HomeMy WebLinkAbout1850 ELBA CIR - Building Permits4� CITY OF COSTA MESA
BUILDING DIVISION PER IT NUMBER
r DEVELOPMENT SERVICES DEPARTMENT,
PERMIT
B00-00759
(714) 754-5273 Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1850 ELBA Cl Status: ISSUED
Suite: Applied: 05/30/2000
Vicinity: SIDE PROPERTY LINE Issued: 05/30/2000
Parcel Number: 13942104 Zoning: R1 R1
Applicant: ANDERSON, GARY ISSUED BY:
Address: 164 E WILSON ST
COSTA MESA, CA
Owner:
BAKER, RICHARD ALLEN
Address
1850 ELBA CR
Plan Check:
COSTA MESA, CA
Contractor:
ANDERSON MASONRY
Address:
164 E. WILSON ST
COSTA MESA, CA
Zip: 92626
Arch
Address:
Phone: (949)689-3858
Zip: 92627
Phone:
Zip: 92626
Phone: (949) 689-3858
License: 739159
Eng:
Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CONSTRUCT 80 LINEAR FEET OF 6 -FOOT 9 INCH BLOCK WALL AT PROPERTY LINE ADJACENT TO STROMBOLI .
(ADDITIONAL HEIGHT OK BECAUSE OF GRADE DIFFERENCE), THIS IS A CORNER LOT. THE ELBA CIRCLE FRONTAGE
IS CONSIDERED THE FRONT PROPERY LINE, DUE TO THE FACT THE FRONT OF THE HOUSE IS ORIENTED TO ELBA
AND A 20 -FOOT SETBACK FOR THE HOUSE EXISTS ON ELBA CIRCLE.
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall 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 the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections 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) 754-5626
FEESUMMARY,
Plan Check:
$37.08
Calc Valuation: $1,600.00
Permit:
$57.05
Claim Valuation: $0.00
SMIP Res:
$0.00
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$94.13
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0
Rear 0-0 Left 0-0
Right 0-0
ACCESSORY
Front 0-0
Rear 0-0 Left 0-0
Right 0-0
PARKING
Existing: 0
Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall 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 the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections 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) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number are: .
Carrier. Policy Number:
(This section need not be completed i1 the permit is valued at one hundred dollars ($100) or less.)
0J 1 certify that in the AO mance oft work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws YCaliforma, an gree hat if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these ions.
Applicant Signature: ✓f Date:
WARNING: FAILURE TO SECURE WORK COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUWECT "EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE($100,000), INAD ION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION TM6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am license ur of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. # ovisi Class #
Contractor's Signature:1-44 Date:
CONSTRUCTION LENDING A�
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or 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 or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or 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 penalty of not more than five hundred dollars ($500).):
❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
_,., .. orpr ._------'-......._.
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materialso ❑ Ves ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been luny complied with? ❑Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LI No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade).
7 It a pernit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8 (If "yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property tot inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Si nature Of Legal Owner(s) Date
S 3l -;L%r>
And/Or Authorized Applicant Date
CODE If SP N TYP DATE INTITIALS CODE INSPECTION TYPE DATE INTMAIL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall v-f--+-f== 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
244616
e THIS SKETCH IS FOR INFORMATIONAL PURPOSES • SOLID WALLS/FENCES BETWEEN 2'6• k b' IN HEIGHT SHALL
ONLY. APPLICANT LS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 30' FROM FRONT PROPERTY LINE.
AN ACCURATE REPRESENTATION OF THBR PROPERTY
IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND • SOLID WA11S/FENCES SHALL NOT D(CIED 2'6' IN HEIGHT
WITH THE INFORMATION PROVIDED ON THIS SHEET. 101 OF THE FRONT PROPERTY LINE (NOF CURB LINE).
3lD • VIItIEY DISTANCE FROM CURB TO PROPERTY LINE
it �` '-•'- 3` °� vW SHOW ON FLAN. VFRERCATION FROM THE CITYS
-ir( Orr COSTA MESARGWEEtING�� ON ISRIEQUIItED. CALL(714)754,9W
PLANNING DIV.
i SuB,ECT TO BLDG. DEPT. REG.
