HomeMy WebLinkAbout700 16TH ST - Building Permits2����2� ysQ���Z
��
TESTIN6
Laboratories �,f �=��«t�t�,r c«���� z,�«<, r�,��.
. — - – -
P.O. BOk s� . 37i0 �IRP04T w�v . LONG BE�CH UJF. 9C87i . 713; ^753355 • 7�3; e7st?eo .��� 8786�32
� a�n�io• r,�o- c[s
�yi�0. . �.5...<.. t:.-D.... . �q
S+�en.e G�' ,.�ax�ol '�:- 1c55o.e yo�..�c0 e>..•
�1r�19i )NS'o l� 1 i. �o^p P.n.r Cn i a:�u ]V aJn }l f
��i'+..� ,t�..
.._.•
Examination: SC]3-]$4$
COMPRESSION TESTS ON CONCRETE CYtINDERS
Glenn Lane Contractor, Inc
10770 Painter Avenue
Santa Fe Springs, Callfor�fa 90670
PROJECT PRIME PROPERTIES
ADDRE55 16th b Pomona, Costa Mesa
SAMPLE FROM Foat f ngs
MCNITECT
Robert � Sinee Colas, Inc.
ENO�NFEN
Mlx S.0 sack
DATE CAST 10-23-73
DATE TESTED 11-5-73
CYLiNDER NO. 1
COMPRESSION 13^Day
TOTAt IOAD, 1B5. 6$,�00
POUNDS PER SO. IN. 2,j00
COMPLIANCE
nuoE er
CYLINDERS Frank Glenn
CONTR�CIOP
Bresnan Const. Co.
suecoN.ancTon
Glenn Lane Contractor, Inc.
SPECIFIED
STRENGTH 2,000 p5i
SLUMP
11-20-73
2
28-Day
DEtIVERED BY � ' I �
Dave
1'
oisTaieurioN: �
f��
Gienn La�e Contractor, inc. - 2 n„�,r
Bresnan Const. Co. ��i�'
2724 W Ma(n St., Alhambra 91801 y
liobert b Stnee Coles, Inc.
701 W, 16th St., Costa Mesa 92627
� sta Mesa Butiding Dept.
NECEIVED ON
11-2-73
BurrDr�vc saFFn oEP�
�IOV ?. 1973
� �_ .�...
.� „. , .
�LL REPOATS �NE SVBMITTCO �5 TME CONf1OENTl�� VFOPEPTV OG CLIEMTS, AUTMORIZ�l10N fOR VUBIIC�TIOX O� OUR FfVOFTS. COHCLVSIONS. ON EY
Tq�CiS [qOM Oq R[G�9DIXG SMEV IS F[SEAVED PCNDING OVR WPIIiEN �PnFDy�1 �5 � YU�U�C �'PO)EC�ION >O CLIEMI$ 1HF VJ9lIC �ND OLNSLCVLb
330 t2
�
r
�2" s� �
�,�`� -o Twiniaq Laboratories ��f =��ut��=,= ��=�'�fO211U1, �,�.
�._ � ti
P.O. BO% N. 3310 nIRGORT wnY . LONG BEhCH. GLIf. 9080� • �213� a26�3755 • �3�3� 676�I)Pb . �lla� 928�6432
Aa�t+C� O�F;CES:
TESTING isi..o r:,.•e H„os, s.•..� . ��+o.�•���,,.. r.,c�g
S..r.n�eCe���a.�levt>O) �••� ]e554.dandoA.e_0.08o���
� Y 1 �IFI E
� �tl�� 91.IG5 d••� }� q lonq p��cF. Ce11:.90801 �]O� e163J80
. :;V+y�:� °
November 21, 1973
Examina�ion: SC73-7545
COMPRESSION TE5T5 �ON CONCRETE CYLINDERS
Glenn Lane Contractor, Inc
10770 Painter Avenue
Santa Fe Springs, Californta 90670
PROJECT PRIME PROPERTIES
ADDRESS 16th b Pomona, Costa Mesa
SAMPLE FROM Foot i ngs
ARCNITFCT ! � CONIR�CTON
Robart b Sinee Lolas, Inc. Bresnan Const. Co.
