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Home My WebLink About3111 DUBLIN ST - Building Permits� CITY OF COSTA MESA � B!/ILDING DIVISION 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww.v.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 , PERMIT TYPE: B COMBO Sub Type: RES_ALT �oe aoorzeSs: 3111 DUBLIN ST.CM PERMIT NUMBER: BC09-00074 STATUS: ISSUED DATE ISSUED: 03110I2009 ISSUED BY: �� SuitelUnit:; ��, APN: 41814113 � � . Zoning:R1-, , , - Vicinity: IN7ERIOR • . . .. � � �Primary.Occ: R-3 - ConstType: V-B SQ.-FT: 0 Valuation`. 57,500.00 SCOPE OF WORK: REMOVE AND REPLACE 2 EXISTING WINDOWS IN BEDROOMS AND 2 EXISTING EXTERIOR DOORS AND FRAMING. REMOVE NON-LOAD BEARING WALLS IN ORDER TO DELETE AN (E) HALLWAY CLOSET. REPLACE WITH � TANKLESS WATER HEATER AND�RELOCATE TO GARAGE, REPLACE GARBAGE DISPOSAL, RELOCATE AND UPGRADE SERVICE PANEL TO 200A; � - � MINIMAL REWIRE, REPLACE SHOWER PAN, REPLACE (E) HOOD EXHAUST. BEDROOM WINDOWS TO COMPLY WITH EMERGENCY EGRESS REQUIREMENTS. - OWNER: GIBBS, JEFFREY Phone: 849•687•2506 � - APPLICANT: SHEETS, JEFFREY Phone: 949-735-7257 coNraac7oR: SHEETS CONTRACTING Phone: 714-896-6720 ..,. " Cell: 949d35-7257 � . . ARCHITECT: ENGINEER: Address: 3111 DUBLIN ST City/Slate/Zip: COSTA MESA, CA Address: City/State/zZip: License No. Address: 2780 BLUEBIRD ClUnit: City/Slate: COSTA MESA, CA License No. License No. COMBINATION PERMIT FEE SUMMARY Building Plan Check: $0.00 Building Fees: ; `�$153.25 Electrical Fees: - $76.95 Mechanical F�es: $34.15 Plumbing Fees: $43.10 SMIP Residential: $0.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $308.45 "Re(er to fee rec¢ipts for all fees pald for project 705956 Unit: Unit: : ZipCode 92626 PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1. 12•21•92) EXPIRATION: PERMIT EXPIRES 1B0 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. ,� , INSPECTION$: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required insppctlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOE/, ixsv�cnOxrmE 1818 Fixetl System Final Fire Prevention i288 Pool SOa Final 200 Final Re-Root 201 Final Blp�k/ReUining Wall 202 Final Faclory Fire Place 203 FinalSi�n 204 Final Demoliti0n p� iNn oc .ror ixsvecnoNrre 206 Final Mechanital 208 Final Plumbing 210 Final Elednral 212 Final Fire Prevenlion 220 Final Planning Approval 222 Final Site 2W Final Builtling/Occupancy p�g iNnn��s $-3� BE (G7z� WORKERS' COMPENSATION DECLARATION:� . I hereby aKrm under penalty of peryury one ot the follovnng declaration,: ❑ I have and will maintain a certificate of wnsent to self-Insure (or wodcers' compensation, as pr0��ded (or by section 3700 0( lhe Labor Cotle, for the pe�Ro mance of the work for which this permit is issued. ��j{J I have and will maintain workers' compensatlon insu2nce, as requiretl by section 3700 of Ihe Labor Code, for the peAortnance of Ihe v,ork fw which this pertnil is issued. My workers' compensation Insurance wrner and policy number ar Camer:' �`�c.I V 5 I�� .�✓A�+ Cc CC1 N-!)Fl�v..i (rn;ssenlannoeanae��pereeau,eoe„nravawcaararenund3ceaea /�� Policy Numbe[ C) I 0 K� 2r.. i-�,o� lui � ❑ I ceRify Ihat in the peAormance of Ihe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compCnsation laws of Califomia, and agree Ihat i( I should become subjecl to the workers' compensation provisions of Seclion 3700 of the Labor Cod , shall forihwith comply with these pro�isions. 3.It9. og �cau 'ryawre ,Oate � WARNING: FAILURE YO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT 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 aKrm thal I am licensed un0er provisions o( Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code, and my license is in full torGe antl eflect. `�ic. tt' ��55 S b ciass tt� C-- � o 3.�'I O, ncl pio-Sqnelere Da�e _ � CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn [hat there is a construction lentling agency tor the per(ortnance of Ihe worN �a vfiich this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Atldress: SignaWre Date OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or Ihe lollowing reason (Sec. 7031.5, Business and Pro(essions Code: Any city or county which requires a Dertnit to consWct, alter, impro�e, tlemolish, or repair any sWCWre, prior to its issuance, also requires �he applicant for such permit to file a signed stalement that he or she is licensed pursuant lo Ihe pmvisions of the Contractors License Law (Chaprer 9(commencing wilh Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt lherefrom antl the basis for the alleged exemption. Any violation o( Section 7031.5 by any applicant for a permit subjecis the applicant to a civil penalty of not more than five hundred tlollars ($500).): ❑ I, as ov+ner of the properry, or my employees vrith v2ges as their sole compensation, WILL DO THE WORK, and the structure is not intentled or oftered for sale (Sec. 7044. Business and