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Home My WebLink About2094 CONTINENTAL AVE - Building Permits. s : , (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 2094 CONTINENTALAV Suite: Vicinity: RESIDENCE AND ATTACHED GAR4GE Parcel Number: 4225�2�3 Zoning: Applicant: MILLER, DALE Address: 13781 NEWHOPE ST . . . , � Phone: (714)534-6398 GARDEN GROVE;.CA - . � Zip: 92703 Owner. JOHNSON, JEANNINE R Address 2094 CONTINENTAL AVE - /. ",' _ ' . ' ,. " - " COSTA MESA, CA Contiactor: DALE'S ROOFING Address: 13781 NEWHOPE ST " � GARDEN GROVE, CA Zip: . 92703 Arch : Address: Zip: Phone: � � � � Zip: 92627 - .� Phone:- (714) 534-6398 License: - 503508 i_.�' Phone: � - � , License: Status: ISSUED Applied: 10/17/2001 Issued: 10/17/2001 ISSUED BY: � Eng: Address: ": � ' . Phone: License: ' - , SGOPE OF PERMIT _ , . �� REROOF: T/O COMP SHINGLES, REPAIR SHTG AS NEEDED, 1�LAYER 30# FELT, INSTALC25-YEAR COMP�SHINGLES. - " 27 SQUARES . . . . . - - . - . . _ . ._ . . _ , . _, FEE SUMMARY ' Plan Check: Permit: SMIP Res: SMIP Com: Other: , Inspection: Total: $0.00 - $111.25 ' $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front -0-0 �� PARKING Existinq: o NOTES: - - ' ' -- = Calc Valuation: $a,aoo.00 � - Claim Valuation: � Sa,soo.00 Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0- 0 Left _ 0- 0 Proposed: 0 Right 0- 0 Right 0- 0 � 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 780 days. INSPECTIONS: In order tor ihe work authorized undei this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectiona end final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. I FOR INSPECTIONS CALL: (714) 7545626 2646i8 (6/00) WORKERS'COMPENSAnONDECLARAnON: � . � I hereby aHirm under penalry of perjury one of Ihe following daclarations: ❑� I heve entl will maintain e certificate ot consent to self-Insure for workers' com0ensation, as provided for by section 3700 of the Lebor Cotle, for ihe pedormence of the %^�ork lor which this Dermit I5 issued. .�f I have end will maintain workers' compensati insurance, as requiretl by section 3700 ot the Labor Coee, for the pedormanca of the work for w�ich Ihis pemirt is issue0. My work`er9' co pensatlon Insurance w�na policy number ere: G � /' �( / Cerrier. J� r� �!/•'� Policy Number. � 6 S�/�/ b (This section need nat be canp/eted il fhe permlt is.valued et one huntlretl dollers ($700) ar less.) ❑ I certity lhat in the pertormance of tp work for whi is pertnit I5 issued, I shell not employ eny person in eny manner so as to become subject to the workers' compensetion laws oi C'fomia, U agr Ihat I oultl become sub�ect to the workers' compensatlon provisions oi Section 3700 oi the Labor Cotle, I shell iorlhwit� comply with Ihese pro� sio . Applicent Signature: � Date: �/% ^- /%— � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEPAGE IS UNLAWFUL ANO SHALL SUBIECTlW EMP�OVER TO CRIMINAL PENALTIES AND qVIL FlNES UP TOONE HUNDRED THWSPND DOl1ARE (S10D,OW), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SECTION 3]O6 OF THE LABOR CODE, IMEFEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm thai l em licensetl unde� prov�sions of Chapter 9(wmmencing with Seciion 7000) of Division 3 ot the Business end Prp(essions Cotle, and my license Is in full torce an0 eNect Lic. A T Class a �— 3� ' Contreaor'sSlgneNre: � Dete: //$---�7._/ � CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that ihere is a constmction lending agency for the pedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn that under penalry of perjury ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness antl Protessions Cotle: Any ciry or counry which requires e permit to consiruct, elter, improve, demolish, or repair eny structure, pnor to its issuance, also requlres the applicant for such pertnit ta tile a signed statement Ihet he or she is Iicensetl pureuant to ihe provislons oi the Coniractors License Law (Chapter 9(commencing wlth Sectlon 7000) oi Division 3 o1lhe Business and Pmtesslons Cotle) or Ihel he or she is exempt theretrom and the basis for the elleged eaemption. Any violatlon of Section 7031.5 by eny aDPlicent tor e perrr+'. subjects the applicent to a civil penalry of nm more ihan five huntlred tlollars ($500).): ❑ I, as owner ol Ihe property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, antl ihe structure is not intentletl or oHerad for sale (Sec. 7044, Business and Protessions Code: The Coniractors License Law dces not apply to an owner of property who buiids or improves thereon, antl who does such work himself or herself or Ihmugh his or her own employees, provided �hat such improvements ere not intendetl or oHered for sale. tl, however, the building or improvement is soltl within one year ot completion, ihe owner-builder will have ihe burden of proving that ha or she ditl not 6uild or improve for purpose of sale.). ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WIT}f LICENSED CONTRAC70R5 to consiruct the projea (Sec. 7044, Business antl Professions Cotle: The contractors License Lew does not apply to en owner of property who builds or improves Ihereon, and who wntracis for such pmject with e contrector(s) license pursuant to the Contractors License Lews.). � ❑ I am exempt under sec. Business and Professions Code tor this reason: SigneturB: Date: Owner ID venfietl by tlnvets license. ❑ Yes ❑ No Drivafs License No. Expires: Veritication af Ownership by (type of Documen6 i.a. - property tex biil or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavetion tive (5) or more feet in tlep�h into which a person is required to descend, will be matle in connection wi(h work authonzed by this pertnit, end that no builtling simcNre, scaHolding, falsework, or demoli�ion or tlismantling thereof, will ba mora than thirty-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ enyone to do work which wouid require e permit trom ihe Division ot Intlustnel Sefery, es nated ebave, unless such pereon �es a pertnit to do such work from the tlivision. Signature: Date: Division of Industnal Sefery Pertnit Number. CER7IFICA7E OF COMPLIANCE AND AUTMORIZA710N OF ENTRV: I certify under penalty of perjury ihat I have read this application antl state ihat the information given is correct. I egree to comply with ell state laws and ciry ordinances relating to building consWction, and authorize representatives ol the City of Coste Mesa to enter upon the ebove-tlescnbed property tor inspection purposes. I agree not to occupy or allow acupancy of any building authorized by this permit until finel inspection. CODE t. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1268 Pool Spa Finel 200 Final Re-Root 201 FIneI8locWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign , 204 � Final Demolition � � QdjF� INTRULS �� Date /D-- /7- / � Data COpE� INSPECTIONTYPE 206 Finel Mechaniwl 20B Final Plumbing 210 Final Electncal 212 Finel Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy Q�I: IttIID�4$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 2094 CONTINENTAL AV Suite No Vicinity: Parcel Nunmber. 