HomeMy WebLinkAbout1018 SECRETARIAT CIR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
Y OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. / /
-y CONSTRUCTION PERMIT /WS/ fait-pat evr C-'Q-a F —// � 5203 3/f/p/ 25.i0 TL'
Project Address • T,•1_'99•_tI•tiali -- hw5^iBui TYPE OF CONSTRUCTION KNEW Li ADD U ALTERATION LI REPAIR
Applicant's Mails Address , _ 7� ❑ CONVERSION ❑ DEMOLI ❑ OTHER e , A.P.# l Zone
�h Y 1'hI IflC �f0. r)�' 11�1 r�Ey RIPTIOpI�pF WOR i••• A Jail ar! J •
Owner's Name�/c � d -� Phone(/;' s� T ,r /1 � /• � 7 S Main Building: Accessory Building: Z
Address 1-zt•JS N�4� �12YTfu�, "�b' `•^K �"'•+�
TYPE PERMIT GRACING-1 LJ.1 FOUNDATION STRUCTURAL E Front N
Arch/Eng. License No. ❑ TENANT IKELECTRICAL ❑ PLUMBING ❑ MECHANICALB Rear I
Address / �•,,nt� y ❑ OTHER A N
Contractor's Name
eyMVnN Swr3014 Z. inc ea Phoone�O SS 6Z 23 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G
Address(mailing)/n• gp�,X a ��eI4i•e'fJNNi CA-. �77.1 CONSTRUCTION TYPE VALUATIONS $ Left R
' - ZONE GRADING CU.YDS. ACRES Q
City License No. Z Z-7 Ping. Ref.# Park.Fees $
LICENSED CONTRACTOR DECLARATION U
to Remarks: Parking Req./Provided
1 I heby affilm7 that) I am licensedion3 under provisions n rofarter 9(commencing R
00 with section 7000) of Division 3 • e Business an• •rofessions Code,and Use of Building: E
my license is In full orce nd eff:
uce CI s �7c No'�T - d� PLUMBING FEES Planning Notes: M
/ / E
Date' - Signator �W - ..ea...
• N
WORKERS'COMPENSATIOAPPRATION Bar Sink Showers
'N 1 hereby affirm that I helve a q' tale of consent to Sell-Insure or a certificateBackflow Preventer Service Sink S
of Workers' Compensation Insurance, or a certified copy thereof (Section
3800, Lab:C.) (s 17711�r - Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No7_75 VIP 771 ii any yo _xr
Cert)f led copy is ereby furnish• �' Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW
.Ces¢ifie espy I fl led with the 'f., ❑ 5D+ KW
Date S'/'-a- Amalie Clarifiers Solar Collectors Construction Pole Sub /Z /S --1
EXEMPTION FROM WORKERS COMP 'SATION DECLARATION Dishwasher Solar Piping Cooking Unit Meter ❑Up to 100 amps
(This section need not be comp) ed if • permit Is for one hundred ($100)or
less). DrinkingFountainsAver /) 7
I certify that in the performance of the work for which this permit is issued, I Solar Tank _ Dishwasher Meter ver 100 amp /, �`
shall not employ any person In any manner so as to become subject to te '^ - is-
-
Workers' Compensation Laws of California. ^—Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
Date Signature ' •
NOTICE:If,;after making this declaration,you should become subject to the Floor Sinks • Urinal Fan • Motors 00-1 HP 01%-B -
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water ClosetF.A.U. Ina Solar ❑9-15 HP 016-15+ •
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave
of the work for which this permit is issued (Section 3097 Civ. C.) __
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILDER DECLARATION Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap
following reason (Section 7031.5 Business and Professional Code: Any city or • Switches Sign '
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 Roof Drains • Garbage Disposal Standing Sections
to file a signed statement that he/she Is licensed pursuant to the provisions of
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05-15 KW Trash Compactor
therefrom•and the basis for the alleged exemption. Any violation of Section o
•
7031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $25 Issue Fee $ 3
malty of not more than five hundred dollars($500).
