HomeMy WebLinkAbout2724 ALBATROSS DR - Building PermitsA MESA
AOP���ant to till in all spaces exce0t those within heavy borGe� Iines anE si9n a�l appropriate tleclarations.
IT PERM�NO^ �� � �� TRACT NO. LOT NO. UNIT N6.
��ject Address c.�/ � 7' H�- � 9/ h V S.�
�, Applicant'sMailingAddress D�o �/ Sq�r4rr�e.12 ��hr'
Owner's Name ���«}m D4ld 6 Phonc�us�05�
Address �% Z� �G5 ��d S S
Arch/Eng. License No.
Address
%v �37-�0`
Contrector's Nam � Phon
Address (ma I� gl� �O �i/� .S s} 'v� �r7'-.� �!'^,.fj
City License No. ��` e '
LICENSED CONTRACTOR DECLARATION
�I hereby atfirm tM1at I am lirensetl untler provisions ot Charter 9(Commencinq
with section 7000) ot oivision 3 oi the Business antl Professlons Cotle, antl
my license is in fu forc ntl effect. p.�/�
Licen Gla s � 5 �L.�`�
Dat��_ Signature
I �NORKERS' COMPENSATION DECL ATION
Rreby affirm that I have a certi/icate of ronsent to self-insure or a certificate
Workers' Compensation. Insurance, or a ceriitietl_ copy thereot (SeCtion
.00, �ab. C.)
�� Policy No. Company
ii 8Certifietl copy is heieby (urnishetl.
Cer[ifietl copy is tiletl with the city Builtling DiviSion.
'�, Date Applicant
" EXEMPTION FROM WORKERS' COMPENSATION OECLARATION
�(This section neetl not be'completetl It�the permit is for one huntlretl ($300) �or
iezs).
I certify tM1at in the perto�manca o( the work for which i5 p m t is i55uetl, I
' shall not employ any,pe�son in an s to b co e bject to the
worker Co penstitjyn Laws af a'to .
Date � —�e �jl l� Signatur �
NOTICE: If, after making this tleclaration, yo s oultl eco subject to the
Workers'. Compensation provisions of the' Labor Cotle, you must forthwith
comply with suCM1 provisions o� thi5 pe�mit Shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV - -
I hereCy affirm that there is a construction lentling igency for the performdnCe
of the wark tor which rois permit is i55uetl. (Section 3097 Civ.' C.)
Lenaer•z Name
Lentler's Atltlress
OWNER BUIL�ER dECLARATION
1 hereby affirm that 1 am ezempt�from the Contractor's License Law tor the
tollowin9 reason (Seccion ]031.5 Business antl Professional Cotle: Any ciry or
county which requires a pe�mit lo con5truct, alte�, improve, tlemOlish o� �epair
any structure, prior to its issuance, also requires the applicant for such permit
to file a signetl statement that ne/sne is licensetl pursuant to tne provisions af
' rhe Contractor's License'Law (Chapter 9(commencing with Section 7000) ot
'vision 3 of the Business antl Professions Cotle) or that he/she is exempt
retrom and the basis tor the alle9etl exemption. Any violation of Section
31.5 by any applicant foF a permit subjects [he applicanl lo a civil
enalty of not more than five huntlretl Collars ($500).
� I, as owner of the property or my�employees with wages as their sole
compensation, will tlo tlte wo�k, antl the st�ucture is not intentletl o� otteretl
for sale (Settion 7044, BuSiness anG .Profe55ional Cotle: The ConVactor's
License Law tloes not apply to an owner of a property who builtls or improves
the�eon, antl who tloes such work himself/h¢rself'or tnrougM1 his or h¢r own
¢mployees, provitletl that such Improvements are not intentletl o� offeretl fo�
sale. I�, nowever, tne buiitling ar improvament is soltl witnin one year o� com-
pletlon, tnebwner wlll nave the burtlen of proving he/she tlla not builtl or im-
��ove for the purpose of 5ale).
I, a5 owne� of the proper[y, am exUusively cont�acting wi[h licensed con-
fractors [6 construct the project (SeCtion 7044, Business antl Prote55ion5 Cotle:.
The Contractor's License taw does not applY to an owner of property who
builtls or Improves tne�eon, antl who conVacts for such project5 with a con-
tractor(5) I�cense pursuant to lhe Contractor's License Law). I am aware [haC
proof of [heir Worke�'S CompensatiOn insurance shoultl�be provltletl to me:
❑'I am exempt untler'Section _ _ $a & P�. tor this reason
Date �
I hereby certify Na
intormation is correc
antl state laws relatii
sentative f this
inspecti�
Signature
Drivers' License or 5!
