HomeMy WebLinkAbout1895 MONROVIA AVE - Building Permits iusS. EIA. Y. BF CO 'I'A MrE5Pi
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#%�7r ' r 5 CALIFORNIA 92626 P.O. BOX 1200
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.4" ...&C RrJL FROM THE OFFICE OF THE PLANNING DEPARTMENT
• July 30, 1973 .
Mr. Ted Griffin
• District Manager
National Convenience Stores, Inc. .
• DBA Stop N'Go Markets
610 E. 17th Street •
Santa Ana, California •
Dear Mr. Griffin:
The City of Costa Mesa Planning Department has accepted a Cashiers Check in
the amount of $600.00 from you. This is to insure completion of certain
conditions of your building permit #35853 for the property at 1895 Monrovia
Avenue. This will allow this department to final your building for utility
and occupancy purposes. The conditions to be completed are:
6. Provide trash enclosure facilities consisting of a Portland Cement
Concrete pad circumscribed by 6 ft. high opaque (masonry-block-wood)
fencing and opaque latching gate. The location and size to be
coordinated with the Planning Department.
r 9. Applicant shall install 4' x 4' tree.wells 20' o.c. along interior
property lines and plant Evergreen Pear trees. These wells are to
b' provided with sprinklers.
14. Installation of a 6 ft. high (measured from the finished grade height
of highest property) masonry or block wall shall be required under the
direction of the Plannin• g Department.
•
The money will be returned to you upon completion of the above conditions to
the satisfaction of the Planning Department. The return of your money will
involve having these condi tions exonerated by the City Council. and the money
being released by the City's Finance Department. This procedure may take
Several weeks after the conditions are complete.
If you have any questions, please feel free to call me at (714) 834-5245.
Very truly yours,
1(119- 13 ,
R. D. Brittain
Assistant Planner
•
RDB:pbd
cc: Finance Dept w/enclosed check
Building Department
• TYPICAL 611 CONCRETE BLOCK FENCE
Cement Coping Optional 1 .• GENERAL- NOTES
Channel Block With 1-3/8 a .10 Horizontal Top of all
Fences 'MOMI MORTAR: One Part Plastic Cement, and
6° Concrete Block Fence Three Parts Sand
a = GROUT :
One Part Cement Three and
For Fences 5 or Less f One Half Parts Sand
Vert. Bars 3/8" 0 at 4'=0°O.C..' ° �,--' COPING: One Part Cement, Three
For Fences Higher Than ,5' �m LL t`O ®,, 4 Parts Sand
Vert. Bars 3/8' 0 of 32 O.C. _ CONCRETE: Well Mixed 1:2-1/2: 3-1/2
Provide Inspection and II > .'�_ 0� Max. of 7-1/2 Gallons of
P z Water Per Sack of Cement
Cleanout Hole at Location >
of Vert. Reinforcement a2 IA ,, REINFORCING STEEL SHALL CONFORM TO
111111
� I� SEC. A-I5-39 A.S.T. M.
Fill Cells Solid With Grout w o ALL STEEL TO LAP WHERE SPLICED, 2=dt
Where Steel Occurs II LL M ill • 1 . .. . . It, .= =
MINIMUM.
GROUT MAY BE POURED FROM TOP OF
'II --^ __ 111111...... ... ... FENCE IN CELLS WHERE STEEL OCCURS.
HOLES SHALL BE CLEAR, CLEAN, AND
" • - .'_-I I FREE OFT ALL MORTAR, DEBRIS, ETC.,WITH
NATURAL GRADE INSPECTION HOLES AT BOTTOM.
�.,_,�,,. t.���„� BONDS SHALL BE PROVIDED BY LAYING
///A �' D 4 _ - ' e' BLOCKS IN STRETCHER COURSES SO
�/]/ % � o.- .e ' _ N o' THAT VERTICAL JOINTS ALTERNATE IN
EACH• COURSE.
TWO 3/8 0BARS e s ♦ e. °.. e .
CONTINUOUS I
t-0—WIDTH TO 16' O.C. MAX.
SEE CHART •°, �e p.
STEEL MUST BE TIED IN • I BELOW , DEPTH OF EARTHTOOTH
PLACE AT TIME OF TRENCH • II • _ I oLi 1/3 THE HEIGTH OF FENCE
INSPECTION. ? q L I' . BELOW BOTTOM OF FOOTING.
