HomeMy WebLinkAbout2342 RUTGERS DR - Building Permits I:DORESSOPBLILM°, 2342 RUTGERS DR DMT: CITY OF COSTA MESA - BUILDING PERMIT
avNExsN'aElrlDro"N: KIPPER, ISABELLE TR PERM NO: B 083187
olmss, 17861 SAN CLEMENTE ST
1 FOUNTAIN VALLEY,CA 92708 PERMIT NO: B 083187 PLAN CHECK NO: N GOVT: N SUPP: N
AP PL.KUIa+DADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: SIR PURPOSE: OTH
ARCHITECT OR ENGINEER: LIC.ND.: JOB DESCRIPTION : T/0 & INSTALL 25 YR COMP SHINGLE SQ FT: 3, 950
ARCK OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: 3, 950 . 00 CALC-VALUE: 3, 950 . 00 GROUP OCC: R-3 /0-1
CONMACTORSNAME PRECISION CONST & DEVEL (714 ) 540-8577
CONTRACTOR'SMMUNG 1115 EL CAMINO COMMENTS: RESIDENTIAL RE-ROOF
ADDRESS: COSTA MESA CA uO No.: 658880 '**********************************************************7t+F***K-IP+t****iEit K-3k***ItiE
92626 UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aeim under penalty of perjury that I am licensed under provisions of Chaplet 9 SETBACKS
(commencing with Section 7000)a Division D of the Business end Professions Code.end my license is in fug torte end effect
CITY UC.NO.: 059380 LJC.CLASS: C-39 LIC.NO.: 658880 XP: 04 /98 MAIN BUILDING ACCESSORY BUILDING
Date: 'S '�17 contwlel� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT
IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I em exempt from the Contractors License Law lot the
' 'stowing reason(Section 7031.5 Business and Professions Code:Any ply or county which!Noires a geme to casbud.akar,i Wroe. PARKING REQ: PRO V: PARCEL: 14147221 Z NE: REF NO:
emoteh,or reels wry s o:sure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she
s licensed pursuant to the provisions of the Conlredas License Law[Chapter 9(commencing with Section 7000)d Division 3 of the PLANNING NOTES>
Business end Professions Code]or that he or she is exempt therefrom and the bans for the alleged exemption.My violation of Seer >
7031,5 by any applicant for a permiw.4ees the applicant to a nisi penalty of notmae than the hundred dams MOOD. dF3E'k3F****#1f3EiF3f3EIt##dfjEdEillEiElE***TE7FkdElFlldEiEfEifiFjf#jEiF****itiEik4lflflE*********#1EiElElffFdElk) ****irk***
O I.as owner o the property or my employees with wage%es their sole compensation.will do the work.and the tincture is not intended DEVELOPMENT SERVICES R E
or offered for sale(Section 7044.Busman end Professions pply
rs Code:The Contractors License Law does not ato en Cetera properly Q U I R E M E ,N T $
who binds a improves thereon,end who does such work Nmeell or herself or through his or her own employees,provided that such
improvements ere not intended or awed for sale.ff,however,the building or improvement a sold within one year of completion,the ZONING APPROVED BYDATE:
ownenbuilder will have the burden of proving he or she did not build or improve tor the purpose of sale).
❑ I.as owner of the property,ern exclusively contracting with licensed contractors to construct the project(Section 7044,Business and
Professions Code:The Contractors Licence Law does riot apply to an owner of properly with builds or improves thereon and with BUILDING APPROVED BY : DATE: •
contracts for such projects with a marwmr(s)licensed pursuant to the Contractors License Law).
❑ tem exempt under Section: B.a P.C..kr this reason: APPLICATION ISSUED BY: /eft DATE: it-e
************************************************ ******************. * * * ***
Date: Oxssn LEGALIZATIONiN F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby candy that I am aware of and understand the requirements of California Health and Safety Code Setons 25505.25533,and
25534.and that I er any future balding occupant will/wit not(cob one)need to comply with said sae codes and the requirements for
a permit forcoestmnor or modification from the At Guilty Management picric,Residential mamsionappiatenswe exempt from Ossa BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/ICES GRADING
provisions. PERMIT 87 . 25 . 50
Date; Aprr(oen: S M I P/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby Om,under penally of perjuryone of the to0owing decimations: PLAN
ISSUE FEE
o I have end will mitten a certificate of consent to sethineure tor workers'compensation.es provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,for the performance of the eat for which this pend is issued,
Q -have and will maintain workers'compereelon insurance,as required by Section 3700 a the tabor Code.b the Performance a the TOTALS - 87 . 75 0 . 00 0 . 00 87. 75 87 . 75 00
work tor which this permit is issued.My workers'compensation insurance carrier and policy number are:
Caner: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87. 75 OVER/SHORT: . 00
Policy Number: 14410' 0-95 08/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN-CHECK
(This section need not be completed I the pend is for one hundred dollars($1001 or lass) 87 . 25 . 50
o I tend'that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner iso as to
become subject to the workers'cornpeaaton laws Of Camara,and agree that if I should became aijes to the *ea" ****************.k***********lit************)E*****N******************%***1k********
campeasatlon pros Sectionthe LaborCode,I.hen lannw�k comply .
INDIVIDUAL F E E BREAKDOWN
Dat.: 6-5-11 1 1 th3700 of frookW: /�/�fi "�
Warning:Failure to secure workers'compsnsadon coverage Is WWNl,and shah subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
ofvU fins up to one hundred thousand dollars($204000),In addition to the cost of compensation damages as provided for In
Section 3705 oftsLabor COW,Interest and atlumsyslesa SFR 3950 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 950 . 00
CONSTRUCTION LENDING AGENCY:I hereby atom under penally of perjury that there is a conwnwian lending agency for the END OF FEES
Performance of the work la whish this pens N issued(Section 3097,C'e.C).
LENDER'SS:
LENDER'S'SADDRESS:
I candy that I have read the application and dale that the above information is coned.l agree to comply with all aft end county ordinance
and state taws reaig to building construction and hereby authorize representatives of this dry to enter upon the ebove'mentoned property
for inspection purposes. CLIFF VON TING JUN 0 5 1997
� d t��todor Dale:,: 6 s-9� CITYOF COSTA MESA
OmhwyApert/
(5151.45.WP) whim-Building&Safely;Green-F-4:Canary-Appicant;Pink-Revenue;Goldenrod-Assessor
" CONSTRUCTION AND PLANNING PC L 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 OF 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, O 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
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 r (4#7 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
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 r----
45. Sound Attenuation
r"
46. Handicap Regulations
fll
G�i/97 fey" Id\ t
r
47. FINAL STRUCTURE & BUILDING , c
48. FINAL PLANNING '-
49. Electric Release to Edison 1 :' •c
crii
50. Gas Release to Southern California Gas Co T
51. CERTIFICATE OF OCCUPANCY ._.t)
No. Date
ROJECT ADDRESS: 2342 RUTGERS DR4
UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 060587
pr
OWNER'S ISABELLE TR
ADDRE5S: 2342 RUTGERS DR PERMIT NO: M 060587 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626 •
CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
545-7934
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : FAU CHANGE OUT SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: 1 , 700. 00 CALC—VALUE; GROUP OCC; R-3 /
PERMITTEE.
GEORGE BRAZIL ( 714 ) 535-7905
ADDRESS: 3022 N. HESPERIAN WY 101 COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME PRIOR TO FINAL
SANTA ANA CA 92706 *************************** ***************************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions al Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 0l the Business and Professions Code,and my�kC��se is in lull force and effect. SETBACKS
CITY LIC,:055.3 ISTATELIC.443064 / � S:
J % �� Signature: .,/ �� MAIN BUILDING ACCESSORY BUILDING
WORKERS' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation
COMPENSATIONra DECLARATION: I hereby alfirm that i have a certificate of consent toset!-insure m a cenilicafe of Workers'
Compensation Insurance.or a certified copy mereol(section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.:PC947525 EXP.DATE: 01 /01 /94
'MMPANY:REPUBLIC PARKING REQ: PROV: PARCEL; 14147221 ZNE: REF NO;
Certified copy is hereb furnished. 1C1 Certified ci.y is file: i•the c Building Division. PLANNING NOTES>
3 >
Date: /�� Applicant: / ri *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT S E R V I C E S REQUIREMENTS
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. ZONING APPROVED BY ; DATE;
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : i/ DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / '
CONSTRUCTION LENDING AGENCY: I hereby affirm that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE• A aw
which this permit is issued(Section 3097,Civ.C). *************************** * **-y- **** **** •• ***************{F* **
LENDER: ******************************************** ' *** *****************************
ADDRESS: LEGALIZATION:N F E E S U MMA ` STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt Irom the Contractors Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC F IRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 . 00
repair any structure,prior to its issuance.also requires the applicant(or such permit to file a signed statement that he/she is licensed 25t SM I P/NON—RES
pursuant to the provisions of the Contractors'State 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 PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE -. 15. 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9.00 15. 00 L 0.00 24 . 00 24 . 00 . 00
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 employees.provided that such improvements are not intended or offered for sale.If.however the building or improvementpuof s within). BLDGPMT PLUMBING ELECTRICMECHANIC FIRESMIPOT one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION
—_ O4 • OVER/SHORT:
/S
forthepurpose GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 .00
❑ and Professions Code: The Contractors Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts tot such projects with a cbntractor(s)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
that proof al their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner—MEC 1 INST FORC—AIR/GRAV1FURN <= 100 K BTU 9.00
9 . 00
I do hereby certify mat I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit tot construction or modification from the Ait Duality Management District.Residential construction applications are exempt from
these provisions. •
Dale: Applicant:
I hereby certify that I have read this application and stale • e above information is correct.I agree to comply with all city and county S
ordinances and stale laws relating to building construction q'by aut.. .e represe;autres of this city to enter upon the above-mentioned •
moperi XOt!ion 0 5.
Date: Signal ,SP- &__ _� _
P;
Driver's License or Social Security • .. •' ; , • •
•1641.46 White—Building:Green—Code Enlacement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
•
CONSTRUCTION AND PLANNING P01 SPA 1
APPROVALS Permit �`r Date Inspector APPROVALS Permit ;r Date Inspector
1. Temporary Electrical Service or Polo . - 52. Pool & Equipment Location
✓ :
Sqil Pipe-Undrgrnd - 53. Steel Reinforcement .
3-Ethctrical Conduir•Uidity•Undrgrnd. - 54. Forms
• : • 1Cctrical Condart-Undrgrnd. 55. Electrical Bonding
L
_ 5. e1 Reinforcement-
56. Rough Plumbing& Pressure Test i
' $Jtictrfcal UFE1`a, rnd. 57. APPROVAL TO COVE R-GU NITE = 1
.
•t-. Fdtotings 58. Electrical Conduit-Undrgrnd. `
y
S.UFoundation - 59. Gas P,pe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgid. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Lim& House Connection 62. Backwash & Receptor-Final
• 12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - - 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 9 67. Fencing & Access Approval
17. Rough Wiring Sigd 68. APPROVED FOR PLASTERING
18. Rough Electri4-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou_gh Heating& Air Conditioning a s _FIRE p,FpT. R OUIREMENT S
20. Roush Fiact¢ly Fireplace r. L C S 7 ` " 7' ,APPROVA .1 9)erriit # - ,r_
21.-Outts, irtStrncture'r •• s x > - - * x :70. Uhdergroiinrt}Hydro
22 Aus,Ventr ti T T CS S :-t'• x •• 'r r d
Gt - irk;v _ , _ 4 c,`. .e1. Productr6.9in Cl bas 0"Oil
23.7Gas Pipe,Rough& Fest •3 .r' = t C••;" F -72. Underground Flash:
24?fioo1 Framing V• * " ^ tr _ .1‘ ;,73yUndergrnd Stora Tankti Gas 0 311
1 .y -' 1., ., f.. - ,S ,
25. Roof Stmathin9 •r •� 7" .a>: * 74;Overhead HydroD e
26.;27-E41 Ceiling (Strvoturall &9vjondcoat f'.: `5 Cr' ;]: s 75jDry Chemical _ _
27, rarpe acid FlashiPrr _ r r a x 76. Dry Standpipe ripe ;• a '_
�-_ f
-28. Lathing-& Sjding;' • - X '•t -, 77 FIXED 5,..'STEfs(t,f11NAl.+. '•
y :- . - r :�- I ..I; ., J ;
29. Insulation • _ •• x I r T 78FIRE PREY. FINAL 'u ' -
• r30. Drywall Nailing ,' I j r i< - HEALTH.`bEP1t REQUIREMENT
ENT I
,31. Plaster Brown Coat. *. - s r 1 . r79.`FINAL INSPECTIQN •
32.-Electrical Poiver:MP-Final - *' c- ^ T80.".FOOD CERTIFFCA7E 1$,, 14D
__'_� 'Y. .. AJ, � ' w
33, inaJ Electric. j. = � Notes: 1^i12 VC'�oOp. :l,1ryyE_r(E�
.'=34.-;Final Heating& Air Conditidning• •• �4/h IC.�a• r x - _ _
r 35:-Final Gas Pipe-Te,sC ' - I',. * _ r, _ _ a .r
.r36. Hood or Canopyr _ - i T s_ r'o K .9 1 r J
A- '4'. r. __--
-'37."-inat Factory Fi(iiplace, '- j . x ., c••a
-38. Final Plumping t- --
r • (• I a L < w
1 ,, r • . r t. ,, . ,a'•J 0 L: q ,
r.
-39. Water Service-Fipa , I. l • ;,.• _ ;
;40. Gas Service-Final'y r - c - I , ,. _ : to- ._
'-41. Solar Domestic-�-in?( '' 7-1 I i'i '• . ' 7
' 42 Backflow Preventer. •' A f I I- ; = n
. r
43. Backflow Irrigation ` 4: 11 ` •
>• • r R .. )
.n44. Landscape Irrigation System_ IC' y
.g .• n
- 1 r r t rS t . Sr
. " -
>45:Sound t,tteuatica �„ r , , 7' _ Z • _ ,
d6. Handicap Regulatigns
` ;- s .c 1; *. >
47.�FINAL STRUCTURE & BUILDING ` I•` ' - •
. •_ .; a x
48:Fit�}AL PLANNING 1 - .: r r -
"49.-•'Eledtric Release to'Edison ' I Iii ' ` % 1 _
-50.-sGas Release to Southern California Gas Co r . •i.7. .
. 51. CERTIFICATE OF OCCUPANCY - T - .. -
No. Date
OWNER AMHERST Dj;VI',IAPMENT CO.. DATE 11-1347 _
JOB ADDRESS 231t2 Rutgers Drive' - BUILDING PERMIT NO. 6027
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 13,690.00 _
AP. No. LOT 70 TRACT 2953 FIRE ZONE DESCRIPTION OF WORK Residence w/att gar.
GROUP I & J TYPE V ZONE R14 PLAN NO. 6058
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
/ DATE NUMBER
Trenches dig-Forms Steel ajar /'7./S7
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam ,
Frame,and Flashing ‘*.i Z./— t4_ I.' , p
Lathing, In Out //b1.14-. 11/f/3 4'
Plaster, brown coat "' a/- WeriSC
Underground soiljW 'iW/G Pipe Test/N/4( /1-/3-97
Top Out '.
Furnace MM'S 1-2,-rr _ _'�.�,r .VV 1 J 4/- .1
Gas Vents �i - 1JJ WG2
Rough Plumbing44MS .L-//-str /,�-(¢i/.-/..-- NOV 1 3 19518
Cesspool Septic Tank
Prop. Swr. Line House Con/04,St. Swr. l-/3-3-s"' 'Y ._ x - 3- . -
Sprinkling System - - - - i �r
Heating Final Al HS S/v-.51/ lI /l
Plumbing Fixtures, Final Al/AC S'-y,.3 (/n
Final Gas Test /3 /0/74S SZL-S fete, , /
'Construction Pole //rthh- 'J1,M.2 u ■ U-/S-S7 c 7/7
Underground Power ��
Rough Wiring }if _J -..)X "f20,-- ..-,-, aa!"."--ro. -t--- N 2 3 195 6662 i J
Fixtures, Final 711
-'-Lq sq
"OCCUPANCY /ii.0-.0 . 4'3l6,- /
Form 210-5M-1-57 ✓ -
6058 : IL r CCCiVED
COSTA MESA BUILDING DEPARTMENT // - /3-57
• P.O. BOX 3I7 L.,----
COSTA MESA, CALIFORNIA FINANCE DEPT.
FOR APPLICANT TO FILL IN APPLI�CTATIFONnSFOrRSPERMIT
ADD EISS 2342 Rutgers Drive BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
OWNER Amherst Development Co.
MAIL c RECEIVED BY DATE RECEIVED D027
60E
,v/SVE
ADDRESS 419 E. 17th St. p //-/..)-C? OV 1 3 195,
CITY Costa Mesa To: LI 8-1159 ADDRESS
ARCHITECT Carlson a LIC_
OR ENGINEER Middlebrook NO. COSTA MESA. CALIFORNIA
Garden Grove FIRE
ADDRESS ZONE
20ttNO.OF TYPE GROUP
nni'k�" CITY LIC. PLANS
CONTRACTOR/yne and Colegrove NO. 7333 ( . Y
ADDRESS E. 17th
aSMeta Mom
LI 8-1159 L. APPROVED —
BY DATE
LEGAL LOT 70 2 CORRECTIONS
DESCRIPTION NO. BLOCK TRACT 953
A.P.NO.
SIZE NO.OF SLOGS.
OF LOT 75 x 105 NOW ON LOT none
USE OF —
EXISTING BLDG. none
SETBACK LINE FROM
CENTER OF STREET XXI 55* REAR YARD 29! CO
SIDE YARD RIGHT •5' LEFT 5'
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION
REPAIR . MOVING DEMOLISH
NO.OF
SIZE DIN G1601 sq. ft. ROOMS 6 STORIES 1
EXTERIOR WALL stucco COVERING Comp.
COVERING
USE OF NEW
BUILDING Single family residence,
garage attached.
Plan No. 750B
I HEREBY ACKNOWLEDGE THAT I HAVK READ THIS APPLICATION AND .
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND ST E LAWS REGULATING BUILDING CONSTRUC.
TION. /l/ ` I ^ �$ VALUATION M
SIGNATURE OF [f/fiV// PERMIT FEE S 32.00
PERMITTEE
13 690.00 PLAN CHECK S 16.00
s
AUTHORIZED AGENT Dike and Colegrove, Inc. TOTAL FEE $ 48.00 /
/'