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HomeMy WebLinkAbout1174 BOISE WAY - Building Permits Ao CITY OF COSTA MESA , BUILDING DIVISION Fy ,I77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us t>. FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: M10-00084 PERMIT TYPE MECH STATUS: ISSUED APN: 14169139 DATE ISSUED: 08/27/2010 ISSUED BY: RMD - ' JOB ADDRESS: �1 ,BOISE_Wl(°CNI Suite/Unit: Vicinity: HALLWAY CLOSET SQ. FT: 0 • - SCOPE OF WORK: MECHANICAL PERMIT TO CHANGE OUT A FAU < 100 K BTU, SAME LOCATION (HALLWAY CLOSET)AND ALTER DUCTING THROUGHT•OUT FORA SFD. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. OWNER: HUANG CHEN C H Address: 1174 BOISE WAY Unit: PHONE: 714-435-0370 City/State/Zip: COSTA MESA,CA APPLICANT: KERNAN,CAROL • Address: Unit PHONE: 714-525-5994 City/State/zZip: CONTRACTOR: GOLDEN WEST HEATING AND COOLING License No. 922314 - Address: 123 S PRITCHARD AVEUnit: UNIT 4 --- PHONE: 714-525-4020 City/State: FULLERTON,CA ZipCode: 92833 ' CELL: , • MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $52.00 PLAN CHECK FEE: - ' $0.00 INVESTIGATION FEE: - $0.00 • REINSPECTION FEE: $0.00 TOTAL FEES: $52.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE*. INSPECTION TYPE DATE IN1I1IALS CODE* INSPECTION TYPE DATEf IINN1111AL$ n 1616 Fixed System Final Fire Prevention 206 Final Mechanical X M-a r'/Q 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 -Final Demolition 250 Final Building/Occupancy - of . lf WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver s e. ❑Yes ❑ No 1 I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance, as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Car°er?, or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed A the permit is valued at one hundred Collars($100)or less) 2,Art 2,Sec.341,Title B,Califomia Administrative Code). (C../ Number: ❑ As owner-builder, I will not employ anyone to do work which would l 1! I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless iss 'd, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should be a subject to the wor ers' compensation provisions of Sectio 3700 of Applicant's Signature Date th L bor Cod,9P a?fo with comply with thgse provision. 'Si awr I ur e n JAM_ on^ J\ oIP. Division of Industrial Safety Permit Number: t` �• e, HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in ull fore and effe t. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.•— ' It, C-lass-#t • —c ' (Section 25533 of the California Health and Safety Code, with some /L1/ exceptions, requires registration with the Costa Mesa Fire Department by / i` �:J/ each business which at any one time has on hand a quantity of acutely conttado SG. ure" Gogte hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work/or which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑ No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the Califomia Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If'yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 01 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the 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 authorize. by this permit until final inspection. Sing ature of al 0 merle) Signature Date '//[rjf/,/rA//,/i/t # . ) OAr� 3057-46(3/07) O Simplified Prescriptive C^�` a of Compliance: 2008 Residential HVA( -atinns CT-IR-ALT-I3VA([ �., Chin tc Zones 1 and 3-7 1 S ' / Site Address: l'p( Q_1 w41 Enforcement Agency. p Dats in(dentin,0l o�� ( J Conditioned C•''DDuccttinssrluiatiot , ilk ` Equipment Type' List Minimum Efficiency2 Floor Area requireme _ 1�Q_ Thermostat • O Packaged Unit Over 40 f f duc 4umace O AFUE O COP 0 Setback 0 Indoor Coil OSEER I 0 1-1SPF7.7 Served by system added, re I n sf pnpfidilio a pace (Utall ahead,present.must be 0 Condensing Unit 0 EER_ 0 Resistance tGYR 6 (CZ 1,3-5) installed)lledJ . ❑Other Y 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies: 13 SEER,78%AFUE,7.71ISPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application. /� Name: y_.