HomeMy WebLinkAbout2074 FEDERAL AVE - Building Permits� :
(7t4) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
,lob Address: 2074 FEDERAL AV
Suite:
Vicinity:
Parcel Number: 42250105
Applicant: ROSS & BARROWS INC.
Adtlress: 260 E ALTON AVE .
SANTA ANA, CA �
Owner: PELAYO, ALFRED L
Address 2W4�FEDERALAVE �
COSTA MESA, CA
Contractor: ROSS & BARROWS INC.
Address: 260 E ALTON AVE
SANTA ANA, CA
Zip: 92707
Arch :
Address:
Phone:
Zip: License:
Zoning:
Phone: (714) 557-7440
' Zip: 92707
Phone:
Zip: 92627
Phone: (714)557-7440
License: 327802
Eng:
Addressr
ISSUED BY:
a�.vre vr rercrvn �
TEAR OFF EXIST. COMP. SHINGLES AND 1�LAYER 15LB FELT AND�30 COMP: SHIGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation:
Permit: $11125 � - - Claim Valuation:
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $111.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
PLANNING & ZONING
Rear 0- 0 Lek 0- 0
Rear 0- 0 Left 0- 0
Re uired: 0 Proposed: 0
Right 0- 0
Right 0- 0
Status: ISSUED
Applied: 08I17J2002
Issued: 08/12/2002
Phone:
License:
$4,350.00
$4,350.00
NOTICE: The work aulhorized by this permit shall comply with all applirable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or it work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell
required Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this pertnit.
FOR INSPECTIONS CALL: (714) 754-5626
!aas�ae IeAo)
WORKERS' COMPENSATION DECLARATION: f � 4
I hereby aMirm under penalry of perjury one ol the tollowing tleclarations: �
❑ I have antl will maimain e cenificate of consant to selt-Insure for workers' compensation, as provided for by section 3700 oi the Labor Code, br Ihe peAormance ot t�e
ork for which this permit Is issuatl.
I have and will maintain workers' compensation insurenca, es requireA Oy sectlon 3700 ot Ne Labor Code, for �he pertormance ol t�e work for which this pertnit Is issuetl.
\My w e compBns�a/tlq/� Insurenc wrIne�r a/� p/�policy number are: ,(�
Certier ��� %£�Yi �(/�✓�/l PolicyNumber SL �� �OZ � O�O S�/r
(This secfion need nof be comp/efed i�permif /s valuetl et one hundred dollars (S700J oi less.)
❑ I certify that in Ihe peAormance ot t�e work for which t�is permit is iuued, I shall not employ any person in eny mannar so as to 6ecome subject to tha workers'
c �on lews of C,a�ifornia, entl egree that If I should bacome subject to the workers' compensatio�p[ �visions of Sactian 3700 of ihe Labar Cotle, 1 shell fonhwith
om I wi�h ese pr�si n5. � \ ^ � Z` Q�
��`P� ��� / \ C/
licanl Signature� ( Dete: J D
WARNING: RE TO SECURE WORKERS' CAMPENSATION COVEiiAGE IS UNLAWFUL ANO SHALL SUBJECT AN EMPL O CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNORED
THOUSAND DOLIARE ($100,000), IN ADDITION TO THE COST OF CAMPENSATIpJ, DAMAGES AS PROVIDED FOR IN SECTIdJ JI06 OF THE IABOF CODE, INrEREST, AND ATTOFiNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 h licansed under pmvisions of Chapter 9(commencing with Section 7000) of Division 3 ot the Business d Protessions Code, entl my Ilcense is in full
� e and . Lic. q�,���l� "Z lass �`.7 y
CONSTRUC710N LENDING AGENCY:
❑ I hereby attirm that there is a constmction lending agency for �he pedormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lentlefs Name: Lender'S Atldress:
Signature: � Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn that under penalty oi perlury ihat I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sac. 7031.5, Buslness end Professlons
Code: Any ciry or county which requires e permit �o construct, eltar, improve, tlemolish, or repair any sWCNre, prior to its issuance, also requires tha ep0licant lar suc� pormit
m file a signed statement thet he or she Is Ilcensetl pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) oi Dlvislon 3 ot Me
Business antl Profassions Code) or Ihet he or she is ezempt therefrom end the besis for tha alleged e:emption. Any violation of Section 7031.5 by eny applicent for a permit
subjecis the applicant to e civil penalry ot not more �han five hundretl tloilers ($500).):
❑ I, as owner of ihe property, or my employees with wages as Iheir sole compensation, WILL DO 7ME WORK, and ihe structura Is not intentletl or otteretl for sale (Sec.
