HomeMy WebLinkAbout252 WAKE FOREST RD - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations..." %t;
CITY OF'COSTA MESA I '- - " - -_ ' - - PERMIT NO. .TRACT NO ' - LOTNO. - - ' BLDG. NO. -- "
2015 "1 /06794 5.0Cr• Tl i
CONSTRUCTION PERMIT . . , : . , • - p _/d.4"?,/_ ,ir .
• . •Protect Address 0 SZ Wok - re,&El- • - -J' TYPE'OF CONSTRUCTION• 1 ❑ NEW ❑ ADD- LI ALTERATION' LJ REPAIR - -
ApplicantsMailingAddress. ° y - ❑ CONVERSION `❑ DEMOLISH :❑ OTHER e ' - ° r I Zone. l ' , •
�1 AT.#
Owner's Name 1 I` Lai-CCL • 4&L i i:-. Phone •s��°- 03(L' - '.DESCRIPTION OF WORK ' •-
IZ 5-1-- ' (•.y.A1c£ •T02ef% /L�' - ., - ' _ E. Main BulldirTg 1 r _ _ Accessory Building:-. 0
Address' - TYPE OF PERMIT, ' .❑ GRADING-0 FOUNDATION' ❑•STRUCTURAL T Front`! • - - - - ' - ' ' _ • N
Arch/Eng I • License No, - '❑ TENANT ❑ ELECTRICAL ® PLUMBING' ❑,MECHANICAL `• B Rear. - > e' • I
Address; - 7 /..$
I . ❑ 'OTHER . . i• ' 'I - , A _ - - G
• •I PROJECT DESCRIPTION. SQ. FT.f -' - • •OCCUPANCY' C Riglit '
Contractor's Namr Phone - K - ,�Adde55Imailing) • , +- ' I CONSTRUCTION TYPE - VALUATION$- - - S Left - • - E
I ZONE • - GRADING• CU,YDS. ' .ACRES ' Pin Ref. , Park Fees $I 'rt ' ' - O
City License No. - - - ! -. - . _ 9 _ • _ U ,
LICENSED CONTRACTOR DECLARATION ' Remarks: - Parking Req./Provided •, I.
I hereby affirm that I am licensed under provisions of-charter 9 (commencing d • R
with section 7000) of Division 3 of the Business and Professions Code, and ( Use of Building: 1 ••
.
my license is in full force and effect. ' - -
License Class - License No. i ` t Plannin Notes: .' , ' I•' E
PLUMBING ' ,1 FEES 9 •
Date • Signature - ' ' - , _ , N
Bar Sink Showers
WORKERS'COMPENSATION DECLARATION' ' - - T
I hereby/affirm that I have a certificate of consent to self-insure or a certificate t• 'Bar
Preventer - I -® Service Sink ' ' l I , i i 1 S
-of-Workers'-Compensation Insurance,^or'a-'certifled:copy thereof (Section - - -- - - . -- - - - '
3800, Lab, C.)- !, - i I • • Backflow Irrigation Sewer Cap • ELECTRICAL I FEES
Policy No. 1 ... Company . r
9 Certified copy is hereby furnished. ' i Bathtubs i i Sewer_ Connection Automatic Washes , _ 1 - ;Transformer D.151-50 KW
Certified copy is filed-with thecity Building Division- - ❑ 50+ KW
Date - Applicant - ' Clarifiers Solar Collectors 'Construction Pole Sub.
-EXEMPTION'FROM WORKERS',COMPENSATION-DECLARATION+ - -' piste Masher - 0 Is .
