HomeMy WebLinkAbout195 MORRISTOWN LN - Building Permits AD ESS OF BUILDING: 195 MORRISTOWN LN UHT: . CITY OF COSTA MESA - BUILDING PERMIT
ONNEWsCOME IF 1040YRA HILL, LYDA MAY,TR PERM NO: B 073483
ADDRESS: 195 MORRISTOWN LN S
i
COSTA MESA,CA 92626 PERMIT NO: B 073483 PLAN CHECK NO: N GOVT: N SUPP: N
AP PL.MMLINGADDRESS, CONSTRUCTION TYPE: VN PERMIT TYPE: SIR PURPOSE: OTH
ARCHITECT OREVGNEER: UC.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 2, 999
ARCH.OR ENc.•s ADDRESS: LINT: CLAIM VALUE: 2, 999 . 00 CALC-VALUE: 2, 999 .00 GROUP OCC: R-3 /
CONTRACTOWS NAME: STOUT ROOFING INC ( 310 ) 923-6775 ,
CONTRACTOR'SMNUNG P 0 BOX 4309 COMMENTS: SMOKE DETECTORS ARE REQUIRED PER 91 UBC
ADDRESS DOWNEY CA LE.NO.: 402536 *********************iEiEiE+ERESERE*RE*AERESEAEfEstat****RERtRERERtRE****SE** SERERE**RE*REx*RERtitiFiEiE*******
90241gNT: ZONING REQUIREMENTS
•UCENSED CONTRACTORS DECLARATION:I hereby affirm under penal:"of niury that I am licensed under pr of Chapter 9 SETBACKS
(commenting with Section 7000)of Division 3 d
the Business and Profession and my license u in full farce act.
(Clrruc.NO.: 059377 u cu . 0 39 UC.N . 4 253 EXP 10/9 MAIN BUILDING ACCESSORY BUILDING
�FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
\Dale: /7"1:1/I- Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License w fon the
following reason(Section 70315 Business and Professions Code:Any city a county which requires a permit to construct, r,improve, PARKING REQ: PROV: PARCEL: 41916572 Z NE: REF NO:
demolish.or repair any simcaoe,pdor to its issuance,also requires the applicant for such permit to fife a signed statement that he or she PLANNING NOTES>,
is licensed pursuant to the provisionsthat
of the Contractors License Law(Chapter 9(commencingl with Section 7000)of DNeon 3 of the '>' -
Business end Professions Code]Of that hes she is exempt therefrom and the basis for the alleged exemption.My violation of Section ..0
7031.5 by anY applicant for a permit subjects the applicant to a ckdl penalty of not mere than fire hundred doilies lS5001). *******************************************************************************
❑ I.a9 owner of the property or my empbytes with wages es lhei cote compensation.will do thew rk,and the avucture is not intended D E V E- L OPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an owner of property .
who builds or improves thereon.end who does such work himself or herself a through his or her own employees.presided that such
improvements are not intended or offered for sale.If,however.the building or improvement is sold within one year of completion,the ZONING APPROVED-•B Y DATE: n.
ownerbuider will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the property.any exclusively contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE: ,./s4Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who , t
contracts for such
ElIamexemptunderSection: B.8P.C..forthisreason: APPLICATION ISSUED BY: DATE:
projects with a contractor(s)licensed pursuant to the Contractors License Law). .
*************************************iA
** ********** ********4e* **
Dale: Owner LEGALIZATION:N F E E MRY STRUCTURA SEGMENT:Y
I do hereby certify that I are aware of and understand the requirements of California Heahh and Safety Code Sections 25505,25533.and
25534,and that l or any future building occupant will/wd not(circle one)need to comply with said state codes and the requirementsb BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modification from the Ar u6-Tety Management District.Residential construction applications we exempt from these PERMIT 54 .00 . 50
provisions.
