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HomeMy WebLinkAbout2335 RICHMOND WAY - Building Permits ADDRESS OFBMLDNG: 2i.:5:1 RICHMOND WYE IT• a CITY OF COSTA MESA - BUIL TNu—.._. OMNER'S NAME IF IirlgyN: REYNOLDS, JAMES N - - _ AIMRESS: 2335 RICHMOND NY I _ COSTA MESA, CA 92627 PERMIT NO; B 072586 PLAN CHECK NO; N GOVT: N SUPPc- r, _ APPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: OTH ARCHITECT ORE NEER: LIG NO.: JOB DESCRIPTION ; T/OFF, SHEATH & REROOF N/COMP SHINGLES SQ FT : 2, 924 ARCH.OR ENG.'S ADDRESS: UNIT: CLAIM VALUE; 2 , 924 . 00 CALL-VALUE: 2, 924 . 00 GROUP OCC; R-3 / coNTRAciars xANre STOUT ROOFING INC ( 310 ) 923-6775 CONTRACTORS YOUNG P 0 BOX 4309 COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRESS: DOWNEY CA Uc.l : 402536 +Esac+t+sit.r-W4545****�c:;+f.****.f7fica;iRiE+Esicr+fic+c**-1*.e;b**—NN- .a+Fit-R.:.c++:ic+e+t+tc+t•-rtrkac****-1Y N.-*a:ac-IdE<.EW*as Sttn 90241 WIT: Z ON ING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally• that I am licensed under. • -of Chapter 9 S E T B A C K S (mmmendng with Section 7000)of Division 3 of the Business and Profession: my linen, S in full force and CrrYuc.ND,: 059377 uc.cuss: C 39 uC.NO. ' 2536 EXP : O/95 MAIN BUILDING ACCESSORY BUILDING J� NT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: 3/ / 9r Contractor 4 C / ,,e7G�d / / LEFT: FT IN RGHT; FT IN LEFT : FT IN RGHT: FT IN OWNER BUILD DECLAPIATION:I hereby affirm under of perjury That I am exempt from the Contractors License : for the (allowing reason(Section 70315 Business and Professions Code:Any city or county which requires aperni to consbucl.eit•.improve. PARKING REQ; PROV; PARCEL : 41916462 ZNE; REF NO; demolish,or repair any structure,prior to its Smarms,also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES> S licensed pursuant to the provisions of the Contractors License Law IChapler 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she S exempt therefrom and the basis for the alleged exemption.My violation of Section > ' 7031.5byayapdicant fore permit subjects the applicant to a civilpenalty of nit more then lire hundred dollars(5500)). ***air**********iF+faist**til***')t*+F+i****alk****iF-k*#itac***********iF*******r+****,*****if**'M* ❑ I.as owner d the Maeda ormyemployees with wages es their sole compensation,will do the work,and the structure it not intended DEVELOPMENT SERVICES R E Q U I R E M E N tT S or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an hamar of property 1 who holds or improves thereon,end who does such work himself or herself or through hit or her own employees,provided shat suchr., improvements arena l intended offered for sale.f.however,the budding or is within one Year a completion,the ZONING APPROVED BYDATE ; owner-builder will have the burden of proving he or she dl not build or improve for the purpose of sale). ❑ I. ofCode:The Contractors Licenseusively Lawdooees not with licensedapto ennoowwneerr of pray whobuWw or i�mpmoves thereononand who BUILDING APPROVED BY DATE; I contracts for such woods with a axnrsctor(s)licensed pursuant to the Contractors License Law). � �( — ❑ Iamexempt under Section: B.&P.C.,for this reason: APPLICATION ISSUED B`1; DATE: / J *********************************4**** ******************************ar *Tor*f,- *'r Dalt ONTer: LEGALIZATION ;N F E E SUMMARY STRUCTURAL SEGMENT ;Y I do hereby cenity that lam aware of and understand the requirements of Catalonia/health and Soley Code Sections 25505,25533,and 25534,and that l or anyhaure building occupant will/wdl nor one)need to comply with said date codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modification From the A'P rury ahagement District.Residential construction applications are exempt from these PERMIT 54 , 00 , 50 provisions, SHIP/NON-RES Date: Applicant: PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE ❑ Ihave and wmsimanaceddicateelconeenttoself;nahmforworkeidnompensation,asprovided for bySection 3700otheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code for the performance ofthe work forwNoh this permit is issued. TOTALS----> 54 . 