HomeMy WebLinkAbout910 WILSON ST - Building Permitsmopessaveuimio: 910 W WILSON $T
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NERSWyIEIFpIOWN: HOPPS, STEVEN
�� 910 W WILSON ST
COSTA MESA,CA
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4LENSED CONTN�CTONS DECLAN�TION: I MMy all:m uMr penJy N pem�ry tlm I vn liwnrd uMar pvAeon� d Cluqw 9
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OWNEfl BUIL�EX OECLANATION: I hveby dfum under peiWy d parjvy �het I em evemq han �he Canmam liroros lew la tln
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mnvecte Iw e xiih e mrureeor(e) licaneed punuent t r e onlredae Licerus Lew�.
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WOPIlEN'S COYpp14ATON DECL�RATION: I hersby elfirm uMr priMy d pr�uy ms d Ns Idbrrirq dsderdbn:
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 080780 PLAN CHECK NO: N
CONSTRUCTION TYPE:
JOH DESCRIPTION .
CLAIM VALUE:
VN PERMIT TYPE: PLU
SUPPLEMENTAL TO P-79337
CALC—VALUE:
PERM NO; P 08078U
GOVT: N SUPP: Y
PURPOSE: OTH
SQ FT;
GROUP OCC; R-1 /
COMMENTS: DAAZN FOR WASHING MACHINE
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Z O N I N G R E Q t1 I R E M E N T S
S E T B A C K S
------ --- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 42235322 ZNE: REF NO;
PLANNING NOTES>
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D E V E L O P M E N T S E R V I C E Sy R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY :
LEGALIZATION:N
PERMIT
PLAN
ISSUE FEE
�:���Z!=,L�
�
F E E S U M M A R Y
PLUMBZNG ELECTRIC MECHANIC
8.%5
25Y
6.50 � �
FIRE
DATE:
DATE: )�
DATE:
*��***** �*
STRUCTURAL S GM NT:N
SMIP/RES GRADING
SMIP/NON—RES
� IMveardrNmeiivei�ecen3rsudmmanlbuCinwraforxakr+'mmpensmian.upraiddlabySeCim�l00d�Mlabv HUILDING—DIV—> PERMIT ZSSUE PLAN� CHECK TOTAL PAID DUE
cae.�«in�wn�.am.�xi«�n:�nu,m�vm�.a. TOTALS----> 8.75 6.50 0.00 15.25 15.25 .00
❑ in.rew.ame:v�.,o�«d.•oomo�o��w�.o�wm.aevsee�,rrooam.i.nacoe..au»v��au.
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c�;.,:
ra�N�mc« BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
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Dete: AppfranC
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Sxtlon J106 0l Ms Le6or Cob, Inhn�l, �ntl ettomsyl Isu.
CONSTIIUCTON LENOINO �OENCY: I hxaby elfi�m uMa penMy d pxpiry thm �hra u e oonn�utlon b�ip epe�wy br tln
pe�amence d IM xoM1 la xfiitl� ihu pe�mi u Yurod (�� �. Giv. CI.
LEN�ER'S NANE
LENUEH'S ADDPE54:
I cMily ihal l he.e md Nu eppfWion entl ama thei the ebma'vJanroiion b conw.l epies locanp�y rmh e� �Yy W oouiVy ord'ewns
end eima lewa Mmnp m buildiq cmmuuion eM Mraby einhorrse �apresemefnaa d Ne ay io eNr upon �M eEava�mwuned popary
����'°'��°�"`STEVEN �. F}OPPS
Dms:
(SISIJB.WP) Whno-Buildinp 8 Selmy; Oreeo-Flle; Cenery-Rpplicenl; Pink-Rmenue; poNenio�/useaaor
