HomeMy WebLinkAbout2231 SAYBROOK LN - Building Permits R MF
4� CITY OF COSTA MESA •
BUILDING DIVISION
f 1 DEVELOPMENT SERVICES DEPARTMENT
tr
�• �,.
as
v • PERMIT PERMIT NUMBER
699-00011
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: � SAYBROOK LN Status: ISSUED
Suite: Applied: 01/04/1999
Vicinity: 2231 SAYBROOK LN Issued: 01/05/1999
Parcel Nunmber: 41901342 Zoning:
Applicant: PEARSON, VESS
Address: 4872 CANDLEBERRY AV
Phone: 714-761-8173
SEAL BEACH,CA Zip: 90740
Owner: GARDEN PARK VILLAGE
Address HOMEOWNERS'ASSN
P O BOX Phone: - - _
%HOME FEDERAL S&L ASSN Zip: 92112
Contractor: G M ROOFING
Address: P.O.BOX 3908
Phone: 714-761-8173
SEAL BEACH,CA
, Zip: 90740 License: 472566
•
Arch : Eng:
Address: Address:
Phone: Phone:
' Zip: License: License:
•
SCOPE OF PERMIT
INSTALL 25-YR LAMINATED COMP SHINGLES 0/EXIST LAYER(SINGLE)3-TAB COMP. ROOF CERT ATTACHED TO
PERMIT
GARDEN PARK VILLAGE HOA.
•
ROOF"I"COVERING 2231 SAYBROOK LN.
-
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $1,175.00
Permit: $40.25 Claim Valuation: $1,175.00
SMIP Res: $0.50 •
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00 •
Total: $40.75
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: y
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 01 the Labor Code,for the performance of the
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 section need not be completed if the permit is valued at one hundred dollars($700)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 alifomia,ands:Tee that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with thes •ro.sions.
Applicant Signature: , - t _ Date:
WARNING:FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND COLLARE($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 licensed under pro/vlsions 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#
Contractors Signature: \�fl :V�— ✓L..�� Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
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 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. ❑Yea ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,1,0.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑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 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 Califomia Health and Safety Cate 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 Califomia 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 application a ppermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes ❑No
(Section 65850.2 of the Califomia 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? ❑Yes ❑No
(If Nes",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 Alr 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes ❑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 end 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.
Sign: a Of Legal Owner(s) Dat
• 4
ndi•r Authorized Applicant Date
CODE L INSPECTION TYPF DATE INTIMALS CODE! INSPECTION TYPE PATE l fAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing _
200 Final Re-Roof f -( 11 7a 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
2446-46
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. - TRACT NO. LOT NO. r UNIT NO. 0425 . - 15/84
CITY OF COSTA MESA CONSTRUCTION PERMIT 3 �Z .. 8.00 'TL'
Project Address -'Z.Z'3 I• ,SA�'BIeCIOIL LFY{4.�(' / �' M, , -
Applicant's Mailing Address ??31SF}Uifee 'L -Pc/ . TYPE OF CONSTRUCTION • El NEW I� ADD U'ALTE RATION U REPAIR - a
01-EY KEOL'J . 1 C�/y � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER •• E # Zoite
Owner's Name \GG Yom+ Pflon -DESCRIPTION OF WORK/USE OF BLDG.
