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1088 WESTWARD LN - Building Permits
,EJECT PROPERTY INFORMATIOI, 1) Property: 1088 WESTWARD LN, COSTA MESA CA 92627-3994 C035 APN: 935-23-010 Use: CONDOMINIUM County: ORANGE, CA Tax Rate Area: 15039 Total Value: $97,000 Census: 636.01 Prop Tax: $1,019.78 Land Value: $49,725 Map Pg: 31-Al Delinq Tax Yr: Impry Value: $47,275 New Pg: 888-F2 Exemptions: HOMEOWNER Assd Yr: 1997 Phone: 714/642-6542 % Improved: 48% Owner: FORBESS ROBERT E Mail: 1088 WESTWARD LN; COSTA MESA CA 92627-3994 SALES INFORMATION IMPROVEMENTS LAST SALE PRIOR SALE Bldg/Liv Area: Transfer Date: 05/15/78 #Units: Sale Price/Type: $70,000 FULL #Bldgs: Document#: 1273401588 #Stories: Document Type: $/SF: 1st TD/Type: Yrblt/Eff: Finance: Total Rms: Junior TD's: Bedrms: Lender: Baths(F/H): Seller: Fireplace: Pool: Title Company: Bsmt Area: Transfer Info: Construct: SITE INFORMATION Flooring: Air Cond: Improve Type: Lot Size: Heat Type: Zoning: Lot Area: Quality: County Use: 1 Parking: Condition: Bldg Class: Park Spaces: Style: Flood Panel: 060216-0046E Site Influence: Other Rooms: Phys Chars: Legal: L1 TR9083/UNIT 10 A, B, G, P OF PROJECT Comments: Copyright©1996-97 Experian Page: 1 of 1 1'l ' , ,511 CITY COSTA MESA 4 BONDI�G DIVISION Y4.J r,,. `1DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER PERMIT B05-00726 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca,4�LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1088 WESTWARD LN UU Status: ISSUED Suite: Applied: 05/05/2005 Vicinity: Issued: 05/05/2005 Primary Occ: R Type of Construction: V-N Parcel Number: 93523010 Zoning: Applicant: BRENT ORZOLSL..., _ - - ISSUED BY: Address: 5702 RESEARCH DR,,, ::", _ ' ` I /Phone: 714.968.7188 " HUNTINGTON•BEACH;CA -Zip: '92649 - Owner: LINGO;STEAVEN J" ` Address •1088"WESTWARD I N C..�;`; -- - , - - , '/�' S; F'-_ Phone: - COSTA MESA,OA ,>% Zip: 82627-3994 r . / • Contractor:" CALIFORNIAREBUILDERS '2 ' ` ' i 'Address;',,,5702 RESEARCH DR • , ' Phone: 714.968.7188 . HUNTING dTON BEACH,CA , , ;T'=i .Zip: 92649 :license:- 493636 . Arch / i" :. .. ;:� 1 i✓_ q-.; : Eng: , 'Address: . Address: " ,•,. 1 „ -- -....`t Phone: Phone: Zip:- ;,, ;s License: License: ;`SCOPE OF."PERMIT; ' REPLACE WALL STUD,LATH STUCCO PATCH, DRYWALL AND REPLACE ELECTRICAL OUTLET. , ' FEE SUMMARY , - ' - Plan,Check: r, $0.00 '}. Calc Valuation: $800.00 Permit: $32.65 • - . 4, .. „- ---- Claim Valuation: - S600.00 SMIP Res: - . $0.50 ;(' - - , SMIP Corn: $0.00 _ . .. Other: $0.00 - - Inspection:' ' $0.00 :_' ° ' Total $33.15r,r,. _ . PLANNING SETBACKS .!" '/ ,yam - ,/,- MAIN STRUCTURE',Front 0-0 , Rear '0-0' t. _ Left 0 0 ' ' r Right • 0=0%.- , ACCESSORY Front -0=0 ' Rear''0=0 Left 0 0. Right'' 0. 0- ,% -,-�� ,._.. PARKING Existing: -0 ,,Required .0 = Proposed \ 6, NOTES: ' - - - 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 to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)75445626. 244646(6/00) WORKERS'COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: . . 0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.!tILJ pave and will maintain ion nscompensationedoliinsurance,as required retl by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. • y3%My w ars'c 1pensation Insurance carrier and policy num/per are: A Carri Q 4Sr C,n•�/n S4�;On )n< _h v3 0.22 04-1 (This section need not be completed if/J permit is valued al one hundred dollars($100)or less.) �,m-----"�----� D 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 Califomia,and agree that if I h Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provis' �Appllcapt Signa[ure::'�•y� ��� D_^te" -J/ ..5///"S 1 WARNING:FAILURE TO SECURE WORKERS'COMPENSA ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI 6 NAL 9ENALTIES AND CIVIL FINES UP TO ONE HUNDRED - THOUSAND DOLLARE($1OO,000),IN ADDITION TO THE cam-OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereb affirm,thaRl amlilicenunder provisions66 of Chapter 9(commencing with Section 7000)of Division 3 of the Busines y,.Professions Code,and my license Is in full force:and elfect..Lic:# x/95 Contra ro s'Signature: Date:_._. _ L., CONSTRUCTION LENDING AGENCY:" • ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or 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 to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 civil penalty of not more than five hundred dollars($500).): ❑ 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 for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Des or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ignature .f Legal 0 e ) De �i/!) OS .And/Or Autho' e••••plident'�-..w. t Datet,. CODE Y INSPECTION TYPE' ' ' DATE" INTITIALS CODEC INSPECTIONTYPE ^ QA�f, INTITIALS 1616 Fixed System Final Fire Prevention - . 206 Final Mechanical - 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof . . . ' 210 Final Electrical - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval .• ' 203 Final Sign 222 Final Site - • 204 Final Demolition 250 Final Building/Occupancy • y ' y CITY OF COSTA MESA 4 ,BUILDING DIVISION fC r( ,.-4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1 wi: ± : 1 o j .PERMIT Iktboonn 64E05-00427 (714)754-5273 • Fax(714)754-4856 www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1088 WESTWARD LN Status: ISSUED Suite No • Applied: 05/05/2005 Vicinity: SIDE OF BLDG Issued: 05/05/2005 Parcel Nunmber: 93523010 Applicant: BRENT ORZOL ISSUED BY: Address: 5702 RESEARCH DR"i-<. - - - - �r Phone: 714.968.7188 ` /.. HUNTINGTON BEACH;CA- Zip 92649 - -l . - \ \. - Owner( • ,, ,LINGO;"STEAVEN J . Addres's ' n1088 WESTWARD:LN' --' , . . j Phone:• COSTA MESA,CA Zip: 92627-3994 . . ' Contractor: CALIFOR • NIA REBUILDERS . Address: 5702 RESEARCH DR - 'Phone: 714.968.7188 HUNTINGTON BEACH,'CA Zip: 92649 . • License:493636 • `-' ' SCOPE OF PERMIT 7 REPLACE WALL STUD,LATH STUCCO PATCH,DRYWALL AND REPLACE ELECTRICAL OUTLET. FEE SUMMARY. ' Quantity - ____ _ _ _ Quantity ISSUE FEE - - - $23.50 - -.. - Temp Dist System/.Lighting. $0.00 0 - Temp service test $0.00 Busway/100 ft • $0.00 0 " Reth.a/c package'. . $0.00 Standing'Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 - New Res(3+units) $0.00 0 Transformers'up to"1 kva/kw $0.00 0 Pool/Spa, $0.00 0 up to 10 kva/kw $0.00 0. Lighting Fixts • - $0.00 0 - up to 50 kva/kw $0.00 `0 Recept Outlets $1.10 1 "up to,100 kva/kw • $0.00" "0 Switches " '$0.00 0 "over;100 kva/kw.: _$0.00 . 0 ' Non Res Appl- $0.00 - 0? Low Voltage Equipment J{ $0.00' 0 • • Res Appl $0.00 - 0 Low Volt Wiring System/Ckt. ,"'.$0.00 0 Service to 200a , - $0.00 ; ,.0 Misc.Conduit $0.00 " ' 0 Service to 1000a - $0.00 - CR, - ' . - Misc.Conductor ' $0.00 0 Service over 1000a - - $0.00 0 • . Circus(gen or.ride).- $0.00 0 Motors to 1 hp $0.00 0 ' Circus(mech ride or lights) '. . 10.00 ;0- Motors to 10hp . - $0.00 - . - - If.• . - - Christmas Tree Stand, $0.00 . 0 Motors to 50hp , - $0.00 0' _ Fireworks Stand:l. • - . $0.00- �-0 Motors to 100hp $0.00 - " 0 - i Other Electrical'Fee\ . ' .$0.00 Motors over 100hp Communication drops $0.00 0- - Investigation Fee �- $0.00 Sub panel to 200a $0.00 -0, - Plan Check Fee, - • - ' $0.00 Pole Light Pkg $0.00 0 - '• ReinspectionFee- $0.00 Sign Circuits $0.00 0 • Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $24.60 • NOTICE: The work iauthorized-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-permitshall.automatically expire.and,become-void if work is not commencedwithin-180 days,-or if work is suspended or abandoned , for a'period.of 180 days. INSPECTIONS: In lorder•forthe work,authorized,under this permitto!be.considered legal,-such•.work'must comply with-all applicable codes, and all ., irequlred.Inspections-anddinelapprovalimustbe'obtainedJFailure'ito obtaiminspections:and-final approval will result in the-expiration of this permit. :FOR:INSPECTIONS'ICAL'L: -(714).754-5626 2446-46(6/00) DECLARATIONS fl fl WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations:' '"• ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. • My wo rs'c mpensation',trance carrier and policy number/are: /.,{� Carrier: 9 -4><e Covn -/,n s n+y.'in /r7.S Policy Number: /V 3 o ti (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ 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 California,and agree that if 1 hould become subject to the workers'compensation provisions of Se tion 3700 of the Labor Code,I shall forthwith comply with these prowsi Applicant Signature: > Date: S • WARNING:FAILURE TO SECURE WORKERS'COMPENSA ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100,000),IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under v' ions of Chapter 9(commencing with Section 7000)of Division 3 of the Business a Professions Code,and my license is in full force and effect.Lic.8 4/136 � Class# Contractors Signature: Date: S /� i CONSTRUCTION LENDING AGENCY: . ❑ i hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or 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 to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 civil penalty of not more than five hundred dollars($500).): O 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 for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). - ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0N (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ignatu e N Leg wn r(s) Date P5 And/Or Auth nz pplicant Date CODE* INSPECTION TYPE . . ` pig ' INTR(AL$ ' ' ' CODE IN5PEC11ON TYPE PAIS =AU 1616 Fixed System Final Fire Prevention • 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical <ii1--• 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory,Fire Place ' 220 Final Planning Apprbval 203 Final Sign 222 Final Site • 204 Final Demolition _ 250 Final Building/Occupancy • -:'''.t.:7-7, • • • • .i • - C.. "�I '„ ..- . . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 N. APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only g V� ' RECEIVED BY I DATE RECEIVED DATE ISSUED BUILDING V -- ADORES / OWNER �[ / PE H7�ILT 0 / /_ A.P. NO. ' MAIL q�[ �G+' BUILDING T" • ADDRESS 704 I• '�"✓• /�,f /ter ADORESS'�gQ -2-�•L-F Esfu�ae(� �A/ • CIT {[-/fits/, o NE0L/ ��Z.— TRACT LOT - BLOCK CO UCiIOf•J Y 'NEW/ ADD ALTER REPAIR MOVING OFMOI ISH LENDER / / ' BRANCH -. / �7' +e ADDRESS OWNER /Jail-lope? 1-kq 1RD I C•41710(.1 " ` I VALUE J/I I '•s't ARCHITECTaWell L. SE -7 `71I�LI'" v n E Iy'/ OR ENGINEER FIRE ` ADDRESS ZONE TYPE"� GROUP/?jf, f 1 APPROVED 777 .+ CONTRACTOR &21241- BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW I CITY - NO. PLANS BUILDING i F STATE `y's CITY YARDS APPROVED YARDS APPROVED i LIC.NO. d Q 2-7 LIC.NO. MAIN BUILDING ACCESSORY BUILDING I {{{"' (FROM C/L STREET) Be ZE i NO.OF NLDGS. � OF OF LOT C - NOW ON LOT FRONT FT. FT. cn USE OF EXISTING BLDG. _ R.SIDE FT. FT,_ I N PE H Separate permits are required for L.SIDE FT. FT. — electric,plumbing and heating work. WREAR FT. FT. F. USE OF BUILDING ND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q MAIN BLDGS. ACCESS. BLOC'S. CD DATE ., Q sl./1 yl� ""V/v // 14 i J✓`t�/�Q `-'s•"'r cr�^� C URP.3(E APPROVED • APPROVED GC LLI 4 U h;ii•S I-11^0 'YII' TJ' _lIk +-iq Y•' pI hereby acknowledge that I have read this application and state 31f^1I „u��} I?70`� 1_ ,(yC Ih.,(I /�•t y that the above information Is correct and agree to comply with {V� IL I/ �K 7�// M. all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of _ Zthe State of California. /JC C.{/5 ..t-• QI � /J f V7r O 3 I hereby certify that I am properly licensed a . contractor under fL' ( O. FT. ,J= Itiw�+l/ 4 j ,sem A. the State of California :us) -ss and Protessi. s Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m itti Chauraexempt and that s ro iri'nsao ot r ein fsul/t Cala d effect,or a 8usine I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: p and Profen ••ns o• D' si 3, ap '+ VALUATION PERMIT FEE $ J, fh m / ////�/� •PLAN CHECK $ 'n qo Signature of V� i Si. `/r•�� o Permittee - $ TAX $ filo � 7 U h Authorized Agent / TOTAL PAID y� A• 0 -1 `.,f., F.h Clc.^'.'56} f¢' t .. u ,. i ., t 9 t t" a:JC rcrravNs ' ' Si ri.:F t I . . . ,€3= ,Yy 1 COSTA ME././..."."--SA BUILDING-SAFETY DEPARTMENT I P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only DATE ISSUED .� //r/�(!,�ff / �j y'7 y'Js���t�� RECEIVED BY DATE RECEIVED > ADRESS`✓Qe.2-i/-o-() WECriv YCo t) u �'7�{/� PERMIT NO. • r OWNER r`�/ /�'1�'!-fJ/f/Iew A.P. NO. �}�y+/� /� / • ']/I� MAIL / p VviQi�{J AODRIESO V . . 4 � it/Y . I ADDRESS FI CITY NOL TRACT I LOT BLOCK CONSTRUCTIONN, EW ADD ALTFR REPAIR_ MOVING DFMOLISH LENDER \ /\, BRANCH ..rr--)r ,�_�rr,�/J�yy) jJ�y� , OWNER I//TUI L/[ ''T/c-,e/ tO • i ADDRESSALUC ��s $ ARCHITECT TEL. - _USE (.�C.[) c •• OR ENGINEER NO. FIRE i ADDRESS -- ZONE TYPE GROUP APPROVED I CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW CITY NO• , PLANS BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING {Ly SIZE NO.OF BLDGS. (FROM C/L STREET) a. OF LOT NOW ON LOT FRONT FT. FT. USE OF ct EXISTING BLDG, R.SIDE FT, - FT, COI Z Separate permits are required for L.SIDE FT, FT. . I t— electric,plumbing and heating work. G REAR FT, FT. 1 Ek., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CA. i C MAIN BLOCS. ACCESS.BLDGS. VAR.# DATE ' E C.U.P.# APPROVED 7 APPROVED ,- CC _DATE i. CC ILI 0 I hereby acknowledge that I have read this application and state I rx C$ that the above Information is correct and agree to comply with m O, 1 all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of = the State of California. m I hereby certify that I am properly licensed as a contractor under SO. FT, N 0 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: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ 3 and Professions Code,Division 3,Chapter 9. [}/�7(,/ u+ t m PLAN CHECK E G Signature of 14.. Permittee $ TAX $ a '` J^ F U 7[Authorized Agent TOTAL PAID S 3 / L/�/' - .. COSTA MESA BU1LDI > �Y DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only �y 8 to `� / / RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING ,-J[ V/�'.W!//� l/,(J�/LLQ- ADDRESS (J'-fen, PERMIT NO. OWNER �— � L1�1Y�_ r � MAIL �j �r� n // BUILDING j0� II {f�f,�y.Iap n,/fn ' fs 11 ADDRESS` �W L/`. /6• y ADDRESS VVIA�j`{V� io L.ty i TEL. {. TRACT ,u OTo�/tom OCK CITY 1 v. -t:�d. -A if. NOI. of q.� sof (D4 CONSTRUCTION n �1_/ `NEWW ADD ALTER REPAIR MOVING MFMOLISH LENDER dna- 29-1Z- . �j � ��.r� / '-/��p�� BRANCH ` ��I�%� 1� /OWNER Y4Orrre— �OV�'KF�O ' ADDRESS ///"/// /� /,�- I,� /A / ARCHITECT /k /./a%- TN i/9%/T^ USH..6 Q w/ VALUE OR ENGINEER C \���// LL7` J J , aO 40142/41,A467 . FIRE GRO UF: ADDRESSZONE TYPE APPROVED CONTRACTOR gra BY DATE ADDRESS TEL. ZONE NO.OFUSE OF NEW CITY NO. PLANS� BUILDINGe0/20 iikftanke. /-•1 STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO.2 ffe 3 LIC.NO. MAINI,BUILDING ACCESSORY BUILDING (FROM OF LOT NOW ON LOO 44 SIZE NO.OF BL ,,hk Pt. l �/l T • FRONT CI Q�FT. OI, r-j' of a USE OF I y�,y� EXISTING BLDG. _R,SIDE .A.,„‘•7 7 F_T.t5[Jrr 1�_ FT. 1.0 E Separate permits are required for L.SIDE /FT.It a FT. G electric,plumbing and heating work. REAR . X61 774 FT. _ — W USE OF BUILDING AND WORK TO BE PERFORMED Y T.�� F DISTANCE BET. BET.MAIN O Q [-,,1 ,q•^_ ,(///.t,� _MAIN BLDGS./ ACCESS.BLOCS. ���t�� Q 2 V�A,,,,ii a s"l.oto _C VRP.4, 6/���3 APPR��OVE�EDL.er`[/N--TML-77- -]a p6� HOLDRAPPy OR SPEC TRtKtWltiV�., w 0 I hereby acknowledge that I have read this application and state N. rig that the above Information is correct and agree to comply with A• all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of tri the Suite of California. - 3 I hereby certify that I am pro•erly Ilcen d as a contractor under l/j7O SD. FT.� � f �Q ry the State of California -i, sii ssend Prof ssions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that s n ar In ull forge and eff: t,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; to am exempt f - t a -Ion of � e 'tato of •alifornia :usiness VALUATION PERMIT FEE $ lir and Profess ons C••.,/ si• e e• et _ vi / PLAN CHECK $ n Signature of / m 0 Permittee $ TAX S 2 • U U Authorized Agent TOTAL PAID $ I N • toPi Fia IoS,b, 101,0, CITY OF COSTA MESA lOcePt t ? i$iq g b,Ci PARK FEES No 2 4 8 i Fee Payment Receipt Project Address/a27— f Q! r 661E64c�cj-nd Park Area / A. P. No. f/S —6602-0/i 0c2 por O 5) r Building Permit No. Owner's Name 4r72-4 dreg' 44 !Q M' Mailing Address c2'/nn a_) . y •4 FEE Single Family ' No. of Units @ $455.20 = Multiple Family •• No. of Units Gig @ $32132 = D> •V8 TotalFeen \^Planning Department Api .y: t to - _ By_ `/e�R P6— /� 'Applicant's Signature FAT ' • City Ordinance 72-44 •• City Ordinance 72-45 ••• City Resolution 74-124 White-Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174-26 RI Gait 11130 L i b ,