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Home My WebLink About765 SAINT CLAIR ST - Building Permits T �F CITY OF COSTA MESA 4 9 BUILDING DIVISION Fit• •,,,, 4 1.11(14 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER / •-. PERMIT Jstbeftlarale# B05-00740 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 765 SAINT CLAIR ST Status: ISSUED Suite: Applied: 05/10/2005 Vicinity: PARKING LOT Issued: 05/10/2005 Primary Occ: B Eat<50/Office/Bar<50 Type of Construction: V-N Parcel Number: 41817201 Zoning: C2 Applicant: SADEGHI SHAHEEN AND.LINDA;r..?'--'.+a_., -- ISSUED BY: IVAD ' Address: 709 RANDOLPH AVE-C ,./J?— • - - - -_ r;;M:�';,.-Ac l•- t ,, i' Phone: t ' ' COSTA MESA;:CA 92626` '- - Zip: 92626 '• Owner SADEGHI SHAHEEN'+AND LINDA - - , N' Address 709RANDOLPHAVEC /' • r> .-. Phone • ' �i ;,1I - �ig ��A`= COSTA MESA,CA•92626" Zip: 92626 � , 7 jz �. � } \ '` Contractor: OWNER-BUILDER OA /// ',Address: '.;' - Phone: ' V Zip: -5--;:' License:';000000 - . ` - .- , - i - - •;,,, c'.. - - '�) a Address: • .`,, -Address:' - - - - �-Phone : - Phone: - Zip: -- - ,License: License: - f ' - SCOPE'OF PERMIT - ' DEMOLISH 900SF OF CONCRETE FOR.PAKING AREA'. A n .Ytip i /L. Vp p , • FR . EE SUMMARY • - Plan Check:',.' $0.00 __. _ __ Calc Valuation: �$2 506.60 Perin it:- • $83.25 Claim Valuation: . $2,500.00 '.�SMIP Re's: $0.00 ; ? -SMIPCorm ' ,C.$0.53 '/ ' in': Othei': : `.-$0.00 o; Inspection: ; $0.00 ' Total. $83.78' "/ `. �/ \ �� PLANNING'&ZONING ' .'..;;7 N SETBACKS `-` U' �`: , - , i^ \/_ / ///// / / MAIN STRUCTURE,Front ` 0-:0 ,/r N Rear,` 0;0'x.- - -,.-Left 0 0 Right 0-0;2 ,i�62 -7 ACCESSORY Front:.:„0-'0 _ I; ;Rear 0-0 ._ Left _ 0-0 -,', - \ Right'` 0-.0 .,' 7" ' PARKING Existing: HOZ Y`_, 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. FOR INSPECTIONS CALL: (714)754-5626 2446-46(600) • DECLARATIONS r. I. r"t 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 section need not be completed if the permit i5 valued of one hundred dollars($100)or less.) • certify p, p y y poison in any manner so as to become subject to the workers' Q I cent that in the a • an of •rk kir which thi :rmit is issued;I shall not:m to an compensation law • Califomi. •gree that if I s•. .ecome subject to the •rkers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with thest provisions. Applicant Signature. - —7 rt3atea; -/ I ' 0 � AA NIN 'T• C : ••RKERS'COMPENSATION COVEMGE IS UNLAWFU • D SHALL SUBJECT AN EMPLOYER 0 CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION.DA : ES AS PROVIDED FOR IN SECTION 37060F THE LABOR**DE,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.Lic.If Class If Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ' ❑ 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). Lender's Name: Lender's Address: _Signature: Date: OWNER-BUILDER DECLARATIONS: 3 !! r < - 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 ,, jbierts the applicant to a clvil.penatty 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.It,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.). • ❑ 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 o roperty who builds or improves thereon,and who contracts for such project with a contractor(s) license purs - . : tors License Laws.). . ❑ I am ex :.slness and Professions Code for this reason: nc • -natu =' �-� =Dae * T • a Owner ID veritr's license.r • es ❑N. Orl�ver•s,License.No: aprtes,cri!' ' 4 Verification of Ownership by(type of document,i.e.-pro+erty tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 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? ❑Yes 0 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 0 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)? I ❑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 California 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes 0 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 pan 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 and 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 Califomia Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (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: a Date: cCERTIFICA'9 OFC PLIANCE- UTHORIZATION OF NTRY:I certify under penalty of perjury that I have read this application and state that the information given is orrect.I ..r.e to omply with a laws and city ordl noes relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-des rib:•pr.•. for' urposes.I agre not to occupy or allow occupancy of any building authorized by thisg rmit until final inspection. — 6. 0 • or t �Siggaluie:Ol:Lepal,Ow er(. G�!e:- And/Or Authorized pplicant Date CODE'S. INSPECTION TYPE' ' ' PAIE 'IN 8 CODE! INSPECTIONTYPE - '^ ' - RATE INTTML§ 1616 Fixed System Final Fire Prevention _ . 206 Final Mechanical - . 1266 Pool Spa Final 208 Final Plumbing - • ' 200 Final Re-Root _ • - 210 Final Electrical , - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ 250 Final Building/Occupancy - Z//8/9 Lt • „yeLee fts-W% Cc 7.] 74 FP S . !'IT 0 , :C. . 43 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 P ION FOR BUILDING PERMIT For Applicant ♦ to Fillllii/n�Completely SrRE V O A MERREEC,EIVED DATE ISS ED/� BUILDING ADDRESSL / r __.57:- r r 1.��1/t!C/ S ( / /%-71' �/J_,0 47✓ / 7 VERMIT NO. OWNER /2/0/...", BUILDING MAILn �/ !/`O j d A.P. NO. �-4�� ( Z I . ZT LW"LTl Z ADDRESSO?O /— PL.0-ta/�J-- Les �/ ADDRESS pp�,0 S(�]"c' `^ S 101•�1�? B O CITY Lu ui �r/�/s N ys�f0�� _ TRACT3(J 1� TLDT '� BLOCK / Z Q CONSTRUCTION NADD I ALTER I REPAIR !MOVING DFMOLISH a V)ENDER _ID BRANCH ' JN /'/ I R OWNER (/(, •3. EB,--,,& CO<rw J ADDRESS (/�-/� �-7 /� ' . m ARCHITECT//////// /z(/ TEL. USE QGiC(CER4017 VALUE �jn i}� J Q OR ENGINEEFy'u"sl / / NO. Rug U vs WQ / J C7�/1 // FIRE // CC ADDRESS///- i /Isis"`�9_/ (�j(/o ZONE /Jr��T YPEs/GROUP 2 Ja W Lir APPROVED �L/ sCl 2�"{,r\ O CONTRACTOR -e ,y,Q/y BY DATE r CO J oc ADDRESS p L0 Lis p Z CITY NO. 20N NO. ANNSOF 2 BUILDING NEWUSE OF 3 l O-• W O STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET/11 SIZE I NO.OF BLDGS. Qom�// OF LOT NOW ON LOT FRONT 84 FT.' FT. USE OF •//��,, /r EXISTING BLDG. _A.SIDE eFT? FT. Z NEW SIZE BLDG. (i 7F r) 3 e-/NO. it TORIES p( L.SIDE CD FT. FT. Z Q EXTERIOR WALL /// ROOF �s / U �s COVERING W OTO COVERING 7 REAR 41 FT. FT. J USE OF BUILDING AND WORK TO BE PE FORMED DISTANCE BET. BET.MAIN& 1 aACCESS.BLDGS. BLOCS. r 0 co,,,, I _o, CALF.*VAAPPROOVV_E_DI- /� , CO 0 ROVED/• �/ /CTPT)T DATE�/!t ry- - 2 ThIS OI I hereby acknowledge that I have read this application and state liULD FOR YSPP SPECIAL—RW QV+ igV\ Dthat the above information Is correct and agree to comply with • d CC all laws regulating building construction, and I shall not employ 1- any person in violation of the workman's compensation laws of y the State of California. co ? I hereby certify that I am properly licensed as a contractor under O.FT. G the State of California Business and Professions Code, Division 3, /1,E AMOUNT SHOWN UNDER VALUATION IS FOR 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 VALUATION and Professions Code, Divisio 3,Chapter 9. �.s// m r (J" PERMIT FEE $ IN 3 Signature of �� X1l/J /J L^fit' m Permittee AS?, f §/"'Q a� PLAN CHECK $ L. 7= E / . o Authorized Agent TOTAL FEE $ Pal!) i 3� 15 'UiI23-75�A5:002325 d-'***71.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely 7f!/ L��A/2 J'r. RECEI �/LS�JC� DATE RECEIVED t� 5p�� BUILDING (/�/'yr� 7 (SAL, ADDRESS I/ r1' (/� /� Wei// Eee,2c PERMIT NO. //(/ OWNER A.P.NO. MAIL BUILDING ADDRESS ADDRESS Z d U TEL. CITY NO. TRACT I LOT BLOCK Z Q CONSTRUCTION NEW IADD ALTER IREPAIR IMOVING OFMOLISH d cn LENDER _ID BRANCH ' J to OWNER CO J ADDRESS VALUE J CO ARCHITECT TEL. VSE $ Q OR ENGINEER NO U N FIRE w rt ADDRESS ZONE TYPE GROUP CL w APPROVED W Z CONTRACTOR BY DATE J C) m Z J pc ADDRESS W W TEL. ZONE f NO.OF USE OF NEW Z2CITY NO. _ (PLANS BUILDING H STATE CITY YARDS APPROVED YARDS APPROVED NCL LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOCS. (FROM C/L STREET) OP LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDE FT. FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. VEXTERIOR WALL ROOF _ _COVERING COVERING REAR FT. FT. —I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL a MAIN BLOCS. ACCESS BLOCS, _ rVA .* DATE Q D/E/a'!G E. U0 C .P.0 APPROVED I— APPROVED V) ABY DATE Z O I hereby acknowledge that I have read this application and state ��////�1 �, / D that the above information is correct end agree to comply with 1/1 //y✓, CC all laws regulating building construction, and I shall not employ '/v{�/'s I" any person in violation of the workman's compensation laws of V) the State of California. te ? I hereby certify that I am properly licensed as a contractor under SO. FT. 'CP 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 PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business 7/ • IV CC VALUATION and Professions Code. Division 3,Chapter 9. e m PERMIT FEE S' w D Signature of rr— B Permittee $ . --- PLAN CHECK $ 7 E / GU Authorized Agent TOTAL FEE $ r /fl- Temp. Tag #165 OWNER cCOLDWELL =BANK 20. .TE 7/22/63 JOB ADDRESS 765, 771 St. Clair Street BUILDING PERMIT NO. 20187..- GENERAL CONTRACTOR Union Sign Co. VALUE $ 60.00 AP No. 141-272-68c7 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK NonEl.Temp.Pole INSPECTIONS Signature DATE GROUP J TYPE Sign ZONE Ml Sign Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water • Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line ❑ House Con. 0 St. Swr. 0 S rinklin System Construction Pole Underground 0 Power ❑ Rough Wiring Trenches ❑ Forms ❑ Steel Reinf. 0 �.ALA „Mfg Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing— In ❑ Out ❑ Plaster, brown coat Refrig. ❑ Air Con. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final 7►-4195 e OCCUPANCY Form BU4—SM-3-63—S-B P g7 • 20187 1 lwe"tag EE R - EIVED• '9Xl COSTA MESA BUILDING-SAFETY DEPARTMENT/ -r " JUL 2 2 1963 P.O.BOX 917 COSTA MESA.CALIFORNIA FINANCE OEPI. For Applicant to Fill In Completely APPLIC4,11QN01080MMRIESA TYPE OR PRINT BUILDING BUILDING 76 i. /2.? / c f.chi" i� For Office Use Only ADDRESS J / L-[,ncc-.r RECEIPT NO. PERMIT NO. . COSTA MESA. CALIFORNIA a/2/t" Fa D TE RECEIVE• DATE ISSU OWNER /. 9f. I` 8a .Ire? a /A-r)/-��/� .�- eP' I i i_ MAIL c _/ BUILDIN, / moi+/ `,/ r �� ADDRESS OO F. cora_S7 / eJ ADDRESS ( .5w / , _ (/ 1 E TEL./ FIRE }, r ' 1111( CITY A P Al Y' • k=a+ ..k NO./O S�aD PO ZONE TYP y�:-�I'.i APPROVED/ 7 ' 2 /3 ARCHITECT TEL. BY .� DATE IF/ OR ENGINEER NO. ZONING ADDRESS Z• E NO.OP ,1I use OF NEW r I •all I I PLANE •1/ I BUILDING , all CONTRACTOR GIA/ICN Si Ct+AI a �� ! 41 aq2 ADDRESS /a St 34 a'+I k5 n • LEGAL 1 }� DESCRIPTION ell l CITY S 4YL! A P n.. A.P.NO. - r (i NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE ;10.7 TEL y Sr TO SIDE B REAR p.L. LIC.NO. 74. 3 NO. /1 / 2- (1"fl}* SIZE / 4 EAVES OF'LOT U T .1_( . I No.OF BLDG'S. ALLOWED (U.B.C.REQUIREMENT) NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET) SETBACK LINE FROM FRONT FT. 2/O FT. C h CENTER OP STREET REAR YARD �{-r SIDE YARD I LEFT RIGHT R.SIDS FT. )/f FT. /- DESCRIPTION�/ OF WORK L.SIDE FT. ),..1 FT. 7 NEW h ALTERATION _ ADDITION REAR FT. V FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING NO.OF VAR.# DATE SIZE ROOMS STORIES C.U.P.# Jf APPROVED '1) 13 EXTERIOR WALL I ROOF APPROVED/L///�//✓/" ) /� 2 J COVERING COVERING BYSATE 9 USE yF BUILDING AND W RK TO BE PERFORMED / /ryY L: x iem 'p. 4p1 sIcN II Fey Re t.i- I Ye 1CI, .4 • its L o r� / N - I'Y .13-9-#4-4i ^ DA U �1T j i (4 c C(1- SO.FT. B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 0 BUILDI NG CONSTRUCTION. N SIGNATURE OF )/ ` ) PERMIT FEE 5 j PERMITTEE N 7L_t-'-+A-, �)-t.'^. Cnr m r $ O LamC EC �— I AUTHORIZED AGENT /�J��// J , .,.,L/'/ .1 a ^' C__. TOTAL FEE S. CI �� • Temp. Tag m1.005 OWNER -:COLDWELL _BANTER CO. DATE 7/22/63 JOB ADDRESS 765, 771 St. Clair Street BUILDING PERMIT NO. 20187. - GENERAL CONTRACTOR Union Sign Co. VALUE $ 60.00 AP No. 141-272-6&7 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK NonEl.Temp.Pole INSPECTIONS Signature DATE _GROUP J TYPE Sin ZONE M1 Sigr Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 _ Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line 0 House Con. 0 St. Swr. 0 Sprinkling System Construction Pole Underground 0 Power 0 Rough Wiring Trenches 0 Forms 0 Steel Reinf. ❑ „t-;t-1 Floor System Bond Beam 0 Steel Reinforce 0 ' • Sheathing Frame and Flashing _ Lathing — In 0 Out 0 Plaster, brown coat _ Refrig. 0 Air Con. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final ; 4 ff OCCUPANCY -' . Form BU4-5M-3-63-S-B P 20i87 Wit/ /^' P L' ; `. i 1 ; i > —i,14,S COSTA MESA BUILDING-SAFETY DEPARTMENT / 'JUL 2 2 1963 P.O.BOX 317 i! COSTA MESA.CALIFORNIA _ p _ For Applicant to Fill In Completely APPLICAYIONUfCRCQ MITag:: - TYPE OR PRINT BUILDING . BUILDING 76 d �1 (',j.. ail, For Office Use Only ADDRESS 1 y J l�(�(�J� CALIFORNIARECEIPT NO. PERMIT NO. COSTA MESA. C ,i'/9/f2 REC��W�gJ0 V D TE K�[CEII VVEE/D�` DATE ISSU OWNER: t•. i ',[, .:i..^ , i-1 ., z bZ2 BUILDING-74\2V.��<J�I% Lf 7 �i MAIL ADDRESS/ �/ .r / •TEL./ - ZONE 'ft'PFIRE � G O , CITY A.l.. .' , T . / NO,L. ,c_;l. . APPROVED/e2 ARCHITECT • TEL, ' BY f/-ir DATE 7 2 6>3 OR ENGINEER NO, ZONING ADDRESS ' ZOlI[ ` i1 PLANS USHOFNBw'� � PLANe BUILDING CONTRACTOR ;, ,/i . R A, , . C .v LEGAL .L4.1/ /y o-(( J.r(�g/�//T/ " _ DESCRIPTION ( / ADDRESS . , .-. . .. . - _ . A.P.NO. I 141 - 17.1- / CITY .. . ._ r... .._ - G 4 7 STATE TEL. . NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.NO. .::.•:' NO, Z. , != , L.,,_: �• 30"TO SIDE 3 REAR P.L. SIZEEAVES OF LOT O 4-16 I now ON LOTS ALLOWED (U.B. REQUIREMENT) USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG, MAIN BUILDING ACCESSORY BUILDING - IFROM C/L STREET) /y SETBACK LINE FROM FRONT FT, 110 FT, Ch i CENTER OF STREET REAR YARD • _ ,}. SIDE YARD I LEFT I RIGHT R.SIDS FT. 1--J" FT. / DESCRIPTION OF WORK L.SIDE 14 FT. NEW _{ ALTERATION — ADDITION REAR FT, y"�FT. DISTANCE BET, BET.MAIN 8 _ REPAIR MOVING. - DEMOLISH MAIN BLDGS. ACCESS.BLOCS. - BUILDING .NO.OF VAR.# DATE SIZE ROOMS STORIES C.U.P,# APPROVED EXTERIOR WALL I ROOF APPROVED.L/ U, /w 9 9;) 2 r � �JJ COVERING COVERING BY it •ATE / USE QF BUILDING AND WORK TO BE PERFORMED K. S ' E <,., J':., Ir , 5 , -. IV ,•r C+ ii Q'n'i 1' r• is i : v. :: ti r - c0..: I. '�.•I -.7 t, / ♦ 76 ; A.' et SO.FT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m BUILDING CONSTRUCTION. N SIGNATURE OFP• j •PERMIT FEE $ PERMITTEEI<.. :j., _ C. J B $ (`�-,0 .' PLAN CHECK B m , O AUTHORIZED AGENTk. TOTAL FEE —