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HomeMy WebLinkAbout186 VIRGINIA PL - Building Permits ADDIttscc BUt. NG: 186 VIRGINIA PL uttE CITY OF COSTA MESA — BUILDING PERMIT ( OWNEnPWIEIPlawm: MARTA & OVIVIO GAVILAN PERM NO: B 083453 ADDREss: 186 VIRGINIA PL C ,M, CA 92627 PERMIT NO: B 083453 PLAN CHECK NO: 02487-97 L GOVT: N SUPP: N APPL.YAIUNOADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: CON ARCHITECT OR ENGINEER: UC NO.: JOB DESCRIPTION : CONST. 100LF 6 ' HIGH BLOCK WALL SQ FT: 100 ARCH OR ENG.'S ADDRESS: WIT: CLAIM VALUE: 1 , 000 . 00 CALC—T.TALUE: 2, 200 . 00 GROUP OCC: R-3 / • cONmACTars NAME: COMMENTS: SHARED BLOCK WALL BETWEEN 182 & 186 VIRGINIA PL COMPACTORS MMLD ******************************************************************HE************ AODRES& CN0 ZONING REQUIREMENTS then: SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby tem under penalty of perjury OW I am licensed under provisions of Chapter 9 (Commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. CITY LIG.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN. Dale: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT • IN RGHT: FT IN ^WNER lowing rreason(Section73ER p51 Blueness and Professions Cod A perjury ywhdi mpt ui'res theContractorsconstruct,License Law for PARKING REQ: PROV: PARCEL : 42606215 ZNE: R1 REF NO: amolsh,or repair any structure.prmr toils issuance.*Aso requires the applicant for such permit lo file a signed statement Math or she PLANNING NOTES> CONSTRUCT 10 LF 2 . 5 ' HIGH BLOCK WALL AND 100 LF, 6 ' i$IGH is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of D;vwon 3 d IM > BLOCK WALL ON THE LEFT 5 SIDE PROPERTY LINE. Business and Professions Code]or that he or Me is exempt therefrom and the basis for the alleged exemption.Any violation of Sector 7031.5 by any applicant for a permit subjects the applicant to advil penalty of not more than five hundred dollars(5531). ****-***************************************************************t*********** ❑ I,as armee of the property or my employees with wages as Ihei sole compensation.wit do the work,and the shoe:tura is not imended DEVELOPMENT SERVICES R E Q U I R E M E N„T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property (. who Grids or improves thereon,and who does such work himself a herself a through his or her own employees,provided that such \ ^I f improvements are not intended or offered for sale.I;hwever.the building or improvement is sold within one year of compMion.the ZONING APPROVED BY \// ` , DATE: owner builder Will have the burden d proving he or she did not build or improve for the puryme of sale). �� ❑ I.asovmerdthe propety.emaxdudMm ynlradiigS toenaedconbmmmwt orstohepgect(Sed;on70es,Busnssend BUILDING APPROVED BY : DATE: Professions Code:TM Contractors License Law does not apply to an owner of property who builds or improves thereon end w4 0 V contracts for such projects with arts)licensed pursuant o the Cont:.. e vi Iemexemgn..,sxl;orh:B "y B_BP.C.,brMi°neason:Ultr.H .UILDER APPLICATION ISSUED BY : DATE: �- !c 9s 7 ,sumer: . . Cr llk,,, • . • ******************************************************************* ** • LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y s :reby certify that Ian aware of and understand the requirements of Calf omia Health and Safety Code Sections 25505.25533.and 25534.and that)or anyfuore building occupant Willi will no(dmle one)need to complywih said stale cries and the requirements or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for constmdioaormoddicationfrom the Apr sty enagement District.Residential applications are exempt from thesePERMIT74 75 50 provisions. Date: Apdicam: PLAN 48 . 