HomeMy WebLinkAbout2872 EL RIO CIR - Building Permits�
PflOJECT AOONE55' � II-� � tL R I U C I
OWNEfl'SNPME: T ARIVIERE ROSE
Aooeess: ZII72 Ei Rf0 CIR
COSTA MESA,CA
ABCN/ENGINEEfl:
, AO�HESS:
uxiT:
92626
BEG.NO.:
UNIT:
PENMITTEE: t�ANEWINKER CONS'P ( 619 ) 434-4702
aooeess: 3820 NANTICAL DR
a ' CARLSDAD CA 92008
LICENSEO CONTNaCTOP DECIANaiION: I hereby aftirm ihaU am IicenseA unaer pmvisions ol Chapter 9lcommencing with Seclion
70�0� ot Orvision 3 of Ine Business and Pmfessions Cade. and my license is in full farce ntl ettect.
ciTvuc.:047570 sTaTeuc.: 9699 c�ass��� /
a
Oa�e: � ' �� SignaNre:
'IOBREBS' COMPENSATION DECLAPATION: I hereby at�irm el I have a c tlilicale of consent �o sel4insure o� a certiticate of Workers'
impensation Insurance, or a ceridied copy inereof (Sectio 00, La�. C.
JLICY NO.: E%P. DATE:
COMPANY: .
I � Cetlifiea topy i5 here�y furnished. ❑ Cerli�ied copy is �iletl wi�h the Ci�y Building �ivi5i0n.
�a�e: ApPlicani:
EXEMPTION FflOM WOHKEPS' COMPENSPTIDN DECUflRTION: (ihis Seciion neetl nol be Com01ete0 if the permii is for one hUndretl (5100) Or Ie55�.
I cetlify Ihat in Ihe pedormance oi Ihe work for w�ich ihis permi� is issued. I shall not en ploy any person iry� ny ma��pp¢¢ so as (o �ecame
Suble�� i0 Ihe Workers' Compensalion Law oi Calilornia. ^ I /' // /
Daie'. -U SignaNre. C.K �M� G1 ! L�-u-� �✓�
NOTICE:I�, atlei making Ihis declaration. you shoWd me suble �o Ihe Workers' Compensa�ion provisions ol the Labor
Cotle. yau must fotlhwith camply wi�h such pmvision r Ihis permi� shall be tleemetl revoketl.�
CONSTHOCTION LENOING pGENCY: I here�y aliirm �hai �here is a conslmciion lending agency tor ��e pedormance of Ue work for
which ��is permil is i<suetl (Seciion 3097. Civ. C).
LENOEfl:
IIODHESS:
OWNEB BUILOEH OECLABpTION: I hereby a��irm Nat I am exempt Imm Ihe Contrac�ors' S�a�e License Law �or lhe following reason
(Sec�ion 7031.5 Business and Prolessional CoOe: Any cily ol county whlch reQuires a permit m constmct. al�er, impmve, demolish, ar
repair any simcture, prior lo its issuance. also reauires ihe apDlicant for such permit to file a signe0 statement ihat he/she is licensetl
pursuam Io Ihe pmvisions ol �he Con�raciors' Staie License Law (Chapier 9(commencing with Section 7000) o� Division 3 ot �he Business
and Pm�essions Code) or thai �e/she is erempt Iherefmm and t�e basis for Ihe alleAed exemp�ion. Nny violation o� Sec�ion 7031.5 by
any applicani lor a permit Suhlecis �he applicant �o a civil penalry ot nol more �han five huntlred tlollars �8500�.
I. as owner of ihe OmDeny or my employees with wages as Iheir sote compensation, will do ihe work, an0 t�e
.� simcmre is not imenOeA or offereA for sale (Sedion 704a. Business and Prolessional Cotle: The Coniractors' State License Law
' Uoes n0i aDDty �o an owner oi a O�operiy wha bui105 or impmve5 ih¢re0n, antl who tloes Suc� wOrk himself/hersel� or ��mugh
�is Or her own emplayees, pmvitled �hai SUCh impmvements are not intenOeA Or o��ere0 br Sale. I�. �owever �he building Or
impmvemeni is sold wilhin one year of compleiian. I�e owner will Aave �he �urUen ol pmvinA �e�she tlitl nat builtl or improve
for Ihe purpose af sale�.