TYPE
PLU
QTY D E S C R I P T I'O Nd. UNIT COST TOTAL COST
1 FIXTURE SET/TRAP W/PIPING 6 BACKFLOW 8.75 8.75
END OF FEES
Q1 D022D`bi—OQ22D`�b4 T C�T 1`,2`
• OpTE: 1?tOd/95 TItlE: 04:21
, CONSTRUCTION AND PLANNWG - POOL ° SPA
APPROVALS Permit # Date Inspector AppROVALS Pe. ..rt # Date inspecror
r
�1. Temporary Electriral Service or Pole ;� 52. Pool & Equfpment Location �
2. Soil Pipe-Undrgrnd. � 53. Steei Reinforcement
3. Electrical Conduit Utili[y�Undrgrnd. � 54. Forms
4. Electrical Conduit�Undrgrnd. _ 55. Electrical Bonding '
5. Steel Reintorcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Grnd. 57. APPROVAL TO COVEfl•GUNITE .
7. Footings 58. E�ectricai Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. '60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor Svstem - 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. Electricai-Final
75. Rough Electrical-Conduit 66. Solar System�Final
76. Rough Elec[ric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiiing 69. POOL;SPA SYSTE�AS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough factory Firepiace . APPROVALS Permit #
21. Ducte, in Structure 70. Underground Hydro
22. Ducts, Ventilating � 71. Product-Pipin� OGas OOiI
23. Gas Pipe-Rough & Test . 72. Underground Flush
24. Roof Framing � � 73. Under9rnd. Storage Tank O Gas O Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and F�ashing . 76. Dry $tandpipe .
28. Lath�ing & Siding' • 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUtREMENT
37. Plaster Brown Coat� , 79. FINAI INSPECTION
32. Electrical Power Meter�Final $0. FOOD CERTIFICATE ISSUED
33. Finai Eleciric � Notes:�a.9 '�(a COR 1=L'v N ICC
34. Final Heating & Air �Conditioning . .�
2�3C- rc
35. Final Gas Pipe-Test � 7 '7 Q� �`
36. Hood or Canopy ' �. �! � -
37. Final Factory Firepiace ' �
38. Finai Plumbing 6
39. Water Service-Final � �
40. Gas Service-Final -
41. Solar pomesticFinal _ � -
42. Backflow Preventer . � .
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation .
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAI PLANNING � '
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY � ' ,
.- �,
No. Date
�
�
����8�� 910 W WILSON ST
.QYI�RSNAYEIFqAWN: HOPPS, STEVEN ',•
��� 910 W WILSON S�
COSTA MESA,CFi� 92627
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LICENSED CONTFRCTOXS DKIAH�TION: I le�eDy efRm uMm peiuly d pajury tl� I em fcaued uMr prwa"vu d Cheqx 9
(mmmanmq wnh Sxlion "/000) tl 0ivison 3 W Ns Bus'unav aM Pmlea�ims Code. and mY Gcems u in IW laru vd allw.
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OWNEN BNLOEN OECUN�TION: I hamby e1Nm uMar perely d pr'Wy tM I em exemp Irom iM Caumum lioema lew la iM
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«deei.e �a eele (secwn �oas. ausroas end vmeanaian.code: Thecanreaa. Licenea La. dea, na ewNm en oww a poperry
who WiM a inV��s therean, ud v.ho does euM wak Nmeell or henel or Waq� liu ar her am emWNM�.O�+db Ihe� uwh
impwemmd are mt imended a Wered la aeb. tl, Mwever, �M W ikinp a inpovemeM b wltl xilhm ons yw d camWe�un, tM
Y o�.a�ad., w�n n� in� w,e� a o�m ne w mb da � wud «�mwo�,a ia m. wmo.. d.�).
LJ �. a+owror a mo wwem. em e�d��velv oommena wtln �icen.ea conv.cmn ro mnmua �» wd� ts.aun �ou. anu,e.. ene
Pm/essiona Coda: The COMretlwa L'ceme law Eaee M eCDN b en owror dV�W�Y xfio WiNs a' u Ilwaon and wM
wmreds M wch pqeda wnh e mnlredw(e) IicemeE qmueM to Ihe CaMreda� Licenss Lew�.
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Oele: Ovmec
I do hereby eNy IMt I em ewera d anE uMantaM IM requiremenb d CelAomie Mmtlh end Stlery Cade Sedi • OS, 2551'f. end
255Ja. ard thm 1 or ury Mun buiNi�q oaupenl xill / wil �(�b am) ewed to canpy xih eek mte mdm enC IM nQuiran Ws far
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pweiono.
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WOPNEfl'S CONPENSATION DECIAP�TION: I Mreb/ elfirm uMer penMy d perjury aw d ths /ollovrirp EeWretbne:
� I hew eM W mai�uen e wNlbete W mneent to �tlireure br Mwkero' aanpemelion, m prwidM /a by Saeion J10� d �M lebar
Cotle.l« �M pa�lamence ot Iha wwk In wNch ihie parmn'n ivued.
❑ in..<.�a.u�ne:,wo����w�o�m���.m�.a�e.enrsw�a�aoam.�.mcoa..m.m.w�o.�w�o.wm.
wak la xliirh Nn D� e iaaueE. MY wvYere' mm0e�ion imuruice mnier enE D�Y rwmbr me:
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Pdry Number:
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� I cenAy Net in ihe perloimence M tM wwk 1« xAch thia permn u ueuad. I eheA mi smpby erry peno�in e�ry muiner o n to
bacanb aud� to �M xakera' canGevelion lewa d Ca4lanu. Wrea Ihel il I�hwk b�omF .aRa b in. wn.n•
wmpena ' u d Satlian 9]00 d tM lsbor Code. I YWI I t ' mmpy wah Noe pro i�b a. �
om.: � '� 9 ww�:
W.mmp: casun ro s.c n wonren comp«u.uon eov.rep. �• unwnq .nd Nn� wnNn.n.mpiorr ro rw p.n.mw me
ciH� nns. w ro m. nu,ane mou.em dwrn ls�alaooA m emuon ro m. co.r o� nmv.rwrhn �.�w u pev/ew ro. in
9�ctlm ��06 e/ tM L�borCoOs, /nfrut, �nd �mmsy's lsu.
CONSTAU(.TON LENOINO RQENLY: I haeby effi�m uMar perolry d per'�vy Ihm iAen u e awwrudion bM'vp eperw.y M tM
peAormee� d �M xwk tar whidi Ihe pemiY e uwed (�� �. Civ. C).
LENDEfl'S NAYE:
LENDEq'S �OOPE55:
I cenEy thm 1 haw �aeE Nb eppfcetion ud atma iMt the ebova intoemetion u cortea. I pree to oomply v.n� e0 Uy enE mmty ad'vwca
vd ete�e kx2 �aletip to W�ldiq mmUudim eid hmebY eu1M1a¢a �eqetenle4ws d Ihu dlyb ml« upon IM ebma�maitlid�ad papMy
�«��0��w�°� STEVEN R. HOPPS
PnM Neme
Dae:
Sipvlurea dApa�/ ira �
(St51d6.WP) WAXe-Buikiq8SelNy:OreemFb:Camry-�ppirent:Rnk-Re�aur:OdCeiwd-Maevar
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 079337
PERMIT NO: P 079337 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: VN PERMIT TYPE: PLU PURPOSE; OTH
JOH DESCRIPTION ; WATER REPIPE 6 WATER HEATER CHANGE—OUT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
ik 1E ff k 1E 1E 1f 1E 1E iE k 1E IE iE iE if 1k iE 1E 1k 1t 1E �E iE 1F iE 1f iE 1E 1E fF fE 1E 1E IE 1E 1f 1E 1E 1f 1E iE 1E 1E iE if iE 1E 1E iE 1! 1! 1k k iE 1E iE 1E 1E iE iE 1E 1E i! iE ff iE fE 1E 1k 1E iE 1E 1E fE 1E if iF 1E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEET: FT IN RGAT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42235322 ZNE: AEF NO:
PLANNING NtSTES>
i
If IE iE iE 1f 1E 1F 1f if if iE 1E 1E 1E 1E 1E 1E 1E �E IE IE 1E fE iE 1E 1E fE 1E 1E iE 1E iF 1E 1E 1E 1F IE iE 7E iE fE IE 1E 1E 1E 1f iE 1E 1F IE 1f �f 1f 1f IE if IE iE IE 1E if Ik iE If iE if if 1k i! It 1E If 1E 1E 1E iE �f 1E IE
D E V E L O P M E N T S E R V I C E S- R E Q U I R E M E N T S
ZONING APPROVED BY .
HUILDING APPROVED BY :
APPLICATION ISSUED BY
1E 1f ik 1f 1E 1E 1E IF iF i! IE 1E 1f iE 1E If 1E 1f Ik 1E ik
LEGALIZATION:N
BLDG PMT
PERMIT
PLAN
ISSUE FEE
PLUMHING
19.75
25t
22,��
Q
m
F E E S U M M A R Y
ELECTRIC MECHANZC
FIRE
DATE:
DATE:
DATE: O �t� CL-6
iEiEiEiEiEiEiFiE iFiE
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN,—CHECK TOTAL PAID DUE
TOTALS----> 19.75 22.00 0.00 41.75 41.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 41,75 OVER/SHORT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK
41.75
1kiFitiE1f1E1kikiE1f1E1FiFififlE7Eil1ElEiEif3EfliElflkfEfE1E1F1E1Ef4flikff'IE1E1EiE1E1E1ElEiklElEiEiE1f1lk1ElEiEiE41E1liEiElEiElElElEiPiFlEiFiFlFikiklFiklEif
