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HomeMy WebLinkAbout221 23RD ST - Building Permits CITY OF COSTA MESA _ t 4c 9 BUILDING DIVISION j F ,i DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER PERMIT B02-01436 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 221 23RD ST Status: ISSUED Suite: Applied: 09/09/2002 Vicinity: ROOF Issued: 09/09/2002 Parcel Number: 42607405 Zoning: Applicant: ZERGMAN, ROB ISSUED BY: Address: 17092 VAN DYKE LN Phone: (714)542=5397 HUNTINGTON BEACH,CA • Zip: 92647 Owner: IRANI, ZACKARY %STRADA PROPERTIES Address ,UNIT 100 NEWPORT BEACH,CA Phone: 140 NEWPORT CENTER DR Zip: 92660-6920 Contractor: ROB'S ROOFING Address: 17092 VAN DYKE LN Phone: (714)542-5397 HUNTINGTON BEACH,CA Zip: 92647 License: 532516 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 15#FELT,40 YR COMPOSITION SHINGLES,CLASS A,900 S.F. FOR RESIDENCE ONLY. . FEE SUMMARY Plan Check: $0.00 -- - Calc Valuation: $1,167.00 Permit: $44.85 Claim Valuation: $1,167.00 • SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $45.35 • - PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front " 0-0 " - Rear 0-0 , Left 0-0 - Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-4e(6/00) Cd D.ECLADATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: v ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the _zav,wolk for which this permit is issued. 'have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance o1 the work for which this permit Is issued. "-1My workers'corn enation Insurance carrier and polOyoumber are: --� ( C t( FUti UPolicy Number:] G _(This-section need no a completed(I the permit is valued at one hundred dollars($100)or less.) ❑ 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,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provis• Applicant Signature: _ _�� coats:- ARNINGrFAILURE-TO SECURE WORKERS'COMP''o• ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMP.LOVER-TOfCRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($10pC00),IN ADDITION TO a • T OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed der r isions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Profess' s Code,and my license is in full force and effect.Lic,#15 Class p1 – Contractor's Signatures - � (Date: s= q 4 -oz_ J v � CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): • DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: __ Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safely Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ul Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. j, cure Of Legal Owner(s) Daae �t,�_% LAn r AuthgrizerApplicant S �" Dde CODE r INSPECTION TYPE lam INTTALS CODE r INSPECTION TYPE PSIS INTR141.6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -. 200 Final Re-Roof c?_.i&�' 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy Y CITY OF COSTA MESA a. BUILDING DIVISION >w'01n• DEVELOPMENT SERVICES DEPARTMENT PER NUMBER b. t /� t PERMIT , ro� .• B02-01437 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 221 23RD ST Status: ISSUED Suite: Applied: 09/09/2002 Vicinity: ROOF Issued: 09/09/2002 Parcel Number: 42607405 Zoning: • Applicant: ZERGMAN, ROB ISSUED BY: Address: 17092 VAN DYKE LN Phone: (714)542-5397 HUNTINGTON BEACH,CA • Zip: 92647 Owner: IRANI, ZACKARY %STRADA PROPERTIES Address -UNIT 100 NEWPORT BEACH,CA Phone: • 140 NEWPORT CENTER DR Zip: 92660-6920 Contractor: ROB'S ROOFING Address: 17092 VAN DYKE LN Phone: (714)542-5397 HUNTINGTON BEACH,CA Zip: 92647 License: 532516 Arch : Eng: Address: • - Address: • Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL 15#FELT,40 YR COMPOSITION SHINGLES,CLASS A,600 S.F.FOR DETACHED GARAGE ONLY. • FEE SUMMARY Plan Check: $0.00 _ Calc Valuation: $1,167.00 Permit: $44.85 Claim Valuation: $1,167.