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HomeMy WebLinkAbout1813 VIOLA PL - Building Permits • ay' CITY OF COSTA MESA BUILDING DIVISION f i �I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER o PERMIT E03-00276 Raise : • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1813 VIOLA PL Status: ISSUED Suite No A Applied: 04/15/2003 Vicinity: UNIT A Issued: 04/15/2003 Parcel Nunmber: 42424119 Applicant: MICHAEL DINKEL SEELEY ISSUED BY: Address: 1 EASTMONT Phone: 949-651-6422 IRVINE,CA Zip: 92604 • Owner: STRETTON, JUANITA Address 1813 VIOLA PL#C - Phone: COSTA MESA,CA Zip: 92627-2725 Contractor: MICHAEL DINKEL SEELEY Address: 1.EASTMONT /� Phone: 949-651-6422 • IRVINE,CA 1a. I I •" Zip:-92864- ' License: 449910 • • • SCOPE OF PERMIT RELOCATE 100 AMP SERVICE FOR UNIT A. - - - - • 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 Res.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 $0.00 0 . . . . - ' .. 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 $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 . 0 Service to 200a- '$30.50 1 Misc.Conduit $0.00 0 • Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 . Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 - 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 • Other Electrical Fee , $0.00 Motors over 100hp $0.00 0 " 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 Reinspection Fee " $0.00 • 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)754-5626 2446-46(6/00) • t 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 ins rance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensa'on In urance carrier a *di ber are: Carrier: ! s IA& . Policy Number: (This section need not be complete•if the permit s valued at one hundred dollars($100)or less.) rtify that in the performance of the work for which this p,rmit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California n//tlpp999gree J�0{11mme I show •atom: subject to the workers'compensation provisions of Section 700 of the Labor Code,I shall forthwith comply with these pr��.Ly2%�/ / r r ( a"b Applicant Signature: -0-� // Date: ((- WARNING:FAILURETOSECUR ORKERS'COMPENSATION COVERAGE IS I NLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OVIL FINES UP TO ONE HUNDRED THOUSAND DOI I ARE($100,0J0),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of n hSection 7000)of Division 3 of the Business and Prole ions Code,rlLJ€')ty license is in lull force and effect.Lic.# Class# Contractor's Signature: )_////���9y e Date: 41 i Q �) CONSTRUCTION LENDING AGENCY: V ❑ 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. 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: ❑ 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,Sac. 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: I 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? ❑Yes 0 No '• m. (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). 4 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 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 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 ❑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 Califomia 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 a plication akermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U 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 0 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-described1�`beproperty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. f L wn 1/l� Or Authorize Applican 13 Date CODE 0 INSPECTION TYPE gag 1NTITIAL$ CODE! INSPECTION TYPE DATE Its 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 2081Final Plumbing L _� 200 Final Re-Roof 210 Final Electrical ,:/i' o ��� 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 0CITY OF COSTA MESA 4 BUILDING DIVISION > �� �' ,� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER to I !f PERMIT Ay-4008 riio ' B03-00789 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1813 VIOLA PL Status: ISSUED Suite: A Applied: 05/08/2003 Vicinity: APT BLDG WITH UNITS A AND C Issued: 05/08/2003 Parcel Number: 42424119 Zoning: Applicant: PELLICIO, JEFFREY ISSUED BY: Address: 1653 SUPERIOR AVE • Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 Owner: STRETTON, JUANITA Address 1813 VIOLA PL#C Phone: COSTA MESA,CA Zip: 92627-2725 Contractor LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AVE Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 License:, 349686 Arch : , Eng: Address: - Address: Phone: • Phone: • 'Zip: License: License: SCOPE OF PERMIT_ REROOF APT BLDG WITH UNITS A&C:T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 30#FELT,APPLY"20- YEAR COMP SHINGLES."15 SQUARES " - - • FEE SUMMARY Plan Check: $0.00 - • . Calc Valuation: • $2,500.00 Permit: $83.25 - Claim Valuation: $2,500.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 • Total: $83.75 PLANNING &ZONING SETBACKS • MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-,0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 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 it 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)754-5626 2446-46(6/00) DECLARATIONS C.-) U ' 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. AIhave 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 w�g,(k-/g�rs'co'^mpensatl n Inmos-urr nce carrier and policy number are: Carrier: L'/ "'fc compensation Insurance Policy Number:N.?)9( -02)O3 (This section need not be Completed if the permit is valued at one hundred dollars($100)or less.) t O 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 C 'fami I ree that If I should become subject to the workers'compensation provisions of Section 3J 00 of he Labor Code,I shall forthwith comply with these pray' a --, ///�r7/1o/( Applicant Signature: iii Date: " �7 Y 3 WARNING:FAILURE TO• WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(- rr:rr),IN ADDITION 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 Iii nsa rprovisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lic.i\ Class# Contractor's Signature: • /y � /1,1,Lt Date: 4 v 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. 