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HomeMy WebLinkAbout131 21ST ST - Building Permits 1 471J' CITY OF COSTA MESA BUILDING DIVISION ar. • F I /r .. ) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER S PERMIT B05-00759 (714)754-5273 Fax(714)754-4856 • www.cLcosta-mesaDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 131 21ST ST Status: ISSUED Suite: Applied: 05/11/2005 Vicinity: RESIDENCE AND 2 DUPLEXES W/GARAGES Issued: 05/11/2005 Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N Parcel Number: 42618213 Zoning: I Applicant: BAKER, MIKE • - Address: 908 MAGELLAN ST ISSUED BY: .0" %. _ Phone: (714)549-0305 COSTA MESA,CA' ' Zip: 92626 Owner: JUSTICE; D BARRY-TR . Address 10606 CHINOOK AVE - Phone: FOUNTAIN VALLEY;.CA Zip: 92708-4836 Contractor: ROBERT TRIBOLET Address: 908 MAGELLAN ST Phone: (714)549-0305 COSTA MESA,CA Zip: 92626 • License: 374368 Arch : ' - Eng: Address: - Address: Phone: - Phone: Zip: License: • License: SCOPE.OF PERMIT REROOF RESIDENCE AND 2 DUPLEXES AND ATTACHED GARAGES:,T/O 1 LAYER COMP SHINGLES, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 15#FELT,APPLY'30-YEAR DIMENTIONAL COMP SHINGLES."45 SQUARES TOTAL FEE SUMMARY . Plan Check: $0.00 Calc Valuation: $6,750.00 Permit: $139.25 Claim Valuation: $6,750.00 SMIP Res: $0.68 • SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.93 - PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 .Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0" Rear 0-0 Left 0-0 - Right 0-0 PARKING Existing: 0 Required: 0 Proposed: -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. FOR INSPECTIONS CALL: (714)7545626 2446-46(ONe) 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 ��e�[/ work for which this permit Is Issued. `, I have and 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: ea er 5+-AL1-e, Findeeir" miner: t (03504e2 —oS.. (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) �`A'' O 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 California.and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provis ns. ApPican l Sip tura: ` CEJ oaten 5 '// - O S WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE Is UNLAWFUL AND SHALL St/EJECT AN EMPLOYER TO CRIMINAL PENALTIES AND am RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,oc0),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed undoJ provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professipns Code,and my license is in full force and effect. .Cs.Y. q 3'•6 CI� c_-3 3 b / Cbntrectors;Slgnatur-a—'- '1 ���s�i� f 5—// -05 CONSTRUCTION LENDING AGENCY: . ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: 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 Ls 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 fore permit subjects the applicant to a civil penalty of not more then five hundred dollars(5500).): ❑ 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 properly,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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of documen,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: 1 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? 