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2515 LOYOLA RD - Building Permits
Applicant to fill in all spaces those within heavy border lines and sign all appropriate declarations. ' p' RMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA CO'/STRU/CTION�ERMIT • 2396 , 9• _/02/8_6_ ' '.5:00 TI., .Project Address 85/ S��/,`/OL!i? �l LD �sr, ' • Atli Z-G Deg-too TYPE OF'CONSTRUCTION ❑ NEW LI ADO LI ALTERATION REPAIR --- _Applicant's Mailing Add s2 f S� ,,{y .LS ��/1Y • ❑ CONVERSION ❑ DEMOLISH ❑ OT / ! A.P.# - - _ , • I Zone • Owner's Name U V �J®� Phone DESCRIPTION OF WORK/USE OF BLDG. d� -Address jr/,SQL v L+9'- R� •G M , - - S Main Building: _ _ Accessory Building: .. . Z + '' ' ' - -TYPE OF PERMIT LU GRADING ❑ FOUNDATION ❑ STRUCTURAL Fronti - I - ' ,Arch/Eng: Licenie.No: T _ O j `Address -' El,TENANT ❑ ELECTRICAL-.PLUM GING III MECHANICAL A Rear . • - - - - N Contractor's Name �� J//] Phone ❑ OTHER 'c C Right N Address(maelingl' /f 7 / 1�• - PROJECT DESCRIPTION SQ FT. I OCCUPANCY - • g - ' G L/////// f,LJ K C ON STRUCTION,TYPE -VALUATION$ S Left • '- i CityLicense No. , ZONE m - ' GRADING CU.YDS.' ACRES - R • -LICENSED CONTRACTOR DECLARATION , - - - Ping. Ref.# , • Parking Req./Provided E y ,Thereby affirm that I am licensed under provisions of Charter 9 (commencing; Remarks: _ I I • Planning Notes: I , _• M ;with-section 7000)-of Division 3 of the Business and Professions Code,and ' _ -:My license is In full force and effect. -• I ' - ' - T License Class • License No. •« • i - - I - S Date' - - Signature , ! ' PLUMBING - 'FEES .� , WORKERS'COMPENSATION DECLARATION , Bar Sink Showers ' - ' • !hereby affirm that I have a certificate of consent to self-Insure'or a certificate I I ELECTRICAL ,FEES ' Workers"Conipensation' insurance,_or.a.certified copy thereof (Section. .. - Backflow Preventer •-- -- Service Sink '- - - '"" - - -' • Automatic Washer Transformer❑ 15-50KW "300. Lab. CJ , <;,•�: Policy No. I Company Backflow Irrigation , Sewer Cap - 0 50+ KW ' Certified'copy is hereby furnished. • Construction Pole$ .- , R-Certified co Pv,is filed with the city lBuilding Division. Bathtubs i Sewer Connection - Cookin• g'Unit•5 4 ^�_ Meter ❑up to 100 amps • I r t Date ' Applicant -^ - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher • i Meter ❑over 100:amps • (This section need not be completed if the permit is for one hundred'($100) or` - -- - - -- - _- _ - _ . . _. less). ,• • Dishwasher. Solar Piping , Dryers OGS '❑Electric Sub Panel , I certify that in the performance of the work for w ich this permit is issued,t - - shall not employ-any'person in.any manner so te m subject to the Drinking Fountains • Solar Tank Fan '5 ^;/, ' • Motors 00-1 HP 01%:8 orkers' m sation Laws di,California. / �rp� _• - v, 1 ate Signature yH' Floor Drains Swimming Pool w/Spa F.A.U. - J ' NOTICE: If,after:making this declaration„ should become,subject to theInc.Solar ❑9.1$ HP ❑76-1$+ , • Workers' Compensation provisions of the bor Code, you must forthwith • . Floor Sinks - • -- • - - ' Urinal - - - - - - - --- - - -• comply with such provisions or this permit shall be deemed revoked. - - -Fixtures:- Microwave' CONSTRUCTION `LENDING,AGENCY Gas Serviee• -Outlets - Watef Closet - • Device Boxes' I hereby affirm that there is a construction lending agency for the performance - - - - Pole Light , • • of the work ,for•which this l permit is issued. (Section 3097,Civ., CJ Interceptor; - _Water Heater Outlets Lender's Name - ' - Range • _ , Lender's Address• - • - - ' Kitchen Sink - ,)i •Water Servicein' Switches � Sign • OWNER.BUILDER DECLARATION' ' ' '- - hereby affirm that am exam Pt from the Contractor's License Law-for the' .Lavatories • -Auto-Wash Garbage Disposal ' ' following reason (Section'7031.5 Business and Professional Code:'Any city or' - 9 P Standing Sections, l • county which.requires a permit to-construct,alter,improve,demolish or repair - PL-Trap • - Laundr Tra 5 ' Y- Y ' ' Generator ❑0-5 KW 05-15 KW Trash Compactor -any structure, prior to its issuance, a is equirethe applicant for such permitP -to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - • 'the Contractor's License Law(Chapter 9 o(commencing,with with Section 7000) of ' - - - . . - • :-Division 3 of"the Business and Professions Code) or that he/she is exempt ,_ -erefrbm 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 - - - JYartele- - _• - c +ally of not more than five hundred dollars,($500). , • , • - - • • I, as owner of the Property . - • • Reinspection Fee ` $15 Issue Fee ;$ 3, - for sal wHe,a, will do•the work;and the structure is not.:intended or offered - - , Reinspection Fee I $15 Issue Fee I $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's i -- , MECHANICALI. 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 r DEVELOPMENT'SERVICES REQUIREMENTS: I • employees, provided that such improvements are not intended or offered eretl f for Boiler' 'Hood or Type I ED - , sale. If; however;the building improvement is sold within one year of com-' _ Canopy Type 0 , Zoning Approved By Date • � prove , the p the,owner will have the burden of proving he/she did not build or im _ DUct- Under Ground - Building Approved By i Date • prove for the purpose of sale). • ��©� 0 I, ai owner of ctthethe perty,am exclusively contracting with licensed Con-, Duct-Structural 1 Refrigeration System . Application (sued By SL.J� ' Dat: ' 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 - , , 001 C0,000 BTU 0100 000 BTU SUMMARY OF FEES builds or-improves thereon; and who contracts'for such projects with a con,' - - tractor(s) ucense,pursuant to the Contractor's License Law). I am aware that BUILDING PERMIT $ ;SMIP $ proof o their Worker's Compensation insurance should,be provided to me: Exhaust System ❑ Multiple ❑ System Repair/Alteration _ PLAN CHECK . $ I 1 PERMIT 1 ' ❑ I •am •exempt under Section- j -. + p.C.for this reason •` Firepl/Fact.Blt. ICBG# 1 Fire Dampers ' 00 I ISSUANCE $ , I / - - PLUMBING $ - , Date - 'O• - owner ar l Heating System& Ducting. Registers . . PLAN CHECK 25% $ ENERGY P.C. $ ,- ..I-hereby certify that I nave read this .•plication and state that the-above" - - - ❑o-100,000 BTU 0100,000 BT - ' ELECTRICAL $ GRADING ' $ '_ ' • information is correct/I agree to comp with all city and county ordinances' II ' • .b. • and state laws relate t- b tiding construction, and hereby authorize repre- — - - - ' I I MICROFILM $ sentatives of thi /y o - -r •'n the above-mentioned; propert for' ' , , PLAN CHECK 50% $ , ` spectlon pure.-e/ �Z�j : - 1 MECHANICAL $ 'TOTAL FEE $11 : °' ignature r,/r rr�� •.t¢ - - I , , I •rivers' Lice i�r SS# �> ' i Reinspection Fee , .313, Issue Fee I I$ 3, PLAN CHECK j 25% $ 1 I I , •CMF 0865-46,rev.10/84 'White • Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 'CONSTRUCTION AND PLANNING # POOL °A - Date Inspector Ci Date • Inspector APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,„-• 2. Soil Pipe-Undrgrnd. -1' 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings 58.. Electrical Conduit-Undrgrnd. - , . 8. .Foundation _ • 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. ' ; 60. Backwash Lines,P-Trap, O Undrgrnd. y 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 f 13. Roof Drains . 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final f , 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 Strdcture 70. Underground Hydro - - 22. Ducts, Ventilating 71. Product Piping 0 Gas CI Oil 23. Gas Pipe-Rough & Test72. 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 76. Dry Standpipe 28. Lathing & Siding • 77. FIXED SYSTEM FINAL 29. Insulation 78.' FIRE PREY. 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 °Mfg _A7 ' • .39. Water Service-Final • Pl 0.1 c-t- ' 40. Gas Service-Final 7�� AA 41. Solar Domestic-Final 42. Backflow Preventer - ,43. Backflow Irrigation - - :. •• r4-4, Landscape,Irrigation System • 45. Sound Attenuation • '46. Handicap Regulations ' , _ u, 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements Completed , 49. Electric Release to Edison .. - 50. Gas Release to Southern California Gas Co - - • 51. CERTIFICATE OF OCCUPANCY . , No. Date -_ LU SA r / I O -� 1 r'd^ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ^ Y OF COSTA M SA OpJ'�'TRUCTI PERMIT ' PE$MI�S.! �� TRACT NO. I LOT NO. UNIT NO. - olectAddresssIJ i•�Ol� - r •' r 1 I,� _ "2395 : '9%02/86 33e50 IL -- pplicanYs Mailing Ad ess -��l/� 0�4 -(Ie 42 TYPE OF;CON$TRUCTION ❑ NEW IJ ADD hY ....;; R 10i ❑ REPAIIitt - ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER `(f•�— L'0 .GNner's Name' O /� Phone S '4.;Sear DESCRIPTION OF WORK/USE OF BLDG. - A.P.# tone . , Address �_ irL�OGT C � . • -- • ' - r • . rrppr•' S Main Building: - - Accessory Building: - I Arch/Eng._ - - License No. TYPE OF PERMIT : Et GRADING ❑ FOUNDATION,DT-STRUCTURAL T - Fronts , • - • O Address - ' ' ❑ TENANT_ ❑-ELECTRICAL- ❑ PLUMBING . ❑ MECHANICAL B Rear , - - N Contractor's Nam• A .# Phone_ • -10 OTHER I - A - • - '` • PROJECT DESCRIPTION 'OCCUPANCY .0 Righ:N4Lores: - N 'Address(mailing) - CONSTRUCTION TYPE - •VALUATION $ s Left G R City License No. ZONE -' GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. RefParking Req./Provided - E.1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:' . ' , •Pia nning I . •• M with,section' 7000) of Division 3 of the Business and Professions Code, and' - ' . • 1 my license is in full force and effect. -• _ - - T' . $, License Class License No. - , • • PLUMBING ' FEES Date - - 'Signature _ . WORKERS' COMPENSATION DECLARATION ' Bar Sink Showers ELECTRICAL FEES ' : I hereby affirm that I have a certificate of consent to self-insure or a certificate 1 • • I Workers';Compensation Insurance, or-a certified copy-thereof (Section " - . . - _ - - _ _ -1-- Backflow Preventer Service Sink - ", )0, lab, C.)' • A• utomatic Washer - Transformer 0 15y50_KW rolicy No. • Company Backflow Irrigation Sewer Ca 0 50+KW P Construction Pole Sub. -- ®':Cert if i e dco p is hereby f urnished. 1 ' .Certified'copy'is filed with the city Building Division. r Bathtubs Sewer Connection Cooking'Unit Meter ❑up to 100 amps Date ' Applicant_ •, • - - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers •' t ' Solar Collectors I • I Dishwasher Meter ❑over'100 amps _ (This section need not be completed if the permit is for one hundred ($100)or • - -�" "' - - - " -- less). ' Dishwasher' Solar Piping Dryers ❑Gas ❑Electric • Sub Panel ^ -}, I , I certify that in the performance of the work for which this permit is issued, I t- • shall not employ any person in any menne 5 as /yob}'come subject to the' Drinking Fountains Solar Tank ' Fan I • ' Workers' C.mnp�nsation Laws of California. '/J4' �/� Motors ❑0-1(HP ❑,1%�'-8 Date ' rl f,�� Signature Floor Drains ' Swimming Pool w/Spa F,q,U, Inc Solar ❑&15 HP ❑i6-15+ ' NOTICE:If,'aftenmaking this declaration, u should become subject to the Workers' .Compensation provisions of the bor Code, you emed'revok th Floor Sinks - • ' comply with such provisions or this permit shall be deemed•revoked. Urinal - - Microwave'" I CONSTRUCTION 'LENDING:AGENCY '' ' Gas Servile. Outlets Water Closet .: I ' s 1 Device Boxes Pole Light ' I hereby affirm that there'is a construction lending agency for the performance - I 9 , of .the work .for which ,this permit is issued (Section 3097 Civ. C) Interceptors Water Heater - ' Outlets ' Lender'•s -Name' -• _ - - Range Lender's Address • + • - ' ' Kitchen Sink • - •' ' Water Service • - • - Switched Sign ' ' OWNER BUILDER DECLARATION - ' ' I hereby affirm that I am exempt from-the Contractor's License Law for the ' Lavatories Auto-Wash - Garbage Disposal following-reason (Section 7,031.5 Business and Professional Code: Any city or. - - - . 9 P Standing Sections • county which.requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays- • - Generator ❑0-5 KW ❑5-15 KW Trash •Com actor• ' • to fileructure, prior to Its issuance, also'iequires the applicant for such•permltP ' to file a signed statement that-he/she is licensed pursuant to-the provision5'of Roof Drains : ' - the Contractor's Licensiness (Chapter 9,(commencing with Section 7000)of - - ' S Division 3 of"the Business and'Professions.Code) or that he/she is exempt , r , - - ' - • ' 'refrom and the for the alleged exemption. Any violation of Section , - - 1- 1.5 by .any -applicant for a -permit subjects the.applicant to-a civil) • ' - - • - + - 1 ' illy of not more than five'hundred dollars($500).. . - ' - - - - , -U, as owner of the property Reinspection Fee I ' $15 • Issue Fee $ 3' p will do the work,and the structure Is not•intended or offered. ' 111 1 Reinspection Fee - for sale (Section 7044, Business.and Professional Code: -The Contractor's' _ - • - _, • MECHANICAL FEES i - p I $15 • Issue Fee I • $ 3 License Law does not apply to an owner of a-property who builds or improves • thereon, and who does suchworkhimself/herself'or through his or her:own '- , -- I DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are not intended or offered for- Boiler. c .Hood or Type ❑' I I • sale.rlf; however;the building'or improvement is sold within one year of com- --. - Canopy Type II ❑ r Zoning'Approved By Date pletion, the,owner will have the burden of proving he/she did not build or im- Duct-Under Ground: Building Approved By Date ' prove for the purpose of sale). - C ❑ I, owner of the property, am exclusively contracting with licensed' A con-Duct-Structural . Refrigeration System ' ' Application Issued By ' 5.Li..!\ Date ( 1-a/gin 1 tractors to construct the project (Section 7044, Business and Professions Code: , The Contractor's License Law does not apply'to an owner of property whoDuct-'Ventilating- _ . _ 00-100,000 BTU,❑100,000'BTU l7:>.8../._' SUMMARY OF FEES ' builds or improves thereon, and who-contracts for-such projects with a.con- - u` 2 ' •SO tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 , System Repair/Alteration - BUILDING PERMIT $ '• - I SMIP $ Proof of their Worker's Compensation insurance should•be provided to me. PLAN CHECK $ 'PERMIT, Onam exempt under Section 1 • . & P.C.'for this reason: Firepl/Fact.Bit. ICBG# i Fire DampersI PLUMBING i $ ' SS UA NCE $ I Date 9= - Owner s • - i Heating System&Ducting Registers ENERGY P.C. $ PLAN CHECK 25% $ I-hereby certify ;that I have-read thi application and state that the above —' 00100,000 BTU 0100,000 BTU- ` ' - -' ELECTRICAL • $ • GRADING $ _ information is correct:I agree to com ly with all city and county ordinances, and state laws relating t• building construction, and hereby authorize repre-, - - - - I PLAN CHECK ' 50% $ ) t -MICROFILM ' $ I_ inspection of this ci vyep upon the above-mentioned pro erZ MECHANICAL $ • inspection purposes. / .�1o'(y�/ , Signature i :.., Date ' I TOTAL FEE $ ' .5� Drivers' License or vS# /'�' / / • • Reinspection Fee ,$15, - Issue Fee .$ 3 PLAN CHECK 25% $ I 1 CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor r 1 \ ' 'TRUCTION AND PLANNING POOL A - APPROVALS Permit# Date Inspector APPROVALS Permit* Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location r 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. , 8.. Foundation - -• 59. Gas Pipe, 0 Undrgrnd., Test 9. WaterPipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Struciural 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 - -r 14. Rough Plumbing 65. Electrical-Final (t 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 0 Gas 0 Oil 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 76. Dry Standpipe 28. Lathing &.Siding -- 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 • - rn 44° Landscape Irrigation System 45. Sound Attenuation • 46:;;Handicap Regulations ' - ' 47,-'FINAL STRUCTURE & BUILDING p� • - 48. Special Requirements Completed d - - . 49. Electric Release to Edison _ 50. Gas Release to Southern California Gas Co . • 51.tCERTIFICATE OF OCCUPANCY t• No. =x-- Date . .- 11 11 OWNER ROSS, W. J. DATE 8-18-67 -JOB ADDRESS 2515 Loyola Road BUILDING PERMIT NO. 27455 GENERAL CONTRACTOR Pacific Installers DESCRIPTION OF WORK Retile bath AP No, 141-1112-52 LOT TRACT FIRE ZONE VALUE $ 120.00 I"""nECTIONS I Signature Date GROUP I TYPE V ZONE R-1 PERMITS ISSUED Gas SUBCONTRACTOR I Date 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 p _ Rough Wiring Heating and Vent. Trenches 0 Forms 0 Steel Reinf, 0 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Frame and F S Lathing—I Out 0 b'''u/_G7 Plaster, Brown oat Structural, Final Electric ' ig, Vent., Refrig. and A.C., Final I-_ –oing, Final and Gas Test 0 Electric, Final Building, Final r^ _ /6i __ , 211455 i owF CITY OF..COS fit MESA yVCOSTA MESA BUILDING-SAFETY DEPARTMENT IP p ,(r P.O.BOX 917 COSTA MESA,CALIFORNIA M `ry Q,`/ � • AUG 21R, 7 For Applicant to Fill In Completely AP (CATION FOR PE TYPE OR PRINT F ! Off i 11f cj,I A/ d BUILDINGCX� �q` _ ADDRESS RECEIPT NO COSTA1n/ MESA, CALIFORNIA 2 /2d'? 27455° OWNER //�� (/// (�l(,/ilri/�O/• /a-4J - REL./Cw•[^(/, AMAILD RESS O( 5 /6V //1 4 j / BUILDING c2.5/r+ greet- 'pn/�, �,rFIRE /��/ // ADDRESS �f eJ !J /�// CITY £ t zZL. NO�JV(D�7`� ZONE v-7 TYPE GROUP (`1C AROVi,j,rio �{Q/i DATE ' Q 4-4 ARCHITECT TEL. O (NEER NO. ZONING • AL .55 • Q ''YtJ'/Le5''t ZOry. / NO.OF I USOF NEW e ,(LJ PLANE BUILDING ya CONTRACTTOOR � ladJ 0 /� f/ ) /� t4,//- ��JrFYi� //4 / / LeawL A �0 -�/(��C-tX�%ST ADDRESS _J/ 74,1-(2-.. DESCRIPTION ' / / CIT 7/ / ,!/;�{`,�J' A.P.NO. I�7/ //� __S-elm LIG.NO.011///in NO. U�'/ V72 C NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL SO"TO SIDE B REAR P.L. EAVES SIZE - I NO.OP SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT USE OF • YARDS APPROVED YARDS APPROVED EXISTING BLDG. ' - ., MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SETBACK LINE FROM FRONT FT. FT. CENTER OF STREET REAR YARD SIDE YARD LEFT I RIGHT R.BIDS FT. i FT.fr DESCRIPTION OF WORK L.SIDE �V Fr! FT. N1 1,7I ALTERATION ADDITION REAR FT• FT. DISTANCE BET. BET.MAIN S RE. MOVING- DEMOLISH .MAIN BLDGS. ACCESS.BLDGS. BUILDING NO.OF VAR.$ DATE SIZE • XTROOMS STORIES C.U.P.# APPROVED /` EXTERIOR WALL ROOF • APPROV/1 7 /(n� p COVERING COVERING BY (/, `�.)�iILNDATE O �t� �/ <)ZF B/�U�v�}yI7�GAND WORK �RFO� Ite SQ.FT. 4 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. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTR ON D'A h ' /��� PERMIT FEE E SIGNATURE OF /�/ PERMITTED �./� �',1i.1/ (J , E AUTHORIZED AGENT Y 0 TOTAL FEE $ I v • f s - 8530I L. CeL L; aE • COSTA MESA BUILDING DEPARTMENT, FlN, �E MACE DEPT. P.a BOX 317 IIS r r.nnr�+ t?[Q COSTA MESA. CALIFORNIA - �! 3f ' 7' FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ABUILDING DDRESS 2515 Loyola Rd. BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY TT.. RECEIPT NO. FERMI853 OWNER Mesa Highlands, Inc. O MAIL 1555, Placentia _ REC VED BY DATE RECEIVED {6 pATE STj 9 �J/ ADDRESS ! J� - a'75 S7 ft- -ID o- ', CITY Newport Beach, Cal. TN O . MI 6-3227 LDING ADDRESS ARCHITECT same LIC. ORF NEER NO. COSTA MESA. CALIFORNIA FIRE ADDN-.,S same CoZONE K. W. Koll Const. CCITY LIC. 1217 ZONE I NO.OF TYPE O OVP CONTRACTOR NO. �k(l .1" y�p-9 ADDRESS Same . TEL., APPROVED same BY DATE LEGAL LOT 3j 2029 CORRECTIONS RI LESCPTION NO. 3O BLOCK TRACT A.P.NO. SIZE . OF LOT 60 S.lOO NOWONLOTO USE OF .• r EXISTING BLDG. SETBACK LINE FROM CENTER OF STREET 50 - REAR YARD 25 _ SIDE YARD RIGHT 5. LEFT 5 DESCRIPTION OF WORK NEW % ALTERATION , ADDITION REPA MOVING DEMOLISH • SIZE BUILDING 1611 - 420 ROOMS 6 STORIES 1 • • EXTERIOR WALL ROOF COVERING StUCCO COVERING WOOd shingle _ USE OF NEW BUILDING Residence & att. garage. Plan 1-A The Amount shown under valuation is for the I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND purpose of establishing a permit fee only. STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES ANjSTATE LAWS •EGULATING BUILDING C•NSTRUC• TION. / VALUATION PERMIT FEE s 35.00 SIGNATURE OF If ii ' AP a W/ PERMITTEE % 15,967.00 17.50 PLAN CHECK S S AUTHORIZED A E.iT TOTAL FEE S 52.50 ,9th