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Home My WebLink About874 PROSPECT PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber ApplicanC Address: Owner: Address Contractor. Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+unils) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t 000a Motars to 1hp Motors to tOhp Mators [o SOhp Motors to 100hp Motors over 100hp � Communication drops Sub panel to 200a Pole Ligh�kg 874 PROSPECT PL 41806413 DAVID CAHSE 8512 LORRAINE DR HB,CA JORDAN, MICHAEL A 874 PROSPECT PL COSTA MESA, CA DAVID CAHSE 8512 LORRAINE DR HB,CA ELECTRICAL PERMIT Phone: 714-965-0175 Zip: 92646 Phone: Zip: 92626-2954 Phone: 714-9650175 Zip: 92646 � License: 800746 Status: ISSUED Applied: 01/24/2005 Issued: D1/24/2005 ISSUED BY: � � , � . ^�� ' / � . i d,r SCOPE OF PERMIT REMOVE EXIST CONC. SLAB IN THE LIVING ROOM FOR THE PURPOSE OF LOWERING THE THE NEW FINISHED FLOOR TO MEET THE EXISTING FLOOR ELEVATIONS. - $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 3220 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 _ 2. � 0 0 0. � �: 0 0 0 0 0. 0 0 0 0 0 _ . _ FEE SUMMARY Temp DisPSystem / Lighting Busway/700ft ., Standing Section _ Misc Electrical Equipment - ` Transformers up to 1 kva/kw . .:; %... � . ..........::...:up to 10 kva/kw : .' - . � ..:.........."..up to SO,kva/kw � . ....:.._........up to 100,kva/kw ; " ........:.........over 100 kva/kw Low Voltage Equipment , Low Voit Wiring System / Ckt� � Misa Conduit � � � - Misc. Conductou . - � Circus ( gen or nde) Circus (mech ride or lights) . Christmas Tree Stand � . Fireworks Stand '. � . :Other Electrical Fee ' _ -�Investigation Fee� ' . - � Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 ,; �0" $0.00 -; � - 0 $0.00 '" 0 50.00 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 50.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No.92-28, § 1, 12-21-92) ,�•� EXPIRA710N: 7his percnil shall automaticaily expire and become void it work is not commenced within 780 days, or it work is suspended or abandoned for a periotl of 780 days. t 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 inspectlons and (inel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot�this permit. FOR INSPECTIONS CAL�: (714) 7545626 24a6-46Ifi/00) WORKERS' COMPENSATION DECLARATION: � I �ereby eflirtn under penalry ot perjury ona of the following tleclarations: ❑ I have end wlll maintain e certificate of consent to salf-Insure for workers' wmpensetion, es provided tot 6y section 3700 of the Le6or Cotle, tor t�e pBAortnance of the work tor which Ihis petmit is issuetl. ❑ I have antl will mainWin workars' compensetion insurance, as raquiretl by section 3700 of the Lahor Cotle, for ihe perfortnance of Ne work for which this pertnit is issuetl. My woMers' wmpensatlon Insurance carrier and policy number are: Carrier. need not be crompleted il the penrrit is or less.) Policy Number: f� 1 cenHy that in the pedortnance ol the work for which Ihis Dermit is iuuetl, I shall not employ any person in any manner so es to bacome suhject to ihe workers' �compensation laws of Califomia, entl egree Ihat it I shoultl become subject to the workers' compensetion provisions o1 Section 3700 0l the Lebor Cotle, I shall tort�wlth camply with these pravisions. APP� � WARNINO: FAILURE TO SECURE WORKERS' WMPENSATION COVERAOE IS IINLAWFUL PND SMALL SUBJECi AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED iiKK15AND DOLLARE ($100,000), IN ADDRION TO THE COST OF COMPENSATION, OAMAGES AS PROVI�ED FOP IN SECTION 3IOB OF THE LABOq CODE, INTEREST, AND ATTORNEI"S FEES. LICENSED