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Home My WebLink About300 BUCKNELL RD - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.c�.costa-mesa.cFg�ILDING PERMIT 77 FAIR DRIVE, CASTA MESA, CA 92628 �obAddress: 300 BUCKNELL RD Suite: Vciniry: HOUSE AND GARAGE ROOF Primary Occ: R3 Type of Consiruction: V-N Parcel Number. 14141113 Zoning: Applicam: LUCK, GARY Address: 448 MONTGOMERY ORANGE,CA Owner: SCHMIDT, GREGG A Address 300 BUCKNELL RD COSTA MESA, CA Contractor. LUKE ROOFING INC Address: 448 S. MONTGOMERY � , � ORANGE,CA. Zip: 92667 Arch : Address: Phone: Phone: 714-612-8806 Zip: 92868 Phone: Zip: 92626 Phone: 714-633-8798 License: 672569 Eng: Address: ISSUED BY: Status: ISSUED Applied: 07/26/2006 Issued: 07/26I2006 Phene: Zip: License: License: SCOPE OF PERMIT TEAR OFF {E) ROOF MATERIALS, INSTALL 1 LAYER OF i 5if FELT AND REROOF WITH COMP SHINGLES ON ATTACHED HOUSE AND GARAGE, APPROX 26 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. FEESUMMARY Plan Ch�ck: $0.00 Permit: $153.25 SMIP Res: $0.80 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Calc Valuation: se,000.00 CI81�1'1 V81U8tI0f1: 58,000.00 Total: $154.05 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0- 0 Left 0- 0 , RigM 0- 0 ACCESSORY Front Q- 0. Rear 0. 0 Lek 0- Q Righf 0- 0 , PARKING Existin : 0 Reauired: 0 Pr000sed: 0 NOTICE: The work authorized by this permit shall comply with all applfcable handicap access requirements under Califomia slatutes and related regulations. (OM. No. 92-28, § 1, 1241-92) EXPIRATION: This pertnit shall eutomatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 18Q days. INSPEC710NS: In order for the work authorized under thts permif to be oonsidered tegel, such work musf comply with atl applicable codes, and ali requlrod Inapeetlone and Ilnal epproval must be obtained. Failure to obtain Inspectlons and final approval wili result In the expiratlon ol this permit. FOR INSPECTIONS CALL: (714) 754-5828 zsae+s(arool WORKERS'COMPENSAnONDECLARAnON: I nereDy eMrm under penelry of per�ury one oi iho lollowing tleGaretians: ❑ 1 have erW will ma�ntain a certiflcate of consent ro setl-Insure lor workers' compensation, es pmvlded for by sectlon 3700 oi Ihe Lebor Code, lor Ihe peAormance of the work tor which Ni9 pertnii Is issued, � I heve ernf will mflintain workers' compensatlon Insurence, es requirotl by sectlon 3700 of Ihe Lehor Cotle, lor Ihe peAormance of Na work for whlch NLq pertnit is L9suetl. My woMera' compensatio�n °surence corder entl policy num�er ere: (---- --� Certier. � .�L7� i�e�.,/ �Policy.Number.. � �O/6aSL (Thls section neetl not be comp�etetl !f tho perml!!s ve/ued ef one huntlred dollars ($f 00) or less.) ❑ 1 ceNty ihet in Ue PeAortnence of Ihe work lar which Ihls pertnit is Issued, I shell not employ eny person in any menner so es to become sub�ect to the workers' wmpensatlon laws ot Celtlomle, entl e e lhat It I s�oultl Decome su6Ject to the workers' crompensetlon proNslons ot Section 3700 of the Lebor Cotle, I shall lorlhwlth comply with ihese Provisions, r— .. � AppllcantSipnaNre: Date: - - 7`Zr�� VJARNIN(3; FN�UfiE TO SEa1RE WIXiNERS' OOMPENSATIpN COVEMGE IS UNLAWFiIL AND SHML SU6IEGT AN EMPLOYER TO CRIAVNr1L PFIULTIES iVlD CML FlNES UP TO ONE HUNDRED TIIOUSMlD DOLIARE (5100.000), IN ADdTION TO THE COSi OF OOMPENSATIIXJ, OAAMGES AS PRd��DED FOR IN SECfIpJ 3)OBOF THE UBOP CODE. INTEREST, AND ATTORNE`/'S FEES. LICENSED CONTRACY�RS DECLARATON: I hereby eHirtn Ihet I em licensed under provislons of C�ap�er 9(commendng wlih Sectlon 7000) oi DlNsion 3 0l the Business and Prolessions CoGe, end my license Is in full rorce entl�eHect. Llc:�u 6 71 S� % Cless�a—. �•� 9 cbntrec�ors SlgnaNre: �oete`__. � 7 =� _« � "_'_ CONSTRUCTION LENDING AGENCY: � ❑ I hereby attirm Iha� �here is e constiuctlon londing egen�y tor Ne peAormance of ihe work lor w�ich Ihis permit Is issued. (Sec. 3097, Civil Cotle). Lentlers Name: LenCats Adtlress: Sipnatura: OWNER-BUILDER DECLARATONS: Date: I hereby ettirm ihat untler penfllry ot per�ury Ihet I am EXEMPT FROM TME CONTRAC70RS LICENSE LAW lor the following reeson (Sec. 7037.5, Business entl Professions Code: Any Gry or wunry which reQWres e pertnit lo construct, elter, imprwe, tlemollsh, or reDelr eny structuro, pdor to its issuence, elso roQWres the epplicant for such permil to flle a sipned stetement thet he or ahe Is Iicensed pursuem to Ihe praNslons of 1he Coniredors LJcense Lew (Chepter 8(commandng wilh Sectlon 7000) of Dlvision 3 af the Business entl PrMesStoY�s Codo) or thaf he or ahe is axempt thereirom end tha �asU tor ihe aliegetl axemptfon. My daladon of Secllan 7037.5 by eny epplicent tor e pertnit sub�ecLs the applksnt to e dvll penalry of not more then flve hundred tldlers (5500).): ❑ I, as owner oi Ne properry, or rtry employees with wages es Iheir sde compensalion, WILL DO THE WORK, end Ne siructure Is not Intentled or oflered tor sale (Sec. 7044, Business antl Professlons Code: The Contredors License Lew Aoes not apDh to an owner of property who builtls or Improves Nereon, end who does such woAc himselt or herselt w throuph hls or her own amployaes, D��tled that such imprwements ere not intended ar ottered for ule. If, hov.•ever, Ihe builtling or impro�ement is soltl wllhin one yea� of completion, the owner-builtler will �ave Ne burden of proving that he or she tlid not build or imprwe for purpose of sale.). • ❑ I, es owner of the property, am El(CLUSIVELV CONTAAGTNG WRFI LICENSED CONTBACTORS to construcl the pro�eci (Sec. 7044, Business end Piofessbns Code: The crontrectors Ucense Lew does not epply to en owner ot pmpeny who builds or improves thereon, enC who contrects tor such pro�ect wit� e con[rector(s) Ilconse pursuant to the Contrectors LJconse laws.). ❑ I em esempt unde! sec. Businoss and Prolesslons Coda for this reeson: Sipneturo: Date: Owner ID verilled by Grivefs Iicense. ❑ Yes ❑ No Orivefs License No. Eupires: verNlcnuon of Ownersnp by (rype m aocument, t.e. - properry tsx Mi� or tleedj�. DIVISION OF INDUSTR�� SAFETY PERMR CERTFICATON: ❑ I hereby ceNty that no excavation five (5) or more feet In depth Into which e person is required to descend, wlll be metle In connecpon wlt� work euthonzetl by this permit, enC lhat no bullding strudure, scattolding, felsework, or tlemditbn ar Cismantling t�ereol, wlll Oe more Ihen Ihirty-six (38) leat hiph. (Chep. 3.2, Gry 2, Art 2, Sec. 341, T1tle 8, Calilomla Adminlslrellve CoOe). ❑ As owner-bullder, I wlll not employ enyone to do work which would requlre e permit irom the Divislon oi Intlustnel Sefety, es notetl ebove, unless such person hes e pertnll Io do such work Irom the dlNslon. Signeture: Date: Dlvlsion of Industrial Safery Permil Number: CERfIFlCATE OF COMFLIANCE AND AI7TT10RIZATON OF ENTRV: I certity under penalry of per�ury Ihel I heve read this applicatlon enA stete Ihet Ihe intortnation glven b correcL I egree lo comply with ell stete lews end clry ordinances relatinp to bulltllnp consiructlon, entl euthodze represematives of Ihe Clry of Cwte Mesa to enter upon the ebove•dexdbed property �ar Inspection purposes. I egree not to occupy or ellow occupency ot any bullding euthodzed by Nis pertnit un�il Ilnal InspecUon. COOE �. INSPECiqNiYPE 1616 Fixetl System F��al Fire Preventlon 1266 Pool Spa Final 200 Finel Re-Roof 201 Flnel BIacWRetalning Well 202 Finel FeMory Fl�e Place 203 Final Sign 204 FtnalOemWiUM . Pd7E - -� � ��6 !f- �ate % , 2 ,=QL l Date �i u�srecnoNTrve 208 Finel Mec�enical 208 Final Plumbing 210 Final Electrical 212 Flnel Flre Prevanlion 220 Flnel Plenning Approval 222 Final Slte 250 Flnal BuildingiOccupenq � lt�� '` \ \` PPOJECT p00HES5: 3 O O BUCKNELL RD awr+cnsNnme:MR. GREG SCHMIDT AOOHESS:SAME AS ABOVE ABCHIENGINEEfl: � S 1— z 5 � 4 nonaess: flEG.NO.: � uxiT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 062818 PERMIT NO: H 062818 PLAN CHECK NO; 02333-93 S GOVT; N ; N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OT'H uxiT: JOB DESCRIPTION : BI]ILD A WOOD LATTICE PATIO COVER SQ FT; 300 PEflMITTEE:CAMPOS PATIOS & SCREEN ( 714 ) 776-9345 aooRess: �09 N, PAULINE STREET P�NF�fiEIM CA 926�Q5 LICENSEU CONTNACTO OE LAPNTION: I herehy aifirm Iha� I am IicenSeA unAer provisions o� hapier 9(commencing wilh Section 7000) of DiNsion 3 oi Ihe Business antl Pmtessions Code. antl m license is in lull force 4 eltec�. CITY LIC.: � STATE LIC.: �SS: _�\��T� 021252 37529 6� f�e' _ra� ..T�— Si9naWre'. WOPREFS' COMPENSATION OECIAflATION: I here6y �irm Ihai I have a tertilital � con5enl Io Self-insure or a t Nhcate oi Workers' Compensalion Inmrance, ar a centlietl copY ��ereo� (Section 3800, Lab. C). POLICY NO.: E%P. UATE: COMPANY: ❑ Cerlified copy is �ereby fumishea. ❑ Certifiea coDY is filetl with t�e ciry Building Division. Da�e: Applicant: E%EMPTION FflOM WOFNEAS'COMPENSATION �ECLAFRTION: h' edion n ed nolbe tolpple�¢ �he p¢rmiiis�arane hunArea($100�or1e55�. I cetlify �ha� in �he Oer�ormance o� �he work far which this il�;sue I shall not ediploy y perso n ny manner so as �o become subjec� /ty_ Ihe WOBers' Compensation Laws oi Calilorni . �y, /� .��,� Aat¢: CJ - z 9- 93 SignaN� : ��/�—`+ NOTICE: It, atler making this aeclaration, you s uld become sublect �o the Wy �ers' Compensa�ion provisions o� ��e labor Cotle, you must lonhwith camDly with such pr isions or ihis permit shall he deemeU revoketl. CONSTBUCTION LENOING ACENCY: I hereby affirm ihat ihere is a constNction lending agency for the pedormance ol ihe wark for which I�is permit is issuetl (Section 3097. Civ. C). ' LENOEfl: AODflE55: OWNEN BUILDEN DECLABATION: I hereby a�firm Ihai I am exem0� ��om Ihe Cantractors' Slate License Law lar the tollawing reason (Seciion 7031.5 Business and Pmlessional Code: Any ci�y o� counry which requires a permi� lo constmc�, aller, impmve, tlemolish, or repair any simcNre. prior lo iis issuance, alsa requires the applicant �or such permit �o �ile a 5igne0 slaiemen� �hat helshe is licensed pursuam m �ne pmvisions oi �he ConiractoK S�a�e License Law �Chapier 9(commencing wi�h Seclion 7000) a� �ivision 3 0� lhe Business antl Pwlessions Cotle) or Ihat he/sne is exempl l�erefmm and Ihe basis for ��e allegetl exempiion. Any violalion oi Section 7031.5 by any applicant tor a permit sublecis Ihe apDlican� Io a civil penal�y ol no� more Ihan �ive huntlred Oollars (SSOU). I, as awner af Ihe Dmpeny or my employees with wages as their sole compensation, will do �he work, an0 �he ❑ slmcture is not mtentled or o��eretl �or sale (Semion 7044, Business antl Pwiessional Catle: The Con�rac�ors S�a�e License Law does noI appty Io an owner o� a pmpetly w�o �uilds or imOmves ��ereon. antl who does such woB �imself/hersel� or �hmugh hi5 or her own empl0ye¢5, pmvitletl Iha� Such impmvemenis are no� in�en0etl or ofiered Ior Sale. I�, however Ihe builtling Or impmvemeni is sold wilhin one year al completian. Ihe owner will have Ihe huraen oi pwving Ae/she tlitl not �uila or impmve �ar Ihe purpose o� sale) I, as owner ol Ihe pmpeny, am exclusively conUacling with I¢ensetl conVac�ars �a consimct �he project (Section 7044, Business ❑ antl Pro�essions Cotle: TAe Conlractors' Siale License Law tloes no� appry �o an owner o� pmperty who builds or impmves thereon antl wha contrac�s tor suc� pm�ecis wii� a comracloqs)license pursuanito Ne ConVactors' State License Law). I ar� aware �hat pmaf oi Iheir Worker's Compensation insurance 5hou10 be pmvi0ed la me. \ � I am exempt wder Semion: B. 8 P. C. \ for I�is reason'. ' � �aie: Ownec I tlo hereby ceni�y ihat I am aware a� antl unaers�anA Ihe requiremenis of Caldornia Neatlh and Safety Code Seclions 25505, 25533, and 2553G antl Ihat I or any future building occupant will/will noi (circle one) neetl �o camply wiih saitl s�a�e codes and Ihe reQuiremenis for a permil lor consimction ar mo0ilication Imm ihe Pir Oualiry Management �isiricl. Residential consimction aDPlications are exemD� �mm (hQSP pf0VI510f15. �ate: AOPlicant. I here�y ceriify I�al I have reaa this applica�ion ane slate t Ihe a�ove informa�ion is carr I. I agree �o comply wiih all ciry antl county ar4mancesandsta�elawsrela�ingiobuilamgconsimclion yau rizerepresema�iv Ithisciry enteruponthea6ove�mentianetl pmperly lor inspedion purpases. r. �� "Oa�e. �t-93 Sgnal e oriver's License ar Social Secu�iiy x.� 164t�46 Whne—Bmltling; Green—Code Eniorcemenq Canary—ApplicanC Pink—Fevenue; Goltlenmd—Assessor CLAIM VAI,UE: 1,600.00 CALC—VALUE; 4,440.00 GROUP OCC; R-3 / COMMENTS; 300 S� FT OF LATTICE PATIO COVER TO REAR OF SF HOUSE *�r*x�+r**��rxxx** *�**��*��r�**��r�***x��*�e***x***�***��t�r�r*+�*+�**��r�t*x*��x�t*�r*** f Z O N I N G R E Q U I R E M E N T S G s E T a A c x s ------------ MAIN BUILDZNG ---------- --------- AC�ESSORY HUILDING --------- FRNT; 20 FT IN REAR; 13 FT 8 IN FRNT; FT IN RfiAR: F1' IN LEFT; 6 FT IN RGHT; 6 FT IN LEFT; FT IN RGHT; FT IN PARKING RBQ •� PROV; PARCEL; 14191113 2NE; RS REF NO; PLANNING NtiTES> ADD A 300 SO FT. LATTICE PATIO COVER TO THE: REAR OF AN > EXISTING SIIdGLE—FAMILY RESIDENCE, +r��r�r�r**+r�r*��r�**�r***�r��r��*�r*x��*x��**+t�t�r��r��*��r***�xx��**�r�r�r� �t��**�r*x ��*�* D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E A/�T� S ZONING APPROVED BY • L' DATE: CrT.