HomeMy WebLinkAbout618 18TH ST - Building PermitsG10 W 1.bTIi 59"'
IRLEY KELLL•'Y
ME
11fltM1ENGINEEN:
ROOHESS:
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PEG.NO.:
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PEflMRTEE: LEE ROOFI�IG • 1714 ) 6'42-�7223
nooxess: 1G53 SfJPERTUR
' CM CA� 9262.7
LICFpSEO CONiMCTOP �ECIAMTION: I hereEy atlirm that I am IicenseE under proWslons oi Ctupter 9(wmmencinq xitA Sectlan
7p00) of Orvwon 3 oi the Business an0 Professions CaUe, ane my licenu a in lull force an0 etlect. ' �
imuc.:028751 sr�rzuc.:3496R6 u� C-39
'��e: SipnaWre:
IXEHS' COMPENSIITIOq OECIAMTIOX: I �ereby alfirm Ihat I luve a cetlific�te al conunt to ulHnsur¢ or a cetlilWte oi Warkers'
.npensation Insurance or a�certifietl copy thereai (Section 3800, LaD. C).
Iroucrxo.: 40U�162894 E%P.D17E: OE)�'jO/9O1
COMP�NY: LI S rIUELITY
❑ Certifie0 copy is hereby tum¢he0. � CeN(eJ copy is fileU wi[h the ciry BuilOinp Oivislon. i
�ate: ApDticant: -
IXEMPTION FlIOM WONItEH3' �pMPENSATION OECIAMTION: (T�¢ Seclim nee0 noi EB mmpleted'A Ihe p¢rmn is �or one hunGreO (5700) or kss�.
I ceNry that in the pedormap�e ol tAe work br which t�is permit is issue0. I shall not emD�oy any persan in any manner sa as ta Oecome ,
sublect ta t�e Workers' Campensation Laws ot Califomia. � '
Daie: ' SiqnaNre:
NOTICE: If, after makiqp Nis tleclaration, you shoul0 becama suble� to ihe WOM1ers' Compensation pmvisions of the La�or
CoOe, you must torthwith compry wit� such provislans ar t�is permit shall be deemetl revokeE. , �
CONSTBULTION IFNUIN6 AGENCY: I �ereEy aKrm t�at t�em is a congruction IenOinp apency tor i�e DeAormance of IAe work for
which ihis permit is issuetl (Sectlon 3097, Gv. C�. . �
LENOEH:
RDORES3: - • - . –.` ,
OWNEfl BUILUER DECIAMTION: I Aerehy atlirm t�at I am axempt Imm t�e Caniractors' State Licensa Law for tAe lollowinp reason
it t nsimct ' im rove Oamolisn or
i i i un wni n uires a' erm o co alter
(Section 7031:5 Bus neu and Pratessional Code: My c ry o co ry c req p . , P ,
rapair any structure, Driar to fts issuance, alsa requires tha applicani tor such Dermit ro.fila a si0netl statament IAat he/she Is licenutl
pursuant to t�e Orovisions oi tAe Can[ractars' State License Law (C�aD�er 9(commencing wit� Section 7000) af Divislon 3 at ihe Businau
�� Pmfessians CoEe) ar Ihat Ire/sAe ic exem0� therefrom anE tna basis tor tne allepeE exem0�ion. My tiolation at Section 7031.5 Oy
appliwnt tor a permit �hlecls fAa aDPlicant to a civil Oenalry ol not more than five hunOred dollars (5500�. . .
I, as wmer ol t4e pmDeM or my employees xit� v,a0es as tncir sale compensation, will Oo tAe work, aoE tAe
❑ structure is not IntenOeE or offeretl tar sale (Section 7044. Business anE Pmlessional CoEe: The Contractors' Stale License �aw
Eas not appty ro ap owner ol a D�OenY'� �Was or imprwes ttrereon, anE wlw'tloes such xrork himutl/�ersetl or throuph
� �is or �er own employees, proNtletl that suc� improvements are nat intenGed or oilereE for sale. Ii, �owever t�e 6uil0in0 or .
improvement is soltl witMn ane year af completlon, )he awner will have t�e Gurden of proving he/she altl nat buIIE or ImDrove
br the puryase of �le�. .
I, as owner ol ihe p�operry, am evclusively conlractin0 w��� IicenseA contractors to constmct the prole�t (Section 7044, Business
❑ and Prufessions CoOe: The Cantactors' State Lianse Law tloes not apDN �o an awner ol prope�1y wtw huJ0.s or improves Nereon
an0 who contrac(s for suc� pmjects vn(h a comractaqs) lipense pursuant to tAe Cantractors' State License law�. I am aware
ttut prool of thelr Worker's Compensa�on insurance sAau10 Ee D�ohUeO ro me. -
� I am exempt untler $���on: � . B. d P. C. �
tortNs reazon:
Date: Owner:
I Co Aere6y certity that I am awara ol an0 unGerstantl the requirements oi Catifomia Healih antl Satery CoGe Sections 25505; 25533, antl
25534 anE inat I or any IN4re bWIUinO occupant wiluwlll not (circle ona) need ta camply with sai0 state cotles and t�e reQuirements for a
permit tor consiruclion or mpdificaiion Imm the Nr ualiry Manaqeinent Oistnct. He90ential consiruction aD0lications are exemD� �rom
IAese O�ovisions. . ,
Date: MD����
I �ereUy certiy tAat I Mve ha0IN5 apDb��on anA state Itwt IAe a0ove iniormation ¢ correct 1 apree to comDN �� all pry an0 counry
orEMances an0 state laws relaunp ro WBEinp camYnicGon anE here���yy...aaauu�M1ttlarim re0���� of ttns dry ro enter upon Ne aEore�mentioned
propeM �or inspection Durp�es. �]� , �j� ��
-oate:� � 2��— �`-� sipnature:� -�
Driver's Licenu or Social SecuAry N: �
18aHg Wnite--BuilEina; Graen—Cdtla Enforroment: Cenary—Apolicant; PInk—Fevanue: Gobenro0—Fssesaor
. . .' . CITY,OF COST`Fi� M6SA� -' BUIIJ?]:AIG PERMIT FERM D10: B 046634
FfiRMTT NO: B U4G634 PT,AN CHECK MO�; Pt ��GOVT: 'AI SUI?P; 1�1
CONSTRUCTION TYPI:: � PERMIT TYPE:�STR PURPOSE:'ALT
JOB DESCRIPTION :'TEP.R OPF / REROOF SQ FT:, 9,000 •'
. � . . - .
CLAIM �tALU£: '4,000.00 CALC-VALUE:• ; 4,000.'00 GROUP OCC: B-2.' /
COMMENTS: TEAR OFF / REROOF !d�COMP • •
if iE {E N� if �1f 3f k iE if� IE k iE iF iE K�E iE aE iE iF iE IE # iE if -%if 3E �1! K� IE 3E �E iF iE �lE ik iE iE lE lE jE �lE iF IE iE iE iE �lf aE iE iE aE �)E lf iE iF 1E iE �IE-)E �E iE if iE 9E 3f iE # iE 3E !E � N M IE K�N�
7. O N I N G R E Q U I R E M E N T S •
S� E T B A C K S, ,
�
-�----------�-- MAI�I BUILDING -------- ----•----- ACCF.SSORY BUII.DING' -�--------
FRNT: FT ' IN REAR: FT IN FRNT: • FT IN REP,R: FT • I1�1 ��
LEPT: FT IN RGHT: • . FT IN , LEFT: FT IN RGHT: P"P Std-
PARKING REQ: PROV; FARC�L:,13930220 ZNF;: RF.P NO:
YLANNING NGTES> � '
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iE iF iE iE iE dF iE iE If M�lE iE �� iE 3f # if iF �1E �1F ik iF k N iE iE iF if 3E �1f iE iE iE iE iE iE iF iE iE iE iE iE if !f 9E 1E �IF iE iE 3E iE iE i! 1f iE i! if it iE iE iE iE 3t i! iE iF lE%1E 3E iE 3E iF if N-i( jk ik iE
D E V E L O P M E tJ T S E R V I C E S R E Q U I R E M E N T. S �
ZONING APPROVEll BY ___
BUILDING APPROVED BY :
APPLICATION ISSUED BY " '
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iFiFifiEi(�iEifiE#iEiEiEMifMicjEitiEif3F3c3(�itlEifiEiEiFiEitif%1f E-k'iF
LEGALLZATIODI:TI F E'E S U M
. • �-
•BI,DG PMT PLUMHING ELECTRIC
.�Y._ DATE: — �=--- -
DATE:
llATE d..�3 �z2 ��
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iF1E�7EjkiflfifiEiE1E1E1f1FiEiE�kiEaEiPiFlEiFitlFkX�ifiFK-fki�7EfE �
A R Y. STRUCTURP.L �SEGt4ENT:,Y
>. � .
ANTC�i PSRE SMIP/RES ' GRP.DINC,
PERMIT '63.00 ' , 50 •
. . - � r; SMIPIDION-RES
PL �
AII , , _ /
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f.S C .FEE
�U �'
HUILD"iNG-DIC'-> PERMIT� LSSUF_ 'PLFiN;CHECK± TOTAL PAID �DUE
1'OTALS----? 63.50 '� 0.00 0:00 63.5U ; 6:3.50 .QO
/"f ' I
REVENOE DIVISIODI T'OTALS--> CULLECTED: 6'3:50 OVER/SHORT: .00 '
BLDG PMT PLUMDING EI,ECTRIC MECHADIIC FIRE�.,SMIP/T01' GRAllING PLADI�-CHLCiC
. C]3'.00 ..? J. .�JO '
�.
iE it 1f iE iF iE iE �� 3F i( iE iE iE if if iF if iE iE iE iE k iE iE i( 3E if M 3E if if if 1E 3E lk IE -1E if�if !E iE iE 1E iE iF M iE if if iE iE �%if IE iE iE if k iF if if 3E iE �f �%M� iE if 3f iE i(� if i(� iE #E 3E iF df if
' I Pl L I L' ' T' D U A L' F E E B R H A K D O W Al
TYPE QTY ii E S C� R I P T I O DI �. . Ur1IT COST TOTIIL COS'f
SFR 9UOU REROOF BY VALUF. RESIDEMIA7,; �NOZONE 1.00 • �4,000.00'
„ END� OF FEES. �.;, : .
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� �, ,' O1 00056739-000`6740 Ti:lT 63.50:
:� DATE:' 03/22/90 'TIPiE: T3:43 •
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i G10 W].t3TIi ST` u�rt:
SHIRL�Y KEI,LL•'Y
SAME.
,
�RCH/ENGINEER: qE0.N0.:
, aooxess: � , - uxir:
PEflMITfEE: LEE ROOFING � ('714)6'42—�7223
ROOHESS: 1(jS3 SUPERIOR -
CM CA�92627
110EHSED WNTMCTOR DECIAMTION: I �ereGy alfirm that I am Iicen5e0 untler pmNsions ol Chapter 9(commencinp vnN Sectlon
7WI!) of �ivision 3 of ihe Businoss ane Pmhuions Cooe, anA my.11cense Is in tull force anA ettecL '
ciTr uc.: 0 2 it 7�i 1 srnTe uc.: 3 9 9'6 8 6 cuss: C— 3 9
. Siqnaiure:
oINENS' COMPENSIITION OFCIAMiION: I h¢re affirm that I �ave a ceNfcateof caisent to ulNnsure or a certiGwte ot Workers'
�ipensation Insurance or a�certilie0 copy Nereol�Senion 3800, LaC. C�.
voucrxo.:40U�162894 exr.onrz: 06/•30/90
con+raNr: iJ S P.IUE:LITY • �
❑ Certifie0 wDY is herehy tumishe0. � Cetlilled coDY is file0 with Ihe ciry BuilAinp OiNslon. ,
Date: ppvlicant: '
IXFMPfION FNOM V/OflNEAS' fAMPENSI1T10N OEGAMTION: (It� section �eA not be mmpleteC il Vre pe�mi� is for one hunOreO (5700) or kss�.
I certiry ihat in Ne peAormance of Na xrork tor w�ich ihis permit is isSueE, I shall nat employ any Derson in any manner so as to 6ecome �
su6lect to Iha WaBers' Compensation Laws oi Califomla. � � , ' .
Oate: - � SiO�atum: �
NOTICE: II, after malonp ttus Uedaration, you 5Mu10 Decame suEject ta the Wo�kers Campe�nation D«�s ol the Labor
n
COEe. you mus� fort�with comDN �+�h suc� proW9on5 or this permit shall be EeemeO mvokeE. �
CONSTRUCTION 1FN01NG RGENCY: I herehy attirm Itwt I�ere is a consWction lentlinq a0ency lor the pedormanca oi [he wod lor
which this Oermn is issuetl (Sectlon 3097, Gv. q. , �
LENUEfl: � . '
ROORES3: . . . ' . _..
OWNEP BUILOEB OECWMTION: I �ereby affirm that I am exempt iram lhe Convanors SWta Licenu Law lor the tallowinp reason
(Section 7031:5 Business antl Proleuianal Code: My ciry ot counry which requires a Dermit to construct, alier, imDrove, tlemolis�, or
reDair any stmcture. pnor ro Rs issuance, also repuires the applicant for such Dermit ro;fila a sipnetl statement I�at he/she is IicanseE
pursuant to t�e Dravisions of tha Cantractars' State License Law (Chapter 9(cammencing witA Sectian 7W0) oi Oivislon 3 ot ihe Business
� Pmlessions Code) or t�at hUshe Is exempt therelrom and Ihe Casis far t�e alleAed eremptian. My violation ol Section 7037.5 Dy
�OPu�nt lor a perm0 suhlects me aDD�icant to a civil penalry oi nol mom than five �unOretl tlolWrs (5500). ,
I, as owner oi [he propeM a� mY empI�yees with vrapes as thelr sole mmpensatlon, will Oo tM woM, ana tM
L� structure is not iniende0 ar otlereC far ule (SeCtion 767d, Business anA Pmtessional CoOe: The Cont2ctors' Slate Licensa �aw
Ooes not aDDly ro an owner ol a properry w�o builUs or imDmves �hereon, an0 who'Ooes such work �imself/Aenetl or thmup�
_ � his or her own employees, provlAeE that such impmvements ara not inten0e0 ar otteretl far�sale. Ii, however tAe huildinp or
impmvement is so10 within one year ai completian, the owner will Aava ihe burtlen of DrovinA he/sAe AIO nat DuilA or improva
.for the Duryose oi ule�. .
I, u owner ol Ihe Dropeity, am eMClusiveN wntnctin0 �� ticen5e0 conVactors ta construq t�e Droject {Sectlon 700O3 Business
❑ an0 Prulessions CoOe: TAB Contracrors' State Llanse Law Oars rot appy to an oxner oi Droperrywho Uu�lds or impraves Nerem
anE who contraMs for wc� pmjecls vnth a comrattor�s) licensa Dursuanl ro ihe Coniractars' State Licensa Law�. I am aware
Ihat prool ol t�eir Worker'S Compensation insurance s�oul0 be OrodOeA ro me.
� I am oxempi untler Sectlon: ' B. 8 P. C. � ' ' � �
for Ihis reason: � ' '
Date: Owner:
I Oo hereby certiy t�at I am awam oi an0 unCerstanE t�e requiremenis ol Califomu Health an0 Salety COEe Sections 25505: 25533, an0
25534 anG t�at I or any fuNra Guiltlin0 occuDant will/will not (circle one) neetl to comD�Y with SaIE state codes antl t�e repuiremenis for a
permit for consimction or modificatlon trom Ihe Air ualiry Management District FeSiAential consimction aOPlications are exempt Irom
Ihese Drovisions. , ,
Ddte: AppliCanl:
I �ereby certiy IAat I �ave 2ad this apDlication and stata tAai tAe aEove iniormatim is corteci. 1 apree ta compty with all dry anE counry
nNinances and strta laws reWtlnp to DuilEinp consimction antl here horize reprzunWiNes ol Ihis ciry ro enter uDon the abwe�mentionetl .
DroDe?Y �or inspection Duryoses. �j� � i}�
� -� 22-`jzj
Date: Signature:
T�'
Oriver's license or Sadal Securiry M: �
184tJ8 W�ite—BuilOino; reen—Code Enforcemenl: Canary—Acolicent: Pink—Ravanue; GolEenrotl—Asseamr
� ' , CITY,OF �COSTA' �MESF: - HUILJ)]'DIG PERMIT FERM �lq: B 046G3+1 �,
PF'RMl'T D10: D `09G634 Pi.AN�CHf'CK �D10�: N ��GOVT: 'Id SOPP: Id
CONSTRUCTION TYPL-:: � PFRMIT TYFE:�STR PURPOSE:'ALti
JOB DESCRIPTION : 'TEAR OPF / REROOF, . � . � SQ FT:,. 4,000 : ' ,
CLAIM C�ALUE: ."4,000.00 CALC-VALUE:• � 4,000.!00 GROUP OCC.: B-2r' / ��
COMMENTS: TEAR. OFF / REROOF W COMP , - -
lE9EiEif�lEif3f1F�F�fiEiEiElFiE#�ElEifif�f��9Eaf�lEfEX�lEiEiki(�IEiF3fiEffif9E#1Ejk1EiE��7FiEifikifiEif�7EiEiEif1F#iE�faEif16�1fiE�EiEiE#kif#lE�3E3E�K1f1EK�� .
7. O N I N G R E Q U I R E M,E N�T S :
� S E T D A C K S, ' i '',
--------------- MAIN 13UILDZNG --------- ---------- ACCF.SSORY HUILDING� ---------
FRNT: FT ` IN REAR: FT IN FRNT: � FT IN REAR: FT' IN;
LEFT: FT IN RGHT: • FT IN., LEET: FT IN RGHT: f"P. IN�
PARKING REQ: PROV:. FARC�L: 13930220 2NE: � RF.P NO: • .
PLANNING NOTES> • '
. �_ . . . . . . � . . _ . . ' '
iF iE iF if 1E 1E if iE 3F 3f if 3f if M iE iE if iE iE it iE iF?E N iE if iE if iE 1E 1f iE iE �1F iE jE if �E jE IE iE iF iE if fE it iE iF 1E iE iE iE iE k i! i! �)f it iE if iE iE x-�F iE jE �%� IE if iE iF iE if 1(� N ik 3F iE
D E V F. 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 APPROVEll BY' _ _ ' �___�__ DATE: =.
BUILDIAIG APPROVED BY : � DATE:
I PPPLICATION ISSUED BY ' llATEi,�3�ZZ 7�
�lf 3E iE lE if iE if iE if 3E if if iE �X� K� iF if if k iF !E iF�iE7i�7Z �X7i-TFiFiF if� if iE 1f jF iE if iE if iF 'R'�fFiF�lFii�7f�K� if.?(-
ifiEifiE�M�iEiEiE#iE%�lEftiEifdEitftit3EifiE3E3EikifiEififiFiEitK-N fiEi fiF1E�N�iF�EiFitiE3F3EiE�FiE1E3E�kiEiFiFitiFiEki6�3fiFiEkitiE��1E
LEGALIZATION:A1 F E E 'S U M.� A R Y, STRUCTURP.L 'SEGt•tEMT:,Y
.. . . . � �� . v. .
HI�DG PMT PLUMBING ELECTRIC •CHANIC�� PIRE SMIP/RES GRPJ�IDIG
PERMIT '63.00 , , 50 •
PLADI . � ' '-, SMIP%NODI-RES
ISSUG FEE � �• � �
BUILDiT1G-DIV-> PERt4ZT� ,LSSUE 'PLAN;CHECK� TOTAL PAIA DUE
7'OTAI,S----: G3.50 = 0.00 0.00 63.SU ; 63.50 .00
RF..t'ENUE UIVSS.T.ODI '1'C�TALS--> CULLECTF:ll: 63:50 OVtiR/SHORT: .00 '
BLUG PMT PLUMDING ELECTRIC MECHADIIC FiREf-5MIP/TOT GRADZNG PLAN--CHECK
63.00 ' .SO
�.
� 3FjEif�3Fif�ifiFM3Ei(iEiEikiFKififiEifiEiElFififitjfiFfEiEifffiEififlfifjEiflElEif1E3E1fifiEiEiFN�ifiE#iE�ifiEiEiE7E3E1EififlEiE#jf-iP3f3fiflh#jElfifiEi(-M?E
' 7 1J L I V; I' D U A L� E' E E . H R.,E A K P�O 1�1 rl
TYPE QTY I) E S C� R I P 1' I O�Di � UNIT COST TOTAL COS'P
SFR 400U REROOF BY VALOE RESIDEDITA7, DIOZONE 1.00 • 9,000.00
, END� OF FEES. - .
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01 OODS6734-OOQ`6740 TOT b3.50
� DATE:; D3/22/90 'TIPiE: T3:43
- . .. . _ _ _ �,'
�sta usesa Building Department APPI.ICATION FOR PEh.
\ + 111 EAST 20th STREET �q G'1-y � U I L D.� N G
\ COSTA MESA, CALIFORNIA �$v�s
!/ iH'OR APPLICANT TO FILL IN �'OR OFFICE USE ONLY
_ Receipt No. Permft N�
Add�esa � � i.Ci 0 — �—C . I � � ` '
Costa Mesa, Ci&�OPlll`d� Recelved by I Date Rec'd. Date Issm
Nearest / • � �� �'S� � �^
Cross St. (� Building
� ;� Address
o`""°'' Costa Mesa, California
Mail
Address � � Nearest
Tel./J o/ Cross St.
Cit �� �7LL� No,� � g 7Q ,{ Ir Zone . 'I No. of T e � Grou
Ar hitector Lic. _�Plans _I y�/y I P�
I I Lot
:lon N0.
Metes and
Size
Use
No.
Addition
Demolisf
� / '. 6 i _ _ F�x�i�f9r�
��
I hereby acknowledge that I have read this Application Lath. Int.
and 5tate that the above is correct and agree to comply
with all City Ordinances and State Iaws regulating Lath. Ext.
building constructlon.
Signatureo,��/J, � / � Plaster, Int.
Pern+ittee � � "`"` �i�1,o �1 A. __ _ _
Valwation Permit Fee $ � O O
q� Plan Check $ f�;� O O Bond Beam
$ /� 0 ��� Total � b d
Fee $ �.� � � FINAL
RM 204 p-M 2M 8•54
CORYtECTdONS
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COSTA
�.AR -6-55PDIiESA '%75a tr•.•�.•] 2.rQ
, ', PLOT PLAN
'. Bhow locatlon and dfstances from
proPerty Iine�and betWeen.buildings.�-. .
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COSfA MESA BUILDING-SAFETY DEPARTMEPR
P. O. BOX 1208 COSTA MESA� CALIFORNIA 92820
For App11mM fo Fill In CompPeNly
TYPE OR PRINT
AGDRH'8G - W - 8 — sr �
COSTA ME$A, CALIFORNIA
OWN6R F/Z RI. C/ S �N P
MAIL
ADDR S T
..��,. �o a Tii %1� ca _ ���-
o�c-6-�7�„Sp00 2s7 �*�**�5.00
fPLICATION FOR PERMfT
BUILDING
for Offlc� Us� Only
RtC[I►! NO. �t11MIT NO.
c�n cn wn i eu¢o
. � iz-L—G �
o j2-G-6'�j .�
TYP OROUP
CITY A. P. NO. 6"� � �^ ~C,.% ��.
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LIC. NO. N. 80' TO 8I�6 p REAfi . L
BIZE I / No.oleteo�. ALLOWBD (U.B.C.REGUIR6MHNT) �
OF LOT O NOW oN LOT
USHOP 1'ARCDMPROVED ROVBD
EXI6TIN0B �/� MAINBUILDINO ACCHSSORY UILDINO
( FROM C/L iTR6HT )
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DE3CRIPTION OP WORK LBID 3�. em.
�
NEW ALTBRATION ADDITION RBAR PT� n FT
' DIeTANC6 BQT. BhT. MAIN Q � �
�Alfl MOVIND D6MOL1 X MAIN BLD08. ACGE83. LD08
BUILDIN6 7 ,/ NO.Ow / V�•� DAT6
SIZB �( D/� ii00M6 @TORI C C. . APPNOVHD
CXTERIOR WALL ROOP /1r! [D
GOVERIN6 COV8RIN6 DATi �
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1 X�A6lY IICRNOWL[DO[ AT.I NwVI 11�I1D'Yf1�� A��LIGTON T1[ AMOYM /HOWl� t1t�C6H VALUATION l0 POR TM{ �
AND 9TATC TNAT TM[ ABOV{,�8 CORRLR AND AOp66 TO tAY. �URPoB[ O! iITAGLIGNINO A P6RMIT /6[ ONLY. �
PLY WITX �LL CITY ORDINANOft AryO �TAT6 LAW� 9[OYLATIMO yALUATION p
OU�LOIXO COHBTRYGTION. K �y �
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AVTHORIZiD AO[NI' (� O n
TOT�tI. PE6 �J ' �'
COUNTY OF ORANGE
BUII.DING DEPT.
636 No. $roadway
Santa Ma, CaG(omia
Phone: KI 2-6211
Application for Building Permit
AND FOR A
Certificate. of Use and �ccupancy
Permit No....�.�.�.�r. �,.,'J�
//-v7-s/.
` Datc.-------------- _--- -----------..... -------...-----.....---..
1. OWNER'S NAME ... � i-� -IY �.....'�'_ ���. fd...1...�R-� � Y__✓� -- PHONE:._�_.�. .�yC-�...�J:_.. �]
MAILING ADDRESS.?_�....4. �-- J.�. ���_ � Y�.-r'� - LA '.dc�- -- --... CITY--�-,.6 S�Cs...Lti1e..?.�-_ �
Name .........5. �_ d '��. - - .... Name - �1. t i I �n_- o-'�{'.. - - - i�. U..\ 1.�-A..Y
... _....._ ....- . .................. - - -
(Archirect or Engineer) � (Contracmr)
Address
C:ty ......- ....
State
Lic. No...........
z. JOB
3. LEGAL bESCRll
(Meres and Bounds
_ �� Addre=_s
7'h o n c-------... ------ ..................
r
(Namc o(
a �// i�,.l,� .1P
City _.
Stace
Lic. T'o.
Phone_-----...._
—�:1"---------------
or Schoo] Disttict)
:....------ Tract..--------�-�-�I---�------------
4. CORNER LO'I' (�/) INTERIOR LOT (9�.THROUGH LOT ( ) SLOPE OF LOT ( )
\, Z C � C r� _� /
i. SIZE OF BLDG.:.....�_._.Q ......�....�REA:._..r.-.-''---'�-...------.SIZE OF LOT:_--1�.2--ti-- --- --L-��9REA:_._�--J---bU........
�k � �+- _.� o o: r, � �
G. HEIGHT OF BLDG.:.........I.....�...�\1 �............CEILING HEIGHT:._...._� �......_NO. OF STORIES_...._I....._._........__.
7. NO. FAMILIES....------I_ .....................v---Sizc of Smallest Bedroom:.--.--_.L ��.� �.. �-._.--_ Size of Kitchen--_--�...Q.'-�.-d--------.
S. EXTERIOR WALL CONSTRUCTION:..���� �" _.......�TN?ER10R WALL COVERING..._..�..... R�,..
............ . . ......... . � ...
(Framc, Smcco, Ett.} �S O (Plastcr�Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Sveet_----,��..;-r..V�.... __.--_.__...---_--------------_.-------......._._..._-_-
Nearest Sidc Yard.._...�... V........Rear Yard...�.�.��..'.'.'...Distancc in Fect Betwecn $ldgs. on Same Lot...a�.-..$.....���.�...!..—'..._.......
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
9! r� /� / !r
ll. For (a) Footing: Width---.......�.. � ......................Depth in Ground-----�--.G-----`---.Width of Wall-'r.�-,----.._----------'
Accessory %
Bldgs. and b Siu of Sluds:........�.�.�I..S acin /v ..CC Matcrial of Floor----..--_--_-__-_-._--_.---_.....__-.
Similar � ) � P 5........-------' .
Structures: �. ,. � / /
(c) Size of Floor Joists:.....'��..�..�.� ----------------Spacing--..-._---1---t�---.-------_-..-_--' CC
� ,/ � ��
(d) Size of Rafters:...� � `�� ..- - - ..............-Spacing - -- ��. - - - ��CC
]2. VALUATION OF PR POSED WORK;i Induding all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ ........... . ..�._.... � J....Q..�.....
13. I HERE$Y CERTIFY THA�TDOOTH BEST OF MY RNOWLEDGE AND BELIEF'THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA AYPLICABLE THERETO.
r� � ,� ''%n �. f`
---...-'-'---......... Signed
Plans Filcd:----..l�.f...'..Y......�..���
Bldg. Permit
Plan Chetk
Total - -
Receipt No.
Paid ro •
Date _........_.
` / (Authorixed Agent)
FOR DEPARTMENTAL USE ONLY
FEES:
� �..D....a.D.... cxovr_._.. . .....�..........
� -......�....Ur_�... TYPE........� ...................
n $.......�..3.sO.:O.. DIST. /o
r Ur. .. . MAP.......L..l./.�— - -
�� ��'.....,..
........T1�`�=�'.P.. . SHEET NO ..... . ................
DATE......-- .._l..E ... ...i/J�
5 M-B-51
APPLICA
ZONING........-- - �-!f
PLANS AND
SPEC'S - - -- --
CORRECTIONS
V ERIFIED .................... ....
L:l'1
HEALTH -- _...----
FIRE
MARSHAL-----------.._ _. _..
STATE......_..
ENGINEER
�
V