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HomeMy WebLinkAbout824 19TH ST - Building Permits' wEST 192v smctEem 824 ' Complete . (36191)Shop Bl.dg. 2 '� ?J -� ' i comp. 4-8-59 (�'i2)si�n �•Complete� ��5531)Inter.Add. Comp. 4-16-59 (8746)Elec. NC 7uJ-�..U;j Comp. 4-15-59 (8669)Alter. Store � comp. 4-8-63/� i3�95)rib�. ,a '�,•s� rt u.� ��P• 5-8-63I�S i1S�3)Pilec. NCae,���—�E'�_� ^Comp. 2-24-6L�FDE(215�)2 Ven-F1ec. � :da11 SiSas _.._:__... .. �-�. .--�� 51549�,.�0. �,7.83 Non-elec. Canopy Sign 50. .. 51516- Elec.Proj.Sign(824�) 500. . 'CaiJu-1 i'n;u. o.•;^d:�, "� ..._,.�. _. .�.� ..-. . _.;.�._--� �vC� %_�/_PS-- .-"���:i c �5� /z �<J. �9 � _ �.����..��.� _E2� 7 3`ras Fhc osure 5600.00 — ii����-�as � E2 749 - Ind�Hldg. � �� F26981 Paint'�Booth Di'p Chsuical i ! a�&� :,syer.ea s�soo. — ` -.� ----------- ---- - �ac�z4�-�rxP�rtd ��-(o� ? 5 — � x��vGd Il • �� � w � ���- IORANGE COUNT� �DG.:DEPT.�• ' , 1896 636 No. Broadway � � .Santa Ana, California - D a t e-----^� �-�--�^°"� � ------------' -----' ---------- � � -�COUNTY OF ORANGE CERTIFICATE' OF OCCUPANCY '�F>�.�,#]. - "'�53.��'��Ec^� n£�,5, ��{)(3 Bldg. Yermit No'y_".._..........�lect. Permit No �._..__... �__Plumb. Permit No...........__.. z -Use of Buildin � - � � '���� ��i`'�"��'�M . . g----�-------------�-----------------------------------------------------"-------..... .... TheUvilding located' at-� .............................-----------------------------------------------------�---------- ��'�..�'r iI. ;�P. j uFi t?r$. � Q�"flO�Ls ?aQt7� --- -._.._.....---............ — � - - --� -- ---- - -....... .. -- -------- -------------- - - .... - - - � - ' Lot. -.. : �- ---------`- Block------�-----�- - ---- ---- Tract.._��� -----....-- - -� -- ---- -- � � ��(See Reverse, Side for Ivtetes and Bounds) Has been inspected and found to comply with the provisions of all County of Orange Ordinances applicable thereto for a Group ............._._._�_�...... Occupancy.' • ISSUED TO.: � � C. W. DONOHUE, ny ra{��� � . � County Bidg. Inspector �+. 4�s `i�jVSi . . � � �9M �} (Owner .04 Building)J np• yBp. L1We 'VQ�r �dLii�:�4• V e�..����i*4C�L�3• ZJGo�iti se.... CC: Origival—Omaer ]st Co➢Y—Gas Co. nd Co➢Y—���son Co. SM-7-50 m COUNTY OF ORANGE BUILDING DEPT. 636 No. Bcoadway Santa pna� California Phone: KI 2-6211 Application for Building Permit AND FOR A Certif+cate of Use and Occupancy Date_.____.. Permit No..✓-_�C__-.!._1___• --------�..o_-�.-�i----------------- -- I. OWNER'S NAME-------A.`--R..__CRUM._------------------------------------------------------------------------ PHO[VE 2. 3. 4. 5. MATLING ADDRESS---------11�—E`--15�$---St.--------------------------...--�-----------CITY.---....009�&__M6.8.8.------'---------- Name -----'--_""'_""'- Address ................... ciry-- -__-------------- �-- $tate Lic No. _..--'----'-----.. PRQpOSED USE: (Archiocc� or Engince:) Phone Nam�._...._..SO U.TH.__C.QAST._..C.ON STRIIC TION__.CQ...______ (Conoracror) a.dd«55-�----23.0. --3_0_th._St•-�----------------------------------- c�tY ------------------._N.e.wPor.t.._Be.ach._..Calif-•------------- Sta[e Lic. No.'---"-_---------` ................ .. Phone----------'--"'---'-------- J08 LOCATION_-------824-----W'---�9th_._St------------------------------��8ta--Mes.�-�----------...------------------------------------ (House No.) (Name of Screec) (Town or School Disaico) LEGAL DESCRIPTION: Lot----7------------- ---Blotk I% ...---------------,---Tracc .-----612._------'----'-------- _-------------- ------- ------ (Meces and Bounds Descripoon—Use reserse side oE form) CORNER LOT ( ) INTERIOR LOT ( X) THROUGH LOT ( ) SLOPE OF LOT ( ) 20x30 effice SIZE OF BLDG.:4�X60---shO�AREA:____3.8QQ___.___.___._._SIZE OF LOT:11?._v8_X207.,�&Eq: 24323___sq.ft.. 6. HEIGHT OF BLDG.:_____.24_.__ ...............__.CEILING HEIGHT:___12.._..._.._____.__.__._._. NO. OF STORIES.________1__,________ 7. NO. tAMILIES -----'---'_-_--__-..___-_-------.Sizc of Smalles[ Bedroom: _.------....----_--_-'_:- Size oE Kitchen: _---- ---_--------.--__"- 8. EXTERIOR WALL CONSTRUC'I'ION:_Ga�V..1.I_.OIl_..__.______INTERIOR WALL COVERING._____Qe10.�2X._._,___._.. (Frame, Scucco, Eaa) (Plaster-Drywull, Etc.) 9. SETBRCKS: Front Yard from Ccntcr Li�e oE Street...._�J.O_____________________________._______.__.__._____.__._......__..__..—.,._ Nearest Side Yard.._.._`.LD__.___._....Rear Yard.._.__13O______.Distance in Feet Between Bldgs. on Same Lot...._..__.r____________ __ _________ IU. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRC)CCURES AND USE OF EACH. ll. For � (a) Footing: Width'--'14X��„ ................Depth in Ground....1Z._..-_-..-----..---.Widch of Wall"""-_...1!�....---_ Accessory , - Bldgs. and b Size of Scuds: ...__St_e_e.l,_.______.S azin 'CC Material of Floor .____ .......................... Similar P g"""-"-"- ----- -------------� $trUc[ures: See Detail drawings of steel frame (c) Sizc of Floor oists: ------__--.-------'-'- J '."_"'_'.. Pacing _".__"""""_.____.'_._'._."_`�C�. (d) Sizc of Rafmrs: ----'-"---------------- �-------------.Spacing ----"---------------`-`-- ��CC ?2. VALUATION OF PROPOSED WORK: Induding all laboq plumbing, electrical wiring, hea[ing, fire sprinklers, paint- ing and sewage disposal $._._�.._l�?705._QQ---------'--'----_-_-_ l3. I HEREBY CERTIFY-'t"HAT�TO THE BEST OF MY KNOWLEDGE AND.BELIEF 1'IiE iivFORraArION Irt THTS APPLICATION IS CORRECT AND THAT THE COIVSTRUCTION WORK WILL COIVFORM TO ALL LAWS OF THE COUNTY OF ORANGE ANI7 THE STATE OF CALIFORNIA APPLICABLE THERETO. ;; � _' Signcd: .---- - -'� -'---""--'---"--'---'- ---�------'-"_'---------------------"'------' � R. R: Crum Owner Plans Filed:_--_---._� - � . � -- `---------------�- � - ----- - �----- - -- ----------- --------------- - Y'W'-B` ellott - �e �;��r,e��. FOR DEPARTMENTAL USE ONLY FEES: Bldg. Permit - �.... Plan Check - $._._ Total - - - �.___ Receipi No. - - ____ Paid ro - - ____ D�te ---.....--"------------'--�--' � �d� � DA E_S_/..� 5M-) 90 DIST. �j MAP-----!!1.- ------ �------- SHEET NO._.._._._�...__._ �� �4���9 C�X CnHE,�CKIIVG BY APPLICATION_/�'_�i HEALTH.__ ........................ v FIRE ZONIIVG.------------- --- MARSHAL ----------------- ---- PLANS AND SPEC'5.---------------v.. STATE --- ------------------------ CORRECTIONS ENGINEER V ERIFIED .-----------------.. CAL..-- ---- - - ------- --- � ���.-� �.�� R�� �O ,�� C/� No � Y INSIDt � ETT1= R S � „k y„ ���.��� C�TY OF COSTA MESA PLANNING DEPT. SUBJECT TO BLDG. DEPT, REG 81���� DATE....l.l� � �/ � ����O�ED �� ?�(�� � �Ci?Y�ipf (�ibstq Mesa Building� ----.. __. , -- THESE PLANS M T BE ON JOB AT ALL TIMES ',. ��TTERS � . MAKE NO CHANG WITHOUT PRIOR APPROVAL //�.�v !-EjTGRS OFDEPT. LL�TT� S ���x� iI 5 / C� �' X�.��� THE ISSUANCE OR G ANTING OF A PE MIT OR �PPR�YA OF PLAtlS AND SFECIFl TIONS SNPLI Ni 7 BE fprySTRUED �,, P � T V 'Y �L � W /�' ST ST �C/FF/!_$ TO B A PERMIT F 0 A VA OF ANY OF TfiE PROVISIOYS ' F THIS C00 SU TO GIVE FUTHORITY TO VI � T PR VISI S OF THIS CODE SHALL � S � FA THE WORK OR USEWHICH.I� h � ! TNE�ISSUANCE OF A PERMI ASEI SPECIFiCAT10NS SHpLL NOT QEVENT THE � �.r.....,.-n� ��� i��{D PLANS ND $P GFl�CATIO�NSL-O�R' �� �— G �,4 s5 0 ao� ASS VaoR G�..J�SS w��bc�w � / /i T d �—J � a--_lKl� a�_— sid,e s��-� i-a revkov��,,�. i a'�f ��, ^ �� SN nP �– 5l� �SLIDI N 9/�ax z�3g . ; G �-AS'. CANCEL iNE KCEPT IN SO IS LAwFl1L � .. i PLpNS AND CARRIED ON THEREUNDER WHEN OR OF ANY 07NFR �NDINANGb APPROVAL ONLY � 4TE PfRMITS ARE REQUIRED ELECTRICAL, P'tU."rib!i:'G, �riruc, vEhr��,ti;i�;c a:�» REFRIGERATION WORK r�a� # S % S� 9 NUMBER MUST ACCpMpqNy t't�tSF'�CTiON REQUESTS �• t 1 N p0_W F0�2 B�11DiN,S 4VHEhc PERS BE EPi1PL0YFR wF cnrr_rr 8z�i' +��.ST_ .� g,S_d C'Cv5 �"/i .1v1 E5l�� CALIF. CN�7 T� ScA t E) t� 1 ; � F / � • t�� � i . �_�.._, - ' ,�.� � *�:. 0 � � �:� � . ... � � `� lY� � ��� , i �� �j"� � J ,N���iR�P� � 1 roMMER�;�,� �R__ �. • - � . ' i. . � f ,.. � i 1. •� . � . •` � ti r' �', ; r 4' Y : �'� � � '� � - � '� AGO�icant to fill.in,all s0ace5 except [M1ose within heavy'bortler Iines ana sign au appropriate aeclaralions. � . __._. __`_' __ __ ._. . _ _1_ ��._ ' _' �_� " _ __"_' __ _ "__ _". . _..,. ' " __ . ' _' ' __ _ " _ _ . � r � PERMIT NO� ? �TRACT NO ,1 LOT NO� ;UNIT NO! � ' � i � , ��' 1' � "��' � '-' - -� �l�-� I�CITY OFCOSTA MESA �CONSTRUCTI�N'PERMIT x ; ' � - r � " � ? :0429� I / 19/87 � • � � � � � ; � �j I � � � y --. . � ` _ _:. i : i.� ; : i i � . + � ' � i � ; , . , 25 50 4TL i Proiect Address ��� y IZ- 4 �(.� ./+ i�� _I 1 S�- � # ' - ' . , , � , i i � r ( � . � � i � ` � � � � ; AppliC3nt"sMeiling.AddiCss !'LZgSI LSJSi'A �[.1'� '.E�--'�fo � TYPEOFCONSTRUCTION' µ•,�/NEW��i tADD IALTERATION REPAIR � � � � � � t � I� , ❑ CONVERSION. ❑�OEMOLISH ❑ OTHER � , ! � ( � � Owner's Name' TUN\S �6�OS� _ � Phone��b � ' . . �5- . � �--" � — .. '� . A.P. # .._ . _. _ ' , _ _ _' ' � .. _ .