HomeMy WebLinkAbout2921 PEMBA DR - Building PermitsA�Pliwnt !o till In all ipaeas axeapt t�ou Wit�in
CITY OF COSTA MESA ' pERM� NO. �_ �. , TRACT
CONSTRUCTIONPERMIT '�
ApplicanYs Meilin8 Addreu f ��
Projec2 Address -s � �'' r ' G �
� Owner'sName -�- ��K�t-%��, p�4'�NARit:lpFone$49-177,7
A'ddress � .5A `n t � � .
i� Arch/Eng.. . S 4 tr � Licente, No., .
Address � � � .
Contractor's Nam hone
Address (msiling) . , ,
License No. �
LICENSED CONTNAGTOH DECLARATION
1 heraby.affirm that I am Ilcensetl untler provislons o1 Charter 9(commencing
with sectlon 7000) of Dlvlsion 3 of t�e Business antl ProfeSSlonz Cotle, an0
my Ilcense Is In full force an0 effect.
Licenie Class Lltanse No.
�ate Si9natura , .
, ), n.ORKERS' COMVENSATION DECLARATION ,
%:�-sreby afflrm that I have a certlfiwla o/ ConSenLto zelf-insure oi a certificate '
y'M-'-Workers' Compen5ation Insurance, or a carUfleO,coDY Ihereol (Sectlon
3800, Lab. C.) ' .
' Policy No. Company �
BCertHietl copy 6 �ereby fumisheC. � - ,
Cer[IfieC copy Is flleC with the CIty.Bulltling Dlvizlan.
Date AOP��cant �
EXEMPTION FROM WORKERS'COMPENSATION OECLARATION
(This saction nBeE not EB tompletetl it Ihe Dermit Is for one huntlretl (§700) or
less).
I certity �that In the perforTdnca O( thB wOrk tOr whic� [hli perm�t I5 ISSuetl I
shall not employ any Oerson in any manner so �as to bacoma subject. to f�le ;
� Workers' CompenSatlon�Laws ot Calitornla. , ,
Date � ' S19�ature �
NOTICE: It, atter making�thli tleclatatlon, you shoultl become subject to the '
Workers' Compensation provlsions ot [he Labor Cotle, you must forthwith
� comply with such .Orovl5ion5'.or this permlt shall be tleemeG revoketl.,
;CONSTRUCTION IENDING AGENCV' � " '
� 1 neretiy aftirm that thara I5 a conitructlomlen0ing agency !or the per(ormance .
I of the work for. whlch � thls permit is Issuetl (Sectlon 3097 CIv. C.J
� Lentlerh Name � - � - �
, Lentler's Atltlress' ` � �
Licanse Law for the
tl Cotle: Anv tltv or
5 by �any applicant for•;a permlt subjects tM1a appllcant to a dvll
y of not more than flve huntlretl tlollars ($500). , - �
as�owner of�tha Droperty ov my employees with wa9e5 as thelr sole
�nsation. will ao t�e work. antl t�e structure is not IntenGeO or o(feretl .
EorAar Ilnas anE slgn all ap0�oorlate aeclarotions.
. LOT,NO. B . . '
5 �
TYPE OF CONSTHUCTION LI NEW :'� %�DD ALTERATION ' REPAIR '.
❑ CONVERSION ❑ DEMOLISN ❑ OT�y(I�ER'
� DESCRIPTION-OF WORK ���^---"Ci �'� Ca��
�
TVPEOFPERMIT. GRADING FOUNDATION STRUCTURAL
, ❑�TENANT, ❑ ELECTRICAL ❑ PLUMBIN ❑�MECHANICAL
'O,UTHER - (�)-y�JLfV �YGC.�✓�Q.t1.G� �-
PRQIECT DESCRIPTION Sq. F� OCCUPANCv—
CONSTpp UCTIONTVPE VALUATION$ OCO.
20N� ^ � GRAOING CU. VDS. ' �ACRF� �
Ramarks: � A%nn. Hn�i ii ��o .S ri.� �.��o
Sink
cflow Preventer
<flow Irrigation
Floor DrainS
Floor Sinks �
I
. Lavatories ' �
. , P-Trap r - . , .