I, as owner o11�e D�oDetly. am eKclusivel9 conlracling with licensetl coniractors to consiNct the pmjeci (5ection 7044, Business
❑ antl Prolessions COUe: The Con�rac�ors' S�ale License Law Uoes no� apDly �o an owner of property who buAas or im0�ove5 thereon
and who Contrat�s �ar Such pmj¢c�s wit� a contracmr�s) li[en5e pur5uam m Ihe COnlfaC�ors' S�aie License Law�. I am aware
Ihat proal af Iheir Warker'S Compensation msurance shoultl be pmvided �o me.
� I am exempt untler Seclion�. B. & P. C. '
lor ihis reason; ,
�ate: Owner.
I tlo nereby ceriify Inai I am aware ol and understantl �he requiremems ol Calilomia Heal�� an0 Salery Code Sec�ions 25505, 25533, and
25534 antl �hat I or any �Wure bullding occupani wlll/will nol (circle one) need to comply wilh saitl s�ate codes ana Ihe requiremenis tor a
permi� for constmcimn ar mo0ilica�ion imm Ihe Air Oualiry Management Oisiric�. Residen�ial conslmc�ion apPlications are exemp� �rom
Ihese pmvi5ion5. '
Oate'. Applicant:
I hereby cer�ilythal I have read I�is applicatio zntl 51aie ihatihe aboveinbimalion is correc�. I a�
ortlinancesantlstaielawsrelatinglobwltling nsimctionantlherehyaWhorizerepresenlaivesotih:s
pmperry lor inspec�ion purpases.
�aie: �—a't{� '_� SignaWre: u'�"�
�rivei's �icense or Social Securiry
�6m-a6 WNte—Builtlinq�. Green—Code Eniorcemen�; Canary—App6cant; Pink—Revenue
Galdenrotl—Assessor
CITY OF COSTA MESA - BUILDIVG PERMLT PEki� NO: B. 049593
PERMIT NG: H 049593 PLAN CHECK NO: N GOVT: N SUPF: N
CONSTRUCTION TYPE: PEkMIT TYPE': S'PR PURPOSEc' OTH
JOB DESCRIPTION : TEAR-OFF SHAKE, RESHEATH.& REROOF 2600SF SQ FT: 6,300 .
CLAIM VALUE: 6,700.00 CALC-VALUE: 6;300.00 GROUP OCC: R-3 /M-1
COMMENTS; TILE ICBO #3769 ,LIGHT WEIGHT �3 �.��r
*��*�,��«�**���«***�t*��x��*�«��****���*�+���Q******�+���*****�r*���8'l��� I I�l���
2 O N I N G R E U I R E M£. N T 5
------------ MAIN bUZLDING _____S-E-T B A_C-K_S_-_ ACCE550RY HUI����� ��--
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARI{ING REQ: PROV: PARCEL: 14156215 ZNE: REF NO:
PLANNING NOTES>
.> - -
**+r*�t�t�t�t**it�t**�trt�r*ati�iti��t**�tit�*�**i�*+t****�t�t**�t�t��t�tit*���**�t��t*�titit*�t�t�t�tt-�tK�*it*i�ita��t��t
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 HY DATE: �
BUILDING APPROVED BY : DATE: �
APPLICATION ISSUED BY: DATE: . �'-2- ''—�f�
�Ifif�FiEiEiEkifiliF3f�fiEiFiEififiEifdEiFif3F�{�iF3FiF3FiFi�7FiF3F�F3F�ii��FiF3FiF ��i3F7FiF�3FiEiEiFififitif�EjEiE� � SjF
if if if if af i4 if iE if If iE iF if iE iE iE ik if i! if iF jE if iF i4 �F �E if iE af iE if ik iF M iF iF if �E 3f jF iE jE if %� if �iF if if ±e IF iF iE iE it dE df ii iF iF iF �E 1f iF # if if iF �%�7E jE iE j4 ie iF if i't R iE
LEGALIZATION:N � F E E S U M M�A R Y STRUCTURAL SEGMENT:Y
PLDG PMT PLUMBING ELECTRIC MECEiANIC FIRE SMIP/R1iS�� GRADING
PERMIT 90.00 50''
' SMIP/NON,-RES
PLAN
ISSUE FEE '
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAi PAID �;. DUE
