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Home My WebLink About681 DARRELL ST - Building Permits. `�t�iN I1�F� 4 �`y o. ` F � ., .� � OqnnxvRCY�s i' _ ' / CITY OF COSTA MESA � . __ ..._,_f BUILDING DIVISION %- -'� . ; ' , 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us �,�.-�--�-� ---�--�--�' FOR INSPECTIONS CALL: (714) 754•5626 PERMIT NUMBER: B11-00259 PERMIT TYPE 8_ROOF2 APN: 42215304 �y�''�►��ce?.,-:':=- r M1r j At,,::.s:.,.: � • ��' ! �� .�.��., r�;:�,.��. . . � STATUS: DATEISSUED: ISSUED BY: Suite/Unit: ISSUED 08/22/2011 CAC Valuation: $6,500.00 . .- ,.. SCOPE OF WORK: TEAR OFF AND INSTALL 1/2" OSB 1-15 LB FELT AND MIN. CLASS B- 30 YEAR COMP. SHINGLES TO' �� INCLUDE ATTACHED GARAGE. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for' �� ' verification of the installation of smoke and carbon monoxide alarms by the City Inspectoc See Attachment w/Inspection,Card <. ;:�: ; OWNER: NAVARRETE,OMAR PHONE: APPLICANT: NAVARRETE, OMAR PHONE: CONTRACTOR: OW NER-BUILDER Address: Unit: City/StatelZip: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $139.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 Address: 681 DARRELL ST City/State/Zip: COSTA MESA, CA Address: 681 DARRELL ST - City/State/Zip: COSTA MESA, CA License No. License No. PHONE: Unit j^ 4.,�,°i;?rpt'� Unit: . License No. 000000 CELL: PHONE: PHONE: ,�; ,. ' .' ... ,:i: �<�rd .� . . u:ui.. . . _. .. TOTAL FEES $140.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/1812010 - PER CMMC Sec. 13-279 � (J.,,'�� `;=� -'" Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal holi New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksqivino Dav and Christmas Dav 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, § i, 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . . INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must comply vnth all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. COOE%. INSPECTIONTYGE �pTE INTITIpLS LOOE/ INSPEC110NTYPE OFTE INIIPALS 1616 Fixed System Final Fire Prevention 206 Pinal Mechanical - 1266 Pool Spa Final /�:�—(�—(y, 208 Final Plumbing ,- 200 Final Re-Roof %:�Z �/ '— `�' ' 210 Final Electriwl � 201 Final BIOCk/Retaining Wall 212 Final Fire Prevention ��;!�' 202 Final Pactory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site "'"' I 204 Final Demolilion 250 Final Building/Occupancy _�=�"'�1'['�=��"''_F WORKERS' COMPENSATION DECLARA710N: I hereby aKrm under penall ( perjury one of the following tleclarations: � I have and will mainta� certiiicale of consent to sel4lnsure for workers' compensation, as provided for by section 3700 0( the Labor Code, for the peAormance o( the work for which this permit is issued. ❑ I have and will main[ain vmrkers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this pertnit is issued. My workers' compensation Insurance carrier antl policy number are: Carrier (This seIXbn neetl ro! �e mmdeletl A t�e peimrt rs value0 al one hvntliM tlollars (5100) orless.) Policy Number: ❑ I certify �hat in the performance oi Ihe work (or which this permit is issue�, I shall not employ any person in any manner so as to become subject to the workers' compensation lavrs oi Califomia, and agree that if I should become subject to ihe workers' compensation provisions of Section 3700 of the Labor Cotle, I shall forthwilh comply with ihese provisions. Appl¢anYs Signalure WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST. AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here6y affirtn that I am licensed under provisions of Chapler 9(commencing with Section 7000) o( Division 3 of the Business antl Professions Code, antl my license is in full force and eRect. Lic. # . . _. Class # Contratlor's SionaWre Oate CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that Ihere is a consWction lending agency for lhe per(ortnance o( Ihe �wrk (a wfiich this pertnit is issued. (Sec. 3097. Civil Code). Lender's Name: Lender's Atldress: Oa�e OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty o( perjury that I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fle a signed statemenl lhat he or she is licensetl pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pmfessions Code) or that he or she is ezempt Iherefrom and lhe basis (or the alleged exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects lhe applicant ro a