0 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 then a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at stands temperature and pressure). uture occupant 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Caste 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). _._ future _ __ .__ 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 Flre Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present;7 future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Alt Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries al a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety 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? 0 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. it . SlgnaLu O� f Legal Owners) Date Mdroc A'utho`rized Appticanl; POPE 1 I$SPECRONTYPE' P6IE NOTfISLi LOPE. INSPECTION TYPE ' ' PAIL gflIGALS • 1616 Fixed System Final Fire Prevention • 206 Final Mechanical • 1266 Pool Spa Final �` ,,,�•�� �/ 208 Final Plumbing 200 Final Re-Roof • 7`uf-of Ca-elA 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 • FORM OV50-2 (1-53) 1HONROE--4-.-CHUIJ Attorney..s..for..fl jE1DA.HTS Address -800- •. .BROADIJA-Y Register Telephone. IjfEZ.Y...3_.84.5A , (Keep Space Above Clear for Clerk's Filing Stamp) • IN THE MUNICIPAL COURT, SANTA ANA.ORANGE • JUDICIAL DISTRICT, • COUNTY OF ORANGE, STATE OF CALIFORNIA • A_....E.....HATCH.AN12...MINARET -----.--._-.-.. HATCH, No 4 241 Plaintiff..-.S: VS. SUBPOENA DUCES TECUM 3..COTCH CONSTRUCT ZON COMPANY A CALIFORNIA CORPORATION, E.T..A.L...., Defendants... THE PEOPLE OF THE STATE OF CALIFORNIA SEND GREETINGS TO: 7FLE-_DI-TY----OF COSTA_--MRSA-...BUILD-INfi.--I�FPdRTTIEN-T-�..--.TC$-Jt>---1JOE----TBg BUILDINC SUPER INTLNDENT THEREOF. WE COMMAND YOU, that all and singular business and excuses laid aside,you attend the Municipal Court, Santa Ana-Orange Judicial District, County of Orange, 610 North Broadway, Santa Ana, Califor- nia,at a session of said Court,to be held on the1-e.T.H..day of .NIOYEPIRER. , 19 5$ at 2:.00 o'clock...P,...M., then and there to testify in this cause, now pending in said Court, on the part of..DgFgNDAN3'S and for a failure to attend, you will be deemed guilty of contempt of Court and liable to pay all losses and damages sustained thereby to the parties aggrieved, and forfeit One Hun- dred Dollars in addition thereto; that you bring with you and there produce the following named documents now in your custody or under your control, to-wit: A.LL,_.P.LAX 8-.AND--..SPE.CIFI.CA-T.IONS_-EO.R....THA.T....CEIRTA,IN-.-C.O-NS-TR IICTZ.ON PERFORMED ON THE LAND AND PLACE CO MMONLY ((NOUN AS' 131 W. 212T ST. CITY OF COSTA MESA, COUNTY OF ORANGE, STA TE OF CALIFORNIA INCLUDING PERMITS AND INSPECTION RECORDS. WITNESS, the Judge of the Municipal Court, in the Santa Ana-Orange Judicial District, County of Orange, this 1.4.2E day of NOFENBER., , 19 56 Attest, my hand and Seal of said Court, the day and year last above written. CHARLES H. TULENE, /8/ Clerk of the Municipal Court,Santa Ana-Orange Judicial District, County of Orange,State of California. (sEAI.) By Deputy. SUBPOENA-DUCES TECUM STATE OF CALIFORNIA,. County of Orange ss. The undersigned being duly sworn, says: I served the within Subpoena by showing the said within origi- nal to each of the following named persons, and delivered a true copy thereof to each