HomeMy WebLinkAbout2974 CEYLON DR - Building Permits(714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.g�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite:
Vicinity:
Primary Occ:
Parcel Number.
2974 CEYLON DR
13923218
Applicant: SALVO, ANTHONY
Address: 2974 CEYLON DR
Type of ConstruIXion: V-N
Zoning: Rl
Staws: ISSUED
Applied: 09/19/2005
Issued: 09/19/2005
�.�,�P,hone . 714-434-1784 ISSUED BY:
COSTA MESA, CA , , P=;Zip 92626-:, �
y `
Owner. SALVO, ANTHON�Y . , ' `�'s;?.
Address 2974CEYLON�DR - ��� �, ,,,� � � ��..�
' - -. ... Phone 714-434 17 � . � � �
COSTA MESA CA - � � � Zip 92626 �. �� , , � ��
Y�..1
Conuactor. � ��OWNER�-BUILDER, �,�, � , ��A�" '
- _ � `�
Address.- � �� �- � � ��-���.
. . � Phone: ... .. . �
> ^ s.
'� ;• Zip_ - License: 000000 � ;3ay,�= "�
Arch : Eng: '
Address: � Address: . . , ^ =z, s�
� . Phone: . , . � . � Phone:�. .
. ,y.` .. _ � � _ _ _ '•a . a. _ - - . .
6�
��ip: � ' , License _ = Ucense':
SCOPE OF PERMIT � � �'.;, .
�, ; REPLACE WINDOW55 WINDOWS�IN THE SAME LOCATION AND THE SAME SI2E. BEDROOM WINDOW SHALL COMPLY WITH UBC SEC. 310.4
� Pla�n Check " ��$81 41��_ � � �
Permit:- _ $12525 �
' SMIF Res ,' $0.60
� " SMIP Com:,� `$0.00 "
� � Other:• $0:00 ;- ; � � ' �
� ��. Inspection. � a-,;, $0.00�, �,� , �� �^ -��
'�Total: ���5�207.26 �
.
FEE=SUMMARY - -
.. Calc Valuat
, ,�_ '_ , Claim�,Ualu�
i #a -. " ss,000.00 .
m . 5s,000.00
F_ r
y
PLANNING & ZONING
SETBACKS� � � � �
MAIN'STRUCTURE .Front • .0-,0:-.. Rear � 0-0. -� . Left � 0-0 - Right
ACCESSORY Front 0,0�-� • Rear . 0-0�;: ��rteft 0-0�_���� '���Right
PARKING�� -� Ezistin �=� 0 - .;:Reawred:. 0"� �� ' �-Pr000sed �.�0 ,� ,�
'��:;
0- 0
0- 0
,. . r'�' � -� z , .
V y,S'n ' .. ;�£ r: �.�..
� . . .. - ;h v Y
._ $.�"
. . . .- . � �;. ::.• ' R .�.�-f-'Y�-�•'
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
Iregulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period ot 1 BO days.
IINSPECTIONS: �n order for the work authorized under this permit to be considereC legal, such work must comply with all applicable codes, and all
requlred Inapeetions and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permi�
' FOR INSPECTIONS CALL: (714) 7545626
zaasre �aroo�
��
WORKERS' COMPENSATION DECLARATION: - - • .
I hereby effirm under penalry oi perjury one of tha following declarations: �
❑ I have end will maintaln e cenificate ot consent to selt-Insure for workers' compensation, es provided for by section 3700 of the Lebor Code, for the peAormence of ihe.
work for which ihis permit is Issuetl. � �
❑ I have antl will mainteln workers' compensa�ion insurance, es required by section 3700 ot the Labor Code, for the performance of ihe work for which this pertnit is issuetl.
My workers' crompensatlon Insurence cartier end policy number are:
Cerrier: Policy Number:
(This secfion need nof be comp/ered i/ the permit is velued et one hundred dallers ($100) or IessJ
❑ I certiy ihat in t�e peAormence of ihe work for which this permit is issued, I shall not employ eny person in any manner so as to become sublect ta the workers'
compensation laws ot Californie, entl agree Ihat if 1 should become subject to the workers' compensation provisions oi Section 3700 of the Lebor Code, I shall torthwith
comply with Ihese provisions.
