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2786 LORENZO AV sur: CITY OF COSTA MESA BUILDING PERMIT
MEiromIl: OLSON ROBERT J TR PERM NO: B 075773
ARCN,OR ENO'S ADDRE55:
ADDRESS: 419 FUJLLERTON AVE
NEWPORT BEACH, CA 92663 PERMIT NO: B 075773 PLAN CHECK NO: N GOVT : N SUPP: N
642-9772
APPL.MuuNDADDREss CONSTRUCTION TYPE: PERMIT TYPE: STIR PURPOSE: OTH
ARCHITECT OR ENGINEER: LIG No:
Wit CONSTRUCTION
DESCRIPTION : T/OFF RESHEATH W/PLY 25 YR COMP SHINGLE SQ FT: 5, 000
CLAIM VALUE: 5, 000 . 00 CALC-VALUE: 5, 000 . 00 GROUP OCC : R-3 /M-1
Cp7mACTOInNAME: PETRONELLA ROOFING ( 714 ) 548-1645
CONTRACTOR'SMARDIS 2626 NEWPORT COMMENTS : SMOKE DETECTORS REQUIRED PER 1991 UBC
omRE
Ass: COSTA MESA CA ucc. 00460707 *+tit-+txiei[SE***SES*it**it*;,t***at**** 5tit*+ex-atx-*** x*K-*fE*+t*******x***+t+f+tx******;,tat******(e**
92627 mm 201 Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Slim under penalty of Perjury that I am licensed under provisions of Chapter B SETBACKS
I (commencing with Section 7000)of Denial 3 of the Bunn;and Professors Code.and my Scene b in lug force and effect.
CITY LIC.No.: 032605 UC.CLAM: C 39 uc.No.: `0460717 EXP : 07/96 MAIN BUILDING ACCESSORY BUILDING
Dam: la'�.1 -9c c«amd.. FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
) =- LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby Shan under•. - of perjuy that am pt from the Contractor Linen=Law for the
fdwwitg reason(Section 7031.5 Busiest and Professions ••. Any city o-• • which requires a penia to construct,alter,improve. PARKING REQ: PROV: PARCEL : 14162604 ZNE: REF NO:
yicensed pini,mepprovorsiioprior
ns to the Contractors tors Li��•Law[Chapter applicant.(corsuch
mme��gtwfile a wihh Seadan 700000)of DSement an 301 the PLANNING NOTES>
„rosiness end Professions Code]or that he or she b exempt I ..• and the. for the alleged nemgion.Aoy=Wen of Section >
pp
7031.5byamyeicard for a permit subjects the applicant to a- •.. .. d-• more than f a hundred dollen[5500)). *******************************************************************************
❑ I.=owner 01 the properly or m/engorna with wags as ghee .. .., pentagon.will do the work.and the sins:tura is no intended D E V E 'L OP M E N T S E R V I C E S R E Q U I R E M E N T S
Profession offered for tale(Section 7044.Business and Professionon Ccde:The Com
uctos al License Law does nappy to an owner of property
who bufds or improves thereon. nee
end efto does such work Nang or be=ef or through hi or her own employees.provided that such
improvements are rot Needed or droned for sale.If.however.the=Wing or improvement is sold within one year of completion.the ZONING APPROVED BY DATE:
owner.builder'.1l have the burden of proving he or she did not build or improve tor the purpose of sale).
