HomeMy WebLinkAbout3040 DONNYBROOK LN - Building Permits�oopEssc�auaanc: 3p40 DONNYBRQOK Ltd
axm�Rsrw�EiFa�xw: DOSTAL, RICK
� : .onwEss: DOSTAL, CAAOL
2710 GANNET DR
COS1'A MESA,CA 92626641-3766
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caam�cTorrsru� CHURCHILL CONSTRUCTION ( 714 ) 826-7508
ca+m�croxs�u�wc 1 0 0 0 N. HOME PL
�WHESS ANAHEIM CA uc.r�o.: 660990
92801 urn:
LICENSED COMHRCTOPS DECLAHITION: 1 heraby eflem uMar paneXy d pmjury Ihel I em licenead uiMx povivona ot Cheper 9
(commenti�B weh Sectian 1000) d Gveion � at Ne Buairoa vM PMeaebm CoEe. eM mY limnse o in lull Iace eM allaa.
cmuc.N'o'7.: 06q8720 uc.cuss: g uc.No.: 6�60-99A0/ EXP: 11 /97
Um,: G"�( (-9_1 oomred«: �f'�'/J �/v �
OWNEH BUILDEP UECLARATION: I hereby etfiim under peneXy d perjury ihet I em mempt fmm �he ContreGas License Lew la Ne
iaw�.�:w �ew� Iseaio� �wi s eus:bsa a�d am��au code: nm cn o. ca,�ry wnw, reauvee e o�*n �o omsuuc�. ene.. i�aro+e.
demoloh, or repeir eny evucture, pior lo m"veueMe, abo reyuims iM epplimM Im auch pmmil lo file a eiqred atmamam thm M a sM
� n limneed W 9�^I lo iM provieione d Me Conlredore License lew [Cl�eper e(oommaMriq v.ilh Sed'an )000) d pvuion 3 d tte
Buainess aM Rdeaiona Codel a �het he a she ia ezamq iherel�om eM ihe b�e fa Ma elleged azamqion. MY videtion at Seaion
]p�t.5 by eny epWimn� lor e parmil wbjeee IM epvlicent w e civil penelry d iwt mae than INe huMrad Eolkn j4500�).
� I.eaowinrdlMpapenYamY�GM�'^�hwapesavlheiedemmpanaetion.v.illEotMwwk.eM�MetnMumeiMirueMad
a oilered br aeb (Seclion )01d, Businem aeM Prdeaeians Coda: TM Conveeon Licensa Lew doea �at epply loen ownerd propa�y
who buiM a inpwea tlwraon. vd xfio does suc1� xak IimaNf or henel a NrapM1 he a Mr awn emWqees. provided ihet wch
improvemenla ere rw� inleMeC w diered for aele. H, Mwever, ihe buiNinp or imqwemmt p eald wi�hin are yeer d mmpbibn, ihe
owrerbuilder will heve tM WMen W parirq he or sM Eid nd builE or imprwe lor iM WN�e d veb�.
� I. es owner d the propaM. em eRduaiwty oonlraem0 �h licensad wntrec�on ta conmrua tM Prol� (`�� )�. Bueinma eM
Pmtmaonc Cade: TM Con�reqon license law doee mi eCWY w en owix d V W�Y who buiMa or'unD�'m Iherean arM who
convana for wM qqeas with e mmretlo�(e) licen»C Wrsuent to iM ConireGan Licerue Lew).
� I an ssamq �Mm Saciim: B. 8 P.C.,1« Ne reemn:
Deie: Pmer:
I Eo hareby urliy Ihet I em ewera M end uMeistend the reQuiremenM M Celfanie Hml�h eM Se1My CoEa Sediona 25505, 2553J, eM
45536. eM tMt I a enY �un buiki�q ottupeni will / wil rwi (orcle are) rieed to mmpFy x'tA aek m�e cado vd ihe �eyuiramenb br
epermn/aconsVuctionamoEifi�bnkantheRi3au y.TianepameniDia�nd.ReeiLenlielconet�uqionsppimtiomenuemplmmiMae
�lOV190119.
