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Home My WebLink About925 AZALEA DR - Building Permits, . . (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 925 AZALEA DR Suife: Vicinity: ROOF Parcel Number: 41221309 Applicant: CHI,K�VIN Address: 925 AZALEA DR COSTA MESA, CA Owner. CHI, SA Y Address 925 AZALEA DR 4 COSTA MESA, CA Contracror: ' OWNER-BUILDER Addrese:� � - , Zip: . •Arch : Address> . - , . Stat�s tSSUED Applied: 10/11/2002 Issued: 10/11/2002 Zoning: R1 R1 ISSUED BY: � Phone: 714-751-5435 Zip: 92626 - � Phone: � . , . � Zip: 92626`. � � � . Phone: License: 000000 , • � ' . : Phone: � Eng: � Address: � , � ' �Ptione: , , . , " � ,' � .. Zip: . , ' , ` � ,License: ' - � � License: SCOPE OF PERMIT TEAR �OFF EXISTING�ROOF. INSTALl201'EAR, COMPOSITION SHINGLES, 15# FELT, 1/2" PLYWOOD SHEATHING. 2,000 S.F. INCLUDES � ATTACHED GARAGE. . - � � . � .� . . . � ," ' _" , ._ i'.', . � ' FEE SUMMARY . = Plan Check: ,$0.00 Calc Valuation: g3,000.00 Permit: $83.25 Claim Valuation: g3,000.00 SMIP Res: $0.50 " _ �� SMIP Com: $O.pO Other: `. ' $0.00 Inspection: ',$0.00 Total: $83.75 � ' � +-, - SETBACKS � �_ . MAINSTRUCTURE Fron[ 0-0 � � Rear 0-0 ACCESSORY Front 0-0 � ��Rear 0-0 PARKING ex�stlnq:. o ��` � �Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Right 0-0 Right 0-0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPoRATION: 7his permit shall autanatically expire and become void it work is rwt commenced within 180 days, or if work is suspended a abandoned for a period of 180 days. INSPECTIONS: In order for the work authorizad under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final gpproval must be obtained. Failure to obtain inspeclions and tinal approval will resul� in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448d8I&00) WOHKERS' COMPENSATION DECLARATION: ' � ' I hereby a8irm under penalty of perjury one of ihe following declerations: � v ❑ I have and will malntain e certiflcete of consent to self-Insure for workers' compensatlon, es provided for by section 3700 of tha Lebor Code, for the peAormence o� the work for whlch �his pertnit is issued. ❑ I have end wlll melnte'n workers' compensatlon insurence, as required by section 3700 ot the Lebor Code, tor the peAormance of [he work for which Ihls pertnit is issued. My workers' compen�etion Insurance carrier end policy number ere: I Cerrier: Policy Number: (This section need not be completed i� the permlt Is valued et one hundred dollars ($f00) or Iess.J � I certity thet In tha pertormance of the work for which ihis pertnit is issued, I shell not employ eny person in eny menner so es t� 2ompensation lews at Californle, end egree that if I should Decome subject to the workers' compensalian provisions of Section comD�Y ti4�h these proviyons. WAANINO: FAILURE TO SECURE WORKEflS' COMPENSAiIqJ COVERAOE IS UNLAWFUL AND SNALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTES TNOUSAND DOLLARE ($100,000), IN ADOITIIXJ TO TNE COST OF CqMPENSATIIXJ, DAMAOES AS PROVIDED f-0R IN SECTION 3%OB OF THE LABOR CODE, II ro the workero' � Code, I shall forthwith FINES UP TOONE HUNDRED W D ATfORNEY'S FEES. LICENSED CONTRACTORS DECLAHATION: � � � I hereby eHirm thet I em licensed under provisions ot Chapter 9(commencing with Section 7000) of Divlslon 3 ot �he Buslness and Professions Code, end my license Is In full force and eHect. Lic. s Class # CoNrecmis Signeture: Date: � _ _. CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there Is a construction lending agency for ihe peAormance of the work