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Home My WebLink About3452 SANTA CLARA CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant Address: 3452 SANTA CLARA CI 41205202 TOLER, JANIS 3452 SANTA CLARA CIR COSTA MESA, CA Owner: TOLER, ROBERT Address 3452 SANTA CLARA CIR Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors l0 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg COSTA MESA, CA ISSUED BY: Phone: 714-5453779 Zip: 92626 �X�1�� Phone: DA� �'�� Zip: 92626 Phone: Zip: License: SCOPE OF PERMIT SERVICE UPGRADE TO 200 AMP. � � � $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 Quantity FEESUMMARY Temp Dist System / LighUng Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw ..:....�..........up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment � � Low Volt Wiring System / Ckt Misa Conduit Misc. Conduclor Circus ( gen or nde) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 04/08/2004 Issued: 04/08/2004 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 , $0.00 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must comply with all applicable codes, and all required inapeet(ona and tinal approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aasas(voo� WORKERS' COMPENSATION DECLARATION: I hereby aflirtn under penalry of perjury one of the tollowing declarations: ❑ I have and will maintain a cortificate of consent lo self-Insure for workers' compensation, as provided for by saction 3700 of the Labor Code, for ihe pedormance ot the work tor which this permit is issued. ❑ I have and will maintain woMers' compensation i urance, es required by section 3700 of the Labor Code, tor the pertortnance of the work for which ihis pertnit 75 Issuetl. My workers' compensa � n In � nc� c� r gl��cy number are: Carrier. � �/ r � � Policy Num6er: rs se ion need no( be complef the pe is ve ued at one hundred dollars ($ f 00) or less.) ' certify that in the pert rmance of the work for which this pertnit is issued, I shall not employ any parson in eny manner so as to become sublect to the workers' compensation lews of alitornie, an e r het If I shoultl become sub�ect to Ihe workers' compensation provisions oi Section 3700 ot Ihe Labo�de, I shell forthwith comply with ihe5e pro ion5. - ��[/ Applicant Signeture: Date: � U � � WARNING: FAIWRE TO 5 UR WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TMOUSANDDOILARE�E1 000) INADDITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]OfiOFTHEL4BOFfADE,INiEqEST,ANDATTORNEYSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirtn that I am licensed under provisions of Chapter 9(commencing with Section 7000) oi Division 3 of Ihe Business and Protessions Cotle, ard my licensa is in full forpe apd ettect Lic. # Class a __ CONSTRUCTON IENDING AGENCY: ❑ I hereby aflirm that there is e constmction lentling agency for Ihe pedormance ot ihe work for which this permi� is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: Lentlar's Atldress: Signamre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm �hat under penalty ot perjury thet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires e permit to constmct, alter, improve, demolish, or repair any stmcture, prior to its issuance, elso requires the applicant tor such permit lo file e signed slatement that �e or she is Iicensetl pureuant