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Home My WebLink About919 EVERGREEN PL - Building Permits�ooxess�r gr9 EVERGftEEN PL �0�.., uNR: �'�'aiOAEiMR 6 MRS WILLIAM LANG noosess: gAME • . � 6145 � 2919 � �flCNIENGINEEfl: RAY TAYLOR eec.no.: C16470 � ' �ooness: zgz9 MYSTIC AV uXR: FOLLERTON' ' CA 92635 PENMIREE: WILL �MAX (714)993-7373 nooeess: 2g29 MYSTIC � FULLERTON. CA,92635 LICENSED CONTMCfOR OECIAMTION: 1 here�y atfirm that I am licensed under pmvisions at ChaD�er 9(commencin0 �� tion 7000) oi Division 3 of the Business antl Pmfessions Code, and my license is in full lorce antl eifect. cirruc.:05077'8 suTeuc.:567159 cuss: gy� � Date: � �L7-'— 9d Siqnature:�.- �/�.�.�,�,J- WOflHEBS' COMPENSRTIDN OECIAMTION: I herehy attirm Ihefl have a cenificxte of consem m setl-insure or a ceniticate oi Workers' CamDensation Insurance or a cenlllee iap t�ereoi (S¢UiOn 38110, Lab. C). roucrxo.: 4—id0139-0� E%P.DITE: OS�1%I91 �MP1NY: CA INDEMNITY Certifietl coDY �s here6y lurnis�etl. � Certifietl copy is fileA with the ciry Builtlinp Uivision. Date: �O �' � �— — p � qpplicant,'" ��/I..p �✓ • �� IXEMP710N FROM WOHKEfl3' COMPEN&1TION OECLAILITION:��fJyiS sec6on nee0 nol be complete0 if �he permfl is far o�re hunEreA �$10� a less). I certity ihat in t�e Dertormance oi tAe work for wAich ihis permrt is issued, I sha�l not employ any persan in any manner m as to hecome suLlect to tAe Workers Compensation Laws of Califomii;� � Oate: - �Siqnature: � - ' N�TICE:I/, atter makinB ihis tleclaration, you shoultl'Decome suble�tto Ihe Workers' Compensation provisions oithe Lahor Code, yau mus[ IanhwitA wmply vn[h such provismns ar ihis permit shall be OeemeE revokeA. CONSTBUCTION 1FN01NG �GENLY: I Aereby aifirm Nil ihere is a cans[mction lending a0e�cy for ihe OeMormance oi ihe work for whicA ihis Dermit is issuetl (Section 3097, Civ. C). // � - LENOEB: , � � � , AODflE35: " � OWNEB 9UIlDEB OECIAMTION: I hereby aKrm t�at I am exempt irom the Contractors' Sta[e �icense Law tor tha following reason (Section 7031.5 Business and Protessional Code: Any ciry ol counry w�ich reQuiies a De�� a consimcl, alter, imDmve, Uemalish, or reDair any simcture, O��or ro its issuance, also mquires the aDP�icant for such permil to fle a signatl statement that �e/s�e is IicanSeA pursuant to ihe provisions of the Contactors' State License Law (Chap[er 9(commencing with Sedion 7W0) of Divisian 3 oi the Business antl Pmtessions Catle) or [hal �e/s�e is exempt t�erelrom anU t�e Easis tor the alle0e0 e�emD�ion. Any Wolation oi Section 7031.5 by any apPlicanifor a Dermit su�lecis Ne aOPlicant ro a civil penalry of not more Ihan five hunOrea Uollars (5500). CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO;• BE 047709 PLAN CHECK NO; 03019-90 S CONSTRUCTION 'I'YPE; PERMIT TYPE: ELE STR PERM NO: BE 047709 GOVT; N SUPP:, N PURPOSE: ADD SOB DESCRIPTION ; 301SF RESID. ADD.,BEDROOM,BATH & LAUDRY SQ FT: '301 CLAIM VALUE: - 24,000.00 CALC—VALUE; 20,769,.00 GROUP OCC: R-3. / ': COMMENTS: SMOKE DETECTOR(S) REQUTAED IN�HOME. *��r�r�*�r*�rxx***�r�r��r�r��**�r*�r**�e*�r�r***�x��rx�r�r��e�r*x�r**x�*�r�i�*�r�r�**�****��**+e****x*� Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: 23 FT IN FRNT: FT IN REAR: �FT IN LEFT: 14 FT 6 IN RGHT: FT IN LEFT; FT IN AGHT; � FT IN� � PARKING REQ; PROV: PLANNING NOTES>.HEDROOM/BATHROOM > RESIDENCE. �.- ;a... �r �t * * * �t �r �t �t �t �t �r �e �r ��t � x �r'�t'x x�x �t'�r �t �t �t �r �t �r �r ' D E V E�L. O'P; M'� E`�'N!f,Tl <%"S � 20NING APPAOVED� BY;.,', ' 1: :` �'� HUILDING APPROVBD BY,:�� APPLICATION ISSUED BY;�� iEitiEiEifitititil�ikifiEiEififiEiEifitiEikiE ,• iE jE iE iE if iE it if 1t ik iF iE iE iE iE iE !f iE it i! iE iE iE �! iE iE iF if 3F it it it PARCEL; 42252115 ZNE: R1 REF NO: ` ADDITION TO AN EXISTING SINGLE FAMILY ��t:*�* x*x **�t�*****x�**�r*x***********�rn*-�**�r� *�t*�t B%=R V I C E S R E Q U I R E M E N T S �Y . �� ' _ , DATE : re �"I2`/rU , �� DATE : 6 . ./S —f0 � � � • DATE: GT-I�- o . /� itifiliFiEitit*ifdt iliE if�tifdFiEfEiEiF7E1F ifitiklfiEiElElElEiEiEiflkifitiElE�t�ElkltiFfEiEitiEififiE%iEiEiEiE LEGALIZATION:N F E E �S U M M A.R�Y STRUCTURAL SEGMENT:Y - ., , HLDG PMT PLUMBING ELECTRIG MECHANYC FIRE SMIP/RES GRADING PERMIT 216.00 56:;00 -' 1.45 , ryf'SOR _ SMIP/NON—RES PLAN 140.90 �15.,00 ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CAECK �=TOTAL PAID DUE I, as owner ol the property ar my em loyees wilh wages as [heir sola comDensation, will tla tha work, an0 ihe I' � ❑ strucmre is nat intenaea ar onered �or sa�e (s�ec�on 7044, BuSiness antl Pmfessional CoUe: The CanVaciors' State �icense Law TOTAL S----> i 7 3. 