•
•
o° Io” j . Z' _J :. SCALE. 1/2" : I'
1
CHART •
HEIGHT 6 ' - 5' 4' 3'
WIDTH 14" 14" 12" 12"
THICKNESS 10" 10" 8 " 8 "
DEPTH OF EARTHTOOTH . . . 24" 20" 16" 12"
SPACING OF EARTHTOOTH. . 12' 14' 16' 16'
OWNERS NAME: _ 'QQQSSS���/// T _ �.,
City of Costa Mesa, California JOB MITDNESS: — 1 �ar_7
Building Department - SIGNATURE:
FORM BU25-2M-0-02
�� C•ste esa Building Dept.
STRUCTURAL APPROVAL ONLY
SEPARATE PERMITS ARE REQUIRED
BY �
MAKE NO CHANGES WITHOUT PRIOR AP/
FOR ELECTRICTh PLUMBING,
THESE PLANS MUST 8E ON JOB A�ALL TI9 5
HEAT'ivG, I, ''fli.h,ilP"G ANDPROVAL
OF DEPT,
RE:=RIGER/I;XI WORK
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
�[ yy
APPROVED OF PIANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED
D-�.�hCG4 TO BE'`A 'PERMIT FOR, VP AN APPROVAL OF, ANY VIOLATION
THIS I t ijCR ' q <OCK (� A OF ANY OF THE'PROVISIONS OF THIS CODE. NO PERMIT PRE-
' -SiI �'CCJ PAHY CITY OF COSTA MESA ----
0
1 SLIMING TO GIVE 'AUTHORITY TO VIOLATE OR CANCEL THE
ALL IPISI'tC �`; ,REQUESTS
PLANNING DEPT. O PROVISIONS 'OF 'THIS 'CODE SHALL •BE VALID, .EXCEPT IN SO,
SUBJECT TO BLDG. DEPT. REG. T MR AS PVIF Wpgk'bR'OSE'yy}{HjHtir.AfN.HORIZFE:{S LEAN/FOL.
nn p� pE ($S'OAT�E aF A fE MTIj9A5�D'GPUN 'PLA'NS AND
FOR DOILDiiVF$ ilriE'E PERSONS S ARE TO BY(� �� L/ DATE,�L:/5/ -f,
SPECIFICATIONS SHALL N07 PREVENT THE BUILDING OFFICIAL
BE Ehi?LOiEO, ltE $:13L= S'i THAT THEFROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS
STATE OF C ;PO,•NIA DIVISION OF DIRECTOR OF PLANNING �+
IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING
A D ADDITIONAL
$ QUIR 'cM CONSULTED FOR BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
ADDITI0114L RE IUIREMENT$, •
N VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE
OF THE CITY.
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RESIDENCE RESIDENCE 14
RESIDENCE ' 'N RESIDENCE
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, OWNER VUN DATE
JOB ADDRESS 1895 Monrovia BUILDING PERMIT NO. 49772
GENERAL CONTRACTOR ICBM & FW POPOFF DESCRIPTION of WORK Fire Repair
0^ No. 116-020-51 LOT TRACT FIRE ZONE VALUE $ 3,000.00
CTIONS Signature Date TYPE GROUP ZONE Cl
SUBCONTRACTOR PERMITS ISSUED
GAS Date I Number I Signature
WATER Plumbing -
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑ �
ROUGH WIRING /\J G .3 ' $t' Heating and Vent.
TRENCHES n FORMS LI STEEL REINF.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING j Y,. 4b-7�
LATHING — IN OUT n J"(_' L/'- SQ
PLASTER. BROWN COAT
-TURAL, FINAL "Qifplertric ,y ,
G. VENT., REFRIG. AND A.C., FINAL Jf4 4 Fgib. TtftI F a'Io1ao � t 4
I dING. FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL EXPIRED
SPECIAL REQUIREMENTS Incomplete irspecnons
1 - __________
13880 3/ 10/60 46.70 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION-FOR STRUCTURAL PERMIT
• 5P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVED BY 'PERMIT At0 49772
For Applicant to Fill in Completely— Use Ink Only N/ /�-
BUILDING .. 11 A.P.NO. /IG� � 1�l7 �-
ADDRESS M.ON R,SOdi A /� /yv.`� (w /
BUILDING + NW� RovtP�
OWNER OR Vo . \ ADDRESS [d•�t 1r/W
TENANT IV
UNIT OR
MAI LING S k d wrb E7 SPACE NO.
