HomeMy WebLinkAbout834 PINE PL - Building Permits�I
�
�
PNOJECT AOOflE55: 8 j t� P I NE PL
�70W:�.P'S NANE: HOOD SIDNEY LEE '
. aooefss: 834 ¢INE PL
COSTA MESA,CA 92626
AHCH/ENGINEEfl:
p00qE5S:
flEG.NO.:
UNIT:
UNIT:
PEflMITTEE: SIDNEY HOOD ( 714 ) 645-1399
noowess: 834 PINE PL
C.M. CA 92626
LICENSED CONTNRCTOB OECIAflAT10N: I he�e0y allirm I�al I am IiCen5e0 unCer D�a��sions ot C�ap�er 9(commencing wiih $eclion
7000) o� O�msion J ol ��e Business aM Piolessions Coae. anG my license is in full brte and effec�.
LITY LIC.: ST�TE LIC.: ClASS:
Da�e: Signamre: �
WOPKEBS' COMPENSRiION oECIABRiION: I hereby atfirm �hat I nare a cenifica�e of consent m sell-insure or a certifiwte of workers
Compensauon Insurance. or a cerUli¢0 copy inertol (Section 3800. Lab. CI.
POLICY NO.: E%P. OPTE;
COMPFNY:
�] Ceni7ie0 topy is hereGy 1wM5hed. � Cenilied wpy is lile0 vnth I�e ciry Btiildnp Div'ision.
�aie: ApDlicanC
E%EMPTION FROM WOXI(EBS' COMPENSATION �ECIAflPTION: (TAis setlion nee� noI be completeG il Ihe Dermil is lor one hundreA (5100) or less�.
I ceNfy Inal in ine perbrmance ol Ine work lo� which Ihis oermit is isspe�. I shall not employ any Oerson in any manner so as lo betome
su�lec� lo IAe Workers' CoAmpensation Laws al Calilomia. /J� �����
�aie: z3 uLV 7 Z Signature: �py�"�"�J
NOTICE: If, aller making Ihis Oeclaration, you shoWE Oecome suyjecl �o �he 1^/arkers' Compensalion Oio�sions of t�e La6or
Code. you must forthwilh comply with suc� pmvisions or lhis PCrmit shall 6e Oeemetl revokeA.
CONSTPUCTION LENUING RGENCY: I her¢by allirm I�al Ih¢re is a COnSimttion lending aAenty br Ihe pedOrmante of Ihe work for
which Ihis permit is issue0 �Section 3097. Civ. C�.
LENDEH:
nooeess: CONVERT EXIST PLOMB ACCES
ROOM INTO LAUNDRY ROOM
OWNEP BUILOEP OECLAflPTION: I �ere�y a�firm Iha� I am exemp� Irom Ihe Conlraciors' SIaIe License Law for Ihe lollowinp reason
(Section 7031.5 Business antl Pmlessional Code: Any city ol tounty Wpich requires a permit to conslNct, al�er, impmve, tlemolish, or
reoair any simtture. prior lo ils issuance. also reouires ihe apvlicant for such permil to lile a siqnea slalement ihat helsne is licensed
pursuam lo Ihe pmvisions ol ihe Comracmrs' Sta�e License Law (Chap@� 9(�ommencinq wilh Seclion 7000� ol �ivision 3 of ihe Business
and Prolessions Cotle) orihal he/s�e is eaemD� Iherelrom ana t0e Uasis lor ihe allegeU exemption. Any violation ol Section 7N1.5 hy
any aDDlicani lor a permi� Subleci5 Ihe applican� Io a civil penaliy ol nol more IAan live huntlretl tlollars (E500�.
,y, I, as owner al �he Oropehy ar my employees wi�h wages as their Sole compensation, will do the wark, and the
CJ simcture is not imen0e0 or ofleretl for sale 15ection 70aa, Business antl Pmlessional COUe: The Contracmrs' Stale License Law
tloes nol aDPly lo an owner ol a pm0eny w�o Uuiltls or improv¢s thereon, anC w�o does suc� work himself/herself or thmugh
�is or ner own employees. D�oviOea ��at SucA improvemenis a�e not intentleG or ofiered lor sale. If, Iwwever ihe �uilAing or
impmvemenl is 5014 wilhm one y¢ar oi Compleii0n, ��e Owner will Aave the buraen ol provinA �e/She Citl noi �uild or imDmve
. for ��e purpose ol sale�.
I, as owner ot the Ompetly. am exclusively coniracting wii� licpnsetl contracmrs to constmct the pmlect (Section 704a, Business
❑ antl Pmlessions Cotle: The Contractors' Stale License Law EOCs no� apPly to an owner o� pmperl9 who �uilOs ar improves iherean
ana who COnVacis lor Sut� O�ole��s wiih a wniratlor�s) liteqse OurSuani IO Ihe Can(ratlor5' Siale LicenSe law�. I am aware
that pwof ol their Worker'S COmpenSalion insuranre s�outtl he DmviGeA to me.
� I am evemp� untler Section: 8. b P. L.
for I�is reason: G]-7� � �
�a�e:�7 �"'mv�2 avner: /1�/"'��'�G ?W/OID
I do �er¢Dy ceriily I�al I am aware ot and UnEerSlanA lh¢ requir¢meniE 01 Cah�ornia Heailh an0 ery CoUe Secibns 25505, 25533, and
2553a ano t�at I or any luture Duiltlmg occu0anl wiNxdll not (Gttle one) neeU lo camDly wil� SaiG state coaes and ihe reduiremenis br a
Oermit for cansimtlion or modificalian fmm I�e Aii Oualiry Managemen� Dislrict. flesiaeniial consVuclion applicaiions are erem0� ��om
Ihese pmvisions.
Oate: Npplitani:
I �ereby ceriily I�ai I �ave read IhiS appli[aiion and Stal¢ Ihal I�e abau¢ inl0rmaiion i5 COrre[t. I agree Ia tampty wilh all city antl COUnry
oraina�es an0 siate lavrs relaling lo UuilOing consimclion an0 �ereby au��p�¢e representalives ol INs ciiy to enter upon ihe ahove-mentione0
propetly lor mspeclmn punrposes.
