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Home My WebLink About240 15TH ST - Building Permits • 44:49 CITY OF COSTA MESA 0 % ` CALIFORNIA 92628-1200 P.O.BOX 1200 J'„ ' B' DEVELOPMENT SERVICES DEPARTMENT March 16, 1987 To: • Building Safety Division Pacific Bell (2) Business License Division Police Department - Ping. & Research Camnunications Santa Ana Heights Water Canpany County Administration Office Sanitary District Engineer County Clerk/Board of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Finance, Revenue Division United States Post Office, Adams Avenue Fire Prevention United States Pcst Office, Santa Ana Manager, MID Zip 4 - Santa Ana Mesa Consolidated Water District File (2) Newport-Mesa Unified School District (2) The City of Ccsta Mesa wishes to advise you that in revising street addresses, the following addresses have been changed: OLD ADDRESS NEW ADDRESS A.P. NO. 240 E. 15th Street 240 A E. 15th Street 425-331-09 240-1/2 E. 15th Street 240 B E. 15th Street For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. Your cooperation in this matter is appreciated. Sincerely,� i>' lam/7a /a &r_ WILLIAM MILLER Planning Intern WM:alp (F-1) cc: Barry T. Faher 16 Pinehurst Lane Newport Beach, CA 92660 Code Enforcement/Business License (714) 754-5234 . Building Division (714) 754-5626 Planning Division (714) 754-5245 77 FAIR DRIVE PP', / (4IJ f 1 Applicant to fill in all spaces�'wr thin heavy border lines and sign all appropriate declarations. CITt'Ort:O$TA MESA CO NSTR UCTJ,ON PERMIT .B PERMIT� NO. 78gbly$E,r LOT NO. UNI 0.. e Prot AMress S' .�• t, V-'2.7,Sa3 rrf-kr:-H'f5 POi 13 31 61. - - n:4.A. U TYPE OF CONSTRUCTION NEW L I ADD L I ALTERATION U REPAIR • 1 npplicane•s Mailing Address /4 JNFHOL'9/ It,Vfll' 7� / ❑ CONVERSION ❑ DEMOLISH ❑ OTHE 2 1 •'.l 1 . Owner's Name • A , ..F1/•�iL Phohe7 OOS1Sf ,} • A.P.# a.S 3 ( O I Zone L? �° DESCRIPTION OF WORK/USE OF BLDG. tr+-c✓ '�" /4'A •/ , Address 0/� I / ' Z 6a„(/ o� S Main Building: Accessory Building: Arch/Eng. 1 v - 1 'IIi'' A )� Lice s- No C-329 TYPE OF PERMIF+ GI7ADING�rYI�, OUNDATION STRUCTURAL T Front 2Gj,.�///-/0 Cl (�(I� ZO • Address 1 4 / /✓/ • 1/ • sem✓/ J ❑ TENANT `ELECTRICAL L7 PLUMBING MECHANICAL B Rear (;' / ! II N Contractor's Name 0 A Phone7fl-0053 ❑ OTHER Av�I Car 4475 A / PROJECT DESCRIPTION SO. FT. 3 V OCCUPANCY �- C Right (8 / N G Address(mailing) • CON ST RUCTION TYPE VALUATION$_�F� DO S- S Left _ 6• R City License No. •ZONE GRADING CU.YDS. . ACRES p/" LICENSED CONTRACTOR DECLARATION' - Ping. Ref.# bp-M-5(U-S( Parking Req,/Provided 4 /4 E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: //> -.y.{�. �{ //�//,.,• C /� �'' PlanningNotes; �-s 1 '1 1. O with section 7000) of Division 3 of the Business and Professions Code, and / c •� `. /'s•i ` $`i A_ i35 ��p 1C(�-•Q+ •_}c/S-ry f\' C,�q i I n s'9 t M my license is in full force and effect- T License Class License No. _ • Ciov-0. -auz r 2 54,1/-4 2_ �d-^ S Date Signature - PLUMBING ' FEES rCS ictsi&c2 eL••..LLtlet.4a& CIAL REOU11ttMtn_L>_ 'ORKERS'COMPENSATION DECLARATION Bar Sink Showers' • iereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section % Backflow Preventer Service Sink 3800, Lab. C,) Automatic Washer Transformer 0 1530 KW • Policy No. Company I Backflow Irrigation +KW 9 Sewer Cap .n 0 50 8 Certified copy is hereby furnished. p2 Da Construction Pole Sub. ( Certified copy is filed with the city Building Division. Z Bathtubs / Sewer Connection ( • CC / Cooking Unit Meter ❑up to 100 amps Date Applicant ( 00 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - • Clarifiers Solar Collectors / Dishwasher Meter Cover 100 amps do (This section need not be completed if the permit is for one hundred ($100) or f/ less). . ,/ Dishwasher Solar Piping 2_ OC / Dryers DGas kl Electric Sub Panel I certify that in the performance of the work for which this per t• 'ssued I shall not employ any person in any mann- so as to b•c•. -p ct to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑i%'8 Workers' C m ion Laws of Californi�� / _ Date �y9 Signature .