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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
c:_�l.r.,.�,...,. cm:.�r..__i_...i.. .
BUILDI
ADDRE
OWNER
MAIL
arv Los
HELTZER ENTERPRISES-BROOKVIEW
740 N. La Brea Avenue
TEL.
Angeles, CA 90038 tio.937-21
'N United California Bank
BRANCH �in Branch
ADDRE55 600 S. Snrine
ARCHITECT
OR ENGINEERF12.Zd5 S Sli
ADDRE55 113 N. San Vi
CONTRACTOR George J
aooaess 740 N. La B
cirv Los AnReles, CA
STATE
uc. No. 3144
512E
OF �OT
USE OF
E%ISTING BIDG.
T
TEL.
; No. 937-
CITV
LIC. NO.
INO.O LBF�DGS.
NOW ON LOT
S12E OF NO. OF
NEW BLOG. ROOMS STORIE$ 2
EXTERIOF WA ROOF
COVERING �laster COVERING wOOd
USE OF BUILDING AND WORK TO BE PERFORMED
Res' ential
�L �P.l l %i �-��L .%�./l�G
R
APPLICATION FOR BUILDING PERMIT
f�y�D BV �TE qE�VF�D DATE ISSU
�f � �
�:.'
FIRE
20NE TVP
APPROVED
BY
�4�3-C No. oF .Z
� PLAN$
VARDSAPPROVED
MAIN BUILDING
(FROMC/L5T/�i. EET r
FROM �C� "'FT. �'I �
e e�..� Y'1.S�r (](7.
REAR .�J�t FT.9�
DSTANCE BET.
MAIN BLDGS.
CURP # � `73�
APPROVED
BLOCK
DATE
USE OF NEW _j (. J(�
BUILDING ,� G
VARDSAPPROVED
DATE (� l
APPROVEDv 7O� /�
. �'��
...+c J'.�._. .
I hereby acknowletl0e thet I have reatl Uis application antl stace �
inat the above information is correct antl agree to comply witn � �
all laws regulating bviltlinB �onstruction, antl I shall not employ '
any person in violation Of Me workmen'S tompensation laws of �
Me State of Califomia. }� f � —� % to
� C' S�. FT. / /� � !'fl"�_ o
I �ereby certity that I am O�operly licensetl as a cOnttactor unCet
the State ot California Businass antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR j
Chapter 9, antl that such licensas are In full force entl effect, or I TNE PURPOSE OF ESTABLSMING A PERMIT FEE ONLV:
am ezempx from M provisiont of tha State of Celitornia Business yA W ATION
antl Grofessions Cotl��ivisiOn 3, Chapter 9. �f� , pERM1T FEE 4
i / �
Sipnature of � ' ' G// / � - / m
Permittee �i�L�� �." ��� 5 � �� `�L�� PLAN CHECK $ L� ✓ /�'�
i: E
�A / . ) i � ! ' `o
Aut�orizeC Apent .
LL
TOTAL FEE S
/
l
;
PHOJECT RO�qESS: ( 1 2 B ROOKV I EW WY
a snamE: BROOKVIEW CONDO HOA
aooness: 6 3 0 PAULAR I NO
CM „ CA., 92627
(714) 587-0399
ApCHIFNGINEFN:
AUDNESS:
PfC.NO:.
uxn:
UNIT.
PEaMiT�EE. MESA AOOFING CORPORATION t714)548-3012
aooness: 843 W. 17TH ST
COSTA MESA CA 92627
IICENSED WN1BnCTOB OECIAflAliON: 1 nereD, a':i�� :>�al I am FcenseU un0e� ➢�wiso�s o1 CnaDtei 9lcmnmeix.ing w�I� Section
700�� ol Drvis�an 3 at tne Busmess a�a Prplestm�5 C�ce anG my hcense is in fuli mr va eneU
c�r.uc.: 035661 sTaTEuc.:56415 cuss: C-39
Date 11� � S�gnature _ � " _ _ � — . —��—+--
WOHN�OMPENSA710N DECUqATION: I �e�e�y a.,� n at i nave a ce , e oi co�sem m seu�ii mre or a cennicate oi Worpers'
'•mpensatio� Insurance ar a cenEiee cop IDe�eo� ISec;ion 380D. laD. C1.
