HomeMy WebLinkAbout3245 NEW YORK AVE - Building Permits� _ , . - - _
AOP�icant to fill in all svaces exceo� ihose within heavY boraer lines anO.sign all avProvriate eeclarations.
,CITY OF COSTA MESA CONSTRUCTION PERMIF ^� PERMIT NO. � �- TRACT NO. � LOT NO. � UNIT N6.,�• . y ;� � ' '4)$B. � I/O2/B5 " y I aOL TL
t Project Address �' �Z'y `�i /iJ J ' ��iC� ' /7''� . � � '�I �7� � - _ . . . . � � � � .
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�t Applicant"SMailingAddres5 /-J`�'�ll'�'�� � � � TYPEOFCONSTRUCTION_ NEW />DO ACTERP,TION REPAIR '-
Owner's'Name r%�^� f'Ju1SK/N G �PhoneS'YG-BSZV � CONVERSION' ❑ DEMOlISH �0 OTHER � p� p# �'- . ' Zone
DESCRIP710N OF WORK/USE OF BLDG. �
Address� 5 <1N'�-Q � � .' � � 5 Main Building: - . ' ' Accessory Building: �
: � E 2
Arch/Eng. S�� LicenseNo. ' TVPEOFPERMITI� GRADING ❑FOUNDATION . STRUCTVRA� ' T pront - � � � p
Add�¢55 ' SH/�'�Q � ❑ TENANT LI ELECT131CAL ❑ PWMBING ❑�MECHANICAL . B . � - . ' N
QWdJEr�—BW�¢i2 — � ❑OTHER ' � A Rear
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Contiacmr's Nam Phone - - C Right - ' ' N
PROJECT DESCRIPTION SQ. FT. OCCUPANCV
Addresslmallin9) I — ''1 �(- G
. , . • CONSTRUCTIONTVPE VALUATIOrvyr ���0 g Left �- . �� --
City License No. � �' '� 20NE GRADING CU. VDS. ACRES - R
._........ . .- -.... � Pln Ref. # � Parkin ' � ' E' �
LICENSED CONTftACTOR DECLARATION 9� q,R¢q./P�ovid¢d - Q
I M1ereby affi�m that I am licensetl untle� provisions of Charte� 9(tommenGing Remarks: + �� � , � � � Planning Notes: � ' - - M
with section ]000) of Division 3 of the Business antl PrOf¢SSions COCe, antl T
my license is in (ull force antl etfect. � ' ' . S
LicenSe Class � �ense No. . , .
Date Signature PLUMBING � ! FEES � �
WORKEf35' COMPENSATION DECLARA ON i Bd�Sink , ShOwe�s, � ' '
I hereby atfirm that I have a certificate of conzenf to seli-insure or a certifiwte • � ELECTRICAL . ! FEES
oi Workers' Compensation Insurance, or a certitied copy thereot (Section _ BackflowPreventer - - �ServiteSink' ' ' ' ' ' ' - -
3800, �ab. c.) . P.ufomatic Washer Trensformer ❑ 75-50 KW
Policy No. Company Backflowlrrigation SewerCa -� ' ❑ SO+KW
e Certified co ' , P Construction Pole Sub. .
py is �ereby furnishetl.
Certifietl copy is 81ea with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up ro 100 amps
Date � � AOPlicant �
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cldrifier5 Z $olar C011eGtors � (p DiShwdSh¢r .Meter ❑Over 100 amps '
(This section neetl nat be completetl if the perml[ is for one huntlretl ($300) or � �
less). Dishwasher � Solar Piping • Dryers ❑Gas ❑Electtic Sub Panel �
I cettify that in the pe�fo�mance of th¢ work fo� which this Oe�m�t is issuetl, I '
shall not e p1�7%p�n�on in anY manner so a to become subiect to the Drinking Fountains � Solar Tank , � �j Fan � Motors �0.1 HP 01 f.- 8 �
Workers' C pe 6 tion Laws of Califo�. .