for which Ihis permit is issuad. (Sec. 3097, Civil Lentlels Neme: Lentler's Adtlress: Signeture: Dete: OWNER-BUILDEH DECLARATIONS: � I hereby affirm that under penalry oF parjury that I am EXEMPT FROM 7}iE CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Buslness and Professlons Code: Any city or counry which requires a permit to construct, elter, improve, demolish, or repeir any Slructure, prior to Its Issuance, elso requires the epplicent for such pertnit to file e signed statement that he or she Is licensed pureuent to the provisions of the Contractors License Lew (Chepter 9(crommencing wlih Secllon 7000) of Division 3 of the Business end Professions Code) or that he or she is exempt therefrom and Ihe basis For the elleged exemption. Any violatlon of Sectlon 7031.5 by any epplicent for e permit sub�ects tha applicant to e civll penelty of no� more �han five hundred dollars ($500).): ❑ I, es owner of ihe property, or my employees with wages as thelr sole compensatlon, WILL DO 7HE WORK, entl the structure Is not intendetl or oHered for sele (Sec. 7044, Business and Professions Code: The Contractors License Law does not appy to en owner of property who builds or improves thereon, end who does such work himself or herself or through his or her own emplayees, provided thet such improvemenis are not Intendetl or oHeretl for sale. If, hawever, ihe building or Improvement is sold within one year of completian, the owner-bullder will have the burden of proving that he or sha did nm build or improve tor puryose of sele.). ❑ I, as owner oi �he property, am EXCLUSIVELV CONTqACTING WITH LICENSED CONTRACTORS to consiruct the pro�ed (Sec. 7044, Business end Professions Cotle: The contrectors License Lew does not appty to en owner ot property who bullds ar Improves thereon, antl who coNrecls Por such pro� Ict wlth e contrector(s) license pursuant to the Coniradors License Laws.). a I'Sfi 8'�iis {'yy�.++sec' Business and Pmfessions Code for this reason: SignatU7 ^r � • ter _ • �, ' Owner ID veriFled Cy tlnveYs Ilcense. Yes ❑ No Drivefs�L�cen .� � qE`tlpl��,yOD Vetlficatlon of Owneiship by (rype of tlocu t, i.e. - property tax bill or deed): ' DIVISION OF INDUSTRIAL SAFETY�ERMIT CERTIFICATION: i ❑ I hereby certity that no excevetl n five (5) or more teel in depth into which e person Is required to descand, wlll be mede In connectlon wlth work euthorized by this permit, end that no building stmcWre, scattoltling, talsework, or tlemolition or dismantling thereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Califomia Administrativa Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit trom the Divislon of Intlustriel Sefery, as noted above,�unlass such person has e permit ta do such work irom the division. I Signamre: Division of Industriel Safety Pertnit Number: Date: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: � i Will the epplicant or present or future bullding ocapant need to tile end certity e Business Plen for emergency response to releese or Ihreatenetl releese of e hezerdous meterlel7 ❑ Yes ❑ No � (Section 25505 ot ihe California Health and Safery Code requires, with some exceptions, that a Business Plen be tiled with the Coste Mesa Fire Depertment by every business which has at any one time tluring e reponed yeer e quentity of hezardous meteriels equel to or qreeter than e weight of 500 pounds, or e volume of 55 gallons, or 200 cubic feet of compressed gas at stendard tempereture and pressure). � ........................................................................................................................................................................................................................................................................................................................................................................................ 