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Home My WebLink About3423 PINE BROOK CIR - Building Permits(774) 754-5D3 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us ii r,vn unrvt, cw i n mta�+, i.r ameo MECHANICAL PERMIT Job Address: 3423 PINE BROOK CI Suite No Vicini[y: Parcel Number. 93506096 Applicant SCHNIERER, STEVEN Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA owner: CORNELISON, MATTHEW J Address: 3423 PINE BROOK CI COSTA MESA, CA Contracror. SERVICE CHAMPIONS Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA FURNACE CHANGE OUT. Quantity ISSUE.FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heal Inst! Rep. Recess Wail HV Refrig Sys <100 k BT� Re(rig Sys >100 k BT� Gas Pipin9 Factory Fireplace Hood w/Mech Exhausl VAV Box Vent Fan / Single DuCt Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handfers > t0000cfm Floor Furnace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 Phone: 714-777-7777 Zip: 92887 Phone: 714-437-7393 Zip: 92626 Phone: 714-777-7777 Zip: 92887 License: 799170 SCOPE OF PERMIT FEESUMMARY Status: ISSUED Applied: 02/24/2004 Issued: 02/24/2004 ISSUED BY: � � . ,, Il� ►' Repair / Alt Absorbtion Unil Repair / Alt Refrigeration Unit Ventillation System Evaporetive Cooler Commercial I nci nerator Domestic Incinerator Compressors / Absarption Systems Upto3hpl100kBTU 3To75hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp I Over 1,750 BTU Boilers Upto3hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 30.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $38.30 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire antl become void it work is not commenced within 180 days, or if work is suspended or ebandoned tor a period of 780 dayS. INSPECTIONS: In ortler tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CpLL: (714) 754-5626 xme-+e �aroo� WORKERS' COMPENSATION DECLARATION: I hereby aflirm untler penalry oi perjury ane af the following declarations: I heve entl will malntain a certificate of consent to seif-Insure tor workars' compensetlon, es provitletl for by section 3700 of ihe Labor Cotle, for the paAormance of ihe w forwhlch lhis permitis Issued. hava end will maintain workers' compensation insurance, as required ty section 3700 of ��e Labor Code, for the perfortnance of Ihe woAc lor which this pertnit is Issuea. My workers' compensation Insurance carner antl policy num�er are: ,I n ca��a�:NN3(\(„niR�� I-ao.cbooG�ec�l,'1.r PolicyNumber: {+N�OC))FVI (This secfion neetl nof be completed i! fhe permit is valued�at one hundr�00) or less.) ❑ I cenity t�et in t�e peAormence of Ihe work for which this permi� is Issued, I shall not employ any person in any manner s�as to 6ecome subjeci to tha workers' compensation lews of alltomia, an gre het il I shoultl become subjact to the workers' compensation provisions of S.tion 370 0l the Lebor Coda, I shell iorthwith compy with these pr �' ae� Applicant Signature: Date: Z � WARNING: FAILURE TO CUHE WOP ERS' CAMPENSATION WVERAGE IS UNLAWFVL AND SHIILL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CI IL FlNES UP TOONE HUN�RED TFKKISlW D OOLLARE (5 00.000�. IN ADDITION TO iHE GOST OF COMPENSATION, DAMAGES AS PROVI�EO FOR IN SECiION 3]W OF THE LABOF COOE, INTEREST. AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATON: I here6y aNirm t�at I am Iicense under provisions of Chapter 9(commencinq with Sectlon 7000) ot Division 3 of ihe Business and rofessions Code, entl my license is in full rome end ettect. uc. a%�i� 17� „� ciass n CZO Con[raaors Signeture: �_�.