HomeMy WebLinkAbout686 19TH ST - Building Permits7I
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PN0.IELTFOOflE55: 686 W 19TH ST. :
OWXEP'SNAMf: JA S MADELEINE �H�t HIRSCH
nooeess: 800 W. SIXTH ST. SIXTH FL
LOS ANGELES
CA 90017-2709
�- ANCN/ENGINEEH: � 2 S 3� G E 3— O S O O qEG.NO.:
AODPESS:
uxiT:
UNIT:
PERMIREE: BURR ROOFING i 714 ) 548-2965
FOONESS: '� S 1 WEELO DR
���C�7 CA 92f�27
UCENSEO CONTBRCTO R I I hereby aliirm lhat I am licensetl untler o�ovisions al Aapier 9(commencing wiih Section
70W� ol DiviSion 3 af the Buiiness antl Ptolesiians Cade. antl my IicenSe 6 in IW� �orce antl el�ect.
LITY LIC.: STRTE UC.: CIASS:
011621 302157 C.�39
Daie: Signatur¢:
WOflNE ' COMPFNSRTION OEC M710N: I �ere�y affirm t l �a�e a cehificate c nsen ¢I4in5ure or a t¢rti�ica�¢ OI WOM¢rs'
tomp¢nsa�ion Insurance, or a cetlifieC copy I�ereo� (Section 3800, LaO. �.
roucrxo.: 1016530-93 E%P.DRTE: Q'��OZI94
comvnxr: STATE FU� �� __�� //// ��
) Cetlified copY �s hereby �umis�ed. Cenilietl caDY(�e iry ng Division.
oate: �"' � � � Aaaiicant:���
E%EMPTION FflOM WOflKEflS' COMPENSRTION OECUIIATION: ,(This secuon neeU no1 De complete0 if the Vermit is fa ane AunGreO (5700) or kss�.
I cenily inal in tAe oedormance ol lne work lor whicn Ihis Oermit is issuea, I shall not employ any perW n in any manner s0 a5 to Oecome
suqect to ihe Wa�ke�s' ComPensation laws ol CaGfoinia.
Date: SiAnaWre:
NOTICE: II, af�er making �Ais Oeclaralion„you ShoUlO became su�le�� �o IAe Workers' Campensation provisions at ihe LaEor
COOe. you mu5t �orlhvn�h mmply wiih Sut� pmvi4�On5 or INS Oermi� 5hall he GCEmeO revake0.
CONSiRUC710N LENOING 0.GENCY: I Iie�eDy a8itm tAat t11eB is a wnstruttion IenMng ageaty lor tAe qertNmance of t11e warlt Ior
w�ich Ihis permi� is issuetl (Sec�ion 309L Civ. C). �� �
LENOEfl: . ,
ROOPESS:
OWNEfl BUILOEfl OECIANBT10N: I her¢�y altirm t�at I am eKemp� Irom Ihe fqntraclors' State License Law �or �he tollawing reawn
(Section 703t.5 Business anA Pmtessional Cotle: Any ciry ol counry which reauires a Dermit to consimcL atter, impmve, eemolish. or
repair any slmCWr¢. priar 10 ��5 issuance. also reQuir¢5 �h0 applicant �or suc� Oermil Io /ile a signetl siatem¢ni Iha� hpJshe i5 IicenSetl
Oursuan� l0 t�e pravisions 0� Ihe Cantratiors' Siate license Law (C�apter 9(commencinA ��h Sectian 7000) ol 0ivision 3 0l the Business
antl Pmlessions CoOe) or i�a� he/she is e�empt lherefmm antl �he basis tor the allaBed exemption. pny viMation oi Section 7031.5 Mj
any aDPlicantlar a Dermil sublects lhe apD�icanl to a c�al penalty af nol more ihan live huntlretl Uollars (5500�.
I, as awner oi i�e pmpetly o� my employees vnth wages as iheir sole compensation, vnil Eo the woA, an0 ihe
❑ slmmure is noi imendetl or o11ere0 �or sale (Secuon 7044, Business an0 Pmiessional Cotle: TAe Coniractors' Stafe License law
. tloes not aDPly to an aw�et o1 a pmDeny wno euiltls or impmves ihereon, an0 who does such work nimself/hersell or thwuAh
his or �er own employees, D�oviOeA that suM impmvement5 are nat intenEeO ar aHereA lor sale. If, nowever the Duileing or
impmvement is SOIE within one year o� completion, �Ae owne� �II have the bur0en of pmving �e/she Jitl nol hui10 Or improve
lor me v��vose ol se�e).
I, as owner ol the O�oVehy, am exclusively coniractinA wit� IicenseU contractors to constmct ihe prolect (Section 7044, Business
O ana Motessirnn Code: Tt+e Convactas' State License Law daes srot apWY �o a� ow�ve� of praqen9 wtw hui�ds w imp�ovu lherean
antl wha coniracls lor such pmlects wil� a contracmr(s) license Dursuant to Ihe Contracmrs' State License Law�. I am aware
ihat Orool ol tneir Worker's Comnensation insurance shoul0 be OmNAeA ro me.
� I am eKemp� under Section: B, 8 P. C.
brihis reason:
Date: �e�
l eo here�y cenily that l am aware o1 and untlerstantl ihe repuiremenis oi Calitomia Healih and Safery Coee Sections 25505, 25533, antl
2553A and lhat I or any lulure building occupant will/will not (tircle one) neetl to comply with saiG slate catles and Ihe requirements br a
permii lor consimclion or mo0ilicalion irom the Ai� Ouality Managemeni Dislnci. Resitlential consifuction appFcallwvs a�e exem➢> >�om
I�ese provisions.
