HomeMy WebLinkAbout2850 MONTEREY AVE - Building Permits��ia� �sa-s2>s • Fax (714) 754-4856 • www.ci.costa-mesa.cB�ILDING PERMIT
Job Address: 2850 MONTEREY AV
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 14161329
App�icant: VALENCIA, RAUL V
Address: 2850 MONTEREY AVE
COSTA MESA, CA
Owner: VALENCIA, RAUL V
Address 2850 MONTEREY AVE
Contractor.
Address:
Zip:
Arch :
Address:
COSTA MESA, CA �
Phone:
Zoning: '
Phone: 774-641-8864
Zip: 92626
Phone:
2ip: 92626
Phone:
License:
Eng:
Address:
77 FAIR ORIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 07/11/2003
Issued: 07/11/2003
Phone:
2ip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL SHEATHING. COVER WITH EAGLELITE TILE - CAPISTRANO VALENCIA. ICBO NUMBER 4660.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$251.25
$1.50
$0.00
$0.00
$0.00
$252.75
SETBACKS
MAIN TRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existina: o
NOTES:
Rear 0- 0
Rear 0- 0
Re uired: 0
FEESUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
sis,000.00
$15,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a penod of 1 BO days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred InBpections antl final approval must be obtained. Failure to obtain inspactions and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 754-5626
zaas�as �sioo�
WORKERS' COMPENSATION UECLARATION: '� ��
I hereby aHirm untler penalry ol perjury one of Ihe lollowing declarations:
❑ I have and will maintain e certificate ol consent to self-Insura tor workers' compensation, as provitlea for 6y section 3700 of the Labor Code, for the pertortnence ot Ihe
work tor which lhis pertnit is issuetl.
❑ I have and will meintain workere' compensation insurance, as requiretl by section 3700 of the Labor Cotle, for t�e peAormance of lhe work tor which this pertnit I5 Issuetl.
My workers' compensation Insuranca cardar and policy numDer ere:
J
Carrier: ' i Polity Number: ' �
(7bis section neeU nol be comp/e(ed i/ Me bertnif /s ve/ued ef one hundred dWlars (5700) or Ie55J
❑ I certity Ihet in the peAormance of the work for whic� this permit is issuetl, I shall not employ any person in any manner so es to become subject lo t�e workers'
compensation laws ol Calilomia, ena egree that It I sh becoma subJect to the workers' compensation provislons of Section 3700 ot Ihe Wbor Cade, I shall fonhwith
fcomPN wiN Ihese DroW��—Tb'—•�ca.C-:� �� �� V =)
r
Applicant,SignaWre: n. .t Date:
WARNIN(3: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED
hKN1SAN� OOLLARE (5100,000), IN ADDITION TO THE (:OST OF COMPENSATION, DAMAGES 0.S PROVI�ED FOR IN SECiION �W OF THE LABOR CO�E, INrEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aMirm Ihat I am licensed under provisions af Chepter 9(commencing with Section 7000) of Divisian 3 0l ihe Business end Professions Cotle, end my license Is in full
toroe antl eHecL Lic. a Clau p
C _ r' r Date:
a
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirm ihat Ihere i5 a cOnSlNttion Iending egency lor ihe DeRormance oi I�e work for whith IhiS permit i5 issued. (Sec. 3097, Civil Cotle).
Lender's Name: Lendar's Adtlress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirtn Ihet under penelty of perlury that I em E%EMP7 FROM 7HE CONTRAC70R5 LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professlons
Code: Any ciry or counry which reduires a Dermit to consirucL alter, improve, tlamolish, or repair any structure, pnor to its issuance, also requires Ihe epplicanl lor such pertnil
to tile e si9ned stetement that he or she is Ilcensetl pursuani ta the provisions of t�e Contrecrors License Law (Chepter 9(commencing with Section 7000) of Division 3 of the
eusiness end Prafessians Code) or thet he or she is exempt therefrom and the basis tor the elleged exemption. Any violation af Section 7031.5 by any applicant for e permit
uble e applicent Io a civll penelry of not more than tiva hundrotl dollars ($500).):
1, as owner of tha property, or my employees with wages as their sole compensation, WILL DO TME WORK, anC Ihe structure Is not Intendetl or otfered for sale (Sec.
