HomeMy WebLinkAbout340 PRINCETON DR - Building Permitsi
Job Address: 340 PRINCETON DR
Suite:
Viciniry: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 14138329
Applicant: ROBERTS, PAUL
Address: 24172 EL TIRADORA CR
MISSION VIEJO, CA
Owner: SONDHU, BALRAJ S
Address 22782 AZURE LN
LAGUNA NIGUEL, CA
Contractor: ROBERTS ROOFING
Address: 24112 EL TIRADORA CR
MISSION VIEJO, CA
Zip: 92691
Arch :
Address:
Zoning:
Phone: 949-454-9060
Zip: 92691
Phone:
Zip: 92677-5439
, Phone: 949-454-9060
License: 699702
Eng:
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 12/02/2003
Issued: 12/02/2003
Phone:
Zip: License: License:
SCOPE OF PERMIT
INSTALL 30 YEAR COMP SHINGLES OVER EXISTING ONE IAYER OF 20 YEAR COMP SHINGLES. INCLUDES ATTACHED GARAGE.
Plan Check: $0.00
Permit: $111.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $111.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existin : o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
left 0- 0
Lek 0- 0
Proposed: 0
Calc valuation:
Claim valuation:
Right 0- 0
Right 0- 0
$5,000.00
$5,000.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or iF work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlted inepeetione and final approval must be obtained. Failure �o obtain Inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
244646 (8b0)
WORKERS' COMPENSATON DECLARATION:
1 hereby aHirm under penalry ot perjury one ol the following deGarations:
❑ I have and will maintain a certificate of consent to selt-Insure tor workers' compensetion, es providetl for 6y section 3700 of the Lebor Code, lor the pertormence of the
� /wark for which ihis permit is issuetl.
J,y� I have and will maintain workers' compensation insurance, s requiretl by section 3700 of tha Lebor Cotle, for the peRormance of the work for which this pertnit is issued.
V My workers' c en atio�n yInSura er antl polity mber ere: �J�
Cerner: �M Q� .(� , -PoliCy Number: �SJ ' 0� � ��
(Thls section neetl not be comp/eted i7 (he pe it Is veluetl a( one hundred dollars ($100) or less.)
i
❑ I certify thet in ihe peAortnance of tha work for which ihis pertnit' issued, I snallnot ertgloy any person in eny manner so as to become sublect to the workere'
compensatlon law�mla, en Ihat i�hould �eco e sub�ect to the workers' compensation provislons of Sectlon 370ppp+++of Ihe 4abor Catle, I shell forthwith
comply with thes visio s. � /�/�/�
AppliceniSlgnewra: CC�t � t0 Dete: �
�- tp�
WARNINO: FAILURE TO SECURE WORNER$' C/JMPENSATIqJ COVERAGE IS UMAWFUL ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL S UP TFlRE OONE HUNDRED
THOUSAND DOLLARE (5100,000�, IN ADDITION TO THE WST OF COMPENSATION, OAMAGES AS PROVIDED FOq IN SECTIIXJ 3]Ofi OF THE LABOR CODE, IMEREST, AN� ATiORNEVS FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereby aHirm thal I em licensed untler provisions of Chepter 9(commencing wil� Section 7000) of Divislon 3 of lhe Business and Professions Coda, antl my Ilcense is in full
brce end ettecL Lic. k Class M
Gomrectols Slgnature: 9, Date: i r1 '7 (YiZ
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirtn ihat ihare is a consiruction lending agency for the peAormance of the work br which this permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Neme: Lenders Address:
Signeture:
OWNER•BUILDER DECLARATIONS:
Date:
I herehy ettirm that unaer penalty of perjury that I em E%EMP7 FROM TME CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business and Pmfessions
Code: Any ciry or county which requires a pertnit to construc6 elter, improve, tlemolish, or repair any siructure, pnor to its issuance, also requires ihe applicam tor such permit
to file a signed slatement thet he or she is licensed pursuant to Ihe proNslons ot Ihe Contractore License law (Chapter 9(commenGng wlth Section 7000) of Division 3 oi the
Business entl Professions Code) or thet he or she is exempt therefrom end ihe basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit
subjects Ihe applicant to e civil panalry ot nm more t�en tive huntlretl tlollars ($500).):
❑ I, as owner ot the propary, or my employaes with waqes es their sole compensation, WILL DO THE WORK, antl Ihe sWCNre is not imended or otteretl for sala (Sac.
7044, Business and Protessions Code: The Contractors License Law tices not apO�Y �o an owner of proparty who builds or improves thereon, and who does such work
himself or herself or thmugh his or her own employeas, provided t�at such improvements are not Intended or oMered for sale. tl, however, the building or improvement is
sold within one year ot completion, ihe owner-builder wiil have the burtlen of proving ihat he or she did not builtl or improve for puryose of sale.). '
❑ I, es owner of the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (SecJ044, Business and Professions
Code: The contractors License Law does not appty to an owner oi properry who builtls or Improves thereon, and who contraas for such projact with a contractor(s)
Iicense pursuant ro Ne Comractors License Laws.).
❑ I am exempt under sec. Business and Professions Cotle for ihis reeson:
Signewre: Deta:
Owner ID verified by tlrivers license. ❑ Ve5 ❑ No Driver's License No. Expires:
Vedfication of Owne�ship by (type ol daument, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certiy Ihat no excavetion tive (5) or more fee� In aepth in�o which a person is requlred to descend, will be matle in connection with work euthonzed by thls
permit, and that no building sWcture, scaHolding, lalsework, or demolition or tlismentling thereof, will be more Ihan �hirty-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Calitomia Atlministrative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would raquire a permit from the Division of Industriel Sefety, es natetl above, unless such person hes a
permit to do such work from ihe division.
SignaNre: Date:
Division oi Induslnal Sefery Permit Number:
CER7IFICATE OF COMPIIANCE AND AUTHORQATON OF ENTAY: I certify under penalry ot perjury that I have read this epplication and state that the infortnation given is
correct I agree ro comply wilh all state laws end ciry ordinences relating to huiltling constmction, end euthotlze representetives of Ihe Ciry of Costa Mesa to emer upon Ihe
ebove-dascnbed property for inspection puryoses. I egree not to acupy or allow occupancy of eny building au�horizetl by this pertnit until final inspection.
�4 'egnat Of Le ner(s) r^/ ^/ �� Date
An,d/Or Auiho ze Ilcant I/ / oaie
tODE �. INSVECTIONTYPE
1616
1268
Flxetl System Final Fire PrBvention
Pool Spe Final
200 Final Ra-Roof
201 Finel BIocWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
� . 1 .1111.
r � ��� i
4QQ:,( INSPECTIONTYPE
206 Flnel Mechenicel
20B Finel Plumbing
210 Finel Electrical
212 Finel Fire Preventlon
220 Final Plenning Approval
222 FinelSite
250 FinelBuilding/Occupancy
➢AIE It�ELB
CITY OF COSTA MESA -
CONSTRUCTIONPERMIT
0
AVDlieant to till in all ipaces except tnase wit�in heavy barGer lines anU si9n all aDOrop�iale tleclara[ionz.
� 97��- I
Project Address j�U �Y�QiNce`i!v�/ ' I TYPE OF CONSTRUCTION � rvE
AppliCant'S Mailing Addreu,/ /�754� C-•l^SVrJ T . ❑ CONVERSION ❑ �EMOLISH
Owner'S N2me - S!°J��fl1� I Phone y32.93Ys , DESCRIPTION OF WORK
Atldress 3�V �R1v�P�,J � Coi� h1��a TVPEOFPERMIT GRaowG.