of the said persons, per- sonally, on the date set opposite their respective names, as follows: , 19 , who did demand Fees, and received$ , 19 , who did demand Fees, and received $ , 19 , who did demand Fees, and received$ , 19 , who did demand Fees, and received$ , 19 who did demand Fees, and received $ , 19 , who did demand Fees, and received $ (Server) Fees for Service $ , Mileage $ , Notary $ ' , Total $ Subscribed and sworn to before me this day of , 19 CHARLES H. TULENE, Clerk of the Municipal Court,Santa Ana-Orange Judicial District, County of Orange,State of California . Notary Public in and for the County of Orange, State of California. By ,Deputy. I hereby certify that I served the within Subpoena by showing the said within original to each of the fol- lowing persons named herein, and delivered a true copy thereof to each of the said persons personally, on the date set opposite their respective names as follows: , 19 who did demand Fees,and received$ , 19 , who did demand Fees,and received$ , 19 , who did demand Fees,and received$ , 19 , who did demand Fees,and received$ , 19 , who did demand Fees,and received$ , 19 , who did demand Fees,and received$ Dated , 19 Marshal of the Municipal Court of Santa Ana.Orange Judicial District, County of Orange,State of California. Costs for serving this Subpoena are By , Deputy. Service$ , Mileage$ , Total$ FORM CV5o-2 (1-53) r_ „P • ' . s . ' . .. . . COUNTY OF ORANGE . . .• BUILDING DEPT. • . - . Permit No 3 0 9 0 8' 636 No. Broadway Application .for Building Permit Santa Ana, California . Phone: KI 2-6211 AND FOR A Certificate of - Use and Occupancy , . Date ildro 1. OWNER'S NAME kb 4:61A."....._ )7t, PHONES44/1.4.__4_21 i MAILING ADDRESS._ 319±- vat • CITY Name Name g• k.) • 43/1-'1.4"..274' (Architect or Engineer) (Contractor) Address Address 34 g Ott SI. City City tcTL.t.T4424/CL. State State Lic. No. . Phone Lic. No. '/I' V 3 Phone__5244/1/1.. 4 44d PROPOSED USE: tti 4Qeafk), 7 2. JOB LOCATION 1.3 1E• VII f i W41 (HouseNo.) 0 1 (Name of Stret ‘..,1 y4 v.4.(11.F oetsS .o, District) tie:4 3. LEGAL DESCRIPTION: Lot Nit__ _ ser,..snalag; k - • act (Metes and Bounds Description—Use reserse ide of for3) 4. CORNER LOT ( ) INTERIOR LOT ( 1.• ) THROUGH LOT ( ) SLOPE OF OT ( ) 5. SIZE OF BLDG.Nr_t___KJ.0_,ILAREA:...1 thil SIZE OF LOTNIV .7 fvfreic/.0 AREA:/1 7 ? il 6. HEIGHT OF BLDG.:.___________f_i__ .. CEILING HEIGHT• S' NO. OF STORIES 7. NO. FAMILIES ek.9, Size of Smallest Bedroom• 1 0 A 11 Size of Kitchen: 71/0 . • 8. EXTERIOR WALL CONSTRUCTION: flreleb..INTERIOR WALL COVERING eidat. - t4i4tAt— (Frame, Stucco, Etc.) (Plaster-Drywall, Etc.) ' 9. SETBACKS: Front Yard from Center Line of Street rase Nearest Side Yard 4Rear Yard .1.1” Distance in Feet Between Bldgs. on Same Lot. 1444.12 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. I i. 11. For (a) Footing: Width i if Depth in Ground / le Width of Wall 54-4 Accessory Bldgs. and (b) Size of Studs: ...___Yk_ii Spacing• - 1 ‘ "CC Material of Floor etnf4a • Similar Structures: (c) Size of Floor Joists: ----- Spacing "CC (d) Size of Rafters: 4*I 4 Spacing 30 • • • 12. VALUATION OP PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, paint- ing and sewage disposal $ 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed: A , 10_ . at„...,-.. int• Plans Filed • 5/072 ' (Owner) By• (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: C... .GKING BY , 0 0 GROO,P 7. ,.....:__ APPLICATI Cep Se HEALTH Bldg. Permit - $ Jai"'I'''. Plan Check $ TYPEi\_. C1.---.' ZONING --67a 411111r— / FIRE Total - $ DIST. mAp___± aie PLANS A D- ese MARSHAL Receipt No. SPEC'S STATE Paid to - - >7..1.44/ SHEETNO CORRECTIONS ENGINEER Date _i•*"./el'Sib - VERIFIED CAL • PERMITQD BY DATE 0#6 ,,,, e 5M-7-50 • rae-e) '\ OWNER HATCH, ALFONSO DATE 1-21-60 JOB ADDRESS131 C & D E. 21ST. St. BUILDING PERMIT NO. 11263 — GENERAL CONTRACTOR Bay Coast Bldrs. VALUE $ 19,118.00 AP. No. 118-020-20 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Duplex w/att. Gar. INSPECTIONS a-y-_,-s DATE I GROUP I & J TYPE V ZONE ft-tt Underground Soil 4444 U.G. Water PERMITS ISSUED i round Gas — — SUBCONTRACTOR DATE NUMBER Ss$, g 0-74head Water and Gas ,4i#.s ?_7-4a Rough Heating 3 „.G n t, WItwCe.-Ce. .L31-4-, rt- /-G . yc,i Rough Plumbing i//.r,r .P .,_.C. .`fes-1-� a -/-A 0 a r<o i Miscellaneous Prop. Stl�tine Hog Con. St. Swr. q/t4lo0 /'I'.t.lt�+of" e0...1', WHO Ica 2.-a'mu /11 Sprinkling System Heating, Final 444, ,6—Y-GD `,,✓r , 0 Plumbing Fixtures 'y r,d c; Final Gas Test /h... p� N/ Z 4/-6A ti, Construction Pole Underground Power Rough Wiring - 16/t!J 1.-/-(.[) C'- L-1:[-c! ,"(z.,-/ -/e -lo //^lO Trenches ✓ Formsti Steel ,R . -, i a. ,y -- 9= .(' o Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sheathing _ 3 —1 -4 4 Frame and Flashing r c_ 3_. / / — tin Lathing, In c/ Out' 2c Aged O` _3 — -/4 — Etre EXfiner, brown coat , 10/ c 3 Z. a_—, co Pc)'bing Fixtures, Final h/ �/�b,%♦!f-L Electric Fixtures, Final 2-4� Building, Final X..�-5 v. OCCUPANCY Form 210-5M-11-59 S-B P _• 11263 14,63 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT 7- /5-_ , 0 P.O.BOX 317 COSTA MESA. CALIFORNIA J FINANCE DEPT. FOR APPLICANT TO FILL IN COMPLETELY APPL A1O0I9Q I RMIT BUILDING TYPE OR P//RINTj �,/� ADDRESS/3J e../ii �.QC/`JL e. , . - COSTA MESA, CALIFORNIA FOR • OFFICE USE ONLY RECEIPT NO. I / PERMITill. OWNER r2 G MAIL 33 � RECEIVED Y DATE RECEIVED ATE/SUED /SUED ADDRESS///]]] ill `-E1�-Ej CI )7%)AT Ll J /R TEL. BUILDING / Si a fr� ..4--.. 0417 CITY `- NO. ADDRESS / J /�. ARCHITECT LIC. OR ENGINEER NO. COSTA MESA,/CALIFORNIAn FIRE ADDRESS (�(] ®,'�// n ZONE TYPE �/ GROUP /��-Y//r/y- CONTRACT�Qy���^JJ �yW/ C.NT(��f�4 ] 7 BYPROVED �.ij ATE /ems)/(U ADDRESS/a-0V L , //.... 13 �NING / LEGAL I LOT T] / /1 �I '2 - ZONE �j ( NO.PLANS � I USE OF NEW DESCRIPTION NO. J'7 BLOCK AI T"R-ACf, //'1 O�/ //'J� BuaDMG/�.//.yam/�f (;� A.P.NO. // .�^ 0 a �� ' P APPROVED YPROV ED///.// N/�'' �D.A�TE / 7; SIZE ��qiJ (` /J NO.OF BLOCS. 3 YARDS (�EVES� OF LO ')pG 3D6) �S NOW ON LOT REQUIRED ALLOWED USE OF _/ (CENTER LINE ST.) ^ j/�f EXISTING BLDG. v ah7.�-5'� FRONT ��/"' FT. ,FL-F/V • IN. SETBACK LINE FROM )�j CENTER OF STREET REAR YARD R.SIDE !J FT. IN. SIDE YARD LEFT I RIGHT L.SIDE .y FT. IN. DESCRIPTION OP WORK V REAR FT. IN. NEW ALTERATION II ADDITION REPAIR �1ry i��/ Il MOVING I II DEMOLISH I B U I LDIN G1t33 'd -'Cao.OF SIZE �J�f)-(/O(�J(��^���,��ROOMS /b STORIES I EXTERIOR iVJ�P>�'_- ROOF COVERING LND COVERINGUSE OF BUILD) AND WORK TO BE ERFORM (1 lb try 1 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- PLY WITH ALL CITY ORDINANCES ND TATE LAWS Rf-GULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCT N. t J VALUATION SIGNATURE �y/ Ga PERMIT FEE $ 31 f,D PERMITTEE yam/ - $ /9//O ' PLAN CHECK $ /9/- D AUTHORIZED AGENT TOTAL FEE $ StJ ' 5-0 a OWNER HATCH, A. DATE 7-6-55 JOB ADDRESS )3LE2lst St. BUILDING PERMIT NO. 11±77 GENERAL CONTRACTOR Don Harper VALUE $ 9,080.00 • LC'T. AN 118-020-20 BLOCK 1 TRACT Npt. Heights Duplex & garage GROUP I TYPE V ZONE Rh FIRE DISTRICT #31195 PERMITS ISSUED INSPECTIONS D•TE SUBCONTRACTOR d DATE NUMBER Footing Trench t?‘-`-'0- SAE Foundation Forms and Grade to Garage Rough Framing ei 't 1/- ' ' Plumbing,Rough to Slate.../4 A- )t44 7® a i. _.. i 7-/f-SS" c4.2.49 (, ! . Plumbing,Rough Complete 0..„Y" rt' c 9-] -Sr 4/1 .. . - ar_•(i!!!a'�J i.. -S-CS ,3(o p oS' • Temporary Pole r.�Qdg'r'^ - p 8-Rough /� '7 c-� -cc . ..a' ! . - L o• 3 /-s-Sc ) J/ p-i Heating, Rough _ V Heating, Final i _ _ Sewer, House Sewer,St. ,a -, �c eO' 9��_SsSr 7 ao B �7�� Septic Tank or Cesspool '/ / a Lathing, In OutX �t-t-- 10-3-5 _ F •iring ,1 ery" I, -4--'6 Pi..abing,Final,Fixtures Com. et 1......_r_.r4 Plumbing,Final Gas Tes sr.P, a J E Wiring,Final Gf.' '0 / i ...-9 •�9< Occupancy yN.-", -9-, Fnrrn 91n(:_H 151111-55 T t 'S ' Costa Mesa Building Department • APPLICATION FOR PERMIT 111 EAST 20th STREET .t14, 5 BUILDING 1 is COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. Building 3 / 5, 2i dc- 5177 Receivedby Date Recd.— Date Issued_ Costa Mesa, California 2— Jy3 , E-d�f Nearest Cross St. Osa A/0/^ Building,'j .., .. ee �• // Address A— / "3 3 at. Owner ,, /y, 7-rev. At Costa Mesa, California . Mail Address ! 3 3 Nearest Tel. . Cross St. City engTp /I /c.C A7 No.h/" '6 6 03' ZoneNo.of Type 1 Group " Architect or Lie. _ �ft I Plans I � I/ Engineer No. Approved S Date L Address -- City ie CORRECTIONS Contractor�,�p�,/ /- . RPcR No..jf%'S/ • Address4,37 ge ,n Rn P/ C !7 = /'/. Legal Lot vE Description I No.en. ¢if Block/ I Trac1e/Y/4OvS, j • (Attach Metes and Bounds)tiPP'!/P-O .O-P-O . -,,,©,..-�. No.of Bldgs. Size of Lot „J. ...iy3o0,/SkhNow on Lot / f•)) `fy�� O Use of I No.of I No.of re--- xi Existing Bldg. IES, Families/ Rooms 1 5 Setback Line from ////// Rear Yard /i22 Ft _ . 19 - _ Center of Street /� / — ..Side Yard S'-„/ ,2„2,5" ,, DESC COSR ON OF WORK Ct� OFe��sjA tOSp New I >I Alteration I I Addition I Repair I I Moving I I Demolish I Building No.of J Size ,jam- „ �.,0 Rooms (O Stories Exterior Wall �� Roof n Covering Wall,. Covering,, Q APPROVALS UBuild nNeW /7 '{,� _ .1110 Foundation Location Inspector Date Building �'/�`S/•-" `o— / ......:„....74. O..4t& Forms,Materials, rec.`..eCee pct„ ; o _ Under-Pinning VAI Frame: Fire Stops, • Bracing,Bolts • I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building const ction. Plaster, Int Signature of \I _ Permittee /Cr✓l n Jr Plaster, Ext. • Authorized Agt. J Masonry Reinforced Valuation 00 Permit Fee $ ....1-C4- el $ �) O 0. Plan Check $ 3, o O Bond Beam - Q Total �/ 0 0 Fee $ oZ /. = FINAL FORM 204 G-H 2M 5-54 J J COSTS o a JUL -6-55PDmt;A 157a *'t**27.00 a ` ,` ^\ Street PLOT PLAN Show location and distances from • property line and between buildings.