HomeMy WebLinkAbout145 LEXINGTON LN - Building Permits I °JEDDS:
145 LEXINGTON LN UNIT CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069642
OWNER'S NAME: THOMAS EARLEEN R
kik ADDRESS: 195 LEXINGTON LN PERMIT NO; B 069642 PLAN CHECK NO: N GOVT; N SUPP; N
COSTA MESA,CA 92626
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION ; T/O RESTH & REROOF W/COPM & HOT MOP SQ FT: 2, 508
ADDRESS: UNIT:
CLAIM VALUE; 2, 508 , 00 CALC—VALUE; 2, 508 . 00 GROUP OCC; R-1 /
PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775
ADDRESS: P O BOX 4309 COMMENTS ; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED
DOWNEY CA 90241 *****************************Sf***3t**************3************4*s6*#************air
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 059,177 STATE LIC.: 4025 CLASS: C 39 EXP : 10/95
Date:_�D q' signature:_ . _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
Compensation Inuggpne or a certified copy thereof(Section 3800.Lab.Cl. LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: IS 22699 EXP. DATE: b 5/19/95
COMPANY: AIG PARKING REQ: PROV: PARCEL : 41916377 ZNE; REF NO:
0 Certified copy is hereby furnished. C(Certified copy is filed with the city
Building Division. PLANNING N TES,>
Dale: I O( 1Qi4 Applicant: ` *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E QU I R E M E N' T S
I certify That in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become -'subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: -
Date: Signature: BUILDING APPROVED BY
NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ',/� t�,CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: •v — 4which this permit is issued(Section 3097.Civ.C). J;€ 14
LENDER: **************************** ************************************************
ADDRESS: LEGALIZATION:N E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,atter,improve.demolish,or PERMIT 54 , 00 , 50
repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business LAN SMIP/NON—RES
and Professions Code)or that he/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). ISSUE FEE
I. as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 54 . 50 0 . 00 0 , 00 5 4 . 50 54 . 50 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.II.however the building or REVENUE DIVISION TOTALS——> COLLECTED; 54 , 50 OVER/SHORT• , 00
improvement is of sold sate/.
one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sate).
I.as owner of the property.am exclusivelycontracting with licensed contractors to construct the project(Section 7044,Business 54 0 0 5 0
❑ and Professions Code: The Contractors' ate License Law does not apply to an owner of property who builds or improves thereon
•
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCR IP T ION UNIT COST TOTAL COST
Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 •
2, 508 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
Date:lQJ 9L / Signature: 4 01 001:0684-00170685 TOT 54.50
Drivers License or Social Security v: DATE: 0/28/94 TIflE: 13:29
t 541-46 White—Budding;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
e. v�'NSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permitr 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 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. $ewer 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 Structu e70. UndergrpundrHy<1ro
22. Duds, Vntilating., -
71. Product Piping ages Dpi I
23. -Gas Pipe:Rough &'Test .72. Underground Flush
24. Roof Framing. . -. •. 73:Undergrnd.Storage Tank C Gas C On
25. Roof Sheathing -
z-gas 64.444-' 74.-Overhead Hydro
.
26. t-Ba; Ceiling (Structurall & Monocoat - • 75.1Dry Chemical
27. Frame and Flashing; - ' „ . ' 76.`DryStandpipe •
28. Lathing& Siding- - •. 77.. FIXEDSYSTEMFINAL •
29. Insulation " -- ;. 78."FIRE PREY. FINAL
.30. Drywall Nailing • - HEALTH DEPT: REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final - a .80. FOOD CERTIFICATE ISSUED
33. Final Electric 'Notes: -
34. Final Heating& Air Conditioning . - ,-
35. Final Gas Pipe-Test I . •
36. Hood,or Canopy . .. - -
37. Final Factory Fireplace •
. t.
