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HomeMy WebLinkAbout126 16TH ST - Building Permits PROJECT ADDPE55: 126 E 16TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062426 4h". OWNER2 NAME:DONALDSON DONALD RAY TR ADDRESS: 1517 W BALBOA BLVD PERMIT NO: B 062426 PLAN CHECK NO: 00801-93 L GOVT: N SUPP: N t NEWPORT BEACH,CA 92660 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: NEW ARCH/ENGINEE": 548-8531 GLENN CONSULTANTS REG.ND.:C17742 JOB DESCRIPTION : 6240SF OPEN CARPORT SQ FT: 13,000 ADDRESS: 2701 E THOMAS RD u I rG PHOENIX AZ 85016 CLAIM VALUE: 13,000, 00 CALC—VALUE: 13,000 . 00 GROUP OCC: B-1 / PEHMITTEE:DONALD DONALDSON ( 714 ) 673-7869 ADDRESS: 1517 W BALBOA BL COMMENTS: 2-3120SF PREDESIGNED INDUSTRIAL CARPORTS N.B. CA 92663 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. z SETBACKS CITY LIC.: STATE LIC.: CLASS: F-- Date' Signature: MAIN BUILDING ACCESSORY BUILDING , WORKERS'COMPENSATION DECLARATION: Iherebya0irmthatIhaveacertificateofconsenttoself-insure or a certificate of Workers' FRNT: 106 FT IN REAR: 3 FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: 3 FT IN RGHT: 3 FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV; PARCEL: 42543105 ZNE: MG REF NO: • 1 Certified copy is hereby furnished. 0Certified copy is filed with the city Building Division. PLANNING NOTES> ADDING TWO 3200 SQ FT, CARPORT STRUCTURES TO AN EXISTING . > VACANT PARCEL FOR STORAGE PURPOSES UNDER THE STRUCTURE ONLY Date: ' Applicant: • ********************************************************************Be********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the worlylor,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 S cc _ DATE: ( '12400 Date: 1/7---Y.442.,- Signator— /�i. /��//C-= -- , NOTICE:I,falter making this declaration.you should'recome subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: Code.you must forthwith comply wilt)such provisions or this permit shall be deemed revoked. 4`^)� r CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: 1 ✓5 5- -- DATE• 'F1 21 SLS which this permit is issued(Section 3097,Civ.C). 'c' *************{F*********************{L**** **{t ********************************* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N FEE .S U M MARY STRUCTURAL SEGMENT:Y 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 14 4 , 0 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 93. 60 - . 2 . 73 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD INGD 1V > PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE )p structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 14 6. 7 3 0,00 9 3 , 60 240 . 33 240 , 33 . 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 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE' DIVISION TOTALS——> COLLECTED' 146.73 OVER/SHORT: 00 , for mepurpose otsale). 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 144 . 00 2. 