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HomeMy WebLinkAbout110 16TH ST - Building Permits PROJECT ADDRESS: 110 E 16TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT rani. ncJ; O Goi »< OWNER'S NAME:MICHAEL SHEEHAN ADDREss: 1665 BABCOCK PERMIT NO: B 061352 PLAN CHECK NO: N vuv J : av sur? : or COSTA MESA, CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: DEM 642-0054 ARCH/ENGINEER: REG,NO.: JOB DESCRIPTION : DEMOLISH NONBEARING WALLS SQ FT: ADDRESS: UNIT: CLAIM VALUE: 1 , 000 . 00 CALL-VALUE: 1 , 000, 00 GROUP OCC: B-2 / PERMITTEE:ROBERT EGER ( 714 ) 650-8598 ADDRESS: 114 E 16TH ST COMMENTS• REMOVE WALLS AFTER TENENT VACATING PREMISES C.M. CA 92627 ########4##################################################x################### LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7600)of Dmsion 3 of the Business and Professions Code.and my license is nt fig force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: MAIN BUILDING ACCESSORY BUILDING Date: Signature: 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 sell-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation Insurance.or a certified copy thereof(Section 38W.Lab.C). POLICYNO.: EXP.DATE: PARKING REQ- PROV; PARCEL: 00000000 ZNE: REF NO: , COMPANY: PLANNING NOTES> o Certified copy is hereby furnished. 0 Certified copy is tiled w th the city Building Division. > ######*if###*if####################SI*########################3F########iHF*if###ie#it* Date: Applicant: DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (T -- •,need not be conp4C. ' e permit is for one hundred(5100)or less). I certify that in the performance of the work for which this pe - ued.I all no em ry an. r, .. . • so as to become ZONING APPROVED BY DATE; subject tjrhe Workers our enation Laws of California ' Date:•-/Z =1 Signatur .CA�.� e : _ .--- ' BUILDING APPROVED BY : DATE: NOTICE:If.alter making this declaration.you should become subject to t• orke's' ompensation provisions of the labor • Code.TIO must DINGvG comply withsuchirm that t e this permit be deem:• ency o. APPLICATION ISSUED BY: 'TY ` DATE: 73I17-19. 1 CONSTRUCTION LENDING AGENCY: t7ereby affirm that there5acon5V ton lending agency for the performance of the work for ##############################-###########%##fryr#################sex-###.#;,W######## which this permit is issued(Section 3007.Civ.C). LENDER: ##################################################N'#################-x-i4. ######## ADDRESS:NO OTHER WORK AUTHORISED LEGALIZATION:N F E E SUMMARY STRUCTRR`AL';SEGMENT:Y OWNER BUILDER DECLARATION: thereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/REST GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 25 . 00 repair any structure.prior to its issuance,also requires the applicant for such permit to Ile a signed statement that he/she is licensed SMIP/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 . 50 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any 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($SW). BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 25 . 50 50 0 . 00 0 . 00 00 25 . 50 25 . 50 . 00 ❑ structure is not intended or offered for sale(Section 7044.Business and Protessional Code: The Contractors'Stale 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.II.however the building or REVENUE DIVISION TOTALS--> COLLECTED: 25. 50 OVER/SHORT: • 00 improvement is sold within one year of completion,the comer wig have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN-CHECK for the purpose of sale). 25 . 00 . 50 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code: The Contractors Slate Lkense Law does not apply to anovmer of Property who buld5 or improves thereon ###-if.1e##,xi(-##-*****####.x##*M.N.###.*##.##.*****.##.##.#-###'x#,#################ie###H,#ii###### and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance shout be pro'i.• : - INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. / for reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST -(7-9S- r Date: Owner- LY.. .� .