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $45.35 • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front '0-0 Rear 0-0 Left 0-0 Right 0-0 - PARKING Existing: 0 Required: 0 Proposed: O NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLS RATLONS WORKERS'COMPENSATION DECLARATION: '.1 I hereby affirm under penalty of perjury one of the following declarations: ❑ I e and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit is issued. ' .I hhave and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensatioon Insurance carder and poll number are: Carder: trnj'1 A-767 PoNcyNumber:- (Thls section need not be completed it the permit is valued at one hundred dollars($100)or less.) �J ❑ 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 ofia, b agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these prow Appr t_ D Applicant Signature: , • WARNING:FAILURE TO SECURE WORKERS'COMPENS ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby.affirm.that,l.am licensed under pro444isioonns of Chapter 9(commencing with Section 7000)of Division 3 of the Business an rofessioQs Code,and my license is in full force end.effecLLJc..tl� tz-.�r.41 Class#-1 L_—7,c cormactprs'Signeture: l}(y1 3`'y Date ce —t' 7 CONSTRUCTION LENDING AGENCY: 0 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to en owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have at of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: • CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sleatuss Of Legal Owner(s) ate rAnd/Or rized Applicant CODE! INSPECTION TYPE PATE 1NTIi1ALS CODE! INSPECTION TYPE PATE MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final j 208 Final Plumbing p -. 200 Final Re-Roof I-16 b!7�-0a- 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy .IOJECT ADDRESS: 221 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 04904 ) owNEWS NAME: MEL ZER MARK H ADDREsS: 920 J,O$NN ST PERMIT NO: B 049049 PLAN CHECK NO: 05786-90 S GOVT: N SUPP : N COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH ( 714 ) 645-4338 JARCWENGaR: REG.NO.: JOB DESCRIPTION : 100 LIN FT OF RCMU WALL @ 5 ' HIGH SQ FT: 100 ADOREss: uxlr: CLAIM VALUE: CALC—VALUE: 2, 000 . 00 GROUP OCC : R-3 /M-1 PERMITTEE: QUALITY CONCRETE ( 714 ) 650 -4945 ADDRESS: 2420 15TH ST COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. NEWPORT BEACH CA 92663ICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T S )of Division 3 of the Business and Professions Code,and my license is in fun force and effect. S E T B A C K S rrvuC.:01,6699 STATELIC.:334712c C— N �J $- '� FRNT: FT MAIINBREAR: FT IN FRNT: 10 FTUILDING CESSINYREARLDINGFT IN ate:_ Q Signature: "l wWORMERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT 6 IN RGHT: FT IN ompensation Insurance,or a certified copy thereof(Section 3800,Lab.C).OLICY NO.: EXP.DATE: PARKING REQ. PROV; PARCEL : 42607405 INE: Ri REF NO: 0PLANMPAxY: g NING NOTES> CONSRTUCT A 100 LF BLOCK WALL ON LEFT SIDE PROP LINE Certified copy o hereby furnished. 0 Certified copy u filed whh the dry Building Division. AT 5 FEET AND STEPPED DOWN TO 3 FT. • Date: ' Applicant DEVELOPMENT SERVICES -...REQUIRS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). I certify that in the performance of the work for which this permit is issued,I shall not em loy any person in any manner so as to become q p� subject to theqWorkers CC.ompe�nsatiioon Laws of Calitamia. �, P ZONING APPROVED BY _,S C._ `3 DATE: __ [$i/N Date: /^/ D ---47 0 Slpnature: -�w--% A._7. BUILDING APPROVED BY Al • DATE: _q�FT-C�D NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor 7.,....7,q q— Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. /p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY- DATE: 'f�[ g!< 0 which this permit is Issued(Section 3097:Civ.C). **********************3F3F..riF*$3'i C"xe **a*iF**" iei* **WgR,. h************** "� *arieTi (:,c** LENDER: ***********yL'**********************x,.