Date 9 Si9nature � � � Floor Drains � Swimming Pool w/Spa F.A.U.
'NOTICE: f, aft r making this tleclaration ou shoultl bec ubject to the Inc.Solar��9-15 HP �76-15+
Workers' Compensalion provision5 0! th Labor Cotle, y must forthwith. FI00! $inks. U�in21 � FixtU�¢5 ' � -
comply with� such 0/ovisions or tnis pe�mlt shall b tleemetl �evoked. 'MiC�OwdvE -
CONSTRUCTION LENDING AGENCV "' Ga55ervice .Outlets WatefCloset DeviceBoxeS POIeLi ht �
1 hereby affi�m tliat there is a construction lending agency fo� tne�pe�fo�mance 9
ot the work for which tM1is petmit is i55ue0 _(Section 309] Civ. CJ -
Lentler's Name Intercepmrs, _ Water.Heater � � Z t'OuUets Range
Lentler's Atltlress � � � ' - Kitchen Sink . - j � Water Service " 'Switches
WNER BUILOER �ECLARATION - ' ' � �� , Sign �
hereby aftirm that I am exempt from ttie'Conlractor'S License Law for the Lavatories . ,- .Auto�Wash � � Garbage Disposal ; Standing Sections � '
following reason (Section �031.5'Business antl Professional Cotle: Any city or ' . ' T
county which requires a permit lo construct, alter, improve, tlemolish or repair ' P—Trap �� ' Laundry Trays - - '- Generator 00.5 KW 05�15 KW Trash Compactor
any 5fructure, prior to its issuance, also requires the'appliwnt for such permit � -
�to file a si9netl statement that he/she is licensetl pursuant to the provisions of RoOf Dlains' � � ' ��/•
the Contractor'rLicense Law (Chapter 9(commencing with Sectlon'7000) of � '
Division 3 ot the Business antl Professions Cotle) or that he/she'is exempt � � ', .�: . . ,
' the�efrom,antl the ba5i5 for the allegetl exempfion. Any violation bt Section , • . � .
.�]031.5 �by any applicant tor a permit. subjects tne. ap0lican[:t6 a clvil . • �• � - ,
� c�enalty of not more than five huntlretl tlolla�s (5500). � � -' . . ' + ,
1 as owner of the proverty or myemployees'with wages as their sole -Reinspection Fea - $15� ISue Fee $ 3
pensation, will tlo the work, antl the structure is not intentletl or ofteretl ��Reinspection Fee $15 ��uue F¢e $ 3,
tor sale (Section 7044, Business ana Professional�Cotle: The ConVactor's - ' � MECHANICAL FEES/ '
License Law tloes nat apply to an owner ot a oroperty who!builtls or improves ' �.'DEVELOPMENT SERVICES REQUIREMENTS, ' � i
thereon, antl,who tloes such work him5elt/herself or through his or her own i gpjl¢ ' ' HOOd Of, T e I,❑ � ��f �
employees, provitl¢tl that such improvements are not intentleG or offeretl,tw � i YP , � ,�2oning Approved By � DdtB � �
' sale. If, however, the builtling or improvement is soltl within one yeacof com- ' � CanOpy ' Type II �❑ 1 . . �. , , �
pletion, tM1e owner, will have the bu�tlen Ot proving he/she tlitl not builtl or im- Duct - Under Ground ' � Building Appraved 6y � • Date '
�rove for Ihe purpose of sale). � '� Z ��
I, as owner of the property, am exclusively contractin9 witti licensetl con- � Duct-Structural � Refrigeration Sys[em ' Applifatian Issued By ' - Dat
tractor5to constructthe prolect (Section 7044, Business and PrOfessions Cotle: . ' r , ,
; The Contractor's License Law does mt apply to an owner ot property who • Duct- Ventilating, ___,_ _ ❑0-t00,000 BTU ❑100,000 BTU _ e)� `$UMMARV OF FEES � ' . �
buildsor improves thereon, antl who contracts forsuch pvojects wrth a�con- � - ' ' ' �O • OO , i
' tractor(st Ocense pursuant to the Contractor's License Law). I am aware that ' ' ' ' � ' �'r+% BUILDING PERMIT $ SMIP ., �$ �• ��
� Exhaust System ❑ MWtiple ��. System Repaii/Alteration �
proof of thei� Wo�ke�'s Compensation insu�ance shoultl be Provitletl to'me. - �/' ' � ' • .