,ucvno.: PwC24167505 f%P.OATE: O7IOS�9�I
comrnxr: GOLDEN EAGLE
❑ Lmniea copy is nereoy �umisMe. B Cenaiea cooy.�, wrtrt tne city emiam - mo
�i L
9a�e: `7— �� � Foolicant' � _7.
� F%EMPTiDN FPOM WDP%EPS' LOMPENSAPUN OFCURATVON'. (SM5 sKiron m¢d nW Oe comDl¢tM �I Itx'dermt 6 iM one Mbte6 {S10H� w 1¢Ss).
I t certi�y that in t�e Derto�mavR al trte �wd to: wtdd� Ilus D!� ^ul R i55UC�".. I ShaA nol emplo'( anY pprsOn in anY Rann¢r so a5 10 be[om¢
SO��PLI 10 tllE Y:Of4Qf5 �.OmP2n5dI1011 �dWS �� C211i0��1d
I �ale-. Sqw;u:e.
NOSICE: Il, allet �na�ine Nis C?Gztalron. y0u sn�ul� Xcome Su��e[t Ia Ne 17orker5' CO���ensation Drons�ons ol l�e La�or
� Goce. you must far.nwitn comory �+t� sucn oro��sio.^.s or tnis oermit shal� De aeemea revoie0.
�I, COhS i qUCTION LENDING PGENCY: I he�'dy a"ir.n G£ t�ere is a conslNc(On IenOing agency for ine oetlormance o� ine work lor
wmcn Inis oermit is �ssueG ISeCno� 3P]7. Gv. GI.
LENOFfl:
a00XE5S:
OWNEP BWLDEfl OECUNRTION: I �¢re0y a��irm :�di I am eeempi �mm I�e Loniraclors' Sid@ L¢¢O5t Law 10� Ih¢ t0110wing �¢dSOn
!SeNOr. 7031.5 Busness antl omleisional Wde Any o;y o` muniy whitn repNrzs a permit t0 CO�vrun. alta. imprwe, Oemofrs�. or
+eonn aa, s:runu�x. c��o� to as �nux�e ��w �eum�=s m= xaW�<am ler suU permn io tile a s�g�e0 itatemem Nai ne(ehe is li�ensea
pursuam io �ne oronpon .: . c Go�tratlors' 9ate Lice�se La�• It�ao�er 9 �commmcmq x+e� Sec;wn 7000� ai Urvision 3 0l �ne Business
ana Pm�essions Coae� or �na� n!is�e is e+emp; inereiroT ane tne Oasis �or �ne aliege0 e�emo��on Any violalion 01 Se[li0n ]p31.5 Oy
any apobcam �ar a Oermii w��EUs I�e apo�Kani Io i ci�nl ce�aCy o5 not more �nan iive �unOr?C aNlars 135W1.
i, as owner ol me o�ooeny oi my emoioye=s m�n waqes as men wle campeasa;ion, nill Ao I�e wo�k, an0 tne
.� simcwre is noi intenoeu or ouerea mr sale iSecew� %W. Business a�a Pmiessional toee Tne Comranors S�ate ��cense Law
aces noi aoWY �o an ownei ot a p�ODe4y +:M �u0C5 9t �m9mve5 V�eteon, an6 v:bp Cp¢s wch wo(� tumselt/IUR¢If o� tluUugA
�is or ne� onn >moio7ees. Orovlae0 tnat sucn imOrov?ments are not in;endea ar o�4reU br saie. i1, �owever t�e �unamg or
improvemem is 5oi0 wnbin one year ol comph��o� m= awner w91 nave i�e ouraen oi �:onng �eis�e Cia noi Wila o� imD�ave
b� Ih¢ Pp�9DSP D1 �i¢)
i, as owne� oi �ne orooenY. am ertWsiveN com:act� ;:.nn I�ttnsea camranars to mnsl:ua tne Dmlen ISenion 7044. Busines5
�� an0 Pro�e5LM5 C We Tne Convanors' Siaie Lrce�s= Law aoez nof a�My �o an ownei ol mocer.y wtm CmiCs a impaves i�rereon
an6 wR� rAnttact5 lat Suc� pto�C[IS wii� a Conl:aClo�151 IittnSC pursVant to I�t COniq[I0:5' $la;e U[ei5e Ldwl. I am aware
t�d� 0�001 01 IRQI� \':pl4p��5 COrtipP�5dIN0 �OW�d�CP 5�0�10 �2 O�ONOCQ 10 RIP.
