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Home My WebLink About2266 FOUNTAIN WAY - Building Permits. � • CITY OF COSTA MESA , � BUILDIN6 DIVISION � � DEVELOPMENT SERVICES DEPARTMENT � � -- H9R-0'1208 �� PERMIT PERMIT NUMBER (714) 754-5273 • Fax (714) 754d858 77 FAIR DRIVE, COSTA MESA, CA 92626 , BUILDING PERMIT Job Address: 2266 W FOUNTAIN WY Suite: Vicinity: Parcel Nunmber: 93�74�1 � npp�icant: FONTAINE, JIM Address: i j , owner. SCHROEDER-WILSON - " Address ASSOCIATES/� � �,� ' .HVJY STE'� �� 2CO�"j � � � <-'-�" 2411 E COAST %SCHROEDEI �„� � �� -�,� � Contraaor. ��FONTAINE, Addressa -%23015 DEL LAI Status: ISSUED � Applied: 07I07/1998 Issued: 07I07/1998 Zoning: Phona: Zip:. ; _ � �,' �, � Phone:- -. . ` ii l _ � •A_\ � - dp: 92825- - � � / . .`- , � ��r� � � !\\ � �\ _ _ `� J �. - .� � � , _� , �� :A �� / i�`.�-,, � �� /, <;?. .� � , � �.`:� . �/'�� A, �//��%/ PhonO: 714-59&8360 ��,��.�/�" i � .� ,��" � LAGUNA-HICLS:CA Zip: 92653 ��V�, � � ��,A'., . i �t•/ !� � � � � License:i708917 \��:�� / . .� Arili%Eng:�., .,/�" . �;\ , - . �'Address:'��' i�, , . . � � . . ._ ./- '::�onei�_� .. � ....'� ` , ' �> ' , � - .. , , , i = � �, , o� .L ,, � Lice s�e: �- - - _ _ - � , �.� . � � , ^� - � SCOPE OF PERMIT T/O REROOF WIBUILT UP 2000SF,2266, 2268, 2272, 2270 FOURPLEX. % � � Plan Check: . ` Permik SMIP Res: SMIP Com: .' Other.� �Inspection: , � �Total: ' $0.00 $99.75 $0.50 $0.00 �' $0.00 �� $0.00 , $100.25 �:: . SETBACKS � MAIN STRUCTURE Front ACCESSORY PARKING NOTES: Front ao. ', % ao �-_ ... � . .�'./,` � �r� . � _ ., ,.�; � � � FFF.SI�IMMARV ... ... . � � _. —� � �;v. �- " --°-. :r`- � - . � . �- - A � �-_ ._ �� ..., '�' PLANNING 8� ZONING � �?�� , %` -.� ,� `,�< , � ,Rear_'��0-0'.- , Left" ,%0-0�, . . .�-._ . . , . � , . �' �` Rear �0.0 � � �� Ceft 0-0 ' ; Exfstinq: - 0 - � " Required: 0- Calc Vaivation: Claimed Valuation: �;? $5,000.00' $5,000.00 ' ' � � . -.. � �i�;; � , ._Right - 0-0 . �/ �!� , � . , : � , ,. �: Right 0-0 .Proposed: 0 - - � i.' EXPIRATION: This permlt shall eutomatically expire and beeome vold if work is not commenced wlthin 180 days, or II vrork is suspended or abandoned 'I for a period ol 180 days. • INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all epplicable codes, end all � requlred Inspeetlone and flnal epproval must be obteined. Fallure to obtain Inspeclions end final epproval wlll result In the explretion of this permlt. ��. FOR INSPECTIONS CALL: (7/4) 750-5828 WORKERS' COMPENSATION DECLARATION: I hereby effirm untler penelry at parjury one oi the followinp declarations: " ❑ I have entl wlll malntein e certiticete of consent to sett-Insure fw workem' compensatlon, es proNtled for by sectlon 3700 of the LeDor Code, for tha peAortnence of Ihe work tor which this Dertnit is Lxvued. ❑ I heve erW wlll melntain wakers' campensetbn insurance. es requireE by section 3700 of Ihe Lebor Cade. for Me peAortnence of ihe wwk tw which Nis permlt is issued. My workers' compensetian Insurance mrtler end poliq number ere: Certier. Policy Number. (Thls