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Home My WebLink About219 PAULINE PL - Building Permits(714) 754-5273 • Fa�c (714) 754d856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Adtlress: Suite No Viciniry: Parcel Nunmber: Applicant Address: 219 PAULINE PL 42614106 HORNAUER, SYLVIA L 279 PAULINE PL COSTA MESA, CA Owner. FiUKNHUt � Address 219 PAULINI �i j ; COSTA M S � � %�� XY�� 1 oATE �a ISSUED BY: Siaws: ISSUED Applied: 07/07/2006 Issued: 07/07/2006 v /% Jl-i'_ __"_ _�' ___�'" '�'�.�� / % r ` �� \ 2 , ��'i�A.. � � - �� R,-SYLVIA'L V '- � � � �` � � .PL t �✓ � �� ' . � . , , . ,, lj, / \� \� %� , ` Phone ".- '� ` ,CA t �, j � -rZip ,� 9262T_1842-,,\.\� `- ��\�\�` ��- -�i�� % i - -%' � V ��A�� %�� '�� , �� `��, � � <'` �� ,:. ,�,. , UIL=DER � � � � � i A � � �\�� \ Phone: A �� Zip: i�' � �� i � �`�� , c;' ��A� License:000000 ; .,��. �, � „-- �� 1 -' - � � ��A' � - �� .>> � � VA �� ` - �,� � `i� . ... . ��°. �• � V �, '? ; ; -� j �_-- `SGOPE OF PERMhT,; '. , � EXTERIOR OUTCET AND.CONDUIT LOCATED NEXT TO DRIVEWAY. '� � _"c ,� - " . - ' _" _ %� ��;_!�" '� " `� FEESUMMARY -i' i� , ' -�� , ',� ��Quanidy � � \� � 'ISSUE FEE � � $23.50 � . - _ . Temp Dist System / Lighting� $0.00 ' �Temp service,test , $0 00 �� - ; f �.-� -ry o-rBuswayl100 ft f y, y„�, ��, � $0.00 � Res: a/c package 50.00 � � � /"' Standmg Section,;; _ � VA � $0.00 -_i., 1.. �.JiL New Res (1-2 unils) , � $0.00 �� - - -0 - - -``- Misc.Eleclncal'Eqwpment`'- ._ , $0.00 '�New Res (3+units) •�', . 50.00 �� 0 Trans(ormers up.to�bkvaBw / $0.00 Pool / $pa , $0.00 0 � ^� ... up l0 10�kva/kw ' $0.00 �ligMing Fixis � � - � $0.00 � f0_�- -`� y �- -- - . �upto_SO;kya/kw � $0.00 RecepCOutlets �,�� $1.10 7�_k __ - = '�� .up��to�100kva/kw $0.00 �� Switches" _. . � $0.00 "..<'0- - � --' .-'"over,100:kva/kw_..� 50.00 Non Res�Appl '`� - $0.00 �. 0 Low Vollage Equipmenl � 50.00 ResAppl'� --� ."� 30.00 0 Low Volt Wiring System / Ckt ' S0.00 Seiyice to 200a �,� � 50.00 � 0 Misa Conduit �, �� '$1820 Service ip 1000a �� '�.' S0 00 ! 0 Misc�Conductor�� 5Q00 Service:over�9000a � �� $0.00 � 0 , � �,Cvcus ( gen or ride) � $0.00 Motors toJhp'� �� \�,� $0.00 � 0 y,�'�>_ Cvcus„(mech ride or lights) `$0.00 Motors to �tOhp �V '$0.00 � 0 � f"�c"� Chrislmas Tree Stand �$0 00 Motors to 50Hp �, 7 ��$0.00 0 , • Fireworks Slandry �$0�00 Morors to�t00Fip ', � �SO 00� ' j.,,, _ 0," ; � �Other Eleclncal Feei ; � Kr ->� $0 00 Motors ove��400hp � � $0 00,�A 0 � ., � � - ' � . �� „ `� �� ` � ,� �� .�, � � � �� _ ,\ ', n�� ; �, � � � 1 -�, ,ry �� , � �� 'I i � � 0� i 0 �.,.' .� �A � 0� ��': � ._J � ` � �, - , � �- �i I / . ,' � 0 {�l1' " ';i'1 � �, 0 �:,' 1 � ' � . 0 /i p�//;� .'� ! �% ,;,�� t ' � � 0 t ' i� � � � � c`, � /r,d 0 ��.� ` / � '/ � p `�/ /�` �ly ��// �. �; � Communication dmps � // $0 00� � �A 0', � � «Inveshgation Fee � " $0 00 �� ' �, , Sub panel to 200a � �!� =$0.00 '� � � 0 - . . - Plan Check Fee , � ,.�/�;� $0 00 �/ � " �%� Pole Light Pkg . ' � ,$0.00 , � �0�� ` - � -�Relnspeciwn Fee-� ;%� �$0.00� �/ �;'/ Sign Circuits �� \ $0 00 � � 0 �, �_ - � �__ '. �%�i % ��% i �� i Temp Pwr Pole ��`� $0 00' �� 0 �-� 70TAL CACCUCATED FEES�� E42.60�/�/ � IntermedPole �� $000��- 0� � "- �^. A�V �/�� ,-V !1 r:�' ;lV� .. ��;� �.� . -',.`�\`. J �. ... '...'/./i%, � _ _ ..� . ' - - .iJ' - - - _. -i__ _ _ NOTICE: The work authorized by this pertnit shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This pertnit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlons and tinal approval must be obtained. Failure to obtain inspactions and final approval will result in the expiration of Ihis permit. FOR INSPECTIONS CALL: (714) 7545626 �40616 (N00) WORKERS'COMPENSA710N DECLARATON: - - ., � I hereby eftirm under panelry of perjury one of ihe following declarations: , �' ❑ I heve and wlll maintain a certificete of consent to selFlnsure Por workers' compensation, es provided for by section 3700 of the Lebor Code, for the pertormance of the work tor which ihis permit is issued. . ❑ I have and will maintain workers' compensation insurence, as required by section 3700 of ihe Lahor Code, Por Ihe pertortnance of Ihe work