HomeMy WebLinkAbout2220 ANAHEIM AVE - Building Permits CITY OF COSTA MESA•
4BUILDING DIVISION
> :J s DEVELOPMENT SERVICES DEPARTMENT PERMIT NU BER
F t PERMIT
44b, eRmsose BO -01783
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2220 ANAHEIM AV Status: ISSUED
Suite: Applied: 10/19/2004
Vicinity: ROOF Issued: 10/19/2004
Parcel Number: 42218107 Zoning:
Applicant: SONIA GUADALUPE PALACIOS ISSUED BY:
Address: 2220 ANAHEIM AV
Phone: 949-650-3288
COSTA MESA,CA Zip: 92627
Owner: VALADEZ, ARTURO GARCIA •
Address 2220 ANAHEIM AVE
Phone:
COSTA MESA, CA - Zip: 92627-2511
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 2 LAYERS OF 30#FELT,30 YEAR COMPOSITION SHINGLES,AND REPAIR/REPLACE SHEATHING AS
NEEDED.2,400 S.F. INCLUDES ATTACHED GARAGE.
FEE SUMMARY
Plan Check: $0.00 CaIc Valuation: $4,800.00
Permit: $111.25 - Claim Valuation: $4,800.00
•
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $111.75
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 end 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
2446.48(WOO)
I•
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.
O 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(5100)or less.)
Ingrrortify that in the performance of the work for which this permit is issued,I shalt not employ any person in any manner so as to become subject to the workers'
compensation laws of California.and a that if Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro
,, � Signature' 'Lyr
ARNINFAILURE
T65 ORI ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS 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,end my license Is in full
force and effect.Lic.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
O 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:
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 tho 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.).
O I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
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,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 B,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).
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 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 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? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this gpplication apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? L i Yes Ll 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? 0 Yes 0 No
(If"yes",the facility must meat 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
6 (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.
Signet -e Of Leg: •,gets) Date
_j J9 O%
CODE r INSPECTION TYPE PATE INTTNALS CODES INSPFCTION TYPE prig Jt�LS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �� 208 Final Plumbing
200 Final Re-Roof ti-7- or f�`/, 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
•
DECLARATION OF AUTHORITY Bldg. Permit# Ce0 —9I
FOR AGENTS OF PROPERTY OWNER This Permit#
TO APPLY FOR PERMITS
Street Address: "22.20 66-2.41, lichen (24 • AP Number:
1. I (we),YcC'jV r'D Uou\a A01,, , declare that I am the Owner of Title of the above
referenced real property,and that I (we)hereby authorize:
•
/me: 13z7nlr"-P0-71.A4-4-45:2-3 Telephone Number: e/9- &So —3 2n
Street Address: 2.0.22.0 6/naAging OW,
/ity:GC /`— 2'A-7 St rftp: 9;•2,62/ -
to
262 -to obtain permits in my behalf,as owner/builder,for '� l CL) 1'6-tQ
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately 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 person, 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 day of 20_, at ,California.
Print Name: 4fr *ft;410 G/IRC/A V/rLDez
Signature: icer *PILL
Date: long/oil
Note: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attomey to secure this permit in any behalf.
0779-46(rev.11100)
►;
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PE IT NO. TRACT NO. LOT NO. UNIT NO.