❑ I.as miner al the property.are exclusively mml°ctigwith lm
licensed m
dcanbmtantoav (Section Business BUILDING APPROVED BY : DATE: '
Professions Code:The Contractors License Law does real appy to en owner of property who builds or improves thereon and who
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). I /f—�—
❑ Iameaempunder Section; B.AP.C..for mb /reason: APPLICATION ISSUED BY : DATE: !J�
975
*********************************************** **************************
Date: °WAef LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: Y
I do hereby certify that I am aware of end understand the requirements of California Neagh and Safety Code Sectors 25505 25533.and
25534,and that I«any Muss building ocaeue will l wig rid(sacks one)need to comply watt and Nate codes end the requinmeM for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
e permit for construction or medBWonfrom the As�iieSiyManeQemed District.Residential nappicetinsaie exempt from Nita
provisions. PERMIT 72 . 00 . 50
Date: APpient:unSMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby Bram der penalty d d at
perjury one O.following derdeons: PLAN 'w
ISSUE FEE
❑ Ihewand dlmsiteiecertificate dmuwtsthle entissrk°n'mrtpenWon,nprovidadl«by9ectbnJ7WdlMlab«
BUILDING PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
ced..t«the p.rlamh.rha.dthe w«kl«wl:a this P.mhaima.d. TOTALS----> 72 . 50 0 . 00 0 . 00 72 . 50 72 . 50 . 00
❑ HAY*and wit maiaai wakes'compersatin insurance.as required by Section 3700 of the Labor Code for the performance of the
work for which this permit is issued.=Wan.c«npnmon insurance owner and pdky cumber are: w
CarrierooN�1A,qU[7T EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 72 .50 OVER/SHORT: . 00
Poky mbe: gSri1 t 5494 01 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
,This section need nor be completed f the pent i tor one hundred done ISiXJ or int) 72 . 00 . 50
❑ I certify NN in the performance d the work for which this penny is bed,I shall no employ any person in any manner gas to
become subject to the workeri compensation laws of C.... :. . agree at a I should become subject to the workers' *******************************************************************************
compensation proviso=d Section 3700 d the Labor :• ,I shat • ghwith comply with provisions. INDIVIDUAL .F E E B R E A K D O W N
Date; 1�a1—� w
S A.pic : .edAr
Warning:Faure secure workers' tp
conanadon co veva is . end shell w
� bhn cremployer to criminal e
lvul esane TYPE QTY D E S C R I P T I O. N UNIT COST TOTAL COST
civil tines ce to one hundred rlounn d dollars($lORA'r' In addition ,the cost of compensation.&tripes as provided tor In •
Section 3706 of the Lebon cod,Interest,and etrom ernes. SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm u •. peroay 1 perasy that there is a connection lending agency for the END OF FEES
performance of the work for which this permit is issued(Sect'••3097 'N.C). •
LENDER'S NAME: •
LENDER'S ADDRESS: •
7
I certify that that I haveread Ni application and Nate that the above iS«mation b coned.I agree to comply with all city endcounty ordinances
•and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above.mentioned properly -
forintpedio rpaxee,
LOID WATTS
Prim Nam° LI :_1+ '>• :..–(Zr r.
�( —�..v � Date:�Z- 11 - -
Signature d Owmr pem/Appe ancmhacor - . . ‘1111\
(5151 d6.WP) White-Btrioi g&Safely:Grs« sryJv
�F e:Ceppicem:Pink-Revenue:GoWorodAaan«
a
CONSTRUCTION AND PLANNING POOL SPA
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
A. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
• 6. Electrical UF Grnd. 57. APPROVAL TO COVER•GUNITE I
, ,-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. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final • •
I
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Etectric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 1 • 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POO USPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough FactoryF I NA L
1 •9. Rough Hea - i Permit#
21. Ducts, in Structure -- 70. Underground Hydro
22. Ducts, Ventilating V 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush ,
24. Roof Framing - • 71- Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 1-2-96 6c., r 74. Overhead Hydra
26. T-Bar Ceiling (Structural) & Monocoat • � 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe ,
28. Lathing 41 Siding •' 77, FIXED SY.$TEMI•FINAL
29. Insulation - 78. FIRE PREV. FINAL '
30. Drywall failing - HEALTH DET. REQUIREMENT
31. Plaster Brown Coat - - 79. FINAL INSPECTION •
I
32. Electrical Power Meter-Final 130.' FOOD CERTIFICATE ISSUED O
33. Final Electric Notes:/z_yy�.3- �se 'aiuYi 3/cart,,
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 r _ L �Q..V(y'���//
42. Backflow Preventer /t1-176- erJ9 �l� /�PL���/J y((
_ - • Far( s-�('s
43. Backflow Irrigation �.. �1r.- _
44. Landscape.Irrigation System
45. Sound Attenuation - - , • _ - -
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDING / aa -
48. FINAL PLANNING . , 1_6-14,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY r - - -
•
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
CITY OF COSTA MESAp, CO IST oR UUCTTI'ON PERMIT PE IT NO , TRACT NO. LOT NO. UNIT NO.
