The URL can be used to link to this page

Home My WebLink About412 19TH ST - Building PermitsAoO��ant to till In all svaces axcept those within neavY �ortler Iines ana sign all aoo�opriate tleclarations. CITY oF COSTA MESA CONSTRUCTION PERMIT Prolect AddrCss t"� � � � � � q ��h � } , C�� P S�` Applicant's Mail' Address Owner's Name Phoneir+�—y7-� Address �'il�� ,]G�o� �c�c'� n'1P ZC� Arch/Eng. License No. Address Contractor's Name � n P r�� iC� Q/ Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby atfi�m lhat I am IlcenSetl untler provislons ol Charte� 9(commCntlng with section 7000) ot Divizion 3 0( lhe Businesz antl Profezsions Coae, antl my Iicense Is In i WI torce antl ef(ect. License Class license No. Date Signature WORKERS' COMPENSATION OECLARATION ''vreby affirm tnat I htve a certificate of tonsent to salhinsure or a corlHicate YVorkers' �ompenvtion, Insurance, or a certified coDY fhereof (Section i0, lab. C,) _ - Policy No. � Company eCerlifietl coOY is hereby furnishetl. Certifiea copy is filetl with the city Bulltling Divizion. Date APPlicant EXEMPTION F0.0M WORKERS' COMPENSATION OECLARATION (TniSsectlon qeed not ba <omD�etetl it tne permit is for one hunaretl (E100) or less). . 1 certity [hal In tbe pe�fOrmance ot the wo�k fOr whicb thit P¢rm�t is ISSueO, t shall no[ employ any person in any man er so as to hecome subje<t to the Worket� CQ(� n5ation Lawz Of Cali(Or � '/� Date _ x—a.��.`1—Sl9nature ° I�Y^.�..,� NOTILE: If, d�ter making fbi5 Oecla�atlOn, You shoultl become Su )ec[ to Me Worker5' CorppCnsation provislon5 of [he LabOr Cotle, y0u muzt forthwitn comply wllh such prOvi5ion5 or this p<rmil shall bG tleemetl revoketl, CONSTRUCTION LENDING AGENCV I hareby altirm that lhern Is a construction Ientling agency for the pertormance of tho work for whlch thls oermit iz issuetl (Sectlon 3097 Civ. CJ I_enaer's Name Lentler's Htltlrass OWNE0. BUILDER DECLARATION I hereby atflrm that I arp axempt trom Ine COM�actor's LlcenSe law tOr Ihe �, following redson ($ettlon 7031.5 BuSineii an0 Grotesslonal COde: Any tltY or Icounty whlch requir¢5 a perTil [o Cons[ruct, alter, improve, �emoli5� or r¢palr any sVucturq, Prbr to Its IssuanCt, a150 reqWr¢Slha aDPlicant for such perml[ � iue a dnn..n eta�wmwnt IM1nt hehhe I511[e05¢d O11�5UdOt [Olh2 DfOVI5101150f R.5 by dny applicant for a oermit Subjec[s th0 applitant l0 a tivll ,lal ol npt mOre than (Ive huntlr¢tl tlollari (5500�. 1, ds owryer ot the prOPtrty Or my Omploy¢e5 wl�h wage5 as Ihalr sole tompenSaUop, wi11 tlo tne work, antl tho structuro is not intentletl or oHeretl for sale (Sac[ion 7044, Business antl Prolessional Cotle: The Contractor's License Law tlocs not apply to an owner oi a property who bulltls or Improves thoreon, anq wno aoes sucn work himsalt/herself or lhrough his or her own employeas, provitletl that su<h Improvements ara not Intentle0 or otteretl for sale. If, howover, Ihe Duiltling or improvoment is soltl wilhin one year ol com- pl¢llon, the pwner wlll hava the qur0en Oi p�oving h¢/sha tlItl not bulltl or IT- �rOva totthp purpos¢ DI SalO). 1, us owqer ol the proparty, am excluzlvely Canlracting with IitonS¢tl c00- Iractors i6 cbns(ruct tha Oroject ($ection 7044, BuSineR antl ProiCzslonz Cotle: The ContraClor's License Law tloes not apply to an owner of proPerty whp bulids or Improves tnereon, ana wno conVacts for suth orojects with a con- lractor(s uCnnsa pursuant to tne Contrattor's LlcanS@ Law). I dm awate thdt proo/ o� lheir Worker's CompensatiOn Insu�an<¢ sboWtl be provitleE to Te. ❑ 1 am Bxempl un0er Section 8. 6 P. C. tor this reason D t — — O (� I h¢r¢by c¢rtity that I nave r¢atl thls application anq state that tna above InPormdtion is correcL I aqree to Comply with all tlty antl counly ortlinance5 antl scate laws relatin9 to builtlin9 consiructlon, ana hereby autnorize repre- sentatives o tnis city to enter upon the aoove-mentionetl pro0erty for inspection r oses �+ O Signature Daia O-�FS—l17 Drivers' Llcense or 55 � ' TVPE OFCONSTRUCTION LJ NEW U ADD LJ ALTERATION lJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. t� �L ✓< <n- TVPE OF PERMIT Ll GRADING Ll FOUNDATION LJ STRUCTV RAL ❑ TENANT � EIECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 50. F7. oCCUaAr�CV_ CONSTRUCTION TYPE VALUATION $ ZONE GRADINC� CU. VDS. ACRES_ Rema�ks: Sink Preventer Irrigaiion rinking Fountains loor Drains loor Sinks as Service Outlets Kimhen Sink Lavatories P—Trap Roof Drains Reinspection Fea � 515 Boiler Duct - Under Ground Duct - StruCtural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFacL Blt. IC80 91E Heeting System & Oucting ❑0-100,000 BTU O 100,0008T1 Reinspection Fee � $15 CMF 0865-46, rC�, 30/84 White - Builtling: Canary - APPllcant; Pink - Accounting; Goltlenrotl - Assessor ShOwers Service Sink � S2W2� f,ap Sewer Connection Solar Collecrors Solar Piping Solar Tank � Swimming Pool w/Spa Urinal Water Closet ' Water Heater Water Service Aulo-Wesh Laundry Treys laua Fee Hood or Typel ❑ CanOpy Type I I ❑ Refrigeration System ❑4100.ODOBTU ❑100,000 J System F�epairlAlteration � � FireDampers ,��m_ ftegisters laue Fee ES A.P. qW S Main Building: E T Front ARear C Righ[ g Left Ping. Ref. # Planning Notes: � Automatic Washer Construction Pole Sub. ! Cooking Unit Dishwasher Dryers �Ges ❑Elec Fan F.A.U. Fixtures Device Boxes � OutIeLS S 3 FEES $ 3 �S 4t:28 E/2 /�7 Zone Accessory Building: Perking Req./Provided ELECTRICAL � Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100 amps Meter over 100 amps � Sub Panel ' Motors�61 HP�lY.�B InaSolar �9�15 HP �76�15+ Microwave Pole Light Range Garbage Disposal I I Standing Sections Generator �0�5 KW �5-15 KW Trash Compactor Fee � 315 � � luue Fee DEVEIOPMENT SERVICES REQUIREMENTS: 2oning Approved By Building Approved By r,�arr. T� FEES S 3 '- SUMMARV OF FEES BUILDING PERMIT $ SMIP $ , PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE $ PLAN CHECK . 25% $ ENERG�' P.C. $ _—ELECTRICAL $ '3S. {D GRAOING $ PLANCHECK 50% $ �G• O� �MICROFILM $ MECHANICAL 5 TOTAL FEE $ �SI. /.� PLp,N CHECK 25% $ Z O N ' 1 N G P E � M T S CONSTRUCTION AND PLANNING ^ � . � POOL & SPA APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector i..Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steei Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Fo�mS 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steet 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, O 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. EleCtriCdl-Final 15. Rough Electrical-Conduit 66. Solar System-Final i 6. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating .77. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM fINAL ' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing , 39. Water Service-Final 40. Gas Service-Final - 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation +�'� 44. Landscape Irrigation System E X P I R E D • 45. Sound Attenuation ncomp Q IlSP 46. Handicap Regulations vate �. _ Sig _-_- 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed ' . ,.. ,.., , .. ' 49. Electric Release to Edison • � 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OC PANCY � No. ate ADP��ant to fill in all soaces exeeot tnose within heavy EorAer Iines antl sign all avProo�iale eaelaretions. PERMIT NO. TRACT NO. LOT NO. UNIT NO. CI7Y OF. CqS7a MESA CONST UCTION PERMIT O A.P. � zo�a Prdject Address y 1.� �� _ � 3 � S Main Building: Accessory Building: Applicant's Ma� � �Addre s 1 . TYPE OF CONSTRUCTION rvEW .°.OD AL7ERATION � REPAIR E Front Z ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � T O Ownp's Name �'� }.�- �n ,/�^ Phone�V�-4�nj DESCRIPTION OF WORK/USE OF BLDG. � �«�� I A Rear N AddressulZ L� ��1� � Y�'/�� Arch/Eng. License No. TVPE OF PERMIT GRADING FOUNDATION STRUCTV RA� I K Right G Addr¢s5 ❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL �, $� Left R Contractor's Nam �` � Phone�µ�}'-�3 � �'OTNER Ping. Ref. # Parking Req./Provided E PRQIECT DESCqIPTION 5(l. F7. OCCUVANCY Planning Notes: n Address (melling) CON STRUCTION TVPE VALUATION $ M T City License No. ZONE GRADING CU. VOS. ACRES- g. LICENSED CONTRACTOP DECLARATION I hereby aHi�m tha[ 1 am licensetl untle� 0/oviSlons ot Cha�tG� 9(cOmmGndng Remarks: Z with seclion 7000) o( �ivision 3 ot [he Bu5ine55 antl Professions Cotle, antl my Iicense iz in tun force antl ef(ecL ELECTRICAL FEES l.icense Class License No. Date Siqnature PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW WORKERS' COMVENSATION DECLARATION ConStluction Pol¢Su6. ❑ 50+ KW I h¢reby a/iirm Ihat 1 hav¢ a certlficate of conSBnt to 5¢IT-inmre o� a.certl/itdt¢ Be� Sl�k $hOw215 - - -Vorkers' Compensation Insurancn, or a certifietl covY thereof (Section Backflow Preventer ServiceSink Cooking Unit Meter ❑up to 100 amps ), Lab. CJ Dishwasher Meter r 100 a s' Falicy No. Company Backflow Irrigation Sewer Cep BCerNfietl copy is nereby fumisned. - Dryers ❑Gas ❑EIeM�it Sub Panel CertifieU copY �s filetl with lhe city Builtling Division. Bathtub5 Sewer Connection �ate AOPlicant � Fan Motors�P1 HP �1'h-8 E%EMFTION FROM WORKERS' COMPENSATION DECLARATION Clarifier5 Solef COIICctofs (Thissection neetl not be mmD�etetl il the Oermit is tor one hunaretl (5100) or DiShvasher Solar Piping F�A�U� InaSolar 09-15 HP �1645+ iess). 1 certify that in the performance of lhe work }or which lhVs perm�t is issuetl, I shall not empioy any person in any manner so as to become subject to the Drinking Foun[ains Solar Tank Fixtures Microwave 3� Workers' Compenzation Laws of Calilornia. . Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If, after making lhis tl¢Claratlon, yoU ShoWA becoma sublect to tha Outlets Ran e ( Wo�kers' Comp¢nSation proviSiOns o� the LabO/ Code, you mu5t fOrthwith FIOOf SinkS Urinal 9 � comply with such provisions or this permit snall be tleemetl revoketl. CONSTRVCTION LENDING AGENCV GaSSerVic.e OUt12L5 ' WetefClOs2t Switche5 Sign Z I nereby aitirm ihat there IS d mnSlruction I¢nqing agency for Ih¢ performance of tno work for which tnis vermit is issuetl (Section 3097 av. C.) � Interceptors Water Heater ' Garbage Disposal Standing Sections �entler's Name Generetor �0.5 KW �5-15 KW Tresh Compactor 3� �enaer's atltlress Kitchen Sink Water Service OWNER BUILOER DECLARATION . I hereby aliirm lhat 1 am exempt from tho Con[ractor's License Law for tha LBvatories Auto�Wash following reason (Section 7031.5 Business antl Professional Cotle: Any city or county wnich requires a permit to conztruct, alter, improve, tlemolish or repalr P-Trap LeundryTreys any Structure, priOr to it5 issuant¢, dlm requi�es lhG applicant fOr such permit . � to file a si9netl statement that he/sne Is Iicenaetl pursuant to the vrovisions of Roof Drains the Con[raclor'S License Law (Chapter 9(cOmmendn9 with SactiOn 7000) Of � Division 3 ot lhe Business antl Prolessions Cotle) or that be/she is ezempt - Reinspection Fee $75 Issue Fee -$-i 'b-':;elrom anE the basis for Ihe alle9etl exemptlon. Any violation of Saclion - , . � - ' �e<� p;�1.5 by any applicant tor a permit Supject5 the appli<ant to d clvil �'�:;%dty oi not more than five nuntlretl tloliars �y500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: lYX I, as owner ot the property or my employees with wa9es as thelr sole Reinipection Fee $15 Isue Fea ' compensation, will tlo the work, antl the struclure Is not intentletl or offeretl 2oning Approved By Date tor sale (Section 7044, Business ane Grofeaslonal Cotle: The Contractor's . , MECHANICAL FEES Building Approved By '� Uate LlcenSe l.aw AoeS nOt apply ro an owner Of a property who bUiltls or Improves . , thereon, antl who Ooes such work nlmself/h¢rself or through his or ner own goile� Hood o� Typ¢ I ❑ APPlication laued By' Date I� 9—� employ¢es, provltletl that such Improvemen[5 are no[ Intentletl or otfer¢d for sale. It,.however, the buildin9 or improvement is sold within one year of com- Canopy Type II ❑ SUMMARV OF FEES pletion, the owner will have tha burtlan of Proving he/she tlitl not bulltl or Im- Duct � Und2r GrOund rove for tne purpose ot sale). BUILDING PERMIT $ SMIP $ � I, as owner oi the oroperty, am exclusively tontracting with ncensetl con- Duci -Structurol Refrigerefion Sys[em PLAN CHEC� tractorsto conscruct the pro�ect (Section 7044, Business antl Protessionz Cotle: $ � PERMIT The COntrat[or's License Law does not apply to an owner ol orooerty who Duct - Ventilating �0.700,000 BTU ' 00,000 BTU PLUMBING $ ISSUANCE $ builtls or�imoroves thereon. antl who contratts for such oroiects wlth a con- ENERG�' P.C. $' tractor(s1 Lcense pursuani m me Contracrors �icense Law). i am aware that ExhauSt System ❑ Multiple ❑ System RepairlAlter -ion � p P�+N CHECK, 25% $� prool of tneir Worker's Compensatlon insurance zhoultl be provltleC to me. � FI F� TRICAL § GRADING $ ❑ I am ezempl untler Sect4on 8. & P. C. for this reason Firepl/Fact. Blt. IC80 � Fire Dampers eCt p11� �SP bLANCHECK 50% $ MICROFILM $ —�� O e Heating System & Ducting Registers MECHANICAL $ ' � I hereby certify that 1'have reatl tnis aoPlitation antl state that the above '❑6/00,000 BTU 0100,0006T - � TOTAL FEE $ Iniormation is correct.,l a9ree to�compry wlth all city antl county ortlinances � S�Q yPNiN'CF7�CK 25% $ . antl state laws relatin9 to builtling construction, antl hereby authorize repre- ..,._ =-W- sentatives oi this ciry to enter upon [ne above-mentlonetl property for inspection pospF. ' Date �� $ignature .A�� Reinspection Fee $15 Isue Fee ' $ 3 �' p, 00023857-Qf��2j3b7 l'7l7' ).i,$J Drivers' Litense or 55 $ "' i Oe65-a6, rev. 5/ee White - Builtlin9: Canary - AO�licant; Pink - Accounting: Goltlenrotl - Assessor UHTE: 01/D?189 TIME� ll:s3 CONSTRUCTION AND PLANNING POOL 'PA APPRO'+lALS� Permit# Date Inspector AppROVALS Perrn�t# Date Inspector '1. Terteporary Electrical Service or Pole 52. Pool & Equipment Location •.. 2. Soil P.ipe-Undrgrnd. 53. Steel Reinforcement 3. �Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � i 5. �.Steel �Reinforcement 56. Rough Plumbing & Pressure Test 6: � Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �7. Footings 58. Electrical Conduit-Undrgrnd. � � . 6. Foundation � � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pi e-Undr rnd. '� � P 9 60. Backwash Lines, P-Trap, O 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 i 65. Electrical-Final 15. Rough Electrical-Conduit � 66. Solar System-Final lfi. Rough Electric Wiring 67. Fencing & Access Approval 17�. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18�. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19.. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Nydro 22. Ducts, Ventilating �1 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing � �� 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame�and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL .. 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing �� HEALTH DEPT. REQUIREMENT 31.�Plaster Brown Coat . - 79. FINAL INSPECTION 32. Electrical Power Meter-Final •� 80. FOOD CERTIFICATE ISSUED - 33. Final Electric -�• - Notes: . 34. Final Heating & Air Conditioning - - � � � 35. Final Gas Pipe-Test 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing , 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer -''� - - � _ • - t- 43. Backflow Irrigation � � � � 44. Landscape Irrigation System � ' r Int 45. Sound Attenuation ' . t 46. Handicap Regulations [ a e --. _ _ - ��g - - "� 47. FINALSTRUCTURE&BUILDWG ,� .J � . 48. Special Recjuirements Completed ij ' ' ' 49. Electric'ReleasetoEdison '.i � 50. Gas Release to Southern California Gas Co • n�. 51. CERTI FICATE OF OCCUPANCY , : . ' ' � � '' � • ,. .' ' No. Date .. � " '; � ._ Costa Mesa Bnilding Department Y .+ P. O. Bo: 3!7 COSTA MESA, CALIf-0RNIA F�R APPLICANT TO FII.I. IN nddresa �/2� ��'' �� Owner Mall Address �� . � ��i: � ..{`.- �N�.� � Tel. Q � .rJ-4'l. I'� YJJZL No. ]�(, ,� or Lie. No. City Lic. � No. %�/ l. � l %�17� Lot I On No. � Block I Tr: 7 l� Repair � � Moving Building , No. of 81ze 1(c X 1 C Room: � `erior Wall I R� ering �'�,c � C� vse of New p Bulidina '1�i. X.. _._ . " �-S�l ,X No. of Bldgs � Nowon Lot No.of t No.of Familles Rooma Rearvard 3=L- � :� I hereby acknowledge that I have mad this Applicatlon and state that the abwe is mrreM and agree to mmply wlth all City Ordinances and State I.aws regulating building rnnstructi . 3lgnatureof Permittee C�7 C . �� '—L AulhoNzed Agt ValuaUon /� p Permit Fea a/ 6 0 0 ,. � Plan Check $ $ �� Total � d v Fee � e.. ,,.. ,,,... ., e . . / APPLICATION FOR PERMIT :��714 BUILDING � FOR OFF`ICE USE ONLY Receipt No. Permtt 9 /� ��. 3 � ecei ed y Date Rec'd. Dgte Is� ui l L� I %//Y/Si Nearest Crou St. Costa Mesa, California 0� CCSTA '�� 7�tG 1)E APPROVALS Foundation Location Inspector Forms, Materfals, Under-Pinning Frame: Fire Stops, Bracina. BoISn Lath. Int. Lath. Ext Plaster. I nL � _ :, ,. _. ' J r t . Show tocatton and disFancea from ��r—',. property Iine and 6etween bulldlnpa �--1 y t � /.a tiJ ' C �% '� O V. IV r' � N i . � 0 a e - '`��..� COUNTY OF OkpNGE BUILDING DEpT. 636 No. Broadway Santa Ana� California Phonc: KI 2-6211 2. 3. Application for Building Permit AND FOR A Certificate of Use and Occupancy c� C�C � Permit No.---.�_.�-_�7 -�1--,?' Iiate___f ��3��_G7._'_""""___________________ OWNER'S NAME-------�- VASI.__---�!_'[�.��....f7'.�rPS-------------------- PHONE/JPa.4o_2---lc�y% MAILING ADDRESS-------- l�P-h.--�---1-�-`''f--------- -- ------------- -------- CITY .LO S�� --- c-=/--P.i'�--- Name .._ Address City --- .. S�a[e Lic No. (Amhitecc or Engineer) Phone Name._�QC�.._� __��ii/`%!-G?//!-._C�'___�O.�J�$' (Con[racm[) ' Address--/�-�----�-•- /..�_li�-`--�---------------------- City - -- �.�F �l/ - /�.P.. 5�------------------ $tace p Lic. No. _l�-�.'1_.�-Q-_11.�-... PhoneL�Rl.¢¢ PROPOSED USE:---__�ES-�.��.'ELI�Gr'-__---------------s�N�-�__--.- � JOB LOCATION -'�/.Z--- .�..� ---�--------------- (House No.) (�m¢ of Street) LEGAL DESCRIPTION: Loc..___�._._.,�._._.__....___.___.Block (Meces and Bounds Description—Use reserse side of form) (Town or School District) . / � ------------Tracc.--/�l�Y`�---/--- 4. CORNER LOT ( ) INTERIOR LOT (�) THROUGH LOT ( ) SLOPE OF LOT ( 5. SIZE OF BLDG.:�j_X_�.3---.AREA:___.��Z.s�.....�._._.__.SIZE OF LOT:G,2�)Cf,2.,(�AREA:.._%.7� Q._____._._... / 4�� / 6. HEIGHT OF BLDG.: _.__.___IG.._._.___..______CEILING HEIGHT:.__.___�__________________- NO. OF STORIES.____._.�_____._._ , � 7. NO. FAMIL,IES -_---__----.�-_-_-__-_---------..Size of Smallest Bedroom:.--9k_-l�__---. Size of Kitchen: ...-'�...�.-.�-T/__-_. 8. EXTERIOR WALL CONSTRUCTIOIV:____S/.t/G.cQ___________.IIVTERIOR WALL COVERING._._/_"_��S%-___.____. (Frame, Stucco, Etc.) / � ""...""" "" ' (Plasrer-Drywall,. Etc')""""""..."" ' 9. SETBACKS: Front Yard from Center Liae of Street..__.V... .�..__. -_._.._—._ .__ / � Neares Side Yard_.__.(�____._Rear Yard _____�G.�___._.Distance in Feet Between Bldqs. on Same Lot ___._�3 "'--_-..- ------- IG. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCIURES AND USE OF EACH. ,/ � y / ti 11. For (a) Footing: Width --'-----_%-T-'----_-----_--Depth in Ground.-----�1c_-__-____.Wid[h of Wall ...-(�-_-. ---___-_ Accessory Bld s. and / � '�,/ / Siinilar (b) Size of Studs:-_-�.�. .ja_-�--_._.Spacing_---_---_�So.-----------_"CC Material of Floor -yyO-U.Q�.--.-- $tructures: ' (c) Size of Floor Joists: _'-__ �L-%�..G-------------Spating -- _--._-_�� _-y_-__ "CC H (d) Size of Rafters: --.,. _Z�-�..----------------.Spacing ----'Z--�-----------_"CC 12. VALUATION OF PROPOSED WORK: Induding all labor, plu�nbing, electrical wiring, heating, Fire sprinklers, paint• ing and sewage dispcaal �---7-Gf-�ii-----------------"'-_-"'-'------ . ' li. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF 'THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUIVTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. ' Signed:.----/---/��--�f /��'-�,------ - ---------- --- --�H�✓ V ------------- /O' � � �j (Owner) v — Plans Filed:.-'------------------------------------------------------' By:.... --'--- -- —'-- --- — --- - --- --------- -- -"'- --- ---- ------------- � � � �� (Authorize Agenc) FOR DEPARTMELVTAL USE O[VLY Bldg. Pennit Plan Check To�ai - - Receipt No. Paid to Dace -_-------... DA 9M-9-90 FEES: - �---/�-�-- - - �-------� �--� - - - � ---a-i-�- �=�0--_- G GROUP - ---- - �----- .. TYPE -------- �----------- DIST. MAP ------�------ ------ SHEET [VO._---_� -__---- r�C NG BY APPLICATIO ______.. HEALTH._..._..._____...___.... .- FIRE ZONING.------- - MARSHAL.--------------------- PLANS AND SPEC'5.----- ---� ----- ------ STATE ---- CORRECTIO[VS ENGINEER V ERIFIED.--� -- - --- --.. CAL. ---.. --- r� PERMIT ISSUED BY: .- ' (` t'1 �'^-,!}' f' i�: courarv 6UILDING .________ _�L._L..___._:.l_________ -_____'.i=E.:-�` �TE1R- oePurv C 1?i� COUNTY OF ORANG& BUILDING DEPT. 636 No. Bcoadway Santa Ana� California Phone: KI 2-6211 Application for Building Permit AND FOR A Certificate of Use and Occupancy Permit No._--�-�-�1._S-.f�-_ Date -- --/O- -..7.-- ��'-'�-"_'---- ----------- L OWNER'S [VAME----------`.Olf_S�__//L'Q�1�1F---�7_�re-S---------------------------- PHONE:llPsttO!l.--�OeZY% MAILING ADDRESS.-----�� - -E'----�-�-�'- - �t - --- - - ---- .....--- -- CITY ..L.OFS/G� �eS4._--- Name Address c��y ----- - State L;a No. __. (Architec[ or Engineer) Phone Name--�PO. _-� ---/`�DI•SZP/-l7--�---�0-l�..S- // (Contractor) Address _.l(O(�......�-_-_f -?--r�-------------"---'----------"_- c��Y -- -- �Jf4-- --�PS�_ - -- -------------------------- $tate D �Q4 Co Lic. IVo. 1�,9-z.1.�.----�`�_-�-.-- Phone.-----'----'--�--(''�.�9. PROPOSED USE: -_-._.G�i4L�.�.li.�..--_-1-!'.�� 2. JOB LOCATIOIV -- ---.7�./.Y-- �-- - �----��---�--'---- ----------- -- -------�OS -T-� — -�%ES.i#---------------- (House No.) (Name oE Street) (Town or School Disaict) . / i. LEGAL DESCRIPTION: Lot -------�- --------------Block -------..-�._...---,---_...---..Tracc ----�.Z.B�`'------------------ ------- --- - (Meces and Bounda Descriptim—Use reserse side of form)� 4. CORNER LQT ( ) IIVTERIOR LOT ( V ) THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLbG.: ._�p._ x_�-0-- AREA:___�.�-0---------..-.SIZE OF LOT:...�224._/.Z J_..AREA: _ 27�_._..._..._. 6. HEIGHT OF BLDG.:...__._.___%�_�__._____.CEILING HEIGHT:____.______.._.___._____......___LVO. OF STORIES._____�.._.___..._.. 7. NO. FAMILIES ........................___r__...____Size of Smallest Bedroom: _____.__.___.____....._. Size of Kitchen: . _.______ S. EXTERIOR WALL CONSTRUCTION:___..S�uGtp_..._____INTERIOR WALL COVERING ______v.....___________________ (Frame, Stucco, Etc.) � (Plas�er�Drywall, Ecc-) 9. SETBACKS: Front Yard from Center Li:te of Street__....___________��__�c____ __.________________________________ � � '/ / Nearest Side Yard _____.�___.__. __ ' g 7`.�..___._. _Rear Yar3____.__3______._.Distance m Feet Between Bld s. on Same Lot ___ ._. IG. A COMPLETE PLOT PLAIV IS REQUIRED, SHOWING ALL STRUCTURES AIVD USE OF EACH. '/ , � / y 11. For (a) Footing: Widch ----_---- �ry�..-_'_.--_---. Dep[h in Ground_---.�.z.......-_------- Width of Wall _-(0-------_--__..... Accessory - Bldgs. and � y_ _"CC Material of Floor __ Similar (b) S�ze of Studs: _--.z..---- � .Spating_---_.__�- _----.- CP-t✓C...,... $tructuces: (t) Sizc of Floor Joists:._ "CC ' / 7 (d) Size of Rafters: -------.�._X..�--'-----------Spacing ----�-y-.------------_"CC 12. VALUATION OF PROPOSED WORK: Including all laboq p�umbing, electrita� wiring, heating, fite sprink�ers, paint- ing and sewage disposal $.._.`J./:L-Q-_�� ' �� - 13. I HEREBY CERTIFY THAT TO THE,BEST OF MY KNOWLEDGE AND BELIEF• THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COU[VTY OF ORANGE AND THE STATE OF. CALIFORIVIA APPLICABLE THERETO. Signed:.-'- -'____`_-'--['�:'�s��:�-4tsv --�� - � .---'--" .._ wner) Ylans Filed:.__, -- - -----_.--- - By� - --- - .---- -- --- --- -- --- ------- -- --- --.....--- --------- Auchorized gent) FOR DEPARTMENTAL USE ONLY Bldg. Per�nit Plan Check Total - - Receip[ No. Paid to Date --- _-_---- f�7•1 SN-9-50 FEES: - $ ------�� --- - �-------�.a---- GROUP---- -�....-- — TYPE ------ �._---- -- -- DIST. MAP------- ---- - -------- -- --- SHEET [VO.___..�....__ CHE K G BY APPLICATION � ..._ HEALTH.__..___._._____._..__... FIRE ZONING --_.------ - ---- MARSHAL.-----------.---._-- PLANS A[VD SPEC'S-- ----- - -----------.. STATE -- -------- ---------- -- - CORRECTIO[VS ENGINEER VERIFIED_----.....--------- CAL..---- ---- PERMIT ISSUED BY: 1! n''^ I' �- COUNTY BUILDING �. F ; . � .. ..: - =1--------IPgJP�CTOR __ DEPUTY Ly�.�/