HomeMy WebLinkAbout2472 ELDEN AVE - Building Permits '1 • • •
CITY OF COSTA MESA '
o 'f= BUILDING DIVISION
77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • wvrw.ci.costa-mesa.ca.us
Ira ' FOR INSPECTIONS CALL:(714)754-5626
•'t'.c, e d•'
PERMIT NUMBER: B09-00289
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 43929109 DATE ISSUED: 1112412009
ISSUED BY: BJK
JOB ADDRESS: 2472 F ELDEN AV CM Suite/Unit: F
Vicinity: BLDG F
Squares: 2500 Valuation: $13,000.00
SCOPE OF WORK: REROOF BLDG F
T/0 EXISTING ROCK ROOF, INSTALL TORCH-DOWN AND HYDRO STOP.25 SQUARES
OWNER: GILBERT, DEAN E TR Address: P 0 BOX 2207 Unit:
PHONE: City/State/Zip: NEWPORT BEACH,CA •
APPLICANT: ALLEN,MIKE Address: 3943 IRVINE BL Unit: :UNIT 297
PHONE: 714-813-2667 City/State/Zip: IRVINE,CA •
CONTRACTOR: ABOVE IT AS ALL ROOFING INC License No. 908069
Address: 3943 IRVINE BLUnit: UNIT 297 PHONE: 714-813.2667
City/State/Zip: IRVINE,CA 92605 CELL: 949-673-9222
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
•
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $223.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $224.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE O. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE, DATE IN1111ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical _
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof . • - 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 - Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
•
r es -
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver a license. El Yes 0 No
I hereby affirm under penally of perjury one of the following declarations: Driver's License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
cJ-'I have and will maintain workers'compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: s- person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,or demolition
Sr:Wor dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(This section need not be completed d the permit is valued at one hundred dollars(5100)or less.)
2,Art 2Sec.341,The 8,California Administrative Code).
Pol Niru 113er: 3c3 —t79
l3 ❑ As owner-builder. I will not employ anyone to do work which would
O f certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to workers' compensation provisions of Section 3700 of Apq,ant's Signature Date
the Labo Code,I - all •rthwith amply with these provisiQnnss.
!
�^ I 1-f IG Division of Industrial Safety Permit Number:
.ppi ignature ( ( HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is 4.full for - an. -ffect. n a registration form for acutely hazardous materials? CI Yes 0 No
iktie Cass l. (Section 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
Cont - azure ' �� n hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑No
(Section 25534 of the Califomia Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No
l hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the Califomia Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044.Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by Califomia
License Law does not apply to an Owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
thereon,and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for B. (If"yes",attach certificate of compliance from the appropriate air pollution
sale. It however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I. as owner of the property.am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Dale
property who builds or improves thereon,and who contracts for such project vilth CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Si nature e IOvmerls) /Date(/ /q
Signature Date
906]-a6(]/e]) AndrbfALlF6 FeAl3ploanr
CITY OF COSTA MESA
°"'F4 .p BUILDING DIVISION
F,, , AI, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
t. FOR INSPECTIONS CALL:(714)754-5626
4yfi
PERMIT NUMBER: BX09-00093
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 43929109 DATE ISSUED: 04/29/2009
Zoning: , ISSUED BY: RMD
JOB ADDRESS: 2472 B ELDEN AV CM • Suite/Unit: B
Vicinity: GARAGE Primary Occ: Const Type :7?
SO. FT: 0 Valuation: $500.00 . •
•
SCOPE OF WORK:
REMOVAL OF EXTERIOR WALL FOR GARAGE CONVERSION IN ORDER TO BRING BACK TO ORIGINAL GARAGE FORM.