�„ iejA t .\ �,j ncik rgnature: J Company::�_1�t ii•/J t. ltU or 40 1 lb�tt Date: ��..1///�/© Address: t�J V I License: f t !� aax3iV CitylSiate2ip: _'f'�G Phone:7/f 5:25—_. `tc-t 2008 Residential Compliance Forms March 2010 (ENFORCEMENTAGENCY • CAN.CU &MIZE' VITHLE1aERFIEAD/SEAL) t 2008 Building Energy Efficiency Standards Residential HVAC Alterations • Climate Zones 1 and 3 through 7 ` GZ-6 c Lasvi• r�RsFi • BUSINESS AND PROFESSIONS CODE,SECTION 7110 Willful or deliberate disregard and violation of the building laws,including the California Building Code,and local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board working in conjunction with the local building department. This action mayconsist of fines,up to S5,000 per violation or suspension/revocation of a contractor's license. WHEN IS A PERMIT REQUIRED? A written construction permit shall be obtained from the enforcement agency prior to the erection,construction, reconstruction,installation,relocation,or alteration of any mechanical system,except as permitted in Appendix Chapter 1,Section 112.2 of the 2007 California Mechanical Code. Projects requiring permits include,but are not limited to: • New I-IVAC installation • HVAC Changeout • • Replacement of furnace,coil,FAU,or condenser • Relocation of an existing HVAC unit •• Adding or replacing more than 40ft ducting in unconditioned space 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces;room heaters). 2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13'SEER. • 3. Newly installed or.replaced ducts must have a minimum insulation value of R-4.2. ,• 4. A setback-type thermostat(24 hr clock with four set points)is required for all alterations. , 5. New,or replacement ducts must meet the mandatory requirements of Section 150(m): •• All'joints and openings in the in the HVAC system must be sealed. • Only UL 181,UL 181A,or UL 181B approved tapes or mastic shall be used to seal duct openings. -• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4ft.max for horizontal runs with no more than 2" of sag between supports and 6 ft.max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. I • PROJECT ADDRESS: 1174 BOISE WY 23a UNIT: OWNER'SWNER'SNAME: TEATS, EDWARD A CITY OF COSTA MESA - BUILDING PERMIT PERM NO; P 067541 ADDRESS: 1174 BOISE WAY DK -rt) f2A 6e-e PRA P tY PERMIT NO: P 067541 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA, CA 92626 wa pt "em • CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH 549-2350 OR 2300 • ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : WATER HEATER C/O SQ FT: ADDRESS: UNIT: PERMITTEE: NOCK PLUMBING CLAIM VALUE; CALC-VALUE; GROUP OCC : R-3 / ( 714 ) 895-1246 ADDRESS: 11610 SEABOARD CIR COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT STANTON CA 90680 ***************+ ********->E****** -**BF*******' **** -*+r•*+r+FBF***yF******yHy *******er***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my ' ense is in full force and effect. CITYLIC.: Ka,�0^50386 STATE LIC.: 5 11 9 7 1 CLASS: C-36Th SETBACKS :.e' —( E{ LY Signature: - J MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800, Lab. C). LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT ; FT IN POLICY ND.: 1167992-94 EXP. DATE: 03/01 /95 COMPANY: STATE PARKING REQ:. PROV: PARCEL: 14169139 ZNE: REF NO: El Certified copy is hereby furnished. m. Certified copy l fled Lwith the city Butldi'g Division. PLANNING NOES> e: -I LiP G(� Applicant --- � *********************************************************************a:********* EXEMPTION FROM WORKERS'COMENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)orless). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE: If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY , DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: t DATE: which this permit is issued(Section 3097.Civ.C). .N.*****{E***********-*.*****y****{(-*.*.*,;-.k-} ,p .y*.-.N.*}p******* W***,******* [L* rt LENDER: ******************************************************************* :*** .******* ADDRESS: LEGALIZATION: N F E E S U. M M A R Y STRUCTU AL SEGMENT : N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 , 00 ,r ' repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed _ pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 2 5 ' ' SMIP/NON-RE S and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work. and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 7 . 00 20 . 00 0 . 0 0 27 . 00 2 7 . 00 • 0 0 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or o0ered for sale. If,however me building or REVENUE DIVISION TOTALS--> COLLECSED• 27 . 00 OVER/SHORT ; i . 00 mprovement purpose oft salei)hin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon '' and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law). l am aware ***********************#•*************-k' * * **************iE***********-)i************ •-' that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL ..:F E E BREAKDOWN ❑ I am exempt under Section: B. &P.C. for this reason: TYPE QTY DESCRIPTION- , UNIT COST TOTAL COST Date. owner: PLU 1 WATER HEATER AND/OR VENT I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and i 7 . 00 7 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END. OF FEES permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from these provisions. ' Date: Applicant: • • I hereby certify that I have read this application and state that the.rove information is correct.I agree to comply with all city and county ' ordinances and state laws relating to building construction andr thorize repres•i tatives of this city to enter upon the above-mentioned - property for inspection purposes. - 01 00162239-00162239 TOT 27.00 tate: IO �(y signature: —gm 1 DATE: 06/14/94 TIJIE: 0947 Driver's License or Social Security a: '"i' 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor . • ' - L CONSTRUCTION AND PLANNING POOL ., SPA APPROVALS Permit Date Inspector APPROVALS Permit 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 UF ER 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. 10: 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 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 # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' 6 35. Final Gas Pipe-Test 6 enSal 36. Hood or Canopy l 37, Final Factory Fireplace /!.\�� 38. Final Plumbing / -7f. t4 ( /LJt� 39. Water Service-Final t�l�l L `T 40. Gas Service-Final 41. Solar Domestic-Final 42. Backt low Preventer 43. Backflow Irrigation 44'. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations , 47. FINAL STRUCTURE & BUILDING • • 48, FINAL PLANNING • • 49:. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and.sign all appropriate declarations __ _ PE MIT NO TRACT NO. .LOT NO. . 9284 8/28/85 - 'e5a50 Tl ES�A[ CQNSTRIICTInh: cFRMLT • • ! , U•NIT NO. i , Pr Au ss I/v7/ s — _c:72.6,4430 ' Y - ' . : 383.3 4' e— r.. _ _ , • /�Q%,,O� TYPE OF CONSTRUCTION'• '❑ NEW%❑ ADD. IJ ALTERATION EPAI R Applicants Marling Address' l^%j� ! - i _ - - ! ❑ CONVERSION '❑ DEMOLISH ❑'O ERk AP # /I : • ' ' . r _ Zone Owner's.Name t =� .:�=/. i 'Phone /s-DyE S JRPT ION OF_WOR K/USE�9F DG. r ��• �e� �� 7� Address ,� • ' - e,( / 5S SEn sc o 51 'e.- . - lot• - b S. Main Building:. .