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Home My WebLink About387 18TH ST - Building PermitsApplicant to /ill in all spaces except those within heavY bortler lines antl sign all apv�opriate aeclarations. CITY OF�COSTA.`M Spq �z _CO ST , � CTIO+�NG,P RMIT PERM N %�'( / TRACT NO. � � LOT NO. , UNIT N0. � ' ; � ' ' ' , . , ProjectAddress T.. O',./'.4 �':..':k+� 4:" �t.A�J��Ni.:.Y'�u � � / / ' . ' � . � 1 . ApplicanYs Mailinc ddt2S5 ✓ � ��/ TYPE OF CONSTRUCTION ., NEW ADD ALTERATION REPAIR ' /��/� ❑ CONVERSION ❑ DEMOLISH O OTHER /�.p.# _ _ . _ Zone Owner's Name ._Phone�(.L..l¢+(/ DESCRIPTION OF WORK/USE OF BLDG. � � Address _ ' '�� ' ' i S Main Buildin9: Accessory Building: ' Arch/Eng. � Licens¢ No. TYP.E OF'PERMIT GRADING ❑ OUNDATION STRVGTURAL � T Front' . � ' � . � Addf¢55 � � TENANT ❑ ELECTRICAL �UMBING ❑ MECHANICAL A Rear • � N � OTHER Convacror's Nam ��Phone 0 � C Right ' ' N �J PRO.IECT DESCRIPTION 5a. FT. oCCUPANCv K , . G Address Imailingl —gE Left , � 2 CONSTRUCTION�TYPE VALUATION$ $ � City Licen N `��J ZONE GRADING CU. VDS. ACRES � - � ' R LtCENSED CONTRACTOR DECLARATION Ping. Fef. # Parking Req./Provided � E I bereby afti�m that I am licensetl untler provi5ion5 of Charte� 9(commencing Remarks: ' Planning NOt25: . � � with section �000) of DiviSion 3 of the Busine55 antl Profe55ion5 Cotle, antl ' M T my license is in f}�,jlYj r e antl etiecL � � �' S License Cyass ` /��O _ Li se � _. f . . . Date—�_�� <a-�-�--�-- �� , � PLUMBING FEES WORKERS' COMPENSATION D A ATION Bar Sink � Showers - ' -� � � (j0 I nereby aftirm tnat I have a certiticate oi consent m self-insure or a certificate ELECTRICAL � , . FEES 1� Yorkers' Compensation Insurance, or a certitiea copy thereot (Section BackflowPreventer ServiceSink � - ��b QQ �1��/ y� Auromatic Washer Transformer�'�, 15-50 KW 1 r.,iicy No. ��( s��s' Company��G�C�L(��L Backflow Irrigation Sewer Cap . Construction Pole Sub. � � 50+ KW ' � p� ertifietl copy is M1ereby umishetl. \$ cer if�e-{��' Is filea with the city B in I n eathtubs Sewer Connection ' Cooking�Uni[ Meter ❑up to t00amps � - Date �� .v.—APPlicant��%��A✓ -� � � ' ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cla�ifi¢f5 . Sol2� COII¢C[O�5 Dishwasher - ' i M2Le� ❑ov¢� 1�0 drtlp5 � (TM1is se[tion neetl not b¢ completetl it the permit is for one Ituntlretl ($300) ar -.. _ . ' iess). . Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric . ,Sub Panel � . I certify that in the performance ot the work fOr which this pe�m�t i5 i55uetl, I shall not employ any person in any manner so as to become subject to the D�inking fountains Solar Tank Fan Workers' Compen5ation LawS of California. , ,MotOrS DO-1 HP 01Ya-8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar_�9-15 HP 016-75+ � NOTICE: If, atter makin9 this tleclaration, you shoultl become subject to the . Wo�kers' Compen5ation p�ovlsions ot th¢ Labo� Cotle, you must forthwith FI00� Sinks U�indl FixtU�¢5 � Mic�Ow3ve. • comply with such provision5 or this petmit shall be tleemetl rewketl. CONSTRUCTION LENDING AGENCV Ga55erviCe Outlets WatefCloSet � ' � 1 hereby affirm that there is a cons[ruction lentling agency for the pertormance DCvic¢ BOx¢5 P012 Light . ot the work for which'thls pelmit' ii i55uetl (Section 309] Civ. C.)