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Home My WebLink About245 CAMELLIA LN - Building Permits(714)754-5273 • Fax(714)754-4856 Job Address: 245 CAMELLIA LN Suite: Vicinity: HOUSE & GAR4GE Parcel Number: 42614309 Applicant: LOID WATTS Address: 2626 NEWPORT BL CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT CO5TA MESA, CA Owner: HORTON, CAROLE M Address 245 CAMELLIA LN CO5TA MESA,CA Contractor: PETRONELLA ROOFING Address: 2626 NEWPORT BL Arch : Address: SHINGLES. COSTA MESA, CA Zip: 92627 BUILDING PERMIT Zoning: Phone: (949)548-1645 Zip: 92627 Phone: (714)646-7055 Zip: 92627 Phone: (949)548-7645 License: 460707 Eng: Address: Phone: PERMIT NUMBER" I✓899-01663 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 10/13/1999 Issued: 10/13/1999 Phone: Zip: License: License: SCOPE OF PERMIT REROOF - T/O, REPLACE SHTG AS REQUIRED, INSTALL 2 LAYERS OF 15# FELT AND 25 YEAR COMPOSITION Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $111.25 $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Frpnt 0- 0 PARKING Existin : o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 $4,250.00 sa,zso.00 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 1 BO days, or if work is suspended or abandoned for a period ot 180 days. . INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapectlona and fihel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this parmit. FOR INSPECTIONS CALL: (71q) 7545626 WORKERS' COMPENSATION DECLARATION: ' I hereby aNirtn under penalry oi perjury one of Ihe following tlaclarations: ❑ I e�e and will maintain a cehificate of consent to salf-Insure tor workers' compensation, as Orovided for by section 3700 of ihe Labor Cotle, for the pertormance of the work tor whic� Ihis permit is issued. I have antl will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the peAortnance of tha work for which this pertnit is issued. " My workers' compensation Insurance carrier antl policy number are: Carrier Policy Number. (This section neetl not be completetl i/ the permif is valued et one hundred dollars ($100) oNess J ❑ I certity ihat in Ihe compensation laws comply with these F Applicant Signatura: WARNING: FAILUR O SEC THWSAND E(E100. LICENSED CONTqhC� I hereby affirm tha! I am force and eHect. Lic. k Comractor's Signetuie: CONSTRUCTIO LENDING ❑ I hereby a m thatthei Lender's Name: Signature: of the work for which this permit is issued, 1 shall not employ any person in any manner so as �o bacome sublect [o ihe workers' and agree that it I should become subject to the workers' compensation provisions of Section 3700 ot Ihe La6or Cotle, I shall fotlhwith X� — 1� oate: � 6—L�--� S COMPENSATION COVERAGE IS UNL4WFlIL AND SHALL SUBJECT AN EMPLOYER TO CFIMINAL PENPLTIES AND CIVII. FINES UP TO ONE MUNDRED NJ TO THE COST OF COIAPENSATION, DAh1AGE5 AS PROVIOED FOR IN SECTION 3]Ofi OF THE L4BOR CAOE, IMEFEST, AND ATTORNEV'S FEES. DECLARATION: 9(commencing with Section 7000) of Division 3 ot iha Business Class #T Data: — " a consimction lending agency for ihe pertormance ot the work for which this permit is issuetl. (Sec. 3097, Civil Code). Lendefs Address: Date: and my license is in full OWNER-BUILDER DECLARATIONS: I hereby aHirm ihai under penalry of perjury �ha� I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a permit to consWct, alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires the applicant for such pertnit to fila a signed statement Ihat he or she is licensed pursuant to ihe provisions ot the Contrectors Licensa Law (Chapter 9(commencing with Section 7000) of Division 3 of iha Business and Professions Code) or that he or she is ezempt theretrom and t�e basis for Ihe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to e civil penalry of not more ihan five hundred