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Home My WebLink About222 17TH ST - Building Permits OWNER JIM'S BARBER SHOP' OCT 2 3 1958 DATE 7-9-58 JOB ADDRESS 222 E. 17th- St. BUILDING PERMIT NO. 7125 . GENERAL CONTRACTOR Powell Neon VALUE $ 606.00 1-17657-10.--18 LOT 93 TRACT FIRE ZONE DESCRIPTION OF WORK Sign GROUP TYPE ZONE PLAN NO. 1" 'ECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod ' Bond Beam Frame and Flashing Lathing, In Out ri•R1 Plaster, brown coat „3" A Underground soil W/G Pipe Test C✓A 1' Top Out _ d." ‘,.. _rt" Furnace (let" if Gas Vents pr i Rough Plumbing /) ,f'' ,/' N Cesspool Septic Tank • / A/''" / Prop. Swr. Line House Con. St. Swr. J P' Sprinkling System Heating Final - . Plumbing Fixtures, Final Pic?;Gas Test CPSe,,X ction Pole Uri&?ground Power ' Rough Wiring &�9/!' - ,,, ertei Vniop `• NthKJ -j-9-58 (,C' 4 `- Fixtures, Final (/6//Q J o " I • OCCUPANCY _ ,+ Form 210.—;- 4-1.57 _ �i • 7125 OWNER Tobias, w. A: / DATE 5-11-56 . JOB ADDRESS 222 East 17th Street BUILDING PERMIT NO. 2991 GENERAL CONTRACTOR 0101Py. VALUE $ 15.00 LOT 93 BLOCK TRACT113° Sign G..../UP Size-10.23 ft TYPE 22" High ZONE FIRED S i ICT 2 3 O 3 0 INSPECTIONS DATE SUBCONTRACTOR - 1 PERMITS ISSUED NUMBER Footing Trench \ 1, `3' Foundation Forms and Grade to Garage 000 Rough Framing t V Plumbing,Rough to Slab V Plumbing, Rough Complete q,� Temporary Pole \1 `} Wiring, Rough A��t \J'� Heating,Rough V t` r tJ Heating,Final tgL Sewer, House Sewer,St. \W •/�i,e Septic Tank or Cesspool v Lathing, In Out P' '^ring P. Ding,Final,Fixtures Complete Plumbing,Final Gas Test Wiring,Final • _ Occupancy i FORM 210 3M 10-55 2991 p51. MF CITY OF COSTA MESA BUILDING DIVISION }:j DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4. t PERMIT !O' ,le B05-00403 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 222 E 17TH ST Status: ISSUED Suite: Applied: 03/14/2005 Vicinity: BETWEEN TWO SUITES Issued: 03/14/2005 Primary Occ: B Eat<50/Office/Bar<50 Type of Construction: V-N Parcel Number: 42539105 Zoning: Applicant: JOHN CARREY ISSUED BY: Address: 1943 WALNUT ST Phone: 951-288-4030 LA VERNE,CA Zip: 91750 Owner: LA BORDE, M M ` A. D12 ' Address %SCHULEIN,JEFF M NEWPORT BEACH,CA Phone: ,,�• t 15 LINDA ISLE Zip: 92660 G Contractor JOHN CARREY AND ASSOCIATES Address: 1943 WALNUT ST - Phone: 951-288-4030 LA VERNE,CA Zip: 91750 -License: 362692 Arch : Eng: MANSHADI, FARHHAD Address: Address: Phone: Phone: Zip: License: License: 36840 SCOPE OF PERMIT CREATE OPENING BETWEEN 220 AND 222 TO CREATE ONE UNIT FOR"NUTRITION SUPERSTORE" FEE SUMMARY Plan Check: $21.22 • Calc Valuation: $600.00 Permit: $32.65 -- -- - - Claim Valuation: $800.00 SMIP Res: $0.00 SMIP Com: $0.50 Other: $0.00 t Inspection: $0.00 Total: . $54.37 PLANNING & ZONING SETBACKS MAIN STRUCTURE Frdnt 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 , 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 2446-46(6/00) DECLARATIONS 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. ❑ 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: i Policy Number: (This ion need not be completed if the permit is valued at one hundred dollars($100)or less.) : -artily that in the perfor ance of .e work for which this permit is issued,I shall not employ any person in any manner so as to becom subject to the workers' 'pensation laws of C�I'fo .,a•d agree that if I should become subject to the workers'compensation provisions of Section 700 o the Lebo e,I shall forthwith codcorn*ith,thesa pro T n O A Ipp 3lgna ut ie i-e- • p r"�DDate"' WARNING:FAILURE Ti SEC -E WO- RS'COM' ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PE IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE -100•••),IN ADDITION