/ Intelc¢ptOfS W3t¢! HC2t¢I �ptl¢t5 - Lentler's Name Range Lenaer's Aatlress - KitchemSink � � Water Service - Switches Sign � � '� OWNER BUILOER �ECLARATION � _ ' I hereby aftirm that I am exempt trom the Contrac[o�'S LicenSe Law for th¢ lavatories Auto-Wash Garba ¢ Di5 OSdI following reason (Section 7031.5 Business antl Professional Cotle: Any city or 9 P Standing Sections county whicn requires a permit to construct, alter, improve, tlemolish or repair P—Trap Laundr Tra s • any structure, prior to ics issuance, also requires the applicant tor such permit Y Y Generator �0-5 KW �5-15 KW Trash Compactor to file a signetl s[atement that he/she is IicenSetl pufsuant to Ihe provi5ions of ROOf DfdinS � the Contractor'S License Law (Chapter 9(tommencin9 with Section 7000) of _ _ Division 3 ot the Bu5ine5z antl Professions Cotle) or that he/she is exempt ' "�refrom antl the basis for the alle9etl exemption. Any violation o� Sec[ion 1.5 by any applicant tor a Pe�mlt Subjects the applicant to a civil ' alty ot not more than five huntlred tlollars ($500). . i� �J I, as owne� of the property or my employees with wage5 as th¢ir sole RainSpeCtiOn F¢e $15 ISsue Fee $ 3 compensation, wlll tlo the work, and the SVuc[ure is not intentletl or offeretl Reinspection Fee $15 I55ue Fee � $ 3 for sale (Section 7044, Business and Professional Cotle: Tne Contractor's MECHANICAL FEES � License Law tloes not apply to an owner of a property who builtls or imp�oves _ tM1ereon; and who tloes such work himself/herselt or through his or her own DEVELOPMENT SERVICES RE�UIREMENTS: � , employee5, providetl that such improvements are not intentletl or offeretl for BOiler �, HOOd O� Typ¢ I ❑ � ' sale. If, however, Ihe builtlin9 or improvement is soltl within one year of com- Canopy Type II ❑ Zoning Approved By Date pletion, the own¢r will have tne burtlen of proving he/5he tlitl not builtl or im- DuCt - Under Ground BUilding Approved 6y ' Dat¢ prove for the purpose of sale). _ ❑ I, as owner ot the �property, am exclusively contracting with licensetl con- Duct - Strucmral Refrigeration System Appl'caYo Issued By n Data�� tracto�s to const�uct the p�oject (Section 7044, BuSinesS antl Professions Cotle: � , Tne Contractor's License Law does not apply to an owner of property who Duct - Ventilating ❑0-100000 BTU ❑100,000 BTU SUMMARV OF FEES ' ' builtls or improves [hereon, antl who cont�act5 for sucb projects with a con- tracmr(sl iicense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proot of tneir Worker's Compensation insurance shoultl be provitletl to me. _ PLAN CHECK $ "� 'PERMIT � ❑ I am exempt untler Section . e. & P. C. for this reason Firepl/Fact. BIt. ICBO # Fire Dampers PWMBING $ !