HomeMy WebLinkAbout2112 PRESIDENT PL - Building PermitsAdd�ess: 2112 PRESIDENT P!
Phone: 949-642-6161 ISSUED BY:
COSTA MESA, CA Zip: 92627
Owner: KONTOS, GEORGE
Address 2112 PRESIDENT PL �
COSTA MESA, CA
Contractor: OW N ER-BU I LDER
Address:
Zip:
ArCh :
Addr�ss:
Zip:
Phone:
License:
Phone: 949-642-6161
Zip: 92627
Phone:
License: 000000
Eng:
Address:
Phone:
License:
SCOPE OF PERMIT
TEAR OFF (E) ROOF MATERIALS, INSTALL 2 IAYERS OF 15# FELT ON A 3:12 PITCH ROOF AND REROOF Wl30YRS GAF TIMBERLINE ON AN
ATTACHED HOUSE AND GARAGE, APPROX 1,BOOSF. REPAIR AND REPLACE SHEATHING AS NEEDED.
Plan Check: $0.00
Permit: $125.25
SMIP Res: 50.60
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.85
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existina: o
Rear 0- 0
Rear 0- 0
FEE SUMMARY
PLANNING 8 ZONING
Lefl 0- 0
Lefl 0- 0
Re uired: 0 Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0. 0
Ri9ht 0-0
ss,000.00
$6,000.00
NOTICE: The work authorized by this pe�mil shall comply with all applicable handicap access requirements under Cali7omia stalutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or ii work is suspended or ebandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepections and finel approval must be o6tained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR 7NSPECTIOMS CALL: (714) 7545626
zaaaae(sroo)
WORKEPS'COMPENSAnONDECLARAnON: � •
1 hereby atllrtn under penalry of perjury one of the following daclaretions:
❑ I have end will maintain a certificate of consent to self-Insure tor workers' compensatlon, es D�ovlded tor by section 3700 of ihe Labor Code, for ihe pertormence o1 the
work tor whith �his pertni� is luuetl.
❑ I have and will maintain workere' compensation insurance, es requlretl by sectbn 3700 of the Lebor Catla, for Ne pertortnance ot the work for whid� MLs pertnit is iswed.
My workere' compensation Insurance carrier and pollcy number era:
Carrier.
(TLjs sJ
Policy Number:
[� bcenily ihet in�the pedartnance of ttie woAc for which this pertnit is Issued, I shell not employ any person in eny manner so as to become subjecl to the workere'
compensetlon lews of Calllomia, end egree thet it I shaNA become su�Ject ta t�e workers' compensation proNslons of Sectlan 3700 of Ihe Lebor Catle, I shall torthwit�
�comply with th� provisians. /
rw�� si�w�a: �,o-� o�� d-N,`�6O �e�a: —�'Ll �l / o�O
WARNINO: FAIIURE TO SECURE WORKERS' OOMPENSATION COVERAOE IS UNUWFUL M'D SHALL SUBJECT AN EMPLOYER TO CHIMINAL•PENALTIES AND GVIL FlNES UP TO pJE HUNDRED
THOUSAND DOLIARE (5100,OW), IN FD�RION TO THE COST OF COMPENSAiION, DANAOES AS PROVIDED FOH IN SECfION 3]OB OF THE IABOq CODE, IMEREST, M10 ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION: '
I hereby eMirm that I em Ilcensed untler provisions of Chapter 8(commencing with Section 7000) ot Divislon 3 of Ihe Buslness end Professions Cotla, end my license is In full
force end eNect. Lic. x Class N
Contrectors SlgnaWre: Dete:
CONSTRUCTION LENDING AGENCV: '
❑ I hereby eMirm Ihet Ihere is a wnstrudion lending egenry for the peAormance ol the work for which �his permil Is issued. (Sec. 3097, Civil Code).
Lentler's Neme: Lendefs Address: �,
SlgnaNre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby efflrtn Ihet under penalry oi perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business ana Professlons
Code: Any clry or counry which requires e permit to construct, elter, Improve, demolish, or repalr any sWcture, pdor to its Issuence, elso requires the applicant for such permlt
b flle e signetl stetement t�at �e or s�e Is Iicensed pursuent to the provisions of the Contrectors License Lew (Chepter 9(commencing with Section 7000) ot Diviglm 3 of t�e
Busineu end Profeulons Code) ar that he or she Is exempt t�erefrom and Ihe besls tor the ellegetl exemption. Any violetlan of Sectlon 7031.5 by any epplicant for a permll
subJecta t�e eppliwnl to e civil penalry of not more ihan flve hundred tlollere ($500).):
❑ I, es owner of t�e proDerty, or my employees with weges es thelr sole compensatlon, WILL DO THE WORK, end Ihe siructure Is not intended or oHered ior eale (Sec.
