The URL can be used to link to this page

Home My WebLink About3422 PINE BROOK CIR - Building Permits(714) 754-5273 • Fax (774) 754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address Contractor. Address: ArchlEng: Address: CITY OF COSTA MESA �- BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 3422 PINE BROOK 93506087 NOCK,RON 11612 KNOTT ST GARDEN GROVE . CA PHILLIPS, ELIZABETH J %FORD, LINDA TR FOR HELEN LOS ANGELES,CA 64121VARENE NOCK PLUMBING 11612 KNOTT ST GARDEN GROVE . CA DISHVJASHER ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drein, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (7� outlets} Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Qil) Interceptors (Santl Auto ) AMT $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.75 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.06 $0.00 $0.00 $0.00 $0.00 50.00 nrv PLUMBING PERMIT Phone: 714 895-1246 Zip: 92&41 Phone: 2ip: 90068 Phone: 714 8951246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub I Washer $0.00 Landscape Irrigation $0.00 P-Trap . $0.00 Pressure Regulator � $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap tor Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial 50.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 Qn 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS PERMIT MBER � P99-00049 77 FAIR ORIVE, COSTA MESA, CA 92626 Status: ISSUED APPlied: 02I01/1999 Issued: 02/03/1999 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (ToileQ Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Senice Water Softener OTHER VIOIATION PLAN CHECK REINSPECTION - TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.75 arr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 BO days, . INSPECTIONS: In order tor Ihe work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failwe to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CqLL: (714) 7545626 WORKERS' COMPENSATON DECLAHATION: I here6y aHirm untler penalry of perjury one of lhe following deClaretions: ❑ I �ave antl will maintain a certificate of consent to self-Insure tor workers' compensation, es provided for by section 3700 of the Lebor Code, for Ihe pertortnence of the � �work tor which thi5 permit is issued. h,Y i have enA wlll maintain workers' compensation insu2nce, es required by seclion 3700 oi the LeDor Catle, for Ne pedormance of the work br which this permit is issued. My workers' compensation Insurance carrler end policy number are: � f ' ` Carrier: ,�fJ � ��'/ � Policy Number. �IJ�C�'� � 3 �" �O � ❑ I certily lhel In ihe peAormance oi the work for which Ihis permit is issued, I shall not employ eny person In eny manner so as to become suh�ect lo Ihe workers' compensetlon lews ot Californie, end agree ihet If I should bacome su�juct to the workers' compensetion provislons oi Section 3700 of the Le6or Code, I shell torthwlth comply with the5e provision �7 �j Applican� Signe�ure: ��— ( � De�e: —Z � �— L � WARNWG FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHP1L SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNORED THOUSANO DOLLARE (5100,000). IN ADOITION TO THE COST OF COAIPENSATIIXJ, �AMNGES AS PROVIDED FOP IN SECiIIXJ 3lOB OF THE LABOR COOE, INTEREST, ANO ATiORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn thet I em licensetl untlelprn�4sions t Ch��tar 8(commencing with Section 7000) al Divisian 3 at the Business end Professiur,s Cotle, entl my Iicense is in tull rorce anC eNea. Lic. a % V /"7 � 5 aass a n,3C ContreciofsSigneWre: �� Data: 'L— 4— �- `! � CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirtn ihet Ihere is a consWction lentling agency tor the pedortnance of the work for which this permit is issuetl. (Sec. 3097, Civll Cotle). Lendefs Name: Lender's Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penalry of par�ury that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW tor Ihe lollowing reason (Sec. 7031.5, eusiness and Professions Cotle: Any ciry or counTy which requires e permit to consWct, elter, improve, demolish, or repelr any stmcNre, pdor to Its Issuance, also requires Ihe appliceN tor such permit m file a signetl staremam that he or she is licensed pursuent Io t�e provisions ot the Cantractors License Lew (C�epter 9(commencing with Sectlon 7000) of Division 3 of the Business and Pmfessions Cotle) or Ihat �e or she is axempt Iherelrom and the basis for Ihe alleged exemption. Any violetion of Section 7031.5 by any eppliwnt lor e pertnit subjecffi the applicant to e civd penalry of nm more than fve hundred dollars ($500).): ❑ I, es owner ai the property, or my employees wilh wapes as their sole compensation, WILL DO THE WORK, end lhe siructure is not Intended or oMeretl for sale (Sec. 70a4, Business end Professions Code: The Contractars License Lew daes not appty lo en awner at properry who builds or impraves thereon, entl who tloes such wark himsetl or hereelf or through his or her own employees, proviAed that such Improvements ere not intentletl ar offerea Far sale. If, �owever, the bulleing or ImOrovement is sold within one year of completion, Ihe owner-builder will have ihe burden ot proving ihat he or she did not build or improve for purposa ot sale.). ❑ I, es owner ol t�e property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business end Professions Code: The conirectors License Lew does not epply to en owner ol property who builds or Improves thereon, end who contracis for such project with e contracior(s) license pursuent to ihe Contractors License Laws.). ❑ I am exempt untler sec. Signature: Owner ID verilied by driver's license. ❑ Yes ❑ No Business and Professions Code tor ihis reason: Verifice�ion oi Ownershlp by (type of document, i.e. - propeny tex blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Driver's License No. Date: Ezpires: ❑ I hareby certlty Ihat no excavation tive (5) or more feet in tlepth into which e person is required to descend, wlll be made in connectlon with work eut�orizeC 6y this pertnit, and ihat no building siructure, scattoltling, lelsework, or tlemolition or tlismantling Ihereot, will be more Ihen thirty-six (36) feet high. (Chep. 3.2, Grp 2, An 2, Sec. 341, Title 8, Celifomie Administrative Catla). ❑ As owner�builtler, I will not employ anyone to do work which would require a pertnit from ihe Dlvision of Industriel Selery, as noted above, unless such person has a pertnit ta do such wark trom the division. Signature: Date: Division ot Industdel Satery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AIITHORIZATION OF ENTRY: I certify untler penalry of perjury Ihet I heve reed this application and state Ihe� the information given is correct. I agree to comply with all state laws and ciry ordinences relating to building constmction, end euthorize representatives of the Clry of Costa Mesa to enter upon the ebove-Cescnbed property for inspection purposes. I egree not to occupy or allow occupancy of eny builtling authorized by this permit until tinal inspeciion. Signa W re Ot Legal Owner(s) Dete ��Z � Z— 5L — 5 � And/Or Authonzed Applicent Date COUE �. IHSPEC110NTYVE 1676 Fixed System Finel Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 207 Final BIocWRetaining Wall 202 203 204 2446 d6 Finel Fectary Fire Place Final Sign Finel Demolition UdIE It1�A65 CODEY INSPECTONTYPE 206 Final Mechanical 20B Final Plumbing 210 Finel Electdcal 272 Finel Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupan� CAiE It�ELS PXOJECTR�ONE55: jQZ� PINE BR�OK UNIT: OWNEB'SNRME: VILLAGE CREEK HOMEOWNERS nooness: ASSOCIATION 3429 TIMBER LAKE CM VA 92626 AflCHIENGINEEH: ('HESTER CARVILLE AEc."o.: C18305 aooeess: 7g2� pgMOUR ST u"�T S,D. CA 92111 PEflMITTEE: PAOENIX ENTERPRISES INC. ( 213 ) 690-9559 nooness: q11 COMERCIAL WAY LA HABRA CA 90631 UCENSED CONTBACTOP UECLABATION: I herebY afiirm �hat I am licensetl pm ' ans o� ChaD�er 9(m cing with Sedion 7000) ol Oivision 3 oi ihe BusinesS ana Pmfessions Code, anG my licen s i ull e and eHect. ciTruc.: 50 S s e ic.:376639 / Oa�e: � Signaiure: _ —� . — WORNEB$'COMPENSAT NOECLpp TION: IhereUyaflirm Ihaveacetli eotconsen�tosell-in5ureoracetli leafWorkers' . ComDensation a c c nilied copy therenf (Section 38W. LaD. Po,��„o.: t�`�85�� E%P.DpTE: %IOS I9S COMPANY: CA COMP 6 FIRE � Ceniliea cop(yys) here� �umis tl❑ Certilietl copY is IileU wi .� B' g Orv�/ry�n. �� /� r--- / 1� Oate: _I.—� �"�� Npplicant�. � (- � / IEXEMPTIONFflOMWOXNEHS'COMPpNSPilONOECNPBTION: (Thi55ectionneeAnatbewmplete4i��heDermAis�oronehunOretl($1W�orle55). I certify Ihaf in the peAormance of �he work br wAah Inis permit is issued I shall not employ any per6on in enV manner so as to become sublecl �o Ihe Workers' Compensdiian Laws o� Califomia. �a�e: SignaWre'. NOTICE: IL a�ter making Ihis tledaralion, you shoultl �ecome subject to the Workers' Compensa�ion pmvisions oi �he LaDor CoOe. you must fo�hwi�h campty wilh such Omvisions ar Ihis permit shall he Oeemed revoked. CONSTflUCTION LENDING pGENCY: I here0y a�hrm tha� Ihere is a cons�mction lending agency lor Ihe Oe�ormance o� Ihe work for whic� Ihis permit i5 issuee (Sec�iUn 3W7. Civ. C�. LENDEN: aooxess: OwNEB BUILOEB oECLAHATION: I here�y aHirm Ihat I am exempt imm ihe Contracmrs' Staie License Law for ihe lollowing reason (Section 7031.5 Business antl Professional Code: Any cily ol coun�y whic� requires a permi� to con9mcl, al�er, impmve, tlemolis�, or repair any slmdure. prior to its issuance. also requires Ihe apDlican� �ar such permit �o �ile a signe0 s�a�emenl Ihal helshe is licensed pursuam to Ihe pmvisions ot the Cpniraclors' S�ate License Law (ChaD�e� 9(�ommencing wi�h Section 7000) ol 0ivision 3 of the Business aoa Pmfessions Cotle) or ��a� �e/;h¢ is �empi �here�mm an0 Ihe basis lor ��e allegetl exemD�lon. Nny viola�ion oi $ec�ion 7031.5 by