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COSTA MESA BUILDING-SAFETV DEPApTMENT
P.O. BOX 1200 COSTA MESA, CALIFOFNIA 92626
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BUILDI
OWNER HELTZER ENTERPRISES-BR00:
MAII
aooaEss 740 N. La Brea Avenue
TEL.
cirv Los Aneeles. CA 90038 No.
BRANCH Main Branch
ADDRE55 600 S. SprinR St., L.A. 90054
OR ENGINEEFi�' 121dS & Silverman No��653-0160
ADDRESS 113 N. San Vicente, Beverly Hil
CONTRACTOR GeorRe J. Heltzer
ADDRE55 740 N. La Brea Avenue
TEL.
ciTv Los Angeles, CA 90038 No. 937-2ll1
STATE CITV
uc. No. 3144 uc. No.
SIZE NO.OF BLDGS.
OF LOT I NOW ON LOT A7n..o
SIZE OF NO.OF z
NEW BLDG. ROOMS STORIES
E%TERIOR WA ROOP
COVERING �laster COVERING WOOCI
USE OF BVILDING AND WORK TO BE PERFOFMEO
Res'dential
{� ��� / 7`S . �� _ ��lCi
APPLICATION FOR BUILDING PERMIT
A.P. NO.
BUILDIN(
ADDRES
ER
FIRE
ZONE
APPROVED
DATE
I�
NO.OF USE OF NEW�.. (���.
� l ��' PLANS � BUILDING t �_,_ �
YARDSAPPROVED VARDSAPPROVED
MAIN BUILDING ACCESSORV BUILDI
FROMC/LSTR�ET) �
REAR 32+F
DISTANCE BET.
MAIN BLDCS.
VAR. #` �
C.U.P. � � � —
APPROVED
BET. MAIN &
ACCESS. BIDGS.
7 � DATE 3 !�C '�.
APPROVEDi
I hereby acknowletlge ffiat I have reatl Mis apD��cation antl state G/ U
thet ffie aCove intormation is correct antl agree to comply with �
all laws regulating builtling consVuction, and I shall not employ �
any person �� �{olation of ihe workman's compensation laws oT
MeStateofCalifornia. r�� /' �, � � . �
/ .' !� S4. FT. / �i n /,+�.r� p
I hereby cenify that I am ptoperly licensetl as a contractor un0er
the 5[ate of California Business antl Protessions Cotle, Divisicn 3, THE AMOUNT $HOWN UNDER VALUATION IS FOq �
C�apter 9, antl thai such licenses are in tull forca antl ettect, Or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLY: m
am ezempc from c�e provisions of the Statt ot Calitomia Business
VALUATION
antl Protessions Cotle, DiY�yion 3, Chapter 9. PERMIT FEE $ ♦ �
r
SiBnature of '/� •• : I (�'t �-)� i/;� m
P¢rmittee ' y(� `LG- : .,/ . � . ' g I � �' / / /' ./ PLAN CNECK S `/' �e J E
i ��' �"a �
Auffiorizetl Apent � :/ �„�.. ��� � u
0
,eeCS'auoaess: 601� BROOKVIEW WY
OWNEfl'SNAME: H� KVIEW CONDO HOA
awness. 630 PAULARINO
CM., CA., 92627
(714) 587-0399
RNLM/ENGINEEfl:
ROOflE55:
flEG.NO.:
UNIT:
I1NIT:
PEflMITTEE: MESA ROOFING CORPORATION ( 714 ) 548-3012
aoon[ss: 8q3 W. 17TH ST
COSTA MESA CA 92627
LILENSED CONTBACTOB OECLAflRT10N: I heie5y afhrm I�ai I am hc?nse7 unGe� �rovi5f0�5 0l C�apter 9lmmmenting wiN $eclian
i0001 0l OiwYo� 3 0l IA¢ Busmess an0 Pm�essions COOe. ana my Oce�s? 4 in b•i�' an0 eHeci.