- � ,i V PLANCHECK , ,�$ PEFMIT , �
' L7 1 am exempt untler Section � B. & P. C. for this reason � Firepl/Fact.8lt. ICBO # Fire Dampers' . � � r pLUMBING $ ��•OD : :ISSUANCE �$
X Date �2 2 owner � •+�� " ' HeatingSystem & Ducting ' Registers � ' r.' p�qN CHECK �25%, $ " ENERGV P.C. $ � '
'.I� hereby' certity �that I, have reatl this application-an e that the•above--�- ❑P700,000 BTU 0100,0006T -- . � - �---�- � . - � - +� � . C.!-:�� GRADING � $ �
'iniormation is correct. I agree to comply with all city tl county ortlinances ( . �� w�� ELECTFiICAL ,$ ' ,
antl state laws relatin9 to bwltling construction, antl hereby authorize repre- � � • ' . � ��' pLAN CHECK 50°� $ �! MICROFILM ,$ �
Sentative5 of [his city' o ente� pon the above-mentlonetl P�o ert for ' ' o. � � . � .
' MECHANICAL $ TOTAL FEE $ 31 .o 0
.inspection puroo e ' '
i Signature � � L? � � peinspection Fee �$15 , Issue Fee § 3 �°r" PLAN CHECK 25% �$ � �
Drivers' Licens or 55 �- —
CMF 0865�46. rev. 10/84 White - Builtlina: Cana�Y - Aoollcant: Pink - Accountina: Goltlenrotl - Asse55or
� - , � . _ " _ _ " ' " _
�� �CONSTRUCTION AND PLANNING : � � , � =- ��"3' POOL & SPA - , �• - �
Date ' Inspector ` ' - � Date Inspectm
' APPROVALS Permit # . . - APPROVALS Permit # . . .
Ji. Temporary Electriral Service or Pole ' �. 52.' Pool & Equipment Locatio�� -
� t 2. Soil Pipe-Undrgmd. . . � 53. Steel=Reinforcement " ��
'3. Electrical Conduit Utility-Undrgrnd. - , "� .. 54. Forms - � ' . '
��4. Electrical Conduit-Undrgrnd.. _ . � - '55. Electrical Bonding � ' , .
- 5� Steel Reinfarcement � ' � _ �. - 56.'�Rough Plumbing & Pressure Test � - �
�6.•Electric�lUFER-Grnd. �. � � � �. 57-. APPROVALTOCOVER-GUNITE j ',
.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.`Strucwr8l Floor System ' ;. 61. APPROVAL TO DECK � � ,,, �,
1.1. �Property Sewer Line & House Connection -'' 62. Backwash & ReceptorFinal
12. Sewer'Cap ' � � - 63. Heater & VenbFinal . •�
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 . .
19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT • � � -�
y 20. �Rough Factory Fireplace . APPROVALS Permit # '
� 21. Ducts, in Structure, � . 70.' Underground Hydrd •
-22. Ducts, Ventilating , � 71. Product Piping OGas. ❑Oil � '.
23. Gas Pi e•Rou h& Test Y � . '
p 9 a. 72. Underground Flush
24. Roof Framing� � ' �- � � , , � 73. Undergrnd. Storage Tank O Gas ❑ Oil . . �
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 � , Nntes: � �_ � ,
34. Final He2ting'& Air Conditioning "
35. Final GaS�Pipe-Test � � ' � � �� • ,
36. Hood or Canopy , , - � - ' _
37. Final FaCtory Fireplace� . � ' ', � ., � ' � : ' . -
38. Final Plumbing , 4 � , ` � '
39. Water Service-Final � • ' ' . , -
40. Gas Service-Final � � � � � •
41. Solar pomesticFinal � �_, ._ ..__. �_ _, ' � �
42. Backflow Preventer � � � � ' � _
43. Backflow Irrigation � � � � � ' ' � �
�• .
44. Landscape Irrigation System � , ` � .
45. Sound Attenuation � . , � � , "'!
;� � '
46. Handicap�Regulations , ' � ' ' - � . .
47. FINALSTRUCTURE&BUILDING t �, ! � � � ' � � � _ � �'
A8. Special Requiremenis Complefed , � ' � , � ' �, . �� • �s � �
49. Electric Release to Edison , � ' - - � ' ' } �'.-' - - ' 'i '•- � ,-' ' ' � � `
50. Gas Release to Southem California Gas'Co � . � , � � � � � � ; � � , �� �
51. CERTIFICATE OF OCCUPANCY '; � . _ . . _ , .' _ . • '
� ' � ,
Nn. ' " Date " ' �
_ . . '- ' . �'. ' "' - :z
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILOER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall.attach to such
notice, and, as a condition preCedent to issuing a building permit, require the completion and require
the return of, an owner-builder verification. �
Attention Property Owner: .
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be
issued until this verification is received.
7. 1 personally plan to provide the major labor and materials for construction of the proposed
property improvement. I�( Yes ❑ No
2. I(have/have not) ��`J� signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
City
Phone ( � � Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone � ) � Contractor's Lic.
City
5 I will provide some of the work but I have contracted (hired) the foltowing persons to provide
the work indicated:
Name Address Phone Typ.e/ of Work
� ,�cKa/Z H�C.O�a.
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the
State of California Health and Safety Code and have completed the above information to the best of my
personal knowledge, in complia ce with this State law.
Signed: � '/ ' Date: � z- ��
Name: �' �" '
(Printed or yped)
C.D.L. #or S.S. #
CMF 1042-46
7545273
t
a
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DII(E COLEGROVE, 11�9C.
19084 Brookhurst Street
Huntington Beach, California 92646
(714) 962-4458
May 28, 1980
To Whom It May Concern:
We give our permission for Mr. Bi11 Stead to
obtain a copy of. the blue prints for the house
on Lot Y26 Tract 3648 in the city of Costa Mesa.
(Property address: 3245 New YorK Avenue.)
DIKE & COLEGROVE, INC.
By C . �--� � --_ --- ---_._ , �`7�. `y" \
�
E. Bruce Twichell
Vice-President
EBT:lc
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(714)754-5273 • Fax(714)754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 3245 NEW YORK AV
Suite:
Vicinity:
Parcel Nunmber: 13910215
/+pp�icant: LATIMER, JEFF
Address:
Owner: STEAD, LOU JEAN TR
Address 3245 NEW YORK AVE
COSTA MESA,CA
Contractor: J R CONSTRUCTION
Address: 03218 OREGON AV
� , COSTA MESA CA
Arch / Eng : -
Address:
Plan Check:
Permit:
SMIp Res:
SMIP Com:
Other:
Inspection:
Total
BUILDING PERMIT
Zoning:
Phone:
Zip:
Phone:
Zip: 92626
Phone: 714-641-7448
Zip: 92626
License: � 485367
PERMIT NUMBER /
898-01998 ✓
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED �
Applied: 71/02/1998
Issued: 11/02/1998
Phone: ,
Z_P
License:
SCOPE OF PERMIT
T/O EXISTING AND REROOF THE HOUSE AND GARAGE WITH COMP. SHINGLE, ROOF CERT ATTACNED. �
$0.00
$87.25
$0.50
$0.00
$0.00
$0.00
$87.75
SETBqCKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Exlstinq: 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
sa,000.00
$a,oao.00
IEXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period ot 180 days. .
INSPEC710NS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required inspectio�s and (inal approval must be obtainetl. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalty oi perjury one of the followinq declarations: �.
�
❑ I have end will maintain a certificate of congent to selbinsura for workers' compensation, es provided for by section 3700 ot ihe lebor Code, lor tha pertormence ol �he
work tor which lhis permit is issued.
❑ I have and will maintain workers' compensation insurance, as requiretl by seclion 3700 oi the Lahor Code, tor the pedormance ot i�e work tor which this pertnit is issuetl.
My workers' compensation Insurance certier and policy number are:
Carrier. ' Policy Number.
(7his section need nof be comp/eted i! fhe permif is valued et one huntlretl tlollars ($100) or less.)
❑ I certiy that in the pertormance of i wo tor which ihis permit is issued, I shell not employ any person in eny manner so es to become subject to the workers'
compensation laws ot lifo ia, en t if I should become subject to the workers' compensation provislons of Section 3700 of tha Lebor Code, I shell lotlhwith
comply with these Dr vis o. / // �
ApplicantSignature: Dete: � � � _9�
WAHNINQ: FAILURE TO SEC ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CiiIMINAL PENFLTIES AND CIVIL FINES UP TOONE HUNDRED
THIXISAND�OLLARE($100, .INADDfT1IXJTOTHECpSiOFCOMPENSATIIXJ,DAlMGESASPROVIOEDFOFINSECTION31060FTHELABORCODE,IMEREST,ANDATTORNEYSFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby effirtn that I am licensed under rovisio s t pter 9(commencing with Section 7000) of Division 3 ot ihe Business end Profeuior�s Cotle, and my license is in lull
force end eHect. Lia u Glass x
Comractors Signature: Date: v —
CONSTRUCTION LENDING A ENCV:
❑ I hereby aifrtn that ihere is e construciion Ipnding agency for the perfortnance of the work for which ihis Oermit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature:
Data:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn that under penalry oi perjury ihat I am EAEMPT FHOM 7HE CON7RAC70RS LICENSE LAW tor the tollowing reason (SecJ031.5, Business entl Profassions
Cotle: Any ciry or counry which requires a pertnit b constmct, alter, improve, tlemolish, or repair any sWcture, prior to Its issuance, also requires the ap0�icant for such permit
to file e signed statemem that he or she is licensgd pursuant to ihe provisions ot ihe Gontrectors Licanse Law (C�epter 9(commencing with Section 7000) oi Division 3 of ihe
Business entl Professions Cotle) or that he or she is exempt iharetmm and Ihe basis for Ihe elleged exemption. Any violation of Section 7031.5 by eny epplicant for'a permit
subjecis �he apPlicant to a civd penalry ot not more ihan Ove hundred dollars ($500).):
❑ I, es owner of the pwperry, or my employees wiih wages as their sole compensetion, WILL DO 7HE WORK, antl the structura is not intenaetl or oHeretl tor sale (Sec.
7044, Business and Protessions Code: The Contractors license Law tloes not apply to en owner ot property who builds or improves thereon, and who does such work
himsetl or herself or Ihrou9h his or her own employees, proWded that such improvements ere not intendetl or oHeretl tor sale. If, however, Ihe DWltling or improvement is
soltl within one year of complation, the owner-builder will have the burtlen oi proving Ihat he or she did not build or improve tor purpose oi sele.).
❑ I, es owner oi the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the projact (Sec. 7044, Businass antl Protessions
Coda: The contractors License Law does not eppty to an owner of properry who bullds or improves ihereon, and who contracts tor such projec� with a coMredor(s)
Ilcense pursuant to the Contrectors License Laws.).
❑ I em exempt under sec.
Signeture:
Owner ID verified by dnver's license. ❑ Yes ❑ No
Business antl Professions Code for this reason:
Vediiwtion of Ownership by (rype ot Cocumem, i,e. - properry ta�c bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CEHTIFICATION:
DnveYs Licensa No.
