HomeMy WebLinkAbout2234 CATHERINE PL - Building PermitsCOSTA MES,4 BUILDIFVG DEPARTIr9ENT
P. 0. BOX 317
COSTA MESA CAIIFORNIA
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COSTA tvSESA
1[NG DEPT.
BLDG. DEPT. REG.
�ALLEY QR PROP. LINE
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MAXIMUM 4 FT. FENCE MAY BE P�ACED ON DOTTED LINES------
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES
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FOR APPIlIC��NT TO FIj.L IN �
BUILDING ADDRESS �3 y� C6�%��P.�FI✓� ��-
Owner �/� �+ 7�R- / V ��
Mail Address � 2 3 y �!9-%�/� 2 L/�lF �G �
City C��S� /i�1�5/�- Ph. No.� / _,�G��
Contractor .� Ph. No �
/ Go3 fi` i� � � .
City Lic. No ��5� � State ic. No �'
Siz oE Lot�i/,�'�/X °J/�.iqP No� �7. -I �� 3 a y�
r� c�0—���J
Setbacks: C/L Stre� � Rear� �
I
Side Yard - Right �1 �.aO k/���/L di,o,�..s
Type of Fence j� �/� C�J o a Q �_/,g ��S"ry� ��
,�E�v� � 2 �G. _ � �T.
I hereby acknowledge that I have read this application and state
that the above is correct and agree to comply with all City Ord-
inances and,State Laws regulating build� c9}}sSyecj}r9n._ „
of
FOR OFFICE USE ONLY
.-x� I �- z - �� I �- ,,� -s <
VALUATION �� �'�
Permit Fee $
� �V �� Plan Check $ "�
TOTAL FEE $ �' ��
iJSE REVERSE SIDE FOR DETAILS
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ADo���ant to (ill in all soaees exceot those within heavy Dorder lines ane sign ail aoarooriate Oeclarations.
CITY OF COSTA MESA�{ CONSTRUCTION PERMIT PER IT NO. TRACT NO. LOT NO. UNIT N6. BI %B B�OEIBS S�OO TL.
. ProjectAddress '�gr�M �_��e,��%aP�P� � �0��
Applicant's Mailing Address TVPE OF CONSTRUCTION �vEW aDD ALTERATION REPAIR
� nA /� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p� p# Zone
Owner's Name Phone � � y
� DESCRIPTION OF WORK/USE OF BLDG.
Address 5 Main Building: Accessory Building:
III���III 2
Arch/Eng. License No. TYPE OF PERMIT GRADING�FOUNDATION STRVGTURAL T Front O
Add�¢55 /� /�j� ❑ TENANT ❑ ELECTRICAL PLVMBING ❑ MECHANICAL B Rear N
ConVactor' N e ��,���� ��������� h ne��7'��✓�-�� �'OTHER - A' N
Address (me'i'r,gl�p�!� �' Q�1. ��� PROJECT DESCRIPTION SQ. FT. OCCUPArvCV K Right G
'� �/ CONSTRUCTIONTVPE VALUATION$ S Left R
City License No. l.�L�I' /-37 ZONE GRHpING CV.YDS. ACRES E
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided
Q
I hereby affirm that I am licensetl untler provi5ion5 of Charter 9(wmmencing Rema�ks: Planning NOt¢5: M
with section ]000) of Oivision 3 of the Business antl Professions Cotle, antl T
my Iicense iz in f/�11�9 rce antl effect. 5
License I /� I Lice No i�
oate_ ' Signature PLUMBING FEES
WORKE� COMGENSATION DECLARATION Bd� Sink ShOw¢�5 ELECTRICAL FEES
1 hereby affirm that I have a certiticate of consent to Selt-insure or a certificate
o/ Worker5' Compensation Insurante, Or a certi(ietl copy thereof (Section gackflowPf¢v¢OtE� S¢rviceSink
3800, �ab. c�1• ���h Automatic Washer � Transformer ❑ 75-50 KW
Policy No. ��Q�- (! Company�,.� Backflowlrri9ation SewerCap ConstructionPoleSub. � 50+KW
�.�Certifietl mpy is hereby furnishetl.