cirxu��/c.: JJJ0'''35681 STATEL�C.:SG4S cuss: C-39
--�Jaie � L��l�, � Si9naw� — _ — — —
W08 fl5' COMPENSATION OELIAflRT10N: I nereGy anrt tnai i �are a ceni e of consem t selbins re or a cetlilicale ol Workers'
Lompensaiion 7y5��y�� o{ �cYr�iLe�rqpy Inereo� �Senwn 30W. la� L,� � O 1� 9 q
POLILY NO.: 1' Wl, 9 6/ V V E%P. ORTE. V
coMvaxv: GOLDEN EAGLE
D CenilieC capy iz nereny IumisheU. L�S Cendiea cod+rltl N�m Ine ciry Buildi eie .
�j c
Oate'. � � _ / � AODhcanl' � —
E%EMYTIOHFflOMWUflBEflS'COMPENSRTIONOECUI1A710. (IDissecuonn¢¢eno—�compieteaiitAepermnisloroire�unareG�11001arless�.
I ceNty t�at i� ��e perto�mance o� ��¢ wo�k lo� wRic� t�is pe�mit is i55uetl, l s�a11 wt employ any De�soa i� any manner so a5 �o hecome .
su��ecl to Ihe Workers' Com�ensation LawS ol Cahlomia. '
Daie: Signamre:
NOTICE: tl. afier making I�is Eeclaralion, you should Oecome su��etl Io the 1Vorker5' ComDensa�ion provisions ol t�e LaCor
CoOe. y0u mu51 Iorthwii� mmpry wiih Sut� O�ovismns or I�iS permn 5�all �e Geem¢0 rtvoke0.
LONSTBOCTION LENOING AGENCY: I �ere�y aflum I�al I�ere rs a cons!mdion lending agency lor I�e petlormance ol I�e work lor
wmcn �nis oe�mit is issuetl (Section 3097. Crv. CI. .
LFNOEfl:
ROOflESS: i
OWNEF BUILOEN DELLAflAT10N: I nereGy atlirm Inat I am e.em0� ��on �ne Cemracmrs' State License Law lor Ine lollowing r¢ason
i5etlion 7031 5 BuSness ana Professional COGe: Any c�iy 0� couniy w�rto reQui:es a petmit to consirucl. al�er, imOrove, Qemolis�. or
�e0art any smclwe. O�im lo its rssuanc¢. also reQuires Ine applicam br suc� ce�mu m hle a signe0 siaiement tlut �e/s�e is Iittnse0
�ursuam Io Ine pm�sions oi Ine Com�acmes' Sia�e License Law ICnxo�e: 9lcamm=ncing wiin Section 7000� o� Drvlsion 3 ot Ine Business
ano Prafess�ons CAoe) ai inat he/sne is exempi I�eretmm a�a ine Dasis fa ine zlie9eo exemD�ion. Any vio�ation of Seclion 7Q31.5 ey
xny aoo�icanl lor a oermil suoiecis ine aoolicant Io a cinl oenalty of noi awre tran Iive nunared eollars (`�1.
I, as owner ol tne orooeny or my empioyees wim wag=s as inei: soie comoensaiion, wili Oo the woik, an0 me
❑ s�mcmre is not intenOeU oi oflerea fo� saie (Secuon 76:a; Busmess z�G Prolessional Cotle: Tne Contraaori Siate Urense law
does �oi aODN Io an own¢r OI a O�oOerly wM �mIGS er imOmv?5 mereon. ana w�o GoeS Sut� work �imi¢IV�erselt Ot I�roug�
�is or �¢t Own em0loy¢e5. O�aviUe� I�al Suc� imD�ovemeni5 a4 �ol iniende� or onerea lor sal¢. II. �owever I�e �uilding or
imoro�emem is so10 wiinin one year ol compleHon. Ih= owner rn!' nave tne 6urden of O�oving he/s�e tlia nol EuiIE or imorove
for Ine ouroose of sa�e�.
i. as ov:nei ot �ne pmDeny. am exclusiveiy mm�aa�ng wnh I¢ens=s comracmrs to cons�mct the Dmle�� ISection 70a4. Business
❑ and Pr01e59on5 CAGe: ihe Caniratlor5' S�aie Lit¢n5e La:: OoeS nGt a�Ply 10 an owne� 01 Dmperly wh0 builCs oi im0�a�es I�ereon
ana w�o comians lor suU o�o�ec�s wnn a connacmqs� bc=as= oursuac, :o Ine Comracmrs' State �icense �aw�. I am awace
��al Oroot ol IAeir Worker 5 Compensation insuran�e spoultl 0° � P:�Oec lo me.