( 1 Accessor Buildm I ; ,- Z ' i7 MSR ��/-LI "y��/j/ (// /f 9 y' g' . Arch/Eng. - License No.' - - • • t • TYPE OF PE , Li GRADING• LJ FOUNDATION ❑ STRUCTURAL • , T Front - - - R T - t - • • ❑ TENANT ❑ ELECTRICAL _❑'PLUMBING ❑ MECHANICAL g - - Address - _ �f� /''� • • ' p _ , Rear I .•i Contractor s Namr'�� i /�Q 4Y�I h -Phone p d��- ❑"OTHER ' - _ A - I PROJECT DESCRIPTION, SQ. FT.' z.y• VC! -OCCUPANCY C Right 1 N • Address(mailing) - 'S . . l7 - l , 7 �y K' - 1 m C' i - CONSTRUCTION TYPE • VALUATION $ D s Left i City License No e' 7 .� I • ZONE GRADING CU.YDS. ' ACR S - - , R LICENSED CONTRACTOR DECLARATION ' • - - Ping. Ref.# • Parking Req./Provided •. - E I hereby affirm that I'am licensed-under provisions of Charter'9 (commencing ' • Remarks: • I • ' - Planning Notet: ' , • I - ' - - . with section 7000) of Division 3 of the Business and Professions Code, and _ _ - - - r - - • T my license'is in f force and effect. , I - - I ' • __ ' • License l repose N ' - - S Date � Si9natu r���Y1 L./.i / -G�'?rd PLUMBING FEES • •.I WORKS 5'COMPENSATIO C ATION . ' : ' - - i , Bar Sink I Showers i ' ELECTRICAL I •;FEES I hereby affirm that I have a certifica of consent to self-insure or a certificate • of Workers' Compensation Insurance,,or a certified-copy t reof (Section ._ ... - _ . �� 3800, Lab. C /'a// V V,//^,',`(ry/p Backflow'Preventer --Service Sink'-' Automatic Washer a Trarisformer 0 15-50 KW • ' Policy No.��i� 7ft/+ ss' Company /G •!/ Backflow Irrigation Sewer Ca-p. ' - ' I i : ❑ 50�+ KW' i • f ❑ Ce bfie copy is y furnished. , ' • Construction Pole Sub. 1 l here • {1 e rtif 4;py: R€d with the city ',ding ' i . . ��{fir 'r� Bathtubs Sewer Connection. ). • Cooking Unit i Meter ❑up to 100 amps ! DDD���fff /Q , • e Applican •, , EXEMPTION FROM WORKERS' NSATION DECLARATION Clarifiers _ ,Solar ColleCtorS _ _ ,Dishwasher _ ,( _ _ _;Meter ❑over 100 amps 1 _ (This section'need not be'complet if a permit is for.one hundred ($100)or - t , f less): I i Dishwasher Solar Piping Dryers ❑Gas' Electric 'Sub Panel- I I certify that in the performance of the work for which this permit is issued,I ' • �'_' shall.not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank I Fan 'Motors❑0-1 HP ❑1%-B j Workers'•Compensation'Laws of California.i _ Date' ' Signature Floor Drains• ' ' SwimmingPool&Spa ' NOTICE: If,after making this declaration,you should become subject to the • ' p F.A.U. Inc.Solar ❑9-15 HP 016-15+ .Workers' Compensation, provisions of the Labor'Code, you must forthwith . i Floor Sinks-; - - -' - - - Urinal ' -- --' - - --' -comply with, such provisions or this permit shall be deemed revoked. - .F ixtur¢5 ,MICfOW¢V¢ 1 i CONSTRUCTION LENDING AGENCY ' ' Gas Service Outlets' Water Closet, T Device Boxes • i ' I hereby affirm that there is'a construction lending agency for the performance' I Pole Light , of the work for which this permit is issued (Section 3097 Civ. C.) t ; Interceptors • = ' Water Heater , ' -. 'l • Outlets 'Ran ¢ ' • Lender's Name - -- 9 I •; Lender's Address - Kitchen Sinks ' ! - Water Service . • OWNER BUILDER DECLARATION ✓. ' - - . $Witches Sign ' I hereby-affirm that I am'exempt from the Contractor 5 License Law for the ' 1 Lavatories • ' - ''• - ' Auto�Wash Garbage Disposal 'Standing Sections following reason (Section' 0 to construct, s and Professional Code: Any city or _ _ - i - county which requires a permit to construct,alter,improve,demolish or repair I P-Trap - Laundry Trays- , 'Generator ❑0-5 KW ❑5.15 KW Trash Com actor I ' any structure, prior to tIts-issuance,tatalso requires the applicant for such permit • • - _ - ' _ p I -to file aligned statement that he/she is licensed pursuant to the-provisions of • 'Roof-0rains - - • I " 'the Contractor's License Law (Chapter 9(commencing with Section 7000) of t ' -. Division 3 of the.Business and Professions Code) or that he/she is exempt - • - _ • ' I . therefrom and the basis for the alleged exemption..the: applicant of Section - - - - • i ' ';-7031.5 by any applicant for "a, permit, rs ts.the.applicant-to a civil ' • ( _ - enalty of not more than five hundred dollars($500). - - I $ j. U I, as owner of the property or my employees with wages:as their sole Reinspection Fee �I $15. • I Issue Fee 3 ' I compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 ' . Issue.Fee . 