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Home My WebLink About662 DARRELL ST - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 CITY OF COSTA MESA BUILDIN6 pIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 662 DARRELL ST Suite No Vicinity: Parcel Nunmber: 422152�8 Applicant: LIPOVIC, MILO Address: - � ' . �, i % � C. ' 'L;% - � ,- i�i/, � �"�. �� .% i r ✓ � _ � ; DARELLTRCIST" ' �%�DORINELCOMAN - � � i i � �%/�/' � `662 DARRELL�ST `� / ///�/ % ,�,r'� � . �l. . . � ` I �, , �.,,,/ � ��( � �.� r/,- � �� r ,1,t. ! � j"� �' �� - � , � lArch 1 Eng�: ��`� �� ; �; ( � Address; i,% �, � , � ,�_ . . , _., � �11 . �__ - ... � � PLUMBING PERMIT PERMIT NUMBER P99-00311 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 0 512 8/1 9 9 9 Issued: OS/28/1999 ISSUED BY: i, /N'�- ". Phone: 714390-6127 � �-� _ i . � ` �.. Zip: . ' /� „ '� �>' i ` ._ 'i � l ��-� � ��c� .,� - �� .� �� . � � \ •� � �• ��. / `� ' � l\/ Phone: 714390-6127 ��:�/� Zip: 92627 \�� Pfione: ZIP. ' � License: - - Phone. ZiP� �. . , �. License: . ,.�� "`' �: SCO � _� - ' ti � '; �f'INSTALL KITCHEN'�BAY.WINDOW "SAME - -'� �'�rAND BATHTUB. , � �` ' 4`��'REF B99-00762. _. F. PERMIT �� -AND"REMOV ACE 4 WINDOWS, _ J . ._�`_ � I/�.��j r i� ` l r�.. "� FEE SUMMARY � � % %,� �� r ; �� ``A �'� � � �'�•AAMT QTY'« � , AMT QTY ', '� ' <� �� AM � ��', \ ISSUE F,EE,� �� $22 OQ Laundry Tub7 Washer � $0 00 0 �Sump P mp' �� $0�( BackFlow iirigahon ,ti� $0 00 -� 0 Landscape Irrigahon - ��, $0 00 .. 0 � �Swimming Pool �� $0�( BackflowPreventer �f� $000��,-0 � . 'PTrap` -. �_,� $000-�' 0' �y�.• � �Trap"Pnmer '-� i'$0.( Bathtub V�� - � ClarifierSystem� � Connect pce,Soda etc) Dental Units � � ��- Dishwasher ` Drain, Floor Drain, Rainwater Drain, Roof ❑rinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil Interceptors (Sand Auto ) $8�75 ��1 � r ;'}rPressureRegulator ,. , $000 � 0 „ : -Urinal % , /, i �$0 00 ��0 � ` ?Process Piping (per10 f1j�� $0 00 '��-,�0 ;? . 5 �Vacuum'Brkr. Bkflow(1;4) � �/$000�; 0 �� Receptors;_� � '� $000,;'�0 '-VacuumBrlirBkflow(5+)� � `$0 00' - 0 � �,Septic Tank ` ,'� $0 00 - 0 ' � Wash Basin`� �.�i i � ��$0:00 "i 0 � � � �Sewer Cap for Demo , . , $0 00„ _ �0 . Wash Basin Set�/� �\�$0.00� ;'� 0 / , � .. Sewer Connect - $0.00 0 �\� �Waste and Vent System f .$0:00, � 0;��'i ' ' � >§ewer Private line $0.00 � 0, ;� �� Water Closet (Toilet) $0.00��> -0 � �;" � Shower � • . �"�$8.75 �1 = WateiHeater/vent $0.00'�� :0 � � �Sink,bar , . � $0.00 , � O.i� , N%afenPipingQnstorRep.) $0.00 ��0_'-,..�--, Sink,commercial�,�, ��.$0.00 0 ;�-,�iWaterRe-pipe $0.00 0 1 �'Sink, Floor $0.00 0��✓'��.:�� '� Water Service $0.00 0 � � Sink, kitchen _ . ,$0:00' �0- � ' Water Sokener $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 0 Spa (public) � $0.00 0 PLAN CHECK ) $0.00 0 REINSPECTION so.00 0 COMMENTS I SPECIAL CONDITIONS $0.00 $0.00 $8.75 $0.00 $0.00 $8.75 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 TOTAL CALCULATED FEES: $57.00 QTY 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 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 end become void it work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 deys. INSPECTIONS: In order for the work authonzed under ihis permi� to be considered legal, such work mus� comply with all applicable codes, and all requlred inspeetlone and flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSATION DECLARATION: � - ' � I hereby ettirtn under penalry oi perjury one oi the followinq declarations: , „ � ,�; _� '_ , ' ❑ I have antl will maintein a certiticate of conseni to setl-Insure for workere' comDensation, as:provitled For py section 3700 of Ihe Lebor Cotle, for Ihe pedortnance of the work tor which �his permit is iuued. "'� � ❑ I have end will maintain workers' compensation insurance, as required by section 3700 of tha Labor Code, for the parfortnance of �he work for which Ihis pertnit is issued. My workers' compensetion Insurance cerner and policy number ere: ' Cerrier: Policy Number: (This section need not be camp/eted i/ the permit is va/ued et one hund�ed dollers ($100) or Iess.J � - ❑ 1 certify that in Ihe pertormance of ihe work tor which this permit is issued, I shall not employ any person in any menner so es Io become subject to the workers' compensetion laws oi Celifomia, antl egree thet ii I shoultl become subjeci to Ihe workers' compensation provisions of Section 3700 ot the La6or Code, I shall forthwith comply wilh ihese provisions. ' Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINPL PENPLTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE ($100,000). IN ADDITION TO THE CAST OF CAMPENSATION, DAMAGES AS PfiOVI�ED FOR IN SEGTIIXJ 37060F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm ihat I am licensed under provisions ot Chapier 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, and my license is in full force and eflect. Lic. # Class # Contracbrs Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby eNirtn that there is a constmction lending agency Por the peAormance of Ihe work tor which ihis permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm that untler penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a permit to construd, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires Ihe epplicant tor such permit to file a signed statement that he or she Is licer.sed pursuant to ihe provisions ot ihe Contractors License law (Chapter 9(commencing wlih Section 7000) ot Division 3 ot Ihe Business ana Professions Code) or that he or sha Is exempt iherefrom and the basis For the alleged exemptlon. Any vloletlon of Section 7031 S by eny applicant tor a permit sublecis ihe epplicant to a clvil panalry oi not more then five hundred dollars ($500).): ❑ I, as owner of Ihe property, or my employees with wages as their sole wmpensation, WILL DO 7HE WOfiK, and Ihe structure is not intentletl or oHered for sale (Sec. 7044, Business and Professions Cotle: The Contractors Licensa Law does not apply to en owner of property who builds or improves thereon, antl who does such work himself or herself or through his or her own employees, provitled Ihat such Improvements ere not intended or oHered for sale. If, however, ihe building or improvement is sold within one year oi completion, �he owner-builtler will have the burden of proving Ihat he or she did not build or improva for purpose ot sale.). ❑ I, as owner of ihe propeRy, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conslruct Ihe project (Sec. 7044, Business antl Professions Code: The contractors License Law does not apply to en owner ot