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HomeMy WebLinkAbout2051 WALLACE AVE - Building Permits fj024- CIN OF COSTA MESA 4 � BUILDING DIVISION °t ' ;-l! DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER is PERMIT 606-01226 4tabe dr (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cSNILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2051 WALLACE AV Status: ISSUED Suite: Applied: 07/24/2006 Vicinity: Issued: 07/24/2006 Primary Occ: MR Type of Construction: Parcel Number: 42228124 Zoning: Applicant: SCHNIERER, STEVEN Address: 3915 PIERCE SUITE F Phone: 949-598-8360 ISSUED BY: LAGUNA HILLS,CA Zip: 92653 • Owner MC CARDLE, RANDALL R TR %ATTN MARGARET L MARTIN Address %IPS MGNT CO - . - - ,_ IRVINE,CA' - - Phone: , PO 60X'19528 " _ Zip: . 92623-9528 Contractor FONTAINE AND ASSOCIATES Address: - 23482 PERALTA - - ' �. • / SUITE F , ' -' Phone: 714-598-8360 • - ' ' LAGUNA HILLS,CA - - Zip: 92653 License: 708917 'Arch :, Eng: Address: ' AddIress: • '1 Phone: ._ . Phone: Zip; License: - - License: SCOPE OF PERMIT TEAR OFF(E)ROOF MATERIALS,INSTALL NEW 3 PLY BUILT UP ROOF ON APT BLDG UNITS(2051-2059),APPROX 3,200SF.REPAIR AND REI?LACE SHEATHING AS NEEDED.,: - _ _ FEE SUMMARY Plan Check: $0.00 ' - <. / :H'Cale Valuation: • . $4,800.00 Permit: $111.25 Claim Valuation: , ' $4,800.00, SMIP Res: $0.50 SMIP Corn: • $0.00 • ' Other • $0.00 ----- ___ , - Inspection: $0.00 -- - , Total: . . $111.75 PLANNING & ZONING ' / - SETBACKS /� MAIN STRUCTURE Front ' 0-0 Rear •CO-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 . Rear 0-0 • Left 0-0 Right .-0=0 . ,/ 7 PARKING Existing: 0 ' ' •Required: 0 Proposed: 0 • ., . . _ - / NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. . . - INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections end final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-4600) . (6/ DECLARATIONS WORKERS'COMPENSATION DECLARATION: fly. I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. i, I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compen_$tion Insurance carrier and policy number are: Carrier: .oA.}t. k.1"a Policy Number: a11-1I p(_, (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) 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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with rhes ons. Applicant Signature: Date: 'l'241a., WARNING:FAILURE I SECURE •-( RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100.000),IN ADDRION 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 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.It 0&417 Class# C3 M Contractors Signature: Date: 7, 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). Lenders Name: Lenders 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.). ' O 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 Drivers 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(38)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 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 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 end 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 CI 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 apereit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the Califomia Government Code requires that the requested information be fumished 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 t]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 boast 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No . . ..t. .... 