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Home My WebLink About1117 DEBRA DR - Building PermitsCITY OF COSTA MESA , BUILDING DIVISION r 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00290 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 41207109 DATE ISSUED: 11/25/2009 FEE SUMMARY Reroof Plan Check: $126.91 Reroof Permit Fee: $195.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $323.16 - - - - - -...7JI76A t.3 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOEtl. INSPEC11014 TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval "`' A 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy — ISSUED BY: CAC JOB ADDRESS: 1117 DEBRA DR=CM "Suite/Unit:, Vicinity: ROOF AND GARAGE Squares: 0 " Valuation:.' $10,950.00 SCOPE OF WORK: REMOVE'EXISTING WOOD SHAKE. INSTALL 1/2" OSB 2 LAYERS -OF -30 LB'FELT AND EAGLE LITETILE 7.0 PSF ENR 1900 OWNER: ORTEGA, MICHELLE - Address: 11 17DEBRA DR '%_ • - Unit: PHONE: _ :. City/State/Zip: COSTA MESA, CA'. - APPLICANT: CUSTODIA TORRES,°. �;; .. 'Address: 103 W ESCALONES Unit: :SUITE A PHONE: 949498-2274 - City/State/Zip: SAN CLEMENTE, CA - qty 0}IP ryL .-.: CONTRACTOR: J L RAY COMPANY INC .. License No. 567238 Address: 103'W ESCALONESUnit:, - -- SUITE A _- PHONE: 449498-2274 City/State/Zip: SAN CLEMENTE, CA 92672 -- - - CELL: ., ARCHITECT:- License No. PHONE: ... ENGINEER: - License No. - - PHONE:, ... FEE SUMMARY Reroof Plan Check: $126.91 Reroof Permit Fee: $195.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $323.16 - - - - - -...7JI76A t.3 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOEtl. INSPEC11014 TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval "`' A 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby arm under penalty of perjury one of the following declarations:. . ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the perfomJance of the work for which this permit is issued. I have and will maintain workers' compensation insurance. as required by section 3700 of the Labor Code. for the performance of the work for which this p Issued workcorPpensation 17surance carrier and policy umb re: l.K- Carder: (Th - rot m eled�lhe pemrtisvapluetl al mehundied dollars (5100)wless.) Poll er: ` / / 9 D /es 3 ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subjSq to the workers' compensation provisions of Section 3700 of the Labor CedLS, I shall forthwith comply with these provisions. ut's S`anat.r ' k Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and //m''y-license is in full farce and effect. D actor's Si alure Da CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penally of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 305746 (310 7) Owner ID verified by driver s ucense. ❑ Yes ❑ No Driver's License No. 'Expires: r Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, a demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applirant's Signature Division of Industrial Safety Permit Number: Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department, 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If -yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If 'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. nature *egal Owners)t5lto r Authorized A I,eant e -- - - Applicant to fill.in all spaces except those within heavy border tines and sign all appropriate declarations. CITY OF COSTA'MESA " CONSTRU-tC'�TION PERMIT Project Address III0 1-k2-bCOL ba r Applicant's Mailing Address I11-1 'rto, YOVep_ . Owper's Name 2 X:� Sir NXanrt �hone Address 1111 Arch/Eng. License No. Address Contractor's Name Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No: Date Signature WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure or a certificate f Workers' Compensation Insurance, or a certified copy thereof (Section .s800, Lab. C.) Policy No. Company B Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thisseclion need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall notiemploy any person in any me er so as to become subject to the Worke);S Co_ ensagn Laws of Califo 1 Dat .-' "I fl Signature NO ICE: If, after making this declaration, you yy u dec bome subject to the Workers' Compensation provisions of the Labb \C de, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance _ of the work for). which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city 01 county which requires, a,permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of .., .