HomeMy WebLinkAbout261 OGLE ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��yjLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 261 OGLE ST
Suite:
Vicinity: ROOF
Primary Occ: R-1 Hotels/Apts/Res >70 Occ Type o( Construction: V-N
Parcel Number: 42522203 Zoning:
Applicant: HAMMARSTROM, HOGAN
Address: 18903 SAN CARLOS ST
FOUNTAIN VALLEY, CA
Owner: FEITLER, JOEL TR
Address 1327 ANTIGUA WY
NEWPORT BEACH, CA
Comrador. ABSOLUT ROOFING INC
Address: 18903 SAN CARLOS ST
Arch :
Address:
FOUNTAIN VALLEY, CA
Zip: 92708
Phone:
License:
Phone: 714-655-7842
Zip: 92708
Phone:
Zip: 92660-4913
Phone: 714-655-2231
License: 761718
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 01/172006
Issued: 01/172006
Phone:
License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30# FELT, 30 YEAR CERTANTEED COMPOSITION SHINGLES, AND REPAIR/REPLACE
SHEETING AS NEEDED. 28 SQUARES FOR 4-PLEX ONLY. 6 SQUARES FOR ATTACHEO, FLAT ROOF, GARAGE.
FEE SUMMARY
Plan Check: $0.00
Permit: $153.25
SMIP Res: $0.74
SMIP Com: $0.00
Other: $0.00
Inspection: 50.00
Totai: $153.99
SETBACKS
MAIN STRUCTURE Front , 0. 0
ACCESSORY Front 0-0
PARKING Existin : 0
Rear 0. 0
Rear 0. 0
PLANNING & ZONING
Left 0. 0
Left 0- 0
Reauired: 0 Pr000sed: 0
Calc Vaivation: S�,aoo.o0
Claim Valuation: s�,aoo.00
Right 0-0
Right 0-0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within' 180 days, or ii work is suspended or abandonetl
for a period of 180 days.
INSPECTIONS: in order for ihe work authoAzed under this permit lo be considered legal, such work must comply wilh all applicable cales, and all
required Inapeetlons and flnal epproval must be obtained. Feilure to obtaln Inspections end final approval will result in the ezpiration oi this permit.
FOR INSPECTIONS CALL: (714) 7545626
2saa�ae �aroo�
WORKERS'COMPENSAnON DECLARAnON.
I �ereby ettirm under penalry ot perjury one ol tne lollowing tlecleretians:
❑ I have entl will malntain a certitiwte ot wnsant to selt-Insure lor.workers'.00mpensatlon, es providetl for by section 3700 0l the Labor Cotla, lor the peAormance of the
��,work�la,w�ich Ihis permit is issuetl.
will
n insuranca, as requiretl Dy section 3700 of the Lebor Cotle, tor Ihe pertortnance ot ihe work lor whkh ihis pertnit is issued.
entlpolicynum6erere: . ���j���
� .��Edicy.Numbe_�_
: ve/uetl ef one hunUreO tlollars (5/00) or less.)
❑ I cenity thal I� Ihe peAortnance of the wo lor w�ich lhis p rmit I5 isSueQ I shall not omploy any person in eny manner so as to become subject to the workers'
wmpensetlo� laws of Califomla entl egr that If I shoul tome sub�eti Io Ihe workers' campensa�lon provisions ot Section 3700 0� Ihe Labor Code, I s�ell Iori�wilh
compl_ y�lhese�m�//�MT�q7,'`- ����� / 7 0�
A�pplimrn'3lpnetu�re'., V�G � ate: . _
W�AR��N��Y Y. PA7NRE TO SECU�RE WORKERS' COMPENSATION ODVEMGE IS UMAWFUL AND SHALL SUBJECT AN EMPlO R TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDREO
TI�ISAND WIURE (5100,000). IN ADpTION TO TNE W5T OF COMPENSATION, DAMAGES AS PqOVIOED WR IN SECTION 3]O60F iHE LABOR CODE, IMEREST, AND ATTORNEYS FEES.