Arch/Eng. � _ License No. ❑ TENANT ❑ ELECTRICAL �
Address - ..� �OTHER '
J ADD L-1 qLTERATION ➢S'J REPAIR
OTFiER
� FOUNDATION ❑ STftUCTV RAL
PLVMBING ❑ MECHANICAL
Contractor's Nam � hone R3( fG7/ PROJECT DESCRIP710N 5c?. FT. oCCUPANCv
Addre551mdiling���nns�r/.Q2� �C- 3��.y�`�- S�t, S'�� CONSTRUCTIONTVPE VAWATION$_
City LiCen52 NO. �?-�+-�� (o�SO ' Z�NE GRADING CU. VOS. ACRE$_
LICENSED CONTRACTOR OECLARATION ' Remarks: � � _ �
1 hereby atfirm that I am licensetl untler provislons of Charter 9(commencing .
with section 7000) of Division 3 of the Buslness antl Professlons Cotle, and ' ' , �
my Iicense is in fuil force antl effect.
License Class C� S Lice �a No. �� �959G 6 �
Date�9 r%w R9_Si9nature BarSink
'YORKERS'COMPENSATION DECLARATION
hereby atfirm that I have a certificate of consent to sel�-insu�e oi a certificate � BeCkflOw P�2VEnte�
.( Workers' Compensdtlon InSurdnce, or a cer0fietl copy thereoE (Settion --
3800, Lab. C.) C �,J Backflow Irrigation
PolicY No. �'1�5,27 3i - P3. companv S�� r��"'"�'
�Certifietl co0 Is hereby fumishetl. '� '. ' B3thtub5
Certitl co a filetl wrth the tity Buri i rvi ioD .
Date AOP��cant /���li...._; . � Clarifiers
EXEM 10 FROM WORKERS' CO�ENSATION-DECLARAT�ON . ' Di5hwa5h¢r ' �
(This sectlo neetl not be completetl if the permit is ibr one huntlretl ($100) or . .
less).
I certify that in the pe�fo�mance ot th¢ work Por whlch this permR is i55uetl, I Drinking Fountains
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of Calitornia. . ' •� � Floor Drains,
Date Signatnre '
NOTiCE: If,'alter making this tleclaration, you shoultl become subject to the Ploor Sinks
Workers' Comoensation provisions of the Labor Cotle, you must-torthwith
comply with such Orovisions or tnis�permit shall be tleemed revoketl. , GasService
CONSTRUCTION�LENDING -AGENCV - �
I hereby a/firm tha[ Ihere is a mnst�uction lentling agency fo� t�e perfo�mance Ipt¢fC2pt0�5
of the wo�k for wnich chis Oermit is issuetl. (SecHo,n 309� Civ. C.)
Lentler's Name' � Kitchen Sink
LROtlC�'S Atltl�¢T5� � - � � � , LdVd[OfIES
OWNER BUILOER DECLARATION� � '
I hereby affirm that I am exempt from the ConVactor's,License Law for the ' p_T a i
following reason'(Sec[ion ]031.5 Business antl ProfesslonabCotle: Any city or � P' �
county whlch �eqvires a Oermit to const�uct, alteq improve, tlemoliSM1 or repai� �
�any strut[u�e, prior to Its issuance, als0 require5 the applicant for Such permit � ROOf D�dins
to file a-siqnetl statement tM1St he/she is licensetl pursuant to the provisions of �
"� ContractoYs-License Law (Chapter 9(commencing with Section 7000) ot` ,
�Slon 3'of the'Buslne55 antl P�ofessions Cotle) o� that be/she is exempt '
etrom anC the basis for the allegetl exemption. Any�violation of Section ..
.e3115 by any applicant fo� a pe�mit subjects �the 5pplicant to d civil
.penaity of not more than tive huntlretl tlollars ($500). Reinspection'Fee
❑ I, as owner of the property or my employees with wages as their sole .
