HomeMy WebLinkAbout2163 NATIONAL AVE - Building PermitsPflOJECT pDDPE55: Z 1 6 3 NAT I ONAL AV
OWNEN'SNFME: GENCO MICHAEL
aooeess: 1933 f4EYER PLACE
COSTA MESA,CA 92627
642-4422
PflCH/ENGINEEB: BEG.NO.:
AOUflESS:
UNIT:
UNIi:
r'
PEHMITTEE: �(S ELECTRIC ( 714 ) 641-3550
nonxcss: 1315 EAST ST. ANDREWS PLACE C
SANTA ANA CA 92705
LICENSEO LONTBACTOP OECLAMTION: I MreCy atfirm I�al I am licensed under 0«ons ol ChaD�er 9(cammencinp with Sec�ion
7000� o� Drvismn J ol IOe 6usmess amf Piolessrons Cotle. ana ense is in IWI lorce anA efleci.
uTvuc.:04 3q7 srnrEuc.:480224 cuss:
�e— �Y/ �� SignaNre:_ _ —
WOflREBS'COMPFNSATIONDECIABRTION: III¢REyaltirmltW�ItWveacerii�i[ateo�ton5enilo5elbinsure e �� �e07Work¢r5'
Compensation Insurance or a ceridietl copY Ih¢r¢ol �Seclion 3800. laC. C�.
aoucv No.: WP80540504 ezv. oaTe: 10 /01 /92
comaaxr: FIREMANS FUND
❑ Ceriilietl Copy )5 hereUy lurnish¢a. � CeM1itietl CopY i fileG ih the city BuilOing Oivisioa �
,�pel� � NPVlitanC KI^' ` " J
E7(EMPTION Fp M WOBKEflS' COMPENSRTION OfCIAB�TION: � hs SMJion nee0 rq� De com�eta� il ��e p¢riu� i51or � red �5100) o ess�.
I cetlify tna� in ��e petlorman[¢ ol Ihe work br w�ic� IhiS Dermii is issuetl, I s�all not employ any person in y manner so as to b ome
suble�� �o the Workers' Compensa�ion lavrs ol Calibrma.
Oale: Siqnature:
NO7ICE: If, aller making IniS aeUdrati0n, you SlioulG GetOme su0i� �o the WoM1eri Compen5ation Drwi9ons al ihe LaGor
Cotle. you must lonhvnin comoly wiin sucn provi5ions or itns oermit snall oe aeemeE revoketl.
CONSTBUCTION 1EN01NG RGENCY: I �ere0y af�irm ttut t0ere k a camWction IenEing agerN,y �or IAe peflormance of Ihe vrork for
wnicn tnrs peimi� is issuea I�ction 9097. Civ. q.
LENOEN:
ADOPESS:
OWNEfl BWLOEfl OECUMTION: I li¢r¢Oy aflirm Itul I am eaempi frOm tice COnl2ttoR' State Lkense Law lor tne tollowinp reamn
�Setlion 70.31.5 Business antl Ptolessional Cotle: Any ciiy of tounry w�ith reduires a permii to consimtt, ailer, imprwe, tlemolis�, or
repair any simcmre. D�ior Io ils issuance. a150 rtpuires tlre apqiwni lor wtA perml Io lile a SiqneA sia�tmm� lhai �US�O 5 licensed
I pursuam �o ��e piovisions al I�e Conlraclors' S�ate Lianse Law (Cnapter 9(commencinp mt� Section 70W) ol Division 9 of the Business
anG Pmlessions CoOe) ari�ai �e/5�C i5 esempl i�e2lrom aM I�C Gasis lof It1e allege0 ¢eemptian. Any vi01ati0n 01 Seciion 7031.5 Dy
any aD�licanl lor a permil SUElecis I�e aODlicant �a 2 ciWl pmalty ol noi mor¢ Nan live �unEreG Eollars (5500�.
I, as owner ol ine ompehy ar my employees vnt� wages as ineir sole wmve�satlon, wi0 Aa Ihe work, antl Ihe
❑ simcture is not imenUed or ollere0lor sale (Section 70aa, Business and Pmlessional COGe: i�e Comracmrs State License Law
aoes not aDPly �o an owner ol a pmpeny who builtls oi improves tnereon, anA wtw Ooes such work himselVherseti or ihmuph
�is or �Cr own ¢mployees, pmvide0 I�al SutA �mpmvemen�s ar¢ noI intenaed of ofler¢4 taf Sale. II, how¢v¢r I�e Ouildinp or
imo�ovement is sol0 wilnin ane year of Completion. ine awner vnll have ihe hurEen af pmvinp he/sne tlid no� Ouiltl or impmve
lor ine purpose of salel.