Da�e: Bpplicani:
1 �et¢Oy Certl�y lhal 1 hav¢ teatl lhis applicalion and slale lhal lh¢ aOOVe inturmalion is [orreCL I aqree la Comply vnN all City an0 Counry
ortlinancesantls�atelawsrelalinplahuil4ingcons�mctiananEh ya r¢e�Ep�¢5�e1NeSa��NSGryloenterupon��eaUove�memionetl
pmDehy lor ins ction pur ases. K
Date: z �1 Signamre: � }�-��
Drivefs License or $acial Security p:
t6<L4fi W�ile—BuilEinO: Green—CoOe En�orcemmC Canary—Aoollcam: Pink—Revenue: Goltlenrad—Pssxssnr
PERMIT NO: B
CONSTRUCTION TY
JOB DESCRIPTION
CLAIM VALUE;
COMMENTS• ALL O
�r�+r*�r***Q�r+e�r**�r
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B Q6360
063606 PLAN CHECR NO: N GOVT; N SUPP; N
E; PERMIT TYPE: STR PURPOSE: ALT
; T/OEXIST. H—U ROOF S APPLY NEW B—U SQ FT; 11,500
11,500.00 CALC—VALUE: 11,500.00 GROUP OCC: B-2 /
NE UILDING WHICH INCLUDES ADDRESSES 686 THROUGH 696 W 19TH
�t�t** �tr**�t�tr+t*�t�r�t�t*****x��t*�e�r*�t�tx*+r**�t�t**�e+t**��t�t�t*�t�t+r�t*�t�t*+t�tx�r�t*
��, 2 O N I N GS ERTEB�AUCIRRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT IN REAR; FT IN FRNT: FT. IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING RE�• PROV; PARCEL: 00000000 ZNE: REF NO;
PLANNING N TES>
> ✓��.
if iF itlt iFlF �f it k �F1f if �F 1f if if iF�Ffk 1t if Mk 1F 1f 1f k if �f if M k 1F 3t df 1f if �k kit 1t �f fFif 1k �tlf itlF �F if �f 1k�f k�f 1Fit M�f �F If k �F�f iF 1f ff if 1�FlF ik if 1F kiliElt ik
D E V E L O P N E N T S E R V I C E S R E Q U I R E M E�N�T S
20NING APPROVED HY DATE: !��
BUILDING APPROVED BY : DATE: %.�
APPLICATION ISSUED BY:�'�� DATE: .'ri r 'Z3�7�
ikifltMiflklFiFk�fiflflkikififififkfflfiF ltffiflfffit�f�tkiF !f{t
iflflklFMiFiF1fMlFklfiflfiFifiF�flf�FiFklF�fitftkififlFMiflfltkif�f�fitlfiflf fifiFif ifitlfiflflflflfllififitlflEifif*�kifiFlfiflFlE�Eif1tlkffiF�f
LEGALIZATION;N F E E S U M M A R X STRUCTURAL SEGMENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 135.00 SMIP/NON—RES
PLAN 2.42
ISSUE FEE
BUILDING—DIV—> PERHIT ISSUE PLAN—CHECR TOTAL PAID DUE
TOTALS----> 137.42 0.00 0,00 137,42 137,42 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 137.42 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
135.00 2,42
iFif 1f 1f if iF M M k�f iF M!f k iFiFif ik �k 1Fjf �f �f if �f 1f 1F iF M�f �f 1f if if k if if iEltiF1F if iflf if iF�F �tif k iF�ki! if k �t if iElklt if iFik M illFff it lkif k �F if 1f ikif it if iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D fi S C R I P T I O N UNIT COST TOTAL COST
SFC 11500 REROOF BY VALUE COMMERCIAL NOZONE 1,00 11,500,00
END OF FEES
01 0014S45Q-00145451 Ti] 7'
DA7E: 08/23/93 TItiE: 21:49
137.42
_ yr
CONSTRUCTION ANDPLANNING , � _ POC .SPA -
APPROVALS Permit # Date Inspector AppROVALS Permit # � Date Inspector
7. Temporary Eiectrical Servic�or Pole 52. Pool & Equipment Locatio� �
2. $oii Pipe-Untlrgrnd. �.rr - � 53. Stee1 Reinforcement �
,�3tF�e�tn�iConduft.U�lity-�ndrgrnd�'� �� 54. Forms . � '
,��
�4 ��{ectdcal Condu id�Jndrgrnd;- f `� 55. Electricai Bonding •
�.TaSt��'RWintor�e" Qi�" -'- 56. Rough Plumbing & Pressure Test '�-
�•; f�iectrdcal UFEf�Grnd. c '/ 57. APPROVAL TO COVER-GUNITE ;r
.�7�F-ootCng� V •+ ^ � S�s ��-58. Electrical Conduit-Undrgrnd. L
C�. ^n r. (�
E� h� i �` .. 59. Gas Pipe, O Undrgmd., Test . �
� oundation
9^ Water Pipe-Undrqrnd. ' 60. Backwash �ines, P�Trap, O Undrgrnd. �
�
7Q���tructural Flbor System �. - 61. APPROVALTO DECK
11j;�ioperty Sewer Lin�-& Ho�r7e Conne�tion .� 62. Backwash & RecepmrFinal '
,-. .�
7T.-'$ewer Cap '�' � '
u ; ; 63. Heater & Vent-Final
13. Roof Drains � �
64. Plumbing System � Final
14. Rough Plumbin� % . 65. Electrical-Final
15. Rough ElectricatConduit 66. Solar SYstem-Final
16. Rough ElectricW iring 67. Fencing & Access Approval
17. Rough Wiring Sgn 68. APPROVED FOR PLASTERING
18. Rough ElectricaPT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT
. . . '7 J' �'...�D�-' 'U'. �: E. {�t
20. � ouq� Fs�torp Fi(Pplace i Q�r, Q�y t p p CTz .1. �QppRCfVA(StiL%�Aerrhh # �' ���"
1+� . t r' t � 1-1 � �Hi+ '1 N.
21. uCtt in tru u .�S fi �� `7 "J�r Sp T] �� [.
� �., cy .� ��ti' i ~� �.S S tJ �-:r� .� �0. �ader9�aT.d�YCiLo .«
, * .
22. uctti Veotilating.x i Cj�t • � Q� r.77, Product�Pi"rig Q O il
H i f
23. 'Sas ht e- �a ` &'Tpst � r. « tr �-� � . t_ �r � � �'+� � T C�: �-�
HP � 4� i t MS #� lti o' c, O.k r.�2. Undergro�n�.i�FIu�77i-�u �!: E-� r�
24. iE400�Pramiqg. �-�,: t i-.t� �•E � > O �' �* ? :73. ' ndergmcG�torageri'ank O Gas ❑OS7�
_ y
25. Roo Sh Ihin 'R ' PJ ;. (ri (r1 p N: :� � �-�F.� x
� � � 9 O* 4 �� � � ;17� ;� �4•�'!erhead F�ydro �-, y
26. --Bas;Ceilin9 (Strjfetural) & �4joapcoat r m �, bY# r 75.CDry Chemical �1 t i-+ b �.