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(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec. 341,Title B,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: I 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 et 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 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 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 0 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? Li Yes 0 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 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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.JI agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si, r�Cil Ls w/ler(s) //T a //// / . . A Jr /VV lir •ndiir u"0 zed-Applicant - Date CODE# 1NSP ON TYPE PAIS INTITIALS CODE6 INSPECTION TYPE - 12l1IE INTIMLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof —c.:1'i 3 � 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 h '' CITY OF COSTA MESA 4� q BUILDING DIVISION F ' 'I • DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER It Pig' : - PERMIT ikly•in Rar so 14fr 603-00799 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1813 VIOLA PL Status: ISSUED Suite: D Applied: 05/08/2003 Vicinity: APT BLDG D Issued: 05/08/2003 Parcel Number: 42424119 • Zoning: der Applicant: PELLICIO, JEFFREY ISSUED BY: aLi Address: 1653 SUPERIOR AVE / Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 Owner: STRETTON, JUANITA Address 1813 VIOLA PL#C Phone: COSTA MESA,CA Zip: 92627-2725 .. . Contractor LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AVE - Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 License: 349686 Arch : - Eng: , .Address: , Address: ' Phone: - Phone: Zip: License: License: SCOPE OF PERMIT . REROOF BLDG WITH APT D:T/O COMP ROOF,REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 30#FELT,APPLY'20-YEAR COMP SHINGLES." 15 SQUARES - -" . . - • - - FEE SUMMARY „ Plan Check: $0.00 . : - Calc Valuation: , $2,500.00 Permit: $83.25 . Claim Valuation: $2,500.90 SMIP Res: . $0.50 SMIP Corn: $0.00 ' Other: $0.00 • Inspection: $0.00 Total: $83.75 , PLANNING &ZONING SETBACKS MAIN STRUCTURE Front .0-0 Rear 0-0 ' Left 0-0 Right 0-0 ACCESSORY Front . 0-0 Rear 0-0 Left 0-0 Right 0-0 , PARKING Existinq: 0 Required: 0 Proposed: 0 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)754-5626 2446-46(6/OO) DECLARATIONS _./ ) 4? 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. 1 have and will maintain works compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 'My worker m cation surance ca er and policy number are: Carder: On Policy Number: ot/Q R goof (This section ne not comp eted if the permit is.valued at one hundred dollars($100)or less.) ❑ I certify that in the parlor•trice of the work for which this permit is issued,I shell not employ any person in any manner so as to become subject to the workers' compensation laws of C. ornia, age at if I should become subject to the workers'compensation provisions of Section 37r of a Labor Code,I shall forthwith comply with these pr. /- . i /J Applicant Signature: ) �A, Date: • J e2r3 WARNING:FAILURE TO' E WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IET 5 ANGLIVIL FINES UP TO ONE HUNDRED THOUSAND DOI I ARB(S r .•),IN ADDITION 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 lice ed r._ p •v'.ions of Chapter 9(commencing with Section 7000)of Division 3 of the Business Processions Code,and my license is in lull force and effect.LW.a _ a i 44F I / I Class NT Contractor's Signature: %La#Z - Dale: 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: 1 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 end 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.). ❑ 1 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: ❑ 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? 0 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 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 j�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? 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 aEEermit tor such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LJ No (Section 65850.2 of the Califomia 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 0 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 Califomia 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. /at :tures :gaiOwner(s) at or -Aro •r .u prized App icant 1 ' ✓ •' Dd{e v CODE I . '. tl•. s'. PAIF INTITIAL4 CODE I INSPECTION TTP€ Offil IN1mALs • 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof Sc/4—03 210 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 %5 ' FY CITY OF COSTA MESA 4 BUILDING DIVISION . •f , DEVELOPMENT SERVICES DEPARTMENT PERMITNUMBER 1- r iwri.�a 1 e - PERMIT 02-00393 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA,CA 92626 PLUMBING PERMIT . . Job Address: 1813 VIOLA PL Status: ISSUED Suite No A Applied: 06/21/2002 Issued: 06/21/2002 Vicinity: _ . , ' Parcel Nunmber: 42424119 ISSUED BY: Applicant: MCCOLLISTER, ELISE Address: 12922 HARBOR BL Phone: 714-530-7320 ,GARDEN GROVE,CA Zip: 92840 Owner: STRETTON, JACK W Address 1813 VIOLA PL#C Phone: ' COSTA MESA,CA Zip: 92627 ' Contractor: EMPIRE PLUMBING Address: 12922 HARBOR BL Phone: 714-530-7320 GARDEN GROVE,CA Zip: 92840 License: 794154 Arch / Eng : • Address: " Phone: Zip: ' License: SCOPE OF PERMIT REPLACE THE MAIN SEWER LINE FROM METER INTO THE BATHROOM. FEE SUMMARY AMT QTY AMT QTY . AMT QTY ISSUE FEE . $23.50 Laundry Tub/Washer $0.00 0 Sump Pump " $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 ., Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 , Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 , Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) " $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $24.65 1 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service - $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $48.15 • COMMENTS/SPECIAL CONDITIONS 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)754-5626 244648(WOO) I n. DECLARATIONS 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,es provided for by section 3700 of the Labor Code,for the performance of the N7!