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HomeMy WebLinkAbout1157 SALINAS AVE - Building Permits CITY OF COSTA MESA 4' ' "rl BUILDING DIVISION '� .. „w i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ppr 10141 • PERMIT M06-00080 t (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1157 SALINAS AV Status: ISSUED • Suite No Applied: 02/21/2006 Issued: 02/21/2006 Vicinity: Parcel Number 41208206 ISSUED BY: Applicant: YENULONIS, LAURA Address: 422 JENKS CI � , a w rY,Pfione 71414 4300 �+K- -998 CORONA CA pa rr � .'�Zip � X92880 Owner: WIMERUNE M TR , JsI Address 1157 SALINAS AVEx - .74�A a ,. hone `` ' ' . 'COSTA°MESA CA fes. Zip: 92626 '"� Contractor ALLIED PLUMBING- HEATING-AIR CONDITIONING Address , 422 JENKS Cf • .,, °. Phone: 714-998-4300 x CORONA,CA Zip: 92880 License 610780 "° SCOPE OF PERMIT, ' �f REPLACE 110,000 BTU FURNACE. "'• £ _' 4 44. t � f =1s FEE SUMMARY • a e sQuantity g._ esipcz _ f 4" Quantity ISSUE FEE0n • ` $2350 Repair/;Alt Absorbtion Unit • - ya $000 0 Inst FAU<100 k BTU a� $0 00 '0°s °' o -Repair/AIt Refrigeration Unit r*•_ fi' $2.00 0 Inst FAU>100 k BTU -' ,$18.20 .1.< L Ventillation(System < ` ` $0;00„.. 0 Repairs/Alt,Cooling/Heald, -, $0.00 0' "'^' • ''-Evaporative Cooler " a ` �' $0 00 ` 0 Inst/Rep.Recess Wall Htr $000, 0 Commercial Incinerator = r ° - $000x0 Rafrig Sys<100 k BTU ; "(.1 $0.624, 0 -o Domestic Incinerator Refrig Sys>100 k BTU "-- r��'a`=-$0 00'%° 0 ` ,Compressors/Absorption Systems Mc. Gas Piping -.-$0 00 0 ., Up to 3'hp/100 k BTU - f_- "$0 00 0 Factory Fireplace >,-4,$0.00 y$0 00± 0 "3 To„15 hp/500 k BTU x,..7$0.00f -$0 00 01 Hood w/Meth Exhaust , � . $0.00 0 15 To 30 hp/1,000 k BTU - $0.00 0 VAV Box $0.00 0 30 To50.hp/1,750 k BTU <^ w ,$0 00 '01 Vent Fan I Single Duct 1$0.00 0 Over 50'hp/Over 1,750 BTU ;;$0 00 0 • Appliance, < 0 44.$0.00 0 Boilers ' r,r Fire Dampers 3 ,$000 0 a Up to 3 hp Smoke Dampers ,. $0 00 0 ., `3 To 15 hp � $0,00 0 Inst or Relocate Appl Venti -�;$0 00 0 • A� 15 to 30 hp,. ey $0 00' 0 Air Handlers< 10000cfm- ”-$0 00 0' •n 3 ` . " '30 to 50 hp �" <;- ,k .$0.00 0 Ali-Handlers> 10000cfm $0 00 0 ' Over 50 hp`J •r $0.00 0 Floor Furnace y 0 f ,`, rkg Other Mechanical Fee Floor or Suspend Heater $0.00 0 r s , Investigation Rat:, �. ,,= $0.00 , max,Reinspection Fee ,� �r- ..� _ .,,zTOTAL CALCULATED FEES $41.70 .COMMENTS"/SPECIAL CONDITIONS ':, 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 it 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 244646(6/00) • DECLARATIONS f f 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. . [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 vfeorkers'compensation Insurance carrier and policy number are: j, we.-a43 y3-Oa Carrier: x l'n permit I Policy Number: -Tuts section need not be completed it me is v ued at one hundred dollars($100)or less.) ❑ 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,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 prns Applcat Signature: ,"-,/./' a <=Dte: . D3\-ao WARNING:FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000).IN ADDM O 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 u r prgyislons of Chapter 9(commencing with Section 7000)of Division 3 of the Business a ro ssions Code,and my license is in full force•end'effact�Llc.sem''" I���CUA�1' •1ass N t C cm7s S gnat ie' -�c1 ,.n Li4 (.J -c—'- a-a\-n( -CCJJ _ - D 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). Lender's Name: ' . Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjurythat 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(commencing with Section 7000)of Division 3 of the Business and Professions 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 fore permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly,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,and who does such work himself or herself or through his or her 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.). ' ❑ I,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 driver's 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 B,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 materiel? 