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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA. CALIFORNIA 92626
APR 30-71cys�C01329 ��-�*x*5.r:a
APPLICATION FOR BU�LDING PERMIT
Fo� Applicant to Fip in Completely -
RECEI ED DATE RECEIVE D IS D
BUILDING S a '��
ADDRE55 '
� PERM��(1
OWNER �r✓ A.F. NO. — � �
MAIL BUILDING �
A��RE55 AODRESS
TEL. � TRACT LOT D BLOCK
CITV N .
CANSTRUCTION EW ADD A R P
LENDER
BRANCH
OWNER
ADDRESS '� ' //L/� ! VALUE �
ARCHITECT TEL SE � l�G S
OR ENGINEEP N
FIRE
ADORESS ZONE TVPE GROUP
APPROVE � //
CONTRACTOR ev � F� DATE
ADDRESS
TEL. �ONE NO.OF USE OF NEW
PWNS � BUILDING
CITY NO.
STATE CITV �'ARDS APPqOVED VARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSOFV BVILDING
S12E NO.OF BLIX"aS. (FROM GL STRFFFI
OF �OT NOW ON LOT FRONT F4' FT.
USE OF
EXISTING BLDG. . SI E � F . FT.
SIZE OF NO. OF
NEWBLDG. ROOMS STORIES L.SIDE FT. fT.
EXTERIOR WALL ROOF
COVEFING COVERING REAR FT. FT.
USE F BUILDING AND WORK TO BE PEftFORMED DI5TANCE BET. BET. MAIN &
O� " MAIN BlIX'aS. ACCF�, gLpGS.
VAR.=k` OATE
C.U.P.# APPROVED
APPROVED� `� A�
L�
I hereby acknowletlge [ha[ 1 have reatl this application antl state
that the above intorma[ion is correc[ end n8�ee to comply wit�
all laws reBulating builtling constr�ction, and I shall noi employ
any person in violation ot the workman's compenwtion iaws ot
a
Me tata o ali Om�a i
I hereby certify thot I am properly lic¢nsed as a contractor untler SQ. FT. �
tha Stato ot California Businass entl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licenus are In (ull force antl effect, or I THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLY'
nm eaempt irom Me provisions ot ffie Srote of Callfornia Business �
antl Prote55iOns COtle, Division 3, Chaptor 9. VALUATION � a
� PERMIT FEE $ �
Signature of� �% � /��j_ �_� / �
Permlttee �y�(+�y �Y./.' [�(l�aY �•/ $/�D PLAN CHECK $ �
Authorizetl Agen[ 5 �
TOTA� FEE $
%
vnrv�R �VEY� Hn6
JOB ADDRE55 2975 Milbro St
GENERAL CONTRACTOR p. W.
AP No. 141-233-15 LOT
� ECTIONS
��Gn5
WRTEP
� ROUGH PLUMBING
�PROP. SWR. LINE ❑ NOUSE CON.
SPRINNLING SYSTEM
MISCELLANEOUS
FOUGH HEAiING AND AIR CONOITION�NG
TEMPORANY SERYICE OP GOLE
UNOERGROUNO � POWER �
ROUGH WIRING
TRENCNES FOqMS STEE� REINF
FLOOR SVSTEM
80N0 BEnM n STEEL REINFORCE ❑
SHEPTNING
F(iAME ANO FLASHING
LnTHING — IN n OUT n
PLASTER. BROWN COnT
STRUCTURRL, FINAL _
V V0. VENT., REfRIG. AND A.C,. FIN�L
P�_ ..BING. FINAL 4N0 WS TEST r�
ELERRIQ FIN�L
BUILOING, FINAL
unit q—z-76
BUILDING PERMIT N
IC��[�P.I
SUBCONTRACTOR
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING �7�`�•— �yJ' /I%_ . —. 1
OWNER (��
MAIL
ADDPESS�
CITY �
CANSTRVCTION
LENDER�
BFANCH
R ESS
ARCHITECT ..
I
TEL.
NO.
TEL.
�
ADDRESS�d'-//J (�'// (LYJ/�
CITY/j(/� \ TEOL.
Z`_ /llz/irrS ZYFi<^+-
� STATE �'7 `�- CITV /�
�IC. NO. p'- 7 /y� �IC. NO�J�
W SI2E � � NO.OF BLDGS.
�. OF LOT yT� /Q � NOW ON LOT
a USEOF -�
,.�. EXISTING BLDG. C � C
y
ESeparate permits are required for
� electric, plumbing and heating work.
[.�. USE F UILDING ND WORK TO BE PERFORMED
Q
Q ./ Q''� � 3 ��1' ��' �
� �' . • 1
r - �
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PA 1 U a� trfr ir ir
4PR —7-76����.-00 133 • 1 f�.50
APPLICATION FOR STRUCTURAL PERMIT
FEC IV BV D TERECEIVED DA EISSUEC
��- 7� � �- %
BUILDING
ADORES:
TRACT
FIRE
ZONE
APPFOVED
ZONE NO.OF�
PLANS
YARO$ APPFiOV ED
MAIN BUILDING
(FROM GL STREET)
DISfANCE BET
MAIN BLDGS.
VAR �k
C.U.P. ,$
BLOCK
VALUE
YARDSAPPROVE�
BET. MAIN &
ACCE55. BLDCS.
DATE
APPROVED
r.�r ���
fi
� 1 hereby acknowletlga thet 1 hava reatl this application entl state
n
y� that the above information Is correci antl aprae to comply with m
a all laws regulatin9 builtling connruction, entl I shell not emplay
i
Z eny paraon in vlolatlon of the workman's compensation lews ot d
ythe State of Celifornle. �
3 I hereby certify that 1 em properly Ilcanaetl az a connactor untler SQ. FT. a
the Stste ot Californle Buslness and Protessions Cotle, Dlvision 3, THE AMOUNT SMOWN UNDER VALUATION IS FOR m
Chepter 9, antl that such licences a�e in full fo�ce entl effect, or I THE PUFP�E OF ESTABLISHING A PERMIT FEE ON�V: "
am exempt trom �rovisions of the Scate of California Busineu a
VALVATION PERMIT FEE S
end Professiona otla,�Division 3, Cha TSt�J. �� u+
m
�[ /� / � PLAN CHECK S � �O ^�
Sipnetura of � �/ /, % �� /./l'� G' � 4
Permlttee �/ ,(—� � C�I $ e ��� TAX S � �
U
Authorized Apent / TOTAL PAID E � D
{ADDRESS --�°
BUILDING PERMIT
GENERALCONTRACTOR Welcome HnmPc VALUE $ q'�����a
�, 1�0 e�ocK TRACT 289G Single Reg.��,�a'r
���� I Sc �T TVPE V ZONE RIy FIREDISTRICT 3Q88
GROUP
PERMITSISSUED
INSPECTIONS DATE SUBCON7RACTOR DATE I NUMBER
Faoting Trench r� la"� b`dG -» .
Foundation Forms and Grade to Garag � %-%-% S i �C-�
Rough Framing - �
Plum6ing, Roughto Slah�o-�j�"� � '
Plumbinq. Rough Comple;e 1C' /�I C 5 �n- R• S'G /3i.�.rt/.s�.�s.l -/S-SI- Sro.� G—
Wiring Rough '///%iC ✓�{. ( ,( n�A t�C.��. ��l S'J 6 ,�f iS G b—
Heating, Rough ,r �
Heating, Final �L° % �7 /J%J/+i �U,.Cii? Clt�s.'S, y/.S -�i� J��i aZ '�l '
ewer, House Sewer, St. � ���e, ���-.., p� j.//- (i, ,C�,�lc G�-
Septic Tank or C spool �
Lathing,ln OutrX P Z z 3
I ering �✓�� � ��' '� �
Plumbing, Final, FixturesComplete%y/�S . ,O� �" _��
Plumbing,Fin.alGasTesk/c5� %1L�.S ,�,"Jb�$7 r�-i•-�-� y o�� J �
Wiring,Final „ �95� 4'1: � ._
iOFM 310 lM 10.�5
- Costa Mesa Bnilding Department
'. : �' P.O. Boz 3!7
' � COSTA MESA, CALIFORNIA
FOR APPLICANT TO FII.L IN
Building
nddress �-3 b;ilbro Street
Costa Mesa, California
Nearert
CrossSt. Post
Owner ti'Jelaor,e Hoires, Ina.
Mail
nddress 6�8 Y7estminstsr P,ve. ,
cit �estminster No�;'{em. 5711
Y
Architect or Lic_
Address
Cil
contractor�lelcone Horre s, Ino. Na
nddress �2� wastminster Ave.,
Legal Lot
Descriotlon No. � Block
No. of Bidga
SizeoTLot 58x102 NowonLot N0=1B
4seof I No.of I No.oi
Existlnp Bldp. NOP,B Families Roemi
Sida
x � Alteration � � ACtlttion
�IPPLICATION FOR PERbIIT
3088 BUiLDING �
FOR OFFICE USE ONLY
Receipt No. Permit No�./
� d r�
Reeeived Date Rec'd. /Date pIssued /
� Jr���r��o J'�d ���o
�tumm�g
Address
Costa Mesa, California
Nearest
Cross St.
Zone�/, I No.of I Type Gro
•r Plans � ��
Approved
by Date _
CORRECTIONS
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te-- '�_._ __. S
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+� � i.— - . =l
O.i 1 i„" �
.- .._�..� ,.... .,�i
Builtling No. of
Size �5� Rooms 5 Stories 1
Exterior Wall Roof
Covering Stuoco Covering Nrood APPROVALS
use or New Sin le fard 1 residonoo ar.d Foundation Lacation insPeetor
Bullding � Y Forms, Materials,
Under-Plnning
—�.,,; e.,. �u,,.;:�. wbcsa:x„�. Frame:FireStops,
Bracing, Bolts
I hereby acknowledge that I have read this App]icaUon
and state that the above is rnrrect and agree to comply Lath. Int.
with all Clty Ordinances and State L.aws regulating
building mnstqqqr���uc���tirrron. Lath. Ext.
Signatureof /,� / ��
Permittee /��U �'H6�� Plaster. Int
te�0 1
valuatio�l"'��
s '�l � �a 0—
,
conm zoa io.ee o. r. e s.
Permit Fee $
Plan Check S
yi masur
� Bond
6 � I FINA
Date
PLOT PLAN
Show locatlon and distances from
property Iine antl between buildings
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