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Home My WebLink About2577 FAIRWAY DR - Building Permits(714) 754•5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2577 FAIRWAY DR Suite: Viciniry: Parcel Number: 43918139 Applicant: SELL ROO�ING COMPANY Address: 18032 LEMON YORBA LINDA , CA Owner. MUNGO,CARA Address 2577 FAIRWqY DR - COSTA MESq, CA Conuactor: SELL ROOFING COMPANY Address: 18032 LEMON YORBA LINDq , CA Zip: 92686 Arch : Address: Zoning: Phone: (714) 52&1758 Zip: 92686 Phone: 631-2272 Zip: 92627-7311 Phone: (714) 52&1758 License: 323842 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 04/15I2003 Issued: O4I15I2003 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXIST. COMP . SHIMGLES INSTALL 130L8 FELT. UNDER 40 YEAR COMPSOTION SHINGLES. Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0. 0 Right 0- 0 $2,soo.00 s2,soo.00 NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requlrements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period ot 780 days. � INSPECTIONS: In order tor the work aulhorized under this permll to be considered legal, sueh work must comply with all applirable codes, and a�l required Inspeetlona end flnal approVal must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. II FOR INSPECTIONS CALL: (714) 750.5626 tmc�ae �erm� WORKERS'COMPENSAnON DECLARAnON: � I hereby aflirm under penelry oi perjury ona at t�e idlovring tledarations: � ❑ I hnve antl will maintein a certificate ol consenl to seli-Insure for workers' compensatlon, es praAded for by sectlon 3700 0l the Lebor Catle, Iw Ihe peAortnance oi Ihe work lor which t�is pennit is issuetl. ❑ I have arW will meinte�n woilcers' conq�ensatlon insuren , es required by section 3700 0l the Lebor Code, lor the peAormance ot t�e work tor wMch this pemut is issued, My workers' compe�sa n nsur nce ca er antl ' number are: f— Carder: . Poliry Num�er. �G ��`' O r5 � (This secBon heetl no! be anp/eted I he peimit is veluetl et one hundred dWlars (5700) or less.) ❑ 1 cer11Ty Mat In the peAormance of Ihe work for wt�lch ihis permit L9 issueQ 1 shatl not employ eny pereon ln any manner so es to become subjed lo the workers' compensetlan laws a� Calilomla, e ee thel if houl ome subject to the workers' camponsatlon provislons of Sectlon 3700 of the Le6or Cade, I shell tort�with comply wit� iheso proNslons. �" /� (� ApPlicen�SipneWre: Do�e: / /—� / WARNINO: FAILURE TO SEGURE WORKERS' COMPENSATION OpVEMGE IS UNLAWFUL AND SNALL SUB1ECi rW EMPLOYER TO CHIMINAL PENAlTIES rWD pNL FlNE$ UP TOONE HUNDRED T/qUSAND DOl1PRE (5100,0001. IN ADDITION TO THE COST OF COMPENSATION, DPN4GE5 AS PROVIDED FOR IN SECTION 3]08 OF THE IABOR CADE. IMEREST, ANO AITORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHlrtn t�et I em Ilconsed undar rovlslo foroe en0 eflect.' Uc. s z Comrectols Signature: 9(commencing with Sectlon 7000) of Dlvislon 3 of the Business entl�role�p n otle, antl my Ilcense Is In tull � aess x L ` 3 � _ oete: ! C� — % — O CONSTRUCTION LENDING AGENCV: ❑ I �ereby eHirm Ihet Ihere is a constructlon IenAing epency tor the peAortnance ol �he work lor which this pertnit is issuetl. (Sec. 3097, Civil