/work for which this permit is issued. —Nave 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 wor�compensation Insurance carrier and poll number CCamer: ? rr,IB�tx swa, 'Ce CO oT N� P n'('hi�lD97 JY (Thi ss (This 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 alifornia,a gr e at if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these.�./f.ns. / /+ n e � ,1 (0 ""21-02-- (Date:. ,, �'7/_O Z �pp6dant Signature: - ` �EJ""' 'Date: . V! G WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOtURE(5100,000),IN ADDMON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: jereby.affirm-that4.an1 licensed under ro�v{{Bions of Chapter 9(commencing with Section 7000)of Division 3 of the Businessand Professions Code,and my,license is in full _force•and•effect Lfcr '1-1151-1 e?s_. ---s G107 C Zo C 3 G., C.c- a, }I1 a. -Contractors-Slgnature:1. VON"-1770- ,m/fweOa[[ e:-----,.�p-2/-C (-- CONSTRUCTION LENDING AGENCY: o 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers 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: ❑ 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). 0 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: I 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 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 ❑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? 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 a permit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency'? Yes L-1 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 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. 9// '- ( bAp 7f e.�; ADDRESS of BUILISNfi 1813 VIOLA PL a"T ® CITY OF COSTA MESA — BUILDING PERMIT OWNER'S NAME IF KNOWN: STRETTON, JACK W PERM NO: H 083160 ADDRESS: STRETTONJUANITA C 1813 VIOLA PL #C PERMIT NO: B 083160 PLAN CHECK NO: 02169-97 L GOVT: N SUPP: N COSTA MESA,CA 92627 '" L.MMUNDACORESS : CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: CON ARCHITECT ORENGNEER: UC NO.: JOB DESCRIPTION : COMET. 150 ' SHARED BLOCK WALL SQ FT; 150 SACK OR ENG'S ADDRESS: UMT: CLAIM VALUE: 1 , 800 . 00 CALC—VALUE: 3, 000 .00 GROUP OCC: R-3 / cONmADTDIrsNAIt R R MASONRY CONTRACTOR ( 714 ) 879-473 2 CQNNACTORS MARINO 1221 N. RODDY DR COMMENTS: BETWEEN 1813 & 1817 VIOLA PL ADDREss: LA HABRA CA uc.No.: 532291 **>E*****ateEaa*Nr***************ar**+(+t*aE********+E******atst**********x*iEatst****at** **at* 90631 u"T: Z ON I NG REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I an licensed under provisions of Chapter 9 SETBACK S (commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. CITY LIC.NO.: L1C.CLASS: C-29 uc.NO.: 532291 EXP : MAIN BUILDING ACCESSORY BUILDING �' Contractor: l!ldC#4 FRNT: FT IN REAR; FT IN FRNT: 30 FT IN REAR: FT 1 IN 1 oats: �— I1 �1 LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN I OWN R BUILDER DECLARATION:I hereby affirm under penalty of perjury Chet I am exempt IM Contmd«°License Law 1«the I mg rococo(Section 7031.5 Business and Professions Code:Any cky or courts Wild,requires a pent to construct,alter,improve, -). nolah,orraperanystructure.priortoIsissuance,alsorequirestheapplicantforsuchpennttoeleasignedstatementthatheorshe PARKING REQ: PROV: PARCEL: 42424119 ZNE: R2—H REF NO; . M1nasedpursuanttothewovisionadteContractorslicenseLaw[Chapter9(commencingsdthSection7000)ofDNiion3oflb PLANNING NOTES> 150 LF OF 6 ' HIGH BLOCK WALL ON RIGHT SIDE P/L (PARTY WALL .:Osiness and Professions Coda]or that he or sheer exempt therefrom and the basis for the alleged exemption.Any vitiation d Section > AGMT WITH 1817 VIOLA PL) OF EX . MULTI—FAMILY RESIDENCE, 1031.5 by any applicant for a permit subjects theeppliief to a°Nilpenelryd not more then Ore hundred dollarsiS500]). ***************************************************** ************************ ❑ h as owner of the properly or my employees with wages es their sole compensation,will do the work,end the structure is not intends D E V E L O P MEN N T SERVICES R V I C E S R E Q U I R E M E N T S or offered for sale(Section 7044.Easiness and Professions Code:The Contractors License Law does not apply loan owner of properly Q who bolds or improves thereon,end who does such-work himself or herself or through his or her own employees.provided that such improvements are not intended or offered for salsi.if.however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY 49 DATE: _____‘,.....tg— owner-builder will have the burden of proving he or she did not build or improve for the purpose of ale). ❑ I,as owner of the properly,em exclusively contracting with licensed contractors to construct the project(Section 7044.Business and Profeaoiona Cade:The Contradors Lin a Law does not apply to an owner of properly who bukds or improves thereon and who BUILDING APPROVED BY :_ (7P4' DATE: 71 contracts for such prgeds with a cahnador(s)licensed pursuant to the Contractors License Law). /p ❑ I am exempt under Section: B.'&P.C.,for this reason: APPLICATION ISSUED BY: Y DATE: Date: Owner *******************************************************************dF*********** Idonerebyoerwydwlamawaetierd eeratadthe requiremerwticatlfomaHWhed LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y Sdny Code Sections 25505,25533.end 25534,and That I or any future building occupant will I will not(circle one)need to comply will said state codes and the requirements for 'I a permit lamuvuctionor modification on Ilse Air Quality Management District.Residential construction applications are exempt lmnthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE'/ SMIP/RES GRADING provisions. PERMIT 74 . 75 L . 50 Date: Applicant: r SM I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN 4859 ❑ l have and wwillmmaintainc a certificate of consent self-insure for workers'compenation.as prthe provided tor by Section 3700 ol Labor ISSUE FEE Code,for thepedowhich BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL d PAID DUE ❑ lhave and wil maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance oo/the TOTALS 75 . 25 0 .00 48 . 59 123 . 84 123 . 84 . 