sectlon need not be completetl IJ the pemJf !s veluetl af one huiMred tlollars (S 100) oi less.) ❑ 1 certify Ihet In Ihe peAortnence ol ihe work tor which thLa pertnit Is Issued, I shell not employ eny pereon In eny menner ao es to Cecome sub�ect lo the workero' wmpensetlon lews ol Cellfomla, end egree thet if I shoula become sub�ecc lo the workere' compensetlon provlslons ol Section 3700 of the Lebor Code, I shall forthwith Comply with the5e provislon9. ^� ^�p�� . Appllcant Sipneture: Dete: / ` / � WARNINO: FAILURE TO SEWRE WORKEHS' COMPENSATION C�OVEPAGE IS UMAWFUL PND SNALL SU&1ECf M! EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED TiqUSFND �OLLME (E100,OOO�.IN ADDff10N TO7HE CO6T OF COAIPFNSATION, DAMAOES AS PROVIOED FOR IN SECTION 7708 OF THE IABOR OO�E, IMERE3T, AND ATfOW�EVS FEE9. LICENSED CONTRACTORS DECLARATION: I hereby effirtn Ihat I am IlcenseA wMer r slaru�Qf C�hat �ter 8(commendng witli Sectlon 70W) oi DlNslon 3 01 Ihe Business entl Professlons Code, end my Ikense Is In full Jorce end etlecL lJc. a %� `7 � ) Cless p Contracrors Signature: Date: `� ��9 � CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that Ihere Is e construction IenOing epency for the pertortnence ol ihe work for which t�is Oertnit Is Issued. (Sec. 3097, CINI Code). Lendets Name: Lentlets Atltlress: Signature: Date: OWNER•BUILDER UECLARATIONS: I hereDy ettirtn Ihet under penelty ot perjury that I am EXEMPT FROM iHE CONTRAC70RS LICENSE LAW for t�e lollowlnq reason (Sec. 7031.5, Business end Professions Code: My ciry or counry whlch requires a permit to conslruM, alter, Improve, dertwlfsh, or repeir eny aWcture, prior to Its issuence, elso requires Ihe eppllcent for suc� pertnit to flle a slpnetl stetement Ihet he or sha Is I�ensed Dursuant to Ue D«slons of the Contrectors LJcense Lew (Chepter 9(commendng with Sectlon 7000) of Dlvisbn 3 of t�e Busineu and Professions Code) or Nat he or she Is exempt therefrom arM the besls tor Ne ellegeA eaemption. My Wolatlon of SeMlon 7031.5 by any epplicant for a pertnit sub�ects Ne applicant to e Gvll penalry of not more than five hundred ddlars ($500).): ❑ I, es owner ot Ihe properry, or my employees wilh weges es their sde campensetlon, WILL DO THE WORK, flnd ihe swqure is no� Intended w oHered lor sale (Sec. 70ad, Business end Pratessions Cade: Tlie Contrnclors Lkense Lew tloes not epDN �o en owner o1 property who bullOs or improves ihereon, entl wlw tloes such woAc himsetl ar herself or through hls or her ov.n employees, provlded that such ImprovemenLs ere no� Intentled or ottered tor sale. Ii, however, the bulltling or improvement Is sold wlihin one year ot completlon, ihe owner-builAer will have ihe buMen oi proving thet he or she did not build or improve for purpose ot sele.). ❑ I, es owner of Ne property, em EXCLUSIVELV CONTRACTNG WRH LICENSED CONTRACTORS to consWc� the Oro�ecl (Sec. 7044, Business entl Protessions Code: The contredors llcense Lew does not appy to an owner ot properry who Duilds or Improves thereon, end who contracls for wch