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Home My WebLink About1587 CORIANDER DR - Building PermitsX Apallicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PITY OF COSTA MEA 9PNSTRl1�TION PERMIT Project Address Applicant's Mailing Address " Owner's Na e N 1 P one 33- 7� Address K 7e)/ 17L AeLlJ Arch/Eng. - License No. Address ' Contractor's Name ' Phone _ Address Imailing) City License No. - - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter,9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force andre e t. License Class License No - Date Signature WORKERS' COMPENSATION DECLARATION I hereby'affirm that I have a certificate of consent to self -insure or a certificate ,t Workers' Compensation Insurance, or a certified, copy thereof (Section - 100, Lab. C.) >licy No. - Company L� Certified copy is hereby fumishetl. ❑ Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection 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 soas t bece subjec to the Worker tion Laws of Califor a a �r Date Signature afl r making this tleclar1 on, you should become subject to the Workers' Compensation proyisions o the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION. LENDING AGENCY,'I - ' 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's Name' Lender's Address - OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031'.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair, any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and .the basis for the alleged exemption. Any violation of Section '131.5 by any applicant for a permit subjects the applicant 'to. a civil nnalty of not more than five hundred dollars ($500). a4 ', as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law doesnot apply to an owner of a property who builds or improves thereon; and who does such work-himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- �ove for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who'contracts for such projects with a con- tractor(s1 license pursuanttothe Contractor's License Law). I am aware that Proof off their Worker's Compensation insurance should be provided to me. ❑ I,am ex erA pt un0^y section B. & P.7. for this reason D t O sentatives Of Is city inspection purp •s Signature Drivers' Li copse or SS CMF 0865-46, rev. 4/84 above PER IT NO. TRACT NO. LOT NO. UNIT NO. 8973 9/87/84 9.00 TL; TYPE OF CONSTRUCTION LJ NEW LJ ADD LPALTERATION REPAIR El CONVERSION '❑ DEMOLISH ❑ OTHER A.P. # Zone. DESCRIPTION OF WORK/PSV OF BLDG. yk-QA 4CS - Main Building: Accessory Building: - E Z TYPE OF OF PE� GRADING LJ FOUNDA ION LJ STRUCTURAL T Front. - - -• 'O ' '❑ TENANT ❑ ELECTRICAL 11 PL ❑ MECHANICAL B N El 'OTHER A Rear - - - C Right R N PROJECT DESCRIPTION SO. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION$ S Left _ R ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided ` E Remarks: Planning Notes: - MI S. PLUMBING FEES ' Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink - Automatic Washer Transformer ❑ 15-50 KW Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW Bathtubs Sewer Connection Cooking Unit - - Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps, Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains I Solar Tank Fan - Motors 00-1 HP 01 X - B Floor Drains I Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP 1:116-15+ Floor Sinks _ - Urinal Fixtures - Microwave - - Gas Service Water Closet ,Zoo Device Boxes Pole Light Interceptors Water Heater Outlets Range ' Kitchen Sink Water Service Switches' Sign Lavatories - Garbage Disposal Standing Sections P -Trap Generator 075K. 05-15KW Trash Compactor Roof Drains ' Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES ' Hood El _ DEVELOPMENT SERVICES REQUIREMENTS: ' ' Boiler _ypel or T+ Canopy Type 11 El- Zoning Approved By Date Duct - Under Ground • Building Approved By Date Duct - Structural - Refrigeration System Application Issued By Date... Duct - Ventilating 120-100,000 BTU 0100,000 BTU ' SUMMARY OF FEES Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ PLAN CHECK ' $ PERMIT Firepl/Fact. Bit. ICBG# ( 9 ISSUANCE $ r PLUMBING ,00$ Heating System & Ducting PLAN CHECK 25% $ ENERGY P.C. $ ❑0100,000 BTU 11100,000 BT GRADING $ - ELECTRICAL $ * PLAN CHECK 50% $ MICROFILM $ ' MECHANICAL $ TOTALFEE $ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 910n White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING - -Date ; APPROVALS Permit # Inspector . , , POOL � ,a - T�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 S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER - 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd..• 8. Foundation • _ _ 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 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 Drains64:1 Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final. 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 21. Ducts, in Structure 1 70. Underground Hydro 22. Ducts; Ventilating 71. Product Piping 0Gas 'D Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas ❑ 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 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 0 CAS MQkQ, Li0 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 10 Ip jlr{ 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow. Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations - 47t FINAL STRUCTURE & BUILDING 48. Special Requirements Completed i 49. Electric Release'to Edison - 150. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date _ (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 1587 CORIANDER DR Suite: Vicinity: HOUSE & GARAGE Parcel Number: 13949210 Applicant: SCHWALBE, JEAN E TR Address: 2860 ALTA VISTA DR rt BUILDING PERMIT Zoning: R3 R3 "y Phohe: NEWPORT BEAZip: Owner: SCHWALBE, JEAN"E TR't y Address 2860 ALTA VISTA DR 1 Phone; �iNFWPnRT.RFACH l:A ��- S 7in ' (949)642`8125 -r -92660 92660 Phone: PERMIT NUMBER /B99-01426 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 09/08/1999 Issued: 09/08/1999 ')Arch Eng a Address: `` �� w� f-!� _ (Address: Phone ,- ,ham Phone:t 1 Zip: + , i" - -License\'�Li6ense: r SCOPE OF PERMIT -, REROOF,' T/O, INSTALL NEW 1/2. PLYWOOD SHTG 1 LAYER OF 30# FELT AND NEW 25 YEAR COMPOSITION'-- ,�; � SHINGLE ROOF, % FEE SUMMARY, 1' ` Plan Check ' $0.00 - _— _ Calc Valuation $4,000 .00 Penrl r ' $97.25$4;000.0 Claim Valuation 0' SMTP Rest -t' $0.50 �1\1'SMIP Com t ,\,,' $0.00 �,A v Other. $0.00 `.Inspection:-, �r�,�$0.00 \Total: $9775 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 :PLANNING & ZONINGS SETBACKS MAIN STRUCTURE Front 0= 0 -tiRear 0-0— left 0 0 °- Right 0 ,0 ACCESSORY `' `Front-' 0-�0 ` Rear-0'0'---� . - Left '0-'0 =_ Right - 0- 0-/ PARKINGExistin :�� 0 'Required: 0 Proposed: '0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU6)ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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. Lic. # Class # Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, altar, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 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 ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered 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 does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving 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 construct the project (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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exam under sec. Z I J3usiness and Professions Code for this reason: Signature:- fW4 - B _ //—� Expires: " �Q Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present 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 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). --------------- _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? []Yes ❑ No -_-_-- __..--._.__.. . _.-_._-.. 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will an -_._ y part of the facility to be constructed under this permit be within 1000 feet from the outer bountlaries ofe_ school? ❑Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 a a permit from the South Coast Air Oestri Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8 (if "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZAT1ON OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-describ property for in ction pu ose agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 9- S- ?2 Signato Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE II, INSPECTIONTYPE DATE INTITIALS CODE INSPECTION TYPE DATE IN RI L 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final' 208 Final Plumbing 200 Final Re -Root x-30 _ 9 y f� 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244616 City of Costa Mesa 2239 C Building Safety Department CERTIFICATE OF OCCUPANCY NO P. O. Box 317 Costa Mesa, California The Building located at 1587 Coriander Th ime-- Tinitn A — D _ has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 11 & J Occupancy. Use of