Loading...
HomeMy WebLinkAbout2324 NEWPORT BLVD - Building Permits S 0 3,4 2-d1 B t 9'-I s q Type of Sign City of Costa Mesa I S 7 s- 0 D� ❑Electric on-electric SIGN PERMIT 4951 6/14/85 4 Project Address J3��- / QnRT (�=y2n5Tt4F39 __ .. ... R75 Ti Applicant's Mailing Address/ SAllE Description Programs - Owner's Name ' He+nrraoe Phone 442--3710 ❑ Canopy 0 Shopping Center/Integrated dev. Address 2-7371 !nP.t r r,P]-a/yi,«,o./ Vtg3n ,C4-42 4477 ❑ Attraction Board 0 By Owner/or ❑by City Arch/Eng. License No. _ ❑ Advertising Statuary Date letter sent: Address ❑ Other Off ice Use Only ❑ Tract Sign (Security&Right of ❑ Variance Contractor's NamP Phone Property ,,,///��� Entry Agreement 0 Planned Signing Address(mailing) 1/ g 9 41.39' 27/'•O5 CZ B ❑ Special Event(Request form submitted) A.P.No. Zoning City License No. ❑ Change of Copy (amortization) C.U.P.No 6 LICENSED CONTRACTOR DECLARATION Ground Illumination Sign Dist. , Date Received es///Tic I hereby affirm that I am licensed under provisions of Charter 9 (commencing Wall Received with section 7000) of Division 3 of the Buzinesa-a d rof slops Code, and ❑ Non-Illuminated by 'r my license is In full force and effect. Roof Interior Illumination License Class LI se o. ❑ Projecting ❑❑ Street frontage: �.O ��v Date Signature ) g Exterior Illumination �6 ppm• ❑ Construction Front: Ft. Street: WORKERS'COMPENSATION DECLARATION ❑ Convenience Right: Ft. Street: I hereby affirm that I have a certificate of consent to self-insure or a certificate 1I^1 �- of Workers' Compensation Insurance, or a certified copy thereof (Section ❑ Super Graphic I '- 8 r Left: Ft. Street: 3800, Lab. C.) J Policy No. Company Rear' Ft. Street' �� 8 Certified copy is hereby furnished. �j ^� Certified copy is filed with the city Building Division. Building set back from ultimate right-of-way ft. Date Applicant ELECTRICAL FEES INSPECTION APPROVALS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Fixtures Sign Date Sign Location section need not be completed if the permit Is for one hundred($100)or less). Front Right Left I certify that in the performance of the work for which this pe it is issued, I Device Boxes Underground Conduit shall not employ any person in any�y�� er so az to c ubject to the Workers' Co n flan Laws of C.rB[II11L'�r,,�� � Outlets /'Date - Signature ^!/M-^^ Sign Description NOTI4: If, fter making this declare , you should become subject to the Sign Dimensions Area Letter Height • Switches 9 /� Z 9 Workers' Compensation provisions • he Labor Code, you must forthwith �/ /r] Y) comply with such provisions or is permit shall be deemed revoked. Foundations CP4� - 47 x 5 �+ _ / `� CONSTRUCTION LENDING AGENCY Sign 9 I hereby affirm that there is a construction lending agency for the performance C..) D� /f ,Sq'ft. / of the work for which this permit is issued (Section 3097 Civ. C.) Standing Sections ® 2. // x /•r ^ yv h+ �Q / Lender's Name -\\J/LC•Q_./,AL % Lender's Address faiw OWNER BUILDER DECLARATION Rough Wiring I hereby affirm that I am exempt from the Contractor's License Law for the = ...following reason (Section 7031.5 Business and Professional Code: Any city or (31 x `- sq.ft. 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/she is licensed pursuant to the provisions of Items of Information: (1) (2) (3) the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt Framing therefrom and the basis for the alleged exemption. Any violation of Section Total for Activity 7031.5 by any applicant for a permit subjects the applicant to a civil Issue Fee .$3 enalty of not more than five hundred dollars($500). �l r - p U I. as owner of the property or my employees with wages as their sole Copy Verbage 10 �Io�Ut/ "i/I 6 !