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PROJECT ADDRESS: 120 YORKTOWN LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 06953E
OWNERS NAME: PETERSON JULIEN M
ADDRESS: HOLMES—PETERSON, NATALIE PERMIT NO: B 069539 PLAN CHECK NO: N GOVT; N SUPP: N
120 YORKTOWN LN
COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: ALT
ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION T/O RESTH & REROOF W/COMP & HOT MOP SQ FT;
2, 508
ADDRESS: UNIT:
CLAIM VALUE: 2, 508 , 00 CALC—VALUE: 2, 508 ,00 GROUP OCC; R-1 /
PERMITTEE: STOUT ROOFING, INC, ( 310 ) 923-6775
ADDRESS: 9700 WASBURN RD COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED
DOWNEY CA 90241 +E*+Ear+Eer+ *4******it**+E**�6**************�E*+r* Fir*********�r*****+,FSE*ft****** ******,r****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONI NG REQUIREMENTS
70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S
CITY LIC.: 059 377 STATELIC.: 402536 CuuS. C-39 EXP: 0/95
sate: (OIC signature:_ MAIN BUILDING ACCESSORY BUILDING
WORKERS'CEdMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation In prance or a certified copy thereof(Section 3800.Lab.C. LEFT ; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY ND.: 55 8 2 2 699 EXP.DATE: 05 /19/95
comm: AIG PARKING REQ: PROV; PARCEL; 41916230 ZNE: REF NO;
❑ Certified copy is hereby furnished. 0(Certified copy i filed with the city Building Division. PLANNING NOTES>
Q / > •
ate: I0l !'"'/r Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed NOTES> ,
.
ate• I 01241 Li Applicant: > •
**** D E V E. L OP MEN T SERVICES REQUIR E M E N :T S
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, ZONING APPROVED BY DATE; .
• •
Date: Signature: BUILDING APPROVED BY
ode.NOTICE:If,after making this declaration,you should becomeor subject s the Workers'
remDensaticn provisions of the Labor : DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE: y^ Qf
which this permit is issued(Section 3097. *********************1E************** ************************'iF iF * *7Ey
LENDER:
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 5 0
repair any structure,prior to its issuance.also requites the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business P L SMIP/NON—RE
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
nN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5tp). ISSUE FEE
I. as owner of the property or my emPloyees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 , 50 0 , 00 0 , 00 54 , 50 54 , 50 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED; 54 , 50 OVER/SHORT: , 00 •
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 00 , 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or Improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware *****'*'*************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. IND I VIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B. 8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 508 .00
I do hereby cenify that I am aware of and understand toe requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant'.
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
pro eny((for inspection(T� ((p�urposesr. 17� _ ///t
ate LO'0� 1''( Signature: jr—'''-- (/
Driver's License or Social Security x: ` _. DATE; 10/20/94170592 13 TOT 54.',G
TtrE: 13:os
1641.46 Wnpe—Building:Green—Code Enforcement:Canary—Applicant:Pink—neve seSSOr
•
CONSTRUCTION AND PLANNING POOL SPA -
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
i
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3.'Electrical Conduit'Utility-Undrgrnd. 54, Forms
4...Electrical Conduit-Uhdrgrnd. 55. Electrical Bonding 1
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
.: E;:Electrical UFER Grnd. 57. APPROVAL TO COVERiGUNITE
•
"• J.-Footings 58. Electrical Conduit-Undrgrnd-
B.-Foundation -n 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undtgrnd. 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 .i
'
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
11
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
rr-. U.
