HomeMy WebLinkAbout270 ROBIN HOOD LN - Building Permits •
Y\ CITY OF COSTA MESA
P y•�.^; BUILDING DIVISION PER NUMBER
PERMIT
' DEVELOPMENT SERVICES DEPARTMENT.
m� •
Sa
00-00630
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 270 ROBIN HOOD LN Status: ISSUED
Suite: Applied: 05/08/2000
Vicinity: HOUSE&ATTACHED GARAGE Issued: 05/08/2000
Parcel Number: 42621414 Zoning:
ISSUED BY:
Applicant: GRIPPI, STEVEN
Address: 177 22ND ST.
Phone: (714)548-8905
COSTA MESA,CA Zip: 92627
Owner: ARKO, ROBERT T TR
Address 270 ROBIN HOOD LN
Phone:
COSTA MESA,CA Zip: 92627
Contractor: TYLER J CONSTRUCTION CO.
Address: 177 22ND ST.
Phone: (714)548-8905
COSTA MESA,CA
Zip: 92627 License: 661717
Arch : Eng:
Address: Address:
•
Phone: Phone: •
Zip: License: License:
SCOPE.OF PERMIT.
ADD 2x10's ON TOP OF EXISTING ROOF STRUCTURE TO CREATE NEW PITCHED ROOF.ALSO, REROOF EXISTING
SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(40 50).TEAR OFF EXISTING ROCK ROOFING,INSTALL 1 LAYER
OF 30 LB FELT,AND REROOF EXISTING PITCHED AREAS WITH 30 YEAR DIMENSIONAL SHINGLES AND HOT MOP WITH
CAPSHEET OF FLAT AREAS.
FEE SUMMARY
Plan Check: $163.31 Calc Valuation: $14,800.00
Permit: $251.25 Claim Valuation: $14,800.00
SMIP Res: $1.48
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $416.04
•
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. 1
FOR INSPECTIONS CALL: -(714)754-5626
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compensation Insurance carrier and policy number are: .
Carrier: Policy Number:
(This se ' n need not be completed if the permit is valued at one hundred dollars($f 00)or less.)
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,and a ree that if I should become subject to the workers'compensation provisions of Se tion 3700 of the Labor Code,I shall forthwith
comply with these pr�/Lk.Isio I _I
Applicant Signature: /JJ.,,w FA -iv-- Date: .5 / der
WARNING:FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.1.1c.Of '7/7 Class q d
Contractor's Signature: — /--J=\ rp1 a' Date: 6`O x`00
CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or 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).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
O I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
o I hereby certify that no excavation five(5)or more feet In depth Into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP Is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air(Duality Management District or from any other air pollution control district or agency? 0 Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code),
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
B (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
denature Ob4egal Owner(s) / Date
And/Or A o zed Applicant Date
;ODES INSPECTION TYPE DAIF Itl7IDA15 ;ODE( INSPECTION TYPE PALE XMAS
AIS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall _ _ 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Dignm 222 Final Site
204 Final Demolition 250 Final Building/Occupancy e��J�11'/E✓
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DIVISION OF BUILDING SAFETY
CITY OF COSTA MESA
APPROVED .
I 78 io +
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y4v Date ��� � �- ___^�-_ ..y,,.,
By _ v Pro per y L;�.c ��
This set ofplans and
staaMUST beY.aptonthis 1 fmmatheD'atii of Building NOT
make on same without written pe �f
PDDI7 LETIONS, OR CORRECTIF`: c"''r I
and Safety,City of Costa Mesa. royal /
•
The stamping olthis p'�and s cificationsSHALL NOT he to or to beanapp BE PROVED BY 7HE`PLANNING DIVISI'Jt';
of th- ''^'"'""^t any provisions of any City of Costa Mesa Ordinance andlor State taw.
r rmdmrdPdSik#se:Wddirtg9i— _. ,_ A' .
These plans and permit shall expire by Limitation a—rSQtlac= `isin t 0 days of issuance. r
rwrk is not commenced and maintained active per LBC§3 - l� y/ U� .
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Owner ', Sob Dolores Arkin Can}rnc}or: Tyler 3, C kruc4\on Go. I
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Costa Mescc , GA 91.4.21 Cos}y Mesa , CA 91611
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COSTA 'MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O.BOX 3I7 „I• ^r ^1VTA P1EQq
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING BUILDING
ADDRESS 274 Robin Hood Lane
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. 711T76
OWNER Sherwnnd Wnrect fev?1nnerG 42E V
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESSNewport Blvd.
