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Home My WebLink About2134 ASTER PL - Building Permits, �� CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE: B COMBO Sub Type: RES_ALT JOB ADDRESS: _ 21�34i�A§TER`PL CM APN: 42615129�— Vicinity: FIRST AND SECOND FLOORS Const Type: V-B SQ. FT: Zoning: , , 121 PERMIT NUMBER: BC10-00262 STATUS: ISSUED DATE ISSUED: 11/10/2010 ISSUED BY: �'('j Suite/Unit: Primary Occ: Valuation: $35,000.00 SCOPE OF WORK: 121 SF ADDITION TO A 2-STORY SFD. WORK TO INCLUDE FIRST FLOOR: 92 SF EXPANSION AND REMODEL OF KITCHEN AND DINNING ROOM. SECOND FLOOR: 29 SF EXPANSION OF BEDROOM # 2 FOR CLOSET. 42 LIGHT FIXTS, 20 OUTLETS, 13 SWITCHES, 1 SUB PANEL TO 200A, 1 DISHWASHER, 1 KITCHEN HOOD, GAS OULTETS (1-4) AND KITCHEN SINK. OWNER: BLOOMFIELD, FRANK R TR Phone: 714d04-2370 APPLICANT: LAWRENCE LE BLANC Phone: 714-631-5978 Address: 2134 ASTER PL City/Slate/Zip: COSTA MESA, CA Address: City/State/zZip: CON7Ra,C70R: LAW RENCE LE BLANC CONST License No. 489594 Phone: 714�31•5978 Address: 22501 CHASEUnit: Cell: Ciry/State: ALISO VIEJO, CA ARCHITECT: WILLIAM MASON ARCHITECT ENGINEER: CLIFF HATTAR COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: License No.C23759 License No.55630 $32029 $0.00 $128.36 $34.15 $49,25 $3.50 $0.00 $2.00 $636.10 Unit: Unit: : UNIT 12213 ZipCode 92656 PHONE:714-427-0688 PHONE:714-447-4870 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2070 - PER CMMC Sec. 13-279 Monday thru Fritlay- 7:00 am thru 7:00 pm. Saturdays- 8:00 am thru 8:00 pm. Prohibited all hours - Sundays and thB f011owing Federal holiday5: New Years Dav. Memarial Dav. Indeoendence Dav. La6or Dav. Thanksaivina Dav and Christmas oav NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) El(PIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COOE %. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 7266 Pwl Spa Final Z00 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 �� 204 Final Sign Final Demolition onTe mnna�s cooez ixsvecnoxnve 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 FinalPlanningApproval 222 250 Final Site Final Building/Occupancy DRTE INT71AL5 WORKERS' COMPENSATION �ECLARATION: I here6y affrm under penalty of perjury one o( Ihe following declarations: ❑ I have antl will maintain a cerlifcate o( consent to self-Insure for workers' compensation, as providetl for by section 3700 of the Labor Code, for Ihe �eAormance ot the work for which this permit is issued. have and will maintain vrorkers' compensation insurance, as requiretl by sectron 3700 of the Labor Cotle, for the performance of the work for which this pertnit is issued. My vrorkers' compensation In rance carrier and policy number are: Cavier: (Thusec(bnneedrw(Oe efetldt�e e�mrtuvaluetlalan untl�MCdlars(4f00)wless) Policy Number: ❑ I certify that in the pertormance o( the work for which this permit is issuetl, I shall not employ any person in any manner so as to become subject lo the workers' compensalion laws of California, and agree tha[ if I should become subject to the workers' compensa[ion provisions of Section 3700 of the Lebof otle, I s all forlhwilh comply with these provisions \ ""!�/ .An�� lJ � 's$ignature Da�e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and �sions Code, and my license is �n full force a/n�d 1eflecL � Lic. — / Class # �� c�br's Signawre Date �� CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that there is a wnswcfwn lending agency tor the pertortnance of the v.ork fa which this pertnit is issued. (Sea 3097. Civil Code�. Lentler's Name: Lender's Address: SignaWre Oate OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any struc[ure, prior to its issuance, also requires the applicant �or such permil lo file a signed statement that he or she is licensetl pursuant lo the provisions of [he Contracrors License Law (Chapter 9(commencing wi[h Seclion 7000) of Division 3 of the Business and Pmfessions Code) or that he or she is ezempt therefrom and the basis (or [he alleged exemption. Any violation of Section 7031.5 by any applican[ for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the stmcWre is not intended or offered (or sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have Ihe burden of proving thal he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct Ihe project (Sec. 7044, Busine55 and Professions