Applicant Signeture: Date:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUaIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLURE ($100,000), IN ADDITION TO THE COST OF COMPENSATIqJ, DAMAGES AS PROVIOED FOR IN SECTION 3]060F THE L4BOR CODE, IfdrEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensed untler provislons oi ChaD�er 9(commancing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full
force antl e8ec1. Lia R Class A
Contrectors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hareby ettirm that there is e consiruction lending agency for the performance of ihe work for which this pertnit is issued. (Sec. 3097, Civil Code).
LendeYs Name: Lender's Atltlress:
Signeture:
Date:
OWNER•BUILDER DECLARATIONS - �C��
I hereby aflirm �hat untler penalty ot ry(�et I em EXEMPT FROM THE CONTRACTORS LICENSE LAW far the tollowing reeson (Sec. 7031.5, Business antl Pmfessians
Cotle: Any city or wunry which req v a p�dirnit to consimct, alter, improve, demolish, or repair any sWCWre, prior to its issuance, also requires the epplicant Por such pertnit
to file a signe0 stetement t�et he or s�e Is Ilcensetl pursuant to the provlslons of the Comractors Llcense Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of Ihe
Business entl Professions Cotle) or ihet he or she is exempt Iherefrom end the basis for the ellegetl exemption. Any violetion of Section 7031.5 by eny epplicent far e Oertnit
siybjects tha eppliwnt to e civil penelry of no� more than five hundretl tlollars ($500).): ,
'[] I, es owner of Ihe properry, or my employees with wages es iheir sole compensation, WILL DO THE WORK, antl the structure is not iniended or oHeretl for sale (Sec.
\7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builds or improves ihereon, end who does such work
himseN or hersalt or ihrough his or her own employaes, provided that such improvements are not intended or offered for sale. If, however, ihe builtling or improvement is
sold within one year ol completion, ihe owner-builder will have the burden oi provinq ihat he or she did not build or improve for purpose of sale.�. •
❑ I, as owner ot tha properry, am EXCLUSIVELV CONTRACTNG WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions
/ Code: The conirac}eJs Licanse Ww does not appty 1qan owner oi pmpeny w�o 6uilds or Improves ihereoq and who contracis for such project with e coniractor(s)
C; license pursuanyfo�(he Copirectors License Laws.)./� _
exempt
verifiatl by tlnver's Iicense. `�es ❑ No
Venfication of Ownarship by (rype ot document, I.e. - pmperry tex bill or deed):
Code tor ihis reason:
Date:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hareby certify Ihet no excavetion five (5) or more feet in depth into which a person is required to descend, will be made in connection with work euthorizetl by Ihis
permit, and that no building structure, sceftolding,lalsework, or demoliiion or tlismantling ihereof, will be more ihen thirty-sia (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celitornla Administretive Code).
❑ As owner-builtler, I will not employ anyone to tlo work whlch would require a permit from the Division oi Indusiriel Safety, as no�ed above, unless such person has e
pertnit ta do such work from the division.
SignaNre: Date:
Division of Industnal Sefery Permit Number:
CODE t. INSPECTIONTYVE
1676 Fixed System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Final
Finel Re-Roof
Final Block/Retaining Well
Final Factory Fire Place
Finel Sign
Finel Demolition
PA�. IMRIRLS
COOEt INSPECTIONTYPE
206 Finel Mechanical
20B ,FinelPlumbing
210 Final Elecirical
212 Final Fire Prevention
220 � Final Planning Approval
PiIE IHfffI�LS
222 Final Site
2so Fina� euimingioccupancy 3 Z/—D6 �
PflOJECT AODHESS:
OWNEfl'SNpME: 297q CEYLON Dk
aooeess: NAPUT,I, JOSEPH C TR
915 KINGS CANYO\ RD
HREA,CA 92621
PflCH/ENGINEEB:
noonEss:
REG.NO.:
uxir: ��
�
uNiT:
PEHMITTEE:
aooeess: RAYMONll 7U CONSTRUC7'ION ( 714 ) 96i-7334
9801 OCEANCREST DR
u�ini�•-rn1r,Tn7�i RF�/'��7 �A 99 d�
LICENSEO CONTflFCTOP DECIABATIDN: I tleieby affrm'ttlaYl'Sm hcenseA und¢r pmvislor(S �C�ap[er 9(cammencing wi�h Section
7000� ol Oivisian 3 0l lhe Business ana Pw�essions Cotle, antl my license is in tull torce and eifect.