Professions Code: 7he Contractors License Law does not apply to an owner of propeny who builds or improves Ihereon, and who dces such work himself or herself or ihrough his or her own employees, provitled that such improvements are not intended or oReretl for sale. I(, however, the building or improvement is sold wilhin one year of completion, the ovmer-builder will have the bu�den of proving that he or she did not build or improve, for puryose of sale.). � I. as owner ot the propeAy, am EXCIUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct Ihe project (Sec. 7044, Business and Pro(essbns Code: The con[raclors License Law tices not apply to an ovmer of property who builds or impmves Ihereon, and wfio contracls for such projec[ with a cml2ctor(s) license pursuant to the Contractors LicenSe Laws.). ❑ I am exempt under sec. Business and Professions Cotle for this reason: JOS]�46 (10]) t � Owner ID,verified by Anver's se. ❑ Ves ❑ No .Driver'S License No. Expires: Venfication ot Ownership by (rype o( document, i.e. - property taa bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certify that no excavation frve (5) or more fee[ in deplh into wfiich a person is requiretl to tlesce�W, will be made in connection with work authorize0 by this pertnit, and that no building sWCWre, sca(tdtling, falsewvrk, or Oemolition or dismanlling Ihereo(, will be more Ihan Ihirty-su (36) feet high. (Chap. 32, Grp 2. M 2. Sec. 347, Ttle 8, Calitomia PAministraWe Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit fmm the Division of Industrial Sa(ety, as noted above. unless such person has a permit to do such work from the division. Applicanfs SiqnaWre Division o( IndusMal Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will Ihe applicant or preseN or future building occupant need to file and certify a Business Plan tor emerqency response to release or threatened release of a hazartlous material? [] Yes ❑ No (Section 25505 0( the Cali(omia Heallh and Sa(ety Code requires, with some exceptions, that a Business Plan be filed vnth lhe 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 o( 55 gallons, or 200 cubic feet of compressed gas at standard temperalure and presswe). 2. Does or will the apDlicant or presen[ or fuWre building occupant neetl to (le a registration tortn for acutely hazardous materials? [] Yes ❑ No (Section 25533 of lhe California Heallh and Safery Code, wi[h some exceptions, requires regis[ration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity o( acutely hazardous malenals equal lo or grealer than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet of compressetl gas at stantlartl IemperaNre and pressure�. 3. Does or will the applicant or present or fuNre building occupant need lo prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes � No (Seclion 25534 ot the Califomia Health and Safety Cotle provides that Ihe Costa Mesa Fire Department may require the preparation, certifcation and filing with the Fire Department ot an RMPP by businesses which are required lo register acutely hazardous ma�erials with Ihe Fire Department. 4. I( an RMPP is presently required, has Section 25534 of Ihe Cali(omia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or presenl or future building occupant require for the vrork which is Ihe subject ol this application a permil for such cOnstruclion or modifcation from the South Coas� Air Ouality Management District or from any olher air pollution control dislrict or agency? ❑ Yes ❑ No (Sectqn 658502 of the Califomia Govemment Code requires that the requested infwmation be (umished on applications !a rwn-residential builtling permits). 6. Will any part of the facility to be constructed untler this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Qf'yes", the facility musl meet the requiremenl of Seclions 25534 and 42303 of Ihe California Health antl Safety Code�. 7. If a pertnit from the South Coasl Air �vality Management District or ot�er air pollution con[rol disMct or agency is required for the work which is the subjecl of Ihis application, have all of the disclosures prescribed by Calitornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If yes", attach certificate ol wmpliance from,the appropriate air pollution coMrol oKcer�. � CERTIFICATE OF COMPLIANCE: I ceAify Ihat under penalty of perjury the information qiven above is wrrect. I agree to comply with all state laws and city ordinances regarding Hazardous Matenals and Emissions. SignaWre Date CERTIFICATE OF-COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalty of perjury that I have read this application and�state that the information given is correcl. I agree to comply with all state laws and ciry ordinances relating to building construction, and authonze representatives of the City of Costa Mesa to enter upon the above-tlescnbed property for inspection purposes. I agree