HomeMy WebLinkAbout3234 DAKOTA AVE - Building PermitsCITY OF COSTA MESA
� BUILDIN6 DIVISION
� j DEVELOPMENT SERVICES DEPARTMENT -�- - J8-00486
� � PERMIT PERMIT NUMBER
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(714) 754•5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 3234 DAKOTA AV
Suite No
Vicinity:
Pareel Nunmber: � 13908509
Applicant: NUNN, JEFF
Address:
_ -- -� � � - Status: ISSUED �j 1 {
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, � Applied: O6I18/1998
Issued: O6/1811998
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- , .Phone: 714-556-3750
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Owner: SMITH �AMES 8 -, �� � : _-_. . � � � � � � ;�',
Address 3234DAKOTAAVE\ � j; � , � .-.� .._ ��.�--..� _ -;� _ � �� •�,'���
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Contractor:= � NUNN,'JEFF � � i
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Address:�� NUNN CONSTRUCTION �`� � � � �.
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-, COSTA MESA, CA Phone: }�; 714 556 3750 .' `- '
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� � 1875 KINGLET CT. ::Zi� 92626.� �,� � ' , �
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, - %License:461751 , ,a ' .
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Address: ' . �: - " • '
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�� � ��. ` -SCOPE OF PERMIT .; �
�t - � �� , � ' „ENL'ARGE 7WO�BEDROOMS. i . � . � �
' _ - � - FEE SUMMARY/� � � �
��'�� �- � � �AMT QTY , 'AMT� � QTY � - . �AMT QTY
ISSUE FEE '' S22;00 Laundry Tub / Washer =$0.00 _0 Sump Pump �. . ��$0.00 0
BackFlow irtigation ' '�S0.00 0 Landscape Irrigation $0.00 0 Swimming Pool ,- _ $0.00 0
BackFlow Preventer -� i 50.00 0 � P-Trap �_'� - $0.00 0 Trep Primer� i -� :$0.00 0
Bathtub . � � � - 50:00 � �. 0 Pressure Regulator' :' '� "�.$0.00 0 Urinal �, � ", $0.00 0
qanfler System -, � 30.00 �' � 0 Process Piping �(per 10;8); -$0.00 0 Vacuum Brkr Bkflow(1-4) �, $0.00 0
Connectpce,Soda,elc) 50.00�:���0 � Receptors���,;,.���r% •$0.00,� 0 VacuurriBrkrBkFlow(5+� ,$OAO 0
Dental Units ' E0.00 ��0,� � " Septic Tank�� �" �� - � -$0.00' 0 �_ - Wash Basin $0.00 0
Dishwasher � 50.00 0 �N'��� _: ;Sewer Cap for Demo � "r� $0.00 =0 � � Wash Basin Set - , � $0.00 0
Drain, Floor � , 50.00 . ; 0 � �� �Sewer Connect . -r-� � $0.00, � 0'� : �.- Waste and Vent System $0.00 0
Drain, Rainwater $0.00 ,'� 0`� �� - -Sewer,priyate Line ` � ; :"$0.00��„ �0. , ,Water Closet (Toilet) $0.00 0
Drain,Roof $0.00- �0 �,�-�� Sliower �' - . �$0.00 � 0 , " WaterHeater/vent $0.00 0
Drinking Fountain $0.00 �� 0 . ' , . . Sink, bar . __ - . $0.00 0 � Water Piping (Inst or Rep.) $0.00 0
ExpansionTank $0.00 . 0 �., �Sink,.commercial $0.00 � 0 WaterRe-pipe $0.00 0
Gas Earthquake Valve $0.00 � -0_ � �. Sink, Flooi � � " , � $0.00 0 , Water Service $0.00 0
Gas (7-4 outlets) 50.00 ���0 � �Sink, kitchen , , , , $0.00 � 0 , Water Softener $0.00 0
Gas (Over 4 outlets) $0.00 0 � � � Sink, service/mop � . �� $0.00 0 , , �, OTHER $0.00
GasRepipe 50.00 0 .Spa�(private) � So.00 0' . VIOLATION So.00
Gas Service $875 1 Spa (publiy - - - , . $0.00 0 PLAN CHECK $0.00
Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors (Sand Auto ) $0.00 0
TOTAL CALCULATED FEES: $30.75
COMMENTS / SPECIAL CONDITIONS
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EXPIRATION: This pertnit shall aulomatically expira and become void if work is not commenced within 180 days, or H work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work euthorized under this pertnit to be considered legal, such work must comply with ell applicable codes, and all
requlred Inepeetlons end flnal epproval must be obteined. Failure to obtain inspections and final epproval wlll result in the expiration of ihis permitxr'
FOR INSPECTIONS CALL: (714) 754-5828
WORKERS'COMPENSATON DECLARATO7�
I hereby eKrtn under penalry at perjury one W Ihe tollaMng dederaUons:
❑ I have enA will meinteln e certificate of cansent to eeN-Insure lor workers' cwnpensetian, es provitleE for by aecllon 3700 of the Lebor Code, tor �he peAormence of ��e
Jwork for whlch IMs pertnit Is ltvued.
�[J 1 have ark wi0 melntain xroAcers' campensatlon Utwrance. as reqWretl Dy section 3700 0l Me Lebor Code� 1w Ne GeAwmer�ce of the xrork fa which Ws Dertnit lv issued.
My workere' pe setio Inw certier en pollq number ere: /� �7"�C� Cy�
Carrier; �I �� �'�P� Policy Numbar. ( J�� � i T J �/
(Th/s secf/ar need not be canp/eteO i/ Ne permitls velue0 et one hundretl dollars (St00) or less.)
❑ I certify ihet In the pertormance of t�e work 1or whlch Ihis permit is issued, I shall not employ any person In any menner sa as to become sub�ect to ihe workera'
compensetlon lew of Californle, and egree het If I should become sub�ed to the workers' wmpensetlon provlslons of Section 3700 of the Lebor Code, I ahell lorlhwlth
comply wlt� Ihese v i ^ �/'
ApPlicentSigneture: Dete: l'n �� h ��_
WARNINO: FAILURE TO S U O E' COM NSATION COVERAQE IS UNLAWFUL AND SW1LL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVI� FINES UP TO ONE HUNDRED
T}IOUSANDDd.IARE(E100, TO 00STOFNlAFENSATION,DAAKOES0.SPRWIDEDFIXiINSECfI0N31080FTHEUBORCO�E,INTEREST,ANDATTORNEV'SFEES.
LICENSED CONTAACTORS DECLARATION:
I hereby emrtn thet I am Ilcensed untler p ovl�ons of
tarce antl ettecL LJc. N
Contrectors Signeture:
9(commencing with Sectlan 7000) of DlNsion 3 of the Business end Professiore CoOe, and my Iicense is in full
Cless N
_/�'� Date: — —
CONSTRUCTON LENOINO.OGENCYI `
❑ I hereby eKrtn that there is e constructlon Iendinp epenq for Ihe pertortnance of the work for which Ihis permlt is IuueO. (Sec. 3097, Civll Cotle).
Lendefs Neme: Lendefs Address:
s�goewre:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eNirm thet untler penelry of perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professlons
Cotle: Any ciry or counry which requlres e pertnit to construct, elter, improve, tlemolish, or repalr eny structure, prlo� to its Issuance, elso requires tha epplicent lor such permlt
to tile e signed stetement Ihet ha or she is Iicensetl pursuent to ihe proNslons of ihe Contrectora Ucense Lew (Chepter 9(commendng wit� Sectlon 7000) of DlWslon 3 of the
Business flnd Professions Cotle) or that he or she is exempt thereirom end the hesis far the flllepetl exemptlon. My Noletion of Section 7031.5 by any epplicant for e pertnit
sub)ecls the epplicent to e civil penelry of not more then Ave hundred dallers ($500).):
❑ I, as owner of the properry, or my employees with weges as their sde compensatlon, WILL DO THE WORK, end Ne sirucNre is not Intentled or ottered for sale (Sec.
7044, Business end Protessions Code: The Contrectors lJcense Lew does not appy to en owner of properry who builds or improves thereon, end who does such work
himseN or �erseH or Ihrough his or her own employees, proNdeC ihet such impmvemenis ere not intentletl or oXered for sale. If, �owever, the builOing or Improvemen� Is
sold withln one yeer of completlon, ihe owner-builder wlll heve ihe 6urden ot proving Net �e or she dld not bulltl or imprrne far purpose of sale.).
0 I, es owner of t�e property,�em EXCLUSIVELY CONTRACTING WrtH LICENSED COHTRACTORS to construd the proled (Sec. 7044, Buslness entl Professions
Cade: The conirectors LJcense Lflw tloes not eppN io en owner of Droperty who bullds or imprwes t�ereon, and wha cantrects tor suc� project with a conirectar(s)
Iicense pursuant lo t�e Contractors License Laws.).
❑ I am exempt untler sec. . Business end Prolesslons Cotle tor ihis reason:
Signeture: Date:
Owner ID verifled by drlvefs license. ❑ Yes ❑ No Dnvefs License No. Eapires:
Verificetlon of Ownership by (type at document, I.e. • properry tex bill ar deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby ceniy ihet no excavetion 11ve (5) or more feet In tlepth Into which e person is required to tlescenq will be mede In connection wIU work euthorizetl Dy thLs
pertnit, anA thet no building structure, sceXoltlinp, falsework, or demolitlon or dLsmanlling ihereot, witl be more t�an ihirty-six (38) tee� �Ip�. (Chep. 32, Cary 2, Ari 2, Sec.
341, Tltle 8, Cellfomia Adminisiretive Code).
❑ As owner-builder, I will not employ anyone to do work whlch would require a pertnit irom Ihe DlNsion of Intlustrlel Sefery, es noted above, unless such person has e
pertnit to do such work from �he tlivision.
Signeture: Date:
Division ot Indusirlal Safety Pertnit Number:
CEHTIFlCATE OF COMPLUWCE AND AUTMOROATION OF ENiAY: 1 ceNty under penalry M perjury that I have read this epplication antl stete that the Information given is
conecL I egree to comply with all stete laws end ciry ardlnances relaung to builtling wnstruaion, and euthodze representelives af the Ciry of Costa Mess to enter upon the
ebove-descdbed property tor inspection purposes. I apree no� to occupy or allow occupanq oi eny 6uildinp euthodzed by ihis Oermit un�il fnal inspection.
CODE � ixevecnoxrrre '
1616 Flxed System Finel Fire Preventlon
1288 Pool Spe Pinel �
200 Finel Re-Roof
201 Final BIxWReteining Well
202 Finel Fedory Fire Place
203 Finel Sign
204 Final Dem
2a48d8
OAg U�AIS
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Date
yQpE� wsvetnoxTrve p� , �Lq
208 Flnel Mechenicel � �
208 Finel Plumbing �
210 Finel Electdcel
272 Finel Flre Preven6on
220 Final Planninp Approvel
222 Finel S0e
250 Final Bulltling/Occupency
�
�oonrssa em�axa: 3 2 3 4 DAKOTA AV
ox�ns'�liv�u�axw: SMITH, JAMES S
• .onnEss: 3234 DAKOTA AVE
' COSTA MESA,CA
A�L. IWIDIG ADDNE54:
1PCNIfECT OX EfANFEH:
uxT:
FLOOD: X 37
92626
uc.ea:
UNT:
cowm�crarsru� LEE ROOFING ( 714 ) 642-7223
CWiPACTORSNNWIO 1653 SUPERIOR
�u: COSTA MESA CA ��.: 349686
92627 urn:
uca.seo cotrrnacroxs oEcuR�noN: i nereey en:m w�e« ��� a�y uw i.m r�.ee �,od« pwmo�,. d cnm« e
(canmmriM wilh Sec�ion ]000) d Drviaion � d iM Busima uM Vmleaeione Cada, uM my Yoenee o in tuA bm end eMetl.
cmuc.No.:_028751 ����8 C-39 �SNo;.,34A4D86 EXP: 03/97
O�ER �IILDEIIDECL�N�TION: I haaby eff uMa penNy d �ury �lut I em uemq Imm ihe CaYMm lioeros Lew la tlr
Idbxvq ieesm (Sadion )031.5 &nnas aM Rvlectiona Code: R W a oounb v.Tid� nVam a V�d to avubuct. Mx. an>a+.
'vndsh. w repv enY el�ucNro. p'v io Ya uwerce. ebo mpw applimnl la vuch prme tolJe e eqrod elmemeM Mel he a�M
�oma w�n io �� nw�. a m. cwreao� �... �cnwe. a ��«pro .an s.a:� moo) w aVe� a a �ro
,udma enE PrMev'vm Cadel a ine� he v eM b ezemq iMMmn enE IM bem ta the NbW� aa�mNion. MY vide�ion d Saeun
]W t.5 W vry epplimnl lor a qrmu wEjeds Ihe apWira�t io e'ivY paroly d iM mpa tAen Ma huMnd doAe�� �SSW�.
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aMsedturaeblSwianlOM.Buairmand PrdmeiauCode:TMGanrenmLiwn�alewdonmtewN�oenbxnerdpropeity
who ddd� a mpowa ilwean. eM Mv does euM wA Nmaetl a MnN n Wwpl� hu a Mr wm emGM�. pa'� tlW acA
impaemeMa ue rM inteMed a otlemd /a veb. tl.Iwwever.IM WiMirp a inpwwineM b wtl wilhm arY� d wmWe�ian. tlw
owirorbuitlr wiY Mro Ihe WNen tl pwinp he a ehe did mi driN rc'vnpwe la iM pvpua tl�elel.
❑ i. a. wT., a me nw.m. �..a�.�wr owAa:w wen u��e �,u.aw. ro�uw u» o� tsee�, rou. e�.m..,.�a
Proleuoem Code: Tha Caureum Lieaua law Eom nol ePdY b en ormer W P�WMY xM duld� a'v�wws� �haaan W Wn
cmnam tor wdi pul�� xvh. mvree«Is) fumod v�uw io iM Cau�apare liorw leM.
� I em ezemq uMx Sa�ion: B. 8 P.G.. la Nu raeaon:
om.: o«�
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eM�lam�WudonvmoEifretionhomiMlv�iy ar�epsmMO'etritl.RaddwnalomprWianeWk'�iwva�a�snqtmmNw
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W OPKEfl'3 COYPENSATIOM DECIMATION: 1 Mroby Nhm �vdr pviMy d papvy ons d the WOow'vq Aetlert�ioro:
� I heva enE W mei�uen a cMXkeb d m�uent io aatlimun M xakai mmpemetian. n prwidod la bry Soqian 3]00 tl �M LeEar
coe.. i« ms vMo�,wK. a m. � i� w�n ma wmm a a.�a.
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,��«.n�'w.°�n4m�e.MY.�«'•S'IA E FOND �'�"�m�u• EXPZRES
c.m..:
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bmm abjeC to tM wvNsa' canpeneetion Nrn d Cafdmua, eM rs I dwld bcpiw aA�ea �o tM wMn'
rom�,.��, wa+ b,�. d s.a� a�oo w ina �e« coe .�jp i �i.mn in uo.. �o.;ao�..
me �J Y �od'c.m:
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S�ctlm 9106 al Cro LWor Cab, /ntwsst +� attomsy i/w�.
CONST1111CTON LENDINO AGENCY: I hereEy effirtn uMx elry d perjury ihel Ihere b e wnqrupion bMiiq epanry br IM
pMameMe d �M wak for wtiid� �h'v perml o'vwmd (�� �]. Civ. CI.
LENDEN'S NNIE:
LENOEfl'S ADDXE55:
I cMity ihm I heve reeE ihia epd�� � p�e thei Na ebove inipme�bn ie canw. I qrea �o oomply wi1M1 M ary eM munry aA'uwKm
vd eute lewa rdu'vp io buiMip wnMwion and hmebY eWvve reprsaenielrvas d ihe dry ro emr upon iM eEws�meMioned properry
r«����w�w�..MII HURKE
PnM Jeme
od.: � /�
. sl a owiro.i env� ppEm,u m,veeo
Si51-iB.WP WMe-BuikiqdSefery:Orean-Fle:Cenery-Appiunl:Pink-Rmenw:0okenmFMsem
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 078971
PERMIT NO: B 078971 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF 6 REROOF W/COMP. SHINGLES SQ FT: 5,783
CLAIM VALUE: 5,783.00 CALC—VALUE: 5,783.00 GROUP OCC: R—J /U-1
COMMENTS: X
x*��x�*��**+�*����****x*rt+��*****�*��*x***�*****�******x+�***+�*********��******�*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
--- -------- MAIN HUILDING ---------- -------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV; PARCEL: 13908509 ZNE: REF NO:
PLANNING NOTE&>' _
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1fiEfflElFfFiE�E1E1EfF3EiEiEiEiEiEiEfEiEiEiE�lEfEiEfE�EiElElElEiF3EiEfE3EaEfEiEiEiEiElkiEl6iEiEfEfkiE3flfiEiE�E�EIE1E�EiFfEifiFiEifiEiElklE�kfElEfEfEiEiFdEiflk
D E V E'L O P M E N T S E R V I C E S R E Q U Z R E M E N�T S
ZONING APPROVED'HY DATE:
HUILDING APPROVED BY : DATE: I-
APPLICATION ISSUED BY: � DATE: �,���j�� V
*iti�*k*iti�***i�i�ifi�*****i�*iFiF�iFiF7F3F�iFiFiF3FiF7F 3F'iFiF�Fifi�'iFiF"ffiFiF3FiFi�****�t**it�* it�i�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL' GMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 112.25 .58
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 112.83 0.00 0.00 112.83 112.83 .00
REVENUE DIVISION TOTALS--> COLLECTED: 112.83 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
112.25 .58
1E IE IE IE i! 1! IE 1E If iE iE 3E fE iE iE 1E 1E iE iF fE iE 3E �E iE �E iE fE IE k iE fE iE fElF iE �E iE 1E if �f !f if iE iF if if iE 1E 3ElE IE iE �E iE ik if if �E fE iE iE fF 3E iE if if if 1f fF if fE iF ik if 1E if �E IE IE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 5783 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 5,783.00
END OF FEES
�ONStRUCTION AND PLANNING � POO >PA
APPROVALS Permit # Date Inspector AppROVALS Permit # � Oate Inspector
��1. Temporary Electrical Service or Pahe 52. Pool & Equipment Locat�on
2, Soil Pipe•Undrgrnd. .' 53. Steei fteinforcement ��
3. Electrical Conduit Utiliry-Undrgmtl. - 54. Forms ' -
4. Electricai Conduit-Undrgmd. 55. Electrical Bonding !
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings � 58. Electriral Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water PiPe�Undrgrnd. �. � / 60. Backwash Lines, P-Trap. O Undrqrnd.