7044, Business end Prolessions Code: The Contrectors license Law tloes not apO�Y �a an owner of property who builds or improves ihereon, end who does such work
himself or herself or through his or her own emplayaes, pravided that such improvements are not intended or oflered for sale. If, however, ihe building or Improvemenl is
sold within one year of completion, Ihe owner-bulltler will heve the burtlen oi proving �hat he or she did not build or improve lor purpose of sale.). �
❑ I, as owner of Ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo consiruct the prolect (SecJ044, Business and Professlon5
Cotle: 7Tie contrecmrs License Lew does noI appty to an owner ol propeny who builds or impwves ihereon, and who contracis for such project with a comrecmr(s)
license pursuant to the Contractars License Lews.).
❑_I am exempt er sec. Business and Profeuions Code for this reason:
sgnawre:. ��[6L�--n-�^-g—���^.,��
Ownar ID veniietl tlriver'sUcenS§ '�.".i�Yes ❑ No Driver's Licensa No.
Venfication of Ownership by (typa ol tlocument, i.e. - properry taa bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON:
❑ 1 �ereby certify that no excevation five (5) or more leet in depih into which a person is required to descend, will be made in connection with work authorized by this
permiL and that no building strucWre, scattolding, lalsawork, or demolition or tlismantling thereot, will be more than ihirry-sla (36) feet high. (C�ep. 32, Grp 2, Art 2, Sec.
341, Title B, Califomla Administrative Gode).
❑ A5 owner-Euilder, I will not employ enyone to do work which would require a permit irom the Division of Intlustnal Sefety, as notetl ebove. unleu such person has e
pertnit to do suc� work irom the tlivision.
Signature: Date:
Division of Industnel Safery Permit Number:
CERTIFlCA7E OF COMPLIANCE ANO AUTNORIZATON OF ENTAV: I certity under penalty of perjury ihat I have read this epplication and state ihat Ihe iniormation given is
correct. I egree to comply with ell stete lews en ciy o dinances relating Io builtling consiruction, and authonze representelives ot Ihe Clty of Coste Mesa to enter upon the
abova-described property lo specU u os I e not to occupy or allow occupancy oF any builtling authonzed by this permit until linel' spection.
/��o- ��--� r _ � �1 I � 0''�
ignatu OI egalOwner(s) Date
And/OrAuthonzed Applicant Date
CODE I, INSPECTONTYPE PAIE
1676 Fized System Finel Fire Prevemion
1266 Pool Spa Final
200 Final Re-Roof
201 Final Block/Retaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolilion
�� p 1 INSPECTIONTYVE
206 Final Mechanical
20B Finel PlumDinq
210 Final Elecidcal �
212 Finel Fire Prevention
220
222
250
Final Planning Approval
Final Site
Final Building/Occupancy
�� ��
C� � C''�°Qta ��eQa �'cc�r�'duuy ?�irri�ia�s
OWNE�-6UILDER
VERIFICATION
A city or county, which is reyuired �o give notice pursuan[ to Section 19830, shall attach to such notice, and,
as a condition precedent ro issuing a building permit, require [he completion and require the retum of, an
owner-builder verification.
Atlen[ion Property Owner: •
An `owner-builder' building pennit has becn applied for in your name and bearing yoar signa[ure.
Please complete and remm this information in the envelopc provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildine nermit will be issued until this
venfication is received.
I. 1 personally plan to pro 'de t major labur and materiais for conswction of the proposed
propertyimprovemenL Ycs ❑ No
2. 1(have/huve not) signed an application for a building permit for
the proposed work.
3. I have cuntracted with the following persun (�ir7n) to provide the proposed eonswction:
Name �
Address
Phone ( )
City
Contractor's Lic. No.
4. 1 plan tu provide poniuns oT the work, but 1 have hired the following person to coordinate,
supervise and provide the major work:
Namc
Address
Phone (
5. 1 will provide some of the
provide the work indicated:
Name
t0a2<6 (REV.99B)
'� City—
Convactor's Lic. No.
I have contracted (hired) the following persons ro
Phone Type of Work
I hereby affirm that I have received a copy of the information set foRh in Section 19830 of the State
of Califomia Hgalth and Safety Code and have comp4eted Ihe above information to 4he bes[� of my personal
knowledge, in compliarice with this State law. .
.l�-� V \
1
Signed:
Name:
(Prinled or Typed)
C.D.L. # OR S.S. #
Da[e: L
Far more information call City of Costa Mesa Building Dirision at (714) 754-5273.
1p12�8 (REV.498)
1
---�
PFOJECTAOOBESS: ��}5Q ;rU.:�_3EY AV
OWNEB'S NAME: Va.- ,'Ni _A �2A:::. �'
aooRess:2350 MO�1�':�tEY A��E
C0� : � :n:;A. CA
(-:—�S�i-8864
NflCHIENGINEEH:
PDOflESS:
UNIT:
q2525
flEG.NO.:
UNIT:
PEPMITTEE:����;, VA;�I:NClA (714)641-885�'.
aooness: � � 50 :%ONTEREY AV
CO:,TA P^.ESA CA 92626
LICENSEO CONTfiACTOB'OEClAfl11TI0N: I �ereDy afiirm �hat I am IicenseA un0er pmvisions ol Chap�er 9(cammencing wi�h Seqion
]000� oi Division 3 0l Ihe Business and Pmlessions Code. antl my license is in full force and efiecl.
pTY LIC.: STATE UC.: CL�15S:
�a�e: Signature:
WOflNEBS' COMPENSPTION OECLAflFTION: I hereby affirm tha� I have a cetlifica�e of consen� to sell-insure or a certilica�e ot Workers'
Compensa�ion Insurance, or a cer�Aietl coDY �hereol (Section 3800, Lab. C).
POIICY NO.: EXP. DFTE:
COMPPNY: .
� Ceriihetl copy i5 here�y Wmishetl. ❑ Ce�i�ietl copy is file0 wiih ��e ci�y Bulltling Oivision.
.�
�ale: Ap0litanL.
E%EMPTION FROM WOBNEBS' COMPENSPTION OECLAflATION: (This section neetl no� be campleletl ii �he permi� is for one hunared ($10�) ar less�.
I certily iha� in ihe petlormance o� the work br w�ich IhiSqermit is issued. I shall noi employ any person in any manner sa as to become
suble�� Ia Ihe Warkers' ComDensa�ion Laws al Calilomia. ,
Dat � Signature: = 4-�' ='�
NOTIC : Ii, aiter making �his declaration, you 5�ou10,� come subject lo Ihe Workers' Compensation provisions a� Ihe labor
Co�e. yau musl fotlhwith comply wiih suc� O�o �isions or this permit shall 6e deemetl revokeU.
CONSTFUC710N LENOING AGENCY: I hereby affirm Iha� I�ere is a constmc�ion lending agency Por �he pedormance ol �Ae work �or
wAich ihis permii is issued (Seciian 3W7, Gv, C). %�
LENOEfl:
ADUflESS:
OWNEB BNLOEfl OELLAflATION: I hereby allirm thal I am exem0i ��om �Ae Coniractors' $tale License Law tor Ihe lollowing reason
�SecUon 7031.5 6usines5 and Pmtessional Code: Fny city of counry w�ic� repuires a De�mil lo consimct, alter, impmve, demotis�, or
repair any simclure, prior lo ils issuance, also reQuires Ihe aDPlicant br suc� permit �o �ile a 5igne0 statemen� �hal �e/she is licensetl
purSuanitoihe pmvisions ollhe Conlractors' State License Law�Chapier9�commencing wi�� Section 7000)ofDivision 3 oflhe Business
and Pmlessions GoOe) or �hat helshe is exempl iherefrom antl the basis �or ��e alleged exemplion. Any violation at Sec�ian 7031.5 by
any apP�ican� �ar a permil su�jec�s �he ap0lican� lo a civil penalry of not mare than five huntlretl tlollars ($500�.
1. as owner ol �he pmpe�y ar my employees wiN wages a5 �heir sole compensa�ion, will do [he woB, an0 [he
❑ slmc�ure is noi intentled or olferetl �or sale (Sec�ion 70aa. Busness an0 Pmtessional Cotle: IDe Contracmrs' S�a�e License Law
does not apply lo an owner of a O�operty who DUlltls ar impmves ihereon, and who Uoes such work himsel�l�ersell or thmugh
�� his ar her own emplayees, pmvitleU ��al such improvemenis are nol in�entled or oHereO for sale. If, however I�e �uiltling or
impmvemenl is sold wi�hin one year of completion. �he owner will have Ihe burtlen ol pmving he/she Ditl nol build or impmve
br Ihe purpose of sale�.
. I. as owner a� Ihe propetly. am exclusively contrading wilh licensetl conirac�ors �a cons�mc� �he pmlec� (Sec�ion 7044, Business
❑ and Pmlessions Code: The ConVac�ors' Sla�e License law tloes not apply lo an owner o� pmperiy who builds or imD�oves �hereon
F ane who conlracis lor such pmlac�s with a contrac�or(5) license pursuanl to the Contrac�ors' S�ate License Law�. I am awa�e
Iha� pmo� ol Ihert Woiker'S Compensation insurance ShoNJ be Orovide0 lo me.
�� � am exemp� untler Sec�ion:B P% O�i 4 B. 6 P. C.
m�tnisie�jasoo: ALL WORK BY OWNER n �
�ale'/��/ l/)/97i Owner � !v . �=n• . ^ �
I do hereby cer�ity Ihal I am aware of and unAerstana Ihe requiremenls ol Califomia Heal�� antl Salery Code Sections 25505, 25533, and
25534 antl thai I ar any luture �wltlmg accupan� will/will noi (circle one) neetl lo comply wi�h saitl 51aie co0es antl the requiremen�s lor a
pe�mil �ar cons�mciion or motlibcatmn Imm �he Air Oualiry Managemenl OisVicL Residen�ial cons�mc�ion applications are exemp� fmm
IIIeSe pi0vi5i0n5.
Oate'. ApPlicani'
I �ereby certitythal I have read �his application ane slaie tha� �he aboveinformation is correcL I agreeio comply with all cily and county
ortllnances antl siatelawsrelatingto building consimclion and hereby authoriierepresen�atives olihis cirylo enter upan�he above-mentloned
properiy �or mspetlion purposei ^
Daie:O y/zL2/ L-3_ Signalure'. � GE�C -��.�4�.�.
� � (
Driver'S L¢ �se o� Sociai Security =:
i6Jb46 WM1ne—Butlaing', Green—Cotle ENorcemenL Canary—Ap0licant: Pmk—Revenue; Goltlenrod—Assessor
e
PERuI: NO: ..
CITY Ot COSTA ."/.cSA - 5U�:.�ING F:rlX�:
062979 P�A!� �HECK N0: Oi485-93 S
CONSTRJC�IO:�: :YUE: 5-ti P£RN.IT TYPr: STR
J03 DES'CRIPT�GN ; COX5=NATIUti :!ASONRY 6 CrIAIN ;,INK FENCING
Dt:.`� :v0; 5 06iS79
GOV:: t� SJPP: ti
?URPOSE: O.Ii
`.�Q = l : 98
CLAIN. VALUE: CALC-VALUE: 1,350.00 GROUP OCC; R-3 /
COMMENTS: 37'OF CHAIN LIfUK O/2'HIGH MASONRY 'v1ALL/29'C?I.LZNR ONi,Y(A:,:, 5""OT)
aE 3f if 1!� ii +E 3E iE 3f ?!� i4 iE �'r 3E ?�i �%� iE 3'r #?E 3E #� Y 3E # tf ##�IF-If iE �1E?E 3E �f if �1E #e t?F iE 1E if iF ##E # 4 iF�If--)f i( ###�lE ###."c ii� #'fi � ii-# # Y.� ##:� x iE :: :". ::• N it
Z O N? N G R E� U I k£ M E N T S
s�.TaAcxs
----------- MAIN BIIILDING ---------- --------- ACCESSORY BUI�DIVG ------ — -
FRtiT: rT IN REAR; FT IN FRNT; FT Iid REAR; F: In.
LEFT: Fi IDl RGHT: FT IN LEF?: FT �,U RGHT; E"; IN
PARRING REQ• PROV: PARCEL; 1916?329 ZNE; Rl R£F NO:
PLANNING Nt5TE5� PROPOSED 37LZ.FT.,2FT,Hi.BLK.WALi AND 4FT,3I,ry.AS\ LZNK
> FEA;CE AND TOTA' 29iI,FT.6FT. HI CHP.IN LINR r'E�CE A�O>:6 "�D'=.
iflEif#?Eii�4iE�lfiEiEiE3EiEif•jEtE#7fif-ifiEiE#jE###iE#i4�1FiEiE#ihiE?E#3EiF�14jEiiiE�tF#3Fif##?EiEit#####tF###i:#ik##3E##iFtix#3e'F�#
U E V E L O P M E N T S E R V I C E S R E Q U I H E,V E ti� S
ZONZ,IG APPROVED BY ;��� � DA�E: yl� 3
� �
BUILDING APPROVED BY : UAT';
V � ,
APP�ICATION ZSSUED HY; _ � UAi'�: �,��
3F?E3EiEiEiFiF3fifiEik?Fi(�?e3f#iF�1F�?E)EIEiF3FftxxF�itit�cr"€��zfrirfricxsirxuirnx+ryT-xit�txxxir:ti##3EifXH�KiF#ax� �y:xttna,:�K�!
�IE iE iF If -le iE 3E 3f iE �E iE iE iE iE # ih # �E #�7(� ## tE # 3f i( if �lE jf if 3F 3r �k iE 3F jF ie f't?F iF �k �1F 3E i(�!E -1E .. # iF Ic iF # iP # if �f 3F # 3t� �f %# # if ### if Yywk ## iE iE ### iF 9E
LEGAI,IZATION:N F E E S J,� M A R Y STItUCTURAi S�GMc\.';Y
RiUG PMT PLUHHING ELECT�yYC� M'c4'"rFJj���;� : iRL SK;P/RES G.cT�7�:�G
PERf:ZT 33.00 � �; 50
PL[iN 21 .45 ,. � !;,. i.- �,� ' : SN.SP/tiON-R.?S
ISSUE EEE �/-- 4; ' � /� w� ' `
BJIiD_TNG-DZV-> PERMIT ISSUE 'P3S�AA1-CiI�ECK r-' '' ..T01AL PAID D'JE
iOTALS----> 33.50 0.00 ,,� '' -2'Z;45 t,� ��;,�,5�4.95 59.95 .00
. � j;
RE��ENUE DIVIS�ON TOTALS--> COL��CTED� �d�.95 OVcR/SdORT; UO
3iDG PMT PLJMBING ELECTRIC MEC3ANI,�' y�'�RE � SN.IP/TOT GRADZNr PLAh-C:IECK
33.00 , � �, !p 4 , .50 21.4�
iE iE if if lF=f. iE i4 iF iE?E if if R%iE ## iF iE?E iE 3e iE if if ## 1E if iE ie?E !E iF # 1E ir �l't i(;3F Y.� if iE �!E?F ia�fE �3E iF �E%# X� # iE iE #### if ### if ### it #Y. X� :£ #�� d iE
I N D I V Z D li A L FrE E�; B'•R E A K P O W N
' ' �. .
TYPE OTY U E S C R I P'? I Q hY '�� ; ONIT COST ':'O' A?. C053
t �
SFR 37 RES-CONCRETE B�OCK WALi,''G %/� FT, 20.00 740.00
SFR 61 RES-W. �RON/CHAIN LFNif'sENCEii;/,FT, 10,00 fi?U.00
� , EIJD OP FEES �
.�
1� �'• �� � �
i. �
i' �1
a �• .:
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DATE•104�3D/931�7IME: 14�20 �4�95 /�
J
, CONSTRUCTION AND PLAiVN4NG '
i
�v APPRQVALS Permit �
t, 7emporary Electncal Service or Fole
2. So�I Pfpe-Undrgtnd.
3. Electncal Conduit Uti{itv�Und•grnd.
4. Electrical Condult�Undrgrnd,
5. STeei Remforcemen;
6� Eiect��cai UFER Grnd
7. Footings
8. Foundat�on
9. �4ater Pipe�Undrgmd.
