HomeMy WebLinkAbout2753 DRAKE AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cBaUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job nddress: 2753 DRAKE AV
Suite:
Vicinity:
Parcel Number: 14130209
npp�icant: TOWNSEND, RICHARD
Address:
Owner: PICCO, JEFF & REBECCA
Address 2753 DRAKE AVE
COSTA MESA, CA
Contrector: MESA ROOFING
Address: 843.W. 17TH STREET
COSTA MESA, CA
Zip: 92627
Arch :
Address:
Zip:
Zoning: R1 R1
Phone: 949-5483012
2ip:
Phone: 909376-4267
Zip: 92626
Phonei (949) 548-3012
License: � 564151 -
- Eng:
Address: � -
Phone: _
License:
ISSUED BY:
Status: ISSUED
Applied: OS/08/2001
Issued: OS/OB/2001
Phone:
License:
. . ' . ' SGVYt Vh YtKMI I ; - ' ' ' ,
TEAR OFF EXISITNG, INSTEALL-30 YEAR ASPHALT SHINGLES OVER 2 CAYERS OF�15 # FELT. � . ,
� - FEE SUMMARY ,
PlanCheck: $0.00 --- - � - =__-- - �. � � - .-- _CalcValuation: �f .' �$s;ioo.00�
Permit: � $125.25 •• - - -ClaimValuation: �'��` Ss,ioo.00
SMIP Res: � � $0.51 • %� ����. ; _ �7 �
SMIP Com: $0.00 � - � '''� ' � -
Other. � t$0.00 � — ` � " ;'�-j�� � �
�
�
Inspection: , $0.00 ;,i '' �
.� .� . , � �, ;
� , =. - ,��, �% " „ ��%
Total: _ $125.76 � , �
;r
� ��� �-. •z�� , � �z'� _ i% ��,
; < . . , „%;
�� �� �� _
; � c�� �/� ����` �
SETBACKS.� :.� � � � `> �����,, ' °"
MAIN STRUCTURE�Front� 0�'0
j �� Rear� �0�0
� " � _'_
ACCESSORY Front �. 0-0 � ' . Rear�.,0-0
PARKING Ezistina: �0_� ��.Requlred: ,0
NOTES:
�U1IVIYIIVV Ot LVIVIIVIJ
� �
� �" �
" - Left 0 0 � � �
Left _0--0 '` "��
, �� Proposed:� `-0 �
j'%r,> � ` � ,; .
% /� i
� //
� ,.� .v �,v�
Right '� 0= 0 ,� ' i"
��, ��%/
R�ghf ' �p-,0, ,.
�-: .
= ,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremants under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permi[ shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cotles, and all
requlred Inspections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
244fid6 (fi/00)
WORKERS'COMPENSATON DECLARAn0�7� �
I hereby eXirtn under penalry ot perjury ona ot the fdlowing tleclaratlons:
❑ I e entl will maintain e canifwte of consent to self-Insure for workers' compensation, es provideC tor Dy section 3700 of the Labor Code, for the peAortnence oi Ihe
ork tar which Ihis partnit is issuetl.
I have and will mainWin work85' compens on i urence, as requiretl by secfion 3700 of IhB Labor Code, tor the performance of Ihe work for which t' pertnit Is issue0,
My workers' compens ion Insu nce c' r e olicy num6er ere: _
Carner: .... Poliry NumDar. �
(Ihis sectlon need nof be completed il the it Is valued af one Aundred Oollers ($100) ar less.)
❑ I certiy [het in Ihe pertortnance of Ih ork For which this permit is issued, I shall not employ any person in any manner so es to become s' ct to the workers'
compensation laws of Calilamie�e that if I should b si1D ecl lo lhe warkers' campenSalion provisions oi Sactipp 3� pf� � bpr Cotle, I 5hell torthwlih
compywiththe� ovisions �/ j
Applicent SlgnetureY � - — Date: ^�
WARNING: FAIWRE TO S RE WO KERS' GY]MPENSATIdJ C MEAe�_`�g 4�NLAWFUL AND SHALL $UBJECT AN EMPLOYEfl TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
TIIOUSPNDDOLURE 00,000),INADDITIIXJTOTHECOSTOFWMPENSATION,�AMAGESASPROVIDEDFORINSECTIIXJ3]O60FiHELABOqCODE,IMEFEST,ANDFTTORNE`fSFEES.
