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Home My WebLink About3158 BRAY LN - Building Permits\ CITY OF COSTA MESA � , BlIILDING DIVISION F � 77 FqIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � ` FOR INSPECTIONS CALL: (774) 754-5626 •�� ri'� PERMIT NUMBER P08-00032 PERMIT TYPE PLUM STATUS: ISSUED APN: 14163121 DATE ISSUED: 0112512008 ISSUED BY: RMD JOB ADDRESS: 3158 BRAY LN CM SuitelUnit: vicinity: SCOPE OF WORK; WATER HEATER CHANGE OUT, SAME LOCATION (GARAGE) FOR A SFD. OWNER: TAM7RUST Address: PHONE: 714-545-5274 APPLICANT: TU, TIEN PHONE: 714-545-5274 CONTRACTOR: OWNER-BUI�DER Address: City/State: ARCHITECT: ENGINEER: ZipCode: 3158 BRAY LN City/State/Zip: COSTA MESA, CA Address: 3158 BRAY LN : City/Siate/zZip: COSTA MESA, CA License No. 000000 PHONE: CELL: License No. License No. PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: PERMIT FEE: TOTAL FEES: $0.00 $35.80 $35.80 PHONE: PHONE: NOTICE: The work aUthorized by lhis permit shall comply vrith all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed untler this permit to be considered legal, such work must comply with all applirable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. CO�E t INSPELiIONTYPE URTE INTf71A15 COOEt INSPECPONiYPE 0� INIRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final , 208 Final Plumbing 3_3 ..c�� 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRelaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy . � WORKERS' COMPENSATION DECIARATION: I hereby affirm under penalty of perjury one of the following tleclarations: ❑ I have and will maintain a certifcate of consent 10 self-Insure for workers' compensation, as providetl for by section 3700 of l�e labor Code, for the pertormance o( the work for which Ihis permil is issued. ❑ I have and will maintain workers' compensalion insurance, as required by section 3700 ot the Labor Code, (or the peAortnance of lhe v.ork for which this pertnil is issued. My vrorkers' compensation Insurance carrier antl policy number are: Carne[ (Tlus setlun neeC mtOe romp'eteJalhe peimA is valuetl et one nunOreO tlo6ars (5100) w less) ��Polic Number: certify that in the peAormance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject lo the vrorkers' compensation laws of Califomia, and agree that if I should become subject to the vrorkers' compensation pmvisions of Section 3700 of the Labo, e I shall wilh comply wiN these provisions � ZS 0 � � ApplicanfSSignawre �_Date ) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLP.WFUL AND SHALL SU&IECT AN Eh1PLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing vrith Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force antl effect. Lic. # Class # Convactor's Sgnawre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that Ihere is a constnicl'an lending agency fw the peAortnance of the work ta v.fiich this permit is issuea. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Date OW NER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury Ihal I am El(EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permi� to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicaM for such permit to fle a signed statement that he or she is licensed pursuanl lo Ihe provisions of Ihe Contractors License Law (Chapler 9(commencing with Seclion 7000) of Division 3 of the Business and Professions CoOe) or lhat he or she is exempl therefrom and the basis for tne alleged ezemption. Any violalion of Seclion 7031.5 by any applicant for a permit subjecls the applicant to a civil penalry of not more Ihan fi✓ve hundred dollars (5500�.