By_
his set
make at
and Sal
The star
of the v
These )
work is
666-00-1
f1 r
K
I� R[90EMCE WME"M '
IVISION OF BUI DING SAFETY
CITY OF CO TA MESA
.APPR VED
Date s a0 06 ,
dans nd spec f cat on MUST be ke t on is job at all times and 0 unlavAul to
loll u r all nation C11 5811D W hoot i intler, pumiirim, hen e. Divisim of &9
_ City Mesa. 0 5g1 z
>g of I ¢ pla and specilimlion, SHAL NO be haW fa permit r to an 30 Noval a
!inn olany xavisions of any City I Cos a Mesa Ordinance and r Stat law. g
as arKopeqni shelf MKFby li itatlo i and ceemomiWd v id if 1 a builc ing REsoocz RESIDENCE s
e com.. -r.rec and .^..31r.!amed a Gre r U91 §303 (dl vrithin if days of asi once.
\Ir
Y '
- --------------------STREET �y� �(rn
BLOCK WALL LAYOUT FOR BUILDING PERMIT
CELETIONS, OR CORRECTIONS SHALL
sY.i'HE PLAPPLANNING DIVISION
11,
0
Cement Coping Optional —
Channel Block With 1 3/8$6
Horitonbl TOP of all
F el,ce%
For Fence% 5' orLets
vert. ears 3/8"•y5 at 4' 0" C
For Fences Higher Than 5'
Vers. Bars 3/9-0 at 32" O.0
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A 15 39
A.S. T.M.
All Steel to be Lapped
24" or to Code
TYPICAL
NATURAL GRADE
14"
14"
12",
12"
THICKNESS
.10" .
TWO 318"0 BARS
g"
CONTINUOUS TOP
DEPTH OF EARTHTOOTH
B BOTTOM -moi
Y
16
HC%Zl :STEEL MUST BE TIED IN
%
PLACE AT TIME OF TRENCH
I
14'
INSPECTION. y
16,
7.
I— WIDTH 1
SEE CHART
BELOW
611 CONCRETE .BLOCK
FENCE
FOOTING REOUIREMENTS CHART
GENERAL- NOTES
MORTAR: One Part Plastic Cement, and
Three Parts Sand
GROUT: One Part Cement Three and
One Halt Parts Land
COPING: One Part Cement, Three
Ports Sand
CONCRETE: Well Mixed 1:2—Il2:3-I/2
Mai of 7-1/2 Gallons of
Water Per Sock of Cement
G"OUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHE BE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN
FORCEMENT SHALL BE CLEAR, CLEAN 6
FREE OF ALL MORTAR DEBRIS, ETC.
H Cs'CARTHTOOTH
1/! THE HEIGTH Or FENCE
B)^LOW BOTTOM OF FOOTING
SCALE' 1/211 a I'
WIDTH
14"
14"
12",
12"
THICKNESS
.10" .
.10"
g"
e"
DEPTH OF EARTHTOOTH
29'
20"
16
12"
SPACING OF EARTHTOOTH
12'
14'
16,
16,
BUILDING DIVISION
Permit #18256
There is a California Lumber Inspection
service Certificate of Inspection attached to
application in legal folder of Lot 17, Tract 4341,
1869 Elba Circle. It also pertains to the following
lots:
1850 Elba Circle
2911 Club House Road
2917 Club House Road
2923 Club House Road
Per.#
e� Lot 21
(18260)
Lot 22
(18261)
Lot 23
(18262)
Lot 24
(18263)
1850 Elba Circle
2911 Club House Road
2917 Club House Road
2923 Club House Road
May 32 1972
Mr. Stephen Vym4�
1850 Elba Circle
Costa Mesa, California
Dear Sir:
A building permit has bissued to Omega Pools to
construct a private swimming poo n your property.
In order that your pool will be a safe one and for
the purpose of advisin you of your responsibility regarding
the requirements of the osta Mesa Municipal Code, we refer
you to Section 8107, a co of which is attached.
This letter is directed to you in order that you will
be aware of our ordinances and can make a complete safety
check of your rea.
Sincerely yours,
RICHARD'HANHART
Building Safety Director
RH:dh
``IA Twininq Laboratories of ,:Sout/2eln cU[lf0'L321Q, 9220.