propeny who builds or improves thereon, antl who contracis tor such project with a comractor(s) license pursuant to the Contrectors License Lews.). ❑ I am e:empt SAer �. � Business and Protessions Cotle for this reason: Signa�ure: 1//i�K.' �Gr.o— Owner ID veritied by tlnvef5license. ❑ Vas ❑ No Drivefs License N0. Veritication of Ownership by (type ot documenL i.e. - pwperty taz hill or daed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: e: ❑ I hereby certify that no excavation five (5) or more teat in depth into which a person is requlretl to tlescend, will ba made in connec�ion with work authorizetl by this permit, end that no building siructure, scatfoltling, felsework, or demolition or dismantling thereof, will be more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Califomie Atlminis�rative Code). ❑ As owner-builder, I will noi employ anyona to do work which would requira e permit irom the Division of Intlusinal Safery, es noted ebove, unless such person has a permil ta do such work fmm the tlivision. Signature: Oate: Division of Induslrial Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty oi perjury thet I have read this application antl stata that the information given is correct. I agree to comply with all state laws and ciry ordinances relating to building construction, antl authorize representetives of ihe Ciry oi Costa Mesa to enter upon the abovZ d'es� pryperqNOr inspection p �. I egr�=cupy or allow occupancy ot any building authonzetl by ihi ��tina� ' n.� /�C r E �/_ %J Signature t alOwner(s) Date And/Or Authorized AppliCant COUE�. INSVECTIONTYPE ' �� 1616 FixeC Sysiem Finel Fire Prevention . 1266 Pool Spa Final 200 � ' Final Re-Roof 201 FInaI BIocWRe�aining Wall 202 ' Final Factory Fire Plece 203 Final Sign 204 Finel Demolitian zaaae6 PAIE " INTITIpLS ' ' --QQQEI INSYECTIONTYPE" 206 Final Mechenical - 20B Final Plumbing - 210 � Final Elecirical 212 Final Fire Prevention 220 Final Planning Appraval � 222 Final Site � 250 Final Building/Occupancy Qd¢, RL �L � (714) 754-5273 • Fax (714) 7543856 CITY OF COSTA MESA BUILpIN6 OIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 66Z DARRELL ST Suite: Vicinity: Parcel Nunmber: 42215218 i !{ A ! , J 1'�r 1(Yj it t�J� , �, � J �� . Y�� npp�icant: LIPOVIC, MILO Address: i'/- t ./ r� � �' . Owner. DAREL'L=TRUST � - � Address %DORWELCOMAN � � �i� � � V � � „7 662DARRELL ST - i � � \ � � \ � / � � �� BUILDING PERMIT Zoning: \ V N' . � PERMIT NUMBER 77 FAIR ORIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 05/28/1999 Issued: OS/28I1999 . , . .� <--.: ` - Phone: 714-390-6127 �- � _ .... Zip: 1 , � ? -�. �� I I r� A�' _� /, � i-�� V�C-a � Phone: 714=390_6127, �_� �� ` � .i �\ ` Zip: 92627 � = � 1 -,' � ; i �� ti \� � \� \/%/ `1/ l %%',%�% Phone:. �\\\�\ ��f /\ '�-� � �t C� � iii'- % \ �� .� � /�v \�\• � �'� � J% .�„,i : � i� � . N �Zip� .�N>" License_ i - , �� '�- � , u� � '/."� J.• � _ '�_� '�-."'�� \,' / % \ Arch ,�.%-.-- � 7 � - ^ I Eng , � �r . , l� � \. �ddress, � , fi , � - � : • Address., .� � . ` ,� -�� _ / f � � �Phone: � - i�.�� ` Phone: - �- -'� rr � �� , �•�="�% : _;},'"�� '�`h�'� `"� � � �/" / �� Zip I �n� ;�� „License: Zip: �� ; tiLicense: ,-„ -i� � �' � ��..�.� ,.� � ,, , � ' '��'' ' ' SCOPE OF PERMIT , , , �= � . �t � � _ � �INSTALL�KITCHEN BAY WINDOW " SAMESIZE' AND " REMOVE�AND REPLACE �4�WINDOWS, SHOWER AND BATHTUB. , . .. . , . , . , _ , . . . <� . . ... ,,. _ � �. `-. _ J t r, � � FEE SUMMARY �,�, � �� PlanCheck'�, �,� $Q00 - r�� ;� ;l �, CalcValuation y �,� $i2,000: otf �'� Permit , $187.25 ' � — '� Claim Valuation i • , g�z,000.00� � 't '�`V� SMIP Res ��,-�i� $1.20 - � � �� ' ��,� � �,��SMIP Com �� ' $0.00 _. � � � �r,� ,- - ` �� ;2�� Other ��\.'•$0.00 � __—� _ � � �� , �V/ ,'�Inspection.'�, ��$0.00 - � �� .,� � � : ,' . �\`\�TotaL•l $18845 � \l\ \ \� SETBACK; MAIN STRUC- ACCESSORY PARKING NOTES: � ca- � 1, l , � %/ �� i�� " � % ' � � E`Fro`nt 0 0�, �Re r� �.0- 0 �A� � - � V-� � 'F.ront ��0�0 � � '� ,Rear 0. 0 i `�.`= �,``,. - i r-. � � - , Existing: ; -0>�, '�Required: 0 i ;'l,�' . � , /` c , ` ; r � �� fri, _. _ . �,. _ �� "'J h _ � � - �/r% -� /Fi/ � �LANNING 8 ZONING { � .ti .' i'% `� !��/ � „ , � , � ,, � � )'/ A �' ` . . , . ,, . > .;, i� = .�i ' /I �� , G i�;' � Yeft �0 0 S -�Right 0_0 j�j" i ' � % Left -0-0 . Right "0-0 , �� 1' 1 J ' �� li' � � Proposed: . � -0 -, � i; � % , �''-r%i' � � . .''t"i'- f 0 Q..��...�- 3 s/d� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automalically 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 authonzed under �his permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectlone end flnel epproval must be obtained. Failure to obtain inspections and final approvel will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION DECLARATION: � ' � � � � � I hereby aflirtn untler penalty oi perjury one of the tollowing deGarations: �" '� ., ;`- . ❑ I heve antl will maintain a certificate of consent to self-Insure for workers', compensation, as provided lor by section 3700 of the Lebor Cotle, For the pertortnance of the work for which ihis permil Is IsSued. ' ' - ❑ I �ave and will maintain workers' compensaiion insurance, as required by section 3700 of Ihe Labor Code, for the peAortnance of Ihe work tor w�ich Ihis perrnit is issued. My workers' wmpensatian Insurance carrier and policy number ara: ' Carner. Policy Number: (This sectlon need not be completed ll the permit Is Jelued at one huntlreAdollars ($100) or /ess.)" '" ' ❑ I cetliry that in t�e perfortnance of the work tor which Ihis permit is issueq I shall not employ any person in eny manner so as lo become su6ject to ihe workers' compensation lews of Celifomie, end agree thet if I should become subject to Ihe workers' compensation provisions oi Section 3700 ot ihe Labor Cotle, I shall fotlhwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SU&IECi MI EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THWSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF WMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3)O60F THE LABOR CODE, IFf�EREST, AND ATiORNEY'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby atfirm ihat I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Divislon 3 of the Business and Professions Cotle, and my license is in full forca end 8ffecL Lic. k Class # Contractor's Signa�ure: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm that thera is a constmction lentling agency for the performance of the work tor which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lendels Adtlress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirtn that under penalry ot periury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or county which requires a permit to consWct, alter, improve, demolish, or repair any structure, pnor ro its issuance, also requires the epplicant for such pertnit to file a signetl statemeni that ha or she is licersed pureuant to tha provisions of Ihe Contractors License Law (Chap�er 9(commencing with Section 7000) ot Division 3 ot ihe eusiness antl Professions Code) or ihat he or she is exempt iheretrom end the basis for Iha allegetl exemption. Any violatlon of Sectlon 7031.' by eny epplicant for e permit sub�ects the applicant to e civil penelry of noi more then five hundrad dollars ($500).): ❑ I, as owner of the property, or my employees with wages as Iheir sola compensation, WILL DO THE WORK, and the siructure is not intended or oHered for sale (Sec. 7044, eusiness end Professions Cotle: The Contractors Licensa Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herealf or through his or her own employees, provided ihat such improvements ere not intendetl or oHared for sale. If, however, ihe builtling or improvement is sold within one year of completion, Ihe owneo-builder will have the burtlen of provin9 that ha or she did not build or improva tor purpose of sala.). ❑ I, as owner of the properry, am EXCLUSIVELY CONTRACTING WI7H LICENSEU CONTRACTORS to consiruct the projact (Sec. 7044, Business antl Professions Cotle: The conirectore Licensa Law tloas not apply to en owner of property who builtls or improves thereon, antl who coniracis for such pro�ect with a contractor(s) license pursuant to Ihe Contractors License Lews.). Business and Professions Code for this reason: verifietl by tlnver's license. Verifica�ion ot Ownership by (rype of document, I.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certity ihat no excavetlon five (5) or more feet in tlepth into which a person is required to tlescend, will ba made in connection with work authonzetl by ihis permit, end that no building slmcture, scattolding, falsework, or tlemolition or dismantling Ihereot, will be more then thiny-six (36) feet high. (Ghep. 32, Grp 2, Art 2, Sec. 341, Titla 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnii trom ihe Division ol Indusirial Safety, as no�e0 ebove, unless such person has a permit lo tlo such work irom the Givision. Signature: Dare: Division of Industnal Safery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTMORRATION OF ENTRY: I certiy under penalry ot perjury that I have reaG this application and state Ihat the information given is correcl. I agree to comply with all state laws and ciry oMinances relating ro builtling construction, antl euthorize represen�atives��pppoi the Ciry of Costa Mesa to enter upon the •above-tlescnbetl pro rry for insDection urposes. I egrea not to occupy or allow occupancy ol any building euthorize � t� pe ii until final fispection. % igneW re Of Legel Owner(s) Date '--� Ar�9l0rAvt ze ApD�i� Date COOE 1' INSPECTIONTYiE ' ' � ' 1616 Fi:eC System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root ' 201 Fina181ock/Retaining Wall 202 203 204 2a48d8 Final Pactory Fire Place Final Sign Final Demolition o� �¢� ' � •`CODEY INSVECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 - Finel ElecMcal 212 Finel Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final BuildinyOccupancy PA7E �$ • r � � ;� � (714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DHNt, GOS IA MtSA, GA y2tiYti Job Address: 662 DARRELL ST Suite No Vicinity: Parcel Number: 42215218 Applicant: DARELL TRUST Addr¢55: °/ DORINEL COMAN 662 DARRELL ST Owner. DARELL TRUST Address: % DORINEL COMAN Contractor: Address: Arch / Eng : Address: [:EY7Ht1:7:77�q.91 MECHANICAL PERMIT Phone: 714390-6127 Zip: 92627 � Phone: 714390-6127 Zip: 92627 Phone: Zip: License: - . � Phone: . Zip: �icense: C/O OF WATER HEATER - - C/O OF FAU. � ISSUE FEE Inst FAU <100 k BTU Inst FAU >700 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Bax Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> t0000cfm Floor Furnace Floor or Suspend Heater Quantity $23.50 $14.80 1 $0.00 0 $0.00 0 �,$0.00� '0" $0.00 , 0 $0.00 " 0 � $0.00 0 �., . $0:00 0 $0.00 0 $0.00 0 $0.00 0 $o.00 0 $0,00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 Status: ISSUED Applied: 03/06/2001 Issued: 03/06/2001 ISSUED BY: /� s SCOPE OF PERMIT . . � ,: Y�, FEESUMMARY • � ��% � ' ; � ', Quantity Repair/AltAbsorbtion Unit � . $0.00' 0 ;� Repair;/ Alt Refrigeration Unit $0.00 0; Ventillation System ,�,- $0.00 � 0� Evaporative Cooler ; _,- .:.. � -� - � � ' $0.00' 0 CommerciallncineratoF �° '"'�� ` $0.00�;�0 Domestic Incinerator ' � $0.00" 0 Compressors/Absorption�Svstems�;/:.� � �� Up to 3 hp / 100 k BTU � . - " :$OAO 0 3 To 15 hp /�500 k BTU � , i-� /$OAO 0 15 To 30 hp / 1,000 k BTU � � " $0.00 0 30 To 50 hp / 1,750 k BTU�� $0.00 0 Over 50 hp / Over 1,750 BTU .� .� $0.00 0 Boilers � . ' Upto3hp ' , - . 3To15hp 75 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $38.30 COMMENTS / SPECIAL CONDITIONS INOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremems under California statutes and related , regulations. (Ord. No. 92-28, § 1, 12-21-92) ��IEXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 7 BO 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 requlred 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) 7545626 24d6d6�N00) �` WORKERS'COMPENSATION DECIARATON: - � I hereby affirm untler penalry of perjury one of ihe following declarations: ❑ I have and will maintain a certifiwte of conseni Io self-Insure tor workers' compensetion, es provitled for by section 3700 of the Labor Code, for the performance of the work for which this permit is issuetl. ❑ I have antl wiil maintain workers' compensatbn insurance, as required by section 3700 of t�e Lahor Cotle, tor the perfortnance of the work for w�ich this Oertnit is issued. My workers' compensation Insurance carner and policy num6er are: Carner. Policy Number: (This section need nol be completed i! the permit is velued et one hundred tlollars ($100) or less.) ❑ I certily ihat in Ihe pertormance of the work for which ihis permit is issued, I shall not employ any person in any manner so as to become subject to the workars' compensatlon laws oi Calitornla, and agree that if I should become sublect to Ihe workers' compensation provisions of Saction 3700 of t�e Labor Code, I shell fotlhwith comply with these provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WOFKEiiS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED T/qUSAND DOLLARE (5100,000�. IN ADDITION TO THE COST OF COMPENSATION, DAM4GE5 AS PROVIDED FOR IN SECiION 3lOfi OF THE LABOR CODE, INTEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS OECLARATION: , I hereby affirm ihat I em licensed under provisions of Chapter 9(commencing with Seclion 7000) ot Division 3 of the Business antl Professions Code, antl my license is in full ' torce ana ettecL Lia a Class q �' CONractofs Signawre: Date: CONS7RUCT10N LENDING AGENCV: ❑ I hereby aRirm that there is a construction lentling agency for the peAormance of ihe work tor which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lentlers Name: Signature: _ OWNER•BUILDER DECLARATIONS: Landers Address: Date: I hereby aHirtn that untler penalty of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any city or counry which wquires a permit to consWc6 alter, improve, tlemolish, or repair any sirucNre, prior to its issuance, also requires the applicant for such pertnit to file a signed statemant that he or she is licensed pursuant to the provisions ot Ihe Contrecrors License Law (Chapler 9(commencing with Section 7000) ot DiNslon 3 of the Business antl Professions Cotle) or that he or s�a is ezempt theretrom and the basis tor Ihe alleged ezemption. Any violation of Sedion 7031.5 by any applicant tor e pertnit subjects Ihe applicani to a civil penalty of not more than five huntlretl tlollars (5500).): ❑ I, as owner of the pmperty, or my employees wl�h wages as iheir sole compensation, WILL DO TME WORK, and Ihe siruaure is not imentletl or offered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply ro an owner of property who builds or improves thereon, and who does such work himself or herself or Ihrough his or her own employees, provided that such improvemems are not imentled or offered for sele. If, however, the building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden ot proving that he or she ditl not Duild or improve for puryose ot sale.). �I, as owner of the pmperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business end Protessions Cotle: The coNractors License Law tloes not appty ro an owner ol pwperty who builtls or impmves thereon, and who contracts for such pmject with a contractor(s) license pursuant to the Comractors License Wws.). ❑ I am exempt under se Business antl Professions Code for this reason: Signa�ure: Owner ID veritied by dmers license. Ves ❑ No , Drivefs License No. �� Venficatian ol Ownership by (rype of document, i.e. - pwperry taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y certity that no excavation five (5) or more teet in aepth into which a person is required to descenq will be matle in wnnection with work authonzed by this permit, antl Mat no building strucWre, scaflolding, talsework, or demolition or disman�ling thereof, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title B, Celifomia Adminisirative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division of Industrial Safety, as notetl aDove, unless such person has a permit to tlo such work from the tlivision. Signature: Date: Division of Inaustnal Satery Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORIIATON OF ENTRY: I certify under penalry of perjury that I have read this application and state that the information given is correct I agrae to comply with all state laws and city ortlinances relating to building constmction, antl authorize rapresentatives of Ihe Ciry oi Costa Mesa to enter upon the ebove-described pmperty for inspection puryoses. I �e je�.not to oc upy o� al � cupa y\of any building euthorized by ihis per�mit �until fin��al inspection. i�----..�:i ��i,�FLCtr G \ .— /i .�7 —O � �.200 / Si re Lega Ow r(s) J te And/Or Authonzed Applicant COOE t. INSPECTIONTYPE Qii INTRIALS 7616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 20G Finel Demolilion , , CODE� INSPECTIONTYPE� 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sita 250 Final Builtling/Occupancy �-$��1 '�L\L (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 Job nddress: 662 DARRELL ST Suite No Vicinity: Parcel Nunmber: 42215218 Applicant: DARELL TRUST Address: % DORINEL COMAN 662 DARRELL ST ' � owner: � DARELL TRUST � Addfe55 % DORINEL COMAN 662 DARRELL ST Contractor. � , AdcJress: Arch / Eng : Address: PLUMBING PERMIT Phone: 714-390-6127 Zip: 92627 � Phone: 714-390-6127 Zip: 92627 Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT CIO OF WATER HEATER ISSUE FEE Backflow i«igation Backflow Preventer . Bathtub Clarifier System ' Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oiq Interceptors (Sand Auto ) AMT QTY $725 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 � Status: ISSUED Applied: 03I06/2001 Issued: 03/06/2001 ISSUED BY: I / a� r : EEESUMMARY :.,_ AMT `QTY � %i ,. Laundry Tub / Washer � $0.00- 0 "t � � � � Sump Pump � - ; Landscapelrrigation $0.00 0 "Swimming�Pool P-Trap" $0.00 0- , �,-TrapPrimer �� , �Pressure Regulator $0.00 0 � �Urinal'- �, �, � � `/ � Process Piping (per 10 ft) $0.00 0�� = � Nacuum Brkr Bkflow(1-4) Receptors $0.00 0 -, Vacuum Brkr BkFlovi(5+) Septic Tank $0.00 0 � Wash Basin� "" Sewer Cap for Demo $0.00 0• � Wash Basin Set Sewer Connect �$0.00 .0 Waste and Vent System Sewer Private Line $0.00 0 . Water Closet (Toilet) Shower $0.00 0 Water Heater / vent Sink, bar $0.00 0��" Water Piping Qnst or RepJ Sink, commercial $0.00 0 Water Re-pipe Sink, Floor $0.00 0 Water Service Sink, kitchen $0.00 0 Water Softener Sink, service/mop $0.00 0 OTHER Spa (private) $0.00 0 VIOLATION Spa (public) $0.00 0 PLAN CHECK REINSPECTION COMMENTS I SPECIAL CONDITIONS AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $19.55 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 N NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related regula�ions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under �his permit to be considered legal, such work must comply with all applicable codes, and all requlred inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 24L6d8(NW) WORKERS'COMPENSAnON DECLARAnON: -- � I herehy attirm under penalty ot peryury one of the following declarations: - � ❑ I have antl will maintain a certificate of consent to seli-Insure tor workers' compensation, as providetl for by section 3700 ot Ihe labor Cotle, tor the peAormance of the work for which Ihis permit is issuetl. ❑ I have antl will maintain workers' compensatlon insurance, as required by section 3700 of the Lebor Code, for ihe perfortnance of [he work for which this permit is issued. My workers' wmpensation Insurance carrier antl poliry number are: Carrier. Policy Number. (This section neetl nat be completed i! fhe permif is velued at ane huntlretl dollars ($100) or less.) ❑ I cenify thet in the peAormance oi the work tor which this permit is issued, I shall not employ any person in eny manner so as to become subject to the workers' compensation laws ot Celitomia, antl egrea Ihat if I should become subjact to Ihe workers' compensa[ion provisions ot Section 3700 ot the Lebor Cotle, I shall totlhwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SEC�FE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU6IECT AN EMPLOYEP TO CRIMINAL PENALTIES AND GVIL FINES UP TO dJE HUNDRED THOUSAND DOIAARE �8100,000), IN AODRIIXJ TO THE COST OF CAMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3]O60F THE L4BOR CApE, iMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm ihat 1 am licensetl untler provisions ot Chapter 9(commencing with Section 7000) of Division 3 oi the Business antl Professions Cotle, and my license is in tull torce antl a%ecL Lic. N Class N Comractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm that ihere is a consirudion lending agency tor the pedormance of ihe work for which [his pertnit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lentler's Atltlress: Signature: Data: OWNER•BUILDER DECLARA710NS: I hereby attirtn that under penalty of perjury ihal I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions Code: Any city or counry which requires a permit to constmct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, also requires the epplicant for such permit to tile e signed statement that he or she is licensetl pursuant to the provisions of tha Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Coda) or that he or she is exempt therefrom and the basis tor Ihe allegetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit subjects t�e epplicaN to a civil penalty of not more ihan five hundred dollars (5500).): ❑ I, as owner of Ihe property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and ihe strucwre is not intentletl or oflerad tor sale (Sec. 7044, Business antl Professions Code: The Contrectors License Law does not apply to an owner oF property who builds or improves theraon, and who doas such work himseH or hersetl or through his or her own employees, provided ihat such improvements are not intended or oflered for sale. If, however, Ihe building or improvement is — /sold within one year of completion, the owner-builder will hava the burden of proving that he or she did not build or improve for purpose of sale.). �K I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construci the project (Sec. 7044, Business antl Professions � Code: The wntractors License Law does not apply to an owner ot propeny who builtls or improves thereon, antl who conirects tor such prolect with a comractor(s) license pursuant to lhe Coniractors License Laws.). ' ❑ I am e:empt u�nd_e�r c/—� — Business and Professions Code for ihis reason: �_ Si e: .�i�//�a— ��t�lCC__ at A� O — Owner ID verilied by driver's license. ��es ❑ No �i 'cen No. /'� [) �Eyp res: /U^�/^-� `� VePoication ol Ownership by (rype ot document, t:e. - pmperty tax bill or DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which e person is required to descend, will be made in connection with work auihorized by this permi�, antl Ihat no building siructure, scaflolding, falsework, or demolition or tlismantling thereot, will be more than thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Califomia Administrative Code). ❑ As ownervbuiltler, 1 will not amploy anyone to tlo work which would require a permit irom ihe Division of Indusirial Safery, es noted ebove, unless such pereon has e pertnit to tla such work from the division. Signature: Date: Division oi IntlusMal Salery Permit Number. CEFTiFICATE OF COMPLIANCE AND AUTHORIZATON OF EMAV: I certity under penalty of perjury ihat I have read this applica�ion and state that �he information given is correct. I agree to comply with all state laws end ciry ordinances relating to OuilCing consiruction, antl authonze representatives of ihe Ciry of Costa Mesa to enter upon iha above-descnbetl propeny for ins/pec�fp�.�urp s.� ��I yeg�(ye not to cupy or allnW pancy an building authorized by ihis permit until final inspection. l�.�==.�%'.6s�%/d't �/l T � 03—R9Gi--ez0C+7� S'. ature�Of�galOwne ) � Dale AndiOr Authonzetl Appliwnt CODE �. INSPECTIONTYPE 1616 Fixed Sysfem Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReiaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition o�TE CODE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Preventian 220 Final Planning Approval 222 Final Site 250 Final BuildinryOccupancy PAIE It��Ls � -k -c� ( �nL i�ooxrssaeuiura: 6b2 DARRELL ST °""E"s"""E"'aa''": Lr1MARRE LLOYD L "°0"� 662 W DfaRRELL ST COSTA MESA,CA �vr�. xuuNc woness urcxrtEcr ox u+m+�+: RLN. ON FNG'S AOORE55: CON711ACTOP'S NAI�: caxm�crons�uiwo �oo�ss UNT: 92627 uc. no.: ur�r: ua xo.: urar: LICENSEU COMfl1CTON5 DECLANATION: I hereby efl'vm uMx panely d perjury that I un IicaneaC uMm poviaions W Cheqer B (wmmena�q vnih Saeiion �aao) d Oivieion 3 d ihe Buunep enE Proleseiana Cada, eM my lieeme ie in full brce enE e11eG. cm uc. No.: uc. cuss: uc. No.: EXP ; OWNER BUILDEN OECLAXRTION: I MrtEy eifirm uMx penelly W peiN�'/ �� I em eRemq imm iM CaMratlwa Licenee lew ta ihe tdlewvq reeaon (Sedion ]W1.5 Buaiiaes vd PMeaeiona Coda: Fny cIy a coumy xfiidi �ayuirp e perm� �o eonevucY, aller, impwe, demd'eh, or repei eny elmcwre, pnor m na eeuarKe, eho raquirec the epplirant lor wch permit to fib e agrod elebmenl the� M or ahe ie licenaed Wnuenl lo Ihe D��aiuna d the Canvenae Licenae Lew �Cheple� 9(wmme�n0 �h Sedan )000) of Di✓uion 3 d IM Buzmaa erM Prdenona Code� a Ihel he a ahe ia ezemp IherNrum end the bvo la Ne dbpeE mempion. My violelion d Setlion )031.5 by enY e0d� lar e permil vubjedv Iha epd�� lo e dvil penelry d na mwe then fr�e huMeed ddlen �5500�). n I.moxiwdlMpropMyamyamplv�eeewihwepmrolheixbcanpewtion.willdothework.eM�heeNwlu�e'orwliMeiMed 7C orMeredbreebl5ection]oM.BudrimeMPrdmaiomCade:TheCoMredorslicemeLewEmanaePM'toenownerdP�WeM wha buida a'vn0�� . �� aucM1 xwk Mmsell m henell a thraph he a her ovm empbyeea, pwitled ihet wch impmwmenle ere not inlerMetl a dlera� /ar ade. H, however, �tw buiNinB a imqovemeM n eald within me yeer d wmd�b�. �he owner-buiNer xill heva iha W Nen M provi'p he or ehe did nM build or imqaw Iw the Wm�e d eeb). ❑ 1, as owrer d iM popeny. em eRduervdy wntreaiq xnh licensad cantreclws Io wnsUup iM qoptl (Setlnn ]ON. Busiwa eM Pmleaiwre Cade: TM Cantreean l'sanae law doee ria epply to an owiw al propMy who Wilda a impwm iMreon end who coniracta la a�F prqMa xilh e aoMreqor(s) IceiueE W�eueM to Ihe Convetlas licerue lew � I em exemp urder Section: B. 8 P.C., br Iho re oe�,: y—� 2— 9 r' �,,,.: i do naresy cen�y inn i em eware d e�w ��ersiaiw ine �uiremenro ot HmiM �d Sdery coa iam zssos, zssaa. ene 2553a. eM thet I a eny Mure buiNiip wwpent xill / wll ew� (d�eb me) meE 1�py wm .