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Home My WebLink About2810 SAN JUAN LN - Building Permits(714) 754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2810 SAN JUAN LN Suite: Vicinity: RESIDENCE AND GARAGE Parcel Number: 14167206 Zoning: Applicant: MILLER, MATT Address: 905 S CALICO CL Phone: (714)226-0747 ANAHEIM, CA Zip: 92804 Owner: VANDEWALLE, JEROME T Applied: 09/13/2002 Address 2810 SAN JUAN LN SMIP Res: $0.62 SMIP Com: $0.00 Phone: $0.00 Inspection: COSTA MESA, CA Zip: 92626-5618 Contractor: ALL PRO ROOFING Address: 905 S CALICO CL Phone: (714) 226-0747 ANAHEIM, CA Zip: 92804 License: 768511 Arch : Address: Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 09/13/2002 Issued:, 09/13/2002 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O EXISTING WOOD SHAKE ROOF, 7/16" OSB, 1 LAYER 15# FELT, APPLY "40 -YEAR COMP SHINGLES." 30SQUARES Total: $139.87 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. 9248, § 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 244646 (6100) J FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,191.00 Permit: $139.25 Claim Valuation: $6,191.00 SMIP Res: $0.62 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.87 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. 9248, § 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 244646 (6100) J WORKERS' COMPENSATION DECLARATION: VF I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 ork for whkh this permit is issued. I have end will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' co pe etlon Ingurance carrier and policy number are: Carrier: ��.. ) inn Policy Number: l .� (This section nabnot be completed if the permft is valued atone hundred dollars ($100) or less.) ❑ 1 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 Celito a, 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 provisi( N}✓✓ --13 n Applicant Signature: z , A s: Date: WARNING: FAILURE TO SECURE WORKERS' CON/PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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 lice0_sad u r�pravi5iops of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and enact. Lic. k J(O�'.� / Class a Contractor's Signature: /' Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 contractors) 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. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 d0 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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 theappplicant 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, hes Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .._ ...................................... ... .._...................................... _......................-....................._....................................................................................._..................................... ...................................................................................................... - ......... _. 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aerrmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 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 o1 the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? []Yes ❑ No (If yes", the facility must meet the 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 Califomla Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..__.........._........................................................................................................................................................................................................................................................................_........................................................................................._. 