I, as.owner of the property or my employees with wages as their sole •
MECHANICAL Reinspection Fee $25 Issue Fee . $ 3
compensation, will do the work,and the structure is not intended or offered . FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I 0
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 Canopy Type II 0 Zoning Approved By Date
sale. If, however, the building or Improvement Is sold within one year of tom- Duct..-Under.Ground ,
pletiof, the owner will have the burden of proving he/she did not build or im- Building Approved By C� Date
rove for the purpose of sale). Duct-Structural • Refrigeration System Application Issued By V/ Data, /�/��
0 I,as owner of the property, am exclusively contracting with'licensed con- Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who -
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMTP' $
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
❑'(am exempt wider Section B.a, P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE ,$
•
Date Owner Heating System& Ducting - PLAN CHECK 25% $ ENERGY P.C. i$
I-hereby cer hat I read t pplication and state-that the above • - - 00-100,000 BTU 0100,000 BTL - - 1
Informati• s corn: t. agre to c p with all city and county ordinances ELECTRICAL $ d"di r_i f/ GRADING $
and st. laws r- n o b iltlin o ruction,and hereby authorize repre- PLAN CHECK 50% $ t— . MICROFILM $
sentat es of Is c t• ter p n the above-mention y f r ,
•inspect • •crposei fo• - MECHANICAL $ TOTAL FEE $
Signature Date/'� qq � �P••YY
Drivers' icense • SS# / inReinspection Fee $25. Issue Fee $ 3 PLAN CHECK 25% $ • - C7.3;ccb
N
CMF 086- - . rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - . .
1CONSTRUCTION AND PLANNING POOL & SPA - -
APPROVALS Permit# ali Cop Date • Inspector APPROVALS -Permit# :. Date 'Inspector
1. Temporary Electrical Service or Pole *Ai/ . "'> 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 LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE -
7. Footings .. . 58. Electrical Conduit-Undrgrnd. •- • - -
8. Foundation 59. Gas Pipe,'O Undrgrnd.,Test . • [ -. ,
•
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, 0 Undrgrnd.- . -
10. Structural Floor System . -• 61. APPROVAL TO DECK - r
11. Property Sewer Line & House Connection i 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 • '1
20. Rough Factory Fireplace 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 O Gas 0 Oil. '
25. Roof Sheathing 74. Overhead Hydro . •
•
26. T-Bar Ceiling (Structural) & Monocoat 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 CERTIFICATE ISSUED . , •
33. Final Electric Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test i
- L;
36. Hood or Canopy •
37. Final Factory Fireplace - '
38. Final Plumbing r
39. Water Service-Final
40. Gas Service-Final - -
41. Solar Domestic-Final --- I.
-
42. Backflow Preventer r;
43. Backflow Irrigation '• - •
44. ,Landscape Irrigation System
45. Sound Attenuation, i - -
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -
48. Special Requirements Completed _ '
49. Electric Release to Edison , -
-
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY - - -
- - -
No. Date _-. - • • - _ ,
FOLEY
CONSTRUCTION CO., INCORPORATED
. , If - •
•
r• :1
July 28, 1978 AM
Mr. Paul Dudley
Planning Department
City of Costa Mesa
P.O. Box 1200
Oosta Mesa, ralifornia 92626
Dear Mr. Dudley:
We request the release of Trots 46 & 47, Tract 9901, to utilities in
order that we may utilize these houses as malels.