1$ 3 • for sale'(Section 7044, Business and Professional Code: The.Contractor's ' t . - MECHANICAL • FEES - . - • License Law does not apply to an owner of a property'who builds or improves - -. . -. - - -- - _ . thereon,:and who'd ods such work himself/herself or through his or her own - _ - DEVELOPMENT SERVICES REQUIREMENTS:, , - employees, provided that such improvements are not intended or offered for Boiler _ Hood or Type I 0 ! • • - sale. If, however, the building or improvement is sold within one year of com- -- - - - �. , Canopy Type II :❑ , - ' Zoning Approved By Date ` pletion, the owner will have the burden of proving he/she did not build or im- i Duct-Under Ground : , i _ Building Approved By Date / prove for the purpose of sale). ,• - / )!Q'/ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System Application Issued By • L ) /AC7 / I Date �/� t ' tractors to construct the project (Section 7044,Business and Professions Code: - —4 - J"4 The Contractor's License Law does not apply to an owner of property who Duct-Ventilating . r., . ( 00-100,000 BTU 0100,000 BTU ' • • SUM A V EES 1 ' builds or improves thereon;and'who contracts for such projects-with a'con- ' I rypp/�), l�� , ' tractor(s) license pursuant to the Contractor's License Law). am aware'thatBUILDING PERMIT !$ -/ ✓ , SMIP• '$ • / J (( ' Exhaust System 0 Multiple 0' System Repair/Alteration I. proof o their Worker's Compensation insurance should be provided tome. , 1 1 I - PLAN CHECK ;$ I • PERMIT • • 0 I'am exempt under section B:&P.C.for this reason Firepl/Fact.Bit ICBG# Fire • Dampers' I PLUMBING $ • ISSUANCE •$ • Date • Owner 1 - - Heating System & Ducting Registers PLAN CHECK 25% $ i ENERGY P.C. $ ' - ' I hereby-certify-that- Ilhave read this application and state that the above -'- El 0-100,000 BTU ❑100,000BTL' - - • - •-- '- - .. '- '- ' ' • ELECTRICAL I$ GRADING $ i E information is correct. I agree to comply with all cicounty riz ordinances e- I and state laws relating to building onstruction, and hereby authorize repre- . ) MICROFILM `$ t sentatives • his .city fo enter on the above-mentioned p -tor = l _ i PLAN CHECK 50% $ inspectio •un. � A_� •_ _ _; MECHANICAL $ TOTAL FEE $ �.I /i1• • Signal e / '�s���.%a'�+9"' Date ori✓ ;5¢or 55# ���� =� '. Reinspection Fee $15 ) Issue Fee $ 3 PLAN CHECK 25% $ • ' , . CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1 1 CONSTRUCTION AND PLANNING f POOL ur SPA ROVALS Permit# Date Inspector APPROVALS Permit Date Inspector Temporary Electrical Service or Pole - 52. Pool & Equipment Location • . 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 UFERGrnd. 57. APPROVAL TO COVER-GUNITE ••.,Footings • • 58. Electrical Conduit-Undrgrnd. 8.4'Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9'Water Pipe-Undrgrnd. - -60. Backwash Lines,P-Trap, 0 Undrgrnd. 10.-Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12.-;Sewer Cap 63. Heater & Vent-Final - 13Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - • 66olar - . SSystem-Final 1.6. Rough Electric Wiring 67. Fencing & Access Approval - 17. 