HomeMy WebLinkAbout896 PEACE PL - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.g�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 896 PEACE PL
Suile:
Vicinity:
Primary Occ: R-3 Dwetlings/ Cong Res <10
Parcel Number: 41805269
Applicant: SNEN SCHNIERER
Address: � �
Type of Construction: V-N
Zoning: R1
� .
owner: BUTCHER, EDWIN J TR
Address 896 PEACEPL `
COSTA MESA, CA ` �
Contractor. -CALIFORNIA ROOF SAVERS INC
Address::� 944 W HOOVER . °- '-
ORANGE,CA �
Zip: 91766
Arch :
Address:
Zip:
Phone:
License:
Phone: - 714-719-1689
Zip: �
Phone:
2ip: 92626 �
Phone: 714-771-7663
License: 727693
Eng:
Address:
SCOPE OF PERMIT
T/OFF SHAKE ANO REROOF 2700SF RESIDENCE W/SHAKE RROOF CLASS'C' MIN.
FEE SUMMARY
Plan Check:- $0.00
Permit: $153.25
SMIP Res: $0.80
SMIP Com: $0.00
Other: $0.00
Inspection: ` $0.00'
Total: $154.05
SETBACKS
MAIN�STRUCTURE Front � 0-0
ACCESSORY Front 0- 0
PARKING Existin : o
Rear 0- 0
• -•�*`� Rear 0-0
�� � Required: 0
Status: ISSUED
Applied: 10/17/2005
Issued: 10/17/2005
ISSUED BY: �� !
Calc Valuation:
Claim Valuation:
ieft � 0- 0 Right 0- 0
iefl 0- 0 , _-.Right � 0- 0
Pr000sed: �� 0- � � '
R
R1P
Phone:
License:
sa,000.00
sa,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all
required inspectlons and flnal approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
241&48 (fl�00)
WORKERS'COMPENSAnON DECLARAnON:
I hereby ettirtn under penalry oi perjury one ot t�e following declarations:
❑ I have antl will maintain a certificate of consent to selFlnsure for workers' wmpensation, as provitled for Dy section 3700 oi the Labor Code, lor ihe peAormance of the
work for which Ihis permit is issued.
� 1 have and will maintain workers' compenseiion insurance, as required by section 3700 of the Labor Code, for the perfortnance of the work for which Ihis pertnit is issued.
My wo�lcers' compensation Insurence cerr�'er entl policy number ara: � �
.�
Carder.
not be
one
or less.)
Policy Num6er: � Z4
❑ I cenify t�et in the pertormanca of the work lor which t�is pertnit is issued, I shall not employ any person in any manner so es to hecome subjact ro the workers'
compensetion laws of falitomia, antl egree that if I should become sub�ect to the w� ' compansetion provislons of Sactlon 3700 oi Ihe Labor Code, I shall forthwith
complywith�hese Ay ion
�i Applicam Signeture: ' Date: !O� 1�. � OS �G
WARNINO: FAIWRE T SECURE WO $' WMPENSATION COVERAGE IS IINLAWFUT AN� SHALL SU&IECi PN EMPLOVER TO CRIMINAL PENPLTIES AND CIVIL FlNES UP TOONE MUNDRED
THOUSAND OOLLARE (5100,0p0), IN ADDITIqJ TO THE COST OF COMPENSATION, DAMAGES AS PRWIDED FOq IN SECiION 3]OB OF THE LABOR CODE, INTEREST, AND FTTORNEV'S FEES.
LICENSED CONTRACTORS DECLAFA710N:
I hereby attirtn that I am licensed under provisions of Chapter 9(commencing wi�h Section 7 0) ot Division 3 0l ihe Business and Professions Code, and my license is in fyHr
force and eaea. ua a Z7� 9 3 Class u C�9
Contrectors Signature:�_�� j� Date: �� i 1 �2C' �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aMirtn that ihere is e consWction lending agency for Ihe pedormance of ihe work for which ihis pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn ihat untler penalry of perjury that I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which requires a pertnit to consiruct, alter, impmve, demolish, or reDair any simcture, pnor to its issuance, also requires the applicant for such permit
to lile a signed statement ihat he or she is Iicensed pursuent to ihe provisions ol tha Contractors License Law (Chaptar 9(commencing wit� Section 7000) of Divislon 3 0l the
Business end Professions Code) or thet he or she is exempt therefrom and Ihe besis �or the allegetl ezemption. Any violetion of Section 7031.5 by any applicant tor e permit
sub�ecls ihe epplicant to a civil penelty ol not more than five hundretl dollars ($500).): _
❑ I, es owner ot ihe property, or my employees with weges es their sole compensatlon, WILL DO THE WORK, and ihe stmcture is not intended or oRered tor sale (Sec.
