HomeMy WebLinkAbout2524 DUKE PL - Building Permits��.
aoo�essaem�auc: Z524 DUKE PL
a`'"E"s""'"E"'°'°"": HEDRICK, BRUCE B
�ooxEss: z524 DUKE PL
COSTA MESA,CA 92626
�vr�, u.�uxc AooAess:
546-1087
ARCXRECTONENtlNFER:
ARCX.OP ENO.'S AUDRE55:
CONiNACiOWSNWE
carn�croas�utwc
,moness:
UNT:
uc. xo.:
UNT:
ua ao:
urrt:
LICENSED CONTNACTOqS DECIAXATION: I hereby e11Pm uMer peneNy W perjury Ihe� I em IC101GC UOEGf p1W181009 M CIIBpIG! S
(oommeMinp v.ilh Seclion ]000) d Divieion 3 d tlro &reiian eM Pmleeeions Code, enL my lioense ie in lull lwce enE etled.
cm uc. No.: uc. cuss: uc. No.: EXP ;
Deb: Comreqor
OWNEH BUILUEN DECLRXRTION: I Mnby elfirtn uMer perely d parjury Ihet I em eaemq Imm iM ConVetlae License lew la IM
lolbwiq iaeeon (SMion )0�1.5 Buairees end Piolmsione Code: Any cily a counry which repuires e permil io wnelrvd, Mer, improva,
'amole�, or mpei eny awqure, prbr to Xs esuence, eleo repuiree Ihe epplirant lor euch permd to file e ai0�� sletemeM thu he a ehe
licansed punuani ta �he povieiona d tM Canlretlon l'xenae lew ICheper 9l�mercirq xi�h Sepion ]000) d Dvwion 3 d the
.rnness eM Pro/essone Code� ar thel he m sM ia memp ihxeliom eM Ihe besia lw IM elbped exemqun. My vbletun of Setlion
)031.5 by eny epDlicenl lor e permil wbjeei �he epplicent ta e crvil perelry d ml more �hen I'xe hundrad Eollen �5500�).
❑ I, as ownar d��e properly or my employeee wih wepea av Ihe'r eole compenselion, will do Iha xnM, eM iM niuc1ure b nM inlmded
w oHered lor aele (Section ]010, Bminass entl Probasions Cade: TM Comrenon Licenae Lew doea rwi eppty ia en ownar ol properry
wM WiCs or inpmvea thereon. eM Ma doas suM'wek limeett or henel or ihroupli hb w her own empbyeea, paiEeE ihm eueh
improvemenls ere nol iMaMed or oHereE Im sele. tl. howwer, ihe buiWiep «inpmvemam is sold wuhin one yeer W romplation, tM
�owner-buiMer vnll heve iha W rden d pmvina he ar .he die nd WiW or imo�e �« IM WN�a ol eele�.
I, m ov.ner d IM V�WaM. am udusn'eM conlraGuq wnh licertsed convecias io crostrue the Pr9ee (Sed'on )061. Buai�a ard
Prolesaiare CoEe: TM Contreaon Lkense lew Eoas � eppty m en oxner d proparty who buiNa ar improvea tMreon arM who
eonveeis iw eudi prqeas wnh a ooeurmar(a) lieenaed Punuanl to the Gonlredan Limme lew).
�
� I am exemq under Seclion: ' B. 8 P.G, im I�i eson: , j / �
o�,: l-l�l—F(o '' "o'�,: ,u.�..� Q �all,ucf
� ao nmeW ceniy me� � am eware a1 ene uMersiena me reauirementv a cmiania Heenn ene smey coae seaima zssos. zssas. arw
2551a, eM �het 1 or eny Mure Wiki�p oavpam will / wil ria (a�cb aro) rieed �o cwnply wih eeid deia mdn erd �M repuinmanie br
epaimillormneVuc�imormotlifirationhantlwRi u�eityn+anapememdatnd.Reeidenlielconat�uGioneppice�ionaerauemp�imm�heea
pradsiana.
Dem: Applcenl:
WOFKEP'S COMPENSATION DECLPN�TION: 1 Mrabyaifi�m uMer pereliy W pxjury ma d Ne Idbxiiq dadvetan:
� 1 hsn end wiG mamen e ceMAkele d mnsant �o aeM�insure lor waMen' compenselion, av provitled lor Cy Sedion 3100 d Ihe LeEa
Coda. la �M pe�amenr.e d Ne xwk far wlich Nia pa�mn e iaued.
� I have arM wil meintem worken' mmpansaiion inaurance, ea rxiuiretl by Sedion 3]00 d ihe lebor COAe, la Ihe pa�lormence d Ihe
woM Iw w1iiM Mia perm� i� iaued. My wakars compenaelbn inwrenca �arrier e�d pdiy number are.
Cemer:
Polry Number:
mis mcrion need ria be compro�ed'f rM permx i: rw one nundred ddbrs /S�oo/ a b.nd
g] I cenly Ihal in Ihe pMormence N tha woA I« whch Ihia permn ia isaued, I shell na emvloy eny pareon in eny menner so es lo
n�� �d«i m ina wona.s �w�� m� a c�n�,e. d,a rorea iw a i,nwa cao� �ci� m me �n
�omro���o� a�sa�s /m�Seaon a�ao m ina �eco, coaa, i ene(JL�`9nnwnn wmWr wn nox o� ions. �,
DNa: I —I � �"/ �O Applranl: � `J IMi} 0, �j _ I�CI�
Weminp: F�llun ro aeeun woAer�'rompxustlon rovsiap� l+ un/ewNl, entl ehsll �ub/sef en employsr ro erlMiu/ 0��„s+enL
civll flnu up ro ons hlndred fMuunO tlNbr� (5f040W), In etltlltlon N Me cwf o/ rompenvtlon, Wimps� as provltleC ror /n
SxMon J105 0/ tlre Labor COW, Infenal, antl ettomsy i/ess.