� I am e.emo� un0e� Sec�ion 8 8 P C
�onnrs reason
Oa;e o:ne.
' ao nere�y ceroiy inai I am aware ot and undeisian0 ine repuiremenis o� Ca�dorme Heatr� and Salety CoUe Seuions 2550i 25533. ana
259d antl IIIAI I or any tulme �uJdmg oceupanl wilVviAl pp1 ftecle onei -E: ;o co'➢pty vnih saiE slale cotles an0lne ieQui�¢menis lor a
;e:mil Ioi cons�mclmn oi mo0d¢auon hom me Au OuaIG� !.L=wg=a=c: �->:rid R?s��enlial consim[Iion ap�licalions are exempl hOm
1'�BSP p�Ovi5i0�3
G?I¢ AOVb(an�
��Pr¢py cPIIdV Ibdi I �dvC rPatl ��i5 appLcaUOn an0 slal¢ I�a; I�e a�0':� n'C+'�dti0� i5 COrt¢tl. I dgrP¢ 10 C001p1y wil� all Ciiy an0 COuniy
Te�nan�esanaslalelawsrelaung�o0ml0mgconsVucOona�anereD-�^'^-�'-'- "'-'^'� �I�iscnyloenleruOonNeaOove�menuoned
J'�ae�P: loi msoeclion pwooses
� � ` /
lilo % / ' /'�� $i9fldlllra '.�1'�
-Y^�
7���re� s ��<e�se o� Souat Sec�nr; •:
=-,�<6 Wbi�e—Bmlamg. Green—Cotle Enbrceme.r, Caaar,—ap;�:a�� '�� —Rev¢nue. Goldenroa—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064027
PERMIT NO: B 064027 PLAN CHECK NO: N GOVT: t3 SUPP: N
CONSTRUCTION TYPE; � PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION ; T/OFF, � 6 REROOF N/COMP SHINGLES SQ FT: 8,645
CLAIM VALUE; 8,645.00 CALC—VALUE: 8,645.00 GROUP OCC:�R-3 /M-1
—��
COMMENTS: REROOF W/COMP SHINGLES INCLUD 603-605-607-609-6118�t00K�IEW WY
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Z O N I N G R E Q U I R E M E N 5— �
S E T B A C K S
------------ MAIN BUILDING ----------
FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN
— ACCESSORY BUILDING — —
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 93405061 ZNE: REF NO:
PLANNING NOTES>
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY ,
DATE:
HUILDING APPROVED HY ; DATE:
APPLICATION ISSUED HY; DATE: '
+r+rit�rrit��r�r***�e+t*w*r+t�rr *+t*�tw+tfrir�rr . *
MMMMMMMffMkMiFiflflfM*MMMMMM1fMffffMlfkMMlfifMlfMMMMMMffMklfMffffffkMff�fitMiflFifftlFklfMlflfMllMMMffrMlFlfMlfY
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108.00 .86
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ISSOE PLAN—CHECK
108.86 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMHING ELECTRIC MECHANIC
108.00
TOTAL PAID DUE
108.86 108.86 .00
108,86 OVEA/SHORT; .00
FIRE SMIP/TOT GRADING PLAN—CHECK
.86
1fMMItffMkkkifRkfflFlflfMkMftMkkMMklfYM7fMlfMffMklfltlfffM7FMif41flt1fklfifY1f47tNMk1f1f1fM1fMM1fMlfifMMiFiflfkifkMiF
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 8645 REROOE BY VALUE RESIDENTIAL NOZONE 1.00 8,b45.00
END OF FEES
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