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Home My WebLink About2476 RUE DE CANNES - Building Permits V CITY OF COSTA MESA a BUILDING DIVISION };j - DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER V. 1 % i PERMIT ma,A. �� B01-07237 mamma(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2476 RUE DE CANNES Status: ISSUED Suite: Applied: 08/10/2001 Vicinity: GARAGE ONLY Issued: 08/10/2001 Parcel Number: 43914153 Zoning: Applicant: HANSEN, DUKE ISSUED BY: Address: 260 E.ALTON AVE Phone: (714)557-7440 SANTA ANA,CA . Zip: 92707 Owner: BACK BAY GARDENS HOA Address 968 CALLE AMANECER Phone: (949)498-1129 ' SAN CLEMENTE,CA - Zip: 92673 '( (' Contractor: ROSS & BARROWS INC. nny S�'' I"`I Address: 260 E.ALTON AVE O Phone: (714)557-7440 SANTA ANA, CA Zip: 92707 License: 327802 Arch : Eng: Address: Address: Phone: - Phone: Zip: License: License: SCOPE OF PERMIT REROOF GARAGE ONLY FOR EXISTING CONDOMINIUM FOR"BACKBAY GARDENS HOA"(4 SO).TEAR OFF EXISTING ROOFING&INSTALL NEW BUILT-UP ROOF. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,950.00 Permit: $69.25 Claim Valuation: $1,950.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 • Total: $69.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) 41 R DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. I, I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'' rnpensation II surance carrier and policy number are: Cartier: I a /011-6 rQ�O Policy Number.OYe -o( bop &30L (This section need not be completed i the permit is valued at one hundred dollars($100)or less.) - — ❑ 1 certify that in the perfo nce of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of all omia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these 9ro isi 5. �j' ,Applicant Signature: (. ��— rDate:'- -' 7-(0-c( -(O-C( • ,WAfiNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAW FuL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES uP TO ONE HUNDRED THOUSAND DOLLARE(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of DMsion 3 f the Business and Professions Code,and my license is in full force and rseffectiLic.fl ,3/'2}"7 g )7_— Contractors 2— ,Class - C.-3 r— Contractors Signature: JL// .� Date: �--!n— CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: 1 hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professioris'Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permitsubjects the applicant to a civil,penaltybf not more than five hundred dollars($500).): ❑ I,es owner of the property,or.my'employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:'The Contractors License Law does not apply to an owner of property who builds or Improves thereon,end who does such work himself or herself or through his orher own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, , or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greeter than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. _.._.._ — _ u _ — __...._.__ 6 If an RMPP Is presently required,hes Section 25534 of the California Health and Safety Code been tufty complied with? ❑Ves ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information bo furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South'does!Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the Information given above Is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: _ CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Cl Legal Owner(s) Date 8-1-1 0— of y And/Or Authorized Applicant - , Date __ POE i INSPECTION TYPE PAM INfRML6 CODE! INSPECTION TYPEPAI, jtMi.s 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof _ 210 Final Electrical 201 Final BIock/Retalning Well _ 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • • CITY OF )STA MESA PROPERTY DETAIL :EPORT • 2476 Rue Decannes Costa Mesa, CA 92627-1468 Owner: Lee Lila A Phone: Resident: Phone: Site Address: 2476 Rue Decannes Tax Address: 2476 Rue De Cannes City/Zip: Costa Mesa/92627-1468 City/Zip: Costa Mesa/92627-1468 Parcel Id: 439-141-53 Own. Occ.: Yes Location: Costa Mesa City School District: Newport-Mesa Unified Neighborhood: Unknown Census Tract: 063102 Wealth Code: 6.0 Year Listed: Legal Desc.: Tr 3433 Lot 53 Unit 53 Of Project Located On Ap119-381-32(Together With An Und .6275 Int In Lots 16... Zoning: Unknown Subdivision: Unknown Usage: 122: Single Family Residential Style: Unknown Construction: Unknown Year Built: 1964 Ttl. Rooms: 7 Blktop Paving: Unk. Stories: 2 Bsmt.Type: Unknown Concrt Paving: Unk. Bdrms: 4 Bsmt. Fin.: Unknown Carport: No Baths: 3 Full Gar.Type: Attached Garage Deck: Unk. Heating: Unknown Gar.