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Home My WebLink About211 BROADWAY - Building Permits p F CITY OF COSTA MESA ' BUILDING DIVISION •,. ..i @ DEVELOPMENT w RVICES DEPARTMENT PERMIT NUMBER F t PIs I "'PERMIT 6. 01-01850 01-01850 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 211 BROADWAY Status: ISSUED Suite: Applied: 11/21/2001 Vicinity: Issued: 11/21/2001 Parcel Number: 42540221 Zoning: Applicant: CLEAVINGER, LUPE ISSUED BY: Address: 211 BROADWAY Phone: 949-548-4666 COSTA MESA,CA Zip: 92627 Owner: CLEAVINGER, LUPE Address 211 BROADWAY Phone: COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXIST. ROOF AT THE GARAGE SIDE ONLY AND INSTALL ALUMINUM ROOFING ICBG 5484. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,000.00 Permit: $69.25 Claim Valuation: $2,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $69.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 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 2446-46 WOO) DECLARATIONS • WORKERS'COMPENSATION DECLARATION: .• I hereby affirm under penalty of perjury one of the following declarations: - ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensatP,1%as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I 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: Carder: Policy Number: (This section need not be completed if the permit Is valued et one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any porson 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,1 shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5106,600),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS 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.Lk.p Class 0 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lenders 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,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to filo 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 m0'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.If,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 properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). . mime air ec. Business and P• - e for this reason: . Ign.ture• .� i • - %.te: // ara'it D verified by drly. s license. -oil es ❑No are se No. // 11219 es: / 7-O% 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 WIII 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? 0 Yes 0 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 filo a registration form for acutely hazardous materials? 0 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 bullding 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? 0 Yes ❑No — 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification from the South Coast Air Ouality Management District or from any other air pollution control district or agency? LJ Yes LJ 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 any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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 AUTHORIZATION 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 ell state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri pro fo gspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until fi I inspect n. Signature f Legal Owner(s) Date Any e CODE r INSPECTION TYPE PATE It17IDs45 CODE t INSPECTION TYPE PATE PALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof -O� #117 210 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 JVTANJV:V• ELIICSL J. • JL. ''^'I. Ci-L}-/O I JOB ADDRESS 211 Broadway BUILDING PERMIT NO. 42366 `GENERAL CONTRACTOR OwnerlBldr. DESCRIPTION of WORKAdd 4 bedrms,2baths& Extend LAP No. _ _ LOT TRACT FIRE ZONE VALUE $ 34 000.00 Fam.Rm. INSPECTIONS Si.notu re Dote ITYPE GROUP ZONE C — 950IL -- SUBCONTRACTOR • 'MITS ISS D GAr. -- Date Number Sitnatu. Ay" Plumbin. etn PLUMBING Mat J 'U�:SWR. LINE❑ HOUSE CON. : _- �=' SCELLANEOUS _—��-- -UGH HEATING AND AIR CONDITIONING li ,e f )b . j r MEM r:-..n t TEMPORARY SERVICE OR POLE 11111111MILDISMI FI�(I�` 111111111111 `,�1 UNDERGROUND ❑ POWER C��l a_-�.�/�(�1�J_7la— R000H WIRING �V l Prrli�1Q�"'� eotin• on:Vent U \4 �'+9 iC ice- T:ENCHES • FORMS •�r,I�/� �J�Q�;ifll�/n.s � y�r raWAM • STEM e____ a itEle��far oral. ,/�— BOND BEAM U STEEL REINFORCE _,��"�n/`�L�i'y(r ,I /�. SHEATHING ��'7 `�j ��' S�iQO,LT171� FRAME AND FLASHINt ��lp -t • _• •' ' j' LATHING - IN OUT �� %��: � -- IMINIS PLASTER, BROWN COAT ' = mi�� 4 STRUCTURAL. FINAL — T - 'Ifl� HEATING, VENT.. REFRIG. AND A,C., FINALrn�f �y��`rr�TCt, yy PLUMBING. FINAL AND GAS TEST • —� �' a ____�j610. !11L�7nil4 j• "tab >4 ELECTRIC, FINAL -tMEIMIllii* R —.- - �M BUILDING. FINAL A . c Oi� !t4 1M SPECIAL REQUIREMENTS S'1 `'•.. - • ` •"e :. V�Lea�. kec..tfi Et&e-r GIP `( C .C. Sf/A- lt der, ,a Cn/t ' Zak VA X/7 474A /.fie-C '/t8i —TS?, an abs. e-kt `r _ 42366 PAIU I'M 26-76c,. 0029116 /' t:,**711 A i COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A L CA 'ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely// — Use Ink Only ADDRESS 21� Sean) 4y RE E) ED V �_91.7 -01VTE BUILDING LL // /('J / T .I/ •�//. /� /� L'./ f�y/� /�/j OWNER C Efl' T. -6 I 0,„(0,✓ 3J z, A.P. NO./// //2' 2 P :4,Z0 � BUILDING lY'��' ADDRESS 21 I . L_. ' D w a MAIL ADORES /fa rop c/u_'c J CITY NOL nip nit seat TRACT< 9 LOT/ S 9/7LOCKa Cos'rt� n• Esq CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER \,x/\ BRANCH (� 1�,�' /j OWNER (r . Jo pMc ,V /L ADDRESS ARCHITECT TEL. USE Ion IEx, H"LCCjtALU$ 34 'n OR ENGINEER NO, E ��(/ FIRE ADDRESS ZONE YPE yGROUP yyn_ APPROVED y CONTRACTOR t71/V_t/CC— 8��,(�� BY I DATE r /r i ADDRESS TEL. ZO / NO.OF USE OF NE / CITY NO. PLANS�j BUILDING?/_ ./4 F YARDS {M�1f!' / STATE CITY YARDS ED APPROVE M LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDIN SIZE NO.OF BLOCS. (FROM C/L/g,,TRE E(yg� / LU O. OF LOT NOW ON LOT FRONT ty0F1_- /✓f LX.Lchl.n2y Q Y USE OF CI /) 0EXISTING BLDG. R.SLDE J FOS' FT, V) // // Fs- Separate permits are required for L.SIDE 63 lar. FT. C electric,plumbing and heating work. REAR /,;r, }— FT. LU USE OF BUILDING AND WORK TO BE PERFORMED Q 'y MAIN BLD BET. BET.MAIN& C AOO V fjFrO�on n11 � � R/1/l��NI? MAIN BLDGS. ACCESS.BLOCS. VAR.* DATE Qf_CyQ re- cot .... L� I�u CI~in C.U.P.* ,,,////// APPROVED APPROVE/ �� I{T— 7-23 -76 - ,AY / DATE C W L I hereby acknowledge that I have read this application and state n C that the above information is correct and agree to comply with r• L all laws regulating building construction, and I shall not employ m Z any person In violation of the workman's compensation laws of 2 Tthe State of California. I hereby certify that I am properly licensed as a contractor under / � SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in fun force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the provisions of the State of California Business 'o VALUATION PERMIT FEE $ `t and Professions Code,Division 3,Chapter 9. v1 Signature J. j �y►-� enz PLAN CHECK $ /_GYM 0 Permittee of�I�►..�r S0�"/!/ —r TAX $ Gam` a_ 3i T/ • pc Q Authorized Agent TOTAL PAID $ '/4S / _/ "c 73.7h4 =:OO1616 0'• ' 3S ^Q ' COSTA MESA BUILDING-SAFETY( DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only �) RECEIVED BY DATE RECEIVED D TE ISSUED BUILDING J„ / a 2.-?? � L ADDRESS V1 ' ��.7 / P y.