TOTALS----> 90.50 0.00 0,00 90.50 90.50� .00
REVENUE DIVZSION TOTALS-->' COLLECTED: ' 90.50 OVER/SHORT: .00
, BLD90P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING,PLAN-CIiECR
a•�'
1E if if ii if iE if iE it if if iE i4 iF iE iE iE ik if iE iE # iE 3E iF 3F if if i� �E 1f if af if i' jE 1E ik aE iF if iE if iE iE i! k 1E df iE �E if iF df if if iF if iE �)f fE K iE if if ie �E �� #)E iE 3F �F±f if iF �Ie * if
�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 UNIT COST i:TOTAL COST
SFR 6300 REROOF BY VALUE RESIDENIAL NOZONE 1.00 '6,300.00
END OF FEES
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oi �oa�z�:2-OQO??713 '7'+=�T �a.�',n
�arE: iarzafso rTnE: os:zs
CONSTRUCTION-P'ND PLANN!tv.. `'� �OL & SPA
APPROVALS' Pe�mit# - 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 Reinforcemerit � . 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
. 8: Foundation � �"� 59. Gas Pipe, O Undrgrnd., Test � �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � 61. APPROVAL TO DECK
17. 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-Finai
16. Rough Electric Wiring 67. �Fencing & Access ApProval
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
.� . . ...�. }
20. Rough Factoiy Fireplace •'�� - , � y + qPPROyACS ?�Permit # � "
21. Ducts, in Structure �. ••• �-• + 70. Underground;Hydro '
22. Ducts,Ventilating,� ��• ' ": ,� �71. ProductPipingO�Gas �,Oil
23. Gas Pipe�Rough &�Tes[ j,� � 72. Underground Flush; :• � '
24. Roof Framing� ' • • "� } .! ' �' � �Y 93;�Undergrnd�.StorageTank OGas ❑Oil
25. Roof,Sheathing � �j � B . i i. � 74. Overhead Hydro���� *
26. T�Bar Ceiling (Structuraq &.Monocoat • "! '' '�` � a 75.' Dry Chemical �, � " � ' �
„� a �. ��. � � i.. -�L: a . � � �i
27.. Frame and Flashingr ;�,":,3: � • j, 1� i i 76. Dry Standpipe ,���� q� -1
28. Lathing&Siding. ���7 _ "' •� • '•�� 4 77,"iFIXEDSYSTEM�F,INALi, , "�
29. Insulation -. - � � . ��� � `� � 78t�FIRE PREV. FINAL � ^ ��
30. Drywall Nailing �� ' � � a HEALTH�DEPT!�REQUIREMENT �
31. Plaster Brown Coat, .• � ;,,,,, + i '� F �,79 � FINAL INSPECTION � � ` ��
- 32. Electrical:Power Meter:Final � +�' i '�� �� t�80.� FOOD CEftTIFICATE ISSUED
� ��•
33. �Final Electric . . " � ' �� " �"Notes: �� ��1' ' , `�
�. '! 1 t��(�J
34. Final Heaiing & Air Conditioning: - � ! � , '� 'i ��' ; i ,:; + ' +• +
,- :� �a r -:i
35. Finaf Gas Pipe:Test � � � ' . � ; "�: � "� ' -
, . I i�. � • t.. �
.36. Hood or �CanoPY -. "y - s ( i N� ,� . ' � t,
�.� n ..i �� n�
'37. Final Factory Fireplace. �t't; ' � 't i ' i�, � - " _ ��;
38. Final Piumbing ' .. . " . j i � ��� 'L , . , �
.i
39. Water Service-Fina� - ,'� . ' � �; � , `� ' ' ;
_ ; �
.40. Gas Service-final t,=� �� � �i , _ � ,
41. Solar pomesticFinal '� �' • i ' ' ' � ;i ;� , `Z;' � ` a
' 42. Backflow Preventer � � i i � 4� �� 'i. - � -�
43. Backflow Irrigation ' - - � , � '� : , '`�' ' = � ' ;
� i.
