HomeMy WebLinkAbout3101 TAFT WAY - Building Permits PROJECT ADDRESS: 3101 TAFT WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 048445
OWNER'S NAME: ELLIS STATLER
ADDRESS: SAME PERMIT NO: B 048445 PLAN CHECK NO: N GOVT: N SUPP: N
•
'4 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
540-9099
ARCH/ENGINEER: RELNO.: JOB DESCRIPTION : REROOF 1400SF RESIDENCE W/COMP. SHINGLES SQ FT: 2, 400
1. ADDRESS: UNIT:
CLAIM VALUE: 2, 400 . 00 CALC—VALUE: 2, 400 . 00 GROUP OCC : R-3 /
' PERMITTEE: ELLIS STATLER ( 714 ) 540-9099
ADDRESS: 3101 TAFT WY COMMENTS - X
C.M. CA 92626 ****************************************************************+r**************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T SMOKE
®�����®�
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S I v F
CITY UC.: STATE UC.: CLASS: • y..�
Date: Signature: MAIN BUILDING ACCESSORY Bk1 IRE. 3----
WORKERS'COMPENSATION DECLARATION: Ihereby affirmthat Ihave acertificate01consent toself-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: 14169312 ZNE: REF NO:
❑ Certified copy Is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOES> •
Date: Applicant: *******************************************************************************
EKEMPIION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed I the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that In the kers' i m e nofs the workafor which this p it is issued,I shall not employ any rsoeas to become/
subj—Ay/.the workers' �mpensaSon La of California. h� ZONING APPROVED BY DATE:
Oats '/ ' !! Signator ' �•
NOTICE: lifter meting t a declaration,you sh becam bled to the workers'Compensation provision of the Labor BUILDING APPROVED BY : DATE:
Code,yo ust forthwith comply with such provisions or this permit shall be deemed revoked. .
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: -
** • •I
which this permit is issued(Section 3097,Civ.C). ****************************************** ********************* ******}iF**
LENDER: *******************************************************************************
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
0.
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 5 0
Crepair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
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.My violation of Section 7031.5 by PLAN
any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred Mars(3500). 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—--—> 54 . 50 0 , 00 0 . 00 54 , 50 54 . 50 • 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 _
REVENUE DIVISION TOTAL S--> COLLECTED• 54 . 50 OVER/SHORT; . 00
forpttreepurposeoflsateihlnoneyearolcomDletloo,thaownerwillhavatheburdenofprovingne/shedidnotbulldorimprove 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 54 4 . 00 0 • 50 0 - ,
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projectsryth acontractor(s)license pursuantto the Contractors'State License Law).l am aware *******************************************************************************
that proof of their worker's Compensdlon insurance should be provided to me. I ND I V I D U A L F E E BREAKDOWN
o I am exempt under Section: B.&P.C.
for this n: / a ( TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: f `7 9v `Drmer: SFR 2400 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 2, 400 .00
Ido hereby certify that I aware of and understand the requirements of .fomia Ith and Safety Code Sections 25505.25533,and END OF FEES
25534 and that I or any future building occupant wiMvill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from theTarry Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant: A
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 elaws relating to building cpatruction and hereby authorize representatives of this Ory to this try en rmentkned /
prope • inspection purposes. /,L
Dov Signature: a r� //re
01 00066924—C0066925 1'zs
Ddweer'sLimn /Social Security it: £ :,- -.
DATE: 03/06/93 7I0E ic:
164146 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
r TV
CON4TRUCTION AND PLANNING POOL & SPA
APPROVAL& 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 UFER.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 _ ,
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 _ . , y , - • APPROVALS-• Permit#