not to occupy or allovi occupancy of any building authorized by lhis permit until final in5peclion. � SignaWr o egalOwneqs) Date "3. l o �`j Analo�Au AppLcant ' Date J � CITY OF COSTA MESA � evno►N� o�v�s�oN 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 TYPE: B COMBO Sub Type: GRN1_RES Jos a,00Ress: 3111 DUBLIN ST CM APN: 41814713 ZOning:R1, , Vicinity: Const Type: V-B SQ. FT: 0 PERMIT NUMBER: BC09-00183 STATUS: ISSUED DATE ISSUED: 0512912009 ISSUED BY: BJK Suite/Unit: Primary Occ: R-3 Valuation: $2,000.00 SCOPE OF WORK: GREEN PERMIT: INSTALLATION OF 2 SOLAR TUBES, 8 WINDOWS (2 FOR PERMIT BC09-00074 8 6 REFRAMED ENERGY-EFFICIENT WINDOWS), AND A 15 SEER <100K BTU ATTIC FAU WITH ALTERATIONS TO THE DUCTS IN AN EXISTING SFD. MECH: 1 FAU<100K BTU, MISC DUCTWORK REF: BC09-00074 (ADDITIqN/REMODEL) OWNER: GIBBS, JEFFR�Y Phone: 949-887-2506 APPLICANT: CIRILLO, STEVE Phone: 949-012-7315 CONiRncroR: LEFT COqST COMPANY Phone: 949-012•7315 Cell: ARCHITECT: ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: "Re(er to fee receipts for all (ees paid for project Address: 3111 DUBLIN ST City/Slate2ip: COSTA MESA, CA Address: 1245 LOGAN City/Slate/zZip: COSTA MESA, CA License No. 849884 Address: 1245 LOGAN Unit: City/Slate: COSTA MESA, CA License No. License No. $0.00 $6925 $0.00 $52.20 $0.00 $0.50 $0.00 $1.00 $122.95 Unit: Unit: :SUITE B SUITE B ZipCode 92626 PHONE: PHONE: '�'<. . ,'H �� `� �♦ � j t� � +: .: NOTICE: The work authonzeq by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and relaled regulations. (Ord. No. 92-28, § 1, 72-21-92) 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 fnal approval will result in the expiration of this pertnit. CO�E � INSPELiIONTYPE 0 7616 Fixed System Final Fire Preven�ion 126fi Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DRTE INTITIRLS CODE! INSPECTIONTYiE 206 Final Mechanical 208 Final Plumbing 210 Final Electnwl 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy onre ixnnn�s �'=3- l�5 fY lf�� WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalry of perjury one of the (ollowing declarations: ❑ I have and will maintain a certifcaie of consent to se141n5ure for NroBers' compensation, as provided for by section 3700 of the Labor Code. for the per(ormance of the work for which this permil is issued. O��I have ane will maintain wnrkers' compensation insurance, as required by sectbn 3700 of the Labor Code, for the peRortnance of the v✓ork for which this pertnit is issued. My workers' compensation Insurance carrier and policy number are: " �Tn��' u� Cairier. (This seam neetl rrot oe cnmpeleo Amepermrt 6 valuetl at one hundretl a�nars (St00) a ress ) Pol yNumber. CY�II -C�7—O� ❑ I certify that in lhe peAormance of Ihe vrork (or which this permit is issued, I shall nol employ any person in any manner so as to become subject to Ihe workers' compensation laws of California, and agree that i/ I should become subject to the vrorkers' compensation provisions o! Section 3700 of the Labor Cotle, 1 shall (orthwith comply with these p�rovisions. � - ' ` � �Cl"�) �% �v �,..��. � .Hu� �e,,,�� Daie� l � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT 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, IrfTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my license is in full force and eHect. Lic?#�►qF�4 Class,#�_ –�— `�l � Z�rC14 onvano� r'_s SipnaWre �ate,:> CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that there is a constnictbn lending agency for the pedormance of the v.ork fa which mis permit is issuetl. (Sea 3097, Civil Code�. Lender's Name: Lender's Address: SignaWre OWNER-BUILDERDECLARATIONS: rsj''t�?� ¢�'�. I hereby aKrtn thal under penalry ol perjury�that 1 am,EXEM�I �ROM THE CONTRACTORS LICENSE LAW tor the ffollowi re'�s n(Sec. 7031.5, eusiness and Professions Code: Any city,or co nt ich requires a permit to construcl, alter, improve, demolish, or rep ny struclure. prior lo its issuance, also requires the applic9nt r s,� permit to Gle a signed s�atement Ihat he or she is liCense�tl pu lo lhe provi5ion5 of Ihe ConlraC�ofs License Law (Ch2pte �:9 (�q mmencing with Section 7000) of Division 3 0( the Business and Pro(e�ss,ioni'Code) or that he or she is exempt therefrom and [he�basis�fo_r Ihe alleged exemption. Any violation ot Section 7031.5 by any applica �[ior✓a permit subjecls lhe applicaM to a civil penally of no� more than five h uiidFetl tlollars (5500).): ❑ I. as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the sVucWre is not intended or oBered for sale (Sec. 7044, Business and Professions Code: The Comractors License Law does not apply to an owner ot property who builtls or improves thereon, and who tloes such work himself or hersel( or lhrough �is or her ovm employees, provided ihat such improvements are not intended or offered !or sale. If, however, the buil0ing 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 EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Professbns Code: The contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and who contracts for such project vrith a cont2ctw�s) license pursuant toihe Contractors License Laws.