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Home My WebLink About2662 CLUB MESA PL - Building Permits. PHOJECT RUOflESS; � 6 6 2 CLUH M ESA DR OWNEN'S NAME: FARRELL PAUL A _aooaess: 208 FOR�ST LN BERKELEY �' CA 94708 • (915)528-5151 AflCHIENGINEEN: F�ONE55: xec.xo.: UNIT: UNIT: PEHMITTEE: PAUL FARFtEI. ( 415 ) 528-5151 aooeess: 208 FOREST LN BERKEI.EY CA 94708 LICENSEO GONTNPCTOP OECIAPAT10N: 1 hereGy aliirm �hat I am I¢en5e0 un0er provisions ol Chapter 9 �commencing wilh Sedion 7000� o� Orvision 3 oi ��e Business and Pmtessions CoCe. anG rtty license is in fulllorce an0 ellec�. CITY LIL.: STqTE UC.: ClASS: Date: Signature: WOflKFPS' COMPENSPTION OECLAPATION: I hereby aflirm ihat I have a certiiicate of tonsent to sell�insure ar a cehificate of workers' Compensaiion Insurance. or a ceriilied copY �hereol (Sec�ion 38IX1, Lab. C). POLICY NO.: E%P. ORTE: 'OMPANY: � Certi�ietl copy is hereby Wmished. ❑ Cetlified coOY is filed with �he [i�y Building Divisioa Oate: Applicanl: E%EMPTIONiBOMWOFNEflS'LOMPENSATIONOECIAMTION: (T�i55eclionneeOiqlbecom0le�eUi�AepermitisloronehunAreU�5100�or1e55). I ceNty Ihat in �he pedormance o� t�e work �or wAich th¢ Oermit is issuetl. 1 shall not employ any Derson in any manner so as �o become su�lecl lo I�e Workers' Campensalian Laws al Cali�ornia. Oale' SignaWre: NOTICE: II, a��er making Ihis declaralion. yau s�oula become subjec� to t�e WorkErs' Compensation Omvisions of the Labor Code. you musl forl�w�ih comp�y vni� sut0 provisions or ��is permit shall be aeemetl revnked. CONSTBOCTION LENDMG AGENCY: I hereby attirm Ihat Ihere is a con5lmciion lentling agency Por �he pedormance of Ihe work �or wnich I�is permi� is issued (Sec�ion 3097. Civ. C�. lENOEfl: ADUflESS: OWNEB BUILOEfl OECLAHATION: I herehy allirm t�at I am exempt Iwm Ihe Coniractors' S�a�e License Law lor I�e bllawing reason (Seclion 7031.5 8usiness antl Pralessional Coae: Any cily of caunty wnich r¢puires a permit to conslmcl, alter, impmve, Oemolish, or repair any simclure. pnor to its issuance. also repuires t�e appliwnt lor suc� permil to lile a siqneC stalement ihat he/she is licensetl pursuant lo Ihe provisions al Ihe Comracmrs' Slate License Law �C�apier 9 �commencing wi1� Seclion 7000) oi Oivision 3 0l t�e BuSiness antl Pmfe55i0n5 Cotle) Or I�al he/She i5 eMempi t�er¢imm and Ihe basis �or ��e all¢geG eeempiion. Any viOWlian 01 SeCliOn 7p3t5 by any a001icani for a permit sublecls ihe applicanl IO a cihl penat�y ol not more ihan Irve hunOreO dollaro (5500�. I, as owner ol the pmDeny or my employees w�th wages as iheir Sale campensatian, will Uo Ihe work, antl the ❑ stmmure is noi imenEetl or otfereU lor sale (Secbon 700a. Business anU Pmfessional Coae: T�e Comractors' S�ate License Law Eoes nm apD�Y ta an owner ol a O�oDeny wtq Ouiltls or impmves ��ereon. an0 who Ooes suM work himseli/hersell or thmuAh nis or ner own emoloyees, pmvitlea Inat such imo�ovemenis ate nol intentleA or ollered lor sate. V, however ihe 6uiltling or � impmvemeni is sold vnl�in one year oi cam0lelian, Ihe owner will hav2 th¢ hu�den af DmNng �e/she tlia not builE Or impmve lor tne purpose ai salel. I. as owner ol ine Dwoerty, am e�clusively contraciing wiih licensetl conlraciors to constmct ihe D�olect (Seclion 7044, Business � ane Pm�essions CoOe: T�e Camranors' State License Law dces rrot apON �o an owner oi pmperry who DuilAs or im0�oves tAereon and who coniratl5 �or Sut� pmlec�s wii� a conlraCloqS�iiCenSe Our5uanl to the Conlraciors' Slai¢ License Law�.l am aware inat pmol ol Iheir Worker'S Compensation insurance 5hould �e Omvitle0 �o me. � I am eKempl un0er Section: B. 8 P. C. for t�is rea5on: \ n � oate: _�.� � � Owner'�] �"'� M � � I tlo hereby ceNty ��at I am aware ol an0 underslantl ihe reduirements oI Cali�omia Nea 1 an 5 25505, 25533, and 25534 antl Ihal I or any IUWre builEing occupant vntUvnll not (Grtle one) nee0 to compty with uid state wd¢s anE t�e repuiremenis lor a permil im consimclion or motlihcation Irom 1he Pir Oualily Management Disiricl. ResiAential Wnslmtlion applicalions are exempi Irom IheS¢ provi5ion5. Da�e: ApPlieanl: I hereby cerlity �hai I have read Ihis applica�mn antl stale I�aI ihe a�ove in�ormaiion is correci. I agr¢e io comply with all ciry and counry ordinances and siale laws reialing Io �uildinq consimtlion anG �ere�y authorrze repreunlaiives ol this dry ro en�er upon the above�menlionea propetly loi inspection purpases. �� Dale' t% Signature: Driver's �icense or So<ial Security =: � _ t6An46 Whne-9uiltlinq; Green—Code Enlorcemenl Canary—Appl¢anC Pink—Revenue; Goltlenrod—Assessar CITY OF