20.-Rough Factory Fireplace . >• -i . "APPROVALS D :Permit # .-
- n-
21.-Ou ts, in,Structure I - -' - `
.. _ . �i70. Unde"rgF;oend Hro
22. Ducts, Ventilating i - _ - '71. Product-Prpiitg ❑)Gas DOil
+
21-Gat Plpe'Rough &'Test - _ X72. Underground Flush •
. - �,
24.-Rodf Framing - � '
- '73.'Underyrnt.Storage:Tank 0 Gas ❑Oil
25. Roof Sheathing _ i2--Iy-4:4 (a(446e. 74r:pyethead Hydro -
26.•T-Bar Ceiling (Structural) & tt4onocoat - •• 75.rDry Chemical
27. Frame and Flashing' • : 761?-01y Standpipe t s ,'
28. Lathing& Siding.71 - _ •• ••'. -- 77' FIXED SYSTEM FINAL' -
29. Insulation I ` : 78,:FIRE PREV. FINN_ _
:30. Drywall Nail'mg - HEALTH.DEPT� REQUIREMENT
31. Plaster Brown Coat' • _ _ - I i` , ,79:�FINAL ItiSP.ECTIO:N
32" Electrical Power Meter F4t
-,Final , ., t : 180.: FOOD CERTIFICATE ISSUED
33. Final Electrict_ : `'�Not'es: _ .1 1 1
:34, Final Heating & Air`-Conditioning.: i t t •-...
ii
35'1Final Gas Pipe-Test '* r - •'r_. r
.. . , , _> `
r
,36.'Hood or Canopy : `i. , -
-37. Final Factory Fireplace I ' ' ' .l." --
38. Final Plumbing • , H .. t 1 _
-39- Water Service-Final - t
> I I -. -t +
0. Gas Service-Final.. ii i` v.
41. Solar Domestic-Final ' - •
,, . . -, .`� ._.
42. 'Backf low Preventer. - •
43- Backflow Irrigation : ., .
•
44. Landscape Irrigation System _
45. Sound Attenuation
46. Handicap Regulatio s
•4 •
7. FINAL STRUCTURE & BUILDING ' 6 pr.q7 664: : .
48. .FINAL PLANNING' ' i .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ..
51. CERTIFICATE OF OCCUPANCY "r _ ,
No, Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 1
CITY OF COSTA MESA CONST• U TI •NAE jMIT r PE�(3VS:-NO. •/ n Q� TRACT NO. LOT NO. UNIT NO. ' ' •A P # I ^ _.
Y r/,' (f� J PENS:-
31� J / V • , .., J Zone..
Prd;-ct Address I V
S Main Building: 'Accessory Building
Applicants Maili • AddreSs �p • TYPE OF CONSTRUCTION NEW ❑ ADD U ALTERATION U REPAIR 'E - • . .. ,— Z
Owner•s'Name ��� III CONVERSION ❑ DE OLISH ❑ OTHER
�' f'r,.6 one LrV�y I!G DESCRIPTION OF WORK/USE OF BLDG. A Rear f= N
Address Ilio Y 0/ 6 I ' /. - i� - - I _
Arch/Eng. - License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATI ❑ STRUCTURAL K' Right-, } n _ f 1L. G
Address ,,//'� • ❑• TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL -$ . Left I ; • -4. I _I , „- R
Contractor's Nam-• G kVr 1 { one ❑ OTHER "' `` Ping: Ref.# . - l -' ?Parking Req./Provided t • i E
•
DECO
7 ' �J./��' I i q PROJECT DESCRIPTION SQ. FT. OCCUPANCY � RECEIVED u —' 2 j��� M
Address(mailing) �0✓y 'll r.91 1� r ' "1;4100 Planning Notes
CONSTRUCTION TYPE VALUATION$ RECEIVED
DECQR$�
LIty LiSN0. • �` / ZONE GRADING CU.YDS ACRES ''I. RECEIVED UI J 198b..'LICENSEDS-
CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - • - '
with section 7000) of Division 3 of the Business and Professions Code,.and
my license is in full for• a - .ars ect. - ELECTRICAL . , ' FEES `
License lass I Li - se Ni. 6.01,..• .
Date . - /-*-tic Signature I•1 a I s .� PLUMBING FEES Automatic Washer; ' Transformer '❑ 1550 KW i'
allWORKERS'COMPENSATION DECLA-ATION Construction Pole Sub. ❑ 50+ KW Ir '
hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers t
'I '- Workers' omp nsation I surance, or a certified copy there f Section Cooking'Unit Meter ❑up to 100 amps _ I
I 00, Lab. I'1(��i (j�', - - - Backflow Preventer .Service Sink _ —_.