CONSTRUCTON LENDING RGENCY: I hareby effirtn uMer perelry d par'ryry thet tMn ia e cwmruaion bMirp epercy br Ne
penorma,m a �ne work ro, wn�di inm ro�n is os�ea (see io xs1. c«. c).
LENDEN'S NMIE:
LENOEP'S ADOHE55:
� c<nM �w � ne�e reea mb eod�wian end aa�e �w me ebove imom,e�ion is wnea. � w� �o amW wnn el� mv �e couory «amenms
eiM s�eieiewsreleiingio Euildiiqconsvudion eid hereby eWror¢erepresentativae oil�iadly�o entaruponiheebova�maniioned o�DaM
tr.:napeclion purposes.
BRUCE HEDRICK
Pnnl Ne e
� ,w..� ������ n�,L i� oaa: ��l rL –9,�L—
Sgnelurbo /Agen pptranUConVe r
(St51Jfi.WP) WM1ne-Buildvp d Sefary; GreerrFle: Cenery-Apptifam: Pink-Revenue; Galdenro�Asaeswr
CITY OF COSTA MESA – BUILDING PERMIT
PERMIT NO: B 076052
CONSTRUCTION TYPE:
PLAN CHECK NO: 00264-96 L
PERMIT TYPE: STR
PERM NO: B 076052
GOVT; N SUPP: N
PURPOSE: OTH
JOH DESCRIPTION : 117 LIN FT OF BLOCK WALL TO CITY STD SQ FT: 117
CLAIM VALUE: CALC–VALUE: 2,340.00 GROUP OCC; U-2 /
COMMENTS: PARTY WALL AGREEMENTS WITH BOTH NEIGHBORS
iEif*x itiEit*it+�***rt*iE�x itx�x�it��atftitatatititatit*it*ieit*itx ***etat�**�r�x x�*�x itieit**+�ieiE�t*�t�at***+r��tit**it
Z O N I N G R E Q U 2 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: 43 FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: 5 FT IN
PARKING REQ• 2 PROV; 2 PARCEL: 14141247 ZNE: R1 REF NO:, •
PLANNING NdTES> 57 LF OF 6' HIGH BLOCK WALL ON LEET SIDE P/L & 60 LF'OF 6'
> HIGH BLOCK WALL ON REAR P/L, (PARTY WALL AGMT SUBMIT.TED)
jF iE'lE 1E 1E iE 1E iE 1E 1E 1f fE 1E iE 1E i(' iE'lf"lE 1E iE 1E 1E iE fE 1E 1E fE iE ik fE iE 3E fE fE fE iE'lElElE iE ik 1E 1f iE iF iElF1E 1k 1FlE iE 1E 1E 1E iF 1E 1ElE 1E 1k 1E 1f� 1E 1E iE iE iE�'k'lE 1E if 1E iE 1(� 1E ik iE
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 /�
ZONING APPROVED BY DATE: -�lo
BUILDING APPROVED BY : � DATE: �
APPLICATION ISSUED BY: � DATE: I �VJ
*********�*�r*����*x�x�+t* ��*��*+t*�+�T�'?�ii��"i�**
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE � SMIP/RES GRADING
PERMIT 54.00 ' .50
PLAN 35.10 �.� SMIP/NON–RES
ISSUE FEE �
BUILDING–DIV–> PEAMIT ISSUE PLAN–CHECK TOTAL � PAID DUE
TOTALS----> 54.50 0.00 35,10 89.60 ! 89.60 .00
i
REVENUE DIVISION TOTALS--> COLLECTED: 89,60 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN–CHECK
54.00 ,50,� 35.10
iE 1E iF 1E aE'lE fE �E iE iE IE iE iE 1E iE iE IE IE If 1E'JE 1E 1E 1E 1E iE iE iE �IE iElE iE 1E iElE iE IE 1E if iE �E iE IElE'If iE iE If 1k 1E iE 1E 16 i(� 1E if iF 1FlE if iE iE iE iE aF 1E 9E iE 1f iE iF iF if iE iF if 1E i(� iE
I N D I V I D U A L F E E B R E A K D O�W N
TYPE QTY D E S C R I P T I O N UNIT�COST TOTAL COST
SFR 117 RES–CONCRETE BLOCK WALL / FT. 20.0�0 2,340,00
END OF FEES
SURVEY OF LOT LINE
��.Y .BE REQUIRES
�i Oni?'r�.'�b-7�79R75L' � a ili
L�FiEt+ Qi/ i� � I':. _5: ��j
�.
ui..hry
CONSTRUCTION AND PLANNING P��� 'PA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soi! Pipe-Undrgrnd. 53. Steel Reinforcement
,:3;,�iecirical Conduit Utfiity-Undrgrnd. 54. Forms
-�4?�Eipctrical ConduiFUndrgmd. 55. Electricai Bonding '
- 5'Steel Reinforcement Z-�� -Y6 �j'G�L 56. Rough Ptumbing & Pressure Test
' 6C Etectrical UFER Gr�d. 57. APPROVAI TO C�VER�GUNITE �
, .i .i
�'7�_.Eootings 2. �- 6 �Gv� 58. ElectricaiConduit-Undrgrnd. -
-��8. Foundation 59. Gas Pipe, � Undrgmd., Test
-9. Water Plpe-Undrgmd. 60. Backwash �ines, P-Trap, C� Urtdrgmd.