21. Ducts,in Structure ,.70. Undergrouhd;Hydio
22. Duces, Ventilating - ' ^ '71. Product"Piping OGas OOil _
23. Gas Pipe-Rough & Test . T _" -72. Underground.Flush .
24. Roof Framing c- 73._Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 6 h' 7f'o,.t p'C 04
"- 74. Overhead Hydro -
26. T•Bar,Ceiling (Structural) & Monocoat • - 75.:Dry Chemical -
27..Frame and Flashing _ ' = 76. Dry Standpipq
28. Lathing & Siding - - _ 5. C; •• * 77;-:.FIXED SYSTEM:F.INAL' -•
~
29. Insulation ' _ '' : 78.: FIRE PREY. FINAL .
30. Drywall Nailing - - r. HEALTH,DEPT.'R£QUIREMENT
31. Plaster Brown-Coat '' - - _ ` 79. FINAL INSP.ECTION . . -.
32. Electrical Power Meter-Final 80.=FOOD CERTIFICATE ISSUED • '
'33. Final Electric. ' Notes: _ 'r - •
34. Final-Heating & Air.Conditioning'- - _ i ,li
35. Final Gas-Pipe-Test - t - -to = --
36. Hood or-Canopy - - ,;a
37. Final•Factory Fireplace -. _ -
38. Final'Pldmbing . . - • _
39. Water Service-Final . - - .
40. Gas Service-Final .. ..
41. Solar Domestic-Final T �') r• 1. r
*
42. Backf lowpreventer _ .1
43. Backflow Irrigation - l
44. Landscape Irrigation System • - -
45. Sound Attenuation - - - _
46. Handicap'Regulations .- -
47. FINAL STRUCTURE & BUILDING Q f6
48. FINAL PLANNING -
49. Electric Release to Edison
•
50. Gas Release to Southern California Gas Co . _ _ .
51. CERTIFICATE OF OCCUPANCY -
No. Date
•
PROJECT ADDRESS: 3101 TAFT WY UNIT: GARAG CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 048446
OWNER'sNAME: ELLIS STATLER
ADDRESS: SAME PERMIT NO: B 048446 PLAN CHECK NO: N GOVT: N SUPP : N
•
4 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
540-9099
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF 500SF GARAGE SQ FT: 800
' ADDRESS: UNIT: 1
CLAIM VALUE: 800 . 00 CALL—VALUE: 800 . 00 GROUP OCC: M-1 /
PERMITTEE: ELLIS STATLER ( 714 ) 540-9099
ADDRESS: 3101 TAFT WY COMMENTS: X
C.M. CA 92626 ************************************+ear**********it***+a****+r*****************at***
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
CITY UC.: STATE UC.: CLASS:
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' FRNT: FT IN REAR: FT IN FRN T: 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: 14169312 ZNE: REF NO:
0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Rus section need not be competed it the permit is for one hundred(5100)or less). DEVELOPMENT 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 issued.I shall not employ any person in any manner so as to become/
subject ttto]the Workers'Compensation Laws of California. J/,/�JQ�� � ys,, 1 ZONING APPROVED BY DATE:
Date:A II �� 197d on Signature: /m �/y i 4 ��
NOTICE:tt er mating this declaration,you should me su ct toWorkers'Compensation provisions at the Labor BUILDING APPROVED BY DATE:
Code,you must forthwith comply with such provisions or this permit shallll be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY
which this Dermic is issued(Section 3097,CN.C). DATE
*************************************** * **************************At mit** **
LENDER: *******************************************************************************
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: My city of county which requires a permit to construct,atter,Improve,demolish,or PERMIT 21 .0 0 . 50
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($505). 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
USJ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 21 . 50 0 .00 0 . 00 21 . 50 21 . 50 . 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: 21 . 50 OVER/SHORT: . 00
for the purpose of sale). 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 21 . 00 . 50
❑ 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).l am aware ************.******************.)E**********.N.******.****.*.*****.****.****.N.***4******.**
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: I/ TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: /7/,9# \ Owner: SFR 800 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 800 . 00
I do hereby certify that m aware of and understand the requirements of California Hea Ih and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to 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:
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 cls to enter upon the above-mentioned
property inspection urposes. `/ �N7 .
Date: \Signature: M• L,�[,�'�C1/ 1 01 00066926-00066927 TOT 21.50
Driver's Licens or Social Security it: DATE: 08/06/90 TIRE: 1D:1;
1641-48 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
e
CONSTRUCTION AND PLANNING P,QOL & 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 -•" J
•3::Electrical Conduit Utility-Undrgrnd. 54. Forms
4', Electrical Conduii-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 -'
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 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.;Duct `S, in_5tructure - ' y. •70. Underground Hydro