Code: The contractors License Law dces not apply to an owner of property who builds or improves thereon, and who contracts for such project with a cmtractor(s) license pursuaN to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Owner ID verifed by driver�e. ❑ Yes ❑ No Oriver's License No. Expires: Verificalion of Ownership by (type oi document, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation fve (5) or more feet in deplh into which a person is required to descend, wiil be made in connection with vrork authorized by lhis pertnit, and that no building struc[ure, scaffdding, falseHvrk, or tlemolition or dismantling thereof, will be more [han thirty-six (36) fee[ high. (Chap. 32, Gry 2, M 2, Sec. 341, Ttle 8, Califomia Administ2live Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit (rom the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. ApP��'s SignaNre Division o( Industrial Satety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will �he applicant or present or future building occupant neetl to fle and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 0( the Cali(ornia Health and Safery Code requires, with some exceptions, [hat a Business Plan be fled wilh the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume ot 55 gallons, or 200 cubic (eet of compressed gas at stantlard tempereture antl pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cuhic feet ot compressed gas at standard temperature and pressure�. 3. Does or will the applicant or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutety hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Cali(omia Health and Safety Code provides tha[ the Costa Mesa Fire Department may require the preparation, certifcation and fling wi�h the Fire Department of an RMPP by businesses vfiich are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Heallh antl Satety Code been fully complied wi[h? ❑ Yes ❑ No 5. Does or will the applicant or present or future builtling occupant repuire for the work which is the subject of this application a permit for such construction or modification (rom ihe South Coast Air Quality Management District or from any other air pollution control tlistrict or agency? ❑ Yes ❑ No (Sectan 65850.2 of the Califomia Govemmen[ Code requires that the requested infortnation be fumished on applications fa non-residential building pertnits). 6. Will any part of Ihe tacility to be cons[ructed under this permit be wi[hin 1000 (ee[ from ihe outer bountlaries of a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requiremen[ of Sec[ions 25534 and 42303 of the Califomia Health and Safely Code). 7. If a permit from the South Coast Air �ualiry Management DisMcl or other air pollWion control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certifcate of compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the information given above is correct I agree to comply wilh all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ihe information given is correct. I agree ro comply with all state laws and city ortlinances relating to building consiruction, antl authorize represeMatives of ihe City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this permit until fnal inspection. S�gnaWr o! egalOwn ) �e SlgnaWre Date ^��/ / ��vZ„��—� /� //(� 905]-46(3I01� � �+5f -fied(or.Au orizeEA Imanl —�� i X i CiTY oF COSTa.MESA CO/N,STRUCT.�IOjN PER� IAT.) Prp'^�ct Address .%�J� � 77 �td' � � /"'� � (" /'k/ AppliwnYs Mailin/g Address gn%-:� � . � -+��.� �Owne�sName ;`--�'+�M� ��I/��f�MTjF��I phone_� L�/'� Address �139' ��'f"�fll � C' N� :.G1a�� y7 Areh/Eng. � EF3/4ULT : License No/ �� D70 Address /� � Contractor'sName �Y`-�N�' 'Phone Address (mailing) _ � City License No. 1' � LICENSE� CONTRACTOR DECLARATION � � ' � � 'ereby affirm that I am licensetl untle� p�ovlslons ot Charter 9(commencing' � h section 7000��yX Division 3 0( the BUsiness antl ProfeSsions Cotle, and , license ii M tull force antl ettect; ' ' . � License�Class � License No. - Date Signature �� WORKERS'COMPENSATION DECLARATIO�1 " � veby affirm tna[ I nave a certiticate ot�consent to self-insure or a.c¢rtificatG lorkers' Compensation Insurance, or a certHietl copy thereot (Section �� i, Lab. CJ _ . . �,my No. � ' - Company ' � eCertitietl copy is hereby fumishetl. . ' ', Certifietl copy Is tiletl witn the city Builtling�Division. pate ' Applicant � � EXEMPTION FROM WORKERS' COMPENSATION'OECLARATION � � (Thissection need not be mmpleted �i the permit is tor one huntlretl ($1�00) or" Iess). . I certify that in tbe performance ot the work /or'which tliis perm�t is issued, I shall not ernplov any person in an ner so as to come subject e Worke�s' �' n Laws of t r a ' • Date Signa[u �- NOTICE: i, at r making thls tleUa Hon, you snoultl oecome ject to the Workers' Compensation provisions of the Labor Cotle, you st (orthwith � wmpty with such p�ovisions or this permit Shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV ' I hereCy afti�m tM1at there is a construction lentling agency fo� the perfo�mance of the work for whi[h this pe�mit is issuetl (Section 309] Civ. CJ Lentler's Name ' �ntler's Atltlress � �NER BUILDEH DECLARATION ' :reby affirm that �I $m exempt from the ConVdctor's License Law tor the ,�lowin9 reason (Section ]031.5 Business antl Professional Cotle: Any city or county which requires a permit to construct, alter, improve,�tlemolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a si9netl ztatement that he/she is licensetl pursuant to the provisions of the Contraclor'S Lic¢nse Law (Chapter 9(commencing with Section 7000) of ^'vision 3.of the Business antl Professions Cotle) or that he/sne is exempt 'efrom antl [hE basis for the allegetl exemptiOn. Any violation of SectiOn 1.5 by any applicant for a permi[ subjec[s ttte applicant�to a civll alty ot not mo�e than five M1untlretl t1011a�s ($500). .� I, as owner o( the property or my employeez with wages as their sole compensation, will tlo the work, aBtl the struchre is not intentled or ofteretl for sale (Section ]044, Business antl Professional Cotle: The Contractor's License Law tloes not apply to an owner ot a property who builtls or improves thereon, antl wno does such work himself/herselt or throu9h his or her own employees, prOvitletl tM1at such improvements are not intentletl or ofteretl for sale. It,. however. tne building or improvement is soltl within one year of com- pletion,'the owner will have the burtlen of proving he/she tlitl not builtl or im- �p� ve for the purpose of sale). I, as owner Of the p�operty, am exclusively conbacting with Ilcensetl con- tractorst8 constructthe Proiect (Section 7044, Business antl Professions Cotle: The ConlraGtor'S Litense Law tloes mt appry to an owner of property who builtls or improves tnereon, antl who contracts (ar such orojects with a con- tractor(s ❑cense pursuant to the Contractor's License Law). I am aware that proot o� their Worker's Compensation inm�ance shoultl be provltletl to\me. .� I am exemOt untle� Section�� B. & P. C. fo� this iea5on x� Date I nei Owner Is aoolication antl state/.Phat t a iances repre- y�tor in all spaces excevt �hose witnin neavy boraer lines antl sign all approoriate tleelarations. 1 TVPE OF CONSTRUCTION LJ NEW I�'I ADD LJ ALTERATION fJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTH R DESCRIPTION OF WORK/USE OF BLDG. �� TVPE OF-PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ EIECTRICAL ❑ PLUf�BING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. CIONSTRUCTION TYPE— �JONE Sink <flow Preventer� <flow Irrigation �yT•vY' �'-� oCCUcar t � VALUATION$� GRADINGCU.VDS. ACR Dr�nking Fountains Ro4r Drains FlaocSinks � Gas Service Outlets Interceptors Kitchen Sink Lavatories �� P-Trap � Roof Drains 1 � � Reinspectian Fee $15 Boiler Duct - Under Ground Duct-Structural ' Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL BIL ICBO �k Heating System & Ducting � ❑0.100,000 BTU 0100,OOOBT X� Signature— 5N �'✓� + oa[a / • "� Drivers' Lice e or 55 � � � Reinspeetion Fee CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash IIssue Fee IECHANICAI ' Hood or Typel ❑ � Canopy Type I I ❑ - Refrigerati n Sy tem ❑0-100,0�0B ❑1 System �pair/ Itera `i Fire Dam rs Registers � �Issue Fee FEES $ 3 $ 3 A.P. # S Main Buildi E /, T Front B Rear a A C Right• " S Left 5 Ping. Ref. # r Planninq Notes: —��j —/�Q�\ � Parking Req./Provided Automatic Washer Construction Pole Sub. Cookin9 Unit Dishwasher � Dryers ❑Gas ❑Electric Fan F.A.U. � Fixtures Device Boxes O utlets Switches Garbage Disposal Generator �0-5 KW C �� N zo�e a ELECTRICAL � Trensformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Momrs OO-1 HP �1 h- 8 Inc.Solar 09-15 HP �16-75+ Microwave Pole Light Range _ Standing Sections 5-15 KW Trash Compacmr ! .. � Fee � � $15 DEVELOPMENTSERVICESREQUI ,Zoning Approved By Building Approved By � Issue Fee 0 FEES $ 3 �_�G _ Z O N I N G R E Q M T S � S MMARVOFFEES . - BUILDINGPERMIT $ �7.so SMIP $ 2,t7 PLAN CHECK $ PERMIT � � PWMBING $ �SSUANCE $� __. PLAN CHECK 25% $ ENERGV P.C. 5 ELECTRICAL., $ . GRADING $ PLA4jVCHECK 50% $ MICROFILM $ ME ANICAL -$ TOTAL FEE $ L9��• � z PL�CHECK 25% $ -' CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector ppPROVALS Permit# Date Inspector 1. .Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinfarcement � 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. 1 Z � J� (� 57. APPROVAL TO COVER-GUNITE 7. Footings S-�(�,�L �_� � p� 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test _ 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. ' 10. Structural Floor System $_� � � f� 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 • 18. Rough Electric2l-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. Undergraund Hydro 22. Ducts, Ventilating . . 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test . 72. Underground Flush � 24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing �� ,�`- 74. Overhead Hydro 26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical � 27. Frame and Flashin ,�Q (� �(� 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL . 29. Insulation (o � 78. FIRE PREV. FINAL 30. Drywall Nailing S HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED � 33. Final Electric Notes: �/ � ` � 34. Final Heating & Air Conditioning - i 35. Final Gas Pipe-Test 36. Hood or Canopy y Y 37. Final Factory Fireplace � 38. Final Plumbing 39. Water Service-Final ` � 40. Gas Service-Final � Q� �� 41. Solar pomestic-Final 42. Backflow Preventer � � 43. Backflow Irrigation __. 44. Landscape Irrigation System . Q C1'� r � 45. Sound Attenuation ' j � � 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING �' 3 - � 48. Special Requirements Completed 49. Electrie Release to Edison ,�,. � 50. Gas Release to Southem California Gas Co �",, ` ��.�..�� - 51. CERTIFICATE OF OCCUPANCY ' - . _, No. Date _ � � . . �: I Applicant to fill in all spates except those within neavY borGe� lines antl sign all aDVropriate declarations. �ITY aF coSTA MESA CONS RU/��TIO PERMIT I Project Address ��` �~ / IAppiicanYs Mailin A dress �� R /' �.�y[�q bwner'sName 9� � �e�� Phone=Lt.bSLL Address � Q �'n ArchlEng. License No. Address �.�q��.�, Contractor's Nam � PN u/ � r phone �� Address (ma i��91 9 n �M City License No. � � �`.�ENSED CONTRACTOR DECLARATION ; teby a(tirm that I am licensetl untler provi5ion5 of Charter 9(commencing , �-; section ]000) of Divislon 3 of� the Business antl Professions CoOe, antl ,' license is in full force antl effect.- ' � License Class � ' License No. Date $i9nature WORKERS' COMPENSATION DECLARATION reby affirm [hat I have a certificate of consent to self-insure or certiticate o�kers' Compensation Insurance, or a certltietl copy th of (Section 0. Lab. CJ ' . Policy No. Company � BCertifietl copy is he�eby turnishetl. - ' Certitietl copy is tile� with the city Builtling Dlvision: Oate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLHRATION (Thissection neetl not be completetl if the permi[ is for one huntlretl (g100) or less). , I certify that in the�pe�/o�mance of th2 work !o/ wltich this permk is i55Uetl, I sM1all not employ any person in any� m� pner so a to-b come subject tqt e Workers' C p ti n Laws of CaI�F � � �,O Date Siqnature NOTICE: If, a er makin9 this tleclara you should become ject to the Workers' Co pensation provisions the Labor Cotle, you st forthwlth comply with Such provisions or [Itis permit shall b¢ tleemetl revoke0. CONSTRUCTION LENDING AGENCV I herety aftirm that there is a mnstruction lentling agency for the Oertormance '� Of the work for which this petmit is issuetl (Section 309] Civ. C.) ' Lentler'S Name Yer's Atltlress JER BUILDER UECLARATION � .reby af(irm that I am exempt from the Contractor's Llcense Law for the I..,tlowinq reason (Section 7031.5 Business antl Grofessional Cotle: Any city or county which requires a pe�mit to wnSVuct, alteq improve, tlemolish o� repaii �. anv c�ni��urw nrmr in in issuanre_ also reauires tM1e aoolicant for such oermit � refrom antl me basis ror tne alleqetl exempLon. Hny vioiauon o� eecuan 