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HomeMy WebLinkAbout645 COVE ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT » FAIFi DRIVE, COSTA MESA, CA 92626 Job Address: 645 COVE ST Sui�e: Vicinity: RESIDENCE & ATTACHED GAR4GE Parcel Number: 42223103 Applicant: LUGO, SERGIO Address: 645 COVE ST COSTA MESA, CA owner: LUGO, SERGIO Address 645 COVE ST COSTA MESA, CA Contractor: OWN ER-B U I LDER Address: Zip: Arch : Address: Zoning: Phone: 949-631-5924 Zip: 92627-2917 Phone: Zip: 92627-2917 Phone: License: 0 Eng: Address: Status: ISSUED Applied: O6/13/2001 Issued: O6/13/2001 ISSUED BY: �� M . r' -; �;. � /�� Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/0 ROCK ROOF, REPAIR SHTG AS NEEDED, FELT PER�MFG SPECS, APPLY 30-YEAR COMP SHINGLES. ROOF PITCH SHOULD BE AT LEAST 2:12. �� APPRUX 17 SQUARES • , FEE SUMMARY Plan Check: $0.00 Calc Valuation: St,�oO.00 Permit: $60.10 Claim Valuation: S�,�oo.00 SMIP Res: $0.50 - SMIP Com: $0.00 ,- Other: " $0.00 - Inspection: $0.00 � � Total: $60.60 � ' � � � � � � - , � PLANNING & ZONING-'= :'- � . � � , SETBACKS MAINSTRUCTURE Front �.0-0 ��. Rear 0-0 ACCESSORY Front 0-0 . Rear 0-0 PARKING Ezistinq: o Required: o NOTES: Lek 0.0 . Right �' 0-.0 Lek 0- 0 Righ4 �. :0- 0 Proposed: .0 ': NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes�and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permi� to be considered legal, such work must comply with all applicable codes, and all required Inepections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 �aasre �woo� WORKERS'COMPENSAnON DECLARAnON: — , I hereby eNirm under penalry of perjury ona of the following tleclarations: ❑ I have entl will main�ain a cenificate of consent to setl-Insure for workers' compensation, es provided tor by section 3700 of ihe Labor Cotle, tor ihe pertormance of the work for which this permit i5 i55uetl. ❑ I have en0 will main[ain workers' compensation insurance, as required by section 3700 oi the Lebor Cotle, for Ne peAortnance ol tha work Por which ihis permit is issued. My workers' compensation Insurence carrier antl policy number ere: Cerrier: Policy iJumber: (This section neetl not be �mplefed il fhe permit !s velued at one hundred dollars ($f00J or less.) ❑ 1 certify that ia the pertarmance ot the work tor which this pertnit is issueq I shall not employ aay person i� any manner so as to become suqect to the workers' compensation laws o� Calitornla, end agree thet ii I shoultl become sub�ect lo Ihe workers' compensellon pmvisions ot Sectlon 3700 oi the Lebor Code, I shall forthwith camply with ihese p�ovisions. Applicant Signature: Date: WARNING: FNLUPE TO SEGIRE WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SHALL SOBJECT PN EMPLOVER TO CPIMINAL PENALTIES AND GVIL FWES UP TO pJE HUNDREO TlIOUSAND OOLLARE (E100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTION 31060F THE LABOR CODE, IMEREST, AND ATTORNENS FEES. LICENSED CONTRACTORS DECLAHATION: I hareby attirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) ol Division 3 of the Business and Professions Cotle, and my licensa is In full force end ettect Lic. p Class # ConirectoYs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm ihat there is e construction lending agency tor the peAormance of the work Por which ihis permit is issued. (Sec. 3097, Civil Code). ' Lender's Name: Lender's Atltlress: Signe�ure: Date: OWNER-BUILDER DECLAAATIONS: I heraby eXirm tha� untler Penelry ot perjury Ihat I am EXEMP7 FROM TME CONTRAC70R5 LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professlons Code: Any ciry or county.Which requires e permit to constmct, alter, improve, demolish, or repair eny stmcWre, prior to its issuance, elso requires ihe apD�icant for such permit to file e signed statement tbat he or she Is�licensed pursuam ro the provisions ot ihe Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of t�e Business end Pmfession5�Code)�or, ihet'he'or 4fie is'exempt therefrom entl ihe basis tor ihe allegetl exemption. Any violation of Section 7031.5 by any applicant for e permit subjects the epplicent to abivil penalry bf not moie than fiva hundred dollars ($500).): �: `s ❑ I, as owner ot the property, or my employees with weges as their sole canpensation, W ILL DO THE WORK, antl ihe sirudure is not intentletl or oflaratl for sale (Sec. 7044, Businass and Professions Code: The Gontractors License Law dces not apply to an owner of propeny who builds or improves thereon, and who Coes such work himself or herself or through his or her own employees, provitled ihat such improvements are not intentletl or oflered for sale. Ii, howaver, ihe builtling or improvement is sold within ona year ot completion, ihe owner-builder will have �he burtlen of proving ihat he or she did no� build or improve for purpose of sale.). ❑ I, es owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTOiiS to construct the project (Sec. 7044. Business and Professions Code: The contractors Licanse Law does not apply to an owner ol property who builds or Improves thereon, antl who coniracts tor such project with a comracmqs) license pursuant to ihe Contractors License Laws.). ❑ I em exempt under 5ec. Business and Professions Code for ihis reason: Signature: Date: Owner ID verifietl by tlnver's license. ❑ Ves ❑ No Driver's Licanse No. Ezpires: Venfication of Ownership py (rype of document, i.e. - property tax bill or deed): DIYISION OF INDUSTHIPL SAFETY PERMIT CERTIFICATION: ['� I hareby certity ihat no excevation tive (5) or more fee� in depih into which a person is required to descend, will be made in connaction with work authorizetl by ihis permit, and that no building siructure, scaHolding, talsewo�k, or demolition or dismantling Ihereol, will be more ihan ihirty-six (36) fe91 high (Chap. 32, Grp 2, Atl 2, Sec. 341, Title B, Californla Atlminisiretive Code). ❑ As owner-builder, I will ot empl�y anyone to do work which would require a permit irom the Division oi Industrial Sefey, as noted above, unless such person has e permit to do such wo� 1� tl� Ivision. � /� � �� Signature: Date: � b � � ^ Division of Intlustnal efery Permit Number: HAZARDOUS MATERIALS ANO EMISSIONS GEFiTIFIGATION: 1 W ill Ihe applicant or p�esent or tuWre building occupant need to file end cenity a Business Plen lor emergency response to release or threatenetl release of a hazardous matenal? ❑ Yes � No (Section 25505 of the Calitornia Healih and Safery Code requires, with some exceptions, tha� a Business Plan 6e filetl with ihe Costa Mesa Fire Department by every business which has at any one time during a reponed year a quantity oi hazardous materials equal to or greater ihan a weight of 500 pountls, or a volume ot 55 gallons, or 200 cubic feet of compressed gas at standard temperature end pressure). ....................................................................................................................................................................................................................................................................................................................................................................................... 2 Does or will ihe applicant or present or tuture building occupam need to tile a registration torm tor ecutely hazardous materials9 ❑ Ves ❑ No (Section 25533 of the Celifornia Heelth antl Satety Cotle, with some e:ceptions, requiras regisiretlon with the Costa Mesa Fire DepaM1ment by aach business which at eny one tima has on hand e quantiiy of aately hazardous meterlals equal to or greater ihan e welght of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ol compreued ges at standerd temperature and pressure). ........................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will Ihe appliW�� or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous ma�erials)7 ❑ Yes ❑ No (Section 25534 ot fhe Califomie Health and Safery Code provides that the Costa Mesa Fire Depanment may require the preparation, ceeifiwtion and filing with the Fire Deoertment of an RMPP by businesses which are required to register acutely hazardous matenals with the Fire Depanment. 4 If an RMPP is presenity required, has Secfion 25534 oi the Galibmia Healih antl Safery Code been fully complied with? .......................................................................................................................................................................................................................................................................... 5 Does or will ihe appliGant or present or Yuture building occupant repuire for Ihe work whlch is Ihe subject of Ihls a pllu irom ihe South Coast Air Duallty Manaqement Disinct or from any other air polWtion conirol tlisMct o� egency7 � Ye: (Section 658502 ot Ihe Calitomla Government Code requires �hat Ihe requested information be furnished on applicatior ........................................................................................................................................................................................................................................................................... 6 W ill eny part of the faCiliry to be consimcted under ihis permit be within 1000 feet irom ihe outer boundenes of a school� Qf "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...... .... ......................................................... ....................................................... 7 II e permil from ihe 5outh Coast Air Oueliry Manegement Disirict or olher eir pollution control district or agency is aOP�ication, have all ot the disclosures prescribed by California Healih entl Safety Cotle Sec�ion 62303 been mada? [ ❑ Ves p No ......................... . .................................................... an a germit tor such consiruciion or �J No for non-residential building parmi[s). .............................................................................. ❑ Yes ❑ No ...................................................................... . quired for ihe work which is the s� Yes ❑ No CERTIFICATE OF COMPLIANCE: I certify that under penelry of perjury ihe information given above is correct. I agree to comply wi�h all s�ate laws and city ortlinances regarding Hazardous Matenals antl Emissions. Signature: Date: CERTFICATE OF COMPLIANCE AND AUTHORIZA710N OF EN7RY: I cehify under penalry of perjury ihat I have read this application and state that the information given is correct. I agree to comply wi h all state le s end city ortlinances releting to 6uiltling constmction, and auNorize representatives of the Gity oi Costa Mesa to enter upon the above-described property ,1�inspection pJ �rposes. I agree not to occupy or ailow occupancy of any huilding aNhorized by this Dermit until (inal inspection. /l.I�1�>�o/!/�Pl- ir�� '- d � ' nat egal Owner(s) � Date AncUOr Authonzed Applicant COOE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/RetaiPing Wall 202 Final Factory Fira Place 203 Finel Sign 204 Final on�F, IMRIRLS CODE� INSPECiIONiYPE 206 Final Mechanical 208 Final Plumbing 210 Finel Electrical 212 220 222 250 Final Fire Prevention Final Planning Approval Final Site Final Building/Occupancy UATE �j Apvlicant to fill in all soaees ezcept those witnin heavy eoraer Iines and sign all apvropriate aeclarations. CITY OF COSTA MESA CONSTRUCTION PERMIT P IT N. , TRACT NO. LOT NO. UNIT NO. '�roject'Address 5Q5� ('nva 4trPat Applicant's Mailing Address ' Owner'sName RUSAN WADDELL Phone 631-399 Address 645 COVE STREET ArchlEng. , License No. Address - Concractor'sName AT,T, AMFRT!`Aj�j PTT7MR�",n 541-975 Addresslmaiiingl 7(177 N_' HFSPFRIAN WAV $A City License No. 29919 � LICENSED CONTRACTOR DECIARATION I hereby a/tirm that 1 am licensetl untler provlslons oT Charter 9(commencing with section ]000) o( Division 3 of tne Business ana Pr f ssions Cotle, antl my Iicense is in f I/ antl e1 t. License Class �—�� e% 4 4 3 0 6 Date�.�_l_..6./_8.G_ Signat e WORKERS' COMGENSATION CLARATION I nereby atfirm that I have a c licate ot consent to seH-Insure or a certificate f Workers' Compensation Insuran<e, or a certlfletl copy thereot (Secilon 800, Lab. C.) Policy r,o. �.Eb.012529 Company_Z.