73 ❑ 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)license pursuant to the Contractors'Stale License Law).lam aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL': F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. i for this reason: YPE QTY DESCRIPTIWN UNIT COST TOTAL COST Dale.p7Z/9'� own¢ SFC 13000 STRUCTURAL BY VALUE '•'PER $1 00 1 .00 13, 000, 00 I do hereby cent y that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END• OF EES • 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. 4 Date: Applicant'. ' I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned , • , property lot inspection urposes. ; 4e Date' 7, signal ' ..c 01 00140247-00140248 TOT 146.73 Driver's License or Social Security x: DATE: 06/02/93 TINE: 10:32 164646 white—Boding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor ' r .. T._ - (!ONSTRUCTION ANP PLANNING NPO SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector .1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •. -II IZ., Soar PApp.Undrgrnd.. 53. Steel Reinforcement - •-:'3.-chctr.Pal`Conduit '.;lt.lity•Undrgrnd. I 54. Forms 4.pi 55. Electrical Cording -'-t3.5ieel Ri= forcement (t.. ..-R3 (wEy 56. Rough Plumbing & Pressurc Test • • rr : - r ._r_____ _. 6 , (CCtr icttt.F ER-I. - rd. 57. APPROVAL TO COVER•GUn`PTE 7. Footings--j _r. 58. Electrical Conduit-Undrgrni. p 1•firFoundatn C-y it 59. Gas Pipe, C l r.urgrnd., Test ' - 9.`�Vater Pipe-Undrgr'nd. f 60. Backwash Lee:. P-Trap, C. U'rdrr -.d_ iii. S1�ructural Floor System '4, 61. APPROVAL TO DECK _I {_-- 11. Prgprrty Seer Lina & HoLse Connection 62. 8 c'c ash & Ricapic^Fiaal r-i 12. Saver Cap 1, 63. Heater & Vent-Final t ^ 13. Roof Drains',_• -E 1: 64. Plumbing System - Final I • - 14. Rough Piurr.b'ng rl 35. Electrical-F.rat , AI 15. Rough Ctectricai•Conduit ~ 9 �' 66. Soler System Tim,. 16. Rough ectri �i'lirin, pry'- -- 1 -- - --- 9 R+1 G g •A 67. Fencing & Access Approval 17. Rough Wirin Sign I - • - - --- 9 9 9 1 68. APPROVED FOR PLASTERING;, 18. Rough Electric;)-T Bar Ceiling I 69. POOL/SPA SYSTEMS FINAL / _ - 1 19. Rough Heating & AL Cord t o_,.g _, T F19F DEPT. 1 QUIRE":1zw . �._-1_i-17,x__1 . 2?. lirt' w. r !--e,„.;!1,2: 4 x j t ce:c-i.-`- r. c > r 20 y.Ro qh rth ct(jr^/ cyfp;ace `„y >: y' . er x ; PPR.V<R.-_7_r',:^.(tit sr. . -'21 t' 21. Ours, irCStrCctu'2': _j x _Y --70. Uhderg.avn^H••:ro ST _ )_ -" C_-•'�.c1 -+ Cyt? 22.�Ducis, •nttfati c-ac ' •`• rt:-5 •.: j 4:t x�^ 1 ._,CM K _ t 'tell;; : C -a 0 -c x 571. Pruouc,. ).1'g s -la'J II !If 23.•GasPipe-Rot'7h & ie5r r,•- * y p• 1r. Cot x -72. UndergroCgid; Flbsf>S T '- = • C H. z- .e r r ' � ••• r t1�.n_x ^ -i•/�--`= ' --- -j- - . 24.=Rc&`f Fra}nin ' . It- ..c., . ? It * < S ti - t .. b" _ 1 _ 9 'r x 73,=Under mi.CSr•atj--r:'k Gas 7 I z �. K 9' -1 25. Root Sheathing . • v r > U = r 74'":i7vcr fac+ad N• _ dr,;_ 26.'`+-Cat Coling (Styli tu•al' P%W�(i' coat`L ; •r_, c. - -?� 1 75 Y +?Iemacal _ R �_ 27, *Frame apd Fjgshirg, ~- x � to-M73> s. Y .-D' `' r.. M S '2,--..!. - - -i-- -z -0•••-el-. r:_s -as-.z 76. Dry Stan_ ''-="- - - '_28�Lath ng'd Shing:,. r• C^- .5 . ^x a ""'' 77 FIXED SISrE y^8',INAI;, " ,- .- . . _ II - s -- - - 29. Insu!atun ^-� ^r ? I-xc 78? FIREPREV. FI\a-t. r > 1_ X30. D•yc.alfNaihng ^' •_`r` _ ,`I N � 118etLTI EPT.R-EQ'IIIREii�ENT ^31. Plaster QLowrtCWr ' S I ( t ' C •j `. r79. FINAL 1"1.tS:.ECTIG.N r' ;32._EIcctricti1 Potter ' 71tx _ I{ " '30;:FOOD CF RTI I- C,TE I4LIED L 1 G.:( - I x it---_yr J __ - r3...( 3. In,{ Elr:t(IC7i T�1 • - I� :F N(C�S: Le/ ,7. " :.34f'Finbl He'atin -& AlIkCac+oridi (,. '` •: %tin r 62n S ,35;Final Gas Pips-TwrC .. 'e - c < e -I - ^!o�.��O f �f` •36. HoGti or Canopy < I • . .1 t •� r' ` Z ar. }_•. �C' .::r3 ^.': x '- -it 14 r' mac' 737.`.F,ral Factory F,rcrecc,= 1 ...if,- d ' -• 'I. ----- --- -(�• ��`., �y� j^ �� • 38. ir}I Plumb!ng -, `•6. n �__•�zrh s •1 l' .:LC-C1 Li-tt-e -//#r ]- .4% tl_ ( ct/ -F'' 't- 1 r39:_lyater ServicegFihal* T I :c I 'x =. >. .- p..ki(y j •40.IGac Seruce-Sana! .• r .Z: r - _ c -r . t. `_ -1 .-:C c ' • _ T Q ' `41:-Solar Domestic-Firt�l' k w '. ' - --- . ), :1 int.:: _ -_- -itis-_.._-_- _ ' 42. Bacicf low Preventer .c r• K • • _1 _ . r i r,r - a : Yti_' - 43. Backflow Ir(Blatiory zS i -uy z _ n _ _ • Ir44. LandscA�ga Icf:gatidh SysterfArri y :1. : 'r v ; .7e - .0 ,n _ e% ,. �S'r { - _:c .f C' j_^.: ;Ser 1 45: Sound s :-o _ - - : 4tteruatior _ .e 'r vac _ M I. . s - - - -' -T F--'j--.----, -_- -,46�•Handicap Regulations - _ .. 1“-C s ; • Q e S F. 47. I< AL STRecTUffE & 8U 1_DING ='Z cls _ 48.51Ni4L-PLANNING ' . . -5 • • 1 r r a - ,. - i '.- I LLS ;] ., '7. �• 49.=Elec ric.Release to Edison -..:.x` ^ r, '1. ,- c - r I •50.Carilelease to Southern Califon-nie Gas OD -, .. • -'51. CERTIFICATE OF/OCCUPANCY 4- . = No. Date I k1 v N ?ORT-MESA UNIFIED SCHOOL r 'TRICT CERTIFA,_ATE OF COMPLIANCE OF DEVEL_ _MENT FEESill/ PURSUANT TO AB 1600 AND AB 181 y� To: -(( ) City of Costa Mesa Plan Check No. Poel ( 1 3 2....( ) City of Newport Beach ( ) County of Orange ) District Receipt No. Applicant: ADP p ft& /j'✓ Address: I 7,Q Cr . ( (o \ '71 e 711 Telephone Number: c 0c U c J Tract/Parcel and Lot Number(s) : r Location of Project: ( Ze `G iloY \ c ( GYn Number of Square Feet of Residential Space x $1.65 Total Residential/ Sr. Citizen Space x $ . 27 Total Commercial and Industrial Space ff.0 C x $ .27 Total 'Xc.-n/o R&D Space x $ . 2652 Total Warehouse Space x $ . 2653 Total Commercial/Industrial Project is: (Check One) 717/4/?r.