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Home My WebLink About1327 CONWAY AVE - Building Permits ADDRESS OF EMILUINO: UHT: 1327 CONWAY AV CITY OF COSTA MESA BUILDING PERMIT ONNERS NAMEIFIDgYIN:NGUYEN, HAN N ET AL FLOOD: X ' 46 PERM NO: B 07741.0 GOVT: N SUPP: N ADDRES5:1114 POPPY CIR COSTA MESA,CA 92626 PERMIT NO: B 077410 PLAN CHECK NO: N 432 0324 APPL.MuwcAODRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; OTH ARCHITECT ORENGNEER: UC NO.: JOB DESCRIPTION : T/OFF REROOF W/ 25YR COMP SQ FT: 4 , 000 ARCH.OR ENG.'S ADDRESS: UHT: CLAIM VALUE: 4 , 000 . 00 CALC—VALUE: 4,000 . 00 GROUP OCC: R-3 /U-1 CONTRACTOR'S NAME:ROB ' S ROOFING ( 714 ) 842-5397 • CONTRACTORS MMUHG 17092 VAN DYKE LN COMMENTS: REROOF RESIDENCE ADDRESS:H.B . CA uC.NO.: 532516 ********************>f******************* **************** ******************>E** 92647 OMT: Z ON ING R EQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I an:licensed under provisions of Chapter 9 SETBACK S (commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. CITY LIC.NO.:051195 LIC.CLASS:C39 lit: 2)516EXP: 06/96 MAIN BUILDING ACCESSORY BUILDING \_ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN j5 Due: Z6 �Q6 Contractor: 44.- LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under namely of perjury that I am exempt from the Contractors License Law for the following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a panne to conmuct,alter,improve, PARKING REQ- P ROV: PARCEL: 14103604 Z N E: REF NO: demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Q licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Di ision 3 of the PLANNING NOTES>' _. sines and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 31.5 by any applicant for apermit subjects the applicant toe civil penally of not more than five hundred dollars($5001). **..***************.**.***********.******,****,************************* K„************* ❑ I.as owner of the properly or my employees with wages as their sole compensation,will do the work,and the structure a not intended D E V E 'L O P M E N T SERVICES R V I C E S R E U I R E M E N T S or offered for sale(Section 7044,Businessand Professions Code:The Contractors License Law does not appy loan owner of properly Q who buids or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such improvements are not intended or offered for sale.ff.however,the building orbngwementissold within one year ofcompletion,the ZONING APPROVED' BY DATE: ownerbuilder will have the burden of proving he or she did not build or improve for the purpose of sale). I.as owner of the exclusively contractingproject(Section 7044,Business and . • ❑ :Th eam wtl a d' with ltod a contractorswnerof property the Professions Code:The Contractors License Law does not apply en owner property who builds or improves thereon and who BUILDING APPROVED BY DATE contracts for such project with a contractor(s)licensed pursuant to the Contractors License Law). •j ❑ lamexempt under Section: B.&RC..for this reason: APPLICATION ISSUED BY: / DATE: 2(O• Date: Owner: ************************************************* 7F************ ****** ** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of Calffomia Health and Safety Code Sections 25505,25533,and 25534,and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for • a permit for construction or modification from the A'r yl�anagemenlDistria.Residential construction applications are exempt from Nese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ProSsions. PERMIT 87 . 25 . 50 Date: Applicant: • SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under panty of perjury one of the following declarations: PLAN ❑ I have and wil maintain a certificate al consent to sell insure l«workers'compensation,as provided for by Section 3700 of the labor ISSUE FEE Code,for theped«menceoftheworkforwhichthispermiisissued. BUILD ING DIC7 > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE hI-1 Ihave and will maintain workers'compensation insurance,es required bySecion3700oftheLabor Code.for the performance ofthe TOTALS----> 87 . 75 0 00 0 00 87. 75 87 , 75 00 work for which this penne is issued.My workers'compensation insurance caner and policy number are: Caner: STATF FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 87 . 75 OVER/SHORT: .00 Policy Number: incidi.nq—cIS 09/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK !is section need not be completed d the permit is for one hundred dollars(VOW or less.) 87 . 25 . 50 J I ceti y that in the performance of the work for which this peony is issued.I shall not employ any person in any memento as to become subject to the workers'compensation lawn d Cafomi d agree that D I should become subject to the woNan' ******************************************************************************* compensation provisorCyt{,of Section 3700 of the Labor Code.I II h,.wi�lh}po�mu oN with those provisions. Dale: / 2.6- V6 Applicant 40__ IND I V IDUAL F E E BR EAKDOWN Warning:Failure to secure worker'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST c/vll floss up to one hundred thousand dollars($100,000),In addition to the coat of compensation,damages as provided for In Section 3706 o the Labor Code,interest and etfomsy'sleew SFR 4000 ALTER BY VALUE . RESIDENTIAL NOZONE 1 .00 4 , 000 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Ce.C). LENDER'S NAME: LENDER'S ADDRESS: V ,T) I certify that I have read this application and state that the above information is correct.I agree to comply with at city and county ordinances E A p�I /R/�/�!(yE\�� }s�� and state laws miming to building construction and hereby authorize representatives of this Ery to enter upon the BbovamBntioned properly iAI,eG j—`�1I Th 1 for inspection pplails9 W ROB ZERGMAN Prfni NameN / 26 [ DATE 01 00,0578:4-1__217,55L7 T_E Tr7,' . Dae: DATE: 04:2 • TIIE: 10::6 Sign red Orman/Agent/Applicent/Conueaor / (5151'48 WP) White-Building S Safety;Green-File;Canary-Appirant;Pink-Revenue;Goldenrod-Assessor J 4� F 7 , CONSTRUCTION AND PLANNING POOL ` A APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement - I • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms .. 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ': ':- 60. Backwash Lines,-P-Trap, 0 Undrgrnd. 10. Structural Floor System - t 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final I 13. Roof Drains • - 64. Plumbing System.- Final 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 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air ConditioningFIRE DEPT. REQUIREMENT J 20. Rough-Factory Fireplace - APPROVALS - Permit# 21, Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating . . • 71. Product Piping 0 Gas 0 Oil -. 23. GM Pipe-Rough & Test - - • - 72. Underground Flush 24. Roof Framing /�' 73. Undergrnd.Storage Tank OGas OOil p. 25. Roof-Sheathing - t( 1af-1, 74. Overhead Hydro 3,ra Id .,�} 26. T-Bar Ceiling (Structural) & Monocoat t �G` `.- 75. Dry Chemical 1'`4 "i . s -+ F 27. Frame and Flashing 76. Dry Standpipe 28. Lathing 8& Siding 77. FIXED SYSTEM FINAL ' • ( -0-, 1 29. Insulation - 78. FIRE PREY. FINAL 0) I 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 r l •38. Final Plumbing - - _ 39. Water Service-Final - 40. Gas Service-Final - - . 41, Solar Domestic-Final ' - 42. Backflow Preventer . 43. Backflow Irrigation . . _ , 44. Landscape Irrigation System - a c - . ' . 45. Sound Attenuation - - • . 46. Handicap Regulations - 47. FINAL STRUCTURE & BUI LDING 48. FINAL PLANNING 49. Electric Release to Edison - 50. Gas Release to Southern California-Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ti 1 M4. CITY OF COSTA MESA 4` 006;1::,„ 6CALIFORNIA ' 8262&1200 P.O.BOX 1200 -w�,.. a c•. V• � DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION NOTICE OF PERMIT EXPIRATION • To: Rob's Roofing Date: • 5-13-97 17092 Van Dvke Lane Permit: # B77410 • Huntington Beach, CA 92647 Project Address:1327 Conway Avenue Costa Mesa, CA 92626 Our records show that the listed permits were obtained for property improvement or alteration at the above address and the project was not properly completed. The permits were obtained by: (X) Contractor ( ) Owner Name: Rob Zergma Phone:842-5397 License Number:532516 To construct or install: T/OFF REROOF W/ 25YR COMP The permits are valid for 180 days from issuance or your last inspection,per Section 106.4.4 of the 1994 Uniform Building Code. Should we not hear from you within 10 days, your permits will expire and additional fees will be required to finalize the permit. Your permits will expire on May 23, 1997 • Please be on notice that without a valid permit and required inspections completed, you will have encumbered your property with an illegal structure. If you need assistance,please contact THE BUILDING DIVISION, at(714) 754-5273, between 8:00 a.m. and 4:30 p.m. • 77 FAIR DRIVE Building Division (714)754-5273 • Code Enforcement (714)754-5623 • Planning Division (714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • ADDRESS OF BUILDING: 1327 CONWAY AV„ UNIT' CITY OF COSTA MESA - BUILDING PERMIT aINERSNAMEIFIDiam:NGUYEN HAN N ET AL FLOOD: X 46 PERM NO: B 077410 ADDR :1014 POPPY CIR COSTA MESA, CA 92626 • PERMIT NO: B 077410 PLAN CHECK NO: N GOVT; N SUPP : N 432-0324 APPL.MUNI ADDRESS: CONSTRUCTION TYPE: V-N PERMIT. TYPE: STR • ,PURPOSE: 0TH ARCHITECT ORENONEER: sae.NO.: • JOB DESCRIPTION : T/OFF REROOF W/ 25YR COMP • SQ• FT: , 000 ARCH.OR ENG.'S ADDRESS: ' UNIT: CLAIM VALUE: 4, 000 .00' CALC-VALUE: 4, 000 .00 GROUP OCC: R-3 '/U-1 CONTRACTORSNAMEROB 'S ROOFING - ( 714 ) 842-5397 CaNTACTOR'SwuUNG17092 VAN DYKE LN COMMENTS: REROOF RESIDENCE • ADDRESS:H.B. CA UC.NO.: 532516 ##############################################################x-################ 92647 DMT: ZONING REQUIREJIENTS • LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I son licensed under provisions of Chapter a S E T B A C K S (commenting with Section 7000)d Dirision 3 of the Business and Professions Code,and my license is in full force and effect. . CRY LIC.No.:05119.5 DC:CLASS:C39 C�/},�y')°�',Gyr�/y�?15lt,16 • EXP: 06/96 MAIN BUILDING ACCESSORY BUILDING Date: IF?6 -9� ,Contractor: @ (TINA w/J_ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN. RGHT: FT IN LEFT: ' FT IN RGHT: FT IN • NER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I ern exempt from the Contractors License Law for the fli corp mason(Section 7031.5 Business and Professions Code.Any coy or county which requires a permit to construct,after,improve, PARKING REPRO V: PARCEL: 1410 3 6 0 4 Z NE: REF NO •w twin,or neper any structure,prior to its issuance,also requires the applicantf`suchge tofile aegrwd statement ihet heist she PLANNING NOTES> licensed pursuantrto the provisions of the Contractors License Law[Chapter 9 comment with Section 7000 of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > • 7031.5 by any applicant for a permit subjects the applicant to acivi penalty of not more thanfbe hundred dollars[55001). ##.l(.## (.######################################################################### ❑ I.as owner of the property or my employees with wages as their sole compensation,will do the work,and the structure a not intended or offered for sale(Section 7044,Business and ProfessionsCade:The Contractors License Law does not appy to an owner ofpropeM D E V E L -O P M E N T S E R V I C E S REQUIREMENTS who buids or improves thereon.and who does such work himself or Mosel or through he or her own employees,provided that such not - improvements • are t intended or offered for sale.ff,however,the building or improvement is sold within one year of completion,the - ZONING APPROVED B Y DATE: ' owner builder will have the burden of proving he or she did not build or improve for the purpose of sale). • ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business act Professions Code:The Contractors License Law does not apply to an owner or properly who bulks or improves thereon and who BUILD ING APPROVED BY : ' DATE: .. contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law), . '/ / ❑ lamexempt under Setcn: B.AP.C..sNtsreawn: APPLICATION ISSUED BY: p DATE: �/ 21D 9L� Dale: Owner: *# I do hereby thatm I eaware of and understand the requirements of California Meekh and Safety Code Sections 25505,25533,end L EGAL Z Z AT I ON:N F E E SUMMARY STRUCTURAL SEGMENT:Y 25534.and that I or any future building occupant will/will not(circle one)need to comply with said state codes end the requirements for a permit forconstmction or modificationfronthe Ar Quality Management District.Residentialcnstmcllon eppiratlornwxempt efrom these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 87 . 