LICENSED COMRACTORS DECLARATION:
I hereby aHirm Ihai I am licensed under provisic
torce entl eflect Lic. x
Contractor's Slgnature: �
7000) ot Division 3 oi the Business antl Professions Code, and my license is in full
Class # � / •
Date: � � � J��—
CONSTRUC710N LENDING AGENCY:
❑ I hereby ettirtn thet ihere is a construction lending agency tor ihe pedormance oi the woB for which this Oermit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Atltlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eXirtn Ihet under Oenelry of per�ury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end ProFessions
Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair eny structure, prior to its issuance, also requires the appliwnt tor such pertnit
to flle a slgne0 statement that he or she is licensed pursuent to Ihe D�a��slons of the Contractore License Law (Chepter 9(commencing with Section 7000) of Division 3 of Ihe
Business end Profeulons Cotle) or Ihet he or she Is e:empt therefrom and Ihe hasis for the alleged exemption. Any violation of Section 7031.5 by eny epplicant for e permit
subjects Ihe apPliwnt to a civil penalry of not more ihan five hundred dollars ($500).):
❑ I, es owner ol Ihe properry, or my employees with wages as their sole compensation, WILL DO THE WORK, end the sirucWre is not imentle0 or oHered tor sale (Sec.
7044, Business and Prolessions Code: The Contractors License Law does not apply to an owner ot properry who builds or improves thereon, and who does such work
himselt or herself or through his or her own employees, provided ihat such improvements ere not intended or otteretl tor sale. If, however, the building or improvement is
soltl within one yeer ol completion, the owner-builder will have the burden of proving t�at he or she did not build or improve tor purpose ot sale.).
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct tha project (Sec. 7044, Business and Protessions
Code: The comractors License Law does not epply �o an owner of propeey who bullds or improves theraon, and who contrects tor such proJect with a contractor(s)
license pursuaM to ihe Conirectors License Laws.�.
❑ I am ezempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner I� ventieA by dnver's license. ❑ Ves ❑ No Drivers License No.
Venticatlon of Ownership by (rype ol document, i.e. - properry te�c bill or deed):
Evpires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certily Ihat no ascavation five (5) or more faet in depth into which a person is required to descend, will ba matle in connection with work euthorized by this
pertnii, and that no building structure, scaXolding, falsework, or demolition or dismantling thereof, will be more then thirty-six (36) teet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Tltle e, Celilomia Adminisiretive Cotle�.
❑ As owner-builtler, I will not employ enyone to do work which would require a permit from the Division of Industriel Safery, as noted above, unless such person has e
permit to tlo such work trom the tlivision.
SigneWre: Date:
Divisian ot Industrial Satery Permit Number.
CERTIFICATE OF COMPLIANCE AND AUTNORIZATION OF EN7AY: I cehify under penalty ot perjury that I have read ihis application and state that the infortnation given is
correct. I egree to comply with ell stete laws and ciry ortlinances relating to building constmction, and aNhonze representatives of �he Giry of Costa Mesa to enter upon ihe
ebove-described property tor inspedion puryoses. I agree not to occupy or ellow occupancy of any building authonzed by this permit uMil final inspection.