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 r (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 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). 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? III31 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 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 California Health and Safety Code). 7 If a permit from the South Coast 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 B (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. Signet Owne AiiWO Of Legal d AppIicr(s)' Date - �And/Or Authorized Appticabt^ '_Date ".;;, T,ODE t INSPECTION TYPE QAU ""`W1TALS ._r'�-_CODE I INSPECTION TYPE p� °0 '' -IC-C9 1616 Fixed System Final Fire Prevention 206 Final Mechanical itgir 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 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 �j�7111.!tY,. CITY OF COSTA MESA • 4 BUILDING DIVISION OA 'P.. °( DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER k PERMIT • se „e E05-00088 (714)754-5273 • Fax(714)754-4856 www.cl.costa-mesa.ca.usLECTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 212 SALMON DR status: ISSUED Applied: 02/07/2005 Suite No Issued: 02/07/2005 Vicinity: Parcel Nunmber: • Applicant: ROTH, DAVID JOHN TR EMI Address: L&DOROTHY C ROTH TRUST ISSUED BY: SANTA ANA,CA Phone: 1694 ORCHARD DR Zip 92707 Owner: ROTH, DAVID JOHN TR EMI Y� I I''0 t- g Address L&DOROTHY C ROTH TRUST '..,e6 t °y SANTA ANA,CA - Phone: D 1694 ORCHARD DR Zip: 92707 `-'f*ti. slit Contractor 1a`�"`r` tri ".1+.i;.. Address: yr• $'r:i1 ; ' `03�. iaf � ": Phone: + -(ir ' 1.a Zip: sa'r'r. s:I g.. r °::'1 ' v x License: el••. .a,,,`r ` ' e � oup2 #a`N ma Wt,� 01 ac E OF P u.lit e REPLACE EXISTING D oT T" eIROx 0 i-:41"'.:.,....: -Cif!! .- -UMM to ` ,• °w .a ., 4 ? .'" ;', 5 "Fars zt T} Quantity rrer. . a +. ISSUE FEE $23.50 '+ 1. '� Tem `$ )Lig 9 $0.00 0 L' Temp se :if* $0 Or574 - Bus ',..111.1/2 e..4 $0.00 0 '"N Res . . $OJ•,. ::., r Sta mg�ect• " $D.00 0 .;°. New R TI ' uJ�)f-�� $0 + ,t - t,' 0 Misdtr uipmenl $0.00 0yit,,$0e0l. 0 .:" .. Trar4h $0.00 0 It $+ ! 0 IV 0;AAppl $a + 0 Lo „0`( 2'gef +;u0 0 Lo Vo{t Warm System/Ckt $0.00 0 $eg is to200a $3r o 1 Mis•rG ddit' $0.00 0 a to 1000a $s >u+ . 0 �,�A. �r Mis y en or ride) $0.00 0 �r egi:. over 1000a $. °p • `'; Cir u s gen or $0.00 0 ,t to 1hp $+ l ^ '' „+ Circus(mach ride or lights) $0.00 0 +Ya.`0 , to 10hp �l.�. 4,„. $•.itto re" + fi 4 Christmas Tree Stand $0.00 0 -v?,Moto' to 50hp 4' $0.+'s r` +. � Fireworks Stand $0.00 0 to 100hp ;Fakir* $0.r}a + ,�2 Other Electrical Fee $0.00 �' Fel, over 100hp $0.0. r4 ' yr ,;.rg mcation d os $0.00 4'F",. Investigation Fee $0.00 `'' Plan Check Fee $0.00 • "` I el to 20e ><i $30.50 1 $0.00 0 Reinspection Fee $0.00 pg� ' { i jra.'i�e.�,,,,,,1'�- e4' egr - . e' $0.00 0 tt cgs` ' • =,, $0.00 0 TOTAL CALCULATED FEES $84.50 .4:,...,,,,.:3, 1 ' -li` - $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and ilrtal approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(8/03) DECLARATIONS (' t /"\ • WORKERS'COMPENSATION DECLARATION: I hereoy affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I nave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. • My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed d the permit is valued at one hundred dollars($l00)or less.) ❑ I certify Ictal 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' j compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply witn these provisions. Applicant Signature: Date: WARNING'FAILURE TO sEcuRE WORKERS'COMPENSATION COVERAGE iS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP IO ONE HUNDRED THOUSAND r%x i ARE 151 W,5AOI.IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST•Ar4DATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: 0A fd d' I hereby affirm that 1 am licensed untler provisions of Chapter 9(commencing with Section 7000)of Division 3 0l the Business an�d,�a`Prolessiona Codesfend my license is in full force and effect.Lie.. Class A AN. 1`9�+� %'I Contractor's Signature: Date: .,. "v_(i)-1i fir Orta CONSTRUCTION LENDING AGENCY: b-as + 14' � A ' ❑ hereby affirm that there is a construction lending agency for the performance of the work for which Ihia pertrel.is issued ($eC. 97.C�hilaGOtle). Lender's Name: / //b Lender's Address: .'3 - ,ka ly.Fe tT.