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Home My WebLink About3497 QUEENS CT - Building Permits� (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3497 QUEENS CT Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 41204263 npp�icant: SELL, RON Address: 18032 LEMON YORBA /LINDA / /J� Owner. FOSTE,R, AI Address ,J3497'QUEENS VG COMPANY CA 11 0 u � ,�oo G WOOD SFiAKE,� �_= $o.00 \',� 167.25 f � $0.89 � a $o.00 �o.00 Zoning: R1 R1 �S,sa�,a � , ��< oit� \�� ii." �. 'di.F�nif1� .vf �Oi ,l � � `^-� /�U �� j/ � o � �SSUED BY: Phone: (714) 528-1758 vC' Zip� 92686 � � _ �� U� c :+c.-•, `� Phone: �`C,,,�, � Zip: 92626 �� O� O �� Stalus: ISSUED Applied: 11/25/2002 Issued: 11/25/2002 4)528-1758 ,,� o ..� 0 0 0 o Q o OO�ocO P % V�,�\�� \�\� G' ��,� Phane: %"`" C�m�a111 � License: �— 11'hlll W IJ�.�! � n "ILES." ICBO 34660; 5:8 PSF 27 : 1 I��f 1 � of Valuation: � Sa,S i Valuation: ��.� i �o�� Po �� \" , o 00 0" V U c o° SETBACKS�� /'�� o � �� G 0 .� ° �o �G� � MAIN STRUCTUR\�t�,0 " R��0-;0,-..,.��Lce� ?0 0.7� Rrgh`tO � `�_-�,�` ACCESSORY Front�-0 O Ce�ar�O-0 "" Ceft- 0-0 � R v� PARKING Exi\: �0� Rea i� tl:J 0 J ��Prou Ud �o � �� NOTES: �`�'�-^� -__ _ _ r./7�� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Orcl. No. 92-28, § 1, 12•21•92) " EXPIRATION: This permit shall automatically expire and become void It work Is not commenced within 780 days, or if work is suspended or abandoned far a period of 180 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 requlred Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (774) 7545626 WORKERS' COMPENSATION PECLARATION: — " � I hereby ettirm under penalry of perjury one of the lollowing tleclarations: ❑ I heve entl will maintain a Certificate of consent Po self-Insure tor workers' compensetion, es pmvidee for by section 3700 of the Lebor Cotle, lor ihe pertortnance of the work fo� which this pertnit is issued. �I heve flnd will maintain woAcers' compansetion Insurenca, as required by section 3700 of the Labor Cotle, fOr the peRonnance of the work for which Ihis pertnit is iuuetl. My workers' co ns tlon Ins nce carr end policy number ere: / �^ Cartier. /�� _�U/kGp PolicyNumber: ! G� 6 J�� (Thls section need not be complB�eU I� tbe permit is va/ued a( one hundred dollare ($f00) or /ess.) ❑ I cenify that in Ihe paAortna�ce of the work tor which Ihis Dertnit is issued, I shall not employ eny person in any manner so es to bacome subject to the workers' compensatlon laws of Celifomia, end egre et if I shoyytl become subject to the workers' compansatlon provisions ot Sectlon 3700 of i�e Labor Cotle, I shall forthwith complywit�theseprovisions. ' //_ �/f �_�_O Applicant Signewre: �'l � Date: �_ WARNINO: FFILUFE TO SECURE WORKEqS' COMPENSATION COVERAQE IS UNLAWFI/L AND SHP11 SUBIECT PN EMPLOVER TO CflIMINAL PENALTIES AND GVIL FlNES UP