.• Project Address t C1 e ae -&t C. 33427
Applicant's MailingAddress TYPE OF CONSTRUCTION LI NEW U ADD ALTERATION LI REPAIR
l . �;� L(p��I� ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# I Zone
Owner's Name w�`�`A`-`� ��s�� Phone�=D�43a o
., DESCRIPTION OF WOF�K/ySF�OF BLDG. V sta'1, -sA�a 7
Address o7-,De, Ar�Y'Q1Yr 'I I,O,Pin '�(G�aS S Main Building: Accessory Building:
Arch/Eng. License No. l 7704.2 TYPE OF PERMIT U GRADING LI FOUNDATION T Z
U STRUCTURAL E Front 0
Address y� 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N
Contractor's Name V1fV\Qt' Phone 437-0(0\ 0 OTHER A 'N
AddPROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G
City License ing) Co�O N. FCKNOFF I C72PtJF6 CA. C
AL3^ CON ST RUCTION TYPE VALUATION$ SRS3' $ Left
City License No. '[ J�J�� - ZONE GRADI NG CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION • Ping. Ref.# Parking Req./Provided . E
- Q
I hereby affirm that I am licensee under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and T
my license is in full forced od effect. '
Licen la£s F7 �I Icepse No. y� S
Date 'e7C- W r Signature L' s (l-,l Q... 94 PLUMBING I FEES '
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
, hereby affirm that I have a certificate of consent to self-insure or a certificate ,
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
,00, Lab. C.) Automatic Washer Transformer 0 15.50 KW
Policy No l41-C533)1 -01"1 Company Llas-ter L` Backflow Irrigation Sewer Cap ' Construction Pole Sub. 0 50+KW
iCertified copy ishereby furnished.
Cer fin-n7.c_opsy- led w the city Sul ding I isiiy{ J Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date
.,-^v-v' - plicant (,/q.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
rr (This section need not be completed if the permit is for one hundred ($100)or
Ci)
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
I certify that In the performance of the work for which this permit is issued, I —
Motors❑0.1 HP 01A-B
shall not employ any person in any manner so as to become subject to the Solar Tank Fan
Workers' Compensation Laws of California. Drinking Fountains
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP❑16.15+
1 NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit snail be deemed revoked.
iCONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
O Lender's Name
Lender's Address i Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor
any structure, prior-toils Issuance,also requires the applicant for such permit
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
revision 3 of the Business and Professions Code) or that he/she Is exempt
erefrom and the basis for the alleged exemption. Any violation of Section
/31.5 by any applicant for a permit subjects the applicant to a civil
' „Cnalty of not more than five hundred dollars($500)-
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered —-— - Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ID SERVICES REQUIREMENTS:
employees, provided that such Improvements are not Intended or offered foryP
sale- If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
plelion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
Drove for the purpose of sale). SIC
1, as owner of the property,am exclusively contracting with licensed Con- Duct-Structural Refrigeration System Application Issued By 7IC Date
tractors to construct the project (Section 7044,Business and Professions Code:
Th Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
' but ds or improves thereon, and who contracts for such projects with a con-
1114 _
-. traSor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ ( �C SMIP $
proof of'their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT
I am exempt under Section
•
ate Owner B.& P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ ISSUANCE $ - -
Heating System& Ducting Registers ENERGY P.C. $
PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above Do-i 00,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $
Informdtion is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of.this city to enter upon the above-mentioned property for So
inspection purpppses.�� (''� •- - t�0 MECHANICAL $ TOTAL FEE $ �/
Signature �,A_Le_A PDQ L-
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
1\\CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ul UUu9L1U-uutu4.(L I Li T 81.50
CONSTRUCTION AND1iPLANNING POOL& SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
1. `Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 1 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation I1 !� r 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 66. Solar System-Final
16. Rough Electric Wiring 67. 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 ID 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
26. T-Bar Ceiling (Structural) & Monocoat 75: Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing.& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED41./41.// )` -
33. Final Electric Notes: / /{, 5,eelf !✓cia '
V ft
34. Final Heating & Air Conditioning r// `7Yier, t:
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final £0 790A-
Ar,PC fie
er ate
40. Gas Service-Final
41. Solar Domestic-Final •
9/E/79
42. Backflow Preventer •
U O O
, 43. Backflow Irrigation
44. Landscape Irrigation System
ly
45. Sound Attenuation i t
46. Handicap Regulations -
L
.' 47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Ga$rRel�ease to Southern California Gas Co
51. CERTIFiCATTF OCCUPANCY
•
No. Date
` t
i
OWNER EASTMONT DEVELOPMENT CO. DATE 11-19-56
JOB ADDRESS 2220_Anaheim-A.te. BUILDING PERMIT NO. #39.66
GFNERAL CONTRACTOR Dike_&_Qolegr9Ve— VALUE $ 11,260.00
LO, 7 BLOCK TRACT 3075 Single Res, w/att. gar,
GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 14007
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench / # isek
Foundation Forms and Grade to Gar/
—
Rough Framing _ 16.71;
Plumbing,Rough to Slab IP . I J, si. /� . /.. //-2P-3-7: 7 y ye
Plumbing, Rough Complete C P—2)- 7
Temporary Pole
Wiring, Rough , JAN 2 3;957 vet // �- -> , _-._ / I t 10 1951 3 8 a
Heating,Rough etj. Y/-$f `
Heating, Final �j/����,I��& S oF r� p ch.- ' /-fJ' --7 ' 7r2.� .2 ✓
Sewer, :uus.���/Iii____i>s rr - -S ,y�„ /J - i-- ♦-3('S— /� O7!