,44. Landscape Irripation System � �� . �� . , �i • • • . � -
45. �Sound Attenuation ,r:�', . � �. -. � �. , , • . • � .
',� ,p i �, . . /'�
' 46. Handicap Regulations ' ' � �� ��' • . . .
47. FINAL STRUCTURE & BUILDING B3p (I� �� '
48. FINAL P�ANNING ; � �; ��� , r •
49..Electric Release to Edison ' ' '
a .i
50. Gas Release to Soufhern California Gas Co �' �' •, , ' �•
� .
51. CERTIFICATE Of.00CUPANCY -. , ,
No. � Date
�
<
+`i:`:•
..�.. ... ♦y9,..:�{�I.,'�i.�
♦
oTm -� ,
' L A B O R A T O R 1 E 5. 1 N c.=
vs oo� ,./ee{(n9 andJno�iecfian �n9i»eera
Test made for
Job Ideritification
Location in Structure
Laboratory Number
Mark
Date moulded
Date teated
Age, days
Weight per cu. ft., lbe.
Dimenaiona, (inches)
Area, aq. in.
Compresaive Strength
Total Load lbs.
Lba. per eq. in.
CObIPRESSION TEST REPORT
Fiesta Pools., 5141 Imperial Hiqhwa So. Gate
�_.o--
LEO RIVIEFiE SlNIMMING POOL!; 2872 E1 Rio Circle
Costa Mesa
GUNITE
LABORATORY DATA
78860 78861
1 lA
3/12/63 3/12/69
3/19 4/9
7 28
6,2x12.3 6,3x12.4
30,19 31,17
112,500 122,500
3,726 3,93�
FIELD DATA
MIX: 1: 4-1/2
Cement FiveTside I
Sand
No. 4
No. 3
No. 2 -
Water 3-1/2 - 3-1/2
1- Fiesta Pools
��-� Costa Mesa Bldg, Dept.
18
3/12/63
6,4x12.2
32,16
,
tl �
�V
Specified Strength C 28 days 2000�$ �
Stump �
Admixture None
Ready Mix Plant
Cyls. made by Contz.
Date cyls. delivered Builders Pickup 3/14/63
Respectfully submitted,
RAYMOND C. OSBORNE
CF-2 - , �. / . , , _ .
235 WEST TWENTY-SEVENTH STREET • LOS ANGELES 7. CALIFORNI�R�•�
v,
R£c'�u,Ed
AP{� 15 1953
DQPt.
C H M O N � 9- 3 1 1 1
.
�
CITY OF COSTA MESA
Building Safety Departmeni
Application for permit for The fabricaTion and erection
of awnings, advertising signs or devices.
:�'`
� ! ��
�
LOCATION
16398
Building Site Address ��' �Z- EL- %1�6 ���LL.�
Name of Leasee �"/��� O � r2� phone ��E �4 �� ��
Contractor��%�`� ��/G-Al ��d , State License No.
address 2� � t-W• �"-� �7. City ��/Y �A� � phone A`� � �G�7
^ ��hitect or
igineer_
�
State License
Phone
DESCRIPTION
Description of awning, advertising sign, or device:
Awnings canvas � metal � �� Width: �ft. "'� in. Lengih: G ft. �_ in.
Ground Sign ;� Projection Sign � Roof Sign � Wall Sign � Metal LetTer Sign �
Banner � Canvas Sign � Gas Tube Eleciric Sign (Sub-section 1.44,�Ordinance 313) �
Combination Sign � Special Device (other) � Explain:
Two copies of plans and specificaTions shall be submitted wiih application for permiT for each sign. Plot on
plan sheets proposed location of sign and locations of all oTher signs at sife. Minimum size sheets must be 18"
by 24" and non-erasable.
If within the 10-fooT prea of front property line, owner is to sign written agreement with the City.
of Sign -� Thickness ft. in. Height ��n ft.��- in. Length�ft. �— in.
Weight Ibs. Height above grade—Sa__ft. in. ' Projection ft. in.
