HomeMy WebLinkAbout3020 CLUB HOUSE CIR - Building PermitsRUDPFSSOFBNLdXG: 3020 CLUB HOUSE CI
°""E"s"""E"'wa`":ROHBINS, ROHERT D
"°o"Ess:ROBHINS, KATHRYN L
3020 CLUH HOUSE CIR
APPL.I/All1NOLDORE55:COSTA MESA,CA 92626
I�RCHRECTOPENtlNEEN:
APCH.ONENG:SADOPE55:
UNT:
uc. ra:
UNT:
cor+m�c,arsruwe:NOCK PLUMBING ( 714 ) 895-1246
ca+m�croirs�uuxo 11610 SEABOARD CIR
�oopEu:STANTON CA ��� 511971
90680 �M
t10ENSED COMNACTOflS DECL�N�TION: 1 hareby efl'vm uMx penetly d pe�jury ihe� I em licenaed uiMm poviebna d Cheqa B
(mmmendip wnh Seclbn ]000) d OiNeon 3 d IM Buaineu eM Proleaeiona Code, eM my lioenx is in lull twcs vM aHed.
cmuc.no.:0 03$ 6 uc.cuss:C-36 uc.No.: 119,] 1 EXP: 02/97
� �27/-liG co��..a� � %��' //.� _ IcY
�DWNCP BUILDEN DECLARATION: I Mreby elfirtn uMer panelly d per'ryry Ihm I em memq Imm IM Contratlps Lkenes Lew Iw iM
iblt6w��e �eewn (Seabn ]�313 Bueinesa vM Profeeeione CaEe: Any cny d counry wfiidi rpuiree e pe�mA lo canalrucY, eller, impova,
molish or repeir eny etructura. piw �o As eeuerice, e6o requiroe iM eppliranl fp wch permN lo �le e eipiwd ste�emenl ihet he or ehe
"F`'lioensed punueni to iM Orovisbne d IM Coniredon Lionae Lew �Chaqm 9(camme��p vrilh Sedion ]000) d 0'vuion 9 d ihe
'��J91fIBM 9M PIMB98YJ119 COEB� O! �IIBI AG IX BIIB 19 GaBlllp IMIM1IX11 BIIE IM E41B IOf IM BIIGQBC lIBIII�A�I. AIIY VOIB�UII Oi SlGOII
1031.5 Ey enY WO��t fw a permn wbjwe tM applicant io e mnl pandry d M more ihan tHa hurdreE ddlan �35001).
� I, es owner d IM propeny w my empbyeee wih weqee sv the'v ede mmpenwion, xill do �he xvAc. end Ne eWdure u not inlendad
or Mered br seb (��n )a�. Busi�wsaeM PmtessbnsCade: Tha Conlredors licame LawEoes iat epplyto en ownxof qupeM
who bulda w inD�ee ��araon, eM x1w doee eucM1 work Nmeetl or MneM or ihrouph he or har own employeea, providaE tl� auch
impwemenla ere nd inteMetl a dlered Iw seb. H, Mwever, �he WiMi�q a'vnpwemeN u edd xilhin one yeer d mmpl&bn. Ns
wner-0uiker will heve �M Wken d qoving M or eM Ek iwl Wild w improve Iw IM W�e d eela).
� I. a+owrrer M iM V�WaM. em eRdinneM oonireaM wnh licenwd wnireMae �o cona��ua the WM� (5epion )Oa1. &»iinea eM
Prolesaime Cade: The Contrenon Licenne law doae na epply �o en owner of propeM � buiNa or impovea �M�eon eM xia
coMrazis iw aM prqeds wilh a coMraqor(s) IicenxC Wnuent to iha Contreqora Limnae Lew�.
� I em exempi under Section�. B. 8 P.C� lor Nia reeaon:
i do nareh can�y inm i� ewara w e�e ��eeAi�e me rea�+�e�� d cei'«nie r{eann ene s�.n cma sea�m. uws, zesu, a�a
255J1, enE Ihat I a eny tulure WilEinp omupent will / wil rrol (arcb one) need to cwnDly wih aeid atete wCes eM iM repuiremeMs br
epermnlacarsvuctionwmod'ifra�ianhan�MA'r u�eregamentDiatriq.Reeidenlielomn�wioneppiratiomeraexemqframtheae
proviaiona.
oa�a�, new�c
WOPKEfl'S COMPENSATION DEttAPATION: I hereby elfiim uMer parully d pe�jury aie d iM Idbr.irq dedarvum:
� I heva vM wJ meinten a cerlilicale d mnaeni ta seMinwro b xarkan' wmpenae�ion. m povided f« by Sepion 3]00 d ihe labor
Coda, fa iha pe�lormence ol iM xoik la which ihis permn ia iaued.