1.5 by any applicant fo� a permit subjects tne appllcant to a civil � alty of not more than five huntlretl tlollars ($500). I, as own¢r of the property. ^+'�'�9�'�'��—�a �puwcaiiM; will tlo lhe work, an s ructu�e is not intentletl or off¢retl for sale (Section ]044, Business antl Professional Cotle: The Contractor's License Law tloes not apply to an owner ot a property who builtls or improves thereon, antl wno tloes such work nimselt/h¢rself or thwugh his or her own employees, provitletl that such improvements a�e not intentletl o� ofte�etl for sale. It, however, the builtling or imprOvement Is soltl within one yea� of com- pletion, the owne� will have the burtlen of proving he/sM1e tlitl not builtl or im- �/Ov¢ tor the purpose of sale). I, as owner of the property, am exclusively contractinq with licensetl con- t�actorsto construtt the O�oject (Section 7044, Business and Profes5ion5 Cotle: Tne Gontractor's License Law tloes not apply to an owner oi property who builtls or improve5 thereon, antl who conVacts for su<h projects wifh a[on- tractor(s) i¢ense pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance shoultl be provitletl�to me. ❑ I am exempt yntler Section--� B, & P. C. for thif rpason Date � Owner � _ I hereby cer ty that I have reatl this application antl sta that the above informat on is correct. 1 aaree to romolv with all tltv and untv ottlinances Signature Orivers' Lic se or 55 � � PERyyTGjyO.� I�SS TRACT N0. LOT NO. UNIT NU. (�C. TYPE OFCONSTRUCTION NEW ADO ALTERATION REPAIR i ❑.CONVERSION ❑�EMOLISH ❑ TMER Ap� DESCRIPTION OF WORK/USE OF BLOG. . S Main Buildi TVPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL T Flont ❑ TENANT �ELECTRICAL � PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION 5a. Fr. OCCUaANGv C Right K Left ��CONSTRUCTIONTVPE VALUATION$ $ ZONE GRADING CU. VDS. ACRES Pln9. ftef. # Remarks: �'_� �if PlanningNotes: Sink <flow Preventer lflow Irrigation Dishwdsher Drinking Fountains Floor Drains Floor Sinks � Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Ora Reinspection Fee � $15 Boiler Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0.100,000 BTU O 100,000 BT Reinspection Fee � $15 r..c necc nc..m., lnian_ wM1ite.-_Ruiltlina:_Canary_- Appli[ant; Pink - Accounting; Goltlenrotl - Assesso� Showers Serv{Ce Sink Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water He ef p � Water � Aa�tcdNesh //�'�. � Laundry Trays Hood or Typel ❑ Canopy Type I I ❑ Refrigera'��ion System ❑0-100,OOOBTU ❑i System Repair/Alter�t Fire Dampers Registers L%dtC r Issue Fee FEES $ 3 FEES $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures� 9�39 II/OG/07 2on8 Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15�50 KW ❑ 50+KW Mecer ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors OO-1 HP �1:4-8 Inc.Solar �9-15 HP �16-15+ Switches Garbage Disposal Gener`ator �0-5 KW �5�75 KW Pole Light Range Sign Standing Sections Tresh Compacmr I Reinspection Fee !$15 I ' Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building:APproved By /1 Issued 17,30 TL FEES $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ � ISSUANCE S PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ � GRADING $ PL NCHECK 50% $ D MICROFILM $ M�CHANICAL $ TOTALFEE $ I�J.3a PL'AN CHECK 25% $ Z O N I N G R E Q M T S ' �\ �"- �':� POOL & SPA CONSTRUCTION AND^•PLANNING � � �APPROVALS Permit# Date - Inspecfor pppROVALS Permit# Date Inspector h.• 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. APPROVALTO COVER-GUNITE 7. Footings,, � 58. Electrical Conduit-Undrgmd. 8. Foundation ��_ � 59. Gas Pipe, � Undrgrnd., Test 9. Water�Pipe�Undrgrnd: �' 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structurel Floor System 67. APPROVAL TO DEC�K 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 .Z ` � 68. APPROVED FOR PLASTERING 18. Rough Electriral'-�T Bar Ceiling �• �`�� 69. POOUSPA SYSTEMS FINAL •<. 19. Rough �Fieating & Air Conditioning ;., FIRE DEPT. REQUIREMENT 20. Rough,Factor,y Fireplace (; � _ t 7.i, APPROVALS Permit # 21. Ducts,�in Structure i� f�'� �"'' �' 70. Underground Hydro 22. Ducts,�Ventilating �,�'-".� t'' - 71. ProductPipingOGas ❑Oil . 23. Gas Pipe-Rough & Test !'; ,.�, • 72. Uniierground Flush 24. Roof Framing � �;� 1 Y�� 73. Undergrnd. Storage Tank O Gas ❑ Oil f, r 25„Roof Sheathing . �� •- 1 �� 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Mondcoat' 75. Dry Chemical �` 27. Frame and Flashin '. '- 9 r/ 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 % 0. FOOD CERTIFICATE ISSUED . „i . 