Oate:�J�'�v7L SignaWre: �
�mer's License o� Social $ecunry .:
t6nL<6 Whna—Bmltling: Green—Cotle EntorcemenL Canary—qpplicant; Pink—Revenue; Gdaenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 060049
PERMIT NO: B 060049 PLAN CHECK NO; N GOVT: N S[TPP; N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION ; RELOCATE EXISTING WASHER/DRYER 6 HEATER SQ FT; 500
CLAIM VALUE; 500.00 CALC—VALUE: 500,00 GROUP OCC: R-3 /
COMMENTS: LEGALIZE DOOR OPENING TNTO EXIST PLUMBING ACCESS ROOM
******�t+r*�r�r��t�e**x�r�e*x�r�e*�r�rx��t�r*�t�t**+��r�t�r��r�t**********�r�r��t�x�r���r�e�e*�t���t+r�r*�t�r�e*��r*
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 ZN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 92245406 2NE: REF NO;
PLANNING NISTES>
i
*�r*����,r,r��«�**�*,����***�r�r,�*�*x�,r*+r***«�***********�«��,r«��r*���**�+�+��**�*********���
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N�_T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : AATE;
APPLICATION ISSUED BY: � DATE: i.I- 2.. `1�
iElE�fiFiEif�iEiF'!fl4klElFikiFlFiklFiFikikik iFiFi��ifiF7FiFiFikkklF'lfifiEifiklF �fif
iE iF�flE if ik ik�f !f 1Fik i! if it �t iE iElklE %!k if �f 1F iE iE ff if iklE i! ik iF iE if iE ik iE if iF ik iE if if it iF iFiE iE iE iFiE iF iF if 1E iE �E k iE if iF if iE 3E if ik iF iF if iF iE iF ik iF IF iE �f if
LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL'SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 30,00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE -
BUILDING—DIV—> PERMIT ISSUE .PLAN—CHECK TOTAL PAID DUE
TOTALS----> 30.50 0.00 ,.-, 0,00 30,50 30,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 30.50 OVER/SHORT; .00
HLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.00 , ,SO
if fF 3FlF iF i! if iF If 1Fif !k!k iE if if iE iE 1F 1E if if iE ik if �f 1f if if �E 1F �F i! if iE �F fE it * iE IE iEiF iF ik ik If if iE if 3F iE 1E iE iE ik ik 1E iF it iFiFiFlf iF if ik if jF iF iF iF i! i! iFlE iF iE k
I N D I V I D U A L F E E H R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 500 ALTER BY VALUE RESIDENTIAL NOZONE 1,00 500,00
END OF FEES
�
��CONSTRUCTION AND PLANNING � POO' -' SPA
•�APPROVALS Permit # Date Inspector AppROVA�S Pe�mit # Date Inspector
7. Temoo�ary Electrical Service or Pole 52. Pool & Equipment Locatio�
2. Soil Pipe-Undrgrnd^ 53. Steel Reinforcement
� `3._E#�ctrical Con�iL,Uiility-Undrgmd. �5A. Forms
�_
�� �
.i 4._EdEctrical CondaiT.Undrgrnd. ' r55. Electrical Bonding
;r�� �.-
:5r�Steei Reinforcement "58. Rough Plumbing & Pressure Test
,� ��,CsYectrical UFEi3:�imd. c57. APPROVAL TO COVER�GUNITE :p
= 7. P$,otinqs - '=58. Electrical Conduit-Undrgmd. -
��. Foundation 6J. Gas Pipe, D Undrgrnd., Test ��
9. Water Pipe-Undrqrnd. =80. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System F`rl. APPROVAL TO DECK
17. Rroperty Sewer LinE & House Connection � 62, Backwash & Receptor�Final
12. S2wer Cap y. � � 63. Heater & Vent-Final `
13. Roof Drains 64. Plumbing System � Final
14. Rough Plumbirfg '` 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SystemrFinal ' '
76. Rough Electric°Wiring� � 67. Fencing & Access Approval
17. Rough WiringSign 68. APPflOVEO FOR PLASTERING
18. Rough Electri�l�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
_ ' R t' r �:-� S a'
20taRoQ3h Eactoxy �'Ireplace � �.n Q % "� �. �^s * � AppROVAY:St�OPermit # _ �T'
.a 5.� � r z� � � x a 4;U --.. -. ..: s.'
:� i- S M ,-� � '-) x x �2, 5_.'-, r X zr
21;�Du'c�t�s,in;St�ctu�'Ek ' .,.. ,�S ,o S : .�,� * -,70. Underqroyn� Hj�ro ..
22. Dui�s,Uentlfatiog� ' :'�S '� F�.2Y�� �71. Produc'TR�ping�6as C70i1
23CGa� PiP�Rou h &'fest ° ' . �` y `"� ... :""': `" '� � � �r � ���
,�9 y, i r�.� � n a �y 0-: .•: r i72• Undergro.und FIusK„ �_ .�
24s�Rotif F(ami�g ;n+c � E- `.- •�-� � � G > x ' 73= Undergrrre}, Smra�Tank'O Gas ❑ 0'il
r. n x � � r x
25. Ro'Sf Sf�athing'�* � v n�� � i;J� *'74`,-,Qverhead�Hydr�' '� x
V �
26.=T�63r Ceiling (Strl+etural) St�vlonocoat �r cc � n7x « 7g;^ Dry Chemical Y� � �t
27�Frame apd Flashjn� F t s ;. � 1� x 78. 'Dry Stan�e ;� �� � .:,�
-,28. Lathin � Sidin �� � � 77.. FIXED 5i'�TERG=�INAp � �
9'$ 2<'= �:t.L z x�g ..+c x r
rl r. : -1 Y1� (^ �l Y
29. Insulat�n � �'� � j.... '� Y''' K; 7�' FIRE PREV. FI�VAL �> �t "
�30. Drywall�Naitaig:��c �� x' x?� _ .kfEALTNiDEPR. REQFJIR�EMENT
�31. Plaster roy�(� Coa# ' "� ` 7� FINAL IN' IECTfDN ;� T;'
� [: � iC � 1 l�' i� i( a: K 4 � .Y7
��32-Electri� Poyyer Mete,T-Pinal s:�. < x:,80_� FOOD CERT JFI�fi,4TE ISSUED
_33�Fin�l E�ctrl .>,c � i '` u 7' � z -�- Na�es: � � /'Z�.7'� `Qxp- ,�.�-
i � x :�7 i ^t i �r �.