/ ISSUANCE $ �� Date owner Heating System & Ducting - Registers � � ENERGV'P.C. $. PLAN CHECK 25% $ I hereby certity that I have reatl this application antl state tnaf the above ❑0-t00,000BTU Ot00,000BT � GRADING $ information is correcL I a9ree m comply witn all city antl county ortlinances ' ELECTRICAL $ - ' antl state laws relating to builtlin9 consVu<tion, antl hereby autnorize repre- . PLAN CHECK 50% MICROFI LM $ sentatives of Ihis city to enter- upon the above-mentiOnetl properiy fo� • $ - . ��ly�� inspect�on purpo MECHANICAL $ TOTAL FEE $,�� Siqnature __�� a�`� peinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25%' $ ' Orivers' License or � Cr�nF o965-46, rev. 10/04 white - Buiitling; Canary - Applicanh Pink - Accounting; Goltlenrotl - AsseSsor �2 U��1�.4�39-9C�g06Y�5? ��7 j,jj{} CONSTRUCTIONAND�PLANNING ' � ' . POOL&SPA . �., . . �� AP.PROVALS Permif# � �Date� Inspector � i" Date' : Inspector APPROVALS Permit# � 1:�Temporary-�IectricaLService or,Pole 52. Pool & Equipment Location ' � ' � , ' I � 2. Soil Pipe-Undrgrnd. ' 53. Steel Reiriforcement � � �-, 3. Electrical Conduit Utility-Undrgrnd. . 54. Forms � � � ��'x": 1 ', . � 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Sfeel Reinforcement , - 56. Rough Plumbing & Pressure Tesf � , � 6.� ElectricaLUFER Grnd. - 57. �APPROVALTO COVER;§UNITE ' r- 7. Footings :��; - 58. Electrical�Conduit-Undrgrnd. ' , 8. Foundation � - 59. Gas Pipe, � Undrgrnd., t��t 9. WaterRi��-Undrgrnd. . � 60..Backwash.Lines,P-Trap,fl•.Undrgrnd. ! :,� 10. Structural Floor System • 61. APPROVAL TO DECK t�..! � 11. Property Sewer Lin"e & House Connection 62. Backwash & Receptor-Fi�nal ' 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 . � 16. 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 ' 71. Product Piping �Gas ❑Oil ', � 23. Gas Pipe-Rough & Test 72. Underground Flush ' , 24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil � � � _r 25. Roof Sheathing 74. Overhead Hydro ,`�� - 26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical N. � � 27. Frame and Flashing �' 76. Dry Standpipe � � 1 28. Lathing & Siding 77. FIXED SYSTEM FINAL �� ' . r�, :, 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:7:� � LFjpi Gy,2,�� G.%� -. 34. Final Heating & Air Conditioning ��'� , iz-c- at Pe¢«rro- E.�.�r� as Pae ia3 v�c 35. Final Gas Pipe-Test , � � • 36. Hood or Canopy - 37: Final Factory Fireplace � 38. Final Plumbing � �� 39. Water Service-Final � � �I � 1 40. Gas Service-Final ' ' t�„ .' 41. Solar pomesticFinal ' y � . i 42. Backflow Preventer � � � �(� J-r; 43. Backflow Irrigation -. , • 'J E 44. Landscape Irrigation System " , .{t ,{' i i 45. Sound Attenuation ' i. I 46. Handicap Regulations � - � - _ � � �I , _ � � 47. FINALSTRUCTURE&BUILDING . . � �i, 1 48.'Special Requirements Completed - • - � "� " 49. Electric Release to Edison ' . ' . �,- 50. Gas Release to Southern Califomia Gas Co ' � , 51. CERTIFICATE OF OCCUPANCY ' , � � N0. Date - ' - � "�: AOplicant to fill In all spaces except those wit�in heavy Eortler Ilnes anE sign all appro0��ate tleclarations. GTY OFrCOS7A-nnESa—CONSTR �� ON PERMIT� PERM N TRACT NO. LOT NO. UNIT NO. ProjeCt Address � Ann��cant'sMailingAddress � Owner•s Name Phone � Addregs Arch/�ng. License No. AddreEs Contractor'sName� �hope� � Address (r"°;�'^^I �i_ Q f% City Licen<a No �l� t LICENSED CONTRACTOR DECLARATION I hereby atfirm that I am licensetl untler provislon5 of Charter 9(Commencinq with s¢�tion �000� of Division 3 of the 8u5iness antl