to t�e pmvislons ot the Contractors License Ww (Chapter 9(commencing with Section 7000) oi Division 3 of the Business antl Professions Code) or thal ha or she is ezempt therefrom end Ihe basis for the aileged exemption. Any violetion ot Section 7031.5 hy any eppliwM for a pertnit subjects the epplicant to a civil penelty of not more than five huntlretl tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensetion, WILL DO THE WORK, antl ihe strucWre Is not intended ar oHered tor sale (Sec. 7044, Business and Professions CoCe: The Coniractors License Law dces not apply to an ownei of pioperry who builds or improves thereon, and who dces such work himself or herseif or through his or �er own employees, provided that such improvements are not intended or oflered for sale. If, howeve�, the building or improvement is within one year ot completion, ihe owne�-builder will have the burden ol proving thet he or she tlid not build or improve for purpose of sale.). I, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business entl Professions Cotle: Th,� comractors Licanse Law does not apply to an owner of pmpeny who builtls or impmves thereon, end who coniracts lor such project with e contractor(s) license pG�rsuant to tne Con�scter_s License Laws.). ❑ I am eze pt unae� sec. Signa�ure: � A i✓% Owner ID v ifi by tlriver's license. es ❑ No Busine55 and Professions Code for �his Verification of nership by (type ot documeni, i.e. - pmperry tex bill or deed): DIVISION O NDUS7RIAL SAFETV PERMIT CERTIFICA710N: Driver'S License No. i ' Data: — �� Expires: ❑ I hereby certity ihat no excavation fiva (5) or more feet in depth into which a person is required to descenq will be made In connection wi�h work authonzed by this permit, and that no building sirudure, scallolding, falsework, or demolition or dismamling thereol, will be more �han thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Californla Atlministrative Code). ❑ As owner-builder, I will not employ enyone to do work which wouid require e permit from the Division of Industrial Safery, as noted ahove, unless such person has e pertnit to do such work irom the tlivision. Signature: Date: Division of IndusMal Safery Permit Numbec CERTIFICA7E OF COM IANCE AND AUTHORIZp710N OF ENTRY: I cetlity untler penalty ot perjury ihat I have read ihis epplication and state that ihe information given is correct I agree to com with ell stateJaws �ciry ortlinances rela�ing to building construc�ion, and euthorize representatives of Ihe Giry of Costa Mesa to enter upon Ihe above-described propei tor inspecti fi p ses. I e not to o� A ccupy or allow occupancy oi any building authorized by this permit until nal insp lion. ` � - f�� , �� Signa ure OI Le Owner(s) Date COOE t. INSPECTIONTYPE 161fi Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rooi 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition Q� AL COOE� INSPECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 22o Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy DAg I[�LS (714) 754-5273 • Fax (714) 754-4856 • vrvrx.ci.costa-mesa��DING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 3452 SANTA CLARA CI Suite: Viciniry: Parcel Number: 41205202 Applicant: SELL ROOFING COMPANY Address: 18032 LEMON - YORBA LINDA , CA " . � Owner: TOLER, ROBERT Address 3452SAN7A CLARA