� 1�
i34��Fir�Bl H�t'3ti g & �F, ( C�onditiOrting 4 � ;� � x .,w. !� � i �� .0 5 ��-
l35nFirial Cr4'b PC('ie-T�SP ,,� � 's � , r'• n _ � r -" �=n
ti36�Hocd qi,yCanoPV�* p� h c-. � Y � io ` x�� a.
�.,•- � x�
' 37�-Fin'al F�tory Fi��lace� ' S:r �. �c :: : x,_ x ^ n
w t-- .1 s K.[ fi "!'
• ^. K +T. I .. .. 'J � lU \ a. `�Y 'R ,
`i38. Fingl P�umbing � m , r.i. a �,c ac � 1 x S
a39. Water SBYvice-Finat � - �K ` �'� � � ��•� =K �
�J : .+: T_ � : � �
c Y ; �
:�40. Gas Service:F.ini�l�` n S,c,r 5 s,n -�c�i , �
i 41. Solar DmmeSiicFinah ' � •• " �= k �+� 'i�� "' { '
- r �r -:c # x r ^O •: '[
'42?Backflo.jd PrevenSeX `' ;� R -' � ;� ';� :�'� • � � �
43. Backflow Irragation .zSi x t x �:'� * J "
}� Y /
'Y y � ; ; (U '{ .
�44. Landsra�e Kripatiqn Systerr� ��z F ,; �r,� C - -,; .t' n� :t; �,? � ,'n o
a45�Sound Attenuation - ' *%' " -' �"*'�" - J'� ? � "'" �
- i �n ,� ':'1.. x � - .7 x
�46:.Handica.Q �gulatipns ' � ,;''' �� ��Y � i � •i �c ' -� �
y47;FIN�aLSTR�i1CTl1FiE&Bl?�LDINGJ �� �j� _,?=�� ✓ �
K � A(
r w x . F ' '
48::'FINAL PLfKNNING ;�� c;;3 R. r- tr, S x - �
� 49-lElectric Release to�Edison , a K:: i; 'x � ; +�' � v
c e .�t ? G`
�50._GaslRete'ase to Soy�thern Califorrua Gas Co ;_ r ; :: '" - . �'ri x ;
� 51. CERTIFICATE OF OCCUPANCS' ; <: •.;, �c. '� �- 3
No. Date
a
�,,,r�,� �� �n
� � ��-� ; � �
\�J
\
��_
.� ����
QCYSi14t •�� � ST AGC�MPA
SNIS ���8�' GiV4N REQ�ESTS
p4L ��ySPE
y� �.
�Jd' . . i
��
l.)l
�� � /
w ( P tti�-��� � t �
A�F����A:���
aty .. �, ;
Q! .:vc;!? :,t:�a �^�..
CfC/� .•-� s(�23_�`t:�
3Y ____. �._ _. . . . . .
TN:-4 " � `• . � . . . ," , .. ".S<c
IfJ(P'—��� �� . � . 'i' ir.1i."i�.
� IL.e �. .., . ' . . . . .�
WVv . . � .,. . .J-'�, i
< i C.'
/^:�'� �.��Y , , � U' { � r ,
c;._�. . ,rt.. � , cn ,
vr�� �c. , , � „u ic .
�n/ , ., � :,�e:. r`�.:d.; n�ri;
. ,,�� :��i... � �. � � .,���ri;
���� r�;i� �; _ , ,- . . . , ;�v
$R9.i .p15 . �
f;UiL;.. ,-Ft I " , ia . . . .-t;[ �i: �P.iIEH N'ii!4!!
. .'+ „i �•�: [� :. �a ��_; _:.i Jr ,q.Y •JfHEfi OHOINANGE OF
71�.. :;ii .
_ ___.._s_. �\ _.
/1\
�
/
PP^JECT ROOflESS: 8 3 Q P I NE PL
�WNEH'SNAME: HOOD SIDNEY LEFy,
aooxess: g34 �INE PL"
COSTA MESA,CA
APCHIENGINEEB:
AODPESS:
UNIT:
92626
flEG.NO.:
UNIT:
PEXMITTEE: SIDNEY HOOD ( 714 ) 645-1399
nooeess: g39 PINE PL
C,M, CA 92626
UCENSEO CONTNRCTOfl OECLABATION: 1 �ereby a�fum ��a� I am licensetl untler provisions oi ChaDter 9(commencing wi�h Seclion
7000� ol Div�sion 3 0l Ihe Business an0 Professions Cotle. antl my license is in full brce and eflect.
LITV LIC.: S7ATE LIC.: CLASS:
Dale: Signalure:
WOHKEflS' COMPENSATION OECLAflRTION: 1 �ereby allirm �ha� I have a cetlilicale o� consent �o self-insure or a certi�icate o� Workers'
Compensa�ion Insurance. or a cerlilie0 coDY �hereo� (Section 3800. La�. C).
POLICY NO.: E%P. UATE:
COMPPNV:
❑ Cerlilietl topy is �¢r¢by �umi50e0. ❑ CenifieA coDY is hletl with the ciry Builtling �ivision.
�a�e: Ap0licanC
E%EMP710N FNOM WONKEBS' COMPENSPTIQN DECLAPpTION: (TM5 seciion nee0 nol be completM if Ihe pe�me� is lw one hunaretl (5700� or less�.
I certily Iha� in I�e perbrmanre oi Ihe work lor wAich this permit is issue4 I SAall no� employ any person in any manner so as �o become
5u0�ecl lo I�e Workers' Compensalion LawS ol Califomia. A i q�
Oate: 23 �JOV9+y Signawre: �N���1 / �
NOTICE: I�. aller making ��is deClaralion. y0U Shoula �eCome su�lecl to th orkers' ComDensation pwvisians oi the Labor
CoOe. you mus� IOMwit� comD�Y w��h such pmvisions or this permit shall �e deemed revokea.
CONSTflULTION tEN01NG PGENCY: I here0y allirm ��at �here is a constmction lenaing agency for �he perlormance o� the work br
WhiCh IhiS permiiis issuetl �Senion 3097. Civ. C).