Project Address a7�16 4-17fel LV a' 757 ry(/ 51IB 5� C'./"u
Applicant's MaibngA�d-dyr¢ss TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION TJ REPAIR - ,
V/ Phone • ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name DESCRIPTION OF WORK/USE OF BLDG.
Address r ,t S Main Building: Accessory Building:.
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING W FOUNDATION U STRUCTURAL T Front • Z
Address / - ///��//,, ❑ TENANT ❑ ELECTRICAL WT PLUMBING ❑ MECHANICAL B Rear . N
Contractor's Nam- bl4 -r / d If 11: 7Phon•�\YYOO< ❑ OTHER A . - I
7 / �r PROJECT DESCRIPTION SQ. FT. - OCCUPANCY C Right N
Address(mailing) l ��'/ / K ' G
gO73-5 CONSTRUCTION TYPE -_ VALUATION 3 s Left
City License No. C7 ! ZONE -- _ GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION - _ - Ping. Ref. Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: CIM
with section 7000) of Division 3 of the Business and Professions Code,and
my license Is in fu f•. - and effect. s T
License -•
I . ,, • I -n. r . , , RECEIVED APR 3 p t�&In S
Date mart rt Signature I Jit -_ - tharrei. - • PLUMBING FEES
WORKERS' COMPENSATION DECLARATION •
Bar Sink Showers ELECTRICAL FEES
cle hereby affirm that I have a certificate of consent to self-insure or a certificate -
Workers'- Compensation Insurance, or a certified copy thereof (Section '
,800, Lab. C. // �7s/ n/, �/
Backflow Preventer Service Sink Automatic Washer - Transformer 0 15-50 KW
Policy No. pet q0�l ias Company /titiala .tet J Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
_....Certified copy is hereby furnished.
•
Cerci le pyits Iled with the city B v n. // i/� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date `��—,OM Applicant ATI (/1 J/I /��i
EXEM TION FROM WORKERS'COM NSATION DECLARATION �j Clarifiers _ - Solar Collectors • - Dishwasher - Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). / Dishwasher Solar Piping Dryers ❑Gas, I]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 - Fan
Workers' Compensation Laws of California. .-- Motors 00-1 HP 011/2-8
Date Signature Floor Drains Swimming Pool w/Spa F.A.U.
