Loading...
HomeMy WebLinkAbout1646 SAMAR PL - Building Permits oai � w CITY OF COSTA MESA abt. 4 BUILDING DIVISION r� ,� DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER PERMIT J tbesetaitsc,,F 605-00478 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1646 SAMAR PL Status: ISSUED Suite: Applied: 03/25/2005 Vicinity: Issued: 03/25/2005 Primary Occ: Type of Construction: Parcel Number: 13928121 Zoning: R1 lffn11 Applicant: KEANE, DAVID - -• ISSUED BY: Y(S Address: 1646 SAMAR PL - Phone: 949 413-3495 COSTA MESA,CA Zip: 92626-3628- Owner: KEANE, DAVID Address i 1646 SAMAR PL - N - , - Phone: - " COSTA MESA,CA- Zip: 92626-3628 , - Contractor: - - Address: - - ,: Phone: " Zip: - , License: • Arch - - "1%- •; ' Eng: _ Address: . " ' - - - Address: " - ` Phone: - Phone: Zip: License: License: -. ._. SCOPE OF PERMIT_ _ FOUNDATION ONLY FOR FUTURE PATIO COVER=24"FOOTING. - ' . FEE SUMMARY , Plan Check: $0.00 Calc Valuation: . ,81,500.00 Permit: $54.00 - - - - Claim Valuation: • $1;500.00 SMIP Res: $0.50 - SMIP-Com: $0.00 Other . $0.00 - - ' Inspection: $0.00 - - Total: _ $54:50 - - , PLANNING &ZONING SETBACKS - MAIN STRUCTURE Front 0-0 Rear- 0-0 Left . 0-0 Right- „0-0 ACCESSORY i Front - 0-0' " Rear 0-0 Left 0-0Right ' 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) 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 ih2 work for which this permit is issued. ❑ 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'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This sect/on need not be completed if the permit is valued 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TOONE HUNDRED THOUSAND DOI I ARE($10opO0),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 Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class 4 Contractor's Signature: . Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there i5 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 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(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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I,as 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,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 rs'a to the Contractors License Laws.). I am 'xempf und:r se.. Business and Professions Code for this reason: Signature: tea.. _ '/ Expires: `l 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,Califomia 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 end 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 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 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 0 No (Section 65850.2 of 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 t0 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 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 slate that the information given is correct. I a o co y with all aws and rdlnances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-de cri revert for ins ction p n to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of eget Owner(s) Date ' And/Or Authorized Applicant Date CODE I INSPECTION TYPE MTh INTfTIALS CODE t INSPECTION TYPE all INTRgl9 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 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 5 " 0841 r 410Y7 e— . / S / 17 we-14-) ^u \ / // % / E=x f • 1Z.4sicl-e nc O APPROVED CITY OF COSTA MESA PLANNING DIVISION EKt sH r1J SUBJECT TO BLDG. DEPT. REG. NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV.) BY:A L DATE: 31�.,5 New 31x 11 f/n� ncxe±Q-pad-0.hd ntn_ iny'JewcenfAr"et er6kein teriyua w;+t nkrrcr+I (,ocks I (e Q sing r P(Q• c� , ------ - -- - - C9-14 • • cerg2-• fa-444:1-% C-160e2.