`compensation wiil tlo the work, antl the structure is not intentlea or ofteretl �
for sale (Section 7044, Bu3iness antl Crofessional Cotle:� The Contractor's .. i
License Law tloes not apply to an owner of a property.who•builtls or improves goiler � �
the�edn, antl who�tloes such work hlmself/he�selt o� through nis or ner own i
em I ees r itl tl th t h' t r i intentletl r H retl'f r�
Outle[s
�
�
p oy , p.ov e a suc improvemen s a e no 0 o e o Duct - Under Ground
sale. If, howeve�, the builtling or improvem¢nt is 5010 wlthin one yea� of com- �
pletion, the owner will have the ourtlen of proving he/she tlitl not builtl or im-
�rove tor tne purpose oi sale). � Duct - Struc[ural
I, a5 owner ot the properSy, am exclusively mntractinq with licensetl mn-
trac[ors to construct the project (Section ]044, Business anG Professions Cotle: Duct - Ventilating .
The Contractor's License Law tloes not apply to an owner ot property.who �
builtls o� improves thereon, antl who ConVacts for Such projEcts with a com E%hBuit SySt¢rtl ❑ MWtipl¢ ❑
tractor(s) license pursuant to the Contractor.'s License Law). '
� 1 am exempt untler Section , B. & P. C. (or this reason , Firepl/Fact. BIL ICBO #
-�,
Date Owner "� Heating System & Ducting
1 hereby certity that I have reatl this applicatlon antl state tbat the above � ❑0-100,000 BTU 0100,OOOBTi
information is correct. I agree to compy with� all city antl'county ortlinances . -
antl state laws relating to builtling const�uctiOn, antl hereby authorlie repre-
sentatives of this at �[o en[er upon tM1e above-mentionetl properry for '
in5pection putpo s p ,_`
S�gnature ��ff f�J/e�6� � Oate� '
'J Reinspection Fee
Drivers' Litense or 55 � ����� �
CMF 0865-46�rev. 7/83 �White - Builtlin9: Canary--A�P��wnp Pink - Accounting; Goltlenrod -Assessor
$25
Showers ��J
Service Sin�
Sewer Cap . '
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimmin9 Pool w/Spa
Urinal �
Water Cloret� '
Water Heater
Water Service ' '
Issue Fee
i
Hood or, TYPeI ❑
Canopy Type I I ❑
Refrigeration Sys[em
❑aioo,000sru ❑iao,oao
System Repair/Alteration '
Issue Fee
0
A
� $ 3
A:P. �.
S Main Building:
E
T. Front -
B Rear •
A
C Right
SLeft
Ping. Fef. # '
Parking Req./Provided ` �
Use of Building:
Planning Notes: ' .
Automatic Washer � ,
. . . " . .. .�e . i
� �
Zone
.mr�rRuildinn� . - Z
Park.Fees
ELECTRICAL
Cooking Unit ' ' -
Dishwasher •
Dryers ❑Gas ❑Eleciric
Fan
F.A:U. ; '
Fixtures
Device Boxes „ �
Outlets
Switches' � ;
Garbage Disposal �
Generator �65 KW �5-15 KW �
ner LJ 15�50 KW
� ❑ 50'+KW
up to,100 amps
Meter LJover700amps
Sub Panel
Momrs �i
Inc. Solar [
Microwave
Pole Li9ht
HP O1'/: - 8
�15 HP �16-15+
Sign �
Standing�Sections
Trash Compactor
I Reinspection Fee I$25 �: �uue Fee�
PUBLIC SERVICES RE�UIREMENTS: .
2oning Approved By
Appliwtion Approved By � ��_
$ 3
O
N
I '
N
G
R
E
Q
U
I
R
E
M
E
N
T
SUMMARV OF FEES � , / '
BUILDING PERMIT � $ SMIP � $
PLAN CHECK � �$ PERMIT - �
. PLUMBING $ ,S'm� ISSUANCE $
PLAN CHECK $ ' ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK ,$ - MICROFILM $ �
� MECHANICAL $ TOTALFEE � $ •S•ed
$ 3 . PLAN CHECK ' $ '
� CONSTRUCTION AND PCA ING �PO� �.SPA �
� APPROVALS . Permit # � 9�f Date Inspector p�ppROVALS - Permit # Date Inspector
7. Temporary Electrical Service or Pole 52.. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. .53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. " � 54. Forms � �
-:4. Electrical Conduit-Undrgrnd. - �55. Electrical�Bonding � �
5. Steel Reinforcement 56. -Rough Plumbing & Pressure Test
-6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation _ � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. � 60. Backwash �ines, P-Trap, O Undrgmd.
10. Structural Floor System -61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72: Sewer Cap � 63. Heater & Vent-Final .
13. Roof Drains 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 Approval
- 1.7. Rough Wiring Sign � 68.`APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT
20. �Rough Factory Fireplace APPROVALS � Permit #
27. 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.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical
27. Frame and Flashing ' • 76. Dry Standpipe
28. �Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating &�Air Conditioning -
35. Final Gas Pipe-Test .
36. Hood or Canopy �
37. Final Factory Fireplace � . �
38. FinalPlumbing ��„�?p� ��,�' � �
39. Water Service-Final �
40. Gas Service-Final '
41. Solar pomestic-Final � �
42. Backflow Preventer � •
43. Backflow Irrigation . �
44. ,Landscape Irrigation SYstem , ' -
45. Sound Attenuation � ' . •
46. Handicap Regulations ' �
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed ,
49. Electric Release to Edison , - , ' �
50. Gas Release to Southem Califomia Gas Co ,�
51. CERTIFICATE OF OCCUPANCY , .
No. � Date ' �
OW NER COLLEGE PARK DATE ZZ—Z]—S6 -
JOBADDRESS ' 34O PT'].I1C6tOR 1}T. BUILDINGPERMITNO. 7tu+53
GENERALCONTRACTOR Harbor COIISt.. CO• VALUE $ ZZ�ZOO C�O
� 61� s�ocK TRACT 2726 Res. w/det, gar.
GROUP I & J
INSPECTIONS
Footing Trench
Foundation Forms and Gr?
Rough Framing
Plumbing, Rough to Slab
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
S�ewer, House � Se�
Septic Tank or Cesspool
V'�ing,ln O
F, :ring
Plumbing, Final, Fixtures C
Plumbing, Final Gas Test �
Wiring, Final
Occupancy
FORM 110 9M IO��S
u
DATE � SUBCONTRACTOR
�
— //
PERMITSISSUED
Costa Mesa Bnilding Department APPI,ICATION FOR PERIVIIT
�-.;,:._ _ P.o.soXa�� �-+4; BUILDING 1
� COSTA �v1E5A, CAUFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO I`ILL IN Recefpt No. Permit N
B�,�d��9 y,s;
Addrcss O PRINCETON DRIVE
Costa Mesa. Cie��liOtII18, Received by oate eedd. oate Issw
Owner O G PARK
Mail
Address 2 � � 6 $O . MA I
Clty $�NTA F1NA. i,'ALII
Architect or
Engineer
'dress
�ontractorHARAOR �.'ONST
Addreu $APA E
Legal Lot
Description No. 6� I BI�
(Attach Metes and Bounda)
size of Lot (� x I 03 I
4se of I
Existing Bldg.
Sethack Line from I�
Centerofstrxt �lµ
DESCRIPTION 1
New I X I Alteration
Repair I I Moving
Building No.of
Tel.
No.
No. of B
Oemnlish
`r'►7n �a �7 s6 ,z-��-sd
Building
Address
Costa Mesa, California
Crass St.
No.