GITY LIC.: STRTE LIC.: ClASS:
056I6fl 470673 H
Daie:._,��� � 9� SgnaNre: — _ — _
WOflREBS' COMPENSATION OECLAPpTION: I �ere�y atlirm ��at I ha a cetlilicate of consen� �o selbinsure or a certihcale ot Workers'
Campensation Insurance. or a cerUlied copy thereol (Section 3800. La6. C).
POLICY N�.: E%P. UATE:
COMPRNY:
❑ Cetlified coOY �5 hereby Wrms�ea. ❑ Cerlified coDY is tiled with ��e ci�y BuilOing �ivision.
oare: noor�a�c
E%EMPTION FXOM WOBKEAS' LOMPENSRTION DECLINATION: (Thi55ecii n¢ed nol �e cample�ed i� Ihe permil i51or One hUntlr¢� (5100) Or 1¢s5).
I ceNfy Ihat in the pedorman[e oi �he work lor whlch ��is permi� is is d, I sh I noi employ any person in any manner so as to �ecome
subjec� to Ihe VJorkers Compensation Laws oi Califomia.
oaie: 3��9�`J3 s�qnamre.
NOTICE: If. af�er making I�is UeUaralion. you shoultl become s jec� Io ihe Wo�kers' CompenSaUon pmvisions of ��e La�or
CoOe. you mu511orihwil� comply wi�h such pmvisions or Ihis De�mit shall be deemetl revoke0-
CONSTflOLTION LENDING FCENCY: I here0y aflirm t�at there is a consimction lending agency lor Ihe pedormance of the work tor
which I�is permi� is issued �Section 3097. Crv. C�.
LENDEH:
AOOflESS:
OWNEB BUILDEB OECIABATION: I hereby aifirm Ihai I am exempl irom ihe Conlraciors' Staie License Law �or Ihe �ollowing reason
(Seciion 703t.5 Business ana Pmiessional Code: Any city of county whic� requires a permii to consimct, alter, improve, tlemolisR or
repair any simcture, prior Io its issuance, also require5 Ihe applicanl for such permit �o file a signea s�atemen� Iha� he/she is licensed
pursuant la �tle provisions ol Ihe Coniractors' Slaie License Law (Chap�er 9(cammencing wilh Seclion 7000) of �ivision 3 0l t�e 6usine55
antl Pwiessions Catle) or ihal hehhe is exempt �herelmm and �he basis �or Ihe allegetl exempiwn. Any violaiion o� Section 7031.5 6y
any applicant lor a permil subjec�s �he applicani to a civil Denaliy of no� more �han �ive huntlretl dallars (E500�.
I. as owner o� IAe pmpetly or my employees wit� wages as Iheir sole compensa�ion, will tlo the work, anA Ihe
❑ stmcWre is na� imendetl or ofleretl for sale (Sec�ian 7044. Business and Professional Coae: The ConVacbrs' State License Law
Daes not apPly lo an owner of a pmperty who builtls or impmves lhereon, antl who tloes such work himself/hersell or through
his or her own employees. provitletl that suc� impmvemwts are not inten0e0 or oHereO for sale. If, however ihe building or
impmvement is so10 wiNin one year of completion, ihe owner wi0 have ihe 6urAen of pmving he/she Oid not build or improve
br t�e purpose o� sale�.