I, as ownerol Ihe pro0eny , am exclusively coniractinp vnt�licensed coniroclorsto consirucithe O�oiect �Section 71W4, Business
❑ anG Vrolession5 COUG' Tti¢ COnIraCI0r5' $Iale Lkp6E Law Op2S n01 appty IO an O+mef al propetl9 wlq built5 Or imprOv¢S IA¢r¢an
antl w�o conlrac�s Ior suc� proletls wit� a conlracior�s� license pursuant la I�e Coniraclors' Stale license Law). I am awam
Nal 0��� 01 I�eir Worke�'S fAmpenSation inswance stwul0 be prOnEed lo me.
� I am ecempi unaei Section: B. 8 P. C.
lor inis reason:
Da�e: Ownec
I Oo nereGy cenity Ihdt I am aware ol an0 unCerstana tlle repuiremenLt of Ca0lornu Heatin anE $dfety COtle Stttions 25505, 25533, antl
2553< ane ��a� I o� any Iuiurt GuilEmg acupani wilVmll not (cirtle one� neeE Io compN m�� �i0 state cotles anE ihe reQuiremen�s �or a
permi� lor constmnion or moGJiwtun Imm rtre Au a!ny Mareqemen� OislricL BesiGenlial con5imtiion aODliaiians are exempl Irom
IAese piovisions
�aie Apotiwm:
I nere0y cerlily t�at 1 �ave reaJ t�is aoV�ication and state tlWl tlle abOve intormdti0n is wrRCL I aqree to wmply vnl� all city and cauniy
o�tlinances ana s�aie IawS relaling to �mlamg COnslNttiOn anG tcereRy autlqr¢e reO��nWiiv¢5 al Ihis Ciiy �o enier upOn IOe a00ve-menlianeJ
pmpetly loi �n50eciwn purposes n � �_
I Dnver's Laense or Social Searity
�en� ne ir.i�..r.. .o.��u...... i:........_I`...�.. C..�..........enr.l`aner�i—Gnnl.�a..�. �.nL_Re�an��e�
CZTY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054979
PERMIT NO; E 054979 PLAN CHECK NO; N GOVT: Y SUPP; N
CONSTRUCTION TYPE; V—N PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION ; SERVICE CHANGE 6 CONNECTION SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /
COMMENTS; �** CITY PROJECT NO. 91-07 **�
�t*�x�*�r*��r�t�r*�r�r�t*x�e*x *�e�e*�ex�t�r**�e**�rx*�*�t***�r�t*r�r+r**�r��r�e**x�**�t�r*�r*�r�rx*+��ex�*��e**�tx��t
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 BUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGNT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 42242413 2NE: REF NO:
PLANNING NfSTES>
>
**�t�+t�r+t�r�rr*�rit�e*�*�r*�e+t�r�e**�r�*�*�e�r*�+�.�t�r�t�t�t�t*�t*�r**��r��**�*+t+t�r*�t�t�t*x****�r*�e**+e�r�t�t�t*
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 ,
BUILDING APPROVED BY :
�flfiffliEiFltltMkitk±flfkiFMitkltkfEk�FlEkiFiFk
LEGALIZATION:N
BLDG PMT PLUMHING
PERMIT
DATE:
DATE:
��+�***D*�***� IZ **
iFifiFifkk fMifif�FkiE�f�Fiflf�fMlEifkkkifMifififkMiFltiEif�F�FM�flfM�fiFkkMlfififM
F E E S U M M A R Y STRUCTURAL SEGMENT;N
ELECTRIC MECHANIC FIRE SMIP/RES GRADING
18$Ot SMIP/NON—RES
PLAN
ISSUE FEE 15,00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
fi4�fi�:'s----� �:0� 0:0� o.00 o.00 .00 .00
REVENUE DIVISION TOTALS--> COLLECTED: ,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
iF1fMMMifiElfMiF%MiFifMiFkifkkkMifMMlfifiFk�EiFlkifiFdEM�fiF�FatiFiF�FiFfflFMit�tltltiFk�tNMiE1lifMifiFikiFlFifiFltMifMifiEifMitjfiFlf
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
ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18.50
END OF FEES
-. P' '._ .
...i _. �� . � . .. '
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�" �
CONSTRUCTION AND PLANNING POOL & SPA !
APPROVALS Permit # Date Inspector p�ppROVALS Permi* � Date Inspector
1. Temporary Electrical Servse� or Polgr 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � w ctC 53. Steel Reinforcement
'�,'�� �E�ctr`Fal Con��ility�bndrgmda � 54."Forms
�
a.F- E�trical Cond�ihlJadrgrnd. ^_ CJ 55. Electrical Bonding
.�
�`@ el fi"yinforc '�� "�r 56. Rough Plumbing & Pressure Test
�S?5'.'yYt�i ��v.... J>;
y�6,!c�tgctrical UFE��r�d. te C 57. APPROVALTO COVER•GUNITE �
5%:'�S tings ^^� �•+ 58. Electrical Conduit�Undrgrnd. ��
� � �.
8.-, oundation � '�' 59. Gas Pipe, � Undrgmd., Test `�
ro
� 9. Water Pipe�Undrg£nd. 60. Backwash Lines, P-Trap, O Undrgmd. =+
10. Structurai Floor 'stem r 67. APPROVAL TO DECK
17. Property Sewer LTne& Hqvse Conrrsxtion 62. Backwash & Fecepmr�Final
r �
�2• SF;1°ef �P �-v,� c � 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbi�.y� � 65. E�ectrical-Final
15. Rou9h Electric`al-Conduit 66. Sofar SYstem-Final
76. Rough ElectrirWiring 67. Fencing & Access Approval
� '
17•. Reugh Wiring S�n 68. APPROVED FOR PLASTERING
�8. Rough Electri v T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Roug� Heating & Air Conditioning FIRE DEPT. REQUIREMENT
. C �i-+¢� �z. u: .r. c- th
20tTRo[�h �vccorH F.Seplace � �m �t"� .� ::� 7 Q% �R +AppRdVA:.:up ;�ermic # � � '"
�D �. t.`" �' tT.�t s � :-� S! F lt: N.-� a .. ��
21 Z�u�yt i Stryttu�e' 1 F'� 'z" > �-a "':o ! b � T7 '� m
. Pj x. �• -�5 a 5:. i-,a x'7 0. �der9i4�� HS9�o *
22, DuCs. \F9ntiA{tirf�- Y t�S �,� .S �t�z �-71. Produc r�iriq C9�i'S O�OiI
- n �-t 3_
�, , � ,::: :.. � i:�7 .. O�
23.�,�iar�ip�>�iotiqh 8i�est ' ms :,_ �„ �.,, � �� h 72. Underg����id�Flu;4- * �..,
`� �'^ir,'_r.-r--i*'� R'-Q'�/ . S-:Cr.. ,� .- -. .
24�-rRo�i F�aming x< ,, _ * � } c' �t. � 3�Undergrni�C S[orary' ank'XO Gas C Cii
25. Ro p"f S �.athing „�` � N � �'� � � N'� '� 7q;-;p�erhead% dro F `'
T � . * .Z '/ ` .!. r'l Na T Y ,� 9.
26„T�Bar Ceiling IStcaoturap &,$rt��ocoat z •a 7 n�. -� 75^'Dry Chemical �'7 e' :-, 0 tu
- . r-.
27:LLFramea�rI Flashi�: i7' ' �1, �..'. 76: Dr Stany`j �E :r.S !n cc
r .- : S � - :-7 tT. .�. a ? :�+ �D � s Y '$ �?.Q F 1i+ t ?
�8. Laj�;ing Sidincp. :.. y`S�-' r .. g .. .� '.;- x 77D' FIXED S'!q'EM1'CIs11VALk ^�
r.r �. n r,
�'29. Insulati�" rr= ,^ ,. .. .. > + „ ' ' � �r. O �+� W
:o{� ^�.. s .. i: y. 78;�;FIRE PREV. FIf�JQ,1. :�> �G
t�30. Drywall Nailing ^ �� �� � � +� � �� F.EALTh1�EPTeREQk11R8MENT
• ' tU"'�,^ v� '7
� 31. Plaster ^.owgCdat;.5 i t�tT' y -& L r79�F�NAL I�P.ECTI�TI � d U G
;V32pElectric� Porver fl7atGr„Finali � � �� � � 'BO:TFOOD CE�iiTIFI,BR`TE IS6UED v
I 'J' X �.JS� C ^:3" + O
�33�ir� EIe,Ftr^ o: �n �ti ! k N`�Yf, -.�: -:.,�, a� ir,
�'p�-,34�-Fin�l Heating;& �i� �ort;ditiq��g; � � �r * cc -v � -S C`a: k , S O
+35:'�Finai G� Pi�-T�SN „�' . * r x .^oo+ of� tn� . t* ^
i T� R ♦ H �:k :G O ii!-i k UJ6'
�' tn n: .t � -T . . .
r�6. i'io�d ot-�2noPY s ^ r rr'7 n ! ;� ' t 'i: a _ �; 'l O � .� ,� '7:*'
',_'37�ir1al F'�tory PireP1aCE_1 � S[� 'a�, r``� f 1 � R :L v '�N
t t-F
' •• �.: �. . � .. .. y >. P I . :
'-.i8. FirZ3J Plu'mbin9 : N i -- .R r. a S :� v� rS. O
�:�39. Wate'r Service-Fina�T i i ';• �� � � �i x' cl p7 x� �x
s k �*
e:
�'.�40. Gas Service-Final �' � y���r ;S s p; I ; r. ;� p p;� w =
5�31. Solar pomesticFinalS :' � •• '� r ' ." �'t � � x
� �� x I .. :* : O C' � X :�
F'42�8acktlow Prevente ;' v :"� � �•. e. t� jc- " O -
43. Backflow Irf�atiorr- � '=sS X � x� u"- * � =�
Y A: .� k. * ti i Y� l^ .
c,�44. Landsc�pe f�igacion Svsteme�n.'�� �X r m i. O ��i. a io ta c�: ^ r o
5:45C:Sound Atteauation ��t- t� +. F_ �!� E-:� a: r,-. r i� :: �
:�7t � .`�' i7' .0
�46:-}iandicap Regulatiq{�s :, * �� � ���: �. � r � Cc ' S �� �
47>FINs1L STRUCTURE & BUtLDING` +�l � � � 4 7 �'� j � •
t � �. x i . �-.
�48��:ki'N�',AL PI.AbNIN� ��r;r x N ( � '�k �l C�7 •t r H
r�49�£lectric Release to•Edison i .. ' i, .:! '�i: � i z _
n : .� �
�O..�Ga�Release to Soufhern Calqfuiqia Gas Co .ty, j - ; ;� :, 11 .� • ��.,in ., ;J `�• /.
�,51.,CEA.TIFICATE OF.,OCCUPANCY = , ,, mo - ». , a ,
No. Date i'. �
PATIO COVER DETAIL 6/1/67
OVERHANG
�.. i w +
�BEA
c�":
STATE
3�16
�STAT
SIZE j
FTERS: �-�*6 l
�.� SLOPED
�� ^ 3�(g x S�Lags 32% —�
:Ainq
MAXIMUM Pred�ill Ledqer � ,.-
Predrill Exieting '/4-3 Deep
�� JOIS7 HANGER
or other approved methods
_ of suppurt a tie.
ALL LUMBER DOUGLAS F/R
CONSTRUCT/ON" GRAD£
POST� AM / v///7�Q�/O!i ���4�.
CONNECTION � n � ,/
�, �
POST ���//�j�
.� ,� %� /J
SHOW SIZE SHOW SPACING . "1 27,��f
SHOW LOCATION ON REVERSE �DE� �� �..�rn enQS,
y�X,a���l�ti�,�,�el�so6 m, .�- z r
� p 5' •�, DROP PATI O FLOOR-
/ �OPE TO DRAITJ— �
-.3' - TFIIGK SLAB'"��'e.l:T.
��. .'�'��� �.::::.l.PUDDLEp�.�'SANDO....:FIIL�.
� .a
%%2, •,
tr��v � Remove G.ass And Weeda Down To Noturul Grade
� ��:�.,'. .�
'. .�t. CONCRETE MIX 1:3�4 MAXIMUM WATER CONTENT /
POST ANCMOR �� �.:�... '� 7# GALLONS PER SACK CEMENT. �
For Pipe Poat.�Embed �1z� Provide 26 Ga G.1. F�osAip'q At Wood Floor Const.—
Pipe In Footinp. �oiJf�qcuS �aun(iJQf;�y
Provide Flmqe Or Weld Plate Screw�ed Or Bolted To Frome. �
FORM BU-�0
CONTINUOU
LEDGER
TYPICAL JOIST ANCHOR
NOTE � USE REVERSE SIDE FOR P�OT PLAN.
NO 1 t — H I NO 2
FOR OPEN EGG CRATE FOR SOLID SHEATHING.
ALUMINUM OR PLASTIC SHINGLES OR BUILT UP
ROOF COVERIN� ROOFING.
