HomeMy WebLinkAbout1964 RAYMOND AVE - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
P i MIT ryO.I TRACT NO:- LOT NO. UNIT NO. anameSIMMINIIMMamaamea
on'OF COSTA-11106Cr,NST CT9N PERMIT] /I _ IIFFii�J 6� A.P.# Zone
Project Address LY/1�1/ D,�tn' .��h�J�J _ - I
� �r"L� - TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION IJ REPAIR �S Main Building: Accessory Building:
Applicant's Mail"'ddress E • Z
/ �' ❑ CONVERSION ❑ DEMOLISH ❑ *IP' R - _ T Front • 0
Owner's Namec-1`'�,1,,_^_—. ----• P .•�: • - RIPTIONO 'We'K SE OF BLDG tejngar i� I A -Rear N
Address 57\in ' a e ►4p - ' - -� •_�`�1t:SJr -f� �'- A Ri ht N
Arch/Eng. - _ License No. - TYPE OF PERMIT . GRADING N FOUNDA ION N 5T• CTURA K g - _ G
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $.. Left
Address - '
Contractor's N. •f A a - - - r �� /`��r� El OTHER �� I Ping. Ref.# Parking.Req./Provided E
` 'O/' PROJECT DESCRIPTION SQ. FT. OCCUPA PlanningNotes: Q
Address(mailing) J.S - �� 7/ CONSTRUCTION r - • M
CONSTRUCTION TYPE VALUATION$ i T
City License No. ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: -
with section 7000) of •' ision of the Business and Professions Code,r1 my license is in full for - . t• -O S7
t. & • ELECTRICAL FEES
l"i Licens- Clas a icense No JJ/
Cl Date _ f lgnature AJ - • PLUMBING - I FEES Automatic Washer - Transformer 0 15-50 KW '
rJ(�' '7 n�' 0 50+KW
WORKER-'CO P'NSATION DEC LA RA •N Construction Pole Sub.
I hereby affirm that I have a certificate of consent to self • re or a certificate Bar Sink Shdwels
of Workers' Compensation nsur c - or a c 'fled y'thereof (Section Cooking Unit Meter Dup to 100 amps
jeNel 3800, Lab. ,`f/' 1. Backflow Preventer Service Sink
•
{ Policy No. Dishwasher Meter Dover 100 amps—
om • Backflow Irrigation Sewer Cap —
'fled c•py is h-reby furnished. Dryers ❑Gas DElectric Sub Panel
rti i-d c.py s f• -• i the cit ¢ ' isi Bathtubs Sewer Connection
ate F
'applicant v Motors 00-1 HP Om-8
EXEMPTIO FRO WORKERS'COMPENSATION DEC RATION Clarifiers Solar Collectors an
(This section need not be completed if the permit is for o undred ($100)or Dishwasher F.A.U. Inc.Solar 09-15 HP 016-15+
less). Solar Piping
I certify that in the performance of the work for which this permit is issued, IFixtures Microwave
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank '
Workers' Compensation Laws of California. • Devic¢Boxes
Date Signature Floor Drains Swimming Pool w/Spa Pole Light
NOTICE:If,after making this declaration,you should become subject to the - •
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range ^��
comply' with such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCYSign •
Gas Service Outlets Water Closet Switches
,.•R' -
I hereby affirm that there is a construction lending agency for the performance
of the' work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections
Lender's Name Interceptors Water Heater -
Lender's Address Kitchen Sink • Water Service Generator 00-5 KW❑5-15 KW Trash Compactor. '
OWNER BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - -
following reason (Section 7031.5 Business and Professional Code: Any city or -
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays -
any structure, prior to its issuance,also-requires the applicant for such permit - -
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains `1 -
the Contractor's License Law(Chapter 9.(commencing with Section 7000) of . . .
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil -
enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: ^>
Li I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By - o'-
compensation, will do the work, and the structure Is not intended or-offered - Date
t
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By ^_ Date
License Law does not apply to an owner of a property who builds or improves �,`1� ,per��
thereon, and who does such work himself/herself or through his or her own Boiler - Application Issued By Date �(�
employees, provided that such improvements are not intended or offered for Hood or Type I 0 �+
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES .
pf, the owner will have the burden of proving he/she did not build or im- Duet-Under Ground ev �'�
prove •
for the purpose of sale). - BUILDING PERMIT $ SMTP { $
U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE •-$
builds or improves thereon.and who contracts for such oroiects with a con- - - ENERGY P.C. $
tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ '
proof Y their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICRONILM $
f - - - PLAN CHECK 50% $
Date I Owner Heating System& Ducting Registers sl!