—I...i nna rntlm r mat eormn nt refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil -eOa Ity of not more than five hundred dollars ($500). Lvl I, as owner of the property or my ^4^' with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business :and Professional Code: The Contractor's License Law does not apply to aq owner of a property who builds or improves thereon, and who does such wink himself/herself or through his or her own employees, provided that such improvements are not 'intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion , the owner will have the burden of proving he/she did not build or im- prove efor the purpose of sale). ❑ I, .G of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with'a con- tractor(s1 license pursuant to the Contractor's License Law)..I am aware that proof'o their Worker's Compensation insurance should be provided to me. ❑,I am exempt under Section B. & P. C. for this reason Date -4a - 19 q5r Owner 0 C I hereby certify that I have read this application and staTe.that the above Snature -_� /V(/Lj Driigvers' License or CMF 0865-46, rev. 10/84 upon The apove-mentlonec, property TorDate 6.3';225-0 1 �)e(a6 � TYPE OF CONSTRUCTION e NEA I -J ADD ❑ CONVERSION ❑.DEMOLISH ❑ OTHER ,DESCRIPTION OF WORK/USE OF BLDG. — ALTERATION REPAIR TYPE OF PERMIT LJ GRADING tZ FOUNDATION 6!f STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER 'PROJECT DESCRIPTION SO. FT. OCCUPAN�CC-Y�/ / -CONSTRUCTION TYPE VALUATION$ rks:-STb, V/ -C 7�,f L• r Sink ckflow, Preventer ckflow Irrigation thtubs arifiers shwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains GRADING CU. YDS. AC Z Latiw 4/1" PuJur Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash FEES Reinspection Fee I $151 I Issue Fee I $ 3 I Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple El Firepl/Fact. Bit. ICBO #. Heating System & Ducting [10-100,000 BTU 0100,00013T Reinspection Fee 1 $15 White - Building; Canary - Applicant: Pink - Accounting: Goldenrod - Assessor Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 1:10-100000BTU ❑700,000 System Repair/Alteration Fire Dampers Registers Issue Fee 1 $ 3 A.P. * -L .S Main Building: (14 TFront30!_`(- 'B Rear A C Right N K S Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit 5418 2/19/88 Zone Accessory Building: 1 8 �o se (Z /- z +D lt1 , hsus Parking Req./Provided 7,1l If hA i�t)-r Wzt.2SC.. ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter 0 u to 100 amps _ Meter ❑over 100 amps Dryers LJGas LJElectric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW ❑5-15 KW Sub Panel - Motors ❑0-1 HP❑1'/:-8 Inc. Solar 09-15 HP EJ 16-15+ Microwave Pole Light Sign r.. in9 Sections Compactor 61,55 TL Z O N I N G R E D M T S FEES I I Reinspection Fee 1 $15 1 1 Issue Fee 1 $ 3 1 1 DEVELOPMENT SERVICES REDJ.JIREMENTS: Zoning Approved By—(� Date Building Approved By Date ApplicationIssued By Date1 1— ' SUM ARV OF FEES BUI LDING PERMIT $7,12242 SMTP $ •� PLAN CHECK $ �_•JLi- PERMIT , PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ - PLAN CHECK 50% $ MICROFILM $ i MECHANICAL $ TOTAL FEE $/ PLAN CHECK 25% $ J 0 CONSTRUCTION AND PLANNING ,APPROVALS , Permit +--- Date Inspector POOL & SPA APPROVALS Permit +,- Date Inspector 1. 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 r 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE. I 7. Footings DRO' 58. Electrical Conduit'Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, 0 Undrgrnd. I 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor *Final' 12. 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 17. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank EGas OOP 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: 65 FTCaS OK 7iC/C _ Qs"t 34. Final Heating & Air Conditioning _ 88 o 35. Final Gas Pipe -Test m Cc D 36. Hood or Canopy .' 37. Final Factory Fireplace 38. Final Plumbing 1' 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final r ' . 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System- • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL' STRUCTURE & BUILDING17 48. Special Requirements Completed ' 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date _ w� l THIS..AGREEMENT, made and entered into this 21,5t day of 1986, by and between .,YJA, 0d&j r,A hereinafter referred to as "LAND OWNER", and Mr,; Mmrg{� — L. CS4eiy hereinafter referred to as "AWACENT PROPERTY CWNER". It is hereby agreed that a party wall will be constructed on the property line between /r in the City of Creta Mesa, Canty of Orange, State -of California, as per map recorded in Book Page_ of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach an l\\1 nebra, Tlrr IN WITNESS KiEREOF, the parties have entered into this Agreement the day and year first above written. 