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Home My WebLink About1865 PARKVISTA CIR - Building Permitsi AOORBS5 BWLp : 1865 PARKVI5TA CI UNIr, OyMERSNAMERKNOYM:THEDE, STEPHANIE M ADDRES&THED£, ERIK N 1865 PARKVISTA CTR P COSTA MESA,CA 92627 APPL.IWIUiG ADDRESS: COSTA ARCHITECT OR ENGINEER: UC. NO, J MICH.OR ENG.'S ADDRESS: UHT: C CONTRACTORS NAME: CONTRACTORS MAILING C ADDRE55: I.C. NO.: UNIT: LICENSED CONTRACTORS DECLARATION: I Mreby affirm under penalty of padury pan I em licensed under provolone Of Chapter 9 (commencing was Section TODD) of Division 3 of the Business and Professions Coda, and my flowers is in lull force end effect. CITY LIC. NO, UC. CLASS: UO. NO.: EXP: — Data: Contract«: L OWNER BUILDER DECLARATION: I hereby affirm under penalty of perjury tha11 am exempt from the Contractors Uce se Lew for the following reason (Section 7031.5 Business and Profession. Code: Any cry or county which requires a permh to construct. Saw, improve, P y.molish, or repo my structure, prior to as lsaueeco, also requires the applkanl for such perms to fife a epnsal statement and M or end P is limned pursuant to the Worrisome d the Contractors License law (Chapter 9 (commencing 00) d wish Section 70Diveion 3 of 1M Business and Profea.ions Code) or that he or she is exempt therefrom and the beefs for the alleged exemption. Any vacation a Section 7031.5 by any applicant for a nrmit subjects the applicant to a chit pwalry, OF not more than five hundred dollen (5500]), id ❑ I, as owner of the property or my employees wish wages as 1Mb sole comperrwign, will do the work, was the structure I. not intended 5 or offered for sels(Senion 7040. Sueineas and professions Coca: The Contractors License Law does has appy to an owner of property who Wide «inpmves thereon, and who does such work NmmU w herself or through his or her own employees, provided IMI such improvements we not intended or o fano for wase. 9. however, the building Or inpmhwment is sold a thin on year of completion. IM Z owner -builder will have the burden of proving he Or she did nm build or improve for the impose of mate). ❑ I, esu owmm d IM property, em wtlutively oontredvg with licensed bmbenora to canWuct tM prged (Bacon 7014, Bmimee errd B Profession, Coda: The Contradom Lammas Law does rho appy to an owner d propend who aside « improves thereon and who contracts 1« such projcom with a mfflumo ) licensed pumumat to the Contractors License Lew). q nderXj�S.dpBB,AP.O.,Iorlhinfam /BUILDER Dec.: - DJY_ Owner I do hereby barely that I was same of and understand the requirements of "dorms Health and! Safety Code Sections 25505, 2ss%L and 25534, and that I Or any future building oowpmt will / will not (drub one) need to comply with weld ode boom and IM requirements for apaions. tmcton«modifireticnh«nIMAi use Iiy.eropemem Piauid.Rmideruiel mrmrupion epp5mtionan eaemgfrom lhme provissions. Date: Applimm: WORKER'S COMPENSATION DECLARATION: I nearby affirm under penally of perjury om of the following dedwatona: ❑ have nM veil mamas a of the ted for w i h eesina smash for sued. t«ngxaelon, m provided I« by Section 3]00 d IM Leber Code, for IM pedormence d the work f« which thin pemH is imVed. ❑ I have and wilt maintain worts%bompenaation Insurance, as matured! by Session 3700 d the Lab« Code. for IM parformerwe d tM work for which this permit in; imued. My w«kers' compensation ie. center ens policy number we: Came' Pdoy Number: (This section neer not be complded If the parent is or one hundred dell -151001 a mi ❑ I coney that in the performance of the work for which this mmH is imued. 1 shell nor employ any person in any manner w m to become subject to the winters' borripenution laws d CaMomle. and agree Nov d I should became subject to the workers' compensation provision of Section 3700 of the Labor Cade, I was (wlhmh comply with those provisions. Dec.: Applicant: Warning: Factum b swum makers' Waterhouse. rovereps 1. unUwfu4 and shall subtest an walido ar to criminal pena/N" and cider ff.. up as lona hundred thousand dO/Mre 15100000), la asd100n b Urs posy of compruathom demagm as protracted A, In Sects 37% .1 ft Labor Cods, interval, and irlromay's fees. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury the then is a construction larding agency for the pedomwrm Of the work for whidr th s panni is issued (Seton 301 CIV. C). LENDER'S NAME: LENDER'S ADDRESS: I Cemify than I hems reel this appliaation who tete Ihel the above information ie comp. I agree to campy with d1 city and county onfirs. and state laws relating to bui ding commucion and hereby autMrbe repramentativm of this day to enter upon the ebovs-mmtbned propend for inlwssion impacts. ERIK THEDE TUI Name Date: 3 Sigmlum of Uwpr/Agent/AwacenUConvad« (5151-es.WP) White-Buildig b Salary; Green-Fse; Cans,_Applo nt; Pink-Revanm; Gddemod-Aa. P L F I B T CITY OF COSTA MESA — BUILDING PERMIT ERMIT NO: B 077811 PLAN CHECK NO: N ONSTRUCTION TYPE: VN PERMIT TYPE: STR PERM NO: B 077811 GOVT: N SUPP: N PURPOSE: OTH OB DESCRIPTION TEAR OFF, SHEATH, RE—ROOF W/COMP SQ FT: 4,500 LAIM VALUE: 4,500.00 CALC—VALUE: 4,500.00 GROUP OCC: R-3 / OMMENTS: SMOKE DETECTORS ARE REQUIRED 9E 9E iE IE fE iE HE 1E*fE*1E 1E 9E*lE iE ld iE*7f RE*9E 1i RE RE iE 9E HE dE HE fE*iE 1F iE*!F*lE RE RE HE IE fE 1E**dE**IE*Hit 1E iE 9f-iE 9t iE*lF if lE**9E iE dE dE lE iE iE dE 9E RE ik Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN EFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN ARKING REQ: PROV: PARCEL: 42431114 ZNE: REF NO: LANNING NOTES); > fE iE dE 1f 3E*9E 1E 3E 9F 3E*1E*RE*dE 9E dE 1E*♦E*9E 1E iElElE9ElE)F 1E dF iElE*1E RE**3E 3E**♦E1E*****if if Rf****fE iE****if lE Ni iE iE 1E*1E lF HE 1E*RE IE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ONING APPROVED"BY DATE: UILDING APPROVED BY PPLICATION ISSUED BY: * iE iE 9E iE iF dE iF iF iE iF iE 1E * *!E iE if 1E iE iF�Fit: EGALIZATION:N F E E U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC ERMIT 99.75 LAN SSUE FEE UILDING—DIV—> PERMIT ISSUE PLAN—CHECK OTALS ---- > 100.25 0.00 0.00 EVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 99.75 DATE: DATE: �F3F�FiE RF RE dF 1E dE 1E 9E lE lE STRUCTURAL SEG ENT:Y FIRE SMIP/RES GRADING 50 SMIP/NON—RES TOTAL PAID DUE 100,25 100.25 ,00 100.25 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAN—CHECK .50 IElE HE RE IE RE*9E dE 3E 9E*♦E 9E 9E*3E 1E iE 9E*1E fE 1E iE fE dE 9E 1E*1E dE 3f*if*dE iE 1E 1f 1E iE 9E**iE 9E*3E*1E fE 1E iE*4E 9E dF RE iE if iE iE 9E 9E dE dE***yF Rd ik if 9E 9E 3E iE I N D I V I D U A L F E E B R E A K D O W N YPE QTY D E S C R I P T I O N UNIT COST TOTAL COST FR 4500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,500.00 END OF FEES ilii C' - T^ ): a Imo• _G •`1_^, .... CONSTRUCTION AND PLANNING APPROVALS Permit# Daze Inspector i POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole _ 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54, Forms 4r Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. S'ieel Reinforcement z 56. Rough Plumbing & Pressure Test - `.6�.Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - 7. Footings 58. Electrical Condu{t,Undrgrnd. "8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System r 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection = 62. Backwash & Receptor -Final f 12. Sewer Cap 63. Heater & Vent•Final 1 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 t 18. Rough Electrical -T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning o^ _ `*' FtRE'DEPT:sREOUIREMENT APPB.OVAL-S: Permit #._;..__' 20. -Rough Factory Fireplace _ r .ti ;', r r 21. Ducts, in Structure'.• _- � _ - 70. -Under ' - ground Hydro 22. Duffs, Ventilating'"' 71. Product'Piping nas 00il - 23. Gas Pipe -Rough & Test _ .- - 72. Underground Flush 24. Roof Framing _ _ i' '. �� _ 73. Undergrnd.StcrrapeTank ❑Gas ❑Oil 25. Roof Sheathings-2or_g6 a � 74. ,Overhead Hydra 26,.T -Bar -Ceiling (Structural) & Monocoat - 75. Dry Chemicat 27. Frame and Flashing, --1 : �; r. T * 76. Dry Standpipe•- C 28. Lathing & Siding'- ' r- _ 77. FIXED SPSTE`'M FINAJ' 29. Insulation, _ _ 76. FIRE PREY. FINAL 30. Drywall Nailing i' - �'" ' ;:• i HEALTH DEPT_RE0UII��MENT 31. Plaster Bcowri Goat 79. FINAL INSPECTION - - 1' 32. Electrical -Power Meter -Final '' 8Q. FOOD CERTI li,ATE If SUED rr 33. -Final Electric Notes: • 34. Efinal Heating & Air Conditioning 35. Final Gas'Pipe-Test 36. Hood or Canopy s ^ c- 37. Final'Factory Fireplace 38. Final Plumbing --- r 39. Water Service -Final '- 40. Gas Service -Final r-- 41. Solar DomesticFinat * •'' - ' 42. Backflow Preventer 43. Backflow Irrigation V 'A4. Landscape Irrigation System �, .. 45. Sound Attendation { 46. HandicapRegulatioris - - •-:__,j ' 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING- _ 49. Electric Release to Edison ' 7 t. 50. Gas Release to Southern California Gas Coi, - - 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF Bu1LDING: THEDE, STEPHANIE M UNIT: MEWS NAMEIFANosta: THEDE ERIK N ADDRESS: 1865 f)ARKVISTA CIR COSTA MESA,CA 92627 &PPL. MMUNG ADDRESS: ARCHITECT OR ENGINEER: UC. NO.: UrcN.OR ENG's ADDRESS: UNIT: NOCK PLUMBING (714)895-1246 CONTRACTONS NAME: 11610 SEABOARD C I R CONTRACTOWSYAILING STANTON CA 511971 "DRESS: 90680 W.NO.: NNjjpp��CC1j�-F� rebs rap cyder q�r� �m �yMilli, yo1, 1pgq� (loom aa'ng aity7$fdRiS d Division d the Bdgnee�a�1 PMesaiony s C AMILA neer h; in Dd16te sed Wetl:0 i O9 z)CITY UC. NO.: UO CLASS: I.C. NO -� �� // `1 e ng__ � / � Contrww: V �+ ,OWNER BUILDER DECLARATION: I hereby, affirm urow penally of perjury that I ah exempt from the Cannanore License Lew for tat following awsp r (Section MIS Bovies. and Aofyaalona Code: Any City Or cony whim mattime a par ad to mmv c .eller, improve demolish, or repair any ehutlwe, prior to its beuea., abo assumes the applicant far such perms to file a signed statement that he or she is licensed pnnuant to the provisions of the Conlracsors License Lew (Chapter 9 (mmmendrg with Section 70DO) of D nsim 3 of the Banum e, end Prdea.iom Codel or that he or she by exempt Ihermorn and the bees far the albped exemption. Any violation Of Session 7031.5 by any spalioam far a permit mbjeds the app6i to a CiN penalty of not mare than fere hundred dolours IS5001). ❑ I, as owner of the property or my employees with wages as their We mmarrossion, will do the work, and the sticture b 0,d intended or named for with, (Section 7044, Business and Professions Code: The Comawsore License Lawdoes not applyto an owner# property who wtda or monism that., and who cars .um work hweaa w hereat w Mmeugh he or her own employees, provided then N,th improvements area Intended or cloned far naba, however, the wikim, or snptovemem is eoU within me year of romp ition, the wnerbuildar will have the burden Of proving he or she did not wind or improve far the pwvaae of sole). ❑ I. as owner of the pmi on oxdusivey mmreding with licensed comrades to eonsi Me project (Section 7044, Business and Professions Code: The Contraaors License e rot Lew dotapply to an owner of property who wigs Or irammme, layman and who commune farmm platoon,waa a mnhaor(r) licensed pursuant to the Cmtraawa Limns. Law). ❑ 1 am wwript under Sroh m: B. A PC,, for This reason: Done: Owner: 1 do hereby certify that 1 am aware of and understand the requirements of Caldomie health and Enter, Cade Seaham 25505, 25533, and 25534, and that I or any frture wilding moupenl will / will a (circle one) need to comply with wait atate mdm end the requirements or e perms formisuuctimor mod.ficatgnhwntheAw tueTiy ganagemere Diana. Residential mmruaun appiretiom are snorts from tlwe moviairom. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm trader penalty of p riury one of the fplowdmg detlaratcne: ❑ have arc wit/ maintain a tertdcate d oremnt to seainsure M wwkera' cwnpensatipn, m worked Iw by Semon 3)00 d Iha labor Code, farthe performance of Ma work ler which this marsh I. byued. ha� 6 (hew end ova mPonlve wakere'mmpareatcn' wailby5ectim 3]OOdde labor Cade,lwt G'AC ltt�alee wmlt far which Mb pemm al hinted. My w' 7111 e �c��r aad I number we: 09/30/96 J Caller: ` Policy Number. rab sou. Read a ber ttnpWy! it las parrn16 y un pay hdred dellen 15 1001 w tenni 1A ❑ I maty mat in the pedwmema d the work fw wench this perm# b in ed, I mall a aov poeon in any manner an as to become mbiw to the woM1egs' cwynpmauoion laws d Cad agrm Om d I k became nmjed to the waken' Dale: � /fir io ion d / r d the Labe. I I h coi with (WeMnHr Fellws to.seuro wortas'Oompnuatlon cowreps 1. uNawN& end aIWI ne/eet sh ernpfoyw as erlMrW Pens -And! cM� gar r W ro ova he.hdred MaavM colo. 15100, Oli In einfiNon ro Me cur Of mmpwwnon densities sa proyron far In Son,don 3706 of Me Labor Cods. Interest and atmrnay's Ira CONSTRUCTION LENDING AGENCY: I hereby aMme under penalty d perjury that Inde b e mnstrWion bnclin, a airy ler the "ft.. of the wok Iw whidm rob perm, 1. bsuyd (Salon 3097, Civ. C). , LENDER'S NAME: LENDER'S ADDRESS: I cartery That I have and this application and satethat the above information i. torted. I agree to tompy wll dry cou ith earcnty on irences and elate lows relating to1frVgonflMTndhereby aulherbe remormilatives of this dy to enter upon the above-mentioned property for inspection purposes. f\ e -7 5 (515146 WP) White-BuSi A Safety: Grmn-Flew Canary -Applicant: Pink -Roma,: Godenmd-Aeaeaor CITY OF COSTA MESA - BUILDING PERMIT n^71c n PERMIT NO: P 075433 PLAN CHECK NO: N I CnNrT. Al cr,po. %r CONSTRUCTION TYPE: V -N PERMIT TYPE:'PLU PURPOSE: OTH JOB DESCRIPTION ; C/O DISHWASHER SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT Z O N T'N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT:. FT IN PARKING REQ• PROV: PARCEL: 42431114 ZNE: REF NO: PLANNING N TES> XX2 __ QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 DISHWASHER > 7.00 ############################################################################### D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S` ZONING APPROVED BY DATE: BUILDING APPROVED BY APPLICATION ISSUED ################### LEGALIZATION:N BLDG PMT PERMIT PLAN DATE: DATE: 91 ,_ F E E S U M M A R Y STRUCTURAL SEGMENT:N PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING 7.00 25t SMIP/NON-RES ISSUE FEE 20.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 7.00 20.00 0.00 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHOAT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.00 I ND I V I D U A L F E E B R E A K D O W N XX2 __ QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 DISHWASHER 7.00 7.00 END OF FEES 01 00195607-00195607 TGT 417.q0 DATES 12/01/95 TIME: 09;27 Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations.- C17Y OF COSTA MESA P E i Ngg,, TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT G2r) '7043 CP oject Address 6 5 1Ad / C 7.4 ,-C TYPE OF CONSTRUCTION (, i Owner LF_ /4 Phone ❑ ADD ❑ ALTERATION D�.-, 6. 8.3_6 7/14161 69u 7 Address G pggZL %q �•G LNEW EAEPAIR ❑ CONVERSION ❑DEMOLISH - ❑OTHER ZONING REGULATIONS Arch/Eng. License No. DESCRIPTION OF WORK M + A.P. � Address pp+C ZONE PLNG. REF. -F Contractor j C Phone' TYPE OF PERMIT Tp PRO YNLI Address / %i/, & •y ,,.. ,�`` ❑GRADING FOUNDATION 2; TRVCTV RAL SETBACK /I. SID YARD LICENSED CONTRACTOR DECLARATION I hereby that I am licensed of Charter 9 ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHANICA LS IEDE VA affirm under provisions (com- mencin9 with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code, and my license I5 in full forte and effect. REAR YARD (TO P/L) 6Z-5 PROJECT DESCRIPTION . Lit¢ N License Class �� ^ PKC. SPACE REQ. PROVIDED ~!'/y �9gnature SQ. FT. �, - - Date STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANC�.��RUCTION TYPE I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BV DAT certificate of Workers' Compensation -Insurance, or a certified copy J.._ � C.). .�./ �f thereof (Spy7q� GRADING CU. YDS. ACRES SPECIAL CONDITIONS: 4Ly�b� Policy Noft0 / Company •S�Q/a /' JA dp ❑ Certified, copy is hereby furnished. REMARKS: rcertified copy is filed with the city Building Division. , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed if the permit is for one hundred ($100) or less). I 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 PLUMBING PLAN CHECK ' 'ELECTRICAL - PLAN CHECK subject t0 the Workers' Compensation Laws Of California. - Date Signature _ BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS URINALS - GENERATOR 0-1 KW_ 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_ 50+KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP-1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS -' (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS,.. FIXTURES OUTLETS WITCHES Civ' C.). Lender's NamB Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS OWNER BUILDER DECLARATIONINTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METER SUB WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to Its Issuance, also re. quires the applicant for Such permit to file a Signed statement that he GAS SERVICE OUTLETS SERVICE AMP I s licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) Or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by CONNECTIONSof any applicant for a permit subjects the applicant to a civil penaltySEWER not more than five hundred dollars ($500). SOLAR TANK COLLECTORS S C ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended SOLAR PIPING SVS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DAT who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES 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 did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDIPERMING $ 39.50 SMIP $ El 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK $ e!-S. 0-:2 PERMIT and Professions Code; The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builtl$ Or Improves thereon, and who con. REFRIGERATION 0-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License law). 