Professfons COEe, antl my Iitense is in full t c an0 eftect. LJCense la L n5e O. Date - - Signature WORKERS' COMPENSATION DECIARATION I hereby affirm [hat I have a certifica[e ol consent to sell-insure or a certlficate of Workers' Compunsation Insurance, or a certifietl cOPy tbereof (Sectlon oo. �ab. �� a �4-�g �ic,� . Fi,c.nd ' I�i,c-y No. � � Company LT certif ietl/c�oppPyY S( I¢tl withrtM1ehC�i�tY B I in �5v�'on � �/ n� �/ Date � � / �% T APP�icant- ��v-�v��-�J � �� " - EXEMGTION F OM WORKERS' COM9ENSATION DECLARATION (TM1iszection neetl not be completed if tha Permit is for one �untlretl (3100) or less). 1 certify that in tne per/ormance of thC wo�k tor which [his pe�m�t is issuatl, 1 5hall �ot employ any person in any manner so as to become subject to tho Workers' ComOensatlon Laws at California. Date Signature NOTICE: If, ai(er making thii tleclaYation, you 5houltl become subject to the Wo�kGrs' ComPensaUon provisions oi Ihe LabOr COtle, you must forthwilh comply with such provisions or this permit spall be tleemeE revoketl. CONSTFUCTION LENDING AGFNCV ✓,i I hereqy a�titm thal lpere Is a ConStrUclion lentling agency fOr Ihe pei(ormance Of tn¢ work ior whlCh this Oermit Is issuetl (Secllon 3097 Clv. 0.) Lentler's Name Lantler'S Atltlress OWNER BUIL�EN DECLARATION 1 herQby affirm that 1 am ezempt trom tho Coniractor's Llcensu Law for tha follo�yin9 reason (Sattbn 7031.5 Business antl Professional Cotle: qny clry or county w14Ch requir¢5 a petmit [o ConSt�uct, alt¢�, Improv0, UemO115h o� repai� any s(ructure, prior to its issuance, also reqWres t0e applicant for such permit to ilie a si9netl SldlertlG�t thdt n2/Sh¢ IS IICCOSBtl OU�SUdOI l0 lll¢ pfOVi5iOf11 OI [he Con[ractor'S Ucense Law (Chap[er 9(comm¢ncing wi[h SecHOn 7,000) 0/ Divlsion 3 oi tho BuSiness antl Pro1e55ions Cotl¢) or that ho/ih¢ is exempt therelrOm antl the basis for thu alleg04 examplion. Any violation ol Section '031,5 by any applicanl for a permlt subjecls the applicant to a tivil �al(y of not mora Ihan 8ve nuntlretl tlollars (E500). '4'as owner o� tho Property or my employees witb wagos as tbeir solo omp¢nsatlon, wlll tl0 t�e wOrk, antl Iha St/uCtu�C is not intantlotl or oHeretl , lor sale (Section 'l044, Business antl Prol¢SSIOnaI Cotle: The COnt�aclOr's Licens¢ �yw tloes not applY lo an owner of a property wbo bulles or improvei Ihereon, antl who tlocs such work hlmsalf/nersetl or through nls or her own empl0yee5, provitled tnat Such improv¢menls a�e not intentletl Or oft¢re0 for Sale., I/, however, th0 buil0in9 ot IrYiprovament IS soltl wllhin one year oi com- pletlon, the ownar will have the burtlon oi Proving he/she tlle not builtl or Im- , p�Ovq tor [he purpose ot Tale). �❑ I, ai owner ol the property, am exclusively conttacling wftb licensetl <On- Hactbrs to [onsV uct tbo Oroject (Sociion 7044, Bu5ine55 antl Professlons Cotla: The ConVactor's License Law aoes not apply fo an ownor of prooerty who '� builtls or improves thereon, antl wh0 conlrac[5 lo� Such prOjectz with a con- itrac[pr(s) �ican5e pursuan[ to fhe Contractor's Licenze Law). I am aware that proot oi thelr Worker's Compen5atlon insurance shoultl be provitletl to me. ❑� em exemp[ untl¢r Settion B. & P. C. tOr this r¢a5on Dale I ner¢by certify thdt 1 information is correcL I antl State laws relating � Senta[ives of this Ci�y'� Inspertlon pur0 s.