� Roof Drai - �
-' J�
. Sho � rs � � � �' ' '
Service Sink � ' �
, License Law tloes not apply to an bwner oi a D�operty wno builtls or improves • � g0ile�' � '' �
ihereon, antl who Eoes'such work him5elf/herself or Nroug h his or �er own � -� '
: employ ees, provitlatl that such �improvaments are not Intentletl or offerea for Duct-�Under,Ground '
. sale. If, however, the bulltling or improvement is [oltl within one year of <om- ' �
E pletion, the ownar'will hava the burtlen of proving ne/she tlitl not Dulltl or im- : + Duct - St�uctural -
�rove for the purpose of sale). . �
I, as owner ot the property, am exclusively contractln9�with�licensetl con- � �
' tractorsto construct tha project (Section 7044, Buslness antl ROTessions COCe: Duct _Ventilating �
The Contractor•s Cicense Law does not appty to an owner of property who - �
� builtls or impraves theraon, antl who cantracts for such projects wltb a con- c Ezhaust System ❑ Multiple �
. tractor(s) Ilcanse pursuant to the Contractor's License L.aw). . , � �
❑ I am axempt unGer Sactlon B. & P. C. for this rea5on Fir2p1/FaCt. Blt. ICBO � �
'� Data , Owner � � % � � . Heating Syst2m & DucTing /
� I hereby certi(y thabl,hava rea0'this applicailon antl state'that the above I ;❑6100,OOOBTU�]J10;G008-
information is co�ract. 1 agFee Ao comply with all city'antl county ortlinances � -
- �^ «_�^ ••••- •^ • ^^ •^ •• � ^^ ^^ • ^ tl 'antl �ereG thorize re re-
Drivers' Licenu or 55 � .
; ' Registers �
Canary - Appliwnt; Pink - Attounting; Goltlenrotl - Assessor
Sewer Cap . .
Sewer Cannection " -
So�ar Collectors
Solar Piping '
Solar Tank
Swimming P w/Spa '
Urinal
W r CIouU
ater Heater - '
Watei Service �
. �
. Reinspection'Fee
. laue Fee � , '
IANICAL
Refrigerotion System '
❑0.100,OOOBTU ❑t00,000BTU
System Repair/Alteration
� , :
1
'. Reinspection Fae'
, � laue Fee � '
A.P.qW ��-acv.�—.c
PLNG. REF. aW � .
LEFTSIDEVARD �'
PKG.SPACE REQ. —
STREET WIDTH .
SPECIALCONDITIONS: �
Automatic Washer
Construction Pole
Cooking Unit
.A.U.
ixtures
evice Boxes ' h
Generator � d-5 KW 05-75 KW
Transf er �15-50KW
❑ 5U + KW
$15
Meter ❑uptot00amps
$ 3 Zoning APProwd By
Appliption Approved By �
$15
$ 3
. �3�4 '_ a'/ 1 4/03 :,. aGo.l2
.. . . - , - , . �
ar_ oor_�u nr�nrac � , .
REAR VARD (TO P/U � ��'
RIGHTSIDE VARD �a' �
PROV�DED �
PARK FEE $ '
Meter LJover 100 amps
Sub Panel
Sub Pole ,
Motors �0-1 HP ❑1K-8
Inc.Solar 09-15 HP -15+
Microwave
Pole Li
nge _ _
Trash Compactor i
� �
�
, ReinspecTion Fee � ' $75 ,
APPliration Issued BY � �� : - � Data �/ �� ��
. . �' -S7UMcyMA�RV OF FEES ' � �
BUILDING PERMIT $ �sc , SMIP � ' $ � � 'S�
PLAN CHECK� $� a • � PERMIT ; � �
PLUMBING � $ � � ISSUANCE : ' $
PLAN CHECK , $ ; GRADING ; $ � '
ELECTRICAL, . $. ' � � � � � $ '
�PLAN CHECK $- � MICROFILM � $ .� �
MECHANICAL $, � ' � � TOTAL FEE� $ � �
'PLAN CHECK� ' $' ' ; LESS � ' �
� ' . � . ADVANCED PC $ � r•
. . ' _ FINAL FEE � � $ � a �• /a
r X . ..�,
- ---- -------- -- - '`-
: ��CONSTRUCTION AND�PL - NING, ' _ -� � "� •� : � •. - : - � �. r,_ =POOI :PA _ . �
`Date ^ Inspector - ' `- - �' - Date Inspector
> :;APPROVALS �. Permit�# . - ,` 'APPROVACS � _ •Permit# ' _ .