�,^ 5 Date: CONSTRULTION LENOING AGENCV: ❑ 1 hereby aflirm thet there is a constmction Ientling agency br ihe Dedormance of tha work for which ihis permit is issued. (Sec. 3097. Civil Code). Lender's Neme: LentleYs Aatlress: Signature: OWNER-BUILDER DECLARATONS: Date: I hereby attirm ihat under penalty ot perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the followinq reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires e permit to construct, alter, improve, tlemollsh, or repair any sWcture, prior to its issuance, also requires the a0�licant tor such partnit to file e signed siatement that he or sha is Ilcensed pursuant to the proWslons al the Contractoro License Ww (Chapter 9(commencing with Section 7000) ot Division 3 ot ihe Business antl Pmfessions Coda) or that he or she is exempt t�erefmm end the besls for the alleged azemption. Any violation of Section 7031.5 by any epplicant tor e permit su6jects the epplicent to e civil penalry of not more than tiva hundred dollere ($500).): ❑ 1, as owner ol the proDerty, or my employees wlth wages es iheir sole compensetion, WILL DO 7HE WORK, and the slructure Is noi intentletl or oflered for sale (Sec. 7044, Business end Professions Code: The Contractors Licensa Lew does not eppty to an owner of property who builds or improves Ihereon, and who tloes such work himselt or herself or ihrough his or �er own employees, provided that such improvements ere not intended or oHered for sale. It, howevar, Ihe building or improvemeni is sald within one year of completion, the owner-builder will heve Ihe burden al proving that he or she did not Duild or improve for purpose ol sale.). • ❑ I, as owner of Ihe properry, em E%CLUSNELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 70G6, Business entl Professions Code: The contractors License Law does not apply to en owner of propeny w�o builds or impmves lhereon, antl who coniracts tor such pro�ect wlth e contracbr(s) license pursuant to Ihe Contractors License Laws.). ❑ I am exempt unaer sec. Signe�ure: Ownar ID veri/ied by ddver's licensa. ❑ Ves ❑ No Business end Professions Code for this reason: Veritication ol Ownership by (type ot document, i.e. - property tez bill or deed): DnvefS LiCensa No. Date: E:pires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ 1 hereby certify Ihet no axcevetion five (5) or more feet in tlepth into which e person is required to descend, will be mede in connection with work au�hodzed by �his permit, end the� no building slrucNre, scattolding, lalsework, or tlemolition or dismantling ihereof, will be more than thirty-si: (38) leet high. (Chap. 3.2, Gry 2, An 2, Sec. 341, Title B, Califomla Adminislrative Code). ❑ As owner-6uiltler, I will no� employ anyone to do work whlch would require e pertnit trom the Division ot Indusinel Safery, es notetl ebove, unless such pereon has e permit to tlo such work tmm the division. Signature: Date: Division ot Industnal Satery Pertnit Numbar: CERTFICATE OF COMPLIANCE AND AUTHORVJ1T10N OF ENTRV: I certity under penalty of perjury that I hava read thls epplication and stata thet ihe information given is correct. I egree �o