25 50 Date: Applicant: . SMIP/,NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN n . ❑ I have end will maintain a certificate or consent toself-insurefes workers'compensation,as provided for by Section 3700 of the LaborISSUE F E E self-insure for the performance of the worfor which this permiisissued. BUILDING-DIV-> • PERMIT ISSUE PLAN-CHECK . TOTAL PAID DUE I have and will maintain workers'compensation insurances as required by Section 3700of the Labor Code,fes the performance l the TOTALS----> 87. 75 0 .00. 0 . 00 87. 75 87 .75 . 00 work for which this permit is issued.My workers'compensation insurance carver and policy number are: Carder: STA'T'F Frr*tit EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87.75 OVER/SHORT: . 00 Policy Number: 1094609-Q5 09/01 /96 BLDG B7PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOTT GRADING PLAN-CHECK (This section need not be completed I the pent/is for one hundred dollars j$iCOI or less.) o I certify that in the performance of the work for which this pent is issued,I shall not employ any person in any manner so as to • • become subject to the workers'compensation laws o Califam' and agree that H I should become subject to the workers' #############1E################################################################# compensationJprovisiohn of Section 3700 of the Labor Code,I sin l 1 hwit �hy with those provisions. try-7-2'6- V6 Applicant: C^/ INDIVIDUAL FEE . BREAKDOWN Warning:Failure to secure workers'compensation coverage is un/ewtu(and shill subject en employer to criminal pana/du and TYPE QTY DESCR IP T ION . UNIT COST ' TOTAL COST civil tines up to one hundred thousand dollars($504000),In add/don to the coat of compeneatlon,damages u provided for In section 3706 of the Labor Code,interest, rorn eendaaya/aaa. SFR 4000 ' ALTER BY VALUE RESIDENTIAL NOZONE 1 .. 00 4, 000 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). . LENDER'S NAME: ' - • LENDER'S ADDRESS: . ' I certify that I have read this application amid pale that the above information is correct.I egree to comply with all sty and county ordinances _ • and stale laws reefing to building conscudion and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. ' • ROB ZERGMAN,Print01 00205366-00205367 TOT 87.75 Name • 7 /• 1 + / [ 6. DATE: 04/26/95 TIME: 10:16 Date: / 4-sa �v Sp re nt/Appkant/Contrador (5151-4e.WP) Wh e-Building A Safety:Green-Ale:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor OWNER COLLEGE MESA COMPANY DATE 11-20-58 _ JOB ADDRESS 1327 Conway -Avenue BUILDING PERMIT NO. 8011 GENERAL CONTRACTOR The Halp Company - VALUE $ ' 12,599.00' _- AP. No. LOT 22 TRACT 2671 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar. GROUP I & J TYPE V ZONE R1 PLAN NO. PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR ` DATE NUMBER Trenches Forms Steel j - ._ -fi /. .'a. •1k Floor System 12-/I-It Steel Reinforce Chimney Re-Rod 1 n - Bond Beam t-.Y A -.Z4 "i y Frame and Flashing 4 if / •..�4 _ st-/ _ �-"� Lathing, In Out .��: S .-3.--a y Plaster, brown coat �---t 3..-S _r f• Underground soil 4W W/G Pipe Test L,w, /R-//•y'y Top.Out /t'//•TV • _ f Furnace I w /tIp-.51 9,, 6t ,-t., yv,.Aic-c-r t /-/3-t-9 l6 %4i `— Gas Vents Rough Plumbing /,J �/716159 /C rOd2° ,c VOV 2 1958) 2 h4y��Zf Cesspool Septic Tank [jH,,, .t. �1 Prop. Swr. Line V House Con./ St. S ir. l�-'2y-J 6✓1t -,�e-tYtc y, !.