HomeMy WebLinkAbout2390 SANTA ANA AVE - Building Permits PROJECT ADDRESS: 2390 SANTA AMA AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 052674
OWNER'S NAME: FLYNN, PATRICK S
ADDRESS: FLYNN BIENVENIDA PERMIT NO: P 052674 PLAN CHECK NO: N GOVT: N SUPP: N
2216 WATERFRONT
CORONA DEL MAR,CA 92625 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: 548-4417 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : REPLACE WATER HEATER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: AAMES PLBG & HTG ( 714 ) 530-2440
ADDRESS:
10422 TRASK AV COMMENTS: SMOKE DETECTOR REQUIRED
G G CA 0000
*************************** *************1F+F1E+F*******iF******iEiF********* *) ******
LICENSED000)01CONTRACTOR d uiAMTInhereby a ode that am licensed under provisionsrael Chapter 9(commencing with Section ZONING R EQUIREMENTS
70001 of Derision 3 of ins Business and Professions Code.and my license is in tun force and effect. SETBACKS
CITY u... ..— � STATE LIC.:00 2 500- . cuss:
�le: --57TH signature:_ _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cern lwte of consen 0-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: PC941094 EXP.DATE: 03/01 /92
COMPANY: REPUBLIC PARKING REQp• PROV: PARCEL: 43923102 ZNE: REF NO:
❑ Certified copy is hereby furnished. )i Certified copy is filed the city' ilding ' ion. PLANNING NOTES
7 �j// ,BuJJ�Is >
Date: C 7/ Applicant ��� ` '—6�a/ ********************************************** ********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the is for
one hundred(5700)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify Nat 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:U.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must lonhvnth comply with such provisions or this permit shall be deemed revoked. i
CONSTRUCTION LENDING AGENCY: I hereby allem that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• --V�._ 'T� DATE
which this permit is issued(Section 3097,Civ.C). *.************,********4 t *********.**y�** **.� *.*.*
LENDER: *********************************************Mh•
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: t hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 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 2,00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed ,
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 2 5% SMIP/NON—RES
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(S500). ISSUE 'FEE 3 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—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----> 2 . 00 3 . 00 0 . 00 5 . 00 5 .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
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 5.00 OVER/SHORT; , 00
for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5. 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts'for such projects with a contracter(s)license pursuant to the Contractors'State License Law).l am aware ****{E************************************************************.**********.****
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: 6.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
_
Date: Owner: PLU 1 WATER HEATER AND/OR VENT 2 .00 2. 00
I do hereby certify that 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 for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
theseprovisions.
Date'
ApDlicanl: (',/////
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state taws relating to building construction and hereby authorize representatives of ' qty to enter upon the above-mentioned -a'
Property for inspection purposes =1 ][iQ4;2n i-L f D5 139 7 -57Yi1Cr •- -
/� i n' TE: 57/1.'2:9!9 'aril: 14.11.:
/ 'Date: 7 �! - _ Signature:
Driver's License or Social Security.:
1641.46 White—Biulding:Green—Cade Enforcement:Canary—Applicant:Pink—Revenue:Golenrod—pssessor
•
_ CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole b 52. Pool & Equipment Location
2. Soil Pipe Undrgrnd._ '� o'.7 53. Steel Reinforcement
`-3:-EIectr cal Condtut%t+lity-Undrgrnd_ .r 54. Forms
o4i'Electdical Conduit-Undrgrnd. 55. Electrical Bonding
• id{.r.
•
Y55. Sieh!_F$einforcemept y 56. Rough Plumbing & Pressure Test
:•'6.nEtbcuical UFER'Grnd. c: 57. APPROVAL TO COVE R-GUNITE
�; V S'iv .
.Z ooUngs c 58. Electrical Conduit•Undrgrnd. •
-i$.:6pundation 59. Gas Pipe, 0 Undrgrnd.,Test
59.tatti Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. -
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Linc& HotBe Connection 62. Backwash & Receptor-Final
12. Sealer Cap v 63. Heater & Vent-Final
13. Roof Drains -- 64. Plumbing System - Final
G
14. Rough Plumbing' c 65. Electrical-Final
15. Rough Electrics!-Conduit • 66. Solar System-Final '
167-Rough Electric tiring 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
. ..... _ - - - J' - x a -
20.2otigh9ctor Fireplace - M t -• ° APPROVALS. • "Perrnit# v4.