8 (If yes",attach certificate of complianceance 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. oat IOwner(s) Date And/Or Authorized Applicant Date CODE# INSPECTION TYPE - QdIE INTRIALS CODE If INSPECTION TYPE PATE INIMLE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place . • 220 Final Planning Approval • 203 Final Sign 222 Final Site 204 Final Demolition _ ,250 Final Building/Occupancy . A DRESSOFSULaNG: 2051 WALLACE AV WMT: A — D CITY OF COSTA MESA — BUILDING PERMIT / mYNERSNAMEIER4OIAN: MC CARDLE, RANDALL R TR PERM NO: B 075218 emu: tATTN MARGARET L MARTIN YIPS MGNT CO PERMIT NO: B 075218 PLAN CHECK NO: N GOVT: N SUPP: N P 0 BOX 6348 ORANGE, CA 9261: APDL.IMMO ADDRESS: CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH ARCMRECT OREtOREER: UC 110; JOB DESCRIPTION : T/O & REROOF W/COMP SHINGLES SQ FT: 2, 880 ARCH.OR DIG'S ADDRESS: WIT: • CLAIM VALUE: 2 , 880 . 00 CALC—VALUE: 2, 880 .00 GROUP OCC: R-1 /M-1 CONTRACTOR'S NAME: CELOSEAL ROOFING ( 714 ) 998-2990 CGNTRACTORS MAIK 2325 N. BATAVIA COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 2400SFSF +y4.R--�UENIyT�l.APARTMEN j� p ADOREss: ORANGE CA Liam) 263519 ***'***'********************** ****************************smokL V get 92665 UNIT: Z ON I N G R EQU I R E M E N T LICENSED CONTRACTORS DECLARATION:I hereby deem under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS ///�����, /�A+ (commencing with Section 7000)of Division S d the Business and Prelpsaa Code.and my License is in IW lace and rifted. 1 A..(`�——— CRYLIC.NO.: 45 87 uC.Cuss: C-39 UC. 263519 EXP: 00/00 MAIN BUILDING ACCESSORY B U_" P �L FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN • Dale ��/� � ��,� Contractor: V LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUI DER DE LARATION:I hanky affirm under penalty of that I ramp from the Cmtredon License Law for the following reason(Section 7031.5 Business and Professions Code:Any ' orcounty ich regdres apennytoonstruct,Ater.improve, PARKING REQ: PROV: PARCEL: 42228124 ZNE: REF NO: widish.or repel any structure.prvb its issuance.also requires theappOmn or ouch perms to file a signed statement that ha or she PLANNING NOTES> licensed pursuant m the provisions d the Contractors License Law(Chapter 9(commencing with Soden 7000)of Denim 3 d the .uanesa and Professions Code]or the he a she is exempt therefrom and the basis for the alleged exemption.Any violation ci Seniors '> - 7031.5 by any applicant lore perms subjects the applicant cid a W penally d not more than Ind9E e hundred dollars(3500)). *4* *!E1E***1E4*4*9E1EIE*1E4!E7EiF if1E**IfiE41E**IE1E4)*444**iE1E161E**1E4*1E41E**********4******1E1E******* El I.as owner of the property Or myemployees with wages as Nei eotacampemation.oiido thewwk,and thes0oture Is no wended D E V E L OP M E N T S E R V I C E S R EQ U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Common titans Law does not appy to an Owner el property who builds or in proves thence.and who does such work tinsel ce herself a through his or her own emplryw,Folded that such _ ow tidrrwilillhavee no iMbuirdeendprvingM«'MhedidnttbAd«rimavel�er.rppoedawithin e)anayear d`ompwa''me ZONING APPROVED BY DATE: ❑ aeow the The Coram e.racton Lorne araw dwnotth am owner d prmert wconstruct M ealdsori rowos s thereon iness and BUILDING APPROVED BY DATE : contracts M such prgeds with a coareaa(s)licensedpunuau Io the Contractors License Law). tiliS exempt❑ IamexemderSection: B.AP.C.,bthisreason: APPLICATION ISSUED BY: DATE: VW% ******************************************** ******************** **** **** Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y I do hereby candy that I am aware d and understand the requirements ol CauoM&Heath and Safely Code Sections 25505.25533,end 25534,end thelaeny Mui building occupant trig/wDmlmcb aril needbnonpy with said gale codes.ndlhe requirameruAM BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for consuuctbn or modihcatnn ban the Mit anagenru District.Residential commotion apple/ionsare exempt from these provisions. PERMIT 54 . 00 . 50 Dale: APpwe: SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby effum under penalty d perdisy One of the following dedarmiora: ISSUE FEE ❑ Ihaveaiwil maintana codifies)))d anent tosetinsun for workers'compenwbn.as prodded for bySedion 3703 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the penprmencedthe work for which this wet eissued. TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 ❑ I have end•11 maintain workers'compensation insurance.as required by Section 3700 of the Labor Code,tor the performance d the work to.which this permit a issued.My workers'can neatian insurance minand policy number are: Caner: STATEa FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: . 00 Policy Number: 4935211-95 06/08/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,Thissection need not becompleted 1the peritistor onehundred dollars MOO)ormui 54 . 00 . 50 ❑ I any that in the penonnance el to work for which this penia Is issued,I shall not employ any person in any manner so as to Beane subject to the workers'compensation taws d Cafdamia.and agree the i should shdbeans subied to the waken' ******************************************************************************* com ion provisions ian d Section 3700 d the labor Code,l I comply with those provisions. I ND I V I D U A L F E E B REAKDOWN Dale: /l // ? App'am: L Wamig:Fa/usettoL(cwe worker. wbm comperpon coveragearnd and I to an employer criminal penalesand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines tp to one hundred thousand dollars(5000,000),In sddf0on to she cost of cempanss:an dumps as provided for In Section 3706ofdeLabor Cade,Interest end etfomeyafees. SFR 2880 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 880 . 00 • CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty ci pedal at ten construction a wconstruction landing Cogency bthe e END OF FEES perlace d manthe work for which this panne is issued(Section 3057,Db. th C). LENDER'S NAME: LENDER'S ADDRESS: I candy tha I have read this application and gale lhat the above iNonnano is norm,I agree to comely with all my and sounly ordinances and stale lewd relating to building construction and hereby aWaree representadres of this Wyse enter upon the above-mentioned property for inspection purposes. JERRY BOLT _ Pc'Name (,T� / 1: ' 'tet e I Dale: 1//J tic( ellr ore d e . r•ppkrany0orurmor (5151 d6.WP) Whit- r ilding&Safety:Green-Flo:Carery-APplmnl:Pink-Revenue:Goldenrod-Assessor o CONSTRUCTION AND PLANNING POO SPA APPROVALS Permit# Date Inspector APPROVALS Permit# _ Date Inspector • 1. Temporary Electrical Service or Pole- 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utllity-Undrgrnd. 54. Forms `4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System ,t 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 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 0 Oil 23. Gas Pipe-Rough & Test - - 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing f//_-ZJ/psi'/ 74. Overhead Hydra 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning - 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace ' • 38. Final Plumbing .. 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation . • i 44. Landscape Irrigation System 45. Sound Attenuation , - 46. Handicap Regulations' re 1 r% 47. FINAL STRUCTUREBUILDING flim 48. FINAL PLANNING ' l 49. Electric Release to Edison -. 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. {late r � I 13192 FE RECEIVED s, QOSTA MESA BUILDING-SAFETY DEPARTMENT /9 OCT 281960 L.,- P. O. BOX 917 COSTA MESA. CALIFORNIA C FINANCE DEPT. , CITY OF COSTA MESA a For Applicant to Fill In Completely 0) APPLICATION FOR PERMIT a TYPE OR PRINT a BUILDING ADDRESS 2051 Wallace Avenue w COSTA MESA. CALIFORNIA For Office Use Only U) RECEIPT NO. PERMIT NO. a. OWNER Santa Ana Ranchos I o U. MAIL RECSI D Y DA CEIV"Ep DTE IBBU O ADDRESS 1 Baker Street fC /-6� – —&v C CITY Costa Mesa NOL:R191151 BUILDING 1 ADDRESS x ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA OR .I NEER i•i, 1phT.o.rk NO. "�..� ADDRESS Garden Grove FIRE I / V y�1.y FIRE TYPE V GROUP _l//j/{_� CONTRACTOR Dike & Colegrove. Inc. APPROVED BY DATE ADDRESS 1533 Baker Street ZONING Costa Mesa ZONpEfl '] NO.OP USE OF NEWL CITY K` (/I PLANS I BUILDING Li"1 up it AP STATE No. 167293 TEL. MI 9-1151 LEGAL 000��� V P NO. DESCRIPTION Lot 30, B1k. "BII, Tr. 612 SIZE NO. Oct. LDGS. non /I OF LOT 63.51 x 2901 I Now. LOT A.P.NO. ! iC - 3 +3 -O Y USE OFYARDS EVES `�/� EXISTING BLDG E..- (, APPROVED ALLOWED SETBACK LINE FROMr (CENTER LINE STA ^ CENTER OF STREET 501 REAR YARD 2101FRONT 5 II�I C) FT. IN. /� SIDE YARD I LEFT 10.51 I RIGHT 201 R.SIDE /,-0 FT. IN. DESCRIPTION OF WORK L.SIDE `. lam��/1''�� FT. ( C IN. NE Ix V ALTERATION I V ADDITION I REAR .2 '4 FT. z�� • IN. REPAIR I V MOVING I I DEMOLISH I APPROVED'1' BY Lu411.. YyYi{�J DATE �b :21 S �� SIZES3960 sq ft t ROOMS NO. OF 20 STORIES 2 /`� Cg EXTERIOR WALL ROOF iC G�(, &/ COVERING O COVERING rock " . \''.. USE OF BUILDINGING AND WORK TO BE PERFORMED n / Multiple family dwelling (four 3J6 (2 `�"' living units.) Plan A I - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE OF (..,,c2ePERMIT FEE $ 52. PERMITTEF �� A n $ 32,947.00 PLAN CHECK $ 26. AUTHORIZED AGENT Dike IColegrove, Inc. 78, o TOTAL FEE - E 1` /8/ 99- FEc RECEIVED F GARAGE 281960 ui OSTA MESA BUILDING-SAFETY DEPARTMENT MANCE DEPT. 11 P. O. BOX 317 COSTA MESA. CALIFORNIA V CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT .1 TYPE OR PRINT a BUILDING 2051 Wallace Ave. Li BUILDING c ADDRESS COSTA MESA. CALIFORNIA • For(Office Use Only Q. to Santa Ana Ranchos RECEIPT NO. I PERMIT - / ' a OWNER ^^YY�/ Ce MAIL RECEIVED BY D T! RECEIVE DATE ISSUED .- ADDRESS 1533 Baker Street (/[1/ ,f> 62/ /1/_/_ 4a - TEL. BUILDING C CITY Costa Mesa No.KI91151 ADDRESS z ARCHITECT Carlson & TEL. 10R :INEER WI do)chrnnle NO. COSTA MESA. CALIFORNIA1 ,/�/ ADDRESS Garden Grove FIRE ZONE TYPE V GROUP - CONTRACTOR Dike & Colegrove, Inc• APPROVED (/// BY DATE ADDRESS 1533 Baker St. ZONING Z�IVB, NO.OF USE OF NE r ( CITY Costa Mesa Y /(/ ) I PLANB2, I BUILDING Rit.. '•., ^Q/.-] ( . _ T LIQ ND. 167293 NO. KI 9-1151 LEGAL ❑ ❑ DESCRIPTION Lot 30, Bi k. "B"., Tr. 612 SIZE MO. OF SLOGS. OF LOT 63.51 X 2901 NOW ON LOT none A.P.NO. USE OF none YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM A 1 (CENTER LINE BT.) 6 /'. CENTER OP STREET 11911 REAR YARDI1401 FRONT FT. 1C{ IN. SIDE YARD I LEFT 113.51 I RIGHT k3.Ar I d R.SIDE (O FT. / IN. DESCRIPTION OF WORK L.SIDE (! 2i FT. (/ 4... : IN. NE` I X II ALTERATION I II ADDITION REAR / S 0 FT. +- 121-111‘7--.---� vIN. REPAIR II MOVING I II DEMOLISH BYPROVQDI \ 1\. 1jV���- DATE t(' 241:: y� BUILDING L� Meg I�((I"M,' �^^R SIZE 1780 sq. IRDOMB - STORIES 1 /. EXTEROR ROOF COVERIINGWAL1,BLUCCO ICOVERING rock VC' .10,-,..-.,..9,-. USE OF BUILDING AND WORK TO BE PERFORMED A •cQ n tW` -1,_ ^ 8 car •2saae . id. mandril. ro.m - / j4 with common - .. all. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS BMOC TING BUILDING CONSTRUCT ON. �-- VALUATION // SIGNATURE OF } C / / ‘*....4PERMIT FEE $ /j PERMITTEF ! Ell e . '7�� p $ / PLAN CHECK $ 7 a` AUTHORIZED AGENT Dike & ColegroveT Inc. K TOTAL FEE $ � - — 4