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
I
45. Sound Attenuation -
46. Handicap Regulations
47. FINAL STRUCTURE &BUILDING 6-q -- ps 66,41
48. FINAL PLANNING .
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-
CITY OF COSTA MEACONSTRUCTION PERMIT PER"T NO. TRACT NO. LOT NO. UNIT NO. 5248 2/ 7/ei3 5 OII Ti
iS 1 xi rt bailed P3a198 e
Project Address gyp!/
I9/a ern #� TYPE OF CONSTRUCTION ❑ NEW U ADD H ALTERATION La REPAIR
Applicant's Mailing Add//ess n n
Owner's Name 7/?O (<S Phone-75/190Q E CONVERSION ❑ DEMOLISH ❑ OTHER - - A.P.# Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING OUNDATION ❑ STRUCTURAL E
Front 0
Address • ill TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N
❑ OTHER A I
Contractor's Nam- Id 4 _ iAl� ✓ 't one C Right N
^ �1ss
��,t( '/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G
Address(mailing) i��� GS/ � Tr •�"
CONSTRUCTION TYPE VALUATION $ $
Left
City License No. 1�i
E
ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes:•
M
with section 7000) of Division 3 of the Business and Professions Code,and RFCEIVEU FEB 1 0 1988 T
my license is in fu . and effect-
License CL �t� L� i nr. s; iv1 t S
Date — aite; Signature &'r7i-I No rar". W PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers II
ELECTRICAL
I hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section 'Backflow Preventer Service Sink
Automatic Washer Transformer 0 15-50 KW
3800, Lab. C�y7/ is j. Q. pn 4 -11_ � � 0 50+KW
Policy rvo. /N /�.7 O / Company p���(,�� Backflow Irrigation Sewer Cap Construction Pole Sub.
1 _rCertified copy is hereby furnished.
7 Cer ifi copy filed with the cityBu' in si IIIBathtubs • Sewer Connection CookingUnit Meter ❑u to 100 amps
j y- P P
Date (.-16.".6 6 Applicant %/1y/{p��,•����["yg}`'pt/////,����(//A ��
•
EXEMPTION FROM WORKERS'COMPEN ATIS ON DEC LKR ATION Clarifiers Solar Collectors Di5hwa5her Meter Dover 100 ampsI
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping ■d Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is Issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains , Solar Tank ■I■ Fan - Motors 00-1 HP OVA-8
Workers' Compensation Laws of California, - -- -
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith -Floor Sinks El Urinal' I Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTIONLENDING AGENCY Gas Service Outlets Water Closet Device BoxesI
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097' Civ. CJ Interceptors Water Heater Outlets Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I 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 Laundr Trays
any structure, prior to its issuance, also requires the applicant for such permit Y Generator ❑0-5 KW ❑5-15 KW Trash Compactor
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
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). $ 3
0 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 1 $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 Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: '
employees, provided that such improvements are not Intended or offered for
sale- If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 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). ,�
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 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 00-100,000 BTU 0100,000 BTUSUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple Ci System Repair/Alteration •BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason . Firepl/Fact.Bit. ICBG# ■ Fire Dampers PLUMBING $ 5 r W ISSUANCE $
Date Owner -.- _ Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00.100,000 BTU ❑100,0006711— GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre-
sentatives of this ci to enter u••n the above-mentioned property for •
. • Q
inspection ,I�'•s9Q - - i MECHANICAL $ TOTAL FEE $ CA�
Signature / ,•�7 /_ -. Date /l��O /) •
Drivers' License or SS# ���� Reinspection Fee I $15 Issue Fea $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 white - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND'PLANNING POOL &SPA •
ft?PROVALS Per/y.111# Date Inspector APPROVALS Permit Date Inspector
1!.Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. 'Steel Reinforcement cart
3. Electrical Conduit Utility-Undrgrnd. 54. Forms p
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
Lir
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundatidn 59. Gas Pipe, 0 Undr rnd.,Test
g . :
9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap•O 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 r 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 73-f• . .
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 ?Ala GiCO
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final '
42. Backflow Preventer
43. Backflow Irrigation .1
.44. Landscape Irrigation System
45. Sound Attenuation . .
46..HandicapRegulations - •
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
- . ,t a.14ton Lane WA C c.t v
`IJOB ADDRESS 5 g BUILDING PERMIT NO. 33125
GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Cut window in wall
AP No. 930-03-067 LOT TRACT FIRE ZONE VALUES 100.00
•1 INSPECTIONS Signature Date TYPE V GROUP I ZONE R-3
SOIL • PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number Signature
SILI
Plumbing
.y ROUGH PLUMBING
PROP: SWR. LINE n HOUSE CON.
i!i SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER
ROUGH WIRING Heating and Vent.
TRENCHES n FORMS STEEL REINF. ❑ •:// S
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING ��4/
FRAME AND FLASHING f /`/4(L ]d_2F;-,L
LATHING - IN n OUT n
PLASTER, BROWN COAT
STRUCTURAL. FINAL Electric •
HEATING. VENT., REFRIG. AND A.C.• FINAL
PLUMBING, FINAL AND GAS TEST El
ELECTRIC, FINAL q��{
BUILDING, FINAL at4frkp r/.. 77 .
• 38125 PAIL
tt ?1-3a Tr9,O 676R vc,. r*,:-5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT i, r1- 1!7- ,--
- P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely r
RECF,I,V E,p 9,44TE DATE—I� D
7i
BUILDING U�i AT
ADDRESS /�ta .4 ex ) 11,5-47.,, LA pa
,Q /y PERMIT
NO.
OWNER // t X,nenrcm an A.P. NO.9�' O� CM— `��/ 812
MAIL BUILDING
ADDRESS .5 a m e ADDRESS/V� jn 1q�� n.
Z r D
o_ L) CITY NO.sgs4,3/S TRACTfS/(' LOT 67) BLOCK
ZZ NEW ADD I ALTS REPAIR `MOVING DFMOI LSH
Z CONSTRUCTION
ON LENDER Nanta
Il m
J D BRANCH /�
JN OWNER /4, ••aren/Iemo'.J
Q W ADDRESS
/ �j�1 /^
-CO ARCHITECT TEL. US Erdal or/P rjpr if;X: ! cc
Q OR ENGINEER NO.
U Q FIRE
w cc ADDRESS ZONE TYPE GROUP
w 2 APPROVED �(/ 5 19 7
WZ CONTRACTOR /I/�^ --y�!L bl BY �i`,/ DATEJJJ o•cG' /
J O lJ
m2 -
J m ADDRESS
w Lu TEL. ZONE . INO.OF USE OF NEWT+tPf'eyytOn
O= PLANSBUILDING (/7/F {�� 7
Z H, CITY NO. 4 M O[` n j^GII r�7U
O STATE CITY YARDS APPROVED YARDS APPROVED
LU
Q LIC.NO. LIC. NO. MAIN BUILDDDD��J�NG ACCESSORY BUIL
7 O _ (FROM C/L STr♦ T) /
SIZE Na OF BLDGS. /
OF LOT NOW ON LOT FRONT T • Vt IUSE OF
EXISTING BLDG. R Sino5I— SIZE OF NO.OF \ `ry'` 1Z NEW BLDG. ROOMS STORIES L.SID 1 FT. 1 IFT.
VEXTERIOR WALL ROOF t^��.(Y
_ COVERING COVERING REAR FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
n'0. MAIN BLDGS. ACCESS.SLOGS.
Q -1/s / Wii(-7-J0C-(-) n CORP.# DATE
APPROVED
C/) /� / / t/:74�< J C l�L /✓`W� _lY ROVED _ l� Yl • s DATE 4.3-120-7,1
OKa—/ ,1
o rQ/ CJ
(._,. D
TA1 hereby acknowledge that I have read this application and stateDthat the above information is correct and agree to comply withCC all laws regulating building construction, and I shall not employany person in violation of the workman's compensation laws ofCO the State of California. TAX bz I hereby certify that I am properly licensed as a contractor under SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: cp
CC
am exempt from the provisions of the State of California Business VALUATION 5—ez U
and Professions Cup.), Division 3,Chapter 9. m
PERMIT FEE $ N
•--_
Snaue / m
Perigmittteerof G• v�Z��, ��t/ $ ��� PLAN CHECK $ E
p V o
Authorized Agent
5-61
LL
TOTAL FEE $
PAID
27785 NOV 13-67c#00 529* ****90.00
[NSA
COSTA MESA BUILDING-SAFETY DEPARTMENT
p,O. BOX 1200 COSTA MESA, CALIFORNIA 92628 .
's.
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
P4244--2.-
174)14
1 For Office Use Only
BUILDING I�i � R/_ _ _ _
ADDRESS -T � T.� (tN hG(��l.X� RECEIPT NO. P[R111Tr1¢�r
COSTA MESA. CALIFORNIA DATEC l l5
REC[IY.[�//DL /0-3/-4/
T5,967
oWNER San Vista Bldg. Co. KKJJ���
Bu!LOINS
MAIL ADDRESS
ADDRESFIRE
S
8BR 2249 Wanderer Drive - n/
OI,I„T San Pedro NOL833-3320 ZONE TYPE kVGROVP iy
ARCHITECT TEL. _ APPROVED DATE U
OR ENGINEER Clif Olsten NO,• 923-122
ADDRESS 90253 E. Florence, Dowy ZONING
Boyce P_
- ZONE/1 ` NO.OF Un OP NEW 1 �/ ��
Same K eauDlN- p /
CONTRACTQR ,_(_, /- l�t—`
ADDRESW Same
DESCRIPTION LON 6-2 f,.t A/Lo (1
CITU _Same A.P.NO. / / - 70/ -
TEL. 30'
NO EAVE OVERHANG SHALL BE LESS THAN
STATE
SIC.NTO, SIDE
EAVES
OF LOT e2-.X1 /J I NOW Or ON LOT •_ ALLOWED <U.E.C.REQUIREMENT)
USE,OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBAC • FR•NT a PT.
CENTER OP STREET REAR YARD f
SID' YA EFT• LNIGHT TE$IDR C) PT, PT.
DESCRIPTION OF WORK L.SIDPT. PT.
NEW � ALTERATION ADDITION �4 FT.
I DISTANCE BET. BET.MAIN B (/)
REPAIR MOVING DHMOLI=N ," MAIN SLOGS. ACCESS.BLOCS. -•
BUILDING///� NO.or3
�1 VAR.* , DATE IL.I
.' SIZE Nz_X �'0 ROOMS /STORIES ` l C.U.P.# ///(71L C_ APPROVED G -/d' -6 3 w
EXTERIOR WA AJ I ROOF V A APPROVES/ 1 . 7 E4
COVERING (}Q,(,(( I COVERING Jv >: ire 1.vvvttY xxTi 111 I i DATE /D-�0' é / •"'
• USE OF BUILDING AND ORK TO IPERFORMED G► I 9, d
3
/39 ROAM �17.Y01 ,t, nydtei al , D? u.,
a U
I HEREBY ACKNOWLEDGE THAT.I NAVE READ THIS APPLICATION THE AMOUNT SH UNDER VALUATION IS FOR THE 0 a
AND STATE TNA ABOVE CORRECT AND AGREE TO COL •PURPOSE Or ESTABLISHING A PERMIT PEE ONLY. N
PLY WITH ALL RDINANCES AND STATE LAWS REGULATING VALUATION a
BUILDING CONST' •N. /�D PI
SIGNATURE OF A /\''-''''''''.-----.
� PERMIT FEE 5 (�/
PERMITTEE gr
\A / �� /y� E u'
s �Q /f�- PLAN CHECK S c-?c:9 ^ w C
AUTHORIZED A• NT TOTAL FEE $ 70 C