4 S 1 S. � 0 14 �. 4 0-- .. 4 28 , 8 S 4 2 8. 8 5 i . 0 0 �Aces not appty ro an owner ol a pmperry who EuilOs or improves I�ereon, aM w�o Aoes such work �imself/herseli or IhrouAh ' � � � � ' y �' Ilis or her own amployees, proviOeA thal such impmvements are no�intentle0 or afleretl tar sale. If, however Ihe huilEinp or `impmvement is saltl wrthin one year oi completioq the owner will have Ne burOen ot provinq hUshe Oid not bui10 or impmve REV ENUE D I V I S I ON TOTAL S--> • COLLECTED : , -- �2 8 8. 4 5 OVER / SHORT : i � � mnnepurposemsaie�. BLDG PMT PLUMBING EliECTRIC MECHANIC �FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner oi ihe pmpeM. am ezclusiveN contractin0 �h licensed cantradors to canstrud tAe pmjed (Section 7094, Business � z 1 6. O O 71 . 0 � ', ; �= � 1. 4$ ❑ antl Professions Cotle: TAe Coniractors' 3tate License Law Uoes not apDly to an owner oi pmperry who 6mlds or imD�oves thereon ' � ' �: anOwhocontracisforwthproleciswithacontactor(5)IicensepursuanitotheCaniractars'SlateLicenseLaw).lamaware jE9Eif�iEiEik-%�iEiEitiE9l3FifitdEiE3tiEiEiEiEdEitiFitikiEiElEiEiEiEit-k'.ikdE3k�kititiEiEiEiEiEiE�lEiEiEiEiFifit-1FdtiEjEdE�%�k-lE'1FiE-%-1fiE-ki(�7f-%�k�%'1t�1(")til'jEiF �hat Drool o� IDeir Worker'S Compensaiion insurance shoulE 6e pmvitleE �o ma. ' I N D I V I D U A�'L } F E E B'R,, E A R D O W N � ' , ' � �I am exempt untler Sectlon: 8. d P. C. � ,.� � rorteisreason: '�' TYPE QTY D E S C R I P T I O'N. , UNIT' COST TOTAL COST � , . Date: � ' Owner: � 1 tla hereDy ceniry Itut I am aware of and untlerstanG ihe aquirements ol Catitomia Meal[h anE $afery CaOe Seciions 25505, 25533, anA 25534 antl that I or any future �uilOinA occupant will/will no[ (circle ane) neetl to campty wiN sai0 state coAes anE t�e requiremenis for a permit lor constmction or moditiwtion irom ihe Nr �ualiry Manaqement Oistrict. HesiGential constructlon applica[ions are ex¢mpt irom t�ese provisions. , . �ate: Applicant I �ere�y.certiry t�at I have 2ad this aDDlication and state that ihe ahove inlormation is cortect. I aA�ee to comply with all ciry and counry orainances anA stata laws relatinp to OuiiEiny construction and hereby authonze representatives ot this ciry ta enter upon the above�menuoned proper/ly forinspection Durpases. Date:(D — � 2 ��U SignaNre' _� .�v • ■�d�^��— Oriver's License ar Sociai Securiry x: (' ) ). � 1661-46 W�I�e—Builtling; Green—Code Entorcaman�; Cenary—Applicanp Pink—Revenue; Goltlenrotl—Assesaor �— SFR 301 DWE—TYPE V—WOOD FRAME .,'GOOD 69.00 20,769.00 ELE 10 FIXTURES, LIGHTING a{1 ST 20�,�� EA. .75 7.50 ELE 14 RECEPT/OUTLET %';�1 ST 20 " EA. .75 , 10,50 ELE 12 RECEPT/SWITCH Y��1 ST 20 `�'EA. .75 9.00 ELE 6 RES APPLIANCE NOT OVER T,:O-HP 3.00 18,00 ELE 1 SUB—PANEL i , ' 11.00 L1.00 � END OF FEESti: � ' • ,' f . .� O1 44D62963-t7G052�4.`, TQ+T i?��7E� �6?12/;G 'iil'iE� �''i:5�� '$a.=�` CON�TRUCTION ANDPLANNING • PO SPA '� ' Date �Inspector � � � Date Inspector � � : APPROVALS Permit # ' - ,-, APPROVALS ti.:_rmit # � �� . ,. - 1. .emporaryElectrical Service �or Pole . ' ' . 52. Pool & Equipment Location '" _. r. �i. � Soil Pipe-Undrgrnd. . - " � � 53. Steel Reinfarcement V. 3. Electrical Gonduit �Utility-Untlrgrnd., = � 54. Forms � , 4. Electrical Condui6Undrgrnd._� " 55. Electrical Bonding ' 5. Steel Reinforcement j c. • .- 56. Rough Plum6ing & Pressure Test 6�. Electrical UFER Gmd. -' S7. APPROVAL TO COVER-GUNITE : 7. Footings ' ' . f. • LZ D 58. Electrical Coaduit-Undrgmd. ;�� 8_ Foundation ' ;�� ,,Y � . 59. Gas Pipe, O Undrgrnd., Test ��' � ` 9. Water Pipe-Undrgrnd. � � 4 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural floor System � � �y � 67. APPROVAI SO DECK � � 11. Property Sewer Line & House Connection -�1 � - 62. Backwash & Receptor-Final 12. Sewer Cap . " ' . ,� � 63. Heater & Vent-Fi�al � ' ., � 13. Roof Drains ' �_� �� 64. Piumbing $Ystem - Final � .:<.' 