2 Does or will Ihe epPlicen� or present or future 6uilding occupent naed to file e registre�ion fortn for ecutely hazerdous meterlels7 ❑ Ves ❑ No (Section 25533 of tl one time has on h fAmpfe55ad A05 8t or present or 25534 of the Califomia Health and S ant of an RMPP bv businesses which with some exceptlons, requlres regisiretion with the Costa Mesa Fire Department 1 meterials equel to or greafer then e welght of 500 pounds, or e volume of 55 en thal the Coste Masa Fire Depenment may require the ler ecutelv hezardous materiels with the Fire Deoertme business which at any . or 200 cubic feet of and filing with Ihe Fire It en RMPP IS pfesen�ly reqwreQ n0S 59Ctlon 25534 at tlte Geliiomle Heellll end eetety GOtlB beBn tulty COmpllBtl wlin7 �J Ye& U NO � .................................................................................................................................................................................................................................................................................................................................................. Does or will the eppllcant or present or future bullding ocCupant require tor ihe work which Is the sub�ect of ihis a plication e permit for such consiruction or irom ihe South Coest Air Qualiry Menagement Disinct or trom eny olher air pollutlon control disMct or egency? � Yes LJ No I (Sectlon 658502 of lhe Celifornia Govemment Cotle requlres ihat the requestetl intortnation be turnished on epplications for non-residential building permlts). ............._Y F .............................ry ..............................................................P................................................................................................................................................... ...................�.................., ...................... WIII an art oi the facili �o be consiructed under this ermlt be wlthin 1000 fee� irom Ihe outer boundarles of e schoolY ❑ Ves No � Qf'yes", the fecllity must meet ihe requirement ot Sections 25534 end 42303 of the Califomia Heellh end Sefery Code). � .................................................................................................................................................................................................................................................................................................................................................. If e permit from Ihe South Coest Air Quelity Manegement District or other air pallution cantrol disirid or egency is required for the work which Is the a� eppllcetion, have ell of the tllsclasures prescribed by Celitornla Health entl Safery Code Sectlon 42303 been metle� ❑ Yes ❑ No (Ii'j�es°, atlach certificate at complience irom the eppropriate air pollution control officer). ' CERTIFICATE OF COMPLIANCE: I certity that unde� penelry of perjury Ihe informetlon given ebove is correct. I agree to comply with all stete laws end clry ordinences regerding Hazerdous Meterials and Emissions. � Signeture: Dete: ' CEHTFICATE OF COMPLIANCE ANO AUTHORRATON OF ENTRV: I certiy under penelty of perjury that I have read ihis application end state that the Informetion