10. Struciural Floor SYstem � 67. APPROVAL TO DECK
t t. Propetty Sewer Line & House Con ection 62. Backwash & Receptor�Firtal ,�
72. Sewer CaP ' -
63. Heater & Vent�Final � �
73. Roof prains �. 64. Plumbing System � Final '
14. Rough Plumbing 65. ElectricabFinal
15. RougN Electrical-Conduit 66. Solar System-Final
i6. Rough Elearic Wiring 67. Fencing & Access ApProvai '
17. Rough Wiring Sign 68. APPftOVED FOR PLASTERING �'
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Fattory Fireplace RPPROVALS Permit #
21. Ouas, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O G. s O Oil
23. Gas PiPe-Rouqh & Test 72. Underground Fiush
24. Roof Framin9 73. Undergrnd.StorageTank OGas OOii
25. Roof 5heathing �`3��'/(y ��� 74. Overhead Hydro
6
26. T�Bar Ceiling (Siructurall & h4onocoai 75. Dry Chemicai
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Ins�lation 78, FIRE PflEV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Elecirical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: . , -
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Flood or Canopy _
37. Finai Factory Fireplace
38. Final Plumbing �
39. N'ater Service�Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System -
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING � �_c1� (Q�/� �
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA
CONSTRUCTION PERMIT
Applicanl [o flll In all ipace* except thofe wlt�in �eavy �orAa� Ilnes anG si9n a11 aovrooriate aeclantlons.
PE�IT N}��� TRA�Ta O._ LOT NO. BLD . .
(0 3�r. 5
Applicant'sMailingAddress j� • �C� 'fVPEOFCONSTRUCTION NEW ADD AL ERATION REPAIR
ProjectAddr855 ?.y�,/��� 4� ��� ��'/I� _ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER /�
OWnEf 5 Neme �`'� �� S S��"^ "^"'hone DE§ CRIP IONq F WORK ��� �� �—� u� ��' ���X � -
/� (� �-- A (�
Addr855 �Z��� .y-n"�.0 n�i4 TYPE OF PERMIT GRA�ING FOUNDATION STRUCTURAL A. P. qy�
Alch/Eng. Licen52 No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL PLNG. REF. qW ^
Addr¢55 ' ❑ �OTHER TO BUILDING
�7-/Jo „� i ct�oJ vhone q4�-9�"� PROJECTDESCRIPTION Sp.FT.S� - OCCVPANCV PE Y INE
Contractor's Nam /� . Y-�s�c—
Addresslmailin9) n�� ���'FS�"{'-� "�'��n� P��" V CONSTRUCTIONTVPE VALUATION$ Q�.sc� � LEFTSIDEYARD
- ����Li - ' ZON$ GRADINGCU.VOS. ACRES PKG.SPACEREQ.
License No. .
' LICENSED CONTRACTOR DECLARATION ' ' Remarks: � STREET WIDTH .
L.hereby,affirm that I am Iicenietl untler proviilons ot C�arler 9(commen<Ing .
wit� sectlon 7000) of Divislon 3 of tha Business antl Professions Cotle, and SPECIAL CONDITIONS:
�y Iltense is In (y II force anC effect.
cense f�I s/.— �-- 9•—� �—, L�@ nsa o.��'�9� �L'� PLUMBING ffy�, /�,Q�!/V �
Jate ��r/��/��i 5i t .✓ Iile _�I/1� _
WORKERS•COMPENSATIONDEC�RA�pN(j BefSink .
� I hereby �aftirm that I �ava a certiTiwte ot cdfisenYto ult-insure or a cerHiiwte • Backflow Preventer
, ot Workers' Compensatlon Insurance, or a certi(latl topy [hereof (Section -
. 3800, ub. CJ . . , Backflow Irrigatiou
Policy No. � � Company -
eCertifled copy IS �ereEy turnisheE. . BdthtUbS
CertNietl copY is filea with the <ity Builtling Divislon. � � .
Date ADO����t Clerifier5 �
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION � � DiShtYdSh¢f � '
(This secllon neeC not be comD�etetl if the permit Is for one huntlretl (5300) or
. less): � Orinkin Fountains
. 1 certlfy Shat in the Oerlormance of the work for which this permk isissuetl I 9
shall not employ any permn in any manne so as bec me subject.to t�a . �
, Workers' pa s ip Laws of Californi , Floor Dreins. •
Date � i9nature '
� NOTICE. Ii, af er making ihis tleclaratio yo o I becoma sub7ec[ to the Floor Sinks - � ��
Workers" Compensation provislons of lhe La r L tle, you must forthwith .' ,
comply with Such p�OvI510n5 0� thl5 ,pe�mit Shall DB tleemetl revokea. � GesService �� Outlets _-
CONSTRUGTION
I nereEy afiirrtl that
ot the work for
Lantler's Namo _
l.entlel'S AtltlIe55
OWNER BUILDER
-d he�e�v a!ll�m tha
tha pertormance
3097 Civ. C.l. �
tha COntrac[or's �IcenSe Law tOr thB
7031.5 by- any aOPlicant for a permlt subjects No -Spplicant to a clvil :
�analty ot not more than five hunOretl tlollars (E500).
I, ai owner oi Ihe O�operty Or Ty amployell with wdge5 as Meir sole ,
compensation wi11 ao the work, antl tne structure Is not Intentletl or oT(eretl
for sale �(Secfion 7044, Businass, antl, orotessional Cotle: The Contractor'S
LJcense Law tloes not apply to an Owne� of a prop<rty who builtl5 or intproves
tM1e�eon, untl who Ooes suc� wOtk himself/harsel/ or tnrough hls o� he� own
employ ees, provitlatl that SUCh Improvements a�a not IntenEBtl O� otteretl for
sale. I/, �owever, the bulltling or Improvement I5 soltl wlthin one year of com•
pletion, the owner wlll nave tha burtlen o/ proving he/she tli0 not builC or im- �
�rove lor tha purpose of sale).
1, as owner of tha proper[y, am exUusivaly tontracling with Iicensed con-
-tractorsto construct the Oroject (Settion �044, Buslness antl Professions Cotle:
The Contractor'S License law does not apply to an owner of property who
bullAs o� improvas thereon, antl who contra<ts (or su<h pro)acts wlth a con-
tractor(s) Iicense Dursuant to tne Contractor's UcenSe Law).
❑ 1 am exempt unGer Settlon B. d P. C. for this reason
Date Owner
I hereby certify that I have rea0 thiz applicatlon antl state that the above-
Informatlon is torrecl. I agree [o comD�Y w��h all ciry antl tounty ortlinances
antl state laws relaC�pg to builtling c,pnstructlon, antl �ereby authorize repre-
sentatives o/ Ihibqlry� to �er yryon the abova-mentlonatl Property for
Drlvers' License or 55� -
CMF 0865-06 rev. 12/82 WM1ite - BUIltling; Canary - APPi�wnt; Pink -
Kitchen Sink i
Cavatories
P-Trep �
Roof Drains �
Showers "
Service Sink J
Boiler
Duct - Under Ground .
Duct-Structural �
Duct - Ventilating
Exhaust System � Multiple ❑
FirepVFact. BIL ICBO #
Heating System & Ducting
� 6100,000 BTU � 100,000 BT
Hood or Tvoe I ❑
, I Registers •
Golaenrotl - As5es5or
Solar ColiectOrs '
Solar Piping
So1ar 7ank ' �
Swimming Pool w/Spa
Urinel '
Water Clouc
Water Heater - �
Water Service .
Reinspection Fee $15
laue Fee 'a 3',
IANICAL � ' .
Refrigeration System
❑0.100,OOOBTU ❑100,OOOBTU ' -
System Repair/Alteration � '
Reinspection Fee
Iswe Fee '
♦ +
$15
$ 3
Automatic Washer ,
Construction Pole
Cooking Unit
Dishwasher
Dryers ❑Gas �Electric
Fan '
F.A ,U.
Fiz[ures
Device Boxas �
Garbage Disposal
: Generator �0-5 KW �5�15 KW
.. Transformer �15�50KW
' �5U+KW
Meter ❑up to 700 amps
2oning APProved By
ApPlicetion APProved B�
Appliwtion Issued 8y
6936 4/li/8d
REAR VARD (TO P/U
RIGHTSIDE VARD '
PARK FEE $
��
Meier LJover100amps
Sub Panel �
Sub Pole ' •
'Motors �0-1 HP 01X-B
Inc.Solar �9-75HP �i6-15+
Microwave -
Pole Light _
Range ,
�1.9� TL
Standing Sectidns , '
Trash Compactor '
Reinspaction Fee $15
laue Fee ' S 3
Date '
oee6 �� 3
� ., .. /n.
SUMMARV OF FEES
BUILDING PERMIT $ ��`3•�0O�.. SMIP
PLAN CHECK $ "• -/aL PERMIT •
PLUMBING . $ ISSUANCE
PLAN CHECK $ GRADING .
ELECTRICAL $ ' �
PLAN CHECK $ ' MICR�FILM
MECHANICAL $ TOTALFEE
PLAN CHECK $ � LESS
' � � ADVANCEDPC
FINAL FEE
$ O. S�O
$
$
$
$
$
$
$
,�.�
a�
C� �CONSTRUCTION�AND PLANNIi�_ � � �' "' " - _ JL & SPA , - - . � � -
;' � " - ' _ '� Date '� ' Inspectbr ' � ' ' � - � � ' ' - - Date Inspeetor
- -APPROVALS .;, Permif# � � � APPROVALS .. Peimit #� _ -
. . � , .-
' ilr. Temporary Electrical Service or�Pole � - 52, Pool & �Equipmen£Location' . � � - -
`� r. - -
�� 2t Soil Pipe-Undr,grnd.,� '- � ��� .' . � 53_ Steel Reinforcement � . � ' -
r-
3' Electrical Conduit UtilitwUndrgrnd. _ � � �54. Forms' � � �
,
� 4. Electrical Cbnduit-Undrgmd. . � � ' � � • �55: Electrical Bonding . � � � �
Y 5. Steel Reinforcement. � � ' - - - -. - 56.., Rough Plumbing & Pressure Test � � .
6. Electiical UFER Gmd.� ` E - 57�, APPROVAL TO COVER-GUNITE
7. Footings � , �. � ' 58. ,Electrical �nduit-Undramd. .� ' .
8. Foundation , � , �� - � . • ' ' 59. Gas Pipe, O' Undrgrnd., Test .
9.� Water. Pipe iUndrgrnd. � � - �• -, '60. Backwasfi. Lines, P-Trap, O Undrgmd. .
10. Structural Floor SYstem � .' ." 61. APPROVA'L TO DECK - - '-
11. PropertY Sewer Line' &�House Connectiom • -. .�62. Backwash & Receptor-Final
i �
12. Sewer Cap ; �• ' ° " 't63. Heater & Vent-Final � � '
, ;n - - .
13. Rouf�Drains < < � ' . � .64. Plumbing System - Final '� �� ,
Q 14. Rough Plumbing � � � � � - �65. Electrical-Final � � '
' � 15�. Roiigh Elect�ical=ConHuit'i -T--'- • -" �" -' -- �- � - '� �-
�� �� T _. , 1 ; I - C 66.� Solar System-Fi'nal� '� � �� - - �'� � '
� :�16.''Rough Electric Wiring : � � � � .� - � � i . " "- - _', _ � '67.� Fencin9 & Access.Approval �� - � -
- ' 17. Rough Wring"Signr' ,' � � � - � - � ; � �68. APPROVED FOR,PLASTERING �
- ' 18, Rouyh Ekctrical.T�Bai Ceiling �' ' : � '' �" ' ,69. POOUSPA SYSTEMS FINAL _
� � 79�. NRough�Heating &�Air�Conditioning ._ i � , ! ` i . FIRE DEPT, REQUIREMENT � ;
''' ��0. `Rough_Factory Firgplace i �� � , � � APPROVALS Permit # , � -
�
21. iDudts, in Structure- ' - ' � ' ' � ' � '
__ _ � � 70. Unde'rground Hydro
' ,� 22. �Ducts, Ventilzting . „ � � � ' � � ;71: Product Piping � Gas ❑ Oil �
r
t��23.�Gas-Pipe-Rough & Test _ � _ �� 72; Underground Flush �
-24. �Roof Framing - ' • � ; � ' i , . ' � �73. Undergrnd. Storage Tank O Gas ❑ Oil '
�
' � 25. floof Sheathing � . ' I � , � I -. � .� , , ' 74. Overhead Hydro , ' '
a "
� 26. �T-Bar Ceiling (Structural) & Monocoat � _ - ' 75. D,ry Chemical r ' � '
, 27.,F�ameand�Flashing� �' � � ' � �, ; 76� DryStandpipe - ,
' 28. �Lathing & Siding � - � . �� � 1 � � ' �77. FIXED SYSTEM��FINAL � .
:�_29_�,Insul�tion .�� � � , , � i'76. FIRE PREV. FINAL
'- `-30. Drywall Nailing �,�,y !' � � � ' � � � � � � Notes: j �� ' A �' �
� :�31. Plaster Brown Coat, ' � � ' { ; ' � T
� Ta u G'
' ' 32. Electrical Power Meter-Final � i � � � ; � ��j
� -
33.�Final Electric ' � �� ' � � � ,L O �S �_
34. Final Heating &�Air Conditioning � f , � I i ' � .
. � �. �' t ` r � � � ,. . - . _., -
35. FinalGasPipe-Test ! _ - _ - �
1 �N1� ' I
36. Hood or'Canopy�`� °' i . , � � � .` � � , - ' • � � - . �
� ,�
37. Final Factory�Fiieplace' -: i .?' � � � . � ' � .-j,; � . ` , .
�
�
38. FinalPlumbing� ' � r� , ` � � � , � - .'
a
39. WaterlSeivice-Final � `, : � � � �� I � ' I � ; -
- �
, � . , , - � , ! . . ,� -. : ' -
.40. Gas Service-Final � i � � � ' � : ' � , I _' : '
41. Solar pomestic�Final ' - � � � � .., _ _ �_ � _ � __ �� �
� r -'
42. Backflow Preven;er � - • ' ' ' ` � .
i r- - --1 -- -i---- - - - �.
: i ' - � . ' i , . - �
43. Backflow Irrigation . . • . � - - - - , , ,
•� - i : i
��
44. Landscape Irrigation�Systemj •i � : � ` ' ' � � � � � ' � � _
45. Sound _Attenuation �. . � , , ; �" I j , � _ � -
46. Handicaj� Regulations' � � ' � , � � � _ � ' � , ' ., � " ' .
47. FINAL STRUCTURE'& BUI�LDING ' � � � � ' � � " � , .
� i i � �y7/1S: � i
48. Special Require'ments Completed ' � _ � `� � � � ^ � � �
49. Electric Release to�Edi,son � �' !_ ' _ _ _. -� _ ' ' _ ' � , �
� ' � i ' f ' -� -r 1'
50. Gas Releaseto Southe'rn CaliforniaGasCo � � � ' ' � i i '� '� • '
51. CERTIF�ICATE OF OCCUPdNGY _ _ . �_r. _,_ _ _ i ._., t ._� _.� '.._ . .
No V I Date ,
0
t CITY OF COSTA MESA
° BI/ILDIN6 DMS/ON
' --
F DEVELOPMENT SERVICES DEPARTMENT 698_0� 083
� � - PERMIT PERMIT NUMBER
•� �
(714) 754-5273 • Fex (714) 754�4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 3234 DAKOTAAV '—" '- . Status: ISSUED C�r1
Suite: , Applied: O6/18/1998 ��
. Vicinity: Issued: 06/18/1998
Parcel Nunmber: 13908509 Zoning: �
Applicane NUNN, JEFF __ �
Address:
Phone: 714-5563750 �
, ?�P�_ �.
Owner. SMITH, JAMES S;��!`�" �' � �� � ' ,i '� �
Address 3234 DAKOTA AVE' % = , � � ' � i ` - �
i, , , , :
/�'�i, � �,— � _� � Phone: , � � . . � _� -� . .-�
COSTA MESA;CA �" � - rLp: - 92626 - � �- � ���=�
- ��N� ' \ i .�-;� _ _ � - � _.-� `�. � � � V��� . A
������ � � � � _� � �1(��� l� A�,_�.
Contracror�NUNN,JEFF�� �
,( . � . � . ;.� `� � � ��� �.