42250203 . - 1--.� � - Applicant: JOHN Address: HODGES � �/ J'/!� ,- ;.;�. , � ' � , \.- ' l 4 f �f/ �� t, S Phone: � ��l`�� i - � �-.Zip �.L \ � i �-�; �/i.% SON..ilEANNINE R AVE Status: ISSUED Applied: 03/30/2001 Issued: 03/30/2001 � - -- ISSUED BY: v/� � ' `- " ; �; � __ i .949-548-5558 /� % I ` � � � �"'� � � � � � i� ,1 .A� _,.:� .`'`„' ,_`�� ' , \ � \` � � � �\ �✓ . ��\ � �� \( , ,% \�?\ \�,� �, ; / �_�` � \\ � ,/ �:. j ry// , �l/i� Phone: , � ; �� ,i� � i. f .�r! �� /f' i� � i�'� / : � t COSTA MESA, CA Zip: .92627 �\,`�� (,ii� � �'�� ` /,�� : . ; _ ', � v,'�- � l /�� ''l�� ;l '� � '''� ' �"�� u �; Contiactor �JOE CARLOS PLUMBING ✓% f ' �� '^S � 7 -- ( , �:,� -� , - VAz _ � . � � , , _ AAn��. � j �; � Address. � � 1675 SUPERIOR AV_ � � -- � . � � .� �- . .. /: ' i p � � r�.r,, � � "' .; - � _ - . � '� �; �.�.' i��ol �-��t_ -` Phone: p14)548-5558 ' ='j.-�� V ��^��1�� ----�.� _ \�m i �� 3�t ' �I ICOSTA-MESA; CA� �, Zip: 92627 , . �,!. �" �,. � �( � � i I,��" _ License _385443 �� '�' � I � ` 11�� . � 1 � �ri r � i � � ' ,�� ,:� � i I I � l� i ��l = ' / >- -�r- � r� � � -� , - j+""; � �� O i � Arch/Eng�,%I '. . .vi : i ��_ �i.�r - � '.: `::.0 • � �iii ._J �, �'. � �Address�i�� ! � J 1 x�1'� � s ��f/'i '�'�� 1 � ��J��.;ii � � � a_Phone J '�,,`-� � ,: � l ;� �` �;'�\� __ '._.._.'.Z�p ��ii �1�✓<<-..a<^�. � � �` f-,-� \" ,: I Lic'ense " ' ,� � / � �\ lr- �,' . ! � � C�� f� � ��VV�r, , SCOPE OF PERMIT�-,;_. ' � � ' %%/�' \\� \` ,\ INSTALL A SEWER CLEANOUT. NO OTHER WORK AUTHORIZED BY THIS PERMIT. �V �� ) \\�� ..';i�T:'.. t � � ., 1 \v� ti� AM ISSUE FEE\ `^' ` Backflow irrigat oi n � Backflow Preventer� Bathtub �� ClariferSystem C Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drein, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 0 0 0 0 `,�-�FEE 5UMMARYa�:.,.,,- i:iU' ,,,,'o�L'ocAMT, 4(3TY ry Tuti FN/ashei Ci� °' �$0.00�' '''0 � capelrrigation�"o� $0.00 �,0 i o0 0" ° o o � $0.007 ; 0, "c n��N��s.-- -_--' - -=�au.uu� �v SepticTank � - � --`-$0.00 0- SewepCap for-Demo �$0.00 0 Sewer Connect ! �': �; �rl $24.65 ��1`� Sewer Private Line � $0.00't_- 0 " \�', f�.1 Shower ' $0.00 0 :jJ, Sink;bar_��, - --�$O;Oy�O�; Sink; commercial� �'�-�=,'$0.00-'"0� ' Sink, Floor $0.00 0 Sink, kitchen $0.00 0 Sink, service/mop $0.00 0 Spa (private) $0.00 0 Spa (public) $0.00 0 COMMENTS / SPECIAL CONDITIONS "V �> Waste'and Vent System Wate� Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION O $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: $48.15 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPEC710N5: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicabla codes, and all required Inapections and tinal approval musl be obtained. Failure to obtain inspec�ions and final approval will result in the expiration.of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2d4&68 (6/00) � � y . . WORKERS'COMPENSAnON DECLAAATON: � � ' , ' ` I hereby aHirtn untler penalry oi perjury one oi i�e following declaretions: ❑ I have end will maintein e certifica�e of rqnsent Io self-Insure for workers' compensation, as proNtled for by section 3700 of the Labor Code, lor Ihe pertormance of the work for which Ihis pertnit 15 issued. ❑ I have arW will maintain workers' rAmpensation insurance, as required by section 3700 oi Ne Labor Code, for the performance of the work for which this pertnit is issue0. My worke ' pensation Insura arrie any tl polity numbar are: I,1 I�� S�� Carrier: � o'��'—� PolicyNumber. /`� (This sectlon not be comp/eted i! fhe Oermif is veluetl af one hundred dollers ($ 0) ar less.) ❑ I ni at in the peAormance of the work for which this pertnit is issueq I shell not employ any person in any manner so as lo become subject to tha workers' om nsatlon laws oi Celif ia, and agrae Ihat ii Isss�� ouldp ecome sub�ecl ro the work�compensatlon provisions of Seclion 3700 of Ihe Labor Cotle, I shell forthwith C ply with �hese provi ' n. % __� / Ap want Signature: �yY d f'Y'�— Date: � r� WARNINO:FAILURETOS WORI�RS'��PENSATIONCOVERAGEISUNLAWFULANDSHALLSUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFlNESUPTOONEHUNDRED TMOUSANDDOLLARE 00, ),INADpTIONTOTHECO$TOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]O60FTHELABORCAOE,IMEREST,ANDATTORNEY'SFEES. LICENSED C ACTORS DECLARAT�ON: I hereby eflirtn that I am licensetl nder mvisions Chepter 9(commencing with Section 7 ) of Division 3 oi ihe Business antl�fes5ions Cotle, end my licensa is In full force an0 effect Lic. # Class a %i ContrectofsSignawre: / Date: �, r-��i_�� CONSTRUCTIO DING AGENCY: ❑ I hereby ettirm Ihat there is a cons�Nction lending agency for Ihe pedormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). Lendafs Neme: Lenders Address: Signelure: Date: OWNER•BUILDER DECLARATIONS: I hareby eflirm that under penalry oi Derlury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Protesslons Cotle�. Any city or county wfiich require5 a permit to construct, elter, improve, demWish, or repair any sllucture, prior to its issuance, also requfres the applicant for such permit to flle e signed stetement ihat he or she is licensed pursuant to ihe provislons ot ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of Divisian 3 oi the Business and Professions Code) or the� he or she is eaempt therefrom and ihe besis for the allegetl exemption. Any violation of Section 7031.5 by eny applicent for e parmit subjecis ihe ep0liwnt to e civil penalry Of not more ihen five hundred dollars ($500).): ❑ I, as owner of the properry, or my employees with wages as t�eir sole compensation, WILL DO 7HE WORK, and ihe structure is not intentlea or otteretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of properry who builCs or improves thereon, end who tloes such work himsetl or �erself or Ihrough his o� her own employees, pravidetl ihat such improvements are not Intended or ottered for sale. tl, however, the building ar improvement is sold wit�in one year oi completion. ihe owner-builder will have the burden of proving ihat he or she did not huild or improve for purpose of sale.). ❑ I, es ownar of the properry, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044. Business antl Professions Code: The contreciors License Law tloes not epply to en owner of propeny who builds or improves ihereon, and who comracts for such projea with a contractor(s) license pursuant to the Coniractols License Lews.). ❑ I em exempt under sec. Business and Protessions Cotle tor �his reeson: Signeture: Date: Owner ID veritietl by tlrivafs license. ❑ Yes ❑ No Driver'S License No. Ezpires: Venficatlon of Ownership Dy (rype of do�ument, i.e. - property tax bill or deatl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenity lhat no excavation five (5) or more feet in depth into which e person is required to descentl, wiil be made in connection with work authorizad by this permit, and that no building strucWre, scaHolding, falsework, or demolition or dismantling t�ereot, will be more than thirty-six (36) feat high. (Chep. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomla Administretiva Code). ❑ As owner-builder, I will nol empltly anyane ta do work which would require e permit from the Division of Indusirial Safety, as noted above, unless such person hes e permit to tlo such work from the Q`�sion. Signature: Date: Division of Industrial Sefery Permit Number: CERTIFlCA7E OF COMPLIANCE AND A�1iMORVA710N.OF ENTRY: I certily under Denalry oi perjury Ihat I have read this epDliwtion and s�ate that the informa�ion given is correct. I egree to comply with all state laws and city ordinances relating to building construaion, and authorize representatives of the Ciry ot Costa Mesa ro enter upon ihe above-descnbed pmpeAy for inspet�ion puryoses. I egree not to occupy or ellow occupancy of any building authorized by fhis permit until final inspection. GOOE �. INSPECTONTYPE 1616 Fixed Systam Final Fire Prever�tion 1266 Pool Spe Finel 200 Final Ra-Roof 201 Final8locWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition � � � � 3.— 2�(��- °�a/ Date � �( INSPEC110NTYPE 206 Final Mechanical , 208 Final Plumbing 270 Final Electrical 212 Finel Fire Prevention � 220 Final Planning Approvel 222 FinalSite 250 Final Building/Occupancy GBIF 1t�1S �� , ., ,. , _._ _ OWNER TAFT, C. M. JR. �" MAR 11 1957 DATE 9-28-56 � JOBADDRESS 2094 �ontinental Ave. BUILDING PERMIT NO. 3%S3 1 -/GENERALCONTRACTOR Owner-Builder VALUE $ 3�2$�.�0 LOT �12 BLOCK - TRACT 1%1Z ACId• t0 DW@Z].. ' GROUP I INSPECTIONS Footing Trench Foundation Forms and Grade to G Rough Framing � Plumbing, Rough to Slab Plumbing, Rough Complete ~ Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer, House Sewer, St. Septic Tank or Cesspool � Lathing, In OutX Plastering Plumbing, Final, Fixtures Complel Plumbing, Final Gas Test Wiring,Final ' Occupancy �la_ FOFM 210 3M �O�•vi V ZONE � FIRE DATE I SUBCONTRACTOR I— PERMITS ISSUED I NUMBER „� {. �, Costa Mesa $uilding Department APPLYCATION FOR PER � ,�;F.� '._ P.O.Box3�� z�9� BUiLD1NG �/ ��' �” COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOYZ APP�ICANT TO �II�L IN Receipt No. , Permit No. Building Address ' ..S .: Costa Mesa, C1L�OPll1iL Received by Date Rec'd. �I Date Issued Nearest � � —5 �T �4 '� S CrossSt. ,�,.d% Building Address Owner „P �, Costa Mesa, California Mail - � Address �Q � Nearest Tel. /y"� �fi Cross St. City '�� '�7'�i�AJ No. .I'7 A'G Zone 1� 1 I No.ot I Tvpe ,i Group Address Contractor Addreu Legal I Lot Description No. (Attach Metesand Size of Lot 4se of Existing BI Setback Li Center of S B Lic. No. City No. Block i % J �" ' Rear Vard ��" D � SideYard ,t-� 'TION OF WORH � teration I I Addition I� rving I I Demolish I „ No, of Rooms � Stories � I Roof _ "'-F.�.a� iLC /°�-�...._�.,..,wti I hemby acknowledge that I have read this Appl� tion and state that the abOve is correct and agree to comply with all City Ordinances and State Laws regulating building construction. Signatureof � � il_ / ,i K � ', I L APPROVALS :ion Location Inspecto ;, Materials, •-Pinning Fire Stops, la. BOItS Permittee Plaster, Int. Authorized Agt Plaster, EuL Valuatian � �,,. � PermiL Fee $ �� Masonry Retnforoed _ � �� J � d Plan Check $ � Bond Beam � �� O � � , ,� � Feea' ' S � � � FINA� �� -_.i �. � t .�i FORM 204 10�55 O. P. 8 5. . t',•- ^."�� ]_f� - a: ' �T6 Date O � � 2 D r -u c J d I a J d a` PLOT PLAN 6how Iocation and distancea from :a • ''" property Iine and batween buildings c v � J i �� 1 � C i�' �� C� ` c i� � -�'� 1 ; P � � .� . � [t /' J�. . ,.�� i . .. �, , . �'t\� �'\' \. \�('C � o, _,c, J f � ' `� J .� ``; .�: .,, � � .. �9].r. � � . .. .... .- ��. ti, -. � .� _� \, . ... . 1.., :�'y...�` . \ ` _, . . \ ♦`� . . � �� .1`, �• ��i � . ' � " � • • ' l •' � ._ • l. . .J�� .. .A� . .. .,.�� ` \ � �+ :?:. S ti � � ' � . OWNER TAFT JOB ADDRESS AP No. 115-L INSPECTIONS coat e LOT TRACT � Signaturc .- � FIRE ZONE DATE GROUP � BUILDING PERMIT NO. VALUE ^y 795.00 D�SCRIPTION OF WORKAdd TYP� n 7.ON� o SUBCONTRACTOR & WS, � I ,_ ;��`J2 CbSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA ME6A. GALIPORNIA For Applicant fo Fill In Completely � TYPE OR PRINT BUILDING � ADDRE86 STA MESA. CALIFORNIA OWNER MAIL. 2 a4��6�,�, � AOORF�G / I'y1Pi1 �I " � ADDRESS CONTRACTOR A�DRESS GITY 6TATE LIC. NO. SIZE /�/ '�' OF LOT /L USE OF EXI87'ING BLDG. � BETBACK LINE FROM %1 ■ BUILDING TEL. F E RECEIVED SEP 2 2'^if - FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only NECEIPT NO. pCRMIT NO. /� T7s PECEIVED � I iE��l`F/I. D�yT1yI�Uq� `�y J IIDING � O /i� DRESS % COSTA MESA. CALIFORNIA FIRE ZONE TYPE � APPROVED �/ BY OP =o �NO.OF a rurvs TEL. "'-� LEGAL NO. DEBCRIPTION �� I NO. OF BLD66. I�� NOw on Loi A p N� / � YARDS APPROVED (CENTER LINE BT.1 REAR YARD FRONT / /� � RIGHT �yF� R.SIDE F' �N OF WORK i n ; NO. AP� BY /, U8E OF NEW Bl11LDIN6 r' ( / 'G� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH16 APPLIWTION TME AMOUNT SHOWN IINOEP VALUAT�ON I6 FOR TH¢ AND BTATE THAT THE ABOVE I6 LOflRCCi ANO AGREE TO COM- PUIiP09E OP EBTABLI9H�NG A PERMIT FFE ONLY. PLY.WITX ALL QTY ORDINANCE9 AN� 9T�TE LAW9 REGULATINO BIIILDIN6 CONBiRU ION. VALUATION SIGNATURE OF� � ^n PERMIT FEE $ L• � PERMI7TE O"� u ' $ �� + PLAN GHEGK S '^ F AUTHORIZED AGENT TOTAL FEE �� 4 � OR�4NGE COUNTY BUILDING DEPARTMENT j '� 636 North BroadwaY ' � . - SANTA ANA, CALIFORNIA � APPLICATION FOR PERMIT YI� ■D � V FOR-APPLfCANT TO FILL IN 'FOR OFFICE USE ONLY 9UI�DING d ADDRE55 Z(�9j� Ca�tii�g�t�l �PQ� scHoo� oisr. OR TOWN REC�. NEAREST CROSSST. Q�[ strPAi: rT BUILDING / OWNER C3j�(1gA f��ffjQB 1(j�� AODRE55 � MAIL D ,i SCHOOL DIST. ADDRESSC�'36"3 +.uilehix� L'ZQ�.t� OR TOWN BeverlY Hllls TE`.CR 54361 CITV NO. NEAREST CRO55 ST. ARCHITECj QR `� �� LIC.,��,� ,�,�� ZpNE I Fli 1 ENGINEE A II < ADDRE55 . �� CONTRACTOR NP{ ADDRE55 ��h`� LEGAL �� ]ESCRIPTION I NO. SIZE OF LOT+rF �� I NOW ON LOT O USE OF NO. OF NO. C EXISTING BLOG. Fnml�i[5 ROOM SETBACK LINE FROM: REAFi YARO CENTER OF STREET 5O P��SIDE YARIDii � DESCRIpT10N OF WORK NEW I � Z A1 TFRATION I I qpO1TION EXTERIOR WALL I ROOF 1 COVERING gt11�p(� COVERING USE OF NEW BUILDING 4en�A..�...� FOUNDATION: I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FOIRMS,! APPLICATION ANO STqTE THAT THE ABOVE IS CORRECT UNDER-PI AND AGREE TO COMP4Y WITH ALL COUNTV OR�INANCES FRAME: FIRE BRACING AND STATE LAWS REGULATING BUIL�ING CONSTRUCTION. LATH.INT. SIGNATURE OF LATH,EXT. PERMITTE PLASTER, INT AUTHOHIZED AGT PLASTER,EXT t� Peemii FeE $ �� MASONRY REI VALUATION $ �gOG�OO P�pH CHecK $ BOND BEAM � TOTAL �� FINAL FEE 8 9-30-59 OATE REC'O. � �� f I T CORRECTIONS APPROVALS i�s � DATE ISSIIED ;,�3,�-� . / -// i 0 a � Z D r W_ ' � '" ' __ Z + W � Z a � J � �O . \ �". ` �' �� rt , � ¢ • ' -. ' O a _ . ¢ c' '` ` ,\ ... � :_ '-\ ;� - , a . -� - . - ;� _. , �` � . . : '. , �� . .. . . . \: ( \.. -\ _; :: ,. 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