ADDRESS I
y ` TR.NO. • BLK.
CITY c..0 ST
p A ItAeSPk NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER ✓
BRANCH
• OWNER VO NI
ADDRESS VALUE
ARCHITECT TEL. USEt A0Y� :raga .. ----
OR
�
OR ENGINEER • NO.
ADDRESS t-- II..•• ZONE Cf TTY,PE GROUP
CONTRACTOR .�1, CVi M c W vpac# BYAPPROVE� �— V DATE..? /D-rD
tAt T[
ADDRESS 11 ,, sv is ell-0 Q to
CITY G0 srA. M A TEL.. 96 3 33,1 _
F STATE CITY APPROVED SETBACKS
LIC. NO. 3 ► —7 4 S 7 LIC.NO.
(FROM C/L STREET)
SIZE A. NO.OF BLDGS.
R. OF LOT IOC)x to Q I NOW ON LOT I FRONT FT.
Q USE OF �
q EXISTING BLDG. L•IcCQ 1.1 OR., Si-c 2.-ER.SIDE
rA
FSeparate permits are required for L.SIDE
G electric,plumbing and heating work: _ REAR Frj. p...//(W,,. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
DATE
Q APPROVED _
} �Y DAT e-/ T7
..1
Cd
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aI hereby acknowledge that I have read this application and state 0'
that the above information is correct and agree to comply with
Pr all laws regulating building construction, and I shall not employ i
Z any person In violation of the workman's compensation laws of m
' the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
D
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FE ONLY: to—
am exempt from the provisions of the State of California Business PERMIT FEE $ a
VALUATION
and Professions Co Division , Cha r 9.
ri
Signature of ,/`�� /'�00 PLAN CHECK $ / 7•
mo
Permittee ASK( $ '1/agVT AX $ it L
3or
xx
Authorized Agent Date • / • C..J TOTAL PAID $ 70 U
( ,....,_.. N C S Re»lty- WAIL £-i4-73
\JOB ADDRESS 1895 Monrovia Avenue BUILDING PERMIT NO. 36794
GENERAL CONTRACTOR Ed Johns DESCRIPTION of WORK Block Wall
t • 116-020-44 LOT Poor 10Q1TRACTNpt Mesa FIRE ZONE . VALUE $ 1,300.00
:TIONS Signature Date GROUP ,T TYPE TTT ZONE (Ti
,J1 Ste. SUBCONTRACTOR PERMITS ISSUED
v GAS Date
Number I Signature
\WATER Plumbing
J ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE •
UNDERGROUNO ❑ POWER n
ROUGH WIRING �+ Heating and Vent.
TRENCHES FORMS fl STEEL REINF. n/1ytA Q' �.•y -7 L
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
S' ' RAL, FINAL Electric
HI r, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL //�I
BUILDING. FINAL ''9j e- (4-2(-1;
36794 JUN 1 -73Pa10
4 001226* ****20.00
• - COSTA MESA BUILDING-SAFETY DEPARTMENT cwsa
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For
r/Applicant
c. (to Fill in Completely /� ../)- /� RE'V E�BY JDATE ECEIVED
ADBUIDRESS G I O 1 I�t� K}��C� �I t l.C7j/.L//CJ L ��� 1V/• �/ /G-�I ,� DATE_/ISSEDE
OWNER nk . C. S • l c 4l.�' A.P. NO.///—O2O� #2////! PC/EO_R M�TL. Q�
BUILDING
Z
ADDRESS • ADDRESS (X 1 S oNRnyi/4 HVE
al ai hk.iP4 Pcte..
a 0 CITY NO. TRACT yl%S LOT/40/ BLOCK
Z
k-
CONSTRUCTION NEW I ADDi ALTER REPAIR MOVING OFMOLSH
O LENDER • X
am
J D BRANCH /s ark arta OWNER SJ CS rktxi l
ADDRESS VALUE
TEL. USE
ARCHITECT 6LoL ',C . f AL.- $
J Q OR ENGINEER NO.