7044, Business and Protessions Code: The Contractors License Law dces not apply to an owner of pmperry who builds or impmves Iheraon, and who tloes such work
himselt or herselt or through �is or her own employees, provided thet such improvements are not Intended or oHeretl tor sale. If, however, the builtling or Improvemeni is
sold within one yeer of completion, the owner�Duilder will have iha burden ol proving �hai he or sha did not build or improve for puryose ot sale.).
❑ I, as owner of lhe property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct tha projact (Sec. 7044, Business and Protessions
Code: The crontrectors Llcense Lew tloes not epply to an owner ot property who builds or improves thereon, and who contracts tor such pmject with a contrector(5)
license Dursuant to ihe Contractors License Lews.).
❑ I am exempt under sec. Business end Professions Code for ihis reason:
Signature: Date:
Owner ID venlied 6y tlriver's license. ❑ Ves ❑ No Onvers Licensa No. Expiras:
Venfiwtion oi Ownership by (rype of documem, i.a. - properry taz bill or daed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATION:
❑ I hereby cartity Ihat no excavation live (5) or more teet in depih into which e person is requiretl to descend, will be matle in connection with work euthonzetl by Ihis
permit, and that no building siructure, sceftoltling, falsework, or tlemolition or dismantling �hereot, will be more ihan t�irty-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle B, Celilornia Administrative Code).
� As owner-builder, I will not employ enyone to tla work which would require a pertnit irom the Division of Indusiriel Satery, as noted ebove, unless such person has e
pertnit to do suc� work trom the division.
Signature: Date:
Division of Industnal Safery Permit Number:
CERTIFlCATE OF COMP�IMICE AND AIfTMORQATON OF EMRV: I certity under penalry ol perjury that I have read Ihis appliwtion and stata that tha information given is
cortect. I agree to compy with all sate lews entl city ortlinences relating to building consiruction, and authorize represeniatives of ihe Ciry of CosW Mesa ta enter upon the
ebove-descnbetl pmperty tor inspeaion purposes. I agrea not to occupy or allow occupancy of eny builtling authorized hy this pertnit un�il tinel insDection.
[1T7��1IF9�tyi[•P.i�79�
1616 Fixed System Final Fira Prevention
1268 Pool Spa Finel
200 Finel Re-Roof
201 Finel BIocWReteining Well
202 Final Factory Fire Place
203 Finel Sign
204 Final Damalition
PAg 1tII�L5
GODEI ixsvecnoxrrve
206 Final Mechenical
208 Final Plumbing
210 Finel Electrical
272 Final Flre Pravention
220 Final Planning Approval
222 Final Site
250 Final BuiltlincyOccupancy
�
Applicant to flll (n ail zoaces except thase within heavy Eoraer lines ana sign all approvriate tleclarations.
�C�r. ra MESA � LO STRUCTION� _ERMIT '"'T�'`^T "'^ � nr �in
Project Addre� 20 �1j/�'��%��.rA�- /t�[f/�
ApplicanYs N��iling A dress � �������//
� L- Phone �f��[�
Ownr.'s Name �
Addreos �� — ' �
Arch/Eng. � � License No.
Address 2 /!i �_l E
Convactor's Nam � Phone ��'Sx�'
Address (mailing) '� � • G •
Cicy License No. �� �"
IICENSED CONTRACTOR OECLAR TION
I nereby aHirm lhat I am licensetl untler provl5ion5 ot Chdr[er 9(CommenCing
with section 7000) oi Olvision 3 of lne Buslness antl Protestions Cotle, antl
my license is in f W I(orce ar�Qeftect.
Litense Class ��p. �S�- Licejn e � o
Date � � �j _u./ 51g t �„�M� /
RKERS'COMPENSATION DECLA0.ATION
reby aifirm that I have a certifica[e ot mnsent to self-insure or a<ertlfica[e
orkerz' Compe/nsation Insurance, o� a certifi¢tl coor tnereor (SeCtio
0. Lab. C.'/�L -rTI • •.' - c�`�� �J �^.
cy No. �Y _ ..Company `
Certitietl mpy iz hereby fumishetl.