�.I//u ► . ._ t Floor Drains SwimmingPool w/Spa 'jr P F.A.U. Inc Solar❑9-15 HP 016-15+ NOTICE: If, fter making this declaration,you s come subject to t • Workers' Compensation provisions of the Labor Cade, you must forthwith Floor Sinks Urinal comply with such provisions Or this permit shall be deemed revoked. — 4/11 Fixtures • Microwave 3 8C CONSTRUCTION LENDING AGENCY (if Gas Service a Outlets ' f 3 Water'Closet oo� Device Bo%es • - / U/] I hereby affirm that there is a conftruction lending agency for the performance Pole Light -/V of the work for which this permit is issued (Section 3097 Civ. C.) •Interceptors . Water Heater Outlets Lender's Name - - �' Range • s4- ftp ,. Lender's Address - - - / Kitchen Sink Water Service •� OO'/'I Switches Sign ter- T V OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the , Lavatories Auto-Wash o� Garbagep - . following reason (Section 7031.5 Business and Professional Code: Any city or • G Dis osal $tending Sections OG county which requires a permit to construct,alter,improve,demolish or repair - P-Trap Laundry"Tra s any structure, prior to its issuance, also requires the applicant for such permit 7 y y LOC Generator 00.5 KW 05-15-KW Trash Compactor t• o file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains / • le• Contractor's License Law(Chapter 9 (commencing with Section'7000)of - .. - ivision 3 of the Business and Professions Code) or that he/she is exempt v - ' -nerefrom 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 • - alty of not more than five hundred dollars($500). I as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee • $ 3 o pensation, will do the work,and the Structure is not intended or offered 1 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL • FEES Reinspection Fee I $15 Issue Fee $ 3 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 'r• REMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 3 2- �- sale. If, however, the building or improvement is sold within one year of com- Canopy Type 11 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 Approved By Date -- /� • prove for the purpose of sale). . Building I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By .- --1��/��a..� Dat, ' s 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 00100,000 BTU 0100,000 BTU . SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with acon- 7 `L tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust S stem 0 Multiple 0 System Repair/Alteration 'j BUILDING PERMIT $ 3b�q/ •aso/ SMTP $ 5.1 proof of their Worker's Compensation insurance should be provided to me. .yCl.� PLAN $ f�[�I P PERMIT ❑ lam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers (X PLACHECK $ S • c' ISSUANCE $ ING Date ownerHeating System& Ducting Registers I 14 40 PLAN CHECK 25% 7 ENERGY P.C. $ I hereby certify that I have read this application and state that the above / X0-100,000 BTU ❑100,000BTL /� ,.✓ GRADING $ information is correct. I agree to comply with all city and county ordinances Y w ELECTRICAL f and state laws relating to building construction,and hereby authorize repre- sentatives of this city to ent f u op e above-mentioned propert for inspection pungens. MECHANICAL $ ft- TOTAL FEE $ _ r i ob Signature /p/,✓r•�•�59�s•"�''�}��j /tL` � 2.-0.0 �e�l 7 - CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant: Pink -Accounting; Goldenrod - Assessor - c/JNSTRUCTION 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. if-2.4 7 (i. 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. *bin GA/ 57. APPROVAL TO COVER-GUNITE / 7. Footings 5 411-21vV` 6P) 58. Electrical Conduit-Undrgrnd. 8. Foundation . A/6t.359. Gas Pipe, 0 Undrgrnd., Test 9. Water-Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System Vs 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection f44(•C7/GQ, ` 62. Backwash & Receptor-Final 12. Sewer Cap 2W1- 62. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 0147 CIA 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring Sli411f7.a 11 67. Fencfg,& 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 sit zi #icC.!' ' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing S. /C�� 6 !✓/ 76. Dry Standpipe 28. Lathing& Siding Wu i7 ar 77. FIXED SYSTEM FINAL 29. Insulation S ;411yr/ 78. FIRE PREV. FINAL 30. Drywall Nailing 6)1,jtl (r(✓ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat G/,o% Go"1 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: •ioLD FOR SPECIAL RCOUIRE`AcPT5 7.. -0•-e $f 34. Final Heating & Air Conditioning y-2•g.f87 ? > Iv res S•aid`0e V G !'aV/cc 3f7•Y� 6' 35. Final-Gas Pipe-Test • J1\ r*su/,$w .s.r;A eSh -. AR Pens;40/1201 36. Hood or Canopy eiftSfr7 efria,_// i hear u� 37. Final Factory Fireplace ig __ 4,4,4 �[�(!D-� ,a4 7 38. Final Plumbing _ -f� n'3 y/2 1//Fi t /�vxwrC ` O r'Z r L -/ s z 39. Water Service-Final c%/L/p,,� (J•e.t e erAtifrfes' D/Or/fP 40. Gas Service-Final /x/r G 29eijni. .4S7 ,z,��r�u,�/ 41. Solar Domestic-Final -7'21 -17 Ai ECD .5061,St* DRAW VR, FdA� N'cAT 'FA . 42. Backflow Preventer 49-347 raided F;F- WDA 4 .Aio1 7•444014G4"- ' 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ?Mir / 1-1 48. Special Requirements Completed B7S(g7 /1/4 44 / 49. Electric Release to Edison , 7 r 50. Gas Release to Southern California Gas Co ' / I 51.. CERTIFICATE OF OCCUPANCY •7 Lf , 1, No. Date • • ,\ ) s . A I , CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT I Developer/Applicant : €ALX'% / I tAheiQ ` /6 f/N6miesT /Sr�e �Ew riq Ga �'2G/oo Address : EAcd Telephone Number : (,/,> 7S -C72-iD Tract/Parcel and Lot Number(s) : /409eb2S ^ 33/-1C)�' Location of Project : _7$b 8. E. /6t4 G',.r,r 1 ��da•. Number of Square Feet of .y0 x $1 . 50 Uy Residential Space /`�! Total °37-7 -- Number of Square Feet of Commercial and Industrial Space x $0 . 25 Total The provisions of Government Code Section 53080 are not applicable . This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be made payable to Newpo t-Mesa Unified School District . / ndC, ! V A-10 Business Manager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/Applicant agrees that if it is later determined that such representations are not true then this certificate shall automatically terminate and the appropriate City/County shall be notified . ,,� ir ti- Date : 444g. ..2,/987 Devel:Ter • • pWican ' N. 3163 3/02/87 881 .51 TL • CITY OF COSTA MESA PARK FEES • Fee Payment Receipt 001071 Project Address 2'7 b E - A.P.Number q26-- — 33/ - 0 9 Building Permit Number Owner's Name BA(SRy —r• PAe& Mailing Address 1(0 PJNE,-f ()RS7" LANE IJCLo POIe-r act, • 126424) FEE: Single Family * Number of Units 2-Bedrooms or Less @ $ 861.76 = 3-Bedrooms @ 1,205.67 = 4-Bedrooms @ 1,545.62 = 5-Bedrooms+ @ 1,810.50 = Multiple Family " Bachelor or Studio @ 474.37 = 1-Bedroom @ 573.18 = 2-Bedroom ' @ 881.51 = b&tsi 3-Bedrooms+ @ 1,229.38 = Total Fee * vQ�_ // •S Planning Department Approye5Date 2 g 7 A • Applicant's Signature tter • * City Ordinance 72-44 •• City Ordlnanc 72-45 City Resolution 78-116 1p; pn n � (yr CMF 0174-30,rev.7/85 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant UUU!I;,J1 i BARRY T. FABER 16 PINEHURST LANE NEWPORT BEACH, CALIFORNIA 9266❑ July 29, 1987 City of Costa Mesa Building Department 77 Fair Drive P.O. Box 1200 Costa Mesa California 92626 Re Certification of Drainage 240 B. 15th St. Permit No. G-27523 Design Review No. 86-51 Gentlemen: This letter will serve as certification that the above described property was graded and constructed to the best of my ability in accordance with sheet #6 of submitted and approved plans. In my opinion, the water drainage from my property will not flow on to any adjacent private property. If you have any questions, please contact me. Very truly yours, Barry T. Faber City of Costa Mesa INSULATION CERTIFICATION , Building Safety Division 240 E. 15th St. Costa Mesa Orange Number and Street City County Newport Heights Por. 13 Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF NA Material Brand Name Thickness (inches) Thermal Resistance (R Value) -EXTERIOR WALL Q Material {,/A-I Brand Name Manville Thickness (inches) 3 Thermal Resistance IR Value) 11 CEILING Ban or Blanket Type Batt Brand Name Manville Thickness (inches) _ 11 Thermal Resistance (R Value) 30 Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft?) Thermal Resistance (R Value) w'FLOOR, ELEVATED Material .. Brand Name Manville Thickness (inches) 6 Thermal Resistance (R Value) 19 FLOOR,SLAB Material - Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material - Brand Name Thickness (inches) _. . Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). Builder/Owner General ��9tactor(Builder) License umber / S-r r Owner 749 4 / V Signature and Title r Date Sub Contractor(Insulation Applicator) License Number Signature and Title Date CMF 1106-46 /[3 5 2 7S?- 7 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. I �� /O^/87 `' OCems C PER NI}Z NQ 13527 TRACT NO. LOT NO. UNIT NO. •--. . COSTA MESA'LCON�ST�R/t,CTIOyN PERMIT �� ` a `/ 2 ' 9 U5 it ° Project Address A 7 � �/�//•.� S/. � ) �•�— _ 7LJ Applicant's Mailing Address x-r��/A/Av.- 5'T ,44w en • TYPE OF CONSTRUCTIO NEW ADD U ALTERATION U REPAIR ?. ❑ CONVERSION DEMOLISH ❑ OTHER A.P.# —Z 1 Owner's Name = /a a /. FA-QCP n:7' —ea9V . _ - •gas-I..... / — U 9 ( Zone R � DESCR I PT ION OF WORK/USIOF BLDG. -- e�'� dr Address i-" - t S _ 0 N a f,.` G o �,�jl�^Q a S Main Building: 1 Accessory Building: • Arch/Eng. License No. TYPE"OIF PERMIT) 1LJ1 GRADING FOUNDAT %N ❑ STRUCTURAL • E Front .16 f •7p •t� 0 Address CI❑ TENANT ❑ ELECTRICAL El PLUMBING El MECHANICAL BA Rear �Ct144J N OTHER Contractor's Name 0/8 Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right ,4 - N Address(mailing) - K ' _ ` G CONSTRUCTION TYPE VALUATION$ 1000 .$ Left s City License No. ZONE GRADING CU.YDS. ACRESI R LICENSED CONTRACTOR DECLARATION Ping. Ref.# l Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: e P : it /-tn/� �(yc,� A.-„,,46.-a75---23 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and C '�L/ T`J��1` To T my license is in Tull force and effect. • $ License Class License No. -. Date Signature PLUMBING FEES _ WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate xf Workers' Compensation Insurance, or a certified copy'thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap J O Construction Pole Sub. ❑ 50+ KW 8 Certified copy is hereby furnished. 1 Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date - Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION 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 OGas DElectric -: Sub Panel I certify that in the performance of the work for which this permit is issued, I ill shall,not emp{oy ny person in any manner so as to b•c•m• subject to the Drinking-Fountains • Solar Tank • Fan Motors 0 HP ❑1%.8 Workers' Cpp�en at jqn Laws of Califor IF.Date 'y4 Signature --�! '/d _ ' Floor Drains Swimming Pool w/Spa F.A.U. • - NOTICE: If, f e king this declarat on,you - ou - become•subject to - e - Inc, ar 09-15 HP 016-15+ • Workers' Compensation provisions of the La•a r Code, you must forthwith Floor Sinks Urinal Fixtures ' comgly with such provisions or this permit shall be deemed revoked. - icrowave 'I CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet , I hereby affirm that there is a construction lending agency for the performance Device BOX¢s POIe Light of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name - Interceptors Water Heater Outlets Range 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 Dispo following reason (Section 7031.5 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 Generato 0-5 KW ❑5 15 KW • any structure, prior to its issuance, also requires the applicant for such permit 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 e alty of not more than five hundred dollars ($500). Q�.(IJ�I, as owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee $ 3 doTn pensalion, will do the work,and the structure is not intended or offered Reinspection Fee $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 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 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duc[-Under Ground Building Approved B -_ i Date Urove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Sys Application Issued By � r��_.i� - Dat: a S 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 TU 0100,000 BTU - SUMMARY OF FE builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ stem Repair/Alteration BUILDING PERMIT $ / 7, -SO SMIP $ . proof of their Worker's Compensation insurance should be provided to me. -- No?"�P{-qN CHECK 5 PERMIT 0 I am exempt under Section B.& P.C.for this reason- Firepl/Fact Blt.ICBG# Fire Dampers • PLUMBING $ a . oo ISSUANCE $ Date /1'//7/5( Owner • Heating System& Du g Registers • PLAN CHECK 25% $ - ENERGY P.C: $ I hereby certify that I have read this application and state that the above 00-100,000 BT 100,000 BT GRADING $- information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building con uction, and hereby authorize repre- PLAN CHECK 5096 $ MICROFILM S sentatives of this city to en . -to t•. above-mentioned pro•ert for inspection puree-s. r� Signature Imo'/'� r r0../�' _ Date .!(- I • MECHANICAL .$ • TOTAL FEE $ p-) ` Q Drivers' License or �� Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 111 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 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, 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 • . • V/ 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;S&'STEMS 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 t'.Il. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED j ..- 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. FI NAL STRUCTURE & BUILDING istibi V, - 48'. Special Requirements Completed vv tr 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date - - • Y . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CO STRUCTION gMITaj tr- PERMIT NO. TRACT LOT NO. UNIT NO. _ret 7/ `re 29t /s sr CO/ v � a 9 so a �,� grojpcPAddress 7 (,'q Applicant's Mailin ddress 4( ,%si✓E74. 'n t I Q 172d6a TYPE OF CONSTRUCTION NEW ADD ALTERATION LI REPAIR L/ �lP2 F4g6.--r2 PhoneZ5�.�a4C) ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 9,-5--- 33 / d r5 Zone —L Owner's NameDESCRIPTION OF WORK/USE OF BLDG. Address /� /Ne may ,S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT O-y ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front ZO Address p ❑ TENANT IJ ELECTRICAL ❑Eng. OTHERLice ❑ MELI cr CHANICAL ANICAL gA Rear N Contractor's Name D7jL-1 1 Phone 7-591-47247° / y �A� C Right N Address(mailing) PROJECT DESCRIPTION SQ. FT. 37 A / OCCUPANCY R +N 2 K _ CONSTRUCTION TYPE VALUATION$ S Left R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION ping, Ref. # Parking Req./Provided E �7E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /` — .27.3-2. .7.4___ Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and tttYYYT my license is in full force and effect. License Class License No. S Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers 'ereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES Workers' Compensation Insurance, or a certified Copy thereof (Section Backflow Preventer , Service Sink .d00, Lab. C.) - _ Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap0 50+ KW 8 Certified copy Construction Pole Sub. is hereby furnished. ^ /�1 Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit r Meter Duo to 100 amps ///r/1�1 Date Applicant �(I EXEMPTION FROM WORKERS'COMPENSATION DECLARATION 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 DElectric Sub Panel 1 certify that in the performance of the work for which this permit Is Issued, I shall not employ ny