I, as awner ot ihe pmpehy, am eKclusively coniracOng with licensetl coniractors to constNd ihe pmject (Section 7044, 6usiness
❑ and Piofessions CoOe The Contractors' Slate License Law tloes nol aDPly Io an owner oi proDehY w�o builtls or improves t�ereon
antl w�o coniracts lor such D�olecis wiih a coniraclor(s�license Dursuanlio Ihe Cantracmrs' State License Law),I am aware
Ihai proof oi Iheir Worker's Compensa�ion insurance shoultl be pmvitletl �o me.
� I am exemo� uneer Section: B. 8 P. C.
for Ihis reason:
oate: Owner
I do hereby cenity Ihal I am aware oi antl untlerslan0 ihe repuirements o� Calilomia Heal�� anU Salery Cotle Sec�ions 255�5, 25533, and
25534 ana tha� I or any Iuiure builtling occupan� willlwill nol (cirele one) neetl to comply wi�h saitl s�a�e cotles antl �he repuiremen�s for a
permi� br conSlmciion or motlihcaiion imm Ine Air Oualiiy Managemen� DiStrici. Fesitlential cons�mction applica�ions are exemD� �mm
IhCSP D�Ovi5i0�5.
�ale: Appbcan�:
I here�y cerulythal I have reaa ��is applicalion antl slale Iha� Ihe above inlormationis correct. I agree�o comply wi�h all ciry antl county
ordinanceszntlslatelaw5relatingtobuiltlingconslmclionantlherebYTul��r epresena�iveSoflhi5cityioen�eruponlheabove-mentioned
pmoer�Y for mspec�mn -p}urposes.
Dale: j ��/�..J Signalure'
Orivef5 LltenSe oi Social Securily p: ,�,� �� ��
l6at�a6 Whue-6mltling; Green-Code Enlo¢emenf, Canary—Apphcanl: Pink—Revenue; Goltlenmtl—Assessor
CITY OF COSTA MESA — HUILDING PERMI'f
PER�SIT NO: B 061436 PLAN CHECK NO: N
COi�ISTRUCTiON TYP6; 5—N PERMIT T'YF�E: STR
JOB DESCRZPTION : T/O EXIS'PING 6 APPLY NEW 30YR CUMFO
PERM NO: B 06Z436
GUVT: N SUPP; N
PURPOSE; ALT
SQ FT; 6,000
CLAIM VALUE; 6,000,00 CALC—VALUE; 6,OOO.UO GROUF' OCC; R-3 /M-1
COMMENTS: SNOKE DETE:CT'ORS I2E&OIkED PER THE 1991 ED. OF 1`HE UBC T C�O�
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Z O N I N GS �RTE�(�AUCIKRSE M E t3 T S � IR�D
REQU
------------ MAIN BUILDING ---------- --------- ACCESSORY BUSLDING ---------
FRNT; FT IN REAR; PT` IN FHNT; FT IN RElaF2; FT SN
LEFT; FT IN RGHT: FT IN LEFT'; FT IN kGH't; fiT IN
F'ARKING kE�• PROV; PAftCEL; 13923218 ZNE; REF NO:
PLANNING N 1'ES%
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D E V H:'� L, O P M E N T S E R V I C E S R E Q D I R E M E,�i �`# S
'LONING APPROVE1l�BY L7ATE:
BUILDING APPkOVED bY ; D'ATE: �
APPLICATION ISSUED HY: � � DATE; �
lFjE)EJfN'3f3fiFlEiE1E)F'K�i}iE!('fflElFlEiElfi�jF rt �1� �itiF . k��if i� %- �n�3FiF�t�k����i%3h-%7EiF3(JE'lEif�X�k��ftr'k':.____�3(�%
ifiElE�hifi(�iErtiE�lEiE1E1E`�iF1(�fEiS�iF�EififififiFiF%i4%�iEi(-IE3Eiflf�f�F�E�EiF =' jP�(�iE#iEj(�3I�iE!f�if%�fFiFiEif#%i(�3fiE�i���X�X�7(if#!(�jEiE±EififiEX�k�ii�
