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HomeMy WebLinkAbout3016 ROYCE LN - Building Permits • Applicant to fill in all spaces except those within heavy border lines and sign all approp • CITY OF'COSTA MESA CONSTRUCTION PERMIT PERMIT NO. - TRACT NO. LOT NO. UNIT NO• . '_�� ' - Project Address 3016 Royce Ln•, G.M. 3 a 13 B rI 'tet 4920 9/I,0/B7 sl • 27.50 TL • 126 Commercial ' G.M. 92627 TYPE OF CONSTRUCTION LI NEW L,ADD rid ALTERATION H REPAIR ' Applicant's Mailing Address t `_ HarryLostrom 545-5770 ❑ CONVERSION, ❑ DEMOLISH ❑ OTHER A.P. ' Owner's Name Phone n .n - - Zone - 3016 Royce Ln.; C.M. • DESCRIPTION F WORK/OSE OF BLDG I • II I a M Address y I rate £lbergQass s!lingles. -w meta 2eage as ingsr S Main Building: I Accessory Building: Arch/Eng. • License No. TYPE OF PERMIT • ❑ GRADING ❑ FOUNDATION STRUCTURAL • E Front, • . • 0 • • Address • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • B hear I I N Contfactor's Name Crank Bros. Roofing Phone •548-5559 ❑ OTHER A C Righb - - - - - I N Address(mailing) 126 Commerci,alr G.M. '92627 PROJECT •DESCRIPTION Sq. F7. ; 2,688 OCcu PAt�,tcv Sln K • G City License No. 005993 CONSTRUCTION TYPE residential VALUATION$ ` ,0 0.0 ' S Left ZONE • ' GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION • i I Ping. Ref. # . Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' - ' Planning Notes: • M with section 7000).of Division 3 of e Business and Professions Co• .n. - • LI• my license is in full for,ce ewe effect. A %/moo./ 1 ; T License a -r�-�p•7 ‘a-:59 License s .�/ 4'g!% / - - • - - S l"L.' Date / "-1/Df Signature pr ; _ i Anwri � :PLUMBING - FEES - - �i . WORKERS' COMPENSATION D- A ATION I hereby affirm that.l have a cer ate of consent to self-insure or a certificate . Bar Sink ' Showers ELECTRICAL FEES of Workers' Compensation ance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800 Lab. c . - • Automatic •Washer Transformer 0 15-50 KW • ' X85%224-t p y State Fund . ' Backflow Irri atidn ' Poli fti1ie.r Company g Sewer Cap0 50+ KW Certified copy is hereby furnished. - " - Construction Pole Sub. • QQCCertif(' q y5� filetl with the city Iltlin D' islon. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amp Date' •al ��/•+� Applicant Bros. Roofing Co. -' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers {.i • Solar Collectors .. - Dishwasher ' Meter Dover 100 - ps .,(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 Tar Fan Motors a-1 HP ❑1''4-8 • Workers' Compensation Laws,Of California. - . Date Signature Floor Drains • I Swir ing Pool w/Spa F,A.U. • Inc solar ❑9-15 HP 016-15+ NOTICE:_If,after making this declaration, you should become subject,to the _ • • -Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks drinal ' comply with such provisions or this permit shall be deemed revoked. Fixtures ficrowave • CONSTRUCTION LENDING AGENCY Gas Service :OutletsWater Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light ' of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets Lender's Name _ I Range Lender's Address -`- • _ Kitchen Sink Water Service ' Switches • OWNER BUILDER DECLARATION - 4' Sign . I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following'reason (Section 7031.5 Business and Professional Code: Any city or - g P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0- W ❑5-15 KW any structure, prior to-its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drai - • 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). I r 3 • . is • ' 0 i, owner of the property or my employees with wages as their sole Reinspection Fee 1 ,$15 Issue Fee $ ' compensation, will do the work,and the structure is not intended or offered sss - - Reinspection Fee ! $15 Issue Fee _ _ $ 3 for,sale (Secion-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 , thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I i sale. If, however,'the building or improvement is sold within one year of com- -- Canopy T • I 0 Zoning Approved By Date • f -pletion,•the owner will havethe burdenof proving he/she did not build or im- Duct- Under Ground - Building Approved By - 1747 q//Date_ 5 I ,) prove for the purpose of sale). {` ` O ❑i, as owner of the property, am exclusively contracting with licensed con- Duct-Structural . Refri•• .tion System Application Issued By !late 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 -• 100,000 BTU 0100,000 BTU SUM ARV OFFEES builds or improves thereon,and who contracts for such projects with a con- - tractor(s) license-pursuant to the Contractor's License Law). am aware thatBUILDING PERMIT $$$:., �� 1_60 SMIP $ 4-3 proof off their Worker's Compensation,insurance should-be Exhaust System 0 Multiple 0 System Repair/Alteration I p _ provided me. PLAN CHECK $ PERMIT l 0 1 am exempt under Section - 'B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ - ISSUANCE $ • Date Owner z Heating System& Du ng , Registers PLA N'CHECK 25% $ - ENERGY P.C. $ I hereby certify'thattl have re yd this application and •to peat the above ' ❑0-100,000 BT a 100,000 BTL - • ELECTRICAL $ GRADING $ information is correct. I agree omply with all cit�c. ty ordinances ' - _ . - and state laws relating to buil. g construction, a•• eby-uthorize repre _ , ' PLAN CHECK 50% $ - MICROFILM $ sentatives of this city to en -on theme io•-d property for - ' inspection purposes. - ./��ji / - - MECHANICAL $ - •;tet Signature �_ •• / -a"f[MMAY ' ' Reinspection Fee $15' Issue Fee _ .$ 3 ' - PLAN CHECK 25% -$ • CMF 0865:46,rev. 1'0/84 /rite'. Building; Canary :Applicant; Pink - Accounting; Goldenrod - Assessor '- - '' .. I CONSTRUCTION AND PLANNING POOL & SPA • Date Inspector Date Inspector, APPROVALS Permit# ' APPROVALS Permit# 1.- Temporary Electrical Service or Pole . 52. Pool & Equipment Location - , 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement ;1 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,. - \, 4. Electrical Conduit-Undrgrnd. " . 55. Electrical Bonding1 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 h 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1 10. Structural Floor System - 61. APPROVAL TO DECK • - I 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final I 12. Sewer Cap 63. Heater & Vent-Final I 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing65. Electrical-Final' i 15. Rough Electrical-Conduit • ' 66. Solar System-Final 1 16. Rough Electric Wiring ' • : 67. Fencing &Access Approval - ' 1 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1 18. Rough Electrical-T Bar Ceiling ' - 69. POOL/SPA SYSTEMS FINAL 1 ' 19. Rough Heating & Air Conditioning FIRE DEPT'. REQUIREMENT - t 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Powe? 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 , 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. FI NAL STRUCTURE & BUILDING rD/7 Al Q?kJ- 48. Special Requirements CompletedI. E - ;� '." - - 49. Electric Release to Edison •- : . - 50. Gas•Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date ii, lep?1 C Nr`C' T {.Y.�\ µ J Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF,COSTA M SA I CONSTRUCTION PERMIT PERMIT N TRACT NO. LOT NO. UNIT NO. e. _ .,.. Project Address CO ��(F.. t Ab.is. • m 7 93 uk6z 2/0467- 7.00 TL ffff{87{{{878787 n, • • 0� H REPAIR' ^"` Applicant's Mailing 3ressG TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION .` 1 .' ,t- �..'�O ,,IM CONVERSION ❑ DEMOLISH OTHER • A.P.# _ - • Zone - Owner's Name d.���.- `' CC-JIB\ Phone DESCRIPTION OF WORK/USE OF BLDG. re/14n Ott'.