-/getr)M ISVOttin JUN-09-2005 10 :36 All 7145463711 P_ 02 • • rO 3t, , y ,61 %ca ; ��h u � d Ex(s�(n9 Rea(denc� � r S APPROVED CITY OF COSTA MESA PLANNING DIVISION ett n9 SUBJECT TO BLDG. DEPT. REG. Gunter N(Yfl ADDITIONS, DEL ETU INS, OR CORRECTIONS SHALL HE APPROVED BY THE PLANNING DIV. eye-6144 DATE:3 3e SA Afv,ur1yx/7'rarr. .l pa� t� P toner Ia MveY>!. lhal-*in/ewers thrall re w ra. kutA615 Per1wbi6 k - c..611( Vogl (El W (v f mar P(ace. • r Po et Fireoess, I l0`(W Stmt( .62I!^L.c.._-- &iG- c, 00`1-70 )k 73 : 1db Z�x ` - 2 zy 3 .,. l\5 �, y ti�S _ I I I gee4ie pcs+N n „op-a� .' fed;iM& (-Z) W y &las rep 4 a,0 ,; Y 7- �l ? o - 7 'a'` y ;342 tet) /8 o/c X30 i H c atyS a` s 30 -lap ) Cso (KA /d - ! iW J p -l. sA -10 cU•-+r (7:-rr�r ._ 4 " enc- c s146 i' _ . • • irl it'BE99aeunoND: 1646 SAMAR PL MU: B, _ • CITY .OF COSTA .MESA — BUILDING PERMIT OWNERS NAME IF KNOWN: MC VEIGH SUSAN • • _ ._ . PERM NO: P 074780 ADDREss: 1646 SAMAR PL - - — - _ . • PERMIT NO: P. 074780 . . „ -. • PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 546-1203 , APPI.MAILING ADDRESS: CONSTRUCTION TYPE: V—N _ . .. PERMIT TYPE: PLU - PURPOSE: OTH ARCHRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : C/O WATER HEATER SQ FT: ARCH.OR ENG'S ADDRESS: UMT: CLAIM VALUE: _ • CALC—VALUE: GROUP OCC: R-1 / . CONTRACTOR'S NAME: NOCK PLUMBING (714 ) 895-1246 CONTRACTORS MAILING,11612 KNOTT AVE COMMENTS: NO BUILDING PERMIT ASSOCIATED WITH THIS PROJECT ADDRESS: GARDEN GROVE CA uc.No.: 511971 ************iF***********xfE7F+Ei(IEtF#1F1FifiFiElF** fEitlElEir*** fF1E1E1fiFiFiE#1FiF1E1E1Ff **** ****lEiE** x 92641 . UMT: 17 . ... ZONING REQUIREMENTS • LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force end effect. CRY LIC.NO.: 050386 uc.cuss, C-36 uc.NO.: 511971 EXP: 02/96 MAINBUILDINGACCESSORY BUILDING Date YD/y�l�j C Contractor [) J,fl/�T n?6 FRNT: _ FT.. IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 'WNER BUILDER DECLARATION:I hereby affirm under penaly of perjury that I am exempt from the Contractors License Law for the owing reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,alter.improve, PARKING REQ: . PROV: PARCEL: 13928121 Z NE: REF NO: nofeh,or repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING N TES> 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 for apermh subjects the applicant lo a civil penalty of not mon gum five hundred dollan(B5001). {F{L.{F.{L.{F1L.{F{F{F.{F•{E.{E.*{F{F*♦f{D{F•{F{E{F.Ip{L.{5{L.{E*{(.{F.{F.{(•{F{(.{F{F{5{F{(.{F{F{(.{FAD{(.{F{(.{(.{(.f(,{(.{(. (.*{(• (. (.{(.{(.{(.{(.{(.{ {(.*j(, (.