237.25
PO BOX 5180 Unit:
BALBOA ISLAND, CA
27106 PACIFIC TERRACE DR Unit
MISSION VIEJO, CA
License No. 625894
PHONE: 949454-1938
CELL:
PHONE:
PHONE:
NOTICE: The work authorized by this permit shall comply wilh all applicable handicap access requiremenls under California slatutes and related
regulations. (Ord. No. 92•2B, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all
required inspections and final approval must be obUined. Failure to obtain inspections and final approval will result in the expiration of this permit.
C�DE� pSPEC710NTYPE
1816 Fixed System Final Fire Prevention
7266 Pool Spa Final �
200 Final Re-Roo(
201 Final Block/ReWining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demoliti0n
o� �� � iNsvernox.rae
208 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuildinglOccupancy
� INiIiIRlS
WORKERS' COMPENSATION DECLARATION:
I hereby aHirtn under penalty of perjury one of the W.....ving decla2tions: �
❑ I have antl will maintain a certificate of consent to self-Insure for vrorkers'
compensation, as provided (or by section 3700 of t�e Labor Code, lor the
peAormance of the wnrk for vfiich this permit is issued.
I have antl will maintain v.orkers' compensatbn insurance. as required by
ectbn 3700 0( the Labor Code, for the peAortnance of Ihe v.�rk lor which ihis
pertnit is issued. My vrorke ' compensati Insurance�c rtier and policy
number are: �
�Camei:} . �—�
(T�aserf0nn not0e�ampefed�l/m/e�' e0a�menuiMiedddlan(SiO�)wless.J
Policy.Numbeh, � �l11
❑ I certity that in the peAortnance of the v.ork lor which this permit is
issuetl, I shall not perso manner so as to become subject
to e compensation laws of Califom and agrea tha� if I shoultl
co sub t to the workers' wmpensation pro ions of Secti 3700 of
1 abor Code, all forthvriN comply with these pro isionc.� „� /
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE�HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDfTION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE U180R CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hareby affrm that I am licensed unCer provisions ot Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Prolessions Code, and
my license i II c � /�// �9
�.� «7 /J ri�«x Y� `� /�
CpNS7RUCTION LENDING AGENCY:
❑ I hereby af(um that there is a consWction lendirg agency fa the
peAortnance W the v�ork for which tltis pertnit is issued. (Sec. 3097. Civil Cotle).
Lentler's Name:
Lender's Atltlress:
Sie�awre Oate
OW NER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of peryury Iha[ I am E%EMPT FROM THE
CONTRACTORS LICENSE LAW for [he follovnng reason (Sec. 7031.5.
Business and Pmfessions Catle: Any ciry or counry which requires a permil t0
conSWct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permit to fle a signed statement
thal he or she is licensed pursuant to the provisions ol lhe Contractors
License Law (Chapter 9(wmmencing with Seclion 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt iherefrom and
the basis lor Ihe alleged eaemption. My violation of Section 7031.5 Dy any
applicant lor a permit subjects the applicant to a civil penally of not more than
five hundretl dollars ($500).):
❑ I, as ovmer o( the property, or my employees vnth wages as lheir sole
compensation, WILL DO THE WORK, and the sWCNre is not intendeC or
oftered tor sale (Sec. 7044, Business and Pmfessions CoCe: The Contractors
license Law does not apply to an owner o! property who builtls or improves
t�ereon, and who does such work himself or herself or throuqh his or her ovm
employees, provided that suih improvements are not intended or oHered for
sale. II, hovrever, Ihe buildinq or improvement is sold within one year of
completion, the ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITF1
LICENSED CONTRACTORS ro conshuct the pmject (Sec. 7044, Business antl
Professbns Code: 7he cont2ctors License Law dces not apply to an ovmer of
property who builds or improves thereon, and who cont2cts for such projecl v,ith
a contracior(s) license pursuant ro the Cont2ctors Ucense Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
305�-a6�3�0]�
Owner ID verified by driw .ise. ❑ Yes ❑ No
Driver s License No. Expires:
Verification of Ovmership by (lype o( document, i.e. - property lax Dill or deeE):
OIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ 1 hereby certAy that no excavation (rve (5) or mae teet in depth into wfiich a
person is requiretl to descend, will be made in connectbn with vrork authorized
by this pertnit, and that no builtling sWCNre, scalldding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2. M 2. Sec. 341, Title 8, Calilwnia Administ2tive Code�.
❑ As owner-builder, I will not employ anyone to tlo work which v.oultl
require a permit from the Division of Industrial Safely, as noted a�ove, unless
such person has a permil lo do such vrork from the division.
/oo�iwm's Spnalum
Division of Indus[rial Safely Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 ot the Calitomia Health and Safety Code requires. vrim some
ezceptions, that a Business Plan be Netl with the Costa Mesa Fire
Department by every business which has at any one lime dunng a reDorted
year a quantiry of hazartlous materials equal to or greater than a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic leet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or fuWre building occupant nead to file
a registration form for acutely hazarCous materials? ❑ Yes ❑ No
(Saction 25533 of the Calilomia Health and Safety Code, with some
exceptions, requires reqistration wilh lhe Cos[a Mesa Fire Department by
each business which at any one time has on han0 a quanti[y o( acutely
hazartlous materials equal to or greater lhan a weight of 500 pounds, or a
volume ot 55 gallons, or 200 cubic feet of compressed gas at standarC
temperawre and pressure).
3. Does or will the applicant or present or future builtling occupant need to
prepare an RMPP (Risk Management and Preveniion 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 Ihe preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials vnth the Fire Department.
