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Home My WebLink About937 SERRA WAY - Building Permits(714) 754-5273 • Fex (714) 754-4856 • wv+w.ci.costa-mesa.ca.us AIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT -: r� JobAddress: 937 SERRA WY �� . •' Status: ISSUED Suite No Applied: 70/24/2005 Vicinity DA� Issued: 10/24/2005 Parcel Nunmber: Appliwnt: Address: Owner: Address Contractor. Address: ISSUE FEE Temp service test � Res. a/c package New Res�(1-2 units) New Res (3+units) Pool / Spa Lighting FiMs Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Motors to 7hp Molors to 10hp Motors to 50hp Molors to 100hp Molors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuils Temp Pwr Pole Intermed Pole 14132817 MCMAHON,MARK WAYNE 937 SERRA WAY COSTA MESA, CA Phone: 714-751-6816 Zip 92626 . j�i HASHIMOTO, YUKO � 937 SERRA WAY . Phone: 7�4-751-6816 � � COSTA MESA, CA -. Zip: 92626 � OWNER-BUILDER � Phone: � , Zip: '_ _ . . . License: 000000 SCOPE OF PERMIT UPGRADE SERVICE PANEL UP TO 200 AMPS LOCATED AT REAR OF PROPERTY. $23.50 $0.00 50.00 50.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 330.50 $0.00 50.00 $0.00 $0.00 so.00 50.00 50.00 50.00 i0.00 50.00 50.00 30.00 50.00 Quaniity FEE SUMMARY Temp Dist System / Lighting Busway/100ft � Standing Section , Misc Electrical Equipment Transformers up l0 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 Vofl Wiring System / Ckt Misa Conduit Misa Conductor Circus ( qen'or ride) Ciras (mech ride or lights) Christmas Tree Stand Fireworks Stand ' - Other Eledrical Fee Investigation Fee Plan Check Fee Reinspection Fee 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 $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 80.00 $0.00 50.00 $0.00 TOTAL CALCULATED FEES E54.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply wNh all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically eupire and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned for a period ol 180 days. INSPECTIONS: In order tor the work authorizetl under this permit to be considered.legal,.such work must comply with ell appllcable codes, and all requlred Inapeetiona end final approvel must be obtained. Failure to obtain Inspectlons and final approval wlll result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2448d818�00) WORKERS' COMPEN5.4TON DECLARATION: . ' ' I �erehy affirm under penalry oi perjury one of Ihe tollowing declarations: � ' ❑ I �eve and will meintain e certificate oi tOnsent Io sell-InSure tor worker5' compensatlon, as provitletl lor by section 3700 ot the Lebar Cotle, br the peAormanca of the work lor which this pertnit is LssueC. ❑ I have entl wlll maNialn workers' compansaUon ireurance. az reqWreE by sectbn 3700 of Ne Labor Code, for the peAortnance Oi the work tw wh�h thLq pgrmit is issued. My workers' compenution Insurence carder antl polity number are: Carrier. Policy Number. (Thls sectlm need not be completed i! Ne pemtitls velued af ine hwMred dd/ers (5700) or less.) .. . ❑ 1 certity Ihat in the Pertortnance ol tho work for which this pertnit Lq issuetl, I s�ell not employ any person In eny manner so as to become sub�ect to t�e workers' compansalion Iew4 a� Callfomia, antl epree t�et II I shoultl become sub�ecl to Ihe workers' compensatlon provislons ot Settlon 3700 0l the Lebor Code, I shflll forthwith comply wlih Ihese p�ovisions. Applicent Signeture: Date: WAHNIN(3: FAILURE TO SE�1RE WORKERS' COMPENS�TIpN CpVEMOE IS UNUWFUL M1D SMALI SUBJECT AN EMPLOYER TO CRIMINAL PEWILTIES AND CNIL FlNES UP TOONE NUNORED THWSMID DOLLARE (E1 W.�1. IN ADDRION 10 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37080F THE LABOF COOE, IMEREST, M!D ATTORNE`fS FEES. LICENSED CONTRACYORS DECLARA710N: I hereDy eMlrm that I am licensed under provislons of Chapter 9(commencing with Section 7000) of Divislon 3 of the Business entl Prafessions Catle, and my Ilcense �s in full brce and eHect. LJa x_ Class a Conirectols Signature: Dete: CONSTRUCTION LENOING AGENCY: ❑ I heraby eMirm thet there is e constructian lentling egency tor l�e pertortnanca ol iha work for which thls permlt Is Issued. (Sec. 3097, Civll Cotle). Lenders Neme: Lentler's Address: Signatura: Dete: OWNER-BUILDER DECLARATONS: 1 hereby eMirtn Ihat untler penelry ot per�ury t�al i am E%EMP7 FROM THE CON7fiACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business enA Professlons Cotle: My Ury or counry which reQWres a pertnit to construct, alter, improve, demdish, or repair any strucwre, pnor to Its issuance, elso requires t�e epplicant for such permit lo lile e signeC statemen[ IG� he or sha is Iicensetl pursuant to the provislons of Ihe Contrectors LJcensa Lew (Chapter 9(cammencing wlth Sectlon 7000) ot Division 3 ai the Business aM1 Protassions Code) or Nat he or she I5 exempt iheretrpn and the basis tor the sllegatl exempiion. Any v{olatbn of Section 703t.5 by flrry appiicent fo� a permU subjects t�e epplicent to a civil penalry of no1 more than five hundred dollers (5500).): ❑ I, es owner ol ihe proDerty, or my employees with wages as iheir sole compensalion, WILL DO 7HE WORK, ena the structure is not Intentlatl or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Contreclors License Lew tloes not appty lo an owner of proparty who builtls or improves thereon, end who tloes such work himsetl or hersetl o� Ihrough hls or her awn emp�oyees, prwidetl that such impravemenis ere not Intended or otteretl lor sale. If, however, 1he bullding or Improvement Is soltl within one year of completion, the ownerbuiltler will have�the �urtlen ol proving that he or she did not builtl or improve for purpose of sale.). • ❑ I, es owner oi lhe properry, em EXCLUSIVELY CONiAACTING WIiH LICENSED CONTfiACTORS to conSlrucl Iha O�olect (Sec. 7044, Business antl Protessions Cotle: T�e contractors License Lew tloes not appty to an owner:ol propeny w�o builds or Improves thereon, entl who contracts for such proJect with e contractor(s) �,.-,licen5¢ pursuant Jo ihe Camractors License Lews.). BuSiness entl Profe55ions Coda tor Ihis rea5on: driv8r51TBf(se. ❑ Yes VedllceUo� af Ownecship by (type at documeni, i.e. - proqerty ten 6111 DIVISION OF INDUSTRI� SAFETY PERMIT CERTIFICATION: ❑ I hereby certily ihet no excevetion five (5) or more feet in Aepth into which e person Is requiretl to Cescentl, wlll be metle in connection wl�h work euthorized by Ihis pertnit, entl thet no Duiltling struClure, scaflolGing, lalsework, or damoli�ion or dismantling thereot, will be more then thirry-six (38) leet high. (C�ep. 32, Grp 2, An 2, Sec. 341, Tltle 8, Celifom�a Atlminisiretive Catla). ❑ As owner•builder, I wl�l not employ enyone ta do work whiU would require e permit trom the Dlvision ot IndustAel Satery, es noted above, unless such person hes a pormit to do such work Irom the tlivision. Signetura: Date: DlWsion ol Industrial Safery Permit Number: CERTIFICA7E OF COMPL�NNCE IWD AUiHORVA710N Of ENTRV: I cetllty untler penelty oi perjury thet I have read this application and stete that the iniortnation given is carrect. 1 agree t compy with ell siate laws end ciry ordinances releting to bulltling construction, enO euthotlze represematives ol the Ciry ol Cosia Mese to enter upon the ebove-desrji��rope � or i p tl� rposes. 1 egree not to occupy or allow accupenry of any building euthorized by ihis permi� untilOfinal inspection. � � �/�_ _��-'�-�_ / D- Z �f-_� —'�--' �e��_..._1r — Antl/Or Aut�orizetl Appliwnt Date COOE �. INSPECTION TYPE 7618 Flxetl System Final Fire Preventlon 1288 Pool SDa Finel 200 Finel Re-Rool 201 Flnel &xWReta��g Well 202 203 204 Final Fectory Fire Plate Finfll Sign Final Dertrolition PAg 1t�dlS §QQf,� INSPECTONTVPE 206 Finel Mec�enical 208 Finel Plumbing 210 Final Electrical 212 Finel Fire Prevenlion 220 Finel Planning Approval 222 Finel Site 250 FInaIBUllding/Occupency PAIF I[Q�1& { � c� 3 7 � �'`� �`� �a3 _ p/175 SABER INSTALLATION SUMMARY Pier Installation Log for Job #: 34097 120,000 100.000 80.000 S - 60,000 w � 40.000 O LL 20.000 Location Pier # I Pier #2 Pier #3 Pier #4 Pier #5 Pief #6 Pier #7 Pier #8 Pier #9 Pier #10 Pier #11 Pier #12 Pier #13 Pier #14 Pier #15 Pier #16 Pier #17 Pief # 18 1.4 12 1 � 0.8 � 0.6 o.a o.z 0 1 2 3 4 5 6] 8 9 10 11 12 13 14 15 16 17 78 Pier Number Analysis of Driving and Ultlmate Force 0 Calculatetl Fwntlation Loatl � Drive Pressure O UlGmate Pier Capaci�y 1 2 3 4 5 6 1 8 9 10 11 12 13 iC 15 16 1] 18 dation Driving i/Pier Force -Ib 8,t44 22,352 8,144 28,446 8,144 22,352 e,t44 24.384 8,144 24.384 8,'144 20,320 e,144 24.384 8,144 28,448 8,144 26,416 8,144 28.448 S.144 28.448 8,�44 30,480 8,144 28.448 8,144 26,416 B,t44 26,416 8,144 18,288 8.144 28.448 9,'144 20,320 Ultimaie Cap. - Ib 101,000 IOI,000 IOI,000 101,000 101,000 101,000 10I,000 101,000 101,000 101,000 I O I,000 101,000 101,000 107,000 101,000 101,000 101,000 701,000 Project Analysis Working Ultimat FS FS 2.74 12.40 3.49 12.40 2.74 12.40 2.99 12.40 2.99 t2.40 2.50 12.40 2.99 12.40 3.49 12.40 324 12.40 3.49 12.40 3.49 12.40 3.74 12.40 3.49 12.40 324 12.40 324 12.40 225 12.40 3.49 12.40 z.so iz.ao 025 025 025 0.70 0.70 0.70 0.70 0.75 025 0.75 1.70 1.00 0.60 0.60 0.60 725 0.75 o.io =_pth io 3ring " t 36.00 35.00 36.00 35.00 36.00 31.00 32.00 31.00 33.50 30.50 36.00 42.00 36.00 36.00 37.00 28.00 31.00 35.00 SaEer - Con«ete FoundaHon Leveling 800-922-2488 � SABER INSTALLATION SUMMARY Pier Installation Log for Job #: 34097 1Y0,000 100,000 a 80,000 g - so.000 w K 40 000 O LL 20,000 Malysis of Driving and UlUmate Force 0 Celculatetl Fountlation Loatl � Drive Pmssure 0 UlGmate Pier Capaary 1 2 3 4 5 6 ] 8 9 10 11 12 13 14 15 16 1] 18 Location Foundation Dnving Ultimate Load/Pier Force - Ib Ca .- Ib Pier#1 8,144 22,352 101,000 Pier#2 8,144 28,448 101,000 Pierk3 8,144 22,352 101,000 Pier#4 8,144 24,384 101,000 Pier#5 8J44 24,384 101,000 Pier#6 8,144 20,320 101,000 Pier#7 8,144 24,384 707,000 Pier #8 8,'144 28,448 101,000 Pier #9 8,144 26,476 101,000 Pier #10 8,144 28.448 101.000 Pier p'I l S,144 28.448 101.000 Pier#72 8,'144 30,480 101,000 Pier #13 8.144 28,448 101,000 Pier R14 S,144 26,416 101,000 Pier #15 B,144 26,416 '10�,000 Pier#16 8,144 18,288 107,000 Pier #'17 8.'144 28,448 101.000 Pier #18 8.144 20,320 101,000 Project Analysis orking UlTimate Approx. Depth to FS FS Lift - in. Bearin - f 2.74 12.40 025 3fi.00 3.49 12.40 025 35.00 2.74 72.40 0.25 36.00 2.99 12.40 0.70 35.00 2.99 72.40 �0.70 36.00 2.50 12.40 0.70 31.00 2.99 12.40 0.70 32.00 3.49 12.40 075 31.00 � 324 72.40 025 33.50 �� 3.49 12.40 0.75 30.50 � I 3.49 12.40 1.10 36.00 � 3.74 12.40 1.00 42.00 � 3.49 12.40 0.60 36.00 324 72.40 0.60 36.00 324 12.40 0.60 31.00 225 12.40 125 28.00 3.49 12.40 0.75 31.00 2.50 '12.40 0.10 35.00 SaEer- Conaete Fountlatlm Levelirg f• 800.922.2480 (714j 754-5273 • Fax (i14j 754-4856 • www.ci.costa-mesa.c�y�ILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 937 SERRA WY Suite: Viciniry: FOUNDATION Parcel Number: 14132817 Applicant: FROEHLICH, FR,4NZ Address: Owner: MORRIS, JAMES W TR Address g37 SERRA WAY COSTA MESA, CA Zoning: R1 R1 Phone: 714-981-4759 Zip: Phone: Zip: 92626 Status: ISSUED Applied: 07/10/2003 Issued: 08/06/2003 ISSUED BY: � Contractor. SABER Address: 2250 MORRISS ROAD SUITE 214 Phone: 949-675-6852 FLOWER MOUND, TX Zip: 75028 License: 737563 ,nrch : Eng: ALPHA CONSULTING & ENGINEERING INC Address: Address: SURESH C SABHLOK Phone: SANTA ANA, CA Phone: 714-541-9980 1823 E 17TH ST Zip: License: 92705 License: 2838 SCOPE OF PERMIT STABALIZE SLA9 ON GRADE FOUNDATION. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $199.71 $307.25 $1.90 $0.00 $0.00 $0.00 $508.86 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY Calc Valuation: 3�s,000.00 Claim Valuation: sis,000.00 PLANNING & ZONING Left 0- 0 Right Left 0-0 � Right Proposed: 0 0- 0 0= 0 NO710E: 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 tor a penod of 7B0 days. INSPEC710NS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectione and final approval must be obtained. Failure to obtain inspections and final approval will resutl in the expiration of this permit. FOR INSPECTIONS CqLL: (714) 754-5626 2aa6-aslfil00) WORKERS'COMPENSATONDECLARAnON: � I hereby eftirtn untler penalry ol perjury one ol Ihe following aeclaretions: , ,' - ❑ I have antl will maintain a ceNlicate of consent to selt-Insure for workers' compensation, es provitled for by section 3700 ot the Labor Cotle, br the pertortnance of the work tor which this pertnit is issuetl. ' � I have and will maintain workers' compensetion insuranca, es requiretl by sectlon 3700 ot the Lebor Code, for Ihe pertortnance of Ihe work Por wNch this permit Is issuetl. rkers' compensation Insurenca carrier and policy numher are: Ce ier: ,�NI�C�P.ir�A $�T}� �'cy..p Policy Nurp6er: /Z 3`�i�0 7 f/on neetl no( be complefed il the permit is velued af one huntlretl dollars ($f 00) or Iess.J ❑ 1 certity ihat in �he peAormance of ihe work for which �his Oermit is Issued, I shall not employ a erso in ny mannor so es to become su6jac� �o ihe workers' �CO�ettpn lews ot Callfarnle, antl egree �hel if shoultl become sub�ect to Ihe workers' co pensation pr vislons ot Section 3700 ot the Labor Cotle, I shall torihwith �complywithlhesepro3ions. � ApPlicant Signa : �7 ate: �"� �' — V � ILURE TO SE PE WORNERS' COMPENSATIIXJ COVERAGE IS UNIAWFUL AND SHALL SUBJECT PN EMPLOYER TO CRIMINAL PENPLTIES AND dVIL FlNES UP TOONE HUNDRED TMOUSAND OOLLaHE (5100,000), IN ADORION TO THE WST OF COMPENSAiIpJ, DAI.NGES AS PROVIDED FOfl IN SECTION 3IOB OF THE LABOR CODE, IMEREST, AND AT70RNE1"S FEES. DECLARATION: of Chapter 9(commencing with Section 7000) of o 1 e Business and Protessions Code, end my licensa is in full qass s Cfr/ _, Date: >fs--G--FYi CONSTRUCTION LENOING AGENCY: ❑ I here6y aNirm that there is a wnstruction lentling a9ency for the pedormance of �he work for which this permit is issued. (Sec. 3097, Civil Cotle). LentleYs Neme: Lantlefs AdGress: Signeture: Date: OWNER-BUILDER DECLARA710NS: I hereby eMirtn thei untler penalry ot per�ury that I am EXEMP7 FROM THE CONTRAC70R5 LICENSE LAW far ihe tollowing reason (Sec. 7031.5, Business end Pratessions Code: Any ciry or counry which requires e permit to construct, alter, Improve, demolish, or repair any siructure, prior to its issuance, also requires the eppliwnt for such pertnit to tile e slgnetl statement that he ar she Is Ilcensed pursuent ro the provisions oi �he Contrectors License Law (Ghapter 8(cammencing with Sectlon 7000) ol Division 3 of [he Business anC Pmfessians Code) or t�et he or she is e:empt therelrom end the basis lor the elleged exemption. Any vlolalion of Seclion 7031.5 by eny epplicant for a permit suh�ects the epplicant to a civil penalry of not more ihan live huntlretl tlollars (5500).): ❑ I, as owner ot Ihe property, or my employees with wages as iheir sole compensa�lon, WILL DO TME WORK, antl �he siructure is not intentletl or ottered lor sale (Sec. 7044, Business antl Professions Code: The Con�ractors license Lew does not apply �o an owner of proparty who 6uiltls or improves Ihereon, entl who Ooes such work himself or hersetl or thmugh his or her own employees, pmvided Ihet such improvements ere not Intended or oMeretl tor sale. If, however, ihe building or Improvemenl is sold within one year oi completioq the ownerbuilder wiil heve�the burden of Oroving thal he or she did no� builtl or ImD�ove for purpose ot sele.). ' ❑ I, as owner of ihe property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Prolessions Code: The contracmrs License Law does not apply to an owner of propeny who builds or Improves thereon, end who contracis for such pmject wl�h e comractor(s) litense pursuant to Ihe Conirecbrs LicenSe Laws.). ❑ I em exempt under sec. Business ana Professions Code for Ihis reason: SlgnaWre: Date: Owner ID verlfied by dnvef5liCense. ❑ Ves ❑ No Drivers License No. Ezpires: Vedlicatlon ol Ownership by Qype of tlocument, i.e. - property tex bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hareby certify ihat no ezcavation five (5) or more feet in depth into which a person Is required to descend, will be metle in connection with work emhodzed by ihis permit, and that no building structure. swttolding, falsework, or demolition or dismantling thereoi, will be more lhen Ihirry�six (36) teet high. (Chep. 32, Gry 2, An 2, Sec. 341, Ttle B, Califomia Atlministrative Code). ❑ As owner-6uilder, 1 will not employ en}rone to do work which woultl require a permit Imm Ihe Division of IndusMel Sefery, as notad ahove, unless such pereon �as e permit to do such work from the division. Signature: Date: DiviSion ol Indus�rial Safety Permit Numbar: CER7IFlCATE OF COMPLIANCE AND AUTHORVATION OF ENfAV: I certity under penalry of perjury that I have read Ihls epplication and state t�el Ihe iniormation given is wrrect. I egree ro wmpty with ell stete lews and ciry ordinances relating to builAing consiruction, end authorize re0�esenta�ives oi the Ciry ol Coste Mesa to enter upon Ihe ebove-descnbetl property for inspection purposes. I agree not to occupy or allow occupency of any building authonzed by Ihis permit until tinal insDection. CODE I, INSPECTIONTYPE ' 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root � ' - 207 Finel Block/Retaining Well 202 final Factory Fira Place 203 Final Sign 20E Final Demolition OATE ' �� CO�E1 INSPECTIONTYYE � �• � 206 Final Mechanical 208 Final Plumbing 210 � Finel Electdcal - 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupanty Date � - Pd1E U1�JSL5 rGG R��tivtu •� ��,,,�„�2 I,ot 66, Tract [t285, P1an l�00 B SEP 6 1961 :`= FINANCE �EPT. COSTA MESA BUILDING-SAFETY DEPARTMENT � CITY OF COSTA MESA P. O. BOX 9f7 COBTA M68A. CALIFORN�N For Applicani fo Fill In Complefely APPLICATION FOR PERMIT TYpE OR PRINT COSTA MESA CALIFORNIA OWNER Mesa Del Mar Develo ment Co. ADDRESS 3UOO E.' Coast Hi W ��y Corona del �ar, Cali£. No:OR 3112 ARCHITECf __ _ . . - TEL. __. ..� .. E. E. Coast No: OR 3-1J22� INO. OF BGDGB. USE OF none EXISTING BLD . B6TBACK LINB PRON55' CEMQR OP 6TPCET I LEFf �-�� I RIGHT 6� DESCRIPTION OF WORK I�IIALTERATION I IIADD1710� �o�+,.Kz� e°;,3a LDING AND FIRE Ih _ LEOAL BUILDING For Office Use Only P¢CEIM NO. I PQRMIT NO. BY COSTA MESA. CALIFORNIA ZONING xo. ov1 I use ov N PLAN9 I BUILD�NG ' lC8NT8R LINe BT.) /-� �......� ��J � /o y� � etc. 68 S F � xex¢er AGKNOWLED6E TMAT 1 HAVB PBAD TX18 APPLIWTION 7HE AMOUNT BNOWN �1NUER VALUAiION 16 FOR THE AND eTAT6 THAT THE ABOVE 19 COpR6GT ANO A6RE6 TO COM- pUPPO9E OP E9TABL19HING A PERMIT FEE ONLY. PLY WITH ALL GITY ORDINANC89 AND 6TATE LAWB p60ULATING BUILDINa CaN8T1UR10N. � VALUATION p SIGNATURE OF PEftMIT FEE $ � ^ � PERMI'RE a Del Mar Develo - [y �i �� /�/ $ 18 24'�� PLAN CHEGK $ / / � AUTHORRED AG �'�^'�G � _ ST�OO F 0 LL Phi.lip W. nnTE 8-27-62 G�NERAL CONTRACTOR VWIIEx'-.uaar• VALU33 $ "Lj10.W AP No.l�l- Za-O%F LOT 1'RACT FIRE 7.ONE DlSCRIPTION OF WORKI 1N5PEC'PIONS I Signnture DA7'E GROUP I TYPG y 7,ONE Soil PERMI n.._ SUBCONTRACTOR :�.,.,..-T cout -- —_ _-R!�_'e:.f_ytyr•cC =�:daolGii::_� , COSTA MESA BUILDING-SAFETY DEPARTMENT P, O. BOX 917 COBTA MeBA. CALIFORNIA Fo� Applicanf fo Ftll In Comple+ely TYPE OR PFtINT COSTA MESA. CALIFORNIA . _ lil � �.i TEL. 6TATE �_�TEL. LIG NO / , . NO. SIZE �/��.� _. • � no. oP atncs. � FPOM � L�'� i � I LEFT �� I F:�GHT I�' DESCRIPTION OF WORK EXTERIOR WALL ROOF COVERING COVE � USE OF BU�LDING AND WORK TO /�'/ x Jy' I HERlBY ACKNOWLeD08 iHAT I HAVE RB�D THIB MPLIGTION ANO 6TAffi TMAT TXE ABOVE �B GOPREGT AND AaREE TO COM- PLY WITN ALL CIlY OFDINANCEB ANO BTATE LAW9 OULATING BUILDINO CONBTIi/Uyp/ O/y/�f {�//�� 81GNATURE OF / y� // � Dv] /AI/� /M D_ / � AGENT FEE RECEIVED � AUG 2 i i:;oo C� ofC'��i7 D.F,C,�� PERMIT �- 1 Mtan 1 ING For Office Use Only HELEIPT NO. _PCftMIT NO. 1 PIRE 20NE APPROVED LE6AL COSTA MESA. CALIFORNIA ZONING no. or �,., I use or H PLAN/ ��rauaomc cor G6 y� 42. �l-/ _ 2J_T/- �� / p / .�L�l%� WJ /%-E�i.l�ii�✓�_a TXE AMOUM BHOWN UN�Eq VALUATION 18 POH THE PURP08E OR EBTABLIBHING A PEPMIT FEE ONLY. $ �� I b`a� �