dollars ($500).): ❑ I, es owner of ihe property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intended or ottered for sale (Sec. 7044, Business antl Professions Code: The Contractors License lew dces not apply to an owner of property who builds or improves thereon, antl who does such work himself or hersetl or thmugh his or her own amployees, pmvided ihat such improvemenis are not intended or oRered for sale. It, however, the building or imprcvement is sold within one year of completion, the owner-builtler will have the burden of proving �hat he or she did not builtl or improve for purpose of sale.). ❑ I, as owner of Na property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, 8usiness and Pro(essions Code: Tha contractors License Law tloes not apply Io an owner of property who builds or improves ihereon, and who contracis for such project with a coniractor(s) license pursuant to ihe Comractors License Lews.). ❑ I am exempt under sec. Business antl Professions Code for ihis reason: Signature: Date: Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Driver's License No. Ezpires: Veritication of Ownership by (rype of document, i.e. - propeny tax hill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certily Ihat no excavation five (5) or more faet in depth into which a person is requiretl to descend, will 6e made in connection with work authorizetl by ihis permit, and Iha� no building strucNre, scaffoltling, falsework, or demolition or dismantling thereof, will he more t�an thirty-six (36) feet high. (Chap. 3.2, Grp 2, Atl 2, Sec. 341, Ttle 8, Celitomia Adminisiretive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Indusirial Safaty, as noted above, unless such person has a permit to do such work from ihe division. Signature: Date: Division of Indus�rial Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AIffHORIZATON OF ENTRV: I certity under penalry of perjury ihat I have read this application and state that the information given is correct. I agree to comply with all state laws and ciry ordinances relating to building constmdion, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-dascribed p�rty tor inspection puryoses. I agree not to occupy or allow occupancy of any builtling authorizetl by this pertnit until tinal inspection. cooe �, n 1616 Fi S m Final Fire Prevention 7266 Pool Spa Final 200 Final Ra-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition 2446 46 oa�r iNrrtin�s � �-1 ate� Date CODE♦ INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DATE INTRIRlS CITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT pia� �sa-s2�a • Fax (�ia� �sa-aess Job Address: 2001 REPUBLIC AV Suite: Vicinity: HOUSE ONLY! Parcel Number: 42248119 Applicant: LOEHREN, MARC Address: 2001 REPUBLIC AVE � n Owner: Address 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Status: ISSUED Applied: 09/08/1999 Issued: 09/08/1999 Zoning: ISSUED BY: � :C:_�Phone: =(949j6423212>-�`_ :-.� COSTA MESA, CA �-� ;',.� . � !� �Zip: 92627 ""-� � -��-`,=�� \ t� � Contractor. � �� i u �� i Address: � � � ;!;,`Y� �', �/� �:,r/ c,,,Zip, '�r, / , ._ f /i/•il /� `� � i � l ' 1 /� % ^� � �� . ;e , `� ; .;_ ;_�', uf ��I ��\:�� E_ , �. �. � .`.,� �� A � � �.Phone ; r_��. ��.._`;� � � , �. ( � ��'\ � � 5 . - � Zip 92627 �-1 '., i � '` �\ i .�� z:�� '��,:� ��. /j i,� ;�=' �\� �, � j� � Phone� ��`�� .�� i. icense::' � (��Arch-.` ``�� /- - , i � " ,/",... Acldress.� ; � �, �� y'� , �. ,L_ T�._ -� � /PhoneE � �r�� _ ;��{. _ i f� a ' �_ �:'i -" ; ;�\^Zfp: �„�f� i� �� I� ,. � r � � V•� i'�� v I } ; ti!f�/ ) �, � ; � -REROOF - T/O, REPIACE �, �' � SHINGLE ROOF. �. `' . . _ .. . A . L , Plan Ctieck ,; �,-., $0.00 � ` ' Permii'.f ,� $83.25 �•�� SMIPRes:`V"��t,�' $0.50 ` �SMIP Com �\ ' � $0.00 � �� Other ��P� $0.00 ��I,nspection.t ��$0.00 � �, � > � ��.., ��•l Total:� �$83675 � � .