22. Ducts, Ventilating; . - y • •71. Product Piping 0 Gas 0 Oil -
23. Gas'Pipe-Rough & Test t '•'• ; -72. Undergrourid',Fluh ' . "
24, Roof Framing - • 43. Undergrndd Storage'Tank 0 Gas 0 Oil
25. Rodf Sheathing 7 -� 74. Overhead Hydro '- _ .
26. T-Bar,Ceiling (Structural) & Monogoat . - 75.try Chemical J m
•
27.'Frame and Flashing; - - - 76. Dry Standpipe 2
28. Lathing & Siding - -
_ • 77.-fIXED SYSTEM FINAL
29. Insulation ', . -, - 78.' FINAL .-PREV. FINA - • .-
30. Drywall Nailing r •:-. - HEALTH,DEPT: REQUIREMENT
31. Plaster Brown„Coat x' ` ,T ' -79. FINAL INSPECTION
32. Electrical-Power Meter-Final r.. , '80, FOOD CERTIFICATE ISSUED
,33. 'Fina-rEleE.tria,,' ;. ' Notes: _ - , .;
34.'Final Heating& Air Conditioning '
- -
35. Final Gas Pipe-Test •• �' a _ - .•
36. Hood,or Canopy i - - 0 _
37. Final Factory Fireplace ' - • '
38. Final'Plumbing - .'
39. Water Service-Final • - - '
40. Gas Service-Final -
41. Solar Domestie-Final : .
42. Backflow Preventer _ - - -
43. Backflow Irrigation • • ' •
44. Landscape Irrigation System , . . - . ' -
45. Sound Attenuation - . • - - - - - • .
46. Handicap'Regulations / ^jam`47. FINAL STRUCTURE & BUILDING -K(r0. ;r�,��'r^ S" „ /Q�C : St
48. FINAL PLANNING ' /9'�- ( - - St
49. Electric Release to Edison - .-
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER STATLER, ELLIS J. DATE 6-9-77
JOB ADDRESS 3101 Taft Way BUILDING PERMIT NO. 44127
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Patio Slab : & Cover
AP No.141-693-12 LOT 8 TRACT 5005 FIRE ZONE VALUE $500.00
INSPECTIONS Signature Date TYPE V GROUP 'J ZONE R-1
SOIL PERMITS ISS4ED
GAS SUBCONTRACTOR
Date I Number I Signature
WATER Plumbing
ROUGH PLUMBING
^
lJ
PROP. SWR. LINE HOUSE CON. 7
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
rSROUGH WIRING /yA{� _ Heating and Vent. -
S TRENCHES ❑ FORMS u STEEL REINF. u /i p1�Ej..77
FLOOR SYSTEM / \
BONG BEAM 11 STEEL REINFORCE n \
SHEATHING \
% FRAME AND FLASHING \
.ILATHING — IN Tl OUT f I
PLASTER. BROWN COAT
STRUCTURAL, FINAL Electric I
HEATING, VENT., REFRIG. AND A.C., FINAL I
PLUMBING, FINAL AND GAS TEST n
ELECTRIC. FINAL �/�/1 y�
BUILDING, FINAL /_ jet m' 7.•7 . - _ -
/
4412 PAID
7 ,IIN —9 77r,as;.On 9F,8',**** 5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
RE IV BY aTF�ECf}If�cD pgTE I�ED
ADDRESS E/
3/0 / TIS+ tk) �y//y//2C77 D^ (r/J� /j
OWNER (� //1.5 '�I ‘,.. ----111-1-J Y-2___ A.P. NO. I7/� �!`� _/^ ��
MAI L BUILDING ' 1 I, '
ADDRESS 3/ o t T/tej I�147 ADDRESS 'CO / /'�F9�(/J� .y 4/
CITY C S� h/ S H. Cti, I/ NTOL.3L/o 9099 O TRACT�JOa LOT y BLOCK
D q C` (l
CONSTRUCTION / NEW ADD. ALTER REPAIR MOVING DEMO!ISH
LENDER L/,/�1
BRANCH OWNERELL/S S /Al/i
ADDRESS I_ 1�
�J /,y� VALUE �—
ARCH ITECT TEL. USE n7,,O cLa,f tC��
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
//
APPROVED 1/)/ /f / yyy
CONTRACTOR Okay 13//¢E� BY /T"� DATE (� 7
ADDRESS T • l nn / ////
TEL. ZON E�� I PLANS / BUILDING e`aUSE OF ✓
CITY NO.
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLDGS. (FROM C/L STR E�JT),j^�•
C. OF LOT NOW ON LOT FRONT 4 7? `�' I.- FT.
Q USE OF / / '
rn., EXISTING BLDG. R.SIDE/J b FT. FT.
V. /
F Separate permits are required for L.SIDE 20
1 FT. FT.
electric,plumbing and heating work. y
W REAR 7s FT. FT.
(..i USE,O,F BUILDINp AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
O377 10 4{a `d' ('a U (Sri v MAIN BLDGS. ACCESS. BLDC-S.
VAR.# DATE
QC.U.P.# // APPROVED 7 r/s
—BAPPROVEDC((JQ bele DATE v' (/ /
II
3'
0 I hereby acknowledge that I have read this application and state n
I, that the above information is correct and agree to comply with m
LL ell laws regulating building construction, and I shall not employ
vZ any person in violation of the workman's compensation laws of
W the State of California. /In1 �s.�{ At
I herebycertifythat I am ✓d[� SO. FT. w
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:
am exempt from the provisions of the State of California Business �� �1 y
VALUATION PERMIT FEE
and Professions Code,Division 3,Chapter $ • (I�'♦r/ 0
m
�p/� �) 1. PLAN CHECK $ m
Signature of y� //�f_ /( o
Permittee C ���'�/ $bIr/f TAX S.
t ��t 2
V V ./C/ U
Authorized Agent TOTAL PAID $ e: d
2i �s� rtt KtUtIVLU
.1 JAN 2 2 1964
t COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O2ioX 91T COSTA MESA.CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING tn�p Way ADDRESS 3101 Taft RECEIPT NO. PERjAIT No� /-
COSTA MESA, CALIFORNIA d"//[/J -
RECEIVED•Y
TE
OWNER Nor thgate Homes /'/r- / P/�/��(J/I/T/ / ..d_ ,/["
BUILDING
' ADDMAILRE98 15939 Las Flores ADDRESS
^
FIRE (/(a/--
CITY 'Penntoin valley NOL5316792 ZONE TYPE GROUP
1�.c+ n APPROVED
ARCHITECT /� Hiller NOIKE52OO/ BY DATE
OR ENGINEER V ,a t
ZONING 1 A
ADDRESS Anaheim _ EDN[/- I No.0u9E oP NEWI - - )'LLS
1` PLANEr �[VILDIN 1
CONTRACTOR Bons-r Const, Inc. ted-IC77LLHOAL
ADDRESS
15939 Las Flores DESCRIPTIONIbs
CITY Fountain Valley A.P.NO.
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIO.Nn. 215049 No 316792 90'TO SIDE ft REAR P.L.
11 EAVES
SIZEOF LOT 1WOR113 I NO.OF SLOGS^ ALLOWED (U.B.C.REQUIREMENT)
NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. 00
!FROM / TREE) SLE
/�
SETBACK LINE PROM .,o .oL S FT:. ��
FRQ
CENTER OP STREET 50 1 REAR YARD FT. ,L.//.
HIDE YARD LEFT 51 I RIGHT 51 R.SIDE. FT.CCMAIN / FT.
DESCRIPTION OF WORK L.SIDE t, FT.
"�%J/�/_ /O Fr,✓ _
NEW E ALTERATION ADDITION REAR ZFT. " y / 8 FT.
DISTANCE BET. BET.MAIN d
REPAIR OVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS.
•
BUILDING y.p.�� 'S Y NQ.OF / VAR.S� DATE
SIZE �L �J r ROOMS /n STORIES 1 C.U.P.* APPROVED
EXTERIOR WAL{, ROOF "`��� APPROV�D�� ,1�I / 'y/
COVERING S tuCCo I COVERING shingle BY IA`it'1 '�W l DATE /� / JV
USE OF BUILDING AND WORK TO BE PERFORMED _C p4
ale Thin res W �F4ft_ gnr C
des /1163 °' ti.2b p'
���9 y N
PrAM NTSQ �J
I HEREBY ACK • .DO� - 8 CTREADD THIS APPLICATION THER EU OTESTABLISHING SHOWN
UNDER VALUATIONERMIFOR i'
AND TH' -OV[ IS COR'STT ANDL AGREE TO COM. PURPOSEIOOF A PERMIT FEE ONLY. O
DU WITH
- N CITY O:� 68 N. STATE LAWS REGULATING 46 ��,�nV
BVILDIN• CONBTRUV VALUATION r $ / V
81GNAT -E O' /9 7�;J ` PERMIT FEE
PERM ITT Alt AIL0 ,I r _O
S 00 P C O
LL
AUTHORIZED AGENT l TOTAL FEE $ C(2^