S Tank or C- ..•••1 `
L— .,ng, ln9j 7 Out A s" �-4 !Si
, Plastering ger 1 y0
Plumbing,Final,Fixtures Complete j4�� t/J, e l
75
Plumbing,Final Gas Test I4' cis 6. . , i V e7 S4-, 7 ---7'- r
Wiring,Final APR 4R 195 VCn - . Ala. 7 it i/
Occupancy r, ,
7----- 3? .
FORM 210 3M 10.53
.Costa Mesa Building Department i APPLICATION FOR PERMIT
P. O. Box3!7 aaIn7 BUILDING 1
t '-0 COSTA MESA. CALIFORNIA
F FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
Building
Address 2220 Anaheim Avenue 376o
Received by Date Recd. Date Issued
Costa Mesa, California
Nearest 4— ( 9-4---6 //—i? -CZ
Cross St. Wilson St. Building
Address
Owner gastmont Development Co.
Mail Costa Mesa, California
Address b19 D. 17th St. Nearest
Tel. Cross St.
City Costa Mesa No•Li. 8-1159 Zone No.of Type// GrouiyJ
Architect or Lie. �� I Plans I Y L,/t/Q.
Engineer Carlson & Middlebrook Approved (//j
by Date
-dress Garden Grove CORRECTIONS
I City Lie.
,,_.,tractor flitrn an,3 Cnlnernv4Jo• 4 15
Address 419 D. 17th St. , Costa Mesa
Legal I Lot , I
Description No. I Block I Tract3075
(Attach Metes and Bounds)
No.of Bldgs. none
Size of Lot 61 E 98 I Now. on Lot
Ilse of I No.of 1 I No.of 700
Existing Bldg. none Families Rooms 0
Setback Line from Rear Yard 20,51
Center of Street 501 Side Yard 51 Z
. D
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
Repair I I Moving I I Demolish I
Building No.of
size 1300 sq Pt Rooms68 Stories 1 .Or
Irior WallRoof
Anent).erinAnent) I Covering Comp. & root APPROVALS r
Use of New
Building SinEie family residence Foundation Location Inspector • Date
Forms,Materials,
C)L o1. Under-Pinning ,p
Plan Z650r ' Frame: Fire Stops, N
Bracing,Bolts O
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int. co
with all City Ordinances and State Laws regulating Al
building construction. Lath. Ext
Signature of
Permittee ,,.+ Plaster, Int.
Authorized Agt. (`, C ci1,,,v�.L,( Plaster,Ext O'
oF►"
Valuation Permit Fee $ 070� Masonry Reinforced O.
Plan Check$ /re --- Bond Beam
$ 16 a 6,0 Total
Fee $ 7� FINAL O
FORM 204 1O...55 D.P.&S.
.
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o a A
a
a • .