�(/ �� Siqndture �� Driv@rz' License or 55 $ Owner have teatl (his application antl state Ihat lhe abovo a9ree to comply with all city antl tounty ortlinances o builtlinq conSVuc[ion, dntl hereby authoriie repr¢- � e/9!�/er Aupon/ fthe above-mentionetl propertyS t r `-^' V V. //L -.,,, / Date '� ��1 _ .� 3 3 7 TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCFiIPTION OF WORK/USE OF BLDG. TYPE OF PERMIT LI GRADING�FOUNDATION LJ STRVCTVRAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5�. FT. oCCUaArvCv_ CONSTRUCTION TVPE VALVATION S ZONE GRADINGCU.YDS. ACRES— Remarks: Sink ktlow Preventer <floW Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceprors Kitchen Sink Lavatories P-Trap Roof Drains Rainspaction Fee Boiler Duct - Under Ground S15 Duct - Ventilating ExhauslSys[em ❑ MWtiple Firepl/Fact Blc ICBO # Heatfng System & Ducting ❑aioo,000 eTu �ioo,aoo Reinspection Fee � $15 CMF OB65-46, rev. ]0/84 White - Builtlin9; Canary - APPlicdnt; Pink - Atcounting; Goltlenrotl - A558550r Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service AutO-Wesh Laundry Trays Issue FB8 Hood or Typel ❑ Canopy Type II ❑ Refrigeration System ❑0�100,000 BTU ❑100,000 BT System Repair/Alteration Fire Dampers Registers Issue Fea ES S 3 A.P. 5W S Main Buildi E T Front B Rear a C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit D ishwasher Oryers ❑Gas ❑Elec Fan F.A,U. Fixtures Device Boxes Outlets SWitches Garhage DiSposal Generator �0�5 KW C ".8978 4/19/C'1 50'. 1'' Zone Accessory Building: 2 O N i N G R Parking_Req./Provided �7�� E .L�: M � T $ ELECTRICAL Trensformer ❑ 75�50 KW ❑ 50+ KW - Meter ❑up to 100amps Meter ❑over700amps Sub Panel � Motors�0�7 HP01h-8• Inc.Solar �9�15 HP �i6-15+ Microwave Pole Light Renge I I Standing Sections 5 KW� I Trash Compactor Rainspection Fee -I $15 luue Fea FEES � DEVELOPMENTSERVICESREDUIREMENTS: Zaning Approved By Buildin8 APProved By � $ 3 FEES S3 SUMMARV OF FEES BUILDING PEFMIT $ SMIP S PLAN CHECK $ PERMIT PLUMBING $ � ISSUANCE $ � PLAN CHECK 25% $ ENERGY P.0. 5 ELECTFICA� $ GRADING $ PLANCHECK 50% $ � MICROFILM $ ��'/)j) MECHANICAL S TOTAL FEE $ '`�Z�� PLAN CHECK 25% $ CONSTRUCTION AND.PLANNING POOL & SPA APPROVALS Permit�#� Date Inspector qppROVALS Permit # - Date Inspector 1.',T,remporary�Electrical �Service or Pole 52. Pool & Equipment Location fr 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement =t' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms �, : 4. Eiectrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure•T�st � 6. Electrical UFER Grnil�. , ' 57. APPROVAL TO COVER-GJ.W ITE 7. Footings �� 58. ElectricalConduit�Undrgmd;! 8. Foundatio'n 59. Gas Pipe, O Undrgrnd., Test„ -.N 9. Water Pipellndrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 70. 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 76. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Elearical-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 OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. S[orage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structurall & 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 2}! �,/) 39. Water Service-Final •I 1 40. Gas Service-Final � � L 41. Solar pomestic-Final ! 1 42. Backflow Preventer ' 43. Backflow Irrigation �t) � 44. Landscape Irrigation System . : � 45. Sound Attenuation �f 1 46. Handicap Regulations � I 47. FINAL STRUCTURE & BUILDING . � y I � 48. Special Requirements Completed � 49. Electric Release to Edison 50. Gas Release to Southem California Gas Co �'' 51. CERTIFICATE OF OCCUPANCY - � . No. Date � _ ' , t- •.; '.Costa Mesa Building Department AI'PLICATION FOR PER � �?'�' P. O. Box 3�� 3444 B U I L D 1 N G COSTA MESA, CAUFORNIA FOR OF'FICE USE ONLY FOIiR APPLICANT TO 1+�ILL IN Receipt No. Permlt No. ndaress .� � .�! �� i�'.� � / Costa Mesa, California Received by Date Rec'd. ODate Issued Nearest � ' / — J � I 0 � CrossSt. �� Building � �L/� Address Owner • Costa Mesa, California Mall � , �nA� Address �z� ��i-c Nearest A� �1 Tel. Cross St. City C". /' .. /� No.�/� .T� Zone I p�ans I 7ype � Group Architect or Lic. Engineer •—� No. Approved b Date eArl�aee r .-..-.��.�.��.. �tractory�f//[�/ /�%YJ.7"1S ryo: � dress Lega—I ��✓� �scription I No. / I Block � Tract�� ttach Metesand Bounds) A��/ 7-Zd2�i � X ,�� Na. of Bldgs `I eofLot ./J NowonLot eof No.of No.oT isting Bldg. ��' Fa illes I Rooma :back Line from i_t.. / •, r Vard • New �� Alteration � Repair I j Moving I Bullding Z,�� Q No. of Size Rooms — •terior Wall {� a Roof iering �(/!�L`L�� Cove .,se of New �Y1 . _ i_ ' Yl. ._ Addition l � �.5 G.�' b' �,{E L ,b,. 0 I hereby acknowledge that I have read this Application and state that the above is correct and agrce to comply with all City Ordinances and State Laws regulating building construction. Signatureof ��in�r� �iif/jS.-flf l�,{ Permittee �� /�� L� � �� %� s.�� :� .. , fa ' �a�'.�.F� . ru�N T�CH. � '"� c�'f\ � n � _ � �� f ��,�� y , v .�. ,'{ . _.. �,�i.� Forms, Materials, Under-Pinning •ame: Fire Stops, Braeina. Balts Int Valuatlon Permit Fee $ ,3 02 — Masonry Reiniorced Plan Check $ / 6 '� Bond Beam $ /�` �� Fee I �a � FINAL r y� � , _ . PLOT PLe3N 8how Ioeation and distancea from property Iine and between b411dinga �. •• �n "{.. � �. � �l .��'} `` p CII..T�A n� _c5f �NEs.. "•S?�' ='='r `�•j;S.r� !..\ .`\ - �, .\ _ � ♦ . `" ` ` l .� \ �- . �.- � ��'�\\• �_. '1..:\�.' ;��.. — �`��\ . . . . -. . � ��- ,. �. � ;.,�:�,7, \ �. �'\C , "� ` ._ � � . _ -:�� .•;, ,i. ,. - ,�. , _ ..:.v "k� �a �t, ` _ -, rs �: �. \ � � . ' `1 ' ' . �. ? ';�-. i` : ��': � �. ., __ �` _ s '� � �� 't;.. , �..-,'�.� , . � .. �, .: ��: � �} ' c'-, y� �� . . ,� — � �\ _�,��... . �� '.� _��.. , ._ �. � , � \ j � 1� ' Costa Mesa Buiiiling Department APPLICATION FOR PERMIT �� P.O.Boz3�� 3�43 BUILDING � " COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY ' • FOR APPLICANT TO FII.L IN Receipt No. Permit N naa°�'� e� � � �ff 3 j�o ; Costa. Mesa, L'3�llfOi7118, Received by oate Rec'd: te �ssu� Nearest ' �� Cross St. ^/ Building Address Owner , I.