HomeMy WebLinkAbout502 STURGEON DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Atldress: 502 STURGEON DR
Suite:
Vicinity: 2ND STORY
Parcel Number: 41803214
Applicant: KUTCH, MARYE
Address: 502 STURGEON DR
COSTA MESA, CA �
Owner: KUTCH, NORMAN P
Address . 502 STURGEON DR
COSTA MESA, CA �
Contractor. O W N E R-B U I LD E R
Address:
Zip: .
� , . .
, AFch . , - � �.
Address:
Zoning: R1 R1
Phone: 714-546-0382 '
' Zip: 92626
Phone:
Zip: 92626
Phone:
License: 0
" En9:
Address:
Status: ISSUED
Applied: 03I14I2002
Issued: 03I14/2002
ISSUED BY: L�l^7� —
Phone: . , . Phone:
Zip: , License: � License:
SCOPE OF PERMIT
INSTALL DOUBLE PANE GLASS WINDOWS IN 2ND STORY BEDROOMS. 2 BAY WINDOWS TO THE FRONT OF THE
RESIDENCE (2 BEDROOMS) AND CHANGE OUT 1 WINDOW (BEDROOM) ON WEST SIDE OF RESIDENCE. KEEP EXISTING
DIMENSIONS AND OPENINGS TO COMPLY WITH 1997 UBC.
FEE SUMMARY
Plan Check: $72.31 " Calc Valuation: Sa,soo.00
Permit: $111.25 Claim Valuation: Sa,soo.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: 50.00
Inspection: _ $0.00
Total: 5184.06
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existina: 0
NOTES:
Rear 0- 0
Rear 0- 0
Reauired: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Propasetl: 0
Riqht o- o
Right 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes end related
reguletions. (Ord. No. 92•28, § 1, 12•21-92)
EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
lor a period of 180 days.
INSPECTIONS: In order lor ihe work authorized under this permit to be considered legal, such work must comply with all appllcable codes, antl all
requlred inepectlone end final approvel must be obtainetl. Failure to obtain inspections end final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
µ� ���
WORKERS'COMPENSAnON DECLARAnON:
I hereby aflirtn untler penalry of perjury ona of the tollowing declerations:
❑ I heve entl will maintain a certificate of consent to self-Insure for workers' compensetion, es provitletl tor by section 3700 of the Lebor Cotle, tor the pertormance ot the
work for w�ic� t�is permit is issuetl.
❑ I have end will maintein workers' compensatlon in5urence, es requiretl by 58cGon 3700 of Ihe LBbor Cotle, for the performance ol Iha work for which NLs pertnit is iSwed.
My workers' compensation Insurance carder entl policy num6er ere:
Carner: Poliry Num�er.
(This section need nof be comO�etetll! Ne perm/f Is va/ued et one huntlred tlWlero ($700) or less.)
� I certily ��at In (he pertormance of Ihe work lor which t�is permit is issued, I shell not employ any person in eny menner so es to become subject to the workers'
wmpensation laws of CeIlPomia, entl agree that It I shoulE Dacome subject lo the worker9' compensatlon pmvislons ol Section 3700 oi Ihe Labor Code, I s�all fonhwith
campty with Ihesecpr�ovis oAns. �� /y� /,,/
�PP.�nt�Slgnature:—�//(�//��r iE�i.i.n / ale: �— � / ���
NING: FAICURE TO SECURE WORKE MPENSqTIpN MGE IS UNLAWFIIL AND SW1lL SUBJECT Ml EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
TMOUSANO OOLLARE (5100.000), IN ADOfiION TO THE COST OF ODMPENSATION, �AMnGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLARA710N:
1 hereby etlirm thel I em licensatl untler provislons ol Ghapter 9(wmmencing with Secllon 7000) of Divislon 3 of Ihe Business and Professlons Cotle, antl my license Is in full
lorca end ettect.LJc. a Class a
ComractoYs Signeture: Dete:
CONS7RUCTION LENDING AGENCY:
❑ I hereby ettirtn t�at Ihere is a construc�ion IenCinp agenty tor the pertormante ol l�e work for w�ich 1�I5 permii is iuuad. (Sec. 3097, Civil Code).
