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Home My WebLink About942 PRESIDIO DR - Building Permits(774) 754-5273 • Fex (7/4) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Jobnddress: 942 PRESIDIO DR Suite No Vicinity: Parcel Number: 14132814 Applicanl: Address: Owner: Address: i 1 , . Coniracror �.,Address: MECHANICAL PERMIT JOHANSEN, ROBERT C„TR 1700 HIGHLAND DR ,-�� _ NEWPORT BEACH, CA , �1 � i . - � JOHANSEN, ROBERT C TR 1700�HIGHLAND DR -� i' :--,`'� - i �. � NEWPORT,BEACH�CA�' � ,i; �� / �� CHANGE OUT FURNACE. � _ - ISSUE FEE Inst FAU �100 k BTU ' Inst FAU >100 k BTU Repair/AIt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU � Refrig Sys >100 k BTU Gas Piping Faclory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct � Appliance , Fire Dampers . Smoke Dampers - � , Inst or Relocate Appl Ven� Air Handlers < 70000cfm AirHandlers> 70000cfm Floor Furnace ". Floor or Suspend Heater ; Phone: 714-540-9400. Zip: , 92660-4815 � , Phone: Zip: 92660-4815 Phone � Zip: . • , License: � � SCOPE OP PERMIT ' Stalus: ISSUED Applied: 04/06/2007 Issued: 04/06/2007 ISSUED BY: � FEE SUMMARY � ' �� > �. � � �: � Quantity � � . � Quantity $23.50 � Repair /AIt Absorblion Unit .�. ��$0.00 0 �. $14.80' 1" '�'/ '� � '�% ' - Repair LAIt Refrige�ation Unii �- ' � $0.00 0 ' $0.00 - 0 _ "-'� - � � � �- Ventillafion Syslem -' ' • -, $OAO 0,� ` $0.00 0 - Evaporative Cooler � ' " $0.00 - 0, � i $0.00 0 - -. Commerciallricinerator � � ,� $0.00 0' , ' 50.00 0 . - - �,.Domestic Incinerator �- �! ; $0.00_ 0 . $0.00 0 � _ - -- - : � Comoressois / Absomtion Svstems ` _ ' � $0.00.� � 0'"� - �'- ' , Up,to 3,hp / 100 k BTU � , t '; _ $0.00 0 � -�'� $0.00 � 0 3 To 15 hp / 500 k BTU �$0.00 ,-'0 '' $0.00 0 15 To 30.hp / 1,000 k BTU $0.00 , 0 � $0.00 0 30 To 50 hp /1,750 k BTU ,. . ' $0,00 : 0' � �' i� $0.00 0 Over 50 hp / Over 1,750 BTU �'$0.00�� 0�+• � $0.00 0 Boilers ! ;� $0.00 0 ;"s: � �`' :' �.;Up to 3 hp � " `� _ $0.00 , 0 � � �. $0.00 0 -�-`�%� c� � 3�To 15 hp /.,.,'�� $0.00.' 0; 50.00 0 ' � 15 to 30 fip�.._ <%j�- � - $0.00 ��0 ,_ $0.00 _. _,0 .. , � " . � " 30 to 50 hp'i':.� :�'-;�--,:::... �. �/ ", ; $0.00" ; 0 -$0.00� 0'�� . , - .-�Over50hp. ..��`�.'..=,"- .�, ' � $O:OOi 0 �$0.00 0 � -- � -,OtherMechanicalFee _ � �' � ` . , $0.00 �.0_ - , � , . �Investigation Fee ,-,=�: i� �� ,� ; /.$0.00 - . ��Plan Check Fee --, �/ , � �- $0.00 .� � , , , �� ReinspectionFee�' �,�% � /$0.00 __ . � , , . . , � - � - . - � '-.. � . _ � � - � TOTAL-CALCULA,TED FEES -/ �$38.30 COMMENTS / SPECIAL CONDITIONS , , � - � � �, , � � , � i ,� �. , 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, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within iB0 days, or if work is suspended or abandoned for a period oF 780 days. INSPECTIONS: In order tor the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inapectlona and flnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 i eww-ca �aw� WORKERS'COMPENSAnON DECLARAnON: � ' I hereby aflirtn under penalty ot perjury one of the following declarations: , ❑ I heve and will maintain e certificate oF consent to setl-Insure tor workers' compensatlon, es provitletl for