.y
27. �jrame and Ft��hiri�.� �S� '; �, m ,� t; 76.'U�/ Stand'�t�t r��.Ft', �` �`'� z
J
�Lathin y � r�r � � �� r.. , ..
. g �Si�ing • �,: r � �y,n :c s �' •• * 77.of IXED SYSFEM'RfNAL � �V �T
%29. Insulatia�Tii '-� "� � ~�'•,•• > x`•' � 7g,�FIRE PREV' FIN�(a;� a� � N�j�,
Sx S ,
;30. Drywall hlailing �•K ' �` � �� HEALTH DEPT.�WF�QWI�REMENT
�
�1. Plaster B��w �Coai�* �._ i ; . „; ;,Z9.�FINAL IN$�`ECTIQAi Y r' ` • �
j32. �Flectrical�pow�tr t�e�r;Final � F� � ri; ' �c .M ;$O.�Fj00D CE �Y_IFIQXtTiE ISSIJED � � �
3. fCinaG''ElecVic� "+': � � �' :i� :Tl ' ;. �6 �Jot�e � �s' ' l � '�
r r r> > c:r ! � a. . t 7�' '7 tr :%h J J �:*1
r .-� � . �_r-. a: i� . - a � � i -- a
;34. Fina�Ie�,Un9� A�i� �oiiditionicLq�' �� a. �:,: 0. S �• 1: x a' i�7t7
35. ifSna7-GaSPi�x'!yTe'sfl � . .'n "7 ." ' •� .+ �� C� M:� " i� ��O
� . i: rv � E-� K T' ^� .t.^. 0.., ,� -+t,'
c, n,�; ;_ •• i: x.. R; ...�i si.
36. Hoo�,or ipnoPY �:: � � r�; c .. n � r. s 5: ��o > -' ,
�37. �Fina7�FaCtbry Fir�iF3arl i S� � r r � �? z �' M ��
r.
r ., .. - v!„ � i .. .. p x e� _ . 'i i .. • -
�,8. Final;Alu�bing z,x N , p : S`, �- =� c� O
. . . ' r ? y C� �_�.r � "� -�
t�.9. Watec:Se[vice�FinaC? o x
„,-: -; 4 x :: y -. i.- :. S
�$O. GasServf�e-Final`''; „� �. i= � .'' � ''' r�" • :• `,
.r � � :� . p�
;4:1. Solar pomestie�FirtaF ; c'�` �.. n G 'aa. - '"' '' �
�x - C' +� 7_ J
317. 8eckflow Preventer� �" .V x � , ~ /v °t = 'j
� r .S .7 L-' -i
43. Backflow irri p��tioaY cCS: x '�' , '�� � v . `
>4 � " A: . �5 i� ,t ('�
�4. Landscape Irr pa ^"SYstem �r. �` � � T ' i �. x "� �
i .� � �� :C.- C.`. w ;.-7 G �7 x +. ;A !l S.(�
. •a... v. " _. .... . - .
;5,5. �und Attenuatiom �xF, . � 1 r t-* R n �' "' ?v �`� '�
�: r' s J' o' �'J tt
. � ... -, � .-� .. .. : - � -
�6. �klandica�iRe§�y,latjb�r`�s • •' + � � : �n. .. � '�
n c� � -k r. :. x r�c:a S T
47. �IN_�L. STRl.1CTl'kFCE & BUI,�DING Y( Cy�' �'� ��� ,J k�
� � . �
48. FiNFi`l P�AM1tNIPIC" i fT-F, ? r_ r' .T. ;r ¢ '' �`
�
49. ��lectf,ic Reledse to_ . ison � Y' _ Y. G ' �' y -'
i •a" H'
,50. �ias Release to Soutbern Calif��n'�a Gas Ca '` � �` y � �''" �� `• � •
c a: i�-� '.J • U :
`51. CE�IFICqTE OF {JCCUPA, CY' � �a a �; �� �ro sc �: [� �
No. Date
'7HOJECT'Ti00flES5: 6 B 6 W 1 9 TH ST
OWNEN'SNAME:HIRSCH TRUST
aooAess:800 WEST 6TH STREET
LOS ANGELES
PflCM/ENGINEEN: z 1 3� 6 8 3— 0 5 � 0
ROUHESS:
flEG.NO.:
/ � .
uxir: ""' CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 062845
PERMZT NO; E 062845 PLAN CHECK NO; N GOVT; N SUPP; N
UNIT:
PENMITTEE: PERr�ECT L7.GHT ( 714 ) 650-2969
noosess: z089 GARDEN A
C05TA MESA CA 92626
UCENSEU CONTflACTOB OECIABBTION: I here�y allirm t�al I am licensetl under D�o�isions o� Chaple� 9(commencing wilh Sec�ion
7000� ol Orvision 3 0l Ihe Business an0 Pmlessions Cotle. an0 my license is in lullforce antl eflecl.
c�Truc.:026900 �T^TEu°.q22517 c�ass:C10O /7 �
oate: —%— � — ,L-� siqnature: _��,�[ (�
WONKEPS' COMPENSRTION oELtAliA710N: I hereGy affirm t�at 1 �ave a certiliwte ai cansent ta sel4i re or a cenificate al Workers'
Compensation Insurance. or a cen�tietl caoY �hereol (Seclion 3800. Lab. C).
roucrxo.:0638056 ExP.oaTE:01/O1/94
COMPRNY:STATE FUND
❑ Ceni�iea coOY is �ere�y fumishetl. Q Cenilie0 copy is liled vnt� the ciry BuilOinA Division. �
M �j�j �N I
Dale: / � / � / _ 7 APDIiCanC aL/�L� 1/ / "�Y
E%EMPTION fflOM WONKEFS' fAMPEN5ATI0N OECIAflATION: (This seciion nee0 nat �e completed i� Ihe permil is or one AunU�etl (5100) or less�.
