HomeMy WebLinkAbout1785 ANAHEIM AVE - Building Permits City of Costa Mesa. j�,r �'
Building Safety_Department "
CERTIFICATE OFOCCUPANCY Sy4Ye ' gG]756
"t r iS" tFIVL
P.O. Box 1200 . •,( yi - -
' Costa Mesa,California-. s
;, The Building located"at.. - i7ERc Annhrniin Avenui? tin4tim A:"t?.' P4 1'
has been inspected and found to comply with the':provisions of:all City of Costa Mesa.Ordinances applicable thereto'
for a Group a `- Occupancy. 6 : - •
.-— • d g L Use of Building i:4rintrdi ivl+h nttnrhhrt^ 0Ai-rsre - t - .'‘' r .r, .
` L'egal Description .., A.' P, $iii»1$a iS 11 : a" . ... .� • ,. - _ k
7,'1 ' " < A c 4 9 1 P (See reverse side for Metes and Bounds) A
x s� i '4• �� a+41,Zvi`�� E ii:4 j 'N ` � li 4 . ��
Building Permit No ' '�'� "� Electrical" Permit No -eeft.'.^ ' Plumbing permit No = +� ; .,
' az i #t " ;.;4,-,,,I,',;+ i i'
s-•qr4. rh ard s 1-1:44 . e!` ; t ' " r n .a .;z
- d
artments : 03 � -'and/orguest rooms . .. s' -4• m 1.--« ,=n
_
3 ISSUED TO ; Bulldl�ngOfflclal`
t�oxt'44414-att. Tttie1l.•, r ` u. by # ,w==;4. t, .t it,... ..,.' 4 t»;-iL,.
- -y
- r Date't- Mat 27. I473 • . •
This Certificate of Occupancy SHALL;BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
1,\ . Building Official of theCity.of Costa Mesa under Sec 306.1e) U B C
G Form eu 34 Rev. 11/70 i' '
11
Oil—. ®0/37
ADDRESS OF BARN& 1785 ANAHEIM AV DMT' CITY OF COSTA MESA — BUILDING PERMIT
aVNERSNASEIa1DAT& PHIL PARSONS ( PERM NO: B 08 712
ADORES& 1785 ANAHEIM •
PERMIT NO: B• 086712 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.tUNO ADORES& CONSTRUCTION ' i • . '—• PERMIT TYPE: SIR PURPOSE: OTH
•
ARCHITECT OR ENGINEER: MC NO.: JOB DESCRIPTION : •T/OFF RESHAETH & REROOF W/COMP. SQ FT: 5, 000
ARCH.OR ENWS ADORES:: MIT:
CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000 . 00 GROUP OCC : R-3 /U-1
CONrnACTORSNAII ATKINS ROOFING ( 714 ) 898-1169
CONTRACTORSMARD1G 30251 GOLDNE LANTERN COMMENTS : REROOF
ADORES& LAGUNA NIGUEL CA ucma: 361441 *ft*****iriE*Sf**+rx**RETE+t*iFMMAE****AE+t*?'Hx* Ht+EiEH(it+E*** RE**************Stir*3E***x**********
92677 utT: E361 Z ON ING R EQU I R EMEN TS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 • SETBACK S
(commencing with Section 7000)of Diveion 3 of the Business and Professions Code.and my lienee S in D forte and Sled.
CITY UC.NO.:037677 UC.CLASS: 39 36144//XP : 05/98 • MAIN BUILDING ACCESSORY BUILDING
Z Z _ !� ( Cpmma« /� � . FRNT: FT. IN REAR: FT IN FRNT: FT IN REAR: FT IN
(( III �- LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
IliWBUILDER DECLARATION;I hereby affirm under penalty of perjury that I exempt from the Contractors License Law for the '
orl;ng reason(Section 7031.5 Business and Professions Code:Any city or county enrich requires a Penta to mnao-ud.alter.improve. PARKING REQ: I P ROV: PARCEL: 42426322 Z N E: REF NO:
• Wendish. t*h.or repany structure,prior to Is issuance.eho requires the applicant for such permit to file a signed statement that he or she -
licensed pursuant to the provid (commencing of the Contractors License Law(Chapter 9(commci ng with Section 7000)of Derision 3 of the PLANNING NOTES>"
!trainees and Professions Code)or that he or she is exempt therefrom and IM basis fa the alleged exemption.Any violation of Section >
7031.5 by any applicant fore perms subjects the applicant to a dW penalty of not more then five hundred dollars
MOOD. ***************jf***************************************************************
ElMrt the « n7BrsntTO0"�ansebothe structure raintendedd D EVEI . OP MEN T SERVICES R E .QU IR EM EN T Sor offered for So044 at andProfesios their
rontworI� Lw does not apply loan Owner property
who bolds or improves thereon.and who dose such work himself or herself or through he a her own employees.provided that such —
impovemaes we not intended a alaedforsale.Il,however.the building or inPmvamaa is add within°a°Year d wrnPleticitthe ZONING APPROVED BY DATE:
owner-bolder will have the burden of proving he or she did not build or improve for the papdsa of tele).
❑ I,a owner of the property.em exclusively oonnedim wOh koreed coned&to mmr l the prpjed(Soden 704e.Business and
Professions Code: Contractors The Coors License not maser does t apply to an of property who builds or improves thereon and who BUILDING AP II;ROV ED BY : DATE:
contract,b nth m
contrasuch projects wa ntrepursuant dor(s)licensed puue to the Contractors License Law). y
❑ Iamexempt rrdrSecton: B.AP.c..for this reason: APPLICATION ISSUED BY: DATE: `1
******************************************** ********RF********** **
Date: Owner. LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby caddy that I am aware of and understand the requirements of Callornia Health and Safety Code Section 25605.25533.and
?CCM.and that I or any Mare building odM+ant will/Wil nit(circle one)need to comply with said state codes and the requirements tor
a permit for construction«mdil«nsion from the Ai Dually Management District.Residential mmmaen&middes ars mann(Iron hese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisea. PERMIT 99775 . 50
Date, Applicant: SMIP/NON—RES
I
WORKER'S COMPENSATION DECLARATION:'hereby affirm under penally of perjury as of the folowisg declensions: PLAN
ISSUE FEE •
❑ I!awe NMwil milli"a°war".dM
calm" erw«
huuak»'oompm
eation,esprwiddforbyam
Sink(' BUILDING—DIV—> ' PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,f«the performanced work this permit hissued. TOTALS----> ,•,.... 100 . 25 0 . 00 0 . 00 100 . 25 100 . 25 . 00
❑ I have and viii mantas workers'compensation imamate.as required by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.My workers'compensation insurance caner and poky number are:
Cartier: REVENUE DIVISION_TOTALS--> COLLECTED : 100 . 25 OVER/SHORT: . 00
Pofay Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
- (MIS sect,need not be completed a the permlS kw ono hundred dWers/$IOXJ or less.) 99 . 75 , . 50
}t] I ow' that in the performance of the work for which the permit is issued!that riot ample any person in any manner so as to
**subject to tis • .. . .. .:ion laws el .and than agree at 1 d became retied the **
to workers' *****************************************************************************
..ion .«a ,. the lobar Code s I
forthwith can ss prondde.
Data:�
Y, t74414al Aper INDIVIDUAL F E E BREAKDOWN
W-, .,:Fedaam - arae workers'compr sauon coverage is unleash,sn smell subject an employer to atMmlpenaluaand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
c
fines t 47 Ia one te,dred thousand dollars($IOg000A It addldon to coat of compensation damages as worded for In
don 3msotthe Labor Code Interest,and afoneYalea SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 •
5, 000 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there 1 a construction lending agency for the END OF FEES
performance d the work b which dire perm is issued(Soden 3097,Civ.C).
LENDER'S NAME
LENDER'S ADDRESS: .