��� Cer py is filetl with the city Bypdjn vi i . � Bathtubs Sewer Connec[ion Cooking Unit Meter ❑up to 100 amps
Date Applicant ��� �
EXEMP ION FROM WORKERS' COMPENSATION DECLARATION CI � Sola� C011ect0l5 Dishwasher Mete� ❑Ov¢! 1003rt1ps
(This section neetl not be completetl if the permit is fo� one huntlretl ($100 or
less). ' � Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify.that in the periormance ot the work tor which ihis perm�t is issuetl, I
shall not employ any person in any manner so as to become subject to the � Drin ing Fountains Solar Tank Fan ' Motors �0-1 HP �1 h-8
Workers' Compensation� Laws ot Cali(ornia.
Date - Signature Floor Drains � Swimming Pool w/Spa F.A,U. Inc.Solar �9-15 HP �16-15+
'NOTICE: If, atter makin9 this tleUaration, you Shoultl become subject to the
Wo�ke�s' Compensation provisions of the Labor Code, you must forthwith FIOOf Si0k5 Urinal ' Fixtures Mic�Owdv¢
comply with such provisions or this Detmit shall be tleemetl revoketl.
GONSTRUCTION LENDING AGENCV GaSS¢fviC¢ �utl¢t5 W3te�C105¢[ DCvic¢BOx¢5 PoICLight
1 hereby aftirm that there is a const�uction lentling agency for tne performance
of [he work fo� which thi5 permit is issuetl (Section 3097 Civ. CJ �nterce LOIS Wat¢�'H2dt¢�
Lentler's Name P Outlets Range
Lentler's Atldress ' Kitchen Sink Water Service Switches
OWNER BUILDER DECLARATION Sign
I hereby at(irm that I am exempt irom the Contractor's License Law for the Lavatories Auto-Wash ' Garbage Dispo531 ' Standing Sections
following reason (Section 7031.5 Busine55 antl Profe55ional Cotle: Any city o�
county which requires a permil to construct, alter, improve. tlemolish or repair p—Trap Laundry Trays Generator �0.5 KW �5-15 KW Trash Compactor
any st�uctu�e, prior to itz isSuance, alm requires the applicant for such permit
to tile a signetl statement that he/site is licensetl Ou�suant to th¢ Provisions oi ROOf D�ains
th¢ Contractor's License Law (Chapter 9(CommenCinq with Section 7000) ot
DiviSion 3 of the Business antl Prote55ion5 Cotle) or that he/she is exempt
[herefrom antl Ihe basis tor the allegetl ezemption. Any violation ot Section �
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty ot not more than five huntlretl tlollars (E500�. $ 3
❑ I, as owne� ot the property or my employees with wa9es as their sole R¢in5pection Fee $15 ISSUe F08
compensation, will tlo the work, antl the structure Is not intentletl or ofieretl Reinspection Fee $15 ISsue Fee $ 3
for sale (Section �O4a, Business and Protessional Cotle: The Contractor's MECHANICAL FEES
License Law tloes not applY to an owne� of a p�operty who builtls or Improves
�hereon, antl wno tloes such work nimself/herselt or tnrough his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employces, Provltletl that such improvements are not intentletl or offeretl for Boiler Hood Of Type I ❑ �
sale. If, however, tne builtling or improvement is solC within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, tM1e ownei will have the burtlen of proving he/she tlitl mt builtl o� im- DUct - Und¢� CirouOd Bullding App�OVBd By DdtO
�rOve tor the purpo5e of sale).
I, as owner oi the property, am exclusively contracting with licensetl con- Duct - Structural Refrigeration System Appliwtion Issued By �-�� � Dat
trac[otsto construct the project (Section ]044, Business antl Professions Cotle:
The Cwbacror's License Law tloes not apply to an owner oi property who Duct - Ventilating . ❑�-700,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or improves the�eon, antl who mntracts fo� such proj¢cts with a con-
tractor(s1 license pursuan't�ro the ConVactor's License Law�. I am aware that Ezhaust System ❑ MWtiple ❑ System Repair/AI[eration BUILDING PERMIT $ $MIP, $
ptoof of their Worker's Campensation insurance shoultl be provitletl to me., PLAN CHECK $ �— ' PERMIT
❑ 1 am exempt untler Section B. & P. C(or this reason FirepVFact BIt. ICBO # Fire Dampers PLUMBING $ -)� ISSUANCE $
Date owner � Heating System & Ducting Registers pLqN CHECK 25% $ ENERGV P.C. $ �
i hereby certity that I have reatl mis application and state that the above ❑0.100,OOOBTU �100,0006T ' - ELECTRICAL $ GRADING $ '
informatlon �s correct. I a9ree to compry wich all city antl <ounty ortlinances
antl state laws relating to builtling wnstrucHon antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ �—
sentatives of this Cty • to enter upon t ie above-mentionetl Property for ,�� � �
inspection pur se � 9 MECHANICAL $ TOTAL FEE $ �1 v v
� Signature . Date �7 .