. .�. .
� 1� Temporary Electrica�l Service or Pole � " � ' =t . l .�52= Pool &'Eguipment Location � � .
F 2y Soil Pipe-Undrgrnd:- - �� � t s i�-- �;53;" Steel Reinfo�cement � - .� F,
� � 3! Electrical�Conduit Utiliiv-Undrgr�d � ' ��, - � � 54�a Forms; �� ` �- . � - � - - �
�' n Electrical Conduit-Undrgrnd'. � .' _ � - , . 55` ElectricabBonding'�.- . ' ' _ � . � ,
5: Steel,Reinforcement � ' ;; ',; � `- ' ' ' ';56. Rough'.Plumbing & Pressure Test " " ' �
i �
6. �Electrical UFER Gmd. � � . : , � � � 57'' APPROVAL TO�COVER-GUNITE � �
i � v
7. Footings � ' , � '� o-,' , , . _ ;, � � ; 58. Electrical �riduit=Undramd:_ "�. � ' � � -
6. Foundation 1 ' , � ' _� - " � - . • 59. Gas Pipe,'O: Undrgrnd ; Test `� - �
- �
9. Water� Pipe-Undrgrnd. , _ � - � ' ` 60. Backwash� Linee, _P-Trap, O Undrgind. � � �
10. Sfructural Floor System � - ; , � ' _ � 61. APPROVAL:TO_D�ECK . � .
11. Property SeweF Line &'House Connection - ,, 62. Backwash'&.`-Receptor-Final ''
12. Sewer Cap , ' � � ' ' � - 63. ,Heater &.Vent-Final � � - � �"
i . - � .
13. Roof��Drains � , � ; . � ' ' , ,�64. Plumbing`System•.rFinal � _ _ , � �
14. Rough'Flumbing' . . - � "65. Electrical-Final� '-' '
�-
= , 15: Rough Electrical-Conduit' ��� � �;-"" - '"""',- " i""�" .-- ' �' - �
' T �' � � , 66.j Solar System-Final .",
'�16. :Rough Elect�ic Wiring- , � . � i� ��--�� � � � -. ' `�"6Z.. Fencing &�Access Approval . - � ` �-
��:r� �,
- �� 17� Rough:Wiring Sign;' �: �� ' �� , � `' - .>. 68. APP.ROVED FOR PLASTERING ' � -
-� 18. Rough Electrical;,T;Bar.Ceiling, � , � 69. POOL/SPA SYSTEMS FINAL � .
19.�Rough Heating & Air Conditioning � , ,-, I' FIRE DEPT. REQUIREMENT- '
20! Rough' Factory Fireplace ' .� �' � � � � QPPROVALS ' Permit # � �
i �
��� 21. Ducts, in Structure; � „ � � � 70._' Undeiground Hydro � �
�';22 Ducfs,,Ventilatin � � � � � ' � � � �
9. � '� � � 71. ProductPiping�Gas ❑Oil
;;23. Gas Pipe-Rough &Test _,' ^ '� � � � I 72.� UfldBfjfOUO(I FIUSYI �
, � 24. Roof Fiaming� �, � � � ' I, '� ,� � � , � �. •- � : � -- � � 73.� Undergrnd.StorageTank 0 Gas �OOiI
� 25. Roof Sheathing : . ' ' ��' , - - � '" � ' �` ' 74.' Overhead Hydro � �
� =-26. T-8ar Ceiling (St�uctural), & Monocoat � .. � � � � 75.- Dry Chemical � � ' � . , ,
r
^ �•27. Frame and Flashing � ' �� � ' � , . � , 76.� D'ry Standpipe . -
' y�28. ;Lathing & Siding' ;� � � � , '� � f•� � _ i ' 77. FIXED SYSTEM"FINAL '
p i,i 29. `Insulation _ ` � i -' � � � �� � • , � ! � � �78.j PIRE PREV. FINAL ' . . � ~
., ,
a 30. �Dr'ywall Nailing ' � �� ' ' � � ' � � � '
r ,
I� � '. � � i I t� n , � 1 � � �Notes:' i ,
� � ' . !
