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Home My WebLink About839 CONGRESS ST - Building Permits(71a) 754-5273 • Fa�c (7t4) 75a-a856 • www.ci.costa-mese.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 839 CONGRESS ST Suite: Vicinity: ROOF Primary Occ: R-3 Dwellings/ Cong Res <70 Parcel Number: 42243212 App�icant: RANDY RAMSEY Adtlress: 31731 SANTA MARGARITA� Type of Construction: V-N Zoning: Status: ISSUED Applied: 07I062006 Issued: 07IO6Q006 Phone: 949-240-7934 ISSUED BY: SAN JUAN CqpISTRANO, CA _ _. -�- -----Zip:_ .92675 ' �� ri �',�G�, �,. '"'�'.^-.�_i-- �. .'��._ owner TAYLOR, GLENN"KENNETH �� =:'�,'` �� Address 843CONGRESSSTj� -��, �� , ; - � �;'�� ', � ��. " � , _ Phone:� . 1 � "�� COSTA MESq, CA � `� �• . � Zip:�, 9262� l � �\i �� .� / ; � �.� �'. � � , -- _ ' � /� � � � \� ��-. Contractor � RAMSEY�ROOFINGj "'_ �� ;�� / : , � � / -_ \ ��\ \\\ Address �� 31131 SAN7A� MARGARITA _- . - �� A �A �� '; . � � �� j j % Phone. 949-240 7934 �� `�VA � � SAN�JUAN CApISTRANO, CA �� / ��/ � ��.� / � //; Z p: 92675 � ;� j License: 847775 \\ \ \ / \ ,�\ Arch �: � �� ; � / i, Eng: � ;:�� i ..A �. �� Address:; - Address: � �,A � ,� �, � � . �„G'�� . ' . � A , � , d . Phone: - _ _ =.�Phone:� , �_� � . " V > •, o _ , � � � , �� i; � �/� _ � � ' �\', _ ,', � -; ' � ` _ , rZip:- -�� . � � License' � %� � -�� • ` License: � � �, � , ;'�'_ � �� .�- t� �� , . �,� ��- � � <�: _- SCOPE OF`PERMIT ,�� _ . i,,� - � �� ', TEAR OFF EXISTING ROOF. INS7ALL 1� LAYER OF 30# FELT, 30 YEAR COMPOSITION SHINGCES A �,REPAIR/REPIACE SHEATHING`AS � , ' NEEDED. 19 S�UARES.INCLUDES ATTACHED GARAGE. � `_� ' . - � \ � i �� ' " _ FEE SUMMARY ` � , � � � � �. Plan Check: � $0.00 �� "` �U� ?;'�''� �'"' � � `%'-��'��Calc Valuation: �, ss,000.00� � Permit: $8325 ��- - �- `��'� � � '��1'' '��` L� �`��'�Claim Valuation: �� ;;� , �� ss,000.00� �SMIP Res: �. $0.50 � _ _ � — � " -- - ^ - -� � � ` SMIP Com: $0.00 �� ^� . �� j�i' % � � � Other. . $0.00 -- `'= /-��A ` � -� % � _; -_' % ' � Inspection: $0.00 „ _ � ; j/ i��. ' _ , � � : % � / � °� � � � Total: � 583.75 � ��= _ '' �, ; . �'i, � , .. , �� -� � . .- �- e.. PLl SETBACKS-� �� - � s;''�'' MAINSTRUCTURE Front�O-0 Rear� 00�, \ � � ' , � ' �' • �_ 't ACCESSORY Front, �6=0 � ' �- -''Rear � 0-0 ', .'-., '�, �� . PARKING �Existin :" 0 ��'�'Reawred: 0 . . � _, � ,, �� :�� ' i �„� � �� . �,,, �; ,,�� \ „ � '� VNING & ZONING i��/ � �� ; / � ,' i �.- ii, � �.�, � �� / LeR - 0�0 r Right � 0,-0/ �, ,,, :�^` �i_v:=r.....;:ii/i i �� l �ea � a o ., R�gn� jg o � , /-� /� / � Pibnosed: 0 , ,l �;i��,,->` v�. � �', / %� < l � , / � i� % , �A� � "i , -•_ , �;,,��</��% , �\ ,,. �� , l_. n�v -��\ �,, , ; -� a�i %�� ' ;� % � _ ,�� NOTICE: The work authorized by this permit shall compty wlih all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-g2) EXPIRATION: This permlt shall automatically expire and become vold it work is not commenced within 180 days, or if work is suspended or abantloned Por a period of 180 days. INSPECTIONS: In order for ihe work aulhorized under this permlt to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetiona end final approvel must be obtained. Failure to obtain Inspections and finel approval will result In the axpiration of this permit. FOR INSPECTIONS CALL: (714) 