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, 8999 - Cancel 4-23-59 ?001 $4,000.�
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UWIVCK CLA VAL Comi
JOB ADDRESS 800 West
GENERAL CONTRACTOR Mc]
AP No. LOT
ir� -cTior+s
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GAS
W pTER
ROUGH PLUMB{NG
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING PNO AIR CONDITIONING
TEMPORANY SERVICE OR POLE
UNDERGROUN� � POWER �
ROUGH WIRING
TRENCMES FORMS $TEEL REINF.
FLOOR SYSTEM
BON� BEAM n STEEL REINFORCE (-j
SHEATHING
FRAME PN� FLASXING
LATHING - IN n OUT n
PLASTER, BROwN COAT
STRUCTURAL, FINAL
HF G, VENT., REFRIG. �ND A.C., FINAL
PL. �ING, FINAL ANP GFS TEST ❑
ELECTPIC, FINAL
unit �_
BUILDING PERMI
RIPTION of WORK F.xnlns
ZONE VALUE 3 �n_,
)UP TYPE
SUBCONTRACTOR
r t ��� £3933
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 3f] COSTA MESA, CALIFORNIA
fOR APPL/CANT TO F/ll /N COMPLETELY
TYPE OR PRINT
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COSTA MESA, CALIFORNIA
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LIC. NO.
rvO.OF BL�GS.
NOW ON LOT
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DESCRIPTION OF WORK
IOR WALL ROOF
_ ING COVERING
OF B`IILDIN� AND WORK TO BEn PER'FORMED
le' �l�(.�sr� C�/
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REBY CNNOWLEDGE THAT I HAVE FlEAO TH 5 PPL CAT ON
, �� ����i�l��
FIN1A'VCN EPt.
C�TY OF COSiA. �Egq
Y
APPLICATION FOR PERMIT
BUILDING
fOR Off/CE USE ONIY
� I RECEIPT NO. I P�II��^
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�ED aT � OAT NEC .yCD �.g IB G➢.
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COSTA MESA, CALIFORNIA
BYPROV�pGyi{��� t � �DATE v
�/ - �
ZONING
�pNE NO. OF USE OF NEW
��Yl/I/ PLANS BOILDING
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APPROVED %i� !/ /I� L
LINE 6T. l� �/ ,
�- 3 �. O�,u� .
E A I P I I
I STATE TNAT THE 1BOVE IS COFRECT ANO /�GREE TO COM� THE RMOUNT SHOWN UNDEN VALUATION �5 FOP TXE
WITH qL TY OR�INANCES AND STATE LAW EGULATING PURYOSE OF ESTABLISHIN('i Il PEHMIT FEE ONLY.
LDING C ST CTION.
� VALUATION , ���
IATURE OF PERMIT FEE $
AITTEE //
� ^. � $ �oO O v PLAN CHECK $ � i0 ��
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�ORIZED AGENT � TOTAL FEE 8 � —
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� 36760 1UN —7-73cnsa,00 529� *** 1 �z.40
COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLIC TION FOR BUILDING PERMIT
For Applicant to Fill in Completely qECEI V EO V DATE R C o
D TE ISSUE
BUILDING , T� % T �� — ��
AODRESS O � �
PERM�T N
OWNER C C%i . r A.P. NO. %(. (1
Z .
ADDRESS � O� We Z� ��EI ADDRIE S 0 o L.L%• �� T� �I� �
a U CITY Q 5� NOL TRACT LOT BLOCK
ZZ
Q CONSTRUCTION EW ADD A P
O N LENDER �/
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J � BRANCH
JN OWNER � C
m� ADDRESS � VALVE /�
J a OR EN IN EF NEL. SE � C S (/' OOO
U N
Q FIRE
W Q ADORESS ZONE T PE GROUP
JO CONTRACTOR j�/ CC:�'�CN��UX �O� �� BVPROVED DATE
m Z
J � ADDRESS Z�O ��
W w TEL.,/ ZONE NO.OF USE OF'NEW
Z2 CITY C� NO. `/�� PLANS BUIIDING
H
� STATE CITY �'ARDSAPPROVED VARDSAPPROVED
y� LIC. NO. � D LIC. NO. MAIN BUILDING /�CCESSORV BUILDING
�� SIZE NO.OF BLDGS. (FROM GL STREET)
OF LOT NOW ON LOT FRONT FT. FT.
USE OF �q
E%ISTING BL�G. T �% ItI [""/ �- FT
� SIZE OF NO. OF
Z NEW BLDG. ROOMS STORIES L. SIDE FT. FT.
U EXTERIOR WPLL ROOF
COVERING COVERING REAR FT. FT.
VSE Of BUILDING AND WORK TO BE PEFFORMED DISTANCE BET. BET. MAIN &
MAIN BLOGS. ACCESS. BLDGS.�
� /-/ /C O Fi� NI� � C URP.# AP ROVEO �
~ APPROVED
y 8
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VI hereby acknowletlge Iha[ I have reatl this application antl staie �
� that tha ebove inio�mation is cOrrect antl ag�ee to comply with
� all laws regulatin8 builtlinB construction, antl I shall not amploy
F any person in violation of the workman's compensation laws of
y t�e State of Calitomia. �
zI hereby certify that I am properly licensetl as a contrector untler , Sn' FT' o
tbe Scate ot California Business and Professions Cotle, Divisicn 3, THE P.MOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, and that s e�enses ere in full forca antl attett, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
em exempt frPm [ pr isio s of he Staie of Celifornia Bueiness ¢
antlProfessions �ae iv ter9. VALUATION QC) �
PERMIT FEE 5 �
�
SiB�ature of ^� O'� m
Parmiitea � $ ^a p./�T,� PLAN CHECK $ d E
AuMoriza Apant j VVU � u
TOTAL FEE 5