LICENSED CON7RACTORS DECLARATION:
of Chaptar 9 ommancinp with Section 7000) ot Dlvl l0 3�o4ihe�Busin�¢s a ofessions Cotlo, antl my Ilcense is In full
�Glessp .0 ���
�oe�a�.,L—% --� 6
CONSTRUCTION LENDING AGENCY:
❑ I hereby eflirR� �hat Ihere is a consiruction lentling agency br t�e peAormance af t�e work for which Ihis portnit is issued. (Sec. 3097, Civil CoOe).
Lentlels Namo: Lender's Atltlress:
Signaturo:
OWNER•BUILDEq DECLARATIONS:
Date:
I hereby eHlrm that under penalry of perjury ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any city or Gounry which requires e permit to construc6 elter, Impmve, demolish, or repeir eny simcture, prlor lo its issuance, also requlres the eppliwnt tor such pertnit
to file a sipned stetement thet he or s�e Is licensetl pursuant lo Ihe provisions af t�e Contracbrs LJcense Lew (Chepter 9(commencing with Sectlon 7000) ol Divisian 3 oi the
Business entl Professions Code) or Ihat he or she is exempt iherelrom and the basis for the elloged exemp�ion. Any violation ot Section 7031.5 by any epplicant for a pertnit
subjacts the epplicant to e civil penalry of not more than five huntlred dollars ($500).):
❑ I, as owner o1 Iha property, or my employees with weges as their sole compansation, WILL DO TME WORK, and Ihe stmcture is not intended or oHeretl lor ule (Sec.
7044, Business and Professions Gode: Tha Coniractors License Law does not apply �o an owner of propeny who builds or improves Ihereon, antl who tloes such work
himself or he�self or through his or her own employees, provitletl t�at such improvemems ere not intended or oHered for sale. If, howe�er, the building or improvement is
sold within one year ot completion, iha owner-buil0er will have the burden of pmving that he or she did not builtl or improve for purposB of sale.�.
❑ I, as owner o� lhe pmperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the pwject (Sec. 7044, Businass and Protessions
Cotle: The ctlntractors Licensa Law tloes not flpply to en owner ol pmperty who builtls or Imprwes thereon, and who contracts tor such proJect with a coniractoqs)
license pursuant to the Contracrors License LewsJ.
❑ I am axempt untler sec.
SlgnaWre:
Owner ID vonlied by tlrivefs licanse. ❑ Ve5 ❑ No
Business antl Profes5ion5 Cotle lor this reason:
Verification ot Ownership Dy (rype of document, i.e. - properry tau bill or tleetl):
Driver'S License No.
Date:
Ezpires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceni(y thet no excavetion five (5) or more feet in tlepth into which e person is requiretl lo tlescend, wlll ba made in connection wil� work authodze0 by �his
permi6 ana tdat no builtling swcture, swttolding, falsework, ar demolition or dismentling Nemol, will be more Ihen ihiny-six (36) feet high. (C�ep. 32, Grp 2, Art 2, Sec.
341, Tllle 8, Celifomla Adminislreiive Cotle).
❑ As owner-buildar, I will not employ enyrone lo do work w�ich would require e pertnit from tho Division ol Intlustnal Sefety, es no�etl ebove, unleu such person hes e
pertnit to Go such work Irom t�e didsion.
Signawre: Date:
Division of IntlustriBl Safery Permit Number:
CERTIFlCATE OF GOMPLIANCE AND AUTHORIZA710N OF EMAY: I certify untler Oenalty oi Oerjury Ihat I have read ihis application entl s�ale lhat ihe inlormation given is
correct. I egree to Wmpy with ell state laws entl dry ordinances relating m building wnsWction, anC authorize represeNatives ol the Ciry of Costa Mesa to enter upon the
ebove-descnbed prOperty for inspection purposes:l egree not fo occupy or allow occupancy at eny 6uilding authonzed by this permil until linel inspection.