REF#: C09-0891
OWNER: GILBERT, DEAN E TR Address:: P 0 BOX 2207 Unit
City/State: NEWPORT BEACH, CA ' Zip Code: 92659
Phone:
APPLICANT: GILBERT, GARY • Address: 2472 ELDEN AVE • Unit:
City/State: COSTA MESA, CA Zip Code: i. 92627
Phone: 949-910-3972
CONTRACTOR: RENOVATION INSPIRATIONS INC . . - License No. 843600
•
Address: 2472 ELDEN AVE Unit:
City/State: COSTA MESA, CA
Zip Code: 92627 Phone 949-910-3972 Cell:
ARCHITECT: License No.
Phone
ENGINEER: License No.
Phone .
FEE SUMMARY
Building Plan Check: $0.00
Building Permit: $23.50
Electrical Permit: $0.00
SMIP Residential $0.00
SMIP Commercial $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $24.50
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes,and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. INSPECTION TYPE DATE INTITIALS CODE S INSPECTION TYPE DATE IN1ITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign222 Final Site �
204 Final cu
Demolition 250 Final Builtling/Ocpancy `
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver a license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: . person is required to descend,will be made in connection with work authorized
Oerrier-�
57A[ e- h uinn by this permit,and that no building structure,scaffolding,falsework,cr demolition
Lor dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(]hirs section need nor be m'mple(t@id if the peon is valued at one hundred collars(S100)or less) 2,M2 Sec.341,Title B, California Administrative Code).
PoltcyNumber: /e N c]
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shall forthwith comply with these provisions.
A�,1" 2q 0 1 Division of Industrial Safety Permit Number:
1I � HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
GUJ Clae��` - (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
/l/}/L..,, •-�f� t/Z9 f7g each business which at any one time has on hand a quantity of acutely
ti--CSntradors Signature '"Dater hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 10No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the properly, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own B. (If"yes",attach certificate of compliance from the appropriate air pollution
employees,provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of Legal Owner(s) Date
Signature Date /1^ �_ rl/2�/ 7
305746(107)
. • 4l L/ •a tea- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY G COSTA MMES//A y CONSTRUCTION PERMIT .0 i yR_3 NO. TRACT TRACT NO. • LOT NO. 4i10s .
'Project Address r ! ' ' i9mOl° D / /7/ 5014 4/01 /B0 63650 TL
Applicant's Mailin• Address Y i / at../, • TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name ,_=�// �J :ii!/ Phone DESCRyTION•0F WORK/USE OF BLDG. �,4/ • �— -
• / S Main Building: AccessoryBuilding:Address , I _ i I. L' ''� i!i �� i 7 9 _
Arch/Eng. / ' License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front Z0
Address • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B• A Rear N
Contractor's Nam- A. /' ! „� /rum-•�i_ h ne �n//�[� ❑ OTHER - C Right N
Address mailing) '�JJ��//{{ CO•• [/= �!]L �fjJ PROJECT DESCRIPTION SQ. FT. 3/700 OCCUPANCY�.../�Q- K • G
'^��� �_ "-' .�'•Z�Z�yn CON ST RUCTION TYPE VALUATION$ $ Left �- -
CityLicenseNo. _ 1/�1 SO ZONE GRADI NG CU.YDS. AC S R \
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
• I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: � ��i7 _ �� IA ' Planning Notes:
0
with section 7000) of Division 3 of the Business and Professions Code,and °/y M
my license is in f :f • . a ` T
License Clas • Y ----' Lic- 5- o. r ��J S
Date - - •1. Signature / - :�- ' PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
I hereby affirm that I have a certificate of consent to self-insure or a certificate •
A ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
V( l00 Lab. C.) � Automatic Washer Transformer 0 15-50 KW
\ y No. 873 ?.9-'7 r
I r1"f 1=Company S N'D Backflow Irrigation Sewer Ca - 0 50+KW
P Construction Pole Sub.
Certified copy is hereby furnished.
Certified copy copy isfiled with c city Buil4Z-t wslop Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 hmps
Date y'/' �� Applicant S L/EC LAR /(� rite� Clarifiers Solar Collectors Dishwasher - Meter
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dover 100 amps
• (This section need not be completed if the permit is for one hundred (5100)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 T Fan Motors 1:10-1 HP 01%-8
Workers' Compensation Laws of California. _
.Date Signature Floor Drains ming Pool w/Spa F.A.U.