40UE t. INSPECTIONTYPE
1876 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-R0o1
201 FInaI BIocWRetalning Wall
202 Final Factory Fire Place
203 Finel Sign
204 Final Demolition
P�i¢ IMRIALS
s�/v � Date
Date
�QjjF.j INSVECTIONTYPE
206 Final Mechaniwl
20B Final Plumbing
210 Final Eletirical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Sita
250 FinalBuilding/Occupancy
Q[�j� INTRI�LS
.00n�ssoem�on�c: 2�53 DRAKE AV
avxexsxu/eiraioxm:MENDOZA, GILBERT
,woxessMENDOZA, KIMBERLY A
2753 DRAKE AVE
OSTA MESA,CA 92626241-15f33
APPL. WII➢!G IDDHFSS:
urcxrtecron e+ax�+:
UNT:
2''�
uc. xo.:
ur�r:
corimecrarsxu¢NOCK PLUMBING ( 714 ) 895-1246
cwm�croxs�uiwo 1161 2 KNOTT ST
moxessGARDEN GROVE CA uera.: 707775
92841 urn: 17
4CENSED CONTHACTOHS DECLAHRTION: 1 hereby eR'vm uMx penely A paijury thet I em licansetl unEer provbions d Cheqer 9
(eommentleq wilh See�ion ]OW) a�� 3 ot ihe Bu&rieu aM PMmdma Cade. uM mY �� �✓� WII faee enE Nlea.
cmuc.No.:05 386 uc.euss:C-36 uc.No. 07 75 EXP: 02/98
o�e: �7 co�mma: �
OWNEN BUILDEN DECIAPATION: I henby elfirm under paneAy d pmjury tl� 1 em eicemq Imm IM WMrepas Licenae lew la Ns
lolbwing reeaon (`�ion ]W 1.5 Bwiie+a e�M Ndavsiw�v Cade: Mry c'ry o munry whidi �ayu'vae a peimY to ounWn. elix. imqova.
Eemd'oh, or ropei any slructure. pnor b Ys cweMe. ebo reyuires iM epplirant lor such pa'mtl to fib e eigrieE eblemenl Ihet he a eM
's licensad Wnuent lo Ihe provieiom d the Coniredon Licenae lew �Chepter 9(mmmararp with Setlion )(q0) d Owebn 3 d tha
3ueineas eM Prdesaiona Codel a Ihet he a aha ia uemq iherehwn eM iM bean In ihe elbped azemqion. My violelion ot Sedion
lOJ1.5 by eiry epplimnt Iw a permn wbjatln IM epplicent b e avJ perely d m� mwe Ihen lira huMred ddlere �SSU011.
� I,scow�ardthaprape�lyamyempbyeeewhwagmeathreobcwnpenealion,vnlldo�hexork,end�heeduciurewndintended
or aAered la seb (Seclim ]01d, Buv�saeM Prd»aiona COEe: The Camreaon lioensa law Eoea �wl epplyto en ownxal p�opeily
who builEs w vnqwea theieon, enE who doee such xak himeell a MnM a Ihraph h'o a Mr own empbyesa, pwidad ihet auch
imqovemeMa ere mt inteMeA or aflaed Ia eeb. H, however, tha buiNiiq w'unprwemen� in aold wilhin ona yeer d mmplatun, tM
owrorbuiWx will heve Ihe WNen d proviip ha or eha tliE nM CuiIE a im0� �a iM qiryoee d eab).
� I. av owrne d Ihe propeny. em aztlusivaly mnt�ea'vp xith IieenseE eantreeton �o emabua tM p�opa (�� ]�. �+inma ud
Proleasione Goda: Tha Contreaae Licanea Law dros nd epp�y b en owrnr d p�openy who builde a'unpovea IMreon enE Mw
contrena lar wW prqMa xilh a awu�fa(s) Icerroad W�� �o �he Conlradae Limnse Lew).
� I em ezemq uMer Section: B. 8 V.C., br Nie �mwn:
Dem: On+ier:
I tlo ha�aby uMity ihet I em eware d ud uMweieM Ihe requiremenle d CalRomie Neel�h erd Selety CaAs SaUben 25505. 2553�. enE
25531. enE Inel I a any iulure buikiip mvpent will / wil na (uicb wn) naed Io camply wih uid qela mdes vd Ilr �puinmmb br
apermn/aoommwYion«madifmionhaniheAi u3eTi l.�iy anepenwniDistnd.Feakaniialmnstiuuuioneppiratbmereezempiromihme
pfONq119.