10. Structwsl Ploor System
11. Properry Sewer Line & liouse Connection
12. Se�.ver Cap
73 Roof Drains
14. Rough Piumb�ng
15. Rough EleetriraLCondu�t
�76. Rough Elettric Wifing -
17. Rough tViring S�gn
18. Rough Electricai-T Brr Ceihng
79. Rough Neat�ng & Ar, Co��ditianing
20. Rough Facmry Fireplace
21. D�Cts, in Structure
1.2. Ducts, Ventilaun9 ��
��23. Gas Pipa-Ro�gh & Tes:
f,co` Framinq
7.5. floo+ Sheathing
2"u. T�3ar Ce�l�ng IS;ruc2urail & �v.o^.ucoat
� 27. Ficmeand Flashl-,g
� 1tl. l2thi�y & Siding
_7.9. InsuiatiOn
, 30 C�y:van �Va�Lng
� --
3' ',aster 3ror�r, Coac -
32. Elec?ricai Power UreterFinal '
33 Ff-,i E'ec. c
34 Fir7i Hcat�nG & A;r Co'��i�o-�:�i
35. Fina� Gas P�pe�Tect _
� 3'u. Hood or C2nopy
� 37. F,nai Fc �o�y Frepiacc _
� 33. Firal Pt�mbing
� 3�. 1Vater Service�Finai
� ---
I40. Gas Serv�ce-Fina�
� 41. �lar pomastioFinal
- L
�2. Oackflow Preventer
43. Backfiow Irrigation
� 4�. Lardscape Lnqauo^� $ys[�T
-'y '_
� 45. Sound Attenuatien
Handicap Regula;ions
Date
-� y�
POC, SPA
Inspector AppROVALS P�rmit�;=�'
` 52. Pool & [yuipment Locatifln�
53. S�eel Reinforcement .
5a. Forms - �
>5. Eler.tricat Bonding ��
56. Rough Plumb ng & P�essure Tes!
57. APPROVA� TC COVER GU' 'C
� 56. Electnca! COncu�t�UnJrgrno.
59. Gas Rpe, Cl Ur��g��d , Tesi
60. Bac4�.vash Unes. P�Trap, !'� Vn:�:-.��� �;.
61. AFPR6VAL TO UECK
62. Backwash & Rr.cGptcr Final
63. iieater & Vent�F�nai
64. Plumbing5?strm f•^a1
65. Elect�+cal�Final
�66. Solar SYs.em�Final _ �'
--�-
i
Date Inspector I
I �
67. Fencing & Accse� Aop-uvai �
68. APPROVED fOR'LASTERING �
�__�J�
69. POOL�SPA SYST�A15 FINAt_ _' _
FIRE DE°T. fiEQUIRENii ���T i
AP'ROVALS P:::mit :---- I
70. UndergiQund H��-io -
77. Product R:ping I. Cat ._' Oil �
-'-_ _--- I
77.. Under,rpw'�J � I,,; i
-- ______ _.__ __ �__
73. U�.dc�grntl_�:-i_.�_�_--r� C7G.s . J I
?4. Ovcrh;eaci NYaio _ ____ ____��
_ 75 Dry Cnem:u'
_ 76. Dry Star,cpr� -------
f 77. FIXED SvSTE�.' r INAL
� - - =-
� -
�
7E. FIR!: pRcV. Fi��:AL � � _�
- -- -1 --
hiEALTH DEPT. REQUIREi,iEA�-
79. FI\'4L 1;1`.;�[CTiQN ----- _- -- -- }_ ,
�80. FOOD CERTif ICATE ISSUED '
-� - -- �/ -- - -� -----� - - ..
--�N�t 5 l� Q-3 /"a One �ivw-e �'�--_
_ -= 3 -� �- � �- _---_ -_ ;
�!- " _C "3 d_�cr�.e-�- �.b�j6�w�a�y_� �
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- -�o _oi Y i3 oaT�•r✓� /wGvvt.lSeT _ .
