HomeMy WebLinkAbout260 SIERKS ST - Building Permits Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. •
`CITY OF COSTA MESA Pcg MIT NO. " 'TRACT NO. • LOT NO. ' :BLDG.NO. '- . - -'
'CONSTRUCTION PERMIT /''-a`74a3 •
•
Project Address 1/ l� \.,' ra a', •
I P{(a n S�.C'/l S- - TYPE OF CONSTRUCTION - _.I 1067 1 /21 /82 ' 5.00 LTL
"--,-
1 Ouvner Tyr .�-/-/SoA./ Phone/.44-1/17‘ 0 NEW ❑'ADD 0 ALTERATION 1 • �"
1 Address es&,if, SS 4*-/PK5- - 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS
Arch/Eng. - • License No. - 0 OTHER •
O DESCRIPTION OF WORK A.P.
Address - • ZONE PLNG. REF.If
Contractor , . : I Phon•7 - i TYPE OF PERMIT. . BUILDING TO BUILOINC '
Address/S{3 LI L��p4 affiff=afil 0 GRADING • ❑ FOUNDATION 0 STRUCTURAL SETBACK CD T. PROPERTY UNE
LICENSED CONTRACTOR DECLARATION 0 TENANT-❑ ELECTRICAL PLUMBING ❑MECHANICA SIDE YARD
•
I hereby affirm that I am licensed under provisions of Charter 9 (com- - RIGHT '
mencing with section 7000) of Division 3 of the Business and 0 OTHER .
Professions Code, 30 my license is In full force and effect. REAR YARD(TO P/L)
PROJECT-DESCRIPTION - _
License lass -
` - License No- ,4Data ..-.: �
Signator. -.: . -� „� Ails. SO..FT. -
WORKERS'COMPENSATIO DECLARATION . OCCUPANCY_CONSTRUCTION TYPE STREET WIDTFI PARK FEE$
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE 'ZONING'APPROVED BY I DATE
certificate of Workers' Compensation Insurance, or a certified copy - -
thereof(Section 38 bb( C.). may'' GRADING CU.YDS. ACRES • SPECIAL CONDITIONS: -
Policy No �4ir�IT 'r` Company-RRef/ y4./s -
-
0,Certified copy Is hereby furnished. REMARKS: ' . . - _
Certified copy Is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION .
(This section need not be completed if the permit is for one hundred
($100) or less). .
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 PLUMBING PLAN CHECK ELECTRICAL " PLAN CHECK
subject to the Workers'Compensation Laws of California. - UW LLLING • taR RAG E�
Date Signature BATHTUBS SHOWERS e .
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10.KW-
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW 50+•KW - - .-
revoked. . _
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS -' MOTORS 0-1 HP_1-1O HP '
•
I hereby affirm that there is a construction lending agency for the per- SERVICE SI NKS SUMPS - - - . (INC.SOLAR) • 10-50 HP50+HP '
formance of the work for which this permit Is issued (Section 3097
Civ. C.). ' - FLOOR SINKS 7 . FLOOR DRAINS ..' FIXTURES OUTLETS SWITCHES
Lender's Name
Lender's Address DRINKING FOUNTAINS • . - GAS TUBE SIGNS -' -' '
OWNER BUILDER DECLARATION - -- . . - INTERCEPTORS CLARIFIERS .POLE LIGHTS ' - -
I hereby affirm that I am exempt from.the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING'POOL P TRAP - LUNS I RUL I.IUN
Any city or county which requires a permit to construct, alter, • POLES METERED SUB
Improve, demolish or repair any structure, prior to Its issuance;also re-' WATER SERVICE ' ALTERATION . - PANELS' MAIN' SUB
quires the applicant for such permit to file a signed statement that he - '
Is licensed pursuant to the provisions of the Contractor's License Law GAS-SERVICE OUTLETS 'SERVICE - - -' - AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS -BTU OUTPUT- 'p`y
basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit-subjects the applicant to a civil penalty SEWER CONNECTIONS .` - '- -"
of not more than five hundred dollars ($500). - . , -
❑ I, as owner of the property, or my employees with wakes as their SOLAR TANK .. COLLECTORS•s,". - •
sole compensation,.will do the work,and.the structure.is not intended - - - `
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. _ -' ' 'APPLICATION ISSUE FEE — _ - . -
Contractor's License Law does.not apply to an owner of a property •
