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HomeMy WebLinkAbout2092 WALLACE AVE - Building Permits 1. . COUNTY OF ORANGE - A BUILDING DEPT. • 3 , 3- , 636 No.Broadway Permit No Santa Ana,California Application for Building Permit • Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy . Date il—oZz erg ' r.2 2-1 /cYe� 1. OWNER'S NAME /d� w- PHONE:,,1petlas^4yl nl� MAILING ADDRESS--.-- - £ 7 •,7lt -e!.n-si"�-"" L- CITY.(-dajel '�— Name Name (Architect or Engineer) (Contractor) • • Address Address • City City State State Lie. No Phone --Lic. No Phone PROPOSED 99USE:.....-- -2.o.a...-r-! -. -- --- --A--:,,,,,,s 2. JOB LOCATION. l (/lS/ // �i„ O v (House No.) Z4..1'(Name of Street) (Twnoor drool istrict) 3. LEGAL DESCRIPTION: Lot....- ... -. At 2—, Block :..e. Tract-><f-w/a-.. -.c.°1-. ,-. Y°" 4t1--- (Metes and Bounds Description—Use verse side of form) aWte..ea.a 4. CORNER LOT ( . ) INTERIOR LOT ( ) THROUGH LOT (// ) SLOPE OF OT( ) O a R.-.z.-.,., 5. SIZE OF BLDG.JD .11241 'AREA 62 D SIZE OF LOT:..I?3..SX Igk...AREA• 6. HEIGHT OF BLDG • CEILING HEIGHT • NO. OF STORIES 7. NO. FAMILIES... Size of Smallest Bedroom - Size of Kitchen �J S. EXTERIOR WALL CONSTRUCTION:..J 'cINTERIOR WALL COVERING_..-�..,�P ta (Frame, Stucco, Etc.) .5-4 / j (Plaster-Drywall, Etc.)• '� 9. SETBACKS: Front Yard From Center Line of Street Nearest Side Yard....._i Rear Yard ' Distance in Feet Between Bldgs. on Same Lot • 10. A COMPLETE PLOT PLAN 1S REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width hi Depth in Ground 7/2 Width of Wall-.-.LO Accessory Bldgs. and Similar (b) Size of Stud=• k vt/ Spacing /4 "CC Material of Floor..-- Structures: (c) Size of Floor Joists 1' Y Spacing / 6/ "CC • (d) Size of Rafters 2 'I V Spacing /6 ' "CC • 12, VALUATION OF PRO OSED SJ2tK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage'disposj,l $..... O..b..�_ 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE 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 THERETO. Signed- ,7 . Plans Filed (Own r) By- ._,lr1a?era.. ,___...e6.44(2) , - a (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: ECKING BY • Bldg. Permit • S 3 - 00 GROUP / APPLICATIO . .. . HEALTH Plan Check - $ Q", TYPE FIRE 1----- ZONING y..-.. Total $ OQ DIST. �� MARSHAL Receipt No. G PLANS AND p �/ 9 .& 7 MAP / SPEC'S / t STATE Paid to .47--id SHEET NO...., CORRECTIONS ENGINEER Date /' Z-.1.^S.la VERIFIED CAL � 1fi rcC: UU16d lU • PERMIT ISSL1/4ED :h^c r ' f ' • I .5 ;G.iOR • DATE flieV -- r/j - . . nFpuTy .... 