HomeMy WebLinkAbout263 21ST ST - Building Permits Applicant to fill in all spaces within heavy borderlines and sign all appropriate declarations.
,CITY OF COSTA MESA twin-jVO. j� TRACT NO. LOT NO. BLDG.NO. r 68995/30/82 • 5.00 IL
CONSTRUCTION PERMIT J/7/(/Q(f�j}
.{y �/ '
Project Address '� •( � / rmi—) TYPE OF CONSTRUCTION i t. _ ,
•
Owner r/f `(!S.^'/iJJ/�. -' Phone-•-w ❑ NEW ❑ ADD ❑ ALTERATION '
43 Address �l - -- ❑-REPAIR ❑ CONVERSION 0 DEMOLISH ZONING REGULATIONS
l Arch/Eng. License No. 0 OTHER P _ - •
Address' - _ DESCRIPTION OF WORK -
ZONE PLNG, REF.$
Contractor/��/��� ✓ , Phdne jfQ 9 TYPE OF PERMIT - '- BUILDING - T .BUILDING -
�p '77 SETBACK C/L 5T. T PROPERTY LINE
Address S.7- !� ❑ GRADING 0 FOUNDATION - ❑ STRUCTURAL - -SIOE,-YARD - - •-- - - .-
LICENSED CO RACTO DECLARATION , 0 TENANT 0 ELECTRICAL LUMBING ❑MECHANICAL/ SIDE-YARDE - - • . - - ' -
I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT
mencing with section 7000) of Division 3 of the Business and -❑ OTHER _
Professions Code, n m license Is In full force and effect. REAR YARD(TO P/L) ,
No/ _PROJECT DESCRIPTION •
License Class - Lice No - - PKG.SPACE REO.' "PROVIDED -
Date,� Signature -' (///� f//�e�./ SD. FT. _ _
DateWOIS'COMPENSATION DECLARATION :OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH _
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ,ZONING APPROVED BY 'DATE --
certificate of Workers' Compensation Insurance, or a certified copy - - - - .. ... _ - 1
thereof(Se (tips 338000 Lag, C.). i C.f+ •\ • ORAOING•CU. YDS. - - ACRES 'SPECIAL CONDITIONS:- •• -- '
I `.y NO.Y-TI!'lv•� 7 Company J/..'� Pa AIA -- - _ _ " _
,rtified copy is.hereby furnished. _ - _ • REMARKS: ' ' - _ . - '
__ -_ _ _
)•-.. 'ertified copy is filed with the city Building Division. _ - -
'EXEMPTION FROM WORKERS' COMPENSATION-DECLARATION- . - - -- - - - - - — - r 1
(This section need not be completed if the_permitis for one hundretl - - • r
($100) or less). -- - - -t- - - - - - -- _ - -. ..
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 PLUMBING r" PLAN CHECK -. -- "- ELECTRICAL - - PLAN CHECK- -
subject to the Workers'Compensation Laws Of_California. _ - •• - - - ' - "` DWELLING GH HAGS -
Date • Signature BATHTUBS" - SHOWERS- "- ' SO FT 50 FT - - -
NOTICE: If after making this declration, you should become subject TOILETS - i =URINALS - -- - -GENERATOR 0-1-KW_1-10.KW - - - '
to the Workers' Compensation provisions of the Labor Code,-you must 'TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS-- - --- .APPLIANCE' 10-50 KW_SO.+ KW - -- -- - ,
revoked. __ • _ _ __ _ _
CONSTRUCTION LENDING AGENCY KIT.SINKS . - DISHWASHERS - - ' • - - - MOTORS - - 0-1 HP_1-10 HP- - -
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS z SUMPS - - - - - • - 4(INC.SOLAR) _ 10-50 HP -50 +HPC ' -
formance of the work for which this permit is issued (Section 3097 • - - - - • -
Civ. C.). - - -'- - - FLOOR SINKS - - - FLOOR DRAINS - - -- FIXTURES OV TLETS SWITCHES" -- ' - •
_- . -
OWNER BUILDER DECLARATION - • --- - INTERCEPTORS CLARIFIERS - - -- POLE-LIGHTS - - ---- --• -- -
I hereby affirm that I am exempt from the Contractor's License Law for ..
the following-reason (Section 7031.5-Business and Professions Code:- -SWIMMING POOL P TRAP -- - •t-UNS I NUL I IVN_ _
Any city or county which requires a permit to construct, alter, POLES METERED SUB
improve,-demolish or repair any-structure, prior to its issuance,also re- WATER SERVICE ' ALTERATION- ' - - ;PANELS - MAIN -SUB -
quires the ap.licant for such permit to file a signed statement that he •
is licensed pursuant to-the provisions of the Contractor's License Law (GAS SERVICE - 5 OUTLETS -_ --et. 'SERVICE -- - • - - - AMP •
-- -•
(Chapter 9 (commencing with Section 7000) of Division 3 of the a`L -
Business-and Professions-Code) or that he is exempblherefrom and the -WATER HEATERS BTO'OUTPUT- -- -^ - - • - • -- - - - • -
ba•- for the alleged exemption. Any violation of Section 7031.5 by - - - ' _
a- rplicant for a permit -subjects the applicant-to a civil penalty 'SEWER CONNECTIONS - - - "' - - ' - - - - - - - -- - •-- - -
o more than five hundred dollars ($500). - - • -
❑ as owner of the property;or my employees with'wages'as their ' SOLAR TANK- COLLECTORS'. I - - -- - - - - - •
sole compensation, will do the work, and the structure is not intended • ' .-
or offered for sale. (Section 7044, Business and Prof essious Code:The SOLAR PIPING SVS. - ' ,I -- - - j - - ISSUE FEE - ' -- - - - - - '
Contractor's License.Law does not apply to an owner of a property APPLICATION APPROVED BY-- -
who builds or improves thereon, and who does such work himself or ISSUE FEE -- • ' --- • - - - - 37040 - - •DATE - -
through his own employees, provided that such Improvements are not __
-
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK - j SUMMARY -OF.F EES I
Is sold within one year of completion, the owner will have the burden ^
-
of proving he did not build or improve for the purpose of sale). - - - BUILDING - - - -- - - • -
❑ I, as owner of- the property,-am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP . $
AND DUCTINGPLAN CHECK $ PERMIT,
licensed contractors to construct the project (Section 7044, Business 100,000'+ BTU )
and-Professions Code: The Contractor's License-Law does not apply to �-+ ISSUANCE $ -
an owner of property who builds or Improves thereon,and who con- REFRIGERATION O'lOO.000 BTU PLUMBING g SL O s
tracts•from such- projects-with-a-contractor(s) licesned pursuant-to SYSTEM •. - -_-- -_ - j _ _ GRADINGr'- $.
the Contractor's License Law). 100,000.4.Btu - (PLAN CHECK $ - !`y - r,
D'I am'exempt under Section " - - - - B.8 Pr C.for this BOILERS BTU - - - $
s
ELECTRICAL $
reason - MICROFILM'S •
SYSTEM REPAIR,ALTERATION -- - PLAN CHECK E _ - -
Date Owner ---- ' --'• MECHANICAL E - TOT_AL FEE'S
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE 1 • 'LESS AD- _ '
information' is correct. I agree to comply with all city and county - .- -• PLAN CHECK -$ - -- VANCE-PC $_ -'
ordinances and state laws relating to construction,and hereby authorize I
representatives Or this city to"enter upon the above mentioned -' r� ' 4 -
property for ijljpe;{lon pyr es. C ��( ', ' FINAL FEE $ -7 -`0U
Signature lam /' �
• - - ISSUE FEE - - " - - .___ - - _
CMF 086546 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
Pr
CONSTRUCTION AND PLANNIN POOL& SPA
•
Date Inspector , - Date - Inspector
APPROVALS Permit# �� APPROVALS Permit#
-
1 Temporary Electrical Service or Pole •, 43. Pool & Equipment Location - - - -
. 2 _ Soil Pipe-Undrgrn,: . 44. Steel Reinforcement - - - - -
3 Electrical Conduit Utility:Undrgrn 45. Forms -
4 Electrical Conduit-Undrgrn - - 46. Electrical Bonding - --
5 - -Steel Reinforce_• _ -_ 47. Rough Plumbing & Pressure Test -- -
6 Electrical UFER Grn- .. 48. APPROVAL TO COVER-GUNITE -
7 Footings - - . . . 49. Electrical Conduit-Undrgrn
8 Foundation. - - - . . 50. Gas Pipe, O Undrgrn,Test .
9 Water Pipe-Undrgrn - _ _ 51. Backwash Lines P-Trap,-0 Undrgrn - - - - -
.10 Structural..FloorSystem . . •. 52. APPROVAL TO DECK • _- . ... . - •
-11 .Property Sewer Line & House Connection _ . . _ _ • • 53. Backwash & Receptor-Final
1.2 - Street Sewer Connection "_ .. -- . - 54-. Heater & Vent-Final: - A
13 Rough Plumbing - - _. . . _ . _ S5 Plumbing System-Final LL - V
14 Rough Electric-Conduit - - -- • ''56. Electrical-Final • •• .
15 Rough Electric-Wiring .. - . - - - 57. Solar System-Final- - - . , , . '
16- Rough Heating & Air Conditioning ' - - - b8. Fencing &Access Approval ,
17 Ducts, in Structure - - - - - - 59. APPROVED'FOR PLASTERING ' .
18 Ducts, Ventilating - - . — - - __ -
19 Gas Pipe:Rough &Test - . . -60.. POOL/SPA SYSTEMS FINAL
20 Roof Framing- - -- - . . 4 -
21 Roof Sheathing - - . -
22 Frame-and Flashing - ' NOTES; „ , ,.
23 Insulation - - - - - - .. - . -
24 Lathing & Siding - - - • - . - - • - - _
25 Drywall Nailing - - -' . - -
26 Plaster-Brown Coat - - - -
27 Electrical Power Meter-Final - • . , . - .
28 Final Electric - - -- - ' 1 '
29' Final Heating & Air Conditioning _ - . -- -7- -
30 Final Gas Pipe-Test - - ez��/�Z � 5- - _
31 Final Plumbing- . - t
32 Water Service-Final - - - • - -- . - .-. - .
33 Gas Service-Final - . - -
34 Solar Domestic-Final-
35 Landscape Sprinkling System .
, 36 Sound Attenuation - -
37 Handicap Regulations ' - - „
38 FINAL STRUCTURE & BUILDING - . ' .
39 Special Requirements Completed " .•
40 Electric Release to Edison •
' 41 Gas Release to Southern California Gas Co. •-
42. CERTIFICATE OF OCCUPANCY • '
No: - Date , —
OWNER HILL, OLIVER, / DATE 10-6-55
JOB ADDRESS 263 E. 21st St. BUILDING PERMIT NO. 1952
GENERAL CONTRACTOR Owner-builder VALUE $ 3:1156.00
I 'La-, - BLOCK TRACT 2 bedroom & carport addition
GROUP TYPE ZONE FIRE DISTRICT #1851)
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
C ,C,y C ;i DATE NUMBER
Footing Trench �� /
Foundation Forms and Grade to)Ga�ra e
Rough Framing «c.5r f - I •
Plumbing,Rough to Slab �4- YO e t 4j 1 it
Plumbing,Rough Complete _
Temporary Pole
Wiring, Rough r (i1'¢l el -- `4«„e �t, /O-G-S5 i-/� y v
,Heating,Rough rt,(/ % . i�
,Heating,Final " C11 .(Gf...i-N/h./ /-/.:( 'SG ,p73g /—
Sewer, House Sewer,St.
Se-`ic Tank ori Cesspool
L ng, In AM ithc. out dome.
Plastering �V C' u .� -� 'V
Plumbing,Final,Fixtures Complete`�6 l_ _ .'f��
Plumbing,Final Gas Test '(I`g.� i f!• S '
Wiring,Final
......”--4,-.......”--4,-. •/_ a4/`r
Occupancy t
Form 210 G -I 15001-55
1.1.111p
to Mesa Building Department APPLICATION FOR PERMIT
111 EAST 20th STREET BUILDING I
,w . COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICAPNT TO FILL1/IN Receipt No. Permit No.
Building
(v3 G • 026 ,eJ�is-P�� / .s-.-1
Received{by 9—Date Rec'd� Date Issued
Costa Mesa, California
Nearesto! at /v�G s�
Cross St _-2: Building
Address
Owner �_94���P ��7 Costa Mesa, California
Mail
Address S/ 2 9 %/21_,....•-n_i Nearest
//�� el. � Cross St.
C�RZr�/C_n7 t , . l-,� 4 o. T /� t Zone I No.of I Type Group
Architect or Lic. Plans
Engineer �(� No. Approved
�� by Date
Address CORRECTIONS
/ City Lie.
Tractor No.
Address
Le
l
Lot
Description I No. I Block j /Tract
Eli ig
''(Attach Metes and Bounds) ,4P�/S"14 0- 2 / 1, T _5-=�1-1 r t:/i_
/ / / No.of Bldgs. Cl!
Size of Lot (p0 X/ 0 I Now on Lot - 0
Use of " I No.of } No.of ..s SEP 2 0 Jg55 s
Existing Bldg. Families /� Roomaj V a.
Setback Line fro Rear Yard &
Center of Street Side Yard q p e y
DESCRIPTION OF WORK
New I I Alteration I I Addition II
Repair I oving r I Demolish
r t� ��
Building I/' 'No.of
Size / A 02- Rooms a. Stories
E' - -ior Wall // 'llYtdef
( ing,,o4,yµta.c.-4 I Covering ebnirAPPROVALS
Use of New q
Building p( te_c h ../L,,eiy � Foundation Location Inspector Date
Forms,Materials,
•-•/i/ _ ,i_ ,l_ _ Under-Pinning
Frame: Fire Stops,
.9? ..,-, ' Bracing,Bolts
I hereby acknowledge th‘t I have read this Application
and state that the above is correct and agree to comply Lath. Int
with all City Ordinances and State Laws regulating
building construction. Lath.Ext
Signature err
Permittee (/2/t.. UC\y /{C _
Plaster, Int
Authorized Agt. Plaster,Ext
Valuation % / Permit Fee $ /,A, fa& Masonry Reinforced
(//5 (r0. Plan Check$ ,a,a 0 Bond Beam
$ T Total '/,
Fee $ ,T 6 O FINAL /
inn .. /'
..
• 0
a`. a` STr
• cEP PO-55PQtlEsa- c322 c:r&14.no
Street `
PLOT PLAN
Show location and distances from
property line and between buildings. '
OWNER HILL, Oliver A. DATE -�0-54
JOB ADDRESS 263 E. 21st St. BUILDING PERMIT NO. 107
GENERAL CONTRACTOR Owner-Builder VALUE $ 3,000.00
V LOT AP# 118-1110-21 BLOCK TRACT Residence
n
b GROUP I TYPE V
R-4 FIRE DISTRICT # 201
PERMITS ISSUED
INSPECTIONS SUBCONTRACTOR
`i 1)7
"��/ DATE NUMBER
y Footing Trench /1-616 . . 4e
Foundation Forms and Grade to Garage �/�
,, Rough Framing .- L ,
tFPlumbing,Rough to Slab /J 2�-0 - .
X. Plumbing, Rough Complete .. 6 t�—,$iC� 7(U .%-:-/E1-1) "-- l!
- —Sy 5 ,_
Temporary Pole
Wiring, Rough Lyam Cr — )14, Av
-}C ‘24.-�4-- 7✓-c& V:-s--se /7
Heating,Rough
Heating, Final
Sewer fl-i *gib i' Cet-4,C - A:, %I'. ¢07
Septic Tank or Cesspool� l1 (f.
IV 0 C
Lathing fi AJ
0 a
Plastering 01(/$
Plumbing,Final,Fixtures Complete/4st ,Z3- .4
Plumbing,Final Gas Test /J1b-LW� 3
Wiring,Final -7-.C.0---7-.C.0-- ��//ii" Sr
Occupancy cD.��� 5,-a' sS I
Form 210 G-11 131 12-53
Costa Mesa Building Depai&ent APPLICATION FOR PERMIT
2
r! -_ , - 111 EAST 20th STREET UU�4 ,B U.I L D_,I"N_G. _._ '.
- COSTA MESA, CALIFORNIA --
• FOR APPLICANT TO FILL IN • FOR OFFICE USE ONLY I
�/ / �o /� ' " -� i Receipt No. Permft:No. i
Address cc
(03 G d � iefa -e-cr 1 i ,a� // 7
• i Received by. Date Recd. Date Issued i
Costa Mesa, California ,
Nearest /JJ I ' " APR 26 104'
Cross St. Building i / �7 //'/,11
�' Address (? /L `�
Owner w4- , (C i Costa Mesa, California
•:
Mail V- -Ain . .
Addre-- /7 rat - r L�— Nearest
Cross St-
Cit .- a. _aO '76&S' at No.of Type 1/I Group �-
Architect or Lic- Plans / 1 ' 1.
Engineer ses,- �z� 0. , Approved' •
by , ! Date
Address CORRECTIONS
ca
//��,�,,� �.c City Lic-
ntractor('fl-'JZy
Address► LL,� - •
._
Lr(4a1 ' Lot - --
Description I No. I Block /I Tract - .
(Att�i Metes and Bounds) f7 r *— t/y-O Z/ 1. �,� !'
I No. of Bldgs.
Size of Lot O ,,KK /,,, .
aO c. Now on Lot • - _ - - - - - v �� 0
Use of _ No.of No.of `- ''/ F
Existing Bldg. / I Families I Rooms _% ✓�,f�'1: ,n
Setback Line from 5 0 Rear Yard .2 S - - " ' -" -•I 0 ' 2
Center of Street • Side Yard S. :i
DESCRIPTION OF WORK 00, • • r
New f •--- I Alteration I I Addition I -
Repair I I Moving I I Demolish I 1
, Building No.of 4.
Size ,
€.../....1
Rooms Stories
F--terlor Wala-,a,.��I Roof �� •
trine l - Coveri
L• ngett r ...`r• - APPROVALS
of
," New Foundation Location Inspector Date-
Building •� G XZ�: Forms,Materials, p
Under-Pinning
'- Frame: Fire Stops,
Bracing,Bolts
t, Lath. Int.
1 hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Ext-
' with all City Ordinances and State Laws regulating ,
building constr tion.
Signature oi� /// •� `. Plaster, Int.
Permittee ; Plaster, Ext.
Authorized gt. Masonry Reinforced
Valuation Permit Fee $ /Q
O Plan Check $ Bond Beam
$i 00 0 Total
Fee $ FINAL
Tniia�4 3IO51 T OITpA�^I.a-ate �n`sm�qs� gnib1iufY sesMQ siaoD
a m i ® i 6N n >, }=:› T33AT8 MOS TBA3 ttt • y- f
AINAO'IIJAO ,A23M ATSOO r
•
J
•
- u
C 0
J
J
O. n
a
•
•
•
•
a
j}#
Street
PLOT PLAN . .
Show location and distances from
property line and between buildings.
.._.a.u, J arca, LA1'G Play C7 L7U7
- JOB ADDRESS 263 East 21st Street BUILDING PERMIT NO. 24215
GENERAL CONTRACTOR Owner-builder DESCRIPTION OF WORK Add of 1 bdrm & 4 gar
AP No. 8-141-03 LOT TRACT FIRE ZONE 3 VALUE $ 9,804.00
Qr^rSPECTIONS Si:nature Dat GROUP I & i)TYPE V ZONE R 1
Gas SUBCONTRACTOR
/./ f��I I PERMITS ISSUED
Date I Number I Signature
r Water !(. // l//`,(mac Plumbing
Rough Plumbing ri.4 ,,/7/ CiLlffes rA . W . T.. _ •C •- •.. • Ler ir
Prop. Swr. Line ❑ House Con. 0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning /'.e $//f//,S
Temporary Service or Pole /
Underground 0 Power 0
Rough Wiring /Q /< 7-12-43 Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0 'Ad./le/Mgr, e:-../9-65- ii 1 ra/or'
Floor System a fti i tp Ai-,2 ,-1116.915
Bond Beam D Steel Reinforce 0
Shea thin 'E<.7—itiOlt S
Frame and Flashing ,p,�{
Lathing— In, Out ill
Plaster, Brown Coat x Q- /p7 jA S,
Structural, Final g p Electric p
'ng, Vent., Refrig. and A.C., Final o ,e.e.,Cl�..c py°r,11e-r.4sr�7-go- .6— o?4t7 3
1. ..ibing, Final and Gas Tester- ,C /?�./-4y p l .
Electric, Final /e lit!-6C
Building, Final /9/ IZ-z3-be ,{9L
t. 242 ! 5 CITY OF COSTA MESA
.4tOSTA MESA BUILDING-SAFETY DEPARTMENT • MAY 25 1965
P.O.BO%817 COSTA MESA.CALIFORNIA
For Applicant to Fill In Completely APP lit T S'„ vu[' D;RMR
TYPE OR PRINT ')--$EJB • '• •
For Office Use Only
BUILDI G tz0.3 .E.2 La, 51vee+1,
"' R[C[IPT NO. P[gMIT NO
COSTA MESA. CALIFORNIA , , , 24 2I
•CC[IV BY 3 R/[C yfrV[D DATE ISSUED
OWNER OIIUPN .`I'�lll. - , . �.. . . Ii .14(66
MAIL --.•J'1 ADDRESS . - C �T—
ADDRESS `=2�3' �. 'Z. rts. ._•. ,: a 6 3.;.: .: 'tel s.
_. ..._..L.._ LnI _ FIRE -T-
CITY COS C4 j1A-PS:CQ . NE. .._ .'-. 'ZONE _ /�' TY Er(� GROUP—1j f.
ARCHITECT C 1 ,i. eC IC T,Ect 45:72/ry APPROVEDr.
/ly��/lf/ DATE ��
/J�/ Q., . . _. _. .. ._ f!,(j1Ll C 1-E N'C'7:ZONING(a . 4_1_49.
At BE / a"; I V UI e(.(/ YL°ad ZONE / NO:OP " FUSE OP NEW 1.41.4
_ PLANS. BUILDING
_ . , R y . td ti .--o4-
CONTRACTOR `yL1/��i - - yvy�*'�a+t
.^ LBOAL DESCRIPTIOADDRESS . _ L.,. DEHCRIPTICI: • • .•_ "CAI'L SiF/I fre
p el
'� ..
CITY • A.P.NO. (I s- /qa_ a 3
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE — TEL 80'TO SIDE 9 REAR P.L
LIG.NO. �/ t NO.
EAVESF
OLOT (ho )C �(J I Now ON LOTS ALLOWED (U.B.C.REQUIREMENT) Pr/Z
YARDS APPROVED YARDS APPROVED
USE OF 1d E'i1CP MAIN BUILDING ACCESSORY BUILDING Q/
EXISTING BLDG. es C 1 (FROM C/L REET) //
SETBACK LINE FROM LI REAR YARD /' FRONT .!/✓✓PTq .D-&I CC (/ FT. �'� {� a
CENTER OP STREET (J V - /�
�
V[t]
SIDE YARDI LEFT QI RIGHT s) , R.SIDE Q CFI'. .99 RT. V
DESCRIPTION OF WORK L.SIDE C? FT. a" Fr.
NEW X ALTERATION ADDITION J� REAR flied. !1-i( FT' U
DISTANCE BET. BET.MAIN& 6 r (y
REP. MOVING DEMOLISH MAIN BLOCS. ACCESS.BLDGS�./ (y
/� VAR.* I I( O DATE I"' H- bS
BUILDING ZA✓-7A ROOMS 3 STORIES I C.U.P.# APPROVED E'
SIZE T67`Y O
EXTERIOR WALL rft `Q I ROOF APPROYSP�,O, c�?�--/C w
COVERING COVERING �01{N-Q. BY (L�((// DATE �7 IA•
LLSEIOF BUILDING AND WORK TO BE PERF RM ED tin ! 0
&k11 cou of- out top rimntµ }n-.,.r..... a ..ca26-yge.,Trn.b aKbs o
YPSICIPUrr t 4 9QVQgA4 i ,Lin cL ctcue.e.,
a (
74 SQ.F'T. S 6 c n v
A'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOV IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. „
BUILDING ALL
CONSTRUCTION ORDI CESVALUATION CO
ANDPLY WITH /50TATE LAWS GULATI O �
SIGNATURE OF / I ///` PERMIT FEE j
PERMITTEE n..e _b car $ //���- �F� _.� //' E
D
v CO
AUTHORIZED AGENT / 495°0
9 J° 4
TOTAL FEE
agile[ ;:s YAM -. . : _. -,;. - ., . . ` ". .
�� i g ti
peeing_ Requirements: , _
1. That existing house be brought up to reasonable. code .
standards;
2. 'That new' unit 'be one story; • - '
3. Installation of residential sidewalks, including •
- concrete _driveway approach, across the •front of this
- . - .: ..property on 21st Street by the applicant, at his-expense
- ."as per standard Epecifications of the City of Costa
'' ' - Mesa; .. , -
4. Four car garage, which'would serve both units on the
,property; • ._ ... •. .. .-. .. . .
. 5. Plan to be reviewed by the Planning Commission and
approved by them --this-was done at the meeting •
' , ' held on,Monday, May,24, 1965. . ; . - .
•
:,.
-. , .
: '. '
.
' I