-? /w OWNERAll&/(y,• IPP1 s A.P. NO. V 6 MAIL U • BUILDINGADDRESS I / ADDRESS TEL. CITY NO. TRACT LOT BLO CONSTRUCTION NEW ADD ALTER I REPAIR MOVING DFMOI ISH LENDER BRANCH 4,_./2 /`/ / ii OWNER C?e1� // I. ADDRESS / ; ALU$ p ARCHITECT TEL. S II/ OR ENGINEER NO. aLTE FIREADDRESS ZONE GROUP APPROVED CONTRACTOflls� +a° ^ lken• — BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. PIANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 0.1I SIZE NO.OF BLOCS. (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. R.,SIDE FT. FT. — 2 Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. WREAR FT. FT. - LSE F II�IN .ND •••-K TO LIE R� DISTANCE BET. BET.MAIN& Q {{„ / MAIN BLOCS. ACCESS.BLOCS. • VAR.# DATE lc,!� I?—V- / , ,is • C.U.P.#' APPROVED / APPROVED —HY DATE I 0. I hereby acknowledge that I have read this application and state n N that the above information Is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of E 2 the State of California. ,- I hereby certify that I am properly licensed as a contractor under SO. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business `o VALUATION PERMIT FEE $ i3 a,Q a and Professions Code, Division 3, Chapter 9. 9 ,, PLAN CHECK S / in Signature of �-' o, \, Permittee $7t TAX $ \e‘.:`,_ � 9. 13aa� U `�j{ Authorized Agent TOTAL PAID S ' V OWNER BRANDT, KING DATE 4-29-65 JOB ADDRESS211 Broadway BUILDING PERMIT NO. 23947 GENERAL CONTRACTOR Air-Vent DESCRIPTION OF WORK ;att. patio roof AP No. 117-172-21 LOT TRACT FIRE ZONE VALUE $504.00 INSPECTIONS _Signature Date GROUP J TYPE IV ZONE Rl Soil PERMITS ISSUED _as SUBCONTRACTOR I Date 1 Number I Signal Water - Plumbing Rough Plumbing _ Prop. Swr. Line 0 House Con..0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole _ Underground 0 Power 0 Rough Wiring Heating and Vent. Trenches 0 Forms 0 Steel Reinf. 0 1 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Al, Frame and Flashing !//d .Kr/r Lathing—In 0 Out 0 Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final Building, Final 4 T r— Special Requirements • • 23947 CITY OF COSTA MESA COSTA MESA BUILDING-SAFETY DEPARTMENT APR 29 196 P.O.BOX 317 COSTA MESA,CALIFORNIA \ / ,� For Applicant to Fill In Completely P9T�r$JbR PE IT TYPE OR PRINT For Office Use Only BUILDING 2 I r'. . 13,EnA.1 wa ADD RECEIPT NO. .2PERMIT p� p. COSTA MESA, CALIFORNIA 4 7 BY ligi , REC81 :D A . 18971 OWNER IC I siJ, a 2 A Aj d y 2' .. rignmprAppil ADDRESS 7..../I C . 8 ,e-n4d4...)ay TEL ZONE GROUP CITY l G-- NO.. 'I:,'APPROVED I �~ iZONING CONTRACTOR /A/A - VP") �� /- ADDRESSn /5 oQI d. 431,,.._- 73:L. b_ // n (I CITY AAJL(—_ A.P.NO. (/ 9 - /pp NOTE: �rTEL. NOTE: NO EAVE OVERHANG SHALL BE LIC..NO.ATE �/i763 NO. r �72. - .i32CJ 90'70 SIDE BREAR P.L. EAVES OFELOT r'L ,L/LL�G 1 ]V l U / I NNOOWPNBLDT .LOLOWED (U.B.C.REQUIREMENT) USE OF pp TD // �� YARDS APPROVED YARDS APPROVED EXISTING BLDG. F.. TD udeJ.V/, MAIN BUILDING ACCESSORY BUILDING (FROM C/L STI • SETBACK LINE PROM I FRONT CENTER OF STREET REAR YARD PT. I SIDE YARD I LEFT I RIGHT R.SIDE 2 04 rr. DESCRIPTION OF WORK L.SIDE 9 rFT. FT. ALTERATION ADDITION REAR JO FT. FT. DISTANCE BET. BET.MAIN& REPAIR MQVINb DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING // �/ NO.OP VAR.# DATE ' SIZE /^/ JS/Z_ ROOMS 6i STORIES / C.U.P.# (� APPROVED EXTERIOR WAL/^ `f. I ROOF .(�j /C BY / //�i/ E 1f_/ COVERING L_„ 114,12 /r ,o_ IJ USE OF HUI INO AN�yy;OR OBE PERFOR E.7 (fi7Jr I ( 111 R<_ . .A co-,ace- ' . .le) Se ..d fes, _�.4___ !, N I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE E . AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION. �'�- M 1 PERMIT FEE S D SIGNATURE OG 1 I P S PERMITTEE ��1/ iLLn�n✓✓/111 [.v `` /} S PLANF CHECK $ C AUTHORIZED AGENT /1-7a_'L,��t. L.0. '�)1 A �/ 0 TOTAL FEE $ •,..• �•• r11'.RL.a; unviaau[v a•avnivflL .L •.•• JOB ADDRESS 211 BroadwayBUILDING PERMIT NO. 49617 GENERAL CONTRACTOR Dickerson Sign & GraphfCRIPTIONofWORK Electric Projecting Sign AP1.40117-172-21 LOT TRACT FIRE ZONE VALUES 150.00 INSPECTIONS Signa Dote TYPE GROUP ZONE C SOIL SUBCONTRACTOR PkRMITS ISS�ED GAS Date I Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE 0 HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS u STEEL REINF. C ‘it. FLOOR SYSTEM BOND BEAM El STEEL REINFORCE n FU E SHEATHING • FRAME AND FLASHING DAIEWAtirilde LATHING - IN ri OUT in PLASTER. BROWN COAT •STRUCTURAL, FINAL ILiLOy^tl HEATING. VENT., REFRIG. AND A.C., FINAL _ __ _ Cei • L-i -.ko q7//d PLUMBING. FINAL AND GAS TEST n J� Al ELECTRIC, FINAL BUILDING, FINAL SPECIAL REQUIREMENTS i/Q4"/ SIGN PERMIT CITY OF COSTA MESA Tag No. 0825 2/01 /80 20.46 TI. Planning & Building Safety Departments Type of Sign S -IN { ; P. O. Box 1200 (C.f� -INA; Costa Mesa, CA 92626 (714) 754-5245 Electric ❑ on-electric ,.,l,r rs, :.tOfftceUuQnly Location Building Site Address 211 5�o4.6 W AL( Phone / /o2-IXL D A,p•,ya l ( 1' f'•1I 4:61k d"l tvop'"ZerotnyiL,n _x- +° ^` h Name of Lessee P1 e R CL \'J[tc 1 N-6JL•s LL 3 Aa A A WA y APT 6 r2-9/50 Stgn Dist. Date Recetted. - s7 �` ^A hone • v 'Ssr-`S' .„ .er e R, C,.` r�-_op /� I State License No. .,/-SQ�1 Received by e ��/l= ✓ Contractor D I r K E R. - OO ( CA (`•) � vl -K N P Iry I-1 ) - City License No. - Street frontage: - r - �` ��^^� Fiont: 2930-/4 C L ANE CC) ESA9o.1EZG� ' - ft Street n �. Address Q A E City Zip ' Right: :ft. StieeC' ' .4r ' � / Left: ft Stfeet: � B Sign PtEKcE $Rt-rHaas `?402r cAR`" 6yz-9/Sd , ;_ Legal Owner of Phone _ Rear: ft. Street: ^�C5� Zip 9vn t Address 2.1 uilding set back from center line of street ` ,(3iee.v,Du/A Y City CoC-/'D STA ('1 'f[�' -, Master Plan Highways ultimate right-of-way" GUSign Location 0.0 Descriptions Illumination Front r` Right Left fY p+ Between property line&ultimate right-of-way 0 Ground 0 Canopy 0 Non-illuminated W0 Wall 0 Attraction Board Ground Signs 0 Roof * Advertising Statuary 0 7 ft.& IS sq.ft./or 0 Table 2 Planter Area Projecting 0 Other $, Directly lighted • W ❑ Construction 0 Tract Sign(Security&Right of Entry Agreement) _- Siigngn - F~- ❑ Convenience 0 Special Event(Request form submitted) Area of Sign L ft. -5 in.x .2-ft. in.=_-� & 1-.,. .. W 0 Super Graphic 0 Change of Copy.(amortization) 0 Indirectly lighted _ r1�1 r ., 1 �r -fit• T - U. Ground Clearance d �f- I/•s't ) r, W Overall height- /f � 14 Programs . Letter height X c LI, ,. ^- - I-1 Items of Information ,p+ Total Sq.Pt.of all Signage Me-769 (�" ' 0 Planned Signing 0 Shopping Center/Integrated dev. 0 Variance_ t s ✓1 {-�, a qnD�• _ c. 5 W C.U.P.No. ❑ By Owner/or 0 by City Copy verbage 1 ' (./'�.C, 1.1C �U _y m G G. (Date letter sent ) 0 Minor Variance Amortization Subject to Amortization: yes 0 no/'S�- - All applications must be filled out bythe Applicant,all footing,framing,electrical and final Insect',ns shall be called. (714)754-5273 e` PP PP & B P Expiration Date .. Valuation: Signature of Permittee �_ tanning fee 6 Office Use Only -$ r-./.i- ,O d D -"';',Its„ , , ► Building fee Insp.B Px B N No. Fin.., Px A - Ps No. Authorized Agent RW!>flf - VII �� • SI) D 7.- /� Total Fee $621146 U i !F'. - Received by • c--, Date'02///0 O Date Approved o'• /• 0 0 - ��ZG-r. li 2'Y " /lit AB-- /LCkai / C-14-9W Signature(Bldg.St' Signature(Planning Staff) Y =- '. Date (Approval subject to the condition of Ord.74-25 Sec.III 3.d) - ffi- "-• CMF 0068-32 White • Building; Green - Customer; Canary - Planning; Pink - Finance; Goldenrod • Assessor