�. ❑ I am exempt under sec. Business and Professions Code for this reason: SiB�aWrc 309-a6 �JIO]� � • 1 Owner ID verified by tlriver'Slicense. ❑ Ves ❑ No Driver's License No. Expires: Verifcation o( Ovmership by (type of document, i.e. - property lax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cetldy that no excavation frve (5) or more feet in depth into wfiich a person is required to descend, will be matle in connection with work authonzed by Ihis pertnil, and that no building slrucWre, scaftdding, falsev.ork, ar demolition or dismantling ihereof, will be more than thirty-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TM1Ie 8, Califomia Adminisl2tive Cotle). � As ovmer-builder, I will nol employ anyone to tlo work which woultl require a permit (rom the Division of IndusMal Safety, as noted above, unless such person has a permit to tlo such work from the division. AppliG)n(s Sgnalure �ale Division of Induslrial Safe[y Permit NumDer: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicam or present or future building occupant need to file and certi(y a Business Plan for emergency response to release or threatenetl �elease of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires. with some exceptions, that a Business Plan De filetl with lhe Costa Mesa Fire Department by every business which has at any one time during a reported year a quaNily of hazardous matenals equal ro or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperaWre and pressure). 2. Does or will the applicant or present or (uture building occupant need to file a registration (orm for acutety hazartlous materials? ❑ Yes ❑ No (Section 25533 0( the Cali(ornia Health antl Safery Code. wiih some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hantl a quantity of acutely hazartlous matenals equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet ot compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or fulure builtling occupant need to prepare an RMPP (Risk Management antl Prevemion Program for acutely hazardous materials)4 ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health and Safety Code provides that Ihe Costa Mesa Fire Depanment may require the preparation, certifcation and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazartlous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 o( the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicanl or present or fuWre building occupant require for the vrork which is the subject of Ihis application a permit (or such construction or modifcation from the South Coast Air Quality Management DiSMct or (rom any other air pollution wntrol district or agency? ❑ Ves ❑ No (Section 658502 of the Cali(omia Govemment Code requires that the requestetl information be fumished on applicalbns for non-residential building permits). 6. Will any part of the faciliry to be conswcted under this permit be vrithin 1000 feet Imm che wter bountlanes of a school? ❑ Yes ❑ No (If'yes", the facilily must meet the requirement of Sections 25534 and 42303 of Ihe Califomia Healt� antl Safely Cotle). 7. If a permit from the South Coast Air �ualiry Management District or other air pollution control district or agency is required for the vrork which is the subject ot this application, have all of the disclosures prescrihed by California Health antl Safety Code Section 42303 been madel ❑ Yes ❑ No 8. Qf yes", attach certificate of compliance from the appropnate air pollution control oKcer�. CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the information given above is cortect. I agree to comply vrith all state laws and city ortlinances reqartling Hazardous Matenals and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalry o! perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating Io building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-tlescribetl property for inspection puryoses. I agree not ro occupy or allow occupancy of any building aulhorized by this permit until final inspection. SignaWreollegaiOwneqs) Oa`�eI n � � ��7��f' �n iTar.�uRionie0A0Pliwnl �VOale- CITY OF COSTA MESA OyTpMFS BUILDING DIV/SION it�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wiw.ci.costa-mesa.ca.us F � FOR INSPECTIONS CALL: (714) 754-5626 �`D+�m ^` PERMIT NUMBER: BC09-00135 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_AL7 DATE ISSUED: 05/29/2009 ISSUED BY: BJK �os a,o�aess: 3111 DUBLIN ST CM APN: 41814113 ZOf110g:R1, , Vicinity: Const Type: V-B SQ. FT: 367 Suite/Unit: Primary Occ: R3 Valuation: $40,062.80 SCOPE OF WORK: 367 SQ F7 FIRST FLOOR FAMILY ROOM ADDITION. FOOTING REPAIR/REPLACEMENT ON THE SOUTH SIDE OF DWELLING AND PORTIONS OF EAST AND WEST SIDE OF THE DWELLING. ELECTRICAL TO INCLUDE: 6 LIGHTS, 6 OUTLES AND 6 SWITCHES. PLUMBING: RELOCATION OF 1 SHOWER AND 1 WATER CLOSET. 