HomeMy WebLinkAbout316 SANTA ISABEL AVE - Building Permits ADDRESS oPBUttUC: 316 SANTA ISABEL AV Wit A & B CITY OF COSTA MESA BUILDING PERMIT
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STEVENS, JOAN LINDA PERM NO: B 082711
LEVINE
SUITE '160 357 PERMIT NO: B 082711 PLAN CHECK NO: N GOVT: N SUPP: N
11 N HAYDEN RD SCOTTSDALE,AZ 8526(
oAOOREss CONSTRUCTION TYPE: V N PERMIT TYPE; STR PURPOSE: 0TH
T� �
Nat DESCRIPTION T/OFF & REROOF W/WOOD SHAKE SQ FT: 11 , 048
ARCH OR END'S ADDRESS: LINT:
CLAIM VALUE: 11 , 048 . 00 CALC-VALUE: 11 , 048 , 00 GROUP OCC: R-3 /
CONTRACTDITSNAME ROSS & BARROWS INC. ( 714 ) 557-7440
CONTRACTOR'SMMUNO 260 E. ALTON AV COMMENTS : X
soot SANTA ANA CA L1CNo_ 327802 ******************************-**-* **************-**********9E********** *******4+*
92707 MT: Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Nim under penally of perjury that I em licensed under provision Or Chapter 9 SETBACKS
(commencing with Semon 7000)of Division 3 d the Business end Professions Code,and my license is in full force and affect.
cmuC.No.: 020924 MC.CLASS: C-39 LIC.NO.: 327802 EXP: 11 /97 MAIN BUILDING ACCESSORY BUILDING
1--, - 27 D«Wed« 0,lfw• FRNT: FT BUILDER
REAR: FT IN FRNT: FT IN REAR: FT IN
41
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under penally el peiryry Ilial I em exempe from the Contractors License law toe the
(Section anes isend Pwewacounty idprime one Code:Any A ,requires paw construct alter.improve, PARKING REQ: PROV: PARCEL: 43913129 ZNE: REF NO:
• dish.a repel a y uncture,prior toes issuance,also requires the applicant for such permit to fib a signed statement tat he a she
ie licensed pursuant to the provisions of the Contractors License Law'Chapter 9(commencing with Section 7000)of DMeton 3 of the PLANNING NOTES>
Business end Professions Coder or the he a she is exempt therefrom and the basis for the alleged exemption.Any violation of Medico . >
7031.5 by any applicant for°permit subjects the applicant lois evil penalty ofno(more than fere hundred dellen l$500D. ********************************************************************RE**********
❑ I,as owner ol the properly or my employees welt wages ars their sole compensation,will do the work,and the structure 6 riCil intended D EV- EL O P M E N T SERVICES R V I C E S R E Q U I R E M E N.;T S
or offered for sale(Section 7044,Business end ProfessionsCode:The Contractors License Law does not apply to an Owner of property
Q
who builds or improves thereon,end who does such work himself or herself or through he a her own employees,provided that such
improvements are not intended or offered ler sale.II. the building or improvement b sold within one year d pompelion.Us ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he a she do nes build«improve for the purpose of sale).
❑ I,as owner of the properly.am exclusively contredrig with licensed contractors to ca drug the props(Section 7044.Business end
Professions Code:The Contractors License Law does rep apply to an owner of properly who builds or improves thenen and who BUILDING APPROVED BY : DATE:
contracts for such propos with a mntrada(s)licensed pursuant to she Contractors License Law). .
❑ Iamexempt under Sewah: B.APt..f«Miereason: APPLICATION ISSUED BY: At DATE:
********************** t -•w... . . . ****iE***** *
Date: Owner; LEGALIZATION: N F E E S U M A R Y STRUCTURAL S •GMFNT:Y
I do hereby certify Met I am aware of and understand the requirements of California Health and Solely Code Sections 25505,25533.and
25531.end the I a any future building occupant will/wil not)doe one)need to comply with said pate codes and the requirements for
a pante f«construction or modification from the Ai agement Diedd.Residentialconstruction epplmias are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 187 . 25 1 . 10
Date: AppJirann: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby elfin, d the under penalty of palmy one following dedenUm
o : PLAN
ISSUE FEE
o
I adwilm°intancefBcaledc"twimnon,
ynimw°ke 'conpetinproridadfabySarim3100afIMLabar BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Cob,for the maintain of the wank for which this permit is issued.
QIhaveendwillmentaiiworkers'compamatinisurahc.=InquiredbySection3700of LaaborCode,fortheperormancesus TOTALS 188 , 35 0 . 00 0 . 00 188 . 35 188 . 35 00
work for which this permit is issued.My workers'compensation inerrant.wrier end poky camber are:
Carrier STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 188 . 35 OVER/SHORT: . 00 .
Policy Number. re4r;—QFnpfS1(17 07/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section nheedreef be completed I the Anna.for One hundred dollen(MOW or lass.) 187 . 25 1 . 10
❑ I nerdy ger in the performance of the work for which this permit is issued,I shell no(employ any parson in any manna so as to
became waled I°thewakers'camiweationl°ws aCaldemia.end ere tatd Ishadd beMnie nijedlo the "Wken' ************,***.*t*******)E******.************************************************
compensation provisions of Section 3700 of the Labs Code.I NN forthwith comply wshMose prav®s.
.ate:
- -97 *Pee;eki �C�^z'�, IND IVIDUAL F E E BR EAK DOWN
Warn!g:Failure nsecure workers'compensadon coverave Is on:snafu?,and shall subject an employer to crimited penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil req to one hundred thousand dollen($104000A M sed/den to the coat of compensation damages as provided for In
S .ar]105ofm.Labor Cods Interest,and stromryYfees. SFR 11 048 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 11 , 048 , 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction leafing agency for the END OF FEES
performance or the work for which this Fermi a issued(Section 3097.Civ.C).
LENDER'S NAME
LENDER'S ADDRESS:
I certify the I have read to epplicalion end stale Thal the above information a carts.I agree to comply with all oily end county ordinances
end state laws reWng to building construction and hereby authorize reresenatives of this city to enter upon the above-mentioned property
for inspection purposes.
NANCEE KILBOURNE 05-02-1937/03:44 PIV$188.35
Pam"' RCPERMIT:082711
Ilia. —G --Lavant. Date: t�
` SignatSignaturenure. w .. .. . n , recta)
(5151d5.WP) Whits-Buil: Fl
kc&Safety:Green- e:Canary-A
y/ pplicant:Pink-Revenue:Goldenrod-berm
CONSTRUCTION AND PLANNING POOL & SPA
-'-APPROVALS Permit #
Date Inspector APPROVALS Permit # Date Inspector
.1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. 'I 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
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, O4.ndrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK •
11. Property Sewer Line & House Conhection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater& Vent-Final -
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 Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing / 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 57str7 OI 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing &Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1
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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
7�'� (JG�17'
48. FINAL PLANNING
49. Electric Release to Edison --T
'
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ill
-tie 7111L
RAUB, BEIN, FROST & ASSOCIATES
1401 Quail Street
Newport Beach, California
December 11 , 1975
Job No. 17240
Page 1 of 1
DESCRIPTION
ca/6 Santa Isabel Duplex
Reciproca Ingress-Egress and Drainage Easement
Y
All that portion of Parcel 2 in the City of Costa Mesa, County
of Orange, State of California, as said Parcel 2 is shown on a map filed
in Book , pages and of Parcel Maps, records of said
Orange County, California, described as follows:
Being the northwesterly 12.00 feet of the southwesterly
103.50 feet of said Parcel 2.
SUBJECT TO: All Covenants, Rights, Rights-of-Way and Easements
of Record.
EXHIBIT "B" attached and by this reference made a part hereof.
A041/
WILLIAM J. FROSTir d Surveyor
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• PREPRRED fa :
• DRN/9 if 4141/7741
3315 NEPY,0417" ZSZY0
SUITE 205
NEWPORT denChc 64.9zheem/9/ñ -
EXHIBIT ' B ' _ SKETCH - _ --,..
TO ACCOMPANY LEGA!. DESCRIPTION '
• FOR RECIPROCAL INGRESS - EGRESS 8r.. Alli: 7iLaub73eirifErestZe2ssociate
DRAINAGE EASEMENT. .,,..? c, -, r. t I 4. f% IL Bal FesINf RS 1. r..<0.1.1•4S
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A
DA'E SCALE _ FIELD EICOE JC/8 N2
. DECEMBER II, 1975
I I": 201 507-R 17240
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
r CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 1098 3/17/86 iloC' • TL
1 Protect Address 3/6, .4 SAn.+i Z1 el-5 A/j E //-I' P-z f 1
S4 iY/ 6 TYPE OF CONSTRUCTION L I NEW LJ ADD LJ ALTERATION 'F
Applicant's Mailing Address REPAIR
t ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner's Name Jd/Ani STF I i F rt--/5 Phone7? ?-FG`YG A•P•# ( Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address 3/6 A SQ^'7-A =SP 3 e//"i �I S Main Building: Accessory Bujlding: -
Arch/Eng. License No. `1/3D6'y TYPE OF PERMIT ❑ GRADING, l.,{l FOUNDATION ❑ STRUCTURAL E Front • p
Address y3e a ❑ TENANT ❑ ELECTRICAL J,4p1�1 PLUMBING ❑ MECHANICAL B Rear N
'sianino eft P J — .c ❑ !OTHER A 1
Contractor's Nam- " «ice -- — Phone c(/-5753
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) lc) Ps R fiF5 EPi'<+^� L-✓AY K . G
2gal CONSTRUCTION TYPE VALUATION$ S Left
City License No. ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided - E
Do I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: Q
I with section 7000) of Division 3 of the Business and Professions Code,and M
my license is in full force and effect.
License Class C 3igliceppjye No. 3-�')' =! ._ S,
Date 3-/ -7RS .Signature
�-jy� 162 /N'z_(Y/1(/ b PLUMBING FEES
WORKERS'COMPENSATION DEC bA RATION - Bar Sink Showers
I hereby,affirm that I have a certificate of consent to self-nsure or a certificate ELECTRICAL •
FEES
of Workers' Compensation-Insurance, or a certified copy thereof (Section - Backflow Preventer Service Sink
3800, Lab.1,4 b` ZG ZCfl Z)•- Automatic Washer Transformer 0 15-50 KW
Policy No. Y ` Company Backflow Irrigation , Sewer Cap ❑ 50+ KW •
j Construction Po le Sub.
i�2artifietl copy is filedhereby furnished.
Certified copy is filed with the City Building Division. Bathtubs • _ Sewer Connection Cooking Unit• Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps - '
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountains Solar Tank - Fan
Workers' Compensation Laws of California. - Motors 001 HP ❑1%-8
Dale - Signature - Floor Drains Swimming Pool w/Spa F.A.U.
NOTICE: If,after making this declaration, you should become subject to the _ Inc.Solar❑9-15 HP 016-15+ -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks* Urinal
comply with such provisions or this permit shall be deemed revoked. •
.' Fi%tUr¢5 Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet - Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater •
Lender's Name - �K¢ •_ 2— Outlets Range .
Lender's Address Kitchen Sink - Water Service - L Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - '
following reason (Section 7031.6 Business and Professional Code: Any city or Garbage Disposal , Standing Sections
county which requires a permit to Construct,alter,Improve,demolish or repair . P-Trap LaundryTrays ' ' ' '
any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0.5 KW ❑5.15 KW Trash Compactor ,
to file a signed statement that-he/she Is licensed pursuant to the provisions of ROOF Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of •
Division 3.of the Business and Professions Code) or that he/she is exempt —
.therefrom and the basis for the alleged exemption. Any violation of Section -
•
7031.5 by any applicant for a permit subjects the applicant to a civil _ -
•
penalty of not more than five hundred dollars($500).
U 1, as owner of the property or my employees with wages as their sole Reinspection Fee . $15 Issue Fee- $ 3
compensation, will do the work,and the structure is not Intended or offered • _ Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL FEES - - - -
License Law does not apply to an owner of a property who builds or improves 4
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such iibprovements are not intended or offered for Boiler Hood or Type 0 ',
sale. If, however, the building or improvement Is sold within one year of coin- - Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground : Building Approved By Date
prove for the purpose of sale). - Q i/�
O I, as'owner of the property, am exclusively contracting with licensed con- • Duct-Structural Refrigeration System y Application Issued By_ 5
Date —!i �T'�
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct- Ventilating - 00-100,000 BTU 0100,000 BTU
builds or improves thereon, and who contracts for such projects with a con- •
'SUMMARY OF FEES
tractor(s) license pursuant'to the Contractor's License Law). I am aware that —Exhaust System ❑ Multi le❑ I BUILDING PERMIT $ SMIP $
proof off their Worker's Compensation insurance should be provided to me.; Y P System Repair/Alteration
PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason ' Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ � ' ISSUANCE $
Date Owner' ' Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
.1 hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTL GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and'state laws relating to building construction, and hereby authorize repre- MICROFILM $
sentatives of t•'s city to enter u•on th- ove-mentioned property for ,PLAN CHECK 50% $ {— �-{7�
ingnatuonp r•o.es. 1 a<,$-/,-$6 MECHANICAL $ TOTAL FEE $ goat'
•
Signature 1 + W
Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $
CMF 0865.46,rev.10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL &SPA
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
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' 61. APPROVAL TO DECK •
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final •
16:I 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 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & 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: S-3c---gb (.errC.pao.land,
Ls.° it os--
34. Final Heating & Air Conditioning t �iNG�N
7- /
U!
35. Final Gas Pipe-Test ' y Za6
36. Hood or Canopy
37. Final Factory Fireplace
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
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
`an CR
PROPERTIES WEST, INC. uAit 11-13-75
JOB ADDRESS 316 Santa Isabel Avenue, A & B BUILDING PERMIT NO. 40611
qq GENERAL CONTRACTOR Owner/Bldr.
DESCRIPTION of WORK Duplex w/2 Garages
'4 AP No.439_131-04 LOT TRACT FIRE ZONE VALUE E 68,000.00
INSPECTIONS Signature Date TYPE V GROUP T Fe .T ZONE R-2
sow OS .4-. - 'h' SUBCONTRACTOR PERMITS ISSUED
GAS Date I Number I Signature
wATER(4.4H-At Je%r�.-+ ( yc2< /7. ! -76 �1 Plumbing C.
ROUGH PLUMBING - II--II S , p ' L, yip ,. J,yc. i/AZO-7S 8/6.2-7-----
PROP.
SWR. LINE [I4HOUSE CON. LTJ" S // 2J 0 ._ 490 • i -'y7.r sin 4.-/-
SPRINKLING
/
SPRINKLING SYSTEM - _
MISCELLANEOUS e
ROUGH HEATING AND AIR CONDITIONING LiT j %- g -76 ,
TEMPORARY SERVICE OR POLE 4I I� J/-/14-76
UNDERGROUND ❑ POWER d
ROUGH WIRING A..JC - - Heatin n Vent.
TRENCHES f FORMS II STEEL REINF. (07f 2 lit
FLOOR SYSTEM Z-7
BONO BEAM ❑ STEEL REINFORCE
SHEATHING ue IC/ • •7 r
FRAME AND FLASHING IAC -�. "76
LATHING - IN in OUT f Z-34+
PLASTER, BROWN COAT
STRUCTURAL, FINAL Elec ri
HEATING, VENT., REFRIG. AND A.C.. FINAL
IS
y- 1-n7 '.1 . /1-13 -9C 3q�g, P4
PLUMBING,CTRIC, FINAL AND GAS TEST -. _i -7 {` ��yy / . h9-3-i5-3AJ r1
ELECTRIC, FINAL �KJN•-�'�J_[ ' • �
BUILDING, FINAL • CLG-�-4
c_O _ !_
PAI[
y�(�6 ! SEP 30-75c ,;r001370* ***116.26
// COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only RE I/ BV DATE RECEIV
SSUED
/
ABUDIDLRDEISNSG 3/6 5-NaelyfAae . 9-4-7, I7_ /�
sP _
OWNER / .2� //���/ /enc. A.P.N6 *3� I� '�V� ERIT NO.