7044, Business and Professions Code: 7he Contractors License Law does not appry to an owner of property who builtls or improves ihereon, and who does such work
himself or herself or through his or her own employees, provided ihat such improvements are not intended or oHered for sals. If, however, the builtling or improvement is
sold within one year of completion, tha ownerbuilder will have the burden of proving ihat he or she tlitl not huild or improva tor purpose of sale.). '
❑ I, as owner ot Ihe property, em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRAC70RS to constmct the project (Sec. 7044, Business entl Professions
Code: The contreciors Licensa Law does not epply to an owner of property who bulltls or Improves ihereon, and who con�rects for such project wiih a contractor(s)
license pureuant to the Contractors License Laws.).
❑ 1 am axempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Ves ❑ No Drlver's License No. Expires:
Vedficetion ot Ownership by (type of document, i.e. - properry tex bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihet no excavation tive (5) or more feet in depih into which a person is required to descend, will be metle in connec�ion with work authodzed by Ihis
permit, and ihat no building siructure, scaHolding, falsework, or demolition or dismantling thereof, will be more ihan ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title e, Califomia Atlministrative Code).
❑ As owner-6uilder, 1 will not employ anyone to do work which would require a permit from ihe Division of Industnal Safety, as notetl above, unless such person �as a
pertnit to da such work fram ihe division.
Signature: Date:
Division ot Industrial Safery Pertnit Num6er:
CER7IFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I certity untler penalry of perlury that I have read ihis application and state that ihe intormation given is
correct. I agree to comply with all state laws and ciry ordlnances relating to building constmction, end euthorize representatives of the Ciry of Casta Mesa to enter upon the
above-described properry for inspection purposes. I agree not to occupy or ellow occupency ol any building authorizetl by this permit until final inspection.
COUE N. INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
12fi8
200
zai
202
203
Pool Spa Final
Final Re-Rooi
Final BIxWRetaining Wall
Final Factory Fire Place
Final Slgn
204 Final Demolition
ygL IMRIALS
! � ��J�/ /
COOE� INSPECTIONTYPE
206 Final Mec�anical
208 Final Plumbing
210 Final Elecirical
212 Finel Fire Prevantion
220 Final Planning Approval
222 Final Site
250 Final Building/Occupency
_ . Date
29g INIID�9Lfl
(774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��MBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 896 PEACE PL Status: ISSUEo
Suite No Applied: OS/222006
Issued: 05222006
Viciniry:
CLOSET INSIDE SFD
Parcel Nunmber: 41805269
Applicant
Address:
Owner:
LITTLEFIELD, SCOTT
24707 SAN FERNANDO RD
SANTA CLARITA, CA
BUTCHER, EDWIN J TR
Address 896 PEACE PL
COSTA MESA, CA
Phone: 661-259-7131
Zip: 91321
Phone:
Zip: 92626
Coniractor: AFFORDABLE WATER HEATERS AND PLUMBING
Adtlress: 24707 SAN FERNANDO RD
�Phone: 661-259-7131
SANTA CLARITA, CA Zip: 97321
License: 627368
ISSUED BY:
' SCOPE OF PERMIT
CHANGE-OUT OF A 50-GALLON GAS WATER HEATER WITH SAME IN A CLOSET IN THE SFD.