pro�ect wIN a wntrador(s) Iicense pursuant to ihe ConVactors License Lews.). ❑ I am exempt under sec. SlgnaNre: Owner ID verifletl by drivafs license. ❑ Yes Vedticetlan oi Ownership by (type oi document, i.e. Business enA Professions Cotle for this reason: ❑ No Drivefs License No. property tat bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CEHTIFlCATION: Date: Explres: ❑ I �ereby ceNfy thet no excevation Ilve (5) or mwe teet In depU Into wNch e person L9 required lo descend, will be metle in cannectlon wIN woAc authorizad by IhLa pertnl6 end thet no bullding structure, uaflddlrg, leLsework, or tlemdltlon or tllsmentllnp Uereot, will be more then thirty-six (38) teet hlpR (Chep. 32, Grp 2, Atl 2, Sec. 341, Ttle B, Celitomla AtlministreWe Code). ❑ As owner-builder, I will not amploy enyone to Co work wNch woultl reQuire e pertnit irom ihe Dfvision o1 InCusirlal Sete y, es noted ebove, unless such person has e pertnit to tlo such work from Ihe Oh+ision. Slgnamre: DaW: D'Msion of Industriel Safery Pertnil Number. CERTIFlCATE OF COMPLIANCE AND AtJTHOR¢ATION OF EMAV: I certify under penelty oi perjury thet I heve reetl this epplication end steta that the infamation given is cortect. I epree to compty with all state laws end Gry ordinences relatlng to builGinp wnstructlon, end euthorize representetives of the Ciry of Casfe Mese lo enter upon Ihe above-tlescdbed properry for InspecGon puryoses. I epree not to occupy or ellow occupenry of eny buildlnp euthodzed by this permll until tinel Inspection. Signature OI Legel Owner(s) a �� AnNOr Authodzed Applicent Da e FQQ�/, INSPECTONTYPE 7818 Fixed System Finel Fire Preventlon 1288 Paol Spe Finel 200 Flnel Re-Roo1 207 202 203 204 z4a&4e FIneI8locWReteining Well Flnel Fectory Flre Plece Finel Slgn Finel Demolltlon �g �� LQQEj INSVECTONTYPE 208 Flnel Mechenicel 208 Flnel PlumGinp 210 Final ElectAcel 212 Final Fire Preventlon 220 Flnel Plenninp Approvel 222 Final Site 250 Final Building/Occupency �ff � .un. ; ApPlicant to fill in all spaces except thosa within �eavy Dortler lines antl si9n all avurooriate eeclarations. CITY OF COSTA MESA CONSTRUCTION PERMIT , PEF}[v11T NQ. TRACT NO. LOT NO. . UNIT NO. Project Address 2z 66 � z26$,z2 ia 2272 �+oTain WA/ yvPy_% Applicant's Mailing Address 6041 � n� 1�� (�(/� 13 Owner's Name �� Phone Address Arch/Eng. License No. Address Convactor'sNam Lo{�C2c%oi/.�.a�riT<ni' �ix�r,/ .ahoneSy6736ff Atldresslmailing) ��Qa'�'—�� CJ'm�� /(?�1 ' CityLicenseNo. $33fo �ICENSED CONTRACTOR DECLARATION I.hereby aHi�m Ihai 1 am Iicensetl untle� provislons of Charte� 9(Commencing witn section 7000) of Division 3 of [he Business antl ProfeSsions Cotle, antl my I�cense is in tWl �orce antl eitect. 6 S/ License Class � L' ens o. q Date�-zr- �s`� Si9nature WORKERS' COMPENSATION DECLARATION � heraby affirm that I have a certificate of consent to sel(-insure or a cerNficate �' Workers' Compensation Inmrance, or a certlfletl copy thereoi (Se<tion 300, �ab. CJ Policy No. Company eCertifie0 copY is hereby fumisnetl. Certifiea copy is tiletl witn the ciry Builtlin9 Division. Date APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl mt be completetl if the permi[ Is tor one huntlretl (5300) or less�. I terlHy tnat in the perto�mance ol (h¢ work to� wlticn tni5 pe�m�t i5�i55ueQ I snall noi employ any person in any manner so as to bewme su ject [o tne Woiker�—iomPe{�s�tion Laws Of Cali mia. , Date �`� $i9nature _ NOTICE: 1f, afier making this tleclaration, you shoultl become subject to the Workers' CompOnsdtio❑ provlslons of the Labo� Cotle, y0u musl forthwith comply with suc� Provisions or this permit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I ne�eby altirm Mat Ihere is a Constructlon lentling agency for tha pCrformance of tne work for which [his petmit is i55uetl (SeCtion 3097 Civ. CJ Lenaer's Name � Lentler's Atltlress OWNER BVILDER DECLARATION I hereby atfirm tha[ I am exempt from the Contractor's License l2w for the fallowing reason (Section �0315 Business antl Professional Cotle: Any Nty or county which reQuireS d permit to construct, alteq improve, Demolish or repair any structure, prior to Its Issuance, also requires the applicant for such permil t0 file a signetl Statement that he/she is Ilcensetl pu�suant lo the p�ovi5ion5 of [he ConlractorY �icense Law (Chapter 9(commencin9 with Section 7000) of Division 3 0( the Bu5ine55 antl P�ofe55ions GoOe) o� that h¢/zhe is exemPt refrom antl the basis for tbe allegetl exemption. Any violation of Section '1.5 by any applicant for a pe�mit subjects the ap0licant [o a civil .�alty ot not more than five huntlretl Oollars ($500). u I, as owner of the property or my empioyees with wages as their sole wmpen5ation, will Oo lh¢ wo�k, antl [!te structure I5 not Int¢ntletl o� otfe�etl !or 5ale (Secllan ]044, 8usines5 anG Professlonal Cotle: The Contractor's License Law tloes not apply to an owner ot a property who builtls or improves thereOn, antl who aoe5 Suc� work himself/h¢rs21f or tnrougM1 his or har own employees, provitletl that such Imp�ovements a�e not intentletl or o(feretl tor Sal¢. If, however, t�e builtling cr improvement is Soltl�wilhin one year of com- pletlOn, the Owner will have the bu�tlen Of provinq he/she dia not builtl or im- �rove ior the purpose ot sale). I, as owner ot the property, am extluslvely Contractlng with Iic¢nse0 con- tractors to constru<t the oroject (Sectlon 7044, Business antl Profezslons Coae: The ConlraCtor's License Ww does not apply to an owner of property who builtls or improves thereon, antl wM10 contracts for such projects with a con- tractor(s1 license Dursuant'to the Canlractoi's �icense Law�. I am awarn that oroof o( [heir Worker's ComPensatlon Insurance shOultl be provitl¢tl to mG. ❑ I am exemp[ untler Section B. & P. C. for th6 reason Date Owner I hereby certity that I have reatl thlz application ana state that the above intormation is correc[. I agree to Wmpty with all tlty antl county o�tlinances ana state laws relating to builEin con truction, antl hereDy authorize repre- sentatives of thii ciry to en r up the above-Tentionetl properry for Inspection p ozes. Signature �. � D t ��_ Drivers' License or 55 � TVPE OF CONSTRUCTION LJ NEW LJ ADD U AL.TERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p_# DESCRIPTION OF WORK/USE OF BLDG. 5 Main Buildin9: E TVPEOFPERMIT GRADING FOVNDATION STRVCTVRAL T Fronl ❑ TENANT ❑ ELECTRICAL � rPLVMBING �,❑, pMECHANICAL B Rear ❑�OTHER \ �-1nVlr�— p' PROJECT DESCRIPTION 5Q. Fr. oCCUPAtdCv C Right K Left CONSTRUCTIONTVPE VALUATION$ $ LONE GRADING CU. VDS. ACRES ping, Ref. # Remarks: Planning Notes: 8ar Sink Backflow Preventer Backflow Irrigation eathtuhs Clarifiers Dishwdsher Drinking Fountains FloDr Drains Floor Sinks GasService Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structurel Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ o-i oo,000 eru O i oo,000 Reinspection Fee � 315 CMF 0865-46, rev. 4/84 White - Builtling; Canary - AppliGant; Pink - Ac<ountinq; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping�, Solar Tank Swimming Pool w/Spa Urinal Water Closet Wa2er Hea[er Water Service r?i - n � GaP� Issue Fee Hood or Typel ❑ Canopy Typell ❑ Reirigeration System ❑o-ioo,000aru ❑ioo,000 System Repair/Alteration Issue Fee FEES 5 3 FEES $ 3 Automatic Washer Construction Pole Sub. Caoking Unit Dishwasher Dryers ❑Gas �Electric Fan � F.A.U. Fixtures Device Boxes Outle[s SwitCheS Garbage Dispoul Generator �0-5 KW 05-75 4850 7/25/B4 �a/ {iR1111�1 � I Zone � Accessory Building: �n � 1511 � . rf � �'i t'i��l�i�,. �Q�/�ciiyrm�rovided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps . Meter ❑overt00amps Sub Panel Momrs�0-1 HP �1'/:-8 Inc. Solar �9-15 HP � 16�15+ Microwave � Pole Light Standing Sections TraSh Compactor � Reinspeetion Fee �$75 � � Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By Building Approved By - Appliwtion Issued BY d�-A SUMMARV OF fEES BUILDING PERMIT $ SMIP PLAN CHECK 5 PERMIT PLUMBING $ S.GC1 ISSUANCE PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTALFEE PLAN CHECK 25% $ $ FEES $ 3 Z O N 1 N G R E � M T S. CONSTRUCTION ANDPI NING POOI 'PA APPROVALS Permit# - �!S Date Inspector pppROVALS Permit# Date Inspector i. Temporary Electriral 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 5. Steel 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, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � 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. Rough 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing • 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. �ioof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. f•rame 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 38. Final Plumbing j1/(�� (i� 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer _ 43. Backflow Irrigation . . 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date / , BUILDING.SAFETY DEPanTMENc' �7 � P. �.�Boa Mo. 317 1\ �. 13 8 8 � Costa Mesa, Califomia nat� � ,'�l i � � `/ /`/f � CPCY OF COSTA MESA - CERTIFICATE OF OCCUPANCY - Building Permit No.�n •J/ `f Electrical Permit No. Plumbing Permit No. Use of Building �i u:�i _— � 4' i -�d, �� 6 G 6� 7�, �!� ��--= LcJ m�_� _/r /�.� The building located at i. �. " �, ;� --� Legal Descrlption (See reverse side for Metes and Bounds) ' beeu inspected and found to comply with the provisions of all City of Costa Mesa Ordin- �.. .es applicable thereto for a Group �� Occupaucy. ISSUED TO: �^ City Building O(ticial j �ai11 !` �o•�.� �'�7�.��..di ,'. ' I�l . �/.,., � .l. (Owner of Building) By -� -�� •- CC: ❑ Original—Owner ❑ Sst copy—Gas Co. ❑ 2nd copy—Edison Co. ❑ 3rd copy=File Form 208 S-B P IM 1-W J �. .r. . � -" f COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31� COSTA MESA. CALIFORNIA fOR APPL/CANT TO f/[L /N COMP[ETELY 1 o i. TYPE OR PR191T ��aIEL.L/. COSTA MESA, CALIFORNIA Paul E.Rober FYY�a SET9.�CK LINE FfiOM CENTER OF STHEET TEL. NO. MO.OF 9LUG8. DESCRIPTION OF WORK � 5 Z�E DING 3•Z X SS ROOMS I HEREBY ACRNOWLEDGE THAT 1 HAVE RE/�O THIS �PPLIC�TION NND STATE THRT THE ABOVE IS CORRER �ND �GRQE TO COM� PLY WITH ALL CITY OROIN/�NCES AND 6TA1E LAWS REGULATINO BU�LUING CONSTFUCTION. SIGNATURE OF AUTHORIZED . . _..-/•c �l �-Si :li! �i,CL DE;'-(. Jc�. Cl7: Q': rncr. _:rc:'. APPLICATION FOR PERMIT � � BUILDING E .. o � FOR Off/CE USE ONLY Ineceirr No. �ngrl+�. HECEI��Y I DA'[$ HELEIV6D I TE 189UED �(J^ ` �a iv /b-, BUILDING r ADDRESS COSTA MESA, CALIFORNIA FIRE ZONE TVPE GROUF APPROVEO BY ATE � Z NING ZOI�jE _, / I NO. OF ` I U6E OF NEW �) PLANB `) BUILDING �CENTER 4NE ST.1 L I THE AMOUNT BHOWN UNDER VALl1ATION I6 FOft THE PURP08E OF ESTA9LISHING A PEFMIT FEE ONLY. VALUATION � PERMIT FEE $ �/� �'� �� ? ° 5 � PLAN CHEGK S � y' � TOTAL FEE S �73 � .. � 1. �3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] CpSTA MESA. CALIFORNIA foR naPuc�Nr ro fnc in� comacFrEcy � a. b�o `-Z_ TYPFi OR P{ilh{T �_ / n� }- � MAIL COSTA MESA, CALIFORNIA Paul E Roberta�n Inc I`.C•]I �,�� :.�,`�1 i�� n — I Ct -.5�7 Ft�lANCE DEPT. v ti T netc4 AP�PLICA7101V4FOR PERMIT BUILDING FOR Off/CE USE ONLY I RECEIPT NO. I _ ➢EflKIT COSTA MESA, CAGFORNIA nooaess �r� We6t 19th St. C09tH Mt'eH FIRE TTT��_,,,,,,�� ZONE TVPE GROUP Paul E Roberts�II �a�vTATE ��{Q6O APPROVED �f�- � � CONTRACTOR �IC.NO. gY L�� DAT AD�RE55 777. W 19th St Geta �88 ZONING � LEGAL I LSiT p I , I �lx 20�' � I NO. OF � `I USE OF NEW �E3CRIPTION NX � RI (]�K TR C P�ANS 9UILOING �� j��l OF LOT 65 x 135 .14 I no. ov e�ocs. NOW ON LOT USE OF EXIST�NG BLDG. SETBhCK LINE FFOM 90.14 REAR YAftD CENTER OF STREET SIDE YARD ILEFT 1().(j IRIGHT A(� DESCRIPTION OF WORK NF_W I �II ALTERATION I II A�DITION BUILDINGnn X /.O, NO.OF SiZE LL � ROOMS I STORIES 1 EXTERIOR WAI�O� �COOVERING ��Kt �M COVERING W I HEHEBY ACKNOWLEDGE TXAT I N/�VE REAO THIS APPLICATION AND 6TATE TH.�T THE ABOVp IS CORRECT�AND AGREE TO COM� PLY WITN ALL QTY OR�INAl�CES AIO 5 ATE L6W5 REGULATING BUILOING CONSTFUCTION. SIGNATURE OF PERMITTEE AUTHORIZED AGE (CENTER LINE ST.) THE AMOUNT BHOWN UNOER VALUATION IS FOR THE PUNPOSE OF E9TABLI6HING il PENMIT FEE ONLY. VALUATION p� PERMIT FEE $ /O •'^" 5 P,� ��,0 � PLAN CHECK $ S —� TOTAL FEE $ ��