LENDEP:
aooness: CONVERT EXIST PLUMB ACCES
ROOM INTO LAUNDRY ROOM
OWNEP 9UILOEB OECLi1flATI0N: I hereby aflirm tha� I am er¢mpt imm I�e Coniractors' Siate License Law for �he following reason
�Seclion 7031.5 Business antl Pmfessional Cotle: Nny city oi counry whic� requires a permil �o cons�mcl, alter, impmve, demolish, or
repair any slmcWre. Orior Io its issuance. alm requires ��e applicani �or such permit to hle a signed 5ta�ement �hat he/she is licensed
pursuanl io Ihe pmvisions ol Ihe Conlraciors' S�a�e License Law (Chapter 9(commencing wi�h Section 7400) a� Oivision 3 ot Ihe Business
ana Prolessions CoOe) or I�at �e/s�e is exempl lherefrom antl Ihe ba5i5 for lhe aliegetl eKemption. Any viola�ion of Sec�ion 7031.5 by
any applicani lor a De�mit SUGletls IAe apDlican� �o a civil penalry oi no� more �han five hundreA Dollars (5500).
� I. as owner ol Ihe pmpeny or my emVloyees wilh wages as Iheir sole comvensation, will do ihe work, and ihe
s�mcmre is noi imentletl or otiered for sale (Seclion 7044, Busmess and Prolessional Cotle: The Cantmctors' S�ate License Law
�oes not apply to an owner ol a pmperly who Ouilds or impmves ��ereon, an0 who tloes such work himself/hersel� o� ihmugh
his or her own employees, pwvitled t�a� such impmvemenls are no� in�ende0 or offeretl br sale. I�, however lhe builtling or
impmvement is sala wiihin one year ol cample�ion. �he owner will have Ihe burden ol pwving he/she did mt bui10 or impwve
for �he purpose o� sale�.
I, as owner of ihe pmpeny. am e�clusivey contracting wilh Iicense0 coniracmrs m constmci Ihe pwject (Section 7044, Business
❑ and Pmfessions CoOe' The Coniractors' Slale License Law Oaes no� aDOty lo an owner ot pmpehy who builOs or imP�oves thereon
and who conirac�s for such prolec�s wiih a conVac�or(s)license pur5uani to �he Contrac�ors' State License Law�.l am aware
Iha� pmo� ol Iheir Worker'S Compensaiion insurance shaultl be pmvitled lo me.
� I am exempt under Seclion: B. 8 P. C.
tor Ihis reason:
�aie'. 73UOV 9Z Ownec �M�� ��
I tlo hereby ceni�y I�ai I am aware oi antl under5�an0 ��e requirements o� Califomia Heal�� antl Sa�ery Cotle Sec[ions 25505, 25533, antl
25534 antl Ihal I or any IUWre builtling occupanl will/will no� (circle one) neea �o comply wi�h SaiA s�ate co0e5 an0 the requiremeni5 for a
permii for cons�mclion or motlAicaiion tmm Ihe Nir �ualiry Managemen� DisVicL Fesitlential canstmc�ian applications are exemp� �mm
Inese Pmvisions.
Oale', Appl¢am:
I here�y cerlity I�ai I M1ave reatl Ihis applicaiion antl sla�e Ihat �he a0ove in�orma�ian is correcL I agree to comply with all ciry and county
ordinances ana staie laws relaiing Io builtlmg conslNe�mn antl �ereby aWhorize representabves o� �hls city �a enter upon �he abov¢-men�ionetl
pmperty for ins0ec�ion purpases.
/7 � �1f�
Oa�e: Z3N�V 7 L Signa�ure'. � i's'✓i+o� I
Driver s �icensu or Sociai Securiry a:
16ai_G6 Whlte—Butltling; Green—Code Eniorcemen�; Canary—Appllcam; Pink—Revenue: Goltlenrod—Hssessor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: P 060052
PERMIT NO: P 060052 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE; ALT
JOB DESCRIPTION ; RELOCATE EXISTING WASHER/DRYER 6 HEATER S(� FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
*�****�*�e****�***�rD00*�e�**�***x***�****�*�*�**B**��r***�*��r*��*;e��**B******�*�r�r
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 RGHT; FT IN LEFT; FT IN RGHT: FT ZN
PARRING REQ• PROV; PARCEL; 42245406 ZNE; REF NO;
PLANNING Nc�TES>
i
�xx��r��r*�r**�t*�t�t�t***�r*�*���r��,r�r��r�r�r�r�rx**�t�r�r�r�r��r�r�r�t�r�r�r*�r�t*��t�r�r*�r�r�r**�r*�r****+t�t****
D E V E L O P M E N T S E R V"�:I C E S y,.. R E Q U I R E M E N T S
�
ZONING APPROVED BY ' DATE:
HUILDING APPROVED BY : ..: DATE:
APPLICATION ISSUED BY: .�i—�•'' DATE• 1 Z3 L�fZ
1fif�lElElFiEiEiEiElElkiflEififlFiklFlFkiElE3FiFiF�'iF3FiF�if 3F'iF�ifiFiFifif3fiEififiEiE iflF
if iE iE iE iF �! iE iF iE 1F i! iE 3f iF ff if iF Ik ik iE iF ik iE ik iE if if iF iE iE iF k ik iE 1E iFif ik if iE k if iE iE M iE k iE iE if if if ik if if if ikik ik iFiF iE if if ik �E �E iF iklF iE fE iE iE if iF if iF�1F
LEGALIZATION;Y F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRZC MECHANIC FIRE SMIP/RES GRADING
PERMIT 38,00
25Y SMIP/NON—RES
PLAN
IS5UE FEE 20,00
��TA�i�—ty��/-3 1!{�g�b¢ 2��•,y�1 t+'LAN—COE00 58T 0 58A00 DOQ
�'�' � , �
REVENUE DIVISION TOTALS--> COLLECTED; 58.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
rJ � , Q �
iF if !F iE �f ik ik k if if iE if 7FlE iE 1! it 1tlElf iE iF iE k!f 1t 1F 1E if If !E ik 1E iF k ik k�! 1k i! 1t 1F 1k iE 1k if ik iEik 1tiE if If if 1F iF if iF iFlf 1f iF i!1! ik iF iF if k if !F �E iF 1E 3! iF iF if ik
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST
PLU 1 LAUNDRY TUB OR WASHER 7,00
PLU 1 WATER HEATER AND/OR VENT 7,00
PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5,00
END OF FEES
TOTAL COST
7,00
7,00
5.00
.�
� � � P,OQL &�SPA
��_ CONSTRUCTION AND PLANNING - ' - � - `
APPROVALS Psrmit # Date Inspector qppROVALS Permit # Date Inspector
� 7. Tem orar Electrical Service or Pole . '
P Y 52. Pool & Equipment Location ,
2. Soil Pipe�Undrgrnd._ y53. Steel Reinforcement
�Mli (
-�-�.,�E)�ctrical Con�it;;l�tility-Undrgrnd. ' �j�i,4. Forms -
•� 4:-E'Igctrical Cond&it=Undrgrnd. :='55. Electrical Bonding
}
,s �el Reinforcem�nt ' 5�. Rough Plumbing & Pressure Test
.���E�ectrical UFEB �rnd. 67. APPROVALTO COVER�GUNITE t
�r. � .
