HomeMy WebLinkAbout172 FLOWER ST - Building Permitsw
January 22, 2003
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
To:
Building Safety Division
Code Enforcement
Communications
County Clerk
County Planning and Dev. Services
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
Fire Admin. - Training Officer
Fire Admin. - Mark Brown (Station 6)
Fire Prevention
Irvine Ranch Water District
Mesa Consolidated Water District
AT&T Broadband
Newport -Mesa Unified School. Dist.(2)
Pacific Bell
Police Dept. - Planning & Research
Sanitary District Engineer
Sanitation Division Office
So California Edison Company
Southern California Gas
State Board of Equalization
U. S. Post Office - AIS
U. S. Post Office, Adams
Thomas Brothers
File (2)
OLD ADDRESS NEW ADDRESS A. P. NO.
172 Flower Street 172 A Flower Street 425-234-02
172 %2 Flower Street 172 B Flower Street 425-234-02
Your cooperation in this matter is appreciated.
Sincerely, _
Willa Bou r-Klleen
SS anne
C: Mike and Su -Hwa Lin
1958 Port Edward Place
Newport Beach, California 92660
Building Division (714) 7545273 • Code enforcement (714) 7545623 • Planning Division (714) 7545245
FAX (714) 7544856 • TDD (714) 7545244 www.oi.ccate-meaa.ca.w
t
February 28, 2002
Planning Department
City of Costa Mesa
77 Fair Drive
Costa Mesa, Ca 92626
RE: Address change of 172 and 172 '/2 Flower Street, Costa Mesa
Dear Sirs:
We are the owner of the property at 172 and 172 '/2 Flower Street and would like to
request to change the property address to 172 A and 172 B Flower Street, respectively.
Should you have any questions, please contact us at:
Sincerely Yours,
Mike and Su -Hwa Lin
1958 Port Edward Place
Newport Beach, Ca 92660
Telephone # 949-644-0292
S4-257 -7ay' -D z
January 22, 2003
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
To:
Building Safety Division
Code Enforcement
Communications
County Clerk
County Planning and Dev. Services
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
Fire Admin. - Training Officer
Fire Admin. - Mark Brown (Station 6)
Fire Prevention
Irvine Ranch Water District
Mesa Consolidated Water District
AT&T Broadband
Newport -Mesa Unified School. Dist -(2)
Pacific Bell
Police Dept. - Planning & Research
Sanitary District Engineer
Sanitation Division Office '
So California Edison Company
Southern California Gas
State Board of Equalization
U. S. Post Office - AIS
U. S. Post Office, Adams
Thomas Brothers
File (2)
OLD ADDRESS NEW ADDRESS A. P. NO
172 Flower Street 172 A Flower Street 425-234-02
172 '/2 Flower Street 172 B Flower Street 425-234-02
Your cooperation in this matter is appreciated.
Sincerely,
rim
c: Mike and Su -Hwa Lin
1958 Port Edward Place
Newport Beach, California 92660
Building Division (714) 7545273 • Code enforcement (714) 7545623 • Planning Division (714) 7545245
FAX (714) 7544856 • TDD (714) 754-5244 • v .ci.costa-mese.ca.us
February 28, 2002
Planning Department
City of Costa Mesa
77 Fair Drive
Costa Mesa, Ca 92626
RE: Address change of 172 and 172 Y2 Flower Street, Costa Mesa
Dear. Sirs:
We are the owner of the property at 172 and 172'/2 Flower Street and would like to
request to change the property address to 172 A and 172 B Flower Street, respectively.
Should you have any questions, please contact us at:
1958 Port Edward Place
Newport Beach, Ca 92660
Telephone 9 949-644-0292
Sincerely Yours,
Mike and Su -Hwa Lin
COUNTY OF ORANGE
BUILDING DEPT.Permit No3
------ -.1?�
636 No. Broadway ------- -- ---
Santa Ann, California Application for Building Permit
Phone: KI 2.6211 AND FOR A
Certificate of Use and Occupancy
.io. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width ....... ..................__Depth in Ground ........ !.;�Y ---------- width of Wall ---------- I ...........