LEGALIZATION:N F E E S U M M A R Y S'TRUC1'URAI, SEGNENT;Y
BLDG PMT PLUMBING ELECTRZC MECHANIC
PERMI'i' 81.00 F ;
PLAN 4' •"1 �'
ISSIJE FEE �
BUILDING—DIV—> PERMIT ZSSUE P.L'�AN—� HECK
TOTALS----> E1,60 0,00 �', 0,00
r � r
REVENUE DIVISION TOTALS--> COLLEGT•ED;
BLDG PMT PLUMBING ELECTRIC N$CHANIC
81,00 �
FZRE SMIP/RES GkAPING
60
SMIP/NON—RES
TOTAL PAID
81.60 81.60
lg1,fJ� �UL��SH�K�r;
FIRE SMIP/TOT Gk,AUING
.50
D00
00
PLAN—CHECK
nf
1E 1E 1E 1E iF iE IF 1Elf IE # IF 1E iE iE !E iF if 16 if 1F iE iE iE iE if� N� ih i4 iF iF �7F if iE 3E if 1E 3k a�f iF fE K� �F-1(-�k 3F �)E-lE iF if� iP if �1Fi( %� if� N� 3E %�lt iE %� 3(�'�(�-% iE 3P 3f- iE 3f 3E'lE 1f 14?(� if� i4 i4 iF
I N D I V I D U A L;' ��F E E B R E A K D O W N
TYPE Q'fY D E S C k I P T I OiNJ UNIT COST TOTAL COST
t
SFR 6000 REROOF BY VALUE RESID�NTIAL NOZONE 1,00 b,000.00
END`,O� c EES
•? ��
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Llr ._. .., , , ., � , __ .
COfVSTRUCTION AND PLANNING
- APPROVALS Permit #
' t. Temporary Electrical Service or Pole
2. Soil Pipe�Undrgrnd. �
3. Electrical Conduit UtiGty�Undrgrnd.
4. Electricai Conduit�Undrgrnd.
5. Steel Reinfo�cement
6. Eiectrical UFER Grnd.
7. footings
8. Foundation �
�I 9. K�ater Pipe-Undrgrnd. �
� 70. Struccural Ploor System .
, 11. Property Sewer Line & House Connection
� 12. Sewer Cap
73. Roof Drains �
14. Rough Pfumbing _
15. Ro�gh Elecirical-Conduit
'I�. Rough Electric Wi�ing
f ��Y7. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiiing
19. Rough Heating & Air Conditioning
20. Rou9h Fac:ory Fireplace
21. Ducts, in Structure
22. Oucts, Ventilating
23. Gas Pipe•Rough & Test
24. Roof Frami�g
25. Roof Sheathing
26. T�Bar Ceiiing (StructuralE & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywali Nailing
37. Plaster Brown Coat
32. Electrical Power Meter�Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Pinal Piumbing
39. `f/ater Service-Final
40. Gas Service�Final
41. Solar OomesticPinai
42. Backflo�v Prevenxer •
43. Backfiow Irrigation
44. Landscape Irrigacion�.ystem
45. Sound Attenuatiorr�� .
46. Handicap Regulatioris� r^--
� �.. V�
� 47. FINAI STRUCTU� E�BU�LDING
r'r
4$. FINAL PIANNif�6' •`''
rv-, �
49. Electric Release Cq.��E'disola
50. Gas Retease to Spyihe'tii"fatifornia Gas Q
57. CERTIFICATE�OF 6GUPANCY
Date
Daie
r'.:JL & SPA
I�spector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
- 55. Electrical Bnr.ding
56. Rou9h Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical ConduirUndrgrnd.
59. Gas PiRe, O Undrgrnd., Test
� 60. Beckwash Lines, P�Trap, O Undrgmd.
