HomeMy WebLinkAbout1918 KAUAI DR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PE MIT rN>OZ / TRACT NO. L030. UNIT NO. • 6277 12/23/B5 I (JoGG IL
. Project Address 9 19 Ka ii AT I imoi/4C LI)i' L �• I
Applicant's Mailing Address 19 I 1(a L4 i P/4ce TYPE OF CONSTRUCTION NEW ADD U ALTERATION U REPAIR
FRAI& /V1t r L.EAJ4 Phone • z .-.0RiZ�
CI CONVERSION CI DEMOLISH ❑ OTtyER , A.P.# , 4 +.��/ — Q� I Zone g/
Owner's Name 1/ 7 DESCRIPTION OF WORK/USE OF BLDG. L4'rlc ,vas Q eCk
Address 19 18 k!a i�i1 A l 67)/4 Ct= Ig
1 • S Main Building: Accessory Building:
g �'�Lril.�-.5 -4- I'l.is$'OC . S .� YSl .Ty �.�-1 Z
Arch/Eng./ /' License No. I y O TYPE OF PERMIT U GRADING ElFOUNDATION S7RUCTV RAL T Front �/ ILL
0
Address 1 s-1 IDES"/�rINV L^/1? (� ��-z
El TENANT El ELECTRICAL 171 PLUMBING III MECHANICAL B Rear o �' N
I ! ye'-S 16A' �Ic1'.�C'S. Phone 7� r._(a C�]9
CI OTHER g I
Contractor's Name OSTB STB"
S+ PROJECT DESCRIPTION SQ. FT, e9SYJ OCCUPANCY S, r. X3 ?, Right S-- G
Address(mailing) g3 '1 SO• /-47.2 Li/c k2v
CONSTRUCTION TYPE VALUATION$ ono, S Left
N) City License No: bU - Ping. Ref.# 4.7:- Parking Req./Provided R
ZONE _ GRADING CU.YDS. ACRES E
I _ LICENSED CONTRACTOR DECLARATION Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
0 with section 7000) of Division 3 of the Business and Professions Code, and [� ���jjj T
my license is in full f me and effect. P C, t %Z1-e�S
`) License Class — I Lice o. 2 // ! V S
Date)Z-; q-8S Signature _ �D� PLUMBING FEES .
` ,VWR 'COMPENSATION DECLARATION iyL - ELECTRICAL FEES
4. 'herebyORKEaffirm
OMthat haveNSATIOa Certificate of consent Bar Sink Showers
to self-insure ora certificate
Workers' Compensation Insurance, or a certifie cop thereof Section Backflow Preventer Service Sink 0 15.50 KW
r Automatic Washer Transformer
PoliCO No. cot SZ �S Compan4 - $ Backflow Irrigation Sewer Cap0 50+,KW
Y b 9 Construction Pole Sub.
Certified co y is hereby furnished.
Certified copy is filed with the city Bu I Divisioyn� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100-amps
1 Date /7 —y- `M Applicant ` Y' - -
ni EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter !Dover 100 amps
t. o (This section need not be completed if the permit is for one hundred($100) or
less). Dishwasher Solar Piping • Dryers ❑Gas ❑Electric Sub Panel
1 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 Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1 Ni-8
Workers' Compensation Laws of California. _
Date Signature Floor Drains Swimming Pool w/Spa F.A.U.NOTICE: II,after making this declaration, you should become subject to the _ Inc.SOlar 09-15 HP 016.15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance
of the work for which his permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Name Rang¢
Lender's Address Kitchen Sink Water Service Switches
OWNER BUILDER DECLARATION Sign
1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
Garbage Disposal ;Standing Sections
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 Generator ❑0.5 KW❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash DOmpaC[dr
to file a signed statement that he/she is licensed pursuant to the provisions of
Roof Drains
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
therefrom and the basis for the alleged exemption. Any violation of Section
31.5 by any applicant for a permit subjects the applicant to a civil
salty of not more than five hundred dollars($500). $ 3
I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
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 DEVELOPMENT SERVICES REQUIREMENTS: /
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ ZoningApproved ByDKC�Q'4-� Dat0 d��3/��
sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ pp
prove the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By /� Date_ I
prove for a purpose of sale). V .