person in any manner so as to cp me subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1''s-8 Workers' C t' Laws of California. /, - _ Date 7l r Signature i� X Floor Drains Swimming Pool w/Spa — F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ NOTICE:Compensation r moon rov ideclaration,s you s o Id , you subject forthwith te - - c orplys' ith su h pr provisions of she Labrmitr Cade, eou et rekd. Floor Sinks - Urinal - Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes 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. C.) Interceptors, Water Heater Outlets Lender's Name Range 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 c. 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 , Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its Issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof.Draihs the Contractor's License Law (Chapter 9(commencing with Section 7000) of .. . `'vision 3 of the Business and Professions Code) or that he/she is exempt, `i3�&� refrom and the basis for the alleged exemption. Any violation of Section' : ..lmmm,�•`��,`"'''31.5 by any applicant for a permit subjects the applicant to a civil "ypr,alty of not more than five hundred dollars ($500)./R�'l�I, as owner of the property . • Reinspection Fee I $15 Issue Fee $ 3 ueeperrsettoa,will do the work,and the structure Is not intended or offered - Reinspection Fee $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 D 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 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 ❑0.100,000 BTU ❑100,000 BTU SUMMARY 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 ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should provided to me. P PLAN CHECK $ PERMIT 0 I am exe pt un r Section B.& .C for this reason Firepl/Fact.Bit. ICBO# Fire Dampers ISSUANCE $ PLUMBING $ Date ' � Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certif that I have read t is apwlicati d state that the above ❑O-100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to co ply with a city and county ordinances ELECTRICAL $ and state laws relating to building o (ruction, and hereby authorize repre- sentatives of this city to enter p the above-mentioned pr erty for PLAN CHECK 50% $ inspection pure��p� , / .�/9P MECHANICAL $ TOTAL FEE $ !.0•0O Signature P�7 / CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant: Pink - Accounting; Goldenrod - Assessor 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 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, ❑ 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 ❑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 FOOD CERTIFICATE ISSUED - • 33. Final Electric ,.gcx.eV c ' 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 48. Special Requirements Completed 49. Electric Release to Edison _ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . • No. Date PrCosta Mesa Building Department iv?"' (IMPLICATION FOR PERMIT , 0. Box 3!7 .�7. ,. `'J/ COST. .ESA, CALIFORNIA BUILDING ', / P vR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. BAddress O E" / . I 13 6 G / Address /Costa Mesa, California Received by �jDate Redd. pDate Issued Nearest (.� 7,2,2 /JLC / �/� 'S C / �/3-.� Cross es fet„ f ryt S Y\ Building Address - _. Owner M w p3/4'I '/�g y .1.., a /ol5 Costa Mesa, California Mall / Address a V O F Is Nearest Tel. I. Cross St. City COI/J�,. Me- S Q. 4 No.. t --ta 9 Zones No.of Type , / Group Architect or Lie. I", I Plans I l/ Engineer (SoctiC u t ,h �, No. Approved p/`{('�7''�' yp��•7 _e Address d 3 k . U el-1A C• 'a )— 6 APi 11�V �11 S Ie rr�� City Lic. Contractor CJ C.1.7M 0.-Y No. Address S it- -it 4-,4_ 4 er, a`... ./ CITY OF COSTA MESA Legal Lot Ls-, �y%��,/tp/4- . YI.ANIci t'ri Description I No. !� I Block I Tract -- -- - - ' ' - (Attach Metes and Bounds) //-j.