Accessory
Bldgs. and
Similar (b) Size of Studs:_,_!�L�(A�� ......... Spacing ........ ...... ........ CC Material of Floor .....
Structures:
(c) Size of Floor Joists:..---.._.._---- : .................. Spacing --------------------------------- .......... Cc
(d) Size of Rafters:....__ L,7 ----------__._..----Spacing...._!. u ........... .......... "Cc
12. VALUATION OF PROPOSEDXORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ ------ APA70- .......
13, 1 HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed:----- ------------------- --- --- ------
Plan. (Owner)
Filed __K
...................................
By: .-------------------------------
(Authorized
--- ----------------------- ----------
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES- CHECKING BY
GROUP.....
................... APPLICATIO HEALTH ----------------------------
Bldg. Permit $-----` --- -------- 11�1$14V
Plan Check $.. . ...... TYPE ------------ x .................. ZONING -------------- FIRE
Total $ -�_11 DIST. MARSHAL-------------- ----------
- ------- MAP ........
f (,t PLANS AND
Receipt 2 . .... - -- - --------- SPECS ---- ------ -- STATE .......... ---------------------
... ... SHEET NO ...... 157' CORRECT10NS.... ENGINEER
Paid to ............
Date................................ ................................... ------ —CAL ... ................
�put I r buiLD
UU2 .
PERMIT ISS ED INSPECTOR ING
DATE -----...........................................................
.............
-------------------------------------------------
st....
L )
�Date------------ vz Z/ - J_ -J.-
----------
OWNER'S NAME...- ---------
----------------------------- ---- ........
PHONE:/
1.
--- ----------------------------------------------------------
tlq'Ll..162:-4e:
CITY.-- .
MAILING ADDRESS--- - ----- . --------------------------------------------------
...
Name -------------------------------------------- ---------------------------------- ---------- Name ..................................................
�
-------------------------------------- ------
(Architect or Engineer)
(Contractor)
Address----- --- ------------------------------------------------------------------------ -- Address -----------------------------------
q ----- ----- ------------- ------------- ----------------
City -- ---- : - --------------------------- : -------------------------- ---------------------- City - ----------------------------------------------
--------------- ------------------------ - - ------
State State
Lie. No..----------------------------. Phone----'---....... Lit. No._ ------------------------------
Phone..--------------------------
----------------------------------
- C?
PROPOSED USE:------- � i An
---------- ------------------------- . ..... ......... .........
0
2.
LOCATION /� a) -r-1 /(6
_v--.�-!2�/,/2Z ........ ... 2t�._
JOB ---------------------------------- -------------- ------- I ----- - ------_----------------
(House No.) (N f (Town or School District)
--
C
3.
LEGAL DESCRIPTION: Lot.. -.._7.. ---- ------------- -----------------------
Tract_��177 -----
(Metes and Bounds Description—Use reverse side of form)
4.
CORNER LOT INTER LOT THROUGH LOT
y
SLOPE OF LOT
5.
SIZE OF L�Z ........ AREA: ---------- !THROUGH
t.
SIZE, OF LOT:__AS_
_.AREA: ----------------------------------
6.
t
HEIGHT OF BLDG ...... ...............CEILING HEIGHT:._... ----- � ----------------
NO. OF STORIES.........../._
/ -------------------
7.
NO. FAMILIES ----------------- .................... Size of Smallest Bedroom: -------- _x_ ��) ---------
Siz,.of Kitchen..._ c�4,;7,
S.
EXTERIOR WALL CONSTRUCTION:--.���t�-r.."tz4��l-N,T-IERIOR WALL
COVERING_......
9.
(Frame, Stucco, Etc.)(Plaster,Drywall,
me, Stre /Z/)
SETBACKS Front Yazd F et....
Etc.)
_,ron to of .... ..... .......... .................
............................................ ----------
Nearest Side Yard ------ j6itl_l'Rear Yard ---s . .7 ............. Distance in Feet Between Bldgs.
on Same Lot -------------- /. ------------- ......
.io. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width ....... ..................__Depth in Ground ........ !.;�Y ---------- width of Wall ---------- I ...........
Accessory
Bldgs. and
Similar (b) Size of Studs:_,_!�L�(A�� ......... Spacing ........ ...... ........ CC Material of Floor .....
Structures:
(c) Size of Floor Joists:..---.._.._---- : .................. Spacing --------------------------------- .......... Cc
(d) Size of Rafters:....__ L,7 ----------__._..----Spacing...._!. u ........... .......... "Cc
12. VALUATION OF PROPOSEDXORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ ------ APA70- .......
13, 1 HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed:----- ------------------- --- --- ------
Plan. (Owner)
Filed __K
...................................
By: .-------------------------------
(Authorized
--- ----------------------- ----------
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES- CHECKING BY
GROUP.....
................... APPLICATIO HEALTH ----------------------------
Bldg. Permit $-----` --- -------- 11�1$14V
Plan Check $.. . ...... TYPE ------------ x .................. ZONING -------------- FIRE
Total $ -�_11 DIST. MARSHAL-------------- ----------
- ------- MAP ........
f (,t PLANS AND
Receipt 2 . .... - -- - --------- SPECS ---- ------ -- STATE .......... ---------------------
... ... SHEET NO ...... 157' CORRECT10NS.... ENGINEER
Paid to ............
Date................................ ................................... ------ —CAL ... ................
�put I r buiLD
UU2 .
PERMIT ISS ED INSPECTOR ING
DATE -----...........................................................
.............
-------------------------------------------------
st....
L )
LIN
DO
PRCJECTAOORF,$S: 172- FLOWER ST UNIT:'
OWNER'S NAME: MIKE LIN
ADDRESS: AME AS ABOVE
. ARCHIENCINEER: REG.NO.:
ADDRESS: UNIT:
I
PERMITTEE: M I L ST EAD ELECTRIC (71,4)-6 36-4855
ADDRESS: 10'10.() W. KATEL.LA Fs' -
ANAIiEIM CA 92804
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions 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.,
CITY LIC.: 0 4 9 0'7 6 STATE LIC -5 715 0 2 cuss: / 10
Date. Y Y,10i/ 71`j Signature:
c-,/`l-v'�`^
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q.
POLICY NO.: 1' 1. 1 3 4 7- 8 9 EXP. DATE: 0 3/ 01 / 9 0
COMPANY:STATE FUND
❑ Certified copy is hereby furnished.' 91 Certified copy Is d with Ina cly By Oivia!on.
/ / G• //�� .. ,
Date: 7 tGc ✓ $ % Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less).
I certify that in the performance of the 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 of California. I
Date: - Signature:
NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civ. C). ,
LENDER:
ADDRESS: -1 --
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure, prior to its issuance, also requires the applicant for suchpermit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and ProfessionsCode) of that be/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 (5500).
1, as owner of the property or my employees with wages as their sale compensation, will do the work, 'and the
'❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law
it not apply to an owner ata property who builds or improves thereon, and who does such work himself/herself or through
- his or her own employees, provided that such Improvements are not intended or offered for sale. If, however the building or I
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or Improve
for the purpose of ule). , ..
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code: The Contractors' Slate Licence Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date: Owner:
I do hereby Certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a
permit far construction or modification from the Air Duality Management District. Residential construction applications are exempt from
these provisions. {
Date: APPlicant:
I hereby certify that I have read this application and stab
ordinances and state laws relating to building construction
property for inspection purposes.
Da hi 7, Signature'.
