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Home My WebLink About3112 PIERCE AVE - Building Permits(714) 754-5273 ' F2% (714� 754-4856 • www.ci.costa-mesa.c��LDING PERMIT �� FAIH UHIVt, GUS IA MtSA, l:A BYtiZti- JobAddress:� 3112 PIERCE AV Suite: Vicinity: Parcel Number: 14165204 npp�icant: CROWELL, LEO Address: Owner: Address ,, $o.00 $139.25 ` $0.66 ; $0.00 'i$0.00 \$0.00 ACCESSORY PARKING NOTES: f� Zoning: R1 R1 .�.- ..-_ _i � � � ��t"� � Zip:< f � � � 1 � i Il y \ 1 l.� �_ �_- UL i,� .'_..---� � �-%;�=�c�o��:�` ��=r-P.hone:' -- � ti: � � �'�! Zip: 92807 � .� Phone��714-939-9779 i l� i ��License��777257 � Ji•�'^,.\ eo ��!,�V • ,,1.;.y ly�-.. ddE me �� "�` ` --- ise: ----=SCOPE=OFPERP `WIUH2�E�R�COMP�� 1 -3 . rf ,-J�frf�4�l /C �iJ O �f s N�f( �'. � ° � � „ o �D o ° ^ ��PLANNING`& Status: ISSUED • Applied: 11/O6/2000 Issued: 11/O6/2000 ISSUED BY: .1 AY _�J , r �._._Calc Valuation: _�-Claim Valuation: \\<y� /)� U4 -LVIYIIYV =�� O p vryn c � `�� -�� C� o°o° �d 1 ° ao o�� d 0 0 � o° ci �ReYR\ r`�� (Left� ; 0-O�ight 0-0 �/�`; � � �-°�--�--,�= � n ��"�� \,'"J��J�%``��_-----"---.Ceft�'_0=0 Right ,0-0 D �Requ� \UV � �ired: �0 ��P_ropo es d� C.-0� ..� 1) _' � J � � � �U\�,�_�-�� rJ'�D � C U :} I O 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) ' EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned , for a'period of 1 BO days. � ' ' _ _-, - ,. . „ , I, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all � required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. � FOR INSPECTIONS CALL: (714) 7545626 � � 2446-4fi(6/00) . . WORKERS' COMPENSATION DECLARATION: , t ' ' I hereby aflirm under penalty/' perju�yene of the tollowing declara�ions: .. ' � ��► ❑ I heve end will maintain e certificate of consent to selFlnsure for workers' compensation, es providetl for by section 3700 of the Labor Code, tor the pertormance of tha work for which Ihis permit is issuetl. ❑ I have antl will maintain workers' compensation insurance as required by section 3700 of tha Labor Code, for the perfortnance of the work for which Ihis pertnit is issued. My workers' compensatlon Insurance carrier and poli �iumber are: � Carrier. � n�,[-.7� (//W�� PolicyNumber: his se ion need no( be comp e�ed i! fi(e permit is valued at one hundred dollars ($100) or /ess. J I certify that in the peAormance of the work for which this permit is issue0, I shall not employ eny person in eny manner so as to become subject to iha workers' compensation laws of Celifornia, antl agrea that it l shoultl become su6ject to the workers' compensatlon provisions of Section 37 oi the bor Code, I shall totlhwith comply with ihe58 prov,i5�ion�s. � .,/ / -ApplicenPSigneture:� � ✓� y �-""�'L4�'J Date: �` �f/ � �-�' ��WARNING FAILURE TO SECURE WORKEflS' COMPENSATION COVERAGE IS UNLAWFUL M1D SMRLL SUBJECT AN EMPLOVER TO CRIMINNL P NALTIES D CIVIL FWES UP TOONE HUNDRED THIXISANO DOLLARE (E10p,000). IN ADDITIqJ TO THE COST OF COMPENSATION, DAMhGES AS PROVIDED FOR IN SECTION 31W OF THE LABOR �DE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: t I here6y aHirm that I am licensed under provistatfS�ot�Chapte om cing with Section 7000) of Division 3 of ihe Business antl Professions Code, and my license is in full torce end eHect Lic. a �� i c�ass x C� ontractor;s.5ignalure: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aNirm ihat ihere is a constmction lending agency tor ihe peAormance of Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Adtlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby effirm ihat under penalty of perjury ihat I am EXEMPT FROM 7HE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any city or counry which requires a permit to consimcl, alter, improve, demolish, or repair any strucNre, pnor to its issuance, also requires t�e applicant for such permit to file e signetl stetement that he or she is licensed pursuant to the provisions of the Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that ha or she is ezempt iherefrom antl the basis for tha allege0 anemption. Any violation of Section 7031.5 by any applicant for a permit suhjects tha applicaN to a civil penalry of not more than five hundretl dollars ($500).): ❑ I, as owner of Iha property, or my employees with wages as their sole compensation, WILL DO THE WORK, entl ihe strucWre is not intentled or ottered lor sale (Sec. 7044, Business and Professions Coae: The Contractors License Law does noi apply to an owner of properry who builds or improves thereon, antl who tloes such work himselt or herself or Ihrough his or her own employees, provided ihat such improvements are not intended or ottered for sale. I(, howevar, the builtling or improvemem is sold within one year of completion, the ownerbuilder will have ihe burden of proving Ihat ha or she tlid not build or improve for purpose ot sale.). ❑ I, as owner of lhe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contrectors License Law does not apply to an owner of property w�o builtls or impmves thereon, and who coniracis for such project with a contractor(s) license pursuant to �he Con�rectors License Laws.). ❑ I am exemp� under sec. Business and ProfeSsionS Code lor �his reason: Signature: Data: Ownar ID veritietl by tlnver's license. ❑ Ves ❑ No Driver's License No. Ezpires: Verificetian ot Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ' ❑ I hereby certity ihet no excavation five (5) or more feet in depth into which a person is required to descand, will be made in connection wi�h work authonzetl by this parmit, and ihat no building s�mcWre, scattolding, falsework, or tlemolition or tlismantling Ihereof, will be more ihan ihitly-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title e, California Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permil irom ihe Division of Indusirial Safery, as notetl a6ove, unless such person hes e permit to do such work Irom Ihe division. Signature: Division of Industrial Setety Permit Number: Date: CERTIFICA7E OF COMPLIANCE AND AU7TiOHIZATON OF ENTAY: I cenity under penalty of perjury ihat I have read this application and state Ihat the information given is correct. I agree �o comply with all state laws and ciry ordinances relating to building consiruction, antl authorize representa�ives of �he Ciry ot Cos�a Mesa to enter upon the above-descnbed proDerry for inspection purposes. I agree not to wcupY or allow occupancy of any building authonzed by this permit until final inspection. COOE �, INSPECTIONTYPE 161fi Fixetl System Final Fi�e Prevenlion 1266 PoolSpe Final 200 Final Re-Roof 201 � Finel BbcWRataining Wall 202 Final Fac�ory Fire Place 203 204 Final Sign Finai Demoli�ion ➢� IMRI�LS 1/-ZZ � � / � � / q�� Date -��' UUDate CO�E I INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 �Final Planning Approval 222 Final Site �F � �� iPBOJECTR00flE5S: 311Z PIERCE AV � ' � � � uNi?:� �- ' , ' ' ' � - �- •--� - 1" � CITY OF COSTA�MESA - BUIliDING PERMIT �� PERM NO; B . 04y8�7 : ' OWNEWS NPME: HARTON;: ROBERT W �� ' , � - ' • ' - � � � � � ' ' • ' ' ' . . . • • ' - � `' -: ' .' 1 .' � ' � ' I ' = aooeess: BARTON ' THERESA M. �.' �, :� '� PERMIT NO: B 049877 ' ' PLAN CHECK` NO; 06669=90 �S' G(� T;' ;� P; C ':1'121- CbRONA LN : � ' - - ' � ' ': . ' . � , • ' ' COSTA MESA, CA • 92626 � � , ; � CONSTRUCTION T'YPE: _ � • � � �- � PEIiMIT TYPE:� .STR , , ' � . � - ' ' FUk[�QSE: ALT �� .�97.9-9530, . ! , , . � . _ _ �: � • • , ��I�7CH/ENGINEEfl: � _ . ' BEGNO: r � JOB' DESCR2PTION�' : •INSTALL- lOLF-WALL Td CREATE;'A �L'IBRARY� • � � �SQ.FT�;'• � -900�� F)�;. nooness:. • . � , uNir: ' ' t � ' � ., � , � ; • .., T .. . . ' CLAIM VALUE: 900,00 CALC-VALUE: •'•900,UU GROUP OCC': R-3' / ��( _PEflMITTEE.-QUALITY SERVICE �SYSTEMS ('714.)897-2223� - - - �:: : •� � �� . t � -.� , �. , � � - , - . ' • '' ' � FODflESSC I2781 ,WESTERN AV �� .y : S . " COMMENTS:' NO 'OTHER -S'PRQCTURAL. WORK PERMITTED � � �� •, ' � r � � � � � ;. -G.;G: ' � . CA 92641 � : i . �*�**�***��r�*�**�*x��r�r��r�***�r*�***�r*�r**�*x*�r*��***�r**�*****�e�r*******�****�r�r . :; ` ; ; , , LICENSEU GONTFAGTOR OECIAflATION: I hereGy attirm Iha� I lice seC unde Om'visions apier 9(commencing wilh SecUon °` � � ' �' Z 0 N N G F B� U E M E N�T J� - ' � �` � 7000) o� �rv��sian 3 oi �he Busin¢55 antl Pmfessions CoOe an� my 6c se is'i I �arce efiecl. �• ' , - .,.. , . n �� , . , �, S.RT� A C IKRS i � ' �. I CITYLIC:OQ �4 s,n.euc.� 35934 c sH . � �_ � • ' ',: ' . , . ' i � � , � :. � ' � �i� � ' . �(�u� A/ -' ; ` � f --:-------- MAIN!BUILDING ---------- —=----�-- ACCESSORY BUILDING -- � oaie: si9nawre ' FT IN REAR:' . � �FT IN ' F}2NT: � F'f ' -IN REAR: F'P IN � FRNT�: WOPKEP$'CO P SRTiONUECLPAni�ON: �hereby tlirm� havi certi�icateo�conseni,�ore�binsureoracenifica�eo�Workers' LEF�P; , � FT ' IN RGHT: � FT - �II� ; LEFT�: � • FT ' Ir) 'FZGHT:� '- F'T� IN � r ComPen5a0on k apco p( d c�tlifiM WPY thereol ec�ion 0. EI.