�.29-S ' / S �(�/ (t Sprinkling System A . Heating Final Plumbing Fixtures, Final ry Final Gas Test Construction Pole I 4 Underground Power Rough Wiring //� ,t 30-5 Fixtures, Final fg.J (', /off' $ Q.5-'7 c OCCUPANCY Form 210-5M-1-57 I Ir• ,1 EEE RECEIVED • COSTA MESA BUILDING DEPARTMENT i'iiac�ScS P.O. BOX 317 FINANCE DEPT. COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDINGBUILDING . ADDRESS 1327 Conway Avenue COSTA MESA. CALIFORNIA • FOR OFFICE USE ONLY RECEIPT NO. T O OWNER COLLEGE MESA COMPANY �� MAIL • RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS P.0.Box 2277, Brookhurst Station fir/ ,/-i y-ST NOV 2 0 195E TEL. BUILDING CITY Anaheim NO.KE 31,1 ADDR• ARCHITECT Bulot, Quigley LIC: OR ENGINEER and Clark NO KE 719 COSTA MESA. CALIFORNIA' FIRE ADDRESS 1102 W. 17th St. . Santa Ana ZONE CITY LIC. ZONE NO. OF TYPE GROVP `/'�. CONTRACTOR Th Hale rnmpany NO,7350 (i1 Y /71 ADDRESS 1777 W.Lincoln,AnaheirrNo:KE 3-3161 APPROVED ADDRESSDATE !!!///////// LEGAL LOT CORRECTIONS DESCRIPTION NO. 22 BLOCK TRACT 2671 lan #4-Alt A.P.NO. ' SIZE 63 x 117 I NO.OF SLOGS. None OF LOT NOW ON LOT 1USE OF EXISTING BLDG. SETBACK LINE FROM 49 • CENTER OF STREET 501 REAR YARD 1. SIDE YARD RIGHT 71 , LEFT 71 DESCRIPTION OF WORK • 111 NEW X ALTERATION ADDITION REPAIR MOVING DEMOLISH - BUILDING 12221 -Liv.- NO.OF SIZE 4401 -Gar ROOMS 5 STORIES 1 EXTERIOR COVERING WALL St UCCO COVERING Compo USE OF NEW BUILDING Single dwelling w/att. garage I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. OLLEGE MESA COMPANY VALUATION PERMIT FEE $ 30.00 SIPERM!ATUEE O B • THE HALE COMPANY n.P rtnar - PLAN CHECK $ 15.00 $ 12,599 AUT /J,iA/ �� TOTAL FEES 45.00 fir _APR 1 8 1960 OWNER FREEMAN, ELSE DATE 11 -30-59 — JOB ADDRESS 1327 Conway BUILDING PERMIT NO. 11037 GENERAL CONTRACTOR owner VALUE $ 92.50 AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK WI mark wall INSPECTIONS DATE I GROUP J TYPE ZONE M. Underground Soil U.G. Water PERMITS ISSUED Underground Gas SUBCONTRACTOR DATE s. NUMBER Overhead Water and Gas , Rough Heating Rough Plumbing _ Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final p Plumbing Fixtures Final Gas Test Construction Pole _ Underground Power Rough Wiring Trenches Forms Steela _.)___„. ....,7 - Floor System _ - _ Steel Reinforce Chimney Re-Rod / tom.{tel LL A..the scat,i� ezed . ?____, Bond Beam _ i Sheathing // s z/–/-o i _ < .- �� L/ 1 Frame and Flashing fes„ .j> ,,�1�� A P / : �4' -'rl�i I`/ Lathing, In Out _(/4�/-5th; .i /-e.e-to !�_ _ . _6.! Plaster, brown coat Plumbing Fixtures, Final Electric Fixture se in.L - Building, Final�/ ' .e Art /7 't- OCCUPANCY / / `i7 Form 210-3M-4-59 r - - .1.1U57 ;) /f 3G -S-9 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. U P.O.BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR fittl/ PRINT' BUILDING BUILDING /3 ,. y - L_ •0; _' ADDRESS COSTA MESA, CALIFORNIA / FOR OFFICE USE ONLY RECEIPT NO. PER M ITS SID7 OWNER F /J L ��1 //,. .S7 I �_.. O.) / MAIL `j // YORE E/I�VED BY DATE RECEIVED DATE ISSUED//�%f ADDRESS /3 R7 C o 4, f/L7 0../ N//< ._ I I/-se' _/ %I /1-Se ^/ /fes c TEL. BUILD N // ) 7 /, CITY �'� ��Q /�'/ L�„/� NO. • ADDR 6, � 'X ViC '-L-C Cj2.0 ARCHITECT LIC. COSTA/MESA, CALIFORNIA OR ENGINEER NO. FIRE ADDRESS 7--) //' ZONE �� - c C TYPE GROUP A�- O w N R H, 8 aq STATE APPROVED-//i( 1 . (-� // / T J / CONTRACTOR LIC.NO. BY / ' DATE ADDRESS . 1-ZONING ' - LEGAL NOT - J 2.6 I ZOJ{F� ( PLANS USE OF NEWpAtit DESCRIPTION I NO. "--• I BLOCK J TRACT' J I PLANS /1 I BUILDING / 1() ^ 1c S — I 3 BYAP l ,/ �� ll DATE /'�la J SIZE NO.OF SLOGS. YARDS W V VES l OF LOT U I NOW ON LOT REQUIRED ALLOWED , EUSE XISTING BLOC. // CJ IN - (CENTER LINE ST.) TL' FRONT FT. ! IN. SETBACK LINE FROM .� _ 111 CENTER OF STREET _ REAR YARD R.SIDE IN. SIDE YARD I LEFT C) I RIGHT L.SIDE FT. 0 IN. DESCRIPTION OF WORK REAR IN. NEW I V II ALTERATION I II ADDITION 1111 REPAIR MOVING 1 I DEMOLISH I . I . • BUILDING - NO.OF SIZE ROOMS STORIES - EXTERIOR WALL COVERING I ROOF ' COVERING - E OF LDING E YScon, xi,,1/AN/D�IWORK --FBNc-E.RM� „ . • 4 ' ' .A7;aq //XX/J/////''O c _TA/0 'f71-e_,,, /'e N C • / $ 3 n �n w 9 • . I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION ' AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRtLCn///o'rv. VALUATION /✓// eV SIGNATURE OF 6 /,��1��/ �f/ /!i//.•ni�r�-� PERMIT FEE S a, �— PERMITTEE YYYJJJ.111"`^^^K I //Xn'/' //J� O S La ------ PLAN CHECK $ AUTHORIZED AGENT / /%'1 TOTAL FEES ' •