Loading...
HomeMy WebLinkAbout233 FLOWER ST - Building Permits�_� CITY OF COSTA MESA � BUILD/NG DIYISION ' 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa. .us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. P08-00106 PERMIT TYPE PLUM APN: 42540315 JOB ADDRESS: Vicinity: SCOPE OF WORK: F OWNER: MADER,. PHONE: APPLICANT: BRYANT, PHONE: 7'14-641-'I CONTRACTOR: Address: City/State: ARCHITECT: ENGINEER: 233 STATUS: DATE ISSUED: ,ISSUED BY: " r ' : r 2 ST.CM � �� ` SuitelUmt ;, `' ;,� � w ;� ., ':r . ;t� .....:,.. METER TO RESIDENCE. r , ��{ yy ;,: ,� ' 'i ERT v ,I.`� : _ _ ,•£' Address: _City/Sia,te2ip: ' - Address:., ., ""City/Siate/zZp: �,: ISSUED 04I21I2008 KJ B �- >418 HOLIDAI' RD NEWPORT�BEACH,:CA' � 1525 MAC�ARTHUR.BL""�': : LOSTA-MESA CA ° .� f _ C AND;R�DRAINS INC License No:-; )531746 '� ' 1525 MAC ARTHUR BL �i;.:' � .. .. .. . . . . .. . . ..: PHONE ' ��..714-641 1545 ,�' COSTA MESA CA��.- � ZipCode. �92626 . . , � � . � , `� CELL: � � � '� .-. ..:. � ... . . . - i . -�- �'i i„�, � " . License No..�. . ' s �PHONE - , ,;��; ' ...�. .. � :.__ License�No. � : ��... , �-: . . PHONE "-.� � , _ , .. ... ._ _ - . _ _ i '-: _T� _ . - .. - - t ' .4 �.::.- ., ' . ,_ . _ _ _ . - ' . - .. ; FLUMBING PERMIT FEE:SUMMARY _ t. , , <-;. :: = - . - :,� -PLAN CHECK FEEi'-, _ � - $0 00 � PERMIT,FEE ::'. :. . . . , , _ - : $33 30 , ' _ ,� 3_. � TOTAL FEES =: - y � $33.30 NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requirements under Califomia statutes and relaled regulations. (Ord. No. 92-28, § 1, 12-21-92) ' EXPIRATION: PERMIT EXPIRES 160 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for ihe work authorized under this permit to be considered le9al, such work must wmply 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. OC UE t. 1616 1266 200 20t 202 203 204 INSPECl10N TYPE Fized System Final Pire Prevention Pool Spa Final � Final Re-Roof Final Block/Retaining Wall Final Facbry Fire Place Final Sign Final Demolition DRTE INiIiIRL � INSPEClIONTYPE 206 ""' Final Mechaniwl 208 210 212 220 222 250 Final Plumbing �/� Final Electnwl Final Fire Prevention Final Planning Approval Final Site Final Building/Occupancy oan ixmu Sir'/� % � % � / � w WORKERS' COMPENSATION DECLARATIO, I hereGy affirm under penalry of perjury one of thc ,ollowing declarations: ❑ I have and will maintain a certifiwle of wnsent to self-Insure for workers' compensalion, as provided for by section 370C o( the Labor Code, for the peAortnance ot the v.ork for which this permit is issued. � �❑�I have and will maintain workers' compensation insurance, as required by sectqn 3700 of Ihe Labor Cotle, fa lhe peAortnance ot the v.ork for which Ihis �pertnit is issued. My workers'� compensa�ion Insurance carrier and policy number are: ca�—'� � M PL���.2 S � (111��tin/S�� (Th6 sedion nee0 iq1 be mmpleleE �Ihe peimrt is valued at one huntlretl da%ars (St00) oiless ) �P.olicy:Number:l � � (r �or��9 Q��� ❑ I certify ihat in the peAortnance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers' compensation laws of Califomia, and agree that if I shoultl become subject to Ihe workers' compensation provisions of Section 3700 t the Labor Code, I shall forthwith comply with these provisi n� � AOd� Ipnl's5lgnature _ (_Dale _ ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWfUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, IMEREST, AND ATTORNEV'S FEES . LICENSED CONTRACTORS DECLARATION: I hereby aKrm tha[ I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Protessio Code, and my license is in full force and effecL ,� ����. #� J3 ��� '- ` Class # —Conlra _ _ ur _-� - te CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm that there is a consWction lending agency for the per(ormance o( the work fa v.fiich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Date OW NER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury [ha[ I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for [he (ollowing reason (Sec. 703t.5. Business and Professions Coae: Any ciry or county which requires a permit to consWct, alter, improve, demolish, or repair any struG[ure, pnor to its issuance, also requires the applicant for such pertnit to file a signea statement lhat he or she is licensed pursuant to the provisions of the Conlractors License Law (Chapter 9(commencing with Section 7000) o� Division 3 0( lhe Business and Pro(essions Code) or lhat he or she is exempl therefrom and the basis for lhe alleged exemp[ion. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the svucture is not intended or oftered 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 dces such work himself or herself or through his or.her own employees, provided that such impmvements are not intended or oRered for sale. If, however, Ihe builtling or improvement is sold within one year of completion, the ovmeo-builder will have the burden of proying 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 tons[mct the project (Sec. 7044, Business and Protessions Code: �The contractors License Law dces not apply to an owner of property who builds or improves thereon, and who coniracts for such project with a contracta(s) license pursuant to Ihe Contractors License Laws.). ❑ I am exempt under sec. - Business and Professions Code (or this reason: SignaWre � Oale 9059-4fi(3IOl) ' � Owner ID veri(etl by dr ice �] Ves ❑ No Driver's License No. Expires: Verifwtion o( Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certdy that no excavalion frve (5) or more feet in depth into wfiich a person is requiretl to tlescend, will be made in connection with vmrk authorized by this permit, and that no builtling slmcture, scaffdding, falsev.ork, or demolitbn or dismantlinq thereof, will be more Ihan thirty-six (36) (eet high. (Chap. 32, Grp 2. Art 2, Sec. 341, Ttle S, Calitomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to do vrork which would require a permit fmm [he Division of Industrial Safety, as noted above, unless such person has a pertnit lo do such work trom ihe division. AO�licanl's SignaNre Division of IntlusMal Safery Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will ihe applicant or presenl 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 0( the California Heal[h and Safery Code requires, with some exceptions, tha[ a Business Plan be fled with lhe Costa Mesa Fire Department by every business which has al any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure). 