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HomeMy WebLinkAbout1710 MISSOURI ST - Building Permits `' , o y CITY OF COSTA MESA , BUILDING DIVISION I/I- 1 ..7...7. 4,� ' DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT NUMBER P98-00781 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1710 MISSOURI ST Status: ISSUED Suite No Applied: 10/14/1998 Issued: 10/15/1998 Vicinity: Parcel Nunmber: 13906213 Applicant: MC NEALY, DANE • Address: Phone: , Zip: Owner HOUSE, LENARD - - Address 1710 MISSOUTRI • Phone: COSTA MESA,CA Zip: 92626 , , Contractor: APPLIANCE INSTALLERS, INC .Address: 3823IDUSTRY AV - _I Phone: 562-595-4500 \ LAKEWOOD,CA , .. _ - - Zip: 90712 License: 594282 Arch/Eng: Address: • Phone: Zip: License: SCOPE OF PERMIT , INSTALLATION OF A NEW DISHWASHER,CHANGE OUT ONLY • FEE SUMMARY - - AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 ' 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 . r Process Piping(per 10 ft) ,$0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkfiow(5+) $0.00 0 Dental Units - $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $8.75 1 Sewer Cap for Demo $0.00 0 ' Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect . . . - $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0- Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 ' Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen . $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $30.75 COMMENTS/SPECIAL CONDITI S 1W, 1G 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 period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) ❑ 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 workers' compensation laws • - ' • :•ree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these• f� Applican.Slgnetu e _ GDate:• r o—t J S/5 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# , ' Class# Contras Stgnbture: L.� -F �' cD81� � --� — %C7:- CONSTRUCTION tj CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). • Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,end the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements ere not intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,end that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas et standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management end Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification end filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (if'yes",the facility must meet the requirement of Sections 25534 end 42303 of the California Health and Safety Code). 7 If e permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (if yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ig al Owner(s) - Dater., AI1d/Or:Authorized Applicant Date. GOOF F, INSPECTION TYPE GATF =ALS OM INSPECTION TYPE OATS gIDDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical - 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wail 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 ADDRESS OF Sim nue, 1710 MISSOURI ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT OWNERSNAKEII ): HOUGE, PATRICIA G FLOOD: AE-37 PERM NO: B 071672 r : 9540 WESTBOURNE CT CYPRESS,CA 90630 • PERMIT NO: B 071672 PLAN CHECK NO: N GOVT: N SUPP : N APDL. LING WORM CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT - ABCHRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/O EXIST ROOF, APPLY NEW 25 YR SHINGLES SQ FT; 2, 400 ARCH.OR ENG.'S ADDRESS: UNIT: • CLAIM VALUE: 2, 400 . 