NOTICE:If,after making this declaration, you should become subject to the — Inc.SOI 9-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. crowave
CONSTRUCTION LENDING AGENCY Gas Service Outlet Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater ts Outle
Lender's Name Range
Lender's Address - Kitchen Sink - Water Service Switches
OWNER BUILDER DECLARATION - Sign
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 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays
any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0-$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
131.5 by any applicant for a permit subjects the applicant to a civil
' enalty of not more than five hundred dollars($500).
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered - - - Reinspection Fee I $15 Issue Fee $ 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 REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler
/ pel
0
sale. If, however, the building or improvement is sold within one year of com- Type II 0 Zoning Approved By 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`ieifi. y
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structuraln System Appli anon Issued By //� fl:fir Date / /-tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating0BTU ❑100,000 BTUSU ARVOF FEEbuilds or Improves thereon,and who contracts for such projects with a con- /tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multippair/Alteration BUILDING PERMIT $ C'3 •� SMIP $ j�
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ PERMIT
ISSUANCE $
Date Owner Heating System& Ducting Registers• I ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL— PLAN CHECK 25% $
information Is correct. I ag -e to comp) 'th all city and county ordinances ELECTRICAL $ GRADING $
and state laws relating to 7 i •'ng eo ction, and hereby authorize repre-
sentatives of chi y r u••f •a above-mentioned property f r MECHANICAL $
inspection purpo ,/ -/ (,,�py� •
Signature /L • / - Date Y /- O V TOTAL FEE. $ �/'
Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or 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 Inspebtor
1..Temporary Electrical.Serviceor 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 UFER Grnd., 57. APPROVAL TO COVER-GUNITE
7. Footings58. Electrical Conduit-Undrgrnd.
8. Foundation - • i^ 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd" 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line&-Fiouse 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 _-K.
24. Roof Framing 73. Undergrnd.Storage Tank O Gas ❑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 C
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
S
33. Final Electric Notes:
34. Final Heating & Air Conditioning
.1•
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plumbing a' '
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 ppp
47. FINAL STRUCTURE & BUI LDING �/,A/ fa-- I •
48. Special Requirements Completed 1 IO i'��
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - O.
51. CERTIFICATE OF OCCUPANCY ,
•
No. Date
7252 EE RECEIVED
f.� /:
C
OSTA^MESA BUILDING DEPARTMENT — —.5'g v c.
P.O.BOX 317
FINANCE DEPT.
COSTA MESA. CALIFORNIAL
cITs nF COSTA MESA
•
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ABM
-RDE
c # 70, E /den Ave BUILDING
•
�
7 [� a_
// i/COSItA MESA. CALIFORNIA FOR OFFICE USE ONLY
OWNER ,D{J(�jr'n E, &I I hp`/�
RECEIPT NO. _PMI 2_
ADDRESS ,211- / 1 F Idle h A v RECEIVEDii�Y(/'7 jy=E El .pj f-T25'UED i
CITY Costo Mesa NO.A.I' 7/3 ADD EIS: L ( 72. 670441 Qv A✓IG_- 11-/f/y
'ARCHITECT LIC. C
OR ENGINEER NO. COSTA MESA. CALIFORNIA '
FIRE IADDh_.-5 ZONEI
CITY LIC. ONE}? NO.OF TYPE ! GROU /
CONTRACTOR 0 L erNq. //'}I ,TEL. may/
ADDRESS NO. BYP O / 4r
/�` i'J -/f DATE
LEGAL
CROWN CORRECTIONS
DESCRIPTION BL
OCK TRACT 300
A.P.NO. / / 9--/p [J - (9_ /jA.�� (}Tpy���y,�•• \j/�{�`��/fy _SIZE O.OF BLOT • PPRV Y EOF LOT G6 X 3 0s OW ON `°T CITY OF SI A rvlE-a
USE OF
EXISTING BLDG. pr &Fd ., G UFIT I.
SETBACK LINE FROM t.A� , SUBJECT TO DG. DEPT. REG.
CENTER OF STREET SIO REAR YARD `�
l / /
SIDE YARD RIGHT /�/ LEFT2 BY 0./rid DATE
DESCRIPTION OF WORK U PLAN TECH.E 7 _
NEW ALTERATION p ADDITION •
REPA... I MOVINGQyyAppp DEMOLISH
BUILDING rte, St. O.OF
SIZE cIOw, F 4 LLYYOOMS /0 STORIES /
EXTERCOVERIOR ING WALL CC,//UO C✓OVROOF
EERIINNG Zr11 -tChwe �
BUILDING •
USEW IneiiJ nee .1 �(// 7 e
//6#'7'° 4-0-40---
e .6/
iso-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND �� ;J/ I
STATE THAT THE ABOVE IS CORRECT ANDjCONSTC.
0 COMPLY WITH ALL f/
CITY ORDINANCES AND ST E LAWS REGEVIL I TION. a
VALUATION
SIGNATUREPERM ITTEE OF` OQl2 P MIT FEE 5
J
- s v
/I Seo_, PLAN CHECK 5 (.7
AUTHORIZED AGENT / TOTAL FEE 5 ...6-" 2 - •friF
je.r itt .e
9547c t. 6-{t i l[. I 'if
• pv .Lic9 1869
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA, CALIFORNIA CITY OF COSTA MESA
FOR APPL/CANT TO flit IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING iii
ia EIceh five
ADDRESS r�A/� p
COSTA MESA, CALIFORNIA/A � Tyle OFFICE USE ONLY
OWNER Den IA F. G.I be(1.- ��p///���EEEDDDVVV I RECEIPT NO. I cTV7
MAIL ^, 1 E Id e�V VV"t T"l)/ EO BY I pA^E ECEIV I 17/AT s/� -
MAIL
ADDRESS
C) 7,c
I� g-1771 ,\Nlyl�' C/''l/7O /
CITY Lf),c 4 '`1 esa TND. ADD A 2- / / �1Z �/Pq/ 'g�1e,
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER NO. FIRE - V
ADL_ ..S ZONE , ,
it
STATE APPROVED ��/ -4
CONTRACTOR Ooh eIr LIC.NO. BY en/.- • DATE �$ S/
ADDRESS ZONING
LEGAL I S(� y1 /Y� ZONE NO.OF UBEOFNEW ,..p
DESCRIPTION NOTs ua lB I/I_BLOCK /) I TRACT 3u/ ry+(��� I�
PLANS
//�� /BUILDING //! p �
A.P.NO. 1/ �J Cb
Y/ - / I BYPG// !X 6i-----/MS / 1�.!/' Ia 7
VE
// . 3/\ r f NO.OF BLDGS. YARDS / 1' EVES ,D
OF LOT !Y-/ X (J,.J. NOW ory LOT REQUIRED ALLOWED
USE OF Y (CENTER LINE ST.)
EXISTING BLDG. 1IAI lex " ?SI dPyle� FRONT / O FT. R/ IN.
SETBACK LINE FROM rO 1 • /i 'j
CENTER OF STREET S.
REAR YARD b R.SIDE /�/ FT. IN.
SIDE YARD I LEFT S. I RIGHT I(J' L.SIDE ' O FT. IN.
DESCRIPTION OF WORK
NEW Ix II ALTERATION I II ADDITION REARPJ. FT/ A I w IN.
REF. .. II MOVING I DEMOLISH ^[�/--
Fri N a20 s 5Ltvuge.
SIZBUE
Q /� xn ROOMS g STORIES I WC Q � 0j'-/#� �/
EXTERIOR W�A(L•LJC I UCCo ROOF
I COVERING r?IOCks 1 (,-
COVERINGXTIOR .S 1
USE OF BUILDING AND WORKTO BE PERFORMED
RO 1pIIPin C P „ f-7%7
ataratA
I HEREBY ACKNOWLED THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND TATE LAWS REGULATING PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCT
VALUATION
/'/A BD
PERMIT= OF
Fi _gr..4,1 / /L,IT `^X f`,5767---, PERMIT FEE $ .3 i-
JJJ 02�/ `LAN CHECK S /5:AUTHORIZED AGENTJ/,
.V.21 Q.rj 1 . TOTAL FEE $ ,
►)
13304 I FERECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 1 n . 9 !r(�0_ �0 r
P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
•
For Applicant to Fill In Completely APARACitOPEEVVIT
TYPE OR PRINT p BUILDING
BUILDING P 41 /1 E en (y. 1'e,
ADDRESS COSTA MESA. CALIFORNIAFor
`I� For Office Use Only
OWNER Defi `� G- Q` `r` I RECEIPT NO. I PlgA1 NEL5 L ('
MAIL LI Lien r RECEIVED BY DATE RECEIVED 2,1/ SSUED 1
ADDRESS/ ( �� f I 17��a �-CO( �_ D
CITY` A-9 S A WE'.c a NO.�.i k673J ADDRESS
ARCHITECT0 TEL• - COSTA MESA. CALIFORNIA
OR .INEER UJYIP �- NO. , / I
ADDRESS ,^.- FIRE
ZONE. TYPE y GROUP 4111 i
CONTRACTOR 0 (A) h e r- APPROVED /y/
BY • DATE
ADDRESS "-- NING --• e
ZONER IPNLAOSCITY BUSLDOFNGNW
STATE TEL. LEGAL / / ',i �,/_ �j�
LIC.NO. NO. DESCRIPTION /�j(p Olr�p'{� �-
SIZE D -
OF LOT If OC- NO. OP sLBLOOMlI
APNO '�e��d
3 O NOW ON LOT A.P. . //y-- (7 116
USE OF 1 .. 11p eYARDS EVES
EXISTING BLDG DUO .II I VI •
)(�' APPROVED ALLOWED
{n,.
SETBACKNTERLINE FROM T /1 / REAR YARD 3J / 1 FRONT(CENTEA..5.—
LINE ST.) /C FT. 7-j�-c//' , IN.
CENTER OL SEREST ll r / /
SIDE YARD I LEFT (OH I RIGHT • 6 , R.SIDE ST. IN.
DESCRIPTION OF WORK
syr L.SIDE `7 FT. IN. -
NEV /\ I ALTERATION I IIII�I ADDITION I REAR •
.�/ FT. / /ISN.
REPAIR I I MOVING I II DEMOLISH I AABYPPROVEDE�I / - , , DATE Ail. 1✓ ,
BUILDING 40 y ies �/ O. OF 4I C(/? 7rl 0---.211
h �1�J
SIZE ^ I" ROOMS STORIES pL, / IY /� 1.
EXTERIOR WALL I ROOF 7 /I 4-020 -O -.in p(.v 0
COVERING SfQPf'O COVERING 4V' rass l
USE OF BUILDING AND WORK TO BE PERFORMED /6 a/ -3 ,,//- oir
4-3 O a' J - .'.-
•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT OWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STAT LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRU VALUATION C/
SIGNATURE OF • //�J� � r ' /��p PERMIT FEE $ J'�• }Q
PER M ITTEF �'L/T� 4/' /[1t p �..?Q, S.�y�
s .� a S , PLAN CHECK $
AUTHORIZED AGENT .. O o A
/ TOTAL FEE - G �' `S y j
: att. , FEE RECEIVED
16984 MAY 4 1962
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX 917 COSTA MESA, CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT _ BUILDING
BUILDING jA y a(e�� ( iJtif
ADDRESS N �� CIG XiL,LLfG�
,(�
COSTA MES• CCA/�UFO�RN/NIIIA/L //� For Office Use Only
OWNER 402in M 16' a. c 9 -'/ c/ V I REC81PT NO. PERMIT NO.
AMAIL
DDRESS ' ReCelyeo rTy�SIVA_
D- 2 1
� a��
TEL BUIL G / 4
CITY NO. ADD SS - `/ 2
ARCHITECT Oat-eh
[/��]� TEL.J 73 cqsT4 ESA CALIFORNIA
OR .INTER I. F'-7 Q-�e+ NO �/'`"r,�,"'`',
I /7 L
ADDRESS s W I F�>A -!'S/'C. ZONE TYPEIG UP /
CONT'ACT,OQR�n'f., /'/. /'/s [,G� WIy BY (194614
(/J.�1ATE 4/1/O
ADDRESS Aseb / W / U `Z/V�ING
M ' w ZONE LAOF /� UUI OF NEW q
CITY / — -rte yPLANB •/ //BUILDING if, 'T''✓/-`���+_-(���
STATE TEL.'/,�KDg/ r eeCRIPTION J/((/[J /24-n �,Jy/1 I:12-3��
E
OFSILOT. X—� c"----6
'\ I NO. OF NOW ON LOTS A.P.NO. // / — O Lfi V� / `"
OF LOT c-- v
USE OF YARDS EVES
EXISTING BLDG. �1 APPROVED // ALLOWED // /�,,
SETBACK LINE PROM 9. v1 REAR YARD'V4 FRONT LINE ST.I /II FT. /fIN.I3e
CENTER OF STREET O� V /yam
SIDE YARD I LEFT I RIGHT R.SIDE / / FT. IN.
DESCRIPTION OF WORK
L.SIDE / 7 FT. IN.
NEI I� I II ALTERATION I II ADDITION I" REAR ..J FT. IN./ J
REPAIR I V MOVING I (DEMOLISH I APPROVED L v,/ .5---2-
BYDATE -b
BBZILDING $E 0. OFMS STORIES HOLD FOR SPECIaQUIREMENTS
EXTERIOR WALL I ROOF _ i
COVERING COVERING i� it, ,,_
USEUILD NG AMID WORK TOLE PERF RMED r-
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONT AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- - RPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONBT,R�Uj�T�ION.
J /V/J VALUATION 22_�7
SIGNATURE OF�y/I/y/ �'`�� PERMIT FEE $
PERM ITTEF { IT{'`�' ���III Qa o
�/' / $� s00 — PLAN CHECK $
AUTHORIZED AGENT • / D 1 C
— TOTAL FEE $ /// I,
18540 FEE RECEIVE (
COSTA MESA BUILDING-SAFETY DEPARTMENT . JAN 7 1963 ON
P. O. BOX SI7 COSTA MESA. CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely cispa6cRa tgPPERMIT
TYPE OR PRINT
• BUILDING
BUILDING ....z.I./..7 3_ e Lbe A J A d e
ADDRESS
COSTA MESA. CALIFORNIA For Office Use Only
I RECEIPT NO. I . FELIMITz71.0
OWNER -INEAfj / .4"•-5
MAIL RECEI ED BY I/,DAT,REC9V.E, I DATE ISSU 03
ADDRESS SAME — — W
TEL. ......___
CITY NO. B.g.1 Lig kt..2 el 7€g e-a
ARCHITECT \....___ TEL COSTA MESA. CALIFORNIA )
OR 1INEER NO.. -
--------. FIRE
ADDRESS ZONE TYPEjtr.GcOUP .
CONTRACTOR 00 Mt LA L- et LT" row;imu out, :YPPROVED
DATE
ADDRESS I 11 4 4.9. 13 5 r ZONING
r
• 0
ZOT NO.OF , USE OF NEW
CITY S Af--I TA AA — ... 1 'n-um 3— 1BUILDING 0
STATETEL lc, ,_.0 0 tc
LIC.NO. (q NO. DISEGSACRLIPTION P 0 d9 Lot 'A (I 47C 300
OVELOT G6' Y.- a oo r 1 NO. OP SLOGS. /
NOW ON LOT I
A.P.NO. ii 7- c 6a — if 'y •
USE OF YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK UNE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT b FT. IN.
SIDE YARD I LEFT I RIGHT R.SIDE 40 FT. IN.
DESCRIPTION OF WORK
L.SIDE FT. IN. ..
.,
NEV 1.)‹ I ALTERATION I D ADDITION I REAR --Fr IN. ,
REPAIR I II MOVING I II DEMOLISH I APPROVED Lv. L 0
BY DATE
BUILDING NO. OF 0/1/1
SIZE ROOMS • STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
a-Or COMA41bUrry
l4 f
tf )(AI; 1.,a-o ( OMMumil-y
--- .L.-ot.-W lnj A L L— .
I HEREBY ACKNOWLEDGE THAT I H4/READ THIS APPUCATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS REJECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH AU. CITY ORDINANCES STATE LAWS REGULATING
BUILDING CONSTRU ON• VALUATION
r
SIGNATURE OF - - - PERMIT FEE $
PERMI77EF -- ...._..-z.._-___
$SO---- PLAN CHECK S ,11.
AUTHORIZED AGENT etd g
,,. TOTAL FEE $
u.
. .
25080 CITY OF COSTA MESA
COSTA MESA BUILDING SAFETY DEPARTMENT JAN 7 1966
P.O. BOX 1200 COSTA MESA, CALIFORNIA 02020 .
For Applicant to Fill In CamphNly Fopoultithl9DR PE IT
TYPE OR PRINT
eu1LINa y{ For Office Use Only
ADDROBSY 47a 'PI. 04r A-de_
RECEIPT NO. A�.(r!!MIT N
COSTA MESA. CALIFORNIA ,J 5 p CI
O
RECESY Ric IVEDD / //W' ��AWNER TAaam L- L,f/bev�
MDDRS .3st72.. Elriam A-v e,-- ADDRSSn2 411 72 E TAJ./ /V/
t
FIRE
CITYCel) ff-! Me 4 4 No. /
AP TYP / aRouP/%
ARCHITECT
T L BYPROVQD D4ATE //5
Z NNO
CRESS
�!:' � NO,OF USE
DNEW may/
-- ROAM "BUILDING �
A.(
COKTRACrOR (� }-� !�
DESCILIPTION Ph R Y •`
Leri 1' 3 Y a
ADDRESS
CITY A.P.NO. iI?-- 0CV -lI
NOTE: NO HAVE OVERHA
STATE TEL EO•TO SIDE&REAR P LNG SHALL Be LESS THAN
LIC.NO. NO.
812E OT G 6 X 3 I NOW ON LOT ALLOWED (U.B.C.REQUIREMENT)
OF L
YARDS APPROVED YARDS APPROVED
USE OF
EXISTING BLDG. R e S 14�A CP MAIN BUILDING ACCESSORY BUILDING
�f (FROM C/L STRE i__
SETBACK LINE FROM l-t,.{'�/� REAR YARD J I FROM' st `> FT.
CENTER OP STREET Q I(Q_IlM/. ,� /f)
HID5 YARD I LEFT 6- RIGWIOC t1T..41 R'RIDE en( �i �` (( FT.
DESCRIPTION OP WORK \y` L SIDE ‘FT, PT.
i ALTERATION ADDITION .. REAR 3/ RT. FT.
111 ` DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGH.
BUILDING � //�� // NO.O! VAR.* DATE
SIZE o1-V X 2b .ROOMS /R( ST/j1OOjRIESr/7 C.U.P.* APPROVED
EXTERIOR IN WALL4/�J I COVERINa{,AJ711'V{I' gill WO OYlROVED i , Sep ' F% E /�1f / 6
COVERING ���Y/ U 11 9-4 v
Use OfAutuI,� rrin ii WORE Bill PERFORMED Q
I
�!1!
Q� I de-t^- , aLd
I HEREBY ACKNOWLEDGE THAT.1 NAVE READ TIRE APPLICATION TIE AMOUNT SHOWN UNDER VALUATION IS FOR THE
E
AND STATE THAT TIE ABOVE IS CORRECT AND AGREE TO CON- PURPOSE OF ESTASUSHING A PERMIT FEE ONLY.
PLY WITH ALL CITY O RANCID AND STATEin RELYLATNG
BUILDING coNeTRY N. // // // VALUATION ®c ' ^ Q> 01
�y/'/ X//�//rU// PERMIT FEE ; ,c+'y E
SIGNATURE TEP Of
PBRMiTTH! �-�� -I _1 m6
AUTHORIZED AGENT S�. 5 O Q PLAN CHECK 5 1 2 w°
CO
- .. , .. .. .. . . TOTAL PEE $ 3 6
. -------.:
Pa!
4N 27-751c,c00 746 *****5.50
39530
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A I'L CATION FOR BUILDING PERMIT
For
LApplicant
ttto Fill in CompletelyL� p R E VE BY DATE RECEIVED DATE ISSUED
ADDRESIX SG S 1 /ca /--. IClc44/ / u c /2 PERa7-7s
OWNER ADDRESS nertAA-Pt7-�i �Y 'r k4 �t•
BUILDING
I' z� 'f k th0L/ yI . JV
ADD ADDRESS 0( yin
C (IQ-IT/
Lu LdZ //�, �')^/^' ( TRACT-30° T8, BLOCK
d Z CITY a S to__ /I Ie] a_. NOTELs`�/r�73L NEW ADD ALTER REPAIR MOVING. DFMOI ISH
ZQ CONSTRUCTION
O o. m LENDER
J r BRANCH '
J OWNER A-ACV /6/�Lyy��Aq finr-J}� _
CO W- I ARCHITECT TEL. USE pLOKTOR-S -`0/""4/IeU$ "'9V✓ •—
OR ENGINEER NO.
Z ct FIRE //r_ S
w W ADDRESS ZONE PE La-- GROUP
!' , APPROVED {'Ij��'
W Z CONTRACTOR O W n e���ldi: BY � / /! _ DATEf 27-7�
JO C�
mZ /�
W m /�
ADDRESS m O'lrG� ZONE NO.OF USE OF NEW
0= TEL. PLANS Z BUILDING
Z l- CITY NO. �c+ WAu--
W-O STATE CITY YARDS APPROVED YARDS APPROVED
cn X LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
NaOF BLOCS. (FROM C/L STREET)
S12E I
OF LOT NOW ON LOT FRONT FT. FT
USE OF
EXISTING BLDG. B SIDE FT. FT.
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. lie FT.
VEXTERIOR WALL ROOF n-
_ COVERING I COVERING REAR FT. -0 FT.tit P4E� .
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
d MAIN BLDGS. ACCESS. BLDGS.
I I / VAR.. DATE
U �ot. , ire i c e _ t hin -6 41,4
19 4 C.U.P. APPROVED
~ A9e1=MC t YI I ia_sieV 1 k /}O I . _HY ROVED�� DATE F2-7::2%.;-
u)
r L�
Z CsrncFefgbInc
o /stags
UI hereby acknowledge that I have read this application and state 9
that the above Information is correct and agree to comply with 4
CC all laws regulating building construction, and I shall not employ
/- any person in violation of the workman's compensation laws of .JpX
V) the State of California. to
I hereby certify that I am properly licensed as a contractor under SO. FT. o.-
the
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
CC
am exempt from t.. provisions of the State of California Business
on 3,Chapter VALUATION
Professions C Divisicoon N
PERMIT FEE $ D
Signature of , // m
Permittee I /61Zf S $ is�iJ(/ PLAN CHECK $ E
VV /v� `p
Authorized Agent
6111...---•"'
LJ• a'
,. TOTAL FEE $