3700 )11 1l1 7-,11 -5-5- AUG 4195
CITY Newport Beach Z. OR 5-1240. BUILDIIN
ARCHITECTL,._e LIC.
OR ENGINEER Raymond Vannes NO. C74 7 COSTA MESA. CALIFORNIA
FIRE
ADDRESS ZONE
ZONE NO.OF TYPE GROU�,
CONTRACTORLldO Construction NO. 7520 .p1✓PUNS I/ �a
ADDRESS 2700 Newnort Blvd. TNO.OR 2-1240 APPROVEDEL DATE
LEGALo
DESCRIPTION NOT 12 BLOCK TRACT 5289 CORRECTIONS
A.P.NO.
SIZE F LOT 791 X 801 NOWSLOGS.
O
NOW OFON LOT none
OF
USE /-
EXISTINGBLDG. L,L
SETBACK LINE FROM
CENTER OF STREET 451 REAR YARD 31'
SIDE YARD RIGHT 51 LEFT 5'
DESCRIPTION OF WORK
•
NEW ZF ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BSIZE 1672
NO.OF
1672 ROOMS STORIES 1
EXTERIOR WALL wood ROOF
COVERING c}nprn COVERING rock
USE OF NEW
BUILDING Dwelling:
Att. earaae 400 so, ft.
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-
TI
PER. w /� VALUATION
SIGNATURE OF /'] �I'y11ry//- PERMIT FEE 5
ERMITTEE / �V / G
/� '] PLAN CHECK S / !1
$!/ / _ V
AUTHORIZED AGENT / TOTAL FEE $ SMF
a (AYH LK ANW, LLUbfitVP DATE 0-10-14
(JOB ADDRESS 270 Robinhood Lane BUILDING PERMIT NO. 385b1
GENERAL CONTRACTOR a . : . . • t DESCRIPTION of WORK Add Din-Area & Coy. Patio
n�AP No. • '- -• LOT TRACT FIRE ZONE VALUES ,500.00
1 INSPECTIONS Signature Date TYPE V GROUP I & J ZONE RI
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date l Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING ,
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING / — ).3` 7,c- Heating and Vent.
TRENCHES 0 FORMS ❑ STEEL PEINF. I. j
FLOOR SYSTEM ` t K - - '
BOND BEAM n STEEL REINFORCE '
SHEATHING D P -.7-45-I
FRAME AND FLAnSHING �/j' , �GY'�T`/�J77/ �.2� )L(Y�
LATHING - IN 'k' UT /�i�///J "D-71
PLASTER, BROWN COAT
STRUCTURAL, FINAL �bF�"�lectric ,/
HEATING, VENT., REFRIG. AND A.C., FINAL c K �r4't.'. o-,V-7 326 vo/--
PLUMBING, FINAL AND GAS TEST in
ELECTRIC, FINAL ee -yC2 7�—/i''79
y
BUILDING, FINAL —2 Lf741 . •
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3856 i )I; ,F-,IIF=IDOO
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 1
PP C TION FOR BUILDING PERMIT
For Applicant to Fill in Completely
BUG �7 t-I /,� • 1 RE D DATE RECEIVED •/•�i��A
ADDRESSI2 (V TSO 15 f Ai /4OA A i— ry //r I Z�
/t `, �/`r PARMIT
OWNER lRe'a _RT ARCO A.P.Non R- 14$—o4 +zQ /
MAIL ^ ^ O BUILDING .—t U /
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ADDRES5 2 J QUA I AJ I�QOD LAI AODR ESS 4.-- / 31fp {app `IQ.
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2 U CITY l C, NO. 6445.3//0 � Z
3/IO TRACT3 { LOT' BLOCK
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z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMO!LSH
—1—LENDER
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_ID BRANCH
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OWNER r .K�t
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U N FIRE y'
W 2 ADDRESS ZONE TYPE i GROU Pj I
0- tL r��- APPROV y
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CONTRACTOR Al
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Z_ S 0 \ PLANSNS �•�, �(✓
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STATE .-t 7 CITY YARDS APPROVED _ YARDS APPROVED
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CC LIC. NO. t2 LIC.NO. MAIN BUILDING ACCESSORY BUILDING
7 0 (FROM C/L STREET)
SIZENO.OF BLOCS. ,t
OF LOT I NOW ON LOT FRONT QIC FT. FT.