750.5626 zm�ae �aroo) WORKERS'COMPENSAnON DECLARAPON: I hereby attirm untler penalry of per�ury one o1 the tdlowing Aadaretions: � ❑ I have and will meintein e ceNNcate ot consent ta seN-Insure br workere' compensation, es provltletl for by sectlon 3700 of ihe Labor Cada, far the peAortnance ot the wark for whlch this permit is issued. I��ave and vAI maintain workers' compens tion insurence, es requlreC sectlon 3700 oi t�e Labor Catle, for Na Aormance of the wark for which this q' Pa pBrtnR is is5ued. '--My wo�rk+e�j comPe�n�satlo urence �er antl policy number are: .L � �^ � Carder., cJt—Cc.'TW_. ��tv PollCy Number.' d—I � d 33 ��sec(ion need not be comp/e(ed tl fhe permu is ve/uetl et one huntlretl tlollare ($100) or less.) �— ❑ I certify that In the Dertortnence ol Ue work tor w�ich t�is pertnit is Issued, I s�all not employ eny person in any manner so as to 6ecome subject lo Ihe workers' campensetlon law Califomia, entl egree t � II I ahould bacome sub�ect to lhe workers' campensatlon provisions oi Seclion 3700 oi the lebor Code, I shail forthwith comptywlNthes p Isions. � 9 /_ / ApPlicant�6ipn'eture: �pe�g: 7/ (f��-lp W,,/(7NIN(3•'FAIW ETR OSEWREWORKE COMPENSATIONCOVERAG UNLAWFi1LAND5Hl1LLSUeJECTANEMC50YERTOCRIMINALPENALTIESANDGVRFlNESUPTOONEHUNDRED �i}IOUSAND DOLLARE (5100.W01. IN AOdT10N TO THE COSi OF COMPEN , DMUGES AS PiqVIDED FOR IN SECTION 310fi OF THE LABOR CODE, INfEREST, AND ATTORNEY5 FEES. LICENSED CONTRACTORS DECLANATON: I hereby eHirm that I em Iicey� d�y7.d� r provis oi C�apter 8(commendng with Section 7000) of Dlvlsian 3 0l the Busines er�C �P�ntessions Cade, antl my license is in tull brce.and�ettecL,uc,a 7�'Y�-1� % . Cess� a'�.}'Si �,; a Con�iracta"`w'�r's=ur8: � i. y�L�;'. 7� G�� CONSTRUC710N LENOING AGENCY: ❑ I hereDy BHirm t�at t�ere is e conSiNtliOn lentlinp Bgency tor Ihe peAormence ol the work lor which ihi9 permit is i55ued. (Sec. 3097, Civil Cotle). Lenders Name: Lendefs Address: Signature: OWNER-BUILDER DECLARATONS: Data: I hereby aflirtn Ihet untler penelry ot per�ury t�at I em EXEMPT FROM TNE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Pmfesslons Code: Any ciry ar counry which reqwres a pertnit to construct, elter, improve, tlemolish, or reDeir eny sWCWre, prior to its issuance, elso requlres the epplicant for such pertnit to fila e signed stetemem Ihat he or she is Ilcensed pursuant to the provisions of the Comrectars IJcense Law (C�aptar 9(commencing wit� Sectlon �000) ot Division 3 at the Busineu en0 Professlons Cotle) or that he or ahe is e:empt iherelrom end Ne Desis tor the elleged exemptlon. Any violation ot Sadlon 7031.5 by any applicant fw e pertnit subjecis the epplicant lo a civll penalry af not more than frve huntlretl tlollars ($500).): ❑ I, as owner of �he properry, or my employees wil� wages es their sole compensetlon, WIIL DO THE WORK, antl the structure Is not intentle0 or otterad for sale (Sec. 7040, Business and Professions Code: The Contractors LJcense Law does not apply to en owner ot properry who builds or improves thereon, and who dces such work himselt ar herselt ar through his or her own employees, pravidetl Ihat such improvemants are not Intentletl or oHered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of DmWnB ihat he or she