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HomeMy WebLinkAbout406 PRINCETON DR - Building Permits6 PACIFIC ffiSTALI,ERS, INC. 7541 Anthony Avenue Gazden Grove, California 92641 P.O. Boz 'j28 Weetminster, Calif. 92683 state �o. # �.� city r.�o. # Sy -3 nate / S 77 cuetomer Name�7J7.��d-!•— � j/ Pexmit No'e. /�/7a3 ,> . - ,� / �: �/ . � i�:� � , _ City of �'��� ��'� Department oY Buildi.ng and Safetq Geatlemen: Plesee be adviaed that es of /�5''/7� all work by Pscifio Inetallere, Iaoorporated, on the pexmit numbera lieted above heve been oanoelled. Therefore, Paoi,fla Iaetallere, Incorporated, requeste that the pexmita be canoelled and that all pre-paid feee be reftuided. Thie oancellation notioe ie advioe to qou Inoorporated, hae ao reepon¢}bility for �r Pexmite noted at �U(o /'�,��i�.o,c. PI-264 Rev. 3�7l� that Paoifio Inetallere, rk.acoomplished uader Very truly yours, PACIFIC INSTALLIItS, INC. �' �'/�-� �_ �__ _� -- — - ADP���ant t0 /III In dll SpdtlS Wlthin neavy bortler Iines ana sign all appropriate aeclarations. CITY OF COSTA MESA P RMyT NO. TqqCT NO. LOT NO. BI.DG: NO. CONSTRUCTION PE$MIT � (pX� S � � Address —" � Aj/'f� � Arch/Eng. � G /// y + mTV<P'E OF CONSTRUCTION PhOne �cnEW ❑ ADD ❑ ALTERATION �� - - ' ❑ REPAIR ❑ CONVERSION �DEMOLISH License No. - ❑ OTHER A.P. q ZONE 74,?� 4/ I y/R' VING REGULATIOM PLNG. REF. qp Contractor ; Phone 7ypE OF PERMIT � � -SETBACK C L 5T. Addres5 � , � p ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SIOE VARD �LICENS CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICA PLVMBING OMECHANICA � 5EpFE V R ,I hereby affirm tn:.t I am licensetl untler provislons ot Charter 9(tom- RIGNT men<In9 `Mith sec[ion 7000) of Divlsion 3 0l thr Buslness antl ❑ OTHER f Aofessions Cotle a� y Iicense is In kl�fo an e� pROJECT DESCRIPTION _ REAR vARD (TO P/L) Llcen Gla Licens � . PKG. SPACE REQ. ,Date' Sl9nature � � " STREET WIDTH WORKERS•COM ENSATIO E) T '� OCCVRANCY_CONSTRUCTIONTVPE 1 .I hereby aftirm tnat I have a t IC ' e D <onsent to self-iniure or�'a VALUATION � ZONE ZONING APPROVED BV ��certificate of Wo� c S' omp on lQa�i ance, o� a cerUfietl cOpY tbereo(( 0 0} � l� GRADINGCU.VDS. ACRES �SVECIALCONDITIONS: Policy No. ipany ❑ Certiiletl copy is y turnishetl. 0 Certi(letl copy ii flletl wilh the city Builtling Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectiOn nlGtl nOt b¢ mTpleletl if the permi[ is fOr O huntlr¢U (E100) or less). _ i cerH�v that in tha oerformance o( the work for �MPper� 0 PLANCHECK " ' �NOTICE: If after making this ��a n, y h�tl be<ome subject TOILETS VRINALS ''- to t�e Workers' Compensation ov onz e Labor CoOe, you must - torthwith compty with suth pro ons is permit 5hall be tleemetl LAVATORIES DOUBLE LAVS' revoketl. CONSTRUCTION LENDI AGENCV - '' KIT. SINKS " DISHWASHERS I hereby affirm that � e is a mns[ru<tlon lentling agenty for the pen SERVICE SINKS . SUMPS ' - tormance o( tne w for wnich this permlt Is issueG (Section 3097 C1°' C'�' -' ' � FLOOR SINKS • FLOOR DRAINS LenGer'S � Na me Lentler's AUtlress ' ' DRINKING FOUNTAINS ' OWNER BUILDER DECLARATION � ' INTERCEPTORS ' CLARIFIERS � �� I hereby affirm thal I am exempt from the Contractor's Ucense taw for. Ihe tollowing.reason (Sectlon 7031.5 Business antl Profezsions Cotla: SWIMMING POOL PTRAP '' AnY City or County which YeqWres a permit to cons[ruct. alter, qWreS tpe ap(IiUn[ br SucM1 permit to flle a Signetl statemenl that he is licensetl pursuant �to the provisions o( the ContraCtor'S LiCense Law (Chapter 9(wmmencing wi[h Section 7000) of �Ivision 3 oi [he Bu5ine55 antl Prp1e55ion5 Cotle) of that he is ex�mpt Ihefetrom antl Ihe �asis for [he alle9etl exemption. Any violation of 5ection 7031.5 by any applicant for a pormit subje<[s the applicant to a civil penalty of nol more lhan /ive huntlretl tlollars ($500). ❑ I; as owner ot lhe property, or my employees with wa9es as thelr sole tompen5dtion, will tlo [he work, antl the structure Is nol int¢ntletl or otteretl for sale. (Sec[lon 7046, Business antl Rolezslons Cotle: The Contractor's License I..aw tloes not apply to an owner of a property wh0 builtl5 or improve5 thereon, antl who tlOes such work himseH or through his own employees, provitlotl [hat such Improvements a�e not Intendetl or offeretl for sale. If, howeveq tba builtllnq or improvement is Soltl wilhin one year of compl¢[ion, the owne� will have Ihe burtlen of proving hc tlitl not Ouiltl or Imp�ove to� th¢ pU/pose of Sale�. ❑ 1,. as owne� ot tlte properly, am ¢xcluzively cont�acling wlth Iicense0 contractors to construct the project (Section •7044, Busines5 antl Professians Cotle: The Conlractor's Licensa Law tloas nol apply to an owne� of p�operty w�o builtls o� improv¢5 th¢reon, antl wno con- tracts irom such projects with a contractor(s) licosnetl pursuant to the Contractor's License Law). � I am exempt untler Section B. & P. C. (or tbis reason Ddl¢ Own¢r I hereby certify inat I have reatl t�' applitation antl state that the above intormdtion is correct. I a9 lo m wilh all city antl county ortlinances antl state laws r ing ction, a r 'authorize representatives of h' city upon e menllon tl prop¢rty for ins ion p Siqnature AccOuntin9: Goltlenrotl-Assesso� DED. FEE! ELECTRICAL PLAN CHECK. ' GENERATOR 0-1 KW_ 1-30 KVJ _ TRANSFORMER APPLIANCE 30-SOKW_SO+KW_ 'MOTORS -04�HP_1-10 HP. _ �--- QNC. SOIAR) 30-50 HP 50 t HP _ '� - `FIXTURES ' OUTLETS SWITCHES " ' � GAS TUBE SIGNS ' ' ' POLE LIGHTS ' � . WATER SERVICE - ALTERATION ' "` GASSERVICE OUTLETS WATER HEATERS BTU OVTPVT " SEWER CONNECTIONS • " " '" ' ' SOIAR TANK ' COLLECTORS " SOLAR PIPING SYS. ' � ISSV E FEE MECHANICAL PLAN CHECK HEATING SVSTEM 0-100,000 BTU AND�VCTING 100,000+8TU � REFRIGERATION 0-100,0008TU SVSTEM 300,000�t BTU BOILERS BTV SVSTEM REPAIR,ALTERATION EXHAVSTSVSTEM MULTIPLE CMF PANELS MAIN SERVICE ISSUEFEE "- ' � . APPLICATION APPROVED BV � DATE .9 q SUMMARV OF FEES � , ,' BUILDING ' ' ' - . '- PE(tM1T $ ' SMIP E PLAN CHECK E PERMIT ' m d ISSUANCE $ PLUMBING E� .PLANCHECK $ � GRADING 5 ELECTRICAL y � a PLANCHECK E MICROFILM E MECHANICHL $ TOTAL FEE E �PLAN CHECK g LE55 AD- � , VANCEPC $_ FINAL FEE b �� � � A#�� yh CONSTRUCTION AND PLANNING , POOL & SPA - • Date � Inspector '� � � � � - �Date � Inspector APPROVALS Permit# APPROVALS • -. �Permit�h' ' „ 1. Temporary Electrical Service or Pole � 43. Pool & Equipment �L'ocation ��- �� � � • � il ipe-Undrgm - ' 4 . Steel Reinforcement - � - � � � � 3. Electrical Conduit Utility-Undrgrn 45..,Forms � - - - � - � 4. Electrical Conduit-Undrgm � � - • 46:'� 'Elec[rical Bondin � �- � - � . tee e�n orce , . � 47. Rou h Plumbin &�Pressure Test " -' � � ' ' 6. Electripl UFER Grn - ' - 48. APPROVALTO COVER-GUNITE ' � � � � � - - 7. ootings � 49. Electrical Conduit-Undr rn ' ' ' 8. Foundation _ 50. Gas Pi e, ❑ Undr rn, Test -� • 9. Water Pipe-Undrgm 51. Backwash ines P-Tra �'� 'ti i r ' � ` 10. Structural Floor System 52. APPROVALTO DECK ' ' ' '' 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � ' � 12. Street Sewer Connection � ' - � � � - 54. Heater & Vent-Final � � � �� � 13. Rough Plumbing ` ' ' • 14. Rough ElectricConduit ' ' • ' ' '�56.-•Electrical-Final �- � � - � . 15. Rough Electric-Wiring - � � - 57. �.'Solar System-Final � - . � � � 16. Rough Heating & Air Conditioning - . • encing & Access Approvai -� 17. Ducts in Structure APPROVED FOR PLASTERING � 18. Ducts, Ventilating _ _ . _ - , � � _ � '� , 19. Gas Pipe-Rough & Test - . 60. POOUSPA SYSTEMS FINAL �. ' 20. Roof Framing - - - � '� 27. Roof Sheathin � - � � � 22. Frame and Flashin NOTES: . . ' 23. Insulation � ' � �3. �_ � 24: Lathin & Siding 25. Drywall Nailing . � ' • 26. . Plaster Brown Coat ' ' '� - � � � 27.. Electrical Power Meter-Final � � 28. Final Electric ' :. 29. Final.Heating.& Air Conditioning. _ � � � - • � � - - �• '_ 30. Final Gas.Rpe-Test • . � : 31. Final Plumbing ' � ' " � - ' - .32. Water Service-Final . ' , L � ' ' ' - - . ,, ' ' ' - - 33. Gas Service-Final ._ � � � � ' � � ' ' - � � 34. Solar pomesti'cFinal �� � � � � ' " �� � ' ' ' � � � , 35. Landsca e S rinklin S stem � ' . 36. Sound Attenuation ' " � � � 37. Handicap Regulations � � ' " � - ' � -� '� � • � � � ' ' 38. FINAL STRUCTURE & BUILDING -� ' ' - '. 39. Special Requirements Completed ' � � • � - , 40. Electric Release to Edison ' + - •� � � 41. Gas Release to Southern California Gas Co. ' -- � � - • � � 42. CERTIFICATE OF OCCUPANCY _ . ' ' No Date - � �' � . .- .. . - . . Aoolicant lo fill In all soaces erceot those withln heavv DorCer Iines antl si9n all a00rOpriale Eeelaralions. CITY OF COST ESA ONSTRUCTION P�t MIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 06 _RiNcc ro�J i'Jic 2�SSS A.P.�k Zo�a Project Address ,p S Main Building: Attessory Building: AppliCant'S Mailing Addf¢5�� 7��S�I � �fi��l� � TYPE OF CONSTRUCTION NEW ADD LTERATION REPAIR E Z � ��' ❑ CONVERS�ON ❑ DEMOLISH ❑ OT ER ' T Front p S:•v Name "1 ��1 Phonsv�r� �ERooF tJ/T� 8 Rear N �1 � TL%N /J C T OESCRIPTION OF WORK/USE OF BLDSG. L hess A I �' TVPEOFPERMIT GRADWG FOUNDATION STRUGTURAL I C Right N 9 Eng. � Licenu No. — K C+ \ � � � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S LC(t R Contractor's Nam a d Phon �"y ���THER Ping. Ref. q1E Parking Req./Provided E �� �►— /� PROJECT DESCRIPTION Sq. Fr OCCUaA C� planning Notes: M Addresslma'�'�g✓T aL�%1�LL a� /1'! � CONSTRUCTIONTVPE