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Home My WebLink About341 SYDNEY LN - Building Permits1, Applicant to fill � CiTY oF cOS7A MESA CO�V T UCTION �P/E�R�MIT • Project Address ! y L{— � ApplicanYs Mailing Address • �/11�� r�� +/ Owner'sName G Phone,/16oS=V1!'7 Address Arch/Eng. Licenu No. Address — � Contrector's Nam P one �✓ Address (mailing) -} — City License No .�f/� J � LICENSED CONTRALTOR DECLARATION I her¢by affirm that 1 am Ilcensetl untle� provi5ion5 of Chart<r 9(commencing with section ]000) ot Oivision 3 oi the Businezs'antl ProteSslons Cotle, antl my license is in 1 II ce antl eltect. Licenze Class Lic to N. � Da[e $i9nature � WORKERS' COMPENSATION DECl/1RATION � I hereby aifirm that I have a cerHlicate of conunt to self-Insure or a certiflcate l of Workers' CompenSatiOn Insurance, o� a certifiatl Copy thar¢Of ($ection � 3800, Lab. n /( ,/� . Golicy No. � N�� Company 1��no �,A,IA.I�.(iL°. ❑ Certi(ietl coPY iz (letlbwitltrlheh<itY �W�y,��y��sI�J,J /� / �/� Bi�/�{ qp y Date,/�/ "�'6 l2_ Ap0licanl�N �.�UJ.��"' `�' ��— E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectlOn neetl not be Complet¢tl il lhe Oermit IS for one huntlretl (E100) or less). I certity that in the pertormanc¢ 01 the wo�k fo� which thi5 pe�m�t i5 i55uetl, I snall not employ any pe�son in any manner 50 a5 to D¢COme Subjet[ to the Workers' Compensation LawS of California. Date Signature NOTICE: It, afiet making Ni5 tleclaratiOn, you sboul0 become subjecbto the Worke�s' Compensation prOviSiOni OI the Labo� Cotle, you mu5t forthwith comply with Suth provisions o� this permit Shall b¢ tl<¢me0 revoketl. CONSTRUCTION LENDING AGENCV � I hereby afOrm [hat there Is a constructlon lentling agency for ine periormante ot [he work tor which this permi[ is issuetl (Section 309] Civ. CJ Lentler'S Name LRntlar's AtlOress � OWNERBUIL�ER DECLARATION I herCby attirm that 1 dm exempt 1rOm the ContrdCtof'S LlcenS¢ Law f0/ tlle following reason (Section 7031.5 Business antl Professlanal Cotle: Any city or county which �equi�es a permlt to const�uct, alte�, Improve, tl¢molisn o� r¢pair any ztructure, Drior to itz issuanca, also requires the appllcant tor su<h permit t0 file a Slgnetl S[atement that ho/She is Ilcens¢tl pursuan� [o lh¢ PrOvlsion5 of the Con[raclor's License Law (Chap[er 9(commendng with Section 7000) of � _ Oivlsian 3 Of the'8usine55 antl Prote55ion5 Cotle) o� that'It¢/slte IS ex¢Tpt � Merefrom antl the Easis for tha allegetl exemption. Any violallon of SecHon I 7031.5 by any applicant tor a permlt subjecl5 Ihe aOPIIcaN to a civil �endlty oi not more than �ive huntl�etl Co11ar5 ($500). I, as owner of tM1e� propC�ly or my employees with wd9e5 d5 their SOIe compensation, will tlo the work, antl the structure is not Intentletl or offeretl ' for sale (Section J044, Business antl PrOf¢Sslonal Cotle: The Cont�actor'S License �aw tloes not apply to an owner of a properry wno bulltls or Impmves thereon, antl wno tloes zuch work hlmseli/herself or through his or her own emD�oYees, provitletl thaPsuch improvemen[s are no[ in[endetl or otferetl for sdle. It, how¢ver, the builtlin9 or Improvement I55oltl within one y¢ar ot <Om� pletlon, lne owner will have Ne burtlen of oroving hc/she altl not builtl or Im- ��ove for Ihe purpose ot sale). 1, as owner of [he properry, am exUusively con[�acting wi[h IiCenS¢tl COn- t�actors to const�uct the projeC[ ($ection 7044, Business antl PrOfessions Co4e: The Contractor'S License Law does no[ appty t0 an owner ot property who builtls or improves tnereon, antl wM10 conVacts for such projetls with a con- � Vactor�s) iicense pursuant to tM1e Contrac[or's Licensa Law). I am aware that proof of their'Worker's Compensation insurance shoultl bo provitletl to me. ❑ I am exempt untler Section' � B. & P. C. ror this reason Date - Owner I hereby certify that I nave reatl this SDo��ation antl state that the above information is correct. I agree lo comply wilh all cliy antl county ortlinance5 antl state laws relating to builtling construction, antl hereby authorize repre- sentatives o tnis ciry to enter upon the above-manlionetl property for inspec[lon /� �� p Signatur �ate��/�tn �a� ezcepl lhose within heavY Oo�tler lines anE si9n all appropriate TRACT NO. LOT NO. UN1T NO. TVPE OF CONSTRUCTION LJ rvEW lJ AOD LJ a�TEaaTION C� aEaaiR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p# DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi E TVPEOFPERMIT GRADING OUNDATION STRUCTVRAI T Front ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAI 8 Rear ❑ OTHER %� PROJECTDESCRIPTION Sq.FT. oCCVaaNCv C Right K Left CONSTRUCTIONTVPE VALUATION$ $ ZONE GRADING CU.YDS.� ACR[5' p�ng. Hef. # Remarks: Planning Notes: Preventer Irriga[ion Clarifie[s Dishv2sher Drinking Fountains Floor Drains Floor Sinks GasService OuUets ditchen Sink - Lavatories " ?-Trap Roof Orains fleinspaction Fea $15 Boiler Duct - Under Ground Duct - Strucmrel Duct - Ventilating ExheustSystem�O� MWtiple Firepl/Fact Blt. ICBO # Heating System & Ducting ❑0-100,000 BTU �100,000 R ' ct F I� einspe �on ee �rivers' License or 55 � CMF 0865-46, rev. ]0/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenrotl - Assessor $15 ShOw¢rs Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 ' Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee 1 Hood or Type I ❑ Canopy Type II ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration ' Fire Dampers Registers Issue Fae FEES $ 3 $ 3 Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan Fixtures Device Boxes Outlets Switches Garhage Dispoul Generator 00.5 KW 6oie 10/27/B6 ' Zone Accessory Building: Parking Req./Provided ELECTRICAI Transformer � 15�50 KW ❑ SO+KW Meter� �up to 100 amps � Meter ❑over 700 amps Sub Panel Motors �0.1 HP 01:5 � 8 Inc. Solar �9-15 HP �16-15+ Microwave Pole Light � Range Standing $ections 5 KW Tresh Compactor I Reinspection Fee I$15 I I litue Fee DEVELOPMENT SERVICES RE�UIREMENTS: 2onin9 APVroved By �Building Approved By Appliption luued By � 5.0� Tt, FEES $ 3 Z O N 1 N G R E Q M T S . SUMMARV OF FEES , , BUILDING PERMIT $ SMIP � - $ PLAN CHECK $ PERMIT - PLUMBING $ �• p� ISSUANCE $ PLAN CHECK 25% $ ENERG� P.C. $. E�ECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ `� MECHANICAL $ TOTA�FEE $ � � v PLAN CHECK 25% $ � CONSTRUCTION AND PLANNING POOI & SPA APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector 7. Temporary ElectricBl Service or Pole 52. Pool & Equipment Location� ; 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Elect�ical Conduit-Undrgrnd. 55. Electrical Bonding � " 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUf�ITE 7. Footings 58. Electrical Conduit-Undrgrnd;( 8. Foundation 59. Gas Pipe, � Undrgrnd., Tes � 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, �`Undr9rnd. 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 OGas ❑Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas O Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: Gt �_�� n�` ��o,�, �,3 (J�. L� 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 pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � 49.� Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No. Date . �� PflO1ECT AUOPESS: 3 4 1 S YDNEY LN ' uNiT: owxensr+ame: EVERGREEN ASSOCIATES AOUflESS: CIO JIM LOCHER 326 SYDNEY LN (�14A64656{57A 92626 AflCN/ENGINEEH: HEG.NO.: � ADONESS: UN ; � PEHMITTEE: CRANK HROTHERS ( 714 ) 548 55 9 F aooaess: 126 COMMERCIAL WAY � COSTA MESA CA 92627 f— UCENSEO CONTNFCT08 OELLAflAT10N: I hereby allirm ihal I am licensetl under pm n$ ol Chapier 9(commencing with Section 7000� ol Orvision 3 al IAe Business and P�ofessions Co�e, antl my license is in tuli forr� ifecV c�TYuc.:^005993 STPTELIC.:QO8E1%% cuss:C3 �ale: —,L� 2 -S � Signa�ure'. ��T� WUBNEHS' COMPENSOTION OECLABATION: I �ereby a��irm t�at I have a cetlJicate o� consenl to selbinsure or a cetli�icate o� Workers' Compensaiion sy� e.Qj �j�{�y�Q �p�( e ( eciion 380q Lab. ) POLICYNO.: �8�—J�""yl" � E%P.UATE: SIOS�94 comrnxe STATE FUND,5I, ❑ Ce�ihetl copy is hereby IurnisAed. IJ CehilieE copy is IileA wiih I�e ciiy Builtling �ivision. �g n � 4 � �r�� Dale: Y1C' S' S' Applicant: / E%EMPTION FpOM WOBREBS' COMPENSAiION DEQHflATION: (This section neetl na� be campleietl il �he permil is for one �unOreO �3100) or less�. I cerlity Ihal in ihe petlormance o� ihe work for which Ihis permi� is issued. I shall no� employ any Derson in any manner so as b become subjecl to �he Workers' ComDensalion Laws o� Cali�omia. Oaie: Signature: NOTICE: It. afler making Ihis eeclaration. you snould hecome subjeci to ihe workers' Compensation Drovisions oi ihe �abor CoEe. you must forihwith comply wiih such Orovisions or �his permit shall Oe deeme0 revoked. CONSTHUCTION LENOING AGENCY: I here�y a�firm I�at �here is a conSlNction lentling agency for Ihe pertormance ol Ihe work for which I�is permil is issuetl (Sec�ion 3097. Civ. C�. LENOEfl: nooeess: OWNEP BUILOEP OECIAFATION: I here0y aifirm Ihat I am exempt Imm �he ConVac�ors' State license Law �or the following reason (Sec�ion 7037.5 Business and Pmfessional Cotle: Any cily of counry w�ic� requires a permii to consimct, al�er, improve, Oemolish, or re0air any S�mcNre. prior to iis issuance. also repuires the apPlicani for suc� permit to file a signed s�a�emeni ��ai he/she i5licen5e0 pursuanl Io Ihe provisions of Ihe ConVaqors' Sia�e License Law (C�apler 9(commencing wil� Section 7000) o� �ivisian 3 0l the Business an0 Pro�essions Cotle) or Na� helshe is exempt Ihere�mm and �he basis br I�e allegetl exemplion. Hny violaiion oi Section 7031.5 by any applicani far a Dermi� suble��s ��e applicant �o a civil penal�y ot no� more than tive hunAreO Oollars ($500). I, as owner ol ine pmperty or my employees wilh wages as tneir sole compensation, win �o ine work, an0 me ❑ stmcWre is not imenaed or afleretl for sale (Secbon 7044. Business antl Pmfessional Code: The Contractors' Slate License Law Does not apP�Y �o an owner o� a pwperty who �uiltls or impmve5 ihereon, antl who does such woB himself/hersel� or thmugh his or her own employees. providee �hat such impmvemenis are nol in�en0ed or olleretl �or sale. I�, however I�e building or impmvement is soltl wiihin one year of completion. �he owner will have �he burden o� pwving he/sAe tlitl no� �uiltl or impmve lor ihe purpose o� sale). I, as owner oi Ihe propetly, am exclusivelp coniracling with I¢ensetl conlrac�ors �o conslmc� Ihe pmlecl (Seclion 7044, 9usine55 ❑ antl Pmiessions Cotle. The ConVacmrs' Slaie License Law tloes not appty m an owner of Drope�y who bui105 or improves t�ereon and who Conlrat6 �Dr 5ut� pmlecls wiih a COniraC�or(5)license pursuant�a the COntraCiors' Siate License Law),I am aware Ihat pmoi of Neir Worker'S Campensation insurance S�oWa be pmvitletl to me. � I am exem0� under Sec�ion: B. 8 P. C. lor l�is reason'. Daie: Owner I Oo hereby cenily I�at I am aware of and understand Ihe reQuiremenis ol Cab�omia Heallh anU Sa�eiy Code Seclions 25505, 25533, and 25534 and Ihai I or anyluture bwlding occupanlwill/will nal (circle one) need lo comply with saitl state cotles antl�he reQuiremenisfor a peimi� �or cans�mclion or moatlica�ian imm Ihe Air Ouahly Managemenl Di51ric1. Resiaen�ial consimction applications are exemp� irom Nese provi5ion5. Oaie'. ADPhcanP I hereby certAy Ihat I have reatl Ihis application and state ihat Ihe above mformation is mrrect. I aB�¢e lo comply with all city and county ortllnances and s�alelawsrelaiinglo bwltlmg canslmciian antl hereby aN�orixerepresen�a�ives o�ihis ci�yio en�eruponlhe above�men�ionetl pm0eny �or inspection pwposes. ^ �j /J Oale: �— ' — � � Signaiure: /_ /� ✓ —" ��` Driver's License or Social Searily p: i6<La6 Whpe—Buildmg: Green—CoOe En�orcemenL Canary—ApphcanC Pink—Revenue: Goltlenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT ER . PERMIT NO; B 063819 PLAN CHECK NO: N , , CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/O COMPO 6 INSTALL NEW FBGLS COMPO SQ FT; 1,560 CLAIM VALUE: 1,560.00 CALC—VALUE; 1,560.00 GROUP OCC; R-3 /M-1 COMMENTS• SMOKE DETECTORS RE�UIRED PER THE 1991 EDITION OF THE UBC �O � **��r*x�r**�t*�r*x��*�r*�rx�r�e**�r�r�* �r*�t�rx�r�r�rx*�+t**�r�t�t*�t�r�r*�r��r+�**��r�r c*��pvir��F� . Z O N I N G R E U I R E M E N T S ,� C t— '. S E T B A C K S `�� ,ra��RECD ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILD-IIVG � -------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGAT; FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL: 93519014 ZNE; REF NO; PLANNING NtSTES> .� .i iE if ik if k if ik iE i! i! if iF iF iE.jE iFif 1E if iE 1E if it iE ib iF ik iE iE iE it iE if i! it if iE ik iE iE jE iE iE if iE iE iF iE iE iFiF iF if if it if itiE it it iE if it iE iFiE iE k Il� i! if 1E itiEjf iF iEik it D E V E.L O P M E N T S E R V I C E S R E Q U I R E M E N'T S 20NING APPROVED BY DATE: � BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY; DATE• � iFiEif�FiliF�EiE�lifiEiFiliFiEiEftitifki!!E 1E1fiFlPik�k7EifiEiE �Eif �fiEiE�fik�E�F�E�IF�k�fiE�liF�f�EiEiEkiEiElElfiEilitiflFif�E�E3f�fifif�fifiFiFififiFiFiEiEiEiE�E FiElEiFifiEiFiPifiEif3FikiliEiliE�%�1FlFiffFiEil�f�lE�FiEfFiE LEGALIZATION:N i F E E S U M M A R Y STRUCTURAL SEGMENT;Y / BLDG PMT LUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 37;00 ,50 SMIP/NON—RES PLAN ISSUE EEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 37,50 0.00 0.00 37.50 37,50 ,00 —> COLLECTED; 37.50 OVER/SHORT: ,00 ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK .5� iE �E iE if if iF it if,i� iF 1E if if iF 3F iF if iE 1E iE i! iEiE iF 1E iF ik iE iF iE �E iF 3F�f if if iE iE �l�E iF�E �E 1E iE iE if iF iF iFit iE iE �lif iE iE if iE iF 3t 1F 1k 1E �E iE �E�t iE k ik if iE iE if 3k iE iE if � I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1560 REROOF BY VALUE RESIDENTIAL N020NE 1.00 1,560,00 END OF FEES i�i D�?iio.'i4�—QOIL•S'=�? -i-i iT J'7.5� QAI�: p4l0"s/93 TT(1E: 1�:ua s CONSTRUi. i iON'AND PLANNING APPROVALS Permit # 1. 7emporary Electricai Service or Poie 2. Soil Pipe-Undrgrnd. 3. Electricai Conduit Utdity•Undrgrnd. 4. Electrical Conduit-Undrgmd. � -5. Steei Reinforcemer.t 6. Eiectncai UFER-Grnd �7. Footings , 9. Water Pipe�Undrgrnd, 1U, Struetural Flow SysTem 11. Property Sewer Lina & House Conaection 12. Sewer Cap _ ' 73. Root Dra�ns 14. Rough Plumbing � 15. Rough Electricai-Condwt � i6. Rough Elettnc Wiring 77. Rough �Ninng Sign 18. Rough Electrical-T Bar Ceiimg 79. Roueh Heat�ng & Air Conditiomng k 20:'Ro�9h Factory Fir�piace � �� ' � 7 � 21. Ducts, in Structure i�.. .. � i 22. Dueis.l%en:ihtin�" � ' i i L � 23 .Gas�?iFe�Rough & Yest � „ i i .. � 24. Roof Framing . � � �• 25. Rapt Sheathing � � '`� 26. T-Bar Ceding (Structurall & Monocoat 27. Frameand Flashing � � 28. �thing & Sitling - ' . r. �. " 29. insufation .. ' �� . 30. D�ytivall iVai:inq '- , 3L Plaster Bro�vn Co�t � ,. � r�--r-- 32: Electricai Power Metei-Final 33:'Pirla� E�ectnc - . . 34. Fi�i Heating & A�t Cor.,iitioni�g � .�i , 35:,Final Gas Pi�e�Tes[ „ 36. Nood or Canopy • � 37. Finai Factory Fireplace � . - . �- .38. Finai Plombing 39. 4Vater Servicc�-Finai � 40. Gas Service-Final � 41. Solar pomestic-�inal 42�Backfiow Preventer ' 43. Backflow �rrigation - 44. Landsqave Irrigaiiona;Vster' ��. 45, Sound Attenuatior 3 ` �•ti 46. Hardicap Fiegul�fir•^�.: t^r r� l � 47. FIIYALSTf�UCTI�Tc?813UILOING � 48. FINA�PLANNINCi •�=.� 49. Eiectric Release to �Eiiiq'�.T CS 50. Gas Release to S6utrie�ijCalrfornia Gas Cr 51. CERTIFICATE QF-i?dCl1PAhCY Oate Date POOL & SPA Inspector qppROVALS Permit # 52. Poo! & Equipment Locat�on 53. Steel Reinforcement 54. Forms 55. ElecYrical Bondmg 56. Rough Plumbing & Pressu: e Test � 57. APPROVA! 70 COVER-GUNiTL 58. Electricai Conduit�Undrgrnd, � 59. Gas P�pe, � Undrgrnd., Test 60. Backtivash Lines, PTrap, L: Ur.ti�g�nd 61. APPROVAL TO UECK 62. 6ackwash & ReceGtor-Final 63. Heaier & VenbFina� 64. Plumbing System � Fina! 65, Electrical�Final 66. Solar SYs.em��inai 67. Fencing & Acr:�ss Approvai 68. APPROVED FOR P�P.STERING 69. P00�/SPASYSTEM5FINAL FIRE DEPT. REQUIREM[NT - �. ,. , � ,:' ' 'APPROVALS, ' ,'N� mit -". �`T T^T. .' . �. � . . -- • . , � � ; �l� 70. �UndergrC�lnm Flpd,o - �' -'"' 71. Product �tPing I 5 C�aS '��,.Oil � r-t� 72. UndergrG�lnd Flus� .i` � i • ,�--;_�_4-,:-.�;, . . '.��'. �,_7T Undergrnd. Stni ayc Tank� � Gas_ ��i:i �� 74. Overhea�l� F{ycJro � 75, Qry Chemical � . , .� . 76. �Dry Standpip=. J 77: FIXED SYSTECI;�FINA� L� � . 78. FIRE PREV. FI!VAL � � HEALTH DEPT.'REQU�REN 7j: FINAL I,.'�iSPECTI(;N � ' _ � �I �80. FOOD CERTIFICqI'E I�SUED '"�t� . � i --= � , . -- _L_� NPtes _---- _ Date I Inspecmr ! � IOWNER B�ALiS & PIGNERI � AP No.115-220- \, INSPECTIONS V'SOIL c�s WATER ` 'i ROUGH PLUMBIN �PROP. SWR. LINE � \\SPRINKIING SYSTEM �MISCELLANEOU$ � ROUGH ME�TING �ND �TEMPOR�NV SERVICE n UN�ERGROUND � ` FOUCH WIRIHG �TRENCHES FON! FLOOR SVSTEM BOND BE�M ❑ �5' SXEATMING LOT AIR CONDITIONING' FRAME AND FLASHING LATNING — IN OUT PLASTER. BROWN CORT ST FINAI DATE 3-1-77 BUILDING PERMIT N0. { Res/w/att. VALUES 29.185.00 SUBCONTRACTOR a ., - �' _. .4�3�5 COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUIIDING ['� _ F C {i] a ¢ y � S F C � F Q G :� 6 � r .