Dele: Applicent:
WORKER'S CONGENSATION DECLAN�TION: I hereEy elfirm uMar pandry d perjury me d tlro lolbwi�p Eetlarmons:
❑ � ner. end w mei�ie:,. cenAvte a omse�i io een:nw�e tn xaAceea' cwnw^Wi^^... vwkw �o. M s.mo� alao a �n. Lma.
coda m� me van�� m m. wn� i«.�m�on m�a w�u �. ���ae.
�7 � nm�e a;d Mi� meio�en xalm�.� wmw�on lim,rerim. m rev��e nv s«vian sloo a �n. Lebor cod.. ror ine v�� d �n.
�C woM for wliich Mia pa�mll is iaeued. My warkers' cwnpenemion inwrence remer eM po4ry numbm ere:
c�: STATE FUND EXPIRES
Policy Number. 1 L�..{ 1���
rn:, �c� ��e �ar ae c�Wared r me o+�e b b, are n��d�d dd�ls�oo� a kd.l
� I eenAy thet in Iha perlormenee d Ihe wak br whieh Ihie paemn u iewad, I d�dl iwl emd%' �Y Va� in eery menner eo u lo
beewre wbjar to �na wwlees' eom0aree�ion lerre a ee4lwnu. erd wrae itw A I dauH bxm�e subptl �o ihe xaMen•
compansetion pmrispuns opl5etlion 3)00 W Ihe LeEor Gotle, I ehell lo�hwilh mmp�y wilh p
4na
Dele: 2�I /'"' l 7� ApqienL ��
Cii
Wem/n0� Fellun ro aecun woAsn'rompwwtlon roveraps /a unlewN( ene MN/ alb/�c! an mplorx ro crlM�x/ pmeMu eM
clvll Ilms up ro are huntlre0 thouurM rldbr� (S10q000), In edtlltlon ro Ms roat ol rompsiwtbry Asmepu u prov/tlM b� In
Sxtlon J]G6 ollhe laEor COW, /nfens�, vM elromsy� /ww
CONSTFUCTION LENUINO ACENCY: I Mmby elfirm under penelry d parlNry �hm �Mre u a conmriwion bMiip epenry br tM
�,���, a �M,�.�,���ha �, h�«� �,. �.. �,.
LENDEF'S NIWE:
LENOEF'S ADDRE55:
I cenM �� I heva reetl �nu nppfration erd pele IM1et the ebove iNameiion e cortetl. I ep�ea to c«nply xiih dl ary vd mun7 �ir�eeKee
enp etete lawe releiing lo builEing cronsimdian aM hereb/ euHwrrze ropeeentativee d thia drym enler upon iM ebove-menlioned piapeny
�«��'°'tlp�p1D�� SCOTT CHURCHILL
Pn 5ma 7 q
Oete: L—�� ( �
SiB��ura d Onnr/RganUAOpFfenVCm�rada
(5151de.WP) While-Builamp d Selary:OreerFle: Cenery-Appkranl: Rnk-Revanue; dWdenmE-baesaor
CI'fl OF COSTA F1ESA —}3UILDING PERMII'
PERM NO: B 0£S1f;6
PERMIT NO: B 081667 PLAN CHECK NO: N GOVT; N SUPP: �7
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURL�OSE: OTI{
SOB DESCRIPTION : T/OFF ROCK & REROOF W/COMP. 25YR SQ FT: 3,500
CLAIM VALUE: 7,500.00 CALC—VALUE: 3,500.00 GROUP OCC: R-3 /U-1
COMMENTS: RESIDENTIAL REROOF
iE 1E 1f fE �f iE if iE if iE ff iE iF iE 1F 9E iF 1E iF 1E 1f 1E 1E iF iE iF iE 1E iF iE iE iE iE iE iE fE iE �E �E iE �E-7FjE jE iF 1F -0E 3E ik �E M if 3E k� �E jE iE if 1E �K� �f jf- 3E 3E iE if if jF if �E if jf iElE �f iE iE iE �f
Z O N 2 N G R E Q U I R E M E N T S
S E T H A C K S
--------- -- MAIN BUILDZNG --------- --------- ACCESSORY AUILDING ------ --
FRNT: F'1' IN REAR: FT IN FRNT: FT IN kEAR: FT IN
LEFT: FT ZN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: , PROV; PARCEL: 14116602 ZNE: REF NO:
PLANNING NOTES> f.-
� '
3E �E iE dElE !E �E jE iE 3E �1(� if df !f 1f �ElF aE iE�lE fE 1f 1E 3f 1ElElP fElE �E 3ElE iE fE iE iE 1E fE iF 9E iF �E 1E jF iE iF iF iE iE iE if iE 1k jf if fE 1F 1E iE �E �E aF �E if �)F iE 1E iE 3f �1ElE �E iE �E �E iE 1E �E 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 NIT S
ZONING APPROC�ED BY DATE; t_-•
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: 2—��-9 7