1 WATER HEATER
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
FEE SUMMARY
AMT QN AMT C�N AMT gN
ISSUE FEE 523.50 Laundry Tub / Washer $0.00 0 Sump Pump 50.00 0
Backflow irrigation 50.00 0 � Landscape Irrigation 50.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap 50.00 0 Trap Primer $0.00 0
Bathtub 50.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System 50.00 0 Process Piping (per 10 fl) 50.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
ConneIX (Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set 50.00 0
Drain, Floor 50.00 0 Sewer Connect $0.00 0 Waste and Vent System 50.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0
Drain,Roof $0.00 .0 Shower $0.00 �0 WaterHeater/vent $12.30 1
Drinking Fountain $0.00 0,. � Sink, bar $0.00 0� ' Water Piping Qns� or RepJ $0.00 0
Expansion Tank $0.00 �. �0, Sink, commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earihquake Valve $0.00 0'� - Sink, Floor $0.00 0 Water Service $0.00 0
Gas (1-4 outlets) $0.00 -" 0 -. Sink, kitchen � $0.00 0 Water SoRener $0.00 0
Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER " $0.00
Gas Repipe $0.00 0 ' Spa (private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 � Spa (public) $0.00 0 PLAN CHECK $0.00
Interceptors (Grease, Oiq $0.00 0 REINSPECTION $0.00 0
Inlerceptors (Sand Auto ) $0.00 0 � .
- TOTAL CALCULATED FEES: E35.80
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell
requlred inspeetlone and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2048d818�00)
WORKENS' COMPENSATION DECLAfiATION: � �
I here�y effirm undar penalry ot perjury one at the following declaratlons: . ,
❑ I heve entl will melntain e certificate o1 consent to self-Insure for workers' compensation, es provlded tor by section 3700 of the Lahor Cotle, for the pertormance of the
�work for whlch ihis permit Is issued.
�have antl will malntain workers' compensation Insurence, es requlretl by section 3700 al tha Lebor Cotle, far tha perfortnance of the work for which thLs pertnit is issued.
My woAcers' compensation Insurance carriar entl polity number are: /
.Carrier.--��1�'10 ��1�"�% � PolicyNumber: �675'C1P70
-(This secfion need nof be comp/eted il fhe permit Is veluetl at one hundied ddlars (5100) a/ess.) ��
❑ I certity that in t�e perto ance of ihe work for which this pertnit is iuuetl, I shall not employ eny person in eny manner so as to hecoma subject ro t�e workers'
compensetion laws oi �fomi and egree thet il I shoulA bacome subject to Ihe workero' compensation provisions of Sec�ion 3700 0l the Lebor Catle, I shall torthwith
comply wit� these pro ions.
Applicant Signature: �pe�:i S' a a— V(+
-;.s^-..��
'WMNINO.`FAICURETOSE EWORKERS'COMPENSATIONCOVERAGEISUNUWFUIrWDSHALLSUBJEGTANEMPLOVERTOCRIMINALPENALTIESANOdVILFINESUPTOONEMUNDRED
TTIOUSANDDOLLARE(St ,OOO�,INFODITIONTOTHECOSTOFCOMPENSAiION,DAlMGESASPROVIDEDFORINSECilON7/O60FTHElABORCOOE,INTEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I am licansetl untler pmvisions of Chepter 9(commencing with Section 7000) of Dlvislon 3 of lhe BusineSs and Pmfessions Code, entl my license is in full
�o�ce end enect. cro: a, l� a 7� h X" i cia«u �: 3 io
CONSTRUCTION LENDING AGENCY:
❑ I �ereby ettirm Ihat ihere is e construction lentling aqency tor Ihe pertormance of the work lor which Ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lenders Neme: Lenders Adtlress:
SignBturB:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aMirm the� untler penalry ot perjury ihat I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any city or county which requires a permit to consiruct, elter, improve, demolish, or repair any structure, prlor to its issuance, elso requires Ihe applicant for such permit
b file e signed statement that he or she Is Iicensed pursuant to Ihe provislons of the Contrectors License Lew (Chepier 9(commenGng with Section 7000) of Division 3 oi the
Business end Prafesslons Code) ar that he or she Is exempt iheralrom end the basis for ihe alleged ezemptian. Any violetion oi Section 7031.5 by eny appliwnt for a permit
sub�ecis ihe epplicant to e civil penelty of not more than live hundred dollers ($500).):
❑ I, es owner of the property, or my employees wl�h weges es Iheir sole compensation, WILL DO TME WORK, antl the strudure Is not intendetl or oNeretl for sale (Sec.