�� Zone �_,._ ' _ _y.. _ p � . , DESC IPTIOjV �OFWORK%� USE���Q F BLDG-� . � t Addrew 'a 2-y `/Z- 1/� ' � '� �. ST � i . � � � � � (YAi r( T� '��r<I �. .+iA-� - "��/ -.. ` .. i' S Main Buildin9. I ' Accessory Bmlding � � : � � � Arch/Engf � � � - � License Na � � � � TYPE OF'PERMIT i GRaoirvG � F NOU DATION�-0 STRUCTURAL �'s""''� T Front� � { ' � � � ' i { � � 1 ' O I � � � I M � � ' � j � � '. � � , � O,� �T NANT , O ELECTRICAL ❑ PLUMBING O MECHANICAL � i g � , � � � ^ N � Address _ � i � ��� ,�.� Ld"oTHER � � �CP'Q-' � � , � . . . ,A Rear � i ; � � i i . � � � " Contiactor'sName �g� �N J"z�fDE..�� Phone�9.L"_� . � . . . � . C Right,."�-'_ .. ".i"..t .^- •- , _ -._.! . � j � _N. � PROJECT DESCRIPTION � 50. FT. OCCUPANCV Address (mailin9) � ��l {�4t.n' �2\�Cr �L'ZbrO �%1b'�o ' i � i ' ` �Q � . 'S Left � � 1 , � . � . . G �� u � GONSTRUCTION' YPE VA�UP.TION�$ SOO . . ,' y �� i� 1 . � � � City��iceriseNo. ' 7�3�� ' � , � 20NE-• -� ;GRADING�CV.VDS. -� ACRES� " � � • -+ � = - i �� � R �- � . � � ; ! � , Ping. Ref. # . � y � • Parking�Req /Provided 1 E ' LICENSED CONTRACTOR OECLARATION � . { . ' - i f� 1 hereby aff rm tM1at I am licensetl untlet provision5 of Charter 9(commencing Remarks: �, ' '�a� �,-� !�.,,. '` Plamm�g Notesi i' i. � �_ ,� � ' {� M j with�section 7000)�of Division 3 bf Ihe BusinessantliProfessionsCode,antl _ ' � y - " _ ' � � � � • � � my license is imfull for e antl etfect. , ' �O6 ' � � - i ��. � � � ,� ' � 1- � .' � - • :' f 5 4. � _ � � ,: i 1' T Licerize Qass � �-r� 4 ' ��y OJ"(; • ' ' " � �' ' S E - , '7 ; , . - � ' r 1 .c .PLUMBING � � - � ` � ' I, �FEES �� . ! � 1� � i . � , i ' � 1 q � :v foatc signaiure � - , ' � � s. ' I � _ . •! _ ' ' � = - 1 .. _ » i' ' "; , WORKERS' COMPENSATION DECLARATI . � ' ) ' � - r - p � ±., � t = . 'i f ; i ' 1 u 1 hereby alfirm�thac'�I nave a certificate ot consent to salf-insure or a certi�ica�te j Bar Sink �,y _ i p;�� i Showers . �y, , � .'� ;ELECTRICAL ." _�� � " FEES �`' i N Workers' Compensation InSurance, o� a certifietl cOpy�the�eof (Secfion + ' ' � _, � ' 1 , . ' - a ' � , , � • , � . � , BackflowPreventer' ' ServiceSink �"�' i � i „�+ � i � i` "�Qutomatm Washer Transformer �-❑� 15 50 KW " 1� 1800, Lab.' CJ j : ' ` � ' - - - . � � Policy No: . - � Company t � I � ' � j Backflow Irngabon _ ;q Sewe� Ca v , � � � t• ' 1 ' ' ' � j � '� 50+; KW' � � j . CerLLetl copy is�hereby furnishetl.� j � � � � ' ' � � -- � P �� � =- ' + r . r ConStructwn:Pole Sub , ' � � : , . �, , - - � � � a Certifietl copy i5 filetl with the city BWltling Division. � � � { BatFitubs� - - _� f !v ;� � Sewer Connection � .c � ' - .t. ' � � ' Cookin Unit� � � ;+ ' i � r ' - � - � 9 _ �. � �; Mecec �up to 100 amps � .• Dale � APPlicant - � ' .. � ' ' . u . . - --' - ` . .i • ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � , ClarifierS _ � �� ' � 17 �, � Sola� ColleCtorS�, t j ,a ' _ - DiShwashef � � . 7 �� � �1 � ' � Meter ❑over,100 amps j _ > ' � �' (Thissection neetl no[ be completetl if the pe�mit is for One huntlretl ($300) o� , �� . , � � � . � " ' _ ' '� less).i � . . � ' Dishwasher,� _ - - _ � Solar Pipin9 -' _: j •� 1 y � .� '� � ;. Dryers'�Gas ,�Electnc , ' ,Sub Panel'� O i =' - .. ; I certify that in the�pe�fo�mance of tbe wo�k fo[ which�this perO Is issuetl; I -. .. ' � _ , - � - , ' � ' � � ` • �J� ^' � m, ' shall �not employ any person in any ma y.' so s to c me ; b ect ta the � Drinking;Fountains _, i_ � , Solar Tank , i. � �, ��ry F .� ( Fan �, �� .��� � '� Motors �0-1`,HP 01�'/a ,8 �, .� � ! Wo�kers' Co pe ion Cawsbt Californi ,. ' ' ' Oate � ��'�� ' Si9nature � I FfoorDrains - � � 1 "' � ' ; $wimming Pbol w/Spa � ''� i ' � i `� p q �J :`�' i - � ! + • -' NOTICE: If, after making this tle[laration, you shoultl, ecOme 5ubjecT.to.t�e._ ' ; , • � � _ � �OC SOIa�� '�9-75 HP, �1C�7$+ � i C Workers' Compensation provisions;of ihe Lzbor.Cotle; you must forthwith . FIoo�Sinks t' � �Urinal ; � � � � � . wmply with such� provizions o�; this( permit sball ibe tleemetl revoketl. - �� � ' i ' � FixtW25 . . � � : M�c�Owdv2� � I � � CONSTRUCTION LENDING�AGENCV ` , � , � i : GasService Outl¢LS � �WdLefC1052t � � � � ' { r � . , �� 1 nereby affi�m that there is a constructian lentling agency tor the performance ' ; � � D¢vic2 BOxES - 1 ( � t j Pole Light'. � � • of the work ;for !which this permit' is issuetl (Section 3097 Civ. C.) , Interce tors ' �• r i'Water Heater � �- ' i � P f Outlets , r' Lenaer's Name � � � � �� - ' . . � , i Range� � . _ I_entler;s.ntltlre's's, ' ' � ' � ' ' � � - -� Kitchen.Sinkr_.. _..:_. i p.WaterServ�ce � _ _ , '_ , t._ +• p__ - .