_ Cl i n.w ene w meimen waken• comw�un Irm,rar�m..a na���d M seaim a�ao a �ne lem. code. �« ma oeAO�me�m a �ne
}� woM1 fa which Inia permit is ieaueE. My w«kere' mmpaneation inwrence ramer erd poliry number are:
came�: STATR EXPIRES
Pa�yN�mn��: NwC3211�1�� 09/30/96
.nis senion neeC nw be cvmderedY �he permx is la are huMred ddlaa /YiOol w bss.l
� 1 unly thel in tha pxlormeMa d iM work fa whc� this permn ia isaued, I ehell rot empby e�ry penon in eny menner eo ea io
e eubl� b tM worMrs' canpanaetion le� d CalAwnia. dap ae Nel il I shwN becann e�bjeq �o IM workere'
c mpenmiion 0 >��s N on 3]00 d the Lebor Code. I� onhxit� �omvM �hA visione.
ete: v AodKenc \
Ing: Fallun ro�xun Moikxi compmu0en cwsiay� b unbwlu( entl �NII �Wl�cf en mip/oyx ro ctlMru e/Hu ene
elvll flros yi b om �u�tlreE flpusen0 tla/kn (310q0001, In etltlltlon ro Ms coa( ol rompmuflon, Oemepe� u prov or /n
Sxtlon J)O6 0l Ms LeboiCOW. InM1naf. siMettomsyi /ssa.
CONSTPUCIION LENpINO pGENCY: I M1emEy elfirm uMx pendy d parjury i1W than u e mnei�uaion bMinp egerwy 1« �ha
�na�eo� oi ina won io, wn��n mm w�n �s as�d (sea�, sos�. cH. q.
LENDEF'S NAME:
LENDEH'S ADDflESS:
I ce�ity tM1el I heve read Ihis eppl'retim vM atete thel lhe ebove inlarmeiion ig comea. I eprea lo canpty xvih ell tlly eM muMy oMinerces
'�.. eMe�elakwsMeliploWik'upwnWWionenEherebyaNhorixerepesente�iveadlhiatityloenterupontheebave-mantionedD�GaM
. brinspeclion Purposea.
ome: �Ti�
(5151<6 WP) Whne-Build'mp 85elery; GreemFle; Canary-AOPFcem. Rnk-Revenue; OoldenroFbxswr
CITY OF COSTA MESA — BUILDING PERMIT J
PERM NO: P 076574
PERMIT NO: P 076574 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : C/O WATER HEATER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: X
�x*x*+cx��*�**x**�*�t�t� �t�t+�***�*+t**x��x+t�*��t***�t�r*�**+�*+�**�**x xx�x+�+tx� x�x�+t�t*+�xx�x���t***�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
isEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 14167210 ZNE: REF NO:
PLANNING NOTES>
%
1E 1E 1f 1E IElE jf 1E 1E ih 1f if 1E 1E 1E 141F if 1E 1f 1E iE fElh �E 1E fElE fE iE 1E iE fF �E 1flF 1k jE 1E 1E IE iElE iE �If 1E 1E if 1f �E 1f i[� 1E 1E �E 1(� iE 1E iE 1E iE iE iE 1E 1k iF 1f 1f 1E iE fE iE 1E iE 1E 1E 1f j(-iE
D E V E L O P M E N T S E F V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED HY: � DATE: �.� / U
�t*x�3t**x�x�*x�*�tat***iE*i�*i��tiF7F3f3t-3F�F3FTFiFiFTFTF7F�{F'iFiF3F�FTF'iFiFiF3F3FTF�fiF�F7F7FiF7�'iF*�t�t*****i�iF **
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGM NT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7.00
258 SMIP/NON—RES
PLAN
ISSUE FEE 20,00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 20.00 0,00 27,00 27.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
27.00
!E 1E if fE 1E iE �E 1E')E fE 1E 1E 1E iE iElE 1E iE 1E 1ElE fE 4E 1E 1E 1f �E iE')E �ElE 1E 1E 1f 1E 1E 1f 1E 1E'lE 1E 1FlF iE 1E iF iE 1E 1E �flF 3E 1E fE if iE if fE 1E iF 1Elf IE iE 1E fE 1E'X' aE 1E iE 1E iE 1E 1E iElE iE 1E