�e .u�a ooda..�e in. ,.a��n r« e Oamm laconsuuaiana modifimibnhanlMAi�it7%nepemenl Dofnd. Revdm�ial mnarwion eFG�iomeneaemq M1om Iheae a�,;s�. Deta: Applicem: W OPKEP'S COMPENSATION DECLARATION: I Mreby effirm urdx parW�y d perjury aw d tha lallaxiip dpivazione: � I Iwa eed wil meimen e eenJiule d oomm�t �o aeXiiuun br xakers' eompenaetion, u povkeE for by Setlian 9]00 d ihe labar c�, i� m. wno�a a �„ � �«.w:on m�. v�a m��e. ❑ i neve ene xi� meimen wonen• como«ne6 n I�w.erice. m �ea��ee W saim a�ao d �ne t.enw caee. w �ne ro�«mance a �ne work ta which thie partnit is iseueE. My workan' compenaman inaurvice mrr'ar end pdiry number are: c�e�: PoliryNumber: � ' (1M1is secfion neetl rrof be romplNeE! fM permR is br me h�ndreE ddlen (Sf00/ w/en.) . ❑ I cen/y tMl in IM1e perlamvwe d iM wak 1« xhch tho pamN re iaaued. 1 ahell m� empby erry pe�am in enY menMr ao n to bxama wbjea io iM waMx: canP�saiion bwe a caliromia. arM w�ea t t E I ehauM � wbi� �o iM xwken• compenseiion provisiom W Seaion 3)00 d tM lebor Code, I ahdl fanh wil� IM pr ' ue�e: �(� _ �—`% �— Aow��: Wem/ng: Fellun ro ucvro wonws'rompawtlon rover�ps /s undwN( entl aNl Net an �mploysr ro eN� rol psna/tls. erM c/vll flnss tp b m� huMrotl fMuurtl AMI�n (ff0({OpOA M edditlen b/M cmf ttmpxu�tbiy Lemspu �� pevMSE bi In Sxtlon J)OS ol fM LeEor Cadr, /ntaut, arrd ettomsy'� Isa. , CONST(i11C710N LENDING AOENCY: I hereby elfirm undar penaly d perjury thet than a e wnslrud'wn NnEinp epeMy tor tM parbrtnenca M ihe wak lar which Ihe peiml is asuad (Sedion 309], CN. C�. LENDEP'S N11ME: LENDEH'S ADONESS: I cenM �� I hsn iaeE Na epplicmbn eM atme Ihet Ue ebv.a iMmretion n conq. l eprea io campy wnh all ay uM couMy pdinar�oes 8114 9�B�B�9W8fB�B1Y10�0 b1ibC1000fIe1fWIO11B11d�lyYB�'BN�1MZB R�NB.9B1118�NB9 d�hllC1�'IOen�Bf11pp111hB BbOIB�men�OflBj �IO�IB11)' mrinspaeion o�.noaes, o�a: . 4— / � - gS � � ""u�l,__ WhXa-Buildiq 8 Selety: Green-Fla; Cenery-Applifant; Pink-Revanue; OOIEenroFAeammr CITY OF COSTA MESA — BUILDIP7G PERAM1IT FERMIT NO: B 071883 PLAN CHECK NO: N CONSTRUCTION TYPE; PERMIT TYPE: STR JOB DESCRIPTION : T/OFF REROOF W/COMP SHINGLES PERF4 NO: B 071E8_ GOVT: N SUPP: N PURPOSE: OTFI SQ FT; 2,600 CLAIM VALUE: 2,600.Q0 CALC—VALQE; 2,600.00 GROUP OCC; R-3 /M-1 COMMENTS: LEGALIZED 26005F RESID REROOFING, SMOKE DETECTORS REQ. FER 91UbC +�*�-iait***�******+�+trerecrtjt*****ri��-**�r�t***ic*r*r******ricricac��-�****r*acat*w-r�-+Fac�r+t**+r***�� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING -------- FRNT: FT IN REAR: FT IDl FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROC�: PARCEL; 42215218 ZNE: REF NO; PLAP7NING NOTES> i 1E iE Y iE iF 1E iE �!P M if if if 1f iR if it if M%1E iE i if if iE if;f if !f iP 1E 1f iP 1f iF if It iE iE i�- ff iR ff iE iR iE iE �H- �f {F i4+c ic ic iF iE+f iF 9f af j4 iE if iF iR if af �1(-aR i4 iE iF #F iF iR if aE iF D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S ZONING APPROVED BY DATE: � BIIILDING APPROVED BY : DATE: APPLICATION ISSUED BY: �%� DATE; , 2%� �*��*�*�*,�*�*�*�**�*��• �� ,��,«��**��* ��,�. �*�*�*�,«�«* F�*, F��» ** LEGALIZATION;Y F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMZT 108,00 SQ SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIC�—> PERMIT ISSUE PLAN—CAECK TOTALS----> 108.50 0,00 0.00 REVENUE DIVISION TOTALS--> COLLECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC 108.00 TOTAL PAID DUE SO8,50 108.SQ .00 108,50 OVER/SHORT; .00 FIRE .SMIP/TOT GRADING PLAN—CHECK .50 jE if iF 1f if fh iF if if� iE if iE iE i(-1f if iR if iF if if if �f if if if � fr� if if iE M iE Y iE aE iR 1� iF fF iE aF N� if iR af iE 1E iE M iF it 1t 1F * it 1F rt K iF iE if if iF 1� if iF?F �4 iE Y� af �F i4 i4 �f if iF I N D I C' I D U A L F E E H R E A K D O W N TYF�E QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 260Q REROOF BY VALUE RESIDENTIAL NOZONE 1.QQ 2,600.00 END OF FEES 01 OOt7i8:2-00179812 ')"f:�'� ,'��]�,5f� DRT[: C4;12/95 TFf1E: 24c35 L CONSTRUCTION AND PLANNING� � � POOI & SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. TemporarY Electrical Service or Poie 52. Pool & Equipment Location . ! 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement � �' t 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' `,' , 4. Electrical Conduit�Undrgrnd. � 55. Electrical Bonding .� 5.. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE .'� ; 7. Footings - 58. Electrical Conduit-Undrgrnd. �:�� 8. Founda[iDn . 59. Gas Pipe, l� Undrgrnd., Test �� 9. Water Pipe-Undrgrnd. ' 60: Backwash Lines, P-Trap, rJ Undrgrnd. �' � 70. Structural Floor System . ''. 61. APPROVAL TO DECK ' i 11. Property Sewer �ine & House Connection � ,� 62�. Backwash & ReceptorPirral�'j , 12. Sewer Cap � . :', 63. Heater & Vent-Final 1 _ 13. Root �rains �'i 64. Plumbing SYstem - Final `,?. 14. Rough Pivmbing ', 65. ElectricabFinal � • . � .n� 15. Rough EI¢ctricai•Conduit - _�� 66: Solar SYstem-Final ` i6. Rough ElCctric Wiring 67. Fencing & Access Approval.� 17. flough Wiring Sign . � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINFit � 19. Rough Hsating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace � ' ' - '� APPROVALS_� - Permit # ' 21. OuCis, in Structure � •• • � - . � 70. �Underground Hydro ' 22. Ducts, Ventilatin9 _ � � ' 71. Product Piping O Gas u Oii 23. Gas Pipe-Rough & Tesi � . ' 72. Underground FIuSh � ' 24. Roof Framing � ' ,�. � 73. Undergmd. Storage TanQ � Gas ❑ Oil 25. Roof Sheathing � � 74. Overhead Hydro 26. T�Bar Ceiling (Stracturaq & Monocoat . - . 75. Dry Chemiczi � 27. Frame and Flashing _ _�� . 76. �Dry Standpipe 28. Lathing & Siding ' ' _' � '' � . ' 77. FIXED SYSTEM FINA� ' 29. Insulation • •� � � 78, FIRE PflEV. FINAL � 30. Drywail Nailing � ' , ,HEALTH DEPT. REQUIREMENT 31. Piaster Brown Coat �. . : 79. FINAL INSPGCTION 32. Electrical Power Meter-Final ' � ' 80: FQOD CERTIFICATE ISSUED 33. Finai Electric � ' � Notes: 34. Final Heating & Air Conditioning _ � � ,� � � , . � 35. Final Gas Pipe�Test � � ' ' , . 