ENOINEEN SUlCONTRACTOR
Glenn Lane Concractor, inc.
SPECIFIED
MIX 5.0 sack STRENGTH 2,000 pSf
DATE CAST �0-23-73
DATE TESTED II-5-73
CYLINDER NO. 1
COMPRESSION 13'Day
TOTAI LOAD, iss. 65,000
POUfV05 PfR SG. IN. 2,j00
SLUMP
11-20-73
2
28-Day
83.500
Z,955
COMPl1ANCE 23-Oay test Complies with speciflcatlons.
w�ce er DEtIVERED er
CY�INDERS Frank Glenn Dave
RECEIVED ON
i1-2-73 �
msTRiwnoM:
Glenn Lane Contractor, Inc. - Z gUILDINC �AFETY DEPT.
Bresnan Const. Co. � �
2724 W Main St., Alhambra 91801
1��
ay
���
Robert s slnee co�es, I�c. �iOV 2 7 1973 .''
j01 M. 16th St., Costa Mesa 92627
�,Ebsta Mesa Building Dept. � ��' ; - f �;�.r,,,_„
UO �- �� ,
�lL NEYORT$ .�RE $UBNITLEO �5 TME CONiI�CNTI�L VROPENTV Of C�IENiS..�IITNORIIATION iOR PVOI�CI�,TION Of OUR REpORTS. CONCLUSIONS. Ofl E11�
iX�CTS fROV ON MEG�NOING iM[M I$ RF$[MVEO PENOING OUA WM�TTEM �PVROV�L �5 � MVTV/.L VYOTECTION TO Cl1ENT5. TNE GUBLIC �ND OURSEI,VES.
330�12
�
:+
�
� tisq
�,z�'���� ��°ti
a�
TESTING
Laboratories �F ��uE��=,� �«c�f�=,=u�� �,_�.
PO. BOA a) , 3710 /+1?FOFi WP,Y . �ONG BEP.CH, CALI'r. 90e�1 . �)13� 426d355 . �213j 6762)86 . �114) 828�6433
9anvC� OcqCEs:
ISI�.D No"F Yn.oe� 5'.en. •• • ::.+ �et�r�c-.ve ia�'�rq
Se.•e,1mGa.�m..eG]�OJ 0°� 1GSSRadanaoA.�.,PO,Oa•�9 '
Ply 5]I.}0�5 d�~�� ;� la�g Beecb. Ce6� 9p801 p13� OJO�DBE
.�
.��'��� : 3�
Examination: $G]3-]9%4
COMPRESSION TESTS ON CONCRETE CYLINDERS
Glenn Lane Gontractor, INc.
10770 Painter Avenue °
Santa Fe Springs, Californla 90670
PROlECT PRl)iE PROPERTIES
ADDRE55 16th b Pomona, Gosta Mesa
SAMPLF FROM Panels
ANCMITECT
E oobeR t b Sinee Goles, lac.
MIX
DATE CAST
DATE TESTED
CYtINDER NO.
COMPRESSION
TO7AL LOAD, LBS.
POUNDS PER SQ. IN.
� COMPLIANCE
0
CYLINDERS
5.4 sack - 1� c.c.
i1-12-73
ll-20-73
1
8-Day
49,500
1,7$0
r�uo[ :er
f�ank Glenn
. .• DIST0.IWTION:
Glenn Lane Contractor, INc. - 2
Bresnan Caist. Go.
2724 N. Matn SC., Alhamura 91d01
Robert 6 Sinee Coles, Inc.
701 41. 16th Street, Costa Mesa 92627
Costa Mesa Butlding Department
CONTRACTOR -
Bresnan Consi. Co.
SUBCONiPACiON
Glenn Lane Gontractor, tnc.