�L compensation, will do the work, and the structure is not intended or offered Valuation $ 700 r-- (� 1 for sale (Section 7044, Business and Professional Code: The Contractor's Final Electric prat ,- ^a� / J License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/M1erself or through his or her own ���� employees, provided that such improvements are not intended or offered for Planning Fee $ n 3•7•S 4 o e 0 - ' �A/&7i N . , I% sale. if, however, the building or improvement is sold within one year of com- .S/B'/V. pletion, the owner will have the burden of proving he/she did not build or im- Building Permit $ /O r ' Ci. / q r prove for the purpose of sale). Ground Sign: Overall Height S q Planter Area XLZ o I, as owner of the property,am exclusively contracting with licensed con- Plan Check $ 6 Co F'•.I Planning tractors to construct the project (Section 7044,Business and Professions Code: Electrical $ — 3 / The Contractor's License Law does not apply to an owner of property who Ground Clearance builds or improves thereon, and who contracts for such projects with a con- -� /� i tractor(s) license pursuantPlan Check 50% $ �o �� ��/ to the Compensation insurancera License should be I aware that proof oftheir Worker's Compensation be provided to me. SMIP $ • S9 Total Sq.Ft.of All Signage r IDI am exempt under Final Sign Section B. P. or this reason TOTAL FEE $ 2 3 • 7 J • . 3 • / ••) ����Y - — .' r This activity Total Site Dat Owner-�/ .!!• -'.D,�� ��� J�� I hereby certify that I have read is applicat••n and state that the above Notes: information is correct. I agree to c•• ply with .11 city and county ordinances DEVELOPMENT SERVICES REQ IRE ENTS: and state la. - ting to building onstru• i•n, and hereby authorize repre- �•-j�'I `/ g sentatives •f this city to enter .on ' above-mentioned property for Planning Approved By: p��'��`rr Date esii y_ inspect io purpose / 4 /� /As-- Drivers' AS Drivers' _i/// ` ./ Application Issued By: Date �/I LI I C - s068.30, rev. 7/84 While-Building; Green-Code Enforcement: Canary-Applicant; Pink-Revenue; Goldenrod-Assessor • ADDRESS OF BUILDING: 2324. NEWPORT BL WIT: •CITY."OFn"COSTA MESA — BU.81LDIN'3 PERMIT OWNERS NAME IFIWOWN:HOOVER, JAMES W TR `F'v PERM NO: E 077539 9 ADDRESS:27.371 MONFORTE " MISSION VIEJO,CA 92692PERMIT, NO: E . 077539 PLAN CHECK NO: N GOVT: N SUPP : N ( , . 642-3710 l APPL.WIDNGADDRESS: • CONSTRUCTION TYPE:' PERMIT TYPE: ELE PURPOSE: OTH ARCNNECTOR.EJIGNFER: GCS JOB DESCRIPTION : SERVICE UPGRADE SQ FT: ARCN.OR ENG.'S ADDRESS: i UHT: • CLAIM VALUE':`' 5, 000 . 00 '`• CALC VALUE: GROUP OCC : B / r CONTRACTOR'SNAIAEiSIERRA' ELECTRIC ( 714 ) 544-7060, CONTFACTORSMMImD 1782 SIERRA ALTA COMMENTS : NO OTHER WORK = ,iD0RESS:SANTA. ANA CA uallo.: 491972 ********* ******�Ftt*****so-x'*-K•*tr -�t�Frtat**->E**it'+Fit-�c*->ESF�F*Tt -*�F�F*K-* -*�t**+t**** -*-x-*+E*it****-x • 92705 UHT: Z O N I NG REQUIREMENTS ' LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 `, . SETBACKS (commencing vdth Section 7000)of Division 3 of the Business and Professions Code and my lice is in full force end effect. ' • cmLIC.No.: LIC.cuss:C10 UC.NO.: 972 E}�P: MAIN BUILDING ACCESSORY BUILDING Date: rJ ?, �� comred«: �[ � FRNT: " FT IN ' REAR: FT IN FRNT: FT IN REAR: FT IN I — LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER ECLARATION:I hereby affirm under penalty of perjury that 1 em exempt from the Contractors License Law for the following reason(Section 7031.5 Business and Professions Code:Any city or county whirls requires a permit to construct,atter.improve, ' PARKING REQ: PROV: PARCEL: 43927105 Z N E: REF NO: demolish,or repair any structure.prior to As issuance.also requires the applicant for such permit to fib a signed statement that he or she is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commending with Section 7000)of Division 3 of the PLANNING NOTES> 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 penally ofnd more than five hundred dollen MS5001); ******************************************************************************* ❑ I.as owner othe properlyormyempoyees with wages astheir sole compensation.will dothe work.and the ewctureisnalintended DEVELOPMENT SERVICES R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property Q who bolds or inproves thereon,end who does such work himself or herself or through he or her own employees,provided that such improvements are not intended or offered for sale.II,however,the building or inpsovemem u sold within me year dcompoton.the ZONING APPROVED BYa DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose d sale). • _ ❑ I.as owner of the property,em exclusively contracting with'Sneed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does M apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY •• DATE: I contracts for and r Section: : a conlrectorts)licensedpursuant ..f r this r as Contractors License Law). ^ 1 , ' teat exempt unser section: B.Apc..for cols re..cn: APPLICATION ISSUED BY: L DATE: /Ji °t Owner:erLEGALIZATION:N FEE • R Y STRUCTURAL SEGMENT:N I do hereby certify that I sen aware of and understand the requirements of Cduoma Health and Safety Code Sections 25505.p55'3,and 25534,aendmdloran futureormod buildingoccupantQualitlltan(gnboneineed to comply wcorshet slate codes eexem requirements for BLDG PMT PLUMBING ELECTRIC M FIRE SMIP/RES GRADING a permit to that I uctiona(any otmod mtighocupant unity 1—enegrclent oe)neeR lid conn nepco are ehe remptlmmtsfor provisions. l PERMIT 37 50 Date: 5179( Applicant: �1 0$ SMIP/NON—RES WORKER'S COMP SATION DECLARATION:I hereby affirm under penalty of perjury one 01 the following declarations; PLAN ISSUE FEE 15 . 00 ❑ I hays and WI maintain a conical.el consent to sett-insure for workers'oompensedion.as provided for by Section 3703 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the ped«m.rte.dthe work for which this permit i.issued. TOTALS----> 37 . 50 15 . 00 0 . 00 52 . 50 52 . 50 . 00 ❑ I here and ail maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the perfcrmarae of the work for which this permit is issued.My workers'compensation insurance carrier and policy number we: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 52 . 50 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (Thi section need not be completed I the pent is for one hundred dollarsISIOxl or less+ 52 . 50 1 certify that in the performance of the work for which this perm)is issued,I shall not employ any person in any manner so as to subject to the workers'compensation leve of California. and eeeyggrreeeppp and Id become *d to the workers' *****iE********************************1E*********************3E****************** compensation°Ppr//jyison d Section 3700 of the Labor Code.I shall forthwlfh opmpfy wise t pr IND I V I D U A L • F EE BR EAK D OWN ...........0 Date: $ /_ so /iv`�` 7/Q Applicant: /sTg�/ � Warning:Failure to u workers'compensation coverage is unlawful,and shall subject en employer to cdminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($104000),In addition to the cost of compensation,damages as provided for In Section 37osolthe mintent, attorneys Labor code,lntaandamaysfees, ELE 1 SERVICES BELOW 600 V & 201— 1000 AMP 37 . 50 37 . 50 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that them is a construction lending agency for the END OF FEES pedonnence of the work for which this permit is issued(Section 3097,Civ.C). LENDER'S NAME: i LENDER'S ADDRESS: 11 E EXPTI crab,that I have read this application and date thecorrect the above information is correI agree to Comply with all city and county ordinances i ') endcrate laws constructionrelating d g to building and hereby authorize representatives thisry propertyto enter upon the above-mentioned for inspection purposes. OWE, DAVID DATE _L.: e — -7 —oeswe CtN gnature of genVA I/Contractor • 1, (5151se.WP) White-Building 8 Safely:Green-FIe:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor f CONSTRUCTION AND PLANNING i•; POOL & SPX- APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1'. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soit.Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UP ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - , 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64.' Plumbing System - Final 14. Rough Plumbing 65.- Electrical-Final 15. Rough Electrical-Conduit solar System-Final 16. Rough Electric Wiring �� 7. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro is 26. T-Bar Ceiling (Structural) & Mondcoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown.Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED • - - 33. Final Electric Notes: 34. Final Heating& Air Conditioning • 35. Final Gas Pipe-Test -- 36. Hood or Canopy , • • �y J 37. Final Factory Fireplace 3 38. Final Plumbing • •39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Costa Mesa Building Department APPLICATION FOR PERMIT./ •COSTA MESA, CALIFORNIA. 111 EAST 20th STREET ��� -- - -- - -U_i_L.D LNG_... f 1,_ FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY i Regeipt No. ...... �{ 0. Building -' i 7 Address,3? V yfvpO.e7' OAC vv . . l/7 \ Costa Mesa, California Received,by D to Reed. Dat Issu Nearest /8/s �y Cross St. ,2 3 R� ST. AddrBuilding ess 2 a f A�V E a R�_ /� Owner W, ii FL EflME C Costa Mesa, California Mall Address 93 -o /i/fs wfo der BAUD, Nearest I , Tel. 8 Cross St. , City et.STA. fro 1ESP No. /.j,oS-to Zone... No.of Type / 1 Gro}tp Architect or Lic. - I Plans Engineer c , : . No. Approved � ' by G,L Q 4/ Date.WS- Address •Z .n!E AV!r / Address . 2 AltA2CORR CTIONS eoFity Lie. Contractor 87W emitsr,Pment*l No. Sj 41) - Address af.1C. Al 6a/PORT pwe • Legal ' Lot /' ///JJJI . .- Description I No.60 K / I Block----I Trac't3C /G ^ (Attach Metes and Bounds) j19 0//-- S j • ' I No.of Bldgs. Size of Lot 46—y, J75 Now on Lot • - - - -- - -- 0 Use of pmemeac I No.of a I No.of ,/ s Existing Bldg. Families Rooms 7 t N • Setback Line from Rear Yard t _ - ® Center of Street Side Yard ) N 1-`- ` j DESCRIPTION OF WORK 2 It" r New IAlteration I I Addition :JAR .l U 1954 �ARepair I I Moving i I Demolish ! I N _ �gyOl apt `+i-Seeding No.of - CITY t OF COSTA 1 s' Size 90 lc 3 O Rooms a.. Stories i ��) Exterior WallI Roof Covering S%rfcco4$RIC/(I' Covering COMM P. • .- .- APPROVALS -UseofFoundation Location -Inspector - Date Building ZT4aC (Forms;Materials; I--' • -Under-Pinning . .. Frame: Fire Stops,. �. - • - . 4 ,, Bracing,Bolts- . Int.' - I hereby acknowledge that I have read this'App]ication Lath. 1 L • - - 'and state that the above is correct and agree to comply .'}. :'' 1- • with •all City Ordinances and State Laws regulating Lath.Ext;„ „• - . •• . 'Wilding construction. • Signature of �� n ..t may,,. n Plaster, Int. • 1 Permittee CvH9�lKC�s�� ea: ;'Plaster, Ext Authorized Agt. ,pe.ficifirrie,0 Masonry Reinforced valuation 06, Permit Fee $ i '7/ Plan Check $ yBond Beam $ 3o Total 1 // t24 Fee $ / 7 FINAL Form 20)4 (:-13 1M )2-53 • - u c Y :`71 o. • a a • ._,.e_:.,.l® . , wash �zo� 4 M Ate. 411 s fal.- VU 3 IVO 9146 a s C .oIA4rnata+ till . ou.j® nww%u _4 s . I -En x�J Street \ Jvacr acil PLOT PLAN • Show location and distances from property line and between buildings. • You carry Workman' •`7R1UN 1►awdae s Compensation Insurance? Yes ltaoT4 No 0 I am aware of Provisiond3700 of the State Labor Code which requires every employer to be insured against liability for yorkmaa's compensation.. ' • gaped a t OWNER Bill Fletcher .-. DATE' 3-23-51a JOB ADDRESS 2324 Newport Blvd. BUILDING PERMIT NO. 3147 GENERAL CONTRACTOR Bay Construction VALUE $ 3,500.00 Lor AP#119-011-b-5 BLOCK TRACT SStore VGROUP G TYPE V ZONE C-P RE DISTRICT 1116 PERMITS ISSUED 1 INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench a- I �/j/ Foundation Forms and Gradeyo Gara•e Rough Frarping Y'` �/ J kI-r-F� er 51- /'.rSy J. •Yr Plumbing,Rough to Sla _:;:e/2/5172--7 _ � �.. ... .�._•— Plumbing, Rough Completee.---XV ,j V �i� / C- / $-t_ -90X Temporary Pole) arra, - - Wiring, Rough „de e"t4 "� J�1?.6 f`f.r_.Yw.Cce.... e 5-y_sv 17 J Heating, Rough Heating, Final /jt I Sewer - L • 8se' Septic Tank or Cesspo.Lp.1 AIV r • r(• 4 45G Lathing 4,) ?Ott_ )ii X77 C " Plasti ring f 4 / Plumbing,Final,Fixtures Complete 11 3 • Plumbing,Final Gas Test iSil I J( Cii.-e#n f.-_ 6.—/k--1-4�_p 1 Wiring,Final Ca/G/g- 6 1 `-Q4 0,-41----d ,4„...._ 6i/g'--i/ _ a 9 �i i Occupancy AAsigiorovn tau-rsr_4/ -Zte445-- t•.• -.V- ,.. Do._1:...,4et.,A. (,-i/2, c.r 3 n .P COSTA MESA BUILDIF)GDE?ARTMEtTersib• ri NQ ' A . A 111 •East 20th Street lr Y Costa Mesa, California �v/ Date �G7 r / 17 _--_--. CITY OF COSTA MESA r CERTIFICATE OF OCC ANCY nn S 4 Building Permit No./ -....Electrical Permit No.../.-!.7 _Plumbing Permit No.-.f Use of Building ... ...,41- --yt•• .. ....... iA:'e7w--- The building located ateke `1—. ..,---P‘ .C.# Lot IL '—Pi/ ^�'k e Tract �. (See reve se side for Metes and Bounds) has been inspected and found to comply with the provisions of all City of Costa Mesa Or- t dinances applicable thereto for a Grou ....� Ottvpancy. ISSU ' 7 ._ A. J. VOL City Beijing (Owner of Building) By _...V CC: 0 Original—Owner ❑1st copy—Gas Co- 0 2nd copy—E Ison Co- 0 3rd copy—File Form 206 C-H IM 12-53 BUILISING SAFETY DEPARTMENT El O. Boa No. 317 N? 1597 c Costa Mesa, California Date Z — -- 2 CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No.// C r Electrical Permit No Plumbing Permit No Use of Building f"', it%Jf ', -, .;-f'�'- 4-. -jr `" The building located at -2 3 2 9 i t a5.7 .-r_f S.-424s Legal Description (See reverse side for Metes and Bounds) has been inspected and found to comply with the provisions of all City of Costa Mesa Ordin- ances applicable thereto for a Group - 2- Occupancy. ISS TO: / ^� City Buildiag,bffieial %l. • 'C f " BY--� . +!s ;7 of (Owner of Building) CC: ❑ Original—Owner ❑ 1st copy—Gas Co. ❑ 2nd copy—Edison Co. dirird copy—File Form 206 S-B P iM 1-60 17008 rEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT IWn`r 1 0 1%?. P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant fo Fill In Completeij APPLICATION MR ItERM'OSTA MESA TYPE OR PRINT BUILDING BUILDING .2 3 2 (� ?p" /3�,Q ADDRESS f�/ C COSTA MESA. CALIFORNIA For Office Use Only c/ IW , 7. e9ec Jer.e l RECEIPT no. I PegMtiH�. Off/ OWNER n �y/'f/�f// // � I /V ADDRESS a• 3 a 5 eter Tet 440 . REc VED By DAT�RE IVE DATe ISSUED If , -7-V?-- 4,--V is i - S�� Al‘475-4, TEL. BUILDING 3 /� CITY( n S�. NO. ADDRES6 �J �zgec'f/ ARCHITECT /�I�, cog*, TEL.//qin � COSTA MESA. CALI RNIA OR ENGINEEf F� /J NO. C ADDRESS /3 2 3 34 t I.'.( CAI - FIRE ZONE TYPE ,�//ROUP �S. �'q � BYPROVED OA �( DATE /1::. ;4 CONTRACTOR //LL++'`'Y/-- sr7 i ADDRESS 3> 3 Z Se 1,%NING I //)� / zoN ] No.NO; USE or NEW `I-- YY14L• CITY Cil-s-(201--At.n�P Sd . /J �r'/� I PLANS y BUILDING r)..04.4.-4-49-4 n`y `n LIC.TNO.1/ ! 3O C TNO./b 7 zr g DESCR +,� 3/10 / Gt r- ( l/� //II�� JTT DESCRIPTIO ,` 1/ (/� OF LOT �LJ x IU V I NOW ONLOT / A.P.a°. 1 lci —©/ / — it USE OF 7/e/NAL S Lo? YARDS a EVES EXISTING BLDG.7/e/Aft la APPROVED ALLOWED SETBACK LINE FROM ISr�I r CENTER OF STREET REAR YARD FRONT ?J/1/6i. N. -- SIDE YARD I LEFT 0 I RIGHT O R.SIDE �'e5--.) .FT. IN. DESCRIPTION OF WORK NEW I_ L.SIDE �7/ IN. ALTERATION I IIADDITIONI� REAR !///}}}O(((���� _ • nIN. { REPAIR I I MOVING I II DEMOLISH BYPROVEQL I/ DATE 5 ^ 7 BUILDING Q/� r .{- NO. OF 'V��(r SIZE .7 y. /'t/v'},�(inp.ROOMS STORIES / EXTERIOR WALCr/1 GOOF .VVYLT op COVERING /,VCCU COVERING USE OF BUILDING AND WORK TO ERFO ED C/A1MrF .y cns-! _ e. , .- Ls — 5b` I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THS ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDI NCE ND STATE LA REGULATING SulO1N0 ConSTRUCTIo VALUATION SIGNATURF,O PERMIT FEE $ j3 , PERMITTEE\ I ��. J o S / J PLAN CHECK $ 7/ AUTHORIZED AGENT \.,_ , TOTAL FEE S (I. ' -'—0 I