COQE 1. Itli¢ECIl4tiTYPE
1616 Fized System Final Fire Preventlon
1268
200
201
202
203
204
Pool Spe Finel
Finel Re�R�1
FIneI elocWRetaining Well
Final Fetlary Fire Place
Finel Sign
Finel Demtl�����
�
tooer iNsvecnon*rve
208 Flnal Mechanical
20B Finel Plumbing
210 Pinal EleciriCel
212 Finol Flro Prevention
220 Finel Plenning Approval
222 Final Siie
250 FinelBuilding/Ottupancy
P�1F 1t�EL5
wonFss a auiwu:
OWNEA4WWEIFp10WM. MRS WILLIAMS
�� CC�STAGMESAT
MPL YAWNO �D�RE59:
uNr: CITY OF COSTA MESA — BUILDIP]G PERMIT
PERMIT NO: B 089152 PLAN CHECK NO: N
ApCNRECT Ofl ElNiNFER: 11C. NO.:
�RCX.OHENO.'S ADDRE54: VNf:
w�m�cTon.s„•„�. CRANK BROTHERS ROOFING CO ( 719 ) 548-5569
cwrn�crarcawuuxc 126 COMMERCIAL WY
��p�s COSTA MESA CA �� 408677
92627 uNT:
LICENSED COM,R��CtTpOn�fljS0{pDE)pCIL1flArI0N: 1 hereBbuy �eRkm, yuM�qar penetly d peq�u,ryp ��hpeyl I ,efpm �Ic�arieed uMer provieimddett ��dyyCheqm B
CRY IJC 0 V l/'J 7`J .7 � C. CL153: C.�,7 i v �,�Nep ieV 75 bY // u in t �'/ erd 9 II
q �l /
o.re. �� L — / � c�o-�,« ���
i
�OWN BUILOEN OECLANATION: I haeby dfirtn imEer psiely d et I am eiemq hom IM CONretlon liorns lew la IM
'dbxip eeeson (Setlion ]0.11.5 &niim� eM Pmimsona Code: A c cauniY xliid nOwm� e V�� to wwbuct. Mm, unVrow.
bmd'e�, a repei ry vouctun, pia lo Ia'vaeMe, e6a np�irm t ' Ia wN pamw b file e ripwA �tatament tlW he a�M
u IioenseE punueni lo iM1e po.viona d Ne Comreqon timnae law ICheqer B(�me�p rmA Sqion )000) a�''vion ] N �Ir
Bunrco W Prtlsa'nn Codel a t1W ha a eM u ewemq therelmm eM iM buu ta IM eAeWd umqon. Am/ vdelion W SW ion
�mi s M�r eodimni iw e ox�n s�qea• ine aoWiam io e aa pmemi a �w mvs men Me w�k�ed mne�. Rsaop.
� I.eaownerdlMpopeilyamyempbyesswihwepeamtMiaolscpnpmmalon.v�Eotlrwk.eMtlr�luWn'snalWaded
adleed br ub (°,ed'n� )Du. Buurcv vW vrdaasbru Coda: The Camream L'vua lawdoe� m� eWhloen owiera prapeny
wla WiEs a inC�'es Ilwiaon. end Mw Eros euN wwk h'vneetl a hersM a Wa� he a!w own anVbAe�. pw'�d �hY wM
impwemeNa ue M iNdded n alle�eE Ia eW. tl. however. tM Cuitlirp rc inpwwnqY u sold wilhm oroY� d mmplYun. the
owwbuitlx wiA heve tM dWm d Pa+�O M n�he Etl nal ddd a impw+la Ihe WVae W uM).
❑ �. m o.,., a in. ww«n..m �a�dr �w.ane .w rb.we ano.mi. m wm�,d m. o� (s«,ion ro... aub... ene
Pmim�ime Gade�. The Camreum Lkaue law dree m� eCVN �o en wnw d PW�Y Mn dnld� a imAwr ilw�an ud Mn
convacb br wdi pqWe xvh a mvmfa(e) licensed pwsueN lo �M CaN�etla� L'mme LeW.
� I em uamq urder fieclion: B. 8 P.C..W Nb rmson:
Deu: Mnar.
I!o Mreby cenEy Nel I em awaro d ud urcbrsuM Ne raQuiremeMa d Cellanu HSMh eM SNary CoM Setliaa R5505. Y551J. eM
P55�1. vM IMt I a enY Mun dnkm0 �+Te^� xill / wil nd (ri�cb one) med m canW wih eeld mta � uW tM n0�emeh M
a D�d loromnbuction w modifirmion haniMAi�enepemem Oiatriq. ReeidaMil camiudion W W'e�iaman e�mmq leom tMa
qo-rispm.
Dde: ApW'��eeY:
WOFKEP'S COMPpl9ATIIX1 OKLAF�TON: I hereby elfum uMar pmNy tl perjury ar d tM Idbwieq detlerubu:
� IhevaudvrilmainlanacenArslsdcmmnl�oseH-inwreturwken'wmpenWion.nprovidedlaby8apion3)00dtMLeEor
COEa, lar Ihe peAwmvee W Ne wo'k la wNch Mia permn u muad.
� I heva eM wil meinten wMn' mmperuelion im�rame. m repu'ved by Satlian �]00 d Ne Lebor Code, br iM prbrme�we d IM
won� �or whid� ihia qrmn u imuee. My worke% �oqoaa�io�ine�rae�r�er em pdicy numeer me: E H P I R E S
c°'"°` O1 /O1 /98
Pdiry Number.
(TM1ia sedian neeC nw be compleied i tM permd is b one hundred dolbn /Si0p1 w Isea.l
� I cenA' �� in the pMortneze W �M wark br whch thia pamiu e I MeA m� empby ury peieon N ury menew w n lo
become wCjec io iM xoikera' compenea�ion lex+ d CelAwnu.. epras Nq A I shwW becams wbjw io tM xwlmn'
�v�('��a� o�o.;s�. a sepe� /m/oo d me �eeo. coae. i.nen n' n oomoN wnn u.v...�qqy���/u�
D�� i5 ��Z � / / podram: �� ✓ �(
HNun ro ucvn
u
CONSTAUCiION LENDINO ROENCY: I haraby dfirm uMer psiMy d pr'ryry tIW �Mn u a aaM�ud'an Wdinp epr�ry tor tlr
peAwmarre W tM wak la wM1ich �M1i parmY o uweE (Seaion �09). CN. Cl.
LENDEN'S NAYE:
�FNOEP'S 1DUNESS:
I caniN �het I Mw ieeE Nu eGP�iration ud qate IM1et ihe ebwe'udvmation c canW. I eC�a �o canDh xnh eA my ud cvunry ad"v�enms
aM e�ate lexs rNmiq to buAdip oonWunun eed hereby eWw¢e iepeaentenwe dtlin ary b aMs upan iM ebo.e�mmYiansd peopery
%/Z
(5�51d6 WP) While-&nldiq 8 Se/ery; GmemFb; Cvivy-Appimnl: Pink-Rwxun:OdCnuod-M»av
CONSTRUCTION TYPE:
JOB DESCRIPTION .
V-N PERMIT TYPE: STR
T/O EXISTING INSTALL 20 YR SHINGLES
PERM NO: H Oti41S:
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 2,287
CLAIM VALUE: 2,287.00 CALC-VALUE; 2,287.00 GROUP OCC: R-3 /U-1
COMMENTS: REROOF
��*�**��t*���3tjt* ��r�r�r*at*****ifrt*it�;�*it�t�***********��****��**it�rio-�**�r*jtat**�t*�atatit�it��
Z O N I N G R E Q U I R E M E N T S
S E T H 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: 92522203 ZNE: REF NO:
PLANNING NOTES>
' M1.
!f iFlf iF f! if �E �E �E fE �1! 3E �! if� �F iE 4 ik k �! 3t i! 3t iE if iF if �f 1f ft k it 1f it iE iF �f 1f iElb if ik if dk iflE iF �E k iP iE 1E iE �E �f ff iE �E iE 1F �E iE 1F iE if ih iE �lE-?E �f iE if if iF if dt if iE df
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
20NING APPROVED BY DATE: '�'`
.