USE OF c •
EXISTING BLDG. XES I DI"AJCC R.SIDE S FT. FT.
1— SIZE OF t( 4. v % M NO.OF ))
Z NEW BLDG. ^ ROOMS 1 STORIES / L,SIDE 3aFT.t FT.
EXTERIOR WALL ROOF p / /
0 COVERING 5TUC,CQ I COVERING 7V�eAP REAR /LJ FT(O rr FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
a D I6./i AI Cr A tgA MAIN BLDGS. ACCESS. BLDGS.
Q VAR.* DATE
O et COUa PATI') C.U.P.# APPROVED
~ APPROVEDI u
z _flY •ATE
Z0 s1AYK
Emi
0 I hereby acknowledge that I have read this application and state L (f
O that the above information is correct and agree to comply with ••• �:J
cc all laws regulating building construction, and I shall not employ 1,
F any person in violation of the workman's compensation laws of jr
co the State of California. / J SQFT. r
? I hereby certify that I am properly licensed as a contractor under / i/Y . 6 6 � tQ
o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLY: •
cc
am exempt from the provisions of the State of California Business VALUATION
and Professions Code, Division 3,Chapter 9. a
/� PERMIT FEE $ t"
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Signature of t tY n1 1 ',-m
Permittee �r�s,�' `JyJ $fe--e PLAN CHECK $ /1 • E
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TOTAL
i / // 6=�
Authorized Agent 9[.
_ TOTAL FEE $ /T
arcw, nooerL .� o-lo io
JOB ADDRESS 270 Robinhood Lane BUILDING PERMIT NO. 42476
GENERAL CONTRACTOR AlliKool DESCRIPTION of WORK Encl. Patio Cover
AP No. 118-144-04 LOT TRACT FIRE ZONE VALUE $ 600.00
INSPECTIONS Signature Date TYPE GROUP ZONE R-1
SOIL SUBCONTRACTOR PERMITS ISSUED
GAS Dote Number I Signature
WATER Plumbing
-PROP. SWR.LINE ❑ HOUSE CON. [
SPRINKLING SYSTEM
]
MISCELLANEOUS LLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM 7 STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT fl
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST ril
ELECTRIC, FINAL /}
BUILDING, FINAL RG6 D a/-
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SPECIAL REQUIREMENTS
42476 Pk7� O 16-7 . 071,1,� *6.5
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely— Use Ink Only APPLICAT N FOR STRUCTURAL PERMIT
A 14n
RECEI DATE RECEIVED' riyTij195U;
ADBUILDING a DRESS C.. oniAI 14l".C •D LA 7�oYY{J �r//(P,I�1C/O_
OWNER ROBERT 7 ARK A.P.NO. IUS- I V't PERMIT NO.
MAIL -'1 •,f� "� BUILDING 2......70 14 Opp L.1
ADDRESS 2 o I�nR1N Melon LA.TELADDRESS . p��I N.
CITYC04 .� AAESR No64&3I10 TRACT 3!/r� / LOT 17j BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH
LENDER r X
BRANCH
OWNER R/�-h.F- rYs yr-J p '
AM1-K0
ADDRESS
VALUE
ARCHITECT TEL. USE • b co s Li
'fled
OR ENGINEER NO.
FIRE
ADDRESS ZONE �-7T P GROUP //11� 77
CONTRACTOR
n Di UAB A Kort._ BAVPROV ED //• DATE F.141-/,p
AOORESSISZ‘ E GAJ RSi4 _ it TEL ZONE NO.OF // USE OF NEW
R
CITY L A . NO. q,`4.' _ F PLANS -4...< BUILDING ffir,m.,, w....
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC, NO.26 exciQ Q LIC.NO.636'7 MAIN BUILDING L STREET)
(FROM C ACCESSORY BUILDING
W SIZE NO.OF BLDGS. I
p. OF LOT NOW ON LOT ' FRONT Pl?Z.iber, FT.
Q USE OF f
.i EXISTING BLDG. Dui E LL (
. _R.SIDE CTFT, FT.
/ate
T t Separate permits are required for L.SIDE 5 s/ FT. FT.