NOTICE: •
If,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
comply with such -provisions or this permit. shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCY • Gas Service • Outlets Water Closet Device Boxes -
I hereby affirm that there is a construction lending agency for the performance Pole Liyht
•
of the work for which this permit is Issued (Section 3097 Clv. C.) Interceptors' Water Heater Outlets
Lender's Name _ Range
Lender's Address Kitchen Sink Water Service
OWNER BUILDER DECLARATION Switches Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash ... GarbageDisposal
following reason (Section 7031.5 Business and Professional Code: Any city or P 'Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - Generator ❑0.5 KW ❑515 KW Trash Compactor
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
-livision 3 of the Business and Professions Code) or that he/she is exempt -
erefrom and the basis for the alleged exemption. Any violation of Section
331.5 by any applicant for a permit subjects the applicant to a civil • _ —
penalty of not more than five hundred dollars($500). -
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee ' $ 3
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 0
sale. If, however, the building or improvement Is sold within one year of com- - Canopy Type II ❑ Zoning Approved By Date
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 Approved ByDate '` p/
0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Cl/1V\ Date l !1!n
tractors to construct the project (Section 7044, Business and Professions Code: -
The Contractors License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTU
builds or improves thereon,and who contracts for such projects with a con- SUMMARY OF FEES
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 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. ICBO# Fire Dampers PLUMBING $ S�0PERMIT
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 0100,000 BT •ELECTRICAL - $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repre-
sentatives of is city to enter u•on the above-mentioned prIoper for '
inspection p se �'V MECHANICAL $
Signature rP A j I n./JAG Al Date 1 1 YI f/, - TOTAL FEE $ ,..5-C.)O
-
Drivers' License or SS#
- -
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POO. 3PA
" 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 UF 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, 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 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 7-259-1(6 C-1FA
39. Water Service-Final
40. Gas Service-Final ..-
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System .-_t
45. Sound Attenuation
46. Handicap Regulations
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
-AUWNtK
DATE
GRAY, WM. J. 8-6-68
JOB ADDRESS 2786 Lorenzo Avenue BUILDING PERMIT NO. 28949
, JOB
CONTRACTOR Owner-Builder DESCRIPTION of WORK Pilasters Only - Fence
± O. 141-626-04 LOT 14. TRACT 4784 FIRE ZONE VALUE $200.00
:;X:
IYa,� *;�aCTIONS Signature Date GROUP ,T TYPE TTT ZONE R-1
SOIL PERMITS ISSUED
�cns SUBCONTRACTOR
Data Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE� OR POLE S.UNDERGROUND POWER 0 A" ' /-/?_eCt
ROUGH WIRING,./1 Li �. (p ' • - = Heating and Vent.
TRENCHES S4 FORMS • STEEL REINF. ® /920 9-n--ue
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
ST' -TURAL, FINAL Elect is ������
H. .G, VENT., REFRIG. AND A.C., FINAL /�otrei . �z--Su a574.-'
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL A' _?^,7-?CI
BUILDING, FINAocucure ^ (& eI
lir - .
28949AlSc —6-6 o0 347 *****3.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
r� ,( For Office Use Only
ADDRESSINL 71` LDREWZO 4✓o .
RECEIPT PjryUg4
COSTA MESA. CALIFORNIA 'LJLYJ!`LJJ4`9
..
R[en Er raj caw J,�9An/JBsue
OWNER WM . T. 62A y .1 L/ ✓ t�"
p BUILDING _77869 at
,�
ADDRESD//����27 p 6 �•OREIV za AYE` ADDRESS CX J V/ //////��/I �� l .L!/lJ
FIRE
CITY W:TA .A4 ESA TEL-SW-KA/
o S6- ZONE .4W-5 TYPE
1 GROUP 7/ [��/
I"C.H ITECT TEL APPROVED Y DATE O (p 0
NGINEER NO. f!%G`
ZONING
ADDRESS ZONE NO.OF USK OF NEW rp
,/'� J f7 I PLANS Z I BUILDING I': Vl e
CONTRACTOR (Oa/Atrite.rite---Inti /uF la f� l /� 1RST-PA L'
ADDRESS DESSCRIPTION SIO 1 4/ i Yd ci- 47 81
A.p.NO. 141 - /1026 - 04
CITY
NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
STATE TEL 30'TO SIDE&REAR P.L
LIC.NO. NO.
SIZE NO.OF SLOGS. VES
A
ALLOWED ((U.S.C.REQUIREMENT)
OF LOT I NOW ON LOT I'
YARDS APPROVED YARDS APPROVED
USE OF4]E-S./DEWCE MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. /C.
(FROM C/L STREETI
SETBACK LINE PROM FRONT 1 4,0(Zcitiz(.1 PT.
CENTER OF STREET REAR YARD
_ 1
SIDE YARD I LEFT I RIGHT R.SIDE �i� FT. * I! - FT.
DESCRIPTION OF WORK �/ L.SIDE !o /Pyr. FT.
_ ALTERATION ADDITION ^ REAR `1T• FT.
DISTANCE BHT. BET.MAIN&
REPAIR _MOWING DEMOLISH MAIN BLDQI. ACCESS.BLDGS.