TOIXJE HUNDREO T}IOUSANO DOLtARE (5100,000�, IN MDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DHCLAHATION: I hereby aHirm Ihat I am licensed under provisic force end eHect. Lic. q ? GontractofsSignaWre: /1 with Section 7000) ol Division 3 of ihe Business and ProJgssion�oy�, and my license Is in full Cless k Ci 7 Date: // � Z i—O Z_ CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirm that there is e conslmction lending agency for the pertormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signeture: Dete: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penalty oi perjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW For tha tollowing reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or county which requires e permit lo wnstruc4 alter, improve, tlemolish, or repair eny structure, prior lo its issuance, also requires ihe apD�icant for suc� pertnit to file e signed stetement thet he or she Is Ilcensed pursuant to the provisions of the Coniractors LJcense Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business entl Professions Cade) or ihat he or she is exempt therefrom end the besis for the alleged exemptlon. Any violation of Section 7031.5 by eny epplicant for a parmit subjects the applicent to e civil p9nalty of not more then tive hundred dollers ($500)J: ❑ I, as owner of the propeny, or my employees with wages as their sole compensetion, WILL DO THE WORK, and Ihe struciure is not intended or oflere0 for sele (Sec. 7044, Business and Protas5ions Cotle: Tha Contractore License Law does not epply to an owner of properiy who builds or improves thereon, and who does such work himseN or herself or ihrougn his or her own employees, providetl thet such Improvemenis are not Intended or oHered �or sale. If, however, �he building ar improvement is sold within one year of comp�etion, the owner-builder will heve the Durden ol proving t�at he or she did not builtl or improve for purpose of sele.). � ❑ I, as owner ot the property, am E%CLUSIVELY CONTRACTNG WITM LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business antl Professions Cotle: The contracrors License Law tloes not appty ro en owner of pmpeny who builds or Improves ihereon, antl who coniracts for such prqect wiih a contrecror(5) license pursuant to ihe CoNractors License Laws.). ❑ I em exempt untler sec. Signamre: Owner ID verified by drivefs license. ❑ Ves ❑ No Business and Professions Code for Ihis reason: Veriticetion of Ownership by (type o1 documem, i.e. - pioperry taz bill or tleetl): DIVISION OF INOUSTRIAL SAFET' PEqM1T CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby certily ihet no exca�ation flve (5) or more feat in depih Into which a person is requlred to descenq will be mede in connection with work euthonzed by IhiS pertnit, and that no builtling siructure, scaHoltling, falsework, or