any aOPlicant lor a permi� subleds Ihe applicam m a civil penalry of no� more than �ive hunOred tlollars �8500�. I, as awner oi ihe pmpetly or my employees wilh wages as �heir sole camDenSalion, will do Ihe work, and [he 7 s�mcWre is no� inlen0etl or o��eretl for sale (Section 7044, 9usiness anU Professional Code: The Conirac�ors' Sta�e License Law does not appry �a an own@� o� a pmperty who builtls or impwves thereon, an0 w�o tloes such work �imsel�/herself or �hroug� his or her own emDloyeeS, proviaetl ��at such improvemen�s are not intended or ofiered for sale. II, �owever �he Ouiltling or impmvemen� is soltl within one year of compleiion, Ihe owner will have �he burden of pmving helshe ditl not build or impmve lor Ihe Durpose o� sale). I, as owner ol the properlY. am exclusively conVacling wi�h lic¢nsetl conVdc�ars �o constmc� ihe pmlecl (Secfion 7044, Business ❑ antl Pwlesvons CoOe: The Coniracmrs' State License Law does not appty lo an owner of Oropeny wla huilds ar impmves Iherean an0 v�ho canlracis �or suCh pwlects wilh a conVactor(5) license pursuani to the ConVaciors S�ate License Lawl. i am aware , Ihal Omo� o� their Warker�s Compensation insurance shoultl be pmviAed to me. I� I am exempl under SectiOn: B. 8 P. C. br Ihis reason'. Date: Owner I tla hereby cenify Ihal I am aware o� and unaerslana �he requiremen�s of Cali�omia,Healih and Sa�ery Code Sec�ions 25505, 25533, antl 2553a ana I�at I or any �Wure �uilding occupant willlwill no� (circle one) neetl to compty wi�h said slaie cotles and �he requiremems �or a permit for conslmclion ar motli�ica�ion iwm the Air Oualiiy Management DislricL Residen�ial cons�mction applications are exempt imm ihese pmvisions. �aie: _ ADPlicanc I hereby cer�ily Ihal I have read Ihis applicalion and Sla�e Ihal Ihe a�o � m ma�tieon' correcL I agree �a � with all ciry and counry ordinances antl Slalelawsrelalingio builtling con5imc�ion an0 hereby�i �ep ta�ives ofthis ciry r Pon��e a�ove-menlionetl pmpetly for inspec�ion purpore� /Il0 � V �`i , Oale: _ �r�_— Signalure: - �river'SLicenSeorSocial5ecurilyq: 16C646 White—Bmltlmg'. Grebn—Code EnforcemenL Canary—AppbcanC Pmk—Revenue: Goltlenrod—Assessor CITY OF COSTA MESA — BUILDING PEAMIT PERM NO; H 05052 PERMIT iJO: B 050528 PLAN CHECK NO: 00160-91 A GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PiJRPOSE: REP JOB DESCRIPTION ; REPAIR SETTLEMEN'P DAMAGE SQ FT: 143 CLAIM VALUE: 19,300.00 CALC—VALUE: 14,300.00 GROUP OCC: R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION ****x*xx��eKx***�r***x�*�rt*ux�**x*�******�e*�******+�*�x�*x*x*�tF**�*r��*��******r�*� 'L O N I N G R E Q U I R E M E N T S saraAcxs ------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN LEFT; FT IN RGIiT: FT IN LEFT: FT IN RGHT; FT IN PARKING REO• PROV; PARCEL: 93506124 ZNE: R2 REF NO; �PLANNING NtSTES> FOUNDATION REPAIR. 7 �E iE iF !f 3E jE iF 3F 3E % lE iE iE 3f if iE if !E iE iE iF ib i! if 1E 3F iFiE iE �F �f iE jE �f iE dE iE iF iF if iF if 3F �1F iE iF iF iE iE 3E if if iE 1E if �E if iE iE If 1E iE lE 3E if iE 3E �iE iE.iF IE !b ik iE �1F �t 3F 1F jf D E V E L O P M E N T S E A V I C E S R E Q U I R E M E N,'T S ZONING APPROVED HY �..r7 li� �� DATE: �; "I I.S � 1 BUILDING APPROVED BY : Li 1 L CJ G�.c� DATE: APPLICATION SSSUED $Y: — — DATE• ' ikiEiE�IEiF�EiFiE�fif�flE�lEiEiEIEiEiEiF1E1Eik r iEiFlfIFlEjtif�E3EiF iEif 1E�FifiF3EaEik%iE3F�3F1E*3Fi6iFiE3FiElE3f3fiFitiEiF3FiFif3E1E F�EifiEif 3FiFfEiE*ffiflFiEltiF�EiFiEiF3EiflEiEiE1EjF1Eik3FiEiE3E-IEjF'iE3fifififiEiEiE3EaE LEGALIZATION:N F E E U M M A R Y STRUCTUR.�L'SEGMENT;Y BLDG PMT PLUMBING ELE RIC MECHANIC FIRE SMIP/RES GRADING PERMIT 162.00 1,00 SMIP/NON—RES PLAN 26,33 ISSUE FEE BUILDING—DIV—> FERMIT ISSUE PLAN—CHECK TOTAL FAID DUE TOTALS----> 163.00 0.00 26.33 189.33 189,3J .00 REVENUE DIVISION TOTALS--> COLLECTED: 189.33 OVEk/SAORT; ,00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 162.00 1.00 26,33 iE �lk 1f * 3F dE 3f iF iF if IF ib If iE jE if iE 3E 3E iE iE 1f iE aF iE if 3E iE if if 1E iE 1E �E jF �E 3E iE 1E IE IF iE �E if if iF if if #E iE IF 3f if if iE if IF if iF iF iF iE iF iE iF aE iElf 3F IF 3f iE if iE 3E iE 1E iF iE 2 N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 193 STRUCTURAL HY VALUE PER 5100.00 100.00 14,300.00 END OF P£ES flii0;81,a$-I�UO]�h6�3 T'4�1ir 15? ;� �lE: 01/:t.i/91 TIY£: i�:�2 CONSTRUCTION AND PLANNING � �L & SPA APPROVALS Permit # Date Inspector p�pPqOVALS Permit # Date Inspector i 7. TemOorary Electrical Service or Pole � f 52. Pool & Equipment Location � p, Soil Pipe-Undrgrnd. %� �� 53. Steel Reinforcement �� T 3. Elec[rical Conduit Utility�Undrgrnd. -, -! 54. Forms � 4.�Electrical Conduit-Undrgmd�= � y� 55. Electrical Bonding �-' 5. �Steel Reinforcemen[- 56. Rough Plumbing & Pressure Test � r 6._�IectricalOFER�Grnd. . - 57. APPROVAL7000VER�GUNITE 7. Footings - " � 58. Electrical ConduibUndrgrnd. , B. F.oundation" ' 59. Gas Pipe, � U�drgrnd., Test ��' i 9. Water Pipe-Undrgrnd. . �•' �^ 60, Backwash Lines, P-Trap, O Undrgrnd. ;�•, r , �„ 10. Structural Floor System �� . ��y;c 61. APPROVALTO DECK _ -'� 11, Property SewerLine-&' f use Connectio� •" 62. Backwash & Receptor-Final 1'2. Sewer Cap K r. � ",� ` � :, 63. Heater & Vent-Final 13. Foof Drains ' i� '' �� " 64. Plumbing System - Final ` 14. Rou h Plumbin � � " � � 9 9 �� 65. Electrical-Final ;• 15. Flough Electrical-Conduii �" .� 4,`, 66. Solar SYstem-Final i.,�'� � 16. Rouqh Electric Wiring ! �' '� � �1'n 67. Fencing & Access Approval �- 17. Rough Wiring Sign .� ,� 68. APPROVED FOR PLASTERING '� 18. Ftough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rou9h Heating & Air Conditioning I' � FIRE DEPT. REQUIREMENT 20.�Rough F,actory Fireplace � - � �APPROVALS � Permit # 21. DuCts, in Structure. � • Y�_70, Underground HYdro . 22. Ducts, Ventilating � �, -71. ProductPiping �Gas ❑Oil 23. �Gas Pipe'-Rough & Test , 72. Underground Flush �, � 24. Roof Framing � - � - - 73. Undergrnd.Smrage�Tank OGas ❑Oil • 25. Roof Sheathing � ' ' � '' �` � 7q, Overhead�Hydro� � 26. 7�Bar Ceiling (Structuraq &�Monocoat' _ � 75. Dry Chemical �� 27. Frame and Flashing - ' �, 76. D'rY Sfandpipe ' � � ' 28. 4athing & Siding •. � � 77. FIXED SYSTEM FINAL- 29. Insulation � � � 78. FIRE PFEV. FINAL � 30. Drywall Nailing � � I � , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � _ ( � '' 79.'FINAL INSP,ECTION , � -32. Electrical Power Meter�Final � , I �- 80. FOOD CERTIFICATE ISSUED . 33.