HomeMy WebLinkAbout2839 SERANG PL - Building Permits PNOJECTAODRESS: 2839 SERANG PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06487E
OWNER'S NAME: VAN GEEM, JAMES R JR
ADDRESS: VAN GEEM LUCY A GROETSCH PERMIT NO: B 064876 PLAN CHECK NO: N GOVT: N SUPP : N
2839 SERANG PL
r- COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: 0TH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF SHEATH & REROOF W/COMP SHINGLES SQ FT: 4 , 000
ADDRESS: UNIT:
L PERMITTEE: JAMES VAN GEEM ( 714 ) 662-3627 CLAIM VALUE: 4 , 000 . 00 CALC—VALUE: 4 , 000 . 00 GROUP OCC: R-3 /M-1
ADDRESS: 2839 SERANG PL COMMENTS : REROOF 3000SF RESID 6 GARAGE W/COMP SHING, Frr a
C .M. CA 92626 *******�E3r+r***+r3E+E******3EBrx3F************Br*+E*3Fit**x*3r*3r*ar *numigUMVI' `i R -+E
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS REQUIRED
CITY LIC.: STATE LIC.: CLASS:
Date: signature: MAIN BUILDING ACCESSORY BUILDING y...
WOAXERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate 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 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• PROV: PARCEL: 13932217 ZNE; REF NO;
" ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> .
Dale: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is la one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMEN TS
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 Casfomia. ZONING APPROVED BY DATE:
'4e: i 1
Date ,AQSignature:%7/ - /v�
NOTICE:If.after making this declaration.you Slq me subject to the Workers'Comcen iron provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provi Signature:
this permit shall be deemed revoked. c I
CONSTRUCTION LENDING AGENCY: I hereby affirm t,. there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: +--- — DATE- J111.
1
which this pernut is issued(Section 3097.Civ.C). *************************************** ***********************4* , .94-w**
LENDER: aE******************************************************************************
ADDRESS: LEGALIZATION:N . _ F E E SUMMARY STRUCTURAL 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 63 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 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
any applicant for a permit subjects the applicant to a ala penalty of not more than five hundred dollars($5W). ISSUE FEE
rm I. as owner of the property or my a loyees with wages as their sole compensation, win rip the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ' DUE
ILI structure is not intended or offered for sate Lection 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 63 . 50 0 , 00 0 . 00 63 . 50 63 , 50 . 00
does not apply to an owner of a properly who builds or improves thereon,and wino does such work himselt/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or REVENUE DIVISION TOTALS——> COLLECTED: 63 . 50 OVER/SHORT• 00
forptheepurpose of sale).
one year of completion.the owner will have the burden of proving he/she did not build or improve 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 63 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not appy to an owner of properly who builds or improves thereon
and who contractslorsuch projectswith acontractor(s)license pursuant to the Contractors Stale License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date:�Ei~3 Owner ; �' r SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 000 . 00
Ida hereby certify that I am aware of and understand the requirements of r. is Health and Safety Code Section 5505.25533,and END OF FEES '
25534 and that 1 or any future building occupant wit/will not(circle one)nee. comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ,
these provisions.
Date: _ . Applicant: e
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned Cl 00150542-00150543 T$a'i" 63.50
property for inspection purposes. DATE: 11/12/93 1111E 5
�L .
" 2Date II—IZ— r� Signature: �! !r[' uur._w x
Driver's License or Social Security+: 1
1641.46 White—Building:Green—Code Enlorcemenr:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL of 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test • i
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 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 /2 3 '(.3 ��' Loy• f F _ dro
26. T•Bar Ceiling (Structural) & Monocoat / 775. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Fir',
42. Backf low Prevent,'r
43. Backflow Irrigation!
44. Landscape IrrigatGn-SgsieI'n
45. Sound Attenuation `
46. Handicap Regulatfhs -
47. FINAL STRUCT( F r,'.JILDING lz-to_?7 awe � 1 '._a%-. _
48. FINALPLANNINP.1 _1
49. Electric Release td.'Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill In all spaces except those within heavy border tines and sign all appropriate declarations-
' CITY OF COSTA MESA PERMIi NQ TRACT NO. - LOT NO. BLDG.NO. 75.I I 4/2.., ' 1 .,e. T.
CONSTRUCTION PERMIT I �J /9 �./ I
(y� / In ` �J
"I Applicant's% Mailing
9Address/S 3•� 1,/ • -/#,,/!'^/! / TYPE OF CONSTRUCTION . U NEW U ADD U ALTERATION U REPAIR
Project Address r' t-3yCQ '— 414 I •
- 0 CONVERSION ❑ DEMOLISH 0 OTHER
"71' G'r// v /3// DESCRIPTION OF WORK
Owner's Name Phone " • .ZONING REGULATIONS
Address 'S/-r-1" '' -ew -• '
U
TYPE OF PERMIT GRADIN FOUNDATION U P
STRUCTURAL A. . • ZONE
Arch/Eng. - License No. ❑ TENANT 0 ELECTRICAL•LUMBING 0 MECHANICAL PLNG.REF.qts BUILDING -
O Address - 0 'OTHER JJJJJJ - TO BUILDING - • SFTB^rr rh 5T
N. PROPERTY LINE REAR YARD(TO P/L)
Contractor's 1$arnPnr'ti tar-AZ/4 7N^ Phonal'/,U ?41^ PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) .4-4 q- 4J /^/-�/� .4n/•'/'P/er7 ' CONSTRUCTION TYPE VALUATION$ LEFT SIDE YARD RIGHT SIDE YARD , •
c1.f 74`x7 1 • ZONE - GRADING CU.YDS; ACRFS PKG.SPACE REQ. PROVIDED '
License No. __ / -
LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH 4 PARK FEE$
' I.hereby affirm that I am licensed under provisions of Charter 9 (commencing - - '
with.section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: , • i - .
my license is in full force and effect. ' ._
License Gass' ( - 't License No14/7 _
C'-I- 7 ' PLUMBING -
•
I
Date 4-F'/=? Signature R• at 9sC4 I .
.�.'•pRKERS'COMPENSATION-DECLARATION • Bar Sink Sewer Cap ELECTRICAL
.ereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer - Sewer Connection -- • - Automatic Washer _ , _ Meter Dover 100 amps
-
<,f--Workers' Compensation�/ Insurance, or a certified copy thereof (Section • - Construction Pole 3800, Lab. C.) 04�r(� ' '�'VC✓ .71.L5 Backflow Irrigation - Solar Colle_ctors Sub Panel
Polley No. Company - •
Cooking Unit Sub Pole '
Certified copy is hereby furnished. / Bathtubs • Solar Piping
El-Certified
copy is filed with the city Building Division. / Dishwasher4.
' Motors 00-1 HP 0118-8
Date U-.Y-f 3 Applicant K 'd4 • • ,D ir✓ Clarifiers • Solar Tank
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dryers OGas Electric Inc.Solar 09-15 HP 016-15+
(This section need not be completed if the permit is for one hundred($100)or Dish Wash¢r Swimming Pool w/Spa e
• r
II certify that in the performance of the work for which this permit is issued I Drinking Fountains Urinal Fan' • Microwave ,
shall not employ any person in any manner so as to become subject to the - - r'
Workers' Compensation Laws of California, Floor Drains Water Closet F.A.U. ;! _ Pole Light
Date Signature
NOTICE:If,after making this declaration;you should become subject to the - Floor Sinks , 1 - - ' / Water Heater <1.2 . Fixtures . • Range - -
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 Service - Device Boxes Sign
CONSTRUCTION LENDING AGENCY - - Outlets
I hereby affirm that there is a'construction lending agency for the performance ' Interceptors • - , Standing• ' Sections ,
of the work for which this' permit is issued (Section 3087 Civ. Ci. . •
Lender's Name - • _ - . - , Kitchen Sink, • - . Switches i Trash Compactor
Lender's' Address• - 1 - '
' OWNER'BUILDER DECLARATION - Lavatories . , - . Garbage Disposal ,
I hereby affirm that I am-exempt from the Contractor's License Law for the - - Generator 00.5 KW 05-15 KW ' I ' •
following reason (Section 7031.5 Business and Professional Code: Any city or • P-Trap , , . - '
-
county which requires a permit to construct,alter Improve,demolish or'repair • Transformer 015.50 KW ( •
' any structure' prior to its'Issuance, also requires the applicant for such permit Roof Drains • • '
' to file a signed statement that he/she is licensed pursuant to the'provisions of 050+KW;
,_.he Contractor's License Law(Chapter 9(commencing with Section 7000)of _ Reinspection Foe $16
z;>ssion 3 of the Business and Professions Cotle) or'that he/she Is,exempt Shouters Reinspection Fee $15 . _
efrom and the basis for the alleged exemption. Any violation'of Section Meter Oup to 100,ampa Issue Fee • .$ 3
•- a-31.5 by -any applicant for a permit subjects the applicant to a civil
F~!Inslty of not more than five hundred dollars($500). ' Service Sink ' Issue Fee - $ 3JZoning Approved By ' Data
U 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 - MECHANICAL • Application Approved By Date
for sale (Sec/ion 7044, Business and Professional Code: The Contractor's _ �/�� •
License Law does not apply to an owner of a property who builds or Improves ' ' Boiler ' Refrigeration System A Ilcation Issued Byf fA ����
thereon, and who does such work himself/herself or through his or her own PP •Data
employees, provided that such Improvements are not intended or offered for - 00-100,000 BTU 010Q000 BTU
sale. if, however,the building or improvement Is sold within one year of corn- , Duct-Under Ground SUMMARY OF FEES • '
pletion, the owner.will have the burden of proving he/she did not build or Im- - t •
groove for the purpose of sale). ' Duct-Structural System Repair/Alteration - BUILDING PERMIT $ ' SMTP . $
U I,as owner of the property,am exclusively contracting.with licensed con-
tractors to construct the project(Section 7044,Business and Professions Code: _ ' DLitt-Ventilating . , . _ ' _ 'PLAN CHECK: $ PERMIT
The Contractor's License Law does not apply to an owner of property who - - • I
builds or improves thereon,and who contracts for such projects with a con- . • Exhaust System 0 Multiple 0' PLUMBING $ — ISSUANCE ' $
tractor(s) license pursuant to the Contractor's License Law). - - - - PLAN CHECK • $ GRADING $
❑ Pam exempt under Section B.& P.C.for this reason • Firepl/Fact.Blt. ICBO IF • '
Date I Owner Heating System& Ducting ,ELECTRICAL .. $ - -
hereby'at certify that I haverread ims application ytl state'diet the above 04100,000 BTU 0100,000 BTU
- PLAN CHECK $ MICROFILM $
information is correct. I agree to with all city and county repre-
ordinances • i TOTAL FEE. $ •
and state laws relating to building construction, and hereby authorize r . . Hood or T ' MECHANICAL $
sentatives of this„cily,to enter upof) the above-mentioned property for Thine I ❑ Reinspection Fee $15 LESS 1 s
• PLAN •CHECK $
inspection purpos ' •ll f1f I Canopy Type II 0• - ' ADVANCED PC ' $
Signature re or'SSLA i'
' r Registers Issue Fee t $ 3 • r
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
NI
• • 10 -„POOL PA
r2 nCONSTRUCTIONiAND:-PL:AN I G, ' . -- • -tzc 1 - -
APPROVALS _, Permit,# ` 'Date Inspector _ o' - - ' ..Date 'Inspector. -
-: ' en&' . a APPROVALS`"' Permit#
n" L: Temporary Electrical Service or'Pole ` - _ z '52 Pool &iEquipment Location 1 ' '
(r- 2' Soil Pipe-Undrgrrid.° p F' : .. , ; . . '' g' _`tet : 53.' Steel Reinforcement ' r. -- - -_ '
3} Electrical Conduit Utiliiv-Undrgrnd: I• a • 3 . 54-' Forms p - u "-1' -
4' Electrical Conduit-Undrgrnd_ , r : - - _ 55: Electrical Bonding,- - _
5'. Steel Reinforcement I ' n L ;
OWNER FOYLE, BUD DATE 6-6-62
JOB ADDRESS 2839 Serang P1. Lot #51 BUILDING PERMIT NO. 17207
GENERAL CONTRACTOR Walter F. Kenrich VALUE $ 367.60
AP No. 139-322-17 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Blk Wall
INSPECTIONS Signature DATE GROUP J TYPE III ZONE R-1
Soil PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
,r
Rotigh Com. Refrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous
Prop.Swr.Line 0 House Con. 0 St.Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power C
Rough Wiring
Trenches Forms 0 Steel Reinf. ❑ 'Zsaj
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathin'
Frame and Flashing
Lathing — In 0 Out ❑
Plaster, brown coat
Ref rig. G Air Cond. 0 Final
Heating, Final
P**Icing Fixtures, Final
1-f -, Gas Test
Electric Fixtures, Final
Building, Final ./e / " 1—
OCCUPANCY
FORM BO4.SM - 7.61 17207
- 17207 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 61962
P. O. BOX 917 COSTA MESA. CALIFORNIA f F' INANCE DEPT.
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
L-O -r../ TYPE OR PRINT /
BUILDING 9 03 % 7 BUILDING -
ADDRESS COSTA MESA. CALIFORNIA ' For Office Use Only
I RECEIPT NO. I PERMIT jGO. 7
OWNER BS/ A $o - E /``//�� /
MAIL G RECEIV a BY DA RE IVE=. D E ISSUED
ADDRESS 7-. O I - S • N6- • L Jf%- - -,9-1L
CITY Co s TA MTELADDRESS ? 93$A- NO. BUILDING Acle-tet /P 4
ARr--•TECT TEL. ,� COSTA MESA. CALIFORNI
OF UINEER ..- NO.
..- FIRE •
ADDRESS
ZONE TYPE)II GROUPJy,
CONTRACTOR W41- T ER F. ,('ENRItIl APPROVED DATE U
ADDRESS 3 3-3 SERA Ai t- p 1-- ZONING1
�.( C ZONE I NO.OF ,� yUBE OF NEW _
CITY C O S'TA /-I J PLANS r I BUILDLNO�Q /(/, pI�
STATE l� TEL. 1 /f - 9 3 % "- 4 LEGAL 7 s J TD\ ' //o o O
LIC.NO. 6 / ' / NO. /� A DESCRIPTIO '7
SIZE M v NO. OF SLOGS. •�
OF LOT / 6- X /c O NOW ON LOT ' A.P.NO. 3 7- .3,-----,1... / 7
USE OF No Al & YARDS EVES
EXISTING BLDG - APPROVED ALLOWED
SETBACK LINE PROM J (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT ,45-OFT.
t5t FT. IN.
SIDE YARD I LEFT Cl RIGHT 0 R.SIDE FT. GIN.
DESCRIPTION OF WORK o
L.SIDE FT. IN.
NI I. I II ALTERATION I II ADDITION I REAR p FT. U IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED ` f y' //1 DATE / J
BUILDING NO-OF— __ Of
✓` �(J (� IO (�
SIZE ROOMS STORIES
EXTERIOR WALL ROOF
COVERING - COVERING -
USE OF BUILDING AND WORK TO BE PERFORMED
GOA/ c RE re- aLGGJ ujALL
oN NoRr#J Soo rN/ WEs T
•
`/L ( D/yl
I EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.qI� VALUATION
SIGNATURE OF "Wti '/ , PERMIT FEE $ -)J-�
PERMITTEF16 N
$ PLAN CHECK $ ,-
AUTHORIZED AGENT 7 -� o
TOTAL FEE J 4
-cu
ei
Lots .i _ 13971 '" ',J/ . FE RECEIVEDg(
COSTA MESA BUILDING-SAFETY DEPARTMENT CL6 R
P. O. BOX 917 COSTA MESA. CALIFORNIA r�''�H(�CE9?EPT.
For Applicant to Fill In Completely APPLICATION FOR PERMITTA MESA
WE 7 OR PRINT
cr BUILDING
ADR
DESS •."-7 J�j '. C..,r t.-. .,\\ 2
COSTA MESA. CALIFQRNIA For Office Use Only
RECEIPT NO. I PERMIT NO.
OWNER Investors Marine Inc. - 00C1
MAIL RECEIVED BY DATE RECEIVED DATE ISSLTED�
ADDRESS 1600 W.Ccast Highway 1C, I —07:6/ I ', R iCIA1
CITY Newport Beach,Calif. E 1655 NG g(J /212
ADDRESS .1 �T •
ARC 'MGT Same TEL.
O �Y??Gi COSTA MESA. CALIF IA
I OF �INEER NO. t"JjS O/ i
ADDRESS FIRE / (�
ZONE TYPE GROUP }(-
Mesa Verde Builders, Inc.
APPROVED
(/
CONTRACTOR BY DATE
ADDRESS 1653 Minorca Drive ZONING -
Costa Mesa,Calif. ZONE NO.OF USE OF NEW C o + /—
CITY 1R t I PLANE y-'EUILDINDa T1 I t
STATE 181269 TEL.NO. Kl 94)395 LEGAL %too� —�/1 /
LIC.NO. (r— DESCRIPTION !\!. ������� J
SIZE 74.501 x 100' I NO. OF.BLDGS."
OF LOT Now ON LOT A.P.NO.
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM [CENTER LINE ST./ �^l (�
CENTER oP STREET 4111 REAR YARD 271 FRONT L, FT. (L....-^—(9- i IN.
SI
SIDE YARD I LEFT 5 I IRIGHT R.SIDE 3FT. IN.
DESCRIPTION OF WORK L.SIDE SFT. IN.
NI I X II ALTERATION I V ADDITION I REAR �.J/��2 2 FT. IN.
II MOVING I II DEMOLISH I BYPROVED(A R� DATE c3 —3—4/
REPAIRg '��N
SIZE 17(10 Sq.FtROOMS 7 STORIES 1
EXTERIOR WALLL$lgping ROOF Sh$]L� '
COVERING W SllOCO COVERING SLIT,le 0. I/O
USE OP BUILDING AND WORK TO BE ERFORMED
single family residence and garage cy ,ygyaY
Model No. 750-A
Attached garage 462 Sq.Ft.
1 HEREBY ACKNOWLHIGE T I HAVE READ IS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOV IS COR ECT AND GR B TO COM-
PLY WITH ALL CITY ORDIN NCES AN STATE • OULATINO PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
BUILDING CONBTRUCT19lNJ•/ I, //,( VALUATION
SIGNATUR OF c /I /°/� A) I , '���I', ^ / /J/ / Of 1 PERMIT FEE $ -1�/—�L al
P
I I $ OJ' /f 7 N N PLAN CHECK $ C2 O/`� �
X
AUTHORIZED AGEtIT le
p
TOTAL FEE $ y
•
4589'. :3/07179 . 66.53 n
COSTA MESA BUILDING-SAFETY DEPARTMENT 6189 ' 3/07/79' .. 66:5`'NI[Kit]
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ' 6'589 . 000U4476 18 _� I A,��I�
A LIC TION FOR-STRUCTURAL'PERMIT 1V11VVV11ppp(((///
For Applicant to Fill in Completely- Use Ink Only
REC E(/Q V DATE RECEIVED DATE ISS ED
BUILDING 2839 Serang Place ✓'" g Y
ADDRESS
H. Gill Jr . A.P. NO. i—3 -`e / PERMIT NO.
OWNERBUILDINl 7
MAIL 2839 Serang Place ADDRESS 2839 Serang Place
ADDRESS
Costa Mesa, TEL.540_131, 4008 I 51
CITYNO. TRACT LOT BLOCK
CONSTRUCTION Sec. Pac. Bank NEW ADD ALTER REPAIR (MOVING DFMOI ISH
LENDER
BRANCH H. Gill jr
ADDRESS Harbor & Lincoln, anhm. OWNER
ARCHITECT TEL. USE ADO ref-Am KI
VALUE
((//..
OR ENGINEER NO. �J
FIREi T
ADDRESS ZONE PE GROUP —
y
Wa ne Howard Contr. APPROVED //C 7 ?J
CONTRACTOR BY / �- ' DATE 3- / y
ADDRESS 1116 Harbor Blvd.
tr r� 8 ZON NO.OF USE OF NEO 4. ie/
CITY Santa Ana, NOJ31-6` 1V / IPLAf � BUILDING ��'l1'
I—. STATE 351941+ CITY 07447 YARDS APPROVED YARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILD NG ACCES RV BUILDING
SIZE 100x74 NO.OF BLDGS 1 (FROM MST ET) /,/_
L OF LOT NOW ON LOT FRONT a FT& G/,�/ FT.
Q USE OF fam room T 71-
z EXISTING BLDG. R.SIDE /7 FT. — FT.
A / /
H Separate permits are required for L.SIDE -Z./OFT.
/ O FT. FT.
electric,plumbing and heating work. REAR // F /e I/ FT.
USE OF BUI{- NG AND WO TO BE PERFORMED DISTANCE BET. YJ BET.MAIN&
a residence- °Y`m room MAIN BLOCS. ACCESS. BLOCS.
0
/� /� VAR.. DATE
Q VAR.#WF/p,,/ �"//J��/� APPROVED 'J��jj
APPRO yC"L Lryr'"'""`�` 3 7/
.>.1 ,$Y L DATE /
X
0 I hereby acknowledge that I have read this application and state in
r.
a that the above information is correct and agree to comply with m
0. all laws regulating building construction, and I shell not employ
Z any person In violation of the workman's compensation laws of i
the State of Calif ornla. /� ^ m
I hereby certify that I am properly licensed as a contractor under (/Lli SQ. FT. cv
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;
us
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ e
and Professions Code, Division 3,Chapter 9. •�//
Wayng -ward ntr.. pO PLAN CHECK $
Signature of L.-/ — CO� m
�/ o
Permittee • $ z/ TAX $ L' LL
///// L7 L
Authorized A L U
TOTAL PAID $ .53