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HomeMy WebLinkAbout2038 CAPELLA CT - Building Permits N' ADURESSOPSmLmNO: 2038 N CAPELLA CT WMT: CITY OF COSTA MESA - BUILDING PERMII OWNER'SNAME IF KNOWN: CAMPBELL( WILLIAM T FLOOD : AE-46 PERM NO: B 08462( ..s. looms: 2038 N CAPELLA CT COSTA MESA,CA 92626 PERMIT NO: B 084620 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MMUNG ADORESR CONSTRUCTION TYPE: V-N PERMIT TYPE: SIR PURPOSE: OTH ARCHITECT OR ENGINEER: arc.NO.: JOB DESCRIPTION : T/0 EXISTING ROOF INSTALL COMP SHINGLES SQ FT: 5, 600 ARCH OR ERG'S ADORERS: UM: CLAIM VALUE: 5, 600 . 00 CALL-VALUE: 5, 600 . 00 GROUP GCC: R-3 /U-1 caDneclar5NAia: W GANN ROOFING ( 909 ) 923-1124 CONTRACTORS MMlgiG 1625 BANYAN CT COMMENTS : X ADDREss ONTARIO CA ue.No.: 656030 if if3i3i3i3i3i3i3i3i3i3i3i3iii3i3i3i3r3i3i3i3iifiiii3i36iriiii3i3iiiii3iii3iiiiiiiii#ii3i3fitititiiif-3i3E3i3i3i3i3iw3iiiiibfir3i3i3i it•ifiri4icieiEri*ie3i 91761 um ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I em licensed under provisions of Chapter S SETBACKS (commencing with Section 1000)of Diviscn 3 d the Business end Professions Code.and my License is in lull lace and effect. CRT UC.NO.: uc.cuss: C39 uc.No.: 656030 EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dafty g-S -S7 Contractor: ,t - LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN O BUIfor the greaLn1(SDECLARATION:I hereby SedisnlO31.5 Busima end Prosffirm under essi ns Code:nakyof that I am•• •. whichhmgtesMpermi to=struck atLicense ter.improve, PARKING REQ: PROV: PARCEL : 13940202 ZNE: REF NO: demolish or repair any structure,prior to its issuance.also requires I .applicant for such permit to Ne a signed statement that he or she PLANNING NOTES>. 's licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7003)of Division 3 of the .,> ramose end Professions Codel or that he or she is exempt therefrom and the boas for the alleged exemption.My violation et Section / J31,5 by any applicant fore permit subjects the applicant to a chit penaltyor of nmore than free hundred dollars(SSCOD. *3i***ii******i *t�••**ii****3i**ie*****3333**3i9i******9i***********€i*5i3i 4*iiiijiliifiFi�-tiiiiiiieiini*** ElLaoownerel the property or my employees with wages as their sole compensation,will do the work.and theebtwtireenmiderded D E V E L O P M E N T SERVICES REQUIREMENTS or offered for sale(Section 7044.Business end Professions Code:The Contractors License Law does not apply to en armed property who buids or improves(hereon,end who does such work himself or hersel or through his or her own employees.provided that such improvements ere red intended aoffered foreele.U.however.the building oinprovernerfo sold within ono year of completion.the ZONING APPROVED BY DATE: owner-builder vial have the burden of proving he Or she did nor build or'improve for the Pansies of cab). ❑ I.es ownerd the property.amexth y cotradkq with licensed contractors tocanmw the project(Sadsm 7044•Business end BUILDING APPROVED BY : / DATE : m Profeon s Code:The Contractors License Law does not apply to an owner d property wd bolds or inaneOwnern end who contracts for ouch projects wiNamarxta(e)licensed pursuant to the Contractors License Lex). APPLICATION ISSUED BY ' rl/ / , �'�{ DATE: _Gf / ❑ Ism exempt oder Section: B.AP.C..ler this reason: i************3i3w jr..tf**st**ii-t*it sttx it V. tvxtrrr It..Rtefte xsr*sr*3e it oi3rar+t m+iifiiiiiiiiiiiiiiii fire on-tote it no rtfriirt Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,Pawn.and 25534.and that I or any future building occupant will/will not(circle one)need to comply with said suite codes and the requirements kr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modification from NeAiQuabty Management Distrix.Residential construction applications ere exempt from those PERMIT 112 . 