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 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74..OJerhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation" 78. FIRE PREV. FINAL 30. Drywall Nailing 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 35. Final Gas Pipe-Test • 36. Hood or Canopy' 37'.'Final Factory Fireplace - - 1 38. Final Plumbing 39. Water Service-Final • • 40. Gas Service-Final • 41. Solar Domestic-Final - 42. Backflow Preventer 43. Backflow Irrigation . 44. ,Landscape Irrigation System 45. Sound Attenuation • . ' 46. Handicap Regulations JJJJ , �a/ 47. FINAL STRUCTURE & BUILDING ' 8/�.7 gr. 48. Special Requirements Completed -` I�"'" .. • 49. Electric Release to Edison - - :50. Gas Release to Southern California Gas Co • . i I51. CERTIFICATE OF OCCUPANCY No. Date , _ _ .. ,•• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA CONSTRUCTION PERMIT PER NO cT��. TRACT NO: LOT NO,: • UNIT Nib,, ! + 4669, I I /22/85 5000 TL Project Address '�/-/ q��-1/,c�,t�/(flit �'t - , •j c �• '1 .�:u „ ,� - _ ' Applicant's Mailing Address' p ///C..�W' /7 • - • TYPE OF CONSTRUCTION `❑•NEW'U-ADD U ALTERATION L/REPAIR - ' - S. Owner'sName.. / n 'Phone' - ❑ CONVERSION -❑ DEMOLISH ❑ OTHER- A P # - - t , . t Zone , ��.�s _ _ _ `DESCRIPTION OFzWORK/USE OF."B LDC. - - Address �Lf�// CA - - - - _ S Main Building: Accessory,Bwldmg I- - + _ .' - _ E _ . Z Arch/Eng.' - License No., • ' ' ' . TYPE OF PERMIT ' ❑ GRACING_ ❑-FOUNDATION ❑ STRUCTURAL: . _ T Front ; , ! t I ❑ TENANT -❑ ELECTRICAL •❑ PLUMBING ❑ MECHANICAL B N Address - t 'p /�/� r :-❑ .OTHER v' :. - _ - A Rear + ' ,. Contractors Name 114 a./� 1 / /phoneFSQ uaJ - C Right r ^ - -t ' . N g �i'�' ,r, I PROJECT DESCRIPTION SQ, FT, ( r OCCUPANCY' _ I Address(mailing) •/ -�-L r • -CONSTRUCTION TYPE - •VALUATION $ . K Left . , R� City License No. D7 - 4 ZONE - GRADING CU.UDS. • ACRES ping, Ref, # ' Par king'Req./Providedi -' - E ` LICENSED CONTRACTOR DECLARATION I - ' - •" - Q. I hereby affirm that I am licensed under provisions of Charter 9 (commencing . Remarks: • Planning'Notes ' M i with section 7000) of Division 3 of the Business and Professions Code, and • - - . • - ' _ - - ` my license is' force and effect. ., . - _, - ' y • I - •' I • i License CI ice s• _ $ i Date--2 SignatureI. �77� % / _ .%O. 1 I PLUMBING • 1 FEES A RFCFIVFII ,1f1V' I R 1QAF ' WORKERS' COMPENSATION DECLARATION • I Bar Sink 1 Showers • ELECTRICAL FEES �. I herebyiaffirm that I have a certificate of consent to self-insure dr a certificate - - - ' 1 ) of Workers' Compensation Insurance„or a certified copy thereof (Section y--- _ _ _ __- � 3800; Lab.-&)&242624,,,A -- -- - - - Backflow Preventer - - Service Sink, '• 1 - - - Transformer 15-50 KW - p-� Automatic Washer �\ Policy No, p J• Company ' /14 (., - 1 Backflow Irrigation l Sewer CapI 0 50+KW ❑Eertified copy is hereby furnished. O Construction Pole'Sub. ' ®"CertJJJ'i/'p���a/jjj co y is filed with the cit �`0'.•/• Div / I Bathtubs Sewer Comlection Cooking Unit ! Meter ❑up to 100,amps I 1 • Date/ KERS an NS ON I i _ - ._ - - __ ._ .. .- Clarifiersp" EXE PT N.FROM WORKERS'COMPENSATION DECLARATION Solar Collectors Dishwasher _ 'Meter ❑,Over 900 am s -(This section need not be completed-if the permit is for-one hundred ($100)or - ' '" - - , less). I Dishwasher - Solar Piping Dryers ❑Gas' (]Electric !Sub Panel, l I ( {- I certify-that in the performance:Of the work for which this permit is issued, I • - '^ ' shall.not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank : Fan , .. ' 1 1 Workers' Compensation)Laws of California,' — ' r; !' Motors Lb0-1 HP 01'3-'g Date Signature Floor Drains Swimming Pool vd/Spa I F.A.U. -Inc.Solar-u9-15 HP 016-15+ 'NOTICE: If,after making this declarati the you should become subject to the - 1 1-- - - 1 Workers', Compensation provisions of the Labor Code, you must forthwith,,," ' Floor Sinks.: _ _ ' - •, Urinal --- - -i - - - Fixtures' " '�'"' CIO a e "'"' - comply"with,-such provisions or• this permit'shall be"deemed revoked. - 1 - ,M' w' v r I 1 1 CONSTRUCTION-LENDING-AGENCY , ' _ - - • - I I Gas Service ' $'Outlets ,Water Closet, Device BoxesPole Light I hereby affirm that there is mconstruition-lending agency for the-performance. , , g 1 of the 'work for, which this permit is issued,_(Section 3097 Civ. C,) - - - , r Lender's Name- - - t Interceptors' - •1 Water Heater " - - • - • 0Q Outlets Range ' 1 , - ! • Lender's.Address - - - _ I ' .