•
Street C
l,' 1 7:
•
PLOT PLAN
Show location and distances from .•
property line and between buildings
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IA
4-1O • •
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Vi
OWNER PERRY, JOE SEP 2 4 1957 DATE 6-11-57 _
JOB ADDRESS 2220 Anaheim Street BUILDING PERMIT NO. #5289
GENERAL CONTRACTOR Heet Bros. VALUE $ 9)4.00 .
AP No. LOT 7 TRACT 3075 FIRE ZONE DESCRIPTION OF WORK Fence
G. IP TYPE ZONE PLAN NO. #5322
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches Forms Steel f Y
Floor System `'
Ft,-"
Steel Reinforce Chimney Re-Rod p '
Bond Beam N
Frame and Flashing C �/
Lathing, In Out ,ft/ it //
Plaster, brown coat lA, r�' /
Underground soil WIG Pipe Test 4'i /L-7 A,ti-
Top
�
Top Out •' /- 1
Furnace vl Ai / 74 ,
Gas Vents ////,/ 0 lirf's
Rough Plumbing ,,/`' e• L /j V �� b(h6
.:csspool Septic Tank r'hyr t
Prop. Swr. Line House Con. St. Swr. -/" C
Sprinkling System
Ps- :,g Final
P'. ing Fixtures, Final
Final Gas Test
Construction Pole
Rodehground. Power -
ds
Rough Wiring .b
Fixtures, Final
OCCUPANCY —a ,
Form 210-5M-1-57 ORQ
BUILDING DEPARTMENT
-- i' COSTA MESA e r
P O. BOX 317 I 532
COSTA MESA CALIFORNIA I
FOR ' "LICANT5 FILL IN
C.L. OF STREET
BUILDING ADDRESS J c.�--2/1-.
_____ __JiPROP LINE � Owner 0 I I /'
10 FT. FOR 60 FT. STREET :1 2% FT7-REOR 1-1\ I Mail Address -• - --ce.„
City p L .- n _Ph. No.
Contractor oma._ / /�
I �� �. Ph. NoSJ W 7 / 7 S4
Address cqq _ Z/
50 FT11F FRON City Lic. No. 6 3 /..S State Lic. No.
I ! c��i OF PROP F // a ' {� T
50 FTS 53 W tc Size of Lot 3X 7 l5 AP No. 7.. / R goys
�� 9
1- 1- Setbacks: C/L Street 97j f Rear C'i
wz • J 41 1in
w Side Yard - Right (}�L 0p LeftL .��,
to f \ OP a . Type of Fence 1N AR_.+ oi' q T I
LL \ALLEY QR PROP. LINE / a d S
0. N I
F;"_ ' --1 I I hereby acknowledge that I have read this application and state
-1 m 1i.= O n c )% ( that the above is co •=ct and agree to comply with all City Ord-
ci cc i Ntp a i ' F- `C inances and State 'a s re. latingbuil construction.
< a. -
�? Signature /
ii c� ' of Permittdp
V '.:: I FT I Agent
0 gilt
' I FOR OFFICE USE ONLY
37 6 I N. 0 `r o
r -' -
FT. �, Ir_ d m z _ 40
J V N a FT 1 G(JG� '*- 0Z� I PS tJ y
o:
co
0 60 F ST. _I Recei17dt
by Date Received Date Issued
-//-.J 7 —7/- .S7
Ii 50 FT ST. i F i 7
PROP LINE �` VALUATION0,„0 Ail
�-
_.,,.....-PROP. I - - - - - -� FaCOTA
EQ DIVEDPermit Fee $ � a J
In
iilfli
CE DE T. ` - $ Plan Check $C.L. OF STREET— (MESA 6--o
TOTAL FEE $
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - ---
MAXIMUM 6 •Fit FENCE MAY BE PLACED ON SOLID LINES . USE REVERSE SIDE FOR DETAILS
/i/. , . 1j -