1 hereLy certify that I have -:d this application and state that•the above ❑0-100,000 BTU D100,000 BTL • MECHANICAL $ TOTAL FEE $
Information is correct. I agr•e t• comply wi h all city and county ordinances • PLAN CHECK 25% $
and state laws relati • to •uild;• on on, a • hereby author ze repre- ‘
tatof this ci - tt• e � e- entione�r�er or
inspection purposes. _
Signature Dat
Drivers' License or SS , . // Reinspection Fee $15 Issue Fee $ 3 01 00021990-00021991 7'f_f T• 21•SQ
0865-46,rev.5/88 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 12/13/88 TIME: U9:08
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-Undrgrndt- ' . -_ -_ 54. Forms
'-A.. Electrical Conduit-Undrgrnd.• 55. Electrical Bonding
I
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ,
6. Electrical UFER Gr .nd. , ' 57APPROVAL TO COVER-GUNITE -
..7-. Footings - . i 58. Electrical Conduit-Undrgrnd. • 1 '
.8: Foundation _ .- - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd./ V 60. Backwash Lines, P-Trap, 0 Undrgrnd. .
10: Structural Floor System - _ , 61. APPROVAL TO DECK - - -
•
11. Property Sewer Line1& House Connection ' -- 62. Backwash & Receptor-Final
12r Sewer Cap + 'I 63. Heater & Vent-Final
l
13. Roof Drains r. ' 64. Plumbing System - Final
.'14' Rough Plumbing j 65. Electrical-Final ,
-
15..RoughElectrical-Conduit 66. Solar System-Final .
16. Rough Electric Wiring 67. Fencing & Access Approval
- 17. RoughWiring 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 O Oil
23. Gas Pipe-Rough & Test 72. Underground Flush •
24. Roof Framing , 73. Undergrnd.Storage Tank 0 Gas O Oil '
-
25. Roof"Sheathing 74. Overhead Hydro
4.
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 _1 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Cot 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Finaltlectric 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 f
43. Backflow Irrigation 1
44. Landscape Irrigation System IIJCO p(friss!
E D I #
P wectlons
45. Sound Attenuation • _ Dale �a o�c`
46. Handicap Regulations �J18 _ -
47. FINAL STRUCTURE & BUILDING
48. Special Renuirements Completed • • i .
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.
v PERMIT NO. TRACT NO. LOT NO. UNIT NO.
CITYOFCOSTAi5444Citt9n/RUCTION PERMIT rI A.P.# Zone
Project Address Kfi'Y r"�Ov✓� G _ �� �(� a 5 Main Building: Accessory Building:
q(7 y��� � Ntd."I �7- _ TYPE OF CONSTRUCTION U NEW LI ADD LI ALTERATION Li REPAIR E Z
Applicants Mailin/y/Address ! /�I L �" vs, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 1 T Front _ 0
Owner's Name 1.4)41504-fl clic i I-L-O Phone 646—c3,141
,I� DESCRIPTION OF WORK/USE OF BLDG. B Rear N
Address (9�y fyMor,(r� KVI/ A I
Arch/Eng. License No. TYPE OF PERMIT CIGRADING��U�FOUNDATION CISTRUCTURAL C Right G
Address ((77 ❑ TENANT ❑ ELECTRICAL L.. PLUMBING ❑ MECHANICAL S• Left R
Contractor's Name S4 ' r/ JL• r Phbr�t To-17 , ❑ OTHER �Ping. Ref.# Parking Req./Provided E
Address(mailing) Yom id. /47/•'I a 101,.. PROJECT DESCRIPTION SQ. FT. OCCUPANCY City License No. Planning Notes: M
1 cele CONSTRUCTION TYPE VALUATION$ T
ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: •
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full for e and effect. �f ELECTRICAL FEES
License Cl. s - -" . - - Lice 1. Vf 2-7�
Date - Signature
�1 _� i PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORK •S' OMPENSATION DEC RATION Construction Pole Sub, • 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Dup to 100 amps
3800, Lab. C.) .