tor which this pertnii is issuetl. My workers' wmpensation Insurance wrrier end policy number are: Carrier. Policy Number. (This section neetl nof be completed il the permit is valued ef one hundretl dollers ($100) or less.) ❑ I certify ihat in ihe peRortnanca of the work for which this permit is issued, I shell not employ any person in eny menner so as to become subject to Ihe workers' compensatlon laws of Califomia, end egree that if I should become sub�act to the workers' compensation provlsions ot Section 3700 oi the Labor Code, I shall forihwith comply with these provisions. Applicant SignaNre: Date: WARNING: FAILURE TO SECUFE WORKERS' COMPENSATIqJ COVERAGE IS UNLAWFUL AND SHAIL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVII FlNES UP TOONE HUNORED TLqUSAND Dq1ARE (E100,000), IN ADDITION TO THE COST OF COMPENSFTION, DAMNGES AS PiiOVIOE� FOR IN SECTIqJ 3106 OF THE LABOR CODE, INTEREST, AND FTTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn that I em licensed under provisions of Chapler 9(commencing with Section 7000) oi Division 3 ot the Business and Professions Code, antl my license is in full force and eflecL Lic. A Class k Conirectors Slgnature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm ihat Ihere is a construction lending agency for the pertormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLAHATIONS: I hereby aHirm Ihet under penalty of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions Cotle: Any ciry or counry which requires a permit ro construct, alter, improve, tlamolish, or repair any structure, pnor to its issuance, also requires ihe applicant for such permit to flle a signetl stetement ihat he or she Is licensed pursuant to Ihe provisions of Ihe Contractors License Law (Chapter 9(commencing with Sec�ion 7000) oi Division 3 of the Business antl Prolessions Code) or ihat �e or she is enempt therefrom and the basis for ihe elleqetl exemption. Any violalion o� Section 7031.5 by any epplicent For a pertnit subjects ihe applicant to a civil penalry af not more than five hundred dollars ($500).): ❑ I, as owner ot ihe property, or my employees with wages as their sole campensation, WILL DO THE WORK, and Ihe swcture Is not Intentletl or ottered tar sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to en owner of property who builds or improves thereon, antl who does such work himself or herselt or ihrough his or her own employees, provided ihat such improvements ere nol intended or oHered tor sale. If, howevar, ihe building or improvement is _/ sold within one year of completion, the owner-builder will heve Ihe burden of proving ihat he or she did not build or improve for purpose ot sale.). - �Tas owner of t�e propetly, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTOHS to constmct the prolect (Sec. 7044, Business and Professions �Cotle: The contractors License Law Does not apply to an owner of properry_who builds or Improves Ihereon, antl who conlracts for such project with 0 conirector(s) licenge�pilrsuant to the Contractors �icense Laws.). —� ❑ I am xempP untle sec. • Business and Professions Code tor this reason: Signa�� Owner ID venfied tl ver's license. ❑ Yes ❑ No �jO�''ri�ver's� L�-icense'No. Verification of Ow ersh by (type of dxumenl, i.e. - propetly tax bill or deed):` DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavation tiva (5) or more faet in depth into which e person is requiretl to tlescentl, will be matle in connection with work euthorizad by this permit, and ihat no building structure, scaHolding, falsework, or demolition or dismantling thereot, will be more then thiny-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 71tle B, Celilornia Adminisiretive Cotle). ❑ As owner-6uilder, I will not employ anyone to do work which would require a permit irom ihe Division ot Indusirial Satety, as noted ebove, unless such person has a permit to do such work from ihe division. SignaWre: Dare: Division of Industriel Safety Permi� Number: CERTFICA7E OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cerlily under penalry oF perjury that I have read this application end state that �he information given is correct I agree t with all state laws end ciry ortllnances relating to bulltling consWction, end authorize representatives oi ihe City ot Costa Mesa to enter upon �he ebove-described roparty,tor inspection purpo es. I g e not to occupy or allow occ f-eny�building authonzed 6y Ihis pertnit until tinel inspection. �, (,�.