Certi(ietl�o�y i f'letl with the city Bujj��g D vision. � ./� .[,
Date S � . � APplicant /� � � d�^'�,
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissettion neetl no[ b0 compleletl if the permlt IS for on¢ huntlratl (E300) or
Iczs).
1 certily tnat in the perlormance of Ibe work tor which this Oerm�t is issuetl 1
SM1all not employ any porsOn In any manne� so as to b¢come SubjeG[ [o the�
Workers' Compensation Laws of Calitornia.
Date Si9na[ure+ "^
NOTICE: I(, after makin9 this tleclaration, you shoultl become subject to the
Workers' Compensation provisions ot the Labor Cotle, you must forthwith
comply wi[h such p�ovl5ion5 or tnis pe�mit shall be tleemetl revOk¢tl.
CONSTRUCTION LENDING AGENCV
I hereby altirm that there Is a construction lentling agency tor the parformance
of the work for wMch this permit is issuetl (Section 3097• Civ. C.)
Lender's Name
Lentlei's Atlaress
OWNER BUILDER DECLARATION
I hereby a(firm that 1 am exampt from the Contractor's Llcense Law for the
lollowing reason (Section 7031.5 Buziness antl Professional Coae: Any city or
county whicn �equire5 a pe�mit t0 cOnSVutt, alte�, improve, aemoli5h O/ repai�
any slructure, prior [o its issuance, also requlres the applicant for such permit
lo /ile a signetl sta[ement that he/she i5 licensetl pUrsuant to th¢ Provisions of
Conlractor's License Law (Chapter 9(commencing with Section 7000) of
ion 3 of [he Business antl Profesvons Cotle) or that he/sne is ezempt
from antl tne basis lor the alleqetl exemp[lon. Any violation of Section
5 Dy any applicant tor a pe�mit Subjects the applicant to a civil
Ily of not more than tive huntlretl tlollars (5500�.
as owner of tne OrOp¢r[y or my employe85 with wage5 as thelr Sole
compenSation, will tlo lhe wo�k, antl [he st�ucture Is not intentletl o� oifGr¢0
lor sale (Section �044, Business antl Professional Cotle: The Contractor's
License Law tloes not aDP�Y to an owner oi a properry who builtls or improvez
thereon, antl who tloes such work himself/hersell or through his or her own
employces, provitletl Ihat such imprnvement5 are not intEntletl or ofte�etl tor
sale. If, however, lhe bulltling or improvement is soltl within one year oi com-
D�etion, ihe owner wlll have ihe burtlen of proving he/she tlltl not bulltl or im-
prove fortne purpose of sale).
❑ I, as owner ot tne property, am exclusivaly contracting with IlcensaE con-
tractors to construct tne projec[ (Section �044, Business antl Professions Cotle:
Tbe ConVactor's License Law tloes mt apply to an owner of Oroperty who
builtli or improves thereon. antl who con[rac[5 for Such oroiect5 wi[h a r.on-
tractor(sl Lcense pursuant to tne ConiractoYs LiCunse Law). I am aware thac
proof o� lheir WorkePs Compensa[ion insurance Shoultl be p�ovlAetl [o me.
❑ I am exemp[ untler Section B. & P. C. for this reason
Date Owner
I hereby certity that I have reaa this applicatlon antl state Mat the above
informatlon is correct. 1 a9ree to comply with all city antl county ortlinances
antl s[ate laws r�{7�� to builtl'v(d WnStrucUon, antl hereby autttoriz� re0re-
snntatian: ni uSiz ci! c6 eN€Jud6n the above-mentionetl ornne tv tur
Icense or 5�/$ _
rev. 5/88 White - Bu
��67ag �• �7��- ,� 3S � .,..., ,..,.
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ �EMOLISN ❑ OT E • 3 F
4ESCRIPTION OF WORK/USE9 F BLDG.