Cotle). Lentlers Neme: LendeYs AtlAress: Signeture: OWNER-BUILDER DECI.MATIONS: Date: I hereby eHirm that untler penelry ol perjury thai l em EXEMPT FROM 7HE CONTHACTORS LICENSE LAW tor Ihe lollowing reason (Sec. 7031.5, Business end Proteuions Cotle: Any Gry or counry which requires a pertnit to construcl, a�tar, impmve, demdish, or repair eny atrucWre, pdor to its issuance, elso requires the epplicant tor such permit b tile a signed atatemem �het he or s�e Ls licensed pursuant to ihe proNsions of iha Contrectars lJcense lew (Chapter 9(commencing with SecUon 7000) ol DMsion 3 at the Business end Pmfessions Cude) w Nat ha or s�e is exempt therefrom end ihe basis tor the elleped exemption. Any dolation oi Section 7031.5 Dy any epplicant far a pertnit subjects the epplicant ta e civil penalry ol nat mare than tNe hundred dollars (5500).): ❑ 1, as owner ol the property, or my employees wil� wages as iheir sde wmpensation, WILL DO TME WORK, and the structure Is noi Intendetl or oflered for uie (Sec. 7044, Business and Professions Code: The Coniractors License Law tloes not appty Io an owner of propeRy who builtls or Improve5 thereon, and who does such work himself or herself or through his or her own emplqrees, providetl that such improvements ere nat imendetl or ofleretl br sale. It, however, the 6uilding or imprwement is sold within one year oi completioq the owner-builder will have iha burden of proving that he or she did not Duild or improve for purpose oi sale.�. � ❑ I, es owner ol the properry, em E%CLUSIVELV COMRACTNG WITH LICENSED CONTRACTORS to construct the pro�act (Sec. 704a. Business and Professions Cotle: The contractors License Lew tloes not appty to an owner ol pmperty w�o builds or impmves thereon, antl who contrects br such pmjeq with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I em ezempi un0er Sec. Busineu and Professions Cotle for this reeson: Signature: Date: Owner ID verifiod by dnver's license. ❑ Ves ❑ No Driver's License No. Expires: Veriflcation ol Ownership py (rype of daumenL I.e. - proparty tax hill or dead): DIVISION OF INDUS7RIP�- SAFE7Y PERMIT CEH7IFICA710N: ❑ I herehy cenily that no exwvetion flve (5) or more feet in Oepih into which e person is required to descend, wlll be matle In cannection with work eut�odzed by this permit, end that no builtling strudure, scaflolding, falsework, or demolition or tlismantling Ihereol, will be more ihan t�lrry-six (36) leet hig�. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Calilomie Administretive Cotle). ❑ As ov.ner-builtler, I will not employ anyone to do work which would require e permil from the Divislon ol Industriel Sefety, as natetl ehove, unless such person hes e permit to tlo such wo� irom the division. Signawre: Date: Divislon ol Intlusirial Selery Permit Numbar: CERTIFlCATE OF COMPU�ICE AND AIfTHORVA110N OF ENTFiY: I cenify untler penalry of Darjury ihet I heve read this epplication and state ihat the Infortnation given is correct. I egree to comply wilh ell siate laws end dry ordinances relating ro building constructlon, ena euthodze representatives ol the Gity ot Costa Mesa to enter upon the ebove-descnbetl pro0erty for inspection purposes. I agree not to occupy or allow occupancy of eny building euthonzed by ihis permit until finel inspection. Signat OI egalOwner( Dat �� r 6 � M r Autnodzea Appliwnt � ta COOE �, INSVECTONTYPE 1616 FineC System Finel Fire Preventlon 1268 200 201 202 203 Pool Spe Flnal Finel Re-Roof Finel BIxWRetelhing Wall Finel Fettory Flre Plate Finel Sign 204 Finel Domolition PAiE UII!