HomeMy WebLinkAbout2718 DRAKE AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2718 DRAKE AV
Suite No
Vicinity: FRONT YARD DRIVEWAY AREA
Parcel Nunmber: 14131204
Applicant: GARCIA, GREG
Address: 1531 W FIFTH ST
SANTA ANA, CA
Owner: STUCKEY, ELAINE M
Address 2718 DRAKE AVE
COSTA MESA, CA
PLUMBING PERMIT
Phone: 714-953-7111
Zip: 92703 .
Phone: 774-957-6175
Zip: : 92626
a
Contracror: JOHN FLYNN ORANGE COAST PLUMBING, INC. ,
Address: - 1531 W�RFTH ST - � _` . .
SANTA ANA, CA
Arch / Eng : � �
Address: �,
Phone: 714-953-1111
Zip: 92703
License: 596002 _ �.
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License: � � � / i
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� � � SCOPE OF F
' �'� CCEAN-OUT INSTALLATION OUTSIDE HOUSE MAI
� � ; 1 OTHER (CLEAN-OUT) `-• •� ' ^
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Status: ISSUED
Appl ied: 07/10/2001
Issued: 07/10/2001
ISSUED BY: �
VER ACCESS FOR�AN
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,� �; �, ���FEE SUMMARY� , %'.� ,,,, � „, '//� � y `; /
� � AMT � QTY �`. :' � � - -: ' � . AMT � QTY -. - :=;��j' � � � � %AMT
ISSUE FEE ,�. $23 50 ��� �Laund Tub-/ Washer o � p r p $0.00
ry- ,$000� a0 Sum Pum1.� /�, i
Backflow irrigahon�;� ii$0 00.'� ������Landscape Irngation - � $0 00 � 0 �`� �Swimm ni g�Po'ol j l� � $0.00
Bath ub P�eventer �.�, \ $0:00 /� �0` - �`�Fie`ssure RegulatoFR �" ° $O.00v �s0�i''�Ur�' aP��%r✓��/ $0.00
� $0.00
Clarifer System ``$0,00` ;��; 0/ j, Process Piping (per 10 ft) -$0.00 -"0 \�� Vacuum Brkr Bkflow(14) $0.00
Connectpce,Soda,etc) $0.00, � 0`��� ' �,Receptors - -" $0.00 y;0;�� \\VacuumBrkr'Bkflow(5+) $0.00
,
Dental Units $0.00� `�0 ' �f � �SepticTank ��� �,$0.00 � � �0�� � � � �Wash:Basin� $0.00
Dishwasher $0.00� a'0 �. �� �. Sewer Cap for Demo; �'$0.00 ,;:0 i �Wash�Basin Set $0.00
Drain, Floor $0.00 ,,0" ��;; �� Sewer Connect �, ��� : �. 1 $0.00 --0 � , .%'r;i�Nlaste and Vent System $0.00
Drain, Rainwater $0.00 0 -� � �Sewer Private Line � $0.00_ . 0 r�/-- '� � Water Closet (Toilet) $0.00
Drein,Roof $0.00 0 � ,§hovier ��,-- ,,, J �,_�$O�.00G'�0�- " WaterHeater/vent $0.00
Drinking Fountain $0.00 0 Sink,�bar --_, _ _�$0:00- � 0 Water Piping (Inst or Rep.) $0.00
Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00
Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00
Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $9.80
Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00
Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00
Interceptors (Sand Auto ) $0.00 0
TOTAL CALCULATED FEES: 533.30
COMMENTS I SPECIAL CONDITIONS
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NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
. regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shal� automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aas-as �voo�
WORKERS'COMPENSAnON DECLARAnON: —
I hereby eMirtn under penaly of perjury one of tha following tleclarations:
❑ I heve and wlll mainiain a ceNficate ot consent to self-Insure tor workers' wmpensation, es provided tor hy section 3700 of Iha Labor Cotle, for the pedormance of the
work for whith lhis permit is issuee.