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con- - j
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ toe.so SMIP $ .�
proof of their Worker's compensation insurance should be provided to me. PLAN CHECK ' $ 444. Si PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ ISSUANCE $
HeatingSystemDuctingRegistersPLAN CHECK 25% $ ENERGY P.C. $
Date Owner &
I hereby certify that I have read this application and state that the above Ci 0-100,000 BTU 0100,000 BTL • - GRADING $'
information is correct. agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this cit o enter ••n the above- entioned property for //�• S
inspection our(•• s. 'r /2.-q-?-5-
_ gS^ MECHANICAL $ JCY
Signature -- 11A aS Date 7- TOTAL FEE $
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK • 25% $
Drivers' Lice se or SS i...—
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL ' 'A
'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 OF ER Grnd. / 57. APPROVAL TO COVER-GUNITE
7. Footings `1571 uC� 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. POOL/SPA 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 O Gas 0011
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 �/�s bt, p 5 76. Dry Standpipe
28. Lathing & Siding �7 /� 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 Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING Ph/get S
48. Special Requirements Completed •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY ' •
No. Date •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PER NO. TRACT NO. LOT NO. UNIT NO. �w
E /�COJV�STR UCT �y PERMIT " i( I A.P.# ( zone
/�/�/}� N« TS Main Building: Accessory Building:illir
t s Mallin• Address L Y 'L% A TYPE OF CONSTRUCTION NEW HADD H ALTERATION U REPAIR E Z
ef•r p ll' ❑ CONVERSION ❑ DEMOLISH ❑ OT} R �y—„ • ' T Front 0
Owner's Name//rr .•/ K .�I one +�/ awl' DESCRIPTION OF WORK/USE OF BLDG. -2/�Str1SL'� I, d � Rear N
Address /qit 'tqA-+ ''E'« ' A I
I C Right N
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING H FOUNDATION STRUCTURAL i K G
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g . Left R
.SW??' (j /. ❑ OTHER e I Ping. Ref.# Parking Req./Provided E
Contractor's Nam• 1:V
Pr
TA PROJECT DESCRIPTION SQ. FT. OCCUR CV O
Address(mailing) trzgaw� � = iI. - Planning Notes:
City License No. V t� s CONSTRUCTION TYPE VALUATION Se M
T
ZONE GRADI NG CU.YDS. ACRES S.
LICENSED CONTRACTOR DEC ARATION ,�J ijy�/(////�'�}�}/•c,�,.
I hereby affirm that I am license• under provisions of Charter 9 (commencing Remarks: ✓� I��/IT `� L/ � C
with section 7000) of Division 3 of the Business and Professions Code, and /A•F�'�`
my license is in full f.Ce an• - ecA ., �, CI' —.` rp ELECTRICAL FEES
License Class Lic• se N•�1 •e / rade") _. �T
i� Automatic Washer Transformer ❑ 15.50 KW
Date i�a, Signatur I. `�� �- PLUMBING FEES
1. WORKERS'COMPENSATION • LA RATION Construction Pole Sub. 0 50+ KW
%N. I hereby affirm that 1 have a certificate of consent to self-Insure •r a certificate Bar Sink $hOWera
Porkers' Compensation Insurance or a certifi d opy t tereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
Nb.$774735 s� S
Dishwasher Meter ❑over 100 amps
Policy No. Company Backflow Irrigation Sewer Cap
P Certified copy is hereby furnished.' Dryers ❑Gas ❑Electric Sub Panel
• Ce tyyed copy i IWith the ci .j; Ilding D Ion. re / Bathtubs $ewer Connection
.atea• - ^ ANA. :. .u. i .� _ Fan
Motors ❑0-1 HP ❑1' -a--
EXEMPTION FROM WORKERS'C•M'ENSATION D CLARAT •N Clarifiers - Solar Collectors
- (This section need not be completed if the permit Is for one hull• -d($100) or —Dishwasher Solar Piping F.A.U.
less). Inc.So -15 HP 016.15+
I certify that In the performance of the work for which this permit is Issued I Fixtures
shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
. Date Signature Floor Drains Swimming P /Spa Device Boxes Pole Light
NOTICE: If,after making this declaration, you should become subject to the '
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Uri Outlets Range
comply with such provisions or this permit shall be deemed revoked. •
CONSTRUCTION LENDING AGENCY / Switches Sign
I hereby affirm that there ia construction lending agency for the performance
Gas Service Outlets Water Closet
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
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 •
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 Grains
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ,
pivision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
-zrefrom and the basis for the alleged exemption. Any violation of Section
..-,y%31.5 by any applicant for a permit subjects the applicant to a civil
'natty of not more than five hundred dollars($500). • DEVELOPMENT SERVICES REQUIREMENTS:
ii I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
Zoning Approved By Date
compensation, will do the work,and the structure Is not intended or offered -
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES • Building Approved By 1 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 •..� • . Date o.z--/'
employees, provided that such Improvements are not Intended or offered for .. Boiler Hood or Type I 0 l A��
Mic
sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II 0 MARY OF
pletion, 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 $ 1025, a' l^B•-
SMIP $ s `-' O
0 1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrig tion System PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply t0-an owner of property who Duct-Ventilating 100,000 BTU 0100,000 BTUPLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts frail:such oroiects with a con- ENERGY P.C. $
tractor(s) license pursuant to elle Contractor's License Law). I am aware that Exhaust System 0 Multiple El System Repair/Alteration I PLAN CHECK 25% $
proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ GRADING $
IDI am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date - Owner Heating System&Ductin Registers MECHANICAL $ TOTAL FEE $ C/0 p ra
I hereby certify that I have read this application and state that the above ❑4100,000 BTU 0100,000 BTU
Information is correct. I agree to comply with all city and county ordinances _ PLAN CHECK 25% $
and state laws relating to building constr •n,.., an. hereby authorize repre-
sentatives is city to en a upon sive entionetlproperty f r •
inspection r es. �{/� /4C pr/�a(y/`
Signature is
If Date/�'�17 -D
Drivers' Li se or SS , '�• Reinspection Fee $15 Issue Fee $ 3
G
0865-46,rev. 5/88 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod - Assessor 01 00021606-00021607 TOT 1.72.57
nATF: 0/RR/R2 TTMGs isigil
.