P.O. BOX 47 . 3310 AIRPORT WAY . LONG BEACH CALIF. 50801 . '7131 426 3355 . 1213) 6362386 . 1714) 8286432
BRANCH OFFICES
TESTING i5iA ON .m.•b•. N.HDo ..Tw
S - -A A'. C.O."T. 17103 2.55 INJ;,-e. 1- P.O 9.•.7
(7111531 2G5 -q 8 -ch. C,11 00801 12U1 636.2386
May 17, 1972 Examination: SC72-2877
COMPRESSION TESTS ON GUN I TE :YLINDERS
L. E. Sprague
1411 Windemere Lane
Tustin, California 92680
PROJECT Swimming Pool for STEPHEN C. VYM
ADDRESS 1850 Elba Circle, Costa Mesa
SAMPLE FROM I s o- deep end: 2 c 5 shallow end: 3 6 6 bond beam
ARCHITECT
CONTRACTOR
- - -
Omega Pools
ENGINEER
SUBCONTRACTOR
- - -
Grove Gunite Co.
SPECIFIED
MIX
Gunite
STRENGTH
2,000 psi
DATE CAST
5-10-72
DATE TESTED
5-17-72
5-17-72
5-17-72
4 "HOLD"
CYLINDER NO.
1
2
3
5 "HOLD"
6 "HOLD"
COMPRESSION
7 -Day
7 -Day
7 -Day
TOTAL LOAD, LRS.
117,000
95,000
102,000
POUNDS PER SO. IN.
4,180
3,390
3,640
SIZE:
5-3/411 x 12-1/211
5-3/4" x 12-1/2"
5-7/811 x
12-1/2"
COMPLIANCE
7 -day test complies
with specifications.
MADE BY
DELIVERED BY
RECEIVED ON
CYLINDERS
L. E. Sprague
LES
5-11-72
DISTRIBUTION:
ostaMega Bldg. Dept.
Omega Pools
Grove Gunite Co.
L. E. Sprague - 2
BUILDMIG SAFETY DEPT.
MAY 19 1972
ALL PLeOPT5 ARL SY 1u111E0 .3 INC CON1I0EN1I1L PPOIEPTT 01 CLIENT/ AUSN0.11.110N Inn . N "I OlP wEMORTS CONCLUSIONS OP C.
TRACTS )PON O. RL4.POIN4 TNEu 1 P ISE.YI. .L NOING n,R NPi TLN AILR0— AS A N. • N'S N[ JSLIC AND OURSELVES
11 IS
OWNER VYN, STEPHEN DATE
JOB ADDRESS 1850 Elba Circle BUIL[
GENERAL CONTRACTOR Omeea Pools DESCRIPTION of WORK
No.139-421-04 LOT
IRE ZONE VALUE $ 4.800.00
INSPECTIONS
Si ..tare
Date
GROUP i
TYPE
ZONE R-1
SOIL
SUBCONTRACTOR
PERMITS ISSUED
GAS ,/ �Y +1
Data NumberI Si .stare
WATER
Plum i
ROUGH PLUMBING
-
PROP. SWR. LINE Q HOUSE CON.
SPRINKLING SYSTEM
p- Z
MISCELLANEOUS i -
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNOERG RO UND POWER
•(,Z- 7Z -
ROUE WIRIN
2''%Z
Heating and
Vent.
TRENCHES FORMS STEEL REINF.
FLOOR SYSTEM
'
BOND BEAM STEEL REINFORCE F -J
SHEATHING
F INGG
'7z'72-
LATHING — IN n OUT ❑
_
PLASTER, BROWN COAT
STRUCTURAL, FINAL
^/
Elect,
c 7
HEATING, VENT., REFRIG. AND A.C., FINAL
>
G'JL
PLUMBING, FINAL AND GAS TEST
2 -
ELECTRIC, FINAL
...i
T1.36 S
.uu aur. ruins
A 79
34619
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
� z�-��P�-`-00� 772• �,y��43.84
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEI D
DA E IVED
'�y
D TE ISSUED
BUILDING
r
ADDRESS
OWNER
A.P. NO.
MAIL
BUILDING �j�
ADDRESS
ADDRESS a
TEL.
CITYCfCS746� NO.
TRACT
LOTH BLOCK
CONSTRUCTION
NEW
I ADD
ALTER REPAIR
LENDER I
BRANCH
�'c
OWNER J /
ADDRESS
VYLUE$
S
ARCHITECT .1
OR ENGINEER /V S.
IRE
ADDRESS 7';00
ZONE TYPE GROUP
APPROVED
CONTRACTOR - -
BY ATE e
ADDRESS /,L ,
TEL.
ZONE
NO.OF
PLANS
USE OF NE
BUILDING
CITY 5 NOk )
STATE�/ CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. 7Q LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLDGS.
(FROM C/L STREET)
OF LOT
NOW ON LOT !/
FRONT FT.
FT.
USE OF
A
EXISTING BLDG. �' - Q - _R.
E FT.
FT.
SIZE OF NO. OF
�z
NEW BLDG. ROOMS STORIES-
L. SIDE FT.
Ia FT.
EXTERIOR WALL
ROOF
C
COVERING '—
COVERING'
REAR FT.
p FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS. BLDGS.
-
VAR. #
DATE
C.U.P.#
APPROVED
d
A
— 7
C
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and 1 shall not employ
any person in violation of the workman's compensation laws of
r
the State of California.
I hereby certify that I am properly licensed as a contractor under
T' ;
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
VALUATION
9 r
PERMIT FEE $ OL �
O
1
Signature of _
Permittee
$ yeo
PLAN CHECK $ So
Authorized Agent
�',S
TOTAL FEE $
2i
COSTA MESA BUILDIN(S-SAFETY DEPARTMENT
P.O. BOX SIT COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
(� `TYPE OR PRINT
NO
AD REISS Ba7� E1-%
TCOSTA MESA. CALIFORNIA
OWNER I \
■ ARCHITECT
0
CITY IIIAJv
STATE ♦ TEL
LIC, NO. 1 1 1% Iy3 NO. 7 %Z' -I 3 ZLi
SIZEnT (r'y o /O
nCI
SETBACK LINE FROM ��
CENTER OF STREET L REAR YARD
SI --YARD I LEFT L RIGHT E
DESCRIPTION OF WORK
FEE pRECEI9g6VED
FIN NCE DER'
CITY OF COSTA MESA .
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
BUILDING STT i IT/ t� A Cj
ADDRESS / b G 1.J I1
ZONING
ZONE y� NO. OF UBE OF NEW
A( PLANS BUILDING X11 / N
LEGAL
DESCYRI\PTION T�`21 ,1 L4�3'_1�y
A. P. NO. / 3 /
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
90' TO SIDES REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMENT)
YARDS APPROVED YARDS APPROVED
MAIN BUILDING ACCESSORY BUILDING
BUILDING /� I/ OP
VAR.#
DATE
_NO.
SIZE /l ROOMS
STORIES
C. U. P.
APPROVED
EXTCOVERIOR WALL ROOF
�//
/U
CP VE �1
/!_
/-S�"'C
OOVERINO
t -C �/
DATE
Is USE OF BUILDING AND WORK TOOK PRRnRNFO
60. FT.
2- zzx1l'
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TMIS APPLIOATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION V
BUILDING CONSTRUCTION.
SIGNATURE OP ` PERMITPEE $
PLAN CHECK S
PERMITTE
1 $ 0 0
AUTHORIZED AGE �
w • E::1::82=60
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX BIT COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
G04Yp �nDA as a'Bt�%'S�
p�COSTA 7s
APPLICA M-146 `"IERMIT`�
BUILDING
For Office Use Only
RECRIPT NO. I PRRMIT NO.
BY
COSTA MESA. CALIFORNIA
APPROVED
PAI
ZONING
20NE!� —� I 0. or K or NFAY
Pus
LANE )_I BUILDING
LEGAL
SIZE
NO. OF BLOBS.
OF LOT l) /D
I
NOW ON LOT
A. P.
USE OF
EVES
EXISTING BLDG. �—
ALLOWED
SETBACK LING FROM t->� /
ILINE
ST.)CENTER
OF STREET `/ f/
REAR YARD /
�7 r/FT. IN.
ILEFT
SIDE YARD !%
RIGHT �o
T.
DESCRIPTION
OF WORK
i D FT IN
EXTERIOR WALi
ERING t'--YI/�J[FI ROOF G5 I f/ '
COV
COV ERIN 'P
USE OF BUILDING AND WORK TO BE PERFORMED
SGL / er
lc .� 77 �' _1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATIOSHOWN UND VALUATION IB FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COPLY WITH ALL CITY ORDINAHCEB ANtl STAT¢ U1W8 R¢GULATINEDTABLIBHIN6 A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. SIGNATURE OF �/PERMIT FEE SPERMITTEE✓o - a — PLAN CHECK S , 7�✓r�
I AUTHORIZED AGENT �. ?-
%/
TOTAL FEE $ / '^