__ _ • OWNER BUILDER'�ECLARATION ' ,� ' I ' ' - �' . � � � � � ? � � J' }' SwrtChCS-I-•� �'- ; _'' ; `$IgO. ' 1 '_l_` ' � I hereby affirm that I am exempt from'the Cont�aBtor'S License; Law for the � Ldvdton¢s f 't . Auto-Wash Ga�ba E Di5 OSdI i ' , following reason (Section 7031.5 Business antl Professional Cotle: Any clty�or ' " � ' • � ' . ? , P , Standing Sections t � ! county which requires a permit to construct; alt¢r� improve,;tlemolish o� �epair � P-T�ap' � � 3 ' �' ' LaU�d� 'T/d 5�' � � � ' ' ' - - j any ztructure, prior, to its issuance, also reqWres tne applicant tor, such permit � - � • Y Y � � Gene�amr OO-5 KW�O5-15 KW : � lo tile a si9netl statement ihat he/she .is licensetl pursuant to tne provisions,ot � , ! j 1 1 • . �� Roof Drains . � � ' • � � I the Contractorfs License Law (Chapter 9(commencing witn Section 7000) of �• • � + � ' � � � ; Divisiom-3- of �the- BusineSY antl �Professions CotleJ-or that �.ne/she� is ezempt - � � •- � i -- —,- _. _. _ ; _ _ _ _. _ _ � _._ � _ ' _ Trash;Compactor I � -.+t;gerefrom� antl, the basis•fo� tne allegetl exemption. Any violation of Section � ; ; ' . � 1 i � ,. y � � j � � , i � i 1 _ _ t ` 1 .s'�)31.5'by any applicant tor a permit subjects the applicant to�a civll � � � � � ' , � � ��' nalty.o[ not more thartfive huntlretl tlollars ($500): ! ._ ! ' � i - ' + � , i ' � , , . � � � � ��L7 I, as� ownei of �the� property or my employees with wages as th_eir sole Reinspection� Fee' $15 i .` ; Issue Fae , � $:3 , , .`; � i i � l i i ' compensation,1wi11 tloRhe work, antl the structure is not intentletl' or otferetl � � � for sale (Section 7o44,:Business antl Professional Gotle: �The Contractor's � r � ' MECHANICAL f - � ! Reinspection Fee ��($15 Issue Fee i � - � ;$ 3 _ { . ' „FEES � ' � -' � � License�Law tloes nbt apoly to an owner of a'property who builtls or improves • ' - ' • � . �_ ' Y thereon,� antl who tloes such.work himself/herseli or througn his or her own i goiler '_� � �� j Hood or { Type I ❑ • , �� -" �DEVELOPMENT SERVICES REQUIREMENTS: , ;- 5� .�� `"' '; employees, provitletl that suth improvements are mt Intended or offeietl tor _ , , � ' � , � • � � � � � ,sale: If; �oweveY lhe bWltlin9 or improvement is soltl wifhin one year of com- . ., . CariOpy � Typ¢ 11 ❑ I � {.- Zoning Approved By ^' � - �=� Date �� t '.I . j �,pletion, the'owner wlll•have the burtlen,of proving he/she_tlitl no[ builtl or irn- � Duct - Und¢� G�OUOd � _ � � ' : , . � � . - ; Building Approved 6y � ' ��� � � 'DetO r �prove for the purpose of sale)J ' . : ' i - , j _ � . . . , , � � i , � � � � -�`I; az owner ot the.property, am exclusively contracting with licensetl:con- ' Duct - Structural . �� � I Refrigeration System� �' � _:1 „- .ApplicaYon IA ed By 1' � p t � , ' tractorsto�ronsVuct fhe D�oject (Section 7044, Business antl�Protesslons Cotle: " � ' �' � � � � The Contractor's,License law doesrnot apply�to an,owner of property'_who ' Duct- Ven[ilating � -❑0-700,000 BTU ❑100,000 BTU �.� � ; 1�' j-? 1- SUM V O 'FEES : �' ' � builtls �or �improves�the�eon, antl who conttacts"for such prOjectS with a-con- - - � ; ' • � ��� � '� � � , � , � j, tractor(s)'�I¢ense-pu�suant to the Contractor's License-Law). I�am aware that' ' ; BUILDING PERMIT-�' $-���'- � 1 t �' , proot of tneir" Worker's+Compensation insurance shoultl be provitletl to me- Exhaust System-❑ Mu.ltiple 0_ ' System.Repair/Alterabon a, �� 1 , � �SN1�P � �� ($ � ��� r I - „ � � _ _ ' . _ _ , . : PLAN,�CHECK . '• $= ..PERMIT. : :: � r � _�, �� L7' I am-exempt antler Section� - � _B: &'P.�G..tor this reason-. ' Firepl)FacC BIt.�ICBO # + i iFire Dampers � i r� - - �� 1 , p; ;; � f' , ,. . . .. . , . . ' .- ' � '-ISSUANCE f. $t. i � - - i . %,. ' P.LUMBING ' $_ � '1 Daie� � v " Owner y � _- �� � Heating System & DucUng � _' . Registers . � �r - ' � -• i pLAN CHECK ��25%. $.' ' = � ;'�ENERGV�P.C.,„ $. [ ` �� : '� _ :. : ' . � ` � . . . !J . _ . . . . . � . f - F I hereby tevtifycthat:l have reatl,this application antl state that the above�. ❑4100,O�OBTU �100,OOOBT �_. - �� ��_ '� i, � ' - GRADING �$ r� ��information is correct. I agree m�comply wiih au city antl munty ordinances`- ' - ' i . s T- ; � t ELECTRICAL . �. �$� � '+ , , _ _ iantl"state laws relatin9-to builtling constru ion; ana�hereby authonze repre--. - � �, � ; �. , - ' � � = , ' L� f . PLAN'CHECK .�50% � � sentatives,of-chis c"tyt `+ent ont above-ment�onetl�property for�� -� _ _ + - ' „� " � 4 , - $-, , .MICRORLM� .$ ' - � '= -� � �inspection�purpo5e5. � i N � � ' 1'Z � ; : .. . . � '.. � � � -� � ' MECHANICAL �,' $'-. t ! + . j . c; S—�j� • Si9nature' ... I . � Date- » � ,' � - ' :a ` -� " , - . � • TOTAL FEE r 1$ � - �,Onvers' License or 55 � ; . ' �" : �� ` c: Reinspection Pee ; r � $15" , r� I`ssue Fee � � ' � % �$i3- � �� �' PLAN�CHECK -25%� $f �' �' � � � j " ; " t . .. .. . . . - . .. . , . . , i , , . . . . . . , , � �. a � '""'_.-...'"'�.'�'_.'_'___ "_.�."_-�_'.._ _. __�_.._.__... _._ <.......'_"_"_'__ '._ .__.__��_..�"' "__'__' ' _ -_ _ '_'_._..'___' '�'_�'_.A._...'�_' _ ' CMF b865-46, rev. 10/B4 White - Builtlinq; Canary Applicant; Pink Accounting: Goltlenrotl Assessor _ , ' „ . , , . . . � � � . . � � ,CONSTRUCTIONAND.PLANNING � � '. . . ,. .•. W' POOL&SPA.-;� ... _ ; ;c� . ? �� .. � � Date � Inspector � ' � ' ��� `�Date `� Inspecfor APPROVALS � Permit #� , APPROVALS Permit # , � a . _ i � a � � j1•. Tempoiary Electrical Service or� Pole . ' ! : 52. Pool & Equipment Location � , � p ' � , - . .. . . . � . 2. Soil Pipe-Undrgrnd.' . . � ; . � 53. Steel Reinforcement � � � � � ,. • 3. Electrical Conduit Utility�Undrgmd. � ' � �54. For,ms� : � - � � � � � ; � � 4:•`Electrical Conduit-Undrgrnd. � - .55. Electrical Bonding i ; .� : � • � . 5. Steel-Reinforcement ' � � ' _ . 56. Rough�Plumbing & Pressure�Test• � ' 1 �' � _ ` 6. Electrical UFER Gmd. - ' . - . � �57. APPROVALTO COVER.GUNITE , � - . ' 7, Footings', ' � . , . � ' ' � '58. Elecfrical Condult;Undrgrnd. ; � � i e . i�-, � Si Foundation. ' ' ' . - . - - . • � � 59. Gas Pipe,-O Undrgrnd., Tesf + ' i ? � ' �t � 9. Water Pipe-Undrgrnd. . - ., , �- -� �60.•Backwash'Lines, P-Trap, � Undrgrnd.. i � . 10. Structural Floor System , � 67. APPROVAL TO DECK ' ' � . � i . � '; , 11: Property Sewer Line & House Connection ' ' � 62. Backwash & Receptor-Final � . � ' � �: �. � 12. Sewer Cap � � � � 63. Heaten& Vent-Final . • � ' i � 13.:Roof. Drains-� ' • ' � � ' 64. Plumbing System - Final � , , � � i�. � , � - 14:� Rough:Plumbing �� ' . ' � , 65. Electrical-Final � � � - • ' 15.'��Rough �Electrical-Conduit � � . t � -66. Solar System-Final � I f ' � , ' 16. Rou h ElectricWirin � �� � - � ' � � � � 9 9 � 67. Fencing &�Access Approval � . 17. Rough Wiring Sign ' - " • � ; ' , '68. APP.ROVED FOR PLA$TERING �� ' - � ' 18. Rough Elecfrical;7 Bar Ceiling �' , � 69.�POOUSPA SYSTEMS FINAL ". � � 19: Rough Heating & Air Conditioning ' , , � ' , FIRE DEPT. REQUIREMENT � , i � � . � 20. Rough' Factory Fireplace � � � � , � APPROVALS ; Permit # ' - _ � _ �� -�' 4 � 21: Ducts,�in Structure - ' 70. Underground Hydro � ' ' ' :-^"� ' ,- �i`�" } � ' 22' Ducts; Ventilating�- , � � ' � � 7j, Product Piping O Gas ❑ Oil' . � � ' � � � r � ; ; 23: Gas Pipe-Rough & Test: _ �. � � � � 72. Underground Flush ' . � � - � ' � �-� , 24? Roof Framing'� � ' , , .' ' � '• � 73. Underg�nd,StorageTank OGas ❑Oil . � , � ' � � � 25.' Roof Sheathing _ _ ' '- ' , ' ,�r 74..Overfiead Hydro : �� , . � � � `'� ~ i � 26. T-Bar Ceiling (Structural) & Monocoat � , �� .75. Dry�Chemical: � �, ' � ' !-ZJ'-�� ,�����. , ' �27. F�ameand�Flashing " � ' , - � - - � � �76. Dry�Standpipe � ' � , � � ���,.; �i.,�..._ �. :.�, : 28: Lathing & Siding ' - ' `7 FIXED SYSTEM FINA�L �'� ;,,� /%� �cY ��'�; , ;;�ri .�, ' 29: Insulation • � • v+ i � '/ � � , 78 . FIRE FREV. FINAL �p _ ��, ? ;!� - ��� . � � `'�� 30� Drywall Nailing � � - � � • - HEALTH DEPT. REQUIREMENT, � "_ �!''' ° , 31: Plaster Brown Coat � ' ' � ' 79. FINAL INSPECTION , � - ' �� - ��;..:.c�` . - � 32. Electrical Power Meter-Final �� � 80.�F.00D CERTIFICAT:E ISSUED '��'�y � . , : . � � 33.� FinalLElectric ' ' � ' � ^ _ ' Note's� � � � � _ ;��� � � � '�� � � 34. Fina_I Heating & Air Conditioning, � ' . � . � � . ' � • � � . . - : . ' �� 35: Final Gas Pipe-Test � � , � � � . � ' � ' , � - 36. Hood or Canopy s �, � . . _ . , . . � - .," � � 37- Final'Factory Firrplace , , . : . � � - � , , � '38. �Final Plumbing - � ; " . .. . . ' . 1 � , ' w I '� � �39-N/ater Ser,vice-Final � � .. � � �' �- � ' .. ' . � . - � ° , . . �� - . , 1: , 40. Gas_Service-Final' ' � ' . ' � ' ' � � _ � ' 41. Solar pomestic-FinaL . • � ' ' �� • � � � . , i , ' ' f. � � i . , • �' �.. � ' 42. 8ackflow Preventer � � . , � - - � � _ _' ' � ,- � 43.