33. Final Electric • . otes: �+� '�� -, 1 34. Final Heating & Air Conditioning .»• i 35. Final Gas Pipe-Test / �� j'�Q j p�� 4�� 36. Hood or Canopy i 37. Final FaFtory Fireplace 3 �i� . 38. Final Plumbing � ��'� ' �_ ' � 39. Water Service-Final � ---- �' � �� .i o�. ,. � �w. ; 40. Gas Service-Final � � - � - -41. Solar �omestic-Final � , :'. ,�/�j' • 42. Backflow Preventer "c " � i � 43. Backfltiw Irrigation ? � � '' EXPIi2ED • 44. �Landscape Irrigation System ' • . • 5. Sound Attenuation ' 46. Handicap Regulations EJ��Q ._.� . .. $�g - ' ' ' 47. FINALSTRUCTURE&BUILDING , � � r �6 � ,_, t. . 48. Special Requirements Completed �' ', '49.' Electric Releaseto Edison j . 50. Gas Release to Southern California Gas Co � q� 51. CERTIFICATEOFOCCUPANCY.:_ �' � i No. Date " �'r , Applicant to fill in all spaces except those witnin heavy bortler lines ana sign all apora0riate Aeclarations. CITY OF COSTA MES CO T UCTIq.I,V PERNJ#T ,� � P MIT NO. �(� � TR T NO. LOT NO. UNIT N6. �.� 3 �. �r.r-- �/ C. �yi �5 h _,:, , . _ Project Address . , - - -�- - � � _ . � � TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAI R Applicant's Mailing ddress � i_ a Q a�_a '❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p# Za�e Owner'sName � � PhoneyLX�•_v7� .�DESCRIPTIONOFWORK/USEOFBLDG.Re-��^«'-�[ DbL Address � � . 'YN Ce. E Main Building: Accessory Building: Z Arch/Eng. —License No. �b� �� TYPE OF PERMIT GRADING ❑ FOurvoATIO�cNt STRUCTURAL T Front p Addre55 ❑ TENANT ❑ EIECTRICAL ❑ PWMBING !71 MECHANICAL 6 Rear N ContreCtor"SName U�N r ' Phone �� OTHER �: � . PROJECT DESCRIPTION 5p. FT. oCCUParvCv C Right N Addresslmailingl .CONSTRUCTIONTVPE VALUATION$ g Left G CityLic2n52N0. ZONE GRADINGCU.VDS. ACRES R LICENSED CONTRACTOR DHCLARATIOr1 � Ping. Ref. # Parking Req./Provided E I hereby atfirm tha[ I am IicenSetl untle� p�Pvisions ot Charter 9(Commencing Remarksr Pl2nning Not¢5: M with section ]000) of �ivislon 3 of the Business antl Professions Cotle, an - ' ' licens ' in full force antl eftect �, �' $ _ � � �f $ {,i � # 6 S—S"_ g � S Li s ic � � Date Si9�ature � PLUMBING FEES WORKE S' PENSATION D ARAY�ON Bar Sink Showers ereby aftirm that I have a certi cate of censent to selRins e or a certificate ELECTRICAL FEES orkers' Compensation Insurance, or a certifietl copy thereof (Section gackflowPrevente� ServiceSink , Lab. C.� . � />utomatic Washer Transformer ❑ 15-50 KW oiicy No. � - Company � BackflOw Irrigation Sewer Cap Construction Pole Sub. ❑ 50+ KW 8 Certitietl copy iz hereby furnishetl. , Certifietl copy is tiletl with the city Building Division. Bathtuhs Sewer Connection Cooking Unit Meter ❑up to 100amps Oate APplitan[ � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' Cldlifi¢�5 SOldf C0112ct0�5 Di5hwa5hE� Meter ❑Ov¢� 700 amp5 (Thissection neetl not be completetl if ihe permit is for one huntlr¢tl ($300) or � less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Su6 Panel I certity that in the performance of the /k fo� which jhis p¢rm�t is iss etl, I shall not emPlo any pe�son in any an e� so 5 to/b� ome sub'ect the � Orinking Fountains Solar Tank ' Fan Workers' p ion Laws oi Ca i Mo[ors �0-1 HP O1'/a - 8 'Date Siqnature � Floor Drains Swimming Pool w/Spa F,A.U. Inc.Solar 09-75 HP 01fi-15+ NOTIGE: t, [er aking this tle[lara ' Vou shoultl become bject to the — Workers' Co pensation provisions the LSbor Cotle, you i Sf forthwith FIOOf $iOks U�ipol � comply with sucM1 p�ovisions o� this pC/mit snall be tl metl tevoketl. FiztU�¢5 Mic/Owdv¢ CONSTRUCTION LENDING AGENCV GasService Out12tS WatC�CIOSCt �� Device6oxes POI¢Li ht I hereby affirm that tnere is a construction IEntling agency tor the performance 9 of the wotk tar which this p rmit is �ssuetl (Section 309] Civ. CJ Interceptors WffiB� H¢dt2f �Utl¢t5 Rdn e Lenaer's Name 9 Lender's Atlaress � Kitchen Sink Water Service Switches Sign OWNER BUILDER OECIARATION I hereby affirm that I am exempt from th8 Cont�actor's LicenSe Law for the Lavamries AuLO�W35h tollowin9 reason (Secfion ]031.5 Business antl Professional Coae: Any city or Garbage �isposal Standing Sections county wfiich requires a permlt to construc�. alter, improva, Gemolish or repair P—Trap Laundr TIa s any