��.� � � �� -D �=� � � ignature0(LegslOwner(s) "— �- Date�_... CO�E 1, INSPECTIONTYPE Q�¢ INTRIALS 1616 Fizetl System Final Fire Prevention 7266 Pool Spa Final 200 Final Fe-Roof 201 Fina181ocWRetaining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition COUE� INSPECPONTYPE 206 Final Mechanical 200 Final Plumbing � 210 Final Electricel 212 Final Fire Prevantion 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency Q�� IMRUL i SucE� ?�u�c¢ca� .DER iN Permit #: A city or county, which is required to give notice pursuant to Section 1983Q shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an ownerv builder verification. Attention Property Owner. An `ownervbuilder' building permit has been applied for in your name and bearing your signature. Please complete and retum this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building pemiit. No buildine oermit will be issued until this verification is received. ( � 1. ) I personally plan to provi the major labor and materials for construction of the proposed , �� property improvement. es ❑ No 2. I(have/have not) II�/� .�- o_ signed an application fot a building permi[ for the proposed work. 3. [ have contracted with H�e following p/er'son (finn) to provide the proposef�construction: Name �(�,o � ( �eo VD/i.6-t�Qd� / Address � � City Phone (��1 33�- 3 �.i-- Contractor's Lic. No. 4. I plan to provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major work: Name Address Phone ( City _ Contractor's Lic. No. 5. 1 will provide some of the work but I have contracted (hired) the following persons ro provide the work indicated: Name Address Phone Type of Work ID02J6 (Rev. 11I04) I hereby affirm that I have received a copy of the information set foRh in Section 19830 of the State of California Health and Safety Code and have completed the above infortnation to the best of my personai knowledge, in compliance with this State law. T'd-� Na e: �� J l� i\% 0. L.l-� fa (Prinred or Typed) C.D.L. #Ai�3."# �� For more information call City of Costa Mesa Building Division at (714) 754-5273. 1042-06 (Rev.11I04) � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suife No Viciniry: Parcel Nunmber: Applicant: Address: Owner: 219 PAULINE PL 42614106 HORNAUER, SYLVIA L 219 PAULINE PL COSTA MESA, CA HORNAUER, SYLVIA L Address 219 PAULINE PL COSTA MESA, CA Contrector: O W N E R-B U I L D E R Address: ISSUE FEE Temp service �est Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fi#s Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ISSUED BY: Phone: 714376-3552 Zip 92627-1842 Phone: Zip: 92627-1842 Phone: Zip: License: 000000 Status: I SS U E D Applied: 03/30/2006 Issued: 03/30/2006 SCOPE OF PERMIT RELOCATION AND CHANGE-OUT OF AN ELECTRICAL METER WITH THE ADDITION OF A SUB PANEL FOR THE GARAGE. 1 SVS TO 200A, 1 SUB PANEL TO 200A NO OTHER WORK AUTHORIZED WITH THIS PERMIT. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway/100ft Standing Sedion Misc Eledrical 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 Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $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 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES 584.50 euro � ener�w� NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectiona and final approval must be obtained. Failure to obtain inspections antl final approval will resul� in ihe expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 �.. ,.�W,�� WORKERS' COMPENSATION DECLARATION: I hereby affirm under pen8�ty oi perjury one of the toilowing declarations: ❑ I have antl will main�ain a certificate of consent to sel4lnsure tor workars' compensetion, as provided tor by section 3700 of Ihe Labor Code, tor Ihe pertormance of ihe work for which �hi5 permit is issuetl. ❑ I have antl will main�ain workers' compensation insurence, as required by section 3700 of the Labor Code, for the peAormance ot ihe work for whic� ihis permit is issued. My workers' compensetion Insuranca carrier and policy number are: Carrier: Policy Number: (This section nee0 not be �omp/eted il fhe permif is valuetl af one hundred dollars ($100) or less.) �� 1 cenity Ihat in iha performance oF Ihe wodc br which thls permit Is issued, I shall not employ any person in any manner so as to become subject to Ihe workers' compensation le aliforr7ie, and agree that it I shoultl become su ect to t�e workers' compensation provisions of Se tion 3700 oi the Labor Co�e, I shall forthwith comply with thes �ahsiadc.l �� 1 / 1 ! 'APPlican�, t9r 9 �rrewie:—... . 1�k�0 �ate. �J 3UC�� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVEP TO CRIMIN PENA TIES ANO CIVIL FINES UP TOIXJE HUNDRED THOUSAND DOLI.ARE ($100,0�),IN ADOITION TOTHE COSTOF CAMPENSATION, DAMAGES AS PROVIDED FOF IN SEGTIQV 3]O60PTHE L4BOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLANATION: I hereby aHirm that I am IiGensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full force and eHecl Lic. k � Class # Contrectoi s Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a constmction lentling agency for the pedormance of �he work for which this permit is issued. (Sec. 3097, Civil Cotle). ' Lender'S Name: Lender'S Address: SignaWre: Date: OWNER•BUILDER DECLARATIONS: I hereby aflirm Ihet under penalty ot perjury �hat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires a pertnit b constmd, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement Ihet he or she is licensetl pursuant to tha provisions oi tha Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the Business and Proteuions Cotle) or ihat he or she is exempi Iherefrom and ihe hasis for ihe alleged exemp�ion. Any viola�ion o� Section 7031.5 by any applicant for a permi� sublects ihe epplicant to a dvil panalty of not more ihan five hundred dollars ($500).): ❑ I, as owner of ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe stmcwre is not imentletl or ofleretl tor sale (Sec. 7044, Business and Professions Code: The Coniractors Licensa Law tloes not apply to an owner of property who builds or improves ihereon, antl who tices such work himsell or herself or ihrough his or her own employees, provitled that such improvements are not imentletl or offered lor sale. If, howeve�, ihe building or improvement is sold within one year of completion, ihe owner-builder will have the burden of proving that he or she tlid not build or improve for purpose ot sale.). �I, as owner of ihe property, am E%CWSIVELV CONTRACTING WITH LiCENSED CONTRACTORS to constmct the projact (Sec. 7044, Business and Pwfessions Code: 7he coniractors License Law tloes not appry to an owner of propeny who builds or improves thereon, antl who conirecls for such project wi�h a contractor(s) license,�utsuant ro tha Contractors License Laws�. � L�� ID verified by drivef's license. Verification of Ownership Dy (�ype of s � No i.e. - propeny taz bill or deed)�. DIVISION OF IN�USTRIAL SAFETV PERMiT CERTIFICATION: for this reason: ❑ I hereby certify ihat no excavation five (5) or more feet in depih into which e person is required to tlescend, will be made in connaction with work authonzed by ihis pertnit, and thai no building simcture, scaflolding, falsework, or demolition or dismantling ihereot, will be more ihan ihirty-si: (36) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Title 8, California Atlministrative Code). ❑ As ownerbuiltler, I will not employ anyone to do work which would require a permit imm the Division of Indushial Safety, as noted above, unless such person has a pertnit to tlo such wtl� �rom ihe division. Signature: Date: Division ot Industrial Safery Permit Number: CERTIFICATE OF COMPL�ANCE AND AllTHORIZA710N OF EMAY: I certity under penally of perjury that I have read this application antl state ihat the information given is wrrect. I agree t�o ly with ell state laws and city ordinences ralating to builtling constmction, and authorize representatives oi ihe Cit ol Costa Mesa to enter upon ihe above-describ �propeA for insRection purposes. I grea not to occupy or a cupancy of any building authorized by Ihis permit until 1' al ins ection. � • -�v i _ 3 ..