., ,,. , , � . �i � � - - - ; � t f -; ..- - - ---
° 31. Plaster Brown Coat'•� •� � �� . � , � � � � � . � . � . � ' �
,
� �32.'Electrical�PowerMeter,Final � i� :� ' ' � i . ' � � � i � � ' - ' � � �
; ,i 33. Final Electric � ' ' ; � � � } ' j I � � ' , i �
1. _1.
34. Final Heating &�Air, Conditioriing � � ' �� � �� � ' ' �
, i In._
35. Final GasPipe=Test� � . , . ' � ' ' ! �' . � � � ° _ . . �
! i � i
� � i - � . . � • , - i , i � i : . , � , . .
36. Hood or Canopy , '� 4 � ' , -,. ,
.� i � ti� ol
37. Final Fac[ory Fireplace`• ' � , �' � � . � n I � � i � � �� j -� - . � � '
,,
38. Final Plumbi,ng � ' i � . . j.� � � ' � � i i ' ; _ . .
39. WaterSer'vice-Final � ' �� ' � � � _ � � ' , t � . � . � <
' i
40. Gas Service-Final ' � � , . , ' ' � : , � _ � ,
41. Solar pomesticFinal � , ' � , . j ' � � _ _ _._ _ �� '
r- .. -' - - . .
42. Backflow�,Preventer� , ' � - �- �-----�--- -'- , + i�_ .
43. Backflow�lrrigation� ' � ' � ; � - ' � . ; � � � '
� � �;.. �' , - � - -, � -
44. Landscape I�rigation:System . � � , ' � i - � � • � ` .
45. Sound��Attenuation , ,,, ' � � ' . , _ , � . , . , . � � � �
46. Handicap�Regulation's', � � � _ i ' ' • �� � . , . '
47.�FINALSTRUCTURE&BUILDING �� /3 ,S , ' � � '
48. Special Requirements Completed� � ��� f'� 1 � , ! ' ; I �' , . .
49. Electric R,elease�to Edison' � I ' - -�-_'--'- .- -'---�- '- .--.- - - . '
50. Gas Release to�Soufhern California GasCo t � � i � , ' i ' '� �� � � �
51. CERTIFICATE OF,OCCUPANCY �' I . � '___i_ � _ �_�. _ . .
No. A �f � � Date � � � ! r ' � � �
:� . .
�
�
. �
. �....,, _._,. , z. . ' -`^ . ----- � - -- -�� --'---- - " ' �
1
CITY OF COSTA MESA J
BUILDING DIVISION �
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent 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 si9nature.
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 building permit will be
issued until this verification is received.
1. I personally plan to provide the malor labor and materials for construction of the proposed
property improvement. .�Yes ❑ No
2. I rhave/I�[) signed an application for a building permit for [he
proposed work.
3. I have contracted with the following person (firm) to � roposed construction:
Name
Address
Phone (
Contractor's Lic. No
4. I plan to provide portions of ihe work, but I have hi
supervise and provide the major work: /
Name
Address
City
owing person to coordinate,
City
x ..
Phone ( 1� Contractor's Lic. No
5 I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated: '
Name
Address
Phone Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 79830 of the
State of California Health and Safety Code and have completed the above information to the best of my
personal knowledge, in compliance with this State law.
Signed: �/'/�/� (��e��� Date: � `�
l� �
Name: i�,NRRL C�TTE �—YKG
_ (Printed or Type
C.D.L. #or s.s. # �
CMF 3092-46
754-5273
1
Mr. Robert
Clty ii�t11.
Costa ��esa,
Uear_ : Sir:
1�_YI
Un;or, City h;anager
Californ:la
JOn�Car�AJei� 14� 19��2
Pur�uant to oar recent conversation and �cting upon �our_
z�3vico� wo tne unc?ersi�ne<I� are suU�ittin% 'G'.ii� letter ta you
for nreseni;ation to tl�c cSty co�ur_cil, r��;arcllnL a drain��;o
�roblea cau5ed by i;ho existi:;u gradin� casulit�.on of the dpvelop-
IIont o.f a tract d.irectly Uehind our propQrty.