Address (S#1-X4 `F-) ' - - - S Main Building: - Accessory Building: i
E
Arch/Eng. License No. ` TYPE.OF PERMIT ' ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL -- T Front 0
Address El TENANA
CI TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' B' Rear .. N
Contractor's Name ..Y Phone - - - I
PROJECT DESCRIPTION SQ. FT. • ' OCCUPANCY I C Right N
Address(mailing) 0 /, „ \tt \ - K G
lr�-JVv • CONSTRUCTION TYPE VALUATION $ S Left
City License No. ZONE GRADING CU.YDS. •ACRES ' E
LICENSED CONTRACTOR DECLARATION .. • r _ Ping. Ref.4 •
Parking Req./Provided
O
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and - _ _
my license is in full'force and effect. ' T
License Class License No. _ - $'
-te Signature • PLUMBING FEES
I
RKERS'COMPENSATION DECLARATION Bar Sink •
Showers
:relay affirm that I have a certificate of consent to self-insure or a certificate • ELECTRICAL FEES
•
L'r Workers' Compensation Insurance, or a certified copy thereof (Section BackflowPreventer. Service Sink
3800;Lab. C.) -- - - - - - Automatic Washer- - - _ Transformer ❑ 15-50 KW .. -
Policy No. Company , Backflow Irrigation Sewer Cap •' Construction Pole Sub. • 0 50+KW
8 Certified copy is hereby furnished. , -
.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection _ Cooking Unit Meter ❑up to 100 amps •
Date Applicant - - '
•EXEMPTION'FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors f' Dishwasher Meter Clover 100 amps ,
(This section need not be completed if the permit is for:one hundred ($100) or -
'
less). , Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sul]Panel
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 Drinking Fountains Solar Tank ' • Fan - •Motors❑0-1 HP 01%-8
•
Workers'Compensation Laws of California. - - _
• Date ' Signature Floor Drains Swimming Pool w/Spa �— F.A.U. 'Inc.Solar 09-15 HP 015-15+
• NOTICE: If,after making this declaration, you should become subject to the - - '
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal Fixtures ' Microwave '
comply with such provisions or this permit shall be deemed revoked. - - -
CONSTRUCTION LENDING AGENCY - -
' Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction-lending agency for the performance - `- - g -
of the work for which this permit is issued (Section 3097 Civ. C.)• Interceptors _ Water Heater - Outlets Range
Lender's' Name - - - -
• Lender'sAddress - - Kitchen Sink - ' Water Service1 Switches • Sign
OWNER BUILDER DECLARATION'. . - -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories 4• - Garbage Disposal , Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or _ -
county which requires a permit to construct,alter,improve,demolish or repair P-Trap • _ - o Generator El 0-5 KW❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit - - _ _
file a signed statement that he/she is licensed pursuant to the provisions of Roof •
Drains - ^_ �
Contractor's License Law (Chapter 9 (commencing with Section 7000) of - - � m�� €414.--. S.;inion 3 of the'Business and Professions Code) or that he/she is exempt -
..erefrom.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). $ 3 •
I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee , I -
compensation, will do the work, and the structure'is not intended or offered - Reinspection Fee '1 $15Issue Fee $ 3
for sale. (Section 7044, Business and Professional Code: The Contractor's MECHANICAL - I FEES .l
License Law does not apply to an owner of a property who builds or improves _ , . _.. - -: '.'7.._ - -
thereon, and who does such work himself/herself or through his or her own Boiler • - Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: ,
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- . Canopy Type II 11:1Zoning Approved By Date
pletion, the owner will,have the burden of proving he/she did not build or im- ' Duct- Under Ground • Building Approved By • Date
rove for the purpose of sale). eweaI as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ter• ' Dasr
t:
tractorsto construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating , 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who-contracts for such projects with a con- -
tractor(s1 license pursuant to the Contractor 's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUI LDING PERMIT • $ SMTP. $
proof o// their Worker's Compensation insurance should be provided to me. • PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& i c for this reason Firepl/Fact.Blt. ICBG 4 PLUMBING ; $ ISSUANCE $ -
a' i/
Date Owner Z7.2��' -az/Tom' - Heating System& Ducting PLAN CHECK 25% $ : ENERGY P.C. $
I hereby certify. that I have read this appli ation and state that the above 00100,000 BTU 0100,000 BT -1 - ELECTRICAL $ �•� GRADING $ _
information is correct. I agree to comply with all city and county ordinances • •
and state laws relating to building construction,and hereby authorize repre- s,, I PLAN CHECK 50% $ - MICROFILM $
sentatives of Etc y tyy�..._��gpppttt�ggr the above-mentioned property for •
inspection purggses /// upQ�gq,�,�� )) MECHANICAL $ TOTAL FEE $ _Ql.�
Signature /F-�t- / //
Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ ,
a
CMF 0865-46,rev.4/84 White- - - -
/ Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
'CONSTRUCTION AND PLANNING • - I .&SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
: 2. Soil Pipe-Undrgrnd.' • 53. Steel, Reinforcement - -
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms - - -.