2. Does or will the applicant or present or (uNre building occupant need to file a registretion (ortn tor acutely hazardous materials? ❑ Yes ❑ No (Section 25533 ot the Califomia Health and Safety Code, with some exceptions, requires regishation wim the Costa Mesa Fire DepaAment by each business which at any one time has on hand a quantiry o( acutely hazardous malenals equal ro or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature antl pressure). 3. Does o� will the applicant or present or future builtling occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous matenals�? ❑ Yes ❑ No (Section 25534 of the California Heal[h and Safery Code provides that the Costa Mesa Fire Departmenl may require the preparation, certification and (ling with the Fire Department of an RMPP by businesses which are required ro register acutely hazartlous materials vrilh lhe Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fulure building occupaN require for ihe work which is the subject of Ihis application a permit for such construction of modifiCalion (fOm Ihe SOu[h CoaSl Air Quality Management Dislrict or irom any other air pollution contml tlisMct or agency? ❑ Yes ❑ No (Section 658502 of the Calitomia Govemment Cqde requires ihat the 2questetl information be fumished on applications fa non-resitlential builtlinq permits). 6. Will any part of the facility to be consWcted untler this pertnit be vrithin 1000 feel from the outer bountlanes o( a school? ❑ Yes ❑ No Qf "yes". Ihe facili[y mus� meet ihe requirement of Sections 25534 and 42303 of Ihe Califomia Health and Safety Code). � Z If a pertnit from the South Coast Air Quality Management Districl or other air pollution control tlistrict or agency is requiretl for the work which is Ihe subjecl of lhis application, have all of the disclosures prescnbed by Califomia Health znd Safety Cotle Section 42303 been made? � Yes ❑ No 8. Qf "yes", attach certifcate of compliance from the appropriate air pollution control offcer). , � ' : ' CERTIFICATE OF COMPLIANCE: I certify,that under penalty.o( perjury ihe infortnation given above is correct. I agree`to comply with�alfstate laws �and ciryordinances regarding Hazardous Materials and Emissionsr•�, � ' . SignaNre , Date , CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have�reatl this application antl state that the information given is wrrecL I agree to comply with all state laws and city ordinances relating to building construction, antl authorize representatives of the Ciry ot CosW Mesa to enter upon the above-describetl property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. $i a e al wriyr Date An0/orA o ,__ nll ( Da�e � t G_ --_ — ... . . � J � CITY OF COSTA MESA F� BYILDIN6 DIYISION � . DEVELOPMENT SERVICES DEPARTMENT / '��, PERMIT PERMI� / ✓ _ . , . 699-00259 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 233 FLOWERST Suite: Viciniry: Parcel Nunmber: 42540315 Applicant: JOHN SKI Address: Owner: MADER, JOSEPH W Address 2418 FiOLIDAY RD ,-"NEWPORT BEACH,CA Contracror: SHARP ROOFING Address: 10782 S. MEADS AV . " ORANGE CA Zip: 92869 � Address: Zip: Phone: License: BUILDING PERMIT Zoning: Phone: Zip: Phone: Zip: 92660 Phone: 714-771-0718 License:� 571575 Eng: Address: Stalus: ISSUED Applied: 02/23/1999 Issued: 02/23/1999 Phone: License: , SCOPE OF PERMIT T/OFF SHEATH AND REROOF 1500SF SLOPED AREA