• Kitchen Sink. ' b; Water Service ' - ' - Switches Sign - I OWNER BUILDER DECLARATION " " - .. - ' - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories .o - I . _ Auto-Wash " ' Garbage Disposal 'Standing Sections ' following.reason (Section 7031.5 Business and Professional Code:-Any city or ' . county which requires a permit to construct,alter,Improve,demolish or,repair P-Trap. ' - Laundry Trays - , ' , T. Generator 00-5 KW 05-15 KW ' • any structure, prior to Its issuance, also requires the'applicant for such permit + " - Trash Cofnpactor to file ed statement that-he/she Is licensechpursua it to the provisions of Roof-Drains r •, _ - i • the Contractor's License Law (Chapter 9(commencing -that action 7000)of. - • • - Division. 3 of the•Business and Professions Code) or that he/she is exempt , - - - _ ' -therefrom-and the basis for-the alleged exemption, Any;violation'.of Section ' _ r ) 7031',5 by any. applicant for"ad permit subjects the,-applicant,to a civil ' - - - _ • _- - • l - 'coenalty of not more than five hundred dollars($500). '1( - - - . - • $ 3 , , • I 1; asi owner of the property or r4.-em-ployees with wages as their sole .Reinspection Fee': I. $151 Issue Fee ' • , compensation, will do the work, and the-structure is not intended or offered "' -Reinspection Fee I $15 ,Issue Fee, $ 3 for sale (Section :7044, Business and Professional Code: The Contractor's - ,•- - MECHANICAL FEES - - - • - ' License Law does not apply to work hi er of a property who builds or improves ' ' -- - - thereon,;and who does such work'hv see/herself or through his or her own , r , ' . ., - . - • F ' DEVELOPMENT SERVICES REQUIREMENTS:' - 1 I ' employees, provided that such improvements are not'intended or offered,for Boiler - Hood or Type I I 0 • - • sale, If, however, the building or improvement Is sold within one year of com- - Canopy + Type II 0 I _ - Zoning Approved By Date • + prove f, the owner,wilthave the burden of proving he/she did not build or im- Duct-Under Ground - • - /' Building Approved By 1 Date _ ' prove far the purpose of sale). i • ' , 0 1,as owner of the property, am exclusively contracting with licensed con- —J Duct-Structural Refrigeration System j : - " Application Issued By Date / --C. ,.3 J tractors to construct the project (Section 7044,Business and Professions Code: •- - - , , , The Contractor's License Law does not apply to an owner of property who _ JI Duct-Ventilating ' Do}100,000 BTU ❑100,000 BTU I SUMMARY OF FEES - • ' -builds or improves thereon,and who contracts for such-projects with-a-con- J - - "_ �- - - "- - - -- - - tractor(s) license pursuant to the Contractor's License Law), I am aware that j BUILDING PERMIT $ r SMIP $ - • Exhaust System D Multiple 0 System Repair/Alteration t- , , proof of their Worker's Compensation insurance should be provided tome.. - PLAN CHECK $ RR PERMIT : I 0 I am exempt under Section - B.