HomeMy WebLinkAbout2803 EUROPA DR - Building Permits•.—
�1
PBOJECT ADUflE55: L� O 3 6�tJRQ�H DR
OWNEq'S NAME: �UGLLER � MARI{ P
aooness: ML]ELi.�BR JANE3 B
2803 EU{iOPA DR
COSTA MESA CA
(7]4)751-1`290
RNCH/ENGINEEN:
p00flE55:
� UNIT:
92626
flEG.NO.:
UNIT:
PEflMITTEE: SANTTAGO AIR CONDI.TIONING ( 714 } 998—].600
ADOBESS: z3I HLOERIDGE
ORANGE CA 92665
LICENSEO CONTXACTOfl OECLAPpTION: I here�y allirm thal I am licensetl un0er provisions oi C�apter 9(commencing wilh Sec�ion
7000) o� �ivision 3 0� Ihe Business ana Pm�essions Cotle, anA my license is in full force and el�ec�.
ciTvuc.:017264 sTareuc.:2F�9496 cu�C-7.0
Daie: y��� I ��_ Signature: �1 �- �^���
WONKEflS' COMPENSRTION UECLANATION: I here6y aifirm tha� I have a cetli�icate ol consent lo se&insure or a cerii�icate ol Warkers'
Compensaiion Insurance. r a cenified copY Ihereo� (Seciion 3800, Lab. ).
aaucrr+o.:PC94gU71 exe.onre: 7/O1/93
co�v: REPUBLIC INDEM
CeNiietl copY is hereby fumis�e0. � Cenified coOY is liled with Ihe ciry Building Division.
(J"' ! �-�'1 l� � C�a o
uate: / �'� / 7 �^ AVPlicam:
E%EMPTIONFflOMWOPREPS'COMPENSATIONDECLANPTION: (lhis5ectionnee0no�becomple�edi�IheDe�mi�i5foronehunOre4�5700)orless�.
I cetlify ��ai in Ihe pedormance oi Ihe work for which �his permi� is issuetl, I shall not employ any person in any manner so as lo become
SUGlect �o Ihe Workers' Compensa�ion Laws ai Calibmia.
�ale: SignaWre:
NOTICE: If, a�ter making Ihis tleclaralion, you s�oultl become suhlec� �o Ihe Workers' Compensa�ion pmvisions of the La�or
Code. you must lonhwiih tomply wilh such provisions or ihis Dermit shall be tleemed revoke0.
LONSTflUCTION LENOING AGENCY: I hereby aflirm thai �here is a con5tmciion lending agency tor �Ite pedormance oi Ihe work for
which Ihis permit is issued (Sec�ion 3097. Civ. C�.
LENDEP:
AODNESS:
OWNEfl BUIlOEP DECIABATION: I here6y al�irm �hai 1 am eremo� irom ihe Cantractors' Sta�e License Law tor Ihe �ollovnng reason
(Section 7031.5 Business an0 Pmlessional Code'. Any city at counry which requires a Oermit Io conslmci, alter, impmve, tlemolish, or
repau any simcNre. prior ta its issuance. also requires the applicant tor such permit to tile a siAned statement that he/she is licensed
pursuam �o ihe provisions ot Ihe Contracmrs' S�ale License Law (Chap�er 9(commencing vn[h Section 7000) of �ivision 3 0� lhe Business
antl Pmies5ion5 Code) or I�al ne/she is exempt ��erelmm antl �he �asis for t�e allegetl ezemp�ion. Any violation o� $ection 7031.5 6y
any apPlicant for a permii su61eci5 the applicanl �o a civil penalty o� noi more Ihan tive hunOred tlollars ($500�.
I, as owner oi �he pmpe�y ar my emVloyees wi�h wages as their sole compensation, will �o �he wark, an0 �he
❑ s�mcmre is not intenOeA or offeree lor sale (Seclion 7040, Busmess anA Pmtessional Code: The Contractors' State license �aw
Ooes no� apply lo an owner of a pmperty w�o �uilds or improves �hereon, an0 w�o does such work himsel�/herself or ��rough
his or her own employees. pmvi4e0 t�at such impmvements are no1 intended or ofiere0 for sale. It, however the huilding ar
impmvement is soltl within one year oi comple�ion. Ihe owner will �ave the burden ol pmvinA he/s�e Oitl not build or impmve
�or I�e purpose of sale).
,
I, as owner ol �he Dmperty, am exdusively contrac�ing wiih licensed contractors [o consVuct �he prolect (Section 7044, Business
❑ and PrO�essi0n5 Code: Tt1e Contrat�OrS' S�a�e License Law Ooes no� apply to an Ownef o� D�aPeny w�o bUiltlS a� impmve5 �hefe0n
and who conlracis �ar suc� pmjecls wi�h a comracmr(5�license Outsuant b Ihe Contracmrs' Siate License Law�. I am awa�e
Ihai pmof ol Iheir Worker's Compensation insurance should 6e proviAetl �o me.
� 1 am exempt untler Section: B. 8 P. C.
�or Ihis reason:
Da�e'. Owner
I do hereby cetlily Ihat I am aware ol an0 un�erstanA Ihe repuiremenis ol Califomia Heal�h and Sa�ery CoOe Sec�ions 25505, 25533, antl
2553a antl ihal I or any lulure builAing occupant willlwill no� (circle ane) need ta comply with saiU s�ate codes an01Ae requiremen�s for a
permit br cons�mc�ion or motli�ica�ion �mm ��e Air Ouality Managemen� �iSlricL Residenlial conslmc�ion applications are exempt tmm
Ihese provisi0ns.
Da�e: Npplicani'.
I hereby cerlily ihal I �ave reatl IhiS applicalion antl Slaie Ihat �he above inlormation is correcL I agree to comply wilh a0 cily antl counry
ordinances antl 5taielaws relatinglo buil0ing consimc�ion and hereUy author¢ere0�esen�ative5 oflAis ciryto enter upon��e above-men�ione0
properiy Clarinspeclion Ourposes. �I^` /�,� n,
Date:_/ /�� yZ SignaWre: ��_ 1 —/F' `�'-�+
oriver's �icense or socia� security a:
i6at-a6 Wbue—Bmlaing; Green—Cotle Enlo¢emem; Canary—Applicam; Pmk—Revenue: Goltlenrod—Assassor
v
CITY OE' COS't'A MESA — BUILpLNG PERi�lIT PERM AIO; M 0�5210
PERMIT NO; M 059210 `PLAN CH�CIC NO: �N GUVT'; N SUFF; N
CUNSTRUCTION TYPE; S—N PERN;IT TYPE; MEC PJRPOSE; OTH
SOH DESCRSPTION : A/C & FIJHNACE UNIT CHANGE OUT SQ FT:
CLAIM VALUE; CALC—VALUE: GROliP OCC; R-3 /
COMMENTS; NO 'B' PERMZT INVOLVED. MEC WORR ONLY:
���**� **x x x �c�c x ��*�c**x �**� � x*��*�c**x�*�*x****T��r ****�*±��*�x-�*��*��r�r***�*�**t;�**�c-�
'l O N I N G R E Q U I R E M E N T 5
ssT�Acxs
----------- P9AIN BUILDIN� ---------- --------- ACCESSORY HUIL,DING --------
FRNT: FT' IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: ].3940409 ZNE: REF NO:
PLANNING NtST'ES>
i
*�*��x*������**�*�����#�����-*���x-*,��**�*�*������*�«*,������*���*�����*�*�+«*,��*��x
D E V E L O P M E Al T 5 E R';'�V I C E S R E Q U I R E twi c N T S
i
ZONING APPROVED BY ,_; DATE:
BUILD.ING APPROVEll BY : DATE:
APPLICATION ISSUED BY; ����" 'J — DATE• 23 /Z
iF�lEifiE�7k�If�iF3F�1E3FiEiE�FlEl4iElFK-ffiflk�E3FiFiFw,.�.t ir i['3Flt� 'iF. 3'i rt Tt3F t'FTr3FTi�EiEiE�Ei!if�if)f•iFiEiC � iFiF
iEiEiFiFI'tiEiF�%ih�lh3t�FlEi(�ififK�3E3E1E�E1F�%%3EiF3hih3EiE#ikiF�F*i4�EiE�1F3EiF�7EiF)EiFiF 3kif�iF3E�3FlEiFiEfFiEiEififiEih�1(-iF3E3E-1EikiEjF3(�if3eii��1E%ifiF
LF.GALIZATION;TJ F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP{RES GRADING
PERMIT 18.00
258 SN,IP/NON—RES
I5SUE FEE �'' 15.00
BUILDING—DIV—> PERMIT ISSUE P�,AN—CAECK TUTAL PAID DUE
TOTALS----> 18,00 iS,00 0.00 33,00 33,00 ,00
REVENUE DIVISION TOTALS--> COL'(,ECTED: 33,DU OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN—CHECK
33,00
iE aF if 3E �f� iE iE iE �!E 3f 34 a�F if i(� 3E iFlF j(� k iE iE iF iE fk iF jF if K-if iE ik 1f 3E 3f If'3F iE 3F �C iF iE 1E IF 1E iF iE !E iF # iE 1E 3F�F k 1E jf iE iElFiE if if if iE ii iE iE if iE�E iE 1f i(-�E i't iE iE if 1f
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 B 5 C R l P T I O N UNIT COST TOTAi, COST
MEC i REPAIR/ALT COOLING;, UNIT/SYS W/CNTLS 9,00 9,00
MEC 1 REPAIR/ALT HEATING. UNIT/SYS W/CNTiS 9,00 9,00
END OF FEES
i
. i,.'. , ' , ' _ _
nTi. . . . . . � ��' .
