HomeMy WebLinkAbout3020 BUCHANAN WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.��LDING PERMIT n FAIR �RIVE, GOSTA MESA, GA 92626
Jobnddress: 3020 BUCHANAN WY
Suite:
Viciniry:
Parcel Number: 14114125
Applicant: SHEATZ, JOHN
Address: 2129 N.PINE ST
ORANGE,CA
Owner: BRANNICK, WILLIAM L
Address 3020 BUCHANAN WAY
COSTA MESA, CA
Contractor: THE ROOF GUY
Address: 2129 N.PINE ST
ORANGE,CA
Zip: 92865
Arch :
Address:
Zoning:
Phone: 714-921-1500
Zip: 92865
Phone:
Zip: 92626
Phone: 714-921-1500
License: 638593
Eng:
Address:
Phone:
ISSUED BY:
Slatus: ISSUED
Applied: 04/04/2003
Issued: 04/04/2003
Phone:
Zip: License: License:
SCOPE OF PERMIT
REMOVE EXISTING COMP ROOF. INSTALL 30 YEAR COMP OVER EXISTING SHEATHING. INCLUDES ATTACHED GARAGE.
Plan Check: $0.00
Permit: $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAINSTRUCTURE Fronl 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Lek 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0
sa,000.00
sa,000.00
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, § 7, 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
requirad Inspactlona and finel approval must 6e obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (7/4) 7545626
taa6�ae �aroo7
WORKERS'COMPENSATON DECLARAnON: �
I hereDy eRirm Vnder penalry of perjury one ot the following declaratlons:
❑ I heve end wlll maintain a cenifiwte of wnsent to sell�lnsure lar workers' compensation, as Drovidetl for by section 3700 of the Wbor Cotle, lar Ihe peAarmance oi ihe
wark tor w�kh Ihis pertnit is issuetl.
�
hava end will main(ain wo penseC� ms es repuiretl saction 3700 of Ihe Labor Code, for the pedortnanCe of the work tor which this pertnit is issued.
My workers' camp�nsatl n �qr end pollcy u her are: �
Cartier. �� i� , Polity Number.
(This secNon need not be cromple(etl il fhe permit is v ued a! e hundre dollars ($100J oi less.)
❑ I cenily thet in ihe perfortnence of the work tor w�ich this permit is issue0, I shall not employ any person in any manner so as to bewme subjact to ihe workers'
comp Ynsellon lew P� mia, antl a�hat ii I.ahoultl become subJect to ihe workers' compensation provislons ot Se� tipn����abor Code, I shall fort�with
com I wi�h these rovi AU/' t�� �
Applicent Signature: ____�= e� �� Date: ��f I
WARNINp: FAILUPE TO SECORE WORK6AS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUflIECT NN EMP�OYER TO CRIMINAL P NALTIES AND CIVIL FlNES UP TOONE HUNORED
TFIOUSAND OOLLARE ($100,000), IN AODITION TO THE COST OF fAMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR CADE, INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eNirm Idet .a ed _ �ns of Chapter 9(wmmencing with Section 7000) ol Divlslon 3 of the Business antl Protessions Code, and my license is in tull
�
force end ettecL Lia k �I Cless N
Cantracbfs Sig�eture: Date: �% i��
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirtn ihat ihere is a construction lentling agency tor Ihe peAortnance of ihe work for w�ich this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name: Lendar's Adaress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettlrm tnat under penalry oi per�ury Ihet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW lor ihe following reason (Sec. 7031.5, 8usiness and Professlons
Code: Any city or counry which reQuires a permit to construct, alter, improve, demolish, or repair any simcture, prior to its issuance, elso requlres the epplicent for such permit
to lile e siqned gietement Ihat he or she Is Ilcensea pursuant to tha provisions of tha Contractors IJcense Lew (Chapter B(wmmencing with SecNon 7000) oi DlWsion 3 ot the
Business entl PlafeSslonS Cade) or that �e or she 19 exempt therefrom and the ha5is lor the elleged ezemption. Any vloletion of Section 7031.5 by eny applicanl tor e pertnit
subjects Ihe epplicent m a civil penelry ot not more than five hundred tlollars (5500).):
❑ I, es owne� of Iha property, or my employees with wages as t�elr sole compensation, WILL DO THE WORK, and Iha sWCWre is not intendetl or otteretl for sale (Sec.