***{(,*.M,***1I.1(M, ❑ I.as owmer of the popery or my employees with wages as their vote compensation.will do the work.and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7040,Business and Professions Code:The Contractors License Law does not apply to an Owner of property who bolds or improves thereon,and who does such work Sneed or herself or through he or her own employees.provided that such improvements are rot intended or offered for sale.N,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I,as owner of the property,am exclusively contractkg with licensed contractors to construct the project(Section 7040.Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contra tors)licensed pursuant to the Contractors License Law). ❑ lamexempt tinder Section: B.&P.C.,for this reason: APPLICATION ISSUED BY: DATE: 4�_ ********************************************** ************** ****** *** Dat Owner: LEGALIZATION:N F E E SUMMARY - STRUCTURAL SEGMENT:N I do hereby certify that I ant aware of and understand the requirements of Caldomie Health and Safety Code Sections 25505,25533,and 25534,and lhm I or any future building occupant will/wtl not(dmb one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING aperms for construction or modification from the Akadfyny anagement District.Residential construction appicatione°n exempt from these provisions. PERMIT 12 .00 Date: Applicant 25% SMIP/NON—RES • PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE _ 20 .00 le ❑ Ihave and MImeintanacengceof consent loset'insure for workers'compemmbn,esprovidedfor bySection3700ofthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE Code,for the perfotynence of rhe wont for wNch this pemiltbiased. TOTALS----> 12 . 00 20 .00 0 . 00 32 .00 32 . 00 . 00 yI have and wit maintain workers'compensation insurance,es required by Section 3700 of the Labor Cole,for the performance of the �C work for which this pennh S issued.My waken'com nier ation insurance MIS and policy number we: Carrier: GOLDEN EAGLE _ . EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 32 .00 OVER/SHORT: .00 Policy Number. NWC:511151U° 09/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed i the pens is for one hundred ddiars 131001 or lass.) 32 .00 ❑ I certify that in the performance of the work for which this perms' 1 shall nod employ any person in any manner so as to become subject to the workers'compensation ems o Car•. degree that H I should become subject to the workers' ***************************************************************************iH*** compenestionp ions of ion 370o of the Labor Cove,I! with oomph, hose provisions. INDIVIDUAL F E E BREAKDOWN Date: / O7 9 -) Applicant Warning:Failure to secureworkers'conpensedon coverage Is unlawful,and shall subject an employer to crimes penalties and TYPE . .QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000),In addition to the coat of compensation,ansgse as provided for In f sepuon3706otmewprCoda,inerest,and aromay'atw. PLU 1 WATER HEATER AND/OR VENT 7 .00 7 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 .00 5: 00 performance of the work for which the permit is issued(Section 3097,Civ.C). END OF FEES / LENDER'S NAME: LENDER'S ADDRESS: eq T'j TT I stale that have read this applications and alma that the above Informationnese is correct.I spree to comply with all city and county ddirogeny ~L-jja.Jey l �-, , ,� 1 and elate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property '`/,Th/ ) Iwinepectpon pun s. RON NOCK DSTE 01 00192925/?5192981 TOT 32.00 prynePrinttheme q�// r— / DATE: 10/25/?5 