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HomeMy WebLinkAbout2193 SANTA ANA AVE - Building Permits S CITY OF COSTA MESA 041"ME: BUILDING DIVISION 9 ).• to 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 '44;^ ^'3 PERMIT NUMBER: BC11-00578 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 11/14/2011 ISSUED BY: KJB • JOB ADDRESS: 2193 SANTA ANA AV CM Suite/Unit: APN: 42615311 Zoning: , , Vicinity: • Primary Occ: Const Type: SQ. FT: 0 Valuation: $3,500.00 SCOPE OF WORK: NON-STRUCTURAL BATHROOM REMODEL 1 EXISTING BATHROOM ONLY. ELEC TO INCLUDE:2 LIGHT FIXTURES, 1 OUTLET, 3 SWITCHES. PLUMBING TO INCLUDE: 1'TUB, 1 SHOWER, 1 WASH BASIN, 1 TOILET. NEW TILE. NO OTHER WORK AUTHORIZED BY THIS PERMIT OWNER: MITCHELL,WILLIAM R Address: 2193 SANTA ANA AVE Unit: Phone: City/State/Zip: COSTA MESA,CA APPLICANT: JAMES FALCONE Address: 8771 CLIFFSIDE DR Unit: : Phone: 714-658-9587 City/State/zZip: HUNTINGTON BEACH CA CONTRACTOR: JAMES FALCONE License No. 829014 phone: 714-658-9587 Address: 8771 CLIFFSIDE DRUnit: Cell: City/State: HUNTINGTON BEACH CA ZipCode 92646 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Ran Check: $0.00 Building Fees: S97.25 Electrical Fees: $30.10 Mechanical Fees: $0.00 • Plumbing ees: $62.70 SMIP Residential: $0.50 SMIP Col,dnercial: $0.00 Bldg Std A'Imin Fund $1.00 TOTAL FEES: $191.55 *'Refer to foe receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 Monday th,u Friday.7:00 am Mut 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day, Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. Odin N. INSPECTION TYPE DATE INTITIALS CODE If INSPECTION TYPE DATE INIITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing X /a-ail `I/ 200 Final Re-Roof 210 Final Electrical 201 Final Block/Reteining Wall 212 Final Fire Prevention ht 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ( 204 Final Demolition 250 Final Building/Occupancy < Id-.�-/ _�t- . * WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive,„license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed ifthe 'permit is•value`date h/"undred dollars($100)orless.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Ditty Number: (�/1,�1 0 As owner-builder, I will not employ anyone to do work which would certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of gppiiwnrs 9gnawre Date the Labor Code,I shall forthwith comply with these provisiyyyns. / /1/44,r ( ( Division of Industrial Safety Permit Number: / Applicant's Signature l/ OatP HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE ' +1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No si Lic.# {J cRQa/% 'Class# / (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 Conn cmr's Signature - r.te - 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve. demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance.also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications fix non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penally of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Le•a • ens F Date / Signature Dale %/ I 13Y7 3057-46(3/071 /Llfr _And/or Authorized Applicant Date HART'S PLAST ING COMPANY 2199 SANTA ANA AVENUE COSTA MESA • CALIFORNIA PHONE LIBERTY 8-6779 July 16, 1958 Costa mesa Building Dept. Costa Mesa, Calif. Dear Sirs, This is to verify the fact that we have engagec the Harbor Cement Co. to complete the swimming pool at 2193 Santa Ana Ave. started by the Picket Pool Co. 7.(..r Lv✓ (g•.,53/44.2 Waldeen D. Hart COUNTY OF ORANGE BUILDING DEPT. - - .,Permit {, No ���..!/yy Santa Ana,California 636 No. Broadwayia Application for Building Permit Phone:Kl 2-6211 AND FOR A Certificate of Use and Occupancy Date CCe/t / 'Q1 / 9S2 �,,//// 6/�� L ( JI I I. OWNER'S NAME / /v{' C�--// �( Y ` ' eP_I' PHONE 6777 MAILING ADDRESS__2-133 S 6. Y1 L, 6 n I G .a LcI - CITY CeS n...1rn L S c` Name C c� nw � iT etu._, tt Name L1 Y C.l • (Architect or Engineer) (Contractor) Address Address City - _ _ City State State Lie. No Phone .� Lie. No �,/' / �' Phone {� / PROPOSED USE:. ac.., , ... „..- ' ! Qrl Y r ... l% '1.2:t,L12� ✓..S &.v2t3- t 14..'^�fj..> i cealip 2. JOB LOCATION2/., 3 SQ--v-- -, GC-,e_ Ct-.r JCS Vroq.h• (House No.) (Name of Street) (Town or School District) • 3. LEGAL DESCRIPTION: Lot 3ii• _ Block Tract 1 A) d (4,9.....k (Metes and Bounds DescriptionnUse reverse side of form3` 4. CORNER LOT ( ) INTERIOR LOT ( k< THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDCJ,ti7 — 32- .. AREA•& 9 V 4 SIZE OF LOT75-- /SS AREA:...LQ)-./L...'I... ... �: 11 6. HEIGHT OF BLDG • 9.i;:V[ CEILING HEIGHT- ,3 A NO. OF STORIES ( 7. NO. FAMILIES / Size of Smallest Bedroom- Size of Kitchen f� S. EXTERIOR WALL CONSTRUCTION -„A„ INTERIOR WALL COVERING YRS, (Frame, Stucco, Etc.) jl� �j�f (Plaster-Drywall, Etc) , 9. SETBACKS: Front Yard From Center Line// of' Street T4j! p V Nearest Side Yard..5. Rear Yard.-1G ..I.d"-r-----.Distance in Feet Between Bldgs. on Same Lot 1 Q {"t I 10. A COMPLETE PLOT PLAN IS REQUIRED, S OWING ALL STRUCTURES AND USE OF EACH. n it 11. For (a) Footing: Width...J " 1 't-z�2- Depth in Ground si h Width of Wall Accessory • Siand (b) Size Studs- 2 Spacing 1 CO Similar ofxT Sacin "CC Material of Floor Structures: (c) Sizc of Floor Joists- Spacing "CC / 7. /- (d) Size of Rafters` T X Spacing.,�4" "CC 12. VALUATION OF PR9 SED AORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and . sewage disposal $ '!. /J 0'O 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF TILE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE TH RETO. �f / y/ Signed- / / .. -- �GL, f/ (Owner) Plans Filed- / - a1 —` �3 of By. (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: �CHHEECCKING BY Bldg. Permit - S.../ ° ° GROUP f APPLICATION. HEALTH Plan Check $1„, TYPE Lo'"-- FIREZONING as DIST. G MAR SHALTota] Align MAP — R 4PLANS AND Receipt No. - SPEC'S STATE Paid to • - SHEET NO +5- CORRECTIONS ENGINEER Date 4-_ i 7 r VERIFIED CAL PARI TISSUE BYd:' COUNTY BUILDING Vr °`'' "`J1Vr I.I Lr ti:SPcCTOR u:A - ---, DEPUTY ' 5M-291 -' -- • � C 1, e OWNER HART, WALDEEN B. DATE • 6-13-58 • JOB ADDRESS 2193 SANTA ANA AVE. BUILDING PERMIT NO. 6848 GENERAL CONTRACTOR PICKETT POOLS VALUES 2400.00 . AP. I4o18-1 5O—Z1)T2R4 TRACT NPT FIRE ZONE DESCRIPTION OF WORK SW IMM I NG POOL GROUP TYPE ZONE ;4 PLAN NO. 6848 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE / NUMBER Trenches Forms Steel JAW Floor System rallinir -W Steel Reinforce Chimney Re-Rod ` Walt r Bond Beam I/ i� Frame and Flashing �7 Lathing, In Out _ Plaster, brown coat 4. �e I ''�r% 11r Underground soil /G Pipe Test IIMffiliartAlinfrair'ri�ea Top Out Furnace �� �lMII la FAMMIST Gas Vents /' ('•+ �♦—�� -��%A �� a�,� Rough Plumbing rl. it NaS Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Ellia—,����. JI-- Sprinkling System ='J�Mal ' Heating Finali 1 MIfljV Plumbin! Fixtures Final KKR SI9fiSi� FinalGas Test —fit = Construction 'ole Underground Power Rough Wiring =Fixtures. Final . OCCUPANCY AO Form 210.