Loading...
HomeMy WebLinkAbout1776 SANTA ANA AVE - Building Permits r PROJECT BO/DRESS: 1776 SANTA ANA AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 06536c AMER'S NAME: MINTIE, JAMES M ADDRESS: 1114 SAN FERNANDO RD PERMIT NO: B 065369 PLAN CHECK NO: N GOVT: N SUPP : LOS ANGELES, CA 90065 CONSTRUCTION TYPE: V-N PERMIT TYPE : STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMOVE ROCK ROOF & APPLY NEW COMPO SQ FT: 4 , 500 ADDRESS: UNIT: CLAIM VALUE: 4 , 500 . 00 CALC-VALUE; 4 , 500 . 00 GROUP OCC : R-3 /M-1 PERMITTEE: WEATHER-TITE ROOFING ( 714 )768-4992 ADDRESS: 23704 EL TORO RD 320 COMMENTS : REROOF DUPLEX W/GAF CLASS 'A' COMPOSITION SMOKE DETECTOR EL TORO CA 92630 *******************************nit##*###***n*******************-wv-'+*4x***�3.er4. u LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMENTS R EOU I Rib 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S CITY LIC.: 056084 STATE LIC.:441988 CLASS: x39 Date:-((q-,It Signature: _ - . L MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copythereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICYNO.: 285-93000097 EXP.DATE: 01 /01 /94 COMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 42501402 ZNE: REF NO: © 0 Certified copy is hereby furnished. Certified copy is filed with the city Buildin Division. PLANNING NOTES> / Dp / > ✓ Date: ft �IEC_ Applicant: : —�/i IC *********************************************#n#**B-*#********* **3******4i**n##K EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred 15100)a less). DEVELOPMENT SERVICES REQU IR EH E N.: T S 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 :_ _ _ DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �- - CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y : DATE: (-24 (42 (V? which this permit is issued(Section 3097,Civ.C). **************'********71 x*#***47Fsc#***# Z#—#iris ********3t3* WITTI,E.r:#'KK LENDER: *********##*******#**n***#*********n******i ************#***#n****n****#**K-*#** ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I 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 703t.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 2 . 0 0 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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 live hundred dollars(S500). ISSUE FEE 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----> 72 , 50 0 , 00 0 , 00 72 , 50 72 , 50 . 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 wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 72 . 50 OVER/SHORT: 00 for the purpose of sale). 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 72 . 00 , 50 ❑ and Professions Cade: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors'Slate License law).l am aware *..**.*.*.N.*..k.*#**************************n*****#*****************#**#*#**#*n#**#**n* that proof or their Worker's Compensation insurance should be provided to me. o I am exempt under Section: B.&P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 4500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 500 . 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 An Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read Ibis application and slate that the above information is correct.I agree to comply with all city and county • ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property qfor inspection purposes. ^1e Q� Date:/�-- (Lk Signature: JP.(�----6I • 01 0015:418-1o152419 TOT 72.c2 Driver's License or Social Securitya: DATE: I:/14/93 TI E: 10:39 164 t'46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink-Revenue:Goldenrod—Assessor !'CONSTRUCTION AND PLANNING I POOL& SPA I i APPROVALS Permit Date Inspector APPROVALS Permit '1E Pate Inspect.