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Home My WebLink About2542 ELDEN AVE - Building Permits - Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. - CITY OF COSTA MESA CONSTRUCTION PERMIT PEMIT NO.3/ /� /, TRZA(C�T,N,O. LOT NO. _ UNITT=O. • 9549 11 /13/87 ;17000 TL , -'Project Address .. -6-111 2 CC/a , // Applicant's Mailing Address v 4M€ TYPE OF CONSTRUCTION NEW ❑ ADD L.tl ALTERATION U REPAIR )�- _ I /lS�GL/%70e F � s-b O 3�� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P..J6 47-1 6 ^c' '1 Zone 1Z Th_.... _ Owner's Name Phone !-t D CRIPTION OF WORK/USE OF BLDGa laic*MR ' 1 Y+ 1 Address 7S YZ C/d'e-7 CZAC cr TO /Ts 0:e/4'/IV -,%. CATE S Main Building: Accessory Building: Arch/Eng. _License No. TYPE OF PERMIT Li GRADING U FOUNDATION (..J STRUCTURAL E Front O Address ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N ❑ OTHER A - Contractor's Noma QIGI/ /1 Phone M_/ C Right N Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY C O N ST RUCTION TYPE y VALUATIONS Sor00 8 Left G City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided LL E P ( Planning ,1.� 4 � 1tO�^ �P.7'10✓•p -� M I hereby affirm that I am licensed under provisions of Charter 9 commencing 'Remarks: Notes: �.! withysectionis 7000) of Division 3 of the Business and Professions Code,and // 1 1 T my license is in full force and effect. a( 41/a yy-p 1 r, --4t+n S robs^'' ' s i '•Q License Class License No. (3 Q S Date Signature PLUMBING ' FEES O ra 14 11a&-5; ON WORKERS'COMPENSATION DECLARATION Bar Sink Showers ',hereby affirm that I have a certificate of consent to self-insure or a certificate - ELECTRICAL FEES ' ' Workers' Compensation Insurance, or a certified copy thereof (Section -Backflow Preventer Service Sink 300, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap _ Construction Pole Sub. 0 50+ KW 8 Certified copy Is hereby furnished. ' Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less)- Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel ' I certify that in the performance of the work for which this permit is issued I shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Fan • Motors 00.1 HP OVA 8 - Workergg Co ansa�Jgp Laws of California _ Date/ � jJ Signature f 91 eStf[,P 1 Floor Drains - Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service ' Outlets Water Closet Device Boxes 'Pole Light 1 hereby affirm that there is a construction lending agency for the performance of the work for which this pgmit - Is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name _ ---0--",�4�� Lender's Address - Kitchen Sink Water Service - Switches Sign OWNER BUILDER.DECLARATION , • I hereby affirm that I am exempt from the Contractor's License Law for the ' Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or Standing Sections county which requires a permit to construct,alter,improve,demolish or repair • any structure, prior to Its Issuance, also requires the applicant for such permit P-Trap Laundry Trays Generator ❑0.5 KW❑5.15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she Is exempt •erefrom and the basis for the alleged exemption. Any violation of Section ;31.5 by any applicant for a permit subjects the applicant to a civil ,eenalty of not more than five hundred dollars($500). .W I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee - $15 Issue Fee 5 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds Or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REDUIREME NTS I employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 1(- I ?)i sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By I S Date ! .� pletion, the owner will have the burden Of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,.Business and Professions Code: ❑0.100,000 BTU ❑100,000 BTU - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- aro tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ //0, 00 $MIP $ proof of their Worker's Compensation Insurance should be provided to me. _ PLAN CHECK $ 6.so PERMIT ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date 2,2__454/..Z- Owner Yee, Heating System& Ducting - Registers PLAN CHECK 25% $ _ - ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BT $ GRADING $ Information is correct. I agree to comply with all city and county ordinances ELECTRICAL and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this City to enter upon the above-mentioned property for '7 Inspection purposes. y p MECHANICAL $ TOTAL FEE $ /• an Signature / e�.�� Date// cS �/7 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 'Drivers' LlcensNor SS# , CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit 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 OF ER 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, ❑ 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 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 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 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 I 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 1.0 ;6 0 ),L 48. Special Requirements Completed Q 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co - ; 51. CERTIFICATE OF OCCUPANCY No. Date - _ .- �• Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. , CITY-OF COSTA MESA - P MIT NO.�, / TRACT NO. • LOT NO. BLDG.NO. - 5255 -a/29/522 '93.72 TI. CONSTRUCTION PERMIT( ,5 3c. /'2 : - �j • • ' i•• I Project Address 2.�/•L Ll,�` EN VT- ` • , ,TYPE OF CONSTRUCTION •- - . _ ,• . t . OwnerCre-2 �£as /••-•a -. Phone‘732. 79 kNEW 0 ADD - 0 ALTERATION - ' , •• - - -� . - - " ,�(.�,/ T ❑'REPAIR ❑ CONVERSION ❑DEMOLISH Ir - Address 9'sJ - - '- -- " ' - 'ZONING REGULATIONS ' -- ••- - •Arch/Eng- - - 1 - . -- ' -License No. ❑ OTHER •• '-f _ — DESCRIPTION'OF WORK•": . _ - - _ .__ . . A.P, , 39 -NICD I_Dal _ _ t-- , - f Adores:' - �-- -- --- -= - - - - -' — - - - - DETA-04ED • 2 CA e-CAeA-Cc -- -R Z- - - / - -- ZONE' � PLNTTGop.'R��E/1F.� '- pp Contractor 0-ui N F.ws .,- - - TYPE OF PERMIT -- - •- - '-- - 'SETBACK K C/ T. • IPROPEIRTDVNLINE z '.ld5 iOn Address - l - -- - - - - - . • 0 GRADING 0 FOUNDATION. .STRUCTURAL--- • 5I• YARD r u - - - - - • 'LICENSED CONT.RACTOR DECLARATION_ ',' LE - . •• • I fl 4I ❑'TENANT ❑:ELECTRICAL ❑PLUMBING ❑MECHANICAL SID V• •.- 17•�n - L� •. -" . 1 hereby affirm that I am licensed under provisions of Charter 9(corn- I RIGHT. o i - Is ) -C.7O �..1 ''J,/d�C- meneing with-section--7000) of;Division_3 of the .Business antl) _ ❑,OTHER ,-REAR VARD(TO P/L) ('D'1Q° -t[T�Q,�,a1 G{ ,Profosslons Code, land my license Is in full force and effect. PROJECT DESCRIPTION'_ '1 _ Li Cense Class - - - - - License No: '- tuft -\ Date. . _-' - -_! ' Signature A • -- • 50. FT. 7// -- _ �- - -_ {. 'WORKERS'COMPENSATION-DECLARATION OCCUPANCY CONSTRUCTION TYPE _v STREET WIDTH' "PARK FEE E- 1 I hereby affirm that I have a certificate of consent to self insure ora VALUATION Q-ZONE l - ZONING APPROVED BY-I� -'�Y1,I-DATE Li- 'p dJdied; -certificate of Workers'_Compensation-insurance, or_a certified copy - _ _ _ - __ 1-� l / CC( thereof(Section 3800,Lab.C.). 1 GRADING CU •YOS. ACRES - !SPECIAL-CONDITIONS:'•- . POIICY'No.- • - -Co mpanY ._ flimmimemsmow_. _ _ l (I- �n ^2)'iQj1Q-�_.V-:129--'. 7. ^ertlfietl copy is•hereby furnlshetl. _ _ REMARKS __ _ lertifled copy Is filed with the city Building Division _ XEMPTION FROM WORKERS' COMPENSATION DECLARATION ..re - - - •I - _ 1 t/ JyIe f ,-m `� mVVV V (This section need not be completed if the permit Is for one hundred q Lh;n' •.r1. �./�� 9_ta 1� '- 55100) or-less). T , .. _ -._ _. + - - -_ - �l_7 L7[� !+u/f l(�,,,, - �C'•'"' certify that in the performance of the work for which this permit Is ,t" y1',�s-w s'. (v -I issued, I shal not employ any pens in y ma ner so as to ecome 4 PLUMBING .•PLAN CHECK -- - --- -- -,ELECTRICAL -V_ sf --PLAN • subject t t�-WF o�r-k�C-r-i�Co mpensatioorlzl�/ yof ..jlfor ia.s- �- • -BATHTUBS' ` �SO FT INU ` CO FT V Date+ : Making e£ p(y vl� come-subjectr NOTI E: If atter ma kin this de lara[io of should TOILETS,, URINALS -- -- ?-- - - -- ,IGEN ERATOR - '0-1 KW�Cl'-10'KW- - - ,' -to the Workers' Compensation Provisio o the labor Code,you must TRANSFORMER .i -N I forthwith comply with such provisions or this permit shall be deemed LAVATORIES OOUBLE•LAVS--- --I - - - •{APPLIANCE- 10.50 KW - 50-+ KW - revoked. i - 0 ---.__ KIT.SINKS- - -- - --DISHWASHERS-- - -- ^- 'MOTORS- 1 CONSTRVCTION LENDING AGENCY •1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS -,- r,�• SUMPS• - -^- - -- _. 'UNC:SOLAR) -. 10-50 RP 50+HP' '' 't' s��r' :formance of the work for which this permit is Issued (Section 3097 - ' - - • : - - _ • - Civ:CJ:- -- - - --- - - - - -- - - FLOOR SINKS" - - - FLOOR DRAINS--- -'r -- -" ' -" FIXTURES- - ,OUTLETS- --SWITCHES -. - - ---• -- Lender's Name ' Lender's Address - - - - -- -DRINKING FOUNTAINS -- - - - • 1---•. •- - GAS TUBE SIGNS--- - 'OWNER BUILDER DECLARATION--- -_ - - - -- INTERCEPTORS- '-- CLARIFIERS -"' -" - " 'POLE LIGHT$•-- - - - -- - - -- - - - - -1 -t hereby affirm that 1 am exempt from the Contractor's License Law for - - • _ -- the following reason-(Section 7031.5-Business-and Professions-Code:- SWIMMING POOL- --- -P TRAP. . ..... ..... - t-urvblaiU�nory -- - - Any city or county which requires a permit to construct, alter, • IPOLES- •• --'-METERED'- - SUB --" ="I Improve,-demolish or repair any-structure, prior-to-its-issuance,-also-re-. -blATER-SERVICES-'--"'ALTERATION- - = quires the apilicant for such permit to file a signed statement that ho ---,• MAIN•-'- - ' :UB-- _- Is.Iicensed•pursuant.to the provisions of-the Contractors-License-Law -GAS SERVICE-- -'OUTLETS- ' - T -L--- -.SERVICE - - • • --EXPIRED: Is AMP-•L' (Chapter 9 (commencing with Section 7000) of Division 3 of the - - - Business and-Professions-Code) or that he Is exempt therefrom and-the- -WATER HEATERS - BTU OUTPUT - • -- - •- • -• 'IRCOIIIp a e-IIu(1CC--- basis for the alleged exemption. Any violation of Section 7031.5 by - antd_- _ 1 p- ''applicant• for-a permit subjects the applicant to-a civil penalty SEWER CONNECTIONS -- L - -- •- - - --` d more than five hundred dollars ($500). i -, - - Q - - SG Daae ; -ig , as owner'of-the•property, SOLAR TANK -- - COLLECTORS -- - - - - - .- •-••e-.will do the work, and the structure is not Intended '- } Or offered-for sale. (Section 7044, Business and Professions Code:The- SOLAR PIPING SVS.—' -. - - -- - -'ISSUE FEE - - ' - - - - — Contractor's License law does not apply to an owner of a property - - •--- _ -. .-. .. APPLICATION.APPROVED.BV-. / who builds or n employees, provided who does such work himself or " ISSUE'FEE `- -` 1 - - -± ` - - 'r OAT.E`Ffjq/�Z through his own employees, provided that such improvements are not _ _ ( ( Intended or n oned-for sale. If,-however, the building or improvement MECHANICAL --- PLAN CHECK - ! - y- - . SUMMARY OF FEES�, - -' - I Is sold within year of completion, the owner will have the burden - _ ,I (� i of proving ner o" not build' or improve-for the purpose of sale). HEATING SYSTEM 0-100,000 BTL �PERMII. . $ •SO SMIP - $ y-d• - ' 0.1,-as-owner of_the constructexclusively the project (Section 7044, Business 100,000+BTU 1PLAN CHECK 5' 35.72 PERMIT and-Professions Coder-The Contractor's License-Law does.not apply to - _ _ - _ . _ .._ISSUANCE-E ` an owner of property who builds or Improves thereon, and who con" REFRIGERATION 0-100,000 BTU i !PIOMBING--- $ tracts_fro .projects.with a_contractor(s) licesned pursuant to SYSTEM .. . 1 _ ._ r GRADING'-E '' the Contractor's License Law). • 100,000 i BTU' f �'PCANCHECK S- - - a - ---- ❑'1-am-exempt under Section- - - ' - - ' -' B. : •.-C.for this - - -- -- - - -- _-- - ..� "' ' ) $ _ . BOILERS - BTV IECECTRICAL-'$-- reason • _ - _ - _ _ 1 I 'MICROFILM $ -• - 4 I �LI� SYSTEM REPAIR,ALTERATION 1 ;PLAN CHECK-$ - - , - 4 Date cert �_ - c - _ _ ._ . _ t - TOTAL FEE$ _ I 1 ;MECHANICAL $ I hereby cert fy that I have read this ap• 'cation .nd `e that the above EXHAUST SYSTEM . MULTIPLE s 1 - ., LESS AD- ' as correct. I agree to-•amply ith all hereby county ,PLAN CHECK S • ' VANCE PC-5_ • - - s represents ordinance and s -te laws relatin• o •er-u ction,and hereby authorize t I , il,� I , represent. Ives/•f thl cit To - ter-upon- the -above me tion d - - - - - • 9 Property •s: Pec •• ,I.••s -_ .- . np -. -_ _ f• FINAL •FEE $ / �•�� y Signatur ` Date��C 7 ISSU E.FEE - Drivers' Livens: or 55• -' - -- __ - ' '--'-- - - - 1 1 CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&.SPA • - APPROVALS Permit # Date Inspector APPROVALS Permit# Date — - . Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location- -. - ' ' - 2. Soil.Pipe-Undrgrn • 44. Steel Reinforcement - - - •• - - • 3. Electrical Conduit Utility-Undrgrn - . _- 45. Forms - - 4. Electrical Conduit-Undrgrn . - 46. Electrical Bonding - - - . - - 5.. Steel Reinforce. - - _ .. 47. Rough Plumbing & Pressure Test - - -21 - - - I. _6. . Electrical-LIFER Grn t _ - 48.. APPROVAL TO COVER:GUNITE - - _ -7. ,Footings •- • 49. Electrical Conduit-Undrqrn ' • --• 8. Foundation - - - 50. Gas Pipe,•❑Undrgrn,Test ' • 9. Water Pipe-Undrgrn . 51._ 'Backwash Lines, P-Trap" ❑Undrqrn - 10_ Structural Floor System .. - _. _ 52. APPROVALTO DECK - - • .11r Property Sewer Line.& House Connection _ ' - _ . . _ 53. - Backwash&Receptor-Final . . 12 StreetSewerConnection. - _ - -- 54. - Heater Si Vent-Final • 13 . Rough Plumbing . . - . ., - ., _. - 55Plumbing-System -Final - ' , 14 Rough Electric-Conduit - . - -_ . - :56: ' Electrical=Final ' 15 Rough Electric-Wring - . - . - - 57. Solar System-Final • . ; 16 . Rough Heating& Air Conditioning ' - - - - -. .b8. Fencing &Access Approval , , . 