ditl not Guild or improve for purpose ot saleJ. ❑ I, as owner oi the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business and Pmfessions Cotle: The comractors Llcense Lew does not apply to en owner oi property who bullds or Improvas thereon, and who comrecis tor such project wiih a contrador(s) license pursuant �o t�e Con�rectors License Laws.). ❑ I em exempt under 58C. Signature: Owner ID verilled Dy tlriver's licensa. ❑ Ves ❑ No Business enA Professions Code lor this reeson: Verificetion of Ownership by pype at tlocument, i.e. - property te: 6ill or deed): Driver9 License No. oate: Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: ❑ I he�eby certily the� no excavetion Ilve (5) or more leet in depth Into which a person Is required to descend, wlll be made In connection with work euthorized by t�is permlt, end t�et no builtling siructure, sceNdding, lelsework, or Oemolitlon or dismantling �hereal, will be more ihan thlrty-slz (36) taet high. (Chap. 3.2, Grp 2, Ah 2, Sec. 341, Tl�le B, Califomla Administretive Code). ❑ As owner-buildar, I wlll nol employ enyone to da work which woultl requlre e permll Irom ihe Divislon of Intlustrial Safety, es noted ebove, unless such persan hes e permit to tlo such wark Irom the tlivision. Signeture: Date: Division of Intluslrial Safery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUiHORIZA710N OF EMRY: I ceNfy under penalty ol perjury that I heve read this eppliwtion anA siate �hat Ne infortnetion given is correct. I egree to comply wit� ell stete laws end ciry orGinances relating to building constructlon, anC aut�orize representatives oi the Ciry of Costa Meu to enter upon the ebove-tlescribed property lor Inspection purposes. I epree not to occupy or allow occupancy of eny huilding authonzad by this permit until final inspection. CODE t. RISVECfIONTYPE 1616 Fixetl System Finel Fire Pravention 1266 Pool Spe Finel 200 Final Re-Root 2a1 Final Blxk/Hetaining well 202 Final Fectory Fire Place 203 Final Sign 204 Flnel Demolltlon PLIF It�l9 � � � COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Flnal Plumbing 210 Final Elecincal 212 Flnal Fire Prevention 220 222 250 Final Planning Approval Final Slte Final Building/Occupancy I�;iilincl ADO��ant l0 fill in all spaces exce0� lltose within �eavy DorOer lines an0 fign ail a00ro0riale tleelaratlons. PER I N TRACT NO. LOT NO. UNIT NO. CITV I,�F COSTA MES CONSTRUCTION PERMIT a v vw [P:oject Address 83� �orv��ss C.S'VI _ •Applitant's Mailing Address �� 3 � ��!�55 �,r��-�✓�V)�q�� Owner'sName -� r�;LDiZ 7:Ifi'IVE�jfpne"IL�O--�%� Address 843 Con/�Aess• r.wi Arch/Eng. License No. Address Comrector's Name—� �� Phone Address Imailing) City License No. LICENSED CONTRACTOR DECLAFATION I hereby attirm Ihat I am IlcanSetl untllr prOvi5iOn5O1 Cbarte� 9(commentlng with section �000) ot Dlvislon 3 01 the Busine55 antl Professlons Cotle, antl my Ilcenze is in tull force antl eHect. License Class Llcense No. Date Si9nature WORKERS'COMPENSATION DECLARATION I hereby aHirm Ihat I nave a Certi(ICdte Ot Consent to Self-InSu�e o� a C¢�BflGd[< of Workers' Gompensation Insurance, or a cerUfietl copy Nereof (Sac[lon '"�0, Lab. C.) .y No. Company Certitietl copy is hereby fumisnetl. ❑ Ceriifietl coOY is filetl with the city BUIltling DlviSiOn. Date APplicant E%EMPTION FROM WORKERS' COMPENSATION OECLARATION (This section neetl not be completetl it the Dermit is for one nuntlretl (5100) or lezs). I certity that in Ihe pertormdnte O7 tne wo�k (Or whith [hls p¢rm�t ii Issuetl, I shall not employ any p<r50n in any mann¢r SO a5 [O become sub�ec[ to tha Workers' Compen tion Laws of Calif'prnia�� q. _„_ � Da[e — S�9�ature N�Q ��'f1L[OL NOTIC : If, afle� making [hiz tleclaration, you ShOultl come sub�ect to lhe Worker5' Compensalion proWsions ol tha Labor Cotle, You must forthwith tomply with 5uc� provisions or this parmlt snall be tlaemetl rovokotl. CONSTRUCTION LENDING AGENCV I hereby altirm that there is a conscructlon lentling agency for the Darlormanco O/ the work tOr which th15 pormil Is issuetl (SettlOn 3097 Civ. CJ Lentler's Name Lender's Atltlress OWNER BUILOER DECLARATION 1 hereby aflirm lhat I am exnmpl /rOT Iho Contractor'S LlCensO Law for Ihn followin9 reason (Section 7031.5 Business antl Protosslanal Cotla: Any clty or counly wbich reqWfaS d pelmil lo COnStNCt, dlt¢f, ImprOvO, tlemoll5h Or lepall , any structure, prlor to its issuance, alw raqW�as tha applicant for such permlt to file a signetl s[atemenl lhat ho/sne i5 Iitenzetl pursuant lo the provlsion5 of the Contra<tor's Llcenze Law (Chapter 9(mmmoncin9 wilh Soctlon 7000) ol pivision 3 Ot tlle Bu51ne55 dntl Prote55ions Cotle) Of [Flat ho/Sh0 Is exampt Iherelrom and U¢ ba515 tOr lhe all¢getl axamptlOn. Any vloldtiOn of $Ottlon �031.5 by any applicanl for a p0�mlt Sub�otts [he aDP��canl l0 a tivll ialty ot not more than iive hunGretl tlollars (E500). I, as ownor o/ tha Property ��,�pa��wt�n will tlo Ine wOrk, antl Ih0 strutture Is nOt InlBnCetl or olfBrOtl or s�Y ale (Section 7044, Business an0 Protesslonal Cotlo: Tha Con(ractor's License Law tloes nol apply to an ownar of a Oroperry wM10 builtls or Improvos lhereOn, antl who tloes such work himsell/ner5011 0� tn�ough his o� he� own employee5, prOviCetl that such improvumanti ara not intontlotl or otiarOtl fo� sale. If, hOwever, tho builtling or ImProvement I5 soltl within Ono year of COm- pletion, the owner will have tha burtlen ot proving he/sha Altl not buIIG or Im- prove for [he purpose of sale). ❑ I, as owner o( tne property, am exUusively tontracting wlth Iicensetl con- Vaclon to construci the Project (SecUon 7044, Businoss antl Prolessions Cotlo: The Contractor's License Ww does not aPply to an owner ot property who builtls o� Improves lhereon. and who mnt�act5 1or zucb o�oleCts wlth a con- tractor(s I�censa pu/suan[ ro tne ConVactorY l.lmnse �aw). I am awaro lnat proof o� their Wo�ker'S Compensatlon insu/ance shOultl ba provitl¢0 to me. ❑ I am exempt unaer Sectlon—�.� B. &ff. Q. lor this r¢ason Date �'U�a� Owner 1 M1e�eby certify that I have rea in(ormation is correct. I agree to antl Slate laws �¢la[ing t0 builtli� sentatives of tnls Uty ro enter inspection purp es. Si9nature Drivers' License or 55 �f. `�� 0865-46, rev. 5/BB liwtlon antl state tbat-the above ith all dty antl county ortlinantes :llon, antl he�eby auth0/IEe rep�e- e a ove-mentionetl Propeertyq for Date3'�31�D ( � � S Main Building: TVPE OFCONSTRUCTION NEW °.DD ALTERATION REPAIR E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � T FrOn[ DESCRIPTION OF WORK/USE OF BLDG. A Rear TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL I C Right ❑ TENANT ❑ ELECTqICAL ❑ PLUMBING ❑ MECNANICAL g l2ft ❑ �OTHER Ping. Fief. � PROJECT DESCRIPTION 50. F7. oCCUaAr�CV Planning Notes: C O N ST RUCTI ON TYPE V ALUATION S ZONE GRADING CV. VOS. ACRES Remarks: Sink Preventer Irrigation Drinking Fountains FlOor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories Roof Drains Reinspaction Fee � $15 Boiler Duct- Under Grountl Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL BIL IC80 # Heating System & Ducting ❑0.100,000 BTU 0100,OOOBTi Reinspection Fae I $15 Whit¢ - Builtling; Candry - APpliGanh Pink - ACCOunting; GOltlenrOtl - ASSesso� Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank � Swimming Pool w/Spa Urinal Water Claset Water Heater Water Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeration System ❑aioo,000aru ❑ioo,000eT System Repair/Alteration Fire Dempers Registers Issue Fee $ 3 FEES $ 3 Aummatic Washe� Construc[ion Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas � �Eleci Fan F.A.U. Device Boxes �U112tS Switches Garbage Disposal Generamr �0-5 KW Zone ELECTRICAL Trans(ormer ❑ 15�50 KW ❑ SO+KW 5 KW Meter LJup to 100 amps Meter �lover 100 amps Sub Panel MotarsOO-i HP �1X-8 Inc.Solar �9�75 HP 016-15+ Microwave j� Pole Light Range Standing Sections Trash Compactor I Reinspection Fee �$15 I I luue Fee DEVELOPMENT SERVICES REOUIREMENTS: 2oning Approved By Building Approved By � AppliWtiOn ISSuOd BV FEES N I N G R E � M T S. SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PEPMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ —�-/��-/� ENERGV P.C. $ ELECTRICAL $ J� GRADING $ PLANCHECK 50°,6 $ MICROFILM $ MECHANICAL S TOTALFEE $ � "S� PLAN CHECK 25% $ oi �oo�a�i?-cooze2i^ T�ti .{_j", DH?E: 03/Ie.�89 7:4G: ;:t;r CONSTRUCTION AND PLANNING POOL 8 � .- �:�.� APPROVALS Permit # .�ate Inspecior p�ppROVALS Permit #, � Date lospector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Loca�ion 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement �' 3,- Electrical Conduit Utility-Undrgrnd. � ' 54. Forms ,� '4.'Electrical Conduit,-Undrgmd. 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-Unc�rgrnd. 6. Foundation 59. Gas Pipe, 0 Undrgrnd`:, Test � � i . 9. Water Pipe-Undrgfnd. 60. Backwash Lines, P-Trap, O Undrgrnd. ' ' 10. Structural Floor 5Ystem __ '�>� ' 61. APPROVALTO DECK . _, � 11. Property Sewer Line & Fiouse�Conrlection �' 62. Backwash & Receptor-Final • .• � 12. Sewer Cap � 63. �Heater & Vent-Final ,: r. 13. Roof Drains � 64. Plumbing System - Fin�l " 14. Rough Plumbing 65. Electrical-Final , 15. Rough Electrical-Conduit 66: Solar System-Final 16. Rough Eleciric Wiring 67. Fencing & Access Approval � t17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �'1'8. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # �1'. Ducts,'in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑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 IStructural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 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. 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 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer � - �%� ' � � '� 43. Backflow Irrigation � � � 44. Landscape Irrigation System i� �. 