-SM-1-57 • • ;48 J bd48 6. COSTA MESA BUILDING DEPARTMENTCOTT P.O. BOX 317 JUN -2.58PB f 17a *tr*til 5.0 0 A15.00 COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADDRESS .2/93 Sg1, 16 AM/ 9e BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY "� . ,1�/r�. RECEIPT NO. PERM ITszp OWNER Lioiefe ey hi 6 COI( MAIL �I 75:11.-4/ �1 J /, 4 n RECEIVEDDATE -E`V e DAiISSUED e ADDRESS i/Y3 �'W^�nk� U -ne l/)%- N' '¢, TEL. / BUILDING CITY �U S��¢ ,Y'F���^^^"S NOM ` 7�� ADDRESS ARCHITECT cn'wfg /c y/as/4r LIC. OR-ENGINEER'04 conn," NO."err° COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE ///��� SONE NO.OF TYPE GROUP( ` •�- / CITY LIC. PLANS i\/\//,}(.y_ CONTRACTOR f%L/c�// 1204.1/4 O. NO. C���-� ADDRESS An771/1414 0 re" NO. APPROVED DATE LEGAL LOT sZ 'IN--�4'� CORRECTIONS y DESCRIPTION NO. , / BLOCK T C "• ��JJJ ___ -. A.P.NO. ? / S. -,, / .3"--0,--• _. SIZE 7 t$5._.so fig/rR NNOOW.OOF NBLLDOGTS. �OF LOT APPROVED USE OF CITY OF ;TA MESA EXISTING BLDG. ` ,( � --J . e SETBACK LINE FROM / `"�— � / PSL"•'\1\ll(V Jam!'}. CENTER OF STREET V6' �[. ,' REAR YARD SUBJECI TO B G. DEPT. REG. ry , 1 SIDE YARD RIGHT J"� LEFT ��"� �� DESCRIPTIO OF WORK BY CO XPLANT DATE(A'a NEW ALTERATION ADDITION Cr' n REPAIR MOVING DEMOLISH G-1-J -r SIZ BUILDING/� 30 NO.OF ROOMS STORIES EXTERIOR WALL ROOF _COVERING COVERING USE OF NEW BUILDING SC.(>//'1/ M /7 • �O/ ,.......-------.-.-/91‘74: 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 STATE LAWS REG G BUILDING CONSTRUC• TION. ^/ /� 1 VALUATION 1 ' c. o ^� \`/ , • k PERMIT FEE S ��/ PIGNATTRE OF ( 1 11C/ `\ I` 4 PERMITTEE / //W/ PLAN CHECK $ �_.— AUTHORIZED AGENT TOTAL FEE $ i\S�'-c--- `Ph OWNER WALDEEN B. HART • OCT 2 8 1958 DATE 7-31-58 _ JOB ADDRESS 2193 Santa Ana Ave. MAR 2 1959 BUILDING PERMIT NO. 7242 G NE AL CONTRACTOR Harbor Cement VALUE $ 2,400.00 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Swimming Pool GROUP ,T TYPE TTT ZONE R4 PLAN NO. INSPECTIONS •ATE PERMITS ISSUED SUBCONTRACTOR DATE NUMBER Trenches Fo Jr...-. Steel'p� �A.::: Floor System�)� /J:/ .-- zj / S e Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing • Lathing, In Out •Plaster, brown coat r,/�✓r_r/ Underground aoil� ,/7j W/l: m., Ttet y13A-7 _ ,t Top Out Furnace \) eAl0 • Gas Vents/� 1 pp ��ff II,�] �/ �t�Gy."-m, X11 3--e-�'-T9 ( 93 a`-�/ ` ��I Rough Plumbing P 1+ .f�i�7`!'J 7 ,4'1 .BO/Q c G'AlT 6,-/-67? YVS 4',6 Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. r Sprinkling System 4)D sitJ.e= Heating Final /I/O/J• .. Plumbin Fixtures, Final ) S-7 kl t, Final Gas Test b ,e. 4Nl�V I Construction Pole a "� Underground Power t//.,1,J / j Rough Wiring tn.- 9—i0..✓S� (,o•a I`euti—0.N�c�—r44—se Q1 e �(V',�i 9 , Fixtures, Final 7" 24_7 )' 'OCCUPANCY 4/• 64.7-4-t? ..Form 210-5M-1-57 �.- 72h2 r r E RECEIlIEC ` Z COSTA MESA BUILDING DEPARTNME T FINANCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CITU OF COSTA ME } / FOR APPLICANT TO FILL JJ IN APPLICATION FOR PERMIT BUADORILDINGE55 J 219 3 S a 4 a `.. BUILDING fJ /I jy • COSTA MESA. CALIFORNIA T�� FOR OFFIC U E ONLY /� n R R'CEIPT O. NO, OWNER \(\[ AI, a E N 8. I4 A AT / Y Y • . G •*7 ADDRESS R. 1 9-3 SA id el 1 ;Lys:. l J �I CO �y,.f / „NW?CITY �C� {��• IY�E��w� f TN O. A ��l ADDRESS ORGE IGINEER 0. 