HomeMy WebLinkAbout2276 PAMELA LN - Building PermitsEXHIBIT A OR ATTACI�I�NT 1
CITY OF COSTA MESA
HOUSING REHABILITATION LOAN PROGRAM
WORK WRITE-UP
Name: Christian Sl.ytte
Phone:(7l4)898-1337
Address: 2276 Pamela Lane
Costa Mesa, CA 92627
ALL WORK TO BE DO�E PER CIi'S' OF COSTA MESA BUiLDINC, PI,ANNtNC AIVD PUBLIC WORKS CODE. IN ORDER TO
ESTABLISH STM'DARDS OF QUALITI', THE DETAll.ED SPECIFICATIONS MAY REFER TO A CERTAIN PRODUCT BY NAME
AND/OR FROM A ALWOR MANUFACTIIRER THIS PROCEDURE IS NOT TO BE CONSTRUED AS ELIMaVATINC FROM
COMPETITION OTf�R PRODUCTS OF EQUAL OR BETTER QUALITY BY OT}!ER MANUFACTURERS. THE CON7'RACTOR
S11ALL FUiNISH THE LIST OF PROPOSED DESIRED SUBST[TUCIONS PRIOR TO SIGNING THE COdTRACI'. ALL ITEMS
LISTED ON TFIE ��'ORK DESCRIPTION. UNLESS OTHERWISE SPECIFIED, SHALL IIVCLUDE ALL PATCHINC AIQD F7NISH
WORK, INCLUDIIPG I'RIM, HARDN'ARE, PATCHING AND FINISH PAIhTING AND/OR STAIIVING. PRIOR TO WORK START-UP,
THE SELECI'ED GENERAI, CON'I'RAC70R WILL SUllMIT TH7S WORK WRITF UP TO THE BUILDING DEPARTMEN`T (2nd
FLOOR) FOR THE PURPOSE OF DRA�i7NG NECESSAA]' PERDIITS. THE CONTRACTOR IS RESPONSIBLE FOR ALL PERMITS,
FEES, CIT]' BOSIA"ESS LICENSE, PLMS, ETC.
Ciry otCosta Mesa Sca¢dard Rehabilita6on Specifications apph� to all i�ems Iisted on wo�k dcscription.
� � . �' •����
y W;ndnwc� Provide material and labor to re qye and replac
g71_aze vinyl nail-on sli er wui ows. Two (2) existing sliding
I�upper umt, o�ne (1) shdmg dooi to placed'with'S°Oz3
' � - - ----- �
interior drywall repairs. Windows aze to be weathersh-ipped
interior and exterior �-im. Windows to have no grids.
install new dual
aze nQt
Shicrn• Provide material and labor to remove and dispose of e�sting wood siding, lath and
weather strip from enrire main building and south side of garage. Use e�sting fascia boazds on
main building. Restucco same areas to code. In`ad'diTion emove fascia boazds from south and
west sides of garages and replace. Front of garages to have tnm around garages removed and—
replaced. All new wood to be primed and painted with two coats of Vista, Sinclair, or Dunn
Edwards paint. Owner to select color.
3. necking and halrnn� rai� Provide material and labor to
building and replace damaged wood
from landine at
at upper unit at side of
dwellmg. Kemove and.replace.all detenorated and dryrott wood. Resheet deck with 37<" ply_wood
,._-_ -F�.-�Q-�.�.-��-...�-:� - �
and properly flash and instail Pacific Polymere with sand finish. Deck to sheetflow to gutter and
downspout and terminate at gound IeveL Install new decorafive iron railings.
Updated OB/16/2002
RECENED
au� 1 � Zooi
r.ODtiENFORCEME �o,,t=
..�. _...ti
:
�
4. C airwav. Provide mate:
stainvav wlvch leads to
�
b.
Z
8_
uiia s�irway oniysco_sucuiar_aunensions usmg proper
Pacific Polymere with sand Snish as waterproofing.
Railings to be decorative iron.
Heater accecc dnnr� Provide material and labor to remove and dispose of off-site eacisting door
neaz unit #B and replace with sunilar solid core exterior door with vent, weather stripping, and
hardware.
RxtPri�r lighrinv provide labor to install lighting sup�lied by owner to existing locarions.
Pnct at �mit #A • provide material and labor to pour a footing with column base and install a post
to support roofand fascia in front ofunit. �� j ----
Cmnke detect�rs• Provide and install smoke detectors to code in all units.
}p;dl�t� �'t �� wvi.Q�, 7
TOTAL
CONTINGENCY
(City Code requires any inspection beyond 2nd
inspection be ct�arged $30.00 per inspection)
LOAN DOCS AND NOTICE OF COMPLETION
GRAND TOTAL
TOTAL LOAlV AMOUNT
Updated O8/16/2002
1.
2.
3.
4.
5.
6.
7.
8.
BID SUNIMARY
for 2276 Pamela Lane
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 2276 PAMELALN
Suite:
Vicinity:
Parcel Number: 42237221
Applicant: UNKNOWN
Address:
Owner: SKYTT�, CHRISTIAN
Address 12702 AMETHYST ST
GARDEN GROVE, CA
Convacmr. JK CONSTRUCTION
Address: 915 LAKE ST
HUNTINGTON BEACH, CA
Zip: 92648
Arch :
Address:
Phone:
Zip:
License:
Zoning:
Phone:
Zip:
Phone:
Zip: 92845
Phone: (714)404-9846
License: 450297
Eng:
Address:
Status:' ISSUED
Applied: 08/23/2002
Issued: 09/17/2002
ISSUED BY: / /CI� Q
�— �
Phone:
License:
SCOPE OF PERMIT
TRI-PLEX BUILDING UNITS A. B AND C. REMOVE AND REPLACE ALL EXISTING WINDOWS WITH DUAL
GLAZE,
REPLACE DAMAGED WOOD AS NEEDED. REMOVE 2ND STORY DECK. REPAIE STAIRCASE DECK(PLYWOOD AND
DAMAGED
MEMBERS) SAME SIZE AND REPLACE EDGEMETAL WITH SAME SIZE. INSTALL A COLUMN BASE POST TO SUPPORT
ROOF
AND FASCIA IN FRONT OF UNIT "A". SAME SIZE OF POST TO BE USED.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$502.85
$3.60
$0.00
$0.00
$0.00
$506.q5
FEE SUMMARY
Calc Valuation: 83s,000.00
Claim Valuation: $36,Oo0.00
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21•g2)
EXPIRATION: This permit shall automatically ezpire and become void if work Is not commenced within 180 days, or if work is suspendetl or abandoned
for a peAod ot 180 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must compy with all applicable codes, and all
required Inapections and flnal epproval must be obtained. Faiiure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626 I
2aaba6(N00)
WORKERS' COMPENSA710N DECLARA710N:
I hereby eHirm under penelty of perjury ona of iha following declaretions:
❑ I have entl will malntein a cenificate of wnsent to selt-Insure for workers' compensation, as pravitleA for by sectlon 3700 0l iha Lebor Code, for ihe pertormence of the
���,,,/// work tor which IhiS pertnii is issued.
/p� I have and wlll malntain workers' cwnpensation insurance, as requiretl Dy sectlon 3700 0l Ne Lebor Catle, for Ne pertortnance oi the work for which this pertnit Is issued.
� \ My workers' compens ton InsurapC9 carrier end policy number are:
Cerrier: * Policy Number:
(Thls sectlon need nof be comp/eted Il he permi �s velued ef one hundred dollers ($100) or /ess.)