CON7RACTORS DECLARATION: I hereby attirm that I em licensed untler provisions oi Chapter 9(commencing with Section 7000) of Division 3.0�,� e Business and Professions Code, end my license is in lull farce.and.eflecNL�N �Cless x r�� Contiector's�S16 aNre: �Dat,e,_ CONSTRUCTION LENDING AGENCY: ❑ I hereby aRirm that there is a consWction lending agency tor the pertortnence of ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Name: lender's Adtlress: SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aNirm thet under penalry of perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Protessions Code: Any ciry or county which requires a permi� to consiruct, alter, improve, tlemolish, or repair any simcture, pnor to its issuance, also requires Ihe epplicant for such pertnit b file e slgned statement that he ar she Is Ilcensed pursuent to ihe provisions of the Contractors License Lew (Chapter 9(commencing wi[h SecHon 7000) ot Divislon 3 ot Ihe Business entl Professions Code) or Ihat he or she is exempt therefrom and the basis tor the ellagetl exemption. Any violation ot Section 7031.5 by any applicant for e parmil su6�ects the applicant ta a civil penelry of not mora then five huntlred dollars (5500).): ❑ I, as owner ot the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is noi intantletl or otfered for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew dces not ap01y to en owner ol properry who builds or improves ihereon, and who tloes such work himsell or herself or through his or her own employees, provided ihai such improvemen�s are not intended or ottered tor sale. If, however, the building or improvement is sold within one year oi completion, the owner-builder will have the burtlen of proving that he or she did not huild or imD�ove tor purpose of sala.). � � I, as owner of tha property, am E%CLUSIVELY CONTRACTING WITH LIGENSED LONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions Code: The comractors License Law tloas not apply to en owner oi propeny who builds or improves ihereon, end who contrects tor such project with e comrector(s) license pursuant to the Coniraciors License Laws.). ❑ I am ezempt under 58t. Business end Profe55ion5 Code tor �his reeson: Signature: Date: Owner ID venfietl by driver's license. ❑ Ye5 ❑ No Dnvers License No. Vedfication oi Ownership Dy (type of tlocument, i.e. - property tax bill or dead): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation five (5) or more feet in depih in�o which a person is requiretl to descenQ will be matla in connection with work authorized by t�is permit, and t�ai no building sirudure, swftoltling, falsework, or demolition or dismantling ihereot, will be more ihan ihirty-six (36) feet high. (Chap. 3.2, Gip 2, Art 2, Sec. 341, Ttle B, Calilornia Adminisirative Code). � ❑ As owner-6uilder, 1 will not employ anyone to do work which would require e permit irom ihe Division of Indusirial Satery, as noted above, unless such person has e permit to do such work irom the division. Signature: Date: Division ot Indusinal Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE ANU AIJTTIORVATION OF EMAV: I certify under penalry of perjury that I have read �his application end stale Ihat �he information given is correcl. I egree Io comply wlth ell state laws end ciry ordinances relating to building construction, and euthonze represematives of Ihe Ciry of Costa Mesa to en�er upon the ebove�descnbed property for inspection purposes. I egree not to occupy or allow occupancy of any building au�horized by ihis permit until final inspection. Signature Oi Legal Owner(s) COUE �. INSPECTIONTYVE •" 1676 Flxed System Flnal Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demolition Qdjg IMITIALS yODE 1 INSPECTION TYiE 206 Final Mechanical 208 Final Plum6ing 210 Final Electncal 212 Final Fire Prevention 220 'Final Planning Approval 222 Final Site 250 Final Building/Occupancy 14\li `�� (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 874 PROSPECT PL Suite: Vicinity: Parce� Number: 41806413 Applicant: DAVID CAHSE Address: 8512 LORRAINE DR HB,CA Owner: JORDAN, MICHAEL A Address 874 PROSPECT PL COSTA MESA, CA Contractor. DAVID CAHSE Address: 8512 LORRAINE DR HB,CA Zip: 92646 Arch : Address: 2oning: R1 R1 Phone: 714-965-0175 Zip: 92646 Phone: Zip: 92626-2954 Phone: 714-965-0175 License:" 800746 Eng: Address: ISSUED BY: Status: ISSUED Applied: 01124/2005 Issued: 0'I/24/2005 A Phone: � Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXIST CONC. SLAB IN THE LIVING ROOM FOR THE PURPOSE OF LOWERING THE THE NEW FINISHED FLOOR TO MEET THE EXISTING FLOOR ELEVATIONS. � " Plan Check: $63.21 Permit: $97.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $160.96 SETBACKS MAIN STRUC7UftE � Fron[ 0- 0 �. ACCESSORY Front 0- 0 PARKING Existinq: 0 FEE SUMMARY Rear 0- 0 Rear 0- 0 Re uired: 0 Calc Valuation: Claim Valuation: PLANNING& ZONING , � - Left � �0- 0 _ - �� Right � �0- 0� � " . Left 0- 0 Righf � 0- 0"� � .. . Proposed: �.0 " - - NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California 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 if work is sus{ lor a period of 780 days. INSPECTIONS: In ortler for the work authorized under lhis permit to be considered legal, such work must comply with all appl required inspectlons and tinal approvel must be obtained. Failure to obtain inspections and final approval will result in the expira� FOR INSPECTIONS CpLL; (714) 7545626 2448-46(fY00) $a,000.00 $a,000.00 related abandoned es, and all permit. WORKERS'LOMPENSATON DECLARAnON: � I hereby efrirm under penatry ot perjury one of Ihe tollowing declarations: ❑ I heve entl will maintein a certilicate of consent to setl-Insure for workers' compensation, es provided for by section 3700 of the Lebor Code, far the peAormence of Ihe work for which this permit is issuetl. ❑ I have and wlll maintain workars' compenutlon insurance, es required by section 3700 of ihe Lebor Code, for the peRormance of Ihe work for which this pertnit is issuetl. My workers' compensatlon Insurence carner and policy number ere: Carrier: Policy Number: (This secJlon nee0 nof be comp/eted i! (be permlf is velued at one huntlretl tlollers (5100) or less.) cetllfy that in Ihe peAormance oi ihe work for which this pertnit is issued, I shall not employ eny person in any manner so as to become subject to Ihe workers' compensation laws of Califomie, antl egree Ihat it I should become subject to the workers' compensation provisions of Section 3700 of tha WDor Code, I s�ell fonhwith wmply with these provislon5. App`licanCSipnetufe: Deta: WARNINO: FA LURE TO SECURE WORKERS' COMPENSNTION COVERAGE IS UNLAWFUL AND SHALL SOBIECT AN EMPLOY H�jO�CFtl1.UNAL PENALTIES AND CML FlNES UP TOONE HUNDRED T/IOUSAND DOLL4FE �Et00,OD0). IN qDDfT10N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]W OF T�E LABOR CODE, INTEREST, ANO ATiORNE1^5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn�aLl.am licensetl under provisions of Chaptar 9(commencing with Section 7000) oi Division 3 of the Business entl Professions Cotle, and my license is in full CONSTRUCTION LENDING AGENCY: �-"'� ❑ I hereby aflirm that there is a consiruction lending agency for the petlormance of the work for which this permit is issued. (Sac. 3097, Civil Cotle). Lenders Name: Lender's Address: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby eifirtn thet untler penalry of perjury lhat 1 am E%EMPT FROM THE CONTRACTORS LICENSE LAW fo� ihe tollowing reason (Sec. 7031.5, Busineu antl Professions Code: Any ciry or counry which requires a permit to consiruct, alter, improve, demolish, or repair any struciure, pnor to its issuance, also requires the appliwN tor such pertnit ro lile e signed statement Ihat he or s�e Is Ilcensetl pursuent to ihe provisions of the Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 01 Ihe Business and Professions Code) ar that he or sha is e:empt theretrom end the basis for Ihe ellegetl exemption. Any violation oi Section 7031.5 by any applicent far a pertnit subjects the eppliwnt to a civil penalry of not more ihan five hundred dollars ($500).): ❑ I, as owner ot the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and Ihe structure is nol intendetl o� ofleretl for sele (Sec. 7044, Business and Protessions Code: The Con�ractors License Law does not apply to an owner of property who builds or improves thereon, antl who tloes such work himsel( or hersetl or through his or her own employees, provided thai such improvemen�s are not Intended or ottered lor sale. If, however, the building or improvement is sold within one year ot wmpletion, the ownerbuilder will have the burtlen of proving that he or she did not build or improve for purpase oi sale.). � ❑ I, as owner of Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construtt Ihe project (Sec. 7044, Business end ProtesslOns Cotle: The contiadors Llcense Lew doas not epply to an ownar oi property who builds or improves thereon, antl who contracts lor such projact with a coniractor(s) license pursuani to the Contrectors Licen58 WwS.). � I em exampt under sec. Business and Protessions Cotle for this reason: SignaWre: Date: Owner ID veniietl by dnver's license. ❑ Yes ❑ No DriveYs License No. Venfication of Owners�ip by (type of document, i.e. � pmperty tax biil or dead): Expires: OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavetion five (5) or more feat in depih into which a person is required to descend, will be made in connection with work authorizetl by this permit, and Ihat no building structure, swffoltling, falsework, or demolition or dismantling thereof, will be more than thirty-si: (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tule 8, California Administrative Cotle). � ❑ As owner�Duiltler, I will not employ enyone to tlo work which would require a permit from the Division ot Industnal Safery, es notetl above, unless such pereon hes e pertnit to do such work trom the division. Signature: Data: Division ot Indusirial Satery Permit Number. CERTIFlCA7E OF COMPLIANCE AND AUTFiORIZATION OF ENTRV: I cenity under penalry of perjury that I have read this application end state that ihe intormation given is correct. I egree to comply with ell state laws en0 city ordinances relating to building construaion, antl auihonze representatives of the Clry ot Costa Mesa to enter upon Ihe ebove-descnbed D�operty for inspection purposes. I agree not to acupy or allow oaupancy ot eny building authorized by t�is permit until finel inspaction. SignaWre OI Legal Owner(s) COOE1, INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1288 Pool Spe Final 200 Final R8-Rool 201 Final Block/Retelning Wall 202 203 ?04 Final Fectory Fire Placa Final Slgn Final Demolition PdIE IN7IDss64 tl7ID