VALUATION �fl City License No. OO ��g T ZONE GRADINGCU.VDS. ACRE$ $, LICENSED CONTRACTOR DECLARATION I hereby al/irm ttldt 1 am Iicenietl untler prOvisions ot Charter 9(commenClOg qemarks:� S MD `r � r' wlth Secllon 7000) of OIviSlon 3 01 [he Buzine55 dntl Pr0lesslOnS Cotle, antl �L" my license is in / I lorce� flect. O � . S Z ELECTRICAL FEES License Cla s � Lic¢ e Dale7=l�8 Signature PL MBING FEES P�ummatit Washe� Transformer ❑ 15�50 KW WORKERS'COMPENSATIONDE LARATION BarSink $hOW¢�5 ConstructionPoleSub. �50+KW 1 hereby aflirm thal I have a cerlificale ot consCn[ to self-inswe o� a CertiliCatC o( Workers' Compensation Insurance, or a certifietl copy thereot (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab. /.�� ' Poiicy N��, companrZll ' Backflow Irrigation Sewer (:ap � Dishwasher Meter ❑over 700amps �Certitletl copY �s hereby furnishetl. Dryers ❑Gas ❑Electric Sub Panel Certi/l¢ op � iletl wlth Ihe ci " 9 Divis n 82LhLubS Sewer Connection . Date Applicant F2(1 EXEMPTION F0. M WORKERS' COMPE SATION LARATION Clarifiers Solar Collectors Motors 67 HP 1 X- 6 (This section neea not be complatea if lhe Oermit is for one huntlretl (E100) or Dishwasher Solar Piping F�A�U� Inc. Solar �9-15 HP � 16-15+ less). I C¢rlity tbat in Ihe pe�lormanGe ol Itte wOrk IOr which t�is Oe�m�t ii BSuetl I Fi%Lu�¢5 shall not employ any oerson in any manner zo as to become subject m t�e Drinking Fountains Solar Tank Microwave workers' Compensatlon Laws oi California. Device Boxes Pole Li ht Date 95�ature Floor Drains Swimming Pool w/Spa 9 NOTICE: It, atter making this tleclaration, you shoultl become subject to t�e Outlets R2nge Workefs' COmpenSdtlon provislons O1 th¢ Ldbo! Cotle, you mu5t lorthwlM FIOOf $ink5 Ufindl tOmply with such provisions or thl5 petmit shall be tleem¢tl �evoketl. CONSTRUCTION LENDING AGENCV GasSefviCe OuUets WaterClOiet SwilCh25 Sign I hereby alfirm l�at lher¢ is a conilructiOn Ilntling agency tor th¢ pertormance � o/ tho work tor which tnis permit is issuetl (Section 3097 Civ. C.) Interceptors Water Heater Garbage DiSposal Standing Sections Lentler'S Name Lenaer's Atltlress Kitchen Sink Water Service GeneratOr �0-5 KW �5�15 KW Trash Compactor OWNER BUILDER DECIARATION I he�eby aHlrm lhat I dm eaempt trom thC ConVdcto�'s License Law for tho Lava�ories AptO-WBSh followinq reason (Soclion 7031.5 Business antl Professional Cotlo: Any clty or county which raquiros a permit to construct, alter, imorove, tlemolish or repair P—Trap Laundry Treys any 5lruCWre, priOr lo It5 iSSuance, dlio fequir<s the dpP��Ganl fOf Suth pafmit to tile a signetl statement that ne/she Is licensed pursuant to tne provislons of Roof Drains the Conlractor's Licenso Law (Chapter 9(commencin9 wilh Sectlon 7000) ol Divislon 3 0l Ihe 8u5lnoss antl ProfMSlonS COtlO) of that Il¢/sile I5 9xUmpt RBiOSpBttl011 F00 $1rJ ISSUB Fee $ 3 therelrom antl lhe basis /or tho alle9ea exemption. Any violalion oi SocHon 7031.5 by any applicanl Por a permil subjects th¢ applicanl l0 a tivll enalty ol not more than tive huntlretl tlollars (5500). S 3 DEVELOPMENT SERVICES RE�UIREMENTS: � 1, as owner oi the