59 L•' _ SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE ❑ Ihave end wiImaintanacerilkateos coenttoself-insure for workers'compensation. o n.asprovidedforbySetion3700theLabor BUILDING—DIV—> PERMIT ISSUE PLAN -HECK TOTAL PAID DUE Code,for the pedmothe TOTALS----> 75 . 25 0 . 00 - c-48 . 59. 123 . 84 123 . 84 . 00 ❑ Heave end will maintain workers'compensation insurance,s required by Section 3700 of Code.forMo the Leta the performance of the work for"nknpermit ua°° o®°d.Myw° ars' p°°aakiaaan° ae °°dpoy°mbar °°: REVENUE DIVISION TOTALS--> COLLECTED: 123 . 84 OVER/SHORT: . 00 Oenw' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Policy Numbs: (This section need not be completed Ithe permit tsfor one hundred dollars WOW atMes.) 74 . 75 , 1 r„ . 50 • 48 . 59 ❑ bcertify eubdln the forpadomnkwdnMwaailaws of thisromaadagehetrM elaoyany person In dbecomeubje manner eonlo ************************************/*************************************** become subject to the workers'compensation on laws d California,Celiloeand agree Met H 1 should become sbjed to IM workers' compensation provisos of Sedan 3700 of the Labor Code,I shall forthwith comet"with those preAsions. INDIVIDUAL 'F E E BREAKDOWN Date: Applicant: ye Warning:Failure to secure workers'compensation coverage is unlawful,end shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(6104000),In addition to the cost of compensation,damage,as provided for In Section 3706 of Me Labor Cods,interest,end attorney's feet SFR 110 RES-CONCRETE BLOCK / FT. 20 . 00 2 , 200 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END>OF FEES performance of the work for which this permit;s issued(Section 3097.Cl.C). LENDER'S NAME LENDER'S ADDRESS: .j e —44 it I certify that I have read this application and slate Mat the above information is correct.I agree to comply with an city and county ordinances v 1; ' D '� and state laws relating to building construction and hereby aahor¢e representatives of this city to enter upon the above-mentioned properly lwinap°dion pease''MARTA AVILAN — Jct. i!/, JUN 2 5 1997 Pam Name 0a ter. (� bate: a 5/3 CI -f ' Signature d• •" nt/ApptoantrConirador / �• COS�� . AA Er $ (5151-46.WP) White-Build • - derby;Green-Ale:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor A CONSTRUCTION AND PLANNING - - POtJ� &.SPA APPROVALS Permit# -Date Inspector APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - _ 53. Steel Reinforcement --_? . „ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - _ 4. Electrical Conduit-Undrgrnd. ' • 55: Electrical Bonding - - 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test '• 6. Electrical UF ER Grnd. 7 APPROVAL TO COVER-GUIVITE 7. Footings • J/�_. 58. Electrical Conduit-Undrgrnd: 8. Foundation • { 59. Gas Pipe, 0 Undrgrnd.,Test ' • 9. Water Pipe-Undrgrnd. • I - • - - • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System ; - - - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - - 62. Backwash & Receptor-Final • 12. Sewer Cap - - 4 , 63'- Heater.