�Backflow Irrigation � � � � � . � ` . ;., r • ' �. � -, ,,-. ' , �44. ,Landscape Irrigation System � � � - � � � ' . . , ' ' � � � � ` ' � � 45. Sound Attenuatipn' _ � . . , � � . - , � �46. Handic9p Regulations ' . . � � � ' � � . ' . - ' , � � . 47. FINALSTRUCTURE&BUILDING' ,� - . , � .. �' . ' ' ' � ,. �; , _ . , � 48. Special,Requiremnnts.Completed ' ... , ' � - �� . ��. ` '' � - , . .. •'-"t• : 49. Electric Release t0 Edison -- - � - � . - � . ' ' . . - ' "' . - - . � � ' j , �. . •' .50. Gas•Release�to Southem California Gas Co _ � - ' ' . , " - - - ' . '_ , � 51t CERTIFICATE OF OCCUPANCY� � - � � . � s No.; . � .- . Date � : . ' _ . . � . ' .- - , : , - � - - � ._ _ . . . . . . -- - . . ... . ...� _ _ . .. _ . (714) 754-5273 • Fax (71Q) 754-4856 • www.ci.Cos�a-mesa.Ca.us 77 FAIR DFNE, WSTA MtSA, GA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: fn71 824 W 19TH ST 42230117 Applicant: PRAUM, STEVE Address: 1049 MELROSE Address: �� Status: ISSUED Applied: O6/05/2003 Issued: O6/06/2003 ISSUED BV: f �-�- � Phone: (714)23f1-7507 ���� � ZipU28871 (� 1 �� �� @ �� � �t`�� `/// /( � .--""= _-`; -�..�'�J � � 'c�co`� 1 (� � �""d+.�atV�\ � � \ Phone: �` � � � � Zip: 90051 ��� / � ELECTRICAL CONTRACTORS � )SE�"b�` �"••� «��o � n !' o ,9P,hone: (714) 980-22 �`% \.. (�� `�..�,-'r__ 1C�,�' if�_..---�' Zip: 92887�.�- /� License: 747129 ° $0.00 � $0.00 O $0.00 $0.00 � $0.00 � ����� $0.00 Recept Outlets ^ . \$0,00 Switches�� ��� $0.00 Non Res Appl� $0:00 Res Appl � � $0.00 Service to 200a O �83:00 Service to 1000� � f $0.00 Service over 1000a V $0.00 Motors l0 1hp \$0�00 Motors to 10hp � t$0.00 Motors to SOhp �$0:00 Motors to t00hp $0,00 Motors over 100hp $0.00 Communication drops $0.00 Sub panel to 200a $0.00 Pole Light Pkg $0.00 Sign Circuits $0.00 5 p; Misc �� � �D ' �a � , � „ � ���' �......... jhdm �« /� 0 Gn �0 ��� ` , . .. n � � � Low \ /� `� .�i �Low;,\ °' o�-': .. Misc. � ". � `� � Mist. :��� p���,�..-...�,_,��; _ �_ � c>�'`p� G � � �' G r� �„�.�,.,�, �. � � � � � �_� )�� ERGROUND�FEED. �=�� � i � �s1 � L_ _=� --� �� �� �! � - „J � ( ,�,,,,�, � � � - ��� �� Quantity'i���' �`�'--( �stem / Cightin9�� $0.00 0 � `, `� % ft% $0.00 0��//I ! )� :tionp �$0.00 0""// +� �y 31.Equipment $18.20 /1� '"'`�J �� up to 1 kva/kw '$0.00 /j 0 �\. J I to 10 kva/kw $0.00 0 to 50 kva/kw $0.00�0 �[o�700kva/kw $0.00�0 j�J� ier 100�kva)kw�' ' ,,.$0 00 0 ��r / t:., ���� L" f� Equipment � $0.00 0 ng System / Ckt ��$0 OO�A, �a � t • � .or� �j/� $000 �//'0� /„ � :tor,.,,,� � $0.00 � C, 0� ���id'e)� �$0.00� 0 f'� �ride or lights) \�,$0�00 /0� � �e.Stantl'� ��$0.00!�0 m_d'.���� $0.00�0 al�Fee � ,/$0.00 ��...���CJ ee�/O.� $0.00 $0.00 Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92} EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 180 days, or it work Is suspended or abandoned for a period ot 180 days? '- INSPECTIONS: In order �or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: � � I hereby afFirm untler penalty of perjury one of ihe toliowing tleclarations: . ❑ I have and wiil maintain a certiilcate of consent ro seN-Insure for workers' com0ensation, as pmvitled for by section 3700 ot the Labor Coda, for ihe pertormence of the work for which ihis permit is issuetl. '�"' I have end will maintain workers' compensa(ion insurance, as required by sectlon 3700 of �he Lahor Code, Por the perfortnance ot the work for which this pertnit is issuetl. - My workers�' -com�p�ensetion Insurance cerner and policy number ere: ^I Car�er: � �5��{T�i ��Jr3 f� Policy Number. rZ Z�I -G g (ihis secNon neeq wf be completed il fhe permrt rs veluetl at one hundred dollars ($700) or less.) ❑ I certify ihat in tha perfo ance Ihe work for which this pertnit is issued, I shall not employ eny pereon in any manner so as to become subjec� to iha workers' compansetion lews of fomi nd agree thei if I should become sub�ect to the workers' compensatlon pmvislons oi Section 3700 ot Ihe Lebor Code, I shall fonhwith . comply with these provi s. APAlicant Signature: �,� Date: �-9' � � WApNING: FAIWRE TO SECURE WORKERS' CAMPENSATION WVERAGE IS UNLAWFUI NJ� SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES ANO GVIL FlNES UP TOONE HUNDRED TMOUSAND OOLLARE ($100,000), IN AODITION TO THE COST OF COMPENSATION, OPMAGES AS PFiOVIDED FOR IN SECTION 31O60F THE LABOR CODE, INTEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARA710N: I hareby aNirm ihat 1 am Ilcensetl under provision�Q f Ch�pter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full foroe and eNect Lic. A 1 N�i I 2�i V � 1� Class N � C� ConiractoYs