TO '- OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I he�gaffirm.that'I'am'llcense.un =r•rov':- sof Chapter 9(commencing with Section 7000)of Division 3,of.the,Business an ofessions Code,and my license is in full force,and.e ectrLicr# L•• f' — 9J t.? \ Yµ ComractorsSgnature:—= - maw 4I 1 - Date:^^• CONSTRUCTION LENDING •t ENCY: ❑ 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: `v/-Ni_ Date: o✓, _I i.', 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 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 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,end who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 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 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 e 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 I. 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 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 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 applicant or present or future building occupant need to prepare an RMPP(Risk Management end 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 ere 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 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes 0 No (Section 65850.2 of the Califomia 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? ❑Yes 0 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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described propertyfor in pection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. lir 'gnature Of Legal Owner(s) 'ate A ,r 44ii res.... J !y/. gr.,r' ,plicent -'•fix.- �.,. ' :,^;1i.,�. CODE• 9TION TYPE ram INTITIALS CODE• INSPFCTION TYRE _ PAIL R(T lA4$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pod 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 PROJECT ADDRESS: 222 E 17TH ST UNIT: 0 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: EM 047856 . OWNER'S NAME: REALONOMICS/ ADORESS: JIM' S HAIR SALON PERMIT NO: EM 047856 PLAN CHECK NO: N GOVT ; N SUPP : NI 3500 E. COAST HWY, #1 CORONA DEL MAR, 92625 CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC PURPOSE: OTH 714 /675-6700 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMOVE OLD & INSTALL NEW AIR CONDITIONING SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALL—VALUE: GROUP OCC : / PERMITTEE: ANDERSON AIR CONDITIONING ( 714 ) 998-6850 ADDRESS: 1872 N. CASE TREET COMMENTS : • ORANGE CA 92665 ******er+rer*>tx*********Erer*******x******x*******+a**+t+rx+t**Et***+r*+r+r***** *** **Er*sr** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I a licensed to•er •rovisions of Chapter 9(commencing with Section ZONING R EQU IR E M E N T S 7000)of Division 3 of the Business and Professions Code,and my lice -is Iy force and effect. SETBACK S CITY UC.: 014238 sum UC.:257570 / — 0 .✓Date: //,„.1FT 90 Signature: A /� — MAIN BUILDING ACCESSORY BUILDING WORKERS IAPE TION DECLARATION: I hereby affirm that I have. +Nfiate of consent to sell-insure or a ceNNgte of Workers' FRNT: IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified cothereof(Sect 3800.Lab. LEFT: FT IN RGHT : FT IN LEFT: FT IN RGHT: FT IN POucyNO.: 83CK020140O77CP DATE: 12 / 1 /90 =PANY: AETNA PARKING REQ; PROV; PARCEL: 42539105 ZNE: REF NO: /canned copy is hereby furnished. ( Certified _ py is i ed t city raddingg Division. PLANNING NOTES> Date: 9.19 / Applicant: – j **********************************Yf******************************************** • earn( FROM RKERS'COMPENSATION=LARAllow (This section not be completed a the permit is for one hundred($100)or less). DEVEL OPMENT S E••R'V I C E S REQUIR EMENTS 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 r ',• subject