- ca-'terry Warehouses Motel Preschool R & D Bank Auto Repair Movie Theater Neighborhood Shops - Hospital Mini-storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park - Fast Food This project is exempt because • This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Ne rt-Mesa Unified SchooloDistrict. By: ��tch ` Authorized Representative The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true then this certificate shall automatically terminate and the appropriate City/Countyf shall be notified. I 1- , Date: _ f 0 / P r ' . � � Appli 3 ,J M , Mon /An-) . • V.L. COSGRO Bus. (714) 539-0346 - Inspection Service Beeper(714) 372-7019 9852 W. Katella Ave., Ste. 188 Anaheim, CA 92804 S • �. r JOB REPORT OF INSPECTION ei/y OF t ORANGE C_O) L.A. CO. UBC TITLE 21 011 05140c 4 M�� Building Permit No. c3 , ge- a 6o Date of Inspection: From /2-y /p,J Thru Project Name& Date . , ./d ca. o'A/ M;YEO Phone# //7 .J 4'8-0S5/ Project Address /26LC /6 T'4.5 7 Cos7it 4y/ESI Phone# - C7 General Contractor ONA/eZ � U/UJEz Phone# 7/7`Sqg 03 3f ' Sub Contractor 07ry/ WEL.DINco STA MesA G Phone# //4/-"39.8^a/6a .2701 s.1U.34'4S ,(W Structural Engineer C4414/ QALS' gN/3�G 37fc"PiinwEi y Phone # (002- 965.-/di& fiat, Architect • Phone# BILL TO: TYPE OF INSPECTIO it Welding Other Shop Bolting Off-Site Fabricator Report: PQAt/iLZ ) I//Sc/Al Calv7i'A/aoas TNsFecT dm or 6t) („o/A?G 64/ Da c/&6 C IA/7.'462165 . Cn-2 Pdel--.- GJp/n/.va, 1 - � ; - Ie - 1 Nle NCS /Ett " / 'ai .7) ' i A . a ' "4/4/es lcLO/1VC / /v C041PidAA l� A/CE i-cJ,Tr1 4405-. 7 / . /- ?z AA)z2 t) es r . s7n4J.Af _ �f/ 27 CEel f/e4 AJED5C Electrodes: /1fjr� X11-2/•� a// i,Jler Welder Certifications: L `H ' c/ T 1� CE�-ir r e S /eucly, t/ .SLEnv -�//l n NAME: Icfrin eo 'ROTA! 7SDaiNUMBER & EXPIRATION: ''T /V /1023 / Et P. D075 9- / 7-7.5- Daily ly Hours Worked: Mon. Tues �{ic S OFFICE USE Thurs. Fri. Sat. i Sun. HOURS Inspections based on a Minimum of 4 Hours and over 4 Hours - 8 Hour Minimum. In addition, any Inspection extending past noon hour will be an 8 Hour Minimum. Miles: king Fees: Regular O.T. t �-7 CQD1 ��/i Inspector's Signature /r ( nspector's iee-ncse# Q F�NB�' Contractor's Representative �. 011 1', 0Au/ S/� Pay Hours Benefits V igna re to verify Inspector's presencq.6nly.) Remarks Distribution:White & Yellow-V.L.C.I.S. • Pink-Customer Invoice No. -2z ) / / COUNTY OF ORANGE \ BUILDING DEPT. Permit No. 3/6 4) 636 No. Broadway ._ Santa Ana, California Application for Building Permit Phone: KI 2-6211 AND .FOR A Certificate of Use and Occupancy r �J\ Dates / J r ��'0 I. OWNER'S NAME-0 . O/1IA/O�$QN yies�p1 1/Mitive, PHONE: Be 647 2 MAILING ADDRESS /09-Cr / 4 Tq Ge $ 1":14. T.e.•_S-4CITY ' Name C90V/1Jfa— --- Name CAA.) r,.. ei,, ('e......0 (Architect or Engineer) (Contractor) Address Address City - City State State Lic. No. � � .-1 Phone Lic. No. // Phone '� PROPOSED USE: J s.t?,e4S___k-_!�_-}� /- ..e! -7 0 Al 2. JOB LOCATION 1.• G `-7 4 m d% ! ♦ noS r- .V Fa._. (House No.) (Name of Street) (Town or School District 3. LEGAL DESCRIPTION: Lot D v C et • Block Tract (Metes and Bounds Description—Use reserse side of form) 4. CORNER LOT ( ) INTERIOR LOT CA-) THROUGH LOT® ) SLOPE OF LOT ( ) 5. SIZE OF BLDG - 0-149 X .9O AREA• cc C _.