-Cars: Patio: Unk. Cooling: Unknown Gar. Sqft: Pole Barn: Unk. lir. Lot: Unknown Roof Mater.: Unknown Pool: No Terrain: Unknown Roof Style: Unknown Fireplace: 1 Water: Unknown Attic Type: Unknown Gas: Unk. Sewer: Unknown Condition: Unknown Electric: Unk. Sqft 1st: Lot Dim: Units: Sqft 2nd: Lot Size: .041 acres Sqft Bsmt: Lot Sqft: 1785.96 sq. feet Sqft Total: 1825 Market Value: $154,828 Gross Tax Semi Ann.: $810.26 Assessed Land: $70,030 HB920 Credit Semi.: Assessed Bldg: $84,798 RB Credit Semi Ann.: Assessed Total: $154,828 RBA Credit Semi.: Percent Improved: 55% Homestead Exemption: Delinquent Taxes: Spec.Assmt. Semi.: Tax Semi Ann.: $810.26 Sale Date: Oct-17-1986 Mortgage Date: Sale Amt.: Mortgage Amt.: Deed Type: Unknown Mortgage Type: Volume& Page: Volume& Page: Seller: Lender: Title Company: Unknown Mortgage Term: Multi-Parcel: No Mortgage Rate: The information is deemed reliable but is not guaranteed. 2001-2002 Tax Year Copyright 2003 Haines Printed Jul-02-03 SOUTH ORANGE CA PROJECTADDRESS: 2476 RUE DE CANNES UNIT: - CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 06U494 OWNER'S NAME: LEE LILA A ADDRESS: 247E. RUE DE CANNES PERMIT NO: M 060494 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: V—N PERMIT TYPE; MEC PURPOSE: OTH ARCH/ENGINEER: • REG.NO.: JOB DESCRIPTION ; REPLACE EXISTING FURNACE SQ FT: ADDRESS; UNIT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: S & S HEATING & AIR COND ( 714 ) 837-2000 nuns: 27324 CAMINOR CAPISTRANO 157 COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ' LAGUNA NIGUEL CA 92677 **+E**#*##********#**#****#*#x****#**********#**+6###*+P***#**##*+:**# *#***#***##* LICENSED CONTRACTOR DECLARATION: I hereby atlirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and ellect. SETBACKS CITY LIC.: 027758 STATE LIC.:39381 cuss: AAC—20 Dale: I L —7-5 —5 t Signature: (1 re: _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT I N REAR: FT I N FRNT: FT IN REAR: FT I N Compensation AsyWgcg,¶ c t eC cgRN treof(Section 3800,Lab.c1.1 /01 /93 LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: W l�Assn)/ 16 J 7 V J EXP.DATE: (J COMPAelY: CNA ,t;,x PARKING REQ• PROV; PARCEL: 43914153 ZNE: REF NO: r 7] Cenified copy is hereby furnished. L� Certified copy is filed with the city Building Division. PLANNING NOTES> �/t �-�.. > Date: � L— t.` —1 � Applicant: *#*****#*******##*if#***#*****)f**#3h***3E*****#********if****IE***#fF*****{:*3e******li iE EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SEE- VICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become , subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - _ • DATE: Date: Signature: BUILDING APPROVED HYDATE: NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor , Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ..' r CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; �P, DATE: 0-1J:11:1.'V which this permit is issued(Section 3097,Civ.C). ****************************************** I*************************ke3r** LENDER: **************************************************.***************************** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9t00 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5 S SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7001)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15. 00 I. as owner of the property or myemployees with g wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for ate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15 . 00 0 . 00 29 . 00 24 , 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 24 . 00 OVER/SHORT; 00 improvement is of Sasale).owithin one year of completion the owner will have the burden of proving he/she did not build or improve or the purpose BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 24 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contractsfor such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware #****#******#***#*******'*********#********#************************************ that proof of their Worker's Compensation insurance should be provided to me. • INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner; MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 I do hereby certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of thus city to enter upon the above-mentioned property for inspection purposes. Y, Dale. I L_ 11-1 — 1 i Signature: --=_ Diver's License or Social Security x: 1641.46 White—Building:Green—Code Enforcement:Canarv—AoolicenC Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POG SPA APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector 1.'Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House ponnection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank OGas 0Oi1 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: 34. Final Heating& Air Conditioning 1 4/`nL4,6935. Final Gas Pipe-Test 1L1 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date OWNER DOYLE & SHIELDS Development Co. , Inc. DATE 6-3-63 JOB ADDRESS 2476 Rue de Cannes BUILDING PERMIT NO. 19641 GENERAL CONTRACTOR )yle &Shields Dev.Co. , Inc. - VALUE $ 19,417.00 AP No, LOT 53 TRACT 3433 FIRE ZONE DESCRIPTION OF WORK Res.w/att.gar. INSPECTIONS Signature ,-DDATTE��GROUP I&J TYPE V ZONE R-2 _ Soil `� " SUBCONTRACTOR PERMITS ISSUED Gas 41/5 //5 , -' . DATE NUMBER Water Jo/7J Rough Com. Refrig. 0 Air Cond. 0 Rough Heating // 3 �3 Bl 196, H-a 974 - Rough Plumbing I Z'14/-(.3 f'at 6. -2 - . ..,,fileMiscellaneous 0 Prop. Swr. Line Q1 House Con. ✓iYSt. Swr. ❑/11-7A5- /7-6-4,:i. ton Uto7/ir2C*- On?-.2-6.1 m znpir Sprinkling System Construction Pole 1 I6i Underground 0 Power ,❑ / 'Jae �f vti Rough Wiring � ///-G3 ,644 0. . . 4- 3 -6 I A 790 - Trenches - Forms ti- Steel Reinf.41- ,4 1 7-7-7<, Floor System PAL 7-5c-c.. ,f Bond Beam 0 Steel Reinforce 0 ‘ '� t Sheathing /- �/ Frame and Flashing A/,+.f2`.r�S 1Sc ' � dv j Lathing - In Z_ Ou.e ,7 ii1r 9 I Plaster, brown coat i V� e - �/(a 3 c.11 Refrig. ❑ Air Con. ❑ Final Heating, Final ,(lt 1 Plumbing Fixtures, Final l ....Ce.. a- r1 Final Gas Test S - Electric Fixtures, Final 3-/ Building, Final y7-t;f� . OCCUPANCY , -Form BU4-5M-3-63-S-13P HOLD nits. Li-Int.. RtyvixtivihdN 1J 19641 FEE RECl�lED COSTA MESA BUILDING-SAFETY DEPARTMENT 3 1. P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT. . \ !��T y d rVK MC For Applicant to Fill In Completely APPLIC I fi • TYPE OR PRINT BUILDING BUILDING �i / (�/�� /��4 ��(2,/ For Office Use Only ADDRESS 1-.lb 2A-V...E 92C0Yy✓TI- � RECEIPT NO. [REU COSTA MESA, CALIFORNIA 1111\\(LYU]�I L {I�l /1 / /�+ RIVED SYY ,/ DATE RECEIVE /,•_CAT.E Issue y,j 0 1063 OWNER�/OLt I�.. ill;air pe✓ W• in C.- BILDING,„ `/'7( LC�iln1 MAIL (-3l SO. id In el"rflRr" nut.. A DRESS ADDRESS/,77 Y(0.4•5... I' / .�yl�,+ 7 NFIRE (� `/ CITY T]/7 O.-A C//1'I/ 1.0�/(,� N0L3V4`o�'o ZONE TYPE V- GROUFi ..lj ARCHITECT {/./'_ T.,117.41,/- ` APPROVED DATE OR ENGINEER/ 14-! C. / 04i ap 10 BY //'�' �j(..� Caleb /��.(/ ZONING ADDRESS Y/QO WLJ • r)`a N We M1P1_ � I l.( ZO NO.OP BUI DI NE� f � c. PLAN9 lel VS � CONTRACTOR S4,,.., v AA�� LEGAL L } /n0 � . I, ADDRESS S^^'�a, DESCRIPTION O J to 3733 $- CITY .. �RS(l✓1. a A.P.NO. • STI..- 434 NO. lie. O(��'•OaO 30"TO SIIDE@ REAR P.LNG BHALL BE LESS THAN ATE EAVES SIZE OT 33 X a-3sb I NOW F LOTS. .. ALLOWED (U.B.C.REQUIREMENT) OF • USE OF �---'-- YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/la,�TREET) SETBACK LINE FROM . (p�,/ FRONT (�J CENTER OF STREET REAR YARD (� SIDE YARD I LEFT -/ I RIGHT R.SIDE �/ FT. Fr. 4 DESCRIPTION f`yOF WORK L.SIDE 0 FT. FT. NEW I/\ ALTERATION _ ADDITION REAR ICI FT. FT. I, DISTANCE BET. BET.MAIN @ REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLOCS. BUILDING +J // NO OF •-� VAR.# DATE SIZE 13 ,c57./��-f0 ROOMS 7 GSTORIIES e!" C.U.P. APPROVED qJ ' COVERINGEXTERIOR WA-7i C,>O I COVROVERING "y'�% BBF YPROVI��1 DATE �JP"� 3 USE OF BUILDING AND WORK TO BE PERFORMED / e.fi de he c_, W/4itAJ/ "1 Q"'")c-- , 'c dam% Ufa AP,y 38c Q' SO.Fr N : I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SH UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF E ABLISHINO A PERMIT FEE ONLY. 0 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION / •� N BUILDING CONSTRUCTION. PERMIT FEE $ G V( SIGNATURE OFbilk • . ' �,y/ / Inll', //v� //�� (.( ^/ ) o • PERMITTEE �'Y/SI G`� UW• UI• P $ / // / / / PLAN CHECK $ �/ -� B •; AUTHORIZED AGENT , 1huNK.' u 'i,..q, .. . . . . .. I I AS/ TOTAL FEE $ / / 57