�,'� ' � eCert{fjqtlypyjyfJ�atl wApp ica Ity ui tl ' I i , Date ������� ���i( EXEMGTION FROM WORKERS' CO PENSATION DECLARATION (Thi55¢c[ion naetl not be completC the permit 6 for on¢ huntlreC ($300) or less). I cerNfy that in the per(ormance ot che work tor which this perm�t is issuetl I shall not employ any person in any manner so as to become subject to t�e Workers' Compensation Laws of California. Date Si9nature NOTICE: If, alter making this tleclaration, you shoultl become subject to [he Workers' Compenwtion provlsions of the Labor Cotle, you must forthwith comply with such provisions o� this permit shall be tleemetl revoketl. CONSTRUCTION IENDING AGENCV 1 hereby affirm that Mere is a construction lentlin9 a9ency (or the peiformance of the work tor which this permit is Issuetl (Setlion 309]� Civ. C.) Lentler's Name ientler's AtltlreSs ' OWNER BUILDEH DECIARATION ' I hereby affirm that I am examOt from the Contractor's License Law for [he following reazon (Section ]031.5 Business antl Protessional Cotle:�Any dty or county which �equires a permit to con5truct, alter, improve, tlemolish o� repair any SlruCture, prior to its issuance, also requirM the appllCant fOrshch permit to file a siqnetl zWtement Ihat he/5M1e is Ilcensetl pursuant ro the O�ovi5ion5 of the Contractor's License Law (Chapter 9(commencing wlth 5ection.7000) of Division 3 of the Bu51ne55 antl Prote55ion5 Cotle) or that h¢/s�e i5 exempt [herefrom antl the basis for [he alle9etl exemption. Any violation of Section 7031.5 by any applicant tor a.pe�mit subjects th¢ appli<ant to a clvil �enalty of not more than five huntlretl tlollars ($500). LJ I, as owner ot the property or my employees wim wages as Ihelr sole compensation, will tlo tne work, antl [he structwe is no[ in[entletl or offered for sale (Section 7044, Business antl Professional Cotle: The ConVa<tor'z License Law tloes no[ appty to an owne� ot a property wno builtls or Improve5 thereon, antl who tloes such work himself/be�self or tnroug� his or ner own employees, Provltletl that such improvements are not IntendCtl o� offeretl fo� sale. It, however, fho bulltling or improvement Is soltl withln one year nf com- pietion, the owner wlll have the burtlen Of proying he/sh¢ tlIC not builtl or im- prove for the purpose of sale). . ❑ I, as owne� of th¢ property, am exclusively cont�acting with licensetl con- tlactor5t0 constfuctthe pfOlect 15etfiOn 7046, Busine55 antl PlofeS5ion5 Cotle: The Con[ractor's License L2w does not aPply to an owner of Pwpe�ry wM10 builtls or improves thereon, and who contracts tor such projects with a con- Vactor(51 ucen5e pursuant to tM1e Contra<tor'S License Law). I am aware tnat proof of their Worker's Compensatlon insurance Shoultl be provitletl [o me. ❑: I am ezempt untler Section B. & P. C. for this reason Date Owner I hereEy certify that I have reatl Ihis application antl state t intormation is'mrrect. I agree to c oly with all city antl coui antl sta(o-I;ws relating [o builtlin L�onstruction. antl herebv ai � (� � , TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Ap # ' DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL �T FfOnt ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER - �C Right PROJECT DESCRIPTION Sp.FT. OCCUPANCV K CONSTRUCTIONTVPE VALUATION$ S Left � ZONE GRADING CV. VDS. ACRES p�ng. Ref. � qemarks: . , Planning Notes: Sink <flow Preventer <flow Irrigation Drinking Fountains Floor Drains Floor Sinks GasService Outlets Interceptors Kitchen Sink Lavatories Roof Drains Reinspec[ion Fee � $15 Boiler Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact.81L ICBO # Heating System & Ducting ❑ai oo,000 sru O � oo,000 ISignatu Date �n�'�i�±iii � � �Drivers' L, nse or 55 q Reinspectian Fee CMF 0865�45, �ev. 10/84 Whit¢ - Builtling; Canary - Applltant; Pink - ACCounting; Goltlenrotl - ASSe55or $75 Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑aioo,000eTu ❑ioo,000 System Repair/Alteration Fire Dampers Registers Isua Fee $ 3 $ 3 Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electr Fan F.A.U. Fixtures Device Boxes Outlets Swimhes Garbage Disposal Generator �0-5 KW�O! 5 7231 11/14/86 2on0 Accessory Building: G,�C'.Ei�1Gv :�.