HomeMy WebLinkAbout303 23RD ST - Building Permits ("S Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
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GI OF COSTA MESA CONSTRUCTION PERMIT PER^ ` ' t'T 0 TRACT NO. LOT NO. UNIT NO. Zone A.P.#
303 E. 23rd Street, C.M. O.T D
Project Address S Main Building: Accessory Building:
a TYPE OF CONSTRUCTION LJ NEW U ADDX*J ALTERATION U REPAIR
Applicant's Mailing Address M.
Cross Commercial a 1 Way, C.M.
❑ CONVERSION Li ❑ OTHER T - O
Ellen 548 1788 Front
Owner's NamePhone DESCRIPTION OF WORK/USE OF BLDG. I nsta I I 301 felt adn I B Rear N
Address 303 E. 23rd St. , C.M. 92627 r A I
CLASS A her lassShlOOIPc._NEw Pd,P� flashing mPtal .IC Right N
Arch/Eng. License No. TYPE OF PERMIT CCJJ GRADING LJ FOUNDATION STRUCTURAL K G
Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL S Left
❑ OTHER R
Contractor's Name Crank Rrna Rnnf j ng Phone 548-5569 Ping. Ref.dk Parking Req./Provided E
PROJECT DESCRIPTION SQ. FT. 3,800 OCCUPANCY 5 I ng I e PlanningNotes: Q
Address(mailing) 176 Commercial Way CM 97677 CONSTRUCTION TYPE residential VALUATION§ 5,935 00 M
City License No. (105993 ZONE GRADING CU.YDS. ACRES T
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
J, with section 7000) of Division 3 of the Business and Professions Code,and ELECTRICAL FEES
my license is In full force and effect.
\ License Class r_39 ansa No. 408677 •
Date /J f.. Signature at
PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORK RS'CO PENSATION DEC LrA�R AT� Construction Pole Sub. 0 50+KW
I hereby al firm that I have a certificate of c nt t0 self-Insure or a certificate Bar Sink $hOWefi
• Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter Dup to 100 amps
'c, Lab. C.) Dishwasher Meter Dover 100 amps
,icy No. 289(774-R9 Company State Fund Backflow Irrigation Sewer Cap —
A Certified copy is hereby furnished. Dryero ❑Gas ❑Electric Sub Panel
Certifjed cpyy i ilea with the city Bui jy Bathtubs Sewer Connection
-
Date !O^`� Applicant Fan Motors 1:10-1 HP-01-15-8
EXEMPTION FROM WORKERS'COMPENSAT DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the per s for one hundred($100) or F.A.U.
less). Dishwasher Solar Piping Inc.Solar 9-15 HP D16-15+
I certify that in the performance of the work for which this permit is Issued I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE:If,after making this declaration, you should become subject to the e Outlets Ran
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal9
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator ❑O-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the Lavatories Auto-Wash
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 Laundry Trays
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 Drains
the Contractor's License Law(Chapter 9(commenting with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
-vrefrom and the basis for the alleged exemption. Any violation of Section
11.5 by any applicant for a permit subjects the applicant to a Civil
' ,alty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By Date
compensation,c, will 0 the wus ne and the structureis not intended C n ractoofferrtl -- - e---/
for salese (Section not Business and Professionalf aprCode: The Contractor's MECHANICAL FEES Building Approved By Date
thereon Law does apply to owner himself/herself
f a property or who builds s or Improves
eploy, and who tloes such work ovem nts are
lot through his or ere own Application Issued By �1 Dat
employees,le. oweveridthat such or poes not titletl or red for Boiler Hood nO oy Type I 0 t/,/
pletl If, hwothe building improvemento i gsoldwithin one year of com- Canopy Type II ❑ SUMMA'V F FEES
prove , 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 PERMIT $ $ o SMTP $ t re
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK S PERMIT
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 0100,000 BTU PLUMBING S 'rr-c_,i-,_ ISSUANCE '$- -
builds or improves thereon.and who contracts for such oroiects with a con- _
tractor(s) license pursuant to tne Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ,,,,it' -'r' 'l '. ENERGY P.C. ,$�
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.8 P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $
— PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers /�
I hereby certify that I have read this application and state that the above DO-100,000 BTU 0100,00087E MECHANICAL $ TOTAL FEE $ / �l!