COUE� INSPELTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Finel Fire Preven�ion 220 Final Planning Approval 222 Final Sita 250 Final Building/Occupancy 2ATE 1[�A45 No. _ WILLIAMS INSULATION COMPANY OF CALIFORNIA 1201 E. Hunter Ave., Santa Ana, California 92705 (714) 972-9632 ' THERMAL INSULATION CERTIFICATION THIS IS TO CERTIFV THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH � CURRENT ENERGV REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24 STATE � OF CALIFORNIA, IN THE BUI�DING LOCATED AT: Tract Name � Lot No. � 3� Tract No. 10513 glock No. , Street � � � /�� City COSTA HIESA ' EXTERIOR WALLS: Mfg. Owene Corning Thickness/Type_ � Ceilings: - . Batts: ' Mfg. (k.,o.,a �.,r.,tp$ Thickness/Type_ ' Blown In: , � Mfg. Thickness/Type _ � Sq. Ft. Covered No. of Bags Used Floors: ; Mfg. Thickness/Type _ ` Other : Mfg. Thickness/Type �� Generel Contractor - � � California Contractors Cicense No. t Signature �, Williams Insulation Co. of California Calrfornia Contractors License No. 267522 JOB COPV-WHITE GENERALCONTRACTOR-VELLOW R— " Value 19 R— " Value 11 R— - Value R— Value R— Value R— Value Date Title ' 8/29/79 Date _ Field Supt. Title BUILDING DEPARTMENT-PINK FILE COPV-GOLD r -- CITY OF C06TA MFSA RFX7CTFST FUR OCQJPANCY TRACE NO. J(�I S� � IIATE: ,� _ 1� —6 G ��. Iq n�� 3/jl �'lo� �l ,'�(P f� �� e developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been oonQleted and its streets accepted b� the City of �sta Mesa. By exea�ting this agreement, the undersigned acknowledges that he/she/they was/were advised that this tract has not been given final inspection nor has it been accepted b� the City of Costa Mesa as having oonQlied with the oonditions of approval which were i��ed_ b� the City at the ture the Final Tract Map was apprwed. The City assimies no liability for the enforcP�nent of the oonditions nec.�essaLy for approval other than th�e oonditions protected b� surety bond. The undersigned agrees to ind�v7ify and hold the City harmless fcaci any claim resulting in da�ge or personal injuzy to the undersigned bf reason of the aforementioned unazrpleted condition(s). 0 BY L� ��w.---� . I.,�J'1n�-��---____� (Signature of Purchaser) BY �.GCJ/ (M �..�'�� (Signature of DeveloQer and or authorized representative SY (Signature of Lender) _ �.. � � ,.�.� �� _...� � � _ 4/79 ,, �§ i �' k ��- � �� r ; �� ,. ; �� : �� t'. �� er :�� ; February 11, 1980 Union Federal Savings & Loan 17400 Brookhurst St. Fountain Valley, California 92708 ATTENTION: Mr. Braker RE: Tract 10513 - Lot 19 3116 Klondike Avenue, Costa Mesa Gentlemen: Foley Construction Co., Incorporated, is in escrow with William and Jacqueline �9hite as seller of the above-referenced property. The city of Costa Mesa has requested that we inform you, as lender on the transaction, that the final inspection, acceptance, and exoneration of bonds for public improvements installed in Tract 10513 has not occurred. The dwelling unit has received final inspection by the city of Costa Mesa Building Department and is complete and ready for occupancy. If any clarification of this matter is needed, please do not hesitate to contact me. Very truly yours, Carol A. Graas CAG/c� cc: lanning Department, City of Costa Mesa 2101 EAST FOURTH STREET, SUITE 100 • SANTA ANA, CALIFORNIA 92705 • TELEPHONl=: (7141 543-947t r F � W M a y y CL'i F O F a �i .] a > i" �, x w w � a a W "y' 3 � � COSTA MESA BUIIDING-SAFETY DEPARTMENT. P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADDRESS%j , � OWNER MAIL ADDRESS CITV CONSTRUCTION LENDER BRANCH ADDRE55 ARCHITECT OR ENGINEEfl ADDRESS CONTRACTOfl TEL. NO. L. ADDRESS