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
8LU 1 WATER HEATER AND/OR VENT 7,00 7,00
END OF FEES
o� e��zo��.3- ���an�3:s� da��- ?7.,�p
CffE: C�. �".,��. T'i�c; �17.G7
_. _ . ._.__/{oVlicant to ti11 in au spaces exceot ehose within nea�y eoraer rnes ana s�vn�a�� aparooriate aeaarauo�:. _ _ _ _,_ � _ � _ . , . �IiB4 :_B/ I J/BFi �- � �� �
_ .�v.'�'
. CITY OF COSTA MESA CON T U ION PERMIT '°EAMiT TRACT NO. iLOT NO.. i UNIT Nb.' � , � � � i�� ." ?" �' � V S�OO ' TL
Piviect Address � n .r. � � • � . • ' ; � � � ' � i . � . , �
� ' . TVPE OPCONSTRUCTION NEW'. ADO' ALTERA7'ION REPAIR ' � � �
' AppliCanYs Mailing rEss ❑ CONVERSION ❑ DEMOLISH 0 OTHER _ q,p, #. . l - - ' . -- ' . .. , -. .ZOne . - . �__
Owner'sName Phone DESCRIPTIONOF WORK/USE OF BLDG. �
Address � � � ' � ' � S Main Building: .Accesmry Building: ' '
Arch/Eng.� ' ' � License No. � TVPE OF PERMIT ❑ GRADING � OUNDATION ❑� STRUCTURAL � T FFont � � � � � • : � ' : �
AddrE55 � ❑ TENANT O ELECTRICAL � PLUMBING ❑ MECHANICAL � , A Rear � . 1 ' i N
Contractor's Name .^ ne pqp❑jECT DESCRIPTION� 15Q. FT. � � oCCUPANCv C Right ' ' , . 4 - • N
AddreSslmailing) CONSTRUCTdONTVPE � � �VALUAT,ION$ � � g Left ; � � � 7 � � . � , ' R
City Licensr No - \ - ' � � 'ZONE` �GRADING CU.Y�S. ' � ACRES � ' Ping. Ref. # - .Parking-Req./Provided ' ' E
LICENSED CONTRACTOR OECLARATION, � ' ' - , �
1 hereby affirm',that I am licensetl untler pvovlsions ot Charte� 9(commencing Remarksr� � , i �, '" Pl2nniny NOL¢5:� • , _ •
wiN 5ection ]000) ot Division 3 ot tne Business antl Profession5 Cotle, antl '� � � M
mY license.is in full o ntl ettect. . , � � '; ; . ' . . . ' ' � � i ' ' I ;. . ' ' T
�License � � ' • Li - . � � _— , . ' . . � .� ' . • , .... S:
Date Si9nature .� i P�UMBING � -FEES . �
WORKE ' CO PENSATION DECLARATION ! �
\ �ereby affirm that I have a certificate of consent ro selt-insure or x certiiicate Bar Sink Showers - i_a , i - , ELECTRICAL . , _ F,EES
�' Workers' Compensation Insurance, o� a ce�tifietl cOpy thereot (Section ` � � J _ � ��
aoo, �ab. cyy'n �„ /'�� �� /.4�- Backfiow Preventer .Service Sink � :� Autbmatic Washer� �, Transformer �0.15 50 KW r
� Policy No. (�'�< <•1' Company �i. � Backflowlrri9ation SewerCa �, � ' � � � - i . ❑•50+KW' . .+�
� y- -/- � P Construction Pole Sub ' � i „ , .�
�rti(ietl mpy is hereby fumishetl. � i - , - . . , _
C a i tiletl witn the ciry tli r'I.��i/p/��/p�� // /� , Bathtubs +Sewer Connection . '� Cookmg Unit, � �Meter ❑up to 100 amps
f Date APPlicant �� "G ` � A//6 - -- � ' -
EXEM TIO FROM WORKERS' COMPENSATION DECLARATION - CIB�ifiE�S� LL _ � 5012� COIIecLO�S , - ' � DishwashEi _ � ,, -M¢tC� ❑ovE��100dmp5, � - �. � �i
(TM1is section neetl not be campletetl if the permit i5 for one huntl�etl ($100) or � �� "'` �� ' '' '
. less). � - Disliwasher� - 1 � �SolarPipin9 - ' - � y - � � Su6;Panel ' ' '
y � p t is issuea, i ' Dr ers �Gas ❑Electric� '