67. APPROVA� TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Finat
65. Electrical-Fi�al
66. Sola. SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOUSPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
� APPROVALS Permit #
70. Underground Hydro
77. Product Pipir,g O Gas ❑ Oii
� 72. Underground Flush
�73. Undergrnd. Srorage Tank O Gas ❑ Oii
� 74. Overhead Nydro
75. Dry Chemical
76. Dry Standpipe
� �� 77. FIXED SYSTEM FINA�
� !i 78. PIRE PREV. FINA�
�- ' HEAITN DEPT. REQUIREMEN'T
� 79. FINAL INSPECTION
i
� 80. F00� CERTIFiCATE ISSUED
�
� ./• n
•1_' ( Notes: �('_ �_,/_w� �_..G_ A.
n
�
0
Date �Inspector
/
e
0
ADDRESS
lon Drive
�SOIL
'GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND PIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS STEE� REINF.
FLOOR SVSTEM
BOND BEAM � STEEI REINFORCE n
SHEATHING
FqAME AND FLASHING
LATNING - IN OUT
PLASTER, BROW COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL ANO GAS TEST n
ELECTRIC, FINAL
BOILOING, FINA�
DATE
BUILI
SUBCONTRACTOR
PERMIT N0. �6555
c and room addition
= r" 3b58�
' COSTA MESA BUILDING-SAFETY DEPARTMENT
� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILOING /J q�1i �{
ADDRESS ,G / 7
�
OWNER �+� %
MAIL .n ' ,� �% �
aain '�.
„�•� -3-73cna.�0 15'1.=� ::t: s:t�9 3�
APPLICATION FOR BUILDING PERMIT
A.P. NO��'J/ �
BUILDING �./p
ADORESS H C
Z . ...,,. � - -.� �
d U CITV �O;f � H 4 NOL TFACT
Z
Z Q CONSTRUCTION W ADD A
O N LENDER �( .
d 0] /`
J � BRANCH
J N WNER
m J AD�RESS '
�J m ' ARCHITECT TEL �SEO DG
a OR ENGINEER NO.
V Q FIRE
w � ADDRESS 20NE
a w - APPROVED
JO CONTRACTOR �\.VNI12 G�L I2 BV
m Z
J � AD�RESS
� W TEL. ZONE PO�OJrF'�
Z= CITV NO. �C/
H
w � STATE CITV �'APDS APPROVED
y� 11Q NO. � LIC. NO. MAIN BUILDING
7 O ' (FROM G S EET)
SI2E � � NO.OF BLDGS.
OF LOT 7 � NOW ON LOT / FFONT FT.
USE OF
EXISTING BLDG. ��(/�LL �.\! S E F,
F� SI2E OF b NO. OF
Z NEWBLDG. �L ROOMS STOFIES L.SIDE FT.
U EXTERIOR WALL ROOF
COVERING .G[7 COVERING � If / REAP � FT.
J USE OF BUILDING AND WORK TO BE PERFOftMED DISiANCE BET.
a MAIN B�DGS.
a
Q ' vaa. #
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F . APPROVED
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UI her¢by acknowledge that I have read this application antl state
� ffiat the above information is correct and agree to comply wiffi
� all laws regulating builtling consttuction, and I shall not employ �
� any person in violation Of ffie workman'S compensatiOn laws of
y the Sta[e of Califomia. n �
zI hereby certify that.l am properly licensetl as a contractor under OS SQ. FT.
the State of Califomia Business antl Protessions Cotle, Divisicn 3, THE AMOUNT S O1
Chapter 9, antl thst such licenses are in tull force and effect, or I THE PURPpSE OF ES
� am exempt from ttie provisions o( the Stare of Calitornia Business VALU TION
antl Professions Cncie, Division 3, Chapter 9.� ' �
- Signature ot � !
Permittee $
Authorizetl Agant `(,�j� (�
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DATE ��J�' (�
USE OF'N � �
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VARDSAPPROVED
ACCESSORV BUILDING
BET. MAIN &
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DATE
APPROVED
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VALUATION IS FOR �
A PERMIT FEE ONLV: m
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C�STA MESA BUILDING-SAFETY DEPARTMENT
� P.O. BOX 317 COSTA MESA. GALIFORNIA
FOR APPL/CANT TO f/Ll /N COMPLETELY
TYPE OR PRINT
ADDRE'S5 2974 Ceylon Drive
COSTA MESA. CALIFORNIA -
ow�ERKenprof Development Co„Inc
ADDRE55 1555 Placentia � �
Newport Beach TNoMI.,
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�ARCH ITECT L IC.