�: �I�� I, as ovmer ol the property, or my employees vnth vrages as their sole compensation, WILL DO THE WORK, and tha structure is not intended or oftered tor 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 hersell or through his or her ovm employees, provided lhat such improvements are not intended or ofteretl for sale. If, however, Ihe building or improvement is soltl within one year of wmpletion, Ihe owner-builder will have the burden of provinq that 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 construcl the project (Sec. 7044, Business and Professbns Code: The contractors License Law dces not apply to an amer of property who builds or improve5 Ihereon, and wh0 Gontracts for such project vrith a contracla�s) license pursuant to the Cont2ctors License Lavrs.). ❑ I am exempt untler sec. Business and Professions Cotle for Ihis reason: �(�2,,._ f Z,j� o � SignaWre _ �ie 305]-Afi(3I0'!) Owner ID venfietl by driv� .ce. . Yes ❑ No Dnver's�CicenseNo. �• . �Expires �Z 0 O�I L. I Venficztion of Ovmership by (type of ocument, i.e. - pmperty lax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N: ❑ I hereby certiFy Ihat no excavalion (rve (5) or more feet in depth inlo wfiich a person is required to descend, will be matle in conneclion with work authonzetl by [his pertnil, and that no building sWCNre, scaffdding, falsework, a tlemolition or tlismamling thereof, will be more ihan thiny-six (36) feet high (Chap. 32, Grp 2, M 2, Sec. 341, Title 8, Califomia Atlministrative Code). ❑ As owner-builtler, I will not employ anyone to do work which vrould require a permit from the Division of Industrial Safety, as notetl above, unless such person has a pertnit to do such vrork from the division. Appliwnfs SignaW re Date Division of IntlusMal SaFety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will Ihe applicant or present or future builtling occupant neetl to file antl certify a Business Plan tor emergency response to release or threatened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Califomia Health antl Safety Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazardous materials equal ro or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas at standard temperature and pressure�. 2. Does or vnll lhe applicant or present or future building occupant need to file a registration fortn for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some excep[ions. requires registration with ihe Costa Mesa Fire Department Dy each business which at any one time has on hantl a quantity of acutely hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standartl temperature and pressure). 3. Does or vrill the applicant or present or fuWre building occupant need to prepare an RMPP (Risk Management and Prevention Program lor acutely hazardous materials)7 ❑ Yes ❑ No (Section 25534 of the California Health and Sa(ery Code provides Ihat the Costa Mesa Fire Department may require the preparetion, certificalion and filing with Ihe Fire Department of an RMPP by husinesses which are required to register acutely hazardous materials with the Fire Deparlmenl. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safery Code been (ully complied with? ❑ Yes ❑ No 5. Does or will the applicant or preseN or future building occupant require tor �he vrork which is [he subject of Ihis appliwlion a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control tlisMct oi agency7 ❑ Yes ❑ No (Section 65850.2 of the Califomia Govemment Code requires Ihat the requestetl infortnation be fumished on applications for non-residenlial buildinq permits). 6. Will any part of the facility to be constructed under Ihis permit be within 1000 feet from Ihe wter boundanes of a school? ❑ Yes ❑ No Q('�jes", the facility must meet the requirement of Sections 25534 antl 42303 of the California Health and Safely Code). 