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating o building construction,and hereby authorize repre-
sentatives of this cit / • en upon the above-mentioned property for
inspection purposes.Ajp/o� / L p Q
Signature //{%
Reinspection Fee $15 Issue Fee $ 3 0_'�L` _ _
Drivers' License or SS 3" LI.vEI r, - - -
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor
JrA,CONSTRUCTION AND PLANNING - POOL 'A
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 UFER Grnd. 7 57. APPROVAL TO COVER-GUNITE
7. Footings ' •,, /y 58. Electrical Conduit-Undrgrnd.
r8. 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 Connedtion r 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
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation •=1
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /1/yq
jar
48. Special Requirements Completed [ 0 /
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. - Date f,
�1
CITY OF COSTA MESA PLANNINu DEPARTMENT 'PB 3D-7f�q,�OO1878RcJi*' **2S ('O
A. P. No. 11.(.-11.'-1,'
Bldg. Permit No. 3/715/
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 27:'3 Av: nui _ Cnnto 10Gq
Owner's Name
Bachelor or 1 - Bedroom Units t @ $25.00 = $25.00
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 = 125.13
Total Fee
Total number of Dwelling Units 1
Planning Department Approval Date ,._i.,_•n- Park Area No. •
By A.. orris. Applicant's Signature
�1 UWNtX AkurWl4U'I.L JUri1V
�10B ADDRESS 303 East 23rd Street BUILDING PERMIT NO. 30583
GENERAL CONTRACTOR Air-Vent DESCRIPTION of WORK aim patio cover
" No.118-203-58 LOT TRACT FIRE ZONE VALUE $ 538.00
'ECTIONS Signature Date GROUP J TYPE ZONE Ri
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
A_ Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. n
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS [0 STEEL REINF. U
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
S TURAL, FINAL Electric
H. NG, VENT., REFRIG• AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL r' ,/�
BUILDING, FINAL f/1 I4 Q '//�. /o
•
30583PAID *.r***
u,O. 31-69cnsti002632 6.00
COSTA MESA BUILDING-SAFETY DEPARTMENT . /
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVED BY DATER IVED DATE ISSUE
BUILDING 03 ar -2 yd y/��/ �7 �{ pp.. []
ADDRESS J`i —� X/ / ✓aL���/ 7-2/-6
/
,�(tr /Q } PERMIT NO.
OWNER . LK ..1 .1.Yf.C:. r. A.P.NO. II G -dG J' S ,'s(1 Q7
,/�,•.- BUILDING �`-
Z ADORES t.#1,1_t, ADDRESS -..03 a .-23
ILU C IT LLcLate_t... �.I�9In NO •
W IL LGi 5( 43' TRACT /, LOT / BLOCK
I- Z
Z Q CONSTRUCTION NEW ADD I ALTER REPAIR MOVING OFMM ISH
O-N LENDER
0. 03
J O BRANCH i� r ----- \� \ ,
-I m u, `r O W N E Q /n'
C W ADDRESS { ll_ /)/� f/'-ri- .
CO J / /1 t VALUE rocsc/p
J m ARCHITECT t% �a^ TEL. USE U /.:� tq!"�'i4J $•_LJJ /
Q OR ENGINEER NO I
N /j�,yL /J FIRE
WCC ADDRESS /R' .,,7^ '/" C - �<; l ZONE TYPE GROUP / I
APPROVED .3'
J Z CONTRACTOR /�I�1LJV.--177
..- / e�v'��"J'/, BY ✓ ATE l ;Vf9
Jm cc ADDRESS /II U'7 / / fano KL{^ '�/t� as r 11 Y/
LL w One..
TEL. ZOIQE NO.OF USE OF NEW ' P/-
O= „J 7 y� / Ul' 1 PLANS L BUILDING au-
Z 1- CITY 7nw b'C+C-r�x_.) NOC'i')/�"3^IG%c -_
-O L1.1STATE CITY YARDS APPROVED YARDS APPROVED
N Ir LIC. NO. /7c�IQ:Z LIC.NO.5957 MAIN BUILDING ACCESSORY BUILDING
=O SIZE !/ / ANO.OF BLOCS. (FROM C/L STREET ,
OF LOT (7.3 ft . q / NOW ON LOT FRONT a(. to ..4_7• FT.
USE OF 2 ' `'
EXISTING BLDG. [,�. ,A j� R.SIDE /OFT, C FT.