CIR , COSTA MESA, CA , Contractor. SELL RpOFING COMPANY Address: 18032 LEMON� � YORBA LINDA , CA Zip: 92686 Arch : Address: Zoning: Phone: (714) 528-1758 Zip: 92686 Phone: Zip: 92626 Phone: (714) 52&1758 License: 323842 Eng: Address: Status: ISSUED Applied: 05/19/2003 Issued: OSI19/2003 ISSUED BY: � • Phone: Phone: Zip: � License: License: SCOPE OF PERMIT TEAR OFF .WOOD SHAKE AND BUR.REROOF WITH EAGLE LITE TILE ICBO 4660 5.5 PSF OVER SLOPED AREA AND BUR OVER THE FLAT AREA. " Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.69 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.94 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: o Rear 0- 0 Rear 0- 0 Required: 0 FEE.SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pro osed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $s,soo.00 $s,9oo.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) 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 7 BO days. � - INSPECTIONS: In order for the Work authorized under this pertnit to be considered legal, such work must comply with all epplicable codes, and all ��. required Inepectlone and final epprovel must be obtained. Failure lo obtain inspections and final approval will result in tha expiralion of this permit. FOR INSPECTIONS CALL: (714) 754-5626 ��a �� WOWKERS' COMPENSATION DECLAFiATON: ' I hereby eflirm untler Denelry of perjury one ot the tollowing declaratlons: ❑ I have and wlll malntaln e certllicete ot consent to sell-Insure lor workers' compensetion, as providetl for by section 3700 at the Lebor Cotle, tor the pertortnen�i of the work tor which Ihis permit is Iuued. � I have end will maintein workers' compensali Insurance, as required by section 3700 of the Labor CoOe, tor the pertortnance of �he work for which ihis pertnit is issuetl. W6rlAr ' cOm s lon n5ur cerrl nd oli number ere: r %s a %� v � f(��a6SS� ertier. o ar: (This s " n neetl not be comple ed I the permit is veluetl et one huntlrea tlollers ($100J or less.) ❑ I ce i Ihat in tha pedartnance af Ihe work f which Ihis pertnil is issued, I shall nat employ any person in any manner so es to become subject to the workere' compen tion lews ot Califomle, end e c et II I shoul hecom u6�ect to the workers' mmpensation provisions of Sactian 3700 ot t� Leb f Cotle, I shell torthwith mply wi h �hese provisions. ! plicaniSi Wra: ��lM _ Date: U P FAILURE TO SECUflE WORKERS' COMPENSATION COVEMGE I$ UNLAWFUL AND SHALL SU6IECT AN IPLOYER RIMINAL PENALTIES PND C IL FlNES UP TOONE HUNDRED TMOUSANDDOLLARE�5100,000),INADDITIONTOTHECOSTOFCOMPENSATIIXJ,DAMAGESASPROVIDEDFORINSECTIO 3]060FTHELABOHCqOE,INTEREST,ANDATTORNE`fSFEES. LICENSED CONTRACTORS DECLARATION: ;hereby eMi at I em licensed under proNsions o�Chapter 9(commencing with Section 7000) of Division 3 ot t sirreu and Profassion Code, antl my Iicense Is in lull ___ ". ��:_ .. � -i �. 