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HomeMy WebLinkAbout1605 ORANGE AVE - Building Permits PROJECT ADDRESS: 1605 ORANGE AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 061966 OWNER'S NAME: HANSON FRANS R TR ADDRESS %HI—TIME CELLARS PERMIT NO: F 061966 PLAN CHECK NO: 01368-93 L GOVT: N SUPP: N 250 OGLE ST COSTA MESA, CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: FIR PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : BACKFLOW RETROFIT SQ FT: ADDRESS: UNIT: CLAIM VALUE: 5, 200. 00 CALC—VALUE: GROUP OCC: / PERMITTEE: FIRE STOP ( 714 ) 569-0016 ADDRESS: 1253 S. WRIGHT 0 COMMENTS: BACKFLOW RETROFIT SANTA ANA CA 92705 *9(************************************************************-BE**************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: 42116 STATE LIC.:5 01419 CLASS:C—16 �— Date: 30_ Signature:_ _ P a MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:P WC 18 2 6 4 3 EXP.DATE: 05/15/93 c :GOLDEN EAGL4E PARKING REQ: PROV: PARCEL: 13965201 ZNE: REF NO: ❑OMPANY Certified copy is hereby furnished. ✓ Certified copy is filed with the city Building Division. PLANNING N !ES> �. Date: y�i„/ �� Applicant: T � _ #*****#********#*###*##*******#*#**#*#********###*###*##*#****#*#############** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS 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 Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: / NOTICE:If.atter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ,D`, DATE: .36) Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ( CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the penormance of the work for APPLICATION ISSUED B Y; DATE; 30 — whichthispermitisissued(Section 3097.Civ.C). *************#*#******** e*#lex*? **-. +e kir:<#i *Test t#Fir#* *xituit**#*##*#** • reit irK. - *de##* l LENDER: ***************#***##**###*##****###***#*##*#''SE#***BE***#***##****###*****###*** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 703t.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 ,00 repair any structure.prior to its issuance.also requires the applicant for such permit to life a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 66% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 52 . 65 any applicant for a permit subjects the applicant to a civil penalty al not more than live hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS—--—> 81 . 00 0. 00 52 . 65 133 . 65 133 . 65 . 00 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 employees,provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 81 , 00 OVER/SHORT: , 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 .00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License law).l am aware ***************#*#*****#*******#*******##*********#*****#***##**#************y.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: FIR 81 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1 . 