HomeMy WebLinkAbout2574 CARNEGIE AVE - Building Permits. . '�
• M
� CITY OF COSTA MESA
� BIIILDIN6 DIVISION
} �
� DEVELOPMENT SERVICES DEPARTMENT
�• PERMIT PER IT NUMBER
�� V
648-01441
(714) 754-5273 • Fax (714) 754-4856 77 FA�R DRIVE, COSTA MESA, CA 92626
JobAddress: 2574 CARNEGIEAV
Suite:
Vicinity:
Parcel Nunmber: 14137309
Appliwnt: AMBURGEY, JEAN E
Address: 2574 CARNEGIE AVE
COSTA MESA,CA
owner: AMBURGEY, JEAN E
Address 2574 CARNEGIE AVE
Contractor:
Address:
Arch I Eng :
Address:
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
COSTA MESA,CA
BUILDING PERMIT
Zoning:
Phone:
2ip: 92626
Phone: 949-546-5833
Zip: 92626
Phone:
Zip:
License:
Phone:
ZIP
License:
SCOPE OF PERMIT
TEAR OFF ROCK ROOF & REROOF WITH 25 YEAR COMP. SHINGLES.
$0.00
$99.75
$0.50
$0.00
$0.00
$0.00
$100.25
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING existinq: o
NOTES:
Rear 0. 0
Rear 0. 0
Reauired: 0
FEE SUMMARY
�
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0. 0
Right 0. 0
Status: ISSUED
Applied: 08/12/1998
Issued: 08/12/1998
ss,000.00
$s,000_oo
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor 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 inapectlona end flnal epp�ovel must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
r'
WORKERS' COMPENSATION DECLARATION:
I hereby eKrtn Under penelry of perjury one oi the following tlecleretions:
❑ I heve end w�ll meintein a ceNiicate ot consent to self-Insure for workers' compensalion, as provltled for Dy section 3700 of Ihe Lebor Cotle, far the pertortnence o11he
work far whic� t�is pertnit is issuetl.
❑ I heve and wlil maintaln workers' compensetion insurance, as required by seclion 3700 of ihe Lebor Cotla, for the peAortnance af the work for which ihis pertnit Is issued.
My workels' compensation Insurence cartier end palicy number are:
Cartier: Policy Num6er:
(7h/s secflon neetl nof be completetl i/ the pe�m/l is valuetl ef one hundred dollere ($100) or less.)
❑ I certily that in l�e pertortnance of ihe work tor which this pertnit is issued, I shall not employ eny person In eny manner so as lo become subject to the workers'
compenseilon lews of Celifomie, entl egree ihet if I should bacame sub�ect to Ihe workers' compensatlon proWslons of Section 3700 of the Labar Cade, I shall forthwith
comply with �hese provisions.
Applicant SignaNre: Dete:
WARNIN(3: FAILUFE TO SECURE WORKERS' Q�MPENSATION OOVEMGE IS UNIAWFUT AND SHALL SUBJECT AN EMPLOYER TO GRIMINAL PENALTIES AND qVIL FINES UP TOONE MUNDFED
TFIOUSAND DOLLARE (5100,000), IN PDDRION TO THE COST OF COAIPENSATION, DMIAGES AS PROVIOED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNEI^S FEES.
LICENSED CONn7ACTORS DECLARATION:
I hereby eHirtn inet I am licensed under provisions oi Chapter 9(comme�cing with Section 7000) ot Divislon 3 of iha Buslness entl Professions Code, antl my license is In full
brce antl eHecL Lic. p Class p
Contracror's SlgneNre: Deie:
CONS7RUCTION LENDING AGENCY:
❑ I hereby eHirm Ihet ihere is a constmction lending egency tor Ihe perfortnence of the work for which this permit is issuetl. (Sec. 3097, Civil Code).