Li I am ¢vemDl unCer Secbon: B 5 P C
�0� I�iS �Pd50�
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064034
PERHIY NO: B 064034 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTROCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
.,/'1
JOB DESCRIPTION ; T/OFF, • 6 REAOOF WICOMP SHINGLES SQ FT: 8,645
CLAIM VALUE: 8,645.00 CALC—VALUE: 8,645.00 GAOUP OCC: R-3 /M-1
COMMENTS: REROOF H/COMP SHZNGLES, INCLUDED 6d�-614-616 HRG(,�ICV�EW
w«��wrrwr*�«rrw«**w�r*w*«*ir**rr�*w**r*rr**�«w«s**�wrw*«�c*rr*�c*w�t�«��w**+�+cwr**w*
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 ----------
ERNT: FT IN REAR: FT ItJ
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING ---------
FRNT: FT IN R£AR: FT IN
LEFT: FT IN RGHT; FT ZN
PARKING RE�• PROV: PARCEL: 93405Q65 2NE: REF NO:
PLANNING N TES>
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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
20NING APPROVED BY , DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; � DATE: �
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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
PLAN SMIP/NON—RES
ISSUE FEE
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECH TOTAL PAID DUE
TOTALS----> 108,96 0,00 0.00 108,86 108.86 .00
REVENUE DI�IISION TOTALS--> COLLECTED: 108.86 OVER/SHORT; ,00
BLDG PMT PLUMBING £LECTRIC MECHANIC FIftE SMIPlTOT GRADIt�1G PLAN—CHECK
108,00 .86
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I N D I V I D U A L F E E B R E A K D O W N
TYPE
Oa�e O.+ner I SiR
i oo •�ereDy cero�v i�ai i am a+:are oi ano un0ersiane ino ro;,.,•>�¢nts ol GaOlomia N¢xitn anC Sa'e:� Looe Seniais 25505. P553?. an0
2553+ ana mai I or ;ny �mure �mmmy acupam vnN+.,a nc: rtrc�= onel neea io comory wrcn sam n,ate cooes an0 tne �ea���emems �m a
pp:�Mt t0i COns{�u[1wn 0� mOW�4dkM1 I�Om 111f Pt1 Cua9:. !1i''dg?Infnt URV10. FkLU¢nJal fArSPyCIWt1 dp�hLd'JU�IS d(e 2+¢f110� 1fOm
mese o�ovisions
'Jate Apoi¢ant
i nere�p cermv ��at i nave �ean mrs apokaiwn ane siz�= rz; me aowe mta�mairon rs wrrea i z„�ee m compiy xvn all �ily an0 county
o'Cmancesanosin;ebr.sr¢Idlm9la�Nlaingw�9mtl�oo2'I;,h=:�-+^'^^•••. °'�IalivesollNSCuyf�?r;e�up00illea00ve�menllone4
o:a_=nv to� mso^nwn pu:�oses
� � `_
7�> r/, � �" �� 5ign r= J--�—'
,—
o����>rs ucense a: Sooa� secumy =
�6-L<6 '��hue—BmlCina. Green—GoOe Enlo¢emev Ca-a�_:—AoO���anC Pmi—Revenue Go�aenrpa—Assesso:
QTY D E S C R I P T I O N
8645 REROOF BY VALUE RESIDENTIAL NQZONE
END OF FEES
`' i`f:"1:��' ��.�_ , i
t.; �. � '�l-f
R��?UlRE1�
UNIT COST
1,00
a
TOTAL COST
8,645.00