HomeMy WebLinkAbout347 NASSAU RD - Building PermitsAOP�icant to fill in all sDaees except those witltin �eavY bortler lines ana si9n all apo�a0riate aeclarations.
CITY OF COSTA MESA � PERMIT.NO. � TRACT NO. LOT NO. BLD . . • B I O8 4/05/84 �5vOO TL
CONSTRUCTION PERMIT . — oZ�p.� � .
PrOlect Addresi TYPE OF CONSTRUCTION NEW ADD , ALTERATION REPAIR '
Applicant'SMailin Address�. ' � ' ❑ CONVERSION ❑ OEMO�ISH ❑ OTHER - q,p,#� ' Zane� ' ' . '
�,!J'^/� DESCRICTION OF WORK
Owner's Name � /� -, hon�� _ �r. � � S Main euilding: Accessory Building: Z
Address �Z/.lLS'Sl�IA ' � E . . �
TVPE OF PERMIT ' GRAOINC'y` FOUNDATION ST�L T Front ry
Arch/Eng., License No. ❑ TENANT ❑ ELECTRICAL �f�J�aLUMBING ❑ MECHANICAL B , - . - ' . ' �
A Reart N
Addr¢ss ❑ �OTHER �i� y � _
Contracror'sNam -�' 'p f Phone/� PROJECTDESCRIPTION SQ:FT. " OCCUPANCV '( C Righty . � �+
Add�¢55 (Tdi110g� 3t�� N/I ��jI �(J I 0 CLIC/H� : C�NSTRUCTION TVPE VALUATION $ZCSl�/") � OO S� L¢ft ' � ' � � R
E•
�n��.l �' ZONE ' GiEAOINGCU.vDS. ACRES p�n9.lief:# � Park.Fees $ �4
Ciry License No. '�-�
U
LICENSED CONTRACTOR DECLARATION qemarks: . Pa�king Req./Provided � � " ' ' �
4hereby a(firm thdt I am licensetl untlEr provi5ions of Cha�te� 9(commencing � � ' USC Of Bulldi❑ � R
with sectlon 7000) ot Divi5lon 3 of the Bu5ine55 antl Protesslons Cotle, antl " . � � 9� - ' ' E
my license is In full force f p,Ft. / 1" - . �
Licen}g�C ss ` "� u nsa No. `' � � - PLUMBING - FEES Planning Notes: M
� DateY` 519 t �� BarSink � Showers N
�WORKERS'COMPENSATION DECLA ATION , � . . 7
. I hereby at/irm that I nave a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S
of Wo�kers' Compen5ation Insu�ance, o� a certit' tl copy t e�eo( (SeCtion � �
�3Boo, �b. ��,S�,Q� 2� Backflow Irrigation Sewer Cap ', ELECTFICAL FEES
\Policy No. Company
�Certifietl copy is �ereby turnishetl. • Bathtubs Sewer Connection Automatic Washer Transformer ❑ 15-50 KW
Certifi=tl �y' 'IeE with the city Bu'I g IVlsip[✓ /./ ❑� 50+ KW
Date APPlicant� /\G�XJHSe Clarifiers $olar Collecmrs � Construction Pole Sub.
EXEMPTION<� F—�RO WORKERS' COMP SATION DECLARATION Di5hwa5hCf 5012f Pipillg � Cooking Unit .. Meter Oup [0 100 amps
(This section neetl not be <ompletetl if the permit is for one huntlretl (5100) or �
Iess). Drinkin Foun[ains '
1 certify that In the performance of the wofk to! which thi5 pelm�t i5 i55ueQ I 9 - $oldf T3pk Di5hwa5hC! M2t¢! �Ov¢f 100 3mp5
shall not employ any pe�son in any manner So as to become subject to the . -
Workers' Compensatlon Laws oi Calitornia. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
�ate $ignature
NOTICE: If,iafte� makinq this tlecla�ation, you Shoultl become subject to the FI00� SinkS U�in21 " ''Fdn ' MO[Ots ��-1 HP �1 %- 8
Workers' Comp¢nsation provisions of the Labor COGe, you must forfhwith .