&Vent-Final •- - • 13. Roof Drains i - _ 64: Plumbing System -,Fin-al , 14. Rough Plumbing - - ' 4, ; 65: Electrical-Final . 15. Rough Electrical-Conduit - - ' -66. Solar System-Final I •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 Heating & 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 009 23. Gas Pipe-Rough& Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas U 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 PREY. FINAL 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 7. 3, S' Strait efr ' VG YYYY 34. Final Heating & Air Conditioning -1/VII 0e yo to " al ^35. Final Gas Pipe-Test 3311(( // ( _ (7/�C/V 36. Hood or Canopy - 37. Final Factory Fireplace -- ' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final /, ,,> 41. Solar Domestic-Final I'C�3 r R �. 42. Backflow Preventer ft% -3 G 43. Backflow Irrigation Ir; S ,_� 44. Landscape Irrigation Systemti.. "- •- 45. Sound Attenuation . ., - . -C 467 Handicap Regulations - ,- 47. FINAL STRUCTURE & BUILDING 1..? f/ •, / ' _ `� 48. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY __ No. Date \. apt �R� DELETIONS, OR CORRECTIONS SHALL 1 LNG SAVETY Mqk Fy 0,c- ADDITIONS, 61111 D BE APPROVED BY THE PLANNING DIVISION p1V15>o�oF os n p �RFp��SNF G_1 - App #Cj 3 Jho/ ara •b.- and v �._. _'_ WOonti wnten C.O. N ee • ._r vj r�wns*AUS'fD ofl5E�Co µera. 01 1" APPR3 JiJD a ,esot eeipti �_toee M fi�ut `Pte"make.' won", ptJt u.... lto e • sNALL anvGnlotGosta CITY OF COSTA MESA nis . „mg* 5� PLANNING DIV. ciMIS Plan otan`1V°16 void ,in9 r eypai" 'On Neo V� 1 SUBJECT TO BLDG. DEPT. REG. Sta londafroi�an0 NJ to i. vii e*reoY nd meg zi p BY- „„„‘ ATE _', Ori .4'�. ano 1;:,.:, �m,n �":r Z t� S 1 (Ik h ' 41�Of "^v`,1\•U�1 'w yp, wi.„, f s. 1 , L.4, . ..,- _2 _ _ IC cs% l NJ ellel R[11DENCE RESIDENCE O - RESIDENCE RESIDENCE 1F Drs ital. it • h Ea t _1 — �-- STR�nE�nET9, a V I r"(I • OA:a(..1 7"E? &L1 ct ,62 o car 6x- -- 7 / 0r ,Db- Guj4y L� c1dtV 7 r • TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional ;711 GENERAL- NOTES ' Channel Block With 1.3/80 it Horizontal Top of all - --_ - Fences I 1 MORTAR: One Part Plastic Cement, and • Three Parts Sand For Fences 5'or Less i9 GROUT: One Part Cement Three and Vert.Bars 3/8" at 4' -0"O.C. Iii o One Half Parts Stand a = — COPING: One Part Cement, Three For Fences Higher Than 5' " u III �EH -� Ports Sand • Vert. Bars 3/8"A at 32" O.C. >- - — - _-- -- . CONCRETE: Well Mixed 1:2-1/2: 3-1/2 cc = Max. of 7- 1/2 Gallons of Fill Cells Solid With Grout I > 2 • _ " UI I Water Per Sack of Cement Where Steel Occurs I ll a ;o --- Reinforcing Steel Shall 2 -' �I GROUT MAYBE POURED FROM THE TOP Conform to Sec.A-15.39 w O - _ _ OF THE FENCE IN CELLS WHERE STEEL ' OCCURS. A.S.T.M. III c_, ~ I—I—�, CELLS AND AREAS OF HORIZONTAL REIN w n FORCEMENT SHALL BE CLEAR,CLEAN& All Steel to be Lapped �� v. FREE OF ALL MORTAR DEBRIS,ETC. 24" o!to Code Mill r NATURAL GRADE i otn " I - rime/41w N'a . \" . . I, . a TWO 3/8"0 BARS ''�� Dn ! s s CONTINUOUS TOP I •. &BOTTOM Hr—WIDTH • -.0, TO 16 0 C. MAX SEE CHARTS t. ' HOR%S.STEEL MUST BE TIED IN BELOW e. DEPTH OF CARTHTCOTH PLACE AT TIME OF TRENCH ' I/3 THE HEIGTH OF FENCE INSPECTION. 'p •• 1 j !- - .. ` j - SCOW BOTTOM OF FOOTING. ..• 3� . . • t o� 410,'• 2, "~ SCALE: 1/2" : li . r ,,FOOTING„REQUIREMENTS,CHART.,, ; 3 WALL HEIGHT .6'' ".i.--;..:-,.: _ 't +s. . .;>:5.• ..- ' ;>•�y . ;..i:4'... 31 WIDTH • +. 1,4” ..--.•-.--.-.. p. 5...-;y:.,.14,".' :. ;,:; :..cz.C',,, , 12".', i . . 12" THICKNESS . . . . . . . , '.10 10. '"`:•:P' !;:>: ; _' �:;'..8 , .. • . . 8 " DEPTH OF EARTHTOOTH . . ;. 24" . . . . . . . . .20 . .- . rt., -,--.:.:..1:z116"),. . . 12" SPACING OF EARTHTOOTH]. 12' '. ': t, e_I4' .. . . . `1 .. 6'I . . . . . . 16' i -.. f1, : :" . x. y.. i City of Costa Mesa, Califo�rn'i i. '` ~`1/f ' • r Building Department 3 IZHvnen NOV.82. . i ---" PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this 1 e f 1619-R day of , by and between ?Nee, I+eyo� hereinafter referred.to as "LANDOWNER;' and NOD C • &R Il i hereinafter referred to as "ADJACENT PROPERTY OWNER?' It is hereby agreed that a party wall will be constructed on the property line between 1(62 (J I(Ll,itiii f QLr h•-117 Io•'o V{Q(Pi r uA RN/6 (Address of Adjoining Properties) Nsryk . CAu Fc *-t•-0 cirtUr2,-4- in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDO R ADJACENT PROPERTY OWNER r /( 11 — e)• 7t Aic r (Signa tire) ( ignature) a >yt°e ey>�2 © v,dyrs 6 �� vsriAnt • Name (Typed or Printed) Name(Typed or Printed) \(62U“Z iNxA P fg6 • v . (7r-ice . (Address) (Address) NOTARIZATION REQUIRED 1906-46 • ?Iain 's ''R ig65S OWNER YOUNG. JAMES V. DATE 6-27-61 JOB ADDRESS 186 Virginia Place BUILDING PERMIT NO. 14696 GENERAL CONTRACTOR ROmar Builders VALUE $ 1,650.00 AP.No. 118-082-20 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK Det.pvt.gar. • r IcTIONS DATE I GROUP J TYPE V ZONE R-4 :ground Soil U.G. Water _ — SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing _ Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenches Forms Steel Qfv£ 7^1-4 —61 Floor System Steel Reinforce Chimney Re-Rod Bond Beam 'fig r 6 and Flashing yl e-- — 1^ .ag, In ut9 z/ —ro 4-- Plaster, —Plaster, brown coat • c—, . -7 --- Cep L Plumbing Fixtures, Final Electric Fixtures, Final Building, Final _ _ • OCCUPANCY Form 210-5M-11-59 5-B P 14696 FE c.... RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT ; [y' JUN 1610 MY • P. O. BOX 917 COSTA MESA. CALIFORNIA TT1 IN�ANCE DEPT. For Applicant to Fill In Completely APPLICATIONrlF6R'tkW MESA /gy�pp /TYPE OR PRINTQ�r BUILDING BUILDING ADDRESS /fJ C �e/l gi/w/A lL, COSTA MESA. CALIFORNIA For Office Use Only �.9�t_ �/ RECEIPT NO. JE ITNO: OWNER Yf/ /o(f/,.6. Ui MAIL ` ^ A�,y,//�O�T .,,,A RECEIVED BY DAVE REC VSD' /DATE ISSUED ADDRESS 7 22- �`"sw, /SQA i /!/ --V&r A/I c -.27`' CITY aQ r,Fr /4(Ef4 TEL. /)3.,) BUILDING AD ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO, ADDRESS FIRE Q ' q ZONE TYPE i GROUP. CONTRACTOR y//��j, �(�/�y4p��Sl/`^ ABYPPROVED 0a 71-DATE 0 �i ✓l/ ADDRESS 2132- /W)vPOn( 8LV4 ZONING 1„„(yy ,(/""""-t �9 ZO L I NO.OF I OF NENjJ.�' jl E CITY Or 7119 /Yi3:09 �`, PLANS/� / BUILDING,/B / ,1( /11 '/lV/�' LSC TNO./6B 6/¢ No:k/. 93.a?39 LLEBCRIFTION P6R ` a /^L/ ! V\ !-{.19 OF LOT .�j f x' /lo NO. O BLOTe.© \ A.P.NO. 1 l f .- 2 a . 3-0 NOW ON LOT USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) CENTER OF STREET REAR YARD FRONT 3 4 FT. .1.1-1-- IN. SIDE'YARD I LEFT I RIGHT R.SIDE ''��3 FT. IN. DESCRIPTION OF WORK L.SIDE } FT. • IN. NEW I rtLTERATION I II ADDITION I REAR S^ F/Tj. 6:1 INN. // REPAIR I II /MOO`VING I II DEMOLISH APPROVED ( �/ �� A// DATE (n r l6 ''.6 S ZE DINC>,M�x SSD 11�9OMS / STORIES I ` l- VV))” EXTERIOR W \ ROOF / ' COVERING J . VCCD COVERING /1.251/4 U7 ByIL�.11N$AN(J W R�` Be RFORM ED e .4-0A- Q/ f,I '.KL1 • 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 O'• CES AND STATE OULATING BUILDING CONSTRU • r'+1 VALUATION /y.�/: SIGNATURE OF ��,�N� Ap PERMIT FEE $ (y PERMITTEE (Inert �a $ c/) L PLAN CHECK $ �rq-4' AUTHORIZED AGENT ' �y p . TOTAL FEE $ Ma -O x OWNER YOUNG, JAMES V. -- - DATE 6-27-61 JOB ADDRESS 186 Vir•inia Place BUILDING PERMIT NO. 1/1695 GENERAL CONTRACTOR Romer Buil dere VALUE $ 15,559-00 AP.No. 11 R-0R2-211 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Si ngl a reg CCTIONS 7-/Q-6/ DATE I GROUP I TYPE V ZONE R-)1 :ground Soil/I4-#X U.G. Water S,$/,_ -7"/' G-' PERMITS ISSUED Underground Gas cfa' .7•-Z� �/ SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough HeatingCi_ Rough Plumbing � S i-irGr ,ta.a. a b,�T7>�o :1 t3'(.1 = 3Q�•]O. Miscellaneous Veriff Prop. Swrryine Housaon. St. Swr. 8175%6/ %.,,-.-,.._w Fril1`ici 7/ 3 7 Wr° Sprinklin(System Heating, Final /Al-ccl '' _(/ Plumbing Fixtures et/ !!/ . .( Final Gas Test ,f',Gt id I �✓ Construction Pole ` Underground Power `� N v Rough Wirint -' iT 77-6- • C +, - Trenches orms r Steel //G��nr— fl'S Floor System Steel Reinforce Chimney Re-Rod Bond Beam S' "gig /3 f-fl — /-- 4! , and Flashing ,13 `�` . St— / S — / .g, In Out Or; m a--„; 9' , 7 / r 6 / Plaster, brown coat ,) • .02 °— — — T 6 Plumbing Fixtures, Final Aft, g7;6/ Electric Fixtures,Final era f(/ Building, Final er —/ty ' OCCUPANCY I Form 210-5M-11-59 5-13 P 114695 • 14695 FEE RECEIVED 'JUN 161:,01 COSTA MESA BUILDING-SAFETY DEPARTMENT \Pi NARbt6RPT. P. O. BOX 517 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS �l MO/N/AikP COSTA MESA. CALIFORNIA For Office Use Only � '/ �/ RECEIPT NO. 1 PERMIT NOS./ OWNER. c%/In Lam. /(7(/ 69 1 /�// 9 Mp.IL /� ��77 RECEIVED BY DAJ� RECEEtVED OAT@ ISSU D ADDRESS 2-122-. eartviser it vP �L V�'`� �O-'..� ��! TEL. /� BUILDING CITY A f.�If NO. � ��.�Y pDDRE88 ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ^ ADDRESS FIRE b1j/�/ p.p — ZONE TYPE /V 1 GROUP c CONTRACTOR�[�-TQAlb �paiaA-e5 APPROVED *SATE //2 9/ �k ADDRESS L7✓2 /Ya4oc'ET .&4a. ZONING ,ts tiV4I �s7� ZQ'1�j/ NO.OF L USE OP NEWT it CITY . ,79 / n",d \n ._r 4' I PLANS J� I BUILDING U.' �U' /IC0STAr/%�• LIC.NO. WO 6�� No:/�'/ 9.9.3.E 9 LEGL DESCRIPTION PO R r4 0) I f '!' rnn� �<� / SIZE (�' I NO. OP NOW ON LOTS V A.P.NO. U '-.U .�( - d l• OF LOT �/ VVVV USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE PROM (CENTER LINE ST.) //^� CENTER OF STREET- REAR YARD FRONT Y 0FT. IN. SIDE YARD I LEFT • I RIGHT R.SIDE '/y FT. IN. DESCRIPTION OF WORK L.SIDE / 'FT. N. NEW I r ALTERATION I II ADDITION I REAR 34 FT. "fa IN./ / REPAIR I II MOVING DEMOLISH I) APPROVED C / A /I� DATE /p"lp2 BUILDING/46..2 0 ROOMS ! STORIES / lel(l am/i07 / SIZE ~/✓ EXTERIOR WALL�.y_ ROOF J� COVERING .0/4C-/-0 COVERING /rO Q USE OF BUILDING AND WORK TO BE PE FORMED �" 0 _neva"- �79L7/LY iuj. //y I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE A=-VE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY O • CES AND STATE LA REGULATING BUILDING CONSTRU VALUATION SIGNATURE OF /��� L PERMIT FEE $ 3 S— PERMITTEF LLL!!! ^J w $ / PLAN CHECK $ /7So 4 AUTHORIZED AGENT $lC.1- J� • 5-C C o TOTAL FEE 'j