1F.@Lii^.40:0 (Signature) A Name (Typed orPrinted) ml I mn _,np)nr o, fir: //ZG 50111Ya-1 V(� (Address) (Address) (NATE: Please see reverse side for notary's statement) +31, STATE OF CALIFORNIA ) ss. COUNTY OF ORANGE ) On before -me, the undersigned, a Notary County and far.the of Orange,..State of California, personally appea#e� known to m° to be the person(s) whose nane(s) is subscribed the within instrument and acknowledged to me that (he/she/they) exe ted the same. WITNESS my hand and official seal. (SEAL) Signature Name (typed or printed) STATE OF CALIFORNIA in 1 ss. COUNTY OF ORANGE ) On , before me, the undersigned, a Notary Public in and for County of Orange, State of California, personally appeared known to ne to_the person(s) whose name(s) is subscribed to the within instrument4'1`/ acknowledged to me that (he/she/they) executed the same. WITNESS fiv hand and official seal. Name (typed or printed) (SEAL) . y /• • C' ilk 1} .THIS, AGREEMENT, made and entered into this hereinafter referred to as "LAND OMER", and hereinafter referred to as "ADJACENT PROPERTY.CWNER". day of It is hereby agreed that a party wall will be constructed on the property line between t 3" in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page_ of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS 6d-IEREOF, the parties have entered into this Agreement the day and year first above written. LAND CWNER (Signature) 'Robert �ti. Or'e.1\ar�C,Z Name (Typed or Printed) t 1 t -i D60V-01 MY - (Address) r gna ur Jag1'F1-r J �Rt�AYD Name (Typed or Printed) mck, 'D elor c0. (•. (Address) (NOTE: Please see reverse side for notary's statement) STATE OF CALIFOFINIA ) ss. COUNTY OF ORANGE ) On 'before me, the undersigned, a and for the County of Orange, State of California, personally ]mown to me to be the person(s) whose name(s)' is sub instrument arca acknowledged to me that (he/she/they) WITNESS my liand and official seal. Signature Name (typed or printed)_, STATE OF CALIFORNIA ) ss. COUNTY OF ORANGE ) Public in to the within' d the same. (SEAL) On , before me, the undersigned, a Notary Public in and fort County of Orange, State of California, personally appeared known to meto the person(s) whose names) is subscribed to the within m instruent acknowledged to ire that (he/she/they) executed the same. WITNESS `.hand and official seal. Name (typed or printed) (SEAL) COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 11200 'COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only PAID QV 10-77cn5R00 564'-= =** 122.64 APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY I DATE RECEIVED MATE ISSUE[ OWNER Pro YY1es West Development Co A.P. No. It MAIL BUILDING ADDRESS 508 29th Street ADDRESS TEL. CITY Newport Beach CA No. 675-4910 TRACT CONSTRUCTION A LENDER BRANCH ADDRESS OWNER PrO EMNAF=1 ,—_ >st Develooment C VALUE r s 73.400, GROUP Tt DATE' 1 - ✓a USE DEW BUILDI lu YARDS APPROVED ACCESSORY BUILDING p I hereby acknowledge that 1 have read t epptleatlantl nate FIRE ADDRESS 2240 Newport Blvd., N ZONE p( that the above Information is correct an spree to comply with APPROVED CONTRACTOR Owner BY ADDRESS TEL. O NO. OF CITY NO. PLANS .F. STATE CITY YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING w SIZE NO. OF BLDGS. (FROM C/flEET) Y OF LOT A ' NOW ON LOT R NT FT. Q THE AMOUNT SHOWN UNDER VALUATION IS FOR USE OF EXISTING BLDG. Chapter 9, and that such licenses are in full force and effect, or 1 H FSeparate permits are required for L. 5 DE FT. PERMIT FEE. E electric, plumbing and heating work. G REAR FT. tw. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. QMAIN BLDGS. Permittee .-Gi✓��i"/I-'+c,l $ TAX E 5.14 VAR. ¥ C.U.P. y h Plan # 4 `Y se EMNAF=1 ,—_ >st Develooment C VALUE r s 73.400, GROUP Tt DATE' 1 - ✓a USE DEW BUILDI lu YARDS APPROVED ACCESSORY BUILDING p I hereby acknowledge that 1 have read t epptleatlantl nate {OLD FOR �?ECI� L P p( that the above Information is correct an spree to comply with m C' all laws regulating building construction, and I shell not employ z any person In vlolation of the workman's compensation laws of the State of California. 3 I hereby. certify that I em properly licensed as a contractor under SO. FT. 2 m � the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provjsions of the State of California Business VALUATION PERMIT FEE. E and Professions Code, Idon 3, Chapter 9. uqi Signature of �// 9 / �P]L' 7`�s400' PLAN CHECK E 117.50 m c LL Permittee .-Gi✓��i"/I-'+c,l $ TAX E 5.14 � Authors.. A9ant ,// —G//L�C.c�(tw�Gc TOTAL PAID $