CONSTRUCTION AND PLANNING POOL 'PA
APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector
t. Temporary Electriwl Service or Pole 52. pool & Equipment Location
2. Soil Pipe�Und�grnd. � 53. Steel Reinforcement
3. Electrical Conduii Utility�Undrgrnd. 54. Forms
4. Electrical Cond�ibUndrgrnd. � 55. E�ectrital 8onding
� 5. Steel ReinforCement 56. Rough P(umbing & Pressure Test
/
� 6. Elecvital UFER Gmd. � 57. APPROVAL TO COVER-GUNITE
' 7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. 60. Backwasfi Lines, P-Trap, O Undrgmd.
� !. Structural Floor System 61. APPROVAL TO DECK
I. Property Sew&r Line & House Connection ' 62. Backwash & Receptor-Final �
i2. Sewer Cap 63. Hearer & Vent-Pinal �
13. Roof Drains 64. Piumbing SYsiem - Final
14. Rough Piumb�ng 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Elettric Wiring 67. Fencing & Access Approval , .
• 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrica6T Bar Ceilinq 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning fIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure .' 70. Underground Hydro
22. Ducts, Ventil�ting 77. Product Piping [7Gas ❑Oil
23. Gas Pipe�ftough & Test 72. Underground Flush
24. Roof Framing ' 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathir�9 74. Overhead Hydro
26. T-Bar Ceiling (Struciuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Sta�dpipe
28. Lathing & Siding � � 77. F{XED SYSTEM FINAL
�
29. Insulation i � 78. FIFE PREV. FINAL
30. Drywall Nailing r ; HEALTH DEPT. REQUIftEMENT
31. Plaster Brown Coat i � 79. FINAL INSPECTION
32. Electrical Power MeterFinai � � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric , Notes:(b!/r��(Z �o0/y'E(101�E- �T�2�'�%�
34. Flnaf Heatfng & Air Conditioning 1� �.''1r77"'-� �
Y/u
35. Final Gas Pipe�Test
36. Hood or Canopy
37. final FaMory Fireplace � � '
38. Final Plumbin9 ,
39. Water Service•F�nal � �'
40. Gas Service�Final i
47. $olar pomest�cFinal
42. Backflow Pre�enter ' �
43. Backflow Irrigation
44. Landscape Ir�iqation System
� 45. Sound Attenuation
46. Handicap Regulations
�� � 47. fINAL STRUCTURE & BUILDING
48. FINAL PLANNING �� ,
49. Electric Release to Edison � - , �
50. Gas Release to Southem California Gas Co .!�
51. CERTIFICA7E OF OCCUPANCY
No. Date
�+
PflOJELTF00NESS: 2803 EUROPA DR
awNeasxnme: MUELLER, MARK D
�oosess: MUELLER JANET H
2803 EU{tOPA DR
COSTA MESAgCA
� AHLM/ENCMEER: ( 714 � 54�-9829
�DONESS:
UNIT:
92626
flEG.NO.:
uxiT:
� vesmmee: HOMESTAR ROOFING ( 714 ) 538-1878
nooecss: 1539 ORANGEGROVE B
ORANGE CA 92665
LICENSEo LONiBRC70fl OECUflATION: I neRey anirm tAat I am IkeRSetl unaer Druvition5 of Chapte� 9(commencinp witn Section
i 7000) al Divipon 7 0� I�e Bu5ine55 an0 Prolesvons CoGe, anE rtry Ikenu is in tW lar[e anE elitt�.
ciTruc.:044971 srnTeuc.:516205-.-�n �uu° ^-39
Da�e: I.��y-C/�-. Si9nawre:-1 � �C� �-��1c�
WOPNENS' COMPENSR710N OECLAMTION: I �ereby allirm that I �ave a cenifiwte oi consem m selbinsure or a cenilicate al Workers'
CompenSaiion Insutance, or a cetlilieE coOY ��ereof (5¢ciion 38011. LaD. C�.
PoucrNo.: PWC114317-00 E%P.ORTE: O9�OII93
cornrnxr: GOLDEN EAGLE
r] Cenifie0 copy is here6y Iumis�eG. � Cenilietl copy is IileO unih the city Building Division.
I /� /` -a�-� �4 ' Q '
�ale: � � "� 7 � 7 Z ppplicanl: 'P � O.W
El(EMPiIUN FflOM WOXKfPS' LOMPENSAPON OECLAM710N: (This section neM iai be compk�e0 il �he permt i5 �or oile �undred (5100) ar less�.
I cetlily Ihal in Ihe Detlormance al �he work �Or wAich I�is perrtti� iS issueA. I s�all noi employ any per5on in any manner so as lo become
su�le�� �o Ihe Workers' Compen5ation Laws al Califomia.
Oale'. SiqnaWre:
NOTILE: II. alter makinp Ihis Geclaralian, yau s�oulG Oecame subjecl l0 1�e Warkeri Compenuiion pmvi5ron5 0l IAe LaUor
CoOe. y0U must to�hwl� COm01y wil� Su[� OrOvi5i0n5 ar IhiS p¢rmii ShdO Ge Aeemed revOk¢C.
CONSiflUtTION LENOINC AGENCY: I here0y affirm lhal i�ere 4 a conslNclion lentling apenty �or Ihe peAormance ol l�a work lor
whicM1 t�is Oermil is i55uea (SecliOn 309Z Civ. C�.
IFNDEfl:
RDDNESS:
OWNEN BUIL�EB OECIAflRTION: I �er¢Gy a��irm I�ai I am eM¢mpi Imm flle fAnirattoR' Stace License Law lar tne lollovnnp reason
ISeciqn 703t.5 Business an0 Pmles4onal CWe: My qiy of counry whrcn reQuires a perrtui to mnsiruc6 alter, imD��e, demolish, ar
RUai� any simcture, prio� lo i6 iuuance. a150 rCpuirts itre apptiwnt lor such permit to lile a sipnea statement tlwl ne/she is licensea
pursuam to t�e pmvisions ol I�e Comracmri Slate License Law (CAap�er 9(commencin0 �+�� ��ron 70W) ol 0ivision 3 of iAe Business
anG Pmles9on5 CaUe) or tlWt 1ie/Slie a eaempt tllertimm aiM t�e Ed35 Iw tl1e allege0 exempti0n. My violation ol SeCtion 7031,5 Ey
any aD7liWnt for a permil suojecis ihe apo����� lo a GW penalry ol not mo2 ItWn irve nunarea dMlars (SSIXI�.
I. as awner al tlle praperlY or my emp�oyees wiU wa0a � Ueir sole wmpensation. will Ja Ihe wark, and tlle
❑ sVucWre is not intenOEtl or offere0lor Sale (SCttion 7614. Bu9nC55 anE Pmfe55ional CoOe: T�e COniracton' State Licenu Law
aces tro� aDOW to an owner al a D�opetly wta GWES ar imD�%'es I�Creon, anE wlp does such xrork himsell/ilersell or Ihroup�
nis ot ner own emo�oyees. Omviaea Ihat sucn imW�emenis are no1 intene¢G or oflere0 for ule. tl, nowever Ine EuilAinp or
impwvement 6 sd0 wi�kn one year ol completion. t�e owner wfA have ihe EurGen ol provinp �e/s�e Oi0 not �ui1G or improva
lor Ine puro0se al salel.
I, as owner o� me ompeny, am e*cWively coniraCiinp vnl� IkenSeU coniractors Io conSlmci Ihe D�olec� (Seclion 7044, Business
❑ antl Prolessions CoGe: Tlie Cantractas' State Lieme Law aces mi appy to an owner of pmpeM � Omlds w imo��s thereon
antl w�a conVac�s �or suth projetis wllh a contractaqs�license pur5uam to I�e Conirattors' Staie L¢ense Law1.l am aware
Ihai pmot 01 t�¢ir WarkeYS Compen5aiion in5urante ShoulG G¢ proviG¢d Io me.
� I am exempt un0er Section: B. 8 P. C.
lor Inis rWson:
Onte: Owner.
I tlo �ere�y cetlily ��al I am aware ol an0 unGerSiantl IOe requirements ol California Heali� an0 Salety COde Seciians 25505, 25539, and
2553< anG that I or any lulure EuilAing acupani wilVvnll not (cirGe one) nee0 lo wmpry Wih SaiU s�a�e co0es and �ne re0uiremenls lor a
permil lor conslmclion or mo4Aicalion Imm Ihe Air Ouahly ManaAemenl DiSlrici. flesiaenlial con5imction aOPlications are eeemD� �mm
Ihese provisions.
�aie: pD0licanl:
I here�y tetlily Ihai I �ave reae I�is applitalion an0 Slate iha� ��e a0ove in�ormalion is cOrreti. I agre¢ l0 tamply vn�� ail cily and COunry
ordinances aM slate WM5 �eWling Io 6uB0ing consiruttion an0 h¢�eby autlpr¢e represeniatives ol tlis dry 10 enter upon �Ae aUwe�meniionetl
pmperly lOr inspet�i0n /p�urp05e5. r / ,, n
Oate:.�� - � "7 - C1 �— Si9naiure: � \� i lX�f'1e
oriver's �icenu or Sodai Securny �:
t6at�a6 WM1ne-BoiMing: Green-GoOe Enlorcemem: Canary-AOp����L Pink-Revenue; GdOenrotl-Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PtRM NO: H 0595%4
PERMIT NO; H 059574 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: S—N PERMZT TYPE: STA POAPOSE; ALT
JOB DESCRIPTION : RESHEATHbRE00F,1/2"CDX PLY 6 COMPOSITION SQ FT: 6,500
CLAIN VALUE; 6,500.00 CALC—VALUE: 6,500,00 GROUP OCC: R-3 /M-1
COMMENTS• SMOKE DETECTORS RE�UIRED PER 1991 UBC S MOKE D ETECTO R
*�trt*x�x��trti�i�*�r,r�**x�**x��t*x�rt*x�rtx� x�x��t*��x*i�#*�t**+t�ti���rit*ft�x-it�t*ft�t***�t�r*kir�t*#ft��*x-*��tu-#*
2 O N I N G R E Q U I R E M E N T S R EQ UIR E D
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGFIT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REp • PROV: PARCEL; 13990409 2NE: REF NO;
PLANNING N(STES>
i
iE iE if iE iE iE �f 3E iE # iE iE iF iE iE jF iF 3F i! ##iF if iE # 1E �E if iE 1F 3F ik if if if # if iE i! if �)k iFlf if iE if iF if if iE if i(- iE iE if #!h iE if iF )f # iE iFiE if iFlE iE iE if iE if if fF iE 1t # if
D E V E L O P M E N T S E R V I C E S R E Q U I ft E M E N T S
20NING APPROVED BY DATE;
BUILDING APPROVED BY
APPLICATION ISSUED B
ik fk �E iE 1E 1E if fE 1E 7E 1f it iE 1f iE iFlflF iE 1f
ik iE if -If tE if iE iE iF iF k#� ik iE k it iE iE iE if
LEGALIZATION:N
HLDG PMT
PERMIT 90.00
DATE;
�
• o� DATE • ��2
1EiFi2� ifif�r'iF x� :iF � e�e� �Fir . fF�`a4Fif7'eiri�iF3FiEiF�IFiE#if�lEi(�ifiE x ,r,�xx#if
iEiEiEfFlElElfiEiFiEiEiEitiFlEiEiEiEiEi(�itiEN IEiFifiFfkilifiEiEiEiEiEifiE3FiEif3FiF#iFiF%�it#iEiEihk#ififiE�k
F E E S U M M A R Y STRUCTURAL SEGMENT;Y
PLUMBING ELECTRIC MECHANIC FIRE SMIP/R65 GRADING
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIC�—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 90,65 0,00 �: 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
90.00 '
TOTAL PAID DUE
90,65 90,65 ,00
90,65 OVzR/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
.65
if iE iE iE if-ik if iE if 3h iE iE iE iE if �1F if iF if iE iElf iE iE il� �E iE iE iE if if iE iF iF if iE �)f3k ik If iF i(� iF # IE iE lE 1f if iF IF Ik 1E iE �IE i!� if !E �E if # t4lF !E if iE fE iE iE iP ikiE iF # 1f �f ###
I N D Z V I D U A L `F E E B R E A H D O W N
TYPE QTY D E S C R I P T I O N UNIT CO5T TOTAL COST
SFR 6500 REROOF BY VALUE RESIDENTIAL NO'LONE 1,00 6,500,00
END• OF FEE5
.
�4',T.:' • . _ .
CONST�TI�N AND PLANNING POOL �A .
APPROVALS Permit � Date Inspector qppROVALS Permit # Datc Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locat�on
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Und�grnd. 54. Forms
4. Electrical ConduR-Undrgrnd. 55. Electrical Bondmg
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. FoOtingS 58. Electrical Cqnduit-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. APPROVA4 TO DECK
11. Proacrty Sewer Line & Ho�se Connection 62. Backwash & Receptor�Final
�z. SQ°"e� CaP � 63. Heater & Vent-Final
73. RoPt Drains � 64. Plum6ing Sys[em • Final
14. Rough Piumbing 65. Electrical�Final
15. Ro�9h Electrical•Conduit 66. Solar System•Fina�
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 66. APPROVEO FOR PLASTERING
18. Rough Electriral�T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Heating & Air Conditio�ing FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
27. DuCts, in Structure 70. Underground Hydro
22. Ducis, Ventilating 71. Product Pipin� OGas OOiI
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing � "/3. Undergrnd. S[orage Tank Q Gas ❑ Oii
25. Roaf Sheathing �p D V 74. Overhead Hydro
26. T•8ar Ceiling (Structuraq & 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 i i HEALTH DEPT. REQUIREMEN7
37. Plaster Brown Coat � � 79. FINAL INSPECTION
32. Electrical Power Meter�Final � ' � 80. FOOD CERTIFICATE ISSUED
33. Final Electric j i.�� Notes:
34. Final Heating & Air Conditioning � ; r /
G�'�9z �%o �_bv�� ,
35. Pinal Gas Pipe-Test � •
36. Hoad or Canopy � �
37. Final Factory Firepiace ' �
38. Final Plum6ing � ,
39. Water Service�Ffnal 1 i '�
40. Gas Service-Final
41, Solar pomesticFinal i � i �
42. BaGkflow Preventer � �
43. Batkflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
� 46. Handicap Regulations .,
47. PINAL STRUCTURE & BUILDING �(� ��,�j-
48. FINAL PLANNfNG - � '
49. Elec[ric Retease to Edison � '
50. Gas Release to Sou[hern California Gas Co '
61. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECTA00PESS: ZSO3 EUROPA DR
OWNEfl'S NRME: MUELLER, MAR3C D
nooRess: MUELLER JANET B
2803 EUAOPA DR
COSTA MESEI CA
(714)540-4�529
RflCN/ENCINEEN:
RDONE55:
UNIT:
97626
flEG.NO.:
IINIT:
PEflMITTEE; MARK MUE:LLER ( 714 ) 5�0-4829
aooxess: 2g03 EUROPA DR
COSTA MESA CA 92626
IICENSEO CONTRRCTOB OECIANATION: I her¢by allirm I�a� I am lic¢nsetl unaer pmvisions ol Chapler 9 kammencing wiN Seciion
7000� ot Division 3 0l IhE Business an0 Pmlessions CaOe. antl my licens¢ is in lull forte an0 e�fect.
Cltt LIL.: ST�TE IIC.: CIASS:
Date: SignaWre:
WOHREBS' COMPENSATION DECLAPpT10N: I hereoy allirm iha� I nave a rertilicate ol consent to se&insure or a cenificate olworkers'
Compensation Insurance. or a cenifieA caoY �hereoi (Sec�ion 3800, lab. C).
POLICY NO.: E%P. DRTE:
COMPRNY:
r] Cerli�i¢tl CopY �5 IlefeUy Iurnishe0. ❑ CenilieU coOY �s fileG wi�h ihe city Builtling Division.
Oale: Applic l:
E%EMP710NFBOMWOBRE85'COMPENSpTIONOECIAMT : (i'senionnee0notefamleteGiiihepermnis ronehunOreC(5700�orkss�.