`Final Electric ' � � � i � � Notes: �, ' 34. Final Heating & Air Conditioning - � j _ � . . � i � 35.:Final Gas Pipe-Test, � I ,! ' �- ' i 36. Nood or'Canopy �� > i � � . . � 37. Final Factory Pireplace , � ' '� I (, - �, � i �38. Final Plumbing . � � �• . - � :-39: Water Service-Final _ � � �' ' �- ' 40.,Gas Service-Final . ' I i ' 41. Solar pomesticFinal � � � �' � ` � t_ . ' 42.'Backflow Preventer, ,` � � � ' � . 43. Backflow Irregation � � � ' - � 44, l.a�dscape Irripation SYstem � , � . , .. � , � 45. Sound Atterivation • ` - 46. Handicap Regulations ' � ., . 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING i j :�. . 49.� Electric Release to Edison I � { • 50. Gas Release to Southern California Gas Co � I j_ .� � � _ � 51. CERTIFICATE OF,OCCUPANCY , , �. . No. Date JOB ADDRESS � �.I4b=054-tlI""LOT I1, ECTIONS 50 ROUGH PLUMBING PROP. SWF. LINE � MOUSE CON. MISCELLANEOUS ROUGH HEATING AN� AIR CONOITIONING tINOERGR011N� Lf POW�R Lf ROVGH WiRING TRENCHES � FORMS STEEL FEINF. FLOOR SYSTEM SHEATHING FRAME ANO FLFSHING LATHING - IN L OU PV�TER, BFOWN COAT 5 LURAL, FINAL HE..� ING, VENT., REFRIG. PLUMBING, FINAL r1N0 GP ELECTRIC, FINFL BUILDING, FINAL BUILDING PE SUBCONTRACTOR Z . aU �- Z Z Q O v~i am J � J N Q W p� J - p] J a U N 2a w� aw W Z J Q m Z J � W w O= Z F- W � N � �O ` 4.1.863 CO OTBoxEtioo Ucos�r�a m SA�CALI ORNAIA 9 626 T hAY � 3"?C�r=-uOO �I� LI%t *'� ;t i APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVEDBV DATERECENED D'y�TE S�9 U D ADDRESS 3422 Pine Brook �^� �J� ¢ _�//_U/( OL PE I OWNER State-Wide Developers, Inc. p`�P�N�• 'G —O� ��g ' ADDRE55 9461 Grindlay �+ODRE S�Z2 {'n2�'pa� CITV C ress No�$26-4550 TRACT ��o LOT BLOCK CONSTRUCTION W AD P LENDER X BRANCH /�� OWNER� (.{/jV� ADDRESS VALUE E1p��j�IT�EC�T� TEL SE $ 8 NO. — � FIFE nooaess 17848 $k PdPk B1Vd Irvine ZONE TVPE GROUP APPROVED CONTRACTOR SCate-W�de DEVe�O e�'$ Inc. BY DATE AODRESS 9461 Grindla TEL. ZONE NO.OF USE OF NEW/j,�, W CITV C ress N�826-455Q �2' Gp P�� Z BUILDING STATE CITV �'ARDSAPPROVED VAFDSAPPROVE LIC. NO. 224�� O LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT � 2.093 acres NOW ON LOT � FRONT FT. FT. VSE OF EXI5TING BLDG. E FT. FT SI2E OF NO. OF NEWBLDG. FOOMS STOFIES L S�DE FT. FT. EXTERIOR WALL as er ROOF Shake REAR FT. FT. COVERWG COVERING USE OF eUILDING AND WOFK TO BE PERFOFMED DISTANCE BET. BET. MAIN & MAIN BLOGS. ACCESS, BLOGS. New Construction-Condominiums CURP# � APPROVED —� 1 Residence w/att gar �ROVED � 2_ �-IOLD FOR S. C:A RGQUIP<EI:F�' S I hereby acknOwledpe ffiet I heve reatl ffiis epplication and staie 1 that the above information is carrect antl aBree to comply with ell laws r8g�laUng builtling consbuction, antl I shall not amploy any pe�son in vialation ot the workman'S compensation laws of the State of California. o I hereby certify Mat I am properly licensatl as a contractor untlar ��oo SQ. FT. J-645 the State of Calitornia Businesa end Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR Chapter 9, antl that such licenses ara in f�ll torca antl ettect, or I THE PURPOSE OF ESTABLISHING A VERMR FEE ONLV: am exempt from the provisions of the State of Celiforn' Businass VALUATION - I' antl Protessi s C de, �v� ion Cha ter 9. ';�� PERMIT FEE $ � (T/ �ia�e-l�ide Deve9opers , p s�e�e��.a o � Permittee $ PLAN CHECK $ � nutnorizetlABenc Vice President TOTAL FEE $ 38.23