*****.:**ie********************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'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,alter,improve,demolish,or PERMIT 45 .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 SMIP/NON—R E S pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 29 . 25 r, and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE L as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS————> 45 , 50 0 . 0 0 • :29 . 25 74 , 75 74 . 75 . 00 ❑ structure is not Intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State 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 employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS——> COLLECTED: 74 .75 OVER/SHORT• 0 0 improvement is sold whin 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 sale). 45 . 00 r . 50 29 . 25 I,as owner of the propertyam exclusively contracting with licensed contractors to construct the project(Section 7044,Business ' . c. ❑ and Professions Code: The Contractors State License Law does not apply to an evmer of property whobuilds or improves thereon ,N,****.1f**********************************************************************iE** 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. IND IV I D U A L • F 'E E BR EAKDOWN ❑ lame for thisrereason:pt under Section: B.AP.C. TYPE QTY DESCRIPTIO N, UNIT COST TOTAL COST • i i Date: Owner: SFR 100 RES—CONCRETE BLOCK WALL / FT. 20 . 00 2 , 000 . 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 witlNnll not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from theN�afry Management District.Residential construction applications are exempt from n , these provisions. Date: Applicant: Y • 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 ` rt, _ _ property for inspection purposes. \ 01'000x59849-00064851 TOT v•. Gy _/� \v`, DATE: D41I614C TINE: 13:11% // Date: !—'��"" 1 0 Signature: �• --U + .0:, / Driver's License or Social Security x: ,//_+/4r.T�_A` 1641-46 White—Building;Green—Code Enforcement Canary—Applicant Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POtPA 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.'rclectrical Conduit-Undrgrnd,- 55. Electrical Bonding 5. Steel Reinforcement y27- 0 F/"" V 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings T 27-40 b%vk 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 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 ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 4 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 C RTIFICATE ISSUED 33. Final Electric - _ Notes: 9 2a r a pL 34. Final Heating& Air Conditioning - . all- 35. Final Gas Pipe-Test 9-2 r-.. yam_ cF T" 36. Hood or Canopy Y f ' % I`r R`j/ croft, Jr • 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Anal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations , , , 47. FINAL STRUCTURE & BUILDING bI � {YV{I�/ 48. FINAL PLANNING d11 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • NOTE APPROVEDADDITIONS, DELETIONS, OR CORRECTIONS SHALL • BE APPROVED BY THE PLANNING DEPARTMENT CitytyofofCosta Mesa Building Dept. BY _��_ / DATE 7/C 19 90/ THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE Ae NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. 9003 30 THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A AlaaaPROVED PERMIT FOR, OR AN APPROVAL OF,ANY VIOLATION OF ANY OF /00 L THE PROVISIONS OF THIS CODE.NO PERMIT PRESUMING TO GIVEir 1. /3C0 AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF THIS GTA .4� CODE SHALL BE VALID EXCEPT IN SO FAR AS THE WORK OR USE PLOWING WHICH IT AUTHORRES 15 LAWFUL. q ro I. THE ISSUANCE OF A PERMIT BASED UPON PLANS AND art as. SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REOUIRING THE CORRECTION OF ERRORS IN U SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING Permit �{• G 1D 41 ..... BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN '7� C IN VIOLATION OF THIS CFDE OR OF ANY OTHER ORDINANCE OF THIS NUMBER MUST ACCOMPANY THE CITY. ALL INSPECTION REQUESTS A 4 C P � � S ail RCM= •p10[MCE ; � •ISIDEUCE NQq[MC[ z OR INSPECTION, gt Q ;IA- 0w CALL I.. Z h 754-5626 I ` / or \ Te_ . no I . 