TIME: 12:0u II 1 Date: /4 �, ti Signature of Ownadpgent/AppYcel/ConR6G« (5151.49.WP) White-Building A Safety;Green-Fie;Canary-Applcant:Pink-Revenue:Goldenrod-Assessor _ / f-'"'``" MOORE. R. C. I'^ ` 7-14-/b JOB ADDRESS 1646 Samar Place BUILDING PERMIT NO. 42282 GENERAL CONTRACTOR Pacific Installers DESCRIPTION of WORK Tile around Tub AP No. LOT TRACT FIRE ZONE VALUE $ 522.00 R INSPECTIONS Signature Date ,TYPE IV GROUP I ZONE R-1 sou PERMITS ISSI ED QGAs - • SUBCONTRACTOR Date l Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON, ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICE OR POLE UNDERGROUND D POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. Q _ FLOOR SYSTEM BOND BEAM 0 STEEL REINFORCE n SHEATHING . FRAME AND FLASHING 'p LATHING — IN OUT f �1 to\L.. rp4r11/0 PLASTER. BROWN COAT _ STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC. FINAL / )) BUILDING. FINAL R LG 4% 2, SPECIAL REQUIREMENTS . / 4228.2 PAS/ kn. 14-76FflL.,OO1536'' ,,**::•*6.50 COSTA MESA BUILDING-SAFETY DEPARTMENT ' • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY DATE RECEIVED . // 'J/ /j D•TE IS U • ADDRESSBUILDING (P -/ rr/ �/ / C �U-- .. v' /✓ S (� f n Aging OWNER 12_ C . �s-e- _ . A.P. NO. P- : MAIL BUILDING Al 49 Z ADDRESS I LOH 7„/y'y' (0 5tLQy_,Li ce ADDRESS om/�L �•� TEL. [// L/ TRACT LOT BLOCK • 0_ U CITY •r!r ! o/J a.,, NO. .c-/(�/ ZNEW ADD I ALTER REPAIR MOVING DEMOLISH I— Q CONSTRUCTION O- LENDER d D p J O BRANCH .! . •/ . CO --I ADDR ESS US .2 ALU �� •l J m ARCHITECT TEL US _ Q OR ENGINEER NO. - - O Q FIRE r./,� W CC ADDRESS ZONE TYPE v GROUP y UJ W r APPROVED ��/A W Z CONTRACTOR PO,�1LC 21A1J ITir�QQ-JZ-0 BY 641 LU DATE f... m Z ' (I ` 666 l J CC ADDRESCTY' • ZW W TEL. 5 7 ZONFfl NO.OF USE OF NEW /e I- CITY (/QJl(�ytiti NO. J°32 r/0- /i-/ PLANSyr BUILDIN�_^`�Y' 0 STATETVI C-�_ CITY YARDS APPROVED YARDS APPROVED Ell CC LIC.NO. pt ,/ 2 /8 LIC. NO. 2 J MAIN BUILDING ACCESSORY BUILDING D O I (FROM C/L STREET) SIZE NO.OF BLDGS. ar OF LOT NOW ON LOT z FRONT FT. FT. USE OF EXISTING BLDG. tC R, l[IE FT. FT. _ I— SIZE OF NO.OF ' Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. VEXTERIOR WALL I ROOF COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& O. C- MAIN BLDGS. ACCESS.BLOCS. • Q / I 64-/C----6 [ `6i r( VAR.# DATE O 6 i/2 9.-7L-7)9.-7L-7) .4U� L� , C.U.P.# APPROVED I-- `-L • APPROVED (A • RY DATE Z . o a V _sad 'Ian I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I"' any person in violation of the workman's compensation laws of e In the State of California. m zI hereby certify that I am properly licensed as a contractor under SQ. FT. rhe Stare of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPCSE OF ESTABLISHING A PERMIT FEE ONLY: R am exempt from the provisions of the State of California Business VALUATION and Professions Code, Division 3,Chapter 9. 4 mPERMIT FEE $ • ry D m Signature of �^/ ryes �7 �.,�-��� Permittee L't " \ y��-+ $ ��' 7 r p (J P NCH K $ }///�7T�� Authorized Agent V// P TOTAL FEE $ rra . FCC ItEVsIVEU COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.p MESA ESA P.O.BOX 317 COSTA MESA. CALIFORNIA - CITY OF COSTA l • FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 1646 Samar Place ADDRESS COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY 6@MIT-NO OWNER Glpe_nverde Homes. Inc. RECEIPT NO. I1 AMAIL DDRESS Box 65 RECEI A D BY DRE EIV IN_OATS ISSUED CITY Balboa Island,Calif. TN9r3-4220 BUILDING ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA, CALIFORNIA . FIRE / ,.,L ADDRESS p ZONE TYPE L GROUP�T 0 IC. CONTRACTOR Macco Corp. LNTo.98808 APPROVED BYDATE ADDRESS Box 65, Balboa Island,Calif. ZONING n LEGAL LOT 110. {p�^/ ZO NO.OF USE OF N81.