10. Structural Floor Svstem 67. APPROVAL TO DECK
11. Property 5ewer Line & House Connection 62. Backwash & Receptor-Finat
12. SBwer Cap 63, Heater & Vent-Final
73. Roof Orains 64. Plumbing Syscem - Final
74. Rough Plumbing {„ 65. Electrica!-Finai
15. Rough Electrica6Conduit = ' 66. Solar SVstem-Finai
16. Rough Electric Wirin9 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Reugh Eiectrical�T Bar Ceiling 69. POOUSPASYSTEMS fINAL
19. Rou9h Heating & Air Conditionmg FIRE DEPT. fjEQUtREMENT
2D. Rough FaAForu Fir�p#ace x;� ,� �, - �-� V. !� APPROVAt'S '-,PeFmit # �
21. [�ucti; in $t�uCtures7, � � . _ _ . 5 rj ��*: � �� 70. �.Under ro�up(] H dro . �
r- r; �` �
22. Oucts,Ventila(jng:�r � �'; i.,� �.� °�j ��'77, Product�P�pingC7Gas CSOiI
23. Gas Pipe-�ougfi & Test n1-.= k-; , ��.1" �-72. Underground Flysfi" � l -
24. R'oof-Frakting.. - � � '.`. r - `' �; ',73.`,UndergrnB.Stora9e�Tank'G1Gas ❑Olt
25. Roof Sheathing V� . �`� _ 74--'0veehead Hydro'. '
a
26. T=6arCeiUng (Structqral) & MotSncoat ' '�� �' - ��A 75 Dry,Ghemical . � " r
z .1. >�. . ��
27. Fiame and Flashln� r �L -- " _ J � a: 76.^ Dry Stand'pipe r
- 28. Lathin & Sidin _''='y ` .. ..' '" . , - `
9 9 "' �` -y�..;_ ��� :.� • � 7T,'. FIXED SX5TEM,F,INA4 _. .� �
29. Insulatlom � � t. � .-. � � � � . * 7�'. FIRE PREV. FINA� '� � � ` �
�� 30. Drywall f�jdiiing . H - ` �; �� -' �HEALTH�DEPT.�REQI�IR`,EMENT ' - ;
-,31. Plaster Brpwn Eoaf-. r: �' -ir ' � �• 79 �FINAL INSEEC7tpN • - '
---�---�; - - .. . - . �
��32. Elecvical'PowQr Mgt€r��inal �� � ;, ' '• 80y.'FOOD CERTIFt�ATE ISSUED_. - �
L33. Fina4-Etecfric- �;.,» • �-�- � . ' � Notes: i=� e: `, - -
's34. Final:HeaT�ng:& Air Condiiioning'.= �'%�� . �' 'x -. �% =' �. _
- c � - „ _ � ,-� • G
35. Final Gas.PiPe�Tes�, r , - ' - "• _ -', � _
- 36. Hood-or Canopy - ' . . '_ � ' � i • '. � - " ' a M � '
_ _ R - .l f i}' ' � " _ �
_. ` . . �� - . �.. -
y37. Final Factory Firep�ape - �.;_. . �* � �
-�38. FinaPPlumbing - -. � �� � -� ' , _ . - -
.a��,:�k i - t.,
�39. WSteiSer.J,ice�Finalr:« ' " :�,�� �. �,�. " ,;. `. :
�40. Gas Service-Final �• - - _ +'� �T! _ � "•��= "�
� , t e;
= 47. Solar porrfestic�Final � - ' "`" �Y - - . .. ` . - I
42. Backflo4v Pieventer � �'. - �s y . �. � E- • s ^ -�
�- ^.G- ;
:�� � Z
43. Backflow Irrig tion r 4't ; x -�Z.-Lt�-'��; J •Y,��_L _�(v�
4A. Landscap¢,Irri�pationSystem -"kT� - - -��' iu �:�_� �+ n' �� j
� �,= - E i-
�-+ � C: ,y. _ c � i , _ � _ ,.. <.. ,
45. Sound Attenuation'. ... ;�;,*` :, � c • -O �
Q6. HandicepRegutaiions� .� ^• <.r� � " ;� .S �'-, �'
< C �.�.
47. FINAiS7RUCTURE.&BUIL`DIPIG ��7�0/ � "" _; ;..
( '-.
48. yNAkPLANNING x '-i-^ �' � �' ' . '� `" �
a � »: - - � + -�^
49. Electric Realease to Edison , `� � ` ' � - - � ' ''
W' Y`
50. Gas Release to Southem Califomia-Gas Co � r� =. �'"~ ` ,,
- • JC � i
51. CERTIFICATE pP OCCUPANCY • � -' .� rt • + -
No Date
�
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this
January, 1996 , by and between Bruce B. Hedrick
hereinafter referred to as "LANDOWNER;' and Irwin Sauer
hereinafter referred to as "ADJACENT PROPERTY OWNER"
j T�
day of
It is hereby agreed that a party wall will be constructed on the property line
between 2524 Duke Pl. and 2523 Loyola Rd.
(Address ot Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book 112 , Page 5�6����of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach �ally into both parcels.
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
(�ature���L�
Bruce B. Hedrick
Name (Typed or Printed)
2529 Duke P1.
(Address)
1908.a6
ADJ ENT PROPERTY OWNER
(Signat re) �
Irwin Sauer
Name (Typed or Printed)
2523 Loyola Rd.
(Address)
NOTARIZATION RE�UIRED
�s..�r�.ti,•_- ' ' . � ,.�
dI ./,-`-; �� JOE H. NATION j�'
o,, �-y<<_�, COfv��1.; 10096�4 �
� � +: ;`v,./� ;,T1^.Y PUBLIC�L.".Di:.illA �
� ��� ✓ ORANGE COUNTY N
�� t.lY CO�:�.115SION EXPIRES fi0'!. 21. 1997 �
v"�r�r�,;.+-v-v—: vw-ov�i:
� V
.� CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of �� l J�n� nf � J�
County of 6✓�p nr GE
N0.590]
On � nl a Y�}1 �efore me, �U� �•� 14�7 0 N� N 0�74,t�Y�
DATE 1 NAME. TITLE OF OFFICER - E.G.,'JANE DOE, NOTARV PUBLIC'
personally appeared �. f� �y C�- �. hF � D/2 � �/l �j- � 2(aJ I►J L� • S�4 l�F.YI,
NAME�S) OF SIGNER(S) �
❑ personally known to me - OR - l�, proved to me on the basis of satisfactory evidence
to be the persor�(� whose name s is/ar�...