8 (I} yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: 1 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 stale 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. Sp9ature Oflg�al Own Date A/p " M yLLO�` nd/O�ionzed Applicant I Date CODE f. INSPECTION TYPE p&U INIAL$ CODES INSPECTION TYPE 2AU I({UTIA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof - 1 i "'BZ 1� 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 Applicant to fill in all spaces CITY OF COSTA MESA CONSTRUCTION PERMI Project Address - Applicant's Mailing Address Owner's Name 9�%`/ bone, •"'/ , Address O < Z Arch/Eng. -- License No. Address r ' Contractor's Name -'� Phone cu_?; City License No. I, LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing j with section 7000) of Division 3 of the Business and Professions Code, and ` my license is in full force an elect. License Class Iice Imp No, Date Signature - K RS COMPENSATION DECL ATION ;by affirm that have a certificaA of consent to self -insure or a certificate ,Vorkers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab.:"_"__�"__ r Policy No. Company tified copy is here y furnished. Cer1T'etl cop -iY fNed with the city Builgin 'visio .� Date % 6 APPI can - -'�— EXEMPTMPT ONRKER$' COMP SATION DECLARATION (Thissection need not be compleletl if/t permit is for one hundred ($100) or less). I certify.thal 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 t6 Workers' Compensation Laws of California. Date - Signature NOTICE: If, after making this declaration, you should become subject to the ryx Workers' Compensation provisions of the "bar Code, you must forthwith `l1 comply with such provisions or this .permit shall be deemed revoked. •V CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) II Lender's Name - Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the -..7 following reason (Section 7031.5 Business and Professional 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 •ile a signed statement that he/she is licensed pursuant to the provisions of '.ontractor's License Law (Chapter 9 (commencing with Section 7000) of on 3 of the Business and Professions Code) or that he/she is exempt Arom 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 enalty 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 (Section 7044, Business and Professional Code: The Contractor's License law 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 improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). Cl I, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: .;;ttThe Contractor's License Law does not apply to an owner of property ,who )Quills or improves thereon, and who contracts for such orpiect5 with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Proof at their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner ohereby certify that I have rem Iformation is correct. I agree to and'state laws relating -to buildir sentatives of this city to enter Inspection purposes. Signature Well m 15 '6(o(P04 se within heavy border lines and sign all appropriate declarations. TRACT NO. LOT NO. UNIT NO. P. # TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION 11DEMOLISH 1:1OT R F, DESCR I PTION OORK/USE OFB G - LJ f."� TYPE OF PERMIT LJGRADING- FOUNDATION STRUCTURAL 1:1TENANT ElELECTRICAL ElPLUMBING ❑ MECHANICAL ❑ -OTHER PROJECT DESCRIPTION Sq. FT. 7_ . R) OCCUPANCY p r CONSTRUCTION TYPE y p� VALUATION $ — — _ _ �- ZONE GRADINGCU.YDS. ACRES A. S Main Buildi E ,T Front B Rear A C Right K Left Flag. Ref. # Planning Notes: Accessory Building: Zone O N I N G R E Q M T S. Remarks: ELECTRICAL FEES PLUMBING FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑50+KW ' Bar Sink Showers Backflow Preventer Service Sink' Cooking Unit Meter ❑up to 100 amps - Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100amps` Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel ti , Clarifiers Solar Collectors Fan Motors 110-1 HP 0.1 X - 8 Dish Washer Solar Piping F.A.U. Inc. Solar 09-15 HP 016-15+ Drinking Fountains Solar Tank Fixtures Microwave Floor Drains Swimming Pool w/Spa Device Boxes Pole Light Floor Sinks '� Urinal Outlets Range e ` Gas Service Outlets Water Closets Switches Sign Interceptors Water Heater ` Garbage Disposal Standing Sections Kitchen Sink Water Service .Generator ❑05 KW 05-15 KW Trash Compactor Lavatories Auto -Wash P—Trap Laundry Trays Roof Drains Reinspection Fee $15 Issue Fee It 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Dat Reinspection$ Fee $15 Issue Fee 3 ; {- MECHANICAL FEES Boiler Duct - Under Ground Hood or Type I. ❑ Canopy Type II El(,! - t- ,.,- BUILDING PERMIT PLAN CHECK '�" PLUMBING CHECK 25% ELECTRICAL PLAN CHECK 50% fir' MECHANICAL PLAN CHECK 25% SUMMARY OF FEES �•p $ SMTP $ _�_ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ $ MICROFILM $ $ TOTAL FEE $ $ 1'O Duct -Structural Refrigeration System Duct -Ventilating 00.100,0006TU ❑100,000BTU -s' Exhaust System 11 Multiple Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBG# Fire Dampers Heating System &Ducting Registers ❑0-100,000 BTU❑100,000BT Drivers' License or - , I I Reinspection Fee 0865-46, rev. 5/88 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Issue Fee $ 3 ni CIi: 12/07-OOQ2146E i5:28 DATE: i2iR7iE9 TIM: :`1:22 �/ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PC 4r SPA - APPROVALS . ermit z#- Date - •Inspector 1. Temporary Electrical Service or Pole 1. 52. Pool & Equipment Location 2. Soil Pipe;Uridrgrnd. •,I 53. Steel Reinforcement 3.•Electri'cal Conduit lUtility-Undrgrnp.' 'R - 54. Forms 4. Electrical Conduit-,Undrgrnd. , 55. Electrical Bonding ' 5. Steel Aeinforcemenf, " 56. Rough Plumbing & Pressure Test 6:; Ejegiridaf,UFER'Grnd. i 57. APPROVAL TO COVER-GUNITE 'r 7. Footings - ,,; `.'i _ 58. Electrical Conduit-Undrgrnd. (u 8: Foundation ! ! 59. -Gas Pipe, 0 Undrgrnd.; Test : 9Watn;ePipe-Undrgrnd'.-r', �' 60. Backwash Lines,.P-Trap, 0 Undrgrnd. '^' 10. ,Strucpura! Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ,, 62. Backwash & Receptor -Final 12. Sewer;Ica pra �., 63. Heater &Vent -Final- 13. Roof Drains "• 64. Plumbing System - Final 14. Rough Plumbing.'J 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 19-_1 Rough Electric Wiring 67. Fencing & Access Approval - 1 -1 -.)Rough Wiling Sign 68. APPROVED FOR PLASTERING 18.1 Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19., Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT APPROVALS Permit # 20.E Rough.Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas LI Od 23. Gas Pipe -Rough &Test, 72. Underground Flush 24. Roof Framing '�,i 73. Undergrnd. Storage Tank ElGas 0Oil 25. Roof Sheathing _ 74. Overhead Hydro 26. T-Bar,Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing 4 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 ISSUE 33. Final Electric ` j Notes: i y eG Y 34. Final Heating &Air Conditioning 35. Final Gas Pipe -Test 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 t^ 43. Backflow Irrigation J 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /s r.• 48. Special Requirements Completed - T 49. Electric Release to Edison L.. 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 'i°!, JIFESA DLL MAR DEV.CO. JOB ADDRESS colo man Juan Ln. BUILDING PERMIT NO. 2U52;( GENERAL CONTRACTOR Macco Realty Co. VALUE $232925,00 An ni.. inm Q TA AI+m i 9 ITPT I) ITV 7 nVF OPTPTMM I W AUnDW n,c P.A. INSPECTIONS _Signature DATE GROUP I&J TYPE V -ZONE Rl _ Soil ��_y-�'3 SUBCONTRACTOR ISSUED NUMBE. _ Gas DATE Water -L'3 -rl _ Rough Com. firing.Air Cond. 0 Co.; 0g. Rough Heating /} /7_Gg OCT 2 19 Rough Plumbing Z- -L3 2 1 7 1963- Miscellaneous Prop. Swr. Line El House Con..p St. Swr. ❑ 8-19 6 3 S rinklin System Grp._ --i/ - .r Construction Pole vII Underground ❑ Power p Rough Wiring Trenches p, Forms L� Steel Reinf. p- /a Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing[ - Frame and Flashing Lathing - In .per Out p� Plaster, brown coat 7/-k7 Refrig. O Air Con, Ej Final Heating, Final _ Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final•� L Building,_ Final 's -K7 OCCUPANCY rte.