4. If an RMPP is presently require4 has Section 25534 of the Califomia
Healih and Salery Code been lully complied with7 ❑ Yes ❑ No
5. Does or will Ihe applicant or present or future building occupant require (or
the work which is the subject of this appliwtion a permit for such conSWcliOn
or modifica[ion from the South Coast Air Quality Management Districl or Irom
any other air pollmion control GisMa or agency? ❑ Ves ❑ No
(Section 65850.2 of Ihe Calilomia Govemment Cotle requires that the requested
information be fumishetl on applications lor rqn-residential buildirg permits).
6. Will any part of the faciliry to be constructetl under this permit be within
1000 feet (rom Ihe outer boundanes ol a schooll ❑ Yes ❑ No
(II'yes", the facilily must mee� the requirement of Sections 25534 and 42303
of I�e Califomia Health and Sa(ery Code�.
7. If a permit from the South Coast Air Qualiry Management Dislrict or other
air pollution control tlistricl or agency is requiretl for Ihe v.ork which is the
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No,
B. pf "yes", allach certificate of compliance from the appropriate air pollution
conirol oKcer).
CERTIFICATE OF COMPLIANCE: I cenify,that under penalty ol perjury the
informalion given above is'correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Matenals and Emissions.
SlgnaWre Daie
CERTIFICATE OF COMPLIANCE AND AUTHORI7ATION OF ENTRY: I
certify under penalt o ' that I have read Ihis appliwtion antl state that
the infor ' rven is correct. to comply with all state laws antl ciry
ord ces relating lo building conslructi and authorize representatives ot
e Costa Mesa ro enter upon th above-0escribed property for
inspe ion pu . I agree not to occupy or al occupancy ot �ny byilding
(...` ; • .
CITY OF COSTA MESA
77 FAIR DR 2ND FLOOR P.O.BOX 1200 CALIFORNIA 92628-1200
DEVELOPM1iENT SERVICES DEPARTMENT
EMERGENCY ESCAPE AND R�SCUE WIIYDOWS
All sleeping rooms in dwelling units below the fourth floor shall have at least one operable wfndow or door approved for
emergency escape or rescue. The emergency wfndow or door shall be opereble from the inside to provide a full, clear
opening without the use of sepa2te tools. Escape or rescue windows shall have a min(mum net Gear openable area of
5.7 square feet. The minimum net clear hefght dimension shall be 24 inches. The minimum net clear width dimension
shall be 20 inches. When wlndows are provided as a means of escape or rescue, they shall have a finished sill height not
mpre than 44 inches above the Floor.
The table below shows the mfnimum height and width of requfred 5.7 square foot
'H 2U 20.5 21 21.5 22 22.5
HT 41 40 39.1 38.2 37.3 36.5
H 2T.5 28 26.5 29 29.5 30
HT 29.8 29.3 28.8 28.3 2T.6 27.4
23.SII 241I 24
31 II 31".5
25.5 26 26 �
32.2 316 31
33 335 34
24.9 24 S 24.1
(
a5. u�mension on the plans 30" mir �ar width for water closet compartment a 24" min. clearance �n front of the water
closet. (UBC 29D4)
46. Wall coverings in showers or tubs with showers shall be cement plaster, tile or approved equal to 70" above drain. (UBC
807.1.3 )
47. Net area of shower receptor shall be not less than 1,024 sq. in. of Floor area, and encompass a 30" min. diameter circle.
(UPC 410.4)
48. Prov'rde one openable escape window or door meeting ali of the following: an o enab e area of not less than 5.7 sq. ft.,
24" min. high antl 20" min. wide, and a sill height 44" max. above the floor in 'l�O��M (UBC 310.4)
49. Show location(s) of hard-wired smoke detectors: (UBC 310.9.1)
a. Ce�trally iocated in corridors (or areas) leading to sleeping areas, and inside each sleeping room.
b. On ceiling of upper level in close proximity to the stairway when sleeping areas are on an upper level.
c. On each floor level and in basement.
d. In the adjacent room (or area) where the ceiling height exceeds that of the hallway by 24" or more.
e. Battery operated smoke detector permitted in existing construction.
f. Note on plan: detecfor shall sound an alarm a�dible in all sleeping areas.
g. Smoke detectors shall be hard-wired and equipped with battery backup.
EXITS. STAIRS AND RAILINGS
50. One exit door shali be not less than 3'-0" wide and 6'-8" high and provide 32" min. clear width. (UBC 1003.3.1.3)
51. Landings at doors shall have a length measured in direction of travel of not less than 36". (UBC 1003.3.1.7)
52. Within individual units a door may swing over landing that is not'more than 1" below the threshold or 8" max. if the door
does not swing over the landing. (UBC 1003.3.1.6) �
53. Occupants on Floors above the second story shali have access to two separate exits. (UBC 10042.3.2) (EXCEPTION:
occupied roof area or third Floor within an individual dwelling unit less than 500 sq. R. may have one exit.)
54. Provide section and details of interior/exterior stairway showing:
a.
b.
d.
e.
8" max. rise and 9" min. run; or, 7" and 11", respectively, where stair serves two units (UBC 1003.3.3.3)
36" min. width (UBC 1003.3.32)
6'-8" min. head room (UBC 1003.3.3.4)
Details and notes showing framing (stringer) sizes, bracing, connections and Footings
One-hour fire-resistive construction on enclosed usable space under the stair (UBC 1003.3.3.9)
55. For winding stairs provide 6" min. tread and provide the required run at a point 12" from the narrow side of the tread.