Drivers' License or 55 � — Reinspaetion Pee $�5 laue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46, �ev. 10/84 White - Builtling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assassor
C,ONSTRUCTION AND PLANNING � POOL & S°A
� APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspecmr
' 1. Temporary Elecirical 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 �einforcement � . � 56. Rough Plumbing & Pressure Test
6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -
7.'Footings . 58. Electrical Conduit-Undrgrnd.
8. Foundation � � 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. � ' 60. Backwash Lines, P-Trap, O Undrgmd. �
10. Structural Floor System • 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal -
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 ElecVic Wiring - 67. Fencing &�Access Approval -
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling 69. P00 VSPA 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 � Gas ❑ Oil .-
23. Gas Pipe-Rough & Test 72. Underground Flush -
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil �
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (StructuraU & Monocoat 75. Dry Chemical
27. Frameand Flashing 76. DryStandpipe
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. Electriral Power Meter-Final 80. FOOD CERTIFICA7E ISSUED
33. Final Electric � ' Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy � �
37. Final FBctory Fireplace.
38. Final Plumbing � �c��� (��
39. Water Service-Final �
40. Gas,Service-Final '
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation � ,
44. LandscaPe Irrigation System �
45. Sound Attenuation �
46. Handicap Regulations � � � � , .
47. FINALSTRUCTURE&BUILDING � �
48. Special�RequirementsCompleted
49. Electric Release to Edison -
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY -
��n. Date '� �
• . � ADC��cant lo till in all spaces exttpt those within peavy Eortler lines an0 sign all aDcrovriate tleclarations.
CITV OF COSTA MESA CO T CTION PERM T PERAQ� N%�� O TRACT NO. LOT NO. UNIT NU. 6JI E 3I I �IBB 5,0� '
I� J`
Project Address �
Applicant'sMailingAddress TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p.# Zone
Owner's Name Phone
DESCRIPTION OF WORK/USE OF BLDG.
Address 5 Main Building: Accessory Building:•
E Z
Arch/Eng. License No. TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front O
Address ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL 8 Reaf N
❑ OTHER A �
� Contractor'sName Phon C Right N
^ PROJECT DESCRIPTION 5Q.F7. ocCUPANCv K G
Address�mailin9) CONSTRUCTIONTVPE VAIVATION$ S Left R
City LiCen52 No. ZONE GRAOING CU. VDS. ACRES E
LICENSED CONTRACTOR DECLA0.ATION Ping. Ref. # Parkin9 Req./Provided
�
I hereby affi�m tM1al I am licensetl untler provisions of Cltarter 9(commencing Remarks: Planning NOtes: � M
with section 7000) of DIvlslon 3 of the Husiness antl Pmtesslons Cotle, antl � T
my Ilcense is in (up tor e ntl etiect. 5
LiCenzc ass i ns lo.
Q� Date —� Si9nature PLUMBING FEES
„ WORKERS' COMP NSATION DECLAfiATION
iBar Sink Showers ELECTRICAL FEES
I hereby aHlrm that I have a certi/itate ol consent to selLinsure or a certiticate
o( Workers' Compensation Insurance, or a certifietl cooY thereoi (Se ion gackflow Preventer Service Sink
� 3800, Lab. �/ �j p Automatic Washer Transformer ❑ 15�50 KW
( Polity No. ���Y^ X/7 Compan�� Backflow Irri ation Sewer Ca ❑ 50 + KW
� 9 P Construction Pole Sub.
ertifietl copy is hereby furnishetl.
Certitiatl copy is filed witn the cit tlin si .� Bath[ubs Sewer Connection Cookin Unit Meter �up ro 700 am s
�� 9 P
Date Applicant��p
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION Clarifiers SOIa� COIIECLO�S Dishwasher M¢t¢r ❑Ov2� 100amps
(Thissection neetl not be Completetl i/ the permit is to� one huntlretl ($300 or
less�. � Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I ce�Nfy that in lh¢ P¢rformanc¢ of the wo�k fo� whicb tbis permk is i55uetl, I
shall not emoloy any person in any manner so az to become suGject to the Drinking Fountains Solar Tank Fan Motors �0.1 HP �7K - 8
Workers' Compensation Laws of Calitornia.