!�]�' -y-�>ft V Dishwasher ' Meter Dover 100 amps
Policy No. (4y Company N Backflow Irrigation Sewer Cap ': _
Certified co y is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Cer ifi 'tl c • filed with the CIL Oivisl0 Bathtubs Sewer Connection
Date Applicant ,--,1,r, Motors 00-1 HP ❑1%-B
EKEM 10 FROM WORKERS'C PENSATION DECLARATION Clarifiers Solar Collectors Fan /
(This section need not be completed if the permit is for one hundred ($100)or F.A.U. - • Inc.Solar 09-15 HP 016-15+
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is issued, IFixtures
• shall not employ any person in any manner so as to become subject to the ' Drinking Fountains Solar Tank - Microwave
Workers' Compensation Laws of California. .-
Date • Signature Floor Drains Swimming Pool w/Spa Device Boxes-•'t Pole Light
NOTICE: If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • Outlets / ' Range •
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCYSwitches - Sign
Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink . Water Service Generator 00-5 KW 05.15 KW Trash Compactor
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit � �
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains • I. 1.-t' P1 F�j
E
-the Contractor's License Law(Chapter 9 (commencing with Section 7000),of
Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
therefrom and the basis for the alleged'exemption. Any violation of Section - -
7031.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars ($500). DEVELOPMENT SERVICES REQUIREMENTS:
I, as owner of the property or my employees with wages as their sole Reinspection Fee ` $15 Issue Fee $ 3 Zoning Approved By Date
compensation, will do the work, and the structure is not Intended or offered - -
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES Building Approved By Date
License Law does not apply to an owner of a property who builds or improves �(,J
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Date_ —I ��U d
employees, provided that such Improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
Prove for the purpose of sale). BUILDING PERMIT $ SMIP $ -
❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System .
PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ 1.,-tV ISSUANCE . $ -
builds or improves thereon. and who contracts for such'oroiects with a con- _-
tractor(s) license pursuant to the Contractor's License Law). I am aw. hat Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their worker's Compensation i- urance should rovid=• GRADING $
I ELECTRICAL . $
0 I am exempt oder Section , i,for Firepl/Fact.Blt. ICBG# Fire Dampers
i MICROFILM $
/ PLAN CHECK 50% $
Date Owner �w� / / 6_-.1401.1Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $
I hereby erti y that I have read -'A.pplic, . n 'state that the above ❑0100,000 BTU ❑100,000BTL—
informati n is correct. I agree to • 'ply I I city and county ordinances PLAN CHECK 25% $ ,
and state laws 'rating to bui • con u• n, and hereby authorize repre-
sentatives of/Iris. city to - upo• : above-mentioned pro'erty for
inspection `T•oses.
Signature s �iL.1_-... a_/ Date - /
Drivers' iceri e o „� Reinspection Fee $15 — Issue Fee '$ 3 9 T- 23
01 000_2836-00 2_ 36 TOT 5,00.
0865-46,rev. 5/8: White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 12/19/88 TIME: 12:59
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 , l P.
'& Electrical UFER:Grnd.• , 57. APPROVAL TO COVER-GUNITE •C):: ^ .'1
7 Footingsr' ' 58. Electrical Conduit-Undrgrnd.
8. Foundatjon i '� `'- ri 59. Gas Pipe, 0 Undrgrnd.,Test { �•)
' I
9. Water Pipe-Undrgfnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10f Structural Floor System i' 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 .` • '
,r?
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final •
Rough Electric Wiring 67. Fencing & Access Approval
•17t 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
120. 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 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 •
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 & BUILDING
48. Special Requirements Completed
r'
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co -
I_
51. CERTIFICATE OF OCCUPANCY •
No. • Date '
® Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MES•A CONSTRUCTION PERMIT PE T TRACT NO. LW.NO: UNIT NO: I
ill/ '1 �` '`�ZZ a419-� •9 I —
AppProlitAddress 19by PA-9,KaN i /tip' 1'-'r) 4 qu'J Li ADD U ALTERATION U REPAIR
PQ I e5c. I 110)fS AcCr iAms� Q�21 TYPE OF CONSTRUCTION ❑ NEW '
Owner's
Na Mailing Ad"dr4uss� [� ❑ CONVERSION ❑ DEMOLISH ❑ OTHERZone p
Owner's Name y61`.r.+(r n (M1-(GI1-{') Phone �f'tf�'S'�I� A.P.# 1•�,�(p -� �O3 — �� /�I - ,
I (W4' I7r44htID10D Alm DESCRIPTION OF WORK/USE OF BLDG.
Address LLL S Main Building: Accessory Building:
E 2O`' O
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADIrvG ❑ FOUNDATION U STRUCTURAL T Front, gT(ACN
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear '� a' •"±'f + 88fi I N
( IC
•
❑ OTHER
Contractor's Name , \ Phone - ��3 C Right I/ ( �nr • -3 N
y PROJECT DESCRIPTION Sc.. FT. tr� OCCUPANCY ^' G
Address(mailing) CC ll K Left
CONSTRUCTION TYPE SLI VALUATION$ 2-
13
$ 4�iGL{- ,r.` R
City License No. • ZONE GRADING CU.YDS. ACRES �{'f^ E
LICENSED CONTRACTOR DECLARATION pat.„-_,....