25 provisions. . 56 Date. Applicant: PLAN SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedarmions: ISSUE FEE ❑ Ihave and wMmaintain acertificate of consent toself-insure brwvken'compensation,esprovidedlet bWtm Se3TeeoftheLeber BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the penamancedrework faweichtispemmis issued. TOTALS----> 112 . 81 0 . 00 0 . 00 112 . 81 112 . 81 . 00 Ui I have end vel maintain workers'compensation insurance,as required by Section 3703 of the Labor Code.for the performance ofthe re work which this permit is issued.My workers'compensation insurance carder dhry and pmamba ere: REVENUE DIVISION TOTALS--> COLLECTED: 112 . 81 OVER/SHORT: . 00 Carney policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed f the pennk is for one hundred dollars/51001 or less) 112 . 25 . 56 ❑ I caddy that in the performance of the work for which this permit is issued,I shall not employ any penton in any manner oro as to become subjed to the workers'compensation laws d Cddan' and agree that H I Mount become subjed to the workers' ********3i ii*iiii*ii*********sr-lir*ii******iiiiit*****w***Oeiin,t*******iris**3i*iiiiiiii******:riii:,vr ��jo"m�peneation provisions of Section 3700 of the Labor Code,l Mall h pity with those provisions.• I N D I V I D U A L F E E B R E A K D U W N g:Failunroescurs workers'compensation coverage is unlawful,and stall subject an employenrocrlMnaf p.r,aldes and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines rpt to one hundred thousand dollars/5100,000),N add/don to the Cost of compensation,damages es Provided ler In Sectlon3706 of the Labor Code,Interest,andafromey'a fees. SFR 5600 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 600 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097.Cb.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application end date that the above information is correct.I agree to comply with all dry and county ordinances and state laws relating to bddng construction and hereby authorize representatives of the day la enter upon the above'mremcned properly for inspection purposes. 09-09-1997/01:56 PR/$112.81 N � KCP70:b1-3316310 Air _ AI/ _ —..s.--..-- D...: C -FZ PERMIT:084620 Signature• Owner/Agent/A..... • rector (5151<6.WP) White-Buleig A Safely;Green-File:Ca nasy-Applunt:Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL .,PA APPROVALS Permit# Date Inspector 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 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 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, ❑ 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 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 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing q_jB-q7 .�4, 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: 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. Backf low Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING )bp�/77,'� ("- /- 48. FINAL PLANNING ��CC 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P MIT NO. TRACT NO... _I .--1�OT NO. BLDG.NO. 5. BO 3/1 /p'9 5.00 TI., CONSTRUCTION PERMIT P-//..5-7 / r Project Address +zh'§c' N' AP/t�-L+4' TYPE OF CONSTRUCTION LI NEW LI ADD ❑ ALTERATION LI REPAIR - - ' - Applicant's Mailing Address ^ �r,�i�y/7//5s;.5-3`0-57%/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone GAfrPi LL 'JO' PhOT¢44'2-9fl DESCRIPTION OF WORK Owner's Name / S Main Building: Accessory Building: Z Address u'7E�hY/- •.j ,A-Pri+-LAE TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑.STRUCTURAL T Front N • Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear Address 1� /s {�y1 •/1 ❑ OTHER A N Contractor's NampX /'' ` ` 'likiej 7 Ph?e�l5*7-5?