Driver's License or Social Security x: '
1941.08 While—Buitdina: Green—Coda Enforcement: Canary—Applicant:
is correct. I agree to comply with all city and county
natives of this city to enter upon the above-mentioned
Goldenrod—Assessor
CITY OF
COSTA' 'MESA;'—BUILDING PERMIT PERM NO E' ' i044'786 '
PERMIT NO: E'' 044 786
PLAN .CIiECK NO: Ply GOVT: .N SURPe PI '
CONSTRUCTION TYPE:
PERMIT -TYPE: ELE PURPOSE: NEW
JOE;UESCRIPTIUN ADD NEW
METER FOR -REAR HOUSE- >.,SQ FT:
TOTALS---'->
?GROUP
.CLAIM VALUE:
CALC--VALUE: OCC:. /
'COMMENTS:
33..50 'OVER/SHORT:
Z O N
I N G R G', Q'U I'R E M,E N T S f
PLUMBING ELECTRIC MECHANIC
�S E T B A C K S l y'
PLAN -CHECK
MAIN DUILDING
----------------- ACCESSORY:BU;ILD'INC, `---------
FRNT: I'T IN'REAR:
FT IN. 'FRNT: FT IN REAR:j FT IN
-LEFT: FT' IN RGHT;
FT IN LEFT: FT IN RGHT:j FT, IN -
PARKING REQUIRED:' PARKING
PROVIDED: PARCEL: 42523:402 ZONE:
PLANNING NOTES>
I. ,
>-
r
TYPE QTY
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 -
TOTAL COST
ELE, L
ZONING; APPROVED BY
DATE:
BUILDING APPROVED BY :
- ;I)ATLe-
_ END OF FEES
APPLICATION ISSUED.BY:
(, rDATE:
LEGALIZATION:N
F•'E''E S U M M -A' R Y STRUCTURAL'-SEGMENT:N
BLDG PMT PLUMBING
ELECTRIC 'MECHANIC FIRE 'SMIP/RES GRADING 1
PERMIT
18.50
50% SMIP/NON-RES
PLAN
'ISSUE FEE
15.00
,
-BUILDING-DIV->
PERMIT ISSUE PLAN -CHECK
TOTAL PAID
DUE
TOTALS---'->
18.50 15:00 j0„00
33.50 3-3. 50
.00
REVENUE'DIVISION TOTALS--> 'COLLECTED:'
33..50 'OVER/SHORT:
00 .
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE .'SMIP/TOT ,GRADING
PLAN -CHECK
33.56 ;
I N D, I V I D U A,1, F E E'
B R E A K O W N
r
TYPE QTY
D E S C R 'I• P T I O N
UNIT' COST;
TOTAL COST
ELE, L
SERVICES BELOW 600 V & BELOW
200 AMP i 18.50 ,
18,50
_ END OF FEES
f' rDQ45i73-YL'9 64 ; ;43-F J
D8TE: 11%02139 TIriZ: 1: ':b -
_ CONSTRUCTION AND PLANNING-
APPROVALS .Permit#
_
Date.
Inspector
POOI ;PA -
APPROVALS Permit#
Date
Inspector
1. Temporary Electrical Service or Pole _
. 52. ,Pool & Equipment Location
2. Soil.Pipe-Undrgrnd.
• is
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.._
r
54. Forms
4. Electrical Conduit:Undrgrnd.
55. Electrical Bonding
•
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER.Grnd. ",
57. APPROVAL TO COVE R-GUNITE
-
•
7. Footings
58. Electrical Conduit-Undrgmd.
_
' 8. Foundation
59.'Gas Pipe, O Undrgrnd., Test
i -
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd. -
10. Structural Floor System
-
61. APPROVAL TO DECK
11: Property Sewer Line & House Connection
--
62. Backwash &Receptor -Final
'
12`Sewer Cap
63.. Heater &Vent -Final
13.. Roof Drains -
64. Plumbing System - Final
1.4. Rough Plumbing
65." Electrical -Final
I
15: Rough Electrical -Conduit
66. Solar System -Final
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
APPROVALS _Permit #
20: Rough Factory Fireplace •r
-.