civil penalty of nol more [han fiv hundred dollars ($500).): I, as ovmer of the property, or my employees with wages as Iheir sole mpensation, WIIL DO THE WORK, and the strucWre is not intended or o ered for sale (Sec. 7044, Business and Professions Cotle: The Conhactors License Law does not apply to an owner of property who builds or impmves thereon, and who does such vrork himselt or herself or thmugh his or her own employees, provided that such improvements are not intended or ofteretl for sale. If, however, the building or improvement is sold within one year of wmpletion, the owner-builder will have the burden of pmving that he or she ditl not build or improve for purpose of sale.)- ❑ I, as owner o( the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS ro construct lhe project (Sec. 7044, 8usiness and Pm(essions Code: The contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and who contracts for such project with �a ontracta(s) license pursuant to the Contractors License Laws.). am exempt under sec. Business and Protessions Code for this reason: % .��_� � �� ieo�- f_%if �e�t V �( % Owner ID verified by drive. _.,cense. L7'!es ❑ �No �� • D� r s Licens . Verifcation of Ownership by (rype of tlocument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavalion frve (5) or more feet in depth into which a person is required to descend, will be made in connection wilh work authonzed by Ihis permit, and that no building structure, scafldding, falsev.ork, a demolition or tlismanning thereof, will be more man thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit (rom [he Division of Industrial Safery, as noted above, unless such person has a permit to do such work fmm Ihe division. Appl¢ant's Signature Division o( Industrial Safety Permit Number _ HAZARDOUS MATERIALS AND EMISSIOkS CERTIFICATION: t. Will Ihe applicant or present or fuWre building occupant need �o fle and certify a Business Plan (or emergency response to release or threatenetl release of a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 of the Califomia Health and Safety Code requires, with some excep�ions, that a Business Plan be fled with �he Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperaWre antl pressure). 2 Does or will the applicant or present or fuNre building occupan[ need to file a registration form for acutely hazartlous materials? ❑ Yes ❑ No (Seclion 25533 of the Califomia Health antl Sa(ety Code, with some ezceptions, requires registration with the Costa Mesa Fire Depanment by each business which at any one time has on hand a quantily of acutely hazardous matenals equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic teet o( compressed gas at stantlard temperature and pressure�. 3. Does or will the applicant or presenl or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Calitomia Health antl Safety Code provitles that the Cos[a Mesa Fire Department may require the preparation, certi6cation and (ling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous ma�erials with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or fuNre building occupant require !or the vrork which is ihe subject ot this application a permit for such consiruction or modification from ihe South Coast Air Qualiry Management District or (rom any other air polWtion control tlislrict or agency? ❑ Yes ❑ No (Section 658502 of lhe Califomia Govemment Code requires that the requestetl in(ormation be fumished on applica�ions for non-residential 6uiltling permits). 6. Will any pah of the (acility to be constructetl untler �his permit be within 1000 feel (rom lhe ou[er boUndarie5 of a SChool? ❑ Ves ❑ NO Qf'yes", the facility mus� meet Ihe requirement of Sections 25534 and 42303 of the Califomia Health and Safery Cotle�. 7. If a permit From the Sou�h Coast Air �uality Management District or other air pollution conirol disirict or agency is requiretl for the work wliich is ihe subject of Ihis application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certificate of compliance from the appropriate air polWtion control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury 1he information given above is correcL I agree to comply with all state laws and ciry ordinances regarding Hazardous Materials and Emissions. SignaluR Dale CERTIFICATE OF COMPIIANCE AND AUTHORIZATION OF EN7RY: I certify under penalry ot perjury that I have read this application and state that the in(ormation given is correct. I agree to comply with all state laws and ciry ordinances relating to building construction, and authorize representatives o( the City of Costa Mesa to enter upon the above-described property for insp qtion purposes. I agree not to oca py or allow occupancy of any building fized by Ihis r it until final i ion. 5 g ure o! Legai Owne Oal 305]A61y0]) An0/or Aut�or¢e0 ApPllcan� \- s ;, '�.--^��.. ,_� City of Costa Jl�Lesa �uiCdi�ig 1�' ivision Costa Me�a �� Fair Drive, Costa Mesa, CA 92626 714-754-5273/Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # ��i - OOo2 ,S'-�t Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at /„F/ �..�� (/ �fi We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. �J�1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Gvl/2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �.�[3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit fled in his or her name instead of my own. �4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. G.✓1�5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. ��j�. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal govemment, withhold payroll taxes, provide workers' compensation disability insurance, and contribu2e io unemployment compensation for each "employee." ! also understand my failure to abide by these laws may subject me t0 serious financial risk. �. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 �,.`,. L✓i 8. I understand,as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. �/L9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. �/�CIO. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: j��11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. �i1L 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is �s ed to verify the proper owner's signature. Signature of property owner��/�/fl/�� Date: �f' ��' �� Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally fillec out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3148-30 CALBO Jan 1, 2009 OB Packet template 2 Of 2 CITY OF COSTA MESA CALIFORNIA 9262&1200 P�O. BOX 1200 DEVELOPMENT SERVICES DEPARTMENT September 26, 1994 Dear Costa Mesa Pr.operty Owner: In reviewing past permits, we find that work has been done on your property located at 681 Darrell Street, Permit No. B64650. for a roofing permit. The permit is valid for 180 days from issuance or your last inspection, per Section 303 (d) of the 1991 Uniform Building Code. Should we not hear from you within 10 days, your permit will expire as stated herein and additional fees will be required to finalize the permit. Failure to final a Building Permit could possibly impact the future sale of your property. To activate the above permit, please follow these steps: 1. Telephone (714) 754-5626 or 754-5627. 2. Request an inspection; state address, permit number, and type of inspection. 3. Be sure to have working smoke detector's as required per Section 1210(a) of the 1991 Uniform Building Code. 4. Have an adult present at the property at the time of inspection to provide us access. Should you have any questions regarding this process, please contact me at (714) 754-5273. Thank you for your cooperation. Sin�el_y, _ �/ � ( (Mn�C_� � landa Huapaya Permit Processing Specialist 77 FAIR DRIVE Builtling Orvision p14) �Sa�5273 • Cotle Enforcemem O14) 754-5623 • Planning Division �J14) 754-52d5 - FAX (1191 556]508 • TDD 014) 754-5244 �� ' PflOJECT AODPESS: ( S S DARRELL ST pWNEfl'SNPME: DAGUE BRIAN aooxEss: 681 DARRELL ST ` COSTA MESA.CA AflCN/ENGINEEN: pooqess: UNIT: 92627 NEG.NO.: uxir: PENMITTEE: BRIAN DAGUE (714)C�31-443U�i aooR[ss: 681 DARRELL ST C.M. CA 92627 LICENSEO�CONTBFCTOfl OECIl�NATION: I here6y alli�m thal I am Iicen5e0 un0er pmvisions ol Chapfer 9(commencinp wit� Section � 7000�.oi �iv��sian 3 0l the Business ane Pm�essions CoOe, antl my license is in full forr.e antl eftec�. CRY LIC.: STATE LIC.: CLASS: Oate'. SignaWre: WOBKENS' COMPENSATION UECLAPRTION: I hereby al�irm Ihal I have a certificate of consent to setl�insure or a certificale of Workers' I Compensation Insurance. or a certitied copy t�ereof (Section 3800. Lab. C). I 70LICY NO.: EXP. DATE: COMPANY: ❑ Cetlifiea capy is �ereby lumished. ❑ Centlietl copy is lile� wii� Ihe city Builtling Division. �ate: ApplicanC EXEMPTION FBOM