/P PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Address(mailing) /70/ .S ' ��RRi}7X.:J A7Y7r 471/�f/%�'TO j CONSTRUCTION TYPE VALUATION $ S Left R 2 p E . City License No.X - l 0 P� ZONE GRADING CU.YDS. ACRES Ping. Ref.# 'Park.Fees $ G U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Buslne ofessions Code,and Use of Building: _ E my licensels In full fo ce and of ect. License Clas i -a ii: il. 0 PLUMBING FEES Planning Notes: • E Oate / - Signature _Mr N WORKERS'COMPENSATION DEC •?' f Bar Sink Showers T ' hereby affirm that I have a certificate of consen to self sure or a certificate Backflow Preventer Service Sink S ' Workers' Compensation Insurance, or a certified opy ther-of (Section _ .800, Lab. C.) i Backflow irrigation Sewer Cap ELECTRICAL FEES Policy Nogg-70—f..515 - Company -✓y (ti*�`�- ertified copy is hereby furnished. � / Bathtubs Sewer Connection Automatic Washer' Transformer 0 15-50 KW Certs le c p is filed with the city Builtlin• 0 50+KW Date /i�X//` Applican .417.4(-_-.'' _A Clarifiers Solar Collectors Construction PoleSub. EXEMPT(ON FROM WORKERS'.C•MPENSATION a sir.. ' Dishwasher Solar Piping CookingUnit Meter ❑u to 100 ampi (This section need not be completed if the permit is f• on- ndred ($100)orP P less). certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank Dishwasher ,` Meter Dover 100 amps shall not employ any person in any manner so as to become subject to the - Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Signature — NOTICE: If,after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors 1:10-1 HP 01%-8_ Workers' Compensation provisions of the Labor Code, you must forthwith - comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets /.(cater Closet CONSTRUCTION LENDING AGENCY di90 F.A.U. Inc.Solar 09-15 HP 015-15+ I hereby affirm that there is a construction lending agency for the performance Interceptors _Water Heater Fixtures -Microwave of the work for which this permit Is'issued (Section 3097 Civ. C.) - Lender's Name - Kitchen Sink ' Water Service Device Boxes Pole Light Lender's Address ' Lavatories OWNER BUILDER DECLARATION • Outlets Range , I hereby affirm that I am exempt from the,Contractor's License Law for the p-Tfa following reason (Section 7031.5 Business and Professional Code: Any city or p - Switches Sign 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 Roof Drains' Garbage Disposal Standing Sections 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)ofGenerator ❑O-5 KW ❑5-15 KW Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exempt P herefrom and the basis forthe alleged exemption. Any violation of Section /031.5 by any applicant for a permit subjects the applicant to a civil 3 penalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee $ LI I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 ' Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered FEES for sale (Section 7044, Business and Professional Code: The Contractor's - - PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate employees, provided that such improvements are not intended or offered for Canopy Type II 0 ' sale. If, however, the buildingor improvement is sold within oneyear of com- Duct-Under Ground Application Approved ' pletlon, p pp By Date orove.f r h owner se have the burden of proving he/she did not build or Im- Crove.foi the purpose of sale). Duct-Structural Refrigeration System ' Application Issued By Oat: � I,as owner of the property, am exclusively contracting with licensed con- ❑4100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License-Law does not apply to an owner of property who BUILDING PERMIT $ SMIP builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration $ _ tractor(s) license pursuant to the Contractor's License Law). • PLAN CHECK $ - PERMIT ❑ lam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# PLUMBING $ b-' l]P ISSUANCE $ Date qwner Heating System&Ducting PLAN CHECK ' $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BTL—� ELECTRICAL $ GRADING $ information is correct. I agree to i. • with all city and county ordinances and state laws relating to Id' g consbr a tion,and hereby authorize repre- - PLAN CHECK $ MICROFILM $ sentatives of this cit -r upon�Pe abve-mentioned property for Inspection purposes. A - l Signature A �� Reinspection Fee -$25 Issue Fee $ 3 PLAN CHECK $ eumw. CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - -- - CONSTRUCTION AND PLANNING POOL ,,.SPA APPROVALS Permit# PI 1611 Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole, • J 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -. 53. Steel Reinforcement 3.`Electrical Conduit Utility-Undrgrrid. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.•Electrical UFER Grnd. i 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, ❑ 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 14. Rougt(,:plumbing 4 • .. • 65. Electrical-Final J 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 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test _ .7.2. Underground Flush 24. Roof Framing '73. Undergrnd.Storage Tank 0 Gas 0 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 PREY. 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: Ho .LJowrt -37/5/d"f sie 34. Final Heating & Air Conditioning No ase I-lo, - c rr CARA5- k/t(/:`Y C 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing y//' / CIO 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-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. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date FEE RECEIVED : r 16540 U! MAR 2 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT fl FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COS1A MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING Gor!;a regeir-4 f - y ADDRESS a 03 North Cve//a Co4v7' COSTA MESA. CALIFORNIA For Office Use Only � /� RECEIPT NO. PERMIT NO.. OWNER /'�/%Pei r-7-45e, P1/,s 16540 AMAIL DDRESS/ /J / e- <" G RECEI�/E.D BY I t----• ••--/ � f.RM F4 I66U 62 cry %4r/A' Mf=fg . (39L/f= NO,.'/0^5/1: ADDRESS` 1 111 OR C ITENEEERF•9/,�//.. etaragei1if Noo�f\c 7Qc 99 COSTA MESA. CALIFORNIA ((/� �[/. ADDRESS 9/ 7/J /i creii-rf rl✓6it - /7 /AHC/M ZORNE TYPE K GROUP t Y, CONTRACTOR AMID ,eo 5 LINO a. APPROVED BY DATE ADDRESS /6s-.2 Ali ith5e'aiiilie. ZONING O //•/ r� �,/ ! -,/ ZONE NO.OF USE OF NEW Sn9 >+y../PA4 CITY V'S'r// /i f9�lJ.�/` RSI I PLANE I BUILDING 4.,/,‘77- 9S F. LEGAL LICNO. /87/ GG TEL.NO. ♦ Lo1` 3o r? W3y9 /! 90 39r DESCRIPTION SIZE ��JJ NO. OF BLDGS. OF LOT /O X /00 NOW ON LOT A///LG A.P.NO. USE OF YARDS EVES EXISTING BLDG ._ _. APPROVED ALLOWED SETBACK LINE FROM r 3 z (CENTER LINE ST.) •7 CENTER or STREET 0 REAR YARD FRONT -SQ FT. _� IN. SIDE YARD I LEFT I RIGHT S R.SIDE S FT. IN. DESCRIPTION OF WORK — L.BIDE S FT. IN. 11 NEW I/`�[/�.IALTERATION I II ADDITION I REAR 3a- FT. IN. REPAIR I II MOVING I II DEMOLISH I APPROVED LU V o�n DATE a//6/G I-. SIZEDINO /4 9 4 ROOMS STORIES / /V /1 !� EXTERIOR WALL A00Ch 1 ROOF WOOD er I COVERING 577/17ac COVERING .540/9 i$ I'Ic♦J�Cl USE OF BUILDING AND WORK TO BE PERFORMED ' . sr 1-' i A , L= 'jCCC''��� /4A/0 - G7/Vt.//69 � V grim:wed /2r-3 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION `/ S1= - T RE OF c+-. PERMIT FEE $ /r� i : / _ / / s/b 48/- PLAN CHECK $ / 7f.� ♦=JK)\ 'ORIZED AGE T // N, TOTAL FEE 5 cT .