21eDucts, i Structur
-• .. ..
a � * `70. Undergtound.Hytlro
22. Ductt, VentiCating I tr 'S - _ . 71. Product,Pioi(g CJiSas D'Oil
f ,
rFlou h &Test r `72. Under It_
23.�'GaSPiPC' 4 I s C . gri i 1 Flush',
24:-Roof Framing' ' +r _ .a - 773.:Undergrnd.Storage Tank 0 Gas 0 Oil
•
25. Roof SItA�athing '{'_ ,_ '.. s . ' = �:-• f - y .
74,?Overhead H dro„'
. it
26.',1-Bar Ceiling (Structural) &•-Monocoat n , . 5 - t`, ' * 75j-Dry Cherncal ,' 1 • -
27, rarpeaod Flashibg- ..riz.t , _ j_ . 76. Dry Standfllpe C.I. ' ••• s .r
t . 'L , -
_28. Lathing$ Siding_! _< � x c l 77= FIXED SYa,TEM.F'1eAL% i-
'29. Insula `yx " '
t$ 3 I : . 78�,FIRE PREY, FINAL
t1-3▪ 0. Drywall Nailing ',-* .ii -,. I iD
'HEALTHEPT: REQUIREMENT
X31. Plaster own C• gat.' c z l,, - i•
,79: FINAL I`�1S6CTIQN c
.L . . , .- r .r ..
32-Electricjf Power Meter.-Final i • a :80.• CA
FOOD CERTIFICATE ISSUED
-,. -• ...
i
.33..rfin4l El?ctric ':' r I _t `Notes: r r r
34;Fin) •Heating`& Air Conditioning: I v. ' x
,35rFinal Gad Pip -Test' r. •• t .
'
t36. Hood or Canopy -, . - : >, -
,:
.. W i 1: ��C : tis rr,
`37`;Fin41 Factory Fireplace . ,t;it r 1 r s f
�: y <t 1a "L
n ht .,. -
`38. Final Plumbing _ i. s y
▪39. Water Service-Final" L' 'T
.rte �.
i::$0. Gas Service-Final Jr - i. . - • t_--, C. -
;'41. Solar Domestic-Final 'z • k - I y ' '+�
A .t I is . :c C- tr Y ./.. ---#
..4.• :'. ••••• -- ....••#'' /
.
-
- 42-Backflow Preventers, .. . ; .a x j� • _ -
43. Backflow Irtatiori' '`. 1 1 f'�- ; c.
71- . 1 - 1 .
a.
,44. Landscape Ivigation Systems , "' 'r u u i C +'
•45''Sound Attenuation !'' - ° l �'* s
. T
=46:•Handicap Regulations 7 C ". ;1 i < ..
r.
47.*:FINAL STRUCTURE & BUILDING
t
48 INIAL PLANNINGi - ti ii C-
- i Y .i -
�49 Electric Release to Edison y I i (;;• r , it _ y
�50,�Gaf Release to Southern California Gas Co r I . " f• 1, l - .• o,: --
,51. CERTIFICATE OF OCCUPANCY = - • . C : c, - r t
No. Date
r lt.UL'Vl1J-l. MIS a MO. I min, I c
v vn aIn l.A
JOB ADDRESS 2390 Santa Ana BUILDING PERMIT NO. 2l II l�
td GENERAL CONTRACTOR Atlas Builders DESCRIPTION OF WORK Two Family Duplex
AP No. 119_291-10 LOT TRACT FIRE ZONE VALUE $ 21f,300.
3. INSPECTIONS Signature Date GROUP I TYPE V ZONE R_2
_ SoilI PERMITS ISSUED
Gas SUBCONTRACTOR Date i Number { Signature
Water asPl • bing
Rough Plumping `" j' i. '. ;( C-
Prop. Swr. Line House Con.Q /14-1 CM-e-bo- • 9,4111 i / . rd 7v-'J �'
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning - 4 9/ �«5-
Temporary Service or Pole 7
Underground 0 Power 0
Rough WiringC •23 (. Heating and Vent.