➢�l9 Y -c' � j�QQE,( INSPECTIONTYPE � ZO6 Final MBc�enicBl 200 Finol Plumbing 210 Finel Electdcel 212 Flnel Fira Preventlon 220 Finel Plenning Appmvel 222 Final Site 250 Final Bullding/Occupency QdIE Q�LS (714) 754-5273 • Fex (714) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Adtlress: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 2577 FAIRWAY DR REAR OF RESIDENCE 43918139 DVORAK,TOM 414 PLACENTIA AV PLACENTIA, CA HU NTER.'CHRISTOPHEf2 Status: ISSUED Applied: 02I01I2002 Issued: 07J01/2002 i � ' ��L_ / Phone: 714-240-4475 Zip: Address 2577 FAIRWAY DR Phone: COSTA MESA, CA Zip: 92627-1311 Contractor: FRIESEN CONSTRUCTION SERVICES Address: 1919 ASPEN CIRCLE � . ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+uniis) Pool / Spa Lighting Fixts Recept Oullets Switches Non Res Appl Res Appl Service to 200a Service to t000a � Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intertned Pole .-Phone: 714-990-1894 FULLERTON; CA Zip� 92635 License: 463944 SCOPE OF PERMIT ELECTRICAL: INSTALL NEW ELECTRICAL PANEL AND UPGRADE FROM 60 AMPS TO 100 AMPS $23.50 $0.00 50.00 50.00 50.00 50.00 so.00 E0.00 50.00 50.00 $0.00 $30.50 50.00 $0.00 $0.00 50.00 $0.00 50.00 50.00 50.00 $0.00 $0.00 $0.00 so.00 $0.00 �uantiry FEESUMMARY' Temp Dist System / Lighting Busway/100ft Standing Section Misc Eleclrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .............:...up to 100 kva/kw ..................over 100 kva/kw � Low Voltage Equipment -� - Low Volt Wiring System / Ckt Misa Conduit Misa Conductor Circus ( gen or ride) Circus (mech nde or lights) Christmas Tree Stand Fireworks Stand� Other Electrical Fee �Investigation Fee Plan Check Fee Reinspection Fee ` Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 , 0 50.00 0 $0.00 0 , $0.00 0 $0.00 ' 0 50.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES E54.00 COMMENTS / SPECIAL CONDITIONS � NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Californla statutes and related regulations. (Ord. No. 92-28, § 1, 72-27-92) EXPIRATION: This permlt shall automatically ezpire and become vold if work Is not commenced wlthin 180 days, or ii work Is suspended or ebandone0 for a period of 180 days. iNSPEC710NS: In order lor the work authorized under this permit to be considered legal, such xrork must comply with el� applicabte codes, arW all requlred inapeetiona and (inal approval must be obtained. Failure to obtain inspections and tinal approval will result in �he expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaaas �e�oo� WORKERS'COMPENSAnON DECLARAnON: � I hereby affirm under penalry of perjury one of the following tledaratlons: ' ❑ I have end will mainteln a cenificate of consant to selGlnsure for workers' campensatlon, es provide0 tor by section 3700 of ihe Labor Code, tor the peAortnence ol the Work for which Ihis permit 15155uetl. ❑ 1 have antl will mflintain workero' compensaibn Insurance, es reQuiretl by aecUon 3700 0l Ihe Labor Cotle, for Ihe pertortnanca of ihe work for wNch this pertNt lv IuueA. My workers' compen�satlon Insurance cartier antl policy num6er ere: Carrier. Policy Number. (Thls secf/on need nor be completed i/ Ne pertnifls valued et one hundred ddlars (5100) or Ie55J �I cenity Ihat in the peAortnance ol the work lor which t�is permit is Iuued, � shall not employ eny person in any manner so as to becoma sub�ect to t�e workers' wmpensetlon laws of Calllomia, an0 egree that it I s�ould become sub�ect ta t�e workers' compensation prodsions ol Section 3700 0l Ihe Lebor CaCe, I shall tortMvith comply with these provl � s. �// plicenlSigneture:"6��.� Dete: �/ �n�n� NIN(3: FAILURE TO SECURE WOFKERS' COMPENSATION COVERAGE IS UNLAWFULlWD SHALL SUBJECT AN EMP�OYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TFIOUSANO WLLARE (5100,000). IN ADDfT10N TO THE COST OF COMPENSATIqJ, DAMAGES AS PPOVIOED FOR IN SECTIIXJ 3]O60F THE LABOF CODE, INfERE57, AND ATTOfiNE1^5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm Ihoi l em force entl eNec . lJ�c. k�' ot Chepter 9(commencing wlth Soc�lon 7000) of Division 3 0l ihe Business entl Prolessions Code, antl my Ilcense Is In lull iass �� L/9 ` oa�e: T /�s-� K, CONSTRUCTION LENDING AGENCY: �, ❑ I �ereby eflirm Ihat Ihere is e consWction lending egency br Ihe petlormance ot the work tor whic� this pormit is issued. (Sec. 3097, Civil Cotla). �� Lentlels Nemo: Lendefs Address: Signe�ure: � Date: OWNER-BUILDER DECLARA710N5: I �ereDy afllrm thel untler penalry ol perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Cotle: Any ciy or counry which requires a pertnit to consWct, alter, improve, tlemolish, or repair any sWCNre, prior to its issuence, also requires tha epplicant far such permit lo file e signetl stetement that �e or she is licensed pursuant to ihe provisions ol the Comrectors License Law (Chapter 9(commencing with Sectlon 7000) ot DMsion 3 ot t�e Business end Pmtessions Catle) ar t�at �e or s�e Is exempt t�arefrom end the basls tor t�e elleged a:emption. Any violatlon of Section 7031.5 by any appllcant for e pertnit subjecis the eppllcenl lo a civil penelry ol not mora than tive hundred dollars ($500).): ❑ I, as owner ol Iha properry, or my employees with wages as thelr sole compensation, WILL DO 7HE WORK, and Ihe structure is not intentletl or oMered lor sale (Sec. 7044, Business and Professions Coda: The Contraciors License Law tloes noI apply lo an owner of properry who builds or improves thereon, antl who does such work himselt or herself or through his or her own employees, provided that such Improvemenis are not intentled or ottared for sale. If, however, ihe bullding or Improvemeni Is sold within one year ol completion, the owner�builder will have �he burden of proving Ihat �e or she tlid not build or improve for purpose of sele.). ❑ I, as owner of lhe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct ihe prolect (Sec. 7044, Busine55 Bnd Protessians Code: The