5 M-13-51 - '+ A METES AND BOUNDS DESCRIPT1, I 510 110 • 2I0 3:0 4,0 610 =1 :■■O •::a•: _ inns _---_ ■ . •:.- _� TWO 1111 .. • a= ► . 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ANENT■■11�i ■ ■ . ■■ .■ ■ ■ "::■: •' : :�■■'• anp:' mim �er::■■■::_i : 1111. o = ITL=- I I I : an 1-1114141111111011411. ■ e■ 11111 a ■■ ■■ wain _ s 1 1 1 ?74: 7 / g ' s° - 71745- COUNTY OF ORANGE �1 BUILDING DEPT. r 636 No.Broadway _ ' Permit No Santa Ana,California Application for Building Permit Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy. Q /� �. Date /— .2 -/S� 1. OWNER'S NAME •w`� ' ,/ .tom ! � L ti PHONEat ..//L+0G MAILING ADDRESS_...? ah 9 /l-i-e CITY... zt-na-e--� Name Name (Architect or Engineer) (Contractor) Address Address City City State State LicNo Phone Lic. No Phone 7 PROPOSED USE- �G/c — Slate r. - i_.LtC eea- .l...O 4 -214��1ut__`^in` z. JOB LOCATION ? sr- ' e -0I �cs''��O- I�-4- - (House No.) ( me of Street) , Town Cr School District) 3. LEGAL DESCRIPTION: Lot .net...Block ..410" — Tract (Metes and Bounds Description—Use reverse side of form) IN 4. CORNER LOT ( ) INTERIOR LOT ( ) THROUGH LOT ( ) S OPE OF LOT ( ) D LL _ 5. SIZE OF BLDG.:` •in. lc t$' AREA- SIZE OF LOT:._6. ,^�. xL)Sc `V .AREA• 6. HEIGHT OF BLDG - • CEILING HEIGHT- NO. OF STORIES 1 1 ft 7. NO. FAMILIES Size of Smallest Bedroom- Size of Kitchen ,1•/) S. EXTERIOR WALL CONSTRUCTION:...tliO.7T-O -.,_INTERIOR WALL COVERING (Frame, Stucco, Etc.) �� 2 (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard From Center Line of Street 4i Nearest Side Yard--..,_) Rear Yard Distance in Feet Between Bldgs. on Same Lot . 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width Depth in Ground Width of Wall Accessory . Bldgs. and Similar (b) Size of. Studs- Spacing "CC Material of Floor Structures: (c) Size of Floor Joists Spacing "CC (d) Size of Rafters- Spacing "CC 12. VALUATION OF,);ROPOSE%WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $-...1---U.0 •—'" 13. I HEREBY CERTIFY THAT TQ THE BEST OF MY KNOWLEDGE AND BELIEF THE 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 THERETO. Signed- •t"' �5 if) Plans Filed:._ L e--(,�) 6 3 C By:� . ���- FOR DEPARTMENTAL USE ONLY (Authorized Agent) FEES: CHECKING BY Bldg. Permit - $...2....0 0 GROUP - {tel APPLICATIOI thi1i HEALTH Plan Check - $ • 370 TYPE ZONING A FIRE Total - - Di $ 2,50 DIST. MARSHAL Receipt No. G c/2 -MAP e Y PLANS AND SPEC'S STATE Paid to - - �/ SHEET NO CORRECTIONS ENGINEER Date ( ) - - 51- VERIFIED CAL PERMIT ISSUED BY: ._L t v'rc 1 2- DATE ({...