CORRECI`IONS
Co.ering � Coverfn9 []PPI{QV��'
Use of New � Foundation Lo�ation Inspector
Butlding RESIDENCE �t OETACHED Forms,Materiais,
A R A G Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hemby acknowledge that I have read thls ApplicaUon
and s[ate that the abwe is correM and agree to comply Lath. Int.
with all Clty Ordinances and State Laws regulating
bui7ding rnnstrttction. Lath. Ext
Signatureof
Perm�ttee HAR80R CONSTRUCT I ON C0. P�aster, �nt
Valuation Permit Fee S o�'� /�—
Plan Check $ � ! —
g I I �200, Total L�
Fee � 7 �-
Bond Beam
O
�
G)
2
D
r
o.
u.
c�
0
ln
0
�
�
PLOT PLAN
Show Iocation and dtstanees from
property Iine and between buildinga
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0
A
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,-- �
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OWNER KRUGA'IEZIIi�, Cdi'1 �E: � . j,-: . . � .� , � . ' DATE . 9�].z-K7 ._
)OB ADDxESS qJ,p princeton Drive � BU�LDING PERM�T NO. 5688
GENERALCONTRACTOR SO. G31'lf. Greenhouse VALUE$ 228,00
AP. No. L.OT ((� TRACT�C"j26 FIRE ZONE DESCRIPTION OF WORK Glass Greenhouse
GROUP J 7'YFE V� � ZONE � PLAN NO. �FiiFi
?ECTIONS I DATE I SUBCONTRACTOR I___ PERMITSISSUED
roat
Test
�
.�.
=� s6�� FE�,RECEIVED �, ;
COSTA MESA BUILDING DEPARTMENT x � 5 � � ,' (��% •^ `J ��,
P. O. BOX 31�
COSTA MESA. CALIFORNIA FINAN DEPT.
FOR APPLICANT TO FILL IN �PIT�PQFIC.°S�RViv'�OR PERMIT
AD�RE55 3�-(i h�nc���o n li!- � BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
G� /� �� y� RECEIPT NO. /P.�EBLM�TJ}V�O^
OWNER � L I �'L v✓ L' J'�
MAIL p n RECEIVEO BV TE RECEIVEO OATE ISSVED
annaFsc��[�9 Udc✓D /IO_ �_l �Q//SL_ i-.�+. t./ 9.i =.0 % �i—/ L_1
ARC
OR
CONTRACTO
ADDRE55
LEGAL
oescnirrioN
A.P. NO.
/.J � TEL.
NO.
�"
v
—1 2. c� �
/ CITY LIC.
— ( �'�.rf-_/L NO.
.- /Y.� Sc-7r+i.
SIZE // ��S � NO.OF BLDGS.
OF LOT � 7 X / d v_ __ now orv tor
useoF %�jPS/eJ��Tl�CQ.
EXISTING BLDG.
SETBACK IINE FROM �{.7
ccrvr[p oF sinee• J� {/��(�yZQ�EAR YAR� �'
SIDE VARO RIGHT ��,J , LEFT '�/
DESCRIPTION OF WORK
NEW / ALTERATION II ADDIT�ON
REPAIR MOVING DEMOLISH
BUILDINGG�����(,�" ROOMS STORIES
SIZE � /�
EXTERIOR WALL ftOOF
COVERING GOVERING
USE OF NEW ��✓� rj n /. /� q /��(
RIIIIIIINf. C:� C//I/�rl C V
STATE TMAT TXE I
CITY OFDINANCES
TION.
ING
I55
COSTA MESA, CALIFORNIA
CORRECTIONS
CITY OF
14
SUBJECi TO
8�
A TdESA
�
UEPT. REG.
RRECT AND AGFEE TO COMPLY WITH qLL
LwWS GULnTI G UILOING CONSTRUP
VALUATION
PERMIT FEE S
�� � �� PLAN GHECK S
�
TOTAL FEE $
ri
STM7YS.
JOB ADDRESS 34�
GENERAL CONTRAG
AP u�.141-383-2!