Very y yo
1, -1 -10
J• Mcla in
esident
JJM/cj
2101 EAST FOURTH STREET, SUITE 100 • SANTA ANA, CALIFORNIA 92705 • TELEPHONE: (714) 543-9471
III •
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 1018 SECRETARIAT. CI CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 06361E
ADDRESS:SNAMEBOS, ABRAHAM
BOS CLARA B PERMIT NO: B 063615 PLAN CHECK NO: 03143-93 S GOVT: N SUPP: N
1018 SECRETARIAT CIR
COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT -41
ARcx/NGINEE
EEL:• KURIC-GRAHAM CONSTRUCTION REG.ND.: C2176 JOB DESCRIPTION : T/O SHAKES,RESHEATH W/1/2"CDX6 CLAY TILE SQ FT: 12,950
P 0 BOX 1491
PEgMInEE: INDIO CA 92202 CLAIM VALUE: 12,950. 00 CALL-VALUE: 12, 950. 00 GROUP OCC: R-3 /M-1
agDITEE: CRANK BROTHERS ROOFING (714 )548-5569
126 COMMERCIAL WAY COMMENTS: REROOF 3400SF RESIDENCE 6 GARAGE W/CLAY TILE ICBG I '¢, ,±; crl� R
COSTA MESA CA 92627 +ESE+E**�E**� ******�r�r�E�E*****�r+r�r:ESE******�r�r�E�E�E�r�E�E�E� ******:E�r�r****ger +ry � +T:kilfE�r
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ' Z ONING REQUIREMENTSW REWIRED
7000)of Divisio/n/3 of the Business and Professions Code.and my license ilk fun force effect. $ E T B A C K $
CITY LIC. /J l l STATE LIC.: 408 .r{�1 p C C •
/ Date'. Li3 SignatureT/_t� MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby a um M l I have a)enific to of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 0, Lab. ,). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 285-93UNIT00224 EXP.DATE: 01 /01 /94
COMPANY: STATE FUNIC PARKING REQ• PROV: PARCEL: 41237149 ZNE: REF NO:
❑ Certified c y is here y furnished LX Certified co i filed with Ih:(�, Building ' isio PLANNING NOTES>
• • L, 4
` . Date: Applicant: 4 ************* *
******************************************************** *********
7 EXEMPTION FRO WORKS S'COMPENSATION DECLARATION: ( his ection nee'not be co pleted if the permit is for one hundred($100)or less). D E V 7,E L O P M E N T 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 ssued. all not: ploy any person in any manner so as to become —
sublect to the Workers'Compensation Laws of California. ZONING APPROVED BY --
• DATE:
-
Date: Signature:
NOTICE:If,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. y! `\f^ .,may'
' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION.%ISSUED BY: �-{-�F'r DATE• v' L t co
which this permit is issued(Section 3097.Civ.C). ******************************************.****lllfff********************3E*if*****���FFF 0**
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I 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 144 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed1 . 30
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/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 93. 60
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500. 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
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 145 . 30 0. 00 93. 60 238. 90 238 . 90 . 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 238. 90 OVER/SHORT: . 00
for the purposeof sate). 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 144 .00 1 . 30 93. 60
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************,************•************
that proof of their Worker's Compensation insurance should be provided to me.
O am exempt under Section: B.a P.C. I N D I V I D U A L F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 12950 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 12 950. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that t e above informs correct.I gree t mply with all city and county
ordinances a •state laws elating to building construction a h eby authorize repiesentitives of chi cit upon the above-mentioned
propert er spection I rposes.
C
iya Date: a Signature: 01 00145484-00145486 TOT 2—
Driver's License or So ial Security C: DATE: 08.20/93 TIME: 14:35 �8.90
164140 White—Build'ino:Green—Code Enlorcemenn Canarv—Aoolicant: Pink—Revenue:Goldenrod—Assessor
-
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # _ Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. co 53. Steel Reinforcement 1 _
.( ., f .
401,),Pafrrical ort`dt Utility-Uridrgrnd ' . 54. Forms ' -
_4. Electrical-Conguutt'stkdrgrnd. =,
- 55. Electrical Bonding
•'-5'$t el:Reiforcerffy{nt I 56. Rough Plumbing & Pressure Test •
.l rc.
`, .... S 'U .L C.
k•tl c:trical &FER:ead. .- ,n 57. APPROVAL TO COVER-GUNITE
`4. 'Fobttigs`•Li en r. - 58. Electrical Conduit-Undrgrnd.