I certlf ttiat in tne performance of ine work for which thiz erm� " - - � '� �
snall not employ any person in any manner�so as to become subject.to the Drinking Fountains' ' 'SolarTank � Fan� �
�� ;( Motors O0.1 HP O1'/='-,8
Worker5' Camp¢nsation Laws o( California. � � ' � � „ „ ' ' ' � � - � . . '
oate 5iqnature � ' Floor Drains � ' Swimming Pool w/Spa � �� F.A.U. � �
NOTICE: If;'atte� makin9 this tleclaration, you ShOultl become subject-to�etie ' ' - - - -- - - - - - - -- ��. Inc. Solar.0' 9:75 HP. �]6-75+. . _ ,
Wo�ke�s' Compensation provi3ions of the l.dbor COtle, you must torthwi[h FIOOf $inks � � � . ' � ' • ' • ' �
comply with Such ,provisions o� this, pe�mlt Shall be tleemetl revoketl. U�i021 FixtU�¢5 MiC�Owdve �
CONSTRUCTION IENDING AGENCV ' . �,� � � � �
1 h¢�eby affirm that there is a construction lentling agency farth¢ pertormance G25 SCfVICC A11L12L5 WdfEf CIOSCt � I Device BOxCS POIe Light � ' �
of th¢ work for which this permit i5 issued (Section 3097�lCiv. CJ ' i - , . .
Interceptors . f Water Heater ' Outlets � Ran e
lender's Name 9 � �
�enders natlress -- � '� - - � - - - Kitchen Sink- - � Water Service - - - ' � 1 SWitches "�" - "-'?' " - ' Sign � 1�� � -
OWNER BUILDER pECLARATION `� � ' ' - � � , ' '
I hereby attirm that I am exempt trom �the Contiactor's License'1_aw tor the Lavatories � � � � Auto-Wash � � ' � Gar6age Disposal � Standing Sections �,
following reason (Sectlon �031.5 Business antl Protessional Code: Aoy city or �
county which requires a permit to construct, alter. improve, tlemolish or repair P-Trap � � , Laundry Trays � � Generator �0-5'KW 05-15 KW �
any structure, Orior to i[5 issuance; also requires the applicant for sucit permit ' Tr85h Compactor �
to tile a si9netl statement [hat he/She is licensetl pu�suant to the�p�ovisions b/ ROO? D�ainS ' I � ' '
wthe Contractor's �icense l.aw (Chapter 9 (commencing with Section'7000).of ` _ _ _ _ ' , _ `
.. 9ivision 3 of the Business antl Professions CotlE) oi that fie/she is exempt � � � , . i
"�;�refrom antl the basis Po� the allegetl.ex¢mption. Any violation of SectiOn , � � . ' , ' � � ' , ' , � . '
�s=`31.5 by any applicant tor a permii subjects [ne applicant to a civil ' � � ' �
- �"��dlty oi not more�than tive huntlretl t1011a�s ($500). � ;3 • � � � � t ' '
���� I� d5 OWlICIi Of Sh2 PIOp2Y[y OY TY EfIlpl0y2e5 WI�FI Wd9C5 d5 �hC1I SOIC RQIOSjIBCilUO FBB $15 .� � Isue Fee • $ � ' . - -
� compensation, will tlo ihe work, antl the structure is not intentletl or offeretl ^ Reins ection Fee � -
� for. sale� (Section �O4h, Business antl Protessional Cotle: The Contractor's "� � � • • MECHANICAL � . . ' FEES � P � $�5, � Issue Fee _ _$ 3
License Law tlOes-uot apply to an owner of a property who builtls or improves ' - ,
thereon, antl wno.tloes such work-himself/herself or throu9h his or her own � -�� . DEVELOPMENTSERVICES REQUIREMENTS: � ' •: •
employees, prOvitletl that such improvements a�e not intentletl or'offeretl for BOiI¢� „ ' HOOd��O� Typ21 ❑ �
