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HomeMy WebLinkAbout253 19TH ST - Building Permits rn Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 11926 12/ I Err,- r • 7. , Ti CONSTRUCTION PERMIT . - • Irn" IOCCDCO LI • . b ra 5 �'s /9 h; TYPE OF CONSTRUCTION U NEW ADD ❑ ALTERATION U REPAIR Project Address AA Applicant's Mailin Address Cry) - JA_rate ED CONVERSION 1111 DEMOLISH 0 OTHER A,P,# Zone Owners NameAl_ �L/c• • • Phone DESCRIPTION OF WORK I ISTD OAF , r - 74._. F S Main Building: - Accessory Building: Z Address TYPE OF PERMIT U GRADING FOUNDATION' U STRUCTURAL E Front . 0 N Arch/Eng. License No. 111 TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL BA Rear . - I Address 0 OTHER ' - , • N C Right G Contractor's Name CAL./Fd2U/64 w&T +Phone 957- 51 PROJECT DESCRIPTION SO. FT. - OCCUPANCY K - . Address(mailing) 2-2-80SI /�atn ��� CONST RUCTION TYPE • VALUATION$ $ Left • - R City License No. "111 l! / Ping. Ref. # Park:Fees ' gI/151 ZONE GRADING CU.YDS. ACRES $ O LICENSED CONTRACTOR DECLARATION Remarks: i Parking Req./Provided Thereby affirm that I.am licensed under provisions of Charter 9 (commencingR Iwith section 7000) of Division 3 of the Business and Professions Code, and - • Use of Building: _ 1 _ E my license Is in full force and effect. • s License CI s lcense o. PLUMBING FEES Planning Notes: I • M `ate Signature _ ��- _ • • ilikW :aN ORKERS'COMPENSATION DECLARATION E Bar Sink Showers T I hereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink • S of Workers' Compensation Insurance, or a certified copy thereof (Section - , 3800, Lab. C.) � . Backflow Irrigation Sewer Cap ELECTRICAL FEES z Policy No. 7/-r4/47-07--- Company -c Of COO • Si --- -- _ .q.�Certifled copy is hereby furnished. • Bathtubs _ Sewer Connection Automatic Washer Transformer 0 15-50 KW • ertifi co y is tiled with the city Bul 10g ivision. / 0 50+KW Date 17 //t�4 S Applicant J���/s^'t 4 -+ ' - Clarifiers Solar Collectors Construction;Pole Sub. , EXEMPTION FROM WORKERS'COMPENSATION OECL•RATION Dishwasher Solar Piping Cooking Unity Meter ❑up to 100 imps - - (This section need not be completed if the permit is for one hundred($100)or less). DrinkingFountains - I certify that In the performance of the work for which this permit is issued I Solar Tank Dishwasher 4 Meter Cover 100 amps shall not employ any person In any manner so as to become subject to the - • Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas DElectric Sub Panel • • Date Signature • NOTICE: If,after making this declaration,you should become subject to the - Floor Sinks - - - - Urinal ' _ - ' Fan _ - - Motors❑0.1,HP ❑1 X-8 Workers' Compensation provisions of'the Labor Code, you must forthwith . comply with such provisions or this 'permit•shall be deemed revoked. Gas Service OutletsWater Closet - F.A:U. - Inc.Solan❑9-15 HP 016-15+ CONSTRUCTION LENDING-AGENCY - ` , . I hereby affirm that there Is a'construction lending agency for the performance Interceptors' • • Water Heater ' • • Fi%tures ' 'Microwave of the work for which this permit is Issued (Section• 3097 Civ. C.) Lender's Name- - - - Kitchen Sink , ,Water Service ' . , • Device Boxes ' Pole Light Lender's Address - I OWNER BUILDER DECLARATION • ' Lavatories .. Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Ora . following reason (Section 7031.5 Business and Professional Code:'Any city or p - Switches • Sign •county which requires a permit to construct,alter improve,demolish or repair . - 'my structure, prior to Its issuance, also requires the applicant for such permit •Roof Drains - i ' • • Garbage Disposal Standing Sections • : file a signed statement that he/she is licensed pursuant to the provisions of , - ' - ,e Contractor's License Law(Chapter 9(commencing with'Section 7000) of - - Jivision 3 of the Business and Professions Code) or that he/she is exempt - ' ' , Generator ❑0-5 KW❑5-15 KW Trash Compactor , , 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 Reinspection Fee - I $25. - Issue Fee • $ 3 •' enalty of not more than five hundred dollars($500). U I, as'owner of the property or my'employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee' $'3 compensation, will do the work,and the structure Is not intended or offered . . .I FEES for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an.owner of a property who builds or Improves Hood or Type 1 ❑ thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate employees, provided that such improvements are not intended or offered for e• Canopy Type II ❑ I sale. If, however, the building or Improvement is sold within one year of com- - - Application Approved By - Date • pletion, the owner will have the burden of proving he/she did not build or Im- - I rove for the purpose of sale). a Refrigeration System Application Issued By • Date , I, as owner of the property,am exclusively contracting with licensed con- a 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who , BUI LDING PERMIT $ SMIP $ builds or Improves thereon, and who contracts for such projects with a con- ■ e ■ System Repair/Alteration - tractor(s) license pursuant to the Contractor's License Law). COs PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason :e a• w i $ ISSUANCE $ PLUMBING Date Owner Ducting "PLAN CHECK $ ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above ■0-100,000 ■ •s •ss s , GRADING $ information Is correct. I agree to comply with all city a.• ,ounty ordinances '.ELECTRICAL $ and state laws relating to building constru •n,and h:reb authorize repro- . MICROFILM $ " sentatives of this :tenter up,;/, t • a•-ve- - do ed prop rty for ,PLAN CHECK $ Signature s � /S 2 /` .MECHANICAL ' $ 1 at TOTAL FEE .. $ '7. Signature �J / -� •ata Drivers' License or$5 Be -- $25 ReinsIssue Fee PLAN CHECK : $ .- - .. CMF 0865-46 rev.'7/83 White--Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - ._ ' - ' - • • . . . . CONSTRUCTION AND PL NIN Pt . &SPA APPROVALS Permit# 0 6 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole . - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. . , - 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding . 5. Steel Reinforcement . . 56. .Rough Plumbing & Pressure Test ' 6. Electrical UFER 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, 0 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 ' - 1-8. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . 1,8. 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 PREY. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 1. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ,� ....i......i.... 33. Final Electric Notes: , dtLf&✓ ex - Ae/-7 7 n.rd •.?/1v/n.%4r 34. Final Heating & Air Conditioning ,/ No-1- HOME LC-¢T ty1#40 ] i2. 20's CC' 35. Final Ga's Pipe-Test .1( /' /'r 2t1/i, 4P£ 36. Hood or Canopy - - /J��/J�4! 37. Final Factory Fireplace /q�� /��le : t � 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. -Landscape Irrigation System ' ' - ' 45. Sound Attenuation ' ' • 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements,Completed ' 49. Electric-Release to Edison . • - - --• . 50. Gas Release to Southern California Gas Co ', ' - 51. CERTIFICATE OF OCCUPANCY - I - No. - Date • - _ Applicant to fill In all spaces except those within heavy border lines and sign all aPPrtl Crlate declarations. 9.1- OF GOSTA MESA .''�tTE UATION PERMIT P `MIT S. 00 . * TRA T NO. LOTIN.. UNIT NO.• A P # �f 7/ I / d 9 ` �G Zone •Kl Pr ?Ail'dress ` S Main Building: Accessory Building: 4.,..-7, ` ` • • OF CONSTRUCTION III NEW ADD C ALTERAION N REPAIR CONVlicant's MailiTng Addre- -. . 4r 1, K,r• ERSION ❑ DEMOLISH ❑ OTHER FXV -37- S�� ' T Front • 4 ' O O nets Name �`9s/YEP.� P,Pfvps Phone 7�a afa0 B //1y4� P DES RI T NOF WOR US- O BLDG. Rear / rK•` N /Address�rlUOBRMG.73 GIQI/Pg 40100 ALV! S* 940/Nd 946 • Alec./ ( '.• /L •✓ ' mac A ^ t J'�lyy d I Arch/Eng.,' License No. TYPE OF PERMIT MI GRADING . FOUNDATION . STRUCTURAL C • Right r/ C Attt 4t) G ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I $ . Left �I�II a 'NA ,a R Address -7 `! Contractor's Name OCO/�-���--•J Phone/24'T 2A1 ❑ 'OTHER x I Ping. Ref.# Parkin Rep./Provided E PROJECT DESCRIPTION SQ. FT. OCCUPANCY /C `I Address(mailing) T . I Planning Notes: /�Q Lh 4 t i M CONSTRUCTION TYPE / VALUATION$gC / P YP City License No. ZONE GRADING CU.-VOS. ACRE T LICENSED CONTRACTOR DECLARATION 4', en tat TT j( S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing'- Remarks: �G ���0'O s �,C�•e+.�,-'�1 1 057 3o — with section 7000) of Division 3 of the Business and Professions Code, and D L ( ELECTRICAL my license is in full force and effect. t� S"- 4--N 89 FEES Date_ Signature License Class License No. PLUMBING FEES / Automatic Washer Transformer 0 15.50 KW 3 ©O 'RKE@RS'COMPENSATION DECLARATION ) Construction Pole Sub. 0 50+ KW rebjl affirm that ( have a certificate of consent to self-insure or a certificate Bar Sink / Showers2 _ Workers' Compensation Insurance, or a certified copy thereof (Section / Cooking Unit Meter ❑uto 100 amps 3800, Lab. C.) < , Backflow Preventer Service Sink , • p 3 90 Y company _ ` - 9 Sewer Cap - - - -� Dishwasher' / Meter Dover 100 amps 2! Sp Folic No. Com an Backflow Irrigation • Codified copy,is hereby furnished. ^ L'- Dryers as lec[ric Certified copy is filed with the city Building Division. ' al' Bathtubs - w Sewer Connection T - Sub Panel 3 09 Date_ Applicant - ` 1. - • :I . Fan Motors❑01 HP ❑7'h 8 6 gFf EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • (This section need not be Completed if.the permit is for one hundred ($100)or • rr F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ less) /i Dishwasher Solar Piping _ •, -'j 'I u `e) I certify that in'the performance of the work for which thi permit Is issued •I - ♦ I .f j' Fixtures./-'. Microwave //� •7 shall hot a toypp ny person in any m so as to b o e subject to a prinking Fountains Solar Tank - r • _r� _ ( 7 •1 S DateWors�sPer�s Laws af Calif nia.- . . Device Boxes Pole Date E`% e Signature Floor Drains Swimming Pool w/Spa i' Light NOTIC If,after making this declaration ou should become subject to the 9 Outlets Range ZJ' Workers' Compensation provisions of th Labor Code, you must forthwith Floor Sinks Urinal zo comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY / Gas Service Outlets Water Closet / - ?r4 SWitche's J . Sign f� , I hereby affirm that there is a construction lending agency for the performance [� - of the work for which thispermit is issued (Section 3097 Civ. C.) Garbage Disposal • - StandingSections - .7 Lender's Name Interceptors Water Heater 2 — _ V 00 Lender's Address /(JO/l1fr / Kitchen Sink Water Service L Generator'❑t)-5 KW'05-15 KW Trash Compactor • ; OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories / Auto-Wash 6 - - following reason (Section 7031.5 Business and Professional Code: Any city or - ." - , • —�, - county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays r - , any structure, prior to its issuance, also requires the applicant for such permit .. file a signed statement that he/she Is licensed pursuant to the provisions of Root Drainsr oo Contractor's License Law(Chapter 9 (commencing with Section 7000)of - • /r.IDt` ision 3 of the Business and Professions Code) or that he/she is exempt .refrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee ! $15 Issue Fee $ 2- 7031.5 by any applicant for a permit subjects the applicant to a civil - • enalty of not more than five hundred dollars($500). I • DEVELOPMENT SERVICES REOUI EM N ',1,p� /� ///••• U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By_ - or j ,w6K - ( . I. �-( • compensation, will do the work,and the structure is not intended or offered _ _ Date / for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES' Building Approved By l License Law does not apply to an owner of a property who builds or improves n Date thereon, and who does such work himself/herself or through his or her own • Applicatioh•lssued By I ' Datab° employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 : • j ' 1�/7�./�s, _a SUM ARV OF FEES pletibn, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground '/'•� pr ve for the purpose of sale). BUIf_D ING PERMIT $ t- SMIP $ as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK [�•J � ractors to construct the project (Section 7044,Business and Professions Code: S J PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0100,000 BTU ❑100,000 BTU er _ PLUMBING $ 27. ©o ISSUANCE $ builds or Improves thereon, and who contracts for such oroiects with a con- . • tractor(s) license pursuant to the Contractor's License Law). I am aware that GRADING $Exhaust System ❑ Multiple 0 System Repair/Alteration I - • PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. /] '.ELECTRICAL ❑.I am exe pt under Section B. .C.for this reason Firepl/Fact.Blt. ICBG#/41/ Fire Dampers 41 $ tie• eVt••• MICROFILM $ PLAN CHECK 50% $ j, Date Owner Heating System& Ducting Registers MECHANICAL $ '•t Z. I hereby certi y that I have read th' pplication and state that the above / 00-100,000 BTU 0100,000 BTL 6 OD TOTAL FEE $ information is correct. I agree to com y with all city and county ordinances / ,PLAN CHECK 25% $ -. 7483.) and state laws relating to building construction, and hereby authorize repre- sentatives of this city to ter, upon the above-mentioned pro e ty for • , Inspection PurpQSr)S. A/J • 1 y ignature / /-%�/ �� jY�• / ate Reinspection Fee $15 Issue Fee $.��. . - - 01 JQa�+1�40-'•' '2S:�i' 7?+ rivers' Licen or SS - r� •;♦ -• • L: ILS 9�1 u5, .o ( ,: ...• h- 0a65-46,rev, 5/88 White - Building; Canary -Applicant: Pink -Accounting; Goldenrod - Assessor ' • . . . aC0 STRUCTION AND PLANNING PC 1 SPA X ,X ' • Date Inspector - • Date Inspector ROVALS Permit•# • q• APPROVALS Permit# 41 • 44,.. .. 'L1 pTemporary-Electrical Service or Pole �, 52. Pool & Equipment Location ` • 2. Soil`Ptipa'•-Undrgrnd. /6_34t( La,- 53. Steel Reinforcement (• / ;.I : 3fEIecU } Conduit Utility-Undrgrnd. cr 54. Forms 44,, rir ya el Ae I Conduit-Undrgrnd. 55. REMcgh Pl Bonding ■� .1 +t,5. Steel;Reinforcement 56. RIN . ough Plumbing & Pressure Test 6.:Ele'ctficn UFER Grnd. • " ' 7 /ry, 57. APPROVAL TO COVER-GUNITE4:2. /1` -5..-n- 1 C7r f 7. Footings, J q •' Id. 58. Electrical Conduit-Undrgrnd. . Li/ 84•;...F nda ion " V 59. Gas Pipe, 0 Undrgrnd.,Test XX �0 s, 9. �atei:ei�pe-Undrgrnd. • • 4 60. Backwash Lines, P-Trap, O Undrgrnd. !t A 10. Structural Floor System, /13 if .1, 1 61. APPROVAL TO DECK /e' i0 11. Pcoperty+Sewer Line & House Connection go-45-414 i ( 62. Backwash & Receptor-Final ' r 12. Se Gap _ - . 6 63. Heater & Vent-Final • tj, di nt 13. RoofA Gins ' . . "" - 64. Plumbing System - Final ' * en • 14. F3o M l umbingo Sec teams We:1M 149 65. Electrical-Final , . ' . 15. Rough Electrical-Conduit ( 0 �• 66; Solar System-Final t16�� RoughElectric Wiring ' 'I b I I ,"Y ' C �-- /�Rq /� 67. Fencing & Access Approval .1,7..Rough,Wiring Sign .' \ ' ' 68. APPROVED FOR PLASTERING x 18? Fiough- ctrical-T Bar CeiiTn'g.. 69. POOL/SPA SYSTEMS.FINAL t 19! Rough Heating& Air Conditioning Is �� j FIRE DEPT. REQUIREMENT 201. Rough Factory Fireplace 1'd_ t ` • • \ APPROVALS Permit# . 121. Ducts, Ir�.Structure . .k ''t.i, - • . . • 70. Underground Hydro ....•-• ' - • 22. Ducts, il Ventatin � 9 �� � �t 71. Product Piping 0Gas 0Oil {2 i(Gas Pipe=Rough& truest � 721 Underyrpund Flush . • 24: Roof Framing r 73. Undergrnd.Storage Tank ?Gas DOH , �Y� 25./Roof Sheathing ' �U4 _ t 74. Overhead Hydro / 26. T-Bar Cling (Siiuctural)f8)AMo4ocoat 75. Dry Chemical / . - . , • -27-. Frame,and Flashi g - at ft b �` ei, 76. Dry Standpipe 287 Laihing7& Siding A . - 77. FIXED SYSTEM FINAL 1 ' 29. Insulation " ' 0.1'9 �/ lr�.� ,/ �� 78. FIRE PREV. FINAL 30. Drywall Nailing 1 r,y 0 , 02 HEALTH DEPT. REQUIREMENT 31. Plater Brown Coat if,. I'o 79. FINAL INSPECTION 32. Ele'etricel Power Me e Final d` A // ZZ 0 4,0 86)(1O2D•OERTIFICATE ISSUED 33:'Final,Electric ° �'t0 Notes: ,/d0/y 91 W' • e e : � �. 0 . ,i / 34. Final Heating & Air Conditioning, �r i 0 t- ,1=7,2'7 + r /�y-��y-€ fi jl doll! 35. Final Gas Pipe-Test IO/ ° U"- Ci 01- OD �� ,I ! �rig Ogg- . L@. Hood or Canopy ' -• • 0 {{ ' 1.37. Fina(Factory Fireplace -' ( ef) _ r! kd Ill!/s/5:579 5y/G. CC..DS. .eendorF. ?38. Final Plumbing l f2gti L !O_Ze,--yer • 139. Water.Service--Final. U 'C / l')3i6 to • F %' - 4.Q. Gas Service-F.-incl�'7V O I • . n ; 41. Solar Domestic-Final // / (�Q 42. Backflow PreventerC' • / 1 • • ' r/' i• i 1 t __ �•isU6LLS+ 43. Backflow Irrigation ' - 44. LandscapetrigationcSystem - F 1, 45. Sound Attenuation=l. /1-, n//✓^/ V 46. Handicap Regulations g�1 I d �. _roJ/ f3-/C- 47. -(C �L 47. FINALSTRUCTURE & BUILDING y /f Fair ,((r / "'.; r.•`/�(Qe I 48. Special Requirements Completed i(��'� J,� ✓ [^ ' 49. Electric Release to Edison - I / 4 "� 4, I 1_ t- Q. Gas Release to Southern California Gas Co 1 1 - - TJ. ...' •"'1 ,L 51. CERTIFICATE OF OCCUPANCY1 t_• .-• "> ' ;� 'V' r.:;" No. • Date .. t , 1t IIP 1 Y_•i ' r` y y r - . '. $0257 . c_ r ti v-. _-• q-zG-Sc( vk_51._ COSTA MESA BUILDING-SAFETY DEPARTMENT \ 1 CE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA E�NIV IP. ';I1 is "USIA MESE FOR APPLICANT TO F/LL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING y,�^ CALIFORNIAr421...... BUILADDRDIENGSS -/ �j / /j COSTA MESA.F ` LIFORN /� FOR OFFICE USE ONLY I L. Le � I RECEIPT NO. IA Y�P�I 7 OWNER 1 )MAIL � 4e 1[yJ�M/,l^J1 ADDRESS ' y-6/� 3 1/i�- / / , L[�, )��j RECEIVED BY DATEiE�CEI VEO / pAiE ISSUED S/, �' CITY Ccs / T t`I esp4, TNO.FAitei ADDEI•/SSG c 5 ,Ir3/ E' /7 " A�w_/b ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIG r .^ ADDRESS FIRE ZONE TYPE GROUP / �� )) ``/1)// STATE APPROVED / CONTRACTOR e CLe1� LIC.NO. BY DATE I ADDRESS /// ZONING LEGAL I LOT }=99 ZONE PO.OF USE OFDI NEW DESCRIPTION! NO. ,//�� BLOCK TRJlC.1- I PLAnNS /� BUILDING✓/` - A.P.NO. // 7- p� /.-�" a / BYPROV tV� iC/ , DATE J SOF LOT 5�,i�/ I I57 C• 5 1NO.OF NOW/SON LOT .2_.2_ YARDS REQUIRED V OWED USE OFEXISTING BLDG, pc S• '' a-A /`46—E. FRONT LINE(CENTER ST.) 7 FT. . IN. SETBACK LINE FROM /' //..-'A / CENTER OF STREET /La 3 REAR YARD � "' R.SIDE • - /FT. ‘IN. J SIDE YARD LEFT S / IRIGHT at ,/$.' L.SIDE c . ' SFT. IN. DESCRIPTION OF WORK 111 REAR 1 D FT. IN. NEW 1 ALTERATION I [ADDITION I REPAIR I II MOVING 1 I DEMOLISH S ZIE DING/. LN+i ROOMS / STORIES EXTERIOR WAL I !_ ROOF ��' / COVERING - I LL' COVERING CC VSE OF B(-INC AND WORATO, PERFORMED ' ,T! t? ?-^ f/ LL-• 3 O cf ./.../ CO ,�• ,s-70 ,_7 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CI Y ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONST UCTION. VALUATION 4-.-0 SIGNATURE OF ,C.LL, n� 1 (400- PERMIT FEE S • . PERMITTEE K- dJl $ 2 7949'19 PLAN CHECK S AUTHORIZED AGENT TOTAL FEE $ ‘• el-0 EE RECEIVED 17416 JUN 2 6 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT- FINANCE DEPT: P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUIBUILDING ADDRESS 253 East 19th Street COSTA MESA. CALIFORNIA For Office Use Only RECEI Pi NO. I PERMIT NO. OWNER Jeanette McKeown 17,416 MAIL RECEI�D BY DA RE EI ED DAT ISSUED ADDRESS 253 East 19th Street T ,4 . I Ll--6�- h ,z4-.ti)/ CITY Costa Mesa NO �'#9 BUILDING (y CJ �, ADDRESS �-�� (n � 7 Yom/ ARCHITECT TEL. OR ENGINEER NO. COSTA MESA. CALIFORNIA " ADDRESS _ FIRE / E LT,YPE GR/O/UP P CONTRACTOR ��'``,�OWller C21 di'" APPROVED �% /,_/ y DATEy42 ZC/ . Z ADDRESS _x/Me Y�S-ZONING 1 I (1 ZOfff E NO.OF UBE OF NEW - j C..- CITY [J_ I /II PLANE /�/ BUILDING ./LI' (�'/// LIC.STATNO. �Ltr NO.p DEEBCRIPT1oN(_Ot ( `i of 1/ r dc F 11 SIZE OF LOT 50 X iasl �L3�i O�1 I NOW oN OTB 3 A.P.NO. /I / I Y' k / USE OFhome YARDS EVES EXISTING BLDG /�7� APPROVED ALLOWED • SETBACK LINE FROM abt fyLJ tQ existing (CENTER LINE ET.I /f -yl , CENTER OF STREET a .L J.n REAR YARD FRONT St. f a FT.I,; - .T IN. SIDE YARD I LEFT 14 I RIGHT 25 R.SIDE O /ll IrFT. IN. DESCRIPTION OF WORK I 0 ' - L / L.SIDER I FT.L.�---C `7" IN. NEW I II ALTERATION I II ADDITION IX REAR /p FT. �AJI,�-"j� '/ IN. ' REPAIR GG I II MOVINGpI II DEMOLISH I APPROVED �/ I .I�I DATE ( - )J- 4 V BZEri�(7m 9 X 8 ROOMS 1 STORIES 1 '• 1/l /���/� ali2 EXTERIOR W2,qLL, ROOF COVERINGV, � rW $1d1fl LOVER I NG shingleQy aQ`Q /'�LD "t.`'Nanl+RaQke Pou LR wall _ '/1 G Y to form bedroom___.- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE REGULATING BUILDING CONSTRUCTION. ['-I/� VALUATION SIGNATURE O Qg/li/0 / ri r PERMIT FEE $ 11--PERM -- SIGNATURE GVVV�uufwv� 1! v�t��l/ / o $ 702a / PLAN CHECK $ 4 x AUTHORIZE AGENT E TOTAL FEE $ "�" 0