COSTA MESA — BUILDTNG PERMIT j—P�FtF , PERMIT NO: G 049858 PLAN CHECK NO: 06651-90 S �D'G�I; tTSIIFlT'�' CONSTRIJCTION TYPE: 5—N PERMIT TYPE: ELE MEC PLU STR PURPOSE: ALT JOH DESCRIPTION ; MINOR KITCHEN ALTERATIONS SQ FT: 2,000 CLAIM VALUE: 2,000,00 CALC—VALUE: 2,000,00 GROUP OCC: R-3 /M-1 COMMEN'f5: NO INCREASE IN SQ�UARE FOOTAGE x�**�r�x+r�x��r�r�r�c+�**x*��r*x*�r�e �r�r*��*�****�r*x�a�+r***��r�r*�*�e��r***+�+c�***+�+�x***��*�� Z O N I N GS ERTEBQAUCIxRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUTLDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEF'P: F'T IN RGHT: FT IN I�F.FT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 43921338 ZNE: REF NO; PLANNING NU'CES> i *�r*arxu�*�**+r�r�*� �r�t*�r***+r*�r�r�r*+t�t*�t�t+tx�t*�r*�t****��**��r***�r�r��*****�t-�r�*****xx��*+t*�t�r 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 HY ' DATE; BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY• _ DATE: i� �fi, *�r�c•�r**��r*�t�r**�*�*x�**+t�r *�rx�t�rxx�r*��'�F��i��i�** if�kifiFiFifitiEiflk%iEM�ifiEfElEikK��lflfiflEiEiEif�EifMlEififlflfiFiEiE iE� iF �f1E�EiEifiE�f�fifiElflbifiEiFlfiFdFiE�1E1E1FiFi(�i�iF iPiFaElfik�IfkiFif LEGALI2ATION:N F E E S U M A R Y STRUCTURAL'SEGMENT:Y BLDG PMT PLUMBING ELF.CTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 45.00 4�0= 1550Y 9'15Y SMIP/NON—RES ISSUE FEE 2y�25 3.00 15.00 ,15.00 .50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 'POTAiS----> 69.75 33.00 29,25 132.00 132.00 ,00 REVENUE DIVISION TOTALS--> COLLECTEll: 132:00 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE S'MIP/TOT GRADING PLAN—CHECK Q5,00 7.00 30.75 19,50 ,SU 29,25 iE iE if M� 1f �E it if If iF iE iE �F iE if 1F �lP iF ik �f iF if� �lE if %�E iE k if iE af af iE If if if if iF lE iF if if �lf �If if iE k# k 1f iF iF k af k ik 7F Ik iF if if 1F af iE if dE iE If IE 1F iF aF iP iF 1F �f 1F �f �E I N D I V I D U A L F E E B R E A K D O W N TYPE SFC EI� E ELE �LE PLU PLU QTY 200Z 4 3 2 1 1 1 1 D E S C R Z P T T O N ' ., ALTER BY VALUE COMMERCIAL NOZONE FIXTURES LIGHTING 1 ST 20 EA. RECEPT/O�TLET 1 ST 20 , EA. RECEPT/SWITCH 1 ST 20 EA, RES APPLIANCE NOT OVER 1',0 HP MOTORJPOWR APPARATUS 0,0 — 1'.0 HP VEN'tILATION FAN CONN TO SINGLE DUCT DISHWASHER . SINK, KITCHEN � END OF FEES UNIT COST ' 1.�5 .75 3,00 3.00 4.50 1..00 2,�� TOTAL COST 2,000,00 1.50 3.00 2,25 6,00 3.00 9,50 ?,00 �'. '�L�..;.'_l�Dl>: ' - _ . �i. _-Z.T;�i --�iac�i �l �.�'c� ,. .. ♦ 'Y.\ CONSTRUCTION AND PLANNING PG y SPA APPRO,VALS Permit # Date Inspector pppROVALS 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._Etectrical Conduit-Undrgrnd. 55. Electrical Bonding �5;,5{2�1 Reinforcerrieni_ 56. Rough Plumbing & Pressure Test • � 6:-Electrical UFEA�Grnd. 57. APPROVAL TO COVER�GUNITE 7�., Footings ' 58. Electrical Conduit�Undrgrnd. • ��8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test ' 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 � 14. Rough Plumbiny 65. Electrical-Final 15. Rough Electriral-Conduit 66. Solar System-Final , 76. Rough Electric Wiring 1� �1� 7: Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOF PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOLJSPASYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' - - - - - .r � . .. . -- 20. Rough Factory Freplace , ' - _ - • �APPROVALS _ Permit # ''' - .l .'�.7, - :•a - i� 21:I'Ducts, in Stnucture, i� i� � - -•. _70. Underground Hydro - 22. Ducts, Ventilating - ! _ - .71. Product Piping O�Gas ❑Oil 23.; Gas Pip�=Rough & Test ' � „ `- ' ; � 7z, Underground FlusFi . - 24. Roof Framing _ ' : • G ; � + • �73: Undergrnd.Storage �ank OGas OOiF • � ' 25. Roof Sheathing = ' �� " � ' � �7q,, pverhead'Hydro �� 26. T�Bar Ceiling (Structural) &.Monocoat �• i:� � i 75. Dry Chemical � �• � � �_ ' - ' � ' r.� " 27: Frame and Flashing ,,., . 76. D'ry Standpipe - . � , � .28.- Lathing,& Siding . • � . ! ' � . 77. FIXED SY�STEM�FINAL• ' •�- " ..' .�, :: � 29. Insulation ` - : - ' ' ., ' � � �i �'�� ; 78, FIRE PREV. FINAL � ;; �f, ' � � - ' e. � 30. Drywall Nailing �-.�• i j�� ', i�� •:HEALTHDEPT,. R�EOUIR-EMENT _ .' . :31. Plaster Brown Caat` . . ,� '; I : �� 79'. FINAL' INSP�ECTION, ' - `' ,r' � ' . � 32. Electrical Power Meter�Final � • � �� 50., FOOD CERTIFICAi'E ISSUED , 33:' Final Electric � � . � I Notes; .--l��_�,-. - v _� � ,•34:-.Firial Heating & Air Conditioriing; - I (,�. ' - �i�� i . 1 ! T 35..�Final Gas Pipe-Test ` - � �i ; f' _ ' � ' 5;�� ` � �� - � 36. Hood oF'CanoPY ' ' - , � � f. , � - • _ I i. ,/ . - 37:-Final Factory Fireplacej -- - ' �' �i ��' 4 � • - � /��/� w ' 38.,Final Plumbing . " . . -' �I�IY�v Y"-�" - - �' L . - ', 39:-Water Service-Fina1- � ( � .