21: -Ducts, iii, Structure -
>
70. Underground Hydro `
22. Ducts, Ventilating
71. Product Piping 0Gas ❑Oil
23. Gas Pipe -Rough & Test -
72. Underground Flush
24. Roof Framing
73: Undergrnd. Storage. Tank -❑Gas E) Oil
25. Roof Sheathing -
-
-
74. Overhead Hydro -
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 -
,1
78. FIRE PREV. FINAL _
30. Drywall Nailing -
-,
HEALTH DEPT. F(EQUIREMENT
31. Plaster Brown Coat:.:
9. FINAL INSPECTION -
32. Electrical Power Meter -Final
(y Q
80. FOOD CERTIFICATE ISSUED..
'"-33: Final Electric '-
y
Notes: - •* - -
34. Final Heating & Air Conditioning..
35. Final Gas Pipe -Test-
_ 36. Hood or Canopy
37. Final Factory Fireplace
- -'
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final '
' 41. Solar Domestic -Final
-
42. Backflow Preventer
43. Backflow Irrigation
r
- -
'44, Landscape lirigation Systems-
-
45: Sound Attenuation
_
46. Handicap Regulations
_,47. FINAL STRUCTURE & BUILDINGZ,
48: -FINAL PLANNING`
49. ,Electric Release to Edison
- 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No.' Date
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
.BUILDING
DRESS 1 �J
AD . F1I9 iW
1611 6/19/80 20,00 TL
APPLICATION FOR STRUCTURAL PERMIT
ESA J PERMIT N° 50272
A.P. NO.
—
UNIT OR
MAILINGSPACE
ADDRESS r7
NO.
TR.NO. LOT
I3,
CITY a� � NOL.&Lf
!'
11pp `y\ ?•� �� `fir
NEW
I ADD ALTER
REPAIR
IMOVIN
CONSTRUCTION 2
LENDER OLI-5Aj J
BRANCH
O W EFkk- V ZZ
FT.
NI
�the
ADDRESS
VALUE
ARCHITECTT7�1�c- TEL.
;Y
THE AMOUNT SHOWN UNDER VALUATION IS FOR
S
OR ENGINEER �F�S N0.
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
ADDRESS
ZONE TYPE -ROU
APPROVED
CONTRACTOR
BV DATE
PLAN CHECK $ �—
ADDRESS
TEL.
0
CITY NO.
$L
F+
STATE CITY
LIC. NO. - 802LIC. NO.
APPROVED SET B S
96
/Sao
SIZE t0 S S'
OF LOT
NO. OF BL OTS.
NOW ON LOT Z
(FROM C/L ST
gON1T
Authorized AgentDate
USE OF
EXISTING BLDG. ,Q
LQ_
51 E
y
FSeparate
L1
permits are required for
electric, plumbing and heating work.
L. SIDE FT.
REAR FT.
F
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
Q
QAPPROVED
DATE
7
APPROVED
LATE
i'RY
.d
a
w
-
andtate
I hereby acknowledge that I have read this applicatiojde
fir'-!\ i�Vii,"tJ
that the above information is correct and agree to cith
I3,
all laws regulating building construction, and I shall ploy
!'
11pp `y\ ?•� �� `fir
,�
any person in violation of the workman's compensas ofthe
State of California.SQ.
hereby certify that I am properly licensed es a contrntler
FT.
NI
�the
State of California Business antl Professions Cotlen 3,
THE AMOUNT SHOWN UNDER VALUATION IS FOR
In
Chapter 9, and that such licenses are in full force andor I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of Californess
Professions
PERMIT FEE
$and
Cotle, Division Chapter 9.VALUATION
PLAN CHECK $ �—
SignaturePermltte
0
$TAX
$L
Authorized AgentDate
TOTAL PAID $ Q0 0
4i )935
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
PA3G * ****
aEc—a-est--5;00 2ss 30.84
n
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
REGI V�O BV
(�1'
DATE ECE V�
- dA
DATE ISS ED
BUILDING. Jt""''
ADDRESS I�
OWNER S EI6-fe �-7nI
A.P.NO. II7-ILy-0?BUILDING
IT
MAIL
I % 'FLOW ER
ADDRESS
ADDRESS -
'/
CITY NOL 48 j
�}7''
TRACT 7
LOT
BLOCK C'
CONSTRUCTION7� I !7 •o FH
e
A
PLISH
LENDER t- I
n
BRANCH nTty Eno -
OWN
,VALUE
ADDRESS
TEL. /
ARCHITECT II
I
OR ENGINEER J b'I
FIRE
ADDRESS
ZONE TYJE GROUP
I JJ
APPROVED
CONTRACTOR IJLU 10.'Q^
BY DATE
ADDRESS
TEL.