00 81 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby evilly that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state Paws relating to building construction and hereby authorize representatives of this city to enter upon the abov'mentioned property for inspection purposes. n--------. Date: 20 ' Signature: _ _goo.'" f. 01 00138254-00138254 T4T 81.00 Driver's License or Social Security : DATE: 04/30/93 TIME: 10:17 t64146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permits Date Inspector APPROVALS Permit ,'> - Date Inspector--i I 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location ?. 55 ' Pipe-Undrgrrd, 53. Stool Reinforcement 3_ Eli 7irical Condu!t lit 'ity•Undrgrnd. I 54. Forms 1 ' . -r mai Ccroi.it'U •drgrnd I I 55. Electrical E,rci ng 5. Etrt1 Reinforcement 56. Rou•,h Plumbing & Pressure Test ri E .ca' LIFER Grrd _ _ 57. AP?RCVAI. TO COVER-GUNITE --- 7. Foo' ngs J I58. E:ecbical Condu;t-Undrgrnd. -, ---- - - -- II - --- - --i 3. Fn ,-jat on I 59. Gas r pd, 7 U^tlrgr'C., Test 9 '.,.ter Pipe-Undrglcd. 60. Bec::v,dsh Lines, P-Tr,.p, 7 Undrgrnd. - I � 10. Structs' Floor System 61. APPROVAL TO DECK 11. c .;, I,r t; .- . Sr. :zr Lar [' l cLJce j,on nect,on I ++ 162. Back'eeesn & Receptor-F gnat I -, L 12. S.,., r Cap I 53. Flo it_r & VLnt-Fina'. �- 1 ' 3 aii-s Dra ^s E . RVum'ong S;stem -F.n,tf 1 .r. ,:inP:umS1n9 65. Elect,icaI'F6ral -- _-_ t5 ; Eectr w'-Conduit - -- I e-------- -i '"`I' 66. plot Sytfm•l-ir?I i I , ..3. ilnegh Electric`.:'irinq 67. Fcno'tq & Arress Approval I as. APPROVEC FCR PLASTERING to Rough EI^c•rical-T Bar Ceiling G9. POOL/SPA SYSTEMS FINAL i r'� ' c, ,;,h Paanng & AV' Co^tlit.ornng - --- FINE DF_P-i, REQUIREMENT -- - ____..i ?E n Factory F rc•uiace _--_ _ I 1 APPROVALS Permit .7 I ^ St-_c:-,, : -... '�•..,rq o... ' ?2. Ducts, Vrtnt l.itingii- 71. Product Pi,,r; •.q :.1 Gaa Li 071 '3 '.F"-Roy oh & Test '2. U di grou'rl F..,s-. ,'6 b•-eP h4. four Framing I 73. Undergrnd.Storage Tank OGas 03On 1 -JF.. .! r Con.r.9 :Sir,.crn-ail & a tern.lt -- - �� •, 7 Dry Ci1em:_eI I - -- a- ' 1cth1- ------ - ---- - - -- ---- -- -- - -- -- - --1-- _ 76. Dr, $t,. 'cr'.,.e IT ?E . ,.th n9 rriShing 77. AXED SYP-iE\" FINAL --- - ' t T. 178. FIRE 'REV F".<.; � - -- _/b193�I -4_ 77. . _ai. ;L. ,rc - - 'I - --- F r.LTH OFP7. REQUIREC-L ' - - 3 D. CJ6t 79. FAA: .CT!- , I 1 _ _ 32ir cr 'cal Pm,, er Meter Final 80. FOOD CEHTIFICAT I ISSUED ' 7,3. I Kle_. Nutri• - • , A . 35. :;.n_. Lias Pipe-Test 33, Ihn,' Or Carso PY _-- --i , 27. :.. -: Factory Fireplace 7 L. _ - F 35 7_1 F'Amn,rg 3]. '"iter Szrv'c.' Fina! I - 43 2,-;, ServiceiF mai - "-__ __-_ _- -- ._-__. - 1 41. Solar Domestic•Final _-- ^� - - - - _- 1 - . . 3 . flow lrr gator, L ? __. , �'.. ; : dsctoe irrigaticn System 45. Sound Attenuation r:5. F!c^dicaP R:rulations -- ------ -I -- - -- ---- - -- ------ - • T v7. FlIv,OLSTRUCTURE & BUILDING I f %S FI:\: '• -- - -- --- -- -- - -'- ---�. s_, S I- 49. Electric Release to Edison ," ' ' '-s----_i - -- r0. Ca: Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No Date _ CITY OF COSTA MESA -1. BUILDING SAFETY DEPARTMENT SUPPLEMENTARY FIRE SPRINKLER SYSTEM , l OWNER: �, j(4.44 ISSUANCE DATE: /�///_�/��I 3-7 ; ADDRESS: ! IW `,'J41# % / L 41""x// (,l PERMIT NO: 40-0 CONTRACTOR: .. of . VALUATION: #"t21 — PERMIT FEE: 90. ti / / .. a_ce_ nL 1, r 7-5 s / Z- .74 -Tr/ 5 /a -moo -2e. • CMF 0368-46 • OWNER ; Frans DATE 11.24-76 JOB ADDRESS 1605 Orange Avenue BUILDING PERMIT NO. 43091 GENERAL CONTRACTOR Dahn Bros. DESCRIPTION of WORK Fire Sprinklers AP No. 117,072,-05 LOT TRACT FIRE ZONE VALUE S 5,900.00 INSPECTIONS Signature Date TYPE V GROUP F-2 ZONE C-2 SOIL ' SUBCONTRACTOR PERMITS ISSMED GAS Date I Number I Signature WATER Plumbing , ROUGH PLUMBING PROP: SWR. LINE C HOUSE CON. SPRINKLING SYSTEM ^� MISCELLANEOUS uly�.1Lt44.O '� os II Z41. ROUGH HEATING ANO AIR COIA�ITIONING O . TEMPORARY SERVICE OR POLE UNDERGROUND 9 POWER 9 ROUGH WIRING Heating and Vent. TRENCHES LI FORMS Li STEEL REINF. U FLOOR SYSTEM BOND BEAM [, ••STEEL"R INFORCE QwA.�.1e4 4 .I.....a1, Q46 I1‘rYs :7 FRAME AND FLASHING LATHING - IN inOUT 1 f�1 PLASTER. BROWN COAT STRUCTURAL, FINAL Electric HEATING. VENT., REFRIG. AND A,C., FINAL PLUMBING, FINAL AND GAS TEST 11 • ELECTRIC, FINAL . BUILDING, FINAL _ _ 01‹ a a°' 4309.E COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIVED BY DATE RECEIVED DATE ISS 0 BUILDING / ADDRESS •V 1 e I a_. I .j . (.- t. .. �J j ' PE-'I NO OWNER kCr, ,�4_�Arintel` BUILDING MAIL -( ,..�_���iV A.P.N O.//7tOs 7c2" .d- .i ADDRESS: 7Q'I,�WV a j) (J' � ADDRESS /fo(� ' Lkcx f ti c TECITY L . ouzo_ (a_' NO. TRACT LOT V BLOCK CONSTRUCTION ION �rm^ NEW ADD ALTER REPAIR MOVING DEMOLISH LEND R BRANCH fit/ VJ�� ,� /� 1 OWNER PLA • �An /Iwr 1`ifv-naonYLJ ADDRESS �p/�, VALUE -ti/y' ARC F tW TEL�-/�'(j_�u'�II USE .1.�� $lt)�tJLJ•� OR IGINEER�?�.4_I_Nly A oa NO1/4,Leo J4�� � FIRE — Z ADDRESal ab,z.Rend TYPE GROUP AVPPROVED DATE //feCONTRACTOR /ADDRESS ALi' 1 i / / 20N• NO.OF USE OF N 41.7� CIT ��r� / i / TEL PLATS �_ BUILDIN -*/ .'. ,. /moi i H nii,/ STATE CITY YARDS APPROVED VAR•(APPROVED LIC. NO. LIC.NO. if go� MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOCS. (FROM C/1_STREET) S OF LOT NOW ON LOT _fJRONT FT. FT. Q USE OP mss^ ' 4 EXISTING BLDG. w(��_ A,y9 H E FT. FT, VI FSeparate permits are required for L SIDE FT. FT. electric,plumbing and heating work. R FT. Iw., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAINS( GI r MAIN SLOGS. ACCESS BLOCS. 2 DATE ::1) /�/�. C.U.P.C U.P,go APPROVED O"-� APPROVED >. _BY DATE -a I:4 w 0 I hereby acknowledge that I have read this application and stato n N g4 that the above Information is correct and agree to comply with m C+ all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of xthe State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOP m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from the provisions of the State of California Business ��(6. ` � y and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ �J ( -e �•�s ,_�S PLAN CHECK $ m Signature o r 4 O� i A f^ „' t!� ^//yy (4' TAX $ ,..2) 0 Permittee /` V `(-jLlfC/\ $ rrt�Q.-/I U Authorized Agent TOTAL PAID $ 0 OWNER HANSON, Frans DATE 30-6-76 JOB ADDRESS 1605 Orange Avenue BUILDING PERMIT NO. 42827 GENERAL CONTRACTOR Pat Roy DESCRIPTION of WORK R1nrkwal l/Trash Rnrinsurn AP No. 117-072-05 LOT TRACT FIRE ZONE VALUE $500.00 INSPECTIONS Signature Dote TYPE V GROUP J ZONE C=2 SOIL - SUBCONTRACTOR PERMITS ISSItED GAS Data I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE [] MOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS _ ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICE OR POLE UNDERGROUND Li POWER Li ROUGH WIRING Heotin• and Vent. TRENCHES ` FORMS • STEEL REINF, FLOOR SYSTEM BOND BEAM STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT fl PLASTER, BROWN COAT STRUCTURAL. FINAL Electric HEATING, VENT., REFRIG. AND A.C.,�FINAL El PLUMBING, FINAL AND GAS TEST I l ELECTRIC, FINAL e,,,. n,ur rue n 1.44 i.:/__,v • 42827 t' PAID ,,nrr -e 7rc305* .. 5CMsn COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A P "A ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only �t ` '��'j��(�j,�//�1����7 R I DATE RECEIVED DATE IS U BUILDING Il V✓' ©cF�`ae"�t/ �_(I 0,�1 ADDRESS f' �t/ �r 74—O( PERMIT N . OWNER 1/) d # A.P.NO. / il MAIL p�j BUILDING ()��/��//�J(��t� / C. /� ADDRESS �p (. __=� ?) 7-4046 ADDRESS TEL.—/ �)S l / /J NC-J Yi s/��� CITY � (v ' ,,,¢SLK_ NO` O ,Q�I' •RAT 13 LYS � BLOCK CONSTRUCTION NEW qO p. ALTER REPAIR MOVING DEMOLISH LENDER BRANCH L� ^ ' cc,ws Ls •O ER {'tJ W ADDRESS �` (//yy� /J"j1 t ARCHITECT e. lea TEL. USE h • GL�/ $ (J(fes OR ENGINEER - y{ NO, FIRE ADDRESS ZONE T PEGROUP APPROVE'. /nr CONTRACTOR V . I, - BY I A ,Z DATE ' r . ei V . i ADDRESS 9 6/ /`,, = ;��- - . C- �• • TEL. / !N NO.OF ' US OF NE / CITY , a NO. - 6 0 r 0,3 „�� PLA r BUILDING ` _ r I••• STATECITY YARDS APPROVED YARDS APPROVED LIC.NO. /55t 1/ LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE ,/ ,t NO.OF BLDGS. (FROM C/L STREET) / /LIQ t' L OF LOT Hi-^ ) 4 NOW ON LOT FRONT FT. ( FTC eite �I C. hUSE OF EXISTING BLDG. • _ ' /I $,SIDE FT. C:/FT. h F .373-Ti permits are req red for L.SIDE FT .373-Tielectric,plumbing and heating work. REAR FT. Q.c La I.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QQ � / _MAIN BLDGS. ACCESS. BLDGS. VA in J""'4" (O y 04,0 CUR.# APPROVED 'C // /dDATE [/�- / y / /0 • // / p r/ ..J _ APPROVED f/ nATF/6 —/ -/.(� W ID /Y 11 .f I ��IL��� tX Q I hereby acknowledge that I hive read this application and state N. N CC that the above information Is correct and agree to comply with , 0• all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of e Sthe State of California, !� Am I hereby certify that I am properly licensed as a contractor under .(lam flat FT. N 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 effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FE LY: e am exempt from the provisions of the State of California Business VALUATION 6 V and Professions Code Olvision 3,Chapter PERMIT FEE $ w �lr .� to o Signature of PLAN CHECK $ n 0 Permittee $ TAX $ >� LL Y . Authorized Agent TOTAL PAID $ 6;5 D OWNER SHORES DR. GEORGE A. DATE 11-21-61 JOB ADDRESS 7605 Orange Avenue BUILDING PERMIT NO. 15879 GENERAL CONTRACTOR Owner VALUES 101.00 AP No. 117-072-05 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Demol.stor.bl( INSPECTIONS Signature DATE GROUP j TYPE V ZONE R-2 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. ❑ Sprinkling System onion Pole Underground 0 Power C Rough Wiring Trenches 0 Forms 0 Steel Reinf. ❑ Floor System }^•0 Bond Beam 0 Steel Reinforce 0 _ Sheathing Frame and Flashing Lathing — In 0 Out ❑ Plaster, brown coat Ref rig. 0 Air Cond. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final £4.4 -/! - 2. OCCUPANCY FORM Bll4•5M — 7-61 15879 7.;58.;'9 • FE RECiVED Nov 2119a9 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 311 COSTA MESA. CALIFORNIA ' CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT //jj__//11 TYPEORPRINT/� T // • BUILDING AD RESS Ka() S \/ �A I•Y I/� r �✓ E COSTA MESA. CALIFORNIA For Office Use Only VIII RECEIPT NO. I PgRy1f 7 OWNER /�-/L/ /N��yV�WA„L��p� (/5 7 MAIL ' ^ XQ,Q� RECBI BY OA E V D/ DA ISSUED,/I ADDRESS if O t'eY-`I_ {/t&6 -4._ C/// I /l—d/--V� /j[r\/gi./�( / CITY ear -A- 'IIS 041 )712M- NO.OSIO96 ADDREISS 1 4 n.- Q Asti-no !-C 1�C ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS ZINE // z ( FINE TYPE {' GROUP CONTRACTOR b w---AA ".„..u.P. .,_ APPROVED BY DATE ADDRESS �.+Q ZONING � �j ` ZONI� yIO.OP U USE OP NEW I CITY I BUILDING "it "401 STATE IC. TEL. DLEGALESCR i �(1� . ��� I / � LIC.NO. NO. DESCRIPTION SIZE / u `' O cNO. OF BLOOD / q (/ OF LOT T r ✓l� NOW ON LOT I A.P.NO. /l 9 - U ) ` Q • USE OF \� YARDS EVES 'EXISTING BLDG 1-` -' APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST. 5......e4 OP sneer REAR YARD FRONT FT. IN. SIDE YARD I LEFT I RIGHT R.SIDE '` FT. IN. DESCRIPTION OF WORK / L.SIDE FT. IN. NEW I II ALTERATION I II ADDITION I REAR ,,((,I FT. IN./ REPAIR I II MOVING I II DEMOLISH /` BYPROVED !Ay VI/, DATE /I-R/ -V// BUILDING NO.ROOMS Y SIZEOF STORIES EXTERIOR WALL I ROOF COVERING ROOFRINGay^ USE OF BUILDING AND WO T IBE PERFORMED K/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING COURTi% CDOH. 44"1--C_ n1 VALUATION SIGNATURE OF P / ,/( (50/ PERMIT FEE $ 02 PERMITTER Li 'e 4 $ / 7 ,PLAN CHECK $ i e AUTHORIZED AGENT 1) 1 TOTAL FEE $ E . _ _ , / •/ i 422.7.3 JUL 13.76cM;t1001467* ***110.91 I. „ - A. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A'P C• ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RE : a •TE RECEIV D DATE ISSUED BUILDING • a , I. Al • ADDRESS 4 _ 4 �1 s. t—rr C/t lyl.ls I/ks /Oom £Do IIhN Tu 1 A.P.NO.[17- 072_-os PERMIT NO. OWNER izr,}4r `fir NV /`I A ADDRESS4e-�/r�) g ,('pI 1714, V... �,r�.. p t�A`D(IDRE 'S I(tr�S� �r !. \r CITY CC S l rr MESA 9"1.4 2/ NOLS"r73 t11 ' 1"__�T(iACT r•t r• �OT �L BLOCK CITY CONSTRU N ' NEW ADD ALTER REPAIR MOVING DFMOLISH LENDER frgAt4c HAN.4ON EOUCAT1MJ sJc , BRANCH IT' 1-k tog 1 ' -' g OWNER l[�/t EO• ADDRESS /t, '6L r,-$ '1-.�->f� ARCHITECT I20 tjERT I-FOLFOM TEllI'O'�gg3�? USE s `j �JVO"I� 9R ENGINEER E.8Gl4 ARIA 0'(t�2 N`c 7/44 /6 4-011511• ADDRESS Jy �/ r �^ /SRI sr-rt' met Jj � V mmcmj — ZONE TYPE SIL GROUP r -2_ r PA-Milt _re/ APPROVED A CONTRACTOR ` /�t��/,� Q, '� o BY DATE ADDRESS ,aolo1 BIS c1 FA- vprJ r� i /j CITY I-IJA3Ti Ai 1Y t01J B qoH NOLry 9'(v'Fi z� 20a (PLANS (� BUILDING USE OF NEW F STATE 1 L"'rO"1 CITY Y� YARDS APPROVED YARDS APPROVED LIC. NO. 1 J LIC.NO. MAIN BUILDING ACCESSORY BUILDING LU SIZE �( �tN— NO.OF BLOGS. ..,�zz,, (FROM C/L TREET) r C. OF LOT ��" 1 (NOW ON LOT V FRONT 7y FT./C - FT. Q USE OF '1 l' /f �-, EXISTING BLDG. /v OKI E R.SIDE FT. L/r FT, Frn 2 'r Separate permits are required for L.SIDE F . FT. welectric,plumbing and heating work. . REART* FT. i.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q MAIN BLDGS. ACCESS. BLDGS. QrL17_ �/ RCP / VARCUP# e % i/iAPPROVEED r 7 -7 G > APPROVE'. ' V3r7cor •/ i E • cc HOLD FOR SP ' t L REQUIREMENTS. OI hereby acknowledge that I have read this application and state n CL that the above information Is correct and agree to comply with 0^ all laws regulating building construction, and I shall not employ co Z any person in violation of the workman's compensation laws of a the State of CaliforniaI . -So -I m I hereby certify that I am properly licensed as a contractor under J (`fi SQ. FT. w the State of California Business and Professions Code, Division 3, THE A OUNT SHOWN UNDER VALUATION IS FOR m 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 VALUATION y '0 PERMIT FEE $7fl and Professions Cndg, Dunn Chapter 9. 4 m Professions,,Costes PLAN CHECK $ I o rn Signature of `{ r L1 07•90 U. Permittee \` 'I.' l V• / $ it3 -r&' TAX $ �1 O / U. t� G/V 3- t Authorized Agent , TOTAL PAID $ i I /1 .Ci'' A /7LQ�7� ulr, —9-76-61c-70U 785 ;:t,},:166.GO , r 'r COSTA MESA BUILDINM- A,CALIFORNIAY DEPARTMENT P.O.BOX 1200 COSTA MESA,C 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink y J66 ' ^ RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING l//IY//' ADORES$ 1 J t Ji��, / t PERMIT NO. OWNE {r(I{ -..5/) A.P. NO. sme MAIL BUILDING / �,��y^ ADDRESS ADDRESS I d TEL. TRACT LOT BLOCK _t. CITY NO CONSTRUCTION NEW ADD ALTER REPAIR MOVING r'EMOI ISH LEI !II LENDER / BRANCHr OWNER ''y , / ADDRESS / •VALUE /v....ARCHITECT TEL. US $ . OR ENGINEER NO L FIRE lr j/ 2 ADDRESS � �,/ pL/) /J��,�(//�� ZONE TYPE GROUP ,rrT Visf.. ��`_zt7/� l APPROVED CONTRACTOR BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING IQ SIZE 'NO.OF BLDGS. (FROM C/L STREET) O. OF LOT NOW ON LOT FRONT FT. FT. USE OF 0. EXISTING BLDG. R SIDE FT. FT. rn F Separate permits are required for L.SIDE FT. FT. F electric,plumbing and heating work. REAR FT. FT. ILI(.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QQ MAIN SLOGS. ACCESS.BLOCS. VAR.# DATE .71 Alaillif A) at C.U.P.aK APPROVED APPROVED --BY DATE W 0 I hereby acknowledge that I have read this application and state u gC that the above information is correct and agree to comply with m L all laws regulating building construction, and I shall not employ I Z any person In violation of the workmen's compensation laws of u the State of California, 'ii 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, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABL HING A PERMIT FEE ONLY: ur am exempt from the provisions of the State of California Business VALUATION v p ERMIT FEE $ / ` s-Q j� and Professions C••• Division 3,Chapter 9., s n a I PLAN CHECK $ o_� Signature of 1\ LL Permittee $ TAX $ r. U Authorized Agent TOTAL PAID $// /s40.s