Signature: Date: _ �ji -9-0 � CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm that there is a construction lending agency for Ihe pertormance of the work for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lendefs Name: Lendeis Address: Signeture: OWNER-BUILDER DECLARATIONS: Date: 7 hereby aNirm thaf under penalry of perjury thet I am EXEMPT FROM 7HE CON7RACTORS LICENSE tA W br the following reason (Sec. 703t S, Business antl Professions Cotle: Any ciry or county which requires a permit to construct, elfer, improve, tlemolish, or repair any sWcture, prior to its issuance, also requires the applicant for suc� permit �o �ile a signed statement thet he or she Is licensetl pursuent to ihe provisions ot Ihe Contractors License Lew (Chepter 9(commencing with Sectlon 7000) ot Dlvision 3 ot the Buginess and Protessions Code) or that he or she is exempt therefrom end ihe besis for the alleged exemptlon. Any violation of Saction 7031.5 by any appllcant for a permit su6jects tha aOP�lcant to a civil penalry of not more Ihan tive �undred dollars (5500).): ❑ I, as owner ot the propeny, or my em0loyees with wages as their sole compensation, WILL DO THE WORK, and the simcture is not intentled or oflered for sale (Sec_ 7044, Business and Pmfessions Gode: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such woAc himseit or herself or t�rough his or her own employees, provided Nat such improvements are not intendetl or oifered Por sale. It, however, the building or improvement is sold within one year of completion, Ihe owner-6uilder will have.the burdan of proving ihat he or she did not builtl or improve for purpose of sale.). � ❑ 1, as owner of the property, am EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the prqect (Sec. 7044, Business and Professions Coee: The coNractors License Law does not apply to an owner of propeny w�o builds or Improves thereon, entl who coniracts tor such prolact wlth a conlrector(s) license pursuant to the Contraclors License Laws.). ❑ I am exempt under sec. Signature: Owner ID veritied by drivars license. ❑ Ves ❑ No Business antl Protessions Code for this reason: Vedtication o1 Owrtership by (type of document, i.e. - property tax bill or deatl): Orivels License No. Date: Expir85: DIVISION OF INDUSTHIAL SAFETY PERM17 CERTIFICATION: ❑ I hereby certity that no excave�ion tive (5) or more feet in depth in�o which a pereon is required to tlescend, will be made in connection wit� work authonzetl by this permil, antl lhat no building sirucWre, scaHolding, falsework, or OemWition or dismantling ihereoi, will be mwe Ihart lhirry-six (36) feet high (Ghap. 3.2, Grp 2, Atl 2, Sec. 341, Title 8, Califomia Atlministrative Cotle). ❑ As owner-bUilder, I will not employ anyone to tlo work which woultl require a permit irom the Division of Industriel Satety, es notetl abave, unless such person hfls a permit to do such work fwm the tlivision. - Signature: Date: Division of Industrial Safery Permit Number: CHRTIFlCATE OF COMPLIANCE AND AUTMORVJITION OP ENTRY: I certity under penalry oi perjury ihat I have read thvs epplication and state ihat Ihe intormation given is correct. I egree to comply wlth ell state lews and ciry adinances rela�ing to building construction, antl authorize represemetives of the Ciry of Costa Mesa to enter upon Iha ebove-descnbed roperry or inspection puryoses. I agree not to occupy or allow occupency of eny 6uilding authorized by Ihis pertnit until final inspection. / �gnaWre Of Legal Owner(s) Date % � -6 "'�� Antl/Or Author¢ed Applicant —�— �� Data S�9DE1 INSVECTIONTYPE ' 1616 Fixetl System Final Fire Preven0on 1286 Pool Spe Final 200 Final Re-Roof 201 Finel BIOCWRetalning Wall 202 Final Fectory Fire Place 203 Final Sign Z44 Final Demolition � INTRIALS �QQ$( INSPECTIONTYYE 20fi Final Mechenical 208—Final Plumbing_— ---� 210 FinalElectrical` __ _ 212 Final Fire Pravention 220 222 250 Final Planning Approval FinalSite Final Building/Occupancy PSIE Iti�lELS � '�� ` � 4'754 ,�: �. � '.` .; �� .,. --COSTA:MESA BUILDING DEPARTMENT ; . . P.O. BOX 31] 7 COSTA MESA..CALIFORNIA 1 FOR APPLICANT TO FILL 1N � • aui�oiNc �r / T� S'� � ' ADDRE55 COSTA MESA. CALIFORNIA OWNER ��_isN�n � i va._i � /1/�i„rnn�A-�v ADDRE55 � � •� � ( 7 � S , ' � ' � ' TEL�i � ��� . CITY NO qpruiTECT . - � � LIC. � , C �INEER - � NO. A. 55 �i CONTRAGTOR NO.. TEL. ADDRE59� �N U � NO.' ' LEGTL LOT � � / /' oEScaivTiON NO- � BLOCK TRACT A.P. NO. �� �� �'7 G �� /',- � . 