7044, Business end Professions CoOe: The Contractors License Lew does not appty to an owner of property who bullOs or Improves thareon, an0 who does such woA
himsell or.herself or through his or �er own employees, prwided ihat suc� improvamenis are not Intended or otteretl lor sale. If, however, the bullding or Improvement Is
/solC within'one yeer of completion, the ownao-6ullder will heve ihe burden of proving that he or she did not build or Improve tor puryose oi sele.). '
��I, sa owner ot Ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to construct Ihe profect (Sec. 7044, Business entl Professiona
Cotle: The contrectors lJcense Law tloes not epply to en owner of pmpeny wha builtls or improves thereon, enA who contrac�s for such pro�ect with e coNrector(s)
Ilcense pursuant to ihe Contractors License LewsJ.
❑ I em exempt u der sec. Business end Professions Code for this reason:
Signeture: 7 ��
Owne Ir D verilletl by tldvels license�� Yes ❑ No Ddver�cense No: �
Vedticatlon ol Ownershlp by (type ol document, i.e. - pmperty tex blll or tleed):
DIVISION OF INDUSTRIAL SAFETY PEHMR CERTIFICATON:
❑ I hereby certify that no excevation tive (5) or more feet In depth Into which e person is required to descend, wlll be meCe In connection with work euthodzetl by this
permit, antl Ihat no 6uiltling sWcture, scaffolGinp, lalsework, or demalition or tlismantling thereof, will be more ihan Ihiny-siz (36) fcet Ngh. (Chflp. 32, Grp 2, Art 2, Set.
341, Tllle 8, Calllornia Administrative Cade).
❑ As owner-builder, I will not employ enyone to do work which would requlre e permit tmm the Division of InCustrlel Sefery, es noted above, unlesa such pereon hea e
pertnit to do such work fmm the division.
Signature: Date:
DiWsion oi Industrial Selery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZ4TION OF ENTRV: I cenity under penelty ot perjury that I have read thls epplication antl stele ihat the informetion given is
wrrect. I egree to compty wl�h ell state lews end clry ordlnences rela�ing to building construction, antl euthodze representecives of the Ciry ot Coste Mesa to enter upon Ihe
ebova-descdbed property i. or inspectio�purpases.� a9ree nm to occupy or ellow occupancy of eny building euthorizetl by this pg�� un ��Fne� nspeclion.
y,�°i`v-tr 1m i i v o'1 ��1J Q�/ K7
(,Signe�FLegalOwnar(s) Date �^�„
_ ���
AnNOr Authorizetl Applicant Date
CO�E I, INSPECTIONTYPE
7616 Fixetl Systam Final Fire Preven[ion
1266
200
201
202
203
Pool Spa Final
Finel RB-Rooi
Flnel BIaWRetaining Wall
Final Factory Fire Placa
Finel Sign
204 Final Demolition
P!g I[it�L4
1�
i
f�l , �/.�
CODEt INSPECTIONTYPE
206 Finel Mechaniwl
20B Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Flnal Planning Approval
222 FInelSite
250 Final Builtling/Occupenry
Q� IIIIIDEL9
(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
,lobAddress: 2112 PRESIDENTPL
Suite No
Vicinity:
Parcel Number. 42244234
,4pplicant: KONTOS, GEORGE
Address: 2112 PRESIDENT PL
COSTA MESA, CA
Owner: KONTOS, GEORGE
Address: 2112 PRESIDENT PL
COSTA MESA, CA
Contractor: OW NER-BUI LDER
Address:
MECHANICAL PERMIT
ISSUED BY:
Phone: 949-642-6161
Zip: 92627
Phone:
Zip: 92627
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
REPLACE EXISTING FAU < t00K BTU IN SAME LOCATION.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt CoolingMeat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refriq Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood wlMech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < t0000cfm
AirHandlers> t0000cfm
Floor Fumace
Floor or Suspend Heater
$23.50
$14.80
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00 .