❑ I certity ihet i� peAormence the w rk lor which this pertnit is issued, I shall not employ any person in eny menner so as to become subjecl to ihe workers'
compensa' n law i Celifaml , entl r that if I should Gecome subJect to Ihe workers' compensation provlsions ot Sectlon 3700qqq111 ihe Lebor Code, I shell forthwlth
com � ' these p ovis' s. Q//� //
Appli ignetu . l � `"L
W Ej W �/ ORKERS'COMPENSATIONCOVERAGEISUNUWFULANDSHALLSU6IECTAN�OCRIMI PENALTIESANDCIVILFINESIIPTOONEHUNDRED
TFqUSAND Dd.I.N:SE,� 100,0 f, IN AD�ITION TO THE �ST OF COMPENSAiION, DAMAGES AS PROVIDED FOR IN SECTION 3)OB OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
6�
LICENSED CONTRACTORS DECLARATION: //
at I em Iicensed
uc. x i�
CONSTRUCTION LENpHQG AGENCY:
Sectlon 7000) of Division 3 of the Business antl Professions Code, end my license is in full
❑ 1 hereby eHirm t�at there is a wnsiruction lending egency for the peAormance of the work br w�ich this pertnit is issued. (Sec. 3097, Civil Cotle).
Lenders Nema: Lendels Address:
Signeture:
OWNER-BUILDER DECLARATONS:
Date:
I hareby eHirtn Ihet under penalry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Profassions
Code: Any ciry or counry w�ic� requires e permit to consWct, alter, improve, tlemolish, or repair any strucWra, pnor to its issuance, elso requires t�e aOPlicaN for such permtl
b file a signetl statement t�el he or she Is Iicensed pursuent to the provislons ol the Cantrectors License Lew (Chepter 9(commencing with Sectlon 7000) of Dlvision 3 ot the
eusiness entl Professions Code) or ihet he or she is exempl therefrom and Ihe besls lor Ihe elleged exemption. Any violetion oi Section 7031.5 by eny epplicent for a permit
sublecis the applicant to e clvll penalty of not mora then tive huntlretl tlollars ($500).):
❑ I, as owner oi the properry, or my employees with wages as their sole compensellon, WILL DO TME WORK, and the structure is not intended or oNere0lor sale (Sec.
7044, Business and Professions Code: The Contractors License Law dces not epply to en owner of propeny who builds or improves ihereon, end who does such work
himself or herselt or Ihrough his or her own employees, provided �het such improvements ara not Intended or oNeretl for sale. If, however, �he building or improvement is
soltl within one year of completion, Ihe owner-builder will have the burden ot praving that he or she did not 6uild or improve tor purpose of sale.).
❑ I, es owner of the property, em E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Prolessions
COCe: The contrectore License Law tloes not appy to an owner ol property who bullds or impmves thereon, and who contracis for such Droject wlth a crontrettor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am evemp� untler sec. Business antl Pmfessions Code for Ihis reason:
Signature: Date:
Owner ID veriliad by d�ivel911cense. ❑ Yes ❑ No Onver9 LiCense No. Eapires:
Venfication of Ownership by (type ol document, i.e. - properry ta�c bill or daed):
OIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify that no excavation tive (5) or more feet in depth into which a person is raquired to descend, wlll be made in connec�ion wi�h work authorized by this
permil. and Ihat no 6uilding structura, scaHolding, falsework, or demolition or dismantling thereol, will be more than thirry-su (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title e, Celilomie Atlministrative Coda).
❑ As owner-huilder, I wlll not employ enyona to do work which would requira e pertnit from the Division ol Industrial Satety, as noted above, unless such person hes e
pertnit lo tlo such work from ihe tlivlsion.
Signature: Date:
Division ol lndusirial Safery Permit Number:
CERTiFICATE OF COMPLIANCE AND AU7TIORVA710N OF ENTAV: I cehify untler penelty of perjury that I have reea ihis applicetion and stata Ihet the infortnetion given is
correct I egree to comply wlih all state lews end ciry ortlinances releting to building consiructlon, entl euthonze representatives oi iha Ciry of Coste Mese to enter upon ihe
ebove-described pr�erty for inspection purpos�Cll agree ngyto occupy or ellow acupancy of eny building authodzetl by this permit un�il tinal inspec�ian.
FOUE �. MSPECTIONTYVE
7616 Flxed System Finel Fira Prevention
1266 Pool Spe Final
200 Finel fie-Roof
201 Finel Block/Reteining Well
202 Final Fectory Fire Place
203 Final Sign
204 Finel Demolitlon
Q�¢ fy(7�5�$ 4Qp$a INSPECTIONTYPE
206 Final Mechanicel
208 Final Plumbing
210 Final ElecMcal
212 Finel Fire Prevention
220
222
250
Final Planning Approval
Final Site
Finel Building/Occupancy
I�����i7.1S�1
/a -i3 -oa
(714) 754•5273 • Fax (714) 754<856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
ConVactor.
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 unils)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recepl Outlets
Switches
Non Res Appl
Re5 Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1hp
Motors to tOhp
Motors to SOhp
Motors l0 700hp
Motors over 100hp
Communication tlrops
Sub panel to 200a
Pole Liqht Pkg
2276 PAMELA LN
42237221
UNKNOWN
SKYTTE, CHRISTIAN
12702 AMETHYST ST
GARDEN GROVE, CA
ELECTRICAL TO INCLUDE:
REF.: 802-01353 3 LIGHTS.
$23.50
$0.00
so.00
$0.00
$0.00
$0.00
$3.30
$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
Quantiry
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
ELECTRICAL PERMIT
Phone:
Zip:
Phone:
Zip: 92845
Phone:
Zip:
License:
SCOPE OF PERMIT
FEESUMMARY
Temp Dist System / Lighting
Busway/100ft
Standing Sectlon
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech nde or lights)
Christmas Tree SWnd
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Status: ISSUED
Applied; 08/23/2002
Issued: 09/17/2002
ISSUED BY: �,�_�
Quantity
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void ii work is not commenced wlthin 180 days, or if work is suspended or abandonetl
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
requlred Inspeclions end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhls permit.
FOR INSPECTIONS CALL: (714) 7545626
zaases �eroo�
WORKERS' COMPENSATION DECLARATION: �
I hereby aMirtn under penelry ot per�ury one oi the following tlecleratlons:
❑ I have end will melntain e certificate of consent to setl-Insure for workers' compenseHon, as pmvided for by section 3700 ot the labor Cotle, tor ihe pertortnanca ot t�e
�work tor whlch this pertnit is issuetl.
I heve antl wlll malntain wo rs' compensation insurence, es required by sectlm 3700 0l the Lebor Cotle, for Ne peAortnance of Ihe work for which NI5 pertnit is issuetl.
My workere' c�� eti Insurance��,7,,q����,r and po/I'�Ey number ere:
Certier. // C � Y� .�! Policy Number. o y C- ��
(This secfion need nof be completetl il th rmit is va/ued et hundred tlollers ($100) or Iess.J
❑ I certify ihat in the peAortnenca ot the w c for whi i� pe yis iuued, 1 shall not employ any person In eny manner so as to Decome subject to Ihe workere'
compensetlon I s-el-6 Itomia, end r e Iha�Coma subJect to the workers' compensation proWslons ot Sactlan 3JJJ00 ot t�e Lebor Code, I shall forthwlN
c i' e pmvisio s. �/ f /�
Ap01' ign Date: � l
WARNINO:FAILURET CUj� WOHI(ERS'COMPENSATIqJCOVERAGEISUNLAWFULANDSHPLL5UBIECTANEM FTOCFIMINAL ENALTIESANOCIVILFlNESUPTOONEHUNORED
TTIOUSAND 00 (S]{IB;600), IN AD�ITION TO THE COST OF COMPENSATION, DFAMOES AS PqOVIDED FOR IN SECTION 31O60F THE IABOR COpE, IMEREST, AN� ATTOfiNE`fS FEES.
LICENSED CON7RAC70RS DECLARATON:
I hereby affirm thetl am Ilcense �Rr i3jon\s of Chepter 9 mmendng wlih Section 7000) of iNsion� at the Business a9pProfessions Code, antl my license Is In full
fo � . Ic. A �� 7 ciass a ��
ntrect neture: Data:
CONSTRUCTION LENDI GENCV:
❑ I hereby ettirtn �hat ihere is e construqion lentling agency for t�e peAortnanca ol ihe work for which this pertnit is issueA. (Sec. 3097, Civil Code).