,8. Fi ndatlion_. t"- t, 59. Gas Pipe, 0 Undrgrnd., Test
9, Waiter Pipel7ndc end. 60. Backwash Lines, P-Trap, 0 Undrgrnd. r
¶t0. S%ry,ctura.FFloof_Sustem - - 61. APPROVAL TO DECK
11. Proper ty,Sev(er,[ine-& House-Connection 62. Backwash & Receptor-Final
12. Sew¢r Cap 21..:
' 2 `• 63. Heater & Vent-Final
t.
13. Roof Drains , is
.i 64. Plumbing System - Final
r '
14. Rough Plumbing '"- 65. Electrical-Final
15. Rough Electricai:Conduit 66. Solar System-Final •
16. Rough Electric-Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectricaPT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
C. t• I o 'i C' 'T'--C H U t-- Ot
20.tRough Factory Fireplace : z rn s;-i C, r. LI't< Lx tAPPRQVALISk.)G'erin5t # > n•
e r i ..0 "-X I - „1 .I,4, x t i 17".•• x !l O• ... :',31-1_1-, a x. a1 g
21.(Quc , in-tStr to e* I „ ,. _,•g , r, 1_I r: `y'0. t>Tndergrou-od lyc$o -
22. Ducts, Ventilating-u I (;S • '� -S f.‘ fi 1'71. Product:P1' idg 0•' s ❑Oil
S Ci ,1 nl. I Cl, r " * r '.tix S t , J -
23.rGas!PpeFRough &•'P,'est , m.> .r ;r; d 11.::.; ; r*/2. Underground FIgt1'n, •D' r
24.tRoo(•Framing• r. I :-,F• ••I-• t + !f�3.2-UndergrndStor tjank �GasCIOR .
25. RocitSheething -i., s "�/�!' J::: K. C'r+ v r+f-
y e .., �/4.,, erftead Hydros x
26..E-B@rIr Ceiling (Strueturall & osocoat s, 75.:.Dry Chemical • : * 1_, t7 c:
il
27. Frame a d Fia'shin T '�-• � ;. a. r "-.m %:, C. t z
-, a. t.n ,* DX x ,. " .... 4 76.• DC Siand�ipe (..._ y.
,28. Lathing& Sidingcu.k r7 '-J^: . •a a •'> 77'XFIXED SMr6TEMJFINAL" l-
=29. Insulation c' " C ^ J X • , S
S •• .t; .,x • 78.SFIRE •
PREV. F11\14. w,> x x>
, .. J Mir . t.', w \ Y .L. V J
-B0. Drywall Nailing (Jr. + T HEALTHDEPTAREQUIREMENT
p31. Plaster Blow Coala ' I ! ` r79.1- `P FINAL IN CTleN :SiCr'
i J32.thlectricaf;Powfr Ml-eter:Final I c . 1 i▪ * .80.:,EOOD CERTIFICATE ISSUED --
:.
53- 3.'ET,i nal'EleEtricl ` 1 C' " •, K , trNo eS: n `7 '
'.34. .Finai'Heating_& Au conditioptnyy ( .. J: r, CJ
S •
,' I 1 i I - a T'
35.tFinal'Gas Pipe Te x c-' "1 Y I i * i •^,SZr!'1 OW ! r n J .• a'x, n,• r
, .. I I+- . • ."7:L J 1i .Y,'l< h.\-
,� '. 1. .. ••(. x.
36.'Fiood or.Qanopy .: : . I": � i f •,,. .
£ (,
Factory o
37.(Final Firitace I : ' s _ 1x
I -
1-38..Final-Plumbing I.?' li ^C. 1 .. •. C * :J > .- > o: C -
:39. Water,Service-Finale ' I a' < r 1 •_Li r.
- x !` I " 'C v A >, 'A CO ..
;
x r.1
'=40.'(;ias Serwc�..,e-Finale_.- „ •r-.t. -- .r ` r ,<
t i ..
-41.(Solar Domestic-Final s C`. •• cad r, 4
;'42.`Backflow Preven iec 't . x ` j 7' r , S
,J wT. tL' - ' , , Fib-) • c.