(This section need not be completed if the permlbis for one hundred ($100)or '
less)', , I f 1
I cerin fy that!in the performance of the work fortwhich this permit is.issued, I , Drinking Fountains e ■. 100 I'
shall'not employ any person in any manner sofas to become subject to.the
Workers',Compensation Laws of California,: , t Floor Drains, 1 0Gas,, ■
Date Signature ' •
NOTICE:If,'after-making-this declaration, you should become subject to the ' ' Floor Sinks ,. 1 - ■s ■
Workers' Compensation provisions'of:the-Labor'Code, you-must forthwith-' ' 4 -` - "-'- ' - - -
comply with' such ,provisions•orathls tpermit,shall .be'deemed•revoked. -^ Gas Service; , '"Outlets 1- ■• • El f6-15!1-
CONSTRUCTION• LENDINGr-AGENCY- • ; •i ' , v -
I hereby affirm that there is a construction lending agency for the performance Interceptors', fir' Water Heater Fixtures ' ;Microwave •
-
of the work for which. this permit;is issued- (Section-3097 Civ• . IC.) ' F. • '" - '- •' - - _ -
L.ender•s; Name, m - - c 'i Kitchen Sink . Water,Service - "' •- -
Lentler's Atldress - - l - - _ - ' Device Boxes ; Pole Light -
OWNER•BUILDER DECLARATION r I - I Lavatories. ) :n •. _ . �' a ' Outlets - �' Range
I hereby affirm that I am exempt from the-Contractor's.Llcense Law for the P-Tri •p, •
-
following reason (Section 7031:51Business and Professional Code:•Any city or p - - ' __ _ - - Switches. Sign ' '
County which requires a permit to construct,alter,improve,demolish-or repair - . A i _ - Garbage Disposal (Standing Sections
.any structure;prior to Its issuance, also requires the.applicant for such permit • .Roof Drains '
to file alsigned statement that he/she is licensed pursuant to the provisions of 1 u - '- - - - - -
•the Contractor's-License Law(Chapter.9(commencing with Section']000)of , - - _ - Generator ❑0-S KW❑5-15 KW 'Trash Compactor • • ,
'Division 3 of the Business and Professions Code) or that he/she,is exempt 2-' ..- h - '
.,therefrom-and the basis for the alleged exemption. Any;violation of Section - ' • _
7031.5 by any-applicant fora' permit'subjects 'the applicant to a civil ' ' - '- I i '
natty of,not more than five hundred dollars($500).' - r , jReibspection-Fee .$25 I Issue Fee": I , .$.$
•�p�p�.((�I1 I, as owner of the'property or-my`employees with wages as their sole _ • • Reinspection Fee 1 $25 Issue Fee $'3 t
compensation, will do the work, and thestructure is not intended or offered i _ ' :" i j ' ;MECHANICAL - - , t FEES . - -
for sale (Section +7044, Business and'Professional Code: The Contractor's • - - - _ ----- . PUBLIC SERVICES REQUIREMENTS: 1 ' •
License Law does not apply towork ner of a property.who'builds or improves' ' Boiler Hood or: Typo I 0 7 '
thereon;and•who does.such work himself/herself or through his or'her own "' ! ;'t Zoning Approved By - Date_'
employees, provided that such improvements are not Intended or offered for - , Canopy I Type I L 0 ,
sale. If, however, the building'or Improvement is sold within one year of cam- Duct;-Under Ground . Application Approved By - I • / Date_ / / •
pl ove f&he owner will•havelthe burden of proving he/she did not build or'im- I ;. I
74/
�oveJpi the purpose of sale). ! - ) Duct-Structural I ( Refrigeration System • "�, Application Issued By - 7 �/ Date I G 0
LJ I,as owner of the property, am exclusively contracting with,licensed con- 1 , ❑0-100,000 BTU ❑100,000 BTU '
tractors to construct the project (Section 7044,Business and Professions Code: Duct-VentilatingI SUMMARY OF FEES
-The Contractor's License-Law does-not-apply to an owner of property who . - - - e - --'-- •
BUILDING BERMIT $ SMIP- t $ ' 1
uids tractor(s)or license the nt to•tne Conotractor.•scts for
Rich projects witch a con- f . Exhaust System 0 ;Multiple 0, System Repair/Alteration 1 , , - , ,
I PLAN CHECK • $ • PERMIT '
❑ Pam exempt under Section B.& P.C.for this reason Firepl/Fact.'Blt. ICBG# - - PLUMBING , $ i' �i C ISSUANCE f •$
Date owner. - ' I Heating System& Ducting - t •• - . ,I PLAN CHECK . $ ENE RGV�P.C. i $
I hereby certify that 1 have read this application and state that the above 00-100 000 BTU ❑100,000 BTL GRADING l $
'information-Is"correct'''agree to complywith all Cit countyordinances -' - - -- - -- '- ^^ - - ' '
city count ELECTRICAL $
and state laws relating Ru building construction;and hereby authorize repre- t PLAN CHECK • $ MICROFILM $
sentatives of-this)city, to-enter' upon the above-mentioned property for • 1 ,
Inspection purpose . 2 00 e - ' pate F 1 -•
MECHANICAL - $ TOTAL FEE '+ $ S /De
Signature pros.
