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Home My WebLink About159 WILSON ST - Building Permits • ' Mp CITY OF COSTA MESA 4<i.t ke BUILDING DIVISION Y%11� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4t.. 00 ' J PERMIT M01-00028 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 259 E WILSON ST Status: ISSUED Suite No Applied: 01/22/2001 Issued: 01/22/2001 Vicinity: HALLWAY Parcel Number 11913112 - ISSUED BY: Applicant: DEANGELIS, DON • Address: 14 SANTA CATRINA - Phone: (949)589-6592 RANCHOSANTA MARGARITA,CA Zip: 92688 . / 6',i Owner " WILSON,SANDRA Address:' ,259 E WILSON ST- , - - , Phone: , COSTA MESA,CA Zip: 92627 ' .0 ' • :- sk i\ ': Contractor:-.);COAST AIRE g/ • � '• Address: ' 14 SANTA CATRINA DO- \ ' ' - Phone: (949)589-6592 . , ' ' • RANCHO SANTA MARGARITA,CA Zip: 92688 , . ' License: 355425 Arch/Eng : - ' Address: / ` ' ' • Phone: - - " . License: i SCOPE OF PERMIT ' REPLACE EXISTING.FURNACE. ; . , 1 FAU<100K BTU. ii FEE SUMMARY ' Quantity _ ___ 1/',� , , Quantity ISSUE FEE- $23.50 Repair/Alt Absorbtion Unit Inst FAU<100 kBTUi $14.80 1 Repair/Alt Refrigeration Unit ' $0:00 / 0 Inst FAU>100 k BTU .. ,- $0.00 0 • Ventillation System „ 7, -i/ ' $0.00 ,0' Repair/AIt>Cooling/Heat'- '7, $0.00-: 0 . - Evaporative Cooler ,- - - 1// . $0.00//0 Inst/Rep. Rebes's.Wall Htr � _ ,x$0.00 0 ' ' � Commercial Inclneralor -�� . -. $0;000 Refrig Sys<100 kelp '/j" ' $0 00\.0 - Domestic Incinerator $0.00 0 RefrigSys>100 k.BTU y \ �l/ � $0 00�0��c " Compressors/Absorption Systemsi �j �!%/ Gas Piping A . /7$0 00 0 _:. .Up to 3 hp/100.k BTU" 7. '�' /,/1$0.00 0 Factory Fireplace ��N - ( $0.80 .0 3 To 15 hp/500 k BTU . ' �l/ ;'" $0.00 0 Hood w/Mech Exhaust `'�N - .$600 0 -- 15 To 30 hp/1,000 k BTU' " $0.00 0 VAV Boxes , $0.00 0 30 To 50 hp/1,750k BTU r $0.00 0 Vent Fan/Single Duct ��- ;'$0.00 :0 - , .. Over 50 hp/Over 1-,750 BTU ,,79 $0.00 0 Appliance -x$0.00 - 0 ' Boilers Fire Dampers $0.00 0 - . . Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp , . ' " $0.00 0 • Inst or Relocate Appl Vent $0.00 0 _ - .15 to30 hp . - $0.00 0 Air Handlers< 10000cfm $0.00 0 - - -- 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 . Reinspection Fee $0.00 TOTAL CALCULATED FEES $38.30 COMMENTS/SPECIAL CONDITIONS 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 expiratlon.of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS WORKERS'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 work for which this permit is issued, El 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'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This ection need not be completed i1 th rmit is valued at one hundred dollars($100)or less.) certify that in the performance e 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 Califs nd agree at If I should become subject to the workers'compensation provisions of Sectio "3700 of the abor Code,I shall forthwith comply with these Prov on / Applicant Signature: Date: S•2- WARNING:FAILURE TO SE R RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIM AL PE S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100 ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF TH LABOR E,INTEREST.AND ATTORNEY'S FEES. I LICENSED CONTRACTORS DECLARATIO • I hereby affirm that I am licensed under p •v' ions of• .•ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code, nd my license is in full force and effect.Lic.kClass# Contractor's Signature: /" Date: /' 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). 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,Businessand 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.It,however,the building or improvement is sold within one yea`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 en 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 ❑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: 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 ❑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 ❑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 aEermit 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 L-I 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? El Yes ❑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 Coast Air Duality 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 prescribed by California Health and Safety Code Section 42303 been made? ❑Yes El 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 AUTHORIZATI• ' •F ENTRY' 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 ci dinances F'ing to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes ,•ree not t• •• upy or allow occupancy of any building authorized by this permit until final inspection. Signature fr.'Off,'=& ' 7 2 : D- O/ iI And/O vi'ar Applicant Date CODE! pISPECTION TYPE PdIF WTRIAI$ CODE! INSPECTIONTYPE PATE INTmAL$ 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 5"1 itge 40 • • CITY OF COSTA MESA o v._�,•4 BUILDING DIVISION PERMIT NUMBER 1.1 m_. ,. � DEVELOPMENT SERVICES DEPARTMENT * • PERMIT P00-00136 09 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 159 E WILSON ST Status: ISSUED Suite No Applied: 03/16/2000 Issued: 03/16/2000 Vicinity: FRONT OF PROPERTY Parcel Nunmber: 43926119 ISSUED BY: Applicant: GRUBER, GARY MARTIN Address: 1280 BISON ST. NEWPORT BEACH,CA Phone: (949)645-6188 SUITE 139392 Zip: 92660 Owner: ' SHEPHERD, DARCY ` ' Address ' 159 E.WILSON ST. - - , . Phone: , COSTA MESA,CA Zip: 92627 Contractor GRUBER PLUMBING COMPANY Address: 1280 BISON ST. • _ NEWPORT BEACH,CA' ' Phone:. (949)645-6188 SUITE 139392 : . Zip: 92660 . License: 716639 Arch/Eng : ' - Address:, Phone: . Zip: License:7 - . SCOPE OF PERMIT INSTALL NEW SEWER LINE. - - • FEE SUMMARY AMT QTY - AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub)Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 , P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub -. $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System _ - $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units - $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo • $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $24.65 1 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial - $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 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, 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 DECLARATIONS • t j WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sett-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. O 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'compensation Insurance carrier end policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) AI certify that in the pert mance 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 lifomia,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 these pro ions. Applicant Signature: L. .-ti _..-------- Date: 3---/C 4-, WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),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 licensed under revisions 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.# -71 5I_ Class# C —3 6 Contractor's Signature: — Date: Z—/C,'—tet, 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). 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).): o 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 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 6,Califomia 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 Califomia 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). ....-..... will tor..... g.._.__ ...t.o...pr _.. . Management and e. materials)?.. ............ 3 Does or wthe applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous mate ❑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 Califomia Health and Safety Code been fully complied with? 0 Yes 0 No .tion.._ _ ueilntrequ __tion _ ___._ _._ __._ tio _ 5 Does thee-will the applicant orQuality presentaa emen building occupant at y other for the work ontch districtIs the subject agency?this a Yesestion aLEi No for such construction or modification from South Coast Air Management District or from any other air pollution control or � LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ._—Will any the facility .__._._ nmittion na .-_.ol .....--...-_.._-.....___ 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .....___ . from -......... .... ..___ ....-...___ .o.......__ ..__..__ of this 7 a tiothan the South Coast los Air Quality Management or other air pollution control district agency is required for the work which is the subject this application,have all of the disclosures prescribed by Californiaia 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 MPLIANCE 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 t omply 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-describe roperty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date 3 — (C—w And/Or Authorized Applicant Date CODE or, INSPECTION TYPE OAS INTRIALS COPES INSPECTION TYPE PATE INTmALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical �Y • // 1266 Pool Spa Final 208 Final Plumbing 3�/7/KJ IJ�iAtyy,— 200 Final Re-Roof 210 Final Electrical U 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 2446-46 OWNER PARSONS, DONALD-L: DATE 4-9-57 JOB ADDRESS 157— 0.677,\ �5. Wilson Street BUILDING PERMIT NO. /f4815 GENERAL CONTRACTOR Romar Bldrs. VALUE $ 7,316.00 AP119-052-35 LOT 95 BLOCK TRACT 300 Res. w/att. gar. As Der U. B. C. - GROUP I & J TYPE V ZONE R4 FIRE DISTRICT 4841 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR cc y�t ..�� ! DATE NUMBER Footing Trench �p & 4 'dA `i/ , i r ,/ . . Foundation Forms and Grade to Garage/ ,t eaF • .yi..CC t^-'_7 S---../0 '" 7 r Rough Framing e. vGp S ' ,J, ' Plumbing,Rough to Slab `9 'rtic sir/A-5 MPAPOSIWPOr _ /- - FS/ ) 9 r/ Plumbing, Rough Complete _ Temporary Pole Wiring, Rough Mit,Y 1 . 1951 VCB / /7�i 9- �-ler-s7 4,Q/1 (t Heating,Rough V J. it-,1l y-/0-5-7 re/ 7 S/ V' Heating,Finali `J ,'/S�-$-7 Sewer, House Sewer,St. L....../ ///y/ -j .....K.,...4446-----" 7/75 / 'kg/ Septic Tank or Cesspool Q �r� Lathing, In ry1 Out X (y4j 6- -,z� ' 7 Plummng,Final,Fixtures Complete in Ca? JS'S 7 S / — Plumbing, Final Gas Test /SO" h.b S %-/ ,s7 )�",_�n 7 ASV' /I ' ' Wiring,Final [� i 4e. C. U • _ Occupancy 4_ rl�A it-i6-s) FORM 210 3M 10.55 4815 4841 FEE RECEIVED COSTA MESA BUILDING DEPARTMENT CNC /2,17.-S 4(? P.O. BOX 317 NANCE DEPT.p^ COSTA MESA, CALIFORNIA CITY OF COSTA MESA 47FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING/g ` A- W_iSoN t BUILDING ADDRESS / tom{" ' COSTA MESA. CALIFORNIA FOR OFFICE USE Olyl�.Y // }}�� RECEIPT N(J�(S P�3,2;115 Na ]T OWNER D%1/Q1-.0 2. AiikaSf'1fy.S CC((//CCii/((44((yy/a1D 0 T _ �C..1J MAIL tt .�/ EC NED' Y DATE RE EDS/ /y0�,TE ISSUED ADDRESS /J 9 //-- I/v/,(.S OiC/ 17-..5--S / -7- y TEL BUILDING CITY vs 74 �r:SA NO/IS%463 ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE ADD?. S ZUNI -�/'� CITY LIC. ` ZONE, 'pJ�' _Fq/�n*p/* Y '/ -ROUP CONTRACTOR Tt a1/24�it ,�LaP//j�NO./,� 6 N, rig f/ W � �/ Fr r i ADDRESS / Q9]ry4. /S �rtl J.T61AYYYJJJ�i`�gige BVP`�°I'H' OF C'`UjJIVVV'V_!ll r iy{I ELEGAL ��/� NS DESCRIPTION NO. •.....,./ BLOCK f"`�Z TRACTS00 SUBJECT TO LCC. DomEC. A.P. NO. /// -a r '� -33-- SIZE 3� `'`CV SIZE .•77 9 X/3 OFROSLOGS. / EY i /• DATF%�j' ) OF LOT 2 O NOW LOT / USE OF VLNI. ILLII. EXISTING BLDG. ` /÷ ' SETBACK LINE FROM [ rt+ CENTER OF STREET •�J� (^1 REAR YARD 1�J T - SIDE YARD RIGHT .,,) T LEFT / v I DESCRIPTION OF WORK NEW t ALTERATION ADDITION REPA, MOVING DEMOLISH BSIZE al.L)- S I ROOMS 7 . STORIES / EXTERIOR WAtIL!L , T� ROOF COVERING./S, 0/(JC{,(J COVERING PnCK USE OF NEW"7.�^{{�--J_'T/ ^ //'' BUILDING /i Cc, 2e�7TACNIl) STjaiI6t"- >4.4I / 9s.TU, a2 . I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND ST TE LAWS REGULATING BUILDING CONSTRUC. TION, i / VALUATION SIGNATURE O / /�`/��`=Y. �1 PERMIT FEE S �Y '— PERMITTEE ` /K/��•QL+A% I –�I I / (•7 PLAN CHECK $ /a 3 AUTHORIZED AGENT TOTAL FEE S fl' NeniF