I cetlily Ihal in Ihe Detlormance ol Ihe work lOr whiC� IhiS Oermi� i5 i55ue4 I Shall not employ any Oerson in any manner 5o as l0 becOme
' SuOjetl to I�e Worker5' Compensabon Laws of Calilomia.
�ate: SiAnalure:
NOTICE: If, al�er making �his declaralion. you s�oultl Gecome sublea� �o �he Workers' Comp¢nsa�ion pmvisions ol tAe Lahor
COA¢, you mus� forihwi(h comply vni� 5ut� pwvi5ion5 0( I�is Oermii 5hall b¢ DeemeG rewkea.
CONSTflI1CTI0N LENDING AGENCY: I Aereby aifirm ��a� t�ere is a constmc�ion Iending apency lor Ihe peAormance ol �Ae work lor
w�ich ihis Oe�mi� is issued (Setlion 3W7, Civ. C�.
LENOEfl:
AODflE55:
OWNEB 9UILDEB DECuflRTION: I hereoy aflirm ihat 1 am eMemD� ��om the CAniractors' State litense Law lar ihe IallowinA �eason
(Section 703L5 Business and Professional CaOe: Any city ol county whic� repuires a permit to constmct, alter, im0��e. tlemolish, or
reDai� any stmtlure. O�ior �o ils i55uance. al5o r¢Ouires fhe aOD�iCan� lOr Su[h permii �0 �ile a 5igneE Sia�emen� �hat hels�e is liCenSetl
pursuani io t�e pmvisions of the Cantrac�ors' S�a�e License law (Chapier 9(commencing vnl� Section 7000� af �ivision 3 0l I�e Busineu
anU Prolessions Coee) or thai ne/s�e is exempt i�ereimm antl ��e Uasis lor the allege0 exemption. My vioWtion ol Section 70.3t.5 Uy
any applicanl lor a permil subjec�s the applican� �o a civil Denalty ol noi more IAan live �untlretl tlollars �5500�.
I, as owner ol I�e O�a�erty or my employees wilh waqes as Iheir sole compensation, vrill Oo �he work, an0 Ihe
I❑ stmcmre is no� intentled or oflerea tor sate (Section 70aa. Business ana Pmfessional Code: T�e Comraclors' State License Law
does not apO�V �o an owner ol a pmpetly who builds or im0�o�e5 Iherean, and who Ooes such work himseltl�e�sell or I�mugh
�is or �er own employees, pmvitled thal such improvements are nol intended or olfered lor sale. I�. howeve� Ne builtlinp nr
improvement is 5010 wi�nin one year ot compleiion, ��e owner will �ave ��e Gurtlen of Omvinp he/she tlid not �uild or improve
lor Ine puroose of satel.
I, as owner ol Ihe pmperry, am exclusively contracting with licensed coniracmrs m consimc� IAe Drojec� (Sedion 7044, Business
❑ antl Pmtessions Cotle: T�e Conlractors' Sla�e License Law Ooes not appry lo an owner o� pmpeny who bmltls or improves thereon
and who conlracts �or 5uch pmjecls wil� a con�racbr�s) IicenSe pursuanl Ia lhe Contractors' $Idi¢ LILEOSC Ldw�. I drt1 3WdfC
Ihal pmol ol ��eir Worker's Compensation insurance s�ou10 be provitled Io me.
� I am exempl uneer Seclion: B. 8 P. C.
fo� ��is reason:
Dale: Owner.
I ao nereey cenity inat I am aware of and untlerstanA ine reauirements ol Califomia Healtn antl Safery Cotle Sections 25505, 25533, an0
2553E an� ��at 1 or any �uWre buil0ing occupani will/vnll nol �circle one) neea to comply vnih 5aia Slaie codes anA Ihe iequiremen�s for a
permil lor conslmclion or motlilicaiion irom �he Nir Oualiiy Management Dislricl. flesi�ential consimclion applicalions are e�emp� Imm
ihese provisions.
Oaie: APPlicanl:
I hereDy ce�lilytnat I �ave reatlt�is applicaiion anA s�a�e thal Ine aboveinlormaiion is cortect. I agreeta camply wi�� all ci�y antl county
or0inanre5 antl statelawsrelating�o budAing consimciion antl �ereby authorize�epre5entaiivesollhi5 tilyio enieruponlhe above-meniioned
pioperly lorinspeciion purposes. n � � //
/ � J/
Dy�!J�— � �' SignaWre: , �,L`f �. �.�— ��'�+� —
Oriver's L�cense or So<ial Searity a: `/ __ _
I6at�n6 WM1ne—Bvileing: Gieen—CODe Enlorcemen�: Canary—AOO�KanC Pmk—Fevenue: Goltlanrotl—Assessor
CONSTRUCTION TYPE; V—N PERMIT TYPE: ELE PURPOSE; OTH
JOB DESCRIPTION ; INSTALL 3 FLOOD LIGHTS 1 METER SQ FT;
CLAIM VALUE: 500,00 CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: INSTALL 3 FLOOD LTGHTS 1 MF.TER
*��***it�r��r**+r********it****rt**�rxit*���it��t�c***x*rt*�r*itxar�r+�*���x*itx�ar�� �*�*�x+t�x x�*��t�t*
Z O N I N GS ERTEBQAUC7K�5E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILD'ING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REp • PROV; PARCEL: 42224220 ZNE; REF NO:
PLANNING NfST'ES>
i
iF ik!! iE �k it ik if !F 1f fF if if i! it iE iF if !f iF iE 1E k k iE iF iF it iE if 7F1f if iE f! �E 1E ik iE if �k iE�E 1P if 1f iF ik 1F iF iF iElF iE 1F k �E-k ik fE k iE�F ik �E1f iElt k iF ff k if iE 1E iE 3E i! iF
D E V E L O P M E N T S E'R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DAT'E;
BUILDING APPROVED BY � � DATF:; % L 3
APPLICATION ISSUED BY• �% Qt'+Q� DATE; %/ �%c�
iEiFiEiEiFififiFkifkikifikikifftiElfifiFlE�3F�F3F�FiF3i{F�FiE3FiF3FiF � SFiFiF3FiF�7FTF3f�Fi"FiF7FitififkikiFklElFlF ifif