r �
='J.'F�otings - `�. Eiectrical ConduibUndrgrnd. �.�
igt Foundation .; $� . Gas Pipe, � Undrgrnd., Test �
�
9. Water Pipe-Undrgrnd. =6a. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor SYstem 6}. APPROVAL TO DEGK
11. P�3perty Sewer Lir�& House Connection �8�. Backwash & Receptor-Finaf . '
72. S€wer Cap 1, ;63. Heater & Vent-Final
13. Roof Drains '= 64. Plumbing System � Final . �
� ✓
14. Rough Plumbi�g ` 65. Electrical-Final
15. Rough Eiectrica!-Gonduit 66. Solar System-Final .
16. Rough Electri�Ji�ing 67. Fencing & Access ApProval .
17. Reugh Wiring $ign 68. APPflOVED FOR PLASTERING
18. Rough Electri5a�-7 Bar Ceiling ' 69. POOLlSPA SYSTEMS FINAL �
79. Rough Heating & Air Conditioning - PIRE DEPT. REQUIREMENT '
' ' ' 7 T.- �.0 x p" U'
20:'7io�`h cto'� Fue lace � '"� � � x �� �:"* ^ ��'"� -- _
S�� � tY 2>P IS:*� .x'Q x S_,�.x,� APPR,�IVA�.�� �Ver';rnit# x c
� - . i .-."' :.� . - ... r_ �r . �
21.-Du�ts, iC.Strpctur�x .. .- :-�S r S - �x --: �70. k}nderground J-Ipilro �
22.SDu�zs, Vbnt� ting;* � �` - � n � x X �77. Product.�i;�iir�g O'@as �Oil
t : � i S * �. � r�A X � .r - • .: f .
23.;Ga�3ip�Rouyh &�est � ry x n 6 � �+, x 72, Undergrour�d�F4acly � -
a '
24�Roo7 F'ramirtg ?t�r � �"�' ",n `' ^' y '"i �x x . ��Undergrnd��tor�g�7ank�77Gas ❑071` '
y x 2 x�� �_ � i ?. x x - .-� x
25. Ro� SFsgathing ,> ` �� . x ._ j ;�;,; x 74; �Overhead Hydrq: �^ >�
26:=T�Bar Ceiling (Steaetural) &SlM1onocoat � � D �% �hx x 75;-Dry Chemical . '' ' -� ?3 �
27 ;Frame a d Flashia D � L " n �' - ��` = �� -" ` S '' - - u
,$ -� ,_„� z x p' 'r ,n s r. 76�. Dry StandpipC :- �_ � x �=, �r
��28.��Lathing� Sidin�%" ^�Ly' - � � ••Y " 77_ FIXED SYS".�'�EOg•'(�AL� y '
q ^ ... .. .. x �n ti :a , ' R r
�'29. Insulatia�n r t" � :. ;� �� 78s:FIRE PREV. FINtqL a: � S.-<i S
.r30. DrywallMailing �* "� x' -'� yI-4E'ALTId"DEPY. R�EQdIRENfENT
A 5[ . l.� Y. .0 •
�31. Plaster �owa Co�t" 5 � �,-�. ` t ;� .-7g�'�NALi'NS?�CT{QN ; " ' C,L',;
v i r r . `
:-327'Electrieat Power Mete�Final• .. <�•. sg0;�7F00D CERTIFfCl�fTE 19SUED 3Y
,, : -
s33.�Firrml El.�ctr� F,, -. i � Y � '" x `�Ndt'�,es: ` .�.`',y q _ - �s'�,.,
i_34;�Firrgl Heating& ifir<ConditiontD� (^ � x x �.� ,, r. ;s .c} _
`35:;-.. -: r < � C x 5 ._ :-eC +: � - J
Final Ga� Pi{Sc•TE5't*` - � '` '` �'� C'. .nS .:,r� .S �J
� :�s .. �� c x , s �. �.�
•.�36.�Hood or`r.CanoPY��- i:r- a .^ x x ' r ,� `. c. .• r
x r .5 `
'-37:�Fin�l Factory Ficeplace � S,r vr x-r, : x : ;'t x .a
.c t.�i-• a 'cx -c x �n;
_ _ '
-38. Final PLmmbing �� '- �- x� 5 -� c[
�39. WaiOr Service-Fi �pfM1 ' '�' �` < °: A <�� _ ? i s t�
� t + �.c K �e - c -
� .i �+., .. - _ � ...
,=,.40. Gas Service-Final'* r� �,r�� g � ,r, -_ -� ,�;_+ .
- +
s41. Solar 06mesticFinalS �r� " * =` x x �� � � ^c � c
[� f. ��
J42�Backflow Preven'tgr.; �; �, " ,' x - %� - > �
43. Backflow Irc`Lqati_Qr�` . � S 5 x s X x 3 � ': -' ,� �' ;�-,
: ,44. Landscape �rigancui Systenn;q^ :t _� � K .z :� itZ ' :i: .,., �
5'45 =Sound Atte�uati6�f N-` ^ '•- x f -`' ` ' r .- " - `t'4
j a: i'1 R; �r. K< tj" .i , l-
�46:.}iandic2A Re9ulai14ns = .� z .-. .. ..:, .c � rz S C ,.. 5 +�
47�FIN'ALSTRGICTURE&BUCLDING K ':` = z% S ^ "
� 'C < :: i� a: i _r r..
T48:`FI�AL PI.AIVNIN� ��. : �:v � r n ¢
�49^Electric Release to'}Edison �� * -� ' �
v � ,� < � w
�50,�GasLRelease to Southem CaGfornia Gas Co � � I � r' = _ • p,� c� �,� y
,�51. CERTIFICATE OF..00CUPANCY . , v. ; �, ; .;, .� - ;:,�o
No. Date
T I
�
nooe�!s: ,�34 PINE PL
1'SNAME: HOOD SIDNEY I,EE
ADOflESS: 834 �INE PL
COSTA MESA,CA
NHCHIENGINEEfl:
AOOflESS:
UNIT:
92626
XEG.RO.:
UNIT:
PERmiTTEE: SIDNEY HOOD ( 714 ) 645-1399
nooness: g39 PINE PL
C,M, CA 92626
UCENSEU CONTflACTOB OECIAHATION: I hereby a�firm tpai I am licensed under provisions ol C�apter 9 �commencing wit� Sec�ion
700�) of Division 3 of roe Business aM Pmie55ion5 Code. dnA my Iicense is in full force antl eflect.
CITY LIC.: STATE LIC.: ClASS:
Oa�e: Signamre: —
WOPNEPS' COMPENSFTION OECLl�NATION: I hereby alhrm Iha� I have a cetlificate of consent to sel4insure o� a certilicale ot Workers'
Compensa�ion Insurance. or a cenifieU copy �hereo� (Sec�ioh 3800, I.ab. C�.
POLICY NO.: E%P. URTE:
COMPANY:
] Cerii�iea copy is here�y tumi5hetl. ❑ Certi�ie0 toOY is �ilea wilh ihe tity Building Divisi0n.
Daie: ADPlicanC
E%EMPTION FflUM WOflREPS' COMPENSATION OECLAHPTION: (Thi55et�ion n¢etl no� be compl¢�eU ii �he permit is �or One hunOreO (510�) ar 1¢Ss�.
I cetlity Iha� in ��e perlarmance oi ihe work lor which �his permrt is issuetl. I shall noI employ any person in any manner so as to become
subleci to �he WarkerY Co�m7pensation Laws oi Cabbmia. /�
Oale: Z3 �0� 7 Z— Signaiure' __ _. �ya/�til.(�( %��
NOTICE: Ii, a�ler making Ihis Aeclaration. you 5�ou10 b@�pme subject lo the Wo�ke �ompensation pmvisions ol ��e labor
Code. you must forihwith comply wit� 5uc� pmvisions or ��is permii shall be deemetl revoketl.
CONSTflUCTION LENOING PGENCY: I �ereby al�irm Iha� �here is a constmclion lenaing agency br ��e pedormance oi Ne work tor
w�icb Ihis permit is issuetl �Sec�ion 3097, Civ. C�.
LENOEP:
aooeess: CONVERT EXIST PLUMH ACCES
ROOM INTO LAUNDRY ROOM
OWNEB BOILOEfl OECLAPRTION: I hereby affirm Ihat I an� exempl Imm lhe ConVactors' Slaie License Law for the lollowing reason
(Setlion 7031.5 9usiness antl Pmfessional Cotle: Any ciiy 4f county which requires a De�mii b consimct, alter, improve, tlemolish, Or
repair any stmqure, D�ior lo its issuance, also requires the applicant for such permit to file a signed stalement ihat helsne is licensed
pursuant lo Ihe pmvisions oi Ihe ConVac�ors' Siate License Law (C�apter 9(commencing with Section 7000) o� Oivision 3 of Ihe Business
antl Pmiessions Cotle) or ihat he/she is exempt Ihere�mm and lhe basis lor �he alleged exempiioa Pny violation ot Seclion 7031.5 by
any applicant br a permi� sublecl5 �he applicant to a civil penal�y of nol more than five hundred tlollars ($50��.
I, as owner of �he property or my employees �yith wages as �heir sole compensalion. wiil tlo fhe work, and Me
� s�mclure is noi inlenaetl or offere0lor sale �Sec��on 7p64, Business antl Pro�essional Code: The ConVac�ors' Slate License Law
tlaes nol aDPty lo an owner o� a pmperiy who builtl3 or impmve5 ihereon, and who tloes such work �imSelUherself or lhmugh
his or her own emDloyees, pmvided Ihat such imD�ovements are nol in�endetl or offereG for sale. Ii, however the Duiitling or
impmvemenl is soltl within one year o� completion, �he owner will have �he burtlen ot proving �e/she diU no� builtl or impmue
br Ihe purpase ol sale�.
I, as owner o� the properly. am exclusively contracting wi�h licensetl conVac�ars to con5lmci �he pmjec� (Sec�ian 70a4, Busine55
❑ antl Pm�essions CoOe: The ConVac�ors' S�ate Licens¢ Law Uoes noi apPly �o an owner of pmpehy who builtls or impmve5 �here0n
and who conlracis for suc� pmlecis wii� a contracioqs�license pursuan� ta the Contraclors' S�ale License law),I am aware
Ihat pmol o� Iheir Worker's Compensalion insurance should Ue provitle0 b me.
� I am exemp� untler Section: B, g P. C
IOf Ii115 fCd5y00: J,.�/
Da1e' �� N�/� / ` _ Owner ��._���
.
I tlo here�y cenify Ihai I am aware a� antl undersiand the requiremenls of Calilornia Heal�h and Sa�ery CoOe Sec�ions 25505, 25533, antl
25534 antl iha� I ar any �uWre building occupant wilVwill not (circle one) neetl Io compty wi�h saitl s�a�e codes antl �he requiremen�s tor a
pe�mil for constmction or mo0i�ication imm Ihe Air Oualiiy Managemenl OisiricL Residenlial cons�mclion apDlications are eKempt tmm
Ihese pmvisions.