� HUILDING APPROVED BY ; < <I,l DATE; �'� APPLICATION ISSUED BY� DATE; � 1EiFififitifikifififlEiflFiklF7E1EiE1fklfiF � �EiFiFlfiFiElEiFffiE ** iflF3ElEiE�EiElElEiFlFiEiEif�F�lhiFiF3Eil1PlFiFiEiE1F�EiEiEikiEiFiEiEltitifiE iE �EiEiEitiFlEih3fiEiEiEikiEiE3FN�iF1EiPiEiEifiF�F�E�FikiEiF3EiEiEiFiF LEGALI2ATION;N F E H S U M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72,00 50 PLAN 46.80 SMIP/NON—RES ISSUE EEE BUILDING—DIV—> PERMZT IS5UE PLAN—CHECR TOTAL PAID DUE TOTALS----> 72.50 0,00 46,80 119.30 119,30 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 119,30 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK� 72,00 .50 46.80 iE if iE it rt if iE iE it it �1F iE iF 1F it iF fF �Elt i! ik k!E �E ff il� iE jF iE �P k if iE 3E �E if if IE if fE 1f 1F 3FiE iE ik if �f 1E dE k�E fE i61P if if iE iF 1E fE �F iF'1F �F If i4 �E iE 1E * fE IE IE fE if iE *�E 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 E S C R I P T I O N UNIT COST TOTAL COST SFR 300 RES—PATIO COVER—POST' & TRELLIS 14,80 4,490,00 ' END OF FEES 0 O1 0014i957—�0141959 T O T 1i9.30 DATE: Ob,'24/93 TI11E: 12:15 � \ CONSTRUCTION AND PIANNiNG POOL & SPA . � APPROVALS Permit# Date Inspector qppROVALS Permit# Date inspector , ' t. Temporary Electriaal Seroice or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical Conduit Utility�Un53rgrnd. 54. Porms 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVA�TO COVER�GUNITE 7. Footings �7��i/4 � 5B. Electrical Conduit�Undrgrnd. - . � 6�! 8. foandation :- 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe�Undrgrnd. .- ,t - 60. Backwash Lines, P-Trap, C Undrgrnd. �� 70. Strucmral Ploor System 61. APPROVAL TO DECK . , 1 t. Property Sewer Line & House Connection 62. Backwash & RecePtorFinal I 12. Sewer Gap � 63. Heater & Vent-Final � 13. Roof Drains , 64. Plumbing Sysiem - Final - 1A. Rough Plumbing . 65. Electrical-Final , 15. Rough Electrical�Conduit 66. Solar System-Finat ��' � 76. Rough Eiectric 4Niring 67. Fencing & Access APproval . I 1 i. Rough Wiring Sign 68. APPROVEO FOR PLASTERING ' 18. Rough Electrical-T Bar Ceiling 69. POQL/SPA SYSTEMS FINAL i9. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducts, in Structure 70. Under9round Hydro 22.Ducts,Ventilatin9 � 77.FroductYipinyOGas ❑Oil 23. Gas Pipe-Rough & Test � 72. Underground Flush 24. Roof Framing � , , � 73. Undergrnd� Storage Tank L� Gas ❑ 6il 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (StructuralS & Monocoat 75. Dry Chemical 27. Frame and F�ashing � 76. Dry Standpipe 28. lathing & Siding � 77. FIXEp SYSTEM FINAL � 29. Insulation i j i 78. FIRE PREV. FINAL 3Q. Drywail Nailing � � � HEALTH DEPT. REQUIREMENT 31. Plaster 8rown Coat � 4 79. FINAL INSPECT40N I ( 32. Electrical Power Meter-Final � � � � 80. FOOD CERTIFICATE ISSUED �-�� 33. Finai Eleciric - � I ; Notes: 34. Final Heating & Air Conditioning � • - � i 35. Final Gas Pipe�Test � � 36. Hood or Canopy i � 37. final Factorv Fireplace j � ' 38. Final Plumbing � � j 39. 4Vater Service-Finat - � � 40. Gas Service-Final � i 41. Soiar pomesticFinal j � 42. Backftow Preventer � 43. Backfiow Irrigation - 44. Landscape Irriqation SYstem � 45. Sound Attenuation 46. Mandicap Regulations 47. FINAL STRUCTURE & BUILDIiVG � � � � �� , 4$. FINAL.PLANNING � ' 49. Electric Felease to Edison ' I 50. Gas Reiease to Southern California Gas Co ' 5L CERTiFICATE OF OCCUPANCY ' No. Dace �oonEssaeN�roia 300 BUCKNELL RD ox'r+ERSN.r.�EiFa�o^*+SCHMZDT, GREGG A woness:SCHMIDT, LORI L 300 BUCKNELL RD COSTA MESA,CA 92626 �vai. �uuNo �uo�ss: AfICNRECT Ofl FlYiNFEN: UMN.ON FNG.'S AUOflESS: caeim�crarswu�SEA POINTE CONSTRUCTION cam�croxswWwic15791 ROCKFIELD HL wo�ss: I R CA 92618 UCENSED COMNRCTONS DECLANATION: I hmWy dlim uMx pero�y d pe�ury Ihel I art (mmmendip wiih Sanwn'la00) d Div6ion 9 d �M Busirom entl Pralasaione COEe. uM mY lic ciW[itwo.: . _ uc. cuss: g uc. yo.: b 6 51 14 uhr: uc. xo.: UMT: (714)380-8659 uc. ra.: 6 6 51 19 urn: IcensW uMx prwiabne d Cheqer e fllb OIIIi11��01CB 911� B1�Bd. / /.EXP : L JDme: � / Cauretla: /�^� �� s- +sdW NE UILDEN DECLAflRTON: 1 Anetry dfirm uMx pauty d parN « I emy � hom iM Wmree«e licmea lew la tM 9euo o ro�an (Setlion )W 1.5 Bueiieaa ard Hdeaioru Cads: �M � a mun7.aa re0�� e Deemn to arrehuC. ellm. hnOrove. Mmd'a�, a repai arry etlucWre, q'v io a cauenca, e6o ieQwm iM d� �a � G� lo fib a sqmd staleme�h ihal M a ahe y i��e w+m,dn m me ao,;�: a na cw�mws u�o» �w [cnaa� s(oo��,a wn sm� �000) d d.e� a a ma \ eusnas+ ena vraesaure wael «�mm �e «sne a uemp �nsdrwn .ne �ne enb t« Ne elbped a.amqion. Anr �idmion d seabn ]a�1.5 by env eGW�� fa e permil aubjae+ iM epplcem to e dvil penelly d nol maa then fne hurdreE ddlen �SSW�. ❑ i.a.ow�an»wov�r�mv«�dwb+wm.�a,ma:.ob�o��.wmeo�won.�au».wa��moa�m�ase «on,.ea e« �a cs«w� �oa.. e��.