� �/ t1�--6�u-wC4: m/� �iC�/�/G �
- �� __. _-' ___ - _1
47. FI,1AL STRUCTURE & BUI�DING Q_Cf_G��_�
_ v _^[
48. f-INAL PLANNiNG ' �'
45'. ciectric Release to Edison � � �
50. Gas Release to Southern California Gas Cn , � �
Date
CITY OF COSTA MESA
2 � � 20 Building Safety Deparfinent
Application 4or permit for ihe fabricotion and erection of classified signs.
Location
I Building Site Address
Ta9 No. !9� FEE RECEIVED
Type of Sig � '����- D6C 4 T9b�3
❑ Elec. �,r,o�-eie�. FINANCE DEPT.
Name oF Leasee MAC C T� "�= d� T� Phone
Con�racfor C� AaTir�� lC N �Ei � State License No. ZO% ! SL—
Address7111 �.ti . S� �� City �1.1�14 �:N11 Phone K� 11 ��,
Arc�-"ecf or
''�neer State License No.
Address
ty
I Descripfion: �ract $ign
� Appurtenant and Incidental Advertising $ign
❑ Off-site Advertising Copy $ign
Phone
❑ Roof Sign
❑ Gas Tube, Elec. Sign
Sec. 1.37, 1.44
Two copies of plans and specifications shall be submitted with application for permit for each sign. Plot on plan
sheets proposed location of sigh and locations of all other signs at site. Minimum size sheets SHALL be 18" x
24" and non-erasable.
� If between property line and established setback line, owner is to sign written agreement with the City.
$ionature of Property Owner
Date
The undersigned hereby agrees to fabricate and erect the advertising structure within the intent and meaning and
in sirict accordance with fhe provisions of Ordinance 63-13, Ordinance 344, ihe Electrical Ordinance of ihe City
of Costa Mesa, and all amendments thereto.
ALL APPLICATIONS MUST BE FILLED OUT BY THE APPLICAN7. ALL FOOTING, FRAMING, ELECTRICAL
AND FINAL INSPECTIONS SHALL BE CALLED.
$ignature of
Permittee �
Authorized Agent
Recd. by � Date
FORM BU-30-1M-'//63
The amount shown under Valuation is for the purpose of
establishina a oermit fce onlv
VALUATION
s �7_50 �
5�
Permit Fee $ �
--�
Plan Check$
�
Total Fee 5�
CITY OF COSTA MESA
FOR OFFICE USE ONLY
Date Issued ,�� G� permit No. ^//d�
Fire Zone Type / Group
Approved by Date/ % .
PLANNING DE RTMENT
Zone II�� A. P. No.�✓�b.�, `7D� �-
BIdg.Site Address �-(g ��
Legal Owner %_�C�--C/C.�/
Address /
City
5� P,
Area of Sign: /�ft. in. X�Qft. in. =.36-0�
Required Bldg. Setback To�� �
Center line of Sfreet
Location of Sign:
Behind 61dg. $etback Line �
Between Property Line and /��'
Bldg. Setback Line ,�Q �""'`�
Front '3 S Feet
Right � F�eet f� �
Left �� Feet "�/< �%I�mLs't-�
Projection �Feet
Ground Clearance� Feet
C. U. P. C. Date Approved
Clearance Chap. VIII, Art. 5. Section 8504 (b)
Clr� � l�c.��ti- — �i(
$ignature (Planning $taff)
Signature (Dept. of Public Works)
Da te:
T�p. T8s #196
JOB ADDRESS
UENliRAL CON1'RACfOR
BUILllING PERMIT N0.
SUBCON7`1LACTOR
�SiG7�l
�i �n��q
iSTA MESA BUILDING-SAFETY DEPARTMENT
V.O. BO%91] C09TA MEBp� CpLIROPNIA
For Applicant fo Fill In Complefaly
TYPE OR PRINT
COSTA MESA, CALIFORNIA
88 3800 E. Coast Hi
Corona del Mar, Calif.
; _�_.__ :
.............. _. ......