MAXIMUM SPAN SiZE SPACING MAXIMUM SPAN
I'7" 0"" 2x6' 12% 15� I�
�6� �- 2�x6� �6�,� �3� 3-r
I 5' 0" 2"x 6" 24 % I 0' I I�,
I 2" O` 2'z 4" I 2'% 9' I I'/:
II� 0" 2"a4' Ifi°k 8� 8j
10� 0 2"z 4" 24% 7� 1"
NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
WALLS ARE TO BE BUILT. USE N0.2 CHART ONI.Y.
WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
SPACING ONLY.
FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO
WALLS ARE TO BE BUILT SUBMIT COM�,T,ic HOUSE
AN ADDITION PLANS
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�A�P�OVED
Ciiy of Costa Mesa Building Dept.
�,1/� -� �!_ � �
THESE PLANS MUST BE ON JOB AT ALL TIM 5
MAKE NO CHANGES WITHOUT PRIOR APPROV L
OF DEPT.
THE ISSUANCE OR GRAPITING Oi A PERMIT OR APPRO L
Of PLPpS AIJD SVECIPICATIONS SHALL NOT BE CONSTRU D
TO BE A PERMIT FOR, OR AN APPI?OVAL OF, ANY VIOLAT N
OF ANY OF THE PROVISIO;JS OF TIi15 CODE. NO PERMIT P E�
SUMING TO GIVE AUTH�kITY TO VIOLATE OR CANCEL HE
NROVISIONS OF THIS CODE SHALL BE VALID, E%CEPT IN SO
FAR AS THE 1YORI( OR USE WHICH IT AUTHORIZES IS LAW �•
THE ISSUANCE OF A PERMIT BASED UPON PLANS �ND
������i��rinuc cuei i uf77 PREVENT THE BUILDING OFFI AL
`� _ ROM THF�8�1t REQUIRING THE CUNRtGnun ur cnnv�..
� IN SAIO PIANS'IiND SPECIFICATIONS OR FNQM PREVENTING
��B�LDING OPERATIONS BflING CARftIE� qN THEREUNp€R WNEN
IN YIOtAT10N OF THIS GODE OR OF ANY �TNE� URBINANCE
OF TNE CITY.
L , �
'�L_L^� s �-��
a:
ADDRESS
�
ROUGH PLUMBIN6
PROP. SWR. LINE rl HOUSE CON.
AIR CONDITIONING
UNDERGROUND � POWEFl
ROUGH WIRING
BEAM
'HING
�ar.m�.nr.���mn
HEATING
PLUMBIt
ELECTRI
BUILOIN
AL, FINAL
VENT., REFRIG. AND A.C., FINNL
. FINAL AND GAS TEST I�
FINA
FINAf
TRACT
DATE
BUILDING PERMIT NI
SUBCONTRACTOR
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3016G
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
ADORE55 �[,����TO/�Ii�
OWNEFMANUeL ���/� ����
MAIL /!P3 /�/ H//DI�H�
ADDRESS
c�T� OSz�A�eSR NOL��f�-13
CAN5TRUCTION
BFANCH
ADDRESS
ARCHITECT TEL.
CONTRACTOR V /i(/Y/ G � '
ADDRESS
TEL.
CITV NO.
STATE CITY
uc.No. i2G• I�fl�Z•S� uc.rvo.
SIZE ��� � � �NO.OFBLDGS.
OF LOT �"" ��8 I NOW ON LOT
USE OF / /p�� E
E%ISTING BLDG. TT
NIEW BLDG. �� ���/ ROOMS I STORIE:
EXTERIO:i WALL n-' ROOF �
COVERING ?' E� COVERING S�/NG
USE OF BLIILDING AND W09K IO BE PERFORMED
I horeby ecknowlBtlge that I have reatl thia epplication antl state
thet Mo obove intormation is corract entl apree to comply with
all luws raguleting buildin8 �onsttactlon, entl I shell not employ
nny parson in violadon of [he workmen'a compenmtion lewa of
t�e State of Celifomla.
I hereby certify [hat I em properly Iicenwtl as a COntractOr untler
the State of Calita���a Businass antl Pro(eulone Cotla, Div(sicn 3,
Chaptar 9, antl that such Iicensas ara In foll forea antl affacx, or I
am exampt irom the provlsions of Me Srote of Calllomla Buslnass
antl Pr0(essiOns COtlO, DiviSiOn 3, Chapter 9.