�� DESCRIPTION NO. BLOCK I TRACT3481 1 PLANS :)___ I BUILDING J APPROVE//D( � 1rs--,A.P.NO. BY J.J ^ DAATE (1�' SIZE OF LOT 7000 • 1 HO.OO BLDG8.0 YARDS /CELLO 1 Now oN LOT REQUIRED 1, ALLOWED USE OF (CENTER LINE ST.) 9.- 1' �T EXISTING BLDG. FRONT 9 V FT. IN. SETBACK LINE FROM �` CENTER OF STREET 50 REAR YARD 31 R.SIDE 5 FT. IN. SIDE YARD I LEFT 5 I RIGHT 5 L.SIDE 5 FT. .-//�_ IN. DESCRIPTION OF WORK REAR �) FT. 'I IN. NEW I % II ALTERATION I II ADDITION I REPAIR I 1� III MOVING I 8 II DEMOLISH I BUILDING DINGNO.OF SIZE 1504/430 ROOMS STORIES 1 COVEXTERIOR WALL3 VERItuCCO ICONG rock . ERING USE OF BUILDING AND WORK TO BE PERFORMED residence l.ciailf I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCT(• VALUATION SIGNA OF Dn PERMIT FEE 536- ,.../ �Z PERS �L ' 1WE eO .S3 INC_ lb. �• 7 ay PLAN CHECK $ it/ AUTHO--��'` � iri/ © TOTAL FEES a 07 41 N C 17403 FEE RECEIVED • COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 22 1962 P. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT, OW— . For Applicant to Fill In Completely DiFtiala$PFASPERMIT //BUILDING ""S�TYPE OR PRINT BUILDING ADDRESS /c , y6, 69 MA/' PL/r-e2- . . COSTA MESA. CALIFORNIA For Office Use Only re 6&/ /. 1../ . /'�O'OI�Y�' /_ I RECEIPT NO. I PERMITRNO. OWNER A.O 5/cP-3 MAIL /6 � ' 6gin e. � . RECEIV BY D ATE'RE7 � ,TE ISSUED�� ADDRE//S'�S� /n Il Pia�/ // // l/l'� ✓yI TEL CITY ` O c to /,/�S/9-• NOI`I S wi/g ADDRESS /(l 46, YI L!!.N it-e ARCHITECT _ TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS FIRE " h ZONE PE (i" GROUP CONTRACTOR (°l ,-w.tA"e C4-11I- be-r' APPROVED T)-/�. BY J.(-j DATE ZZ /j',�Z ADDRESS - ZONING A /dy,�III '� ZONp�r/ I NO.LANS - I USEO EW V UjJI/ CITY / / PLANS r. BUILDING lies !V_IJ/y (' STATE / .TEL.LIC. LEGAL LO. of //a 1 /n /> (/ 0 SIZENO. /1 ( N 1 NO. OF SLOGS. DESCRIPTION ) (.L > y OF LOT IC'LF.CP 10(r ./ I NOW ON LOT I 1 C/ .- D-V " )N / USE OFJ2� S x yQ� YARDS EVES EXISTING BLDG. / # r A- CC_ — APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) / CENTER OF STREET � REAR YARD FRONT re �F�IJ _iv IN. I "o"___ f'7 I/ SIDE YARD LEFT RIGHT R.SIDE r / FT. IN. DESCRIPTION OF WORK L.SIDE (� YFT. IN. NEW I I ALTERATION I II ADDITION I le"- /REAR I FT. '(/ IN. REPAIR V MOVING I DDEMOLISH I APPROVED 1 r A/2 DATE (.-')-/" .- ,:1.--1-- BUILDIM¢¢qtyer.y•I r NO. OF /' II//L. V`- .I^,r), SIZE ::/y'G /\ I�• RODMS _STTTOORIES/./( (VVV\yV// /1 COVERING EXTERIOR WAL / UCd COVERING 2PCP USE OF BUILDING AND WORK TO BE PERFORMED 69 '7 ---- /lop. 0iN: Roo (-7 / ` / / . NQS' . I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- 'PLY?WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING w PERMIT see ONLY. BUILDING CONSTRU VALUATION 1 'SIGNATURE OF/!l� -�7�1�/Q,� PERMIT FEE`. $ 9t "--- SIGNATURE ` ����LL"'�" Z� - 1 �� w_ :$ / .". ^.- s;, PLAN CHECK $ �✓`-g-o, AUTHORIZED AGENT • . . . �L�3K... TOTAL FEE $ _/'.2.LS—d o r