7044, Business and Professions Coda: The Coniractors License Law does not apply to an owner oi property who builtls or improves t�ereon, entl w�o does such work
himsalt or herself or through his or her own employees, provideOlhat such improvemenis are not Intended or oflered tor sale. If, however, Iha builtling or improvement is
sold within ona year of completion, the owner-bulltler wlll have the burden of proving that ha or she did not build or improve for purpose of sale.). �
❑ I, as ownet of the property, am EXCLUSIVELY CONTRACTNG WITF1 LICENSED CONTRALTORS to consiruct the project (Sec. 7044, Busineu and Professions
Cotle: 7Te ���ractors Licensa Law tloes not apply to an owner of pmperty who Dullds or Improves ihereon, entl w�o contracts tor such project with e contraaor(s)
license pu/suent to the Contrectors License Laws.).
❑ I am exemp� under sec. Busines5 and Professions Code lor this reason:
Signature: Date:
Owner ID ventietl Dy tldver5licen5e. ❑ Yes ❑ No Drivefs License Na,
Vedficatlon ol Ownership by (type oi documenL i.e. - property tax bill or deetl): _
DIVISION OF INDUSTRIAIL SAFE7Y PERMI7 CERTIFICA710N:
Expires'.
❑ I hereby cehity ihat no ezcavetion five (5) or more feet in depih into which e person is required to dascenq wlll ba metla in connection with work euthorized by ihis
permit, and that no building siructure, SwHolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Atl 2, Sec.
341, Title 9. Califomia Adminisirative Code).
❑ As owner-pullder, I will nol employ enyone lo do work which would require e permit trom the Division ol Intlustrial Safety, as noted ebove, unless 5uch person has e
pertnit to do such work from the tliNsion.
Siqneture: Date:
Division of Indus��al Safery Partnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTMORVJ1710N OF EMRY: I certify under penalry ot perjury that I have read this application an0 siate ihat the infortnation given is
corcect I egree tP comply with all state laws end clry ordinences relating to Cullding construction, end authorize representative5 ot Ihe City ol Costa Mese to enter upon Ihe
above-described p�aperty far inspection purp0.5es. I egree not to occupy or allow occupency of eny building euthonzed by this permit until final inspactian.
/
____ ���o����- � V-� c� �a�a
���
r Authorized Applicem ate
COUE �. INSPECTIONTYPE
1616 Fixed System Finel Fire Prevention
1266 Pool Spa Final
200 Finel Re'Rooi
201 Final BIak�Retaining Well
202 Final Factory Fire Place
203 FInalSign
204 Finel Demolition
P6g I[+�I1SLfl
�11-03 �
LOOEI INSPECTIONTYPE �
206 Finel Mechanical
208 Final Plumbing
210 Final Elecirical
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
QdiE INTITWLS
�
Pfl0.1ECT RODNESS: 3O Z O HUCHANAN �WY uxir:
OWNEfl'SNRME: BRANNICK WILLIF,FI L
nooxEss: 3020 HUC{iANAN WAY
COSTA MESA,CA 92626
(714)549-1290
AHCHIENGINEEH: C, j( , pI,LEN JR , flEG.NO.: 1 8 Z 3
aooxess: 1967 ROSEMARYPLACE UNIT:
renminee: W�ILLIAMEBRANNICIC CA 926 ( 714 ) 549-1290
aooness: 3020 BUCHANAN WAY
COSTA MESA CA 92626
LICENSEO CONTHFCTOfl DECLAflRTION: I �ereby a��irm Ihat I am licensetl under provisions of ChaO�er 9(commencing wiih Sec�ion
7000) ol �iuision 3 0� ��e Busines5 and Professians Cotle. antl my license is in �ull force and efiec�.
CITY LIC.: STFTE LIC.: CIASS:
�a�e'. Signamre:
WOflNEflS' COMPENSATION UECU1PpT10N: I herehy aflirm �hat I have a ceni�ica�e o� consen� �o sel6insure or a certitica�e oI WOBers'
Compensaiian Insurance. or a ceriilied copy �hereo� (Section 3800. LaD. C�.