//t1
MAIL ����//// /T� �r r BUILDING I y.� /� A
ADDRESS 1�{�,..�/// �9.-.N..sJf� y+riyG`"'Lp ay ADDRESS 2' 1�5A1J/ `�A Lit rr g
TECITY NOL(0 ran TRACT SCS Ir V LOT L BLOCK
K`�
CONSTRUCTION NpW ADD ALTER REPAIR MOVING DFMOLISH
LENDER
BRANCH
` I1_y/7 ` }1{
OWNER I �
1f` „a, (/Ec-i_ kit
ADDRESS ��///� � �`( ,n �7�,t�- kr. y
ARCHITECT /� 4seee . .-_ ' NEL. y.t USE DV G4&A7E�J/�VALU$ eo/ C
FIRE /
ADDRESS /a ( l9,Sey�y,_ (( i '/Jam_ Y�Y�. ZONE T PE IY GROUPS L TJ
CONTRACTOR LFo��% W!` A/CJ(.LvfLth0. BVPROV ED ' / DATE// /y !
ADDRESS
TEL. Z•prW/E NO.OF�j' USE OF NEW i:X?P6ek
CITY NO. 2._
PLANS [__ BUILDING W/ Alt 6y.....6.7. //`�,,
F^ STATE CITY YARDS APPROVED YARDS APPROVED "J
gLIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE /',( NO.OF BLDGS. (FROM CIL STREET)
�e OF LOT rid /y NOW ON LOT FRONT SO FT. FT-
Q USE OF
V) EXISTING BLDG. PA A / �''`
I vT R.SIDE 27 IO
FT. e" FT.
cin •
1•-• Separate permits are required for L.SIDE S' FT. FT.
electric,plumbing and heating work. 8
LGI REAR FT. FT.
E.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
A /n MAIN BLDGS.
ACCESS. BLDGS.
DATE
Q (ge/�i(/1 G�^C. as'�✓ 6L C U.P.#' -e 75—� APPROVED / --I^^7 S
›. Q'' (Q.t, Cor C=�CE�C _-ByPflOVED/I f-moi J DATE t- 13" /�"'.
x HOLD -R ..,PEC!^moi !2 QU'iREMiENTS
O I hereby acknowledge that I have read this application and state n
eg that the above information is correct and agree to comply with --
L all laws regulating building construction, and I shall not employ
4 any person in violation of the workman's compensation laws of
b.
ILI,,r the State of California. m
I hereby certify that I am properly licensed as a contractor under SO. FT. a
. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ at
and Professions Code ivision 3,Chapter 9. n
en Signature of i//'� j 77 PLAN CHECK $ /�j,_ U.
Permittee /`// $ t/C/L/� �-� TAX $ /// 76 2
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Authorized Agent • TOTAL PAID $ //eir;h
4
.- _ __ _ -
T. 11-71-1-.
7zo
,� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APP. ICATI IN FOR STRUCTURAL PERMIT
For Applicant to Fil om etely —Use Ink O y REC , ppp 5S$$ Ej�
BUILDING R / 444, / ��
ADDRESS (�/ 4/t(;.
�r ���////// PERMIT NO.
OWNER 14,9 gf�r' A.P.NO. -
ADIL ��v
BUILDING
MAIL ; ` S„�s�.
ADDRESS ADDRESS .(I�I�(/ �j�'j(i
TEL. TRACT LOT BLOCK
CITY NO. I I
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH
LENDER
BRANCH //�� Wer-jr�
OWNER �AI ,........erl
ADDRESS �/ VALUE
ARCHITECT TEL. E $
OR ENGINEER NO. U$ /
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW
PLANS BUILDING
CITY NO.
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET)
L OF LOT I NOW ON LOT FRONT FT. FT.
Q USE OF
V) EXISTING BLDG. R.SIDE FT. FT.
rn
(-1
Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work. REAR FT. FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
[--� DISTANCE BET. BET.MAIN&
CMAINAIN BLOLDGS. ACCESS.SLOGS.
VAR.+ DATE
C.U.P.# APPROVED
APPROVED
P.. _HV DATE
a
IY
W
aI hereby acknowledge that I have read this application and state in
a that the above information is correct and agree to comply with co
-
0. all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of o
W the State of California. -
C.3 I hereby certify that I am properly licensed as a contractor under SQ. FT. tI
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 0
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business ERMIT FEE $ v
and Professions Code,Division 3,Chapter 9.
VALUATION aa.3 --m
PLAN CHECK $ en
Signature of
0
Permit-tee $ TAX $ u.
E
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Authorized Agent \ I TOTAL PAID $�„// ��