The undersigned hereby agrees to fabricate and erect awning or advertising structure wiThin ihe intent and
meaning and in strict accordance with the provisions of Ordinance 95, Ordinance 313 (ElecTrical Ordinance of
the City of Costa Mesa), and all amendments thereto.
ALL APPLICATIONS MUST BE PILLED OUT BY THE APPLICANT. ALL FOOTING, FRAMING AND ELECTRICAL IN-
SPECTIONS SHALL BE CALLED.
Signature of ��
Permitee
Authorized Agent (�jQ�� S[G�IV CL
Racd. by ��� Date � l� `' �
Form 214--1M—Il-B�3-B P
The amount shown �nder Valuation is for ihe purpose ol
establishing a permiT fee only.
VALUATION I Permif Fee $ � "�-
Plan Check
Total Fee $ � '
;';
FEE RECEIVED � ''
��FEB 8
FINANCE�PT:
CITY Of COSTA MESA I
FOR OFFICE USE ONLY I
FEB 1 4 1962 ��� fc�
Date Issued Permit No.
Fire Zone ype Group I
Approved by Date I
ZONING�/�
Zone� Use of Bldgs.2C
I_�.G�/�%�i7LL771v�
eldg. Site
Legal Owner �-� ��
Address
City ��7'� Phone
Yards Approved.
Large Sign in excess of 8 sq. ft. Setback from center line
of street to front property line �ft. _ in.
From property line to edge of sign —Lft, in.
Side Yard Setbacks:
Left Side _—�ft. in.
Right Side �ft. in.
Building Line $etback from
cenTer line of street �ft. in.
Area of Sign �fT. in.
U/�
Height above Grade —_lzfr. in.
Projection ft. —_Qin.
Awning Size-Widih ft. in.
Length ft. in.
Awning Height above Grade ft. in.
Projection . ft. in.
� �ir» ��g
Location and size /• � in r
approved by_
oare l-- 3i— (� Y
Lor 5
I -: Z_� ..t���'7
COSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 917 C08TA M88A. CALIRORNIA
For Appliean+ fo Fill In Complefely
TYPE OR PRINT
BUILDINGZ8�2
ADDRES6 E1 Rio Circle �
�._ COSTA MESA. CALIFORNIA
3800 E. Coast Highway
orona del Mar No'OR 3422
ucTNo.98808-SB-1 NO.
I6�ZE..� 7Gf.Osc 6ix��Z9 �xo.o.a��
9CTBACI( LIN6 PPOM
CENTeR OP STReeT � REAR YARD �
61DE YARD I LEFT J� I RIGHT 6�
DESCRIPTION OF WORK
BUIL�IN�a NO. OF
SIZE 4R � X S 1� ROOMS
EXTERIOR WALL _. IROOF
BE
F E RECEIVED
JUL 2 B 1961.
FINANCE DeEPAATE.�
APPLICriTI� R9RTPHtRdi�'
eua�iN�
Fo� Office Use Only
RECEIPT NO. PERMIT
BY
crran.�:e
COSTA MESA- CALIFORNIA
PIRE
ZONING
ZONE NO. OP U98 OP NCW
R—, PLANB � BUIIDINO �
�.eo.� P.�c. , 8 Se.ry
!13 — z�o — 67
EVE6
ALLOWED
9iJ � / �
�� FT. IN.
� FT. IN.
7 FT. IN.
�� FT. �_ , IN.
W �(l DATE � /Z ! b
�•• �`� •�••• • " �" 016 C LCd � 1� '
a ��
1 MEREBY AGKNOWLEDOE TNAT 1 XAVE RGD i1118 ARLIGTION TXE AMOUNT CHOWN UNOER VALUATION IB POP TM!
I�ND BTATE THAT THH A00VE I6 COPRECT ANO A6RCE TO CAM- pURP06¢ OP. 88TAlLIBHIN6 A PERMIT IPE ONLY.
PLY WITH ALL CITY OXOINANCEB ANG 8TAT6 LAW! RlOUL11TIN0
BUIIa1N0 CON6TRUCTION. - . ' VA�UATION t.�
P RMATURE OF A D L MAR DEVELOPMENT C0. ' PERMIT FEE $�%�'��
B}�: $1�{�LZL.00 _PLANCNEGK $ /'//��
AUTNORIZED AGENT . ' __ __
� N� . - • I8679
, COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 91'f COSTp MEBA, CALIFORNIA
For Appl7cant �o Fill In Completely •
- �TYPE OR PRINT
A�ORESS •� �� �� . � � V ..
COSTA� MESA, CALIFORNIA �
52E �' ��( � - NO.OPBLOOe.-
OF LOT /\ Now oN LAT
USE OF
EXISTING BLDG. � ���i 1
eerawcK ��ne vAor �� �p( REAR YARo 6•
CENTER OFBTREET
� (� /
SIDEYAROI LEFT � � RI�HT• x
DESCRIPTION OF WORK
� USE OF
1 XEqEBY ACK
AND 9TAT8 T AT TI
PLY WITN AL CITY
B�IILUINO CO STRUf
� AUTHORIZEDA6ENT.
� XAVB RE
CORRECi
3 ANO 9TA'
1
FEE _RECEIVEp
FEB 1,1 1963 �
�P I� �� Md s�,R
For Office Use Only
� xeceirr No, rgqyi�
ZONIN(i '
ZONB ^, NO. OF UBE OP NEW �) _ _/
v6`� PGN9' � Bl11LU1N0 `�Lf�•e�
.� ' / (]
88CRIRION � 1 �/ �" � ��
AP.NO. �'y/� vGO��'/�
NOTE: NO EAVE OV ERHANG BHALL BE LE55 THAN
90' TO 81 DE 8 REAR P. L.
EAVES
ALLOWED (U.B.C.REQUIREMENT
YARD8APPROVED YARDSAPPROVED
MAIN BUILDIN6 ACCESSORY BUILDINO
REAR � F
DISTANCE BET.
MAIN BLDGS.
VAR. #
HOLD FOR
TX8 AMOUNT
PfIRPO6E OF
DATE
a
0
UNOEH VALl1�T10N IB FOR TH8 �
19HINO ♦ PERMIT FE8 ONLV. p
Jn '. A 0
PERMIT FEE S /!/1 � �'�/� �
�
m
PLANCHECK $ �'U"'C� ¢
y�Y �,,�J LL
TOTAL FEE S �IJ s �`�
, 19572
COSTA MESA BUILDING-SAFETY DEPARTMENT
• P. O. BOI H1] C06TA MCBA� CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
eui�oiNc � '
ADDRE55 ' � �� `- /6
COSTA MESA; CALIFORNIA
i+� 6
� MAIL
Y USE OF
��•!�ti
? /Y�l/�/�%/ (�,
�NO. OP BLOOB.
EPT � I RI6HT j�
DESCRIPTION OF WORK
/�/\�� ROOMS �67'ORIfiB /
WALL� I ROOR �`/�f/�riN.�:
I HEREBY ACKNOWLEOOH TX�T 1 N�V! PEAO TX18 APPLICATION
ANO BTATE THFT THE ABOV6 i9 COHHECT AND AOREE TO COM-
PLY W�TH ALL CITT OpO1NANC[B AND BTAT� LAWG N6O LATINO
BUILUINO CON6TRUCT�O �✓
�)
S�GNATU_fyEqP_ ���r/j . �J�1d/h/�
� AUTHORIZEO AC6NT
F E RECEIV�D
" :,tAY 2 7 1963
FINANCE DEPT.
APPLICATION f0 i�wP� COSTA MESA
BUILDING
For Office Use Only
-� P6C61R NO. � PEFMIT NO. �
�nuns
L80AL ) „ �
NOTE: NO HAVE
YARDB APPROVED
.MAIN BUILDINO
!OM GL STREET) "
D18TANCfi BET.
MAIN BLDGB.
VAR. #
1186 OF H!W
eui�oina
— 7 (Qo( ' /7
10 SHALL BE LESS THAN
YARDSAPPROVED
:CESSORY BUILOING
DATE
�D C) "
eo. � �
TXH �MOUNT BXOWN UNOER VALU�TION IB FOR TX8 y
PURP09H Op H6TABLI6XIN0 A PERMIT FEE ONLY. p
VALUATION I m
PERMIT FEE S v �
� � �
a m
� -- p
0
4
- TOTAL FEE $ �