-,i!' 'd '7:+!Y Signature: J,1 it /1,-- 1//�'.. .eS ^�S+ri,"?�.l'«'�'tTpR��4'tK1 Del 7n='-:'i5i.!f4!Z'3'm/ - , - tw r ..w.r..-...a=,cr'+: xp"i' 'SY:wvHrn-.zW+a:w; OWNER-BUILDER DECLARATIONS: _.4 z I"�tialff - r'fl l'{„rt`' 1 I hereby affirm that under penalty of perjury that I am EXEMPT FROMITHE CONTRACTORIJCENSE LAW for tilt lotlowing reason(Sea.;,7 res t,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or ripatr`ei Law,priapte its ISSUane n iig flthUires the applicant for such permit to file a signed statement that ho or she is licensed pursuant to the priwfaidnt e bhe Contracture License Law(Chepler 9(tion menDi g withSection 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt Morel*errd the basis for the a lobed exemption..Anj violation of Secbon`.7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars(SS00):): Y-11 r - ct,u�,q wA ❑ I.as owner of the property,or my employees with wages as their sale Compensation,WILL•DO,THE•.WORK;end the structure!'not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Lew does rot'epply to an owreer.ot:piiiperly who builds or impne as thereon,and who does such work himself or herself or through his or her own employeesfprOVlded Inst`mien lmprevements arai11U1 4aBlded'or offered for sale.Il'however,the building or improvement is sold within one year of completion,the owner-builder drill have ttia burden 04preving that ifircZaheidicleof build or improve loripjirpgse of sale.). axe*:,e ..- c..54%.........r v., rcwat.:�--ti. - - �.o `P- 7.04! ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LENSED CONTRACTORS to construct the project(fiec57044,Business and Professions Code:The contractors License Law.does not apply Ilan owner of propeity`iwfid builds Or,inprovealttiereon,and who contracts lur,nrcti project with a contraclOrts) license pursuant to the Coniractore lkerlse Laws.)t ' `" iso Lir}•yrp Sr_ ..v lir ,N... ❑ I am exempt under sec. ,4:r`eexs.;5 'I . Business and Professions Code for this reason: �'�= Signature: Areaixk'':9:th ,C%+,.'4.,�Z-1 'rt I3L-1,1- I. Yx'se?i Dale: Ik' Owner ID verified cry driver'91I .license!, th Y4A QNo !Nivea Licenfe Noss( Expires: .a a_ rew--a 'S slaw,(. p fl•-;<, Verification of Ownership py.(type of dacurnent,i.e.-propem,tax bill or dee :7- ?'' �s..rn:�:I trun-K""t..-:+atYxW."tkVN S+Jc_D41 t',c2r,-..w irx.xs'x.w DIVISION OF INDUSTRIAL S1:71.11.AFRM ETY PERMIT CERTIFkATION: �-'viz 'macF�v " �i Kb :d ❑ I hereby certify tftet ro,axdavation live(5)or more lest N tlepth into which a parson is lagmred to descend,will be made in connection with work authorized by this permit,and that hai biking structure,scaffoldingrfalsework or demolition bedismantfrattriensli.will be more than thirty-six(36)feet high.(Chap.3.2,Gm 2,Art 2,Sec. 341,Title B,Caldoma Administrative Code). 1 v +]t`'` tilat „. ❑ As owner-builder,Itwis not employ anyone to do rzaktwflichwould require a permit Irom the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. ZIPS L - .,j Signature: (�r.A15mw. - .r., %Yir P.SS• l+ Date: f ai d fF•• g ff Division of Industrial Safety Permit Number,. vi 4.a•,- k..are A r_:_ ., M., .a...-,.... HAZARDOUS MATERIAL'SYAND EMISSIONS:CERTIFICATION: I mWillat the apPlicaneW present or tuNre budding occupant need to lila end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yeaj`e"'k��N,III��"-1187 +rsi„California.Heatt!I swhich Of the ata yens bHeahJr ng Safety Coder a requires.with some exceptions, that a toone ness Plan filed with the Costa Mesa Fire plum a of every businesscwhich hasco epr ssed"neat a p aa quantity of hazardous materials equal or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet df;EOirtpr9ased"neat standard temperature and pressure). 