�u�aG Signature,Of Legal,Owner�s)--•�"'— Dete- And/Or Authorized Applicant Date COOE �. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 203 Final Factory Fire Place Finel Sign 204 Final Demolition OpTE IN RIAL SODE� MSPECTIONflPE 206 Final MeChanical 20B Final Plumbing 210 Final Elecincal 212 Final Fire Pfeventi0n 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy 2aS INTffIALS - .06 �(1� � �� a� L�a�ia ��%da S'uiE� Div.i.�io�t OWNER-BUILDER �'''u� VERIFICATION � �G �� Address: �-f ��i�tX,c�tns�- �� •/ /'E�dA `�� a2 i Permit #: � A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition preceden[ to issuing a building permit, require the completion and require the return of, an owner- builder verification. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No buildin¢ permit will be issued until [his verification is received. l. 1 personally plan to provide the major ]abor and matenals for construction of the proposed property improvement. � Yes ❑ No 2. I(have/have not) signed an application for a building permit for the proposed work. � I have contracted wi[h [he following person (finn) ro provide the proposed conswction: Name �GI,U� � I�i I,U� �n.2,Y" Address Z/ Phone ( �'�� A�Q . City Ci� ��_ Contractor's Lic. No. C� n� t�� .S ��{� 4. 1 plan to provide portions of the work, but I have hired the following person ro coordinate, supervise and provide the major work: Name Name to42-a6 (Rev.tVOa) Address Phone ( City — Contractor's Lic. No. 1 will provide some of the work bu[ I have conhacted (hired) the following persons to provide the work indicated: Address Phone Type of Work �� I hereby affinn that I have received a copy of the informa[ion set forth in Section 19830 of the State of Califomia Health and Safety Code and have completed the above infonnation to the best of my personal knowledge, in compliance with this State law. Signed: �•' fV V �/`/LU.�nA�— Name: > �6 � li I G� � � � (��-Y `�� ,:. E_(Z� (Pnnted or Typed) C.D.L. . # _ �� (� � Date: � �% � For more information call City of Costa Mesa Building Division at (714) 754-5273. 1042-06 (Rev. HIOd) OWNER EX'1' JOB ADDRESS AP No.11n-1_ lT"'pECTIONS S coat OCCUPANCY 'ORM PIIG.5M � LOT Lot � DATE 12-5-61 :(LOt B� BOILDING PERMIT NO. 15�9 atry Homes vALUE � 9_ 9 0.00 TRACT FIRP ZONE D�SCRIPTION OI' WORK ReS.w d Signature DATE GROUPI & J TYPE V 7.ON� R-1 /2�10^fi/ PER\4ITS ISSU . . . _ . . SUBCONTRAC'1'02 ,...,..�, � _.... _. '-��f/�� FJ .gar. I� Pe� � �5�3:�'�:� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BO% 91'1 C09TA MEBA. CALIFORNIA For.� /Applitanf to Fill In Com 1ee��{�pp1�y7/� Z�(� i` L� \ T�'PE OR PRINTp�I� y�.W� BUILOING ��-� �.S !�ov�'N tlFi� E: c t. �-�'�. 1_Y= � � A STG.TNO. J'C' L! C' (G.7 TEL. � . I. ' l NO. 81ZE^T �, � � � r � ��INO.OPuBtDOe.�� ..e � v n i�1 X nfl.(..R �,.. � BETBALK LINB FROM DESCItIPT10N OF WORK 9 ZE DING � S x;-;E��k jROOMS " 6TORIES / EXTERIOR WALL IROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED 5i'��4.� C= F} ��t. tt�� t.�.c� f�j � 1 HEREBY ACNNOWLPF�B THAT 1 HAVE RHAD THIB APPLIGTION •N� BT�T¢ THAT TH6 �BOVE I6 COHR ANO AOREE TO COM- PLV WITH ALL CITY O��NANCHB ANP �Te LAw9 R¢6ULATINO BUILDINO CONBTtUGY�ON. � IAUTHORRED _ FEE RECEIVED NOV 271961 � FINANCE DEPT. CITY OF COSTA MESA % APPLICATION FOR PERMIT Ii-r BUILDING For Office Use Only HECEIPT NO, /PC ��NO� 7 NHC6IVED BY DATH RECEIVED /DwT¢ 195y¢D J��-%" ��/�'E/ I /��.5'/r BUILDING // ADORE65 ��9 � Q-LLeL7LFJ COSTA MESA. CALIFORNIA FIRE / �� fflNF /� TVPF l�Rfl11C � �ean� ZONING I PLANS z I U6E OF NEW�� y� BUILDING � ��- T �'t -Po,� ts3 �f/'�Cf'lFTf T7P ��Q ��b YAR�S EVES APPROVED (CENTEP L�N¢ 8T.1 FRONT � � � s� R. SIDE ./. F L.SIDE /�L� wcaw / . '� c 3 sfi �� y r/ � iH. �/ v7�� _lo � pCd p�r. 1 ,310 p� aY, iJ� v , TXE AMOUNT 9HOWN UNDER VALUATION IB FOP THE PUPP08E OP EBTABLI9HING A PEqMIT FEE ONLY. VALUATION ,/ PERMIT FEE $ � 7`I � �'C $ ) ��U PLAN CHECK S � L •