1 APPROVED BY OgTE
who builds or improves thereon, and who does such work himself or ISSUE FEE el
through.his own employees, provided that such Improvements are not _ _
intended or offered for sale. If, however,the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
Is sold within one year of completion, the owner will have the burden BUILDING •
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ -• SMIP $
❑ I,-as owner of the property, am exclusively contracting with AND DUCTING - - - - " ' ' '
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT
and Professions Code: The Contractor's-License Law does not apply to - ' ISSUANCE $_
•
an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $
tracts from such projects with a-contractor(s) licesned pursuant to SYSTEM - -. GRADING $
the Contractor's License Law). 100,000+BTU - PLAN CHECK $ .,µ' •
❑ 1 am exempt under Section B.& P.C.for this - ' - $
BOILERS BTU ELECTRICAL $
reason MICROFILM $_
Date Owner - SYSTEM REPAIR,ALTERATION 'PLAN CHECK $ - TOTAL FEE$_ '
•
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE :MECHANICAL $
LESS
AD-
information is correct. I agree to comply with all hitt' and county PLAN CHECK $ VANCEPC $- •
ordieand state laws relating toConstruction,t onend herebyveauthorize representatives -
of this city to enter upon the above mentioned
property for...t pn p=oses.�/
(1 ISSUE FEE -
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNI G POOL&SPA
a�a3 Date Inspector - Date Inspector
APPROVALS i Permit # - APPROVALS . Permit#
1. Temporary Electrical Service or Po e 43 . Pool & Equipment Location .
. 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn45. • Forms •
-
4. Electrical Conduit-Undrgrn 46. Electrical Bonding -
•
5. Steel Reinforce - 47. Rough Plumbing & Pressure Test - - •
6. Electrical UFER Grn 48: APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn • -
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test
9.. Water Pipe-Undrgrn . - _ , _ 51.- Backwash Lines. P-Trap; ❑Undrgrn - •
10. Structural Floor System 52. APPROVAL TO DECK _ . '
11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final, •
• 12.. Street Sewer Connection . _ . -. . 54. Heater & Vent-Final • •
•13. Rough Plumbing _ . . 55 Plumbing System :Final
14. Rough Electric-Conduit . - '56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating & Air Conditioning . . b8. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
.18. Ducts,.Ventilating.
19., Gas Pipe-Rough'&Test 60. POOL/SPA SYSTEMS FINAL .
20. Roof Framing ' - ' •
21. Roof Sheathing ' -
22. Frame and Flashing `NOTES:= = _ l=- = -frfi •' __
23. Insulation - - ..
24. Lathing & Siding . •
25. Drywall Nailing
26. Plaster Brown Coat •
27. Electrical Power Meter-Final . . '
•
28. Final Electric • - •
29. Final Heating &Air Conditioning - •
30. Final Gas Pipe-Test
31. Final Plumbing raw 1,� -g"S." •
32. Water Service-Final - - _
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System .
36. Sound Attenuation
37. Handicap,Regulations _ .
38. FINAL STRUCTURE &BUILDING
39. Special Requirements Completed • -
40. Electric Release to Edison •
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY ' . .
No Date
i,, _� INTERNATIONAL TESTING CORPORATION
- — GEOLOGY - FOUNDATION ENGINEERING • TESTING - INSPECTION J
To, 4.—<_ =s.' et 1671 "D" Placentia Avenue, Costa Mesa, California
N 1 �i
A:\--41------(
1 TELEPHONE Hopkin. 64522 - Hopkins ]-1]51 • 3552 BUENA VISTA AVENUE - P. O. BOX 578, LEMON GROVE. CALIFORNIA
REPORT ON GUNITE TEST SPECIMENS
Identification No. : P-161-482; 535
Client: Hal Whitaker
General Contractor: Hal Whitaker
Structure: Swim Pool for Barbara Heslin, 260 Sierks,
Costa Mesa, California
Sample From: Bond Beam Center - Shallow end.