� I have and will maintain woAcere' compense�ion Insurance, as requiretl by section 3700 of ihe Labo� Code, for the peAortnance of Ihe work for which ihis pertnit is issued.
My warkers' compensallon Insurance cerna� end policy number are:
Carrier: Policy iJumber:
(This sectlon need not be completed i/ the permit is veluetl a! one huntlred Callars ($100J or /ess.)
❑ I certity that in the pertormance of ihe wQQQrk ior which this pertnit is issued, I shall not employ any person in eny manner so as to become subject to tha workere'
compensation laws of Ce�mle, entl p�r�e9 that tl I should become subject to the workers' compensatlon provisions of Sectlon 3700 of tha Lebor Code, I shall forihwit�
camply with ihesa provi s. / �
Applicant Signature: Date: �' l �� V�
WARNINO: FAILURE TO SE ORI RS OMPENSATION WVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMMOYER TO CRIMINAL PENALTIES ANO CIVIL FlNES UP TOIXJE HUNDRED
T/IOUSANDDOl1ARE(5100. �.INADDIiI TOTHE�TOFCOMPENSATION,OAW�GESASPROVIDEDFORINSECTION3]O60FTHELABORCODE,INTEREST,ANDATfORNE`fSFEES.
LICENSED CONTRACTORS DECLAHATON:
I hereby attirm that I em licensed
torce end eflecL Lic. k�
Contractofs Signature:
CONSTRUCTION LENDING AGENCV:
ot Chapter 9(commencing wi�h Section 7000) ot Division 3 0l ihe Business and Pmfessions Cotle, antl my license is in full
Class #
Date: �' — (O • O/
❑ I �ereby aHirtn that Ihera is a construciion lending agency for the performance ot t�e work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lentlefs Name: Lenders Address:
Signewre: _
Date:
OWNER•BUILDER DECLARATONS:
I hereby affirm that untler penalry of perjury ihet I am El(EMPT FROM THE CONTRAC70R5 LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Protesslons
CoCe: Any ciry or counry which requires a permiC �a construct, elter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant tor suc� pertnit
to file a signed statement that he or she is licensed pursuant to iha provisions of the Contractors License Law (Chepter 9(commencing wiih Section 7000) of Division 3 of Ihe
Busineu antl Professions Code) or �het he or she is exampt Iherefrom end the basis lor the alleged exemption. Any violation ol Section 7037.5 by any applicent for e permit
subjects the epplicam to a civil penalty ot not more than five hundred dollars ($500).):
❑ I, as owner of t�e propetly, or my employe� N'ith wages as their sola compensetion, WILL DO 7ME WORK, antl t�e siructure is not intendetl or oflered for sale (Sec.
7044, Business antl Protessions Cotle: The Contractors License Law does no� epply to an owner of property who builds or improves ihereon, antl who does such work
himself or herself or ihrough his or her own employees, Drovidad Ihat such improvements ere not intentletl or ottered for sale. If, however, the building or impmvement is
sold within ona year ot completioq the ownervbuilder will have �he burtlen of proving that he or she did not huiltl or improve tor purpose of sale.).
❑ I, es owner of Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, 8usine5s entl ProfeSsions
Coae: The contractors Llcense Lew tloes noi apply to an owner ot property who builds or Improves thereon, and who contracis lor such pmject with e contrector(s)
license pursuanl to the Conlractors LicensB �-ew5.).
❑ I am exempt undar sec.
Signeture:
Owner ID venlied by drivers license. ❑ Ves ❑ No
Business antl Professions Code for this reason:
Vedfication af Ownership by (type ot documen�, I.e. - property taz bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Drivers License No.
Date:
Expires:
❑ I hereby cenify that no excavation fiva (5) o� more feet in depth into which e person is requirad [o descen4 will be mede in connection wiih work authonzed by ihis
pertnit, and that no building siructure, scettolding, talsework, or demolition or tlismantling ihereof, will he more ihan ihirry-six (36) feet high. (Ghap. 32, Gry 2, Art 2, Sec.
