HomeMy WebLinkAbout2753 CIBOLA AVE - Building Permits�ooxessaveaidra: Z753 CIBOLA AV uxr:
°"^'E"!1s'E"'Q'°'''": WEBB, THOMAS L Z�,J�
� /0°"Es$' 27451 VALDERAS
. MISSLON VIEJO,CA 92591
�. �u�c wo�ss:
770-1804
uicxrt[cr on u+axun: uc. No.:
1PCH OP FlIG.'S AWRES4: UNT:
��"•�Ta"""'�' WATER NETWORK ( 800 ) 223-157
CWIPACTORSYYIIN(i 55 PO BOX
'D°"� YORBA LINDA CA �0N0= 309530
92686 uNT:
LICENSED COMHACTONS DECL�NRPON: I MreW eMim uMs penely d peejury Mm I em licemed uMx pwiriona d Chaqx e
�mmmena^Y wilh Section ]000) d Diviaion � W Na Busirresa arM Prdeaaionv Code. erd mY lioertx o in h0 taro vd eHad.
�No.: uc. cuss: C 3 6 uc. No.: 3 9 S_ /��� EX�%
/(Jme. � � Gonimao� ,�'�1����^"'�/�
r
O P BUILDEP DE� IAN�TION: I heeeby �rm under penaly d perjuy Ihel I em eRemp Irom IM Comrmon Liunaa lew la the
xip raemn (`�ion ]091.5 &mim� md Rdeasbna Code: �m cry a couMy r.fiidi ispuime e peimil to mmtrucl. elter. imOrova.
Cemd'eh, a rapeir eny strutlum, pw io ea ueuence, ebo requi�ee iM epplirant ta wch pom�n lo Rb a eqiwC Helsmenl ihel M a vM
n liceneed pueeuent lo iM powcns d Na COMreGare Licerue lew ICluqs B(commeMi�p xnh Sspion 100p) d Di.vion 9 d Ihe
Bua'uwsv eM Prdeniona Codel a Ihm he a ahe ia exampt ilweham W Ihe bem la iM ellpad uamqun. My vulmion d Setlian
]W 1.5 by mry epplifenlla e pem�n wEpae IM epplcenl lo e tivil pe�Wry d rol mote Ihen 1'rve huMretl Edlen �5500�.
� I, ea owrrr W �he propeny «my employma wYh wepes ai �hei ede rompeiuetion, vrill do tne xwk, eM Ne aWnure e ml intandeA
«wmea �«.ab (s«tim �a,. euvroa ena amlen.pn, ca.: m, cdumeoA unMs le.eoes m eppym.� o.,.,a awero
who Wddv or vnpmvea the�ean• ud Ma does such woA Nmaell or Mne1 w �hrwph he ar her own empb�m, pwidetl iMt euch
impdameMf are nd InteMed a dlertE ta seb. tl. Mwever. IM buYdinp a inpwemml c add xithin pp Y� d oomplelbn. �M1a
owror-butiar wiil hew iha Eurden d pwirq M or ehe d'd � Wik w impwe Ia the puryme al mb).
� I. m oxrwr d �hs prope�ry. em utlu+ivaly coniradiq wiN IicenroE convectaa �o mnarua Ns qqal (SerJion )OM. &nieve vd
vidm.iaro code: rnn com.mon Licena. L.w eoee �a ewM �o en ow�« d wow�r wno wlu. «'vnpwn m..on .�e wno
convecu lor owh pqetla w4h e wrureaor�e) Icenaed WA� �o IM Caqretlaa Licwe Lew).
� I em uemq uMer Sectian: B. 8 P.C., b No reem:
Daza: Owiwr:
� eo he�eM un�M �,u � em ewere a ero wdmstena tha rea�r«naw d ca0mda wmn ene smar coae see'vn zs5os. zssaA..ne
Y5551. erd IMi I w eny Mun Wikirp ooa�pani will l wdl nd (arcb aw) need to canyy wiih aeid neie oodae xd tha raQuinmenre M
e V� 1«mreWctbnamoddration han�te/�i�lyF�aieYeniem Oistria. Resdxuol mnmrudion eGV�ianwezanq Imm Ihevs
a��.
De1e: �OW�:
W OPKEH'S COMPENSATION DK4PATtON: 1 Mrcby dfirm uMer penelly d pajury an d the Idbrrirp Mtluetiom:
� IhwaenEwilmainienacmMiraiadmneenitoseX�inauielav.akaa'canpense�ion,espovidedlaEySwimJ]ODdthaLebar
coe.. �« �ne oenmwc. d N. wwx �« .vl:cn �nie o� a muea.
❑ � nm. d,e wie mdn�ew wawm.• mmvmmlion inaurer�w. e� nwiied M s.aim aroo d �n. Lebo, wa. k. �ne w�«mance w �n.
work Ia Miitli Ihif pxmit u ba�eE. MY wvMen' mmpanaelion'umurerca �eeeie� W pdicy numba ue:
Certier:
PdcyNumber.
(Tli' .seciion metl mr be camP'NeE / NSV�^�t s b me hwered ddbn (flWl a Ims.)
I cenM Uei in �M Derlarmence al �M wwk M whkh the P�� ia mid. I ehdl m� emPM enY Oa� n M' memwr ao m to
becon�e aubj �a �he ' psnution lewe W Cefl«n'�ey ihet � I ehwk Exoma wbpu to tM warke�c'
pemel'� d 5/I'vrJl00 d IM lebw��f fo p' py Nil) Ilp�e�
s: J �,�:
� /��� �
WemMp: F� n ro��c�n woMwti ro�tlon p� IkeVt �iHul, uW iN/l Wb/�ct en wnployw ro cr/Miul p�n�lllu �iM
c/vll fliwa �q ro om �unEreG lMua�rM tlo/4n (JI00,0001, M�Ctl/tlon ro M� cwf al romperwlbM1 damep� u poMded ror In
SNI�M J�QI0I1�10 �.160f CO(Y� IIIfV!!1. iI141IMMry'�l /N�.
CONSTNUCTION LENDIN� �OENCY: I MreEy �rm uMw penely d perjiuy Ihm Ihera ia e raiaeWion Wqinp eporv.y M tM
perlameMe d Ihe wwk la whidi th'v pamY o ewad (Sedian �091. C'v. C).
LENDEN'S NMIE
LENUEN'S ADDNESS:
1 cenily �hel I hew reeE i�ia epplireiion enE 9ab Ihet Ihe ebova intamelian e canea. l ep�ee �o wmply wilh ell dry aM cauMy adinencea
eM elele lexe relatn0lo buiNvp canLtWcn ud hareby eNhor¢a npexn�etivea d Ilin tily lo emer upon IM above�rtanlioneE propeM
IOf IM�NLIIIXI 011fpp9B8.
�i RICHARD HOPKINS i i
(StS�<8 WP) WAne-Bultlip d Sdery: �raeMFle: Canery-�ppireni: Fnk-Revanue: Cialdenro�Renvw
CITY OF COSTA MESA - BUILDING PERMIT /
/ PERM NO; P 07340
PERMIT NO: P 073404 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : REPLACE SHOWER PAN & WATER DAMAGE FLOOR SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: REPAIR DUE TO WATER DAMAGE REF; B-73403
f�x�ft��titi�**x��t*�i�f��x�x�x�f�fr�tx��f�ititx�x�*���+tx���t*irx�ititiri�itit�t�t+��r�t�x�x��rx�x��+tr�tx�*x���rir�t�x�ft�tir+titx��titit*
.. 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 HUILDING ---------
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: 14164409 ZNE: REF NO:
PLANNING NtSTES>
i
if 1I� if iE 1I� if iE if 1f iF iE fE 4 iE iE 1E 1E IE 1E 1F 1E 1f 1k 1f if if IE iE 1f� iE 1E ik 1(� 1E IE IE IE 7! iE if iE if iE 1f 1f 1E iE iE 1f 1i iE 1E if iE 1f 1E if 1k1@ 1E if fE if 1E 1F 1E iE 1E Ik iE iE ik 1E 1f iE iElE if IE
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 BY DATE:
BUILDING APPROVED BY : ,� DATE:
APPLICATION ISSUED HY: %��L DATE: � '�
s��s���x��+t�t�t���x��s�����+����r+[�+�+�+[� '�4Tf�'���x��*'���fFi�if7F+�*�*�r*x�x�+rx� �x�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 14.00
25Y SMIP/NON-AES
PLAN �
ZSSUE FEE 20.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTP.L PAID DUE
TOTALS----> 14.00 20.00 0.00 34.0/0 34.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 34.00�/ OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
34.00
it if iF 1h iI' iI' 1E iE iE i1' il' if if 1%if if iE ii' if if * i41f IE 1f iF iF 1k il' iE 11' ii' iR iF if ih iF ih ih i%iF il' iE'�F 1E i4 iE K K iF iE 1l' ii' 1h 1(' iI' 1(' 1E IE i(' i%if if if 1E 141F iI' iF ih 1h iE ih iE if if iF iF 1I'
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 5 C R I P T I O N UNIT COST TOTAL COST
PLU 1 SHOWER 7,00 7.00
PLU 1 WATER CLOSET (TOILET) 7.00 7.00
END OE FEES
OJ L'OiF: S•`,��y, � "'�_�-- �
CA--_. C:'. �-. 7i; _ 4 �4, -.r.':ii
i;
C�NSTRUCTION AND PLANNING � VO.. _& SPA
,•1 APPROVALS Permit �`r ' Date inspector qppROVALS Permit # Date Inspector
1
t. Temporary Electrical $ervice or poJe 52. Pool & Equipment Locatiou ' �
2. Soil Pipe�Undrgrnd. 53. Steel fleinforcement � �
3..Electrical Conduii UMity�Undrgrod. 54. Forms _ ,
.�m���lActrical Conduit;Ur�rgrnd. 55. Electrical Bonding v
5. S[eel Reinforcement �� 56. Rough Plumbing & Pressure Test ��
�EILTCtrical UFEP_Grt�, 57. APPROVAL TO COVER�GUNITE �
.�_ .�
;�T;�'Qotings ; r.; � � 58. Electrical Conduit-Undrgrnd. �
8: � Foundation � 59. Gas Pipe, C Undrgrnd., Test � �
9. Water Pipe-Undrgrnd, � � 60. Backwash Lines, P-Trap, �7,'UnfJrgrnd.
10. Structural Floor SYstem . 61. APPROVAI TO DECK . �
1 i. Property Sewer Line & House.Gonneciion 62. Backwash & Receptor�Final '
12. Sewer Cap .. .. 63. Heater & Vent-Final ..
13. Root Drains " 64, Plumbing System - Final
•14. Rough Plumbing �. 65. Electrical-Final •
75. Rough Electrical-Conduit • � ' 66. Solar SYstem-Final
16. Rough Electric Wiring �� 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLqSTERING �
18. Rough Electrical�7 Bar Ceilin9 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. ftough Facto.ry Fifeplace �,�. r;" , - C -- _ ,.�APPRDV`�`S� ~ P mit # � " �'-'
4. � r � �-:+�---'--
21. Oucts, in�truc[ur� - �= " -' -Y" � , 70. �lnd�' r�'yr,�ci F�ydro ` ��� l
22.Qucts Veratilatingy� ��. k �J .Y' L ••,yn19�� �
�:x i 77.'Produs€.E2+pin '7 as Oil
23. �as Pipe-Rougti & Test � - - c^ �-<' � 7z, Under§Pgund F9usTi x C:
,.
`.r- � ~
24. ftoof,Framing;. .'} �_ .t - �„ " y': 7� Undergrna�Stof�ge Tank'.O Ga�O fliL.
25. Roof-Sheathing _ 4^ m G �=+ . 7q; Overhead�HydrCF- •
26. T�Bai Ceiling (Structi�rall & f�Co�osoat ; � ,z, `r , �;�. 75, pry ChemicaV �� � ,., ��
� � _ . < � �
27. Erame and Flashing - � c � s 7f; Dry Startetpipe � T�_ �+ S;�, '= �
� L y
28. 'i:athing $�.Sidin9 �. r �: �.,^, � * < '.. r. 7�, FIXED �T��,iNA�: � � � �
IJ:J t �
^ 29. Insulation '. ' �+ •. .. > Y T- ' J * ^7
_ ; �% 7 � FIRE PREV. FlNAL
�, 30. Drywall Nailin9 `_'' ;. = �� y_ ' � � �`; �H EAL'1"�DEP�'. REQUIRE�OENT
.FFy ^ 1 J�i�J ViJ ll �
' 31. Plaster Bcown Co�t' � i I'� 79'�ff,kAlAL11dSPECTa9N r � „
32. ,Electricat'Power tv}et�r>Final •�"` ;� �; i i 'a , SQ}; FOOD C'E��TIFi1CQTE 1�9UEC7" Fr.' �
. .. ; r I r, _
_ 33. Pinat'Electric � - a ?: � �� , • Na}es: _c•I S_ " / 'x ��j�'�
�i
y .. ._ �. ^ y r 'f F � is!!1 � c.. r _'
34. Fina�ie�ing� Air� �onditionirjg " i _
- � aS xT jr c, S i.z * �n
' 35. .�)nat-Gas<Pipe=Tesr r � a• : i !r n ,'+ cvs * - � '
36. Hood'or'Ganopy '' ^r :" ' �• ^ . , "'% `
N� r C. � �r i � In g. M
, � .r�• w
- 37. Fj'nal�Fa�tory FirePlacw � 5:-* � m , ` •t :� � J 'r � ?'.
38. FinalPlumbing � � ^,L � '•. .. ' � - � � ` � F, � a
39. WatervService�Final � � G '� ` ��� ` �r , c�
` 40. Gas Service-Final � ` � � ` �- ' ` �'
�l kF' r-r�� �i �4 GP: .F
. _ z q . ��r . ,
-• 47. Solar pomesticFina( � :.`� .. * -, � �o `..�
�42. BackflowJ'reventer � N -- ' � - �F � T �
_ �' _ . .x. .. T J .
43. Backflow�lrrigation > ` � � _> < p ' - ;: �., . p _, �
�A4. Landscape IrFigatiortSystem '^x _ . " ' = ' -
�m: ti G :.t� � 2:J � �nJ
45. Sound AYtenuation � ,_ _ T ��� _ � � ,- - � y' r�
. 7 � c•
16. HandicaP RegulationS = � F - ' �'# �' � � ••�-+ *
i � .� :t :r � - S '!
47. FINALSTRUCTUR�&BUI�DING " � �"• '`' -' "
.. �k . � w
48. FINAL PLANNING' � �' -• .' � , �r �- =' '7 w i=
, h-. �� K: [•^. < w F
49. '�lecft�c Release to Edison • •x � ' • _. �
� �y ti
50. Gas 8elease to SoutNem California Gas Co + +' % � 1. � --
�;: � �-, - �� f-1 x
51. CERTIFICATE OF OCCUPANG�'- +_' � _ V �_ _
No Oate
PLOYEE:
RMIT NUMBER:
LUATION:
RM1T FEES: <
BUILDING PERMIT LC
�'� i ��t l�S
3 I r3DZ� �•
P 73� �-� TYPE OF PERMIT: ��i �-- Z��z�Z
S�UARE FOOTAGE:
AS
OUT 1 ACTMTY
e
ao�ssocewiowo: Z753 CIBOLA AV
OWNEHSIUYEIFRlt111tl: WEHH, THOMAS L
A°°"E�' 27451 VALDERAS
MISSION VIEJO,CA 92691
�P� ��.�u 770-1804
UNT:
ANCHRECT ON FNtlNHP: 11G NO.:
PCH.OP FNG'S AOONE54: UNT:
CONf""C0"5NA1�' WATER NETWORK ( 800 ) 223-1573
cam�crarswuuxc SS PO BOX
"°°"Ess yORBA LINDA CA °GNOi 309530
92686 °NTi
IJCENSEU CONlPACTOFS DECLANATION: I Mreby eRirm uM« perely d perjury �hm 1 em licenaetl undar pansiom d Cheqm 9
lca�me�,e .mn s«iion �000l d onision a a ina euv�.e �d aw�.�,a cada. dd mr umnse u m �un ro2e ena enea.
��"yC. NO.: UQ CL/�55: 11C. NO.:
_ �]� p� C36 �� 309530�- E�`XP:
Da1e: � l/r/�_ Conveaa: �//y.Yf1 %tiL'J �^O L�
.
NER BUILOEH OECLR ATION: I Mreby elfiim uMm panety d parjury ihm I em examq han ihe CaNmon Limme Lew ia Na
Idbxvq rmson (Seclion ]031.5 Bus'vroaa anE Prdmaione COCe: Airy cEy a oounry xfii A requirea e pe�mu �o mrehud. el�x. imprwe.
demWeh, or repei eny awnure, pbr io �s ewvxn, e6o reQuirea iha eppiicenl ta wch pertnA lo file e sg�E cletemenl tl�et M a sM
ia licenSeE W��I lo Ihe proviaions d IM Conlreqors License Lew �Chepler 9(oomme�atp xil� Setlqn ]OW) d Ovcion 3 d Ihe
Budmas erd PrWessiuna COCej w �hei ha a ehe is exemq therehom arM IM bsvis la Iha elbpeE uamqion. My violelion d SeUion
)031.5 by enY aOW�� I« e permn wbjecN IM epqiceM to e avil panelry d rat mae ihen Irva huMred ddbn f�l).
� I. es owner d IM propeM a my ampbyeas vAh wapea as Ihei wb compeneetion. vrill da tha xwk. ard ihe evunure a� inieMed
or oRared br �la (Seetbn ]Os1. Buvraa er.d Pmf»sma Code: TM Comeepwe Lkmae Law does ml epply lo an owner d prope�ly
who Eudds a inpwee thereon. end xfio Eoes such wwk IvmeeM or Mne� a Mraph Ao a her own empbyeae, provided �hm wch
' povemenls ere rot inieiMed a atlereE Iw sele. tl. Mwerer, IM1e WiMinp a'vnpmemen� h add wuhin ar year ol wmpinion, tM
owrer�LuiMer xiil heve IM WNen d povirp ha or sha Aid nd build a improve lor Ihe Wmoae d aeb).
� 1. av ownm d IM ryapeny. em eatlueiveN �Irediq xiN IicenaeC conCeclpa to caMruU Ne pmjea (Smun )ON. Bus'vieve erM
. a.a�: coa: ma com,eaon u�» �. ao� �a wdv �o �, ow� a mororo wno w�u. a�wae. �naroo�, �e wno
wnvuv fa eu� Prol�s �h e mm�aeor(s) lice�reed W�� to tha Conlredae Lioenve Lew).
� I em exemq uMm Sectbn: B. 8 P.C.. M Nia reexn:
Data: �e�
i ao na�w �v ��� aw�e a�a ��i.�d ine �n��mm�re w c�eoma �.nn �e sdmv coe. sm� assas, zssaa �e
25St1. eM Ihel I a eiry Mure Wikirp ampeM will / wAI nol (d�cb me) need io canply wih aeid eWe wdes ard �he �epuireme�M far
epertnnlwmiutruc�ionamotlifiWionhwn�MA'r ue�y arepementDimria.RaeideMWoonstruponeppimiomenevemqlromNesa
proviaiona.
Dela: Applicenl:
WOHKER'S COMPETI9ATION DECL�RATION: I Mreby elfi�m uMx peraM1y d parjury ore M tM Idbxiip dadvmiom:
❑ 1 heva eed x�l meinten e eerliirata d mment �o eNlimum �w wnkeea' eompemetion. ro providaE Iw by Sedim 3lOD d �M lebor
Gode, ia ma venwm�e w ub �� t« �n mg ��u �. i��e.
� I heve eM wil meinten woiken' oompenaetion inaurence. m�uireJ by Seeim 3]00 M Ihe LeEw CaEe. br iM pMamance d Ihe
wark lor whiM I�ie permn u iseued. MY warMers mmpen�bn inwrenca umx eM polky n�mbsr ara:
c�.,:
aacy N�mna.:
�r�{.�nr� ��e �or aa �v�ae i ma ro�x g ro. w�. n��d,.d edi� �aiaul w�n...�
{� I cenh' � in tM perlwmvKe d �M work M x1ic� Inie pe�mu ia iaeued. I JWI na emplay arry pe�son in enY menner eo n to
\ become wbla lo tM xqkxa' canpenee�ion le� d CeIX pree Ihet il 1 eMUW Eecome wbjeU to iM xn'Yen'
�/TpmpeneyAm pmpybne M Segpn 3100 d IM laba . thell 1 ' h oompb wilh Nme or9wiare.
Weminp: ReNun ro 4cun wo'keri rompawUon �iap� ls up(Mul, �ntl (�WI s�bfecf en wrrp/ryr ro ulMml peneMu �ntl
e/vll 9nu �.q ro on� hi.vidistl llwua�nd Jo/kn (S1W,OW1. In edrlltlon ro Ms m�f ol rompxwHOR ��pu as praHtlM br In
S�ctlon �106 ollhe Lebor Cotlq /nhnat, entl atromsy'c lsu.
CONSTFUCTION LENOINO AOENCY: I Mreby effirtn uMer pe�aly d par'ryry thellhere o a mew�uaion ie�ebq epeney �w uie
parlormance ol tM xuM Ia whlM IM1c peimE ie eeUed (�1m 308). CM. CI.
LENOEfl'S NRME:
LENDEF'S ADDNE59:
1 ceniN Ihel I hew roed Ihis eppliceiion eM steb ihel �he above iniwmelion is cortatl. I prae to rompy wilh ell dly eM munry oMinentte
and s�ate lewa relelvq to Wild'm0 ��a��� � Mreby euMrae reqeeenretivea d ihu rny to enier upan tM ebave�men�ionad poparry
fainspeaion Wrpoeea.
RICHARD HOPKINS
Pnnl Neu r
( Dete �
grewre d OvmedA A Fce onveqor
(5151d6 WP) Wh�e-Buikip d Sde�Y: a�n-Fle: Canery-Appirent: Pink-Revenue: GdCenrod-Avseasor
CITY OF COSTA MESA — BUILDING PERMIT
�/ PERM NO: B 07340
PERMIT NO: B 073403 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOH DESCRIPTION : REPLACE SHOWER PAN & WATER DAMAGE FLOOR SQ FT: 2,700
CLAIM VALUE: 2,700.00 CALC—VALUE: 2,700,00 GROUP OCC: R-3 /
COMMENTS: REPAZR DUE TO WATER DAMAGE
�t�r*x ****�c**�t**+��*� ***+���t*+�itit�t**�t*�t�t**x �t�it+t***+�+�*�t�t**+�*********�+t*itx��tat*x *�t�t**�r**
Z O N I N G R E g 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; 14164409 ZNE: REF NO:
PLANNING NOTES> ,
>
if 1f iE 1E If 1f iF ik if If� iE iE 1f iE il' if 1f iF 1f� iF iF if iE IE I(� it iE iE 1(' 3f M iI' 1E 1(' 1(' ik 1E 161E 161(� ib if 1E if� IE iE 1F IE 1E 1E if 1E if iF 1E iE M if if ib 1F iF i(� iE iE i(' iF if' iF 3F IF IF iE 1f 1F 1F �@ 1('
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 BY : DATE:
APPLICATION ISSUED BY: DATE: �
iEiFikikilikiEikiFlklkiklFiF�lEiE1ElEifilillE 1E1f1E1E1f1EiE1(�1E� ItiF
LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL EGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 . .50
.. SMIP/NON—RES
PLAN � . ��','
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PL'AN—CHECK TOTAL PAID DUE
TOTALS----> 59.50 0.00 0.00 54.SQ 54.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: , 54,Sv OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC. FIAE SMIP/TOT GRADING PLAN—CHECK
54.00 " .50
1F iF 1f 1f iF iF iF fF if ik 1F iE iF iF iF iF iF 1F 1E 1E iE 3E 1F if iF 1E ik ik 1! 1F 1E 1E ik i! 1E 1E 1E 1i if iF fF 1E� if 1F 1f 1k iF k Ik 1f 1klf 1E 1F 14 fk IE 1E 1t iE i! 1E iE 1ilF if 1E k iF iF 1k ik il' M iE �f'k iF it
I N D I V I D U A L' F'E E 8 R E A K D O W N
TYPE QTY D E S C A I P T I O N UNIT COST TOTAL COST
SFR 2700 ALTER BY VALUE AESIDENTIAL NOZONE 1.00 2,700.00
END OF FEES _ ,
i� V
Q1 t�.'?'.8�=^.?!—�C1853?2 �'a3'g ��.v�
'vAi'c: U7.'�`�.., ?I{"E: S;;tlo
�
POOL & SQA '
� CONSTRUCTION AND PLANNING� . (
�� APPROVAl.S Permit 9'f_.�`- Date Inspector APPROVALS Permit #• � Date �nspector
�
t. Temporary Electrical Service or Pole 52. Pool & Equipment Locatioii ;� �
2. Soii Pipe-Undrgmd. 53. Steel Reinforcement !
s �
. �i��.-Flectrical Conduit Uvrtrty-Undrgmd: 54. Forms '
�'C?;:'�t�c?ricai Conduii-`(�n�rgrnd, 55. Electrica� Bonding =+
,,
�5- ${�ei Reinforcem�rst - 56. Rough Plumbing & Pressure Test �
='� :Etectrical UF£R;Grr�$. 57. APPROVAL TO COVER-GUNITE ,
� � 58. Elect;ical Co�duit�Undr md. - -�
���,Ootings - g
�8;�Poundation � c, 59. Gas Pipe, O Undrgmd., Test
i' ��
9. l�Vater Pipe-Undrgrnd. _ . 60. Backwash Lines, RTrap, � Undrgmd. � �
10. Structural Floor Sysxem 61. APPROVAL TO DECK ' �
. r
ii. Property Sewer Line & Nous��on'nection 62. Backwash & Recepcor�Final ,
12. Sewer CaP `" �. . .
63. Heater & Veni-Final .
13. Roof Drains 64. Plum6ing System - Pinal
tA. Rough Plumbinc�- - 65. Electrical-Final
S5. Rou9h EtecvicaFCon2Soit ��' 66. Solar System�Final
4` ^
16. Rough Eleetric �Viring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
r.
18. Rough Electrica��7 Bar Ceiliny 69. POOL/SPA SYSTEhqS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
r- !'• -� �a - w- F- �. * '
20. �"ough Fai'�,tory�FiCe{�lace `^^ � >' i; �� �"* - APP � � � �C ' '� �' `--
� � . c: x. �� �. �. RDVALS F Pri.mit #
.. .
2L 6ucts in�Struatur�-;; , -- - .a ^ G �r ] 70. �FJndergrou�tl F{�dro '+
22.pucte,VAntila`ingi'x ��. :�; 6 5 ��.�7�.produ7�i�?iPinc�'t7.'�"Gas C�OiI
23. Gzs LiAe-Rpuc�,h & Test � �« ,.-. � � � r - 72. Undergra6nd F�.tesir, * � I
-�.
� 24. Fi'ooF�Framing^ " • - '�'� `�'�' � x HY � 73° Undergrnd.StoF�qeT'ank`,.,L�Gas ❑6il
25. Roof,She_a`thing c`; v v r�� O � :�w 74'J�9verhead Hydr�� l
26. F�Bai"Ceiling (Structaral) & Nbriv�c,oat *� } r' ����' 7�pry Checqicai �� i-' -' �
H
27. F'rameand.Fias,hirig a " ; c- >+ w�: 76r 4r Starid�� �` �`� .
���r J^:: Y G+UeF� a t*7
28. LathingRi'Sid�g ;xv -_ z ks .. "..�; 7�. FIXED�ST�NYrFINA�_ - M
' ti .. . � ��tr a . . .. .
29. Insulatiom �� -�v� - � �• � '� 7� FIRE PREV. FINAt s.^ x
"30. Drywail Nailirig ��: ^, �V '� � '� � �i�EAI.TF�OEP;.`ftEQ�UIfj.F�,MENT
� . r
- 37. Piaster Browo-Coat'; y , i-;- :: ' ;� , 79� FINAL FPyS�'ECT�QN � ` ,:;
- 32. ElectricaC�Power �tar:Einal ��� ;� 8Q� FOOD CERTIF�;CATE I�SS�JED �
33. �inai�Elecuic�. .� x � 4 fi`�' 'y "� N tes: I(/,f��C/ i 0/y `. /(�� f ��%
/� 34. Finaly-leating•�& Air Eon�rtipnirlgc � x � t v "i + ^
- �, .. �, . - , : > /L�- �3 2L��� > ,uo �o.✓� ���
35. �inaf"Gas Pipe;Test �� ��= ,, r'., :, ; c L.m�' !J, j(%p �Klr �,��,..'
r. 36. Hood or GanoPv -� ?'^ `- 7 �: :i: T
�- - _. : -.- ` . ,_t. -- -
�37. Fjnal;�actorYFirePi3ce r � �� �.. r� -� `--,'� ,� j - - �_ - �--
' ,� - .... ._ .. . .. _
-�38. FinahPlurdbing :c N � ! '� S - -=
tr �- u.
�'39. WatexSernce�Finat'� ' � * �` • 't'`-'� *'� :'
�. s K r ' a
� 40. Gas Serviee-Fi�al .� - e;;,r S :r � ' .. ._^.� vN .� '. .-.
nr a -
41. Solar pomest e-FinaH' � � " '� "-" ' ,fi ef1� - �
[Y M �" ,�I
� 42. Bzckflow�Preventer „ r N � . ;`.r S � r • a'�
' � c
43. Backfiow irrig`ation "� SSS 4 • ",�� � -'
r ?• b'. . ' i i
�14. Landscape irripation,5ystem : �.; � :T, � O �s � v cJ xC #� ` ' • -
- - - � - s n � a c �,
35. $OUnd Atten�idtiOn �' - • � `r- �'" ` `��f- `' " �' '�� �'Q t.
�- . . r r �� r rJ' y. E. Li i:
48. �landicap Regulations = ,7 �: �� ���,�. c; •S Oo x
_ „
47. F_INAL STRIIETURE & BU�L"DING (7�G1 �p�'= �^ =�-� c, r
r,
48. F{NAL PLANNING-n -. � o� ; ;,,� ;; �c :� �. �a
� « r,
69. Electric Release to Edison � :�' `�� ^ R -
i: • >� I : � *:
50. Gas Release [o Southern California.GasCo > '� �� .-� C • .��cn ��� G •
' rt ^�
51. CERZIFICATE pF OCCUPANCY" y . , r.� . _ �, c
No. Date
�
Mr. Thomas L.
27451 Valderas
Mission Viejo,
CITY OF COSTA MESA
CALIFORNIA 92628-1200 P.O. BOX 1200
DEVEIOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
NOTIC$ OF PERMIT ERPIRATION
Webb
CA 92691
Project Address: 2753 Cibola Av.
Costa Mesa, CA
Our records
improvement
completed.
March 12, 1996
Permit: # B73403
show that the listed permit obtained for property
or alteration at the above address was not properly
The permit was obtained by Water Network, license number 309530 and
phone number of (800) 223-1573.
The permits are valid for 180 days from issuance or your last
inspection, per Section 106.4.4 of the 1994 Uniform Building Code.
Should we not hear from you within 10 days, your permits will
expired and additional fees will be required to finalize the
permit. Your permit will expire on March 26, 1996.
Please be on notice
inspections completed,
an illegal structure.
that without a valid permit and required
you will have encumbered your property with
If you need assistance, please contact the Building Division, at
(714) 754-5273, between 8:00 a.m. and 4:30 p.m.
77 FPJR DRNE
Building Division (714) 754-5273 • Code Entorcement (714) 754-5623 • Planning Division (714) 754-5245
FAX (714) 754-0&56 • TDD (714) 754-5244 . _
ren�ecr r�oeess: z � 5 3 C I BOLA AV
�.�AYNEH'SNPME: WEBB, THOMAS L
aooness: z�53 CIBOLA
COSTA MESA,CA
714) 770-1804
APCNIENGINEEP:
ADOflE55:
uxiT:
92691
HEG.NO.:
UNIT:
PEflMITTEE: PAUL GARCIA ( 719 ) 774-9036
aooeess: 15 0 61 OAKWOOD
CHINO HILLS CA 91709
LICENSEO CONTNACTOfl OECIAflATION: I hereby a��irm at I a - e ea un0er pmvisions al Chap�er 9(commencing with $ection
7000� o� Division 9 alt�e Busine5s antl Pmiessions Co0 . anG licen is in lutliorce anC etlecl.
C IC.:(} STFTE LIC.: ( O S 6 � C 3 9
�aie: —b�/s�9� Signai e:
REflS' COMPENSA7ION ECLFPATION: I hereby aitirm tnat 1 have a certilitate ol consent to seli-insure or a cenificate of Worker5'
Compensaiion Insurance. or a certitietl copy I�ereof (Seclion 3800. La�. C).
POLICY NO.: EXP. DATE:
COMPANY:
❑ Cerlifie0 coOY is hereby tumi5he0. ❑ Certifietl copy is liled w�N9�he ciry BuilEing �ivision.
Oa�e: Npplicani:
E%EMPiIONiflOMWONREflS'COMPENSATONOECIAXATION: 4 Iionnee notbecomple�eA epermiiis�oroneh
I certily ��ai in Ihe Oedormance ol the work lor whic� this p,mi ' i55ue0, I hall not empl any person in any manner so
yipicl Io Ihe Workers' CamOensation Laws o� Cali�omi
�NOTICE: II. a�ter making Ihis Oeclara�ion, yau shd(d �ecome SubjECTlo t�e Work¢rs' Compensa�ian provisions o� IDe Labor
Cade. you must fortAwiih compty wi�h such pmvi5ion5 or iNs permit stwll �e 4eeme0 revoke0.
CONSTflUCTION LENOING RCENCY: I here0y a�firm �ha� ihere is a constmction IenEing agency lor ��e pedormance o� the wark lor
which Ihis permit is i=sue4 (Seciion 3097, Civ. C�.
LENDEfl:
AUGHESS:
OWNEB BUILOEH OECIAflATION: I hereby af�irm Ihal I am exempl �rom the Contraciors' Staie License Law for [he �ollowinp reason
(Section 7031.5 Business anU Pwlessional Coae: Pny city ol counry w�ic� rt0uires a Dermit Io constmct, alter, impmve, tlemolis�, or
repai� any simtlure. prior to its issuance. also repuires ihe apDliunt lor sucn oermit to file a siBneO statemeni �hat hUshe is licensetl
pursuant to the Drovisions ol the Comracmrs' State License Law (Chapter 9(commencinp wit� Sec�ion 7000� oi Oivision 3 of ihe Business
� and Pmlessions Cotle) or ihat helshe is exemD� �heBirom and ine 6asis Ior Ihe allegea exemption. Any violation o1 SecGon 7037.5 hy
any aD�licant lor a permii SUGIeciS the ap0licant �o a civil Oenalry ol no� more �han �ive �unAreO dollars (5500).
I, as owner ol ihe OmDeny or my employees vnt0 waAes as their sole compen5ation, will Oo �he work, and the
❑ simcmre is not intenEea or oflered lor sale (Section 70aa. Busmess and Prolessional Code: The Coniractors' State License law
tloes not aD01y to an owner ol a Dmperty who Euilds or imDmves thereon, anE w�o daes sucll work himself/hersell or I�wuAh
his or ner own emoloyees. pmviaeU Ihai sucn improvemems are nol intentlee or oiferea for sale. II, however tne OuilOinp or
impmvemenl is Soltl wit�in one year ol completion, t�e owner will have the CurEen o� pronn0 he/slle Aitl not builA ar impwve
for ihe purpose of sale).
I, as owner o� the proDer�y, am exclusively coniraclinp wiih licensetl coniraclors to constNd t�e Orolecl (Seclion 704a, Business
❑ an0 Pmiessions COtle: TAe Conlfatl0r5' State L¢ense Law tlocs not appN �o an ovmer al Dmperty wtw bmlds Or improv¢5 there0n
and who conlracis lor suc� pmjects with a canlractor(5) license pursuant �o �he Can�ractors' State Lic¢n5e Law�. I ain aware
t�al pmol 01 IAeir Workei 5 Compensalion insUrance S�oultl �e pmvidea lo me.
� I am exempl un0er Sec�ion: 9. 8 P. C.
mr mis reason:
Oaie: Owner
I tlo �ereby cenify Inal l am aware ol and unAerslan� ihe reQuiremenis ol Calilomia Healih antl Satery Coae Sections 25505. 25533, ana
2553d ana ihat I or any luture �uilding occupant wilUwill nol (cirtle one) neeG lo camply with saiA siale cotles antl Ihe repuiremenis for a
Uermillor conslmclion or motlilica�ion Irom ihe Air Oualiry Managemenl �iSVitl. ResiCen�ial con5imction aDPlicalions are exempt Imm
Ihese provision5. .
Daie', Aoplicanl:
I hereby cerGiy ave eatl Ihis ap0licaiion antl stati
ordmancesan elaws Ialingio�uildingconsime�i0n
e� lo eclion , rposes.
Oate: — �
% '� ;
is torrec�. I to comply wi�h all ciiy and coun�y
nlaiive is cily nterupOnt�eabove-mentioneG
t6ai�a6 WM1ile—Builtling; Green—Code Entorcement; Canary—AOP���wne, Pink—Revenue: GoltlanwE—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; H 06848
PERMIT NO: B 068482 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: M-1 PERMIT TYPE: STR PURPOSE: OTH
JOH DESCRIPTION : T/OFF 6 RESHEATH 6 REROOF W/COMP, SQ FT: 2,995
CLAIM VALUE: 3,000,00 CALC—VALOE: 2,995,00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS ARE AEQUIRED IN EVERY BEDROOM 6 HALLWAY, 1991 UBC
x�rx+r*r�r+t�r*+r+rx�*x��t�r+r�r*x�x�***�r�r+r�r+r+r�rx�x�x�r+t+�**�rx�fr*x�r*+�+�****x�***+r+r*x�*�r*x�x�***�r+��r�tx-***�r*
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: FT IN RGHT: FT IN LEFT: FT IN RGAT: FT IN
PARKING REQ� PROV; PARCEL: 14164409 ZNE; REF NO;
PLANNING NaTES>
' � F���
>r�F�r�r�t*�r*ir+�+r+�i��r�rir*�r�r*x+r +�+r+r*�r�r�rx�*�r�rx��r�rx��*x�*+�+r�ri�i�x���r*�rx�r*���r+r+�x�r*x�*�rx�**
D E V E L O P M ��fi�rF S R E Q U I R E M E N T S
ZONING APPROVED BY ;�(�I 111�r�.., i,R DATE:
HUILDING APPROVED BY ; DATE: � .
APPLICATION ISSUED HY; '
DATE;
1FiflEiEiFiEiFiFiEiFitMifiEiEitiEiFiFlfiEiF iE7fiEifiElFikitifit iEiE
itikititiEiEiEitiEif4iEiEiEfEifiFitikitifiEiEfE1EiE1EiE1ElfiEifitiEiFil4lFitMitifiEiE1liEiElfiFikiEiEiEil�fffifiElEifiEiFltiElfiEfEiFikitifiEiElFif fEffiF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC
PERMIT 54.00
PLAN
ISSUE FEE
FIRE SMIP/RSS� GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL � PAID DUE
TOTALS----> 54,50 0,00 0.00 54.50/ 54.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 54,SO�OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTAIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CAECK
54.00 ,50
ik 1! 1k 1E if if ik iF 1k fE 1k k 1E iF ff ff ff 1Flt 1! 1t iE if i! fE if !!!f k 7f iflk if ik k 1k if 1E iF k 1ElFlk ft 1f ik iE ff f! it 7k it %i! 1E 1! ft 1! k 1f 1k if 1! 4!t ik ft it fE fk ik fk 1! 1! ft f!!E if f6
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY D E S C R I P T I O N
2995 REAOOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
UNIT COST TOTAL COST
1.00 2,995.00
V
Q1 OOib5974-0�165975 T�] T 54.SQ
DATE: 48/16/94 TItiE: 16:34
.���CONSTRUCTION AN6 PLANNiNG POOL � SPA
�r APPROVA45 Permit #`r Oate Inspector qppROVAIS Permit # Date InspecYor
� t. Temporary Electricai Service o� Pote 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3; Electrical Conduif Uiility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding
5. $teel Reinforcemenr 56. Rough Plumb�ng & Pressure Test
�,6. �IectricalUFERGrnfi. - 57. APPROVALTUCOVER�GUNITE
J. Footings � . 58. Electrical Cond�rt Undrgmd. �
' 8. Foundation � 59. Gas Pipc, C Undrgmd., Test �
9. Water Pipe�Undrgrnd. 60. BaCkwash LmeS, P�7rap, C Undrgmd. �
10. Structural Floor Svstem 61. APPROVAL TO DECK �
15. Property Sewer Line �. House Connection 62. Backwash & Receptor�Final
12. Sewer Cap � 63. Heater & Vent�Final
73, Roof Drains - 64. Plumbmy System � finai
14. Rough P�umbing - 65. Electrical�Finai
15. iiough Electrical-Condurt 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Acces< Approval
17. Rough Wirin9 Sign 68. APPROVED FOR PLASTERING
7$. Rou9h ElectricaLT Bar Ceiling 69. POOUS�A SYS'EM1-1S F�NAL
19. Rough He9tiny & Air Conditioning ' PIRE DEPT. REQUIREMENT
�
20. Rough Factorq FirePiace _*, - - _. � APPRQVAL'S-.' Permit #
- r - � _ .
27. Ducts, in tructure � � ' ` , .
�✓ .•.� )0. Uadergrovrid�Hyci'ro
22. Dutts, Ventilating _ • y' ;7, product��'tping f_�iGas ❑�ii
23. Gas Pipe=�iough &'Test �- � � 32, Undergrowvd Flush ;, � : „
24. Roof Fram�ng• ' -. . � > � ' • -73. ''Underyrnd. Storagt 7ank � Gas ❑ 0?1
Z5. Roof'Sheething .. 8:.<?�� �L(/61 � yq, jjverhead Hvdro • �
26. T�Baq Ceiling (SvucWrall & pAo�omat ' . :'y 75. `qry Chemica� ' � '
27. Prame and Flashing '' ;� � . 76. Dry Standplpe �, �
28. Lathing & Siding , � - - 77. -FIXED Sl`6TEM�FCNAL
29. Insulation ' . ' '' � � l. � 78. FIRE PREV. FINAL
30. Drywall Nailing , �' � i - � HEALTH pEPT. REQUIREMENT
31. Plaster BroWn.Coat . _ ,�.� I `, 79. FINAL INSf'ECTION � ,
32. Electrical`Power M;ter-�inal . � ,. 80. FOOD CERTIFICATE ISSUED
33. Finai EleCtric, y � ' �� ! 'Nore3: . � , `1,
34. Final Heating & Aig Conditioning : '. ' �' , , � , . , ,
,
35. Final Gas_PiPe�Test ' ' ' ` �-� � ^ ' " � � � � - . �
36. Hood,or CanopY � ' . � � '
�
37. Finat Factory FireplAce' ' ' ' i ' ,; � -
38. Pinal Plumbing . ' _ - � �- : - �
39. Waier.Service-Final � • � . -�
40. Gas Szrvice�Final . _ , � , , .; �
41. Soiar �omestirFi�ai � � . � ' . !
42. BaCkflo�n• P�eventer � � � '. .
43. Backf4ow Irrigatian . - . � - - . .
44. Landscape IrcigationSystem - . - � � . , .
45. Sound Attenuation . • � • _ ' �
46. Handicap Regulations _' '� �� - . �
47. FiNA� STRUCTURE & BUILDING _�Q _� �L�/ - • _
)V
48. FINALPLANNING . .� � � • _ - -
49. Electric Release to Edison �� � � �
50. Gas Release to Southem Califomia Gas Co � ,. _ �
51. CERTIFICATE OF OCCUPANCY � . - �
No. Dare -
' l8�33
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 C06TA MEBA. CALIFORNIA
—
Fo� Applicanf +o Fill In Complefely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
Mesa Del Mar Develoi
Corona del Mar
� ARCHITECf
sae 6045 S.F. INo.oPB
OF LOT Now Or+
USE OF none
PXIHTING BLDG
S6TBACN LINB PROM
ceNTert OF sifteeT SO � REAR YARI
SIDE YARD I LEFT G� I RIGHT
DESCRIPTION OF WORK
NEW I X II ALTERATION I II ADOITIO
� USE OF BUILDiNG AND WORK TO BE
„h�-�-�,Pn�os�N,zzs 4��112:5!
APPLICATION FOR PERMIT
BUILDING
For Off3ce Use Only
R6CEIPT NO. I P�I�
i
ev Ip2qTE �RECe��ED� I owTe
-i ��� tytno
BUILDING
A�DRESS
C�STA MESA. CAIIFORNIA
FIRE
ZONING
NO. OF ^ uee oc
PLLNB / 'BUILDID
LEOAL
IC6NTI[N LINB 0TJ
'6"
FftONT
�
EVES
S.F.
�
Gara e rea: 4eu s.F. -
� HEREBY ACKNOWLEDGe THAT I HAVH RlAD TH18 APPLIWTION THE AMOUNT BXOWN UNDER VALUATION 18 FOR TME
AND eTAT¢ THAT THE ABOV¢ IS CONR¢GI' AND AGREE TO COM- PURPOBE OF, EeTABL18HIN6 A PERMIT FEE ONLY.
PLY WITH ALL CIiY OROINANCE9 AND BTATE LAWB eE6ULATINC
euaowa coxeTquciloN. VALUATION /JS
SIGNATURE OF PERMIT FEE $ /✓
PERMI7TEF Mesa Del Mar Development Co.
�• � ��� � 23,925��� PLAN CHEGK $ ' —.i S�
i
AUTHORIZE� A f�T gt.�g�/ %� �,r�-,.� � _ i i 7_/-,-/