00 CALC—VALUE; 2, 400 .00 GROUP OCC: R-3 /M-1 CONTRACTORS NAYS YOUNG ' S ROOFING ( 714 ) 953-5444 CONIRACTORSMNUNO 100 S HATHAWAY COMMENTS: T/O EXISTING ROOFING 6 APPLY NEW 25 YR COMPO SHING ^p p® � °,TOR ADDRESS: SANTA ANA CA uc.la.: 568560 ** '*'+A+('* '**'**+(' '************** '*****+F*****aa*�Hir*it+t****K'*+H+E***it'�a'f�tir'+ 92701 urT: C000 Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION'.I hereby allies under panel,d perjury Mat I am licensed under provisions d Chapter 9 SETBACKS REQUIRED (commenting with Section 7000)of Division 3 d the Business end Professions Code,and my license is in full forte end effect. CRYDale' o.NO.: 048128 uc.cuss: C 39 LIC.N_ o.: 568560 EXP : 08/95 MAIN BUILDING ACCESSORY BUILDING •3—Z9 9�5-- Contractor: { i FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Data: LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt 1• the Contractors License law for the following reason(Section 7031.5 Business end Professions Code:Any city or county which moor a perms to construct.alter,improve. PARKING REQ: P RO V: PARCEL: 13906213 Z NE: REF NO: demolish.or repair any structure,prior lofts issuance.also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES> is licensed pursuant to the provisions of the Contractors license Law[Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code]or that he or she ls exempt therefrom end the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the applicant to a mil penalty of net more then(we hundred dollars(55000. ******************************************************************************* o 1,asownerotheproperlyormyemployeeswihwagesastheirsolecompensation,willdoMewwk,andthdstmcureisnetintended DEVELOPMENT SERVICES R E U I R E M E N T S or offered for sale(Section 7044,Business end Professions Code:The Contractors License Lawdoes not apply to anOwner of property Q who builds or Improves thereon,and who does such work himself or herself or through he or her own employees.provided 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 BY owner-bolder willnot buildd have the burden of proving he or she did or improve for the purpose sale). DATE: o I,as owner of the pr penY,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY Professions Code:The Contractors License Law does net apply to an owner of propend who wills or improves thereon and whoDATE: contracts for such projects with a contreaor(s)licensed Pursuant to the Contractors License Law). o APPLICATION ISSUED BY; 1 , S / i DATE: 312, ( I anti exempt under B.A P.C., th' reason: 11K((31Fe F 1 3 —zLi = 93 ************************ **** *** * ***A **** a******************* ** *** — Date' °NeC LEGALIZATION:N F E S U M A R Y STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Health sty Code Sections 25505,25533,and 25534,and that I or any haute building occupant will/will not(circle one)need to comply wi said state codes and the requirements for epermit for wn,,rooroncmmod;ficationfrmthe AiWanagement District.Residential COMOUclion appiC131iOni ere exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING Provisions. PERMIT 54 , 00 . 50 Date: Applicant: PLAN S M I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury an of the following deduatkes: ISSUE FEE o I have and MI maintain a certificate of consent to self-insure for workers'compensation.es prwidedfor bySection 3700al the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the performance a thework tor which this permit i.issued. TOTALS----> 54 . 50 0 . 00 • 0 . 00 54 . 50 54 , 50 . 00 c' ❑ I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued.My workers'compensation insurance carrier and policy number are: Carrier_ FREMONT COMP EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 , 50 OVER/SHORT; . 00 Poky Number. WP94-329900-03 04 /24 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ' (This section need not be competed I the henna is for one hundred dollars($0001 or less.) 54 . 00 . 