52E �( f No. oF e�ocs. /p OF LOTIO� /\ I I �- NOW ON LOT • . USE OF � EXISTING BIDG. SETBACK LINE FFOM ` � c[rvi[rt oF srR[ei �! Q REAR YAR� �v� SIDE YARD RIGHT ��rtLEFT �,'.F1Y- DESCRIPTION OF WORK � �NE�' ALTERATION x ADOITION REP...�i MOVING - �EMOLISH • BUILDING j( NO.OF - ' / SIZE �O ROOMS /�yL SaT.O�RIES E%TFRIOR WGI I A� �_ � ROOF ` V� Y�_ FEE RECEIVED `�Ma����'—�`t�"��`��� , . FINANCE DEPT. � CITY OF COSTA MESA APPLICATION FOR PERMIT BUILD'ING FOR OFFICE USE ONLY RECEIPT NO. � P[N.Y�IT NO. � ING � ��( '.SS �- ^ i"Lf 7 � COSTA MESA, CALIFORNIA FIRE ZONE APPROVED BV SUBJEC7 l0 �[¢G. DEPT. '� HERE9Y ACKNOWLEOGE TXAT I HAVE REl�D iH15 RPPLICATION PND STATE TM/T TME A90VE I$ CORflECT nNO iGREE TO'COMPLV� W!TH ALL � . . CITT ORpINPNCES ANp STFTE L�1W5 (iEGUL ING,Bl11L�ING CONSTflUC- riorv. ' � ' VAWATION / SIGNATURE O 6 ` C A O PERMIT FEE $ PERMiTTEE � '�\ � .� / ` �� . ' `� ��� D � PLAN CHECK $ V . $.. J AUTHORIZED AGENT ' _ � � " � TOTAL FEE $ ;/ S O � ��M� � � �: .. �v��l� . � � . �, ' S531� ;� � �F RE EIVED �✓ � � ������� COSTA MESA BUILDING DEPARTMENT � � �q P� a�x 31� '' ANCE DEPT� `�"`�( COSTA MESA. CALIFORNIA �' � . �"'\ � " CITY OF COSTA MESA � FOR APPLICANT TO FILL IN . �� APPLICATION FOR PERMIT qooRess ��4 bu.l9r=i S��Yt . � � BUILDING . COSTA MEsn. cauFORNin � FOR OFFICE' USE ONLY w RECEIPT NO. q�EAMIT NO. OWNER � .. � � 1`/ IH i� � . . ' J'S �. e,. 'n �RECEIVlO BV L�ATE RECEIVE(O O I UE ADDRE55 �24 W• � T� S {�`�� �%�� O V �Z s/ ciTv ��4Tp k'� S � TNo: �� AooRE�ss 0 2 Y�� �� - ARCHITECT � ♦ LIC. � . � oa ENGINEE J21Nyt� �UNb ISA.L��o� ' � COSTA MESA. CALIFORNIA ADDRE55 � 'E, ��Tµ S IZ • A MtS A ZONE �� 20NE NO.OF ?VpE GROIIP'�� � CITY LIC. ' /J PLANS / ' /I 7 CONTRACTOR NO. ( ' / � v'� \' TEL. APPROV / � � / AD�RESS NO.� - BV'„ \ O%WR' TE �z S LEGAL LOT � C d DESCaiPTiON NO. 6LOCK � TRACT �o1�L � CORRECTIONS A.P.NO. /IS �� �^ � � / � SIZE' � ` NO.OF BLDGS. ' oF �or ��� •'32 X � l�= 1$ ��ow o�+ �o, � ��i � USE OF �//� / . EXISTING BLOG. j�EAI, ti.S l. k m- , �7.A1 �Qf_ SETBnCK LIrvE FROM � � � CENTER OF STREET SO Rena vnRo �I� SC �' PLANN G DEYT. � . �, � � ' SUBJ C •. • SIDE VARD ' RIGHT �G LEFT L . 3 2 ' � -/ / � DESCRIPTION OF WORK - /� � � � � � iUTE.R10�. PL.AY T_CH. NEW ALTERATION ADDITION REPAIR MOVING OEMOLISH ' - 9UIL�ING �J ...,NO.OF . SIZE J. O� S• .ROOMS STORIES �' � EXTERIOF W �4 L � � ROOF `/�^� � ' -,.y COVERING�i{E WE AC COVERING J{�i�LT M1l ls'r'/LL, ' USE OF NEW � `/� / � BUILOING� S IZ�S � '"'O�LA�p'� ' e_cNU�R J'� cYaA(c� �Lu(. i^'I � , , J' p aAfc E<h- ''Z S""C f2 E$ 1 H REBY nCHNOWLEDGE THnT i NqVE REhD THIS nPPLKSTION AND . STflTE TMtT�THE'ABOVE IS COPRECT ANO TGREE TO COMPLV WITM ALL ' CITT OFDINANCE$ AND STATE LPWS REGULATING BUIL�ING CONSTRUC� norv.. � � � \ VAWATION � SIGNATURE OF • �G ' � f �� n � � p � � PERMiT FEE $ - PERMITTEE �^ L �� - ' • � /� O /� �-�,� PLAN CHECK $ C � ! �./ . AUTHORIZEO AGE � � TOTAL FEE $ / � veM/ � F _ . � yh . _ . ; �-�«Z � �EE �ECEiVEO ... ,,_..;:_ ., � t�z��:� , ;' . �;�rw�t/ � Fee, ��� :�n COS7A MESA BUILDING DEFARTMENT / �^f J 319$9 ' � P. O. BOX 31] ; , . � �N lf � � FINANCE DEPT. ' ' � . COSTA MESA, CALIFORNIA, . � '� CITY OF COSTA •MESA � � FOR APPLICANT TO,FILC IN APPLICATION FOR.PERMIT B"��o�"� :� aT�'� S'T �j�C. BUILDING ADDRE55 COSTA MESA, CALIFORNIA � FOR OFFICE USE ONLY . uara�� QTV . . .(,� , {J. /- AR�"�ITECT �r1.�.I � C :INEER. r� rr F� �yt•jn..� ��.� ST 2 TNO. O� ✓el�� ADDRE55 V � � ✓' '� �' N�o. C, (' ��35 COSTA MESA, CALIFORNIA L, I �� CITV LIC ^,:r�u�� < � CONTf2ACTOR C/, /S/{��� No. �,�tX/ ADDRE55 S�J-I_I� ' NO. S/J�y BV LEGAL LOT;] / o[scAiPnorv NO. IaQ BLOCK TRACT (� I A.P.NQ — Sd^ ' .. SIZE V � O.OF BLOGS. oF LOT ^��, riow orv �01 � LISE OF (1� E%ISTING O�DG. � � J IOeA�CT� ' � SETBACK LINE FROM � � /,^ �� �� ceHiee oF sreEEi SO REAR VARD � �REPAiR 1�449 RIGHT �(,.^ � LEFT ��� � L ` ' DESCRIPTION OF WORK ALTERATION ADDITION MOVING DEMOLISH' /D X�a Q ROOMS � STORIES I �v'.i_" '.— ROOF _'022�otF%E� U STnTE iNt�T iME 4BOVE IS CITY OROINPNCES � ST< TION. � SIGNATURE OF " PERMITTEE IAUTHORIZED AGENT 2 � 'ROVEA���i"'4i. � `/I�/� ( DATE .: C— -OR�R�E�TtQfVS—' � � � �.� � � � '� �� :u � . t ct�'v oF ccsTa n�es�+ L�:.:':19:1•••_ L;Gt'I. SUBJCCT TO E� C"'. h`FT. REG. BY • , i�ATE — ( pt"n� r_�-u ���� / .G-s^i�'.� '__"-��C � THIS 4PPLICATION /�NO E TO COMPLY WITM ALL G BUIIUING CONSTRUC� � � VALUATION - � 3L�� g "I PERMITFEE ��Z� PLAN CHECK $ � ` TOTAL FEE $ IeF� y9Mi,