comply with ell stata laws end ciry ordinances relating to building consiruction, and authonze representatives of ihe Giry of Costa Mesa ro enter upon t�e above-descn6ed property for inspection purposes. I agree not to occupy or allow occupancy ol any building authonzed by �his permit until tinel inspection. A� r(s) �"j l/ O �Date // L.. Applicent Date 40pE 1, INSPECTIONTYPE QA_E 1616 Fixed System Final Fire Prevention 1288 200 201 202 203 204 Pool Spe Final Final Re-Roof Final Black/Reteining Wall Final Faciory Fire Place Final Sign Final Demolition �$ 4opE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Eleancal 212 220 222 250 Final Fire Prevention Final Planning Approval Final Site Final Builtling/Occupency � 1l�fl PHOJECT A�OflESS: 34 Z 3 PINE BR��K UNIT: OWNEfl'SNAME: VILLAGE CREEK HOMEOWNERS nooness: ASSOCIATION 3429 TIMBER LARE CM VA 92626 ANCHIENGINEEfl: CHESTER CARVILLE NEG.NO.: CIH3OS aoonEss: 7922 ARMOUR ST uxir: S.D. CA 92111 PEHMITTEE: PHOENIX ENTERPRISES INC. (213)690-9559 aoosess: 411 COMERCIAL WAY LA HABRA CA 90631 LICENSED CONTflpCTOH OECIl�BATION: I hereby alfirm Ihzi I am 6cen5eA tler provisions o� Chapter 9(commencing wi�h Section 7000� oi �ivsion 3 olihe Business and Pmlessinns Cnde an� r se i fullforce antl eflec�� ciTvuc.:05078/8��'lsrnreuc.:37663��: B�_ /r2„ / Date //�� `� `�-� Signature�,_ '��/ WOHNENS' COMPENSATION OECIAHRTION: I hereby alh m Iha� I �ave a cetlificate of consent �o self-insure or a ceri�Cate Of Workers' Compensation �e�� ej 5c4ni�ietl copy �hereof (Sec�ion 3800. Lab. 61-� � O 1� y 1 roucr xo.: CA COMP 6 F I RE E%P.DATE: U �OMPANY: Certi�ied coDY is hpreby /lum�ishe .❑ Cehified copY is Iil t �y Builtling �ivision. � Date: [ � ` � ` ApplicanC `� " EXEMPTIONFqOMWOHREPS'COMPENSATIONOECUBRTI�N: (ihisseaionnee nolbecomple�eUiRheDermiiislaronehu�retl($t00�or1e55�. I cetlity Ihal in Ihe pedormance �I the work lor w�ich I�is permi� is issuetl. I shall not employ any person in any manner so as �o become sublec� �o the WOBers' ComOensation Laws ol Cali�ornia. • �a�e: SignaWre: NOTICE: If, aller making ��is aeclaration, you shoultl become sublect Io lhe Workers' Compensa�ion pmvisions of the Labor Code. you musl �ohAwith compty wiih suc� pmvisions or �his permii shall be tleemed revoked. CONSTBOCTION LEN�ING AGENCY: I here6y aflirm I�a� Ihere is a constmtlion lending agency �or lhe pedormance o� Ihe work for which �his permil is issuetl (Section 3097. Civ. C�. LENOEP: aoonEss: OWNEB BUILUEB OECLAflATION: I hereby alfirm Iha� I am exempi �mm ��e Contracbrs' Slaie License Law tor t�e tollowing reason (Sec�ion 7031.5 Business antl Pmlessional Code: Any ciiy of county which requires a permit to constmc�, alter, impmve. Oemolish, or reDair any 5irucNre, priar to its issuance, also requires �he applicani lor suc� permit �o �ile a signed slatemenl thal helshe is licensetl pursuam m �he pwvisions ol the Comramors' State License law (Chap�er 9(commencing with Section 7000) af Division 3 oi �he Business antl Pm�essians Code) or Ihal helshe is e�emp� �herefmm and Ihe basis br Ihe allegetl exempiion Nny viola�ion o� $ection 7031.5 by any appl¢antfor a permil sub�ecis ihe applican��o a civil penaliy of not more �han �ive hun4re0 Oollars ($500�. , as owner of Ihe propetly ar my employees wiih wages as �heir sole compen5ation, will tlo �he work, antl Ihe ❑ stmcWre