LenAefs Name: Lender'S Atltlress:
Signeture: - Dete:
OWNER•BUILDEA DECLARATIONS:
I hereby eMirm Inet untler penalry of perjury ihet 1 em EXEMPT FROM 7HE CONTRACTOqS LICENSE LAW lor the Iallowing reason (Sec. 7031.5, Business antl Professions
Cotle: Any ciry or counry w�ich requires a pe�it to wnsirud, atler, impmve, demolish, or repair any structure, pdor to its issuence, also requires Ihe eppliwnt for such pertnit
to tile e signed slatement that he or she is licensetl pureuent to Ihe provislans of Ihe Contractars License Lew (C�apter 9(commenpng with Sectlon 7000) of Divislon 3 oi the
Busineu an0 PN�essions Code) or t�at he or she Is exempt theretrom and the hasis for iha elleged e:emption. Any violation ot SecUon 7031.5 �y any epPlicant for e pertnit
sut�ect5 Ne app6�m to a civil penalty of noi more then five hunAretl Collars (S500j.):
❑ I, es ownef of Ihe properry, or my emplayees wit� weges es their sole compensation, WILL DO THE WORK, end the siructure Is not intentletl or oNeretl for sale (Sec.
7044, Business end Protessions Cotle: The Contractors License Law does noi apply to an owner ot properry who builds or improves thereon, and who tloes such work
himself or nerself or Ihrough his or her own employees, provlCed ihat such Improvements ere not intended or oHereC br sele. N, however, the bullding ar Improvemant is
sold within one year ot completion, the owner-builtler wlll have Ihe Durden of proving that he or she did not bulld or Improve ior purpase of sale.).
�" I, as owner of ihe property, am E%CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to consiruct ihe projed (Sec. 7044, Busine5s end Professions
\ Cotle: The contrectors License Lew does not apply to en owner ol property who builds or improves ihereon, end who coniracis for such project with e conirector(s)
license pursuent to Ihe Contractors License Laws.).
sec.
tlrivels license. ❑ Yes
Business and Professions Cotle lor this reason:
Vedflcetlan otih+'nerehip 6y (rype of dxument, i.e. - praparty ta�c blll or deed):
Dnvels License No.
DIVISION OF INPUSTRIAL SAFETY PERMR CERTIFICATION:
❑ 1 hereby cBhHy Ihat no excavation five (5) or more faet In tleD�h into which a person Is reqNred to tlescend, will be mada in connection with work euthodzed 6y �his
permit, and �hat no builtling structure, scaHoltling, falsework, or demdition or dismantling thereof, will be more then thirty-six (36) feet high. (Chep. 3.2. Grp 2, Art 2, Sec.
341, 7111e 8, Calltomie Adminisirative CaAe).
❑ As ownerbuilder, I will not employ anyone to tlo work which woultl require a pertnit from the Division of Industrial Setey, as notetl above, unless suc� Oerson hes a
pertnil to do such work from the division.
SignaNre: Deta:
Division of Indust�al Safety Permit Number:
CERTiFlCATE OF COMPLIANCE AND AUiHORVATON OF EMRY: I certify untler penalry ot perjury that I have read ihis epplication anC state that iha infortnation given is
cortect I egree to comply with all state laws end city oNinences relating to building construction, end authonze representetives ot the Ciry oi Costa Mese lo enier upon Iha
abova�/�-Q\es//cpp���bbed p�olpe nspe/c/ye� �pu�rp�osas. I agree not to occupy o� allow occupancy ot any 6uilding authorized by this permit until final ins0edion.
��C�/ `�!Lf__���Z�
�T igneWreOf galOw s) Da
AnNOr Authorized Applicant Dete
COOE 1. ly$QEGD�.�E
1618 Flxed System Finel Fire Prevention
1266 Pool Spa Final
200 Flnel Re-Root
2ot Ftne181o�WRataiMngWall
202 Final Fedory Ffre Place
203 Final Slgn
264 Flnel Demolitlon
zaa&a8
�.I JIII..