7. If a permit From Ihe South Coast Air Quality Management Districl or other air pollution coMml dislrict or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Safery Code Section 42303 been made? ❑ Ves ❑ No 8. Qf yes', attach certifwte of compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is conect. I agree lo comply with all state laws antl ciry ordinances regarding Hazarclous Materials antl Emissions. SignaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read Ihis application and sWte that lhe information given is correcL I agree to comply with all state laws and ciry ordinances relating to building construction, and authonze representatives o/ the City of Costa Mesa to enter upon the abovedescribetl property for inspection purposes. 1 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S'i5�na)tweolLe�` a-l7Oxner(s) Oale !.[.a.�'� (rN /� 2- ��0 ,(/ . An�/or`AulhOriz¢tl Appl¢ant I Dale DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS Bldg. Permit # This Permit # � StreetAddress: � �J�.Sg gRA"i [�i � Cb� (Pr 1v1�ESi� �CA 9Z�Z�iqpNumber: � ,� � "1. I(we), �� 1� , declare that I am the Owner of Title of the above � referenced real property, and that I(we) hereby authorize: �76-3u3-6/�F6 ��-BP �. � Name: �/� Z/ Telephone Number: �� F " S�F S— S�� , Street Address: � � � �� '+e � Ciry: lsiid /I�-ie State: C%�- Zip: gZ�76 V� ��. to obtain pertnits in my behalf, as owner/builder, for itJc� h(s� it�/�uc,cr.w^�. at the above referenced property. 2. Should any petson become an employee engaged in the improvement of the property, I(we) shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the Ciry of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or o�cers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. Executed this z� ' day of JA.� � 20 � g , at � S% H.fe Sa . Califomia. /„} � Print Name: � /�M �� v Si�; .� atu e: � J�/1M l Note: This authoriiation does not grant authoriza6on to perfortn the work as owner, it solely provides for limited power of attomey to secure this pertnit in any behalf. O179d61rev.11/00) 1 ApP�icant to fill in all ipaces except those within heavy bortler lines antl sign all apP�opriate tlecla�ationi. CITYOF coSra MESA C TRUCTIpN PERMIT Project Address _ G ��f% r Appli�nt's M�ng Address�s � [ �� 7q� Owner's Name � PhoneU3TJ�VOEQ Address • Arch/Eng. Licpnse No. Address Contracto�'<Na�„,�7 �S ph e �i'�BF� Address (m �I' 10' 7iS� ��/✓��i C p _�.� City license Na. ��%�72�� LICENSED CONTRACTOR DECLARATION I ne�eby attirm [hat 1 am licensetl untler provisiong oi Charte� 9(commencing with section �000) of Dlvision 3 of the iness antl Protessions Cotle, antl my license is in full to � a fect. Licen ��5� �Sig�ure —� 4 / Date, . WORKERS' COMPENSATION DECLA ATION 1 hereby atfirm that 1 have a certificate of consent to seli-insure or a certificate �t Worke�s' Compensa[ion Insu�ance, or a cert(fietl cOpy the�eot (Section 3800, Lab. C.) Policy No. Company eCertifietl copy Is nereby fumishetl. Certified copy is tilea with the city Builtlin9 Division. Date Applicant EXBMPTION FROM WORKERS' COMPENSATION DEGLARATION (ThisseZ[ron neetl not be campletetl it the perm' is for one M1untlretl ($100) or I¢55). I certity that in the pe�formance of the wor fo 's, ' e� i�t is i55uetl, I shall not employ any person In any man r 5 Subject to the Work Cry e Laws ot Calilor • Date �=.L��Signature NOTICE: If, a�ter makin9 this tleclaration, you shpu ome s b�ect to the Workers' Compensation provisions of the Labor Cotle, you st forthwith comply with such provisions o� this p¢�mit YM1all Ce tleemetl revoketl. CONSTRUCTION LENOING AGENCV 1 hereby affi�m that th¢r¢ is a construction lentling dgency fo� the pertormance of the work tor wnich this permit is issuetl (Section 309] Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUILDER OECLARATION 1 he�eby atfirm thdt I am exempt from the Cont�actor'S License Law for the following reason (Sec[lon 7031.5 Business anC PrpfeSsional Cotle: Any city or munTy which r¢qui�es a permit to conSVuct, alter impwve, demolish o� repair any st�ucture, p�io� to its issuance; also �equires the applicant fo� such pe�mit to file a siqnetl stdtement that he/zne i5 licensetl pur5uant to the provisions ot tne Contractor's License Law (Chapter 9(commen�i�q with Sedion 7000) of Division 3 of [he Buslness antl Protessions Cotle) or tM1at he/she is exemp[ :heref�om antl [he basis for the alle9etl exemption. Any violation of Section 7W3.5 by any applican[ tor a pe�mit Subjects the applicant to a civil �enalty of not more than five huntlretl tlollars (E500). LJ I, as owner ot the property or my employees with wages as their sole compensation, will tlo'the work, antl the structur� is not intentletl or offeretl fa� sale (Seciion ]044, Business antl Professioqal Cotle: The Gont�actor'S LicenSe Law tloes not apply to an owner of a propercy who builtls or improves �hereon, antl wM10 tloes such work himself/hersery ar tnrou9h his or her own employees, proviaetl Mat such improvements are not intentletl or otteretl tor sale. If, M1oweveq fhe bulltling or improvement is:oltl within one year of com- oletioq tne owner will nave the burtlen of proving he/she tliC not builtl or im- prOve tor Ihe purpose of Sale). ❑ I, as owner,0f the propevty, am exclusivery cqntracting with licensetl con- t�actars to consttuct the project �Section 7044, BUSiness antl Professions CoOe: The Contractor's License Law oes not apply to an owner of property who builtls or imOroves tbe�eon, antl who mn[ract5 fbr such project5 with a mm tracto�(s) license pursuant to Ihe Contractor'S LlCense Law). I am aware that proof of their Worker'S Compensation insu�ance shoultl be provitletl to me. ❑ I am exempt untle� Section B. & P. C. for this reason Date Signature "l� �/"� Drivers' License or 55 � Owner this plication and state that the above ompl with all city antl county ortlinances n ructlon, antl hereby authorize repre- tionetl property top Oate�.��.� TVPEOFCONSTRUCTION IJNErV LJ.AbD L€ Tiy,_ RePAIR ❑ CONVERSION ❑ DEMOLISN ❑ O�i�IER v ��DESCRIPTIONOF�OjiK/U EOFBLDG��; ^ � � [',(�(ivai ry�l ii,.r X� Aa�lu re%., ix� L i� TVPE OFPERMIT �oIN ❑ ourvDAT orv ST UCTVanL� ❑ TENANT ❑ ELECTRICA ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.� oCCUaarvC � CONSTRUCTIONTVVE VALUATIONS �' ZONE GRADINGCU.VDS. ACRES Remarks: / Bar Sink Backflow Preventer Backflow Irrigation eathtubs Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trep Roof Drains Reinspection Fee 0 Showers Service Sink SeWer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outlets Water Closet Water Heater wBSEf $2fVIC2 Auio-Wash Laundry Trays $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust Syscem ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0-700,000 BTU 0100,OOOBT Reinspectian Fee � $�5 CMF 0865-46, rev. 30/B4 White - Builtling: Canary - qpplicant; Pink - Accounting; Goltlenrotl - Assessor Isue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration SYstem ❑0-700,OOOBTU ❑100,0006T System Repair/Alteration Fire Dampers Registers A.P. �i`- S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: Accessory Building: ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fiztures Device Boxes OUtIQIS Switches Garbage Disposal Generator �0.5 KW �5-15 KW Zone Meter LJup to 700 amps Meter ❑over100amps Suh Panel Motors�0-7 HP�iX�B Inc.Solar �9-15 HP 016-15+ Microwave Pole Light Ran9e Sign Standing Sections Trash Compactor $� Rainspection Fee $15 Isgue Fee FEES DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By � � / _ Aoolication luued Bv Issue Fee � $ 3 BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PIAN CHECK 25% $ EI.ECTRICAL S PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ FEES $ 3 Date Data ��"+ Data�—� R'$ ES l2 J V SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ � '� � � TOTAL FEE $ _( �• ' �' Z O N I N G R E Q M T S CONSTRUCTION ANPPLANNING POOL&SPA �• �' Date Inspector Date Inspector APPROVALS Fermit # APPROVALS Permit # 1� Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. •� 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � ,ry 4. Electrical Conduit-Undrgrnd. 