Ue�B: APV���
W OPKEN'S COMPplS�TION DECL�RATION: I Mreby elfiim uMar perelly W paryury ona d Ne Idbrrirp ExJeretbna:
� I heve enE wil meinlan e cerlifcab d wnsem to aeMinwre br wakera' canpa�ion, n praided fa by Semon J]OD d tM lebor
Coda. in IM pMamviee ol the xvek lor wlieh thn pe�mil o ueued. .
�I heve eM W meintain worken' wmV��ion'vuurence. m rcQu'ved DV Setlion 3]00 d IM lebm Code. la Ihe Oa�amence d IM
work la whiM I�ie permil is iuueE. My warkan mmpanamion inwrence cemm eM pdiry numbar ua:
c��: GOLDEN EAGLE EXPIRES
aa� N�mn«: 0 9/ 01 / 9 7
m. �nron need �a be romW�ad � rne ro�x e ro. are nuneree edials Isra/ a�v.)
�❑ 1 ceM/Y Il�et in the pMamenca d iM wark br whch Ihp paimil p eauetl. I Mell �wl emplry ary pe�em in erry men�nr eo n �o
become eubj a io iM w rkere canpemmbn lexa d CelManie. ak roree Nm j I ehouN bacome eubjw m tM vroNeie'
comp vueto provoiau S tlbn 9)00 W Ihe lebor Coda. I ehdl lo FWI mmpy knnl BB p10V181IX19.
D�e: �i I A„��t: �—�. �---�
Wem/np: Fsllun ro�xun woAwi rompwwtlon covsnp� la �n/ewNl, aMalW/ w0/xf an wmp/oyer ro alMn
clvll 11na up ro ms h,ntlreL fhousrW rblMn (SiPO,OWA M atltllfbn ro tlro cost o1 romprwtbrt a�pu sa pmNrled b�
Sxtlm 310G ol tln Lebor Cotls, Infrsst, �nd attomsy'� Isu. �
CONSTIIUCl10N LENDINti A�ENCY: I MreEy etFrtn uMm penelry d perjury Ihm iMre is e conM�ud'wn IaMinp epericy br tM
panam� d m...w� ior wni� ine �em�n is sa�.d Isaa�, aoei. cr. cl.
LENOEH'S NAME:
' LENDER'S ADDNESS:
1 canM �� I heva reaE Nie epplv:elon rM mtle thel the ebove intame�ian is cortea. I y�ae �o compy wnh ell dly enE counry wdirencee
entl stete levn relelvp la WiWne conevudion aM hereby eulMrize rapesentalivee d ��b dry lo enim upon IM ebove�meMioneE poperlY
�o,msa��,w,w�RO�• NOCK
Pnnt Neme /
Dme:
Spnmure d Owwr/qpenVAppicen �nireJ« .
(5t51de.WP) WM1ne-BuilEmpBSefery;areeo-Fle;Cenery-ADp���lA�k�immue;C,oldenmE-Naeneor
CITY OF COSTA MESA — BUILUING PERMIT
PERMIT NO: P 082214 PLAN�CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
SOB DESCRIPTION : UISH WASHER CHANGE OUT
CLAIM VALUE:
CALC—VALUE:
PERM NO: L� U82214
GOVT: N SUPP; N
' PURPOSE: UTH
SQ FT:
CROUP OCC: R-3 /
COMMENTS: NO OTHER,WORK ASSOCIATED WITH THIS PERMIT
u*�+rx*x���+��t�**�*�*****x***�x*�x+��rt�****�**x��**x��*�*�*x*x�*x*�r*+�+�x�x��*x+���**;���*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
.EFT: FT IN RGiiT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14130209 ZNE: REF NO:
PLANNING NOTES>
i 1
ih 1E iE 1E 1f iE iE 1E ik 1E 7E IF ik if !f ik 1E 1E # iE fk fk fk fE iE iElElE 1f� 1E if iE iE iE fE iE �E iE )E 1E iE iE 1E 1f 1E IE iE.-0E �lE-0E!E 1F'lE iF iE 1E iE �1F )f !E iE' 1F'lElE'IF'IE iE 1E iE'IE 1ElE iE iF iE iF iF if 1E
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 T S
i�.