�ale'. ApPlicanl'. _
I her¢by ceruty ihat I have rea0lhis applica�ion and s�a�e Iha� Ihe ahove inlormation is correcL I agree lo comply wi�h all cily and county
ortlinances antl siale laws rela�ing to butlding conslmc�ion antl hereby aulhorize repre5enia�ives a� �his ciry to enler upon Ihe above�mentianetl
pmOer�Y �or inspection purposes.
r �Date: Z;�DV� SignaWre: _ .r
Oriver's License o� Social Secwity a:
16aLa6 White—Bulltling�, Green—Cotle EnlorcemenL Canary—ApplicanL Pink—Revenue; Goldenmd—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E
PERMIT NO: E 060050 PLAN CHECK NO: N GOVT: N SUPP;
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : RELOCATE EXISTING WASHER/DRYER 6 HEATER SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
*�+Mt�**�**�r***�'***�rD00**�**********��*�********B***�r**+�r****�����****H*�**��r�r�**
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 RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARRING REQ• PROV: PARCEL; 42245406 ZNE: REF NO;
PLANNING NOT'ES>
i
�t�r�r*+t��r�*�e�r�r�r�r*�r,r�r�r�r�t�r�t�t*�t�t*�t�t�t�t**���t�r�r�t*�r*�t�r*x�r*�r�t�r�e�r�r��r�r�r��r******�t�t*�t�r*�t�r�r�e�r�r�r
D E V E L O P M E N T S EzR V I C E S R E Q U I R E M E N T S
20NZNG APPROVED HY ';<• DATE;
BUZLDING APPROVED HY ;
APPLICATION ISSUED
�Fil�FlEiE�EiEiElfilifik�kiFlFdFikikiF
k!f if iE iF jt iF �E 1F iF �F iF�E iklt iF!! iE iE
LEGALIZATIONeY
BLDG PMT
DATE; _
DATE: �
iEiEifiEiEiEiFiFiEiEiEiEiFiEiliFlFiFiFiFillEitililifikiFiFitiEititiEjF�k�tdElEiliEiEiF�FiE�EiFiFlFikikiEiF3Fif*�FlE
F E E S U M M A R Y STRUCTURAL SEGMENT;N
PERMIT PLUMBING ELEC6RI�C� MECHANIC FIRE SMIP/RES GRADING
SOY SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 6.00 15.00 0.00 21,00 Z1,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 21,00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21,��
M IF iF iF ik if iE iE iE iflf 1E 1E 1E iE iE iE iE i! ik k iEiE �lf� k �k ik if iE iE iE iF �E iE iE iklE �FiE if if if �k ik if iF 3FiE fF1F if 1f iF iE iF 1f if if iF fE iE 1k�E it iE iElE iFlE iEiF1F if iE �f iF ik if iE
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 1 RES APPLIANCE NOT OVER 1,0 HP 3,00 3,00
END OF FEES
CONSTRUCTION ANDPLANNING P9 'SPA
� APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
Z�Soil Pipe-Undrg�nd� 53. Steel Reinforcement
o , ^ -,
�v�,n��ctrical Conagi�4{tility-Undrgrnd. �l. Forms
=� 4:_EWctrical Condnit-Undrgrnd. "�,55. Eiectrical Bonding
_ r
�$.j„�el Reinforcea�nt ��. Rough Plumbing & Pressure Test _
.��'�i"ectrical UFE9+Grnd. � 7. APPROVAL TO COVER�GUNITE rc
n _ .
�T'7. Pdotings �� �_�a�. Electrical Conduit•Undrgmd. -
� a.
�. Foundation $. Gas Pipe, O Undrgrnd., Test
,
9. Water Pipe�Undr9rnd. '60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System �H]. APPROVAL TO DECK
11. PToperty Sewer Lin�& House Connection �y-2, gackwash & Receptor�Final
12. $ewer Cap y �+63. Heater & VenbFinal - .
13. Roof Drains '= 64. Plumbing System - Final '
� �;
14. Rou h Plumbi `°
9 �8 65. Electrical-Final
15. Rough Electrioal-Conduit 66. Solar System-Final
.r
16. Rough Electri�Jiring 67. Fencing & ACcess ApProval
1�. Rcugh Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electri�'I-T Bar Ceiling 69. POOVSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
U' J -' ^ (- at ','.7
20,T�Roigh F cto`ry F"yE"place � xm C': x O� _^'»� � PPR' VA --��-PeFinit # F "-'
s 3 � d�.,,. � S? '.c6 r S �'T: x: ��� 1:-� > �
' l' �1 •._ � r'I 1 J J L:
21.:Ducis, i��Str�yctuee� I~•• �-.> M S �-� ?' �70. HindergaoJnd Hyilro �
_ n
22. D^s, nti ti ~* � ��S � S¢a M- r
X,? �, :,71. ProducLPc�$ng C`}Eras �Oil
x I i K J ("' Y:\
�3�iPP�ROIi'hif[��2St I ir1S /:I*1 7¢ 1-+tiM 9• I �..� x _
nx:e .72. Under rotlnd Flus
� -
24*Roo7 F�mirtg �x i i-� �•T �? G � r� Y 73rUndergrr�.Stor8y�7ank�Gas ❑Oil
l x >. .l x r •r J x x Y v -- =
25. Ro� S�eathing :z .i v� x � � tU . x 74^Overhead Hydr� �
26:cT�Bar Ceiling (S[rueturall &°ivMhr,coat M s' �?x � 75= Dry Chemical `•' � s
rt.- a ^ :: x c -n
27` Frame a�d Flashiqq D ` '' x '` " � �'• f S '� n'
:;c,= � T y 1,* t 75 Dry Stan" "'rPe `i,= x
��28.� Lathing� Sidin�= %� '-Q= x x� '-� %' 77„= FIXED SY',�fEM �FINAL�'�', .
r x n -, .c x � •
f 29. Insulat��n " `-' ' "" > x ,� s u > .y -
�4 C-� s »� x x 7gs'FIRE PREV. FINHcL M> :.