by section 3700 ot Iha Labor Code, for the peAormence of the work tor which this permit is issuetl. , - . ❑ I have antl will maintein workers' compensa�i� insurance, as required by seclion 3700 of Ne Labor Cotle, for the peAortnance of the work for which this pertnit is issuetl. My workers' compensation Insurance carrier and policy number era: • Cartier. Policy Number. is valuedet orless.) � I certity that in the peAor iance ot the worl< <or which Ihis pertnit is issued, 1 shall not employ any person in any manner so es to become suDject to lhe workers' -' compensetion laws of d�ifa�ni and agrea that If I should become subject to Ihe workers' compensatlon provisions ot Se tlon 3700 01 tha Labor Cotle, I shell fonnwith comply with Ihese Dr ��o A. ��' ^� 4ppliwniSignaN��e'.� � "� Dete: ��' � WARNING: FAILUFE TO S GRE ORKERS' COlAPENSATIqJ COVERAGE IS UNUWFUL AND SHALL SUBIECT AN EMP�OVER TO CRIMINAL PENALtIES AND GVIL FlNES UP TO dJE HUNDRED TTqUSAND DOl1ARE ($1 ,000) N qDDITION TO THE �T OF CAMPENSFTION, DAMAGES AS PROVIDE� FOR IN SECTION 3]O60F THE IABOR CODE, INrEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Nat I am licensetl under provisions of Chapter 9(commenr.ing with Section 7000) ot Division 3 of the Business antl Professions Code, and my Ilcense is in full force end ettect. Lic. N Glass N ContractoYs Signature: Data: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that Ihere is a consiruction lentling agency br ihe peAormance ot the work br which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Atltlress: SlgnaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm ihat under penalry of perjury thet I am E%EMP7 FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Protessions Code: Any ciry or counry which requlres a permil to consiruct, alter, improve, demolish, or repair eny strucWre, prior to its issuance, also requires the applicant for such permit to file e signetl statement t�at he or sha is IlcenSed pursuent to lhe provisions of the Contrectors License Lew (Chapter 9(commencing with Sedlon 7000) ot Division 3 of the Business and Professions Code) or Ihat he or she is eaempt thereirom entl Ihe basis Por the allegetl exemption. Any violation ot Section 7031.5 by eny applicant tor a permit �su/b'�e�cs the epplicant to a civil penelry of not mere than live hundretl tlollars ($500).): �I, as owner of ihe property, or my emD�oyees wilh wages as their sole compensation, WILL DO THE WORK, antl ihe structure Is not intantle0 or otteretl tor sale (Sec. 70a4, Business and Professions Cotle: 7he Coniractors License Law does not apply to an owner ot proparry who builtls or improves ihereon, antl who does such work himseli or herselt or through his or her own employees, provided thet such improvements are not Intended or oHeretl for sale. tl, however, Ihe building or improvement Is sold within one year of wmpletion, the owner-builtler will have ihe burden of proving that he or she did not build or improve for purpose ot sele.). • ❑ I, as owner oi the pmperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTpACTORS to consiruct tha project (Sec. 7044, Business and