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2344 ELDEN AV B CITY OF COSTA MESA - BUILDING PERMIT
ADDPf54°E SMLWMT: UNT:
1 OWNERS NOE IF wink TR UJ I L L Oz RAY PERM NO: B 081413
ADORES& 2344 ELEDEN AV #A
COSTA MESA, CA 92626 PERMIT NO: B 081413 PLAN CHECK NO: 00361-97 S GOVT: N SUPP: N
APDL.IUILRNOADORES& CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
RCNDEcTORDGNEETmGEORGE HANDY ARCH t*tio: C19024 JOB DESCRIPTION : 185SF CARPORT ADDITION TO EIXST GARAGE SQ FT: 185
aiCKOREt .5imREss: 24621 VIA SAN FERNANDO UNT:
MISSION VIEJO CA 92600 CLAIM VALUE: 2, 500 .00 CALC-VALUE: 2, 664 .00 GROUP OCC : U-1 /
CONTRACTORS PULE:
CONTRACTORS MARRIO COMMENTS : CARPORT ADDITION
ADORES& LK.NO: *******************************************************************************
UNT: ZONING REQUIREMENTS
UCENSED CONTRACTORS DECLARATION:I hereby affirm under panty of perjury that I em Boomed wider provisions of Chapter 9 S ET B ACK S
(commencing with Section 7000)of Div:bn 3 d the Balinese and Pblsesio'Code.and my Scenes.in hi base and effect.
CITY LIG.NO.: LIC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: 7 FT 4 IN FRNT: FT IN REAR: FT IN
Dae: C«maa«: LEFT: 5 FT 4 IN RGHT: 25 FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby ohm under penally of perjury that I en exempt from the Contractors License Law/
hfor the
tahowibawn(Section 70313 Busies and PrOhee:pne Code:At cry or aaaty which requires a permit toovnsbad.atter. PARKING REQ: PROV: PARCEL: 43926122 ZNE: R2-M REF NO:
ema'sh.«repair any structure.prim to is issuance. Rartaeuance.ebo require* artafor such peal lo Me a signed statement then he or she
accreted PLANNING NOTES> 1-SPACE CARPORT ATTACHED TO REAR OF UNIT B ( FRONT BLD
Business and Profession Code)or the he«she omenet therefrom end the basis for the awed exemption.Any Section > CARPORT WILL BE 3RD COVERED PARKING FOR THE 3 anyUNITS .•: - P
7031.5 by any applicant fore permb 0
subjects a appEua d camen to ova penalty t more fwe hundred dollars *-
s(MOD. * ************************************************'******SE***********.* ********
)0 I.ae owner athepeopeiy«ny rmares.w.h wagesasthei sole conperaabn,wa doth•wok and the*Ovatea not intended DEVELOPMENT SERVICES REQUIREMENCP S
or oilseed for sale(Section 704e,&Mina=and Professions Code:Thr Contrrton License Law does not apply to en ownproperly
ds or
who bain proves thereon.and who does such work tinsel or herself or through he«her own employees,provided that such
Impmvemeaeere miaarded r nlfaedfr We'It haassar•Ilw laWaing m kslaaswneal N said Salm aneyew ammgrbn,to ZONING APPROVED BYC E DATE: I ct (' r
owner-builder ell have the burden of proving he or she did not laid or impure for the perigees of sale).
❑ Lae«w,adlhe. .•
ems nna'act i,p amenmars."la BUILDING APPROVED BY : DATE:
Professions redoes License Law does cat apply to an owner d property who builds or improves thereon end who
ttatracb : . :.., with•nnntracta(el T.�.,r. ..pmtenat b the Contceaa lloensa Larry.
❑ Ien . ` �� APPLICATION ISSUED BY: DATE: �() o
3 ************************************************ *****************************
Da // -ea all- /' : v LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I em aware d. . .the eras of anis ..1 and Safety Code Sections 25505.25533,and
25534,end that 1 or Wry future building....n, b neeih d to-• . wsaid Saea
codes d the requirements ler
proal e pal for constemion or modification tram the A,.,a,' .District.. .:. •m,marucla aopicatims are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 74 . 75 . 50
DB1e APPlant SMIP/NON-RES
WORKERS COMPENSATION DECLARATION:I hereby am under a
p. b01rj
y pay One of the declaims:wvq declims: PLAN 4 8 . 5 9
ISSUE FEE
❑ Code.f dala mdownceof weamneerubewmaaeis vette* emper'atm.a*pwdedhrlys.mm37matne abo BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
epee.f«meped«maeadawerwiha*pma:mae. TOTALS----> 75 . 25 0 . 00 48 . 59 123 . 84 123 . 84 . 00
❑ I have and wD meiaen worker*'compensation insurance,as reigned by Section 3700 of the Labor Code.for the performance a the
work for which this synth S Saved.My woken'compensation Minsurance carrier and policy number me:
Ceder: REVENUE DIVISION TOTALS--> COLLECTED: 123 . 84 OVER/SHORT: . 00
Poky Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
' ((This section need nctammplaadrthe part.i.tor ono hundred dories,pl0OlrMac) 74 . 75 . 50 48 . 59
o 1 may that in the performance of IM work for Meth this pend b bard,I shall not employ any person in any manner to ra to
become abject to the workers'co pesatkin laws d California.and agree that t h stood ha * ****
become subject to the workers' **************************************** * *********************************
provisionscompensationprovisionsa Section 3700 d the Labor Code,I shall forthwith oompy with those pnw:bns. INDIVIDUAL F E E BREAKDOWN
Dae: Applicant:
W.mhp:Faun to noun WorkricOnpmeadonorrsp/s unlawful,and shell subject an employer to Aminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines Ipt to one hundred thousand dollars($104000),In addition to the cost of conper'atbr4 relies as Provided b,In
Sendon3706ofmsLabor Cods lmafmattorney's reliesSFR 185 RES-CARPORT (OPEN) 14 . 40 2, 664 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that then is a construction lending agency ler the END OF FEES
performance of the work ler which this permit is issued(Section 3097,Civ.C).