36. Hood or CanoPv ' � � - � � 37. Final,�Factory Fireplace � : ' � ' � 38. Final Plumbing . � •. ' 39. Watei Service-Finaf , . ' � � � 40. Gas Service-Final , ' 41. Solar pomestio-F(nal ' � '. ' � 42. Backfiow Preventer - � � 43. Backfiow Irrigation ' � 44. Landscape Irriqation System . � ' - 45. Sound Attenuation _ „ , ' � . - ' - ' 46. Handicap Regulations �� ' 47. FINAL STRU,CTURE & BUILDING Gj� ,�� 48. FINAL PLANNING - � 49. Electric Release to Edison ' � ' ' 50. Gas Release to Southern California Gas Co 57. CERTIFICATE OF OCCUPANCY � No. Date June 5, 1998 �ITY OF COSTA M�A CALIFORNIA 92628420D DEVELOPMENT SERVICES DEPAHTMENT To Whom it May Concem: RE: 662 DARREL P.O. BOX 1200 Entry into the residence at 662 Darrel for the purpose of clean-up and repairs is authorized for the property owners or their designees between the hours of 7:00 a.m. - 5:00 p.m., Monday through Saturday. � � Rick Brown, CBO Building Official ca Code enforcement file ri Faa oan� Buldng Division (714) 7543273 • Code Enforcement (714) 754-5623 • Plenning Division (714) 754-5245 FAX (714) 754�856 • TDD (714) 754-5244 . � ; , , . k V. LAWMAST6R 8 CC.., INC. 7940 MAIN STREET — STANTON, CALIFORNIA 67LM5-186MM-002 828-8040 XXX Field Data on Test Specimens Core Concrete Gunite Grout/Mortar_ Projeti Lloyd �aMarre Swinpool Permit No. 97d5� Project' location 662 �arrell Coata Mesa Con}racfor Anthony Poola Architect a ow en on eam Location in Structure 2A3B Deep end bottom Engineer Adams Date Moulded 9/5/fi7 . No of Specimens 6 Slump Specimens Marked tf,–b, 2�+–b, 3A–B Specified Strengih at 28 days 200� P.S.I. Mix Designation Age to be tested�days��days days days READY MIX PLANT AGGREGA7E SOURCE J F3 T Weather Condition 1 Yd. Yd. Batch Cement Type Cement, Ibs. 750 sks Admix Sand 38 ton Specimens made by J f4cDougal ,'�q Data by �3 Delivered by #2 Dafe Delivered # REMARKS: Water, Gals. 3 per sk Lab. No. Date of Test Specimen Dimensions Area Ultimate Load Lbs, per sq. in. H/D Corrected �� -j� G� tA B 2A B 3A B FOR LABORATORY USE ONLY 3343 3346 3344 3347 3345 3348 7 DaY Test 7 Day Test 7 Dav Test a 2,998 � 2,842 2,,,z �h; (�}i-�C� I �6'� u.....— Test ING SAFETa' OEPT. �equire tr' ] ,^, iVGI CITY OF C05TA MESA CALIFORNIA P.O. BOX ��200 FROM THE OFFICE OF THE PLANNING DEPARTMENT Octaber 23, 1963 iloyd La Marre 662 Darrell Street Costa Meaa, California Dear Pool Ownere The Costa Mesa Planning Department has been notified of the completion of your swimming poo2, So that your pool wfll be a safe one and for the purpose of advising you of your responsibility regarding the requirements of the Costa Mesa Municipal Codeo we quote Section 9298,9e lo No swimming pool sha11 be cosystructed closer than five (5) feet to any property lines� measured from water line of pool, 2, No swimming pool shall be constructed under any electric power lines or on any-electric power easement, 3, No swimming pool shall De constructed unless the yard surrounding such pool is completely enclosed by'a fence six (6) feet in height and has a self-closing and locking type gate or gates. This courtesy letter is directed to you so that you will be aware of our ordfnances and can make a complete safety check of your pool area, Sincerely yours9 William Lo Dunn Director of Planning OWNER I,p JOB ADDRESS OUGN PLUMBING RO�. SWF. LINE � PRINKLING SYSTEM DATE g_7_ LOT 1 TRACT 221 FIRE ZONE VALUE Si natur� Dot� TVPE GROUI SUBCONTRACTOR � ROUGN NEATING AN� �IR CpN01TI0NING TEMPOF�NV SERVICE�OR-POIE - - UNOERGROUN� � POW�p � ' AOUGN wIRING satin and Vene. TRENCHES u FOAMS STEEL REINF. FLOOR SVSTEM BON� BEAM STEEL qEINFORCE SHEATMING FF�ME ANO FLASHING PLASTER,BROWN C04i TEST � �.. �'�- 7496 � � COSTA MESA BUILDING-SAFE'fY DEPARTMENT P.O. BOX 7YW COSTA MESA, CALIFORNIA 926YE For Appllcanf ro FIII In Completoly. TYPE OR PRINT BVILDIN6 ADDRE58 �! Q P C� COSTA ME3A, CALIFORNIA � � � ARCHITECT oF �07 '/ � G� now ri �•uoa. USE OP EXISTIN6BLD0. L/, �. Q ' Q YETlACK LINt PROY canTeR aP mttR RBAR Y D DIOBYARDI LtPT �� RIOHT DESCRIPTIOPI OR WORK NO. OP ROOMS WALL - ROOr � �� 1 XBP6BY ACKNOWL6p08 TXAT H � RGD 16 ,LIC AND 8T�T8 TX/�T TN[ ABOV • pgGT A /� 8 io PLY WITX I1LL CITY OPDIN C� IO �TA LI1 eU1lOIN0 CONB/iRy�sf 61GNATURB OP PERMI7T6 AUTHORIZiO AD[NT �((� L�jP,1I C (� �J` %`UUJO�UI�.��SHa�%�/..11� �i:�i1�:�iSi�i�j.�J� APPLICATION FOR PERMR BUILDIN�i : For Offim Use Only 11[c[I'T No. I P� ZONING ION[� NO.O� UyY[�O��N[W K �1AN)y2 e./�'u-fA ��/iM.�. osicR�moH �.�7�- /�Qcf' e2.e7/�S—G A.P.NO. //� — I/J/�- �� N0T6: NO RAVB OVileHAN6 SHALL �6 LCBBTMAN 80' TO 81D6 O RBAR P. L EAVEB ALLOWHD (U..B.C.REQUIRfiMENTI YARDHAPPROV6D YARDSAPPROVHD MAIN BUILDING ACCESSORY BUILDIN6 d PROM C/L IITRRIT) �� RRONT FT. PT. i. R_IIIOQ FT_ � > RT. VM• # I DATE APPROV[ ' �q ��/ B�' DATE � 1 / a , � •� � sa. ar. � 0 TN6 AMOUNT BXOWN UNDBR VALUATION IB FOR TXB j ■UPPo9Q OP [BTABLI8HIN0 A PERMIT F66 ONLY. 5 VALUATION . � s �� PERMITFEE •' �— X � 4�. / � �TOTALFEE � OWNFft LA GENERAL AP No. 11 Pools nnx� �-21-67 BUII.DING PF1iMIT NO. DESCRIPTION OF WORK PVt. FIRE 'LONE VALUE $ 2 SUBCONTRACTOR W ZONE , 27456 ", ,COSTA MESA BUILDING-SAFEfI' DEPARTMENT , P.O. BOX 7200 COSTA MESA� CALIFORNIA B272E For AppUcaM ro Fill In CompbNly TYPE OR PRINT ou��oina �v (vc� ��/��c G,� � . AGDREDS COSTA MESA, CALIFORNIA OWNER /., .�. O �/l) �./a �f1,�.GC T C ADAMS TRL. BHR NO. �A7i FTF�F.STOIdE BLVD. ron ANTHONY POOLS r871 FIRESTONE BLVD. SOUTH GATE 190179 �4 � 612E .L�Vs7 vJ� / � no.ore�oaa. a. /��> 5� �C/ iOM � ` :T S RQAR YARD- 7 �� li � � R�o� .5` DESCRIPTION OF WORK BUILDINO J/ GS{�' NO.OP �61ZE �Y"' ROOMS 8TOR1 EXTHRIOR WALL ROOP COVEIiINO COV8RIN0 U98 OF BU IIDil16 AND WORK TO B6 PQRFORMlD PRIVATE SWIM POOL 1 H[RRBY ACKNOWL[p0['*11AT.1 MAV6 q1AD•YXI� APII ANo BTAT6 TNAT'TNi AlOYi.19 CORR6CY/AND AOR86 PLY WITX ALL CITY OROINANCL AryD �1'AR LAW� R[0 OUILOINO CONBi11YCf10N. / H16NATUR! OR/�"-"'�- „ % �j—s"C"'c' PHRMITT6�'� ��yyy �r AUTMORIZEOA6[tiTi'��- C�'i%��%/'�"" 1:UG?_1-67��si0�1003'� ��'�1�;.uC APPLICATION FOR PERMR eunuiNc For Offlco Ut� Only 116C[I!T NO. �I eu��o�Na uo�� YARDB MPROV 6D MAIN BUILOIN6 vwR. # HO D FOR � � � � e- so. vr. TN6 �MOYM YNO' PIIRP08[ O� �DT VALUATION ar7so�fl/. � �� J/UyP X�G ZONING �f�. � � l � �—� LL BE Ll88 THAN B.� . RBQ� YARDSAPPROV6D OAT6 IB POR TXB P68 ONLY. a � W OWNER T,A MdRRF TTl7YT1 JOB ADDRESS (�Fi'� Tln.�..ol l � BUILDING PERMIT NO. GENERAL CONTRACTOR owner�builCer VALUE $q(,� �� AP. No. T,OT io TRACT-�oi C FIRE 'LONE DESCRIPTION OF WORK h'in..L ..,��1 INSPECTIONS � DATE I GROUP .T TYPE Gas Form 210-3M-4�59 SUBCONTRACTOR . "_ � � ��F�� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. GALIFORNIA FOR APPL/CANT TO F/LL /N COMPLETECY TYPE OR PRINT BUILDING � % aA {� _ / � .� 'T COSTA MESA, CALIFORNIA MAIL ADDF CITY LEGAL ILOT DESCRIPTION NO. A.P. NO. ��%� SIZE � OF LOT USE OF EXISTING BLDG. SETBACK LINE FHOM CENTER OF STREET SIDE VARD ILEFT rre// S% / ES� TNO. 0 FEE RECEIVED ��— /� —s / V« �Ty�� P�€�'' APPLICA� IT �BU DING fOR OFF/CE USE ONLY RECEIPT NO. I w �FERM1N^ 1�L� RECEIVED BY DATE ftECEIVED D I51 �,.-,� �i - f 6- s� � ir�� BUILDING COSTA MESA, CALIFORNIA TYPE !J:'I' GROl1P STATE APPROVED IG NO. BY DATE ZONING y/ S ZONE NO. OF USE OF NEW I n �� I IP�ANS �I BUILDING NO. OF BL�GS. NOW ON LOT �whC,( DESCRIPTION OF WORK icc i.�ur��ir.r�a. V BUIL�ING NO.OF SIZE ROOMS STORIES EXTERIOR WALL IROOF COVERING COVERING USE OF BUILDIN AND WORK TO BE PER'/ RME% ' . f u . � .t'S a �,�� A,r„ �/�� I HEFEBY ACKNOWLEOGE THFT 1 HAVE FEAO THIS APPLILATION AND STATE THAf THE ABOVE IS RFECT AND AGPEE TO COM- THE AMOIINT SHOWN UNDER VALUATION IS FOR THE PlY WITH ALL CITY ORDIN NC AND STATE WS REGIILNTING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. euuoirvc corvsTeucilo VALUATION $f/ SIGNATURE OF � �✓f PERMIT FEE $ ��'� `� PERMITTEE � � �'V" _ _ $ . PLAN CHECK $ AUTHORIZED AGEN TOTAL FEE $ � ♦ �� owrrr.a LAMARRE, LLOYD naT� $�1(�/59 _ JOB ADDRESS ��a�� r�orcc„�� BUILDING PERi\1IT NO. �p]g� _� GENERAL CONTRACTOR Owner builder VALUE $ 5j.pp AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Rl nr.k Wal l �NSaECTIONS I DATE SU6CONTRAGTOR Form 410-3M-4-59 " 1O181 w. ': �l1-1�1 G�STA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 GOSTA MESA. CALIFORNIA fOR APPL/CANT TO f/LL /N COMPLETELY TYPE OR PRINT BUILDING - AODRESS Z � COSTA MESA. CALIFORNIA � cvca:�uxn� LEGAL I LOT OESCRIPT!ON NO. A.P. NO. 512E / / � C 1-15 Z�l:/ LIC. NO� FIRE ZONE STATE pppR� .�C. NO. By I�R�� ZONE APPRI 9Y NO.OF BLDC9. ypRD'. NOW ON LOT ovn�� .� ca �., C� L_ V �.. �: �li S._ ;� c.I;G l f; i959 ��`n,n�CE DEPT. �!1'� �;: ^nc;n rAGc+�. APPLICATION FOR PERMIT BUILDING FOR OfF/CE USE ONLY I REGEIPT NO. �I !1 PERNIL NO. USE OF 1 ICENTER LINE EXISTING BLOG. I FRONT SETBACH LINE iROM � � cervieA oF eiAec�' SO REAR YARD � R. siDE SIDE YARD ILEFT Q' IRIGHT �' L.SIDE DESCRIPTION OF WORK BUILDING NO.OF SIZE ROOMS STORIES EXTERIOR WALL IROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMEO ii_" _'" �i�/ fL��v efV Cll� I HENEBV qCKNOWLEDGE THAT I HAVE READ THIS APPLILATION AND STATE THAT THE ABOVE �S CORRECT qND qGftEE TO COM� pLY WITH ALL CITY ON011 N�J RND TAT WS FEGULATING BUILDING CONSTRUCTI R SIGNATURE OF � �'-F-�� PERMITTEE Al1THORIZED AGENT ATE ISSUEO � /C�..1 COSTA MESA. CALIFORNIA TYPE GROUP DATE ZONING NO.OF ^ USE OF NEW PLFNS / BUILOING /�J IGII THE AMOUNT 6HOWN UNOER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLY. VALUATION 'W�� • �{ �.�p PERMIT FEE S �OS • $ �.( �Y PLAN CHECK $ / TOTAL FEE $ �� owNEx Santa Ana Razchos DATE 9-30-58 loa aDDREss 662 W. Darrell Stree't BiIILDING PERMIT NO. %C>72 GENERAL CONTRACTOR I7ike & Cole�rove VALIIE $ 15�jZ%,00 AP. No. LOT 19 TRACT 2215 FIRE ZONE DESCRIPT[ON OF WORK Single Res. A'it. saz`. GROUP I 8t J TYPE V ZONE Rjt PLAN NO. INSPECTIONS I DATE I SUBCONTRACTOR I___ PERMITSISSUED Plumbinq Fixtures, Final /y}jS //-sy � � � _ Final Gas Tut !3"" /LJff /�—S'4 � c�osrA /T�i u'� MESA BUILDING DEPARTMENT P. O. eOX 3I� COSTA MESA. CALIFORNIA �EE RECEfVED Q o-�� FiI�N� DEPT. FOR APPLICANT TO FILL IN Ct�APP��CAT�IO�N FOR PERMIT BUILDING 662 W. Darrell St. BUILDING A�DRE55 COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIpT NO. P�� OWNER MAIL T. 'In11 Sl AECENEO BY OnTE wECEIVEO TE ISStIEO ADORE55 �� r�• 1l lill �. - 3d -,r� SE� 3 0 199@ CITY Costa Mesa, V$111 • TNO. �• 0��5� q0 REI55 ARCHITECT �$Qn uc. COSTA MESA. CALIFORNIA OR ENGINEER CLLBbI'OOIC �o. FIRE � AODRE55 ZONE �k}��a1 & T,. ITY LIC. A ��E p�eN$ TYPE GROUP CONTRACTOR V�legrove 111�• NO. O� 1` ADDRE55 �] EO 1(th St• NO.�• 8-L1.59 gyPROVEb OATE "�"` ^,C CORRECTIONS OESCAianorv NOT l� OLOCK TRHCT 2F.1J A.P. NO. SIZE � No.oF a�ocs. OF LOT 6�- X g�g now orv �or i10II0 USE OF EXISTING B�DG. SETBl�CK LINE FROM �/ ef . cervlEa o� srr+c[r 54' REAR YARD Iv{.�06� SIDE YARD RIGHT � LEFT I DESCRIPTION OF WORK . NEW � ALTERATION ADDITION ' REPAIR MOVING DEMOL�SH SZIEDING gg 3�ROOMS 7 STORIE51 COVERIINGWALL J�UCCO COV�ERING COICIp• USE OF NEW a��o�� Sin le f�nil residmce with attached ar e. Plan 120B ' I HEREBY FCKNOWLEDGE THPi I HpVE ftEAO THIS APPL�CATION ANO STLTE THAT TNE ABOVE IS CORRECT ANO AGREE TO COMPLV W!TH aLL CITV OROINANCES RNO ST4T PWS REGULATING BUILDING CONSTRIIC- TiON. VALUATION �j SIGNATURE OF PERMIT FEE Fi J6�OO PERMITTEE M ' ' s 15,32'7 PLAN CHECK $ ��w AUTHORIZED AGENT p� COZE VC� J1aC• ' TOTAL FEE $ S��OO ewr �wtvr:tc LA MARFiE� LIAYll ��.ros aDnaEss 662 w. Darrell GENERAL CONTRACTOA Owner-B `� AP No. 11 5-h19-1 4 LOT 19 INSPECTIONS � SoIl or Final Street BUILDING PERMIT I�O. 27�4�i6 \y:\rl4�l SUBCONTRACTOR . F � a Q h F G W F a A ..1 a > r a x w o. � R�. F. z W CC 3 / �. ��;�2f COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to F81 in Completely — Use Ink Only BUIIDING // G� I_ i A . .. OWNER TE CITY `Q i CONSTRUCTION BRANCH ADDRESS ARCHITECT ADDRESS CONTRACTOR OW n � AODFESS TEL. qTV NO. STATE � � / CITV LIC. NO. /4O �lp � LIC. NO. g�2� i NO.OF BLDGS. OF LOT NOW ON LOT USE OF � EXISfING BLDG. _� Separate permits a required or �� electric, plumbing and heating work. USE OF BUILDINa �+ND WOflK TO BE PERFORMED I heraby acknowlad9e that I have reatl this application antl staie that the above information Is correct and agree to comply with all laws ragulating Uuiltling construction, antl I shall not employ any person in violation of the workman's compensation laws of the State of Celiforn�a. 1 he�eby certify thaT I am properly licansetl as a contractor under the State of Californie Business and Professions Cotle, �ivislon 3, C�apte� 9, antl Mat suc� licenses ara In full force antl effect, or I am ezempt from the provisions t the tate of ifornla Business and Professions Code, Divis' , C er Slgnature of Parmlttee Authorized ABent RECE 2335 8%07%7�tr "`„`��CATI�' 2335 870T/io:'� ..2335 Q9dQ446521 Np+-'--- _ ---_ �.,. - w ;�r�.t -:. � . . . FOR STRUCTURAL PERII4IT DATE RECENED ��G icci icrt � �„� A.P.NO. I�� G ADIDRIE 5 � �� TFiACT .[ Z OWNER US� FIRE ZONE T APPROVED BV 20NE o / NO.OF /�, PLANS YARDSAPPROVED MAIN BVILDING (FflOM GL STREET) DISTANCE BET MAIN BLDGS. VAR..iE ^ /�) PERMIT NO. � d � LOT / BLOCK I � / / 6Q/11V..I VALUE USE OF NEW BUILDING VARDS Af BET. MAIN & ACCESS. BLD DATE APPROVED THE AMOUNTSHOWN UNDER VALU THE PURPOSE OF ES"fAeIISHING A PERI VALVATION PERMIT FEE $ $ �{/�� PLAN CHECK S �/ D TAX $ TOTALPAID $ A L L � n m i v ro N ON IS FOR m FEE ONLY: � %/ 0 � ua'� m �' ^i 0 LL • O U