�� -
Dri-vers' License or 5$# ( '�- ' I ! Reinspection Fee ;$25' •
Issue Fee • $ 3 ' PLAN CHECK $ -,
CMF-0865-46 rev: 7/83 -- White-Building;'Canar ''-yApplicant;Pink=Accounting;Goldenrod -'Assessor- • • - - - '' - - --- - - - - - -_
•
CONSTRUCTION AND PLANNING. POOL&SPA
Date • Inspector Date Inspector
APPROVALS,• Permit# , --' APPROVALS Permit#
-,1. Temporary Electrical Service or Pole _ 52. .Pool & Equipment Location'
- 2.' Soil Pipe-Undrgrnd. - _ '53. Steel Reinforcement
3. Eledtrical Conduit Utility-Undrgrnd. . - , - 54. Forms - . -
4. Electrical Conduit-Undrgrnd. - .:55. Electrical Bonding .
. 5. Steel Reinforcement - • . • 56.. Rough.Plumbing 8/Pres-sure Test - - ' . -
•
6.' Electrical UFER Grnd. - 57. APPROVALTO COVER-GUNIT.E
7. Footings • ' - _ ; - 58. Electrical Conduit-Undrgrnd.
B. Foundation , ,59._Gas Pipe, 0 Undrgrnd.,Test - •
9lWater Pipe-Undrgrnd. - 60.:Backwash Lines, P-Trap, 0 Undrgrnd. •
10. Structural Floor System . . , 61. APPROVAL TO DECK
11..Property Sewer Line & House Connection - . 62.-Backwash & Receptor-Final
12: Sewer Cap 63.. Heater & Vent-Final . -
13. Roof brains ' - • 64._Plumbing System - Final -
' •
14. Routh;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 0 Gas "1:1 Oil • -
t 3. Gas Pipe-Rough &Test 72. Underground Flush
•
X24. 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'& Siding77. 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:
34. Final Heating & Air Conditioning
-35. Final Gds Pipe-Test . . . - -
36. Hood or Canopy - - - - ' -
37. Final Factory Fireplace
38. Final Plumbing ,-?S34 yse - -
•
39. Water Service-Final ,
40. Gas Service-Final . , .
41. Solar Domestic-Final . ' - . . - -
42. Backflow Preventer -
•
43. Backflow Irrigation '
, ,
44. ,Landscape Irrigation System .
45. Sound Attenuation : .
46. Handicap Regulations - I
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed • • -• t •: ,
e 491 Electric Release to Edison P ' - • ' - , w .
• 50. Gas Release to Southern California Gas Co . I
I.
51. CERTIFICATE OF OCCUPANCY
No. - - Date -
OWNER ' ' PASADENA BUILDERS, INC. DATE 1-28-58 _
JOB ADDRESS 252 Wake Forest Road - BUILDING PERMIT NO. 6350
GENERAL CONTRACTOR Dike & Colegrove, Inc. VALUE $ 13.690.00 •
AP. No. LOT 82 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Ra ci,anep w/nt+ (hrngo
_GROUP I Sc J TYPE V ZONE Rl PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches L rAFForms Steel Minle
Floor Syst'm
-
Steel Reinforce Chimney Re-Rod .
Bond Beam
Frame and F hfgg G�
Lathing, In Out /1, .f
Plaster, bro coat
Underground soilr,,,,// 13.. .Zl 5i�'
IG Pipe Tesr?$ 2,04.21/4
Out
ea
Furnace ,(5#s v->//..-C.Wes.2a...42"."-Y/cZ E EE 2 0 1956—1,261_1
Gas Vents
Rough Plumbing 44/9-5. 4'-iv-L JJIn., Jwr• - /-- 7-Sr L2 f< V
Cesspool Septic Tank �"��,
Prop. Swr. Lincfr House Con4% t. Swr. -)—'if ft, U [��.+-Z`i.,, ,�ln.�, a-,y-Sr 3aler / n
Sprinkling System q /�
Heating Final W /^4 _ SQ /(f
Plumbing Fixtures, Final 141' 9 e ,. it-(/ _ 1l
Final Gas Test Igo Lw 7..,o.- L
Construction Pole / ant, y My Y i..ate,. a--2S-.r L Art-
Underground
St /
Underground Power 1 {
Rough Wiring - - lir . ,J1. _ !!AR 1 1 1St it .? I]
Fixtures, Final �/ ),2 f .. i 7 i7
-OCCUPANCY 1 '
Form 210-5M-1-57 6350
. .
,14f . 6350 i'�:.E RECil1,V4di
:COSTA MESA BUILDING DEPARTMENT ja4_,— . ' fl) V L—
.P.O.BOX 317
COSTA MESA. CALIFORNIA - FINANCE DEPT.
FOR APPLICANT TO FILL IN APPLICATIOONC �'�FOAR�EPERMIT
ADDRESS 252 Wake Forest Road BUILDING
COSTA MESA. CALIFORNIA' FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
OWNER PASADENA BUILDERS, INC. • 6350 .
MAIL •
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS 419 E. 17th St., /V S' JAN 2 8195:T '
BUILDING .
CITY Costa Mesa, Calif. NO. LI 8-1159 ADDRESS
ARCHITECT Carlson and LIC. COSTA MESA. CALIFORNIA
OR ENGINEER Middlahrook NO.
•
Garden Grove FIRE
ADDRESS ZONE
n�I� 20NE PLANS TYPE V OROUP
coNTRX(,'4 & Colegrove, InEI:Y No: 73333 A tl
PLANS
ADDRESS 419 E. 17th St. . C.M. NO. Li 8-1159 APPROVEDTEL.
BY DATE
LEGAL LOT 822955 CORRECTIONS '
DESCRIPTION NO BLOCK TRACT
•
A.P.NO.
I
SIZENO.OF BLDGS.
OF LOT 70 X 100 A 00 NOW ON LOT none
USE OFnone t"' C
EXISTING BLDG.
SETBACK LINE FROM
CENTER OF STREET 501 . REAR YARD 321 _
SIDE YARD RIGHT 5' LEFT 5'
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION
-
REPAIR MOVING' I DEMOLISH '
S ZIE DING 1601 $(1. ft..
N00.
6 STORIES 3
EXTERIOR WALL StuCCaROOF
COVERING COVERING Comp.