SPECIFIED
STRENGTH 2,000 p51
SIUMP
12-10-73
2
28-Uay
�EIIVERED BY
Dave
RFCEIVFD ON
Il-i9-73
•Ll REPON�S �RG 51lBMITTEO �5 TNE CONFIDENtI�L FROPERTY OG CIIENTS. �l1THOFIIATION GOR PUBLIC.TIOM O` OLIR REVORT��VS ONS, OR E%�
TP�CTS fRPM OR w[G�RDING TMEM IS RESENVE� VENpING OV�+ Wp1{1EN �PGROV.�I 15 � MI1Tl1�L PROiECiION TO CLIENTS. TME G119�IC �NO OURSELVES.
330.12
- 1
2� 2,f. /
�,�`�``� ��o Twiniaq Laboratories �>f ��«t���=,� e�=<<h=,�«�, �,_�.
�_� y PO BOX a� . 73�0 AiQoO?1 WP.Y . IONG BE4CN CAUF. o060i .•2�3, eZ= 375ti . 7�3 6J63336 .'�'<� 828�6<37
eanno. r,Fc,CL'
TESTING s . c � ... �., , t�•..� . . �, e.. . . •;
s.-�.n., c, � •.vno� ., `"� � »ss .a � ..�oo e,..�
tiu Sl� 195 ��;� . �-. �, a.::i q t q: ]1Fe
, �_n..,,
'i' . �
Examination: $C)3—a166
COMPRESSION TESTS ON CONCRETE CYIINDERS
Glenn Lane ConCractor, Inc.
107j0 Patnter Avenue
Santa Fe Sprtngs, talifornia 90670
PROJEGT
ADDRESS
SAMPIE FROM
PRIME PROPERTIES
16th 6 Pomona St., Costa Mesa
Panels
A0.CXITECT '
Robert 6 Stnee Coles, Inc.
ENOINFFR
MIX
DATE CAST
DATE TESTED
CYIINDER NO.
COMPRESSION
TOTAI LOAD, L85.
POUNDS PER 50. IN.
COMPLIANCE
CYLINDERS
5.8 saek Pozzoiith 30
11-16-73
11-27-73 -
8
11-Day
45,000
1.590
r.uoe er
Frank Glenn
DISfRI�UfION:
Glenn Lane Contractor, Ine. - 2
Bresnan Const. Co.
2724 W, Main St., Alhambra 91801
Robert 6 Sinee Coles, Inc,
701 w. 16th St., toste Mesa 92627
CONT0.ACTOR
Bresnan Conet. Co.
SU6CONTRACTOR
Glenn Lane Contractor, Inc.
SPECIFIED
0 STRENGTH 2,000 pS1
SIUMP
12-14-73
9
28-Day
OFIIVENED EY
Dave
RECEIVEC ON
11-26-73
BUILDING SAFETY D�PT.
N OV 3 01973
ta Mesa Bldg. Dept. ,, �; ,r.,,,:.� .
�±:; c-r' :'i' ._ st':. .. .
�LL MCVOAiS �RE SVG�ITTED �5 TNE CONf10EMT1�L CMOPERTV O� CLIENTS. �VTMO412�TION GOR PUBLICI,TION O�,OVR qEPORiS. CONCLV510N5. OR C}
iY�CiS fROM ON 9CG�NOING iME� 1> AESENVED PCNOING OUA WoIiTEN �VPYOV�L �5 � MUTU�L PFOTECTION TO Cl1ENT5. Tr1E PJ9�IC �ND OVRSELVES
330�12
DUKE TIMBER CONSTRUCTION COMPANY INC.
CALIFORNIA LICENSE B1-180710
De artment of Building & Safety
c� Costa Mesa City Hall
P.O. Box 1200
Cosat Mesa, California
Re: Job Natne ��,,rv�...a-
�G��
Fri.me Properties
lbth R Pomona
Costa i�esa, California
We are sending:
Per your request
Shop drawings
Calculations
Lav-out sheets
Please check job address-if
not correct-please fill in.
x Building Inspector
x Beam Certificate
Date: 6 December .1973
Please have your Engineer/Architect call us by
approval or corrections.