7044, Business end Professions Code: The Conirectors License Law dces not apply to en owner ol property who 6uilds or improves Ihereon, and who tloes such work
himsetl or herself or through his or �er own employees, provided ihat such improvements are not Intended or oHered tor sale. If, however, Ihe building or improvemem is
sold within one year of completion, Iha owner-builtler wlll have �he burden of proving that �e or sho did not build or imprave tor purpose oi sele.).
❑ I, as owner ol Ihe property, em EXCLUSIVELV COMRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Professions
CoAe: The conirectors License Law does not apply to an owner ol pmperty who builds or Improves Ihareon, antl who con�racts lor such project with a contracior(s)
license pursuam to the Contractors Licensa Lews.).
❑ I am eaempt untler sec. Business and Pwfessions Cotla tor this reeson:
Signawra: Date:
Owner ID verifietl by tlnveYs licanse. ❑ Yes ❑ No Driver's License No.
Verlllcetion of Ownership by (type of document, i.e. - propeny tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PEFiM1T CERTIFICATION:
Eapires:
❑ I hereby cenify that no excavation tive (5) or more fee� In depih into which e person is required to descend, wlil be made in conneciion with work euthorized by Ihis
permit, and that no building siructure, sceHoltling, lalsework, or tlemolition or dismantling thereol, wiil Oe more than thirty-six (36) leet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Tltla 8, Celifomia Adminisirative Code).
❑ As ownerbuilder, I will not employ enyone to do work which woultl require a permit Irom the Division ol Indusirial Safery, es notetl ebove, unless suc� person has e
permii to tlo such work from �he division.
Signe�ure: Date:
Division of Industnal Salery Pertnit Number:
CERIIFlCATE OF COMPLJANCE AND AIffHORIZATION OF ENTAV: I certify under penalry of perjury thet I have read this appliwtion anC state t�at the infortnation given is
correct. I agree to wmply with all state laws entl ciry ortlinances relating to 6uiltling conswction, entl au�horize reDresentatives of Ihe Ciry ol Costa Mesa ro enter upon Ihe
above-tlescriDad properry for inspection purposes. I egree not to occupy or allow occuDancy ot any building euthonzed by Ihis permit until tinel inspection.
COOE 6� INSFECTION TYPE V QSIE INTRIALS
1616 Fizetl System Finsl Fire Prevention �
1268 Pool Spa Final
2ao
201
202
203
Finel Ra-Rool
Finel BIocWRetaining Well
Final Fectory Fire Place .
Final Sign
204 Final Demolition
S'aa'��, Date
COpEj INSPECTIONTVPE
20fi Final Mechanical
208 Final Plum�ing
210 Finel Elec�ncal
212 Final Fire Prevention
220 � Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
Y
� . _ � � �..W � ' No.
t "
� WI�LLIAMS INSUL"ATION COMPANY
�
OF '�CAL:IFORNIA
^.• 1201 E. Hunter Ave., Santa Ana, California 92705
,�� s ' (714) 547-5148, _
� .. . , �;
� - THERMAL INSULATION•CERTIFICATION •1'�
. - v
THIS �S TO CERTIFV THAT.INSUTATION HAS BEEN INSTALLED IN CONFORMANCE WITF
CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, 71TLE 24 STATE
OF CALIFORNIA, IM THE BUILDING LOCATED AT: �
.. , �
� �Tract Name:
L .o. �!�� Tract No. 2ASi3 Block No.
/^ ��
-Street �Cl/ �„��P� '�' ' � City
'
EXTERIOR WALLS:
a
Mfg. �� ���� + Thickness/Type
�' . Ceilings:
��
. � 8atts:,�f ;F
�� .Mfg: �i�`�+���:a Thickness/Type
� Blown In: � '�
; Mfg, t - Thickness/Type
Sq.�Ft.�Covered "�� - No. of Bags Used
;;-�ors: - .,
r
"°��-1. Thickness/Type
r....:r- . �..�. . - .� -. -: ,:�...e... _, .
�" �
Othef y
Mfg.
�
Contractor
Contractors License No.
r
�. S�gnature .�y
�Williams Insulaxion Co.�of~Califomia 4P.