to the Workers'Compensation LawsolCalifomia. ZONING APPROVED BY DATE: Date: Signature: NOTICE:If,after malong this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILD ING APPROVED BY : DATE: Code,you must fontnvith comply with such provisions or this permit shall be deemed revoked. ,r/ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: 'n r DATE which this permit is issued(Section 3097,CW.C). ********************************** ***. ************************ i6 �� LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: I hereby Ohl that I am exempt from the Contactors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,Improve,demolish,or PERMIT 7 . 5 0 18 ,00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0% 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars(5500). ISSUE FEE 15 . 00 15 . 00 , I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Whoa 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 25 . 50 30 . 00 0 , 00 55 . 50 55 . 50 . 00 does not apply to an owner of a propend who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not Ntended or offered for sale.Ii,however the building or REVENUE DIVISION TOTALS TOTALS--> COLLECTED : 55. 50 OVER/SHORT: , 00 four theeppuurp�olsale)Mn one year of completion,the owner 60 have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 22 . 5 0 3 3 . 0 0 . ❑ and Professions Code: The Contractors'State License Law does not apply than owner of property who bollos or improves thereon and who contactsfor Such Protects with acontractor(s)license pursuant to to Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDI• V IDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.6 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Cvmer: ELE 1 MOTOR/POWR APPARATUS 1 . 1 — 10 .0 HP 7 . 50 7 . 50 I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 25534 and tailor any future building occupant will/will not(circle one)need to comply with said sate tads and the requirements lora MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 . 00 9 . 00 permit for construction or modification from the Ai ity Management District.Residential construction applications are exempt from these provisions. END OF FEES Dale: Applica• : I hereby certify that I have read this application and tate that t e above info .to is correct.I agree to comply with all city and county ordinances and state laws relating to building construddion and ho' :rep lathes of this city to enter upon the above-mentioned property for inspectoonnpurposes. ` ' `Date: ��2,y np�6 Signature' • Drivers License or Social Security r: 01 00064164-00064165 TOT . 55.50/ 164146 White—Building:Green-Cade Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor DATE 06/28/90 TINE: 11:16 CONSTRUCTION AND PLANNING • POO' SPA APPROVALS Permit# - Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole ,: 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. / I • 53. Steel Reinforcement 3. Electrical Conduit Utility-Ugrnd. - ndi54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • - • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF 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 66. Solar System-Final I t 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 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 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 ISSUED 33. Final Electric WQ'v Mi.O Notes: 34. Final Heating& Air Conditioning o(fjzs to 35. Final Gas Pipe-Test [r� } 36. Hood or Canopy • 37. Final Factory Fireplace 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 & BUI LDI NG . 