-r- • 1. TemporaryEtectrrcai Ser;,ce or Pole I 52. Pool & Equipment Location 2. So I Pipe•Undrgrnd. I ~ 53. Steel Reinforcement ' 3. Electrical Conduit Ut'Lty•Undrgrcu. - 54. Forms l 4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding I I 5. St..el Reinforcement 1 56. Rough Plumbing & Piessura Test 6. Electrical UFER Grnd 5/. APPROVAL TO COVF.H•GUNl1F I - - - - - - --- - -t-- 1 -- 7. Footings 58. Electrical Condo t Jed-erne -} 8. Foundation I 59. Gas Pipe, Ti UndrnnJ The.' 9. !':,;ter Pipe•Undrarnd -itCO. BackwashC e , P.Tr,F. - '_ 10. St•uctural Floor Systemj 4 61. APPROVAL. TO Et CR 11. Property Sower Line & House Conruction ----- 1 62. Backwash & Rrtr ca _- ---' - - _ 12. Sever Cap -- - - -J .63. Reuter & Vent-Fir.,;. _ 13. Roof Drains 64. Plumbing System • Pie ii 1 I 14. Rough Plumbing 65. Eleetrical•Final ! 15. Rough Electrical-Conouit 1 9 66. Solar System-Final 16. Rough Electric Wiring • J 67. Fencing & Access Alamo:II 17. Rough!'lir ng S;gn I 68. APPROVED FOR PLASi EHiNG 1 18. Rough Electrical•T Bar Ce.4ng 69. POOL/SPA SYSTE'.'S FINAL 19. Rough Heating & Air Ca' d.t.on.eg FIRE DEPT. REOUIREi,.1C^."' i 20. Roi.gh Factory Fireplace FIRE Permit ;. ___ 21. Ducts, in Structure I 70. Undergrouru: Hy r, o 1 22. Ducts, Ventilating 1 71. Product Piping E ;Gas ' :Oil 23. Gas Pipe•Rough & This: 72. Underground Flus'. -- r - - 24. Roof Framingl. -~-__ 73. Undergrnd_Storayc iar..( ._IG,ip _:G,i _ - 25. Roof Sheathing `2--0-g7C- 4. Overhead Hyrlrn -- I- 26. T'BjirCiting {St'urtu•; v '.-o_oCoat - I _- 75. Dry Chernicai __ - iI - 27. Frame and Flashing r 76. Dry Standnioe t 28. Lai`. fn ng LiSrc � -� - -_ 77. FIXEDSYSTE1..". :NiAL-- - - -- ' - - 29. Insulating f 78. FIRE PREV. FINAL L ,_ 30. Dry:.a'i ••:alma I I HEALTH DEPT. REQUIRE.:EFUT 31. P.,.ttcr Brown Coat _-_-_-- 79. FINAL INSPECT IC% I 32. Electric& Po',�er r.•e;e-•r- 11� J X 80. FOOD CERTIF IC ',- I. 1`Tl:r ) I _ - '� • ----- --- ---- - _L-.- i -- 33. Final Ei„ctric Notes: 34. Final Heating & Air Conditioning _ 35. Final Gas Pi ReTest --- - - - ---- - ------- -- _ - 36. Hood or Canopy - --_ �---- -- -� - ------ - -- - 37. Fina; Factory Fireplace- - - -- --- - ---- --- . 38. Final Plumbing 39. Water Service-Final - ' . -- - 40. Gas Serv'ce•Fina! 41. Solar DornesticFrna! . - 42. Backflow Preventer t-- 43. 43. Backflow Irri2SLlun - 44. Landscape Wud nr apn System f_ 45. Sound Attenunl F4--1 �. 46. Handicap Regulatier0 --- - ---------- --- -- - 47. FINAL STRU i 'R BUILDING ,Z 48. FINAL PLANNZ11v*G CC - - f 49. Electric Relcasr rq, Etjon . 50. Gas Release to ki.Othern California Gas Co 51. CERTIFICATE 9.P OCCUPANCY No. Date . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA,MESAA CO TRU,,([��TIO PERMIT PER RAMO. 'y/ TRACT NO. LOT NO. • UNIT NO. ' • lrroiect Address /7 7 /) Jou CSC • 3 //tag/tag/ rr I 4 4, TYPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION a REPAIR Applicant's Maili.• ddress _ _ a AI „I-♦ �� I_� D CONVERSION ❑ DEMOLISH ❑ OTHER A-P,# Zone Owner's Name �j �- �t�A■ 1d Phone _ • �D DESCRIPTION OF WORK/USE OF BLDG. - • Address /rile Celli _ K S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑'GRADING El FOUNDATION ❑ STRUCTURAL E Front Z ' Address • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear • N Contractor's Name A -' Las L/.• • •1/■':4ie 1-_s ❑ OTHER . --- A I DESCRIPTION SQ. FT. ._ . OCCUPANCY_ C Right N Address(mailing)jQ 1 K P• y - - , (C cask s• 14- ` • I / `��,I�� C PROJECT DESCRIPTIONON VALUATION$ S Left • G • City License No. b Cisil GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./PFovided E I hereby affirm that I am licensed nder provisions of Charter 9 (commencing Remarks: Planning Notes: • _ Q with section 7000) of Division 3 .f -nd Professions Code, and •^^ M myT Uc license is in fu^fes s- :... -.i� • �� _ RECEIVED JUN 1 0 1988 5 Liten/Fse Class . manse No.40.1304-16 Date/O-n3^SSiT Signatur �� --•e PLUMBING FEES WORKERS'COMPmthat c • CLARAT •N Bar Sink Showers . I hereby affirm that I have a c rti tate of erns: t to self-Insure or a certificate ELECTRICAL FEES li of Workers' Compensation Insur• ce, or • certified copy thereo (Section Backflow Preventer Service Sink 3800, Lab.t C.)