HomeMy WebLinkAbout3025 GRANT AVE - Building Permits-
L
.�oox�saeu�pw: 3025 GRANT AV ��+T�
oxmexsewemaiw/x: REEDNICK, JOSEPH A FLOOD: X 47
mo�ss:REEDNICK, MARJORZE S
3025 GRANT AVE
:OSTA MESA,CA 926'16241-7167
�vr�. �uwa �ss
INCXRECT OP FllC�NFEH:
ARCII.OP FN4.'S /iDINiESS:
uc. xo.:
UNf:
c«im�cTarsruue PRIMO ROOFING ( 714 ) 841-4456
CWfP1LTOR5YYLPp 17066 PALMDALE ST
�ooeess: HUNTINGTON BEACH CA ucno.: 331120
92647 uM:
UCENSEU COMRACTORS OECLAFATION: I Mreby Nim uMar pe�aty ot pe�ury thm I em IicameE urMer pwivone d Cheqx 9
(mmmenaep vnt� See�ion ]000) W Drv�son J d Ne Buvnea enA Pmteauam Code, uM my lirome is in full taree vW eXed.
cmuc.No.:007639 uc.cuss: C-39 uc.No.: 3311�0 E�P�. 03/97
.
ome: �— / �� �e co�„��: � /� /�FI
OW NEX BUILDEN OECIARRTION: 1 hareby elfirm under penely d perp�ry ihe� 1 em ezemq from tM Contrmae licaree law la Ne
Idbwvp ran+on lSeaion )03f.5 Buaiima vd Proimsioris Catla: AnY ��Y a couMy Mhirh rtqui�ee e qrmA to carebucl. ells. impow.
Mmolah, a repei eny elructure, qior to iu ewenca, alao requim �he apd�� for euch parmn �a fib a agmd netamam thel he a aM
lieensad punuenl to Iha provieione W iM Conlreciore Lieenae Lew �Chepm e(mmme�eq vmh Seabn l000) d Divuion a d Ihe
reineav eM Prdmeune Cade� or ihel he a aha is exemp t�aralmm end iM baeu In the elbpeC uemqion. My vdelion d Seqion
.OJ1.5 b/ enY ��I lw e permil wbpGs IM epplicanl �o e wil pmehy d rol maa ihen fxa huMred EaYen �SSOOu.
� I,eaowneroflhepmpanyamyempbyeeewhwe0�%9�he'redacampensation,wi11do1hewak,anEtMeM1uclurebmlin�enEed
w oMered br We (Se Yion 104a, Buaineas enE Protesrione Gode: The Conlredon Licenae lawdoea mt epplymen owr�erd popeey
wla bulEs a inD�es ihmeon, enE Wn daee eud� wwk limcell or hene� «Nrwph he or Mr oxn emdoReo. q�� Ihet wch
imqwemenls ere nol inteMed ar dimeE Im aeb. tl, howerer, the buiNi�p «inpv.emaM e ealtl xilhin ane ymrW campblion. iM
owmarbuiNx will heve Ihe EUNan d provieq M or sM diG not buik a improve la iM WN^ee d aeb�.
� I. u oxner d iM popaM. � eKNusrvey mntree'vp xnh liwnaed eonoacmn �o wnmeua tM pmjatl (�� ]WA. Bw'vims end
rid.seiau com: TM ca,vmors Licensa Le. daan na evWr a�, o�, a ww�r wno d,iw «'unpw.. inam, .na wno
conVac�e for wM CqeUe wi1M1 a mM2dor�s) Icensetl Wmuanl �o �he Can�ratlae Limnae lew�.
� I em eaemq undm Sectim: B. 8 P.C., lor Ihis mamn:
Daie: ��
i ao nereW can�y Na i em a..�,e w�d unaersiene me rea���e�m � caieomie Haenn e�e s.my caes sea�on. usos, zsssa, �e
?553a, aM that I or eny Mure WiMi�p orapent will / wtll nM (drcb aie) neaE Io canply wYh eaH eble oodm eM �M mpuinmeme M
eM�ni«owVuctionwrtadifratianhantlwAi�y arapemmiDipnd.ReadsnidmnmrueionePO�iomenexemHlmmYwa
a�a�a.
oma: nooi��
WONKEP'S COYPENSATION DECL1flPTON: I heraEy dfirtn under qroEy d perjury one W Ne IoOowi�p Eetluel'vro:
❑ I neve eM vriA mdmein e cenHicete a consen� �o een-inaure 1« warkere' comP�emion, u vrovided lor M Seabn a]oo of IM lebar
Code, lw �tw peAomunce ot Ne wak br xtich ihie paimn ie inued.
r] � neve eiw aie meimen wmm�' mmw�+e��im InwreMn... �.e��red M 5eeim s�ao d m. l.no. eue.. ror �ne o�«mum ae �na
�f wpk �a which Mie paimit is iesued. My warken'�mmyaGeetion ineurence'enier ene pdiq number ve: E X P I R E S
Pd'cyrNumber: 1 11 / 01 / 9 6
n;s sxe�on �eed �w ae m�m.�ed r me v�R s ro, � nund,ad ddiers R+ool w i....�
� I cenAy thet in ihe pedormerKe d iha woA la whch Ihie permfl ia eeued, I ehell rat empb/ e�ry peivon in eny mennar m o to
yxpn> wyjep b ihe xorken' eompansetion lewa d CelMomie, eM eper thm J I eh999���k bm ro o tM xpken'
[om nW ian ppwisaa4jd S/eqpn ]]00 d IM labor Ca1e. 1 eM1ell Iwt IM1 awnpl� xM ,�QI Pro ' ons.
Dele:�— I 6 ' /[o AGdicene 1'i'l/� (/
Weminp: Fsllun ro sxun wortsri campawtlon covwaps h un/awNl, �ntl �lv/l rb f en xrplqw ro plMnl penaffl�s eM
<Ivll flroa up ro ons hurlre0 tMu�siM Aollars (Sf00,000), In eW/fbn ro tlro cwt o/ rompxu�Wrt d+�P� �+pAM� brin
Swtlon 9]O6 0l Ms LMor COM, Intws�( entl atrornsyY Isu.
ws
CONSTflUCfION LENDING AOENCY: I hereby effi�m undm penely d psjury ihm �Mn u a mM�udion brdi�p penc/ br ihe
peAwmarim d Ihe xwk Iw whiM iha pe�ml is csued (Seeun 309), C"v. C).
IENDEN'S NM1E:
LENOEP'S ADDFESS:
I cenM �hm I heve read ihis eppliratim eM eteb IIW the ebove inlametion e cmrea. I epree to canply wnh eA tily eM oouMy ordiwime
end slete kwe mlelmp to WiMinB �rWion eM Mreby euthorae repreae^ielivee d Ihie dly lo en�er upon the ebo.e�memuneE pmpery
�«1nap0dq0w`P°'°' TOM LIEBHERR
P /
Lrtd oma: ' �' �lo
' SigneNre a� OwnerlApenVAppFranVContreew
(5151<B.WP� Whna-BuiM'vq 8 Sdery; GreamFle; Cenery-AO t: Pink-Rewnue; (3oNenroFMxaa
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 079509
PERMIT NO: H 079509 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
SOB DESCAIPTION ; T/OFF ROCK 6 COMP REROOF W/ 20YR COMP SQ FT: 3,969
CLAIM VALUE: 3,969.00 CALC—VALUE; 3,969.00 GROUP OCC: R-3 /U-1
COMMENTS: REROOF RESIDENCE
�E if iE iE 1(� iE iF jE 1t fk iE 1f �IE fF fF iF 1E 1E 1f k iF iE 1F iE iF if !F 1F if if 3E �F �E iE �IF 1f iF 1E 1E iE iE jE 9E�F �f 1F iE iE 1flE 1E�E if jf iFlE if fE 3E iE ik iE 1F iE �E �E jF iE �IF iF 9E 3E iE iE iE IE �E jE 3E
Z O N I N G R E Q U 2 R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT "IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14113307 ZNE: REF NO:
PLANNING NOTES>
>
3E1EIEiE�EIE�E1E�EiEiE1EIP1E1EfEfEfEfEfElEiEfEfEIE1EIE�EiEIE�EiE3EfE�FiFiFfhifif*ififiEifik3EiEdE1F�E9EdElF1E�Elf1ElEiE1fi43f1EiE�EfElE1E3EiE'IEiFik1EIE�ElEiF
D E V E L O P M E N T S E R V 2 C E S R E Q U I R E M E N':T S
/r"
ZONING APPROVED HY .
BUILDING APPRO�IED HY :
APPLICATION ISSUED BY:
iF ik iE 1E iE iE iF if 1f if 1E 1E 1E 1E fE fE fE ff iE iE 1E �1
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 87.25
DATE:
_ DATE:
DATE: 9" "��
��iE1EiElfiFiE1f1E1kif 9EiE
STRUCTURAL SEGMENT;Y
FIRE SMIP/RES GRADING
50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 87.75 0.00 0.00 87.75 87,75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 87.75 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
87,25 ,50
iE ik ik ik iE iE iE iE 1E if 1f iE if if �E 1E if 1F 1E iE �E if if �E If iE 3f �E 1f aE iE iE iE iE iE iE �E ik fF IE ik iE IE IE iE iE iE iF i6lE if iE 1E iElE iE 1E iE fF if iE iF jf if 1f 1k �E iE �f 1E IE �E iE IE fE IE fE 1f *
I N D I V Z D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 3969 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 3,969,OU
END OF FEES
O1 00215163-0�215164 T C7T
DATE: Q9/18/95 TI14E: 24:37
P
87.75
�
CONSTRUCTION ANDPLANNING POOL PA ,-
APPROVALS Permit # Date i�spector qppROVALS Permit # Date tnspector
t. Temporary Electrirai Service o� Pole 52. Pool & Equipment L.ocation
2. Soil Pipe-Undrgrnd. •� . 53. Steel Reinforcement �
3. Eiectricai Conduit Ut:liiY•Undrgrnd. 54. Forms .�
� 4. �Electrical Conduit-Undrgrnd. • 55. Electricai Bonding �
5, Steel Reinforcement 56. Rough Ptumbing & Pressure Test
G. Hectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ``
7. Footings 58. Electricai Conduit�U�drgmd.
� 8. Foundation 59. Gas Pipe, O Undrgrnd., Test "
9. Water Pipe�Undrgrnd. f 60. Backwash �ines, P•Trap, O.Undrgmd. '
10. Siructurai Floor SYstem 61. APPROVAL 70 DECK ..
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final
12. Sewer Cap � �� � 63. Heater & VenFPinal
73. Roof Drains . 64. Ptumbing System � F�na6F,�
'14. Rough Plumbing � 65. Electrical-Finai . �
15. Rough Eiectrical-Conduit , � 66. Solar System-Final . '
i6. Rough Electric Wiring ' 67. Fencing & Access Approval . ��
77. Rough LViring Sign � - 68. APPflOVED FOR PLASTERING� �
78. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEh�S FINAL �
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireptace .- ' ' APPROVALS. ' Permit #
21. Oucts, in Siruccure . . � _' 7p. -Underground Hydro
22. Duas, Ventilating � -. � 71, Product-Piping OGas OOi1
23. Gas Pipe-Rough & Test - ^ 72. Underground Flush
24. Roof Framing , . � 73. U�dergrnd.StorageTank CIGas OOiI
25. Roof Sheath ng� ��y], p 7��-�G� ' 74. Overhead Hydro
26. T-Bar Ceiling 'Ctructura�l�� at 75. Ory Chemical
27, �Frame and Fiashing �� 76. Dry Standpipe � .
� S
. 28. lathing & Siding -� � � .�. 77. FIXED SYSTEM FINAL
29. Insulation '� ' �� 78. FIRE PREV. FINAL
30. Drywall Nailing . � HEA�TH DEPT. REQUIREMENT
31. P�aster Brown Coat . � 79. FINAL INSPECT�ON
32. Electrical Power Mater-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 Fireplac= .,
38. Final Plumbing � -- _
39. Water Service-Pinal � �
40. Gas Service-Pinal . .. . .
' 41. Solar pomestic-Fina! . '
42. Backfiow Preventer .
43. Backflow Irrigation �
44. Landscape Irriqation System
45. So�nd Attenuation � - �
46. Handicap Regulations � � .
47. FINAL STFUCTURE & BUILDING q Z3.cl� �'(,� �
48. FINAL PLANNING �
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Oate
JOB ADDRESS p2 Grant
ENERAL CONTRACTOR �p
AP �10.141-133-07 LOT °
��,� _�
'�:cnoNs
50'i':
GAS
W ATEft
ftOUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. f
SPRINNLING SYSTEM
MISCELLANEOUS
ROUGM HEATING ANO AIR CONDITIONING
TEMPORARV SERVICE OR POLE
UN�ERGFOUNO � POWER �
ROUGH WIRING
TRENCHES FORMS TEEL RE
FLOOR SVSTEM
BOND BEAM n STEEL REINFOftCE [
SHEATHING
FFAME AND FLASHING
LaTHING — IN OUT �• �(�1/.
PLASTER. BROWN COAT
Date
H IG, VENT., REfflIG. AND A.C., FINAL
PLUM6ING, FINAL AND GAS TEST �J� �y
ELECTRIC, FINAL � S�'��l`�'
BUILOING, FINAL Sr/1 6'9
DATE
SUBCONTRACTOR
I.y:7b1��.Na
� • w�-� � �
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING � /��J_� Y� NT U�
ADDFESS L/L-
OWNER � O S� r (7 `.
MAIL 3o2S ANT —
Z ADDRESS f
aU CITV OS�� F5A NOL
HZ
Z Q CAN5TRUCTION
O �F LENDER
am
J � BRANCH
J N
Q ADDRESS
tl
J ARCHITECT O1J� TEL.
4 OR ENGINEER N
U N
Q
W CL ADDRESS
aw ��) ^'� �/7
j � CONTRACTOR 1/ L Il U/ L�C./�
m Z
J � ADDRESS
w w TEL.
� CITV NO.
Z H
W � STATE CITV
(n CL IIC. NO. LIC. NO.
7 � SIZE �� NO.OF BLDCS. /
OF LOT X�� NOW ON LOT /
USE OF 4/���, �
EXISTING BLpG. �:�'/ %%1 � (�e/
I— SIZE OF NO.OF
Z NEW BLOG. ROOMS STORIES
a E%TERIOR WALL ROOF
V COVERING S 4C�V COVERING
J USE OF BUILDING AND WOFK TO BE PERFORMED
o /�e /� .�� roo.� �`f�afLi
H
N
Z
O
UI hereby acknowletl6a tha[ I have �eetl this application antl stata
� that [he above information is correct and agree [o comply with
� all laws regulating huilding consVuction, antl I shall not emplay
F any pe�son in viola�ion ot the wOrkmun's compensation laws of
y the State ot Calitornia. � m
zI hereby certity ihat I am properly licansetl as a contrector untler � SQ. FT. o
ihe Stete of Califor��a 6usinass antl Profassionz Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licanses are in full (orce entl ettact, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON�v: Q
am exemp[ trom ihe D�ovisions of the State af California Busineas VALUAT�ON
antl Protessions Co , Division , Chep r N
OB PERMIT FEE 5 / 4 6 ]
Signature ot n %
m
Parmittee � 5� Q`�O PLAN CHECK $/ � �O E
/ Q' LL
AuthorizetlA t TOTALFEE $ ���OO
QPAIDOO 031� ***�48.00
MAR —4-6.cwsa
APPLICATION FOR BUILDING PERMIT
RECEI E BV DATE RECEIVED OATE ISSUED
- " -3 - 3-�-6
PERMIT NO
A.P. NO. /' �L
BUILDING �
ADDRESS
� TRACT lOT BLOCK
W ADD P
X
OWNER �
S GUC'// VALU$ (O DOO�..J
FIRE
ZONE � TYPE GROUP �
�AVPROVED ��' DATE J��—/Q7
��� 0 J
20NE NO.OF
� PLANS
VAROS APPqOV E
MAIN BUILDING
(FROM C/L STFjEET)
YARDS APPROVEO
L. SID� e.� Y FT. FT.
I
REAR FT. .� I FT.
DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
VAR.aF` DATE
C.U.P.# APPROVEO
�APPROVED// .M/ neT� . � �-(! �
OWNER
ESS
APuo. 141-14i-07 LOT 52 TRACT
�oi� _ _ "
GAS
W ATER
ROUGH �LUMBING
PROP. SWR. LINE
SPRINKLING SYST
MISCELlANE0U5
ROUGH HEATING ANO AIR CONDITIONING
TEMPORFRY SERVICE OR POL
UN�ERGftOUND � POWER
ROUGH WIftING
STEEL REINF.
FLOOR SVSTEM
BONO BEAM ❑ STEEL FEINFORCE
SHEATHING
FRAME ANO FLASHING
LATMING — IN OUT (]�
PLASTER, BROWN COAT
ST �TURAL, FINAL
H. 1G, VENT., REFRIG. AND A.f
PLUMBING, FINAL ANO GAS TEST
EI.ECTRIC. FINAL
IN
�1—
DATE
I�IIr.[e]
FIRE ZONE VALUE
GROUP TYPE
SUBCONTRACTOR
- �. � 30292 vain
• " I�AY 16-69�NSAO01043� *=*�34.50
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applicant ta Fill in Completely APPLICATION FOR BUILDING PERMIT
RECE VED BV DATE RECEIVE DATE ISSUED
BUIIDING . -- � �
ADDRE55 F , � �—�
/ P RM
OWNER L A.P. NO. — � O
ADIDRESS �J��
MAIL / ve //Q�q �
ADDFiE55 O �- G2N
a U CITY C, NOL�/ 6' ,j% TFACT7Y�.70� LOT r� BLOCK
�— Z '
Z Q CONSTRUCTION W A P
ON LEN�ER �1
d m
J � BRANCH y/✓�
J N OWNER . V •
Q ADDRESS
� VALVE ��
hftCMRCST TEL. S SZ Q D�
J N OR-EMfTREER G J N
V Q FIRE.�/� �
W� ADDRE55 ZONEr� TVPE GROUi
d w APPROVE� � / / � / /
W Z CONTRACTOR / j' BV DATE� (�_(O
J Q
m Z
J � ADORE55 . ��
w W TEL. ZONE C� NO.OF USE OF NEW
Z� CITV - � NO. 'a�U " -/ PLAN$ � BU7LDING
w� STATE CITY �'ARDSAPPROVED YARDSA�PRpVED
? O LIC. NO. L�Y ��o. No.ap3 MAIN BUILOING ACCESSORY BVILDING
512E NO.OF BLDGS. (FROM C/L STREET tYJ
OF LOT NOW ON LOT FOM FT. �" FT.
VSE OF
EXISTING BLDG. � E � FT
� S12E OF NO. OF 7
Z NEWBLOG. � / Ii00MS STORIES � l.S1DE FT. FT.
U EXTEFIOR WALL �100F
COVERING COVERING U� T REAR i� FT.
USE OF BUILDING AND WORK TO BE PEFFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCEa.8LDG5.
4 VAR.� DATE
O C.U.P.�{'+ APGROVED
� ' APPROVED /
fn � G `
Z
O
VI hereby acknowletlge thec I have reetl chis application and stete
= that the above InformatioA is correct antl agrae io comply with
� all laws repulatinB b�ilding consttucNon, antl I shall not amploy
F„ any person in viole[ion ot the workman's comp¢nsation laws of
y Me Stare of Culifomio. y�� m
zI hereby certlfy thot I am properly Iicanmtl es e cont.ector untler J SQ. FT. o
[ho S[ato of CelHornia Bus(�ass antl Profosslons Cotle, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chap[er 9, and the[ Such li�enses ara In full force antl etfect, or I THE PURPp6E OF ESTABLISHING A PERMIT FEE ONLV: ¢
om exempt from tho provi5�ons of tho Stam of Celitorni u�inesi VALUATION
antl Professiona Cotlu, Division 3, Chepmr 9. m
A,, PERMR FEE 5 �
` / �'fl ]
Slgneiur f �1 m
Permlttee / yyt � 90 �� PLAN CHECK $ E
�� n O
Au[hOriietl Agont ^ LL
TOTAL FEE $C/ - � U
LiT 5Z TRACT 4Z Z
, ��. ���
COSTA MESA BUILDING-SAFETY DEPARTMENT
� P.O. BO% 31] COSTA MESA. GALIFORNIA
fOR APPL/CANT TO F/LL /N �'OMPL,E,�TfLY
TYPE OR PRINT C,y—
BUILDING �� ^ C LQrn..Z% Cc.1�
ADDRESS a�il
COSTA MESA, CALIFORNIA
OWNER K S�B DEVELOPMENT C0. INC.
MAIL
ADDRE55 � PLACENiAI AVENUE
crcv {dEWPORT BEACH TN�'lI 6illi
FEE RECEIVED
SEP 271�61
�FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
fOR Off/CE USE ONLY
I HECEIPT NO. I PEFMIT NO.
'Q i- "!y t1
�N D BY DAT RECfi1VED 'DATE�193U[D�
I �c�J�"�Q� =..r:; 7 iQf.
NG
STATE/ APPROVED �
CONTRACTOR K.W. Ko�� LIC.NO.Ol� BV DATE
LACENTAI VENUE
nooRess NE J�ORT BEACH �j ZONING
IEGAL ' LOT Z3 L ZON NO.OF USE OF NEWB/^' `7J.� �.
OESCRIPTION NO. �� BLOCK TRACT ��I I P�-AN9 Z I Bl11LO1NO ���y
IµI
A.P.NO. BPPROVED(��� DATE �/LL/�I
512E / NO.OF BLDGB.
OF LOT p � � Now on �oi O REOU RED ALLOWED
USE OF (CENTEP L�NE BT.1
EXISTING BLDG. NONE FRONT �/ Ff. IN.
SETBTCK LINE FROM � ��
cenren or eTweer REAR YARD R. SIDE s_ FT. �N.
SIDE YARD I LEFT � �� I RIGNT � L. SI�E I� F7, / IN.
DESCRIPTION OF WORK J
REAR / Ff. � IN.
NF� I X II ALTERATION I II ADOITION I
EXTERIOR WALL ROOF
COVERING COVERING ROCK �
USE OF BUILDING AND WORK TO BE PERFORMED . I'�
SINGLE FAMILY RESIDENCE AND ATTACHED i'�
GARAGE / p /
PLAN 0. A /
1 MEHEBY ACKNOWLEOGE THAT 1 HAVB pEAO THIB APPLICATION TH8 AMOUNT BNOWN IINOER VALUATION 18 FOfl THE
pNn STATE TH�T TXE ABOVE IB CORPER wND wGREE TO COM-
PLY WITM /�LL CITY OqDIN�NCEB AND STATE LAW9 REGULATING PURP08E OF EBTABLISHING p PEFMIT FEE ONLV.
BUILDING CONSTRUCTION. VALUATION
SIGNATl1RE OF ��� r/ /� ��I PERMIT FEE $ ��j '—'
PERMITTEE L� �7 /%
s /� �O�U�— pLqN CHECK $ / /,,��
AUTHORIZEDAGENT TOTAL FEE $ V~ �iS1
FEE �����V��
',-.,. • (6dQ � FEB2718
COSTA MESA BUILDING-SAFETY DEPARTMENT FINAN�i� (���:
P. O. BOX 917 COBTA MEBA. CALIFORNIA
CITY d� C6�(A �i��A
For Applfcanf fo Fill In Complefely APPLICATION FOR PERMI7
TY E OR PRINT
BUILDING J ' " � �S ) BUILDING
ADDRE68 i Q S 1 D�
COSTA MESA. CALIFORNIA For Offite Use Onl y
APPROVED
� BTATE tn ,., r n/�. �1 Q TEL. Ti �.n o. . ■ �eo.�
r+o. or e�ome.
USE OF
EXIBTING BLDG
fi6TBACK LINB PNOM
DESCRIPTION OF WORK
I II ALTERATION I II ADDITIO
I IIMOVING I IIDEMOLIf
�[ I j S/ ROOMS STOF
WALL IROOF
COVERING
I�LDING AND WORK TO BE PERFORMED
COSTA MESA,
NO. OP 9E OP A
PLANB .•� Bl11LDIN6
YARDS
APPROVED
(CENTER LIN! 9T.1
�
f�
I HCHHBY ACKNOWLHDOe THAT 1 HAVB R6AD TH19 APGLIGTION TH6 AMOUNT BHOWN UNDEfl V�LU�T�ON IB FOR TH6
ANO BTATE THAT THH ABOVH IB COPRHR �NU A6R86 TO CON- pUPPOBE OP E8T/.9LIBHING A PERMIT PHE ONLY.
PLV WITX ALL WYY O ANC88 ANO HTAT LAWB RHOOL.hTINO
BUIto1Na COrveTHu N VALUATION ��
81GNATURE OF PERMIT FEE $�
PERMITTE 7�/j
S 'SM � PLAN CHECK S
AUTHORIZED AGENT � ' � �