Address J�NUNN CONSTRUCTION �' �� �, � � "
i
. i i � ��� C � �\��.\
,�(��� COSTA�MESA;CA'/� Phone: 7145583750 �V A:��`, i � �.`
� V� � � �
.�i � 1815KINGLET'CT Zip: 82626 �� _��� '
! :��i /�,-� i �� ' License:�:481751 � � � � . , =
�� � '..�A� � '� � �.
; � ' ' /: /, � "� �, . . _ .
�
Arch f Eng � y. y �
. ,iv i 1, � '�� �� _ .
� Address� J � ,�! iy' � : 7 _ - ` � . '�'
/ �. ',/ _ ; ..Phone'� i��..�`i' � ' ' + � ,t
� iy � . , J� ....- -r" - * . �d . . . -�..
/ � ' . , � � �r ( �Zlp�"'I - . .F �1 .
,� i ,.< .� License =� - � � �^. , h: , � �� `
� � , 1/, � � /..-/
�
� �' �� i,,; �.� .�% �,'�,-- � � SCOPE OF PERMIT � � ' �
� ,�' � � � i ENLARGE PNO BEDROOMS. '� �, � �
"��� � .l. � q ' •` ��. :I' 1 ,n � �'' ; .\ . � ,
�l. / � �' �. •
1 .��y " ' / .. . �-C'�'-��. . ' . ,
� � �
\' ' - - - FEE SUMMARY- _ _,-_. - '
� PIan�Check: ` �' $186.71 � ;', �• ��/ Calc Valuation: ' S2o,000.00 ` '
� `" Permit: „" $287.25 - ' ��"ti+2' �-` �,� � '-�,� "'' � `
�.•�=.. , . Claimed Valuation: $zo,000.00 .
�SMIP Res {, $2.00 - _ _ _-- `' ' _ . . i
SMIP�Com , �$0.00 - . � , ,
'',��.Other ��;;$0.00 , y_� � � � � �;
/,,
Inspection. . �• $0.00 � � _ — � �!;; � ��� '. `� �
����� ���;,, ���; ,'i,
'\:A `.�'' �ch, �� ." �,'i,
� Total: ` $475:86 • ;.� ' "' � `
����� �\� �� r'�-.( '�^- � �' ��
� �_ `r , ,� PLANNING & ZONING
� � ���� , -i ' �
�:�� �� � .; i - �, i �
,�, "
� V� � � ���Ar � �-��� i �,/ � ��. � i .
SETBACKS.' �.� :. �>__� r,�, ,;�.��3�� '� ��c% �i'i'
MAIN STRUCTURE Front �0 �0� " Rear � 0- 0 � � ` Left� 0- 0� - - � � Right . 0-�0 , �i. ! � ,
� _ �,-. - � _� - ' � ; - �; �
ACCESSORY Front 0- 0 i,'Reac _ 0- 0 � Left 0- 0 Right �� 0- 0' ',
' � ,��- -� . , , ' ������
- - - "i ,' • - ,- .
PARKING Existina: �--o- _� Required: 'o � � � Pr000sed: o � - � �
�. � f
NOTES: . � „ .
s
EXPIRATION: This permit shall automatically expire and become void if work is not commenced xdthin 180 days, or'rf work is suspended or abandoned
for a period ot 180 days.
INSPEC710NS: In order tor the xrork authorized under this pertnit to be considered legal, such work must comply with all applicable codes�d all
requtred Inepeetlons end flnal epproval must be obtained. Failure to oblain inspections and final approval will resuft in the e:piration ofzt rs permit.
FOR INSPEC710NS CALL: (774) 7545828
WORKERS' COMPENSATION DECLARATION: ,
I hareby aifirtn under penalry of perjury one of the tollowing tlecleretions: . � � � . ,
❑ I have end wlll meintain e certiticete a� consent to self-Insure for workers"compensetion, as provlAetl for by section 3700 ot the Lebor Code, for iha peAormence of the
/�ork for whiCh �hi9 permit is issuetl.
'[] I heve entl will mein�ain workers' Compensation insurence, es required by section 3700 W Ihe Lebor Code, for the peAortnance of ihe work br which ihis pertnl� is issued.
My workers' p sati n Insur certier ntl pollcy number ere: /�)�f��.%��/''�7
Carrier. ���� � Policy Number: V / > ' ' � J / /
(7h/s section need not b camp/etetl/l the permit7s valued et one hundred dollars ($loo) ar /ess.)
❑ I cetlify that in Ihe pertortnance of the work for which this pertnit is issued, I shall not employ any person in any menner so as to became subject to ihe workers'
compensatlon laws of Califomla, end @F�B Ihat if I shoultl become sub�ect to the workers' compansetion provislons of Sectlon 3700 of Ihe Lebar Cade, I shell forthwith
, pcomply wiM these visi /'� G �JC�
pllcant Signeture: Deta: l �0 �� O � r i'i
WARNING FAILURE TO S U <ER CO PENSpT7pN CpyER4GE IS UNLAWfUL AND SHALL SUBJECT PN EMPLOYER TO CRIMINA� PENALTIES AND GVIL FlNES UP TO IXJE HUN�RED
THOUSANDDOLLARE(5100, IN DITI TO HECp$7pFCOMPENSATION,DAMAGESASPROVIDEDWRINSECTIIXJ3/080FTHELABORCODE,INiEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eRirm that I em Ilcensed u er provisic
7orce end ettect. Lic. a %
Fontredors Si9neture:
CONSTRUCTION LENDIN�, �jG
❑ I hereby affirm IDat ihere is e
Lender's Name:
Signature:
(commencing with Section 7000) of Divlsion 3 of the Business end Protesslons Cade, end my license is In full
Class #
Date: �� —
agency for Ihe peAortnance of the work for which ihis Dermit is issuad. (Sec. 3097, Civil Code).
Lender's Address:
Date:
OWNER-BUILDER DECLARATIONS:
1 hereby eHirtn ihat under penalty oi perjury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Prafesslons
Cotle: Any ciry or counry which requires a permit tp construct, alter, improve, demolish, or repair any struMure, pnor to its issuance, elso raquires the epplicant for such permit
to flle e signetl statament that he or she is Iicensetl pursuent to Ihe provlsions of t�e Contrectors Llcense Law (Chepte� 9(commencing with SecHon 7000) of Divislon 3 of Ihe
Business end Professions Code) or that he or she is axempt therefrom end the basis for the alleged exemption. Any violation of Section 7037.5 6y any applicant for a permit
subjects ihe epplicaN to e civil penelty of not more then five hundred dollars ($500).):
❑ 1, as owner ot the proDerty, or my employees with wages as their sole compensation, WILL DO THE WORK, end the siructure is not intentled or offered tor sale (Sec.
7044, Business end Pmfessions Code: The Contrectors License Law does not eppty to an owner ol property who builds or improves ihereon, and who tloes such work
himself or herself or through his or har own gmployees, provitletl thet such improvements ere not Intendetl or oMeretl tor sale. Ii, however, �he bullding or Improvement is
sold within one year of completion, the owner-builder will heve the burden of proving ihat he or she did not build or improve tor purpose of sale.).
[] I, es owner of ihe properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe proled (Sec. 7044, Business antl Protessions
,\ Code: The contractors License Law does not eppty to en owner of property who bullds or improves thereon, and who conireqs for such pro�ect with a contrector(s)
license pursuant to ihe Contractors License LewsJ.
❑ I um exempt under sec. Business and Protessions Code tor ihis reason:
!�jnemre: Dale:
Owner ID verified by dnver's license. ❑ Yes ❑ No Driver's License No. Expires:
Veriticetion ot Ownewhip �y (rype of daument, i.e. - property ten bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMR CEpTIFICATON:
❑ I hereby certlly Ihat no ezcavation five (5) Or more feet in depth Into which a person Is required ro descend, will be matle In connactlon with work authodzed by this
permit, and t�at no building structure, scaffolding, telsework, or demolition or dismantling thereof, wiil De more then thirry-siz (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Tltle 8, Cellfomla Atlministretive Gotle).
❑ As owner-builtler, I will not employ enyone t0 do work which woultl requlre e permit from ihe Division of Indusirial Safery, as noted above, unless such person hes e
permit ta da such work from ihe division. �
Signeture: Date:
Divislon ot Industnel Satety Pertnit Number:
WIII �ha applican[ or present or tuture bullding occupent neetl to tile and certity e Business Plan tor emergency response to release or threetened release of a hazardous
matenel? ❑ Yes ❑ No
(Section 25505 ot the Celifomia Health end Setery Code requires, with some exceptions, that a Business Plan be filed wiih the Casta Mesa Fire Department by every
business which has et any one time during a reported year e quantity oi hezardous metenals equal to or greater than a weight of 500 pounds, or a volume of 55 qallons,
or 200 cubic feet ot compressed gas et stendarU temperature and Dressure).
................................................................................................................................................................................................................................... .....................................