'//17�. _AI
GOLEj INSPELTIONTYPE
206 Finel Mechenical
20B Finel Plumbing
270 Finel Electrical
212 Final Fire Prevantloa
220 Final Plenning Appravel
222 Final Site
250 Finel Building/Occupency
�ff ��
/
�
.�
�ooxessoremwu,c: z579 CARPdEGIE AV � u"T
avr�Easru�Ei�p'°r'": AMHURGEY, JEAP7 E ,�
ADDNE33: ZS%� CARNEGIE AVE
COSTA MESA,CA 92626
�vv�.wuura �uon[ss:
546-5833
�PCNRKT OR ENf�NFEA: IIC. NO.:
MCN.OP ENO.'4 AODNE55: UNT:
caam�crarsxwe NOCK PLUMHING (714)895-1246
c«rtn�crorrswuiau+ 11612 KNOTT ST
�oopEu: GARDET7 GROCTE CA �G� 511971
92641 u�: 17
LICENSED CONTNACTOflS OECLAPATION: I hereby eA4m urMer perally M perjury thet I em IicenmE under qwivions ol Cheqm 8
(commemrp vmh Saction J000) d Oiwun 3 d iM Buzrbss eM PMaeiona Coda, ud my licenx o in lull face eM efletl.
cmuc.no.:05 38 uc.cuss: C-36 ��cw."oc.: 51 97///9� �E�/XyP��: 02/96
Dem: !� � Conlraaor 1 V� ! �/�/G?' �
OWNEN BUILDEH OECLRPATION: I Mreby e/fiim uMer pane�y d parlNiY �� �� a��N /mm IM Conireqws Limnee Lew Iw tha
�olbwing reeaon (Sedan ]031.5 Bus'vwff eM Prolmaiam Code: Any ciy a coun�y M�ich rtyuiree e pe�mn lo conavucl, eller, improva,
demd'ah. a repei vry aweiure, qbr w na cwenee, aho repuirea ihe eppliranl la weh paemn to file e tiB� �amaM thel M or eM
n i��e w�� m me no�;:�s a m, c�n,mo,. u���e �w [cnea.. a(o�me��e .mn seao�, �000) a o�� s d iro
Bueiness eM Prdesauna Codej m the� M a eM is eRemq iherehom eiW IM besie la �he elbpeA examption. Nry videtion d Sed'an
103i.5 by eiry epplifani I« e permn wbjeds �ha epplicent ta e avil perelry M m� mae �henlve huMred ddlen �5500�).
❑ I. es amier W Iha pmpanY a mY empbyaee weh wepea ea thei ede cwnpanamion. xiil da Ihe xvA. end ihe avucture u na intaMeE
or oilereCbr vle (Section )Oas, Buainess eM Prolessiona Cotla: TM Coniredae Lironse lewtloes rwl xpWyto en ownmd propany
wlo Wids a inpovea ihwean. aM who dme auch wwk Nmsetl a henell w Mraqh he ar Mr own emplryeee. pwideE Ihm auch
improvemenla ere mt inteMed a dlered lor eale. X, however. Ihe EuiMiip a improvemeM o eotl vrilhin an yeer d mmplMion. iM
owror�builds will heva ihe WNen d provinp he ar eha dk � Wild a improve Iw �M WTo*e of ede).
� I. av ow�er d IM p�operlY. em ezdinively oonlrad'vp wi1M1 IimnaeC conlre[Im ro mnbt�ud Ihe pojett ($ed'on )041. Buairoaa eM
Vrotesviorre Coda: The Coniraciwe licenae law tloes nd eppry b en owiwr d prope�y xfio buiNe w impovea thereon eM who
wmrena for wM projeae wiih e con�redoKe) licenaed Wnuant to tM Convmare Lioenae lewl.