Lentlefs Neme: Lender'S Address:
Signatura: � Date:
OWNER-BUILDER DECLARATIONS:
1 hereby aHirm t�al untler penelry ol per�ury Ihet I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7037.5, Business and Professions
Code: Any ciry ar counry which requires e permit to canstruct, elter, improve, tlemWish, or repair eny strucWre, pnor to its issuance, elsa requires Ne apD���nt tor such permit
to file a signed slatement Ihat he ar she is licensetl pursuent to Ihe proNsions oi Ihe Contrectors License Law (Chepter 9(commencing with Sec6on 7000) oi Division 3 ot the
Business antl Professions Code) or Ihel he or sha is anempt therelrom and the 6asis br the ellegetl ezemption. Any violation of Section 7031.5 by eny applicant for e pertnit
sublecis ihe epplicant to a civil penalty ol noi more than live hundred dollars (5500).):
'' , as owner ol the property, or my emplayees wil� weges as t�eir sole compensetlon, WILL DO THE WORK, end the structure is nat intendetl or ottered for sele (Sec.
7044, Business antl Professions Code: The Contractors License Law tloos not apply to an owner of property who builtls or improves therem, and who does suc� work
himself or herself or ihrough his or her own employees, pravitletl Ihet such improvements ere not Intended or oHeretl lor sale. If, however, Ihe building ar improvemen� Is
soltl within one year of wmplation, the ov.•nerbuilder will heva the burden of proving that he or she did not build or improve tor purpose of sale.).
❑ I, as owner ot ihe proPaTy, am E%LLUSIVELY CONTRACTNC WITH LICENSED CONTRACTORS to con5iruci the project (Sec. 7044, Business and Protessions
Cotle: The contractors License Lew does not epply to en owner of property who builtls or improves Ihereon, entl w�o contracts for such project with a contractor(s)
license pursuant to the Comreciors License Lews.).
❑ I em 8 em er sec.
�SlgneWre:
wner ID vedtied by vaf icen.
Venfication oi Ownershlp Dy (type
Business anC Professions Code for this reason:
n ❑ No Ddver'S License No.
I.e. - pmperry tex bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PEHMIT CERTIFICATION:
Ezpires:
❑ I hereby cenify that no excavetion five (5) or more leet In depih Inro which e person is requireU lo tlescend, will be made in connection with vrork authorized by this
permlt, and that no building structure, sceflolding, lalsework, or tlemolltion or disman�ling ��oreot will be mora Ihan Ihirty-siz (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Ttle B, Calibmla AtlminlSireUve Code).
❑ As owner-hullder, I will not employ anyone to tlo work which would require a pertnit Irom ihe Divislon ol Intlustriel Sefery, as noted ebove, unleu such person hes e
permit to tlo such work Irom the tlivislon.
Signature: Oele:
Division of Industrial Safary Permit Number:
CER7IFlCATE OF GOMPLIANCE AND AUTMORVA710N OF ENTAV: I ceniy under penalty ol perjury that I have read this application antl state �hat Ne informatlon given is
correct. I agree to compty with ell s;are laws entl dry ordinances relatinp to builCing conswction, end authorize representatives of the Ciry of Costa Mesa to enter upon Ne
eDove-de �ribje� properry lar Ins ti p s. I egree t to occupy or allov, accupenty ol eny building authonzetl by this permit until tinal inspectim.
�°///C1�,,.P.��2���f��-�ri � -/ u--OZ
' � 0 Sgnatu e OI ner(s). . E. ? Oate� >
G>� .
AnNOr AutfrorizoC ApPlicant Date
GOOE �. INSVECTIONTYVE QD¢,
i616 Fixetl System Finel Fire Prevention
1286
200
201
202
203
204
Paol Spa Finel
Final Re-Raof
Flnal Block/Retaining well
Flnal Factory Fire Place
Final Sign
Finel Demolition
�$ �( INSPECTONTYPE
206 Finel MechaniCal
20B Finel PIum6ing
210 Finel Elecincal
212 Final Fire Prevention
220 Finel Planning Approval
222 Finel Site
250 . Finel Builtling/Occupency
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,�oowtssaraw�ou'c: 502 STURGEON DR
rnvNexsr�eivaawx: KUTCH, NORMAN P
monEss: 502 STURGEON DR
COSTA MESA,CA
�vr�. �uuxa �ooxess:
AfICNIfECT OH E1MdIFFA:
UNT:
FLOOD: X 4'7
92626
uc. xo:
ncx on �o.�s woxEss: urrt:
COMPACTd1'SNAYE GOTCHA COVERED ROOFING ( 310 ) 4 39-1661
cam�croas�Wiwo 254 �UINCY AV
�nEu LONG B ACH CA �c�, 591614,
90803 uNr:
LICENSED CONfHACTOFS OECLAPATION: I hweby elfrm ivMer penety d pajury Net I em IcsrueE uMs poneione ol CMq« 9
(commmtiq wtlh Seciim ]OW) d Oimian ] tl Ne Bue'ume eM Pidea�'vu COEe. eM mY Lcmr u in h0laca anE atlan.
cmuc.No.: uc.cuss: C 39 uc.r � 591614 EXP:
o�. j�/� �Lpr �������_�.-
OWNEfl BUIIDEP OEC4N�TION: I Iw�eby dfirm urder penety d parjuy that I em ssamq fmm IM Cartretlon Lironee Law ta Me
'bx+q ieewn (�ian )UJI.S Buaiwsa vd Rolwbna Cods: Arty <ry a couny whitli ismiuee e pamn to eonew�t. Mx. improve.
md'nh, a repei eny euucY�rte, pw u u ewerca, ebo mQu've+the eppfimnl fa ach penine io Rb e ipned petaireN tlet he a ehe
., r��e w�em io ma ao�=�,. a me com�eaore �.a �. �C�eqm 9(cammerc^Y wnh Seaion ]000) d Drvubn 9 d Ihe
Busirea W Vrdms'vo Codel or �hm M1e a ahe 6 exemP� tAerNrom ad �he beao la Ne eAepeE exemqion. Art�'vobtion d Safian
]03t.5 by eny eppliram fa e parmil ahjeda �M eppficanl to e dW panely d M mom Ihen fxe huMred doAen �55W�).
❑ �.mow�wra�MwW�r«mra^oM�•.anwageamine:.deoomw��:.,.»,9eou,awork.enau»aruau�oenawene.e
a Maeed lor eeb (Sectim ]Oad.Buvmes eM Pidesaoru Coda: TM Caurmwa Lirnx lew doee nd eDdY loen owrerM popMy
W�q �Ild43IX �IIMwA� IhBIlql. Blld M}q dOM 9Uf�1 Mq{'.11Y118lo IX �IlRG� IX I�IIMIQ�1 �1G IX h!! ONT BTi�WbO. C� Ih1 fYth
impovemmU ve ro� intendeA a dlared lar seb, tl. lwwe.er. tM buitluq a inpw'emeN o wld xrhin ar yaer d mmP�ion, the
ownmEuiMer will Mve iM WNen d pwiiq M w Ma EE nd drik u'vnpan lor iM pu�pose d aebl.
� I. ea ovmer d the popMY. am utlutivety ca4�atl�q wuh Gmmed cmvmaa b wnmw Ne pqatl (Smion 1WI. &s'vime and
Prolesaiona Coda: The Caureeae Licenx Lew doas m� epply �a an owrer d popeny wAo buitls or impv.•m Iheieon xk who
convecu tor wch p4bs wuh a mveeeMa) IicemeE WrswN �o IM CaNrsWe Liaeve ler.i.
� I un e�emq wEer SecYan: B. d P.C.. b N'v �maon:
De�e: �
i eo nmeM �.�r uw i.m awere a m,a uwd.i.m n» na�+am a ceuo�rce Haeen e�w s.rorv coa. seac�. zsws. usaa..ne
usaa. ene mm � or env nwre driwim ar+mem win � wn na (aeeb u») neee io eanWr wn.nid ws eoeae ene �ns mauimn«m b.
eD��laoomVuctionamadifrelbntrom�M�i�i enepe�antDotritl.ReaidMNmMrWuneGV��"vueroerem0�iromthew
prwiapne.
oms: �od�:
WORKEfl'S COMPENS�TION OECL�RATION: 1 MreEy elfim+ uMx p«uXy d paryry aw G the to0ovrirq detlueliom:
� IheweMwlmeimenece�dw�dmmmlb�epirmv�brxMen'wmp�vtlian.mpo+idedlorby5�mm9ro0dNaL�bar
COAe.lor ihe parlamuice d Ne wM1 ta whch Nb pmnG u usued.
Q i new.�d wie meimei� .,on`o� oomw��, ��w,ence. e. na�✓�a M seaion aroo a me �w« coae. m. m. wao,meno. d m.