Professions Cotla: The contracrors License Lew does not eppry ro an owner oi properry who builds or Improves Ihareon, entl who comracis tor such pro�ect with e comractoqs) licen5e pur5uan� b lhe COMraCtors LiCen58 Laws.). ❑ I am ex er sec. Business antl Protessions Code for this reason: uref` Date: Owner ID v ie by drivers license. ❑ Yes ❑ No Dnvers Licensa No. Enpires: Veritication of nership by (rype at tlocument, i.e. - properry te�c 6i11 or deed): � DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity that no excavation five (5) or more feet in tlepih in�o which e person is requiratl to descend, will be mede in connection with work authonzed by ihis pertnit, and ihat no building sWdura, scallolding, lalsework, or demolition or tlismantling thereot, will 6e more than thlrty-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitomla Adminis�ra�ive Cod@)� ❑ As owner-builder, I will not employ enyone to do wark which wauld require e permit from Ihe Divisian of Intlustnfll Sefery, as notad ebove, unless such person has e pertnit to do such work trom Ihe division. SignaNre: Date: Division ot Indusinel Safery Permit Number. CERTIFlCA7E OMPLIANCE AND AUTHOH�ITION OF ENTRV: 1 certify unUer penalry of perjury Ihat I have read ihis application and state that ihe infortnatlon qiven is correcL I egr comply with ell state laws end ciry ordinances relating to bullding construction, antl authodze representatives o1 the Ciry oi Coste Mese lo anter upon Ihe above-des �erry for inspection purpos�s. I egree not to occupy or allow occupancy of eny building authonzed by thi� ryit unti�Qel inspection. ��5�' �� l0 7 fSlaneture Of Leael �'�BF(5)'^4. Date CODE �. INSPECiIONTYPE . 1676 Fixed System Final Fire Prevenfion 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demolition Q1IE Rmru�s COUE� INSPEGTIONTYPE 206 Finel Mechanical 20B Finel Plumbing 210 Final Electricel 212 Final Flre Prevention 220 Final Planninq Approvfll 222 Finel Site 250 Final Building/Occupflncy Data o.}!ihnoosess: qq� pkE5ID3t� UR OWkEH'SNAME: SOF'IANS�N ROBERT C ,,aooeess: 1760 IOW`A Si C_OSTA McSA,CA 426T6 241-8154 APCH/ENGINEEN: . AUOPESS: PEG.NO.: uxir: UNIT: PEBMITTEE: GREAT�R PACTFTC 1�00'r'ING ( 714 ) 836-7.960 aooness: 1016 E. FIRST S'P SANTA ANA CA 92701 LICENSEO CONTflFCTOB OECIANATION: I nereby a��irm Ibal I am licensetl untler pmvisions ot CM1apter 9(commencing with Seclion 700�) ol �ivision 3 of t�e Business ane Pmiessions Code. an0 my license is in �ull force and e�fec�. ciTruc.: 56ASR srnreuc.:Fz1368 SS' -34 —9a�e: — Signa�ure:. � WOHKEflS' COMPENSPTION OECIAflFT10N: I nereby ailir e a certilicate o� consen� to selFinsure or a cenilica�e of Workers ' ComDensalion Insurance. or a cerutiea copy thereal (Seciion 380 a0. C) - j voucvNo.: 285-92IIN1T00186 EXP. TE: U� IOI I93 COMPRNY: S 1 ATE FU�IP � Cenilietl copy is hereby lurnis�ed � Cenilietl coOY is liletl with the city Building Oivision. � �e: `�� 1� 'APOIi nP. E%EMPTION FPOM WORRERS' COMPENSl�TION OECIABA :(Thi se io neetl not be camDl¢�ed if Ihe Deimrt is lo� one hunarea ($100) or less�. I ceNty I�at in Ihe pertormance oi Ihe work �or which �his permi is suetl. I 