100,000+BTU PLAN CHECK $ _S= ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason PLAN CHECK $_ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL $ TOTAL FEE $ LESS AD- I hereby certify that !.have reatl this appl' tion and state that the above information is correct. agree [o co/ iPlywith all city and county PLAN CHECK $ VANCEP PC $ ortl induces antl stat law$ relati g to E $Vuctio d tl hereby authorize _� representatives This city t ypon t above mentionetl 1 t 7 property ectiOn s Signature Date _ '•rte FINAL FEE $.-l•1.L-_ Drivers' License or SS if� ISSUE FEE CMF 0865-46 White -Building; Unary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector' t 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn',' • - 45. Forms 4. Electrical Conduit-Undrgrn - N 46. Electrical Bonding 5. Steel_em orce 47. Rough Plumbing & Pressure Test 6. Electrical•UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings ---� - _ 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test ,.9. Water Pipe-Undrgrn . 51. Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System 52. -APPROVAL TO DECK '41*.' -Property Sewer'GinV&-Hbu�e Connection 53. Backwash & Receptor -Final ' 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing ' 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring -61 C_ 57. Solar System -Final 16. Rough Heating & Air Conditioning _58. Fencing & Access Approval 17. Ducts in -Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. _ POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation i 24. Lathing & Siding 25. Drywall Nailing $•�j i. 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO.LOT NO, BLDG. NO. ' CONSTRUCTION PERMIT M 220 7O Z/2 r(s TYPE OF CONSTRUCTION El ry/FW ❑ ADD ❑ ALTERATION LYREPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER 3145 8/II/81 5e00 ZONING REGULATIONS Piolect Address S A I Owner'— •• Phone Address Arch/Eng. License No. DESCRIPTION OF WORK A.P. # ZONE PLNG. REF. :P Address Contractor Phone -/_ TYPE OF PERMIT GRADING ❑GRADING ❑ FOUNDATION EI ❑ TENANT El ELECTRICAL ❑PLUMBING Lff01ECHANICA D LDING SETBACKC L T. 55IDE YARD LEDE Y AD WrpOBU�1IPE RL ING LINE PR�V Address LICENSED CONTRACTOR DECLARATION 9 1 hereby affirm that I am licensed under provisions of Charter (Com- 7000) Division 3 of the Business ❑ OTHER RIGHT men ting with section Of and Professions Code, and my license Is in full force antl effect. REAR YARD (TO P/L) e• �?S PROJECT DESCRIPTION Licenspfl License r9 PKG. SPACE REQ. PROVIDED �Cl�as�s �� Date d=[.L9 Signature / / SQ. FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY_ CONSTRUCTION TYPE 1 hereby affirm that I have a certificate of consent to self -insure or a VALUATION ZONE ZONING APPROVED BY DATE Certificate of Workers' Compensation Insurance. or copy thereof (Section 3800, Lab. C.). "a'certifi,ed GRADING CU. YDS. ACRES SPECIAL CONDITIONS: pil/6!✓ policy No. Company J%�/- ✓ ❑ Ce ifletl Copy is hereby furnished. REMARKS: art lfled Copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for One hundred ($100) or less). I Cert fy 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subjet to the Workers' Compensation 4,aws of California. _ BATHTUBS SHOWERS DWELLING UARAUE Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_ 1-10 KW. to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_ 50+KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP -1-10 HP I hereby affirm that there is a construction lending agency for the per; SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). -- - Lender's Name Lender's Address DRINKING FOUNTAINS -GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS ' OWNER BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for -SWIMMING POOL P TRAP-- POLES METERED SUB the following reason (Section 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 re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE- - AMP is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - - - - any applicant for a permit- subjects the applicant to 'a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS '- -• ❑ 1, 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner ofproperty ... - ISSUE FEE APPLICATION APPROVED BY DATE _a who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK _ SUMMARY OF FEES Imended 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 did not build or improve for the purpose of sale). HEAT M 0-100,000 BTU BUILDING PERMIT $ SMIP $ C3 1, as owner of the property, am exclusively contracting with licensed 7044, Business AN VCTING 0 /00,000+BTU /J contractors to construct the project (Section and professions Code: The Contractor's License Law does not apply to G 00 PLAN CHECK $ PERMIT ISSUANCE $ an owner of property who builds or improves thereon, and who con. REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK $ ❑ 1 am exempt under -Section. B. & P. C. for this BOILERS BTU - ELECTRICAL $ $ reason ' SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL $ MICROFILM $ TOTAL FEE $ _s �� - Date Owner I hereby certify that I have read this plication and state that the above Information is correct. agree t comply with all city antl county PLAN CHECK VANCE PC $ _ ordinances and state laws re tin construction and hereby authorize representatives f this y enter supon a above mentioned property p ctlo r o S. �� 7Oo �- a/ Slgnat ure Ole C ISSUE FEE C FINAL FEE $ _ it Drivers' License or SS $ CMF 0865-46 White -Building; Canary -Applicant, Pink -Accounting: Goldenrod -Assessor TL CONSTRUCTION AND PLANNING, APPROVALS Permit # Date Inspector - - POOL & SPA - _ , -- - ', I Date Inspector• APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Uncrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8.. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.El Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbina S stem -Final - -- 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating& Air Conditioning-! -�/ encing & Access Approval 17. Ducts in Structure _ 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning ,$ `j - I., 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &BUILDING A 5 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date APPROVED FoyA P P R D I ED CITY OF COSTA ME/S;aAtVopjj PLANNING DEPT. i'City of COSI 50 BUIICIIfIg �'}D p - X�j SUBJECT TO BLDG, DEPT, REG. DATE.