57<G "(G _ � n — x � aflirm ihat there is e consiruction lentling agency tor the pedormence ot the work for which �his permi� is issued. (Sec. 3097, Civil Cotle). Lenders Neme: Signeture: _ OWNER•BUILDER OECLARATIONS: Lender's Address: Date: I hereby eflirm ihat under penalry of perjury Ihat I em EXEMPT FROM THE CONTRACTOflS LICENSE LAW for tha toltowing reason (Sec. 7031.5, Buslness entl Protessions Cotle: Any ciry or county which roquires a permit to consimct, elter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the epplicent tor such pertnit to tile a signed stetemant thet he or she Is Ilcensed pursuant to ihe provisions of the Conirectors License Law (Chepter 9(commencing with Sactlan 7000) oi Divislon 3 of Ihe Business end Prolessions Code) or thet he or she Is ezempl therefmm antl the basis for tha alleged e:emption. Any violetion oi Section 7031.5 by eny appllcant for a pertnit subjects the epplicant to e civil ponelty af not more then five hundred dollers ($500).): ❑ I, as owner oi I�e property, or my employees with weges es ihelr soia compensation, WILL DO THE WORK, end ihe sWCWre Is not Intended ar oHeretl tor sale (Sec. 7044, Business and Professions Code: The Contractors License law does noI apply to an owner ot pmperty who builds or improves lhereon, end who does such work hlmsetl or hersetl or thmugh his or her own amployees, pwvided that such improvemems ere nat Intended or oHered br sele. If, however, the building or improvement is soltl within one year ol completion, lhe owner-builder will hevedhe burdon of proving ihat he or she did not build or improve tor purpose o1 sale.). � ❑ 1, as owner of the propeM• am E%GLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 704a, Business end Professlons Cotle: The contrectors License Ww does not apply to an owner oi property who �ullds or Improves thereon, antl w�o contracts tor such prolect with e contrector(s) license pursuent to the Conlrectore License Lews.). ❑ I em exempt under 58C. Signature: Owner ID veritiad by drivafs license. ❑ Yes ❑ No Business and Professions Coda tor this reason: Vedtication of Ownership by (rype ol documem, i.e. - pmperry tex bill or deed): Drivefs License No. Date: Ezpires: OIVISION OP INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity thet no excavation five (5) or more fee� In depth inio which e person is required lo tlescend, will be made in connectlon with work euihonzetl by �his pertnit, end that no building siructure, scalloltling, falsework, or demolition or dismantling thereof, will be mora then thirry-si: (38) teet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Ttle 8, Califomla AGmInI5lreilve Cotle). ❑ As owner-bullder, I will not employ anyone �o tlo work which would requira a permit irom the Division of Industnel Sefety, as noted above, unleu such persan hes e permit to tlo suc� work from the divisian. Signature: Date: Division ol Indusirial Safery Permit Number: CERTIFlCATE OF COMPl1ANCE AND AUfHORVATION OF ENTRV: I certity under penalty ot perjury Ihet I have read Ihis epplication end slaie that ihe Information given is correcL I egree to wmply wlth ell stete laws enC ciry ordinances releting ro building construc�lon, antl euthodze represent2tives ol the Cil ot Cas Mese to enter upon the ebove-descriDed properry tor ins o purposes. gree not ro occupy or allow occupancy of eny building authorized by this permit until I el insp clion. L=��o s % Signature ^Ot Legal Ov.