I cenily t�ai in �he Oedormance ol lhe work br which Ihis it i issued I s I t e loy any Derson i any manner sa as to Gecome
suGlect �o I�e Workers' Compensation Laws of Califomi .
�aie: �� � �-� � SiOnaiu :
NOTICE: IL a�ter making Ihis declara�ion, you sh Itl b e suhleci I � kers' Compensation Omvisions of t�e La�ar
Cotle, you musl Ionhwiih tomply wilA such provisions or Ihis Dermii s all be deemetl revokeA. •
, CONSTPUCTION LENOING RCENCY: I here�y allirm Iha� �here is a constmc�ion IenOing aAency for �he peAarmance.ol �he work lor
�I w�ith IhiS permii i5 i55ue0 (SediOn 3097. Civ. C�. .
IENDEB: � �'
noosess:
CITY OF COSTA N.ESA — BUILDING PEdMIT P�RM NO; E 0�9699
PERMIT NO; E 059699 PLAN CHECR NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE; V—N PEi�MIT TYPE: ELE PURPOSE; OiH
JOB DESCRZPTION ; EXTEND MASTER BED ROON, SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
COMMENTS: RE; BS9697 PRIMARY BLDG. PERMIT,
*#�tr##**#*#��*x�rt�##tt*#**#ft��*�***#ittt#ir##�it*#xitit*z#ft�r##*�##ft����##�#�xu#�x#itrtst�
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: rT IN REAR: FT IN
LEFT; FT IN RGAT; FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL; 13990409 2NE; REF NO;
PLANNING N TES>
i �
x*�*�#�#+t��x*�r*#x�*��*x+�##�r##�*��c�#*�t��c��•x-*�-**�c�#�**trrtx��####tt �r�x�r�#*�t*x�*�x�t�*r x#*�
D E V E L O P M E N T S T',;Ft V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY �� DATE;
BUILDING APPROVED BY ; DATE;
APPLiCATION IS3UED BY• .—._.� DATE; ifl 2G,��
iFf(-iEihlEiEiEikifiF#�lFlFiElFifiEftl(if%�#7Fii�c� � f x 't7x�7 .x-/, ft .f�utti'�ri�fr�TeTie3i�3Fk�##if�1EiF�fiF3FiFiF t iex�r�F#
IE�1tiEiF�(�iPiE�lfiEfFiFil�iE-1FiFi4iElF#3EiEiE###if�lFi4iEififie9e�if3E?(�iEiri4lf�it' i4ifl4#i4iFihM�iFlElEYE#lEM�N-#�f#N��3F##iFlfiEiEiEi(�iF#iF%iE#
LEGALIZATION;N F E E S U M M A R Y S'PRUCTURAL SEGNc',VT;N
OwxeeauuoEaoecu�naTioN: Inereeya�firmihatiamexempuramineContracmrs'StateLicenseLawiorihefollowingreason BLDC�i PMT PLUMBING ELECTRIC MECHANIC FIRE 3MIP/R$S" GRADING
(Section 7031.5 Business and ProlesSional Cotle: Any ci�y ol couniy whic� repuires a permii to con5lmci, alte�, improve, tlemolish, or pER%9I T 3. 7 5
reDair any slmcture, prior ta its issuance. also reQuires ihe aDPlicant �or such permii �o lile a signed statemen� �hat he/5he is licensed rj �$ S�N I P/ NON—RES
pursuam m tAe pmvis�ons ol Ne Cantracmrs' State license Law (CAaprer 9(commencing wit� Section 7000) ol Division 3 of the Business pLAN
an0 Professions Cotle) or Ihal helshe is exempi Inertimm and the Oasis lor the allege0 eaem0�ion. Fny Nolation o� Section 7031.5 by
any ap0licam lor a De�mit su6le��s the applitam to a civil Denalty of no� more than live �unOretl tlollars (5500). 1 SSUE FEE 1 5, 0 �
i, as owner ol tne pmoeny or my em loyees witn wages as meir soie compensation, win tlo the work, ano ine BUILDING—DZV—> PEFiMIT IS$U$ PLAN—CAECK
❑ s�mcwre is not imenaeA or offere0lar sale I�cuon 70ad, Business anE Pmte55ional Code: T�e Con�racmrs' State �icense �aw TOTALS---- > 3, 7 S 1 5, 00 0, � 0
tloes nol aD�ly lo an owner ol a Dmpehy w�o Euiltls or im0�ove5 Ihereon, antl w�o doe5 5uc� vrork himsell/hersel� or IAmugh
�is or �er own ¢mployees. pmviAeO Iha� such impmvements are no� inlenCetl or Oflered tor sale. 11, howev¢r t�e building or REVENU
impmvemenl is 5010 wil�in one year ol compl¢�ion, t�e owner vnll �ave t�e burtlen o� pmving he/she Oitl noi builtl or impmv¢
lor ihe purpose oi Sate1.
I, as owner ol ��e pmpetly, am exclusively conlraciing wi�� licensed wnlractors to canstmci e pmlect (Seclion 70ad, Busineu
❑ anC Prolesvws COGe' T�e Contractors' Siate License Law Goes no� apDH �o an ovmer oi pro M� 6mIAs or impmves ihereon
E DIVISION TOTALS--> CULLECTED;
BLDG PM1' PLUMBING ELECTRIC MECHANIC
18.%�J
T'OTAi PAID DUE
18.75 18,75 ,OQ
18.75 OVER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN—CHECK
antlwhotonlrat�5�or5uChprole��Svnl�atonirat�or�s�lice epur5uant1olheCon�rac�o'SlateLicenSeLaw).lamaware �f#kifft#1EiliE3E#lfif#k!f%�iEifiF#iEiEiEfflFlEii��1F*1F�)FiElE1ElEiF�lFiFfEfFitikif!liE1E#1EiFifiEiE#iF1PiFlF#%K�iFfE�F3E1EiklEk#iElEfEiE%�*fFlF#
��� D�ao1 0l tneir Worker's Compensation insurance snoule b rwieea to me. I N L1 I V I D U A L F E E B R$ A IC D � W N
d � am eKemui unaer 5ec�ion�. B P% O 4 4 B. b P. C.
�a�misreasan: NO EMPLOYEES TYPE QTY D E S C R I P T 1 O N UNIT COST T01'AL COST
oaie: �v'Z�"SZi er: ELE 3 RECEPT/OUTLET 1 ST 20 EA ,7S 2 2S
I Oo here�y cenify ihat I am aware ol ana unAers�anU ihe repuiremems o i ornia Heatlh n0 Sale�y Cotle Sections 25505, 25533, antl gj, E 2 R EC EP T/ S W I TCH i S T 2 0 EA . . 7 S 1, S �
25534 anU Inai I ar any fuWre builUing occu0anl will/will noi (circle one� neea Ia comply wi�� saia siate codes antl Ihe requiremen�s for a
permil �or Consimtli0n or m00iliCalion Irom Ihe Aii Oualiry Managemeni DisMti. fleSiUeniial con5tmcii0n appliCation5 are exemp� tmm END �F f�L' EJC
Illes¢ proVlsioni �
Da1e: Appli�
I �ereGy cerlily ttul I have reaG t�is aOD���alion ane
orainances antl slalelaws�elalinplo builaing consimi
prapetly �arinspec�ion purposes.
�ate: �U 26� �� Sipna
oriver's license or Social Security
Io tampty vn7j� all city and [ounry
to enter uooAtAe a6ove-mentionetl
164146 Wlu�e—Builtling�. 6reen—GoCo Enlo¢emont', Canary—ApPlicant: Pink-Revenue Goltlenrotl—Assessor
;'T, „ .. . . �, _ , '
CONSTR-UCTION ANDPLANNING POOL TA
APPKi0VA45 Permit# Date Inspecior qppROVALS Permit# Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrntl. 53. Steel Reinforcement
3. Electrical Gonduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrntl. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. E�ectrical Conduit•Undrgmd.
