HomeMy WebLinkAbout704 16TH ST - Building Permits(714) 754-5273 • Fa% (774) 7544B56 • www.ctcosta-mesa.c��LDING PERMIT 77 FAIR DRIVE, GOSTA MESA, CA 92626
Job Address: 704 W 16TH ST
Suite: �
Vicinity: ROOF
Primary0a: B Eat<50/OffcelBar<50
Parcel Number: 42412120
Applicant: LEMUS, RAFAEL
Address: 2016 WALLACE AVE
UNIT B
COSTA MESA, CA
Type of Constmclion:
Zoning:
owner: CLEAR DAY ASSOCIATES LTD
Address 704 W 16TH ST .
COSTA MESA, CA
Contractor: LEMUS ROOFING
Address: 2016 WALLACE AVE
UNIT B
COSTA MESA, CA
Zip: 92627
Arch :
Address:
Zip:
Phone:
License:
Phone: 949-642-7057
Zip: 92627, '�-
Phone:
Zip: 92627
Phone: 949-642-7057
License: 826813
Eng:
Address:
Status: ISSUED
Applied: 12I15f2005
Issued: 12I15/2005
G(
ISSUED BY:
Phone:
License:
SCOPE OF PERMIT
TEAR OFF EXISTING�ROOF. INSTALL 1 BASE SHEET, 2 11# PLIES AND ROCK #4-5 FOR COMMERCIAL BLDG. 23 SQUARES.
Plan Check: $0.00
Permit: $1'11.25
SMIP Res: $0.00
SMIP Com: $1.05
Other: $0.00
Inspection: $0.00
FEESUMMARY
Calc Valuation: ss,000.00
Claim Valuation: $s,000.00
Total: $112.30
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existina: o
Rear 0- 0
Rear 0- 0
Reauired: 0
Lek 0- 0
Left 0- 0
Pronosed: 0
Right 0. 0
Right 0- 0
NOTICE: The work authorized by this permit shall comply wlth all appllcable handicap access requirements under Califomia statutes antl related
regulations. (Ord. No. g2-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
for a periotl of 180 days.
INSPECTIONS: In ordar for the work authorized under thts permit to be considered legel, such work must comply with ell epplicable codes, and ell
requlred Inspectlon4 and final approval must be obtalneA. Failure to obtain Inspectlons and final approval will result in ihe expiratlon of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2448d8 (8�W)
WORKERS'COMPENSAnON DECLARATON: - ' ��
I here6y ettirm under penalty of perjury one of the following tleclarations: '' �
❑ I heve entl wlll mainteln e cartiticete ol wnsent to selt-Insure tor workers' compensation, es provitled for by section 3700 ot the Lebor Cotla, tor the peAortnanca of the
r„_„ wo�ic tor wNch this pertnit Is issuetl.
n insurence, as requiretl by secUon 3700 of the Lebor Code, for the peAortnance of Ne woAc for whlch Ihis p¢rtni( is issued,
endpollrynumberere: �� �� ^ ^/ ,^�A��
. P, �jcy.Number._ - L 5 �� �}�
; ve/ued et one Auntlretl tlollars ($100) or less.) � , ,_
❑ I certity that in the peAortnanca ol t�e work for which this permit is issuetl, I shall not employ eny person in any manner so es to Eecome subject to the workers'
compensation laws ol Calitomia, end egree that It I s�ould become subject to the workere' wmpensation proNsions ol Sectlon 3700 o the LeEor Code, I shall foMvrith
comply with ihese� vis�i�o� �s. � � �
PP�fSlgne e� _��l\YN V`-� 1 �.�� �' /� � et�—L Z � S d5
I Y.Tc� � �
WARN rFAR.LRETOSECUREWORKERS'COAIPENSATION VERAGEISUNLAWFULANDSHALLSUBIECfANEMROVERTOCRIMINPLPENALTIESANDCMLFlNESUPTOONEHUNDRED
�D DOl1ARE (5100,000�, INl�DITION TO TME CQST OF CAMPENSATION, pAMAGES AS PROVIOED FOR IN SECTION 3]OB OF THE IABOR CODE, IfJrEREST, AND FTTOfiNEVS FEES.
LICENSED CONTRAC70RS DECLARATION:
9(commencing with Section 7000) of
CONSTRUCTION LENDING AGENCY:
Catle, end my license is in full
[7
❑ I hereby eHirtn Ihat there is e consimction lending agency for �he peAormance of t�e work ta which this permit Is Issued. (Sec. 3097, Civil Cotle).
Lenders Neme: Lendefs Atltlress:
Signeture:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eMirtn that unLer penalty of perjury Ihat I am EXEMPT FROM T1E CONTRACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business and Protessions
Code: Any ciry or counry which requires e permit to construd, alter, impmve, demolish, or repair any structure, priar to Its issuance, elso requires the applicam for such pertnit
to file a signetl stetement ihet he or she Is Iicensetl pursuant to Ihe provisions at the Contrectors License Lew (C�apter 8(commencing with Section 7000) of Dlvision 3 ot ihe
Business end Professions Code) or t�et he or she is exempt theretrom and the basis lor ihe ellegetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit
subjects the epplicant to e civil penelry of nol more then tive hundred dollars ($500).):
❑ I, as owner of the praperry, or my employees wi�h weges as their sole compensation, WILL DO 7HE WORK, entl the structure is not intenaetl or ofrered for sele (Sec.
7044, Business antl Protessions Coda: The Contractors License Law dces not appy to an owner of property who builds or improves ihereon, and who tloes such work
himselt or harselt or through his or her own employees, provitled ihat such improvements are not imended or oNeretl for sele. It, however, Ihe building or improvement is
soltl within one year af completion, the owner-6uiltler will have Ihe burtlen of proving Ihat he or she tlid not build or improve lor puryose ot sele.). •
❑ I, as awner of t�e D�operry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo construcl Ihe project (Sec. 7044, Business anC Profession5
Cotle: The contrectors License Lew does not apply to an owner of properry wha builtls or Improves therean, entl w�o contrecis for such pro�ect with a contrector(s)
licen5e pursuant to the Contractors License Lews.).
❑ I em exempt untler sec. Business and Prolessions Code for Ihis reawn:
Signalure: Dale:
Owner ID verified by driver's license. ❑ Ves ❑ No Dnvafs License No. Expires:
Venfication of OwnersNp by (type ol dwumem, i.e. - pmperty tarz bill or deed):
DIVISION OF INDUSTRIAL SAFETY PEFMIT CERTIFICATION:
❑ I hereby cenify that no excevetion five (5) or more tael in tlepih inro which e person is required to descentl, will be meda in connectlon with work eutharizetl by Ihis
permi�, and ihat no building siructure, sceHolding, falsework, or demolition or dismantling thereot, wlll be more then ihirty-si: (38) taet high. (C�ep. 32, Grp 2, Atl 2, Sec.
341, Title e, Celilornie AtlminiSlretWe Code).
❑ A5 owner-builder, 1 wlll not employ anyone to do work which would require e pertnit from the Division oi Industrial Sefety, es noted above, unless such person has e
permit lo do such work Irom ihe division.
SignaNra: Date:
Division ol Intlustrial Safery Permit Number:
CERTIFlCA7E OF COMPLIANCE AND AUfHORVA710N OF EN7RV: 1 ceniy under penelty ot perjury thet I have read ihis epplication end state Ihet the information given Is
correci. I agree to comply with ell stete laws end ciry ordinances releting to building construc�ion, anC authodze representatives ot I�e City of Coste Mesa to enter upon Ihe
ebove-descnbed property lor inspactian purposes. I egree not to occupy or allow occupancy of eny building euthorized by this pertnit until final inspection.
[•b71�,�Ii6i7�n�i•P,iiliq
1616
1266
Fi:etl System Finel Fire Prevention
Pool Spa Finel
200 Finel RB-Rool
201 , FInaI BIocWRetelning Wall
202 Final Factory Fire Plece
203 Final Sign
�204 Final Demolition � • •
Appocant_ _ _ � �
PAg I[�ALS
i's. � � ��
'�( . INSPECTIONTYPE
206 Finel Mechanical ' �
20B Final Plumbing . .
210 Final Electrfcal
212 Final Flre Praventlon
220 Final Planning Apprwal ' '
222 Final Site ' ' �
250 Finel Builtling/Occupancy �
�
I
�. Pfl0.1ECT ADOHESS: '] O 4 W 1 6 TH $ T
owxee•s x�Me: V. �? . AND ERSON
I "00flE� SFiMt AS AbOVE
,i ,714/642-5230
RHCN/ENGINEEfl:
�ooness:
flEA.NO.:
uxrt:
unrt:
r�m^mEE: EARLS PLUMBING ( 714 ) 772-3470
�ooxess: 1533 W. LINCOLN
ANANHEIM CA 92801
LICENSED CONTMCfOH OECUPIITION: I AeraGy attirm that I am Iicense0 unAer Omvisions of ChaD�er 9(commencinp wit� Section
70001 0l Division 3 0l IAe Business antl Pmleulore COEe. and my license is in tull loru anE effect.
cm uc.: 0 0 5 9 3 8 $TRTE lJt.: 2 S'] G S cuss: C— 6
-- Date: 6 � �,"7—Q � SiqnaWre: �Q^^ �����
WOBNENS' COMPENSRTION UECLAI4ITION: I hereby atlirm that I Aave a certi0cate ol consent ro se16i or a cenilicata ol Workers'
Campensatian Insuranca, or a certitieA coOY ��ereof (Section 3800, Lab. C). .
raucr xo.: 0 4 8 4 0 exr. onre: 10 / O 1/ 9 0
coMraxx: BEAVER
❑ Certifie0 coDY is Aereby Iumishe0. � CeNlied co is fileA with Ihe ciry 6uildinp Didsion. �,/� I l
� .le: �l��� �C � PODlicanl: �� I'\ l�� /—i1�VV���V
E%EMPf10N FBOM WOHNEPS' COMPEX&1TION OFCLAIWTION: Rhis sectlon neea not be comD�� � �he permit is lor one hunOreA �51 W� a less�.
I certity Ihat in Ihe Dehormance ol the work for wAich t�is permit is issued, I shall nat employ any person in any manner so as to hecome
SuDlect lo tAe Workers' Compensatian Laws ol Califomla.
Oate: Sipnature:
NOTICE: If, alter makinp IM5 4eUaratbn, you s�oWE Eecome subject to Ihe Workers' Compensatbn O��s ol tAe LaOor
CaUe, you must IonAvntA camDly with suc� provislons or this De�mit shall Oe OeamaE revokeE.
CON3T8UCTION IFNUINO �GFNCY: I AereEy aMrm itwt there 5 a construciion IenOinp a0ency lor tlro peAormance ol t�a woM for
wliich ihis permii a iwuetl (Sectlon 3W7, Gv. C�.
lFNOEH:
�DOPF83:
OWNEB BURDEB OFCWLITION: I hereby amrm ihat I am exempt imm Ne Contactors' Stata License Law iw t�e idlowin0 reasan
(��tion 7037.5 Busineu antl Pmtessional CoOe: My ciry oi counry whicn requires a permif to construd, alter, imprwa, Eemolish, or
repair any stNcture, Driw to Its Lssuance. aLso reQuires the appliwm lor such pemtit to lile a vqne0 sWtement that he/she ¢ IlunseC
pursuant ro tAe provislans of t�e Caniractors' SUte Liunse Law (Chapter 9(commendnq xith SecGon 7000) of Diuisbn 3 ot Ne Business
anA Pmlessions CoGe) or tAat hUs�e is exempt t0erefram anE the hasis tor ihe allepe0 axemD��on. Any Wolation of Section 7031.5 by
any applitant for a permil 5u0jecR �he apptitant to a civil penalry oi nOt moR tllan five �uMretl OWlars (5500).
I, as ovmer ol t�e pmOeM or my emyloyeas wit� wapes as tAeir sole comDonsation, will Ao the work, anU ihe �
❑ struciure L5 not IntenGed or oifere0 for sale (SecUon 704I, Business antl Prafessional CoOe: The Cantractors' State License Law
- Ooes not appty to an ovmer al a D�operty wtro builtls or imprwes thereon, anA who Uoes such woB Nmsetl/Aersell or throuph
his or �er own employees, D�ovi4eU that such improvemenis are not intenAeE or oifereA for sale. Ii, however t�a builEinp or
Impmvemeniis sold within one year ol completioq the owner will have the burden of D�oNnp he/s�e AIA nat Guild orlmD�ove
lor Ihe Duryose ot sale).
I, as owner oi tAe DraOerry, am exclusively cantractlng with licensed contractors to constmct iha Dmlect (Sectlon 7044, Business
❑ an0 Pmlessions CaAe: The Caniractors' State License Law tices not appty to an owner o1 pmperry vAio Owlds or Impmves therean
anA who conlracis for such pmjects ryt� a coniractar(s)liunsa pursuam ro the Cantactors' State License'Law),I am awam
tAat 0��� a� �heir Worker's Compensellan insurance shoul0 be provi0ed to me.
� I am exemD� unOer Section: 8. 6 P. C.
br �his reason:
Oate: Ownec
I Eo hereEy cetliry ihat I am aware oi anG unGerstan0 tha repuiromenis of Catifomia Healih anA Salery COAe Sections 25505, 25533, anG
2553C d0G Ndi I Of 2lly fNpfO Oulldipq pCCUpolli VAIINAII OOI (tilq! One) OEE� t0 COmPhJ Wltll Shcd Sidt! LOG05 ind IIIB fEQuIRR1E0�510f d
permi� lor constmction or moGiliw[ion tmm t�e ar Uualiry Manapement Oistnct. HesiOential wnstmction aDPlications are exempt trom
Ihese Dravivons.
Oate: Aypliwnc
I hereEy certity ttut I have rea0IN5 applkation an0 state that Ne aGove informatian is cortect. I apae lo comDM ��h all qry an0 coumy
or6nancesanOStatelax5relatlnO�oCuildinqconstructlona abyaulMrizereDresenutive,$ oitNsc'�y Iocmeruponthea�ovo-mentianeU
omDem for i�Datlon ouroos s. �% \^ n �//... ���[��� � �
Date: SlOnatura K �C��✓ lYn ��—��v.�l%-��^
Oriver's ticenm or Saciai Securiry x: �
1861J8 W�itB—Buibirg; Green—CaEa Enlorcoment: Canary—Applicent; Pink—Revenuo; GdtlenraE—Avemr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 097937 PLAN CHECK NO: N
CONSTFtUCTION TYPE: FERMIT TYPE: PLU
JOH DESCRIPTION : GAS LINE REPLACEMENT
CLAIM VALUE:
CALC—VALUE:
PERM NO: P 047937
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC; /
COMMENTS:
�t*****x**�t�r�r*i��r*±t*�t*********�t�r�*�r� x�t****�r*�t�t�a�t�r�t�t*x*�**+t****�***�*�c�t��r****�**��t
Z O N I N G R E Q U I R E M E N T S
S E T b A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 00000000 2NE: REF NO:
PLANNING NOTES>
>
ik if iF if it 3E iF ik jE ik dk iE k iE i4 if iE iE if if iE iE iE if iE iF if� iF 1E 1E 1E iE ik 1E if it 9E if iE iE iE if iE if iE iFik iE 1E iE if iE �f �E if iF if iE 3k iE if iP if ik iF 9F iF �)E if if if �)E iF �f iE if 1E iF 9E
D E V E L O F M E N T S E R V I C E S. R E Q U I R E M E N T S
ZONING AF�PROVED HY • �� DATE:
BUILDING APPROVED HY ; // � DATE:
AP�LICATION ISSVED BY; /! �' DATE: � /[�
ifititiEiEitiEif�-ififiEikititititifiFitititiF�iFit�E�FTF7F'ifiFiFiF?�FiF3F3E3f3F3F�'iF£�'3FiF3F3fiF3FiFitifitjt*it3titiF3tiFiFi� �,Fit-x-iF
it ik i.` ik jE 3E ik if *�k 1t ik it ik',k 1f ?t it it it 1f if if if iE iE jt iF if it �E iE k iE if i! iE iE iE iE iE if iE ik k if �f 1E iE ff �E if it iE it if iE if !f iE iE �f iE �F iE �E jE iE'E iE iE iE iF iE �F if if iE iE
LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTASC MECHANIC FIRE SMIP/RES GRADING
PERMIT ZZ58 SMIP/NON—RES
PLAN
ISSUE FEE 3,00
bUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2.00 3.U0 0.00 5,00 5.00 .00
RE��ENUE DIVISION TOTALS--> COLLECTED; 5.00 OVER/SHORT: .00
bLDG PMT PLCTMSING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECI<
J.00
it it iE if if iE iE if 1E iElf if iE !E iE ik if if 1E it if 4 ik i! iE ik it ik iE iE it iF ik iF 1E it jE if iE iF ib if iE it i! if it i! �F iE tf it it fP iE iE if if if 1E if 1E iE iE iE iE it iE iE iE iF fF iE iF iE 1E ik 1f iE
I N D I V Z D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O �N UNIT COST TOTAL COST
PLU 1 GAS SERVICE 2.00 2,00
END OF FEES
02 00064�19—DOQ64119 iaYT 5.04
DATE: 6b/27/90 TIiiE: i6�11 �
CONSTRUCTION AND PLANNING P���' , A
APPRO�l.ALS Permit # Date I�spector qppROVALS Permit # Date Inspector
t. Tempofary Electrical Service or Pole 52. Pooi & 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 UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. -Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O 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
73. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. E�ectrical-Final
15. Rough Electrical•Conduit 66. Solar SYstem-Final
16. Rough Elettric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriwl•T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ve�tilating � 71. Product Qiping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Pinal Heating & Air Conditioning �
35. Final Gas Pipe-Test � �Q (�!
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing a{�
39. Water Service�Final
40. Gas Service-Final
41. Solar pomestic•Final
42. Backflo`N Preventer
43. Backflow Irrigation ,
44. Landscape IrriGation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTAUCTURE & BUILDiNG '
48. FINAL PLANNING -
49. Electrtc Release to Edison �= �
50. Gas Release to Southern California Gas Co �� '
51. CERTIFIGATEOFOCCUPANCY ,
No. Date
City of Costa Mesa
6uilding Safefy Department
P. O. Boa 317
Co�ra Mew, Californio
CERTIFICATE OF OCCUPANCY N� 2209 C
The Building lomted at � �°� � �
hos been inspected and 4ovnd to comply with the provisions of all City of Costo Mesa Ordinantes applicable thereto
for a Group �"'a � �'� Occ�pancy.
Use of Building � �+f1$
Legal pescription ��
(See rovona sida for Mete� ond 8ovndi)
B�ilding Permit No. � Elecirical Permit No.�e�� plumbing Permit No._�Q
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
requirsd under Sec. 2308 U. B. C. . required vnder Sec. 3307 (1) U. B. C. _
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has baen issued a valid certificate of occupancy by the enforcemenf agency.
(b) A new certificate of occupancy shall be obtained whenever fhere is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or g�est rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as req�ired under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of aparimenfs and/or guesi
ISSUED TO:
�yc..y; , u � n,. , r:,�,,
Building Officiol
by ����
� . t ��...v -
This Csrtificafe of Occupancy SHALL BE posted in a conspicuous place on fhe premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fo�,,, sva�—�x_u�sa r
i
� � - 2350�
� COSTA MESA BUILDING-SAFETY DEPARTMEM
P.O. BOX 917 C09TA MEBA, CALIPORN111
For Applicant to Fill In Completely
TYPE OR PRINT �
eui�oiNa %Dy u%es� �� r- S7;
.wooaess
��� COSTA MESA, CALIFORNIA
co
� O �
ILIC.TNO. / d��S� No� or. 3-�Q�
6RE / � .� 10 �/ I NO.ORBLOOB.
■ 6ETBACK LINE PROM
DESCRIPTION OF WORK
e�i�u�n� no.or
SIZE X 0. ROOMS
COVERINGWALL �aC1 COVER
USE OF BUILDIf�C AND WORK TO BE
�1 HEREBY ACKNOWL8D0H TXAT I XAVH NEAD TX19 APPLIWTION
AND 6TAT! THAT THH ABOV6 IB COqRECT /�ND AORE6 TO COM-
PLY WITM ALL CITY OHO�NANC68 ANO YTATH I.AW9 p80Ul.ATINO
9UILD�NO CON9TRLCTION.
FEE RECEIUEU
FIIVANCE EP.��
O4�PP� �9PTISPFITR�'161 E�^��r
BUILDING
For Office Use Only
R[C61'T NO. ��
r o�r n� e[cci o o� e tsauiy
/ Z�r f� �– %G-
s 70� �(' �i� "' I6 �
��„o � �
ZONING
�ZO NO.OR Ui80PN6WI�t N3r✓/q�
/ rLANB z SUILOINa pI
�/ N �y
OHHCPIRION ^0� �O / /1 %�S /
A.P.NO. I/�- 29/- 33
NOTE: NO EAV E OVERHAN6 SHALL BE LE83 THAN
90• TO SIDE Q REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMfiNT)
YARDBAPPROVED YARDSAPPROVED
MAIN BUILOING ACC6SSORY BUILDING
(FROMC/LGf'RfiET) �h s,r
PRONT �S FT, � W /� PT,
R. BIDH �� F'f. FT.
L. SID � FT. � FT.
REAR �O FT — Ff.
D16TANCE BET. BET. MAIN B
MAIN BLDG9. ACCESS. BLDGB.
VAR.}2 DATE
HOLD FOR
n
/C90 sc. Fr. "
THE AMOUNT HHOWN UNOEP VALUATION IB POR THE F'
PURPO58 OP iBTABLIBHINO A PEflMIT FEE ONLY. p
� AUTHORIZED A6ENT ' � /� 5G0�
v
V�ll•
GENERAL
IP'"�ECTIONS
Date
LH1G Y ) VJ
BUILDING PEFiMIT NO.
DESCRLPTION OF
FIRE ZONE
SUBCONTRACTOR
. CITY OF COSTA MESA
. ' �`�gt� fj Building Safety Department
Application for permit for the fabrication and erection of classified signs.
�i/ /u . / ��j� �ocation
7 �- �
ra9 No. / 3 7 3
Type of $ign ���� �- ���oft%
[� Elec. ❑ Non-Elec.
r
Building Site Address �� � �� � � � �
Name of Leasee '/ • ' 7 J ry,V ,��/t- OQ �J Phone K' — 7�vU J
Coniracfor�-�A��1� (�i'lli��i ���i� �i (l State License No.C��
�
Address�6�—�' w/�yI�VGTUIU 6ity ' �' ' Phone
Architect or
'Engineer _
Address
ity
I Description: [� Tract Sign
❑ Appurtenant and Incidental Advertising $ign
❑ �ff•site Advertising Copy Sign
License No.
Phone
❑ R f Sign
w�g� Gas Tube, Elec. Sign
Sec. 1.37, 1.44
Two copies of plans and specifications shall be submitted with application for permit for each sign. Ploi on plan
sheets proposed location of sign and locations of all other signs at site. Minimum size sheets SHALL be 18" x
24" and non-erasable.
� If between property line and established setba�k line, owner is to sign written agreement with the City.
Signature of Property Owner
Date
T� indersigned hereby agrees to fabricate and erect the advertising structure within the intent and meaning and
in _.rict accardance with the provisions of Ordinance 63-13, Ordinance 344, the Electrical Ordinance of ihe City
of Costa Mesa, and all amendments thereto.
VII j {9i� �lls:a�i1W /tl1iV�
APR 5 1965 �
�N
Y
Date Issued r/5�/� 5 Permit No.Z3g�
Fire Zone�Type�L�Group
i
Approved by � Date 'S S�
PLANNING ARTMENT
Zone%LA. P. No. �� � — � %��'— 3 �
BIdg.Site Address �� `f L�%� � `�.��� .
Legal Owne�' d1J,('.l--G�_� �
Address /_�� `2/U-{ /
c„Y C'iliy/ •
Area of $ign: /�ft.
fiequired Bldg. Setb<
Center line of $treet
ck to � � /
`j Z� "��
Location of $ign: ��
Behind Bldg. Setback Line �
Between Property Line and
Bldg. $etback Line ❑
Front ��/'_ TFeet �L �/`' '
Right V Feet
Left
Feet
ALL APPLICATIONS MUST BE FILLED OUT BY THE APPLICANT. ALL FOOTING, FRAMING, ELECTRICAL projection �Feet
AND FINAL INSPECTIONS SHALL BE CALLED.
Ground Clearance� Feet
Signature of ,,, - ,Q � P �. U. P. C. Date Approved
Permittee U/�"'�`-�l � The amount shown under Valuation is for the purpose of
establishing a permit fce only Clearance Chap. VIII, Art. 5, $ecfion 8504 (b)
-- G(J . ?�, C�
Authorized Agent VALUATION �� Permii Fee $_ ��_ Signature (Planning Staff)
$
s �
Recd. by Date �
FORM 9U-30-iM4/63
Plan Check$ �
� ��O Total Fee $ �
ignature (Dept. of �P/ublic Works)
Date: %' `�— � �_