� ..OleIV /�}? L<`^ --. . thY S M-8-51 I ��—. ._ .. l-.. * • METES AND BOUNDS DESCRIPT - • I O 2,0 3!0 4 0 SIC 610 --L---- ' 1 1_L ' _ • - ._III keit C '-j-: =E98 .iji4i :: E! 1iI-L1bHH111 _ . ■■ ■.. ■ . ■■■■ni ■■. ■::■■ 11. 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E 19 .......:.:.:.99. ...19:1 9199 - :i.■■■ i:9 ■■■■■1i■1■■i■.i9.. ■■ ■11: -:74:-E: : ...p . 91 . ■1..■..■■■■. ..:1.1:11■.■ : _ 1111■ : 1■ ■1■ 1■■■i■1 :■■i1■ 1■ �_ _ _- . 1111 : ■ 111=1191:::8 :I16119:9 _ - -_ '1119 ■ 1119111a11e111�999111111- --- - - - ■ 1111■1■ ■■1 1111■■i■■■■ ■ _■ - 011111111111111 ■9 ■■■■■:■ 1 i■1■■1 1■ - o _ ■Ia• l88E1a99118::1981IIIIIIIIIII-U--m-m- - : e■891. . ■.■11. . ■■8■■.. .■■■ 9. ■i1 ■ iii .■. 1■■■■■■■■■■ . 8'9:9.1 : :: 1 ::89::::::::::8:�8::::o:: 8:1 -- --1 1911111 a 11111111111:11999:C91� EB 1_ -_ ___- . . 1111 . �= 1 .1111 E■ E. ■ ■i.■■1 ■■a9■■: :9:: :::.11::■ : - _ _ Bno 8■ : ■■■■■::■■■■ . ■1 ■i ■ - �H--___: 1 X18:9.E._e 411�In11111111�1 11 11 '_ I : 9 11 .1: ■■1 :.■ 1 ; ■ 1 __ --- - ■ B:�• Ilk : 8 1■ ■8 1111 9 1 991E_ �- _ + ■. ■ - -_--- - -■ - -I- ■■ •• . - -_EL - 111.1 ■88998:: 9■ _i ■ ■ ■ ■ ■1 ■ I=_I-__ = 1 . _-1 _ 1■ 1 9 11 1 99 -• _ E 1_ �-r-___�,1 =1-10= II99 AI e. _ .I___ _ _ o I I I �III 1 1 1 1 II I i OWNER GROTH, C. A. DATE 10-25-62 JOB ADDRESS 2092 Wallace Ave. ' BUILDING PERMIT NO. 18061 • GENERAL CONTRACTOR Owner-Bldr. VALUE $ 960.00 AP No. 115-311-5-45 LOT TRACT FIRE ZONE DESCRIPTION OF' WORK ] `a_h t & add�bath to Re 1 'ECTIONS Signature DATE GROUP I&J TYPE V ZONE R-2 Soil - b- -// 4.7I-4y . PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water k,4 l -at_ Rough Corn. Refrig. ❑ Air Cond. ❑ Rough Heating1- -- ..W...-- Rough Plumbing /7 7_.(0,_ _2767X ..TMiscellaneous _ _/�Prop.Swr.Line use Con.8-St.Swr. ❑-ej /4.4,..Z ,,(/`C-..v�� f63 3 7y 4J�-- Sprinkling System �'Z- 3 y �/'� Construction Pole - Underground 0 Power 0 ..- Rough Rough Wiring -tag' /7 -Li .4 2. el-w->�,c.- L 1 �-., //-at-e? /fl-oS Trenches 0 Forms 0 Steel Renna. [f' {er]_6?,..' Floor System _ Bond Beam 0 Steel Reinforce 0 /-'-Yh / fix'_._. Z Sheathing r 2-Ty / Frame and Flashing _ _� Lathin In aj ��� g — C��Outm�,vLl/' `�M (��l`6�-%'Jf'!_/_-2-‘3 F 1r, brown coat / h .g. 0 Air Cond. 0 Final Heating, Final Plumbing Fixtures, Final A94'5 41-2--0 Final Gas Test /S 444-5. 49-`z--63 i Electric Fixtures, Final i /vv 67/ 5C- ‘` 1 Building, Final ��-t, 1 OCCUPANCY FORM BOE•5M — 7-61 1 53!1(.'1 , 1`tt hli `'" \ 1..,j�. J ' ;M• . _ 1 j* ' • 1 18067 OCT 2 6 1962 ' COSTA MESA BUILDING-SAFETY DEPARTMENT Fill ,G� TE�.''