�,.t. \��, \�: ; �,� � License. \�i . �� i � `� ,�ti � � � . � . rA�A� \.l � 1 ' �� _' - _ ' ...��r.iAl r� . �� Eng. I ' s�.h� �`\ � < � � `' ,i \�� e: � � � ��, s 1, ` \i �� . � se: ""`, 'i 1'i� I r% _ SCOPE OF PERMIT--_- A � I'� i� �'_ � �'� ; ITG AS NECESSARY; INSTAIL 1 LAYER�OF-30# FELT�AND 25�YEAR COMPOSITION � �,. �' ', '��/ ['�A t^^'< '�(1�/ �� /' 'iA' -,h - 'A L 1, Vi. ..il, VJ A� .._�1_ � i...Ai.-1 .�' .. .. .. ' _ '_') �I�.'li � i�� - - FEE SUMMARY ` � -- 1 ', � -- � � ,. ,_ -� f y�. _ � � � ` Calc Valuation � . �'1 � � .g2 soo.00 j = - '`J - _ � _ � �.'�"� Claim Valuation ? `- % j , $2;300.bo� _- - . � _ __ . �-'- i > _ __'i j,`. - _ �:� � �x� �j�'r � 'Y ( i i� _� �'l'l ` � -- . 1 �fi �� i� � � < . -' — i' f? i r�r � r �i�i ' . �.�.p � �,', �';;��; .� '��.' �v �l ti �C;//� ..i "�� , ti. -. � � ,;y . . ,,.%, . _ i,!; V�'�A ✓' ��`� �i."i-%'"�• - -F ACCESSORY PARKING NOTES: � � _ / � :,� j � � � , �� . � Front 0�0 � Rear � 0-0�_ Front" 0 �0 � �' � � � �Reai -0� 0' �' � � �. _ Existinq: � 0' �.:. � `,'R�eauired:. , 0 ANNING & ZONING� � :.f,�.4:;�� ;i%` `` j '� � � '' ' � �' '_,� i � i�,. � � r ' ; �" � i�j �:r�� . I„ ; �left 0- 0�, �, Right 0- 0, � % �� % , . �i,� .. � T. "_.��'i . .--�Left �0-0=:-�� Right, 0-0� i'�� - - � � _ . j i: /�i Proposed: � -0 � ' � -�,�i . , .� /- . - �, �, � � , j j:% , . . .. .. �f�, . . i-.i'��'';.� • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or i( 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 requlred Inapeetione and finel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 1(JORKERS' COMPENSATION DECLARATION: l�ereby ettirtn under penelry of perjury one of the following declarations: ❑ I heve entl will meintain a certificate of consent to seN-Insure for workers' compensation, as provided for by sectlon 3700 oi ihe Labor Code, for tha pertormance of the work for which ihis permit is issua0. ❑ I have antl will malnteln workers' compensation insurance, as required by section 3700 of the Labor Cotle, tor the peRormance ot ihe work for which ihis pertnit is issuad. My workers' compansation Insurance cerrier entl policy numbar are: Cerrier. Policy Number: (This sec0on need not be comp/eted illhe pertriit is valuetl at one hundred dollers ($100) or less.J ❑ I certity ihai in ihe peAormance af the work tor which Ihis permit is issued, I shall not employ eny person in eny menner so es ta became subject to Ihe workers' compensatlon laws ot California, and agree that if I shoultl become subject to the workers' compensation provisions of Section 3700 of ihe Lebor Code, I shall fonhwith comply with Ihese provisions. Applicent Siqnature: Date: WARNING FAILURE TO SECURE WORKERS' COMPENSATION CAVEPAGE IS UNLAWFUL PND SHPLL SUBIECT AN EMPLOYER TO CRIMINAL PENALiIES AND CIVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN A�DITION TO THE COST OF COMPENSATION, DAANIGES AS PROVIDED FOR IN SECTIOtJ 31O60F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the eusiness antl Protessions Code, and my license is In full force antl eHecL Lic. # Class N COn�radofs Signature' Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that ihare is a consiruction lending agancy tor the pertormance oF the work for which this permit is issued. (Sec. 3097, Givil Code). Lentlers Name: Lentler'S Atld�ess: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby aHirm ihat under penalty of perjury �ha� I am EXEMPT FROM TNE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit to construct, alter, improve, tlemolish, or repair any structure, prior to i�s issuance, also requires the applicant for such permit to file a signed statemeM ihet he or she is Iicensed pursuan� to Ihe pmvisions of ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business