754-5627 2 -2-\ D.,3 -v- STREET TYPICAL 611 CONCRETE BLOCK FENCE a. a - Cement Coping Optional r7j -- �— GENERAL- NOTES - Channel Block With 1.3/80 '11i i 1-6- Horizontal Top of all ee Fences {11 MORTAR: One Part Plastic Cement, and Three Parts Sand For Fences 5'or Less i0 GROUT: One Part Cement Three and Vert.Bars 3/8"15 at 4' -0"O.C• Sd� o One Half Parts Sand and a = reit COPING: One Part Cement, Three For Fences Higher Than 5' "I� • w u Parts Sand Vert.Bars 3/8"0-at 32" O.C. - _ CONCRETE: Well Mixed 1:2-1/2: 3-1/2 Fill Cells Solid With Grout S ! > Max. of 7- 1/2 Gallons of ,�9 z ' Water Per Sack of Cement Where Steel Occurs > -Reinforcing Steel Shall 111f 1O GROUT MAYBE POURED FROM THE TOP I I OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15-39 , w o - OCCURS. A.S.T.M. ,'ISZ ~ CELLS AND AREAS OF HORIZONTAL REIN- I FORCEMENT SHALL BE CLEAR.CLEAN& All Steel to be Lapped i LL - , iFREE OF ALL MORTAR DEBRIS.ETC. 24"or to Code ', . • • - � � _. . • NATURAL'GRADE ,,,��� II • TWO 3/B••4 BARS '' , e CONTINUOUS TOP I &BOTTOM Ham--WIDTH TO 16 0 C. MAX. SEE CHART • �• c BELOW HOQSTEEL MUST BE TIED IN 7ZDEPTH OF EARTHTCOTH PLACE AT TIME OF TRENCH el s. O 1/3 THE HEIGTH OF FENCE INSPECTION. L I SOW BOTTOM OF FOOTING k—° _l1_194-1- 2..�� SCALE: 1/21 :: 1' 11 FOOTING REQUIREMENTS CHART WALL HEIGHT 6 ' 5 4' 3' WIDTH . . 14" 14" 12" . . . . . . . . 12" THICKNESS . . . . . . 10" 10" 8i' 8 " DEPTH OF EARTHTOOTH . . . 24" . . . .20" . . 16" . . . . . . 12" SPACING OF EARTHTOOTH. . 12' . . . 14' . . . . . . . . . 16'. . . . 16' City of Costa Mesa, California Building Department ___ F2F_`:t'w Nov.82. '.uu,v,uuaI, STATE OF CALIFORNIA n r�At V C SS. COUNTY OF ((��V IUnn1��lQi On `1- pc_ ,{�O T-�n befffre me,the undersigned,a Notary Public in and for said State,personally appeared -�m tc.l p1-P C - ticiti17 pe7ronally vno..-to-me (af proved to me on the basis of satisfactory evidence), to be the person_ - whose name 15 subscribed to the within instrument and acknowledged that ty OFFICIAL SEAL execu ddthth same. 0;i/' e ` MARIBETH F. MCKINNEY 11 '"'� " NOTARY PUBLIC.CALIFORNIA p♦� �1 PRINCIPAL OFFICE IN WITNE my hand and official seal - ` -�y4 ORANGE COUNTY!r n 1-s My Commission Exp.Oct II, 1992 Signature LE 76(71821 (Thl am for official notarial seal) • t PARTY WALL AGREEMENT ®TARIZATI®N REQUIRED • THIS AGREEMENT, made and entered into this 1/ day of *APT-ft/kW:IL 1990, by'and between "VIC M>%V,Z01 - hereinafter referred to as "LAND OWNER', and Po/2-7714 /-444A hereinafter referred to as 'ADJACENT PROPERTY OWNER'. It is hereby agreed that a party wall will be constructed on the property line between X21 23 f'° yT AND 223 2317-9 yT (Address of Adjoining Properties) • , in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach AIncoCIMAinil 4 " 6N ei7?tS. 5sPt OP fgPePt 717 L,Ne IN WITU 3S WlicmD) , the parties have entered into this.Agreement the day and year first above written. •7 LAND OWNER ADJACENT PROPERTY OWNER /frobg .a..y. a_yfenJ A/46V (Signature iggnature Name(Typed or Printed) Name (Typed or /Printm4)/4,12 qzo Jo,4NN (Address) 6S7 /fru � G�ess7o�T tc'e s (D,4.926&J 2 Pt r nro s o /s�c py` { MARIBETH F�McKINNEY I ^v! tbt{l'Pij .Ca`tftlin2 Y { NOTRRY PUBLIC•CALIFORNU �` o E COUNIY PRINCIPAL OFFICE IN � ' • . E'7Ccri-!1 EDtnNT.27,1993 � �F ORANGE COUNTY "4 Cy Cmnmitsion fig.Oct II, 2992 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAI CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address ' ^Ca ( C: 023-1 Sr- P- /V/3? 