50 o 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 r _— become subject to the workers'compensation lava d California, and agree Mal H 1 r wbj become ed to the workers' ******************************************************************************* compensation provisions of Section 3700 d the Labor Code.I shall forthwith comply with provisions. Data; 3— .2'-‘7^ 9 C' Applicant: INDIVIDUAL FEE BREAKDOWN Warning:Failure to secureworkers'compensation coverages unlawful,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST to civil fines upone hundred thousand dollars/5100,0001,In addition to the cost of compensation,damages n provided for In Section 3706 or Me Labor Code,Inrerss4Ind'homers lees. SFR 2400 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 400 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penetty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permi is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: EXPIRED T\��L-T cais ca I middy that I have read this application end stale that the above information red.l agree to comply with all city and county ordinances Y L L end state laws relating to wiling construction and hereby authorize representatives\� of this city to enter upon the above-mentioned property • for inspection purposes. i GH ( L f e V& DATE - 961 . Print Nene/ 2cr^ 01 00178123-00173924 T n T 54.50 / Dae: 3 ! l DTE: 03/3005 rIi1E: 15:59 .—� Signature of OwneriAgenvAppticenlrontred' (5151-46.W P) Whha-Buildi g&safety:Green-Ale:Canary-Appicant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOH .4 SPA APPermit# _ Date Inspector APPROVALS Permit # Date Inspector 1. nporary Electrical Service or Pole 52. Pool & Equipment Location - . coil Pipe-Undrgrnd. r 53. Steel Reinforcement ' 3. •Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding " .. 5'. Steel Reinforcement 56. Rough Plumbing & Pressure Test ` 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE I. _ 7. Footings 58. Electrical Conduit-Undrgrnd. _ 8. Foundation . 59. Gas Pipe, 0 Undrgrnd.. Test _ 9. Water Pipe-Undrgrnd. :, 60. Backwash Lines,P-Trap, ^ Undrgrnd. - 10. Structural Floor System r 61. APPROVAL TO DECK . 11. Property Sewer Line & House Connection 62, Backwash & ReceptorFinal` - 12. Sewer Cap .. ' - •63. Heater & Vent-Final - 13. Roof Drains - 64. Plumbing System - Final 14, Rough Plumbing 65. Electrical-Final "15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring_ 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 . ' - APPROVALS Permit# ". 21. Ducts,in Structure • • •• _ - -' " 70. Underground Hydro 22. Ducts, Vehtileting - _ , . 71. Product Piping 0 Gas 0 Oil + 23. Gas Pipe-Rough & Test - _ • 72. Underground Flush - 24. Roof Framing' - " ' • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 4 •° r:- le ayset--/�� 74. Overhead Hydro _,� "; 26. T-Bar '. Ceiling (Structural) & Monocoat -``,-, 75. Dry Chemical • - • „i 27. Frame and Flashing' r 76. Dry Standpipe - - i 1 28. Lathing & Siding , ' 77. FIXED SYSTEM FINAL - i 29. Insulation + 78. FIRE PREV. FINAL - 30. Drywall Nailing -. ; HEALTH DEPT. REQUIREMENT i 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final "' • 80.. FOOD CERTIFICATE ISSUED, - 33. Final Electric' . - . ' - Notes: • . .. 34. Final.Heating& Air Conditioning . 7 7CG-' cl - Lec-� ktce(Je� ._ 35. Final Gas,Pipe:Test - _ ; p _ :_ -4 �,l✓ / 36. Hood or Canopy . /00? 3/1-1 / " 37. Final Factory Fireplace _ d 38. FinalPlumbing :. 39. Wate'iService-Final I• 40. Gas Service-Final S . i _ 41. Solar Domestic-Final - . 42. Backflow Preventer. - ' - 43. Backf low Irrigation . r . - 44. Landscape Irrigation System ' ' 45. Sound Attenuation, .. 46. Handicap-Regulations 47. FINAL STRUCTURE & BUILDING I j. • .. 48. FINAL PLANNING ' 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY ` No -Date _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. r CIT OF COSTA MESA • • PERMIT NO. ' TRACT NO: - LOT NO. ' BLDG.NO. • c 8970 '4/1.9/84 7'3.92\ CONSTRUCTION PERMIT }} -/2 13 �p � S • • Project Address f if m �^0lpl . TYPE OF CONSTRUCTION NEW ADD H ALTERATION H REPAIR /] /.� Applicant's Mail! Address . 0G, 003. /We 140 •of.R. . ❑ CONVERSION ❑ DEMOLISH1 ❑ OTHER rf A.P.# f�I `L o )—/ Z, • 'Zone q I - , Owner's Name a/ 1�bUQ� Phone�����1�++��77������ ' D'SC TION OF WOR/• � l Li z ` e� ` I fn ./�Lt./L(a/t//� t /v• i 1.1710 � inn 1 (C! / f[ S Main Building: Accessary Building: Z Address /'��//ll ��` _ • TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front N •Arch/Eng. LicensepNo. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING N ! ❑ MECHANICAL B Rear , I Address R� 15ire i� ❑ OTHER , �r� A N Contractor's Name`4" &' r"4�=tT Phone(ngO 1 / PROJECT DESCRIPTION ..FT. / 7/ OCCUPANL5V fit' C Right G !yP D trig.- • CONSTRUCTION TYPE VALUATION$ .3 sOr-1 - K Left R Address(mailing) .-moiq PAI v i s _ E / e' A 1' Q� ZONE GRADING CU.YDS. ACR Ping. Ref.# Park.Fees $ 0 I City License No. Il '•f ri /� J U LICENSED CONTRACTOR DECLARATION I Remarks: Parking Req./Provided 4 /!/. ,4 tiney[ni CP 4�erten, I hereby affirm that I am licensed under provisions of Charter 9(commencing _ �f q G""'�,t� f�f with section 7000) of Division 3 of the Business and Professions Code, and Use of Building:a/7�`j h .M w Rea �(1/ z/ '! G(.0-�E my license is in f f.r e and effect. '` /Y-� if License C ass Lice.se No. _ _ / r • PLUMBING FEES Planning Notes: _oZ " I r tt M Date L . Signature i --,. �/. -� . ,' / kfrilvzsnetE v; ,;'fRKERS'COMPENSATION DE ARATION Bar Sink Showers l,� /j t�j /LJ,,./���s..� �{ �� T >i.-areby affirm that I have a certifi ate of consent to self-insure or a certificate Backflow Preventer Service Sink -W�-�I -Side ►[J.Gle 21- 6,1. • S 4`riti, Workers' Compensatio Insurance, or a certified copy thereof (Section Y 3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. Company laCertified copy is h eby urnished. Bathtubs Sewer Connection Automatic Washer . Transformer ❑ 15-50•KW Certified copy is fi ed with the city Building Division. Date Applicant Clarifiers Solar Collectors Construction Pole Sub. ❑ 50+ KW EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ish Washer $Olay Pi In ' D (This section need not be completed if the permit is for one hundred ($100) or p 9 Cooking Unit Meter ❑up to 700 amps less). - - I certify that-in the performance of the work for which this permit is issued I Drinking Fountains Solar Tank Dishwasher Meter ❑over 100 amps shall not employ any person in any ma er so as . .-come subject to the Workers' 9rope ti Laws of Califor Floor Drains Swimming Pool w/Spa Dryers ❑Gas DElectric Sub Panel Date Z4//7/77'1 Signatur - .4_' ^�� i • - ' NOTICE: f,laf4(er making this de lara on, you should become subject to the . Floor Sinks . ' Urinal- • Fan Motors 00-1 HP ❑1''4-8 Workers' Compensation provisiobjsp the Labor Code, you must-Jorthwith • comply with such provisions or this• permit shall be deemed revoked.. ' Gas Service Outlets - Water Closet F.A.U. Inc solar 1:19-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY' _ % , I hereby affirm that there is a construction lending agency for the performance Interceptors ' Water Heater Fixtures Microwave of the work for which this permit is issued (Section 3097 Civ. C.) I ' Lender's Name Kitchen Sink - Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION • . Outlets Range ' I hereby affirm that I am exempt from the Contractor's License Law for the p-Tra following reason.(Section 7031.5 Business and Professional Code: Any city or p . Switches Sign • county which requires a permit,to construct,alter,improve,demolish or repair - ' any structure, prior to its issuance, also requires the applicant for such permit Roof Drains • I _ Garbage Disposal Standing Sections ' to file aligned statement that he/she is licensed pursuant to the provisions of ' 'e Contractor's License Law (Chapter 9(commencing with Section'7000)of .ision 3 of the Business and Professions Code) or, that he/she is exempt . ' - Generator DO-5 KW El 5-15 KW Trash Compactor • --13refroin and the basis for the alleged exemption. Any violation of Section :-''31.5 by any applicant for a permit subjects the applicant to a civil :Reins action Fee M penalty of not more than five hundred dollars($500). : p .I $25 - Issoe Fee $ 3 1.--- u I; as'owner of the.property or my employees With wages'as their sole Reinspection Fee $25 Issue FeeI '$ 3 compensation, will'do the work, and the'structure is not intended or offered MECHANICAL . I FEES for sale (Secion 7044, Business and Professional Code: The Contractor's —, I s PUBLIC SERVICES REQUIREMENTS: . License Law does not apply to an owner of a property,who builds or improves Boiler Hood or Tyke I ❑ REQUIREMENTS: /' �f thereon, and who does such work himself/herself or through his or her own i ; Zoning Approved By old — Me Date Y_ r `� employees, provided that such'improvements are not intended or offered for Canopy Type III D Duct-Under Ground sale. If, however, the building improvement of pro i sold within one year of rim- ' Bollding'Approved By Date Drove o,thepurposowner-will have the burden of proving he/she did not build or im- rove for the purpose of sale). i • Duct-Structural Refrigeration System Application Issued By ��� •i Dat.C I,as owner of the property, am exclusively contracting-with licensed con- ' tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating - ❑0-100,000 BTU _0100,000 BTU SU�M)IM RV OF FEES J( • The Contractor's License'Law does not apply to an owner of property who BUILDING PERMIT $ '/'4/4 iSO SMTP S^v builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration p $ ' tractor(s) license pursuant to the Contractor's License Law). • ' PLAN CHECK $ Ca O . !c PERMIT ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING' $ ISSUANCE $ ' Date i Owner. - - Heating,System&Ducting _ PLAN CHECK 25% $ ENERGY P.C. $ -I hereby certify that I have read this application and state that the above E10-100,0000-100,000 BTU 0100,00 _0BT -"" GRADING $ ' information is correct. I agree to comply with all city and county ordinances • - $ ELECTRICAL and state laws relf ng to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives pofu th" ity to e. -r .on e above-mentioned pr p •� Q inspection par. •- y� • MECHANICAL $ TOTAL FEE '$ 7.3 Drivers' - r or SS , �- I --\CMF 0885-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOI PA' Date Inspector Date Inspector -APPROVALS Permit# �APPROVALS Permit# 1._Temporary Electrical Service or Pole - 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement _ 3.•Electrical Conduit Utility-Undrgrnd. 54. Forms 4; Electrical Conduit-Undrgrnd. . - 55. Electrical Bonding - q 5'..Steel ReinforcementVL Mr - S'T>,::� Y. G nt 56. Rough Plumbing & Pressure Test . 6. Electrical UF ER Grnd. Y- 57. APPROVAL TO COVER-GUNITE . 7. Footings f"d"9 wU steel 7'` clrpr of 4-.2 y -y f p . 58. Electrical Conduit-Undrgrnd.: rWr'tn, 4 8. Foundation 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. . 60. Backwash Lines,P-Trap, 0 Undrgrnd. • • 10. Structural Floor System 61. APPROVAL TO DECK• - 11. Property.Sewer Line & House.Connection 62. Backwash & Receptor-Final ' . . • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains . - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final , 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing &Access Approval 17. Rough Wiring Sign • • " 68. APPROVED FOR PLASTERING . - 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rotigh Heating & Air Conditioning • FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping El Gas ❑Oil 23.-Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil • - I 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 77. FIXED SYSTEM FINAL ' . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning .. 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace r.' I -4, - 38. Find(Plumbing - • 39. Water Service:Final -', - 40. Gas Service-Final ? '- • ' 41. Solar Domestic-Final '"'' - 42. Backflow Preventer ' 43. Backflow Irrigation _ •0 44. ,Landscape Irrigation System%. . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING r, 4 .70 ,c yLt--- 48. Special Requirements Completed 49. Electric Release to Edison '-'., - ' 50. Gas Release to Southern California'Gas'Co /- 51. CERTIFICATE OF OCCUPANCY "- No, Date 'P ADDRESS OFBMLDINO: 1710 MISSOURI ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT ONNEWStAYEIFKCM*MUNOZ, LEONARD FLOOD : AE-37 PERM NO: M 081310 ADDRES :19 308 WRATH AV - CERRITOS,CA 90630 PERMIT NO: M 081310 PLAN CHECK NO: N GOVT: N SUPP: N 828-1866 AFP L.MALMO ADDRESS: C;" C- CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC - PURPOSE: ALT ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : FAU REPLACEMENT SQ FT: ARCH.OR ERG'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1 mulTttgfr$ps,w.GREENWOOD HTG & A/C (714 ) 621-7070 CdURACTORS IDAHO 5221 LINCOLN AV COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: CA uC.NO.: 271636 *****iE�r�ERE*REREx-*****x-RER9REREREREx� ***RERE�ERE�E****RE+r****RE***Rr**x*x*Rrx+r*�E*RE+E�E*�r�EBr+E�r*�E***�E�ERE 90630 C ZONING R EQU IR EMENTS LICENSED CONTRACTORS DECLARATION:I hereby tarnunder pronely or Miley dat 1 am"Sneed under prwsrpw e1 Chalet.9 SETBACKS (commencing with Section 7000)of Division 3 of the Business end Professions Code.end my license is in fug force c�md shed. CITY UC.NO.: uc.cuss:C 20 uc.NO.:271 �� MAIN BUILDING ACCESSORY BUILDING — oZ4l— 7? FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dare: Contractor: IY) LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury than am evaenpt from the Contractors License Law for the !Wooing reason(Smion 7031.5 Runless aol Profeeeiom Code:Any city or wanly which requires a armee le canemcL.ager,inProve. PARKING REQ: P ROV: PARCEL: 13906213 Z N E: REF NO: temobh.«repel any structure,price to its issuance.also requires the applicant for such permit to file a signed statement that heorshe PLANNING NOTES> n licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)d Division 3 of the > Business and Professions Coder or their he or she u exempt therefrom and the basis for the alleged exemption.Any vidation of Swim 7031.5 by any applicant for a perms subjects the applicant to a Sat penalty of not mere than five hundred dollars 1550op. ******************************************************************************* ❑ I.as owner d the property«my emPlwas was wages as their sole compensation.wig do de work,and de structure a not intended DEVELOPMENT SERVICES, REQUIREMENTS or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an ownerof popery who builds or in prates thereon and whe does such work himself or hersel or through hie or her own employees,Provided that such inproyemew ase not itended or reared for sde.a,however.the building or improvement is sold("ghat one year of completion.the ZONING APPROVED BY DATE: owner-builder vi l have the burden of preying he or she did not build or improve for the purpose or sale). ❑ I.es owner of the property,am exclusively oontradiug withficensed connectors to construct the project(Section 7044.Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not apply to an owner d property who builds or improves thereon and who o maw for such Projects with a oontradmp)licensed pursuant to the Contractors License Law). APPLICATION ISSUED B Y: '' DATE; 1 ?'� ❑ Tem exempt wmo urger Sen: B.B P.C..tor this reason: *************************************df******** * ******************* ********** Date: OW1er LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am aware of end understand the requirements of California Health and Safety Code Sections 25505,25533.and 25534.end thetI«any Mure building occupant wig/we rot(cicle one)need s conplywih said stale codes and therequvemente for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a perms forconstnnton«modifiCationfrmif"AiouueyTi Management Dielrid.Residential omtns40n applWknsare exempt fromOgee PERMIT 13 Pry. . 2525% SMIP/NON—RES Date: Applicant: PLAN ' WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one or the following dederations: ISSUE FEE 22 . 00 o 1haveand yid nsintvhacertificate alaasenttoself-insure krwaken?cornpeatlen.asprovidedforbySection3700dthetabor BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Cade,tor the pedmn oanceotheworkforwlichthispermitisissued. nsTOTALS----> 13 . 25 22 .00 0 . 00 35 . 25 35 . 25 . 00 o I have and sol maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the parlormance of the wok Tor this pemdleiasuad.My w«kens'campunmion insurance ceM«and policy number are: REVENUE DIVISION TOTALS--> COLLECTED: 35 . 25 OVER/SHORT: .00 Can"' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN—CHECK Pricy Number. (This section need nor be completed I the permit is for one hundred dollen/55001 or less. 35.. 25 171,Icen/y that in the pdormance of the work for which this penitis in any person In any manner so aslo ******************************************************************************* become subject to the workers'compensation laws d Cdfoni. become m to the workers' compensation provisions of Soden 3700 d the Labor Code,I '.' IND D I V I D U A L --F EE BR EAKDOWN Date: 4 .2-�'r^I•7 Applicant ._ -. o Warning:Failure to secure workers'compensation • wNm f,as1O/.cI en employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Sit nup to one hundred thouoend donna(SI o to Me cwt of compensation damages es provided for In Section 3706 olds Labor Cods,interest,Indstbmey'a foes. MEC 1 INST FORC—AIR/GRAV .FURN <= 100 K BTU 13 . 25 13 . 25 CONSTRUCTION LENDING AGENCY: I hereby etfmm under penalty Of perjury that there is e mnetn,dion lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and date that the above information is correct.I agree to comply with all Sly end county ordinances and state laws relairp to building construction and hereby authorize representatives of this city to enter upon the above-mentioned propend for inspection pur..,... o s GRD- .WOOD 1' 535.25 me n 81 24 1997/11:39 RM/ mats; .4 _ ate--4.' Dale / 4e1i//�7 - RCP TR:�1310 S. alum.. .riAgent/Rooken,erja :is PERMIT:O (5151-4655R) White-Buldip 6 Suety:Green-He:Caiwy-Appicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POC SPA -t APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector, 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location r 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement :3.*Electrical Cond.-Olt-Utility-Undrgrnd. 54. Forms 7, . - '4._Electrical Cond liI-Undrgrnd. 55. Electrical Bonding - .5.St-eel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. . 57. APPROVAL TO COVER•GUNITE - -' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines,P-Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12.-Sewer Cap t 63. Heater & Vent•Final -13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring • 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 1 _ _ FIR,E DEPT. REQUIREMENT 20. ,Roggh Factory Fireplace -,n- - , s - - H -APPROVALS Permit# - Y- 21.-Ducts,it Structut-e• ..' - , _. 70._Unde ground Hydro 22.2Duc't's, Ventilating it!. 71. Product.Piping ,0 Gas OOil _ 23. GasPipe_Rough & Test _ _ - 72. Underground Flush 24: Roof Framing ,, - . ' :• 73. Undergmd.StorageTank 0 Gas OOii 25. Roof Sheathing C---4. - - 74. Overhead Hydro 26.IT-04. Ceiling (Structural) &-rlonocoat 75. Dry Chemical -. - .. 27._frame and Flashing - - 76. Dry Standpipe-'` ' - „ ` 28. Lathing& Siding: - IT. - .c ., ., • 77. FIXEDS•YSTEIYI FINAL `i 29. Insulat bn 78, FIRE PREV. FINAL :, 2. 30. Drywall Nailing sHEALYH DEgTTREQUIREMENT 31. Plaster Brown" Ccrat' - 79, FINAL,I:NSPECTION x ,-, _ 32.'Electrial Power Meter-Final - 80. FOOD CERTIFICATE;ISSUED -''� 33.-Final Electric r - _ Notes: "� 2-L _2 v .a � s� _ 3 Final Heating & Air Conditioning © �-10.-q..1) �N Flo CO- Fr'i�ra 1, F_p .iv 35. Final Gas Pipe-Test- - _ 36.-Hood or Canopy-' - - ``- 37.•Final Factory Fireplace: :.'- - i:' - , _ -, . `. - -. 38. Final Plumbing - s r _ . - 39. Water Service•Finali - - . 40. Gas Service-Final - T - 'jr. - 41. Solar Domestic•Final " - . _ - -. - - - - 42. Backf low Preventer• _ _ ., - , 43. Backflow Irrigation _ i• '• II 44._Landscape Irrigation System - `. - - - - - ' -45.;Sound Attenuation - r r - c 46. Handicap Regulations - I. - 47. FINAL STRUCTURE & BUJ LDING . - - _ -' - 48.-FINAL PLANNING - , - '- 49. Electric Release to Edison - - . 50. Gas Release to Southern California Gas Co r = : . 51. CERTIFICATE OF OCCUPANCY t. No Date nor- TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional — ® ii .. GENERAL— NOTES Channel Block With 1-3/8 —, A ■,I'_- _.� 0 Horizontal Top of all FencesUMW—NMI MORTAR: One Part Plastic Cement, and _ Three Parts Sand mI U For Fences 5'or Less __ lg. : One Part Parts Three and Vert. Bars 3/8"Oat 4' -0"0.C. o One Half Parts Sand _ COPING: One Port Cement, Three =_, w �i� Parts Sand For Fences Higher Than 5' Vert. Bars 3/8" Oat 32" O.C. >- w CONCRETE: Well Mixed 1:2-1/2 : 3-1/2 - I Max. of 7- 1/2 Gallons Ct Fill Cells Solid With Grout > Z Ii " Water Per Sack of Cement Where Steel Occurs >-: Reinforcing SteeiShall —� III f - —i� I GROUT MAYBE POURED FROM THE TOP OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15-39 w o - — OCCURS. A.S.T.M. I Z1-- Il II 111 _ CELLSANDAREASOFHORIZONTALREIN- FORCEMENTMI SHALL BE CLEAR,CLEAN& Ls. a All Steel to be Lapped FREE OF ALL MORTAR DEBRIS,ETC. 15"or to Code H I'1�� all NATURAL GRADE 4 BONDS SHALL BE PROVIDED BY LAYING . ''�eyti1 I:Yyv. v .. 1 " IBLOCKS IN STRETCHER COURSES SO THAT 140 am • u • - • EN wi1/41 � - VERTICAL JOINTS ALTERNATE IN EACH —.'%' L---( >..,� .♦ . -O . e ♦ a _ COURSE. e TWO3/8"OBARS -�. �. o .♦ ♦ e ♦ e CONTINUOUS TOP &BOTTOM -,.1 • WIDTH - TO 16 0.C. MAX. SEE CHART ♦ -• o • v BELOW . DEPTH OF EARTHTCOTH • y 1/3 THE HEIGTH OF FENCE oL -o.• •bj . 1:::. BELOW BOTTOM OF FOOTING. • ksi0 0" 2"b . -- SCALE: 1/2" = I' •FOOTING REQUIREMENTS CHART - WALL HEIGHT 61 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' pJ�(�� rr ' 16' OWNERS NAME: _Per _*dere C� _ _ _ _ _ _ City of Costa Mesa, California PERMJOB ITNUMBER �<243.191•62(7:— � 'M� L _ __ _ _ Building Department SIGNATURE: _ =�t�" A f .. • siv3f. r : � r,owan r J, and 03nns,- �~ N;; 1VJjSP0N) / do NOISIA;O t.An3 ,7vo do 3ikas 3H1 1VH1 1S:""nS 3i '03A01dIN3 38 �I 01 38V S;I k OSi3_;'._n i SON101118 {Od '"LQh C u�� ,2/ S1S3038 IE;,10!10: AN d611000H cI,.,J 8I 71N s 1SHVII 8- 1M1N SIH! / / ' �/ /O AP RO ED 1ISOM NOI1Va301Ha3a ifr 2 , ° 'gh /2.)/al' @NV ONIi'Nl11N3A `ON111/3H CartiNCeiOSTA:lc; `9NI8v'JOId "II/31813313 a03NGD03a10tj3a 3F1V S11Wa3d 5DYLAG. D , iO 31Hbyd3S/MO 1VA08cfi imus sYL -= DATEa g u DIRECTO! Of PLANNING ___ __ FT'S, a x w`& 5G'Set 1 V .x CL ib, RESIDENCE RESIDENCE Ct RRES}IDW ENCE RESIDER I.- IM l-1 W W D It ti h H \ * 1 \ 3 / STREET 1 O j1 W _\_ Lot 55 • Tr 3722 12983 COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED P. 0. BOX SI7 COSTA MESA. CALIFORNIA 6 (..k• (3—(30— . . For Applicant to Fill In Completely FIPIANkkg7 enikinc A t &PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 1710 Missouri Street COSTA.I.AESA. CALIFORNIA For Office Use Only I RECEIPT NO. 1 OWNER K & B Development Co.,Inc. i PTRI MAIL . RECEIVED BY I 12TE.,RECEIVED . DATE ISSUED ADDRESS - 1555 Placentia ave - 6)--70,,ed OCT 1 4 19Rn CITY Nezzort Beach TE 0L Nii 6-322r AB g DI LRDas 1: ARCHITECT TEL. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE TYPE I/ GROUP .L' i,ii CONTRACTOR W. KO IZA APPROVED BY DATE i ADDRESS 1.555 Placentia ave . ZONING ZONE NO.OF I USE OF NEW Single fan. CITY Ne •ort Beach R-1 I PLANS 2 BUILDING Wi att gar .. STATE TEL. LIC.NO. 61195 NO. rum 6-1227 LEGAL , DESCRIPTION Lot 55, Trart. 3722 SIZEI NO. OF BLOCS. 0 OF LOT 6.5.57x100 NOW ON LOT A.P.NO. none USE OF YARDS EVES EXISTING BLDG, None APPROVED ALLOWED SETBACK LINE FROM 50 t (CENTER LINE ST.) CENTER OF STREET REAR YARD 20' FRONT ,5 73I FT. IN. , SIDE YARD I LEFT 5' I RIGHT 101 R.SIDE /19 F.T. . IN. DESCRIPTION OF WORK- ' L.SIDE icT. IN. NEW I XV ALTERATION I D ADDITION I REAR 911) FT64 IN. REPAIR I LOVING I V DEMOLISH I APPROVED BY W T, 0 1). DATE 10-10-60 BUILDING LD I NG 1 at NO. OF A ROOMS ...1 STORIES 1 ' EXTERIOR WALS-tUC CO I ROOF Rock COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED Single FP71:11 y Residenrp and Attached Garage .. . t : ! I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND time THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. • U PERMIT FEE S SIGNATURE OF 0 VALUATION_eej 91-4)...nt(„__KIL .) ei PERMITTEF / /43/6 Al 4 S PLAN CHECK $ gi-- r AUTHORIZED AGENT r,.E - . TOTAL FEE $ 0-9----- Ir.