� � �" -� �� . ` �� - _� - 40.i Gas Service-Final , : , � � - - � 41�r Solar pomesticFinal� • - � � �• _ -� 42.�-Backflow Preventer '- � I f " • ' ' : � - - 43. Backflow Ir�(gation - ;�� ' ' - ' � ,. ^ . ,44. Landscape Irripation System� ' - - . - , _. � - ' _ , . ,- � _ 45.:Sound Attenuation -• T • ' . i��• ' ' -• • - . ��46. Handica,p Regulation: - - ' �� ' ; , , . ' � . � 47:•.FIIJAL STRUCTURE & BUILDING � Z� � . �_ 48. FINAL PLANNING „ I ' ,- ' • 49. Electric Release to Edison (' , ' . 50. Gas.Release tp Southem California Gas Co ' � ' �' � ' � " `_ 51. CF�iiT1FICATE OF, OCCUPANCY � � � ; � , �r,-. , , � , „ •!�n ,-�• . No Dace r � � --sl PflOJECTq00NESS: ZEEZ CLUB MESA DR OWNEfl'SNpME: KALISCH GERHARD K TR aooeess: 4530 ROkBURY CURONA DEL MAR,CA 92625 631-2010 AflCNIENGINEEfl: HEG.N�: AOOPESS: uxiT: UNIT: PEFMITTEE: CRANK BRQS ROOFING CO ( 714 ) 548-5569 aooxess: 126 COMMERCIAL WAY COSTA MESA CA 92627 LICENSEU CONTflACTON UECIAFATION: I here�y a�firm ihat I am licensed waer pmvisions ol ChaD�e� 9 �commencing with $ection 7000) ol �iv�sion 3 0l Ihe Business and Pmlessions Code, and my license is in full torce antl eifect. ciTruc.:005993ey sTareuc.:'108677 /C�/yQ� Daie'_IZ�7' / � Signa�ure: ✓� WONREBS' COMPENSATION DECLl�BATION: hI ¢�ere�y affirm Ihai I have a cehihcate o� consenl �o selbinsure or a cer�ilica�e af WOBers' Compensation In�su�ca ja o� ajcUlV 1 1p� �L Y�(Section 3800. Lab. C1.1 / U 1/ 9 4 POLICY NO.: E%P. OATE: U comraNv: STATE FUND � Cetlitietl copy is hereby fumishe0. Q Certified copy is liled wi�� Ihe city Building Division. oaie: ! L - % " `% 3 nPnr�a�c ��G�'t/ E%EMPTION FNOM WORNEPS' COMPENSATION OECLAHBTION: (This sec�ion neetl not be complete0 i� IAe permii is �or one huntlre0 (81W) or less). I cetlity Ihat In �he pedormance a� �he work br which this permit is Issuetl, I shall nat amploy any person in any manner 6o as to become subiecl to the Workers' ComDensation Laws ol Califomia. Da�e: Signalure: NOTILE: 1�. atter making �his Declara�ion. you shoultl become 5u01eci ro Ihe Workers' Compensation pmvision5 0� the Labo� Cotle, you mu5i fori�with comply wit� such pwvisions or �his permii shall De OeemeU revokeE. CONSTHUCTION LENOING FGENCY: I hereby a��irm �hat there is a cons�mc�ion lending agency 1or Ihe perlormance o� the work for whlc� Ihls perm7l Is Issuetl (Seciion 30W. Civ. CJ. LENOEN: aooeess: OWNEN BUILOEB OECLAHRTIDN: 1 here�y aflirm �ha� I am exempi Imm ��e Contraciors' S�a�e License law �or lhe lollowing reason (Seclion 7031.5 Busine55 an0 Professional Cotle: Any city oi couniy which requires a permii Io construc�, al�er, impwve, demolish, or repair any SVucture. prior Ia its issuance, also requires Ne applicanl for such permi� �o lile a signetl statement �hai he/she is licensetl pursuant �o Ihe pmvisions of ihe Contracrors' Stale License Law (Chapter 9(commencing wi�h Section 7000) o� Oivision 3 oi �he Business ana Pmfessions Catle) or Ihal helshe is exemp� �here�mm antl Ihe basis br Ihe allegea e�emp�iaa Any viala�ion of Section 7031.5 by any applican� �or a permi� sublecls �he applican� to a civil penalry ol not more �han five hundred Oollars (5500). I. as owner ol �he Ompetly or my employees with wages as iheir sole compensation, will tlo Ihe work, and �he ❑ SVuc�Ure is noi inlentle0 or o��ered Ior Sal¢ ($¢ction 704C. Bo5ine55 and Protessional Code: The ConiraC�ors' S1ate License Law Ooes n0� ap01y �o an owner o� a pmperiy w�o builtl5 or impmve5 ihereon. and who tloes 5uch work him5ell/her5¢II Or t�mugh � his or her own employees, pmvided �hai such improvemen�s are noi in�en4e0 or ofiered for sale. I�, however �he builtling or impmvemen� is soltl wi�hin one year of completion. Ihe owner will have Ihe bur0en o� proving he/she tlid noi builtl or improve �or Ihe purpose ol sale�. I, as owner of Ihe pmperty, am exdusively conVacting with licensed conVac�ors to con5lmct �he pmlect �Sec�ion 7044, Business ❑ and Pmfessions Cotle'. The Contrac�ors' Sta�e License Law Uoes not apDly lo an owner of propehy who builds ar improves lhereon antl wno coniracls lor such pmlecls wii� a canVac�or(s)license Dursuan� �o I�e Coniraclors' S�ate License Law�. I am aware �hal pmoi of Neir Worker's Compen5aiion insurance shoNd be pmvi0ed [o me. � I am exempi un0er Seclion: B. 8 P. C. for �his reason: �aie'. Ownec I tlo hereby ceniry I�at I am aware ol an0 untlersland ihe requiremeNs o� Cali�omia Heal�h and Safery Cotle Semions 25505, 25533, an0 2553d antl t�at I or any fuiure �uildmg occupani will/will not (circle one� neetl lo comply with said s�ale coDes