\EN,C\\ P. O. BOX 917 COSTA MESA. CALIFORNIA Cmy CiY l y� .IES\ For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT PRINTBUILDING BUILDING 02.06l� Of( i /4j 4�' N4BUDRESS • CO�1 TA MESA. CALIFORNIA For Office Use Only /1al-ft-24r / i/2 I RECEIPT NO. I PPEERMI/T�No. OWNER /` !//L/ I �P� MAIL /� ` Real • BY DA SIECEIVED 1........, DATE ISSUED ADDRESS _ 2 L (/._ S , ' -oI. 1.1 ., .d-- TEL. �, CITY N ,d gBUILDING ADDRESS AR' SCT TEL. — COSTA MESA. CALIFORNIA OF NEEgY`-/, . ,4 ���-- �NO. ADDRESS •-----• ZIRE J Y I ZONE ,L_� TYPE GROUP^ 4J' CONTRACT° / - /: ___Z•2_. AAPPROVF,Di /1 y DATA//jO ADDRESS// wy -is /L ZONING I / 99q CITY ('G ZONE, — I PLANS a I BUILDING R I Vo.,-74...., 1 STATE _-_ TEL. LEGAL ,p /7`Z a/4 4 G -orate LIC.NO. (� NO. `- DESCRIPTION ��' /N {/ (��L OF LOT/ ,] k /75-- I NOW OON LOTF S / ii 3 3 / LC-- / 3 A.P.NO. USE OF YARDS EVES EXISTING BLDG. /, ('' APPROVED ALLOWED CENTERSETBACK (CENTE OFLINE NSTREETM x/7 5`X, REAR YARDS,/ FRONT LINE Si.J#q C4 T. �X�,_/. 17 IN. SIDE YARD I LEFT �/ 2. > I RIGHT /J` Y r/4 r /s� R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE FT.z Fr. IN. NE' I II ALTERATION I H ADDITION I REAR 7.4° Ft _ IN. REPAIR I H MOVING I II DEMOLISH I BBYPROVED fr, , DATE �e�t S/ � ( SSIZE DING1....-A- ROOMSZ STORIES / �Y7V EXTERIOR WALL ROOF /� � /q/ COVERING „STcGCa COVERING( �F.... lbCe USE OF BUILD! G AND W LI TO BE PERFORMBiI .. / , s/ • A, 1 / "--_ e .moi /� a . i if 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 ATE LAWS REGULATING BUILDING CONSTRUCT! VALUATION SIGNATURE OF /' jN c ^ PERMIT FEE $ U� PERMITTEF ✓ $ / . ///� PLAN CHECK $ I AUTHORIZED AGENT /_ — p TOTAL FEE •- 6 is. o OWNER GROTH, C. A. DATE 11-21-62 JOB ADDRESS 2092 Wallace Ave. BUILDING PERMIT NO. 18265 GENERAL CONTRACTOR Owner-Bldr. VALUE X200.00 AP No.115-345-45 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Add firepl.to - Res ?ECTIONS Signature DATE GROUP j TYPE V ZONE ft_'Z Sou _ PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing _ '*t l/ Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power C Rough Wiring """ ��� Trenches 0 Forms 0 Steel Relit ❑ �P' � R/L //-y'jtiy Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing — In 0 Out 0 ;•.ter, brown coat 0 Air Cond. ❑ Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final Cid• enFa 441 '/ OCCUPANCY FORM 8t14.SM - 7.61 .1 R94 182 FEE RECEIVED NOV 2_1_1982 COSTA MESA BUILDING-SAFETY DEPARTMENT VfINANCE DEPT. P. O. BOX SI? COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT /n�j/STYPE O/R,PRINT 21.-.4. BUILDING BUILDINGADDRESS oma-'`� 7� L�A C rt/9- MESA, CALIFORNIA�� For Office Use Only OWNER ( t v /{ D7 /� - _ I RECEIPT NO. / DAT IT U& MAIL y2 / }• �e�} /REEC IV BY O EECv71,(,/{D_oi DAT lion-- OWNER DD 'j� . ADDRESS ai Y Co4_ :S I(z+.. /_/c-„!i/ �!`„' ' I�� lib L!/ /i ov !C/ TEL. BUILDING' ��J //�/J CITY N�/ 7OA ADDRESS C>C ® W Fv,EGT INEER +Lc P ]'.7T///'' /_ _ TEL. NO. COSTA MESA. CALIFORNIA O' 4 FIRE ADDRESS q�L/ /�/ �Q • / ZONE (/e-TYPE Ab- CONTRACTOR 0MAC� /cJ a lie . APPROVEDts, " 2�. ,1.�'�. c9 �� - BY �'f�/'y+�1 DATE '/.2--/A Z.-- ADDRESS ./ADDRESS ZONING .„f.; ,- ZONE R.7-1 r/{� NO.OF USB OF NEW CITY l \� PLANS BUILDING STATE .--.. TEL. LEGAL ` 2 ( 4J ..-16/ LIC.NO. y NO. DESCRIPTION )--- SIZE �/ / I .^I NO, OF BLDr ,` OF LOT .ZV• F""7/ J Now ON LOT / ` A.P.NO. // 5 3 �5 - 4 4I USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LING FROM ..--.. (CENTER LINE ST.) CT /� CENTER OF STREET �/n REAR YARD FRONT �J Z) FT. �(T� IN. SIDE YARD I LEFT o '-� ( RIGHT — R.SIDE 42 . &'f. & I IN. DESCRIPTION OF -F WORK L.SIDE �] FT. N. NF - V ALTERATION Y� II ADDITION REAR ' x///999 -5-7T. f IN. /� REPAIR I MOVING I DEMOLISH BYI'ROVED/i .• O DATE /I-21 '7----------- BUILDING � BUILDING - NO. OF (/L/ ,-,/J�7/ SIZE- ROOMS STORIES EXTERIOR WALL I ROOF COVERING COVERING USE OF UIL INC AW.,WORK TO FORME, ezitice / °)I HEREBY ACKNOWLEDGE THAT ( HAVE READ THIS APPLICATION TH 4? DIONISPOKHE /AND STATE THAT THE ABOVE IS COR AND AGREE TO COM- PURPOSELISHING A ERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AN TE LAWS REGULATING BUILDING CONSTHU /. of VALUATION +L ga C SIGNATURE OF LF PERMIT FEE $ V'(' iJ PERMITTEF n $ Art el 2) ,'• _ PLAN CHECK S i-rt. 'S AUTHORIZED AGENT 1, TOTAL FEE n OWNER GROTH, Carl DATE 12-13-63 JOB ADDRESS 2092 Wallace St. a... . BUILDING PERMIT NO. 21122 - GENERAL CONTRACTOR Owner-Bldr. VALUE $ 9,131.00 / To. 115-345—k5 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Rea.wldet.dbl.ge I,.._:ECTIONS Signature DATE GROUP I&J TYPE V ZONE R-2 Soil L3- - PERMITS ISSUED Gas '37--Zey SUBCONTRACTOR DATE NUMBER Watery9Alffsaly S r/7-Cir Rough Com. Refrig. 0 Air Cond. ❑ 4 Rough Healing 2_,S -I 3-ZY 9710 4 acil, — Rough Plumbing in-/-1_(-1-7-01/ �- 3---"d0-6c7 -7 a'7 p — Miscellaneous i/ Prop. Swr. Line ❑ House Con. 0 St. Swr. 0 j27,(/,/fes 67.2e/64z /' -4..ni �� 3-.).i-‘L u/a G \ j. Sprinkling System 7 /10° Construction Pole //J Jl Underground 0 Power :0 Rough Wiring /is • l7,- .Cy ,t )-1 ,01 n % LA-Zs-1/4)14 2't. r xi Trenches '❑ Forms q Steel Reinf. 