subscribed to the within instrument and ac-
knowledged to me that he/she/thev executed
the same in his/her/their authorized
�� ;��.� JOE H. NATION �Q capacity(ies), and that by his/her/their
o 'v c��: COfv1M. �1009694 �
� �`�J� NOTARY PUBIIC�CALIPoRNIq � signature s on the instrument the person s),
3�v'y ORAyGE COUNTY � or the entity upon behalf of which the
9' ��v co,w:.I1SSIQi� EC?tftES COV_ 21, I997 :6 person(s) acted, executed the instrument.
.o,�;
WITNESS my hand and official seal.
��
$IGNATURE �F N TAflY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
rme�s�
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
m1993 NATIONAL NOTARY ASSOCIATION • 8236 Remmet Ave., P.O. Boz 7184 • Canoga Park, CA 9130941Ba
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this
Januarv 1996 , by and between �uce B. Hedrick
hereinafter referred to as "LANDOWNER," and ��Y Stsickler
hereinafter referred to as "ADJACENT PROPERTY OWNER:'
� S �� day of
It is hereby agreed that a party wall will be constructed on the property line
between z524 Duke P1. and 2528 Duke P1.
(Address of Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book 112 , Page5�6���$ of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach equally into both parcels.
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
(Signatu� � ��
Bruce B. Hedrick
Name (Typed or Printed)
2524 Duke P1.
(Addres5)
1906 46
ADJA T PROPERTY OWNER
( ignature) �
Denny Strickler
Name (Typed or Printed)
2528 Duke P1.
(Address)
NOTARIZATION REQUIRED
.:1..�-�v._.��la.�cac✓..v
�I , ���, JOE H. NATION IP
p 'f o �;j',� COfviPA. � 1009694 �
L ��+-��= � IIUTO.R'( PU9LIC�CALifORNIA �
�y ` �`.i ;r%� ORANGE COUtVTr �
�� I.:Y CO'1;.fISS:ON :%P;RES f.OV. 2I. 1997 i�j
v�--�(`�',���'
. _�= _�
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
(
State of C r�� � Fae nl ��}
County of C72RI�%G�
No.590]
On '�SS�}NU�►2y 1 S/R9(o before me, �E- fI - NA-'7'ib�✓ � IS� tR�y�i
DATE � I NAME, TITLE OF OFFICER - E.G.,'JA DOE, NOTAflY PUBLIG' �
personally appeared R11 uCE- �• /d �D2�G1 �- ��)1U� S't,e � I�L.E,r
NAME�S) OF SIGNER(5)
❑ personally known to me - OR - L� proved to me on the basis of satisfactory evidence
to be the person(s1 whose name s is/are
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
�I^ ^"<-.�-^ JOE H. NATION � the same in his/her/ eir authorized
o a`�%� COMM..{�1009694 � capacit ies , and that by his/her/�j.�
�°\t;1,"�i NOTFFY FUBLIC CkLiFORt71A � signature(s) on the instrument the person s,
� -� ORi�iJGE CGUtJTY N
9; �av co�raassiur� exNir.es r,ov. z�. is9� �4 or the entity upon behalf of whiCh the
�"v`v""-"`"'Y`''`"`"'�"'"' person(s) acted, executed the instrument.
WITNESS my hand and official seal.
SIGNA URE �F NOTARV
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reatlachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(5)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(5) OR EMIIV�IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
�1993 NATIONAL NOTARV ASSOCIATION • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184
PNO`�CT POONE55:
i �INEN'SNRME: zS%4 UUKE PL
aoosess: HEDRICR BRIJCE B
2524 DU{CE PL
COSTA MESA,CA
AflCH/ENGINEEN: 5�x 6— 1 U A 7
aooness:
UNIT:
92626
HEG.NO.:
uxiT:
PEflMITTEE:
aoonEss: HEN� Y, JOHN ROO i��Gp�`S ( 714 ) 548-6213
,��-c'p /� (�a�'2(0'� �1
LICENSEO CONTHRCTOKOECGARiION�enreby allirm Iha� I am Iicense0 untle7'pl6visio�er 9(tommencinp with Sec�ion
71100) ol Oivision 3 0l ihe Business ana Pm�essions CoOe. an0 my license is in lull larce anE eltttt.
CITY UC.: STRTE LIC.: C SS:
034827 41523 �C
Date: %,2� — 9Z Signalure: . _ _
WOflKEflS' COMPENSA710N OELNflATION: I hereb u at 1 Adve a cenifiW@ ol cansen o sell-in5ure or a cenifiWte o1 Worker5'
fqm0ensation Insurance. o� a cenitieE coOY �hereof ion 3800. LaE. C�.
PoL1LY NO.: E%P. ORTE:
COMPANY:
❑ CenitieA coDY �s hereCy IumisheA. ❑ Cehifie0 coOY is IileA witn the city BuilOing Division.
Ua�e: Applicanl:
E%EM1IPTION FPOM WOflKENS' COMPENSRTION OECIAMTION: (TM5 5eciion nee0 irol be completeG il �he pttmA is lor one �u�dre0 (5700� or less�.
�� I ceriily Ihal in �he De�ormance ol t�e work lar whic� I�is permi� is issuetl, I all na p�oy an�ny manner so as la b¢come
subject Io t�e Workers Compensaiion Laws ol Calilomia. /�)
Date:�7 cd7'43 SiqnaWre: ���
NOTILE:If. aner makin8 ���s aeclaration, you e ome suUject ta tAe workers' CA p ian D�oNsions ol the Labor
COAe. you must Iorlhwiih comDty wiih such p'' ns a� Ihis Oermi� shall 6e 4eemeE re ed.
CONS7PULTION LENOINC �GENCV: I �ertby aHirm I�at t�ere is a constmction IenUing a9ency for the pertormance of ihe work lor
which Ihis Oermil is issued �Seclion 3097. Civ. C).
LENOEfl:
ROOPESS:
r- i
OwNEH BOIlUEB UECL7NATIDN: I nerehy alfirm Ihat I am exempt Imm tAe Comraclors' State License Law for ihe followinA �eason
�Section 703t.5 Buaness ana Pmfessional COGe: Any ciry o1 county wNch reauires a permit to constmct, alter, imD�ove, Oemolisn, or
repair any simclure. Dnor to its issuance. also reQuires Ihe applicant for sucA permit to file a signed statement Inat he/she is Iicense0
pursuan� lo I�e O�ovisions ol ihe Coniracbrs' S�ale License Law (ChaO�er 9 �commencinp wilh Seclion 7000) o� Oivision 3 oi Ihe Business
and Prolessions COAe) or ��at �e/s�e is eKempi t�erelwm an0 the basis for iAe alleAeA exemption. Any violation of Seciion 70315 �y
any apPlicanl lor a Dermit sublecis I�e aOPlican� to a civil penal�y o� not more ihan live huntlretl Aollars (3500),
I, as owner ol ihe pmpeny or my empIoyees witn wa➢es as tAeir sole compensation, will tlo �ne work, and ihe
❑ s�mcWre is noi inlenEetl or oflereU lor sale (Seclion 7044, Busmess antl Pm�essional Code: The Contraclors' Slate License Law
Ooes nol appty �o an owner ot a pmp¢tly who �uilJs ar impmve5 ihereon, and wh0 does 5uch wo�k himseli/herseli or �hmugh
his or her own emDloyees, Drovitlee tnat sucn impmvemenls are no1 inleneetl or oilered lor sale. I( Aowever the 6uilUinp or
impmvemenl is SoIA wilhin one year ol comple�ian. Ihe owner will have �he burtlen o� pmvin8 he/she did no� bui10 or impmve
10� IhC OUlpOSC 0� SdIE�.
I, as owner of Ihe pmpeny. am exclusively conlracting with licensed coniractors lo consiNct Ihe pmle�� (Section 7044, Business
❑ an0 Professbns Caae: T�e Contractors' State License Law does not aDDly lo an owner oi pmperty who 6wltls or imp�oves ihereon
antl who Conlrat�s lor sucA pmle��s wii� a COnifaCloqs�lit¢nse pursuani �o ��e Coniratlors' Staie LiCenSe Law�.l am aware
� that pmof ol �heir Worker'S Compensa�ion insurance shoultl be pmvidea to me.
II � i am exemp� under Sec�ion; B. b P. L.
�ar I�is reason:
Date: Ownec
I Eo hereby cerlity Ihai I am aware ol anU untlerSlanC I�e reduiremenis oi Calibmia Nealfh ana SaI¢ry CodE Seciions 25505, 25593, ana
25534 antl t�at I or any luwre �uilding occupam willlwill not (circle one� neetl to comDly with sai0 slate cotles and �he repuirements lor a
permi� lor conSVuctian or mo0ilica�ion imm�he Air Oualiiy Managemen� UiSiricl. FesiEenlialconslmc�ion apD�ica�ions are e�emp� �mm
Ihese provisions.
Date: ApDlicanl:
I �ere6y terlily I�al I haver¢a0 Ihis apPliCaiion an0 S�ale Ihatlh¢ aGoveinlOrmali0ni5 torreCi. I aA�¢e to Comply wi�� allti�y antl County
orainances an0 sta�e lavrs rela�ing lo builtlmg conslmction anU here6y aut ¢e re ma1Po' cily �o emer upon I�e a0ove-menlione0
pmpeny lor inspeclian OurOoses
oate. � —� 7 — 9 Z $ignaiur
Driver's Lirense or Soclal Secuniy a: ��, ��.�
CITY OF COSTA MESA — BUILDING FERMIT PERM NO: B U5�331
PERMIT NO; B 058310 PLAN CHECK NO; N GOVT; N SUPP; h
CONSTRUCTION TYPE; PERMIT TYPE; STR PURPOSE; OTH
JOB DESCRIPTIOtJ ; REROOF 3900SF RESID 6 GARAGE W/COMP SHIN SQ FT: 3,2�0
CLAIM VALUE: 3,250.00 CALC—VALUE; 3,250,00 GROIIP OCC: R-3 /M-1
COMMENTS• CLASS "A" ROOFING ��QK�D�f�G�kOR
�k lf fFdf �IE �N iE9f 1E X%��IF if� 1E � 9E if if iE�%� 1E iE �F �)f k 1F 3E �E 9F )f if 3E if �IE �7E if 7E lE iFif �lf iF lf aE �%� iE it ik if �E �k�K� 1( �IF iE �!F if-
7, O N I N GS Ex'CEB�AUCIxRSE M E N T S REQUIRED
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING -----�^--
FRNT: Fi IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING RE • PAOV; PARCEL; 14141247 ZNE; kEF NO;
PLANNZNG N 'I'ES>
>
�e�r�r�***��*�x�**x�***��*��**��*��x�#±�**u�r*��r*�r*�+r� �r�:��**x��*��r*u�u***���r�r��������
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N-T S
20NZNG APPROVED BY DATE: � _
HUZLDING APPROVED BY ;