1f * ik �f �E if ik iE k iE !E!t i!!E!! ik i! iF f! iE if iF it k if fF iE if iF if if if iHE k iElk iF iF�E 3f 1E iFlf iF if !F ik if fk kif it if 1f iE 1E 1f it 1E �F ik if iF ff i! if iF if 3F iE iE 3E iE if 1� iE it if
LEGALZZATION:N F-E�E 5 U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 32,50
SOY SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BOILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 32.50 15.00 0.00 47,50 97,50 ,00
REVENUE DIVISION 'POTALS--> COLLECTED- 47,50 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC� FIRE SMIP/TOT GRADING PLAN—C`HECK
47,50
ik ik i%i%1f if )F 1h 1f if if 1E �l' ik �E'1f' 1f if if �f if ik 1f i4 if If if if �f if if !f if if if iE ii ii if if i%if if if if if if if if iE iF i%ik i%iP iE iE iElF'lE if if iE if if ikiP 1F if if ik 1F i%i! ii' iE if if i%
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 3 FIXTURES LIGHTING 1 ST 20 EA, ,75 2,25
ELE 1 RECEPT/O{1TLET 1 ST 20 EA, ,75 ,"75
ELE 1 SERVICES HELOW 600 V 6 BELOW 201 AMP 18.50 18,50
ELE 1 MISC CONDUCTOR NOT LISTED REp PERMIT I1.00 11.00
END OF FEEs
0! 00142115-00142115 T OT 4i.50
DATE: 07/�i/93 TIflE: Q9:S2
, _
CONSTRUCTION AND PLANNING POG . SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
t. Temporary Elettrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement �
3.. Electricai Conduit UtititY�Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgmd. , � 55. Eiectrical Bonding
5. Steel Reinforcemen[ ' 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test •
9. Water Pipe�Undrgmd. 60. Backwash Lines, P-Trap, � Undrgmd. �
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
73. Roof Drains 64. P�umbing System - Final �
74. Rough Plumbing ' , 65. Electrica��fina!
15. Rough Electrica6Conduit • 66. Sotar System-Finai
76. Rough Electric Wiring 67. Fencing & Access Anp�oval
17. Rough Wiring S�gn � 68. APPROVED FOR PLASTERING �
18. Rough Electrica�-T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQU�fiEMENT (
20. Rough Factory Fir�place � ' APPROVAIS Permit 9`r ,
21. Ductc, in Structure � - 70. Undergsound Hydro
22. Ducts, Ventilating ' i . 77. Product Piping O�Gas CJOiI
f .
23. Gas Pipe�Rough & Test 72. Underground Flush
, 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing . 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashirig 76. Dry Sta�dpipe
28. (athing & Siding � � � 77. FIXED SYSTEM FINAL "
29. Insulation 78. FIRE PREV. FINAL
30. Drywali Nailing � I � HEALTH DEPT. REQUIREMENT
31. Plaster 6rown Coat ; � 79. FINAL INSPECTION•
32. Electrical Powar Meter•Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � �� "t ! oces:
� �
34. Final Heating & Air Conditioning I ' �
35. Final Ges Pipe-7est I . - � .
36. Hood or Canopy � ����'
37. Final Factory Fireplace � � �
38. Final Plumbing . "�
39. Water Service-Pinal ` -
40. Gas Service-Final ' I
41. Solar pomestic-Final
42. Backflow Preventer I �
43. Backflow Irrigai�on
44. Landscape Irripation Sysrem . • � � � �
45. Sound Attenuation ,
46. Handicap Regulations
i i �
47. FWALSTRUCTURE&BUILDING � i .:� � � � ' �
J '.
48. FINAL PLANNING -� I 'i, ' ,
49. Electric Release m Edison � i� ��
50. Gas Release to Southern California Gas Co 1�' . �
51. CERTIPICATE OF OCCUPANCY •
No. Date
�
E 33
IProjettAddress IQbo— �� D l 1 1`� J/ �
ApplicanJ �Mailing Ad�dre,scs �k�)
OW'�fEr'sNamue ��✓G�'�'N���+�'N�+� Phone]Q�$L�
Address � -y.�l�n �1l�Lw �(J �J1'�� � O�_
Arch/Eng. License No.
Address
Contractor's Nam �+�y '�+� � 5 P,�,ho`ne �S�:A �
Address(mailing) �3R.fY_Pr��4�• �� liJ t{•LiF+�Cji
City License No. _(7 ��Sp 3
LICENSE� CONTRACTOR DECLqRAT10N
I hereby affirm that I am iicensea untler provisions of Charter 9(commencing
with section ]000) of Division 3 O( the Business antl Profezsions Cotle, and
my Ilcense Is In (ull tarte�AM1effect.
LJCBOSB d55 � � ` LlCa�HO ���
Date � r aanar rw _
vreby affirm that 1 have a certiLcete of rtCfo selt-insure or a certificate
Norkers' Compensatlon Insuran�e r a certifietl c�op y hereo Section
J0, lab. 1 G{Np1A`�t, H�FQ
PolicY No. ����SO ComPanY L�S. C-0 .
❑ CertiTie co y is hereby tumizhe0,
J71�cr �n < v�: r witn cne o��� u� o
Date ApplicaM
E%EM 10 FR ORKERS' MPE TI CLFRATION
(Tnis se lon neetl not be completetl �( the ermi is for one huntlred (5100) or
less)
I certlry thal In the pertormance ot the work br which this perm�t is issuetl, I
shall not employ any perton in any manner so as to become subject to the
Workers' Compensation Laws of Calitomia.
Date Signatur@
NOTICE: If, after makin9 this Oeclaration, you shoultl Decoma subject to the
Wo�ker5' Compensation provisions o( Ih¢ Ldbo� Cotle, you mu5t fOr[hwith
comply with su<h provisions or (his permit shall be Oeemed revoketl.
