HomeMy WebLinkAbout295 16TH ST - Building Permitsr Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CO STR UCTION PERMIT PERMIT NO.
TRACT NO. LOT NO. UNIT NO. A P # R
/��I V3p473) aq3 � a gas-- Zone �,
Project Address 2-77 r/e/ sr �L� f (A.B.
S Main Building: Accessory Building:
Applicants Mailing Address Z-�Z`�C�� ��-/"� ��� TYPE OF CONSTRUCTION L I NEW ADD LI ALTERATION El REPAIR E - Z
-I g ❑ CONVERSION ❑ DEMOLISH ❑ OTHER L.oCi+t IP - cc1-i U ' T 3 Q ' - . - 0
��`�` C G�Fg Phone Front
Owner's Name DESCRIPTION OF WORK/USE QF BLDG. ��vQr "• A/ Q14.'+ A Rear �� N
Address GA,/ W V t V
Arch/Eng. License No. TYPE OF PER T ■ GRADING.FOUNDATION a STRUCTURAL C Right A-n-�GN CLQ - N
Address ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL i $ Left se 4.0 post• tic,. 1 ea ie a-0ef` kaytp. I R
❑-OTHER Ping. Ref.# ParkingUL
Contractor's Name 0/-� Phone- _ &$ !fi -r Req./Provided E
PROJECT DESCRIPTION SQ. FT. o Co`�1CCUPA OY J� Q
Address(mailing) `r_ c I Planning Notes: - oz euii 0 COU e. M
CONSTRUCTION TYPE VALUATIONS c� ^r1.7^'^•c T
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION ``` �rf` $'
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: P �} «` 9 1
•
with section 7000) of Division 3 o} the Business and Professions Code, and \ (/ t'mdeY S/T'1 ` a t•t./Qd`iir'
my license is In full force and effect. ELECTRICAL FEES
License Class License No. ( .h.4P-1 r
I FEES
Date Signature PLUMBING Automatic Washer Transformer 0 15-50 KW
-
WORKERS'COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 0 50+KW
I hereby affirm that I have a certificate Of consent to self-insure or a certificate
' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Duo to 100 amps
0, Lab. C.) 0-
.icy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
8 Certified copy Is hereby furnished. ..
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Dryers ❑Gas ❑Electric �— Sub Panel
Date -Applicant - Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors 00.1 HP 01%-8
(This section need not be completed If the permit is for one hundred ($100) or
less). Dishwasher Solar Piping F.A.U. I c.Solar 09-15 HP 016-15+
I certify that in the performance of the work for which this permi is Issued I
shall not employ any person in any manne so as' opecome .'fact to the Drinking Fountains Solar Tank Fixtures Microwave
Workery ion Laws of Californi. .4
Date iS ��� j Signature 2- ....fle Floor Drains . • Swimming Pool w/Spat Device Boxes Pole Light '
NOTICE: If,after making this declaration, you should beco e su•ject to the Urinal Outlets Range Compensation provisions of the Labor Code, you must forthwith Floor SinksRan e _
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY I Gas Service(l .Aa)utlets Water Closet ....o_. _ Switches Sign
I hereby affirm that there is a construction lending agency for the performance I -
of the work for which this permit Is issued (Section 3097 Civ. C.) Int¢rceptOri Water Heater . Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink I Water Service ,��� Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
_- 1 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(commencing with Section 7000)of '
Division 3 of the Business and Professions Code) or that he/she is exempt Fee
-arefrom and the basis for the alleged exemption. Any violation of Section Reinspection , $15 Issue Fee $ 3
?'1.5 by any applicant for a permit subjects the applicant to a civil
•
$=n - DEVELOPMENT SERVICES REQUIREMENTS:
"4slty of not more than five hundred dollars($500). #�A' a
l,'as owner of the property or my employees with wages as their sole -Reinspection•Fee I $15 Issue Fee $ 3 Zoning Approved By 1t 4,-` Date Wales
compensation, will do the work, and the structure Is not intended or offered
for sale (SectionBusiness and Professional Code: The Contractor's MECHANICAL • FEES Building Approved By Date
License Law does notof 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 Application hued By Dat
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 SUMMARY OF EE
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground �/ Z
prove for the purpose of sale). BUILDING PERMIT $ FJ O SMIP $ . SO
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK •
tractors to construct the project (Section 7044,Business and Professions Code: - $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ 7• dV 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❑ System Repair/Alteration PLAN CHECK 25% $ / • c7 0 ENERGY P.C. $
proof of their Worker's Compensation Insurance should be provided to me, - ELECTRICAL $ GRADING $
— ED3
I am exempt under Section 13.8. P C.for this reason Firepl/Fact.Bit. ICBG* Fire Dampers
PLAN CHECK 50% $ MICROFILM $
Date taw Owner to, se" — Heating System& Ducting Registers / [��
I hereby certifyy that I have read this application and state that the above 00-100,0001-C_
100,000 BTU 0100,000 BTL— - - MECHANICAL $ TOTAL FEE $ 777
information Is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to bulldin• construction, and hereby authorize repro-
nspe Ives of this ci y to ant pon the above-mentioned property tor'
ISignature con pu(tf / /2/..,
/iXI& Date Olryig6
Drivers' License or SS - , Reinspection Fee $15 Issue Fee $ 3
01 00011040-00011043 TOT . 46.45
0865.46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 08/02/88 TIME: 14:29
I I
CONSTRUCTION AND PLANNING POOL /QA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole. 52. Pool & Equipment Location -•
_9 .