•ner(s—)�— �aV r �—� And/OrA ze9�rk� e COUE 1. INSPELTIONTYVE 1616 Fixetl Syslem Finel Fire Pravenllon 1266 200 201 Pool SDe Final Flnel Re-Roof Flnel Blak/Re�aining Well 202 Final Fectory Flre Plece 203 Finel Slgn 204 Final Demolition �g. �� CODE 1 INSPECIION TYPE 206 Flnal Mec�anical 208 Final Plumbing 210 Final Elecinwl 212 Final Fire Prevention 220 Final Planning ApD�oval 222 Final Site 250 FinalBuilding/Occupency Q� II�LS JOB ADDRESS INSPECTIONS Pool Location � Forms Main Drain Steel Reinforce Elec. Bond Approval m Cover Underground Electri� _ Gas Piping Test Filtering System Lines _ Backwash Lines and Recep. Electrical Final Heater and Vent Final _ Fil2er System Final Backwash and Recep. Final Fencing Final Approval for Finish _ ircle BUILDING PERMfT DESCRIPTION of WORK TRACT FIRE ZONE VAL E$ SUigIn�atere Da�e GROUP TYP� �v r,�i��I SUBCONTRACTOR F Darc / ' �Q —/yr � Electric /" � � 3/� 7 1 C .�,r,�� Plumbing '- G ' f5•77 I-s-eo '!�- ,P C 7-�5. » —43678. �spa — MITS � _ � - 43678 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIfORN1A 92626 for Applicant to Fill in Campletely BUILDING �7y 3452 SANTA CLARA CIR ADDRESS OWNER LEO MAININI MAIL SA1�31'+ ADDRESS uTv COSTA MESA N�L BFANCM ADDRESS ApCHITECT TEL. CONTRACTOR pNTHONY POOT.S nooaess 5$�1 FIRES$'ONE BLVD. TEL. cirr SO (ATE Na• SP9; LIC. NO. 1 Ol UCyNO. 51 Z E NO.OF BLDGS. OF LOT NOW ON LOT EXISTING BLDG. RES APID GAR SI2E OF �88 NO. OF NEWBLDG. ROOMS $TORIE: EXTERIOR WALL ROOF COVERING COVERING USE OF BU�LDING AND WORK TO BE PERFORMED PRIVATE SPIIM POOL & SPA A.P. NO.`� /p�'�' BUILDING AODRESS TRACT �I F�1� ��e »-��= OO�o��z> ��-�:.5p.5G N FOR BUILDING PERMIT DATE RECEIVED D TE 1$�ylE l 7 _ .� ,.� PERMITNO. LOTU,7 I BLOCK LEO MAININI swlM PooL & �R�g 5400. APPRO V E BV ZONE NO.OFr PLAfS VARDSAPPROVED MAIN BUILDING (FROM C/L STRE�T)/{ FROM �FT. (/ t R. SIDE �� FT.� / L. SIDE FT. REAR � FT. DISTANCE BET. MAIN BLOGS. VAR. alt C.U.P. #'- _ I hereby ucknowletlpo thet I hava reatl thit application anG cteta that Me ebove information is corract antl epree to comply wit� all laws regula[Ing C�iIG(n8 �Onsbuction, anC I shell not employ nny p¢rwn in violetlon of Me workman'a compensation laws of the Stete of Colifornle. I horeby certify t�et I am proparly licensetl as a contrector untlar S�. FT. Me Sm[o of Calitornta BusineEs antl Profealons Cotla, Divisicn 3, TNE AMOUNT SH Chapmr 9, antl that such liceni¢s ere In full forca ontl offoet, or I TNE PURPO6E OF I em axompt m the provis(ons ol tho St ol Cnlilornia Businass VALUATION and Profa ons Cotla; Division 3, Chapiar . SiOnntur of ��' /��Y�K OJ- / (/K% Pormltteo �! $ S�Q, Authorizetl AOant �7u�p/ USE OF NEw BUILDING YARDSAPPROVED ACCESSORY BUILDING b N BET. MAIN & DER V iING A � O IS FOR a ONLV: Q rv � m E 0 n�n uHi[ � nDDRESS Z45? Santa Cls�ra Avenye BUILDING PERMIT N0. � 3447� _ JERAL CONTRACTOR KannPth Nelson DESCRIPTION o{ WORK pAA l�r�,,..� hath R ggrg�� No. 4i�_n59_m LOT liq TRaC7 �z� FIRE ZONE VALUE b��nn.�n - acrnnuc 5�...,,...... n,.._ TVPE v f:R[111D � vnuv __ SUBCONTRACTOR PROP. SWR. LINE U HOUSE CON. U SPRINNLING SVSTEM MISCELL4NEOU5 ROUGN ME�TING r1ND MF CONDITIONI! TEMGORARV SERVICE OR POIE UNDERGNOUND � POWER � ROUGH WIRING TRENCHES FORMS STEELI FLOOR $VSTEM BONO BEAM n STEEL REINFaRCE SHEATMING FRRME RNO FLr15HING LATHING — IN OUT PLASTER, BROWN COAT $TRUCTURRI, FINRL MEnTING, VENT., REFflIG. AN� �.C., I PLIIMBING, FINP.I RND G/.5 TEST � ELECTRIC, FINPI BUILOING, FINAL cornei avniuocucurc , • � 74 I I ar,7 31-73�„Sc001231 �**' ��62.13 �/ ` COSTA MESA BUILDINGSAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 - APPLICATION FOR BUILDING PERMIT For ApPlicant to Fill in Comp/ete/y ADDRESS '�S � ps��% �jl � �VED BY D`A E RECEIVED D TE� �fED BVIIOING � O / ! ) /f (�T � —[IZ �O� PERMIT O. OWNER � pJ / � ' � - A.P. NO. MAIL �J �� /% /� qD1DR�E s 3�f52 SA�7�� L,�CL Z ADDRE53� Y� C `, a U CITV �6'S �� /�% F�'i' TOL TRACT �p3 LOT TS BLOCK �� Z Q CONSTRUCTION / // W A A R P ON LENOER �O/� ��E/�V a m 7¢/''i �� '. J � BRANCH � — J N OWNER Q W qDORE55 ' 00 J VALUE G� J QARCHITECT TEI. S I� � N OR ENGINEER N V Q FIRE W� ADDRESS 20NE VPE GROUP aW .