48. FINAL PLANNING ' 49. Electric Release to Edison r• 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY ' No Date Costa Mesa Building bepartment APPLICATION FOR PERMIT t'' P. 6. Box 317 3935 BUILDING 11 I! COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR-APPLICANT TO FILL IN Receipt No. Permit No. Building `^`-r"`.— /� / Add esgpr —==,�,StO ' '/7 _ //'r \ I 376 •'sn y2costa Mesa, California �IlReeceeivveed by 7-LV- Reddi. / DS Nearest" �! ! �-ad Cross St. �— Build ing\i ) Caw Address `CS s-0 ¢' 07 07 Q , /7 =L Owner 0)- 71- Costa Mesa, California Mail /7 !�j(, moi/ Address O 0 ../y 4-±r "-' Nearest CiteI _ Tel. Cross St. No. Zon%' No.of Typ Group '� Architect / �QJj/ Lic. v Plans Engineer er .. �:9/./�/ No. Approved / /' p --� by ( / Dater - 6 it=, Address /^ CORRECTIONS City Lic. f ' tractor" `G��a No.(� '7)110 J p —0 ` Address"le-VC / C�d�--'N ��"'9+-�/ - ' Legal Lot .V7 Description I No. 3 I Blocs% I Tract /VA .0 ' rt 32 ' -e %f,94 s�.co r y 3 1" tit? — (Attach Metes and Bounds)yp 'Ai 71-$. S rrbell y16}';t Al p--745- LAI°.of Bldgs.7t Size of Lot 3 a X304 Now on Lot/'�+'� Ilse of _ I No.of I No.of A Existing Bldg. Families Rooms APPROVED LE Setback Line from_rl / ii Rear Yard Sit"..1.h 2 Center of Street Z.., ID Side Yard E,S` HA CITY Of: CRSTA 11,4FSA DESCRIPTION OF WORKRS,-51 - PLANNING DEPT. New I tViAlteration I I Addition I SUBSBCT TO BLDG. DEPT. REG. ch Repair I I Moving I I Demolish I n Building / No.of _/ BY 1^' "ei �' DATP7 -I Il` r-+A Size [d X Rooms -/' tories / PLAN 20,4 F---nor W II Roof — ring ��^�o� �(Coovv�eriinn APPROVALS I of New GCI_ n / Building ¢-n.(' ¢ Foundation Location Inspector ' Date l Forms,Materials, a Under-Pinning A Frame: Fire Stops, CO Bracing,Bolts O I hereby acknowledge that I have read this Application e and state that the above is correct and agree to comply Lath. Int. Al" with all City Ordinances and State Laws regulating Al building construction. Lath.Ext , Signature of ' / • Permittee -.2'0 /� I ► Plaster, Int Authorized Agt Alt( g , eC.02-1/ Plaster,Ext. C M. Valuation Permit Fee $ ,a.a/ .� Masonry Reinforced p 7 7� Plan Check $ / % --:"I Bond Beam $ //, / Total o I/O?:`f• • ee $ a( FINAL FORM 204 10.33 O.P.&S. / e . ,.. •. • A - • - ‘.. '--%' • ../to, • ,. . . " 0 C 0 C :i 0 a •••••••"N. , "t g_ 0 n• ‘ L. 0. . ,.. .. ,. .. ' ' \ --..EN. r:: CI. \ ,- • , • , •t .t. . ) ‘ . , •\ ',-.\ ' ,„A,'II y ,.,N .-2. . . •• N., 1/4:\ . 4 3/4- \ •., V 1,-) N'',....‘j,'. ' . ‘,:, , • i•-. 1 ‘.., •••• ",..!: ) 7:', -1).•`• " . . , ... A V• ,:•,: _ ----,• - -- ' ' ' 1 -, • N C.0\ ;,,. \ . ‘... , . 2".1.• ".j r . -...- Street .- : • :.'.. . • • ••• I .'•.. . • • • PLOT PLAN. ' •-• - - •- Show location and -distances from ..,, r. , property line.and between buildings..., Cr- •▪ .al.. --t . \ • . k ‘- C .i• ‘‘‘V-. ' • a •... t 1 - \ ..\L.‘, . - ..-_ •A \ • ' • , , • ...-•-••• .__, '; .., • t ' ..::: k ' i‘...\,i t..../ :..... 0 it • .. - , .. •, ', 1\ 'Ai '1', o . • •-• , -, ,.... L , .L • , , -'1 ••••-< COSTA MESA BUILDING DEPARTMENT N° 191 C 111 East 20th Street l� .7 Costa Mesa, California _ 7 Date / - 2 - J..__. CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY 7r14-4' Building Permit No03?6" Electrical PermiterNo�'1_1«�PlumbingPermit No Pr a� Use of Building.._E✓al F be-k . { ip. '' .._ ....ter_-7771A The bui(9in located at22tr 1 -2 i — 4 — 7/ -7!..-;« In yen )/o .. ,t _ ._ FirCOI - Lot 91 3 Block. —Tract' r-e4oYC .�I (See reverse side for Metes and Bounds) / has been inspected and found to comply with the provisions of all City of Costa Mesa Or- P ices applicable thereto for a Group r a Occupancy. Ia..JED TO: e"--.,----. + A. J. VOL .1.:��..".A - J s-. t�{A� City BO VO lug �,om/� (Owner of Building) By..l/ �ed -- /t� j� CC: ❑Original—Owner 0 1st copy—Gas Co. ❑2nd copy=Edison Co. 0 3rd copy—File Form 206 GH 151 12-58