-__-SIZE OF LOT- /G °X /' 3 AREA: ems• CO GI., 6. HEIGHT OF BLDG.: __--�.._ '.-_?7_L4_.CEILING HEIGHT• NO. OF STORIES / 7. NO. FAMILIES Size of Smallest Bedroom: Size of Kitchen: 8. EXTERIOR WALL CONSTRUCTION• .S -( IJf C 0 INTERIOR WALL COVERING o Y" G'__. (Frame, Stucco, Etc.) (Plaster-Drywall, Etc.)c. 9. SETBACKS: Front Yard from Center Line of Street d/6--- FA- ' FA-r'+• EtJ 02A-ntr�ikhl. v Nearest Side Yard `7 Rear Yard 402 7 Distance in Feet Between Bldgs. on Same Lot_rgrJE3(lere, 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width i`y Depth in Ground ' 0'• Width of Wall Accessory Bldgs. and (b) Size of Studs: 2:_Y_y____.Spacing / G "CC Material of Floor _T./R tie-_7i& Similar Structures: - (c)-Size of Floor Joists: h- -- Spacing _.-- . "CC • (d) Size of Rafters: 4` Spacing / 6 " "CC 12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, paint• ing and sewage disposal $ /1_,.‘, O 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE-COUNTY OF ORANGE AND THE STATE OF CALIFORNIA � A/PPPPLICABLE THERETO. - - Signed:.-----4/ .-ret �_ll.__14.y-ry-.bm+• (O.dher) Plans Filed• / t/ -)- r U By. (Authorized Agent) FOR DEPARTMENTAL USE ONLY • FEES: D CHECKING BY Bldg. Permit - $ LP v`�"•• GROUP APPLICATION "/CHECKING Q 6 Plan Check - $ 2 £ ` TYPE FIRE Total - - $ ��. ..t.: � DISTM./ p O NS AND MARSHAL Receipt No. -��+• .___ _ e% MARCS/ Z SPEC'S STATE Paid to - - SHEET NO. S CORRECTIONS")aENGINEER Date /4 '6.----_ c d VERIFIED V! -I CAL Or C. W. DONOHU , PERMI"ySSWEsikaj , INSPcTO- 8010 r' ' DATE l--Y} s' ;Eia� - JIC1 - SM-7.5p e-.r^ G 3 N ? a METES AND BOUNDS DESCRIPT d: � E"ern oze- Na,✓ yov o { Su/ / yjorT S/ ' . Ek✓ /�orr ff�iGbir 0 1!0 2,0 3.10 4!0 5!0 610 ! I • o • o _ (i 0 • rri • O - 0 • • b . o — • • -co- •• 0 O. 'COSTA MESA BUILDING DEP MENT NQ 24. J B 111 East 20th Street l� Costa Mesa, California Date /a — ' 2.. 1 CITY OF COSTA MESA 7491ItTIFICATE OF OCCUPANCY Building Permit No,01.817LEl ricaavpermit o /49 .Plumbin PermititN /382 Use of Building Woe'G � A01 .5©/t`/ (//L .U9e r) The �bfuilding locate at JJ" �� /.rc — /4. /L(l�Lf'LLC /�GCo GCS' Lot Block 19,eTract //—D7/ (See reverse side for Metes and Bounds) has been inspected and found to comply with the provisions of all City of Costa Mesa Or.. dinances applicable thereto for a Group Occupancy. DI EED�.TO: / A. J.cOLZ / /7A/A /Z boA/A J`D� City.19 ing YY (OwnEr of Building) By kr ...-. ...... CC: 0 Original—Owner 0 1st copy—Gas Co. 0 2nd copy—Edison Co. d copy—File Farm 206 G-B 1M 12-53 • !§ta Mesa Building Department E1�Q APPLICATION FOR PERMIT ~!• COSTA MESAZDCASthTRERNIA • 3� B U ' C D .I N G FOR AP TO TOT IN FOR OF!iCE USE ONLY Ost-a cB&. Receipt No. - Perm Nr Building P 33 / t/, Address -7 if California Received by. Date Rec' . Date Issued Costa Mesa, /1----7---S1/ Nearest - CrossSt. eimuu torr . Building Dittmar &Donaldson Address MailOwner 126 , 18 st. -Pasta Mesa. Costa Mesa, California :• Address Nearest , 1 Costa Mesa. Teti 8 4201 Cross St. q City No. Zon _ • I Plans No.of I TYPy l / I Gro4E3 Architect or Lie. �/ .E_ Engineer Owner No. Appr ved r by Date Address CORRECTIONS City Lie. Contractor Owner No. Address Description I No.51 I Block I Tract .AJI1 '7 - C71— s------ — (Attach Metes and Boundsy-r• • No.of Bldgs. Size of Lot 100 x 183 I Now on Lot 2 Use of Weodshep I No.of I No.of Sill It Om Existing Bldg. Families 41kooms , d OJ r n Setback Line from Rear Var ,t2 Center of Street 451 Side VardO1 Nnv 0-1954 y DESCRIPTION OF WORK r New I X I Alteration I I Addition I - Repair I Moving I Demolish I • CITY OF coSTA.MESA Building 451 x120 No.of 1 Size Rooms Stories Exterior allI Roof Coverin O. r. steel Covering APPROVALS Use of Building Wood. shop / 5 Foundation Location Inspector Date Building C, 9 6 Under-orms, innerials, Under•Pinning ' Frame: Fire Stops, �1—'I"��- 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 A� Plaster,Ext. Authorized Agt./9-2., ,..-c—) Masonry Reinforced Valuation Permit Fee $ Plan Check$ c•— Bond Beam $ A el Total //_ & o _, Fee $ Y / .FINAL I. `ORM 204 n-H 2M 5-54 • o J � ( . d. v y i . . _ d. tI r -- 1- - - - - - - . . . sc./7 { 0 _ _.-1b& - - - �s - tee, • - -f — •. . .Street • " - _ to". n._ . . • PLOT PLAN — Show',location and distances from / property li: ,1e nd4$etwe �en _ter abuildings. , r - (-.•. f.' I - - .r, ' . . _____ - _ _ .. . .__.__ - _ _ r . _ .11:7 •. . ..? is • % . - .a • 561 FEE RE .IVSD COSTA MESA BUILDING DEPARTMENT FNA a b / �T g P.O.BOX 317 _ E DEI T. A COSTA MESA, CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN i APPLICATION FOR PERMIT NIDI-RW:/2c -i6- ST i BUILDING COSTA MESA. CALIFORNIA , FOR OFFICE USE ONLY ••��---- / RECEIPT NO. L PERMIT��L /10 OWNER J11j/mn.r 'r D,AJ/j/ ,4-/SD� V / )ity,,,,,,„,MAIL �fitATE -R�ECCEEIVED/ �D TE ISSUED ADDRESS /2 C -/ G S/• /J f '`� / d'�aP.J� //�� J , TEL. ADDRESS 1/ BUILDING CITY ['/[[JI✓� ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS 1 ZONE TVgC) ✓ CITY LIC. v Zorn / NO.PLANS Ns i/1'/V_ ORO% �^ CONTRACTOR 6L /v Eft NO. TEL. APPOD ADDRESS NO. BY DATE LEGAL -,JOT. OT AP" -C7/-S CORRECTIONS DESCRIPTION N OO. `, / BLOCK TRACT /�A//p A.P.NO. // /-07/- J -5 tJ//� CL--y — cr StiarZ 6,00. SIZE NO,OF BLOCS. -qs �/ ` OF LOT Ace/.5 3 NOW ON LOT USE OF a /7� 1 EXISTING BLDG. �7 L' /V�j SETBACK LINE FROM ,.// / ` ( i CENTER OF STREET .'-.) REAR YARD l 5 , I SIDE YARD RIGHT d LEFT 01 DESCRIPTION OF WORK ‘1412/Y-PLl-A-S-IQQ NEW X ALTERATION 1 ADDITION [ REPAIR MOVING DEMOLISH [APPROVED BUILDING NO.OF SIZE ROOMS STORIES CITY OF C STA MESA EXTERIOR WALL ROOF 7714 /, c PLANNING DEPT. _COVERING COV ERI Nji�--1 USE OF NEW 7 EG. BUILDING ./D0"P-1 ui ic�/y G 4 t BY DAT PLMIV IcI,H. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION SIGNATURE OF /4 �_ ' Mi...".... PERMIT FEE $ PERMITTEE �� i'tGf9�`� $ 1 / C�b PLAN CHECK $ 'r'�' AUTHORIZED AGENT J • TOTAL FEE Sh . 81