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : .' DATE:
APPLICATION ISSUED BY: -� DATE: �� �Ji"�
3EaE�ElEifiFiEiEiEiElEfE�E�EiEiElEiE�f1EiE1E kiflEifiFlElEiE1ElE��� �FIF
LEGALIZATION;N F' E E S U M M A,R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRI�DING
PERMIT 8.75
25�
PLAN
ISSUE FEE 22.00 •
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 8,75 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
30.75 '
SMIP/NON—RES
TOTAL PAID DUE
30.75 30.75 .00
30.75 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
iF �lh it # K� iE iE M� )E #�fE iE iE if-iE iE 1E # iE iE iE iE iE 1E iE iE �(- iE iE �lE iE iE �lf- iE iE iE iE iE iE �(-iF iE iE 1E 4 ik fE iE iE iE 3E iE fE iE iE iE iE �lE iE iE iE aE iE if iF 1E iE 3E iE iE �F iE iE iE �lE �I(� ik iE k
I N D I V I D U A L, F E E H R E A K D O W N
TYPE QTY D E S C R I P T 7 O, N UNIT. -f��T�' « x TD'�i � OST
_.. � I Ij EJaJ:•i Ya��a� �
PI.�U i. DISIiWASHER � fl' � '�'� 5
END OF' FEES � 1
�,r,� is�:; ; e i337
C1TY OF C�S:iA MESA;
CONSTRUCTION QND PLANNING � - - _ . ?OOL ?A .
,- APPROVALS Permit# - �Date �Inspector APPROVALS .Permit,"'t� Date Inspector�
1. Temporary Electrical Service or Pole ._ 52.� Pool & Equipment location �
2. SOiI Pipe�•U�drgrnd. , - . . � - �53. $teel ReiaiorcemeM _ - ' ' . � �
. ;
'3: E�ectrical ConduirUtility•Undr9rnd. . � - � 54. Forms � - ' � .. ,
' 4-. Electrical ConduiFUndrgrnd. ' _ 55.= Electrical 8onding. �� �
' 5. Steel Reinforcement ' '�. - � 56. Rough Plumbing & Pressure Test �
6..Electrical UFER�Grnd. ' . - 57., APPROVAL.TO COVER-GUNITE
7. Fooiings ' •� � . . _ 58. Elect�ical Conduit�Undrgrnd: -�
.8.. Foundation - � . ` ' . 5,9. Gas Pipei, t7 �Undrgrnd;, -Test � � ' �
9. Water Pipe�Undrgrnd. ' -' " '� . 60. Backwash Lines, P�Trap, � Undrgrnd.
70: Structural Floor System � .� 61: APPROVAL_TO DECK � '
i t, Property Sewer Line & House Connection - . ; 62. Backwash & RecepiorFinal : ' � �
� -
12. Sewer Cap I - �. 63. Heater & Vent-Final �
13. Roof Drains . � . - . ' � �64. Plumbing System - Fina� } -
14. Rough Plumbing - 65. Electrical-Final ' �
15. Rough Electrica6Conduit ' � �66. Solar SYstem�Final �
16. Rough Electric Wiring� .. - . 67. Fencing & Acce"ss Approval . .'
17. Rough Wiri�g Sign - .6fl. APPROVEO FOR PIASTERING
iH. Rough Electrical�T Bar Ceiling ' �. - 69. POOUSPA SYSTEMS�FINAL �� F �
19. Rough Heating & Air Conditioning ' _ , ,. F��E,D�PT. AEQUIREMENT .
20. Rough Faetory Fireplace _.-- .. - : - � APPROVALS �` Permit #
21. Ducts, in.Structure' , '� ' � '. 70. �Underground Hydro
22. Ducts, Ventilating � r: - - 77. produc2 Pipi�g O_Gas ❑ O�l
23. Gas Pipe-Rough & Test �� •� _ - _ 7z. Underground Plush
24. Roof Praming � ' M" = c - : 73: Undergrnd.StorayeTank �Gas ❑Oil
25. Roof�Sheathing ' � _ � _�r 74, OverheadHydro_.
26. T-Bar Ceiling IStrucEuraq & Monocoat . = 75: Dry Chemical �-
27. �Frame and Flashing - • " 76. Dry Staadpipe ,- .
28. Lathing & Sidin9-.. :- ' � � . 77�. FIXED SYSTE0.7 F-.INAL -
29. Insulation ' _ - " ' � 78;..FIPE,PREV. FINAL . -
30. Drywall Nailing a_ _ - „-HEALTH DEPT. REQUIREMENT
31. Plaster BroWn Coat' ' - " 79, FINAL INSPECTION _
32..Electrical Power Meier�Final �- , 80. FOOD CERTIFICATE ISSUED
' 33. Finat_Electric • ' _ ' _ Notes:Nd,R���S ����y •_/2 �+ _
34. Final Heanng & Air Conditioning- , " � ' '-'
35. Final Gas Pipe-Test ' �� � �' - - �
� 36. Hood or Canopy � . : . ; ' .. _ ' ,_
� 37. Fi�ai Factory Fireplace " - : •
38. Final�Plumbing �. _ . . .�.j��� � T , . - -
39. Water Serv(ce-Final - � � . ' _ � - .
40. Gas Service-Final - - � � ' � � '
_.. f -
� 41. Solar pomesticFinal -� � " - - . '-
42. Backtlow Preventer � � � �' 'x - ;
43. Backflow Irrigation. �� � + � . . �
44. Landscape Ir7igation System .� � ,,� ; . • - �
45. Sound Attenuation � �• � � � � � � � ' ` �
46. Handicap Regulations , - - � ' '=;
47. FINALSTRUCTURE&BUILDING _ , - . -
-�
48. FINAL PLANNING � ' '. " ' {��
49. Electric RC�ease to Edison � ' , �: � � . . - -• _ '
50. Gas Release to Southern California Gas Cv ' ` -:-
�-
51. CERTIFICATE OF OCCUPANCY
No. Date
.
j - �22�'��� FEE RCCEIUED
COSTA MESA BUILDING-SAFETY DEPARTMENT �.� �UN 17 1960
P. o. aoX 9,� ��„ MEBA. CALIFORNIA ° F�NqNCE DEPT.
For Applieanf fo Fill In Complefely APPLICATIONCK�R�VERRI�1'A h�ESA
� TYPE OR PRINT LOt �'l`�+1 gU1LDING -
BUILDING Plan lf �IA
ADDRESS
COSTA MESA, CALIFORNIA " FOI' Offite Use Only
PECEIPT NO. A ��'�D�/
OWNER C '� � �
"'a" Suite 1 �p�� Y� C�$gt H� hW$ AQCEIVED GY I qpTEj ECE=VED I DATE 183UED
ADORE55 f.. g Y b �o(J '/� i o
c�n Corona del Mar '' No`� 34220 pODRE55 75
o. �TiNeeR No. Oi 3%OL �STA MESA. CALIFORNIA
ao 'ss 3432 Via orto Ne ort Beach FIRE //
ZONE TYPE !/ GROUP �
CONTRACTOR M�CCO C01�70i8C10I1 - APPROVED '
BY DATE
ADDRESS 3800 E. Coast Aighway ZONlNG .
CITY COrOQ$ del M8r � �oNe I NO. OF I U9E OF NEW
PUNS 9UILDING
� c.`rE,o. 98808 No`: � 3-4220 DEBCRIPTION Lot 41T,ract �� 3749
OF L07 ]� X 93 I xo. oF etn¢8. 0 -
xoW oN LOT p, p, NO.
USE OF ' YARO6 EVES
EXISTING BLOG. APPROVED ALLOWED
8ETBACK LIN! FROM ^ FRONT L1Ne eT l/' FT. IN.
CENTEN OP BTRE6T 42 REAR YARD L�
SIDE YARD ILEFT S IRIGHT 5 R.SIDE FT. IN.
DESCRIPTION OF WORK r'
- REAR FT. 1 ,
REPAIR I IIMOVING I IIDEMOLISH I BYPROVED DAT
BUILDING NO. OF � '
SIZE ROOMS 6 570RIE5 �.