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement './
3. Electrical Conduit Utility-Undrgrnd. • - • 54. Forms .
4. Electrical Conduit-Undrgrnd. g/S/i8' G-!`" 55. Electrical Bonding
5, Steel Reinforcement �Y// 56. Rough Plumbing & Pressure Test / !'
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE `+
7. Footings ..i 58. Electrical Conduit-Undrgrnd. •, I
8. Foundation -/ 59. Gas Pipe, 0 Undrgrnd.,Test r'
9. Water Pipe-Undrgrnd. 6.460. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System r 61. APPROVAL TO DECK `
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • r•
12. Sewer Cap '•- v. 63. Heater & Vent-Final •
1. ,
13. Roof Drains Ji 64. Plumbing System - Final
14. Rough Plumbing §Jf/gg G/`!/ 65. Electrical-Final •
15. Rough Electrical-Conduit "`��� 66, Solar System-Final
16/ Rough Electric Wiring 67. Fencing& Access Approval
sir Rough Wiring Sign _ . 68. APPROVED FOR PLASTERING
118. Rough Electrical-T Bar Ceilln - 69; POOL/SPA SYSTEMS FINAL
",1:91 Rough Heating & Air Conditioning icy FIRE DEPT. REQUIREMENT
'ii
120. Rough Factory Fireplace , ' ARRROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating ' :ti 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough&.Test 72. Underground Flush
24. Roof Framing r•_ -- 73. Undergrnd.Storage Tank O Gas 0 Oil i '
25..Roof Sheathing ,_ - .74. Overhead Hydro
26. T-Bar:Ceiling (Svuctural) & Monocoat 75. Dry Chemical
27. Frarhe and Flashing 76. Dry Standpipe
28. Lathing 4/Siding.' ., • 77. FIXED SYSTEM FINAL
29. Ins9lation .. • 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . I _ 79. FINAL INSPECTION •
3'2. Electrical Power Meter-Final. 80. FORD CERTIFICATE ISSUED
33. Final'Electric ) Notes: a.:ii,_,_07.-9-
01
0' enLrf� -
lJ /*of ins - -
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test g JSlit( G-
36. Hood or Canopy l
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final. . _ - - •
40. Gas Service-Final -4
41. Solar Domestic-Final :-4--,. L•
42. Backf low Preventer . 4
43. Backflow Irrigation ? • ./, 7 1)
44. Landscape Irrigation System I %'� ..
45. Sound Attenuation - - .i:
46. Handicap Regulations , ,
47. FINAL STRUCTURE & BUILDING 0 L, -
I�
48. Special Requirements Completed I AiVs
49. Electric Release to Edison '
t .
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY 'r i.t :r
�'
No. Date '- 1
•
201;6.ROOF CONNECTIONni DEVELOPMENT DETAILS SERVICES D� PATIO COVER
ARTMENT• •
SOLID BLOCK
BUILDING SAFETY DIVISION T Y P. PLANS
CONT,
LEDGER
4 RAFTER OWNER: DATE :
ADDRESS:• PHONE:
I/2" DIA. X 5" LAG!grow _ SCR. CONTRACTOR: • LIC. NO.
AT 32" ADDRESS:
� - PHONE:
APPDROq\� O
City of Costa Mesa 13uaojng Dept. RAFTERS .
RAFTERSAPPROVED FOR
��19 CARPORT, PORCH OR PATIO LIGHT WEIGHT ROOF COVER OF BUILDING PERMIT
•
6 _ ___DATE NOT SUPPORTING CEILING LATH, FIBERGLASS, ALUM.
By Date
THESE FLANS MUST BE ON JOB AT AL1 TIMES MAKE SIZF, SPACING SPAN SIZE SPACING SPAN
NC CHANGES WI H"UTPRIOR APPROVAL OF DEPT" 2"x4" 12"O.C. 9'-6" • 2"x4" 16"O,C. 9'-6" —
CR a CL "TECO GENERAL NOTES:
16" 8'-O" 24" 8'-0"
TF=1ISSUANCE ORG:e ITWC OLLIKANGER TRUEDTO BEER 24" 1. These plans must be
PLA ER l5 ECRIF:CA IG�. 6'-6° 32" 6'-6'r
' EC.N , %NY VIOLATION OF •NY OF
THE IRO o RTI, 1�1Fy NO 'ORESUMING 0 GIVE 32" 6'-Q" 48" 5'-6° . k'epton the' job at
�.yANCER '^ S OF THIS _ i " " 16" -
24"
" . 16'_6" all time during
AU" iORITY TO VIOLA ; _ �f" '..-. 48" 5 0' 2 x6 16
CO £SHALL BE VALID, I :EFT '�-`� F T,gA-IE w.: OR USE 2"X6" 12" 16' -6" 24" 14'-6" construction.
\VF CH IT AUTHORIZE t LAWFUL 16" 14' -6" 32"• 12' -0" 2. All framing to be
HE ISSUANCE 0 . "WITH BASED UPCZN CLANS AND 24" 12' -O" 48" 10' -0" Douglas Fir N92 .
SPL:.IFIC AT40N5 SHAIL IGT�gdE�9l piE%B15iDLU5GDF$IC R! 32" 10' -6" 2 XB 24 19- O
„ ,. _ ,,.. grade minimum.
I FR' M THEREAFTER REJU.RIPICA'TE f(�'I��FQT(�9N OF ERRORS IN -
SA ) PLANJ AND SPECIFCATKJNS OR FKUM PREVENTING 8' -0"
32" 15'-6" 3.. Rafters may !oef:-
i
oU DING OPERATIONS BEING CARRIED ON THEREUNDER WHEN k 48" 42" •13'-6" p attach CO faIN 'IOLATIONOF THIS CODEFAtIY2'HER ORDINANCE OF 12"x8" 24" 15' -6" kept for lfa
rH a Y. 32" 13'-6"
48" 11'-6" as shown on details;
4"x6" 24" 17'-O" HEADERS. i. 20lWroofs must use
'OI�.OR LIGHT WEIGHT ROOFS 32" 15'-0" Y a continuous ledger
ONLY CONNECTION DETAILS LIGHT WEIGHT ROOF ONLY
36" 14'-0" attached as shown
SIZE' POST SPACING` Ion details #1 #2,
2" X FACIA -MIN. REO. 4"x8" 24" 21 ' -0" ,
32" 19'-0" 4x4. _ __ - C.-0" 4. Light weight roofs
�� _ 36" 18'-0" 4x6 9'-O" may attach to facia
pi 48" 16'-O" 4x8 12'-O" for 14' span max. ,
i_� kir 4"x10" 32" 22' -0" 4x10 .15'-O" spans over 14' must
Ns36" 21'-0" •
use a continuous
CARPORT, PORCH OR PATIO ledger as shown in
APPROVED METAL 48" 2O'-0" SIZE POST SPACING detail #3.HANGER 72" 17'-0" 4x4 5'-0"
4x6 8'-O"
DETAIL 3 4x8 1O'-O"
4x10 12'-6" GUM
U
NOTE: SHOW AND DIMENSION PROPOSED
PATIO COVER AND YARD AREAS
SEE DETAILS ON REVERSE SIDE
\ ROOF SHEATHING
ts
•
I \ _X_RAF .�....
\ AT_0.0. •
,�
N \ _X_BEAM
- C \
�� I- \ T-STRAP EA. SIDE
11ii -!� FOR POST- BEAM
�' L / L�ctfttC'L p& ;O Cover 0 \ .CONNECTION. 0w .0
EL
o p \ a F- O
7 1� Q Z Z
4X QosT- 1 $ ) CO \ N I- H a
I ' \ co H ~ 0 O i
�10J2Vrifrli I I� I ` (� -It _> a Oa CC i
o f AX)- 9. V7 \ Q -
G.zr.ce) N N o m Z �I
W 0 10 o W �'
J 0 N Z O W
fej
I \ DROP PATIO•• W LL i X 0 W O
FPROVED FLOOR 2' O o
Z m
OF COSTAMESAI \ o.m y 'a \ o C
io
I 1 SLOPE TO DRAIN I ABOVE SLAB�'� j
I FUNNING Den. 1 — . ..
aim TO 6{D0.DEPT.URco
. . . . '...�1\1; o
ar �l.M a' _ 26 GA. G.I. FLASHING? N 1 I
a WOOD FLOOR __ J
CONSTRUCTION PIERS 12" SOJA o
4
¢
/1/_ �}ve. i
STREET SIDE ELEVATION
PLOT PLAN CONSTRUCTION DETAILS
.., 95 C' /av ��/- Applicant to in all spaces except those within heavy border lines and sign all appropriate declarations. ,
PET NO, 739 TRACT NO. LOT NO. UNIT NO.
CPTy OF COSTA M.Eine CONSTRUCTION PERMIT E 3• A.P.# Zone
ProjecrAddress s ss y "'- `n r A// ' gz. - S Main Building: Accessory Building:
. Applicant's Mailing Address d�S.44010(a/ATYPE OF CONSTRUCTION NEW ADD ALTERATION I_J REPAIR
/'1 /s/ /y�,' U U U CONVERSION 0DEMOLISH' 0 OTHER T Front 0
Owner's Name '�!: i - -- - �PhoneS yL-SGOf 'DESCRIPTION OF WORK/USE OF BLDG. B Rear N
Address 4 -- - ea - - / '/ - e/4Gi4A4' /�/44A e ci44a iCf! ,A I
TYPE OF PERMIT CUJ__GRADING Lal FOUNDATION [� STRUCTURAL C Right N
Arch/bng. License No. K - G
Address ❑ TENANT IlIa ELECTRICAL 0 PLUMBING ❑ MECHANICAL S Left -
/I1 i.�(54 (.4/Phone ten:-iLOSb ❑ OTHER Ping. Ref.# Parking Req./Provided E
R
Contractor's Name/r,�Rt//i7 CPS, �sA PROJECT DESCRIPTION SQ. FT. OCCUPANCY PlanningNotes:
Address(mailing)WS— p�JOWA �// '"/C'� G�og M
�iI y CON STRUCTION TYPE VALUATIONS `^ / T
City License No. ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: •
with section 7000) of Division 3 of the Business and Professions Code,and
my license is In full force7 ntl 5ifect. ELECTRICAL FEES
License Class ��yy L"� c e N Y/ 4Y/
Date/0--a -fat Signature •�'`f�s= � PLUMBING I FEES Automatic Washer Transformer ❑ 15-50 KW
WORKERS'COMPENSATION DECLARATION Construction Po le Sub. ❑ 50+ KW
I hereby of firm that I have a certificate of consent to self-insure or a certificate (Bar Sink I Showers
pi Workers' Compensation Insurance, or a certified copy thereof (Section I{Backflow Preventer Service Sink Cooking Unit Meter ❑,,,�ulp to 100 amps
7,;;70, Lab. C.) Dishwasher t Meter Id fiver 100 amps I$ /I
`i'Jcy No. Company Backflow Irrigation Sewer Cap /- �v
yI 1 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
LI Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant . Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION
Clarifiers Solar Collectors Motors 0-1 HP ❑1%-B
(This section need not be completed if the permit is for one hundred (5100)or Dishwasher Solar Piping F.A.U. Inc.Solar 09.15 HP ❑16-15+
less).
allcertify thatm in the person performance of the work for which this permit is t to I Fixtures Microwave
shall not employ any person in any manner so a becom subject to the Drinking Fountains Solar Tank
Workers' fz�np¢ SatlPa Laws a Calltq/�ja,
Date /a bt4a Signature //�I.-� Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE:If,after making this declx atlon, you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
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 Generator 00-5 KW ❑5-15 KW Trash Compactor
Lender's Address Kitchen Sink Water Service
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(commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she Is exempt Reinspection Fee $15 Issue Fee ' S Sic
therefrom and the basis for the alleged exemption. Any violation of Section
- '1.5 by any applicant for a permit subjects the applicant to a civil
ity of not more than five hundred dollars(5500). DEVELOPMENT SERVICES REQUIREMENTS:
as owner of the property or my employees with wages as their sole I Reinspection Fee $15 Issue Fee $ 3
Zoning Approved By Date
compensation, will do the work,and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Dat
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 Boiler Hood or Type I ❑ Application Issued By Dat /
employees, provided that such Improvements are not intended or offered for
. sale. if, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ SUMMAR OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
prove for the purpose of sale). BUILDING PERMIT $ SMIP $
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ 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 00100,000 BTU 0100,000 BTU PLUMBING • $ ISSUANCE $
builds or improves thereon.and who contracts for such oroiects with a con- ' ENERGY P.C. $
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ 1
proof o// their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ 33•s� GRADING $
0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers MICROFILM $
PLAN CHECK 50% $ ,l
Date Owner Heating System& Ducting Registers MECHANICAL $ 3
I hereby certify that I have read this application and state that the above 00-100,000 BTU ❑100,000611. TOTAL FEE $ 3•S(�
_
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of/this tiff jt�•nter upon the above-mentioned propertyfor
ISignattion urre /iL• e2 4 Date/O./14i
Drivers' License or SS 9f Reinspection Fee $15 Issue Fee $ 3
01
0865-46.rev.5/B8 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor DATE:
10 10/18/3501735E TOT 33.50
lEl23 'tIflE: 15:21
CONSTRUCTION AND PLANNING POOL P "A
r APPROVALS Permit# Date Inspector APPROVALS Pern.,.# Date Inspector,
1' Tempora- Electrical Service or Pole ti' 52. Pool & Equipment Location
2. Soil PipA'Undrgrnd. , -• 53. Steel Reinforcement
•
3. Electti,jl Conduit Utility-Undrgrnd. ,, 54. Forms
4.I'Electrieal Conduit-Undrgrnd. I 55. Electrical Bonding •r
5. St?ellRe(nforcementi„I, - 56. Rough Plumbing & Pressure Test
6. Elect?ical UFER Grni ✓ 57. APPROVAL TO COVER-GUNITE
7Fdotings• •1 58. Electrical Conduit-Undrgrnd.
•
8. Foundation 'I LI '� 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrfj'rnd. • 60. Backwash Lines, P-Trap, O Undrgrnd. /;•'
10. Structural Floor System 61. APPROVAL TO DECK
11. PrOpert) Sewer Line & House Connection 62. Backwash & Receptor-Final
Line,
•
12. Sewer Cap • ' - 63. Heater & Vent-Final •
•
13. Roof;Drains 64. Plumbing System - Final it
14. Rough Plumbing I 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
7716. Rough Electric Wiring 67. Fencing & Access Approval
rt7. Rough Wiring Sign 68. APPROVED FOR PLASTERING
'•18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
59. Rough,l-leating & Air Conditioning FIRE DEPT. REQUIREMENT
Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, 'entilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe;Rough & Test - 72. Underground Flush
24. Roof Frjming 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 j 79. FINAL INSPECTION
32. Electrical Power Metdr-Final _21_99 to 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 ft/
43. Backflow Irrigation
'I
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING
1
4R. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co '•�
51. CERTIFICATE OF OCCUPANCY •
Y•
No. Date •� ' -�
PROJECT ADDRESS: 295 E ; 6TH ST UNIT: 5212 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 05829:
OWNER'S NAME: SWIFT, IOM
ADDRESS: 295 E 16TH ST PERMIT NO: N 038292 PLAN CHECK NO: N GOUT: N SUPP; N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC PURPOSE: 0TH
( 714 ) 631-6275 •
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : EAU CHANGE—OUT & A/C ADD—ON SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: GRAHAM BROTHERS (714 ) 546-1653
ADDRESS: 2952 CENTURY COMMENTS: *
COSTA MESA CA 92626 '•. ***x***** ****tic*; ***ittt;f*It****XE********Ti•***XESE* * •* *****x******** t•***aE********N-V:
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITYLIC.: 005963 STATE UC.: 24860' cuss: C-2!1
Date: ' €1-0- Signature _ MAIN BUILDING ACCESSORY BUILDING
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
WORKERS'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 IN RGHT: FT IN
Compensation l u g0 e a a certified_ thereat(Section 3800.Lab.�l
POLICY NO.: ! 61030216 EXP. Vo/01 /92
^` 1
COMPANY: LIBERTY MUTUAL PARKING REO: PROV: PARCEL ; 42516413 ZNE: REF NO;
0 Certified copy is hereby furnished. af Certified copy is filed with the city Building DNisioPLANNING N TES>
n or ^ >
--- date: 1 • 24 • \Z MpticanL_(K/E^'�--. 1 l .� 7--�r ***********************************al************N****************>'*******ae*****
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (DIS section need not be completed it the permit is for one hundred(S100)or less). DEVELOPMENT SERVICES REQUIREMENTS
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. ZONING APPROVED BY • DATE;
Date: Signature: BUILDING APPROVED BY
NOTICE:u,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor - DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �/
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: L� Amy'
,.�„ DATE- 7 / �j
which this permit is issued(Section 3097,Civ.C). *********************4 - - - ...":" 4".7'4- - - ' ' ''4 • . • •:•*************-F7 . . x^s...
LENDER: **********************************************. *******************************
ADDRESS: LEGALIZATION; N F E E ' S U MIM A R Y STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I 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 18 , 00
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5't SMI P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN
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 penalty of not more than live hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the property or my employees with wages as their sale compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS 1 B , 0 0 1 5 , 00 �- 0. 00 3 , 00 33 . 00 . , 00
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 : 33. 00 OVER/SHORT: 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve
rol
the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
lir
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33 .:00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projectswith a contractor(s)license pursuant to the Contractors'State License Law).l am aware *'N'******:Y.***************************lf****V.*****I(1i***T(***********)(.*1(.***1e ii*iF*****
that proof of their Worker's Compensation insurance should be provided to me. INDI V I D U A L • F E E BREAKDOWN
❑ I am exempt under Section: B.6 P.C. r
for this reason: TYPE QTY DESCRIPTIQ N. UNIT COST TOTAL COST
Date: Owner: MEC 1 INST FORC—AIR/GRAV(IFURN <=- 100 K BTU 9 , 00 9 , 00
I do hereby certify mat I am aware of and understand the requirements al California Health and Safety Cade Sections 25505,25533,and NEC 1 REFRIGERATION SYSTEM''' <= 100 K BTU/H 9 , 00 9 , 00
25534 and that 1 or any future building occupant w01NriB not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit los construction or modification from the An Quality Management District.Residential construction applications are exempt from
these provisions. I rI
Date: Applicant: .
ui
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 budding construction and hereby authorize representatives of this ' to enter upon the above-mentioned
property for insp�ecctio purposes. ^ F
------ Date: '7' / 4. -�Z Signature`] ! SL �J+ .
s
Driver's License or Social Security n: .• _ r
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
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 IIII
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,
t0. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House.Connection - 62. Backwash & Receptor-Final
12. Sewer Can 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 1 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 a
. 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 PREY. 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: 7lnitig 1(0 OPtC lio4RC- UCFTC/le o-Ute)
34. Final Heating& Air Conditioning .//y/ Ail-R/iO/�{ 1 (`},o owe 6}omE-
35. Final Gas Pipe-Test l ,/7I $!!ZY(92 N-to OKC.140net t-- C -Lc0
36. Hood or Canopy
C//v71-22, � �4-sext_- I CY
37. Final Factory Fireplace
38. Final Plumbing •
39. Water Service•Final
40, Gas Service-Final
41. Solar Domestic.Final
42. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
1
PROJECTADDRESS: 295 E 16TH ST UNIT: \IT\ CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06385 /
OWNER'S NAME: SWIFT, TOM ADDRESS: SWIFT, KELLY PERNO: P 063857 PLAN CHECK NO: N 1GOVT: N SUPP: N ip 295 E 16TH STCOSTA MESA, CA 92627 CONUCTION TYPE: PERMIT TYPE: PLU ! PURPOSE: OTH
ARCNJENGINEER: REG.NO.: JOB DESCRIPTION : GAS LINE FOR FIRE PIT SQ FT:
ADDRESS: UNIT:
A CLAIM VALUE: CALL—VALUE: GROUP OCC: /
1 i PERMITTEE: KELLY SWIFT ( 714 ) 631-6275
ADDRESS: 295 E 16TH ST COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
C.M. CA 92627 *********************+r*********+E*********x*************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U I R E M E N T S
70001 0l Division 3 of the Business and Professions Code.and my license is in full force and effect. e.,'
SETBACK S
CITY LIC.: STATE LIC.: CLASS:
MAIN BUILDINGACCESSORY BUILDING
Date: Signature: FRNT: FT IN REAR: FT IN -FRNT: J FT IN REAR: FT IN
WORKERS'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:. 4 FT IN RGHT: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). -
PCOMY PANY: EXP.DATE: PARKING REQ: PROV: PARCEL; 4251691/3 INE; R2 REF NO:
COMPANY: 0
0 Certified copy is hereby furnished, 0 Cemeedcopy isfiled with the city Building Division. PLANNING -N TES> CONSTRUCT CONCRETE PATIO SLAB- ANI' A RAISED BARBEQUE PIT.
> I
**********'*************************************** ****************************** !
date: Applicant' DEVELOPMENT S E R V I C E S R E U I R E M E N T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This ssection need not be completed if the permit is for one hundred($100)or less). L Q
•
I cenily that in the performance of the work for which this per it i ssued, shall note any person in any manner so as to become
subject to the Workers'CC�pmp2ensation Laws of California. ZONING APPROVED BY DATE:
•
—1 Date: �' 1 — ` 7 Signature: + BUILDING APPROVED BY : - '• ., DATE:
NOTICE:II.after making this declaration.you should become subject I 1 Workers'Compen lion provisions of the Labor . . -
Code,you must forthwith comply with such provisions or this permit 5 be deemed revoked. • s
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; ' DATE: °L(7 i al S
which this permit is issued(Section 3097.Civ.C1. ********************************************* **********IF************ *********
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E S U M MARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'Stale License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ' -
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter.improve,demolish,or PERMIT 5. 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5$ SIIIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
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 penalty of not more than five hundred dollars(3500). ISSUE FEE 20. 00
I, as owner of the property or my empployees with wages as their sole compensation, will do the work and the BUILDING—DIV—> PERMIT ISSUE PLANTCHECK TOTAL PAID DUE
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The ContractorsState License Law TOTALS----> 5. 00 20 . 00 0. 00 25 . 00 25 . 00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through • Ir
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 : 25. 00 OVER/SHORT• . 00 f._
improvement sold
de ffs sale).
eone year of comvletion,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 mpurpose t.
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25 00 /
❑ and Professions Code: The Contractors' LitensoLaw does tapply t an o ner of propeSwho cense improves thereon
and who contracts fr such projects with ncontractor(s)
o e aidoesepursuant
papat to the Contractors'S S.e License Law) l em aware
*******************************************************************************
that proof of their Worker's Compensation insurance should be provided to •. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
tor ni5 reason: ' TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: q '�- 9.3 Owner AII.1 ii. V PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5 . 00
JI do hereby certify that I am aware o1 and understand the requirements of California Health and .lety Code Sections 25'1 .25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with 5 v state codes and the requirements for a
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from 'Y(
these provisions. 7;
- i
Date: Applicant: EXPIRED
I hereby certify that I have read this application and state that the above i formation i•corr. I.I agree to comply with all city and county ..
ordinances and state laws relating to building construction an.her.y au a ire repress tatives I this city to enter upon the above-mentioned E1cORV to Inspections
properly for inspection p rposes. I
(� 01 00146444-00146494 TOT 25.00
Date.��'l5 Signature: . J# Al . I� OrM Sig 4 • .. DATE: 09/07/93 TIME: 15:13
Driver's License or Social Security b: X
164146 White—Building:Green—Code Enforcement,Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 9.
ill s. s• ‘..'
CONSTRUCTION AND PLANNING POOL ?A
Date Inspector Date Inspector
APPROVALS Permit;
APPROVALS Permit d`- _ ,
' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Locat on .
•
2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgrnd. 54. Forms •._r
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
_
5 Steel Reinforcement 56. Rough P!urr.hng & Pressure Test
o Electr:ca' LIFER Gr nd , 57. APPROVAL TO COVER GI i%1TE -,
i i
7. Footings 58. Electrical Cordut•Urd!a no._
8. Foundation - - 59. Gas Pipe, ❑ Undrgrnd., Ttst _I L - J
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. - _
10. Structural Floor System .� 61. APPROVAL TO DECK _ -_ I •
1 11. Property Sewer Line & House Connection 62. Backslash & Receptc •Fi ir' I I`
12. Sewer Cap -- J •� -' '-
63. Heater & Ve��t-F;na'
•
-
-3 Roof Dra ns 64. ?lambing System F.••al
14 Ro..g'n Plumhin3 65. Electrical-Final
15. Rough E.ectr•cal-Conduit 66. Solar System-Final •
16. Rough Electric Wiring 67, Fencing & Access Approval . _
17. Rough Wring Sign 68. APPROVED FOR PLASTERING -.
18. Rough Electrical•T Bar Ceiling 69. POOLtSPA SYSTEMS FINAL -
19. Rough Heating & Air Corditoning FIRE DEPT. REQUIREMENT r
•
20. Rough Factoty Fir'eplace '
( APPROVALS. ' Pelmit -';_ _
• 21. Ducts,in Sty-retort j 70. Underg.cunt.cHi,mo ----
�. 22. Ducts, Ventiluting
71. Product Piping CI Gas L-Oil
.
23. Gas Pipe-Rough & Test pi � f�!+r' (4/7/L1� 72. Undc:grcand FGus1
.