00 work for what this permit is issued.My workers'compensation insurance crier and policy number are: l Carder REVENUE DIVISION TOTALS--> COLLECTED: 123 , 84 OVER/SHORT : .00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT'1 GRADING PLAN—CHECK section need not be completed r the perm*re her•one hundred dollars MOW or len.) 6e: 74 , 75 . 5 0% 48 . 59 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 es to become eubied to he"edema'compensationif« leas el Cenie,and agree that if I etecsuthe ould bome •'-- to wOrke1e. *****************************************1(*************K*****************#If*-IE** � mpensalion provisions of Section 3700 of the Labor Cede.I sh. with•• ply with .r- provisions. 4-it— 77 APpl amL graft •ra ,.......di i IND IV IDUAL FEE B R E A K D �_W N Warning:Failure to secure workers ComlPw4aion coverage la unlit I,and shall Curb t an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT 'COST TOTAL COST clvll fines up to one hundred thousand dollars(5100.000),M addition to the cost of compensation,damages as provided for Its section 3106 oh the Labor Code,Interest,and anornay'afees. SFR 150 RES—CONCRETE BLOCK WALL / FT. 20;. 00 3 , 000 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES ..i performance of the work for which this permk is issued(Section 3097,Cit C). • LENDER'S NAME: e LENDER'S ADDRESS: I certify that I have read this application end state that the above information is coned.l agree to comply with al city and county ordinances EXPIRED ' rr and state less relaing to building construction ed hereby authorize representatives of Ihs city to enter upon the above-mentioned propend i1 LrV `1 !r for inspection purposes. �j , ROBERT RUBESHAW 1� U 86-04-1957/88:34 AFa/x123.84 Print • 0/ DATE I I , RCN:J:51-341/EN •i./ sTtt .. _ Date: o'y �� PERMIT: 083160 rent .of Owner/AgenVAp•' . *or (5151 sS.WP) WhaeBuilding A Safety:Green-Ale: anary-Appfic°nl:Pink-Revenue:Goldenrod-Assessor - POO SPA CO TRUCTION AND PLANNING - � - . API tOVALS Permit# ' 1 Date Inspector - APPROVALS Permit Date Inspector • 1. 4.0porary Electrical Service or Pole . 52: Pool & Equipment Location l. , 2. Soil Plte•Undrgrnd. - ' 53. Steel Reinforcement - - ; 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms - r 4. Electrical Conduit-Undrgrnd. -• 55. Electrical Bonding , '. 5. Steel Reinforcement 6-1.17 1p w`,� 56. Rough Plumbing & Pressure Test . i 6. Electrical UFER Grnd. 57. APPROVAL TO COVER"GUNITE 7. Footings 6-5"--17 `pg,-40-. 58. Electrical Conduit-Undrgrnd. , 8. Foundation 59. Gas Pipe,.0 Undrgrnd.,Test '.� 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. l 10. Structural Floor System _•, - • - 61. APPROVAL-TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final•; " ' 12. Sewer Cap 1 63; Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final , • 14. Rough Plumbing - • 65. Electrical-Final 4 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring67. Fencing & Access Approval - 17. Rough Wiring Sign • . 68. APPROVED FOR PLASTERING 18. Rough Electrical-7 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 0 Gas 0 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: •°^ ec 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test , 36. Hood or Canopy - 37. Final Factory Fireplace °d • 38. Final Plumbing -.,. 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 6=Q?1 7 - 0A- 44. Landscape Irrigation System ^ y ,' / 4�� 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison #1 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date • PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this _7)-tel day of �Gte , /997 , by and between &7:7)/ 6-2E ✓c?/ hereinafter referred to as "LANDOWNER," and (1c7kAl tStge traz ' • hereinafter referred to as "ADJACENT PROPERTY OWNER" It is hereby agreed that a party/wall will bee constructed on the property line between _, Iicri_f!� (Address of Adjoining Properties) /177 he. , eafte frefso in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER ADJACENT PROPERTY o NER � r r (-i9nature),J, (Si. re) er ��G� t.e 2Mj Name or Printed) Nam y e or Print 8 d) it/7 $Ca / aa t b FL c s (Address) ( d res NOTARIZATION REQUIRED ,90646 TYPICAL 611 CONCRETE BLOCK FENCE Cement Caping Optional I -- - -i ' GENERAL- NOTES Channel Block With 1-3/80 II ',• Horizontal Top of all r Fences f 1 MORTAR; One Part Plastic Cement, and 1 Three Parts Sand For Fences 5'or Less fat f - GROUT: One Part Cement Three and Vert.Bars 3/8"¢at 4' -0"O.C. id! o One Holf Parts Stand e: = COPING: One Part Cement, Three For Fences Higher Than 5' •, w 'i '-, �. Parts Sand Vert. Bars 3/8"0 at 32" O.C. a w CONCRETE: well Mixed 1:2-1/2: 3-1/2 c r Max. of 7- 1/2 Gallons of Fill Cells Solid With Grout Si� > z '." ,�-' Water Per Sack of Cement Where Steel Occurs > — - - --- al. yr Reinforcing Steel Shall f � �� - GROUT MAYBE POURED FROM THE TOP l OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15-39 w o -- - ■ OCCURS. A.S.T.M. ll Z •- —I—�1 11�t CELLSANDAREASOFHORIZONTALREIN- All Steel to be Lapped LL FREE OF T SHALL BE CLEAR,CLEAN& 24"or to Code �� �' ` �. FREE OF ALL MORTAR DEBRIS,ETC. MI NATURAL GRADE v �'� v `V I •. 'I �4,w�� ..iii: f7 / •/ .� TWO 3/8"¢BARS 'n� t. . r . e . . . . • • En • .. . CONTINUOUS TOP &BOTTOM • -..-1 WIDTH - TO 16' O.C. MAX. • SEE CHART ♦ �. • ROMI2.STEEL MUST BE TIED IN BELOW • DEPTH CF E ARTHTCOTH PLACE AT TIME OF TRENCH `�"'� . r I/3 THE HEIGTH OF FENCE INSPECTION. T57.- . I""` ►. " '- .�, 0 BOTTO 9.fbs 10-r1NG• . cl /P+ ? t , % : SCAL`E;-11.2" e �M ' - ter-.-. -1-, . FOOTING REQUIREMENT S_CHART -i--1: -. • WALL HEIGHT 6 ' 5 I :-.11141-1c: -.., - . 4 .. 7! r"-I. -.., WIDTH . . 14" 147 "`'c•- ' 12" . :.- . _..r-:T�l2.. r THICKNESS , . . . . .10'. . . . . . . . . . . 10'f ---._._ • 8' ._,:-.--..87_1__� DEPTH OF EARTHTOOTH . . 24" . . . . 207 . . 16 -.-, `-t:q'2 SPACING OF EARTHTOOTH. . 