2 Does or will the applleanrdr.present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533sof na CelilorniaHeof andSafety Code, t some exual do or greater a ewith the u Msso Fire oeme of 5t by each,businesswhich at any one time has un standard my acutelyanhazardousressmaterials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic foal of compressed gas at slanaaro temperature and pressure). 3 Does or will the applicant or present lir future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and tiling with the Fire Dapanmont of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 It an RMPP is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 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 horn the Soup,Coast Air Quality Management District or from any other air pollution control district or agency? U Yea LI No (Section 65850.2 el the California Government Code requires that the requested information be 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 III-yes".the facility must meet Me requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 II a permit from the South Coast 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? []Yes 0 No 8 III yes",attacn certificate of compliance from Ins 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 stale 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 Of Legal Owner(s) Date And/Or Authorized Applicant Dale cal d15PECLDN TYPE ps[F INTITIAI$ CODE p INSPECTION TYPE WI INTRIAL$ 1616 FF SCistteem Fore(Fire Prevention < „- . +.rs._.. 20e FNal Magi l : r*^'+—-' "' . , F1zii-'P'`pct 'r N (<i5 'q:€'viFY A`ja`di Lt alT. d4"•s-4.4.-)„,-1:1 �F. P�T�`'�N AG' ..Nt.-`I'? P' t2fi6 nPod Spa Foal Fr, ,.ray4y+.zf r zd�ll. 20 ,Fhtel pat�a�n �A7 r `TF'Ls'�" }2a .ii ' .�°Su ra3`'�' "?Sn Xfh°'" •'" jx. 200 r� Roof # t�.`a. a 21 1 1 Electrical } •2x v at 201rh; Fhial Block/Retaining Wall d�u6 �� k'- ..syr 2120jFhaiiiafFaa'Wawantfpn-ra` T' '^'Nf v �'+v 51)5iia [f��trr. .>s :a fir. ;1' s= 'a r11 .T U,w L40, 202 F *actory Fire PI IP 1? -- 220}T`,,,..eenni g Approval .t-t t '� ,LC 555 ,,��}.,{, k' v H-c �c 203 \�, Sign ^,, .t" _:' f, vNJt .aSrgs+3. T.,..• :fE+.r-t%,,. � 222 p Site Rk i �V!!'�'r,r,T. s k, . an .S'X -re ' �E'r.°•`.t.:tl Vit y . 204 Fine!Demolldan s,- ' 254 FintlAutlding/Occupancy ' k 7{c ainievelojimeni i. August 16 , 1982 Mr. Victor Newton Director of Building and Safety City of Costa Mesa 77 Fair Drive Costa Mesa, California 92626 Ref: Wimbledon Village/Tract 10276 Dear Mr. Newton: Due to timing, we had to plaster, scratch and brown coat approx- imately 35 square foot door opening that was deleted from our Sales Office conversion at 1157 Salinas Avenue ahead of lath inspection. This letter shall certify that the lath and nailing was installed properly and exceeded City of Costa Mesa standards . V- truly yours , e Marks t- eral Superintendent GM/cv 1470 ]amcoree, 1oacf rJ'ewportrBeacui, Ol fornia_, 92660 • (714) 640-6800 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. * CITY OF-COSTA MESA' -- ' „ j TRACT NO: LOT NO. . BLDG:Nfl. - ' a•1 ',' r\,•� - -- -' -- _ "_-- - - -^ -- • -"" PERMIT NO. , / [7/ C//-J[ (CONSTRUCTION PERMIT 5 ,11 - - 2.3 c. 0,27(0 "{r T "I:• 3049' '7/1'6/82 41 .62 ;IL Project Address 1 ' _t: ", :, I i _ _ tt �- 'A't.;‘,"' ' 1157 Salinas Ave. - TYPE OF CONSTRUCTION G/ �}�l .Owner'. - . . - , -. Phone - :- ! -,/ ir•-or � � - ' 1^ WlmbledOn• ASS 64O-6Hf0o"NEW".wv-nAxD� D` OALTERATION /'Address- ' ❑!REPAIR L'1'TONVERSION' ❑DEMOLISH _._ r. r ,51{ ) 5470 J"dmbOree" RCIT NeWpOrt' BedC ZONING'REGUL"ATIONS, ;,;w-, j-Arch/Eng:COr}J 1n/Yamafll /'-License No. -6832 - .Tri'OTHER_ ' • �� _ _ - _ _ ry _ - _ DESCRIPTION OF WORK Convert Sa es 0 A'P- ' .z.-7o 5 40607.`- r Address 179921-Mitchell- So. --Irvine '--' - ` ---.- - -'--- ' ,ZONE- PLNG REF' 44:. o , orginal state (_garages) 3 � rContractor`MCIia Tri Dew.' -CO 'Phone6-40-681 to , PERMIT-. , -' . -*-" -- -- ,BUILDING - - ILDING -7,i— -. ABdrfess 1 1 SETBACK- LST. P RTV'LINE 5 ''. T4.70 Jamboree Rd:-,New•OrtBea-Ch' -,❑GRADING , ;.O"FOUNDATION OSTRUCTW LICENSED'CONTRACTOR-DECLARATION-- • -- • • }r> . 1 © TENANT_-•••• • • ..CAL- PLUMBING OMECHANICA • •• .t ' hereby affirm'section- I am licensed Under provisions of Charter 9,(corn-. .h^•' Convert .SCO • •a - • - mofessi•'wIth -section-7000)-of•;Division-3-of-the -Business, and- [ MOTHER " _ _. „-- -� Professions Code, land my license is in full force and effect.; - - • - T REAR YARD(TO PA.) - - - - ( - - - "-'_ . -__—__e PROJECT DESCRIPTION _ _ _ _ License Class -B1License No. -273'875-:- r ti44O,' '. 11 I _.__ tPKG`SPA-E REO. "-" -P,ROVIDEDi _ -' 7/"1 3/82 - - _ _ •-•• SG FT n Date SignSCure�( """ - - EET WIDTH' PARK FEE$ WORKERS'COMPENSATION DECLARATION•-- -• O OCCUPANCY Sgt CONSTRUCTION TYPE frame�R{-1 'ZOj. NING APPROVED BY ``•``���JJJ--� DATE reby affirm that I have aCompensation certificate of consent to self certified' ,oG a ' T -- . -_. ./_- .Z VAccu TION� 'nOn R,O,NE _ = �• � 7 /!J/ fi irs' Compensation Insurance, or.a certifietl copy g of(Section 3800,Lab.C.). • -{ GRADING- V OS. " �- !SPECIAL CONDITIONS PqupvNo.WPRn-1`1-25R4cpmpany-Fraamnnt` Tn�lPmrl 9°v------. - .._ . .- ACRES an. _ .__ ------ - - t--- ------ -- • -- —_" _._.___ __. . -. _ _ -- l ❑ Certified copy is hereby turnished. .- _-_ Divi-.- n __ _. REMARKS ' w r _ __ __ _ _ _ �zEerbfietl copy is-filed with the city Building Division. - - - _ `-'- " ' EXEMPTION'FROM• .WORKERS'"COMPENSATION DECLARATION { _ ` '- + - I � ' `" �t`' �''' -I. '�I 1 (This section need-not be-completed•if the-permit-is-for-one-hundretl .- -_ - _ ph., _ •.;'-u' r :1 �..I. �` f ($100) or less). . I •'.-"` - .:-_.k - .'^ ' � • __ - � - . _ 1.certify_thatin the.performance of the work for which this permit is I Issued, I shall not employ any person In any.manner so as torbecome 1 PLUMBING. .-.r,ti - : PLAN CHECK -' ' - -- -)ELECTRICAL-- ' subject.to.the Workers'-Compensation.Laws of California. _ " - - _ 1 Date 1 Signature ' • _ 1 NOTICE: If after making this decli-ration, you should become subject ' T,OILETS:r- ' • j,4 ,'-URINALS-- "-- - •:GENERATOR---"0=1'KW' to the Workers' Compensation provisions of the Labor Code,you must - /'TRANSFORMER" th IR e, forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS-- - ;APPLIANCE --10-50 KW_50.+.KW----- CONSTRUCTION LENDING AGENCY ^" SINKS; 0-1"HP-----1-30 HP= - - -. I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - ^,i•ISUMP5 - - - .(INC.SOLAR)_._10-50-HP 50.+-HP. formance of the work for _which this permit is Issued (Section 3097 - �- - - • • - Civ:Ca. - tender's Name Wimbledon Assoc. FCOOR SINKS- -FLOOR"DRAINS`- " .FIXTURES-3'-OUTLETS 3W 5ITCHES-/"- 'Lender's Address 147A Tamhn raa Pw T1i]n Yf RParh DRINKING F_OU NTAINS ;:- "' "•'-"" -.GAS-TUBESIG NS--- •V 1 OWNER-BUILDER'DECLARATION ---'- - - . ---- - I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS --- the following-reason-(Section-7031:5'Business•and Professions-Coder "-SWIMMING'POOL'" • P TRAP' - -- --- - Any city or county which requires a permit to construct, alter, /ALES { Improve; demolish-or'repair-any'structure;prior to'its'issuance,ralso-re-• -WATER SERVICE- ''AL'TE RATION '-' { quires the ap'aicant for such permit to file a signed statement that he ensed'pursuant'to-the provisions of'the-Contractor's-License-Law. - GA55ERVICE - `"OUTLETS pter 9' (commencing with Section 7000) of Division 3 of the ess'and-Professions-Code) or-that-he is exempt therefrom and the- -'WATER HEATERS" 'BTU OUTPUT - ' i is for the alleged exemption. Any violation of Section 7031.5 by t - ' any-applicant-for-a-permit-subjects the applicant-to-a-civil-penalty' -SEW ER'CONNECTIONS- -11 •�'- _ r of not'more than five hundred dollars ($500). ••T - D I, as owner of the property 6r iriy employeerlkith-wage5 as"ttieir SOLAR TANK' -"--COLLECTORS- - { sole compensation„ will,do the work,,and the structure Isnot Intendetl or offered for sale: (Section 7044, Business and Professions Code: The - SOLAR PIPING SVS. ` -- -- --” whot builds _r improves thereon,o