coNrec�ors License Lew does not apply to an owner ol property who builds or Improves thereon, and who contracts lor such project wlth e coniractor(s) license pursuani to the Contractors License Laws.). ❑ I am exempt untler sec. Business and Professions Cotle for Ihis reason: Siqneture: Date: Owner ID verilied by dnvers license. ❑ Ves ❑ No Orivefs License No. Eapires: Vedticetion of Ownership by (type of tlocumem, i.e. - property tac 6111 or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I here�y certily lhai no excave�ion Me (5) or more teet In depth Imo which a person is requiretl to tlescend, will be made In connection with work authorizetl by Ihis pertnit, end thal no builtling struqure, scaMolding, talsework, or Oemolitlon or tllsmantting lhereol, will be more than thirty-six (36) feet �igh. (Chep. 3.2, Grp 2, Art 2, Sec. 3a1, Tlle 8, Celifomia Administrative Code). � As or.neo-builder, I wlll not empby enyone to tlo work whic� woultl requlre e permit Irom lhe Division of Industnel Sefery, es notetl ebove, unless such persan has e pertnit to do such work trom the division. Signature: Date: Divialon ol lndus�nal Safeiy Permi� Number: CERi7FICATE OF COMPLIANCE AND AUfHORIZA710N OF EMAV: I certity under penalty of perjury that I have read this aDGlication entl state Ihat the information given is correcl I egree to comply wlth ell s;ate laws enC ciiy ordinances relating ro building consimctlon, and authorize represen�atives of ihe Clly ot Coste Mese to enter upon Ihe ebove-described property for inspection purpases. I egree not to occupy or ellow occupency of eny building authorized by this permit umil linel inspection. GOOE1, MSPECTIONTYPE tfil6 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Final Ra-Rool 201 FInaI B1ocWReteinlnp Wall 202 Final Fectory Fire PlaCe 203 Finel Sign 204 Finel Demolition Date � � �.�C-J Z ^--..'_. ate,_ pA� Q�LS CODEI ixsrernoxrrve 206 Final Mec�anical 208 Final Plumbing 210 Final Elet�rical 212 Finel Flra Preventlon 220 Final Planning Apprwal 222 Final Site 250 FinelBuilding/Occupancy � � uw.: COUNTY OF ORALVGE BUII.DING DEPT. 636 No. Broadway Santa Ana, Califomia Phone: KI 2-6211 Permit I�'o...Y.�.L%.11Q......-- Application for Building Permit AND FOR A Certificete of Use and �ccupancy Date. -$ePt......4.s__1�5.2... - ....-- ._.... - 1. OWNER'S NAME........_.Dike_ &_ Colagroye - �- ..... - - - -- ................. .. PHONE:_.�e.&....4225..... -� - MAILING ADDRESS.... -15th.:.. &_ Irpine_ St�.. ......_..... -- ....- - ..... ....... CITYNebtp9z't...Hs.&�.h ..... -......-- - Name Addres .... Ciry ._ Sta[e Lic. N . . . ' .................... (Archicect or Engineer) _ .. Phone ......... - - ...... --.... Name ....__D1k�..&..Co1�P['Ove....... --- -.... (Con[ractor) Addre=_s _a.5�h,---&..IrYa.ne--Sts.----------.---------.....--- City ----._��Wj24St...�e.A9.tle---...('i.&�.j.�----"--"-----------....------" State Lt�. rro....125�92.._....... .... nho„�...B.ea...7225 ._.._. PROPOSED USE:......... - - - ReS.� S�.e..n9.e-- -�""'. - .. ... _!,VL�... � . .. 2. JOBLOCATION ..... -._......z5?.%........._Fai#�uay-A,C�.Y.�..- - --....Co�ta..Mesa.�_.California--......