HomeMy WebLinkAbout281 20TH ST - Building Permits p F CITY OF COSTA MESA
44.1 14 9 BUILDING DIVISION "` '
F „„, ; 4virttflORE 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
J . . P03-00039
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 481 E 20TH ST Status: ISSUED
Suite No Applied: 01/22/2003
Issued: 01/22/2003
Vicinity:
Parcel Nunmber: 42632407 ISSUED BY:
Applicant: RUIZ, DENNIS
Address: PO BOX 3341
Phone: 714-412-1025
NEWPORT BEACH,CA Zip: 92659
Owner: BOWER, PAULINE
Address 481 E 20TH ST
Phone:
COSTA MESA,CA Zip: 92627
•
Contractor: MIKE KILBRIDE, LTD
Address: PO BOX 3341
Phone: 714-412-1025
NEWPORT BEACH,CA Zip: 92659
License: 738400
•
Arch / Eng :
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
PLUMBING TO INCLUDE: 1 SEWER CAP AND 1 SEWER CONNECTION.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 , Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $9.80 1 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $24.65 1 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
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 period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
2FOOR INSPECTIONS CALL: (714)754-5626
lia24 ta-46(WOO)
DECLARATIONS
•
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under penalty of perjury one of the following declarations: •
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is Issued.
KW I have end will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier/^� and policy number are: / \
Carder: c1 i-7- Fol' D Policy Number: 3Gava-S- OZ
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.) .
❑ I certify that in the performance of the work for 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 Call • la,and agree that if I s•ould become subject to the workers'compensation provisions of Sect 3700 of the Labor Code,I shall forthwith
comply with these provis•
Applicant Signature: / - • Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERA•ItUNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND COLLARE(5100,C00),IN ADDITION TO THE COST OF COMPEN ION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.N Class It
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this p.rmit is issued.(Sec.3097,Civil Code).
Lender's Name: (7( '< Lender's Address: i • ( —/
Signature: Date: / 0 _
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires:
Vellication of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application agermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safely Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature OIL I ner(s) !// .÷/21
And/Or Authorized Applic t Date
CODE# 1NSPFCTION TYPE PATE IMRIALS CODES INSPECTION TYPE RAIL IKIM&B
1616 Fixed System Final Fire Prevention 206 Final Mechanical 4�',/�i' r
1266 Pool Spa Final 208 Final Plumbing 'T/r/AIUt%('q.(_y,
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
w^•`l'"1 AIYVWL"1"VSI. flan' usiara -V .'.� vu
JOB ADDRESS 281 E. 20th Street BUILDING PERMIT NO. 25598
GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Add Room over Garage
An No. 118-114-11 LOT TRACT FIRE ZONE VALUE $ 9,975.00
PECTIONS Signature Date GROUP I TYPE V ZONE R-i
1 Soil PERMITS ISSUED
Gas SUBCONTRACTOR I Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con..0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground ❑ Power 0
Rough Wiring j 4' .,i-/2.6C Heating and Vent.
Trenches 0 Forms 0 Steel Reini. 0
Floor System iit ((,
Bond Beam 0 Steel Reiaf.,ce 0
Sheathing a/'"CMi0. 4ACrir 11'
Frame and Flas - / 11.c- -MTC1-)
Lathing — In i Out F i ,any .
Plaster, Brown Coat Cr 07/4‘
„ll/
aural, Final Electric c/J rC
L....dng, Vent., Refrig. and A.C., Final , &p, . 'j-//-(06 x69'7
Plumbing, Final and Gas Test 0
Electric, go- 7/ i.
Building, Final 7 6
•
25598 .
♦ CITY OF C 61S a A MESA
COSTA MESA BUILDING-SAFETY DEPARTMENT
\ P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APR g 1966
1
For Applicant to Fill In Completely APPLICATION�FOR PERM
TYPE OR PRINT a 442 Only
BUILDING -♦1,81 S (� A},( cod ane- �b EI
ADDRESS O�o (/t.V / T� name- RECEIPT NO. PERMIT NO.