+ Address 2/Q1 t0 "�`"� . • S Main Building: Accessory Building:- - Z Arch/Eng. License No. • TYPE OF PERMIT • ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL • T Front • - - 0 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING i�MECHANICAL B N ' Address - y�r��• • '' �,1� }�' A Rear Contractor's Name "'s7 • Phone5`f'�e63 ❑ 'OTHER' - C Right - . - N 2t SL r(.,... / ca..-. / PROJECT DESCRIPTION SQ. FT. OCCUPANCY K. G ; Address'Imailing) QL �tta�'"1 ��( �- - • - CityLicenseNo. ' l-O� - . CONSTRUCTION TYPE .VALUATION$ S Left • • ZONE GRADING CU. .ACRES Ping. Ref.# Parking Req./Provided - E LICENSED CONTRACTOR DECLARATION - ���� D • I hereby,affirm that I am licensed under provisions of Charter 9 (commencing •Remarks: ✓ lJ__`` 'p Cul"— - Pla onto Notes: ��jj • with section 7000) of Division 3 of the Business and Professions code and ' YJ: a t�N111r�/ Cul • - g RECEIVED FEB 'J • - M ' my license.is in full force and effect. .. , $ dateUce 'd55^ 'rQ � L nS_' [ _ _ _ _ Date Signature �' L Q�.-�� PLUMBING " FEES WORKERS'COMPENSATION DECLARATION , I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance;or a certified copy thereof (Section Backflow Preventer Service Sink - 3800, Lab-,) `� - - - - -- ..�` - . -'- -' --' Automatic Washer - • ,Transformer 0 15-50 KW—. -r Policy No� - { Company r2' 1FblL� fiN2 • Backflow Irrigation Sewer Ca• . .. . 0 50+ KW ' ertified copy is hereby furnished, • p , ,)Construction Pole Sub. , Certified copy is f'etl with the city Division. 1.t Bathtubs Sewer Connection Cooking Unit Meter ❑Up to 100 amps Date 7-7 'ROM Applican , EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - ' Solar Collectors • Dishwasher Clover' .Meter Over 100 amps (This section need not be completed if the permit is for one hundred ($100)or - • ' l less). Dishwasher Solar Piping • Dryers ❑Gas DElectric Sub Panel I 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 Motors❑0-1 HP ❑1%-',g Workers',Compensation Laws of California. Date Signature ' • . Floor Drains I Ss'imming Pool w/Spa F.A.U. _ Inc.Solar''❑9-15 HP 016-15+ • - 'NOTICE: If,after making this declaration, you should become subject to the - - - s Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal Fixtures -- - Microwave. -- _ • -• comply with such provisions or this permit shall be deemed revoked. - ' " .. . - ' . -- "' " " CONSTRUCTION LENDING AGENCY, - Gas Service Outlets lWater Closet - Device Boxes ' 1 hereby affirm that there is a construction lending agency for the performance _ POIe Light 4 of- the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater an Outlets Range Lender's Name- - - g _ Lender's.Address - - Kitchen Sink Water Service Switches • I OWNER BUILDER DECLARATION -, _ - Sign _ • I hereby affirm that`I am`exempt from the Contractor's License Law for the • Lavatories . - Auto-Wash Garbage Disposal Standing Sections following reason (Section,7031:5 Business and Professional Code: Any city or _ - county which requires:a permit to construct,alter,improve,demolish or repair , P-Trap - - Laundry Trays '' Generator ❑0-5 KW ❑5-15 KW Trash Compactor any structure, prior.to its issuance, also requires the applicant for such permit P -to file a-signed statemenuthat 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 chef 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). - - , -- ❑ I, 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' (Secion 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 _ thereon, and who does such work himself/herself or through his or her own ' DEVELOPMENT SERVICES REQUIREMENTS:' , employees, provided that such improvements are not intended or offered for Boiler ry Hood or Type I D _ , sale. If, however, the building or improvement is sold 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 prove for the purpose of sale). Building Approved By . I Dat• e ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued ByOD.C Dat 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 . ❑o-100,000 BTU 0100,000 BTU ' SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- ' tractor(s) license pursue ntto the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIPI $ Exhaust System D Multiple ❑• System Repair/Alteration proof oftheir Worker's Compensation insurance should be.provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Ill Fire Dampers PLUMBING $ ISSUANCE $• Date Owner, F Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I. have read this application and state that the above ` SO-100,000 BTU 0100,000BTU :�,'! ELECTRICAL • GRADING $ information is correct. I agree to comply with all city and county ordinances _ $ ' l and-state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM i $ sentatives of this city, to enter yon the above-mentioned property for • • - f ar�r N\ , Inspection purposesr-, Y`+ .r/)' t 7--b" + 6,t-2 `A�J1'�"•-- sl._d'(1L.f_..... MECHANICAL $ e TOTAL FEE $ i t�U Signature I ys.. Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS , �\ CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - CdNSTRUCTION AND PLANNING • - POOL &SPA Date Inspector Date Inspector APPROVALS - Permit# APPROVALS Permit# 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 I - 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. Rough Electric Wiring . ' . • 67. Fencing &Access Approval 1 -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) & Mono.coat 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 p/�,;/})1 41:2) . 35. Final Gas Pipe-Test 'Y `l 36. Hood'or Canopy ' . . - 37. Final Factory Fireplace . • __ 38. Final Plumbing cT- - 39. Water Service-Final °r-' 40. Gas Service-Final _ , 41. Solar Domestic-Final in 42:-.:Backflow Preventer ft" 4 • - 43. Backflow Irrigation - 44: .Landscape Irrigation System 45. Sound 'Attenuation � ' 46. Handicap Regulations -- - _ 47. FINALSTRU&TURE & BUILDING - . . , 48. Special Requireieents Completed 49. Electric Release to Edison; - - - - • - _ . 501 Gas•Release to Southern California Ga4 Co ' i - 51. CERTIFICATE OF OCCUPANCY - , _ _ - No. Date ' I - : ' ' costa Mesa Building Department '('i8APPLICATION FOR PERMIT ^ • • . 111 EAST 20th STREET BU . DING 1 1e COSTA MESA, CALIFORNIA 1101, FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Building Address 3016 Royce Lane / 7.1-1 Re Costa Mesa, California `ceive�d'by Date Redd. date issued Nearest ,/ --c=A- I 7 /y .-s3-1 SFP 1 F long Cross St. Baker Avenue Building .1 • Address Owner College Mesa Company Costa Mesa, California Mail Address 8002 Central Avenue Nearest . Tel. Cross St. City Garden Grove No.LE 9-2158 ZoneNo-of Type ^/ Group Architect or tic. �51 Plans Engineer Davis & Quigley No. C-1790 Approved S Date Address 43 Malaga Cove Plaza,Palos Verde. CORRECTIONS City tic. Contractor The Hale Company No. 3422 Address 8002 Central Ave. , Garden Grove Legal Lot I Description I No. 52 I Block I Trac12341 (Attach Metes and Bounds) I No.of Bldgs. • Size of Lot 7034 I Now on Lot None 0 Use of I No.of I No.of 70 Existing Bldg. Families Rooms 3 Setback Line from501 Rear Yard 40' Z Center of Street Side Yard 61 _ D DESCRIPTION OF WORK New I X I Alteration I I Addition I ' Repair I I Moving I I Demolish Building No.of Size 1270 Rooms 6 Stories 1 Exterior Wall I Roof -- Covering Stucco I Covering Rork APPROVALS Use of New Foundation location Inspector Date Building Single family dwelling with Forms,Materials, attached garage. Under-Pinning W Frame: Fire Stops, u1 Bracing,Bolts t^ I hereby acknowledge that I have read this Application o and state that the above is correct and agree to comply Lath.Int. rein with all City Ordinances and State Laws regulating ply building construction. Lath.Ext. _m. Signature of Permittee T HALE COMP tTi Plaster,Int. Authorized Agt. 1 A7 • , ca ALI Pot.,_. Plaster,Ext. u. SILVIA LARDNER " Valuation Permit Fee $ „.,2U. 4'0 Masonry Reinforced * Plan Check$ .j,o O w $ O Total Bond Beam • co Fee $ / - <>°- FINAL illEMP FORM 204 5-BP 2M 6-55 Costa Mesa Building Department � �� APPLICATION FOR PERMIT P. O. Box 317 BU . D NG . : ` COSTA MESA, CALIFORNIAon NovaFOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Building - S6 .7/ Address 30(6 X 0 y 0 E aiiE - �J / Costa Mesa, California Received by Date Recd: • Date Issued Nearest /Q , r'/U '��-6 ' g� /� � Z Cross St. V3 AF/1 Building �/ / Address Owner #9RR y`T I n S?Lao m Costa Mesa, California Mail Address 3a/6 ,pyc& f1/U II Nearest Tel. ���� / `� Cross St. City CosJM frneSp No./(/ ,!6E9S Zone ;/ No.of Type. Group Architect or`/ Lic. al Plans 1�� 's Engineer /reyiARo e. e4,k 0. Approve Address 0 .af f gg0 Vivo (,/lit by e�(i�$, ;�!7�j( S Date Contractor Aop l 1, 0 City Llc. C f!f A fiSti/���T{ Address a,2,/S jig g/oR filviA e,m, — CITY OF COSTA MESA LegalLot I '/ PLANNING D . Description I No. .JAZ. I Block Tyr2J9act / ' :e - • ' . . •- . - (Attach Metes and Bounds) // 3— 2 to y/—/ , (7 No.ofBldgs. C/, ):�1 Dq_G VSs Size of Lot I Naw on Lot - BY'+ fl IO PLAN T CI-C4-2/1 C Use of I No.of I No.of eao' ttL` ,o Existing Bldg. Families Rooms ��1 Setback Line from Rear Yard X if, n Center of Street Side Yard O✓ • y DESCRIPTION OF WORK ti' New Alteration I I Addition I Repair I I Moving I I Demolish I FA Building No.of Size Rooms Stories Exterior WallRoof — 0• Covering I Covering APPROVALS Use of Newt /� Foundation Location Inspector Date Building 6/, ,,c.4,p /7 Forms,Materials, e5 tt-.-, Under-Pinning X 6, Frame: Fire Stops, 4 . Bracing,Bolts N I hereby acknowledge that I have read this Application itp and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating �p�' building construction. Lath.Ext. . H6 Signature of Permittee TV -.�--rtie / Plaster, Int. .. Authorized Agt. plaster,Ext. Valuation Permit Fee $ 2 Masonry Reinforced ji► E Plan Check$ V Bond Beam $ �� s Total / Fee $ aI FINAL •' .. FORM 204 10-55 D.P.a 5. . Th").' v • r • • ;•‘. A I 0 d. o. a. _ Ct Lor :4 .4 2 ; . _ . • - _" •, Street • PLOT PLAN Show location and distances from property line and between buildings. er, 14 • 4 0 _44 11•• L=3 . r^ ` I, 1 ^, 4835 COSTA MESA BUILDING DEPARTMENT 4., FEE RECEIVED • P.O. BOX 317 COSTA MESA. CALIFORNIA • �C7��/%�i SO FOR APPLICANT TO FILL IN APFIt4ANQETIEREFOR PERMIT BUILDING '30/c, Qo_ G� /'AWS �( CITY OF ��RLNG ADDRESS COSTA MESA. &CIFORNIA 8 FOR OFFICE USE ONLY 1 // —/} RECEIPT NO. yPERMIT NO.2 OWNER �/ �R/C X !. �©�J��o (DATEISSUED MAIL ADDRESS//� ,n5 Onk/.1/A�Q o yeE /n / !t RECEIVED / DATE RECEIVED7 6z.--e-,c-7 7 CITY ('.�s l/Y1P57/T TN 15./\I S6{9�III�pQ BUILDING ADDRESS q/ (r! rV/ 7 1 ARCHITECT LIC. t OR ENGINEER NO. r5 COSTA MESA, CALIFORNIA y FIRE ADDRESS n�lVi ZONE 1'/h co. f ZONE '^ PLANSNO.OF TYPE GRODP\� CONTRACTOR S'Ef NNO. IC/ TEL. I" APPROVED ADDRESS NO. BY DATE • LEGAL' LOTqq n / 'CORRECTIONS O. DESCRIPTION INSz- IBLOCK ITRAOTr[S� A.P. rvD GF BLOBS NO. / /J ` 47 G T SZ / APPROVED OIFE /�LOT e;(pY� �/I C� NOW ON LOT • USE OFn I CITY OF OSTA MESA EXISTING BLDG. e J Q_K/,LE PLG:,1'iNG DL-PT. SETBACK LINE FROM / CENTER OF STREET CO .2S REAR YARD i SUBJECT T LOG. DEPT. REG. SIDE YARD 6 RIGHT' 2"2,1_EFT • k /�['j/� DESCRIPTION OF WORK BY - DAA ` %?�" 4,- PLAN MCH. NEW ALTERATION ADDITION • REPAIR MOVING DEMOLISH SIZEBIDING �/ 0 .�/ /J dz., NO.OF ROOMS / STORIES ------- EXTERIOR-WALL /E O` !J ROOF ,QRC 0MSS COVERING ((( • COVERING (// USE OF NE .-}�� A l /-/ -/' q/ BUI LDINGE# -/ 0 C(c( c( , /j a/V 7 ,io lis 8 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 STAT LAWS GULATING BUILDING CONSTRUC. TION. VALUATION SIGNATURE OF PERMIT FEE $ 6 PERMITTEE ` vti g oi/,D • --- PLAN CHECK S $ AUTHORIZED AGENT TOTAL FEE $ rp — VKMF