is naI imen0e0 or o��eretl for sale (Semion 7044. Business and Professional Code: The Contrac�ors' Sla�e License Law tloes not applV �o an owner oi a propehy who builtls or impmves [hereon, and who Ooes such work himsel�/herseli or Ihmugh �is or her own employees, pmvidetl Ihal suc� improvemenls are not intended of offere0 for sale. If, however the building or improvemem is sold wi�hin one year of comple�ion, I�e owner will have �he hurden of pmving �elshe aid no� huild or impmve for Ihe purpose of salel. I. as awner al ��e pmDetly, am exclusively conVacting wi�h Iicense0 conVac�ors m cons�mcl [he prole�t (Section 7044, Business ❑ and Pmfessions CoDe'. The Conlraclors' S�ate License Law does not apply �o an owner o� pmperty who builtls or impmves �Aereon antl who coniracis lor such pmlecis wi�h a conVacbr(s) license pursuani to ihe Contractors' S�ale License law�.l am aware ihal proof of their Worker's Compensation insurance shoultl be providea to me. � I am erempt unCer Section: . B. 8 P. C. �of IhiS fPd50n: . �ale' Ownec I tlo hereby ceriify Ihal I am aware oi antl untlers�anA ihe requirements o� Calilamia Heallh an� Safe�y Cotle Sec�ions 255U5, 25533, anA 25534 antl �hal I or any luture Duilaing occupanl will/will nol �circle one) need �o compty with saitl s�a�e codes and Ihe reQuiremen�s for a permit fo� cons�mction or moaAicalion Irom Ine Ai� Oualiiy Managemen� OistricL Residential cons�mction applica�ions are exempl Imm ihese pmvisions. �a�e: Ap0licanl: _ I �ereby cer�Aylhal I have reatl�his applica�ion antl sta�e Iha� 11 ordinances antl sialelawsrelatinglo builtling con5lNclion an� pmperty �o i s0eclian purposes �ate: �� `�' Signalure:/ oa�ers��censeo�sociaisecudtya� maiion is correcL I agre comply with all city antl represenlatives o�tti �e�uponiheabove-m�c t6a1-a6 Whiie—Bmltlmg�, Green—Cotle EnlorcemenC Canary—Appllcan�. Plnk—Revenue: Goltlenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT . PERMIT NO: B 049934 PLAN CHECK NO: 06459-90 A , , CONSTRUCTION TYPE: V—N PERMIT TYPE: STR FURPOSE: REP JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143 CLAIM VALUE: 14,388.00 CALC—VALUE: 14,300,00 GROIIP OCC: R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION **�t**�t�***�t*�r**�t*�*�t�**x�t*x��*�t**�*�r**x***x********�**��t*+�****�•x �*�e�x�r+�x�*+r**�r�r 2 O N I N G R E Q U T A E M E N T S S E T H A C K 5 ' ------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: fiT IN REAA: FT' IN LEFT; FT IN RGH7': FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: FARCEL; 93506124 ZNE: R2 REF NO; PT,ANNING N'I'ES> REPAIR EXISTING FOUNDATIUN; > HOLD FOR SPECIAL RE4UIREMENTS if iF if If if� iF iE if �F �l(� 3h IF if iE k if if 9F ih iF if iE iFiE �1F %iE if iF iE �lE iE1E if iE iF iE if 1k if 1f �E 1f iE ih 7k �E 1f iE ik 1E ik 1F 1f iE iF if iF if k iE 1f 1E if if if iE if if if IF 1E if iF it if if iF iE 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 HY :� � � UATE: '�I'L i.S�C� BUILDING APPROVED BY : L.✓ IC...00r/�� DATE; , , /' APPLICATION ISSUED BY: - DATE• ' IflflkiE7fif�FififiFlFiFiEiFlElfif�fiEiFlF �lfifif3EjF3EfE1flElf iEiE kiFiFjFifkkifjFiF3F9fiFiFkifiFifjFiEk ifiE3fiE iFiElfifkiEiFlFiE�)FiEiflEiF3Ek3Eifi(•iEiE�FiFiFifiEiFK�iFiFiFifiFiElEltifiF�! LEGALIZATION;N E E . U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELE IC MECHANIC FIRE SMIP/RES GRADING PERMIT 162.00 SMIP/NON—RES PLAN 26.33 2,15 ISSUE�FEE BUILDING—DIV—> PERMIT TSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 164.15 0,00 26.33 190.48 190,98 ,00 RF.VENUE DIVTSION TO'tALS--> COLLECTED; 190,48 OVER/SHORT: ,00 ALDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK 162.00 2,15 26,33 �f if k3E �t iE �E if if 1F iP iF 3F If iF iF ik iF if if IF if IFiP if iF iE iF iF 1F IF iE 3F iE 3F 3E iE if iF iF iF iElE iFlf IF iF iE 3E iE IE iE iF if iF iF if If fE if �f iE iE 3E iElf iF iE if iE iE iE iF if iF �E �lE if iF 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 TOTAL COST SFC 143 FOUNDATION BY VA7.UE PER $100 100,00 14,300,00 END OF FEES �;: ai aac,�s7a-coU�,sia -; P+� �:,TE: lt�?7�un TI'r',c� OS:a . oi oao��sy�s-eco��sa�� -+ �1 M oArE: 11I27/4u TzliE' a3:�,- ic,..u� 1,5. . . CONSTRUCTION AND PLANNING .� ' POI. _.v SPA � � APPROVALS Permit # Date Inspectoi� qppROVALS Permit # Date Inspector 1. Temporary" Electrical Service or Pal�,. 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement . : "3:'4Electrical'.Conduit Utility-Undrgrnd:-' 54. Forms ' .�--4�Electrica4�ConduiYUndrgrnd. 55. Electrical Bonding �'5"Steel Reiriforcemen't „ 56. Rough Plumbing & Pressure Test ��:6: Electrical'UFER Grnd. t,- . 57. APPROVAL TO COVER-GUNITE ,; A:�7. Footings �` ��;,� `� 58. Electrical Conduit�Undrgrnd. • �; 8. F,oundation ;.. -� �1 59. Gas Pipe, � Undrgrnd.. Test � ?9. Water Pipe-Undrgrnd. . . , 60. Backwash Lines, P-Trap, O Undrgrnd. � T0. Structural Floor 6Ystem ' ,: � 61. APPROVAL TO DECK 1=1. Property Sewer.: Line & Houte Connection 62. Backwash & Receptor�Final 1'3. Sewer Cap �, ' , 63. Heater & Vent-Final 13. Roof Drains- 64. Plumbing System - Final 14. Rough Plum6ing -� ' 65. Etectrical-Final 15. Rough �Electrical-Conduit 66. Solar System-Final - 16. Rough.Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring,Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica�l-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rouc�h Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' ' ' - c' � . .. ;, : 20: �Rough Factory Fireplace ''%:'�' '�-� J �--- AppROVAL''S-'� Permit # � �i --r. .'r -. � c : ^ � -c- T �. - r.'i - - 21,� Ducts, in Stiucture. .. . '�� = . � .. � t 70. �Underground Hydro t 22. Ducts, Venfilating,A ' i�'� ! i� ? �' *�;77, produciP'rping C7Gas OOiI 23:�Gas�Pi e=Rou h&�Yest �i `-'" '�`" � � � � - ' = „ P _, � 9 �.. i,i � r, " : : � � 72. Underground Flusfi �r, . -. 24rRoof F�aming � ' � � � •� ��- � - '� ' � = 73?� Undergrrid. Storagg Tank°O Gas ❑ Oii - �r +.� ♦. ..� .. 25. Roof Sheathing,�7 � ; ' " �= �':� `- "7q=.Qverhead�Hydro� ��- � 26r_T-Bar Ceiling (St[uctural) &SMonocoat}� -- � ' ' ' 75.. Dry Chemical 1 - - ,-�� r - ' 27.^ Frame and Flashi,n'g 'll,_ ,µ `-L �. :y , '; 76. ��ry'Stand'pipe '�'' ', '� ` - -28. Lathing�&Siding»�� u� _.�r'� �.�.�� .+ �� ••y: 77? FIXEDSYSTEM�FINAL � _ �-i:: �-� ,.. ... �� : : �:t �.� ._ .� .. - "29. Insulation ��; , , '� - . ;�� ,�, -. 78' FIRE PREV. FINAL - _� � � � 30. Drywall�Naiting.n'4 c' + �- ;� �� ;+� HEALTHiDEPT. REQUIREMENT 31. Plaster�Brown Coi�. �. � _.,.. '' '� � �';�/, J9:�' FINAL INSPECTION „ =' " ' 32; Electrical Power�Meter-final �. - �� -. "-� i . �F�a ' 780:^.FOOD-GERTIFICYaTE ISSUED " " � - 33,' Final E�ctric �r:=: '`' fi �' � ��r.. � N ,�es:� .j= '� _ m ; ;�34.-,Final Heating&A�f Conditioning; : � '! - � '- ' �� % :!� ; f�! �35� Final Gas Pipe-Test� � -_ ; � �:i' �:i�;�; ' y;� '"_' • ' -. p �i . � 36.�Hood or CanoPY_-' 7 ,.,`c '..- !i"� � t �, rY�, . r - . � 3T�'Final Factory Fi�rePlacer ' �,` _ ' � j � � i ' - � " ' � 1 i E: ;y � - 38:.Final Plumbing �. � . i .. . - � L� � i (^ ., -- .i ��39.'WaferService'-Finel ' - � i ' • _ -� ; 40.'. Gas Service`F,inal � _ .� x .l � �. - �� _ . -v�r=-- �n. Li+.itiY� an ="41:'=Solar pomestio-Final - - � �-" � ' '�� = ' � _ r n i +42; Backflow Prevent�C ` �, ' � �; ' ' � � � _. 43. Backflow Irrigation - , r; ' " - �^'- ' _ ' ; S � � S, i'r . . s � t 44. �andscape lirigauon System ��•,,: -r �_ � ,�• _ - . _. ., `45: Sound Attenuati0n . � - :` �: �.' < ' � - " '" �_ <-; " . � > - - :r.� - . =-46.. Handicap R'egulations � --', "' � � � x , - :;` _� _ � � 47:.FINALSTRUCTURE&BUILDING � �^ - '��- • . , zc y . • , asi�: - � �I �: ;„ ;: : ` _ _ _•49 ,- Electric Release t0•Edison ;^� ,� r � ` % �_ �� I I ', ., '',50.-Gas_Release to Southem Califomia Gasi„Eo -� �;',� ' I�. ;. ' ; - . _ � � . - � • `51. CERTIFICATEOFOCCUPANCY tv , i:;� n i;.r. � �� :, No. Date JOB AI GENE6 I' �o. GAS E 55 WATER ROUGH PLUMBING PROP. $WR. LINE ❑ HOlISE SPRINKLING SYSTEM MISCE4LANEOUS ROIIGH HEATING ANO AIR CONDITIONING TEMPORAR� SERVICE OR POL UN�ERGRQUNO � POWER flOUGH WIRING TRENCHES � FORMS � FLOOR SYSTEM BUNO BEAM [] STEEL FE SHEATNING fRqME AND FLASHI LFTHING - IN V PLASTER,BROWN C (IJRAL, FINN Ht,.. iNG, VENT., R PWMBING, FINAL / ELECTqIC, FINAL BUIl01NG, FINNI Ai STEEL FIRE ZONE v�'� 4-28-76 BUILDING PERMIT N0. K Res w att. VALUE$ 39�0 0.0 SUBCONTRACTOR Z . aU z zF ON am J � J N Q W GI J • [t] J Q U N Z a W � aw WZ J Q m Z J � W W 0 = z� w� N � �O H Z Q U J a a Q � � y Z O H U � � F N z 4..1.85. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely su��o�N�3423 Pine Brook ADDRESS XkX�k Circle OWNER State-Wide Developers, Inc. MAII ,�.�. „ . .. TEL cirv Cypre55 No. BPANCH ADDRES ADDRES5 ADDFiES57401 urinaiay TEL. c�Tv Cvpress "� 826-45 �Ic No. 224710 LICVNO. oF �or 12,093 aCl'e5 NOWON LO S O USE OF EXISTING BLDG. SIZE OF NO.OF NEW BLOG. ROOMS STORIES EXTERIOR W�+LL a$ er ROOF COVERING Wnp(� COVERING Shake USE OF BUILDING AND WORK TO BE PERFORMED idence wlatt aar I hereby acknowletlge [hat I hava leatl thiz epplication antl smte that the eDova information Iz carrett antl aBree to comply wlth all laws ragulatinB builtlinp construction, nntl 1 shall not employ any person �n ��olation of the workman's compensation laws ot t�e Stata o� Celitornia. I hereby certify that I am properly Iicensetl as a contractor untler the Stam Of Californie Businasz entl Profeaslons Cotle, Div(sicn 3, Chapter 9, entl ihat suc� licanses ere in tufl force entl aftact, or 1 am exempi from the provlsions ot tha State of Cali ornia Business and ProfesSions Cotle, Division 3, Chaptar 9. State-Wide Develope,rs Inc. SiB^ature � Perm(ttee AuthorizadP.9ent Vice President w.�v i3-�r,`"-1°00 Gh2 ` 238.Z3 cn�� 'r f..�� APPLICATION FOR BUILDING PERMIT A.P. NO. '• • �—D$fJ--6I I _. �'7. I�.V� ADI R'ES�qZ3 �� 6� �vL�C TRACT �iSSE LOT BLOCK " I OWNER VALUE FIRE ZONE APPROVED NO.OF USE OF NEW / �j� PLANS � BUILDING RDS APPROVED VARDS APP ROM DISTANCE BET MAIN BLDGS. VAR. # QU.P. # APPROVED -�IOLD FO] THE AMOUNT 51 THE PUFiPOSE OF VALUATION �� BEf. MAIN & TOTAL � 0 FOR ' �LV: S ¢ N � .� m � o O LL