- - -----�- (HoU<e No.) (Name o( Sveet) (Town or School Distric[) 3. LEGAL DESCRII'TION: Loc .....� .... - ....... ...Block - -...........-- -... -.... Tract -127.9. ....... (Mctes and Bounds Descnption—Use revcrse side of form) ' 4. CORNER LOT ( ) INTERIOR LOT ( X) THROUGH L07' ( ) SLOPE OF LOT ( ) i. SIZE OF BLDG.:..---1�_X..25._.......AREA:.._J.QSQ ..............-..SIZE OF LOT:---..6Q..%..135-----......AREA:----82Q�.....------------- G. HEIGHT OF 13LDG .:............_1/al............._._...CEILING HEIGHT:_....._.&.!............_._....NO. OF STORIES......._.1...... 7. NO. FAMILIES ...............1........_----........Sizc of Smallest Bedroom:_1Q..%..11_................... Size of Kitchen--_1Q..X..1�.......-------. R. EXTERIOR WALL CONSTRUCTION:..........Stacca............_....1NTERIOR V✓ALL COVERING.....pla&tar ................._._.. (Frime, Smcco, Etc.) , (Plas[erDrywall, Etc.) 9. SETBACKS: Front Yard From Center Line of Screet.........._��_... _-_------------------_-._----------...._..........._. Nearest Side Yard......`1...........___Rear Yard...._......___.......Distance in Feet Betwecn Bldgs. on Same Loc......._.�.... � 0 � one . ................-- ]0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. ll. For ---------------De th in Ground......--12-----------Width of Wall-------.�...................... (a) Footing: Width'--.__..........�1+.° p n Accessory Bldgs. and b Si;e of Studs:...._._.�..�i..�........5 acin Ifi...._......."CC Material of Floor......1�1ROC�...._ ...................__. Similar � ) P &........- - Strucmres: � (c) Size of Floor Joists:......,2--X-�----- .................Spacing.....__...lfi._...__.---_..----.•CC ,2.-� � - .............. S acin 16.......... —'- ... ,.CC (d) Si;e of Rafters :............ p g------------ 12. VALUATION OF PROPC�OSED �ORK: Induding all labor, plumbing, elecvir.al wiring, heating, fire sprinklers, painting and sewage disposal � .............f �� - -- .... ' 13. ] HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION ]N THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. � DIKE AND COLEGROVE , GE�'i ��_CON;RACTOHS Signed:........-- -- -- - ........ - — ................... ...._ - ................ --- - - 15th z� d :: �; �e ' e��p q-- ....- - -- Plans Filed :................• Phone B 9-J B�,L �.. p FEES: Bldg. Permit ' S---.(,�'.. Plan Check - S.....,... Tota] , . , �---�, Receipt No. - � Paid to • • .� Date---.......----- .................�a,.�.. DA7'E....... /......1 L 5 M-B-51 By.-- ................-----__...---- •- - ---- •�-- (Authorized FOR DEPARTMENTAL USE ONLY Os� GROUP..T%..........r........ _� d .... TYPE-- - -� .................. ao -.. .... ._ ---..... D1ST. 'J .y. -- �� MAP- -L.� 1 ................ . --......... SHEET NO......s5.- .............. [� i 'L APPLICAT ZONING............_ _ PLANS AND S PE C' 5 .............. _... _.. - CORRECTIONS V ERIFI ED----.-------------.. l:il HEALTH._ .. ............. .... FIRE MARSHAL STATE........ ENGINEER � � APR 2 1 1960 DATE 1-20-60 GENERAL CONTRACTOR Ai't's r'ence VALUE S 110.W AP. No. 119-112-30 LOT T1tACT FIBE ZONE DESCRIPTION OF WORK COimn. loCkc�7a11 INSPECTIONS DATE I GROUP TYPE ZONE –1 UQdOLpCOLLna SOil U.G. W�[0[ I PERMITS ISSUED —z8•. ______...__ ---I SUBCONTRACTOR , OCCUPANCY Form 210–SM-11-59 SB P U �i�R� ,. �� S ; C STA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 3I7 COSTA MESA. CALIFORNIA � EE RECE�V ED �„�nNr.F DEPT• , ��.,..�-(�OSTA ME� fOR APPL/CANT TO f/LL /N COMPLETELY APPLICP�j�IVF�bR PERMIT TYPE OR PRINT BUILDING BUILDING LS�� Al��✓A�/ J� ADDRE55 COSTA MESA. CALIFORNIA FOR OFFICE USE ONCY S ^� j� �/ I PECEIPT NO. I PERMIT^NQ.� OWNER C � .L O/ MAIL RECEIVE BY OATE HECEIVED OA E 189U¢D ADDRESS '� % 7 �! J�t Lf%4 � I '�O�G dl �,Z�- TEL. BUILDING CITY NO. ADDRESS wP^vi7ecT �� COSTA MESA, CALIFORNIA ( IGINEER NO. ADDRESS FIRE ZONE TYPE GROUP J STATE. APPROVED CONTRACTOR �= �IC. NO.I GaSP BY DATE ADDRESS 2 S Lb co �i�F'q ZONING LEGAL I LOT f I I I.} 7% ZONE/2 I I NO.OF � I OSE OF NEN( ,� /]— J OESCRIPTION NO. � BLOCK TRAQ � P��NS BUILOIN6 �N (/ A.P.NO. �( ` � .�� APPROVEDI 1• Y/ r DATE '-�i o� BV ,� OF LOT i� J� J I�ow on �oT6 YARDS '�EVES � REqU1RED ALLOWED USE OF (CENTER LINE ST.) 1 � / E%ISTINGBLOG. FRONT .�J�FT.T IN. SETBACK LINE FROM ceNrEw ov s'rwen REAR YARD R. SIDE FT. C%IN. SIDE YARD I LEFT I RIGHT L. SIDE �' FT. IN. DESCRIPTION OF WORK — REAR FT. IN. I IIALTERATION I IIADDITION I REPAIR I IIMOVING ( II�EMOLISH I BUILDING NO.OF n SIZE ROOMS STORIES �� L EXTERIOR WALL IROOF � � IGLU� COVERING COVERING � �Y�I USE OF BUILDING AND WORK TO BE P FORMED / y� %% � � � (i "/��/' O Y /_ . J/ , I HEHEBY ACKNOWLEDGE THAT 1 HAVE READ TMIS APPLICATION THE AMOUNT SXOWN UNOEft VRLUATION 19 FOR THE AND STNTE TNAT THE ABOVE 18 CORRECT ANO AGHEE TO COM- pLY WITH ALL CITY OROINqNCES AND STATE LAW9 FEGULATIN6 PUPPOBE OF ESTABLIBHING !� PERMIT FEE ONLY. B111L�ING CONSTflUCf10N. VALUATION SIGNATURE OF �) PERMIT FEE S � � PERMI7TEE J �-l1�r'�-v �'�"'�'�� 5 // ` PLAN CHECK $ AUTHORIZED AGENT TOTAL FEE $ � �� V W1V 'L.lt rviv�iwl[w �.�co unar. / �+ v � JOB ADDAESS 2577 Fairway IJrive BUILDING PERMIT NO. 2700 GENERAL CONTRACTOR Driver-Fddv Co. nEscssP�[ox oF woxx Fire Damage Repaar VALUE TYPE SUBCONTRACTOR � 2:( COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 � COSTA MESA, CALIFORNIA 92826 Por Applicant 4o F(11 In Completaly TYPE OR PRINT BUILDINO � � � ADDRE88 COSTA MESA, CALIFORNIA c � /,/ [fWNPN U �F.0 �'(/ FfQ JT�YI a�-» TEL rt f/a21rE�cr- l q�,� C �i c�rr L-0 d / A ��/ES�1 ��T�o. 12.2eo2 No` G�fL- �LI USE OP DESCRIPTION OF WORK �OM/�D / 'T� ;. '� s '� s s ' Ce x� R w • y- - �/9 c /Y!/� 1 HENEBY ACRNOWLSO06 TNAT 1 XAV� 1l6AD TM18 APPLIGTION AND BT/�T8 TXAT TH6 AEOV6 19 CORqBCT ANO AORE[ TO COM. PLr wITH ALL e1TY ORDINANC�Y AND /TAii LAWY R[OYI.A BUILCINO CONBTRUGTION. ^ � SIGNATUR80P � /^/ ��fe PERMITT6 �o —1 AUTHORRiD AQ[NT Mt�Y-8-67chi,,,00 347;� _��:*:=18.GD APPLICATION FOR PERMR BUILDIN(; . For Offlce Use Only R[e[II! No. � �' BUILDIN6 � ' ZONING ZOy MO.O� UY[OIN[W � / �LAND � OUILDINO nvan�r�nnu /// �—//� �' . � � MAIN VAR..R DATE LE88 TMAN APPROVHD RY BUILOIN6 er /� ('I DATE � 'i0 a w � eo. rr. � 0 TH8 AMOUNT_9XOWN UNDHR VI�LUI�TION IB FOq TH[ j �URPo98 OP 69TABLIBXIHO A PEPM�T PH8 ONLY. � VALUATION � � - PERMITFEE $ /� � g�D00 F /v/-, w TOTAL FEE $ / // i