& P.C.for this reason • Firepl/Fact.Blt. (CBO# Flit-Dampers PLUMBING $ • V'a d ISSUANCE ' $ . • HeatinS PLAN CHECK 25% • $ • ENERGY P.C. , $ Date Owner' Heating:System& Ducting ' Registers �� ' " i 1 I hereby, certify that I have read this application add state that the above - 00-100,000 BTU-0100,000BTL • • • - • - - - - - , $ ' 1 - ' info • rmation is correct. I agree to comply with all city and county ordinances " - ELECTRICAL ' $ GRADING and state laws relating to building construction -and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ ' sentatives of this,city to enter upon the above-mentioned property for zs-�' inspection Pur. s,•{ . I I 1(/V ' • ' Signature �� Al1 i.t0i i.r_ • Date /O — ' MECHANICAL $ • - TOTAL FEE ;$ Drivers' License or SS# . - Reinspection Fee ; $15.; Issue FeeI $ 3 PLAN CHECK 25% $ , . _• - - _ . - - . . __ I _ - - .. - CMF 0865-46,rev.10/84 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod - Assessor ‘• ' . CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# 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 S.,,Steel Reinforcement _ 56. Rough Plumbing & Pressure Test , 6. ElectricalUFER.Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings h 58. Electrical Conduit-Undrgrnd. 8. Foundation a 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. 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 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# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe:Rough & Test 72. Underground Flush 24. Roof Framing 73- Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat i • ,, 4 75..Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Piaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: g cgr-r-C ,J 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing _ - 3-Y6 L.lib 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer '43. Backflow Irrigation 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date 20739 . FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT . OC I 7 IU63 P.O.BOX 917 COSTA MESA,CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely igiFFI STIC69 q'WR 11T • TYPE�OR/��PRINT - BUILDING • BUILDING 1' w_ `Vp_/ For Office Use Only ADDRESS 1374 rnr j r W v RECEIPT NO. 707,a.9 9 . COSTA MESA, CALIFORNIA .. 4((1111773 RECEIVED BY • DATE RE ElyED DATE ISSUED • 41— OWNER Nor thc'ate,a nartnerehin �� A3 'T t C BUILDING 7/ ��/ i/b'�1. - _-_ }A r/`^� MAIL 15939 LasFlores St. ADDRESS '7` �O`Y�Z.L J ADDRESS TEL / ^ FIRE �/ CITY Fountain Valley No.5316792 ZONE ' TYPE ' {�' GROUP yr ARCHITECT ' TEL. APPROVED OR ENGINEER C. Hiller. KE3200; BY DATE No. Anaheim / ZONING ADDRESS � /�' - ZON ./ %/ I NO.OF /J USE OF N i 'i , , CONTRACTOR [�Bonser - Const. Inc. 1� PLANS Y/(\ BUILDING ADDRESS 15939 LasFlores °°`"'n'° / 1'� 'S—Oo'f� • CITY Fountain Valley A.P.NO. C =° NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.NO. 215049 NQ. 591-6792 90'TO SIDE B REAR P.L. - EAVES SIZE !� NO.OF BLDGS. ALLOWED - (U.B.C.REQUIREMENT) OF LOT601X1nn1 NOW ONLOII'Inre YARDS APPROVED YARDS APPROVED USEOF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. none (FROM C/L STREET) SETBACK LINE FROM , FRONT e 0 FT. FT, C / CENTER OF STREET 4 J r REAR YAfiD. �rj 1 SIDE YARD I LEFT . ) 1 ' I RIGHT Al R.SIDE .5C PT. FT. DESCRIPTION OF WORK L.SIDE 6 Fr. 3 1 FT. • NEW X ALTERATION ADDITION REAR S FT. FT, 1 DISTANCE err. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING�C }'t ROOMS VAR.P. DATE SIZE 1 J9sy 5 STORIES 1 C.U.P.# APPROVED EXTERIOR WALL ROOF APPROVED 7 io T--G3 COVERING StUCCOI COVERING sh inu'1e BY l� DATE USE,OF BUILDING AND WORK TO BE PERFORMED ' r single family res. Ix,�attach.ear 6 • • /x-59 N SQ.FT. . B I HEREBY ACKNO DOE T T ' VS R • THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE TH THE AB• E E C,R-ECT ND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL ITT ORD A ES • STAT': LAWS REGULATING VALUATION - BUILDING CON TRUCTIO.. • PERMIT FEE $ ! '--- j SIGNATURE F PERMITTEF . •.~/'• - ,/ �I m $lY 7�� L C E i o' ¢ AUTHORIZED AGENT /� $ a — I'' TOTAL FEE .•te