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HomeMy WebLinkAbout1577 CORSICA PL - Building Permits(7.14) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.®WILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1577 CORSICA PL Suite: Vicinity: Primary Occ: R3 Parcel Number: 13919216 Applicant: YOUNG, JEFFREY W Address: 1577 CORSICA PL COSTA MESA, CA owner: YOUNG, JEFFREY W Address 1577 CORSICA PL COSTA MESA, CA Contractor: OWNER -BUILDER Address: Zip: Arch : Address: Phone: Zip: License: Type of Construction: V -N Zoning: R1 Phone: 714-546-4439 Zip: 92626-3733 Phone: 714-546-4439 Zip: 92626-3733 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 05!302006 Issued: 05/30/2006 ISSUED BY: ( ZZ V�_ C_ Phone: License: SCOPE OF PERMIT NEW EXTERIOR WINDOW NEXT TO THE FIREPLACE. LOWER EXISTING WINDOW IN BEDROOM 2 TO COMPLY WITH UBC SEC 310.4. REMOVE WALL BETWEEN THE DINNING AND LIVING ROOM AND INSTALL A 4X10 BEAM. FEE SUMMARY Plan Check: $63.21 Permit: $97.25 SMIP Res: $0.50 SMIP Com; $0.00 Other; $0.00 Inspection; $0.00 Total: $160.96 PLANNING & ZONING Calc Valuation: $4,000.00 Claim Valuation: $4,000.00 SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0- 0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (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 if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 [aao-aa (aw) DECLARATIONS WORKERS' COMPENSATION DECLARATION: 4 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation. as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 Jr ❑ I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Carder: Policy Number: (This secdoa need not be completed if the permit is valued at one hundred dollars (5 100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions Of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), W ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Uc. N Class M Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affiml that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 at the Business and Professions Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions e: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) e se pursuant IO the Contractar5 License Laws.). examp undersoc. Business antl Professions Code for this reason: a 0:ve' d nve c ❑ No Dr' ea License eeE firen of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth Into which a person Is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has e permit to do such work from the division. Signature: Dale: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ NO (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 Cubic feet of compressed . . ...._. ..__.........._................._....................... .__._.......... __........... __.......................... .............. .. .... 2 Does or will the applicant or present or future building occupant need to file a registration torn for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials aqua to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). es or_........._................-._...........sento.....___..........._._....."up'.............. d--t"-p—re..........................._....(RI's,Ir.......................................................___....................*o.r ..-.._.t.e.1'........_._-r'd- ........._.............Is*) _ 3 Does or will the applicant or present or Future building occupant need to prepare en RMPP (Risk Management end Prevention Program for acutely hazertlous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .__.._..__._.._......_..____...... tlyreq._.__............._.....................................___...........................__._..................cle,....__.____........._.............__............................._.................._......... ...................._............. ......__. 4 II en RMPP is presently required, has Section 25534 of the California Health and Safe. Code been fully complied wiN7 ❑Yes ❑.No 5 Does Or will the applicant or present or future building occupant require for the work which Is the subject of this a plication a permit for such construction or modification from the South Coast Air QualityManagement District or from any other air pollution control district or agency? Yes jJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ..............................................................................................................................................__._.....-...................._......................................._...................._.........._....................................__................_...............................................__. 8 Will any part of the facility to be constructed under this permit be within 7000 feel from the outer boundaries of a school? ❑ Yes ❑ No (It "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................... ..... _._............... _......................... .... ... _.... ... .._........ _..___.__........... ___...... -.-__............... _......... _............. _.............. _._.._............... -.................................... _.... ....................... I .... _._.............. _. 7 II a permit from the South Coast Air Oualiry Management District or other air pollution control district or agency Is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ......_._................_.........._................_......................................................................................................................................................._._............................................................................................................................................................ 8 (If 'yes-, attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above -des ed properly for ins action purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. D lure O at Own - ate And/Or Whorized Applicant Data CODE 1. INSPECTION TYPE gAj$ ISL$ CODE.d INSPECTION TYPE PATE IRMA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BulldinglOccupancy Z % (714) 754-5273 - Fax (714) 754-4856 • www.ci.costa-mesaOL&DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1577 CORSICA PL Suite: Vicinity: THROUGH OUT HOUSE Primary Occ: R3 Parcel Number: 13919216 Applicant: YOUNG, JEFFREY W Address: 1577 CORSICA PL COSTA MESA, CA Owner: YOUNG, JEFFREY W Address 1577 CORSICA PL COSTA MESA, CA Contractor: OWNER -BUILDER Address: Zip: Type of Construction: V -N Zoning: R1 Phone: 714-546-4439 Zip: 92626-3733 Phone: 714.546-4439 Zip: 92626-3733 Phone: License: 000000 ISSUED BY: Status: ISSUED Applied: 04/05/2006 Issued: 04/0511006 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: CAW413E OUT����22 WINDOWS AND 1 SLIDING GLASS DOOR EET 197 SHALL MUBC EGREES REQUIREMENTS. NO OTHER WORK AUTHORIZED UNDER THIS PERMIT. REF#: C06-0585 FEE SUMMARY Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.70 SMIP Com: $0.00 Other: $139.25 Inspection: $0.00 Total: $279.20 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existing: 0 1 WINDOW IN BEDROOM #2, NO CHANGE IN HEADER. Calc Valuation: $7,000.00 Claim Valuation: $7,000.00 Rear 0-0 Left 0-0 Right 0-0 Rear 0-0 Left 0-0 Right 0-0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (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 if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensatich, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensallon insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) E]—1 cer ify-that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' .cornpensation laws of California, and agree that It I should become subject to the workers' compensation provisions of Section 3700 of the Labor Coda, 1 shall forthwith comply with these prov ons.. / Applim M.Signetu . T /L1/ 4 -- l�Daie:A—//—i In WARNING:.FMWRE TOS RS' SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLIOYER TO CRIMINAL ANAAES AND CAVIL FINES UP TO ONE HUNDRED THOUSAND D0LLARE Is 11 ,000),IN ADDRI O E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION a06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full force and effect. Lic. a Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Dlvlsion 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): -pt— as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or Offered for sale (Sec. ✓'7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. IL however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am oxemp untler sec. Business and Professions Code for this reason: tOwnerv IDa�ogdYy flice es ❑ No DrtvefsT1censexNo. Expires:_ Verification of Ownership by (type of dodumem, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feel in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2. Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and comity a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a to oned year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ....................................._........._................................................................................_..........................................._............................................................................................................._................._........................._................._..........__...... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ._....................................................................................... ................................................................. .......... .............................................. ............................................. ............. ...................................... ... ........... .................. ................. ............... 3 Does or will ENO or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous matodals)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, codification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..................................................se'*..........."q"u..................................................................'C"a..ifor.............................................'-6-.....................................................w" ith'?*........ ..e ....................................................................................... 4 If an RMPP is presently require0I. has Section 25534 0.. the California Health and Safety Code been fully complied with? [3 Ye ❑ No ..................................................................................................................... ildi........................................................................................................................................................................m......................................................................cati........ 5 Does Or will the applicant or present or future building Occupant require far the work which is the subject c this a plication aEEermit for such construction or modilicetlon from the South Coast Air Ouellty Management District or from any other air pollution control district or agency? � Yes L_1 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ..11 6 WIII any par of the ladlity to be conslructod under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ................................ ............................... ._......... _........................................................................._._........................... ............................................................................................................................................................................................. 7 II a permit from the South Coast Air ouality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .._..........__........._._............_—_................_............_..................................................... ............ _._._........._........._............._.......__._..... _.._...... ...................... ___.......................___........................................................................ B (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I comity under penalty Of perjury that I have read this application and state that the Information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above nbe property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. 62Z 7— nalureOlLegal Owner(s) And/Of Authorized Applicant Date �z CODE 1. INSPECTION TYPE PATE INMRAL CODE. INSPECTION TYPE PATE 1NTIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final BlocklRetaming Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 2G4 Final Demolition 250 Final Building/Occupancy 12 Z 9 6 s y C PROJECT ADDRESS: '577 CO l., ICA PL UNIT: OWNER'S NAME: TONER GEOFFREY O TR ADDRESS: 2743 +,LTA VISTA DR NEWPORT BEACH,CA 92660 ARCNIE NGIN EEO: 644-1393 flEG.NO.: ADDRESS: UNIT: PERMITTEE: EARLS PLUMBING (714)772-3470 ADDRESS 1533 W. LINCOLN ANIANHEIM CA 92801 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under previsions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY 1005938 STATE LIc.:2 17 6 5 7 CLASS rT Date .� Signature: WORKE S' CO PE ISATION DECLARATION. I hereby affirm I ave a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. Q. POLICY NO.;'339225-93 EXP. DATE: 03/01/94 COMPANY: STATE ❑ Cer if/Ted copy is hereby furnished. 21 Certified copy is filed with the city Building Division. Date: J Applicant: E%EMPTI NFR AWO8SERS' COMPENSATION DECLARATION: (This secenr be completed it the permit lshrone hundred(S1(10) or less). I earthy that In the berlormance of the work for which this permit is Issue shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cade. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ, Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsStale License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). I. as owner of the property or my empployees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that Such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that steel of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above Information is correct.I agree to comply with all ally and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property led Inspection pur�pposes. Date'. J > Signalum Driver License or Social Security 164146 White—Building: Green—Code Enforcement: Canary—Applicant Pink—Revenue: Goldenrod—Assessor C`TY OF COSTA MESA — 31UILDI:,G P,:2MII ?_ttM XO: P 062085 PERMIT NO: P 062085 PLAN CHECK NO: IN GOVT; N —' -PJ; N CONSTRUCTION TYPE; PERMIT TYPE: P: JOB DESCRIPTION : WATER HEATER INSTALLATION SQ FT: CLAIM VALUE: CALC—VALUE: GROUP UCC: / COMMENTS: X ZONING R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IF RGHT: FT IN PARKING REQ• PROV: PARCEL: 13919216 ZNE: REF NO: PLANNING N TES> 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 ZONING APPROVED BY 1 DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY:DATE: LEGALIZATION:N F E E S U,;'M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRJC;%MECHANIC FIRE SNIP/RES GRADING PERMIT 7,00 25%LAN i. SMIP/NON—RES ISSUE FEE 20.00 l BUILDING—DIV—> PERMIT ISSUE PBANTCHECK TOTAL PAID DUE TOTALS ---- > 7,00 20,00 ,c 1 27,00 27,00 ,00 REVENUE DIVISION TOTALS--> COLtECTED4 27.00 OVER/SHORT; 00 SLUG PICT PLUMBING ELECTRIC ME�HI�NIE FIRE SMIP/TOT GRADING P:,AN—CtIECK 27,00 ✓ I N D I V I D U A I,• 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 PLU 1 WATER HEATER AND/OR VEN'P^? 7,00 7,00 END•Or FEES 1993 MAY n 7 CITY OF A Nr1ESA CONSTRUCTION AND PLANNING POOI PA APPROVALS Permits Date Inspector APPROVALS Permit ;� Date In 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location j ! 7 So! Piae Undrgrnd. 53. Steel Reinforcement 3. EI.:-c-rlcal Conduit Utility-Undrgrnd. 54. Forms 4. F'ec!real Conduct-Undrgrnd. 55. Electrical Bond -no 5. Steel Reinforcement 56. Rocyh Pl imb,ng & Pressure Test , 6_ E' c. .cz. UFER Grnd_ _- -- -, i 57. APPROVAI. TO COVER GUW+ E � 7. ',rotrigs 58. Electrics! Conduit-Undrgrrtp. 6. Foandat:on 59. Gas Pipe, CI Undrgrnd., Test 9. - ',ldter Pipe Undrgrnd. 1 60. Backovash Lmes, P -Trap, Undrgrnd, 10. Svuetural Floor System 61. APPROVAL TO DECK 11. %'ope';y Srwer Linn & House Connection 62. Backs-vash & Receptor Final --� 72. Server Cap 63. Neater & Vent -Final 13. 1+-.. P.i_,+ Craws Reun'a Plumbing 64. Plumbing System r:nal 65. Electrical -Final I 66. Solar System -Flnai --- 15 Ro_gh electrical -Conduit j 16. Rough Electric Wiring 67. Fencing & Access Approval .7r:ng S.gn 68. APPROVED FOR PLASTERING 18. Rough Electrical T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 79. Remi, Pc.,.-] & Air Ccndition.ng FIRE DEPT, REQUIRE:MEN i APPROVALS Permit ' 2C. Ru,.yh Factory F:rep,ace 21. Duc+s, in S7,mre 70. Lnd•gro uroi L:sr:o : 7.2. Ousts, Vant+satin 9 77, Product Pip;ny : ] G.n ZE Oil 23. -_-_- Ga: '.pc-Rou p &Test 72. Undrrgro.:d Flu; . 14. Roof Framing 73. Undergrnd. Storage Tank rLD Ga: _, 01, -T--- S`_L thing 74 Ovonccad Hydro 26. -i E.r• Co lino (Structwal) & wloriccoat 75 Dry Chemical lashing 76. Dry Stzr*c;r. , c 8. La to ng +U Siring j 77. FIXED Sv , E." + ,r'.Al_ - TSu.aL on 78. FIRE PREY. It 0. Drys_.a i_!a:!;ng l:aALTH DEPT REQUIRERiE:%!T - j 31. paetcr E u.vn Coat I}- 79. FINAL INS, ECTION ---- J 32. E,:_ :..ail Poker Mcier.F,na. T l 30. FOOD CERT.FICA7t ISSUE:: -- 33, F:nzi El.:ct�.c Mc"es:6/i143 No0K��ON7'E.^LlcFrGaZo- l.eb _l------ -- - - -- / � 2.0(43 f,(ooniE. �loyrlE- L.o.-ior"co&o- L4w - ' 34. F.nal PeaLrg & A,, Cor.dition:ny I 35, _ Final Gas P, w -Test - ----- -- --- ----- - - - -- 26. Hvod or Car;py , ----------- -------- ----- r_3_7,7 nal Factory Fireplace r- ;.l P��!mu:r. 36. F!ng - 39. 'dater Service -Final ------------_ - --- Scrsl[l-Final 41. Solar Domestic -Final -- ---- -----`-- -- ----- 2. 8i-cf:c:: Prevanter --- 43. Backflow Irrigation 44. 1 ,:-scane irrigation Sy5tem - ---- -` _---_ - ----- -- - ----- -- ---- - -- --- ----- ------ 45. Sound Attenuation - -- "IS.HandicapRegulations 47. FINAL STRUCTURE & BUILDING _ I-_______---'- ---- - --- 1 8 PI_ANIMMG -FINAL 4S. Electric Rnleme to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY - - -� No. Date PROJECTADDRESS: 1577 CORS ICA PL UNIT: OWNER'S R'S NAME: TONER GEOFFREY O TR ADDRESS: 2743 ,ALTA VISTA DR NEWPORT BEACH.CA 92660 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: EARLS PLUMBING ( '714)772-3470 ADDRESS: 1533 W. LINCOLN ANANHEIM CA 92801 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.:r STATE LIC.: CLASS: 0<0/, 38 21.765 7 -36 Date: � Signature: WORKER OMENSATION DECLARATION: I hereby affirm that e a certificate of consent to sell insure or a candidate of Workers' Compensation Insurance. or a certified copy thereof (Section . Lab. C). POLICY 11339225-93 EXP. DATE: 03/01/94 COMPANY: ST ATE ❑ Certified copy is hereby furnished. © Certified copy is filed with the city Building Division. Date: % Applicant: " EXEMPT( FA d WORKERS' COMPENSATION DECLARATION: ecban need not be completed if the permit is lot one hundred ($100) or less). I certify that in the performance of the work for which this per it is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law far the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to life a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapler 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) orthat he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($SOO). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended at offered for sale (Section 7044. Business and Professional Code: The Contractors' Slate License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered lot sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting wOn licensed contractors to construct the project )Section 7044. Business ❑ ano Professions Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' $late License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: 0. & P. C. for this reason: Dale: Owner I do hereby Bendy that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505, 25533, and 25534 and that 1 or any future building occupant will ill not (circle ane) need to comply with said state codes and the requirements for a permit lot construction or modification from the Air Duality Management District. Residential construction applications are exempt Irom these Provision$, Dale: Applicant: I hereby certify that l have read this application and state that the above information is correct. l agree to comply with all city and county ordinances and slate laws relating to building construction and hereby autradi representatives of this city to enter upon the above mentioned property for inspection purposes. Dale: 'ell? Signature:/! •��'� Driver'License or Social Security 1641.45 Wrule—Building; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDLNG PERMIT' PERM NO: P 061611 PERMIT NO: P 061611 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOSE; OTH JOB DESCRIPTION INSTALrLED WATER HEATER SQ FT: CLAIM VALUE; CALL -VALUE; GROUP OCC: / COMMENTS; NO OTHER WORK AUTHORIZED BY THIS PERMIT Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13919216 ZNE: REF NO: PLANNING N TES> REVENUE DIVISION TOTALS--> COLLECTED; 27,00 OVER/SHORT: > BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.00 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 ZONING APPROVED BY DATE; BUILDING APPROVED BY DATE: APPLICATION ISSUED BY; ## � 4- DATE; I21� 3 iF 1�Riia iF'7F3i=F3Z##iI%######z LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 1.00 258 SMIP/NON-RES PLAN ISSUE FEE 20,00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 7,00 20,00 0,00 27,00 27,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 27,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.00 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 PLU 1 WATER HEATER AND/OR VENT 7,00 7,00 END OF FEES CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL ,PA Permit=„` Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. i 10. Structural Floor System l 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 74. Rough Plumbing 65. Electrical -Final 15. Rough Electrica[-Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencinp%&. Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit ,- 20. Rough Factory Fironlace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping L7 Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas O Oil 25. Roof Sheathing 74, Overhead Hydro �- 26. T -Bar Ceiling IStructurall & Monocoat 75. Dry Chernical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31, Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final --d 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy r 37. Final Factory Fireplace 38. Final Plumbing // 15 y-�, // -3 39. Water Service -Final 40. Gas Service -Final ' 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1577 CORSICA PL UNIT: OWNER'S NAME: TONER GEOFFREY 0 TR ADDRESS: Y743 ALTA VISTA DR NEWPORT BEACH,CA 92660 644-1393 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: EARLS PLUMBING (714)772-3470 _ADDRESS: 1533 W. LINCOLN ANANHEIM CA 92801 LICENSED CONTRACTOR DECLARATION: I heresy court that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in lull force and effect. CITY LIC.:005938 STATE LIC. :217657 CLASSIC -36 "!f Late:.} v 447` Signature: - WORKERS COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to self -insure or a certificate of Workers' Compensation InsurajC .Qyryy ggrufi�g�jQ spy thereof (Section 3800, Lab. C) POLICY NO EXP. EXP. DATE: 03/01/94 COMPANY: STATE Certified copy is hereby furnished. 9 Derailed copy is filed with the city Building Division. Date: / //x • Applicant: - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This sudden need get be Completed if the permit is for one hundred ($100) or less). 