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HomeMy WebLinkAbout3093 WARREN LN - Building Permits gg8 - oo4-ia$ AODREsscPBML00 3093 WARREN LN °M` CITY OF COSTA MESA - BUILDING PERMIT OWNERS N""E'P'D'0""'HOLLIDAY, VERNICE M TR FLOOD : X 46 PRRM Mn' P 0R7S07 AD0PESS: 3093 WARREN LN A COSTA MESA, CA 92626 PERMIT NO: B 087507 PLAN CHECK NO: N GOVT: N SUPP: N APPL MAILING ADDRESS:540-1569 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: LSC MO: JOB DESCRIPTION : T/8FF & REROOF W/COMP SHINGLES SQ FT: 4 , 500 ARM OR END.•°ADDRESS: uMT: C3HDIACTdTB NAI@ CLAIM VALUE: 4 , 500 . 00 CALC-VALUE: 4 , 500 . 00 GROUP OCC: R-3 /U-1 ccailu uusE:CONSUMER SERVICES ( 714 ) 839-4549 - I �< -�y- �V� 2 e�ESt C 16702 MT BAXTER COMMENTS : REROOF 2500SF RESIDENCE W/COMPy o.rp ADDRTS&FOUNTAIN VALLEY CA BCNU: 676090 *******atat�tx-M�rtt�E�t****aE**�t�tx�r�t�E*a*�t�Eat�tat�t�t�r***�t�E-�t#****iE********+t�E** Ir**�r�t�t+t'S *****+t 92708 DNT Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penely d perjury Net I am limed under envisions of Chapter 9 SETBACKS (oommendng web Sidor 7000)d Division 3 d the Business end Professions Code,and my license is N he force end Sled. CITY LID.NO.: UC.CLASS: UC.NO.: 7 61742 C39 l 6 0 P: 10/98 MAIN BUILDING ACCESSORY BUILDING `� Dae: ?>lli}Q� Cramer: J/ a FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN OWNER BUILD RDE RATION:I hey affirm m uder penalty peonthat l am exempt from the rector,License Law for the LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN reb laoowig reason(Section 70313 BWneee and Pmlessern Code:Any ay or county wtarh requires a peas to compo!.alar,improve, demolish.or repair any structure.prior bas Shone's,also mquues t sap caro for suchpermit to Me a Signed statement that he orehe PARKING REQ: PROV: PARCEL: 14103808 ZNE: REF NO: S licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7003)d Derision 3 d We PLANNING NOTES> Business end Professions Code)or the her the is exempt therefmrn and the bass for the alleged exemption.My violation of Section 7031.5 by any ap$cam for a permit sublets the applicant to a civil penalty of rd more then Tire hundred dollars 155031). > e_ ❑ I,aownrdlM property or ma empb/ese wet wages atfri edit compensation.ell do the work,and the structure is not intended ******************************************************************************* oroffered fur sae(sectionThe1,Seine=and Professions Cods:The CaYrmae License Law doeerdaPPly loan ownor dgopenY DEVELOPMENT SERVICES R E Q U I R E M E N -T-•S who bateds or inproves thereon.and who does such wait Himself or here)or through he or her own employees,provided the such improvements are not irdendsd prhedtSOProvement pedl'"ynamn°le`m'N' owneiur whaave the Gdenof dovrg improve*ehedtar the purpose ZONING APPROVED BY DATE: o I.ed owe of the property.ern exclusively ovnrmio with Sensed contactors to construe the poled(Sedan 700,Business end Professions Cade The Crdrmoalicse Law does not wet to an ma of proceed vete bolds or Improves thereon and*hp BUILDING APPROVED BY : DATE: ' contacts for such pnlede with a mrlrmar(s)licensed pursuant to the Contractors License Law). 4 ❑ Iamexempt uderSecdn: B.AP.C.,wthe reason: APPLICATION ISSUED BY: DATE: 331 I 1S Date: Owner ************************************************* **************************** I do hereby certify that I am aware of end understand thernrd requires CalirHeath nia and Selly Code Sedira 25505,25533,andLEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y 23531.and marl or any Mur Wading occupant, i3Ter tyle—amm will y a rd(circlemply rele one)need to cow°h said gate codes and the requirements for sperm°frmdi rauuonor moddmenham lhAk peentDitrict.ReddenlidmMndmthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE -- SMIP/RES GRADING provisions. PERMIT 99 . 75 50 Dale: Andean:: PLAN � SMIP/NON-AES WORKER'S COMPENSATION DECLARATION:I hreby diem under peavey d peone d the blowing dednier: ISSUE FEE ❑ Cl�rrdwafor the�aterof theworkf�b �S reed mnsrmm.esPrrdedlprby8edon3700dMLabe BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL • PAID DUE ❑ Ileveee'm dwigmaidenwar/sernpensaion'vuunea,mrequired mcif Ice TOTALS----> 100 . 25 0 . 00 0 . 00 100. 25 100 . 25 . 00 X� work for which this dente u Peed.My workers'compee eoion insurance carrier and policy number are: Carrier: (:nTPPM PAI:TP EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 100 . 25 OVER/.SHORT: . 00 • PolpyNumber: NNC2592603 03/23/99 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT ' GRADING PLAN-CHECK This section need not be completed I the prone is for one hundred dollen(Stool r lees.) 99 . 75 . 50 ❑ I certify that in the performance d the work dr which this permit S Sexed,I Shap m employ any peens in any manner so se to become Bion to the waken'compensation laws d CaMmde,and agree that if l should to lid workers' dE it it dE lE dE if dE dE itkf it dE dE dE lF It dE Rk oft lE oft oft RE oft df dF df it 3t dF iH dE dE kE oft it dF kE iE it**lt it lE it oft*********** ******************* woo d Section 3700 ol the Labor Code,Ieheal hwvhDern ebbe y Date: 2)1elf; Aodnam: t WC INDIVIDUAL F E E BREAKDOWN Warning:Failure to secure waer%cniplensfgan muted*Is rwwit4 and shah embitter an an**,ro ryn+ndpendnm end TYPE QTY DESCRIPTION UNIT COST TOTAL COST dell tires re to one hundred thousand dollars($104000A In eddldon to the cost.!conpensateR denudes as proelded for/n Section 3106 ol the Labor Code,Inheres(and afbrmys lee. SFR 4500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 500 . 00 CONSTRUCTION LENDING AGENCY:I hereby earn oder penalty d perky that there is a co stndbn landing agency for the Performance d the work ler which the pens is Sued(Section 3097.CM.C). END OF FEES LENDER'S NAME LENDER'S ADDRESS: , I certify the I have read this apptnalion and gate that the above information S coned,I ague to comply with all city and county ordinances • end state laws relating to building eons-mew and hereby authorize representatives d this city to enter upon the ebove'mentioned property for inspection purposes. FRANK MANGISI p3 31 1998/pl:ll PN/fl©p•�5 C1 7 Dui.: 31 31 fel8 Fcarp:pi pa�165e PERMIT :087 _H07 Signature d Osie/AoeYl r (5151a9.WP) WMe-Builry&Sidety:Oreea-rtCaney-App°cem;Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & „PA 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-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 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOVSPA 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 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 1 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 � G-l� Q., er-� �j•/w� 44. Landscape Irrigation System �!f 45. Sound Attenuation 46. Handicap Regulations el � 47. FINAL STRUCTURE & BUILDING e /J7 t.i - 48. FINAL PLANNING ll7! 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date 1635 WEST GAYLORD sr. . BRANCH OFFICE: P.O. BOX 9065 37915 N. 6TH ST. EAST LONG BEACH 10. CALIFORNIA P.O. BOX 970 HEA-LOCK 5-7493 PALMOALE. CALIFORNIA NEvAOA 6-5176 A p /� WINO90/�R 7-5911 Twining' Laboratories Of CCc ottEl2212 CaLLfott2Ca ' Inspection and Testing Engineers Soil Foundation Analysis Chemical Analysis IOctober 29, 1959 GUNITE REPORT OF es,h4.a.4lI.;: TEST CYLINDER Examination No. C59-48x6 Project SWIM POOL - J. Breathaupt - 3093 Warren Lane, Costa Mesa, For - Executive Pools California Sample from Stti mining Pool Architect Lawrence H. Boyd Contractor Executive Pools Ltd. Stix Gunite I part cement, 1.4 parts sand Water, gal./sk. cement 3 gal . per sack Slump - Date cast 10-1-59 Date tested 10-8-59 10-29-59 Cylinder No. I 2 COMPRESS IONN TEST 7 Days 28 Days Total load to destruction, lbs 56,000 86,000 1/C12.1 founds per square inch I ,980 3,0(}0 ,I• oCylinder made by Dennis SmithOJ 1>,' 25nCylinder delivered by T . . iii Newport � / ��' �" t Vi Itti . tc.a- - �ti�o Cylinder received on 59 �c• u - �' 10-2- �I 91 cc: Executive Pools Costa !Mesa Blab. Dept. TWINING LABORATORIES OF SOUTHERN CALIFORNIA JLab 1 J.. Breathaupt , ALL RETORTS ARE SUBMITTED AE TME CONFIDENTIAL PROPERTY OF CLIENTS.AUTHORIZATION FOR PUBLICATION OF OUR REPORTS.CONCLu.Iola.OR a TRACTS PROM OR IMO THEM is RESERVED PENDING OUR WRITTEN APPROVAL As A MVNAL PROTECTION ToCLIEMTE-THE FOELIC AND OUR EElVCI. 1I OWNER COLLEGE MESA COMPANY DATE 11-20-58 JOB ADDRESS 3093 Warren Lane BUILDING PERMIT NO. 8019 , GENERAL CONTRACTOR The Hal e Company VALUE $ 12,599.00 AP. No. LOT 34 TRACT 2671 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar. GROUP 1 & J TYPE V ZONE RI PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE' NUMBER Trenches Forms Steel /{,111FAiffEr Floor System , is S.- . " Steel Reinforce Chimney Re-Rod '" Bond Beam 11.---6---E. l/,'L _te a }S Frame and Flashing %.iS-"t 5- -IE - 7 Lathing, In Out a/ y /. 9 Plaster, brown coat 2/.. ?G 3-n-i f Underground soil I_y/ WIG Pipe Test A y/r.4 Top Out /2-/C-41C _ Furnace ,k.W $--fO-5' 9,, rrF"wrt. WC?ariAt- 1-13 —A-9 / E R s-,1 --- Gas Gas Vents Rough Plumbing NHS y7-SF AJ rOt/to/C .cv 9 (1 1q5: 16504 ,...- Cesspool Septic Tank - - Prop. Swr. Li J(HouskGpit. St. Swr. i n-4 w-l(1 r _ ej-, '1.�it.(),Th ,/.cs '�'� v A Sprinkling System (/ Heating Final - , Plumbing Fixtures, Final 1- Final Gas Test /4-,•24/22.5- ' -s Construction Pole j • Underground Power an Rough Wiring a _5 i E. - . ✓i.r/-r-.n. ' /. - 3o-.�1f ; • L/1. Fixtures, Final ' J-fir ' ,t. , OCCUPANCY r 7-$7-r% Form 210-5M-1-57 - / r 80i9 ut, RECUUVED „. COSTA MESA BUILDING DEPARTMENT FlNA'NCE IDEPT. P.O.A. 317 AL CITY OF COSTA VISA COSTA MESA. CALIFORNIA tli 1, L::LS171 FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADDR SS 3093 Warren Lane B U I LD I N G COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT D. et{T ycq OWNER COLLEGE MESA COMPANY X00 Li 1_, MAIL RECEIVED BY DATE R DATE ISSUED ADDRESS P.O. Box 2277, Brookhurst Station _ �L-Y //-/7-,r NOV 9 Q 195 CITY Anaheim TEL. KE3-3161 ADDRESS Bulot, Quigley LIC. OR ENGINEER an Clark NO. RE 7191 COSTA MESA. CALIFORNIA FIRE ADDRESS 1102 W. 17th St. , Santa Ana ZONE ZONE NO.OF TYPE GROUP CITY LIC. I1�� PLANS // CONTRACTOR Th°J1 1P Cnmp ny NO. 73513 1 ` - ✓ -16.4-7 ADDRESS 1777 W.Lincoln,Anaheimo. KE 3-3161 By DATE DATE o LEGAL CORRECTIONS DESCRiPiIOry NO? 34 BLOCK TRACT 2671 Plan i3-CR A.P.NO. SIZE NO.OF BLDGB. OF LOT 68 x 104 NOW ON LOT None ///��� USE OF EXISTING ING BLDG, yFL SETBACK LINE FROM CENTER OF STREET 50' REAR YARD 27' SIDE YARD RIGHT 9' LEFT in, DESCRIPTION OF WORK , NEW x ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDING 1222' -Liv. NO.OF SIZE /i '0' tar. ROOMS 5 STORIES 1 EXTERIOR WALL ROOF COVERING Stucco COVERING ' Comp(' USE OF NEW BUILDING Sin• 7.e dwelling Watt. agarage 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. VALUATION SIGNATURE 0 COL " E MESA COMPANY PERMIT FEE 5 30.00 PERMITTEE ' • 0 D BATF COMPANY ran Par r 5 12,599 ��� PLAN CHECK S 15.00 AUTHORIZED��j / 'T 'TOTAL FEE $ 45.00 vWINEK HOLLIDAY, ARTHUR DATE 11-19-69 NJOB ADDRESS 3093 Warren Lane BUILDING PERMIT NO. 31123 GENERAL CONTRACTOR Air Vent awnings DESCRIPTION of WORK Patio Cover _ AP No. 141-038-08 LOT 34 TRACT 2671 FIRE ZONE VALUE $ 600.00 _ INSPECTIONS Signature Date GROUP J TYPE It7 ZONE R-1 SOIL PERMITS ISSUED GAS T SUBCONTRACTOR Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SErRVlICE OR POLE Ll UNDERGROUND POWER ROUGH WIRING Heating and Vent. TRENCHES fl FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - 71."1-1 OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL Electric _ HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL .Sn BUILDING, FINAL- -r6-.61 • i - 2 i 173May 19-69P"—tD00 871 cd+*****6.00 CMSA COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely _n RECEIVE ) t DATE/RE Vii DAJE BUILDING 30 93 0A ILA E� I n.r.� (IKJS 11- /(/1 �i /17—/7- y ADDRESS / (� ,1 q F-- ^ �y fj�s OWNER A rts,,4... l4LLON A.P.NO. Ii//J Cv✓i'J --DJ PEQITIN/_S MAIL I BUILDING 3093 4la� ,1c.—_. ADDRESS s�,prq ADDRESS Z n O O CITY an'f _ NOL,S.�1-/���. TRACT.�tQ 7/ LOT3y BLOCK ONZCONSTRUCTION ll IA� __ NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER Akt°%>L �( J COO. BRANCH /` // J N OWNER / m J LU ADDRESS '. �//// ////. VALUE / Oo m ARCHITECT p TEL. �� USE //L/'. ( L. - $ �0a J N OR ENGINEER L. 6 A q NO ' �1 '/ WCC ADDRESS 21 l Vz. 1n .--.` 2 . . ZONE FIRE TYPE�s� GROUP. a w APPROVED W Z CONTRACTOR Ai e •1Ad. BY DATE 0 O 1�t, /� ,/y. Li cc mZ ADDRESS l,�U9 RCI. r-/ ?t.. W W TEL. ZO NO.OF USE OF NEW s✓r Z� CITY A4 ,nA,.._. NO-S36/1366 /.`� PLANS BUILDINGJ,, 44 `/zit,!✓ —O STATECITY YARDS APPROVED YARDS APPROVED LU (AQ LIC.NO. lit' G 2. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 00 (FROM C/LST EET) SIZE INO.OF BLDGS. / kyr . l - SI LOT 4.0( iQp NOW ON LOT FRO C 'f/Yw FT. USE OF � EXISTING BLDG. S 1' ; . g. . R.SIDE CIO FT. FT. I SIZE OF Is NO.OF Z NEW BLDG. A K 1S ROOMS STORIES L.SIDE /5-FT. FT. Q EXTERIOR WALL ROOF // V_ COVERING COVERING Alt,...... . REAR tK/FT. FT. ' ' J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL d MAIN BLDGS. ACCESS. BLDGS. C. .P.# APPROVED I ++-ter JH.C.d+V W7✓'•-V —B_UROVEDV JIQCJ DATE// /7 .-e 9 z 0 V I hereby acknowledge that I have reed this application and state r 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 the State of California. as ? I hereby certify that I am properly licensed as a contractor under 3 0 O SQ. FT. 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 effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2 am exempt from the provisions of the State of California Business and Professions Code, Divislo 3,Chapter 9. VALUATION m . PERMIT FEE $ " N O n AZ Signature m Permittee ^ $ &(/s+ PLAN CHECK $ E �� Authorized Agent loLL STOTAL FEE $ APR 2. 6 1960 OWNER BRETTHAIIPT 1 DATE 9-21-59 JOB ADDRESS 3093 Warren BUILDING PERMIT NO. 10h20 GENERAL CONTRACTOR Executive Pool VALUE $ 3,350.00 AP. No. 113-256-08 LOgT / TRACT FIRE ZONE DESCRIPTION OF WORK Pvt. Swim Pool INSPECTIONS' ro / 06) DATE GROUP TYPE Pool ZONE R 1 Underground Evia• U.G. Water PERMITS ISSUED _ , Underground Gas — SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing eeCFr —,Z�-s,�ei,-',n�� ®h 4;.—q �' 7�l' "o?07j� Miscellaneous • C +�Qools _ _ i jam - �_ P Prop. Swr. Line House on. St. Swr. tinSystem r�F=C/� jWAP Heating, Final Plumbing Fixtures j a y Final Gas Test - if., -B4-.771, 62-ccn4 .1/ //-'6 - SY in/#.7 5x99 Construction Pole . Underground Power C Rough Wiring I MC e tlzor iu-i5-LTi /C 53 / Trenches F rm Steel Floor System ` Steel Reinforc •miey Re-Rod Bond Beam Sheathing Frame and Flashing Lathing, In Out I Plaster, brown coat Plumbing Fixtures, Final tw //.Q--527 Electric Fixtures, Final \ Building, Final Li-2%6'n ' \ OCCUPANCY I Form 410-3M-4-59 _ 10/420 10 0 r EE _ RECEIVED C • 9-023-5-7 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS v 7 yO ry (�(� 3 / )n,enEN T COSTA 4' MESA, CALIFORNIA FOR OFFICE VSE ONLY 1 �� OWNER i 1 ��,iLiP��idI RECEIPT NO. It\j.�/bV MAIL _ RECEIVED BY I A?ECEIVEQ DATE ISSUE ADORES A - A �� 3 V 1q 9-3-5 1 CITY _ // , _i TEL.NO. G 0 7 ADDRESS 3 a 93 ARCHITECT ///� LIC. COSTA MESA. CALIFORNIA OR ENGINEER . • r' NO.0 R�ai�, �I 17.�(/J� / FIRE0 car ADDRESS Nan..,� 4..... / 2....? / ZO E 4 TYPE ft - CONTRACTOR / 0 C NTD. -I'V( ` D //�/ q -c /� • / r.• Bp DATE / 2, I ADDRESS (�(rj...c .aJ (yl/ ZONING _ LEGAL LOT /(� ZONE 111 NO.OF USE OF NEW / DESCRIPION I NO. �/ ``I BLOCK qq (� TRACT _ )' F. I PLANS I BUILDING , / ! J� V!J BYPR7/(Dl / D. DATE y__„2-3_ SIZE 7 C,S / rv0.of BLDG.. : YARDS u'EVE5 / OF LOT y� NOW ON LOT REQUIRED ALLOWED USE OF ! • (CENTER LINE ST.) EXISTING BLDG. FRONT 4. FT. M-f'�j1 i IN. • SETBACK LINE FROM CENTER OF STREET REAR ARD .. R.SIDE SFT. IN. SIDE YARD I LEFT I RIGHT : L.SIDE JFT. 71 IN. DESCRIPTION OF WORK ` ' REAR SFT. IN. ' NEW I II ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I • BUILDING NO.OF • SIZE ROOMS STORIES • EXTERIOR WALL I ROOF . COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED I. i . .4_ - 40•• as. I HEREBY ACKNOWLEDGE THAT I HAV READ THIS)APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES A 0 STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRU7ON VALUATION SIGNATURE OPT r/i. PERMIT FEE $ /ate 0z9 PERMITTEE IY06✓ ' $ . �S \d -� OV CHECK $ (6,. O AUTHORIZED AGENT 9 JJ TOTAL FEE $ eir/ Qit>