�j NO FEES WERE SELECTED FOR THIS PERMIT I do hereby certify that I am aware of and understand the requirements of California Health :'sale Code Sections 25505.25533,and 25534 and that I or any future building occupant will/will not(Circle one)need to comply wit,sat: ate codes and the requirements for a permit for construction or modification from the Air Duality Management District.ResicI/rat construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state t,. rive infer alien is • : I.I agree to comply with alt city and County ordinances and state laws relating to building construction. iautlbrQ' epr sen.tiv:,,of this c .rove-mentioned properly for inspection poses. Date: signator. '� - All( - _ - L Driver's License or Social Security# - 1641.46 While—Building;Green—Code Enforcement:Canary—AppI.:nt:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING - PO ' SPA APPROVALS Permit--f` Date Inspector APPROVALS Permit ;k Date I Inspector • 1. Temporary Electr.cal Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -_--J 3. Electrical Conduit Utility-Undrgrnd 54. Forms 1 4. Electrical Conduit-Und&grnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrarnd. I ! 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 1I l 9. Water Pipe-Undrgrnd. I 60. Backwash Lines,P-Trap, it Undrgrnd. 10. Structural Floor System . 61. APPROVAL TO DECK . -~--t 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -- --1 I 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final A 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final { 16. Rough Electric Wiring 67. Fencing & Access Approval I • 17. Rough Wiring Sign I 9 968. APPROVED FOR PLASTER' 1 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Firep'ace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas CI Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 01; __ 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 I 77. FIXED SYSTEM FINAL 29. Insulation I I 78. FIRE PREV. FINAL -{I 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT 1 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -I 33. Final Electric Notes: 34. Final Heating & Air Conditioning _, 35. Final Gas Pipe-Test • 1 36. Hood or Canopy ___i __' ___� 37. Final Factory Fireplace 38. Final Plumbing I 39. Water Service-Final 40. Gas Service-Final i 41. Solar Domestic-Final i 1 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation i 46. Handicap Regulations 41;- 1 47. FINAL STRUCTURE & BUILDING / `/p� 1 48. FINAL PLANNING l 49. Electric Release to Edison • 1 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date europoon cY& soles & roftorotion • 1665 BABCOCK , COSTA MESA , CALIFORNIA 92627 TEL ( 714 ) 642 - 0054 • FAX ( 71 4 ) 642 - 1205 March 13, 1993 I, Michael Sheehan, owner of the building at 110 E. 16th Street, 7 Costa Mesa, California, authorize Robert Eger, tenant at the premises, to remove all non-bearing interior walls from 110 E. h Street and to remove all debris from same premises. Mic ae de enamor ,4 PROJECT ADDRESS: 110 E 16TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: F 061357 OWNEWS NAME:LEWI S BROTHERS BATTERY ADDRESS:SAME PERMIT NO: F 061357 PLAN CHECK NO; 00770-93 S GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N PERMIT TYPE: FIR PURPOSE: 0TH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : BACKFLOW RETROFIT SQ FT: ADDRESS: UNIT: CLAIM VALUE: 5, 600 .00 CALL-VALUE: GROUP OCC: B-2 / PERMITTEE: FIRE STOP ( 714 ) 569-0016 ADDRESS: 1253 S. WRIGHT 0 COMMENTS: NO PRIMARY PERMIT ON FILE, ' F' WORK ONLY! SANTA ANA CA 92705 *�E)r>E**#+E*****x >EN- ***it�ETE�f -* �E�fkf*****#* *********+fly**g ****>Ex***** <#*aE+f*Tf****** ** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 70110)of Division 3 of the Business and Professions Code.and my license is in full force and elfect SETBACKS CITY LIC.:042116 STATE UC.501419 cuss:C— € 65, r- 7-7e.."-7---..__� ,- MAIN BUILDING ACCESSORY BUILDING Dale: - lZ` _ Signature: 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' Compensation Insurance.0r aertifl d copy thereof(Section 3800,Lab.C)„ LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PDLICrND.:PWC182643 EXP.DATE: 05/15/93 CDMPANr:GOLDEN EAGLEPARKING RE • PROV: PARCEL : 42436112 /.NE: REF NO: ❑ Certified copy is herebybyfurnished. ® Certified copy is filed with the city Building Division. PLANNING NOtES> Dale: '3_(Z __E.3 Applicant ���/� r ** -*****?f********3E*****************If************RI**-lE**********************?f** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (1s section need nal be completed if the permit is for one hunprd($100)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 man er(r so as to become subject to the Workers'Compensation Laws of California. ZONING A•PROVED BY j_ DATE: Date. Signature: .1 NOTICE:II,after making this declaration,you should become subject to the Workers'Compensat provisions of the Labor BUILDING APPROVED BY : r /[�� I l/ DATE: 3 r/( 73 Code,U TIO must foDING G comply with such firm that this permit shah be deemed revoked.f ^ 5 1- DATE: e.3 CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: • / 2/� j. �qI( Aff which this permit is issued(Section 3097.Civ.C). ************************.. /r * * f*** ./***7f%* - *********** - •***./t .*'ft** LENDER: **************%***************9E*-*7E*iE*** �E****/********lfk***********ii***iE****** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N 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 81 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 65* SMIP/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 52 . 65 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(S500). ISSUE FEE I. as owner of the properly or my employees with wages as their sole 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----> 81 . 00 0 , 00 52 . 65 133 , 65 133 . 65 . 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 sate.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED• 81 . 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 • for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 81 . 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 projects with a contractor(s)Iicense pursuant to Me ContractorsState License Law). l am aware **************%*************X************************'*X*******X'X*'X-*'*********X*** that proof of their Worker's Compensation insurance should be provided to rhe. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: FIR 81 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1 . 00 81 . 00 I do hereby cenify that lam 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 will/win not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from theseprovisions. Date: Date: Applicant: • 1 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 erste upon the above-mentioned . property for inspection purposes. Date: 20L-L-_12. - 9J Signature: "��� T - Driver's License ar Social Security.: 1641-46 While-Building;Green-Code Enforcement:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POO SPA APPROVALS Permit Date- _ Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd.': 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings I 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. .Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. : I 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 . t 64. Plumbing System - Final .� 14. Rough Plumbing 65. Electrical-Final -1 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 . ~I 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 4/4.d33 Wye • 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 •Vtill LuVI, I 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . i 79. FINAL INSPECTION l 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 - 1 38. Final Plumbing 39. Water Service-Final 4 ' --H 40. Gas Service-Final 41. Solar Domestic-Final __ f 42. Backflow 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 • i . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5193 •Gtateof California OPTIONAL SECTION mows CAPACITY CLAIMED BY SIGNER County of Orange Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the document. 12th of March Kathleen Chauser ❑ INDIVIDUAL On cetore me, DATE NAME,TITLE OF OFFICER-E.G.,"JANE DOE,NOTARY PUBLIC" Michael Sheehan ®CORPORATE OFFICER(S) personally appeared NAME(S)OF SIGNER(S) TITLE(S) personally known to me -OR -0 proved to me on the basis of satisfactory evidence ❑ PARTNER(S) LIMITED to be the person(s) whose name(s) is/are El GENERAL subscribed to the within instrument and ac- ❑ATTORNEY-IN-FACT knowledged to me that he/she/they executed 0 TRUSTEE(S) the same in his/her/their authorized ❑GUARDIAN/CONSERVATOR capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), ❑OTHER: • or the entity upon behalf of which the • person(s) acted, executed the instrument. SIGNER IS REPRESENTING: WITNESS my hand and official seal. NAME OFPERSON(S)ORENTITY(IES) SIGNAT OF NOTARY OPTIONAL SECTION THIS CERTIFICATE MUST BE ATTACHED TO TITLE OR TYPE OF DOCUMENT THE DOCUMENT DESCRIBED AT RIGHT: NUMBER OF PAGES DATE OF DOCUMENT Though the data requested here is not required by law, iould prevent fraudulent reattachment of this form. SIGNER(S)OTHER THAN NAMED ABOVE ©1992 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184•Canoga Park,CA 91309-7184 OWNER Lorenze Spitz DATE 3-23-54 93 JOB ADDRESS 110 E. 16th St. BUILDING PERMIT NO. 146 GENERAL CONTRACTOR Owner-Builder VALUES 650.00 LOT BLOCK TRACT Addition GROUP G TYPE V ZONE 11-1 FIRE DISTRICT App#156 • PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR _ DATE NUMBER Footing Trench _ Foundation Forms and Grade to Garage _ Rough Framing _ Plumbing, Rough to Slab Plumbing,Rough Complete _ Temporary Pole ,�// er Wiring, Rough )L!/« _ "1/2/..//4/R> A1417:7; '� /c -3-ArAir 11-41 Heating,Rough _ �, t Heating, Final _ Sewer ��. + Septic Tank or Cesspool I r - 1� Lathing I_ Plastering .. Plumbing,Final,Fixtures Complete 410 Plumbing, Final Gas Test _ _ Wiring,Final , Occupancy '� / I Form 210 C-H Ili 12-53 Costa Mesa Building Department i56 APPLICATION FOR PERMIT 111 EAST 20th STREET _ _ B .0 I.LD1 N.G _ .. .. _1 f� COSTA MESA, CALIFORNIA — FOR OFFICE USE ONLY ' iFOR APPLICANT TO FILL IN Receipt No. Permiit/t.No. ; Address i (o (._ . IC S t . 09 AZb Costa Mesa, California Received by. Date Recd. Date Issued Nearest - /y37/ Cross St. SUPeRleo2. Building Address ' Owner Loaalam Sc'1 7 Z_ Costa Mesa, California Mail a p Address ( .I (5 N . r01 t'3S E TTA 0R— . Nearest To. Cross St. Lie Zone 1M F I I ro r No.of City LO$ ANGELES I Type I G Architect or Lie. Plans Engineer \ No. Approved • Address 4 '`~ O w N r IL �t% t t r by COII'RECTIONS aze 7� City Lic. antractor No. • Address Legal I Lot Deikription I No. I Block I Tract (Attach Metes and Bounds) No.of Bldgs. Size of Lot CaO S. t ea O I Now on Lot I Use of No.of No.of o Existing Bldg.VL ASTICS I Families I Rooms tj-\R /' 3 i9b'� 9 1..�. O Setback Line from Rear Yard - - Z Center of Street • Side Yard DESCRIPTION OF WORK � 5 �—CfriC4ASNT—r• New I Alteration I) I Addition I 1 ' Repair I I Moving I I Demolish I _ .• Building No.of ' Size Rooms Stories r -prior Wall I Roof • _ring Covering APPROVALS • Use of New Foundation Location Inspector Date Building Opt, trits . a F L4)reltio("C'. Forms,Materials, p L.sC. aewe,hiG /zoom__ (a's1c%`' Under-Pinning Frame: Fing,reBolts Stops, -t ks ) -Sties! gL��'40 X Lob Braci Lath. Int. I hereby acknowledge that I have read this Application.' and state that the above is correct and agree to comply Lath. Ext. with an City Ordinances and State Laws regulating ' building construction. Signature of Plaster, Int. - Permittee Plaster,Ext. Authorized A• rS a_1. ` Masonry Reinforced Valuation • Permit Fe$ � O 4:4„?. Plan Check $ / V- o Bond Beam ,. $ ` Total FINAL /2/ An-o7 ]- -- Fee $ u C o j E J d 2 o a S. a • Street PLOT PLAN Show location and distances from property line and between buildings. • ,'TF• 24666 CITY OF COSTA MESA COSTA MESA BUILDING-SAFETY DEPARTMENT SEP 1 1965 ? P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 For Applicant to Fill In Completely IDA It SFOR 'EMT•ER TYPE OR PRINT — rt •� ING // © J � I For Office Use Only ADDRESS RECEIPT NO. PERMIT4 NP.i, / --,44 COSTA MESA, CALIFORNIA G6'IF/' /��) J �([j l' `,,'ter R[ F.Rnc[I/y[o- TE ISSUED' OWNERL e/VU4x 64 eCy CA rA C. ! �/ `Ys 1 ../... l�S MAIL ADORES! // U L / ADDR IN (/ } J FIRE cITY --0 SCIA-///111 e Y TI`�Y.1-'12512 ZONE r ,�.{ 1'YP � GROUP Q ARCHITECT y � TEL ' BYPROV[D4�j 1 J / ,/ DAT J- UL �ENOINEER/X Q.(//✓ NO. 'ICJ{�// i l ZONING ADDRESS ,�///f���� 1 :..4144-:,��4 I+` V `+ 2qq .- 1 I NO.O. � I Ye[OrN _L.Lm� �Ne USED NO ���9 �/(L,� CONTRACTOR (LlLI/L/ DEEc[m(ON O'!Jic cots/ �{�1 LEGAL ADDRESS lJ ttei4-32� (] CITY A.P.NO. 117 -07/ -0 NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL. SO'TO SIDES REAR P•L. LIC.NO. NO. _ VES SIZE NO. O SLOG[. AL OLOWED (U.B.C.REQUIREMENT) F LOT ' cf �' I NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STRE[T) DETHACK LINE PROs FRONT PT, tJ PTfi CENTER OF STREET REAR YARDJ SIDE TARP I LEFT I RIGHT R.SIDE PT. /PT. • DESCRIPTION OF WORK L.SIDE PT. /�/(J>� PT. \� ALTERATION ADDITION J� REAR PT. l — DISTANCE BET. . BET.MAIN a REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLOCS. BUILDING NO.OF VAR.# DATE SIZE ROOMS STORIES _ C.U.P.# APPROVED • EXTERIOR WALLROOF APPROVED // �42 it COVERING GT I COVERING BY Ll/VJ' E p /"�(/ USE OF UILDIHG AN OB 4.--. P. , / 0_42.40 /✓iSoy ; SQ.PT. I HEREBY ACKNOWLEDGEAT.1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C AND THAT THE A VI IS CORRECT ANQ AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL'CI U R NANC[S AND�T OVLATINO _VALUA7IWN I GI BUILDING ALL CI U // 1\\ SIGNATURE OF NO fr GI PERMIT FEE S �, PERMITTEF J... . ._ . ..... ... . _ .. S/V( �- I PLAN CHECK S e w AUTFRIZ[D AGENT' _._ . ...:- .. .. .. ..... .. . .. TOTAL FEE ;