HUILDING APPROVED BY : _ AI DATE:
�:�����������\���Y����� ���
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 74.75
PLAN
ISSUE FEE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 75.25 0.00 0.00
REVENUE DIVISZON TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
74.75
� L
�iFMiE1E�E'1Eif'lElfififi%lFiFiFiF7FiF�F� iFifif
STRUCTURAL� SEGMENT:Y
FIRE SMIP/RSS� GRADING
SMIP/NON-RES
TOTAL PAID DUE
75,25 75.25 .00
75,25 OV£R/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
.50
�f if 1f iE �h iF 1t if iE �f ik �f if if iF �f �lf if it 1f if 1t if if if 1f 1t ff if M f! M 1! 1f 1f if 1k 1E if iF 1k �E iF 1k i! ik i! �t �E if �E if 1E 1k iE �! if if 1f df �F �f !F!! 1E 1E 1f 3f iE if if iF fF 1E iF �E 1E iE ih
I N D I V I D U A L F E E B R E A K D O W N
TYPE (aTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2287 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,287.00
END OF FEES
88-12-1997/11:30 AN/f75.25
RCPik:al-Q�lE�b�t
PEkMIT':084152
CONSTRUCTION ANDPLANNING POV�&SPA
APPROVALS Permic # Oate Inspector qpPROVALS Permit # Date inspector
1, TemDo�ary Electrical Service or Pole . 52. Pool & Equipment Location
r 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Uridrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
�5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electricai UFER Grnd. 57. APPROVAL TO COVER�GUNITE
� 7, Foo[iogs � 56. Electricai Conduit-Undrgrnd.
6. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash LineS, P•Trap, O Undrgrnd.
10. Structural Floor Svstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent�Final
73. Roof Drains _ 64. Plumbinc� System � Final
74. Rough Plumbing 65. Electrical�Final
75. Rough Electrical•Conduit � 66. Solar SYstem-Finat
76. Rough Electric Wiring � 67. Fencing & Accoss Approval
17. Rough Wiring Sign �68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling � 69. POOLISPA SYSTEMS FINAL
19. Rough Heating & Air Gondi[ioning FIRE DEPT. REQUIREMENT
20. Rough Factory F.ireplace � _' ' APPROUAI.S ; Permit #
21, Ducts, in Structure . �-_ � 70. Undergr�und Hydro
22. Dutts, Ventilating � �� - �' 71. ProdUct Piping tiGas ❑Oil
23. Gas Pipe�Rough & Test . 72, Underground Flush� .
24. Roof Framing 73. Undergrnd. Srorage Tank O Gas ❑ Oil
25. Roof Sheathing , ' .�,.,� Q�7 �y,/((Z jq. Overhead Hydro �
`C / rv
26. T-Bar Ceiling (Strucwraq & Monocoat . - _' 75. Dry Chemical
p7, Frame and Flashinc� . . . . - � 76. Dry Standpipe . = �
28. Lathing & Siding �., � 77. FIXED SYSTEP,9 FINAL
29. Insulation ' �� ' . � .
- Z8. FIRE PFEV. FINAL
30. Drywali Nailing , � - HEALTH DEPT. REQUIREMENT
31, Plaster Brown Coat� .. � �- � 79. FINAL-tN§PECTION ,
32. Electrical Power Meter-Final �� 80. FOOD CERTIFI.pATE ISSUED
33. Finai ElectciC , � '� Notes: � �
34. Final Heating & Air Conditioning - 1 � , �
35. F�nal Gas Pipe�Test • . : � �
;
36. 'Hood or Canopy ' . , �.
37. Pinal Factory Fireplace � - �
38. Pinaf Plumbing �
39. Water Service-Final _ ", '
40. Gas Service•Pinal , � , -, �
41. Solar pomestioFinal � ,
42, Backflow Preventer' - - ,
�� 43. Backflow Irrigation ' '
4G. Landscape Irrigatiqn System • � � �
.45. Sound Attenuation _ • -.' ,
46. Handicap Regu4acions - . � -
47. FINAL STRUCTURE & BUf�DING �lp,,,LJ ��(�.�.i
! i
48�. FINAL PLANNING �
49'. �Electric Release to Edison -
50. Gas Release to Southern California Gas Co i -•
51. CERTIFiCATE OP OCCUPANCY
No. Date
� No. 117•
SPECTIONS
IL
ROUGH PLUM6ING
PROP. $WR. LINE rI HOUSE CON.
MISCELLANEOUS
ROUGH HEATING AN� AIR CON�ITIONING
UNOERGROUN� U POWER
0.0UGH WIRING
INF.