t.dpply_who doeso an such owner a.Prs if ty,or _ _ -IL ••• • ••• • -• , , who builds i or improves thereon, and who chsuch work himself or "1551)E FEE'-' //1-I through.his.own own for employees, pro hert building uimpr0 ormems are not _ _ ' intended torh n.one for sale, If,lhowever,,_th the buil d log' improvement MECHANICAL PLAN CHECK - • of proving none year .build on, the owner will have the burden 1 of proving he did not.build or improve for the purpose-of sale). HEATING SYSTEM 0-100,000-BTU- 1-1-as--owner--of •the-property, am:-exclusively-contracting-with -AND DUCTING 0;�+-- ---- -s ------'• - - i licensed contractors to construct the project (Section 7044, Business 100,00BTU • and Professions-Cotle:-The•Contractor's Llcense•Law does not apply-to- _ _ 1 an owner of,property who builds•or improves thereon, and who con- REFRIGERATION 0-100,000 BTU f tracts- from-such projects'with a-contractor(s) Ilcesned-pursuant.to. -SYSTEM-- - - - - - I the Contractor's License Law): - - 100,000+BTV ❑ lanexempt under'Section ' -'- ---B:& P.-C:for this- - -- - RS BTU - s Date - Owner SYSTEM REPAIR,ALTERATION e,0 1-hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE . , i information is correct.-1 agree to comply with city`and-county- , /� II " :• ordinances and state laws relating to construction,and hereby authorize s.w- {� - representatives Of-" is city to ei% 5 LLPon p7e boyyy��4-mentioned' ® • 1 property�•fo sect •n purposes. 1°Y:1•-11j'1 YC�: W / 1 P Signature - 11 yip S •'•Ssi Date 7713/82. Drivers'License or 5S - "ISSUE FEE• - - CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor • . CONSTRUCTION AND PLANNING - POOL:&SPA . a• t APPROVALS Permit# /3.47ta' 4 Date n Inspector' - ^• • Date - Inspector APPROVALS • � ' Permit 9I‘ 1. Temporary Electrical S&rvice Or Pole_ 43. Pool & Equipment Location - -' - - - 2.. Soil Pipe-Undrgrn••._ _ - 44. Steel Reinforcement - -- --- - - - - - -- 2.• - 3.- Electrical Conduit-Utility-Undrgrn - - \'•. ._ _ + _ . 45. Forms - - - - - -- - - - - - 4 '...4. .Electrical..Conduit-Undrgrn,_ -.- _: '.:'• _.._''- . . .._ . -_ . . _ 46. Electrical Bonding ,} -- - - -- _--_ _ - _ ._ _ _ - li 4. _5.__ Steel_Reinforcer;_• 47. Rough Plumbing& Pressure Test ' - --- - - a ._. 6. ,_Electrical:UFER Grn��__ ,.. ,1_ I 48. APPROVAL TO COVER-GUNITE- --- :_ - - ' 2.-.1 ' • il _ 7.__Footings '- • : - - -49. Electrical.Conduit-Undrqrn . ' - • - 8.- - Foundation_ _- ... _.- __ __ .-_ _-._ _ -. ' 50.-•.Gas-Pipe,,D Undran;.Test ". •4. - '.. . - - - - : }.-9.--Wateu.Pipe:Undrgrn__ ..__ __ .. - 51, Backwash Lines,P-Trap, ❑Undrgrn ' -.-• - -�• -• v :_10.. Structural Floor,_System . -,. . , . -,;1. ...1- _ • . . 52. • "APPROVAL TO DECK' _ - "- --- - -. " _ - •-1.1..',..Property Sewer:Line'&_House Connection_ _ .• . . _ __ , 53. Backwash & Receptor-Final ' • • - - •' • is I .12. -Street.Sewer.Connection_ .-. :. _'_ :_ _ - ''s - 54- .Heater & Vent-Final' 4 13._,. Rough Plumbing ___ _ _ _-_ . - . _- - ' . ' 55 -Plumbinu Sv-stem-Final - - • - 14. Rough Electric-Conduit -- ` - - - - - --56. -Electrical-Final - ..i., - • , . 15. Rough Electric-Wiring ' ---7-419-st /err:, - - 57. Solar System-Final " ` ' •,--•-- , ` -`^ ;'.1 '`„ - -•16. Rough Heating'&Air Conditioning" ' -4--" - .. .- - 58. Fencing &.Access Approval 17; Ducts; in Structure;.,.,: - •--- ';._: + ...... _- -._59. APPROVED FOR PLASTERING " , . . - „-' .'- ,' .' -. 11 ' 18: -Ducts, Ventilating--._i - --- ,fir _! .. ; .. ._ : _ •.�,... _ - - - : 19: Gas Pipe:Rough'&Test _ . _ .,' . -- 11.'60. POOL/SPA SYSTEMS FINAL^ „•; ' "^; •• '"'•c • 20. Roof Framing._.- _ - - -- •- - - 1 . . , . ....... _ 21: RoofSheathing ,- 1. _ _ . - -- - - - - - ' 22. Frame•and Flashing 7 �Z)v - Z7� NOTES: , , , , - -- - - - -- - - - .. 241 Lathing & Siding- - -- - - - - { ._ . , - .__ .:. _ .. - _. -_ - _.- . _ . 25. Drywall Nailing- . -. . r -. . : 7.7'3-S tO _'. _--._- '._ - . . . 26:.--Plaster Brown Coat -#.:Ll` -- - 3 . I _ _. _ _ __ _ . _ ' 5 . , ., - - , , 6 t 27: -Electtical Power Meter Final- ' -- .. . 