$�YSZ�1�t—K.�]eQ A �
TYPEOFPERMIT L�GRADING FOUNDATION STRUCTURALI
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL
❑ OTHER I'1� ����� /
PROJECT DESCRIPTION Sq.F7. oCCUaA,N�C.v . `' I�� '
CONSTRUCTIONTVPE� VALUATION$_3/./Fs/'=
—�• --�—
ZONE GRADINGCU.YDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
rinking Pountains
loor Drains
loor Sinks
85 $2lVIC2
Kitthen Sink
Lavatories
P-Trap
Raof Dreins
Reinspec[ion Fee
$15
Boiler
Duct - Under Ground
Duct - Strucmral
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. BIL iCBO #
Heating System & Ducting
00-100,000 BTU O 100,000 BT
Reinspection Fee
Ganary - Applican[; Pink - Attountin9: Goltlenrotl - Assessor
$15
4� 2sj 8Y
ABING
Showers
Service Sink .
Sewer Cap
Sewer Connection
Solar- Col lectors
Solar Tank '
Swimming Pool w/Spa
Urinal
Water Closet
Warer Heater Re�
Water Service
Auto-Wazh
Laundry Trays
Isue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration Sys[em
❑0.100,OOOBTU ❑100,000
System Repair/Alterotion
Fire Dampers
Registers
Issue Fee
n.P.# L1-SC
S Main Building:
TFront � �
A Rear S� �
C Right S`� p
S� Left ((� �
Ping. Ref. #
Planning Notes: �,
��
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher - ." '
�Dryers ❑Gas Electric �
Fan '
F.A.U. _
Device Boxes
Outlets
SWISCI125 �
Garbage Disposal
Generator �0.5
ReinspeMion Fee
zone
Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ SO+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps .
Sub Panel
Motors 00�7 HP O1 h- 8
Inc.Solar 09�75 HP �16-15+
Microwave �
Pole Light
Range
KW OS-75 KW
♦i
•
$75
Standing Sections
TraSh Compacmr
laue Fae
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zoning APProved By
FEES Building A{iproved By
T Aooliption laued Bv
FEES
J
, SUMMARY OF FEES
} BUILDINGPERMIT $ ZR%.SO SMIP $ Z.I�
PLAN CHECK $ PERMIT
' PLUMBING $ � ��UANCE $
PWN CHECK 25% $ ENERG� P.C. $
ELECTRICAL $ GRADING $ '
PLANCHECK 50°6 $ MICROFILM
, MECHANICAL $ TOTALFEE $
� PLAN CHECK 25% $
� �J.-r-� �
i�.I�JuT v:. �.�1;-rJ_'�43
U'i f���. ii?� .b.'rr___. '"
.�r �. . ,.,. ... . __ _ .
O
N
1
N
G
R
E
Q
M
T
$.
� . .. .
. 4�
, CONSTRUCTION AND PLANNING ' P� '0'
' APPRC�VLjLS Permit# ate Inspector qppROVALS e�# Date Inspector
�.
1�. Temporary Electrical Service or Pole 52. Pool & Equipment Location
f
-�. Soil P pe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. . 54. Forms '
4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding .
.: Steel Reinforcement 56. Rough Plumbing & Pressure Test �,-�
6. Electrical UFER Grrid. (� 57. APPROVAL TO COVER-GUNITE
,� •
7. Footings �� �/, 58. Electrical Conduit-Undrgrnd.
8. Foundation • � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. ;•�
10. Structural Floor SYstem , e 61. APPROVAL TO DECK '
,
11. Property Sewer Line & House Connection . , 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final
'• �
13. Roof Drains � . 64. Plumbing System - Final
14. Rough Plumbing , �? � 65. Electrical-Final
,
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
a
1�8. Rough'Electrical-TBarCeiling 69. POOL/SPASYSTEMSFINAL
19. Rough Heating & Air Conditloning FIRE DEPT. REQUIREMENT
�20. Rough Factory Fireplace 'i APPROVALS Permit #
' 21 . Ducts, in Structure ��� 70. Underground Hydro
� 22. Ducts, Ventilatirx� f i ��, ��. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough"& Test ' / 72. Un rgro�d Flush
24. Roof Fr�ming,i :: � v 73. Undergmd. Storage Tank O Gas ❑ Oil
25.,Roof*heathingl)'� V� 7i3 74.OverheadHydro
26. T-Ba� Ceiling (St#uctural) &jNlonocoat 75. Dry Chemical
� .