CONSTRUCTION LENDING AG@NCV
I nereby a/Brm that there Is a construttion lentling agency tor the performance
o/ the work for which this permit is issued (Sec[ion 3097 Civ. C.)
l,entler's Name
Lentler'S Atltlress
OWNER BUILDER OECLARHTION
I hereby affirm that I am exempt }rom the Contractor's License �aw for fhe
followin9 reason (Sactlon ]031.5 Qusiness antl Professional Cotle: Any city or
county w�lch reqW�es a pe�mit to pOnst�ucl, alte�, improve, tlemoli5h or �epair
any 5tructurC, Prlor to its issuance, als0 requires Ihe applicant for zucn permil
to flle a signetl statement that ne/she is Ilcensetl pursuant to the provisions of
the Con[raclor'S License Law (Chapter 9(wmmencing wilh Section 7000) of
'�iision 3 oi the Business antl Profe55ion5 COtle) or that he/she Is ¢xempt
�efrom antl [he basis for the allegeG exemptlon. Any violation o� Section
J3.5 by any applicant tor a permit subiects the applicant to a civll
enalty of no[ more than five huntlreA tlollars (y500j.
� I, ds owne� ot th¢ P�operty O� my em0loye¢5 wilh wa9es as their SOIe
compensation, will tlo the work, aqtl Ihe stru<ture is not Intendetl or otferetl
for sale (Section 7044, Business an0 Professional Cotle: The Contractor'S
llcense Law tloes nof apP�Y to an owner of a property wno builtls or Improves
th¢reon, antl who tloCs such work hlmselt/herself or tnrouqh hi5 ot her own
Cmploye¢S, provitletl that such imprOvements are not inlentled o� o/ter¢tl f0/
sale. It, howavlr, Ihe builtling or irhp�ovement is soltl within one year of com-
pletion, tne owner will nave the b4rtlen of proving he/zhe tlitl not bullA or Im-
�rova for the purpose of sale).
I, as owner ot the property, arr� exclusivaly contracting with Ilcensetl con-
tractors to tonstruct the project (Section 7044, Busine55 antl Professions Cotle:
The Contiactor's License Law tlops not applY �o an owner of property who
builtls or improves [hereon, antl who contracts for such projects with a con-
tractor(sl litense pursuant ro the Contractor's Licensn Law). I am aware tnat
proof of Ihel� Worker'S COmpensation inSU/anG! shOultl be provitletl to me.
❑ I am exempt untler 5ectlon B. b P. C. tor this reason
Oate Owner
I h¢reby certlty that I have reatl thi5 app�itdtlon antl Sta[e that [he above
�.,o.....�r�.... �c ..wn_ i anrnn tn c..,.,,,i., rn au citv ann munNortlinances
of Sign w�" L�--� City of Costa Mesa
�lectric �Nonelectric SIGN PERMIT
Description
❑ CanoPY
❑ Attrection Board
❑ Advertising Statuary
❑ Other
❑ Tract Sign ISecurity & Right of
Entry Agreement
❑ Special Event (Request form submitted)
❑ Change of Copy
� Ground
Wa71
LJ Projecting
❑ Construction
❑ Convenience
❑ Super Graphic
ELECTRICAL
Fixtures
Device Boxes
Outlecs
Switches
Sign
Standing Sections
FEES
IIuue Fee I $� I
VeluatiOn $ � /'
Planning Fee $ �
Building Permit $ g�• �D
Plan Check $ SZ-' Lf
Electrical $ � Z�• �
Plan Check 50% $ S�• Sy
SMIP $ ^ • 7�
TOTALFEE $ `r3�-�IZ
DEVELOPMENTSERVICES
Plannirg APProved 8y: —
Building Approved By: _
Application Issued By: —
B/86 White-Builtlinq; Green-Cotlo Entorcement; Canary-qpplicant; Pink-Revenue; Goltlenrotl-Assessor
Programs
❑ $hopping Center/Integrated dev.
❑ By Owner/or ❑by City
Date letter sent:
R�
Variance
Planned Signing
C.U.P. No
I Ilumination
Non-Ifiuminated
Interior Illuminetion
Exterior Illumination
INSPECTION APPROVALS
Sign � Date
Underground Conduit
0023 5/05/BE
Office Use Only
434092 TL
r
��.�n Property %%� /
A. P. No. TdX�a�o2 a� Zoning `-� a
Sign Dist. Date Received ���
Received by j1'��
Streetfrontage/
Front:� Pt.
Right: Ft.
Left:�d Ft.
Rear Ft.
Street: /N / � �
Street:
Street: ' �j,j'L2(1�2.�
Building set back from ultimate rightofvuaV ft.
SiBn Lodtion
Front�_Rear Right Leit
Sign Description
Sign Dimensions Area Letter Height
Foundations �
c,'� a' x /6 = �'� ,q.,t.
(2) � x � / _ /� sq. ft.
Rough Wiring
Framing
Date �
Date �
Date
(3) x = sq.ft.
Itemsof Informacion: (1) (2) 13)
f Totel for Activity
Copy Verba9e �C�(��ru��
� �
Ground Sign: Overall Height Planter Area
Ground Clearance
This activity
Notes:
Total Sq. Ft. of All Signage
Total
• I r. I V 1�74
' COSTA MESA BUILDING•SAFETY DEPARTMENT
P, p. BO1[ 9il COBTA M6HA. CALIFORNIA
For Appllcant fo Fill In Complately
TYPE OR PRINT
COSTA MESA, CALIFORNIA
STATE
LI0. NO. �
SIZE
OFLOT
USE OF
EXISTIN6 BLD�.
98TBACK LINB PROM
'1 XERBBY ACKNOWLHDae
•NU BTATH TXAT TX8 A6
PLY WITH ALL CITYypDI
BUILOINO CONBTqtiETlpn
AOENT
�
OF WORK
BE
� FEE RECEiv�D
FE81 9 1963
FINANCE DEPI. ��
�}�YIG�f I��€�11.�L�'v1R
BUILDIN(;
For Office Usa Only
aeceirr Ho. ree
�
�NO. OF/� �� U8H OP NI
- / �LANB yi OUILOINO
1RIRION I�O,\ �i L I\ L'J
�. No. — u -
'E: NOEAVEOVERHAN68HALLBfiL SBTHAN
TO SIDH Q REAR P. L.
ES
.OWED (U. B. C. REpU1REMENT
YARDSAPPROYED YARD9APPROVED
MAIN BUILDING ACCES80RV BUILDIN6
IOM WLSTREET)
VAR. #
BET. MAIN Q
ACGESB. BLI
DATH
' �__ "" � � V ' ' o
80.