�e a,w�� coaa: me cw�ma. um,.. �..wma. �w acdr�o �� w wawm wlw buaG+ar inpmves tMreon. ud who Eoea suM xak h'vn�ll «M1neM aWapM1 he a har own emplv+eae. D�+d �hm %uch impovemmla era ml inlenEeC o oMa�ed lar eeb. tl.Irowws.IM bullinp a inqouaneM w aold xilhin apY� d mmplelion. IM owrerbuJler wYl hew ihe EUMen d P�q he or eM ditl na W2E ar'unA� tor �M W W+e d aebl. ❑ i. � o�, w me wwam�..m••�v �m�.aro ..;m rK«.,ea �n.ca. ro w�aw m. adaa ts�� aa. a..�. �e d wn Pmfeviwu Code: The Canreeon liww Lew does m� eGVN b en oxner d pWMY xfio dutle a imV�'m iherean ud who mnirecU la mxA prq«te wdh e mareea(a) ticeroeA qusuen to ihe Com�mae lic«ue lewl. � I em uemq uMm Sec�ian: B. d P.C.. M Nu �maon: Dme: �� I do hereby ceNN �hv I em ewere d erd urMei+ie�d tM repWremam M CNiomie IbMh end Selery COEe Sediau ?5505. 255�3, enG 2553a. vk thm I a emy Mivs b ldi�q 000qeiq T/ wil ml (cwch pn) nsaG ro mmply wih eeid ems mdee erW ihe mpuiromann br Dele: �VW�: WOqKEP'S COMPENSATON DKLAPATION: I MraEy eKmm udr px�My d pryvy ms d tlw faOoMeq dedvat'wn: � I heve vM xil meiMe'si a anAuts d mmmt �o eeMiwrs M xwken' compenW nn. n prwided taW Swion �]OD af tAs leEu cae, �« ins o��a d m..«x i« �+:�n w v� m d.�e. �] I hew end wil meinlen woMn' mmpneeton i�rerce. m npu"vad by Sedian i/W d �hs LnEa Cods.lor iM peilormence d IM woA la which I�is W�n is ia�ued. MY xvrFen' oomG�ian'pqurencs mner eM DaKY wmEer are: cerrbr: CALIF COMP EXPIRES Pd'ry NumEu: Q 2� � 1� 9% (T1ris asdion nead na De mmdered I tM permt u M ane huMreE Edbra �St00� n Iw.) � I wnty Nel m tM1a p«lamenro d IM w«k br xfiicA thu permu u miad. I dWl m� employ erry n ury m eo m b becoma eubjea io iM ..anan• canoeneeron bw. a cwrmw,�a eoree u� a i M�.�dw � n. wonon� � comonw�ionn.wouna.w sea� s)ao d me Lee« coee. i wMa+h�n oomob �nn i W /np: Fsllun ro��curo wo�kori mmpwuetlon covxp� l� un (�ntl �lull ! en �nploysr ro crliM�sl p�v/tl�� en0 vll Iln�� up ro on� h�ntlrW fleua�nL �all�n (SfOqOGOA M M�1! ro M� roaf ol mp�rwfbR Gm�p� �s provldM br In S�ctlon 91a6 0l M� LMor COW, IMru4 �� mN+ �� CONSTNUCl10N LFNUINO AOENC�: I Iwaby eH uMs pr�My d perjury �IW IMre u e conmrud'pn WMirq epency b Ihe peAarmarKe d Ihe wM1 Iw whirh �na peemY b eaueE (Sedion �p9]. Civ. C). LENDEH'S NNIE LENDEN'4 110�NE59: 1 cenity IM1at I hare �md iho epplicmion uM elma thm ihe ebon iMpmelion b wnM. I eprea ta comply waA eA tlry erd oouMy adinenoes vM etme lern nletiq lo Wiltivp conmumai end MrebY e�e iep�mmiatiwe d �he dlyto eMer upon IM ebwe-memnned popeiy la imCedion WrP�s_ _. _.. _ WNIo-Buildiq Dme: �� Pink�levenue: Goldeneod-Asuaear CITY vF COSTP. MESA — BUII�DTNG PERMIT PERMIT NO: B 081101 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE; STR ERM NO: B 081101 GOVT: N SUPP: M PURPOSE: UTH JOB DESCRIPTZON : INSTALL BATHTUH SQ FT: 1,500 CLAIM VALUE; 1,500.00 CALC—VALUE: 1,500.00 GROUP OCC: R-3 / COMMENTS: REPALCE BATHTUH 6 TILES �c*****x�*�c*�****�cx**+��c**�*�****x+�*+c*x�*#�x�**�c+c�c�c*****�c�*�c*�»*�c�c*�c***�+��c*�c+��**+�+�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S -------- --- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: F'f IN RGHT: FT IN LEFT: FT IN RGHT: FT It�l PARKING REQ: PROV: PARCEL: 14141113 ZNE: REF NO: PLANNING NOTES> i *****�****�***�****�*��x��*�*�*�***�***+�*�**�x��*��****��*�*��**�x***�**�;�;� D E�� E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S ZONING APPROC�ED BY DATE; !� DUILDING APPROVEU BY : DATE: I APPLICATION ISSUED BY: ��c_� DATE: �1� � ��IEifiFlE1FlEiflfiflf-ikiEiEiElEI(-if1E1ElF1ElE�f��lf��f��f�f�3f3F iF3fi��3f3FiFi�3F7FiEdElElf�lEiElEiFiff(� i1iE �ILEGALIZATION:N P E E S U M M A R Y STRUCTURAL SEG ENT:Y BLUG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 48.50 .50 - _ SMIP/NON—RES FEE NG—DIV—> PERMIT ISSUE PLAN—CHECK ----> 49.00 0.00 0.00 ENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 48.50 TOTAL PAID DUE 49.00 89,00 —40.00 49,00 OVER/SHOAT: .00 FIRE SMIP/TOT GRADING PLI�N—CHECK .50 1E if iE ik 1f 1E iE� iE iE iE iE if iE if iE iE 1E iE if if iF ik iE it dE iE if if if if it iE iE iE 1E it iF iE iF iE %� ik if ik 1E iE iE IE 1E if iE iF iE 1F iE iF iF if ik 1E if if iE fE iE iE �E �E iE iE if iF iE f! 3E aE iE iE ik I N D I V I D U A L F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1500 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 1,500.00 END OF FEES B1-B9-1997/83:47 PM/f49.00 �cvra:ei-�aeeaea PERMIT:681191 CONS7RUCTION AND PLANNING L& SPA � � APPROVAIS Permit # Date Inspector pppROVALS Permit #___._ Date Inspeetor 1. Temporery Electrical Service or Pole 52. Poo� & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement . 3. Electrical Conduit Utility�Undrgrnd. 5A. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesl 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe•Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrrid. 10. Structural Floor System • 61. APPROVAL TO DECK ' i t. Property Sewer Line & House Corinection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent•Final � 73. Roof Drains 64. PlumGiny SYstem • Final 14. flough Plumbing 65. Electrical-Final 15. Rough Electrical�Conduit , 66. Solar SYstem�Final 76. Rough Electric Wiring 67. Fencing & Access Apuroval 17. Rough Wiring Sign �• 68. APPROVED FOR PLASTERING . 18. Aough ElectricabT Bar Ceiling 69. POOL7SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducts, in StruMure 70. Underground Nydro 22. Ducts, Ventilating 77. Product Plpiny O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Undergro�nd 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. Freme and Flashing 76. Dry Standpipe 28. Lathiny:�-� BACKFR ARD 'I�` % »• F�XED SYSTEM FINAL 29. Insulation 78, FIRE PREV. FfNAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electricai Power MeterFinal 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:, _�6.a's7 Q p _U� d2�C� � 34. Final Heating & Air Conditioning . �-(�, L {% n/ `1 1\ t ) � ! 35, final Gas Pipe�Tes[ � 36. Hood or Canopy • • 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Finai 40. Gae Service-Final 47. Solar OomesiicFinal 42. Backflow Preventer 43. Backflow �rrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING ��z�_G�� '(v� 48. FINAL PLANNiNG 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . No. Date �oonEssaew�ou+a ]00 BUCKNELL RD OYMERBNAIIEIFpqWN: SCHMIDT, GREGG A "0°"E� SCHMIDT, LORI L 300 BUCKNELL RD COSTA MESA,CA 92626 ,vvi. Yuiwo �oo�ss uKxrtEcron era��nn: ARCX. OP ENG.S AOOPES3: uc. no.: UNi: UM: �+^+�T�g"�°SEA POINTE CONSTRUCTION (714)380-8659 � cwrn�cToaswuuxa 15791 ROCKFIELD BL �pEu IR CA �c�� 665114 92618 �NT LICENSEU COMRACfOHS DECIAXATON: 1 Mleby dl�im u�ds perely d ps�ury Wt 1 am IcemeC uMn powmm d CMqw e (oommwiM xilh Sxrian )aa0) d Oi+u'nn a d Ne &aneaa eM Pmleasiana Code. ud mY lioeree b' IuA /acs ud e ea. uc. . /� ^ u. cuss: B uc.///�ppppp/16 6 51 14 X P: Va: / — � Cmtraear: VV ,NNE UI�DEP UECLANITION: 1 hmeby elfirm uMer penely d pe ry m I am mm IM CoNraqm Liorua lew In iM �sewn (Setlian 1W 1.5 Buinme eM Prolmfiona Code: AM muM' �fiitli 'vea e Pmnd lo mtubuG. ells. imNA'e. demdih, ar repei ary evudwe. pia io in buwnu, deo rayu'vea IM eppli sM la ach permu io fib a eqrotl Nelemenl Not ha «she n liceneed W��I �a tM pariviom G ihe Conirmore limma law IChepix e(commend�p xiih Seeion lppp) d Oi+eian 3 d iha Buaimn aM Prdeaons Cotle� w thel Iw p ehe ie eaemq Iherehom arM �ha beele la the elbped uamqion. Nry violeion W SeUion )031.5 by eny apdifent lor e permil �ubjxJe Ihe eppl'rem to e ckil per�elly W ml mas then 1'rv� huMreE ddbn �$SOpj�. � I.mow'wrdlM1epapenyamyemplayeeexvhwepeaaviMiedemmpeneation.wJldotMwak.eMlheaWCYunum�iniaMed or Mered lor eeb (SSAon )OM. BumroaeM Pmleceiona Code: TTe Comrmaa liomea Law dou m� eGVN �oen ownerd popenY wla buiEe a inpwea Iherem. vd Mw Goee vuM v.wk Nmaetl a henN a Waqh he a her ovm employw�. pwidW tAet wrJi impwemaro are m� imended a aflaAE fa e+b. tl, howevar. tM buik'up a inpwrnam o edd vritNn ms yw d mmWe�ion, IM ow�wrb�iNer xi0 hew �hs Eu�den d potinp M a tlro did m� dik or Mpove lar Ihe WT^ae d veb). � I. u mmer d IM pW�Y. em udeiYyy catlretl�q Mah 4wnfaA can4e[lon to cmmutl IM pqetl (Setlion )OM. Bus'vwa eM PMa�eone Coee: The Gaq�aqm L�caros lew dom nal rodY ro en oxm d V�wNY Wa buUds a imo�'x tMeaon ud wM contrec�e In wN pqw� wN a mnbeor(s) 4cemetl Wrmuant to tM Conirmm Lioense lex�. � 1 em eammq uMer Seclian: B. 8 P.C.. tar Nb iaeaon: '� Dale: Owner: I do �emEy eeniy Nel 1 em ewere d erd wdentaM IM reQuimnwua d Cellomu Heellh uM Sdety Code SeUiom 25505, 255Si, eed Y5551, eM �Iw 1 w e�ry tulun WiNirq aowyni xill / wYl nM (tlrcb me� need �o canpy wYh eeiC et4e coda ard �M rsQu'uammb far e permn laconetruc�ion«moCifiutunhant� A'v�arapemeni Dietria. RmideniW rnw�ion eppiretiamers e�emq Imm Npe povisiona. Dva: Npd'cw: WORKEX'S COYPFNS�TION DECWi1T�ON: I Mraby elfmm uMs pmMy d pajW me al tM kOOMmp ErLrmioro: CITY OF COSTA MESA - BUILDING PERMI7' PERMIT NO: P 081102 PLAN CHECK NO: CONSTRUCTION TYPE: V-N PERMIT TYPE; PLU JOB DESCRIPTION : INSTALL BATHTUH CLAIM VALUE: CALC-VALUE: N ERM NO: P 081101 GOVT: N SUPP: N PURPOSE; OTH SQ FT: GROUP OCC: R-3 / COMMENTS: REPALCE HATHTUB & TILES REF:B-81101 **�**��t*it*��it*��*�*�t�t**ie�teat**�*at��*�*�*it��xx�+�*�*�***+�***�r*x*ae*+��*�*+�**�*�*�# Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN HUILDING ---------- ----- --- ACCESSORY BUILDING --------- 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: 14141113 ZNE: REF NO: PLANNING NOTES> • i -� if iE iE if 1E �E iE �E IF 1E �E if 1E if if if �)E iE IE iE IF Ib if if jF �F 1E iE 1E iE 1E 1E 1E �F iE iE 1E iE 3E iklE 3f iE if !E if if.iF iE i(-1E iE iE iE 1E iE fE 3E �E k 1E IE 1F 1E 9E 3E IE �E IE �E 3E iE it iE fE fE 3E iE IE D E V E L O P M E N T S E A V I C E Si- R E Q U I R E M E N T S I ZONING APPROVED HY . BUILDING APPROVED BY APPLICATION ISSUED BY: iE if 1E iE fE 1E �)E 1E 1E �F iE iE if iE if if 1F if lE iE 1E iE LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE PERMIT 26.25 258 PLAN ISSUE FEE 22.�� DATE: DATE: DATE: iEiE1E1EiFiFiflE � 3( STRUCTURAL .EGMENT:N SMIP/RES GRADING SMIP/NON-RES ❑ in...d,e»e�a,:�e�.nu'wed,�„mio..n.�,.,�ar«�a:�w�.e.wabeet«Wsw:.,s�oodm�iaeor $UILDING-DIV-> PERMZT ISSUE PLAN-CHECK TOTAL PAID DUE Gode. ta tM perlmrencs d Ns warl( la wNc� Mie pamu is inueE. � i��,��,•W,,,��„��„a�u,a��a�„�,�,b,�i„�„m,,,qa��„ TOTALS----> 26.25 22.00 0.00 48.25 48.25 .00 ., wak la wtiidi thie M�n u mueA. MY wrtMen' mmPancetian ina�vies �amar erd W�Y number are: c�..: ('ALIF COMP_ EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 48.25 OC�ER/SHORT: .00 'aK+'"°'"^^° �:��F.'•'�'�11555 �)�/�1/97 RLL-�G PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK �mr: s.e;� ,�e �,a ae �v�ee r m. ro�x r: ro. �e n��d,ed da� Isiool w i.a..l 4 8. 2 5 ❑ I canN Um in tha pMwmarca d iM work for whcA ihia peimit u iavusd. 1 ehell � employ eiry pemn in Y men�ror o n to �arow4�totMxorYereconpenwion4vndCdilanie. WreetlWdlehol becmre� qtotMnwYae' iE1E1E�fkiElEjEihifiElElf3ElfiflFiflfiEifiE�lElEiEiflf�iEifi(�ififlElfiFiEifiEiE�E�IEfE�EiEiEiE1E3ElE1ElflElEih1E1f1EiEiEiE1(-iE1F1Fif-ifiElElEiE1E1E�lEiEiEfEj(-ifiElF w pen �iayqria�o aun �ypp d ihe leEor CaEe. I ehell�h wmpry MM th m.vion�. i�r � I N D I V I D U A L F E E B R E A K D O W N ovn: nop�m: we OF�Yunbs�cwvrortri�o�q�nonr.wsnw�� ,��euw� hct+�«ro�o�rorn�wow�u»Ne TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST flnu �q ro wro ��rEreC �Inuurtl e�yn (S1PO,OWA a+ � b M emt ro�wrwlbM1 �anup�� u prvHOM Iw In Sxtlon3lo6oltluleborCob.11rtnu(�Memmsy�lwa PLU 1 BATHTUH 8,75 8.75 CONSTHUCTION LENqN6 AOENCY: I �weby eifimi uMar qrely d pxj�ry Ihei Ihen o e conn�uaion WMinp porcy br Ne PLU 1 SHOWER B,% S A,-I S �n��ame..w�e�wn�wme,.mire4.,reats��be�.c�.e�. PLU 1 WASH BASIN -- 8,75 8.75 LENDEfl'S NM1E: LENOEfl'S ADDRESS: END OF F E ES I cenAy ihol I �eva reaC �hc epdwdim uM qye ihet Ne abova iNmnation u conae. I epne io canply wnh ell iily eM couny ordinenoae - enA elate lewe rNeliq lo buikip mutrutlbn vtl Mreby eNhqr¢e repeaenle�ivee d Ihia cily 1a anler upon �M ebwa�meMuned qoperly i«m.oea;Mw�o�WYMAi� LANC oma: � . � 81-89-1997/83;48 PM/f48.25 RCPTR:81-8089384 PERI'IIT: 681182 CONSTRUCTION AND PLANNI� ' JL & SPA ' _ APPROVALS Permit # Date Inspector APPROVALS Pe�mit # Date Inspector 1. TemPoraiy Electrical Service or Pole 52. Pooi & Equipment Location � 2. Soil Pipe•Undrgrnd, 53. Steei Reinforcement � 3. Electrical Conduit Utlity-Undrgrnd. 54. Forms . � 4. Efectrical Conduit-Undrgrnd. � 55. Electrical Bonding 5. Stee� Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE 7. Fooungs 58. Electrical ConduirUndrgrnd. • 8. Foundation 59. Gas Pipe, � Undrgrnd., 7est 9. Water PiPe-Undrgrnd. • 60. Backwash Lines, P-Trap, C] Undrgrnd. 10. Struaturai Floor System � 61. APPROVAL TO DECK . it. Property Sewer Line & House Co�neciion 62. Sackwash & fleceptor-Final 12. Sewer Cap ' • 63. Heater & Vent�Final 13. Roof Drains � � 64. Plumbing SYstem � Finai ' 14 Rough Plumbing i I`IS'9 �� 65. Electrical-Final 15. Rough Electrical�Co�duit - 66. Solar System�Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign . 68. APPROVED FOR P�ASTERING 18. Rough Electricaf-T Bar Ceiling 69. POOL/SPA SYSTEMS FIPIAL 19. Rough Heatinq & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Duc[s, Ventilating 71. Product Piping O Gas p 0il 23. Gas Pipe-Rough & 7est 72. Underground Flush 24. Roof Framing 73. Undergrnd.Stora9eTank �Gas ❑Oil 25. Roof Sfieathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Ory Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sidinq 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Dryv.