�IN ;TIONS
SOIL
� GAS
W aTER
�ROOGH PLUMBING
PROP. SWR. LINE Q HOi
SPRINKLING SYSTEM
MISCELLANEOUS
FOUGH HERTING ANO Alq
TEMPORARV SEPVICE Oq
UNOERGROUND � PO
ROUGM WIRING
TRENCMES FORMS
FLOOR SYSTEM
BOND BEAM �J STEE
SMEATHING
FRAME FND FLASHING
LATHING — IN 01
PLr15TER, BROWN COAi
ST"--'TUR4L, FINAL
Hl 'u. VENT., FEFRIG
PLUmBING, FINAL AN� G
' ELECTRIC, FIHAL
BUILOING, FINAL
carnni avnivavrsrura
L[ill
CON.
CONOITIONING
TEST
f�
UAI[ 11 Gb (
BUILDING PERMIT
SUBGONTRACTOR
. .. -. J � ;�'.�i
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUI�DING _ .� ' . . •
Fato Y �i.ttt
"i1V 26-73cr�;•00 910.. 7.
A.P. NO. �
BUILDING r{�/
' _ _�- (� �, ., ADDRESS . 7�yn
FOR BUILDING PERMIT
Z
W W TEL.
Q.0 CITV�A�3� L•f NOSS -J�j� TRACT
ZZ
Q CONSTRUCTION W
O � LENDER
d m
J � BFANCH
J �� OWNER / J O�
� ADDPESS
� �
ApCHITECT TEL. S
J � OR ENGINEER
V Q FIRE
w ¢ ADDFESS ZONE P
d w
APPROVED
� Z CONTRACTOR �� � BV
J Q
m Z •
J � ADDFESS�
w W TEL. Z�N NO.OF
ZF CITY NO.,'j�-�SZ� P�'�
w� STATE CITV '�ARDSAPPFOVED
(n K LIC. NO. �IC. NO. MAIN BVILDING
�� SIZE NO.OFBLDGS. (FROMC/LSTREET)
OF LOT A�T NOW ON LOT 1 RONT FT. /
USE OF � �
EXISTING BLDG. 5�
� SIZE OF NO. OF V
Z NEWBLDG. ROOM$ STORIES L.SIDE
U EXTEflIOR WALL ROOF � �
COVERING ' ti. COVERING (. REAR C i fT.
�� USE OF BUIIDIN AND WORK T BE PERFORMED OISTANCE BET.
d � � CL MAIN BLDGS.
Q ' VAF.aW
� /.fI:7TQL 2 � — —/ cC✓.a C.V.P.vW
y° �nnQ _ �! c . //U • ). - APPROVE �G (✓
� L.z i�iJ
UI hareby acknowledBe �het 1 have reetl this npplication antl state
� that Me abova information is corract antl aprea to comply wlth
� all laws regula[inp bul�tling construction, antl I shall not amploy
F any permn in vlolati0� of th¢ warkman's compansation lawf of U
y th¢ Stata of Califomia.
? I hereby cartify Not I am properly Iicensetl es a convector untler SQ. FT.
Ne State of Californlo Businass antl Profezslons Coda, Divisicn 3, THE AMOUNT SHOWN
Chopter 9, antl thac s�ch licansas ara in full forca ontl ofioct, or I THE PUFiPOSE OF ESTAI
am exomp[ t�om ll e O�ovlsions of tho S[aco of Celifornia Business VALUATION
nntl Protessione C��uo, Division 3, Chaptar 9.
, `" PI
SiB�atura of %���ff// �'Y
Permittee �� �!'��1Y��.% l �lM1/1'ld 5 // //D � PI
Authorizatl ABent / (/
TI
lOT
USE OF
BUILOIN
YAR
BEf. MAIN &
BLOCK
ED
DI
~ / �
0
R VALUATION IS FOR �
3 A PERMIT FEE ONLV: °
¢
EE S � �
7
m
ecK 5 E
O-�j LL
2E 3 .