Building 4 Unit Avartritent with attached narn a and laundry Legal Description 2si'act 5475, root 9 _ (See reverse side for Metes and Bounds) Building Permit No. 23770 Electrical Permit No. --2375-4 Plumbing Permit No. 44867 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the 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) Occupancy classification of a building or portion thereof 2) The number of apartments or guest 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. Number of apartments4 — and/or guest rooms ISSUED TO: Building Offi 'al RAT,-SOUrffi DEVELOI�hi;iNT CORP, by��_ Date July P. 1965 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. corn, sv3a TM-11.63--S-s r zq =� ; 232-; o .;ABTA MESA BUILDING•SAFETY DEPARTMENT BOX it] COSTA MESA, CALIFORNIA For,Applicant to Fill In Completely TYPE OR PRINT BUILDING a -� ADDRESS COSTA MESA, CALIFORNIA FEE RECEIVED DEC.1 1964 FINANCE ��DEPT. � APPLWI�IA P�@R'TPERAKFYA BUILDING For Office Use Only BY RECEIPT NO. I PERN4' BUILDINGNO. OF VAR.# DATE r SIZE 46 X 79 ROOMS 25 STORIES 2A C. U. P. # APPR� ;III EXTERIOR WALL I ROOF 0 APPROVED 1 D / 1 USE OF BUILDING AND WORK TO BE PERFORMED- V 1 I 4Unit Apt & 9 Car Gara e 7 BQ. PT. LI ,Q,el $' 6 1 1 HEREBY ACKNOWLEDGE THAT 1 NAVE READ THIS, APPLISMTION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TS COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORD; ANCIIS AND BTATE LAWS REGULATING VALUATION BUILDING CONSTRUCTI IGNATUREOF -C�ti--r� PERMIT FEE $ PERMITTEI/ AUTHORIZfiD AGENT PLAN CHECK_ TOTAL FEE 5 FIRE CITY Fu erton LL,� NO.b 71-823 ZONE TYPE GROUP r APPROVED ARCHITECT TEL. BY DATE OR ENGINEER NO. -- ZONING ADDRESS -- Z NO. OP - USE NEW '-3 PLANS . }-� EUILDINO DI CONTRACTOR CONSTRUCTORS VI N LEGAL� P-- 5 7 \ ADDRESS 1442 Smith Eu DEIICRIPTIO 11 CITYFullertonA. P. NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN p LIC.STATNO. B 02. 641 NO. 8/1-8235 B 30" TO BIDER REAR P. L. EAVES SIZE . NO. OF BI.DGB. ALLOWED (U. S. C. REQUIREMENT] OF LOT NOW ON LOT YARDSAPPROVED YARDS APPROVED USE OF EXISTING BLDG. _ _ MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SETBACK LINE FROM CENTER OF STREET SO 1 REAR YARD 10 1 FRONT .:i O FT. FT. 8IDE YARD I LEFT ! � RIGHT t R. SIDE FT. FT. DESCRIPTION OF WORK L. SIDE FT. FT. i 0 REAR FT. FT. BUILDINGNO. OF VAR.# DATE r SIZE 46 X 79 ROOMS 25 STORIES 2A C. U. P. # APPR� ;III EXTERIOR WALL I ROOF 0 APPROVED 1 D / 1 USE OF BUILDING AND WORK TO BE PERFORMED- V 1 I 4Unit Apt & 9 Car Gara e 7 BQ. PT. LI ,Q,el $' 6 1 1 HEREBY ACKNOWLEDGE THAT 1 NAVE READ THIS, APPLISMTION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TS COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORD; ANCIIS AND BTATE LAWS REGULATING VALUATION BUILDING CONSTRUCTI IGNATUREOF -C�ti--r� PERMIT FEE $ PERMITTEI/ AUTHORIZfiD AGENT PLAN CHECK_ TOTAL FEE 5 23775 CITY CF LISTA MESA l3bSTA MESA BUILDING -SAFETY DEPARTMENT MAR 24 1965 P.O. BOX 817 COSTA MESA, CALIFORNIA For Applicant to. Fill In Completely AP ! C 1=G'i ERMFT TYPE OR .PRINT For Office Use Only BUILDING ni2: ADDRESS 1S9'2 �8 - _. R8c81PT NO. PSR�F[ COSTA MESA, CALIFORNIA V<< 11tiLi�J'J 5 RBCEIV Y OA ERECB ED D EIS9 D 2 6 OWNER '- L - MAIL BUILD NG ADDRESS' ADDRESS_ FIRE 1, CITY NO. ZONE PE' ROUP JL ' APPROVED' ARCHITECT TEL. BY DATE OR ENGINEER NO. ADDRESS ZON NO, OF I USE OF NEW PLANS .� 1�BUILDING 'I L CONTRACTORZ Z- LEGAL I ADDRESS � DESCRIPTION Y'V'� �- A. P. NO. ' CITY J 1 j/ Yj� NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE/� Z No 90" TO SIOE a REAR P. L. LIC. NO. % �1 EAVES SIZE - --�'-` NO. OF SLDOB. ALLOWED N. B. C. REQUIREMENT) OF LOT NOW ON LOT . YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ' ACCESSORY BUILDING EXISTING BLDG. ( FROM C/L HTRLEET/) FROM SETBACK LINE FROM (% J ZIT. OL L FT. CENTER OF STREET REAR YARD I R. SIDE FT. SIDE YARDI LEFT RIGHT DESCRIPTION OF WORK L. SIDE FT. FT. REAR '. "FT. NEW ALTMOVENOTION'_ DISTANCE BET. � BET. MAIN Q B MAIN BLDOS. ACCESS. SLOGS. REPAIR DEMOLISH VAR.# DATE BUILDING _ SIZE ST RIES C.U.P.# APPROVED (RIOOMS EXTERIOR WALL _.ROOF-- �— APPROVED - COVERING COVERING BY. USE OF BUILDING AND WORK TO BE PERFORMED SO. FT. 1 XBREBY ACKNOWLlOOk THAT 1 HAVE'REAO THIS APPLICATION THEAMOUNT SHOWN UNDER VALUATION IS FOR THE S AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COM. PUS POSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONBTRUCTIO S VALUATION - - PERMIT FEE $ �7 O SIGNATURE OF �v[ PERMITTE $ \ o f PLAN CHECK AUTHORIZED AGENT TOTAL FEE J