Trenches ® Forms IR Steel Reinf. .0 /9)0 9sr- ,3.4. ,(jperizif Lo. y y- s y(')Yd
Floor System //954/ S j4-5—
Bond Beam 0 Steel Reinforce 0 7 c pe oruxo�isr
Sheathing - w -,/,.fief ( /� ""5{�n
Frame and Flashin tJ_✓'
Lathing — In. Out - c ? 7 GS knob —eek
Plaster, Brown Coat
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final l' - I /It/ )C'tuel ter/In-/PR. 7-.2o-651.2�'sn
Plumbing, Final and Gas Testes-/.T' Je
Electric, Final it/,' 'O. ply
ire
Building, Final ','4%r , 41/ b •
•A
24449 CITY CF CCSTP9 MESA
•COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA.CALIFORNIA JUL 2 3 1965
For Applicant to Fill In Completely TION_FIIR-P r.• I
. TYPE OR PRINT 1;M r
AIM
I
Of-VR! {'>��nl
BUILDING 3-390 5Al.�Tq AtJA .. -
ADDRESS
REC6I PT NO. PEAR.^]IT NO/
COSTA MESA, ALIFORNIA 2 `f 4:/
�/n h11�S.. CAPgUEvI� ERACE . .;77z
RC
?Eg 6 s
OWNER IVIG , - w` .
MAIL �J' �/ BUILDING r'1 s Cc,,• S'3- (y-^ �
ADDRESS .1I�� 1s.Z LOlw7(TQf..3E/ O2,_ ADDRESS 1� ` /YrLI ''F-`
FIRE
CITY COSTA MFC .•NO. 5-46 c ZONE . . TYP C .
GROUP
ARCHITECT i' . ..TEL. APPROVED L,/. �/ /JJ�E r /
OR ENGINEER N9.
-J /I NT' J
ZONING /
ADDRESS ZD HO.oP ^ USE OF New 4-D 1
.r� al PLANS BUILDING 1
CONTRACTOR I`T L-A i Ia�11 I_ CIL�25 T((TTT•••
ad
\=yDESCRIPTIQl1 Qo R .( o V ( u 6 PP ,3 0 O
ADDRESS 2432 f3 /( oa-i- 1:3t-go• •�
CITY COSTA MecA _A.P.NO. l ' 4 _�11— 4
STATE /�1�q / TEL. Sill
90NO?TO HOHAVE IDfi A REAR OVERHANG SHALL BE LESS THAN
LIC.NO. C.' 444- NO. et S-/4/3
EAVES
SIZE y NO.OF BLOTS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT C X I ZO NOW ON LOT BLOCS.,
YARDS APPROVED YARDS APPROVED
USE OF ...---1— MAIN BUILDING ACCESSORY BUILDING
EXISTING SLOG.
(FROM C/L STREET/
SETBACK LINE FROM Sty t5Q I FRONT 53 FT. FT.
CENTER OF STREET .J REAR YAR D 1
SIDE YARDI LEFT I I I RIGHT 12' , R.SIDE /)sr. FT.
DESCRIPTION OF WORK L.SIDE I7 i/h
/FT. FT.
_ ADDITION•
REAR 3 FT. (%(�/(}. FT.
NEW kI ALTERATION
DISTANCE BET. BET.MAIN Q
MAIN BLOCS. ACCESS.BLOCS.
REPAIR MOVING� DEMOLISH 2V .41-^2',,�/j/�•- �/ 2
SIZE
BUILDING /gilt' '/�' NO.OF ROOMS I O. STORIES CAU.P.# U-� APPROVED / �6/O.�
EXTERIOR WALL ROOF APPROVED ' L// , / /
COVERING Y.l:O I COVERING GaMPO -goct BY
�VV /ATE 7-a)-{'J3
USE OF BUILDING AND WORK TO BE PERFORMED
�N;T2vcT 2 FAMILY HOLD F R SPEC REQUIREMENTS
•
/?4464.FT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE E
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY OR ANCES AND STATE LAWS REGULATING VALUATION \\ w./� p
BUILDING CONSTRUCT' oV $ 78 W
SIGNATURE PERMIT FEE
PERMITTEE cfletc-r,/ 644/1ifKSf $ 243
/JJC -3
9 B
AUTHORIZED AGENT l
TOTAL FEE $ I7
n
1.2..' c` .`4ic..6r 1 @Iii i
1 t'A ,, t
. ..:Spec)�i�al Reguiiements:
(i t. i
- 1. :Dedication to the-City 'of Costa Mesa.all land 30' from
c/l existing Santa Isabel for street purposes.
. i•. .
2. Dedication to the City of 15' spandrel at the Southeast
corner of Santa Ana Avenue and Santa Isabel for street
Purposes. •.
3. Installation of residential.sidewalks, including.
concrete driveway'approches bytapplicant, at his
• expense,. on Santa Ana Avenue.
.