<
Z
Q FIRE
WCC ADDRESS ZONE TYPE 14 GROUP
p- W }{�.. o APPROV
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Z CONTRACTOR ...tk a A. its BY DATE L,'{ -q
L3_
CCI Z srs3 Cs+ EI Ivi-ctet� C1�
Lir ADDRESS
W w •• TEL. ZONE/A� NO.OF USE OF NEW
0= CITY C L NO. ✓I PLANS e BUILDINGS/it V /
C STATE CITY YARDS APPROVED YARDS APPROVED
j
O LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING `ty,
•
(FROM C/L STREET)
SIZE NO.OF B LMC.
p. VIOF LOT NOW ON LOT FRONT • FT. (/ FT.
USE OF
EXISTING BLDG. R.SIDE FT. OFT. rn�VVV
I— SIZE OF NO. OF V
Z NEW BLDG. ROOMS STORIES L.SIDE FT. OFT.
V 'EXTERIOR WALL I ROOF ^
COVERING _ COVERING REAR FT. C) FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET. BET.MAIN&
MAIN BLDGS. ACCESS. BLDGS.
Q L / VAR.# DATE
O Z1+ 0 1i M•j�` .-r—� 6"Cr Cp ban C.U.P.# 1 APPROVED
Z cave
C11 1*ZL —G rain flY ROVED J Ln Y� DATE �Y`'
0 I hereby acknowledge that I have read this application and state D. (d•
ll !�``�� '
that the above information is correct and agree to comply with K'"
CC all laws regulating building construction, and I shall not employ /
F any person in violation of the workman's compensation laws of
to the State of California. CO
zI hereby certify that I am properly licensedas a contractor under SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 9
Chapter 9, and that such licenses are in full force and effect,or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLY: 0
am exempt from the provisions of the State of California Business �ry
VALUATION j T-
antl Professions Cribs, Division 3,Chapter 9. cowA: PERMIT FEE $ /)/ N
// e V D
Signatureo ./ tt
Permittee\i� 1� ts,�/�,.�/J(�, $ I � PLAN CHECK $ / I
Authorized Agent IL- /'- / TOTAL FEE $ /f `✓ /
\UnINER STOP N GO Market DATE )—E0-1.5
)JOB ADDRESS 1895 Monrovia Street BUILDING PERMIT NO. 36710
GENERAL CONTRACTOR Federal Signs DESCRIPTION of WORK Electric ltooi Sign
'' Z .• 116-020-39 LOT TRACT FIRE ZONE VALUE $ 900.00
ACTIONS 14 Signature Date GROUP J TYPE IV ZONE Cl
5:.... SUBCONTRACTOR PERMITS` ISSUED
GAS Date I Number Signature •
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
-
UNDERGROUND LI POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM _
BOND BEAM ❑ STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN ❑ OUT in
PLAcTER, BROWN COAT
S 'JRAL, FINAL Electric _ L
n
H. i, VENT., REFRIG. AND A.C., FINAL 1Vj,1J/T . ,��jr J5-223773 .:sc -5
PLUMBING, FINAL AND GAS TEST - /_
ELECTRIC, FINAL ;14-) 7-)-'J
BUILDING. FINAL /./2-. -,_,2,7?
—��u . h .
• ' CITY OF COSTA MESA T 70011;"
Tag No. / ', '
357( 0 Building Safety Department Type of Sign 1���� , 9.,1' 25-73P'4 k)O 1 37G.• ' ' "-*9 5Q
/ 7 cr:,-
O.Elec. 0 Non-E ec. '.
Application for permit for the fabrication of classified signs. FOR OFFICE USE ONLY
•
• Location
} - Date Issued �J� ��2 Permit No. t.3_47/27
Building Site Address / g 9 5
p� Fire Zone Type Group
. Name of Lease i -14-._.*? �i Phone ..G_ � . 1]
_ Approved by • /2 Date Z�
/� D State License No.a( 77 3C—'/S
Contractor ' di/ a.-- /J.2-002-co - � PLANNING DEPARTMENTy •l
•
/�y//� /� /a�// ry) City License No. i �a`i'- Zone C.-1 A. P. No AP i•* i I ‘-ca o -Yry r-I -
Address ,��•�. LY A�• City .C1/Xnfi(LGt'. • ,-1 -
- Phone b4G- 707 -Bldg.Site Address 1595 Mon-1 1.1/4- .