Does or will tha applicant or present ar future builtling occupent neetl to tile a registretion form For ecutely hazertlous meterials7 ❑ Ves ❑ No
(Section 25533 ot t�e Califomia Heelth and Setery Cotle, with some exceDiions, reQulres regisiretion with the Coste Mesa Flre DeOertment 6y each business which at any
one time hes on hand a Quantiry of acutety hezertlous meteriflls equal to or greater then a welght of 500 pountls, or e volume of 55 gallons, or 200 cubic feet of
compreuetl gas at stanCard temperature entl pressure).
. . . . . ......... .... .. .. . . . ......................................................................................................................................................................................
Does or will the applicant or present or tuture Duilding occupant neetl to prapare an RMPP (Risk Management and Prevention Program tor ecutely hazardous materials)7
❑ Yes ❑ No
25534 oi the Celilomia Health
en� ot en RMPP by businesses
Ihat the Coste Mase Fire �epartment may require the preperation, certitication end tiling wlth Ihe Fire
ter acutely hazardous melenals with ihe Fire Depariment.
4 It an RMPP is presently required, has Sectioq 25534 of the Calitomia Health and Satery Gotle been tully complied with7 LJ Yes LJ No
.............................................................................................................................................................................................................................................................
5 Does or will ihe appllcant or present or futurp building occupent require for ihe work which is ihe subject of ihis e plication e Permit for such constructlon or
from the South Coast Air Queliry ManegemeM Disirict or irom eny other elr pollution concrol dlsMct or agency? � Yes LJ No
(Section 658502 ot Ihe Celifomie Govemment Code requires that Iha requestetl intortnation be fumishetl on applications lor non-residential builtling permits).
.............................................................................................................................................................................................................................................................
6 Will any part of ihe tacility to be consiructed under this pertnit be within 1000 feel from the outer boundaries of e school7 ❑ Ves ❑ No
pf'yes", the taclliry must meet the requiremeM of Sections 25534 end 42303 ot the Celitomie Health end Safery COCe).
..............................................................................................................................................................................................................................................................
7 It e Pertnit fmm the South Coest Air Oueliry Managemem Dis[nct or ot�er eir pollutlon control tlistrid or flgency Is reGuired for the work whlch Is t�e st
eoolicelion. heve all of the disclosures prescribed bv Celitomia Heelth and Safery Code Section 42303 been metle4 ❑ Ves ❑ No
B (tl yes", atlach cetliticate of compliance irom the appropnete air pollution control oHicer):
CERTIFICATE OF COMPLIANCE: 1 certity thet under penaliy of perjury ��e infortnetlon given abova is correct. I egree to comply with all state laws and ciry ordinances
regarding Hezardous Meteriels and Emissions,
Signature: Date:
CERTIFlCATE OF COMPLIANCE AND AUTHORLTpTION OF ENRiY: I cetlity under penalty ot perjury ihai I hflve reed this applicfltion end state that ihe information given is
correct. I egree to comply with all stete laws end city ordinancas releting to building construction, end authorize representatives oi the Ciry of Costa Mesa lo enter upon ihe
above-describetl property tor inspection Durpose9. 1 flgree not to occuDY or allow occupancy of any building authorizad by this permit uniil final inspection.
�
COOE I.
1616
1268
200
201
202
203
Fised System Finel Fire Prevention
Puol Spa Final � �
Finel Re-Roof � �
Final BIocWRetaining Well
Final Fectory Fire Plece
Final Sign
204 Finel
2408i6
�siE It�l�et
(O'C (� �K
Date
CQOE� INSVECTIONTYPE QS¢ . IIi1IDAL$
206 Final Mechanical
20B � Final Plumbing ' ' � � -
210� FlnelElectricel
212 Flnal Fire Prevention
220 Flnel Plenning Approvel,
222 Finel Site
250 FlnalBullding/Occupancy
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�
E98-00588
PERMIT NUMBER
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
SWte No
Vicinity:
Parcel Nunmber:
3234 DAKOTA AV
13908509
i
Status; ISSUED �rj
� � , ��
Applied: 06/18I1998
Issued: 06/18I7998
- __ � ... •�, i
npplicant: NUNN. JEFF ' ' • . ' ,..;., ; ''••:~ '
Address: � � -' �
� Phone: 714-556-3750 �
._ .... , _ ZiP, ,. '
, -.y� , � � . ' � ' .. �- .
;:i;- , � � . �
� � �, - _
Owner. SMITH, JAMES S"� � �
��- =,�
Address 3234DAKOTAAVE . �� '� ' , �
iiv/i".'� Phone _ �: - '_ '� , �� ��-�.
i,� i � � / ; ^ . �')�V`.��.
�COSTA�MESA',CA� _ =Zip-- 82626 - . .\ `- . / :--� �
, � � � � � ��. .�
�i.. / � /�j'` /� �y`� � ' � `���
� `� / �7 ii"/_ i ' : A, � ., / >
Contrector. NUNN; JEFF.�7 �a'�� �' /
�
� �.� ��
� � � i.:. � ;:�� /
Address: �? NUNN CONSTRUCTION � .�` , - � �� �
� �
,'� y ! !; ��COSTA'.MESA, CA Phone:'714 558 3750 ,� � � � ,
i�
�,v- ' 1815�KINGLET CT Zip: � 92626 . _ � �� � � �� ���
�:
� � � � �j� � ' �License' 48'1751 • •�� � � , . �
� �
V �•
� '-� - ,. � - �
, i '
� „ ,
ENLP,RGE TWO BEDROOMS.
, � �.i '>
_ ' � j,,.i' ,,, ' , ,�
J ,
SCOPE OF PERMIT "
�
` �/ ' � FEESUMMARY�` � ��'�
, � � : , . �� . ,
,:
� Quautity .. __ -' _ ..� .:�..��. �. `..: .. . . - � �
ISSUE FEE � $22.00 � Temp Dist System FCighting �
Te'mp service test ' $0.00 ' Busway /100 R ��',
Res. a/c package � � $0.00 , _ -- " '� , - -�Standing Sediorr <.- - .
New Res (1-2 units) ' - $0.00 . 0. - - � .-Misc Electrical.Equipmen£ -
New Res (3+units) ' 50.00 � 0-'� - - -- Transformers'up to 1 kva/kw
Pool / Spa, `, , �' 50.00 0 ...............:up tm10 kva/kw
Lightin9 Fixts' - •^'; •'- - � 87.00 ,. • 1 `.up to.50 kva/kw -
Recept Outlets � ', 88.00 8 � ...... =.::.upto 100 kvalkw
Switches� r � , �� ': �. �� �,;;' $2.00 . 2 . .........'..:_'...over 100 kvalkw
Non Res Appl� � �•` �, 50.00 0 �?�Low Voltage Equipment
Res Appl .�� -- ��` 50.00 0 ��,' 'L"ovi Volt Wiring System I Ckt
Service to 200a � . 30.00 0 �, � Misa Conduit
Service to 1000a ` � $O.00�r 0 + " ,..��� Nlisc: �Conductor -
Service over t000a . � , 50.00?: - 0' -� � � Circu's ( gen or ride)
Motors to 1hp ', E0.00 `.�� 0!�> Circus (mech ride�or lights) �
Motors to 10hp � � � / $0.00 �;0�, - � . �Chri'stmas Tree Stand
Motorsto50hp ' 50.00 � ''0.-�� �.`�_,_ _ � " � ��FireworksStand� • . - �
Motors to 100hp 50.00 - � �0 � . � ' .. � .Other Electrical Fee - �
Motors over t00hp � $0.00. � ,� 0� , . . -
Communication drops $0.00 �� �� , 0; - � , Investigation Fee �, �
Sub panel to 200a 50.00 . � 0` , . Plan Check Fee ?
Pole Light Pkg $0.00 _ � 0 � ' Reinspection Fee �. � ,
Sign Circuits $0.00 � � �..0 ' ' � � - "
Temp Pwr Pole . $0.00 - 0 � -� .TOTAL CALCULATED�FEES
Intertned Pole $0.00 0 - ' �
COMMENTS / SPECIAL CONDITIONS
�
i"
Quantity
so.00 0
$0.00 0
so.00 0
$0.00 0
so.00 o ,
so.00 o'
so.00 o;
$0.00 0 . � - � ,
,$0.00 �= 0� " � �
$0.00 r'��.0 � '� ,.� ,.
$0.00 �,:� 0 ' '
$0.00'� 0 ,'�..
. �$0;00 � 0 ," "
$0.00 . 0
$000_',',.0 �,, '�/
� $0.00.�'i -� % '� i
$0:00 � 0 �
$0.00 � , ,
$0.00' ;
$0.00
$0.00
533.00
�
�
' �
EXPIRATION: This pertnit shell aulomatically expire and become void if work is not commenced within 180 days, or it xrork is suspended or absndoned
for a per(od of 180 days. '
INSPECTIONS: In order for the work aulhorized under this pertnit to be considered legal, such work must comply with all app�iceble codes, and all
requlred Inepectlona end flnel approvel must be obtained. Failure to obtain inspec[ions and final approval will resutt in the expiration of this permR. i
FOR INSPECTIONS CALL: (714) 7545828
WORKERS' COMPENSATION DECLARA710N:
I hereby ettirm under penalry of per�ury one of the following tlecleretions:
❑ I �eve entl will melnteln e certlficete oi consent to seN-Insure for workers' compensetion, es provided for by aection 3700 of the Lebor Code, for the pertortnence ot ihe
rk for which Ihis permlt Is luuetl.