I- SIZE OF NO.OF J �1 q
Z NEW BLDG. ROOMS 'STORIES L.SIDE d FT. FT.
EXTERIOR WALL ROOF
V COVERING COVERING REAR / 0 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED
d DISTANCE BET. BET.MAIN&
1 MAIN BLDGS. ACCESS. BLDGS.
Q r // 12* - '1 ) VAR. DATEO (err
_ L.>lj //: �V-/{/L/ C.U.P.# APPROVED
APPROVED
co —ELY (�/V1� tD TE �/ / C
o Of /
UI hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC all laws regulating building construction, end I shall not employ
I- any person in violation of the workman's compensation laws of
Ca the State of California. es
zI hereby certify that I am properly licensed as a contractor under - SO. FT, 0
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9. and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0
CC
em exempt from the provisions of the State of California Business
end Professions Code, Division 3,Chapter 9. VALUATION �,`� m
PERMIT FEE $ N
Signature of D
�_ Cy," (//J m
Permittee / v S /�/) PLAN CHECK $ / ',..//l E
Authorized Agent 9 Of ddd(/ TOTAL FEE 3
dr ✓ - LL
UIYNCK KAMAI,AN.L, John DAIt 3-27-73
JOB ADDRESS 303 East 23rd Street BUILDING PERMIT NO. 36299
<GENERAL CONTRACTOR Owner-builder DESCRIPTION of WORK Add family room & dining rnj.
+CAR,No. 118-203-58 LOT 1 TRACT 47$7 FIRE ZONE VALUE $ 5.600.00
SECTIONS Signature Dote GROUP T TYPE V ZONE R1
`5c,,
GAS SUBCONTRACTOR PERMITS ISSUED
WATER Date I Number 1 Signature
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE I. HOUSE CON. S
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER O
ROUGH WIRING [-� f7;P ) 514/yell Heating and Vent.
Uy'
TRENCHES 0 FORMS 0 STEEL REINF. ,t=C s— /z-7J
FLOOR SYSTEM C 5--,.."-c-?3
BOND BEAM n STEEL REINFORCE n •
SHEATHING /// 0-1P-t- ")
FRAME
Pt-
FRAME AND FLASHING / A 5 '^�� 4''C
LATHING - IN OUT
PLASTER, BROWN COAT r 7 C A - 7Y""`�
ST" -'URAL, FINAL . Eleatri
HE TC9n, VENT., REFRIG. AND A.C., FINAL c-ctflt7 AAP-64- . 'J'7t ,37o7ai
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL gel '�'71FJC
BUILDING, FINAL R, +ftr
f
, • 36299
"'. - PAID, ***C148.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 "AR ?7-71�;;�U ' 067::.
P C ION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RE V D DATE RECEIVED DATE ISSUED
BUILDING
ADDRESS 303 E. 23rd St. ��JJ��a D .3-w2 - V,
OWNER JOHN KAMALANI A.P.NO//f C/+/3-c PYZT f q,
MAIL BUILDING h �( '7
ADDRESS 303 E. 23rd St. ADDRESS.�d3 E• & Cr
z
a0 CITY Costa Mesa •
NOL'646-4676 TRACT /!)O I' LOTS! BLOCK
~ ZCONSTRUCTION EW ADD ALTER 1 REPAIR ' MOVING DFMOI LSH
a m LENDER Crocker Nat'l Bank
J BRANCH Anaheim Branch ,&, / ,(��, (4.J/ i
OWNER [r^•t /\ ��y
mJ ADDRESS 1201 Euclid Ave. p /((/rJ�� Jr�/ UE �j� (J�
J m ARCHITECT TEL. USE,ADd�I'I/�"I 0/tl�r $ �/"���
N OR ENGINEER Owner NO same • r7,//� T
FIRE
WCC ADDRESS s'n'e ZONE 1 // T PE �1� GROUP -t.
dui APPROVED/,// DATE 27 7
ui 2 CONTRACTOR Owner BY U[ 1/)
mZ
ri cc ADDRESS same
W w •TEL. ZON�!�j NO.OF - , ?USE OF NE% v/.yri./4` 144
_ZH
CITY same `NO same / '— PLANS .-- BUILDINT�m IOD,'4ik :
W STATE CITY YARDS APPROVED YARDS APPROVED
rn K LIC.NO. LIC.,NO. MAIN BUILDING ACCESSORY BUILDING
00 SIZE NO.OF SLOGS (FROM Cit STREET)
OF LOT 96.45 x 63' NOW ON LOT 1 FRONT FT.