(UBC 1003.3_3.8.2)
56. Spiral stainvay shali not serve as required exit for area exceeding 400 sq. ft. (UBC 1003.3.3.8.3)
57. Provide manufaCturer, model # and ICBO # for prefabricated spiral stair. Alternately, submit construction drawings and
structural calculations for spiral stair and supporting elements.
58. Provide spiral stairway column base connection/footing detaii.
59. Provide connection details on plans for guardrails and/or handrails on open sides of balconies, decks, landings, and stairs
adequate to support 20 pounds per lineal foot load applied at a right angle to the top rail. (UBC Table 16-B)
60. Handrails shall satisfy the following: (UBC 1003.3.3.6 and 509)
a. Provide continuous handraii for stairways with 4 or more risers (2 or more risers where stair serves two units)
b. Handrail shall be 34"-38" above the nosing of the Veads
c. Openings in balusters shall be less than 4" in diameter at open side(s)
d. The handgrip portion of the handrail shall be t-1/4"-2" in cross-sectional dimension with 1-1/2" Gearance to wall
61. Provide 36" min. high guardrail for decks, porches, balconies and raised floors (more than 30" above grade or floor below)
and open side(s) of stair landings. Openings between balusters/rails shall be less than 4" in diameter. (UBC 509)
C�1L7_L��`�I� : . . � -
2552d6
I V � .
� UNIFOHM BUILDING CODE
�pCass to, and egress from, buildings mquired to be�accessibl
�� ye provided as spocified in Chapter 11.
�gyumen�s in dwelling units and every sleeping room below
310.4
310.9.1.3
If any room has a furted ceiling, the presaibed ceiling height is
required in two thirds the arw thereot, but in no ezse shall the
height o( the furted ceiling 6e less than 7 fea (2134 cnm).
�ye foutth story s6a11 have at Iesst onc operable window or door �310.6Z Floor acea. Dwelling units and congrcgate residences
�„�rpv�� emerEency eswpe or rescue that shall o0en dircctly shall have at least ono e room that shall have not less than 120
'iuto a ublic strcet, pubhc ailev. vard or ezit court. The emergenry square teei (11? m'-) of floor azea. Ottier habitable rooms exce�t
Aoor or wm ow s a e operablc from the insidc to provide a full, ���rhP..< <hall have an area of not less than 70 �aJ,,,��ar,e f_et (6S m-).
dear opening without the use o( separate tools. Efficiencv dwelling units shall comply with the requirements of
EXCEPIION: Thc windox� or door may opcn in�o an atrium com-
plying with Seclion SO'_ pro�'ided Iht WindoW or door oprns oNo an
' exil-aecess balconr and the dweliing uni� or guesi room has an exit or
exii-aecess doorwap tha� does noi open imo thc ainum.
Escape or rescue windows shall have a minimum net clear
APopenable area of 5.7 sQuarc feet (OS m'-). The minimum net clear
^%�, openable heieht dimension shall be 24 inchcs (610 mm). The
minimum netlear openable u•idth dimens�on shall be 20 inches
(508 mm). When windows are provided u a means o es�
reseue, they shall have a finished sill height not more than 44 in-
ches (i11.8 mm) above the (loor.
Escape and rescue windows u�ith a finished sill height below
the adjacent �round elevation shall have a u•indow well. Window
wells at escape or rescue u�indows shall comph� with the follow-
ing:
1. The clear horizon[al dimensions shall allow the window ro
be fullv opened and provide a minimum accessible net clear open-
in� of 9 square feet (0.64 m'-). with a minimum dimension of
36 inches (914 mm).
�. Window wells with a vertical depth of more than � inches
(1116 mm) shall be equipped u�ith an approved pertnanen[ly a6
fixed ladder or stairs that are accessible with the window in the
fully open posieion. The hdder or staus shall not encroach into the
required dimensions of the windok� well b�• more than 6 inches
(li2 mm).
Bars. erilles, erates or similar de�•ices mar be installed on
emergency escape �or rescue w�indows, doors or window wells,
provided:
1. The devices are equipped with approved releue mecha-
nisms that are openable from Ihe inside without the use of a key or
special knowledge or effort: and
2. The building is equipped u�ith smoke detectors installed in
accordance with $ection 310.9.
310.5 Light, Ventila[ion end Saoitation. Lieht and ventilation
shall be as specified in Chapter 12. The number of plumbing fix-
tures shall not be less than spec�ed in Senion 2902.6.
310.6 Room Dimensions.
310.6.1 Ceiling heights. Habiu6le space shall have a ceiling
height of_not less than 7 feet 6 inches (2286 mm) except as other-
wise pertnitted in this seaion. �tchens. halls, bathrooms and toi-
let companments may have a ceiling height o( na less than eet
(2134 mm) measured to the lowest projection from t�e ceTng.
Where exposed beam ceiling members arc spaced at less than
46 inches (1219 mm) on center, ceiling height shall be measured
to the boetom o( th�se membtrs. Where exposed beam ceiling
members are spaced at 48 inches (1219 mm) or more on center,
ceiling height shall be measured to the bottom of the deck sup-
poned by these members, provided that the bottom o( the mem-
bers is not less than 7 feet (2134 mm) above the floor.
If any room in a building has a sloping ceiling, �he prescribed
ceiling height Cor the room is required in only one half the area
thereo(. No portion of the room measuring leu Ihan 5 feet (1524
mm) (rom the finished floor to the finished ceilinR shall be in-
cluded in any computauon of the minimum area thereof.
Section 310.7.
310.63 Width. Habitable rooms other than a kitchen shall not
be less than 7 feet ('' li4 mm) in any dimension.
310.7 E[ficiency Dwelling Units. M efficiency dwelling unit
shall conform io the requimmems of the code except as herein
provided:
1. The unit shall have a livine room o( not less than 220 square
feet (20.4 m'-) of superficial floor area. An addition�sauare
feet (93 m') of supe�cial floor area shall be provided for each
occu ant of such unit in ezcess o( nvo.
2. The unit shall be provided with a separate closet.
3. The unit shall be provided with a kitchen sin}:, cooking
appGance and refrieeracion facilitie�, each having a clear working
space of not less ehan 30 inches (76'_ mm) in &onc. Lieht and ven-
tilation conformin� ro[his code shall be provided.
4. The unit shall be provided with a separa[e bathroom contain-
ing a water closet, laca�on� and bathmb or shower.
310.8 Shaft and Ezit Enclosures. Exits shall be endosed as
spec�ed in Chapter 10.
Elevator shahs. ven� shafrs. dumbw�aiier shafrs, cbthes chutes
and other venical openines shall be enclosed and the enclosure
shall be as specified in Sec[ion 711.
In nonsprinklered Group R. Division 1 Occupancies, corridors
serving an occupant ioad of 10 or more shall be separated from
corridors and other areu on adjacent floors by not less than ap-
proved fixed wired glass set in s[eel frames or by ZO-minute
smoke- and draft-control azsemblies, which are automatic clos-
ing by smoke detection.
310.9 Smoke Detec[ocs and Sprinl:ler Systems.
310.9.1 Smoke detectors.
310.9.1.1 GeneraL Dwelling unitt, coneregace residences and
hotel or lodeing house guest rooms Ihat are used for 5leeping pur-
poses shall be provided with smoke detenors. Detectors shall be
installed in accordance with the approved manufacmrer�s instruc-
tions.
310.9.L2 Additions, al[ecations or repairs [o Group R Occu-
pancies. When the valuation of an addition, alteration or repair
to a Group R Occupanry exceeds 51,000 and a pertnit is required,
or when one or more sleeping rooms are added or aeated in exist-
ing Group R Occupancies, smoke deteaors shall be installed in
aeeordance with Seaions 310.9.13, 310.9.1.4 and 310.9.1.5 of
this section.
EXCEPIION: �Re a��rs m thc cz¢rior sudaces of a Gmup R Occv-
pancv are exemPl ro�m thc rcquiremrn�5 of �his seetion.
310.9.13 Power source. In new construction, required smoke
detectors shall rcceive �hcir primary power from the building wir-
ing when such wiring is served (rom a commercial source and
shall be equipped with a battery backup. The duector shall emit a
signal when the batteries arc low. wring shall be permanent and
without a disconneaing switch other than those required for over-
current protection. Smoke deteciors may be solely battery oper-
ated when installed in existing buildings; or in buildings wi[hou[
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR ORIVE • CALIFORNIA 92fi28-1200
DEVELOPMENTSERVICES DEPARTMENT
New State Law:
Swimming Pool Safety Act of 2006 (Assembly Bill 2977)
Effective January 1, 2007
California Health and Safety Code Section 115928 "(d) Whenever a buildin�permit is issued
for the remodel or modification of a sinQle family home with an existinR swimming pool,
toddler pool, or spa, the permit shall require that the suction ou[let of the existing swimming
pool, toddler pool, or spa be upgraded so as to be equipped with an anti-entrapment cover
meeting the current standards of the American Society for Testing and Materials (ASTM) or
the American Society of Mechanical Engineers (ASME)."
2z� ��� �--� ���-��s�-, c� -
Address/Permit Number
Permit Applicant or Contractor's Affidavit (Please check appropriate box):
❑ There is an existing swimming pool, spa, or toddler pool on this property. I will
install an anti-entrapment device that conforms to this law, a�d I unders[and that the
installation of this device is required prior to final building inspection approval.
is no swimming pool, spa, or toddler pool on this property.
l�
6uilding Division p74) 754-5273 • Cotle Enforcement p74) 754-5623 � Planning Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 • www.ci.wsta-mesa.ca.us
.
CITY OF COSTA MESA
BlIILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
��ia)�sa-sz�s • Fe:(�ia)�sa-aass
Job Address: 2258 PAM�LA LN
Suite:
Vicinity: WHOLE BUILbING
Parcel Number: 42237217
qpplicant: BOULGER, SHAWN
Address: 2851 E. LACRESTAAVE.
ANAHEIM,Cq
Owner. CHI, MICHAEL C TR
Address 12862 BERKHAMSTED ST
CERRITOS, CA
Contractor LINNERT ROOFING, INC.
Address: 2851 E. LA CRESTA AVE.
ANAHEIM,CA
Zip: 92806
Arch :
Address:
� Phone:
BUILDING PERMIT
NUMBER
77 FAIR ORIVE, COSTA MESA, CA 92626
Zoning:
ISSUED BY:
Phone: (714)632-1900
Zip: 92806
Phone:
Zip: 90703
Phone: (714)632-1900
License: 664319
Eng:
Address:
Status: ISSUED
Applied: 02/22/2000
Issued: 02/22/2000
Phone:
e�
Zip: License: License: �
SCOPE OF PERMIT
REROOF EXISTING 3-UNIT APARTMENT BUILDING (20 SQ). GO OVER EXISTING LAYER OF COMPOSITION SHINGLES
WITH 1-LAYER OF 30# FELT & 25 YEAR COMP SHINGLES. .
'SUBJECT TO PRE-ROOF INSPECTION.
Plan Check: $0.00
Permit: $83.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
Rear 0-0
Rear 0. 0
FEE SUMMARY
Calc Valuation: $3,000.00
Claim Valuation: Ss,000.00
PLANNING & ZONING
Left 0- 0 Right
Left 0- 0 Right
0- 0
0- 0
NOTICE: The work authorized by this permit shall comply witli all applicable handicap access requirements under California statutes and rela�ed
regulations. (Ord. No. 92-20, § 1, 72-21-g2)
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 7 BO 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
requlred inapectlona and tinal approval must be obtained. Failure to obtain inspections and tinal approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS'COMPENSAnONDECLARAnON:
I hereby aHirtn untler penalry of perjury one of the following tlaclarations:
❑ I hava end will meintain e certilicate of consanl to setl-Insure lor workere' compensation, a5 provitled For by 5ecti0n 3700 of Ihe Labor Cotle, for �he pertOrmance ol Ihe
�wark for which this permit is issued.
will mainiain workars' compensation insurance, as requiretl by seciion 3700 of the Labor Code, for the pedortnance of Ihe work tor which Ihis pertnit is issued.
�rc�� �p�"se�ion Insurence carriar and poliCy numher are: �(�aU�O(/ I U�6
lfT�elr .=.+'LiLc,fG,'1GQ Polic Numher.
�d wt be camp/ered i! (he permit is valued ef one hundretl dollars ($100) or less.)
❑ I cartify ihet In the peAormance of the work for which this parmit is Issuetl, I shell not employ any person in eny menner so as to become subjeci to Ihe workers'
compensation laws of Califomia, and agrea that if I shoultl hecome sublect to the workers' compensation provisions of Section 3700 of lhe Labor Cotle, I shall forthwith
comply with these pr�v}%ions�.
�pplicantSignaWre:�y,nr 'S� ate:�- �a'.�•UQ
ARN��INB-fRiLUflE TO SECURE WORKERS' COMPENSATION COVEFAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDREO
TiqUSAN� DOLLARE (510D.000). IN ADDITION TO THE WST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 3'lO60F THE L4BOR CAOE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DELLARATION:
I hereby aRirm t Sns�e !under rovisions of Chapter 9(commencing with Section 7000) of Division e.Busjn�es and Professions Code, and my license is in full
brceantleHect Lic k � —(dn�Y��l1 G�ass"tt _�"3y
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm Ihat there is a constmction lending agency for t�e pedormence oi the work lor which ihis permit is issued. (Sec. 3097, Civil Code).
Lendels Name: Lenders Atltlress:
SignaWre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm �hat untler penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business and Pwfessions
Code: Any ciry or county which requires a permit to consimct, alter, improve, tlemolish, or repair any stmcwre, prior to its issuence, elso raquires the applicant For such permit
to file a signetl s�atemen� thet he or she is licensed pursuem to iha provlslons of the Contrectors License Law (Chapter 9(commencing wlth Section 7000) of Division 3 of the
Business ana Professions Cotle) or ihat he or she is exempt therefmm and the basis lor ihe alleged ezemption. Any violation oi Sectlon 7031.5 by any applicani for a permit
subjacts the epplicant to a civil penalry of not more than fiva huntlred dollars (5500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe structure is not Intentletl or offered for sale (Sec.
7044, Business ana Professions Cotle: The Coniractors License Law does not apply to en owner of property who builtls or improves thareon, antl who does such work
himselt or herself or through his or her own employees, providetl t�et such impmvements are not intended or oRered for sala. It, however. Ihe building or improvement is
soltl within one year of completion, ihe owneo-builder wi0 have ihe burden ol pmving that he or she tlid not build or improve tor purpose ol sale.).
❑ I, as owner af the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe projeci (Sec. 7044, Business antl Professions
Code: The contrac[ors License law tloes not epply to en owner ot property who Duiltls or improves t�ereon, and who conirects for such project with a contractor(s)
license Dursuant to the Contractors License Lews.).
❑ I am exempt untler sec. Business and Profeuions Code for ihis reason:
Signatura:
Owner ID vanfietl by tlriva/s license.
❑ Yes ❑ No Driver'S License No.
Ventication ol Ownership by (type of document, i.e. - propetly tax bill or deed�:
UIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION:
Date:
Expires:
❑ I hereby certify that no e:cavation five (5) or more feet in tlepih inm which a person is required ro descenq will be matle in conneclion with work authonzetl by ihis
permit, and that no building simcture, scaffoltling, falsework, or tlemolition or dismantling thereoi, will �e more than thiny�six (36) feet hlgh (Chap. 32, Grp 2, Art 2, Sec.
341, THe B, California AdminisireWe Code).
❑ A5 owner-builtler, I will not employ anyone to do work which would roquire a permit from the Division ai Indusirial Sefety, as noted above, unless such person has a
permit to do such work from the tlivision.
Signature: Date:
DiNsion of Intlustnal Safery Permit Num6er
CERTIFICATE OF COMPLIANCE AND AUhIORIZATON OF ENTRY: I certify under penalty o( perjury that I have reatl ihis epplication antl state that the intormation given is
correct. I agree to compty with all stale laws and ciry ortlinances relating to building consWc�ion, an0 authonze representatives of ihe City of Costa Mesa to enter upon lhe
ebove-tlescribed property for inspection puryoses. I egree not to occupy or allow occupancy of any building amhorized by ihis parmi� until linal inspection.