''''''III 1 + _"' `Flog. Ref.# Pa Req./Pro. d
I hereby affirm that I am licensetl under provisions of Charter 9 (commencing Remarks: e ^'_ p� -_. /w. ,_ "1 Planning Notes: carte C � �/`/�Q /r T M
with section 7000) of Division 3 of the Business and Professions Code, and (I w-�' W Y'ClV (—/7�— (/9 T
my license is in full force and effect'.
• License Class License No. S
Date Signature PLUMBING ' FEES '
WORKERS'COMPENSATION DECLARATION Bar Sink - • Showers '' • ELECTRICAL FEES
I hereby affirm that-Ihave a certificate of consent to self-insure or a certificate ,
of workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink
3800• , Lab. C.) - Automatic Washer Transformer 0 15-50 KW
•
Policy No. Company Backflow Irrigation Sewer Cap ❑ 50+KW
Construction Pole Sub.
8 Certified copy is hereby furnished. •
Certified copy is filed with the city Building Division. Bathtubs; Sewer Connection Cooking Unit • Meter Cup to 100 amps
•
Date Applicant -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - Dishwasher - . Meter Dover 100 amps -
•
(This section need not be completed if the permit is for one hundred ($100) or •
less). Dishwasher - Solar Piping . Dryers ❑Gas ❑Electric Sub Panel ' .
I certify that in the performance of the work for which this permit is issued, I •
- - -
shall not employ any person in any man so as to beco subject to Drinking Fountains, Solar Tank . - Fan Mown❑0-1 HP 01%-8
workeL� Co peppsa on s of Califor /ry/{ - • - -
Date /— / iL� I Signature /i� /•� Floor Drains Swimming Pool w/Spa Inc.Solai 09-15 HP 016-15+ '
NOT( E: If,after making this declaration,you should be ome-subject to the . - - -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. - Microwave ,
CONSTRUCTION LENDING AGENCY Gas Service Outlets ' - Water Closet Device Boxes
I hereby affirm that there is a ostruction lending agency for the performance Pole Light -
`
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heater Outlets 'Range
Lender's Name - .
Lender's Address - Kitchen Sink - - 'Water Service - -' - Switches - , ' ' Sign -
OWNER BUILDER DECLARATION '
I hereby affirm that'(.am exempt from the Contractor's License Law for the Lavatories Auto-Wash ' GarbageDisposal . Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair LaundryP—Trap , • Trays
any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW ❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of . -
Division 3 of the Business and Professions Code) or that he/she is exempt • -
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil .
alty of not more than five hundred dollars($500). . '
•
I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
co pensation, will do the work,and the structure is not intended or offered 6
for sale (Section 7044, Business and Professional Code: .The 'Contractor's • MECHANICAL I FEES •
Reinspection Fee _ $15 Issue Fee $ 3
License.Law does not apply to an owner of a property who builds or improves -
thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: �7 r
•
employees, provided that such improvements are not intended or offered for • BoilerZoning Approved By MM Date 1//Ol,96
:rale. If, however,'the building or improvement is sold within one year of com- Canopy Type II ❑ •
pietion, the owner will have the burden of proving he/she did not build or im- Duct- Under GroundJIBuildinAroved By Date
• rove for the purpose of sale). - g pp ��+ y ,p
.❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date--Hr—€1"3
,tractors to construct the project (Section 7044,Business and Professions Code:
,.The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU '++77 `'�p �y SUM ARV OF FEES SV
•
builds or improves thereon,and who contracts for such projects with a con- - - — yBril`DRV�PERMIT
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration • - $ G, — SMIP $ OCC)
of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for
this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date 7'/ {_59 t Owner /2i1&M� 4/..rt.(.1 l- Heating System&Ducting RegistersENERGY P.C. $ -
PLAN CHECK 25% $- •
I hereby certify that I have read this application and state that the above 00-100,000 BTU 1:3100,0006T ELECTRICAL $ GRADING $ '
information is correct. I agree to comply with all city-and county ordinances -
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ - MICROFILM $
sentatives of this city to enter upon the above-mentioned property for r
• inspection pureDate " QCT' MECHANICAL $ TOTAL FEE $Signature / i, Reinspection Fee $15Issue Fee - PLAN CHECK 25% $
Drivers' License
lietICMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor .
Q.
' POOL&SPA'
CONSTRUCTION AND PLANNING
APPROVALS IPermii# ' ' Date Inspector APPROVALS Permit# Date Inspector
1'r-temporary Electrical-Service or Pole 52. Pool & Equipment Location ;, •
2. Soil Pipe-Undrgrnd. 'Th.
53. Steel Reinfordementr
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
f
4. Electrical Conduit-Undrgrnd. 55. Electrical Bondig
5. Steel Reinforcement 56. Rough Plumbic) s
& Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings . . '- 58. Electrical Conduit-Undrgrnd. '
8. Foundation 1" ' - •
59. Gas Pipe, 0 Undrgrnd.,Test,
9. Water Pipe-UndFgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. i
10. Structural Floor System 61. APPROVAL TO DECK -
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 1" .
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 i.
18. Rough Electrical-T Bar Ceiling69. POOL/SPA SYSTEMS FINAL t
i
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT :y}
(
20. Rough Factory Fireplace APPROVALS ' Permit# r,
I
21. Ducts, in Structure 70. Underground Hydro t
22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oili
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
r'
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical _ _ •
27. Frame and Flashing 70,4 / /� 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 - (/1
32. Electrical•Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1
33. Final Electric Notes: --
34. Final Heating & Air Conditioning
r}
35. Final Gas Pipe-Test
36: Hood or Canopy
i
37: Final Factory Fireplace e: '
38. Final Plumbing '
39. Water Service-Final •
:40. Gas Service-Final �'
v41. Solar Domestic-Final
,42. Backflow Preventer /^,
i
43.-Backflow Irrigation - 4
. , r
44. Landscape Irrigation System - • • .
45. Sound Attenuation I
46. Handicap Regulations
47. FINALSTRUCTURE & BUILDING /S�jG�/ .
48..Special,Requirements Completed ! U _
v
49.. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY,
No. - ' Daft '-
1 _ . . _ . _. . . _
,. 44.
w - A L LE-0 -
,
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• City of Fossa Mesa Buil.ing Dept. $
D..
BY T3"^ DAT n-141 p
�`--- ---�� • I HFSEPSCa13F
FhNL.SLON JOB AT •LL TIMES MAKE (V
t NO CHANGES WITHOUT PRrO An OVAL OF DEPT. 1 - h-
MING OFA PERMIT OR APPROVAL OF I -
'
PLANS AND SPECIE CATIO i'rr�'A i RTpT;•P'"ettl5+.cr= = o t
PERMIT FOR, OR AN APPROVAL OF,ANY"VIOLATION OF ANY OF�'�'"""""^ (�
(I IE PROVISIONS OF THIS CODE.NO PERMIT PRESUMING TO GIVE V
,P APPROVED , ODE SHALL
TO VIOLATE OR CANCEL. THE PROVISIONS OF THIS
t "ODE SHALL BE VALID, EXCEPT IN SG FAR AS THf. WORK OR USEi (3.—
•:HUGH IT AUTHORIZES IS LAWFUL.
aho A1�SA
OR -I THE ISSUANCE OF A PERMIT BASED UPON PLANS AND
pp��������������...�� A ✓ '� :CIFlCATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL
PUNNING DEPT. e :•'OM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN
Juana TO two. ca at ,. ' I:, PLANS AND SPECIFICATIONS OR FROM PREVENTING p
CILUING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
1 VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF P
DA S !H F CITY. •
mac*or I!414IUHO ___v.
23' G� ( " ' 71
65 , I
4L. L-C
•
•
C2f2- r-j :Z3 Q(...1S•ciC
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TREEI S 1 t AJ0t lept
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c OQE. (foo -z'Li_�__ 1
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OSE Site NAS A
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pi-(op ACc7hSS Itis Ai'7t s '._ •
) 2 f 6" _' .� 21S 21 L' (j C �, �'. CosPc "v Asa ti ;i:c{ing Dept. �� .
\Yi a THESE PLANS MUST BEAN JO .AT ALL TIMES MAKE •
!( NO CHANGES WITHOL f PRIOR APF ROVAL OF DEPT. I
! ;
t I
THE;ISSUANCE OR GRANT 4C OF A ERA OR APPRC)AL OF .
PtANS AND SPECIFICATIONS SR U.NC T BE ONSTRUEi>TO BE A
'ERMIT FOR, OR AN APPP..O‘ 4L Cr-, Ar- !VIOLATION OF ANY OF
'HE PROVISIONS OF THIS C--IE.740 PE MIT PRESUMING TO GIVE
UTHORITY TO VIOLATE OR CANCEL HE PROVISIONS OF THIS
ono CHAtI BE VALID. EXCE T IN SO i 4R AS THE WORK OR USE
I I r a • t HICH li AUlhUhtC o .. WWI_ f'� ti
' C • ` _.,.,. . THE I:CUANCE. C` ,A 1 iRMIT BT 52n UPF,K1 PLP LAND. rP � r •--C-'
`---- .__.W........,.,..._.. .._..............�.._.. ..,.CI'IrAirci�+ `moi,."--"'^.z. ..:=•.E.`,S•nl' T.r.c RLIIIDINFS'OFFICIAL,.y \.
__ ..t.M THEREAFTER REQUIRING THE COR- RFCti.;. * •�--'+ti+-^>w•--•,=G.:
/..% ., PLANS Al"' `^=''""^^_IS_ ,FROM PREVENTING f
I WING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
V'OLATION OF THIS CODE OR OF ANY OTHER ORDINANCE Of
+P. CITY.
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA M SA CONSTR UCTIQN PERMIT P MIT(N�,Ot. ' TRACT NO. LOT NO. UNIT NO. rfl. fl9
- 2onProject Address • - a . d -
1 Accessory Building: NAppliYs Maii Add ese Z�j�=:�,I TYPE OF CONSTRUCTION- Va�iVEW U ADD U ALTERATION U REPAIR -
yy]] /I ❑ CONVERSION [1] DEMOLISH ❑ OT ER _ T Front • •
G
Owner's Nagme� ��IA l'd L� Phone_ DESCRIPTION OF RK/�`}p�E r71•�F,�B LD • y = B Rear N
A►dress JexrL-✓' �'Q0� tf�•L, 1.t� Z'I H- ML ��v Cf� I
•
`u C Right - N
Arch/Eng. - License No. TYPE OF ERMIT GRADING FOUNDATION STRUCTURAL K- • - _ G
Address �.l n`•' ❑ TENANT ❑ ELECTRICAL ❑ P UMBING ❑ MECHANICAL S • Left • _
' R...w - one FT. I Ping. Ref.# Parking Req./Provided l E
PROJECT DESCRIPTION SQ. FT. rA OCCUPAN
Address(mailing) gSs^b,ll��//�L 1 - - F•' + Planning Notes: M
City License No. 1"311% • - CONSTRUCTION TYPE - V•LUATION $ Ira
T
ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION • -
I,hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • '
with section 7000) of Division 3 of the siness and Professions Code, and ,
my license is in full f�r4e,_ f ffect. 1 ��• •
ELECTRICAL 'FEES
Licen•- I ss `/ '07 Li -•se No. Slb drt9
Date • Automatic Washer. Transformer 0 15-50 KW '
r �� Signature �V�_� PLUMBING FEES
WORKERS'C.MPENSATION DECLARATION • Construction Pole Sub. ❑ 50+KW '
•
I hereby affirm that I have a certificate of consent to -If-insure or a certificate Bar Sink Showers
of Workers' Compensation Insurance, or a certifies cop hereof (Section . -ZCooking Unit - Meter ❑up to 100 amps _
3800, Lab. ) - 1 Backflow Preventer- Service Sink. _ , -
Policy No. �(D�' � comp. -1 • Backflow Irrigation Sewer Dishwasher Meter Dover 100 amps !
Certified copy is hereby furnished. Cap V— Dryers ❑Gas ❑Electric Sub Panel
rbetl Sop (sit d with the city :ull•f�a' ion. Bathtubs Sewer Connection
D ry-',U1� 7SR Applicant a�MLs_a Fan - Motors❑0-11HP ❑1%-8
EXEMPTION FROM WORKERS'COMPENSATION DECLA 'A ION Clarifiers Solar Collectors • •
(This section need not be completed if the permit is for one hu • ed ($100) or ' ' -- Inc"Solar ❑9-15 HP 016-15+ - -
less). • Dishwasher Solar Piping ' F.A:U. ,
I certify,that in the performance of the work for which this p• mit is issued I Fixtures •
shall"not employ any person in any manner so as to become subject to-the Drinking Fountains Solar Tank Microwave ,
Workers',Compensation Laws of California.
Date • Signature Floor DrainsSwimming Pool w/Spa Device Boxes Pole Light
NOTICE: If,after making this declaration,you should become subject to the -•
=Workers'. Compensation provisions of the Labor Code, you must forthwith • Floor Sinks _Urinal • - Outlets Range '
,r comply with such provisions or this permit shall be deemed revoked. •
`V CONSTRUCTION LENDING AGENCY Gas Service - Outlets - -Water Closet - - Switches • Sign )
I hereby affirm that there is a construction lending agency for the performance
I of the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections- '
Lender's Name. Interceptors Water Heater ,
I Lenders'Address. • _ - ' . ' Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor
•
^ OWNER BUILDER DECLARATION .. - -
- - - ,
J I hereby affirm that I am exempt from the Contractor's License Law for the ' Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code:'Any city or '
county which requires a permit to construct,alter,improve,demolish or repair P-Trap •
Laundry Trays -
any structure, prior to its issuance, also requires the applicant for such permit . -
to file a signed statement that he/she is licensed pursuant to the provisions of ROOF Drains - -
:the Contractor's-License Law (Chapter 9 (commencing with Section 7000)'of '
Division 3 of the'Business and Professions Code) or that he/she is exempt • _ Reinspection Fee , I $15 Issue Fee $ 3
therefrom and the basis for the alleged exemption. Any 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($500). - I • 3 - DEVELOPMENT SERVICES REQUIREMENTS:
yes as owner of the property or my employees with wages as their sole Reinspection Fee I $15 _ Issue Fee' $ Zoning Approved By Date_
-compensation, will do the work,and the structure is not Intended or-offered - •
for sale (Section-7044, Business and Professional Code: The Contractor's MECHANICAL FEES _ Building Approved By .iv Date
License Law does not apply to an owner of a property who builds or improves '•�
L
thereon, and who does such work himself/herself or through his or her own - Application Issued By-- Date` �
employees, provided that such improvements are not Intended or offered for Boiler ' - Hood or Type I 0
sale" If, however, the building or improvement is sold within one year of com- Canopy. Type II 0 , _ SUMM V OF FEES
pletign,.the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
rovB for the purpose of sale). BUILDING PERMIT' $ r`
1 - SMTP $ Vl !as owner of the property, am exclusively contracting with licensed con- Duct-Structural • . Refrigeration System PLAN CHECK $ • PERMIT
tractors to construct the project (Section 7044,Business and Professions Code: - •
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU PLUMBING $ • ISSUANCE $ _
builds or improves thereon.and who contracts for such oroiects with-a con- - -
tractbr(s) (,cense pursuant to the Contractor's License Law). am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration - PLAN CHECK 25% $ ENERGY P.C. $
proof o their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# ' Fire Dampers MICROFILM $
PLAN CHECK 50% $ • •
Date Owner Heating System& Ducting • ' Registers • _• OI J�
❑0.100,000 BTU ❑100,000 BTL - - • MECHANICAL $ . TOTAL FEE $ U
I hereby certify that I have read-this application and state that the above -'- PLAN C •
HECK 25%
information is correct. I a: - to comply with all city and county ordinances - - $
and state laws relating t. ilding construction, and hereby authorize repre- -
-
sentatives of•this ci-y •/nt-r. up•• the above-mentioned 'proproperty for - - •
- -
Inspection purposes, Date]
•
Signature �'� Reinspection Fee $15 Issue Fee $ 3 J(, Ol 00031 r36-000214337 T120:321- >?]•U�f
Drivers' License or SS �/ _ ` 0c
0865-46,rev. 5/88 White - Building; Canary -Applicant; pink - Accounting; Goldenrod -Assessor GATE: 13<Ci/R�' T[F'iC: '
CONSTRUCTION AND PLANNING r POOL&SPA
APPROVALS Permit# _ Date ' Inspector APPROVALS Permit#I •n . , . - ; •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 Reinforcement56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd 57. APPROVALTO COVER-GUNITE
7. Footings - - - - 58. Electrical Conduit-Undrgrnd.
8. Foundation - r.. 59. Gas Pipe, 0 Undrgrnd., Test '
9. Water Pipe-Undrgrnd. 1-' C� 60. Backwash Lines, P-Trap, 0 Undrgrnd. ,
10. Structural Floor•System t, 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
J "
•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 •
120. 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 :••••1::--' - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
ci.
25. Roof.Sheathing t I 0,./ 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. FOODCERTIFICATEISSUED ``..
33. Final Electric Notes: Sj..... lc_c 7)t Q/'t'
34. Final Heating & Air Conditioning f a _,/
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 . - C. 1
45. Sound Attenuation •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING let
• -
48. Special Requirements Completed .
49.\Electric Release to Edison
50. Gas Release tolSouthern California Gas Co . '
51. CERTIFICATE OF OCCUPANCY j
No. Date
OWNER
WESTWIND BUTLDERS, INC. V/ DATE5-5_55
JOB ADDRESS 1964 Raymond BUILDING PERMIT NO. 1283
GENERAL CONTRACTOR DOVOTSpike - VALUE 48-$500.00
LOT 9 BLOCK TRACT 21497 Dwelling & Det. Garage
(
_ GROUP I TYPE V ZONE R4 FIRE DISTRICT 1299
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench & 1E
""�g i&s,f�
Foundation Forms and Grade to GaragIt#4 _/f-.
Rough Framing c/e��!t! 4'
Plumbing,Rough to Slab la-j` 5 -/% ! s
Plumbing,Rough Complete >L�✓s 4-1.7• S r (y,'y.,_.2/./_-_,,,......
i , 5.--/,--.11-- f,4 /n
Temporary Pole
Wiring, Rough l-_L4, .‘— l%^J j
Heating,Rough /j.rt_‘,//Z ¢} y /%A.JnA,46) j----r-Si ) nV
Heating,Final / U /
Sewer, House 'V Sewer,St. �� ,�/5sriL.E P> a_ 5-3- 706,
Septic Tank or Cesspool G �� ��j "NCa-,��� a -5 S-- . .S-1 S'
' Lathing, In y, outX r IPlastering6GS L .- •M-- •
•
Plumbing,Final,Fixtures Comp ete - -�--r �y/�
1-7
Plumbing, Final Gas Test <T"i/tit,— i _ i_ 2rir
Wiring,Final I� :$'S_ re
.>� -.fe
Occupancy itjy — 1--i
Form 210 G-H 1500 1-55
"P ' . Costa Mesa Building DepartmentAPPLICATION FOR PERMIT
111 EAST 20th STREET ✓ 299 BU . D I N C 1
Z COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN _ _ -_ Receipt No. . __.Permit No.
Building 1964 RAYMOND /1-173 •
Costa Mesa, California Received by Date Rec'd. Date Issued
Nearest WALNUT STREETPEG 5-5-55 ,r--...s
S
Cross St Buildingrs 1964 RAYMOND
Address
Owner WE STW I ND BUILDERS Costa Mesa, California
Mail
105 E. L8TH ST. - Nearest
Address
Tel 4 Cross St. WALNUT ST.
City C. M. Nol l 8-7182 zoneNo. f Type v Group
Architect or Lic. R4 I Plano
Engineer No. Approved
by Date
Address CORRECTIONS
City Lic. 1552
Contractor DOVER SP I KE No.
Address
Legal Lot ■-�,
Description I No. 9 I Block I Tract 249?'. - - ,:�'!
(Attach Metes and Bounds) fl),_/ ..
J
No.of Bldgs. • 0 1QP,Lj
Size of Lot 50x122 I Now on Lot !' 0 O
• Use of No.of No.of - 71
Existing Bldg. - I Families I Rooms 8
Setback Center of StreetLifrom 2 ;
50 t Side Yard `, - Of COS[�. S`� z
D
DESCRIPTION OF WORK G�� r
1.
New IX I Alteration I I Addition
Repair I I Moving I I Demolish I
Building No.of
size 45x26 Rooms 6 Stories 1
Exterior Wall Roof
Covering STUCCO 1 Covering WOOD APPROVALS
UBuild ng of Foundation Location Inspector Date
g Forms,Materials,
DWELL I NG & DETACHED GARAGE Under-Pinning
Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application Lath. Int.
and state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and State Laws regulating
building construe a on.
Signatureof7 #, // Plaster, Int
Permittee -/4 - Sri" /aft
1.61
//y� Plaster,Ext.
Authorized Agt �� PA,/121
Masonry Reinforced
Valuation Permit Fee $
Pian Check $ ', :
Fee � Bond Beam
$ 8,5DD.DO al $ 25.00 FINAL
FORM 204 G-H 2M 5-54
--
.. . -- - - - --
: t. . _
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i d - r
q . - NAY 6_55 P�COSTA ?o:
MESA Z4o
* a*Z5.Q0a. =
I _ _. _ _ _ (_:1nar: br.C' ) +"
• i __ - - Street - �. v, ::il[mc�_ nJ- •,
i - - PIAT PLAN — '' 'd'":-"r' fl ,r,1-,- -r,— 4
I Show location and distances from ' ' na".h.-'. ". '‘ . X
-
•
property line and between buildings. g v .!r,c,I>�'� -,. ^� .^`.S • �L
_ I 1 1., :i -- . . ,II-I. - .
' '1ni•c7G �' rcioor "- -CP
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v^�.`.is� 7r-. vcD -,
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