USE OF
EXISTING BLDG.Residence R.SIDE �. FT. FT,
I— SIZE OF NO.OF
Z NEW BLDG. 13'X28'711 ROOMS 1 FSTORIES 1 L,SIDE Zt-- / FT. FT.
Q EXTERIOR WALL ROOF
V COVERING Stt1CCn COVERING wood shake REAR/CPS-FT. FT.
—I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1
C- MAIN BLDGS. ACCESS.BLDGS.
Q VAR.* DATE
Family room and dining area C.U.P..# APPROVED
I— APPROVE
CO HY 7 DATE -��—��
Z LL
��
U I hereby acknowledge that I have read this application and state )j
�
O that the above information is correct and agree to comply with .I
¢ all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of .I•
N the State of California. �� SO. FT. to
? I hereby certify that I am properly licensed as a contractor under - O
the State of California Business and Professions Code, Division 3. THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such license are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
am exempt from „a provision o the State of California Business VALUATION
32.- -n-
and Professio ode, :Maio
h.. . m
• at, -.J. PERMIT FEE $ w
(/�„� O1�s7 O
Signature of //�/s 0 [a
Permittee �r 4/ii L%-,i_A— Zi✓ PLAN CHECK $ / sY E
.....---
Authorized Gtie,.____ `o
Authorized Agent TOTAL FEE $ LL
•
CJ OWNER KAMN, JO* DATE 5-119-64
JOB ADDRESS 303_East 23rd Street BUILDING PERMIT NO. 22348 . -
✓)GFNERAL CONTRACTOR Owner-builder VALUE $ 300;00
rL '0.118-203-58. LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Wall Pvtt
INsPECTIONS • Signature DATE GROUP TYPE ZONE
• Soil PERMITS ISSUED
r Gas SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. 0
J Rough Heating
C Rough Plumbing
Miscellaneous
Prop. Swr. Line 0 House Con. 0 St. Swr. 0
Sprinkling System
Construction Pole
Underground -0 Power 0
Rough Wiring
Trenches,El Forms 0 Steel Reinf. ofd /1✓T4c/
Floor System _
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
I 'ig — In.p Out 0
F. •ar, brown coat
Refrig. 0 Air Con. i0 Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final �/
Building, Final 70- Id/%i�//�6"' ---- -- --- -- ---
OCCUPANCY •
Form 13U4-5M-3-63—S-B P ooabA
??348 FEE RECEIVED
lYllf 2 9 1984
r
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
" P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 -
CITY OF COSTA MESA
For Applicant to Fill In Completely , APPLICATION FOR PERMIT
•
TYPE OR PRINT BUILDING
OU ILDINo �3 e . 3� �. For Office Un Only
BUILDING S RECEIPT NO, PERMIT NO.
COSTA MESA. CALIFORNIA 2 2
WI.SY ri REC//VD DATE
•
E
OWNER TUr/ K e9/11•9-69-4•0 _
BUILDIG
AMAIL
DDRESS C5o3 s - 23& S . ADORE NS b ..,..442 Si
/J �j� TEL• ,/e-.
ZONE TYP iv GROUP
ram
CITY 0057,57-'//7634 NO. Ce - 1
EL
ARCHITECT TAPPROVED T •ATE
• N
OR ENGINEER NO, V
. 1NG 1
ADDRESS
'/ /� /� TA' HOOF .1......... USEOFNEW 7
CONTRACTOR Qw Com'-' �.�/^'G�/ . PUNS I Eu1LDINB
utGAL
ADDRES, So 3 C _ n.3 . -7-. . DESCRIPTION ) /� [ 1 3
CITY �s7fA �ESie A.P.NO. ,I •� - .)V3 - .J
ATE / ]�L• //' 13
1 NOTE NO HAVE OVERHANG SHALL OE LESS THAN
LIC..NO. /3 _( "4 ,, l -rI/• e' o- 74 EAVES 50" O SIDE S REAR(�.L.
SIZE Cr J b NO.OP BLOCS / . ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
USE OF
`)a/e YARDS APPROVED YARDS APPROVED
USE OF O BLDG. c/'v� MAIN BUILDING ACCESSORY BUILDING
EXI (FROM C/L STREET)
SETBACK LINK IRON FR•NT A
CENTER OP STREET REAR TARP
SIDE Y&RDI LEFT RIGHT
DESCRIPTION OF WORKFr.
NEW /ALTERATION ADDITION yr'
SC
-I DISTANCE BET. BET.MAIN A
REPAIR MOVING DEMOLISH _ MAIN BLDOB. ACCESS.SLOGS.
BUILDING NO.OF ' VAR.S DATE
SIZE ROOMS STORIES - C.U.P.# APPROVED
CEXTERIOR
O ERINGWALL I ROOF ;COVERING APPROVED 1/10 +D £E /�_/
USE OF B illi AND WORK TO BE PERFORMED I ) (/) G
if
.Bz0C,C Irl ,�_ �r '7 %4a7 1‘..JJJ / ;
/in 1, 4
I HERESY ACKNOWLEDGE THATI HAVE READ THIS APPLICATION E AMOUNT SHOWN ORDER VALU
BV AlAT"2,1,1,POR THE " O
AND STATE THAT THE AOC•RRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PEREE ONLY.
PLY WITH ALL CITY ORDI �,,D STA RE NO VAW TION _ / D
BUILDING CONSTRUCTION. , '
PERMIT PEE O)
SIGNATURPERMITTEE O AV €
Si ea PLAN CHECK S J W
AUTHOR! ED AG '
. ... S . .. v. .. TOTAL FEE S
• 18010 r t c/.// rb N',i1/4.
COSTA MESA BUILDING-SAFETY DEPARTMENT �� `7 / i /
P. O. BOX MT COSTA MESA. CALIFORNIA / 0 S'C___ FINANCE DEPT.
•
For Applicant to Fill In Completely APPLICATION FORT PERMITOSTA MESA
TYPE-OR PRINT
BUILDING (L� 2 BUILDING
ADDRESS COSTA MESA. CALIF RNIA For Office Use Only
OWN
ER /1/44,41)
(/ RECEIPT NO. I PH/W!
a
ADDRESS .? 33 C. / 7 A RECEIVE. BI DATE JIECENED 2✓ ',To!!,ISSU
D
/ LqR
'
T
CITY E.- if/ "JO3 /: . 6( 3~ _ .ADDRESS
NG ARCHITECT --- ItL. COSTA MESA. CALIFORNIA
OR ENGINEER NO. �I
FIRE +/ /^ ,y
ADDRESS ZONE TYPE V GRO UIR
APPROVED
CONTRACTOR SIL-114.-4 BY DATE
ADDRESS .. - ZONING �/�
-------------
ZONE NO.OF USE OP NEW`tr.,'
.y/ 7M At..
CITY 2 I PLANSa
i BUILDING wf ..,h
STATE i'1 TEL. 1^�� LEGAL
-./- J��/
LIC.NO. O' NO. DESCRIPTION /d/ 2 r,,r L/7 V /
SIZELOT / 3 X q6, )3 I NO. OF BLOCS. O �-
OPNOW ON LOT A.P.NO.
USE OF - YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE FROM %J (CENTER LINE BT y
CENTER OP STREET REAR YARD IG it FRONT FT.
IN.
/ a /
SIDE YARD LEFT RIGHT R.SIDE FT. IN.
DESCRIPTION� OF WORK L.SIDE 'S —_FT. IN.
NEW I VK II ALTERATION I II ADDITION I REAR / ? FT. // IN. __,'
REPAIR I II MOVING • I (IIIDEMOLISH I APPROVED DATE /O �C�C
SIZE DING 1 17/c(�j/'{)" ROOMS a STORIES /
EXTERIOR WAL dLC ' I ROOF
COVERING WALLS)
COVER! G14/644
US/E OO�F�IBU� �/I/INj�G AND WORK TO = PERFRMED
Gam. GC__. L 412DpJ /We a/ 19da d.
I HEREBY ACK LEDGE THAT I HAVE READ B APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE TH THE ABOVE 18 CO AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY OR DANCES A E LAWS GULATING
BUILDING CONSTRUc�G N. / VALUATION I
SIGNATURE OF'/A C //�� PERMIT FEE $ 'O
PERMITTEE !//// �L $ /t 335- PLAN CHECK $ _3 0 —
F
AUTHORIZED AGENT re !
TOTAL FEE 4