27. Frimeand Fla'shing .�� U7� 76. Dry Standpipe
28. Lathing�& Siding `! 77. FIXED SYSTEM FINAL
�-
29. Insulation =� e7 78. FIRE PREV. FINAI
30. Dr,yw211 Nailing ��� %��' �` 7z � . HEALTH DEPT. REQUIREMENT
31. Plas'ter, Brown Coaf•� `� Y, 79. FINAL INSPECTION
32. EIecEFical�Power Met2r-Fina�l'"' - 7�� 80. FOOD CERTIFICATE ISSUED
33. FinaI:ElGctric �,�,i �''� • Notes: . . �
� ,
34. Final Heating & Air Conditioning/ � � � �, �f! Qg /J
ai
35. Final Gas Pipe-Test • � (�J
36. Hood or Canopy _ ��,�-� B
37. FinabFactory Fireplace - ' .' �
38. Final�Plumbing � ' ?�/ Q� (,�
39. Water Service-Final : ��Q� �
�40. GasService-Final � �3� �
41. Solar pomestic-Final �
�' i..
42. Backflow Preventer ' «'t ' ��:
43. Backflow Irrigation ' '' ' . . }
'� d,:
44. Landscape Irrigation System • .�'li , ;:(
• 45. Sound Attenuation , ' ' � ' �.
46. Handicap Regulations _,
.
47. FINALSTRUCTURE&BUILDING � � 0" '
48. Special Requirements Completed ^ �,
49. Elect;ic Release to Edison •�� � `�� �
1
50. Gas Release to Southern California Gas Co � �• ' -. -;' �
51. CERTIFICATEOFOCCUPANCY . .� � ,.� ' t� :���:�� .�,�.�.
No. Date . • � �' '
.�
ITY OF COSTA ME'' �
CA�IFORNIA 92628-1200 P.O. BOX 1200
Insulation Certificate
� � �� -�� � � �, ,�� C����-- wl�,�
N�,� �,a s�« c�ty
02�Nc� �r�A�K� �� � 2 35
coW,ty . s�ba;rision tqinumber -
Description of Installation "`
ROOF /
Material ��/.s�SI�`r,,.� BtandName ��� y-P/C
'Ihiclrness (inches) � fu '� 'll�ermal Resistance (R-Value)
��
$XTBRIOR WALL /
Materia] ,.-.o � S Brend Name �.S o/�.� �n s� e�
Thiclrness (inches) 3 i .r �� Resistance (R-Va1ue) /
CEILING ^-� / �,// /�
Batt or Blanlcet Type ,C�.-- �T Brand Neme � o%� ^ /�/a.sf-�'c ��
'Riiclrness (inches) ���� 'ihermal Resistance (R-Value) 3 �
Loose Fill Type Brand Name
Conuactqr's minimum iRstalled weight/ft Ib Minimum thiclrness inches
ManuCacc�er's installed weight per sq�are foo( to xheive T7iamat Resistance (R-Value)
RAISED FI.00R
Material
'Ihiclrness (inches)
SLAB FLOOR
Material G c � c- r�t
Thic}a�ess (inches) 3 � � '
Width (inches)
�OUNDAT[ON WALL
Ma�eriai
'IhicF�ess (inches) —
Brdnd Name
Thermal Resistance (R-Valuej
Bcand Name
"Ihemial Resistance (R-Value)
Brand Name
'Ihermal Resistance (R-Value)
Declar3t9or_
I heieby certify that the above insulation was installed in the building at the above location in conformance with
che cwrent Building Energy Efficiency Standards for new residenual buildings contai�red in TiUe 24 of the
Califomia Administradve Code.
_ �// C� ,�..-/� ,� S%o ss�a
—�Ger 4a �Con�actor Builder) L�censc Number �
_ �.e��.� ,�-s.�� y � 9�
' Signazu�nn'dTitle Date .
SubContracinr(Insulazion Installer)
Signature and
Licrnse Number
Costa Mesa Building Department APPLICATION T� OR PEYZDZIT
111 EAST 20th STREET �1 B U I.L,D 1� N.G _. _'.
COSTA MESA, GALIFORNIA - -
FOR APPLICANT TO FILL IN �OR OFFICE USE ONLY '
Receipt No. Permit:No. ^
Building �O?v y� n w I ' �pC�-
Addra%9 G_ j lAM�- � . .
