HomeMy WebLinkAbout1336 CONWAY AVE - Building Permits •
PROJECT ADDRESS: 1336 CONWAY AV UNIT: - CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 054083
OWNER'S NAME: PHAM, TUAN THE
ADDRESB: PHAM, ANN HANG PERMIT NO: B 054083 PLAN CHECK NO: : N GOVT; N SUPP; N .
1336 CONWAY AVE
COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
850-0635.
I ' •
REG.NO.: UNIT: JOB DESCRIPTION : REROOF 2400SF RESID & GARAGE SQ FT: 5, 000• •
CLAIM VALUE: 5, 000 . 00 CALC-VALUE: 5, 000 .00 GROUP OCC: R-3 /M-1
PERMITTEE: WESTERN SIERRA ROOFING . ( 714 ) 660-8505 •
ADDRESS: 17932 SKYPARK CIRCLE COMMENTS : REROOF W/SIERRA TILE ICB0#4361 (�,"{�,g -
IRVINE - CA 92718 **>E>E>FTE.x*** L� ***BETE>EaLTETCTL>F*�L+E*�k�E**�E*�E�E ->F*�E�E>E*>E*>FrE**kN**�HTE*****°TL•i;' ligl',p�e• 0 . �E*E*Tc+E
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section • Z 0 N ING R E U I R E M E N T S �A �`'�
7000)of Division 3 of the Business and Professions Code, and my license is in full force and effect. •
SETBACKS RE/�V��% �.,Yf
CITY UB.: 9,3999 ATE LIC.: 9 2 5 9 9 /n/� �,c s: C��9 \ •
•
REQUI n
Date: (/ ?- / signature:_(\'�C�< ' rh3,e,e/ 7 MAIN BUILDING ACCESSORY BUILDING -REle/---
WORKERS'CCCDMPENSATIDN DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN N REAR: FT IN - FRNT: FT IN REAR; FT I N
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C. LEFT: FT IN RGHT: FT IN ' LEFT; , FT IN RGHT; FT IN
POLICY NO.: 01WCP12072 ) EXP.DATE: x4/01 /92
COMPANY: SUP. NATL PARKING REQ• PROV; PARCEL; 14103816 ZNE; . REF NO: •
❑ Cenified copy is hereby furnished. EX Ce fled copy is filed with the city Building Division. PLANNING NOTES>
,ate: 9—Y'-9 ( icant:Af j i 2 a _ / ******************!E******IF**********************************************3e** *-Ik*
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section heed not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICESRE Q U I R E M E ..-
S •
•
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become ,
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY •
• DATE:
•
Date: - Signature:uBUILDING APPROVED BY : • DATE:
NOTICE:de, If,after making this declaration,wihu should become this
permit s the Workers' rempensation provisions of the Labor
Code.you must forthwith comply with such provisions or permit shall be deemed revoked. . � ,--
'
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: G * *.*.*. DATE. �['7
which this permit is issued(Section 3097,Civ.C). *************a(.**.*.*****.****.*.*.***i(.***.**..7F****. *.*.*7� * ***{(.*.*.**.*.*.*.*. ' {F.*.
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/REST' GRAD'I NG
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,ort PERMIT • 72 . 00 . ." 50; • ' -
repair any structure.prior to its issuance,also requires the applicant for such permit to file a'signed statement that he/she is licensed ( - 4
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business, - , $MIP/NOh1-RE$
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN yy '.' P. '�'
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE A .4, ,/� ' .
L•as owner of the property or my employees with wages as their sole compensation, will do the work, and the' BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK — TOTAL —PAID ,n . DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> . , 72 . 50 0 . 00 0. 00 72. 50 i 72-5'0. . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ( ' , g,
his roro herm owntemployees,witin provided that suchlion.the o ms are note heintended or offeredofrfor she/.Ifinothowever d rbuildingmr or REVENUE DIVISION TOTALS--> COLLECTED• • 7 2. 50 OV,ERI/SHORT• 00
• improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve ,t
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOS'=-, GRADING-PLAN-CHECK
I.as owner of the property.am exclusively contracting with licensed contractors.lo construct the project(Section 7044,Business 72 .00 5 'n
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon' at
'and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law). l am aware *********************************************************-*******aF***********-(7**/-
mat proof of their Worker's Compensation insurance should be provided to me. IND I VIDUAL F E E B R E A K D O%A W N , • ) '
o I am exempt under Section: B.8 P.C. G
i't f
for this reason: TYPE QTY D E S C R I P T I O N � UNIT COST TOTAL COST '%
. -r /Ir, .
Date: • Owner: • e
SFR 5000 'REROOF BY VALUE RESIDENTIAL NOZONE ' • 1'. 00 `4 5, 00000
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ! , if':.�
25534 and that or any allure Molding occupant will/will not(circle ane)need to comply with said state codes and the requirements for a - _ END OF FEES ,�; ri, ;. ; `-
•
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. 4•
•
. rt ,
ri
Date'. Applicant' I . ,/.2
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all ci and county I yr •
.M G .-
-
ordinancesandstatelawsrelatingtobulldingc struction and hereby authorize representatives of this city to enter upon the ab e-mentionedsi ';
property lar inspection purposes '
.•.
/ \ 4 Y 01 00048036-011092037 TOT \. '.`` �
Date: � �— Signalure: 4/ ��(.(� I 7 GATE: 09/25/91 TINE: 12:.t2 '
Driver's License or Social Security e: ' '
1641.46 white—Building:i Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor .
a
. CONST.IUCTION 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. . . 4 53. Steel Reinforcement •
' 3/Electrical Conduit Utility-Undrgrnd-. . . 54. Forms .
4. Electrical Conduii=Undrgrnd;" -• 55. Electrical Bonding
5;',Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. EI-eCtrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE 7
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 ' . _ 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final ' C
12. Sewer Cap ! - 63. Heater & Vent-Final
Y
13. Roof Drains f' 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 Ceiling69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
201'-Rough Factory Fireplace . ,,•,. r, ; �',, .
!APPROVALS] `Permit # -
21'Dupts,in-Strkctu�e.: ., „ rr �� ; '70. Unde7ground Hydro '` "t
22. Ducts,Ventilating .y S + ` .71. ProductPiping O Gas 0'011
23'- R
Gas Pipe-Rough & Test 72. Underground Flush'. - - ,�
24.tRoo1 Framing . r :.73.^Undergrnd.Storage Tank-b �
Gas 0 Oil
25. Roof SFieathing -`- - '74,rOverhead'Hydro-
26. T-Bar Ceiling (Structural) &-Monocoat _ - •u 75.-Dry Chemical ,,
275.7-Frame and Flashing " • r - ` 76: Dry Standlpipe -5• S. "t
28: Lathing,& Siding... .-a v 77_ FIXED SYSTEM•FINAL". i• '
•-29. Insulation c' '� "' '`` 78,-,,FIRE PR.EV. FINAL x 'L -_�_._-
730. Drywall.Nailing - < • • • . HEALTH,DEPT: REQUIREMENT •--
:31. Plaster Brown Coat ` 79 FINAL INSPECTION
-_32._ Electrical Power Meter-Final, '' I. . ,80.-FOOD CERTIFICATE ISSUED'
, 33.'Final Electric - ` 'Notes: _ _ r
'734.-FinTil Heati g.& E r,Conditioning t ,r., u
35.-Final Gas Pipe-Test. - ' . T'= :t -� `
I .. . :o
,36.-Hood or-Canopy : - • LI •• 'p `_I "'
37:-Final Fattory Fireplace I ' ' ' F 'I.
„-* t
"38. Final Plumbing y ' v, -f n" ' - -
:39. Water Service•Final • • -k - * .r
;40. Gas Service_Final
-.41. Solar Domestic-Final•, _ I t° 1-Gv - ' x
42. Backflow Prevente( " ,
e1.27-47- 1�af,rte=.
43. Backflow Irrigation- `• -. k . /4O B4o e
,44. Landscape Irrigation System;. ." l � '.- ' ' _
o
10 Y45'Sound Attenuation > * (C•' 0"ii_ �--/
ffaw� Sire- 'IA.
46. Handicap Regulations ' t ' - ;o
47. FINAL STRUCTURE & BUILDING 1424-p /c try t 2 y`� _e�l: c r-6.43
48.'FINAL PLANNING ;' l �K ^�; • C/�l , ` _
49. Electric Release to Edison • . ,. - /7�
',50. GasReleaseto Southern California Gas Co I I' n -'• l-1?-R�-- ic.j - /ti;, ;-J�i. !/vi `� e�
51. CERTIFICATE OF OCCUPANCY , >• r ` �r� : ���f�a� (�
No. Date �p - b1t_ c
OWNER . COLLEGE MESA COMPANY DATE 11-20-58 _
JOB ADDRESS, 1336 Conway Avenue BUILDING PERMIT NO. 8015
GENERAL CONTRACTOR The Hale Cnmpa y VALUE $ 12.599.00-. -
AP.
2,599.00 . -
AP. No. LOT 26 TRACT 2671 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar.
GROUP I & J TYPE V ZONE R1 PLAN NO.
INSPECTIONS DATE PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel airZ /* -y -Se
Floor System -e 4 /,Z-ir b'
Steel Reinforce Chimney Re-Rod
Bond Beam S/E--t /...2 p -
Frame and Hashing fir./EC g 7 0 !7
Lathing, In Out £—fll s -/C --6 H
Plaster, brown coat Th---a4: 3 -_5'. AW
Underground soil W/G Pipe Test,Jt//s.16=619. _
Top Out i -/b--A (�
Furnace ,I,./q/ 2.4-617 -tin c&, , 1y� , 1-/ 3-.5- _/ 6 915- __.
Gas
.5 ---
Gas Vents C?_ t aG c 6r-✓S / NUN �+C�,yy�
Rough Plumbing " 'C / d-6 • r� K / rCrOe ,a2 NMN `2 0 1 `J 16500
Cesspool Syptic Tank
Prop. Swr. IS/\Hotlge?con. St. Swr. I`N vy i n- /17-_,Q,t,Jr cu-j4 . Id--,; 5-S S- / SS S
6 � /
Sprinkling System
Heating Final IV 91/-; V _
Plumbing Fixtures, Final ( ' 7/-3j`9
Final Gas Test /4 it 3-r!/-6-9 _
Construction pole
Underground Power tt� �^+.� ^ �� h� P
19q,
Rough Wiring 1 /-h.n , 1 (,�, ett 4J--3o-.til_ -7 y 6/
Fixtures, Final 3 -yy�y _
OCCUPANCY /AW 9-3/-A7
Form 210-5M-1-57 /
8015 . ' iEE RECER!EU
• COSTA MESA BUILDING DEPARTMENT 11 E 6 c---
-
—
P.O. BOX 317 Fl�A{�CpE�.DEPnT.pp
COSTA MESA. CALIFORNIA CITY OF COSTA CISSA
_ FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 1336 Conway Avenue BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PgMIT1 5
OWNER COLLEGE MESA COMPANY i,/nlf�(
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS P.O.Box 2277, Brookhurst Station -i? NOV 2 0 195$
/L N'�
hi `/
BUILDING
CITY Anaheim TNO. KE 3-3161 ADDRESS
ARCHITECT Bu lot CQu gley LIC
OR ENGINEER an° ulark - NO. RE 7191 COSTA MESA. CALIFORNIA
ADDRESS 1102 .W. 17th St. , Santa Ana ONE
CITY LIC. ZONE
PLANS TYPE / GROl1P
CONTRACTOR The Hale Company NO. 7350 RI (/ ���
TEL. APPROVED
ADDRESS 1777 W.Lincol rAnaheJraw- KE 3-3161 BY DATE •
LEGAL LOT 26CORRECTIONS
DESCRIPTION NO, BLOCK TRACT 2671
Plan #3-BK
A.P. NO.
SIZE NO.WO F BLDGS.
OF LOT 65 x 91 NOON LOT None
USE OF �I
EXISTING BLDG. �IILJI'I
SETBACK LINK FROM
CENTER OF STREETM 501 REAR YARD 24'
SIDE YARD RIGHT 7' LEFT 17'
DESCRIPTION OF WORK
NEW X 1ALTERATION . ADDITION .