rolicy No. U'/ f✓ Company!ficrE N V Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps
certified copy is hereby furnished. - -
er ;fie cop iletl with the city Builtltng givisio ., I I ^ Bathtubs Sewer Connection Dryers a5 I¢Ctric I Sub Panel ' ,
lhpplyllfS.Vf /Tc/ '%AI VI (s/N1y ❑G ❑E
n
ate— Applicant I
f' Clarifiers I Motors❑0.1HP 8
EXEMPTION FROM WORKERS'COME A ION D CLARATIO Solar Collectors -
-(This section need not be completed if the emit is for one hundred ($100) or- - - - — - --- •--^+— _ -- -
less) Dishwasher ' • Solar Piping F:A:U Inc;Solar'09-15"HP Q76=15+
I certify that in the performance of the work for which this permit is issued, i Fixtures, Microwave , '
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank � • I -
Workers' Compensation Laws of California.; • - Device Boxes
Date - Signature Floor Drains Swimming Pool w/Spa i Pole Light
NOTICE:If,after making this declaration,you should become subject to the , _ Outlets • _ Range a I_ I _I_ `
Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks Urinal - _ _. _ g _ __ _
comply with- such provisions or this permit shall be deemed revoked: - - - " —, - — "' — ,
CONSTRUCTION LENDING-AGENCY - - Switches - • Sign '
Gas Service butlers Water Closet , =. 1 9 i ' i •
I hereby affirm that there is a construction lending agency for the performance - -
of the work for which this permit is issued (Section 3097 Civ. C.) •
Garbage Disposal Standing Sections;
Lender's Name Interceptors Water'Heater - _ 1
Lender's Address - Kitchen Sink • Water Service ' Generator 00-5 KW 05-15 KW Trash Compactor l
OWNER BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash - .. t
following reason (Section 7031.5 Business and Professional Code: Any city or - - _
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays • , A -• !
any structure, prior to its issuance, also requires the applicant for such permit _ ,
.to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - . • • i ! I - •
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of - ., -
Division 3 of the Business and Professions Code) or that he/she is exempt Reins eaion Fee -
' ti131.5 m and the basis for the alleged exemption. Any violation of Section P I ! $15 Issue Fee i j $ 3
131.5 by any applicant for a permit subjects the applicant to a civil ,` - r
•natty of not more than five hundred dollars ($500). r ' DEVELOPMENT'SERVICES REQUIREMENTS: I 1 '
O i, as'owner of the. propertyor my employees with wages as their sole .Reinspection'Fee $15 Issue Fee $ 3, I
e I Zoningapproved By Date '
compensation, will do the work, and the structure is not intended or-offeredtracto ;
for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES'; ' Building Approved By' Date
License Law does not apply to an owner of a property who builds or improves '
thereon, and who does such work himself/herself or through his or her own , - • - Application Issued By I 1 - ' 1 /// , I Datg
employees, provided that such improvements are not Intended or offered for Boiler - , Hood or Type I. 0 '`lam
sale. If, however, the building or improvement is sold within one year of corn- Canopy" Type 11 0 ( SUMMARY OF FEES
prove , the owner will have the burden of proving'he/she did not build or im- Duct-Under Ground • •
prove for the purpose of sale). ' BUILDING PERMIT i $ SMIP j $ •
❑ I, as owner of the property, am exclusively contracting with licensed con- - Duct-Structural Refrigeration System PLAN-CHECK , F f
tractors to construct the project (Section 7044,Business and Professions Code: 'e} : ; $ I PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating f'00-100,000 BTU.0100,000 BTU 1 • PLUMBING ' $ 1 I ' ISSUANCE $
builds or improves thereon. and who contracts for-such oroiects with a con- - - - . - ' q
tractors license pursuant to the Contractor's License Law). I am aware thatII 4 P.LAN(CHECK 25% $ ENERGY, P.C.
Exhaust System 0 Multiple 0 1 System Repair/Alteration - , ,
proof o their Worker's Compensation insurance should be provided to me.
ELECTRICAL $ (GRADING I $ I
❑ I am exempt under Section B. & P.C.for this reason , Firepl/Fact.Blt. ICBG# Fire Dampers EXPIRED 1 1• .J
tt PLAN CHECK 50%. $ ' ;MICROFILM $ i i
He in System&Ducting Re isterU coin to I tloi1L /
Date Owner - - 99 g C �, I MECHANICAL 1 $ I /�� i $ ! m! I Q(
I hereby certify that I have read this-application and state that the above. 0100,000 BTU 0100,000 BT ///�q '7{ TOTAL FEE
information is correct. I agree to empty with all city and county ordinances ///G4,-/, I PLAN,CHECK j 25%' $ 1 — r`r'c) ! - I 1
and-State laws elating to building onstrucsentatives otter • -mentioned •inspection • Date -' / k 4 - I I !
•
Signature I \ i / /
Drivers' License or S$9F ��� '����� Reinspection Fee $15 Issue Fee I7 •, $,�' a .1 1 O1 t7002?552—(10 2�Q,82 _•"(ti rig I �L,�I tfi
. _ _ _ _ — -
0865-46,-rev. 5/88 White - Pink -Accounting; Goldenrod -Assessor nTk;" 1 ���!u T.JJC• r_<..J
T i7s:;:S�
- - ` ,
CONSTRUCTION AND PLANNING - POO. SPA
Date Inspector Date Inspector
'.'APPROVALS Permit# • APPROVALS Permit #
1. Temporary Electrical Service or Pole52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd: i - 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. ElectricalUFER:Grnd. 57. APPROVAL TO COVER-GUNITE -
7..Footings . "r 58. Electrical Conduit-Undrgrnd. • •,
-
8.•Foundation - } - * 59. Gas Pipe, El Undrgrnd., Test
9. Water Pipe-Undrgrnd-. - • , - 60. Backwash Lines,P-Trap, 0 Undrgrnd. +'
•10. Structu?al Floor2System _ r I . ' '
61. APPROVAL TO DECK ,:
•
-H 1..Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 't ,,- • 63. Heater & Vent-Final
13. Roof D-ains 8 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 '
);Eq. Rough Electrical-T Bar Ceiling 9 69. POOL/SPA SYSTEMS FINAL
.19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
4
20. Rough Factory Fireplace APPROVALS Permit# •
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23r Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil .S
: 25. Roof Sheathing 74. Overhead Hydro•
26: T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical -1
•
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 . : -
i
31. Plaster Brown Coat 79. FINAL INSPECTION - - •
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED +t-
33. Final Electric Notes:FS:-yct tea ogee, Gc
34. Final Heating & Air Conditioning 3
35. Final Gas Pipe-Test '---
� i.ime/A /iis,tar •
36. Hood or Canopy .
37. Final Factory Fireplace
38. Final Plumbing - .
39. Water Service-Final -
40. Gas Service-Final . " ti`
tr ) I4i \
41. Solar Domestic-Fin14 rn - i ,-- __
42. Backflow Preventer--' "Jr- ' J
43. Backflow Irrigation' ) t . . . !- ,
. 11 :.3
44. Landscape IrrigatiorfS•ystem f - I '
45. Sound Attenuation _ - •
46. Handicap Regulationsq:-c: , -
47. FINAL STRUCTURE.&BUILDING _ - . . .
48. Special Requirements Completed .
49. Electric'Release to Edison -• ' ,_ •- '
50. Gas Release to Southern California Gas•Cci . .�'J ��'
51. CERTIFICATE OF OCCUPANCY - �~` • t. :
.-
No. ,Date - - �Q,f �r
_ - _
OWNER SAN VTS'PA RITTT.DTNfT COMPANY DATE 6_1 _61
JOB ADDRESS 120_Yorktown_I,ane BUILDING PERMIT NO. 222A9
GENERAL CONTRACTOR __ _ VALUE $ 545 n0
AP No. LOT 3n6 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res w/att_gai
•INSPECTIONS Signature DATE GROUP TRT TYPE v ZONE g
S PERMITS ISSUED
/ 4 'rai SUBCONTRACTOR DATE NUMBER
Water f efr / -
Rough Com! i ❑ Air Cond. 0 q /
Rough b ��u/'//(,S/ i 1 A�� ///.AL .� .��
Rough Plumbing , /� OIl f /y/ .6-/- fp (L f/ •••r-
Miscellaneous
.r
Miscellaneous /- /� /
Prop. Swr. Line q/House Con.TA St. Swr. 0 f///, - j� [..i /- e - DEC—T19537
Sprinkling System / �4{
Construction Pole ieIii
Underground 0 Power 0 ,9�, /J
Rough Wiring 9!L!� 7- 7Y -`� /.,�/�4j,` .(1.&.CJVY 7-10-44 e �,��`�' e.--
Trenches 0 Forms 0 Steel Reinf. 0 e (' / S//(-T
Floor System _
Bond Beam 0 Steel Reinforce 0
Sheathing /I /.
Frame and Flashin! ii/i - :77Agnir
Lathing— In,t Out ter kat - SAr.
Plaster, brown coat / o- n [t4
Rr"y. 0 Air Con. ❑ Final /
I ig, Final / 7/--,71.07/
frJ
Plumbing Fixtures, Final ✓i/j//' SaK.Rea. ti.r
Final Gas Test Aye` ,,;7/ / /`il (J.*.j'�
Electric Fixtures, Final jj/`.r?? / - TT- r 4 Dote
Building, Final
OCCUPANCY
Form BU4-6M-3-63-5-B P _,....n rnD CPPrTAMERFUTREMENTS
22289FEE RECEIVED
•COSTA MESA BUILDING-SAFETY DEPARTMENTCCET.
P.O.BOX 517 COSTA MESA.CALIFORNIA
�
OF COSTA MESA
For Applicant to Fill In Completely APPLY* ION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING 120 Yorktown Lane
ADDRESS RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIAI 7'2', n
S
RECEIVE Y DA ' ICE, HD CI B'TE ISSUED,
OWNER San Vista Building Co. —//- .1UN 1 1964
BUILDING
ADDR
MAIL ESS 1166 E. 58th Street ADDRESS
FIRE
�^ ''��
TCL ZONE TYPE I/ , GROUP.4:r-
APPROVED
ly)
CITY Los Angeles 11, Calif. No.'AD 37187
OR ENGINEER Raymond Levanas NO OR 37010 ByPROV HD DATE \1
ZONING
ADDRESS 3432 Via °Dart:Os Newport Beach Ix I NO.OF I sUILDI ,1 I
K...
-� PLANS SUILDIMO. 1. �I^
CONTRACTOR San Vista Building CO. K. (/N\ _(�-- I
LEGA
DESCRIPTION Tract 5160 - Lot 306
ADDRESS 1166 E. 58th Street / /
A.P.NO. C `/I . L 17-- 3 ..-- \.L
CITY Los Angeles 11. Calif. l S 1
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE LIC.NO. 192782 NO AD 37187 90'70 SIDE 3REAR P.L
EAVES
SIZE 20 x 70 I NO.OF BLDG,. 0 ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED -
UUSE SE
OF BLDG. None MAIN BUILDING ACCESSORY BUILDING .41
NG ' (FROM C//LSTREET) CW
SETBACK LINE FROM 13 1
FRONT (Th FT. PT.
CENTER OF STREET REAR YARD /� N
_SIGH YARD) LEFT 0 I RIGHT 0 R.SIDE ( PT. _ FT. C
DESCRIPTION OF WORK L.SIDE C` . FT. (n
/ 8 `' �
NEW X ALTERATION ADDITION - RSR �' ,L„-
111 DISTANCE BET. BET.MAIN e i
REPAIR �MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS. I1.1
CE
BUILDING //II �j NO.OP 7 H E VAR.* `/ DATE /
SIZE OC O 5 ROOMS STORIE C.U. APPROVED Op
,1q /c— W
COVERING • COVERING BYR e { • I DATE S �• 1> On`
USE OF BUILDIP) AND WO K OBE PERFORMED 1. .)
Residence a
.A4afterej
aViValoHT. - 7070 rt.- 0
I HEREBY ACNN9 EDGETHAT I HAVE READ THIS APPLICATION rc
THE AMOUNT SHOWN DER VALUATION IS FOR THE TO
AND STATE Tr T E ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF BSTABLI HINO A PERMIT FEE ONLY. DI .
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /_� „
BUILDING CON Tpu ION. PERMIT FEE 5 n
SIGNATURE OF '� 7�/��L/`�(vA�--�
PERMITURE l 1 /4'1^733:-PLAN CHECK $ C23 '5-$C2 o
AUTHORIZED A ENT \ •J/ / '//may/ 5-(� L
TOTAL FEE $ / ✓".
t I