POLICV NO.: E%P. OpTE:
'OMPPNY:
J Ce�ilie0 copy is here�y �umished. ❑ Ce�ifietl topy is �iled with �he city Builtling �ivision.
Date: Applicant:
EXEMPTION FflOM WOflNENS' COMPENSpTION OECIAflATION: (ihis sec�ion nee0 noi be cample�ea ii Ne permi� is �or one hundred (S1W) or less).
I cetlity ��ai in Ihe perlormance o� the waB tar which Ihis permi� is issue4 lyeyl no� emDloy any person ay-n � so as lo �ecome
Subjeti lo Ihe Work¢rs' COmpenSa�ion Laws Of Califomi�� � �
oa�e: $- Ig- �j3 s��;;� /� ��
NOTICE: I�. al�er making ihis declaralion, you sho�ltl bec e ublec� to �he Workers' Ca nsa�ion pwvisio of �he Lallor
CoCe. yau must forihwith comply wiih suc� pmvisions or I 5 permi� shall be tleemed revoke .
CONSTBIICTION LEN�ING RCENCV: I hereby ailirm �ha� there is a conSVuction lentling agency for �he Dedormance ol ��e work �or
w�ich ��is permil is issueA (Sec�ion 3097. Civ. C�.
LENOEP:
aooeEss:
OWNEfl BUILOEP OECUBATION: I �ere�y aHirm tha� I am exemp� �mm t�e Contracrors' State License Law �or ��e lollowing reason
(Seclion 7031.5 Business anE Pmiessionat Cotle: Nny ciry a� counry which requires a permit to cons(mc�, alter, impmve, demolish, or
repair any Slmciure, prior Io iis issuance. aiso re0uire5 ihe apPlican� tor such permit to lile a signe0 staiement tha� he/she is licensetl
pursuam to ihe pmvisions af ihe Coniractors' S�a�e License Law �Chapler 9(tommencing with Sec�ion 7000) o� �ivision 3 0� the Business
anU Pmlessions CoOe) or Ihal he/she is exempt Ihere�mm antl the 6asis for ��e allege0 exemption. Any viola�ion of Section 703L5 by
any apDlitanifor a permit SUbj¢Cts �he aDPlitanl �o a tivil penalry Oi nol more Ihan �ive huntlreA d011ar5 (5500�.
I, as owner of ine o�operty or my employees with wages as iheir sole tomoensation, will Oo ihe work, antl tne
❑ slmciure is no� in�en0ed or ollered tor sale (Section 7044, Business and Pmfessional Cotle: The Cantractors' Sla�e License Law
Ooes noi aDDly lo an owner o� a pmperty who builtls or Improves therean, and who tloes su[h work �imsel�/hersel� or lhmup�
his or �er own ¢mployees. pmvidea Ihai such improvemenis are not intendeU or offeretl for sale. I�, however ��e builUing or
impmvemenl fs soltl vn��in ane year oi complelion, �he owner will have �he burAen of proving he/she ditl noi bui10 or impmve
lor Ine Durpose of sale).
I, as owner af Ihe O�opetlY. am excNsively conlraciing wiih licensetl conVac�ors Io cons�mc� ihe pmle�� (,Section 7044, Business
❑ ana Pmlessions Cotle: The Contracmrs' State License Law does not aOPN �o an owner ol pmperry who Gmlds or impmves tAereon
antl w�o coniracis lor such Owlac�s with a contrac�oqs�license Dursuan� to the Contrac�ors State License Law),I am aware
Ihal D�ool ol I�eir Worker'S CompenSalion insurance shoultl b¢ pmvided to me.
[jS � am exempi under Senion: HP7Q4 4 B. 8 P. C.
m� mis �easo�: BY OWNER S FAMIL
Oaie�, � � � ' g� Own
I tlo hereby cenily Ihat I am aware ol and un4erstan0 ihe reQuirements oi Calitor w Health ane Safery Cod � 5. 25533, and
25594 and that I or any luture �uiltling occupant will/will nat (circle one� nee0 �o compty with 5ai0 state cotles antl the requiremenis tor a
permil lor conslmclion or motlihca�ion irom Ihe Nir Oualiry Managemenl Oistricl. FesiOential constmc�ion ap0lication5 are eeemp� imm
ihese pmvisians.