$0.00
Quantity
�
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeretion Unit
Ventillation System
Evaporative Cooler
Com m ercia l I ncinerato r
Domestic Incinerator
Comoressors I Absorotion Svstems
Upto3hp/100kBTU
3 To 15 hp I 500 k BTU
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
Up to 3 hp
3To15hp
i5 to 30 hp
30to50hp � ,"
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Stalus: ISSUED
Applied: 08I30/2006
Issued: 08/30/2006
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
E38.30
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21•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 180 days.
INSPECTIONS: In order tor the work authorized under this permit to be'consldered legal, such work must comply with all applicable codes, and all
required Inapectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
244&48 (8�00)
WORKERS' COMPENSA710N DECLAilA710N: . �
I hereby aHirm untler penalry of perjury ma ol the following tleclarations: ' � , � ,
❑ I have end will maintain a cenilicate of consent to sel4lnsure Iw workers"compensatlan, es pmviCed for by section 3700 oi ihe Lebor Code, br the peAortnence of ihe
work Por w�ic� t�is permit is Issuatl.
� I have and will maintain workers' compensation insurance, as required by section 3700 of I�e Lebor Cotle, for ��e peAormance of the work for which Ihis permit Is issued.
My workers' compensation Insurence carrler and policy number ara: •
Carriar: � Policy Number.
(Th/s secf/on need no( be complefetl ll fhe permit Is velued et one hundred dollers ($100) o� /ess.J
��. jcertify Ihat in Ihe pedortnanca of Na work for which this pertnit is issued, I shall not employ eny person in eny manner so as to becoma subject to the workers'
1��compensation laws oi Califomia, end agree Ihat il I should become subject to t�e workers' compensation provislons of Section 3700 of the Lebor Catle, I ahall fotlhwi[�
compy wilh these pmvisions. 1� )� �'7p /
Applleant;Stpneture�-�. .%P�.4 11 !C �7 � at1"e; � r[ / � d ( 0 `�
WARMNO.'FAINRETO SECURE WORKERS' COMPENSATION GE IS UMAWFUL rWp SHALL SU9IECT PN EMPLOYER TO CHIMINAL PENALTIES AND pVIL FlNES UP TO ONE HUNDREO
T1qUSAND DOLIARE (5100.000�.IN ADdTION TO TME COST OF WMPENSATION, DAMAGES AS PROVIDED FIXi IN SECiION �OBOF THE IABOq CODE, IMEREST, AfJD FTfORNE1"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I am licensetl untler provisions af Chapter 9(commencing with Section 7000) of Division 3 0l Ihe Business entl Professions Cotle, end my license Is In full
force entl effect. Lia a Cless x
Conirecbr's SignaNre: Date:
CONSTRUCTON LENDING AGENCY:
❑ I hareby aHirtn that there is a construction lending agency for the pertortnance of �he work for which �his permi� is issued. (Sec. 3097, Civil Code).
Lentlels Name: Lendafs Atltlress:
Signaiure: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby eHirm ihat under penelty ol perjury Ihei I am E%EMPT FROM THE CON7RACTORS LICENSE LAW for the following reason (Sec 7031.5, Business entl Protessions
Codo: Any city or counry which requires e permit to construct, elter, improve, demolish, or repair any siructure, prior to its iuuance, also requires the epDlicant tar such pertnit
to flie e signetl statement that he or she Is licensed pureuam m the provisions oi ihe Contrecmrs License Ww (Chapter 9(commencing with Sectlon 7000) ot Divislon 3 ot Ihe
Business end Professions Cotle) or that he or she is exempt therefrom end tha 6e5is lor iha ellegetl ezemption. Any violation af Section 7037.5 by eny aOP�icant for e pertnit
subjects ihe epplicant to a civil penelty of not more then five hundred dollars ($500).):
❑ I, as owner of ihe properry, or my employees with weges as iheir sole wmpensatlon, WILL DO 7ME WORK, antl Ihe structure is noi inten4e0 or ottered tor sale (Sec.
7044, Business and Professions Cotle: The Contractors Licensa Law does not apO�Y �o an owner of properiy who DuilCs or improves ihereon, antl who tloes such work
hlmself or herselt or throuqh his or her own employees, Dmvidea that such improvements are not intended or oflared for sele. It, however, �he bullding ar Improvement is
sold within one year of completion, ihe owner-builder will have Iha burden of proving �ha� ha or she did not builtl or Improve tor purpose of sale.).
�s owner ot the pro0erty, am EXCLUSIVELV CONTRACTINC WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 70G4, Business and Protessions
Code: The coniraciors Llcense Lew does not apply to an owner oi pm0eny who builds or Improves thereon, entl who comracts tor such pro)ect wilh a comrector(s)
llicen5e pursuant to the Con�rectors License lewsJ.
❑
Owner ID verifietl by tlnvefs license.
Verification ol Ownership by (type ol
Business anA Professions Code tor this reason:
Ye5 ❑ No
�,` i.9. - properry lax bill or
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no exwvetlon flve (5) or more feat in depth into which a person Is requirad to descend, wlll 6e matle in connection with work authodzed by ihis
parmit, and that no building slrucWre, scaHolding, falsewoB, or tlemoli�ion or tlismantling thereol, will be more ihan thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Ttle B, Califomia Atlministretive Cotle).
❑ As awner-builder, I will not employ enyrone to tlo work w�ich would require e pertnit irom the Division of Industrial Safety, as notetl ebove, unless such person has a
permi� �o do 5uth work trom �ha tlivi5ion.
Signeture: Da�e:
Division ol Intlustnal Satery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVATON OF ENfHY: I certify under penalty of perjury that I have reaa this epplication and state that the informalion given is
correcL I egree to comply with ell state lews and ciry ordinances releting to builtling construction, and authonze representatives of Ihe Ciry ot Costa Mesa to enter upon �he
ebove-descnbe roperty for inspectionburposes.� e not to ocapy ar allow wcupanty ot any building authonzed by this 30 until fin � inspection.
n� O ��� a �J o
' • �tagaPwmar(e C_�a�e_�
Antl/Or Authorized Applicant Date
COOE �. MSPECTIONTYPE
1616 Fixetl Sys�em Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Root
201 Finel Block/Retaining Well
202 Final Factory Fira Plece
203 Finel Sign
20C Finel Domolition
�
COUEI INSPECTON7YPE
206 Final Mechanical .
208 Final Plumbing
210 - Final Electricel
212 Final Fire Prevention
220 .Final Planning Approval
222 Final Site
250 Finel Building/Oaupan�
�
City of Costa Mesa Buil �ny u ety Departmeni
CORRECTION NOTICE
NAME-L.S�G'���' �ONTOS DATE��%�%y�
ADDRESS !��� � ��K r= ,j ��r'IV T j��, N� C.,F
INSTRUCTIONS:
The Following corredions are required by the building codes;
�s-�T/O C� ��= �c No j J')/e� i i Ml�-
CUiJr Rf-:Qc�� Rc- n��ivTs_
/- q L�<= � t/i)N6� i a t3'=
3 �' F-oni �,m��_�ry Gi N�,
2 - 5�,��o�r �o sT ��"
�1r-u w� ���o��<.h'ry �, �u�_,
/
3- ��3ov�- C������)'roNS
' j'1\ V� 1 I�J i_ /(� 1� �J�. l�-� L7. W I T 1'T
/
— I��-a�n �T r"t��u���D
,
Dn s �-o,�..G��;,�i�oL��4�VGE
When corredions are made, or.if;;there ore any quesfions, please
call the Building Safety Departmeii�t at-bd6-�d+1-
� a'5� -.3-i..-' 73
Time �' G�<%n% ����/%�r�
( e� � .�.+�.
�- WSPECTOR
.ILAS
OWNER KONTOS� GEORGE DATE 1-],Z-rp _
JOB ADDRESS Q119 Preaident Place BIiILDING PERMIT NO. �9(�
AP. No.
GROUP
INSPECTIONS
coat
Pinal Gas
TRACT 187@�E ZONE
TYPE
HOLD FO
DATE
SUBCONTRACTOR
��.'.c�L '.�y-G'
PLAN NO.