`Iou liwv4 adv2ss3 u� by phor_e that tdr. Gay�ncr� the doveloper
of tl�:at tracL� r<+co!;nis,os 'tY�e existing cir�9.su;�•e proble� but,
cl��.�:s that ihr� cosc ot building �z ratsinl�.=; zr��:.[I uron tzis trict
davo2o�:ment 1Joezi.d Ue prohibitiva. �o Yu�� graciously;offored to
eliminate Che clrainaf;e prc�ble� by aonstructii�g a z•etaining wall
upon our oaistiri�; Ulocic Vial1,
You havo also advlsed us tl�t 1�'s. Gayru:r r�u�i have our
�xuthori�ation in orrler to build u�,vn our prapc:rLy. LJa aro �ost
hapoy to s�tve :s. �:�a;nie�• our auti:orization Lo �;rucead if the
Yollolring corulitior.s ure u�oti
7.. Tl.at the reta3nin� waZZ �aill be preperly en,inereed
accordin; to tho city co:io. '
2, Tha.t our pre�ent �aa?2 �:�ill nov ae subject to auch
stress anu straYn bg th3s acidition Cand �ossibio
acldecl fill) ti�at will causo 3� da.:,.��'ca.
3. Tt�,�t L.".� cost of perr�itsy cnns�ructinn� :�:xd li,-
'h111.ty of i!7:Lti addition �r;L11 be borne l�y ,�Sr. Gn;�mcr.
'iaercaStor, not;?3nQ 1s t� t>e cs�nstrucd ::o a�x to g2ve
licen�e� or rights to our la:-rful propert;�.
tle feel t_h�t I�r. Gayner wi12 orYtv�ncc ilzo v;alue of tLt� pro�:-
erty and sho�.tld eliminate i:Yie existin�; druir�;e proble�:, and
thzt he is �roporly tryin�; to pratect ua. �'or tiii� we titisti t�
c�,nvey our ti•iac�:s to 2•:r. G�.yner and to yoci, F;r. Un�er for �:ki.r_g
the n�cessary arranso�:ents. ,� � �
Y$i'.T:l.Ci: e V�..G"�290t1
2915 peniba J)r2ve, Costa iiesa
�1 �v�rv truiy yours, �� � ��
�
ilo:^er U. L;�;;e
2921 F'omba UrivQ� Cost4 24esa
lta�emary Jrscoiison, 2925 c'oiuba Dr. � i:o;;ta N:esa
i�c�
�
029�� ��,�,e�- kL�., C�. %l�, � �.��_
, �
-
- Gv� � - �.Qn�c�c��-. Q`- - �e �� -�2.�-C'-C.,l_ .��^-��'"` "`y`� - .
- - - �— - = - - - - - ---- - -- - o l -
_��� � - - �cv�� _
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--- — - �_� - �,�-�.�.z., _� - --- =—
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�%<<vt-._ ��w�— Lc1a/ ---GC.���ti�� - �' - — --
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� _ _�-,.e� .�=�-�_�:.� ___�..e��..,,�.�,-_� : -_.
-_ .��- �� ��.-��- ��G�-�..-.-�� - �
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^-a�-�-�- �� _-� -Q�-� �-��-.����
- - - - - - - - - -- - - - - - - - � `l -���c- 01
S�
--- - - -� - -_ _ - - ,
— --1.:�.-- - �—FJ�-L � - - ;_ _�6' G�✓��-e-�'-� U�-�= -���- i- 7r✓� �t'`^'�'- _
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`-�-� �°`�i �_ � .�,�� � �. ��-�-�,.��-�-
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_____ _ __ __ ____. __ _ _ _ _ __ ___ __.
-- U�` — rs�=`=`'fi --��,,..�—.c�----5,-�..-�..�.- - -X� rr�- -
- - � — ---- --
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_.
CITY DF COSTA MESA
CALJFORNIA 92826 P.O. BOX 1200
FfiOM THE OFFICE OF THE CITY ATTORNEV
March 29, 1979
Mrs. Charlotte Lyke
2921 Pemba Drive
Costa Mesa, California 92626
Re: BOUNDARY DISPUTE at 2921 Pemba Drive
(other party: Robert A. Eastman)
Dear Mrs. Lyke:
In response to your recent letter of March 11, 1979 to our City Council I must
apologize for our office's failure to follow through on your visit in January.