8 rata Q7 NIOA,F 07.7 v COSTA MESA. CALIFORNIA ADDRESS 3 4 co.) 'r+ S'I'. 5�A^+ �J Z6NE I�C I MI.�(I,z NO.OF TYPE GROUP N AR�� CITY LIC. PLANS CONTRACTOR b NO. CR/V191., TEL. APPROVE ADDRES 0 3 SA' NO. BY DATE LEGAL b'` g �� 1 CORRECTIONS DESCRIPTION NO. F� L� I BLOCK h`lS A.P.NO. 118 - 15 VS Ze SIZE 7 4 NO.OF BLOCS. K/� 1{Iro !1 OF LOT / � A. •�� NOW ON LOT ^ APPROVED ".,.< D USE o _ R, ^� I 51.01m ©o CITY OF aSTA. MESA I 6ETBACK 619._ L ( (jS f 1 1 PLANN I}G L-I'1 • } CENTER OFLINE STREETFROM1i'M Ir i�E f YARD CHF'IFCI TO DG. DEPT. REG. . LEFT I4•" In r•-• Sig DESCRIPTION OF WORK pl'�10 g,.�i�'P DATE -7-14FLAN Ti_CH97'J7 NEW V ALTERATION ADDITION REPAIR . MOVING N o�j, q�DEMO(L�IS(H� \ .Q // SIZEDING / ` ,13 4' R901%7 ( Aix �TSSS� Ar /� /P"i��'lS 7/ 1 EXTERIOR WALL U� ix,C (r t't /� �' pgµG ItG .J COVERING C7V N ITE n'{"((J,eiv �t J USE OF NEW x.{ /T r Q ` Z1C BUILDING t,,�l // „ ��/� (l c2 i-g4.;w,na...n.,...) I HEREBY ACKNOWLE9 GE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULAT G BUILD! G CONSTRUC• TION. // / `y / VALUATION SIGNATURE OF j/1 LI 1., / • /Ss PERMIT FEE S /O '� P RMITTEE / 'l, ii ` ' / f•() /' /� P._ 30776 —`cy- s-3 I S �/�f DD / PLAN CHECK S /0O/V •G 'UTHORIZED AGENT HAR ot+A C�/Yli:At mo' . TOTAL FEE $ /O Od Nwir �.,� tiif r$. . . OR9NGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT •• North Broadway -SANTA ANA, CALIFORNIA BUILDING 636 • rOR APPLICANT TO FILL IN Ir, FOR OFFICE USE ONLY /' �] (`(�, T�//I, ANA A 1/�y_ RECEIPT NO.; PERMIT NO. BUILDING / % '1 � `fiN // ANA AV f• 3 y 33 . 5'C2Se. ADDRESS c SCHOOL DIST. [+ TA + A RECEIVED BY DATE OF APPL. DATE ISSL, D • OR TOWN Q J ( (l ��/T NEAREST . —L F 3 ^y�-S • ' I ^ a . OWNER /21.IR , I/4 ,R7 A ADDREISS �� ( � /' u� ADDRESS �/4••? f^��, fffAllrA ANlJ ;"'I��� OR TOWN IST: �y _�y_I CITYe an•A !lM��FSSA- E. No:B-733s"/l CROSS S T. � �� L-�� ENGINEERARCHITECT OR 7Y /./�A�IF' NO.TEL. Z _ //I PTA NSF 7. I TYPE / I GRO • ADDRESS / A SETBACK LINE FROM CENTER OF ST. "' 0(� •. VTRACTOR 0 p �a, /j NO. REAR YARD:"/ SIDE YARD RDD ,_S2. S �j 4• �/� BYPROVEL /�// • -' DATE s3 ADDRESS Yom{/ LEGAL 1 I`_/.� _ /� CORRECTIONS DESCRIPTION I LOT NO,/ e /PBL�OCK�' Q TRACTCH METES @BOUNDS J eP c3I?8"6 V _ SIZE OF LOT'S ,USE OFQ?.r<I NOW ON LOT NO.OF SLOGS.2.. EXISTING BLDG'V0 `•ddAAAIzF°I°Es I ROOMS . .: DESCRIPTION OF WORK - NEW I I ALTERATION I I ADDITION IX 0 O REPAIR I I MOVING I I DEMOLISH I Z BUILDING n/1^� ^ r•NO. OF G j r SIZE e.(p5!{ ✓ff T �RjOOMS ce STORIES • WCOV RING PA Act, /T I COVERING rift\I-PA . BSLOFNGEW 4p40 / 7,ay To nisi'. APPROVALS i . ' • FOUNDATION: LOCATION .,..INSPECTORDATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, //\.i o '2 r13 APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING /� V' AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. ( •/7 3_/O G/� AND STATE LAWS REGULATINGq/ BUILDING� CONSTRUCTION. BRACING, BOLTS l/ f Y" LATH. INT. SIGNATURE P RMITTEFF /^'�D• "%Z. � ','I..� LATH. EXT, ��� / / / 'PLASTER. INT. I AUTHORIZED AGT. �` or /� PLASTER. EXT. $✓ ODD' P. C' S /L• mm MASONRY REINFORCED FEE /2 {AJC ' BON BEAM,j • r! , VALUATION i oc - Hr� a FEE FINAL W Z W d PLOT PLAN • • o .. ... _. . ao re a c a • • • • T 4 > v�U ` U 0 N STREET • • £S- 6Z HAV 0 1 0 0 • 00.14 - V