•
REPAIR MOVING DEMOLISH
BUILDING 122 ' - Liv. NO.OF
SIZE 4401 - Gar _ROOMS 5 STORIES 1 .
EXTERIOR WALL , ROOF
COVERING tucCO 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. '
•TIONCOL GE MESA COMPANY VALUATION PERMIT FEE S 30.00
SIGNATURE O ,i
PERMITTEE �y: � e Hale Company,Gen.P3r��er
/, �^�� s 12,599 PLAN CHECK S 15.00
AUTHORIZ ti ? #/, 4/ , TOTAL FEE S 45.00 4e.«r
OWNER PRINS. JAC.M. ABC2 1 t"Si DATE 2-7-61
JOB ADDRESS 1336 Conway Ave. ^"u i ' 1UZ.a% BUILDING PERMIT NO. 13795
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 2,4 0.00
AP.No. ll3-256-16 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK Conv.Gar.to ,RE
INSPECTIONS / DATE I GROUP I TYPE V ZONE R1
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas ..
Rough Heating
Rough Plumbing
Miscellaneous _
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final _
Plumbing Fixtures
Final Gas Test _ _ _
Construction Pole
Underground Power M
Rough Wiring Olt5c,-5"-(1 n .�..
u ,.-Q•szy.., . 5-19-4,1 j.�1l.re
Trenches Forms Steel
Floor System _ / _
Steel Reinforce Chimney Re-Rod i
Bond Beam '
Sheathing _
Frame and Flashing g(_i5/- a/
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final / /�/J R �. 6 5 ,-('�- y�,.,�9 _
Building, Final (/ ) it
OCCUPANCY 1q
Form 210-5M-11-59 5-B P 137915'
13795 _
COSTA MESA BUILDING-SAFETY DEPARTMENT . [E E RECEIVED CCEI1ED
P. O. BOX 917 COSTA MESA. CALIFORNIA 7 1961
• For Applicant to Fill In Completely APPth SMA faTPERp
elAr
//TYPEIOR PRINT R'Y 1= •
CITY QF,IC��S���IESA
26
BUILDING
ADDRESS 1 3--/ ( _Q MwAV • YY
COSTA MESA.
CALIFORNIA� , For Office Use Only
QAC: /-'i r2C I IV S RECEIPT NO. 13°11195
OWNER
MAIL RECEI BY DATE RECEIVED DAT ISSUED/
ADDRESS 1336 rn w AY AQ _ �x� 4.7- 7—G/ •2 - 7-y
TEL.Sal 5 (�
(�(/�yj A MEyA NO. -. BUILDING
CITY7�79 ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
—
—
ADDRESS FIRECX
MO kr ZONE TYPE GROUPOU
CONTRACTOR LJLy (-`• Ic - U I D1^ (� BYPROVEO '), DATEA. -4%
ADDRESS 7 NING• //JJ�
ZONEA NO.OF USE OF NEW LA-%LPl{�4�.,
CITY PLANS a I BUILDING w-le/
STATE TEL. cog* c,.
t
LIC.NO. NO. LEGAL -'r - / / G{.{� 7 /
DESORIPTI {((BOO czo 6
SIZE 1 NO. OF SLOGS. / / ^�'F LOT /� NOW ON LOT A.P.NO. / ! J_ . - S ISr, —. I
USE OF CAtZAGE . YARDS EVES
EXISTING BLDG. [ APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.1
CENTER OF STREET REAR YARD - FRONT �1/FT. IN.�FT. IN.
SIDE YARD I LEFT I RIGHT R.SIDE / .
DESCRIPTION OF WORKL. /�
NEW I II ALTERATION I VII ADDITION REAR SIDE ..._J iZ/ FT. a IN.