�all Nailing HEAITH DEPT. REQUIREMENT 37. Ptaster Brown Coat - 79. FINAL INSPECTION 32. EVectrica{ Power Meter�finaf 80. FOOD CERTIFICATE ISSUED 33. Fina� Electric Noter. �� Jr rn6lnlG V '�/ i�7 �i�uc.H-P_�.0 �-K,_ 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy . 37. Fina� Factory FireplaCe 38. Fina�Plumbing '-2�-q, �� 39. Wate� Service-Final 40. Gas Service-Pinal 41. Solar pomestie�Final 42. Backflow Preventer 43. Backfiow Irrigation 44. Landscape Irrigacion System 45. Sound Attenuation 46. Hand�caP Aegufation5 - 47. FINAI STRUCTURE & BUIIDING , • 48. FINAI PLANNING 49. Electrie Release to Edison ' 50. Gas Release to Souchem Califomia Gas Co ��_ . 51. CERTIFICATEOFOCCUPANCY No Date OWNER KENNEDY� Robert G. JOB ADDRESS 300 Bucknell Road GENERAL CONTRACTOR Owner-Bldr. AP No.l 1- 11-13 LOT TRACT INSPECTIONS S�qnof� SOIL GAS W ATER ROUGH PLUMBING PROP. $WR. LINE � HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AN� AIR CONOITIONING TEMPORARV SER UNDERGROUNO [ ROUGH WIRING TRENCHES � FLOOR SVSTEM BON� BEAM � SHEATHING POWER FORMS Lf STEEL REINF. STEEL REINFORCE n FftAME ANO FLASHING LATHING — IN n OUT [l PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. ANO A.C., FINAL PLUMBING. FINr1L AND GAS TEST I� DATE H-4-71 BUILDING PERMIT N0. DESCRIPTION of WORK Blockwall FIRE ZONE VALUE S 00.00 SUBCONTRACTOR � � . . 33489 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant [o Fill in Complete/y ".lIG-�;-71�a:o00 ?84 �,�:.::;.a�^Q APPLICATION FOR BUILDING PERMIT EI E BV TE' R/ECEIVED DATE ISSUI ADDR�SS c�)(J(/ �L � / Q]/� � Y' � 7� 'P�- //. OWNER ) L � {i�,��n A.P. NO. MAIL � BUILDING D AOORE55 Z ADDF�SS � a U CITV � �y�(�L�NpL�'�•'6 TFACT a/ ZZ � Q CONSTRUCTION a m LENDEq �/ J� J � BRANCH —^ J N OWNER m J ADDR�SS � m ARCHITECT �– TEL. — S "� � OR E fNEER V Q FIRE w K ADDR�SS 20NE 7 aw W Z APPROVED J O CONTqqCTOR B� m Z J � ADDR�55 � W TEL. ZON `/ PLANS ' Z � CITV NO. w0 STATE CITV �'AROSAPPROVEO y K LIC. Nb. LIC. NO. MAIN BUILDING � O A (FROM C/L STREET) OF L07 � pLr X � DU t NOW ON LO S I ROIYT FT. USE OC ` � EXISTING BLDG. F' SIZE OF NO. OF �- Z NEW84DG. — ROOMS �— STORIES L.SIDE FT. U EXTERIOR WALI �_ ROOF _� COVERING COVERING REAR FT. J USE OF gUILDING AND WORK TO BE PERFORMED DISTANCE BET. a o, `' r.ww a�ocs. � ��/7" D v� c u P� N� � �� APPROVEO Z 0 VI �areby eeknowladpe thet I have reatl this application antl stnte � Mat Na above Infarma[ion is correct and agrea to comply with � all luw= ragulating builtlinp cpnstruttion, antl I shall not amp�oy � nny Pofson In violatlon ot �he workman's compensation laws of y tho Sta�o of Colitornie. ZI hereby carNty thnt I am pro0erly licansetl es a convactor untler S�. FT. the Sta�e o� Celifornia 8usinass end Pro/en7ons Cotle, Div7s7cn 3, TNE AMOUNT SHO Chaptar 9, entl chat sueh licanses ara in tull force entl affect, or I TME PVRPOSE OF ES nm oxampt irom me provlzions of the Stete of California Buzinezs VALUATION antl Prqtossionf Cotle, Division 3, Chaptar 9. Sipnntu�e of ��J n�' ///'yyy �,/% Parmittee " ' • S �/�1i i7 � Q / ¢.Li AUNor(iatl AOant LOT ROUP � DATE USE OF NEW BUILDING VARDS APPROVED ACCESSORV BUILDING �� /,f FT � �/� FT. FT. I t/� BET. MAIN & ACCESS. BLDGS. DATE APPROVED IIATF Y �� // TOTAL FEE A m � O UATION IS FOR iMR FEIE O'NLV: Q C� r � �� m �� `o LL � � f � � '• 9��$rg COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA •FOR APPLICANT TO FILL IN BUILDING 1� n� ADDRE55 �OO _BIICtiue� RLL. COSTA MESA. CALIFORNIA OWNER yY' MAIL ADDRESS 1 ch, Cal. 93ID0 $�8 �� 9 � � L,� APR ai �� L_ �ic�a��CE DEPT. ��v �;� c�sTA ra� APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PEf1MIT,NO T�o: MI b-322'7 ADDREI55 ��c. COSTA MESA. CALIFORNIA NO. 'll y�71$t. UO. CITY LIC. NO. IEGnL ILOT I DESCFIPTION NO. � BLOCK A.P. NO. 5'ZE 62 x l00.1,8 OF LOT USE OF E%ISTING BLOG. SETBACN LINE FNOM r/� �E�_ APPROVED NO. SSID9 BY TRACT <�� OF BlDGS. 0 � ON LOT REAR YARD 25'-6�� SIDE VARD RIGHT 6 LEFT O DESCRIPTION OF WORK NEW x ALTERATION I ADDITION REPAIR I pMOVING 1_ DEMOLISH S ZIE DING �/��0 ROOMS 6 STORIES 1 O EXTERIOR WA�L ROOF COVERING 9tuaC0 COVERING wood Shing USE OF NEW BUILDING residence and att.�arage I�lBil 1—A CORRECTIONS ihe Amount shown under vaivation is for the 1 HEREBV ACNNOWLEOGE TN�T 1 XAVE RE�O TXIS APGIICATION �ND � Q Q es a is mg a permit fee only. ST<TE THnT TMQ iBOVE IS CORRECT AND �GREE TO COMPLV WITH �LL CITY OPOINPN� ♦ ST�TE L/.WS REGUL�TING BUILOING CONSTNU - iior+. VALUATION SIGNATURE O e�_ PERMIT FEE S �Jr�OO PERMITTEE /�/� y7. SO 15,967�W PLAN CHECK $ s AUTHORIZE GENT TOTAL FEE B Jr�L•JrO "e�r :