14. fiough Plumbirig � �1�, �' 65. EleCtriCal-Final � "� 15. FoughElectrical-Conduit ; �� 66..SolacSystem-Final . � 76. Rough EleCtric Wiring � � � �� 67. Fencing & Access Approval 17. Rough Wiring Sign ` - , - 68. APPFOVED FOR PLASTERING '� �. 18. Rough Elettrical,-T Bar' Ceiling ' .� � 69.'POOUSPA SYSTEMS FINAL 79. Rough Heati�g & Air Conditioning - '' � � �r� � FIRE DEPT. REQUIREMENT 20. flough Factocy Fireplace ' - ' •APPROVALS � �Permit # � _ 2L-Ducts,in�Structure- � �••• - ' ' � 70. Underground'Hydro - 22. Ducts, Ventileting; _ ' , _ ` - ', `71, Product Piping O Gas O.OiI ; 23. �Gas Pipe-Rough & Test � . � 72. Underground Flush' 24:Roof Framing �''`' "' • - . . -73.:.Undergrnd'Storage:Tank OGas ❑Oil 25. Roof.Sheathing �. - - .� j � d _Q� � 7q.:Overhead Hydro - 26: �T-Bar Ceiling (Structural) & Monocoat •=, . � _`I �� 75. Dry Ghemical � � � 27. � Frame and Flashing. _- :, 2 Z� � ' � 76. Dry Standpipe � - � � - 28. Lathing&6*dirx}�. � ' - - "� �'�� 77, FIXEDSYSTEM_FINAL 29. Insulation • � - _ ' - $( j�'Q -,.� ' 78. _FIRE PREV. FINA"l 30. Drywall�Nailing ` , -�C�� 6�,�/'�' HEALTH.DE,PT. REQUIREMENT � 31. Plaster Brown Coai� ., �, , � �� _ .� ,-7g, �FINAL INSPECTION � � � �'32.'Electrical,Power Meter�Final =' ' � ~� ,�'�e '80. ��FOOD CERTIFICATE ISSUED � - 33. �Final Elect��c - - . � � �I� � d� Notes: � " 34. Final Heating^& Air Conditioniri9 � �� _- � _: ' 7 - - �� i v '� , ; (; Z� p 'a0� Po , C.v� - - . 35.��FinalGas�Pipe�Test� ' - . �; f: �� . ` � � _ ' S; ,f' %. _ �,,- _ . . � 36. Hood or.CanoPY � - . " , � :G.�', ,. � . _ r _ � - . � >l'. ' x 37. Final.FactOry Fireplace ' . � �' � � -�' t� r;� - i ` , �,�. y 38.�Final'Plumbing , - " �`�' � j (;---� ' - 4 a 39.: Wate'r Service-Final 1�: -. � `'�' ... 1 �,., 40. Gas Service-Final � -. � �' . ' .,.._.1 - • � - �.�„ . _ 41. Solar pomesticFinal � ._ � . � _ . � _ , � 42. Backflow Preventer � , � . � ' - � � 43. Backflow Irrigation , � , ' _ , ' . . . . 44. Landscape Irrigation System � �' �� ' ; � _ � _ • - 45. Sound Attenuation . . .. . ' '.,� � _ '- ' 46. Handicap Regulations . � � ' ' . ' , - 47. FINAL STRUCTURE & BUIL'DING J� �� _ 48. FINAL PLANNING� � �• c; �� 49. Electric Release to Edison - ' ' ' - . . � . �/ y �r. - - 50. Gas Release to Southern Califomia Gas Co � J - - ' - � - � . ' ' 51. CERTIFICATEOFOCCUPANCY ' • i � No. Date "'"+. PA0.IECTRUDflE33: � 91[j EVEAGREEN PL OWNEH'SNRME: MR 6 MR5 WILLIAM LANG nooecss: SAME • , . � uxrt: ' 645-2419 RXCH/ENGINEEfl: REG.NO.: noneess: RAY TAYLOR C1�N�70 , 2829 MYSTIC AV • PEpMm�E: £ULLERTON CA 92635 nooeess:WILL MAX (714)993—%373 2829 MYSTIC � FULLERTON CA 92635 ❑CENSED CONiMCTOB OECUMTION: I hereby attirm ihat I am IicenseA unEer pmdsions ai Chapfer 9(commencing with Sec6on 7000� oi Division 3 of the Busineu ana Pmfessions Catle, antl my license is in tull force anA etted. cm uc.: 0 5 L7 7 8 sTere uc.: 5 6 715 euss: m� Date: —�p � 90 SiAnature: — 1/L.��^�� WOBKEPS' COMPENS�TION OECIAMTION: I Aereby afl m t I have a certificata oi consent ro ulbinsure or a cenifica�e of Warkers' ComDensation Insurance, or a ceRilied copy thereot (Sect , Lah. C). roucvxo.: 4-100139-00 E%P.DITE: OSIS%I9S cornrnxr: CA INDEMNI�Y J Ce�ilietl coDY is here6y fumishe0. CertitieU copy is fle0 wit� Ihe ciry BuilAinp Division. / � p �Oa�e: �%��'�� LD Applican�: - IXEMPTION FROM WONIIEIIS' COMPENBRTIOX DECUIIRTION: RMs ectian neeA nol he mmpietetl ii tAe perrttit is lor one AmMreU ($100) w less�. I certity Ihat in the peAuimance of t�e work for whic� ihis Der ' s issue0, I shall not employ any person in atly manner so as to became suhject �o �he Workers`�C6mpensaiion Laws ol Calilomia. '; j ;� ,. �ate: ' Sipnature: - ` � NOTICE: If, after m3WnA ihis tleclaration, you should hecome 5ubjeci ro t�e Workers' Campensation`Drovisions of the Labor Code, yrou must forthwith comply with such pmvisians or this permit s�all he EeemeE revoked. ,�� - CONSiflUCT10N LEN�ING �GENLY: I here�y atfirm ihat Ihere is a consimclion lendinp aAency tor tfie peAormance ol lhe work br which�ihis permit is iisue0 (Section 3W7. Civ. C). IFNDEfl: � RODflESB: ' OWNEB BUILDER OECUMTION: I here�y atlirm ihat 1 am exempt fmm Ihe Contracrors' State License Law for [�e fallovnnq reason (Section 7031.5 Business anE Prufessional Code: Any ciry oi counry whic� xqulas a permit ta construct, alter, Impmve. AemolisA, or repair any 51rucWre, pnar ro its issuance, also repuires the aODlicant tor such permit to fJe a si0ned statement Itut Ae/sAe is licensetl pursuant to ihe pmvisions of the Contractors' State License Law (Chapter 9(commencinp with Section 7000) of Division 3 oi the Business anE Pmfessions Cotle) or that he/she is exemD� ��eretrom an0 t�a basis for the alleA� exemption. My Nalation ol Section 7031.5 by any apDlicanitor a�permiDsubjects the aDPlicant ro a ciWl Denalry of not more tAan frve hunOretl dollars (SSW�. I, as owner oi ihe Droperry ar my employees witA waqes as Neir sole' comDensation, will Oo the work, anA Ihe ❑ stmctum is not inten0e0 or attered far sale (Sectian 761d, Business an0 Pmiessional Cade: The Contractors' State License Law ^ daes not apDly to an awner oi a DropeM who �uilOs or imDmves thereon, antl who Does such wad him5ell/herselt ar throuph his or her own employees, provided tlut SucA impmvemenis are not inten0ed or oflereE lor sale. tl, �owever the huiltlinp or imD�ovement is sa10 witAin one year of completlon, ihe awner will have the Curden oi Droving Ae/she tliE not buil0 or improva for tAe puryose of sale). , I, as owner oftAe Droperry , am exclusively-wntraclinp wil�licenseE coniraitors to cons�mc� t�e prole� (Seclion 7044, Business ❑ an0 Pmfessions Code: The Contractors' State License Law tices nat apON �o an awner oi DropeM �o bml0s or imDroves Nereon an0 who coniracis for such prole��s w�h a contractoqs)license Oursuant ta tAe Coniractors' State Licenu Law�. I am aware Ihat Dmo/ ol Iheir Workei s Compensation insurance should Oe proviCeE to me.' ' � I am exempt wAer Section: � B. 8 P. C. . for Ihis reuon: ' ' � ' Date: Owner: I do hea�y cerlity Ihat I am aware oi antl untlerstanA ihe requiiemenis of Califomia Healih an0 Salery Cotle Sections 2550.5, 25533, and 25534 znA ihal 1 or any future huilAinp occupant wilVwill not (circle one) need ro compty wltA saitl state codes and the repuirements far a permit for consimctbn or motlification Imm Ne Nr dualiry Management Disinct. Resitlential canstmction aODlica[ions are exempt Irom t�ese Orovisions. ' Date: ' ADDlicanC I hereby ceniry tAat I have rea0 this aDDliwtion an0 state that ihe a6ove iniormation is correct I aAree ta comply with all ciry anU caunry orAinanas antl sta�e laws relatinq to OuilAinp consimction anU hereby au[honze representalNes ot this cRy ro enter uDon [he above-mentioneG pmpeny for insp¢ction purpocufs. Oate: � r I�_ r D Si9nature. ��^ Onver's License or Social Secunry N: � 1641�48 Whi�e—BuiWing; Green—Cotla EniorcamanF, Cenary—Applicant; Pink—Ravenue; GOldenro0—Assessor ^ PERMIT NO: P CITY OF,COSTA MESA — BUILDING PERMIT 097766 PLAN CHECK NO: N PERM NO:.P 047766 GOVT: N SUPP: N CONSTRUCTION TYPE: ' P£RMIT TYPE: PLU � PURPOSE: OTH JOB DESCRIPTION : FLUMHING FOR SFD ROOM ADDITION SQ FT: CLAIM VALUE: CALC—VALUE: � GROUP OCC: R-3 �/ COMMENTS: BE-47709 /�y�, � �,�(,y��yiy ` **�*�r�rxir**�t*�t�t�tt�ir�tiF*�r*�txit �*�t+t�r*�r*�r ��-x-**�r*+r*��r*�t�ir�t*****x�*x�i�***x�*atx�+t�t*�i-**�*�x�� • Z O N I N GS ERTEBQAUCIKRSE M E N T S ' � ------------ MAPN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FANT: FT IN REAR: FT IN LEFT: FT IN RGHT: 'FT IN , LEFT: FT IN RGHT; FT IN PARKING RE�• PROV; PARCEL; 42252115 ZNE: REF NO: ' PLANNING N TES> � � . �;.. . - iF iE if it i! �f iE �E iE �f 1ElE iE 1E �F iEiE j! ik ik iE iE iE iE iE iE iE iE jE iF iE if if if if i(� k 3F iE jE.iE iE iE iE iF iE * 3F it 3E iE if iE ik ik i! ik iE iF iF iE iE jE it it �)k jf �k if iF iE if if if iE if iE iE iE D E V fi L O P M E N T S E R V 3�C E S?. R E Q U I R�E M E N T S • ..r' ' , ZONING APPROVED BY �fi 'DATE; bUILDING APPROVED BY : I�i DATE: � APPLICATION ISSUED HY: '° � DATE: ��F��7 � ifiEiEiFiEiEi6iEiEiEikiPiEifiEiFifiEitiEikiF ikikiFiElEiEiEiEiE?E iEit �E if iE jE iE iE iE �f if iE �! ik iF iF'lE if',f 1k 1f it it if iE iE iF 1E iE iE iE iE iE �JE iE iE iE jf-iE 3E it 1E iE ik iE iE ik if if # it iE ik f(� iE iE',(� ik it �f it iE ik iE iE �1E if iE iF iE iE iE �lE iE if iE 1E iE if ik 9E.. LEGALIZATION:N F E E. S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PEFtMIT PLAN ISSUE FEE BUILDING—DIV—> TOTALS----> 21.00 , 25� 3.00 PERMIT ISSUE 21.00 3.00 PLAN—CHECK 0.00 SMIP/NON—RES , TOTAL PAID DUE 24,00 24.00 ' .00 REVENUE DIVISION TOTALS--> COLLECTED; 24.00 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADINGtPLAN—CHECK 24.�� , i! iF iE iE 1E if it if #'k iE if iE if if if if �IE �1f �IF �lE iF iE if iF 1(-jt if if it it iE iF �)t if iF 3F iE iF iE iE iF it iE it ik ik ff �1F # 1F if i! i! iE iE iE iE iE k�E �)E i(� iE if iE'1E i! iE iE jE 3E iE iE iF if it iE fE I N D Z 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 PLU 1 BATHTUF3 2.00 2,00 PLU 1 DISHWASHER 2,00 2,00 PLU 1 LAUNDRY TUB_OR WASHER . 2,00 2,00 PLU 1 SINK, KITCHEN 2.00 2.Q0 PLU 1 WASH BASIN 2,00 2.00 PLU 1 WATER CLOSET (TOILETi , 2,00 2,00 PLU 1 WATEk HEATER AND/OR VENT 2,00 2,00 PLU � 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2.00 • 2.00 PLU 1 SEWER, CONNECTION TO bUILDING EACH 5,00 5.00 END OF FEES tl 01 000632b7—p00ti32ti7 Te]�T ,•�,�U DA7E: D3f1`/90 TII�E: iL':�7 CONSTRUCTION AND PLANNING �� - . POO .PA APPROVALS Pe�mit�# - Date Inspector � Date InspectOr APPROVALS . Permit # - ., � . . � 1. Temporary Elect�ical Service or Pole :^ , 52. Pool & Equipment Location 1. 2. Soil Pipe-Undrgrnd. � �' ~u 9D (�� 53. Steel Reinforcement r�� 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 G�nd. 57. APPROVAL TO COVER�GUNITE 7. Footings � 58. Electrical Conduit-Undrgrnd. �. � � 6. Foundation � � a: � �? �% 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pipe-Undrgrnd. ' ��j p,f Cb (�,/, 60. Backwash Lines, P-Trap, O Undrgrnd. � '� c 10. Structural Floor SYstem � '�!� 67. APPROVAL TO DECK 11. Property Sewer Line & House'•Connection - 62. Backwash & Receptor�Final� . -- 12. Sewer Cap �'. � 63. Heater & Vent-Final ' - �: ' 13. Roof Drains . �� jl - 64. �Plumbing System � Final �j 14. Rough Plumbing ��. 7� (�� 65. ElectPical-Final � � I 15. fiough Electrical-Conduit + � i": . 66. Solar System-Final '� � '16. Rough Electric Wiring �i � 1 t.. 67.� Fencing & Access AnProval � j� P 17. Rough Wiring Sign , � . 68. APPROVED FO�R.PLASTERING � � � 18. Rough Electrical-T Bar Ceiling . - " 69. �POOUSPA`SYSTEMS FINAL � 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT . 20. Rough Factory Fireplace . � � � ' , APPROVALS Permit # _ - - 21. Ducts, in Structure � ' -70. Underground Hydro � 22. Ducts, Ventilating _ � � •77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test - . - 72. Underground Flush 24. Roof Framing� � �- _ '73. Undergrnd. Storage Tank O Gas O Oil � 25. Roof Sheathing ' � � � 74. Overhead Hydro .. 26. T-8ar Ceiling (Structurall & Monocoat � 75..Dry Chemical ; . 27. Prame and Flashing � � _ 76. Dry Standpipe - • , - � ' 28. Lathing & Siding � _ - 77. FIXED SYSTEM FINAL � 29. Insulation f ' 78. FIRE PREV. FINAI � 30. Drywall Nailing ,%' � � _ ' -HEALTH DEPT: REQUIREMENT 31. Plaster Brown CoaC ' � � � 79. FINAL INSPECTION � 32. Electrical Power Meter�Final � 80. �FOOD CERTIFICATE ISSUED . , � .33. Final Eleciric i Notes: ' - _ - 34. Final Heating & A� Conditioning , , ' 35. Final Gas Pipe-Testh - y[g Qp - � 36. Hood or Canopy'.^„ , � ' '' l� ' ;, 37. Pinal Factory Fireplace � " " " � 38. Final�Plumbing . 9 O L� � _ �. , � 39. Water Service�Final . - 40. Gas Service-Final - .41. Solar pomesticPinal � �� , , 42. Backflow Preventer � �. .� ' � 43. Backflow Irrigation �� • � � 44. Landscape Irripation System . � . � , ' 45. Sound Attenuation . � 46. Handicap�Regulations . 47. FINAL STRUCTURE & BUILDING . ��, 48. FINAL PLANNING � �"��" 49. Electric Release to Edison �� . . 50. Gas Release to Southern California Gas Co �� ' /� 51. CERTIFICATE OF OCCUPANCY ��/ No. Date � Pfl0.1ECTpODflE33: � t31C) EVERGKEEN PL OWNEfl'SNRME: MR & MRS WILLIAM' LANG �ooeess: �AME UNR: 645-24i9 RflCHIENCINEER: RAY TAYLOR _ weo.xo.:C16470 RDOflE83: z S 2 9 MYST I C AC� - uxrt: FULLEkTON CA 92635 PEBMITTFF: WILL MAX ' � ' ( 719 ) 99 3-7373 , AODRESS: zG�Z9 MYSTIC FULLERTON CA 92635 LICENSED CONTIIACTOB OECLAMTION: I Aerehy aRrm t�al I am IicenseE un0er OroNsions of Chapt¢r 9(commencing wi[h Section 7000) of Division 3 af ihe Business and Protessions Catle, an0 my license is in full force anE ellect. ciTr uc.: 0 5 0? 7$ $TpTE 11C.: S(j'J 1� o cuss:��j �],� oate: �-23 � '�IO Signamre: iI*�'e"e /�/ � �-z�I�� WOBKEBS' LOMPENSNTION OECIAlUTION: I hereby a t t I �ave a cenificate ol conunt to self-inswe or a cenificate at Warkers' Compensation Insurance, or a certifieA copy thereof (Se ' 800, Lab. C�. raucr No.: 4-10 013 9— 0 0 �cv. oar�: 0 5! 