APPLICATION ISSUED BY� �Ci,�� �Cd//�/,
kleielEif9fiElEi!�1EIFi(�iF1FiklEiFiEififlF� .. � x 1t
iE iE IE #�IE IE iF f(� 1f IF if �F ak iF 3E if fE iE iE )f 1E iP # iE 1E iF iF 9F k iE iF ih iE iE 1E �lE i�-ib if
LEGALI2ATION:N F E E ��S
A R Y
DATE; ��
DATE: //�
iE if �1c iF iE if #?F iP 3E
SEGMENT;Y
BLDG PMT PLUMbING ELECTRIC 'MECHANIC FIRE SMIP/RES GkADiNG
PERMIT 63.00 ,'. , - ,;0
� " SMIP/NON—RES
ISSUE FEE � {
BUILDING—DIV—> PER,+7IT ISSUE PLAN=CHECR' TOTAL PAID DUH
TOTALS----> 63,50 0.00 .•0;00 63,50 63,50 .00
REVENUE DIVISIOIJ TOTALS--> COLLECTEIS: � 63.50 OVER/SAOR7'; ,00
BLDG PMT PLUMBING EI,ECTRIC MECHANIC �; FIRc SMIP/TOT GRADING PLAN—CHECK
63.00 ` '� • .5U
-?F if %�if� 3E iF iE �iE iC i41F �1E # if ff ih if !f� IF 14 iF it M� iF if N Ik 1f if N� !f 1E )f �lh 1FlE ikiF iE 1k ff if if iF i6 ie iF iE If iF if iF i! If il� ii� ih if� �161f if� �lelf ik �E ie 3F if if� If lf {.}. {r, y. Y-lE iE �!F %�
I N D I V I D U A L • E, n E b R E A x D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SrR 3250 REROOF BY VALUE RESIDENTiAL NOZONE 1.00 3,25Q,00
END OF FEES
5
16a1a6 wmre—Buiiding; Green—CoO�orcemunl: Canary—ApPlitam: Pink—qavenue: GolOenrotl—Assessor
_
'.
1
CONSTRUCTION AND P�ANNING � POOI 'A
�APPROVALS Permit � Date Inspector AppROVAIS Permit # Date Inspector
7. Temporary Electricai Service or Pole 52. �Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Undrgmd. 54. Forms
4. Electrical Conduit�Wndrgrnd. 55. Electrical Bonding
5. SteeV Aeinforcement 56. Rough Pi�mbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE
7. Pootings � 58. Electrical Conduit�Undrgrnd. '
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. 60. Backwash �ines, P-Trap, O Undrgmd. l
10. Structural Floor System 61. APPROVAL TO DECK ,
11. Preperty Sewer Line & House Connection 62. Backwash & Receptor-Final -
12. Sewer Cap 63. Heater & Vent�Final ,
13. Roof Drains � �' 64. Plumbing System - Final
14. Rough Piumbing ' 65. E�ectrical-Final �
15. Rouyh Electricai-Conduit 66. Solar System-Final .
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Geiling 69. POOL/SPA SYSTEMS FINA�
19. Rough Heating & Air Cortditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating 71. Product Piping O Gas O Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage 7ank L� Gas ❑ Oil
25. Roof Sheathing 74. Overhead HYdro
26. T-Bar Ceiling (StructuraU & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe
28. Lathing & Siding �77. fIXED SYSTEM FINAL
29. Insulation - 78. FIRE PREV. FINAL
30. Drywali Nailing ,,i' HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat � . 79. FINAL INSPECTION
32. Electrical Power Meter�F�nal : �� 80. FOOD CERTIFICATE ISSUED
�.
33. Final Electric , • � Notes:
34. Final Heatinq & Air Conditioning ' � 2/y.,` ���� ��
��-7 �f�-�� q
35. Final Gas Pipe-Test y_ _._ (.���' Ot�-
IP-'BO" �,F^� �
36. Hood or Canopy _ _ __�
37. Final Factory Fireplace
38. Final Plum6ing �� • ; �
39. Water Service�Final '
40. Gas Service-Final J �.` �
41. Solar pomestioFinal ' -
/-
42. Backflow Preventer '
43. Backflow trrigation,�. ' .
44. Landscape Irrigat'otrSystem
45. Sound Attenuation> l.;� �
46. Handicap Regulat� � a �
47. FINALSTRUCTt�R-t _��LDING g Z� .� -
48. FINAL PLANM�fl 3 ,;r, ' �
N �
49. Electric Release to-Edisot>�
ti; -
50. Gas Release to Souit�rri.Gelifornia Gas Co +�
51. CERTIFICATE 0 QCCUPANCY
t
No. -' Date
AOP�icant to fill in all spaces except t�ose within heavy Uortler lines anG si9n all appropriate Aeclarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT
Project Address �La Z�-�' ��K� l�l-..
Applicant'sMailin9Address' S"F'N�
Owner'sName �QULC �• E�R-�G�Phone � �-�d�7
Address 5RN
� �oiyLO!
Arch/Eng. License No. / `�� ,�i
Address S.qmI�'.3.Sb '2p F �Z.C�ic�l6�/KE- .//�
Contracmr's Nama �'�'M+� OF/ 1 Phone
Address (mailing)
City License Na.
LICENSED CONTRHCTOR DECLARATION
I hereby afflrm that I am licensetl untler provisions of Charter 9(commencing
witn seclion �000) of Division 3 of tne Business antl Protessions Cotle, antl
my license is in (ull force antl etiect.
License Class License No.
Dale Signature
WORKERS' COMPENSATION DECLARATION
hereby afiirm that 1 nave a certiticate ot conzent to self-insure or a certiflcate
Wo�kers' Compensation Insu�ance, o� a certi/ietl w0Y �hereof (SeGfion
d00, Lab, C.)
Policy No. Company
eCertifietl copy is hereby furnishetl.