•• `.��«�.n�mb°�mm�.a.MY�.S7ATE� FUND �°dry�m�� EXPIRES
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va��+�mw: — O1 /01 /97
�rnm ..aron oeee �w a. mrWMae. m. v.�� e ro, o,» e�ne,.e dm,n Isiool w b,,.�
� I onM � in iM pMartxrce d tM wak br xfiieh Ihb pemiC b iw�ed. I WY ea� ampb� eiry perwn in ury maniwr o m to
Decome eubl� �o iM worken compemetion lews d Celilortiie, uM epies Ntl J I a1rouN beroms abjea io iM xMa�e'
wmpenWiom m�ium Seaian �100 d tM lebor Code. I h' h mmpy �wlh Yo���ro,,,///qqq///������� /
Oete:� MG�cmi:��� �..w�l J
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Wiminv: F lun ro rcun wortwi compru�tlan rov�rep� Is ✓nNrM, urCWll wCJ�er �n wmylqr ro MmrW pmeltla uM
dvll flrros up ro om ��ndM flrouunC tldYn (JIOqOWA In MLRbn b M� cwf ol rorr�wrwtbn, W�p� �� pov1EW br In
Sxtlon 9108 0l Ms Wor CorY, IMrest �� �mry'� /ep.
CONSTNUCTION LENdNfi 11GENCY: I Iweby elfiim uMu psiMy d perjvy R� Ihss u a mMrWbn Wdiiq epxicy Ia tM
perlormenca M iM wak la whiM ihe permi o ewed (Sedvn ]09]. CM. CI.
LENDEN'S NMIE:
LENDEP'S ADUHE59:
I caniN thm I hew reeC Nu evWiraibn eM tlm. �hm Ne ebove'uJmration o cmm. I nW� �o camW wiln ell �YV eM muMy ardinancae
end alale kwe iele�inB �o Wikvp eonavuman eM Mreby eulhoe¢a repavenmtivee d Iho cry io amm uqm �ha ebaw�mantonetl properly
�°`1napetl�p1D°�°' ROHERT MIRANDA
�z� P��, � �C�
� o�a:
sy�m��e d wnpc��ucomaa«
(515NB.WP)
WhCe-BuiW'vq 8 Sdery: GmeMFle; Caruvy-Appf�en�; Pink-Rerenue; (ioldeneobAssssa
CT`fY OF COSTA MESP. — BUILD'iNG PERMIT
PERMIT NO; B 080590 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: STR
y�PERM NO: B U80S90
GOVT: N SUPP: N
PURPOSE: UTH
JOH DESCRIPTION : T/OFF SHEATA & REROOF W/COMP SHINGLES SQ FT: 7,400
CLAIM VALUE: 7,400.00 CALC—VALUE: 7,400,00 GROUP OCC: R-3 /U-1
COMMENTS: REROOF 2700SF RESID. W/COMP, SMOKE DETECTORS REQUIRED�jP�ER 94UBC
x�**it+e*iti��t�it�r**�*�***�rit*******�t*�-***x��t**+�*+rat*�r**�t*+�+�-+t*x-x�**���f1������
Z O N I N G R E Q U I R E M E N T
-------------- MAZN BUILDING _____S—E—T B A C K S— _ ACCESSORY BLYIi���� ��---
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: ET IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 41803214 ZNE: REF NO: ,
PLANNING NOTES>
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D E V E L O P M E N T S E R V I C E 5 R E Q U Z R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED HY: �]��1�� DATE: I�� Z��G
iEif�llElEiEit9Eif1!lkiEiFifiFiFfEiEltiElflt lElf7tiFM�lff('fEffif��F iF 3FiE1E
LEGAI,IZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/RES GRADING
PERMIT 137.25 ,7q
SMIP/NON—RES
PLAN
ISSUfi FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 137.99 0.00 0.00 137,99 137,99 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 137,99 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
137.25 .74
iE 1f �k IE iE k k 1f 1t iF fE 1E 1E k if 1E 1t if if 1E ik iE 1E iE iE it if k if if iE if iE 1f 1k itlE 1ElF 1t i! 1k 1! jf 1E i! iE IF 1E iE 1E 1E iE if 1E iE iE if !k if 1E 1E 1F 1k �E IElE 1E 1E if �f i! 1f fE iF 1f fE 1f 1k
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 7400 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 7,400.00
END OF FEES
DI �d219S24-00219525 T CFT 137.49
DATE: li/25/45 TItlE: !?:i8
�CONSTRUCTION AND PLANNING PC 1 SPA '