CMF 0865-46, rev. 10/84
have
TYPE OFCONSTRUCTION Ll NEW LJ ADD LJ FJ.yTERATII�I �ftEPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER �«� K— a
�SCRIPTIONOFWORK/USEOFBLD . �
P �acie FK•"� 7::�.: --S� e— e.� e -9'sT
TYPE OF PERMIT GRADING LJ FOUNOATION LJ $TRUCTUR A'��
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SQL./FL aJ oCCUaArv1 C/Jv—��
CONSTRUCTIONTVPE�LrOmP VALUATION$._�Z__
ZONE GRADINGCU.YDS. ACRES
Remarks:
Sink
Preventer
Irrigation
rinking Fountains
loor Drains
loor Sinks
asService� Outlets
Kitchen Sink
Lavamries
P—Trep
Roof Drains
Reinspection.Fee � $75
Boiler �
Duct- UnderGrountl
Duct - Structural �
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFact. Blt. ICBO #
Heating System & Ducting
❑0-100,000 BTU 0100,OOOBT'
Reinspec[ion Fee � $75
White - Builtling; Cana�y - APPlicant; Pink - Accounting; Goltlen�otl - Assesso�
Showers
Service Sink
Sewer Cap
Sewer Connection .
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/$pa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Isue Fee
Hood or Typel ❑
Canopy Type I I ❑
0
Refrigeration System
❑aico,000eTu ❑ioo,000
Sys[em Repair/Alteration
Fire Dampers
Registers
Iwue Fee
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K
g Left
Ping. Ref. #'
Planning Notes:
Automatic Washer � � �
Construction Pole Sub.
Cooking Unit
Di;hwasher
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW �!
$ 3
Reinspection Fee
FEES
, DEVELOPMENTSER
Zonin9 APProved BY_
Building Approved By
Appliwtion Issued By_
$ 3
1691 8%20/86
Zone
Parkir,g Req./Provided
ELECTRICAL �
Transformer ❑ 15-50 KW
❑ 50'+ K W
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel ' '
Motors 00.1 HP � 1 h- 8
Inc. Solar �9-15 HP 016-15+
Microwave
Pole Light ,
Sign
Standing Sections
15 KW Trash Compactor
$15 � ' Issue Fee
�
REQUIREMENTS:
27.5� TL
FEES
$ 3
Z'
O
N
I
N
G
R
E
Q
M
T
S
SU R 7o�F FEES J�
BUILDING PERMIT $ `� SMIP $ . SV
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICA� $ GRADING $
PLAN CHECK 50% $ MICROFI�M $ �ry\
MECHANICAL $ TOTA�fEE $ �7'�'v
PLAN CHECK 25% $ '
ONSTRUCTION AND PLANNING
� PPROVALS Permit # '
�,
, 1. Temporary Electrical Service or Pole
2. Soil Pipe:Undrgrnd.
3. Electrical�Conduit Utility�Undrg%nd.�
'� 4. ElectHcal Conduit-Undrgrnd.
5. Steel;Re`inforcement_ �
6.` Electcical UFER�Grnd:'
�:
7. `Footings� ' " ' ' �
8. Foundation ;. � �,
9,��Water Pipe-Undrgrncl. .
10.' Structural Floor System '
11 . Property Sewer Line & House Connection
12. �SeweuCap � ` -
,
13''RoofDrains � , . �
14. Rdugh Plumbing�'� '' �
15. Rough Electrical-Cond�it
i6. RoughElectricWiring
17� Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21: Ducts, in-Structure
22. Ducts, Ventilating .
23. Gas Pipe-Rough & Test
24. Roof Framing -
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame ancl Flashing
28. Lathing'& Siding
29. Insulation
30. Drywall�Nailing
31 . Plaster Biown Coat ,
32. Electrical Power Meter-Final
33. Final Electric
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 pomestic-Final
42. Backflow Preventer _
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electrie Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
NO' Date
Date
�
POf SPA
Inspector qppROVALS Fermit #
52. Pool & Equipment Location
- 53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
� 58. Electrical Conduit-Undrgrnd.'
� 59. Gas Pipe, � Undrgrnd., Test
� 60. Backwash Lines, P-Trap, � Undrgrnd.