USE OF NEW
BUILDING Single Family Residence
and Garage,_
Plan 750AR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STA LAWS ULATING BUILDING CONSTRUC-
TION. VALUATION PERMIT FEE $ 32.00
SIGNATURE OF ��
PERMITTEE
$ 13;690.00 PLAN CHECK 5 16.006v
AUTHORIZED AGENT DIKE Sc COLEGROVE, INC. TOTAL FEE $ 48.00 "BMF
-OWNER' ,TaTIFNSnN, (;_ DATE 9_1 b_58
. JOB ADDRESS • 2S2 Wake Forest toad BUILDING PERMIT NO. 7585
GENERAL CONTRACTOR Sherman Hart. VALUE $ 1 9) no
AP. No. LOT82 TRAC'1j9C5 FIRE ZONE 3 DESCRIPTION OF WORK Room a[Idi I:i on
,GROUP T TYPE p ZONE pl PLAN NO. 7585
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches orms Steel V iik.wi 7
Floor Sys
Steel Reinforce Chimney Re-Rod
Bond Beam )c
Frame and Flashing 04a— 'V/ /
A
Lathing, In Out d'4 `" 14/1-9/it
. j1
Plaster, brown coat 1L //l t 1.-/C6 1
Underground soil W/G Pipe Test
Top Out
Furnace
Gas Vents
Rough Plumbing _
•
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System • I
Heating Final
Plumbing Fixtures, Final •
Final Gas Teat
Construction Pole _
Underground Power
Rough Wiring /frig, 'il./y•('7/44 R ' #44w,>/B.< /e-/9'-SS t7/'/'7 ✓
Fixtures, Final - r-- /i.4C., \ S
-"OCCUPANCY L7.04, r/, //•c.,
Form 210-5M-1-57 r r r' 5 '/ '�y��...�-G�„� 7505
N(11.D FCIk SPFC ,AI. R. fit fTR tiRlF'NTC 7 7
7585 •
•' . uti i...L,t
c(- I SEI &,pll EsnI86.a odi*t*TZAO
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O. BOX 317
COSTA MESA, CALIFORNIA r! -c ins-r4 rt1FSA a
FOR APPLICANT TO FILL IN • APPLICATION FOR PERMIT
ADDRESS ..-.2.62.04. W/{1.4,6 FOREST CJv'\ . BUILDING
.COSTA MESA. CALIFORNIA . FOR OFFICE USE ONLY
Q /' •'JCOA1 RECEIPT-NO. PERMIT NO.
. B
OWNER ) . � pO�bE/V /
MAIL c RECEIVED BY / DATEJ� RECEIVED D/%TEE�,ISSup,[
ADDRESS -Z�.Z 1-01-Ke Eons r /7 / q:/�1l -7 W
TEL.
CITY & STA IiESA NO. ADDADBUILDIRESS a YNG 2-
(1,
/; I/ C tro/3C S
ARCHITECT - uG.O.
OR ENGINEER ICOSTA MESA. CALIFORNIA
FIRE 3
ADDRESS G ZONE
< a i. CITY LIC..lPJ�h ED fVR• .ZONE / NO.OF TYPE GROUP
CONTRACTOR d/4E'21V1,4/l/ I-MART- NO/ 7.3 (.3 �� PLArvs ..7
TEL.ADDRESS / 713 F OCEf)NI Mu G. NO.O/? 3Ozfri By PR AP ,yq CG DATE �fj /5 ,�
LEGAL LOT -q ^�L`r CORRECTIONS
///
DESCRIPTION NO. 1J/.. BLOCK TRACT.0/O/ �/
...
A.P.NO. � � 1, ITT';
.__..,_... -. .. r '
SIZE NO.of BLOT. 7 .h, ILA L. L -'� •� V. . .•'
OF LOT 7e) x / NOW ON Loi,
USE OF in 7•n re IT n .;Q I_...
EXISTING BLDG. ��7 It.� r �l ;'', f!_ 1 y
SETBACK LINE FROM !`�..� f + j� �'''.�)7. L. Y � 1
CENTER OF STREET V O REAR YARD`` iges., y/ e.
'/
SIDE YARD RIGHT S 1 LEFT V / l` -`- /1., j 'r`
/// T_ p
DESCRIPTION OF WORK VAR. f!o.6-,2APPROVED _!_--/�S_ • :
NEW ALTERATION ADDITION
E
REPAIR MOVING DEMOLISH APP . V D
SZELDING/0 I O NO.OF ROOMS 4. STORIES / CITY OF COSTA MESA
EXTERIOR WALL O ROOF PL;NNir.:G DEPT
COVERING sr0 ca COVERING 600,719. SIIRIEC1 TO BLDG. DEPT. REG.
USE OF NEW /1.0o119 AP PI no - FNN1161' 1.3B0lA'1 i..\.
�-/
BUILDING O- S70/2/446 / n
BY DATE?
LAN T',Iniegerg...11
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC.
TION. ( ` f� VALUATION
SIGNATURE OF {/ ,Vj/�`,.��y�� PERMIT FEE S
PERMITTEE 4/ /
n� PLAN CHECK $ �i
BMF
AUTHORIZED AGENT - TOTAL FEE S /a -- V
OWNER ALLEN Russell DATE -b-13-b'(
ThJOB ADDRESS 25
2 Wake Forest Rd. BUILDING PERMIT NO. 27164
4GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION OF WORK Blockwall
AP No.141-1+62-09 LOT TRACT FIRE ZONE VALUE $ 100.00
INSPECTIONS � Signature Date GROUP J TYPE III ZONE R-1
Soil PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
Water _ Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con. 0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning _
Temporary Service or Pole
Underground 0 Power ,D
Rough Wiring Heating and Vent.
Trenches 2i Forms 0 Steel Reim. E .*-019. ..-M-67
Floor System •
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing— In 0 Outi0
Plaster, Brown Coat
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final I
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final rt L-T 6-vy
2, t R4JU11 13-67PAIAC0 355 d;,=* I l.GG
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 129! COSTA MESA, CALIFORNIA 92620 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
P` For Office Use Only
°; BUILDING
2 W A $k FOREST 12.
RECEIPT NO. Pf�I��1 N$�r'.
C‘.
COSTA�MESA, CA FORNIA 711, E '
•
L'WaL'LIs%'.vCs'i r �r� ' RitiW TED OA r rr3 e•
BUILDING
•• - • _ C . ADDRESS
PIR[ •
r. CITY COS'71 Ade A NO Sv¢03! ZONE TYPE GROUP
ARCHITECT TEL APPROVED
DATE
OR ENGINEER N•. BY'
ZONING
ADDRESS ZO NO.OF Ul[oI N!i2'
•VI I PuNsN , I U LD N . /NCONTRAgL•$. LEGAL
ADDRESS DESCRIP ION- , 'I, — - ''11jib
CITY A.P.NO. Ali62- G 7
T STATE TEL NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.NO. NO, SO'TO SIDE a REAR P.L
SIZE I NO.OP SLIMES. / ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
3';••)
SETBACK LINE PROM PT
CENTER OP STREET REAR YAR•
1
..WI A 6 ' FT.
winYARD' LIFT RIGHT -.
DESCRIPTION OF WORK L BID! '—Fr. PT.
NEW AL RATION ADDITION REAR FT.' FT.
IIr DISTANCE BET. BET.MAIN&
REPAIR MOVING IDEMOLISH MAIN BLOOS. ACCESS.BLDGS.
BUILDING NO.OF
VAR.# DATE
'" SIZE ROOMS STORIES " C.U.P.# 'I A APPROVED
EXTERIOR WALL I ROOF APPROVE? ),// /
4 COVERING COVERING BY , DATE p//44 7
USE OF BUILDING AND WORK TO BE PERFORMED - D.
4L" Ain( k W ALL_ FENCE w
c30 ' Lo ,-' g P///[i
d so.FT.
I HEREBY ACKNOWLEDGE TIAT.I NAVE READ THIS APPLICATION .r THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 2
AND STATE THAT THE ABOVE IS CORRECT AND AGREE To coy. PURPOSE OF ESTABLISHING A PERMIT FES ONLY.