At that time our Deputy City Attorney did fully and fairly explain to you that
your dispute over the proper location of your backyard fence line was a"private
property-line dispute" and did not involve the City of Costa Mesa or our office.
However, you were told we would check into it some more. We did, but failed to
get back to you with the results of our inquiry.
That inquiry reveals that our Building Department officials may have examined
the fences for their structural requirements. Our City Engineer, in signing
off on any Subdivision Tract Maps merely is certifying that those maps meet
certain legal requirements.
None of the above actions of Costa Mesa City officials can legally establish
the true boundary line itself though their testimony and evidence may help
one or the other of the disputants to establish same.
Our office has copies of the several letters involved in your dispute with
the adjoining backyard owner (Eastman). Again, in reviewing these I must con-
cur with my Deputy that "the problem" of whose fence is whose or vhere the
exact property line is located is a civil matter between the adjoinir.g property
owners. If it can't be settled amicably between yourselves then a court de-
cision would be required. By copy to your neighbor and our city officials I
am apprising them of our position. I trust you can resolve your problem amicably.
Our office will take no further action.
Thanking you for your anticipated attention and cooperation.
RRC : l�b
cc: City Council
City Manager
City Clerk
Very truly yours,
- . R. Campagna
City Attomey
�Director of Public Services
D: 'actor of Building Safety
Robert A. Eastman
77 FAIR DRIVE (714� 7545399
DATE
JOB ADDAESS
AP. No. LOT 175 T1it1CT�52qI_ FIBE ZONE DESCRIPTION OF WORK res. w/att.
INSPECTIONS � DATE GROUP �J TYPE V ZONE R1
Underground So' .�G'pU.G. Water f Ui1 � I PERMITS ISSUED
�I�. _ I SUBCONTRACTOR
� �
��J�iR_
OCCUPANCY
Form 210—SM-11�59 S-B P
Lot 17S - Tract 3529
� ��- 1221�
CGSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOY 817 C08TA tdHBA. GALIFORNIA
For Applleanf fo Fill In Complefely
TYPE OR PRINT .
N
COSTA MESA CALIFORNIA
K.W. Koll
1555•.:Placentia Avenee
SIZE NO. OP G1D09.
-- -- o � ..� nn - -- — -
86TBACK LIN6 PNON
CaNTER ov eixeai � REAR YARD �
SIDE YARD I LHF'� 10 � I RIGHT 7� �
DESCRIPTION OF WORK
.,�.., � x U e,.�e.r,..., � �� .,,.,,�,,,., �
SZEDING ���FOSF ROOMS • STORIE6 1
PJ[TBRIOR WALL I ROOF W�OD SH I NlaLES
COVHRING tL3C COVERING
U8H OF BUILOIN6 AND WORK TO BE PERFORMED
Sin ]e -Famil Residence and
Attached Garage p�nN 2�1B
i Heaeer AGKNOW�3GG8 n,�r � Xwve as�c n�ie ,wuGnoH
ANO BTATC THAT TH8 A00V8 IB CAqNECT AND A6RE6 TO COM-
PlY WITM ALL C17Y ORDINANCEB AND 8TAT8 LAW9 R[ODUTNO
BUILDINO CONBTiUGTON.
81GNATURB OP
PERMITI'8 '
AUTHORIZED AGH "
' � ��E R�����EU
�NPN E OEPMESA
�F COSZP
APPLICAT�� FOR PERMIT
BUILDING
For Offite Use Only
RBCHIPT NO. P�I.�yj ji
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�� I�r
RECEIVED CY � � OATB NHCH�VBD I OATE 188U01
COSTA MESA. CALIFORNIA•
APPROVED
ZONING
ZONE NO. OR UBE OP !
D�l PLANB /] BLIILOING
{\ G
EBCRIPlION LOt l l !j �aC
n. P. No. nnne
YAR�S EVES
APPROVED ALLOWEC
�e¢r+ren uxi er.�
APPROVED
TXC AMOUM BHOWN UNDBfl V�LUATION 19 pOH TH8
PUI�OBE OP 86TABL19HING A PCqMIT FHE ONLY.
VALUATION
(j p- PERMIT FEE $ �
S ` �/, v / � PLAN CHECK $ � (
�'P:7:f�1.