Our job number: T-123
(Please use th_s number en all calls and
correspondence)
ror:
Information only
Your use in obtaining pennit
Engineer/Architect IA4tEDIATE approval
Please return, SIGNED by Engineer/Architect:
Shop Drawings
Calculations
DELAY ON TRANSMITTALS hU1Y CAUSE JOE3 SCHEDULE DELAYS. PLEASE RUSH.
If enclosures, received, are'not as listed above, please notify us at once.
DUKE TIMBER CONSTRUCTION COMPANY� INC.
, . ..J / � J 1� .�/
. .. . � - -
with his
���LDIPJG SAFETY DEP`t'.
IJEC 7 1973
19700 SOUTH SUSANA ROAD • COMPTON. CALIFORNIA 90221 • (213) 537-4454
POST OFFICE BOX 5086 • COMPTON. CALIFORNIA 90224
CERVIFICATE
�
���u� oF n�
i
�AITC
OF �
CONFORMANCE
lHE UNDERS/GNED MANUfACTURER HEREBY CERTJF/ES
that the products identified below and on attached sheets Nos. 1 of 1 are rciarked
with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC)
and were manufactured in conformance with applicable provisions of U. S. Product Standard
PS 56-73, for Structural Glued Laminated Timber, and that such manufacture has been at our plant in
Windeor, California , Which plant has a quality control system approved by
the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected
periodically by such Bureau. The undersigned manufacturer further certifies that the work has been
done in accordance with the applicable job specifications.
The manufacture of these members complies with the manufacturing and fabricating provisions of
Chapter 25 of the Uniform Building Code.
JOB NAME: pr�P p�pHTi'j PA
,oe.ocnnoN. 16th 6 Pomona, Coeta Mese� Calif.
CUSiOMFH'S ONOEft �o.P04181�Job � 123 DAIf 11/5/73 MFGH'S ONDFR �o. 5-3536-B-1
2 Glu Lam Beame, 53�" x 34'gH x 58'0-11/16", Comb. 24F, Induetrial Finieh, Exterior Glue
STANDARD STBIICIVRES�INC.
nncsuality Control Dir. ,00ness920 Shiloh Road o,,,E Novembar 29, 1973
A1 TC HEREB Y CERTIFIES that the said company at its said plant is licensed by the
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect of
products which comply with applicable provisions of said Standard, that the adequacy of the quality
control system in effect at said plant is periodically inspected and verified by the Inspection Bureau ot
the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of the under-
signed, said company is capable of complying with applicable manufacturing and testiqq provisions of
said Standard in respect of products manufactured at said plant. Conformance with thfi ��tandard in
respect of any specific or particular product is the sole responsibility of the manufacturer;�AYTG'� D
guarantee hereunder being that the said company is qualified to produce a product meeYing�the said
Standard and that its plant is periodically inspected and verified by the AITC fnspection Bu�eau:3 �973
AITC FORM 18-1-73
AITC Certificate No. 4 O� S Signed for
AMERICAN INSTITUTE Of TIMBER CONSTRUCTION
���i �� ����� .� �u��,.
F.ecui�•e V�ce Preadem
Manoger. InsceU�o� 8ureau
8 19�3 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION
�
The glulam members of the job covered by ,..�s certiftcate are stamped with one of the
foilowing type quality marks. Each qualified plant has an individual qualification
designation. The designation "P-143" shown on the typicel quality marks below is noi
assigned to any piant and is used only for the purpose ot illustration: _
A TYPICAL CUSTOM PRODUCT �UALITY MARK
QUALITY
INSPECTED
�
Indicates that the designated licensed plant
has met all requirements for qualification
and maintains an acceptable quality control
system which is periodically inspected by
A! TC.
P�' 43 AITC designation of qualified licensed
plant.
...'.O'. .i �'Cr, r"�f.•
PS 56-73
. ._. .,. . .v . , �a� � „_,,
tes conformance to U.S. Product
i'rdV for Structural Glued Lam-
Tmber.
!-a-c��:.f- �i\: �I ..- dnL,i„i��. . ,
.A TYP.iGAL N.ON-C,USTOM PROD�UCT..�U.,ALITY MAR,K
:���.. ,.�lJ: ...... �._.r.l- .....� . .i... � . . t,J i ,.� v.. . , . _ <� dq'±t :,6.• �).. ..
�.� u� 1: �'lLay'L J..I�..�.�..li.
Indicates that the designated licensed plant
has met all requirements for qualification
and maintains an acceptable quality control
system which is .periodicaily inspected by
AITC. -
Identification of suucturai use, desig
nated by symbols:
B—simple span bending member; C—
compression member; T—tension mem-
ber; CB—simple, continuous or canti-
lever span bBnding:member.
AITC designation of qualified licensed
P-143 W P�ant
Designates type of adhesive, W for
�� etSPECIES�� WET USE or D for DRY USE.
�
� 0 F AR C H Name of wood species used.
PS 56�%.3 Designates appearonce grade. IND—
� Industrial. ARCH—Architectural.
PREM—Premium.
Indicates conformance to U. S. Pro-
duct Standard for Structural Glued
Laminated Timber.
Designates appticabie AITC laminating
specification and combination symbol;
for example "117•71 24F" or "717-
71 3".
►For a custom product the specifications covering the desired product are included in the plans and specifications.
►For non-custom products essential detail specifications are included on stamp.
s
DEPARTMENT OF BUILDING AND SAFETY
- - — ' . .. _.__ - -�--.� Lo.J•fa.,�,r�f�_:�%���:.f/ �+�i
F . � •
. . . . . . ... __._. , �
Suosrinteadent of Buildiug
and Safety
This repoxt covers work completed during week ending ��y,9 �r ,L ?� h �`'% 7 S'
The addre�s of the job is 70o e,J, .j�'��' ¢/6 0! /�� J'��3 /1 LJ Gard�. /�'l�esR
Tra Building Permit No. 3 7� 3 L Owner Pv �.�,-, .� P,- eA .� ti�� O% . v�, % G a.
�—
The work inspected was ;n/< ( d, ,,.< T. / f- a.n Pc. .� ., � Ge n r, � c. � i.�
� = ., �s
�_:�e General Contractor is
ihe Specialty ( �� �`✓ � r.. ) Sub-Contractor is
Type, i.e., Pta nry
D��cription of Wark:
� '✓, iZ 7 / � 7.3 //�e. l � � �
. � i �P a. c� S/ c�-c
.�.' � h c �� ��
� - ; '
i� � _
L-�, f ; •,i, ,_,< •�. �-s
�%���av{.al
�� /� f- a.. n / 4, h r / r. ����f.V" L � et S ¢ e i
/
c r � .c .- �.�. -r�f , � /r o �i �4, 7`� �- 9 f -f�
K �¢ �.. J L. � T/ h, r i�Y L.. [ / 4 i£, �
J
�'�i � � 9y .
4 (.r/�'!
o h
y
��d iJ i�73 _
/P•. vlr��c�.,.d�
ll = t�� �l T, � � t w�, na h ti� � a�, ,� � �.�� a h�6, ;., ��
� ...
-cw �. l ��, �( a .., � Q /�.
�:
Remarks:
r1/I ��✓l<
�-�- �c. l ��, �— :
0
�a w z�; i�73
DATE'
G-1
Ga.� /wT`C.� rZl/� 6� GK�"/Y'/wd
��� � � y� � � � .
BUILDING SAFFTv I����.
�.� �:�.�
� E E� 19�3 SPECI� INSPECTOR
,l 7 .Z
COUNTY MJMBER
JOB ADDRESS 700 W. 1 th St. BUILDING PERMIT N0.
IN"'
s
GA�
WATER
ROUGH
ING FN� AIR CONOITIONING
SERVICE OR POLE
D I-I POWER �I
FRAME AND FLASHING
LATHING - IN � OUT n
PLASTER, BROWN COAT
STHUCTUFFL, FINAL
HE/-"�G, VENT., REFRIG. AND A.C.
PL NG, FINA� ANO GAS TEST �
ELECiRIC, FINFL
BIIILOING. FINAL
SPF[i>I REOOIFEMENTS
SUBCONTRACTOR
' - ; 7861
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
i..� _ For,Ay�ficant to Fill in Completely
� eUIL 1NG�
U
AD E.^.S f (p
� OWNER
`' MAIL
Z R A�DRESS
W W
a UJ( cl7v �
Z Q CONSTRUCTION
ON LENDER
am
J � BRANCH
J �
m J ADDPESS
m ARCHITECT
J a OR ENGINEER
U �
Q
w Q ADDRESS
aw
J O G CONTRACTOF
mZ
� J � � ADDRESS
^� Q =
�Z � • CITV
w � STATE
n j O) L I 0. N O.
` SIZE
� '�) OF LOT �SI Q
yd\
USE OF
' EXISTING BLDG.
H SIZE OF y
Z NEW BLDG. � /� �1
a EXTEflIOR WALL
, � t�✓v�w
TEL.
NO.
pTV
LIC. NO.
^ ^ / I NO. OF BIDGS.
r 7,Q NOW ON LOT
NO.OF 6 UFF/fE
ROOMS..2 4/ACrf6�{aHl E:
ROOF
PAIO ,s *.;*�
1hN 21-74�.;:; OO 77n:. 11.50
TION FOR BUILDING PERMIT
OATERECEIVEO DAT ISSV
��I.� �
PEFM� NO
A.P. NO.
BUILDING
ADDRESS �
TRACT
OWNER
FIRE
ZONE
APPROV
ZONE N
PI
VARDS APPf
MAIN BUIL
(FROM C/L STR
a r � v �c•� DISTANCE eET.
a, MAIN BLDGS.
Q 6 VAR.�
O C.U.P. #
~ APPROVED
N
z
�
VI �ereby acknowletlBe that I have reatl this application antl stare
� that ffie above intormation is correct antl aBree to comply with
� all laws regulating builtling construction, antl I shall not employ
r eny person in violation ot the workman's compensatiOn laws Of
y 2he State of Califomla.
zI hereby certify that I am properly litensetl es a cOnvactor unGer SQ. FT.
tha Stata of California Business and Professions Cotle, Divisicn 3, THE AMOUNT SH�
Chapier 9, antl t�at such lieenses are In full farce antl eifect, or I THE PURPO6E OF E
em exempt tron tl e provisions of the Stete of Calitornia Business VALUATION
antl Profossions Cnoo, Divislon 3, Chapter 9. v A
SlBnuture ot �EL � �( �
Permittee �2 /n�' G �2oPtiLT/4J g w
Authorizetl Agent
LOT I BLOCK
�,
DAT��
USE OF NEW
BVILDING
YARDSAPPROVED
BEf. MAIN &
V �
O
VALUATION IS FOR �
A PERMIT FEE ONLV: m
¢
_ $ � N
]
m
K S E
� `o
$ LL
� ;'.' � - 33�26
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
ADORE (
�
OWNER y
MAIL .�-._
ocriz-�i�,:,�00 a�aK ����:;3°^p
APPLICATIODd FOR BUILDING PERMIT
Z ....... 1n _ _ __ - _ _
aU CITV NOL / TR�A� IOT�� BLOCK
Z Q CONSTRUCTION W
ON LENDER
n. m
J � BRANCH ,
J N OWNE
m J ADDRESS VALU
m AFCHITECT TEL. S g
J � OR ENGINEER
V Q FIRE
w 2 ADDFESS ZONE TVPE P
� w APPFOVED �
W Z CONTRACTOR BV DATE
J O '
m Z
J � ADORESS `, � .r �'
w W TEL. Z�NE NO.OF USE OF NE
Z= CITY NO. I P�� BUILDING (�
H
w � STATE CITY VARDS APPROVEO VAFDS APPqOVED
(n K L10. NO. 110. NO. MAIN BUILDING ACCESSORV BUILDING
�� 512E / / NO.OF BLDGS. (FROM C/L STREET)
OF LOT ' �� NOW ON LOT RONT FT. FT.