�Califqrnia Contractors License;No,.267522k, �
),/� �'+� .v, . .,-�.^�
I. yr�-_� � J 4• . ... �y, � j.
4' ./
I, Si9namre ' - e - �
. JOB COPY-WHITE " ;�� � �
� GENERAICONTRACTOR-VELLOW ''- �� ;
R— , 1�
V al ue
R— -
_ Value- _ �� —
q_
_ Value
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R—
_ Value
Rf
— Value
' R=
' Value
_ Date
TiN¢
Date 9-29_dY4 � -
—}.. t �:f12C� .rlftilY. �
:-, TiUe' , ' -� " , .
BUILDING DEPARTMENT-PINK
� FILE COPY-GOL�D ,.
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�, �. 16
896 Peace Place, Costa Mesa
��: /%i�79
�
'�e developer of the above entitled tract desires to sell the above set forth
lot prior to t1�e time that the tract has been oortpleted and its streets
accepted. b� the City of Oosta Mesa.
By exew ting this agreen�ent, the undersigned acknavledges that he/she/they
was/aere.advised that this tract has not been given final inspection nor has
it been accepted b� the City of Costa Mesa as having crnplied with the conditions
of approval which were inposed. b� the City at the ture the Final Tract Map was
approved.
The City ass�nnes no liability for the enforcement of the oonditions nec.�essary
for approval other than th�e oonditions protected ty surety bond.
The undersigned agrees to inden�ify and hold the City hazmless fx�an any claim
resulting in dam3ge or personal injuzy to the undersigned bi reason of the
aforenentioned unoa�pleted condition(s).
BY �
R� C E I V E D i 9�ture of Purchaser)
cirv aF cosT� �nesn
«0`,! 3 _ 1979
AM P�A
7�8�9�10illi12s�i2i3i4i5i6
�
a/�9
BY �/j � �1 ����
(Signature of D�veloper and or
authorized representative
sY
(Signature of Lender)
;
4 :
`;IF F:
��7 F �'!° r�, ;�� ; ��� , ,�, ;!' n�:t�= �. .-
November 26, 1979
Ms. Kathy Thompson
Mercury Savings & Loan
P. O. Box 1010
Huntington Beach, California 92647
RE: Tract 10513
896 Peace Place, Costa Mesa
Dear Ms. Thompson:
Foley Construction Co., Incorporated, is in escrow with Edwin
and Stephanie Butcher as seller of the above-referenced property.
The city of Costa Mesa has requested that we inform you, as
lender on the transaction, that the final inspection, acceptance,
and exoneration of bonds for public improvements installed in
Tract 10513 has not occurred. The dwelling unit has received
final inspection by the city of Costa Mesa Building Department
and is complete and ready for occupancy.
If any clarification of this matter is needed, please do not _
hesitate to contact me.
Very truly yours,
��c/L�(� ''����
Carol A. Graas
CAG/cj
cc: lanning Department, City of Costa Mesa
2101 EAST FOURTH STREET, SUITE 100 • SANTA ANA, CALIFORNIA 92705 • TELEPHONE: �774) 543-9477
OWNER �IN & ST�HANIE J. B[TIC!-�R DATE 4/30/80
JOB ADDRESS 896 Peace Place BUILDING PERMIT N0.
GENERAL CONTRACTOR Q•meY-Builder DESCRIPTION o( WORK Tattice Patio 1
AP No. 418-052-69 LOT 16 7
F CTIONS '
5.
c�s
PROP. $WR. LINE �_J MOUSE COM.
SPRINKLING SVSTEM
MISCELLANEOUS
NOUGN HEATING RN� RIR CONOITI
TEMPOR�RY SERVICE OR POLE
UNDERGROUNO � POWER �
ROUGH WIHING
l ENCHES FORMS STE
' i FLOOR SVSTEM
J BOND BEnnn (� STEEL NEINF(
ST^'
FNO FLASNING
. — IN �
AL, FINAL
G, vENT.. REFNIG. �N� A.C., FINAL
iNG. FINAL ANO GAS TEST �
EIECTRIC, FINAL
BUILOING, FINRL
SUBCONTRACTOR
P...• . . -. —.. , ' ci �a �,ianian 5.50 TL
- COSTA MESA BUILDING-SAFETV DEPARTMENT APPLICATION FOR�STRUCTURAL PERMIT -
.:, P.O. BOX 1200 �COSTA MESA, CALIFORNIA 92626� '
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RECEIVED PERMIT
For Applicant to Fill in Completely — Use ink Only � t!