� � w o. � � L Z W x 3 OWNER Ralalia Rr PicnPri MAIL y ADORESS B TEL. CITV T�T....,.�.....+ 4......A N0.4 R ESS TEL. ADORESS CONTRACTOR •? ADORESS TEI. CITY NO � STATE CITY LIC. NO. 9 LIC. NO. fi8� SIZE NO.OF BLDGS OF LOT NOW ON LOT USE OF EXISfING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED �� /�S��y �3�;a.n-7��y0� 8t��, k,:::��;';.5�! APPLICATION FOR STRUCTURAL PERMIT A.P. NO{ I �%^r�� ( BUILDING ��/ � ADDRESS TRACT APPqOV !— _oT� NS YARDS APPROV E MAIN BUILDIN[ 1 hereby acknowledpe ihat I heve �ead Shts epplicaHon antl state that She ebove Intormetlon Is carrect antl apree to comply with ell laws regulating builtlinq conSTruction, antl I shell not amploy any person in vlolatlon ot the workman'a compensatlon laws ot the State of Californle. r I hereby certity that I am propar�V licensatl es n contractor untler /� J� SQ. F the State of Californle eusiness entl Professions Cotla, Division 3, THE AMOUNT Chepter 9, and that such licanses are in tull torce and etfact, or I THE PVRPOSE C am exempt from the provislona ot the State ot Colifornia Business VALUATION antl Profess7ons Code, Dlvlaion'3, Chapter 9. Sipnature of � � • Parmlttee $ �� /p/ Q .l Authorized Agent 1 BLOCK USE OF W 8UIL0 VARDS APPRO BET. MAIN & _ " n m i v I N /N UNDER VALUATION IS FOR m ABLISHING A PERMR FEE ONLV: � PERMIT FEE S a uf n PLAN CHECK $ /3 � e� (� LL TAX $ � O � U TOTAL PAID 3 6�! � F � W 0. Q � h z F f �.:,=� ,�^ _�-�r�.,_ 00 cu<; �-.=�:127.;,r, COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERM[T For Applicant ro Fill in Completely — Use Ink Only RECEIVEDBV DATERECEIVED DATEISSUED BVIIDING ADDRESS • PEFMIT NO. OWNER A.P. NO. MAIL BUILDING �� ADDRESS ADDfiESS TEL. TRACT LOT BLOCK CITY NO. CONSTRUC7ION W ADD AL P LENDER / BRANCH � OWNER ADDRESS VALUE ARCHITECT TEL 5 $ �— OR ENGINEER N FIRE ADORESS 20NE TVPE GROUP APPROVED CONTRACTOR BV DATE ADDRESS TEI. ZONE NO.OF USE OF NEW CITV NO. P�� BUILDING STATE CITV YAR�SAPPROVED YARDSAPPROVED IIC. NO. LIC. NO. MAIN BUILOING ACCESSORY BUILDING SIZE ' NO.OFBLDGS. (FROMC/LSTREET) OF LOT NOW ON LOT RONT FT. FT. VSE OF EXISTING BLDG. S FT Separa[e permits are required for L SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUIIDING ANO WORK TO BE PERFORMED DISiANCE BET. BET. MAIN & MAIN BL i. ACCFSS. BLDGS. VAR.# OATE C.U.P.# APPROVED APPROVED I hereby acknowled8e that I have reatl this application and stete thai the above informetion is corract an� agree to comply with ell laws repuleiing bulltling conrtruction, antl I shall not ¢mploy ony person in violailon of Me workman's compensation laws of the State of Californle. I hereby certity t�et I em properly Itcansatl as a coniractor �ntler SQ. FT. the Stata of Calitornia Businets and Profassions Code, Oivision 3, THE AMOUNT SHOWN UNDER VAIUATION IS FOR Cheptar 9, entl that such Iicanses are in fuil farce antl effect, or I THE PUFP06E OF ESTABLISHING A PERMIT FEE ONLV: am exempt from the provisions of the Stete of Celifornia Business VALUATION PERMIT FEE and Protasslons Cotla, Dlvision 3, Chapter 9. $ •� � PLAN CHECK S Sipnat�re of Permittee 5� TAX E AuthorizodABa�t TOTALPAID S �aD N n m > : m J m e � m m o I LL f i�U