Slpneturao�� ��`yl���w
Parmittoa
A�thorizotl Agant
APR 2�E-69Pat�O01346 c'',***�*(.00
CMSA
APPLICATION FOR BUILDING PERMIT
EI ED BV DATE RECEIVED pA E ISSUI
�r„r, �!_ ��l_ ._ ,l._ s .�
A.P. NO. �
BUILDING
ADDRESS
TRF
APPROVED
iNE NO.OF
/ PLAN$
VARDSAPPROVED
MAIN BUILDING
ROM GL STREEJ) ,
DISTANCE BET.
MAIN BLDGS.
V AR. qIE
C. V.P. �+'
APPROVED f.
�"�
USE OF NEW
BUILDING
VARDS APPROVED
DATE
APPROVED
�
� m
. FT. o
THE AMOUNTSHOWN VNDER VA�UATION IS FOR '
THE PURPOSE OF ESTAgLISMING A PERMIT FEE ONLV: a
VALUAT�ON 6�DO m
��� PERMIT FEE 5 � j
m
J PLAN CNECK $ � E
���V �OQ O
u
T AL FEE S
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT �
636 Noreh Broadway . . - � —:- � � B � � � � � ` - .
�� SANTA ANA, CALIFORNIA • '
i '
. '___ .' _ _. ' "__."'_
� FOR APPLICANT TO FILL IN FQR OFPICE USE ONLY �
� RECEIPT NO. pf��11� jy0�
BUILDING , ���� t� Ltj
aooRE55 2163 National Ave. �
SCHOOL DIST. RECEIVED-BV OATE REC'D. DATE 1654ED
OR TOWN COBtA. Mesa �
NEAREST i �MAY S ' I
�Ro55 5T. Gonernor 3t. � i ���9��J'� AY sqq+ ia5a±
OWNER BWLDING '�/ ` � �YI '7T'- . // � �
CheYenne Homea Inc• ADDRESS (�� ��%��CAI7L(�•C�� >
MAIL 9363 Wilshire Blvd. '
ADORE55 SCHOOL O16T. ///��'� ��q ��/��/%/�� �.
OR�TOWN � (�,IT—' ��LLQC-r/�
arv geverl H1118 �o CR 54361 NEAREST ' , ' �
CRO55 ST.!
ARCHITECT LIC. ZONE N.OF TVPE GROUP
ENGINEER C�`�n—hicKerrachextio. Q� ` I p�q��g I �� �; S;
AODRE55 2��0 E.Walnut—Pasadena 1'�'�
�u�,, BYPROVED�� DATE •
CONTRACTOR Balbbg Homes 1{jpli�143231 � �
! CORRECTIONS � �
AODRE55 9 63 Wilahire—Beverl� Hill ' .
DESCRIPTION NOT Y'1 BLOCK I TRACT ZS ( G , — �
�
(ATTACH METES 8 BOUNDS) , � ' �
SIZE OF LOT �M' R ZO7I NOW ON LOTS O ' ` '
1
USE OF NO.OF NO.OF
E%ISTING BLDG. � Fnmi�ies I ROOMS � ` � " ' �^-_�^ ' �
SETBACK LINE FROM: 1� PY• SEDE YAFO � "'�' -�"'�' �'-"- '- "` "�`�`'
CENTER OF STREET Y' ' -' ��" � � ' "�-
DESCRIPTION OF WORK � °
. .V/^.'� u. A
.,y;-
NEW I bIALTERATION I I ADDITION I '-�^���: •- �.�..,�..•1+ i"�.��.::�+� �.+"lf�, ZD
.t �-..:.. , .,�
r
REPAIR (.� I I MOVING I I DEMOLISH1 I �� � � � � �
52'EOIN y21� sq.f�'OOMS � STORIES y �
EXTERIOR WAL�p y ftOOF
COVERING pyLSCCO COVERING Om
USE OF NEW
9UILDING De.DiAnnew_A M+ /1�.�r�w4
I HEREBV ACKNOWLEDGE THAT I HAVE kEAD THIS
APPLIGATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMP�Y WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING GONSTRUCTION.
SIGNATURE OF Ba1bOA. VSB 4H , CO .
PERMITTE
AUTHORIZEO AGT. ^•
� �V
PfiRMIT FEE § %
VALUATION s� 5902�0 p�qN CNecK 3/ 3
TOTAL J�
FEE
IIIM l.)(l.Si
BOND
FINAL
APPROVALS
: LOCATION INSPECTOR
MATERIALS, ��. _
STREET
PLOT PLAN
Show location and dstances from
property lineand between buildings.
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