demolition or dismantling �hereof, will be more then ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celitomia Administretive Code). � ❑ As owner-builder, I will not employ enyone to do work which woultl require e permit irom the Division oi Intlustnal Safery, es notetl ebove, unless such person has a pertnit to tlo such work fmm the division. � � Signature: pa1e: Division ot Industnel Safery Pertni� Number: CERi1FlCATE OF COMPLIANCE AND AUTXORVJITION OF ENT{iY: I certity under penalry of perjury that I have read this epplication entl state ihat ihe informaiion given is correct. I agree to comply with all state laws and city ordinances relating to building constmction, and euthonze representatives oi the Ciry of Costa Mesa to enter upon the ebove-described properly for inspadion puryoses. I eqrea not to occupy or allow occupancy of any building authonzed by this permit until final inspection. Signemre alOwner( And/Or Aut�orized Applicant COUE�' INSPELTIONTYPE � 1616 Fixed System Final Fire P�evention 1266 200 201 202 203 204 Pool Spa Final Finel Re-Roof Finel BIocWRetaining Wall Final Fectory Fire Place Final Sign Final Demolition �g �� 7 / 7-0/ cr^^'�' //� ZG G � Date COOE 1 INSPECTION TYPE 206 Finel Mechanical 20B Final Plumbing 210 Pinel Electricel 212 Finel Fire Preventlon 220 final Planning Approval 222 Final Si�e 250 Final Building/Occupency PdIE IHfID�Li ��p�� 3497 QUEENS CT ox'r+�n'sxwEiFa+ox'": FOSTER, 1ll2MIN H Tt2 �""�' 3'497 QUEENS CT COS'PA MESA,CA 'i1PVL.IWIINCADDPE55:'. � ' . ' u�cxrtecron�axffn: ' ' • . 1MCX.ON FHO.'Si1DDXE53: ' ' ' ' a . . . . . . uxT: . . . , ' FLOOD: X L38 92626 .' ' � ; • � 1/ � uc.no.: ' ' UNT: caum�cTarsruue: GEGRGE BRAZIL � (714)541-9%53 c«+m�crons�uia+o 3022 N. HESPERIAN WY -� � � moxess SAN'PA ANA CA uc.�.: 679898 92706 uHT: 101 UCENSED COMXACTOHS DECLAPATION: I hereby dtirm uMm penally d pajury ihet I am liceneed uMm prrnaan+ (cwnme�p wnh Senion ]OW) d Oiviaon 3 d Me Bueimn eM Prdxaiore Cale, erd my licenee is in full 1 ed. c�c.No.: pb�� g uacuss: C-20 uc.xo.: ,�� . G �/ / il`1 i iwwr ms� 1031.5 ina com�a�. �,as �w i« ma e pe�mn b min. el1«. improve. dlFd'ah, or repai eny ai�ucture. pnar lo m awence, ebo reQui ne yipimm eucn �o nie e upiwa e�ameni mei m a ane `'ry littmed W�� o �he provisione d Ihe Canvecloro Lioense w�Gheqer 8 me wuh Sea' ) d Oivebn � d Ihe 9uaineav vM Rdea'wa COEeI a ihet M a aM ia azemq �her eM tM In Ihe ion. MY videtion d Sed'un �o3i.5 by vry epplium br e permn wbjeaa ihe eppliceni �o e civi nelry d irot more Ihen fve uedred ddlaes �5500�). �. I, m awnar d Ihe pmpaM or my emplayeee wih wepee av Ihei ede comperce�ian. xill do Ihe xwk, ard iM ewnwa e nd imeMeE w oflered/a eeb �Seclion 10aa. Bum�wea eM ProlesaionaCade: TheConlrmae licer�se Lew doea rwl eppty lo an oxne�d paperry wM W dde or imD�� hareon, eM who doee suM xork FimaeX a Mne� a Mraph he ar her own employesa, pwkeE Ihel awh ' impwemeMe ere iw imeMed a dlered for ceb. H. Iwwever, �M buiMinp w inpovameN iv edd wilhin one yeer W mmpletion, tM1e . ow�.