—. _._i9___ _ THESE PLANS MUST BE ON JOB AT L' TIMES DIRECTOR OF MAKE INO CHANGES WITHOUT PRIOR APPRO _ o OF DEPT. ' &;4 eg .e // .Z.-f opX THE ISSUANCE OR GRANTING OFA PERM OR APP 3 _ �2 - 7Wis'464C: OF PLAyS AND SPECIFICATIONS SHALL NO BE CONSTRUED 1 TO BEA PERMIT FOR, OR AN APPROVAL ,ANY VIOLATION OF ANY IOF THE' PROVISIONS OF THIS CO NO PFjly117,8R6 /� ,�rC A(, p•a JZ SLIMING! TO GIVE AUTHORITY TO VIOL E'OR CANCEL THE -- - PROVISIONS OF THIS CODE SHALL B VALI Dyk'EFJjIN� LL STRUCTURAL APPROVAL ON FAR AS THE WORK OR USE WHICH IT UTHORIZ IS//,,((rzrzpAWFUL 9 THE ISSUANCE OF A PERMI BASED UPON ARS AND SEPARATE PERMITS ARE RErII ED I SPECIFICATIONS SHALL NOT PREV TITHE BUILDING OFFICIAL �� TROM11 THEREAFTER REQUIRING T E CORRECTION OF ERRORS FOR ELECTRICAL-, PLU n'�u l' G. IN SAID !PLANS LAND SPECIFIC IONSI OR FROM PREVENTING HEAT4NG VENTILATING ND 4 BUILDING OPERATIONS BEING RRIED ON THEREUNDER WHEN REFRIGERATION WO j IN VIOLATION Of THIS CODE R OF ANY OTHER ORDINANCE I CF THE CITY, Perr THIS NUMBER f.9U`. � ACCONIPANY ALL INSPECT j FOR BUILDINGS 9'ih'E i 'EPSON$ ARE TO BE EMRLOYED, N,'E 'UGEST THAT THE j STATE OF CALIFOI NIA DIVISION OF j INDUSTRIAL SAFETY E�CONSULTED FOR ADDITIONAL REQUIRI ENTS. I CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. 7043 DATE D rP amhPr 15,._7971 IAT N0. 5(, ADDRESS 1A65 v kyiqtn rirrlp The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he -she -they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. CALAFUZ;QNST$UCTION CORP. Developer ana/or autnoriZea epresentative ED r� Le der MORESSOFNILDIND: 1865 PARKVZSTA CI UNIT. c;tNE;il`[AhnIGON'^NRICHARD LANCE SHEPHERD a AdRESS1865 PARKVISTA CI C,N CA 92627 548-6265 MPL. "LNG ADORERS: ARCHITECT OR ENGINEER: INC NO: RCN OR ENG.'S ADORE35: UNIT: CONTRACTOR'S NATE- COMPACTORS li I AUORESS UNIT: LICENSED CONTRACTORS DECLARATION: I hereby arci,a .M pmaj, d pmm, that I am licensad urde aovissons of Chapter 9 (commarain9 wdh Section 7=1 of Dili.. 3 of Ne Butlnm oust Pmlmaiona Code. end my names is in lug force ami wad. CITY LIC. NO, LIC. Cuss: LIC. NO, EXP: Dns: C«wadar. OWNER BUILDER DECLARATION: I herby ercian anise penalty of p«juy little I am axeonpl hand the Comracm Licanae Law for the fdbwng iesaon (Bodian 7W IS Bnsien and Prdeeeiaru Code: miry cdy «owed, wldde re0ubes a pfrmb to Conned, am. umrpw, demd'ah. «regi my nmrnve. on., b its issuance, also mires the eppoera 1« such peons to Be a eynsd gatmom Nat M w ami is Iicevad pureed to the povlsiaN d the Contrecfm license law (Chapw B (mmmeneuq wah Section 7000) of Oission 3 of Use Business ami Prolaesiam Code) or Ihat M «ahs is exempt Ihmahom and IM bean for Ns~ exemption. Arty ybodion of Sed'on 7031.5 by any applicant for a pems abpaa IM opossum to a endo Penshy d nd mm than live MMvd doMn ISSDDD. ❑ I, m Cmam d the proWnyor M employees with wages m lhak muss coaMnes oo, win do the mark, ami the structure is rwl inrsted «dleoet ler deb (Ssdian 7044, Business and Paiseebne Code: TM Conlmdm Llamas Lew does not apply to an owrwr of property, wM Waste or mpowa thereon. anal who doom nNn work hbnaell or level «IMorgh hu or her own employees. p rm1w! that ach oh r ads me not'vuwded «aHeoed 1« was. R, larshwm. the Wilding or'anpepwrned is sold within ores Year of completion. the ownerLuildor win have IM Water, of paring he « ami did had bdld « impom t« IM Wrpme of esasl, ❑ I, as ower of M Isopety, and axM dy ContreCYep wah Iiceneed commome M Conmud nee pried (Sedbn 7044. Besbesa and pmfeseioro Cpde: The Conlrtlm Horde Law does nod apply to so ower of pWaay she be" « impoves lineman ami adeo meads for van Palms wash a Canradp(e) licensed women Io IM C«aradar U. law). }[] axempcedesmpBP7044 B.AP.C..sethhmoseesso NE{j9/ADOIN/y WO C D a: — Owner: /7{.mss ,p� / . �!: / mby Coady that I am ewers d end uMemtard the requirement, of Callmu N end Safety CodaBaCtion. 25505, 25533, and and Ihn I or any Mum Wilding araupant will I will and Iamb one) need to cwnplY with maid alma andes vd the requtmments for e palmH fpmnstvnion« modAcationfam the Ai u&9iY gmegemeat Dined. ReetdenlWoonnddbn mplcetiane m amend lmm theme pro :.hens. WORKER'S COMPENSATION DECLARATION: I hereby efhm uMee penally of pejury one of the folowhng declaration.: ❑ I hew fad he meinbe a cadEwe rt sox *& to urc;nsam ler waken' oonpeestlion, es apylded 1« by Salim 3]W d the labpr coda. f« IM panomarce d IM work f« wlich this peomb is neesd. ❑ hmre eued soil meintak+ a 1. issued. My on insurance, m regi. by Bodian 3TW d the labor Code, ler the peolormarca d the soak I« which this pemrc n ®evd. MY w«kens canpanambn inarauKa unity and pdicy number am: Cady: Polity Number. (This meclion need nm M completed y 144 perm! ie ler one hundeM edbn (31 W) w bas.) ❑ I Coady that to the padommnce of the work ler which this permit n Nested. I "I m employ uw pe on in any mannw sou to brume subjes to the workers' cornoonution leve of CeHwds, and epee that H I Mould beton. abject to am wohere' con somanan annsi ns of Section 37W Of IM Lebon Code. I Shall f«Ihwkh comply wnh Noes pay goes. Dna: Applied: WamkV: FINUre m ascan woekwi rompeowtlon CovwSW Is unbeAd, woof shall a dUmf an wnplpyw to cdMool Pwnetlaa semi dull dna W b ore hrndrW thousvrd ddbre (S104OW1 M addldon m stn cool of rompwuatloM1 darngws u pmrmiM ler In Section 3705 or to Lebon Coda, Intense, ane/ ammq'S lose. CONSTRUCTION LENDING AGENCY: I hereby, elm uMer penalty of PmMy the Iles n s mrreabn bnd'u i agenc, ler the pedomame of the work 1« whidM Inn More u Naomi (S.d'on 3097, Civ, C). LENDER'S NAME: LENDER'S ADDRE39: I Coady the I haw read this application end nese that the above Warrnnion is Comm. I slime to campy min all City end county oduuuuxw and aMe tow, mods, to building C«uV Wbn and hereby euth«rze rspeesenlalN.. of the City to adv upon the properly for bepedasn pwppm.m. RICHARD SHEPERD ( , (515146 wP) Mid - dldiq A Safe,: Omm,Re; Canary_Apossim: pind- ,,ane; CITY OF COSTA MESA - BUILDING PERMIT --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: PERM NO; B 082388 PERMIT NO: B 082388 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: REP JOB DESCRIPTION : REPAIR DRY WALLS DUE TO FIRE REPAIR SQ FT: 1,200 CLAIM VALUE: 1,200.00 CALC-VALUE: 1,200.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 HALLWAY ############################################################################## Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- ISSUE PLAN -CHECK --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV,: 40,25 PARCEL: 42431114 ZNE: REF NO: PLANNING NOTES> I N D I V I D U A L F E E B R E A K D O W N > D E V E L 0 P M E:N T,. E R V I C E S R E Q U I R E M E N T S .S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: r� DATE:�-7 ###################### # ########## ## # LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING T' 40.25 •50 SMIP/NON-RES SSUE FEE UILDING-DICT-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE OTALS ---- > 40.75 0,00 0.00 40,75 40.75 .00 EVENUE DIVISION TOTALS--> COLLECTED: 40.75 OVER/SHORT; •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 40,25 .50 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N SFR 1200 FIRE DAMAGE/VAL RESIDENTIAL NOZONE END OF FEES EXPRIFV bift-liLiB UNIT COST TOTAL COST 1.00 n X200,00 .... .y .: APf1 p 91997 CITY CGS i flfS A E CONSTRUCTION AND PLANNING ,(I AP1"ROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector Y. 1.' Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe,Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgr6d. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO 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, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ElGas 0Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing Y (�� 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL -. u 29. Insulation L( (S �j7 8. FIRE PREY. FINAL 30. Drywall Nailing ((_ZI C? _2 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning . 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 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 47. FINAL STRUCTURE & BUILDING 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 4' 51. CERTIFICATE OF OCCUPANCY No Date ADDREWORBUILDWG: 1815 PARKVISTA CI UNT, CITY OF COSTA MESA — BUILDING PERMIT ' oNINERSNAMEIFIDOMIN: RICHARD LANCE SHEPHERD PERM NO: M 082390 ADDRESS:1865 PARKVISTA CI C,M CA 92627 PERMIT NO: M 082390 PLAN CHECK NO: N GOVT: N SUPP: N APPL. NAIUNC ADDRE548-6265 �.(SS: '\ CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: REP ARCNDECT OR ENGINEER: MC. NO.: - SOB DESCRIPTION REPAIR DRY WALLS DUE TO FIRE REPAIR SQ FT: ARCH. OR ENG.'S ADDRESS: UNT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / CONTRACTORS NAME: CONTRACTORS NAMING COMMENTS:, REF:B-82388 ADDRESS: I.C. NC.:############################################################################### uw-. Z O N I N G R E Q U I R E M E N T S LICENSED CONTRACTORS DECLARATION: I hereby affkm under penalty o/ perjury that I an licensed under provisions of Chapter 9 S E T B A C K S (commencing with Section TODD) of Division 3 of UM Business and Professions Code, and my license is in full force end effect. CITY LIC. NO.: uaCuss: uC.NO.: EXP:------------ MAIN BUILDING ------------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: Convector. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION: I hereby affimn under penally d m,7ary that I an eaempi from the Contract. Licence Law for the following reason (Sather 7031.5 Business and Professions Cade: Any city a county which renounce a permit to construct, eller, improve.1 demolish, a repo cry, structure prior to its issuance, also requires the applicant for such permit to file a signal statement that he or she PARKING REQ: P ROC PARCEL: 42431114 Z N E : REF NO is licensed summers t0 the provisions of the Contractors license Law )Chaps 9 (commenciag with Section 7000) of Divwio° 3 of the PLANNING NOTES > Business and Professions Cade) or that he a she is axemd therefrom and the basis for IM alleged exemption. My violation of Section > 7031.5 by any applicant for permit wlryeds the abdkant to a civil penalty of not more than the hundred dollar 1S5o0j). ❑ I, as ownerofthewitomyormyemployeeswithwagesastherontocompensation,willdothework,andthestructureI,norintended D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S or oNsnd for sale (Section 7006, Business end Professions Code: The Contractors License Maw does not apply to an cans o/ property who bulls or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such _ improvements me not intended or offeree for rials. 1, however, the building or knprovament is add within orris year of completion, the ZONING APPROVED BY DATE: owner-builder will have the burden of moving he or she did not buil or improv° for the purpose of sale). ❑ I. n owns of the property. am axdusively contracting with licensed contractors to construe the project (section lou, Business and BUILDING APPROVED B Y DATE Prolamines Code: The Contredm Lice onse Law does not apply to an sord owner properly, imreon who Wild$ ca prov» theand who contracts for so. suprojects with a co nsaa(s) licensed W muant to the Cantradora License Law). ressumpyineale:em unear o P7044 B.sFC.,fathisnuseenOWN R D ING K APPLICATION ISSUED BY: > -v� DATE: Dat owner: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N ereby.edifythat I am await d end undeMand IMrmdrememe d California Health and Safety Code Seeiaw ., us . d 530, ane that I a any foum budding occupant win / wgl nd (droleone) seed to comely wait said leu codes and the repuiremen for apsmh/aconstmctionormndificationhomthe Ab�"'i ty tagemeni Dist .Rmidentidconsnneunappkratimaar° mptio thine BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 12 . 2 5 Date: Applicant PLAN - 25% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION: I hereby affirm ands penalty of perjury one of the following demratian: ISSUE FEE . `�_ 22 .00 ❑ IhaveandwPmeimainao rcwedcomentloeelf-insumfaa m'compensetlon,mproMWforbySect 37 dtheLebor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code, for the pedamance of Lite work for wfv'ch this permil is esund. ❑ IhaveandwitlmaintemwoMem'corrimnselloninmrmoe,mrequiredby5eaion3]00diheLaborCnde,brthepedormancodiha TOTALS----> 12.25 22.00 ;-- 0 . UO 34 .25 34.25 '00 work for which this permit is heated. My workers compensAlon insurance radar and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 34,25 OVER/SHORT: .00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (]his section need nal be oanpbfed N the pomk is ler ane hundred dollars (31007 or less.) -.34.25 ❑ 1 candy that in the permit is issued, I shall nit employ arty person in any manes m as to become subject to the worker' compensation laws of Calilamia, and agree I" N I should become subject to the workers' compensation provisions of Section 37M of the Labor Code, I shall forthwith comply with those provisions. I N D I V I D U A L- F E E B R E A K D O W N Data: Applicant; Weming:Fel/um roseeuro worken'compensatlon rovemps is unMwNl, end shellaW/ecf an employe fp MMnsl penel0es pend TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST civil Snsa up Is one hurdled fhounnd dollars (5104000), In erlrlldon to 1hs coat of campsresf/on, demepes as provided for In Section 3706of rhe Labor Code, infant, end Oftomsy's lees. MEC I REPAIR/ALT HEATING UNIT/SYS W/CNTLS 12.25 12,25 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty d perjury that there is a construction lending agency for the END OF FEES pedamarim of the wrk for which the pamN is issued (Section 3097. CN. C). LENDER'S NAME: �r_1rrr��♦♦ ,(� LENDER'S ADDRESS: , R j y R . I certify the have read this a Wing co stand date the Ilia above information W i se is wined. I agree t comply with all d ty and county adinmcee n" end stile leas perming to building correvuaion and hereby authorize rmresentativm tithe my to enter upon Iheebove-mentioned property for InspectionInspectionspInspectionEXPIRED purposes RICHARD SHEPERD t G APR Q 1997 e s DATE 47, Date: CITY Oi k;jSiA A$ ES-ri signature O _ nuApp' vUwtmdor (5151-46 WP) Whit"itildvg 8 Sdety: Grew,cle; Caney-Applicant; Pink-Revenua: Godenmd-Asseemr CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd, 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE' , 7. Footings 58. Electrical Conduit-Undrgrnd, 8. Foundation 59, Gas Pipe, 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. 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 Rough Heating & Air Conditioning ,i 5_ n/ LY FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ElGas 00il 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 z `r 29. Insulation 78, FIRE PREY. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT r 31. Plaster Brown Coat 79, FINAL INSPECTION 32, Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes�J.IJ�_C3��UGrr NvAC �C�K '� 34. Final Heating & Air Conditioning 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 - I -_ 45. Sound Attenuation Cr 46. Handicap Regulations ,- r -47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING ?, 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date I ADDRES$OF BMLDING: 1865 PARKVISTA CI Dir wmw'swuiElPlwmvN:RICHARD LANCE SHEPHERD ADD"Ess:1865 PARKVISTA CI C.M CA 92627 548-6265 APPL. MAILING WORM ARCHITECT OR ENGINEER: UC. NO.: ARCK OR ENG'S ADDRESS: UNIT: CONTRACTOWS NMM: CONTRACTORS MMUNG ADDRESS: Mill), UNIT: LICENSED CONTRACTORS DECLARATION: I hem1hy affirm under penalty Of perjury that I em licensed under provisions of Chapter 9 (commencing wish Section 7000) of Division 3 u1 the Business and Professions Code. and my Leasee is in lull force and enact. CITY LIC. NO.: LIC. CLASS: LIC. NO.: EXP: OWNER BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractors License Lew for the lollowkg rases (Section 7031.5 Busineea And PMeselon. Code: Any city a county which reyuime is small to mrebucl, alter, imProye, demolch, Or repair any structure, pier to its laa«ape, ako recuires the aPPlipm for such permit to Be a signed Netsmen. Met he a she is licensed pursuant to the provisions of the Contractors License Lew [Chapter 9 (one mendrp with Semon TODD) of OiOision 3 Of the Business and profession. Code[ or Ihel he or etre is exempt therefrom and the save for the allotted exempla. Any dolatnn a Section 7031.5 by any Opposes Ip a p«mh subject the applicant to a civil penally of not mole than fee hundred ddlare [$SWIM ❑ 1, as owner of the propend or my employees with wages as their sole compenaetion, will do Ore avrk, and the mucture at not unaided or offered for sele(Section 7040, Buttgss end Profession. Cade: The Contractors License Lew does roll appy to an owner of property, who Wide or ismom ee thereon. and who does such work Nmse9 or herself or through his or her oam empbfest, provided that such iaprwementa «a nal intended «offered for tab. n, however. the bolls, or knpl(Nemanl is split wuhin one Year Of compimicn, the ownerbuider will have the bard. of proving he Or he did rel Wild «improve for IM Wrpoee Of dab). ❑ I. as parer Of the property, am exdusively contractig with loerrsed contractors to construct the protect (Sect100 7041, Runtiness and professions Code: The Cpnlreders Licence Lew doss ltd apply, to an mercer of OmIsal who Wiles d improves thereon «d who ontracts Ip such rojeda vah a co sred«(s) licensed musam to the Contractors License law). I tempt Lina« Sedkr P 7 0 4 4 B. a p.c., w,t/ni,�ma.pnayj E RDDO I N�j �^IORQ Date: I raby certify her I em sets d and understand the reRuiromanb a Ctiomk Health and Slav Coda Sections 25505, ?5533, arra end Mel I a an)' Muro Wi'me occupant will /wit awl (dicta oro) creed to comply wih aid state Wad and IM requiremante b AM.hfor construction or modifreton fran the A'a MTh, aattemenl District. Rewdenlid construction eppimi. aro exemp from these Dote: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury One of the following dedemtiora: ❑ I sero and he merman a Of me a d for which to aentinwro is waken corriipensarion, a pwksd f« by Soden 3JW d the Lend Cnde, for the pertarmenne d tit. work fol whkh this Perms is issued. ❑ I naro.nd tilt mtmen wdkers' �npenaar n mtaran<e. a reawme by salon 3Tao a Me rah« cod.. fol tit.I>edarm«we a the work id wbicia Mk pemah b round. My waken' compenW ion rnwrsnne avr'w end pdioy number are: Conies: policy Number: (Mi. section need ltd be romPWW i the poral he fol are hundred dollars IS1001 d fare) ❑ I certify that in the perfoanarre Of the work br witch this permit h issued, I shell awl employ any peroon in any manner m as to become subject to the waken' compensation kiss of Cetildnis. and Nae that 4 1 should become subject to the waken' compereetian provision of Section 37W a the labor Cods. I shell forham mmpy with those provieioa. Data Applicant Warning: Fail. a secure work«.' conrperlaadon coverage Is unkwNL and ahell aupli c l an anselevw fe criminal penalty. aral civil Rrpa W k one hundred thousand de/ars (SfOg000), In addiden ro d s cost of rompantaflon damages as provided for In S.U. 31 of Me Labor Code, Interval, and of lacy" fes. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury Iht there Is e construction landing avency, for the performance of the work for which this permi is isauad (Section 31)1 civ. C). LENDER'S NAME LENDER'S ADDRESS: I candy that I hew sed this appotton and tate that the above imam cion is cpned.I epee to comply with a1 ply and county ordinances end stale kiss nktig to wilding dmsuudion and hereby auMorire imaxis iativee of this day to soar upon the abvro-marooned property for inspection purposes. RICHARD SIIEPERD , Dote: (5151-0 .wp) Whhe-Buidig A Soley: Green-Fk: Canary-Appicaaa; Perk -Revenue; Goldenrod-bsessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 082389 PERMIT NO: E 082389 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: REP JOB DESCRIPTION : REPAIR DRY WALLS DUE TO FIRE REPAIR SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC; R-3 / COMMENTS: REF:B-82388 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RIGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL; 42431114 ZNE: REF NO; PLANNING NOTES> > fE kf-)E iE dE iElE iE dE iE 9E dE 9E iE di dE kF iF di*db dF kE iE kE ki-kf*IE �E df*IE iE dE iE**9F kE kE IE 9E iE kE dE i(-lE kE if iE*1E*iE*IE iE 1E If iE*iE*lei lei iE*ii*dE -04 )4 dE iE*di*iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY DATE: DATE: APPLICATION ISSUED BY: ( DATE: iE kE kF lE kE kE 9E kE 9E dE dE dE dE iE fE)EIF*df dE fir d43f3F'ifiF�FiFiFiFiF�7fiFiF�3f3FiF3F�F3F� 3F it7E7F3f3F1'f�F 9E 9E 1f if iE 3E#�E 3E iE 1E if LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 11.30 5018 SMIP/NON—RES PLAN ISSUE FFE 22,00 BUILDIN(G�—DIV—,, PERMIT I551JE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 11.30 22.00 0.00 33.30 33.30 .00 REVENUE DIVISION TOTALS--> COLLECTED: 33.30 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK 33.30 *iEd4didOdt)EiflFdFkidEdE��it�iiiiE*�49n�*k�a4*iE�keaE**+r��-*t�-��*�ia4�-x�4a4**�i��-**iE��*x-�P*a4**er**kea4�k*af>E*iEie�-�4 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 10 FIXTURES, LIGHTING 1 ST 20 EA. 1.00 10,00 ELE 2 RECEPT/OUTLET ADDITIONAL EA, 65 1.30 END OF FEES EXPIRED DATE HI -le) ` R AP4�9i997� _ CONSTRUCTION AND PLANNING APPROVALS Permit # i Date Inspector POOL & SPA APPROVALS ; Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60, Backwash Lines, P -Trap, O Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 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 - APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating _ 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T•Bar Ceiling {Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. 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: 34. Final Heating & Air Conditioning 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 fi 43. Backflow Irrigation 44. Landscape Irrigation System r t 45. Sound Attenuation Y 46. Handicap Regulationsr'� 00 47. FINAL STRUCTURE & BUILDING }S 48. FINAL PLANNING.I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date n Wq TMH(�K,G W 01471. To GasGCNE Tat FRU Id]b}b6111 FARTHING DEVELOPMENT, INC. FARTHING INTERIORS 2903 Newport Blvd. NEWPORT BEACH, CA 92663 Llc. #560875 (714) 673.1212 JOB E -I ecrrirat SHEET NO. OF CALCULATED BY DATE Ll c� CHECKEDBY RrrF1ARD fllrPAERD DATE t DEC -z 14SA 0 174# ***133.50 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 'f!6 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVEDB I DATE 9ECEIiVtED/ DATE ISSUED BUILDING /` • - ,)TE /C/ A Ir W W ADDRESS �/ NO. OF ZFCITY TEL. OWNER PLANS A.P. NO. Fa�I NO �I/� MAIL ADDRESS - 6 �D0 BUILDING I ADDRESS ! 6 Z d U Z z< CITY u/ '� TE NLtj ^�, TRACT e NSi W A D ALTER RE! O N LENDERER LENDER E NO.OF BLDGS. O FF � OF LOT P0Q NOW ON LOT FRONT FT. r aC3 EXISTING BLDG. R. SIDE FT. J :D BRANCH J W OWNE . L. SIDE FT. UEXTERIOR m W ADDRESS 'y ✓ ARCHITECT OR ENGINEER TEL. ./ C m J Q U Q W 2 USE DISTANCE BET. FIRE ZONE TVI ADDRESS Q_ CONTRACTOR APPROVED BY O W Z JO ADDRESS j F r in Z J cc W W ZOIC NO. OF ZFCITY TEL. (jet PLANS Fa�I NO �I/� STATE CITY YARDS APPROVED WO X LIC. NO. LIC. NO. MAIN BUILDING D O (FROM C/L STREET) SIZE .M / W NO.OF BLDGS. O FF � OF LOT P0Q NOW ON LOT FRONT FT. r USE OF EXISTING BLDG. R. SIDE FT. H SIZE OF d / NO. OF Z NEW BLDG./OMS STORIES L. SIDE FT. UEXTERIOR WAL ROOF J' 6y v.- _ COVERING !O COV ERIN REAR FT. J USE OF BUILDING AND WORK TO BE PE FORM DISTANCE BET. CL a MAIN BLDGS. VAR. O F r Z O VI hereby acknowledge that I have read this application and state HOLD FOR that the above information is correct and agree to comply with X all laws regulating building construction, and 1 shall not employ F- any person in violation of the workman's compensation laws of J/.) H the State of California. Z O /(p SO. FT. I hereby certify that 1 am properly licensed as a contractor under THE AMOUNT SHO the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ES am exempt from the provisions of the State of California Business VALUATION and Prof ons Co Division 3, Chapter 9 Signatu /_ Permittee $ \ Aut ad Agent OOX OT BLOCK H' VALUE 1 - / 3 G� GROUP DATE E OF NEW LOING rn p f YARDS APPROVED BET. MAIN ACCESS. Bl. DATE —/-7v ti TION IS FOR T FEE ONLY: i 11711 m 33,` LL