�-: Parking Req.IProvided 'ELECTRICAL Transformer � 15-50 KW � 50+KW Meter ❑up ro 100 amps Meter ❑over100amps Sub Panel Motors �0-1 HP � 1 Yh - 8 Inc. Solar 09-75 HP �16�15+ Microwave ' Pole Light Range Sign Standing Sections W Trash Compactor 5.00 TL FEES Z O N � N G R E Q M T S � Reinspection Fee �$15 � � luue Fee '� $ 3 � DEVELOPMENT SERVICES HEQUIREMENTS: 2onin8 Approved By Date Buildin8 Approved By Date Application Issued By � Dat ' SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ •'�� ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING 5 PLANCHECK 50°,6 $ MICROFILM $ � MECHANICA� $ TOTALFEE $ � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL & SPA �APPROVALS Permit# Date Inspector qppROVALS Permit# � Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure:Test G� � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �,� v� 7. Footings � 58. ElectricalConduit-Undrgrnd. �� 8. Foundation 59. Gas Pipe, O Undrgrnd., Test �� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, �; Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK �: � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fjn�al ' 72. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 75. 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 Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush , 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil . 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing e 76. Dry S[andpipe 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 Faaory Fireplace - 38. Final Plumbing r/�7 39. Water Service-Final � 40. Gas Service�Final - � 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap fiegulations 47. FINALSTRUCTURE&BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � �51. CERTIFICATE OF OCCUPANCY >-- . No. Date _ vnivr.ia JOB ADDF GENERAL WORK � VALUE TYPE SUBCON17iACTOR NO. r , , � 27544 COSTA MESA BUILDING-SAFETY DEPARTMEM P.O. BOX 7P110 � COSTA MESA, GALIFORNIA 9261E For Applicanf to Ftll In Completely TYPE OR PRINT BUILDINO AODR888 � E T COSTA MESA, CALIFORNIA ■ wRCHirecr eirv SfATH LIC. NI BIZE � �! �LJf i.. � 76L NO.O� DESCRIPTION OF WORK BUILCIN6 NO.O size nooN EXTERIOR WALLS/ UCYC CO1 COVERING UGq OF DUILDjCY ApD WORK TO PA10 SEF 11-67c�;;n00 7_2?_" �:.'<' ^7I :�C APPLICA710N FOR PERM�T BUILDINt3 FO� �jC9 �if0 �n� R[C[IPT NO. YARDB MPROVHD MAIN BUILOINO tOM C/L➢TR6R'f) / 7 ^AR. �i e �1 HEPEBY ACKNOWL6D08 THAT 1 MAVB RBAD TMIG 11PPL'CA^ION AND BTATE THAT TX8 AGOVH 1� COqp6R�ANO AOpBi TO COY• PLY WITM ALL CITY ORDINANC�B AND /TATI L/�WO P[OYLATINO BUIlO1NOCONSTRIIRIOH. �.� � AUTHORIZiO AOBNT i/ �d- pLu � ' 6'l— t9 � 8HALL B8 LE88 THAN YARD8 MPROVHD ACGEiGORV 9UILDIN� DATE �- ,.� r a O7 � � BC. FT. ,'E 0 TH8 /�MOUHT [MOWN UND6p VALUATON IB FOP TH8 j ■UPPo88 O� rt8T/.BLI8XIH0 A PERMIT FEB ONLY. j VALUATION � � � PERMIT FEE p ��� � a w TOTAL FEE �/ • � ✓ OW NER HARBOR ESTATES / DATE JOB ADDRESS 645 Cove Street BUILDING PERMIT NO. 155� GENERALCONTRACTOR DikP. Fr ColarmnV� VAWE s 8,naano LOT 111 BLOCK 7RACT ��fl6 RPs;�I ncP GROUP I TVPE V ZONE �= FIRE DISTRICT i��-S67 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR ' DATE I NUMBER H Trench ����� T' %�," :ion Forma and Grade to Garag � nemmn _ 1 _ 2.� � ..� Pole HOUse / Sewer, St. Lathinp.ln Out Plumbina. Final, Fixtures C9dlpletE�//1' /Y� 30� W irino. Final � - Costa Mesa Builc�ing Department � � ' 711'EAST 2Uth STREET „ " COSTA MESA, CALIFORNIA FOR APPLICANT TO FILI. IN Bul Iding Address 645 Cove Street Costa Mesa, California rvearest 19th Street Cross St. ow�e� Harbor �states nad�ess 419 East 17th Street c�cY costa r�sa NoLI 8-1159 Architect or Lic. Address nddress 419 E2st 17th Stree Legxl I Lot I Deseription No. ul Block (Attach Metes and Bounda) � No. of Size of Lot i� X 1�.0 Nowc g gldg. nOr10 � Familles � Roa c L��e irom Rear Yard b�t of 5treet �� Side Vard c 1 New � .. � Alteratfon ft. Rooms 5#s Stories by [CATION FOR PERMI; BUILD,ING � t OI+ FICE USE ONLY Date Rec'd. Dat 9_ i0_c� 7— Addrew Costa Mesa, California Nearest Cross St. Zone J � jl Plans I TYPe � I G 7 Approved by Date CORRECTIONS CoveNng Gtu�C� � Covering ��� APPROVALS Use of New Foundation Loeation Inspeeto Building P]y[� 11(i' Forms, Materials, �p mil� re4i[1P.IlGP Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby a�nowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building cOnstruction. Signature of Plaster, Int. Permittee ni kP R. �o� Pgmva ���, , Plaster, Ext. Authorized Agt. Masonry Reinforced Valuation Permit Fee $ �.0, o 0 8 000 00 P�an Check g 3. i a sond Beam $ � • Feeal� $ �3• 00 FINAL �..e.. ��. �_., �.. t_ta O 9 � 2 D r Show Iocatlon and distanees from property line and between buildings. -; . , . .• � �os,� %!�L 7 B-SSPDtlESA J�C� ¢=`*�'Z3.Q0 a . . ..: ,� . � . �.. � - . u;