-w�a�� w�n n� ma a;,e� a ww��a na o, sna eb �w w�b « jmwow ia me wmo,e d..b�, � ❑ �. as ovme. a ine wownr. em e=diui�Mr oonireana �.un fram.d conv.cin. �o canWua un wdetl (seeon lou. aniirs.m . Profesvme Code: TM Conlredus licenx lew tloea m� epph/ to en awner d pmperty who WiNe w impovea Iherson eM who convecn la eutli prqeqa wnh e mMredor(e) IcareeE W�� to iM Coniropan Licenae Law). � I em eammq uMu Seclbn: , B. 8 P.C.. br Nu raecon: ; . I do heraM cwtilY thel I am .wue a eM uMastad tM m9Wremew a Cellomie Meellh vM Seletv cade 3eaionv u5o5. z5533. eM , 25SX, e�M Inm I a eny Mure Wiltlinp aaupenl will l wdl na (arcb a�e) naed to canply wIh eek deb codee eM �he reQuimnarua br e paemn lamminx.lion«moEifimlionhwnthe Ai-Ge ITy .Tenepement Oiatrid. Reaidentil mmtiutlion eppYralbnsere exampt ImmUnea prwiaians. . � . . . . . . I . o�<: - ' nvoi�m: ' W ORKEH'S CONPENS�TION DEttAH�TION: I Mreby elfi�m uMer paneM1y d perjury me d Ihe blbwi�p Eedvtliom: � �, I heve enA wil meimen e<erlRctle d odnent b eeXireun b workwa' canpmation, o provided lar by SeUion 3100 d tM lebv coe.. �« m. o�o�� a m...m i« wnon mre w�n s b�a. � .' � I heva eM wil moimein woNers mmpanaeton insurence. d�puirad by Seeim 3100 W �M labor COEe. br IM pe�lamenm W iM wak la whiM i�ie Va^^n ia iseueE. MY waken' wmGer�ame�ion inwrar�ce faner eM VakY numbr are: . c�.: 'r,�T:nF�a Fn�t,F �XPIRES � vo��r+�mw,r, : � nnaraan�R�—n� 01/01/98 (ihis sedion need rm� he romP�e! / fhe 0�t u lur me hundred dWlers /31P01 ar Iw.1 � �� I cMly tl�m in i d tM work lor whkh t�ie peimG ia wueE I iwl em pe yY menmr m o /�ec ane w' ta t e woekere' eompeneetim �evn d CelEmtie . eo�ee Nel� b, /tb eet to �M �ere' / / clmcerumun d Setlian 3)00 d the hyi1F comp�y t gi6vi»ri3 �Ectlon J106 0l tlis Lebor COW, /nhmt, �n0 ettomsy � Iw. I . `/ CONSTFUCiION LENDINO AGENCY: I hnaby elfi�m uMer pendy d �1BBf�0lTBfICB O�IhO WJI�(�OfW�ll(�1�h6 PB11111 18 WBYBd�$Btlqfl'M�/�:�iN. ' LENOEfi'S NMIE: � � ' , LQlDEN'4 AUDNE54: � fa irepetlon o �o.�m.e ro. �n ia e oonyruabn bMi�p epeiwy lor Ure e�m vM nme Ihet Uro eEove inim�wion ia conw. I roree �o wmOH wilh ell dIY eM mumY oNineMee �n¢IrudioneMMrebyeNlwrae Pi�m�� omteruponiheebove�memuneEpapery S / a r+ � \ Dme: iil ' d M�0 da. ery-ADGF�C oink-Revenue: GaWenea�luvaiaor ; ,CI'fY OF COSTA MESA — HUILDING PEFtMIT PEHMIT NO: M 0831�3 PLAN CHECR NO: N CONSTRUCTION TYPE; V—N PERMIT TY�+E: M�C PERM NO: M OS317 GOVT; N SUPP: N eur�Pose: orx JOB DESCRIPTION : A/C CONFDENSER . , � SQ F'T: � CLAIM VALUE; , CALC—VALUE: ,� GROUP OCC: R-3 / COMMENTS: NO�OTHER OWRK AUTHORIZED HY THIS.PERMIT � *�*x�****�*****x*x�rx*�r**�***x�*x**�r�*x***�x��#x*xx**�*�r*rt**�*�c******x�x-x*�x*�*�r�r*� � - Z O N I N G R E Q U T R E M E N T 5 ' S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING -------- FRNT: FT IN REAR: FT .IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; E,T ' IN LEFT: FT IN.RGHT: FT IN PARKING REQ: PROV: �PARCEL: 91209263 ZNE: REF NO'; PLANNING NOTES> ' _ . . _ r . . . . . _ ik ik if !f iE'k if !F'lE k if jf k lf � Jf 3f iE if if')f iF'1f �lf if if #��1f �k Jf iE i! if dklF�iF if iE �IF dk af I! it iE'k �1F 3f if'1F iF il' iE # 3f iE �)k it iE �k ik if iF �f'1F iF iF JF 7F X� iE'k if 741E 1E'iE iE if D E V E L O P M E N T S�E R C� I C E S R E Q'0 I R E M E N T S . "`1... � . ' . ZONING APPROVEll BY � DATE: HUTLDING APPROVED'BY,: �Y DATE: -- �''� APF�LICATION ISSUED HY; ' � "%. %, DATE: x��r�t*�rie+r�r�r�e;r�r*�r�ex��r�rx�r�r*,F3FiFiF��F�iFiF3FiFiFiF�FxiF3F'iF3��1V ,�F S��'-'3r5F*x�t��r+r�t*i�x � � #* LEGALI2ATION;N- -` F E'E � AS q M M A R Y STRUGTURAL SEGMEN't:N bLDG PMT PLUMBING ELECT&IC : MECHANIC FIRE SMIP/RES GRADING PERMIT 13.25 �' ' .. ; 25� SMIPINON—RES PLAN '� " . ISSUE FEE � Z2,00 bUILDING—DIV—> PERMIT ISSUE PliAN-CH6CT{ TOTAL PAID DUE TUTALS----> ' 13',25 22.00 � 0,00 35,25 35.25 00 RfiVENUE DIVISIUN 'fOTP,LS--> COLLECTED: HLDG PMT PLOMBING ELECtRIC MECHANIC �`� � 35,25 35.25 OVER/SHORT: 00 FZAE SMIP/TOT GRADING PLAN—CHECK � iE 3E k-k'ff IE iE 3f iE jk iE 3E iE )E lE X-'JE dF 7F ik if iE iE ik if ik ik iE iE lE df it 3t iF df iE jE iE 1E df iE �It k 3E iE if 3E M 1F if �k if iE k 3F k�7E iE iF'7F iE 1k dk k i! �f 3F 9E'%�Yc ik k)k # If dk iE �F �i I N U I V I D U A L F E E B'R E A K D O W N TYPE QTY ' ll.E S C R I P'T I O N UNIT COST 'PO"1I�L COST MEC 1� F7EFRIGERATION SYS'fEM <= 100 R H'PU/H 13.25 13.25 END OF F�,ES 0 Y 06-E4-1937/02:27 PN/f35.25 r'ERt'iI TPi@83173 � CONSTRUCTION AND PLANNING F � . -- ..�:Y � . �-- - � - ? '&^SPA � � 4 "` . - .'. t -' -. �S- �; �Date Inspector '� � `'-'f `� - s' _ Date � � �nsPecto �I ; , APPROVALS Permit # ; . APPROVALS Perrtiit # - - - < �-v,� �4' ' F. � - >� �.i,�� ;t ,: v �. � - .,. . ., t+ _ ' � � -i � _' 1. Temporary.Electricai Se�vlce or Pole�� ` [ � � � , i 52: Pool & E_quipment Locat�on � "�}; • - ( . � . o _ _ '"2'. Soii�P�pe-UndrgFnd,` " ! � � � �`,' � �53 Steel Reinforcement � � �' - ' ` 7� +3. Electrical Conduit Utility:Undrgrnd �� • � ° ' � '54 - Forms ; - ' ' • � � � r '� � � _ 4. Electrical Conduit�Undrgrnd. � _.55 Elecvical Bonding� „ �` t� ' r' � 1 R '�� 1� 5. Steel fleinforcement �- {� � '�.� � 56. Rouqh Piumbing & Pressu�e Test t i• � � ';-� ��; f 6. ElectricalUFERGr�d, ) � _ i 457. APPROVALTOCOVER_GUNI.TE_ • � � t � �� 7. Footings � � � ` �. -„ ' = � ks'' ,;, - .58. Electrical:Conduit�.Undr�rtnd: , " � � .- ' ��.� 8.. Foundation �' -_ �' i i - ' -�, 3 ` ' �-'- . - � ,�-, .r' - _ 4 - _ ' 59. Gas P�pe;:�tUndrqrnd Tesr� _ ' ; ; ' � _ ` = , _ - - , ' � - � : 9. Water Pipe�Und�grnd. . � � :.