�y.�� ,2'1z���( /�� 1 Automatic Washer Transformer 0 15-50 KW Po. 0 50+KW Certified copy Is hereby furnished. �y.Ce tifie cp y' f U with the cityy�fBu'Idin ion,,n11� vy1 "Bathtubs Sewer Connection CookingUnit Meter ❑u to 100 amps Date APplicantftY IN,ASI - - 1 P P EXEMPTION FROM WORKERS'COMPENSATION DECLAPPATIONClarifiers Solar Collectors Dishwasher Meter .Dover 100 amps (This section need not be completed if the permit Is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas DElectric 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 Tank Fan Motors ❑0-1 HP ❑1'/==-B • Workers' Compensation Laws of California.NOTICE: Signature - Floor Drains Swimming 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 Urinal - comply with such provisions or this permit shall be deemed revoked. Fixtures Microwav¢ - CONSTRUCTION LENDING AGENCY ' Gas Service Outlets Water Closet 1 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 Range Lender's Address Kitchen Sink 'Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW❑5.15 KW Trash Compactor to file a signed statement that 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 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 _ - Lienalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $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 (Section 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 0 sale. it, 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 Building Approv¢d By Date prove for the purpose the oe). //'/��,7 /_ /L_/i L. ❑ i, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 1. /✓3s- Date IQ HHH�[7 . tractors to construct the project (Section 7044,Business and Professions Code: T/ The Contractor's License Law-does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,,andantl who contracts for such projects with aeon- . tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System &Ducting Registers 1 p ENERGY P.C. $ J PLAN CHECK 25% $ I hereby c rtii at nave d this application and state that the above f VD100,000 BTU 10 100,000 BTV— ELECTRICAL $ GRADING $ informatio i orrect. I agree 16 comp) it .1 ity and county ordinances _ and st-te I. s relating to •ending co r • o-, and hereby authorize pepper PLAN CHECK 50% $ MICROFILM $ sentati -s f thi cit • enter up;n .bore-mentioned property for hII1' ��//�� / ' ,�CC'7� inspects •urpos- / — • MECHANICAL $ � 144 nIO TOTAL FEE $ c74■tJLa Signatur- �'/_ Date -• •l• Drivers' cense or SS F Reinspection Fee $15 Issue Fee 15•.00' $ 3 PLAN CHECK 25% $ CMF 0865-4:, ev. 10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor US UUUU/UYU-UUUU/UIL' II t■ I 1}•LIU • 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' c- 3. Electrical Conduit Utility-Undrgrnd. 54. Forms C 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ^1„ • 5. Steel Reinforcement 56. Rough Plumbing & Pressure:Test 6. Electrical UFER Grr(d;'- 57. APPROVAL TO COVER-GUNITE . v 7. 'Footings - 58. Electrical Conduit-Undrgrnd. 8' Foundation 59. Gas Pipe, D Undrgrnd.Nest 9: Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap4D 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 Healing & 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 D 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 PREV. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ii, 31. Plaster Brown Coat 79. FINAL INSPECTION •� 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED , ' 33. Final Electric Notes: 4/34's j hp ass c a0Y.tn4 64 pr. .T 34. Final'Heating & Air Conditioning 1145-4ere LE,0 Nu inset. G.C.0 35. Final Gas Pipe-Test I- 36'Hood or Canopy - r 37r. Final Factory Fireplace - , •38. Final Plumbing "i 0 ' -� ri 7 r.' f ' • 39. Water Service-Final i , r C' - - r ` A " r .n 40. Gas Service-Final _ - i3• - 41. Solar Domestic-Final F - r • v • 42. Backflow Preventer ' a i . • 43. Backflow Irrigation .1-i _. , 44. Landscape Irrigation System 1 - ., - - 45. Sound Attenuation -. ,. . . . 46. Handicap Regulations - tI, -, 47. FINAL STRUCTURE & BUILDING .- r' ';-) " ' P I 48.'Special Requirements Completed "' `' i I • • 49. Electric Release to Edison - ') (vi -• •- t 50. Gas Release to Southern California Gas Co '3. . e- 51. CERTIFICATE OF OCCUPANCY r , - .♦ No. Date ''S-"t n S ' OWNER GERWICR",_ FRED H. DATE 2-3-61 JOB ADDRESS 1776-1778 Santa Ana Ave. BUILDING PERMIT N013760 GENERAL CONTRACTOR Owner-Bldr. VALUE § 19,706.00 AP.No. 117-2146-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Duplex[�w�"�/att.Cpts INSPECTIONS t� DATE GROUP I & J TYPE V ZONE RI4 Underground Soil2.1)41U.G. Water 1..f4/ if...2.4'.67 SUBCONTRACTOR PERMITS ISSUED Underground Gas ,t. .0 U. 4"-4/ DATE NUMBER Overhead Water and Gas Rough Heating IN 4W-6e tte ' 2 v --)c -G/ cal-9 790 i 1 Rough Plumbing 4/,Ii /i,5'.G I "ie . -, ; Ja 3- -7_ G/ .0,-942.7./Y1/� Miscellaneous U l 4T Prop. Swr. Line-"Houze.Con. St/Swr. N/i4,//e/ vr.,-j&a 4//Z//4/ Z 7 trio qI Sprinkling System Heating, Final /j'!fS f--26-4/ V /t,6 Plumbing Fixtures /f ly ., 7 4,, Final Gas Test Ar-/s- Construction r--/sConstruction Pole Q9J4 Z -Vr-ti/eg-e.lrz a/ /-. c -6/ 1 0/4? Underground Power / �� ,,y Rough Wiring d jha,,, e S ',-67 7�n4p..G. .�n�.�. SS6`-d,/ 144491 j %/t_4te,v) I Trenches Forms Steel 2-2&` et "_ / ,,{cd'1' Floor System 3 - J - 9./ ,,�,t/, j✓ ,�/ Steel Reinforce Chimney Re-Rod _ ,J4' �J 1, II Bond Beam 6 /'' Sheathing 4.--la—f, 4 _/2^ .( Frame and Flashing r - Lathing, In Out • Etr $' �J. Plaster, brown coat /E ,'3 t . e8 Plumbing Fixtures, Final /P J 7_,-7-G/ R Electric Fixtures, Final ^rX KA r ID Building, Final 7-7-t L OCCUPANCY I ' Form 210-5M-11-59 5-B P 13760 • 1376'0 - FE REGLIVLU • JAN 3 0 1361 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 311 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING /y/ ryr�p 'J' ,I /� ^ Sr BUILDING ADDRESSS72 177x$iWTA AAM — COSTA MESA. CALIFORNIA For Office Use Only OWNER Efl''-1� /1. 6 , kV/et- I RECEIPT NO. le-7b0 MAIL RECFAVEy�ev ( /--I fl, I DA ISSUED I ADDRESS /35 FLot�✓t,2 S/, `/]'/ '�. o / /� /1 TEL. L/9 BUILDING/77/ J7 y �i T //-_ - CITY Aid NO. -$g ADDRESS �' /a .(A��,(�(,(,ft` ARCHITECT TEL OR ENGINEER NO. COSTA MESA. CALIFORNIA ADDRESS -`- -' FIRE � �/y{ // /' ZONE TYPE GROUP {YY/- CONTRACTOR cep D Ai I CE Pn/� BYPROVED Anti,n4 DATE 7 - 3-b ADDRESS S,c�.J1�1_ ZONING A, �], Al, 20 NO.OP USE OF NEW jl 1.k/ rr CITY ` - !-, Ir--♦� I PLANS 9 �I BUILDING V-/_ SL1/V I LEGAL /� ` LIC.TNO. `� C y /J�/TNO. DESCRIPTION Po ft L o P !LS 14,4700' SIZE / /. J //1 J V / I • NOW ONBLOTB O A.P.NO. //9.,) 1/44 6 - O 2 OF LOT (6 USE OFi/ C YARDS EVES EXISTING BLDG, .,, ,S% Q�O�L_ APPROVED ALLOWED SETBACK LINE FROMf �/ (CENTER LINZ ST.) CENTER OP STREET REAR YARDS l FRONT I ? FT. IN. SIDE YARD I LEFT 3'1/ I RIGHT S/ R.SIDE / 7C FT. / IN. DESCRIPTION/�IOF WORK L.SIDE A �A(FT. /t /�C N. NEW I VIALTERATION I V ADDITION I REAR a 1 FT. I 6 IN./ REPAIR I I MOVING I V DEMOLISH I APPROVED u�; 1„....n • DATE - 3n j,/ BUILDING E�LGn/ NO. OF er4C/4 / Tics- EXTERIOR �V �� SIZE /GOO --"''fff(• ROOMS �7 STORIES (,// 'V' COVERING WALLS/U��I COWERING ROCIC 19`�/ USE OF BUILDING AND WORK TO BE PERFORMED "/ � /V 7-A-I-S -�- , - Flo !) • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONS ON. fVALUATION SIGNATURE OF �/� PERMIT FEE �_ N PERM ITTEF v - 01.11431 P $ 9 C//,/, 1 PLAN CHECK $ // AUTHORIZED AGENT //� / (/'• 717.0--- 0 TOTAL FEE - n