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HomeMy WebLinkAbout3112 SAMOA PL - Building Permits PROJECT ADDRESS: 3112 SAMOA PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05165`. OWNER'S NAME: SH(NNERS, MARK J ADDRESS: SHINNERS, SUSAN A PERMIT NO: B 051655 PLAN CHECK NO: 017.63-91 S GOVT: N SUPP : N 31 ) 2 SAMOA P1. COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ' ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : 25LF-6FT HIGH CITY STANDARD BLOCK WALL SQ FT: 25 ADDRESS: UNIT: CLAIM VALUE: 500 . 00 CALC—VALUE: 500 . 00 GROUP OCC: R-3 / PERMITTEE: KAB MANAGEMENT ( 213 ) 690-4304 ADDRESS: 1610 SOLEJARR RDRD COMMENTS: X LA HABRA HEIGHTS CA 90631 *****M*);.4* E*****aN ***7t•* a** ***** ***.K: ;*****A*A***uf*, >F***Mx-**k> ?*1+** X-** ****. LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQUIR E M E N TS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETS ACK S CITY LAC.: 051817 STATE LIC6 2033 CLASllik Dater—IL— I / Signature: _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have Jl1hffiAPnsent to II-insure or a certificate of workers' F RNT: FT IN REAR: FT IN FRN T: FT IN REAR: FT IN Compensation Insurance.or a certified copythereof(Section 3800.Lab.C). LEFT : FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN \ -gucYNo.: 1209362 -9EXP.DATE: 07/01 /91 OMPANY: STATE PARKING REQ: PROV: PARCEL : 13915404 ZNE R1 REF NO: J Certified copy is hereby furnished. ® em0ed copy is Bled with the city Building Division. PLANNING NOT E S> PROPOSED 6 'HI BLK WALL ALONG REAR PROP . LINE SHARED I > WITH OWNER AT 3085 MOLOKAI Date' mi.-11 -y1 Applicant: / ***************************'************************OE*************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This sect, a completed if the permit is for one hundred(St00)or less). DEVELOPMENT SERVICES R E Q U I R E M E N.,T S I certify that in the performance of the work for which this permit is issued I shall not employ arty person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY �,LL DATE: .4111_ q/ + _ Date: Signature: NOTICE:II,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : . DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ,[� `/ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• F.{— DATE: J' which this permit is issued(Section 3097^'Civ.C). *************************************.*******16****** *1i-$fr'SF**********iiT**YYY M74 LENDER: ********************.****************** **********-Y.*********iE.l.}..******dE*****i'.*.Y** ADDRESS: LEGALIZATION:N F E E S U M M A R YSTRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 15 . 00 5 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 9 . 75 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE • I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ' I structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS—----> 15 . 50 0 . 00 - 9 . 75 25 . 25 25 . 25 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her awn employees.provided that such improvements are not intended or o0ered for sale.u,however the building or - REVENUE DIVISION TOTAL S——> (•OL;li EC TED• 25. 25 UVEB/S HURT• 0 0 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING' PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 15 . 00 . 50 9 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon ' and who contracts tor such projects with a contractors)license pursuant to theContractors'State License Law).I am aware **-*********************************jF.{(.*.7(..k.a:.*.**.li.*.:.(.j(.******r.j:{(.*.***Ji.**.**..*.j*.):a(.i(.**.***.** that drool of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY D E S C R I P T I .0 N UNIT COST TOTAL COST Date: OwnerSFR 25 RES—CONCRETE BLOCK WALL / FT. 20. 00 500 . 00 I do hereby certify that I am aware of and understand the requirements of Catfornia Health and Safely Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a • permit for construction or modification Irom the Air Quality Management District.Residential construction applications are exempt from these provisions Date: Applicant: I hereby certify that I have read this applical n and state that the above information is correct.I agree to comply with all city and county — • / ordinances and state laws renting to building onstruction and hereby authorize representatives of this city to enter upon the above-men tined Iv/ property for inspection purposes. 1 ' I Date: (—I I— 91 Signature:_7— I . .a An Driver's License or Social Security 01 C0081,72_-L C+.u•• ` 1641-46 white—Budding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 'ATC K 04/121c, TLC.: - CONSTRUCTION AND PLANNING . P & 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 /17-4,Z rfc./$- 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings K-1-qt 4cvi- 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ 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 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 APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product yiping O Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat T 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD C TIFICATE ISSUED 33. Final Electric Notes: c/'Ia 3p O(L A4C0QC'S* 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 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations " ,�/ 47. FINAL STRUCTURE & BUILDING �t-Z -'1� i _- .� c 06-- CC-41Y- 48. FINAL PLANNING 49. Electric Release to Edison .. 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date 57/ZFF T 4 APPROVED �'AnioA Pi- �i �t0�42� ( l2 City of Costa Mesa Building tDept\` C APPROVED � `�� BY J DATE / ,3/10 / THESE PLANS MUST BE ON JO© AT A_L TI" 5 CITY OF 1 NO CHANGES ' MTHt` 1-PPIOR, 'R'RVA OF DEFT \- MIY�Pq Lam. �c ANCE OR GRANtIN 3 OF A('E MIT OR APPROVAL' ri 10 1 THE 1„_U _ { �� i ` PLANS SPG.;ANAT ONS SHALL, ANY VIC ATION OF ANY �Y,� I �� �(, PERWT FOR, OR AN RPlLOF1t o lESurA 1.- 1 0 THE P?F"'l"SIOtiiJ1 T f NP CV IO la C'- O ,�• ' a RAI�� CCOVSH l., 11/.1 T Pki. _ HF WO°k Oc Q CC 7 St{P i� u_iD'...(.t t i� 00 FAR q., All WHICH f1 AJ'f PIC 1:aL IC._tWCUL. ' • El <.'io,_ _ t�` � WA'.. THE ISSUANCE OF \ F .; • :ATH 41. do , S SAID • A N4 L NOT - o _ FROM THESEAFl FR REQUIRING It i. 1RREC O y': SAID till `� ANC SP�C'r C T C S OR r'iO�l � � . 8111LDd.,� : RF: 101 r ri ' CARP.tEL ON_, - 1 1N VI LA} Gil OF THIS CODE OR OF ANY 0 T rR U;4DIN I THE CITY. `' 7 �,5 -.-.r 70� - J.J- t e 60 0° of 0[/10[IIC[ 1/110[AIC{ 111101K1 f 1[110[Kt w Ili ~ �" M h 1 ` Y / o 4 o �E'T.9 / [L . ______________ STREET f6 ♦ - TYPICAL 6U CONCRETE BLOCK FENCE Cement Coping Op nalGENERAL— NOTES Channel Block With 1-3/80 , 10l '—� I Horizontal Top of all Fences __ � ' I MORTAR: Ona Port Plastic Cement, and y ` s �f GROUT: Three Parts Sand For Fences 5'oi'Lest- ;r iE - 11 14• o One Part Cement, Three and Vert. Ban 3/8" st 4'.O"O.C. 11�I o One Holf Parts �ond _ a = COPING: One Port Cement, Three 1f • For Fences Higher T1i Iq�l �` o ''_ —_ 1 , Parts Sand •.: IY CONCRETE: Well Mined 1:2-1/2: 3-1/2 Vert. Ban 3/8"$ at 3—r002' C, a w - - (zIn Inv Javir en �D�i 4 z . Moi. of 7-1/2 Gallons of Fill Cells Solid With Grout 1 > = Water Per Sock of Cement •Where Steel Occurf -` • .pe! s- -- - ` GRReinforcing Steel Shall `i ce+ 4(!6B Z.:1.2 'a OFOTHE FUT ENCEEIN ELLS WHPOURED ERE STEEL M THE OP Conform to Sec.A45-39 --_ IIIYYY CCCIII w o - OCCURS. A.S.T.M. {Bi, •, z I- I_—I Ic> CELLS AND AREASOF HORIZONTAL REIN• • w n a FORCEMENT SHALL BE CLEAR,CLEAN& All Steel to f1e•Lapped . u FREE OF ALL MORTAR DEBRIS,ETC. . 24 'or to Cada 10' I - NATURAL GRADE; j'� - - -`1 V a, ,� -w,.. Jr q 1 ._..j BUD./ "t\� , Y 0 O 4 • ' ♦ J TWO 3/e•'O BARS ' , . • . . ♦ . CONTINUOUS TOP 1 . &BOTTOM �.�..-WIDTH TO 16. 0 C MAX. SEE CHA • RT • a MOQ1ZSTEEL MUST BE TIED IN . BELOW ♦ DEPTH Of EARTHTCOTH PLACE AT TIME OF TRENCH ♦ •I � ♦ a 1/3 THE HESGTN OF FENCE INSPECTION. L tri.OW BOTTOM OF FOOTING o- 1.. 2,.it.— SCALE: 1/2" a 11 FOOTING REQUIREMENTS CHART WALL HEIGHT 6 5 • 4' 3I WIDTH 14" . . . . . . . 14 12". . . . 12" THICKNESS . . .10" . 10" 8 '. . . . . e ' DEPTH OF EARTHTOOTH . . 24" . . . . . .20" . . . . . 16" . . • . . 12" SPACING OF EARTHTOOTH 12' . . 14' . 16' 16' • City of Costa Mesa, California Building Department hgvnr_D Nov.AC a1 PARTY WALL AGREEMENT NOTA, r:7 r. l t 11 1` REQUIRED REQUIR �D THIS AGREEMENT, made and entered into this 3 day of 0 I Fri r l 19`l 1 , by and between _ M KI i2 K �ci n/A/t/�s hereinafter referred to as 'LAN) %B�t", and e/,and of ,l/, µi2,3-FA J hereinafter referred to as 'ADJACENT PROPERTY OWNER'. property line between , 3// 2. .5749/71 o ,4 ��. 4—.30g/ Mo Io/IC (Address of Adjoining Properties) in the City of Costa Mesa, Comity of Orange,aState of California, as per nap recorded in Book /Of , Page 7/(!af Miscellaneous Maps, in the office of the County Recorder of said County. The party walls shall be permitted to encroach 1ti e r,J 3// 2- 5;4440,A /2 • 4 J�cfil Mc/?/ r491 IN WITNESS WEREOP, the parties have entered into this Agreement the day and year first above written. LAND OQ'tot ADJACENT PROPERTY OWNER (� / rt ignature (Signature m 4ieK 5 SN / npuE,e s N . C 1/7 o c i c,i, Tame (Typed or Printed)p Name (Typed or Printed) QS'g- tock Ave. (Address) Cast( s3 C/nn t ( S VNhCIS ( e-/ / � � (n lir C% U. � IV ciaco.ac OWNER SUH€RLAND LAND CO.- DA,T•E - ;_t i 1 2-- `4 JOB ADDRESS 7-Samoa Pace • . BUILDING PERMIT NO. #111178 GENERAL CONTRACTOR Owner Bldr• VALUE $ 11,424.00 • • • LOT 3o6 BLOCK TRACT 2353 sing ]e res. w/att• gar. GROUP I & ,J TYPE V ZONE FIRE DISTRICT 4531 PERMITS ISSUED • INSPECTIONS DATE SUBCONTRACTOR ,rDATE NUMBER Footing Trench g,.,V, -g 4 -2S- .i'', Foundation Forms and Grade to Garage Rough Framing y-& 6 �?-r-5 '/ / :Plumbing,Rough to Slab tad, Irt4•.G Z �j t j li 7'�,� , Q/y y'- I `.$7 ye 9 a. g .. Plumbing, Rough Complete )YIP r5 6-6-.t7 la v `.Temporary Pole Wiring, Rough JUN 5 1: ' • 9TJi c �, _ - ,. y c/G 3 ✓ Heating,Rough Yel CiS G-6-47 a H . (, r 'Lr-. 5= a7-;7 9VY6 ' y- Heating, Final 144 c-S b-/; Sewer„Ho s1 e;504 Sewer,St4/6/S / -&n SI i” '- -� f. •--..-• '- {(;(} / r/ Septic Tank or Cesspool � f Lathing, In Out��• igl D "-AP '., Plastering 1 L_ P -4- L7 ha' Plumbing,Final,Fixtures Co/mplete` e.„3 p./t.57 o ,8 //1. C, Plumbing, Final Gas Test !S i mci a- 1-4" /f i, /� ...-. /' -)2/cic Wiring,Final rn y� O - I.a _. l `,'t �e Cli � / =•/ Occupancy Jj ?/:.r.^, /0-/8-S7 .. FORM 210 3M 10-55 y^}^ .. • �s�� FEE RECEIVED ' tOSTA MESA BUILDING DEPARTMENT P.O. BOX 317 FINANCE DEPT. COSTA MESA. CALIFORNIA CIIV OF COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING Samoa Place BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERT OWNER Summerland Land CO. 4s ``��,J(( RECEIVED BY 0Z- a.2,17-47 DATE RECEIVED FEDgE2ISSUED MAIL ADDRESS 112h ROA Beverly 879 5) TrSVJ1V CITYP�Tic's Angeles . Calif. BUILDING ARCHITECT LIC. OR ENGINEER 'ff Williams NO. COSTA MESA. CALIFORNIA i ADDRESS 112�I So. Beverly-Los Angeles ZONE Iaummerland Lana ZONE NO.OF TYPE GROU Co.ITY LIC. / pp PLANS CONTRACTOR CNO.o1 VS Int 1/ 11??4 So. Beverly sTEL.`rre 81731eW APPROVED q ADDRESSs Angeles, ,,alifmo: 5-c' 2b BY DATE ; LEGAL LOT (� CORRECTIONS DESCRIPTION NO, 106 BLOCK TRACT 2153 A.P. NO. SIZE NO,OF BLOCS. OF LOT Enon NOW ON LOT none USE OF CO 1 EXISTING BLDG. ,'ufl • SETBACK LINE FROM CENTER OF STREET 50 : REAR YARD 311 SIDE YARD RIGHT 51 LEFT 51 DESCRIPTION OF WORK NEW y ALTERATION ADDITION REPAIR MOVING DEMOLISH SIU BUILDING 131L ROOMS 6 STORIES 1 EXTERIOR WALL ROOF LQnposition COVERING Stucco COVERINCG)}TiTlrleS. USE OF NEW BUILDING S1 Y1 Cry a TI`pni T*- T)vra111110. .. '? G •.C, `k- • s / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND • STATE THAT THE ABOV S CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES A STATE LAWS REGULATING BUILOI CONSTRUC• VALUATION TION. //n //A //A�I SIGNATURE OF �'`,�„�M/,�/p�'�y �! A.. L /yr PERMIT FEE $ 18��O PERMITTEE ���wC /0�������DDDIII YYY���LfA'WW liCCC "Cl AUTHORIZED AGENT4,6974:LC 1 ,// PLAN CHECK $ 1`�,.00 / TOTAL FEES 14.2. 00 velli OWNER MARK J. SH INNERS DATE 11-15-79 JOB ADDRESS 3112 Samoa Place BUILDING PERMIT NO. 49180 GENERAL CONTRACTOR (hyper/Bic I Icier DESCRIPTION of WORK En arge 2 Bed rooms AP No. 39_7c4-04 LOT 106 TRACT 2353 FIRE ZONE VALUES 2,500.00 INSPECTIONS Signature Date TYPE V GROUP I ZONE RI SOIL GAS GA— SUBCONTRACTOR PERMITS ISSUED I Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE j HOUSE CON. E SPRINKLING SYSTEM MISCELLANEOUS ♦� et flaw" ROUGH HEATING AND IR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND n POWER ❑ �fJ� ROUGH WIRING 1 RC. //�" Heating and Vent. J TRENCHES IFORMS LJ STEEL REINF. LI FLOOR SYSTEM BOND BEAM [-1 STEEL REINFORCE n E X P 1 P E D SHEATHING Incomplete Irspections FRAME AND FLASHING 112 iflOz PLASTER. BROLATHING — WN i COAT OT nw� L— nate /a ,,Z9-9F S s STRUCTURAL. FINAL HEATING, VENT., REFRIG. AND A.C., FINAL ` / 47 " PLUMBING. FINAL AND GAS TEST n ELECTRIC. FINAL BUILDING, FINAL 6827 11 /15/79 3.6.50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APP CATION FOR STRUCTURAL PERMIT e P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE i BY PERMIT For Applicant to Fill in Completely —I�Use Ink Only /� N2 / 4 9 1 8 0 _BUIL ENS 3)12. awl0a- p1 • 7t�A.P. NO. k--3 — 15+— O'— OWNER OR A�rL J. Sh i n.nerS ADDRESS U1L01 NG 31 I2 Sarno& P1 . TENANT MAILING ,. UNIT OR c ADDRESS , cor lei SPACE NO. (/ /� / ! �.��I e TR.N�3 5.3 LOT 1G/ (ELK. s1a 1 l &SG- NO.L. --GG �O CITY751-'� CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER /`]i[`• i BRANCH I, '{ .I,t n rL OWNS tIV"v-�^ ADDRESS A� Z BQ7Vi1LUE n ARCHITECT TEL. USE 7.irtsv amt E2,soa• OR ENGINEER NO. cr i, ADDRESS ZONEe4gTYPE = GROUP -4-- / CONTRACTORa BVPROVED DATE 1,77,x777 Dw tir7z-lam «l ADDRESS TEL. CITY NO. F STATE CITY APPROVED SETBACKS i-ig LIC. NO. LIC.NO. SIZE NO.OF BLDGS. (FROM C/L E 1 6W. OF LOT (CO ( 1 o NOW ON LOT I FRONT 1 G USE OF 1 4 EXISTING BLDG. Arlt/0..'1 - kV)n'-e R SIDE SJ FT. VI H Separate permits are required for L.SIDE electric,plumbing and heating work. REAR 7-g lFrZll USE OF BUILDING AND WOR TO BE PERFORMED PLANNING ACTION ao (24\-‘G•r�A i rte{ 0 2- ID2LG'B OYYLS - Q J DATE _W*111 //�0 APPROVED _AY C�S��/-t DATE l�J►5l APPROVE •-1 CO W O. • I hereby acknowledge that I have read this application and state N that the above information is correct and agree to comply with C. all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of a the State of California. p. Q `!L m I hereby certify that I am properly licensed as a contractor under SQ. FT. "4 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: b am exempt from the provisions of the State of California Business VALUATION PERMIT FEE and Professions Code,Division 3,Chapter 9. $ (7 uvi Signature of Stda_14.. /� �/� PLAN CHECK $ /2 OO o LL Permittee O_`-'LLs'� c"�.��/�"'�i`' �S S2 s�,Sri TAX $ `, SQ or Authorized Agent Date r IO- I S/ I 7 7 5 / TOTAL PAID $(34 •`c U OWNER p9R. YORK DATE JOB ADDRESS 3112 Samoa Place ' BUILDING PERMIT NO. — 8730 GENERAL CONTRACTOR Glenn L. Grover VALUE $ 600.00 AP. No. LOT106 TRAC12353 FIRE ZONE DESCRIPTION OF WORK Block Wall GROUP TYPE ZONE PLAN NO. 8730 INSPECTIONS DATE SUBCONTRACTOR - PERMITS ISSUED DATE NUMBER Trenches Forms Steel /f 3- ,S — 9- Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing Lathing, In Out Plaster, brown coat Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating Final Plumbing Fixtures, Final _ Final Gas Test • Construction Pole Underground Power Rough Wiring Fixtures, Final re, OCCUPANCY g—g-c 3 S —3 /7 210-5M-1-57 ( b130 COSTA MESA BUILDING DEPARTMENT P. O. BOX 317 I 8730 COSTA MESA CALIFORNIA E I! E FOR APPLICANT TO FILL IN 3 cos' vu I C•L. OF STREET----- � / � I BUILDING ADDRESS t-3lici "...5:4 m''GA ' P.I FINANC DEPT __„....--PROF! LINE Owner 57242-/13 r�— - 12 FT. 611TF0� -ll Y OF CI STA MMA10 FT. FOR 60 FT. STREET g0 FT. STR ET Mail Address fl'^' 'e-- I I I City ROA �Ntaf 4. Ph. No. I Contracto 3", / SOYO✓Pa Ph. No.e. 713°4 I • Address / 310 0il•4-ihalUt 616 ✓rF� . .tu✓e_ I 50 II I F FRON City Lic. No. /o/` f-- State Lic. No.!6J /) C J OF PROP. I- — 50 FT w Size of Lot/pO X 6° u m APN.�.�/ D , ; , , 3F t- W ` 1- Setbacks: C/L Street sb Rear Li w z m w 3 // I/ a 6 O 71 K u. Side Yard - Right Left 0/ d V Type of Fence I r C ALLEY QR PROP. LINENt-• I a cj /✓f 5�/Lt�IM )w� , t.�, H ': - --I ,� VA' -•1 I hereby acknowledge t t i ave rea td' h application and state J m Z �o C I Z x I that the abov- 's corre i'n'd agree to c�ply with all City Ord- v j sip I7 n- m inances an• tate J,.s reg a buil• g construction. c> �_ f`Oi G a-71 z n w w �/► \ I o < Signat `� ' . ��— \i of Pe o a 10 ® O z - FT I Agent + �_ Il � . I cs 37 6 IN._ ° '1 L FOR OFFICE USE ONLY Ft )- gy w ~ 4 0 I u N W l a FT Permit No. a: m ce60 FT ST. Rece ved by Date Received Date Issued I • I 3 - ) — -5 z/ 50 FT. ST. �1' i 4' I 3- .-.6-17 L _ f_ —PROP. LINE -- — i —_I I VALUATION (.'-D Permit Fee $ I in 1I $ 6-0 , Plan Check $• C.L. OF STREET` • I 0-0 TOTAL FEE MAXIMUM 4 FT FENCE MAY BE PLACED ON DOTTED LINES -- - --- MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS