HomeMy WebLinkAbout3210 WASHINGTON AVE - Building Permits- CITY OF COSTA MESA -
.
BIIILDING DIVIS/ON �
F � 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • �wvw.ci.costa-mesa.ca.us
°.��� FOR INSPECTIONS CALL: (714) 754•5626 � �
PERMIT NUMBER: E09-00234
PERMIT TYpE ELEC STATUS: ISSUED
APN: 13909510 DATE ISSUED: 09/0412009
ISSUED BY: BJK
, ., �
JOB ADDRESS: 3210 WASHINGTON.AV CM Suite/Unit:
Vicinity: REAR SFD � _ .
SCOPE OF WORK: ELECTRICAL�.PERMIT TO�CHANGE-OUT OF AN ELECTRICAL SVS:AT THE REAR OF AN EXISTING SFD. 1 SVS TO
200A , ., ' . .
, �
. . -_ _ �. , . .
OWNER: JOHNSON, JASON PAUL AND JINNA - Address: 3210 WASHINGTON AVE Unit:
PHONE: � � . - � - _ City/State2ip: COSTA MESA, CA
APPLICANT: JOHNSON,JINNA .. _ - Address: 32'10 WASHINGTON AVE � Unit: . �
PHONE: 714-785-2215 � �, City/State/zZip: COSTAMESA,�CA , ' �
CONTRACTOR: OWNER-6UILDER� , �� � � ' - � � �- � -License No. 000000
Address: Unit:',' . ". . PHONE: - �- ,
Ciry/State: ZipCode: , CEtL: --
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00 , .
Reinspection Fee $0.00 . _
TOTAL FE�S � $54.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) - �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � ,
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 lo obtain inspeclions and final approval vrill result in ihe ezpiration of this pertnit.
CODEt. INSGEC710N1YPE QgjF, NI717UL5 �_ INSPEL7IONTYPE , 0� NIIRIRLS
1616 Fixed SyStem Final Fire Prevention 206 Final Mechanical � �
1266 Pool Spe Final 208 Final Plumbing ��
200 Final Ra-Roof 210 Final Electncal
207 Final BIq�WReWining WaU 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/OccuOancy '
WORKERS' COMPENSATION OECUIRATION:
I hereby affirtn under penalry of perjury one of Ihe lollowing declarations: .
❑ I have and will maintain a certilcate o( consent to self-lnsure for vrorkers'
compensation, as providetl for by seclion 3700 of the Labor Code, lor the
peAormance of the work for which this permit is issued.
❑ I have and will maintain workers' cwnpensatbn insurence, as required by
secl'qn 3700 of lhe Labor Code. (w lhe peAormance of the work fa which this
pertnit is issued. My v.arkers' compensation Insurance carrier and policy
number are:
Carrier:
(This secfbn neetl rrol Ee cpmde(etl Afhe permR is valued at one hundretl tldlars (5100) oNess )
Policy Number:
� I certify thal in the peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as lo become subject
to the workers' compensation laws of California, antl agree that if I should
become subject to the workers' compensation provisions o( Section 3700 of
the Labor Code, I shall forthwith comply with [hese provisions.
Applicanfs SgnaWre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEI^SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm ihat I am licensed under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 of Ihe Business and Professions Code, and
my license is in full force antl eftect.
Lic. # Class #
Comraclor's SignaWre �ate
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a constructan IenOing a9ency for the
peAortnance of the v.ork fa wtiich this permit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby aKrtn Ihat under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW !or the following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit lo
construct, alter, improve, demolish, or repair any structure, prior to i1s
issuance, also requires Ihe applicant for such permit to fle a signed statement
Ihat he or she is licensed pursuant to Ihe pmvisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 0/ the
Business and Professions Code) or thal he or she is exempt therefrom antl
the basis for the alleged exemption. Any violalion o( Seclion 7031.5 by any
applicant for a permit subjects lhe applicant lo a civil penalry 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 strucWre is not intended or
oHered for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law dces not apply to an ovmer ot property who builds or improves
thereon, and who dces such vrork himselt or herself or through his or her ovm
employees, provided lhat such impmvements are not intended or oKered for
sale. If, however, ihe building or improvement is soltl within one, year o(
completion, the owner-builder will have the burden o( proving that he or she
did not build or improve for purpose ot sale.). _ � ,
i �
�- -�I, as ovmer ot the property, am El(CLUSIVELY CONTRACTING WITH
L CENSED CONTRACTORS to construct the project (Sec. 7644, Business and
Professbns Code: The contractors License Law dces nol apply to an ovmer oF
property who builtls or improves thereon, antl who wntracls tor such pmject with
a cont2cta(s) license pursuant to ihe Cont2ctors License Laws.).
❑ I am exempt under sec.
Business an0 Professions Cotle (or this reason:
b� -D� -c�l
ure -Date�
30 <6 (3l0
r
'Owner ID verified by drive� _...:ense Yes � No �D
Driver:s License�No. � � F�pires: �
Verifitation of Ownership by (type of documen�, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I he2by certdy that no eacavation frve (5) w mwe feet in depth inro wfiich a
person is required to descentl, will be matle in connection with work authorized
by this permil, and that no building stnicture, scafidding, falsework, a demoliiion
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2. Art 2. Sec. 347, Title 8, Califomia Administ2tive Code).
❑ AS ovmer-builtler, I will not employ anyone to 0o work whiCh would
require a permit from Ihe Division of Induslnal Safety, as noted above, unless
such person has a permit to do such vrork from Ihe division.
Applicanfs SgnaWre Daie
Division of Intlustrial Safety Permit Num6er:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the appliwnt or presen[ or future building occupant need to fle antl
ceAily a Business Plan for emer9ency resDonse lo release or threatened
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 0( the California Heal[h and Safery Code requires, wim some
exCeptions, lhat a Busine55 Plan be filetl wi�h the CoSta MeSa Fire
Departmenl by every business which has at any one time tluring a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume o! 55 gallons, or 200 cubic feel of compressed gas
at stantlard temperature antl pressure).
2. Does or will the applicant or present or future building occupant need [o fle
a registration fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, with some
exceptions, requires registration wi[h the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of acutely
hazardous materials equal lo or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet ot compressed gas at standara
temperaWre antl pressure).
3. Does or win the applicant or present or fuWre building occupant neea ro
prepare an RMPP (Risk Management antl Prevention Program for aculely
hazardous materials�? ❑ Yes ❑ No
(Seclion 25534 of the Califomia Health antl Safety Cotle proviaes that the
Cosla Mesa Fire Departmen� may require the prepara�ion, certification and
fling with the Fire Deparlment of an RMPP by businesses which are required
to register acutely hazartlous materials with the Fire Departmenl.
4. If an RMPP is presentty required, has Section 25534 of the Califomia
Health anC Safery Cotle been fully complietl wilh? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the vrork which is lhe subjecl of this appliwlion a permit (or such construction
or modification from the South Coast Air Quality Management DisUict or from
any other air polWtion coNrol distnct or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requestetl
informalion be fumished on applications fa nornresidenlial building pertnils�.
6. Will any part of ihe facility to be constructed under this permit be within
1000 feet from the outer boundanes of a school? ❑ Yes ❑ No
(If'yes", the facility must meet the requirement of Sections 25534 and 42303
o( Ihe California Heallh and Safety Code).
7. I( a permit trom �he South Coast Air Quality Management District or other
air pollution control distncl or agency is requiretl for lhe work which is the
subject o( this appliwtion, have all of the disclosures prescribed by Califomia
Healt� antl Safety Code Section 42303 been made? ❑ Yes � No
8. (It'yes", attach certificate of compliance from Ihe appropriate air polWtion
coNrol officer�.
CERTIFICATE OF COMPLIANCE: �I certify lhal under penalty of perjury the
information given above is cortect. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Sqnawre Da�e �
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the informa�ion given is correcL I agree to compry with all state laws and ciry
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-describetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authori db 'gpermit n'Ifnalinspection.
��-O`-F-t�/
i8^a r of Le al Ownei�s) Dale '
Elw Au. e0 AOW���� Da�e
� ,
(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
Job Add�ess: 3210 WASHINGTON AV
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Primary Occ: R-1 Hotels/Apts/Res >10 Occ Type of Construction: V-N
Parcel Number: 13909510 Zoning:
Applicant: MILLER, DAVE
Address: 2870 CHIOS RD
COSTA MESA, CA
Owner: MC MINIMY, RONALD F
Address 3210 WASHINGTON AVE
COSTA MESA, CA
Contractor: ORANGE COAST ROOFING
Address: 2870 CHIOS RD
COSTA MESA, CA
Zip: 92627
Arch :
Address:
ISSUED BY:
Phone: (949)631-7924
Zip: 92627
Phone:
Zip: 92626 �
Phone: (949)637-1924
License: 434674
Eng:
Address:
Status: ISSUED
Applied: 03/25/2005
Issued: 03/25/2005
� Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING WOOD SHINGLE AND COMP ROOF, SHTG PER MFGR'S SPECS, 7 LAYER
75# FELT, APPLY "30-YEAR COMP SHINGLES, CLASS A.' 30 SQUARES -- '
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$181.25
$0.91
$0.00
$0.00
$0.00
$182.16
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existin : 0
Rear 0- 0
Rear 0- 0
Reauired: 0
FEESUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Righl 0- 0
sa>>2.o0
$s.i t z.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, 7241-92)
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 Inspeclions and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
!44&48 (&00)
WORKERS'COMPENSAnON DECLARATON:
I hereby ettirtn under penelry ot perjury one oi the following declaretlons:
❑ I heve entl will meintein e certiiicele ot consent to sell-Insure for workers' compensetlon, es provided for by section 3700 of the Labor Code, for Ihe pertortnence of I�e
work for which ihi5 pertnil is i55uetl.
�ave entl will meintei workers' compenselion insu ca, es reqWred by seciion 3700 of Iha LeDor Cotle, for the pedormance of the work for whicti t�is pertnit is issuetl.
My work/er ' mpe tion InSuren erAer end Ilcy number ere: /� �+�'
C�der^�_S� � P ty um r. ��J �� J�
YSS��ectlon need not be comn/etedfY fhe oermY is veluetl e1 one hunOred Oollars !S I001 o/IessJ
❑ I certify that in Ihe peAortner� of Ihe w c Por whi this permit is issued, I shell t employ eny per9on In eny menner so as to 6eCome subjecl to the worknre'
compansatlon laws ot Cep� r ie, end e Ihel I� should be ma sub�ec� �o t workers' compense�ion provislons ot Seciion 3700 of tha Lebor Code, I shell lorihwl�h
comply with these provi (on .
WA I���,a �`�p�'i(� 3 �-t5—_GS'
RE TO SECUR WORKERS' OOMPENSATION COVEPAQE IS IINLAWFUL AND SHALL SUBJECT qN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO dJE HUNpRED
T110USNN0 DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR WDE. IfJrEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS
I here6y aHirm that I am licen!
torce and ettecL L ci,.=+�� �
(commancing with Seclion 7000) ol Division 3 of lhe Busines �antl P�pfpysions Cotle, end my license is in full
CONSTRUC110N LENDING AGENCY:
❑ I herehy aflirtn that there is a consiruclion landing epency lor ihe pedormance ot the work br which this permil is issued. (Sac. 3097, Civil Code).
Lender s Neme:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lender's Address:
Dete:
I hereby ettirtn thet under penelry ol perjury ihet I em EXEMPT FROM TME CONTRACTOHS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness antl Professlons
Codo: Any ciy or counry which raquires a pormit to construct, elter, Improva, demolish, or repair eny stmcture, Orior to its issuance, also requires ihe epplicant for such pertnit
to file e signetl stetement that ha or she is Ilcensed pursuent lo Ihe praNsions oi t�e Contrectors License Law (Chapter 9(commencing with Sectlon 7000) ol Division 3 ot the
Bu51na5s end Protessions Coda) or thet he or she Is exempt therelrom and the besis for Iha ellaged exemption. Any vloletion ot Section 7031.5 by any applicant for a permit
suDjects t�e eppliCant to a civil penelry ot no� more ihan Ilve hundred dallars ($500).):
❑ I, es owner ol ihe property, or my employeas with weges es thelr sole compensalion, WILL DO THE WORK, antl Ihe stmcture is not inten0ed or ofleretl tor sele (Sec.
7044, Business end Prolession5 Code: Tha Conlra[lor5 LICenSe Law does not apply to an ownBr ol Oro00rty who build5 Or impmves Ihereon, antl who tloes such work
�imsetl or �erseN or thmugh his or har own employees, provided that such improvements ere not intentled or oflared lor sale. If, however, t�e building or improvement is
soltl wit�in one year ol completion, the ownar-buildor will have the burden ot proving Ihat he or sho did not build or improve for purpose of sale.).
❑ I, es owner ol �he properry, am E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to consimct lhe Oroject (Sec. 70dd, Business antl Professions
Cotle: The contractors License Lew does not apply to en owner ol propetly who builds or Improves t�ereon, and who coniracts for such project with a contracror(s)
license pursuant to the Contracrors License LawsJ.
❑ I am e:empt untler sec. Business antl Professions Code br ihis reason:
Signeture: Date:
Owner ID venfied by drivers licen5e. ❑ Ves ❑ No Driver's License No. Expires:
Venfication ol Ownership 6y (type oi daument, i.e. � pmperry tez bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hareby certity Ihet no excavation Five (5) or more leet in depih In�o whlch e person is required to tlescentl, will ba mada in connection with work authonzed by this
pertni6 entl ihat no building sirucWre, scaflolding, lalsework, or tlemoiition or tlismantling Ihereoi, will he more t�an thirry-sia (36) feei high. (Chap. 32. Grp 2, Art 2, Sec.
347, Ttle 8, Califomia Atlministretive Code).
❑ As owner-builder, I will not employ anyone to do work w�ich would require e permit from the Division of IntlusMal Sefery, as noted above, unless such person has a
permit to do such work irom Ihe division.
SignaWre: Date:
Division of Indusinal Salery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AN� AllTHORIZA710N OF ENfAY I cotlify untler penalry ot perjury I�et I have reetl this application and state Ihat the information given is
correct. I agree � comply wi all s�ate laws end city ordlnances r ting �o building constmction, end au�hodxa represenlatives oi ihe City of Costa Mesa lo enter upon t�e
above-described�operty fo��spectio�purposes. I egrea n� to uDY or ellow occupancy ot any huilding euthorized by Ihis permit until final inspection.
CODE �. INSPECTIONTYVE
16/8 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Finel Ro-Roof
201 Flnel BIaWRetelning Well
202 Finel Factory Firo Place
203 Flnel Sign
204 Finel Demolition
O�TE INTRI�LS
��� �-^ Date
' cCJ ' QS_
COpE I INSPECTION ttPE
206 Finel Machanicel
20B Flnel PlumEing
210 Final Eleclrical
212 Finel Fire Prevention
220 Final Planning Approvel
222 Finel Sl�e
250 Finel BuilAinryOccupency
)WNER MUNCY, A. M.
`�\ JOB ADDRESS
\� GENERAL C01
��� AP No.139-C
I, :CTIONS
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�GAS
W ATER
ROUGH PWMBING
PROP. $WR. LINE HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO qIR CONOITIONING
TEMPORARY SERVIC� OR POLE
UNOERGROUND � , POWER �
ROUGH WIRING
iRENCMES � FOFMS � 57EEL REINF.
FLOOR SVSTEM
BON� BEAM � STEEL REINFORCE �
SHEATHING
FftAME AND FLASHIryG
LATNING - IN � OUT n
PLASTER, 9ROWN COAT
H IG, VENT.
PLUMBING, FINP
ELECTRIC,fINA
BUILDING, FINAI
IG. AN� q.C., FINAI
GAS TEST �I
Avenue
DATE 6_�
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FIRE ZONE VALUE
GROUP J TYPE
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Complerely
RECEIV D BV D TE R EIVED D TE ISSUED
ADDRESS �72! N• Wj�Sy/y /TVC ` v� �C�
OWNEfl �Q . M, /� U NC y �+�P� NO.
'�D 5'f /D PER�/.T
MAI L BUILDING ♦
ADDRESS � Z � O � - �/Q�S/�f/NGTDN Avt �+DDRESS . ,�
TEL.
CITV CGS1'a MEif�. NO. S�%s-O% TRACT LOT BIOCK
CONSTRUCTION N W A A P
LENDER �
BRANCH
OWNER / LSL
ADDRE55 /� VALU
ARCHITECT TEL. S <<�Y���
OR ENGINEER N
FIRE
ADORESS ZONE TVPE GROUP
CONTRACTOR � W NE2 ByPROVED qTE ��
ADDRESS
TEL. ZON NO.OF USE OF NEW (�
FLANS � BUILDING
CITV NO. —
STATE CITY �'ARDS APPROVED VAROSAPPROVEO
LIC.NO. LIC.NO. MAINB ILDING ACCESSORVBVILDING
SI2E �/ /, NO.OF BLDGS. ( T
OF LOT /� K � O V NOW ON LOT I FT.
useoF RFs1Oe-NCE
EXISfING BLDG. FT
S�ZE OF � X �s NO.OF
NEW BLDG, qOOMS STORIES L. SIDE FT. FT.
EXTERIORWALLNONE ROOF M�9�-
COVEPING COVERING REAR FT. FT.
USE OF BUILDING AND WOFK TO BE PERFORMED DI5TANCE BET. BET. MAIN &
MAIN BLDGS. ACCE55. BLDGS.
N N �r ��T/ d COVE.Q C URP, qW APPROVED
APPROVE
I he�aby ecknOwlatlpa that I heve reatl Ihis application antl sta[e
thnt the nbove informmion Iz carrect end agrea to comply with
all laws ra0�latinB builtlin8 construetion, antl I s�all not employ
any person in violatlon of tha warkman's compensation laws of
[he 5[ete of Celifomie.
I haroby certlfy xhat I am proparly licensetl aa a eonhector untler SQ. FT.
tho Sta[e of Callfornla Business antl Professions Cotle, Divis(cn 3, THE AMOUNT SHOWN VNDER VA�UATION IS FOR
Chapter 9, entl tho[ sue� licensea are in full force entl eifect, or I TME PURP�E OF ESTABLISHING A PERMIT FEE ONLV:
am ezempt from t�e provlsionz of Ne Stete of Ce�ifornia Business VALUATION nI
antl Profossiona Catle, Division 3, Chap[or 9. pERMR FEE S /�_
Slpnetura of
Pormittae �� ����,� $/�� P�qN CHECK 5 —_
S "`
AuMorizetl ABent ��
TOTAL FEE $
. ; 4.�f�5 <'�
—J
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIRORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
ADD e�ss 3210 Washington Averrue
COSTA MESA. CALIFORNIA
OWNER xrojan Land Co.
MAIL x533 Baker Street
ADORESS
��TM Costa hlesa T,�o:K191151
ARCHITEC� � `4On � TEL.
FEE RECEIV��
��SEP 161g6
` FINANCE OEi�T.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
owT6 188U20
COSTA MESA. CALIFORNIA
FIRE
ZONE TYPE GROUP—
APPROVED
1533 Baker st. ZONING
COSi'.8 MeSa (i'31,1f. zoNe NO. OP uee oF r+ew
) R�1 PLANa eU�LOINO W
167293 No: KI 9-1151 �ea��
D88CNIPTION Lot Tr. 8
70 x 100 I N�;.,°�..°`°°snone ._.._ ____
use oF none
EXI6TING B �G.
BHiBACK LINB �OM CO� 31�
d'Nren OP eTAHeT � REAR YARD
SIDE YARD I LEFf 1J � I RIGHT � 7�
DESCRIPTION OF WORK -
c�cu I g II e� rrweT�nu I II enmm�u I
�6{� NO. �F
" `SQ���ilO[]MC STORIFf.'�
EXTERIOR
COVERINC
USE OF BI
Single famill residenc�with
attached araae. Plan 21B
I HEPEBY AGKNOWL¢DGE THAT � H�VE ReAO THIB API
ANO BiATH YHAT THE A00V8 I6 CORREGT AND AOREe
PLY WITX AL� CITY OFiDINANC89 AND UW6 RH
9UIILINO COMBTRuci� (� � �
SIGNATURH �F � � / i
�c¢rma uxa sr.�
APPROVED
TH6 AMOUNT 6HOWN UNOeR VALUATION 19 POR THE
PUPP09E OF E9TABLI9H�N0 A PFRNIT F8H ONLY.
$ �.6�10�.•
IAUTHORIZEO AGEN7 �-ke & Co`Yegrove, Inc�' I � I¢
TOTAL FEE $ �
4