- �' 61. APPROVAL TO DECK
- , 62. Backwash & Receptor-Final
' . 63. Heater & Vent-Final
r 64. Plumbing SYstem - Final .
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit# _
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION I
80. FOODCERTIFICATEISSUED
�
Notes:
0
Date Inspector
,
�
,�
�
Q
ADGlicant to till in all soaces exceo� those within neavy UVGer Ilnes antl sign all approvriate tletlarations.
4 ERMIT NO. TRACT NO. LOT NO. UNIT NO.
CiTY OF COSTA MESA CONSTRUCTION PERMIT fg A.P. # � �
/� L� �J../1 .—� rr G-�nQ .+L/_ �a
Praject Address �7 �"Zy ��8� */� 0.5 5
Ap�ilicanYs Mailing Address r�52 ��:(� � 7� NY1�J �MItS�nN �/1 Clb ��
'Owner'sName I�QU�IPANN/=P �/�Y Phone
Address 17�:�._ �t1HT�-oSS ('ecT/f NuA, PA
Ar.h/Eng. License No.
Address /� p
Controcror'sName�a/UC✓y��S✓�g/ft�{S�� Phone-S's� �%�%Z
Address Imailingl 2 O ' R�� - N(�/Y � 92 S2
� � �,.. � _ — Sa0 %
City �.icense No. �
LICENSED CONTRACTOR DECLARATION
I hereby affi�m that I am litensetl untler provi5ion5 of Chdrter 9(commencing
witn section ]000) of Division 3 of the Business antl�Professions Cotle, antl
my Ilcense is in full force antl effect.
License Class License No: �
Date 'U �_ S� � Signature
w^RKERS' COMPENSATION DECLARATION
�.reby attirm that I have a certificate of consent to selt-insure or a c Ificate
Workers' Compansation Insurance, or a certitietl opy thareo Y
l00, Lab. yt� ) � %�'
PolicY No!` �� 27� Z�`�C�mPan �� `�
ertifietl c y is ereby furni5hetl.
Certifi y,� with lhe city Buil g i on
Date Q� Applicant
EXEMPTI N FR M WORKERS' COMPENSATION DE LAR TION
(Thissection neetl not be completetl if the permit is for one huntlretl ($300) or
less)
I certify that in the pe�fo�mance ot the work for whi[h thi5 pe�m�t i5 i55uetl I
shall nof employ any person in any manner so as to become subject to t�e
Workers' Compensa[ion Laws o( California.
Date Signature
NOTICE: If, after making this tleclaratlon, you shoultl become subject to the
Workers' Compensation Orovisions of the Labor Cotle, you must forthwith
Comply wi�h such provi5ion5 0� tltis pe�mit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that there is a construction lentling agency (or the pertormance
of Ihe work for which thin^_p�mit is issuetl (Section 309] Civ. C.j
Lentler's Name Ca�_�-
Lentler's Atltlress
OWNER BUILDER OECLARATION
1 hereby affirm Ihat 1 am exempt irom the Contractor's License Law tor the
following reason (Section 7031.5 Buslness antl Protessional Cotle: Any city or
county which r¢qui�es a permit to con5truct, alter, improve, tlemoli5h or repal�
any ztrucWre, prlor to its issuance, also requires fhe applicaM for such permit
to file a signetl statement that he/She is licensetl pU/suant to th¢ p�ovlsion5 of
�,rhe Contractor's License Law (Chapter 9(commencing with Section 7000) of
�-'=�yision 3 of tne Business antl Professions Cotle) or that he/she is exempt
�`r:-`,:reirom ana Ihe basiz tor the allegetl exemption. Any violation ot Sectlon
`�`91 5 by any applicant for a permit subjecls the applicant to a civil
�� �benalty of not more than five huntlretl tlollars (y500).
❑ I, as owner of tM1e property or my emo�oyees with wa9es as their sole
compensation, will tlo fhe work, antl [he structure is not intentletl or offeretl
for sale (Section 7044, Business antl Pro(essional Cotle: The Contractor's
Licenu �aw tloes not apply lo an owner of a property who builtls or improves
thereon, antl who tloe5 Such work him5elf/herself or thrOugh his or h¢r own
employees, provitletl tnat such improvements are no[ intentletl or offeretl for
Shce. If, howeve�, the builtling or imp�ovement i5 Soltl within one yea� of com-
pletion, the owner will have the burtlen of p�oving he/she tlitl not builtl or Im-
prova for the purpo5e of sale).