,'j{JCOSTA MESA, CALIFORNIA �.Ij5-cs/
/ /14LI Kv. �1�./1�oiti R[C[IV/p.Y�{' �l-pAT[R[CE'! •I DA�T}I�HDI•.6
OWNER BUILDING G2 Q L///f/ / ,P//_ [/L� di
BUILDING
MAIL :n b / E. a7I ADDRESS
ADDRESS 1,O I li- I/'I
FIRE
• TEL. y ZONE TYPEA-�( GROODU�//q) J/�
CITY:• CT P TEL :21'12. C l ' ! " �/ �
APPROVED
ARCHITECT TEL BY DATE
OR ENGINEER NO. •
INO
ADDRESS
20R////((l1•//E/ NO.OF ^ I USEorNEW/
PUNS l_X"/ BUILDING
CONTRACTOR • P.-
LEGAL
AD•RBHG t yµ�- DESCRIPTION 1 :� : 1
CITY A.P.NO. !/gam / ; 7 - /3
' NOTE: NO[AVE OVERHANG SHALL BE LF-813 THAN
STATE TEL 80'TO SIDED REAR P.L
LIC.NO. { )..2 ,1i•NO...
EAVESF
OLOT 6a/X ¢ I ...orEIN LOT rt
/ ALLOWED _(U.B.C.REQUIREMENT)
NOW ON LGYARDS APPROVED YARDS APPROVED
USE OF ��gg MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. •p4r -f
) (FROM C/LSTR- ) AIM
SETBACK LINE PROM /D ' FRONT/6/ FT.LF PT.
CENTER OF STREET REAR YARD '
SIDE YARD I LEFT as RIGHT 11 ' R.SIDE PT. PT.
DESCRIPTION OF WORK L.SID - rr.
n
NEW _ ALTERATION ADDITI.N REAR /0 PT. FT. •
DISTANCE DET. BET.MAIN D
REPAIR _MOVING _ DEMOLISH MAIN BLDQS, ACCESS.BLDOB.
BUILDING gyp! NO.OF ) VAR.* DATE
SIZE :A C % et I ROOMS / STORIES C.C.U.P.# APPROVED
•
EXTERIOR WA a I ROOF _ APPROVE. / C..
a.
/,
COVERING r. COVERING CO Mn DY •ATE . i ...
USE OF 3...0.LDINDAND WORK TODEP[ '9Rp1ED_y a
Veww� Rnn rw G/(Y/C'JPl/•`! +.nl,+. Q(�,F`J �2iD� �/T D1
mac/X. efe S.) / - 1
7 7 'BCI.FT.
I HEREBY ACKNOWLEDGE TEAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE, j
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT PEE ONLY: •-FSI
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION CO �J � CO
SIGNATURE OF //'�� 0 -,p •
PERMIT FEE $ J3 '` p
PERMITTEE `e Cu'V` 4- I� l/.iJ�(� / '"� Ge
$ / � 7t-� PLAN CHECK $ / I"
AUTHORIZED AGENT / ✓ J/C ��
/ TOTAL FEE $ '7 /
OWNER KNOWLTON. P. C. DATE 5-22-61
JOB ADDRESS 281 E. 20th St. BUILDING PERMIT NO. m5 3
GENERAL CONTRACTOR Owner—bldr. VALUE $ 120.00
AP.No118-1311-13 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Block wall fence
IN"°ECTIONS DATE I GROUP J TYPE III ZONE R-1
l rground Soil U.G. Water _ PERMITS ISSUED
Underground Gas — SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches ' Forms Steel _
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
F 'e and Flashing
L ng, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final eQTY") na --- 7 ' b
I
OCCUPANCY
Form 210-5M-11-59 5-B P 1455Irr
•
3
9 q L F� FETE RECEIVED
14553 '�`- .,.. 229 .
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 1
al
E• .2...01..k.
l
ADDRESS
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. PERMIT NO.
/
OWNER P- e . KWUl OI jQqC r-r°
MAIL n / �/' RECEIVED SY DATE RECEIVED 14AT:hs§UED
ADDRESS Po_ goK // O '( `�. I .S' 2 2-6// I .5--.7,R -c./
j, TEL. 1n, BUILDING
CITY gewpd/7 Qo& NO.4• -2172 ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEERNO.
•
ADDRESS ,/GO FIRE
^
,� ,� , ZONE TYPE�GROUP �/`.
U //./- APPROVED
CONTRACTOR OVAL., //'AAA///t.a«KGG/w"L/ww'L BY DATE
ADDRESS
ZONING
ZONEI NO.OF USE OF NEW
CITY /....\.. // I PLANS I BUILDING �� `
STATE TEL. _------ LEGAL
LIC.NO. NO. -�I DESCRIPTION I/
NO. OP
OF LOT VD ( SLOGS. h 7 I NOW ON LOTA.P.NO. IIR— I3y— /3
USE OF / YARDS EVES
EXISTING
SETBACK LINE BLDG, re
If C4SI/&d LS Cr �l"Av0 9& APPROVEDR
T.> ALLOWED
CENTER OF STREET ,l LI ' REAR YARD) FRONT —0) FT. IN.
SIDE YARD I LEFT O I/ ( RIGHT R.SIDE `J T FT. IN.
DESCRIPTION OF WORK — FT. IN.
L.SIDE �•-+JI ,j
NEW IX II ALTERATION I IIADDITION I REAR ,J /9 / FT.
REPAIR I II MOVING I II DEMOLISH I APPROVEDy,� DATE"'�//�
BUILDING NO. OF /....
i /!/ 7
SIZE ROOMS J STORIES
EXTERIOR WALLv�//,,,, ROOF �•
COVERING
IVV COVERING CA(ly,gn
USE OF BUILDING AND WORK TO BE PERFORMED
ro '/ 6'Y(o j d "YsvK/ri '; i1/ X/c
I3Joc/1 •1/v4i/ FaLc-e 73,7•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION O
SIGNATURE OF IR.p /.(/-I PERMIT FEE $ �( ' �
PERMITTEE B.(� a_
$ /01° PLAN CHECK $ 4.1;
I
AUTHORIZED AGENT TOTAL FEE $ �' C/-C D
LL
OWNER KNOWLTON, PAUL C. DATE 2_-6-61
JOB ADDRESS 281 East 20th Street BUILDING PERMIT NO. is113
GENERAL CONTRACTOR 0lrnar-hni lder VALUE $ 20k,00
AP No. 118-1311-13 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Block wall
PECTIONS Signature DATE GROUP TYPE ZONE R-L
Suit PERMITS ISSUED
Gas
SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop.Swr.Line ❑ House Con. ❑ St.Swr. ❑
Sprinkling System
onion Pole
Underground ❑ Power Q
Rough Wiring
Trenches ❑ Forms ❑ Steel Reinf. ❑ -- �4 l n . l —
Floor System
Bond Beam 0 Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In 0 Out ❑
P- ter, brown coat
.g. ❑ Air Cond. 0 Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final a tt - ?-, j - (a 2—
OCCUPANCY
FORM Rab.5M — 7.51 151+13
i 1� :�_3 F E RECEIVED
• SEP 6 1991
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
91 BUILDING
BUILDING fa,a %J
ADDRESS �l�
/q� 1COSTA/MESfA.. CALIFORNIA(j{/1For Office Use Only
OWNER a{K�'• .1- ykit a�(•sl fI Ito VI.
I RECEIPT NO. ( /p MIA ryp�
ADDRESS O•yt 13 J /� ii 041 A t_2 RECEI V$p BY OA9EI IVED JNLDAf=/Il�6SyjlllE--0
CITY NGlJ1.�QY / eK..plk NO!_11 0BUILDING /C.1/ fJ-1ry/_ly /7J G
ARCHITECT a y,.,-•_„ TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS '-� FIRE
/ ZONE TYPE GROUP
CONTRACTOR F)j,L'A.e1. " j7LU UP V' APPROVED
BY DATE
ADDRESS r ZONING 12-1-0-C.12-1-012-1-0-C.
-��
ZONE^ I I NO.OF I BUILDING
DI NEW
CITY 'IFJ^, PLANS Bf11LOWG
STATE ..---- TEL. LEGAL y// 1 7/ y
LIC.NO. NO. DESCRIPTION j^ ( (O� . -7 �,.
SIZE 41//I, 1, 'I INO. OF BLOCS. �- / �J' `/ /
OF LOT V v J� r�C 7 NOW ON LOT A.P.NO. / / -J j `-/
USE OF nnyy . / YARDS EVES
-EXISTING BLDG. 1_ $rte.:,C-d 4• 6Qr U-ci-t APPROVED ALLOWED
,
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT L.5Z)FT. IN.
SIDE YARD I LEFT I RIGHT R.SIDE 5b D'er--TFy w( -4-2( .4 IN.
DESCRIPTION OF WORK
`�{,. L.SIDE FT. IN.
NEW I S II
ALTERATION I II ADDITION I REAR - FT. IN. _
REPAIR fl MOVING I I DEMOLISH I APPROVED A�/ DATE
2— • #-6./-
BUILDING
NO. O7 ` ,R -
SIZE ROOMS STORIES I G v/
EXTERIOR WALL W,/ r ROOF /- `^
COVERING WC0 1, COVERING C.-Chu-P�
USE OF BUILDING AND WORK TO SE PERFORMED
j3/04k &Ail F..Z...c t
I HEREBY ACKNOWLEDGE THAT I AVE THIS APPIJCATION y THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. if �'�'�" VALUATION n
SIGNATURE OFCD,e I )Cn..�u, .�yv PERMIT FEE $p�
PERMITTEE jet,/
a
$ PLAN CHECK $ ....---
II;
AUTHORIZED AGENT
/ E
\ $ y TOTAL FEE
`voisr
•
OWNER KNOWLTON, PAUL C. DATE 5-14-64
JOB ADDRESS 281 East 20th Street BUILDING PERMIT NO. 22142
�1'� GENERAL CONTRACTOR Owner-builder VALUE $ 2194.00
Y- An No. ]18-134-11 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Det 4-Car Gar.
n--11 ECTIONS Signature DATE GROUP J TYPE V ZONE •
v Soil
PERMITS ISSUED
{I Gas SUBCONTRACTOR DATE NUMBER
14 Water
I Rough Com. Refrig. 0 Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line.0 House Con. 0 St. Swr. 0
Sprinkling System
Construction Pole
Underground O Power 0
Rough Wiring - /TCY-7— -L2 Y°�sr. /ic//F q'a7 �^
Trenches'0 Forms 0 Steel Reinf. ❑ 0/25
g
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing thite
Frame and Flashing
Lathing— In p Out
T„. ��r brown coat ✓l Q// (o f!
Ft-- .g�. D Air Con. 0 Final _
Heating, Final
Plumbing Fixtures, Final
Final Gas Test _
Electric Fixtures, Final"TR /-f cr- 4 ..; /
{•
Building, Final it-613 PI Q' rrc /b + •7t.UAro - ' 4411
..- -
OCCUPANCY
Form BU4-5M-3-63-S-B P <2.7071 001 ho
FEE RECEIVED
22 142 MAY 1 4 196¢
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEP1.
P. O. BOX 517 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING BUILDING
ADDRESS 281 East 20th Street
COSTA�(M�ESA.}CALIFORNIA For Office Use Only
Paul C. Knowlton RECEIPTNO. l PCRMi NQ
ar9
.44
MAIL 281 East 20th St. REDEIlEO BY I p j ey I�-/ }AHD/ /
ADDRESS YY �B p
silt
(W_// T ISSJ/-i-�'/,�'/T/.
CITY
Costa Mesa NO.tILT 62192 BUILDINGADDRESS .(gyp / G 20 2954 "`CY
ARCHITECT �` TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS '— FIRE
ZONE TYPE '1� GROUP
CONTRACTOR Owner - Builder APPROVED \JSIJ ,/ /
BY C9/, / UATE'T /p
ADDRESS Sarno Z NING
_ P�� t. USE OF [/�
CITY Came ONE,...J' I PLANE I BUILDING HW�` '\ •
STATE J TEL. LEGAL J- • /7 74' 7/a
LIC.NO. NO. DESCRIPTION
SIZE ]1 by 60VVIIJJl NO. OF SLOGS. 2
OF LOT NOW ON LOT p p NO. '/ -� / y �� ,J
USE OFYARDS EVES
EXISTING BLDG. Dwelling - APPROVED ALLOWED
SETBACK UNE PROM
LINK ST. /�
CENTER OF STREET p REAR YARDj� 1O1 FRONT 10 .j4..Y<a IN.
SIDE YARD I LEFT i O ,
I I RIGHT iii R.SIDE '/ FT. IN.
DESCRIPTION OF WORK L.SIDE z z FT. IN.
NEW I X IIIALTERATION I II ADDITION I REAR 40 FT. I/NJ/�/
REPAIR I II MOVING I II DEMOLISH I HYPROVED .r/'e��� DATE�A RL'
BUILDING / U NO. OF W��
SIZE 2�IX.�81 ROOMS STORIES 1 /l Ottr An//scat etc/piled ' t
EXTERIOR WAWA. ROOF r / Q
COVERING `•tuCCO COVERING COmp• 1T/.S. if D/t(I• JI `/ and
USE OF_BUFIL ING ANAWORK T EIE PERPpR ED J • / �A tia ,1
agoA l.i.,Ti 'T (�f/�/�vett ciR lecut foolity jet Ot Qi art 4 /(— a Ivry
-7q7 I'sw4* a4.911.' RRpo
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATS THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERM IT FEE ONLY.
PLY WITH AU. CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRU{�.lT10.1;1 VALUATION n ......-
SIGNATURE
SIGNATURE OF / I' 1/ le'
/� ��L 06 PERMIT FEE $ /2, N
PERMITTEE l/ l� /^/�/ q (- 6 :2:$ l y PLAN CHECK $
AUTHORIZED AGENT / z JS'
TOTAL FEE $ O
n