WOflNEflS' LOMPENSNTION OECIAPFTION: (This section nee0 no� be complete ' the permil is for one �untlreE (E100) ar less�. I cetlily �hat in Ihe periarmance ol lhe woB �or which this permil is' 4 I s�all not e I y any erson in any manner so as lo �ecome suDiet� �oJ Ihe W-o7rke/rs�' Compensaiion Laws ot Calilornia. �ate: /�'—LP�� Signamre'. � � NOTICE: II. afier makm �his tleclaration, you shoultl e sub eci lo Ihe ork 9 I pensation Dmvisions af ihe Labor Code. you musl lorthwilh compty with such provisions or t�is permit shall be metl r okeG. CONSTNUCTION LENUING RGENLY: I herehy aifirm �hal lhere is a cons�mcti0n ndin ency for the pedormance ot the work for whith IhiS permi� is issuetl �Seciian 3W7. Civ. C�. LENOEfl: 11DOXE55: OWNEfl BWlOEN �ECIABAT10N: I hereby alLrm Ihal I am exempl Iwm the Conirac�ors' Stale License Law tor �he following reason �Section 703L5 Business and Pmlessional Code: Nny ciry of counry which requires a permit to consiruct, alter, impmve, Oemolish, or repair any stmcture. D�ior lo its issuance, also requires Ihe applicant for such permit b file a signed statement ihat helshe is licensea pursuam to �he pmvisions of ihe Con�rac�ors' S�a�e License Law �C�aO�er 9(commencing wi�� Sec�ion 7000) of Division 3 0� the Business antl Professions Code� or that he/s�e is exempl Iherelmm antl Ihe basis �or ihe allegetl exemption. Any violation of S¢ction 7031.5 Dy any applicam for a permit sublecls �he applicanl �o a civil penal�y of not more �han five hunOreO tlollars ($5110�. L as owner ol Ihe pmDerty or my employees wiih wages as �heir sole comDenu�ion, will do �he wolrc, and ihe ❑ stmcmre is not intended or oltereA for sale (Section 7044, Business ana Pmtessional Code: 7he Contracrors' State License Law does nol apply to an owner o� a pmperty who �uilds or impwves t�ereon, and who does such wark himselflherseA or �Amugh his or her own employees, provitlee Ihat such impmvemenis are no� intended or o��ered �o� sale. I�, however �he huilding or , impmvement is soltl wi�hin one year o� comple�ion, t�e owner will have �he burtlen of pmvinA �e/she tli0 no� Ovild or improve � �or Ihe purpose of sale). I. as owner ol �he pmpeny, am exclusively con�racting with licensed coniracmrs ro consimct tAe Owlect (Section 7044, Business ❑ anA Pmlessions COAe: The Coniracmrs' State License Law does not apply io an owner oi pmDerty w�o builUs or impmves thereon and who conirac�s �ar such pmlec�s wit� a con�rac�or(5)license pursuant �o �he Contractors' S�ate License Law�.l am aware tha� pmol o� Iheir Worker's Compensation insurance shoultl be pmvitletl to me. � i am exempt untler Sec�ion: B P 7 � 4 4 B. 8 P. C. mrteisreaso�: /O�W�ER HUILDER �ate'. I � � �('J'— � Owner. , I do hereby cetlity I�at I am aware of an� unders�ana t�e requirements ol ifomia,Health antl ery e Sections 25505, 25533, antl 25534 antl Ihat I or any lulure bmlding occupani will/will no� (circle one) need lo comply wi�h 5 e cotles and �he requiremen�s for a permit lor consimcimn or mo0ilicalion imm Ihe Air Ouality ManaAement Oisiric�. Fesidenlial constmc�ion aDPlications are exempi fmm lhese provisians. .Oate: Appl7cant: I here�y cetlity �hal I have read this application and S�alelhai ��e a B� fOrmaiion is Correti. I a ee�o Comply with all ti�y antl c0unry oramances antl slatelawsrelatinglo building consimciion antl here aul 6rrzerepresenla ives ol�his ilyio en�eru bove�mentionetl property for inspeclion pur�pnoses. Dale: �� ^Z6 _ J � SignaNre'. oriver's License or Sociai Sewrity n: � t6nLa6 Wbne—Bmltling, Green—Cotle Enlorcemenl', _ ! GOIEenmtl—Assessor _��` CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 06965C PERMIT NO: H 064650 PLAN CHECK NO: N GOVT: N SOPP; N CONSTRUCTION TYPE; C�—N PERMIT TYPE: STR PURPOSE; OTH JOB DESCRIPTION : T/O & REROOF 2400SF W/COMP. SHINGLES SQ FT: 2,880 CLAZM VALUE: 2,880.00 CALC—VALUE: 2,$$0,00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PEA O.B.0 1991 ****�*****�+�****��**�********�*+��**��*�*��**�*x��***�r****��*#�***��x��*�c��*�� 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 BUILAING ---------- --------- ACCESS��RY EUILDING --------- FRNT; FT IN REAR: FT IN FANT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT; FT IN PARKING RE�• FROV: PARCEL: 42215304 ZNE: REF NO; PLANNING N TES> '. ? �ElF i! it 1F i! f! if jE 1E 1E if i! i! if ff it if iE �f �l! 1c if if if jF iE �E if if !f it if i! k 1E if �F 1Flt if if �f iE f! iF iE iE iE iF �! 