W/COMP SHINGLES, REROOF 600SF FLAT AREA W/BUILT-UP. SMOKE DETECTORS REQUIRED PER 94UBC. � Plan Check: $0.00 Permit: $99.75 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $100.25 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Exlstinq: 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left , 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 0 sa,soo.00 $4,900.00 EXPIRATION: This pertnit 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 inspeetlona and Nnel approval must be obtained. Failure to obtain inspections and tinal approval will result in ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 WORKERS'COMPENSATIONDECLARA710N: — I hereby effrtn under penalry of perjury ona ot the followin9 tleclarations: . ❑ I �eve end will meintain a cenificate ot consent to seli-Insure tor workers' compensatlon, as provided tor by section 3700 of the Lebor Cotle, for the peAormence of the �ork iof which thl5 permi� is i%uetl. heve and will meintein workers' compensaGon insurance, as required by section 3700 oi ihe Lebor Code, for the peAortnance oi tha work for w�iU Ihis pertnit Is issuetl. My workers' comyBnsatioplrrsurance c�rrier end policy number era: �,� CBRIBf: � Policy Number � �� V�% / �'� �� Of lB%.� � ❑ I certity ihat In Ihe peAormapCe of Ihe o c Wr wh'Eh his permit is issuetl, I shall not employ eny person in any manner so as to become subject to Ihe workers' compensation laws alii (ni flnd a t at' d.�come subject to the workers' compensation provislons ai Sectiqqqnnn 3700 of the Lebor Code, I spppgggIIII forthwlth wmpy with these rov io s. O / � A �� /�f � C( � o /i. � �Appllcant Signeture: Date: •�vi 7 WARNINO: FAILURE TO SEC E WOPI(ERS' COMPENSATION ODVERAOE IS IINLAWFUL AND SHALL SU6IECT AN EMPLOVER TO CRIMINAL GE�IL FlNES UP TO IXJE HUNDRED TVi0U5AND OOLLARE �5100, ), IN FDDITION TO THE COST OF COMPENSATIIXJ, DAA4IGES NS PROVIOED f-0R M SECTION �O60F THE IABOR CODE, INiEREST, AND ATTORNEV'S FEES. LICENSEDCONTRACTORS I hereby attirm thet I am licen: force and eflect. Llc. p .�p Coniradofs Signature: � JR100) of Division 3 of ihe eusiness entl Prof ssions Coda, end my license is in full Class a / Date: F.! 2 / � CONSTRUC710N LENDING AGENCV: ❑ I hereby effirtn that ihere is a cons�ruction lending agency for the pertortnance ot the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby atfirtn iha� under penalry of perjury thet I em EXEMPT FROM THE COHTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires a pertnit to consWct, fllter, Improve, demolish, or repeir any sirucNre, pnor to its issuence, also requires the applicant for such pertnit to Nle a signed stetement ihet he or she Is Iicense0 pureuent to the provisions of ihe Contractors Llcense Lew (Chapter 9(commencing with Section 7000) of Divlsion 3 ot Iha Business end Protessions Cotle) or thet he or she is exempt thereirom and Ihe basis for ihe alleged ezemption. Any violatlon of Section 7031.5 by any epplicant for e pertnit sublects the applicant ro e clvil penalry of not more than five hundretl dollars ($500)J: - ❑ I, fls owner of tha property, ar my employees with wages as Ihelr sole compensatlon, WILL DO T}1E WORK, and the structure is not intentletl or oflered for sale (Sec. 7044, Business and Professlons Code: The