HomeMy WebLinkAbout821 CORTEZ ST - Building Permits� � BUILDING PERMIT
Job Address: 821 CORTEZ ST
Suite:
Vicinity: RESIDENCE ANq ATTACHED GARAGE
Parcel Number: 14131104
Applicant: ALEXSON, TROY
Address: 1653 SUPERIOR AVE
COSTA MESA, CA
Owner: BAKER, KARIN E
Address 821 CORTEZ ST
Zoning: R1 R1
Phone: (949) 642-7222
Zip: 92627
Phone:
COSTA MESA, CA Zip: 92626-5822
Contractoc LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
, Phone: (949)642-7222
COSTA MESA, CA
Zip: 92627 'License: 349686
Arch : ' " Eng:
Address' , � , � � Address:
� . � � . . Phone:
ISSUED BY:
Status: ISSUED
Applied: 03/01/2004
Issued: 03/Ot/2004
Phone:
Zip: , . , License: � License:
SCOPE OF PERMIT
: TEAR OFF EXISTING ROOF, RESHEATH AND COVER WITH 40 YEAR COMP. INCLUDES ATTACHED GARAGE.
FEE SUMMARY
Pfan Check: . $0.00 Calc Valuation: S�o,000.00
Permit: $181.25 -- -- -- , - ClaimValuation: Sio,000.00
SMIP Res: $1.00
SMIP Com: $0.00
Other: $0.00
Inspection: , $0.00
Total: $182.25.
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
PLANNWG & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Right 0- 0
Right 0 0
NOTICE: The work authorized by this p�rmit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
foi a period of 180 days. ,
INSPECTIONS: In order for the work authonzed under this permit to be considared legal, soch work must comply with all applicabte codes, and afl
required Inapeetlons and finel epproval must be obtained. Failure to ob�ain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626
taa6-4s Is�oo)
WORKERS' COMPENSATION DECLARATON: .
I hereby affirm untler Denalty of perjury one of the following declarations: '
❑ I have end will maintain e cetlifiCete of COnseni to self-Insure for workers' compensalion, es provided for by section 3700 of the Lebor Cotla, for the pertormance ol �he
work tor which this pertnit is issuetl.
14 , I heve antl will maintain workers' compensatlon insurence, es required by section 3700 of Ihe Labor Code, for the performance ot ihe work tor which this permit is issued.
Rt My workers' compensation Insurance carder and policy num6er are:
Cartier. Polity Numbec
(Th/s secf/on nestl not be comp/eted il (he permif is velued et one hundretl tlollars ($�100) or less.)
❑ I cenity that in tha pert rtnance of t e work for which Ihis permit is iuued I shaT not employ any pereon in eny manner so as lo become subject to lhe workers'
compensation ia, that it I should become subject to Ihe workers' compensalion provisions of cti n 3700 o`Ihe Labor Cotle, I shall fonhwith
complBwitht�esepro i i ns. ��I 9�'1 I,
ApplicantSi neWre: Da�9: d I 1 rY
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFUL AND $MALL $UBIECT AN EMPLOYEF TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
THOUSAND DOLLARE (5100.000). IN ADDITIIXJ TO THE COST OF CAMPENSATIIXJ, OAMAGES 0.5 PROVIDED FOF IN SECiION 3106 OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm Ihat� m lic se—d unde{ rovislons of Chapter 9(commencing with Section 7000) of Oivision 3 of the Business and Professions Code, entl my license is in lull
force antl aflecL Lic. M I I A�/�/%/ii._ Cless N
Contrecror's Signa�ure' T� Date: � I �1�
CONSTRUCTON LENDING AGENCV:
❑ I hereby aHirtn that ihere is a consiruction lentling egency for the performance of Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lentlefs AtlOress:
SlgnaNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hareby aHirtn that under Oenelry of perjury thet I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires e permit to consiruct, alter, improve, tlemolish, or repeir any strucWre, pnor to its issuance, also requires tha epplicant br such pertnit
to file a signetl siatement thet he or she is licensed pursuant to ihe provisions oi the Contractors License Law (Chapier 9(commencing with Section 7000) oi Dlvision 3 of ihe
Business and Pmtessions Cotle) or ihat he or she is exempt therefwm and ihe basls tor the alleged exemption. Any violation oi Section 7037.5 by any applicent for a partnit
su6jects Ihe a0�licant to e civil panalry of not more ihan tive hundred dollars ($500).):
❑ I, as owner ol the properry, or my employees with wages es Iheir sole compansation, WILL DO TME WORK, and the siructure Is not intended or oMered for sale (Sec.
7044, Business and Professions Code: TTe Contractors License Lew does not apply to an owner ot property who builds or improves thereon, and who does such work
himselt or harselt or Ihrough his or her own employees, provided that such improvemenis ere not intended or oHered tor sale. If, however, tha building or improvement is
soltl within one year of completioq the owner-builtler will have the burden of proving thet he or she did not build or improve tor purpose ot sale.). •
❑ I, as owner ol Ihe properry. am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS lo construct ihe project (Sec. 7044, Business and Professions
Code: The coNractors License Lew does not apply to an owner oi properry who builtls or Improves thereon, antl who contracts for suc� pmject wIN e contractor(s)
license pursuant to the Coniractors License Laws.).
❑ I em exempt untler sec. Business antl Protessions Code tor ihis reason:
Signature: Data:
Owner ID ventied by dnver5liCensa. ❑ Ves ❑ No Drivers LicenSe No.
Venfication of Ownership by (rype ot tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby ceNty thai no excavation tiva (5) or more feet in depth into which a Oerson is requiretl to tlescend, will be made in connection wiih work euthorized by this
permit, and that no building sWCWre, scaflolding, talsework, or demolition or dismamling thereol, will be more Ihan ihirty-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec.
341, Ttle B, Califomia Adminisirative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which would raquira a pertnit from ihe Division ol Industnal Safery, es noted above, unless such person hes e
permit to do such work from �he division.
Signature: Date:
Division of Industrial Safery Pertnit Number:
CER7IFICATE OF COMP�IANCE AND AUfHORVA710N OF ENfTiY: I certity under penalty of perjury ihat I have read this application and state that ihe infortnation given is
correct I agree to compy with all stete laws and city ordinances relating to building consiruction, anO euthorize representatives ot ihe Gty ot Coste Mesa to enter upon Ihe
ebove-described properry for inspection purposes. I agree not to occupy or ellow occupancy of any building authorized by this pertnit until tinal inspection.
�._
'1: �a : : •
I��J���/;�:
..
COOE I. INSGECfIONTYPE
1616 Fiaed System Finel Fire Prevention
1266 Pool Spe Final
200 Final Re-Root
201 Final BIocWRetelning Wall
202 Final Fectory Fire Place
203
204
Final Sign
Final Demolition
QdjE IMIfIpLS
COUE� INSPEC710NTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
-,. -�.. �, - .
'�� ' Applicant to fill in all s0aee5 extept those within heavy bortler.�lines antl sign all apPropriate Eeclarations. � - 524g �j�C[]��C, , -I � q�l,V �I
•'CITX-�F'COSTAR1ESA'CONSTRUCTIONPERMIT P ITNO � TRACTN . LOT. O. UNITNU., ' � ' . I . , , �. �- �' ;`
�i1.y-�r�� �"-- r s� 3 ----,
Project Qddress4�2' �+7! !7-i� . . ' , ' � ' . � �. i , . . •� . �
��ApplicanYs Maili Addreu' " ' ` - _ TVPE OF CONSTRUCTION �: , NEw' ADD ALTERATION- ' ;REPaiR _ _
� � p� ❑ CONVERSION ❑ DEMOLISH .O OTHER �
. Owner's Name � " � �� Phone ' r 7' ' v,:� . A.P. # ' � I — , . .- " Zane , ,
D��.�R�IP�T�ION �^1Q RK/USE OF D � � -
Address( ' C��)����. ' � � � , �'/��1i1 �/ii/. � ' �'� �� � � � 1 - E Main Building: � 'Accessory.Bwldin9: Z
Alch/Eng.��o[L¢�• �I/�icenseNo. 1� ' � TV, EP OFPEfiMI��./ OUNDATIONN�� -STRUCTURAL; � T Front' � � . �
� ❑ TENANT IJ ELECTRICAL �PLVMBING 'LJ�MECHANICAL B ' .. - , , ' } � � ' N
�Address - , , Y38 . �_/ A Rear I � � � ' i , • �
� �❑�OTHER ' �b
- Contractor'sName� ' G� �ti 'Phone � . / . pROJECTDESCRIPTION' SG�: FT. + � - �oGCUaANCv� C .Right � ' ; � �,- .". ����= � � � N
� Addresslmailing) � �' �' �� , , i p � CONSTRUCT,IONTVPE ' r � ,�VALUATION$ g Left � � ' � � ��- � ', R
�City Cicense No_ . ' ' � � ZpryE ' � GRADING CU. VDSi � ACRES ' . , ; , + �
LICENSED CONTRACTOR OECLARATION �- ' - Ping. Ref. #� Pa�king Req./ProvidEd ��. E
', I hereDy aitirm [ha[ I.am liceosetl untler provislonz of Charte� 9(commencing Remarks: � . , . . ~ Planning NOtes' n
� with section ]000) ot �ivision 3 of [ne Business antl Protezsions Cotle, antl . �J' '`- �
my license'is in full orce antl�eHeca . . ' , �. .] ' ` �SS ' -
�� License C�Ip ss ' � � Li ' e N p � '
,�Q Date /7/� 5'g t ' �� �C������ . . � PLUMBING � . � + FEES p r5 � . ',c3% .
WORK RS' COMPENSATION DE �ARATION � � � � � ,
I hereby aftirm tnat 1 have a certifiGate of consent to selt-insure or a tertiticate ' Bar Sink Showers . � ' ELECTRICAL , , FEE$
� �f Workers' Compensation InsuraP�e, or a ceriifietl copy thereof (Sectlon � � '
. . _ . Backflow Preventer - - - Service Sink � -- � � - � Automatic WaSher ' � 'Transformer ❑ 15=50 KW - -'� �
3800, Lab: ) �[ �' � . �c " `
Policy No.���7' UN�%�Eompany v ND , , gackflowlrrigation . SewerCa � '• ��' �'� '�?�;• � ' ' : , ❑ 50�+KW �
� . , . P � . r'� �ConstructionPoleSub.� • �
Certified m is �ereby (urnishCtl. ' � � ' " � ' � '
�Cer if co etl with the city ui n Dlv' . � � � i Bathtuhs ' ' Sewer Conn¢c[ion�'tFj ,�, f „', Cooking Unit ' � 1 � Meter ❑up to 700 amps '
Da[e � ApplicaPt � � - -
EXEM 10 ,��RKERS' LO NSATI N DECLA AI 1 N� C.larifiers . Solar CollectOrs �i j\ � , � Dishwasher � � .Meter ❑Ove� 100 amps �
�(Tnis sectian neetl nObbe completed �� he Permft 15�(or one huntl� ($300)� or"' � , � , - - - " - " ""' � ' - - ' ' � "
� less). � � r ' Dishwasher Solar Piping , �.. : y,-•' qa Dryers �Gas • �Electric . .Sub PaneF � � ' � �
I certify that in the perfo�mance of the work (or which this perm�t is issuetl I � � � . � „ � ' '
' SM1all not employ any pe�son in ai�Y manne� so as to become subject to the ' D�inki�J FOuntBinS i � SOIa��:TaOk C�., y i?� '� i;� 7�� 'F3p• ' � � '
Workers'.Compensation Laws ot Califoinia.� ' � ^ �-' ' � � � � • �Momrs OO-1 HP �1%,; 8 � . i �
. Date' ' ' Signature ' • • � ' ' � � ' ' ' Floor D�ams' ' � Swimmin Pool w/S a ��, � ' ' � '- j
'NOTICE: If, atter making this tleclaration, you shoultl. bewme Subject to the 9 � P �F,A.U. I Inc. SolarO9-15 HP �i6-15+
� �i
� Workers' Compensation provisions of the.Labor Cotle, you must forthwitn _' , FIOorSinks.�_ _. ��� �. ...--- .Urinal ��-� V. ' � ' � -
' compry with such` provisions � o� this permit Sh511- be tleemed- revoketl. k' �` �" - ' " Z ��FixtU�¢5 � - , ' - Microwave - ' . � � ' " D
CONSTRUCTION�L'ENDING AGENCV-�' •: ' '. � �' GaSServicC � Outleti' ., WatePCloSCt� � ` � ! - '
, I lte�e�y affirm that there is a constNction�lentlinq agency to� the�pertormance ' ,D¢Vic¢ BoxES Pol¢ LiPub . � t
of the .wo�k fo� which thi5 p2rmit is issuetl (Section'3097_ Civ. .CJ �nterceptorsi '- WaterHeater ' ��.Outlets � � Ran 2 � �
Lentler's� Name - 9 '
� � �Lentler's�Atltl�ess , ' � � ' �� ' ' � ' . Kitchen Sink � - . ' � ' � � , � �
�`. J • ` � .Water'Service ,' ' Switches . �i �Sign . . � ,
OWNER BUILDER �ECLARATION � " �� � ' ' ' - � � � . ' �
. � �
._l hereCy. atfirm that I am�exempt trom the Contractor's' Licenre Law tor the � Lavatories � -� . Auto;Wash � � � Garbage Disposal ; Standing Sections :
' .following reason'(Section�]031.5 6usinessantl Professional Cotle:'Any city or � _ - ' ' - • t ! � ' �
Sbounty which requires a permit�to ConStruct, alter, Improve, tl¢mOliSh or repai� � P-T�dp � L3und� T�a 5 � 1, - � ' '
:any structure', prlor to its issuance, also requlres the applicant for such permlt - � Y ��Generator DU5 KW 05-15 KW Trash Compactor -
b.,IO fll2 d.51 OCd SLdICT¢Ili Ihdi'�IC ShQ IS IIceOSCd pIlI5UdI1[ IO IIIC (OVI510lIS OT ' _ �' I .
9 � � ter 9 commencin P Roof Drains� � � � � � '!
;rthe Cont�acto�'s�License Law (Chap ( 9�witM1'Sectlon']000) ot ���' -'i ,.. � d�'i n �
;.tDivision 3bt the Business antl Professions Cotle)"or that he/she is ezempt - - _ - '
^-:therefrom �entl the basi5 Por�the al�e9etl exemption. Any violation ot Section _. . , G, ' � � i • � ' - . � " ' ' , � '
-'':7031:5 by any � applicant for a� Permit subjects tne 'applicant �to a civil ; - '
"penalty of not more tban five nuntlretl tlollars (5500). • : - '. ' - + . ' ' , ; � � � . • ' ) '
'❑ I,- as owner ot the` oroperty or my'employees with wages as their sole' ' Reinipection Fee � .$15' � laue Fee -. • $ 3 " ` � � . �
' comDensation, will tlo the work, antl the-5t�ucture i5 not intentletl or of(eretl ' - � " � ' ' ' '
for sale (Section 7044, Business antl Protessional Cotle: The Contracror's -. `� : ' MECHANICAL - � � Rainspection Fee $15 �laue Fee � $ 3
License Law does not appty to an,Pwner of a property-who•builtl5 or improves ' FEES
thereon; antl who tloes mch worK himself/herselt ar tivough his or her own � - � �� - ' DEVECOPMENT SERVICE Q IR ENTS:
; employees, provitletl tbat such Improvements are not intentletl or offeretl for ' , goilef �"' ;,..� I Hood oI � Type I�❑ ' •� - � / �
, sale. If, howeveq the building or ImProvement is soltl within one year ot com-'' . -�. . Canopy � Type I I ❑ � i Zoning Approved By � j DataJ�S�
' ple[ion, the owner will'�have the bu�tlen of proving he/she tlitl not builtl o� im= � Duct = Under;Giound . . - ' Building Approved By � Date
, ' � prove.fo� the Ou�Oose of sale). . �� . . ' ' ' ' - �
:❑ I, as'owner ot tne property, am�exclusively conlracting witli licensetl con- Duct -Structural � Refrigeration System Application laued By ' � Dat
, Vacto�s to consbuct the project (52otion ]044„Busine55 antl Profe55ions Cotle: � • �
The Contrac[or's License Law does not 5pply to an owner ot property who Duct - Ventilating ' ❑6700,000 BTU ❑100,000 BTU ` � 4.. SUry�MARV OF FEES �
� builtls or improves-thereon,�antl�Who contracts for such p�oject5 with a�con- � - - - - � ^ - -��- • /��j � , � O
� tractor(si license pursuant to the Contractor's License Law). I am aware that , � Exhaust System ❑ Multiple �, System Repair/Alteration f BUILDING PERMIT ,$ I U SMIP; '$ �Q
� proot'of their Worker's Compensation insuranc¢ shoultl be providetl to me. -) �-pLAN CHECK �$ —��� PERMIT , .
' L� Pzm exempt untler 5ection ' B. 6�P. C: tor tnis reason Fiiepl/Fact. Blt.-ICBO # � Fire Dampers� ' �� '$ ,• K� ISSUANCE $
� � . ' ' � � �� PLUMBING� �
� Date • - ' 1 owner � � � � • ' Heating�System & Ducting . ' Registers � �— ENERGV P.C. $ � �
PLAN CHECK 25% � $ �
� I, hereby certify,that I�� have.reatl this appiication ana state thaf-the above 00.100,OOOiBTU 0100,OOOBT - - � ' i GRADING $
, inPormation is wrrecL I a9ree to comply with all city antl county ortlinances ' ELECTRICAL � I$ • . .
antl state laws relating to b i' ing construction, antl hereby authorize repre- : - - � PLAN CHECK 50% �$ ��' : MICROFILM "$ �
sentatives ofltbi�clty�to' er u o- the above-mentionetl property f r �
- inspection pui 65 f � r �
� , Z � � , ' � . . MECHANICAL• $ `�� TOTALFEE �$ �I�.]S
SignSCure Date .
� � - — Reinspection Fee $15 � ' Iaue Fee ' • $ 3 PLAN CHECK 25% $ � ' � � �
� Drivers' L�ce � or 55 � l
CMF 0865-46, rev. 10/84 White - Bulltling; Canary_- qppj{canp Pink - Accountln9; Goltlenrotl - Assessor . . - ' " . �
i. . � � ' � . . . ' . .
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CONSTRUCTION AND PLANNING
.� APPROVALS Permit#
- ,: 7.-Tempo�ary-Electrical Service or Pole
-2. Soil Pipe-Undrgrnd. � � � � �
•'3.,Electrical Conduit Utility-Undrgrnd.
' -4. •Electrical Conduit-Undrgrnd.
. '
5.,Steel Reinforcement� % �
�
6:� Electrical UFER Grnd. • -
,
7: �Footings � � � , , ' ; �'
� 8: �Foundationi � ; '
' 9. Water Pipe-UndrgFnd. ' �
. 10. Structural Floor System � � -
� 11. Property Sewer Line & House Connection
�2. $0W@f C2p � • �
13. Roof Drains � � . '
14. Rough Plumbing : � �
}5:. Rough Electrical-Conduit �
� �;16:' Rough-Electric Wiring �
17. Rough Wiring Sign - ' �
�JB.. Rough Electrical-T Bar Ceiling
19�.� Rough Heating & Air Conditionin'g
� . . - �.
20: Rough Factory Fireplace '•
. 21.�Ducts, in Structure
22:; Ducts, Ventilating . ����
23:' Gas Pipe-Rough•& j'est � � . . '
,
24. Roof Framing-• i , �
25 , Roof Sheathing ' t' `
, ',
26. T-Bar Ceiling (Structural) & Monocoat
r
27.3 Frame and Fiashing , •
:�
28.i� Lathing & Siding
. 29. Insulation -
I 30. Drywall Nailing -:},
31. Plaster B�own Coat.� �, �
I32. Electrical Power Metel'-Final -
' 33. Final Electric �
34. Final Heating & Air Conditioning 1
35. Final Gas Pipe�Test , • : ��'
36. Hood"or'Carfopy � � '
37. FinalFactor�y,Fir"eRlace '') ` .�f,
38. Final Plumbing •� , � .:, .
39. Water:Servi -Final - � � ,
�!
� 40. GasService-Final • �i'�.�
..� ,
41. Solar�DomesticFinal � '+ ;i ""
.. ,�
42. Backftow Preventer . ::� ;• �� �
:.i
43. Backflow Irrigation� . • "�r
44. ,Landscape Irrigation'Systemy ,
45. Sound Attenuation .�� " '
, '�
46. Handicap Regulations � ''
'i' i •.
47. FINAL STRUCTURE & BUI,LDING
48. Special Requirements Completed' ;,
''� 49t Electiie Releaseto Edison�� �; ,i ;•�'
4
�` ` 60'. Gas Relea�se to Southern Califo'rrtia Gas
�, �51., CERTIFICATE OF�OCCUPAN(�Y
Date -
� � � POOL &�SPA .
Date Inspector � � -- Date
APPROVALS Permit �k� -
� � 52. Pool & Equipment Location
. ` ' � ' 53. Steel Reinforcement � � -
��� -� . 54. Forms . � . . � -. .
, - 55. Electrical Bonding � � �
' - 56. Rough,Plumbing & Pres;ure Test �
57. APPROVAL TO COVER:GUNITE
. �, ,
�
�
u
58. Elearical Conduit-Undrgrnd. .� :
S�` 59. Gas Pipe„� Undrgrnd., Test �
60. Backwash Lines, P-Trap, O Undrgrnd.
- 61. APPROVAL TO DECK �
� 62. Backwash & Receptor-Final
� 63. Heater & Verit-Final � .
64. Plumbing�System - Final ' �
� 65. ElectricabFinal " • -
66. Solar System-Final
I� 67. Fencing & Access Approval . --
68. APPROVED FOR PLASTER�ING
. � 69. POOUSPASYSTEMSFINAL -
� FIREDEPT.REQUIREMENT
APPROVALS � Permit #
70. Underground Hydro ,
71. Product Piping O Gas ❑ Oil
72. Underground Flush� �
73: Undergrnd. Storage Tank � Gas ❑ Oil
74. Overhead Hydro � � .
75. Dry.Chemical �
76. Dry Standpipe .
77. FIXED SYSTEM FINAL �
� 78. FIRE PREV. FINAL �
�
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
r��..r:�. - ,Jen-A PaP�� (c
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Inspector
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CITY ❑F C�STA MESA, CALIFORNIA
July 12, 1976
The residet�ce at 821 Cortez substantially meets code.requirements
with the following exception:
1. The planter boxes at the front of the house are filled with earth
that is placed directly atainst the house wall. The code requires
a 2 inch wide air space between the planter box and the wall.
Flashing permitting air circulation is required if the air space
is not less than 6 inches.
RH/ajr
�ir✓c� !a� �
RICHARD HANI3ART
Building Safety Director
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ir �ti.."i���u�1�`��,...�+�_�6i�.iw�109 E CENTURY�OR.' . ._.ORANGE. CALIFORNIA 92669.� , rt. +�4i:�qPHONET94�t�917�6i?�eyaiL �,3+�:��
OWNER t�iFGA T1FT MAR nFtlF'T.t1PMFNT C'AMPANY DATE (�_15-60
JOB ADDR.ESS 821 CortP2 StrPat BUILDING PERMIT N0. tQ301
G�NERAL CONTRACTOR �cco C.orooration VALUE $ 14�515.00
AP. No. LOT �f T12ACT q74.q FIAE ZONE DESCRIPTION OF WORK res. w/att .�
INSPECTIONS �G/ I DATE
L
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OCCUPANCY
SUBCONTRACTOR
Form 210—SM-11-59 5-B P . � - 123�1 .
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA, CALIPORNIA
For Applieanf fo Fill In Complefely
Y BUILDING
COSTA MESA. CALIFORNIA
ADDRESS. SLL�.t@ 1, 3800 E. Coast�Hi
c�rv Corona del Mar , No:�r
ARCHITECT TEL.
3800 E. Coast
Corona del Mar
NO. OF BLOGB.
, SvTemvv r�v'vTeenOM �G RFGF VGRII ��
DESCRIPTION OF WORK
BUILDWG
SIZE
EXTERIOR WALL
USE OF BUILDING ANZS WORK TO BE PERFORMED
Conatruct Single Family Residence
with attached garage
1 HEREBY ALNNOWLEDGE TH�1T I HAVE READ THI6 APPUGTION
ANO 6lATE THAT THE A9 VR �8 CORRECT AND AGRE6 TD COM-
PLY WITH ALL CITY ORDI ANCE6 iO 6TATE W9 6UI.ATIN6
ewtmxa coxernucr1op .
61GNATURE OF f
PERMITTE
` Project.Manager
AUTHORIZED AGHNT . .
� EE ��-�����
S�� �F'NoNC� pApMESA
APPLICATION FOR PERMIT
Lot � 66 gUILDING
Plan R 2C
For Office Use Onl y
. RECEIPT NO. I �Ppy.yj Jip�
•I'{II S
r�rV�
RECEIVED GY DATE RECEIVEO OATE 195�1EO
.� �-�-�..��I / � ii1 �nl L-/T /, n,
COSTA MESA. CALIFORNIA
APPROVEO
ZONING
ZONE NO.OF lI6E OF NEW
— �/ I PLAN9 BOILOING
� ��
"�"` Lot 66 mra�r iE 3�G
fCENTER tINE 9T.)
TXE AMOUNT SHOWN UNOER VpLUAT10N I9 FOR TH¢
PUPP08E OF E9TABL�BHING A PERMIT FEE ONLY.
VALUATION ,j,Z.00
PERMIT FEE $
$ 13�.51.5�00 . PLAN CHECK $ �•EI�00
48.00
0