F�i•71�r,ti�xa�[.�.'i�7
1676
1266
200
201
202
203
Fixotl System Final Fire Prevention
Pool Spa Finel
Final Re-Roof
Final8locWRetaining Wall
Finel FaCtOry Fire Place
Finel Sign
204 Final Demolition
246fiA8
�E INTITIRLS
'�'��• 1
�'��'
CO�E� INSPECTIONTYPE
206 Final Mechanical
{�� 20B Final Plumbing
`�%f, 210 Final Electncal
m� 212 Final Fire Prevention
220 Final Planning Approval
222 Final5it8
250 Final Building/Occupancy
ILRTE-'� � INTRIRLS
�cl,' Yo
• q"a''�..� �
; :.:.::: ; ;
�: ,
CITY OF COSTA MESA
BUILDING p1Y1S10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fax (714) 754-4856
JobAddress: 2258 PAMELALN
Suite No
Vicinity: UNIT#A
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contractor.
Address:
ISSUE FEE
Temp service test
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service ro 200a
Service to 1000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
MOtors to 50hp
Motors to 100hp
Motors over t00hp
Communica[ion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intertned Pole
42237217
MOSCA,PETER
CHI, MICHAEL C TR
12862 BERKHAMSTED ST
CERRITOS, CA
MARC ELECTRIC
9721 POPPY CIRCLE
FOUNTAIN VALLEY. CA
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
Zip: 90703
Phone: (714)7753373
Zip: 92708
License: 619427
SCOPE OF PERMIT
REPLACE EXISTING 100 AMP SUB-PANEL.
522.00
50.00
50.00
$0.00
E0.00
50.00
$0.00
$0.00
50.00
50.00
$0.00
50.00
50.00
50.00
50.00
50.00
$0.00
$0.00
50.00
$0.00
527.25
$0.00
$0.00
$0.00
50.00
Quantity
Temp Dist System / Lighting
Busway /100 ft
Slanding Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kvalkw
.................up to 50 kva/kw
.................up to 100 kvalkw
..................over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Cirws (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigalion Fee
Plan Check Fee
Reinspection Fea
PERMIT NUMBER
� E99-00424
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: APPLIED
Applied: OS/18/1999
Issued:
ISSUED BV: ��
I
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES 549.25
COMMENTS / SPECIAL CONDITIONS
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall aulomatically 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 mus� comply wi�h all applicable codes, and all
requlred inapeetlone end final epprovel must be obtained. Feilure to obtain inspections and finel epproval will result in tha expiretion of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATON DECLAFiATON:
I hereby aflirm untler penalry of pqrjury one ot Ihe following dederetlons: ' � �
❑ I �ave entl will mainiain e cgrtificate oi cansent to selFlnsure tor workers' mmpensetlan, as pmWded tor by sectlon 3700 of t�e Lebor Cade, for Ihe peAarmance ot the
work for wnich this permit is issued.
❑ I have and will malnteln workers' canpensallon insurence, as requlred by sectlon 3700 01 the Labor Code, tor Ihe pertormance of Ne work lor which this pertnit is issuetl.
My workers' compensetian Insurence certier and pdky number ere:
Carder. Policy Numhgr.
(This section need not Ge comp/ete0l! Me perml( fs valued et one �undred dWlars (S700J or less.)
❑ I certity t�et In Ue peRartngnca ot Ihe work lor whlch thls pertnit is IssueC, I shell not employ any porson In any menner so es to 6ecame sub�ecl to the workers'
compensation laws ot Calltomia, arM egree Uet tl I should bewme sub�ecl to ihe woAcers' compensatlon proNsions ot SecUon 3700 of the Labor Cotle, I ahall foMwilh
comply wlih ihes/a� Io-n7S-. ry /1 y
Applicant Siqneture: C.y� A�� db Date: � �d �7 /
�
WARNINO: FAILURE TO SECURE WO�(ERS' COIAPENSATION COVEMOE IS UMAWFUL M'D SHAL� SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUN�RED
THOUSAND DOLLARE (5f 00.000),IN App�ilpry TO THE WST OF COMPENSATION, OMMOES 0.5 PROVIUED FOR IN SECTION 9]080F THE IABOR CODE.IMEREST. ANO ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy afflrm thet I am Iicensed untler provisions at Cheptar 8(commencing wlth Sectlon 7000) ol Dlvlslon 3 of Ihe Business entl Protesslons Code, end my Iicense is In full
torce end enect. Lic. a G d — '( Cless a Q / G
Comreciofs Signamre: �, 7� , ��� Deta: t'- - / & - � �
CONS7RUCTION IENDING AGENCY:
❑ I hereby atlirtn thet there Is e wnsiructlon lentling egency br the pertortnence ot �he work br w�lch Ihis pertnll Is IssueC. (Sec. 3097, Civil Code).
Lender's Neme: Lentlefs AtlOress:
Signature: Date:
OWNER•BUILDER DECLARATONS:
I hereby ettirtn Ihat under penalry ot per�ury thai I am EXEMPT FHOM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business flnd Professions
Code: Any ciry or counry which requlres a pertnit to consWcL elter, imprave, demolish, or repeir eny structure, pdor to Iis Issuance, also requires the epplicent for such pertnit
to tile e signe0 statement that he or she is licensed pursuant to the provislons ot Ihe CONractors License Lew (Chapter 9(commencing with Section 7000) of Dlvision 3 of the
Business antl Prafessions Code) or that �e ar she is exempt therelrom end the besis for Ihe allegeA e:emptlon. Any vlolatlon of Sectlon 7031.5 by any epplicant for e permlt
subJects the apPlicant ro e civll penalry W not more then tNe hundred dWlere ($500).):
❑ I, es owner ol the property, ar my employees with weges es Ihelr sola compense�lon, WILL DO THE WORK, entl the structure Is not intended or ofteretl lor sele (Sec.