12' 141 • • t-706:, ' ---66 1".7I ..,r 6 City of Costa Mesa, California ID'```s° s °�`. - Building Department 1•ZMW c NOV.82. s 1 /s _ • 6 ' / fie. �� APPROVED SAFETY CITY OF COSTA MESA DtVISt�TM O cLok DESA PLANNING DIV. EDSUBJECT T0. BLDG. DEPT. EG. APP�ry�-'/ :� >bnesDAT_E BY -- / Bq ect'ca UST be kept on th lobm �� Yn tions M Mesa 1 laps and sP changes or atte;alion oo�o Gita .47- p s,/Q�� / set o P of to mal;e anY and Safety,GIt' npld to P Mot N it is unlia t0 Ol tan a ct Buildm9 NOT be U;wn iUcauons SHFiI Gpy of Gosm perm" Pro/00M of anY of this Plan and sl>� of ons p �� The stamPin9 l of tha violation Deeome nett acid�� N O T E a 10 a aPPi sot State law. Mesa d ermdp exDjte by fwd mantamed active Pm UBG 4 ADDITIONS, DELETIONS, OR CORRECTIONS SHALL . masaD3�o'Wo is not COmmenced' BE APPROVED BY THE PLANNING DIVISION tholebmW>� da sol ss ' 30311 Wit%I 180 Y • • • b • [ o[ C[RESIDENCE I- RESIDENCE tw RESIDENCE u► le Ct I in j , I � ♦ I ►W (3(3 to 57. v/Ga kaI- N .00/7/7 I V I D L�— STREET _ CITY OF COSTA MESA PLANNINC -PARTMENT �A-� J }40.00 nF, _ �_7�[•i5:�d 265 V'.rird rk A.P. No. 116-092-06 l Bldg. Permit No. ✓.~t 4/.SY PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 1813 Vinla P1arP, rosta Mesa, Calif. Owner's Name Eugene Urschel Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = $40.00 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Number of Dwelling Units 1 Total Fee 40.00 Planning Department Approval Date 4-7-79 Park Area No. , ByW.L.D. RDB Applicant's Signature C�G(�fiii -c 2���G<�i ,� CITY OF COSTA MESA PLANNING APARTMENT PAID PR -7-72 -- 265 **t* A.P. No. �j« ./nn rte Cala�� Ro 40.00 Bldg. Permit No. -312/ SYJ PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 1r.1 .. .. .1% r • '.t.; ... J�r ':St.. ' 11 ; . Owner's Name Fnnnnn Yb•,;,.:...1 Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units @ $40.00 = 4. .,) 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Number of Dwelling Units j Total Fee lqu.06 Planning Department Approval Date A / Park Area No. Byf.L. R:1 Applicant's Signature - �� ji 1 * CITY OF "A MESA PAR.- .ZES Fee Payment Receipt1\1212 0 4 3 Project Address IS l3 NI 1 OLA cps-- • - Park Area / A. P. No. IE (o — 0q2.—OGS Building Permit No. 38SSs 1 Owner's Name CCS IS-E13C--- OTC-SCA-Mt— Mailing C-SCC-Mt-- Mailing Address I iF l3 V 1_0 t_A Rt_ FEE Single-Family * No. of Units @ $338.27 = Multiple Family ** No. of Units / @ $238.78 = 238.78 Total Fee 238,78 — P, Planning Department Approval Date -�-7� Ci L By r' Applicant's Signature - - GO * City Ordinance 72-44 18 0 NO ** City Ordinance lnance 72-45 - 'OWNER URSCHEL, Eugene DATE k_7-72 UJOB ADDRESS 1513 Viola Place BUILDING PERMIT NO. 34546 ,r 'RAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Add Unit to Ex. Residence 116=07296 LOT TRACT FIRE ZONE VALUE $ 14,800.00 ,INSPECTIONS Signature Date GROUP 1&.T TYPE �! ZONE R-2 501E SUBCONTRACTOR I PERMITS ISSUED GASS'-4-•,-, NIS7—2-7-7y Date Number I Signature WATER Plumbin• ROUGH PLUMBING MSi?j/Q t 2- //r^,�7i,t/.• �� �2 51-7-% 4/JL,Z,* >✓ PROP. SWR. LINE []HOUSE CON. ©' 41'i'-j4 -72- f Jv{r�/J/y9- Iflcii// 41--/-7-3_6c,-#/-7--- SPRINKLING SYSTEM Ir' L Z MISCELLANEOUS p^�,, ROUGH HEATING AND AIR CONDITIONING ,4/` SIV-2--/-71---- TEMPORARY IV- J'71---- TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING ,e,A� 4 -/7.77_-- Heating and Vent, TRENCHES n FORMS El STEEL RE INF. ❑ g if4j.2777/./ (//(./A, L4�2, 5'743 l FLOOR SYSTEM �m� / BOND BEAM n STEEL REINFORCE n . SHEATHING _ FRAME AND FLASHING LATHING - IN n OUT n TER, BROWN COAT ,i JCT URAL, FINAL I- t ' HEATING, VENT., REFRIG. AND A.C., FINAL /�, - j / •� PLUMBING, FINAL AND GAS TEST VA St.-lti Nt r,_I ELECTRIC, FINAL V :T(%7z. win" niNr. FnuAl A.-A it V i ' ' • . 34546 'PR --;:7?cAID 271* ****89.54The COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECyE.� i —E CEIVED; D .. ISS ISS UED BUILDING -A,77..-- ,)-. ' ADDRESS/ OWNED ,py.IL A.P.N i/t,'O9.1-06 PERMIT NO. MAIL ` //_ „yam' ` BUILDING ��/� Z, ADORES /// ( G C•�c t / y_ ADDRESS [/O dU CITY ilefte42-411 NOL. �1d1*' TRACT /I'/6 LOT 3 BLOCK. • 1-Z CONSTRUCTION Jt _ _ � NEW ADD ALTER REPAIR MOVING DFMOLISH . ON LENDER �Jq'_r"'^ ., Y �/` pC` J y BRANCH �0- 03 - . 11010 OWNER/c-C1 GE/VG (/ICSC6/CG• - rk ADDRESS �-� W v\ m J 7/n','.1J/I�]. VALUE '/ r ARCHITECT ''� i, TEL./y.479' LGA' 4— $h. Revs Z Q OR ENGINEER _( - NO.�Q1i�/'YO/ FIRE O WCC ADDRESS S-/ C r ZONE TYPE GROUP 1 VL Y a-141VqJ` W 2 .��+� APPROVED ' x.� JO CONTRACTOR e� • BY �. DATE-4,4/!��, CO Z J cc ADDRESS `- ' W W • ZONE n NO.OF USE OF NEW ZI- CITY . 1`t- � : NOL L PLANS 2_,BUILDING 'Q_',(/�re.„.. WO STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC. NO. LIC.NO. - MAIN BUILDING ACCESSORY BUILDING D O SIZE I /' � �NO.OF'BLOGS. (FROM C/L STREET/)) r/� p— OF LOT 6/O ' / 6� ))NOW ON LOT�AJ Z— FRONT 7 FT. G'.urn FT. USE OF • EXISTING BLDG Q`1..ae.(4 �c /rL(. R.SIOF F_T. FT. I SIZE OF YpXL NO.OF / ?/ 1/ Z NEW BLDG pLjJ /1 _ 6 ROOMS STORIES / L.SIDE O FT.(] FT. VEXTERIOR WAL/ 1ROOF , r _ COVERING COVERING _ REAR �_ FT. FT. J j15E O I G ANC? K TO BE PERF M���•••���/// MAINDISTANCEBLD BET. BET.MAIN& CL /r `�Ie7/IQ / 77�. MAIN BLDGS. ACCESS.BLDGS. a / CD Q C VAUpP .# ,I� APPROVED I— _ _g �j APPROVED rs II J\/' �fIATF �/ LJ ( 11,4)— C~.1 I hereby acknowledge that I have read this application and state MOLD FOR SPECIAL RE tlik4hccf§ that the above information is correct and agree to comply with � CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of / Z the State of California. 0.2 /0 © SlO. FT. ill TAX I hereby certify that I am properly licensed as a contractor under S the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UND VA tf ON 1S FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt from the provisions of the State of California c usiness VALUATION /� cmi and Professions Code,Division 3,Cha ter 9. / PERMIT FEE $ / D m Signature of "......%\.1 r��+, —_ E Permittee - s/57, J '//, PLAN CHECK $ 01.-/ o //L.((/rG� may+'if LL Authorized Ape / TOTAL FEE $ s+ O 8 OWNER URSCHEL Eu ene DATE 4-9-75 JOB ADDRESS 1813 Viola Place BUILDING PERMIT NO. 39806 -GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Alter of Garage to Unit / .116-092-06 LOT TRACT FIRE ZONE VALUE $ 6.500.00 L _CTIONS Signature Date TYPE V GROUP H ZONE R7 SOIL PERMITS ISSUED GAS SUBCONTRACTOR _ Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING - TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ROUGH WIRING 1 1/_//-)S' Heating and Vent. TRENCHES ❑ FORMS fl STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING ��nn FRAME AND FLASHING /l13 t 27 15 LATHING — IN OUT Ri tk✓t- P1',TER, BROWN COAT (URAL, FINAL Electric HL .NG. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING. FINAL PAIL APR —9-7F,:,--00 305 **::*60.5G • 39806 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT _ Rf lED BY ATVIEC V E I U BUILDINGDDREI[� [I� Vto LA: — . �o �f- 4/CIA ADDRESS o�� ♦\ ..7 V // I� OWNER eo V A.P. NO.LIl7©_I� G.-06 PE .YOO BUILDING MAIL ADDRESS IBIS VIUfa• ill la TE . ADDRESS p a U CITY NOL TRACT [04.8 I LOT S BLOCK. CONSTRUCTION NEW ADD ALTFR REPAIR JMOVING DFMOI ISH • O I-- LENDER cn /-X/� aca J 7 BRANCH J CO OWNER Qw ADDRESS ,���///// {•(/ ��j +/ _I CO ARCHITECT TEL US E/J r jilld LU$aY(/(Yl ki J OR ENGINEER NO. U toFIRE ILCC ADDRESS ZONE TYPE GROUP/ il a I11 APPROVED !7f .4:11 W Z CONTRACTOR Ou��( BY DATE J Q • co Z J to ADDRESS =Q' W W TEL. ZO tj NO.OF USE OF NEW n CL)&.. ZH CITY NO. _ Lt PLANS 2 BUILDINGTb (Mr lL-O STATE CITY YARDS APPROVED YARDS APPROVED • to Cr LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 7O (FROM C/L STREET) SIZE NO.OF OF LOT I NOW ON LOTS FRONT FT. FT. USE OF EXISTING BLDG. R.SIDF FL \ FT. i— SIZE OF NO.OF L Z NEW BLDG. ROOMS STORIES L.SIDE 1I V\t F FT, U COVE RANG RIOR WALL I COVERINGF VREAR 1 ` IFT. FT. J USE OF BUILDING AN WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& 0- CL MAIN BLDRC. ACCESS.BLOCS. a //�y e — - a ,�G�; kat f/6V l� _C #�r1��� APPROVED DATE 0.2 -24'--7s I_ IIINNN APPROVED/4j LL 217.215-_._ V) _ RY--- -DATF T r o HOLD FOR S°EC!:\L REQR`EMENTl VI hereby acknowledge that I have read this application and state STA-L+^1 that the above information is correct and agree to comply with I- an laws regulating buildingion construction,e ano I shall not employ any person in violation of the workman's compensation laws of Ceco ) CO) the State of California. ea ? I hereby certify that I am properly licensed asa contractor under SO. FT. TAX o_ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effe t,or I THE PURPOSE OF ESTABLISHING A PERMIT EE ONLY: a am exempt from the provisions of the State of Calif or is sine's cr VALUATION O CV and Professions Code,Division 3,Cha ter 9. (L of PERMIT FEE $ 7 el D Signature of C2— ^ -0 al Permittee (((( � 45;0O � PLAN CHECK $ 2.A., E G - 0 Authorized Age 6(...1 �' LL TOTAL FEE $ iJOWNER URSCHEL, EUGENE DATE 8-21-70 OB ADDRESS 1813 Viola Place BUILDING PERMIT NO. 32193 ENERAL CONTRACTOR 41, Owner-Builder DESCRIPTION of WORK Detached Garage O. 116-092-06 LOT 3 TRACT 1148 FIRE ZONE VALUE $ 2,688.00 I ECTIONS Signature Date GROUP I TYPE J ZONE R-2 \SOIL SUBCONTRACTOR PERMITS ISSUED OAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER fl ROUGH WIRING /e //1- Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ y A'0 /A , /' 0 FLOOR SYSTEM ////�!/ BOND BEAM n STEEL REINFORCE SHEATHING R gy./�7/// ` FRAME AND FLASHI 7t& 1/..c I at /4f--I LATHING — IN OUT 171C ^(�i � C PLASTER, BROWN COAT 7/ •TUBAL, FINAL Electric H NG, VENT., REFRIG. AND A.C., FINAL -CO-1...w /J.7-7d ,�/eJts� PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL _1.-Cf/IAqq �� �%t0"/ry 7,-- • V • 32 193 AUG 21-70iPF'BP15AOO 971*+ ****311.5011.5G COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY e •TE RECEIVED D•TE ISSUED BUILDING .y�1 hK ./� 7 . ADDRESS /Vs 'Safi /7:/LL ��I I — - �,. RMINT OWNER CCI�(( { ( 2 .gflr A.P. NO. - r41 / zr PECit'i II:H:q MAIL �.,�t� � BUILDING ADDRESS 2/3 /i4 ., t/ ADDRESS ', /f�j[�/ /yJ � / d U CITY (AJ-`c-� _7 NO. 6 ` `, '�S I TRACT �4 LOT 3 BLOCK ZZ < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH O-N LENDER s/ • a co J O BRANCH OWrNER GZ,f i e G Or5cA e-/ Q w ADDRESS L /; m m ARCHITECT TEL. USE dQ�! y/g-f. VALUE 7 z ry®•ry+y, J Q OR ENGINEER N . / (1� n �'��'`�/ U Q FIRE // w EL ADDRESS /''�'p ZONE /j�TTYYYPPEEt -Z- GROUP • tL W , en �'C�n/Ei�W/ APPROVED 'GY / J / �J LU O CONTRACTOR �A/rti -, BY DATE Z �/ 404 J 2 ADDRESS �� Q� � ww TEL. Z E NO.OF USE OF NEW"" � A,,,{ JZ,� O= CITY NO. lk- J" (PLANS. BUILDING ""(/J/ Z 1—w - -0 STATE CITY YARDS APPROVED YARDS APPR VED co 2 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (/.� (FROM C/L STREET) II OFZE V / �[ NO.OF BLDGS. I ... T /1 A- LOT 0 /\ ( 7 NOW ON LOT FRONT FT. FT. {t/Qi� USE OF //�(�/y�..r/, 7 EXISTING BLDG. • t l..t u�� R.SIDE FT. r FT. H SIZE OF fI� X 3•{ ROOMS { STORIES I L.SIDE FT. 3 p FT. Z NEW BLDG. c /` T < EXTERIOR WALL �s1y/ ROOF COVERING .C�/`^<-tet/ COVERING /•1�� REAR .FT. �FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d 0- MAIN BLOCS. ACCESS. BLDGS. ATE Q .� L r �\ VAR.# APPR O beg- �/ I C.U.P.# APPROVED / y Cl, 1 beg vi- - Y• �Y ROVED �A E Q../I0/7 Z 0 /007 , 07 e t 2 SA y�y eSfrtic vr� T «I I— / / ' U I hereby acknowledge that I have read this application and state n that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall-not employ I— any person in violation of the workman's compensation laws of W the State of California. --!�4 SO. FT. m z I hereby certify that I am properly licensed as a contractor under - b o • the State of.California BusinessandProfessions Code, Divislcn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 am exempt from the provisions of.the State of California Business - CC and Professions Code, Division 3, Chapter 9. VALVATION ,S �c�® 0, Q/p PERMIT FEE $ L D Signature Rtes of // a Permittee Cr/LC r 2 $ /. "' 19 PLAN CHECK $ / /r �a E Authorized Agent TOTAL FEE $ OWNER URSCHEL, Eugene E. DATE 12-29-70 \ JOB ADDRESS 1813 Viola Place BUILDING PERMIT NO. 32597 1-.GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK 2nd Story add.for storage only .116-092-06 LOT TRACT FIRE ZONE VALUE $ 2,312.00 1. :CTIONS SOIL GAB Signature Date GROUP J TYPE V ZONE R'2 sN SUBCONTRACTOR PERMITS ISSUED _ Date Number � Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM I MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER n ROUGH WIRING Heating and Vent. TRENCHES n FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING )• /� j FRAME AND FLASHING / n C y'j j/ LATHING - IN n OUT 'LI - /P i „ P' --TER, BROWN COAT Q 97/ 1 URAL, FINAL Electric h. AG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL , BUILDING, FINAL ¢ I�ry ,,,-'T— • • 259 . PAID DEC 30-70-al-a° 100* **•**34.50 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely✓) RECE VIED B DATE RECEIVED BUILDING /r/'5 Z1'2'- !A !/� CO 9'R 12-Z -7o DATE ISSUED ( /2-19-70. ADDRESS / 'IPE'' IT N. OWNER � M. ' /at ` # A.P.NO. !- - /- -• 0 A . . .2fr BUILDING �/ / MAIL ADDRESS ( ��/�� (/��1, Z ADDRESS�y , I Aft r / /( / .�'i'-(/r `"" Cl.Lu LU 0 CITY l 0 a�i� , NOL 6l-d_3gn? TRACT 7/f LOT BLOCK ~ Z NEW ADD ALTER REPAIR !MOVING DEMOI ISH Z Q CONSTRUCTION ` / ^/ O N LENDER I \ Ct. 03 J D BRANCH J cn OWNER 4 Ill-I ADDRESS /,e,! M/I �L �/J fiat' m ARCHITECT TEL. USE t '�' $ /L/ J Q OR ENGINEER N . O Q FIRE l w Ir ADDRESS /qf ZONE TYPE 1 / GROUPP , J O CONTRACTOR (JPS ---..4:///-‘64 .— // APPROVED /�1/Jjt �l ATE /L��C��j ea O -L7" L �"� r 0//l\O J ADDRESS Sr --- W W TEL. 20N 2 NO.OF `J USE OF NEW11 e 0 ZF CITY • NO. " PLANS Z..-- BUILDING �1 C re/ -O STATE CITY YARDS APPROVED YARDS APPROVED • to Ir LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING D OSIZE /� (FROM C/L STREET) ?7 -f OF LOT 6 0 x tis NOW ON LOTO / FRONT FT. .3 / FT./sae/iv USE OF !l EXISTING BLDG. 41-77 J _ R.SIDE FT. S FT. I- SIZE OF Z NEW BLDG.'S 9Y ..l L? ROOMS STORIES L.SIDE FT. 3/ FT. Q EXTERIOR WAS y ROOF feint V COVERING._.(�/K.(.(„(�(/ COVERING d,�(l�L//II�.CN REAR FT. ,� FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0- MAIN BLOCS. ACCESS. BLDGS. a 0 /� C� C.�. VAR.# DATE A 11 Oil q 1 S r /CO 09 e Y C.U.P.# APPROVED I- �j '/(/ / APPROVED �/n to Lill leer if:go rT BY E DATF /r2'� 9'!4, Z 6!!!/ prof•e/ ©h only. ✓. f , MOLD FORS ECIA REQUIREMENTS I- I hereby • acknowledge that I lave read this application and state ✓7/a O ,//, J 0 that the above information is correct and agree to comply with /rp t /it AA '^ `�� 1 lit CC all laws regulating building construction, and I shall not employ at-Ca 000 F any person in violation of the workman's compensation laws of -22(3ewzanzg tA the State of California. Gd ,/ m 0 7 SO ? I hereby certify that I am properly licensed as a contractor under . FT. - - ti the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: S am exempt from the provisions of the State of California Business VALUATION and Professions Code, Division 3, Chapter 9. ro G� PERMIT FEE $ 2 rc-a j Signature of /// el /� I } (a m Permittee / 1��a Lr✓ 47�OC ui $ 2,3 I• PLAN CHECK $ / /r E ( .FySa . o Authorized Agent TOTAL FEE $ cIWNo< URSCHEL, Eugene UAlt 12-5-73 JOB ADDRESS 1813 Viola Place BUILDING PERMIT N0. 37653 GENERAL CONTRACTOR Owner�Rldr. DESCRIPTION of WORK Garage AP No.116-092-06 LOT q TRACT 1148 FIRE ZONE VALUES 7,098.00 (I 'CTIONS Signature Dote TYPE V GROUP 7-1 ZONE R2 ' SUBCONTRACTOR PE MITS ISS D GAS Date 1 Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE 7 HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER 0 /7jJ /-//'/y ROUGH WIRING '%_7 ),Lr2V Heating and Vent. TRENCHES 0 FORMS 0 STEEL REINF. ORA A���W /�c�� FLOOR SYSTEM D BOND BEAM n STEEL REINFORCE fl SHEATHING L / L 2 FRAME AND FLASHING �l • / ^)))a--(- LATHING - IN n OUT IT r✓ 9-1 /_ /t''7'j PLASTER, BROWN COAT /J /_/ 7 u' STRIIrTURAL, FINAL / Elect •' H VENT., REFRIG. AND A.C., FINAL fq. ,- . _ /�.�Q,�t is -C-'71 It.976 PL NG, FINAL AND GAS TEST n , ELECTRIC, FINAL /7%'l P)-5'7V , BUILDING, FINAL fr1t7 2 '1'5'2 4.-/ SPECIAL REQUIREMENTS PAID DEC -5-73-5 OO 1911* ****57.50 • 37653 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PP I TION FOR BUILDING PERMIT For Applicant to Fill in Completely RE E V O E 7.4E1 D DATE ISSUE BUILDI '$/�j ADDRESS G / �. �/0i-ell - Costa '1 J r5 i-6+- /, I/ ,�bO' _O( PERMITN OWNER �(,fGEN4 U/T'SCNPL A.P.A lD V / C- t0 ^1��IG MAIL 9 �� /1 BUILDING 18 f 3 1 '`�`R \ Il` /ccA Y/mLA ' `'O$TA /14-SA ADDRESS l 1/ CC LL Zmi TE . ADDRESS 0 �� 0-0 CITY COSTA /"/ gsM NOLG'92'r�..� /o• TRACTI • LOT BLOCK z< CONSTRUCTION NEW I ADD ALTER I REPAIR I MOVING DFMOI ISH O N LENDER S' am - I J N BRANCH .... .-067.0,...e- Uttscnec._, OWNER m 03 ADDRESS 4 VALUE /JA/�)10 m ARCHITECT TEL. USE /Uz/J J Q OR ENGINEER O wu E /�. N . U Li) FIRE III W K ADDRESS ZONE E PE�GROUPAPPROVED 11...C.--,-).-; ]� JO CONTRACTOR Otu&p C. BY DATE 03 Z • Q CC ADDRESS ZON NO.OF. USE OF NEW '�. TEL. F122IPLANS Z BUILDING Gitwistco Z 1_ CITY NO. WO STATE CITY YARDS APPROVED YARDS APPROVED co O LIC. NO.�04)/c LIC.NO.((O+VS MAIN BUILDING ACCESSORY BUILDING 512E NO.OF BLDCS. (FROM C/L STREET) q OF LOT f,,0 X /Ps' NOW ON LOT .2- FRONT FT. 1 FT. . USE OF ' EXISTING BLDG. //0 L(S ss R SIDE FT.NO.OF nG FT. SIZE OF --ss c, y ROOMS / STORIES / L.SIDE FT. 2 FT. 2 2 NEWS .I, 8 X 7 Q EXTERIOR WALL ROOF /� '` I� ' �} U COVERING Fi 376X. COVERINGCOMP(S/VP A) REAR FT. 1 FT. Ke\- _I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a 0- GA CA C-a MAIN BLOCS. , ACCESS. BLOCS. Q VAR.# DATE 0 C.U.P.# APPROVED I- APPROVED .'' {uut ���_'' rL_5�3 (q _SY w�-t1yV DATF 2 I O U I hereby acknowledge that I have read this application and state STATE O that the above information is correct and agree to comply with r*., CC all laws regulating building construction, and I shall not employ' U r, any person in violation of the workman's compensation laws of t y the State of California. f "^/ cO Z I hereby certify that I am properly licensed as a contractor under (/19 2 . FT, T o the State of California Business and Professions Code, Divisicn 3,+ THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: co cc am exempt from the provisions of the State of California Business and Professions Cope, Division 3, Chapter VALUATION /r7"C7 PERMIT FEE $ ✓— D Signature of� l /•- sssJJJ ���////// ` m Signature fliff /�'//�.�" - $ / D eJ /PLAN CHECK $ / f.� E • x/J WWW ��' ��_ / / [r �-o 0 Authorized Age t LL TOTAL FEE $ 0 ER BOCK Mr. & Mi'.SQ°C$. M. c$ DATE "7-26-57 ._ JOB ADDRESS 1813--Viola Place I !I BUILDING PERMIT NO. 5493 ENER CONTRACTOR Owner-Builder VALUE $ I120.00 11 PU o. LOT 3 TRACT 11)48 FIRE.ZONE DESCRIPTION OF WORK Patio & 6' Wall _('—IUP J TYPE - ZONE R4 PLAN NO. 5521 PERMITS ISSUED I. .'ECTIONS DATE SUBCONTRACTOR DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod • .. Bond Beam I • Frame and Flashing 1 %/70i.5 / , Lathing, In ' Out V"' Plaster, brown coat _ _ Underground soil WIG Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. H Sprinkling System _ Heating Final Jr 'inn Fixtures, Final 1 Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final w < / _n OCCUPANCY C—AIT- 1/)4/) / 1� 'Form 210-5M-1-57 - v 5493 �`'. 