Date:
Eapires:
❑ I hereby certify ihat no aacevetion five (5) or more taet in tlepih into which a person I5 requiretl to tlescentl, wlll be metle in connectlon with work authodzed by ihis
permlt, end that no building stmcture, sceXolding, felsework, or demolition or dismentling thereof, will be mo�e than thirty-siz (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Celifornla Atlministretive Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit irom the Division ot Industriel Safery, es noted above, unless such person hes a
pertnil to tlo such work from the division.
Signeture: Data:
Division of Indusinal Safery Permit Numbec
CERTIFlCA7E OF CAMPLIANCE AND AUhiORIZATON OF ENTRY: I certify under penalry of perjury that I have read ihis epplication and state that the information given is
correcL I egree to comply with all stete I ws and ciry ordinances relating to building construction, and authonze representetives of the Ciry of Costa Mesa to enter upon the
above-describetl property for insp§c'�or�urposes. I agree not to acupy or allow occupancy of any building authorized by this permit until final inspection.
CO�E � �NevecnoNrrve
1616 Fixetl System Finel Fire Prevention
1266
200
Pool Spa Final
Final Re-Foof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2466-46
➢AIE Vff�ALS
f� /�
te
�� Z _9
Date
COOE I INSPECTION TYPE
206 Finel MeChanical
200 Final Plumbinq
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222
250
Final Sita
Final Builtling/Occupency
�ASF I�AIs
- 12390
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 377 COSTA MEBA, CALIRORNIA
For Applieant fo Fill In Complefely
- TYPE OR PRINT '
BUILDING hleyy York Avenue
ADDRESS 3245 � '
COSTA MESA. GALIFORNIA
owNea Vermont �venue Land �o., Inc.
AD RESS 4.�9 i• 1.%'Fill `S'fi •
arr Costa r:'?esa No: Li8115�
ARGHITEGT C,_9,T'J.SOIl $ TEL.
NO. O�NBLOO9.
NOW none
FEk KtCEl1l�.0
v�-� JUN 21 1960
" FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use On1y
RECEIPT NO, � pgqp/LryO,
NECEIVED BY DATE NECEIVED OATE I63UE0
�/ .� — ez0�6 mc, � , �as
euaoiNc
ADDRE65
COSTA MESA. CALIFORNIA
FIRE
ZONE TYPE �� GRDUP ��
LE6AL
ZONING
NO.OF J� use oe rv
PLANB 1/ BUILDING
USE OF - YARD6
EXISTING BLDG. RORB APPROVED
BHTBAGK LINB FROM (CENTeR 4NC BTJ
CBNT¢R OF eTReeT 49' REAR YARD 27 � FRONT
SIDE YARO ILEFT � IRIGHi S� R.SIDE
DESCRIPTION OF WORK
APPROVED
ROOF
GOVERIP
KTOBE
Sin le famil residence crith
attached ara e. Plan 20C
1 HEPHBY ACKNOWLEDGE TXAT � M/�VE REAO TH18 MPLIGTION .
AND 6TATE TXAT TH6 ABOVE I6 CONREGT AND AGREB TO COM- THE AMOUNT BHOWN UNDEH VALUATION IB FOR THE
PUPPOBE OP EBTA0L18HING A PERMIT FEE ONLY.
PLY WITH ALL CIiY OROINANGEB AN� BTATE LAWB REOULATING
euLLo�Na coxeTRucT,I/ON)/.� /� /p VALUA710N /
91GNATURE OFr A//'/ A/iI i/� - PERMIT FEE $ 3t�•
�� ZV�ZOZ• PLAN CHECK $ lo•
IiiC •
TOTAL FEE $ 5�•
oWNER Vermont Ave. Land Co., Inc. DATE
Jos AnnitFSs 32 New ork Avenue BUILDI
GENERAL CONTRACTOR Dike & Cole�rove, Inc, vaLUE
INSPECTIONS
OCCUPANCY
Form 210—SM-11�59 S-B P
DA
SUBCONTRACTOR
PERMITS ISSUED