•
•
Architect or ..
Engineer - State License No. - -f
Legal Owner p p JA,it/t F..-P- D D . 1245,-A' a-O/`G s'z&
Address 1'-O P . 1 7 • ,
Address - City Phone
Ceti
-
•
Description: . ❑ Tract Sign - ® Roof Sign ' • . Area of Sign:-3 ft. O in. X . . 3 3. ft.O in: = • I I q H'
Required Bldg. Setback to
• 0 Appurtenant and Incidental Advertising Sign (24. Gas Tube, Elec.Sign Center line of Street - -
- - Sec. 1.37, 1.44
• • ❑ Off-Site Advertising Copy Sign Location of Sign: /1Cmt'1"(�ll eo
Behind Bldg.Setback Line S. '_' ! �'
Two copies of plans and specifications shall be submitted with application for permit for each sign. Plot on plan Between Property Line and �
• . sheets proposed location of sign and locations of all other signs at site. Minimum size sheets SHALL be 18" x 24" Bldg.Setback Line O a� 0 `u'7�--
1,,�.e�
and non-erasable: .
fFront . a• e
ALL APPLICATIONS MUST BE FILLED OUT BY THE APPLICANT.ALL FOOTING, FRAMING, ELECTRICAL Right -- •
) AND FINAL INSPECTIONS SHALL BE,CALLED.
.C.
//- /� �C p ` Left
,Signature of Permittee U -. � ' Projection 0 • . Feet , '
• •
aAuthorized Agent • .2 , Ground Clearance I I (. . Feet
• - •- C. U. P.C. - Date Approved 4-- STq�
• The amount shown under Valuation is for the purpose of L Clearance Chap. VIII,Art. 5,Section 8504 (b) / y-
establishing a-permit fee only - ' - e�
C1
V(/ �
f j� VALUATION . .Permit Fee $ 2._ Signature (Planning Staff) • • T
• Recd. by ��" Date ��✓ �� $ Q d0 �� — !
I Plan Check $ Signature(Dept. of Public Works)• "
•
9---
Total Fee $ J Date:
Form BU-30(Rev.) (h
� 35853 m.. - 73�„ ;co
•
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
nn� / RECE{TIRQ fiH DBTE RECEIVED' GATE ISSUED
ADDRESSBUILDING '( r,4 OA. /el/y/1 y� �C/�K�/¢. !/ 3 73 _ j/l.Z// `l.1
OWNER /t/•t-.S. JX T9 do.wp4N-/ A.P.NO.//EJ'-O:20-37/4 [J ref
BUILDING QG'
Z
MAIL '-P O • 3C �as G ADDRESS it
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a /"�/GJ/nj
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ADDREStp LaS' UCJ �•/' A6i
Q. C..) CITY)4) Alec-/ 4aro/ NO.TEL.
•77275in TRACT�ES�� LOT/OD/ BLOCK -
Z Q CONSTRUCTION Ng/ / NEW ADD ALTER!REPAIR I MOVING OFMOI ISH
O cn LENDER
ao3 1 �
J D BRANCH
OWNER /jC. .C. /2cdtTy
ADDRESS /� VALUE ..A�JJ�..n
Q ARCHITECT /- _� S&V/GGA ¢/Aj EL. • US¢�•Cor--E.Gy 532•26-
_I /G"�u'
OR ENGINEER •k+1C /l
U Q FIRE /J
Z
W ADDRESS/,SQO LENAy S%'r//1/0. YwOo/) ZONE / T/ry/PE P - Lam_
�1 �/, APPROVED . t,�1/' u_p
.W.1 O CONTRACTOR (I/..Gt,--/// r/-/;�.� C1" t. BY v✓✓✓IIV77��� DAT E�
m Z
J EE ADDRESS /�
WO w ZONA, NO.OF USE OF NEW,AQa(c.�7
TEL. -..7 (PLANS 27- BUILDING ---
Z
rD.cF-
Z H CITY NO. d' _
WO STATE CITY YARDS APPROVED YARDS APPROVED
to¢ LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D 0 (FROM C/ TREET)
OF LOT ,/O X //f0 SIZE I NOW ON LOT-NO.OF BLESS.
Sb - FRONT ( 3FT.fL FT. •
USE OF /�t //J�
EXISTING BLDG. /�, /">• R SIDE ��F T./IA- FT.
I- SIZE OF NO.OF �J
Z NEW BLDG. •h z X 4ID ROOMS STORIES / L.SIDE �j FT. FT.
-UEXTERIOR WAL - it
COVERING O COVERING REAR 7S---FT. FT.
,
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CON VEN/eMGE '20G.&4/ .5rfaP MAIN BLOCS. ACCESS. BLDGS.
Q VAR.* DATE
O '"/nom`,/,^y.�"/ as, •
APPC.U.P.#s ` ' APPROVED� �] �`t
(~/f �r'� ' //IL.GI.! —FLY ROVED Coq) DATE a-20-7J
Z 'HO j- OR SPECIAL REQU r ME TS
t~.) I hereby acknowledge that I have read this application and state � /�� STATE
lie D that the above information is correct and agree to comply with r_ l
all laws regulating building construction, and I shall not employ g
r any person in violation of the workman's compensation laws of
to the State of California. m
ZW
I hereby certify that I am properly licensed as a contractor under O SQ. FT. �(/ o
the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS-FOR s
Chapter 9, and th. such licenses are in f41 force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
CC
am exempt from provisions of the Stab of California Business VALUATION
and Professions •• Ili tsion 3,Chapter ^- n
PERMIT FEE $ _
Signature of /aamtt (/ 60 m
Permittee - �\J $ 37Oa PLAN CHECK $ �� E
J o
Authorized Agent u_
TOTAL FEE $
--- __ __
...
s.35751/4_ 3 FAI' �. "t 119.00
'E371-7ScT000 689 rj5•
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP' IC• r ON FOR BUILDING PERMIT ,
For Applicant to Fill in Completely
RECE /• =Y DAT RECEIVED [!�
ADDRESS
11.y�f P RMI NO
OWNER z . .S Gyf'L'I •
A.P. NO. at —
MAIL BUILDING rys 'vs ./a
Z .
ADDRESS
ADDRESS CC// Y !'� •
W W TEL.
-. CITY NO. TRACT ' I LOT BLOCK '
ZZ
CONSTRUCTION NEW 1 ADD 1 ALTER J REPAIR [MOVING OFMOI ISH
O y
LENDER
0- co •
J D BRANCH ALS'' S LT
ADDRESS 1 } VAIILUE .
J-. ARCHITECT TEL.
G C
OR ENGINEER NO
6 in
FIRE
W X ADDRESS ZONE / �
lL APPROVE/ 4 / TYPEGROUk
%% /y,��
J Z CONTRACTOR BY DATE;•••y�(/ ^_
mZ
J CC ADDRESS
W W TEL. ZONE NO.OF USE OF NEW
0= CITY NO. PLANS BUILDING
Z h- -
W-0 STATE CITY YARDS APPROVED YARDS APPROVED
to CC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
DO SIZE I NO.OF SLOGS. (FROM C/L STREET)
OF LOT I NOW ON LOT FRONT FT. FT.
•
USE OF
EXISTING BLDG. R,$IDE FT. FT. _
I— SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. _ FT.
V EXTERIOR WALL' I ROOF
COVERING COVERING REAR FT. 'FT.
USE OF BUILDING AND WORK TAFORMED
DISTANCE BET. • BET. MAIN 81
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C.U.P.#
MAIN SLOGS. ACCESS. BLOCS.
Q `VAR.# DATE
O ��QG7 \/ _ _ APPROVED -
I"' / I\ APPROVED
Cf) _$Y _DATE
Z
t~.1 I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with I _
CC all laws regulating building construction, and I shall not employ
I— any person in violation of the workman's compensation laws of •
_
N the State of California. CO
? I hereby certify that I am properly licensed as a contractor under SO. FT. 6
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business
VALUATION /�� m
and Professions Code,Division 3,Chapter 9. PERMIT FEE Ifi(J(✓ N_ D
Signature of at
Permittee $'� PLAN CHECK $ • E
`o
Authorized Agent • O LL
_ TOTAL FEE