TEI. CITV NO. STATE CITV IIC. NO. LIC. NO. SIZE . NO.OFBIDGS. OF lOT NOW ON LOT USE OF EXISTING BIDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO 6E PERFORMED I hareby acknowledga that I have reatl Shis apPlica<Ion antl stata that tha abova Informatian is correct and agrea to comply wlth ail laws regula<ing buil0ing construction, and I shall not amploy any Penon in vlolatlon of Me workmeri s compensation lews of the State of California. I hereby certity that I em p�operly IlcenseA as a contractor un0ar Me State of Callfomla Business antl Professionz Cotla, Divlsion 3. Chapter 9, antl that such licenses are I� full force antl affect, ar I am axempt from tha provisions of the Staie of Caltfornie Businau anG Professlans Cotle, Dlvision 3, Ch d 9. Sipnature of � Permittee Au<hor(zad Agant y 6768 79 225:00 ,. TL;' �..6758 774_._ "22B4OOCKTD �8766 0 _474 43 '�" � I It " . _. _ _ - APPLICATION FOR STRUCTURAL PERMIT ECEIVEDBV DATERECEIVED �oTF�ssiivn /A.P. NO. BUILDING ADDRESS TRACT OWNER F�RE APPROVED BV ZONE NO.OF PLAKS VAROS APPROV ED MAIN BUILDING (FROM C/L STREET) BET VAR. #` C.U.P.� APPROVED BLOCK VALUE VSE OF NEW BUI�DING VARDS APPROVED BET. MAIN ACCESS. Bl OATE THE AMOVNTSHOWN UNDER VALUATION TNE WRa�E OF ESTAgLISHING A PERMIT FEE VALUATION PERMIT FEE S 2 PLAN CHECK E $ TAX S TOTALPAID $ 2 n m > m m 7 m e a, 0 F �' � a Q � y F ��s�;��_ : COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 336e ."` 2!_I �%.79 3362 2/13l79, _ 33b2 0000447443 I� t�7: 27CKTU .,...I.Q ._ •-- APPLICATION FOR STRUCTURAL PERM[T For Applican[ to Fill in Completely — Use Ink Only RECEIVED BV DATE RECEIVED DATE ISSUED BUILDING �J � ADDiiESS / OWNER Fole Construction CO. II1C. p"P' N�' Z PERMIT NO. y BUILDING �� ` � �� ADDRESS 2101 E. Fourth St., ttI.00 �+DDRESS � CITV .Sci[St3 PiI'1$ NOL S�I3-94% 'TRACT ],D�j13 LOT 34 BLOCK CANSTRUCTION W ADD A R P LENDER X BRANCH OWNER Foley Construction Co.,Inc. ADDRESS � ALUE �� /�J/J� �ARCHITECT �es-T�.�ston rE`. 547-086 SE O�`�• OR ENGINEER 'j"`7 N . ADDRESS 777 S. �'�d1n St.r #1�5; O�'ange ZO E TVPE GROU CONTRACTOR �1PS/uc�e�-O�Y ByPROVED DATE ADORESS San� 20NE � NO.OF USE OF NEW �j.� CITV `S�� NOL 1 P�� BUILDING h STATE S`� CITV �'ARDSAPPROVED YARDSAPPROVED LIC. NO. IIC. NO. MAIN BUILDING ACCESSORY BUILr�DING S12E NO.OFBLDCS. O (FFOMGLSTjit�ET) pL p�S eL '/'I OF LOT NOW ON LOT RONT FT� FT. use oF N/A 1� EXISfING BIOG 1 FT.a FT Separate permits are required for L SIDE / FT Fr. electric, plumbing and heating work. � REAR FT.O FT. USE OF BUIL�ING AND WORK TO BE PERFORMED DISTANCE BET. ' BEf. MAIN & MAIN B�DCS. ACC6S. BLDCaS. . VAR. # DATE IiLV21O C.U.P.�' APPROVED detached residence �Rov 3 — .�-7 � I hereby acknowledBe thet I have reatl thic appliwtion antl state ROLD FOR SP .CIAI, RP ^E �� n Mat the above Informaiion is corract and agree to comply with �U� �'�F.N.T. m ell laws regulatin8 bulltline �onstruction, antl 1 shall not employ � any permn In violation of tha workman's compensation lewz of m the State of Celifornie. � . - I hareby cert(fy that I am properly licensetl as a contractor under Q' � tne State of Celifornie Business and Profeuions Cotle, Dlvision 3, THE AMOUNT S OWN UNDER VALUATION IS FOR m Chapte� 9, antl thai such licenses a�e (n iull fOfcO a�tl Bffect, a� I THE PVRPOSE OF ESTABlISHING A PERMfT FEE ONLV: am exampt fram the provlstons of tha State of California Busineu $ a antl Protessions Cotla, Division 3, Cha 9, VALUATION � VERMIT FEE N ��j ✓� ��if� d&� �.b PLAN CHECK E /ZS a SiOnaturaQ��'/ rJ�L/.GC�/:/ $ ' � LL Permlttae _� ��'� TAX S � `U Authorizetl Agent ' � TOTAL PAI D S� 7. u