5hall not employ any person in any manner sa as �o become su�le<f to 1he Wo�kers' Compensation Laws ol Califomia. Dale: Signarore: NOTItE: II, ailei making Ihis Declaration. you should 6ecome suble�� o �he WOBers' Compensation pmvisions of Ihe Labor Cotle. you mus� fohhwiih comply wi�h such pmvisions or �hls permit s�all be deemed revokeA. CONSTPUCTION LENOING AGENCY: I here�y alfirm thal �here is a cons�mction lending agency for ��e pedormance oi Ihe work for wnich Ihis permii is issuetl (Sectian 3W7. Civ. q. LENOEX: ADOflESS: OWNEN BWLOEB OECUHRTION: I hereby ailirm �hai I am exempt Imm Ihe Cantracmrs' Stale License Law far �he following reason �Section 703L5 Business ana Pmlessional Cotle: Any ciry o� counry which requires a permit to cons�mct, aller, improve, demolish, or repair any stmqure, prior to iis issuance. also repuires Ihe applicant for sucA permi� Io lile a signed stalemenl Ihat he/she is Iicense0 � pursuanuo the pmvisions oi Ihe Contmcwrs' S�a�e License Law �Chapter 9 �commencinA wiN Seclion 7000) of Oivision 3 ot ��e Busine55 '� and Prolessions Code) or �hal helshe is exempi Iherelmm and ��e basis for I�e alle0e0 exemption. Fny viola�ion of Section 703L5 by any applicanlfor a permii sublecis the applican�lo a civil penally of no� more [han live hundred Jollars (5500�. . I, as owner of the pmpeny or my emplayees with wages as their sole compensation, will do ihe work, an0 the ❑ slwcmre is not intentletl or ofieretl for sale (Section 70a4, Business and Professional CoOe: The Coniracmrs' Staie License Law does no� apOty to an owner of a pmpeny who builtls or impmves Ihereon, and w�o �oes such work himsell/herself or t�mugh �is or �er own emplayees, providetl iha� suc� impmvemen�s are not in�entled or oflere0 for sale. I�, however Ihe building or improvemeni is sold within one year of comple�ion, Ihe owner will �ave �he burtlen ol pmving Ae/she Oid noi huiltl ot impmve forthe purpase ot sale). I, as owner of the propetly. am exclusively contracting with licensed conVactor5 io cons�mc� t�e pmlec� (Section 7044, Business ❑ ana Pm�essions Cotle: The Coniractors' Sla�e License Law does not apply �o an owner ol prapetly who builtls or impmves Ihereon and who coniracis for such projec�s wiih a conVactor(5)license pursuanito the ConVaclor5' Siale Llcense Law),I am aware ��a� pmo� o� their Worker's Compensalion insurance shoultl be D�oviOed �o me. � I am exempl untler Seclion�, e. 8 P. C. for this reason: �a1e-. - Owner I tlo here�y cenify ihat I am aware af antl untlersiantl Ihe requiremeNs ol Calilomia Heatlh ana Sa�e�y Cotle Sec�ions 25505. 25533, antl 25534 ana I�at I or anyluWre buil0ing ocapan�willlwill not�circle ane) neetl�o comply with saiA stale cotles antl�here0uiremen�s�ora permit for conslNclion or modification Iromihe Air �uali�y Managemeni �islric�. Resiaenlial con5tmction applicatians are exempt imm ��ese pravi5ion5. Date: � qpplicant:. I here0y certilylhal Il�ave reatl�his applica�ion antl slate or0inances antl slate laws relating lo building consimclion ; pro0etly �orin50CtI�On pufp0525. �, �� -9Z c� 06ver's License or Social Security ahove infarmalion is corred