HomeMy WebLinkAbout185 WALNUT ST - Building Permits 901 F 9 CITY OF COSTA MESA •• ;„
BUILDING DIVISION
•j7L"...7"
� ; DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4 jj 1 • PERMIT
!R 'af B03-00426
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 185 WALNUT P�L'S1 Status: ISSUED
Suite: Applied: 03/17/2003
Vicinity: ROOF Issued: 03/17/2003
Parcel Number: 42603214 Zoning:
Applicant: CRANK, JIM ISSUED BY:
Address: 126 COMMERCIAL WAY
Phone: (949)548-5569
COSTA MESA,CA Zip: 92627
Owner: GUTMANN, JAMES E TR
Address 425 CARNATION AVE
Phone:
CORONA DEL MAR,CA Zip: 92625
Contractor: CRANK BROS ROOFING CO INC
Address: 126 COMMERCIAL WAY
Phone: (949)548-5569
COSTA MESA,CA
Zip: 92627 License: 794724
Arch : - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF.INSTALL 30#FELT,20 YEAR COMPOSITION SHINGLES, REPLACE SHEATHING AS NEEDED FOR MFD. 1;700
S.F. INCLUDES ATTACHED GARAGE.
• FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $2,979.00
Permit: $83.25 • Claim Valuation: $2,979.00
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 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 and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS
WORKE4S'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
Niziwork for which this permit Is Issued.
I have and will maintain workers'compensation insurance,as JJJequired by section 3700 of the Labor Code,for the performance of the work for whI'ch this permit is issued.
My workers�urppepusa'on Insurance carr and policy num are: /''fir / ) /
Carrier: / /�(/tL�rY CJ / '� G— Policy Number: ( 1. 4 1 C97
(This section need not be co plated if the permit is valued at one hundred dollars($100)or less.)
❑ 1 certify that in :performance of the work for which th' it is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation la '. ofCalifornia,and agree that it I - •:comet.'-:ct to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these. Isions. t7 „..--` 7 •---- O
Applicant Signatur:• ice. _ Date: r J
WARNING:FAI •-E TO-`}rORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND••LLARE($10 ,000),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 I' •u rC}�� hapter 9(commencing with Section 7000)of Division 3 of the Business and Profs ons 9 de,and my license is in full
force and effect.Lic.rit.� •-O Class# fe-/ ( c
Contractor's Signature: • J _. r3 Date: / 7 C> 3
CONSTRUCTIO ''INC 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. ❑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:
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? ❑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 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 ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No
(Section 65850.2 of the California Govemment 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? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
emit h.. ot...Coast Ar .....aee.t. or other
7 If a catiofrom the South res Quality Management District dhSr airpollutiondooncontrol district3 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? ❑Ves 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
abov- property for inspection purposes.''I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.• — Signature% : caner ) Date
i� -- H ---/ k7 r- C M
��, And/Or Authorized App Da e
• INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE • PATE INTMALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
'j �/
200 Final Re-Roof J !'m)7 Asir 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
Applicant to fill in ail spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA - PEWIT NO. : • TRACT NO. LOT NO. BLDG.NO. - - Id;..-! •, -. ,
CONSTRUCTION PERMIT I —�639c ' , •
Project Address -, A • tl a TA Jr A- TYPE OF CONSTRUCTION ❑ NEW H ADD H ALTERATION H REPAIR • `
Applicant's Mailing Address CA-/4-4
E CONVERSION ❑ DEMOLISH ❑ OTHER g F — !\ n F A.P.# I Zone -
Owner's Name J^ A N t ca aeLui .L'Phone &L/�-7�/.) 'DESCRIPTION OF WORK '
S Main Building: Accessory Building: Z
Address 1 A4 F A R A I / TYPE OF PERMIT ID GRADING ❑ FOUNDATION ID STRUCTURAL
E
Front - - N
Arch/Eng. - License No. • ' ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - - -
Rear N
Address .❑ 'OTHER Rob F ) AiCo A G '
// •//n • PROJECT DESCRIPTION. SQ. FT. FOny - OCCUPANCY C Right ' _
Contractor's Name '( /� Phone' K -
(/ ••I!!/// CONSTRUCTION TYPE VALUATION$ .3xSAO S Left E
E
Address(mailing) - Q
ZONE GRADING CU.YDS. ACRES Ping. Ref. # Park.Fees $ •• u
City'License No. • - '
LICENSED CONTRACTOR DECLARATION Remarks: _ Parking Req./Provided ' -• I
I hereby affirm that I am licensed under provisions of Charter 9 (commencing - _ R
with section 7000) of Division 3 of the Business and Professions Code, andUse of Building: , E
niy license is in full force and effect. I M
License Class License No. PLUMBING FEES Planning Notes: -
E
Date Signature - • .
'"ORKERS' COMPENSATION DECLARATION -• Bar Sink Showers N
i T
nereby affirm that I have a certificate of consent to self-insure or a certificate • BBCkfONr Preventer Service Sink I • S
of Workers' Compensation Insurance, or a-certifiedcopy thereof (Section - - - - .
3800, Lab. C.) Backflow Irrigation . Sewer Cap I ELECTRICAL FEES
Policy No. - - Company
8 Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer ' • Transformer 0 15-50 KW • i
Certified copy is filed with the city Building Division.
Date Applicant • Clarifiers Solar Collectors Construction Pole Sub. ❑ 50'+.KW
-EXEMPTIONrFROM WORKERS'COMPENSATION DECLARATION -- Dishwasher - - Solar Piping -- " -'
(This section need not be completed if the permit is for one hundred ($100) or I p 9 - - Cooking Unit"-- Meter-❑up to 100'amps-
Iess). DrinkingFountains !
I certify that in the performance of the work for which this permit istissued, I Solar Tank Dishwasher • Meter ❑over 100 amps-
shall not employ any person In any manner so as to become subject to the . I _
Workers; Compensation Laws of California. - Floor Drains; Swimming Pool w/Spa. Dryers ❑Gas ❑Electric Sub Panel
Date Signature _
NOTICE: If,'after making this declaration, you should become subject to the i • Floor Sinks Urinal Fan Motors❑0-1 HP ❑i'h 6
Workers' Compensation provisions of the Labor Code, you must forthwith F.A.U.` • - . - -
comply with such provisions or this. permit•shall ;be'deemed revoked. Gas Service Outlets Water Closet FAUInc.- Solar ❑9-15 HP ❑16-15+
CONSTRUCTION LENDING .AGENCY- ' - - • •
I hereby affirm that there is a construction lending agency for the performance Interceptors ' Water Heater Fixtures Microwave
of the work for which this permit is I issued, (Section 3097 Civ. 'C.) - - - ' '
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILDER DECLARATION - - -- - Outlets Range •I
I hereby affirm-that I am exempt from the Contractor's License Law for the ' -
following reason (Section'7031.5 Business and Professional Code: Any city or P-Trap Switches Sign - '
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 - Roof Drains - Garbage Disposal Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of -
'he Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑65 KW ❑5-15 KW Trash Compactor
Ivision 3 of the:Business and Professions Code) or that he/she is exempt - . - ,
ierefrom 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).' Reinspection Fee I $25 - Issue Fee $ 3
LJ I, as owner of the property,or my employees with wages as their soleReinspection Fee $25 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered MECHANICAL FEES - -
for sale (Section 7044, Business and Professional Code: The Contractor'sPUBLIC SERVICES REQUIREMENTS: '
License Law does hot apply to an owner of a property who builds or improves Boiler Hood or Type ! ❑
thereon, andwho-does such work himself/herself or through his or her own Zoning Approved By Date
employees, provided that such improvements are not intended or offered for Canopy Type II ❑
sale. If, however, the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By -. Date
pletlon, the owner will have the burden of proving he/she did not build or im- - /-3 -C-/L .
Drove for the purpose of sale). • Duct-Structural Refrigeration System Application Issued By z rig •_ Data7_
I, as owner of the property, am exclusively contracting with licensed con- • ❑0.100,000 BTU ❑100,000 BTU
hetors tactorsconstruct the project (Section apply tosin and of property
Code: Duct-Ventilating $ SUMfN�R�F, FEES IP $ mss
The Contractor's License Law does not apply to an owner of property who - - BUILDING PERMIT jj,/C[ �J
builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration
tractor(s) license pursuant to the Contractor's License Law), ' • • PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# ' • PLUMBING $ I ISSUANCE • $
Dateh'_q_-_ Owner dikIca ft.._ _.•[_ Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ ' - '
I hereby certify that I have read Ill.application and state that the above ❑0.700,000 BTU ❑100,000 BTL _ ELECTRICAL $ GRADING - $
information is correct: I agree to comply with-all city-and county ordinances ' - -
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK $ MICROFILM $
sentatives of this city to enter upon the above-mentioned property for
•
Inspection urpose , MECHANICAL $ e)
Signature cc _ �y� .� Date //,'Z/;IF y TOTAL FEE $ S
Drivers' se or,SS# + Reinspection Fee $25 issue Fee $ 3 PLAN CHECK $
CMF 0865-46 rev. 7/83 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor . . - - - '
- -
CONSTRUCTION AND PLANNING - PO. ,/ 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 Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrrid. 55. Electrical Bonding
' 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6., Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7: Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation _ 59. Gas Pipe:O Undrgrnd., Test
9, Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10: Structural Floor System • 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
116. Rough Electric Wiring - - 67. Fencing & Access Approval
17. Rough Wiring Sign '68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceilirig 69. POOL/SPA SYSTEMS FINAL
' Rough Heating & Air Conditioning ' • FIRE DEPT. REQUIREMENT •
2b. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
f22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
d23. Gas Pipe-Rough & Test , 1 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
•
25. Roof Sheathing 74. Overhead Hydro
26. T-Rar 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
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /0/.5- ) �/1
48. Special Requirements Completed
49. Electric Release to Edison ; ; - • • .
50. Gas Release to,Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY _ _
No. • Date ' -
IF F, N I . .:. - -.4820 .
________ ____ —Go- ----tt9 o — _ '. -.. :.. .. . in
_..-- i{'arl/yit'f
� w a
I t eine: 7Jfi ny9, _Ca& _
1 i Jaiy/„�3crvs5� i.
!1 L6 ,,,, E i int 13 o2 corgi:
Fail A }dK3s, CS4c — v Iii YCo e e _.
' I ?�I,�Ru'."°.$T.f...STY_" '6ri7'. -i 'I+"Ttta,K.:.r r ':^v --:R--az m
41 K Contractor m -
,1 Address
o - - e - e v o m e o
�{ r City Lic, No, Ph, No.
u:` F�.s _; lr . g Size of Lot yo' x 'AP# J/g-oe r Qi--
g •
p 4
708 �--- w 0 Setbacks: C/�'�'tree�-,�t� Pear ,{�
1 ; iof prop, Siege Yard = Right Leff
I I
a.
Type of Fenced C ��p ant--
---__.
- - - I hereby acknowledge that I have read CI
fi E' this application and state that the
f
ei C+yrr ALLEY �? PROP. yINF Cub w above is correct and agree to complyij
r-' :- i,s la - � 1a y ;a;..--.-moo -1 w with all City Ordinances and State y
a 1 / r' _1_ - 'i Laws regulating building constructio.10
• -, I a QI tj I - - E
H I f ` til l "� Signature /� 1 `°t
:n 1 1 of Permitte�fp�(.G-r�G �'��--C.�.
ai/ a ri _ u Agent
:1 r; �� ;�
haw 1
Is a o o E } - FOR OFFICE USE ONLY
it/ ,v), i 4/ UEcci.
.1 at/ V L m .V 1�
z o < ,...o ', o fl lOQ Date Pecv�. flat Issued
at. ›. -1 - F f —Sa -•S
370 �u ° j )`( g 1 co ELIM
VALUATION - Permit Fee $ j? -r.)
K1 N ;� • 1 0
I L I f Plan Check a `a
r m k + $ p A'4�
5 }0` I ..�rsR,-_a > .r .�_::ar. .. ..• — ID I —/ TCT4L ' . $ i
I FEE ' :CEI D s -
- - - - - - - -14' - - - -- -
.�_
``:.— — - --LINA DEPT. %A
I max, 4' f.-1-1n '— - CITY OF COSTA. MESA
I 0
n
a
OWNER FLAGO. B. DATE 11-19-56
JOB ADDRESS )85'Walnut Place BUILDING PERMIT NO. #39811
GENERAL CONTRACTOR Budget B1drs• VALUE $ 8,192.00
AP118-0$2-12
t" BLOCK TRACT Sinzle Res• w/det• gar,
GROUP I & J TYPE V ZONE FIRE DISTRICT - 3995
PERMITS ISSUED
INSPECTIONS L DATE SUBCONTRACTOR DATE NUMBER
Footing Trench S-1-6 .2. -4
Foundation Forms and Grade to Garage d
Rough Framing g..-3.4- se-7/ et
Plumbing,Rough to Slab IS v. bp 11/ 3.+7 >4mor N--/y-C6 7 ,3 92
Plumbing,Rough Complete e,..5 p./pa.,
Temporary Pole ��11 s,/ ,p
Wiring,Rough frA .C,l. /y/J�.��-d� /0i-3n/' St/ L.173-5—�
Heating, Rough F.j .2-1. 1-itB��'°,` 1/-// -S 6 73 9hid —
Heating,Final c S ,2,,•.,&s7
ewer • - CT Sewer,St. _2. 7 frtn•J D1.. 4- &n 2-a/S7 6 9 9a —
Septic Tank or C��: 's-pAool
Lathing, In V Out �w/t" -/ �` /-/¢-rf
Fri
.wring VV 4 &4 / -3/4[47 �!�� ..., /], gam)
P�umbing,Final,Fixtures Complete/77,e S 3-(>-S-7y gs�ye<F�i 1'j dam 4 �"V'
Plumbing,Final Gas Test /S'd VACS J.t/.r .W' _ — d' - Cr i1-t. • ,
Wiring,Final MAR 7 1957 VCB lT : ' n'Aer
Occupancy MAR 7 1951 , d
FORM 210 314 10.653984
o l 1 �i- 1/4s- ��/
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 317 3995 BUILDING 1
COSTA MESA, CALIFORNIA
metFOR OFFICE USE ONLY
FOR APPLICANT TO FILL Receipt No. Permit No.
Building 8-� �RLNIt/ 3 yi5e
•
Costa Mesa, California Received by Date Reo'd.�JI Date Issued
Nearest -,-",----)-- / /A•/9-5 (A //— /9- c'
Cross St. Fu(I E2rn 4) Building
Address
Owner
f3 , FLAG Cr- Costa Mesa, California
Mailail j� ,,,��
Address Z/L /7'ityt13-p/L Nearest
/�
Tel.
No.L� (OfCross St.
City C • �!n z � Zone No.of Type Grou
Architect or Lie. I Plans I r/, ///o/�
Engineer No. Approved / lyy / nim/
by � Date��//nit
I '+dress pity Lie• 7 CORRECTIONS(( /c�
_.,ntractor (J wwout•r CPRS No. 3i 37
Address 2IL /cntMOR- ,x.vo, APPROVED
LegalLot I COSTA MESA
Description I No. I Block I Tract
CITY PLANKINGOF D1:PI.
(Attach Metes and Bounds) Ar/�- < 't-r 'rZ - s u/5 t6IBJ4F pp&J UG. DEPT. REC
/�^ No.of Bldgs. �M/1,��f1J�1-1 ��
4/4
'7
Size of Lot .7 X/4/j I Now on Lot 8 ! I �/� 6 D
Use of I No.of I No.of . BY DAIb xi
Existing Bldg. Families Rooms PLAN T.CM. E
Setback Line from 1 Rear Yard 2-i1�
Center of Street t D ✓ Side Yard 4' ick. y
DESCRIPTION OF WORK ' _r-
New I ' I Alteration I I Addition I
Repair I I Moving I I Demolish I 2
Bize �uilding �/ X _�f/D No.of •/ / a
maRooms T Stories
erior Wall .car-,. Roof /�
.vering e/( �.(.C� I Covering ea/0 APPROVALS
Use df (ii`�/1E �a� /'9.‘Building [.s • coV- Foundation Inspectorion Date
/� ,�1 Forms,s,Materials,
fl Cot . 4240) Under-Pinning •.,,
Frame: Fire Stops, %a
Bracing,Boltsiti
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath.Int. C
with all City Ordinances and State Laws regulating L;
building constructs• ,. Lath.Ext.
Signature of — S .
Permittee ,, A. • /" Plaster,Int
Authorized Agt ,. °a c Plaster,Ext. C
riff-
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FORM 204 10-55 O.P.&S.
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