OR ENGINEER NO.
V EE R�C�i�/Ei�
C'ed �--3-E �
FINANCE DEPT.
cirr o� cosTa ��rs�
APPLICATION FOR •P RMIT
BUILDING
fo,e aFficF usF oNu�
RECEIPT NO: PE� I NO.
� � � �i°��:
RECE V) Er^Y I D�EiEjEIVED I OATE �SSl1ED
{l:/ ia � d�IS 2 �
COSTA MESA, CALIFORNIA
Tvor l� raniia �.Y T
CONTRACTOR K�W� K011 LCN0.61195 BYPROVED DA7E
cen 8 ZONING
ADDRE55
LEGqL LOT 128 I��2� ZONE /y INO. OF fISE OF NEW
OESCRIPTION NO. BLOCK pC � r I PLANB I BUILDINCs
A.P. NO. � - APPROVED y
BY J ' DATE
oF �oT 76x99 irreg I How oH tois 0 YARDS `'E S
REpU1RED ALLOWED
USE OF None ICENTEN LINE ST.)
EXISTING BLDG. FRONT FJ^ �FT.
SETBBCK LINE FROM �y�
CeHrErt oF sifteei Q' REAR YARD 2 S R. SIDE �:,l�Pi.
SIDE YARD I LEF7 !'� I RIGHT (� � L. SIOE %Pl FT.
DESCRIPTION�OF WORK- � "�'�`
REAR FT.
NEW I X II ALTERATION I II AOOITION I �
REPAIR I " II MO\
BUILDING 1SOO S1
C17F
USE OF BUII�JT
J1
atl f
a
1 HEREBY ACKNO
ANO 9TATE THAT
PLY WITH ALL
BIIILDING CO TI
SIGNATURE
PERMITTEE
AUTHORIZED AG
I ROOF wooa �naxe s
Cp COVERING
ORK TO BE PERFORMED
- amil.y Aesidence
iE THAT I HAVE READ THIS APPLICATION
ABOVE IS CORFECT ANO RGREE TO COM�
IDINpNCEAANO STAT[ LqWS REGULATING
IICII
TNE AMOUNT SHOWN UNDER VALUATION I6 FOR THE
PURPOSE OF ESTPBlISNING A PERMIT FEE ONLY.
VALUATION ' pERMIT FEE $ �J�/
g`� y✓L7 / PLAN CHECK $ �/ �
� TOTAL FEE 5 � J�
, a '� 20363
COSTA MESA BUILDINGSAFEfY DEPARTMENT
�� P.O. BOX 81y COBTA M68A� CALIFORNIA '
For Applicant fo Fill In Completely
7YPE OR PRINT
BUILDIN6
AODRESS
COSTq MESA, Cq FORNIA _
STATE
LIC. N
SIZE
� BETBACK LING
FEE RECEIVED
�EI & e 1363i
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CI�����1��i5�o�y
118C61�T NO. � ' P81
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DESCRIPTION OF WORK
BUILDING '
SIZE
EXTERIOR WALL
'1 HEREBY ACKI�OWLEqpg'�HA'r �
ANO BTNTE THAT TX6 ABOVH I8
PLY WITH A CL� ITY OROINANCBB
BOILDINO CONSTitlQON.
� AUTHORIZED
YARDSAPPROVED
MAIN BUILDINO
VAR. iS
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SHALL BH LESS THAN
<U.B.C.REQUIREMENT]
YARDBAPPROVfiD'
ACCESSORY BUIL�IN6
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BET. MAIN Q
ACCE55. BLDOS.
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$Q. �. �
TXe AMOUNT BXOWN UNOER VALUATION IB FOR THE �
PURPOSE OP H6iABLISHINO A PEqMIT FEE ONLY. �
VALUATION � �J m
�PERMITFEE $ �v �
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$�.S�O�j � E _ /� � ° .
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