Wendy that I have read this application end date that the above information is correct.I epee to comply with all My and county ordinances
and state laws relating to beide°conseudionad hereby authorize representatives of this Sty to enter upon the above-mentioned property EXPI D.
f«napedan purposes.
DANNY ATKINS
•
/�� q Fep 81 P2 1998/83:16 PM/$1SL25
AW-/. �iT�+ ,2—/ DATE �P �� "/ �g6 PERMITT::086718683
2
/•�� Date:
I.T': . .etJAppireM/Cwrma
(5151-45.WP) Wlwe-Building&Safely;Green-Rle;Chary-Appicanl:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING . POOL „-SPA
APPA)VALS Permit # Date Inspector APPROVALS Permit # 4"=/'+ Date Inspector
1. Temporary Electrical Service or:Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ', ,60-
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �'> /'
r ;. i.
4. Electrical Conduit-Undrgrnd. •"� • 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Presstjre Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE '
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., T, .
9. Water Pipe-Undrgrnd. 2 - 60. Backwash Lines, P-Trap, 0 U(tdrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK I
11. Property Sewer Line & House Corinection 62. Backwash & Receptor-Final
12. Sewer Cap ,.r -
63. Heater & Vent-Final I
13. Roof Drains j ' - 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
-
4,4109T rrai,n ,,y 3. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing art74. Overhead Vo
.6. T-Bar.Ceiling (Structural) & Monocoat • Dry Chemical
27. Frame and Flashing I 7�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 s;
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 Domestic-Final
42. Backf low Preventer
43. Backf low Irrigation
44. Landscape Irrigation System
45. Sound Attenuation - V
46. Handicap Regulations -
4
47. FINAL STRUCTURE & BUILDINGen 14
48. FINAL PLANNING r-n
49. Electric Release to Edison r. 1
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY '
No. Date
i I
I1
32387 PAID OCT 27-7O 'gjOO
cnsa11li 1* ***178.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Com letely APPLICATION FOR BUILDING PERMIT
r C- , RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING /t •�/ [\�' y
ADDRESS 1 I � iC .J ' 1/47—27-70
/ PERMIT NO.
OWNER .� of7 4 by CO i A.P. NO. , _ _I
MAIL , BUILDING '
zADDRESS ADDRESS (r115 A_n-c "
a U CITY fu S //J✓ 63.9_,
"/� 7 NOL TRACT s �/ LOT BLOCK
Z - NE ADDJ ALTFR�tiJEPAIR MOVING DEMOLISH
CONSTRUCTION t'}� 111
ON LENDER 1111_`([)\
am _ ,, //j
_ID BRANCH 6 a A ., 7J�A/1X�G�C
JN OWNER //' g0 (rt{��wf
m J ADDRESS VALUE
_j
CO ARCHITECT TEL. USE $
N
OR ENGINEER NO.
U Q FIRE , / n�/
W CC ADDRESS /• /� (\� /J ",_, ZONE TYPE/�/�/V GROUP id0_ Ly / ✓fin
W Z ON t/7 t—r A d 7 ✓1/ BYAPP ROVED MS4TE JO-27(//// 7
J O L!
L / / rej4
Jm ADDRESS ,22 Z G? /' 1� �� 'Lt r�}-r l.�'{`/�2J�,
LU tri �//�lI / `TEL.,....._, Z E NO.OF USE OF NEW
Z ""7 s.s. Al. I n r1-- PLANS \---- BUILDING U4 Pri
CITY ./3.�� NO. Z5-41??no
U.1
O STATE , // / ��j CITY YARDS APPROVED YARDS APPROVED
co K LIC. NO. I�N hp, / LIC.NO. MAIN BUILDING ACCESSORY BUILDIIIIGGGG _
SIZE /,'_/ NO.OF BLDGS. (FROM C/LSTREET)
7 O OF LOT �f
/A " I D2.: O, I NOW ON LOT FRONT SOFT. - FT.
USE OF 8^
EXISTING BLDG. B.SIDF /FT. FT,
I- SIZE OF / NO.OF / LV
ZZ NEW BLDG. 22 V 6 ) ROOMS STO I �'• L.SIDE / / FT. FT.
EXTERIOR WA (DIY ROOF /�' �1�.
CC.l COVERING Lt CCP COVERIN OA-4a REAR /{1 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
0- qMAIN BLOCS. ACCESS.BLOC'S.
Q '/ !� CC WC �� L7//7/CC.V.P.aj
DATE
APPROVED 3`-14— 7 0
I- APPROVED
CO _.11Y ///]//Y _(//`�yV�'/ DATF N 1-31.2o
O ,i. ,I.2*D/A �• l
UI hereby acknowledge that I have read this application and state HOLD FOR SPECIAL REQUIREMENTS
✓ that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
H any person in violation of the workman's compensation laws of
y the State of California. '�Jt m
�` �zO 2-.0 m
I hereby certify that I am properly licensed as a contractor under SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER ALU ATION IS FOR s
Chapter 9, and that such licenses are In full force and - ect, or I THE PURPOSE OF ESTABLISHING PERMIT FEE ONLY:
CC
am exempt from the provisions of the State .f Callfor Business VALUATION
and Professions Code, Division 3,Ch=•ter V / /Q p N
PERMIT FEE $ ! /
D
Signature of/ Pim-- r -,i?y _L � t cd �r^�` _ m
Permittee X • w Sri _ _ _ $ (26.12---- PLAN CHECK $ fJ ,t cS o g.
o
v
Authorized Agent - TOTAL FEE $ /7?
:CO
LL
/
\.._-.--/. - : 33065 `_
COSTA MESA BUILDING-SAFETY DEPARTMENT HAY 10-77�p100O 313 zJ*****5 �;p•
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For
Applicantp / to Fill in Completely/ le _{ .A
ADDRESS BUILDING,�/ p S' ////C/�r/M ft. (OyH /'/z°SC/. RECEtV ED 0}' D E RECEIVED `D,A�E ISSUED)
�1+ / (/J1r{a,�t'-/ty�_ '� 7 /j P RMI T
orOWNER 1,40/443#/7 J 'flJ t Z. A.P. NO. /— 8a-- I a-
MAIL pc//J .,/,, /Axle/e BUILDING 'ft
Z ADDRESS /JS 470 77,374.k (/i.1Lw til 7P "j zi)f/� ADDRESStc, / gs �jQC. �
S-
0_L) CITY �$j/ry 9.2610 / NO. '^ T OTS BLOCK
P1////`Y
zQ CONSTRUCTION O // - NEW •DD ALTER REPAIR (MOVING DEMOLISH
d m LENDER /tc•P! /14e O+'//d7S I - �J.
J BRANCH �1/J fU ���(-' OWN ,JJ
m W ADDRESS E• //r/t fon 4 "7Hl/ //////������//////,��, .��.��_��_���~,,,,,,������r „a op
—/ VALUE sv
J m ARCHITECT TEL. S/$ /V1.tM✓►9'o $Z'�\
Q OR ENGINEER NO.
U
y .
FIRE i7t/Jly
W 2 ADDRESS // //'' ZONE TYPE GROUP
0_ LyU1 O CONTRACTOR •� 44 . •JfANSCIL APPROVED _ . t DATES-7 7
m Z
J 2 ADDRESS A C/ieAlj7/A 'it-ter /UA-UO45 'AA
W wTEL. ZO
//py��
zI- CITY werie, NO. 410/1, '/ Y (PLANS BUILDINGNO.OF USE OF NE ]
0
W STATE CITY YARDS APPROVED YARDS AtROVl
to CC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D O I (FROM C/L STREET)
SIZENO.OF BLDGS.
OF LOT CQ)( /D2. I NOW ON LOT / _FRONT FT. FT. _
USE OF 1
EXISTING BLDG. Ae�tv CM/S. _R.5113F _ T. di 9,l FT.
I— SIZE OF / ', NO.OF / \ /� •[,
Z NEW BLDG. 6Ox4.c) ROOMS /7. STORIES 2 L.SIDE FT. FT.
EXTERIOR WALL ROOF (('^//Q //
V_ COVERING Ua'O COVERING J/C / e • REAR FT. FT. ,
.J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
C
a MAIN BLDGS. ACCESS. BLDGS.
Q ,C"/,/ / 1 VAR.#` DATE �7
O //�44,7,1Cn/c.t z the_ SAhfU"ove - C.U.P.#L,Cp- /�J'- AS APPROVED V—ft,-70
Z gee/4/.1/2e 7? LUr.6- / / RAartyP b� t L, •: S --7-7/
airO
VI hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
fA the State of California. to
? I hereby certify that I am properly licensed as a contractor under SQ. FT. 6
the State Of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
am exempt from the provisions of the State of California Business f[
and Professions Code.Division 3 Chapter 9. VALUATION to
✓ PERMIT FEE $ f N
Signature Of •� c !/ D
Permittee m
$ i{�0 PLAN CHECK $ E
o
Authorized Agent \ S • -..-:-...--.. u.
L TOTAL FEE $
33128
MAY 27-71cM$f°,OQ1232 0****fl),Q0
PAI
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
ADDRESS l7� �O,(ro.+t /yd[. (�f�I //rj17 , RECEIVED BY DAT��RE� t/7/ED D ISSUEE,�7 /
BUILDING J�'••wv/••U �J�"
/� // // 8" — / P MTN,O(
OWNER /j/ a. ,(Ara IG 4L A.P.NO. 1/4—I of ( �lY��
MAIL r /•1s7, re,h «/a U4 BUILDING ) 7 (f�• L ./fof—
Z ADDRESS jf////!/jf; //ay Tf�%npp 9 490 , ADDRESS In 4/
y[��j
d U CITY 771(75-,•f 99110 NO.d3o'r/Cq. TRAC y��() �'I LOT BLOCK
ZZ /
Q CONSTRUCTION mge / ('� NEW ADD ALTER REPAIR MOVING OFMDl ISH
O—N LENDER Fete'iiG .kM. 7 , i .Ooq /0_ ci3
J 7 BRANCH sB/(/a /Go•• / ��'/�✓ ,t ,, /�
_1(n owo&r t-IX�I.-<2 � 4 !_
m J ADDRESS �qrf /7/.' .C/,/fq 9/rd. - VALUE /4-0-0 Q-[�
m ARCHITECT ,�yy TEL. VS rTL/L.[ $OUP
-1 N OR ENGINEER (J//!HC/r NO. 1.4,f//q
ZLII CC ADDRESS �$ n�ar� ZONETYPEGRO UP
;47
D SQ' ,f APPROVED
��(_ C `�I I
J O CONTRACTOR ////JBit �/, BY
/� �r DATE) / `
mZ
J ADDRESS /42Cw alIIAo acc n
Z r CITY �-j^ NO../s f.//Lf- ZO PLANS Ner BUILDING USE OF EWT
TEL
-o STATE CITY YARDS APPROVED YARDS APPROVED
t/12 LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D O ! n (FROM C/L STREET)
SIZE iOF LOT tie) Jt/Q2,.' I W NOON LOGS. /
FRONT FT. Fi ✓---s/e//
USE OF //
EXISTING BLDG. 4z,0i.le}pf{/5• A SIDE FT. I I FT./ /r
I— SIZE OF •�I ' NO.OF n
Z NEW BLDG. GO/.4/C, ROOMS/0 SSTO/RIES.C. L,SIDE FT. .23 FT.
iJ COVERING WALL J L(`Q• ROi.1 FAce .S6/Jtc•• REAR FT. ✓ / FT.
—I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
dCL MAIN BLDGS. ACCESS. BLDGS.
DATE
O /Ji//`1C/ 64/0,2/fry 4WI4. 4° �CU.PpgpP�/ 1// APPROVED > �J
C/3 IISPO ..fret.,* /yL�COLCS /C7 gYP(f'`V// [.µ�jr��/J _ DATE GJ —� /—/
O F.Y/ffiic 4' .6(5,19'//t'1 U
,-
1—
I hereby acknowledge that I have read this application and state
M that the above information Is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
N the State of California. m
ZI hereby certify that I am properly licensed as a contractor under SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR S
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2
am exempt from the provisions of the State of California Business
VALUATIONre—C.2m
and Professions Code,Division 3,Chapter 9.
PERMIT FEE $ O N
Signature of � / l PLAN CHECK $ —� m
E
Permittee $ /1-.0—'d
Authorized Agent D OTl u.
TOTAL FEE $
- • • - 33247
' JUL -9-71fRE 659 d*****5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For
pApplicant to Fill in Completely
Ada.
RECEI D/8 DAJJ R EIVEDIV/ DATE
�IISUED
ADIDRDIENSSG ix $41,..;,. % AZ AWZ. ) (t� / -1/ 7- ! //
A.P.NO. /)11- / —%� PERMIT NO.
OWNER t1(/
MAIL i�ve�'w BUILDING /%� an-L4-44-2,-.2 33247
Z ADDRESS %SS•DO Tlsyr � � Wpi/ ADDRESS y gyp'•//I �Q
0 U CITY �f'//K 926 toui / NO.twat TRACT cax5116 I LOT ,.<--- BLOCK
Z ///
CONSTRUCTION /q� // NEW ADD ALTER REPAIR MOVING DEMOLISH
O I- LENDER I^CF/s�/�'s^�/
J D BRANCH fjt _,sia
_I fp / OWNER X LPIJ#YlSpoil
m J ADDRESS E /7f f.y j . 44,„z VALUE
m ARCHITECT TEL. USE $
'J N OR ENGINEER �— NO. ��
0 tn FIRE
Z
W ADDRESS ZONE• TYPE,--GROUP,
APPROVED // 7
W Z CONTRACTOR (9LfPlf BY DATE r%' //
J j� ..
mO %IgT �' �k�nu/ � /
Jin ADDRESS/3;WG� ����`' /�/ ! 6
LII W �,� 1� ` -- ZO,ME a_ NO.NS USE OF NEW
Z O CITY l uJ//h 72690 NO.f fcn/iY 1f PLANS BUILDING J
ill-
LU STATE / "' CITY YARDS APPROVED YARDS APPROVED
D O LIC.NO. LIC.NO. (FROM MAIN BUILDING ACCESSORY BUILDIJJ �
SIZE INO.OF BLDGS. F�- �' � S —
OFLOT 60 X/02„ NOW ON LOT / FRONT FT. _ ---Fi.
USE OF '
EXISTING BLDG. J �T R,SIDE 0 FT. 'SFT
I— SIZE OFNO.OF �r•�I
Z NEW BLDG. 10,c4.0 ROOMS /7. STORIES 2. L.SIDE " T. 0 FFT.
U
EXTERIOR WALL �}� ROOF
_ _ COVERING ✓�r"«_(0 COVERING REAR ------ —.------
FT.FT� —.------
FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 MAIN BLDGS. ACCESS.BLDGS.
Q „ .', G `ria• a.42r-• C URP.ale - DATE
APPROVED
O.
j��l APPROVED • 7
DATE /
-- 9_ 7/
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VI hereby acknowledge that I have read this application and state
p that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
N m the State of California. m
2 I hereby certify that I am properly licensed as a contractor under 50. FT. o
the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: d
am exempt from the provisions of the State of California Business _ IC
and Professions Code, Division 3,Chapter 9. VALUATION m
J{s N
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Signature of A/ ---// V i1C m
Permittee '(� r " C $ dr PLAN CHECK $ E
lo
Authorized Agent S--/ u.
TOTAL FEE $