-I/ — a O /. _ . // Bgs /ate : Size of Lot log/,7%a� NN I Now of on ldLot PI AN T:CH./ 0 E Existing Bldg.QN'ELL/NG.S I Families I Rooms S Setback Line from Rear Yard K 2 Center of Street Side Yard t/ y DESC ON OF WORK / r • New I I Alteration I I Addition I XII Repair I. /I. I Moving I I Demolish I Building No.of i-• Ty W Size Rooms /fir Stories Exterior Wall * . I Roof Covering 66 0 Covering APPROVALS I Use of New E yt 0o Building p /,fit(- I Y 0 2�•.-p0 J.– � Foundation Location Forms,Materials, Inspector Date 1 , asll-e..4-9 a- XII it.',. y Under-Pinning Frame: Fire Stops, 1-' Bracing,Bolts I hereby acknowledge that I have read this Application O and state that the above is correct and agree to comply Lath. Int. - Alwith all City Ordinances and State Laws regulating Al building construction. Lath.Ext Signature of �� ,t Permittee ah Plaster, Int Authorized Agt 111 tl Plaster,Ext. 0 -4 Valuation Permit Fee $ /re 6 0 Masonry Reinforced O• o6 Plan Check$ Bond Beam /0 O Total C $ O at Fee $ �� FINAL FORM 204 10.55 O.P.8 5. Cer +e1- e f fre4+- /S 57' e C o JC , ' - \ d. U '1 o a a L • a •1 i1 \ hr 37i 111 / I \ 1 . \ ,J , \ \1 , •'h y hoostt F, t — .1/4,\I • ,\ , L - 1. • . 1 •1 1 . a1J/ /& / tY . �c b • . . . _ Street /4 //O/ PLOT PLAN Show location and distances from LC. property line and between buildings. u ` W - 1 .l t c 1 ' 1 , y %q\ O O f `ft `.. ,- . k • o , •r • D- r_ � 1 OWNER REYNOLDS, MARY '5 JAN 11 1957 DATE 9-13-56 JOB ADDRESS 2110 E. 15Th Street BUILDING PERMIT NO. #3699 GENERAL CONTRACTOR Owner Bldr. VALUE $ 100.00 AP117-1111—Ob LOT 13 BLOCK TRACT Npt. HejS. Repair e . carpoLX. carport GROUP J TYPE V ZONE Hit FIRE DISTRICT 3732 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench Foundation Forms and Grade to Garage Rough Framing Pllumbbing,,Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough t►/r Heating, Rough I ji��l► Heating, Final F�uJ7 Sewer, House Sewer,St. Septic Tank or Cesspool Lathing, In Out Plastering _ Plumbing,Final,Fixtures Complete _ Plumbing, Final Gas Test Wiring,Final �/ _ Occupancy /.Ll� FORM 210 3M 10.95 3699 9 ! 6Ro FEE RECEIVED COSTA MESA BUILI,ING-SAFETY DEPARTMENT pfg 2 4 1964 P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING For -Office Use Only ADDRESS 240 EAST 15TH ST RECEIPT NO. I7T . . COSTA MESA. CALIFORNIA _ (/p Q RECEII ��IJ T ECE D DATE ISSUED I.lAf1Y REYNOLDS D�. /r`� �� OWNER '."SS„��// MAIL IC BUILDI 6 �S ADDRESSE b FIRE 2222 MA I N JT ADDRESS (/ 99 CITY HUNT I NGTON BEACH NO TEL 3777 ZONE TYPe GROUP ./ ��// -�-�- APPROVED �/1Z/9 ARCHITECT TEL. BY DATE l OR ENGINEER --, NO. $ NING ADDRESS d - ZON{ NO.Op USE OF NEWS-- &ALI- SELF /{/ pu NO Su IL- 2 CONTRACTOR • t^/A^ cL/I 'G DING {� I �- ADDRESS ` - DESCRIflION.�/” i /'•%5-�//I / L' Yl/FL( 1, A.P.NO. 1/ 7 -- Ic I`� I� -/ CITY NOTE: NOEAVE OVERHANG SHALL BE LESS THAN STATE TEL. 30'TO SIDE @ REAR P.L. LIC.NO. NO. 60 x 127 EAVES SIZENo.of SLOGS. ALLOWED (U.B.C.REOUIREMENTI OF LOT 2 NOW ON LOT 2 YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. RESIDENT I AL (FROM C/LSTREETI SETBACK LINE FROM ,/� CENTER of STREET 2 J n I REAR YARD File FRONT C I�FT./};-. •i ..., FT. SIDE YARD I LEFT 12 I RIGHT it I R.SIDE 2 TFT. /-]...' FT. DESCRIPTIONOF WORK L.SIDE /i FT.GFT. NEW _ ALTERATION _ ADDITION EX REAR (Ltiyr. b._-- I FT. • ' DISTANCE BET. BET.MAIN @ MAIN SLOGS. ACCESS.BLOCS. REPAIR MOVING DEMOLISH VAR.# DATE BUISIZE % .L, /ROOMS STORIES C.U.P.# JJ APPROVED EXTERIOR WALL �- VEJ BPROVE� � DATE --.2. ii �/ 4COVERINGCORING Y USE OF BUILDING AN WORK TO BE P RFORM Ad d)--+,n a Ag.y-W° do. 6 Xah -to eki it/en9 �, ' nn//J ] _lista, L% A lam'- /S PT X a�O�fh)yeL/7 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS • -' AND STATE THAT THE ABOVE IS CORRECT AND ACRE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. • F G PLY WITH ALL CITY ORDINANCES AND STATE LAWS RE LATINO VALUA ION m BUILDING CONSTRU�TION. All N SIGNATURE OF 1`^^ -Vf PERMIT FEE $ /C'. � j� PERMITTEE ' ,1Oki A G II ficad A -e) 0 AUTHORIZED AGENT 41 _/ u i \ TOTAL FEE / ed 1 OWNER REYNOLDS, MARY DATE 2/24/64 JOB ADDRESS 240 E. 15th St. BUILDING PERMIT NO. 21660 GENERAL CONTRACTOR Owner-Builder VALUE $ 4,500.00 AP No.117-141-B LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORicAddBath&Bd.Rm.tc y INSPECTIONS Signature DATE GROUP I TYPE V ZONE R2 Res. Soil I-+-Cs y-2✓-', SUBCONTRACTOR PERMITS ISSUED Gas /J 41C-23-69 -69 DATE NUMBER Water �P� -III Rough Corn. Refrig. 