�I / ' 21326 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JAN it 1954 P.O.BOX 917 COSTA MESA.CALIFORNIA FINANCE DEPT. N , For Applicant to Fill In Completely APZIE.41OcPSTt WAIT TYPE OR PRINT BUILDING For Officej Use Only BUILDING )% ]] ,] `' /� l� ADDRESS- O_, i .A/ • ` Np£Lt.4 CtC(Rid- RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA /�t/f �/ 6.?/-3 22,6 {'}�� �/ n Ott /A—/ rI a/ ,Dy'✓SD67 OWNER Dep�T4LU E y"tRR//v BUILDING o �(�6 MAIL n} AA,, N ADDRESS 203 O "' ���� ADDRESS ,.J(_1 � T/ 'y• ` /S(�C.4-1-si CuUrLf CITY Cp,)I/j rhe.5/a NOFIRE TE. ..r4,4 i5 ' APZONE /J TYPE f GROUP/ jI ARCHITECT TEL. BYPROVE / jam DATE ( /CJ �� OR ENGINEER NQ. ZONING , A ADDRESS A / I 1 �O�[ NO.OF USH OR NEW in i,C I / PLANS BUILDING CONTRACTOR 'J A.L�I� 11 LEGAL 1 1 coT/� �1I, 9 DESCRIPTION / 0 [ c `� 1 b 1 W / ADDRESS .) L CITY A.P.NO. , -t L O d-. - a - NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TELSO*TO SIDE @ REAR P.L LIC.NO. NO. EAVES SIZE NO.OF BLDGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT 70x / co NOW ON LOT / YARDS APPROVED YARDS APPROVED USE OF /� MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. I / it'C l..U/ Al g (FROM C/L STREET) SOM 3 (./ 3 FRONT FT. I.1. CENETBACKTER OF SLINE FRTREET REAR YARD •.S -T SIDE YARD LEFT _} RIGHT IR.SIDE FT. FT. .7 // DESCRIPTION,.EOF WORK L.SIDE FT. --Fr-- NEW _ /� ALTERATION _ ADDITION REAR FT. FT. •J l/ DISTANCE BET. BET.MAIN a REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING NO.OF VAR..jt DATE BUILDING SIZEXTROOMS STORIES APP OVE (J/� APPRO7( / 3 % CXTERIOR WALL I ROOF BYPROVED ^Jf�n�FL/lA COVERING COVERING BY USE)OF BUILDING AND WORK TO BE PERFORMED 8LDctc lc�cj)414UL.s I HEREBY ACKNOWLEDGE THAT I HAV READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Z AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATI.O VALUATION BUILDING CONSTRUCT!DTI. O SIGNATURE OF I}1lV /, . ge PERMIT FEE a PERMITTER (mV� •' 32 ----- - O ses AUTHORIZED AGENT W TOTAL FEE $ FEE RECEIVED 22453 JUN 1 2 1984 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING �ADDRaSso4- 6 4 ' For Office Use Only EUILO9Z 3F (-�' i / 4 I RECEIPT NO. PERMIT NO. COSTA MESA. eALIFORNIA n a 1453 _ ` _/ RECE�ED BY DAYS RECEIVED r� _DATE MS EDED / /7 64z OWNER POW 44/241./If -2e3 `�z� l'�/a7/i (A 152�� ADDRE S /` MAIL ADDRESS ADDRESS an FIRE CITY (J� TEL.NO. ZONE TYP GROUP .� APPROVE�..,/�% )/J ARCHITECT T �i TEL. BY '/ DATE OR ENGINE �/ (ly'F NO. 8 7,'?7 / ZONING ADDRES /�/17m/1' ZONB{/(� OF I n de �� 7\ I PLANSNO.OF I BUILDING NEW CONTRACTOR AR ,/1/Gb/ N[ LEGAL ` T Q �/.�[ DESCRIPTION ✓� 1 I ADDRESS/33D mac, if;72 T (� �7 /L.oS I�/� /^7+K./P S A.P.NO. / a 9-- L eD ,?-• CITY / STATE 6NEOL. � 30'TO SIDE@REAR P. NOTE: H LN68HALL BE LESS THAN LIC.NO./?o7 7// r3-3S7 SIZE K V�,Bq� EAVES OF LOT / -V I NO.OF BLOCS. NOW ON LOT ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF I. MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. . _ S (FROM C/L STRE T SETBACK LINE FROM FRONT -.f ill.• FT. CENTER OF STREET REAR YARD SIDE YARD LEFT I RIGHT R.SIDEFT. FT. DESCRIPTION OF WORK L.SIDE/ h FT. FT. -70 NEW ALTERATION _ ADDITION •�." REAR FT. FT. DISTANCE BET. BET.MAIN ft REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDINGNO.OP VAR.# DATE SIZE /2 ROOMS STORIES C.U.P.S APPROVED EXTERIOR WALL w, ROOF APFPWVE•La".COVERING 'Ye I COVERING UBY WI• / ( . DATE & - / USE OF BUILDING AND WORK TO BE PERFORMED r- ' . u r. • CA- Ctd2- N -3 0 O SQ.FT. B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE I8 CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION B' BUILDING CONST ION. PERMIT FEE $ p 9SIGNATURE (/''yy /�� D PERMITTEF y CO A9 J V F /. l �/J/J $ `Z0O PLAN CHECK $ o AUTHORIZED AGENT (Jup. W'--"tCQ/ / �A� 1' JO \ TOTAL FEE $ /