NSTRUCTION AND PLANNING POOL 'A
-OVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
-mporary Electrical Service or Pole I 52. Pool & Equipment Location -
_. Soil P.ipe;Undrgrnd. ;'' 53. Steel Reinforcement
`3. Electrica( Conduit)Utility-Undrgrn&.. . :(;i 54. Forms j
4. Electrical,Conduit-Undrgrnd. ,.) ' 55. Electrical Bonding
5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test • .•.,
•
N
6.,Electrical OF ER Grn.51' ,`, :1,- 57. APPROVAL TO COVER-GUNITEi.
7.: Footings ' :r- 58. Electrical Conduit-Undrgrnd. i-,- '.'
8.-Foundation - 4, • 59. Gas Pipe, 0 Undrgrnd.,Test !'
19. Water.Pipe-Undrgrnd; • • 60. Backwash Lines,P-Trap, 0 Undrgrnd. : .
•
10.-Structural Floor'System ` /' C' 61. APPROVAL TO DECK 'I
11. Property Sewer Line & House Connection 1• -1 62. Backwash & Receptor-Final
12. Sewers tap " - I' '. . 63. Heater& Vent-Final
13. Roof Drains _ - 64. Plumbing System - Final .L
14. Rough Plumbing 65. Electrical-Final ,
15. Rough Electrical-Conduit -.: 66. Solar System-Final
16. Rough Electric Wiring • 67. Fencing & Access Approval
12. Rough Wiring Sign . �.• 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceilin t
9 9 69. POOL/SPA SYSTEMS FINAL
19: Rough Heating & Air Conditlonin4 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace '• r1 APPROVALS Permit#
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Tpst l 9. 72. 'Underground Flush
24. Roof Framing I • '•i 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof,Sbeathing I +74. Overhead Hydro
26. T-Bar Ceiling 1Str icturall &'Monocoat . 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing &ASiding . , -- 77. FIXED SYSTEM FINAL
29. Insulation . ' 78. FIRE PREY. FINAL
.•
30. Drywall Nailing , HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat i 79. FINAL INSPECTION
32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED
1
33. Final Electric Notes: `.7/i„ ,r/ 6 �/�'� 1vo�Ss, 6"..�
34. Final'cleating & Air Conditioning a -C� �
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 . I
,
43. Backflow Irrigation !
44. -Landscape Irrigation System •
45. Sound Attenuation I
46. Handicap Regulations / • ,I
47. FINAL STRUCTURE & BUI LDING Jn , . /Cyr .
48. Special Requirements Completed � ! �bp
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - •
51. CERTIFICATE OF OCCUPANCY -
No. Date •! '
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STRUCTURAL APPROVAL ONLY
• 1 i i , 1 . : • i SEPARATE PERMITS ARE REQUIRED
I . . FOR ELECTRICAL, PLUMBING',
HEATING, VENTILATING AND
• ; •• REFRIGERATION WORK
(,_.rs.���• Permit #_4
a
2,./o THIS NUMBER MI'SI ACCOMPANY
, ;��� ALL INSPECTION REQUESTS
' ,,�i . 71 — y '� FOR BUILDINGS CiK;_RE PERSONS ARE TO
i 'F',sirdc"' BE EMPLOYED, WE SUGGEST THAT THE
78,411.2441-// E • ' 4 (%L/2-i �G= STATE OF CALIFORNIA DIVISION OF
INDUSTRIAL SAFETY BE CONSULTED FOR
' ' (j12 ADDITIONAL REQUIREMENTS.
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COLLECTOR F/N/SH-
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ROOF CEMENT RAFTF_R
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ROOF PENETX4 T/ON
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LUWNtR FRANK MICHELENA uAlt 1u-uu-/9
JOB ADDRESS 1918 Kauai P1 ace BUILDING PERMIT NO. 48928
GENERAL CONTRACTOR Harold K_ Sung d-th DESCRIPTION of WORK 2 CQ)aar Systems
P MO. ) �q_r77_na LOT T3 TRACT 6384 FIRE ZONE VALUES y,548.U0
-
iCTIONS Signature Date TYPE GROUP ZONE R1
SOIL PERMITS ISSUED
IGAS SUBCONTRACTOR Date Number umber I
Signature
WATER. Plumbing
ROUGH PLUMBING I
PROP. SWR. LINE O HOUSE CON. O
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES FORMS STEEL-14F.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT n
PLASTER, BROWN COAT -
ST -TURAL, FINAL Electric
H. ,G, VENT.. REFRIG. AND A.C., FINAL FX 5 I R E D
PLUMBING. FINAL AND GAS TEST n Incomple e Incpertinna
ELECTRIC, FINAL Cancel
BUILDING, FINAL 4
COPT'IGI RFMIIRFMFNTS nate 1 _n l , /Sig
4487 10/08/79 59.90 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI_CA•TIONOR STRUCTURAL PERMIT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 �j p
For Applicant to Fill in Completely— Use Ink Only N° 4 8 9 2 8
BUILDING j9/ a Ijaua Ft 6- A.P.NO. —57/
ADOR ESS ( 7 \ -
c }/ I BUILDING / / / / / /j'.
TT ENANTOR / GLM�C 1- f rake ADDRESS ` `!I Agog-
MAI LI NG \ UNIT OR
ADDRESS CSQLNv%4 {J� (y j9 SPACE NO.
CITY a s 1 Q I G Pit/.... TNOL Q J7 2952 TR'(� •'7 a�/-//� LOT 3 `BLK.
CONSTRUCTION NEW I OD TER (REPAIR I MOVING(DEMOLISH
` LENDER _ GAJ L I //(1/,/t Hien ffl BRANCH
OWNER /- /G kk //( 1 CL NIt
ADDRESS �ats/V VALUE 6.3 ./r�
ARCHITECT �_ TEL. $ /[r�.�-
OR ENGINEER NO.
ADDRESS I ' I ZONE / TYPE GROUP
7
CONTRACTOR - r• - r/r/t1" ✓a- r^ dr , BY DATE /
ADDRESS (2GG /c/. /A a✓, T /
CITY 144014,NEa1'V -I CA NO. 630-2233
APPROVED SETBACKS
CITY
LIC.NO. 350s 7G LIC. NO.a6sa°
A, 512E NO. ON LOTS. (FROM C/L STREET)
F1. US LOT INOW ON LOT FROMEXE OFNEXISTING BLDG. R,SIDEgr)
F Separate permits are required for L.SIDE Ft/2°f 11
electric,plumbing and heating work. _REAR FT.
F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
Q
°M So��r DO1tQSLo4U)C}� -�, 1 DATE
I APPROVED
r- Sdyi IL11�'`YLCa St/s• µ,-ry, APPROVE . i/ 77
Y--- .1 / _13Y (�'I///LUUJ..../( //DATE/a-�/,J
27
S /ro. c1Z C4 cPr^ eat
m
I hereby acknowledge that I have road this application and state A meet 0--Ar1 dcc - /Pin ic/.
g4 that the above Information is correct and agree to comply with
A, all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of _ ter
1.9,
the State of California. ,C
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from th rovislons of State of Iifornia Business VALUATIONPERMIT FEE $ �� Y
and Professions Cu ee, ivision 3,C ter 9. r� ` n
�. s� PLAN CHECK $ ^I 2 I /_0 o
Signature of (/ /l �L. O 0 �r:7 Y o
Permittee /` S !-, S TAX $ L
or / V
Au[horizetl gent ate_ V/ Q TOTAL PAID $ 9'7
OWNER MICHELENA, FRANK DATE 1-23-70
.:?-.10B ADDRESS 1918 Kauai Place BUILDING PERMIT NO. 31318
$
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Community Block Wall
A 1. 119-511-04 LOT 3 TRACT 6584 FIRE ZONE VALUE $ 250.00
cCTIONS Signature Dote GROUP ,] TYPE ITI ZONE R4
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRINGI.---..t f� Heating and Vent.
TRENCHES D(I FORMS w STEEL REINF. f J'
FLOOR SYSTEMCC �'F'
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT
PLATER, BROWN COAT
Si URAL, FINAL Electric
HEADING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST fl
ELECTRIC, FINAL
0011 niuc riuel PAC 7 _i 19
31318
JAN 76-70tyu00 711 0*****5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely RECEIV D B DAT' AEC IVSD
ADDRESS /9/y' /e(�,L�aL,(i 4_ _e --1 P_1() E ISSUED
ING
I /
y/��s �/' /� /�(///� / I ERMIT prOl R
OWNER l le_!-//L� aC r / r / rjr Ie wwi/- A.P. N / ,3 Sil-" U 3 13 f _�
MAIL BUILDING ) /}
ADDRESS , 2,�(� ADDRESS ¢ (ij- �i (J"-'C.�l
0 O CITY ( s7' /PSS/Q NOui L59fi y TRACT 63 U g. LOT .:J BLOCK
Z
Z Q CONSTRUCTION NEW ADD ALTER REPAIR MO I DEMOLISH
d m LENDER
_17 BRANCH
C to OW L'v//�4 �C/2����LL(sL(/( (.
Q W ADDRESS
m J It�1a I� .�, `, ' / VALUE [�j� /'o
m ARCHITECT TEL. USE ('Vp�1F whiz $�d[J•
_i<
OR ENGINEER NO.
U Q FIRE
w m ADDRESS ZONE TYPE GROUP
W Z O W Nc f1 YPROV ED �rn7-}, n ii
J O CONTRACTOR �jL. ,` BY r/ /J. DATE"l23//
CO Z
:I r ADDRESS S4I//G U 6 '244-,
ZF CITY `S✓I_/te NO. //J�'j /O ill wZOf 1 PLANSNO. BUILDING USE OF E l J
-O STATE �//,l` CITY L�'-I'l Y.. YARDS APPROVED YARDS APPROVED
PI
(ACC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
7 SIZE NO.OF BLOCS.
(FROM C/�-(L/STREET/
SIZE
OF LOT NOW ON LOT FRONT J FT. FT.
USE OF ..--
EXISTING
EXISTING BLDG. R.SIDE FT. FT.
I- SIZE OF NO.OF
2 NEW BLDG. ROOMS STORIES L.SIDE 0 FT. FT.
UEXTERIOR WALL ROOF
_ COVERING COVERING REAR �r FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1Om MAIN BL S. ACCESS. BLOCS.
ATE
CI y� / I I/�(� ra l r �i C.U.P. APPR
1y�/ r.(o`J�` ,�'T�1c2)...-CIS
'- `X[Y,��� �� `}►y CVARyP�q�p SiAPPROVED /�
CO •s\ '.. Q it ti..' v_O.� IS . qy VC1• t lJx DATE /� -2-Cr- 7 O
2 0L.gfii
0
UI hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC ell laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
N the State of California. 03
? I hereby certify that I em properly licensed as a contractor under SO. FT. o
the State of California B '•ass end P . , Ions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR •
Chapter 9, end that suy icenses , e In f I force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2
em exempt from the •rovisions •f the St a of California Business VALUATION
and Professions -.e, D'vision 3 Chapt• 9. t 1'' .L.If CO
PERMIT FEE $- 7 V 0
Signature of �� /e/ O� Oy
' Permitt • /T/i �. ��_ o $ z SQ PLAN CHECK $ �^ E
0
A.tho ' ed Agent Cr, u.
TOTAL FEE $ • t�U
OWNER MICHELENA, F. DATE 2-15-OO
JOB ADDRESS 1918 Kalli Place BUILDING PERMIT NO. 28213
1 AGENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Slut= Stone Wall
1 : RTo. LOT 3 TRACT 6384- FIRE ZONE VALUE 4200.00
I2 tCCTIONS Signature Date GROUP J TYPE �I ZONE R-1
Soil PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing _
Frame and Flashing
Lathing—In 0 Out 0 _
PJcter, Brown Coat
F ural, Final Electric
Fto..ang, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final ,,e-A �P f �J2Y//
Building. Final - Y-4 -ar igtCaS,L Pr. • ' _ .t '
. 28213 1 FEB.,s oe,<sr3 Ej*+►• 1oo:..
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 12® COSTA MESA, CALIFORNIA E2626
•
For Applicant to FIB In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
! For Office Use Only
i: BUIADDLDING
. RESB 1) Q (�Al co;
1 l f! I 1 RECEIPT NO. ZtIM y03
�; COSTA MESA. CALIFORNIA «s.12I
it
II / ETEC[]qD T `S-d ca-/5 6
:1 OWNER F ',�/' \G(rJL�E=�jC� �i/LIN
( BUILDING
MAIL,'r ADORBSII "5
ADDRESS
ZONE IRE
ON! TSP! GROUP
• CITY K-7-r?‘ NO. A
APPROVED
', ARCHITECT TEL BY DATE
ENGINEER
OR ENNE al
•• ZONING ��
• ADDRESS �' �: J, S. ' EO , 1 NO.OF USE OF NEWQ�
�, ' I LEANS I BUILDING / .1 _ n n
CONTRACT•R L•/D-+�- /
LEGAL 3DESCRIPTIO ' -- % 38 y
ADDRESS " DCRIPTIo T'1 I'n` (O
A.P.NO.
' CITY
•• STATE TEL TSI NOTE: OVERHANG SHALL BE LESS THAN
SO•TO SID[E a D REAR P.L
LIC.NO. NO,
EAVES
C. SIZE I NO.OF ELIXIR. ALLOWED (U.B.C.REQUIREMENT)- •
OF LOT now ON LOT YARDS APPROVED YARDS APPROVED
� USE OF MAIN BUILDING ACCESSORY BUILDING
• EXISTING BLDG. '
d. (FROM C LSTREET)
ETBACK LINE FROM iT Q L FT
'`•- CENTER OF STREET REAR YARD FRONT /V RT. J
, SIDRYARDI LEFT I RIGHT • R.SID[ (pll • - - -FT.
•
� DESCRIPTIONESRIOF WORK L.am[ Fr. Fr.
',• NEW t ALER
TATIQN ADDITI•N REAR SIT. FT.
i
., DISTANCE DC. BHT.MAIN&
MAIN BLD• ACCESS.BLOCS.
REPAIR _MOVING DEMOLISH '•
BUILDING NO.OP 1, , ` VAR.4t DATE
y SIZE ROOMS STORM/ • C.U.P.# APPROVED
.I• EXTERIOR WALL I ROOF APP •V •/
r COVERING COVERING BY . , A. DATE 9 -/ S -(o
'l
USE OF BUILDING AND WORK TO BE PERFORMED ^ - - p dr l Et
/9 Y •C%enn� to -
. , , V_,/ti"I ' 1
I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APP TION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS •-RBST AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. i
• PLY WITH ALL CITY OR CSE AN TATE' WS REGULATING VALUATION
BUILDING CONSTRUCTIEl
ON - q
SIGNATURE OP �t _ \ 411 PERMIT FEE F
•• PER IITTE. _ L ' iLCif �J _p/ID ' Co
v ' S 6217°) 7 PLAN CHECK $ k''
AUTHORIZED AGENT
"' :_+ TOTAL FEE $
OWNER MICRII.ENA. FRANK DATE 6-25-68
OB ADDRESS 1.18 Kauai Place BUILDING PERMIT NO. 28757
GE ERAL CONTRACTOR : , • . u• -•• ,A DESCRIPTION of WORK Communit Block Wall
: . LOT 3 TRACT 6384 FIRE ZONE VALUE $292.00
I - CTIONS Signature Date GROUP J TYPE III ZONE R-1
SOIL
GAS
PERMITS ISSUED
SUBCONTRACTOR
Date I Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND MR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING I-� Heating and Vent.
TRENCHES Q FORMS ❑ STEEL REINF. ® Q4tC 6-2 7-Cr
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN rl OUT n
PL'--ER, BROWN COAT -
S URAL, FINAL Electric
HEADING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST Il
ELECTRIC, FINAL
BUILDING. FINAL in ?-3 -63
28757JUN 25-68M002096 d*****3.00
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 120 COSTA MESA, CALIFORNIA 925211 -
For Applicant to Fill In Comp/Wok APPLICATION FOR PERMIT
TYPE OR PRINT `• BUILDING
For Officio U» Only
BUILDING
ADDRESS I•i ' RECEIPT NO. gry;.‘
COSTA MESA. CALIFORNIA /`76
RICE • SY h RSC[VIED �. T[� `
' OWNER ,FRA.JK M/C-/IL2FNA LTJ -5-
MAILp �j BUILDING
F.: ADORE" /9.49- et)k'I A/' FIRE
DDDR. . .
TEL L ZONE TYPEjGROU
CITY . NO:J /L Ds.ZL `` ���P///
APPROVED
ARCHITECT TEL BY DATE
OR ENGINEER NO. •
ZONING I
• ADDRESS faddriCiAl
d
CONTRACTOR 04 2, iNNAfan I
ADDRESS //..S / Agit? 51/fh% '
• CITY C. Ai.
.. NOTE: NO EAVE OVERHANG SHALL BE P. iaciuo.02SO cS& No" THAN
"3'%IL"o%%030'TO SIDE St REAR --
' SIZE NO.OF RLDO[. • • B. REQUIREMENT)
. OF LOT I NOW ON LOT
YARDS APPROVED YARDS APPROVED
use OF MAIN BUILDING ACCESSORY BUILDING
P. EXISTING BLDG.
(FROM C/L STREET/
• SETBACK LINE PROM PR•NT PT FT. C
CENTER OF STREET REAR YARD
! HIDE YARDI LEFT RIGHT R.a1OR PT. dRT.
DESCRIPTION OF WORK L aIDR PT. FT.
NEW ALTERATION_ ADDITION • REAR !T. FT.
C. DISTANCE BET. BET.MAIN a
• REPAIR MOVING DEMOLISH MAIN BLDGH. ACCESS.BLDGB.
•' • VAR.* DATE
BUILDING NO.OP
- SIZE ROOMS STORIES r C.U.P.# APPROVED
EXTERIOR WALL I ROOF , APPROVED
• COVERING COVERING 4 I / DATE / ie.'
, USE OF BUILDING AND WORK TO BE PERFORMED '1 O,
ro
• CM/Ait iri•) 5 'e4
SO.PT. N
I HEREBY ACKNOWLE OE/NAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C
AND STATE THAT TH ABOVE IS CORRECT AND AGREE TO COY• • PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES ANO ATE LAWS REGULATING VALUATION
• BUILDING CONSTRUCT PERMIT FEE $ m
SIGNATURE OF C/ A '�W'/40 $
a292, PLAN CHECK S `-_ w
PERMITTER r I'/
AUTHORIZED AGENT
3
TOTAL PEFEE( ;
ion=A.-_- - ,84
PaR
PAID
2wO«'9 HAY 25-67cnsA001395* ***111.7.,"C
'
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA• CALIFORNIA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING
BUILADDRESS 1918 Kauai Place
COSTA MESA. CALIFORNIA For Office Use Only
owNERClub House Road Joint Ventur I RECEIPT NO. I 2?"
��
( .
MAIL R 1 BY DATE RECEIVED 88UHD
ADDRESS 2850 Mesa Verde Drive I r;'2 67I ,� ?/p7
CITY Costa Mesa No549-039 BUILDING
ADDRESS
ARCHITECT TEL. COSTA MESA, CALIFORNIA
OR ENGINEER E.G.Kaltenbach No.547-804 ///�
ADDRESS1ZONE ,
TYPE {'/ GROUP "PI
CONTRACTOR Republic Homes Corp. APPROVED
BY DATE //
ADDRESS 2850 Mesa Verde Drive ZONING yifir
, �•
ZO7 NO.OP USE OF NEIL a
CITY Costa Mesa Jl-. Y I PLANE / I BUILDING / 'l� ^/A�/
LIC.LITNO. 197838 NO. 549-0395 DLEGAL
ESCRIPTION It ✓3 ,1"R ti ,� i y
SIZE OF LOT 60 X 100 ' Imo. OF BLOTS. fff
NOW ON LOT A.P.NO. .------
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROMU ^�Q (CENTER LINE STT..))
CENTER Or STREET 4J �� REAR YARD. KJ FRONT 11'/ L FT. IN.
SIDE YARD LEFT 5 t I RIGHT `5 1 R.SIDE t ,/ FT. IN.
DESCRIPTION OF WORK L.SIDE � FT. IN.
:)--YNEW- I X II ALTERATION I II ADDITION I REAR ,� FT. IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED We
45---19-07
� p (�
G� BY DATE J --1 -0
SIZE
LDIN L478sJCI. f t.ROOMS 9 STORIES 2
CO
VERING ERING RIOR WAL J y uC CCO I ROOF
COVERING Wood
USE OP BUILDING AND WORK TO
BEE/PERFORMED
7--7 e
j 2X71 ,g rc5/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CI ORDINANCES AND STATFFFyyy LAWS REGULATING
BUILDINGNATUCONE UPyI ,-. // VALUATION Q
SIGNATURE OF �J eM 2 PERMIT FEE $ /�/�—
PERMITTEE l� /'Z�t%G $•/ 'J . PLAN CHECK S / �y
AUTHORIZED AGENT ?� V TOTAL FEE $ / / '� D
I.
43695 'hz 71-1-i1='r,0 i?o1 = A::* .',1%.50
COSTA MESA BUILDING-SAFETY DEPARTMENT t
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
/PP 1 CA ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
R" I / DATE RECEIVED DATE S UE iiittt
BUILDING J�ei�� ,/•I/ ��_ ��� /
ADDRESS �/ �f+ /JL PERMIT NO. I
OWNER/F:0 , /%, OrS. . A . A.P. NOi r A _
MAIL it / BUILDING of / t7
ADDRESS a ,.//6.4/.6.4/.i ADORES /sz 11
/'� ' EL. LOT i' BLOCK
CITY ��, 4 NO. TRAC / 63 I
CONSTRUCTION NEW {ADD ALTER REPAIR (MOVING, DEMOLISH
LENDER I X
BRANCH /�J.. /
•WNER i ///(- p P
ADDRESS ��CC'' v / ALVE 41
ARCHITECT�'{�^�er v�/ •AGS TEL. �1✓I �ri• / A, O
OR ENGINEER �j� �SL'S-a�/Cc2 NO. ina y
/*/-(`/5�/t" /f/-'VST _2, • IRE
ADDRESS ZONE T PE ROU^^P�} `�
CONTRACTOR
/7 AP
f'�(/ �' . APPROVED 'r /C DATE ✓ ' L / 1
ADDRESS /z4 q�p.�j/�
41/A-
TEL. •�F NO.OF USED -- , Ii .
CITY ai A i,-- i NO.
f PLA • _ BUILDING Ij• J/ _\
F ?ii' I
STATECITY YARDS APPROVED YARD APPROVE•
LIC.NO. /C799�3 I LIC.NO. MAIN BUILDIN(FROM C/L ST ) ACCESSORY BUILDING
SIZE NO.OF BLDGS.
L 'OF LOT NOW ON LOT ' FRONT FT.
a USE OF
o. EXISTING BLDG. �S lQf67l1 R SLOE _ FT.
ca i
E—,
Separate permits are required for L.SIDE 'ST. FT.
electric,plumbing and heating work. r /
W REAR /9 FT. /
FT.
1.., USA O//O FF�'BUIL NG AND WO O BrPE O MEED•' DISTANCE BET. BET.MAIN&
s$ e 01 /2e ( / ice MAIN BLDGS. ACCESS. BLDGS.
i—% GGIS "�/ y2C UVARP.3W DATE
1 (//,q APPROVEDPR �J/f
VVV /1 VVV PROVED /�" ATE 3 CV/-7
/ 7
Q I hereby acknowledge that I have read this application and state n
n
:4 that the above information is correct and agree to comply with m
O. all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of 2
the State of California. /t �Jr/ �.'
I hereby certify that I am properly licensed as a contractor under /14 I/C�l SQ. FT. ry
tho State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN U ALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABL H PERMIT FEE O
am exempt from the provisions of the State of California Business /�{ ( cr
and P.. Bions Code,Divisi.. _ ., VALUATION PER IT F E $ A( uli
• rrnn
PLAN CHECK $ o
T
Signature of
Permittee -i $-St 5igTAX $ C.11 LL
•
Authorized Agent _, ,14.76`2_, TOTAL PAID $1 V
i �' "Jv
1
rT is-,-. ,_CO qzt -. :,:::. •zi•xe:
4288.9
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
ADDRESS /9 8 /cquiq P� RECEIu��L DATE RECEIVED D TE I�$�1ED
BUILDING / /•� %!/
OWNER 4 M/t?mCFo,/.a1394 ? PERMIT NO.