L'O5te� nZC3fl� California Recetved by, Oate eec'd. Date leiued ,
� I 5�7�,i5� ;
;
Nearest Buildtn Gf 7 y� �
Cross St. �A� l%� ��� pddress i4 �/� ��+.c�-�-
GtF_�
ow�er � .L i� � Costa Mesa, California ; �
Mail '
Address iO� ) Y ��.P,Y �v� Nea�est � .
,J Tel. Cross St. � �
City Cn </a�- �-V9 a� No. Zon�/ ; I No. ot I Type ,/ i Group
Plans Y l�
ArohiteGt or LiC. _ . . _ _ .
City L
LVI
No. � S Block Traet ����
{CN//o
C...r�
1g.
ie from
New
INo. of Bldgs: /
Now on Lot
INo.of � No.of
Families Rooms �
Rear Vard
Building . No. of
Size � � x �� Rooms /
:eriorWall,fJ�/M,�e�/ I Root
vering ia+X �" Coverin9 '
Use of New , �, . , , , .,
u
� �" '_� 1 It',1 �
�
.t1�=-- - ��'.,J
.n:' •
.. _ . . _ N - 1J� _. _ _. .
, , . � ....
APPROVALS
�� ��" �!• �' Forms,MateNals,
�,�.-,••.... >�V �j'�'�(jc.-� . Under-Pinning
�— � Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application Lath. Int.
�and sCate that the above is crorrect and agree to mmply Lath. ExA
with �a71 City Ordinances and State Iaws regulating
'buildin€ constructp�
Signatureof ,.,f��� �_ ,�] P�aster,lnt.
Permittee �� �""'�fiC
� �- - Plaster, Ex4
Authorized Agt.
Masonry Reinforced
Valuation � / Permft Fee $
Plan Check $ 2'� V Bond Beam
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Fee S � FINAL
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ORANGE COUNTY BUILDING DEPARTMENT ', APPLICATION POR PERMIT ��
" 636 North B.oadwaY -' � ■ .' � �' � ^ — -
SANTA ANA, CALIFORNIA V V
FOR APPLICANT TO FILL IN FOR OFFICE USE'ONLY_
NEAREST
=RossST. Victoria Ave.
OWNER A�EUT HONES� INC.
MAIL /
ADDftE55 ��p� WIL$HIRE BLVD_
TEL
ciTv BEV.HILLS No.�R.
ARCHITECTC�N S� MCKERRACHER TEL.SY
ENGINEER NO.
AODRE55 2jjO E. WALNUT ST.. PA
TEI.
NTRACTOR NEWPORT VISTA CONo. CR
ADDRE55 6 WILSNIRE BLVD. BEV
LEGAL
DESCRIPTION LOT NO. � BLOCK
(ATTACH METES 8 BOUNDSJ
/ NO. OF BLDGS.
SIZE OF �OT pZ Y��Q NOW ON LOT
USE OF ( NO. OF I N
EXISTING BLDG. FnKw[s R
DESCRIPTION OF WORK
BUILDING ��
SIZE
WALL
COVERING �
USE OF NEW
BUILDING
IROOF COMPO
COVERING�,�., �,�.
RESIDENCE `I- � '�-
RECEIPT NO; PERMIT NO.
— �O � J �o. lf�:33 �,
RECEIVED BY DATE OF APPL. �ATE ISSUED
: (0-,23�5,-� !o-%�� �3
BUILOING � � ^//� � � /
ADORE55 / T \ t�I �'�'L
SCHODL OIST. �j_ �
— OR TOWN � / �/Zti—K�
� NEAREST y� �
GRO55 ST. /
� ZON NO.OF TYPE I GRO_U1P
_ I PLANS I I IPi�S �:
A SETBACKLIN�„ F OM CENTER OF ST. 5S 11.• •
REAR YARD L�� j�t }SIDE YARD �]I.F'j�� 11� '
/ .
�L APPROVEO . �
BY DATE
S ' CORRECTIONS �
APPROVALS
FOUNDATION: LOCATION INSPECTOR OATE
I HEREBY ACKNOWLE7GE THAT I HAVE READ THIS FORMS, MATERIALS. �'/1 ^��} �
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING !� 7 �
AND AGREE TO COMPLV WITH ALL COUNTY OROINANCES FRAME: FIRE STOPS.
BRACING, BOLTS /�
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. �{� /� �
LATH. IIiT. ./� 7 "/� / �i �
0 AUTHOF2IZED
s 4830.00
VALUATION
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