Mix: 43i - 1 P.S. I. 2,000
Age: 7 Days 28 Days
Specimen Nos: BH-1 BH-2 T,{- n
Average Dia. : 5. 575 5 . 750 `n T:l:.` �J
Area, Sq. Inch: 24.25 26.0 ;f -/ C
ice. .
f,--7- Eh,of N
Date Made: 8-1-61 8-1-61 • j BuildingAe'.I �`
Date Tested: 8-8-61 8-29-61 /-1 .
COMPRESSION ---
Total load, Lbs. : 35,500 79,500
'k% I C1
Lbs. per sq. inch: 1,460 3,060 1.
Specimens made by: J. Henley
Specimens delivered by: International Testing Corporation '
Date Specimens received: 8-2-61
INTERNATIONAL TESTING CORPORATION
44----4/1441-7 (f��
PROJECT ADDRESS: 260 SIERKS ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 0498 /8 .
OWNER'S NAME: PATTISON LILLIAN H TR
ADDRESS: 260 SIERES ST PERMIT NO: P 049878 PLAN CHECK NO: N GOVT: N SUP?: N
COSTA MESA, CA 92627 .
• CONSTRUCTION TYPE: 5—N PERMIT TYPE: ?LU PURPOSE: REP
• ( 714 )646-1896
ARCH/ENGINEER: REG.NO.: JOB' DESCRIPTION - : MAIN SEWER LINE •� SQ FT:
ADDRESS: - UNIT: '
•
CLAIM VALUE: - CALC—VALUE:. GROUP OCC; R-3 / '
PERMITTEE: GEORGE BRAZIL ( 714 ) 541-0917
•
ADDRESS: 3022 N• HESPERIAN WY 101 . COMMENTS: "HAPPY HOLIDAYS! " FROM COSTA MESA
SANTA ANA CA 92706 *********.*+PSEr*** *SE**R6**RR***** PSE**+E**************+F***********************ir*****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS .
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. $ E T .B A C K S
CITY LIC.: 029919 STATE LIC.:443064 CLASS: C— .
Date. Il—cJ — MAIN BUILDING • ' ACCESSORY BUILDING
signature: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby off MIhave a ficate o consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: ' FT IN RGHT: FT IN
Compensation lr�y�{py,pt aicyrfyljeA copy thereof(Sec n 3000.La 1/01 /91
POLICY NO.: W�-V[7 G 7] EXP. DATE: t
COMPANY: UNITED PACIFIC PARKING REQ: PROV: PARCEL: 42621216 ZNE; REF NO:
Certified copy is hereby furnished. Certified copy is filed with the city Building Divisio PLANNING NOTES> . '
Date: / (—% [ Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATIO Is section nee .be crimple ed if permit is for one hundred($100)or less). DEVELOPMENT S 'E R V I C E $ R E Q U T A E M E T�! T $
I certify that in the performance of the work for which this mit is issued, all 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: BUILDING APPROVED BY : • DATE:
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor
Code,you most foDING G I hther such firm t provisions this permit shall be deemlending
d reno. r
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for. APPLICATION ISSUED BY• • DATE
which this permit is issued)section 3097.Civ.C)- imj/- '************************** ****** * ** ** ** **** ************** a ***
LENDER: r ************************************************ ******************************
ADDRESS: LEGALIZATION:N F E E S U M MAR Y ' STRUCTURAL SEGMENT:N
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 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5,00 .
repair any structure.prior to its issuance.also requires the applicant far such permit to file a signed'statement that he/she is licensed . . - 25 SMIP/NON—RE$
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
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 penalty of not more than five hundred dollars($500). ISSUE FEE . . 3.00
' BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK • TOTAL PAID DUE
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS---->' 5.00 3 ,OO 0.00 8 , OO 8 .00 ,OO
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law
does not apply to an owner of a properly 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 REVENUE DIVISION TOTALS--> COLLECTED: 8 . 00 OVER/SHORT• - 00 .
orimprovement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT/TOT GRADING PLAN—•
for me purpose of sale). CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business - B •OO •
•
❑ 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 contractor(s)license pursuant to the Contractors'State License Law).l am aware ***'*'***************************************************************************
that proof of 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: ' PLU 1 SEWER, BUILDING / TRAILER 5.00 5 . 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 Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
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 laws relating to building construction and hereby authorize representatives of this y to enter a the above-mentioned —.
property for inspection purposes.pp •
Date:— — CD Signature: �1 _ v Ii/• / / 01 0073976—b00?3976 TEET 8,00
9 r DAT_• 11/09/91 TINE: 15:07
Driver's License or Social Security v:
t 64r'46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor - '
•
CONSTRUCTION AND PLANNING - POI. . SPA _
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole., ' 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. o' r 53. Steel Reinforcement
sr - ,a _
r . 3:EIectricaI Condult,f truly:Undrgrnd..r _ 54. Forms
014:lElectrical ConduituUhdrgrnd. - ^ 55. Electrical Bonding
•
r: .:STeel Reinforcement .forceent `.
�S ,,. 56. Rough Plumbing & Pressure Test
tr, 6 CE-ectrical UFER.Grnd. • -_ 57. APPROVAL TO COVER-GUNITE -.
-';7:•'_Footmgs . CC Crr, - 58. Electrical Conduit-Undrgrnd.
i-,8. Foundation it _,f' ._ 59. Gas Pipe, 0 Undrgrnd.,Test C/' o
•9. Water Pipe-Undrg nd. 1 ) 60. Backwash Lines,P-Trap,0 Undrgrnd. -
10. Structural Floor System ._ j 61. APPROVAL TO DECK 7-4
IX. Property Sewer Line & Hous%Connection ;;fgr/�rAy� 62. Backwash & Receptor-Final
12. Sewer Cap a• ✓� nq. r!,) %/I!� 63. Heater & Vent-Final A• )
13. Roof Drains -
- 64. Plumbing System - Final /' 7,
14. Rough Plumbing rt, ;�>ij. 65. Electrical-Final ,
15. Rough Electrical-Conduit yf ' 66. Solar System-Final ,---- it%
16. Rough Electric Wiring / 67. Fencing & Access Approval
17. Rough Wiring Sign _ 68. APPROVED FOR PLASTERING
18. Rough Electrioal-T Bar Ceiling 69. POOL/SPA SYSTEMSFINAL ,t
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -
._ ... .. - - - - _ . .. - -- tY tr 7
20.r-Rough Factory Fireplace I s.i7 w = ' ' a ! :APPROVALS '=Permit# ' -
r ._ w <, .; ,rr- az u: r S .4 ,.4' & .' r
21f Duct's, II Str_ucturet I , S '7 - N. .70. Underground Hydro - -
22. Ducts, Ventiltirfq.. , \? _ _ <T '- '671. Product`Piping 0 Gas OOil
23r,Gas.Pipe:Rough &Test ; ,,. -• ..n c .y - • :; _72• Underground Flush. x
24::-Roof Framing n ro I HH "I" ?• C s „1. 1' 573�_Undergrnd:StorageTank ID Gas 0 Oil
•
25. Roof Sheathing t- ; c' Ir -i > p1'. -a 74 j0verhead Hydro: .
26:-.T-Bar Ceiling (Structural) &1Monocoat -I' - 111 C' :re:* .i. 75' ^Dry Chemical ' '
.. .. c<• ti • 7.I rt' : I !'\ -
27,-Frame and Flashing76 Dr Stand I e 5. L. `r
1.228.'Lathing-& Siding7i r-is„;;. :r: 4: :[: F_ i. ••:Y I, 775f: FIXED SYSTEM FINAL'
[:t
T29. Insulation "i .) I ' `• •• ' '' I r - I
,;t ; .S I [. ,\ 78?FIRE PREV. FINAL > r .:
r30. DrywalliNailing = •
\ ill t -` z- _'-1 •HEALTHiDEPT_. REQUIREMENT
.31. Plaster Brown Coat S r [. til!. ` '
;79FlNAL`INSP.ECTION
t'32:;Electrical Power;Meter:Final: . CU .I :, r801rFOOD CERTIFICATE ISSUED
s33.fFinal Electric r- :' T -,:- `� •, i-f. 'Notes: �I _ ` t--Rt
34.-Final Heating&Air Conditioning; I 1.-.1..,' n x V:C_ •
. .r1 .- . '- li' - .r -.