1 GAS OUTLET (1-4) �.r� 13CD9�q7/�3 O ER: GIBBS, JEF REY Address: 3111 DUBLIN ST Unit: Phone: 949-887-2506 City/State/Zip: COSTA MESA, CA APPLICANT: CIRILLO, STEVE Phone: 949-0�2-7315 CONTRAC70R: LEFT COAS7 COMPANY Phone: 949412-7315 Cell: ARCHITECT: TESORO, JEOFFRE ENGINEER: MORITA, DON SHIGERU Address: City/Slale/zZip: License No. 649884 Address: 1245 LOGAN Unit: City/Stale: COSTA MESA, CA License No.0014855 License No.33355 COMBINATION PERMIT FEE SUMMARY Building Plan Check: $359.68 Building Fees: $553.35 Electrical Fees: $43.30 Mechanical Fees: $0.00 Plumbing Fees: $49.25 SMIP Residential: $4.01 SMIP Commercial: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $1,011.59 "Re(er to fee recelpts (or all fees paid for project Unit: : SUITE B ZipCode 92626 PHONE:714-847-3955 PHONE:NOT GIVEN NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statules antl related regulations. (Ord. No. 92-28, § t, 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 inspeclions and final approval will result in the ezpiration of this permit. GODE 0. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roo( 201 Final Block/Retaining Wall 202 Final Factory Fire Piace 203 Final Sign 204 FinalOemolition onre ixnnn� G0�/ INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final EleCtriCal 212 220 222 250 Final Fire Prevention Final Planning Approval Final Site Final Building/Occupancy OAiF INTIi1RL �: C • IYYI� WORKERS' COMPENSATION DECLARATION: I hereby aKrtn untler penalty of perjury one oi the lollowing declarations: ❑ I have antl will main[ain a certificate of consent to sel4lnsure for workers' compensation, as pmvided for by seclion 3700 of the Labor Code, for the peAormance of the work for which this permit is issued. NMr I have and will maintain workers' compensation insurance, as required by sectbn 3700 of the Wbor Code, fa the peAortnance of Ihe vmrk (or wfiich Ihis pertnit is issuetl. My vrorkers' compensation Insurance carner and policy number are: � Carrie�: S?L�F � (This setldn neetl �rol �e cnmdeletl qlhe perm� is value0 at one huntlretl dallars (5100) w less ) Policy Number ��y�),/��-7 — ❑ I certify Ihat in the perfd17lf2Ac@"Of the w�C for which this permit is issued, I shall not employ any person in any manner so as to become subjecl to the workers' compensation laws o( Califomia, and agree that if I should become subjecl to the vrorkers' compensati0n provisions of Section 3700 of the Lab rthwith comply with these provisions. ` , S/��/<��F ApplifanCs SignaWre. Da�e� , WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5700.000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE L480R CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKirm that I am licensetl under provisions o( Chapter 9(cominencing with Section 7000) o( Division 3 0l the Business and Professions Code, and my license is in full force antl eHect. (� lic..# � Class # L' 1/-1-� . . � , J.LC �� onVaclor'sSi9naWre Da�e � CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn lhat there is a constructbn lentling agency for Ihe peAortnance of the work for wfiich �Ns pertnit ig issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Dale OWNER-BUILDER DECLARATIONS: I hereby affirm Ihat under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permi� to construct, alter, improve, demolish, or repair any slrucNre, prior to its issuance, also requires the applicant for such permit to Lle a signed statement that he or she is licensetl pursuant to the pmvisions of the Contracrors License Law (Chapter 9(wmmencing with Sec�ion 7000) of Division 3 of Ihe Business and Pmfessions Code) or thal he or she is exempi lhere(rom and lhe basis for lhe alleged exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects Ihe applicam to a civil penalty of not more than five nundred dollars (SSoo).): ❑ I, as owner of the property. or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe structure is not intended or oflered for sale (Sec. 7044, Business antl Professions Code: The Comractors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or hersel( or through his or her ovm 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, Ihe owner-builder will have the burden ot proving that he or she did not build or impmve (or purpose of sale.�. ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pmtessbns Code: The contractas License Law dces not apply to an owner of pmperty wfio builds or improves Ihereon, and who contracts for such project with a cmtractor(s) license pursuant to the Contractas License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 305]�<6�3I0]� Owner ID venfed by dnver's license. ❑ Ves ❑ No Oriver's License No. Expires: Verifcation of Ovmership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereDy certrfy that no excavation (rve (5) a more feet in depth into which a person is required to descend, will be made in conneclbn with work autironzed by this permit, and Ihat no building strucWre, scaffdtling, falsevrork, a demolition or dismanlling thereof, will be more �han Ihirty-six (36) feel high. (Chap. 32, Grp 2, Ari 2, Sec. 341, Ttle 8, Califomia Adminis�raWe Code). ❑ As owner-builder, I will not employ anyone to do vrork which vrould require a permit from ihe Division o( Industrial Salety, as nofed above, unless such person has a permit to tlo such work from the division. Appliwnfs SlgnaWre Division of Industrial Safe[y Permit NumDer. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to file and certily a Business Plan tor emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Seclion 25505 of the California Health antl Safery Code requires, wi[h some exceptions, that a Business Plan be (led with the Costa Mesa Fire Department by every business which has at any one time dunng a reporled year a quantity of hazartlous materials equal ro or greater than a' weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas a� standard temperaNre and pressure). 2. Does or will the applicant or present or future building occupant need to fle a regisiration torm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of t�e Califomia Health antl Safety Code, vrith some exceptions, requires reqistration with the Costa Mesa Fire DepartmeM by each business which at any one time has on hantl a quantity of acutely hazardous materials equal to or greater �han a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ol compressetl gas at standard temperaWre and pressure). 3. Does or vrill �he appliwnt or preseni or tuture building occupanl need to prepare an RMPP (Risk Management and Preven�ion Program for acutely hazardous malerials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health antl Safery Code provides ihat the Cosla Mesa Fire Department may require lhe preparation, cehifcation and filing with the Fire Department of an RMPP by businesses which are require0 to register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presentty required, has Section 25534 0( lhe Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or fuWre huilding occupant require for lhe work which is the subject of this application a permil (or such construction or modifcation from Ihe South Coast Air �uality Management District or Gom any other air polWtion control distnct or agency? ❑ Ves ❑ No (Section 658502 of lhe Cali(omia Govemment Code requires that the requested infwmation be fumished on applications fa ran-residential builtling pertnits). 6. Will any part of the faciliry to be conswcted under this permit be within 1000 feet lrom the outer boundaries of a school? ❑ Yes ❑ No (If'yes", the facility must meet the requiremen� o( Sections 25534 and 42303 of the Califomia Health and Sa(ety Code). 7. If a permit from Ihe South Coast Air Ouality Management District or other air polWtion control districl or agency is required for Ne work which is the subject of this application, have all o� the tlisclosures prescnbed by Califomia Health and Safe[y Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certificate of compliance fmm the appropriate air pollution contmloKceQ. CERTIFICATE OF COMPLIANCE: I certify lhal under penalty of perjury the information given above is correcL I agree 10 comply vrith all state laws and city ordinances regarding Hazardous Matenals and Emissions. SignaWre CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state thal the information given is wrrecL I agree to comply with all state laws antl ciry ordinances relating ro building consiroction, and authonze represeniatives of the Cily ot Costa Mesa to enter upon Ihe above�escnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until fnal inspeclion. Signature of Legal Ovmer(s� Da1e �' ��/(��9 Ma�wAut�a¢etlAppliwm Dn�e � � � a� �� of 65 � r . • t.�� PPR�� Costa Mesa Building Dept. 2 r , BY.'_ � ,._ _.__DA iHESE LANS MUST BE ON JOB A7 ALL MAKE NO CHAN6E5 WITHOUT PRIOR APF Of DEPf, THE IS (1F PLAtlS f0 BE A Pf OF ANY OF i SUMINC TO ! °ROV;SION$ i : AR AS THE � :E �R GRANTING Of A PERMIT OR APPROVAI SYEGFlCAT{ONS SHALL NOT BE CONSTRUEO FOH, OR AN APPHOVAI OF, ANY VIOLATION PFOVISIUNS OF INIS CODE. NO PERMIi PRf• E AUTHORITY TO VIOUITE OF CANCEL THE THIS CODE SNALL BE YALID, FXCEPT IN SO K OR USE WHICH IT AU7HORIZES IS IAWFUL, �z�- i/-�� /'Y//�1�iy� l5'�� .i � �60 ✓✓1 �� iNE ISSUANCE OF A PERMIT BASEO UPoN PLANS AND "SICAt10NS SNPII N�T PREYENT THE BUILUING OFFIGAL f!7EREaF�ER RfQUIH1NG THE CONRECTION OF EflRORS � 'P ?IdNS ANO SPECIFIS� ION M R S J�� 5 i�G 'ei � PPE3ATIONS BBNG;GQ[iRI�D � HEREUN "�"O FP TH g CODE`ert Of ANY OTHER ORDINPNCF. ��t�� _ qTY OF tOSTA MESA PL4NNING DEPT. SUBJER TO BiDG. DFPT. RFQ p �. er�'Z.�_,��..._.... DAT 2 i3— OtRECTCR p► I�ANNIN4 � s-�/-�D �.,� / � �/ 5� .. . .. ,,,,�, _.. _ , JOB ADDRESS 31 Dub u1 Stxeet BUILDING PERMIT N0. AP No. iv- Gb G ROUGH PLUMBING PROP. SWA. IINE n HOUSE CON. � SPRINKLIHG SVSTEM MISCELLANEOUS ROUGN MEaTING �NO �IR CONOITIONING TEMPOR4RY SERVICE OR POLE UNOERGROUND � POWER � ROUGH WIRING TRENCHES � FORMS STEEL REINF. F100R SYSTEM BONO BERM [] STEEL REINFORCE � SHEPTHING FRAME r1N0 FL�SN�NG LRTMING - IN [] OUT n P�RSiER.BROWN COAT STRUCTURiI. FIN4L M�-'�NG, VENT., REFRIG. �ND A.C., FIN�L F )ING. F�N4L 4N� GA$ TEST � ELECTRIC. FINAL BUILOING. FINRL SPECIAL REOUIPEMENTS TRACT FIRE ZON SUBCONTRACTOR COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 / For Applicant to Fill in Completely — Use Ink Only BUILDING L` ADORESS �/��I I [N ( OWNER OR / �� L. �r TENANT V1� �) MAILING �� D vb l i n 5T ADDRESS CITV V�S� � e�� ' NOL .� /�+ � COPSTRUCTION LENDER BRANCH ADDRESS ARCH ITECT TE L. F�+ C W S Q .Nn H S F G fad F G � .J a w c. � CG o. Z W S 3 ADDFE55 CONTRACTOR ADDFESS TEL. CITV NO. STATE CITY LIC. NO. LIC. NO. SI2E NO.OF BLDGS. OF lOT NOW ON LOT USE OF Separate permits are required for electric, plumbing and heating work. RF�7 laii't//'a I?„I,� Ti. APPLICATION FOR STRUCTURAL PERMIT �EJ . PERMIT yq 3yB IU A.P. NO. /[{I BUI LDI NG ADDRE55 �I�, VNIT OR SPACE NO. USE 1 P ` i h S-�: CA, LOT l� BLK. FDD LTER REPAIR MOVING �EMOLISH VALVEEQWO TVPE�C. •_GROUP � ° /Z�� 3 - DATE �T T oN -SlTa /,uS. � �/C.Cd��Bx� i � ±�D, b7 'I b�ancK�lN. �t,*S, L ST M ! �FT. i FT. � (i'j FT. G A�I NS_� ////TJ IZ ' 7/ 0.0, onre i_ , � .�, � rw.rni � rx� rvii v 773i� ---b! ^ I hereby ecknowled8e thet 1 heva reatl this application antl rtata that tha above information is eorrect and aBree to comply with ell �aws reBUletln8 builtling cOnrtruction, antl I shall not empioy eny pe�wn In violation of the workman's compansation laws of the Stete of Californla. I hereby ceriify thai I am proparly licensetl as a connactor under SQ. FT. the State ot California Business end Profewions CoAe, Division 3, THE AMOUNT SI Chapter 9, antl that such licanses ara in tull forca antl effect, or 1 THE PURPOSE OF am ezempt from tha provisiOns ot the Stata of Calitornia Businau VALUATION antl Professlons Cotla, Divislon 3, Chapter 9. Signatare of � � - . � �� Permlttae V �'� $ � OOO or (J Aut�orizatl AB �t �te P \ > m m 7 VN UNDER VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONLV: � PERMIT FEE E � a � m PLAN CHECK E� 8�� o TAX E / LL v � u TOTALPAID E 7 i_ I� OWNER JOB AD in DATE �ERAL CONTRACTOR F. S. Neenon Const. Ca. DESGFtIPTION of WORK � No1��1-011-14 LOT TRACT FIRE ZONE VALUE Pooi locetior Forms Main Drain �Steel Reinforce � Elec. Bond Approval to Cover �Underground Electric � D � Gas Piping Test Filtering System Lines — Backwash Lines and Recep. Electrical Final Heater and Vent Final r System Final v Backwash and Recep. Final C C Fencino Final C.�. � SUBCONTRACTOR Electric Plumbing . o. � ; _ �-4 I Q.N COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADDRE55 �/ // ' OWNER � MAIL i�.. . _ .-� _ �. �- _ , .. CONSTRUCTION LENDER BPANCH ADORESS CONTRACTOR vaiu �Ih'��8-77�y<.004497� **fi��2�r,c APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED ppTFISSUFn A.P. NO. ' % � BUILDIN �f �/ � A�ORESS � N�%—Y�3 NEW OWNE TEL. 5 ' NO. FIRE � ZONE � � APPRI �,�N� �° BV LOT W / I BLOCK VALUE � /� r ADDRESS �OS✓ � C� TE ZONE NO.OF USE OF NEW CITVO�(/(��. N. iyy P�NS� BUILDING F STATE /j JT' CITY �'�+RDSAPPROVED VARDSAPPROVED � IIC.NO.(.� �� ".=JV LIC.NO.O MAINBUILDING ACCESSORVBUILDING {i� SI2E NO.OF BLOGS. (FROM C/� STREET) � 0. OF LOT NOW ON LOT ROM' a USE OF � .�., EXISTING BLDG. SI F � � FSeparate permits are required for �, SIDE FT. / � elec[ric, plumbing and heating work. REAR Fr. r[.W. USE OF BUILDING AND WORK TO BE PEflFORMED DISTANCE BET. BEf. MAIN & QQ MAIN BLDGS. ACC65. BLp VAR.aW DATE aC.V.P.# APPROVED � APPROVED } ..1 a w a 1 hereby acknowlatlga thet I have reatl Mis application entl stute � y� thet the ebove informai�on is corract antl a8ree to comply with d all laws repulatlnB builtling conarucNon, antl I shell noc employ z eny Oerson In vlolatlon of the workman's comp¢nsation laws of = Me State of Celifornle. 3 1 �ereEy certity that I am properly Ileensed es a contractor under SQ. FT. the State of Californle Buslneu and Professions Cotla, Division 3, THE AMOUNT SHOWN UNDER VALU Chaptar 9, antl that suCh I(tensez ere (n full torce antl ettect, or I THE PURPO6E OF ESTABLISHING A PERI am exempt trom che pfovlsions of Sha $iate of Celifornie Busina65 VAlUAT10N PERMIT FEE $ antl Profasslons Cotla, D��ia 3, Chapter 9. SIOnBiufe of � PLAN CHECK E Permittee � �� $ /� Q TAX E Authorizatl Ag c TOTAL PAID S t n m i e m N IS FOfl m ONIV: � O� a N m , � o O LL � � � PULGENCIO. Louis D. DATE ]OB ADDRESS 3111 Dublin St, BllILDING PERMIT NO. 6�10� GEN� AL ONTRACTOR Card Construction VALUE $ 90.00 o. LOT 15 TRACI' 2�y32 P[RE ZONE DF.SCRIPTION OF WORK Slab & Footin�s fOI' GROUP TYPE ZONE Rl PLAN NO. F11�5� 11�8 �?ECTIONS I DATE I gUBCONTRACTOR I _ PERMITSISSUED Bcnm coa[ Test hl�n� d. . . - s�o�. f � COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIF�RNIA BUILDING ADORE55 FOR APPLICANT TO FILL IN 3 // /, � � s� COSTA MESA. CALIFORNIA OWNER �LU�� /! �� MAII. ADDRE55 � CITV ARCHITECT OR `NGINEER 4L. .fAS LEGAL L OESCRIPTION N A.P. NO. I SIZE OF LOT USE OF EXISTING 0lD( SETBRCN LINE FFOM � � cenren o� srve[r RE.4R YARD �' SIDE VARD RIGHT L`cFT Gi DESCRIPTION OF WORK ALTENATION I ADDITION MOVING DEMOLISH NO.OF ROOMS STORIES S NO. LIC. NO. nx� BLOCK 1 � ��% ,�3.�� NO. OF BLOGS. NEW REPn... BUILDING SIZE EXTERIOR WALL COVERING � ST.�TE ThAT THE / CITY ONOINANCE$ TION. AUTHORIZED A iL �L �'1 IL V '.� 6 �ti' .� ✓ � - 1 / - s � V �,�. Fii�',i�CE DE?T. ��, . r!1c•,� �.i�$: APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. �P MIT NC Q � N EO BY . , OAT �RC y1 �O�. OA 1$5 F // Sd" 2 (' S anooRe�ss � �� h 1 �� ' COSTA MESA. C'ALIFORNIA � , COFNECT �ND �GREE TO COMPLY WITN �LL IE L.�W$ FE TIN UILDING CONSTRUC� • VALUATION 4L , S y�� CORRECTIONS , ,� � � v!' A i:\ MC,)H ! ��'.o )Cy • BJECi TO U0._DEPT. REO. PERMiT FEE S � �� PLAN CHECK $�� TOTAL FEE 8�� OMr � . - . 1. I � -- �. .�. -. . _ _ .� , - - .' , � s�oi * ' . .. _ .. , . . . .. . , , � . �: � :'.� .. , r . , , ". , -- -,. . � `• 1 : ... �..... � . . . ' • . ... . •. .:�.�_,.:�_. .: .:`. _ �'� 1'a.. - . y: ',.� � � � y - _ �• . � � : .� :, . , �\�y . . i _ rl.. /� % . _ * \.a' . . / �� .' A� I � I. � � f � / � J. � _ ' _ ` " . , t!/ /�l f . -. , ` �inC- . � : . `. � :�. .�, .,.�.� _�,..: ,. ' , '�� . �, �' . , ', �'� �� I,� .;'�-. .�, - , y' =, :� � � . ' Y . ... �.' _. ._. _ ,. :�: �.;.� ~--' . `�� 1 ` � � - - _.: .,� , t, .., . i� � �.-.� � . ., . . , .i ;��;Z�:�.}� j . , ,,.. t 1 � � . .: . .., :. _ . C. •._ ,..-I._.: ♦' .' ,'i.._.r: _. ' ... � "' 1. �t. . -�. h . . ,' k 1 ''�� . . ',f�:.�_t;�" � . �'��i •"" '�-.`�:�yl . ,. � '+i.,. . . . _ . � � ' r . � - � . � . . � . � v 1,._ _' � -.. � . . . ..._ ' '__ . . _, _._ _. ..--.. _ .-.� ' - .� . . ' ' .. I � ' ' . ' ' � � . - ' . .. .t; . . . . . .. . . ' � ' . .. � . ... ..",_' . _ .. :_.. . ... •.. .. i ' � . . . . . . ��.. � ' � . ' . - . . . .. . . . . . . . � . . . . . .. , . , � . ; . - � , . .,.'. . � .\�_�.. .' _ . � . . - ' ',�' . -., ti• . •'� \ .c�: . . . . +1 � ' .. . . . ' , ' �.`�',, .}��S" . ', . .. , . �. . -. , ' . . . .j . , - � ;� ��,, � ; ,, . . ' I'` ; `. . . � � . . . . . � �. �. . � • • - . ' � • � • � � . , + .r � . . r ; .. . � .� . .. ' �"\'' I. . . . • ... f,' � . . . , a I " . . . .. . . . . OWNER College Mesa COII1jJ3Ilj�' DATE 1,-18-56 JOBADDRES3 3111 Dubli:n Street BUILUINGPERMITNO. �7�� GENERAL CONTRAC70R The Hale �O VALUE a 10,960.�� 15 BLOCK TRACT 2I�32 Sin�le Res. w/att gar GHOUP I& J TVPE V ZONE R�1 FIRE D18TRICT �803 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footinq Trench .. � 7 -T �"' I Plumbing, Rough to S Plumb(n9. Rough Con Wi 3�Final �P�%�i...�� /J/, z�.rc .�3s�L House A O f Sewen St. .�-2?-�2 n.il P--�— w��_o_.1/ -u aLlo .... La�"�g, Inx Out P. : ing . ...........yr . ...,..� . ..,.... �' """�"'_ Plumbing,Fin,alGas7est/sjtG e p- 1• / ' Wiring,Final ',�� ` Occupancy M n � /0 ,j �h FORM 210 3M lO�vS - ' C�sta Mesa Bailding Department ''' 111 EAST 20fh STREET • COSTA MESA, CALIFORNIA �OR APPLICANT TO FILL IN nddress 3111 Dublin Street Costa Mesa, California Nearest c�ouse_ watson Avenue Owner Garden Grove No. LE-9-2158 orDavis & Quigley No; C-1790 43 fdalaga Cove Plaza�Palos Verde ,,. The Ha1e Compar�y N�oY L��' 3422 8002 Central Ave., Garden Grove I Lot I �o� No. 15 eio�k i T,��c2432 (Attach Metes and Size of Lot 64 . Use of Existing Bldg. Setback Line from Center of Street nEsc� New I a Repafr I Building Siu ]27 r �•rior Wall No. of Bidgs Now on Lot None No.of I No.of Familles Rooma Rear Vard 4� SiduVeM '/I Demolish APPLICATION FOR PERMIT pq.� BUILDING � �'OR OFFICE USE ONLY I Receipt No. I Perm��. �� Receiv by. Date Rec'd. Date Issued o� ��-s� �L /8-,�`� Building Address Costa Mesa, California CORYtECTIONS APPROVALS wi'ih �Foundation Location Inspector Date Forms, Materials, Under-Pinning Frame: Fire Stops, Bracina. Bolts I hereby acknowledge that I have read this ApplicaUon and state that the above is correM and agree to comply Lath. Int with all Clty Ordinances and State Laws regulating building rnnstruchon. Lath. Ext Signatureot THE HALE COMP�LAI�_ Permittee � Plaster, Int Authorized Agt, Plaster, Ext szLvzn t�axn�x Valuation Permf! Fee $ - Masonry Reinforced $ ` U, �/ p ' Plan Check $ � J� � gond Beam b Total Fee $ �• FINAL anrt �na c_nv nM R-SE O � � Z D r � PLOT P7,AN Show location and distances from property Itne and between buildings A ' !` ' i. . . . i . . . ' .�� Y � COST." r� 1 g"cg��uEs,: �02LL tr,.;.i.79 ��