given is correct. I egree to comply wllh all state lews end ciry ordinences releting to 6uilding construction, end eulhorize represantatives of the Ciry ot Coste Mesa to enter upon iha ebove-described property for inspection puryoses. I agree not to xcupy or allow occupency oi eny building euthorized by ihis permit until finel inspection: COOE P. INSPECTIONTYPE 1616 Fixed System Finel Fire Prevenllon 1268 Pool Spe Finel 200 Finel Re-Roof 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolltion BA7E INiIDSLS /o-Lr-oZ �� COUE� INSPECTIONTYPE 208 Final Mechenical 208 Flnal Plumbing 210 Finel EIec�Acal 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Finel BuildinglOccupancy ,mi. �- DECLARATION OF AUTHORITY Bldg. Permit# �J� — FOR AGENTS OF PROPERTY OWNER 7his Permit # TO APPLY FOR PERMITS Street Address: AP Number: 1. I,(wA), _'�JT �d�(J� t�t'1 � , declare that I am the Owner of Title of the above referenced real property, and that I(we) hereby authorize: Name: �_��1�� (�I I Telephone Number: '7 �T l� �_ Street Address: City: l � State: � Zip: �i��Z'' to obtain pertnits in my behalf, as owner/builder, for �fZ= at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Workers Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of pery'ury that the foregoing is true and correct. Executed this �� day of �� —�{ — 20 OL , at C.K1, , California. nnt N me: � 'I f� N �� I � Note: This authorization does rrot grant authorization to perfortn the work as owner, it solely provides for limited power of attomey to secure this pertnd in any behalf. 0779i6 (rev.11�00) LARWIN Co. nzaiea urive SOIL GAS \ WATER aFOUGH PLUMBING PROP. $WR. LINE � HOUSE CON. SPRINKLING SVSTEM ROUGH HEATING AND AIR CONOITIONI TEMPORARY SERVICE OR POLE UNOERGROUND � POWER � ROUGH WIRING TRENCHES � FORMS STEEL FLOOR $VSTEM BOND BEAM � STEEI. REINFORC� SHEATHING FRAME AND FLASHING IATHING - IN � OUT � P' 'STER, BROWN COAT PlUM81NG, FINAL ELECTkIC, FINAI ANO A.C. TEST ` DATE 7_Z7_72 BUILDING PERMIT N0. _34998 RE ZONE VALUE GROUP J TYPE SUBCONTRACTOR NER B ADDRE �� WATER ROUGH PLUMBING PROP. SWR. LINE SPRINKLING SYST ROUGH ONOERGROUNO L ROUGH WIRING TRENCHES F FLOOR SVSTEM BON� BEAM ❑ SHEATHING FRAME AN� FLAS IATHING — IN [ P' ^STER. BROWN HEATING, VENT., PLUMBING, FINAL ELECTRIC, FINAL eiui niur. ciuei Azalea Drive LOT 66 J AIR CONDITIONING iE'OR'PBL� POWER � iMS STEEL REINF. STEEL REINFORCE I—I 7 DATE BUILI DESCRIPTION of WORK FIRE ZONE VALU GROUP .1 TYPE SUBCONTRACTOR -12-72 .. � . 34956 � COSTA MESA BUILDING-SAFETY DEI P.O. BOX 1200 COSTA MESA, CALIFOR or Ap lic t to FI!l in Completely B ILDING � A DRESS OWNER AODflESS /G„',�T� ��/i�C� TEL. CITV �'j� ��nJ� NO. CONSTRUCT�ION LENDEfi BRANCH ADDRESS �� / ARCHITECT�� n i �iEL. ADDRESS CONTRACTOR ADDflESS CITV ��n( STATE LIC. NO. S1ZE OF LOT USE OF EXISTING BIOG, TEL. N�'�e�i�-t CITV LIC. NO. NO.OF BIDGS. NOW ON lOT SIZE OF NO. OF NEW BLDG. R�OMS STOF EXTERIOR WALL ROOF COVERING CPVERING USE OF BUIIDING P.ND WORK TO BE PEAFORMED PAIil �,�*h p"' ,;� �?-�?�;;S.D�to56�� 3�.[Q fl0 F R BUI� IT /�/�� OWNER APPROVED BV `—. ZON NO.OF PLANS VARDSAPPROVED MAIN BUILDING DISTANCE MAIN BLDi VAR. # C.U.P.#E VALUE USE OF NEW � BUILDING YARDS APP ACCESSOFiV •L'' �1 I hereby acknowletlge thet I ha�i reatl this"application antl s[ete that the ebove intormation is co/rect antl aBree to comply with all laws ragulating builtling consttuction, entl I shall not employ any person in violation of the workman's compensation laws of � the Stete ot Californfa. ' b I hereby certity that I am properlv licensed as a contractor untlar SQ. FT. ' o the State ot Califo�nia Business antl Professions CoAe, Divisicn 3, THE AMOUNT SHOWN UNDER VAlUAT10N IS FOR Chapter 9, antl that such licenses ere in full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m am ezempt from the provisions of the State of California Business ¢ and Professions Cotle, Division 3, Chepter 9. VA�UATION 1/ yp y _ _ � � PERMIT FEE $ v Y � �"_5 ) /1 / � SiBnatura of m Permittee /3� �%O�/YJ% $� � PLP.N CHECK $ l� � E / 444) � v c Authorized Ageni LL TOTAL FEE $ ''� `�� 3 ,659 PI�n ;lol AR fl r COSTA MESA BUILDING•SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 , For A plicant to Fill in Completely _ °�!' —3:?^P�tic�0 13s�r ,r,�� 1 . �r,s, 15 a 31 �PPLICATI�� R BUILDING PE IT��i� RECEI D DA E REC IVED DATE ISSUED • � r )�t� _ i i / I �� 1 � . � � � OWNER� RIA%(N SD. `—all`. A.P.NO. '�"� MAIL �-r �✓ )I BUIIDiNG ' Z . ADDRESS �Z.S�7 V �%�+�G Q /�ODRES ( d U CITV FhG � j�,� NOL �.- �p 5S TRAC Z CON5TRUCTION �oN� W A D O � LENDER am J � BRANCH -� � OWNE a W ADDRESS `� 0] J J Q OR ENGINEERTOUj��j �/�J `j. TEI. ({3�+0�{„ SE 0 DkP N W� ADDRE55 �^I7 � I ��QU/NG' �/�I(�, T�S%/ ZONE TY a W APPROVED JO CONTRACTOR Q(��F �� 8Y m Z . J � ADDRESS � W TEL. Z�� PLANS � Z=' GTV NO. V� � F W O STATE CITY ` �.4RDSAPPROVED �� LIC. NO. �IC. NO. 2I b� MAIN BUILDING �O - (PqOMGLSTREET,) SIZE NO.OF BLOCS. OF LOT �O X IOQ NOW ON LOT � FRONT �� FT. USE OF �� E%I5TING BLDG. J pT, F SIZEOF �?JS ROOMS v �� Z NEW BLDG. STOFIES Z L.51 E ✓ FT. a EXTERIOR WALLQ� ROOF L �% COVERING J/ UGGD COVERING /! � REAR � FT. J U E OF BUILDING ANDj� ORK TO BE PEFFOFMED` / DISTANCE BET. a n � Fa h, �'/ d(.I,1 !�� 4 r14 MAIN BLOGS. Q ,^ VAR. # � �r �— /1 c�P m�nP c.u.P.# � APP E N � p HOLD FOR SPE UI heraby acknowledge that I have read this application and state `%'rz� = that the above information is correct and agree to comply with � � all laws regulating building construetion, antl I shall not employ � any person in violation ot the workman's compensation laws of y the State of California. zI hereby certify that I am properly licensetl as a cantractor unde� SQ. FT. the State of Californie Business antl Profassions Coda, Divisicn 3, TME AMOUNT SHON Chapter 9, antl that such licenses are in full forca antl eftect, or I' THE PURPOSE OF EST � am eaempt from the provisions ot the State of California Business VALVATION antl Protessions Co Division 3, Chapter 9. Signature of �� , /'/ ' Permittee $ Z r �(� Authorizetl Agent // VALUE / $ GfiOUP `r DATE � � ]� � USE OF NEW !�/j BUILDING Jn' =Y� VARDSAPPROV BET. MAIN & ACCESS.BLD OATE APPROVED FEE IMIItJMLl�Bpn j MIT FEE ONLM: m ¢ D $D n �� ] m � o LL � `� 34998 Z . aU ZQ � N am J � J � Q W f� J • Q] J Q UN Za W � aW WZ J Q m z J � W w � 2F w� �O � �;- ��°O��zi2ir• 18.08 ,'=-- ,.:� � � COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REC IV BV DAT^ RE IVED DAT ISSU D ADORESS � � Z LG'A (iY2t�IC' "' FM�j OWNEF L�RIA:(dI � , A.P. NO. �J MAIL _ eU1LDING ADDRESS ADDRESS TEL. TRACT ,� LOT BLOCK CITV NO. CAN5TRUCTION W ADD P LENDEfl BRANCH / %� ' OWNER G ,�,�7J`� C_eJ � ADDRESS - VALUE ARCHITECT. TEL. USE $ OR ENGINEEfi NO. FIRE ADDRESS ZONE TVPE ROUP APPROVE CONTRACTOR (� �E �� BV DATE ADDRESS G4P/t« ZpNE NO.OF USE OF NEW UG TEL. �/!� � / p�� BUILDWG cirv Lo�X ERclf C No. Sd .yq7o Gu �ti STATE CITV �ARDS APPROVED VARDS APPROVED LIC. NO. � LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/LSTREET) OF LOT NOW ON LOT fRONT FT. USE OF EXISTING BLOG. T. FT. SIZE OF NO.OF ,. NEWBIOG. ROOMS STORIES L.SIDE FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUIIDING AND WORK TO BE PERFORMED DISfANCE BET. BET. MAIN & MAIN BLOGS. ACCESS. BLDGS. /�D /� T �j � VAR.