I N D I V I D U A L '•F E E H R E A K D O W N
TYPE
PLU
PLU
QTY D E S C R I P T I O N
1 WATEA HEATER AND/OR V.ENT
1 WATER RE—PIPE -.'
END-OF FEES
UNIT COST
1�.�0
8,75
TOTAL COST
11.00
8.75
.;-
'� CONSTRUCTION AND PLANNING P��� �� SPA
APHROVALS Permit # Date 'Inspector qpPROVALS P....nit # Date inspector
` 1. Temporary Electricat Service or Po�e �' 52. Pool & Equipment Locatio� � -'
2. Soil Pipe�Undrgmd. � 53. Steel Reinforcement �
'=3: Electrical Conduit Ut(liry-Undrgmd. ' 54. Forms . �-
�' 4..EJectrical Conduit�Undrgrnd. � 55. Electrical Bonding '
5. Steei Rein�orcement 56. Rough Plumbing & Pressure Test � �
�;��'Electrical UFER Gmd. 57. APPROVALTO COVER�GUNITE
� 7` Footings 58. Electricai Conduit�Undrgrnd. - '
-�8. ,�oundation 59. Gas Pipe, � Undrgrnd., Test _ •
♦
. Water Pipe-llndrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. •
10. Structural Floor Svstem � 61. APPROVAL TO DECK ' �
1 t. Property Sewer Line & House Connection . 62. Backwash & Receptor�Final �
12. Sewer Cap 63. Heater & Vent-final '
13. -Roof Dreins 6A. Plumbing System • Final
14. flough Plumbing �, . 65. Electrica6Final -
75. Rough Electrical-Conduit ' ,.66. Solar SYstem-Finai • -
16. Rou9h EleMric Wiring -67. Fencinq & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
18. Rough Electricai�T Bar Ceilin9 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. qEQUIREMENT
20. Rough Facmry Fireplace - - - . �, APPROVAIS �" Permit # � - ~
- - r
21. _Ducts, in.Stru'cture� . -. ;' ;_.�- ` - ,� _. : �. 70.:Undergrouiid Hydro � �
22. �Ducts, Ventilating- , � _ r _ a:� 71. Product=Biping'fl�Gas OOiI
23. Gas �Pipe-Rou-h &'Test ',' F �" `
9 , r _ � 72. Undergteund F�ush
24. Roo#�-Framing - - _-' :• _ _ - - - � � � 732 Undergrnd. Storege Tank O Gas O.Oii
25. Roof Sheathing -- � '`'• { a� - 7¢, Overhead H dr,'o ��
�• ' ;J a Y
26. �T�Bat;Ceiling (StructuraQ & �d}onocoat e � z• �_ %t t 757 Dry Chemical � � .,
27. -Frame and Flaihingi , r y �, ` � � 76. Dry Staotlpipe� F�, , � - � •_
`� 28. "Lathing & Siding �� � . -;'�;Y c . �• •v. 777 FIXED-SYSTEM_F.INA�L
29. Insulation : tt ,= "' "'.. > � " , ' 78.. FIRE PFiEV. F1NA� � ' -
30. Drywall Nailing ,-. t `- ' . ��- ' . ' -� _ -HEALTH DEPS.-RE�UIPoEMENT
37. Piaster Brown,Coac' . �_ 73: FINAL t&SPECTIDN '
32. Electricaf Power Mgter•Final � �^„ i �.� � 8Q� FOOD CERTIF�CATE hSSUED '.
. 33. Finai EIG�tric _ . a. "• �. ' NoYes:�0�,9 ;q �' CO R�C L�O� .' O l i C r ' QN
34.;Final-Heating&Ai�Conditionieg� -, y � ' r ` �
-30 ����,� D4� _
35. Finai Ga3'Pipe�Test ' U � � ' Q '
r ". - � lrt ' �7T l �G. �� .�i i _ __ _
36. Hood.or CanopY ;l�< - � - .. . � � rr - . / �-.' ,
- 37. Finai'Fac[ory Fir€y�t'�ace ' -_� ;' � ` � ,� ` '
38. Fina7 Plumbing - , � �� _� - � � .. � ��-
I.
39. Water Secvice�FinaFf� � � � ;�' .- 4 � "
�. .