7044, Businass end Profes„•ians Code: Tha Contrectors Liconse Law does not epply lo an owner ol property who builds or improves thereon, entl who tloes such work
himself or herself or ihrough his or �er awn employees, provitletl that such Improvemenis ere not Intentletl or oNered for sale. If, however, ihe building or improvement is
soltl wlihin one yeer ol completion, the awner-bullder will heve the burden of proving �hal he or she did not build or improve for purpasa ot sale.).
❑ I, es owner ot Iha property, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions
Code: The contractore License Law does not apply to en owner of properry who Dullds or Improves thereon, and who conireds for such Dro�ect with a comractor(s)
license pursuant to the Conirectors License Lews.).
❑ I em e:empt under sec. Business antl Pmfessions Code br this reason:
SignaNre: Date:
Owner ID verified by Crivefs license. ❑ Yes ❑ No Driver's License No. Ezpires:
Verification of Ownership by (type ot dacumen4 i.e. - praperry tex blll or dee0):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cenity thet no excavetlon tNe (5) or more leet in tlepth Into which e person Is requlretl to tlescentl, wlll Ge metle in connectlon wlth work euthorizad by this
pBrmll, and thet no DUIIGing strudure, scaNdtling, lalsework, or tlemolltlon ar dlsmentlinp thereof, wlll be more ihen tAlrty-slx (36) leet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Celitomia Adminlstretive Cade).
❑ As owner-Ouiltler, I wlll not �mploy enyone to Co wark which woultl reQulre e permlt Irom ihe Dlvislon ot Intlustrlel Sefety, es notetl ebove, unleu such person has a
pertnit to do such work trom Ihe CMsion.
Signawre: Date:
Division af Indusidel Sefory Permlt Number.
CERTIFlCA7E OF COMPLIANCE qND AllTT1081ZATON OF EHTHY: I ceM1ity under penfllty ot perjury thet I have reed thls applicetion and stata that the information given is
correcL I egree to compty with all stete laws entl dty ordinances releNng ro bullding constructlon, end authodze representatives oi the Cly of Costa Mesa to enrer upon Iha
above-descdhetl praperty tor Inspection purposes. I egree not ta accupy or ellow accupency of eny bulltling euthodzed by NIs permlt unUl flnal inspection.
�--�t� Si eture Of Legel Owneqs) Dete
e -�a-/� 9qi�Jb'Q/C/� �-� (S' - % 9
� �NOr Aut�oAzed Applicant Dete
400E �. INSPECTIONTViE
1816 Flsed System Finel Fire prevention
1266 Pool Spa Final
200 Final Re-Rool
201 FInaI BIocWRetaining Wall
202 Finel Fectory Fire Place
203 Flnal Slpn
204 Finel Demolition
2a&4fi
�g ��
COOE� INSPELTIONTYVE
208 Flnel Mechenical
208 Flnal Plum6ing
210 Flnel Electrical �
212 Finel Fire Preventlon
220 Finel Planning Approval
222 Finel Site
250 Finel BuildingiOccupency
Q� INTRIRLS
� �� �% %�
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AUG-�i-72cnsn�� 389� ****66.04
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
ForApplicant to Fill in Comp/etely qE�iv ev D E R CEIVED
DATE SS D
BUILDING 225g pamela Lane o� �
ADDRESS
OWNER RO37 �. Ward Co� A.P. NO. I 'C� PE� J�;�
MA I L BUIIDING
ADORE55 170'7 BVestcliFf Drive P.ODRESS
cirv Nevrpott Beach rTio`646-0228 TRACT � t 33 e�ocK
CONSiRUCT10N W
LENDER
BRANCH
OWNER �
ADDflESS 1 VALUE
OR ENGINE R Roy Kiter TE 48 � 52L� $ �
FIRE
ADDRESS 211 WdLRl1L SL� Newport Beach ZONE T PE GROUP �'
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL. �ONE NO.OF USE OF NEW
FlANS BUILDING /�,1'
CITY NO. TM r �r
STATE CITY �'ARDSAPPROVED VARDSAPPROVED
IIC. NO. IIG. NO. MAIN BUILDING ACCESSORV BUILDING
SI2E NO.OFBLDGS. (FROMC/LSTREET
OFLOT 54X11t��E)�IOH�09 ryOWONLOT O RONT FT, FT.
VSE OF None �
EXISTING BLDG. FT
SIZE OF NO. OF
NEWBLIJG. ROOMS STOHIES L,SIDE � FT. FT.
EXTERIOR WALL WQDa ROOF
COVERING COVERING REAR �J FT. FT.
USE OF 8 LDiM G AND WQRI( TO gE�PEF�FORMED DISTANCE BET. BET. MA�N &
�it Lex w� MAIN BLDGS. ACCF�. BLDGS.
� —�^ ,�...,,,.se VAR. # q DATE / ._ S '.� 1�
C.V.P.qW G/C" APPROVED �,
PLAN I �flOVED ig i
sraTE
I hereby acknowletlBa thet I have reatl this application antl state
ffiat the above Info�mation is mrrect antl e8�ae to comply wi[h � I
all laws reguleting builtlin8 �onsttuction, antl I shall not amploy nQ� .r
any person in violation ot the workman's compensation laws of �
the State of Californie. � � m
I hereby certify Mat I am properly licensatl as a contractor untler SQ. FT. l O
the State ot Californie Buzinass entl Professions Cotle, Divlsicn 3, T E AMOUNT SHOWN UNDER VALUATION FOR
Chapier 9, antl that such licensas are {n f�ll force and effett, or I E PUFP06E OF ESTABLISHING A PERMIT FEE ONLV: m
am exampt trom Me ovis' n of [he S[ate ot Ce�ifornia Buzinecs ¢
antlProfessions �l D\� on ,Chapter9. VALVATION ,�.� N
PERMIT FEE $ ]
Si9�amre of / /� /��{ . h�� �i{ L�� m
Permittee � �' $ /� �J - / i�y � PLpN CHECK $ ✓• � J E
�y / V ✓ o
Au2horized Agent ` TOTAL FEE $ � LL
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"CT 19-7?�w5�00 886 �u��126.50
COSTA MESA BUILDING-SAFETY DEPARTMENT �
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
A PLICAT�ON FOR BUILDING PERMIT
for Applicant t 'll in Complerety R Ei E ev DATE RECEIVED
�� DATE ISSUED
A01DRES5 �Z�'CJ LGI'U�CLp. I..J �� �^ v�Z I�`I�` �'�, ,
�I �� FMITN
OWNER � A.P.NO.IJS�C� _ 5��.%
MAIL BUILDING �� �+
ADDRESS
ADORESS CJ y�pEZ
TEL. TRACT L� �� BLOCK
CITV NO.