end Professions Code) or thet he or she is e:empt Ihereirom and the basis tor the allegetl ezemption. Any violation of Section 7031.5 by eny applicant for e permit s�u6��ects tha applicant to e civil penalty of not more than five huntlretl dollars ($500).): ,{� I, es owner of iha propetly, or my employees with wages es their sole compensation, WILL DO THE WORK, end ihe stmcWre is noi intended or ottered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to an owner of property who builds or improves ihereon, and who tloes such work himself or herself or through his or her own employees, provitled that such improvements are not intended or oHered for sale. If, however, the building or improvement is soltl within ona year of completion, the owner-builder wiil have the burden of proving ihat he or she did not build or improve tor purpose of sale.). ❑ I, as owner oi t�e properry, am EXCWSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consimct the project (Sec. 7044, Business antl Professions Code: The contractore License Law does not apply to an owner of properry who builds or impmves ihereon, and who contrects for such project with a contrector(s) license pursuant to ihe Contractors License Laws.). ❑ I am eaempt nder sec. Business and Protessions Cotle for this reason: Signeture: �wf.c � � Da�e: a — � "��' Owner ID verifietl by tlnver's license. ❑ Ves ❑ No Driver'S LicenSe Expires: Venfication ot Ownership by (type of tlocument, i.e. - property �ax bill or deetl): DIVISION OF INDUS7RIAl SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity ihat no escavation five (5) or mora teet in depth into which a person is required to tlescend, will be made in connection wi�h work authorizetl by ihis permit, antl ihat no building stmctura, scaHolding, falsework, or tlemolition or dismantiing thereof, will be more than thirty-siz (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitomia Atlminisirative Code). ❑ As owner�builtler, I will no� employ anyone to do work which would require a permit trom the Division of Indusirial Safery, as notetl above, unless such person has a permit to da such work from the division. Signature: Date: Division of Intlustrial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I certity under penalty oi perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and ciry ordinances �elating to building constructioq antl authorize representatives oi iha City of Costa Mesa to enter upon ihe a v- scnbeg proyp rty r ins ection purposes. I agree not to occupy or allow occupancy oi any building authorized by this permit until final inspaction. �C�t' �-.. �- 4'-g9 SignaWre Of Legal Owner(s) Date And/Or Authorized Applicant COOE 1, INSPECTIONTYVE 1616 Fized System Final Fira Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2446-as RT INTRIALS CODEN INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Pinal Site 250 Final Building/Occupancy j1�f� I TN RIRLS OWNER JOBADDRESS 21t5 Camellia l3S10 BUILDINGPERMITNO. ZZZ3 V GENERALCONTRACTOR Dike & Cale�rove VALUE $ H.SOO.00 i . LOT $ BLOCK TRACT ZJr62 Residence & garage � GROUP I Rt J TYPE V ZONE RLt FIRE DISTRICT 2lli6 � PERMITSISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBEH Footing Trench � � -�j- '— Foundation Forms and Grade to Garage_ Plumbing, Rough to Slab `Zc Plumbing, Rough Complete 4 Temporary Pole Wiring, Rough � Heating, Rough � Heating� in�l. Sewer, % Sewer, � Septic Tank or Cesspool Lathing,ln OutX Plastering Plumbing, Fin�al, Fixtures ComF Plumbing, Fin,al GasTest 2 0 Wiring, Final Occupancy � F'orm 27,0 G-H ],5001-55 ZO r� • ' I I ��V I , COSiA MESA BUILDING-SAFETY DEPARTMENT P. O. 60X 917 COBTA MEBA. CALIFORNIA For Applicani fo Fill In Completely TYpE OR PRINT BUILDING � ADORESS � � CR' COSTA MESA. CALIFORNIA IYIAIL Q� ' \�Ll � �v ADDRES6 . TEL. an��et�ryia„cia:.