REPAIR -`.'.I II MOVING II DEMOLISH I / BYPROVED at, DATE -j,--
BUILDING �) �E )_O NO. OFROOMS / STORIES ( �
EXTERIOR WALLA I ROOF
COVERING COVERING
USE OF BUILDING AND WO TO BE PERFORMED
V
CONi_R-71wJCI�LAIaAC To A
FAMILY RCbM!_/ AkJD ADD OMI. - ---- -/ DU`Y
A . I S. a J- ►rm
I HEREBY ACKNOWLEDGE THAT I HAveiipto THI= APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CO'REC'II AND AG'EE TO COM-
PLY WITH ALL CITY ORDINANCES AN• STATE LAW= REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTIDN. VALUATION O r...•SIGNATURE OF /1 P _ ' PERMIT FEE $
PERMITTEE 1-4.--1-- l9 • s,„2:4/21,O,[I PLAN CHECK $ `
AUTHORIZED AG / p
TOTAL FEE u
OWNER PRINS, MR. J. / DATE 6-4-62
JOB ADDRESS 1336 Conway St. BUILDING PERMIT NO. 17201
GENERAL CONTRACTOR Santa Ana Tent & Awning Co. VALUE $ 1,210.00 _
AP No. l)Il -038-16 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Patio Rb
INSPECTIONS Signature DATE GROUP J TYPE IV ZONE R-1
Soil PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. U Air Cond. ❑
k,
Rough Heating
Rough Plumbing
.1 Miscellaneous • ,
J` Prop.Swr.Line 0 House Con. 0 St.Swr. D •
'C •Sprinkling System
Construction Pole
Underground ❑ Power D .
Rough Wiring _
1 riches 0 Forms U Steel Item!. U
Floor System
Bond Beam ❑ Steel Reinforce D
Sheathing
Frame and Flashing
Lathing — In ❑ Out ❑
Plaster, brown coat
Refrig. 0 Air Cond. ❑ Final
Heating, Final
Plumbing Fixtures, Final .
Final Gas Test _
Electric Fixtures, F nal
Building, Final 1�,., Li -15."4.5
OCCUPANCY
FORM BU4-5M — 7-61 17201
17201 FEE RECEIVED
•
COSTA MESA BUILDING-SAFETY DEPARTMENT l$/•D/
P. O. BOX 917 COSTA MESA. CALIFORNIA I' " ��TTFIINANCE •. . -•
For Applicant to'Fill In Completely • APPLICATION FOR 'I ERMIT COSTA MESA
TYPE OR PRINT -
BUILDING
qoD
BUIDING f 33 ( /maim fly s�•
- COSTA MESA. CALIFORNIA For Office Use Only
I�i\ RECEIPT NO. PERMITMINO.
OWNER M R/� V• 47 r 7
1 I / ---2 c
MAIL 1334
1 rI- RECEIVE BY DATE ECEIII VVV0 DATE (ISS (JED
ADDRESS I3 34 CG0 �- /-k / (.-P-
i TEL /
F I / 3 .) Y,- /A��
CITY P • S r NO, BUILDINGADDRES5
ENGINEEROR ARCHITECT • TELNO. /+gCOSTA MESA. CALII � 'p
FIRE C/9R / 11Q4;,/a- '/` �. . l- 6e
, ADDRESS ZONE - TYGROUP
1 I APP'
/i
CONTRACTOR � � BY � �• � - ���ATE�
Fz,7ING O
ZONE NO.OF USE OF NEW�u,
•1 , ) j - I PLANS ti2I BUILD IN
LIG NO. 19 4 1, R LI TEL I' `{, (' I DESCRIPTION //'�q, `- v- 110 7/
� � p � �7 NO. (�-{II s-O l LEGAL • [/ LLLYYY
SIZE
NO. OP
• OF LOT "TO.6 'f-D- / '-I b .`NOW ON LOTS I A.P.NO. / '//-0 3 g---- / 6
USE A//1
EXISTING BLDG. %Q TRO f!CG I4 J• APPROVED "ALLOWED
• SETBACK UNE PROM
I (CENTER LINE BT.)
CENTER OF STREET REAR YARD � FRONT ' f I .. Fr � IN.
SIDE YARD I LEFT I
RIGHT ' R.SIDE CO FT. IN.
'
DESCRIPTION OF WORK
L.SIDE
/ & FT. IN.
' NEW N ALTERATION I II ADDITION I X �/y REAR 1t 1 2 /ec^ FT. IN.
REPAIR I II MOVING I II DEMOLIS I_ _ TRO D(/,i,�L V . TC O //_/ >—
BUILDING C NO. OF II L/ (f,/ ,� , 4" b
SIZE /E A-4 ° ROOMS STORI E6 i T / / '/ /
EXTERIOR WALL ROOF - �` .i I . �! •
3��' v( w r1� I
' COVERING I COVERING ,� �• �p�-z3�/ii�?
USE OF BUILDING AND WORK TO BE PERFOR ED v
P •
1 L /! ��i'�IF . _ R 1 0 /
i 1
• La n V;R. No.__ 0 I 07)
v01s.- L..:rdlL�Ii�>1 • EY F f>
ifi, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CI ORDINANCES AND STATE LAWS REGULATING
BUILDING OONSTR' ON. VALUATION moi'
I;
PERMIT FEE / --
SIGNATURE OF • $
' ,r J :-
NW
N
PERMITTE � $ 4'. /� x PLAN CHECK $ 3<.0
AUTHORIZED AGENT A Icy rc
TOTAL FEE S z e S� v?
OP -
M . .
•
, VARIANCE • . ,
REQUIRED '
r)-C r -
DATE /
•
VAR. No. /'` APPROVED 6'71
.
„. r4
I
li
• , - , ,
.
•
�� � FEE RECEIVED
4 /9- - / L., - S1
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. v L\
P.O.BOX 317 COSTA MESA. CALIFORNIA
CITY OF COSTA MESA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING iil a..6....."...„
ADDRESS COSTA MESA, CALIF RNIA
FOR OFFICE USE ONLY
9.a.2.44..
� a RECEIPT NO. �� {.I2 O.
OWNER j/Vy/I-LnA- AVS Iw�.V/J �.JL •
MAIL % J �f / �/EI - _ i RECEIVED BY DATE RECEIV�E-WSJ DATEISSUED .,G
ADDRESS /31 .•J/ 1 (6 C ,t cc �/ ../� i' -,o -s / I / a�-/Q-:fl
CITY P�� /G� TNO/I/-V • AADDRESS
UUUU.... ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER NO. �.�7 (//}
ZONE TYPE /J� GROUP
/A��D7DR
ADDRESS P'���+✓� /, G
OC NTRACTOR /� LIC.NOSTATE lj ®JQ1/ APPROVED�y'o DATE /0-%D- `'��
ADDRESS 73/x- _J, „,'13/I". a, '-& , ZONING
LEGAL I LOT A� / / 17 I ZONE NO,OF USE OF NEW WAX/
/ '//
DESCRIPTION NO. 22`D BLOCK TRACT If'� I IPI-ANS l (.BUILDING I A/`,,. AI�/� yy
A.P.NO. /IJ -� S Ao —I BYPROVEDj / / ./ly DAT // -A-s
,VE
, I 6 �( p ?6 no.OF BLOBS. YARDS {I/11'/ v / ,�
OF LOT I NOW ON LOT REQUIRED (ALLOWED
USE OF (CENTER LINE ST.), /{�
EXISTING BLDG. FRONT '�.. FT. 'JL IN.
SETBACK LINE FROM _ llI
CENTER OF STREET REAR YARD R.SIDE FT, 0 IN.
SIDE YARD LEFT I RIGHT L.SIDE 4i / 4- A IN.
DESCR TION OF WORK 0
REAR FT, IN.
NEW I ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
BUILDING NO.OF
SIZE ROOMS STORIES
EXTERIOR WALL I ROOFIC.L.i/
COVERING COVERING J
//4 7A( I( BE 4 - -7t vL /�/)C/1 (C L
USELDING D WORPERFORMED
le
1 3 i(f 1- .SYG/j/,IA f c+f0;7,- 4/ .,-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
QRJ
SIGNATURE OF / PERMIT FEE $
PERMITTEE
j�y( . $ 454.0 PLAN CHECK $
AUTHORIZED AGENT ,, - 4,1-0
a
TOTAL FEE $