- o.74-- m-.,- -L r tPA� �'20527 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MRSA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS COSTA MESA. CALIFORNIA OWNER .Mesa Del Mar Development Co. MAIL ADDRESS Coast.Highway C=D if No:Oriole TEI ORCENGI ARHITEEER Ma CC Realt C NO: Or101e ADDRESS Same aq CONTRACTOR 9LMM3X2C9= M&CCO Realty CO - ADDRESS -Same as above CITY•T . Same as above STATE 207343- A -SB -1 TEL. LIC. NO. NO. SIZEL NO, of BLDGB OF LOT '651 X 1 NOW ON LOT NOn USE OF EXISTING BLDG N ne BACTTK SETBACK Z FT 501 311611 EETRO J CENTS" OFF STREET REAR YARD SIDE YARD I LEFT 61 I RIGHT 1 DESCRIPTION OF WORK NEW I I ALTERATION I ADDITION REPAIR I -II MOVING I DEMOLISH BUILDING NO. OF 1 2 SIZE 54 11611 ROOMS7 STORIES EXTERIOR WALL Wood, &I ROOF Shingle & Shake COVERING COVERING USE OF BUILDIN ORK TO BE PERFORMED garage. Plan 500 -DR 1 HEBHSY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND ACME TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LAWS BEOULATING BUILDING CONSTRUCTION. SIGNATURE OF Mesa Del Mar Develo ment Co. PERMITTE AUTHORIZED AGENT FEE RECEIVED SEP 1 0 1963 FINANCE DEPT. 'alLI AalF COSTA MESA TION FOR PERMIT BUILDING For Office Use Only B0 U1963 I COSTA MESA. CALIFORNIA _ I FIRE (APPROVED ZONING Z NE NO. OF USE OF N 1 PLANS I SUILDIN�� /1 r- A (CENTER LINE ST.) I Garage 11 1160 S.F. I THE AOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSME OF. ESTASLISHING A PERMIT FEE ONLY. VALUATION I — --Id- Is 232925.00 OWNER JERCME VANDEyNl7A= DATE -14-80 JOB ADDRESS 2810 San Juan Lane BUILDING PERMIT N0. 49483 AP No. 141-672-06 LOT 9 TRACT 5252 FIRE ZONE VALUES LrJuu.uu INSPECTIONS Signature Date TYPE V GROUP I ZONE SOIL SUBCONTRACTOR Dote _ PE MITS ISS ED _ Number Si r, GAS WATER Plumbin _ ROUGH PLUMBING PROP. SWR. LINE GI HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLEr UNDERGROUND POWER u ROUGH WIRING n C.t-. - Heating and Vent. TRENCHESFORMS STEEL REINF.Li- FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING n LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL ,Z PLUMBING, FINAL AND GAS TEST _ ELECTRIC, FINAL _ BUILDING, FINAL LO _ SPECIAL REQUIREMENTS 2i COSTA MESA BUILDING -SAFETY DEPARTMENT o n env »nn rncrn nnccn rn� mnr,.un nncnc For Applicant to Fill Completely — Use Intik Only BUILDING -- SAO Ld- 9/V ADDRESS i A0.l OWNER OR TENANT tJ MAILING / ADDRESS-` /Q &/ UQN CITY He TEL 176 6 CONSTRUCTION LENDER O tlI BRANCH ADDRESS ARCHITECT Litt OR EN GINEEFl NE ADDRESS 4 jiI CONTRACTOR .L ADDRESS _j tQ CITU N Sf� C'F1. No SS76-/3' STATE CTY LIC. NO. LIC. No. 60 rr SIZE OF LOT �,s 3 NOWBLDGS. NOW ON LOT / USE OF //JJ EXISTING BLDG. s�AiC9L K.4FFS/ J'v1-7Le: Separate permits are required for electric, plumbing and heating work: USE OF BUILDING AND WORK TO BE PERFORMED t v a . 1 hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State. of California Business and Professions Cod., Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from t a provisions of the State of California Business and Professions C e, Division 3, C,yhapter 9 Signatureof // /tY^',, r(�L"Y Permittee �'I or �y Authorized Agent Date 19822 L/ 14/80 '16.50 I'f94, APPLICATION FOR STRUCTURAL PERMIT REC !B/V PERfMIT p/ / A.P. NO. I"/�� Z Oy BUILDING —19/"-4'TVA.✓ L.e/ ADDRESS UNIT OR SPACE NO. R.NO. LOT BLK. NEW I ADD IALTER IREPAIR IMOVINGIDEMOLISH OWNER TERovr ✓A-rpE if wAtZF USE1 -I _ —VALUE$Z/•9OAO ZONE M1—/ n( ITTYPEE V GROUP .•11� APPROVED �[ BY DATE i Lt`F A)7P �.ay u/ivyowJ I APPROVED SETBACKS 9c SRN 7C-44/ L.f/ —FT. �TT¢C/J TO EX/ST/r�P REAR FT. PLANNING ACTION //../ 8a THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ 2 Bp ®el PLAN CHECK $ r mC� TAX $ • SO TOTALPAIO $3 O