`,'. � � }6Q BackwaSh�Lines,;RTrapj•�,7� Unclrgrnd'. . � _ �' �'; i 10. Structurat Floor Svstem u . { . " ,'�� : - � ;r, ' � -,67. APPROVAL TO�DECK%� • _ � ` . � �� ,, r; �' 71 . PropertY Sewer �ine & House Connecfiom i� ; "� I l � ` ' � � � � -% � '' � `_ � _ -627 Backwash &-Receptor-'Firial _ � i , ; . - :� a- - . � ,� ,-� ' .. 12. Sewer Cap _ � �;, - =;,� i �63: Heate� & Veni�Finel" "� , � �' � 13. Roof Drains i ri. . a-_ � s+� -. -' � � �, .. r i• _ , �� ,� , i ,.64�. Plumbi�gSYstem-�Final . 14. Rough�Piumbing _ ' f _ `. �,n �1 6@� Electrical Pinal � ! t � = � i, � i .-_ - .. . 15. Rough,Electrical�Condu�t'.�� j ; � �'; 4� ; . � 5 � � �66. Solar�Sy,'stem�Firiai' - - � 76. Rough Electric Wiring _ ; : - _ `=5 " � � � , � �67� Fericin �& Access Rpproval ' ` k � � �� - - .� ..a "t� 9:. _ r. 17. Rough Wiring Sign , ;� . 1 =,"- ; -' �S '` ` �=68: APPROVED FOR PlASTERING� - -� ' ' �' �'� - �2 � �r - 78. Rough Electrical-T Bar Ceiling I `: � t �}�` � E � a69 POOLlSPA SYSTEM&FINAL j; , �. ' � � `� � = ��19.=Rough��Heating&-Air Conditioning. � . = �.=_ � . .- __.-. .---- �--- FIRE'DEPT. REQUIRENIENT. - ....=. _ , . - ' . 20. Rough Factory Fireplace - • APPROVALS . Permit # 21. Ducts, in Structure .. ' ' � 70. Underg�ound HYdro 22.Ducts,Ventilating - . 77.ProductPiping�Gas_COiI � 23. Gas Pipe-Rough & Test _ ' 72, Underground Fiush � 24. Roof Praming � � . � 73. Underymd. Stor2ge Tank `J Gas O O�I 25. floof Sheathing - �' ' .' 74. Overhead Hydro' 26. T-Bar.Ceiling {Svuctura�) & Monocoat 75. Dry Chemical � "' 27. Frame and Flashing ' � 76. DrY Standpipe , ' 28. �athing & Siding � 77. FIXED SYSTEM PM1NAL 29. Insulation .'- �' � 78. PIRE PREV. FINAL • 30. Drywali Naili�g � HEALTH DEPT. REQUIREMENT ', 31. Plaster Brown Coat 79. FINAL INSPECTION � � 32. Electrical Power Meter�Pinal � 80: FOOD CERTIFICATE IS5UED , 33. Finai Electric . � � Notes: ; - � 34. Fina� Heating & Air Conditioning � . � I�/t�� - - ' _. ' 35. Finai Gas Pipe-Test � � , . 36. Hood or Canopy ,. . ' . ' . � 37. Finai Factory Pireplace�� ' ' , 38. Finai Plumbing ' � . - 39. N.�ater Service•Final� C ;� - - • t� 40. Gas Service�Final � � � . , ._'.. 47. Solar pomestic�Finai � � , 42. Backflow Preventer - ' � 43. Backfiow Irrigation - � � 44. Landscape lrrigation System ' ' , � . � 45. Sound Attenuation , , 46. Handicap Regulations ' ' � ,- ' � 47. fINALSTRUCTURE&BUILDiNG � � . 48. FINAL PLANNING , l--1 , - 49. Electric Release to Edison . ��_i-��; _ � � 50. Gas Release to Southern California Gas Co �._�,__ - - - . � 51. CERTIFICATEOFOCCUPANCY ' -, � � - N0. Oate -._ OWENS•CORNING Fibergl Blanke�nsulation The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is in- stalled in conformance with current energy conservation regulaYions, California Administrative Code, Title 25, State of California, in the building located at: 03/�9% ��0-�2� l� /4�75"" Sireet . Lot Number Lact Number Exterior Walls �/ �r Owens-Corninq Fiber las Blanket Insulation �� Thickness R-Value Ceilings /„ / Owens-Coming Fiberglas Blanket Insulation /� A� Thickness R-Value Floors � Owens-Corning Fiberqlas Blanket Insulation Foundation Walls General Thickness R-Value Manufacturer Type ' Thickness R-Value License No. By Title Date (SignaNre) , " ! �'� y- InsulaY ont tor ��i�-»��3 .-�1��1/AL'/.bG�fiJC.. License No. �/T__ %'��7 �Q By �'�� Title V; � Date� �4 '�V� ( igneWre� — Homeowner Copy (White) � State Copy (Yellow) OWENS-CORNING FIBERGLAS CORP. Builder Copy (Pink) Insulation Operating Division a�o. rvo. is�e�.ssss-n rnno �n u.s n., d�iy isn Fiberglas Tower, Toledo. Ohio 43659 F � � 0. Q h � F C W Q ❑ , ; 6 > a x w a � 0. Z .y' 3 COSTA MESA BUILDING-SAFETY DEPARTMENT ; P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING 3497 ueens Court ADDRESS. Q OWNEROR Wimbledon ASSOC. TENANT ADDRE55 147� Jamboree RCZ c,T,, Newport Beach �T,o540-6800 � oER`�'o" Imperial Savings & Loan BRANCH � PdSdC�2I13 ` ADDRESS 6�- S. Lake AV2. ARGHITECT Corbin/Yamafuji No�'S49-712 OR ENGINEEF ADDRESS �1%JJZ Mitchell So., Irvine CONTRACTORMCLdlIl DeV. CO. - � ADDRESS 1470 ;Jamboree Rd . CITV Newport Beach � No`.F40-6800 �ic NO. Z%�JH%S " , LICNO. 1HH%3 SI2E NO.OF BLOGS. O OF LOT � NOW ON LOT USE OF ` EXISTING BLDG. - Separate permits are required for . electric, plumbing and heating work: �� VSE OF BUILDING AND WORK TO BE PERFORMED � PRD — New Construction . Single—family dwelling I hereby acknowledge that I have reatl this applicatian antl state that the above intormation is correci and agfee io comply with all laws regulating builtling construction, antl I shall not amploy any person in violation of the workman's compensation laws ot the Stata of California. I hereby certify that I am properly' licansetl as a contrector untler the Siate ot Calitornia Business antl Professions Cotle, Division 3, Chapter 9, antl that such licenses are in full forca and effect, or 1 am exempt from the provisions ott� e Sta e of California Business antl Professions Cotle ivi ioB 3, C�iep r. Sig^atura ot Parmittee or � Authorized Ageni Date Z � APPLICATION FO RECENE V PEf A.P. No. � ��a- BUILDING aooaess 3497 UNIT OR� 18 SPACE TR.NO. LOT 10275 NEW ADD ALTEI X OWNER Wimbled use pRD ZONEPQ/�� APPROVED BV APPROVEDSETBACKS PLANNING ACTION ;�`_ STRUCTURALPERMIT , 95 TL' ` �T N° - 47792 — �'s ens Court BLK. 18 REPAIR MOVING �EMOLISH 1 AssOc. VHLUE S _ . _ 10LD FOR SPECIAL THEAMOUNTS � THE PURPOSE OF VALUATION $ � 3�1 J �NGROUP R-3 DATE I /ZO/7� I m i V , � �i. j VN UNDER VALUATION IS FOR m -ABLISHING A PERMIT FEE ONLV: � � PERMIT FEE $ '� v � m \ PLAN CHECK $ ^� 0 LL TAX $ � � � TOTALPAID S 3 3 