HomeMy WebLinkAbout248 24TH PL - Building Permits •
' MFMF CITY OF COSTA MESA I
4µ •l) BUILDING DIVISION PERMIT NUMBER
DEVELOPMENT SERVICES DEPARTMENT
rcit�• PERMIT
4%,-,„'r`° BOO-01052
(714)754-5273 • Fax(714)754-4856 •
77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 248 24TH PL Status: ISSUED
Suite: Applied: 07/13/2000
Vicinity: SIDE&REAR OF PROP. Issued: 07/13/2000
Parcel Number 43933102 Zoning: �r .
- ISSUED BY:
Applicant: FOCHT, JEWEL M TR
Address:
Phone:
Zip:
Owner: FOCHT, JEWEL M TR
Address 1580 RICHARD DR
Phone: 1' aCAMBRIA,CA Zip: 93428 �� /I�
aI
Contractor PREFERRED GARDENING & LANDSCAPE SERVICE OA
Address: 17608 FREMONT ST
Phone: (800)399-8330
FOUNTAIN VALLEY,CA
Zip: 92708 License: 519363
.
Arch•: ', : , .. , - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
•
SCOPE OF PERMIT
CONSTRUCT 6 FOOT HIGH BLOCK WALL APPROX. 139 FEET IN LENGTH ALONG SIDE&REAR OF PROPERTY.
FEE SUMMARY
Plan Check: $54.11 Calc Valuation: $2,780.00
Permit: $83.25 Claim Valuation: Woo
SMIP Res: $0.50
SMIP Com: $0.00
Other $0.00
Inspection: $0.00
Total: $137.86
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 28-0 Rear 0-0 Left 0-0 Right 21-0
PARKING Existinq: 0 Required: 0 Proposed: 0
NOTES:
•
•
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)754-5626
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.
❑ 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:
Carrier: Policy Number:
(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 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 provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS($100,000),IN ADDITION TO THE maT OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.# Class#
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 permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER,DECLARATIONS:
aunntle_,
I hereby affirm thatrrpenalty 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,counfy/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;thal 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.ofynot:more than five hundred dollars($500).):
O 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.).
,Q.j71;es owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
1/ 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 exe,••t under s c. Business and Professions Code for this reason:
Shire: ' . .. C
`Expires: 7- a 1
Verification 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,wilt 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,Gm 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? ❑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).
or
.l. . t..or.... .._. '
2 Does or will the applicant present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Califomia 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 feet of
compressed gas at standard temperature and pressure).
3 Does
or will the
..
happlicant 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......... is
..requ ... ....He.... u..... with?
w ..- _..
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied wt0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a_EPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 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).
.._....... __...._ school?
._ ............... ___........ .--._.._- .._.
6 Will any pan o of the facilittyytto o be constructed under this permit be within 1000 feet from the outer boundaries of a sch0000 l? 0 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signatur- : Legal Owner.,;,..
wner ,' Date
(—A-rid/OE•.0 bOrtzed ••pilo pat Date
`
CODE A IN P; •. A' PATE INITIALS CODE 0 INSPECTION TYPE PME INTITIAI5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
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
2446-46
e \
69
•THIS SKETCH S FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN re&6'IN HEIGHT SHALLONLY. APPLICANTS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10' FROM FRONT PROPERTY UNE.
AN ACCURATE REPRESENTATION OF THEIR PROPERTY
IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WAILS/FFNC6 SHALL NOT®EE'FFV 2'6•IN HEIGHTWITH THE INFORMATION PROVIDED ON THIS SHEET. W
WHEN 10'OF THE FRONT PROPERTY LINE(NOTCURB LINE.
/� Op — v , •VERIFY DISTANCE FROM CURB TO PROPERTY LINE
APPROVE AND SHOW ON PLAN. VERIFICATION FROM THE CITY'S t'T ENGINEERING DIVISIONS REQUIRED. CALL(714)754-5341
POR INFORMATION.
CITY OF COSTA MESA
PLANNING DIY.
&JECT TO BLDG. DEPT. RE .