•L/ELlS' Costa Mesa, California Mail q�� .t [n;�� Nearest Address G Tl7'7/� Tel. �,/� Cross St. City �• No. C� /%�� Zone I No.of Type I/ Group dmhifwr.tnr � �,. /��it AIdnS I ✓ . / Address ( CORRECTIONS City LiC. itraetor s• No. Address Z� � �,^�Q Legal � I �[/ A MESA Description I No. I Block � T Ll � /� � ANN[NG DEPT. (Attaeh Metesgnd Bounda) /7� %/ �•J�iZ—/ g�g,)ECT TO BLDG. • • No. of Bldgs SizeofLot �l+C•JC3CG�/Ei NowonLot �' �' l�se of I No. of I No. of % �� - ppT ExistingBldg. � Families Rooma p�41,�-( • Setback Line from �^ � Rear Yard / — Center of Street J� Side Vards � . ' D DESCRIPTION OF WORH _�� j� � � � ,, , New "' I A�teretion I I Addition I V , ' ' ,° � ' --�. �. � . .--�_�— Repafr I I Moving I I Demolish I �- � Bullding No.of �"4` � .- ��1�) Size 2'9J(,¢O Rooms � Stories / t; ) l i - — •terior Wall Roof /� �/� iering �@�(j I Covering /��e,l� E�PROVi�.s Ci�[�A .,se of gew u /� Foundation Location o� �laspector" � Date Bufldin L � Forms, Mate,'r+ials, Under-Pinning° �� . �,L / Frame: Fire Stops, Bracing, Bolts I hereby acknOwledge that I have read this ApplicaUon and state that the above is correM and agree to rnmply Lath. Int. �� with all Clty prdinances and State Iaws regulating building constructiOn. Lath. Ext. Slgnature of Permlttee .� �% G� � �� Plaster, Int. Authorized Agt Plaster, Ext Valuatian Fee $ .302 — MasonryRefnforced /� �/� � Plan Check $ � b Bond Beam $ / T Total �/ J� . Fee $ T� I FINAL �..e.. ��. �o.ss o. p_ e s. Y C J 0 a` ( � � i . , ' ;"� �'s .' �' , .• : Street . - u J 0 � a � PLOT PLAN - Show Iocation and distancea from property Iiee antl between bulidingy, 1 • -�,�� `\ ._.� _ 1 \` ' ,� , J COSTI�`•'� \ A.uc-�-ssPOWESA t�� ,::48.nn , . �,` , , .. - �. `�_ _ ._ , . �i . c'•.`< `>. ✓ �. :�,� � ; .'`` .. � .._ . �� ' `�•' � � � ,�� 1 � r �. y� .: l'�. �. �� „ .': � J. ,: 1'. 1. � �. _'� . � =�,� . �=��1`', .. '.'. "`r:':�;� •'t• } i .. , . � � y� •� .�. �' _ � `\�. , .. . ,_; �_ , , ..` .. � . .' .. J , � . _ �, c. �' ' �. . •, ' ' � '79�2 COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN ADD EISS � / � G�[/iOA ( � 1Nl �� COSTA MESA. CALIFORNIA MAIL ADDRE55 CITV ARCHITECT OR EN�INEER ADD�.. .5 � TEL. NO. LIC. NO. � �. CITV LIC. lEGr1L LOT �^/ � DESCRIPTION NO. IRr BLOCK A.P. NO. '�' � �—� , G SIZE NO.OF BLOGS. OF LOT Q �U '�' riow on �or D USE OF /� E%ISTING BLDG. I�/ SETB4CK LINE FROM 0 / � C[rvi[n or srnEtr REAR YARD �G J , ��1 SIDE YARD RIGHT LEFT DESCRIPTION OF WORK NEW ALTERATION ADDITION REPAi,. MOVING DEMOLISH BUILDIN I NO.OF • / SIZE �^ J( �� ROOMS STORIES r E%TERIOR WAl ROOF ' COVERING COVEFING 115E OF NEW 1%� I. i _, r . � �! kSLS ��F9L'�� H lS U cosr,• � �y��45.00 �CT 30-SPPDN�s;. '286a �� Q�t. �JE� � �..``.':J �s� APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY FIRE ZONE BY �u -3e- COSTA MESA. CALIFORNIA � ��2RECTIONS � i n � � / fti� LCi � �O- I � � ,�e Yr' � / _ �� N tl � � \ / � [ . , TY OF COSTA MESA PLAiJt�ING DEPI'. DA S' U 7 y J �' STPTE THqT TME ABOVE IS CORRECT AND �GNEE TO COMPLV WITH nLl (� CITV ORDINANCES TND $TFTE WS REGULATING BIIILOING CONSiRUC� T�ON. . �f� VALUATION SIGNATURE OF �///]L� .� PERMIT FEE S ! O�. PERMITTEE V t� "��' /�� S IQ{ /� � PLAN CHECK $ /S � AUTHORIZED AGENT (�� / TOTAL FEE $ ��