CON5TRUCTION W DD ALTER P
LENDER
BRANCH 1
OWNEfl 1
ADDRESS VALUE
ARCHITECT TEL. S .0 l� S
OR ENGINEER
FIfiE '" �
ADDRESS ZONE TYPE GROUP
APPFOV E �
CONTRACTOR BV DATE ii�
ADDRESS
TEL. ZONE NO.OF USE OF NEW
� PLANS � BUILDING 'T�
GTV NO.
STATE CITV YAAOSAPPROVED VARDSAPPROVED
IIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUIIDING
SIZE NO.OF BLDGS. (FROM C/L /STREET)
OF l0T NOW ON LOT ROfYi L FT. FT.
USE OF
E%ISTING BLDG. S FT. FT.
SIZE OF NO. OF
NEWBLDG. FOOMS STORIES L.SIDE FT. FT.
EXTERIOR WALL ROOF
COVERING COVEqING REAR � FT. FT.
VSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN &
MAIN BLDGS. ACCE55. BlDGS.
\ �� C UpP � L�: � �� ' APPROVED (p �5-70�
� APPROVED 1 i. � a /Za/�L_
lN C.Y
'
I hereby acknowletlBa chnt 1 have reatl this application antl state .+F
tha[ the above information Is corr¢ct antl egree to tomply with �W
all laws regule[ing builtling conitruction, anC I zhell nOt employ SQ
ony person in viola[ion ot the workman's compansation laws of ��
the State ot Califomie. ` � �
T i
I hereby certity Met I em pro0erly licensetl as a contractor untler V SQ. FT. _ i
Ma Scate of Calitornia Business entl Protessions Cotle, Divlsicn 3, THE AMOUNT SHOWN UNDEF VA�UATION IS FOR
Chapter 9, antl Nat such licensas ara in tull force antl attect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
am exempt from t�e vision f the State o( CeII(ornfa Business
antl Professions c e, i is'6 , Chapter 9. VALUATION �"Zj �
PERMIT FEE $ !
SiB�a[ure ot �
Parmlttae $ PLAN CHECK $ �''p
A�thorized Agent / / l �
TOTAL FEE 5 �/ y
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35593
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFOHNIA 92626
For Applicant to Fill in Completely
BVILDING Z4S�� ,���� CQ/l.
AODRESS
OWNER
MAIL
AODRESS
TEL.
CITY NO.
CONSTRVCTION /n
BRANCH
ADDRESS
L.
ADDRESS �
CONTflACTOR '��,
�
ADDRESS
TEI.
CITY � NO.
STATE � CITV
liQ NO. ) LIC. NO.
SI2E I NO. OF BLDGS.
OF LOT NOW ON LOT
USE OF
E%ISTING BLDG.
SIZE OF NO. OF
NEW BLDG. ROOMS STORIE:
EMERIOR WALL ROOF
COVERWG COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
'�- - _� C'A-2 C-�ru�-n a c�--�
I hereby acknowledge that 1 have reatl this application and state
ffia[ the above information is correcY and a0ree m comply with
all lews regulating builtling construction, antl I sM1all not amploy
any person in violation of tho workman's compensation laws af
the State ot Calitornia.
I hereby certity that I am properly licensetl as a contractor untler
the State ot Califomia eusiness antl Protessions Code, Divisicn 3,
Chapter 9, antl that such licenses are in tull force antl etfect, or I
am exempt tro the pro isions of the State of Calitornia Business
antl Protessio s i i ion 3, Chapter 9.
SiBnature of
Permittee
Authorizetl Agent
Pnm
oct i9-t2��,-5,00 a9s� �u**39.28
TION FOR BUILDING PERMIT
BUILDING �I K1��,
ADDRESS /'Lc.
TRACT %
OWNER
FIRE
ZONE
APPROVE
O-J4-�'
� P E � F�
i
�� �}(tZ-�i L.�+
� 3.3 B�o�K
, VAWE �J� .
$
'v�ROUP �
� DAT� a - f q - 'i
20NE NO.OF USE OF NEW p
�� PLANS a BUILDING CAI�(
VAFDSAPPROVED YARDSAPPROVED
FEAR FT. FT.
DISTANCE BET. ^� BET. MAIN &
MAIN BLDGS. � I ACCESS. BLOCS.
C URP. �(�(" � C APPROVED Y 7�'
APPROVEO (� �( y� 13 cTeTG I
' THE AMOUNT SHOWN UNDER VA�VATION IS F
THE PURPOSE OF ESTABLISHING A PERMIT F ONI
VALUATION /
/ � ERMIT FEE S
$ v� %f7F�1 PL,AN CHECK $ �
/ " CI (J a
TOTAL FEE $ �
b
0
m
¢