, �sdl¢. If, however, [he bulltling-or Improvement is Soltl within one year of com- � Canopy Typ¢ II ❑ � � l ZOning Appmved By. � DdtB
� pletiOn„the owner will have the burden of provin9 he/she tlitl not builtl or im- Duct - Under.Ground . - ,Building Approved By , � � Date " ' �
prove for the,purpose ot sale).. ' , ' � ' . -
❑� I, as owner of the property, am ezclasively contracting with licensetl con- Duct - Structural • Refrigeration Sys[em : ` • Appliwtion Iwued By � ' ' � Dat �
, tractors to construcbthe project (Section ]044, BUiine55 antl Professions Cotle: _
The'Contractor's� License Law tloes not apoly to an owner oi praperty who Duct - Ventilating • �0=100,000 BTU ❑100,000 BTU � - �`..SUMMARV OF FEES '� - � � -
, bulltls or improves thereon, antlYwho conGactS'for Such projects witb a con- � ' • � • � • � � - , ,.
' tractor(s) iicense pursuant to the Contractor's LiGense �aw). I am aware'.ttiat Exhaust System ❑ MWtiple.❑ System Repair/Alteration ' � gUILDWG PERMIT $. SMIP � � -$�-
proof of their'Worker's Compensation insurance shoula be provitletl to me.� - • , . P�qN�CHECK ,$'� PERMIT � '
. L7 �I am exempi untler �Section � - B. & P. C. mr this reason ' Firepl/Fact. BIL ICBO # . Fire Dampers . .. � pLUMBING ' '$ �SSUANCE $.�
Date '� Owner - Heating Sysiem & �ucting - Registers ' � " ' ' PLAN CHECK ' 25%' $ � � -ENERGV P.C. $ � � �
, I hereby certiry that I have reatl this appliwtion antl state thaf the above ❑0.100,000 BTU �100,OOOBT _ ' , - � �
. - � � GRADING � $ �'
��
into�mation is co�rect. I agree to compty wlfh all dty antl county o�tlmances
antl state laws relating to builtlin9 Wnstruction, antl hereby authorize repre-�
sentatives of his' ity �to .en er upon the 'abo+e-mentionetl r erty' for �
inspection� r o s ' � '
Signature - '
Reinspec[ion Fee
CMF 0865-46, rev. 30/84 White
; Canary • APPlicanh Pink - Accounting; Goltlenrotl - Aszessor
$15 I I ' ' � Issue Fee
ELECTRICAL $ ,
' � PLAN CHECK 50% $ : ' ' rMICROFILM $ ��y_�(�/(/--
, MECHANICAL . _ $ TOTAC FEE .• $ �
' $ 3 , PLAN CHECK -25% $ , �
CONSTRUCTION ANDPLANNING � ' . � �. � POOL&SPA , ,
, APPROVALS Permit # Date - Inspector, � AppROVALS Permit # " Date Inspector:
4 i
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 i;�� . ' �
5. Steel Reinforcement . ' 56. Rough Plumbing & Pressure'Test ' � �
6. Electrical UFER Gmd. , � 57.'APPROVAL TO COVER-GUNITE �
�:
7. Footings . . 58. Electrical Conduit-Undrgrnd? � :�
8. Foundation .� _ . , 59. Gas Pipe,'� Undrgrnd., T�st ' �
9. Water Pipe-Undrgrnd. . ,., 60. Backwash Lines, P-Trap, E.7;Undrgrnd.
10. Structural Floor System ' 61. ,APPROVAL TO DECK 'j:
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewer Cap � � 63. Heater & Vent-Final "�= �
t
13. Roof Drains � '. 64. Plumbing System - Pinal. '
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 � - '' ' ': f� � � 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 � ' , i 71. Product Piping O Gas ❑ Oil � -