_ 40. GasService-Final � �, , _� „ ' `.:.; �� .
: 41. Solar pomesticFinak : � �• r' � J'
' 42. Backfiow Preventer . ' - �� J - _
> -
43. Backfiow Irrigation - .- " "�� " � . - �
r ^ _
�44. Landscape Irripation Syscem - -. ` . ; � -� t -
.45. Sound Attenuation �'- � n * S. - ^ - � ' - 7 �' -� �
r i- r% - c_ �. Y
46.'Handicap Regulatiops - " _ � " ��; �, �� ~.-;, ��
47. FINAL STRUCTURE & BUILDING � � n = <
�. 4_
48. FINAL PLANNING* - ,: r. , -.
49. Elec'trie Release to Edison � �� � I . a � v
i ! i n s
, i r - a
50. Gas Release to Southern California Gas Co ,,- - . '
51. CERSIFICATE OF OCCUPANCY� . - _` , . _
No. Date
OW NER � r19t01 ESt8t8S DATE �-18-56
JOB ADDRESS 910 Wilson Street BUILDING PERMIT NO. 2801
GENERALCONTRACTOR $.V.Hunsaker vn�ue s $,a56.�
�. �A e�ocK TRACT 2873 Sin�le Res, w/att ear
GROUP I & J
INSPECTIONS �7
Footing TrenCh _��-V'-�l�fi
Foundation Forms and Grade o G
Rough Framing '
Plumbin8, Rough to S�' �
Plumbing, Rough Complete GG
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, F n /3
` S f N 6 Sewer, St.
�8e�+i ,Cesspaol�
L ig, In OutV �
Plas[ering J
Plumbing, Final, Fixtures Compl '
Plumbing, Final GasTest �
Wiring, Final
Occupancy (
FOAM 210 3M IO�v3
/PE V ZONE RIi FIRE DI
— _ D�ATE'� SUBCONTflACTOR �
DA�
i� n
PERMITS ISSUED
I NUMBER
_" Costa Mesa Building Department +���r�APPLICATION FOR PERMIT �
• P.O.Boxa�� BUiLDING �
^ ' � COSTA MESA, CALIFORNIA
FOR OFF'ICE USE ONLY
' FOR APPLICANT TO FILL IN Receipt No. ^Permft No.
Building F3' O W � 4 SO 1V �1�� I p( �D /
Address �t
Costa Mesa, California Rece' �by ,,Q� e Rec�'d7. 'D/ate Issued-7
GY G �J b 'f���%5 6
CrossSt. �LpcL',�.� � 114 �V.�• Building /
—y���S ,� Address
Owner U o L �S'�A-`ES Costa Mesa, California
Mail .�/ ����5 � •
Address � [�p �,_ �f}'S Nearest
! /7 Tel.�Y1� Cross St.
City ��'_1GI�C_% C--/%'� No. ^/' /'��5� Zone ./ I No. of I Tvoe , Groun A.,.!
rtec[or
neer
ntrector S. Vi r/ il
dreu S LYsfiJ �
Legal Lot
:scriotion No. z�
(Attach Metes and Bounda)
Size of Lot �a0 x ��O �
Vse of
Existing Bldg. —
Sethar.k 1 ine f�nm •
New ✓
� � Movin9 �
� O `� i-/, No. of
y� Rooms
Wall I Roof
i S�UCLG cove
u5e or
PP
"°zGQ l
n Lot �
I No.of
es Rooms
V ard'L 3 . 1
Yard :� �' 11 z
ORH
Addition I
Demolish I
Plans
Dale
CORRECTIONS
o�� APPROVALS
�� Foundation Location I Inspector
Forms, Materials,
I hereby acknowledge that I have read this Application
and state that the abme is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building construction. �ath. Ext.
Signatureof �
Permfttee Plaster, Int.
AUShorized Agt. Plaster, Ext
Valuatlon e it Fee $ G�. e� Masonry Reinforced
�}' (�'r f C�� Plan Check $ �� � Qa Bond Beam
$ r� li O (O Total
� Fee s 3 3��� FINAL
PLUT PLAN
Show Iacation and distancee from
proAerty Ilne and between buildinga
�� . � � . ; � ,
� CO=r"
, . � � y r,.., �
_ , J .. `,1 �(i,7 �,g ��t�.ief;,.�, ,. A tr�c;Z? ( [l
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r�aa.1� n � Ln•�
JOB ADDRESS Qll1 W_ Wilsnn Rtreet BUILDING
AT'
or
DESCRIPTION OF WORK
SUBCONTRACTOR
< ? '- 25721
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 � GOSTA MESAr CALIFORNIA Y2620
For Applicanf to Flll /n Completoly
TYPE OR PRINT
BUILDINO
ADDRESD �
COSTA ME3A, CALIFORNIA
nwr�ea � R �. �. IA � F S T
� STATB
���
USE OF
EXISfIN� BLOO.