1E 3(- iE 1E �F'k if iE 1E 1E iE iFlE 7f 1F iE 1E iF i(- Ik iE iE iE 1E iE iElE 9f 3E 1E 1E 9EiF��FiF1E iE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 87.25 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUfi
TOTALS----> 87.75 0.00 0.00 87.75 87.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 87,75 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
87.25 .50
# iE iE N' #!E 1E iE 1E �lE fE fF IE iE 4 iF iE if 1E 3F iF 1E 1E IE iF 1E iE IF �E iE ff 1E'lE �E iE �)f IE 1FlE iE 1F �lE iE 1E iE'.E 1F iElklf �IE If if 1E if iE 1k iE If 1f �F iE-� ff� �!E 7f� �f 1E iE �IE �E iE iE iE # iE IE 3E iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N ONIT COST TOTAL COST
SFR 3500 REROOF HY VALUE RESIDENTIAL NOZONE
END OF FEES
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CONSTRUCTION ANDPLANNING - _ . POOI ,PA
:r!PROVAIS Permit#- Date Inspector qPPROVAIS Permit# � Date inspector
�, 7, Temporary Elec2riral Service or Pole . 52. Poof & Equipment Location
2. Soii Pipe�Undrgrnd. 53. Steel Relnforcement .
3. Electrical Conduit Utility�Undrgrnd. _ 54. Forms
4. Electrical ConduibUndrgrnd. � 55. Electrical Bonding �
5. Steel Reinforcemeni ' 56. Rough Piumbing & Pressure Test -
6. E4ectricai UPER Gc�d. 57. APPRQVA�TQ C6VEft•GUNITE ,
7. Footings � 58. Electricai Conduit-Undr9rnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. 4'Vater Pipe-Undrgrnd. 60. Backwash Lines,�P�Trap, � Undrgrnd.
10. Structural Fioor Svstem 67. APPROVAL TO DECK
17. Property Sewer Line & House Connection . 62. Backwash & ReceptorFinal
12. Sewer Cap � 63. Heater & Vent•Final �
7 3. Roof Drains � ` , 64. Plumbing System - Pinai ,
14. flou9h Plumbing � 65. Electrical-Final .
15. Rough EtectricabConduit 66. Sofar System�Finai �
16. Rough Electrtc Wiring • 67. Fencing & Access Apuroval '
1J. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectricabT Bar Ceiling . : 69. POOUSPA SYSTEMS FINAL
19. Rough Neating & Air Conditioning FIRE DEPT, REQUIREMENT
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Duats, in Structure 70. Underground Hydro
22. Duczs, Ventilating 77. Product Piping OGas ❑OII
23. Gas Pipe-Rough & Test 72, Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑OiV
25. Roof Sheathing �; 2ip"�% f 74. Overhead Hyd'ro
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. Drywali Nailing � HEAITH DEPT. REQUIREMENT
31. Plaster Brolvn Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Pinal 80. FOOD GERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating'& Air Conditioning • �
35. Final Gas Pipe-Test
36. Nood or Canopy �
37. Final Factory flreplace � --
38. Final Plumbing . . � `
39. Water Service-Final
�40. Gas Service-Final
41. Sofar pomesticFinai ,
42. Backflow Preventer � � �` �
t
43. Backfiow Irrigation ,�
44. Landscape Irrigation System � ' � ' -
- i
45. Sound Attenuation _ �`,i �.
46. Handicap Regu�ations �''�,i q� f,.V
47. FINALSTRUCTURE&BUILDING 3_3-q7 �jGV -�"� .\
48. FINALPLANNING ''r�rf �.
49. Electric Release to Edison
50. Gas Release to Souihern California Gas Co
51. CERTIPICATEOFOCCUPANCY
No. Date
�� ACP���ant t0 fill In all spacl5 witM1in
•CITY OF COSTA MESA PEpq� IT NO.
� CONSTRUCTION PERMIT /'''-�.Spp
�.� .. _. ...,_ .. . _ ,.
i�
Address
Address
bortler lines anE sign all approl
TRACT NO. LOT NO.
� L. /� TVPE OF CONSTRUCTION
Phone%" ❑ NEW ❑ ADD ❑ ALTERATION
� � ❑ REPAIft ❑ CONVERSION ❑DEMOLISH
LicenSe No. ❑ OTHER
DESCRIPTION OF WORK
FCTOB DECLARATION
I am Iicensetl untler provislons ot Charter 9
�n 7000) of DiviSion 3 0/ the Busines
ind my Ilcense is in full force antl i
� � �' License No � A �
_ Sl9nature �' - - n"' �
WORKERS' COMPENSATION DECLARATION
I hereby atfirm that 1 have a certificate ot consent to self-Insure or a
certiiicate of Workers' Compensation Insurance, or a certl�letl copY
.thereof (Sectlon 3800, Lab. C.). � T
PolicyNo. ���'%�`f�n Company,'�A��P✓ l'��
=e�tlfietl copy i5 h!�¢by tu�nishetl.
:ertitietl copy is filetl with Ihe tity Builtlin9 Division.
GXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This 5ettian neetl not be completetl if tha permit is (or one huntlretl
(5100) or less).
1 certity that in the plrformanG¢ ot th¢ work tor whicn thi5 permit is
issuetl, I shall not employ any person in any manner so as to become
sub)ect to tha Workers' Compensation Laws of Callfornla.
�dt¢ $IgndturC
NOTICE: If at[er making this tleclaration, you shoultl become subjec[
to the Workers' Compensation provisions of ihe Labor Cotle, you must
torthwith comply wlth such provisions or this permit shall be tleemetl
revOkltl.-
CONSTRUCTION LENDING AGENCV
I heraby�dtfirm that thereds a constrUction lentling_agenCy for the per-
formantt of the work'tor`which'this permit.is issuetl (Sectlon �309Z
Civ. C.I. . . .
Lentler's Name
Lentler'S' Atltlress
a.
Is IlcenSetl pursuant to the provisions of the Contractor's LICe�S¢ I.aw
(Chapter 9(commencing with Section 7000) of Dlvlsion 3 of [he
Buziness antl Professions Cotle) or that he is exempt therefrom antl the
basis for the allegetl exemption. Any viola[ion of Sectlon 7031.5 by
-'v3� appllcant fOr a p¢�mit SUbject5 the applicant t0 a dvil pEndlty
�`�bt more�than five buntlretl tlollars ($500). - .
�;:, as owner of t�e properry; or my;employees with.wages a5 thelr
sole tompensation', will tlo the work, antl the'siructurels no[ intentletl.
or otferetl�for'sale. (Section �044, Business antl Aofessions Code: The
ContractorY� �icense Law tloes not apply to an owner of a property
who bUlltls or ImprOv¢5 thereon, antl who tloes suCh work himself or
through his own employees, provitletl that sucn Improvements are no[
Intentled or Otferetl tor Sale. If, however, the builtling or improvement
is soltl witM1ln onc year of completion, ihe owner will M1ave thc burtlen
of provinq he ditl not builtl or improve for tne purpose of sale).
❑ I, as Owner of the property, am exclu5ivety contracting with
licensetl rontractors to construct the project (Section �044, Buziness
antl Pro(esslons Cotle: The Contractor'S License Law tloes not apply to
an owner ot property who builtls or improves thereon, antl who con-
bact5 fvom SucM1 p�oject5 with a cont�actor(5) licesnetl pur5uant to
the Contractor'S License Law).
❑ I am exempt untler Sectlon B. 8 P. C. for this
reason
Date Owner
I h¢rGby c¢ttify that 1 have �eatl tnis applicdtion antl StdtG thdt [he above
information is torrecL I agree to compry with all ciry antl county
ortlinances antl state laws relatinq to mnstruction, antl hereby authorize
representatives o( th15 city to enfe� upon lhe abOve mentionetl
property for y�j pe<tlon �purp es.
5iqnature ����=A..�.te. /_}J . .^�_.E.r�+ oate ��'�6-�Z'
Drivers' L'cense or 55 � � � ��" � � � �� � /�
CMF 0865-46 White-Builtling; Canary-Applicant; Pink-Accounting; G
.
TVPE OF PERMIT
❑ GRADING ❑ FOUNDATION ❑ STRUCTV RAL
❑ TENANT ❑ ELECTRICAL �PLUMBING ❑MECHAI
❑ OTHER
PROJECT DESCRIPTION
SQ. FT.
OCGUPANCV_CONSTRUCTION TVPE
VALUATION ZONE
GRADING CU. VDS. ACRES
PLUMBING
BATHTUBS
TOILETS
LAVATORIES
KIT. SINKS
SERV ICE SINN
FLOOR SINKS
INTERCEPTORS
SWIMMING POOL'
WATER SERVICE
GAS SERVICE
WATE(3 HEATERS
SEWER CONNECTIONS
SOL'AR_TANK `
PLAN CHECK
SHOWERS
URINALS
OOUBLE LAVS
DISHWASHERS
SUMPS
FLOOR DRAINS
CLARIFIERS
PTRAP
ALTERATION
OUTLETS
BTV OUTPUT
ISSUE FEE
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-100,000 BTV_
ANDOUCTING 100,000+g7U_
REFRIGERATION 0-100,0008TU_
SVSTEM 100,000 * BTU _
BOILERS BTV
SVSTEM REPAIR,ALTERATION
EXHAUSTSVSTEM MULTIPLE
ISSUE FEE
ay
5677 5/10/B2
ZONING REGULATIONS
A.P. �
ZONE PLNTGp. RgUEFL. p�
SEpTEBACKC/15T. PROPE�RTVNLINE
L5EpFTYARD
RIIGHTA
REAR VqRD (TO P/L)
PKG.SPACEREQ. PROVIDED
STREET WIOTH PARK FEE S
ZONING APPROVED BV DATE
SPEC IAL CONDITIONS:
ELECTRICAL� PLAN CHECK
GENERATOR 0-1 KW_1-30 KW _
TRANSFORMER
APPLIANCE 10-50KW_SO+KW_
MOTOR$ 0-1 HP_3-30 HP _
(INC.SOLAR) 30-SOHP SO+HP_
FI%TURES - OUTLETS SWITCHES
GAS TUBE SIGNS
POLE LIGHTS
PANElS MAIN SUB
SERVICE AMP
.a.-\ ' \
ISSUE FEE ' -
APPLICATION APPROVED BV DATE
5.00 TL
SUMMARV OF FEES
BUILDING
PERMIT $ SMIP $
PLAN CHECK $—y— PERMIT �� �
1� � ISSUANCE $r�T
PLUMBING $ �"�
PLANCHECK g GRADING $
ELECTRICAL $ - E
PLANCHECK $ MICROFILM $
MECHHNICAL $ TOTAI FEE S S� C'U
PLAN CHECK $ LE55 AD-
VANCp PC $
Y 1 n/5%� � G' yi/ o
FINAL FEE $ �'' ��
�.
.
CONSTRUCTION AND PLANNING POOL & SPA �
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
. Soil ipe-Undrgrn - 44. Steel Reinforcement
3. Electrical Conduit UtilitY-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
. tee ein orce 47. Rough Plumbin & Pressure Test
6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE
7. Footings 49. Electriral Conduit-Undr rn
6. Foundation 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn
10. Structural Floor System 52. APPROVAL TO DECK
i i. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing
14. Rough ElectricConduit �56. Electrical-Final -
15. Rough Electric-Wiring - 57. Solar System-Final
16. Rough Heating & Air Conditioning • Fencing & Access Approval
17. Ducts in Structure 59. APPROVED FOR PLASTERING '
18. Ducts, Ventilating
19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathin
22. Frame and Flashin NOTES: y �� �
23. Insulation " �
24. Lathing & Siding -�2- �Z .V £' D �
25. Drywall Nailing
26. Plaster Brown Coat .�3 � • �
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test �
31. Final Plumbing " G C /.f Y / <! J4L O. O � .
32. Water Service-Final
33. Gas Service-Final �
34. Solar pomestic-Final
35. landsca e S rinklin S stem
36. Sound Attenuation
37. Handicap Regulations � �
38. FINALSTRUCTURE&BUILDING
39. Special Requirements Completed
40. Electric Release to Edison �
41 . Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
� OWNER Colle�e Mesa CO. DATE q��5�
,I JOBADDRESS 30lt0 Donnybrook I.ane BUILDINGPERMITNO. ZBSC7
GENERALCONTRACTOR Hale CO. VALUE $ $�(x��Op
� �� 1(11 BLOCK TRACT ���i�
I
INSPECTIONS
Footing Trench
Foundation Forms and Grade to
t0
Temporary Pole
: Wiring, Rough
Heating, Rough
Heating, Final
. Sewer. House .
Plumbing, Final, F
Plumbing, Fin�al G
Wiring, Final
Occupancy
I'orm `l10 C-H 1
V ZONE �l
DATE I SUBCONTRACTOR
, �`
LB � � 1 '�
� '/7"�
ewer, St.
Out v p p •
a ie -:
� Complete �Q.Q. � y-27�
Gffl' ,A / c/ )J�
PEHMIT8ISSUED
DATE I NLIMBI
-Costa Mesa Bnilding Department APPLICATION FOR PEI�MI�
" ,. 111 EAST 20th STREET i8�,� B U I� L D�L N G
`�- ,�' COSTA MESA� CALIFORNIA
FOR APPLICANT TO 1+'ILL IN FOR OFFICE IISE ONLY
Receipt No. Perm(t N�
nddre�� 3040'Donnybrook Lane pl.�
Rec iv by Date Rec'd. Date Issui
Costa Mesa, California ,�f� �.
Nearest ��XJ SEP 1 9 �4� '��(��'
CrossSt. j�at90II Building � .
College Mesa Company Address �
Owner Costa Mesa, Ciff�11fOTII18,
Mail g002 Central Avenue
Address � Nearesi .'�
Garden Grove Te1•Le.9-2158' crossst. �
City No. Zone I No.of �I Typ Group
Arohitector D8V13 & Q111 ZE No. ��1`T9� APProved, Plans _
Engineer g y
nad�es� 43 Halaga Cove P1aza,Palos Verdes by �+ Date
c�tY u�. CORRECTIONS
,nt�actor The Nale Com an No. 3422 ^n ^
I pddreu 8002 Central Ave.� Garden Grove ��,� ���
Lega4� � Lot � I � � ��
Descriotion No. t01 Block I Tract 2341 —
Size af
Use of
..se
from
None
�. oT
>r,o�mr—s
S�
I I Moving � i Demolish �
No. of
127� Rooms s SWries �'
� StUCCO I Covering gock
Single family dwelling wi
I hereby acknowledge that I have read this Application
and state that the above is crorrect and agree to rnmply
with all City Drdinances and State I.aws regulating
building construction.
Signatureof THE HALE COl4Pl�
Permittee
Authorized Agt. \ ��-�
sztvrn t,nanrr�
Valuation � Permit Fee $ � � �
Plan Check $ 3 '
$ � O o o Fee I $ p5 �"_
anz zas s-sr u.t e-ss
r ;' '.
�.
i '� . .
APPROVALS
'Foundation Locatian I Inspe¢tor
Forms, Materials,
Plaster, Int
Plaster, Ext
Masonry Reinforced
Bond Beam
' �.:1 Date
j�
1t
�',
j1
° �I
'A ,
=—;
i
�
� PLOT Pi.AN
Show Iocation and distances from
propeMy line and between buildinga
' 4
COSTA. K
SEP?1�SSP��E;a'S74a *'^�:.Z3.Qf
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