• 35!rFirial Gas Pipe-Test• - I _ �' v -• r' :^- - •
I I _ x - 11 w `�J •{_: 1 r it {
.x36:•-Hood or Canopy[; " - I `. .. - - i• I .I eI; S - . , - -.
37.-Final Factory Fireplace r " a .y ,1 �` £ ^o = II i-
CJ
.-.38. Final Plumbing •.. 1/u�/Q(,� •.L' ? .. S _ .t
(739. Wafer Service-Final- ; ft T ` 4-`I'1•L. -, r ter" . -
, l:
z , t* r
740. Gas Service-Final - .`t= „ Cr.. �' /:: v 0: vti; `
?C41. Solar Domestic-Final.: t. - - I \!w " r it; :•
- 42:'Backflow Preventer' '� I I'- :• .-, < - '
_ 43. Backflow Irrigation'' -- - , i. - �_
L' . a.
44. Landscape Irrigation System;• _, z Y _ - ;; •'X !+: :- c
.:45.:Sound Attenuation I >• i--" :- "" '" '=c= 'i'•'y
-.46i,-Handicap Regulations =" - J
s, a
47:sFINAL STRUCTURE & BUILDING I{I .
48 f'FIMALPLANNING E-:-' aI 1/.P s
. p: I Illi. . r .r
_49=Electric Release to-Edison • - S✓:, r'.
-; a
°_50„Gas{Release to Southern California Gas Co f 14,_/;1;< 'i , , C: -
,L51. CERTIFICATE OF OCCUPANCY 11 •i, .r S ;-t lila, i.., c
No. Date
OWNER HESLIN, BARBARA - DATE 7-7-61
JOB ADDRESS 260 Sierks Street BUILDING PERMIT NO. 1/[826
GENERAL CONTRACTOR Swim Pools by Whitaker VALUE $ 2,700.00
AP.No. 118-141-02 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt,swim soca
INSPECTIONS DATE GROUP TYPE ZONE R-1
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas / _ SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating _
Rough Plumbing Coppg.t euL
Miscellaneous Rorort. f;jtt+4 y - v .a., h. la2.`r9,.b., 7—C l 7o3Wl
Prop. Swr. Line Houde Con. St.'S*r. 4
Sprinkling System
Heating,Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring J1� e... Po.9n 6�wg:.�-oRa,.. 1 r
Trenches Forms Steel rill 7-A') -C/
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final ,GfffZ—
Electric Fixtures, Final J/ (� nD
Building, Final f j j}_j
OCCUPANCY
Form 210-5M-11-59 5-B P 11826
•
14826 FEE RECEIVED
`COSTA MESA BUILDING-SAFETY DEPARTMENT VI -JUL 7 19[n
P. 0. BOX 317 COSTA MESA. CALIFORNIA FINANCE DLR
For Applicant fo Fill In Completely APPLICATION IYON COSTA
TYPE OR PRINT
/t P� I� BUILDING
MIT= 4G o S IER, K.S `p I
COSTA MESA. CALIFORNIA For Office Use Only
R-13
yI es -` 1 RECEIPT NO. /%EPMIT NO-
OWNER •\R.V A 'C`�'�,/' �1`4�7` N(�1..��` if(aj nF.l[/J
MAIL 2G O �J to f\-.J V I • RECEyLLO BYI RECEIVED/I 1-1DATE —4
/
ADDRESS //�I���� !//AV� -7-1VO`
�.0 I`A Atri-qs 4 TEL.
NO. BUILDING
CITY /� ADDRESS
RCHITECT (12/ ti
8 / i TEL COSTA MESA. CALIFORNIA
OR ENGINEER11 L C" 1�A^ NO. Cb
ADDRESS 7 W • �" ' '\D" hves FIRE
/T ZONE "-� TYPE GROUP
BY
CONTRACTORS �1
I � �>d�'S I�CZ� PROV DATE /
�/ -T�� A i
ADDRESS 2 ` A" tle" . iONf/f�/ NO.OF USE ZONINGP NEW ,~�
CITY //�� ri I I PLANS I BUILDINGIa^ r/I
STATE I6 D 6 NO. / 8Og, 9 DESCRIPTIONLEGAL
rFL0I (2 t R 3 `-/ 9
LIC.NO. p /
SIZE 5 - •c�S SI Q• I INO.NOW ON LOTOF S ii ? --/�J/ 01
OF LOT I� U A.P.NO. [! /II
USE OF
EXISTING BLDG, p C. YARDS
APPROVED EVES
ALLOWED
SETBACK LINE PROM I. O 3I «.I. / (CENTER LINE ST.) /
CENTER OF STREET l ./ REAR YARD V FRONT /) FT. .1.0. IN.
��JJ I
SIDE YARD ILEFT q G ' RIGHT + R.SIDE ! FT. IN.
DESCRIPTION OF WORK L.SIDE ,a q , N.
NEW %3 II ALTERATION I II ADDITION REAR -- J FT. //��' IN.
REPAIR MOVING I DEMOLISH APPROVED /z �//1,DATE' / ? I
SIZE
S�X 3 (� ROOOMS STORIES l ,!
EXTERIOR WALL%44�,,,f ROOF
COVERING
COVERING +��
USE OF BUILDING AND WORK TO BE PERFORMED
()Tr 514_3 ( M ?06(
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-
PURPOBE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY INANCES AND E LAWS REGULATING
BUILDING CONSTRU 1 N. VALUATION /o--
SIGNATURE OF _ ` PERMIT FEE $
PERMITTEF Gni �/7D1 �C —5— w_
$ (�` PLAN CHECK $
AUTHORIZED AGENT 8
C
— TOTAL FEE $ 5---
II - S9 - s'7 Ni Cf
. COSTA MESA BUILDING DEPARTMENT FI a^,,iCE DEPT.
P.b. BOX 317
COSTA MESA, CALIFORNIA D!I Or cos-LA IiESr.
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 260 Sierks Street BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE,USE ONLY
RECEIPT NO. P6$g.1 j1 39
OWNER Santa Ana Ranchos
RECEIVED BY DATE RECEIVED DATE ISSUED
MAIL q
E. ('�]
ADDRESS 419 E. 17th Street . .�,- /)�-,7.V / DEC AA 3 W /
BUILDING
CITY Costa Mesa TEL
Li 8-1159 ADDRESS
ARCHITECT Carlson & LIC. COSTA MESA. CALIFORNIA
OR ENGINEER- Middlebrook NO.
FIRE
ADDRESS Garden Grove ZONE
CITY L ZONE NO.POF TYPE GROUP
CONTRACTORDikeLand Colegrove, aic.7333 P M v NS
' , 1
ADDRESS E. 17th St.COSta Mesa TEL.NO. Li g-1159 BYPROVEO DATE /
`EGA` LOT 2 0 CORRECTIONS
DESCRIPTION NO. 7 BLOCK TRACT 3 7
•
A.P. NO.
SIZE Eye NO.OF BLDGS.
OF LOT 75 x OV INOW ON LOT none
USE OF none
EXISTING BLDG.
SETBACK LINE FROM
CENTER OF STREET may' 481 REAR YARD 271
SIDE YARD RIGHT 51 - LEFT 5!
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION
REPAIR MOVING I DEMOLISH
1484BUILDING sq. ft.
SIZE NO.OF
ROOMS 7 STORIES 1
EXTERIOR WALL - .6.
COVERING s UCCO COVERING. comp.
USE OF NEW
BUILDING Single Family Residence
Garage Attached .
Plan No. 7420
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 REGULATING L � �BUILDING
�CONSTRUC•
L:
TION. �� / t_.-�f f VALUATION
PERMIT FEE $ 30.00
SIGNATURE OF
PERMITTEE PLAN CHECK $ 15.00
AND }y+ T�TTy�. INC. $ 121784.00
�THORIZED AGENT DIKE COLEGROYG' , CTOTAL FEES 45.00 VBME