Gertitietl copy is flletl with the city Builtlin9 Division.
Da[e Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(TM1issection neetl no[ be completetl if the permit is for one huntlretl ($300) or
less).
I certify tM1at in the pertormance of the wo�k for which this perm�t is issuetl, I
5M1a11 not employ any person in any manner So as o become subje to the
Workers' �e mp nsat ryI,.a s ot Califp� i�a.
Date J'% �� �u �ignature �•1eK-t ^ �
NOTICE: If,afte� making this tleUaration, you shoultl Oecome subject to the
Workero' Compensation provisions of tne Labor Code, you must forthwith
comply with such �pwvisions or thi5 permit Shall be tleemetl rewketl.
CONSTRUCTION LENOING AGENCV
I hereEy affirm that there is a construction lentlinq aqency for the perfo�mance
ot the work tor 'whiGh Mis permit is Issuetl ($ection 309] Civ. CJ
Lentler's Name
Lentler's Atltlress
OWNE0. BVILOEH'�ECLARATION
I hereby aHirm that%I am exempc from the ContractaYs License law Por the
following reason (Section ]031.5 Business antl Professlonal Cotle: Any city or
munly which.�equires a permit to Construct, alte�, impwve, tlemolish o� �epair
any 5[ructure, prior�to its issuance, also �equires the applicant fo/ such permit
to file a signetl statement that he/sne is IicenSetl pursuant to tM1e provision5 of
the ContractorR License Law (Chapter 9.(commencing with Section 7000) of
'livi5ion 3 of the Business antl Professions Cotle) o� that he/she is exempl
erefrom antl the basis fo� the alle9etl exemption. Any violation ot Section
�31.5 by any applicant tor a permit subjects tne applicant to a civil
�enalty of not more lhan five hunOretl tlollars ($500).
❑ I, as owner of Ihe property or my employees with wages as their sole
compensation, will tlo the work, antl the sVuttu/e is not intentletl or o/feretl
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
� License Law tloes not apoly to an owner of a property who builtls or improves
� lpereon, antl wM10 tloes such work himself/ne�self or through his or he� own
�, employees, provltletl tM1at suth impwvements are not in[entletl or offeretl for
I sale. It, however, the builtling or improvement is soltl within one year of com-
� pietion, the owner will have the burtlen of proving he/she tlitl not builtl or im-
prove for the pu�po5e ot sale).
❑ I, as owner of the pro0erty, am exclusively conVactln9 wlth licensetl con-
[ractors to mnstruct the pro7ect (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes not appty to an owner of oroperty who
builas or improves thereon, antl who conVacts for such projects witn a con-
t�actor(s7 license pursuant to Ihe Contrattor's License �aw). I am aware that
proof of their Worker'S Compensation insurance shoultl be provitletl to me.
❑ 1 am exempt untle� Section _ 6. & P� C. fo� lhis reason
Date _,l_'(� �! Owner
I hereby certity that I M1ave reatl
information is wrrect. I agree to <
antl state laws relating to builtlin5
� 5¢fl[d(IV25 O1 11115 Cfly IO EOI¢I
inspectlon pu�pos �
Signature
Drivers' License or 55 �
[ion antl staCe that the above
all city antl county ortlinances
�, antl hereby authorize repre-
ooveimentionetl oraoertv for
._. .,..., ,.,,.
g 3354z �
TYPE OFCONSTRUCTION NEW .4DD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHE
DESCRIkT10N OF WOFK/USE OF BLDG, � Sda�` (0
TVPE OF PERMIT IJ GRA6ING LJ FOUNDAYION LKSrRucTURAL
. ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCHIPTION Sq. F7. oCCUaarvcv t�S
CONSTRUCTIONTVP = n,J VALUATION$�S_/Y9��
20NE GRADINGCU.VDS. ACRES
Remarks: G ��I� � S . L •iS'di...
Sink
Preventer
Irri9ation
Dishwdsher
Drinking Fountains
Floor Dreins
Floor Sinks
GasService Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee � $15
BOiler
Duct- UnderGround
Duct - Structural
Duct - Ventilatinq
Exhaust System ❑ Multiple ❑
FirepVFact. Blt. ICBO #
Heating System & Ducting
❑ 0�100,000 BTU � 7 00,000 BT
Reinspection Fee � $15
CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicanp Pink - Acwuntin9l Goltlenrotl - Assessor
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimmin9 Pool wlSpa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
laue Fae
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,000 BTU ❑700,000 BTU
System Repair/Alteration
Fire Dampers
Registers
laue Fee
FEES
$ 3
FEES
$ 3
A.P. �
S Main Buildi
E
T Front
6 Rear
A
C Ri9ht
K Left
S
Ping. Ref. #
Plannin9 Notes:
Automatic Washer
Construciion PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electtic
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garhage Disposal
Generamr �0.5 KW �5-15
Zona
Accessory Building:
�Parking �Re�q./Provided
j�— V141n� V
�A
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel
Momrs�0-1 HPO1N.-8
IncSolar �9-15 HP �i6-15+
Microwave
Pole Light
Range
Sign
Standin9 Sections
Trash Compactor
Fee �$15 � � luue Fee
DEVELOPMENT SERVICES REQUI
Zoning Approved By
Buildin9 Approved By
Aoolication Issued Bv
FEES
$ 3
N
1
N
G
R
E
Q
M
T
S
SUMMARV OF FEES
BUILDING PERMIT $ L� B�! SMIP $ ' 3—Z%
PLAN CHECK $ PERMIT
PLUMBING S �SSUANCE $
PLANCHECK 25% 3 ENERGVP.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ �'S '�
PLAN CHECK Z5% $
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit #'� Date Inspector qppROVALS Permit # Date Inspector
,c '. "
i'Temporary ElectricaPService 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.i
8. Foundation . � � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structurel 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. flough 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 PLAST.ERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINA�L ��� .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' -
'{ Y . r
20. Rough Factory Fireplace APPROVALS Permit#
. �' .
