Loading...
HomeMy WebLinkAbout612 KNOWELL PL - Building PermitsPflQIECT�R00qESS�� �i 6'12 KNOWELI.. `PL^ - -� . .. , . � - - � uxir: � `� OWNEP'S NAME: U�RY SAVOPOLiis ' f ' � �� � � � ' � � pU0BE33: S�� , . ' . '�RBCHIENGINEEfl: � 4 S -'6•1 �3 > . �• � � `pEG.NO.' ' �. ' nooets's: : , ;. uxir � f . .,: r :_ ', ` • '' � - '� i '�" ' � : . ; ' ' ' r ,.. PEflMITTEE: � . . W£A�TFIF.RSEAI, � (800).334-3336 � � '� aooqess: y200. WESTMINSTER�• . 86. , " " ' WE.S'TMIrIST.�R ` CA 92603 ' - LICENSEO COXTq�1C70B DECLAM710N: I heretiy aflirm that I am Iicense0 untler pmvisions of ChaD�ei 9(commencing with Sec[ion'� 7000) oi. �ivision 3.of the Business and Pmfessions CoOe, antl my license is in full lorce an0.eifect. � ,� cm uc.: 0!� 10 4 II'• 'sraTe uc.:3 6 9 3 61 � cuss: D �. g,e�, //,/�� � �ate: � � ' � -SignaWre: �f/�%'N Y Wa�'uC� ' ' WOBNEBS' COMPENSpTION UEClAM710N: 1 here6y affirm that I have. ertiticate oi co sent to self insure or a certiticate of Workers' Compensation'Insurance, or a certifie0 iopy ifiereoi (Section 3800, La11.'C). ' POUCYNO.: ��. . � , � . EXP.OATF. � � • � � ' . � COMPFNY: � ' ' 'i - � . , ❑ Certified copy is hereby tumished. r Q Certitied copy is filed with the ciry, BuildinA Oivision. � � , _ ..' . ..__,. . .c---� -_,_._ _ . Date: Applicant: E%EMPfION FflOM WOflKEBB' fAMPENSRTION OECUIUTION: Qhis secfian neea nM be compktetl A me permi� is far une hunAred ($100) or less�. . I certiTy that in ihe Dehormance of [he work for which this Dermi[ is issueQ I shall not employ any pers in any manner so as ro become suUject to Ihe Workers' Compensation Laws oi Caltlomia. , /��� �� � Date: —.^....i • ':.. SignaNre:��r�� - NOTICE. fl aher making this tleclaratmn, you shoul0 become su�ler to ihe Workers' ompensa�inn provisions otthe Labor ' Code you must forthwith comply.wi[h such provisians ar ihis pernl(shall he Oeeme avoked. � �- - . � , � CONSTflUCTION LENUING AGENCY: I�hereby.xRirm that �Aere is a cons�mction lending agency tor the perto�mance ot Ihe work �or which this permit is issued (Section 3097 Crv.' C). 1 � . , . LENUEH: ' . ' t + �' • � ... ... � FOUflEBS:' . . � .. '. ., : _. ' i � . • .� ��� � '�; � �- - . ,-. .. . , OWNEB BUILOEP OECIAMTION: I hereby affirm that I xm exempt trom ihe Coniracrors' State License Law tor the followinA ieason (Section 7031.5 Business anOProfessional Cotlei Any city oi counry which requires a permit ro constmct,'alter, improve, tlemolis�, or � repair any slmcNre, prior to ds issuznce, also 2puires the applicant for such permit ro file a signetl statementthat he/she is IicenseA ' purouant to the provisions ot Ihe Coniractors_ State License Law (Chapter 9(commencing whh Section 7000) of �ivision 3 of the Business' and Pmfessions CoAe) or.that he/s�e is exempt therefrom and the basis for Ne alleAeO exemption �Any violation oi Section 7031.5 by, � any ap0lwant fo� a�permtl sublects the applicant to a'civil Denalry af not mo2 Nan five AunArea Oollars (5500)r ' .' i..�. , , `I as owner oi the proDeM or"my employees with wages 5s iheir sole�comDensation, will Jo ihe work, znA the ❑ simcture is.not inten0e0 or offere0 for sale (Section 7044, Business an0 Professional Cade: The Coniractors'�State License Law tloes no� apply to an owner oi a property who builtls or.improves tAereon, an0 w�a Ooes such work himseli/herself o� thmugh � "his or her own employees, D�ovideddha[ sucA imDrovemenis are not intenaeA'or oifered tor sale. If, however �he building or `impmvement is sold within one year of completion, tAe'owner will have the 6urden of pmving he/she tlitl not builtl or imprave for tlle purpose of sale�., _ � , � , - '. I, as owner of ihe pmperty. am excWsively.coniractinA with licensed contractors to construcf ihe O�oject (Section 704q, Business 0 anU Professions CoOe: The Conimctors' State License Law does not aODry to an owner of propeM who 6mIAs or imprnves t�ereon ana who contracis for such projects with a contractor(s) license pursuant to ihe Contractors' State License law�. I am aware . [hat pmof oi their, Worker's Compensation insurance s�oultl be DioviOetl ta me. � � ,. �, I am exemp� untler Section: � ' B: 8 P. C. ' � . ' : '' for t�is reason: ` - . , - . . ' . i . , . . . , , , - Oate: � Ownec ' I tla herehy certM �hat I am aware of and un0erstan0 the requirements oi California Health antl Satery Code Sections 255Q5„25533, antl 25534 and ihat I or,any futwe Ouiltling occupant will/will not (circle one) neeA ro comply with saiU sta[e cotles antl the requirements tor a� permit tor consimction or,modification imm ihe Nr �ualiry Management DisVict ResiOential consimction apDlications are exempt imm tAese provisions. � � � ; j : � . . � ,OateL � � ADPlicant: ' � � c I hereby certity @at I have read ihis application and state tha[ Ihe abo�e information is correct. I agree to comDly with all ciry an0 counry ortlinances an0 9ate laws relatinp to huilding conslmclion and hereUy aNhodze re0resenlatives of this ciry ro enre� upon Ihe above-mentionetl- proDenY �or insp�ition purposes. � ' ' . , , ��� �O ` �¢:' ' � SiAnature: Dnver's License or Sociai Secunry x: . � � tfi41-06 � Whi�e—Builtling; GreeB—Cotle Enbmemen�; Canary=Applitanl; Pink—Revenue; GOltlenraC—Assessor ` � ' - � C_ITY QF CUSTA MF,SF� -;HUILDSNG PF.RMIT � i�fiRM NO: B 04F550 >;, • ' ' � , i '� ' . .. . . . . � . . . _ . . PERMIT, DIO:" �H� • 046550 t PI,AhI CIiECK,.D10.: .031�79-�9�0 S' 'GOVT: rl SUPP': N� � � .. �• � ' . . , , �. � F � � CUNS'PRI)CTION' TYT?F.: � ` . PERMdT.,TYFE: �STTt,. _, � ' PURP05E:: 01'II � � i . ., . . �, � , .. - . ' r r - ' i .�� - ' _ ; ' JOFi ;1)F.SCRIPTIOPI ' . � PATIG'F.DlCL�SURE• ' - � ' � SQ -FT: � 1198 , CLALM VAL[Jf.. i 2,`000.00,, � CALC-VALUE': , 7�,�207.•20 GROUP 'OCC: R.. 3.�/ ' �? � . ,' . i , . } ,: ... , , COMMIiNTS i PATIO 'L•7IdCLOSURE iICBO _tF3421-P/31 35- P � ' ' � ' 'r ' � •' ;., " '**�*�*�c*�**�*�*�x�rt���**��*�***x*�****�*x�*x-**x�*'**��*�**�***i���**r�*+�***�r��**xx- ,-. � ; ' Z O N I� N• G R F_" Q U 3 R E M� Fs N T 5 - .€ • 5 E�T, H A C R:S •: •. , � . ; � • - , : . - MAIA1 Bt7ILDING -- -------- ---- --F ACCF.SSORY BOILDING - � FRNT: Ff ' IN RF.AR: 22'FT IN ` FRNT: F'T:'. IN REAR: ':FT� IN ..LFFT: FT ' ,IDI.RGHT, , FT. IN LEFTi FT' IN RGHT;' ' F'T ! � IN i'ARKING REC,}: PROV: ' PARCF.L:"422i]12�1 LNE:: R1 ..R�F NO: . i- FLANNING NOTES? EDICLOSED PATIO sROOM AT'T�:CPIED. TO TFIE REAR OI' 'THF., EXZSTTTIG ' ' J , ., , � . . . _: > RF..SIDENCE. _ _ _. . ._ ., . _ _� iEiFiE1EdElf.i6�iFiEiE1E3E3E3EiE'iEifjEiFiEiEiEiE3EfEiEiElEiElE�EjfiElEiEjEiElEiFiEiFiFiFiFifki(�EiE1F#iE�iEfEiEiElE�iEiEiE�EjEiF3F1EiFifiEik3fkjE'3E�E�)E�IeiE1E '• �`: �D'E V L.L O P�M E D] T: 'S F..R V I C E S R.F: Q U',i R:E M E N,T�^5. ' ZONING� APPROVED ➢Y : �(�_.—��---_._--': �DATE; U�LS�_�� j. t , � BU.T.LDING'APPROVEll BY : ' - -- � _._ �----- . '- ,DATC: - _. .� AF�PLICATIUN ISSUBD I?Y. ' ,DATE: �'I6 �-L�J jE'iEiEiE3Fif#lE9ElE3F�FiEiE1f-1E���IFiFlF1(-�1f�� —'_ dEi� F ��}�����F��F��iE�F�iE��IkjF�7E�7EjEjkfF3P��{f�l���-����E-If�iE ` iE�1Eif�1E�ltiFif-ItiEiFiEififiEiEi6iEiE�EiEdEiE��iE�lEiEiEifiEik it ikifiE�IFiE�E�IEiEiFjEiEjF�E3f��1(-IE���1fiE�lEiE�lEiFiEi4#ifdEiF�3E3fiF�iElEiEi(��EIEiE�% , liEGALIZ,ATIObI:DI �t F:E L'� �'U M M A R Y" '� STROCTURAL SEGMEDIT:Y "'' BLUG'PMT PLUMAING ELE' i2IC 'MECHANIC `;FIRE SMIP/RES : GRADING PERMI7': ' 99.'00 � . ' � . 50 ' � =: • � ' %" � �SMIP/,NON-RFS '. `PLAN " � . 69..'35 , , � .� . . .I5SUE'FEF. ` � ' ' BDILDING-D`I�V=? PF_RMIT �ISSUE PLAN-CHHCK TUTAL FAID � �DUE ' TOTAtiS=;'=->'�> 99.;5.0 �<�;.,0.0,0� 6A.35 163.85' ' �163.85 • . .00 � f� i. � ' '� f. � .. .� ' . . ' 3 � . . � ; RELT�NUE DIV.ISION T4T�LS--:> COLLECT'F.D: 163:F35 OVER/SIiORT: ' .00 � ` IIliUG PMT PI;OMBIDIG ELECTRIC MECHANIC. . FIRF. SMIP/TOT .GRA1JTr1G, Pi;ADI'-CHECK , 99,.�Up ._ � : : i . � .50 ' 69. 35 • , ' . . . . . . . � _ . `i . , <iE�1E�lEik)fifit�#jE3f�if�lEif�lf7EiEif�lfiEiE#iElEifiE-0EiF�IEiFiF�N-iFiElFiEiEiF-�iE#�1E3fiE�7hiE3F3ElE�EdE3E3E1E�lE�1hiF3EiEiF�1EiE#,3f-%',(-ik�1f�1F3f�iEiEdfif?E3E�7fiE3E � ' , ; ; I Dl D I`. V,I� D U A L� F. E L �H R f' A K ID O W D!' ? � i 'TYPE QTY j+ U E S; G, R.I. I' T I, O.Pd * UN3T COST! TOTAL COST �, SFR 7.9$ R�S-PATTO COVER-ENCLOSE:D PATIO . 36.40 � 7,7.07..2U _ . . r END OF ;FEF_5 ' , + j' I � , ,' • . . i ' i . � ' , . , , . i � ' . . ' . . ' ' . ' ' � . . . � . . - • d . . . , � i : ; �, '�. . �. ` �--. . . : ' i . , � � { + , � � O1, 0005&262-pi105b264 Ti7'T - -...JA?E: 0311bl90 TIME� 12:4$ t � � `: � � j .. �' "". " � CONSTRUCTION AND PLANNING - �_ � ; POOL & SPA � � • ! � APPFOVALS Permit # - ,Date. Inspector APpROVALS . Permit # - Date Inspector ��1. Temporery.Electrical Service or,Pole : 52. Pool & Equipment Location 2..Soil Pipe•Undrgrnd. � _ - ' � ' � 53.��Steel Reinforcement � 3=Electrical Conduit Uti�ity-Undrgrnd. . � 54. _Forms � � - . ' 4. Electrical Condui[-Undrgrnd. � . � 55. Electrical Bonding ,5. Steel Reinforcement ' � � 56. Rough� Plumbing & Pressure Test - ' 6. Electrical UFER �Grnd. ; _�-" _ � � 57.. APPROVAL TO COVER-GUNITE . ' '� 7. Footings _.. � � � ' � . 58. Electrical Conduit-Undrgmd.. - .� 8. Foundation ' ' �': �� • � 59. Gas Pipe, O �Undrgmd., Test � � % - i � 9. Waier Pipe-Undrgrnd. ��y , �y 60. Backwash Lines, P-Trap, O Undrgrnd. l 10. Structural Floor System ./� ' ' �� �- 61. APPROVAL TO DECK . �� 11. Property Sewer Line & House�Connection 62. Backwash &�Receptor�Final �! 12. Sewer Cap A�= 63. Heater & Vent-Final �, , 73. RoofDrains . `%' �� ��' � � 64. PlumbingSystem-Final . � A 14. Rough Plumbing ' ,� � . 65. Electrical-Final � ,'/�'?' 15. Rough Electrical-Conduit -� ^ f� .. 66. Solar System�Final ? 16. Rough Electric.Wiring .- 67. Fencing & Access;ApP�o�al '7, 17. Rough Wiring Sign • ', 68. APPROVED FOR PLASTERING � • 19. Rough Electrical�T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL - 18. Rough Heating & Air Conditioning � � �� _ � , ; ._FIRE DEPT. REQUIREMENT. � 20.`�Rough Factory Fireplace -= G :.� - - , �APPROVALS";_Permit # 27.'DuCts,inStructuie' � - - ""} 70. Uodergiound.Hydro 22-Ducts, Ventilating � -� _ -, -.. ;77, Product Piping OGas ❑Oil 23. GarPipe•Rough & Test ''� • 72. Underground Flush •- � - 24.` Roof Framing ,y : - . " ' . , '.J3. Undergrnd. Storage�T,ank �O Gas ❑ Oil 25. Roof Sheathing� �- • ; e: 74. Oyerhead Hydro�: � - i�< ? -- . _. - 26: T-Bsr Ceiling IStiuctural) & MOnocoat - � : , �. :_ ;� : 75=-Dry Chemical _ - 27r Frame and Flashing� =��' � � � "' + 76. Dry Standpipe `��� . ;. ., .. �. _ .. ;_28. Lathing:& Siding_', _ _ � " " ' �'� , ,, 77�� FIXED SYSTEM�._F.INAL� - - 29. Insulation � " .,7 ���� _ 76�FIRE PREV. FINAL � ' � �30. Drywall-Nailing � __ '� ._. ' ]� . � r'. � �� HEALTH DEPT: REQUIREMENT • 31. Plaster Brown Coat, � r" . �` ; T,�„ T•79. FINAL INS@ECTION � � - t:32� Electrical Power Meier-Final - `' �' .., ;.;�; ,� S0._ FOOD CERTIFICATE ISSUED �- �.33rFinal Electric ..�e \ � j�F� J Notes:"'- � ' -. ' '� . r � 34. Fin`al Heating�& Air Conditioning�� �. t i�;'r����, �" ' - - . - - � 35. Final Gas Pipe�Test, �_ +' �- �i r �-!� a ' - . _ -+ ' � 36.,,.Hood or CanoPY �' � - � ." . ' � ` .'.. ': - - _ � - .- � :�- - � . -�- ��.. -37. Final Factory Fireplace � -� � � � �; i� . _ � � _38. Final Plumbing `' � , ; ' ° .' - • ` �39. Water Service; Final{ _ �; ,. - � ... ... � '.-'40. Gas Service-Final % ' '" " � � � ' - f: , r . - c ^ . � ,� .. . . . '�91.` $olar pomesticFinal' - ��, . , . - 42. Backflow Preventer �; 3" ' � ' -� � a i ' "l ~ ' _' - . � 43. Backflow irrigatiori. � -'" , � . 44. Landscape Irripation System '�' % ' � '�`= = � �` " . , 45. Sound Atte`nuatio�: ` `:'•• ^•_ , �' -s . t� �- �; , :' , _ . �.r . �.�. �46. HandicapRegulations ��-% " ' " � '�� - � • .�,: /J� � - - .47r FINAL STRUCTURE & BUILDING '.: �,: • `� (� �i - - "' - , 48:_FINAL PLANNING ' -- ' � • " ' +� "• ' - ' - - - �;"� � 49.�Electrirfteleaseto Edison . � �.t� : � ' _ _ , �.50."Gas Release to Southem Califo�nia Gas Cv � ;�`�. C�i � : - .' ' , 51. CERTIFICATE OF OCCUPANCY `J • No Date UWNER Djk,'W. JOB ADDRESS Steel Reinf. DATE GROUP. I TYPE V ZONE R ^`PERYIITS ISSC SUBCONI'1tACTOR 771 S'� a� 22152 � COSTA MESA BUILDING-SAFETY DEPARTMEM P.O. BOX 1�M COSTA MES�1. CALIFORNIA 92629 Foe AppllcaM fo Flll In ComplNdy ��TYPE OR pRINT sm�o�Na � ,y e� ADDREDD COSTA ME6A. CALIFORNIA �— GONTRA T �R "�—� ADDR68 �— CITY �1 BTATB _� �Y /II /� � I NO. OI pLpO�. BCiaACKLINt�POM /� / // CEMER OP 9TRH8T %GI 116AR YM WD YAR L6lT �S � RIQIiT S� (� �� DESCRIP710N OF WORK .._.. I I.._—•—._..I ......_._.. � WALL �/��' �/A-C� , Gldd rd _/� �S 1 XBR6GT ACKNowc[po[ TI1AT.1 NAV6 Ri1�D Y1/1/ A�KIGTON AND 8TAT6 TXAT iflt AlOVt.i9 CORR«7 AND A011[�'M COY. GLY WITH ALL CITY ORDINANCtl ANO �Tl1i{ IJ1Nti IItOUTATINO suuo�wo coNernumoh. . 1 \ .� � wuTHOR�uo wactti FEE RECEIVED A�AY 1 5 18@4 FINANCE DEPT. CITY Of COSTA MESA 11rPLICATION FOR PERMR BUILDINO for Offlw Y» Only IIiC[IR NO. � ►tRMIT NO. % ZON� NO. O! YO[ O! NI ►LANO fi _ �YILGINO �-' /� lioAL �� .� 1/ � i �.No. ,�s-3ri- � 'E: NOEAVEOVBRHAN08F1ALLB6LEBHTHAN TO SIDE S R£AR P. L EH .oWBD � f U. B. C. REqUIREME! YARDfMPROVED YAR09MPROV6D MAIN BUILDINO ACC6HSORY BUILPII VAR.7C DAT6 l. I w m � ea. rr. � TMi AYOYM �XOWq Ory0lR VALUATION IB POH THL y_ ►URlO!{ O! tRAlLIBNINO A PHRMIT !8B ONLY. � VAWATION `� ` 3 � 0 6 pgRM1T F!6 �, : 'f D� w ! . . -. , .. .. ... . v OWNER ROGERS, K. K. DATE �) %—Z6-7µ JOBADDRE886��Zws7KriOld211 PZSCO BUILDINGPERMITNO. �23 GENERALCONTRACTOR ��t,,per VALUE $ 9y�i20.00 ( LOT I,� BLOCK TRACT 2].(B Dyt211]SI� GROUP I TVPE V ZONE RJ.1 FIREDISTRICT I�ItiLt INSPECTIONS I DATE I SUBCO TRACTOR I DATE PIRMITS�NUMBI Foundatfon Forms and Gi Rough Framing Plumbing, Rough to Slab Plumbing, Rough Comple Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer %�oy Septic Tank or Cesspool Lathing Plastering Plumbing, Firual, Fixtures Plumbing� Final GasTest Wiring, Final Occupancy Farm 210 Gi[ IM 12-68 �:Gosts� Mesa Building Department APPLICA�'ION FOdt PERIV�IT t^^�111 EASTw20th STRE�ET w ��� B� � �� G � e i GOPM 206 G-H 2M 5-56 . . .. a � _ ' ' " _ . . _ _ ..... '�{' �_ ._ i' . ."'.�. . . . , �i.id' ... . _ .� .. .. _ _ .' . ' .. u \ 7 � � . u �. .\' r�, l " J- C . . . . . . ' ' . � . , \�_ 6 J " ' . � 6 - � a . � �; a. ,_..,, - � ' � '' � . � - - - ' � �- � - .-' - . � , .. �..�" - . • . . �� ��_� �. \ . . ;. , , � �i . . ._ - - - • �, -,'� �L J � ,�`. � _ • - � � .s 1 • S` • . . _ , �. . � .' ' � F�-S `.',�.� �_ ... _ . J``,_'' —. . _- �'__ _�� \` . .'. . ,. , . • ' ' ' .{ _✓ j�'�i' 't.� � �?' _. _ . . . _ " ' . _ • — ... .�.......ti.�. I . 7... . . � \ it) � . � , . - _ . '....n' . . ' r. ...'- . i. ' �StreetY . , ,.� - ..t.•. :•.il��, _. . .. _ rl= � . . � . - . � . - . i � . . .. � � ' • � �^.� :•• '� � „� �i? '�rr". .-; � ..___ "^ '"_rt�"__. .'�:' ; t''��P �L01' E7:P1Ni3f `ri (� _ _ . at, � � ..�.� �i _ - — — . " � Show Iocation and disYances from ��:.�'.� .- -� ., .'��'�. .. � � . .._ . _ _ . . . , � _ _property line and between buildinga � - � - , - , _ �qn ,�..� . _ . . . � � �- : .. , �, , . � __' ' "_'_ _ '. = F'_ ,. _ _"'_ ' __' }'-. .._. L I' �! ^, . . ♦ �. . . . . . _ � r i ' T - � . _ . . . . . . . \` - . " civ ia . ., . " - ..:�.q�:�.� r - �.n� .� -. �_ .. ' . � � ., . . r-i - ' . . - . .. .� -._ . . . "1.��� ' s" "t. _ � ' , , . . _ `�. - . . . . �: ' tl. 0.. "ll[.`.� . . \ . . . . _ 1 t... J . • . . .�__ _ .�.. .. �. �.. ` � . . _. . .�. . . . . � ... j: . ' .l:' i .. '��. .J.� . , .q i - i ' � n .`idq •' t. . r ' a . . - . .t�... i •• � if-. �L�.�..� .I 1''• .. � 7 ' � .:`. �`e .�1i1���� . ' ... . � I - ' .•,,�. �� � ,��\ �``\'�, , �,' . . ♦\`� �� =; � . .. . . . ` ` .�. . ' . " � ` ' ...1. I. . ..... ' ' " � � � ' �' li" i. .. . � � if � _ _ i ;��• C � •,�� _ . - -- ~ � . ' '_ -- --�-----�-= -' -=— -- - - — - - -' ' ' " _ ' '. _" _____ _'. "' __ _ . ....� n-. A�.. NFtI? ��v' OWNER NE47UMANr H. aos nnn�ss 612 Kr �GENERAL CONTRACTOR ar xo.115-311-20 �INSPECTIONS �- SoIl Gas (n Water y�Q=� �Rough om. Refrig. ,p n,...,.., u,._.._.. Reinf. Form DATE DATE SUBCONTRACTOR or n�Ann 2I802 -COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BO%91] C08TA MEBA. CALIFORNIA For Applleant to Fill.ln Completely TYPE OR PRINT ADDRESS o%!7 �IA/ E� �. " COSTA MESA, CALIFORNIA ' .�� � ARCHITECT TEL. TEL. OF LOT S!J ^�O / I NON 'USE OF EXISTING BLDO. � S• 6ETBACK LINH FROM cexrErs oF sraeer REAR t SIDEYARDI LEPT � I R16HT� DESCRIPTION OF WORK ■ BUILDIN6 �. .i . NO. OP ROOMS I ROOF COYER iK TO Bj'i 3 9./ �" n.z v /' 1 HEREBY ACKNOWL8O08 THAT 1 XAVE READ THIB APPLIGTION FNO 6TATE iMAT iNe A90V6 IB COPHECT AND AOREE TO COM� PLY WITX ALL CITT ORDINANCiB AND BTATE LAW R80ULATINO BUILOINO CON9TFl1R10 SIGNATURE OR �j � � / _ � PERMITTEF ��% / �—�'ti AUTHORIZED AQHNT . .. ... . �EE RECEIV�I) MA R 2 6 1984 FINANCE DEPI.� ... CI1Y OF COSTA MESv. APPLICATION FOR PERMIT BUILDIN6 For Offiee Use Only PBCEIPT NO. PER I !Y pAT[ RHCfiIVBC DAI 5� �_�/.i �- BUILDINO NO. OF � U9E OP NEW PLANB � BWLOINO YARDS MPROVED MAIN BUILDIN6 ;OM C/L STREfiT INT vJ I/ IDE �FT. � ios �r�r.H�/ __. „n VAR. # /�� r�" 9HALL BE LESS THAN (U.B.G.REQUIREMENT: YARDSAPPROVED ACGESSORY BUILDING _r DATE THE AMOtINT BXOWN 11NGEH VI PURP08E OP fi6T/�BLI6HIN� A VALUATION PERMIT ,�� y��- , 18 FOR THE FEE ONLY. ��