SMIP/NON-RES
Date: Applicant: PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declaration: ISSUE FEE
❑ Ihave and will maintain acertificate of consent toself-insure for workers'compensation.asprovided for bySection 370Ddthe Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
������,,,,,,////////////CCCCCCode,for theperormance of the work for which this pent is issued. TOTALS----> 54 . 50 0 . 00 0 .00 54 . 50 54 . 50 .00
have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
ork for which this permit is issued.My woken and poky number ere:
Carrier: �g giy�q'aarenaewm.n EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: .0 .0
PolicyNumber: 0449400004687 10/19 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed i the name isfor one hundred obi. - •tjor less.) 54 .00 . . 50
❑ toenesubjthat ecdthet performance oflhewnsk do whicb of this permit lehellnd employ hould �d to
es to *******************************************************************************
became at to the waken• the work
of compensation lgboor Cdirmn. agree f aloud .,...• y Lied tot waken'
s. pemeatom wer a✓d Section 7 s Code.I �j• /h nom moan•:Aar / . INDIVIDUAL F E E BREAKDOWN
Date: ApptimnL .
Warning:Failure to secure workers'conpensafon coverage Is unlawful,and shall subject an employer to M I penalties and TYPE QTY DESCRIPTI 0 N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollen($I00,000),In addition to the cwt of compensation,damage as provided for In
Section 3106 of the Labor Code,Interest,andattorney''sfees. SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 999 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES
performance of the work for whidt the perms is issued(Section 3097.Civ.C).
LENDER'S NAME: •
LENDER'S ADDRESS:
I certify that I have read this application and slate that the above information is mated.I agree to comply with all city and county ordinances
and Mate laws relating to building constructers and hereby authorize representatives of the sty to enter upon the above-mentioned properly
for inspection pa"Al,ARL ENE BURFIlep ,
7 . Prim/Name "worn Data'. / �2 /
SignaownadAgenuAppranucomredor 01 00187116-00137117 T CE T 54.50
DATE: 07/28/95 TI(1=: 09405
(5151-46.WP) White-Building 11 Safety;Green-File:Caney-Appicant;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING 'POOL & SPA
-•, 'APPROVALS Permit# - Date Inspector APPROVALS ' Permit+ Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
2. Soil Pipe-Undrgrnd. y 53. Steel Reinforcement •' -
-_3. Electrical Cond&it Utility-Undrgrnd. 54. Forms
''-;4�. lectrical Condmt-Ltrtdrgrnd. 55. Electrical Bonding
•}�a".tee( Reinforcement 56. Rough Plumbing&Pressure Test
uv0
�
' rElectrical UFEGrnd. r 57. APPROVAL TO COVERGUNITE •
^7:Footings S j 58. Electrical Con uitUndrgrnd. cr.
-..'"'87 Foundation _4 t - 59. Gas Pipe, 0 U'rrtf rnd., Test ,
:-,9: Water Pipe-Undigesid.a 60. Backwash Lines, -Trap, b Undrgrnd. ,
10. Structural Floor System I 61. APPROVAL TO DECK '
11. roperty Sewer Line.& Hous'Connection 62. Backwash & Receptor-Final'
12.c.Sewer Cap - '
63. Heater & Vent-Final
13. Roof Drains _ 64. Plumbing System - Final
14. Rough Plumbing m • t 65. Electrical-Final ,
15. Rough Elecirica;Cdrduit 66. Solar System-Final
U
16. Rough ElectricaNiripg 67. Fencing & AcceSs'Approvaf
17. Rough Wiring Sign T 68. APPROVED FOFi PLASTERING
• 18. Rough Electrical? Bar Ceiling - 69. POOL/SPA SYST-EMS FINAL •
19.Rough Heating&tA Conditioning _ * Cr FFLR�,WDEPT-REQUIQEME1 T .,
20.Tough F :to&v F eplace _ C< 4 APF$O'4k E J Permit# : -
21.;1 udts-,iri=5trituie' x S "* -" 70.Z1ndeirF�yv'ad t dro
• c x -e �J r-, (-1.* i. ,-, 9r5d,L
22.4)luctf, Venti(gting,•Y "q xZ. c,' .' r-*s 71. ProdtictPiping fl as -E Oil
23. JGas4'ipe-Rotirh & hest ' Tr' t*' cr Q O* 72. Under tqund ETush `-
.L r, rte• �� x SKr 9_ y .a! n,
24.'Roof Fr�ping S* x › a x
�* ?7 * _ r 'H= • 7 . Undergrnd.Staff' ank OGas ❑Oil
25. Roof Sheathing _F II
•- i 6 74.1.-Overhead HYdCo_ '
[v� l x
26.:F-Bar Ceiling (Str plural) &471'411'5c"oat * ,7 > Mill 7 cbry Chemical - _. * m
27.oframe and Flashirrgw w >• 76. Dry Sta papa .x _ Q
' at V '-.4 Y., X .. x Al.