� I am eRemq uMer Seclion: 8. 8 P.G, br Nia meaon:
ove o.�,
i ao ne�M �.Mv �nv i em e.�.a d�ne u��e ma �a���m«�u d cdew�,r Nemn .�a sdmr caae saaia,. zssos, assaa, ene
255�a, aM iMt I«eny M1nure Duikim �� will / wal rol (crcb an) meE Io wmON win aaid aeta oodea eM �M raVuirameMe br
apa�mnlaconsiruclionormod�RrelionhomlMA'v u�6T�epemen�0imntl.Raadamieloonaivabneppi�iareereuemptfmmlhase
provisions.
ome: nPd��,c
W OHKER'S COMPENS�iION DECLAN�TION: 1 hareEy e/firm uMx por�My d pe'jiny ar d tM Idbxi�q Jadaretiom:
� I heva eM xil mainlen e cenAcue W mneent lo eell-ineuro br wakere' compamelbn. m povided Iw by $etlion 3]00 d �he lebor
code. io, ine oen�e a o» wo� i« wricn mrc o�a m moea.
� 1 hero end vnll man�ein warkere' campenseton ineurence, av reQuired Ey Satlion 9)00 d ihe Lebor CaEe, lor IM perlrnmenu d tM
wvk Ia whiM ihia permA is'saueE. My wvMais wmperue�ion iruurenu raenp vd pdiq number ero:
Cerriec CTATF EXPIRES
PdiryNumber: t 1 G`1Q09_OG 03; 01 /96
(inis mcrion neee na be camvretee r rn. pemix is ro. a�e h�nered edre.a lSirol a�J
� I cMLy ihet in Ina pe�lormarice d IM work br whch �hie peima is ieaued, I ahell mi empby erry pareon in e�ry menmr eo es to
becama w4� lo IM warkera' cwnGe���ion kxa M Lelil«nie. vM e0ree Nm il I shwM bacome wbHd �o iM naM1eie'
compense�i p /s�ons I Seqim 3]00 M ihe leEor Cada. I ahell 1 h compy ' pmviawns.
�We:��(�! � RPVf'wam:�_� C
Wem/ny: FeNun ro sscuro worters'rnmpsnutlon eoverep� Is �n/ewful, end ilull �uDNef en �mploysr fo eNMnsl p�
dvrr nns. w ro orw nurerea tnouaem dakn (si00.0001, �n aw�uon ro m. cwr or ronwN+rron ��w• u woHeea ro. �n
Swtlon 3]OS o/ Ms L�Oor COW, Infmal, entl ertorney� Iri.
CONSTtiUCT10N LENDINQ PaENCY: I hereEy effirm uMer paneXy d perjury �I�m �Mn'n e mnmrveion bedi�q epercy la the
periwmeze d tha work Ior whitl� Ihe peimi is ewed (Sedion �09). CM. C).
LENDEN'S NAME:
LENOEN'S?DDRE55:
I<eniy thet I have raed �hia eppliceiion ud sete Ihet tha e iniwma�ion ia wrtae. I apree Io canply wnh dl oy vd counry adirivicae
end atablev.araleiingia buildirp constrWion erd Aarebya ize mpesentaiives Wt�isdtylo enteruponlheebwe-meniioned qoqny
for inspeqqn W� '
�'S^ l -
/��/) Nema �
G'" ' Si�re panVAppkranVCont — Dete:
(5151ie WP) Whne-BuiN'vq 8 Salety; Grear�Fb: Cenery-AppYraM: Pink-Re�renue; Goldenmd-Aaameor
CZTY OF COSTA MESA — BUILDING PERMIT
PERMIT P10: P 071973 PLAN CHECK N0: N
CONSTRUCTION TYPE;
PERMIT TYPE: PLU
PERM P70: P 071973
GOVT; N SUPF: N
PURPOcE: OTH
JOP DESCRIPTION : DISHWASHER CAANGE—OOT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
iF i4 3F �f �M it it iF iE �lf iE iF 1h �)F # i1� ib ih � 3�- af �7!� M+F x+t�?t aF ic iE tF �t aR �M:F �N-� �% u�+f iF i� -u iF iF if� ac ar �t iE �It jf r-14 iF �1F �c �C+t �f aM1+4 �5(� ac N- �%«iF * r if * ic ac �lc iF �th-�E �M
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIT7 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGAT: FT IN LEFT: FT IP7 RGHT: FT' IN
PARY.Ir7G REQ: PP.OV: PARCEL: 19137309 ZT1E: REF NO:
PLANNING NOTES>
:
'7f if iF 1f if iF afif 1E if if 1E af'1F if if if if iF iF �F if if �f iE if iF K if�lf iFiE if iF'� i�-if if'IE iFif if i(�if Y'K'�if-K K iG �F 14 iF Y-iF�Y if if i� if aE ALif ?(-�I4 iF AL?E iF 1fdF iEif �E if-lE �f iF if
D E V E L O P M E Dl T S E R V I C E S R E Q 0 Z P. E M E N T S
ZONITIG APPROVED BY DATE;
BUILDING APPROVED BY ;
5' "
APPLICATION ISSUED BY:
+t�**�c***v�*�-x�a�m�-r*i�*r�*x�+t�c*s�-*�-*+F�trarja�*s+r*ic.s�c*�-�-�r**
LECALIZATION;N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 7.00
253 ,
PLAN
ISSUE FEE 20.OU
DATE:
DATE:
STRUCTURAL SEGMEPIT;N
FIRE SMIP/RES GRADIA7G
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHPCI! TOTAL PAID DUE
TOTALS----> 7,00 20.00 0.00 27,U0 27,00 ,00
AEVENIIE DIVISION TOTALS--> COLLECTEU; 27.00 OC'ER/SHOP.T; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TC>T GRADZNG PLAN—CHECK
?%.Q�
')f iE f iE 1EiFif')f-1f M if if�if if i�-if if iM1 +! if if 1E�if iFY-Y iF�l( 'If #4'/F #'-if iF iF if iE�1f % af 't� if iE if iE if-lEih'M'iR aflf ?f iF i�-iE il'!f'Y�i�-af'If ii'4 if if iF if ?F if iF iF�1E iRiF if iE 1E'Y
I N D I C� I D U A L. F E E H R E A K D O N7 N
TYPE QTY D E S C R I P T I G N UNIT COST TOTAL COST
YLO 1 UISHWASHER 7,00 7.00
END OF FEES
�i QD;307�"u—�^.0l8�7Q8 T raT' y�,pp
OATE� L�4/27I95 €Il�E: ip:i5
CONSTRUC710N AND PLANNWG POO� & SPA
APPRUVALS Pennit # DaFe Inspector APPROVALS Permit # Date Inspector
L Temporary Electricai Service or Pole 52. Pooi & Equipment Location .
2. Sail Piae�Uodrgrnd. 53. Steel Reinforcement , i
3. E4ectrical Conduit Utitity-Undrgrnd. 5A. Pocros -
Q. Electrir.al Conduit�Undrgmd. 55. Electrical Bonding �
5. Steel Reinfcrcement 56. Rough Piumbing & Pressure Test
6. Efectrical UFER Gmd. 57: APPROVAL TO COVER�GUNITE
J. Footings 58. Electrical Conduit-Undrgmd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., 7est .
9. Water Plpe-Undrgmd. -� 6Q. Backwash Lines, P�Trap, G� Undrgmd.
70. Structurat Floor Svstem � 61. APPROVAI TO DECK �
11. Property Sewer Une & House Connection . 62. Backwash & Receptor-Finai
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64. Plumbing SYstem - Final ,
14. Rough Plumbinq 65. Electrical-Final
75. Fough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Elearic 4Uiring 67. Pencing & Access Approval �� �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERWG '
18. Rough ElectriraFT Bar Ceiling 69. POOVSPA SYSTEMS FINAL •
79. Rough Heatinq & Air Conditioning FIRE DEPT. REQUIREMEN'f
20. Rough Factory �irepiace APPROVALS Permit #
27. Ducts, in Structure 70. Under9round Hydro
22. Ducts, Vencilaxin9 71. Product Pipinc� CGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Plush
24. Roof Framing - 73. Undergmd.StorageTank uGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Sttucturali & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. insulation 76. FIRE PREV. FINA�
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Piaster Brown Coat 79. FINAL WSPECTION
32. Electrical Power Meter-Final 80. FQOD CERTIFICA7E ISSUED
33. Finai Electric Notes: 5"� S'� �
34. Final Heating & Air Conditioning
35. Fina1 Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Plumhing S S�
39. N'ater Service�Final .
40. Gas Service-Fina�
41. Solar pomesticPinal
42. Backflow Preventer
43. Backflow Irrigat�on
44. Landscape Irripation System
45. Sound Attenuat�on
46. Handicap Regulations
47. FINAL STRUC7URE & BUILDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
U111VCK .Ei1�L7Ut5l�
JOB ADDRESS 2
GENERAL CONT
AP No. liJl-�7
l INSPECTIONS
y SOIL
� GAS
W �TEF
� ROUGM PLUMBING
PROP. SWR. LINE r
."�tllVt'.5'1'
CON.
ROUGH HEpTING ANO �IR CONOITIONIA
TEMPORYqY SERVICE OR POLE
UN�EIiGRQUNO � POWER m�
ROUGH WIpING '�
TRENCNE$ FORMS STEELI
FLOOR SVSTEM
BONO BEAM L �STEEL REINFORCE
SMEATHING
FRAME AND FLASHING
LATMING - IN [] OUT �
PLASTEP.BROWN CORT
STRUC7URAL, FINAL
HEATING, VENT., REFRIG. ANO A.C.,I
PLUMBIN6, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUIL�ING, FINAL
UAIC '-� V-��_
BUILDING PERMII
SUBCONTRACTOR
4377.1
COSTA MESA BUILDING-SAFETY DEPApTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Com letely — Use Ink Only
BVILDING pS `� � ! � 1� /�
ADDRE55 ri,L �--i' b-/ [
/� �v /J��
OWNER K ��� ' ���V �
MAIL � L��/ ��n�C7 V I
AODRESS �J % JC
T.EL.{'/
CITV �,�„_�. 7—✓d. �%%�S_{,t NOoI'`'�'��d
CONSTRUC�ION ` �ti .
LENDER
_ . � � •
BRANCH " ` `
- `
�.�i—�'77�l17_Ql,' ZrJz'� irv�r:i911.L1
AP LI A' ION FOR STRUCTURAL PERMIT
FE I V DATE RECEIVEO DATE ISSUED
...�
� PERMIT NO.
A.P. NO. G�
BVILDING
ADDRES52
- TRACT L�� BLOCK
W A P
OWNER CQNESi
--- � _�: 4 Bi5
ARCHITECT � . � 'TEL. ' � S
OR EN INEER
FIRE
ADDRESS —7 ZONE � T E'. GROUP�
/l� ` eyG O APPROVED /�' l
CONTRACTOR � BV DATE'/ �� �
ADDRESS - ' � � � ' , '
TEL. Z�NE NO.OF USE OF NEW
CITY NO. � P��� BUILDING �
�
F STATE •' ��� CIT,Vp�' , `�ARDSAPPROVED•� .VARDSAPROVED
� LIC. NO. UC. NO. � MAIN BUIL'DING AC ESSORV�BUILDING n
La] SIZE NO.OF BLOGS. (FROM C/L ST T)
4. OF LOT NOW ON LOT�" -�� . ROfYT -. Q
a VSE OF / �//' y� r '. , � . � .%
.�.� EXISiINGBLDG. %J%L< Q6/pt�"'QI�h E FT S FT.
FSeparate permits-are.required for � \ ` �' �` , L SIDE : � � � FT . � � FT. 1�
electric, plumbing and heating work. . / �
0 REAR FT. 2 L/ FT.
[.W. USE OF BUILDING•AN� WORK TO BE PERFOflMED � � � �
\ � OIS7ANCE BET. .BEf. MAIN & .
Q� � MAIN BLDGS. ACCFSS. BLOCS.
,�f VAq. # , DATE
a/ '�Y ,` �� � C.U.P.3p 'APPROVED '
� •� . APPRO G - /'
y, �4
z E�G�/� . , ,.., \ : ,
w
o. �
p I haraby ecknowlatlpe that I have reatl thiz eppllcation end state . , �
p�. that the above Informetion is correct antl apree co comply with
a ell lews rae�iaii�e bulltllnp conatructlon, and I shell not amploy _ ' �N
Z any penon In violetlon ot Ne workman's eompansation Inws of �
ZMe Staca of Cel7fornia. LO /J� � =� J m
3 1 �oroby cerUfy thet I em proparly Iicansetl es a contractor untlar
`� S�. FT. O / / �v
the Steta ot Collfornie Businev nntl Profasslons Cotle, Dlvlaion 3, THE AMOUNTSHOWN VNDER VALUATION IS FOF m
Chapter 9, and t�at auch Iicenms ere in tull farca antl affect, or 1 THE PURP06E OF ESTABLISHING A PERMR FEE ONLV: e
em oxompt from the Orovlsions of the $tata of Callfornle Businoss V ALUATION PERMIT FEE E �
antl Profesaiona Cotle, Division 3, Cha C r 9. u+
2 m
PLAN CHECK y ^�
Sipnamra ot �� //77 �
Permittea A'��;��" � B/� �J%) TAX S � �
/ � `iv U
Authorizatl ABo�i TOTAL PAIO E
�
�
� � h
I I . J'
, , �---,�=��,�-�.��� ��
� ����
--�, � -�� ���,�� ���
/r�� � ' ,�'���
, � G�
����`�.�o � ��--� ���
� ;� �
��' a ���-�� � �_
���o �o� ��� ����-
�n�rn�e �.�� i�P --� � �� 23 �
� `
�/�'e �' � �� /1 �:� � ��!
��e �� �� �� �����--
� �'� .
,�>L,�o:�Z�ti�i� �v Q/I�ri/brt G� �G�2� /�t-P �G/��j-GG�f��
� " � /� Q�/�� ��-�-r ��.a
���- ,y "
/2 U � � �)-,- �
Gc�7 �" /� %'� �ti�-ef'/�
�� ��-
Vosta mesa isnuu�ng Lepartment
. 171 EAST 20th STREET
i� � COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
Bullding
Address 2574 �erne8ie Ave.
Costa Mesa,, California
Cross St.
New
r�cAT1UN 1+'UK YL�'iGivii'�
�4`� BUILDING
i FOR OFFICE USE ONLY
� Receipt No. � Permtt No.
Tel. �
No. KT .-ril l:{Q Z
ractorHflrbOT Const.CONoY����.rS%GZ
^ess cAi11A
egal LoL I
xiption No. �j¢ Block I TractP,i�
ach Metes and Bounds)
No. of Bldga
of Lot ] Q� x 64 Now on Lot
of -- - I No.of I No.of
ting Bldg. Families Roome
ack Line from Rear Vard
erofStreet 55 sidevard r.
No. of
e�iidi�9 Residence & Detachod
� I J'-9 S'6 I nus i 4�
Costa Mesa, California
% I No. of I TYP� �/ GrouP/
APPROVALS
- Frame: Fire Stops,
Bracing, Bolts =
I hereby acknowledge that I have read this Application ;�
and state that the above is rnrrect end agree to rnmply Lath. Int. -
with all City Ordinances and State I.aws regulating —
building construction. Lath. Ext. "��
Signature of —
Permittee arbor Ci0 tSUCt10II L'O. p�aster,lnt.
Authorized Agt. piaster, Ext � j
Valwatloh Permft Fee $ ��" Masonry Reinforced _
Plan Cheek $ — Bond Beam �
g 11 � 200. Total —
�.
Fee � FINAL
RM 204 S-BP 2M 8-55 �
u
�
PLO� Pi.AN
Show locatlon and distances from
property Iine and 6etween buildinga
a