anA Ihe requiremen[s �or a pe�mit lor con5imclion or mo�tlicatmn Imm ine Air Ouabry Managemeni �i5lrici. ResiOenlial cons�mction apDlicaiions are exemp� from ihese pmvisions. �ale. ApplicanC I �ereby cer�ify �hai I have ioad Ihis appllca�ion and 5�aie �ha� �he above information is correcL I agree to comply wi�h all el�y and eounry or�lnances antl sialo laws relaling to buJding consimc�ion antl �ereby authorize represen�aiivos ol Ihis ci�y to en�er upon Ihe abave�mentionetl PlOPCfIY �Of If15(lECI100 pUfPO5E5. /� �N � � Z , ( � Date: �� Signamre: �--�� i �" Driver's License or Socia�5earity ,: am; Pink—Revanue: Goltlenrotl—Hssessor 0 CITY OF COSTA MESA —'BUILDING PERMIT PERM NO: B Ob5111 PERMIT NO; B 065210 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE: V—N FERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/OFF REROOF W/FIHERGLASS ON PITCHED SQ FT; 3,569 CLAIM VALUE; 3,569.00 CALC—VALUE: 3,569.00 GROUP OCC: R-3 / COMMENTS: REROOF W/BUILT—UP ON FLAT PORTION, SMOKE DETEC,T.{� C PFc�UIRED #**��,��*��,�*�*�,�#��,��,��,�**�,��***��#**#�,��*��,��,.�,��OK�}p C *p°°* Z O N I N G R E Q U I R E M E N T 5 �'�CCTOF� S E T B A C K S REQU��y.� -- --------- MAIN HUILDING ---------- --------- ACCESSORY BUILDtNG""'A ------ 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: 93921338 ZNE: REF NO: PLANNING NOTES> T ' �*****�**�##**#**#��*#�r*#*�r*#+�*u**#*�*��*+�+r�r*��*#***x�*#**+�****#***�*+��*�r*�##»*� D E V E,.L O F 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: BUILDING APPRO� ED BY :%� DATE: APPLICATION ISSUED BY; //i 1�X1_ DATE: � ZI �� iFiF3fiFifiFjfiFiFifiEifif3Eif�Ei�if-1EiF3Eif it`iF"'� �'fi'a''��"�R'�'�'x-�x�+c��c�c�* z"iF** iF iE if �f iE if if ie iF if iE iF �f �E i�� 1E if if iE if iE �lE 1E �li iE if if if iF dE iE if iF iM1 1f 9f iE if iF iE if iF iE �)f iF iF � if � iE iM1 iG if i4 if �E iF iE �3F if i4 lE �K � iG iE 94 i6 # iF if # 3E 1F 14 *)f iE �If LEGALIZATION;N F E E S U M M A R Y STRUCTURAI. SEGMENT:Y BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES� GRADING PERMIT 63.00 .S0 PLAN SMIP /NOI�P� RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ' DUE TOTALS----> 63,50 0.00 0.00 63.50 63.50 .00 REVENUE DIC'ISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: �� ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING 'PLAN—CHECK 63,00 .50 ii iE iE-lE jE i! if if iE iE iE jE dF IE �If !E �lE if jk iE �)E �le 9h iE jf if iE iE 3E iE IF if if 1E it iE iE iE if iE �E iE �f if iE �)E if if iE if iR if 94 3f iE jE iE iF iF iE if i: if 9c jE 1E iE if if 3t�-X� if 3E # iE 3f iF dE if 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 3569 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 - 3,569,00 END OF FEES i ui ooisis�z-oa:szes2 YC:3 G�.sn OATE: 12/�7/S3 iYfIE: OP..2b r � COif$� AIiC?lOf2 AZD PLAt11\�G � kP°ROVALS ?ermit;; � 1. Tempara�y Electncei S��r�cn or Poie 7.. So � P�p- Jnurg-rd-_- �--- - -- --- � 3. ,'_�ect��c:.� Cor^� • ',.t'�.ry�'Jndr�rna. ; <<. Glec[r�cal Condu.t�Und�grnd----- � 5. S�a'� R��r,forc-r*-e^t �_- ______ _ i � ��ectri.d. �` CFl G.rd. 7. Fooun�s 8. Four.Gptmn I_ I �'. ..3:Br P PB�Un;;'r,.Ctl. .0. $:ructu al Floc: $y5tem �-- -- - - ---- - 11 . P�ape�l•/ 5� :��r L��e & No.i�.0 Connechon .� C,:: ,.r CIP'-_ _ _ -_ � :. P��+ 7�., n;_- -_- � 1 ,. �to�,.ph P,u�rl�,n3 �___ '- - - -- - -- �---- ! _ Rc,:;r E':r!r r, �Con9u.t �. �a.��'� E'eCr c l.'ir^7 � '7 fiu,. . -�co 5'qn �. - �--- ---- _- T Bu Cr I��, 1�. Ro�,�hL''ee!nn! 9 � tS.�a ,; B: A" Cc:�.u.�.c� �� i 7^__ y _ J _`_-'-'-_ 21 � Ducts, In Structu�e 7.7_ D„cts.V^n!i�.;ting -�_ 23. Gzs Pi��.Rough 8: 7est 2n. Rcof �rami�,q-- ----- 25 Ftoof Jh�-a[h��nq � i_ _____-___'_-_._ _. __ � 2E T��rCc.:.r�i,.Si-uet��a�i E.1�o.oeoat r27. �r:.'�c aca i'.us�i�n, � 2fi. l.'ath-.r.p 2u S�di^g ! i.°.. ;�5�4z!.c^ � 3�. J'Yr.a.' �.: hro � __-_J- 31 . P�aster 6ro �+n Coat 3? E'ec:��ec'� F::,e• '.:ceer F�:,! ' 32. F•zi EI c.^ � 34. Final He�t�r _� & A��r Co^tl tio��ng 35. Firal Gas Pipe�Test 36. Hnati o� Canap�� 3i. F�i�ei F:ctcry Fvep�acc 38. Final Pl�mbing 3£. 1'�!c'er Scrvicc-Final �i0. Gas S:�r�cc F�nsi r41. So'a� Oume�.Uo-Finai � 42. Backfiov.� Prev�nter� 43 Ba-'<f'or-_,- �e+-Yi ' L-- t I 4'. Lnr.dSG,:Ge :c�q.'t� 5`istn:� �-� - 45. Sou�d Attenuati r '/_�d -Y�-" _ - 45. liandicap Rc�u�at�.�,� � 47. FIt�.AL5T,9UCT��:+'�f iILDItiG �$ FINALI�LAi\i- �If�� 42 Electnc Rel:am to �son 50 Gas Rele.:se to So��++n Calrfom�a Gas Co 51. CERTIf-ICATEOF�:.CUPANCY No. Date �. FG 15 SPA - - i ---,----- Date � laspector qp�ROVALS Permit �� Date Intpector � i I52. Poo! � Equ�pmznt Locat:un I 53. S^. c� Re �fo�n•m�nt . : 5n, ��,�;n�, 55. Eiectrical Bonding 56. Ra.:rih P�un.b ng I5 Pressure Taet 57. APPROVAL'0 COVER�GU�d�TE 58. Electncai Conduit�Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test i -r-- G'Gl tiJ. 8�c!:cash V n�s, F'� I rap, -_. Ur.u�c�rro i � __ _ _ .-_____ '- � 61. APPROVAL TO DECK _ � 62. Eackc:a;h 1§ Ret^ptor�Final --- --- --i "oS. '-!:atcr & l�enbFin;.l � E-i. P4imh- :� Sy;,•r.n F r�l i� ��. -- _'�- _-�-_ 0"5. _:i:ctric0l•Final ------�-� J 66. Sv4,r S;'stcn�F nr�' � ! � 67. � :rc ��g & Acc_.• Anc�o�.al -- --i ----�---. 68. APPROVED FOH PLASTERI�.VG , 69. POOUSPASYSTE_SFI�AL -� �� FIRE D'cPT. NtOUIHE.l%�EN 1' � -�- AFPROVii'_ � P::.n�.t ,r _ i 70. Underground Hydro 77. PrutluCt Pipmy �, Gas �� Oil � 72. Undergroui'd Flus� _----�- 73. Undergrnd. Storayu Tank Cl Gas '] Od _74. Overhead Hydro _ 75. Dry Ch�mica' - ---- ---_J --- 76. Uiy Sta^dpipe 77. FIXED SYSTEA° 4'I�'AL � 1 - -� 78. FIRE PREV. FI�A� ' i-IEALTI-I DEPT. REQUIR[;.:E'JT � 73. FINALIR�SFECTIQ^; --��- _ �-j --�- ---'�- - -+ 80 FOOD CERTIGiCATE iSSUEU � --- --------- --- --1-- -- i� 4 ici: 6 wl PFOJECTAOUPESS: Z662 CLUB MESA DR OWNEF'SNAME: KALISCH, GERHARD K TR nooaess: q530 ROXBURY . CORONA DEL MAR,CA 92625 AflCH1ENGINEEfl: 714 � 631-2010 aoosess: NEG.NO.: uxir: uxir: PEAMiTTEE: SKYLIGHT SPECIALTIES ( 719 ) 645-8645 nooAess: 316 0 I NC L I NAD O SAN CLEMENTE CA 92673 LICENSEO CONTPACTOB OECIABRTION: I hereby allrtm tha� I am licensea under pmvisions oi Chapier 9(cammencing wii� Seqion 7000� of Divisan 3 oi Ihe Business ana Pmfessions Code. a y lic se is in tull force and eitect. CITY LI/C.: Q 2) 7 5 �(� sraTe uc.: 3 9 � 5 r CLASS: y Da�e: S—��I a�� Sgna�ur , WONREflS' COMPENSATION OECIANpTION: I here� ifirm Iha� I �ave a certi�icaie o� consent to sell�insure or a cetli�icate o� Warkers' Compensation Insurance. ar a certilie0 copy thereol (Seclion 3800. La�. C�. PoucrNo.: 0638915-93 ExP.o 09/01/94 comrar+v: STATE FUND ❑ Cetlifietl coOY is here�y Wmishetl. 4: Ceni�ied co is li with �he 'ly Builtling Division. ^oa�a�//G-'S� nvPu�a : E%EMPTION FPUM WOflNEPS' CUMPENSPTIDN UECIAP N: Qhis seciion eea not be comple�etl ilihe permil is �or one huntlretl (5100) or less�. I ceriify ihat in I�e pedormance ol ihe work for which Ihis permil is is q I s�all no� employ any person in any manner so as lo become sub�ectla Ihe Workers' Compensation Laws oi Calibmia. - Date: SgnaNre'. � NOTICE: If. alter making �his Declaration, you shoultl �ecome sublect �o Ihe Workers Compensa�ion pmvisions of �he Labo� Cotle. you musl farlhwiih compty wiih suc� pmvisions or �his Dermi� shall �e deeme0 revokeA. CONSTPUCTION LEN�ING AGENCY: I heBby aHirm Ihat I�ere is a consimc�ion lentling agency lor IAe pedormance ot t�¢ work �or whic� Ihis permit is issued (Section 3097, Civ. C�. LENOEfl: I FDONESS: OWNEB BUILOEP OECLAflPTION: I hereby a��irm �hat I am exemp� imm �he ConUac�ors' State License Law for �he following reason (Seclion 7031.5 Business an0 Professional Code: Any ci�y oi counry which repwBs a permi� �o conslmc�, alter, impmve. Oemolish, or repair any s�mcWre. prior lo i1s issuance. also requires the applicant �ar such permit �o lile a signe0 statement t�ai he/she is IicenseJ pursuam m the provisions o� ��e Coniraclors' State License Law (ChaD�er 9(commencing wiih Section 7000) of Oivision 3 ol Ihe Business antl Pmiessions Code) or Iha� helshe is exemp� �heretrom and ihe �asis for Ihe allegetl exemption. Any violalion of Section 7031.5 6y any applicant �or a permil 5u0jeci5 �he applicani to a civil penalry ot no� more �han five hundreA dollars (5500). I, as owner ol Ine pmpeny or my employees witn wages as tneir sole compensation. wiil tlo the work, and ihe ❑ stmc�ure is not intenUed or o�feretl �or sale ($eclion 7044, Business an0 Pmfessianal Code: T�e ConVac�ors' S�ate License Law tlaes nol apply �o an owner of a pmperly wha �uiltls or impwves Ihereon, an0 who tloes such work himselflherselt or �hmugh his or her own employees. pmvi0etl lha� such impmvemen�5 are noi inten�e0 af o�feretl �or 5ale. If, however �he OuilOing or impmvemeni is soltl wiNin ane year ol complelion. the owner will have the 6urden of pwving he/she tlid no� build o� imD�ove lor �he purpose o� sal¢). I, as owner of �he pmp¢tlR am exclusively conVading wi�h 6censed can�ractors lo wns�mc� Ihe pmled (Sec�ion 7044, Business ❑ and Professions Cotle: The Coniractors' Staie License Law does no� apPly ro an owner o� pmperty who huilAs or impwves �hereon antl who coniracis lor such Drolec�s with a coniractoqs�license pursuant�o Ihe Conlraclors' State License Law�.l am aware thai prool ol Iheir Worker's Compensation insurance s�oultl be pmvitletl �a me. i� I am exempt untler Seclion�. B. & P. C. lor Ihis reason: �ate: Owner. I tlo hereby cerlily �ha� I am aware a� and undersland Ihe reQuiremen�s at Cali�amia Heallh and Sa�ety Code Seciions 25505. 25533, and 255JC antl Na� I ar any Wlure building occupant will/will no� (circle one) need Io compty wilh said sla�e co0e5 antl �he repuiremenis (or a permi� �ar consimction or motlilicaiion Imm t�e Air Oualily Managemeni Oi5lrici. Residen�ial consimclion applications are e�empt �mm Ihese pmvisions. �a�e: ApPlicani: — I h¢�epy cetlilyihdl I hav¢ r¢dtl Ihis appliLdliOn and SIa12��dt or�mantes antl sialo laws relaiing Io butlding conslmction and 1 praperi1y af inSpeCiian puf OSCS. / � �O� / �1ate: SignaWre: // i �nvefs Gcense or Social Securiiy is carrecL Iagree lo comply wiih all ci�y antl counry nia�ives ol �his ciry to enter upon the above�men�ionea Pink—Revenue; GOltlenrOtl—ASSessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06528� PERMIT NO: B 065289 PLAN CHECK NO: 09868-93 5 GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: CON J08 DESCRIPTION : INSTALL "4" SKYLIGHTS, I.C.BO.N 2469 SQ FT: 1,475 CLAIM VALUE: 1,475.00 CALC—VALUE: 1,975.00 GROUP OCC: R-3 / COMMENTS: INSTALL "4" SXYLIGHTS, "2" ARE 22"X37","1" 22"X22", G"1" 22"X46 **+��r*#�ri�i�*+��rx�*�t+t�t**�*�r**�r***i�i�*#�*�r*�r#x�***+�*+t***+r�r*�t**�*�r*u+r*-�***#*********#*-�c�# 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 BUZLDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGAT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93921338 ZNE: R1 REF NO: PLANNING NOTES> INSSALLATION OF 4 SKYLZGHTS. - > it*at***at*at*#**+t�iter*#..ir3t�t�tit***#irx�*��#*ar9r�-*itit##at-********�t�it�*�**�-x�***ac#u�*�u**##+�**� D E V E L O`I� 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: _�Z �O f BUILDING APPROVED BY : �--� _�� DATE: I� /�% J APPLICATION ISSUED HY; ' �'__,�O DATE: �� ' � iE*�fif��EiEiEic�kititiF3tiFitiE�Ei:iE3f**��F�riF3F�iF�iFiFiF �-i, x�FiFiF7FiF;F'iFTFiF;F'3fiF'if�Fi�F'3F�F*iF1clEifit�iriEic*�ivir�7iF-i.3f�?'iF'��f 9f7fiEiF3E9E9FiFjE9f9tifiE9E3Ei(�iEjEi�ififiEitlfjF#'iEiEltiEiFiflEi4ifitiE3EiEiEiE9EiFiFiEiFiF#fitifiE3fiEiE�fiEiFiFiFifiFiFaflF9FiE�FiEiciEi 9fifiFiF :�FiEif LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLOMHING ELECTRIC MECHANIC FIRE SMIP/RES, GRADING PERMIT 35.00 .50. SMIP/NON,�RES PLAN 22.75 ISSUE FEE ,j BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 35.50 0.00 22.75 58.25 58.25 ,00 REVENUE DIVZSION TOTALS--> COLLECTED: 58.25 OVER/SHDRT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING<�LAN—CHECK 35.00 .50 22.75 l iE # iF iF 1E iE 1E i4 iE iE If fE i! iE �1E !E iE iF 9E ff 1E it it iF �It iE iE iE iE iF iE iE �F iF 9E-k �)f iE iE iE �1(-if if iF if iF iF 3f jE 3E if 1E iF if i(� �1F ic iF �k ih iF iE iF if 1E �% if aE iE iE 3f !E if iF if fE IE 3E M� I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O N ONIT COST �TOTAL COST SFR 1475 ALTER BY C�ALOE RESIDENTIAL NOZONE 1.00 � 1,475.00 END OF FEES � / 0100±52.s8—n0i523S0 TiaT SE.?5 GATE: 12/10;93 TII7E: 14:°�8 . ,' i--, � CONSTRUCTION AND PLAiVRWG APPROVALS Permit � � 1_. TemDorary Eleancal Service or Pole I2. Sod Pipe�Undrgr�d. r-- �. =l�;tsiryl CorduiT li!�ti!y�Undtgtntl. 4. El�zctrical Conduit�Undrgrnd. a. S;r^� R�:,nfo�ceme�i G. F��etr.ea'. UFER Gred. � 7. Footinas rB. Foucdabon .' 9. �Se!er Rpc�Undrqmd. ��, 1C, 5,��.ct�,al Ffoor SyStem , , 11. Property Sev�er L.ine & Ho�se Connection 12. Se..,er CaP 13. Roo' D�a�ns 14, Rovgh� :'.uml�inq 15 �'::ug�• Clectr�ca!�Contlurt 16. Rough Electric bV�ring 17. Fough'.'l�.r�r.g $ign 18. Rough ElcctricarT Bar Ce�hng 19. Rouyh Heaunc� R: Air Cundition�ng 20. '?o�s�� Fuc:or� F'veulacc 21 Ouct;, ic Struct�re 22 C,.Rs, l�en[ilahng 23. Gas P�pe�Rou9h t� Test 2r. floo! F.aming 25. Roof Sh:athing 26. �-Ba' Ce.l�ng ISIl�eturall & i�.bcocoat 27. I�-2me ard Flashirg /'� 4 28. L2thi�� & Siding 29. Insul&t,o� 30, Dry�vall Nailing 31. Pias2er Brown Coat 32 clectnal Potve� M14eterFinai 33. Pinal Electric 34. Final Heat�ng � Air Contli:ion nz 35. i=inal Gas Pipe�Test 36. Hoctl or Canopy 3Z Fina� Faetory Fi�eP�ace 38. Fina� Plumbing 39. 1':ater Serv�ce�Finai 40. Gas Serv�ce-Final 47. Salar pomestic�Final G2. Oackfiow Preventer 43. Backflov: irngation 4A. Landscape Irrigation System A5. Sound Attenuation 46. Handicap Regulatlons 47. FIN,�L STRUCTURE & BUILDING 1 L 48. FINAL PLANNING A9. Electric Release to Edison 50. Gas Release to Southem Caiifornia Gas Ca 51. CERTIFICATE OF OCCUPANCY No. __- ___..__ - Date Pt,..� & SPA �----`. Date Inspector qppROVALS Permit � 52. Pool & Equ�pment Locat:on 53. Sieel Reinforeement _ 5A. Farms � 55. ElecVical Bond�ng `+ 5G. Rouyh Plumbine� & Pressure Test 57. APPROVAI. TO COVER�GUNITE 58. Electrical Cond�It�Untlrgrntl. 59. Gas Rpe, CI Undrgrnu., Test I �� 60. Backwash Lines, P�Trap, C Undigmd. � 61. APPRO`lAL Tp pECK 62. Backwash B� Recep!or�F�na1 63. Heatcr & Vent�P.ns� � I 64. Piumb�ng System Fmal � 65. Electrical-Final � 6G. Sviar System�l-�n;,�. � 67. Fencine� & Access Anprova� 68. APP!�OVED FOR PLASTERI�'vG G9. POOUSPASYSTEP.1SFIhAL FIFE DEPT, REUUIREMENT APPROVALS Pem-.rt ;: - � 70. Underground NVdro -- � 71. Product P�p�ry C G.�s �:0�1 72. Underc�round Flush - -- i ' 73. Undergred. Storaoc �i ank C Gas � 0; I 74. Overhead Hyaro 75. Dry Cner�iral r3_.� �(�y� 76. Cry Star.d.^.ine_ ____ 77. FIXED SYSTEIIA FINA� _ 78. FIRE PREV. FINAL .�_ H� ALTH DEPT. REQUIREtv�ENT - ' 79. FINAL INSPCCTIO� --- - -� 8Q FOOD CENTIF�CAI E ISSUED Notes: '`� Date �Inspector CG�t�s�" � i � S P E C I A � I E S � -• �.. A DITIO S, DE Y . � APP OVED � � , i . , /'� NC �ri � A-� I -Skl^'� �„z5 � D£N ZC�Z �(ua �t�sp � I�L Cdst�-�.s� C{A- �1��3!-�ro OR CORREqTIONS yZ. � 5/ _ �-��-� �. R� � r. � e� ia P,Aesa �': �'��n�i p : � � _`', ::,� '•.i n�� ,,.,_- DEPT. ;:' '• -, � =i ROV L C` � �� VJ'Il;�ii�-'i .., yAL� f ., !i'.'.:i O APPR A w„ , ." : � . � ,� ..-�! ,; � pF ANY dFIGA�'�%;:;�`•`�� _ ::. `110LA ION OGIVE l AN N'JR,•.". .'.��:` Ani�f PR � � THIS �TF�IS CU'.'�� E PPO ISIONS OR �E �iEGn� �:5� r oAST EWOR VAL14�XGEF IN _� � JRIZF� {SL1�:;;� ;L. - NS ANI ASED U ON..P s... = ?rv1lT . F ifLC OFFICIP 1NCE Y-'r �� <�.L• TNi:. RROPS� lSSHALL ��_��F •�RRECTONOF VEIRIn FHCOUi'S'�' : c OA F OM � I FTER � VM p�SPEClp� Q:GN.. pNT EREU ER AN r,.aRR� :D p ON NANCE � :{ZpTIdNS 6Eri� , NY OT4 OF T1�.IS GGDr OR GF p COSTA -MFS/� ING DEPi• " �. gpp. DEvt. �[G• i f /C pATE�1/ . 3. D Ol Or NINO . - c��/Qz 1 � '- ; a�r � 4�4�� i�e=� . ; J' r � F,, Si�3rr �/t�LtJ � -�J�-�? �', _�r ��- b ; • �;¢��fi �'( l. - � � � l �j� ♦ . !�� . � � t � 1 " ' " � i i 'f p-±-- r�� °'�. 0;'��0�. � � J'" _—r . _ :---- _ ._ '_. = _= W( F t ��.r . s � I T I �� f� s�� ?�`�� r� f� � � . � � ��`' . �- � ��Z%STd �rf� J�v �� i1, - - � __ _.-- ��.—'. P. t Permit �t S 2 8�� lJ'�'� ��"6 � _ „ THIS NUMBER MUST. ACCOMPANY ALLINSPECTION REQUESTS � 3160 Inclinado • San Clemente • CA 92673 •(714) 361-9233 •(714) 645-8645 • Lic.# B395551 COUN'I'Y OF ORANGE BUILDING DEPT. . 636 No. Broadway Santa Ma, Cafifomia P6one: KI 2-6211 Application for Building Permit AND FOR A Certificate of Use and Occupancy t. OWNER'S NAME...........------flinPs-&-Fn.�i,EC�FiCl1lE ..................... Fermi[ I�'o �� p.�----- vacc DECE�T�.E�i...1Q+...Z4.`.i� � ............ � - ... PHON��d..._72.25..... ---.... MAILING ADDRESS ..................._}5th: &. �`JI�AG��STS....................._.----------........... CITY.Nh"�dkQ}IT..i?r.d.Cki,...CA.LI.F....... Name ...ii'I'ix'3E� i;r i��i''3"�."Y -�-OF . GO:.. i312AF1'i{3G-.-..... �ttrch�tect or �Engineer) Addres= .$10 88t1St - Ii{•1F.� ..................................................... c��,. ..._td��ar�n��;:�et�;..ca�:�� ............................_..... s�,« Lic. No..... -........ - � ......... Phone.... -- ........................... Namc ....... UIKE...G;....4�kGGR�VE . ......................--............... --.. (Contractor) Address ....l�th.._&..�V�: _I's...STS.r .............-----....................... Cicy ......._.[qb;klL'LH.T..BCACH,..GAiSF ............................---..._... s«« Lic No.....125".i,02 - - - -' -' -.... Yhon�3EA....7225.... - ' -" YROPOSED USE:__..---�;:a3JGkiCPi��i.:ID-ATTA6t1£'1-Gl�iAGF.�------------�}---------..._..... ...._ .............................. ......................�-- -- ?. IOB LOCATION__..--. 2662 ..............._- - ........CbUll- :�;SA..P,L,�CF. �� .._..._..GQ5TA..i�SAf �AL�F....._...__... --- ---- -- (Hou<e Vo.) (Namc o( Svicet) (Town or School District) 3. LEGAL DESCRIPTIQN: Lot.--.%--------------_.----.............--------Block ._..__._....._--._.---------------.--. 7ract.1419.._...-------------------- (Metes and Boands Dcscripcion—Use reversc sidc of form) 4. CORNER LOT ( ) II�TERIOR LOT (% ) THROUGH LOT ( ) SLOPE OF LOT ( ) i. SIZE OF BLDG.:.�: $-42 -........AREA: .....1a�1- - �� .SIZE OF LOT: -bQ-X.12Q .............AREA:......7.2(l0. � -� - - G. HEIGHT OF BLDG------------------_.2.5.�................CEILING HEIGHT:._...._.gt.../,!!___.......NO. OF STORIES--._1--..---._.............. .7. NO. FAMILIES....._---��--.....__-..---.----Size of Smallest Bedroom:-------�,O.tb-"---.X--9�8."..... Size of Kitchen.....�,�.X._1Jr ............... F. EXTEIt10R WALL CONSTRUCTION:...�;ltt;w.-&.-.S^.'lIGCO.......II��TERIORWALLCOVERING.....�'�ST�t..... . (Frame, Smcm, Ete) (PlastervDrywall, Etc.) �>. SETBACKS: Fronc Yard From Cencer Line of Strcet ...............5(1!.................._........... . ............................................................... .. Nearest Side YarJ....--5.�-------------Rear Yard.....�Q.�........_...Disr.mcc in Feet Setween I31dgs. on Same Lot.....N9Ae............................. I0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AA�D USE OF EACH. ^. , n I l, For (a) Footing: Width...._..�$n...s!._`.�............Depth in Ground------14P .................Width of Wall.....6........................ Accessory , Bldgs. and b Si+e of Studs.-----.. S acin 9.-----.-- WOod...... Similar �� _ 2. g...(r....... p g.... ...1�i 'CC Material of Floor ......... ... ....................... Structures: (c) Size of Floor loists :............-2i-X--6....--------Spacing.-.------16P----..._...............:'CC �) ,�..g..(� ........... . .Spacing -....._.2Ji°. -- -�- --..:'CC d S;ze of Rafter=:__........ 1?. VALUATION OF PIZOPOSED WORR: Including all labor, plumbing, clecv;cal wiring, heating, fire sprinkler=_, painting and sewagc disposal 5....-&t7t34�00 ..... ... ........ .. 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATIOIQ ]IQ THIS APPLICATIOAT IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUI�'TY OF pRANGE AND THE STATE OF CALIFQRI�IA APRLIJ�,$LE THERETO. ' Signed:.......N...v.-`.._� i Plans Filed :.............._1.�r�� -f---� � __"""""""' ............. By:.."'__.._""__"_ FEES: Bldg. Permit - 5. Plan Check - S. Total - • • S. Receipt No. - . Paid to • - . 0 , m—e�si DEC 1 Z 19� DATE.......--....----- -- .............1......... (Owner) U(Authori^.ed Agen[) FOR DEPARTMENTAL USE ONLY GROUP.....� ..............� - TYPE......;�......... --�- ..... D]ST. � � MAP........�./ ............. �............. SHEET NO..._� .............. APPLICATION�'L�!. ZONING ................... �. PLANS AND SPEC'5 ................... �... CORRECTIONS V ERIFIED ........................ [�'�! � HEALTH ............................ FIRE MA RS HA L ......................... STATE .............. ENGINEER PERMITI Sp1E��YDON yUE COUNTY BUILD�NG � � �, � INSPECTOR ............................ . .... . .........c :: �.c. - �..i..� FANi ................ V� OWNER Far JOB ADDRESS �ete PROP. SWR. LINE IJ HOUSE CON. Lf SPRINKLING SYSTEM MISCEILANC0U5 ROUGH MEATING ANO RIR CONOITIONING ❑NOERGROUND � I POWER �(( �, ROUGH WIRING TRENCMES FORMS S�EEIf FLOOR SVSTEM P?6�`�� BONO BEAM r STEEL REINFORCE SHEATHING FRAME ANO FLASHING DATE 6-13-79 BUIIDING PERMIT N0. SUBCONTRACTOR r 5. F C LV a ¢ y y F C � F O � 7 r J C �] a O � a Z W S 3 � �OSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 7200 COSTA MESA,CALIFOHNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADIDFESS G � `-'LU� pY��/A rG OWNER OR TENANT C_ �ZtQ L L MAILING � �`� ADDRE55 /� � TEL.�-y CITV S�/� YVL�S.� NO.� `��S CANSTRUCTION _ _ _ BRANCH ADDRESS ARCHITECT A .. L.C�.. n_ ._ TEL. CONTRACTOR �Un7["pZ BjC.7L � ��G/? ADORESS TEI. CITV NO. STATE CITV LIC. NO. LIC. NO. 512E ^� NO.OF BLOGS. � OF LOT (( %C �� O NOW ON LOT USE OF /� E%ISfINGBLDG. ¢fS(1�E4�C�C. Separate permits are required for electriq plumbing and heating work. USE OF BUILDING AND WO K TO BE PERFORM D �7`J O.J "�27 'FfSTiwJ(j �l-RWIs �40t�•'', R,�,�� I heraby ecknowlatlpe that I have �eetl ihis eppllcetion entl steta thet the above informetion Is corraci end apree io comply wiih all laws re0uiating building eonscruction, entl I shell not employ any parsan in violation of the workman's compensation laws of the Stata of California. I hereby certify that I am prope�ly Iicensed as a contrector untler the Sieta of Calitornia euzinass antl Professions Cotla, D(vision 3, Chaptar 9, enG thet such licensas ere In full torce entl effact, ar I am axampt from tha provisions ot the State ot Celltornle Business entl Professlo otle, Division 3, Chapta 9. Signaara of � l' . � Permlttee �� or Authorizetl Apent Date APPLICATIO ,F��TR�'�'� nECEIVEDBV � P __ UV'iiYd IV A.P. NO. BUILDING ADDRE55 VNIT OR SPACE NO. NEW I ADD OWNER USE � � � —21 S— REPAIR PERMIT 48.50 TU 4e.aacKra� 224 � � BLK. L 'r� tQ � C L VALUE .�[F_ a Szba APPROVEDSETBACKS (FROM C/L,qT,RE6T) �] / Q�/I R. SIDE I —I F7l I /� L. SIDE � FiV / /� REAR � I Fl4/ PLANNING ACTION APPROVED VALUATION 5 �l�J onre APPROVED r m C i a m FT. N 7 f SHOWN UNDER VALVAT�ON IS FOR m OF ESTABLISHING A PERMIT FEE ONLV: � PERMIT FEE� N ma PLAN CHECK y O d p TAX S S� LL f U TOTALPAID S ( . �l