• 4.-Electrical Conduit-Undrgrnd. - 55. Electrical Bonding .
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test
•
6. Electrical UFER Grrid. - 57. APPROVAL TO COVER-GUNITE
7:,Footings - • " 58. Electrical Conduit-Undrgrnd.
8:.Foundation . - - 59. Gas Pipe, 0 Undrgrnd.,Test • •
9. Water Pipe-Undrgind. . - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. - '
10. Structural Floor System 61. APPROVAL TO DECK •
:11. Property Sewer Line & House Connection - _ 62. Backwash & Receptor-Final -
'12. Sewer Cap 63. Heater & Vent-Final . ' •
13. Roof Drains 64. Plumbing System - Final I'
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit • 66. Solar System-Final -
16. Rough Electric Wiring - 67. Fencing &Access Approval '
17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING "
18.,Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace 1 APPROVALS Permit# -
•
21. Ducts, in Structure • 70. Underground Hydro
22. Ducts, Ventilating - .71. Product.Piping 0 Gas 0 Oil -
23. Gas Pipe-Rough& Test '72. Underground Flush
24. Roof Framing - '73. .Undergrnd.Storage Tank 0 Gas 0 Oil
25.'Roof Sheathing - 74. Overhead Hydro .
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .
C.-
27. Frame and Flashing 76. Dry Standpipe \ ,
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final ?II-fallotes:
80. FOOD CERTIFICATE ISSUED
33. Final Electric s/' ,4y Le,L�CG,�, •
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 i ,
43. Backflow Irrigation
44. ,Landscape Irrigation System - - •
45. Sound Attenuation
46. Handicap Regulations
47. FI NAL STRUCTURE & BUI LDING ' ' .
48. Special Requirements Completed -
49. Electric Release to Edison - - - ,
50. Gas Release,to Southern California Gas Cor .
51. CERTIFICATE OF OCCUPANCY -
No. Date .
. .I .
- -
.. /7
COSTA MESA BUILD AFETV DEPARTMENT APPLICA 4 FOR STRUCTURAL PERMIT
p.o.BOX 1200 COSI. .4A,CALIFORNIA 92626 nl.nn In, i nv-rn ' nn 48 TL
c !//RECEIVED BV 'PERMIT•/f7"/'9193 ' / '
For Applicant to Fill in Completely—Use Ink Only 1 1
.
B ILDINNG$ A.P.NO. 4 iq. - 0(2 — 19, Z7_
• BUILDING ���777 3l 4y'���,r�,r
OWNER OR� „atm -�: ITADDRESS It
TENANT (( t OE
UNIT OR
MAILING 6 ''I SPACES
ADDRESS ,{ ) / .SN TR�.N ���///� LOT7 BLK.
CITY/4M.A pi/hp . NOL 5x93// VC)
ADD ALTER / MOVING DEMOLISH
CONSTRUCTION
•
LENDER gJ ��j {/, `,� ,,///,p,i�
BRANCH OWN E // l.nrin r/b `j// airt»{(L/'
ADDRESS
ARCHITECT �n ' TEL./ // USA I r jai 649/ tS3 3
OR ENGINEE�R/1kit✓ stay
NO / On
�J � � '
ADDRESS/J%;�/� &tau �4. ZONE (-4 TYPE ROUP
CONTRACTOR,/i/L .P �a C, s � d, - BYAPDATE DATE
ADDRESS9'n v/(/,�/��/,,,,l/uuu��[/./�ju,/pd• SJJ VVy Condo
CITU !'1 /,.Y'.(.t,✓,/!/_ NAI( TEel
NOL.." O'Iuf/ l S./ndo ( )I� 1+
- STATE 37�S�atJ CITY APPROVED SETBACKS
LIC.NO!T LIC.NO. if'
14 SIZE —1NO.OF BLDGS /j (FROM C/L STREET)
L OF LOT NOW ON LOT '('/ FRONT FT.
r
et USE OF
Ca EXISTING BLDG. ® R.SIr)F FT.
U)
FSeparate permits are required for L.SIDE FT.
G electric,plumbing and heating work: REAR FT. _."
Iw., USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
.i • i)It L! 4.1d la-di K...l�k/L� ZE— 79 - 58 1A:DAATTF:.
— i (yG 1ll>-. _veel/SisO
Ix r
w
0 I hereby acknowledge that I have read this application and state n
that the above information is correct and agree to comply with
a all laws regulating building construction, and I shall not employ HOLD FOR SPECIAL REOUIREMEN'1'•. >
Z any person in violation of the workman's compensation laws of �j�' 7 E
Wi the State of California. ilk‘SS0 FT. c J k 6p Al '%o/• 7 CZ
I hereby certify that I am properly licensed as a contractor under i Ifs
the State of California Business and Professions Code, Division3, D AMOUNT SHOWN UNDER VALUATION IS FOR ( m ca
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; e 1 •
am exempt from the revisions of the State of California Business
VALUATION
I end Professions Co Division 3,Cha ter 9. uv
PERMIT FEE $
)� m
Signature of (7 VC PLAN CHECK $ /.Z/r 75 o
I Permitteeor
//����i 3e2 S su IL
Authorized Agent Dae I !1f a —7� l TAX $ 3. 73 3 cb
TOTAL PAID $i3Oits? (k
COSTA MESA BUILDAFETY DEPARTMENT APPLICAnril FOR STRUCTURAL PERMIT
P.O.BOX 1200 COSI. ESA, CALIFORNIA 92626 ..'s- - nrr,-, i i i n •nr • -c,00 TU
RECEIVED y}V PERMIT, • ••-
For Applicant to Fill in Completely- Use Ink Only (U X ' T 49••• 304- - •
.BUILDING • A.P.NO. 419-102-19,22
ADDRESS 2231 Saybrook Lane BUILDING
. OWNER OR ADDRESS 2231 Saybrook Lane
TENANT McKinnon-Bibb Properties, Inc
UNIT OR •
MAILIN• ADDRESS ' 2737 E. Coast Highway SPACE NO. Plan C-R
TEL. TR10856 LOT 17 BLK.
CITY Corona del Mar NO. 675-231
CONSTRUCTION NEW. ADD ALTER I REPAIR MOVING DEMOLISH
LENDER Home Federal Savings & Loan X
BRANCH 1702 N. Main •
OWNER ). McKinnon-Bibb Properties,In •
ADDRESS Santa Ana, Ca. VALUE
ARCHITECT TEL. USE Townhouse w/att.garage
OR ENGINEER Gen.R.Wi G Aman NO. A47-5S4
ADDRESS 833 Dover Drive. N R ZONE R4 TYPE V GROUP H&J
APPROVED -
CONTRACTOR Bell as •s BY .v - ,, _ DATE —/ —a,
ADDRESS 105 E. 16th Street
TEL. - Condo Un it
CITY Costa Mesa, Ca. NO. 642-4372
F STATE CITY APPROVED SETBACKS
LIC. NO. 367816 LIC.NO. 7420 as per approved plans
W SIZE NO.OF BLDGS. (FROM C/L STREET) .
6• OF LOT NOW ON LOT 0 FRONT FT.
Q USE OF
'a EXISTING BLDG. 0 R SIDE ET.
rA
PE(-4
Separate permits are required for L.SIDE FT.
l electric,plumbing and heating work: REAR FT.
(._, USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION .
a
G DATE
Townhouses with attached garages ZE-79-58 APPROVED 4-9-79
7 APPROVED
} —BY _oBTE
W
o I hereby acknowledge that I have read this application and state n
y! that the above information is correct and agree to comply with
IS• all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of E
W the State of California.
1456.5SOJ 664 +67.75 62
3 I hereby certify that I am properly licensed as a contractor under . FT. N
the State of California Bu ' .•d Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that s license are in full force fect,or I THE PURP06E OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from th• provislo . of the State of ;for a Business q
VALUATION PERMIT FEE $
and Professions C••a,IC"•n 3,Chap er 9. 195.00 0
Signature of - • PLAN CHECK $ �n c
u.
Permittee pp $ TAX $ _- P
Authorized Agent Date
// -3 eSo U
or
TOTAL PAID $ 195.00