APPROVALS Permit # ' Date Inspector APPROVALS� Permit # Date inspector
1. Temporary Electricai Service or Pole - � 52. Pool & E4uipment Location�.-.
S
2. Soil Pipe-Undrgrnd. , t 53. Steel Reinforcement •� /
3. Elecvical Conduit Utility-Undrgrnd. 54. Porms i -�
4. Electrical ConduibUndrgmd. � 55. Elettrical Bonding /, �'
5. Steel Reinforcement � 56. Rough Piumbing & Pressure Test .
6. ElectricalUFERGrnd. 57. APPROVALTOCOVER�GUNITE �,,�
7. Footings 58. Electrical Conduit-UndrgmU. /+
8. Foundation 59. Gas Pipe, O Undrgrnd., Test ,i
9. Water Pipe�Undrg�nd. . 60. Backwash Lines, P-Trap, ���lndrqrnd. / 1
10. Structural Floor Svstem ��� 61. APPROVAL TO DECK �� -
11. Property Sewer Line & House Co'nnection 62. Backwash & Receptor•Finar �
12. 5ewer Cap � 63. Heater & Vent�Final
13. Roof Drains 64, Plumbing System � Final -
14. flough Plumbing ':�, 65. Electricai�Finai �,i
75. Rough Electrical�Conduic � 66. Solar SYstem-Final � ..
16. Rough ElectricWiring i 67. Fencing & Access Approval � �
17. Rough 4Viring Si9� 68. APPROVED FOR- PLASTERING ��
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEA�S FINAI �^
79. Rough Heatinq & Air Conditioning FIRE DEPT. REQUIREMENT
20. flough Factory Fireptace APPROVALS Permit #
21. Oucts, in Structure 70. Underground Hydro
22. Ducts, Ventiiating 71. Product Piping L] Gas OOii
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oii
25. Roof Sheathing ��-g� �6/ 74, Overhead Hydro
26. T�Bar Celling (Suucmral) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Sta�dpipe
28. l2thi�g & Slding 77. FIXED SYSTEM �INAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTFI DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. POOD CERTIF-ICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Faccory Fireplace
38. Final Plumbing
39. Water Service-Finai '
40. Gas Service-Fina�
47. Solar pomestic-f�nal
42. Backflow Preventer �
43. Backflow Irrigat�on
44. La�dscaDe Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. PINAL STRUCTUfiE & BUILDING ` �-�� �(�
48. FINAL PLANNING �
49. Electric Re�ease to Edison �
50. Gas Release to 5outhem Calitomia Gas Co -
5f. CERTIFICATE OP OCCUPANCY
No. Date
a08 ADDRESS 502 Sturgeon Drive
ENERAL CONTRACTOR Owner-Sldr.
AP No.418-Oj2-1 LOT 1
INSPECTIONS
OIL
AS
TER
ROUGM PLUMBING
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SYSTEM
MISCELLRNEOUS
ROUGH NE�TING �ND MP CONOITIONING
TEMPORARY SERVICE OR POLE '
UNDERGROUND � POWER �
ROUGH WIRING
TRENCMES FORMS STEEI REINF.
FLOOR SVSTEM
BON� BEAM STEEL AEINFORCE
SNERTMING
FR�ME AND FLASNING
LATMING — IN OUT
PL�STER, BROWN COnT �
HEATING, VENT., REFRIG. �NO �.0
PLIIMBING, FINAL RNO GAS TEST I
ELECTRIC,fINAL
B111L01NG, FINAL
:INAL
DATE k_14_
BUILDING PERMIT
E
SUBCONTRACTOR
,e
'✓ �
• ' 4581�
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
_, ADDFESS 6'QQ RtLrplEII 1%i'
OWNER N�imH� KYtiOL
MAIL '
CITV
CqryS(RUCTION
ARCH�TECTpg�, 1 M• StOIIe
OR ENGINEER�
nooaess 4801 E. AIIBhe
CONTRACTOR OWIIQ'i�
ADORESS
CITV
921.6 4/I�./70
TION FOR STRUCTURAL PERMIT
� / � PE
A.P. NO. / � ���
BUILDING � C� �
� ADORESS J/(/
'�'L. TRAC�j�/� LOT��
�546-0382
W P
v I
OWNER/�Di( �l�� U��
TEL.
NO.
Bea�h
FIRE
ZONE
APPROVED
DATE Y• / H' �'
USE OF NENf4[G �(�
BUILOING��yl� �Q�
3605'1 Tt
�
o-Fi STATE CITV VARDSAP7POVED VARDSAPPROVED
LIC. NO. IIC. NO. MAIN BUILDING ACCESSORV BVILDING
{r� SIZE NO.OF BLDGS. (FROM C/L STREET) J �/�
�+ OF LOT NOW ON LOT qpp�7 / � �G ,6
a �'F �•4 o�rr�j FA�v,r>
� EXISTING BLDG, I�LLL .
FN {►Qv ���% mlt/ �
Separate permits are required for �. sio� FT.
Q electric, plumbing and heating work. REAR �7� � FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
�"" DtSfANCE BEf. BET. MAIN &
Q MAIN BLDGS. ACCESS. BLOGS.
'� G X �� C/ �•Q VAR.9R DATE
Q F ..LJ ! L�� C.U.P.� qPpqpVE'D/
'� GTrJo Q ��� /1PPROVED �/ �
�. S�F/ICi ✓
o''C !�L 1Y0 �!C/ L1
w
� I �erebV acknowletlBe t�at I have reatl thif apPlication and stnte
n
y� ffiat the abova Intormatian Is eorrect antl agrea to comply wIM , �
d all Iew4 raquletinp buildinp conrtrucNon, antl I shell not employ m
Z any pafaon {n vtolation ot Ma workmsn's compensatbn lawn of m
,� me Stau o1 Callfornia. „
3 I hereev eenity thet I am prover�y Iieenaee as a eonvaetor under S�. FT, a
the Smte of Callfornia Bueinev entl Profevlons Cotla, Dlvleion 3, THE MOUNT SHOWN UNDER VALUATION IS FOR m
Chepte! 9, and that cuc� Ilcensas ere in full force entl effxt, or I THE VURPO6E OF ESTABLISNING A PERMR FEE ONL�':
em ¢xempt from Ma provisions of ihe State of Californie Buainew t0
VALUATION PERMIT FEE S a
entl Prtltessions CoEe, ONIsi 9. � / u�
m
PLAN CHECK s ^
Sipnatura o /� � �
Permlriea $'/�� [^n LL
`�� TAX E �7.� U
Author�iatl Apant TOTAL PAID E
�
— : ;.
"" . 2�546
� COSTA MESA BUILDING-SAFETI' DEPARTMENT
P.O. BOX 12M GOSTA MESA� CALIFORNIA BZ62E
For App)1caM to Ffll In CompbNly
7'YPE OR PRINT
�ooAe�ac �Z S�
COSTA ME6A. CALIFORNIA
� 6EfBACK LIN6 PROY
3
1 HRM6GY ACI(NO D{
I�ND BTAT6 TXAT [ �
VLY WITH ALL CI OR
euac�Ha cowsrnu a
BIGNATUR! OP
PBRMITT6
AUTHORIZ[D AO[N1'
Ixo. or e�.00s.
NOW ON tDT
� `
N[AR YAR
NIONT
OF WORK
JAN30-67 00 869� *�°}135.75
A►PIIGATION FOR PERMIT
BUILDINO
For Offlc� Us� On1y
R[Cil►� NO. Fl
own
ZONING
""�-
iRHANO BHALL B8 Ll88 THAN
YARDB MPROV ED
MAIN BUILDINO
� VM.SR
G �I P.
1 � 1�
fAC TXI� A�►LIGTION
ANp A011[[ TD COM-
T[ !AN'� RtpYLAT�NO
YARD9 MPROVHD
ACCESSORY BUILDINO
rrr. '
eer, rnw�N e
ACCE65.BLD08.
DAT6
APPROVED
o�Te �L�/-(O /
a
w
�
��°,/�d Ba. �. `T7/ �l`' � �
TX6 11YOYNT lXOWN UNOCIi VALUATON IB POR TN8 �
►U�'O![ OI if�AlYDHINO A PlpY1T P6� ONLY. �
VALUATION p
PBRMITFBE �O �
s0� � �iJ� �-o7`�J,/ w
� TOTALP66 �� J1