FLOOR SVSTEM •
60N0 BEAM � STEEL REINFORCE
SHEATNING
FRAME AND FLASHING
LATHING - IN n OUT
PLASTE0., BROWN COAT
HEATING, VENT., REFRIG. FN� A.C., FINAL I
PLUMBING, FINAL AND GAS TEST n
BUIL�ING, FINAL
DATE
uo��er.���
SUBCONTRACTOR
�
Y � I,�• \1� � ,Jl..�
COSTA MESA BUILDING-SAFETY DEPARTMENT
. P.O. BOX 1200 COSTA MESA, CALIFORNIA 926T6
For Applicant to Fill in Completely
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USE OF
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SIZE OF � �3
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APR29-6`�cnsaQ�157S o*�a�fr(.�0
APPLICATION FOR BUILDING PERMIT
RECEIVj�DNB,� DATEFrJEC�J�D DAjEIS;Urrl
,/°� L.i X J
BUILDING
ADDRESS
TRACT
OWNER
FIRE
ZONE
APPROVED
� 0�
VALUE
DATE
7 FLANS � BUILDING EW �
APPROVECq VARDS APPR
OISTANCE BET
MAIN BLDGS.
VAR. �`
C.U.P.�
APPROVEO
I heraby acknowledpe Met I have reetl thls applicetion antl smta
thet the ebove information is correct antl aBree to comply with
nll Inws regulatinp Cuiltling conrtruction, anE I shall not employ
any person in violation of ihd workmon'� compensetion lews of
cha Sta�a o( Califomia.
1 heraby cerxify [hot I em pro0erly liconsotl os e contractor untlar SQ. F"
the State ot Californie Busine4s antl Profossionz COCa, Dlvisicn 3, THE AMOUNT:
Chop[er 9, antl chat such licanses are In full force untl effect, or I THE PUFiPO6E O
em ezempx from the provl5ions of the S[ata of California e�slnecs VALUATION
nntl ProfassionsCotla, Divislon Che ar 9. Q
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Slpna[ura of ( / Q Q
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Auffiorizetl ABent
BET.
ACCE
DATE
m
�
O
DER VALUATION IS FOR �
11NG A PERMIT FEE ONLV: m
¢
/ � m
T FEE 5 �l� �'
�
m
CHECK $ �^ E
/ . A LL
TOTAL FEE 5 (J •
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5���
COSTA MESA BUILDING DEPARTMENT
P. O. BO% 3I�
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
1 O�le St. A, B, C
COSTA MESA. CALIFORNIA
MAIL 1555 Placentia
ADDRE55
QTY NI
ARCHITECT
OR ENGINE
AODRE55
L08�i.
same
CONTRAL�TOR�� COI1St• VO• CITY
LEGAL ILOT I
OESCRIPTION NO. � BLOCK
A.P. NO.
,
. 3' � 6����1 � ! !� -
•.., z�-sePO„�SA V99a ��*�69_00
� FINANCE DEPT.
CITY Of COS?h ME3A
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
rNo: r;z 6-3zz7 AQDi
LIC.
NO.
FIRE
ZONI
LIC. 1�7 �orvE.
NO.
TNO. 5a410 BYPF
_... __ 2996 r
SIZE LO X 12L No. oF e�ocs. O
OF LOT J l now orv �or
IJSE OF
E%ISTING BLDG. _ �� `� t
SETBACN LINE iftOM
ccrvlEa oF srAecl �� I REAR VARD 1S tO C
SIDEYARD_ _ RIGHT�F7l�`rLEFT TA J �
DESCRIPTION OF WORK
NEW p ALTERATION II ADDITION
REPAIR MOVING DEMOLISH
5 ZIE DING 3123 pOOMS 16 STORIES L
EXTERIOR WALL ROOF
COVERING StI1CC0 COVERING hot—mop
USE OF NEW
BUILDING
COSTA MESA. CALIFORNIA
Trinlex residence and att. arage
Plan 4� x b The
I MERE9Y PCKNOWIEOGE TH4T I HPVE REAO THIS APPLICATION FND
STnTE TM4T THE ABOVE IS CORRECT wNO nGREE TO COMPLY WITH nLL purpose of est.
CITY ORDINANCES FNO $TPTE L<�NS REGULFTING BVIIDING CONSTRVC�
norv. VALUATION
SIGNATURE OF ��
PERMITTEE
$ 26,378.00
AUTHORIZED AGENT
oaTE
mg a permit fee onlv.
PEFMIT FEE S 46.00
PLAN CHECK � ZJ�Q�
TOTAL FEE $ 69.0�
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