FLY WITH ALL CITY ORDWANCRS AND STAT[LAWS REGULATINS VALUATION
BUILDING CONST UCTION. PERMIT FEE .G
SIGNATURE OF �a•Q� /� p) / _ E
PBRMITTBP i (J ///,`/ �_. w
r e
AUTHORIZED AGENT _ _ TOTAL PEE S
OWNER JORGENSON, CHARLES T. DATE 2-11-59
JOB ADDRESS 252 Wake Forest Rd, • BUILDING PERMIT NO. 8665
GENERAL CONTRACTOR Safeguard Const. VALUE $ 1110.00
AP. No. LOT 82 TRACT2955 FIRE ZONE DESCRIPTION OF WORK BLOCK Wall 8665
GROUP TYPE ZONE PLAN NO.
INSPECTIONS DATE PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel 1.2 •qrC/
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
Furnace
Gas Vents
Rough Plumbing
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final
Plumbing Fixtures, Final
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Fixtures, Final //)�
^OCCUPANCY i! j .e.1 4-a — ,••• ///'�
Form 210-5M-1-57 �rwAT 8665
COSTA MESA BUILDING DEPARTMENT
P. O. BOX 3I7 I 8665
COSTA MESA CALIFORNIA _ �
I �E�CEI�En
FOR APPLICANT TO FILL IN
C.L. OF STREET'" } 6 I 1 �UILDIN;Go ADDRESS, 0Zi%? /� PI
_ FINAL i 1959 Owner� T
I ___ __ PROP_ LINE _ \ CEIpEP //jj��r`'
10 FT. FOR 60 FT. STREET F F1520 FT.6STREET 7 ,Tr `� Cn'ir4 f1T Sp Mail Addresc ,-03/45.-42 , .�t�do ` te-t
I I I City /4 2ia.-- • RPh. No —
17V717 4� I Contractors -,,//,, p,, Pm�h. No�}'../ —77/s7) •
u .• I I Address/rfe C� G Z 0 47.{ •
CITY of CC :TA MESA t 50 FII IF FRONT f� 73 Li -Z
J
FL a ,1'I,: : DEPT. I 10F PROP. F City Lic. No. State Lic. No. /70 4f
SUBJECT "•-- G. DEPT. REG. �- L
I 150 FT _L% ' CT — / A W Size of Lot /L j(�dd AP No �L Lfa�rT 91 S`
1_ I /r
W la BY IA•I�B�� WI f Setbacks: C/L Street f Rear Q
W PLAN TECH. El m to /1 o /i
_�-- J Cr a Side Yard - Right Left
u) ---- ---a. V O Type of Fence lii/Xf")(74 i/ X 2 of S LC
a NALLEY OR PROP0 , LINE \ ¢I d 6 7/1/� _- c z , l'
01
F'=": �xjC/� --1 . I hereby ac owledge that I have read this application and state
'--i m WZ iCthat the above is correct and agree to comply with all City Ord-
I U N_tptt � I inances and State Laws regulating building construction.
\111 O
1 I—. I Signature / ` , /' —
10 I of Permittee �O/ 6f��l� 6,-fea-�-
...-� FT I AgenfG� "_'
7 s IN...
II I I FOR OFFICE USE ONLY
FT. m I 40 - I
z I FT , I Permit No.
ce II 8665
60 FT ST. _4 Received by Date Received Date Issued
a 1 I II` _/ 4
I50 FT ST. I H I �YL✓fa oe - // -� c/ J
� _PROP, LINE a - - — _ _ _ _ — f t I VALUATION J enc'
\\- -- — // $ A '
O Permit Fee
I
$ / To Plan Check $
I C.L. OF STREET, I _ i a --O
TOTAL FEE $
MAXIMUM 4 FT. .FENCE MAY BE PLACED ON DOTTED LINES -- — ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS