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Home My WebLink About1075 CHEYENNE ST - Building Permits_ •_; _ _ Applicant to fill in all spaces except those within heavy border lines and sign_ all ap clTwoF' A MESA CONSTRUCTION PERMIT ProjectA �ess i 1075 Cheyenne,t C.M. :;ipiicant's Mailing Address 126Commercial C.M. .92627 Owner's Name ' Margaret' VasZlly j Phone 1545-835, Address 1075 Cheyenne, C.M. Arch/Eng. License No. Address - Contractor's Name Crank BYOS .' Roofing Phone 548-5569 Address (mailing) 126 Commercial', C.M. 92627 City License No. 005993 LICENSED CONTRACTOR DECLARATION I hereby affirm -that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Cotle, and my license'is in full fort Vc1 effect. ' ' License Class C—License o. 408677 Date Signature ,` �'s•'�C �"'Z✓'� IORKERS' COMPENSATION DEC TION hereby affirm that 1 have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. CGbP85362466 Fremont Indemnity policy No. Company Certified copy is hereby furnished. I , Certified copy is filed with the city Building Division. I Date Applicant - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed if the permit is for one hundred ($100) or less). 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. Date Signature NOTICE: If, after ma king -this declaration, you should, become -subject to the \Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section' 3097 Civ. C:) Lender's Name Lender's Address - - - - - OWNER BUILDER 6ECLARATION I hereby affirm that .'am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter; improve, demolish or repair any structure, prior to—its—issuance, also requires the applicant for succi permit r „1,o file a signed, statement that he/she isdicensed pursuant to the provisions of 'g„he Contractor's License Law (Chapter 9 (commencing with Section 7000) of Ck; fivisign 3b} the Business antl -Professions-Code)'or that he/she is exempt *.herefrom'and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the, applicant to a civil j enalty ofinot more than five hundred dollars ($500). 1 1, as owner of the property or my, employees with wages as their sole I compensation, will do'the work, and the structure is not intended or offered ( for sale (Section 7044, Business and Professional Code: The Contractor's 1 License Law does not apply to an owner of a property who builds or Improves 'thereon, -and whodoes such work himself/herself or through his or her own employees; provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im - prove for the purpose of sale).' '-r I, s owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects withla:con- PERMIT NO.TRACT NO. ,LOT NO. l can TYPE OF CONSTRUCTION NEW LJ ADD nJALTERATION ❑ CONVERSION, ❑ DEMOLISH ❑ OTHER TYPE OF PERMIT .❑ GRADING' ❑'FOUNDATION ❑ STRUCTURA ❑ TENANT ,❑ ELECTRICAL 1❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION. SO. FT. 1.700 ' OCCUPANCY CONSTRUCTION TYPE residential VALUATION $ 2.214 ZONE— . G RADING CU. YDS. ACRES Remarks: ! I Bar Sink Backflow Preventer - Backflow Irrigation Bathtubs - - Clarifiers Dishwasher Drinking Fountains' Floor Drains ' Floor Sinks Gas Service Outlets Interceptors Kitchen Sink - Lavatories ` f P -Trap Roof Drains Reinspection 'Fee $15 Structural ±tractor(s) license pursuant to the Contractor's License Law)' I am aware that Exhaust System E]; multiple,[ proof or their Worker's Compensation insurance should be provided to me. L7 I'am exempt under Section B. B. & P. C.for this 'reason Firepl/Fact Bit. ICBO # Date Owner Heating. System & Ducting I hereby certify that 'I'have read this application and state that the above ❑0.100,000 BTU_ 0100,000,61 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and -hereby authorize repre- sentatives of thi city to enter upon the Bove -mentioned -pro ert for _ inspection purpose Signature p/ LLlLv..i Date �D I ' Drivers' Licens. Reinspaition Fee $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING .Showers : , ,Service Sink Sewer Cap '- - Sewer Connection Solar Collectors _ Solar Piping ,Solar Tank _ - Swimming Pool w/Spa Urinal Water Closet - Water Heater Water Service-' ' Auto -Wash Laundry Trays 'Imue Fee Hoodlor Types ❑ , Canopy Type I I ❑ ' Refrigeration System ' ❑0-100,000 BTU 10100,000 System Repair/Alteration late declarations NO' t 6453 1,0/31/66iT'L ,- Transformer ❑ 15-50 KW •' I it i ( 0•50+KW REPAIR: A.P.-# _ Zone., 1SSS A.: S Main Building: I Accessory Building:! Meter El over 100 amps - Dryers ❑Gas ❑Electric Sub Panel , 't' �'- - Fan Li T Front O I BRear i f I N nn P C_ Right-, - -_ ._.� _- N Standing Sections - Generator ❑0.5 KW 05-15 KW Trash Compactor G 00 S Left - R , • Ping. Ref. # I ' Parking Req./Provided i E • Planning Notes( I - M t PLAN CHECK 25%� $ ' , S. FEES 0 $ 3 Fire Dampers - Registers ' ,Issue Fee $ 3 I ='; ELECTRICAL• - `FEES _ Automatic Washersi- W Construction Pole Sub.- Transformer ❑ 15-50 KW •' I it i ( 0•50+KW Cooking Unit Meter; ❑up to 100 amps Dishwasher - - Meter El over 100 amps - Dryers ❑Gas ❑Electric Sub Panel , 't' �'- - Fan -Motors 00-1' HP. 01 % - 8 ; F.A`U. - _ Inc Solar ❑9-15 HP_❑i6-15+ _ Fixtures ' Microwave Device Boxes Pole Light Outlets Range 1 1 Switches r -- - Sign - -- Garbage Disposal ' Standing Sections - Generator ❑0.5 KW 05-15 KW Trash Compactor • 1 I , I I Reinspection Fee 1 $15' 1 1 Issue Fee 1'$ 3 1? I UtVbLV YMtNI SEH VICES HEVUIHEMEN IJ: , ' Zoning Approved By Date Building Approved By Issue Application Issued By 1 I Dat � �I Date1 _ I SUrAWARY BUILDING PERMIT $ .L�L_ Wit-:/ FEES ` 'SMTP $-'. PLAN CHECK $ ! PERMIT PLUMBING ”. $ - _ISSUANCE -.• $ — PLAN -CHECK F ELECTRICAL - 'PLAN CHECK50% .25%_ $ - r $ $ .ENERGY P.C. $ - GRADING $ _t _ 'MICRFILM O • MECHANICAL $ _TOTAL FEE y $ — t PLAN CHECK 25%� $ ' , CONSTRUCTION AND PLANNING APPROVALS Permit # , .Date Inspector POOL &SPA, 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings ! - 58. Electrical Conduit-Undrgrnd. >; y 8. Foundation 59. Gas Pipe, EI Undrgrnd., Test 9. Water Pipe-Undrgrnd. r 60. Backwash Liries, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK i 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 APPROVALS Permit # ' 20. -Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22' Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas ❑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 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 - 38. Final Plumbing' - 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventers 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �B 48. Special Requirements Completed . 49. Electric Release to Edison 50. -Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - Date ilk. ' fAODREss Ot' BUILDING: 1075 CHEYENNE ST UNT: MEWS NAME IFKI*M VASZILY, MARGARET FLOOD: X 47 JDDRESS1075 CHEYENNE ST I COSTA MESA,CA 92626 ` )ON,APPL. "UNG ADDRESS: . ARCNIfECT OR ENGINEER: UC. NO.: OCR OR ENG.'S ADDRESS: UNIT: coumacTowsmim: CRANK BROS ROOFING CO (714)548-5569 CONTRACTORS MAKING 126 COMMERCIAL WAY ADDRESS: COSTA MESA CA uaw, 408677 92627 UNIT: LICENSED CONTRACTORS DECLARATION: 1 hereby affirm under look, d perjury that I am licensed ud« wovaiwn d Chapter 9 ( ,e i� wdn Sealion 7000) d Dor an 3 d Ina Iwsiwee and proles on8 cede. and my fioa a' It forte d efhwt. r�YLIC.NO,005993 UC CUSS C39 u � 4 08 6 E} 06/97 Data: — Contrwim -4 ER BUILDER DECLARATION: hereby affirm under d ry that I em emmpt from the Contrad«e limnae Lew 1« to ollowmg swoon (Sedan 7031.5 Buskeas ad Probsairoa coy a oounly which recuie a pwnYh to Ponmrucl, ahw, improve, molah. «repel any s .wow. prior to in eeuawe, eao ui he epptuant 1« such parmn 1. fib a egnnd emenrBnl Mel a w ant a Soensed Normo to the provisions d the Contractors Lew IChepter B (commendrp with Sadion 7000) of Dm ion 3 of Ie Buvnese and Prdu«Th eans coda] at he or e a m ark basis for th«ehothe bafar the w6gd ale exemption. My vlion d Sedan 7031.5 by airy apptisnl for a permit subjects the appirwo to a civil perwry of rwr more than fee hundred dollen M500j). ■ ❑ 1, via owrw d the propeoy or y empbyees wdh wages as (heir We mmpena«an, will do the work, ad IM wucluro is not inteded on df«nd for sale (Swoon 7044. B.. vol Prdaesiam Cob: The Contraor. License Law does not apply to en owner of laep" we Wilda or knprovea thereon, ad wow does sunt w«k Noosed or herself or through his or her own empbysee. provided Met such improvements we rot intended «offered for sale. It, however. the Wilding or bnpr«wneM is sold within one year of completion, the owner-buiker will have the When of prwio, he or sae db not Wik or worms for the Wmoae of sale). ❑ 1. mown .,of the property, wn exdusivmy, mntrectmg wnh licensed conMcbrs IP eorel t the Project (Sedan 7044. Bnsineee ad Prefwwws code: The Cenuadon Liowse Law does cwt aptly a w owner of prop" who Wilde or impro n Mal ad who codwts for each toleots with a mmrmor(sl licanmd pumuml to the Contractors License Law). ❑ 1 am exempl under $action: B. & P.C., for this reeaon: Dere: Owner, 1 do hereby certify tet 1 am aeue of ad uderannd le rwwwwrw ; of CaN«na Nealfh ad Safety code Sections 25505. 25517, and 25530, and IMI I or any Mure buikinp arvpard will1 wR nol (crele «w) need tP .,1, wkh eeid papa moles ad le roRuiremwta ler e permG 1« mmtm«boon mndirlretion hantMA'r�OuaTylianepenwi Dimrvo. Revdentel mrntnIouon a,picmane aremempt hem Mesa preM9arn. Data: Applicem: WORKER'S COMPENSATION DECLARATION: I hereby affirm udw parWly of perjury one of the followirq dedermbr": ❑ 1 have and call makntaln a of th ere r for b aedinwre ler swell. compereetion. m ptovkd for by Section 3)00 d Me Labor cam, f« to perform«we d the w«x far canon ma perms a ia.ead. ] 1them and.1mamt.w«'corrpwwwm I.... Ws recuirec! by Section 37M of IM Labor Code, for the wforro. of the woA f« which Ma Perms a aaued. My workers• c«npeneation ineuratwe ,armr end ploy namlxa era: ceder: STTATE� FUND EXPIRES Pot Numb«: /I5l—`)7AN21 T2 01/01/98 I (This section reed cwt be condoned y Me permd e b once hundred ddlers I.Sf001 or tow.) ❑ I levity tem b Ie p.rfomunce d le w«k f« canon Ina rmil a issued. I shell cwt .*yanY person b any re.. an n to become subject to Ie workers' c«nPeosaii. laws d c b. end spree del d I hook become subject to the workers' penserion pm ions d Sedan 37M d the Labor Code. steal forthwith eom those ovidone. We: — 3 — _7 Apptaant Wim p: Felluro b ewuro wodrero' cpmpeMetlpn eo rays unbwNl, endaell aub/sor en employ« to cdrNnal penaltlu and CIY/ MI ty fp e!N hWdIW N1alIlIM dd/N (.f10RyLbf, amlmn ro Mo co.r of mrrrP«u.mm�, danlepm Y provMM roc a don 3706 of Me Labor Code, former, end ado ey s CONSTRUCTION LENDING AGENCY: I hereby aNrm undw pene6y of pe" Mat there a e canatmction I d'mg aper y for the mance d performance le ask for which the perms a issued (Sedan 3097, CN. C). . LENDER'S NAME: LENDER'S ADDRESS: 1 cer iy that I have reed this at,,mition and make tel the above informemn is carred. I apes to comply with all sty and county wdinmrcee WW state laws notal to building owevo orlon "hereby authorize re«asentmivea oftha city to enter upon le above-menlioned properly for inspection xepoew. JIM CRANK P' Name % Dap L/ Signature d Owns ApeM/App4ren yfitred« ea (5151�46.W P) Whh- ldig 6 lately: Greer�f ry-Appticenl: Rnk-Revenue: Gddenrd-Aeeeawr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 08161 PERMIT NO: B 081614 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION 'T/OFF & REROOF W/ COMP. & BUR SQ FT- 3,919 CLAIM VALUE: 3,919.00 CALC—VALUE: 3,919.00 GROUP OCC: R-3 /U-1 COMMENTS: REROOF AT REAR OF PROPERTY " FLAT AND PITCHED SIDE" Z 0 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—--------- FRNTg FT IN REAR: F1' 1N 1•RNf: F'11N REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14159522 ZNE: REF NO:vi PLANNING NOTES>' > D E V E `L 0 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 BY: %3n DATE:€�1 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 87.25 .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 87.75 0.00 0.00 87.75 175.50 —87.75 REVENUE DIVISION TOTALS--> COLLECTED: 87.75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 87.25 .50 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 3919 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 3,919.00 END OF FEES 82-13-1997/11:21 AN/f87.75 PERMIT:t081614 CONSTRUCTION AND PLANNING-�`=-batelspectcir APPROVALS Permit 3 - , " -, POLL & SPA APPROVALS. Permit_# y Date -� Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd' 1 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings -58. Electrical Conduit-Undrgrnd. 8. Foundation 59, Gas Pipe, O Undrgrnd., Test r 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. 1 14. Rough Plumbing r g 9 � �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 APPROVALS Permit 20. Rough Factory Fiiieplace - - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas Es Oil 23. Gas Pipe-Rough & Test - - 72. Underground Flush 2 24. Roof Framing - 73. Undergrnd. Storage Tank O Gas 'Doi! 25. Roof,Sheathing z../8-�• t �. 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 PREY. 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 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 - - - 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING i 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date OCCIDENTAL LOAN CO. GENERAL CONTRACTOR OCCI4enTai LC APAPNo_1k1-595-22 LOT TRACT JUN 1 5 OR _ _ . __, PERMIT -__VALUE $ k�'OOO. L" FIRE ZONE 3 DESCRIPTION OF WORK Res. W INSPECTIONS Signature DATE GROUP I & JTYPE V ZONE R1 Move -1 Soil SUBCONTRACTOR PERMITS ISSUED Gas DATE NUMBER Water _ Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line A -House Con.lB St. Swr. ❑ v% Sprinkling System _ Construction Pole Underground [j Power El Rough Wiring ,n�-.f. 1i_.•.. / -� ��i Trenehes Forms,Zji Steel Reinf. ❑ 1,16-GY Bond Beam E] Steel Reinforce ❑ Sheathing _ Frame and Flashing Lathing — In ❑ Out d5' _ Plaster, brown coat Refrig. Air Con. ,❑ Final Heating, Final if 41V V _ Plumbing Fixtures, Final _ Final Gas Test 4 ¢ _ Electric Fixtures, Final _ Building,Final _ _ OCCUPANCY 6 I ~ " 22459 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 9262E For Applicant to Fill In Completely TYPE OR PRINT A 0 STATE LIC. NI SIZE NO. OP smog. I X 1001, NOW ON LOT ROM 65, -I REAR YAR 2 E RO .EFT 5 1 I RIGHT 51 DESCRIPTION OF WORK BUILDING521 .X 47 -Salt USE OF BUILDING AND WORKTO BE 1 HEREBY ACKNOWLEDGE THAT.1 HAVE READ AND STATE THAT THE ABOVE.IS CORRECT AF PLY WITH ALL CITY ORDINANCE AND STATE BUILDING CONETRUCTWM. . AUTHORIZED AGENT a FEE RECEW D du N 1 b 1984 FINANCE DEP1, CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only ' RECEIPTNO. PERMIT NO. 2z�3—rs wE qY O sY AT[ REC[IV D DATE bH 8D f 1 i I/O- 4 BUILDING D ADDRE FIRE ZONE TYP -GROUP APPROVED / By ATB NING N[ NO. O! USE OP NEW �IA� lLANf'1% BUILDING LEGAL D[YCRIPr10N l'� A. P. NO. NOTE, NO EAVE OVERHANG SMALL BE LESS THAN 80' TO SIDE O REAR P. L. EAVES ALLOWED (U. B. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM ZLSTRE[T) FRONT R. SIDEFT. L. SIDE FT. FT. Y Zi REAR FT. DISTANCE BET. BET. MAIN e MAIN BLDGS. ACCESS. BLDGS. VAR. CDAZ{E S �/ C. lj�YIPPROVHD .C`• APPROVED DATE (( �v C4 j TMH AMOUNT *MOWN UNDER VALUATION IS FOR THE PURPOSE OF RSTASLISHING A PERMIT PEE ONLY. YAW ATION ll q e^ -C/ PERMIT FEE s 28 / j v TOTAL FEE sl.J iNOWNER VA97TiY, AiPY DAUILTE R_ �� B ADDRESS inns rr o, e e c+...+ BDING PERMIT N0. vnTaT TRACT 6SvH FIRE ZONE VAL SUBCONTRACTOR W PROP, SWR. LINE U HOUSE CON, LJ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heatimq and Vent. TRENCHES E] FORMS ❑ STEEL REINF. FLOOR SYSTEM SHEATHING FRAME AND F PLASTER, BR HEATING, VENT., REFRIG. AND A.c., F PLUMBING, FINAL AND GAS TEST n 37131 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Co pletely BUILDING/7ADDRESS 11 OWNER MAIL TEL. CITY NO. CONSTRUCTION iy-se n - BRANCH ADDRESS TE ADDRESS,')// j /-4/1 4.10, - I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby -certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Oivisicn 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the provisions of the State of California Business and Professions Cncie, Division 3r Chapter l9• Signature of G Permlttee Authorized Agent PAIU sur-7-73p�f00 161* *****7,11 ATION FOR BUILDING PERMIT R EW t4 BV ATE RECEIVED ^ �ql- yG A. P. NO. 7 DA ISSUED PERM T N67 CONTRACTOR TRAC S,;i ADDRESS W IADDIA P CITY NO fl STATE `�/-�c9sI-i TY 9y.J� LIC. NO. S'f� f- / LIC. NO. (JL SIZE OF SLOGS. OF LOT INO. NOW ON LOT USE OF (FROM LSTREET FRONT EXISTING BLDG. R. SIDE FT. SIZE OF //yy pp�� O. OF NEW BLDG. V (1 ROOMS STORIES EXTERIOR WALL ROOF COVERING VAR.* C.U.P.# COVERING USE OFBUILDING WORK PERFORMED -7 .AND /TOOOIBE I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby -certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Oivisicn 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the provisions of the State of California Business and Professions Cncie, Division 3r Chapter l9• Signature of G Permlttee Authorized Agent PAIU sur-7-73p�f00 161* *****7,11 ATION FOR BUILDING PERMIT R EW t4 BV ATE RECEIVED ^ �ql- yG A. P. NO. 7 DA ISSUED PERM T N67 BUILDING ADDRESS TRAC S,;i LOT BLOCK W IADDIA P OWNER V E SE $ FIRE ONE YPE GROUP APPROVED BY DAT ZON NO. OF PLANS USE OF NEXV BUILDING YARDS APPROVED MAI BUILDING YARDS APPROVED ACCESSORY BUILDING (FROM LSTREET FRONT T. R. SIDE FT. FT. L. SIDE 22-7 FT. FT. REAR J FT. FT. DISTANCE BET. MAIN SLOGS. BET. MAIN & ACCESS. BLOCS. VAR.* C.U.P.# DATE APPROVED APPR V �1 DAT E gat Po, SQ. FT. '(W' THE AMOUNT SHOWN UNDER VALUA ION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION $ ��snv rP fV'- PERMIT FEE $ ' PLAN CHECK TOTAL FEE S / m b 0 i N N 7 m E `c LL 6