Lendefs Nama: Lentlefs Atltlress:
SlgnaNre:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby fliflrtn �hat under penelty of periury Ihat I am EXEMPT FROM 7HE CONTRACTORS IICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Cotle: Any ciry or county which requires a pertnit to construct, elter, Imprave, tlemolish, or repair any strucWre, pnor to Its iuuance, elso requires the applicant for such permit
to file e slgned statement Ihet he or she Is licensed pursuant to the proNsions ot Ihe Contreciors License Lew (Chapter 8(commencing with Section 7000) of Dlvisian 3 of the
Business end Piofessions Code) or ihet he or she is exempt therefrom and the basis lor the elleged exemption. Any vlolatlon oi Section 7031.5 by any epplicant tor a pertnit
sublecis ihe eppllcent to e civil penelry ot not more than five hundretl Collars ($500).):
❑ I, es owner of tha property, or my employees with weges es thelr sole compensatlon, WILL DO TME WORK, end the structure Is not intentle0 or ottered tor sale (Sec.
7044, Business en0 Prolessions Code: The Contractors License Lew tloes not apply to en owner of property who builds or improves ihereon, and who does such work
himseN or herself or ihrough hls or her own employees, provitled iha� such Improvamenis are not Intended or affered for sele. Ii, however, ihe building or Improvement is
sold withln one year ot completion, the owner-builder will heve the burtlen ol proving that he or she did not build or improve for purpose oi sale.).
❑ I, as owner of the proDerty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to Consimct the pwjecl (Sec. 7044, Busines5 and Professlons
CoAe: The contrecmrs LJcense Law tloes nm appty to an owner ol properry wha builAs or improves thereon, entl who contrac�s tor such pmjec� with e contrector(s)
license pursuenl to the Contrectors License Laws.).
❑ I am exempt untler sec.
Signature:
Owner ID varilled by tlnvers license. ❑ Yes ❑ No
Business entl Pmlessions Code for this reason:
Verificetion ot Ownership by (type at dowment, i.e. - properry lax bill or dead):
DIVISION OF INUUSTRIAL SAFE7Y PERMR CER7IFICA710N:
Drivels License No.
Date:
Expires:
❑ I hereby ceNfy ihat no excavation five (5) or more teet in tlepih into which e pereon is required to descen4 wlll be matle In wnnectlon wlth work authonzed by this
permit, entl ihat no builtling structure, scattolding, felsework, or demolition or dismantling ihereof, will be more than Ihirty-si: (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celifomle Administrative Code).
❑ As owner�bulldar, I wiil not emplay enyone to do work which would require a permit from ihe Dlvision ol Industrlel Selery, es noted ebove, unless such person hes e
pertnit to do such work trom the tlivision.
Signeture: Date:
Divislon oi Intlusiriel Sefery Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTAY: I cehify untler penaliy of perjury ihat I have read ihis epplication and state that the infortnation given is
correct I egree to comply with all stete laws and ciry ordlnances relating t mlding construaion, entl euthonze representatives of Ihe Ciry of Costa Mesa to enter upon t�e
ebove-descnbed properry lor inspection purposes. I agree nol to occupy ellow acupancy oi any building authorized by this Dermit until final inspection.
COOE �. INSVECTION TYPE
1618 Fixetl System Final Fire Prevention
1266 Pool Spe Final
200 Finel Re-ROo�
201 Flnel Block/Retaining Wall
202 Flnal Factory Fire PlaCe _
203 Final Sign
204 Final Demolitian
�� �
COOEI INSPELTONTYVE
20fi Flnal MecheniCel
20B Finel Plumbinp
210 Final Electriwl
212 Final Flre Prevenllon
220 Flnal Planninp Approval
222 FinalSite
250 Final Buildinq/Occupancy
�_ � .1111. .
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35595
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
P4I0
nr7 i�-n�„5�00 s9��� `**�39.28
APPLICATION FOR BUILDING PERMIT
Fo� Applicant to Fill in Completely
�j RECEIVED BV DATE RECEIVED D/ATE ISSUE)D
BUILDING �iZ I � � ZZOD � %Y'���-%}' h-Y�`�(�. '0- ��' % Z- [�'��` / �
AODRESS
� W � ��. A.P. NO.IIS ���I'� � PER T�.pI,�QO�
OWNER ��
MAIL BUILDING 2Zij/_ ��zOO ,f1A/EL%i ���E
ADOFESS ADORESS ! �7 O /T/'�
TEL. TRACT LO � BLOCK
CITV NO.
CANSTRUCiION /�� W A� A P
LENDER 1�
BRANCH t Q �7-- W n ^ n �•
OWNER J �, �r!`N
ADDRESS .z _ 3 �� G� VA�VE �Iy1 (�
ARCHITECT TEL. VSE S•ID'Y�oO
OR ENGINEER N .
� FIRE T
ADDRE55 �� 20NE � TVPE ROUP v
CONTRACTOR BYPROV D DATE'�-I�" � Z
ADDFESS
TEI. ZON NO.OF USE OF NEW
PLAN$ a 6UILDING
CITV NO.
STATE CITV O ED VARDSA PROVED
�IC. NO. ��Q NO. BUI�DING ACCESSORV BU ING
512E NO.OF BLDG>. (FROML'�l/�i'F'� )
OF LOT NOW ON LOT FOM FT. � FT.
USE OF
EXISTING BLDG. I � FT. FT
SI2E OF NO. OF
NEWBLDG. ROOMS STOft1ES L.SIDE FT. 33 FT.
EXTERIOF WALL ROOF
COVEPING COVERING REAR FT. FT.
USE OF BUILDING ANO W�RK TO BE PERFORMED DISTANCE BET. I� BET. MAIN &
MAIN BLOGS. O� AaE$$, BLDGS.
� L_ C URP � r'7�' TL APPROVED
APPROVED w � G O �'�
STA?E
I hereby acknowletlge [hat I have reatl ffiis application antl s[ate
that the above intormation is correct antl a8ree to comply with O
all laws regulating building construction, and I shall not employ u ��
any perwn in violation ot the workman's tompensation lawi of [���
[he State ot California. I�)Q m
(/L> `°
I hereby certity ihat I am P�operly Ilcensed as a wnttactor untler SQ. FT. o
the S[ace ot Celifornio Bus��ass entl Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FO(i
i
Chapter 9, antl that such licanses are In full force nntl ettect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: m
am exempt from �o v�o s of Na Stete ot California Business �
ontl Protessians o Di s�o , Chapter 9. VALVATION Q-o W
�� PERMIT FEE $ j
Sipneture ot ��J�/�� m
Permittea 5 �" �"o PLAN CHECK $ E
.+�a `o
Autho�izetl Ageni LL
TOTAL FEE 5
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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Fo�Applicant to Fipin Comple[ely APPLICATION FOR BUILDING PERMIT
R EIV BV D/liEji EIVED DATEI UE
ADDRESS 2276 Pamela Lane v r .O L
OWNER RO Watd Co. A.P. NO. I " .Z 'a —ER ��4 ..
MAIL BUILDING � /� �M � /% . � ,
ADORESS 1]o Westcltff Dr, aooaess ix���ic.c�/
P.WpOTt edC TEL ^ 7 TRACT LOT33 BLOCK
CITV NO.�yG-O._'2tg
COPLSTFUCTION W A P
LENDER
BRANCH ��
OWNER r
ADDflESS
A�� 3 , �
ORENGINEER Roy Kiter NE`5485244 $
FIRE
ADDRE55 211 Walnut St�� Newport Beacn 20NE 7VPE GROUP �
APPRO V E
CONTRACTOR BY DAT � 'Zi
ADDFESS
TEL. ZONE NO.OF USE OF NEW -
CITY NO. P�� BUILDING '1` p�� ,
STATE CITY �ARDSAPPROVEO VAROSAPPROVED
IIC. NO. �IC. NO. MAIN BUILDING ACCESSOFiV BUILDING
SIZE NO.OFBLOGS. ^ (FROMG/LSTREET)
OF LOT 5. X 11 •6 NOwON LOT •.� RONT I U FT. FT.
USE OF none
EXISTING BLDG. 5 FT FT.
SI2E OF NO.OF
NEWBLDG. :a�OMS STORIES L.SIDE FT. FT.
EXTERIOR WALL WOOd ROOF
COVERING COVERING REAR �'I � FT. FT.
USE OF BUILDING PND WORK TO BE PERFORMED D4STANCE BET. BET. MAIN &
Tri 1('i� �7' �� � � �`"� MAIN BLDGS. ACCESS. BLDGS.
�e VAR. alE DATE
C.U.7.iW L�-'- ��"MG APPROVED � l�/ �
PLilN S �:�OVEO Q �'D/��/,
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I hereby acknowletlge that I have reatl Mis applicecion antl state �� V REME
that the above inforrt�ation is corre<t and aB�ee to comply wit�
all laws regulating bu�ltling constr�ction, and I shall not employ C 4
any person in violatiOn of Me workman's compansation laws ot l O� T(V(
Me State of California. � }'') °�
I hereby certify that I am properly Iicense0 as a contrncror untler �Q SQ. FT.1'� o
Me State of California Businass entl Professions Cotle, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that s�+ch licenses are in full forca entl etfect, ar I T}1E PURPOSE OF ESTAB�ISHING A PERMIT FEE ONLV: m
am exempx from che p avisi �the5cate of Calitornie Basiness ¢
andProtessionsCa� ivi�o 3, hepter9. VALUATION —� m
PERMIT FEE $ �
� , a� �
se�ei�ro or /�///ppp /Q m
Parmittee � S ny (// PLAN CHECK $ . E
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Authorixatl Agent LL
TOTAL FEE $
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CAIIFORNIA 92626
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"CT 19-77cnsr.00 8S0 0�+;*
APPLICATION FOR BUtIDING PERMIT
ForApplicant to Fill in Completely
227G (� I �� R�CE VE BV QATERECEIV� DAC`TE`ISSUEO�
BUILDING v�
ADDRE55 l_tl
< P RMIT f�jQ. �
OWNER `O A.P. NO. �� L S
MA 1 L BUI LDING �7 /
A�ORESS ADDRESS f'�7 �p �yy� ��L.a �(.L�C
TEL. TRACT �T� BLOCK
CITY NO.
CONSTRUCTION W A A P
LENDER
BRANCH �
OWNER �'�C' �
ADDRESS
n VALUE
APCHITECT TEL. SE r�� `' �"'� S
OR ENGINEER N .
FIRE
ADDRESS ZONE TVPE GROUP
APPRO D
CONTRACTOR BY DATE ��' �
ADDRESS
TEL. ZONE�� PO�IO�F BUILDING EW���J
CITV NO.
STATE CITV YARDSAPPftOVED VARDSAPPROVED
L14 NO. LIC. NO. MAIN BUILDING ACCESSORV BVILDING
SIZE NO.OF BLDGS. (FROM GL STREET)
OF LOT NOW ON LOT ROM FT. FT.
USE OF
EXISTING BLOG. SI FT. FT.
S12E OF NO. OF
NEWBLOG. ROpMS STORIES L.SIDE FT. FT.
EMERIOR WALL ROOF
COVERING COVERING REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFOFMED DISfANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
1\� �..,�� CURP.qWZF7�� � qPPROVED J�
APPROVED ( i � � �0�1'�I% Z
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I heteby acknowlatlgB that I hsve reatl ihis apP��cetion antl stete p�'�L �
thot ffie above information is correct antl ngree ro comply with J g
all Iaws ragulating builtling construction, and 1 shall not employ p
any person in violation ot the workman'S compensation laws of
2he State of Calitomia. ��J ' /•_ �
I hereby certity that I am properly licensatl as a cantracior under �*� SQ. FT. (f� o
Ma Stace of California Business antl Professions Code, Divisicn 3, 7HE AMOUNT SHOWN UNDER VALUATION IS FOR
Chepter 9, antl that such licensas are in tull forca and ettect, or I THE PURP�E OF ESTAB�ISHING A PERMIT FEE ONLV:
w
am exempt from e ovivo ot tha State of California Business �
VALUATION � �
and Professions otl O i io , Chapter 9. PERMIT FEE 5 �
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Signature of m
Permittee $ PLAN CHECK 5 E
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Authorizetl Agent LL
TOTAL FEE 5