� MWQ1 No.�_�R'_C= ARCHITECf TEL. —� ��— TE�. NO. � L X %r` /G NO. OF BLUGB. ■ SETBACI( LINE FROM / r I RIGHT � �N OF WORK BUILDING NO. OF SIZE ROOMS STOF EXTERIOR WALL ROOF COVERING COVERING U6E OP 9UILDING AND WPRK TO BE PERFORMED "'i H6R8BY AGKNOWLEDaH THAT 1 XAVE RlAD THIB MPLICATION •ND BTATE THAT TH6 ABtlVE 18 CORRECT AND AGREE TO COM- PLY WITX AlL CITY ORDINANCE6 AN� 9TAT6 LAW9 RE6ULATINO BUILDINO CONBTRUCT�ON. SIGNATURE OF� _. . 4 O I e D. aurHoaaeo FEE RECEIVED SEP 1'/ 1�1� FINANCE DEPT. APP�iV�t�G�� IT suaDtN� For Offiee Use Only P6GEIPl NO. PERMIT NO. COSTA MESA. CALIFORNIA FIRE ZONE APPROVED ZONING " ZONE NO. OF U8¢ OF NEW 11 � � I PI.�NS Z BUILDING �{�Q LEGAL / ../ � ^J�/ DESCRIPT�ON LY�T C « A. P. NO. � � //� — �� YARDS EVES ' APPROVED ALLOWED � (GCNTlRL 68T.)[ -� E,�UII-0r FRONT �"' � / � __ . .�-. I"' . . 1 1 / � FT. (� FT. „ ..._� 9/. THE AMOUNT �BXOWN UNDER VALUATION 16 POR TNE POqPOBE OF EeTABLIBHING A PERMIT FEE ONLY. VALUATION PERMIT FEE $ G S/ E�lJI � PLAN CHECK $ (f//(/ �j� � J TOTAL FEE $ t!/ � � - ' ! 02 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MESA. CALIFORNIA For Applicanf to Fill In Completely TYPE OR PRINT BUILDING /� ADDRE59 '�� '� ' �: COSTA MESA CALIFORNIA :Y�i� �I�� I!�i/ii � TEL. 8 d. 5� n 7a,1 /� �"e. o�Na��Ta. ew SETBACK 4�Ne FAOM � O� REAR VARD .0 C6NTER OF e'�e6T SIDE YARD I LEFT -� I RIGHT � I DESCRIPTION OF WORK NO. OF � / ROOMS � �n STORIES ■ USE OF �EE RECEIVED AUG 24 1�2 APPL I CABT� D' FY`lR��'[, E� ING � For Office Use Only NECEIPT NO. _P,p�gf�{�,T_NO. AOORESSOS�i�J�/l.C/i"� i f' COSTA MESA. CALIFORNIA FIRE �ecw� YARDS APPROVED ICENT¢R LINE ZONING � � NO. OF I UBE OF NEW � PLpNB Y BUILDING ��,�� aT� . ,T � �-� G Z— � b�- -� / / / — ! / EVES ALLOWE� TJ 52'�T. o„riu �a. Q �� IN. 2S FT. �i— IN. � � �.9,r��T�N. '�� -1-�-� `l--Y �.y.lw.wr nnTe � • �t%izri S-�� I HER¢BY CNNOWLEDOE THAT I HAVE READ TH19 APPLIGTION THE�AMOUNT BXOWN UNOER VqLUPTION IB FOW TX¢ ANO BTAT THAT TX6 ABOVE I6 GORR¢CT ANO AGREE TO COM- PLY WITH ALL CITY OFUINANCEe AND 8TAT8 I�1W8'PEOULATINO PYFP08E OP E9TABL�6HING M1 PERMR FEE ONLY. eU1LCINtl CONeTfNCT�oN. � VALUATION � SIGNATURE OF � PERMI7 FEE $� PERMITTE � y � . • $J` /^l � PLAN GHECK $ AUTHORI=EO AGENT j V �/ TOTAL FEE . Cqs�, Mesa Bailding I)epartment �' 111 EAST 20th BTREET ' � ,�-/ COSTA MESA. CALIFORNIA � FOR APPLICANT TO FII.L IN ndare� 2�5 Camellia Lane Costa Mesa, California Nearest & �'an�e AVe. Cross St 215t St. n,dd�ess 419 E. 17th St. or Carlson & Contractor Dike & Colegrove Nor "°' 27�7 nddress �9 E. 17th St., Costa Mesa Legai I Lot I Description No. g I Block I Tract 256< (Attach Metes and Bounds) Na. of Bldgs Size of Lot SZ, 5� x 71+.1� I Now on Lot none Useof No•of No.oT 1 Existing Bldg. riOriO I Familiesl Rooma � Setback Line from Rear Vard32, 5 Centerof Strcet 5�� Side Yard Q_ l� r ft. Rooms � Stories 1 APPLICATION FOR PERMIT �6 BUILDiNG ' FOR OFFICE USE ONLY - •Receipt No. Permit N� �/ �i � Received by Date Rec'd. Date Issui - ��P ��- i _ c� ,�_,�_ Costa Mesa, California Nearest Cross S!. Plans txterlor wall Roof Covering Fr Stucco CoveYing Com . APPROVALS Use oT New Building Sin le Fami.l Resiaence & garaoe Foundation Location insPector Forms, Materials, Under-Pinning p� 27A Frame: Fire Stops, Bracfng, Bolts I hereby acknowledge that I have read this Application and state that the above is rnrrect and agree to comply Lath. Int with all City Ordinances and State Laws regulating . building construction. �ath. Ext. Signature of � Permittee Dike and Cole rove Plaster, int. Authorized Agt. � („i ' plaster, Ext Valu,ation Permit Kee $ o o• Masonry Reinforoed Plan Check $ �J � �%'� � gond Beam s 8500.00 roca� A-n Fee $ �� V FINAL DaRe � ��