ZONE
R2
NO. OF
PLANS.-)
USE OF NEW RpoM
BUILDING
CITU NO.
Z-�p
STATE CITY
YARDS APPROVED-
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLDGS
(FROM C/L STR EET)
OF LOT
NOW ON LOT
RONi FT.
-FT.
USE OF
/
EXISTING BLDG.R.
SIDE
F7
Separate permits are required for
,.//
L SI E Airf*T.
FT.
2-
electric, plumbing and heating work.,
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
'DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS SLOGS.
VAR.*
DATE
C.U.P. qW
APPROVED
APPROVED W. 't'
k./2
- q— 7
1 hereby acknowledge that 1 have read this application and state
that the above Information Is correct and agree to comply with
all laws regulating, building construction, and I shall not employ
any person In violation of the workman's compensation laws of
the State of California.
I hereby certify that 1 am properly licensed as a contractor under
SO. FT.
- 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 affect, or I
THE PURPOSE OF ESTABLISHING A PERMrT EE ONLY:
am exempt from the provisions of the State of California Business
VALUATION
PERMIT FEE E
end Professions Coda, Division 3, Chapter 9.
PLAN CHECK E O0
Signature of
TAX E
Permittee
$ ! �QQQ
TOTAL PAID E
Authorized Agent
n
Kj
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
F
Ur a-9-7s�"9
PID 41
AP LI AT ON FOR STRUCTURAL PERMIT
or Apphcant to Fill in Completely — Use Ink Only
RE D DATE
RECEIVED DATE ISSUED
_
BUILDING L.OLtIC"�
�'
ADDRESS
,�.� l _
OWNER S ELS IV
A.P. NO.
PERMIT NO.
MAIL
BUILDING /
ADOR ESS
C.�—
�/ .._..`_7Z-
LOW r`
ADDRESS
.J
TEL.
TEL.
CITY TE
TRACT
LOT BLOCK
CONSTRUCTION -
NEW ADD A
P
LENDER
BRANCH
OWNER
%S
ADDRESS
'
VALU$
ARCHITECT TEL
USE I✓!/
OR ENGINEER N '
FIRE
ADDRESS -
ZONE TYPE GROUP.
'
APPROVED
CONTRACTOR
BV
- DATE
ADDRESS
TEL. -
ZONE NO.OF
USE OF NEW
CITY NO.
PLANS
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY. BUILDING
(FROM C/L STREET)
SIZE NO. OF SLOGS.
OF LOT NOW ON LOT
FRONT FT.
FT.
USE OF
EXISTING BLDG.
R. SIQE FT.
FT.
Separate permits are required for
L. SIDE FT.
FT. '
. electric, plumbing and heating work.
'
REAR FT.
FT.
USE OF BU LDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLOGS:
ACCESS. BLOCS.
VAR.*
DATE
AID %)I
C.U.P. aW
APPROVED
APPROVED
-
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 I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
the State of California Business and Professions Code, Division 3,
THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are In full force and affect, or I
THE PURPOSE OF ESTABLISHING
A PERMIT EE ONLY:
am exempt from the provisions of the State of California Business
VALUATION
PERMIT FEE - $
and Professions Code, Division 3, Chapter 9.
j'
PLAN CHECK $
Signature of
Permittee
$
TAX $
Authorized Agent
TOTAL PAID $
0