� � O 1 � 9 1 . � � • , . . , � , � r . � . . , . � , , , � . POLICY NO.: V L V Y 7 V E E: V , . �ameaxr: STATE � . , PARKING REQ• ' � PROV:: PARCEL• 14165204 ZNE: R1 ' REF NO: , PL%1NNING NOTES> ADDING WALL'TO'ENCLOSE AN EXISTING LIBRARY IN A�SFR. � �� E � Cetlilietl opy hereby Wmi5he0; Certitie0 cop is liled ilh the y ' mg Division. � . ( . -, , , ' � - -+ - � - - t-->,.WORK..AliL- INTERIOR-IN-NATURE, � - - , i/, �_.; - , ***��r*+�**�r�r�*�r******��r**��r*********+�******�r�**��r�r+�**+��**x*x�r�**�*+�*i��r*�*+r*�* � � Dale � � Npplican � I , ; ; � D E� V E L O�P' M E N.-%T S E R V I• C� E S R E� Q�U I R E' M E N=T S �� E7(EMPTIONF M OPI(EBS'COMPENSPTIONDECLAHR ON: (T�i ecoonneednoibecampletetlilthepermJtisioroneAunAreO(5100�oiles J � , .'�. �'7. ' , , � ,; i . ; � I cenify ihat in Ihe etlormance af the work lor w�ich his permi s issueA, I s�all not employ any person in any manner so as to become ' t j � • 1 ' ' , subiec� io �he workers Comuensa�ion �aws o� Cali mia. ' ' . � � _; ZO%1 TNG APPROV�D BY �;..,� � � �.�'_ ' � i ' D.�"1'$ • � �i � �� , � . ..a � � . ` •..o.. . . ; i' . • `ozte. `" -. si9naw�e: � ' . . -' "` �'.. - BUILDING APPROVED 'BY • } � � . - - � - '.. t - DATE -�� ' NOTICE: II. atter making this declaration, you shaul0 become subject to Ihe Worker5' ComDensation pmvisions of �ne La�or � . r•' �r. ,, , � � Cotle. �yau musi lorthwi�h comply,wi�h such pmvisions o� �his permi� shall be deemeA revoke0. n � , • � , � ' .. - - c . . CONSTPUCTION LENOING RGENCV: I hereby a��irm Iha� Ihere is a ConS[mt�ion lentling aqenty lor �he pedormanCe OLthe work fOr' AppI+IC�iTI�N ISSUEn BY •' � � DATE :,\ �( !i� � ' • whichlhispermitisissuetllSeclion3097,Civ.C1. � '. . � � �'*****�*'**��'*'*x'�'K'*�'�'K'�'* 'K'�'�1f'�3('�("M'�l'i('%M'7FiFii��iRi! �' 'LENDEN: � . . � � iE1Fif,iFlklEiE�FiflfifiEif�ifiF�f�E�kjE�FlfiE�E�f�flflklElFlFlEififiEifiFiEifiFlf'1E�E�tiEitiFiE�flEjEif9f3E1Fif1EjE3Ekififlfif3kik�iElFlEiFifiFiFif�fifi{iFiFi! � '"aooness: ' - '� ` ' - � ' ' '' LfiGALTZATION:N' `-' � F E"E � S'U M'.M"A"R Y' ' STRUCTURAL'SEGMENT:Y ' i �.� + .'.,,•, . .� •�; . ,;�.,. ;�. � .. <i � ..,� , � , � " � � � � '' �� HLDGIPMT PLUMBING ELECTRIC ,MECHANIC FIRE SMIP/RES , GRP.DING OWNEB BUILOEB'�ECLNBATION: I hereby aHirm ihat I am exempt iwm the Coniracmrs; State,llcense Law br �he followinA reason' , _ . . . (Sec�ion 703L5 Business antl Professional Coee:; Fny ciry ot counry which reQuires a permit Io cons�mcl, alte�; impmve, tlemolish, ar � iE�i"� 1 T � `2 3.'0 0-• �_ ��. ! . . 5 0 � repair any stmclure. prior �o i�s issuance, also reQuires ��e applican� lor such permi� �o file a sfgnetl�s�atement Ihat he/she is Iicense0 � ' '�' ' ' � �" � ^` � � ' . : . ' �� 'SMIP'/NON-RES pursuam m Ihe pmvisions ol lhe Coniracmrs' State License Law (Chap�er 9(commencing wi�h Section 7000) of �ivision 3 0l �he Business �,; �1LAN • � 1 9.,,9 5' ' � � -�'• ' ' � , antl PiUle55ions Cotl¢) ar I�al �e/she is exem I(here�mm and Ihe ba5is �or Ihe dlle e0 exem �ion Nny violation o� SeCtion 7031.5 6 '' � _ , . '. ; � � 1 ' � i . ' ' , .� _ any applicant lor a permi� sublecl5 ihe applicant �o a civil penalry'o��not more Ihan�five huntlBd dollars ($500). � � l,� Y ISSt�E � FEE' ,_ ' . �' , .� �' > -�- . � , _ _ , _-= - v _ . . �.. : , , _ ' HUILDING-DIV > � �PERMPT ISSUE �PLAN-CHECK , TOTAL PAID � DOE • �i, as ownei o1 me pmpeny,or my empioyees wilh wages as meir�so�e'comoe�s'ation, win oo ine-work—ana ihe�- ='TOTALS—=—�—> +'-' -'�+'": __: � � � ' ❑ s�mdure is noi intentletl or o��ered for sale (Section 7044, Business and Pm�essional Code.' The ConVacrors State L¢ense Law , -'z 3; 50 - ?� ,-0 Q: 1-4 ,-9 5. � 8, 4 5' _ 3 8, Q 5 _ __ , � � tloes no� apply �o an owner ol a pmpeny who 6uilds or improves thereon, antl who does such work himself/hersel� or Ihmugh ' • ^ �.- , ' - ' ' y , �-'' ' .nis or ner own empioyees, oroviaed mat sucn imProvemenis are not imeneee ar anerea mr saie. u, nowever ihe ouiiding o� � REVENUE D IVIS ION TOTALS >�-� COLLECTED • ' 3$�, 4 S OVER /SHORT,• � � 0 . � impmvemenl'is solA wi�hin one year o� comple�ian; Ihe.owner, will �ave ihe Ouraen of pmving helshe di0 no� Uui10 ur impwve , EL�+C•1•R IC '!.io�men�rvoseo�saie�. . .•. HLDG� PMT PLUMBING 1MECHANIC '.FIRE � SMIP✓TOT GRADZNG PLAN-CHECK ti �: ,' .. �,. , " 23.00 ; � +_ . . ' , .50 14.95 ,. T �� I. zs awner ol Ihe pwPenY. am'exclusively conVac�ing with licensetl contraciors to cans�mc� �he prole�� (Section 7044, Business ^ . ' . '• ' ` � � � ' � I �❑ 'andPmfe55ion5Cotl¢: TheConVat�ors'SIaleLicenSeLawtloe5notapPtyloanownerolpropertywhobuiltlsorimpmve3thereon, � + ' � � ' � ' 1 � ' ' . 'andw�oconl�aci51or5uchprolecl5withaconiraclor(5)IicenSepursuanitotheConUac�ors S�ale'LicenseLaw�.lamaware' �*'�'*'*'��"��'*�"��'*��**'�'��**�'**"�**'�'K'�'��'***��"K"�*'��*�'�'�'*"��"x"�'�'�'**"�K"K'�'1*�'*'�*',�'K'*�'�'!�'*�"'K'*'k"�'*"�- lnat pmo� oi meir workers ComPensaoon insurance snou�e be pmvided m me. -''� , ,ry � ,.� • ' I �N D I' V� I D U��A �: T.i , F' E E. B R E A� K� D: O W I� ; . • � � ' � ; I am exempt untler Section: � j - B. 8 7. C. : , j - ' �� - � � - � � - ' ' � � - ' �� ' �m�misreaso�: '-. TYPE QTY,'� � • D E$• C R• I•P T I"O� N �- � � � i 1 UNIT COST r TOTAL 'QbST ; , , , ' i , , ' , • � � , ' i � �:'� � . , . oa�e: ' : • � ' � ow�er: � SFR � 900 ALTER BY VALUE, RESIDENTIAL N07.ONE . . :1.00 ' �900,00 ' r � ' � ea nereby cenity �hat � zm aware o� a�a understand me requiremen�s o� Ca�ilomia Heauh ane Sa�ery Coae Sec�ions 25505, 25533, an0 �- ' � END '��' FEES . , � . , � 2553a ane �ha� I or any IUWre builtling occupant willlwill no� (circle one) need lo comply wilh saitl Sla�e codes antl �he requirements tor a — �• -', -�-- ��- � . - ,- , , ' � � � � , , permil �or consimc�ion or m04ilitali0n hom Ihe Nir Oualily Managemenl �islriCi. FeSideniial COn5lmt�i0n aDDlitaiion5 are ex¢mp� �mm , � � , ' , ' ; � �� ' ' ' � i these provlsions � � ' � , , . ' � � �� .�.1 , - � '� � ' �at&. � . . . j•� 1 ' . ✓-r _ J" � i , � . . . ///NP�Iicani: � ' � ' . .•ry ' ' i f . , , I hereGy cer�tly iha� I have reatl this apPlic� and s�a�e Ihat t ove informalion is corr . I agree to comply wiN all ciry antl couni � � � „/ � � � � � ' ; .� � ' � 'ordin;nceSanA 1zlelwsielaiinglobuiltlm mnslmciionantl reb au�honz represent - sol�hisci�V,�oenteruponlheabove-menliontl �--- � - -'- • - �� 1-- � • . �'�•� � � . , omperiv�urinpectinpurposes. � r � � � � . � � l � r � i ';�� . � . � , OI On0i3S72-CQO?3474 Tr�� J5.$` ' t i �n oa�e. /l si9�awre: �% , , � •{�^ , ' L�,�^.T��' 11/�9:'90 TII7'c: f5:Q4 ' � . . ' , . � ��/''� . onver's Licen i or ocial Secuniy a: . � . . ' ' � � � . •'7 ` , , ' • � i6al n6 Wliiie-Builtlln Green-Code Enlorcemenl: Cana , - ' ' 1 "- .. � . - � .. - ' ' . ` -. ' - ' . . ' ' . . � . . _ .'.- � / 9: �V-ApO�ican�; Pmk-Revenue: Goltlenro0-qssessor - ' --� CONSTRUCTIOW AND'PIANNING� �--'� � -' - ._ _. . . . . . ��PC 3i SPA . . _ . ...� �' - ' `: �x `- .' � Date � Inspector � � � � � • Date ' Inspector , � APPROi/AcS Permir'#' �, � - AP.PROVALS � Permit #, . � ' `i. Temporary;Electrical Sen%ice o� Poler� . _ _ - �52. �Pool & Equipment Location: - ' _ ' _ 2. �Soil Pipe-Undrymd. � «='� �'�� ' _ ' 53. Steel Reinforcement �� rr�..�; :n. : N_r- - r : ' . ��`3.NElectfical Cond'_uit Utility�Undrgind ��' �. ,- 54. _Forms', - - . .; _4S Electrical ConduiYUndrg'md. � � _ � " 55. Electrical Bonding _ � � �"c'--: r.. n. ' H 5. Steel�Reintorce �nt . _ �;' • � 56. �Rough Plumbing�& Pressure Test � �n � 0 ^:<8'cElectrital UFER.Gmd. � ` ` - ' ' . . , 57.'APPROVALTO`COVER�GUNITE ' � �s �• �..t - r�-7i�Footings ��=''� - L, . � �- , - 58. Electrical Conduit-Undrgmd. �>� 8:�Foundation �_ J -_"` r�'' - 59. Gas Pipe, O' Undrgrnd., Test f' ,.�''� 9?�Water Pipe-Und�grnd. . ' . • �•� �. 60. Backwash Lines, P�Trap, O Undrgmd. - r � 10. Structural Floor SYstem � .+ � � . � , �;: . , 61. APPROVALTO DECK ' - 11. Property Sewer.Line &�House Connection' 62.fBackwash & Receptor-Final- i 12. Sewer Cap .L _ f a � �� 63. Heater'& Vent-Final - � 13. Roof Drains �ro ,i � . ., 64. Plumbing System � Final_ �, � � 14. Rough Plumbing " ` 65. �Electrical-Final . _ ' , 15. Rough Electrical-Conduit , � . 66. Solar.System-Final . � 16. Rough Electric-Wiring: � �' - _ 67.� Fencing & Access ApP(oval . 17. Rough Wiring.,Sign � _ - 68.-�APPROVED FOR PLASTERING � ; 18. Rough Electrical-T Bar Ceiling. ,_ � 69. -POOU,SPA�SYSTEMS F,INAL ' 19: Rouc�R Heating�& Air Coriditioning - �' " `-' '- ' FIRE DEPT. REQUIREMENT � ' ' "" � _ . _ _ . ._. � _.,._ .. - - '.. .. . C �� r�:�e-. i.: '-+ ;V 20nRough �Eactory Fireplace , i :�t= � � � C �:� x �'pppROVALS�%OPermit # �' '" � .