BY' C. DATE 31 hcr-i
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RE9pENCCRCSIENCE
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CITY i)F COSTA MESA
AI'iPROV
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,;,;s•1 el plans and spedicatiors IIIUST be kept on this job al all„iT:es and`n is untlwi:a
i"!:E ry Cars ay aheralion on;rine without mitten permission otrii LiSDf:siionei Buil°
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..'!95 gilt, w,.�...,......_. 'eu :atier. ^�{,�'_p17Tbel'IU iC�:(Inl'0!wv,...:..;rr. i kJ'
.;; 1 s ggyiot i of efs plan and pnit ,,r Costa”'sa 0 f:nai•• a an:.,'C1 Sfa'.e 1
1-:i it(p!0:6'AO any prey!: nnr. ;s.. , 1-s' Ili lc ii1C t'u,Iiin ' '
it.::g,ir axioem:flsts!'- ;a ae..
RF9DENCE ;
RC90ENCF RL90EI10E RESOENCE
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` I. MOI 140QC liK{ i;i MO( • '•
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f STREET ALPIL Nie
BLOCK WALL LAYOUT FOR BUILDING PERMIT
PLANNING DIVISION
IM/ –ll_r_:L
•
iN.
TYPICAL 611 CONCRETE BLOCK FENCE
Cement Coping Optional a -
• GENERAL— NOTES
Channel Block With 1.3180 Ii iI _ _� ( I
Horizontal Top of all ee 1
Fences N INN
I MORTAR: One Part Plastic Cement, and
!' Three Parts Sand
to s GROUT: One Part Cement Three and
For Fences 5'or Less
Ven.Bars 3/8"¢at 4' 0"O.C. in a i a Tr- �� COPING: One Half Parts Sand
One Part Cement, Three
For Fences Higher Than 5' Ti U. '�I Parts Sand
Vert.ears 3/8"¢ at 32"O.C. a' w - - _ l CONCRETE: Wel I Mixed 1:2-1/2: 3-1/2
a = Max of 7- I/2 Galicns of
Fill Cells Solid With Grout I,B > „ I Water Per Sack of Cement
Where Steel Occurs > - -
ReminrciAg Steel Shall It
Z to
r GROUT MAY BE POURED FROM THE TOP
IIrYI I OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A-15-39 u 0
A.S.T.M. 1 1 Ir OCCURS.
,BBI LU n , 1� CELLS AND AREAS OF HORIZONTAL REIN
All Steel to be Lapped IM LL ' FREE OF ALLT SHALL BE CLEAR,CLEAN&
24"or to Code _ _�_ _� 1fI I FREE OF MORTAR DEBRIS,ETC.
GRADENATURAL
` i/.'.II FL Nr , '1 1 , rT
'v r =
os 2
TWO 3/e"4 BARS -a ---1
el
SEE CHART
CONTINUOUS TOP 1- _
—
&BOTTOM F . WIDTH TO IS' 0 C MAX
1:
HOaZSTE EL MUST 8E TIED IN BELOW
PLACE AT TIME OF TRENCH • I DC PT/1 CF C4RTHTCOTH
INSPECTION. r In THE HEIGTH OF FENCE
s i 'CLOW BOTTOM OF FOOTING
o' 1. _. . z �1 _ SCALE: I/2r = I'
•I
FOOTING REQUIREMENTS CHART
I WALL HEIGHT 6' •
541 311
WIDTH ".12". . . . 12"
THICKNESS .10" . . . 10" 8 " 8 "
DEPTH OF EARTHTOOTH 24" 20" IC 12"
SPACING OF EARTHTOOTH 12' 14' . 16' 16'
.
(,r
1.
BUILDING DIVISION
(-rd
CowNele) — . -
DECLARATION OF ,-../THORITY --Bldg. Permit #
•
FOR AGENTS OF PROPERTY OWNER This Permit #
TO APPLY FOR PERMITS
a L18 a r-j+1, . L_
Street Address AP Number
1. I (we), _ --I-a- -I-- /Y\ , ccek7 , declare that I am the Owner of Title
of the above referenced real property, and that I (we) hereby authorize:
_Te we , M . Forin i
Name Telephone No.
9q5 01-4-611,, pt
• Street Address
rc7 4L 44 5Ai- (id ga6a )
City State Zip
to obtain permits in my behalf, as owner/builder, for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we) shall im-
mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties as a result of work authorized
by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this / Y day of _(! 19 At) , atafkA4C,California.
Printed Name c4Date
Signature
oc9fXdatd )1/
NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides
for limited power of attorney to secure this permit in any behalf.
0779.46(Rev.7/91)
7
.. AO .272 W52
• COUNTY
G ORANGE
• • Application For Building Permit - 1 a.�9,
636 No.Broadway AND FOR A Permit No "6
Sano California Certificate of Use and Occu
Phone:e:KIKI 22-6211 pane y
Date Sept. 22 1952
1. OWNER'S NAME F. H. Paulsen PHONE:Be9.A-R..n-..&749..2
MAILING ADDRESS-?58..Safritfil...Isethe1...St CITYCoeta Mesa
Name Owner Name 4wzer
(Architect or Engineer) (Contractor)
Address Address
City City
State State
Lic. No Phone Lic. No Phone
PROPOSED USE- Dwelling
2. JOB LOCATION 248 - 24th Place Osaka Mesa
(House No.) (Name of Street) (Town or School District)
NAME OF AND DIRECTION FROM NEAREST CROSS STREET 'lie atmilaate-r...Place .
3. LEGAL DESCRIPTION: Lot 21 Block Tract 1442
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( _ ) INTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT ( )
T. SIZE OF BLDG • 35x36 AREA:1980 SIZE OF LOT:--7as10O AREA:--7200
6. HEIGHT OF BLDG • 12' CEILING HEIGHT. 8'-4" NO. OF STORIES----1
7. NO. FAMILIES 1 Size of Smallest Bedroom- 10x10 Size of Kitchen 9-6 x 16
8. EXTERIOR WALL CONSTRUCTION• stucco INTERIOR WALL COVERING plaster
• (Frame, Stucco,Etc.) (Plaster•Drywall,Etc.)
ROOFING COVERING composition
9. STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EACH---none'
10. SETBACKS: Front Yard From Center Line of Street...501-0"
Nearest Side Yard.. .1,8' Rear Yard 3.0 Distance in Feet Between Bldgs. on Same Lot--.15'
(Property Line) (Property Line)
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
12. (a) Footing: Width 14" Depth in Ground .12" Width of Wall 6"
(b) Size of Studs- 2z4 Spacing 16 "CC Material of Floor. .37011A
(c) Size of Floor Joists 2x8 Spacing 16
(d) Size of Rafters- 2z6 Spacing lilt 24 "CC
13. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ "'rt5oo:o0 i( j t{p'
14. 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 CALIFORNIALIIFAPPLICABLE THERETO.
Srigned I:i_-.�.� CAMS tt-v-
Plans Filed•
"SEP 2 4 r 1 (Owner)
By•
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY .
�
Bldg. Permit - $ p O GROUP.. APPLICATION..a HEALTH
Plan Check - $ 2 v U TYPE :: ZONING r FIRE
Total $
A 3 FL"O MAP DIST. G g yf PLANS AND MARSHAL
Receipt No. - r SPEC'S L� STATE
Paid to - - ... .. SHEET NO ...1" CORRECTIONS ENGINEER
Date . SEP--.2..4 _IB5$' VERIFIED CAL
F - ' I,� �,i I /� COUNTY f3UILDINq
• ---5-31/'''/ �" ,' � '' f'v�
(1�� t < INSPECTOR
DATE (( �S/
SOOn—q-52
AFP.7-..#
I Lo yA/
COUNTY OF ORANGE , Application for Building'Permtc JCi 9°BUILDING DEPT. Permit No
636 No.Broadway AND FOR A
Santa
Phone:a'California Certificate of Use and Occupancy
Phone:KI 2-6211 p y
Date.Se_pt0, 22, 1952
1. OWNER'S NAME F.H.Paulsen' PHONEasaoon 6749J
MAILING ADDRESS 258 Santa Isabel St CITY Costa Mesa
Same
Name Same Name
(Architect or Engineer) (Contractor)
Address._ Address
CityCity '
State State
Lic. No Phone Lic. No Phone
PROPOSED USE• Garage
2. JOB LOCATION 248 - 24th Plage Costa Mesa .
. (House No.) (Name of Street) (Town or School District)
NAME OF AND DIRECTION FROM NEAREST CROSS STREET ;Ye.sUlu iste-r...P.latoe
3. LEGAL DESCRIPTION: Lot 41 Block Tract 1442
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( 1 ) INTERIOR LOTS 101 ) THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OF BLDG • 18x20 AREA:... SIZE OF LOT• 781100 AREA• 7200
8t-4" 1
6. HEIGHT OF BLDG • 10 CEILING HEIGHT NO. OP STORIES
7. NO. FAMILIES Size of Smallest Bedroom- Size of Kitchen
8. EXTERIOR WALL CONSTRUCTION- Stucco INTERIOR WALL COVERING .none
(Frame,Stucco, Etc.) (Plaster-Drywall, Etc.)
ROOFING COVERING Composition
9. STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EACH FIQ.Re
10. SETBACKS: Front Yard From Center Line of Street
43'-0"
Nearest Side Yard 121 Rear Yard 12' Distance in Feet Between Bldgs. on Same Lot 16,-a""
(Property Line) (Property Line)
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
12. (a) Footing: Width 12" Depth in Ground 8" Width of Wall 6"
2x4 16 wood
(b) Size cif Studs• Spacing "CC Material of Floor
(c) Size of Floor Joists 2x8 • Spacing '-6 "CC
(d) Size of Rafters- 2x6 Spacing 24 "CC
13. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ -'690 ^7 �i (a
14. 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 APICABL�O.
SEP 2 4 1952 Signed r !}( •
(Owner)
Plans Filed-
By.
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY
Lf °o GROUP 3 APPLICATION 3 HEALTH
Bldg. Permit - $ o
Plan Check - $....-�. a TYPE -- ZONING ` FIRE
. Total • - - $ t'a DIST.T ,1 MARSHAL
Jt_ 77 / PLANS AND L
Receipt No. �� SPEC'S STATE
Paid to �.-q...lgrg.. SHEET NO CORRECTIONS ENGINEER
Date VERIFIED CAL .
PERiIti[T.", 7:11$®11 di t CO INSPECTOR i 6
a7--
DATE step___'..4...252 c dri I
soon--v-sa r J-
• cm,
Costa Mesa Building Department APPLICATION FOR PERMIT
111 EAST 20th STREET S45 BUILDING . .- 1.
COSTA MESA, CALIFORNIA -- -
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
Receipt No. Permit:No. ,
Building �f-/�/,:�y �j� 5��/ 5,7,9 -
Address ,757 I//.�—l�s,.���1,�- o� 'J
osis Mesa, Cali ornia Received by Date Recd. Date Issued
�y I
Nearest I. A l--AOj- €(.
Cross St. CC2��e. Building ;
Address o? �t _. - � _(�
Owner Costa Mesa, California
Mail
Address ^/"r[ar - - //e
TNearest
Tel Cross St.
City • )/C4No. Zone eT I No.of I Type ✓ I Group
Architect or Lic. Plans �J
Engineer No. Approved
by Date
Address CORRECTIONS
Co Lic.
/�JJ/�40eic Y
Address
Legal .�T
Description I No. „..V.... / I Block��,C��/� II Tract/4t�C. - •
.
(Attach Metes and-�,��"/ 7i (J• f
No.of Bldgs. -f►1�1U{�+-■,
Size of Lot I Now on Lot _ - - - O
Use of I No.of I No.of (jC-e ' 5 D_
Existing Bldg. Families Rooms SEP 1-0-1954
Setback Line from Rear Yard - -- -- - - - - - -- - Z
Center of Street Side Yard y
DESCRIPTION OF WORK CITYOC COSTA
New v I Alteration I I Addition I Sill-J-- t- Mrr 6F1
Repair I I 'Moving I I Demolish I
{ Building No.of
_Size Rooms Stories`erior wall I Root APPROVALS
Bring Covering
Use of New
Building Foundation Location Inspector Date
d, 4 es` 42pForms,Materials,
Under-Pinning
Frame: Fire Stops,
v. r-0.-- — Bracing,Bolts
/ Lath. Int.
I 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 construction.
/� , Plaster t.
Signature o /
Permittee/) -!. L.- aster, Ext.
Authorized Agt. i ... MasonryReinforced
—e
Valuation Per t Fee $ '
Plan Check $ Bond Beam ��1 QQ'� 1'' b
$ � /-- i. Feeal f!$ , o FINAL E4-1 tJ 3 3
Form 204 f:-ll IM 12-53
u
C o -
• J
J
d
o 0
� •
e
a \ o
•
•
t
Street
PLOT PLAN ,,., . :11
Show location and 'distances from
property line and between buildings.