LENDERS NAME:
LENDERS ADDRESS:
I certify that I have read this application and dale that the above information is roe I agree to comply with all city and county ordinances
and slate laws relating to. mina construction end hereby authorize representatives of this city Io titer upon the above.menioned property
for iapwim,pn AY TRU. hi74
•�� 81-38-1997/84:81 P1/$123.84
. �i 1/'?4?-
T:8:81-888133Dae: PERMIT:881413
Ilir _ _ nd „'-'
r*-....\(5151-48.W P) White-Bnidi g 8 Safety:Green-Rb:Canary-Appbunt:Pink-Revenue;Golderaod-Asseasor
/ 1
CONSTRUCTION AND PLANNING P0( ,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. i 55. Electrical Bonding .
5:Steel Reinforcement 4 ,„..56. Rough Plumbing & Pressure Test -
65 Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE
,7. Footings ' �" / /!.
g F./ (� %' 58. Electrical Conduit-Undrgrnd.
.• 8:•Foundation - �/ l,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 & 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 - _ - - t APPROVALS Permit# '"
21. Ducts,in-Structure . a . 70. Underground Hydro
22. Duct& Ventilating- - 71, Product Piping-0-Gas ti Oil
23. Gas Pipe=Rough & Test - -', 72. Underground Fluih- - -
24. Roof Framing c k •'� - - ' 7,3. Undergrnd.Storage Tan�C O Gas 0 Oil
25. Roof Sheathing - .r 74: Overhead Hydro -
26. 7-Bar Ceiling (Structural) & Monocoat - 4. , s - 75. Dry Chemical •: •,-
27- Frame and Flashing, r .• 76. Dry Standpipe
28. lathing & Siding - • 7.7. FIXED SYSTEMuFINAL
•
29. Insulation ' - - Th. FIRE PREY. FINAL
30. Drywall Nailing r - - • •HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat' , - - •- a - 79. FINAL INSPECTIOPP
32. Electrical Power Meter-Final 80'. FOOD CERTIFICATE ISSUED
33. Final Electric , Notes: - .,i•. - o
34. Final.Heating & AiraConditioningv- 3 - -
I 35. FinaFGa-s Pipe-Test' - _ - - , -
36. Hood or Canopy = - _ _•
37. Final Factory Fireplace ; -
38._Final Plumbing - • - _- '
39. Water Service-Final' 7..
40. Gas Service-Final , • . -
41. m
Solar Domestic-Final '= - ..
42. Backflow Preventer -
43. Backflow Irrigation' • - - -
44. Landscape Irrigation System • - - - -• -
45. Sound Attenuation - - _
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING . l I -
48. FINAL PLANNING - WI.
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 except those within heavy border lines and sign all appropriate declarations.
8851 9/25/84 15.00 F
WOSTAMAO� NSTR�I �ER�T�� PER T No. TRACT NO. LOT NO. UNIT NO. •
ress JJ v F n/ "r� I
//l ' / TYPE OF CONSTRUCTION H NEW H ADD H ALTERATION H REPAIR
'Applicant's Mailing Addressd7 -2,%yg nte.A /9 q III CONVERSION ❑ DEMOLISH ❑ OTHER q,p-�6 I Zone
Owner's Name �J7�6� 7-A
oJ.rt� Phone557-2_,33 DESCRIPTION OF.WORK/USE OF BLDG. S Main Building: Accessory Building:
Address
•Arch/Eng. License No. TYPE OF PERMIT H GRADING U FOUNDATION H STRUCTURAL T FrontO
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL a Rear N
/ ,4/ ID A. r 1 rl " CIS t3-6 ❑ -OTHER A I
Contractor's Namr �7 Phone C Right N
Address(mailing)2 's / F t,010PVA t" Al(iP 8/'/1/19 PROJECT DESCRIPTION SQ. FT. - OCCUPANCY K Left G
— 5:73-6 /75� 7 J CONST RUCTION TYPE VALUATION$ $
City License No. y 3 I3 - ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION Ping. Ref. # j Parking-Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9 (comme Ing Remarks: - Planning Notes: • • M
with section 7000) of Division 3 of th• Business and Professions Co1and
my license Is in full force and effect. ' e . t T
Licens; lass _ nse •. - �� •
S.
Date '- 3 Signature %� � / PLUMBING FEES i '
N. '
' - WORKERS'COM•ENSATION D CLARATION • Bar Sink , Showers •
I hereby affirm that I have a certificate of consent to self-insure ora certificate - • . ELECTRICAL FEES
• • of Workers' Compensation Insurance, or a certified'copy thereof (Section Backflow Preventer - Service Sink -
3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. iU 2q4 CI 7 I Compan E , . ers inBackflow Irrigation • Sewer Cap Construction Pole Sub. i El•
50+KW
Certified copy is hereby furnished. ,s
Ce ied c�y-4 led with the city B �insgg DivisrOtl[ /� / ' Bathtubs • Sewer Connection Cooking Unit ' I Meter ❑up to 100 amps
XDate 'l-� Applicant �-01/00 r
EXEMPTION FROM WORKERS'CO PENSATION 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 0111-8
Workers' Compensation Laws of California- -
Date - Signature • Floor Drains Swimming Pool w/Spa F.A.U. /�' Inc.Solar ❑9-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the •'
,NOTICE:
Compensation provisions-of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - - - - - -
comply with such provisions or this permit shall be deemed revoked. ��nrr - Microwave •
CONSTRUCTION LENDING AGENCY XGas Service Outlets / � Water Closet -
I hereby affirm that there is a construction lending agency for the performance ` Z Device Boxes . Pole Light
of the work for which this permit, is issuetl,(Section 3097 Clv. C.)• Interceptors - Water Heater Outlets Range
Lender's Name _ - _
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
•
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal 'Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' '
any structure, prior to its Issuance, also requires the applicant for such permit • Generator 00-5 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 r
Division 3 of the Business and Professions Code),or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section '
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). I
-OI, 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 Hood or Type I 0
sale. If, however,the building or improvement is sold within one year of com- Canopy! Type II ❑ Zoning Approved By • Date •
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground APPlOVed By �-!� Date
Ove for the purpose of sale). � �y� ,I� -Z
I, as owner of the property, am exclusively contracting with licensed con-, Duct-Structural Refrigeration System Application Issued By Dat -J
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-Ventilating. 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that, Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $ SMIP $
proof o their Worker's Compensation insurance should be provided to me., PLAN CHECK • $ PERMIT
IDI am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ S.00 ISSUANCE $
Date Owner • Heating System& Ducting
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify th I have read this appli ion and state that the above 00.100,000 BTU 0100,000 BTL -' ELECTRICAL $ GRADING $
information is co . I agree to comply wi all city .nd county ordinances
and state laws mg to builgjng stru• on,xarn, ereby authorize repre-
sentatives of s city to e r on .e abov; •entioned roperty for e� TT
Inspection p o}}�y , ) -i MECHANICAL $ TOTAL FEE $
J•�V
/ Signature /�lilG('� / r
Pink-Accounting;Goldenrod-Assessor
NSTRUCTION AND PLANNING POOL &SPA
r
ROVALS. Permit# Date Inspector APPROVALS Permit# .Date Inspector
mporary Electrical Service or Pole 52. Pool & Equipment Location -
oil Pipe-Undrgrnd. 53. Steel Reinforcement -ectrical Conduit Utility-Undrgrnd.. 54. Formsectrical Conduit-Undrgrnd. • 55. Electrical Bondingeel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. - . 57. APPROVAL TO COVER-GUNITE
. 7. Footings 58. Electrical Conduit-Undrgrnd. •,a_-
' 8. Foundation . 1 y 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 & House Connection 62. Backwash & Receptor-Final •
12. Sewer Cap . 63. Heater & Vent-Final '
r
13. Roof Drains -. 64. Plumbing System - Final- '
14. Rough Plumbing .- 65. Electrical-Final
15. Rough'Electrical-Conduit l ' 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 _ /�-+
39. Water Service-Final c:Z. .�/ /
•
40. Gas Service-Final , 7 grjS•y der
•
41. Solar Domestic-Final /f-! //71
42- Backflow Preventer
43. Backflow Irrigation - - -
0
44. Landscape Irrigation System
45. Sound Attenuation '
46. Handicap Regulations
47. FINAL STRUCTURE &BUILDING
48. Special Requirements Completed
•
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 except those within heavy border lines and sign all appropriate declarations.
CeY Obf COSTA nMEJ$/A ON U TION PE9MIT PPPEERMIT NO. TRACT NO. LOT NO. UNIT NO• . 98p4 II/I8/87 20e50 TL
Project Address oc•J 7iJ /�. r �'eJ'/'k Sf^ �n/�� I I I -w .
Applicant's MailingApdressrr^,•�- Jf�ZI�� •, TYPE OF CONSTRUCTION U NEW U ADDLTERATION U REPAIR
•
Owner's Name J�"Vy +� ❑ CONVERSION ❑ DEMOLISH ❑ OT�I ��.'�nn _ p,P•*f Zone
3. Gb.fSi Phone 7eG "flzy / t'�� ,�
[�!y n / DESCRIPTION OF WORK/U OF 8 DG. C"'' �'
•
Address J /2-2 /CCtiz" /de-L-+•'- .TSU tkLe. G,q_ V `i _ C G-• !` S Main Building: Accessory Building:
Arch/Eng. License No. _. TYPE.OF PERMIT I♦ GRADIN �■ FOUNDATION U STRUCTURAL E Front - - o
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHA ICAL A Rear _— N
Contractor's Name , 's'�r'i- /' �c+' z""'/� :57192C1/4:7) El OTHER le 'L
Y - ^J i•ho ePROJECT DESCRIPTION SQ. FT. -�C.S.�1 OCCU re J C Right N
Address(mailing ��— —s '�'^' 9y`� V7 '� q ...°'
K G
�S9S/ CON ST RUCTION TYPE VALUATION$ .2.203• $ Left R
City License No. 11 ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARA N Ping. Ref. # Parking Req./Provided E
I hereby affirm that I am licensed uncle rovis is of Charter 9 (•••mmencin9 Remarks: Planning Notes: • M
with section 7000) of Division 3 of t Bus'1 s nd Professlo-s Code,and -
my license is in full ore ns ffect. rT
(}0 License las LI••nse •. rIP G S
Date �" Signature OW" ,- . /" PLUMBING FEES
WORKERS'COMPENSATION DECLARATION -
Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
' of Workers' Compe ion Insurance, or a ertilie copy thereof (Section Backflow Preventer Service Sink
3800, Lao. C) '�'j T Automatic Washer Transformer 0 15-50 KW
Policy rvo. Z• .f'-zr3.59 Comp 5. L��.-.� Backflow Irrigation 0 50+ KW
\ ]s Sewer Cap Construction Pole Sub. _
Certified copy Is'lsereby furnished.
Cert 4tied opyjy(i led with the city B it D slop Bathtubs Sewer Connection _- Cooking Unit Meter ❑up to 100 amps ,
Date // `/��!�' / Applicant /l - - - `
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 DElectric 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❑0-1 HP ❑1'/:-8
Workers' Compensation Laws of California. .
Date Signature Floor Drains Swimming Pool w/Spa j F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
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 •MiCYowav¢
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Clos3t. Device Boxes / •
` POIe Li ht
I hereby affirm that there is a construction lending agency for the performance / ' g
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Wate eater. Outlets / Ran e •
Lender's Name 9 .
' Lender's Address Kitchen Sink ater 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 9 P Standing Sections
county which requires a permit to construct,alter,Improve,demolishorrepair P—Trap • Laundry Trays Generator ❑0-5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit 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
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). $ 3 •
El I, as owner of the property or my employees with wages as their sole Reinspection Fee '$15 Issue Fee - - '
compensation, will do the work, and the structure Is not intended or offered - Reinspection Fee $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 Hood or Type I D
sale. If, however, the building or Improvement is sold within one year of com- • Canopy Type II ❑ Zoning Approved By yr Date
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By `1, / Date /is pq
prove for the purpose of sale). - 'l./� tl Jp `',
❑ I,as owner of the property, am exclusively contracting•with licensed con- Duct-Structural Refrigeration SystemApplication Issued By Oath
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-Ventilating ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or Improves thereon, and who contracts for such projects with a con- ;p •
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUI LDING PERMIT $ 9.0. 0-.1 SMIP $
proof of their rker's Compensation insurance should be provided to me. -- PLAN CHECK $ PERMIT
❑ I am exempt der Sect'on B.& P.C.for this reason' Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
Date Owner - Heating System& Ducting . Registers �
PLAN CHECK 25% $ ENERGY P.C. $ •
I hereby cert' y at l a read this appli tion and state that the above ❑0.100,000 BTU 0100,000 BT, ELECTRICAL $ GRADING $ . "
information Is cor ect. e e to o ply, I all city and county ordinances /// '
and state law rel ling oulltli onsir ion, and hereby authorize repre- / PLAN CHECK 50% $ MICROFILM $
sentatives of thI cit t ent On h ave-mentioned property for /
IDriverionpu I /r� MECHANICAL $ x•50
Signature -
/ Fee $15 Issue Fee $ 3PLAN CHECK 25% $ •
._ _ _
CMF 086546,rev. 10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor /
I
CONSTRUCTION ANL/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 UFER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd.
8. Foundation 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 & 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
39. Water Service-Final •
40. Gas Service-Final •
41. Solar Domestic-Final -
42. Backflow Preventer 1 - •
43. Backflow Irrigation
44. ,Landscape Irrigation System ,
45. Sound Attenuation
46. Handicap Regulations c."
47. -FINAL STRUCTURE & BUILDING 11/36181 ic.1\-) •
,
48: Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date i'
1
• A I
.. 42I 78 PAIL ,c *...*
'^:. ?i-7Fc.—;_002762-- -10.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A'r LI 'A .ON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely -Use Ink Only
RE•EI D s DATE RECEIVED E I - ED
BUILDING
ADDRESS 2344 Elden Avenue -ZI- %o
OWNER Rose Mary Trudeau A.P. NO. 1 Isco i13 PRMT ••
MAIL 2344 Elden Avenue Bcco -13'2.349 Ei DEN) Ai/ i�,�
ADDRESS ("�(V� ss'CNH�
Costa Mesa, Ca. TEL. 714- TRACT LOT\4 BLOCK
CITY NO. 893-559t
CONSTRUCTION Owner' s funds NEW ADD ALT EPAIR MOVING DFMOLISH
LENDER X
BRANCH n
OWNER \C._,M/It'
YLiCoe,4\v1/4
ADDRESS "*".1
1
1 SZ-WA
�J, _VALUE /MD OT/
ARCHITECT TEL. USE lAvv.. nn �C�•Q� s
OR ENGINEER NO
FIRE
ADDRESS ZONE YPE g.--GROUP
APPROVED 4 ��/ /J�
CONTRACTOR OWner_/ j, BY DATE I/ /
ADDRESS As above
TEL. 2 NO.OF USE OF EW
CITY NO. rZ PLANS Z BUILDIN
F —
STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILD' G
SIZE 50 ft x 200 ft. 'NO.OF BLDGS. 2 (FROM C/L$SFjE ET)
L OF LOT INOW ON LOT FRONT//4J PT. FT.
USE OF three dwellingscn /L
EXISTING BLDG. _R.SIDE fO _ET. FT.
CII
H Separate permits are required for L.SIDE)0 FT. FT.
electric,plumbing and heating work. n
inREAR 3a FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
G Laundry and shower facilities MAIN BLOCS. ACCESS.BLOCS.
to be used by all three tenants C VRP #e DATE
APPROVED
�>4 on said property. gx / Z . av R Obit/ -nATF �Z, 1�
CL
ui
0 I hereby acknowledge that I have read this application and state n
C thet the above information is correct and agree to comply with
m
OH all laws regulating building construction, and I shall not employ
Z Person n'
any pato in violation of a workman's compensation laws of 0
�� o
Ma State of California.
I hereby certify that I am properly licensed as a contractor under SO. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, end that such censer are in full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the pr Isions of th SseteVrt tiithtnla Business �! a
and Professions Code 'vision 3,C Ater 9. VALUATION PERMIT FEE $ /Q In
PLAN CHECK $ ^t
SionaPerms ure of •/ �O U.
Permittee $ / TAX 5570 U
E
u
Authoriz d Agen TOTAL PAID $ /oe SD
• 21134.[ FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT DEC 6 INS
P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEVI•
rrTTyyCQII FOTA S
For Applicant to Fill In Completely RP11PLIRMESE PERMIT
TYPE
`�`OOR PR T // BUILDING
ABUILDING DDRESS ,4 R �/ _itt�,_- I t FOr OffICH {I58 Only
RECEIPT NO. �ry'RMIy NQ
COSTA MESA• CALIFORNIA ' —i]Y/�J<
A� Reer-e6DeY pATHRECIIVHD3 :5 7E63
OWNER J�J�S/J/ L/ /r1q (l/ (!/� /P"�Y O/
MAIL �•� / BUILDING
ADDRESS \110--�y� ADDRESS
FIRE
TEL ZONE TYPE GROUP
CITY NO.
APPROVED
ARCHITECT TEL BY _ DATE
OR ENGINEER NO.
ZONING
AL_ . SS
ZON f, I NO.OF �UEE OF NEW
' / •' !/ I PLANS �/ BUILDING
CONTRACTORLEGAL
// J _ DESCRIPTION - r 'S. Tk 3 b 0
ADDRESS
CITY A.P.NO. .1/ /R
8 r/` -33
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE / ? —/—G�' TEL• 20'TO SIDE H REAR P.L
LIC.NO. ✓ 7
EAVES
SIZE I NO.OF BLDGS. ALLOWED (U.B.C.REQUIREMENT/
OF LOT NOW ON WT YARDS APPROVED YARDS APPROVED
USE OP ,y y y MAIN BUILDING ACCESSORY BUILDING
s
EXISTING BLDG. I
(FROM C/ S RE T1 ,..�rE•
SETBACK LINE FROM /A� p'' FRONT FT. A�/�'�I FT.
CENTER OF STREET �i✓ -"REAR YARD 1r'
SIDE YARD Len RIGHT R.HmE�S FT. • FT.
DESCRIPT N OF WORK I
L.SIDE �T. FT.
kNE' ALTERATION _ ADDITION REAR I17.1 P� �/ FT.
_, DISTANCE BET. BET.MAIN 0
MAIN BLDGS. ACCESS.SLOGS.
REPAIR MOVING DEMOLISH
BUILDING NO.OF VAR. DATE
SIZE ROOMS STORIES C.U.P.* A APPROVED
EXTERIOR WALL. I ROOF COVERING BY ' DATE !� -6 - 63
COVERING I6xVJ/(V
USE OF BUILDIN�G4AND
WORKK TO
BE PERFORMED - //n
•
Zile et (V SQ.FT. a
7.
I REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 2
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION b
BUILDING CONS(pt UCTION. // AA //JJ 'PERMIT FEE $1'2�-
•
SIGNATURPERMITTEE O Q 7n LLiL�LLAI,EC',fI(��/j f� �//O� HEC T er O
t L yo
/ LL
AUTHORIZED AOHryT �vOO ����� TOTAL FEE $ lr
I\
:[ Dell/7*�yf 20542FEE
RECEIVED
COSTA MESA BUILDING SAFETY DEPARTMENT SEP EPT.
CE 1 0 1963
P.O.BOX 317 COSTA MESA,CALIFORNIA
For Applicant to Fill In Completely APPLICATIIRa MESA •
TYPE OR PR T Boa
l�
BUILDING �3/!/ /J For Office Use Only
ADDRESS 7 x RECEIPT NO. PERMIT NO,
COS MESA. CALIFORNI ,,��RR;
/ R y ,.� D rIE T./I�IV1 TE ISSUED 5
OWNER O, !/ .....
•IS' o 3 �� [iAJ
/ ADILDING (Jc,/ A. -,
MAIL �_//J ADDRESS 23/ x te.
ADDRESS Q/r/"--
FIRE (
CITY TEL. ZONE GROUP r ,
/
NO. aril" _ /1
ARCHITECT i TEL. BYPROVED ' DATE ��� ~1F`
OP'NGINEER ,�i��. . NO. , _
ZONING ,(I
AL .ESS_ (I•
ZO NO.OP UeHOPNBW V
_ PLANS '/' BUILDING t
CONTRACTOR �} /f h' •�� � D d R Qt 9�i f� O
ADDRESSS1014 O(O(Of W./ LEGAL
DESCRIPTION / �J / ( /
��' 5J' A.P.NO. I I ( �' as ! - ��
CITY /��' /�� l
STATE '1 5 TEL. /90NO?TO SIDE B REAR P.LE: NO EAVE EAVES
NG SHALL BE LESS THAN
LIC.NO. /5 ./ , — NO. -5.--C-4a_/�G/
SIZLEOT1 NO.OP BUDGIE.
NOW ON LOT ALLOWED (U.B.C.REQUIREMENT)
OF
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG.tl7)
�� MAIN BUILDING ACCESSORY BUILDIN
(FROM C/L STREET) y
SETBACK LINE PROM FRONT FT. Y) FT.
CENTER OF STREET REAR YARD
SIDE YARD LEFT I RIGHT _ R.SIDE FT. 6 FT.
DESCRIP OF WORK L.SIDE Fr. 0 FT.
Nr ALTERATION _ ADDITION ' REAR FT. ( FC.
DISTANCE BET. BET.MAIN B
MAIN SLOGS. ACCESS.BLDGB.
REPAIR MOVING DEMOLISH .
BUILDING) r / S MO OF VAR.# DATE
SIZE /J ..Yv36 ROOMS STORIES C.U.P.# APPROVEDEXTERIOR {I
COVERINGWALL COVE G BYPROVED APPROVED /o-�J
USE OF SW INC AND W K TO BEP ORMED 11 L REQUiRFMT'"'r'
.L/
N
SQ.FT. T
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 5
AND STATE THAT THE ABOVE IS CORRECT AND AG TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CI INANCES AND ST E REGULATING VALUATION m
BUILDING CONS UCTIG N
SIGNATURE F PERMIT FEE ^ D
PERMITTED 2 / l �(✓J(///�,��_�'� ,f e a r m_
S /2 / PLAN CHECK S
AUTHORIZED AGE �S jai, ,
TOTAL FEE $
. Costa Mesa Building Department n A APPLICATION FOR PERMIT
111 EAST 20th STREET 3034 BUILDING
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
'/ Receipt No. Permit No.
Address z 4'r CGDEA. J'�
Costa Mesa, Californiainimi ' 4 IssuedsL/
Nearest At - / / �7��
Cross St. L'..sso^� Building
Address
Owner 4. as CIey Costa Mesa, California
Mail
Address 2-1 27 /5175`4402., Nearest
Tel./ Jr., r CrossZi
City �Jpd-p NoG' ca//a, 9 Zone ,/,-,/ I No.of I Type �/ 1 Group
Architect or Lie. /�[ Plans
Engineer No. / Approved
by Date
tAddress ``� CORRECTIONS
atracto.B�l1T/I c lewT,�rrfL,��.i No.Lia a/ .
Address 2/ 207 / �a� r1X. �v Lein
Legal /Lot \ 11��
Description I No,7/7LnBlock I Tract Ale 7 �,1
(Attach Metes and Bounds) k sue/. �/zy re`t`/ H- 015 /S J
No.of Bldgs. / /� `/�
Size of Lot �� Ky00 I Now on Lot �r LCL/ -X C�om!/� L/"( //�
Use of No.of ,I No.of �rSH/.3\1 1 /�, �-� 70
Existing Bldg. �pr I Families�l Roorrls !ll1 LLy��� 11 0
Setback Line from /Q�J��J, Rear Yard - J C��1� LA 11 -�I Z
Center of Street , ,� /.Jt=( Side Yard '^� '�l y
DESCRIPTION OF WORK r
, r riSOC
C.
i A SO .
New I I Alteration I I Addition I I/
Repair I I Moving I I Demolish I -
Building /No.of - COY OE COSI A Ii'kl;S}.�
Size £ dr Rooms Stories
� erio J7 I Roof
ering CoveringGOAlla APPROVALS
Use of New - / .+
Building i9J ,7,7,2 /O e 7' Foundation Location Inspector Date
• 4' �1t4 13 ✓ 20 Under-orms, inningals,
M �w'/�/T /� Under-Pinning
2.41 ire Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application Lath.Int.
and state that the above is correct and agree to comply Lath.Ext.
with all City Ordinances and State Laws regulating
building construct . . t:
Signature of / / a /, Plaster,Int.
Permittee - • - (re..ar..,,
Plaster,Ext.
Authorized Agt. " (dr —'
Valuation ' Permit Fee $ g _-_
$ �� /-�
Masonry Reinforced
_f Plan Check $ Bond Beam
/ Total /� �
Fee $ % � FINAL
FORM 204 G-H 2M 5-54
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_ .f ..
PLOT PLAN
Show location and distances from •=• ..
! property line and between buildings. r _ '
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1
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, . ._ _ ._ _ ___ _ __
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"5-si+i;to Mesa Building Department • APPLICATION FOR PERMIA
' 111 EAST 20th STREET 2575 BUILDING
1
Ilr COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
'f OR APPLICANT TO FILL IN _ Receipt No. Permit No.
;,.
Address
234¢ f fs LDeW �S-69
• Adddress
Costa Mesa, California Received by Date Recd. Date Issued
e' '55cr
Nearest RD. .3- 3D 'S e
Cross St. Building .
Lo C S &o L C Address -
Owner ` /,,,! Costa Mesa, California
il
Address 4'4•t. l f49-SKe`L(_. • Nearest
Tel, p Cross St.
City �A1J Nays NoLI p my i Zone 1 No.of Type I Group
Architect or Lie. �� Plans I Y �¢
Engineer No. Approved/
by , 1..•• act Date
Address !,� i
City LIC.
.Itraetor fJ`{Ytit+{ Lots No. 3
Address tri tuba. APPROVED
LegalLot Dr Q
Description I No.! 'Ri / BlockI Tract 300 7
(Attach Metes and Bounds) CA) Plot �/L 4 ) c 1Y f igMf�T�it
No.of Bldgs. 1 vvv!!rr Y
Size of Lot 50/..12.00 I Now on Lot ! � O
Use of '11 I No.of 2I No.of / ...ill By4(//�/2_ Date/24 7i
Existing Bldg. U}et(., Families Rooms .) i LAN. I LI-H• ! Lt
Setback Line from " Rear Yard - '
Center of Street 2' . - Side Yard, 1-s' . • D
DESCRIPTION OF WORK - - . r
New I ✓1 Alteration I 1 Addition I //i t:C. ! ,% /
Repair I I Moving I I Demolish I So p ,- , i,IR. ° ^ F e H • h Fwr 13 4
Building �J _ Q. / No.of '/ 7j-7,c, —•
Size !6B Rooms ry� Stories / 6 Q
riWall�u&� I Roof
!ring Covering ettisJiri. ;de, APPROVALS
Use of New Loca = Date
Building - /_ 4_.. ...Lisa of, A _ 1. Foundation Forms,Materials,tion Ins peter -
-Under-Pinning _
Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application 1 Lath. Int.
and state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and State Laws regulating
building construction.
Signature of 1 ,i Plaster, Int.
Permittee s"- �`ya ^+ At
Plaster, Ext.
Authorized A'gt.
SAT / LI _
Masonry Reinforced
Valuation mit Fee $ /(lee 0 0
0 • Plan Check $ / 0 0 Bond Beam
$ 6� /1Z0To
Fee 1 $ R7 p,; 0 0 FINAL
FORM 204 0-H 214 5-54
•
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• COSTr.
.__ • _ _._ _ - ._. • - '?,R -�'SE•1p DtlESA17o2}..^•mo :'?.3.110
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. J
♦ • sY
•
Street . ,. . vt_• --1-• 'I,. - .. h _.
-. PLOT PLAN = •
- . -
•
I Show location and distances from• • : rS.1 _;J.' 1
property line and between buildings. , •.l 1
, 'o. a-
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CtpprIF sta Mesa Building Department • APPi.ICATION FOR PERMIT?
111 EAST 20th STREET • !wBUILDING '
COSTA MESA, CALIFORNIA
No— FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
Building -/� - I /6 -5—S�
Address `7` f=,
Costa Mesa, California Received by Date Recd. Date Issued
Nearest 4 /
Cross St. ,z) ' Address aBuildin2 3 ! G C-€......
Owner L.0/e., L7 p .a a Costa Mesa, California
Mail /
Address .`• Nearest
Tel. ', Cross St. i 3 --
City No. Zone 'I No.of T Grou
Architect or Lic. �^I I Plans I Ty P
Engineer No. Approved
•, by Date
Address CORRECTIONS
ICity tic.
ntractor*Dr..'/ A'�Pak No. 3OSC
Address 1437 /yam'/.i 0T/?p7 le CDh'/
Legal I Lot I/
Description I N.. / I Block I Tract 500
SO . zoo• &. A f-0T 9b
(Attach Metes nd• Bounds) 7-Ar•r 1cn/t P}//7 Dc f i I
Size of Lot ,Sn X xnn I Now oNo.of n Lot It ../ O
Use oTNo.of No.of 21
Existing Bldg. •— I Families I Rooms 3
Setback Line from i 6Rear Yard ill Z
Center of Street 3 O — Side Yard -, . ' . >
DESCRIPTION OF WORK ,. r
New I ✓I Alteration I I Addition I - •
Repair I I Moving I I Demolish I
Building / No.of / I o
Size ;1,-3 X (
Rooms p Stories
'Nor Wall Roof "-
ell ng Si occ.,•, I Covering q/QRVC,L APPROVALS
Use of New '
ed-111-41 ' Foundation Location, Inspector Date
Building2
F /S p . Forms,Materials,
/ Under-Pinning tin
Frame: Fire Stops, ul
Bracing,Bolts o
I hereby acknowledge that I have read this Application `tell
and state that the above is correct and agree to comply - Lath.Int. -
with all City Ordinances and State Laws regulating ra
building construction. Lath.Ext ,./1
Signature of (, / PR
Permittee n-» r..R.p1 Plaster,Int.
Authorized Agt. Ext.Plaster, re
C.
Valuation Permit Fee $ e,.O i rY
Mason Reinforced tii
v�
Plan Check$ 3• o=p Bond Beam o
$ 47 . Total • ,, �'
0-19
�,, '- Fee $ FINAL
SnRM 204 S-HP 2M 6-55
,
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- PLOT PLAN
, I Show location and distances from .
i
--_property line and between buildings.
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4.217.9 'p l at-76-up,00276i-, _**-:,30.50
ft
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only P C ION FOR STRUCTURAL PERMIT
RE V
A RECEIVED
BUILDING aT S UE
2eL1ELJN AVe,dUE62 —
ADDRESS
�
ch G Maes c ,EA� ,�5-- 3 PERMIT NO.
OWNER Y A.P.NO. ['J,/J/[�
MAIL z&tel- ELDER/ AVE, DDRE S 2 30
/7 F�D E
ADDRESS ✓ 7QY\+ �js�ys���7•Iii
TEL. I I`{ TRACTS yy LOcr N BLOCK
CITY COS i A� VUGS-� C� No.4`1 i �Cq t
CONSTRUCTION bw + ^� NEW qDp ALTER REPAIR MOVING nFMOI LSH
LENDER U AIDS
BRANCH ///) /J ,/�
OWNER r + IPCJca qt)
ADDRESS VALUE //�/J� ,
ARCHITECT TEL. S 2 $ O(y/r�/�
OR ENGINEER NO
FIRE
ADDRESS 20NE TYPE GROW
n �) APPROV V -V
CONTRACTOR ,p0WNef& 4jJj BY DATE ?�
ADDRESS / sem A-Sc /6
TEL. ZOa` (e IFLAKS Z BNO.OF BSUILDIE OFNG 4%NEW I
CITY NO.
-4
F STATE CITY YARDS APPROVED ARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ,CESSORY BUILDING
A NO.OF BLfY.S (FROM C/L STRE
W SIZE y JE
4 OF LOT S 0 , /\ �.. ``� ,I NOW,ON LOT FRONT pT. FT.
Q USE OF S .ice o e—L. t_I k C-+ 1
� EXISTING BLDG. R.SIDE \ FT.
/-.
Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work.Cc REAR FT. FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET.MAIN&
O ' `` E.� Witt
BLDGS. ACCESS BLDGS.
S.
d\I C 1-,IteP LACE' I V C{} Utl C URF.# _DATE
APPROVED
OC T t-f OUP L E, � lira 17 6
-. DATE
.-1
4.1
a
o I hereby acknowledge that I have read this application and state t
44 that the above information Is correct and agree to comply with N
4 all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of
m
tothe State of California. .-
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. ,v
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: —
am exempt from ill rovisions of the State of Call ornia Business �7C e
//77 D
$ 4'
VALUATION PERMIT FEE
end Professions Co , Division 3,Chapter J int—
/ // PLAN CHECK $ /1 2
Signature of ` / C Oma` , ` ' v
Permittee ��J $ �z�/�(/„// ......--
TAX $
TO 2
Ll
Authorized Agent TOTAL PAID $ 34 53