BUILDING NO.OF VAR.* DATE
SIZE ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL I ROOF APPROVE a'1 W 1-� p O
COVERING COVERING BY `a,.L�6 y2_ DATE O ' �
USE OF BUILDING AND WORK TO BE PERFORMED B,
FE7vcE — p,L As7EQ.0 W
ONc 5)
SQ.PT.
e
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. F15
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. �}�
`/�\ ,/�/ ca
PERMIT FEE $ ,v(/
SIGNATURE OF .1.4J�h2\1 Y7A,. / + -A3 E
PERMITTfiF f TTT�^•• ///111///""'w1wwNFF/// '//��}�} .� �_ C
V a tic o, .. / = PLAN CHECK $
AUTHORIZED AGENT V $
AREMIWEBRISEIBBEramis TOTAL FEE
i 19472 � r' :.Q:. _: t :.
.. STA MESA BUILDING-SAFETY DEPARTMENT \f MAY 2 2 1963
P.O.BOX 317 COSTA MESA,CALIFORNIA •
•
FINANCE DEPT.
PITY nF POSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING 2786 Lorenzo Avenue
ADDRESS RECEIPT NO. 1 �7Ft3�(SrtN3
COSTA MESA. CALIFORNIA � /�
RECEI BY DA (1[CBI17Do ,.yT(IBJUF 63
OWNER Macco Realty Company Kfi, ��``OO�A// RY1� L tl tyPl
MAIL Highway BUILDING
MAIL ADDRESSFIRE 3800 E. Coast Hi hwa ADDRESS . /
E ZONE TYPE v GROUP �V(y_!ly/
CITY Corona del Mar, CaligroL.OR 34220
APPROVED
AR FHITECT Macco Realty Co. N LOR 34220 BY ' DATE
OZONING
ADL—SS same as above
"' '
v ti,,, ,'
,•( -
ZON[ 1IPNO.rvOs � IBUUIELOP N[VTM$CCO Realty Co. Pm% L. • i
CONTRACTOR
LDES
ADDRESS same as above DESCRIPTION Lot 4 - Tract 4784
A.P.NO.
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LICC..NO.207343-A-SEs W. OR 34220 sr TO SIDE a REAR P.L.
EAVES
SIZE 65' x 94' I NO.OF BLOCS.non- ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF Unit MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM ICI/L�'STREET)
CENTERSETBACK LNE FROM 1 REAR YARD 44t FRONT 4 r' FT. FT.
OF STREET / •
SIDE YARD I LEFT 51611 I RIGHT 51511 R.SIDE S PT. 6 , FT.
DESCRIPTION OF WORK L.SIDE )S FT . Fr.
NE' K ALTERATION ADDITION REAR 7"1- FT. FT.
DISTANCE BET. BET.MAIN e
REPAIR MOVING DEMOLISH MAIN BLOBS. ACCESS.BLOCS.
VAR.# DATE
BUILDINGNO.OF
8 ZE 4'x4 1611 ROOMS 7O1CSTT.RIES C.U.P.# APPROVED
EXTERIOR WALL -II ROOF d9co- Z`)' APPROV-LN
COVERING Steen( COVERINGQQLL,,i�n��� ay tI VLV) DATE S "O-l)-- 63
USE OF BUILDING AND WORK TO BE PERIINPM,le 100
Single Fam.Res. W/Att Garage
PLAN NO. 500-D
Dwelling-2266 S.F. Gar-460 S.F. N
SQ.FT. B
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. G
PLY WITH ALL CITY ORDINANCES AND STAT[ LAWS REGULATINGI
VALUATION �
m
BUILDING CONSTRUCTION. N
SIGNATURE OF MACCO REALTY Co. PERMIT FEE $ 7D
PERMITTEE B
$ 23,925.00 PLAN CHECK $ 3:70
SC' al
AUTHORIZED AGENT Ey /,�� TOTAL FEE $ //2'50 a