structure, prior to its issuance, alm renuires the applicant for such permit Y � Generator �0.5 KW fl5d5 KW Trash Compactor to file a si9netl statement thdi he/she I5 licensetl pursuant to ihe provi5ion5 of Roof Drains ihe Contractor'S License Law (ChaO<er 9(commencing with Section ]000) of Division 3 of the Business antl Professions Cotle) or that he/she is exempt � ef�om antl the basis fo� the alle9etl exemption. Any violation ot Section .5 by any applicant fOr a permit 5ubject5 the applicant to a civil Ity of not more than tive huntlretl dollars ($500). . I, as owner of the prope�ty or my einployees with wage5 as their sole ReinSpBctiO� FBa $15 Issu¢ Fee $ 3 compensation, will tlo the work, antl the siructure is mt intendetl or offeretl Reinspection Fee $15 Issue Fee $ 3 tor sale (Section 7044, Business antl Professional Cotle: The Contracror's MECHANICAL FEES License Law tloes not apply to an owner ot a property who builtls o� imp�oves thereon, antl who aoes such work himselt/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, p�ovitletl IM1at such improvemeq�s a�e not iht20tl¢tl O! 0ff2�2tl fOl Boiler Hood or Type I ❑ sale. If, however, the builtling or improvement is soltl withln one year of com- Canopy Type II ❑ 2oning Approved 6y Data pletion, the owner will have the bu�tlen ot Proving he/she tlitl not builtl or im- DUct - Und¢� GlOund Byiiding App�aVed By Ddte��`�. rove Por the purpose of sale). � . 1, as owner of the property, am exUusi�eb contractin9 with licensetl con- Duct - Svuctural Refrigeration System Appliption Issued 8y Dat _I � 6 � t� cto�s to wnstruct the projeci (Section 7044. Business antl Profe55ion5 Cotle: The Contractor's License Law does not apPly ro an owner ot property wno Duct - Ventilating 0-100,000 BTU ❑100,000 BTU 2 �t SUMMARV OF FEES � builtls or improves [he�eon, antl who conttacts fo� such prqeClS with a con- � tractor(s) iicense pursuant to tne contractor's Licenze Law). 1 am aware tnat Exhaust System ❑ Multiple � 5ystem Repair/Alteration { BUILDING PERMIT $ SMIP $ prooi ot their Worker's Compensation insurance shoultl be provitletl to me. PLAN CHECK $ PERMIT ❑ I am exempt untler Section B& P. C. ror ehis Ie son FirepVFacL Blt. ICBO # Fire Dampers pLUMBING $ �SSUANCE $ Date _ owner � Heating System & Ducting Registers � e � PLAN CHECK 25%� $ ENERGV P.C. $ i hereby cer fy at I have reatl is app!icatian 2nd stat hat the above P100.000 BTU 0100,OOOBT �'. . ELECTRICAL $ GRADING $ informat on is correct. I a9ree to omply W�th aii city antl nty ortlinances � antl state laws ting to builtling construction, and hereb authorize'repre- .Y --- PLAN CHECK 50% $ MICROFILM $ sentatives o his city t nt on tpe abo �entionetl Oro er for " , inspettion 's . / MECHANICAL $ 9� �d TOTALFEE $ �C'' �� Slgndture Date " / y� Drivers' Lice e or SS � Reinspection Fee $15 Issue Fee $ 3 V�'.i' PLAN CHECK 25% $ .-..�,.e« .� ..... .�,o. �.,..._ e...�....... �..,�.., _ n..,.r��. o�,.o- . u�....�..��..,.. r_..ine.....n _ a�.e..... CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector qpPROVALS Perinit# 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, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, � Undrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap 63. Heater & Vent�Final 13. Roof Drains 64. Plumbing System - Final 14. 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 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating & Air Conditioning � /�%f�' FIRE DEPT. REQUIREMENT 20. Rough Factoiy Fireplace APPROVALS Permit # � _ 21. Ducts, in��Structure 70. Underground Hydro 22. D6cts, Ventilating � 71. Product Piping � Gas ❑�Oil 23. Gas Pipe-Rdugh & Test 72. Underground Flush .. , ��24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry S[andpipe 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 k 33. Final Electric Notes: _ _� Y 34. Final Heating & Air Conditioning � � `e , 35. Final Gas Pipe-Test- ?- I• � 36. Hood or Canopy / :eI �..v� ia 6 G 37. Final Factory Fireplace •� �� 38. Final Plumbing � �r� � � � �� 39. Water Service�Final � � B/t � air�� •i 40. Gas Service-Final . � 3 41. Solar pomestic-Final � � 42. Backflow Preventer 43. Backflow Irrigation , ' � 44. Landscape Irrigation SYstem �- 45. Sound Attenuation ��complete Ins I 46. Handicap Regulations � � � �,`,`�. -. . 47. FINALSTRUCTURE&BUILDING ; ._ . 