Dale Si9nature Floor Drains Swimming Pool w/Spa F.A,U. Inc.Solar �9-15 HP �16-75+
NOTICE: It, af[er mdking [hi5 tl¢Claration, you shoultl become subject to th¢
Wofkefs' Com0en5dtlon pfovisions of the Ldbor Cotle, you must fofthwith FIOOf SinkS Ufindl FiXtuI25 MiCfOWavC
Comply with such provisions or Nis Oe�ml[ shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV GaSService Outlets WaLefCloSet DeviceBOxEs PpleLight
1 hereby affl�m that there is a conitrutUon I¢ntling a9ency fo� tne pe�fo�mance
of ihe work for whicn this permit is ISsuetl (Settlon 309]iCiv. C.)
Lentler'z Name Interceptors Water Heater Outlets Range
Lentler's Atltlress Kitchen Sink Water Service Swi[ches Sign
OWNER BUILDER bECLARATION
I ne�eby aHirm that I am ezempt irom the Conlractor'S LicenSe Law for th¢ Lavamries AutO�W35h ('id�bag2 Di5p0521 $tandiOg S¢CtiOnS
followin9 reason (Seclion ]031.5 Business antl Professional Cotle: Any city or
county which requlres a permit to construct, alter, improve, tlemolisn or repair P—Trop Laundry Treys Generator DO-5 KW �5-15 KW Trosh Compacror
any sl�utture, p�b� lo il5 iSSuanc¢, a150 r<quirez lhe applicant fo� such permi[
to fi�¢ a siqnetl Sldtem¢n[ tha[ hc/5M1e Is Ilcensetl pulsuant to Ihe prOviSians o/ ROOf D�dinS
the Contractor'S License Law (Cnapter 9(comm¢nGing with Section 7000) ot �
Dlvislon 3 ot ihe Bu5ine55 antl P�ofe55ion5 Cotl¢) or tha[ he/she is exempt
tlte�eirOm anU the ba5i5 for the all¢9etl exemption. Any violatlon of $ection
]031.5 by any applicant fOr d permlt subjecls tM1e applican[ to d civil
�enalty ot not more than /ive huntlretl tlollars (E500�.
LJ I, as owner of the property or my employees with wages as tneir sole Reinspection Fee $15 Issue Fee $ 3
compen5alion, will tlo the work, antl th¢ 5[ruc[ure is not intentletl o� offeretl ReinSpBction F@B $1$ IStue f¢B $ 3
tor sale (Saction 7044, euziness anE Pro(essional Cotle: The Contractor's MECHANICAL FEES
LicenS¢ Ldw tloe5 nOt apply to an owner Of a prope�ty who bulltlz or improves
thereon, ana who tloes such work himself/herself or througn his or her own DEVELOPMENT SERVICES REQUIREMENTS:
emoloyees, provitletl that sucn improvements are not intentletl or oHeretl for Boiler Hood or Type I ❑ .
sale. It, however, the builtlin9 or improvement is soltl within one year oi com- Canopy Type II ❑ Zonin9 Approved By Date
pletion, tne owner will have tne burtlen ol proving he/she tlitl not builtl or im- Duct - Under Ground Building Approved By Data
�rove for tna purposa of sale).
LJ I, as owner ot tne property, am excwsively contractin9 wltn iicensetl con- Duct -Structurel Refrigeration Syslem Applitation Issued By Dat
Vactor5 [o Cons[rucl the project (Section 7044, Busines5 antl Professions Cotle: �
Tne Convattor•s Licenre Law tloes not apply to an owner oi property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or Improves Ih¢reon, antl who contracts for such projet[s witM1 a con-
tractor(s1 ucense pursuant to the Contractor's Llcense Law). I am aware that BUILDING PERMIT $ SMIP $
proot o( thelr Worker's Compensa0on insurance zhoultl be proviaetl ro me. Exhaust System ❑ MWtiple ❑ System Repair/AI[eration
PLAN CHECK $ � PERMIT
❑ I am exempe untler Section B. & P. C. lor this reason FirepUFacL BIt. ICBO # Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System & Ducting Re9isters PLAN CHECK 25% $ ENERG�' P.C. $
i hereby certity that i have read this appiicatlon antl state that tne above ❑0.100,000 BTU �100,OOOBT ELECTRICAL $ GRADING 5
Information is correct. I a9ree to comply with all tity antl county o�tlinancas
and slate laws relatlnq lo builtlin9 <on5lruction, antl M1ereby authOrixe rep�e- $ MICROFILM $�
5¢nta[ives o/ IhiS City to ente� upon [he dbov¢-menNone�l p�operty for PLAN CHECK 54°.6 �
inspectlan p s MECHANICAL S TOTAL FEE $
Signature Daie�_ �8
Drivers' License or 55 � Rainspection Fee $75 luue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46, rev. 30/84 While - 6ulltling; Canary - Appllcant Pink - Accounting; Goltlenrotl - qssesSOr
CONSTRUCTION AND,�PLANNING POOL & SPA
Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
t. Temporary Electrical-Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Elec[rical Condui[ Utility-Undrgrnd. 54. Forms
4. Electrical Condui[-Undrgrnd. 55. Electrical Bonding '-�
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings �! _ 58. Electrical Conduit-Undrgrnd!