DATE
NUMBER
•�,
�
COSTA
� �3�3:3�>
MESA BUILDING DEPARTMENT
P. O. BO% 3 � �
COSTA MESA. CALIFORNIA
` S Pn�7 eµosra640� �:00
1'u 111�1%IYUL`�EPT. �� yas ^
CITY Of COSTA &1ES�
FOR APPLtCANT TO FILL tN APPLICATION FOR PERMIT
BUILDING 2��Z Pes,�e�...1 �/ 2ee BUILDING
ADDRE55
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
NECEIPT NO. PE IT NO. �
OWNER �� Y Q. OYl�OS �
) �f FECEIVfD BY OSTE RECEIVED ORiE ISSUED
ADDRE55 �!1/+ yQ$/.�ew�1' �QC�Q —
CITY �US�A� �S�L. NO. ' L� BUILDING � � r` r��
ApORE55
ARCHITECT ��c. ' COSTA MESA. CALIFORNIA
OR ENGINEER NO.
FIRE
ADDRE55 ZONE
[}��� /I CITV LIC. Z�N pO.n105' TYPE GPOUP
CONTRACTOR "`^'YIp� 4C�10a� NO.
AODqE55 NO. B qTE
S
DESCPIPTION NO /�� BLOCK TRACT��/ � � �� N
a.P. No. /a ^ pf,�'�,-�n � CITY OF COSTA MESA
srze 4�I,7Si l')YG %ll o y D"D X � rvo. or e�ocs. '
oF �or /0�6/ r�ow oH �or � SUBJECT TO BLDG. DEP7. REfi.
USE OF
E%ISTING BLOQ QSI QHC-Q. y /�T
SETBICK IINE FPOM f-T � B l /1 `
cEHrEn o� srac[r J� REAR YARD � J,
SIDE YARD RIGHT �� ,(O„ LEFT J'� •'
DESCRIPTION OF WORK -'---��... �--r---�'-;�;•-��---��-'-�.�-...
�C` �7 r4. �
NEW A�TERATION ADDITiON
� i' :i :.':1 3 .1 � E �C t'v -:J
5"1 R q�1
REPAIR MOVING DEMOLISH
��7 G1 k�; i� r,') M3 ^ A
BUILDING NO.OF •V "+% t✓ �i.f al FS�� �!�
SIZE ROOMS STORIES �'
EXTERIOR WALL .,(/ ROOF p ,�; �� �
COVERING S/N.CCJ COVERING ecwl ' � Y
`. �`I @t i11 _ n
USE OF NEW /� �'���AR. No.�.4P?RGVED Lo'�.'��i_.
BUILDING _(¢Q yQ .� ,u - �.. .
�'he� os i0•: t it a..J r�-O�O F.�' _ -�---
�"�'� o e� s'1-� N � 'f'v.,.�i-�-�a . The Amount shown under valua;ion is for the
I MENEBY 4CKNOWIEDGE T 4T I X1VE PEAD TMIS <PPIICI.TION nNO ung a permi ee ony.
STwTE THnT THE ABOVE IS CORRECT �NO �GREE TO GOMPLY WITM tLL
UTY ORDIN4NCE5 FNp STATE L�WS PEGUL�TING BUILOING CONSTRUC-
iiON. VAIUATION
SIGNATURE OF. PERMIT FEE S ��
PERMITTEE
� �� � PLAN CHECK 5 —
5 � AUTMORIZED AGENT TOTAL FEE $ �O
wi1
•••`• KONTOS_ G
JOB ADDRESS 211
GENERAL CONTRACT01
AP No.11 5-415-34'
INSPECTIONS
SOIL
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE HOlISE
SPRINKLING SYST�M
MISCELLANEOUS
ROUGH NEPTING Aryp AIR C0�
TEMPORARY SEfiVI�E OR POL
UNOERGROUND � POWER
FOffGH WIRING
00N� BEAM � STE
SHEATHING
FFAME AND FLASH�NG
LATMING — IN �
PLASTER.BROWN COAT
HEATING, VENT.,
PIUMBING. FINAL
ELECTRIC, FINAL
BUILDING, FINAL
EL REINFORCE
' �-Z4-/b
BUILDING PERMIT N0. 42550
SUBCONTRACTOR
. . , �.
� . � 42550
COSTA MESA BUIIDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
�
For Applicant to FiII in Co npletely — Use Ink Only
BUILDING
ADDRESS %'
owNea
MAIL
ADDRESS S,
CITV /� Q f�.r f' .�
TE
fl
P�lO
�ura4•�e,��s<O��e�U<:• ��;<��23.f0
I'OR STRUCTURAL PERMIT
DATE RECEIVED �y�F icci i n
NO.I I7 "i` I �—
TRACT I� (� I LOTI 6 Wl BLOCK
� G /
BRANCH
..i OWNER � , C <
ADDRESS J^/� //+�,� V UE �
ARCHITECT TEL. .� 5 /N OWI�
OR ENGINEER ' NO.
