HomeMy WebLinkAbout1628 PRIMROSE ST - Building Permits PROJECT ADDRESS: 1028 ;3R7MRO3£ ST UNIT: CITY Or COSrA MESA — BUILDING PERMIT PERM ,'i0: n 0j43-14
OWNER'S NAME: RYE v.e-;, . R=CHARD rI
ADDRESS: 8YBEE, CATHERTNL: S PERMIT NO: B 059394 i'.,AN CHECK NO: 03891-92 3 GOVis N SL2P; ac
1. 1628 PR .MROSd. ST
COSTA XESA, CA 92616 CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: A11D
641-5178
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 256SF OPEN TRELLIS PATIO COVER ;Q FT: „ 256
ADDRESS: UNIT:
CLAIM VALUE: 4 , 000 . 00 CALC—VALUE: 4 , 788 . 80 GROUP OCC; R-3 /
PERMITTEE: LARS—ERIK LJUNGH ( 714 ) 650- 3333
ADDRESs: 445 GLOUCESTER DR COMMENTS: REPLACE ALUM WINDOWS W/WOOD FRAME',
C.M. CA 92627 **** L**#******#*#+a#*#*iE####*##*#*#***##****x****#TL******** ******N?'r*kFx*;e***N* *
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions al Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETB ACK S
CITruC.: 056964 STATE LIC.:649144 j cis
Dale: IO S2 Signature: B MAIN BUILDING ACCESSORY BUILDING --------
WORKERS'COMPENSATION DECLARATION: I hereby affirm that lhave acertificateofconsent tosetbinsureoracertificateofWorkers' FRNT; FT IN REAR; 10 FT IN FRNT; FT TN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; 35 FT IN RGHT: 1 9 FT 6 IN LEFT: FT IN AGH'r: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ. - PROV: PARCEL; 13928501 ZNE; R1 REF NO;
0 Certified copy is hereby furnished. 0 Gemred7pyistiled with Mecity Building Division. PLANNING NOTES 16' BYFY 160AN TRILLISGTRELLIS PAIIOO COVERiTOO BESIDENCEBE ONSTRUCTED TO THE
Date' Applicall: ******************* ************************•**-**********************k****16*****
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(S100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which Ups permit is- ued.I s II not amply any person in any manner so as to become
subject to the Workers'Compensation Laws of California) 4//_ ZONING APPROVED B Y COG L— DATE; LO'7/0-1 2-
4 Date: IU---1 -'R2- Signature: BUILDING APPROVED BY
NOTICE:If.alter making this declaration.you should become subject to the Workers' ,Compensation provisions of the Labor DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; DATE• -12 [/(((���( •1
which this permit is issued(Section 3097.Civ.C). r, *****#*#************************dry ****x* kt- —* t**-***** *iv*********#***N-A**'l r**kk*
LENDER: IE**#*******#****#*#.******Mk*##**IE#lf***#*********##*#*****k**#K**#**#9F*Sf**** #N *
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL. SEGMEN ;Y
OWNER GUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason PERMIT BLDG2 PMTMT PLUMBING ELECTRIC MECHANIC FIRE SM IP/RESS GRADING
(Section 7031.5 Business and Professional Code: My city of 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/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN 46 . 80
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(55001. ISSUE FEE
I. as owner of the progeny or my empbas yees with wagestheir sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7644,Business and Professional Code: The Contractors'State License Law
TOTALS—---> 72 . 50 0 . 00 4 6 , 8 0 119 . 30 1 19 , 3 0 , 00
does not apply to an owner 01 a property who builds or improves thereon,and who does such work himsellmersell or through
his or her own employees,provided that such improvements are not intended or(dieted for sale.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED; 119 , 30 OVER/SHORT: 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
lOr the purpose 01 sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 .00 , S0 46 . 80
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or Improves thereon
and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware *'***#i4.**********************************************************##*********#K**
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason. TYPE QTY DESCRIPTIO N UNIT COST DOTAL COST
Date: Owner: SFR 256 RES—PATIO COVER—POST 6 TRELLIS 14 , 80 3, 788 . 80
I do hereby certify mat lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 1000 ALTER BY VALUE RESIDENTIAL NOZONE 1 , 00 1 , 000 , 00
25534 and that I of any future building occupant wilUwib not(circle one)need to campy with said state codes and the requirements for a END OF F EES
permit for construction or modification from the Air Ouakty Management District.Residential construction applications are exempt from
these provisions.