A.P.NO.
MAIL A BUILDING //
ADDRESS J9is /•`�J A ��J� ADDRESS /471
7 LOTBLOCK j. �0 /
TEL. T38/94 // L
CITY dit �g'� NO. RAC
CONSTRUCTION NEW ADD ALTER REPAIR [MOVINfl flFMfll ISH
LENDER
BRANCH // �7 AJ
.
OWNER�Hr lC�S(1L�'7U�4
ADDRESS ,At _ _ A r� LUE
ARCHITECT F•�NEL. •54'/ USE ! $
OR ENGINEER#�y22 ?f,Vp G,t.- NO. S�Ai t2,
/ ' FIRE
ADDRESS /�'f}_ ig Worth kw S7 ZONE PE GROUP ^
AYPROVE 0� _//_77
CONTRACTOR A//L/7E+e5 �{jF^jr BY DATE O�`
ADDRESS Him /Y 7.1, 3
TEL. 5r7— ZONE H NO.OF ..-OF NEW
CITY , 4 NO. - PLANS BUILDING / j1 SE'
/. . _ _
F STATE CITY Y R P ROVED �t VA PROVED
LIG.NO. LIC.NO. AD MAIN BUILDING ( ACCESSORY BUILDING
SIZE NO.OF BLOCS. (FROM C/L STREET)
114
C, OF LOT NOW ON LOT I FRONT /,/7 FT. FT.
Q USE OF �J� J 1"EXISTING BLDG. It.{ 51 0git/c Lc R.SIDF 3FT. SFT,
in n
FSeparate permits are required for L.SIDE FT. rb2 / FT.
Ci electric,plumbing and heating work. REAR --SFT._ /y FT. 6 0
til USE OF BUILDING AND WORK TO BE PERFORMED diF MAIN
BLD BET. BET.MAIN&
CMAIN HLDCS. ACCESS.HLDGS.
//D .Th
T VAR. DATE
a /�>< /JlH64/
//Ol / ,fJJ ET S�/r(A'�/vc.� �j 1 C.U.P.. APPROVED ^' �^7
.'rl ge HTC/ ,' y rV Y- / (g5rc 6'1 ' / APPROVE(y,�./ Irl TE �U'�V�l�
d �s7�1Q�17.rM / i 0 �
0 I hereby acknowledge that I have read this application and state �(e _� /�i/ N
a that the above Information Is correct and agree to comply with '-- Lf 4tfP 7( Mt n.
C• all laws regulating building construction, and I shall not employ o
Z any person in violation of the workman's compensation laws of
W the State of California. /)
I hereby certify that I am properly licensed as a contractor under / O SQ. FT. w` I
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m V.
Chapter 9, and that such licenses are In fu tired and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
p rom a provisions of elifornia Business y N.
VALUATION PERMIT FEE $
and Profe ns Code, Divisio 3,C ter 9. ,/ n
Sipnatu y/ coo
-� PLAN CHECK $ 2 /0a Ioy��A,....
Parmlttoe `y `� $ C3 coo TAX $ I I IQ� I. . -
Authorized Agent \\J \\_ TOTAL PAID 5 s 60 '(\J\r 4
Imo_ .
/a? R 71-77x, OS *tt1�P flQ,, , , v
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LI ATI FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
RE I D B DATE RECEIVED DA E ISSUED
BUILDING Il/�
ADDRESS ���lll /I
/�(�/��/9/
,��� / ' I PERMIT NO.
��
OWNER f _I M�eli1`/ EWA A.P.NO. `
// ` BUILDING /fit '���/
MAIL ADDRESS Z
ADDRESS
TEL. TRACT ( LOT BLOCK
CITY NO.
CONSTRUCTION NEW ADO ALTER REPAIR MOVING DFMOI SH
LENDER
BRANCH VALUE o
OWNER/
l �7 ��iL��i /
/..rlr/7l 1
ADDRESS
ARCHITECT TEL. USEAIS 14122/gad $ ��
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
' APPROVED
CONTRACTOR By DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW
PLANS BUILDING
CITY NO.
I-.
STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
1.z.1S SIZE 'NO.OF BLDG (FROM C/L STREET)
C. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
y EXISTING BLDG. R.SIDE FT. FT.
Ln
EI F Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work. REAR FT. FT.
14
# USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET. MAIN&
0 MAIN AINBLDGS. ACCESS.SLOGS.
VAR.+ DATE
'-� C.U.P.# APPROVED
a
7 APPROVED
7. —BY DATE
W
Co I hereby acknowledge that I have read this application and state to
N
a that the above Information is correct and agree to comply with
m
. all laws regulating building construction, and I shall not employ
B
Z any person in violation of the workman's compensation laws of
xthe State of California. m
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. m
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FE ONLY: e
am exempt from the provisions of the State of California Business VALUATION � w
?
and Professions Code, Division 3,Chapter 9. PERMIT FEE $ X/
(J m
PLAN CHECK $ c
Signature of a
Permittee $ TAX $
Authorized Agent ` (wtj U
TOTAL PAID $ 1 0