8. Fo�ndation - 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor SYstem 61. APPROVAL TO DECK
71. Property Sewer line & House Connectio� 62. Backwash & Receptor�FinaV �
12. Sewer Cap 63. Heater & Vent�Final
73. Roof Drains . 64. Plumbing System � Final •
14. Rough Plumbing _ 65. Electrical�Final .
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring ( 67. Fencing & Access Approval
17. Rough Wirinq Sign l��/ �� 68. APPAOVED FOR PLASTERING �,
18. Rough EleCcrical-T Bar Ceiling 69. POOL/SPA 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 71. Product Pipin9 � Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Root Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and F�ashing 76. Dry Standpipe
28. Lathing & Siding � 77. F�XED SYSTEM FINAL
29. Insulation �.� 78. FIRE PREV. FINAL
�
30. Drywall Ne�ling � HEALTH DEPT. REQUIREMENT
31. Plasier BroWn Coat � 79. FINAL INSPECTION
32. Electrical Power Meter�Pinal � -80. FOOD CERTIF�CATE ISSUED
33. Final Etectric 3� 3 otes:
34. Pinal Heating & Air Cond'+tioniog , �
35. Final Gas Pipe-Test i � ;
36. Hood or CanoPY � '
( �
37. Final Factory Pireplace j �
38. Final Plumbing � � �
39. Water Service�Final �,
40. Gas Service-Final ! �
i
41. Solar pomesticFinal �
42. 8ackflow Preventer � ; �
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALS7RUCTURE&BUILDING ' j
48. FINAL PI,ANNING • �
49. Electric Release to Edison � �.-
50. Gas Release to Southem California Gas Co
51. CEfiTIFICATE OF OCCUPANCY
No. Date
PflOJELT ROUflESS: 2 8 O 3 EUkOPA UR
OWNEP'S NAME: MUELLER, MARR D
aooxess: �UELLER 7ANET B
2803 EU�20PA DR
COSTA MESA CA
(714)540-4�29
AflCH/ENCINEEB:
RDOflESS:
UNIT:
92626
xEG.NO.:
UNIT:
PEPMITTEE: MARK MUELLER ( 714 ) 540-4829
AO�flE55: z8O3 EUROPA DR
COSTA MESA CA 92626
UCENSED CONTBACTOfl OECNBATION: I hereDy aitirm I�a� I am licensetl untler pmvisions oi Chapter 9(commencing with $ec�ion
7000) of Division 3 oi t�e Business and Professions Code, an0 my license is in lull force anA etfect.
CIiV LIC.: STRTE LIC.: CLASS:
�ate: SignaNre:
WOflNENS' COMPENSATION DECIAPpTION: I hereby afiirm iha� I have a certifica�e ol consent to sell-insure or a cehilicale of WOBers'
Compensa�ion Insurance. or a certified copy Ihereol (Sec�ion 3000, Lab. C).
POLICY NO.: E%P. ORTE:
COMPANY:
❑ Certilied copy is hereDy fumished. ❑ Cenilietl copy is filetl wi�h Ihe cily BuilUing Division.
Daie: ApDlicanP
' E%EMPTION FBOM WOHKEflS' COMPENSpTION DELLAPATION: his se ' neeU no� be tompl¢ 'H De�mil is �Or on �dreA �$100) of less�.
I cetlity that in ihe pedormance ol ��e work lor whic� ihis per '' issu tl, I s�all no m any erson in any ner so as �0 6ecome
sublec� to the W�7ork/ers' Compensalion Laws oi Califomia.
Dale: ���" �p-' f Z� Signa�ure:
NOTICE: II, alter making t�is tleclaralion, you shoWa become sublect to the Workers' Compensation pmvisions oi IAe Labor
Cotle. Vou mu5i foMwi�h compty wiih suc� pmvisions or ��is Oermit shall 6e Ueemetl revoketl.
CONSTPUCTION LENDING FGENCY: I Aere6y aftirm �hat �here is a coretruction lending agency for Ihe OeAormance o� �he work for
whicb �his permii is issued (Sectian 3097, Civ. C).
LENDEH:
pODflESS:
OWNEN BUIL�Efl OECUBIITION: I hereby aifirm Iha� I am exem0� ��om [he CanVacmrs' S�aie License Law br the �ollowing reason
(Section 7031.5 Business and Professional Coae: Any ciry of county w�ich requires a Dermit to consimcl, alter, impwve, demolis�, or
repair any stmcWre, prior lo its issuance. also reqmres t�e applican� lor such permii to lile a 5igne0 s�a�emen[ thai he/she is licensetl
pursuam lo Ihe provisions o� �he ConVac�ors' Sta�e License Law (Chap�er 9(commencing with Sec�ion 7000) o� Division 3 oi t�e Business
an0 Pro�essions Cotle) or Iha� he/she is exemp� there�mm and �he basis br �he alleAed exemplion. Any viola�ion ol Section 7031.5 by
any applican� lor a permit sublects �he aDPlicant �o a civil penally oi nol more �han five �untlred tlollars �$500�.
I, as owner oi �he pmDetly or my employees wi�� wages as Iheir sole compensation, will Oo Ihe work, antl Ihe
❑ StmcWre is no� intentletl or ofieretl tor sale (SeC�iOn 7044, Busness and Prolessional Coae: The ConVaC�ofs' Slate Litense Law
i does no� apply ta an owner o� a propetly who bui105 or impmves thereon, antl who does such work himseli/herselt or tArough
his or her own employees, pmvitled Ihat such imOrovements are not in�en0ed or ofterea �or sale. I�, however �he builtlinp or
impmvement is sold wi�hin one year al completion. �he owner will have Ihe 6urUen oi pmving he/she OiU no� builtl or impwve
for Ihe purpose o� sale�.
I, as owner of t�e pwpeny, am exclusivel9 contrac�ing wiih Iicense0 conVactors �o consimct t role�� (Section 7044, Business
❑ antl Pmlessions Cotle: The ConVaclors' State License Law tlo no� apply Io an owner o� pmp y who Umltls or improves Ihereon
an0 who coniracis tor sucn projects with a coniraclor(s) lice pursuant to ihe Coniractors Stale License Law�. I am aware
Iha� proot o� Iheir Worker'S Compensation insurance shoultl be ovided to me.
� i am e.emp� unaer sec�ion: H P 7 � 4 4 e. a P, c.
mr mis reason. NU EMPLOYEES
�ate: /��z�' f� 0 er. �
I tlo hereby certity ihat I am aware of ana understantl t�e requirements of alitomia Healih anU�Safety Cotle Sections 25505, 25533, ana
25534 antliha� lor any �uiure builtling accupant willlwill no� (circle one) need to comDly wi�h said state codes an0�he requiremen�s�or a
permi� for consimc�ion or modifica�ion �mm Ihe Air Oualily Managemen� Disiric�. Fesiden�ial constmc�ian applications are eKempt �mm
Ihese provisions. �
Dale'. � ApDlican��.
I hereby cetlity �ha� I have rea0 ihis applica�ion antl stale �ha� e above inlormation is carrec . a e �o comply wi�h cil
orainances antl state laws rela�ing Io builtlmg consimclian antl her y vl or e represenl �ive o� Ihis �y lo en�er upo a6o
pmperly brinspec�ion purposes.
Da�e-. IP'�� S%i Signature:
Dnver's License or Social Secunty a: )']
t64La6 Wbite—Builtling�, Green—Cotle Enlorcement�. Canary—Aoollcanl: Pink—Revenue: Goltlenrotl—Assecsor
and
CITY OF COSTA MESA — BUZLDING PERMY'T PERM NO; H 059693
PERMIT NO: B 059698 PLAN CHECK NO; N GOVT; N SUPP; N
CON51'RUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; REMOVE WOOD FINISH / STUCCO FRONT OF SFD SQ FT: 1,200
CLAIM VALUE: 1,200.00 CALC—VALUE; 1,200,00 GAOUP OCC: R-3 /M-1
COMMENTS; RE: B59697 PRIMARY BLDG, PERMIT,
#if�lfiE#�lf 7FiF####iFiEfFiFif�ififlEiEif#*iE1FiEiFiE!(-iEiEiEihiE1(��ififl6#iE3E##iEif�IFtf #iFff�if#iF3F#it##iFi(�##�1F#�IEifiE###if#iFft#iF3t
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN F'kNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT; rT IN RGHT: FT IN
PARKING REQ • PAOV; PARCEL: 13990409 2NE; REF NO;
PLANNING NGTES> -'
� ��
if#ifif�k#iF3eiEiE-IFiflf#iEi(�i(�if�lEiF#IEiElhlE#fEifiF#iEiE3EifiFiflFiEif1E*i(-#ikiEiEiFiEN�it#iF#3EiF#iF#iki(-3E3Eifikx�iF#iE�Wif ##ih#3F#1h#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��' S
ZONING APPROVED HY DATE; fs•
BUILDING APPROVED HY :�_ _ DATB: /,`
APPLICATION ISSUED HY• � c9^D1�G�-.—� DATE; ������%�
ifif�7Fifik3k1f1FififiE�fiEifiP#iEiE-If�lEjEiESFie�ix �iFi�iF ��.:�\r- � �Firi'irrT•>r..—FfiF i�Fxir'3Fit3F��#iF1F�IhifiEf4### � . irk
if if iE iF �f #iE iF i(� iE iF iE �14 3f iF # 1E )F # iElf �b iF iE 3F i41F �F iF iF iF ih #ih i4 it �E �If iF iE 3F i(� it �IF IM1 # iE�� # K� 3F if # iE �JE iP if #!E 34 iF-1E # lf �lf iF IF iFp`i� 34�7F �f 1E',F fE �E iE #
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL' SEGMENT:Y
BiDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES, GRADING
PERMIT 29.00 .50'-'
SMIP/NON�RES
PLAN �
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ''�'�,}, DIIii
TOTALS----> 29.50 0.00 0.00 29.50 29.50 .00
REVENUE DIVISION 1'OTALS--> COLLECTED; 29.50 OVEft/SHOkT; .00
BLDz9P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT� GRADING,i?LAN—CHECR
r"�
!f iE�X� 1f iE iFiE-1F if if iE iElF�N� * iE �IFiF i(� iF iE # i(� ih k# iE ik i(� if if itlf iF iE iF if it iF # iF if if 3E iF N�-IE 1E 1E 1f 3F1tlF iE i4 # i! if iE 3E!(� ib )h iE iF # if if ib iE # 1E fF iE if �If iF i( iF
I N D I V I D U A L F E E A A 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 1200 ALT'ER BY VALIIE REENDEOFIFEESNOZONE 1,00 �: 1,200,0.0
/1
�q]
��
, _. �. , . . . ,
, ;. -i G , ,
t -�
CONS7RUCTION AND PLANNING� - : POOL .PA
APPROVALS Permit # Date Inspector ppPROVALS Pennit # Date Inspector
i.�_Temporary Electrirat Service or Pote 52. Poot & Equlpment Location �
� 2. Soil Pipe-Undrgrnd. � 53. Steei Reinforcement
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms '
�
4. Electrical Conduit-Undrgrnd. � ' 55. Eleciricai Bonding
5. SIeaI Reinforcement - 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVEH-GUNITE
7. Foo2ings � � 58. Electrical Conduit-Undrgrnd.
$. Foundation � 59. Gas Pipe, 0 Undrgrnd., Test -
9. Water Pipe-Undrgmd, �. 60. Backwash Lines, RTrap, � Undrgmd.
10. Structurai Floor System 67. APPROVAL TO DECK .
7 i. Properry Sewer �ine & House Connection ; 62. Backwash & Receptor-Final �
12. Sewer Cap - 63. Neater & Vent-Final � �
73. Roof prains � 64. Piumbing $ystem � Finai
14. Rough Piumbing 65. Electrical-Final
15. Rough Electrical-Conduit-� - - 66. Solar Syrtem-Finai � � � �
16. Rou�h Etectric Wiring� 67. Fencinc� & Access Approval . -
7�. Rough Wiring Sign .� . 68. APPROVED FOR PLASTERING '
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYS7EMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipinc� O Gas O Oil
23.,Gas PiPe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergmd. Storage Tank L7 Gas ❑ Oii
25. Roof Sheathing 74. Qverhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Qry Chemical
27. Fsame a�d Flashing 76. Dry Standptpe
28. Lathing&Siding i 77. FIXEDSYSTEMFINRL
29. Insulation , j i_ � 78. FIRE PREV. FINAL
30. Drywall Nailing � ' I HEALTH DEPT. AEQUIREMENT
37. Piaster Brown Coat ' � I 79. FINAL INSPECTION
i
32. Electrical Power MeterFinal � i_: � 80. FOOD CERTIFICATE ISSUED
�
33. Finai Electric � � Notes:
34. Final Heating & Air Conditioning . � � t
� i
35. Final Gas Pipe-Test '
i
36. Hood or Canopy � � �
i �
37. Final Factory Fireplace I : �,
38. Final Piumbing � � �
1 � i
39. Water Service-Final i I �' '
i
40. Gas Service�Final � � '
41. Solar pomestio-Finai � �
i I
42. Backflow Preventer � t �
43. Backflow irrigation .
44. Landscape Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ``'z��''�� � d,_ ���
m-(L
4$�. FINALPLANNING I _ �
49. Electric Release to Edison � "
5Q. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Qate
.�-.� i
rxaEcraoo ss: �8U3 e.UROPA DR
OWNEN'SNPiE:1y�UELL�.R, MARR D
,fooxE�is: ;�UELLER JANET H
2803 EU�tOPA DR
^ COSiA MESA CA
(714)540-4§29
RPCH/ENGINEEN:
AOOHESS:
uxit:
92626
pEC.NO.:
UNIT:
PEpMinEE: MARK M[JBLLtR t R14 ) 540-4829
aooeess: zg03 EJROPA DR
COSTA MESA CA 92626
UCENSEO CONTPNCTOfl OECLRHATION: I hereby alfirm Ihat I am Iicen5e0 unAer pmvisions ot Chapter 9(commencing wi�� Seclion
7000) ol Oiv�sion 3 0� Ihe Business anA Pratessions CoOe. antl my license is in full �orce antl e�fec�.
CITV LIC.: STATE LIC.: CtA55:
�a�e: Signa�ure:
WONREBS' COMPENSATION OECLABpTION: I here�y allirm t�ai I have a certilica�e ot consenl Io sell-insure or a cetli�ica�e of Wotkers'
Compensation Insurance. or a cer�i�ied copy Ihereol (Section 3800. Lab. C�.
PO�ICY NO.: EXP. OATE:
COMPRNV:
❑ Certified coOY is hereby furnished. ❑ Certihetl copy is file0 wi�� the ciry Builtling DiWsion.
Uate: - Applitan'
E%EMPTION FHOM WONNENS'COMPENSFTION DECLAPNTIO .(T�is �ion need nol6ec � � tlhe permitisfar hunAretl(3100�orless�.
I cetlify (ha� in Ihe peAormance o� �he work for w�ich tnis pe ' is i ued, I shal o i loy ny per5on in a �anner so as lo become
'�, subjecl �o t�e Warke!rs' Cnompensation Laws o� Califomia�. ,
�ate: �O� ZU/" /L Signamr
NOTICE I�. atler making ��is declaration, you sho � suble�� �o Compensation pmvisions ol ��e LaDor
Code. you musi Iotlhwiih compty wi�h such pmvisions or this permit shall �e Oeemetl revoketl.
CO�STflI1CTI0N LENDINC AGENCY: I hereby afiirm tha� there is a cons�ruction lending agency for ��e pedormance of Ihe work for
w�icM1 t�is permil is issued (Seclion 3W7: Civ. q.
LENDEN:
FOOPESS:
OwNEB BUILOEB oECLA8RTI0N: I here6y afiirm tna� I am ezemo� Imm Ihe Contractors' Sta�e License Law for the I011owinA �eason
(Seclion 7031.5 Business antl Pmfessional Cotle: Any cily ot county which requires a De�mil to cons�Nct, alier, impmve, demolisR or
repair any slmclure. prior lo its issuance, also repuires �he applican� for suc� permi� to lile a 5igne0 s�a�emenl l�at helshe i5licen5e0
pursuant m ihe Dmvisions oi ihe Conirac�ors' State License law (Chapter 9 �commencing with Section 7000) oi Division 3 of ihe Business
and Pmtessions Code) or Ihat helshe is e�emp� Iherefmm antl Ihe 6asi5 for �he allegea exemDtion. Any violation of Sectian 7031.5 by
any applicanifor a Dermil su6lecis Ihe apDlicanl �o a civil penally o� no� more ��an �ive hunOre� tlollars (3500).
❑ I, as owner of Ue pmpeny or my employees with wages as lheir sole campensation, will do ihe work, antl ihe
simcture is not intendetl or oiferetl for sale (Section 7044, Business antl Pmiessional Cotle: 7he Contraciors' State License Law
Eoes no� apply �o an owner o� a pmpeny who huiltls or impmves Nereon. and who does such work himsetl/�erselt or IhmuAh
his or �er own emDloyees, pmvi0etl Ihal such imDmvemenls are no� intentle0 or ofleretl �or sale. I( however the buil0ing or
impmvement is sold wilhin one year ol completion. Ihe owner will have �he 6urUen o� proving he/she did not builtl or impmve
lor ine purvose of sale�.
I. as owner of �he pmperry, am exclusiuely conirac�ing wilh licensed conlractors �o cons�mct the pr ' ct�(Section 7044, Business
❑ ana Pmfessions Code: The Conlractors' State License law tloes not apDly to an owner of pmpeny ho builAs or improves lherean
antl who cantracis tor such D�olecis wiro a comracior(s�license rsuant to Ihe Contractors' St e License Law�. I am aware
Ihal prooi a� iheir Worker's Compensation insurance 5�oulU be pr ided �o me
d i am eremot under Sec�mn: B p 70 Q Q B. 8 P. C.
mr�hisreason. NO EMPLOYEES
Da�e� �d' � g2 Ownec
I do nereby cenity that I am awa�e of ana un0ersiane I�e requirements af Calilomia Heall� an Safet Code Sec�ions 25505, 25533, antl
2553d and Ihal I or any luture �uiiding occupam will/wili noi (circle one) nee0 �o camply wi�h saie state codes antl Ihe requirements br a
permil lor conslmciion or motlilicaiion Imm ��e Air �uality Managemenl Distric�. Besitlen�ial conslmc�ion applica�ians are exemp� fmm
Ihese provisions.
�ate: AOPi�cam:
I here�y cerlily�hai I havereaa Ihls applicaiion and 51aie tha I
ortliwnces ana stalelawsrelalingio butlding consimc�ian antl
pmperiy �ar in50ection purposes.
� �a�e: �Q' � �� Signa�ure
oriver's license ar 5ocial Seariry p:
wi�h all
t6at-a6 W�ile-0uilding: G�een—Cotle EnlorcemenC Canary—Applicanl: Pink—Revenue; Goltlenrotl—Awessor
CITY OF COSTA MESA — BUIi,DING PERMIT PERM NO: R OS9697
PERMZT NO: B 059657 PLAN CHECK NO: 03772-92 L GOVT; N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ADD
JOB DESCRIPTION : EXTEND MASTBR HED ROUM SQ F'P; 81
CLAIM VALUE: 5,000.00 CALC—VALUE: 5,994,00 GROUP OCC: R—J /M-1
COMMENTS; ENCiOSING COVERED PORCH (EX3STING ROOF) �,�O.KE DE��E.GTOR.
*#*��*#*�***�#�u�u##�r*##*#*�u�tx-�r*****#�#n�*u#x#ir�**�x�#�#x�� s. *.., «. f x
Z O N Z N GS ERTEHQAUCIKRSE M E N a S REQUIRED
------------ MAIN BUILDING ---------- --------- ACCES50RY BUIi.DING ---------
FRNT; FT ZN REAR: 28 FT SN PRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; 5 FT ZN LEFT; FT ZN RGHT; F`l 2N
PARRING REp • PROV; PARCEL; 13940409 ZNE; R1 RF'F NO;
PLANNING NtSTES> CONVEkT EXISTZNG OPEN PATZO AS AN ADDITION TO L2VING:�700M.
i �- �
ib iE iE if iE iE�1E �3E iE iE iE iE i(� 3(� iE iF iF iF ih�# lE iE 3hlE �% If fb if if 9F i4iE lE !F iF'�f� !P # iE If fh �lE 3E if iE iE iE ft 3b iEif 9E i4 fE iE %if i(� aF # If %3f # lE # 7E if-� if #� 1E iblC� �Ih 1E iF # iF
D E V B L O�P M E N T.-- S E R V I C E S R E Q 0 I R E M E N T S
ZONING APPftOVED BY �- ; l.J�r� DATE; ✓0 26
BUIi,DING APPRUVED B�i" ; S ' Di�TE; l0 � y
APPLICATION ISSUED HY: �`�, .
DATE • [9 .2�6 2
iP,i(�iEiE###�k�lfiEiE�f1FiE#�lFiFi(•*�FiElfx � ��eir+c�x .�.'�-;f3Fiew�iti�..r-it...��it#��xftz�3E�7fiEll�it#iEiEiE%ir�r�x x�xxxxx#H-
#'i(� �1E iF # iFlf i(-if �%� iE iE 3E #iE iF !f �1F 3t iE # iE iF iE f(- iE i(� it!(� 1E �lf iE 1E iE iF iF iF iF �lf iE iF iE 3h it x iE�F 1f iF 1(� K• X� 1E iF 3F iF 1E �)E iE 3F %16 3f iF i4 if� iF iF 1F3E ii� iF N� iE 1E iE fE� ik �(�
LEGALIZATZON;N F E E 3 YU M M A R Y S'I'RT)CiURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRFC�.,MECHANIC FIRE SMIF/RE�S�� GRADSNG
PERMIT 81,00 � 60-
SMIP/NON';RES
PLAN 57..65 �
ISSUE l�'EE � �j i '�
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 81,60 O.OQ ' S2.65 139,25 139,2� ,QO
REVENUz DIVISION TOTALS--> COLLECT$D; 81.60 OVER/SHORT• �',�
BLDs1�00 PLOMBING ELECTRIC MECHAN�C FIRE SMIP/TO�T GRADING,�LAN—CHECK
i � �
1ElE if iE iE �E iE iE �E iE # it iE if # �(� if ik iFiE 16 if 3F ih �lE jE iE iE ik if 34 fE if it �lE iE �lE # iE 9(-iE ib 3( iFif �E iF 3t� iE 3F iE i4 # iP # iE # iE %� %Il-# fF 3t 3E X� iF#-k ;f� jF if iE 3F iElE iE # iF
I N D I V I U U A L; F.E E B R E A K D 0 W N "
��t
TYPE QTY D E S C R I P T I O N UN3T COST 'TOTAL COST
SFR 81 DWE—TYPE V—WOOD FP.AMD�OF FEES —GOOU 79,00 � 5,994,00
� �.
� ��I
��
' � .. ,� .. .
r`-�-,�
CON$TRUCiIONANDPIANNING P00� 'A
qppROVALS Permit # Date Inspector pppqOVALS Permit # Date Inspector
�
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
' a.
�,. Spil Pipe�Undrgrnd. 53. 5[eel Reinforcement
3. Electrica4 Condu+t Uiility-Undrgmd. 54. Forms
4. EI¢ctrical ConduibUndrgrnd. 55. Electriwl Bonding
5. Steel Reintorcement 1� p li.l- 56. Rough Plumbing & Pressure Test
6. Hecirical UFER Grnd. ���� 57. APPROVALTO COVER-GUNITE
7. Faotings �� � rfL p�- 58. Electrical ConduirUndrgrnd.
�
8. Faundacion 59. Gas Pipe, O Undrgrnd., Test
9. Waier Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgmd.
70. Structural Floor System (����°IZ � 61. APPROVAL TO DECK
i t. Property Sewer Line & House Connection - 62. Backwash & Receptor�Final
l2. Sewer Cap . 63. Heater & Vent-Fina1 '
73. Roof Drains 64. Plumbing System � Final
1q, Rough Plumbing 65. Electrical�Final
15. Rough Electrical-Co�duit 66. Solar System-Finaf
16. Rough Electric Wiring 67. Fencing & Access Approvai
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Reugh ElectricabT 8ar Ceiling 69. POOLISPA SYSTEMS FINAI
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Struaure 'J0. Underground Hydro
22.Ducts,Ventilating 77.Produc[PipingOGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Aoof Framing 73. Undergrnd.Storage7ank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structuraq & Monocoat 75. Dry Chemicai
27. Frame and Flashing �//� �� 76. Dry Standpipe
[�•�
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation (� i�� 78. FIRE PREV. FINA�
30. DrYwall Nailing L_ HEALTH DEPT. REQUIREMENT
31. Plasier Brown Coat � 79. FINAL INSPECTION
32. Electrical Power MeterFinal � ' � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � j �� Notes: ,1 3 r/'y it,u�
34. Final Heating & Air Conditioning � y�/p�� _- 1- /7,,
/ L - ��a�l�/��--.
35. Final Gas Pipe�Test � ' � � _ '� C�
� 1 � _� _ _ B
36. Hood or Canopy � '
i
37. Final Factory Fireplace �
� .. .
38. Final Plumbing
39. Water Service�Final t � .
40. Gas Service-Final ,
i
41. Solar pomestic-Final ' I
42. Backflow Preventer � ,
43. Backflow Irrigation
44. Landscape Irripatiog SYstem
45. Sound Attenuation�
46. Handicap Regulatior�s , �
47.FINALSTRUCTURE&_9UILDING /��L�•��_ �� ,�?;( � ���
� ���.- �
48. FINAL PLANNING "
49. Electric Release to �Edi$4n �
50. Gas Release to SouiAer� California Gas Co ;
51. CERTIFICATE OF OCCUPANCY
No. Date
i� �(� •,�s
���� �ns
�2"� � i °2
TESTING
April 7, 1975
Twininq Labosatories ��f ���«���_,� ��=c�f,zit«<, �,_�.
?Q BOR <] .?3i0 ni2oOP.� wPY . LONG BEACH CP.LiF. 902GI .�L3� ,763355 . 2i3� 53o-2385 . U�al 628-be32
=..nc� n=Fcs
isnDuc..•r• ..s,.ee� - --. G�ro�.., .e �a
Se-�en�n Ce � �aa+U ,� � vass>ed-oo..= oo eo.n
Ili.�9i ]45 �y� n ', - . ,�n Cm ccf0i :lil� :leDEe .
'��.�I;L' ��.
�a_s
Examination: $�]5'�5��
COMPRESSION TESTS ON GUNITE CYLINDERS
MY. L. E. Sprague
5041 Doanoke Avenue
irvine, Lalifornia 32705
PROJECT Sw(mming Pool for JACK FULLERTON PermltN 39712
ADDRE55 2Dn3 Europe, Costa Mesa
SAMPIE fROM 1 b 1i Shallow End: 2 b 5 IJa11: 3 E 6 Bond Bean
APCNIIECI
ENGiNEEu
MIX
DATE CAST
DATE TESTED
' CYLINDER NO.
COMPRESSION
TOTAI LOAD, LBS.
POUNDS PER 50. �N.
SIZE:
� COMPIIANCE
CYLINDERS
CON1RACtOR
Continental Pools
SUBCONINpClOe
Coast Gunite Co.
SPECIiIED
(.] 5F7CIC STRENGTH
3-31-75 CVLINDER sai
4 7-75 4-7-75
� 2
7-Day 7-Day
11II,000 104,000
3,556 3,134
6-I/2" x 12-1/4" ti-1/2" x 12"
7-day test complies wfth specificatlons.
MADF �Y DEIIVENED BY
L.E.S.� L.E.S.
oisrvieunow
'-L3Sta Mesa Bldg. Dept.
� Contlnental Pools
Coast Gunite Co.
L. E. Sprague - �
z,00n �sr
4-7-75
4 "HOLD"
3 5 "HOLD"
6 "HOLD"
7-Day
I11,000
3,618
6-1I4" x 12"
NECEIVED OH
4-t-75
a������� C SAFETY DEP7.
APR 11 �975
c%,��
�� �...,.. �....,,, .,�..� ��,��.,.�.t._. ..�...,�.o4,e.. ���, „�, .,N,
. . O�.e c CO�.CL�.S.pnS .
�• 5 ��n.� � ul .r i .. r.l� ♦ i�f .�. f.:)'., v n� .. .a. •> � v..i.,sL ".. F� V. •G C.�E�.•S .! cVG1iC �nD OiuSfl�'FS
owNEx PACESETFER WEST JO INT VENiURE npTE OCi 2 3 t962
JOB ADDRESS p�Z L3irnrs �va� BUII,DING PERMIT NO. ].7��
GENERAL CONTRACTOR ��OS L&IId CO. VALUE $1H,133.00
AP No.139-��+-09 LOT 2 TRACT �g4g FIR� ZONE DESCRIPTION OF \VORK j�S.W/
INSPECTIONS I Signature DATE GROUP j$�J TYPP y 7.ONE R-1
: PLRMI7'S iSSi
G� SUBCONTRACTOH DATE NON
1
OCCUPANCY
'ORM BU4 � SM - �
. • 1791�9
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 917 COHTA MEBA. ���P���A
For Applicani fo Fill In Complefely
TYPE OR PRINT
Aoo` e'8s 2%D �U � �a.�
COSTA MESA CALIFORNIA
W�C�'�2 !tlEs� � � �
ADORE55 /� �J l �.( ���L/ f�� T
I BLIC.rNO. �� I I�� TNO
NO. OP 6LDG9.
■ 86TBAGi( IJNC FROM
DESCRIPTION OF WORK
� BUIL�ING // / it NO. OF
FEE R�CE6VED
�J ocT 1 ,ss2
FIN?,NCE DEPT.
CITY OF COSTA �IESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
HECHIPT NO. �ellMi7 �Q
� �l l
er � o� � n�eryfoG� �Pv1 `L '3 n�
d
,?�03 �e
COSTA MESA. CA FORNIA
FIRE
i ZONING
20N8 NO.OP UBH OP N8W
�—� I PtAN9 L, I BUILDINO �
L80AL .. _ _4 ✓
YARDS
APPROVED
(ClNT[P LINE BTJ
APPROVED
z o.
2 '7
SUC� 16ti' ���'' i o� -{� '
1 HePH�V AGKNOWLPDGE TXAT 1 HAVB ReAO TNIB APPL�GT�ON TME AMOUNT BXOWN UN�ER VALl1AT10N 1 OR THe
AND BTATE TXAT THE ABOVE 18 GOPNBGT AND AOREB TO COM- pUliPp9E OR EBTABLI9XING /. PlRMIT FEE ONLY.
PLV WITN ALL CITY OFIOINANC¢e AND H}AYQ uW8 qBOULATINO
euiLotHa coHernurno/N. �� , VALUATION /
SIGNATURE OF ,�/ � PERMIT FEE $ v�• ��
PERMI7TE '� �(�j 8�Q
(/�/�/ S /"/ / � � PLAN CHECK $ �O• ��
AUTHORIZED AGEN'Q.^''� ' 't � l7 �
TOTAL FEE O. ��
�
:• OWNER FULLERTON� JACK onTE 3-1�-75
':. JOB ADDRESS �Pa r• BUILDING PERMIT N0. 39'212
�
�
Pool Location
Forms
Main Drain
Stee� Reinforce
Elec. Bond �
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines and Recep.
Electrical Final
Heater and Vent Final _
r System Final
Backwash and Recep. Final
Fencing Final
T
FIRE ZONE VALUE
Date GROUP TYPE
,ZY%`) SUBCONTRACTOR
� Eiectric
�l�l`a P +.�i�in�i.✓%�?OE
. .�
Plumbing
4 A K �!/'0
����
%i� /_7D
' 3�712
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COS7A MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUII.OING, � �O
ADDRESS
OWNER �(/ /�p
MAIL
ADORESS .���!'✓`"Q •
TEL.
CITV QS � ,9 N0.5$J�3
CANSI'RUCTION Q , �
BRANCH
ADDRESS
OR ENGINEEF /-�• � � ��/7 KO � NOL(D��'�
ADORESS �`d3:��!' F✓!/G� c' G'
CONTRACTOR�p�l�i�y p�y��L (.�'ev �S
ADDRE55 �� C�I'� �/�i-�e-L�,iq �!j -" �
iEL.
CITY �Nn /�.i�.� ' NO'�.Z( —O
STATE CITV
LIC. NO. "'Z� p j Qg LIC. NO.
SIZE NO.OF BLDGS.
OF LOT NOW ON LOT
USE OF iJ � ���' �✓��
EXISTING BIOG. S/.y.
SIZE OF / NO. OF
NEW BLDG. (O S D ROOM$ STORIES
EXTERIOR WALL ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
PAIU tk„
•;r,R 14-75�,,c. �t� 497'� * 4R.50
APPLICATION FOR BUILDING PERMIT
'�EIV€O BY DAT%REFEIVED DATE ISS E
4C% � t ` ����
BUIIDING n
ADDRESS p` �
TRACT
OWNER
FIRE
ZONE
APPROVED
" V'% � :� ��
/
�U %Z O i9 ,
LOT �j,� BLOCK
F
i�//�/l %�.✓
� � VALUE �
ZONE NO.OF USE OF NEW$1�/+�^�''�^'
I PLANS � BUILDING �Z
VAR�SAPPfiOVED VARDSAPPROVED
MAIN BUILDING ACCESSORV BUILDING
(FROM GLSTREET)
FRONT FT, i� FT.
q. Slf]F FT .�L O cT
VAR. #
C.U.P. #'
BET
I hereby acknowl¢tlpe thax I have reetl this application antl stete
that t�e ebove infarmetion Is correct antl aBree to comply with
ell lews reBulating building eonnruction, antl I shall not amploy
any penon in viola[io� ot the workman's compensaUon laws of
the Stata of California.
I hereby certify thai l em proparly licensetl as a conbactor ander SQ. FT
the Stete of California Businass entl Profezzlons Cotle, Dlvlslcn 3, THE AMOUNT S
Chepter 9, end Mat su�h Iicensas ere In tull force end affact, or 1 THE PURPOSE OF
am azempt from the provisions of the Siate o( Celltornie eusiness VALUATION
antl Protasslons Cotla, P���sion 3, Chapter 9.
SIB^etura of / // �
Permittea �"�•-����'� � $ �� ,�.
Authorizatl ABent `^' "� � ���
BET. MAIN &
ACCE55. BLDGS.
APPROVED �� � �'7S
1VV-'
/
•aD
/ O
VALUATION.IS•�OR �
A PERMIT FEE ONLV: Q
m
E $ � � �
/� � m
KS E
s �.5� c�J �
LL