• Date: Applicant: '
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to budding coristfixiion and her authorize representatives of this city to enter upon the above-mentioned
property lot inspection purposes.
Date: I p --1 ' '12_
Applicant: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. 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 10_112' 41 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 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 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing t HEALTH DEPT. REQUIREMENT
•
31. Plaster Brown Coat i 79. FINAL INSPECTION
32. Electrical Power Meter-Final I 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
•
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDINGG
48. FINAL PLANNING / �L2 / ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
lam• show ANU DIMENsTOflROPOSED
PAT �OVER AND YARD AREAS
ADDITIONS, DELETIONS, OR CORRECTIONS SHALL
BE APPROVED BY HE PLANNING DEPARTMENT / r SEE DETAILS ON REVERSE SIDE
—� --
t ..••' ROOF SHEATHING
"•..... OVERHANG --�—
IlD ' � I p I 1
�• 3lJ n(6-0. XRAFTE RS •••...�..•
CD , AT O.C.
-416-1115140 t
\ X_ BEAM
• TT .F I,�Qo / 1
f A 4/61 �/ y
111
T-STRAP EA. SIDE
iiilllil 1 FOR POST- BEAM Q
�•� ' CONNECTION. wa ;o
CITY 0 COMA z a 1- .v
FUNNING DIV 1,Anwt_to FP
‘111
¢ w a w
f
saw i0 hu.ICIEI., ' t CO I- .1-
CO O Z
1,-----...............lam`^ c _ /7 ' 2 iiiiiititi o ' N -' o n i `o
o ¢ i
MOOD CO
�_____1 P ROVE ► z o
Clty OI D w 1 J U N Z U w
SI Costa Mesa 11 DROP PATIO Z X _J Z O
By Building �e () FLOOR 2" !Jul °m = 1.
Pt. (1 _o 0 a
THESE PLAN 1� SATE ( SLOPE TO DRAIN v PLATE in
NO CNANr. S PLANS NST BETON DAT arI Is(2 , ABOVE SLAB 4
/&, zs IrIII I•� e. '422rC ALL TI • • c. , I I.
CY •DANCE CHAN,IN` `J /PP3OVAL o n�r . . . .. ' A•I!o
PIANS AND SPECIFOq 1/ -
•
Tie PEIIMIT Fpq OE AN 4F,ON,r�r;' •CONSTRUEDTP1'R OF 26 GA. G. I. FLASHING _N I
AUThROV/ ONS OF rr.uS r,(,.. `PI% ti(O 'p6 CONSTRUCTIONWOOD J� - J w
CODES bLAir ,ter :,� , �`n71pN Or. E A PIERS 12" SO. O
o
W+ll NAIL FSE VA!! �' RES(y„fING NY OP a
CH ITA D F-..,: 1 PA'-„ ¢
UNiO.R7'�c c i�f ; �••cID.� GIV
SPECIE!IILF ISSUANCE ... yt,r" n''ORK• USil E Z
FROM
.7 , ��.�`HA4.1 .'i'- '.,"!.,, l t sr' P:n
• Eff'(+ �.I f,10 5P 1117. I11(?r;,4 , ,r. 0 ," „ ,,_,J.;, f!S AND SIDE ELEVATION LL
' IN Irlou nc;`.1'``•I;c;:'' 'Ar„ :,,., v� SIN
' i • ,i
f ;:-,; °N INC
Lt qF
PLOT PLAN `'----_J CONSTRUCTION DETAILS
201ts.ROOF CONNECTIONDEVIIAPDENT PATIO COVER
DETAILS SERVIrFS DE ARItENr
BUILDING SAFETY DIVISION TYP.:: PLANS
CONT. SOLID BLOCK
LEDGER
OWNER: 9-I c11A2D (C c ATS-{y C?f a eta- DATE : .
M, ADDRESS: 1628 PQiMkOS� PHONE: C��i� — � L-7g
I/2" DIA. x 5" LAG SCR. CONTRACTOR: LAQS —EQ-."C LYL7wc,,A* LIC. NO. 1119 - I411
AT 32" o.c. ADDRESS: LILIS G-LovcE=S.; .. on. PHONE: coS° 6333
•
DETAIL I RAFTERS RAFTERS APPROVED FOR
CARPORT, PORCH OR PATIO LIGHT WEIGHT ROOF COVER OF BUILDING PERMIT
NOT SUPPORTING CEILING LATH, FIBERGLASS, ALUM.
By Date
SIZE. SPACING SPAN SIZE SPACING SPAN _
CR 8 CL "TECO" 2"x4'! 12"O.C. 9' -6" 2"x4" 16"O.C. 9'-6"
GRIPS OR JOIST 16"' 8' -0" 24" 8'-0" S:RNERAL NOTES:
HANGER 24" 6' -6" 32" 6'-6" 1. These .plans. must be
COLEDGER �� 32" 6'-O" 48" 5'-6" kept 'on the job at
I�/ 48" 5'-0" 2"x6" 16" 16'-6" all time during
2"x6" 12" 16'-6" 24" 14'-6" construction.
16" 14'-6" 32"• 12' -0" 2. All framing to be
3/s24" 12' -0" 48" 10'-0" Douglas Fir N4 2
AT ly " O.C.. 32" 10'-6" 2"x8" 24" 19'-0"WA. LAG SCR. grade minimum.
AT
48" , 8'-0" 32" 15'-6" may not'
3.. Rafters
DETAIL 2 2"x8" 24" ..•15'-6" - 48" 13'-6" attach to facia ex-
32" 13'-6" cept for lOBnroofs
48" 11 '-6" as shown on details;
IO1OR LIGHT WEIGHT ROOFS 4"x6" 24" 17'-0" HEADERS 201wroofs must use
ONLY CONNECTION DETAILS 32" ' 15'-0" a continuous ledger
36" 14'-0" LIGHT WEIGHT ROOF ONLY attached as shown
2" X FACIA-MIN. REO. 4"x8" 24" 21' -0" SIZE POST SPACING on details #1$41-2.
• 32" 19'-O" 4x4 6'-0" . 4. Light weight roofs
_ 36" 18'-O" 4x6 9'-0" may attach to facia
�/ 48" .16'-0" 4x8 12'-0" for 14' span max. ,
/11 RAFTER 4"xl0" 32" 22'-0" 4x10 15' -0" spans over 14' must
36" 21'-0" use a continuous
CARPORT, PORCH OR PATIO shown in
ledger as
APPROVED METAL 48" 20'-0" SIZE POST SPACING detail 4s3.
HANGER 72" 17'-0" 4x4 5'-0"
4x6 . 8'-0" — -
-_,2r--- :DETAIL • 3 4x8 • 10'-0"
4x10 12' -6"
C-O TM
OWNER MOORE, GEORGE DATE 14-6-60
JOB ADDRESS 1628 Primrose St. BUILDING PERMIT NO. 11704
GENERAL CONTRACTOR Admiral-Balt Const. VALUE $ 1149.00
AP. No. LOT 1814 TRACT 2822 FIRE ZONE DESCRIPTION OF WORKUomm. Blockwall
INSPECTIONS DATE I GROUP TYPE ZONE R-1
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE I NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches 4-Forms Steel 06,k- q-3-7-0-
Floor
-i -GoFloor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures,Fines
Building, Final /
OCCUPANCY t -17L/a'?//4/J �
Form 210-5M-11-59 S-B P 117014
•
•
EEE RECEUVEn
COSTA MESA BUILDING-SAFETY DEPARTMENT - y-4-Ua
P. 0. BOX 917 COSTA MESA. CALIFORNIA Ylltl\ DEPT.
For Applicant to Fill In Completely APPLICATIO 'I ORCFERA?l fr2E$'
TYPE OR PRINT
BUILDING 0. `�RQ –. S; BUILDING
ADDRESS fI72 �
0 IIMI-PRIMP
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. PERMIT NO.
OWNER C-CORGE M00 2E I / y.
ADD / p ^�`-^�s/w BY DATE R 2 .a — IBSURa
ADDRESS 1 6 7-- 0 Rf21H2 OSE /lf�/.I T/ !C/ (/C /T( (L/'
COSTA MESA TEL. ADDRESS / o v
CITY I �(p 2Q //G mb/G OSS N )
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
FIRE
ADDRESS ZONE �E GROUP
CONTRACTOR A�YlI R(}L-B( I—T CONS-t2. Cfl01, BP,PROVED DATE 4-i- a
ADDRESS 12-14- LAI - 6 S T- NING /l/j
CITY SA nlTnattyO 8 I NO.NO: l / USE OF NEW
Af(;. rI PLANS y I BUILDING
STATE i 5' TEL. ti 6.e...‘ LEGAL ,O
Y\
LIC.NO. 7'36 ( NO, ` 1 GE SC RI PT I ON ZQ 7 (e E I )--, y y
SIZE I NO. OF BLOCS.
OF LOT NOW ON LOT A.P.NO. /l/1 Gild
USE OF YARDS l -_EVES
EXISTING BLDG ___ APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.1 1
CENTER OF STREET REAR YARD FRONT IC�+ Y FT. CI(...-- IN.
SIDE YARD I LEFT I RIGHT R.SIDE FT. 0 IN.
DESCRIPTION OF WORK
L.SIDE -FT. IN.
`Y,�
NEW I /_ II ALTERATION I II ADDITION I REAR ^FT. J/ IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED ( ./ I\ DATE y r(D '_ G/ 0
BUILDING NO. OS l.✓L� IV) 1
SIZE' ROOMS STORIES01.01
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AN WORK TO RE PERFORMED
4,"" ,j. 6. X &4L' — CQwxoniry
'SLoct FENCE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE( THAT THE ABOVE IS COR AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY (HANGED ANO ATE LAWS REGULATING
BUI LO ENO CONSTR N. VALUATION DO
SIGNATURE OF 1 PERMIT FEE $ Z. —
a
PERMITTEE c.Mw`I" / '_ o_
7.
AUTHORIZED AGENT -
$ /�/! PLAN CHECK S 'E
/
TOTAL FEE $ a
JOB ADDRESS 1628 Primrose BUILDING PERMIT NO. 24727
�a�, GENERAL CONTRACTOR Better Bilt Const. DESCRIPTION OF WORK Community Block WaJ1.
yp AP No. 139-285-1 LOT TRACT FIRE ZONE VALUE $ 311.0.00
INSPECTIONS Signature Date GROUP J TYPE IIT ZONE p_i
SoilI PERMITS ISSUED
3 Gas SUBCONTRACTOR Date Number Signature
Water Plumbing
iRough Plumbing
Prop. Swr. Line 0 House Con.O
Sprinkling System
Miscellaneous
1/4
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power a _
Rough Wiring - Heating and Vent.
Trenches ® Forms 0 Steel Reinf. El 1,0N a/ei/er
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing— In 0 Out 0
Plaster, Brown Coat
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final 0W
• 24717 CITY OF COS EA MESA
COSTA MESA BUILDING-SAFETY DEPARTMENT SEP 21 1965
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
•
For Applicant to Fill In Completely APPLIc10, F rAMT
TYPE OR PRINT - ►' -� I �-J
BUIL /4)S G� i� 20 5e For Office He n
ADDRDIESHNG
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA I
1� '{1 1_ ()gist DMI--i
RIC D Y DA RIC a IBS ED :
OWNER R1 1e�l�•� I(�()gi` DM /.— ? 2 6 l/7 z/ "'
ADDRESS / ( 14( �) I - e S C ADDRESS
(6 -'O /-IA11(�,1:pcG-
FIRE
CITY Ca S 1 A r )�'S'p, NOL ZONE /�/(�E GROUP ,,T,//'
ARCHITECT TEL APPROVEDe // /DATE ( r( C
OR ENGINEER NO. �'(/"/
ZONING (p
ADDRESS. '
ZONE i NO.OF USE OF NEW zp J _ '
I • I I PLANE BUILDING LL//i(/L{/
CONTRACTOR .� - 1 ///
Ld LU P e' fR�P]_/�
ADGIIBSS ' BCRIFlION` ( c C—(1)
T^ /�/�) "a
'-A\.P.NO. / ✓9 — DV — / l
CITY . 4n1 7'4V—` .
NOTE: OVERHANG SHALL BE LESS THAN
SI
STATE TEL. 90'TO SIDSE&a REAR P.P.L
LIC..NO: NQ, _
EAVES
SIZE I NO.OF BLDGS. r ALLOWED (U.B.C.REQUIREMENT) _
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
a - - - -- - -- - - (FROMC/L STREET)
SETBACK LINK FROM FRONT `FT. FT.
CENTER OF STREET REAR YARD
SIDE YARD LEFT I RIGHT R.SIDE —FT. FT.
DESCRIPTION OE WORK L.HIDE 0 FT. / FT. rI
'_ NEW ALTERATIDN _ ADDITION REAR 0 IFT. -701--"P-WAIN
FT.
DISTANCE BLDBET. AE . S.BLOCS.MAIN BLDQS. A SH.BLDGH.
REPAIR NOSING DEMOLISH
BUILDING NO.OF VAR.* DATE
SIZE ROOMS STORIES C.U.P.* APPROVED
EXTERIOR WALL ROOF APPRp�(�Ep
COVERING I COVERING
es L.(/ c. �`� DATE 9 ��/�� a
USE OF BUILDINS AND WORK TO BE PERFORMED
Pii
((n(J ' /J ' a 7c74 BG.PT. z
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT V[ IS CECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. R1
PLY WITH ALL C ORD NCES ATE WS REGULATING
BUILDING CON RUCT A � yVALUATION �GCIO y P]1
SIGNATURE OF 1 PERMIT FEE 5 S
PERMITTEE c
w
s 3-1G PLAN CHECK S OU
AUTHORIZED AGENT
TOTAL FEE $
10072 ,
COSTA MESA BUILDING-SAFETY DEPARTMENT AUG 7 1959
P.O.BOX 317 COSTA MESA. CALIFORNIA "• • L L. `• r=
FOR APPI/CANT TO Fill IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1628 Primrose St. •
COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY
RECEIPT NO. l{�ERvMITit1i
OWNER Rosslane Land Co. v 11
MAIL RECEIVED B.Y DA7E RECEIVED DATISSUED
ADDRESS 419 E. 17th St. Z ,i',-.4.-.5—' 1 0 959
EL. BUILDING ,/ {�//) J
CITY Costa Mesa TNO.LT81159 ADDRESS /lam 22/ (///-Z-jn-Lc.c',C- -<7.,1.,"".
ARCHITECT Carlson & LIC. COSTA MESA. CALIFORNIA
OR ENGINEER Midalobrook NO.
Garden Grove FIRE Inc. - �L I y
ADDRESS Y ZONE TYPE—1�- GROUP !7/—
Dike & Colegrove, nc. STATE 167293APPROVED
CONTRACTOR LIC.NO. BY DATE
ADDRESS 419 E. 17th St., Costa Mesa ZONING
LEGAL LOT 184 2822 ZONE `I./�. NO.OF USE OF NEW //��
DESCRIPTION NO. BLOCK I TRACT P` / PLANS o{�{/� I BUILDING �) /I yya.!
A.P.NO. APPROVED v� V DATE 44 Al
/
BY / +'o.'
SIZE 70 X 100 NO.OF BLOGs. YARDS EVES
OF LOT NOW ON LOT non REQUIRED ALLOWED
USE OF (CENTER LINE ST.) //��
EXISTING BLDG. FRONT rC/ FT. IN.
CENTER
SETBACKOF LINESTREET 55FROM 55! REAR YARD261261 R.SIDE S FT. IN.
SIDE YARD I LEFT 121 I RIGHT 01 •
L.SIDE AD FT. IN.
DESCRIPTION OF WORK REAR ,2.Q .71......' Fr. IN.
NEW I XII ALTERATION I II ADDITION
REPAIR I II MOVING I II DEMOLISH I `
SZIE DING �5Ln NO.OF
ROOMS 7 STORIES 1
EXTERIOR WALLSttuc CO ROOF
COVERING S COVERING shingle
U OF UILDING ND WORK TO BE PERFORMED
Single fLAND
residence with .
attached garage.
Plan J20RR ._
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUC r ON. / - VALUATION
I
SIGNATURE OF / PERMIT FEE $ 35.00
PERMITTEE J . - • •
OF $ 15,571 PLAN CHECK $ 17.50
AUTHORIZED AGENT Dike & Colegrove, Inc. TOTAL FEE $ 52.50
'N.