� �
FEE RECEiVED
ilUqLR � 5 1963
rPIVHIVBUILDING PERMR
ClTfoq foitf�"eT,!►s&1Ec3Aly
C ` R[C61'T NO_ _ ^RMIT NI
—� �
,Ntii' � � .,.7, R2%/�3 � .. .�� ��e��
ZONING
ZONB NO. OR U8H OF
R-1 �une .�� ew�ni
L60AL _ _ � � _ .
c�rv SAME AS ABOVE A� P� NO.
NOTE: NO EAVE OVER'.
LIC.No. 207343-A-SB-1No•priole 3-4220 90'TOSIDEBREARP
SIZE 5�� �y Q� ,OFBLO ' ALLOWED
OFLOT �//'�/X NOWONtA �nOn
YARO9APPROVED
USEOF none MAINBUILDING
EXISTING BLD6.
f FROM GL STREET]
BETBACK LINH PROM � 1G11 pRONT 1T.
CENTER OF BTREBT SO RHAR VARD 3S Y
61DH YARD I LEFT 13 � I p�p� p� R. 81DE Ff.
DESCRIPTION OF WORK L.SIDfi 3 r�.
'x41'6"
SHALL BE LESS THAN
VARD9APPROVED
ACCESSORYBUILOIN6
I DISTANCE BET. BET.I
�L�HH MAIN BLOG9. ACCE
VAR.# � DATE
TORIHB 2 4 U. P. iF APPR
shske e�wnovco W.L.D. .,er�
I HEREBY ACKNOWLfiDOE THAT I HAVE qQ,�D TXIB �PPLIC�TION
•NO BTATE TXI�T TNC ABOVQ 19 CORREL`{ AryO /�OHEH TO COM�
PLY WITN �LL CITY ORDIN�NCfiB AHO B7�T[ LAWB R[OULAT�NO
BUILO�NO CONBTHURION.
PERMnITfEEOF M8CC0 C81C Company
AUTHORIZ�ED A ENT � �--
N
$Q. �. �
THE AMOUNT BXOWN UNDHP VALUAT�ON I6 FOP THE F
PURP096 OP 68TABLIBHINO • PENMIT FEE ONLY. p
VALUATION �7 m
� PERMIT FEE $ /��� �
J
s 23,925.00 A c E� / �SO o
TOTALFEE • /���/D LL
JOB
or
DESCRLPTION OF
DATE
C9
SUBCONTRACTOR
f r�
� �3se�
i:.'OSfA MESA BUILDINGSAFEfY DEPARTMENT
P.O. BO%917 C09TA MBHp, CALIPONNIA
For Applleant fo Fi!! In Completely
TYPE OR PRINT
ILDIN6 � gSo �/oNTE17E j
DRESS
COSTA MESA, CALIFORNIA
/NER I�A V G D. F_ .U� 17A�
S
��
■ BETBACK LINH FROM
GEL. � O^
�
NO. OP BLDaB.
DESCRIPTION OF
NO. OP
�RO�OMB
h ROOF
r G^ EW G D V�
O c TO -
1 HBHEBY ACKNO�yLE00! THAT 1 HAVQ qBAD iX19 APPLIGTION
AND BTATE THAT }Hg ABOVe �B COHHECT AND AOpEB TO COM.
PLr WITH wLL CITy ORDINANC88 AND BTATB LAW6 fl80ULATINO
BUILOINO CONBTRULTION. .�C____-;�
SIGNATURE OF �a��--b'-��
PERMITTEE � Y� �
AUTHORIZED AGENT
NO.
U9E OR NCW �/ V
euaoiHa F
� ,-I-R 5� 1;
A.P.NO. �T����—P /�
NOTB: NOBAVEOVERHANOBNALLBHLLS9THAN
YARDS MPROVED
MAIN BUILDIN6
(FROM GL8TRH6T1
VAR. iY
YARDSAPPROVED
ACCESSORY BUILDING
oare
,r.�
0-j� N
o c. so. Fr. "
TXe AMOYNT BXOWN UNOBR VALU�TION 18 FOR TXE S
PUPPOBE Op 89TABLIOHINO A PERMIT F88 ONLY. �
VALUATION � �� m
PERMIT FEE �
�
� m
$ ,2C��d =
/� 0
� L" 4