1t iE iE 1E # iE?F iE 1F iE 3E ic ik # 1E i! iF 1F if iE fE iE it if iF fElE 1E P E V E L O P M E N T S E R C� I C E S R E Q U I R E M E N•T S ZONING APPROVED�BY DATE: BUILDING APPROVEP BY ; DATE; APPLICATION ISSUED BY: �//�/'�--. DATE: .� � 1� �t**�r�t�r*�ri��t**�r**�r*�r**x��r�r*f�**�rx�rx****#Ti€ �r��r**�r****i�******�r***�r*�r** **:*** "�** it it if -k 1E iE if� iF it if jE i41E if iE 1f iE i! iF if iF iE it 1E if i(- 34 # if iE if it if iE if if if it iF iE iE iF iE it * if iE if iE iE 1E if-�lE if if if iE iE it iE ic ih �: it 1E if iE it i(� if iF iE if �k iE if �1! �H� iE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54.00 ,50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID. DUE TOTALS----> 54.50 0.00 0,00 54,50 54,50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 54.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54.00 ,50 iE iE it �f if 1F if �E fE 1E 1E if iF iE 1F k iF iF if iE 1f if it it i! i! iE iE 1k it 1t if if �t if if #! iE f4 if if iF it 1f 1E if �1F 1f if i(� iE iE iE �E if iF # iE 1ElF if M ih # iE iE iF iElf� fE iE iE;h iE i4 if if 1E if I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 2880 REROOF BY VALUE RESIDENTIAL NOZONE SIVIOKE DETEG�'t$O�OQ END OF FEES REQUIRED , 01 ti0Z4g�.2—Q0149tr83 T CST �4.`} ua��: .�i��,93 i?iiE: f� ,� (' ( [ ' • � � CONSTRUCTION AND PLANNING � PUOI & SPA : APPROVALS Permit # Date Inspector AppROVALS Pe�mit # Date Inspector 1. TemPorary Eiectrical Service or Pole 52. Pooi & Equipment Location 2. Soi1 Pipe�Undrgrnd. 53. Steel fteinforcement , 3. EleCtrical Conduit Utility-Undrgmd. 54. Porms � 4. EleGtrical Conduit-Undrgmd. 55. Electrica� Bonding • 5. Steel Reinforcement 56. Rough Plum6ing & Pressure T2st ! � 6. Electr�cal UFER Gmd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electricai Conduft-Undrgrnd. 8. Foundation � , 59. Gas Pipe, O U�drgmd., Tes[ 9. Water Pipe�Undrgmd. � 60. Backwash Unes, P�Trap, � Undryrnd. � � 10. Structural Floor SYstem 67. APPROVAL TO DECK ' 71. Propertv Seveer Line & Nouse Connectio� � 62. Backwash & Receptor�Final • 12. Sewer Cap " ' _ 63. Heater & Vent-Final , . _ 13. Roof Drains 64. Plumbing System � Final ' 14. Rough Plumbing 65. Efectrical-Final , 15. Rough Electrica6Conduit 6fi. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access ApProval � 17. Roi�9h Wi�ing Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-7 Bar Ceiling 69. POOUSPA SYSTERAS P�NAL I �g, t?ou5h Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # 21. DuGts, in Structure 70. Under9round Hydro 22. Dutts, Ventiiating 71. Product Piping ClGas �Oil 23. Gas Pipe�Rough &�Tesc 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �7Gas ❑Oil 25. Rool Sheathin9 `� �('1_ �3 �(,�/ 74, Overhead Hydro 26. T�6ar Ceiling (Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Ory Standpipe 28. Lathing & Siding � - 77. FIXED SYSTEM FINAL 29. Insu�ation 78. FIflE PREV. FINAL 30, Drywali Nailing HEALTH DEPT. REQUIREMENT 31. Plasier Browm Coat 79. FINAL INSPECTION 32. E4ectrical Power A�eter�F�nai . 8�. FOOD CEftT4FICATE 1SSUED 33. Fina� Electric ' Notes: 34. Final Heating & Air Conditioning � 35. Final G2s Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace 38. Fin21 Plumbing 39. Water Service�Finai 40. Gas Service-Final 41. So12r pomestirFinal 4,. 42. Backflow Preventer '� ,� � 43. Backflow Irrigation ` i 44. Landscape irrigation System ',,; i� 45. Sound Attenuation , E„� ; '� -.., 46. Handicap Regulations "'� � � 47. fINAL STfiUCTURE & BUILDING �3,.�L� �w� _;.: T� 48. FiNAL PLANNiNG " �, i �-} 49. E�eCtric Release to Edizon 50. Gas Release to Southem California Gas Co ' 57. CERTIFICATE OF OCCUPANCY No. Date ,- �w i� to (ill in all , CITY OF� COSTA'MESA - i CONSTRUCTION PERMIT a e wim�n `i3 � bortle� linez antl.sign all approp�iate tlecla�atio� TRACT NO. LOT NO.- -� '�BLDG. NO. � Pro�ect Addres _..� �, ,. � CT,�YPE OF CONSTRUCTION � Owner - ' ' lfi UT'p �' ' ' PhOn2 � ' JLJ NEW . � ADD ❑ ALTERATION } �-Add�2ss' � SaII1B-� - - . _ ' . . _ . . . ' .O REPAIR ❑ CONVERSION ❑DEMOLISH � A�Ch/Eng: � � ' " ' - - ' LicenSe-No. � -0 OTFER , AddfE55 '' ' V 8 b So . DESCRIPTION'OF WORK_ _ Contrecto - ' OIf189 Phone pE OF�PERMIT._ - - � �'Addre55' . - ' 'VC . ;,,� ' .' ❑ GRADING, �' ❑� FOUNDATION STRUCTURAL LICENSED CONTRACTOR DECLARATION_ . ' ❑ TENANT��yCLECTRICAL �BING ❑MECHAN6 I hereby affirm that I am Ilwnsetl untler p�ovlsions of Charter 9(com- � � .. .. � . mencln9 wlth section-7000) ot DlviSion 3 of the Business-antl ❑pTHER Professions Co d my Iltenze is in full .forte ft t. LltenseClass �C�� LicenieNo.�� PROJECTDE�CF�F��ID�{�IL11` . _ : .._ \. L. V Date � i u. .. _ _ . SQ. FT.' ��T . D . . . .. , WORKERS' COMPENSATION DECLARATION - - • OCCUPANCVy��NSTRUCTIcpJ�VPE I hereby affirm that I have a certiticate of consent to self-insure or a VALUATION � ZONE �trticate of Worker5' Compen5ation' Insurance', or a•certifletl copy - -- -- . .._ eaf (Settioq 3� 0p.,L,ap��C �-GRADING CU. V�S. � ' ACRES cYNo. "W�1VbOLL�'panY 'i�l�LTil Q�A30C. . . . '_ - ' ' Certlfletl�tOpyis�he�2byfumishetl. . . , . REMARKS:'- 1 Solar.�domestic-he�ate: ifietl COpy is filetl with the city Builtlin9 DiviSiOn. XEMPTION FROM WORKERS' COMPENSATION�DECLARATION ' - 'IAPMO SZ�L2'Z '- - (This section neetl not be tompletetl if the permit is for ane nuntlretl ,. _ . 15100) or 1e551. • ' � ' certlfy that ln th¢.perfOrmance of the work for whlch this permit is Iszued, 1 shall not employ any person In any manner so a�to bewme PLUMBING � .PLAN CHECK subject.to the Workers' Compensation Laws of Calitornla. .' _ . Dat¢ $Igndture � BATHTUB$ SHOWERS NOTICE: If after making this tleclara[ion, you shoultl become subject TOILETS�� 'URINALS ' to the WOrk¢r5' Compensatlon provlsions of the labor Cotle, you must � � forthwith comply wlth such provisions or this permit shall be tleemed LAVATORIES DOUBCELAVS - revoketl. . _ a . _ . . .. _ CONSTRUCTION LENDING AGENCV -KIT. SINKS " DISHWASHER$" I hereby affirm that there i5 a construttiOn lentlin9 agency for the per- SERVICE SINKS , � SUMPS ' '' '� formance of the work for which this permit Is issuetl (SeC[ion 309] Civ. CJ. " ' - � - � FLOOR SINKS � FLOOR DRAIN$ � Lentler'S Name �T � 9 r n- Lentlef's Atltlress DRINKING FOUNTAINS �� J OWNER BUICDER DECLARATION' -' ' - � WTERCEPTORS � � CLARIFIERS � I hereby affirm ihat I am exempt from.the ContractoYs License Law for to `dp[er y (mmmenan iness and PrWessions .s for the allegetl exe y applicant for a per not more than five h 5 Business antl Professlons Cotle: :s a permit to ConsVuct, alter, cture, prior to its Issuante, also re- to tilE a Siqnetl statement that he � Of [h¢ Contrac[ov'S License L.aw' �.ion 7000) of Division 3 ot the at M1e is exempt there�rom antl the y violation of Section �031.5 by tM1e'applicant to a civll penalty� irs ($500). LI 1, as owne� of the property, o� my employee5 with wa9as as t�el� sol2�compensation, will tlo the.work, antl th¢ structure is not intentletl or offeretl for sale. (Sec[ion 7044, Business antl Professions Cotle: The Contractor'S License Law tloes not apply to an owner of a property wh0 builds or improves the�eon, antl who does such work himself or through M1is own employees, p�ovltletl that such.irtiprovements are not intentletl or offeretl for �sale. If,;however, the'builtlinq or,imprpvement is soltl within one�year oi mmpletion, the ocvner.will have'the tiurtlen of proving he tlitl not builtl or improve for the purpose oi sale). ❑ I, as owner of tne •property, am ezclusively contractinq with licensetl contractors [o consVuct the project (Section 7044, Business antl PrOfe55ion5 Cotle: The Contractor's License Law tloeSnot apply [o an owner of property wh0 builtls o� imprOVEs Ih¢reon, antl who com t�acts f�om such p�ojects with a contraGtor(s) licesnetl pursuant to the Contractor's License Law�. ❑ I am exempt untler $ec(ion � ��B. & P. C. tor tfiis reason' - ' Date -Owner I M1ave {,eatl thi5 appliGation antl State that the :ct. 1 pgree to compty with all <ity antl c SWIMMINGPOOL PTftAP' ' WATERSERVICE �ALTERATION GASSERVICE OUTLETS WATER FiEATERS BTU-OUTPUT - SEWER CONNECTIONS - SOLAR TANK O COLLECTORS SOLAR PIPING V5. ISSUE FEE MECHANICAL y) PLAN CHECK �--. HEATING SVSTEM 0-]00,000 BTU ANDOUCTING 100,000+gTU REFRIGERATION 0-300,000 BTU SYSTEM "' 100,000.+BTU BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MVLTIPLE Signature ' �/ at4` - ' I Drivers' License or 55 � �SSUE FEE CMF 0865-46 Whi[e-Builtlin9: �nary-Applicanh Pink-Accounting; Goltlenrotl-Assessor _ ,�� . . _ Oil4 12/31/81 i6.50 TI �. . • .1 ' �� .., y _ � . ._ . _ .. . , ' ' _ '- , _ � -� A.P. � - - , ne.' - , . ZONE � �� .PLNG. REF. � REAR YARO (TO P/L) - � PKG.SPACERE�. PROVIDED � - � STREET WIDTH . �.� . PARK FEE-$ . . . ONS: ELECTRICAL -'" aLArv GHECK � I� � I--- GENERATOR -" 0-1 KW 1-10 KW ' " TRANSFORMER - ' APPLIANCE 30-SOK -SO+KW -- � MOTORS 0-1 HP' 1-30 HP" j' (IN0.50LAR)� 30-SOHP_50+HP-� ' � FIXTURES -'"" OUT�ETS 'SWITCHES " 'GHSTUBESIGNS ' -' , - " 'PANELS MAIN " SUB " ' '� ' SERVICE - . ' AMP - - /.!� _. _. . . APPLICATION APPROVE� BV � - DATE � SUMMARY OF FEES . • BUILDING ' -' - - • � � PERMIT $ SMIP � .. �$' PLANCHECK $�._�__..,]a, PERMIT ' . � / �� ISSUANCE $" r PLUMBING $__L- GRADING .8 PLANCHECK 5�) • . .ELECTRICAL $�`� � •a . PLANCHECK"$ `N1ICROFILM'$�� .MECHANICAL $ � ��TOTAL FEE $ - � - � � LE55 AD- � ' � PLANCHECK S ' VANCEPC"S_ � . . - n�t ., ` . 1 , � FINALFEE S� ,. CONSTRUCTION AND PLANNING POOL & SPA .� � APPROVA�S Permit # Date - Inspector ' � � qppROVALS . Permit # � -, �Date . Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment �Locatiori �� 2. Soi ipe-Undrgrn � • 44. Steel Reinforcement - � _..3... Electri�yl Conduit Utility-Undrgrn 45. Forms ' � � 4.. Electrical Conduit-Undrgm ,� � . • ^46. Electrical Bonding . � - - ' ' . tee ein orce 47. Rough plumbin -& Pressure'Test � �� 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. ootings ' 49. Electrical Conduit-Undr rn ' � B. Founqation _ � � 50., Gas Pipe, � Undr rn, Test � � 9.. Water pipe-Und�grn • ""'51' ` Backwash Lines P-Tra ❑ ndr rn 10. Structural Floor_System ;�n 52:" :AP,PROVALTO DECK ' 11 . Property Sewer Line &. House Connection � 53. Backwash & Rece tor-Final � � ', 12. Street Sewer Connection " ' � - � 54. Heater & Vent-Final � � � 13. Rough Plumbing •- ,,,�t � '� � � - ' ' ' � - - 14. Rough ElectricConduit ' ' � " • - - �56. Electrical-Final � 15. �Rough Electric-Wiring "' -' " � - ' 57. SolarSystem-Final ' ' • ' - 16: Rough Heating & Air Conditioning � � encing & Access�Approval i 17. �Ducts in Structure - � ' APPROVED FOR PLASTERING ' -� 18. Ducts,_Ventilating ' _ , 19. Gas Pipe-Rough &Test � � - 60. POOUSPA SYSTEMS FINAL , , 20: Roof Framing - i . . � ' ' � � . 21. Roof Shea2hin � - ' . - � � � � . • 22o- Frame and Flashin NOTES: . 23: - Insulation � ' ' � � � ' ' 24.-- Lathipg & $iding � - - � 25. Drywall Nailing ' 26. Plaster Brown Coat ' ' , ' ' 27. Electrical Power Meter-Final - � 28. Final Electric � � 29. Final Heating & Air Conditioning . � 30. Final.Gas Pipe-Test � � 31. . Final Plumbing - �32. Water Service-Final � � � ' ' 33. . Gas Service-Final ' ' � ' � 34. Solar pomesticFinal � .+ !� :..-o�' -' � 35. Landsca e S rinklin S stem ' � 36. Sountl Attenuation , 37. Handicap Regulations � • � � 38. FINALSTRUCTURE&BUILDING ; 39. Specigl Requirements Completed � � � � 40. Electric Release to Edison � � ' ' 41 . Gas Release to Southern California Gas Co. � 42. CER7IFICATE OF OCCUPANCY . No � Date - . , . �.--.. . Permit` #�.` ��, f_`13 THIS NU�`ABER MUST ACCOMPANY : Al l_ INSPECTION RQM��OT _. . .,b � �'/- /O d'�. Scheduled Installation SURVEY . :._.. _ �_Date, NAME '� n f"� �� % c:/ � p�"i DATE G�. -� �% / ADDRESS 1, �/ /�p /z/L�=—� S7� SALES REP ��_ %--� � • � �_ � CITY C /�%• ZIP ��':� / HOME PHONE C(�!.'� —� 3�� 1' THOMAS BROS. MAP Page y WORK PHONE Gj 5' %—%v-�� - # PEOPLE IN HOME .�, X p0 GALS.�= HOT WATER USAGE : � BEDROOMS � SOLAR TANK SIZE: 80 120 �� NUMBER COLLECTORS � 3 ROOF TYPE `,%� n r i� ROOF SLOPE l/ I�" � ROOF CONOITION Normal' `� ' � �--��c� � ,�- � RACKS RERUIRED - , Lateral ATTIC ACCESS AVAILABLE �i.�J OPEN BEAM fi.� 0 ' TI1\IV Qrr� T1/� � ' . � . _ .R TARX �OC.9....4 C%r?-ri.,rlc, _� - - - - - - - - - - -. - - - - - - - - - - EXISTING WATER HEATER IQCATION /%�, �,/c� /i' L' /'" /JF !/ � -� PIPE RUN: Number of Feet 1.� �� X 2= lL��' ONE or TWO STORY C�/"✓ �-' ✓ PET CONTROL NEEDED PREVIEW• JYES C� • NO - - - - - - - - - - - - - - - - - - - - - - - - - - SPECIAL NOTES: 1 �(' � �-P � � .s G. �� -�, � �Q.� . j .� . � , � � �P � �%�r � �. i�–% ; � � ,aJ C� C c!� >-:;. ' ; � "- ; I 8uilding Department '^ /%� � , a. . ---,_ _ --- � �: ,�r�r,s . . ,...I;_� . ... � g.�:.e,�� -• � q �„l c--- uate%^ .,..r..:. . � STORAGE fJFFIY�'' :-' Yes-� No �WATER HEATER BLANKET. Yes No ' AIR PAO . • •-• • • • Yes No �/ SIZE: Small � (30-40 gallons.) ELEC7RIC . : . . . . . Yes �/ No - Large ( 50+ gallons ) GAS WATER HEATER ... l �' �# of gallons) R_1000 Home Conditioner .... __ .. LOT� TRACT J cunti"u-w'- ��^-�� 10/81 : .. .. . . : . . _. . p..� Q�o-p-�- �� . . CP � �] l : . .". . �- .. � .... � .. . . . . . .. .` , .. � Ga`�..`SS - � m �6 k'R�-l�RS � C O L �� CTOR rno�� N G ST'H� :Ga9Y�L� i-ro►�T" rnc�T � �3� � .. , ... a 3� �, �c� �� C C7'd2 'W)(?U�t�'►^f� ;. . (� � �'ct�� b . � R � c k�,s. a,x� �a�d�cn. ; 60 6 r A 1 uw+� rJvv,•� _ DrnciceT' M1Lv►�,.vw.� • i=��'S►(rr►� VNL�1^ 5Y(in�ye ,, SCr�w -=►JTo 1QA-�4e r� � �P�R Tc�P_,_�^'j,o�.o�+�i' . ►+'��'Yn� cW�,�e i Sa'nh'�_ rro ^��'!r'9 _- — . _ 71' : ., ^ �� r . . .' ; � � , }. SU ORKS 3'x8' Collectors APMO # 5-2222 � ' � OLIN II•3'x8' Collectors IAPMO # 5-2131 INDEPENDENT ENERGV C-30 CONTROL U.L. # MH-11253 (M) . f GRUNDf05 PUMP U.L. # Z-58326 RHEEM SOLAR STORAGE TANK IAPMO # � BRADfORD- � WHITE SOLAR STORAGE TANK U.L. # MH-11701 � —r -�- �� D��Ilt��l-- _ I� C � 0 ! � � �[i.T�i�� GENERAL CONTRACTOR � AP No. i� C_�� o_I,o LOT INSPECTIONS 0 (�3) DAT� ii l dar VALUE $ 1� TRACT },��R� ZONP D�SCRIPTION OF � Signature� DATF GROUP I� JTYPE �7 SUI3CONTRACTOR � ZONE �aCi.�e, _g��cs� � .�-u'�7� si��-.�� .« �..5`�� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COBTA M68A. CALIFORNIA For App 'eanf fo Fill In Completely 7YPE OR PRINT � BUILDING � ADDRESS COSTA MESA. CALIFORNIA ■ STATE � 6HT9ACK LINB FROM BUILDING SIZE EXTERIOR COVERING USE OF Bl TEL. NO. OF NOW O'. � I RIGHT I OF WORK NO. OF ROOMS IROOF COVERII �K To ee �EE REC�.I��U � AUG 2 91�01 �FINANCE DEPT. CITY OF CUSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. �PEI�� NOf: "L J i, BY � R'1E RE IYED I DATE I66UE� COSTA MESA. GALIFORNIA APPROVED �( BY /' NI ZO �I NO. OF � �' PLANB LEGAL /, �L — DE6CRIPTION VL . A. P. NO. /., � `J � 2' YARDS . E� APPROVEO AI �/ ICENTER LINE BTJ L_ FRONT FT. � r ��+�/.a i� �:�` ` � �� 1 HEREBY ACNNOWLEDG6 THAT�1 HAVE READ TH19 APPLIWTION TNE AMOUNT SHOWN UNDER VALUATION 19 FOq THE � ANO BTATE TNAT TXE ABOVE IS CORPEGT ANO AGREE TO COM- pY[tP08E OF, EBTpBL�BH�NG A PERMIT FEE ONLY. O PLY WITX ALL CIiY OR�INANCEB AND AT¢ LAWB R60ULATIN6 w eWLDINO CONBTRULTION. VALUATION �� q SIGNATURE OF PERMIT FEE S m Q PERMIITE � I(,/+ �/ ' � $� J LilA � PLAN CHECK � �/ _ � AUTHORIZED AGENi ,% �� K TOTAL FEE �' 4 E-� � W 6� a � y F ci F a c � Q 7 � W O d z � 3 45s74 COSTA MESA BUILDING-SAFETV DEPARTMEN P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only IILDING / G/ ��ELL ST• )f1RF5S Ha �W N E R /7N//�� /� ' MAIL / O/ r ADDRESS E�a �� CITV �S� /� CANSTRUCTION �. LENDER BRANCH ADDflE55 ARCHITECT ADDRESS CONTRACTOR ADDRESS GTV STATE LIC. NO. SIZE OF LOT SS BUI IDING ADDRESS OWNER S FIRE 20N APPROVE �. RV TEL. NO. C�TV LIC. NO. NO. OF BLOGS. NOW ON LOT EXISTING BLDG. ��N(�GE �%I//i/L y L . Separate permits are required for electric, plumbing and heating work. USE OF 6UILDING AND WORK TO BE PERFORh �u�� :.: FOR STRUCI'URAL ��vv.Ns , VARDS APPROVED VAF. #�' BLOCK USE OF NEW G��y� BUILDING�y^,6� � VARDSAPPROVED ACCESSORY BUILDIN6 0.4TE APPROVED FT I hereby ecknowledpe that I have�reatl thif applieetion and atate �^ thet the ebova informetion is corract and a0ree to comply with m all lews �aa�ien�e bulltlln8 �omiructlon, enC I shnll noi employ ,� eny penon in violation of ihe wo�kman's compenutlon laws of a ihe Siaie of Califomia. l(/"� - • 1 hareby certify that I am properly licensetl es e contractor untler a U SQ. FT. a the Stexe ot Celifornie Business and Profeasions Code, Divleion 3, THE AMOUNT SHOWN UNDER VA�UATION IS FOR m Chapter 9, entl Met such licenws are in full force end eftect, or I THE PURPOSE Of ESTABLISHING A PERMIT FEE O LV: � am ezempc from tha provisions of the Stete of Celitor ia Buciness VALUATION PERMIT FEE E end Professlona Code, �Ivision�3, Chapier 9. uqi m Slpna re of ' .� PLAN CHEGK ^� Permi� �� v. Y $�� TAX E LL U AuthorizedApent TOTALPAID .a `Q �OWNER CAPASSO ANTHOPIY L. OB ADDRESS 1 Darrell Street .GENERAL CONTRACTOR er- �AP No. 115 1-OS LOT TRACT INSPEGTIONS SI natu so�� G<S W RTEF ROUGM PLUMBING PRaP. SWa. LINE a HOUSE CDN. � SGRINKLING SVSTEM MISCELLRNEOUS FOUGH MERiING nN0 RIR CONDITIONING �iEMPOR�RYSERVICE�OR�POLE — --- UNOERGROOND � POWER � ROWN WIRlNG TRENCHES I FOqMS STEEL REINF. � FLOOR SVSTEM FRFME ANO FLRS L4TMING — IN r PLPSTER,BROWN STRUCTUR4L, FIA HE/�TING. VENT., PLlIM81NG, fINRI EIECTfiIC, FINR� BWLOING, FINLL FT RIG. �NO �.G. FIH�L DATE 3-16-78 BUILDING PERMIT N0. RIPTION of WORK � Z=�'�� ZONE VALUEE PE GROUP 7 SUBCONTRACTOR PE