8. Foundation �- 59. Gas Pipe, � Undrgrnd., Tesi
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C1�ilndrgrnd.
70. Structural Floor System 67. APPROVAL TO DECK ``�
ti•,
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. Rbugh Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
i6. 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 APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑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 & Sicling 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 3�J,� �1� L�
39: Water Service-Final
40. Gas Service-Final ' .
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation . '
44. Landscape Irrigation System ,
45. Sound Attenuation -
46. Handicap Regulations '
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison � .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -
No. Date ,
�,
OWNER FAAS, wALTER N. MAR 2 1959 , nA,I,E
IOB ADDRESS 2231� Catherine Place
BUILDING PERMIT NO.
GCNERAL COxTRACTOR P,yramide Fence VALUE $ 280.00
AP. No. LOT 1� TRACT 32I�PFIRE ZONE DFSCRIPTION OP WORK Fence
GRO[IP TYPE ZONE PLAN NO.
INSPECTION$ I DATE � gUBCONTRACTOR
T'rcnches Porms
coat
Fiaal Gas Tut
✓
. �,
. �.'� 6(39�
� COSTA MESA BUILDING DEPARTMENT
• P.O. BOX 31�
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
eui�DING 972d ('ATLIFRTNF PT.A(1F.
COSTA MESA. CALIFORNIA
R FABRE CONSTRUGTION CORP.
"'"" 3404 Via Lido
ADDRESS
CITY Newp�rt Beach T�oOR 3-1
ARCHITECT LIC.
OR ENGINEER Raymond Levanas �o. C. 747
ADDRE55 3432 Via Oporto, N. B.
�Q�,u� , ,i �-.«�
, ,�,� ;l,��s�
; i�l„'.?CE ��P�i.
^, nF CQS�t:a 1.4�5}l
APPLIC/aTION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
FECEIPT NO. PQRM/q(Jy'
COSTA MESA. CALIFORNIA
zo�+
CONTRACTOR L1C10 CORSYT, CITY JIOC.752�
ADDRE55 3404 Via Lido TNoOR 3-1240 OYPROVED
LEGAL LOT
oescvipnou NO. 17 BIOCK TRAC�z4Z
A.P. NO. '
Size approx.7500 S(l:tt. I��'oFa�oc�ORO
OF LOT �now on �or
USE OF � ��
EXISTING BLDG.
SETBnCN LINE FPOM
c[HreA oF siA[[i b.r]� REAR
NEW
RIGHT 5� LEFT S�
DESCRIPTION OF WORK
ALTERATION II ADDITION
SIZEOING 140� SQ�ft. ROOMS V STORIES 1
EXTERIOR WALLW�� ROOF S e
COVFRIN(: a*nrrn COVERING chinnla
F NEW
DATE
CORRECTIONS
I IIEPEBT ACNNOWLEOGE THPT I HPVE REAp TMIS 4PPLICiTION FNp
STATE TMiT THE f�BOVE IS CORflECT <NO wGFEE TO COMPLY WITM 5LL
CITV ORDINANCES 4NO STwTE LnWS FEGVL4T�NG 91lILDING CONSTROG
iwrv. II/�/ /� I/�' VALUATION
SIGNATURE OF 1 C � D. _ IL I .I D� 1/ PERMIT FEE S
AUTHORIZED AGENT
g / �f/ �0 �L � PLAN CHECK $
vc �
TOTAL FEE 5
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