# DATE / / C.U.P.# APPROVED OG / � �/j/ G�. APPROVE �i��' � STATE I hereby acknowledge that I have read ffiis application antl state � . ihat the above information is correct antl agree to comply with all laws regulating builtlin8 construction, and I shall not employ � Q any person in violation of the wo�kman's compensation laws of the State of California. ' I hereby certify that I am prope�ly licensed as a contractor untler SQ. FT. the State of Callfornia Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR Chapter 9, and that such licenses are in full forca antl aftect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt from the provlsions of the State of California Business VALUATION antl Professions Cotle, D' iision 3, Chaptar 9. / �� PERMIT FEE $ � SiB�ature of 111 �j Permittee A—�_�(� $� J//�.0� P�qN CHECK $ �C%'Z� � µ �� Authorized Agant � TOTAL FEE $ � � ' 35197 ��I �,60STA MESA BUILDING-SAFETY DEPARTMENT 1`P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applitant to Fill in Completely BU7LDVNG ADDRESS Z Le OWNER w 'U L ,'� n^nno�ec IG.7l� Il�w(T�1OL\ l'Ll1 t1 TEL. CITV ��( C �/�j Q NO. CAN5fRUCTION �CO N.E ivvnoo BFANCH ADDRESS � �y ARCHITECTl1._��. /� nA..� TEL.�_�J. ADDRESS �ti �U � /.%1 I'�� Q� CONTRACTOR�D��L� � %S�� ADDRESS ��v ,'�jO� �y+� S`�C'7 �L TE�. Z�' CITV �D� �Ia��L �� No. al1- STATE CITV LIC. NO. LIC. NO. S I Z E I NO. OF BLDGS. OF LOT NOW ON LOT USE OF EXISTING BLDG. ` � � SIZE OF � NO. OF NEWBLDG. �� C� ROOMS STORIE: EXTERIOR WA�L ROOF COVERING COVERING VSE OF BUILDING AND WORK TO BE PERFORMED R� i c, I Ac � r da (� C a J e - SEP 11-72PA�o00 283 ' 21.08 cnsF a "�*t TION FOR BUILDING PERMIT BUII�ING �7 ADDFSESS TpACT OWNER FIRE I NO.OF PLAN$ VARDSAPPROVED MAIN BUIIDING � DISTANCE BET. MAIN BLDGS. VAR. � C.U.P.� BLOCK VALUE DA USE OF NEW � BUILDING VAflDS APPROVED ACCESSORV BUILDI BET. ACCE DATE I � — J — $TATE I hareby acknowledge [hat I have reatl ihis epplication and stata Shat tha above info�mation is correct antl agrea to comply with �� all laws regulating building consttuction, antl 1 shall not employ sny person in violation of the workman's compensation laws of � the State ot Calito�nia. m b I hereby certify thai I am properly licensetl as a contractor under SQ. FT. o tha State of California 9usiness antl Professions CoCe, Dlvisicn 3, THE AMOUNTSHOWN UNDEF VALUATION IS FOR � Chapter 9, and that such licensas are In full force antl effect, or 1 THE PURPpSE OF ESTABLISHING A PERMIT F ONLV: am exempt trom the provisions of State of California eusiness � VALUATION m and Professions Cotle, D��sion 3, tar 9. � PEFM�T FEE $ e — � SlBnature of /� 'Q m Permittea $ / /(�� PLAN CHECK $ .� E V o Authorized Agent LL TOTAL FEE $, � From thc .�tsk of . . . C. M. OLSEN C�J w_+�- .,-. � � ,Q � ,� �E /� L (/ w�`� �e� C��J� �Nc �� Cc.� �� /��cQ (E� . �or�b/�� < � r�-- � �a s s �� CITY OF COSTR MESA CALIFORNIA 92626 P.O. BOX 1200 FROM THE OFFICE OF TNE DEV ELOPMENT SEHV ICES BUILDING SAFETV OIVISION November 1, 1979 . � � :� � � � T'0 1HE CITY OF �STA MESA: RE: Lanain Development-Tract #7557 925 Azalea IJrive *3�{6S� Costa Mesa, California Gentlemer.: - I, Howard Matlof, to hereby aclmowledge receipt of plans for Tract N7557. T do hereby agree to return the said Dkans to City Hall, fully entact, within a period of�hre�eeks. Dated /� � %f'r VN:nh 77 FAIR DRIVE (714) 7545273 � . . 9� i i / �