HomeMy WebLinkAbout1984 MEYER PL - Building PermitsCITY OF COSTA MESA
;` BUILDING DIVISION PERMIT NUMBER
t DEVELOPMENT SERVICES DEPARTMENT
�•� PERMIT
✓B99-00469
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1984 MEYER PL Status: ISSUED
Suite: Applied: 04/07/1999
Vicinity: RESIDENCE ONLY. Issued: 04/07/1999
Parcel Nunmber:
42214239
Zoning:
$59.50 Claim Valuation:
SMTP Res:
ISSUED BY:
Applicant:
ROBERTS, W.
Other:
Address:
1653 SUPERIOR AV
$0.00
Total:
$60.00
Phone: 949-642-7222
COSTA MESA CA
Zip: 92627
Owner: HUBBARD, JANE
Address 1984 MEYER PL
Phone:
COSTA MESA, CA Zip: 92627
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AV
Phone: 949-642-7222
COSTA MESA CA
Zip: 92627 License: 349686
Arch : Eng:
Address: Address:
Phone: Phone:
Zip License: Zip: License:
SCOPE OF PERMIT
T/O (2 COMP SHINGLE ROOFS); REPLACE BAD SHEATHING. INSTALL 220# COMP SHINGLES (SENTINEL BY GAF)
WITH 2/15# FELT UNDERLAYMENT, STARTER COURSE. NEW EDGE METAL 8 JACKS.
FEE SUMMARY
Plan Check:
$0.00 Calc Valuation:
Permit:
$59.50 Claim Valuation:
SMTP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$60.00
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
$1,850.00
$1,850.00
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: This permit shall automatically expire and become void if work is not commenced within 160 days, or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714) 7545626
�I
DECLARATIFONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
ve and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
Ork for which this permit Is issued.
I have and will maintain workers' compensation insurenca, as required Dy section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed /f the permit is valued at one hundred dollars ($100) or less.) -
❑ 1 certify that in the performance of the work for which this penult is issued. I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califomla, end a at If I shoultl become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these
ph
Applicant Signature: G(/ Date: 4e/_ � 7 9
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUMECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE (S100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full
force and effect. Lie. N Class N
Contractors Signature: Llii Date: S1– %— 57 2
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued, (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 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 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, as Owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not Intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves 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 sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose Of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet In depth Into which a 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 or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, TItle 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division Of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Data:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds, or a volume of 55 gallons,
Or 200 cubic feet Of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materiels? ❑Yes ❑ No
(Section 25533 of the California 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 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, cartificatlon and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
5 Does Or will the applicant or present or future building occupant require for the work which Is the subject of this a plication a ff,pmrit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8 (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-descdbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this por mit until final Inspection.
1 Legal Owner(s) Date
Ari Authorized Applicant Date
CODE 1, INSPECTION TYPE PATE IMIALS CODEI INSPECTION TYPE 2M 7ytQ19LSS
1616 Fixed System Final Fire Prevention ._/,,_/Q�!� 206 Final Mechanical
1266 Pool Spa Final —1�— 2Final Plumbing
200 Final Re -Roof • 21010 Final Electrical
201 Final Block/Retaining Well 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,
244&46
rJ
ADDAESS OF BUILDING: 1984 MEYER PL
ONNERS NAME IF G3lOWN: SWITZER, MERTON J
AODNESs 1.984 MEYER PI,
COSTA MESA,CA 92627
548-2178
APPL. MAILING ADDRESS:
Al1CNITECT OR ENGINEER:
LLC NO,
CITY OF COSTA MESA - BUILDING PERMIT
9 `n/ PERMIT NO: M 080566 PLAN CHECK NO; N
CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC
JOB DESCRIPTION WALL HEATER REPLACEMENT
UM.
CLAIM VALUE: CALC-VALUE:
CONTRACTORSNAME COAST TECH SERVICES (714)589-6592
CONTRACTORS MIXING 14 SANTA CATRINA
ADDREss: RANCHO SANTA MARG CA Elena, 355425
92688 DMT:
LICENSED CONTRACTORS DECLARATION: I hereby aRem undut thin I under prwiaions d Chesser P
(mmntma., .nth Section 7000) d Drvinon 3 d the Butane. and nd is in fun lace and effect.
CITY uC.NO.;055 68 uc-r( C 20 LIC NO -:25 EXP; 96
i/ Tr -7 /� �/-
Dee: 1 CommosonV'�j /
OWNER BUILDER DECLARATION: I hereby affirm under peraly summer horn the Comracu m Liomm, Law for Ice
lollowin9 reason (Section 70313 Buameam end Pro eesiona Code: Any cN or county ahictt teyuims a pared to co m mcf, Mer, improe,
demolish, or repair any structure, prior 10 ds eausrce, aloe Muiress the aPpicom for such PmM 10 fib a signed seamed the M a and
. licensed pctsonsunt to IM Provisions of the Caemcfem License Law (Chap« S (canmeuanup with Section 7000) of Mom 3 of the
usim. and Prdeesloro Codel or the M or she is exempt therel om and Use Mm for Ile sleged exemption. My vulmon of Semon
,031.5 by any applied for a panted subjects the applicant to a acid penalty of not mea then fere hundred ddlers 155000.
I,. owner dthe prmeny or cry emptorees ash wag.. Uses sale compensation, wig do the work, and the sumdure b not intended
sto6ared oetas(Sectionmort. Busier. deet P ucl ab Gose:TMCamrmaa,,h he
e Lawtamsratepp sese,p wnaahed ,h
wheysee ok. not iUendW.endwin does ash workrunnelIor hem, or
Mt herowehin me year
providedthe ems
imprevemWer esu not buanded a dlf la aab. r however, the ildor o pr ye let erned in sad within ar Yeu et mmpblon, Ir
ownar-0uiMer will heve the MNan d proving he a she tlk net heid a improve lathe Wryoea d eeb).
l.. ower d the Proper,. sm eudumm y connecting a4h scanned comosesa In construct the project (Section 7011. Business and
Promote a Cab: The Conmdaa License Lew does Mappned a
y to en owr property ohn wilds monomer thereon anti ver
contracts for such projects with o mNmdor(a) Icematl pumuera to the Contract. Limens, Law).
1 am exempt under Section: B. & P.C.. Ia thio reason:
Date: Omer:
I do hereby candy that I are awue of and aderstsrud the ne ovemaraa of Celfaris Health uta Soley Cale Sed'vn 25505, 05500, and
2553x, uta the 1 or an)' Mune h lding omipem will / will not (circle ons) need In campy voth most sues codes and the resdtero" for
e peed lamnewaion ce rurdfi.tM ham the As OMY eneymru Diana. Reddened mnmmrueion epplrmion em exempt hoe, these
provisions.
Own: Apposed:
WORKER'S COMPENSATION DECLARATION: hereby affirm oder pmNy a pajry aro d Ila hNbainp dedarsuiom:
I have and veil maiden a d consent m eMinsum is aaMera' OcmPenamion, n prwMW M by Saaion 5700 a Ilia Labor
Cale. for the peperformanced d 01nor a st work for wNch this peen is i.t
hew and wit madman waken' oanperumlon insurerum, es ipuirad by Sectkn awl
prico Na Lubar Coda, M the Wdormmnoe d IM
wok la whkh this perml is ®sed. MY waMre' i
annp..tbn .ureuce when end y nvmhee aro:
Cerner:
Polity Number:
ma semen need car As complslM I the pwml u M one huskedf dMen IS1027 or la..)
I mnN that in the pedormeuce of the wok M which this pend b iaaueE. I shell net employ wry' pmmm m any manner c as to
Mca,e subject to IM waken' mmGonaedn leas d Cellar. et�,g7na Ne I I should eu*d to the wwkkeerryy
Dale:/ I �d_r 372" Py
App � , I ehM Iollwjth campy xith thea .�'e _
Waminp: Felure to secure waders' mrrpe ss tion ccomepa la unhortut. Ardsholl sa lor:f sit srWloyw of Mmlrol iermltlu and
clyll fines up of one Ipndmd thousand dellen (SIURDOGj M satlldon as tiro co.f of mmpecrou n damsyss u pmvMod for In
Section 3706 of Me Labor Code, ImwesL and eltomey. tees.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penMy of perjury, the then u a commsion lending eyenry, M ttr
oedam.. of the.* M whits UM Perms is seed (Section 3007, civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certiy that l have reed thio appiceti mrd des them IM above idamatian b erect. l yrea m campy with M dy' end ommy ad'mertcea
and muse lows mlmirgreMiMn truaian a MherebyauDYNaereaseerVativeadtsedtyWMlerupantMeba-medipn wopmy
leriropeai0n purp0aea.
DE AN I /J
try Print N/�
�/ em / Date:( r
(5151 wwp) Whoa ilong l Safely G,.,fda; Cwry-AppFan; Pink -Revenue; GoNenrod-Asaa.or
PERM NO: M 080566
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
#######M#######################################################################
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------'- ACCESSORY BUILDING---------
^FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42214239 ZNE: REF NO:
PLANNING NOTES>
D E V E L O P M E N T S E R;V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: — 2aC— DATE: kILF u
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 13,25
25% SMIP/NON-RES
PLAN
ISSUE FEE 22.00
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 13,25 22,00 0.00 35.25 35.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE. SMIP/TOT GRADING PLAN -CHECK
35,25
I N D I V I D U A L F E E B R E A K D O W N
TYPE. QTY D E S C R I P T I O._N. UNIT COST TOTAL COST
MEC 1 INST/RELOC RECESSED WALL HEATER 13.25 13.25
END OF FEES
01 00219742-00219742 TOT 35.25
DATE: 11/22/95 TIME: 15:04
CONSTRUCTION AND PLANNING
APPROVALS Permit # Date
Inspector
POOL 'A
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 LIFER Grnd.
57. APPROVAL TO COVER•GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O 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
1
19. Rough Heating & Air Conditiorling
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0 Gas 00d
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank OGas 00i1
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:I�.arj_9
34. Final Heating & Air Conditioning
��_a$,c16
w/
1`l
1, 6 C
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
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47,. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
-
50. Gas Release to Southern California Gas Co
51, CERTIFICATE OF OCCUPANCY
No. Date
G�
JOB ADDRESS 1982-1984 Meyer Place BUILDING PERMIT NO. 889
GENERALCONTRACTOR George Markel VALUE $1,500.00
LOT AP#115-322-4o BLOCK TRACT Dwelling, relocation and £ounda-
t10
'GROUP I TYPE V ZONE R4 FIRE DISTRICT 900
INSPECTIONS C � �,
DATE
SUBCONTRACTOR
PERMITS ISSUED
DATE
NUMBER
Footing Trench (
-
Foundation Forms and Grade to Garage
Rough Framing
Plumbing, Rough
Plumbing, Rough Complet
/
/(
Temporary Pole
—Y
Wiring, Rough
Heating, Rough
Heating, Final
_
Sewer
Septio,Tenk or Cesspool /YLD
Lathing
c� "
Plastering � �a
- 3,0 -
Plumbing, Final, Fixtures Complete
•!/'r
Plumbing, Final Gas Test ...Z !%ro
_g•-)/-
L",2�CG'C�%•-e��.,
v
J - 3 -�.)
-c�c-
Wiring,Final G<
Occupancy
Form 210 C -H 1M 12-69
sta Mesa Building Department ✓/ APPLICATION FOR
' 117 E STREET
/P/''±'ERMIT
B U I L D I N.
,20th
COSTA A A, CALIFORNIA
__ ^ V_
FOR OFFICE USE ONLY
FOR R APPLICANT TO FILL IN
• Receipt No. Permit No.
Building q n,.�
, n
Address / /iZ%`'/ �!1c/
Costa Mesa, California
Received!by Date Recd. Date Issued ,
Nearest
Cross St. ST
Building
Owner
Address
Costa Mesa, California
Mail
Address `' Q i....����.
it/
Nearest ,
d�
Tel.
C"4— % No.
Cross St. I
Zone Type
C.�
City "4
'/ I No. of I Group 7�
I I
Architect or Lic.
i Plans .4
Engineer No.
Approved !
by Date I
Address
CORRECTIONS
ity Lic.
--- •
Contractor No..
Address
Legal Lot
Description No. 2 3 i Block Tractpri,
(Attach Metes and Bounds ' /S`�33
No. of Bldgs.
Size of Lot q y f� Nawf Lot
t
- - -- - O
Use of No. of No. of
Bldg. F.amil jRoomsfi
! _ - A_
Existing
Setback Line from Rear Yard i'L^�
Center of Street �i% Side Yard /o'
y
DESCRIPTION OF WORN
r
New I Alteration
I
I Addition
Repair I Maving ✓' I Demolish
'•. Building r`L)e Z. L No.of
113
-�
Size_— 1 k_ Rooms Stories
Exterior Wall Roof b?k
Covering �-
5� i.
APPROVALS
_Covering
Use of New
Building
Foundation Location
Inspector
Date -
-� —
Forms, Materials,
Under-Pinning
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 construction
Plaster, int.
Permittee �'S.@ /��1 _/'%/(
Perm
Plaster, Ext.
Authorized Agt.
Masonry Reinforced
Valu,ationr/; Permit Fee $
V Plan Check $ i✓+-�-'
Bond Beam
$ Total-
Fee $
FINAL
PLOT PLAN
Show location. and distances Brom
property line and lietween buildings.
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Street
PLOT PLAN
Show location. and distances Brom
property line and lietween buildings.
7osta Mesa Building DepartmentAPPLICATION FOR PERMIT
111 Et -- 20th STREET /JL_
9_B U.1 LAINGCOSTA a k, CALIFORNIA-
R'nrm G -H 111 12-58
FOR OFFICE USE ONLY.
FOR APPLICANT TO FILL IN
Receipt No. Permit.N
_
Building
I /Date
Costa Mesa, Califofnia
Received by. Re 'd. Date Issued
3
Nearest /�
Cross St. 1`)'
Building
Owner �
Address •
Costa Mesa, California
Mall
Address �jp �6/V%E� '
Nearest
AlTel.
Cross St.
City !tel No•
one No. of {{Type 4 Group
I
Architect or Lie.
QA Plans J
^•�
Engineer No.
Approved
by Date
Address
CORRECTIONS
q' -City Lie.
_
Contra-ctorctor No.
Address �j`
Legal'Lot
Description N. I I r
_Block
(Attach Metes and effsd)
/No. of Bldgs.
' (
Size of Lot �j Now on Lot d}�L_
-- - - -
Use of I No. of No. of
Existi ng Bldg. 4 Families Rooms'c)_
' 77
Setback Line from.i Rear Yard
Center of Street ide Yard
DESC P O OF WORK
New I Alteration I I Addition
Repair I I Moving I I Demolish
BuildingNo. of /)j
Size Zo ,t' 3 fj Rooms /(/ Stories
Exterior Wall I Root
Covering CCD Covering
Use of New
APPROV S „
Building A
Foundation Location Ins ecto
P
stt--
/Date
Farms, Materials,
Under -Pinning
_
Frame: Fire Stops,
Bracing, Bolt
1
AV -
/
I hereby acknowledge that I have read this Application
Lath. Int.
and state that the above is correct and agree to comply
/
with all City Ordinan s and State Laws regulating
Lath. Ext.
✓
building constructi
Signature of
Plaster, Int.
Perm,.He
;
Plaster, Ext. i
Aut o ' d Agt.
Masonry Reinforced
Valuation Permit Fee $ �• Pfl
rtX. Plan Check $
Bond Beam
//
$ 2 4 0 Total
/
Fee $ O 71
FINAL
R'nrm G -H 111 12-58
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Street
PLOT PLAN
Show location and distances from
property line and between buildings.