23. Gas Pipe-Rough & Test � �, �72. Underground Flush �
24. Roof Framing � � � � 73. Undergrnd.StorageTank �Gas �OOiI � � .
25. Roof Sheathing . , 74. Overhead Hydro � �
26. T-BarCeiling (�Structural) & Monocoat ' . � � 75. Dry Chemical . � ' - � ,
27'Frameand Flashing ' �76.-DryStandpipe
i
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 � , S0. FOOD CE�RTIFICATE ISSUED ' ' ,
33. Final Electric , � � � Notes:'�2G-��__-.���g.�+,(�l._,L,� "+
34. Final Heating & Air Conditioning' � ' . � � � �
35. Final Gas Pipe-Test. �
36. Hood or Canopy
37. Final Factory Fireplace e' . , ,
38. Final�Plumbing � � � ' ' �-�-�7 L��� '-. .
39. Water Service-Final � � ' �- •-
� r'
' 40. Gas Service-Final . � � �
.; .
41. Solar pomesticFinal " � - . " �
- i.
� 42. Backflow Preventer � • • '� . �
,43:• Backflow Irrigation ' . � � . '
��44. LandscapelrrigationSystem ' �� , �� .
�45. Sound Attenuation � 4 � .
46. Handicap Regulations � � - � ',��� � , r . ,
47' FINAL STRUCTURE & BUILDING . � � � � '
�
48.�Special Requirements Completed � .� - � �'. � � '
49.' Electric Release to Edison ' . � �- -
.50. Gas Release to Southem Califomia Gas Co ' _ , � ' � - .
51. CERTIFICATE OF OCCUPANCY - • '
No. � Date ' , - - �
, ���na -
COSTA MESA BUILDING-SAFEfY DEPARTMENT
P.O. BOX 017 COBTA MHBA� CALIFORNIA
For ApplieanT to Fill In Completely
T1'PE OR PRINT �
{�` BUILDIN6
COSTA MESA, CALIFORNIA
Mesa Verde Dev.Co.
OWNER
MAIL 2850 M@S'd Verde Dr.
ADDRESS
Costa Mesa, No.549 0395
3ENEERE. Kaltenbach No•5478046
SS i823 s.i7th st. s.a.
ACTOR `S�e aS �:'7ner �
STc". No. 181322 No �549-0395
SIZE 2 X� No. oP e�.n6e. Q
OF LOT S I NOW ON LOT
USEOF �__�__��___� � �
EXISTING BL�6.
6ETBACK LINE FROM
DESCRIpTION OF WORK
x II I II
� , BUILDIN6
Builtup
� U580FBU(LDIMCANqyyONKTOBEPi
� Res.w/att.Gar.
� HEREBY �CKNOWLEDOq THAT 1 HAVE RHAD TH�B APPL�CATION
AND eThTE THAT THe ABOV6 19 CORRECT�AND AOREB TO COM.
PLY WI� CITY OR��NANCE9 �ND 6TATC LAWB p80ULATINO
BUILOI 6 C STRUCiIOry,
/% �i._,.. , i�-='
� AUTHORIZ6O AGENT
FE�-RECEIVEQ�
FEB .25 1965
/���FyINANCE DEPt
AP4L I CAT I9�Y� � �'v11T
BUILDING
For.Office flse Onfy
RtC61RN0. TY!/Q' .�
��'j.
D �Y DAT[ RQC61V[D OATE169UEO
-� ._ � <-_/ �.... . ,��
I & J
ZONING
ZON6 NO.OP US80FN!
Rj}, rur�s2 euao�rvo
�eo�i. j�0't 4$ Tr. 4660
OVERHAN6SHALLBELE63THAN .
YAROSAPPROVED I . YARDSAPPROVEO
MAIN BUILDING ACGESSORY BUILDIN(d
�
�
�
VAR..}�
OATE
BYPROVE `�§ DATE ��-NS'""
—��--
'OLD FOR SPECjA RLQU1ltE.MENTS
iee permit on Lot 1 for conditions
1525 Sa �.. J 44o Bal 66
� TH6 AMOUNT'eHOWN IINDER V�IUATION 18 FOR THE
PURPOSfi OP ESTABLI9NIN6 • PEPMIT FEE ONLY.
VALUATION
j' PERMITFEE $ �]� `-"
S �t?' � Iv�%v A C
OWNER ME:
JOB ADDRESS
Steel
DESCR.LPTION OF WORK
FIRE 'LONE VA
SUBCONTRACTOR