50 0 , 00 0 , 00 54 . 50 54 , 50 . 00 I have end wit meiman workers'compensation insurance,as required by Section 3700 d the Labor Code,for the performance of the work for which this permit a issued.My workers'compensation insurance carrier and policy number ere: caMen :nir. rL�nu - E'%PIKES REVENUE DIVISION TOTALS--> COLLECTED; 54 , 50 OVER/SHORT; 00 Polly Number: • ,, .' _. .v,�� ,,- 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN-CHECK (This section need nor be completed y the permit/s kr one hundred dollars[SI V leas.) 54 , 00 • 5 0 • I certify that in the perlomance 0 become subject t the wwkam'compensation the work for laws this permit ags that aIrapky any person Id become in �-to the so roto E************iris******sir************4.**************-e******rt**********al*********ef** conpenWio son, �s,rwaom%d the Labor code.I s 11 'h Provisions / / IND I V IDUAL F E E BR EAKDOWN C�9/�w /p1 TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Data: ,`ir /, / cent 'r Warning;Falls N such worbri ampavapon average sunk 1,and shall f cont an employer to griming ! •es and chit fines up m one hundred thousand dollars 0100,0005 M addldon to the cost of compensation,damages • -sided for In Ssedan 3706 o the Labor Code,Interest,andslfomey'a fees SFR 2924 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 924 , 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,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: 1 certify that I have read this application and store that the above information is coned.I agree to comply with all city end county ordinances and state laws relating to building conshudion and hereby authorize representatives of this city to enter upon the aboe'mentoned property forinsPecionpurposes.th LENE BURFO r°• . . 710013312100183122 TOTA 54.50 -'/ /. ' / 3i 9C DATE: 05131-45 TIME: 11:39 �`tictor Date: i9rakre dAmar/gpenVA - treaor (5151-4e.WP) While-Boiling&Safety:Green-Re Canary-Applicant:Pink-Revenue;Goldenrod-Assessor . POOL & SPA CONSTRUCTION AND PLANNING --•,. - ' APPROVALS Permit # Date Inspector Date 4ns APPROVALS Permit # pector 1. Temporary Electrical Service or,PoIle 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 - ,1 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 1 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-Firial I 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 • 1 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign68. 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 -7-75" t C.-'It 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: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test .• 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing '1 39. Watei Service-Final' \40. Gas Service-Final 141. Solar Domestic-Final li2. Backflow Preventer 13. Backflow Irrigation 1. Landscape Irrigation System Sound Attenuation Handicap Regulations \FINAL STRUCTURE & BUILDING /(-S-9y" h o-/I FINAL PLANNING L _lectric Release to Edison ', las Release to Southern California Gas Co IRTIFICATE OF OCCUPANCY ; -) Date / • / \ •1 • -- - - - - - -- Applicant to fill-in all spaces except those within heavy border lines and sign all appropriate declarations. - • CITY oA COSTA mESgA`CO STRUCTION PERMIT PE IT O. TRACT NO. LOT NO.' UNIT NO. r •. • • 1 406 12/I'I/67 5900 l- r Protect Address'A 3.7, ) O�aN i �oit/� .in TYPE /S 37. , , _ • . , • Apphcant's Mailing Address /5J (Al 7�/N`-�L TYPE OF CONSTRUCTION LI NEW U ADD U ALTERATION UIREPAIR' - ' yynn �y r�%b-I ❑ CONVERSION -❑ DEMOLISH El OTHER. • • - ,4 P'# ' - Zone' Owner's'Name FE O �., -Phon -DESCRIPTION OF WORK/USE OF BLDG. • - - Address 33� len/) oxiO - -- S Main Budding' : - • Accessory Building.' ' • E Arch/Eng., I License No. TYPE OF PERMIT ❑ GRADING- LJ.FOUNDATION ❑.STRUCTURAL ' ' T' Front _ ' - • - - 0 Address • • ❑ OTHERT 'CI ELECTRICAL ❑ PLUMBING ❑�PoIECH MECHANICAL f 1 BA Rear . - N' T-f�L1� �77 �1�7 n I Contractor's Name/711r EARLS PGJMR/71x�-Phone/2D3Y ') - - - - N C Right LA..) `` PROJECT DESCRIPTION SD. Fr. OCCUPANCY - • - - G Address(mailing) W /.1/1)�OLIO • aN�he1M - K • ' CONSTRUCTION TYPE VALUATION$ s Left R. City License No. ZONE - GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION - . - Ping. Ref.# • _Parkin Req./Provided • I hereby,affirm that I am licensed under provisions of Charter 9 (commencing ; Remarks: - " ' g , REG�fv .i] NOV 3 0 X37 M Plannin Notes: with section 7000) of Division 3 of the Business and Professions Code, and ' - ' - - T my license is in full for an. -ffeci, • tj��j�s-�, ' RECEIVED DEC �+ 198T s License'a55 r ic-ni o, / • - - Date ' one Signature r . •/.u.: I , , , • PLUMBING • FEES s� ' . . . • WORKERS'COMPENSATION DECLARATION ,• I Bar Sink Showers • I herebyaflirrn that I have a certificate of consent to self-insure or a certificate ' ' I ELECTRICAL • FEES of Workers' Compensation Insurance,or a certified copy- thereof (Section Backflow Preventer , S¢fv- Sink • ` 3800, Lab. C.)Q`I g./'�� //L /�5 Automatic Washer 'Transformer ❑ 15-50 KW Policy No. `/ Y Company�f Backflow Irrigation ! Sewer Ca I ❑ 50+KW ! ! P I ,Construction Pole Sub. , . f co Certified copy is hereby furnished. ' k ' I `rir/� Cergqfied,Pyypy isMled with the city BsLyji{dic�yy D vision/ l i , Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps Date `1ION -�% ApplKERS'ant /-1-A. /// . _ - - - --- ._ ' - - • EXEMPTION FROM-WORKERS'COMPENSATION DECLARATION - Clarifiers - -t - Solar Collectors - Dishwasher - I Meter❑over-100 amps ----'i ' 4 (This section need not be completed if the permit 5 for one hundred ($100)or , . _ less).ch 1 Dishwasher , Solar Piping Dryers Gas ❑Electric Sub Panel i I certify that lin the performance of the work foriwhich this permit is issued I shall not employ any person In any manner so•as to become subject to theDrinking Fountains Solar Tank Fan' Motors E10-1 HP ❑1'/z-8 Workers',Compensation,Laws of California. i ' Date Signature ' • ' Floor Drains' I Swimming Pool w/Spa' F.A.U. ' l 'NOTICE: If,after making this declaration, you should become subject to the , _ _ _ _ _ _ _ _ Inc.Solar.❑9-15 HP ❑16-15+ Workers' Compensation provisions of-the Labor Code, you must forthwith • l I . comply 'with such provisions'or. this - Floor Sinks UrinalFixtures ' p y permit Shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY' - "' "' ' Ges Service :Outlets) Water Closet• , Device Boxes I hereby affirm that there is a construction lending agency for the performance , Pole,Light , of the work for which this, permit is'issued -.(Section 3097 Civ. 'C.) • Interce tors Water Heater ^ ' Lender's Name - ' p / —. IX' (�/ Outlets Range ,• Lender's Address - Kitchen Sink r" - - Water.Service ! ..'t $witches' Sign ' ' OWNER BUILDER DECLARATION . '• ' . • - 4 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories , - . ' Auto-Wash , following reason (Section 7031'-5 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 r, ' - Laundry Trays' - • • - `� Generator ❑0-5 KW ❑5-15 KW ' any sigstructure, prior to its_issua also req eapplicant for such permit - - r Trash Compactor • :to file a'signed statement that he/she is licensed pursuant to the provisions Of . ROOF Drains r - - • • 'the Contractor's License Law (Chapter 9(commencing with Section is exempt 7000)101 r - - '• • - , Division 3' of the Business and Professions Coda) or that he/she'is exe , - i - , therefrom and the basis for the alleged exemption. Any violation of Section 1 - . i ' ,7031.5 .by any applicant for a permit subjects the applicant to a civil �' -' - - enalty of not more than five hundred dollars ($5001.4 - I i - .. - , , LJ I, as owner of the' property or niy employees with wages as their sole• I , Reinspection-Fee ' ! $15 ' Issue Fee- • $ 3 _ compensation, will do the work, and the structure isnot intended or offered ! 'S ' - Reinspection Fee ' :I $15 s 'Issue Fee $ 3 • for sale (Section 7044, Business and Professional Code: The Contractor's' 'MECHANICAL - - FEES 1 -- . . '- .- -- • - - .- - - - License Law does not apply to an owner of a property who builds or improves _ ' - - thereon, and'who,does such work himself/herself orthrough his or her own - • , I - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for . Boiler, - 1 Hood or Type I IDI i , - 1 ' sale. If,'however, the building or improvement is told within one year of com- - ' 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 i - I • prove for the-purpose of sale). I - Building Approved By ^ Date / vv ❑ I, as owner of;the property,am exclusively contracting with licensed con- • Duct-Structural Refrigeration System ' • til Application Issued By Date /I� ' tractors to construct the project (Section 7044,Business and Professions Code: • The Contractor's License Law does not apply to such an,owner of property who. Duct+Ventilating • , - '- ❑0-100,000 BTU ❑100,000 BTU - - $ I , SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- _ - Iractor(s) license pursuant to the Contractor's Li pens¢ Law). I am aware that i - - BUILDING:PERMIT ' $ SMIP $ : . Exhaust System ❑ Multiple ❑ System Repair/Alteration • proof of their Worker's Compensation insurance zhoultl be provided to me. PLAN CHECK $ PERMIT ❑!I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING ' $ . DO ISSUANCE ! $ Date - Owner ' ' Heating System& Ducting i Registers ' : I ENERGY'P.C. $ ' ' _. PLAN CHECK '25%' $ • I hereby certify that I have read this application and state that the above El 0-100,000 BTU ❑100,000 BT ELECTRICAL $ GRADING $ information is correct. I agree to'comply with all city and county rite repre- races and State laws relating to building construction, and hereby authorize r ' .. $ MICROFILM $ I sentatives of this city to enter• upon the abve-mentioned ,property for PLAN CHECK ;50%' , • inspection our s s• I .Signature 1 .. Gate t MECHANICAL $ ' TOTAL FEE ' $ 'V"OOl • • Dri vers',License or 5S — Reinspection Fee —$15 Issue Fee - • .- $ 3 PLAN CHECK !25%r $ i 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 UFER 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 - 16r;°Rough Electric Wiring - 67. Fencing& Access Approval ti- 17t.: 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 ❑Gas 0 Oil , 23. Gas Pipe-Rough & Test • - 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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:12-$3_87 LerrCLRo- L.E•i, 34. Final Heating & Air Conditioning 3-7-br CA WIC- AS est 203 opc. L. M 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 . CX _ - 42. Backflow Preventer -C"). f-rl ' 43. Backflow Irrigation El rrj ' 144. Landscape Irrigation Systern 1 1r _ ' \45. Sound Attenuation - t"'i re _ r46. Handicap Regulations _� fi • 17. FINAL STRUCTURE & BUILDING I B. Special Requirements Completed' • - ). Electric Release to Edison '°5 C.i- - • - -" I Gas Release to Southern California Gas Co ICERTIFICATE OFOCCUPANCY _ - i Date . r . . I OWNER SAN VIsTAJUILDING COMPANY DATE 6-i-64 JOB ADDRESS 2335 Richffiond way BUILDING PERMIT NO. 22238 GENERAL CONTRACTOR same VALUE $ 13,895.00 AP No. LOT ]38 TRACT 5]60 FIRE ZONE DESCRIPTION OF WORK re6 watt gar INSPECTIONS Signature D T� GROUP Da TYPE V ZONE A3 Soil ��//�{ PERMITS ISSUED Gas ! /<9//L SUBCONTRACTOR DATE NUMBER Water yy G /./ . fs Rough om. 'efrig. ■ Air Cond. p -� Rough Heating �1 �j/�S .��4 33 -2-- Rough 3 -L-- Rough Plumbing 0 gas, L I" ; i ��'/ - -/-4, .��� • Miscellaneous � � ���✓✓✓ ,/ / U Prop. Swr. Line D House Con. LYSt. Swr. p 1-,_ y,/�/ / e„..". /,.c.c— . , 4 U ./1.9 Sprinkling System f frit' Construction Pole ./L� Underground 0 Power , N Rough Wiring 75 52V-C" P. )9t c .L - 7/2-/ /y , .. - Trenches 0 Forms 0 Steel Reinf. 0 v, L / G 6 Floor System jc' n/6 ce . Bond Beam 0 Steel Reinforce 0 ' Sheathing 4, 11 e- i /jam G - 'O Frame and Flashing { c_ y z/ C V , Lathing—In.W- Out _ //7G V 1 e ' Plaster, brown coat c_ f C 1' -1❑ Air Con. 0 Final illt1 7-r-4--- Heating, Final ©Hlf&" Plumbing Fixtures, Final Snare ]re Final Gas Test/S# PMI _ _� Electric Fixtures, Final g f 10-z9`&a Building, Final at. /I- Y-67- 1 OCCUPANCY 1r it• }f-6`/ • Form BUa-5M-a-63-S-BP HOLD rvK JYti1v., x LcyQM...fa:-a.,.� FEE RECEIVED 222.33 wort 1 .3 100. COSTA MESA BUILDING-SAFETY DEPARTMENT .. P.O.BOX 317 COSTA MESA.CALIFORNIA - FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT ' TYPE OR PRINT . BUILDING I1 J� 1 • For Office Use Only BUILDING J33 S // IYF I/ ILLY , ' ADDRESS �yy\( (0� UiLA✓M - RECEIPT NO. y�rvo. ' COSTA MESA. CALIFORNIA /,�53 RECEIY// D n/¢c -- DATE ISSUED OWNER �-L/IV��Ip_W�`O- ����IyQ) 'l� �! ��� -IIIN 1 'I9G4 BUILDING ADDRES�SS II I In `0 /�/ • `S-� a -y���,//V n'p/7 ADDRESSFIRE �y CITY ' 1 1 �' L NOp/CJ3/p / ZONE TYPE ��Jj GROUP _/��L-� !7 /,J�, p _.yr APPROVED ARCHITECT R//) 07 �1/r`p_�- TEL.S_LSV BY DATE OR ENGIN EE NO. I) ZONING _ ,/ 3Z • l{ �� , ADDRESS�1UA.O`� SNE , I� NO.OP I use oP NR ski �j-000 ` .�I,' /]� T Jy' 1:0.NE BUILIgl�flp`/- /J CONTRACTOR �CJ.i1.L l�l.-AeA4 V� I OSO l'/ '�/ID� �J/J LEGAL (® J/ / 4 C� DESCRIPTION ADDRESS,/J ( / CITY T# Al! / f( w / A.P.NO. INO ` �� STATE l 9;.? `I 7/ (1 NO ✓I iy .3 Wel l 90'r TO SIDE @ REAR PE: NO EAVE H LNG SHALL E LESS THAN LIC.NO. t-� / 6 /7CL o - - EAVES SIZE CVO X ///yyD NO.OON LOT O BLOCS. NOW ALLOWED (U.B.C.REQUIREMENT) OFL / ✓' YARDS IN BUILDINEDG. . YARDS ACCESSORY BUILDING USEOF - MAIN BUILDING ACCESSORY BUILDING ' EXISTING BLDG. (FROM C/ STREET)/ i/ ELINE FROM /9 FRONT f FT. C,CENTER OF STREET / V REAR YARD FRONT SIDE YARD LEFT - O I' RIGHT rip R.SIDE C) FT. - FT. ', DESCRIPTION OF WORK L.SIDE 0 Fir. NEW ALTERATION ADDITION REAR 0 FL - FT. DISTANCE BET. BET.MAIN @ REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS. In BUILDING .) NO.OF VAR.# DATE Z _ SIZE pro )Y 33 ROOMS b P STORIES i C.U.PP1�W#�E[�//(Xyy�-\�/� ) w�( APPROVED ILI !['`' [/ COVERINEXTERIOG COVERING _ / BYPRt jll�l�ywi�Y \ DATE f/ .) ru I/ WL• USE OF BUILDING AND WORK TO BE PERFORMS 13.T /� 5 0 � - oc �r�. N I HEREBY ACKNO LEDGE THAT I HAVE'READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F la AND STATE THA THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O 0. PLYBUILDING WITH ALLCONBTR IOY ORDINANCES N. )�AND STATE LAWS REGULATING VALUATION ..0 6 m y . N PERMIT FEE $ Y-S ry SIGNATURE OR L( 5b O S PERMITTEE 1 .--e---4---' X�—.�" B V (/ "C S / 3, " ' '-6 PLAN CHECK $ 2— ¢ 2 AUTHORIZED`A6 NT // �7 JAS 2 a TOTAL FEE $ l9 /1 ,