�. / APPROVED / J O CONTRACTO � � /- BY DAT 0' m Z J� ADDRESS � ' G`f ti�f'�` �Q �I '� ZON NO.OF USE OF NEW Z� CIT � j-' �i�[ 9' ,i(7 � NO. �� • J PLAKS Z BUILDIN � � STATE.�r CITY �ARDSAPPROVED VARDSAPPROVED N� ��C. NO� � 7 LIC. NO. MAIN BUILDING ACCESSORV BVILDING 7 O � (FROM GL STREET) SIZE NO.OF BLDGS. OF LOT NOW ON LOT RONT FT. ZO FT. C� USE OF /r% � EXISfINGBLDG. �/� ' ' T. S FT � SIZE OF )'/ NO. OF Z NEW BLOG.f. 7�.% Z ROOMS "� . STORIES � L. SIDE FT. FT. � a EXTERIOR W�/— FOOF � V COVERINGv, JCGp COVERING� .F REAq FT. FT. J USE OF BUILO NG �+ WORK � BE PERF D� ' OI5TANCE BET. BET. MAIN & a � �G MAIN BLIX'�.5. ACCESS. BLOGS. a Q 7 � VAR. # DATE O �/,a/ --y: � � C.V.P.�W APPROVED N o� ` CS)� �pJ APPROVED� I( J_W 1� �� OI heraby ecknowledBa [�a[ I �ave reatl this application antl stete � Ma[ tha aboyo Infofma[ion is correct antl aprea W wmpiy wit� � ell iaws raBuleNnB buiidinq construcfion, and 1 sfiall not employ . � F eny person In viola[�a� oi the workman's compensetion lews ot y the State of California. ' T,� � ZI hereby certify Mat I am properly licensetl es e eoniractor untlor � SQ, fT. O Me Stam of California e�siness antl Profeszions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALVATION IS FOq � Chaptar 9, antl that such licenses a�e in full farc0 entl etfatt, o� I THE PURPO6E OF ESTABL6HING A PERMIT FEE ON�Y: ¢ em exempt trom t1i6 provisions of fhe State of California Buslnass VALUATION anA Professiona CnnB, ' �sion 3, Chapter 9. N PERMIT FEE $ ] SIO�atura o /� � � �% m Parmittea /�LiYtJ��i`�� $ �f � PLAN CHECK $ �' E �—i— / � `o Autho�izetl Agent I� LL TOTAL FEE $ ; '. - 295�0 COSTA MESA BUILDINGSAFEf7 DEPARTMENT P.O. BO% 1200 � COSTA MESA, CALIFORNIA 936RE For Appllcanf fo FIII In Campleroly TYPE OR PRINT BUILDIN6 ADDRESS COSTA MESA, CALIFORNIA ��.,Nao 7-lal rzar RnYernri ses-Cos ta Me: � ein Los Angeles 90036 No 936-11 �ARCHITECT .. _ . .._. _.__ T!L_�Zi�±Z cirr os An eles California 90036 uciEio. 201098 No 936-1104 s�ze xo. or ■too.. OFLOT MOW N US8 OP EXISTING BLDO. YlTBACK L�X[ PROY cenrsn o� ernen � RiAR YA D 2 �� SIDB YA D LERT 8� lIIQHT S� DESCRIPiIOId OF WORK BUILDIN6 81ZE EXTERIOR WALL � ZON[ � L[OAL PAIU ��i JAN -7-69�„�,00 202� 94.u[. APPLICATION FOR PERMR BUILDINfi FOr Offlce Use Only 11[C�= O. �p�It��j1A {�.\ �� ZONING MO.O� YY[OIN[W •LAII� q GWLDINO , OV[RNANO 6HALL DB LH88 TMAN YAROB MPROV6D MAIH BUILDINO �VAR.}j 1 C. ll. P. i HHR!!Y ACRNOlYL6D06 TMAT 1 NAV[ RQAD TX�O MPL�GTION AND 9TAT6 T11/�T iN6 AOOV6 �� C011R[Ci AND AOR88 TO COY. PLY WITN /�LL CITY OpDINANCO N/D �TATL I,AWY R[OULATINO sU1LDIN0 CONBTIIULTON. 61GNATURB OP PfiRM1TT8 AUTHORIZiO AG[ YARDSAPPROV6D ACCEf80RY BUILDINO DAT6 - � a m � iyso �. �. � D' � 0 TX6 AYOUfT 6X0 UHOBR VALUATON 16 IOq TX6 j ■UflP08H 0► �BiAl48NIN0 A PBRMIT 188 ONLV. 1� VALUATION / � � PERMITFHH p : �'o, 37� `� ^3,�- w. TOTAL FEE E / 7