CETlACK LIX[ �ROtl
DESCRIPTION OF WORK
BUILDIN6
SIZE
EXTHRIOR WALL
TO 66
,ITY oF Cusra �w�SA
MAY 2 0 1g66
APPLICATION FOR PER
. Fr � BldL6NN(i
c �t d ioiae rrr
BYPROV[D � � D/
F �D
,
� ZONING
- h zo�j�j Ho. o� u.� or
n /l —/ •ura � Auaon
1 HCREBY ACRNONlL6DOB TXAT 1 XAV[ pQAD TXi6 APPLIGT�ON
AND 8TAT8 TXAT TX8 AlOV6 I� CORRBCT�AND AOR6t TO COW
PLY WITH ALL CITY OpDIfU! CO AHD �TATt LAW/ piOYLATINO
BUILOIHO CONSiRUC}ION.
SIGNATURB OP �
PfiRMITTE
AVTHORIZiD AOtNT
YARD9 MPROVHD
MAIN BUILDIN6
vwa. 7f
PERMIT NO.
- .5 �,3 - a-. a-
NO SNALL B8 LE88 THAN
YARD9 MPROV6D
ACGEIISORY BUILDINO
o�Te
��
� • a
{0
�
40 �.R.. �
0
TX6 /�MOUNT BXOWN UNDBP V�L1I�TION 19 FON TM8 j
•UPPO88 OP �BTABLI9XIN0 A PEPMIi PH8 ONI.Y. 3
YALUATION �
PERMITPEE � �� �
% G?
a � SD
TOTAL FEE $ � ��
OWNER WE3P� i�PTETH NUG 1 S. 1961' J� DATE 12_i6-6o
JOB ADDRESS 910 West Wilson St2'eCt�� BUILDING PERMIT N0. ] 35QS
GENERAL CONTAACTOA ifiitPd Pacific Ruildar VALUE $p_ppp_(�
AP. No.
OCCUPANCY "
LOT TRACT FIRE ZONE DESCRIPTION OF WORK
� DATE I GROUP T TYPE
SUBCONTRACTOR
Form 210-SM-11-59 S-B P , 135�
� • w: • 135�C�R
COST�4 MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CAL�F���A
For Applicant fo Fill In Complefely
TYP,� OR PRINT
, BUILDING y,G r�,,�,���, s
jADDRE69
COSTA MESA CALIFORNIA
I MAIL
IAftCHITECf
I SIZE
TEL.
�
NO. OP BIDGB.
8 PROM
RpeeT REAR YARI
ILEFT I RIGHi
DESCRtPT10N OF WORK
FEE RECEIVED
� DEC 1 � 1960
�FINANCE DEPT.
CI(� OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offlee Use Only
R6C81R NO. PEPMIT NO.
'd
rtecei ev I c��n�cFrv p� I �_/�o�
W �O
BUILDING
A MESA. CALIFORNIA
'" ZONING
I NO. OP � I UBe OP N
PLANB BUIIDINO
uaw�
A. P. NO. /� `� S I�iJ -'
YARDS EVES
APPROVED ALLOW
IC6NT6P LIN6 BTJ i
v
NO. OF
EXTERIOR WALL
COVERING
USE OF BUILDIN
I HHRGBY ACNNOWLHDOE TNAT I HAVE RGD Ti118 APPLIGTION THH AMOUNT BHOWN UNOER VALUATION IB FOR TH¢
AND BTATE THAT THC ABOVE IB COHREGT ANO /�GR88 TO COM• pURP098 OP EBTABLIBHIN6 A PERMIT FE8 ONLY.
PLY WRX ALL CIiY OHDINANC88 AND 6fATE U R80ULATINO
BUILDINa EONBTRURION VALUATION /yy
� I�� �� PERMiT FEE $ �J `
SIGNATURE O
PERMITTE / �� v /l, .
8 d J �, PLAN CHECK $
AUTHORIZED AGENT ,�_
TOTAL FEE