43. Backflowilrrirgati6n z<'S >, _ rt-o rC'
7i-� a: .t -U i S (..
44. Landscape luiga(ipQ Systems;'j C w. M j, e . x CO C-, 2�''•: 1 c
i45.:Sound Attenuation^ I-+ -:r- ." - r- _ :- IL 4. i' - ,--, tea' x t
e.
:46.•Handica4„RegulatioPis e1 .., w's ` �' •• '
T. a /� `
FINAL STRUCTURE & BUILDING 'III, "I 11 n. = .-off "
-a
•47. l� �W I 7 1 J a-. _
.r. ` l 1/�1
48.-8INAL P,j•ANNING4 , ,q :,, J.
F .•
_ .. 2, -
(49. ledtiic Release to Edison +. W s -(' , •+•
7 v. x :u
` . Gas�eleye to Southern Californja,Gas Co ; '. _ , p T ' r-
0
• 1. CERTIFICATE OF{JCCUPANCY ,; .. c'', pyo, -6 t •:,
No. Date
' CCT 21-77ro5�001108* ***373.02
44901.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A P C TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
RE E E BY PATE RECEIVED D TE ISSUED
AUILDISN /a/e9
Sc Cr: * - ¢ 7' �d- ' /-�.
ADDRESS oo �rQ L/� ) f"!
OWNER FOLEY FAMILY TRUST A.P.NO. l "'lac/"'lac/ /b PERMIT NO.
BUILDINMAIL
ADDRESSFourth 2101 E. St., #100
ADDRESS 1018 Secretariat Circle
CITY Santa Ana, CA 92705 [Z7543-9471 TRACT 9901 I LOT 46 BLOCK
CONSTRUCTION NEW I ADD ALTFR I REPAIR IMOVING _ OEMOI ISH
LENDER U.C.B.
X
BRANCH 1010 N. Main St.
OWNER Ml.,c 1 am al.V71
ADDRESS Santa Ana, CA 92704 V. UE ,, ` ✓ .
ARCHITECT TEL S. W ‘ I s P. $ , ill
OR ENGINEER — -sa 611 • ' —11 . /
FIRE
ADDRESS ]]] S. �lT #1 Qrj QranQP 9 ()6H ZONE T PE GROUP T,
APPROVED //,. ...
CONTRACTOR Fole COnstru On • 1 BY /. . .4 DAT /O
ADDRESS Same as above
TEL. ZONE I NO.OF USEBUILDIONF G •NEW � i /
CITY NO. R PLANS Z ,�.�i.s�.���J
h STATE CITY YARDS APPROVED YARDS APPROVED'
g LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
-
w SIZE NO.OF BLDGS. (FROM C/L,S/TR_EET)
0. OF LOT NOW ON LOT 0 FRONT 45 FT. G(.-•' FT.
Q USE OF
Ca EXISTING BLDG. N/A R.SIDE SET. FT.
rA
(-0
Separate permits are required for L.SIDE .S FT. FT.
G electric,plumbing and heating work. REAR a OFT. FT.
IW" USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q< GS
MAIN BLDGS. ACCESS.BLD .
i�.
a New construction, single
nstruction, Single family C.U.P.# /1 DATE
���///+++ APPROVED
r. •
N detached, Plan 5, 5 Bedrooms. APPROVFD,�� eJ' 70 x'77
1:4 R&D OR SPECIAL QUIREMENT5
w
0 I hereby acknowledge that I have read this application and state n
fg that the above Information Is correct and agree to comply with m
as all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of m
SW the State of California.
0
I hereby certify that 2920 50. FT. /Gar. 658 sq.ft.I am properly licensed as a contractor under
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: —
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E�/� et o
and Professions Code,Division 3,Chapter 9. 5 m
Perm)to of / �' p . . PLAN CHECK E /Q/1, L—b 0
Permittee /�/e/-/.. / $ 7yA� 7 TAX S Or es�c�J�' I V
Author) I! TOTAL PAID $87 9, 6 2—