EXTERIOR WALL SCUCCO ROOF . q�
COVERING ICOVERING ROC�
USE OF BU D G AN WORK TO BE PERFORMED �, �
L p -`� .
uct Sin le Famil Residence
with attached garage
1 HEReBY AGKNOWLEC6E THAT 1 HAVE PEAD THiB APPLIWT N T{�! AMOUM BHOWN UNDER VALUAT�ON IS FOR THE
ANG 8TAT6 THAT TH6 RBOVE i6 CORRECi ANO AGREE TO OM- pURP08E OF. EBTABLI9HING � PERM�T FE6 ONLY.
PLY WITH ALL CITY OItDINANCE AND TE LAW9 GU TINO
BUILDINo CONeTRUCT1oN. ' VALUATION
SIGNATURE OF � PERMIT FEE $ 3Z.00
PERMITTEF �
' '' $ 13�SLS.00 PLAN CHECK $ 16.00 e
L0,�8CC M3i�$@I i z
AUTNORIZED AGENT TOTAL FEE 4S.00 n
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�� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING �/�j .D���� �UEi
ADDRESS •7 J
TENAi7i /rILJCi L/O�I.IJ'1�Ah%
CITV G�✓sr.�: //�L�,S/i' NOL
CON5TRUCTION •
BRANCH
ADDRESS
ARCHITECT TEL.
CONTRACTOR ��v.Onpf G`�1� �p
ADDRESS `��D3 /�N�'/� �
TEL.s'S3
CITV �ja4J%j�j'�% �� NO. ���,
LIC. NO. ��(j /y�8 LICVNO. �
SIZE NO.OF BLDGS.
OF LOT NOW ON LOT
USE OF » /
EXISTINGBLOG. ///w/�GV/'��.
Separate permi[s are required for
electric, plumbing and heating work:
UIIDING AND WORK TO BE PERFORMED
/d.; t
I heraby acknowledBe thet I have reatl this application and rtate
that the�above intormetion is corract and agtee to comply with
ell laws raBulatin0 building construction, antl I shall noc employ
eny perwn in vlolation of the workman's compensation laws of
the State of Calitornia. ,
I hereby cerNfy that 1 am properly Ilcensed es a eonttactor untler
the State of Californie Businass and Professions Cotle, Division 3,
Chapcer 9, antl that such licenses are in full force antl effect, or I
am exempi trom the provisions ot tha State of California Business
and Profassions Code, Divislon 3, Chap^ter 9. -
Signature of '.7 /��o "'1 �L�
Permittae
or '
Authotized A9ent Date ,
� 0968 2i05%80 48.50 TL
APPLICATION.FOR STRUCTURAL PERMIT - • -
A.P.NO. !YI � JO � � Q �� .
ADDRE55 ���� ����� /PY�
UNIT OR
SPACE NO.
T �NO. � LOT . � / F
NEW I ADD IALTER IREPAIR IMOVINGIDEMOLISH
OWNER
VSE /
APPROVEDSETBACKS
IFFOM C/LSTREETI •
PLANNING ACTION
APPFOVED
m
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' SQ. FT. �C%C%� �— w
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THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
VALUATION PERMIT FEE $ 32, �� q
n
PLAN GHECK $ "�
I S � o
$ ,T + �O/ a� TAX y �•�0 �
V
TOTALPAID E
�i O'�V
vnn�n Ut
JOB ADDRESS
G�5
WRTER
ROUGH PLUM6ING
PROP. $WR. LINE C
SPFINNLING SYSTEM
MISCELLANEOUS
NOUSE CON.
ROUGH HEATING RND AIR CONDITIONING
UNOERGROUNO � POWER
ROUGH WIRING
90N0 BERM U STEEL HEINFONCE
SMEpTHING
FRAME AND FLASHING
LATHING — IN r�
PLASTER, BROWN COAT
Si��iCTURAL. FINAL
IG, VENT., REFRIG. �NO A.C., FINA�
F_ dING. FIN4L AND G�5 TEST �
ELECTRIC,FINAL
BllIL01NG, FIN4L
SPEGAL REOUIREMENTS
SUBCONTRACTOR
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