55. Electrical 8onding 5. Steel ReinforcemenT �', 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnc1. i� 57. APPROVAL TO COVER-GUNITE 7. Footings r %� 58. Electrical Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, � Undrgrnd.. Test 9. Water Pipe-Undrgrnd�� 60. Backwash Lines, P-Trap, O Undrgrnd. �. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line'&,Flouse Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Dreins 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 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL +� � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . � �. � 20. Rough Factory Fireplace APPROVALS Permit # �' . � i' 21. Ducts, in Structure 70. Underground Hydro �t� 22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil�� 23. Gas Pipe-Rough & Test 72. Underground Flush � � • 24. Roof Framing 73. Undergrnd. STorage Tank O.GaS ❑ Oil �, i 25. Roof Sheathing 74. Overhead Hydro �•�` i� 26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical �' � i! .' 27. Frame and Flashing 76. Dry Standpipe � . - ' � � � . 28. Lathing & Siding 77. FIXED SYSTEM FINAL' 29. Insulation 78. FIRE PREV. FINAL '. 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � ,' 31. Plaster Brown Coat 79. FINAL INSPECTION , . �� 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � 33. Final Electric Notes: S�.y�p�l<�t.- �S ' 34. Final Heating & Air Conditioning � �} 1 :�: 35. Final Gas Pipe-Test . 36. Hood or Canopy 37�. Final Factory FireplaGe ' ' • � i ' 38. Final Plumbing 7 ' : �' 39. Water Service-Final ' j. .'_' , � 40. Gas Service-Final ' 41. Solar pomestic-Final 1 � ' " � � � - .. '•42. Backflow Preventer ,� , �� 143; Backflow Irrigation � • r � ` �;,44.'Landscape Irrigation 5Ystem � ��' . ' ' , .' ' � 45. Sound Attenuation . � : � , , . ' 46.' Handirap Regulations • •) � , ' / 47. FINALSTRUCTURE&BUILDING � J , � . ' ; 7 48. Special Requirements Completed - ' • 49. Electric Release to Edison . � � 50. Gas Release to Southem California Gas Co : y 51. CERTIFICATE OF OCCUPANCY No. pate owrrEx �OR HALL OF FAME HOMES, INC. DATE N�v 2 9 1962 aoa nnnx�ss 315$- ray ne �uir,nrn�c rExNiT rro. 18138 GENERAL CONTRACTO$i,fet3[42 R@63d@At1a1 Bld�. COTp. VALUE S 17�075.00 AP No. LOT 9-� TRACT 4356 PIRl 'LONE DESCRIPTION OR WORK Res.w�St't.GRI' IA*SPECTIONS Signature llA'PE GROUP I-& JTYPli ZONE G� I—�I/�%� I SUL3CONTRACTOR DAT��11TS�UMBPj coat e - � �sis� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MESA. CALIFORNIA For Applicani fo Fill In Complefely TYPE OR PRINT BUILDING 3�58 B/1 � / L�� ADDRE59 COSTA MESA CALIFORNIA OWNER Harbor Hall of Fame Homes Inc. MAIL P 0. �R 2066 Lhf1GFGC J8m1SOII 5 "D" St.. Tustin FE/E RECEI�Vz D Lot 9, Tract 4356y��t�� DEPT. ` cm oF cosTa �nEs� P� APPLICATION FOR PERMIT BUILDING For Office Use Only rseceirr Ho. (v�qi�. I REC61/i BY I O�TB��ie��wO�� AnE 198UlD / BUILDING COSTA MESA. CALIFORNIA ADDRE65 Z131 SO• Artesia ZONING ZONE NO. OF U88 OP NCW Sn' '%)n A CITY Santa �iia ��, IPLAN9 � BUILD�NO W�q%� RI LIC.TNO. ZOHV/6 NEo: KI g-2204 LeOAL l_of � y3s6 DEBCRIPTION SIZE � NO. OF 9LD08. Q OF LO7 6� �' Now ora LOT A. P. NO. U6E OF None YARDS EVES EXIBTING BLDG APPROVED ALLOWED e¢ra�cK une vaorn �O� REAR YAR 5�46' ��p uxe ar.� �_ CBNTHH OP HTft86T � FRONT FT. IN. SIDE YARD ILEFT � (R16HT � R.SIDE �_ PT. '-- IN. DESCRIPTION OF WORK ___ � __ .� � BUILDING _ � _ .. NO. OF I H6REBY AGKNOWLEOG6 THAT 1 HAVE READ THIB MPLIGTION AND BTATE TXAT THH �B(1VE 18 CORqECT �ND AGq¢E TO COM- vLY WITX ALL C�TY ORDINANCEB AND BTATE UW PEOYLATING BOILDINO CONBTRUQlOj1J � ^^ /�i // /� � / SIGNATURE 06.—Y/ � I V t. L � AUTHORIZED AGENT 3s ; Y � FT. � �N. O l/ .Gi�o .. � narr ��/i a �C e� — /� /�'3 ��--� �lJo Q, THE AMOUNT BHOWN DER VALUATION 18 FOR TXE PURP088 OF EBTA6LI6HINp A PERMIT FE8 ONLY. VALUATION /y r� PERMIT FEE $ ��/p S //J O �� pLAN CHECK $ �O / �