0 Air Cond. 0 _ _ Rough Heating _ 1J/ L. _ _ Rough Plumbing 4 `r -6/7 -� � t 1_sir ([] bI!/ Miscellaneous J / Prop.'Swr. Line 0 House Con. 0 St. Swr. 0 _ �qW einlil�-t�(-=i j W iNtifirYE`S ve nEN F -c_.,°4 ^ q'�"4 Al Construction Pole • _ _ _ L Underground 0 Power 0 / , . P A .' irre�iirZW' em.- _ Rough Wiring '/Y �t r.� la A . - • , P5 . 1 s- ram - Trenches El Forms El Steel Reinf. ❑ Air �/�/ - J j • i _ -I-4 _ 1 FloorSystem _ _ � t Bondond Beam 0 Steel Reinforce ❑ (!1A- 7 Sheathing - ry�� A 7 - `-• I6ti Frame and Flashing , orn a _> 3, S� lk e /S I Lathing- In Out- .N!$ eft -6 � � ' Plaster, brown coat -- r Refrig. 0 Air Con. ❑ Final _ Heating, Final ; _ �fy!/ Plumbing Fixtures, Final - - w" zt.404 Final Gas Test i• g j Electric Fixtures, Final,.yfw(,u+,QK__a vL`I- r — 'I3 'Gif Buildin: Final / ,00 m- - OCCUPANCY Form BU4-5M-3-63—S-B P 21660 -1877STA FEERECErQgIVED /COMESA BUILDING-SAFETY DEPARTMENT F MANCE d . P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATI FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDADDR EINGSS q%10I r i , J J RECEIPT NO. /G/..F/(8� !7 COSTA MESA. CALIFORNIA �C RECK visit/ rzri�6�9 �� w Maul(' OWNER A 31 eY.1) / NS BUILD /'IVY kr./� /y/ ADDRESS y_aya IV,... A /MAIL ZONE ADDR �(J , {: 1 4 5/ FIRE CITY /i U"I / 111 Q/ I//l t/,1 NO.TEL.Y{{��jU��APPROVED TYPE-J. P GROUPq/• ARCHITECT J __ TEL. / BY DATE (Jp/�1 OR ENGINEER N j .T ( INC ' to rid / ADDRESS p-6 A7 /�/ /I ` / 20N PLANS NO. USE OF NEW �` ` ' N . ) �` 1,/ BUILDING I CONTRACTOR �L .w\ \CJ7U( 1 �� , LEGAL 0 /pT, O �/�/ ADDRESS DESCRIPTION J o k / r i a '/^��l g CITY A.P.NO. // / � • L./ D (1 NOTE: NO EAVE OVERHANG[[[ SHALL BE LESS THAN STATE TEL- 90'TO SIDE a REAR P.L. LIC.NO. -------------NO. EAVES SIZE / 1--(1 I NO.OF 51.005. ALLOWED (U.B.C.REQUIREMENT) OF LOT IU.. C NOW ON LOT USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG, MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) Q SETBACK LINE PROM FRONT CENTER OF STREET REAR YARD SIDE YARD I LEFT I RIGHT R.SIDE DESCRIPTION OF WORK L.SIDE FT. PT. NEW ALTERATION ADDITION REAR FT./ FT. V DISTANCE BET. BET.MAIN REPAIR /\ MOVING DEMOLISH MAIN SLOGS. ACCESS.CLOGS. BUILDING NO.OF VAR.S/ DATE SIZE ROOMS STORIES C.U.P.# / APPROVED EXTERIOR WALL ROOF APPROVED //I '/{ I� COVERING I COVERING BY V / DATA/ham USE OF BUILDING AND WORK TO BE PERFORMED, • , " • Q} -- d Lie a ' e x/ r i-/-k; y c AA_ /G6 / QR C cM SQ.FT. I HEREBY ACKNOWLEDGE AT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE a' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O D O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALU ION R BUILDING CONSTRUCTION. N SIGNATURE OF / „✓ / %? f / f�2 NI PERMIT FEE 53 3 PERMITTER ¢LA.$3Oa • O 4 AUTHORIZED AGENT 3TOTAL FEE $ OWNER REYNOLDS, Mary DATE 8-25-64 JOB ADDRESS 24o- E. 15th St. BUILDING PERMIT NO. 22877 GENERAL CONTRACTOR Owner-Bldr. VALUE $ 300.00 AP No. 117-141-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Int.Alter. ZINSPECTIONS Signature DATE GROUP I TYPE V ZONE R-2 Soil SUBCONTRACTOR PERMITS ISSUED , Gas DATE NUMBEI Water Rough Com. Refrig. ❑ Air Cond. 0 Rough Heatin: Rough Plumbing Miscellaneous Prop. Swr. Line 0 House Con. 0 St. Swr. ❑ Sprinkling System Construction Pole Underground fl Power .0 Rough Wiring (/t' ft P-z 6-G q ,��iliyL/ l eed-/ir cA/ S4-it-A1 23/ c Trenches 0 Forms 0 Steel Reinf. 0 J/ Floor System Bond Beam ❑ Steel Reinforce 0 Sheathing /� ` Frame and Flashing a.. g/ i !L/Cen 54 Lathing — In.❑ Out 0 Plaster, brown coat Refrig. ❑ Air Con. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final �� _ //- Building, Final 9JyJ m- 44/651 OCCUPANCY Form BU4—SM-3-g3—S-g p ?2877