28:' Final}Electric- - - - - - - -• _ _ --- 1-2-'••• /3 1- .' ' ` ' .. ` , 29.- -Final'Heating & Air Conditioning•- - - - - �l/-�r; - , ...._- _ - - . . -- ` , _ . . .. - 11 30: -•Final Gas Pipe-Test - - .- - - - - .. . - ` .i 31: ..Final.Plumbing -- - -.: . - • • 32; i Water.Service:Final_' - - r - -- - __ -- - - • - --- - - it - 33. '`-Gas Service-Final-: ' - .. - _ . _. - . . - -- - . - ^ .. . 34. Solar Domesii'c=Final ' - ' •• __ • '' ' - - ' ' ., . ' , . 4 . ..... . 35. -Landscape Sprinkling%/stern -- ' - - • - .. ' I 36. Sound Attenuation - .• ., ..- " - ' 1 -- - �, ,.. - . . ,.. - I 37. Handicap Regulations - - :n" , . ._. n,. ... i 38. FINAL STRUCTURE & BUILDING 4:3_/-7-ga 239k7 ..- -'- "'` ' . _ . . . - 39. Special Requirements Completed _ . _ '" , - - '- -- . • '� 40. Electric Release to Edison - ' . - - e. ' 41. Gas Release'to.Southern California'Gas Co. . ' 1 r,.-'• ' ' . •%,,•' - • v.. • 42. CERTIFICATE OF OCCUPANCY - - - - •• - •• NO Date , . - _ • _ - . . .. • _ _ . PPROVE ® City of Costa Mesa Building Dept. 7{c ain j3evel ymen e. -----3-7,77 DATIL./L g i— July 16 , 1982 THESE PLANS MUST BE ON JOB ALL IMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION • OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL THE ISSUANCE OF A PERMIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL Mr. Victor Newton ICOM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING Director of Building and Safety BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN City of Costa Mesa IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE 77 Fair Drive CF THE CITY. Costa Mesa, California 92626 Ref: Wimbledon Village Sales Office Conversion Unit #8 , 1157 Salinas/Tract 10276 Dear Mr. Newton: Per our telephone conversation of July 15, attached is a list of work to be completed to convert our existing sales office back to a residential unit in accordance with plans and speci- fications approved by the City of Costa Mesa. These approved . plans will be at the jobsite for inspections . Your assistance in this matter has been appreciated. Please do not hesitate to contact me if you require any additional infor- mation. Very truly yours , ------------Ge ...Marks STRUCTURAL At-rtt lvrtalOSuperintendent GM/cvSEPARATE PERMITS ARE REQUIRED - Attachment FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING AND REFRIGERATION WORK Permit m -Vine 'talc/ i THIS NUMBER MUST ACCOMPANY ' I ALL INSPECTION REQUESTS I , -ut >fNSARE TO1j I ' r ' V . a3T THAT THE I : ST:lE r C'.L: JRl'! DIVISION FORF LI I :, ;,,,:'.Tc.,: ;-:.:7i.';' 1-..17.,CT,�,a"'ULTFqq ` 147o Jamboree, kaclikivpo'r Babi,-_Ca ornia, 92660 • (714) 64o-6800 . . . _ . . • • WIMBLEDON VILLAGE TRACT 10276 SALES OFFICE CONVERSION Work to be completed: 1. Electrical : Remove and disconnect service to five temporary office ceiling light fixtures . Install three plug outlets and relocate one switch outlet. 2. Heating: Turn F.A. U. unit into garage, reconnect. 3. Framing: Install approximately 26 lineal feet stud wall with three door openings . Remove existing pedestrian doors and windows at garage and install overhead garage door. Insulate where needed and drywall. STRUCTURAL APPROVAL ONLY SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, , HEATING, VENTILATING AND REFRIGERATION WORK Permit # rbc '/za THIS NUMBER MUST ACCOMPANY ALL INSPECTION REQUESTS • FOR BJILD;;:;;S ;'Y:—ILE PERSONS ARE TO BE EMILJ;_i!, ;dE SJGGEST THAT THE 1 . __________ ., STAT: Jr G ._IPU„NdA DiVISION OF INDoS i ..;;L S 1 iTy 3E CONSULTED FOR ANDi ..V• �. ; EUUIBEMENTS. OWENS-CORNING Fiberges Building Insulation The contractor named below certifies that the Owens-Corning Fiberglas Building Insulation used carries the NAHB Research Foundation; Inc. label for assured thermal performance and that the Building Insulation is installed in conformance with current energy conservation regulations, California Administrative Code,Title 24,State of California,in the building located at: //: - • tc/ n bl don . V;11°Fe. �.!c? ,Sr../; �h s c /422X5 —x/s Address / City • Tract Number Exterior Walls ��/7 aOwens-Corning Fiberglas Type Insulation Thickness P-Value /' 1W' 6827 F0`/!2/78 (07,73 TL' COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 - APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIVED BY DATE RECEIVED 4 DATE ISSUED BU ADIDRESS Tract 10276, lot 8 ,_... W/,2-pl/-of, O PERMIT NO. OWNER McLain Development Co. A.P. NO. via -o83-O/ MAIL BUILDING C ,fit, ADDRESS 1470 ,Jamboree R3. ADDRESS fin ptA�//VApS /�I�� CITY Newport Beach No.640-6800 TRACT�O.t7� LOT V BLOCK CONSTRUCTION NEW ALTER REPAIR MOVING DFMOLISHS LENDER r ki1 BRANCH OWNE; ADDRESS ' VALUE or .„ge ARCHITECT TEL USE _ I a,n w y �, _ C, OR ENGINEER Corbin/Yatnafuji No.752-5567 ' "'” -^"" / FIRE ADDRESS 3661 Spruce, Newport Beach ZONE -TYPE ROUP APPROVED CONTRACTOR McLain Development CO. BY DATE ADDRESS 1470 Jamboree Rd. ZONE NO.OF USE OF NEW TEL CITY Newport Beach NO. 640-6800 PDR- M0 PLANS BUILDING RCS. STATE CITY YARDS APPROVED YARDS APPROVED .�" LIC. NO. 273875 LIC.NO. MAIN BUILDING ACCESSORY BUILDING {4j SIZE NO.OF BLDGS. (FROM C/L STREET) Ba OF LOT I NOW ON LOT FRONT a O FT. U FT. Q USE OF ti EXISTING BLDG. B,SIDE /7 FT. 0 FT. V) HSeparate permits are required for L.SIDE S FT. 0 FT. L1 electric,plumbing and heating work. REAR r FT. 0 FT. (w.i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& QMAIN BLDGS. ACCESS. BLDGS. � DATE 3 single family residence, c U.P# Z E-78'-3 5/ APPROVED aia7I7F' a New house —AFFRAYEDCw�,I♦Mr DATF a ! /77 a HOLD FOR SPECIAL REQUIREMEN I S O I hereby acknowledge that I have read this application and state n a that the above information is correct and agree to comply with co Q. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of _ o Sthe State of California. Garage 436 FT 1685, I hereby certify that I am properly licensed as a contractor under SO. ', the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR aa Chapter 9, and that such licenses are in full force and effect,or I ' THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business `o VALUATION PERMIT FEE $ c and Professions Code,Division 3,Chapter h Signature of /� /r //�rrr�/��n PLAN CHECK $ . D o Permittee / $/� /y y/• TAX g _�:F LL // '� Authorized Agent i /; i;k' ✓ i (f TOTg WD $ az �Z i 04454 46872 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . APPLICATION FORESf[RUMIXA7.9'ERMIT 207.00 f, For Applicant to Fill in Completely —Use Ink Only RECEIVED BY DA d Eivic .. .-- UE-D, .*DOCK U BUILDING ,,. .I sf UVI .14N. � Q -- ADDRESS z . - S - s - ...: .. ... ri ir '• PERMIT NO. OWNER McLain I evelonment Co. A.P.NO. BUILDING V AMAIL DDRESS ADDRESS . 1157 Salinas Avenue .c! TEL. TRACT- 10276 I LOT 8,� BLOCK CITY NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH LENDER BRANCH - OWNER McLain Development Co. ADDRESS VALUE ARCHITECT TEL. VSE $ OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. --i STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) 4 OF LOT I NOW ON LOT FRONT FT. FT. a USE OF ,N. EXISTING BLDG. R one FT. FT. ca P.±. Separate permits are required for L.SIDE • FT. FT. electric,plumbing and heating work. O REAR FT. FT. E.W. USE OF BUILDING AND WORK TO BE PERFORMED . DISTANCE BET.. BET.MAIN& Q MAIN BLDGS. ACCESS.BLDGS. CilQ -VAR.# DATE -1 C.U.P.# APPROVED a - APPROVED • )'.. SAY IIATF Cg W CI hereby acknowledge that I have read this application and state N r-.a that the above information Is correct and agree to comply with m Ow all laws regulating building construction, end I shall not employ Z any person in violation of the workman's compensation laws of 9. I.& the State of California. 1 3 I herebycertifythat I am SQ. FT. as 9' properly licensed as a contractor under `v the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; e am exempt from the provisions of the State of California Business VALUATIONo and Professions Code rvision 3,Chapter 9. PERMIT FEE $ 207.00 n /' PLAN CHECK $ Cl Signature of } � O Permittee 777�i �� ( //^ $ TAX $ U. Authorized Agen(/fl C`i -� D J 60' TOTAL PAID $ 207.00 U