❑ I, as owner of the oroperty, am exclusivery contracfing with licensetl con-
'i Vactorsto construct the project (Section 7044, Bu5ine55 antl Professions Cotle:
The Contrac[or's License Law does not apply to an owner Of property who
builtls or imOroves thereon. antl who contracts fo� Suth oroiect5 wlth a r.on-
tractor(51 Lcens¢ pu/suant to [ne Contra<fo�'S LicenTe Law). I am awa�e that
proof of their Worker's Compensationdnsu�anc0 Shoyltl be provitletl to me.
❑ I am exempt unaer Section �� B. & P. C. for thls reason
Date owner �G
I hereby cer ity that 1 have reaa ihis
information is wrrecL 1 agree to compl
antl state laws relatin9 to builtling cons
sentatives of this city 'to enter u0on
Signature r///�
Drivers' License or 55 �/
0865-46, rev. 5/8
C
nances
reore-
Iv.tor
TVPE OF CONSTRUCTION �rve
❑ CONVERSION ❑ DEMOLISH
DESCRIPTION QF WORK/USE Of/�
TVPE OF PERMIT LJ GRADtNG LJ
❑ TENANT ❑ ELE TRICAL ❑ P
❑ -OTHER �
PROJECT DESCRIP710N 54. FT.—
CONSTRUCTION TVPE
ZONE G RADI N(
Remarks:
Sink
Preventer
I rrigation
Jrinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
I ntercepmrs
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. �CBO # ^
Heating System & Ducting
❑ai oo,000 eru O i oo,aoo sr�
peinspec[ion Fea � $15
WM1ite - Builtling; Canary - Appllcant: Pink - Accounting; Goltlenrotl - Aszessor
J ADD
OTHER
NG
ALTERATION IJ REPAIR
LJ STRUCTURAL
MECHANICAL
_ VALUATION$
CU.VDS. A(
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
� Laundry Tra'ys
Issue Fae
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑o-ioo,000aTu ❑ioo,000ar
System Repair/Alteration
Fire Dampers
Registers
luue Fee
FEES
S Main Building:
TFront �j �
B Rear
A
C Right
S. Left O
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole
Cooking Unit
Dishwasher
Dryers ❑Gas ❑
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
��i-3
� I -rj Zona i
:�Y� Accessory Building:
2
O
N
I
N
G
R
Parking Req./Provided ������y E
l� Y I �K.J �
M
/ T
S.
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up ro 100 amps
Meter ❑over100amps
Sub Panel
Morors 00.1 HP 01 X- 8
Inc.Solar �9-75 HP �16-15+
Microwave
Sign '
Garbage Disposal Standing Sections
Generetor �0.5 KW �5-75 KW Trash Compactor
Reinspection Fee $15 Issue Fee
$ 3 DEVELOPMENTSERVICESREQUIREMENTS:
Zoning APProved BY �
FEES Building Approved Bv
$ 3
SU V OF FEES
BUILDINGPERMIT $ �.�c SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $�.GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $
PLAN CHECK 25% $
u: :Q?3;J'z_-GD�30734 a ia"a
C','=` ��./�i:�E9 'IflE: :.i:.:_
FEES
. , . . . . ..
h
CONSTRUCTION AND PLANNING PO( SPA
APPROVALS PermitJ� Date Inspector qppROVALS Permit# Date Inspector
o'�porary Electrical Service or Pole .i'�. 52. Pool & Equipment Location ��j' �j Q(�
2. Soil Pipe-Undrgrnd. „ 53. Steel Reinforcement
3. �Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit-Und�,gmd. - � 55. Electrical Bonding
5. Steel ,Rei'nforcement I; �� 56. Rough Plumbing & Pressure Test �„
6.,�Electrical UFER�Grnd. 57. APPROVALTO COVER-GUNITE �j Q'
7. �Footings � , � � 58. Electrical Conduit-Undrgrnd. � � Q�f
8. Foundation : �� : 59. Gas Pipe, O Undrgrnd., Test �j �,
9. Water Pipe-Undrgrnd. �' � '. 60. Backwash Lines, P-Trap, � Undrgrnd. �� ��-.
70. Structural Floor System ' 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection '. . 62. Backwash & Receptor-Final
72. Sewer Cap � ' � � 63. Heater & Vent-Final �
13. Roof Drains � • � '�. '�� 64. Plumbing System - Final
14. Rough Plumbing ; '% 65. Electrical-Final �
15. Rough Electrical-Condui[ 66. Solar System-Final
r'�
1�: Rough Electric Wiring 67. Fencing & Access Approval ��
1-7: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18; Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL !o %
19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
n
20� Rough'Factory Fireplace . APPROVALS Permit #
21. Ducts,iri�Structure -' ' 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
�=23. Gas Pipe�Rough & Test • _ 72, Underground Flush
'24. Roof Framing - 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Speathing-' ' 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 ��i 80. FOOD CERTIFICATE ISSUED
33. Final Electric F Notes: o
i
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 pomesticFinal � "
�42. Backflow Preventer '� f� ;r! � � ry �;�
43. Backflow Irrigation �- � � � � L^ 'l�,�
44. Landscape Irrigation System , � • t� � '�
45. Sound Attenuation � ' • � ^
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING � ,
48. Special Requirements Completed �- � '
49. Electric Release to Edison . � 1 ��'
50. Gas Release to Southern California Gas Co ; i'' � �
51. CERTIFICATE OF OCCUPANCY '" � �: r' ;
" -••i' -.:.i ��:
No. Date `i ''�.i � . �'�
:ZSPCRT OF INS?�C'SICN
'�If 70:
Address
04N E R: � J�J,s1 v
PROJECT
Address
�J[1C�BL2 '� 1
i1dSOf1L"j7 \\ /
Gunite (� )
?OSC.-T2r,qi'.^.R2Q '�.JCIC_?�2
��=eor ina
Reinforcing Steel
ReDort No.
i
�
(
Permi t No./�f �����y
Architect: Lf,T/��Z.e,�,(_ /-(z^JS Lontractor: J��� '�_ _ ��<
Address
Address:
Engineer: (�, G,�i; Subcontractor
(Gunite)
Address: Masonry or
Concre[e)
' InsDec[or: ►�� x �� Address:
--�o.• sk �lPv
Mlx Used:�•�-'
Slump, inches�-
Admixture: e
Designed Strength, P51�4LX)C:.
pATES
�
Cu.YdS. Ho. of
Placed CYis•
� �_
Remarks
L�..LtY �l ei: ne5�l � �c)lN� �-. �.Q`�
Copies of Reports to: (Indicate which 81dq. Oept. G furnish address of any noc listed)
Lot 86 � � �'r�
COSTA MESA BUILDING-SAFETY DEPARtMENT
P. O. BOX 917 COBTA MBHA. CALIFORNIA
For Applican} fo Fill In Complefely
TYpE OR PRINT
ADORESS 2 2 b
COSTA MESA. CALIFORNIA
2850
■ ARCHITEC7
TEL.
I No.o�
NOW o
9ETBACK L�NH PRQM� �O � REAR YAR� �/ �
GENTER OR 6TFEero� a
&ID6YAR0 LEFf ��� RI6HT ���
DESCRIpT10N OF WORK
NO. OF
WORK TO BE
I HE0.EBY ACKNOWLEUOE TH�T I NAVE qEAD THIB APPLICATION
ANO 6TATE TH�1T THE ABOVB 18 CORRECT ANO AOqEH TO COM.
PLY WITH ALL CITY OROIryA! Cfi8 AND 81'ATH �AW6 R8 LATINO
BOILDINO CON9TRUCf10N� , /
PERMITTE E�_ � L✓
AUTHORIZED A
FEE RECEIUED
llpA 31 198�
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RHCCI'T NO. 7_ pppry
F I•
R[CCI 60 OY DATC p[C61V[ DATE
3 3/— g`� RPR 1
BUILDINQ
ADDRE39
FIRE
ZONE TVPE GROUP �
APPROVEO '
L80AL
ZONING
NO. OR Y8E OF NBW S�.II g
runa � eu��oiHq.7� &t g83'.
Lot 86, Tract 5289
none
NOTE: NO EAVE OVERHANR SHALL BE LESS THAN
YARDBAPPROVEO
MAIN BUILDIN6
(FROM C/LBTREETI
VAR. $
YARD9APPROVED
AGCESSORY BUILDIN6
BET. MAIN 6
ACCE55. BLI
OATE
N
$�. �. �
TNE AMOUNT HHOWN UNO2R VALUPTION IB FOR TXE F
PIIHP088 Op HBTABLIBHINa A PERMIT FEE ONLY. Q
VALUATION m
PERMIT FEE �� �
0
$ a/,3o� A 3 -s`� ;
/ i � 1 4