FIRE
ADDRESS � ZONE TV E GROU •
( APPROVED
CONTRACTOR � y QJ BY DATE
ADDRESS � ,/J� ' � �S
TEL. Z� NO.OF �'1 VSE OF NE
CITV NO. / P��L�s-� BUILDING
� STATE CITY �'ARDS APPROVED VA S APPq
� LIC. NO. -� LIC. NO. � MAIN BUILDING ACCESSORV B
w SIZE NO.OF BLDGS. (FROM GL STREET)
a OF LOT � NOW ON LOT � FRONT T%7%/ ^ FT.
a USE OF �
,.�., EXI5TING BLOG. SI E UFT. FT.
y r
FSeparate permits are required for L SIDE Fr.
0 electric, plumbing and heating work. REAq , T • Fr.
� USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET. MAIN &
Q MAIN BlDGS. O ACCF.SS. BlDGS.
� � VAR..$ DATE
� � ' ' � .U.P. #'- APPROVED
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� � � APF'ROVED � � Q_
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� I hereby acknowletlBe t�et I have �eed this application antl state
(Y, thai the abov0 ��formatian is corract antl agrea to comply wiih
0. all laws regulatin8 builtling consttucHon, antl I shall not employ
Z any penon in violation of tha workman's compenution laws of
� the Stete of California.
S �
3 I he�eby certity that I am properly Iicensed as a contractor untler SQ. FT.
the State of Californie Business and Professions Cotle, Division 3, THE AMOUNT SHOWN D ALUATI
Chap<er 9, and that such Iicanses e�e in full furce antl effect, or I THE PURPpSE OF ESTAB S PERMIT
am exempt trOm the provisions ot theStata of California Business VALUATION
antl Professions Cotla, Divislon 3, Chapter 9. P M T FEE S I
/ /� PLAN CHECK S /
Signature ot � G�� � "��j7 � n �
Permlttee --��1�� s E�;4`� $ �%�i TAX $
Authoflzed Apent � � TOTAL PAID y i
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ORANGE COUNTY BUILDING DEPARTMENT
• • ��:- 636 North Broadway �
' SANTA ANA, CALIFORNIA � '
FOR APPLICANT TO FILL IN
aui�oiNc
ADDRE55 2112 President Place
SCHOOL DIST. COBtN Mesa
OR TOWN
NEAREST
caoss sr. V1CtOI'18 Ave.
OWNER Crow Homes Inc.
ADDRESS 9363 Wilehire Blvd.
CITY Beverly Hills �a: CR54361
ARCHITEC7 O�t LIC.
ENGINEER [;AiYI—MC:KP.T`T'Af:I'1P..'P.
ADORE55 2110 R_Walnnf...PnaaAnna
ADDRE55 9363 Wilehire-Beverlv F
JESGRIPTION I NOT ZH6 I BLOCK I TRACT 1C
(ATTACH METES & BOUND51
�J NO OF BL�GS.
SIZE OF LOT 7 r x ZZO NOW ON LOT O
USE OF J I NO, OF I NO. OF
EXISTING BLDG. Fnr+.i�ies ROOMS
SETBACK LINE FROM:• REAR YARD
CENTER OF STREET Pt . SIDE YARD � �
DESCRIPTION OF WORK
D
EXTERIOR WAL�tuCCO I ROC
GOVERING COV
euE�oi��EWRe6ldenCe-Att
I HEREBV ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
SIGNATURE OF
PERMITTE �
AUTHORIZED A� `� �
� �
PERMIT FEE S '���•jjj
VALVATION $ 4830 � O P��H CHECK S '
TOTAL
FEE S /
9�90-l9
APPLICATION FOR PERMIT �
. ' �YY������
-FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
733d I��73
RECEIVED BV DATE REC'D. DATE ISSIaED
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SCHOOL DIST.
OR TOWN
NEARESI
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CORRECTIONS
APPROVALS
ION I INSPEC
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STREET
PLOT PLAN
Show location and distonces from
property line and between buildings.
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