0 2 1 -z b ' t.1- Floor tFloor System Bond Beam 0 Steel Reinforce 0 Sheathing ��QQi 4_ /.d Frame and Flashing T:ea..' a 'Y— I-"Ming — Inl ' Outer'— j i 4'�i ar, brown coat o. it. /a(-/-, Retrig. 0 Air Con. Ti Final Heating, Final /`q� Yell / Plumbing Fixtures, Final /141-5 -3---2‘-‘4/ • Final Gas Test/C ^fJl//-,S ^.c-94-1.4i • Electric Fixtures, Final j'�/[�' 2 1 Building, Final rU i).c'' OCCUPANCY . Form BU4-5M-3-63—S-B p 21122 • 21122 FEE RECEIVED COSTA-MESA BUILDING-SAFETY DEPARTMENT4 Or P.O.BOX 517 COSTA MESA.CALIFORNIA TTFIN(INCE OLY For Applicant to Fill In Completely CIAPPLQCATIC7N'Ftlit•7ERMIT • TYPE OR PRINT BUILDING For Office Use Only BUILDING ADDRESS Z.(,fRECEIPT NO. ERMIT Off. f CO A MESA. CALIFORNIA � o [� /� /////JA.i% REG I{IV�[p0Y DATn - C WED • E ISSUED I OWNER (P. ; '/O/fX- f Z/Jv/V�•((S �j' P ' i�I MAIL' //��/�//J�JJ>> /th y O ADDRESS,-( t 94 gni Q,y ADDRESS ( f of I CJ•"�^-A" �— I Ce '//� '� A TEL.y/'/ FIRE ,. CITY � NQ¢'[. ,0// ZONE TYPE ! OROUPL y �/IV ARCHITECT / TE < r APPROVEDBt Of ";INEE•. .` �� N -F-3/ca w� A' L.(/ - r NTNG Ste.,ff/ AI ES `" � � - ZON[L. .l1 NO.OF USE OF NEW (2Ao. CO- - ,(//� gyp / PLANS ( I BUILDING:4g h ..i /. CONTRACTOR /YiLV�/'IPic- Gar' F 1 0'_ / _ /,J� INw'LC/ V LEGAL n / S-o-✓ ADDRESS��� n9�Z Ci<-' DHSCRIPNOf6A7�f-y off/ 1� !/ 7��& /� CITY «c///( C.? A.P.NO. ✓II .O- a LI - ES S NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL. E0^TO SIDE Q REAR P.L. LIC.NO. a,SL I yr NO. / J� �/ // / EAVES 4 VIE-CIT 3L�) /� /y 3 NOW ON LOTS / ALLOWED (U.B.C.REQUIREMENT) / YARDS APPROVED YARDS APPROVED USE OF - . I/ (I� MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. i :!/)'3/ �p (FROMC/LSTREET) e n SETBACK LINE FROM 75-/ j /..S—FT. I/ I �Drr. r/`- CENTEROFSTREET L) •/ REAR YARD //� FRONT �1 2 p^ SIDE YARD I LEFT /Cf:: I RIQHT'ILJ • 50 R.SIDE ,/EFT. JO/SFT. DESCRIPTION OF WORK L.SIDE 37 FT. !/ . FT. NE" � ALTERATION ADDITION REAR TIT. 3 FT. _____K DISTANCE I S ACS. Q REP...n MOVING DEMOLISH MAINAINBLDGS. ACCESS.BLOCS. LDGS. BUILDING}005— NO OF // VAR.# DATE SIZE ��fY✓�^ ROOMS Jy STORIES / C.U.P.# APPROVED r COVERINGWALL/. 'I COVE IR NG /,�/. BYPROVED I / l ! 0 TE --- L� Pri. USE 0- -UI5L1) GAN[ IRK TO BE PERE 91i MED ( &e ' O-I , 6112 t'-C-v -•-f10 (/ d R--4(/D 64.FT. -44a• � N � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATIO S FOR EF AND STATE THAT THE ABOVE IS CORRECT ND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY 0'•INANCES AND S• T LAWS REGULATING VALUATION ,q BUILDING CONSTRU.- I ! ��m PERMIT FEE 35 S.:, m SIGNATURE OF -� L'e /4 �T PERM ITTE f-,+� SG} • /,71) ---PLAN CHECK S re 0 / /eC f/ LL AUTHORIZED AGENT TOTAL FEE $