prooe�tY or my employaes with wa9es as tholr sola ReinspBction Fee $15 IsSue Fee 2oninq Approved By Date compensalion, will Oo lhe work, antl Ihe structure is not intentletl or otferotl lor sale (Saction 7044, Businoss ana Pmteszional Cotle: The Contrattor's MECHANICAL FEES Building Approved By�����Dat� Litense Law tloes nOl apply f0 an own¢r ol a propGrty who bUiltli or ITp/ove5 �� u�ercon, ana who tloes suth work Nmselt/hersen or tnrou9h his or her own goiler Hood or T e I ❑ �APP��wtion Issued By �� Dat 7 employCes, provitlCtl that tuth Improv¢ments arn not intentlotl or oHeretl tor �P �—F sa1e. It, nowaver, tne builtling or improvement is soltl within ona year ot com- Cnnopy Type I I ❑ SUMMARV OF ES pletion, lhe Ownm will have Iho burtlen Of Proving Ite/sha tlltl nOl builtl or Im- DuCt - Und¢� Ciround Sa nrove for thc purposo oi saio). BUILDING PERMIT $ 6� SMIP 5 � ❑ I, as owner ol the D�ooerty, am ex<lusively contracting with Ilcensetl con- Ouct -Structural Refrigeration System P�AN CHECK $ PERMIT VaCIOR l0 COnsV utt lhe project ($ECIiOn 7044, Bu5ine55 antl RO�eS5io�5 COtle: Tne Contractor's License Law tloez nat apply to an owner of property who Dutt - Ventilating ❑4100,000 BTU ❑100,000 BTU PLUMBING $ I$SUANCE S builtls or imOrovaS lhereon. anE who Wn[racts fo� such oroieGts wittt d con- Vaccor(s1 hcense pursuane w me Convacmrs License Law). I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteretion PL.P�N CHECK 25% $ ENERG�' P.C. $ proot ot their Worker's Compensation insuranca shoultl be provitletl m me. ELECTRICAL $ GRADING 5 ❑ I am eaempt untler 5ectlon e. 6 P. C. for this reason Firepl/FacL BIt. iC80 # Fire Dampers MICROFI LM S PLAN CHECK 50% $ Date Owner Heating $ystem & Ducting Registers 3 ,5�� MECHANICAL 5 TOTALFEE S � 1 hereby certify that I have reatl this application antl state tnat the above ❑4100,000BTU Ot00,000BT PLAN CHECK 25% information is correct. 1 agree to omply wi all city antl county ortlinancas $ antl sta[c laws rela(ing to builtli co tr n, antl hereby authorize repro- . Sentdtives oi Ihii tl to ent n above-mentiOn¢tl property for insoection . Signature Date� � � ReinspectionPee $15 IssueFee $ 3 OS UOti31._3 —04 �7; Drivers' Ucense or 55 $ 1�' S� �1_N ,� � !�,, f7:iSf^, T7rS� -: 0865-46, rev. 5/B8 White - Builtling: Canary - Pink - A<counting; Goltlenrotl - Assessor f � . CONSIFF�N AND PLANNING ,� POOL & SPA APPRO�/A Permit# Date Inspector AppROVALS Permit# Date Inspector 1. Temp�rary Electrical Service or Pole � , 52. Pool & Equipment Location � 2. Soil.Pipe-Undrgrnd. � . ., 53. Steel Reinforcement 3. Electricai 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 Lines, P�Trap, O Undrgrnd. 10. Structural Floor-System ., •� � � 61. APPROVAL TO DECK 71.�Property Sewer Line & HouseConnection •• 62. Backwash & Receptor-Final � 72. Sewer Cap : . . , ' � ; 63. Heater & Vent-Final � / 13. Roof Drains ' _" i"' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final , 15. Rough Electrical,Conduit 66. Solar SYstem-Final 76� Rough Electric Wiring 67. Fencing & Access Approval 17� Rough Wiring Sign �' 68. APPROVED FOR PLASTERING 18' Rough Electrical-T Bar Ceiling �,� 69. POOL/SPA SYSTEMS FINAL 19. Rough�Fieating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace'' _'' APPROVALS Permit # � .i �21. Ducts, in Structure �„ 70. Underground Hydro 22. Ducts, Ventilating ,�i , 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test .. 72. Underground Flush 24. Roof Framing .� <"" 73. Undergrnd. Storage Tank O Gas ❑ 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 MeterFinal- 80. FOOD CERTIFICATE ISSUED 33. Final Electric � � Notes: �_ 34. Final Heating & Air Conditioning 3 � 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final ,i: 40. Gas Service-Final ; 47. Solar pomestic-Final ` . 42. Backflow Preventer . �� ' 43. Backflow Irrigation � ' � 44. Landscape Irrigation Sysrem � ' • / , 45. Sound Attenuation f 46. Handicap Regulations - 47. FINALSTRUCTURE&BUILDING � � �- 48. Special Requirements Completed 49. Electric Release to Edison . ,' 50. Gas Release to Southern California Gas Co ' �. 51. CERTIFICATE OF OCCUPANCY - No. Date " � � OWNER �-23-56 JOB ADDRESS (1Q(�_ pp1T1C8tOI1 DZ'. BUI�DING PERMIT NO. Z9OB GENERALCONTRACTOR Harbor COI1St. CO. � VALUE $-ZZ�ZOO,OO �or 12 s�ocK TRACT 27z7 Single Res. w/det gar GROUP I&'J TYPE V ZONE R� FIRE DISTRICT 2935 PERMITSISSUED INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER Trench .!/.(i.t' If ^ Framin na. Rou -��c-i �irx— Wiring,Rough �u"/� •�1-56 7C. c-17i�i�2..e..�.li /..;J-�G� �G/.Z� � � Heatina. Rouah _ 1 / i �iL ..��- �Yn.`Q1 � C.v.. 7-c _�/ I r c u 9 -� Heating, Final ewer, House t S'eweq St. Septic Tank or Cesspool Lathinq.in Out Plumbing, Final, Fixtu Plumbina. Fin,ai Gas T Wirin Final /i �� � 9� Occupancy / FOliM 210 3M lO�i3 �a Mesa Building Department APPLICATION FOR P�KmiT 111 EAST 20th STREET 2935 g� f � D �L N G 1 "- . COSTA MESA, CALIFORNIA . FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN I Receipt No. I Per�� o� Building �) Address �}�6 PRINCETON �R. �� Costa Mesa, Ci3��OYI11� Reeeived by I ! Date Red�d-.7 pate Issued Nearest 1' ��J"� � ���� CrossSt. GREE�BRIAR LANE Building Address Owner L'O L L E G E P A R K C O.. Costa Mesa, California Mail Address � o SO IV�q � N ST Nearest Tel. Cross St. GtY Senira ANA_ CALIF. No.KI 5—I i39 ZOne/J,/ I No.of I TYpx �/ Group7� 1� or Date Address Cky Llc. No. 37E I Address $AME Descrotion I No. � z I Block I Tract2 Size oi Lot E�(�. x I OS I Now on �ot Useof I No.of I No. Existing Bldg. Families Roa Setback Line from __ Rear Vard '� No. of 1379 Room: APPROVALS Buildfng R�SIDENCE 8', OETACHEO FoundatlonLocation Forms, Materials, G AR A G E Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is coTTect and agree to comply Lath. Int. with all City Ordinances and State Laws regulating building construction. Lath. Ext. s�9natureot HARBOR CONST UCTION C0. Permittee Plaster, Int. Authorized Agt. Plaster, Ext Valuation Permft Fee $ o�p�/ � Masonry Reinforced Plan Cheek $ � y� � $ � � �2��. Total BondBeam Fee $ � � FINAL RM 204 S-SP 2M 6-55 ��IC171Il�II\�`� Show location and distances Trom property Iine and between buildinga � � '^R23•SS��cosTn�61a ` 2�Q i es�� �r. t t-!