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COSTA MESA BUILDINGSAFETY DEPARTMENT - - �
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
PL ION FOR BUILDING PERMIT
' For Applicant to Fill in Completely
REC I E DATE RECEIVED D 4E ISSUED
BUILDING
AD�RESS 994 EL ��{m�No p2, c. �+-� - -
J ���� ER JT'�0:7 1
OWNER Rogezr W. / /�NEQ �+�P�NO. ( f
MAI L BUI LDING n
ADDRESS �4�2 R�ugEAK� Ge��e ADDfiESS :.}- L(,,,� `/� 1N�j
V TEL. TRACT SO l LOT p BIOCK
ciTv if ti7"/"�6 To N 8eqcir No. $4CoSl9
CONSTRUCTION W AD R P
LENDER ONE
BRANCH ^
OWNER �i
AD�RESS '�
UE Q'�
ARCHITECT � TEL. S $
OR ENGINEER � N .
FIRE
ADDRESS ZONE VPE ROUP
CONTRACTOR ^ QG�NE2 B�PA�VED DATE -�'�
ADDRESS
TEL. ZO� NO.OF USE OF NEW �y �
CITV � NO. P�� Z BUILOING '�`K w%iL
STATE CITY �'ARDSAPPqOVEO VARDSAPPROVED
LIC. NO. � LIC. NO. MAIN BUILDING ACCESSOFV BUILDING
SIZE NO.OFBLDGS. (FFOMC/�STREET)
OF LOT %O X�I 3 ' NOW ON LOT � FRONT FT. � O FT.
USE OF
EXI5TINGBLDG. RPAQ�r/�1t.Z�n FT. � FT.
SIZE OF ,� NO. OF ^
NEWB�DG. ROOMS STORIES � I.SIDE FT. i�"'� FT.
EXTERIOR WALL ROOF _
COVERING ^ COVERING FEAR FT. FT.
USE OF BUILDING AND WOFK TO BE PERFOFMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
VAR.#` DATE
�3u,�n CO�v[RG`TF oe.«� �.�AL� �.�.P.� APPROVED
� �� QL UGK ia � N �G /1 APPROVED �� � / �n _ �2
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I hereby acknowledge that I have reatl this application antl state, �'JS
that the above information is correct and a8ree to comply with_
all laws regulating builtling construction, and I shell not employ
- any pe�son in violation ot the workman's compensatiOn laws Of �
the State ot Calitomia. � ,�
I hereby certify ffiat I am properly licensetl as a convactor under � SQ. FT.
the State ot Calitornia Business and Professions Coda, Oivisicn 3,� THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and thac such licenses are in tull force antl effect, ar I� THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am ezempt from ttie provisions ot theState of California Business VALUATION �
antl Protessions Cnue, Division 3, Chapter 9. PERMIT FEE $
SiBnature of � e � ! . �� � /'� �
Pe�mittee L�'u'� ��✓ $ J PLAN CHECK $
Authorizetl ABent TOTA� FEE $ ,� I
� `� 19E72
• CO/'ITA MESA BUILDING-SAFEfY DEPARTMEM
�/�.0. 90X 91] COSTA M86A. CALIFORNIA
��
Po� Appl)cant fo Fill In Complately
nPE OR PRINT
BUILDINt3 �l 1
wooaess Lot 4� TT2Ct 011
COSTA MESA, CALIFORNIA
:']7th St._'Suite
C
ITECT
61ZE NO. OP BLU06.
OF LOT %(1 � V G3Z � ' NOW ON IAT
USE OF
EXISTINO BLD6.
BETBACK IINE FROM 1�
CENTER OF BTNE6T 4O � REAR YARD ZO �
SID6YAROI LfiFT � RI6HT �-O�
DESCRIPTION OF WORK
FEE RECEIUED
FI ANCE D���.
CIT�PP8�A�919� l61�61WE�R
BUILDING
For Office Use Only
rteceirt rvo. pepr�iypapn.
6 �::�C /�
E���� o,�r:r�/J,-ti 3U�('�`�si�o3
ZONING
l . NO.OF � UBEOPNEW �
� ` �LANB lUILGIN l G`�
1
CRIRION � O �I� � Z j
�. NO. �—'��r-
"E: NO EAVE OVEftHANG 6HAlL 8E LE55 iHAN
TO SIDE Q R�AR P. L
ES
.OWED ' (U.B.C.REQUIREMENT
YARO3APPROVED YARDSAPPROVED
MAIN BUILDING AGCESSORY BUILOIN
;OM G(�j7�EET � �
f75! l sb
NO OF . � .. . � VAR. �
�� X 7� � ROOMS 8TOR165 2 C. U. P.
WALL St�� I ROOF rock BYPR
CCO GOVERIN6
IlDIN6 ANp WORK 70 BE P FOR l�D
A�t 4 nlex
�ATE
1 NEREaY ACKNOWLEDOq THAT 1 H�Ve REAO TX18 APPLICATION TIE AMOUNi 9HOWN UNDEfl VA�II�TION 18 FOR TXe
Arvo STwTE THAT TXB AAOVH IB CORHECT AND AOqEQ TO COM- PURPOSfi OR 68T�BLIHHINU w pERMIT FEE ONLY.
PLY WITH ALL'CITY OHO�NANCHY ANO BTATB LAWB p[OYLATINO ypLUATION �'
ewtoma eonsiAucriory, - pERMIT FEE $ /�D�V
SIGNATUREOF NYCROFT TERRACE, INC. ��
PERMITTE 2 /D �
� ///� < - $�� �/- PLANCHECK $ (9
AUTHORREDA6ENT p(. � . /r//f �
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Gity of Costa Mesa
Building Safety Department
P. O. Boz 317
Costa Mem, California
CERTIFICATE OF OCCUPANCY N� 1968 C
The Building located at 99�► El G'0ID1a0 DTiVe — Uh3t8 A2 B� Cs & 1)
has been inspected and found To comply with the provisions of all CiTy of Costa Mesa Ordinances applicable thereto
for a Group �:.T 6cc�pancy.
Use of Building_ 40UTp1CX I'e81dCriCe FTi.th BtteChed �0 _
Legal Description L� �a T�t �3u
_ (See reveree side for Mefes ond Boonds)
Building Permit No. 1�72 Electrical Permit No. 2�� Plumbing Permit No._ ���' _
Floor Load Signs have been installed as Room Capacity Signs have been insfaled as
required under Sec. 2308 U. B. C. . required under $ec. 3301 (1) U. B. C. —
17050� CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until fhe owner or operaTor has been issued a valid certificaTe of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occ�pancy classification of a building or portion thereof
2) The number of apariments or guesi rooms �
3) Ownership
If Group H Occupancy, number of aparTments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, ChapTer 9, ArTicle 8.
N�mber of apariments—� and/or guest rooms
ISSUED TO: Building Official„/
���� �
�s�cyP.C^�Tzsi�aC1��::�7ne ryj`orated by � f—/J�///`�� ��—�J—
Date �1 29� 1�1
This CertificaSe of Occupancy SHALL BE posted in a tonspicuous place on The premises and SHALL NOT BE removed
except by fhe Building Official of the Cify of Costa Mesa under Sec. 306 (e) U.B.C. Fa�,,, sua�inz—ii-sa—s-s r