-._-_-- ------
24 Roof Framing ---- -- I 73. Undcrgrnd_Slorane 7..nk ;7 Gu .s _ Uii -- --
25. Roof Sheathing - 74. Overhead Hymn - ' I- -
26. T-Bar Ce'l.no !Structural'. & Monocoat 75. Dry Chemical
77. Frame and Flashing . 76. Dry StanJp-ra t• _
28. Lath•ng•& S`dr0: I 77. FIXED SYSTErvi FI¢IAL 4
29. Insulation ' - •• 4 1 I 78. FIRE FREV. F `VAL }I
33 DryviafT .Nailing' ' • I . • HEALTH DEPT. REQUIREMENT
31. Piaster grovrn Coat _- -_ I 79. FINAL INSPECTION_ • -- - I _ --_I r
32. Electrical Po.:er Me'ar•Final I i _ B0. FOOD CFHTIF KATE :F_Sll! D - I---
33. Final ElectriIc ; NutesrceldiQj q101cZeaep-(-- ct,vt•c.. Opu Gvb;(¢A(
I ' ----------------.r- -:
34. Final Heating& Air CoJ.titaning - py_ L.G;�r
35. Final Gas Pipe-Test •, •t~'-- t
36. Hood or Canopy i • -�-^�� _ -- �- - ~ -
37i Final Factory Fireplace ./ X I 1
RFO 1. .
38. Final Plumbing ��• f ,nSp_-I I •
39. Water Ser yice•Fin I - '"rCrim
40. Gas Service-Fina. . - i �'
41. Solar Domestic-Final • • I
a2. Bacuflov. Preventet ;-�-+T -
I 17
43, Backf low Irrigation i '
44. Landscape lirlgatton System - � •
• 45• . Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING __• -- -- -_--- J
1 _
{ 49. Electric Release to Edison -
-
II 50. Gas Release to Southern California Gas Co I I
51. CERTIFICATE OF OCCUPANCY
_- _--
INo. Date - - - -- _
I
i
RIGHTMYER CONSTRUCTION
Masonry Contractor Lic. 637516
174 Broadway#B y
Costa Mesa, CA 92627
Phone/Fax (714) 650-5393 9-
Pager (714) 479-7550 -p o-7P.�
1 ) t Lc P.t.. 3c
I2 rAir) \
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X.
' 00 Gat 1\\V‘L • r 1
m
74 7 p de 6� L 6- ! xI x ti
gt4 ,
oHMNYM JO 10133110 r r
on 6M 01 1}7rUif 15 of„/
1d30 ONINNY1d ,f;�i 3 t
153W V1S0) dO Al:: . d
ir�0 �d Fen,
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— 46 L P PL
X75 1G s
Cgsta Mesa Building Department APPLICATION FOR PERMIT
r 111 EAST 20th STREET 2413 BUILDING 1
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
Building 3 O 9
Address 295 Sixteenth Street �,° 7 Kl
Costa Mesa, California %7?d ed by Date Re/ Date Issue
Nearest vZ �0 `� ad-//odd S�
Cross St. Santa Ana Avenue Building
Address
Owner Cyrus H. & R_ MerlA ('.atee Costa Mesa, California
Mail
Address 306 Ramona Place Nearest
Tel. Cross St.
City Costa Mesa No.Li 8-7976 Zoneed l/No.of Type . / Group
Architect or Lie. J� I Plans �0
Engineer Carlson & Middlebrook. Approved
Date I
Address Garden Grove CORRECTIONS r
City Lic. 2707Contractor Dike & Colegrove No.
Address 419 E. 17th St., Costa Mesa
Legal Lot
Description I No. 12 I Block I Tract 2934
(Attach Metes and Bounds)
No.of Bldgs.
Size of Lot 551 x 1111 I Now on Lot none o
Use ofNo.of No.of - 4 - A
Existing Bldg. none I Familiesl Rooms 5 c
Setback Line from Rear Yard 291 . 0 2
Center of Street 50* Side Yard 101 D
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I .
Repair I I Moving I I Demolish I __
Building No.of
�
Size 1017 sq. fispoms 5; Stories 1 __r
Exterior Wall Roof
Covering Fr. Stucco Covering Comp. APPROVALS
Use of New
Building Single Family Residence & Garage Foundation Location Inspector Date
Forms,Materials,
Under-Pinning
Plan # X51BR Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is correct and agree to comply Lath.Ext
with all City Ordinances and State Laws regulating
building construction.
Signature of Plaster, Int.
Permittee
or 4 Plaster,Ext.
Authorized Agt. eu,
Masonry Reinforced
Valuation Permit Fee $ a O—
Plan Check $ /0 — Bond Beam
$ B4OOO.CO Total
Fee $30— FINAL
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• I.4 �- ?;4 ?0,r0
•
•
•
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- - 1
Street .. - u
til .
PLOT PLAN
Show location and distances from
property line and between buildings. •
•
•
r