.TION TH! AMOUM eHOWN UNOHR VALOATION 16 ROP TX8 g
COM. PUxP098 OP BBTABL�8HIN6 A PBpMIT R88 ONLY. o
Q��o VALUAT�ION rj m
1 PERMIT FEE $ L7 ' �
J // '
m
/ �` � ' —_ 9
§- ¢
. � �� .�� �
✓.
,, • All Applications Must Be Filled Out By Applic�t
.• ��� ��C��Depa"rt,ment of Buildings Applicalion N�62O
,.r �� �
fI�AMCE DF�I.ICATtON POR THE ERECTION OF SIGNS
To the Bui13m � nOfilclalTof �thFe�it
g. � y-oLCosta Mesa, Calif.:
Application is h�S
in accordancqs �j'
`���I�S,FDE �
�' i = ; :
Building Address
Lot
Ownei s Na.
Contractor's•
r
Contractor's
��or the'erection� alteration ❑ removal � of an advertising structure
on herein set idrth. (Check sauare what is to be done).
�' i;n r(j�1�q In or � elible Pencil) �
�j�� ,rfi(��.-� _ , _ . . _ �
� OC TION
� I'� ., 7/� �_ �,�� �,��-�� \
r�� � � ,O
� Tfac ' A. P. No.�� — Zone c, - �
� � 1
Owner�scAddres � �
� , �
c��.� ,
State License No. '
�-� �� �, Phone ' Ci4y License No. �. �,
- ��e DESCRIPTION OF SIGN �
/, '.
(Sketch showing lomtion oE propo�ed sign on back side of this sheet. Plans and other data must aLso
be filed.) = �
a
•„Size of Sign—Width—��' {t. Heigh Et. Height above Grade {t.
�Thickness ��� in. Weight ��1_bs. (Including Electrical Transformers, etc.)
State location of other signs on building
The undersigned hereby agrees to construct the advertising structure in strict. accordance with tlie
provisions oE Ordinance 95, Section 39, oE the Electrical Ordinance ot Costa Mesa, cmd all amend-
ments thereto.
CITY 0:= Cv=TA MESA
PL''.i:P�IMG G:.PT.
SUBJEC7' TO kiLGG. DEaT. REG.
BY "� "" uti i c_..c
pLAN TcC
y VAL ATION
$ 5 d �.
Date ecv,, FEE
i � � $ Z�
FOAM 214 IM 1�57
OUT BY THE APPLICANT. INSPECTION MUST BE CALLED
i
gn Here �e%������ -•
QI
USE ONLY
v.
Plans C ecked Permit No.
� (o � �0..
� y�� �S, r�
Plan Examiner
(OVQc�
� . 6620 •. �
,
� _ , , ,_. ��� .'
��FILL IN� ALL ,DII�g[VSIONS
1` SHOW ALL STRU AL MENIBERS
� �Q��jC�� �����. n i
,�..� r � '� - " '! l i'�
FOIi SELFSUPPORTING SIGNS �( i � •
�� Sizo and-Location � 1 i7 � r'� a�
Section 7 of Ordiriance No. 95 O- a,q �,• �iQ� ��'�� n;��f.
r � �l�"
d f�' ,� ', . � ,
: . . � . �s.� � s� - �. �
� , � • . � • JC� � y � 'S� of Ordinanc No. 95
,•. _ � s '� -
--- � o' d � � _
w�acn ar r.o� � � r� / �_�� .
l�:.
a �� "''
� . C/L J � J � � - ' _
f��' �r� �c -
,
1/KI�( GYIIII[f
$ign Area ♦ ' aou.r irorr�.r a.er
� .
10'/o Devlatloa _
frpm C/L of lot (
C/L of Lot — ' '
0
N
� y _ _
• �
. � F
� . . .
�{ / i(4L I Property . �
— . S ' � `! ]. . Gae � .
I ' ,
I " � t . �'ti "' . . ' 1 �C
� �, �
_ Curb �
STREET OR HIGHWAY ' � , "' � � - � .
` . , ,
• . . .'.
All Applications Must Be Filled Out By Applic�t
� (J � I� ��11�� l
Bu i I d i ngs �(�appi����,��ro_
APPLICATION FOR THE ERECTION OF SIGNS �L a�`' � 3' 1 i/ j�
To ihe Building Official of the City of Costa Mesa, Calif.: FlC��IV�ICE DEPT.
�CITV Q� COSTA C,E�
Application is hereby made for the erection � alteration ❑ removal !0 of an advertising structure
in accordar��p;�lQ(x�htion herein set forth. (Check square what is to be done).
v•� � (Use Z or Indelible Pencil)
G L�`S I D E•-R �'� L�'`R EA R� LOCATION -- -i
Building Addre�� L86 1ji�• �97f'/' r% �S%� �ZrfA ���/F '
Lot Bloc� Tract_��Z A. P. No. �� s- 3� O- S% Zone C�
Owner"s Name �BISD�✓�f RICKL/ Owner's Address C�_l�• �9� �
Contractor's Name .���G/� �S �/GN � State License No. ��
Contractor's Addre�s 20�6 ��WP�'e r Phone L�- 83Z� 9 City License No. ��
DESCRIPTION OF SIGN �
(Skeich showing location of proposed sign on back side of this sheet. Pl�s and other data must also �
be tiled.) .'C S{ENS � X � �t/X /� . , ,
L!� �
$ize of Sign—�W�i�dth z y (t. Height ��+ ft. Height above Gr6de J� f��
Thickness�__in. Weight 2� 1bs. �(Iricluding Electrical TransEormers, etc.)
'" _ Department of
State location of other signs on
%/f/� . 'I '
.. i\.'� ..
The undersigned hereby agrees to construct the advertising structure in�strict accordance with ttie
provisions of Ordincmce 95, Section 39, of the Elec[rical Ordinance of Costa Mesa, and all amend-
�� �Q
`a1 Tv r � �\ C `
�:�.4:��i� .C�. aJ: :-.�w
PL-.n;ili�!G DcPT! �
SUBJcCT TO BL�G. UEPT. REG.
�
T BY THE APPLICANT. INSPECTION MUST BE CALLED
i ` i
� L _ n' `.y_ ' "' �
Here � ` ✓«µ-
. BY
ARTMENT USE ONLY
Plans Checke3
/:�._, 4�a-v,a
Plan Excuniner _.,
Dgte�Issued
rz,i- �.�
.,�o. ,,,��..�.�..-- --�.,,.. p Rv
FORM2141M1.57 �OV�L�����j�(.' �^W `.�, �2�,�'� �
4�, ,/�_�:�1,�,. � ._'i .����` -... - ,
.�ii� �`�iin��:� ' . � -
�.?�::: �-��-���:� T.: �r��,�. .
FOR SELF-SUPPORTING SIGNS
Size �d'Location
Sectioa 7 of Ordinance No. 95 "� ,-.
I-- . .. -. ,� , .; .; . - -...
• ' , _. \ ' . _ ' • ", \
_ ' : .
- 4 ' ' ` ----�
Width of Lut - , ,
C/L • . .
J '
� ' .. �., . Si9n Area. .
10% Deviation �"- '
from C/L of lot
C/L of Lot ' �
\�
. , �.
FILL IN ALL DII�g'1VSIONS
SHOW ALL STRUCTURAL MEN�ERS
.T
5 1 G N
- °` � P �.T77
,,..
' � - C r.J, ;� •� {j • � ' � `-� 1 :1
"� r� � f�. J l. �� J 1� !�'. _� y
r
. _�_ '_ � � _ � , � . . .
� `\� Sec. 6 of_Qrdinance No. 95
- �. - - ' ' . . . . • �
�.' "� . , _. _ ,` i... .
J/NI�1LM... ' • l� • /•. CVlI/�[l ,
� " •IOFh �eOH�M1"••.•1� �•
�� �� �
.i . �
o .
� ���
.I .. :. . � . . . . .
d �.'A �,
n
( F t '
.\ • �\ � I Property Jl !I/�/p j.
— ,_ f '� `;, � � ? �. � `, t. ' ' : Llne . j�"I / .t. � �F ��
( ._ . . , .. . _ " (w J
I \ ` ' � P
�� - i a
� , . :� � �� . . �� .ti `
, Curb �R��D TO`�FACE 6F,.
STREET OR HIGHWAY • �I%�CQ:N� {�{1:TI'F �- ,t�„ `
ONE S/G�V oN F�oNr �va �3pCoA/Gl�TE N!t/LS TyK✓ .
• oNF Sit N oN SID F, aaTN _ STUcCo WqLC /N�U- LU�D -
_ �LUSN 7D GuAL[. SbRFAC�•
�'� `
� . � " � . 650'7
COSTA ME$A BUILDING DEPARTMENT
P. O. BOX 3 1]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING � //j T'/y
ADpRE55 i 7
COSTA MESA. CALIFORNIA
OWNER �/L �j/J L '
MAIL � .� � �A/ .w �
IC'
IIC.
GIiY
BY
LEGAL LOT
OESCPIPTION NO. B
A.P. NO. I I 11�� �� O�'
NO.OF 9LOG5.
HOW ON LOT
I s�renCn ��ne r'nom �
CENTER OF STREET REAR YARD
SIDE YARD RIGHT G� LEFT P�JC
DESCRIPTION OF WORK
MEW ALTERATION ADDIT(ON
REPAIR MOVING DEMOLISH
BUILDING NO.OF
SIZE ROOMS � STORIES �
EXTERIOR WALL ROOF �T_ �
t�nvwcivr. COVERING
, ����'�,a U '�.�
u`� 3� I+�, S`6 d U—
¢iG�la�1C � DaP���a
' �l�tl Q.
APPLICATION FOR PERMIT
BUILDING "
FOR OFFICE USE ONLY
E
COSTA MESA. CALIFORNfA
CORRECTIONS
SUBJECi TO �I-�G. DEPT. REG.
1
6T/.TE TH/.T TNE �1BOVE IS CORRECT AND I.GREE TO COMPLY WITH ALL
CITY ORO�N<NCES PND STATE LTWS PEGULATING BUILOING FONSTFIIC�
TioN. VALUATION
, � /� / � PERMIT FEE S
SIGNATURE OF
PERMITTEE $�f�� pLAN CHECK S
AUTHORIZED AGENT TOTAL FEE S
VOY!
. �- 2005i
• COSTA MESA BUILDING-SAFETY DEPARTME � F E E R E C k I U E U
P.O. BO%D17 G08TA M66A, CALIFOpNIA
JU N z 5 1963
For Appllcanf fo Fill In Completely APPLICATIO��.❑j 1$ PERMIT
TYPE OR PRINT FINANG6�Ld�V'
ADD E�88 b Y �i � CIT�°Oi��TIUlME��y
R[C61PT NO, pl
COSTA MESA, CALIFORNIA
H8C¢I GpY O[P6 81V8D DI
OWNER t/e��S � ���, �s
so REBS SO i "— � I/ AODRE'S8
pw/�[L-� —/�a/c
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r,
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■ 88TBACK LINB P110M
DESCRIPTION OF WORK
BUILOINO
size
C%TERIOR WALL
COVERIN6
U8H BUILCIN
d iiv i
I1 HHHEBY ACKNOWLlO06 TM�T 1 XAVe RBAD THIB APPLICATION
I1ND 9TAT8 THAT THH ABOVB IB CORRECT AND AOqgB TO COM.
PLY WITH ALL CITY OpO1NANCfi6 AN TATB LAWB R80YLATINO
BUILDINOCONeTNUCTIO�I.�p/j� � �Q�n��y(,
■ AUTHORIZED
ZONIN�3
ZON� � NO. OP ^ YSt OI NtW
/� PLANII {�� �UIlDINO
�.
LlOAL AA A VJ I I/ /'� n
A. P. NO. [ � .� — �� ( ) �
NOTE: NO EAVE OVERHAN6 SHALL Bb L
YARDBAPPROVED
MAIN BUILDINO
V AR. ii
HOLD
�
YARDSAPPROVBD `
ACCESSORY BUILDINO
F�. I �l
DATB
3
i
- . a
6Q.FT. �
TH8 �MOUNT 6HOWN IINDER VALUATION 10 POR TH8 $
PURPO68 OP 68TABLI6HIN0 ♦ PgRMIT F8H ONLY. 0
VALUATION m
PERMIT FEE S �
j�� - m
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d
TOiALFEE �—