)
- -
i. -, • ,
l s : . . .. _
LOWNER Mlt. MW Mttb." UAtt4IUISV114.1t, LA1M I- 7-vi
JOB ADDRESS 2390 Santa Ana Avenue BUILDING PERMIT NO. 24450
GENERAL CONTRACTOR Atlas Builders DESCRIPTION OF WORK 3 Car Garage
AP No. 119-291-42 LOT TRACT FIRE ZONE VALUE $ 2,232.00
S INSPECTIONS Signature Pate GROUP J TYPE ZONE ;-
Soil / -# SUBCONTRACTOR I PERMITS ISSUED
1 Gas n Date I Number I Signature
Water } �/>iL 5 Plumbing
Rough Plumbing 't U( 3 17.( aZ_Z ‘5 _Ihd_
Prop. Swr. Line 0 House Con. 0
Sprinkling System •
Miscellaneous
Rough Heating and Air Conditioning_
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. .0
Floor System
Bond Beam 0 Steel Reinforce 0 tannin•0.0.
Sheathing ,yJy9 S%r/ct. et.Rin S0Ii Cir..------
Frame and Flashing /'NH Sr/,n/6t' _._7 ] J
Lathing— In.a Out 0 pos
Plaster, Brown Coat X9(34 1,17,70j-
Structural, Final Electric p�
Heating, Vent., Ref rig. and A.C., Final Q4&t'. 9-020-45;c714/41,3
Plumbing, Final and Gas Test AC
Electric, Final 1 /0 x46-
Building, Final jai- v/v/(5-
r ' 445O CITY 0E CCSTh MESA
COSTA MESA BUILDING-SAFETY DEPARTMENT JUL 23 1965
P.O.BOX 317 COSTA MESA,CALIFORNIA
For Applicant to Fill In Completely APPLIVO�F( (tMIT
TYPE OR PRINT �� �f
BUILDING '"� �/ '` ^ ^ ^ ForOffice Use Unly
ADDRESS - 3 / 0 N-'ry /-�O1-�
RECEIPT NO. 2 1 J w
COSTA MESA, CALIFORNIA /—\/ V
I� II' 1' /'n
RICE, BY tDDAT RECK /ESD DWEISSUED
OWNER Me. i Mac. CAQfU OL_LS E 2p.� [OJ 6 ,I:7/379-6C
��fPN 9 cr�y�
MAIL / ADDRESSG 2 J [ e �/`}A A �u//
ADDRESS �_IoG LeFI I AWs-repOE na-
FIRE
CITY COS MESA NO. s44. - ZONE TYP — GROUP
....11
APPROV / DATE
ARCHITECT TEL. BY - L9
OR ENGINEER NO. Z ��y
ZONING >Gr^"
ADDRESS
ZQfl{ NO.OP 1..........1
USEOFNEW
// 47_ FLANS BUILDING
CONTRACTOR ATL,s 13UIUDE24EG Y
/y DESCRIP'TION PG R Lar ( 0 (, rot 300
ADDRESS Zia Z. A W Po 2T' 'BLVD.
q / (�
CITY COST MSSA A.P.NO. j ( 9V � Lr � ( -
-T / / NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.NO.21 ` ¢y 4 NO. i 5-C)a3 90"TO SIDE a REAR P.L.
EAVES
OSIZE
F LOT -50 k /ZO NNO.OF OW ON LATS. Q ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG._ �i
SETBACK LINE FROM C t�I B ' 1J •I/J I (FROM C/LSTREET)
CENTER OF STREET -I ✓�' ? TL
REAR YARD 2 FRONT FT. 3 FT.
SIDE YARD I LEFT 121 j1 RIGHT 1 (DD R.SIDE PT. / FT. C II
DESCRIPTION OF WORK L.SIDE FT. la- FT. 6 I/
NEW ALTERATION _ ADDITION I REAR FT.
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH _MAIN BLOCS. ACCESS.SLOGS.
VAR.# ` / i DATE /J [ ^p
BUILDING 'YJ.-. ROOMS STORIES I C.U.P.# y y) 6 APPROVED 9064-J
SIZE // ��----fit//
EXTERIOR WALROOF APPROVED I / _
COVERING CO I COVERING COM • - P BY V •,. L DATE .
USE OF BUILDINIB AND WORK TO BE PERFORMED
HOLT) FOR SPECIAL REQUIREMENTS
t�RA�,E 3 CAP eLjr.I�. t"'•`.�fr ;/ t-0� 'H`
N
7 e�-OSQ.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 OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORD' NCES AND STATE LAWS REGULATING VALUATION -"+ m
BUILDING CONSTRUCTIO / •
PERMIT FEE $ )/�/� N
PERMISIGNATTE� / eas- / ^ m
PERMITTEE ! �IA•iT'
f / )/ 3Z PLAN CHECK $ b O
//�� L q L
AUTHORIZED AGENT TOTAL.FEE 5 /
v TV/Yruy L[11Y1GL, lL CLL LAlr V-C.rV
&JOB ADDRESS 2390 Santa Ana Avenue BUILDING PERMIT NO. 26959
GENERAL CONTRACTOR Richard W. Thompson DESCRIPTION OF WORK Add sun deck to res.
AP No. 119-291-42 LOT TRACT FIRE ZONE VALUE S 1,500.00
\ INSPECTIONS Signature Date GROUP I TYPE V ZONE 11-2
Soil PERMITS ISSUED
Gas SUBCONTRACTOR Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.C
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power ❑ -
Rough Wiring/ / Heating and Vent. _
Trenches E]" Forms Steel Reinf. ❑ a nC Z$`/(,7
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing / 4 e
Lathing — In ❑ Out{9' °-
0:4
Plaster, Brown Coat
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final /-4-47
4
APR 24-67PAI�OO 1 183* ***(13.50
26959 CNSR
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDORE88ING Q370 .Sa Q4a ,44A A AveADRECEIPT NO. PERMITl! NO.
COSTA MESA. CALIFORNIA 2( 9s
RECH] EDD ST �D-A,TE RECEIVED,/ DATE ISSUED
OWNER Ree/ Pah
iQ.1 V'^"_ DATE
/J [
7 ( 2 -67
MAIL q p /� ADDREBUILDISS „Rif 4.5r dA./ 62
ADDREstoR 3 /0 Sail 71'€) 4A Aa r7V� .4 Q Sr.ITY C 1 TEL. ZONE FIRE �J TYPE GROUP �j/�f//`�
ARCHITECT411( 4 A 1 G TEL�J •• APPROVED iriegX DATE -/^/'"(O7
OR ENGINEER {-fit 1 NO. / /' ZONING J
/^ I 1
ADDRESS?no ltJ.s7 1 G M. ZO No.of Wit OF x[ ,�Q,/Q��4
• /1 _� I PuIU I BUILDING/�+ C'1r 4
CONTRACTOR R/ C A h4 wit 1 /A161/ (, /{./� �/��}�.� /l�'�/,/�
tri(/ L ( 1 }�//j1 LEGAL �l( . %SO Vali•1//V! /06
ADDRESS y3 jO��4j/ 52A*a 40sAa eF //I/Q. LEGAL PTION Or✓
CITY C. ,M J A.P.NO. //9-49/V 447
J / NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE ,(�7 I ggve7 TEL.NO. �J �Z174 SO'TO SIDE a REAR P.L.
LIC. E !1 !! /
SIZE r y ^� NO.OF BLDGS.. EA
I ALLOWED �(U.S.C.REQUIREMENT)
OF LOT t�O A / aO NOW ON LOT
( YARDS APPROVED YARDS APPROVED
USE OF C7� 5 ( J ! G,m MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. ,r 4 /l C. _
(FROM C/L REHT)
SETBACK LINE PROM R0 / t'L'7 FRONT V5 PT. Fr.
CENTER OF STREET 3,/{,'/ REAR YARD ( A
SIDE YARD I LEFT .. / I RIGHT �a. , R.SIDE fI�FT. FT.
DESCRIPTION OF WORK L.SIDE 3 Rr. PT.
/ en'
NEW TERATI N ADDITI N /
REAR PT. FT.
DISTANCE BET. BET.MAIN&
REPAIR MOVING - DEMOLISH
MAIN BLD S ACCESS.SLOGS.
DATE
BUILDINGp / NO.OF
SIZE e( 71,.7
ROOMS STORIES APPROVED
EXTERIOR WALL ROOF /� /� /74:25"-al
/ '/ /
COVERING .S�(�(� COVERING G. /)VQ
P / DATE �7 �T"47
USE OF BUILDING AND W RK TO BEPERFORMED P.
.SO h Deci4al� Sec_oAIJ r9
S "iv F5
SQ.PT. X
G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE
AND STATE THAT THE ABOVE IS T AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. JN.
PLY WITH ALL CITY ORDINANCES AND LAWS REGULATING VALUATION - 9 CO DN
BUILDING CONSTRUCTION.
PERMIT FEE 5
SIGNATURE II 4 r� q_.�_ •E
PERMITTED /Ji/l�J -b`') V V �/O
S PLAN CHECK S i •6
AUTHORIZED AGENT /t
. . . . .. .: TOTAL FEE s13 V��-+t 0