F' electric,plumbing and heating work. (.�z' L 'f
W - REAR 1 I. FT. y FT.
US F BUILDING AND WORK TO BE PERFORMED • DISTANCE BET. BET.MAIN&
QCLOSE- 1-;.-kIST!3-/G �AZ/ Q MAIN BLDGS. ACCESS. BLOCS.
(ioVE LO/ScR.EEklim6 CU.P.#
APPROVED
Q APPROV y ) 67./6 -7e.
DATEJ
a
W
A. I hereby acknowledge that I have read this application and state n
N
Cg that the above Information Is correct and agree to comply with m
1:+ all laws regulating building construction, and I shall not employ
Z any person In vlolation of the workman's compensation laws of E
.�T. the State of California. a
I hereby certify that I em properly licensed as a contractor under SQ. FT. w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F E ONLY:
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $ • UO <
and Professions Code, Division 3,Chapter 9. •
`nl �r PLAN CHECK $ 0
Signature of �0AP,.rs„_ ' $ 600 TAX $ eco U
Permittee LL`»+""' ""•YYYvvv�i�NNN J
Authorized Agent TOTAL PAID $ 0
, Se
•
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-OWNER HELLYER, FRANK DATE 2-13-59
JOB ADDRESS 270 Rphirl Hnn,f Tape • BUILDING PERMIT NO. 867L1
GENERAL CONTRACTOR Better 131191t Fence VALUE $ 245.00
AP. No. LOT 12 TRACT 3289 FIRE ZONE DESCRIPTION OF WORK Block fence
GROUP TYPE ZONE PLAN NO. 8674
INSPECTIONS DATE PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
Trenchc Forms Steel Zo
Floor Syd cm •
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
Furnace
Gas Vents
Rough Plumbing
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final
Plumbing Fixtures, Final
Final Gas Test
Construction Pale
Underground Power
Rough Wiring
Fixtures, Final 1
OCCUPANCY r—}`tt 'A
Form 210-5M-t-57 �f - 867h
COSTA MESA BUILDING DEPARTMENT" I
•
I,
• P. O. BOX 317 18674.
COSTA MESA CALIFORNIA (� r
i' EE R E C 1 141 E D FOR APPLICANT TO FILL IN
C.L. OF STREETS 7o p , ;et / , p
j FINA V� D �.�la 13 19-50,
s50 BUILDING ADDRESS � 70 �/'✓Gu+ /'rPv�f
_ __ __„�PROP. TINE — _ CITY 0 ' COST(
•P,�EI�� ~ . Owners �//,// �� �–i
10 FT. FOR 60 FT. STREET 12 FT. 61N. FOR 7 I Mail Address70 /GCTr�. n� .,e
ST1REET- FT. STREET
C
I City e++ ,/—e t"---k Ph. No. Z/ " 7 9' L
Contractordagr 1444 >CPh. No.Jf- 7. 777
Address 83/2. -.- o-a.on a ftt, .„&„..B.
50 TIF FRON City Lic. No. State Lic. No. /6/00 (
I OF PROP. F,• -
50 FT w Size of Lot AP Nd-014401/ Q
T ' 3, ?
1- 1 N Setbacks: C/L Street L re41' Rear _
Z Ir A
cc J ¢ a (n Side Yard - Right// /� Left - d -
I co r ____ ----I M ype of Fence T /i1 �i � �i
u. . ALLEY QR PROP. LINEN 0 f x sj -a � 4, —', n
a U
F""r p -, '. I hereby acknowledge that I have read this application and state
val aZ 0 d Q% """ w j hat the above is corr t and agree to comply with all City Ord-
I ( N_- p> p o F nances and State a s regulating building construction.
o �' , - •signature ����/
3% 3% m ���111 •f Permittee . C /(- -
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• 37 6 I N. ''� y L
W�. E m ` FOR OFFICE USE ONLY
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Ir___L--1y40 N ai - FT >-
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I0 ff. I` 60 FT ST. Received by Date Received Date Issued
' ' I �Z -43-y-7 c;2-0--C-7
150 F T. ST. Ili I 1
-_iPROP. LINE -- - "- - 1 - _ _ - - - _1 VALUATION Qo
\\- I Permit Fee $ '
0
in I '/ ,,..70.d.I I I $ eA 26 Plan Check $
C.L. OF STREETS I .u.o
TOTAL FEE
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS