HomeMy WebLinkAbout332 MONTE VISTA AVE - Building Permits,\
�JEC7 AODHESS: 3 3 Z MONTE V I STA AV
OWNEH'S NAME: JAMES HONAKEA
aooness:332 MONTE VISTA AVE
COSTA MESA,CA 92627
ANCHIENGINEEfl: 6 5 �— � 4 6 5
nooxess:
UNIT:
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 062520 — PLAN CHECK NO; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
flEG.NO.: JOB DESCRIPTION : T/OFF RESHT REROOF W/ COMP
uxir:
PEPMITTEE: JAMES HONAKER ( 714 ) 650-0465
RODNESS:��33Z MONTE VISTA AV CA .92§�7
IICENSEU CONTPNLT ECLANATION: I �ereby allirm Iha� I am licensetl unaer pmvisions o aD�er 9(commencing wiN Section
7000� ol Division J ol IAe Business an0 Pwtession, Cotle. an� my license is in �ull �orce antl efteci.
CITY UC.: STRTE LIC.: CLASS:
oate: Signalure:
WOBRENS' COMPENSATION DECUPA710N: I Ilere�y affirm inat I nave a cenificate ol consent m selbinsure or a cenilicate ol Workers'
Com0en5alion Insurance. or a ceNlietl copY Ihereol (Sec�ion 3800. Lab. C)-
POLICY NO.: E%P. ORTE:
camrnxv:
❑ Cerii�i¢A topy is here�y lumishea. ❑ Cehilied copy is filetl with �he ciry BuilJing Oivision.
Oate: AOOlicanL
E►EMPTIONFPOMWOBNEBS'fAMPENSIITIONOEtLRBATION: Qhi55ectianneetliro�Uecamyt,LeAilNepermii¢forwehuMre4�51W�oNess�.
�cetlily tt�yt in Ne Dedormance ol Ihe work lor w�ic� t�is permi� is a ed. I shatl n Y�mploy a per5on in any manner so as �o become
SUEIe�� � Ih¢ W01JXryf5 CA n555aaauuu000qqqLawS 0� CaIllOfnid.
Dale: �_ �" _ � Signa�ure: � ��
NOTICE: II, aller making Ihls tleclaraiian. you should �eco ti I to the lM1% r;¢rs' Campensa�ion pmvisions ai Ihe labor
CoOe. you mus� Iori�wilh com0ly wi�� such provisions a hrs per it s�all be tleemetl revakea.
CONSTflUCTION LENOINC AGENCY: 1 hereGy a�firm I�al I re is a n5tmciian len�ing agency for Ihe pedarmanCe ol ��e wOB �or
whicn Inrs permil is issued �Section 3037. Ci¢ C�.
lENOEfl:
ROOflE55:
OWNEP BUILOEB OECIAN�T10N: I �ere0y aflirm t�a� I am exempt Imm the Contractori Siate License Law for ��e tollovnng rea5on
(Section 7031.5 Business anE Pmlessional Code: Any city ol counry which reQuires a Oermit �o conSWct, alter, impmve. tlemolis�, or
r¢pair any 5lmclur¢, prior to ils iuuance. also reQuireS ihe ap0licant for such permii Io lile a sign¢tl stat¢menl ttui htlshe i5licenSeU
Oursuant�olhe Dmvisions ofthe Conlraciors' Slate LicenSe Law�Chapter9(commencing with Seciion 70fI0�ol0ivision 3 o�the Business
anU P�olessions Cotle) or Ihal heR�e is eeempi Ihereimm and ��e Gasis Ior the allege0 e�emptian. Any violation ol Section 7031.5 Gy
any appbpant lar a Oermil sublecls Ihe apDlicani Io a civil penally ol noi rtwrt �han five �untlrea dollars (55110�.
I. as owner ol tAe property or my employees w�th wages as I�eu sole compensation, vnil Ao t�e wark, antl I�e
❑ s�mcmre is no� imenaee or olleree tor sale (Seclion 70d4, Business and Professional Cotle: The Conlraclars Sla�¢ License Law
Aoes no� appry la an owner o� a pwperly who �uilQt or im0�ove5 �hereon. antl w�o tices suc� work him5eif/hersel� o! ��roug�
�is o� Aer Own employees. O�ovitletl Ihat sucn impmvemen�s are no� intende0 or ofieretl lor sale. It, Mwever ihe huiltling or
imD�ovemen� is 5010 wilhin one year ol compleiion. Ihe owner vnll �ave Ihe �urAen ol Droving �e/s�e CiE n0� Euila or impmve
lor ine purpose ol sale�.
I, as owner oi I�e Omperty. am exctusively comracting vn�h Iicense0 comractors m constmci t0e pmlecl (Seclion 7044, Business
❑ antl Pmlessions CoAe: T�e Coniraclors' State License Law tloes nol apD�Y �o an owner af pmperty wtio huilas o� impmv¢s lhereon
and w�o conlracis lor su[h pmjecis w�th a canVacim�s�license pur5uanito the Conirac�ors' State License Law�.l am aware
thai prool ol t�eir Worker'S Compensalion insurance s�oula �e pmvi0ed to me.
�I am exempt untler Section B. 8 P. C.
m�inisr on:�y'.�T'�.B�ORR4BY OWNER
�ale: `-� _ � —' � Owner: -�
I tlo �ereby cenily Ihat I am aware ol an� untlerslana ��e requiremems o� il a ealih an0 Sa�ety Cotle Sec�ions 25505. 25539, and
25594 anA �Mt I or any lulure building accupant willlwill not (circle one) ee010 ca ply with saia slaie coees antl t�e requiremenls lar a
permil lor constmclion or mo4ilicaiion Imm Ihe Air �uality Manageme � �islrict esiaen�ial conslmclion aDDlicalions are exempt �mm
IhESC p�Ovi5i0�5.
oa�¢
I neri
oaie:
Applicanl: _
Ihal I have reatl Ihis apPlicallon ana Slaie Ih[
sla�e lav+s relaiing Io building conslmclion an0
r v _ / � Signa�ure'.
Oriver's License m Social Securiiy p:
1641�n6 WNm—Bwlaing�.Grecn—Coae
I agree �o comply wiih all ciry antl counly
Ihis city �o enter upon ihe a6ove-meniionea
Pink—Revenoe: Goltlenroa—Assessor
PERM NO: H 062520
GOVT; N SUPP: N
PURPOSE; ALT
SQ FT: 4,000
CLAIM VALUE; 4,000,00 CALC—VALUE: 4,000,00 GROUP OCC; R-3 /
COMMENTS: SMOKE DETECTORS RE� PER UBC 1210
r�r�r**�e*��r��r�r�r�r***�r*�e�r*�e�e�r*�r* ��r�e�****�r�r*�*�r�r��r�r*�rx�*��r�r�rx*x�rx*�r�r*+�*�**�r�r�r******�r
Z O N I N GS ERTEH�AUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- 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 AEQ• PROV: PARCEL: 43912130 ZNE: REF NO;
PLANNING NOl'ES> i? •>
> r
*�����*�*�,�*,�*�*�**,���e*+�***,�**����***+�*,�**+�**���***�,�,���,�*�*,�,��,��**,��*���**���*
D E V E=L O P M E N T S E R V I C E S R E Q U Z R E M E N/T-S
20NING APPROVED, �BY DATE; -.�'�
BUILDING APPROVED BY ; DATE;, �'1
/
APPLICATION ISSUED BY: DATE: C9�6�08 �3
if if if k k iF 1F 1f iF if iE 1fltlf Ik iE IE 1E ik fk if iF 1h k if k lkif 1f ik if 1E�ifif3Fit �f
iEiFiFlfkkiklEilkifkiEitiliEihifiklf�FlfiflklflFifiFilkifklEififfE�klEkk itkiFi!lfk�kitk�tilkikikkifiklfitlFlfitikiFif�FlFk.iliEkiEkififk�f
LEGALIZATION:N F E E S M M A R Y STRUCTURAL SEGMENT;Y
PERMZT
BLDG PMT PLUMBING ELECTRI
63.00
MECHANIC FIRE SMIP/R50 GRADING
SMIP/NON"RES
n
:�
TOTAL PAID /, DUE
63.50 63.50 /• .00
63.50 OVER/SHORT: � � ,00
FIRE SMIP/TO�T GAADING PLAN—CHECK
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 63.50 0.00 0.00
REVEN[JE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMHING ELECTRIC MECHANIC
63.00
M M if if if if �F iF 3F if k if 3f ik 3f if iF if k k iE iF �F if 1! k iFif if iflk ik iF ik iE iE ik iE ik ik iE iE iklf k iF iE if 1! k ilif iFiF iF 1f k fk k If �F�E af If iE ik ii if if if�,iF iF 1F ik 1k 1E �F iE 3F
I N D, I V I D U A L F E E B R E A IC D O W N ��
TYPE (jTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 4000 REROOF HY VALUE RESIDENTIAL NOZONE 1,00 �j 4,000.00
END OF FEES �
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01 001<06p2—p0140603 T OT
DATE: Oti/OE/93 TI11E: 11:5?
�
63.`0
CONSTRUCTION ANDPLANNING
APPROVALS Permit # Date
1. Temparary Electncal Sen��ce or Pole
2. Sod Pipe�Undrgmd.-
i "�E�actncal COnduit llt:htY�Undrgmd.
4�. �IeCtr.Zdl CondU�T�Undrgrnd.
�5, Steel Reinforcement
G. E1Pctncal UFER Grnd
7. Foot�ngs '
$. Fo�ndation �
9. Nlater Prpe�Ur.dr97rd,
30. Structural Ploor Syetern
11. Prnperty Sewer Line 8� House Connection
12. $e�ver Cap
t3. Foof Drdms
74. Rough Plumbing
75. Rough Elacricai-Cor.tlwt
16. Rough EleCtriG4Viring
17, Rough lV!ring Sign
16 Rouqh ElcctrieaLT B.v Ceil�ng
19. Rouoh Heating & A�r Cond�uom�q
i �� � r >
20. yio�h �JctoW F;*e�'ace �:i �r� �
' ti:.=
21.°Jucn.��SStnicture.: .... - - '
�
22. DuCFs, Venti�tin� � �.� � ..
23. Gas Pipa-Rouqh & tiest � � �
_��:,.--.__ . � ' '
74 ��flca�' Fr�'r�irg _� i- � ._ R ��
25. Root Shpathing : ¢ v
Z6.'W'•Bar CeiLng fSt��u�all &1V�on6coat �'���I
27.�xrarye and Ftash�eg� . ti .
�28.~Lat7�ng�k� Si�ng�: •' - - �_ .. ; =
29, Ins�lation . � �� •
� 30. Dry��•aii (Vai�mg 'r .
� ---- ':-�'_ - ,
�1. Plaster Brow� Coat•.. :� ! -�• .�
��-�_
`32. :ElectricthPotver t.;ei2r-F�.r.ai' `
i�� - _ _
y�3. �ina�F Eleciric � . . •- �
:.g4 cFindl H88hng& A�i'Cor.dition�.�� "
�
V35.��inat Gas Pipe�T�st � ' �
36. Hood ort CanopYc "' . T ... �
37.'f;nai Psciory fveplace r , _ � � ..
- - 3 •-
38. F�ns� Plumbing ' �
39. 4Vater Service �Final,"� } � �
A0. Gas Service�Fc,�al . ' � 5 �
A7, Sola� Domestic-Final �_
' 4y,�YBacktlow Preventer •
43. Batkfiow trrii�ation: - � ' ' �
J
r,14. Landsw�e Irrigatior System� '
-- POOL & SPA • �-� --1
�
{nspector QppROVALS Permit �,'�` Date Inspector �
52. Po�I & Equlpment Locat�on
� 53. Strel Reinforce�ncnt �
- �
54. �orms
55. Elect*ieai Bondmg _ •
�
56. Rvugh �'lumhin� & Precsure T�st �
'^ 57. APPROVAL TO COVER�GU�ITf. I �
58. Elecvical Corda�t�Untlrq�ntl. . ��- '
59. Gas P�pc, U UnUrgmd., TeSt ' - j
-- ----�
60. Eac!cs�asl� L_ _�., P�TiaP. r! UndrS,ri�tl__� __�-_�
61. APPROVAL 70 DECK � ' �
( 62. Backr.�>h & Rcceptor Final '
63. Fleater & VenFF;nel
_-L' _ �
G4. P;�mb�ng System � F�nal
� -1
65. Electrlcal�F��nal , �
�
66. Solar SVstam�F•n�'. .
---f--- - ------'
67. Fencing & Acctss Appru+,�l '
68. APPROVED FOfi PL45TERING ,
69. POOI/5�.� SYS`E:v:S FtNAL
_ FIRE DFPT, REQUIRE�UENT �
_ - �r.�� , � ...
�� � .. � �APPR(1Vq�S ,� .:Qcr�uit :'� . .' •,
'�`70. U�derg:0un�-H�j,o .�
> '� Y •,
� s .. 71. PruduCt �!pi�:c� .� Ggs �i Od
" K -'-"�'7f 2. Un"� � F!�,r�' , , � '- _ _ '
x��':/3.-Underamd.Storace:.7.ic!<4�Gas _'G''
- - ---�+----- - - .
? 74!:Overhead Hydro �
3 �=' � ----- -- - �
�. _ ..
_ - - Ia � 4cY Ghe��ai .
_ .'-r----r�-- - ----
- 76. Ory Star.dF_.�:e - :
"" 77.' FiXED SY$�EM�fiNAL' �
- �- . . � - - --�
• 78:'FIRE PREV. FIh:A:. • _�, ,
I � � _ FtEALTF+DEPT;'REQUIRE4;�ENT �
� i�--- �79��FINA-LI�iSPECTIQN ., _ . I '
��8' 0. FOpp CE :7;F:'r�',r��F IS���LD, _:__� �I
_' � { Y I -IVQ L�S. �_ T � l . . 1
i 4 � -�`-� - �
- ,t ,
4 '
�_
l�
R �
r
'45.•,Sound Atte'riwatiort ' � ` .; `
n16.��4andicap•Regulatioris - � �
q7.fINt1LSTRUCTURE&BUIIDI�'G /G�
��7
48,��INALPLANNING • -
�tg, Elec'tric Release to �dison '"
50. Gas Release to Southern Caiifornia Gas Co
-51. CERTIFICATEOFOCCUPANCY �
Date
V
n �
�; '
--�
�
PflOJECTAOUFESS: 33Z MONTE VISTA AV
OWNEP'S NAME: HONAKER JAMES H
ADOPESS: 3 3 Z MON'�'E V I STA
COSTA MESA,CA 92627
PHCMIENGINEEB: 6 S O— O A G S qEG.NO.:
AOOflESS:
i
uxiT: �
CITY OF"�'COSTA MESA — BUILDING PERMIT
UNIT:
PEFMITTEE: ORANGE COUNTY SERVICES ( 714 ) 591-9753
RO�flESS: 3OZiy Nn�.��HESPERIAN WY('p q9'7(� 101
IICENSE� CONTHACT�DE�ATIOM:'iNeteby aliirm �hat I am licensed untlery10Vi5i0fiSDl'CflSp�r 9(commencing wilh Seciion
7000) ol D� i iness and Pmlessians Code, an0 my license is in full �arce an0 eifec�.
cirruc.:�'������ srareuc.:67989 cuss: �"2"0 /[����
9Mg J�S--`f � Signature: �e(_��!7���w�
WOPNEBS' COMPENSATION DECIAflATION: I �ere0y aHirm �h ave a cetlificale of consen� to s�lbinsure or a cerlifica�e ol Workers'
Compen5aiion Insurance. or a cerlified coOY �hereol (Seciion 3800. Lab. C�.
roucvNo.:W931100990 EXP.ORTE: OSIOSI9S
comraxv: CA COMP .
]� Ceriilied copy is �ereby fumishetl. ❑ Ce�ihed topy is liled with �he ti�y BUiI g Oivision.
$�e- ��3-�y ApplicanL ��
E%EMPiION FflOM WONREflS' COMPENSPTION UECIAPATION: (T 'Setiian need noi Ge camDleied if t e permit is �or one hunOred (5100) or 1¢55�.
I cetlity Ihat in �he OeAormance of �he work for which Ihis permi� is issued. I shall no� employ any person in any manner so as to �ecome
subjec� to the Workers' Compensalion Laws of Calibrnia.
�ate: SignaNre'.
NOTICE: Ii, afler making this OeClarati0n, you shoNa heCOme Suble�� �o �he Workers' Compensa[ion pmvi5ion5 ot �he LabOr
Cotle. you musl lonhwilh compty wilh sucn pmvisions or ihis permi� shall Oe AeemeO revokee.
CONSTHOCTION LENDING pGENCY: I hereby allirm Ihat �here is a cons�mc�ion lentling agency for Ihe pertormance at Ne work Por
w�ic� I�iS oermi� is i=.sued (Section 3097. Civ. C�.
LENOEfl:
ROOflESS:
OWNEfl BOILOEB UECLAflATION: I hereby allirm thal I am e�empt �rom the Contracmrs' State License Law for the following reason
�Section 7031.5 Bu5ine55 antl Pmlessional Code: Fny ci�y o� counry which requires a permit to cons�mct, alter, impmve, Oemolish, or
repair any simctuB, prior to its issuance. also requires ine aDD�icant lor such permit to file a signea statement tnat nelshe is licensea
pursuant lo �he pmvisions oi Ihe Contractars' S�aie License Law (Chapter 9(commencing wi�� Sectlon 7000) of Olvision 3 0� �he Business
antl Pmfessions Code) or �tla� he/she is exempi Merefmm antl I�e basis far ihe allegetl exemption. Any violalion oi Sec�ion 7031.5 by
any applican� �or a permit sublecls the applicant�o a civil penally of noi more ��an �ive huntlretl Dollars ($500).
I, as owner oi �he pmperty or my employees wi�h wages as their sole compensa�ion, will Oo the work. an0 Ihe
❑ slmcWre is not inlentled or oflered for sale (Section 70aa, Business antl Prolessional Code: The Coniracrors' State License Law
does nol appty to an owner ol a pmperty who builds or impmve5 Ue�¢on, antl w�o does such work himSelVhersel� or Ihmugh
his or her own employees, Omvitletl t�at such improvemen�s are not inlen0ed or ofteretl �or sale. If, however the �uilding or
impmvemen� is SoIA within one year o� compleiion, the owner will have Ihe hurtlen ot pmving he/she Oi� no� buil� or impmve
lor the pm0ose of sale�.
I, as own¢� o� ��e pmpeny, am exclusively conimc�ing wi�h licensed wnlrac�ors �o conslmci �he pmle�� (Sec�ion 7044, Business
❑ antl Pmleuions Cotle: The Contrac�or5' State License law tloes noi aDDly �o an owner o� pmpetly who builtls or improves �hereon
antl who conirac�s for such proiecis witn a conirador(s) license pursuanl to tne Coniractors' Stale License Law). I am aware
ihat pmol of �heir Worker'S Compensation insurance S�oNe be pmviaetl ta me.
� I am exempt un�er Section�. B. 8 P. C.
lor Ihis reason'.
�a�e: Owner
I tlo hereby cenify Ihat I am aware of ana unaerslantl �he reQuirements oi Califomia Heal�� and Salely Cotle Sec�ions 25505, 25533, antl
25534 an4 ihat I or any lulure budding occupanl willlwill na� (circle one) neetl ta comply wilh saia s�a�e cotles antl �he requirements lor a
oe�mi� lor con9mciion or modificalion irom Ihe Air Ouah�y Management OistncL Fesiden�ial constmction apDlications are exemp� imm
these provisions.
Oaie: Applicant: �
I hereby cer�ify Ihai I have reatl Ihls applicalion ana s�ate �hat �he a�ove iniormalion Is carrec�. I agrae to compl � iIM1 all ciry an4caunty
ortlinances antl 51alelawsrelatinglo huilding cons�mction ana hereby authorizerepre5eniative5 o his ciry�o enter ponthe above�menlione0
pmpetly �Or inspet/iio�n p[W�pases. (//x�� � �
�Oa�e'. �� ^7 / Signalure:�� �
�nver's Ucense or Social Security p:
16<La6 WM1ite—Builtling�, Green—Cotle Enlorcemem: Canary—Applicanl; Plnk—Revenue; Goltlenrod—Assessor
PERMIT NO: M 065526 PLAN CHECK NO: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: MEC
JOB DESCRIPTION ; CHANGE OUT 75,000 BTU FURNACE
CLAIM VALUE: 1,200.00 CALC—VALUE:
PERM NO: M 06552
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: MECHANICAL WORK ONLY
it it 1F it 1! iF if �E 1Fif ih if if iFiF1f it iF iF iF iF 1f if iF df iF it ik ltif if �E �f 1! �1F ih ik if �f if 1E if iflf iFk iF �If if if 1!!h 1f if iF il�f �! if ik 1F iF aF�1f �! k iF�t iF if iF iF ik 1F 1f iF �F iF if
Z O N I N GS ERTEB�AUCjKRSE M E N T 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: 43912110 ZNE; REF NO:
PLANNING NOTES>
! �11
if fk if iF if 1E i! i! 1E IE 1f 1E 1f 1f fE 1!!f 1! 1E 1f IE!! 1! M 1k �f 1E ff k if 1Elf 1E 1f 1t If 1E 1E iE iE iE if 1E iF 1f 1f 1f if iF 1k if K 1E if 1F fE 1E if 1f 1plE iF iE iE iE fk M iE 1f iE if iF if iElf iE if M iE
D E V E L O P M E N T S E R%V Z C E S R E Q,U I R E M E N T S
ZONING APPROVED BY . ^
HUILDING APPROVED HY :
APPLICATION ISSUED BY:
iF If iE 1E if M iF iF iE iE iE iF 1f 1k �f iE if 1f iE iF %M
!f iE fFlFlFlflFlf 1E iElt 1f iF 1f 1F iE iFlE iFlf ff M
DATE:
iF
iE
LEGALIZATION:N F E E S.U'M_M`A R Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC. MECAANIC FIRE SMIP/RES GRADING
PERMIT •� 9.00
- 25x SMIP/NON—RES
PLAN - ' ' - '"
ISSUE FEE " '�15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15.00 0.00 24.00 24,00 .00
REVENUE DIVISION TOTALS--> COI,LECTED: , 24.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00 � 5.
if iE if !f iE if 1E k �tlf 1E if if !F if 1t k 1F if iE iF if 1t if if if iE iE if 1t 1E iElf iF iF it ft if fE i! 1t 1F 1f fE 1E 1F 1f if if 1E iE 1E fE fE if K fE 1E iE IE �E iE ik 1E 1E 1ilf 1ElElE iE iE iE fF iElE IF iE �F
I N D I V Z D U A L "P E' E L� B R E A K D O W N
�.
TYPE QTY D E S C R I P T I�O N � i UNIT COST TOTAL COST
MEC 1 INST FORC—AIR/GRAV FURN <=•100 K BTU 9,00 9,00
END OF F-EES
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:lt n�+�:i1-'.—�l`?`. t,��F T4:AT1 24,tS0
uATE: 0 L'D3/54 iIP�E: :1:St7
C0�ISTRUGTIOR� AND PLANNING
i
A('?ROVALS Permit�`r
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53. Steol Reinforcement
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55. Electr.ca' Frnd ng �
56. 7cugh Plumb��nq & Pressure Tes! �
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68. APPROVED POR PLAS7�Ri\G � _�
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' COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 C06iA MEBA. CALIPORNIA �
For Applicant fo Fill In Complefely
TYPE OR PRI T
BUILDING 33z ' �M / �A •/ //�'
ennwvec G1l
� / �
� ARCHITEGT
BTATE �+ (' TEL.
LIC. NO.t/� C � /� NO.
e1zE �/ 3 U X d' JO ' I rao. on auos.
OF LOi / NOW ON LOT
USE OP
EXISTING BLDG.
serencrc una rrsoM //) �
CfiMEp OP BTP¢ET / REAR YARD
SIDE YARD I LEFT O I RIGH7 /�J
DESCRIpTION OF WORK
;RIOR WAL ROOF
ERING COVERII
OF BUILDING ANDx✓ORK 70 BE
'� ��� ��
i �.���yN�E',�E�
OCT 171962
� a �� `� �Ii�,�t;E DEPT.
" -�� � CI � Y OF COSTN ft4ESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO, PERNIT�lW,� .
BUILDING 3� � 7�..,� v-�
ADDRESS
COSTA MESA. CALIFORNIA
�` ��L I PL.hNB �� I BUILDINO k
L60AL f��!- L ;,� y Y
O88CRIPT�ON �
lC6NT¢R LINB BTJ
�3
REAR / 3
ByPROVED ��nf
a�
18911ED
Y
/,v-� Cl� Gt_, • _ /3 5-7 ` �'
I HEREBY ACKNOWLEDG6 THAT 1 HAV6 p T1118 APPLIGTION �ryQ AMOUM 9XOWN U ¢R VALUM1TION 16 FOq TH¢
AND BiAiE THAT THE A90VE IS CORRE AND AOHlB TO COM- pURP096 OF ¢BTABLI6XING A PERMIT FEE ONLY.
PLY WITN ALL CITY O INANCES ATe LAWB f180UlATINO
BuiLoiNG CONeTR oN. VALUATION ���
SIGNATURE OF � PERMIT FEE $
PERMITTE � $��� �^' n 'J
� PLAN CHECK S �1[ % —
AUTHORRED AGEN7 _ `�7_7 ^