17 191 �COMPANY: CA INDEMNITY , ] Ce(tifieC copy is hereDy fumisheA. � Certified wpy is tile0 with the ciry BuilOing Division. Oate� �� / � qpplicanl: �' IXEMPf10N'FHOM WOHKEIIS' COMPENSATION DECUPRTION (T ' secvon neeE not Aa completed i� Ihe permit i5 �a oire huiMaE (5700) or kss�. I cetlity that in ihe petlormance ot ihe work for which this pe � is issueA, I shall not emDlay any Oermn in any manner m az ta Decome suhlect ro Ihe Workers' Compensation Laws oi Calitornia. � �ate: SipnaNa: NOTICE: If, aiter maltinp ihis declaration, you 5houla become subject to t�e Warkers' Campensation provisions oi the LaEor Code, you must 1ort�with comply with such provisions or ihis permi[ shall be deemed revoketl. ' CONSTBUCTION LENOING RGENCY: I hereby aHirm ihat there is a construction IenAinA agency far ihe peAormance oi ihe work for w�ich ihis De�mitis iwuetl (Section 3097. Civ. C�. LENDEO: � RDOBESS: - OWNEB BURDEB OECIAMTION: I herehy aifirm I�at I am exempt from the Contracmrs' State License Law tor the followinA �azon (Sec[ion 7031.5 Business anA Protessional Code: My ciry of counry wAich repuires a Dermit to cansiruct, alter, Impiove, tlemolish, or reDair any simcture, prior to its issuance, also requires the ap0licant lor such permit to file a 5igneE statement that hUshe is licensed pursuant ro Iha pmvisions of t�e Contractars' State License Law (C�apter 9(commencinA with Section 7000) of Division 3 of Ihe Business antl Protessions Code) or t�at he/she is exempt Iherefrom antl the basis far Ihe alleped exempiion. My violation ol Saction 7031.5 Dy any aODlicant for a permtt su�lects t�e apDlicant to a ciNl Denalry oi not more than five huntlre0 tlollars (5500). I, as owner al ihe property ar my emyloyees with waAes as ��eir sole compensation, will � Uo ihe work, anE tAe ❑ siructure k notintentletl oraffereEforsale(SecOon 7044, Business and ProlessionalCotle: The Conirac[ars' State Licensa Law ' does not apDty to an owner of a property who builOs ar improves Iherean, an0 who Oces such work himulA�erulf or t�mup� 'his or her own employees. Drovidetl tha[ sucA impravemenls are not in[en0etl ar offeretl for ule. Ii, however ihe buildinp or imD�ovement is soltl mt�in one year of campletion, Ne owner vnll �ave Ihe burtlen of proving Ae/she tlid not Cuiltl or imDrove for ina ouryose af sale). ' I, az owner of ihe D�oDenv. am exclusively wntracting with licensetl coniratmrs to construct the Omject (Sedian 7044, Business � an0 Professians CoOe: The ConUactars' State Licensa Law tloes nat aOPN ro an owner oi DmpeM1y wlro bmlds or improves Nereon antl who cantractstor sucA prolects :�ih a contracror(s�license pursuantto tAe Caniractors' State License Law),I am aware Ihat Orool of their Worker's Compens.lion insurance shoWU 6e D�oviAeO to me. ' � � I am exemD� untlei Section: � B. 8 P. C. /or this reason: � Date: Ownec I tlo hereby certiy that I am aware of an0 understand [he requiremenGs of Califomia Healih an0 Safery Code Sections 2550.5, 25533, antl 25534 an0 that I or any tuture �uilUing occupant wiNwill not (circle one) neetl ro comply wit� saitl state cotles antl the reQuiremenis for a permit tor constmciion or moEificatian irom tAe Air Oualiry Management �istnct. Hesitlential consimction apDlications are exempt fmm Nese D�avisions. ' Date: AODlicant: I hereby certiy that I have reatl Ihis aDDlication an0 state Nat the ahove information is correct I aA�ee �o comply with all dry an0 counry or0inances and state Wws relatinp to huildinq consWqion antl here6y aN�onza rep2untalNes ot this ciry to enter upon t�e aEovrmentioneE pmpeny for inspectio+�n purpoxs. n / Oate: ��21 �� SiqnaNre:�� ^ J_ � �� oriver's License ar Swial Secunry x: 1641.ae W�i�e—Buildiig; Grean—Cotla Eniorcameng Canery—Applicent; Pink—Ravenue; GoltlenroE—Asseswr , CITY UF COSTA MESA - BUILDING PERMIT PERMIT NO: E 048293 PLAA1 CHECK NO: N. CONSTRUCTIUN TYPE: V • PERMIT TYPE; £LE JOB DESCRIPTION : 301SF RESZD. ADD.,BEDROOM,BATH & LAUDRY CLAIM VALUE: . PERH.NO: E 048248 GOVT: N SUPP: N PURFOSE: OTH SQ FT: CALC-VALUE; GROUP OCC: R-3- / COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. �� t*****�**�t**��r*�***�***�r*��t*stx��*��*��*�t*x*�t�t+��t*�r��t**�t*�r�tx��**�t��*x**�*�:��t�**�� Z O N Z N G R E Q U I R E M E N T S: _ s E T B a c x s ' ------------ MAIN BUILDING ---------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN - ACCESSORY BUILDING - �- FftNT: FT IN REAk: FT ' IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PP.RCEL: a2252115 ZNE: REF NO:. PLANNZNG NOTES> > . . if iF dE if iEiE if jF iE iE iE iF'.E jE 3E jE jE !f i4 3� 3t iE iE � iE iE iE 3f iF 1E jE 9E iE 3f'iE 3(.iE jE iE 9f'lE if',E iE if iE iE iE �Il� iE iE iF if jE iF jE iE iE iE ji iF?E jE iE iE �)E �E jE if?E iF if jE ik ih dE iE �E 3F D E V E L O P h1 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 . BUILDING APPROVED BY :_ APPLICATION ISSUED BY; iE iE if if iE iE iE iE iE iF jf 1f� if iE iE if iE 3E iE it # i(-� #?£ iE if iE iE iE ## 1E if !:- iE if iE if i' * iE iE j' ?(� if 3E LEGALIZATION:N BLDG PMT PLUMBING f�ERMIT DATE: DATE; / DATE: �/23/�O iE iF �)t ik i( ?E df 1E if 1E 1E 1f iE if iE 1f �f �E iP?F iE iE if i6 if iE if jE 3E if jf iE aE 3E iE �ElE iE iE iE iE 1f 1E iF if if iE iE'�-iE F E E S U M M A R Y STRUCTURAL SEGMENT:N ELECTRIC MECHANIC FIRE SMIPIRES GRADING 20.00 508 SMIP/NON-RES PLarr • ISSUE FEE 15.00 bUILDING-DIV-> PERNIT ISSUE PLAN-CHECK TOTALS----> 20.00 '15.00 U.,00 REVENUE DIVISION TOTALS--> COLLECTED; BLDG PMT' PLUMbING ELECTRIC MECHANIC �J,�� TOTAL PAID LUE 35.00 35.00 .00 35.00 OVER/SHORT; 00 FIRE SMIP/TOT GRADI�NG PL'AN-CHECX jE i(� iE?F 3E iF iE iE iE �)t iE jf iF 1E sE iE iE if if if ik 3E �E iE iE iE i(-iE if iE 1f 1f if iE k iF iE if ik iE iE if iE iE ih iE iE iE �E iE iE jf 3E 3E # iE 1E iE iE iE iE �k iF iFiE iE jE ik if iF iE if iE iE ?6 jE 3t jE 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 U E S C R. I F T I O N UNIT COST TOTAL COST ELE 1 FIXTURES, LIGHTING 1 ST 20 EA. .75 ,75 ELE 1 RECEPT/OUTLET 1 ST 20 EA. .75 ELE 1 SERC�ICES BELOW 600 V& BELOW 201 AMP 18.50 . 18,50 END OF FEES 01 OQQ65902-C1G0659D2 Te� T 3`.00 DATE: U7/23190 T2tIE: 12:10 �� CONSTRUCTION AND�PCANNING � . PO SPA ' APPROVAIS Permit # � D'ate Inspector qppROVAIS 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 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. footings . � � 58. Electrical Conduit•Undrgrnd. � 8. Foundation , ', 59. Gas Pipe, O Undrgrnd., Test . . 9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P�Trap, O Undrgrnd. . 10. Structural Floor System � . 61. APPROVAL TO DECK � 71. Property 5ewer 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 76. Rough EI¢ctric Wiring �, 67. �.Fencing & Access ApR�Qval ' 17. Rough Wiring Sign . 68. APPROVED F,OR PLASTERING ' � 18. Rough Electrical-T Bar Celling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning PIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . APPROVALS Permit # 21. Ducts, in Str�cture 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Pough & Test 72. Underground Flush 24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. ftoof 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 {F 'b �JD Notes: ' � ' 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test � ' ' � ' 36. Hood or Canopy ,. , � ' 37. Final Factory Fireplace . 38. Final Plumhin9 39. Water Service�Final . '40. Gas Service-Final . � 41. Solar pomesticFinal � 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations � � 47. FINALS7RUCTURE&BUILDING � 48. FINAL PLANNING 49. Electric Release to Edison . � 50. Gas Release to Southern California Gas Co '' 51. CERTIFICATE OF OCCUPANCY No. Oate e INSULATION CONTflpCTOAS 0 ASSOCIATION • "THEICA ENERGY RATED STRUCTURE" N° 3831 THIS IS TO CERTIFY 7HAT INSULATION HAS BEEM INSTALLED IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: . � �• LOT # TRACT # STREET 919 EVERGREEN � �in, - COSTA MESA EX7ERIOR WALLS: - ' � � �OWENS/CERTAINTEED. 3Z" R 11 MANUFACTURER � THIGKNESS/TYPE ' VALUE' CE�LINGS: BATTS: MANUFACTURER BLOWN IN: MANUFACTURER OWENS/CERTAINTEED THICKNESS/TVPE 10�� vA�ue 30 MINIMUM . R• THICKNESS `VAWE SOUARE FOOTAGE COVEqED NUMBER OF BAGS USED FLOORS: MANUFACTURER �SLAB ON GRADE: MANUFACTURER WIDTH OF INSULATION � _ FOUNDATION WALLS; MANUFACTURER OTHER: THICKNESS/TYPE THICKNESS/TVPE _ INCHES THICKNESS/TVPE R- VqLUE R- VALUE R- VALUE GENERALCONTRACTOR � WILLMAX CONSTRUCTIONLICENSENO. �� BY TITLE Y- P�'� DATE �l �1 �� SI nature) HATCH I U ION 221517 C-2 INSULATION �ACTO LICENSE NO. � 1' MANAGER 9-24-90 BY - TITLE DATE (Sipneture) � ' , � OWNER MAI� �JOB ADDRESS ,� °RAL CON "� �a. i15-4, � INSPECTIONS� SOIL � GAS � WATER ROUGH PLUM6ING UNOERGROUNO I ROUGH WIRING TRENCHES � FLOOR SVSTEM BON� BEAM n SHEATHING ON� Mrs. Margaret 91 ergreen reet �RACTOR Owner-Bldr. 1-14 LOT TRACT Si nat� � HOUSE CON. � M � AIR CONOITIONING E OR POLE POWER � iM5 � STEEL REINF. � STEEL REINFORCE rI FRAME ANO FLASN�NG � "41NG — IN �] � iER, BROWN �OAT G, VENT., ING, FINAL iIC, FINAL DATE SUBCONTRACTOR Z . a cWj F- Z Z� ON am J � J Q U N Z a W � aw wz J � m Z J � W w � Z F— W � N � 70 f' z Q U a � F � z 0 F U � � � N Z ` 33084 HAY 18•71�„�a00 674 �***+�*�j.,�,0 COSTA MESA BUILDING-SAFETY DEPARTMENT � ' . � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � - � , APPLICA'fION FOR BUILDING PERMIT For Applicant to Fill in Completely � � j RECEIVED DATEFECE�7IVED DATEIpSSU D1 ADIDRESS E! Yr• � �E .r. /1/ � ~ � 'I�'/ S I!J ' � / 'OWNER. � (,� � A.P:NO. IIS /I" I� PERM MAIL p . BUILDING �L, EV� � AODRESS ��`/J-NCC S% ADDRESS `e�� 2! /^ CITY G . NOL �3 �pi TRACT /�/ Z LO�bO�' 9LOCK CONSTRUCT�ON � J ,� W ADD A R P LENDER ' V � BRANCH ' � S _ L^� ' - OWNER I�%, ADDRESS VALUE H ' ARCHITECT / - — TEL SEJP S ��' OR ENGINE q V - N. U � FIRE ADDFESS ZONE TVPE � GROUP APPROVED �./ +` n CONTRAC70R �� - BV � / DATES —�— / � ADDRESS ' TEL. ZO� / NO.OF /J USE OF NE CITV ' NO. �` PLANSpL BUIIDING STATE � - , CITV �'/aRDSAPPROVED � VAflDSAPPROVE� LIC. NO. ' LIC. NO. MAIN BUILDING ACCESSORV BUILDING SI2E NO.OF BIDGS. (F RE , OF LOT � NOW ON LOT ' FT, USE OF /�. /J �/' EXISTING B�DG. s/ 'Ld /— ./C-GdS � 1 d F FT SIZE OF NO. OF � NEW BLDG. � FOOMS — Q � STOFIES / L. SIDE � FL PT, EXTERIOR WqLL ROOF - COVERING NOGJE COVERING REAfl � FT. FT, USE OF BUILDING AND WOFK TO 6E PERFORMED DI5TANCE BET. , BET. MAIN & MAIN BLDCi. ACCESS, eLpGS. - � / - VAR. # DATE I LL� LG-. �G �� 'T � C.U.P.# � APPROVED � � � ' � APPROVED — / D �/ �J � I hereby acknowledge that I have reatl ffiis application and state that the abd�e intormation is correct antl aBree to comply with' all laws regulating builtlin8 consttuction, and I shall not employ . . any pe�son in violatiori of the workman's compensation laws ot � the tate o Calitomia. � I hereby cer[ity that I am properly lic¢nsed as a contractof under SQ. FT. Me State of California Business antl Professions Code, Divisicn 3, . THE AMOUNT SHOWN VNDER VALUATION IS FOR Chapter 9, and that such licenses are in full torce antl effect, or I � THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: � am exempt from the provizions of ihe State of California Business VALUATION � � i antl Professions Cotle, Division 3, Chapter 9, � PEHMfT FEE $ ! Signature ot V(1 � Permktee 9 - $�% L w\ P�AN CHECK $`_ // O `� Authorized qgent %L�,� � ,(�.,v �� TOTAL FEE $ ru� Pow, _ Fxa;afc A : GENERAL AP. No, � DATE OCCUPANCY U SUBCONTRACTOR VALUE 6-26-60 Form 210—SM-11-59 S-B P _ . . �. ZZ%SO Li� , :J �F/'��50 CbSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917' COBTA MEBA. CALIFORNIA For Applicanf to Fill In Complefely TYPE OR PRINT � ADORESS �/ �✓ F R E FN PL COSTA MESA. CALIFQRNIA , „ IADDRESS /� / /'✓e��RfF_Al �C Y AR�" SIZE 72 X�I�DO I no. oP e�cs. / OF LOT How oN LOT EXISTOING BLDG Q w�=�� A�9 � 6ETBACK LINE FROM � DESCRIPTION OF WORK � ✓ �� ., r�e.,.,,.., � ✓�� ..,...,.,,. NO. OF CO M/� S tT GAR /YX Lo ,4[ro'�A-T�•-� or= F-<�s'��'�i c.�R' �{Rt To D�,v� L�,-,N u,� i H6REBY ACKryOW1.EDGE THAT i HAVE HEAD TH19 MPLIGT AND STATE THAT THE A60VE IB CORYiECT ANG ACRE6 TO C PLY WITH I1LL CITYi�ANCEB AND HTATE I.AW9 R6GWGCT BU�LDINO CONBTpU O � /��/ `AUTHORIZED AGENT � FEE RECEIVED � z6 - ! 96 o p,p�.�-- APP�L� ��vtlT B 1 G �For�Offiee Use Only RECEIPT NO. PERMIT NO. �a �:c a er o necervee. wre �seuao �i �� o—�a �r�z/. _GD APPROVED 20NE � I I puNe +�,BUILDIN LEGAL � _ .r� A.P.NO. I I .�i —`/ ` ��' YARDS EVES APPROVED ALLO IGBNTER LINH 6TJ `'r5 � TX2 AMOUNT eHOWN UNDER VALUATION IB POR THH nURP08¢ OF, EBTABLI9HING 11 PERMIT FEE ONLY. VALUATION �� /_� � PERMIT FEE $ I� r� � N P $ � PLAN CHECK $ '� Z TOTAL FEE I �5 �— 0 4 ORANGE COUNTY BUILDING DEPARTMENT •• APPLICATION FOR PERMIT . . 636 North Broadway ��. l w � p S•.' � SANTA'ANA. CALIFORNIA e r�� _. . ,. _ ... ..,:�--:.e.rn, , • • , ..�'.i:.?=9i1ti.._ ..��. .. ,.��;1:: . ;: , _. . . . . ..- ... 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