� ADDRESS �l/L� I,E.F�C � L_. ��K'T/'� I����i� A.P. NO. ' � � G � S. � � 'OQ .
� / � 'BUILOING �
T�ENANT�R ���L'✓�/Yr.!1' y'�I �%/�/�%Y�if'i �i ". �tCi':-Hof-: ADDRE55 - 6 '
UNIT OR
MAILING �' " �� : i ��7��,� SPACE NO.
ADDRE55 ����J IFH�� J�j�.. {y�r�(i%�T
CITV �(l::7ia i�/4�o/� � ' NO. �6�/UC� Tq. O / LOT .�/„ . ' ' BLK.
TEL: � Vl
- NEW ADD ALTER REPAIR MOVING DEMOLISH
CANSiRUCTION `ff�,✓F, . . .
LENDER'- .�l " '
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BRANCH �- � - . . . . .. . .
� .. ' . . . � OWNER UT , C ' .
ADDRESS " ' ' ' ALUE Q�.
ARCHITECT . S�4/_ ., . NEL: . . �USE /I i/a' ✓R. s CJV`.
OR ENGINEER
ADDRESS � � ZONE '�� : TVPE I- 'GROUP�
' APPROVED " ' - 3
CONTRACTOR BY '� DATE
AODRESS
' . .� . � , .TEL. � . . � .
� CITV � NO. ` �
STATE � ' ` '> ;';CISV. • � APPROVEDSETBACKS , " , �
LIC. NO. - ' ' ". a CI0. NO. .. , • - . . . •
512E . ' . . - NO.OF BLDGS. (FROM GL STRE T) . ' '
OF LOT ' NOW ON LOT ' qOfYT
' USE OF� �� ' ' ' '
EXI5TING BLDG. • ' � " �S T. O
Separate permits�are,required for . �.. ,,« �. sioe �zFr. v ' -
� --� electric, plumbing and h`eating work: � ' � REAR . yFT. O ' '
USE OF BUILDING AND WORK TO BE PERFORMEO PLANNING ACTION .. ,
' .. " . ' � DATE .
- -' ��APPROVED.
. . . . .- •. , � APPROVED. I / �3d' ��
I hereby acknowl¢dpe ffiat I have reatl this application and state � '-� , '
thai the above intormaiion is corract entl agrea to comply with
all laws reguleting building consttucNon, and I shall not employ . . . ' .
any person in violatlon of the workman's compensation laws ot �
tha State of Californle: . . .� -� � ' . - �D_ �_ ,
I hareby certtfy that I am properly licansetl as a conttactor under / ���Sn. FT.
the State of Califo�n(a Businass antl Professions Cotle, Oivision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, end that such licenses are in full force and effect, or I ' THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am ezempt trom the provisions of the $tate of Californla B�siness VALUATION PERMIT FEE $
and Professions Code, Division 3, Chapter 9 � . S- ^-
SiBnaiura ot �� - � ' PLAN CHECK y �•
• Permittee� ' $ 80•�' TAX $
or y 70 � ' - O • �j
Authorizetl ABent Date � -
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V.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
r BUILDING (�%/% / j� . l� O
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MAIL
TEL.
GTY '�dIj�3� �j[]3i � NO. �
CONSTRUCTION. • . � -
BRANCH
ADDRESS
ORENGWEER �les-Ianqston' nT,o`.'� 547-08
ADDRESS 777�5: Main St.,•#105; Oranqe
CONTRACTOR ati'1pS��EVQlpj�,1"
ADDFESS SdIR2 �
TEL.
CITV - �� ' NO. ' �
STATE CITY '
UC. NO. � LIC. NO. ' '
SIZE � ' � . NO.OF BLIX3S. O
OF LOT ' ' NOW ON LOT
VSEOF N/A• •
EXI5TING BLOG. • � ^
. Sepaiate permits are� required for �
� electric, plumbing and heating work.
detached residence units.
I hareby aeknowletlpe thai I have �eatl this applicetion and stete
that the abova information is' corract antl agrea to comply wlth:
ell laws regulating builtlin8 consvuction, and I shall not employ
eny person In violatton of the workmen's compensatlon laws of
the'Stata of CallforNe: �� - " �- �
I hareby certify ihat I am properly licensetl as a contractor untler
ihe Staie of California Business entl Professions Code; Divlsion 3,
Chepter�9, and ffiat such licanses are in full'force and effect, oi I'.
am eKampt from tha provtsions of the Siate of Californie Business
antl Professlons Cotle, DivisiOn 3, Chap 9. , ' ,
Signamra
Permittee
AuShorized Agent
` "`3338 2%�13�79 II!4��09.JJ�L'
� 3336 -2/I'3%79.,_ I"f4.09CK'f0,
3338 00004474 25 "" � I A"'"' ,
APPLICATION FOR'STRUCTURAL PERM[T '
RECENEDBV DATERECENED neTvicciivn
ADDRE55
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�Ne/a� Fole Construction Company.
_ iYn% w�., nn w �awe h'1 �'-./ / I
FIRE
ZONE
ED
DATE
ZONE NO.OF USE OF NEW' � h
, � PLAN$ � BUILDING T....If?�
�
VARDSAPPROVED VqRDSAPPROVED "
MAIN BUILDING ACCESSORV BUILDING
(fROM GL STRE,€T) y�� P���' ' .
RONT � F�� � FT.
51 / O FT.
L. SiDE ' �� / FT.a � FT.
REAR FT'. O FT.
DISTANCE BET. � � BET. MAIN &
MAIN BLOCaS. _ ACCE�. BLDGS.
VAR.91t � . DATE
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$Q, �� �( N �
THE AMOUNT SHOWN UNDER VA�UATION IS FOR p���
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: '� ""1��
b/1
VALULATION ' PERMIT FEE - $ ' Qg�_i'
�✓/S�' PLANCHECK § / ,_cD.=`T,
�y `, ti "�l
$ z�i,'� TAX , E , Ti� �
p
' � TOTALPAID $,I��O� .
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
, 5740
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3127/79
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00004G74 25
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21'9.00CKTD,
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APPLICATION FOR STRUC7'URAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RECEIVED BV DATE RECEIVEO DATE ISSUED
BVILDING
ADDRE55
PERMIT NO.
OWNER � A.P. NO. . .
MAIL � � . BUI�DING n �
ADDFESS
AODRESS y
TEL TRACT LOT BLOCK
CITV NO.
CONSTRUCTION ' . N W ADD AlT P
LENDER
BRANCH
OWNER
ADDRESS ' VALUE
ARCHITECT , TEL. S $
� OR ENGINEER N .
FIRE
ADDRE�S ZONE ' TVPE GROUP
. . APPROVED �
CONTRACTOR � BV - DATE
ADDRESS
- . ' � � TEL. ZaNE - NO.OF USE OF NEW
CITY NO.
PLANS BUILDING
i-�i STATE CITV ' VARDSAPPROVED VARDSAPPROVED
� LIC. NO. � LIC. NO. MAIN BUILDING ACCESSORV BVIIDING
6a] SRE � NO.OF BLDGS. (FROM GLSTREET) .
0. OF LOT NOW ON LOT qp�.Jt FT. FT. �
a USE OF
� EXI5TING BLDG. ' �
FT
y
FSeparate permits are required for L. SIDE FT. FT.
� electric, plumbing and hea[ing work. �
REAR ' FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. � BET. MAIN &
QMAIN BLDGS. ACCESS. BLDGS.
VAR.qIE � DATE
'= C.U.P.� APPROVED
;APPFOVED
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� I hereby acknowledge thei 1 have �ead this appllceiion and s[ate
p�. that the ebova information is correct and aB�ee to comply with
p+ nil lews reguletinB bull0ing construction, antl I shail not employ
z any person In violation of the workmen's compensetion laws of ''
� tha Stata of Californie. '
3 I heraby cartify ihat I am properly licensed as e contractor unAer SQ. FT.
the State of California Business antl Protessions Cotle„Dlvision 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR
Chapter 9, antl thet such Itcanses are in full force and effect, or i TME PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am ezempt from the provisions of the State ot California eusiness VALUATION
antl Protessions Cotle, Division 3, Chapt 9. , PERMIT FEE $
SiBneture of � � PLAN CHECK $ �.
Permittae $ TAX $ �
AuihoiizedABent , TOTA�PAID $