1 teddy that in the performance of the work for which this permit is issued, I shall not employ any perform any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If. alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwhh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractors State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) of that rte/she is exempt therefrom and the basis for the alleged exemption, Any violation at Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars ($500). ❑ I. as owner of the property or my emDloyee5 with wages as their sole compensation, will do the work, and the structure is not Intended or offered lot sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered Ior sale. If, however the buildrmg or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve fpr the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. S P. C. Dor this reason: Dain'. Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any Were building occupant wiNvrill not (circle one) need to comply with said state codes and the requirements lot a permit for construction or modification tram the Au Duality Management District. Residential construction applications are exempt from these provisions. Dale. Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale taws relating to building construction and hereby authorize representatives of this clay to enter upon the above mentioned property for inspection purposes. Date- "/ ' Signature: 1c:1 Driver's License or Social Security 1641-46 While—Bmlding, Green—Code Enforcement; Canary—AmPlicanC Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 062085 PERMIT NOs P 062085 PLAN CHECK NO3 N GOVT: N SUPPs N CONSTRUCTION TYPE: PERMIT TYPES PLU PURPOSE: OTH JOB DESCRIPTION s HATER HEATER INSTALLATION SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / COMMENTS: X Z 0 N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNTs FT IN REAR: FT IN FRNTs FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHTs FT IN PARKING REQ-NG PROV: PARCEL: 13919216 ZNE: REF NOS 7 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 ZONING APPROVED BY DATE: BUILDING APPROVED BY s DATE: APPLICATION ISSUED BY: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENTSN PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 351 SMIP/NON—AES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7.00 20.00 0. 0 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED27.00 OVER/SHORTS 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 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 PLU 1 HATER HEATER AND/OR VENT 7.00 7.00 END OF FEES MAYO 7 1993 CITY OF COSTA MESA OWNER COMA*. INC. - DATE 5-14-59 JOB ADDRESS 1577 Corsica Pl. BUILDING PERMIT NO. 93. GRNF.RAi, CONTRACTnR Ili ke A4 Colearove VALUE S 1,552.00 AP. No. LOT 74 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK Res. w/att,Gar INSPECTIONSy-in DATE I GROUP TYPE ZONE A 1 Underground Soil /h„LSU.G. Water — SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous 7—b-6' Prop. Swr,."Line—HQuse-Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test ,. 4 ---- Construction Pole Underground Power , Rough Wiring AZ7J Y _ O -/-59 9r9 > Trenches V Forms v Steel t2 Floor System Steel Reinforce Chimney Re -Rod - Bond Beam Sheathing Frame and Flashing Lathing, In Out nP v- 7- r -S Plaster, brown coat 3— Plumbing Fixtures, Final Electric Fixtures Final Building, Final OCCUPANCY I Form 210-3M-4-59 9313 1. 9313 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. CALIFORNIA FOR APPIXINT TO f/LL /N COMPLETELY TYPE OR PRINT BUILDING ADDRESS 1577 Corsica Flo COSTA MESA, CALIFORNIA OWNER Comesa. Inc. RMIT NO. MAIL��E. ADDRESS I.t1 17th St.17th St.$ USE OF none CITY EXISTING BLDG. TND. LIS11 ARCHITECT Carl SOn & LIG. OR ENGINEE SIDE YARD ILEFT 5' IRIGHT 7' NO. ADDRESS Garden Grove NEW I x II Dike & Colegrove, Inc. STATE 167293 CONTRACTOR I LIC. NO. ADDRESS 419 E. 17th St., Costa Mesa ESCRIPTION I NOT 74 I BLOCK I 41Y A.P. NO SIZENO. 62 OF BLDGB. RMIT NO. OF LOT X 0 NOW off 10370ne USE OF none DING ADDRESS EXISTING BLDG. SETBACK LINE FROM 55' 521 CENTER OF STREET REAR YARD SIDE YARD ILEFT 5' IRIGHT 7' DATE DESCRIPTION OF WORK NEW I x II ALTERATIONI II ADDITION I REPAIR I II MOVING I I DEMOLISH I BUILDINGNO. OF 1450 6 1 SIZE ROOMS STORIES EVES ALLOWED (CENTER LINE 8T.) FRONT EXTERIOR WALL ROOF Shingle IN. COVERING Stucco COVERING �/ FT. USE OF BUILDING AND WORK TO BE PERFORMED L. SIDE Sin le %a it diaellin with IN. attached double garage. :27>9f_ Plan 140B 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM` PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE O PERMITTEE AUTHORIZED AGENT Dike & Cole rove Inc. f" I AY 1 s IIs9599 FINANCE DEPT. C!fy or Cl1ITA P1CSA APPLICATION FOR PERMIT BUILDING FOR Off/CE USE ONLY RECEIPT NO. RMIT NO. pEC VED B I DATH RECCIVEDSIZ DATE 1 UE` [7J DING ADDRESS COSTA MESA, CALIFORNIA FIRE ZONE APPROVED / BY DATE { ZONING ZO I / NO. OR PLAN9 USE OR NEW O BLDIN W BYPROY /(I DATE YARDS REQUIRED EVES ALLOWED (CENTER LINE 8T.) FRONT r / U C FT. IN. R. SIDE �/ FT. IN. L. SIDE S� FT. IN. REAR :27>9f_ IN. THE AMOUNT SHOWN UNDER VALUATION IH FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION '1 / PERMIT FEES 34.00 $ +4,552. PLAN CHECK $ 17-00 TOTAL FEE 5 51-00