4549 7/20/84 00[11: TL TYPE OF CONSTRUCTION LI NEW LIADD Li ALTERATION U REPAIR _.—.------_ Applicant's Mailing Addfess X70 A�1CI� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# One Owner's Name �O WaL'/t. as, tt--- Phone�T'1lLC DESCRIPTION OF WORK/USE OF BLDG. Aft., it u'.eq -s Gist, Address 4 e S `Lal4flTe"'oait• l,p/�/n/ S Main Building: Access wilding: _____9- A License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION 5 RUCT AL T Front O Address CI TENANT El ELECTRICAL ® PLUMBING CI MECHANICAL B Rear' / N CI OTHER Contractor's Name Ofd/N..2$4/Ru//Ova Phone C Right N Address(Mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G CONSTRUCTION TYPE VALUATION$ $ City License No. ZONE - GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. e . # Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: D with section 7000) of Division 3 of the Business and Professions Code, and M my license is in full force and effect. - T License Class License No. S. Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION ' Bar Sink Showers I hereby 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 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap0 50+KW Construction Pole Sub. 8 Certified copy is hereby furnished. . 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 ❑Gas ❑Electric - Sub Panel I certify that in the performance of the work for whit this permit is issued, I ' shall not employ any person in any manner so as t become bject o the Drinking Fountains Solar Tank Fan • X Workers'Compensation Laws of California. L _ `_ Motors❑O-1 HP ❑1X-8• - Date --t9—SI Signature t" Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9.15 HP ❑16-15+ NOTICE:Compensation makingrthis isodeclaration,you becomesubject to ite c Workers' such rprovisions the Labor Code, you et forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall b¢ deemed revoked. - - . CONSTRUCTION LENDING AGENCY Gas Service -Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - g 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 OWNER BUILDER DECLARATION - Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories following reason (Section 7031.5 Business and Professional Code: Any city or • Garbage Disposal 'Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap R� J. �. any structure, prior to Its issuance, also requires the applicant for such permit //IT W� tK liav J. Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains Pe � 6/ lcfr r (by,... .2 _J 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 0 enalty of not more than five hundred dollars($500). - 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 - I- - - thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I El • sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II 0 Zoning Approved By '/ Date n n�a "-Fit pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By ^� ' / Date ! -dQ•—pY orove for the purpose of sale). ♦ d I, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System ' Application Issued By ./V...La d Date 2-.0 _r__ 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 ❑100,000 BTU SUMMARY OF FEES 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❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their worker's Compensat 'n insur.nce-should be provided to me. PLAN CHECK $ PERMIT dam exempt under Section ., - B.& P. for this reason Firepl/Fact.Bit. ICBG 4 Kd�i/NJC !�f/i / PLUMBING $ 7, p 0 ISSUANCE $ Date 7--2a "Qe/ Owner ►_ _ ' _ '�'r Heating System& Ducting PLAN CHECK 25% $ /. 00 ENERGY P.C. $ I hereby certify tha 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 comp) with all city and county ordinances and state laws relating o building con ction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this cit to upo e above-mentioned property for p� �� 7 !$"( - - TOTAL FEE $ L� ' inspection perp MECHANICAL $ 00 Signature Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ XDrivers' License or 55%‘ 2 . Accounting;Goldenrod -Assessor ' CONSTRUCTION AND PLANNING POOL &SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. 'Electri cal Conduit Utility-Undrgrnd. 54. Forms .4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steef.Reinforcement 56. Rough Plumbing & Pressure Test ;•- 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduit-Undrgrnd. ' • 8. Fouridation • ' 59. Gas Pipe, O'Undrgrnd.,Test Y 9. Water Pipe-Undrgrnd. 'J 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. Sevder 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: c//'/ �TT 9 li- `ea 34. Final Heating & Air Conditioning 4. d Q /i er 35. Final Gas Pipe-Test • v/; ?/t ' , /K 6; �cz S`./.44 36. Hood or Canopy r/f( _ __ / _ ` 37. Finai4t� Factory Fireplace t g, � < I C 38. Final Plumbing 821/aH C • 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 • C . • OWNER neon 9F, GEORRF DATE _7-9-56 . JOB ADDRESS 221 E. 23rd St. BUILDING PERMIT NO. #3291 GENERAL CONTRACTOR H. J. Wood VALUE $ 912_00 AP 118-120-16 LOT BLOCK TRACT guild gar W att. to works] G JP J TYPE 4 ZONE RI, FIRE DISTRICT 33)19 PERMITS ISSUED INSPECTIONSDATE_ SUBCONTRACTOR ,4"!„ / OcXf"> <��1) 9"-/I--S---b DATE NUMBER Footing Trench t41 7-x-5-4 Foundation Forms and Grade to Gara e Rough Framing 6,S,y Plumbing,Rough to Slab ��'_YYW" .--- Plumbing, Plumbing, Rough Complete. Temporary Pole ^' n / Wiring, Rough av/S to ,'{� t c6- -e./ 9''41 •T4 2 d 5D — Heating,Rough Heating, Final /-' Sewer, House &AC Sewer, St. SeptictiTank or Cesspool _ 1 _ i Lathing, In Out lrl/yJ`N�L�� /O�t� PI—tering F Bing,Final,Fixtures Complete Plumbing,Final Gas Test ' • Wiring,Final (1,',-e:i.. Occupancy 442, /03/X • FORM 210 3M 10.00 3291 Costa Mesa Building Department APPLICATION FOR PERMIT ' P. O. Box 3!7 3349 BUILDING 1 COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANTOOTO FILL IN Receipt No. Permit No. AddressA ��+ In . ��� 3a2- 7I 7 , Costa Mesa, California Received by Date Reed. Date Issued� Nearest 9 7— Cross St. (r - • -Buildin o^ Address Owner �J_ ,C Mall Costa Mesa, California Address!�,.2 7 .,2..�.r Nearest �� " ,, Tel. Cross St. nn City 49,42.... .... /vl/�•µ� No. Zone No.of Type Group (/ Architect or Lic. /� I Plans // oy' Engineer No.. Approve by nate Address AP 's y City Lic.,9 yiy Itractor� 7/ _ No. 7 Address 2 /£2. &..z.A-c.-47 C ms' CITY OF COSTA MESA Le I Lot PLANNING DEPT. Description I No. I BlockI Trac SUBJECT • BLDG. DEPT. RE' (Attach Metes and Bounds) A fl ))e-/A0- ,/O/ g,K/� Size of Lot /,id�C'3[y r9 No.of Bldgs. �/ DATE Now on Lot 7'4 0 ypt T .H O Use of 1 // No.of a Noe.of 70 Existing Bldg. /✓U:[ Jny Families L}-Rooms Setback Line from / / Rear Yard /aS0 t Center of Street y ?A-Side Yard _ Z DESCRIPTION OF WORK r New I vl Alteration _ /Addition "'-"- " , Repair I Moving Iv Demolish , ,i' 47 J Iv J4 Building No.of Size Rooms Stories / ri e r i o r Wall $ t1 A Roof — ering I Covering �° (APPROVAL'S �e of New r ��� I� ,. . Ill'a�� Building AZJZt iV-� a oX.=-V Foundation Location Inspector Date v Forms, nerials, �� • �� loyal, Under-Pinning 41 Frame: Fire Stops, Bracing,Bolts I ere y ac ow ge aver s Appli 'on and state that the above is correct d agree to comply Lath.Int. _ with all City Ordinances and State Laws regulating • building construction. Lath. Ext. Signature of Permitteeri7 ka Plaster, Int. Authorized Agt. kidlike 1 Plaster,Ext. Valuation Permit Fee $ 1p ---- Masonry Reinforced $ % / ///], a Plan Check$ Total Bond Beam / / / A Fee $ / FINAL c y , .J c • nnCO TP n 0 • O. ��. n ...1 lJ G16�1, 0530. a ` • • • • • Street • • PLOT PLAN Show location and distances from property line and between buildings. . •