comply wlth sucn provisions"or this permit shall be tleemetl revoketl. GasService Outlets WaterCloset . . F.A.U. Inc.Solar�9-15HP�16-15+
CONSTRUCTION LENDING AGENCV
I hereby affirm thaf there Is a construction lentling agency for tne performance Interceptofs Wa[er Heater ' ' Fixtures � Microwave
of the work for which this permit is issuetl (Section 3097 Civ. C.} � ,
Lender's Name ' Kitchen Sink Water Service ' Device Boxes Pole Light
L.ender's Atlare« ' Lavatories '
OWNER BUILDER DECLARATION ' � Outle[5 Rang2 '
Lhereby atfi�m that I am exempt from the Contractor's License Law (o� the p_Tre
following reason (Section ]031.5 Business antl Professional Cotle: Any clty or P Switches Sign
county whiCh r¢quires a permit to�construct, alter, improve, tlemoli5h or repair
any structure, prior to its issuance, also requires the applicant for such oermit Roof Drains � Garbage Disposal Standing Sections �
to file a signetl Statem¢nf ihat he/she is licensetl Ou�suant to the provl5ion5 Of
. the Contractor'S License Law (Chapter 9(commencinq with Section 7000) ot � '
Division 3 O/ the BuSinesS antl Protes5ion5 Cotle) o� that he/She is exemot � - Genera[or O0.5 KW OS-15 KW TfeSh COrtlpdCtO�
th2refrom antl the ba5i5 Tor th¢ alleqetl exemption. Any violation ot Sec[ion
7W1.5 by any applitant fo� a permit subjects fhe appli<ant to a clvil ReinSpettiOn Fee $j$ ISSu2 F¢¢ $ 3
�enalty ot not more tnan tive huntlretl tlollars (g500).
LJ I, az owner of the'vroperty or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3
compensation, will tlo the work, and the structure is not intendetl orofteretl FEES ��
tor sale (Sectlon 7044, eusiness antl Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: •
License Law tloes not apply to an owner of a property who builtls or imOroves goiler Hood or Type I ❑
IM1ereon, antl w�o tloes such work �imself/herselt or through hiz or her own Zoning Approvad By Dete
employees, p�ovitletl that such improvEments are not intentletl o� offered fo� CenOpy TypE 111 ❑ ,
Duct - Under Ground
sale. It, however, the builtling or improvement is soltl within one year of com- Buildin0 %�PProved By Date
, pletion, tne owner wlll have the burtl¢n of proving he/She tlitl not builtl o� Im-
rove tor the purpose o( sale). Duct - Structural Refrigere[ion System ' Appliption Issued By ��'� / Dat�
� I, as owner of tha property, am eaclusively contracting wim Iirensetl con- ' ❑0.100,000 BTU ❑ 100,000 BTU • �
tractorsto construct tha oroject (Sectlon 7044, eusiness antl Professlons Cotle: Duct- Ventilating , �'i SUMMARV OF FEES
, The Contractor's Li<ense t,aw does not apply to an owner ot property who- � BUILDING PERMIT $ SMIP �$ �
builtls or improves thereon, antl wno contracts for such pro�ects with a con- Exhaus[ System ❑ MultiplB ❑ System Repair/Alteration ' "
Vactor(s) license pwsuant to the Contractor's License Law). �' PLAN CHECK $ � PERMIT
; ❑ 1 am exempt untler Section B. & V. C. for this reason FirepVFact. Blt. ICBO # � � pLUMB WG • �$ �' � �� ISSUANCE �$
Date ' Owner� � ' - HeatingSystem&Ducting , � � ' � � pLqNCHECK 25% $ ENERGVP.C. $ '
. I hereby carNty that � have reaa this�application antl-state that tne above- � ❑6100,OOOBTU �100,OOOBT -� � ELECTRICAL $ GRADING $
Intormation Is correct. I agree to comply with all city antl county ortlinances ,
anA'state laws ralatin9 to builtling construction, anE hereby authorize reore- � � PCAN CHECK 5096 �$ MICROFILM $
sentdtiv¢s of thl5 c y ttpp ent§� upon the above-�nentionetl proplrty fo� � ' ' .
Inspection pur s /� ���-p�--/ i .' ` � ' ' MECHANICAL $ TOTAL FEE $ � �D
Signature ��,Q�✓i�'
Reinspection Fee $25 Isxue Fee $ 3 PLAN CHECK 25% $
CMF0865-46 rev.12/83 White-Builtlin9;Canary-APpllcant;Pink-Accounting;Goltlenrotl-Asseszor � � /
_ CONSTRUCTION AND.PLANNING ' � " � - ' � ' � POOL & SPA � .i � _ ; � � �
. Date • � Inspector ' ' � ;'Date= Inspectoi �
APPROVALS Permit#-:-= - - APPROVALS� -Permit# ,
�� 1. Temporary Electrical Service or Pole . . 52. Pool & Equipment Location - -.
.- 2: Soil.Pipe-Undrgmd.' _ � - - 53.' Steel Reinforcement - , - /
3: Electrical Conduit Utility-Undrgrnd. - ' � 54. Forms � � _ , �
4: Electrical Conduit-Undrgrnd. '. . 55.' Electrical Bonding -�� � �
.,
5. Steel Reinforcement � - . � , � - 56. Rough Plumbing & Pressure Test - - ' , - .
6. Electrical UFER Grnd. • - , - ' �� � 57. APPROVAL TO COVER-GUNITE - I
7. Footings . ' � . - 58. Electrical Conduit-Undrgmd. - , ' .'
8. Foundation ��_ - 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. - - 60. Backwash Lines, P-Trap, O Undrgmd..
10. Structural Floor System . �' � 61. APPROVAL TO DECK �
i t. 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 � -
75. Rough Electrical-Conduit " - , �� -' 66. Solar System-Final � - "` - " "
i
16. Rough-Electric Wiring, , � - - � - �67. Fencing & Access Approval � � " -
�T i
17. Rough Wiring Sign - � � " _ 68. APPROVED FOR PLASTERING � ' _ � -
18: Rough Electrical-T Bar Ceiling� , � �69. POOUSPA SYSTEMS FINAL i -��: �' �,' .
� 19. Rough Heating & Air Conditioning ' i i' • FIRE DEPT. REQUIREMENT � • �
20� Rough Facto'ry Fireplace APPROVALS � Permit # �� I
21. Ducts, in Structure ;� , � , 70. Underground Hydro , �
2z. Ducts, Ventilating �' � � � � 71., Product Piping � Gas ❑ Oil �
23. Gas Pipe-Rough & Test i ' � 72. Underground Flush �. �
�2A. Roof Framing i • _ � � � 73. Undergrnd.StorageTank OGas ❑Oil' � ' � �
_ 25: Roof Sheathing � � 74. Overhead Hydro . � � .
26. T-Bar Ceiling (Structural) & Monocoat ' � � �75. Dry Chemical � . � �
27. Freme and Flashing � � 76. Dry Standpipe .
28. Lathing & Siding � ' I ' 77.� FIXED SYSTEM FINAL � �
29. Insulation - , , . , ' �78. FIRE PREV. FINAL � � '
30. Drywall Nailing • HEALTH DEPT. REQUIREMENT � , �
31. Plaster Brown Coat -' ' t 79. FINAL INSPECTION � �
32. Electrical Power Meter-Final - � 80. FOOD CERTIFICATE ISSUED �� ,
33. Final Electric � ' � Notes. LE�%C�IZ(�� �]':��fl��y =-�J _ �
34. Final Heating & Air Conditioning '. � ,
35. Final Gas Pipe-Test " � � . - � � � „
36. Hood or Canopy . , � . � ' . � ' �
- 37. Final Factory Fireplace � � � � - ' " - � . . ' ' - '
38. Final Plumbing . � �j�j �K �(�cEO - ' ' i
39. Water Service-Final � , '
40. Gas Service-Final ' � � ' ' ' '
41. Solar pomesticFinal , �, � � - � • � � '
i
42. Backflow�Preventer ' ' ' � � • ' �
I - �
43. Backflow'Irrigation � � _ � ' �, . '
44. Landscape Irrigation System � � �
45. Sound Attenuation � . . � T
� �
46. Handicap'Regulations � ' . . � � ' - -
47. FINALSTRUCTURE & BUILDING . � � I � � � '
48. Special Requirements Completed � �, � -. , � � � ' ' ° �
i
49. Electric Release to Edison � � � � ' . � � - .
50. Gas Release to Southern California Gas Co �� ' � �'
51. CERTIFICATEOFOCCUPANCY - -
No. - _`.Date� - � - _ i.. _ � . .. ' _ .�_. . . . .
. _ /�
` p � CITY OF COSTA MESA �•• 7'
� BIIILDIN6 pIVIS10N
� DEVELOPMENT SERVICES DEPARTMENT R9R-01200
� � � PERMIT PERMIT NUMBEt;
�'� .
(714) 754-5273 • Fax (714) 754-4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 347 NASSAU RD
Suite:
Vicinity: .
Parcel Nunmber: 14144203
Applicant: CARSON, MIKE
Address:
Owner:
Address
Contractor.
Status: ISSUED
Applied: 07/07/1998
Issued: 07/07l1998
Zoning:
Phone:
- ".,2iB: , '" ..
.i � ' ... � ___ ; _
MANN, JAMIE LEA'�%'. � ' " � ' � � �' -
� � � i �� .
347NASSA��RDy��,'�7� , � ' _ , ,�+ ';� `�����'��-_�
�N/' j � � �'� � � PhOnd . _' � � L � , � � (��/ ' �� �
ii
//STAMESA;CA � � ; Zip - 92626_ --`� \ � �
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�.��/�' ���,/ Phone: A�� ��� � � -��
/ �\.
�/ �i� Zjp: �\\��. . �.
��/r License:� ���� / . \� \�\',.
SON ROOFING AND INSPECTION� V�\�., � � �
�;cirRON �N lv'� I . r-� -� �;A. �' '�,'`,
`�.
��/ %j '.'Phone:��714=835=4912 ; � ��\,A �•
�l v \
' ; � �"!�.Zip ,92801 � � � i ' . . ." .�,`
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/ � ��+ 'License: =661526 ''��':::-� � . � ;A �
.� �J-drq� _ . - - .,�fi���` ,�i� e' , �
� / \ �
,/��`� -�' � SCOPE OF PERMIT �` � � , � �.
� .L�i5C8 FELT 8 REROOF�WITH COMP. SHINGLES. � �,� ,
/ �
- � ,� - - _ ��`l'� G� - -_ �, _ ��
, . ,,., . �
,_., , , ,.,.-, , ,
� � � i > :-,..� �;: - FEESUMMAR.Y. '..�.. [:� .:. � , '
; Plan Check: ' $0.00 � " " -• Calc Valuation: $3,000.00;,
� �� Permit: � ' � $74.75 ` �"" r: . /'� Claimed Valuation: 'Sa,000.00�� ,
�, �
� ., �- .� �,r. kt �-- � _i <., ,
�$MIP Res: �_$0.50 r. �i.�_:�f— _ � - � _'. -.�:. -�^
��SMIP Com � $0.00 � �_.. -� '� — . _ �����- — � , �,
', �� Other �, ��?$0.00 �� �� . � � � �
Inspechon 1�$0.00 �� , / ,'��
�� �\� �,�, \��..., --"� , , �.
� " �� \
�;�Total � � $75:25 ' ._ �i/ ��`��� , ��,��;�
�� �.� � �. i� i i
�A�� A . � ���,:'� � ,, '-\� C;�� _' ,
��:��, �. ��� ( '�PLANNING'&�ZONING � � }' � �� �
\ . � �
� �� ���v :. .�O�ir � ,��i � .. .� � ,���-
i
SETBACKS' � � \ � � � � �.., � � � �; ,� ; � ��,. ;
� � ��\ ..> i,. r.a i�C�i �� 1 /i.
MAIN STRUCTURE Front �/0-�0', � � `�'��Rear 0 0 .,� i� � Le8' , 0 0 � -Right 0�0 � �� ��f- �
i ! �� > " � __ � . , � �� ' ; :: �„� j �'�
ACCESSORY Front 0- 0� ' Rear 0, 0� ��� -` L'eft- 0 0� -�� Rlght �"- 0= 0 ���
/%l
\� �_)\\J�/` : ` ` �� .- .�. ��.'� i ,(l�
PARKING Existinai = �0, , ' Reawred:,' o- �� . � Pr000sed:' �0` + ' �`, il j�
, , �,, _ - �
NOTES: � . .. -'i , , `.��.. .- . . .. .
. � ,., � , . , . -..��' ,. "��-
�
�
EXPIRATION: This pertnit shall eutomatically expire and become voi�if work is not commenced wlthin 180 days, or if work is suspended or abandoned
for a period of 180 days. " '
INSPECTIONS: In order for the work euthorized under this permit to be consldered legal, such work must comply with all epplicable codes, and all
requlred Inspeetlona end flnel approvel must be obtained. Failure to obtain Inspections and final epprovel will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545826
WORKERS' COMPENSA710N DECLARATION: .
I hereby eKrtn under penalry ot perjury one of ihe following declarations: ,• ,��� . ,
❑ I heve antl will maintain a certificate of consent to celf-Insure for workers' compensation, es provitletl for by section 3700 of iha Lebor Code, for the pertortnence of the
� work for which this permit Is IssueA. �
,[] I heve end will meintain workers' compensalion insurance, as required by seclion 3700 of the Lahar Catle, for Ne pertomience of ihe work for which ihis pertn% is issuetl.
My workers' wmpensation Insurence certier end policy number ere:
Cerrier: , , Policy Number:
(ThIs sectlon need not be comp/efed i/ Me permlf Is va/ueC et one hundred dallers ($100J or less.)
I certify that in the pertortnance of ihe work for which this permit is issued, I shall not employ any person in eny menner so as to become subJed to the workers'
�ompamel laws of Californie, end egre thet N I shoultl become sub�ect lo Ihe workere' compensetlon pmvlslons of Section 3700 of Ihe Lebor Cotle, I ahell fotlhwith
cOmply wlth ih se rovisions. �/� �y/`�
� � ' / ( Y
. nt Sl9netu . � ate:
INO:�tORE TO SECURE WORKERS' COMPENSATION COVEBAGE IS UNLAWFUL AND SHALL SU&IECT EMPLOVER TO INAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
SRffD�OLLARE(StOD,000),INADDRIONTOTHECOSTOFGYMIPENSATIqJ,DAMA0ESA5PROVI�EOFOR EGTI FTMEUBORCODE,IN�EREST,ANDATTORNEI^SFEES.
LICENSED CONTRACTORS DECLARATON:
I hereby ettirtn Ihet 1 am licensed under provisions af Chapter 9(commencing with Sedian 7000) of Division 3 of the Business end Pratessions Code, end my license is in full
torca enq.eHeettic#� —`� � Class N _, _ i
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn that there is e constructlon lending egency for the pertormance of the work for which this permit is Issued. (Sec. 3W7, Clvll Code).
Landels Name: Lendefs Atldress:
Signature:
Dete:
OWNER-BUILDER DECLARATIONS:
I here6y atfirtn thet under penalry o1 per�ury that I em EXEMPT FROM TNE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business end Protessions
Code: Any clry or counry which requlres e permlt to consiruct, alter, improve, demolish, or repair any structure, prior to Its issuence, also requlres �ha epplicent for such pertnit
to Ille e signetl stetement that �e or she Is Ilcensetl pureuant to the provisiona of the Cantrectors License Law (C�epter 9(commencing with Sedion 7000) of Division 3 ot Ihe
Business end Professions Code)�or thet he or she is ezempt therefrom and the besis tor the alleged exemption. Any violation of Section 7031.5 by any epplicent tor e permit
sub�ects Ihe applicant to e civil penelry ot not more ihen five hundred tlollars ($500).):
❑ I, as owner of the properry, or my employees with wages as their sole compensatlon, WILL DO THE WORK, end the structure is not intenCetl or oHered for sale (Sec.
7044, Business end Professions Code: The Contrectors License Lew does not epply lo en owner of properry who builtls or improves iheraon, antl who does such work
himself or herself or ihraugh his or her own employaes, provitletl that such Improvemenis ere not Intended or oHeretl for sele. If, however, t�e bullding or Improvement is
sold within one year of completion, t�e owner-builtler will hava the burden of proving that he or she did not bulltl or Improve for purpose of sele.).
❑ I, es owner oi the property, em El(CLUSIVELV CONTFiACTNG WI7H LICENSED CONTAACTORS to construct the project (Sec. 7044, Business and Professions
Gode: The contracrore License Lew does not apply to an owner of properry who builds or improves thereon, end who contreas for such pro�ect with e contracror(s)
license pureuant to the Contrectors LJcense LewsJ.
❑ I am exemp� under sec.
Signature:
Owner ID venfietl by tlnveYs license. ❑ Ves ❑ No
Business and Professions CoOe tor Ihis reason:
Verlflcation of Ownership by (rype o1 document, l.e. - praperty tax bill or deed):
DnverS License No.
Dale:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certily Ihat no excavetlon five (5) or mora feet in depth into which e person is requlretl to descend, wlll be mede in connectlon with work eutharized by ihis
pertnit, end Ihat no building sirucNre, scaXoltling, falsework, ar tlemolitlon or dismentling thereof, will be more �hen Ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title B, Califomla Atlminisiretive Cotle).
❑ As owner-builder, I wlll not employ anyone to tlo work which woultl requlre a permit irom ihe Division of Intlusinel Safety, as notad above, unless such person has a
permit to tlo such wark trom ihe divislon.
Signeture: Dete:
Division of Industnel Safety Permit Number:
CERTIFlCATE OF COMPLUWCE AND AUTHORVATION OF ENfAY: I certify under penalry of Derjury that I have read this epplication and stete thet the information given is
coned. I egree to comply with all slete laws end city ordinances relating to builtling construdion, and eulhonze representetives of the Ciry of Coste Mesa to enter upon the
above-described property for inspection purposes. I egree not to occupy or allow occupancy of any building euthonzed by this pertnit until final inspection.
CO�E �. INSVECTOXTYPE
1618 Fixed System Finel Flre Preventlan
1266
200
201
Pool Spa Finel `� � �
Finel Re-Roof �
Final BIocWRetaining Wall
202 Finel Factory Fire Place .
203 Finel Sign
204 Final Demolitlon
264fi-66
I�I:�I�C1111[\R+,
�
�
CO�Et INSPECTIONTVVE
206 Finel Mechenical
20B Final Plumbing
210 � FlnalElectdcel�
212 Final Fire Preventlon
220 . Final Plenning Approvel
222 Finel Si�e
250 Final Building/Occupancy
1��
r
�OWNER RUt�2:
JOB ADDRESS 3�+7 N�
GENERAL CONTRACTO]
AP. No. � LOT 2�
GROUP I & J
INSPECiIONS �(j���
Test
,. ��,
Fon
coat
i D2V. C
�sau Rd.
DATE 8-29-58 .�..
BUILDING PERIWT NO: � � 7361
& ColeF�'ove Inc . VALLIE $ 1 1 .00
' 2954 Fa� zoxs DFSCRIPTION OF WORK Res. w att.
V ZONE � PLAN NO.
DATE gUBCONTRACTOR PERMITSISSUED
DATE NUMBER
� . .. �
'73��3
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31J
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING 347 Nassau Roa.d
ADORE55
COSTA MESA. CALIFORNIA
OWNER Rutgers Develop�.
Ao"oREssG19 E. 17th St.
c,,,, Costa Mesa
ARCHITECT _ � _SOR
CONTRACTOR
ADORE55
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oESceiPnorv
A.P. NO.
1 VUIt
Grwe
CO•
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�— � V� L�V c.. u V i;. L
AUG 2? 1958
rII���M1.�G ��P7.
" ^(1^ • -
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
NECEIFT NO. PEPMIT NO.
r6�a�(�
Z)
ECEIVHO BV D TE RECE VEO OtTE ISSUEO
— - � ,� � –, niir_ o o �c
1NQ�. 8-1159 ADOR
LIC.
NO.
FIRE
ZONE
BC GTV LIC. ioru -
� No. 8
E. 17th St., N�.Li. 8-1159 gyPR
� BLOCK TRACT �95�
5'zE 70 x 100
OF LOT
EXISTING BLDG.
SETBACN LINE FFOM 52,
CErvrEn OG STnEET
��.�F a����.none
HOW ON LOT
REAR YAR� 2/�t
SIOE VARD RIGHTSt LEFT St
DESCRIPTION OF WORK
NEW A� AITERATION I qDDITION
REPAIR MOVING IDEMOLISH
S�ZIEDING ],[�,p0 SC1�S�{�.• ROOMS � STOFiES �
EXTEFIOR WALL 1 ROOF
COVERING SbuCCO COVERING COIIp•
BUELDFNGEW Single £anily residence
ti�rith attached double garage
COSTA MESA. CALIFORNIA
Plan 730C •
I HEFEBY ACHNOWLEDGE TM<T � M4VE RE<O TMI$ PPPLICATION FND
STPTE THqT TME ABOVE IS RRECT ANO tGREE TO GOMPLY WITH PLL
CITY OROINPNCE$ ANO 57 LPW$ FEGULATING BUILOING CONSTRUC�
Tioru. VALUATI ON
SiGNATURE OF
PERMITTEE
— - - - - $15,139.00
CORRECTIONS
PERMIT FEE 5}O�VV
PLAN CHECN �o�OO
TOTAL FEE 554'��
"OM!