AP No. 139-`c
INSPECTIONS
OCCUPANCY
0
Mr. & Mrs�: Homer
21 Pemba Dr:
Ac'j'oR F & J Gerwick
LOT TRACT
I Signature
RIRI� ZONE
AATR I GROUP:
IT NO.
vnLUE $1 9; 7�
D�SCRIPTION OF WORK
TYPE V 7.ONE
SULiWNTRACTOR
�
• - 17700
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f] C08TA MHBA. CALIFORNIA
For Applican+ fo Fill In Complefely
TYPE OR PRINT
BUILDING �p r A Q(
ADDRESS / �- /�
COSTA MESA CALIFORNIA
� SIZE
� SeT9ACK LIN¢ FFOM
TEL. I'C ��
C� I ��...OP BIDG9.
� I LEFf / J / I RIGHT J�/
DESCRIPiION OF WORK
BUIL�ING
SIZE
E%TERIOR WALL
ROOF
COVE
K TO
STOR
FEE RE�F l��
APPLICAT�A� P�gQITt
���sia Me�+
For Office Use Only
RECEIPT NO. I PF��(�.
� � UU
HECEIVED pY ATE RECEIVED �ATE IBSUED
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DRE55 a 9 a i���-�L�-�- �v
CASTA MESA. CALIFORNIA
FIRE
ZONING
NO. OF UBE OF NEW
PLANB BUILDING .
L6GAL
YARDS
APPROVED
lCEM6R LINH BTJ
� �.S
EVES
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� ,_ �, _ _ s' /N Ex , .6 �OG, `
1 HEPHBY ACKNOWLH�6H THAT 1 HAV6 PHAD TXIB APPLIGTION THQ AMOUNT 6MOWN UNDER VALIIATION IB FOR THE
AND BTATE TXAT TX6 ABOVB �S CORPECT AND AGREE TO COM- pURPOBE OF 88T�0L18HING • PERMIT FEE ONLY.
PLY WITH ALL CITY OPDINANC68 ANO BTATH lAWB REGULATIN6
BUILD�NO CON9TIiUR10N. VALUATION
SIGNATURE OF ` $'/n �`�/�� PLANiCHEGK $ /'O�
PERMITTE
AUTHORIZED AGENT V/ �'J
TOTAL FEE $ /J'SG
- - � ����
CO2TA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX S77 C09TA MEBA. CALIFORNIA
For Applicanf io Fill In Compleiely
TYPE OR PRINT
BUILDING �.,i� ��75 " /Y7.7- y1.1(�
nnocca
� ARCHITEGT
U6E OF
EXIS7ING BL�G.
6ET0�GN LINB FROM
TEL.
OF BLDpB.
DESCRIPTION OF WORK
BUILDING
SIZE
EXTERIOR WALL
COVERING
USE OF BUILDIN
OF
WORK TO BE PERFORMED
G' ' \
��� ��,�� (� � �:','�
� JqN 1619Si
�I�qP!CE DEP7.
C1iy OF COSTA M�.�A
APPLICATION FOR PERMIT
BUILDIMG
For Office Use Only
RECEIPT NO. PCNMIT NO. .
.. /
(i / �
BUILDING �)
ADDREB6 0��
COSTA MESA. CALIFORNIA
ZON6�
L6GAL
�LI: / �DATE ���J� .�
(ZONING
NO. OF I t16E OF NEY✓
PL�NB % BUILOING � Q� � A,
YARDS
APPROVED
fCENTHR LINE 8TJ
FRONT
R. SIDE �
�/L��.l i �
� /' • ' _
1 H6REBY ACKNOWL6008 TNAT 1 HAVE RBAD TXIB APPLIUTION }H5 AMOUNT $HOWN IINUER VALUATION IB FOp THE
�ND BTATE THAT THE APOVC IB CORR¢Ci MND �GPEE TO COM-
PURPOB! OP EBTABLIBHING q PERMIT FEE ONLY.
PLY WITH ALL CITY ORD�NANCE9 AND BTATH LAWB H86llUTINO
Bu1LDINo CONBTRUCT1oN. VALUATION j �
SIGNATURE OF � ��y PERMIT FEE $OC �
PERMITTE
S�/n� PLAN CHECK S �
AUTHORIZED AGENT 'v U
TOTAL FEE
O