21. Ducts, in Strucwre 70. Underground Hydro -- �
22. Ducts, Ventilating 71 . Product Piping � Gas ❑ Oil '
r
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 �, • '
c
29. Insulation J8. FIRE PREV. FINAL "� '
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
r
31. Plaster Brown Coat 79. FINAL INSPECTION ' , ,iy
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSU�ED
33. Final Electric Notes: � t�.!
34. Final Heating & Air Conditioning '
35. Final Gas Pipe-Test ' '
',.
36. Hood oi Canopy � '
37. Final Factory Fireplace �
. 36. Final Plumbing y
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 �S , � �
.u•
48. Special Requirements Completed ' � .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
t
51. CERTIFICATE OF OCCUPANCY ;
No. Date ,
' _ 2R825 --
:
COSTA MESA BUILDING-SAFEf`! DEPARTMENT
P.O. BOX 1200 � COSTA MESA, CALIFORNIA 9Z626
For Applicant to Fill In Compietoly
TYPE OR PRINT
w�oR'ss° �L4 OU{�E 1�L C u
COSTA MESA, CALIFORNIA
�„a,HPa �2c�c c NEDe�ci�
� ,
vace � �^.� �
HAfl 24-67�MS�OO 853 " 22.50
APPLICA710N FOR PERMR
BUILDIN(3
for OH7m Ute Only
ZONINCi �
38 ZO L NO.O� UY[OPN[W
�` �' / �une a eu�toinqy
\CTOR J � d CG - � y
aa L 2 2 �. / 7// Si �n�mon �, a�o� /A-/-' 3J�
L.a ,vG l3C� <<.� �. P. No. -/a-
,'L' ^�` �C7 T8L L�/3 EO'TOeD60R8ARpHL68HALLeBLE88THAN
N fl-UqQy
l� K i Q o ��ee
No. o/ �LGo�. ; ALLOWHD .�U. B. G. R[CUIRHMENTI
XOW ON
YARDBAPPROVHD YARDSAPPROVHD
._ _. __ O w�� I f'�cn � �i MAIN BUILDINO ACCEY60RY BIIILDINO
i YlTOACK LINt IM1OY
k# EXTEFIOR
[
[PT � I RIQNT
DESCRIPTION OF WORK
�� HBPGBY ACNNOWL6D06 TH11T 1 XAV6
AND BTATB THAT TH6 AOOV6 IY CORRI
PLY WIiH ALL CITY OROINANC[� AND I
OWLpINOCONBiROCF10N. !l
�
-
y� VAR.3C
1
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DATB
i -L
co a
b�rtcJ �
�
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\PPLIGTION TX8 AMOUHT BMOWN UNDBP VALUATION 1! POR TXH — j
:B[ TO COM• �uAP�B6 OP 6BTABLIBMINO A PBPMIT F86 ONLY. ;
R[ouLwTlNo yALUATION ^s /�/� 5
�yL,� PERMIT FEE /v' U(/ �
�3,�ia�/ -5 - w
TOTAL FEE •�JD
(Y \
�� , ���5
�OST;� MESA BUILDING DEPARTMENT
. P.O. BOx 31J
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
ADD EI55 <S� Lune CYi C8
COSTA MESA. CALIFORNIA
OWNER P:C[3tl
MAIL 1555
ADDRE55
Inc.
�,i� Newport Heach, Cal. TNo:
ARCI-""�CT SRI�B LIC.
OR I lEER NO.
ADDRE55 9EIRe
LEG�1L LOT
OESCRIPTION NO.
A.P. NO.
p�ct L^
OF LOT W
USE OF
E%ISTING BLDG
$ETBACR LINE FROM �O
CENTEF Oi STREEi
SIDE YARD RIGHT
4. liU. CITY �IG 1L1/.
NO.
e NO. `S8II`9
BLOCK TRACT 2O<
. NO.OF BLOG6, O
MOW ON �OT
•REnR YARD Z5`
C ___ G
DESCRIPTION OF WORK
NEV g ALTERATION ADDITION
REPAIR �MOVING DEMOLISH
SIZ'EDING �L�� � nn qQOMS V STORIES
V <.V
COVERINGWALL 9tuCCO COVERING hot—mop
BUELDFNGEW ReSidEnce & 8tt, gatage
�.. �, r ,. , �. ' � . ..
a. I�1 I 5�t �
V"�I'�'�I;�E DEPT.
i`il� � ..'�d .�rC��
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PEFpMIT NC
(9.�n
REC VEp Y DNTE FF PIVF� OATE ISSU�
3 : s � �l
BUILDING
ADDRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZONE� MO.OF TVpE GROl1P
GLAN$ � / ��
Y �%
APPROVED
BY �ATE
CORRECTIONS
. ...._ _.._.__..__ _.._ D o . ._ "_" ""
CITV ORDIN NCES BOVEST�TE L�WS NEGVL�TING BUILOI1NGrCON9TflVC- "urrOSE O establishing a permit fee oni .
nON. VALUATION
SIGNATURE OF PERMIT FEE S �OO
PERMITTEE 15 967��� 17�5�
) PLAN CHECK S
$
AUTHORIZED A ENT TOTAL FEE 3 'z��
vW �
�vwivr:x nr:uni�n ni'uce llATE } c4-v �
JOB ADDR.E5S 252 Duke Place_ BUILDING PEftMIT NO. 2 25
GENERAL CONTRACTOR T, Gottschalk DESCBIPTION OF WORK Add den & bdrm.t0 res.
a°.p No, l�+1-�12-k7 LOT TRACT FIRE 'LONE VALUE § 3, 612.00
SUBCONT1iHCTOR