48. Special Requirements Completed - '�� ` -- � . .. _ % 49. Electric Release to Edison : � „ 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date . 35874 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely �y/( JJ � I ADIDRESS �/.� / S 'G� /t� �/ Z . a U Z ZF ON am J7 J � Q W 00 J m J Q U N Z a W � aw W Z J Q m z J � W w � ZH W � N Q �O OWNER MAIL CITV ( "Q s , CONSTRUCTION BRANCH ADDRESS ARCHITECT OR ENGINEER ADDRESS CONTRACTOR ADDRESS CITV STATE �IC. NO. SIZE / OF LOT � O USE OF EXISTING BLDG. � O QQ V TEL NO. TEL. TEL. NO. CITV LI0. NO. NO.OF BLDf'�5. NOW ON LOT ;,� ,�n�� ,�:: �::z � ;.�i -�-7.,,,,,-,-OG 413 � 4.��Q TION FOR BUILDING PERMIT i��"P� °°'If's�'_ A.P. NO..� I �{ � �� BUILDING �� ADDRE55 % TRACT � FIRE ZONE APPROVED C I �Ort �I" VALUS �n� � TE / — CJ " ZONE NO.OF USE OF NEW (�i�VJ - PLANS w� BUILDING p YARDSAPPqOVED VARDSAPPROVED MAIN BUILDING ACCESSORV BUIIDING (FROMC/ _ EJ�) � F" SI2E OF � �/ � NO. OF � Z NEWBLDG. ROOMS I STOFIES L.SIDE .Fi FT. EXTERIOR WALL ROOF �% COVEFING O� COVERIN �Bp �� REAR I FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. n' MAIN BLDGS. a / ` 1 O .__. I _/� "__ C URP. # .+.n' 1,� F APPROVED r 1/ y v- Z O UI hereby acknowletlge that I have reatl this appliwtion antl stare � that the above information is correct antl agree to comply with � all laws regulating builtling mnstruction, and I shall not employ F any person in violation of the workman's compensation laws ot � y the State ot Calitornia. HQLD z�'I hereby certify that I am properly licensed as a conttactor untler SQ. FT the State ot California Buziness and Professions Code, Divisicn 3, THE AMOUNT 5 Chapter 9, antl that such licenses are in full force and etfect, or I THE PURPOSE OF am exempt from the provisions ot the State of California Business VALUATION and Professio Cotle, Division 3, Cnhapter 9. ' Signature of_ j � /'yy � _ /� $ Permittee 7 C7`"�T199�f�f�A - • - �bQD.a b Authorizetl Agent BET. H1AIN & fi V 3A FEE STATE b 0 IS FOIi � NLV: m ¢ �— m N J J m � `o LL OWNER NJOB AC � GF"'°R cip �in _ P SOIL � GAS DATE NG PERMIT N0. DESCRIPTION of WORK Play Room FIRE ZONE VALUE $ 3,000.00 7UP J TYPE V ZONE H- SUBCONTRACTOR _ PERMITS ISSUED WATER ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEATING AN� AIR CONOITIONING ❑NDERGROUN� M POWER U .�. ROUGH WIRING TRENCHES FORMS � STEEL REINF. FLOOR SVSTEM BONO BEAM � STEEL REINFOftCE � SHEATHING FRAME AN� FLASHING � LATHING - IN ❑ OUT [� Pl -R, BROWN COAT S'. JRAL, FINAL HEAi iNG, VENT., REFRIG. AND A.Cr.x, F PLUMBING, FINAL ANO GAS TEST �7y � � '� ,f r .. � f� 1 i' r♦ . , � �a '� y"'�;,;� � e!_v.�.� u � � �� e� APF 2 b i:;�f -. COSTA MESA BUILDING-SAFETY DEPARTMENT FIIV�'�P�CE DEPT. P. o. aox s,� C08TA MEBA. CqL�P��A CITY OF COSfA P,4ESA � For Applicanf fo Fill In Complefely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 213 Aster Plaue ADDRESS C06TA MESA. CALIFORNIA For O#iee Use Only OWNER Irvin ri. Jordan Rece�nr xo. e�Q w; nn,-� �`Jkt�a��l ADDREBS 3700. Newport B�.Vd• � �D Bv �A R¢C7EIVF D DAT¢ 188uED -/ !� � APR 2 8 196t cin Ne ort B0&ch NoAR 8811 pDDRE'86 oRCENGiNEER D. Southworth Nei,185161 COSTA MESA. CALIFORNIA ADDRESS COStiB. MBSA � FIRE //' / � ZONE TYPE • GROUP CONTRACTOR 'B�P+�--�!"�^ �+PPROVED BY DATE ADDRESS Same ZONING ZONE NO.OF U3H OF NEW ciTr R-1 I PLANB 2 I euu.o�NaL7 3tt g2.r. ��TNa. Bl-$2 7 �.;o: oR3 8811 LeOAL Lot 1 Tr. 8 6 DEBCRIPTION 61ZE / O I NO. OP B{DGB.O OF LOT NOW ON LOT A. P. NO. ROII2 USE OF YARDS EVES EXI6TING BLDG APPROVEO ALLOWED 64TBACK LINB FrtOM (CBNTER LINB BTJ CENTER OF STReET IYEAR YARD FRONT FT. IN. SIDE YARD I LEFT � O�� I RIGHT ZO � O�� R. SIDE FT. DESCRIPTION OF WORK L.SIDE F7. IN. NEW I X II AI.TERATION I II ADDITION I / �N REAR FT. REPAIR I IIMOVING I IIDEMOLISH I APPROVED E�, 1 BUILDING NO. OF i � 61ZE ROOM6 7 STORIES Z EXTERIOR WAL�tucO I RooF Shin le3 � COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED e� � ReS h� ...i Plan #1615B I 1630 s. ft. ( � d 62o s. ft. p , pp7� 1 HEPEHY'ACKNOWL6D06 THAT 1 XAVE PPA� THI6 MPLIGTION VAITN T-9 N�� Al, A'�[Qj��Q_ — e AND BTAT¢ THAT rxe ABOV2 18 COPAECT AND ACRE6 TO COM- p�@�7"XU 6HILi NO A PERMIT PEE ONLY. PLY WITN ALL CITY ORDINANGE9 ANO BTATE LAW9 RHOULATINO BUILDINO CONBTRurnoN. �` VAWATION p SICsNATURE OF �� PERMIT FEE $ 3 1�OO o C N PERMITTE $ Z�,198 pLAN CHECK $ 1V�%O e AUTHORIZED AGE T r rc TOTAL FEE 7• � LL v