17 Ducts, in Structure - - - • - - - ! . 59. APPROVED FOR PLASTERING . . , . , , ' ' . _• , • 18 Ducts, Ventilating -• - - - - - -. - - - - _ .. -_ , 19 Gas Pipe-Rough &Test --. - - - 60. POOL/SPA SYSTEMS FINAL • • 20 - Roof Framing - - - • 21 Roof Sheathing - - - ' , 22 Frame and Flashing- - - NOTES: . ' .. 23 -Insulation - - - -- - - . - . 24 Lathing & Siding - -. - - - . .. - . :' - . -- . - - . _ " . 25 Drywall Nailing - - - -r-r - -: - - - i 26 Plaster Brown Coat -- • - - - - . - 1! 27 Electrical Power Meter-Final 7 - - . 4 • 28 Final Electric ':•• - . .., .. .•t- • - - I - - - - . 29 Final Heating & Air Conditioning - •• 30 Final Gas Pipe-Test a.? . . " :rnrl ' • • • 31 Final•Plumbing .,,..,..•.,,, ..,. .. ' -32 Water Service-Final - • • - - •- -- - -- . 33 , Gas Service-Final - • - - - - - . 34 Solar Domestic-Final " ° • , - _ -. .-- -. - ' -• •_ .� 35 Landscape Sprinkling System -• , - 36 Sound Attenuation - - - - - - 37 Handicap Regulations • . 38 FINAL STRUCTURE & BUILDING . 39 Special Requirements Completed _ `- I 40 Electric Release to Edison - _ - - - • . 41 Gas Release to Southern California Gas Co.. • - 42. CERTIFICATE OF OCCUPANCY - - -• • No Date • - 9940 j 'i ,_ •J COSTA MESA BUILDING-SAFETY DEPARTMENT `-� 4�L" P.O.BOX 317 COSTA MESA. CALIFORNIA "7- A I -6-5 v LL FINANCE DEPT. FOR APPLICANT TO TILL IN COMPLETELY APPLICATION,FOR- PERMIT TYPE OR PRINT - I:IIY OWain IVILOM �(''Q F ,/ y/F BUILDING ADDRESS 2�J 2./ �i.O AI 7t1 ` • rA �.r ��/ COSTA MESA. CALIFORNIA FOR OFF/K USE ONLY OWNER /LEO/I//Ci) ii, ALTO n/ I RECEIPT NO. I PERM O. 7 MAIL �J/� L C/ /1 p A/ AVE- RH ED BY _DATE RECEIveFD��jJ �DATE ISSUED D ADDRESS /1 OC �/'FTYLlO C/�•A/Le`/V /1 Y�/ G q 1, I -D_/-�] / I / --,� -I{Sc1 CITY COSTA Hes 4 TNO.^ -O'dS) -ADDRESS I ARCHITECT. LIC. COSTAMESA, CALIFORNIA OP -aINEER NO. /}- FIRE ZONE TYPEGROUPJ" _ ADDRESS / �/.'/ ` A �//�/J p / /jh ,`/'/ CONTRACTO�IQ/4 E. �!!C/�/7/M� NO.//Nov BY DATE DATE 7/�•� • / ADDRESS 36 //(I(N000 / �4�� A�/4 � ZONING LEGAL I LOTNO. N Q/,V ZONE NO.OF U8E OF NEW DESCRIPTION NO. NIBLICK IBLOCK 0 ITRACTN Y IPLANB BUILDING ALJ // y ! D 7o— S • _ APPROVED //� DATE ?/�y�/ A.P.NO. _ / 006 SIZEFA / it 5O L / I NO.OF eLOGB.�/ 'it: YARDS REQUIRED AEVES LLOWED OF LOT (j9(Q /, J Now on LOT/�/f�A/ USE OF (CENTER LINE 8T.) EXISTING BLDG. _ . . FRONT 5JD FT. IN. FROM `` / CENTER SETBACK OFLINE sTREEr J ✓ REAR YARD,2�S R.SIDEFT. IN. p// / it SIDE YARD LEFT / • ,- RIGHT _O y/'u/ L.SIDE r FT. IN. DESCRIPTION OF WORK REAR ' rb F.T. IN. NE' II ALTERATION I II ADDITION I_ REPAIR I II MOVING I `II DEMOLISH I if it BUILDING�j/�/•),,S` /ROOMS �/ STORIES SIZE 7\7 •L1L/{ J EXTERIOR WALL5-1- c O IOERING CD"/ nO •• z7 '' / 3 siQ 9 ve,COVERING ` USE OF BUILDING AND WORK TO BE PERFORMED lad-1/4_ �O )( 0 P �• a SI#l6b/= FnnitY frSIDLNn/CEl ��(4 �<<-,a r'- ter ax�svnosr/ baU,5L /4"T7 6/1P'W/S. 1/✓O 30-/r',,J e6-y2 ire ,c ra.ec Saar I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION 18FOR TH AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- 7/SS PLY WITH ALL CITY OR• NOES ANDj• TE AWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONL BUILDING CONST' CT • VALUATION SIGNATURE AJ( . _•en PERMIT FEE $ 3 • -�- PERMITTE ap-�1 se /_ men - A A _.•• 2 G $ J �, PLAN CHECK $ /O ' s o AUTHORIZED AGEN - /7 ` ['��/ (—T a,, J /3/ TOTAL FEE 5 L7• 67 (/