x rr
28. Lathing lSi ng ;. ye x •� ! 7�j, FIXED-SrSTEii FINArL- ;�
29. Insulation • '-y S •. •- •' t s, I r iii-. FIRE PR EV. FATAL � ' >
• S
30. Drywall A7ailmg -Ci; -1 lc .^ I I# c -i HEA LTTH DEy,7�REQUI�EMENT
31. Plaster Brbwsl:Coatr S • "L I x r 79. FINALTNPECFTON `- _
32."IectricatPawpr fW,ejer- cinal i x• Lr 80 FOOD CERTIFICATE ISSUE4 ,r:
33.-. inali Electric H rr ! 5 r F Nates: -n 'i O '_
._ N rt x S :a F .ri. y is
34. inaXHeg2inat Airs Qp6itiohi n t' _ S * `_ "
nt i( t _ d, F
is iP 'T i4* O �=
35.;Einal Ga PI s. e .J « .-; ! t« _- • • a0 �..-+ c ~ ,
.' 36..k1 RC S.a =rc r� 1 ' ' F _ r qtr
yo ora noPY ' „ {• ? Sr; * I m K ? _
-
37.I'Rinep
altFacnory Firlace T. ?- -4. L ix T * cu
`- t.tZn
38. Fina1'Plbipg = * cu ! l� S 9 . *- W �___.-.
- 39.39. Wate?Seryice Final r z cc ' I '-'• % S
Y T ,
• 40. Gas Ser Se-Foal xtr.� n r *
c • - x _ • :g
Y Y•
41. Solar Doraes c-Fina f I ' M` - `o
p' 'd I x * c
42.ilackflow:Preventer4, '.'..1- * .4 `^ -ter' ' * :.1 `'
CI) 7.:--t i-t 4 Y 7:�U * F
43. backflow Irrigations y * a, * n c
* , n o
7:4t7 r N
4. ,Landscape IrfigatioISystem=< Tr' r. a ,e* _ E zti' * S tU O
<
45. ound Atterivation.. • * _+1 ;ex G^ • t--0 .:
26. Handicap Regulations x S • I T •S ,. r
dI7.-INO.L STRUCTURE 81 SUFEDINC it.:3-4s " -i w
' : t -
*
• r n
48..FINtAL PLANNING; 1 '-" * RI .X Ite )! :i
r
49. 'ilect(ic Release to k'dison * i I ;y � e : `,
- _ . :.p , I"
-60.*as Release to Southern Caticotpi Gas Co *F
-51. CERTIFICATE OF'OCCUPANCY "' S tJ - -.
No. Date
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA P RMIT NO. '..TRACT'NO. LOT NO. BLDG.NO. 1i692 B/26/E;, Fs:
CONSTRUCTION PERMIT • 1 p— gss ) TL
•
Applicant's Mailing Address - :.: /1-12 X1.12--1a-r-'e-1-7-4---) TYPE OF CONSTRUCTION U NEW U ADD. ❑ ALTERATION U REPAIR
Project Address /9 •' - '/�-'- ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
•Sf1s-4'c49 DESCRIPTION OF WORK
Owner's Name
Al644' Phone / - ZONING REGULATIONS
Address // '2-770.te-•S 7- ,1-'---- • TYPE OF PERMIT U GRADING Ig
FOUNDATION U STRUCTURAL A.P.# - ZONE
•
Arch/Eng, License No. 0 TENANT ❑ ELECTRICAL Iql PLUMBING ❑ MECHANICAL PLNG. REF.9W BUILDING j
Address /1` ❑ OTHER TO BUILDING cPTgvey rn Sr
Contractor's Nam` - - - ��-2'-r-1 �Y'a-j`�!d PROJECT DESCRIPTION SQ. FT. OCCUPANCY PROPERTY LINE REAR YARD (TO P/L)
•
Address(mailing) e-0 /• Cd •(Porn oy-�.i .5�a'--' CONSTRUCTION TYPE VALUATION S:
LEFT SIDE YARD RIGHT SIDE YARD
• !/1 '2 a. 4-, ZONE GRADING CU.YDS. ACRES PKG.SPACE REQ. • PROVIDED
License No. __ J i J
LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH PARK FEE$
I hereby affirm that I am licensed under provisions of Charter 9(commencing -
with-section 7:00) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: •
my,license is I. full force .., effe •
b '
License - -' - can No.��l2C PLUMBING
Date' -w Signature / • , R--'Ar4
WORKE-5'COMPENSATION DECLARATION Bar Sink Sewer Cap ELECTRICAL
I hereby affirm that I have a certificate of consent•to self-Insure or a certificate Backflow Preventer Sewer Connection Automatic Washer Meter Clover 10D amps
of Workers' Compensation insurance, or aicerti i d copy thereof (Section - •
• 3800, Lab. C.) I/ ___ Backflow Irrigation Solar Collectors Construction Pole Sub Panel
Policy No. �39 2/ � //JJ Comps � s _.o- Cooking Unit Sub Pole
C Certified c y is hereby furnished. ; Bathtubs Solar Piping •
Tc./Caroli opy is filed with the city Binding ishon� \/tiDishwasher Motors ❑0-1 HP ❑1X-8
Date Applicant T�/�•.1 0 Clarifiers Solar Tank _ • ,
EXEMPT ON FROM WORKERS'COMPENSATION DECLARATION / - - Dryers ❑Gas ❑Electric , Inc.Solar 09-15 HP 016-15+
(This section need not be completed if the permit is forgone hundred ($100) or C� W45her� iy�dy� Swimming Pool w/Spa p? �- —
less); DrinkingFountairis P`�� Urinal • Fan• Microwave
I certify that in the performance of the work for which this permit Is issued I
shall-not employ any person in any manner so as to become subject.to the - • F.A.U. Pole Light 7 1
Workers' Compensation Laws of California. •• Floor Drains Water Closet
Date Signature Fixtures ' '
NOTICE:If,after making-this declaration,you.should become-subject to the Floor Sinks • Water Heater• - .Range ,
Workers' Compensation provisions of the Labor Code, you must forthwith • Device Boxes i i •
comply with such provisions- or •this permit shall be deemed, revoked: Gas Service Outlets Water Service Sign.
CONSTRUCTION ,LENDING AGENCY Outlets StandingSections
I hereby affirm that there is a construction lending agency for the performance Interceptors
of the work for which. this permit is issued (Section 3097 Clv. C.) • - Switches ' Trash Compactor
Lender's Name Kitchen Sink ,
Lender's Address ' Lavatories - Garbage Disposal
OWNER BUILDER DECLARATION' ' ' . . • /
I hereby affirm that I am exempt from the Contractor's License Law for the P-TrapGenerator ❑D-5 KW ❑$-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or - '
county which requires a permit'to construct,alter improve,demolish or repair - • Transformer ❑15-50 KW
• any structure, prior to its issuance, also requires the applicant for such permit ' Roof Drains '
to file a signed statement that he/she Is licensed pursuant to the provisions of 050+KW i ,Reinspection Fee $15
the Contractor's License 9 (commencing with Section 7000)of Reinspection Fee 1
Division 3'of the Business and Professions Code) or that he/she-is exempt Showers $ 5 Meter ❑u to 100 amps therefrom and the basis for the alleged exemption. Any violation of Section . P P Issue Fee $ 3
.7031.5 by any applicant for a,permit-subjects the applicant to a civil .- • -
Service Sink - Issue Fee $
chatty of not more than five hundred dollars($500): S Zoning Approved By Date
•I, as owner of the property or my employees with wages as their sole MECHANICAL
compensation will do the work,and the structure is not intended or offered Application Approved By • Date •
for sale (Section 7044; Business and Professional Code:,The,Contractor'sc-
,
License Law does not apply to an owner of a property who builds or improves Boiler Refrigeration System Application Issued By -,/^'. ""/ Date a / -orl g3
thereon, and who does.such work himself/herself or through his or her own •
employees, provided that such improvements are not intended or offered for - Duct-Under Ground ❑0-100,000 BTU ❑100,000 BTU
sale, If, however, the building or improvement Is sold within one year of com- SUMMARY OF FEES '
pletion, the owner'will have the burden of proving he/she did not build or im- - '
erove for the purpose of sale). -. Duct-Structural - System Repair/Alteration BUILDING PERMIT $ SMIP i $
•
U 1,as owner of the property, am exclusively contracting with licensed con- •
.tractors to construct the project.(Section 7044,Business,and Professions Code: Duct-Ventilating _ _ • f PLP,N CHEG14 $ PERMIT
The Contractor's License Law does not apply to an owner of property who PL MBING • $ Si 00 ISSUANCE $
builds or improves thereon,and who contracts for such projects with a con- ' • Exhaust System 0 Multiple 0
tractor(s) license pursuant to the Contractor's License saw). 'PLAN CHECK $ GRADING , $
0 I am exempt under Section B.& P.C.for this reason ' Firepl/Fact.Bit.ICBG I* • $
Date owner Heating System& Ducting
ELECTRICAL $
• ❑0-100,000 BTU ❑100,000 BTL PLAN CHECK • $ . MICROFILM $
ifor at certifycorrect.rect I have read ims application all and state thatordinances
the-above - TOTAL FEE $ : '
Information is ogre o comply with all city and county r n res MECHANICAL $
and state laws rely ing !fig construction, and hereby authorize repro .
sentatives of.thi Ity to ant p the above-mentioned property fo/ Hood or Type I 0 • Reinspection Fee $15 PLAN CHECK $ LESS
inspection purpo {{ - / SCJ (y'-�./. Canopy Type II 0
ADVANCED PC $ r
9gnaiure \ t �` � • Date• O T Registers • • Issue Fee $ 3 •
FINAL FEE . $ u'on
Drivers' License orSS
CMF 0865-46 rev-12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - -
-,'CONSTRUCTIONAND,PLA NG- _ - _ - POOL&SPA . _ " - - -_
Date ` Inspector , Date Inspector
'APPROVALS .' Permit 4K APPROVALS - Permit# . - _
r' 1L Temporary Electrical Service or,Pole c ' 52. Pool & Equipment Location _ t _
: 2: Soil Pipe-Undrgrnd.- f , - {: . :- - 53. Steel Reinforcement _
.. 3; Electric•al
; Conduit Utility-Undrgrnd. ,� - , 54. Forms - ; - -
''`r 4 Electrical Conduit-Undrgrnd.` - , x j : ,' ,55.; Electrical Bonding - -
5: Steel Reinforcement 2, : - - -' ,j ' _ " r- _ < : 56, Rough Plumbing& Pressure'Test _ • - , _
6: ',Electrical UF ER Grnd. "' '-i ' , '..•- 57. APPROVAL'TO COVER-GUNITE.
7. Footings . • • ' '. c - _ - - 58.- Electrical Conduit-Undrarnrl- ` _
8. Foundation 1 - a _ r ' 59. Gas pipe, ❑'Undrgrnd.,Test -
9. Water, Pipe-Undrgrnd. , . - _ '•- _ 60. Backwash Lines,P_Trap,'O-Undrgrnd. . -
10. Structural Floor System 4 61. APPROVAL TO DECK - 1 '
11. Property Sewer Line& House Connection : 62. Backwash & Receptor-Final . • • '
12. Sewer.Cap ' ' . , ' - r� : 63. Heater &-Vent`Final - I
13. Roof Drains . -• , , -.64. Plumbing System :Final -
14. Rough Plumbing 65. Electrical=Final
15.-.Rough'Electrital-Conduit, - ' - ' - 66., Solar System-Final - - -
--16. Rough Electric Wiring, T. '=t 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
20. Rough Factory Fireplace ' 1 , . r APPROVALS' Permit# . '
•
' 21. -Ducts,in Structure. r . ' 70., Underground Hydro
22. Ducts, Ventilating i r .71. Product Piping 0 Gas OOil ' •
23. Gas Pipe-Rough & Test 72. Underground Flush ,
• `24. Roof Framing, 0. •. - ' 1- 73. Undergrnd.Storage Tank O Gas O 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 X77: FIXED SYSTEM-FINAL ' 1
e .
_1 ',29. :Insulation - -, " • 1 , ,78. FIRE PREY. FINAL -
', --30. Drywall Nailing C ;1 ' 1 I ; ',Notes: I , , , - ,
31. Plaster;Brown Coat I
' 32. Electrical Power Meters-Final 1 1 i i :
33.'.Final Electric ' ' i I: - I i / i
34. Final Heating &'Air Conditioning
35. Final Gas Pipe-Test I _ - - - '
36. Hood or Canopy - .,, _ - -
37. Final Factory Fireplace . , ' .
38. Final Plumbing) i ,.i r J 47'n 1#fr '
39. Water'Service-Final ' I '
40. Gas Service-Final I, , ' ' - -
41. Solar Domestic-Final I' , .
42. Backflow Preventer , 1 - ' _ _ _ _ __ _ ,_ _ __ •
.
43. Backflow Irrigation : ' ' '
44. Landscape Irrigation System - - • - - -
45. Sound, Attenuation • _
46. Handicap Regulations - -' • -
47. FINAL STRUCTURE & BUILDING ' , 1 1
48. Special Requirements Completed ' 1 I
49. Electric Release to Edison ' 't - 1 _
- . 7- ' '_4_4_.._ , .J_ _ __ .
50. Gas Release to Southern California Gas Co l
51. CERTIFICATE OF OCCUPANCY ' .__ _ - . .' _ - ' ,
No . - ' / Date -
OWNER SAN VISTA BUILDING COMPANY DATE 6-1-64
JOB ADDRESS 195 Morristown Lane BUILDING PERMIT NO. 22261
GENERAL CONTRACTOR same VALUE $ 15,735.00
AP No. LOT 211 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res watt as
INSPECTIONS Signature DATEqGROUP I&J TYPE V ZONE 113
Soil T
al / 2j Iti PERMITS ISSUED
Gas SUBCONTRACTORDATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating � j� Sys 9470�H f/ // t
Rough Plumbing `� -Y in .. __, / . _t i • 72 -/-/ac/ ([1 U - 0'
Miscellaneous J ,r'/�
Prop. Swr. Line 0 House Con. t� St. Swr. 0 C1./� rfilt,1� e.16.--"Leg- (ice,..- C• DE6 °— L63 V
Sprinkling System / / '�
Construction Pole +21
Underground 0 Power 0
ITT
hes[in / Y t ? 9 y �/ „n �£2..� SEP 1 7 l96! . 4 4`A -
Trenches Forms Er Steel Reid. ❑ l(' /7/n 4
Floor System
Bond Beam 0 Steel Reinforce •
Shea thing -A , '=/AY
Frame and Flashing ., 1. q'
Frame ,e,peps.
Lathing - In p/ Out g-' .. , r- C, /G sr s Rm.Sathli {
Plaster, brown coat /: , C f0({30 /,6cc r !11
Refrig. 0 Air Con. ❑ Final ( �, one
id,�
Heating, Final /1 2- `°/
Plumbing Fixtures, Final /_/ .A.,Final Gas Test / �J V '/1
Electric Fixtures, Final -
Building, Final 9 /}/. ''
OCCUPANCY ,I /� oI •
Form 13U4-5M-3.63—S-B P ., r,,,, corm A7 ppm 1TREMENTS
• 22251
COSTA MESA BUILDING-SAFETY DEPARTMENT EE RECEIVED{Q�
P.O.BOX 317 COSTA MESA,CALIFORNIA ^1 nn'��lAYF Pt 9 `08
For Applicant to Fill In Completely APPLIC. �IW,FC SER kA
TYPE OR PRINT `` AU!hi FF NNII
For Office Use Only
BUILDING /9 � .y '
ADDRESS /S �(p —p
RECEIPT NO. 22�y�1
COSTA MESA,.CALIFORNIA t,
. 1 ..{. /rnj� RECEI 8Y DAT RE IVED DATE ISSUED
OWNER sam uizt0. �y lb �-' JUN 1 1964
MAIL �) / T t rrl �J ADDRESSNG
BUILDI
ADDRESS 1/4,to ` ` ; S r �jff ,
FIRE
TEL ZONE TYPE ?Z GROUFL']^`T��
CITY A: M. // No/9D37/217
APPROVED
ARCHITECT ocadi v/ TEL ) BY DATE
OR ENGINEER QC.RiVQ/AC4.V NO. 37O/6
(,(�� 41.34g:
A•A�"�'��- ZONING
ADDRESS 3932- J/w' Y — \IIR-o�/L 'V P•�l, - a/• til
YVVV���— ZO! NO.OF USE OF N
per^ _ / PLAN BUILOINQe p ' �i
CONTRACTOR /✓[A!/ L C ,A//�-T/�}-�//G�[/VY ,/ ./. {�-
ADDRESS i b.4 6' J O IA s DESCRIPTIONr_I/A4c t SAGO 1 [/�/'-et £h1
CITY 17�1 E. // A.P.NO. ( `// ,3L( .•• --Cl
-
NOTE:
I.
9p/782
;701-4.0
O QO 37/17
30"r TO SIDE B REAR P.LNG SHALL BE LESS1THAN
LIC.NO. Q� O rL A�, /
EAVES
SIZE /'1 D y '7 NO.OF BLDOB.O ALLOWED (U.B.C.REQUIREMENT)
OF LOT oC A / D NOW ON LOT
YARDS APPROVED YARDS APPROVED
UXISTINSE OF G BLDG. /�/)7V' '^s-'� MAIN BUILDING ACCESSORY BUILDING
E
(FROM C EET) ' N.
SETBACK LINE FROM /3 • d FRONT 5 FT. FT. „LsCENTER OF STREET 1 REAR YARD
o
SIDE YARD LEFT 0 RIGHT 0 R.SIDE //rC7'��FT. FT.
DESCRIPTION OF WORK L.SIDE OFT. /yJ¢�� FT.
NEW X ALTERATION ADDITION REAR / FT. \ J FT. C"4
DISTANCE BET. BET.MAIN&
flR
MOVING DEMOLISH MAIN BLDGS. ACCESS.SLOGS.
ING NO.OF /PIAny& VAR.# DATE
a o x 31/ ROOMS y` SeTORIESo a G.U'��P'A'�yq}�7�i!'��\'�J�� .�(�_ APPROVED /`l
IN WAItcI COVROVFERING LLA QM BY 'v y ' \QDATE.T di.s _jRING Sqt AND F LDIN AND WORK TO BE PERFOR lam
P.2. oiT
,// fr
12
ns
-� / SQ.FT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOW ODER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTA ISHING A PERMIT FEE ONLY. Q
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION //I .w'1 q
BUILDING CONSTRUCTION. PERMIT FEE $ �/ . V V
SIGNATURE OF
PERMITTER Jr735. m
$ � PLAN CHECK $ O7S�0 O ��e+
AUTHORIZED AGE 76 LSD E 'Vp
TOTAL FEE $ / ` o/ '6