I have end will mainteln workers' compenselion insurance, as required by section 3700 ot the Labor Cotle, tor Ne perfortnance of ifre work lor which this pertnit is issuetl.
My workers' comp� ti Insu�r cen ce ntl policy mber ere: 2 q
Cartier: C, (/V/ �1�1� PolicyNumber: C�%� > Y� `�
(lhls sectlon neetl not be comp/efed U the permi( ls va/uetl et one hundred dollars ($100) or /ess.)
❑ I certiy t�at in t�e pertortnance of ihe work far which t�is pertnit is issued, I shall no� employ eny person In eny manner so es to becoma sub�ed to the workers'
wmpensatlon I of Califamia, antl egr e1lhet it I should become su6ject to the workers' compensetion provislons of S on 3700 of the Lebor Code, I shell forihwllh
comply wIN th pro a / G C�
ApplicenlSlgneWre: Date: � _` D —< �
WARNING: FAILURE TO CU W KE S' COI PENSATIIXJ COVEMGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOYER TO CHIMINAL PENALTIES Ml� GVIL FlNES UP TO ONE HUNDRED
hKK1$ANO DOLLFRE (E1 D ON TO E CQST OF COMPENSATION, OAMAC+ES AS PROVIDED FOF IN SECfION 31O80F iME UBOR CODE, INTERE5T, AND ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby emrtn that I am Ilcensed under provigia
tcrce and eMect. Lic. #,� �
with Section 7000) of Division 3 of the Business and Professions Code, end my license is in full
_ Class a
_ De1e: '
CONSTRUCTION LENDIR9,A62NCY: �
❑ I hereby eHirtn thet there Is e constmctlon lentling agency for the peAormance of the work tor which thls permit Is issued. (Sac. 3097, Civil Code).
LenGors Name:
Signeture: _
OWNER-BUILDER DECLARATIONS:
Lendefs Address:
Dete:
I hereby afllrtn that under penelry of per�ury ihet I em E%EMVT FROM�THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business entl Professlans
CoOa: Any Ury or couny which requires a permit to construct, alter, improve, demolish, or repalr eny structure, prior to Its Issuance, elso requires ihe applicent for such permlt
to file e signed stetemant that he or she is Ilcensed pursuant to the provisions at t�e Coniractors License Lew (Chepter 9(commencing with Saction 7000) oi DiWsion 3 of Ihe
Business and Protessions Code) or that he or she is axempt therefrom end the hasis for the alleged e:emption. Any violetion of Sedion 7031.5 Dy any epplicant for e permlt
sub�ecls Ne eDD�icant to e civll penafly of not more than five hundretl dollars ($500).): .
❑ I, as owner ot lhe property, or my employees wit� wages es their sole compensation, WILL DO T}fE WORK, end the siruciure Is not Intentletl or ottered for sale (Sec.
70d4, Business enO Professlons CaAe: The Contraclors License Lew does not eppty to en owner ol property who bullds or improves ihereon, antl who does such work
�Imselt or herself ar through�hls or her own employees, provided that such Improvemenis ere not Intentletl or otteretl for sale. It, however, the building or improvement Is
sold within one year ot completion, t�e owner-bullder wlll have the burden ot Oroving thet he or she tlid not bulltl or improve for purpose ot sale.).
❑ I, es owner of the properry, em EXCWSIVELY CONTRACTiNG WfTH LICENSED CONTRAC70R5 to construct the prqect (Sec. 7044, Business antl Professions
Code: The contrectors License Lew does not appty to en owner of property who builtls or improves thereon, end who conireMs for such project with a contractor(a)
Iicense pursuant to ihe Conirectors License Laws.).
❑ I am exempt untler sec.
Signeture:
Ownor ID verllled by tlriver's license. ❑ Yes ❑ No
Business and Professions Code for this reason:
Verllication of Ownershlp by (type ot document, i.e. - property lex bill or deed):
Dnvefs License No.
Date:
ExO�res:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: �
❑ I hereby ceRify t�et no excevetlon flve (5) or mare faet In depih Into which e person Is requlretl to descend, wlll be mede in connectlon with woAc eut�odzed by ihis
pertnil, end Ihet no Gulltling atruIXure, sceHoltling, telsework, or demolition or tlismantling Ihereof, will ba mare t�an thirty-six (38) feet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Title 8, Cellfomie Administretive Code).
❑ As owner•builder, 1 wlll not employ anyone to do work whlch would require e pertnit irom I�e Olvision of Intlustrlal Sefety, as note0 ebove, unleu such person hes a
permit to da such work Irom the divislon.
Signature: Date:
Division of Industnel Satery Permlt Number:
CEHTIFlCATE OF COMPIIANCE AND AUTHORVJITON OF ENTRY: I certity under penelry ot perjury thet I have read ihis epplication antl state that the Infortnatlon given is
correct. I agree to comply with ell state lews end ciry ordinances relating to building consiruction, end euthonze representetives of the Ciry oi Costa Mesa to emer upon the
ebove-descdbed property tor inspectlon puryoses. I agrea not ta occupy or allow acupancy ol eny building euthadzed by this pertnit until tinal Inspedion.
G➢➢E.L�"L�t�CE 1 �
1676 Fixad System Flnel Fire PrevenUon
1266 � Pool Spe Fnel � � � �
200 � Finel Re-Roof �
207 Finel Block/Retelning Wflll
202 Finel Fectory Fire Place
203 Final Sign
20M1 Finel Dem
24t&69
1��
� � �'e �ss
Date
CO�E I INSPEClION TYPE
208 Flnel Machenical
208 Final PIum6ing �
210 Flnel Electrlcel'
212 Flnal Fire Preventlon
220 Finel Plenning Approvel
222 FInalSite
250 Finel Bull�
& ",� . INTERNATIONAL TES7ING CORPORATION
� .. r.cn�n�;r . cnuNonnON ENGINEERING • TES7ING � INSPECTION
1671 "D" Placentia Ave., Coata Mesap Calif.
TELEFHONE HOpYim 67532 � Npp\im 7�1751 �)557 DUENA VISTA AVENUE � P. O_ BOX SIB, IEMON GROV6 CAl1fORN1A
REPORT OF GUNITE TEST SPECIMIIdS
Identification No.: P-161-490 ; 52�
Architect or Engineer: :[ackintosh & P4ackintosh, Inc. Engineers
General Contractor: Anthony Pools
,
Structure: 16 x 36 Pool for Elwood Grizzle, 3234 Dakota,
Costa Mesa
i Sample From: Deep end center 2' from top
P'tix: 4� - 1 P.S.I. 2,000
' ASe� 7 Days 28 Dava
; Specimen Nos.: EG-1 EG-2 '�
Average Dia.: 6" 6�� � 3 � 1
� ' � /��r 7( �� �'�"',�' 1,�, \
� Area, sq. In.: 28.27 28.27 � '�?!!c ,��l�FO r;�ah S/
Cl/f, ��y` �
; Date Made: 7-26-61 7-26-61 ,� B�j�q��g�si.'� iN
Date Tested: 8-2-61 8-23-61 • g. P'°< a�.
� ��;5 ,�'
C�RESSION:
�. Total Load, Lbs.: 49,500 64,500
Lbs. per sq. inch: 1,750 2,2gp
Specimens made by: J. M. Henley
Specimens delivered by; International Teatins Corporation
Date Specimens received: 7-27-61 �
INTERNATIONAL TESTING CORPOIiATION
Caller's Name_
Addre�s
CITY OF COSTA MESA
SERVICE REQUEST & PUBLIC ASSISTANCE FORM
Date / � /�� ��
r��-G"d _ Time �/��
�-,- T �-
COZ�G Phone ��(Or ��?��y
Na[ure of Request (lowtion, type, sever�t )
/���� ��� _ ����-9���� �',����� .e<�, �
��o���,�o�� — �a��,�O ��
Referred to ��f � �
�
Per,son Receiving Call /�+�'7.
Call back �
Service Only �
Information Only ❑
3��
�.�'' .
r� `� � ��1��� ...��r�/` ..�.� r.-�
��yl� Ci ��1�-G/�—�'7/ --'y'L�:-c.�l
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OWNER DATE �
JOB ADDRI.SS 32 1! T�8kOt8 AVB. BUILDING PERMIT NO. ZI�%BH
GENERAL CONTRACTOR pnthnnpv Ponlc VALUE $ 9�2nn_n�
AP. No. LOT (y0 T12ACT Z� FIRE ZONE DESCItIPTION OF WORK Fit�i SwJm DOOl
INSPEC7�ON5 I DATE GROUP TYPE ZONE
SUBCONTRACTOR
OCCUPANCY
Form 210—SM-11-59 S-B P . 11.788
� µ
, :; �_ �-��'�$�$
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIRORNIA
For Applfcan+ fo Ffll In Complefely
� BUILDING
� MAIL
COSTA MESh GALIFORNIA
ELWOOD GRI ZZLE
TEL.
NO.
TEL.
ncroa ANTHONY POOLS
;g 587T FIRESTONE BLYD.
SOUTH GATE, CALIFORNIA
OF LOT 3�(0�/� �OO I No. oP BtDce.
Now ON LOT
USE OF •
EXI6TING BLDG
SETBACK LIN6 PPON
Cer+tew OF eiRLeT REAR YARD
SIDE YAR� I LEFT I RIGHT
DESCRIPTION OF WORK
'EXTERIOR WALL IROOF
COVERING COVERII
USE OF BUILDING AND WORK TO BE
II H¢REBY �
ANO BTATC
vLY WITH �
BUIIDINO S
� AUTHORIZED
THAT I XAVB READ TM18 ARLIGTION
DVe 19 COIiNECT AN� A6REE TO GOM-
FIRE
ZONE
LeOAL
FEE RECEIVED
�IUN 301961 Q !,v`�
FaaAa��c� oE�r.
APPLICA�� �RO�t�tvM��
BUILDING
For Offiee Use Only
RECEIPT NO. �'PERMIT q0�
i r Lj ,��
er owre qece�ve� o�3e �estree
I G-7io-6 � Ei-?�o-o/
3234 DAKOT'A AVE
COSTA MESA. CALIFORNIA
ZONING �
II NO. OF ( use or rvew /J A
PLAN9 � BIIILDING SWJ/y_r00•
� i� 3� Z3� -�Z`" 6 9
�
YARD6 EVES
APPROVED
lC3IR[R YNt 8TJ
s
3 7�
6
o,
' � �
�,
6/3 a
TXE �MOUNT BHOWN UNDER VALUATION IB FOR THE
PUfiP09E OF. EBTABLI6HIN6 A PERNIT FEE ONLY.
VALUATION ' ��
PERMIT FEE S � O.
$ �+�OO�OO PLLN C}iFG% i6 .� �
�20WNER lrttl'GGLC.� r:lr+wli � ��ivr;
DATE /^c� oy
BUILDING PERMIT N0.
, YGtNtKAL CUN I Knl.l UK `�^�+�+-"�"� • UtSCRIPTION of WORK i'�'T+tsiocx
SAP No. LOT 9 TRACT 3 25 FIRE ZONE VAWE $ 5 5.
L
0.0UGH PLUMBING
PROP. $WR. IINE
MISCELLANE005
ROUGH HEATING ANP A�R CONDITIONING
TEMPORARV SERVIGE OR POLE
UN�ERGROUNO � POWEF �
ftOUGH WIRING
STEEL REINF.
FLOOR SVSTEM
BOND BEAM �J STEEL REINFORCE
SHEATHING
FRAME ANO FLASHING
LATNING - IN n OUT n
PLASTER,BROWN C9AT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., F
PLIIMBING. FINAL AN� GAS TEST I I
BUILOING, FI
SUBCONTRACTOR
" . .. . 30543 �u� zz-6 �o0s6�o n:**#.**6.ot
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. eOX 7200 COSTA MESA, CAIIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely qECEI V o av D TE RECEIV o
' BUILDING f� /�•y � ��� DATEISSUED
ADDRESS .(/ f} v��IF 7`��
� � �OSi'N
OWNER � `L � A.P. NO. �
BUILDING
MAIL �� ADDRESS ��
Z ADDRESS
W W TEL TRACT LOT BLOCK
d U CITV ' NC� D�
Z
CANSTRUCTION �� W �+DD A R P
ON LENDER $
a m ��
J � BRANCH ' �
J N OWNER
m J ADDRESS V UE �/\� '
m ARCHITECT TEL. $ $ �v
J a OR ENGINEEft N.
U a —' FIRE
W � ADDRESS ZONE TVPE 'GROUP
aw
APPROVED
J O CONTRACTOR Q W y� � B�' DATE
m Z
J � ADDRESS
w w TEL. ZON NO.OF USE OF NEW Q
�= CITV NO. P�NS BUILDING
ZF
w � STATE CITV �'ARDS APPROVED VARDS APPROVED
y K LI0. NO. LIC. NO. MAIN BUILDING ACCESSOflV BUIIDING
� O (FROM C/L STREET)
SIZE NO.OF BLDGS.
OF LOT NOW ON LOT FRONT FT. 3O FT.
USE OF �J�, �� ) �,�[ ,/` ,
EXISTING BLDG. /C�S w/�"// A" !' S E FT. FT
H SIZE OF NO.OF� �'�'
Z NEWBLDG. �— ROOMS STORIES L.SIDE FT. FT.
U EXTERIOR WALL ROOF
COVERING COVERING REAR FT. �
J USE OF BUII IN AN WORK TO BE PERFORMED DI5TANCE BET. BET. MAIN &
d G MAIN BLDGS. ACCESS. BLDGS.
G.
Q / ? �y � VAR. # DATE
O J d C.U.P.�j-` APPROVED
� APPROVED
f� Y
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UI hereby acknowletlge that I have reatl this application and state N(��,n F'Q SPECIA REQVIRE��C
� Yha[ the above info�mation is correct and aB�ee to camply wiih
� all laws regulating building construcxion, and I shall not employ /
F any person in violation af the workman's compensation laws ot
y the State ot California. �
z �
I hereby certity that I am properly licensed as a contractor untler , �
the State of Californie Business antl Professions Code, Divisicn 3, TME AMOVNT S W UATION IS FOR �
Chapter 9, antl [ha[ such licenses are in tull torca antl affect, or I THE PURP�E OF ABLISHING A RMIT FEE ONLV: ¢
am exempt from She provisions ot the S te ot California Business VALUATION � .a���
and Professions Cotle, Division 3, Ch t 9, g V�' �
PERMIT FEE �
�
Signature of � � //"�� '� _f m
Permittee $ C�iC '�� P�.4N CHECK $ E
� � `7 �d LL
Auffiorizetl Agent TOTAL FEE 3 -
�or 69 - TRACT 62
_ ,- :��.��i�
GdSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 COBTA MEBA, CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT �
ADDRess 3z3� DAKOTA AVENUE
COSTA MESA CALIFORNIA
oWNER KENKOL CONSTRUCTION CO•
MAIL �555 P�ACENTIA AVENUE
A�DRESS
CI'rv NEWPORT BEACH rvol°II 6- 2�
ARCHITECT TEL.
K.W• Ko��
Ciry NEWPORT BEACH
�;`� Na. 61 � 95 NEO M I 6-3227
SrzE 6�+x29x�oo IRREG ��o.oFainae. �
OF LOT now oN LOT
USE OF
EXI9TING BLDG. q
88T6ACK LINB FPOM 50� ev�n vwen GOt
1�� f
LEFT RIGHT �
DESCRIPTION OF WORK
I X II ALTERATION I II ADDITIO
BUILDING NO. OF 6 �
g�ZE �� SF ROOMS STORIES
EXTERIOR WALL STUCCOIROOF ROCK
COVERING COVERING
U6E OF BUILDIN6 AND WORK TO BE PERFORMED
SINGLE-FAMILY RESIDENCE AND ATTACHED
GARAGE PLAN �-B
I HEPEBY ACKNOWLED6e TMAT � HAVE READ TXIB APPLIWTION
AND eiATB THAT TH8 ABOVE I6 LORR6CT ANO AGREH TO COM�
PLY WITH ALL CITY O[W��'1ANCE6 AN� BtATE IAWe FIEpUTASING
BUIIDIN6 CONBTAUCTION.
SIGNATURE OF ,!"1 /� 1
� AUTHORIZE�
FIRE
ZONE
APPROVED
BY
ZONe /]
! L1
tecw� �
^T'^d �
�is�� u�11���I�JL�.0
�� �. S-i3-(oo
FiNANCE DEPT.
APPLICATION�FOR P RnMITA MFS{1
BUILDING
For Office Use Only
RECEIPT NO. � PEqMIT NO.
i
COSTA MESA. GALIFORNIA
ZONING
NO. OF �USE OF
Purve emtom
YARDS
APPROVED
(C6NTEP LINE 8T.)
APPROVED
EVES
ALLOWED
J VFT.
/ FT.
C O FT. � L
��T.
� , O DATE �
J / /, �
TXE AMOUNT SHOWN UNDEN VALUATION IS FOR TN!
PURPOBE OP EBTABLIBHIN6 A PERMIT FEE ONLT.
VALUATION � ��
PERM17 PEE $
//�I "2 93 /�,r
$ PLAN CHECK $
' SS�._
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