Contractors License Law tloes not epply to an owner of property who builds or improves thereon, and who tloes such work himself or herseli or Ihrough his or her own employees, provided Ihet such impravements ere nat intended or offered for sele. If, however, the bulltling or Improvement Is sold within one year of completion, Ihe owner-builder will have the burtlen oi proving ihat he or she tlid not builtl or improve 1ar puryase oi sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business entl Professions Code: The wntractors License Lew does not epply to en owner ot properry who builds or Improves thereon, end who cantrads for such pro�ect with a contractor(s) Ilcense pursuant to the Contrectors License LewsJ. , ❑ I am eaempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID veritietl by drivers license. ❑ Yes ❑ No DriveJs License No. Expires: Vedficetion of Ownerehlp by (rype ot dwument, I.e. - property tan bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATION: ❑ I hereby cetlify thet no e:cavatlon five (5) or more feet in tlepth Inro which a person is requiretl ro tlescenq wlll 6e metle in connectlon with work euthodzetl Cy INs pertnit, end ihat no building sWcture, scafFoltling, felsawork, or tlemalitian or tlismentling t�ereoi, will be more Ihen Ihlrry-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title e, Celifomie Administretive Gode). ❑ As owner-builder, I wlll not employ anyone to do wark which woultl require a pertnit from t�e Division oi Indusinal Sefery, as noted ebove, unless such person hes a pertnit ta do such work irom the division. Signature: Date: Division of Intlustrial Safey Pertnit Number: CERTIFlCATE OF COMPLIANCE AND A Ofl¢AT10N OF ENTRV: I certity undar penalry of perjury tha� I have reed �his applica�ion and state thet the Informetian given is correct. I egree to comply with all stat aws flnd city ordinances releting to building construction, end authorize representetives ot the Ciry of Coste Mesa to enter upon the ebovB-tlescribed propert�fo�nspectl Durposes. I agree not to occupy or allow occupency oF any building authonzed by this pertnit until final inspection. / n r Authori � �� INSVECTION TYVE 1618 Fixetl System Finel Fire Prevention 1266 Pool Spa Final 200 Final RaRoof 201 Final BIocWReteining Wall 202 Final Fectory Flre PlaCe 203 Final Sign 204 Final Demolitlon zaaee OAg U�lLS �QQ(� INSPECfIONTYPE 206 Finel Mechenical 208 Finel Plumbing 210 Finel Electdcal 212 Final Fire Preventlon 220 Finel Plenning Approval 222 Finel Site 250 Final Building/Occupency �4.11�I;Ii117.1Fj OWNER x"��., d. A. INS soii GAS W �l HOU iR0 SPR MIS SWN. LINE U NOUSE COM. LING SVSTEM HEATING UNOERGROUND �� POWER ROUGM WIRING FLOOR SVSTEM BONO BEFM � ST SHEATNING FRAME ANO FL0.5HING VT41NG — IN �71 ,LTORAI, FINAL HEATING, VENT., REFRI( PIUMBING, FINqL ANO G ELECTRIC, FINA� BUILOING, FINAL coc('iei oCnuipcucu+c TRACT R AN� �.C., FINAL T— � TEST I� L �v DATE SUBCONTRACTOR � a38 i..a COSTA MESA BUILDING-SAFETY DEPARTMENT P_O. eoX 7200 COSTA MESA. CALIFORNIA 92626 � ,z�, FR 15-77�,�.,.f)I) ?7�� �,;�:r{,1^.5D APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only FECEI =E�Fif�EIV D TE I �ED BUILOING � � [� I �w�V � � ADDFESS � � � � n OWNER I� Q,�✓I A.P.NO. �/ ���� � S PERMITNO. MAIL BUILDING ADDFESS z.33Z— � J�� AODRESS Z 3 3 'F.IUwer qTV � �% IJ NOL 6yL'9n� ' TRACT O( 7 LOT � BLOCK CANSTRUCTION � N W ADD ALT P LENOER BRANCH �j � OWNER �,�e l� f�Q�+✓� ADDPESS q�� p p A� N}p ARCHITECT ' TEL SE P��~� �r �� ��C S S�`CJ� Ofl ENGINEER N . ' A� FIRE ADDRESS ZONE TVPE GROUP APPROVED �� CONTRACTOR BV OATE ADDRE55 TEL. . �ONF� NO.OF USE OF NEW CITV NO. `� PLANS BUILOING STATE CITV �'!+ROSAPPROVED VARDSAPPROVED LIC.NO. LIC.NO. •MAINBUILDING ACCESSORVBUILDING SIZE � NO.OFBLDGS. (FIiOMC/LSTREET) OF LOT NOW ON �OT FRONT FT. FT. USE OF EXISTING BLOG. 51 F Separate permits are required for L SIDE FT v-r. �electric, plumbing and heating work. � � fiEAR FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & � MAIN BLDGS. ACCE55. BLDGS. VAR. # ' DATE L ` C.V.P.�} APPROVED v v ��`/ APPROVE , 1 / � V �� 1 hereby ecknowletlge that I heve reatl�this applicaiion and state � that the above information is corract and ag�ee to comply with all laws reBuleting building consiruction, antl I shall not employ any person In vlolatian of the wo�kman's compensation laws of ihe State of Celifornia. . I hereby certify ffiat I am properly Iicensetl as a contrector untler SQ. FT. : the Staie of California Business and Professions Cotle, Divislon 3, THE AMOUNT SHOWN�UNDER VALUATION IS FOR Chapter 9, antl that such licenses ere in full forca and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am ezempt from ihe provisions of the State of California Business VAIUATION PERMIT FEE antl Professions Cotle, Division 3, Chapter 9. $' D� �O OO PLAN CHECK $ Signature of � 11/C� I� n Permittee �r/—' e���J � S lODD �_ TAX $,� AuthorizetlABent TOTALPAI� $ � n m i . : m 7 m e m M 0 LL- � U �� ` ��ti'7� FEE RECEIl�ED COSTA MESA BUILDING-SAFETY DEPARTMENT ��� �� ���t Q.(� P. o. B� s,� COBTA MEBA. CALIFORNIA FINANCE DEPT. For Applieanf fo Fill In Compleiely APPL4CAQfO�d��t�ER�fiT TYPE OR PRINT " BUILDING BUILDING ADDRESB � /J I'/� ' COSTA MESA. CAUFORNIA For O#ice Use Only _� U RECEIPT NO, P RMIT NO. / OWNER . 1. �" =.iZ/ � t ( " ��oZ%X MAIL f � � RECE VED OY DAT6 RE,L/EIVEO OATE I�BygUED // ADDRE55 o7...J 9 .• / I'!.�!' /� �� I I�I y'—�D I � I /��v / TE `�Y-'-f7� O BUILDING � GITY _ J .�+ /9 �I7 '—^I NO. / AODRESS ARCFIITECT TEL. � STA MESA. CALIFORNIA OR ENGINEER ' NO.' � „ � ADDRE68 . FIRE ZONE TYPE GROUP CONTRACTOR (Ni /(� � .^. -!: . Il I �- /C� BYPR V'� ,\' ATE II ' J � (p . V ADDRE55 O ING . -- ZONE I NO. OF I O6E OF NEW '' G�'ry � PLANe lOILDING STATE TEL. ' ' ' LeGwL ��e LIC. NO. NO. '� DE6CRIPTIO G— SIZE ,� (J _\ " I rvoW oN mca.vC A. P. NO. �' I � l S OF LOT .1 USE OF YARDS ' EVES EXISTING BLDG. � • ��7: / �� APPROVED ALLOWED BBTBACK LINE FROM (CBNTlP LIN6 6TJ ceNTea oF ernser REAR YARD FRONT FT. IN. SIDE YARD ILEFi � IRIGHT R.SIDE , FT. IN. DESCRIPTION OF WORK L. SIDE FT. � �N. NEW I 6��ALTERATION I IIADDITION I REAR / FT. IN. REPAIR I II MOVING I II DEMOLISH I ByPROVED DA7E I/�� — BUILDING NO. OF - - � SIZH i1 � � ROOMS � STORIES EXTERIOR-WAL f _ IRODF ' �� � � � GOVERING !� "�_� COVERING USE OF BUILDINC AND WORK TO BE PERPORMED � TO a / B—,c.� �, , i �' � � T- , � � - urp k -ri�nft I XEPEBY ALKNOWLED08 TXAT 1 HRVE RBAO TX19 APPLIGTION � TX! AMOUNT BHOWN UN�6R V�LUATION I9 FOR THE AND BTATE THAT TH8 ABOVE IB GORRECT AND AOREE TO COM- ' pUWOBE OP, EBTABLI6HING � PERMIT FEE ONLY. PLV WITH ALL GITY OFDI C80 AND 9TRE LAW6 R60UU�TNO BmtniNa cON cTl� ' � �' � � VALUATION ! � . BIGNATURE O �� l��t � � _PERMIT FEE $'/� N PERMITTE ' e � PLAN CNEGK $ AUTHORIZED AGENT � $��'� pQ. O TOTAL FEE y I ' � 1��:'L� COSTA MESA BUILDINGSAFETY DEPARTMENT P. O. BOX 917 GOBTA MBBA. CALIFORNIA For Applieanf fo Fill In Comple+ely TYpE OR PRMT � - � BUI{.DING / a' /pw/` � . AODRE59 :/1J..1 COSTA MESA. CALIFORNIA . N MAIL STATE TEL. � LIC. NO. NO. SIZE �--J) � ,) I NO. OP 9LDG9. OF LOi ."1 � �: 1� V NOW ON LOT ,� U6E OF ��J EXISTING BL�G.�-�.YR//C N B6iHACK LINE PROM ' ce'fren oP 8�neer REAR YARD SIDE YARD I �EFT I RIGHT DESCRIPTION OF WORK NO. OF EXTERIOR WALL COVERING UHE OF BUIL,DING AND PE IV6[ �. BUILDING AD�RESS PIRE ZONE APPROVED F E RECEIVED ocT Z��sso INANCE-DEPT. CITY OF COS?A MESA APPLICATION FOR PERMIT BUILDING For Office Use Only FECEIPT NO. PlRMII /L� er � ow7e,rtecei�{s,o, ,� oq�re �i COSTA MESA. Ory§� y, / I NO. OP .� I lI6E OF � i�� �� PLAN6 �� BWLOIN� LEOAL � _ � � 1 .n / LINH BTJ ./ , , _ 'v� n r. r__ � - - 1 H6PE6Y AGKNOWLEDOE THAT � HAVE REAO TX16 APPLIGTION � THg AMOUM BHOWN UNOER VALUATION 18 FOR TH6 AND BTATE TXAT THE ABOVC � CORREGT AND AGREC TO COM- . pp�08E OP EBTABLI6HING � PERMIT FEE ONLY. PLY WITX ALL CITY ORDIN C AND BTATE LAW9 R80UlATINO smtoixa coNeiRUCTON - VAWATION 1 SIGNATURE OF � /� (J'B PERMIT FEE $ �'� u PERM I7TE - / � / � �_ ' � $ �� PLAN CHECK $ AUTHORIZED A ENT � � p TOTAL FEE y � - Costa Mesa Bnilding Department APPLICATION FOR PERMIT - � � 111 EA3T 20th STREET � B U I L D 1 N G ' � � COSTA MESA� CALIFORNIA . �„ FOR OF'FICE USE ONLY FOR APPLICANT TO FILE� IN Receipt No. I Permtt No. Address .� ��, . p . /,�.�'. � . riO3t& MCS&� rialliOPII1& Received by Date Redd. Date laued i Nearest I �� �� � CrossSt. g. Building � Address Owner Costa Mesa, C&�liOP1113� Mail Address i � Nearest . _ - Tel. Cross St. - Cit ,�, �,_(� G No. �/� Zone No.of T pe '/ Grou Ar hitectorr Lic� �I PPans I Y 4' P� Engineer . F � No. ` Approved - by Date Address /-..; /�n� j. C�. i,[' CORRECTIONS � � City Lic-� Contractor No. Address Legal I Lot I I Description No. Block C I TractS y Eds /�'l �.4' /s`''• P<�p �s R,S'F zG (Attach Metes and Bounds) / No. of Bldgs. Size of Lot m ^' I Nowon Lot � Useof No.of 9 No.of - m Existing Bldg. I F�amilie5"� I Rooms � , �j Setback-L(ne from � Rear Vard A - Center of Street % Side Yard _$' � y DESCRIP'i'ION OF WORH � New I I Alteretion I I Addition I � � ' � ' Repair I I�Moving I I Demolish I Building � � No. of Size Z'�-(� 7[ /G Rooms � Stories / � Exterior Wa 1 Roof Coverin9 '� s�p� ��• Covering .. J��l v��- L�PP$�VLiI.s Use of New / Building ,� Foundation Location Inspectoe Date Forms, Materials, ' � Under-Pinning N Frame: Fire Stops, � Bracing, Bolts in I hereby aclmowledge that I have read this Applicatlon o and state tha.t the above is comect and agree to rnmply Lath. Int �i� with all City Ordinances and State Laws regulating —�; �' building constructi n. Lath. Ext. "Ia Signature ' :� Permittee Plaste�, Int. � � Authorl �Agt Plaster, E�ct �i Valuatlon Permit Fee $ �('j •----� Masonry Reinforced :} Plan Check $ /� � -' Srg �. eond Beam Total ^e $ / G^`� U :� Fee $ -FiNAL � FORM 204 5-BP 2M B-55 .