<. tri � � S.r Cr,'< .� C'i c.: �::'J1�C- � - .� 21 �Ducis,in�Stiuct%e� ; `-;r :r_. Y �' ? :X d 'y � ,�y:'^�.� 9 x m ,.. i ��-t! � v, r: �. � J0. Underground Hydro 22. Ducts, Ventilating�i- CJS r S �� 77. product,Fiping O�Gas OOiI - ., :� � � n ,r r, � v�. �r , 23; Gas`Pip€.Rough &.Test � '^ " ;, -••`� �� ' '� � � •�`-' `�, - � i:i� :;: t-i ^.�:.:; � �72. Underground Plush:c� . :�� ` ,:, - - ` V' . . :- _ , : -:. 24�RoofFraming �_l'r. i:-�l-� v!-' !'C C r' ��'?�,:73UUndergrnii.StorageTank��Gas ❑Oil - 25. Ro`of Sheathin '' ` ''' `'' �' " `•''' ,` � `��"`-' - 9�.. .-„ " r, ry;� ;; :' 74}O,verhead Hydro_; 26,�T-Bar Ceiling (Sfr.uetural) &SMorrocoatC,? �t� � � C� t��i� �r 75s Dry Chemical �" �� -� '_� C - r�r- �. .�r � c'•..� � .y 27."Frame and Flashin� "?�� a�� r�� G� ;�. �s�^ory StandPipe -C''� �' S'`� '� +- ��. .:C..t: r•:= i iC � i � r-.. �-.w�� • i. ,��- . . �; . y, .. ... ,.. :-.,28� Lafhing�.& Sidingi;�t� �� -�•;;�: iX['i�: �i �. �• •� i� :i., 77,^ FIXED SYSTEM�FINAC' J ,n �'29. Insulation �� cl� C �M •• 9'�' �e Dt {i.:! ,.� �..-• �" ��,� . _ ..er, :� I � �t: �,-. 78r FIRE PREV. FINAL ,. ;� ts; , ;�30.DrywallNailing�:�� '-7� �� (,�.{ r� �HEALTHiDEPT:�R�EQUIR�EMENT :;31. Plaster Biown Coat' � `•' ' f,:`. 79�''FINAL INSP,ECTION "' �7 �' •� .o .e t K r pa x I �_ .�. �� iq -�32-Electrical Power;Metec-Final- �J� �q� � rti � � v i�i80�F00D CERTIFICATE ISSUED `�. f� ��33�Final Electric .'�y � i �i�' ^'-r i I �. ;�-Noies. �-�5.��% - SG,4,�� r ,., �,� i YC -r • 1.' 4'. t ' � tL.l �. �nM • �:�� J ;�34.-Finel Heating & Ai{ Conditionin,g; �;n ' ,� � � �K i. :�' �^�;� ,� -.r, � �/„[r a , !.t 35'TPirial Gas Pipe-T"est. - -'` . �. •. r. '��°-+ [�7S t 'r 5C n �s� �<< 'r !-� I I c �a� � 7 vt-, -;_ _.;r •,r , ._ ! � ,y S : I x :. ,, �:. i. . !. ;: � r-� �.36. Hood o`r�CanoPYr�' f-; I cT'- +-, ;'� I <:•� _ y :.o. �,;•�• i �Y-: . � -+37S-Fin`al Factory FiFeplice_ + ��'' "'�`� 'T� m � I 'w * � _ ' . � iT� ��. �:� y `:.'�38.�Final Plumbing ��,n� j � �� r ,`U �. �� I �. - `� �- ;z t^ � :�39:cWaier Service�Finak � ' n,a :: `A .� , �c*; -:'x O T � n, .. �: x.. a: I '� kr : ;;,40'1Gas Ser�vfce,;F�inal , �r.i„ s'- ; .,. � I q -K .,� ,w:-,. "` `•' .' . �^ �41^Solar pomesxicFinal.i :�� ^io C! I i = � �''� - ^ ;x. I t. � �7v - : �" J �-. �� ,� .-• f�: C:`ro = ;� I �. :. r: �t,'- •• ,_. 42: Backflow Preventer� `� ., I f;. ; .., � ;, �; F, _ 43. Backflow Irrigation � •+',rr '� x Y � �` �� F =� �,; - �44. Landsca e Iri �7:": - � T "� " .. :J �r, P i9ationSystem.,_..�1 t:C� - n; C p=.r -,i± .: .;.�.� i�J� u ;Z45�'Sound Attenuation �- . tT � '� - �� `= E-a. * .� - -a% �:•�L v r. r• rn�. rx' - �i H._J `-�46`�Handice Re ulatio`ns '�' ` ` " '`" '� � =+`' •�'� '' l P 9 r : t �:' x C-^, _^.t .S T ��47 ;FINAL STRUCTURE & 8U1'LDING �d ' W:: � _ ... _ � < � �Y �, �48't�FINALPLANNING � Lr;r ��., ;.I ;� x �: i; : � y i rf- �� N ,: r 7 -,� h: � �49.=EIeclricReleaseto��Edison � ., � I . �i-.; : � . z, _ :i. �' ".--� C: "'50._Gat Release to Southern California Gas Co ' � '�'; �` �'� c;::�. �s - c r v o:, *. i.' L: � t � <;;;� , n p . �51;.CERTIFICATEOF,OCCUPANCY 'j; �{�� „ ti;, in�: ^';,, :i, (.• _. No. Date J �� J PflOIECT RODflE53: ' � 311 L p I Etii. T:" AZ% "_'� � f � � ' UNIT: .- T� . OWNEWSNRME.�,$AtZTON,• k03ER.T,. W . �' ��. nooxess: BARTON TkERES'A M �b Q��''� �""�� ' �' ',. � -' 11'21 �r.C��ONA LN ' , 4 xl - c �a � . a =` n i ;;(}OST°.i MESA,CA -' _ y�f3`� j-�cl. , ,' � 5%� -RBCMIENGINEEfl: '; � }� � � � � ' � BEG.NO.: . � ; �ooeess: � i �, _ _ uxir: �_ t � � ; PEflMITTEE: iCUSTOM �Q UAI.ITY EL•ECT'RI<:AL' ( 714�) 96U-i 12-3 ",nooxess. "� 905 FLORIDFi ST ' ' S ; � r. ' H.•H..: ' . CA 926�8 , LICENSEO fANTMCfON OECIAMTION: 1 hereby aRirm itiat I am IicenseE under Dmvivons oi ChaO�e� 9(�ammentinp wlih Sei�lon 7000) oPOivision 3 ai Ihe Business anO�Pmfessions Code, anE my license is in fulbiarce an0 effect.; , � ciT'r uc.: � 5 3 4 S 8 sTaTe uc.: /�i 0 5 2 p, cuss: C 1 i '^ �p Date: �; ��-/ � � � SignaWie: Wn � WONREBS' COMPENSPTION DECIAMTION: I here�y aliirm thzt l e a certilicate oi consent Io seli-insura or a certificate af Workers' Compensation Insurance, or a certifietl copY ihereoi (S¢ction 38W Lab. C�. ' � POLICY Na.: ' - E%P. D�TE: � • . ' � COMPRNY: ' � � ' � ' . i .. � . � Certifietl copy�is hereby fumished. �❑ Certitietl capY is fil 'Ih t�e ciry BuilEing Divisi f _ _'• Oate: � � y �� NDPlicant: � E%EMPTION FHOM WOHI(ENS' COMPEN&1710N OECUfWTION: Rhis udi ee0 nat be campleteA il ihe Dermu is for one nuMree (5100) ar less�. I certiry tAat in ihe perfarmance at the vrork tor whicA this pe '' iss , I shall not employ any person' any manner so as to become i � subject to t/�e- Workers' Compensatian La t Califar ' � � Da[e: � `� ' ��. J � � � - Si9nature: -, � / { . � NOTICE: If, atler makinq Ihis aeclaratian, 'qou sAou10 6ecome suble� lo iha Workers' Compensation pmvisions oi t�e La�ar Cotle, yau mu5i totlhwiih compy with such prodsions or Ihis per ' shall 6e AeemeO revokeE. ' fANSTNUCTION 1FN01NG �CENCV: I here0y affirm that there is a c stmction IendinA a0ency for the peAormance of Ne work for which Ihis Oermfl is issue0 (Settion 3097, Gv. C). ' - . , lFNOEB: ' ( . , � � _ . R�DflESB � ' . — .. . . . . _ . . ^� n• . „ i , i � , . - . , ' r• . . .� � , i ' ' , . �., - ' � � . . i. .. OWNEP BUILDEB �ECLAMTION: I Aerehy atfirm that I am axempt from t�e Contracrors' Stafe License Law tor t�e follovnnA reason (Sectian 7031.5 Business antlPmfessional COEe: My ciry of caunry which reQuires a Oe�it ro constmct. alter, impmve. EemalisA, or repair any stmcmre, prior ro its issuance, also requires t�e ap0�ican[ for such,permit to file�a siAneU statement ihat he/she is licensetl pursuaro to tAe provisions oi the Cont2ctor5' State License Law (Chapter 9(wmmencinp wi[h Section 7000) of Division 3 oi the Business an0 Pmlessions CoOe) ar that Ae/she is exempt iherefram�anU iha Dasis for the allegeE exemption Fny violatian at Section 7031.5 by any.applicanitoi a,permit suhlects t�e 5p01¢ant to a civil Denalry oi nat mora thandive hundreE Gollars (SSOU). . ' •. �I as owner �oi the pmperty or my employees with waAes as their sole�compensation, will'Oo'the wark, andthe O simcture is not intenEeE or allereE for sale (Section 7094; Business an0 Professional CoOe. The Contractors' State Lmensa Law .Ooes not apDN �o an owner of a pmOehY �o DuilAs or impmves ihereon, and who Uoes such work himsetl/Aerself or NmuAh � 'his m �er own emDloyees, DraWJeO that such imD�ovements are not_intentle0 or offeretl far sale. If, howeveothe 6uilAinp or improvement is soltl wrthin one year of,completioq the awner will Aave ihe huNen ot OroNng �e/she OiE not builE or improve ' for ihe purpose ot sale�. � • � � . . . � I, as ownecoi tAa pmDerty, am exclusively coniractinp wiih IicenseG contrac�ors �o cons�mc� �he proleci (Sec�ion 7044, Business 'I 0 and Protessions Code: The COMractors' SWte Licensa Law Oces not apDly to an owner oi D�aperty who �uilQs or imDroves t�ereon �. antl wAa contracls br such pmlecls wit� a cdntractar(s)license pursuan[ to Ihe Contrzctors' State Lmense �aw),I am aware � thai'proof af their�WOBer's Compensa�ion insurance shaultl be pmvitletl to me. � I 0 I am exempt un0er Sectian: � � � • 8.�6 P. C. . ; , � , , � . far ihis reason: ' � � , � . , ' t ; , � . � Date: , �� ' � , ' � Ownec � ' ' � � I Uo Aere6y certity tha[ I am aware al antl untlerstantl the reQuiremen4s ol Califomia Healtfi an0 Safery COAe Sections 25505, 25533; antl 25534 and that I or any IUWre buildinp accupant wilNrill not (circie one) neetl to camply wit� sai0 state coEes anG the repuirements for a permit for cansimciwn or mo0i/ication fmm the Air Oualiry Manapement DistncL Hesidential constmctian apDlications are exemD� �mm Ihese Dmvisions. • , � - ' Oate:~ ( � ApDlicant: ' I here6y cenity that I �ave read this applicati xntl state Ih tion is correct. I a to co y with all ciry antl caunry � oNinances anU sWte laws alabng to builtlinp- iructi �ere6y authorize D�esentatNu ol tA' ' ro er upon t�e a ovrmentlone0 pmverry tor insoection ouiposes� � .. _.--� I Datel� 1 � � � �f SiAnature: ^�� ' � � Driver-s License oGSocial�Securiry N: , , � _ i j ; 16a1<6 W�i�e—BuilCing; Green—Catle Enlorcamenf, Cenary—Applicam; Pink—Ravanue: GolEanrotl—Asaessor � � �, ,��, CZTY OF� COSTA N�ESA = BUILDING PE3MIY-�-- iPERM�,NO::,, E ' 052.46�'i ' � �� PF.RMTT NO: 'r.' ' 0�2469 , . � PLAN CHECF; NO: ` N, � �' GOVT: N'suPP Nj, } , , _ • .. � � - � ' 1 ' CONSTRIJCTION ;TYPE: , , ' . _ ' PERMIT �TYPc.:? EL� ', . ' ' -' i � ,; ; ` ? P.IIRP058: �O�TH ; I �. I , � .. ' y '.� ,I JOB DESCRIPTION' _ : 4 CEI'LiNG �FANS � � � .. � i . SQ : T: { ' ; , ' - +` i CLAIM' VALUE: ' ' .CALC-VALliE:� ` _ GROUP� OCC:' ' / !" i ; ' I � 1 . • . � , ' � . . � � I � ' � � ' ' . ' ` � � . 1 . . � , ' I 1 COMMENTS : NQ :5"CRUCTIJAAL WnRiC PERMIT"tED • ' . : � � ' - � ' :� ' ' - � ' � �%�i��1F�YF�K-��3EiE�Yc�F3fi47f;YielEjElEiEifiF�%kiE�KiF�1EiEYc�7EN��I'.�i(b:-iF1EiE�'�iF��%ic�lF�%'�k7!�?E9EdFfi.*�kiF�E�lE�3fdFYafaF�F'df�}Fdf3F�!u�If�M:��f.•IF�%iEifiE�%�iE�%��K � t • �'I.�ONING' R'EQU�T'RE,�riEN'T,S ' � � SETHACKS �•! � -' i• ':��';� ,- �AIN HU:ILDING ----=----'� ; FRNT; � FT�ESSORY BUILDING '�- � � � , r: � ' F'RM'Ct FT � � IN REAR; FT IN: � � IN REAR;. rT� r IN; � LEFT: ' , FT . 1N RGHT: � cT IN LEFT�; � rT IN RG3T: �. T; ,,`1N- � i PARKING 'REQ• � . � PROV; PARCal,: 19165204 �2NE: � � REF NO: ^ } ' � { PLAIdNING NUTES>� i ' , , .- _' ' , � _f ', a � ._ '__ � '_.. _� - ._ . ... .. ..._. .. -.. ._ _ '_ �. _i . _.. ""'�'». ""' ' _ ' "t ' ififlc*k}�hY-%�iclfklF�IfjEiEfFi(�-k�iff[�3F�IFie7eiEiE3cif1E3F-7(-%iFiEiF�IfN�iEi(�3fi't�d'rki(�ieifiE�3E�3i�iF3i-iiiEr%i-X�liie#�1EiE#��1rif�#iFir7E�R�Ffi��(�'If#iFK� � U E V E L O P M E N T S. E R V I� C E S' R� E Q �U I R E M;E r T; S, � ( , � � - ZONING APP�OU,ED' �Y � � , ' ! � DATE'; � i � ' - . . _ � � _ . ' ; . .., f ' _ `," _ ... _ .. - . .... .�.,. .. . _ _ ' _ , . - . - -�_ � . .. . -� BiJILDING APPROVED HY ; �� .� DATB; � . j APPLICATION ISSUED BY; � � r' � ' � i ' DATE': �O I�"2.�. ' � ie �k K lE iP?(� # if� if �X� if K� k� iE # it ie iE k-it dE ie 3�4�iE3FS�"ic�7� iF ir3F3r3FirTr $3FiCS�it�n� �3F z3riF3F isiF i�iF7v3b N� l'r ii�.9i� ie 1'r >.3i;3f 3e3:ir3.1�� e dE 3r ii-9F�f-1f3E#e�i��li��i�iFi'rlfii�lflflElEibifi(�iFii��1Elf�iEi"rfFiE3Fi4iEirifiM13(�iFiFjfd'r�l:lEliiFiE3e#+ER�F7FlE)Ei4it�'�if,Y.�IY}N�ikieaE3f�ic+EiciFic�if)E3E1i�?EtiPIFi'ri!� � I;EGALIZATION:N i �' "'�' '' F E"E, 'S"U, N�M' A R Y'"r-- i"�-STRUCTUt2'Ai. �HGMEVT:iv "' , , .- i ; . � . .. � . .. . . � . . � . ' �. , I ' , � ' H'LDG; PMT• PLUNBING ELECTRIC , MECHANIC , ' F',IRE' � SMIr,%Rr.S � G�AliIiVG � PF.RNiI'T' • � � � � , , r .12 00 � ! �i ' , i � , 'i �OR . } I � SNIP/NON-:�t".S'� � � P�� ` ' � . ; ;i7 , � � , . 1 � I � r , • i,.,..J.. FEE + , r V ,TS, OU , • ' BT7ILDI�VG_D�V-i> `PE�MIT TSSUe.'` PLAN-CHECF: ' � �OiAI. ' PA'TD� i.,�� DUr. � ro�rALs � , . - i<.00 =;: i-s:oo: . o_.00 �_ ..�.00 ___ ; _z�.00 �,� r. , ,� .00 . .. . '�! . :� � ' � -' � ' -" 7�.7%%�`�. .�t . . REVENOE DIVIS;ION TOTALs'-�>:- � COiLECTED; ' , 27„00 OVER/SHORTj: "`� �r, •.:00 � 4 BLDG, PN:T PLUMHING ELEC'I'RIC 'MECHANIC F3}tE ' SMIPVTOT , GRAiJING3Ps;AN}C3ECK i , -. : �� ..27.00' " i' � i i . i t . � , i.._-r }��; I . - � ' � .- . , - i � ' � ' t£ i= � a� 3F a: 3F 1E %�-1f-'i iF lE N-3E ib� 361E � 3i� �IF iE If 3c lE'ii� iE }� i(��3i if 3i iF � k• �3t� �lE iE k�k 3E 3�� d(� )6 if iE )f N� iFje �k ai�'>� iF �lE k lh.0 %, ii� �hiE �]f } 3i� M� }i ii� #!E i4 if,lF if�i't ?f iE'X. };..K. N� K � , '1 •N D I V I D li:aA �,> F n& ti R E A K� D O W N � ' iJ : J, , � . , . `_> >� i TXPH QTY � ll E S C r�, I� P T I�Q: N'; tJNIT COSi. � iOTA7;; COST ' ELE; ' '4 ' ;MOTOR/POWR`APPA T�US I O,U - 1,0 FiP � .3,�0 � '. , 1�2.OU ! F � . _ . ... . . �END Or r EES. � . ; . �� . . �„d' . . i �. ' � � ( . r � • Inwmpl �1 R D�tions. ' .i�; , ; � ; � � � � , ' � ' � � r% � ' � � ; - . .._ . � . /:.: � "i . . � , � � I 1 .trate ��•---PSlg�;9"'_`� ; t �� Q� � 0? Ott09�?413-f10090L4U !`S�'J" � ,:�I,vU� , ' 'J'; ; ' � DATEa 06/Zif�? 1IF3£: 1E�.�� j t r , i I � . . . � ' i . i � � ' _ � � ' .' � . . . , .. yi. _ . _ _ , _ . _ . {_ _ . . . .. ....� . _ � - . ' . _ i ... t _ ... ._! _ . f;r`i� _L � i � � i� i d1� � � CONSTRUCTION AND PCANNING;i :/ " P��' 'PA - , ' • y . 2_ 4 � � � - - Date�' � I nspector ' • "� ' ? `� Date T � I nspecto� ; '� - APPROVALS �PermiY#• - . AFP.ROVA'LS _ Permit# ' „_�.- i � . � s. � .1. �Temporary�Electrical Service or Pole ,, �, � - • :'52. `Pool &'`Equlpment_Location ` � ' -. � ^! � � �. �, ,� . _ ,�.. i ,� 2. Soil Pipe-Undrgmd. - � j � � �=�� i� _, , 53.=Steel,Reinforcement � �'r7 • ' , - ' .' �% ' ' �- � 3. Electrical Conduit Utility-Undrgrnd. � r�-� � , 54.:Forms . . - � " � - ,r ' , i_ � ' 4..Electrical Conduit-Undrgrntl.-' ' c � . . ' l ^ � 55.,Electrical Bonding : , - � � . � . ,� ! - 5. Steel Reinforcement s �- �- � 56. Rough.Plumbing &, Pressure; Test - .{. 6. Electrical UFER Gmd'� ' � = 57. FAPPROVAL TO COVER�GI�JNITE - -`. f 7. Footings > �, ` � -� - 58. Electrical ConduitUndrgrnd, . � � ��. � � F � =i ,. ' :! �- � > - � - 8. Foundation -� � i��-: �� o �, r% ,� �.- . 59. Gas.Pipe; O'Undrgrnd:; Test -� :{� ` i-- � ' �• f �(/ ( l �� i =/ i i � � . �' ' �� 9.-Water Pipe�Undrgmd. .. � ��.7 60.;Backwash Lines, P�Trap;�0 Undrgmd. �� 10. Structural Floor Svstem- ��.; �� ,� J� _ - 61 APPROVAL TO DECK �, �`� . , 11..�•Property Sewer Line &�House Connection `. 62 -Backwash & Receptor FinaP _ � � r .r b �2:�$BWCf Cd � i « _ . .. _ . . _ . . • ' ' _ � P + � - 63. Heater & Vent-Pinal i ,�, , � ;� 13-Roof�Drains f� � � �� ' �� ° . 64. Plumbing System � FinaG' , . � � � � ^ �? • .� � 74� �RougYh Plumbing . �;� �r �j �' �+i' '� 65. �Electrical-Final� = , � �^!� � _ a' 15`Rough Electrical�Conduit � '- �,; .r �,',' � 66.�-Solar SYste_m'-Final _ � , - - � ��' � ; -76.: Rough Electric Wiringt , ! _ � , �� 67. <Fencing & Access=Approval ' " 2 � + 17t:�RougFiWiringSign 7 i �` � : ' 68.'APPROVEDFFORLPLASTERING � r � � � i ; 18. Rough Electrical�T Bar:�Ceiling: � � �'` ' ' 69.'POOUSPA`SYSTEMS�FINAL � - � o- � '19.�RougFi�He`ating & Aii Conditioning � �' FIRE DEPT REQUIREMENT`� 20.� Rough Pactory Fireplace • . APPROVALS . Permit # 21. Ducts, in Structure, _ , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil ,.-. ^�;, _.. � 23. Gas Pipe-Rough & Test � 72. Underground Flush �� 24. Roof Framing � 73. Undergrnd. Storaye Tank O Gas ❑ Oil �' f . 25. Roof Sheathing ' '� 74, pverhead Hydro j � 26: T-Bar Ceiling (Structur21) & Monocoat � 75. Dry Chemical �` p`- 27. Frame and Flashing 76. Dry Standpipe � . T a; ^ 28. Lathing & Siding � - � . • - 77. FIXED SYSTEM.FINAL ;,�„ v �: � r. r. 29. Insulation � , � 78. PIRE PREV. PINAL ->>`: j 30. Drywall Nailing �. • HEALTH DEPT. REQUIREMENT �� .; � 31. Plaster Brown Coat , - 79. FINAL INSPECTION. ' 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED �..y,_ 33. Final Electric ' Notes: Z-a �-[j/ �lj ��gZ->-- 34. Final Heating & Air Conditioning � ' a., F: 35. Final Gas Pipe-Test' � � - . - -' �,. . 36. Hood or Canopy � � � � 37:� Final Factory Fireplace . , � - 38. Final Plumbing - � _ , . - � 39. Water Service�Final � 40. Gas Service-Final , , , , 47. Solar pomesticFinal . � 42. Backflow Preventer • � .� „ . 43. Backflow Irrigation , 44. Landscape Irrigation System . � � �45. Sound Attenuation � - ' � 46. Handicap Regulations � �j, - 47. FINAL STRUCTURE & BUILDING ' E X P I R E D � 48..FINALPLANNING � 49. Electric Release to Edison . (j�jg Ig __ 50. Gas Release to Southem California Gas Co � �� , . - 5l. CERTIFICATE OF OCCUPANCY , ��' :# No. Date �t / �=_ . . ; . - �� s�� . � COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COSTA MEBA,' CALIFORNIA For Appliwnf fo Fill In Complef`ely TYPE OR PRINT � BUILDING AOORE56 . COSTA MESA CALIFORNIA '� � OWNER MAIL.. � ' RE AD�RESS' TEL BUIL CITY NO. AODI ARCHITECT . ' TEL. ' - OR ENGINEER ' NO. ADDRE56: ' FIRE ZONF nnuren�me �%�nni% %� fiin%wnjfn.., APPF F � �CC�IVED FEB 1 9 1963 � - fIPlANCE �EPT. �- CITY OF COSTA MESA . CATION FOR PERMIT � BUILDIIdG ... ' Office Use Only ' RECEIPT NO. P�Nj3 rv � � � DATE RECEIVEO OATE �65UE� �L� 1 b 196' F�g 1 tS i993 � ��i%/� (:.(µ! . . A MESA, CALIFORNIA ' / TYPE �/ GROUP �. �� . _ . � LIC. NO. / Y/ NO. /��V V TV oescrtirrioH � `�O � S/ �{� �f� 3 6 ' SIZE " I NO. OP BIDG6. �' . OF LOT � ' Now'oN �oT q,p,NO. �—J USE OF � ' ' YARDS . " EVES • � ' EXISTING BLDG: APPROVED� _ALLOWED 88TBAGK LME FROM � ft��dTER Llne eTJ ' , - C¢NTfirs OP BrneCi' �� REAR YARO � �� FRONT . '� 3 FT. —� IN. � " � SIDE YARD ILEFT IRIGHi r ^ R.SIDE � FT. �IN. DESCRIPTIOM OF WORK � S�oE ,s FT. •— ,N: NEW �- I IALTERATION I IIADDITION - I . REAR � � ' FT. � /� 'IN. REPAIR I II MOVING .' ' I II DEMOLISH I ByPRO ^ �J✓W� DATE o` �`�� BUILDING �- NO. OF � - , ' - ' . SIZE ROOMS STORIE6 EXTERIOR WALL ROOF � l � p . - COVERING S�fLC OI COVERING�N�OO� (k ��O US�,.oF BUILR ING AND��y�ORK TO B PERFORMED � 1-Y am. K e..t W¢��a � "an a . , � � ` _ _ '.�J �/` C... _ l( - . �� - ��' �� ' . 1 HEREBY ACKNOWtRDOE TH�1T 1 NAVE READ iHi6 MPLIGTION � THE AMOUNT BHOWN UNDER VAL AT�ON IB FOH THE ANO BTATE TMAT THQ ABOVE IS CORREGT ANO AGREE TO COM- PLT WITH ALL CITY Oq�INANCEB�ANO 9TATE LAWB R¢a11LATING ��'URP08E OF, EBTABLIBHING A PEftMIT FEE ONLY. Bu1Lo�Na coNBrnuFT�oN. , �. � VA�UATION l� SIGNATURE OF ' ' �PERMIT FEE $ / / PERM177E � / � a �i . n ' $ . � � PLAN CHECK $ � v S AUTHORIZED AGEN ' TOTAL FEE ��'J � � ' 4 /9�3 a , ,