I agree � omply with all city and caunry iyauthonzerepresenta��vesa� � ytoenterupontheabov¢-meniionea i64b46 Whne—Builtlmg; Green—Code Enlorcemen�. Canary—Appl¢anl: Plnk—Revenue: Goltlenrotl—Assessor � CITY OF COSTA MESA — EUILDING� PERMTT PERMI"P NO: B 059856 PLAN CHECK NO; N PERM NU: B 0598So GOVT; N SC:PP: N CONSTROCTION TYPE; V—N PERMIT TYPE: S'Pk PURPOSE- ALT JOB.DESCRIPTION : T/OF'F RESHT. REROOF W/FIBEkGL'ASS SHINGLE SQ FT'; 5,470 CLAIM VALliE: 5,470,00 CALC—VALUE: 5,470,00 GROUP OCC; R-3 / COMN,ENTS: SMOKE DETECTOR HE�C7IRF'D �IEif�IciF-1E�%�If�JfK��-1F-)EiE�1EJEiE�Y.�3E�X-#iF#%iF#%�)i� �%%��%fFM�3F�%ifiE%-%iE�%if�%-1E-%3f�IF�)F�k#�1C-�%�lFit��}:�fEitiFiE�I(�9kiflFX%��X�IfiFiE�*-?59E�lFiFk-�F1(�lEli Z O N T N G R E Q 0 I R E M F. N T' S s E 2� � a c. x s ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --- ----- FRNT: FT IN REAR• FT IN. FANT: F1' IN REAR: FT ZN LEF'C; FT I�l RGHT; FT IN LEFT; FT IN RGHT'; 'r'T IIQ PARICING REQ• PROV: PARCEL; 14i32a14 ZNE; REF NO; PLANNZNG NVT'ES% i `E iE iF 3f if iE IF ih %±E :Y� iFlElf� fE �1(� #!F lE Y� iF iElt it iF )k M�lE iE i! iF iE 1f E 1F iE �lF !F 1t 3f 1F it �1F 7E ik iEiF iF if iF IE iE �If !F X� i41E IFi(� ik•N-%�1i"N� if� ik if # iF3Fif iE iE iE iE iEiF � if 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�3;, S ZONING AUPROVEb HY , DAT'E: �''� __ BUILDING APPROVED BY APPLICATSON IS5UED B' 1(� iE %�if iE iE if if fE �E # M� �h iF 1E it iF iE iF fi 3E iE �lt ik 1F �lb i( iF 3F iE 3E i(�-)h �%iF if iE i(" %� % LEGALI'LAT?ON;N BLDG PMT PLUMBING ELECTRIC MECRANIC FIRE SMIP/RE: GRApSNG PERMiT 81,00 5�;,. PLAN . _ SMIPldJON;-RES i3SUE FEE � �' BUILDING—DIV—> PEHP2IT ZSSUE PLAN—CHECK TO'TAL PAID � pt7�; TOTALS----> 81.55 0,00 0,00 81,55 81,55;,`.,� ,UO REVENUE DIVISION TOTALS--> COLI�ECTED; 81,55 OVER/SHORT: .00 DLDG PA7T PLT.7MBING ELECTRIC MECHANIC F.IRE SM.IPITOT GRADTNG PLAN—C?iECK 81,00 y,. , 55 ?f iE #,t if �f iE if if iE 3F iFiE it if # fE if� i4 iF iF iF iE iE iE it iF # iE iF iE ih it 3E �1! iE �)E �X�% 3E 1F tE iE if� ih iE if it iP ik+f iP �K� iE iE # ik iP 1f 3f if� ff �lf� 7f 3E i!- iFlf�� IF i( iE iQ fE �k �lE ti?i Z N p I V I D U A I.� F c E B R E A K D O W N � r TYPE uTY D E S C R I P T I,-O N UNIT COST ;aT.vTAL CO$j SFR 5470 REROOF BY VALUF' RES.IDENTIAL NOZONE 1,00 � 1•�,47U,Op El3D OF FcE5 � 'i . �� D No� � �,9� D � o� CtiY. OF COSTA MESA I' CONSTRUCTION ANDPLANNING �t�APPROVALS Permit# 7. Temporary Electrical Service or Pole �� 2. Soil Pipe-Undrgrnd. � 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. � . 5. Steel Reinforcement 6. Elettrital UFER Grnd. 7. Footings � 8. Foundation � � 9. Water Pipe-Undrgrnd. w . 10. Structural Floor System Y � 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 74. Rough Plumbing 55. Rough Eleccrical-Conduit � 16. Rough Electric Wiring � 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Fleating & Air Conditioning 20. Rough Factory Fireplace � 21. Ducts, in Structure . 22. Ducts, Ventilating � 23. Gas Pipe�Rough & Test 24. Roof Framing � � 25. Roof Sheathing � r) 26. T�Bar Ceiling (Structural) & Monocoat // 27. Frame and Flashing 28. Lathing & Siding 29. Insulation . 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning, 35. Final Gas Pipe�Test � 36. Hood or Canopy .37. Final FaLtory Fireplace 38. Final Plumbing 39. Water Service�Final 40. Gas Service�Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handicap ftegulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southem California Gas C 51. CERTIFICATE OF OCCUPANCY N0. Date Daxe ' I PO� .SPA I . Inspector Date Inspector i' - � I• ! � I.. 1 � APPROVALS Permit # 52. Pool & Equipment Location � 53.�Steel Reinforcement ' 54. Forms 55. Electrical8onding 56. Rough Plumbing�& Pressure Test 57. APPROVA�TOCOVER�GUNITE 58. Eiectrical Conduit-Undrgrnd. � 59. Gas Pipe, O Undrgrnd., Test 60.� Backwash Lines, P-Trap, � Undrgrnd. 67. APPROVAL TO DECK ' 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final ' 65. Efectrical�Final - 66. Solar SYstem-Finaf 67.. Fencing & Access ApProvat 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground HYdro .77. Product Piping � Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Stora9e Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 76. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION � S0. FOOD CERTIFICATE ISSUED Notes: /�%« %Sf, Y1��, _ y 0 CITY OF COSTA MESA SERVICE REQUEST & PUBLIC ASSISTANCn r"ORM Date ��/S�7�L� Nature of i � Referred ion, type, * V 0 •.' , � �� i''i 1` 11 . � ,�� , �� ., � 11 Call back Service Only � � ❑ _ � Information Only � r Person Receiving Call io-s-77 SPoK� l� /y� T"�s/o.y�.to.v. .qar�,JEd 7�f�As EXPA�vf� vE So ic. �,v,q S�/108[ FM fJN,A NvuJ � /y�d/iMYQE .2SAMA6E �,v �v r�//t E . �r�' u�:�0 COSTA MESA BUILDING-SAFETY DEPARTMEN P. O: BOX 9f7 C08TA MBBA. CA6�PORNIA� For Applicani fio Fili In Compietely � �TYPE OR�PRIN7 ■ BUILDING � COSTA MESA: CALIFORNIA OWNER Mesa Del �r Develo men� ADDRESS.�V� F'. Coast�Higheay �,Tv Corona del �ar Calif • NEC OR ENGI EER MaCCO ri0 OT2.t1OR NEC aooRess 3800 E. Coast Hi wa� CONTRAGTOR - �CCO�•COI'pO�ration ucTrEio: 98808-SB-1 No: OR 3�t22C 81ZE UO(�O S F ' . I NO. OP BLDGI C1F l(lT % NOW �N LOT FEE IitGtIVtU Lot 74, Ts'act 4285, P1ap/li00 ARSEP b. �y69' T �Y FINANCE OEPT. CITY OF COSTA MESA BUILDING teaw� APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. PQRHIRry �� % V I O� %CE�/E9 / I DATE IBSUED y �✓ COSTA MESA. CALIFORNIA ZONING No. oF uae oP PLFN9 BUILDIN � U6H OF None YARDS .EVES EXISTING BLDG, APPROVED ALLO BRBAGK LINB PROM 47� 2'] � «NTBq LIN8�8TJ �j ceMew ov sin¢er REAR YARD J FRON7 �( FT. r 1 61DE YARD LEFT . J� 3�� I RIGXT R. SIDE !` FT. DESCRIPTION OF WORK ' �. S�oE .s-- FT. NEW I� IIALTERATION I IIADDITION I pFaq �� Fr SIZE uwcYl � n��xC � no' or V ] J ROOMS EXTERIOR WALL ^ ROOF COVERING $Y.11CCO COVERiI USE OF BUILDING AND WORK TO BE r-� 1 HERBCY ACKNOWLCDOe TXAT 1 XAV6 RGAO THi9 APPLIWTION AND BTATE THI�T THE ABOVE 18 CORREGT AND AOREZ TO COM- PLT WITX ALL CIlY OHDINANCE6 AND BTATE L11W8 P60ULATING BYILDINO GONBiAUR10N. � 61GNATURE OF PERMITfE AUTHOR ED '�/`�—� r... ' � 3 E a //S TXE AMOUNT BXOWN UNDER VALUATION IB FOR THE PURP06E OP E6TABLIBHING A PERMIT FEE ONLY. VALUATION �J PERMIT FEE $ .3 J � n N $1a�2�i7�� PLAN CHECK $ I7 � � Z p R TOTAL FFF A / �o0 0 �.,