341, Title 8, Cellfornia Administrative Codej.
❑ As owner-Duiltler, I will not employ enyone to do work which would require e permit from �he Division of Intlusinel Safety, as noted abwe, unless such person �es e
permit to do such work from the tlivision. -
Signature: Date:
Division of Industrial Safery Permit Number:
CERTIFlCA7E OF COMPLIANCE AND AllTHORI7A710N OF ENTRY: I certify untler penalty of perjury that I have read Ihis application and state that ihe information given is
correct I agree to comply with all state laws and ciry ortlinances relating to building constmction, and authonze representatives of the City of Costa Mesa to enter upon the
ebove-descnbetl property for inspection purposes. I agree not to acupy or allow occupancy of any building authonzed by ihis permit until final inspection.
COOE I. INSPECTONTYPE PL� IMIiIALS
1676 Fixed System Final Fire Prevention
1266
200
205
202
203
204
Pool Spa Final
Final Re-Roof
Final B1ocklRetaining W a11
Final Factory Fire Placa
Final Sign
Final Demolition
Date
�- /� - v/
Date
CODE 1 INSPECTION TYPE
206 Final Mechanical
20B Finel Plumbing
210 Finel Electrical
212 Final Flre Prevention
220 Final Planning Approval
222 Final Site
250 Final Builaing/Occupancy
�g ItffIIlALS
9-13-0/ /�%
PflOJECT AUGHESS: 2"� S S DRAKE �i�%
OWNEP'SNaME:KANE CASSIDY
aoosess:z�18 DRAKE AVE
COSTA MESA,CA
AHCHIENGINEEH: � 7 1 4� 5 4 5— 8 8 0 7
AUONESS:
UNIT:
92626
flEG.NO.: �
UNIT:
'Epmi'TEE:AIRWEST AC 6 HTG (714)963-4245
aooaess:18471 MT, LANGLAY R
FOUNTAIN VALLEY CA 92708
UCENSEO CONTHACTOF OECIAHATION: I hereby aifirm that I a IicenSeA under provisions o� C� pler 9(commencing wi�h Sec�ion
7000) ol Orvision 3 of Ihe Business anA Pmfessions Cotle, anU license is in tull �orce antl eii
cirvuc.:0497q74 srnTeuc.q72640 cuss:C— 0
Date: �2' I � �3 Signa�we: _ _ — -
WOBREflS' COMPENSATION UECIABATION: I here�y aflir a� I have a certilicaie of sent �o seli-insure or a ceRificate oi Workers'
Compensaiion Insurance, or a cenihetl copy �hereof (Sec 3800. Lab C).
eoucrNo.:WP93547298 P opTE 01/15/94
comraNr:FREMONT INDEM
7 Ceriifietl capy is here�y Wmishetl. %(7 Certilie DY � fil ' wiN ��e cily Builtling Division.
Date: � � / � � Applicani'
E%EMPTIONFflOMWONRfBS'COMPENSATIONUECUPATION: i55eclionnee4nolbecompleleGi�t�epermiti5�orone�unaretl�4lIXl�orle55�.
I cenity Na1 in Ihe perlormance oi the work for w�ich Ihi it is issuea, I shall no� employ any person in any manner so as lo become
sublec� ta the Warker5' ComOensalion Laws ot Cali�o i.
Oa�e: Signa ure:
NOTICE: II. aRer making Ihis tleclaration, you shoultl �ecome sublect to Ihe Workers' Compensalion O�ovisions o� the La�or
Cotle. Vou musi forihwi�h comply wi�� such pmvisions or this permi� s�all be deemetl revoketl.
CONSTFUCTION LENDING AGENCV: I hereby a��irm Iha� there is a cons�mction lending agency for the pedormance of the woB for
w�ich Ihis oermit is issued (Seclion 3097. Civ. C�.
LENOEP:
AOONESS:
OWNEX BUILOEH OECLABRTION: I hereby aHirm �ha� I am e�emp� imm Ihe Coniractors' Sia�e License Law br lhe �ollowing reason
�Sec�ion 7031.5 Business and Professional Cotle: Any cily of coun�y whic� requires a permit �o constmci, al�er, impmve, demoliSR or
repair any s�mcNre, prior Io iis issuance, also requires �he applican� �or such permi� lo file a signee s�atement ��a� �els�e is licensetl
pursuant Io�he provisions oflhe Conlractors' S�ate License Law(Chapler9(commencing with Section 7000) o�Division 3 oF�he Busine55
antl Pmlessions Cotle) or ihat helshe is exempi Iheretmm ane Ihe basis for ��e alleged eHemp�ion. Any viola�ion ol Section 7031.5 by
any applicanl �ar a permi� su01eq5 i�e apDlicanl la a civil penalty of no� more t�an live �untlretl aollars (E500).
I. as owner o� �he properiy or my emplayees wi�� wages as �heir sole comDensation, will Oo �he work, anA ihe
❑ slmc�ure is noi imenaetl or ollered for sale (Seclion 70a4, Business and Pm�essional Code: T�e Contractors' Slaie License Law
tloes not appty to an owner o� a pmperty who Ouilds or impmves �hereon, and who does such work himself/her5elf or ��muAh
his or her own employees. proviaed Ihal suc� impmvemenis are nol intentletl or o�fered tor sale. I�, however Ihe 6uilAing or
improvemen� is sold wi�hin one year ol comple�ion, �he owner will �ave Ihe burtlen o� pmving he/she did noi build or imOmve
�ar Ihe purpose ol sale).
CITY OF COSTA MESA — BUZLDING PERMIT PERM NO; M 060958
PERMIT NO: M 060958 PLAN CHECK NO; N GOVT': N SUPP; N
CONSTRUCTION TYPE; 5—N PERMIT TYPE; MEC PURPOSE; OTH
JOB DESCRIPTION ; FORCED AIR UNIT CHANGE OUT SQ FT:
CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 /
COMMENTS; CHANGE OUT ONLY....NO BUILDING PERMIT INVOLVED.
��e�****x**�r��t�*******�t***********�r****�r*�r�r*�r�*�r�e�*�**�*�*� *�����t�t�-z******�*��*�t
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; ET IN RGHT; FT IN
PARKING RE • PROV; PARCEL: 14131204 ZNE; REF NO:
PLANNING N TES>
i
iF iE �f jE iF 3! iE iE IE �F �E if �f �E1F ft ik iE i! if 1F iEiE i!!f iE kiF iE iF iFlElE !P iE iE �E�df iF �k iFiE 1E iE i! lEik iE1E iE if iE if iE 1k iEiE iE ik iF iF iFiE iE iE )f if iE iF iF iF iE iE iE if iE iE 1E iF
D E V E L O P M E N T S E R;V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ~r..? DATE;
BUILDING APPROVED BY ; �7_ . ,, . DATE:
APPLICATION ISSUED BY; •::� — `� �"Ze
****�r*�***x�**� x � �*� ***
iE iE if !E i! ik iE �E iF 1t i! iE iE 3ElE iE iE iE iElE 1E �E iF iE if if �E if if iE iE 1E 1! iE �E iE iE 1E 1f if iE iP it iEiE 1E jf if if
LEGALIZATION;N . F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
�FiFi�lf� iE iF jE iE if iF 3F 1E iF�'�F�E �E
iE iE iF iElE 1EiF 1ElE iE iE iE i! if 1ElE iF iElF if iE iE iE if �F
STRUCTURAL SEGMENT;N
FIRE SMZP/RES GRADING
PERMIT 9,00
253 SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15,00 0,00 24.00 24,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT; ,00
BLDG PMT PLUMBINC ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner ol Ihe pmpehy. am exclusively conVacting wi�h licensed comracmrs lo consimc� �he pmlect (Sec�ion 7044, Business 2 4, 0 �
❑ antl Profe55ion5 COAe: The ConiratlOrs' Staie Litense Law tloes no� appty Io an owner a� pmDe�y who builtls of impmves thereon
anOw�oconlracls�orsuchprolectswilhacon�ractor�5�licen5epur5uant�o�heContractors'$IateLicenSeLaw�.lamaware �.**.*.K.�..�.K.*.K.�.�..K.*.*..K.�..K..�.K.�.�.*�.�.*�..K..K..K.�..K.*..��.*�.*..��..�.K..K.�..K.*..��..K.*�..X..K..K.K.*..K.*.*.*..K.*..K.�.�..��..�.�**.*..�.�.�.,X.*,K.*
�hai pmo� o� iheir worker's Compensa�ion insurance shou�0 be pmvidetl �o me. j N D 1 V I D U A L F E E B it $ A R D 0 W I�
� I am exemp� untler Section�. B. 8 P. C.
ro�mis�eason, TYPE QTY D E 5 C R I P T Z O N UNIT COST TOTAL COST
Oate' Owner.
� ao hereby cer�ity ina� � am aware o� ana uneerstane the requirements o� Ca�ifomia Hea��h ana Sa�ery Coee Sections 25505, 25533, and MEC 1 INS T FORC—AS R/(�iFZAV FURN <= 10 � K$TU 9, 00 9, 0 �
25534 ana ��al I or any lulure builaing occupanl will/will nol (circle one) neetl lo comply wilh said state co0e5 antl �he requiremenis �or a END OF FEES
permit Im consimctmn or modilica�ion �mm �he Air Ouality Managemenl Disiricl Hesitlen�ial constmciion applications are exempl Imm
IIICSE p�0Vi5i0�5. '
Date: Apo�icanL _
I h¢reDy cetlilyihal I have reatl Ihis apPlitalion antl 51a1¢ Iha� Ihe
ortlinances antl sla�e laws relaling �a �uiltlmg conslruclion an� heret
prOpotly �Orinsp2c�i�)n pur as¢5- �
!
Oa�e- � � ' � Signalure: _
onver's License ar Sociai Securi�y x:
i641-a6 W�ile-0uiltling: Green—Code Enforcement, Cana
lo comply wilh allci�y and counry
m enteruponiheabove-memionetl
Pink—Revenue; GolOenmd—Assessor
07 UCld��.-''- .:5.: . "' ,,.
��T�: �°,..,;_ .r:< ..; .. .
CONSTRUCTION AND PLANNING P��` 'PA
APPROYALS Permit # Date I�spector APPROVALS Permic # Date Inspeccor
1. Temporary Eiectrical Service or Poie� 52. Pool & Equipment Location
2. Soi� Pipe-Undrg;nd. . 53. Steel Reinforcement
3� Electricaf Conduit Utii'ity-Undrgrnd. � 5A. Forms �
4. Elecirical Conduit�Undrgrnd. . 55..Electrical Bonding
5: Steel Reinforcemant � . 56. Rough Plumbing & Pressure Test
6. Elettrical UFER Cqrnd. 57. APPROVAL TO COVER GUNITE
7. Footings � . 58. Electrical Conduit�Undrgmd.
8. Foundation ' . , 59. Gas Pipe, O Undrgrnd., Test
9. Waier Pipe�Und�g�nd. ' 60. Sackwash Lines, P-Trap, � Und:grnd.
10. Struaural Floo� Svstem - 67. APPROVAL TO DECK i
17. Property Sewer Line & HouseCon�ection ' 62. Backwash & Receptor-Final
12. Se�ver Cap '° 63. Heater & Vent-Final '� .
13. Roof Drains ". 64. Plumbing Sysrem � F�nal ;-
�
14. Rough Plumbing � � 65. Electrical•finel
75. Rough Electrica�-Conduit 66. Solar System-Final
76. t�ough Electric Wiring � 67. Fencing & Access ApP��val
77. Rough Wiring S�gn 68. APPROVED FOA PIASTERING
18� Rough Electrical-T Bar Cei�ing 69. POOLJSPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning � fIR,.E DEPT. REQUIREMENT
20 : Rough Pactory Fireplace , _ � ' 'APPROVAL5 � � Permit �
' 21. DuMs, in Structure � • - � � -70. Undergraund� Hydro
.
22. Duct$, Ventii0ting , � 1_=77. Product.P.iping O�G�s ❑Oii
23. Gas Pipe-Rough &,Test i 72. Underground Fiush. .
24. floof Froming , � ' � ,73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing - � - . 7A. Overhead Hydro (
26. T•Bar Ceiling (Structurall &'Monocoat . 75. Dry Chemical .
27. Frame and Flashing - � 76. Ory Standpipe
28. Lathing & Siding- ' . . i "� 77. FIXED SYSTEMFINA�
29. Insulation -, � 78. FIRE PREV. FINAL
30. Or � � j' •j- HEALTH DEPT. REQUIREMENT
ywall Nailing .
31. PlasterBrownCoai � i 79.�fINAIINSPECTION
32: Electricai Power Me�tAr�Final� ' '80. FOOD CERTIFICATE ISSUED -
i
33. F�nal Electric . � I A� �Notes: �
34. 'Final Heatiny & Ai iConditioning� `;, 2�/L�gs ,(.���j � - . � .
35. Final Gas Pipe•Test ' ,
i .
� 36. Hood or CanopY - j �- � �
I i
37. Final Factory Fireplace � „ (. .
38. Final Piumbing - � ' ! � _
39. YVater Service-Final � ��� '
40. GasService•Final � i� _ .
� � , �
41. Solar pomestic-Final ' _ . ' ; I .�. � .
42. Backflow Preventer � � .
43. Backflow irrigation � � �
44. Landscape Irriqation System. ' � . . .. � � .
45. Sound Attenuztion
46. Nandicap Regulations �- . .
47. FINAL STRUCTURE & BUILDING - I-� �,
I i
48. FINALPLANNING - : �'� "
49. Electric Release to Edison , � . .
i�
t '.. _
50. Gas Release to Southem California Gas Co � �
51. CER:TIFICATE OFOCCUPANCY �
No. Date
����3
COSTA Iv1ESA BUILDING-SAFETY DEPARTMENT
.,P. O. BOX 917 C08TA MESA, CALIPORNIA
For Applleanf fo Fill In Comple+ely
' TYPE OR PRINT
■ BUILDING
p MAIL
COSTA MESA CALIFORNIA
3432 Via Oporto, Newport_Beach
FEE RECEiV oD
�NRNCE DEPT.
APPLICf�I�I�FUfO��ItPDI`�fSA
Loc � 17 gUILDING
Plan_� 2C
For Office Use Only
FECEIPT NO. I '�PEqMIj�.D
RBCEIVEO !Y
APPROVED
COSTA MESA. CALIFORNIA
ADDRES6 �{y�tH 1 3800 E• C+088t � tIWB ZONING
JV� ZONZ NO.OF USE OF NEW
CITY Ci�rOlj$ Yel l'i6i� California . I PLANB OUILDING
S7ATE TE'-. pr 34220 Leaw� LOC �
��c. r,o. 95808 NO. pE9CHIPT�ON TIeCt � 3749
oF ior 65 x 94 I"� �P eLDGa. 0 _
NOW Ox.Lor A. P. NO.
USE OF � YARD6 EVES
EXISTING BLOG. APPROVED ALLOWED
8ET9ACK LINE PROM /.O �Z FRONTR L1rve 9i.1 FT.
ceNi6R OP BineeT Y REAR YARD
SIDE YARO ILEFT IRIGHT S R.SIDE `� FT.
DESCRIPTIOk OF WORK __ , � _
NO. OF
ROOMS E1
CO ROOF
COVERIN
WORK TO BE
S1
��
�/
with attachetl garage
1 HEREBY �CKNOWLED H TXAT 1 HAVE R¢AO T 8 APPLIGTION THE AMOUNT BHOWN UNOER VALIIATION 18 FOR THE
AND BTATE TXAT TXE BOVE IB CORPEGT AIID AGPEE TO COM- pURP08E OP, EBTABLI6HING � PERMIT FEE ONLY.
PLY WITH ALL CIiY O OINANCE6 AND HTATE W8 R60ULATINC
Bu1tDINo CONBTpucT N. � � VALUATION
61GNATURE OF �/ PERMIT FEE $ 3Z.00
PERMITTE
$�.3 , 515. 00 pLAN CHHGK $ 16 . QD
AUTHORIZED AGENT �OjBCC M8ii888±
TOTAL FEE 4S.00'
�'''� os� .
" COSTA MESA BUILDING-SAFEfY DEPARTMENT
- P. O. BOX 917 C08TA ME9A, CALIFORNIA
For Appli�an► ►o Fill In Comple►ely
' 7YPE OR PRINT -
BUILDINO n
ADDRE53 / i %Z '� �
COSTq MESA. CALIFORNIA
� ARCHITEC7 _ , THL. `�
q� ��y� , . No:�
� �. .. i � I NO.OPBLD09.
� SETBACK LIN6 FFOM
� IRIGHT
)N OF WORK
EXTERIOR WALL
COVERING
USE OF BUIL�IN
���'y �
�� /
I HERE9Y ACKNOWLEq68 THAT I HAVB READ THIB APPLICATION
NNo 6TATE THAT TH! �BOV6 IB CORRECT ANO AGREE TO COM-
PLY WITX ALL CITY OkDINANC6Y AND BTATG LAWB RHGULATING
BIIIL�INO CON9THUCTION. �
SIGNATUREOF
PERMITTE �A !� ^ .
AUTHORIZED AGEN7
FEE �RECEIV-ED
sEP � s isss�-
FINANC�En DT�EPMT�.�p
APPLI�'VICAF POR'4gRN117"'
BtJILDING
For Office Usa Only
R6CEIYf NO. PEqMIT NO. '
ZONING
NO.O! BOPNEW ' - . `"�
l � � YL.ANS �ILOING �
„� � � i 7 �� 7 yc�-
CPIPTION Q� / �.
.�o ���1— ��iz— f,
��
fE: NOEAVEOVERHANGSHALLBELESSTHAN .
' TO SIDE @ REAR P. L.
'ES
.OWBD (U.B.C.REQUIREMENT)
YARDSAPPROVE� YARDSAPPROVED
MAIN BUILDING I(CCESSORY BUILDING �
�
RE'AR �z ��'f.
DISf'ANCE BET. BET. I
MAIN BLDGS. ACCE
VAR.�C � DATE
' ./.'� W wv" -:;� r �
.: .. - +,t._ x .
.j.. .
• N
$Q. �. m
TXe AMOUNT BHOWN IIN�ER VALUAT�ON 18 FOR THE �
PUHP09E OF 68TABLI6HIN0 A PERMIT FE6 ONLY. �
VALUATION � � `� m -
�p�(� PERMITFEE $ j �
$�!!G��J �� � m
/�/ PLAN CHECK $ �,��_ O
/ `` LL
TOTAL FEE $ �
/ JOB ADDAESS
� GENER.AL COS
� APN�
� INSPECTIONS
\ g
l
Water
DATE 9/16/63
BUILDIA'G PERMIT NO.
DATE GROUP 'J TYPE � IV � ZONE R1
SUBCONTRACTOR PERMITSISSUED
DATE I NUMBER
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