HomeMy WebLinkAbout777 16TH ST - Building Permits�
Octobex 31, 1994
_ �
CITY OF COSTA MESA
CALIFORNIA 9262&1200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPARTMENT
pear. Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 777 W 16th Street, Permit No. B64893, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 {d) of the 1991 Uniform
Building Code. Should we not hear from you within 10 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit could possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627.
2. Request an inspection; state address, permit number, and type
of inspection.
3. Be sure to have working smoke detector's as required per
Section 1210(a) of the 1991 Uniform Building Code.
4. Have an adult present at the property at the time of
inspection to provide us access.
Should you have any questions regarding this process, please
contact me at (714) 754-5273.
Thank you for your cooperation.
Sinc rely
����� ���'(/�{'"�
Yo anda Huapaya V
it Processing Specialist
77 FAIR DRIVE
Builtling Division (714) 754�5273 • Code Enlorcement (714) �54-5623 • Planning Division p14) 754-5245
FA% (714) 556-)508 • TDD (714) 754-5244
PflOJECT FDOHESS: %%% W 1 6 TH JrT
owN¢asname: FORTNER, KATHLEEN I
aoosess: P O H OX 3 3 9 7
� NEWPORT BEACH,CA 92659
ABCHIENGINEEfl:
ROOpESS:
XEG.NO.:
UNIT:
UNIT:
PENMITTEE: HULL & SONS ROOFING ( 719 ) 628-8410
nooness: 6040 RIVERSIDE D
CHINO CA 91710
LICFNSEO LONTBACT08 DECIABpTION: I �ereGy atlirm �hat I am IicenseA under pmvisions oi C�apter 9(commencing wii� Section
7000� ot Division 3 ot tAe Business antl Pmlessions Coae. an� my license is in full force anE eltect.
CITY LIC.: STATE UC.: S S 4% Q% cuss: C 3 9 /'�n� �
Date�.�j—�%—y7 Signawre: ��� �'e- �1..�"`�
WOPNEflS' COMPENSPTION �ECLABATION: 1 �ereby affirm tllal I have a certilicate ol consent to self-insurt or a certilicate af Warkers'
Compensalion I s ra c c ilie pY ��areol �5¢c�ion 3800. Lab.
Po���.No.: fYYS�bY`—�� E%P.DATE: 3/OLI99
Icomrnxr: STATE ,s.
, 0 Cenified copy is hereby furnis�eG. L'1 Cenified capy is file0 wih I�e city Buil�inq Divisi0n.
� p �
Date: � � � � �- � � � Apaiicant: ��� � P � Q�a
E%EMPTION FROM WOflKEflS'COMPENSATION OECIAPATION: (ihisse[li0n n0e0 nol�e comple�etlil�he permili510rOn¢hunOrM�5100�a1¢55�.
I cetlity t�al in the pedarmance ot I�e work br whi�h this permil is issuetl. I s�all not employ any per5on in any manner so as lo become
su�lecl lo ��e Workers' ComDensalion Laws ol Calilomia.
Uaie: Signalure:
NDTICE: It. aller making �his tletlaraiion. you Shoultl bewm¢ SUEI�� �O IAe Wotkef5' Campensa�ion pmvi5ion5 0� I�0 Lahor
CaGe. y0U mU9 �otl�with Comply wil� Sut� D�a"�sions or tN5 p¢rmii 5hall he Oe¢meC re'rok¢O.
CONSTflUt710N LENOING AGENCY: I nereoy aHirm ihat there is a COnstNpbn IenAinA a0enty for the Detlormance ol Ine wOrk br
w�ic� Ihis Oe�mit is iSsueE �$¢tti0n 3097. Civ. C).
LFNOEfl:
RUGHESS:
OWNEP BWLUEB OECLANATION: I hereby allirm Ihat I am exempt Irom �he Contraclors' S�a�e License Law br 1�¢ I011awinp r¢ason
(Section 7031.5 Business an0 Pmiessional Cotle: Any ciiy oi couniy whic� repuires a Dermit Io mn5imct, alier. improve, tlemolis4 or
reDair any 9Nclure. pnor to its issuance. also reQuires the applicant tor sucA permit ta file a signetl statement ihat ne/she is Iicense0
pursuant io ine Orovisions ol �he ConUactors' S�aie License Law (ChaD�er 9(commenunq mt� $ecGon 7000) ai qvision 3 0l l�e Buvness
ana Prolesvans CaGe) ar Ilwt �e/sAe is exempl I�erelrom anG the EasiS for 1�e a11e0e0 e.empiion. Any WoWlion 01 Setlion 7071.5 Ey
any aop�icant lor a Dermit suhjects the apD�iWnt to a civil p¢nalry of not more ttun live nuntlretl Odlars (SSOU).
I, as owner of tne OmDeny or my employees with wapes as tAeir mle compensatbn, wi0 Oo t�e work, anE the
❑ 9mcture is nol inten0ed ar offereA for Sale (5¢ction 70d4, Bu5inM5 anE Profe53ional CUOe: 7he CAniractors' State License Law
aoes not apply ta an Owner ol a pmDeny wtlo builds ar imD�oves Inereon, ana wtlo Ooes such woM tlim5ell/herseV or Inrougn
�is or �er own employees. DmviaeE Ihat sucA imD�ovemenls are noi intenOeG or oflertG for sale. II, however t�e Ouildinq or
impmvement is solE wit�in one year ol complelion. t�e owner unil �ave tAe burEen ot pmvinp �e/she OiU not Uuiltl or improve
br the purpose o� sale).
I, as awner ol the O�opehy, am exclusively contracting wiih Iicense0 conVaclo�s lo cons�mci Ihe prolact (Settlon 70aa, Business
�❑ and Pmleuions Code: The Contractors' State License Law aoM noi aDON �o an owner o� pro0erry w�0 builEs or improves Nereon
antl wha contrac�s for suc� pmlecis wilh a wntractoqs) license OurSuani Ia I�e Contrac�ors' Slale Litense Law�. I am aware
Ihat pmol of �Aeir Worker'S Compensa�ion insurance shoul0 �e Dmvitletl Io me.
� 1 am exempt un0er Section: B. 8 P. C.
Iort�4 reason:
Daie: Pwner.
i eo nereDy cenily tnat I am aware of an0 untlerstana ine revuiremenis ol Cabiomia Healih anE Safery COAe Sections 2550.5, 25533, an0
25534 an0 ihat I or any �u�ure building occu0anl wilVwill noi (circie one) neeU lo comply wi�h saitl s�a�e cotles an41�0 repuiremenl5lor a
permil lor conslmc�ion or motlilica�ion imm Ihe Air �ualiry Managemenl Di5lricL NeSiA¢niial cons�mc�ion aODlication5 are eKemO� �mm
IheSe provisions.
Dale: Applicani:
I hereby t¢rttly Ihall have reaU I�iS applitation antl Sla�e Ihalih¢ a�oveinlormali0n is tOrreci. I agr¢eto Camply vni� all tily anA Counry
o�0inances an0 slate laws relating to OuilOing consimction and �ere0y aut�or¢e reD�eSeniatives o� INs 6ry lo enier u0on ��e above�men�iane0
Omperty lor inspetlian purposes. (^�} �_ 0
Date: f /—��—�� SignaWre: � �-/ � �-�/'�
Oiiver's ticense or Socia� Sea�ity x.�
t6at�a6 Whpe—Builtlmg'. Green—CoOe EnlorcemenC Canary—Applicanl; Pink—Revenue; GOldenroE—Assessor
CITY OF COSTA MESA — BUILDIAJG PERMIT
PERMZT NO: H 064893 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: STR
PERM NO: B 06489?
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : T/OFF REROOF W/BUZLT—UP SQ FT: 13,300
CLAIM VALUE: 13,300.00 CALC—VALUE: 13,3Q0.00 GROUP OCC; B-2 /
COMMENTS: REROOF 12000SF BUILDING W/BUILT—UP
*+�*�*r****�+�**+��***�c+��c+��*+r*�*��*r�********�*�c��r-�c*�c***+�*�*�c�**x�c*x�c*�+���c�c*xx*�c�c*x
Z O N I N G R E Q U I R E M E N T S
S E T B A � K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: ET IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN AGFIT; FT IN
PARKING REQ: PEiOV: PARCEL: 92413104 ZNE: REF NO;
PLANNING NOTES>
>
iE iE iG iE if iE iE i1� i4 # i(� �E it if iE 7f iE af if iE iE if if iE i(� if if i! ff it iE iF i! if iE iE �If iE iE if if M if 1E if if it if #f iF it 9E 9E iE if �lt if iE ia if �1F 3f iF iR iF iF it iE if if +F i(� ic� iF iE �1F �7f iE M
D E V E.L O P 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 APPROVED BY DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:
*****x��r�r�r�r�r�r*�-k�i�**�r*+t*�r�3F�"�t+�3F+��titi��r*�*�+���� **���iz***?r+r?��rrr* r * +r�'**
if iEi! iF if iE f:�1: 4E iF jE if #�iElE 1f�)f if iE iEiF if 1f if iE iE if iE 1f i! 1f if if iFiFif if ik if 1f i(�if�1f If fFif fE if�lE ifjFjf fE 1E fF iE iE 1f if K iE 1E iF 1E iF iP 1f !f if if if if lE fE ik iR iF if#
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SE�MENT:Y
� � Y
BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/RES �RADING
PERMIT 153.00 •
. SMIP/NON—R�S
PLAN p , '7 g
ISSUE FEE , `-,
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID' DUE
TOTALS----> 155.74 0.00 0,00 155,79 ' 155.:79 .00
REVENUE DIVISION TOTALS--> COLLECTED: 155.79 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRIADING PLAN—CHECK
153.00 2,79
iE if ih it �E i1 if M iE i! #� fE k if k 1! ih iE it M k!f if it if k it 1!� 1k 1E if ff if �f iE �F 1E iE it if it 4 i! iE fE 1E if iE 3c 9c ic iF iE iF iE if #' jf if iE iE iE if it iE it ii { f if iE iE iF iE 1E aE 1E iF M i�
I N D I V I D U A L F E E B 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
SFC 13300 REROOF BY C�ALUE COMMERCIAL NOZONE 1.00 ' 13,300,00
END OF FEES '
rt Q01`�iS°D-0015Q581. Y+�a"f 1J5.�.'
Ur't:7 1I/i:�/S� 7IilE: i.`•:41
C(�, i�TRUCTION AND PLANNING ''�,
APPROVALS Permit # ,
1. Temporary Electrical Service or Pole �'�..
2. Soil Pipe�Undrgrhd.
3. Eleccrlcal Conduit Utility•Undrgmd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Gmd.
7. Footings
8. Foundation
9. Water Pipe-Undrgrnd.
70. Structurel floor 5vstem
71. Propeity Sewer �ine & House CAnnection
12. Sewer Cap
13. Roof Drains
14. Rough Plumbing
15. Rough Electrical�Condu�t
76. Rou9h Electric Wiring
17. Rough Wi�in9 Siyn
18. Rough Electrical-'f Bar Ceiling
79. Rough Heating & A�� Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structwe
22. Ducts, Ventiiacing
23. Gas P�pe�Rough & Test
24. Roof Framing
25. Roof Sheathing 1
v�
26. T�Bar Ceiling iStructurall & Monocoat
2J. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster BroK�n CoBt
32. Electrical Power Meter�Final
33. Finai Electric
34. Final Heati�g & Air Conditioning
35. F�nal Gas Pipe-Test
36. Hood or Canopy
37, Final Factory Firaplace
38. Final Plumbing
39. Water Service�Fina�
40. Gas Service-FinaV
47. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigatio�
44. Landscape Irrigation Syscem
45. Sound Aitenuation
46. Handicap Regutatio�s
47. PINAL STRUCTURE & BUILDING /`,
46. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Date
��
POOL � �PA
Inspector qppROVALS Permit #
52. Pool & Equipmenc Location
53. Steel Reinforcemr.nt
54. Forms
55. Electrical8onding
56. Rough Plumbing & Pressure Test
57. APPflOVAL TO COVER�GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O U�drgmd„ Test
60. Backwash Lines, P�Trap, C UnArgrnd.
67. APPROVAI TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent�Final
64. Plumt�ing System • Final
65. Electrical-Final
66. Solar SVstem�Final
67. Fencing & Access ApProval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
77. Product Piping OGas ❑Oil
72. Underground Flush
73. Undergrnd. Storaye Tank O Gas ❑ Oil
� �.- 74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXEO SYSTEM FINAL
76. PIRE PREV. FINA�
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTiFICATE ISSUED
Notes:
b"� � �t�- 1�D i'�o
Date � inspector
�
�� f! �i��� �- ���' ^�/�`
1. RAY CONSTRUCTION COMPANY
March 20,' 1969
rlexible 24eta1 Hoae
777 West lo"�h Street
Costa Nesa, Calif.
Gentlemen:
�
1BB E. 19TN 6L - BIIITE 2P
COBTA ME9A, CALIF. 93639
TEIEPHONE 641�431❑
4]e herewith submit cost brea'_rdown Por D�.V117F of parking
lot as ree��-ired b:� the Cit:/ of Costa ;1�esa plue tne cost o` Test
Facility as per approved plane by the City of Costa Mesa.
A111ed Asphalt Paving
J. Ray Conatruction Co., 15�
If present driveway is to be
re-sheeted at the eame time
add as Pollows:
A111ed Asphalt 1'aving
J. Ray Conatruction Co., 15,�
Test Facility Cost as submitted
1�847.80
277.17
2,124.97
360.00
54,00
414.00
Total for all phases
Very truly yours,
2,124.97
�
414. 00
1,397.00
�3,935.97
J. hAY CONST.iiUCTION CQMFAI�TY
,
/ / ` '_�'
% . /'� � i , .%`-��:.��-'`,j.
/ `�A. L. Gatterdam �
Date: L�/% !y �
% J /' �
Accepted• �� _ ..r r :�` / � i %
ALG/eb
�c�� j��� ����`� �-�%�- .
J. RAY CONSTRUCTIOP�f CO;;nPANY � "
1BB E. 1']rn 5T. — 9IlITE 2A
CO5TA ME9A. CALIF. 92627
:i�.-�'C% Zt�p �.'n���.�"� TELEPHONE 642-4210
�ii'�j' 0= l"i0u^ L.9. :4i 52.
Pls.�lriin" De��:rtc�ent
F.E: Tee � Site 7"i r'i;16
JOu L��. ::�:✓�.� vJ.� '.i_ •
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IL 1J �V.� L��!�'.e=✓Y�LnI'.�i5� J/-C.� ��iZ J:=1� 15i��.G Z.
CO'IC1.1 �i Ci:c'i �.SB v2't"iiii � �O JUi1.il 2. '�G'S`l. u1i.2 �?'07-C�.1"1� i9c�
�li.�:c^.�?�2C' �0 ll'.^,��2.i1 ..-s8 :S-��il?l'G iOc.Vi11v c.`_�)- =1+i1'_,JiTl� �S
pe= LL�1a:;s accor�=no i:o City� cf -- '. ,�^ �' �
JO�iVC: �� 4 �.1v:.0i7i��'S
Y:l:�_l:i a„ i�1L�rN�/ �t�'V� ��.t�,�� _IJ�..nl7l'. GU.r��CiV :�o r;��.',;.�e= c�ncli
Ul�i7�•
�•1.^-. c1;�i'8� :.O �i:<!� 8.70V2 Sl`.=�OU-�-=':?OI?5.
S� E�';;I �%'li1;J y OI:iG�
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COBTA MESA BUILDING DEPARTMENi -- • �U 213 C
117 Eart 20th 8treet
�Costa Meaa, California .
. �
oet�._.......1...../..'.....~:..._a.:L..-..........�..7
CITY OF COSTA �MESA
CERTIFICATE OF OCCUPANCY
-;�01 =. �t x �>JL
Building Permit No�.�J.........Electjrical Permit No...4!.S7..E:...Plumbing Permit No�....�_._.....
��� � "� IZi<�� " ��.} �"Jf+
Uxof Bulld(np...L[.e._ �d....r..,._... ......... �...d�C-�..r...,........""" ........................_......___...
The buildin9 located ai/......_�....-{...T....�..�........!�:�.._' '.."L!�.-�_.�.'..I
...r...._.....c..s...::"s_—..._..'�.•.:_._n:.v...: c._..-........._ .............._..........._.......""'............._..._........._..__.....
�ot........_� ..... ......... . !� Y ! �, — � �n _ � c/
............. Blxk........................................... Traet..�.....
_ ........_...»....."'......__.._..... .
($ee rcverae side tor Metes and Bounda)
has been inspected end found to comply with the provisions of all City of Costa Mesa Or-
dinances applicable themto for a Group...1�.'.......�.�.:..Occupancy.
ISSUEDTO: � � � A. J. VOIZ
'^ � � � f r � City,Building Oftieial �/' .
f�'��r:��--....�.�...� ...��1 . _
(o.vnerolsu��dln¢) .. 9y...l..:.F:�:l.��c.a�,E..til....C.:Y:,,,r.
CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison Co. �j 3rd copy—Flle
Form 2�6 GH 1M 12.68
1
City of Costa Mesa
Fire Department
FROM: . COSTA MESA FIRE DEPARTMENT
T0: COSTA ME3A BUILDING DEPARTMENT �'!£��o�c mc%v�( L�oJc �o_
Section ,���� �/c/s��
Location 992LU, /G'=� s�':
Thia is to inform you that an apparent hazard exists at the above address as
follows : (,(/j � jN� iN ��.o .t'���e. �.Por� /�.Vb FY J�ENS/v.f/. c'
--� - - —
�o�¢Q< !ls�d Excess�vcly v usCd As .c� o�,e�is�,�c�.a+�f�.-T,¢c
:. /I �'_ � � a� /! i�
" ' " • / I' ..' � <'
���. � � .
OWNER j-jAj � DATE
JOBADDRESS %%J W, 1()t,]7 St� BUILDINGPERMITNO. 13OZ
GENERALCONTRACTOR Rea H2'OS• VALUE $ 56�000.00
• i � AP# 116-31�p-]l� s�ocK TRACT Machzr� Shnn & Os'P;rP.
GROUP G TYPE I 20NE j� FIREDISTRICT '��8'�
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOp DATE NUMBER
Footing 7rench � _ -6 � � _ �, /' ,(4` _ 7 -/ -.lX�
PI
�tion Forms and Grade to Garage ~"� v�"�"� -� ��
Fremin4. 7-/2- - C�...-..a.,/ 7"
,�
jieating, Final 1GG,
��Sewer, House ewer, St.
.\
Septic Tank or Cesspoot
Lat' �, In Ou
Pla ing
Final, Fixtures Comp t Ci� -/-
Fin.al GasTest/Y� S %k - /.
�
a
Wiring,Final /�Xdb �/'i,%•S� (Q+�il.l(AN_lJt,J I (�',(�(t✓'"I_ �
Occupancy �
1Pnrm 21 O R_N l Snn 1_S5
✓
ao d� � �� �,--: -�'�,c�� . �
� 9�-� a � �f- � � '�`q�" ���i
/` � 4f�63�
/ COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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For Applicant to Fill in Comple[ely — Use Ink Only
BUILDING �%� j'i� ���t� �.frret
ADDRESS
OWNER ���'.GlN'� MPa'a-/ Nose M•G'y Ca
MAIL �y� I../. // /% _�.
ADDRESS / ��� 0
c�rv �c�-slzr �A�esc/ No`bi�!-y�5
CONNRUCTION ^�
BqANCH ��
AOORESS
^ �.��� TEL.
RESS
fRACTOR
ADPRESS
TEL.
GITY NO.
STATE CITV
LIC. NO. LIC. NO.
512E NO.OF BLDGS.
OF LOT NOW ON LOT
Separa[e permits are required for
electric, plumbing and heating work.
US8 OF BVI�DING ANO WORK TO BE PERFORM1
�J.f•Fy�. <� �'o>�ey� . O{�icr
it��7�i'1"/O!'' 4/�7.�� /.'1dtl:�tv.'Frv.�s
I haraby aeknowledpa that I have read this application end state
Shat the abova (nformacion Is correct antl epree to comply with
ell lews reguleNag bullding conrtmcHon, antl 1 shall �oc amptoy
any person in vloletlon ot the workman's compenution laws of
tha 5mte of Calitornla.
I heleby certHy that I am properly Iicansatl as a contractor under
the S<ete of Californla Businass antl Profeuions Cotle, Division 3,
Chap�er 9, and ffiat such Iicenses era In tull forea end ef}act, or I
em exampt from Ma provisions ot the Stete of California Businass
antl Professionz Coda, Divislon 3, Chepier 9.
Slpnature qf /�ls�/d/N l��� �C
PermlttealX
�°�—�-- �
n�mori:aa nya�c w / /�fimu-cc.uc��
A.P. NO.
BUILDING
OWNER
FIFiE
ZONE
VAROS
MAIN
ROM Gl
VAR. #E
C.U.P.qW
Na*e �;:;r;:q
^�7 —2-75�,hs OQ 120�� 6.70
FORSTRUCTURALPERMIT
DATEflECEIVED D TE SUEO
— �0 -�-7�
r
VALUE
V'
VAtiDS APPROVED
&
DATE
APPROVEO
.,,.T� /O —�l —
THE AMOVNTSHOWN UNDER VALUATION
THE PURPO6E OF ESTABLISHING A PERMIT FEE
VALVATION �/� PERMIT FEE $ �
`rv PLAN CHECK E
x� `— TAX E
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COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31�
COSTA MESA. CALIFORNIA
FOR
DING � i
TO FILL IN
PL
quuncpe �� V' ' � V J I
COSTA MESA. CALIFORNIA
OWNER -r�� � f�os�� i�iG�-
MAIL /� � � Ili • I V / �
AODRE55
ARCH�TECT
OR? VEER '�—
TEL.
NO.
LIC.
NO.
CONTRACTOR I\ J J� IC1' N I NO./� -J:
f �1
ADDRESS � fJ � C�IA'�%D�"� NO. f /I��
LEGRI LOT �/T /YPWIIOI� l+l
OESCRIPTION NO. � BLdCK I TRAC
A.P. NO. �—� GI v J � LI
SIZE No.oF eLOGS.
OF LOT / Z� %` Z� �ow oH �o'r
USE OF �/% � �.
SETBACK UNE FHOM }�- /� �
cc�ureR or srnEcl J(/ REAR YARD ��o
SIDE YARD RIGHT Z� LEFT ct
DESCRIPTION OF WORK
NE4Y" ALTERATION I ADOITION
REPAIR MOVING DEMOlISH
BUILOING � �J NO.OF
SIZE %i G X�7 G ROOMS STORIES
E%TERIOR WALL /�O h G COV�ERING /�D�P�O�
COVERING l�
USE OF NEW A/�n _ C[ � I_��
�%y r. i- 2X'�/���/G � C9G. 2vti fc'�
�,! zL, u
(,G✓C✓Gp Ck okP SKiF tv�'%� i>f �y5CO3�(
1 MEREBY SCNNOWLEOGE THwT I H VE NEwD TMt /qPPLIC4TlOrv
ST/TE TNAT THE A�OVE IS COPNECT iND aGPEE TO COMPLV WITN
CITY OROINPNCES I.N TI.TE lAWS EGl1L�{TING BVWW������ G CONSI
TION. /�� �� •/% ��I
SIGNATURE OF� I /�
PERMITTEE � (�.,,� � �..j
FEE RECEIVED
o �.�: � 7, i�� s�r 3�� ,
FINANCE DEPT,
APPLI��AtTiiQ 1N,0�S��1E'�ERMIT
BUILDING
FOR OFFICE USE ONLY
� � 7 � � � V —
COSTA MESA. CALIFORNIA
i � f�
�/ APPROVE �" ` �7
L 7 BY �Yrt DATE /O I/ S•
+"�° ^L CORRECTIONS T �
a�
7�
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VALUATION M
PERMiT FEE $ `
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TOTAL FEE $ Z�
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•COSTA MESA BUILDING DEP,4RTMENT
P.0.90X 31�
' COSTA MESA, CALIFORNIA
FOR
6UILDI
AODRE'.
CITY
ARCHITECT
OR' NE
A��RE55 �
APPLICANT TO FILL IN
� % GU�sy' �� S
TEI.
NO.
�ic. #T � �
NO.
�. �6rtd J�'l
LIG l'7 i1 o q
�NO. ( (/ i.
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TN n � / - l / L
LEGnL LOT� //�
DESCRIPTION NO LOCK TR
�
A.P,NO. � � O^
$IZE ��� x 3 a 9 NO.OF BLDGS.
OF LOT Now orv l01
E%IST�INGBIDG. NI�IIU�J� Mt�,ku
SETBACK LINE FPOM
CENTEF OF STREET _�Q I REAR VARD / G �
SIDE YARD RIGHT �{� LEFT ��
DESCRIPTION �OF WORK
NEV �� ALTERATION A�DITION
REPAIR MOVING I DEMOLISH
SIZELDING��•�/� /(;Q � RO MS STORIES I
v
C VERINGWALL`�F��YP�P COV�ERING y0! / /0�
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CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
s ���
ECENEp BY �4TE PECEIVEO D/TE IS Ei
/1 _ �.. / /_ � �l r�i G /-� / �
BUILDING �
A�DRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
BY
CORRECTI
CITY
STA MESA
G-DCf'�
DG. DEPT• REG.
nare
STPTE THqT THE PBOVE IS CORRECT PND AGREE TO COMPIV W!TX ALL
CITY OFOINANCES 4NO ST/TE lRW$ REGULATING BUILOING CONSTRUC-
T���� VALUATION
SIGNATURE OF
PERMIT FEE S `}� "�'
PERMITTEE ` )
3 p ✓J � A PLAN CHECK S pC- �� O
� $ i � � !
AUTHORIZED AGENT TOTAL FEE $�� J� (, ���
Costa Mesa Bailding Department
: t P. O. Box 3! 7
'' � - COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
e�uai�e rl'77 ly, /� Th s?'
Addresa
Costa, Mesa, California
Cross 6t. j-�/LI�7C.¢ N/� q
—� /7
Ownery`�.2 X � Di(. b ��OS r+
Aaa e s�7•-» w/� Tl, � T'
Tel.
CitY O � �/i' /1'% E'..i �4' No.
Arohitect or Lic.
Engineer No.
��ldress
Cfty Lic.
1.itracMr.— �.i.��0 S i� R!'tiS No. 11
v
Address z-r� / P�- r r �7 {— '
Metes and I
..�I7/ O
Setback
PLICATION FOR PERMIT
•`��q� BUILDING �
FOR OFFICE USE ONLY
IReceipt No. I � �m� �
�Receiv 6y Date Rec'd. Date Issued
/�� � � � a-'� `/'- � =�'�
B�,�tl��s 7 7 %- Cl� — /� �` �
Address
Costa Mesa, California
Nearest �J ��
Cross St. /� �. �. � ( / O�
Zone .� .i . I No. of I Tvoe / GrouD r
of eid9s / � DATE
�on Lot �
of No.of BY P��� A
ifllea I Rooms �
ar Vard S —
feYard lT3� D
cx�nvQn-,i ... r
Alteration � � Addition
Moving I I Demolish
No. of
iering S��GG D � Covering/�O � APPROVALS
Use oT Nevy�
Buildin8 \j j'�J �^/q- tJ Lo � T6 /� Foundation Location Inspector
/o Forms, Materials,
RC1 C �� I �.LY R S Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read tlils Application
and state thak the abave is correct and agree to comply Lath. Int.
with all City Ordinances and State Lews regulating
building cOnstructlon. /% Lath. Ext
Signatureof � /r//�f�
Permittee TV �/i,..i .�C _ plaster, int
Valuatlon � Permit Fee $ �. � D Masonry Reintorced
� Plan Check $ i 0 C)
Bond Beam
$ / z O� Total D�
Fee �� � FINAL
cewrn xoa �o.ss o. v. e s.
1
Dat
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PLOT PLAN
Show Iocation and distancea from
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDtNG 7 � � l /�J�Q� �/i �•'y Li
ADDRESS / V � (U
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ADDRESS 7 % % �' V / (J ��
�- TEL.
cirv ��,..A�lr+�, �L��I G�['i, No. % �%/c,P
BRANCH
AODR ESS
ARCHITECT � i , ., �/ NOL
OR ENGINEER
ADDRE55
CONTRACTOR ' � J\l�t- y � O �V -� / L
ADDRESS � ��� ,�jl � � � �``�
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CITV � ����C4'�GC NO� �
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STATE CITV
U0. NO. ���� Cj ��- IIC. N�.
i
SIZE NO.OF BLDGS. -
OF LOT I NOW ON LOT
USE OF
EXISTING BLOG. �
SIZE OF J NO.OF
NEW 6LOG. / �� ^ �� ROOMS � STORIES /
EXTEFIOR WA}.� //� ROOF / 1
COVEFING ��('Iww��4�Ql�p� COVERING � � � .t� ( "
USE OF BVILDING ANO WOPK TO BE PERFORMED
0
PAID
APR 10-69cnsa0D 477�� ***�Z1.00
APPLICATION FOR BUILDING PERMIT
A.P.NO. {II�—
BUILDING f7
ADDRESS �� 1
IEDT. MESR
` I ^ PE I O.
'1"
IbTM' �
� OT ��3 BLOCK
OWNER �L�D�I� �/ �//C�
VALUE
S � $
FIRE
ZONE TVPE GRC
APPROVED /Y�
ryE NO.OF �
✓11 P�or�s i
VARDS APPROV ED
VAR. #
C.U.P. #
APPROVED
9V
HOLD F
FT
USE OF NEW 7esrinlG
BUILDING
VAFDS APPROV ED
2 + FY- l� � �
O � FT � �
Q = FT. G. � -.
�C' � FT. F� � � ,�
BET. MAIN & C
ACC65. BLOGS. 'J 7 Cd C
DATE j
APPROVED
I hereby acknowletlBe t�et I pave reatl this application antl state �� I� �` ?'` 1 �
Shai ffie above intorma[ion is correct antl agrea to comply with 6 7U CB
all laws regula[ing builtlin8 cO�struction, antl I shall not employ
any person in violation ot the workman's compensation laws
the State ot Califomia. • m
I hereby certify that I em properly Iicensetl as a contractor u tler. /� SQ. PT. o
the State ot Calitornie Business antl Professions Cotle, Divisic THE AMOU WN UNDER VA�UATION IS FOIi
Chapter 9, antl that such licenses are In full force and effect, or E OF ESTABLISHING A PERMIT FEE ONLV: d
am ezempt from the provisions of the State of Califotnia 8�sines5 ¢
antl Professions C e, Division 3, Cha ter 9. VALUATION � OG m
PERMIT FEE S �
! �
Signature of O.d m
Permittee ' S PLAN CHECK $ •E
O� �p LL
Authorizetl Agent � ��� TOTAL FEE $
, � 442� 1 ''w`�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ ro Fill in Completely — Use Ink n(y
BUILDING � „ ` /
ADORESS V�J �/
OWNER
MAIL ',J ^^-}'
ADDRESS w I / i
TEL�/� ��J,
CITY / •1 NO.,(TJ/ �]
CANSTflUCT10N _
LENDER
BPANCH
ADORESS
TS••T .G➢� �sO%%/� TEL.A7/ �
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ADDRESS �/ f� fj
�//A TEL
CITY � ��, (�II S NO. '
STATE �" � CITY
LI0. NO. J D LIC. NO.
SIZE �/ ` Cj� il NO.OF BIDGS.
OF LOT ((J / O �� NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING ANO WORK TO BE PERFORMED
�_a�e : p . ,c
� . .
I hareby acknowlatlga thai I have reatl Shis application end rtate
thai ihe above information Is correct antl agree to comply with
ell laws repuletlnB buildin8 conrtruction, entl 1 shell not amploy
eny perwn in vlolatlon of the workman's compensation laws of
the State ot Celifornia.
1 haroby certify that I a ro0erly Iiconsetl as a contrector ntlar
t�o Staie of Calif ' ss entl Professions Code, Divisi ,
C�epter 9, a thet su liee re in full force entl eftact, or
am ezem from M ovlsi tha Stete of Calitornla Business
entlPro sslonsC ,Riviai .Cha'a'ter�. _�1
of
AOant
N��� s ., , _„ .,
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APPLICATION FOR STRUCTURAL PERMIT
FECEIV E I Dp/'77 E/I�SSUEC
� /, .l� _
1
FIR
VED
Z�PLANS
VARDSAPPROVED
MAIN BUILDI G
(FROM C/L 5T
VAR.
�
USE OF
BUIL
VAROS
&
DATE
APPROVED
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TNE AM HOWN UNDER VA�UATION IS FOR m Q
POSE OF ESTABLSHING A PERMIT FEE ONLY: b
a �y
VALUATION PERMIT FEE S •,,,,� �
m ' 1
5 I�/� PLAN CHECK E b Q
m✓ O TAX E � O � ��
u�TOTALPAID S i
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX1200 COSTAMESA,CALIFORNIA92626
For Applicant to Fill in Completely — Use Ink Only
BU`I'LO=NG ,–�i �1�. �/�.7� � �.IA.
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OWNER
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CITV �QS�
CONSTRUGTION
LENDER �'
BRANCH —
ADDRESS "'
ARCHITECT (_ �
./=1Zr'
TEL.
NO. .
CONTRACTOR �'yRK '?"OKC�ac' �-pN>%�•CD �{
ADDRESS Z�Z� 9 /�{ i�j' A(� ' .y
I TEL.n� �73
CITY SO. I�C– /�.SOhJTL� N0.7�WSYJ�
IIC.NO. ZISJ l C {j� �ICVNO.
SI2E � NO. OF BLDGS.
OF LOT � Z(r X LYO I NOW ON LOT �
USE OF
EXISTING BLDG. Vi �� �
Separate perrttits are required Cor
electric, plumbing and heating work.
USE OF BUILDING AND WOFK TO BE PERFOFME�
vaio rr �c,�;,Z
JUL 21-77CM5;,002420 ` 0.5G
FORSTRUCTURALPERMIT
DATE RECENED c issucn
A.P.NO. �/���Y��
BUILDING ��� �
ADDRESS
�..pi s �r vs4 1
TRACT
E R FL
FIFE
NE,�� /� NO.OF �
///6 P�^�
YAFDS APPFOVED
MAIN BUILDING
90M GL STREET)
�nrrAi %A7�/+�
.�_ I
OISTANCE BET
MAIN BLDGS.
VAR.qJb �_.
VALVE
O�+ Gy S
DATE
USE OF NEW
6UILOING w
BEf. MAIN &
ACCESS. BLd
�DATE
APPROVED L
' f.
BIOCK
�LV•
I hereby acknowledpe t�et I hava raed thh eppllcation antl stata VL�j r�,/�( J1�Lb1 L RL<{IJIKC1Yl
that the ebove informetlon Is corract antl apree to comply with
ell lews regulatinp buildinp conttruction, antl I shall not employ
eny percon in violetlon of the workmen's compenseNon lews of
tha Stata of Californle.
I hereby certify that 1 em properly Ileensatl es a contractor under n• FT.
the Stete oi Callfornie Buainesa end Profanlone Cotla, Divlalon 3, THE AMOUNT SHOWN UNDER VALUATION
Cheptar 9, end that such Ilcenus ere in full forca antl afiact, or I THE PURPOSE OF ESTABLISHIN6 A PERMIT FEE
am exampx (rom the rovlaiona ot the S[am o1 Callfornia Businea9 VALUATION PERMIT FEE 5
entl PIO}8551009 C`Otl�l i n Chep(ef2J.
SI net of j l � P�AN CHECK E
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Pe�mltte� � � J § THX S
Authorizad ABent TOTAI PA1 D S 0
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. eOX 1200 COSTA MESA. CALIFORNIA 92626
JUL 25-77cMSQ002641 ��tr�*72.00
AP AT ON FOR STRUCCURAL PERMIT
For Applican[ to Fill in Completely Use Ink Only qE ED OATE RECEIVED
DATEISSVED
BUILDING �
ADORE55
OWNEfl A.P. NO.
MA I L BUI LDING
ADDRESS ADORESS �
TEL. TRACT LOT BLOCK
CITY NO.
CONSTRUCTION A D A P
LENOER
BRANCH
OWNER �
ADORE55 ^ ALUE '�
ARCHITECT TEL. S 5
OFi ENGINEER
FIRE ' �
ADDRESS ZONE YPE GROUP
APPROV
CONTRACTOR • BV .DATE
ADDRESS ZONE NO.OF USE OF NEW
TEL. p�p,ryg gUILDING
CITY NO.
STATE CITV �'ARDSAPPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT NOW ON LOT ROM FT. FT.
USE OF
EXISTING BIDG. T F
Separate permits are required for L. SIDE FT. FT.
electric, plumbing and heating work. _
FEAR FT. FT.
USE OF BUIL�ING AND WOFK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLOGS. ACCESS. BLDGS.
VAR.qW DATE
' C.U.P.qy+ APPROVED
APPROVED
I �araby acknowletlpa thet I have reatl thif application entl smta °
r
that the ebove Informeilon is corract antl aprea to eomply wHh — a
ell lews rapuleting bulldin9 eon�tructlon, entl I shall not employ
ony person In vloletlon of Me workmen'a compensatlon Inw� of ;
mo s[ete oe colirornle. .
a
I heraby cartity thot I em properly Iieansatl es o contractor under SQ. FT. c
tha Stata oi CalHornla Buslneu and Ptofecsiona Cotle, Dlvlsion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR p
Chapter 9, end thnt suc� Iicensas ere In full foreo entl offoct, or 1 THE PURPOSE OF ESTABL6HING A PERMIT FEE ONLV: �
em exampt from Me provielons of the Stete of Callfornia Bu�inoss VALUATION PERMIT FEE S .� �
antl Profos�lone Cotla, Dlvislon 3, Lhepter 9. �
PLAN CHECK 5 �
Slpnetufa of / e
Pofmittoa $ /// / TAX S
/ I, �/� �
Authorized ABant � TOTAL PAID E . pY