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Home My WebLink About3098 COLLEGE AVE - Building Permits.. F COsrA MESA CON/SJ'.�2UCTION PERMIT Project Addreis �(�'�n� �y ��LL � Appli`anYs Maili Ad.d..re�ss'�C�.-_,Y,�,,� �p�� C 2�.' Owner's N�` �n��cs��p[_l.C.�e.�r_,7—Phone Addres�s �.L1�0�c�� y Arch/Eng. Licensc No. !Qldress Contracror's Nam � LO R nhone 0� Addresslma'I�np �z !R�L�Rmk ir7 � Qy�o �/-� +ity Licenu No. �`�� LICENSED CONTRACTOR DECLARATION 1 hereby aHlrm thal I am Ilcensetl untlGr provisions of Chart¢r 9(tomm¢ncin9 with section 7000) 01 Dlvision 3 of the Business antl Professions Cotle, and my Iicenze is in tv� lorce antl eftect. { LJcense Class License No.{ �� Da�e��.:�iG. e'��ae ��1— � WORKERS' COMP NSATION•DE LARATION ' I hereby afBrm inat I have a certllicate of wnsent to Selhinsure or a certlficate � of Workeri' CompensatiOn InSurance, or a certifietl copTy thereof (Se[tion 3800, Lab. e+� i p�ra'f'E 7+U fY �i Policy No�� a�G'g�_ Company f� BCertifietl capy B hereby furnishetl. Certifietl copy is filetl with tne city uiltlin9 Division. tafe " Applitant �� 'XEMPTION�FRO�M�RKERS'CO ENSATIONDECLARAYION (Thissection neStl no[ bo com0�eted if tha permit IS for on¢ huntlretl (E100) or ICSSJ. 1 ce�U(y thal in lhe perlo�mance ot the work fOr whiGh thiz p¢rm�t is is5uetl, I shall not employ any peison In any manner so as [o become suCject to the Worker5' Compen5atlon Laws OI Calitomia. Date Signature � NOTICE: It, aftor making lhis tlecla�atlon, y0u ShOultl b¢Come subjoct to lhe Workers' Compensalion provl5ion5 01 Ihe L.�bor COUe, you must rorenwim .� Comply with such prOvi5iOn5 or lnis pe�mit Shall be tleem¢d revok¢tl. ' CONSTRUCTION LENDING AGENCV ' 1 nereUy atlirm that there is a construction lentlin9 a9enty for the performance of the wark 1or whlcM1 thls p¢rmit is ISsuetl ($ectlon 309� ,Civ. C.j Lentler's Name �' Lentler'z Atltlress ` OWNERBUILDEH OECLARATION I hereby altirm lhal I�am Oxnmpl 1roT thC ConVactOr'S Lic¢nse L.Sw fOr [he following reasan (Sectlon 7031.5 Builness antl Pro(essional Cotle: Any tl[Y or County whiGh requires a permlt IO cOnsbuGt, dltC/, ImO�ove, tlem011ih o� repair any structure, prlor to �ti Issuance, also roqWres tha applitant for such permit to tile a si9netl stalemonl tnat he/shc Is Ilcenzetl pursuant to the provisions oi the Contra<tor's License Law (ChaO�er 9(tommencing with Sectlon 7000) of DiviSion 3 ot lhC Bu5Mes5 antl Plo1a551on5 Cotle) of tllat M1¢/Slle Is e%empt Ih¢rCfrom an0 lhe basi5 fOr t�e allegotl oxemptlon. Any violation of Settion 7031.5 by any apP�kant to� a permll subj¢CIS Ihe applicant t0 a clvll �enalty of not more lhan Ilve huntlre0 tloltars (E500). 1, as owner ol lha p�oporly o� my employee5 with wag05 as their SOIe comvensaHon, will ao the work, an0 the structure is not intentled or olteratl br sala (SecUon 7044, Buslness anC Profussional Cotle: Tho ConVac[or's 'cen5¢ Law tloes not apply to an owner oi a properry who oulltlz or impmves e�eon, antl wlto EoeS Suth work himsel//harsOtl or throu9M1 his Or hn� own nployees, provitlad tM1at such improvemnnls are not intentletl Or ottereC for sale. II, howevor, the bulltlln9 or Imorovoment is sola wlthin one year oi com- plellon, tho owner wlll have the burtlen ol proving he/she tlitl n0[ builtl or Im- �iOve for the purpose ol Sa10). U I, a5 owner O/ Iho p�operty, am exUusively ContraCUng wlltt Ilcense� con- IraGtors lo const�uct tM1e prqect (S�'C(I00 %044� BUSIfIC55 d04 P!O(ESSI005 COCC: The Contractor'z License Law does nol aOP�Y to an owner of property wbo builas or Improves thereon, antl who contracts tor such projects wltn a con- tractor�sl ucense pursuanl to tne Conlractor's Llcense Law). 1 am aware that proof of Ih¢ir Work¢r'S COmpensatlon InsurdnG¢ shoultl be prOvi�eO lo m¢. � ❑ I am exempt untler Secllon B. 6 P. C. for this reason Date Owner I hereby certify that I have reatl Ihis applicatlon antl state that the above information is correct. I a9ree to comply wltn all clty antl countY ortllnances antl state Iaws relating to building consVuctlon, antl hereby authorize rep�e- sentativ¢s Of i�is cily to ente� upon lhe abOve-mentionetl property tor inspectlon p ses. ' Signature � �-� / � Cr AOPlieani..to fll1 In a11 spaces exceo< <�ase within neavY bortler Iines ana sign a11 aooropriate tleclantlons. PEfjM1T NO. TRACT N, LO NO UNIT NO. 31 Co(oD �j �� l TVPE Of CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISFI ❑ OTHER A p �6 ' L D CRIPTION OF W{p.}Fi(K`(/�US'E OF BLD —�. M�+'r'� �� S Main Building: 7VPE OF PERMIT LJ GRADING FOUNDqTION STRVCTURAL T Ffonl " O TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL 8 Rear ❑ OTHER A PROJECT DESCRIPTION 5�. F7. oCCUPANCv C Right 2,Q K Left �CONSTRUCTIONTVGE- � VALVATIONS $ ��'ZONE GRADINGCU.V�S. ACRES PIng.R2f.'� Remarks: � "�(_�S �1� �� 'Ll @� Planning Notes:. Bar Sink ' Backtlow Preventer Backflow Irrigation Bathtubs Clarifiers � . Dishwasher Drinking Fountains Floor Dreins Floor Sinks id5 $ClVICB �11112I5 Intertep{or5 t�' Kitchen Sink l Lavntories • • P-T,rap' � . Roof Orains � Rainspection Fan S75 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating Ezhaust System ❑ Multiple Firepl/FacL BIL IC80 �p Heating System & Ducting ❑ 0-100,000 BTU � 100,000 Reinspection Fea I $15 9F 0865-46, rev. 10/04 white - Builaing; Canary - Appllcanq Pink - Acmuntinq; Goltlenrotl - Assessor / `� Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Laund7y Treys laue Fea Hood or Type I ❑ Canopy Typell ❑ Re(rigeration System ❑o-ioo,000eTu ❑ioo,000 System Repair/Alteration Fire Dampers Fegisters Issue Fee 2184 12/PG/�;1 �.. � � � Zone Actessory Req./Provided ELECTRICAL Automatic Washer Trensformer ❑ 15�50 KW Construction Pole Sub. � 50 + KW . Cooking Unit ' Meter �up to 100 amps Dishwasher ' Meter ❑over100amps Dryers ❑Gas �Electric Sub Panel Fan Motors �0.1 HP 01'r5 - 8 F.A,U. Inc.Solar �9-15 HP �16-15+ Fixtures Microwave Device Boxes , Pole Light Outlets . Range Switches Sign Garbage Dispoul - Generator �0.5 KW �5-15 KW Standing Sections Trash Compactor 53� � - Reinspection Fee 515 Issue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: p�-�.� Zaning APProved BY �� T'' Data � Building Approved By Date_ � Application Issued By Date. � SUMMARV OF FEES BUILDING PERMIT $ 3�O S� , SMIP PLAN CHECK $ -� PERMIT PLUMBING $ Z'i' ISSUANCE P�AN CHECK 25% $� ENERGV P.C. ELECTRICAL $ Sa r� GRADING PLAN CHECK 50% $ �I � MICROR�M MECHANICAL $ Z� TOTAL FEE PLAN CHECK 25% $ Z S 4240��:� i � 2 O N 1 N G R E Q M T S FEES CONSTRUCTION ANDPIANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. �-- : 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement 6. E�ectrical UFER Grnd. 7. Footings , S�-a21- 8. Foundation 9. Water Pipe-Undrgrnd. 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electriral-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electricaf,-T Bar Ceiting 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventila[ing 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. lathing & Siding 29. Insulation 30. Drywall Nailing • 31 . 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 Fireplace 38�: Final Plumbing 39..Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer +43. Backflow Irrigation ' 44. l.andscape Irrigation $Ystem 45. Sound Attenua[ion i 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 5L CERTIFICATE OF OCCUPANCY � Date � Inspector � � ' LFD POO L & SPA APPROVALS Permit # 52. Pool & Equipment Location � • ' 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVA�TODECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final �' 65. Electrical-Final ' 66. Solar Syscem-Final 67. Fencing & Access Approval 68. APPFOVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro 71. ProductPipingOGas ❑Oil 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: %� 3 p `9 ,4� � ��`� �'Q .t.�.--a. r�'nA � ; � _ '1 , ',i , _ r�� . - ., � , � � ' � m .. 'y- ; � . r, Date � Inspector 0 . _'(_ a : �_. " L: .: � , { ;�- �c� \ Aoplicant to flll in alt spaces exceot those within heavy Eoraer lines ana si9n all aporopriate aeclarations. CITY OF COSTA MESA CONSTR UCTION PERMIT PE�MIT NO. TRACT NO. LOT N0. � UNIT NO. Project Address 3_czQ$�_)� r^ �-EG ��,I Applicant'sMail�i Address�i �Z Z�t- �c�.b Owner's Name l`+�L"�l�RY' Ge{AVYS Phone - 7 Address �-'3 v ��OL-LC—C"�s�[-' Gi+Si /,c M65R Arch/Eng. License No. Address Contracror'sNamp�y r,�� Phon �j� Addreu (mailing) JY�.Z%S1T�EG~-�1/cr�(1/t' �'Nl. � ,�s Ciry License No. � �� '•'i � LICENSED CONTRACTOR DECLARATION I hereby affi�m [Itat I am licensetl untle� 0/ovislon3 of Charte� 9(commencing with section ]000) ot Division 3 ot the 6usines5 antl Prof¢s5ion5 Cotle, antl my ticenze is in 1 I/orce ana ettect. /��y � License,Class License No. Date �'� S'g t � Q' WORKERS' COMPENSATION DE � ARATION I hereDy affirm that I have a certilicate of consent lo selt-insure or a<ertllicate of Workers' Compensa[iOn InSurancq o� a ce�tlfl tl coOY tbe�eof (S¢Ction 3800. Lab. /G/). g �/ ��/� 7� . Policy No.i Y�l__ �'}1 44J'�� Company Tvi�''A �Certifietl copy is hereoy turnishetl. Cer ifietl cop is filetl with the tlty Bw Dlvislon. Jate " Applicant L � �� EXEMPTION FRO WORKERS' CO SATION DECLARATION (T�is section nee0 not Ee completetl if [he permit I5 fo� One huntlre0 (E300) o� lezz). I certity tbat in tne Oetfo�mance ot th¢ wOrk tOr whlch this permit i5 i55ueU, I shall not employ any p¢rson in any manner so as to become subject lo the Worker5' Compenzation Laws Ot Callfomia. Date SignaturC NOTICE: If, a(ter makin9 this tleclaratlon, you shoultl become subject to the Wotkers' Compensalion provislons of ttle LabOr Cotle, you muzt forthwith comply witn such p�ovisions or thi5 permlt shall be Ueemetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby aftirm that tbere is a construc[ion lentling agency tor�ttte partormance of tM1e work tor which [his permit is issuetl (SeCtion:3097� Civ. C.) Lenaer's Name Lentler's Atltlresz OWNER BUIL�EH OECLARATION '�' I hereby affirm lhat I am exempt irom the Contractor's Llcense Law for the following reason (Section ]031.5 Business antl Professlonal Cotle: Any dty or County which requires a Oetmlt lo Construct, alte�, Improve, Gem5lish or r¢pair any structure, prior ro its issuance, also reqWres lhe applican('for'such permit to tile a signetl stalement ihat he/she is IicenSetl pu�suant lo th¢ provl5ion5 ot IhG Contractor's LicenSe Law (Chapler 9(mmmencin9 with Sectlon 7000) Of DiviSion 3 of tne Business antl Profe55ion5 Cotle) or that he/Site I5 exempt theretrom antl Ihe basis for che alleqed exemptlon. Any viola[lon of Sec[ion 7031.5 by any ap0��ant (or a pe�mit subjet[z the applicanl lo a civil penalty of not mo�e than five huntl�etl tlollars ($500). ❑ I, as owne� of the property or my employee5 with wages as their Sole compensation, will tlo the work, antl the structure Is not Intentletl or oftereC for sale (Section 7044, Business antl Protessional Cotle: The Contractor'S ' License law tloes not apply to an owner of a property wbo builtls or improves the�eon, antl who Uoes such work him5elf/hetself or lhrough his o� he� own employces, provitletl that such improvomenes ara not intentloC or oiforatl for �� sdl¢. It, howeveq lhe builtling or imProvemenl i5 zoltl wlNin One year of cOm- �, D�eBon, Ne owner will have tne burtlen oi proving he/she tlitl not bulltl or Im- Iprove forihe purpose ot zale). ❑ I, as owner of tbe p�operty, am exclusively mntracting with IlcenSetl Con- Vactors [o wnstruct [he project (Section �044, BusMess antl Protessions Cotle: The Contractor's License Law tloes not apply to an owner of property who builtlz or imowves thereon, antl who contracis for sucn projects wltn a con- tractor(sl bcense oursuant to the Coniractor's Llcense Law). I am aware thaf proot of their WOrker's Compensation insuran<¢ shoultl be P�ovitl¢tl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date owner 1 hereby certity that I have reatl this application antl state that the above information is correcL I agree to comply with all clty antl county orCinance5 antl state laws r¢lating to builtling con5truttion, antl hereby authOrize tepre- sentatives of is ciry to enter upon tne aEove-men[ionetl =oq�erty to` Inspettion p 5. / C�O Signamre .s�/'Sf'"r �ate/ 0 � � TVPE OF CONSTRUCTION' LJ NEW U ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # DESCRIPTION OF WORK/USE OF BLDG. M1� SL• a y��, . S Main Buildi TVPE OF PERMIT GRADING�,f FOUNDATION ❑ STRUCTURAL T Front ❑ TENANT ❑ ELECTRIGAL Ibi PLUMBING ❑ MECHANICAL B Rear ❑ OTHER %� PROJECT DESCRIP710N 54. FT. ocCUPANcv C Right K Left CONSTRVCTIONTVPE VALVATION$ $ ZONE GRADING CU.YDS. ACftES p�ng. Ref. # Remarks: G 3��p� D Plannin9 Noles: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Claritiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories '-Trap Roo( Drains Reinspection Fee $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # � Heating System & Ducting ❑ o-i oo,000 eTu � i oo,000 ar R" LO' S o 55 � I I einspeCnon Fee CMF 0865-46, rev. 10/B4 White - Builtling: Canary - Applicanh Pink - A<counting: Goltlenrotl - Assessor $15 Show¢rs Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank� Swimming Pool w/Spa Urinal Water Closet Water Heater Water Ser'vice Auto-Wash Laundry Trays laue Fea Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System O�,OOO BTU ❑ 100,000 BTU '�ystem Repair/Alteration Fire Dampers Registers laue Fee FEES Automatic Washer Consvuction Pole Sub. Cookin9 Unit Dishwasher Dryers ❑Gas ❑Elect Fan F.A.U. Fixtures Device Boxes Outlet� Switches Garbage Dispoul u' �, Generator O65 KW 17 2888 I/II/BI1 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ $O+KW Meter ❑up to 100 amps Meter �over 100 amps 5-15 KW Sub Panel Motors �0.1 HP 01 :5 - 8 Inc.Solar 09-15 HP �16-15+ Microwave Pole Light Ranqe Sign Standing Sections Trash Compactor $ 3 Reinspeciion Fee $15 Issue Fee FEES DEVELOPMENT SER VICES P EQUIREMENTS: 2aning Approved By Building Appraved 8y Aoolication Issuad Bv ��µ � � � $ 3 SUMMARV OF FEES ✓ BUILDING PERMIT $ SMIP $ PIAN CHECK $ PERMIT PLUMBING $ �_��/ ISSUANCE $ PLAN CHECK 25% $ ��ZS ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICFOFILM $ MECHANICAL S TOTAL FEE $ PLAN CHECK 25% $ FEES $ 3 Z O N I N G R E � M T S CONSTRUf,TION AND PLANNING � POOL & SPA � �APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspectnr ( 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. 8. Foundetlon ' ' 59. Gas Pipe, � Undrgrnd., Test . 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVALTO DECK 11. Property Sewer Line'& HouseConnection ��Z$B LE� 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. floof Drains - 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical-Final , 15. Rough Electrical-Conduit 66. Solar SYstem-Final . 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough�Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling y ." 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts,in Structure � 70. Underground Hydro , 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil � 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing ' 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Erame�and Flashing r 76. Dry StanHpipe .. . � 28. Lathing & Siding 77. FIXED SYSTEM FINAL • � 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat 79. FINAL INSPECTION ,� -�� 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test �' 36. Hood or Canopy .� . . � 37. Final Factory Fireplace , � '.� � . � 38: Final Plumbing �,�//frQ L� � ' • � '� . .. 39. Water Service-Final /-12�Q$ L7Lo • , � - � ` 40. Gas Service-Final - � ' . :. 41. Solar pomestic-Final ' � ' •- •�� i • � 42. Backflow Preventer � � . y 43. Backflow Irrigation �� s , . . ; , . � 44. Landscape Irriqation System ' 45. Sound Attenuation ' ' �� '. .. ��46. HandicapRegulations �' ' i, , � 47. FINALSTRUCTURE & BUILDING �,� � ' ' � ,� . 48. Special Requirements Completed � `� - � ° - , • • , �49r Electric Release to Edison � �'� ,', ' .� 50. Gas Release to Southern California Gas Co � � � � ; ' . 51. CERTtFICATE OF OCCUPANCY ._ , No. Date OWNER JOBADDRESS . BUILDING PERMIT NO. VALUE $ B.00O.00 , LOT 161 e�ocK �� TRACT p�l Residance � . GROUP I TVPE V ZONE R4 FIRE D13TRICT 1695 PERMITSISSUED ' INSPECTION$ DATE SUBCONTHACTOR DATE I NUMBER Fontina Trench L� � 2 •�] Foundation Forms and Grade to Rough Framing �� Wirir Heati Heati Tank a� •," 7-. Plumbing, Final, Fix� Plumbino. Final Gas Occupancy Form 2l •"✓�.. -s? ' �,;=�osta Mesa�"'Building Department . � 111 EAST 20th STREET ' COS7A MESA, CALIFORNIA FOR APPLICANT TO FILL IN Building Address 3098 C011ege �ut.� C ta Mesa Calif rnia .,�g P-'I:ICATION FOR PERMIT l""' �UILDiNG � FOR O�'FICE USE ONLY os , o ( Nearesc S4atson Avenue I �p /J Cross St. pddress 30 90 � 'owner ' Colle e Mesa Com an CostB,MCs&, Ma❑ nddress 8002 Central Avenue rvearess Address Size of Use of Tel. Cross St `CJ�tic�o i Garden Grove No.IE 9-2158 zone�� I No. of I or Lic. Plans Davis & Qui le No. C-1790 nPProvea b 3 Mal�a Cove P1aza,Palos Verdes CORRE� r The Hale Com a city ��c. P �y �do. 3422 8002 Central Ave. Garden Grove on ILot I No. 161 Block � Tract 2341 letes and Bounds) ^^ 2 6893 SQ, Ft. � NowonBLoiS �� ne rrom sQ � Rear rara so � tn..� cin.. va�.� a t X I Alteration I I Adtlition Repair � � Moving � � Demolish � Bullding No.of 1 Size 1181 Rooms 5 Stories Exterior Wall Roof Covering S'tuCCo Covertng Shake Use of New suiidiny Single family dwelling with detached garage. I hereby acknowledge that I have read this ApplicaUon and state that the above is rnrrect and agree to comply with all City Ortlinances and State Laws regulating building construction. Siynatureof T�{�p� COrIPANY i PP.f TI}tPPi�_ �1 / . Valuation � PermitFee$�0' � � Plan Check $ � S � �� OU Total �� Fee $ RM 204 S-HP 2M 8•55 APPROVALS �n Location Inspector Materials, �inning 1'B Stop9. Masonry Reinforced Bond Beam FINAL p —/ -�/�SS � -�.`, Data 0 , ' .S ' " . . � `: , . Y LV 1 Y LL�l\ Show Iocation and distanee9 from property line and between buildinga � �t; Y�. �.w + : JG 1�:JSPI1vESAA�3Sa 23 �� i.`:ii'i: _ - i. . , _ . t . _ •. � . _ .' ' A . . • .z_.�;�.