�ate: FpplicanL
I here6y ceriify Ua� I have rea0 ��is aDPlica�ion and s�ate �hat Ihe abave iniormation is corre mply wilh all ciry antl counly
artlinance5and51alelaw5rela�ing�obuiltlingcon5lmc�ionandhereby�aN�jo�'�presentaf ofthiscily Ma on�heabove�mentionea
pmp¢r�y lorinspedion purpooses. �,/ �//
—flale'. �� �� ' 13 Signa�ure ���/� 3T�
oriver's License or Social Securiiy a: $
164bC6 White—Butltl'ma�, Green—Code Enlorcemenl', Canary—Aoplsan�; Pink—Revenue', Goldenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO:
PERMIT NO: B 063546 PLAN CHECK NO: 03076-93 S , ;
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION ; AMATEURRADIOANTENNA ON ROOF OF HOUSE SQ FT: 800
CLAIN VALUE: 800.00 CALC—VALUE: B00,00 GROUP OCC: R-3 /
COMMENTS: REFER TO ENGINEERED ROOF MOUNTING DETAILS
**�r�r�e***�e�r*�r��r�r**�r***�e******�r�r�e*�r*�r�*�e*�r�r*�r�r�r�r**�e**x��e**�r*******�r*��r�r*�r�e�rr�r*�*
2 O N I N GS ERTEBQAUCZKRSE M E N T 5
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 14114125 ZNE; R1 REF NO:
PLANNING Nt51'ES> AMATEUR RADIO ANTENNA ON ROOF BEHIND CENTERLINE. HEIGHT OF U
> P TO 45 FT. 2�
� r��e+r�r�r�e****�e�r**�e�r*�r�r�e�e*�r�r�r�r**+e*�r�r�r�t�r***+r�e�e****�r�r**�e*�**�r*+t�r**�e�e+r*+���r+e+r***�r*�e+� �e
D E V E L O P M E N T S E R V I C E S R E(J U I R E M E N:T S
✓ -
ZONING APPROVED HY ��R DATE:•! !
BUILDING APPROVfiD BY : DATE: _gf�s/43
APPLICATION ISSUED BY: ' DATE;� i /
iflfififikikillkifififiFiFifififlfikiFikifiF ififiFifikiFiFiF,ifik ik _'
1t1flt�flf�klFlflf1t1f1t1f1f1tiflkikilMifiFifitifififkikiFitlFikiflflt�F�f�tlkiFikMlf�tltlt kMifkkkMkltMltNit�fiFlflf�l�f.iflf�llffkit�tdf�tlF
LEGALI2ATION;N F E E S U N M A R Y STRUCTURAI;-'SEGMENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIPYRES GRADING
P&RMIT 21.00 ,50
SMIP/NON—RES
ISSUE FEE 13.65
BUILDING—DIV—> PEAMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 21.50 0,00 13.65 35.15 35,15 ,00
REVfiNUE DIVISION TOTALS--> COLLECTED; 35.15 OVER/S ORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT G ING PLAN—CHECK
21.00 .50 13,65
k1f1k1liFlfMlflFklfititkifiFMlFff�tMikiFikfkltif�fiFitMltififlfit�tkif�fiFlF�f�flflfkMlfltlFlflfifltMlflFMifitiFltkif ififfk�F�tifiFMkiflFit
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 800 ALTER HY VALUE RESIDENTIAL .NOZONE 1.00 800,00
END OF FEES
L
Ol 001451&3-00145185 TtJ'T 35.15
DATE: 09/18/93 TItiE: 10:13
CONSTRUCTION AND PLANNiNG PC y SPA
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
.,
o��-�ctr�a���,��-'��iNty-Undrgcnd. � 54. Forms � � �
[.a �. . .
o�. E7gctrical Co'ajWiC�drqrnd. 55. Electrica� Bond�ng '
�'�9.'�'.',q,el ^q ei+� � 56. Rough Plumbing & Pressure Tc�3�
.^.T.(r:d 6i-] ���
=�- 6`' �ctFicr,,,,, �� ��`epd. ; 57. APPflOVAL TO COVER�GU�I� p
i�5-•�- =-
��u.�'rv'bti �=6 aS .i" 58. ElectricalConduibUndrgmd. ^ '. �
_r �. ,
'��.iFoundatiqn � s 59. Gas Pipe, O Undrgrnd., Test a �"
.v�..>Water PipeIlJnd�g?Utd. � 60. Backwash Lines, P-7rap, O Undr9rhd. �
�
H T -.
10'. Structural�loor System 61. APPROVAL TO DECK
11. P=operty Se�er Line;& House Connection 62. Backwash & ReceptorFinal �.
12. Se„Wer Cap _ 1, 63. Heater & Vent-Final ,' .
13. Roof Drainsv ^� � 64. Plumbing System � Final � ''
14. Fough Plurtibf� "O 65. Electrical�Final
15. Rough E�ej' ctri' -Conduit , i 66. Solar SYstem-Final
16. Rough 6tearieANiring 67. Fencing & Access ApProval
17. Rough Wiring�}gn 68. APPflOVED FOR PLASFERING
18. Rough Electri�bT Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Fiough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
.- 7 0` V'HUOI-' 3: k r.. nl
20,-•Aoi'[�h ctooy eplace iicpt �'-� O 5 b'xR.• PPRflVR'L9�rpetmit# �- ���`
r x� x�2 r� Ny Fq. � K �r c:
zt �uFjs, i�st�ct� � [-+E: :cS * •a ^� �-:� n SD�iH t�T� � h'
i. HS # S C7 ��Y. s 70. �iderg H ro
22. DuCDs, Uent�tat�rt�� �dS � �� S�t* r a71, produ dng �i�76t+s C3�Oil
r
23�Ga6'�Pip�+Ro;uqh &'�"est ' Q �' C' '''"' * •" • � ^ �' =�'
�+ i [TJS #[*1 m rC px �� 72. Undergrqt��ttl FF}7b�,�� �r F, o�
24trlio� Ftaming ;qr � F,f. �•c-� �+ p 7� ux A 73AUndergrn2�P.Sto�O'T^nk!,7Gas ❑6il
25. Ro Sfj�athing M'�' � ,v x t*7 .T, O'^�� `-�q'J erhead�'E-lydr ~F"� �`
�: .� C* 6 v x O � n1x # �„P?' � a:
26.� Ceilin (S�Lu ural) "
-Qa/ 9 Rct &�Wecwcoat� � ae t7 !*f> � 757'Dry Chemical ^i +� �-+ b <
.� �,
27!'�Framea d Flashina m ¢ Y '� * x 7�""Qr �ian rr� e�� x S h7 r
6 IL Y CC Cr'. H ' tT ?• l*J x r Y �Q11! H C7 x �-1
S:''La�in Sjdinyjx �i y tz aj s E .� x 77�T FIXED ��Ete]SINAL� � �
�
�'"29. Insulat. `� .-S�y� G S.•'.. �,x �'� k x 7SEFIRE PREV. FI(VAI. x;� x'Y
p-30. Drywal al.hng Sx � O•-r � -� x r � �klEALThirAEPF.; R�EQ�IIREMENT
„�-La , ,�
n31. Plaster $7ow Coet* � �' � , ; ;'� 79�FINAL I�ECT�N � u ' �
M
� 32r.�Electri `c�' Pco�yer g�.t�q-Final� F'F s>�� i; � 80�FOOD C� T FI �(��aTE IS6 E�
334Firfal Etettri� t:'." '� t r.:*; x!n •�` N�e's: Q' "� '� `'�
rN x i 5 k x r, � ii '7 '7 b^, :.c '7 O N�T.
' Y I MF-1 T'..1 ?� F i� " I s ".>
'�`�j34� �FiRT�' H�d[in ,& �S�.C�pditiq �Fl� ns � ' k x ¢; S !"i� * S :J7
35R�irta1 Gas�Pii��TA!`� CG ^.0 �! � � .�y Y.• C7 C'��+ ?7s i!T' s0
x�., eH � �..,-
, .. y* Q �• � r* �; . r; ;.,.
x36.�F1o� orSCanopY,s� � i�c.�; ...a �c n x x g ;;.v r S,r
-37:�.Firi87 FbCtory �irgPlact � S[T' y0 * [*= . � - i i M ~cr
. >. ,c .i� iU
C . .. � � (T: z : : � .J .. a x' ?� - ,c � . ---
p,.r38GFln@) PlLmbin9 �.� �v i ��D a: r x S ,-1 ?� 'u1 O
CJ39cWaier Smvice-FiRak �� i 2�x � x r; r, wr�7 x s O
s
�401'�asSer��tce-'`F�lna1`u� �'S ''` K" ``� • T ..
.r t*: sc*'R' S_� x r�; . fi a On� �::i: a� �
�41:,.&olar pomecLic'FirmlS �'? �'.�i i * � � e' x �2'-� ^ �-+ �
t � f[ t� `7M11 C' l' � �
� 42:t8ackflow Prevente� F� N ;z��„ X� I -�` ;� E�,,, •*. p H
x ,: « .c �
� •
43. Backflow Iroigatiorf� �� t�SS �C * �* Q[-�+� x O '^
* Y i x C7
�44. Landscape iaati�n Syste �� "' * *' � `''
� �b7CJ XS �[�7 O!7 rJ� � :U N ' fJ 1� N O
V- � . � . . �. '
E:45JSound AtteD�2tion rt�F t�'� • � F I� F f�* r i ;-+ �: tr'^.; a;� s
.* "*' T b' C -� 1 #
�46:"Handic�' R��'ulati,�5,s � s� �' �`' .. w'' � "" '..'"' "
. F� 9 *' O h7 M x x� �+; � G u s' �'
y47 �FI L STR�ICTU#?E & B DING �-�O� M ���s Y
ry x � c.
48;�1f�4LPLA`fdNIN�, �'�•"' �' ° . - � "` , *
,� �;-'r * n: . - r x t*: ¢ x 'r.
p49�Elee�ric RelQase to.Edison i �� x x� x� � � -7 c
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-�51•. CER IFICATE 0�OCCUP tdC4' y t r �� �o ;zu x F- o
No. _ Date . .. �
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COSTA MESA BUILDIN6SAFEN DEPARTMENT
P. O. BOX 917 CASTA MEBA. GALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
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FIPIA�CE OEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
auaciN�
For Office Use Only
R8L8�PT NO. PERMIT NO.�
a.
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
ZONING
IONB I NO. OP I U86 OP NCW S� -%� �
/� �' F{.ANB 2 BUILDINO�
No: �°�e,�.,_� �of z z ra y 3 9s
NO. OP BLD69.
DESCRIPTION OF WORK
BUILOING NO. OF
SIZE ROOMS STOF
EXTERIOR WAL �• IROOF
COVERING .C6 COVERING"�
U8E OF BUILDING AND WORK TO BH PERFORMED
YARDS
APPROVED
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R.81DE �O
L. 61DE /�
REAR �'�
APPROVED ��
BY T�
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f. / IN.
f. �� IN.
f. —' IN.
f. —\ IN.
DATE I / IJI62
? a. 7.
l.k�¢a� �e cta-4� .
1 H8R8GY ACKNOWLeDOE TMA� � HAVB R6AD TX19 APPLIGTION TH8 AMOUNT BXOWN I1ND8R VALLlATION 18 FOR THH
AND BTAT! ,TMAT TXE ABOVE �6 CORMBCT ANO AGRLE TO COM• pUfiP09B OP E9TABL19HIN0 • PERMIT FEE ONLY.
PLY WITX ALL CITY ORDINANCH6 I�ND BTATB LAWO RSOULAT�NO
eu�wlHo coNsrnUrnoN. VALUATION
61GNATURE OF ` Mj PERMIT FEE $� --
PERMITTE $/��"/ / �/ pLAN CMEGK 5 I� �
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AUTHORIZED AGENT _ _ .S 7 