USE OF
EXISTING BLOG. FT
F SIZE OF NO. OF
Z NEWBLOG. ROOM$ $TORIES LSIDE F. /--
U EMERIOR WALL ROOF �
COVERING COVERING FlEAR FT. FT.
J USE OF BUIIDING AND WORK TO BE PERFORMED DISTANGE BET. BET. MAIN &
a MAIN BLDGS. ACI;ESS. BLDGS.
a
Q � \ � VAF. � DATE
O .l� C.U.P.# APPROVED
~ � E / �0 � /� �
�
Z
0
UI hereby acknowlatlga t�at I have �aatl this application antl stata
� thnt the abova infarmation is correct antl aprae to comply wIM
� all laws repulating builtlinp construcHon, antl I shell not amploy
� any person in vloiot(on of Iha workmen's comp¢nsatlon laws ot
m
(n t e [am o o i om a. �
ZI heraby certtfy c�at I am proporty ica tl nz a convacror untlar SQ. FT. o
the Stete of Califo Businass e Pr f szton� Code, Dlvisicn 3, THE AMOVNT SMOWN UNDER VALVATION IS FOR
Chepter 9, antl t t ch licenw e ull rca entl eftect, or I THE PURP06E OF ESfABLSHING A PERMR FEE ONLV: Q
am exompt 1ro tha provislon o th 5 ata Celitornie Busineu VALUATION �/��
antl Prolassiona od , Divlslon h t r 9 �� PERMIT FEE $ ��l �
SIB^o�uro o � m
Permitteo $ 3 -�0 PLAN CHECK $ /� E
`o
Authorizetl ABant �� LL
TOTAL FEE $ �
�
�
i
- 371��
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
ForApplicanfto �ill.�rf,Co�tely
BUILD�NG �t��' • ^
ADDRESS �L p / pD/'jLONji} /�-U�
OWNER p�('/lhr i1'�PbP.�i1T� l�Et�i--"L a �
ADDIiESS �O� SU��/C�d/t /�F/��
CITV /YF��O/C7 /J�ry�C�/ NOL.
CANSTRUCTION
LENDER
BRANCH
ADDFESS
ARCHITECT �jl/��i/� /GLG� NOLS�� d�/�
OR ENGINEERF(/ C L
ADDRESS �v� � /(�T� �� Cns7a�4�
CONTRACTOfi �G�Jly�l'� '
ADDRESS
TEL.
QTY NO.
STATE CITY
LIC. NO. - LIC. NO.
SIZE ( 1 � NO.OF BLOGS.
OF LOT � iy(i�( f y� NOW ON LOT �O�
USE OF
E%ISTING BLOG.
512E OF � / NO. OF
NEW BLDG. C FOOMS STORIES I
EXTERIOR WALL ROOF
COVERING Gv�G � COVERING �.0�-�-.P6
USE OF BUILDING AND WORK TO BE PEfiFO.Rb1ED
. �
." -�.i�.
�UG -H'�3CMSDOO 530� **�*�$1.6\
APPLICATION FOR BUILDING PERMIT
REC VE BV D E ECEIV D DATE ISSVE
i/
A.P. NO.
!16 -.�9� �- 3 PERMIT NO,
BUIIDING �%00
ADDRESS e/ Rif7N/A
TRACT �1�7 LOT I BLOC!
FIRE
ZONE
APPROVED
ZONE NO.OF
/vll P�,�
VAR�S APPROVED
MAIN BUILDING
REAR �O
DI5TANCE BET.
MAIN BLDCS.
VAR.#
C.U.P.q�
APPROVED //
� �
� VALUE � �n
$ `p
GROUP ��//
DATE " � '—/
VSE OF NEW � �
BUIL�ING /�`v
VARDSAPPROVED
ACCESSORV BUIIDING
J/WV„�(�-� FT.
FT.
�G Nt+
FT.
FL �
BET. MAIN &
I hcreby acknowl¢tlge [ha[ I heve reed ihis applicecion antl 5iate NR '('
thut ffie abave intormation Is correct antl agrea to compty wiffi e�j
all laws regulatinp builtling consvuctio�, antl I shall not employ ��
any pe�son in violation of the workman's compensetion laws of
T m
the Siate of California. �
I hereby certify that I am Droperly licensed as a connactor untler SQ. FT. o
tha State oi California Business antl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that such licenses ere in full forca entl atfect, or I THE PURPpSE OF ESTABLISMING A PERMIT FEE ONLV: m
am exampt from the provisions of ffie $tnte of Celifornia Businew �
entl Prafessians Code, Division 3, Chepter 9. VALVATION m
PEFMIT FEE $ �
, ` � �
Sienemreof//�- . _ �///l� /� / � m
Permittee �VW L � ` l 5//1 _/ „/ � 41 PLAN CHECK $ � r(/ E
o�� (� 1 C/� /lT� o
Authorizetl Aqent LL
TOTAL FEE $ �
• �;.�
-7 � :.�
r �' � • � �j ! � �j �. S:P 14-73PatooO 471 �*** 156.��
CMS'
GOSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
AP L,I �ATION FOR BUILDING PERMIT
For Applicant to Fil/ in Completely
REC �£ DATE RECEIVED DA E ISSUED
BUILDING 7� � ,
ADDRE55 I ' �
) P T o.
OWNER ry� � T�Y' A.P. NO.
MAIL BUILOING %�� b �T
Z .
ADOFESS ADDFE55 �Q /J/1 G
W W TEL.
a U CIT�' NO. TRACT LOT BLOCK
Z Q CANSff7UCTION W AD A P
a m LENDER
�
� � BRANCH OWNER �I�Y{ L � �
m J ADORESS ,• VALUE -
m ARCHITECT TEL SE /"O �-O 8
J a Ofl ENGINEER N. ���+++'^^'�
U N fIRE /'i%
Wa 20NE TVPE GROVP / !�
� ADPRESS
4' w APPROVE
W Z CONTRACTOA BY DATE
J �
m Z
J � ADPRESS
w W TEI. Z�NE NO.OF USE OF NEW
Z� CIT�' NO. P�+� BUILDING
� STPTE CITV YARDSAPPROVED VARDSAPPROVED
N� LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
7� 512E NO.OF BLDGS. IFROM CJL STREET)
OFLOT NOWONLOT FROM FT. FT.
USE OF
E%ISTING BLDG. F . FT
f' SIZE OF NO. OF
QNEWBLDG. ROOMS STORIES L.SIDE FT. FT.
U EXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT. -- �
J USE OF BUILDING AND WOFK TO BE PEFFORMED DISiANCE BET. BET. MAIN &
a MAIN BLOGS. ACCESS. BlOGS.
a
Q VAR.�W DATE
O %N C.U.P. # APPROVEO
~ APPROVED
�
z
�
VI hereby acknowletlBe ffiet 1 have reatl this application entl smte
� that �he ebove Information is correct and egree to comply with
� all la�'s regulating builtling construction, antl I shall not employ
� any person in violation of the workman's compansallon laws of
y the $tate ot Californla. m
b
z1 heleby certity that 1 am properly ficansetl es a contrecior antler SQ. FT. o
ihe 5tate ot Callfornia Business antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR �
Chepter 9, and thet such licenses ere in full force antl atfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
om pxempt from the provisions of the State ot California 8usiness ¢
entl Protessions Cotle, Divisian 3, Chapter 9. VAlVAT10N � QUj y
PERMIT FEE $ � �
�
Sipnature ot m
Perrr�litee § PLAN CHECK $ E
/ �
AutPorizetl Agent ^ LL
TOTAL FEE $ ��J