45. Sound Attenuation � 46. Handicap Regulations ' !:'- 47. FINAL STRUCTURE & BUILDING r�� i 48. Special Requirements Completed 49. Electric Release to Edison � 50., Gas Release to Southern California Gas Co , � ' t 51. �ERTIFICATE OF OCCUPANCY :�') �' - � " No. Date � + �� ? " - :� �OWNER TAYLOR, GLENPI & DOROTHY J DATE 2-25-55 JOBADDRESS 839 �on�ress Street BUILDINGPERMITNO, n68 GENERALCONTRACTOR Or,�er-Builder VALUE $µ1G OO , LOT 12� BLOCK TRACT ],8%2 Enclose carport and SU17T'OOPl GROUP TVPE ZONE FIRE DISTRICT 982 — I PERMITS ISSUED " INSPECTIONS DATE SUBCONTRACTOR DATE I NUMeER Footing Trench Foundation Forms and G Rough Framing Plumbina. Rouah to Slab Pole Heating, Final Septic Tank or Cesspool � Plumbing, Final Gas Test Wirina. Final N'unn LIO G-H 1M 12-63 JAN 10 1956 �/,GGe ��ur� � 6�- ., _ �OZUi�j. .0,� zi � � _i d'�"�LGL� .�.'�li��fi ��.>G�'rG C(. ��-6�-�-� : � �wr'�.'�'C�,,,� �� L�� % �� - GC�a-,�,� � � s S.s: ��'� ° ` ttt_h/!_ �c t� /��,��.�1. a ��...� Z , / g s� — -��-u.�.� .�,,..�. .�. �1�.�.� �"� -�.�.8... ,CC� o�� .�.-�- .caa .a��a.s ..�•.�o-�-� /�i..aa... � � ( • G�/� �i'++-rJL R"i .If�7� 1',_ -�''' /�� _ %��"�'�"'^�. � �� .r�-� a� ��iG�?G%Gr� �r�-�C(' i��e-�e'�.- � �a �.�9�- �Li�.-1 C'.. .cuz�� .�� q,s-�✓ .��til..-ceaaer �'""""—r,/� G �r - �I ��. ,� �� ,/ �� .G�� .�.,�e. ��p �� / � C9tANGE COUN7Y BUILDING DEPARTMENT APPLICATION FOR PERMIT � � t ; SANTA ANAM CALIFORNIA B �' `� � � � � � J o '� rc a �t \ \ry o �- --- c�. ...: „ .. _ - . . . �, a -.. , -. � . `. . - � � ` ' � • -� _ r. _ '�. '_ ' , 't � ' � ��.._. � _ — . .. .. . \ `'� .�7 , �. . .. , ' '_ ` � . ' ,�, � . .�� - _ .. , _ . , - � � _ _ Si � � ,., �_. ' . . , _. . .. , �r '� .. - .. ...- ' �.�� - a. ... , '- . �i.. STREET - . . s..:.� �. ... ..:� ' . ' • - . , � — ' � \ " . . . . Y i . � • r_ . ' 1 ' PLOT PLAN Show locotion ond distances from . - `� . property line and between buildings. Costa Mesa Building Department APPLICATION FOR PERMI� �• ,.� COSTA�ME A? CAL FORNIA � B U I L D�,� N G FOR APP CANT TO FII.L IN �OR OFb'ICE USE ONLY ec ipt . / PRr� it�N Bullding , �� . j� / Address :�- � ` Costa Mesa � California Received 6y Date Rec'd. Date Issui Nearest " � a� � Cross St. Building Address Owner � ' ^ COSta, MC38y C'i&�01111& Glty I' % - L no. _ zone rvo.or 7ype Group Arohitect or Lic. Plans Engineer No. Approved b Date nddress _ ^,_ CORRECTIONS Address I No. of Bldgs Sfze oi Lot � �' 1' ��C Now on Lot UseoT L� r I No.a1 � I No.of Existinp Blda. ,�-S,�t�2�.� Fam1Ue Ruuma L_� Repair � � Movi^9 � I Demolish Building ��{ L li' No.of 3ize ,L 4w.� D Rooms � StoNes Exterior VYe{I r _ � Roof , , _ APPROVAiC - �� — Forms,Materi � Under-Pinnin� Frame: Fire Sto . Bracing, Bolta I hereby acknowledge that I have read ihis Application Lath. Int. and state that the above is rnrreM and agree to comply Lath. Ext. with all City Oxlinances and S[ate Iaws regulating building constructlon. Signature o� .�p�' 1 ��, !� . � Plaster, Int. Permittee �_,. I/� c� Valuation D PermitFee $ yG. Plan Check $ S y./6, � Total Fee $ �, J cnwu one r..0 au a.sa O I a � ,� Show locatlon and distances from ' property line and between buildings y.. .__ _ �- - -. . .:. . i l�l . ..,...._ . ,r �:,'•� -"l.�in � ' , �_.... ' 4 G