5521 FE RECEIVnE�/D • COSTA MESA BUILDING DEPARTMENT ( 19-6/ ' /� -\ P.O.BOX, AL f ANCE D PT. 317 COSTA MESA, CALIFORNIA pp LLnn��TTpp� FOR APPLICANT TO FILL IN AFrrlI��yy IGF TI hM R PERMIT ADBUDRESSILDING /S/3 //OZ.. ift., BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY ',.^ / ) / / RECEIPT NO. PqRMIT NO. y9OWNER /714 /v�rJeic._V 4 JF7/ MAIL p !� �/AEEEC WED ES DATE ECCEIV`ED''77DATTEJISSSUECD- ADDRESS II! /J /� � L� VZ 7 J`"�v / • d (! .J7 /''1 �,.n- TEL. 'BUILDING CITY ( O' .C.• NO. ADDRESS ARCHITECT LIC. N1 COSTA MESA. CALIFORNIA OR ENGINEER �.� NO. ^� FIRE ADDRESS ZONE ZONE - NO.OF TYPE GRO . �j� CITY LIC. .� NPLANS O.O CONTRACTOR (/fes' NO. 4', TEL. APPROVE ADDRESS NO. BY DATE LEGAL LOT µ,D CORRECTIONS DESCRIPTION NO, .3 BLOCKTRACT ////a A.P. NO. //Ca -O / Z )- (O SIZE NO.OF SLOGS. APP&'{ ®VED OF LOT NOW ON LOT USE OF / CITY .. COSTA MESA EXISTING BLDG. I'��;� i..s VEP'. SETBACK LINE FROM y` I CENTER OF STREET / J REAR YARD SUBJECT BLDG. DEPT. REG. SIDE YARD RIGHT tr. LEFT ?/--7 ���/���}� r DESCRIPTION OF WORK/ ' `BY • DATd� PLAN T_CH. NEW ALTERATION ADDITION REPAIR Vp MOVING I DEMOLISH BUILDING ) NO.OF SIZE /0 �- Yl ROOMS J /^�STORIES / /� EXTERIOR WALL /� COVOE RI NG w••/0v eP (� Iv, COVERING ,'/ CCC /1 /� USEOF NEW d-- ` ' - rtti/J BUILDING �2 /(�.(J (�J��' 1� , �yNr• Ci+ a% %/ AT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL • CITY ORDINANCES AlTA E LAWS REGULATING BUILDING CONSTRUC- TION. {• VALUATION 1/4 / •� �b PERMIT FEE $ 491 SIGNATURE OF PERMITTEE i ^ / 2 a PLAN CHECK $ 'AUTHORIZED AGENT TOTAL FEE $ 7 VV VV '3~F .. s5cszVs -- 38559 - P�1� I '! 'I -711�rja0oil!tJ?�-- :cu'+f.'6L.1U • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . AP LI ATION FOR BUILDING PERMIT ' 0 For Applicant to Fill in Completely D /y// // RE I E BY /LjAT Q�iE/C//EI D -DATE ISSUED ADDRESS / fig 1/64:64/L., / - Q/// ILC�C.F- I + (O(} D / E-82.41 -lel fy OWNER/I/! L> 11'e ✓ CAe — A.P.NO.I16-b 2..-CO(O J `, /// BUILDING 'k'� _ ADDRESS / D q}, ADDRESS `1 �pu t E 2 S E d U CITV J�hLGG'�iL.2j NOL .x'cliy[� TRACT�`iip� LOT 3 BLOCK ZCONSTRUCTION / NEW ADD ALTER REPAIR MOVING f)FMOI LSH OI- \ LENDER /'? �� ‘.><" am J D BRANCH VIOLA._Ern OWNER IR ?�I J IIOL/� EDGE COa IL J ADDRESS VALUE AO()(� Q/y.QI/� co-.0 J Q ARCHITECT , � TEL. � _ u$E AOQ TD 4 I l WB.Poets W U OR ENGINEER t/ut'ruc/v/ NO. U Q FIRE . _ _,�/ �('' y-' w CC ADDRESS ZONE YPE V! GROUP J.� 4.7" 0'w APPROVED J Z CONTRACTOR O2i-n-e" BY �C� DATE (0-1 Y-71 CO Z . J 2 ADDRESS C,c_r.,_i- W WZO E NO.OF USE OF NEW Mx, O-. CITY NO.TEL. t� PLANS 'L Ar BUILDING r.. Z I- STATE CITY YARDS APPROVED i. YARDS APPROVED 7 O LIC. NO. n yy LIC. NO. MAIN BUILDING(FROM C/L STREET) ACCESSORY BUILDING Zap SIZE OF LOT-6 .0,iy/�fs- I NNOW ON LOS FRONT IS FT. r.Iet FT. USE OF EXISTING BLDDG.J4 5t._-�`sk54/ 7" R SIDE S' FT. FT. ZZ NEW BLDG Jt s y _ ROOMS T STORIES L.SIDE 2-7 FT. FT: EXTERIOR WALL('.; ROOF (�/' S. V COVERING -" r-✓et O COVERING _d/{ire 1 REAR p FT. FT. J USE OF BUILDING AND WORK TO BE PERFO ED • DISTANCE BET. BET.MAIN& d a MAIN BLOCS. ACCESS. BLDGS. QO _?,',,,./:, C^ ,/ Q (. VAR.# yZ DATE C.U.P.#LC 'tAPPROVED l-I1 '12- r / APPROVEDW LD40J 2 v BOLD vF -FOR S ECI If'vita,-n. Tly V I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of CO the State of California. / • ..t „ �r o � VJ J G41 Z I hereby certify that I am properly licensed es a contractor under SO. FT. 0 the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 • CC am exempt from the provisions of the State of California Business VALUATION and Professions Orme, Division 3, Chapter 9. f ry PERMIT FEE $ /1 Sienamre of cfr co D Permittee �7,� l $ ]ah/q/(.� PLAN CHECK $�� E Authorized Age t / TOTAL FEE $ 110LL PAIp 38322 APR 2=I 7• . P Ica 971 ***-:c7.2.70 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 t jCATIONP IFOR BUILDING PERMIT For Applicant to Fill in Completely REC v DA E REC IVED � Fj DATE ISSUED BUILDING n ` ( (' ADDRESS l.S�j �1 ‘ 1/4.....#•.M... , pv�I �f OWNER et)G� , (..,117. 11,t...- L_. A.P.NO. P /1 � 4Z� Z MAIL BUILDING 1 C\ 4S VIOL A< Tl' . ADDRESS ,els V,OLA� ADDRESS ` Q • O U CITY Go5A ME,S/t NO.6,42.-.s . TRACT i 1.40 LOTS BLOCK I-Z Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH O N LENDER / 0- c0 /V� JD BRANCH J(n OWNER Ili &—N C Ua c fV .C ADDRESS J VALUE IO�0 CO ARCHITECT TEL. USEr�LI'n' A`1, VtIT $ flet J Q OR ENGINEER NO. • _ C° FIRE U Q ZONE TYPE GROUP Z • 2 ADDRESS aWW Z ......------- APPROVED J O CONTRACTOR BY DATE mZ LULL ADDRESS TEL. ZOmNE NO.OF USE OF NEW C.-00‘43 NNW CITY NO. \ (PLANS Z BUILDING CA(e. rTC LI (V,\ W STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING J SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT I NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDE FT. FT. I- SIZE OFf'NO.OF / 2 2 NEW BLDG. .. f ROOMS STORI ES L.SIDE FT. FT. KtEXTERIOR WALL ROOF _ COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0- 13- MAIN BLDGS. ACCESS. BLDGS. KX 0 /// 0 �A 1IQ {� GNI -� VAR.# DATE 4� tF'1(i l� �L</�{`sr� C.U.P.# APPROVED N �y r APPROVED 19 � t-/T E A: •ATE Z STATE 0 UI hereby acknowledge that I have read this application and state 1� D that the above information is correct and agree to comply with (/ CC all laws regulating building construction, and I shall not employ P • I- any person in violation of the workman's compensation laws of TAX CO the State of California. es W I hereby certify that I am properly licensed as a contractor under 1�'�SO. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR - s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m CC am exempt from the provisions of the State of Californ'. I . ess and Professions Code, Division 3,Chapter,9. VALUATION ro PERMIT FEE $ w /J D Signature of < L`i / r y�� 'r� E Permittee ,�(I(��1 r $ /g' .fro PLAN CHECK $�d E aro C� o Authorized Agen u. TOTAL FEE $