T30. Drywall�Nailing =�x ,✓ � °' ' � HEALTFPDEPT'� REQl11R6MENT
i � x �
�l .. � t *: r: � C:� n .: ^ �r
�31. Plaster �tov�w Co�t,�; � i.,,,,, ,� K,� 79. FINAL IIi�jECTIQIV, �
� � �- c-
-32YElectrical Pocver�Mexe2�Finali M.�' e: r. :80'�FOOD CERTIFICATE I�J5UED O
11 Y '1
-3�Fir¢,I E�ctr� y^ r � � �`�,'� ' � N6ies '� :R: � ..� � ^ ��
��34C;Fir7a.l F�eating&%CiuCopditior�n� C� x � W �r ��-- �� i^:c x� ,S ni.
r -r .c x i-- ^ ic
35��?Firf�l G� Pi3e-T��` '^ -' '� R� t'.o = or rs a. r� �G
1 t ". • ?( � � %F =.^� '� _ . r
. V - �" y ' .
s36. Hqsd oi:yCanOPY-< : � IT'^ a .:� x x' ?'_ :'J � x� �'
r+ x x n r
;:37-Final Factory Fi�e[�ace � �`� `^ " -� ` � `� " :n
.. = i -c• n. w � ;.; �c .1
�J38. Fingl Ptvmbing E;. AN �..... a x�v < S �� c�z -i
v
"�39. W�r S"e+vice-Firr�g' i_ ' � � N • x � i cJ *: y s C�
s � s� <
,r_40. Gaz Service-Final'a q .�rr r S ?: .�1 R.� .i'-� O?- Y
} 41. Solar D"6mesticFinalS r". � » u � ; � ��o -. x
.c ,> •n < K �� ,r r y.
' 42�Backflaw Prevente�� ` ;.� ,� : a: � -i: r �
n
43. Backflow Irfj'gatior� ' �=�'� " "` ` '��' �
y K i�
'r44. Landsc e 4Ji afionS sterrt_*�,^ z x r - ��� x c .� �ar x� ;�
*1 ?P t��p .� Y _ ,-
<
Z45�Sound Atte�uati6fi „�-��': �� ' S- ;,n 'r 'r� � _ - � • :`� ` x
,; J ,. .. � � i
546-„Handicap R�gula�ons _ � � < � z � . S x
V 47.oFIMAL STRUCTRCRE & BUT�DING � " Y � ,- ; �
. x ,.L x:- :. x � a� �-
rr :- +.
48'.jFINAL PI.ANNI`,�G _, K;� r+- R; S s -
=49=Electric Release io�Edison i = * + �. ' ;, � =
i # x n q
�
� 50�GasRelease to Souihem Califomia Gas Co ;� ., �. ` - . o,�- > _ �•
=51. CEtiTIFICATE OF-OCCUPANCS' . < : - � . ..
No. Date
. N �.i Lz
. ti-. I 1 I
L
� �fl
s,
L .� —� o-
o77/�eeK
CiReuits
0
71�A
��
�
�w"��'
--►
zo�q
o, � GFC 1
o �'Ge+�
C�aCv/i'r
L3
53
:.�
J ?�A
YBRM
* Exu��Ng 9arc+
Eor,00so
Pv Z oP 2..
�
8R¢A
Box
— Si4ir
2�
�
7,�„
� V I L
L1
3
53 51
, �
� SI � po
� - EKl5+iN9 834 �iNe P1Ac.¢_
' "Pe2naii'hfo. E ofo0o50
c ___ S w �'rG�. --- - � � -- -- . . ... ___ _ _ . _ _. _ .
I / 1= �('fe H\XtVrLe._.
-y� /
0���� � ou�L E'I'
� 1 _ 7VUGY'OU e�
J
.O I Ot z
ORANGE COUNTY BUILDING DEPARTMENT
. 636 North Broadway �
. ' . •SANTA ANA, CALIFORNIA
FOR APPLICANT TO FILL IN
noorse�ss f3'i4 Pi na Pl ane
scHoo� oisr. �
OR TOWN
NEAREST
CRO55 ST. `Ji
OWNER OSAGE HOMES� INC.
MAIL 9363 w��sH�Re B��o.
ADDRE55
TEL.
CITY BEVERLY HILIS rvo.CR. �i 6�
� ARCHITEC Oq TEL 1.p
ENGINEE q�N B� MCKERRACHER Ho.�Y. �4U�
AODRESSZ��O E. WALNUT ST. PASADENA
CONTRACTOR NEWPORT VISTA CO NO.I.R. 4 �
ADDRE559 6 WILSHIRE BLVO. BEV. I� S
LEGAL I LOT NO. � BLOCK �7��_
DESCRIPTION
(ATTACH METES 8 BOUND51
NO. OF NO. OF
�G. F�miues ROOMS
DESCRIPTION OF WORK
IX I ALTERATION I I Af]OITION
BUELOINGEW RESIDENCE 'r
I HEREBY AGKNOWLEDGE THAT I HAVE REAO THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL GOUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
AUTHOHIZED
s 4830.00 �P. �. 5
APPLICATION FOR PERMIT
8����'��
FOR OFFICE USE ONLY
I RECEIPT NO. I PERA
I 6 -� �-S3
BUILDING /�,
ADORE55 � /G/'
SCHOOL DIST.
OR TOWN
NEAREST u I'�
CRO55 ST. // ✓�.�--
ZOppp111 NO.OF I TYP
� / I PLANS
SETBACK LINE RO�1 CENTER OF ST.
REAR'VARD �,rj'j'j;�.�51DE VAR❑
APPROVE�
JNO
NAL
CORRECTIONS
APPROVALS
TION: LOCATION I�C.
M5. MATERIALS,
IER-PINNING
FIRE STOPS. /l✓l
i. EXT
RY RE
' DATE ISSIiED
� ��-�J"
�■
�
�
Z
D
r
OATE
a?�3
STREET
�\
\
... ; i =.,. _�:..
., . --�:..�r.�
r .. . � r. r �,: � . -
�. • .r• _ :4 ,_. :�:_
� .... ._ �.- .,._n ._ _,if:
� . ... .:.., .;CI ..��.I:.1.
�
'" ..i.l.�..=. _'J "'It:�:l" '
. � � '
� � . �
'_���_.. r'�:y . ' ... _ - . . .
..' 1 - _, _'. I " _ .
, . . . . �
n
CJ .'.- ' ' ..^:13.� �
e