HomeMy WebLinkAbout1370 WATSON AVE - Building Permits Applicant to fill in all spaces except those wit' order lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TR LOT NO. BLDG.NO. .
CONrei RUCTION PERMIT —//cS8Z. _ 5133 2/29/84 &0r( TI
Prbject Address I3 7.07w O14 a v tr TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION U REPAIR
1370 al r$O AJ /QVC ❑ CONVERSION CI DEMOLISH El OTHER A.P.# I Zone
Applicant's Mailing Address :
Owner's Name cal Cf"i 4'1-7 U (WJ J&. Phone5-9S53 DESCRIPTION OF WORK
S Main Building: Accessory Building: Z
Address "10 1.0 A-s.0 NI AVSE 0
TYPE OF PERMIT Li GRADING U FOUNDATION LI STRUCTURAL T Front N
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALB Rear I
Address 11II-- �IOTHER N
C Right G
1'T
Contractor's Name w"XIOW A11R.-. hone PROJECT DESCRIPTION SQ. FT. OCCUPANCY K R
CONSTRUCTION TYPE VALUATION$ S Left
E
Address mailing ZONE GRADING CU.YDS.
City License No. ACRES Q
Ping. Ref.# Park.Fees $
LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing • R
with section 7000) of Division 3 of the Business and Professions Code,and Use Of Building: E
my license is In full force and effect. M
License Class License No. • PLUMBING FEES Planning Notes:
Date • Signature E
WORKERS'COMPENSATION DECLARATION Bar Sink Showers N
, hereby affirm that I have a certificate of consent to self-insure or a certificate - T
Workers' Compensation insurance, or a certified copy thereof (Section Backflow Preventer Service Sink S
"800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No Company
8 Certified copy is hereby furnished. Bathtubs Sewer Connection - Automatic Washer Transformer 0 15.50 KW
Certified copy Is filed with the city Building Division.
Clarifiers 0 50+KW
Date Applicant Solar Collectors - Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher r
(This section need not be completed if the permit is for one hundred ($100)or Solar Piping Cooking Unit 1 Meter igup to 100 amps ] -----
less). DrinkingFountains
I certify that In the performance of th0 work for which this permit is t to I Solar Tank - Dishwasher Meter Dover 100 amps
shall not employ any person In any manner so as to become subject to the
Workers' Compensation Laws of California. Floor Drains . Swimming Pool w/Spa • Dryers ❑Gas ❑Electric Sub Panel
Date Signature
NOTICE:Ifoafter making this declaration, you Should become subject to the Floor Sinks Urinal Fan
Workers' Compensation provisions of the Labor Code, you must forthwith
Motors 00-1 HP ❑1%-8
comply with such provisions or this permit shall be deemed revoked. •_ Gas Service ,Outlets Water Closet F.A.U. Inc.Solar 09 15 HP ❑16-15+
CONSTRUCTION LENDING AGENCY
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I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater • Fixtures
of the work for which this permit is issued (Section 3097 Civ. C.) - 'Microwave
Lender's Name - Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILDER DECLARATION Outlets Range
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I hereby affirm that I am exempt from the Contractor's License Law for the P—Trip reason (Section 7031.5 Business and Professional Code: Any city or p . - Switches Sign
county which requires a permit to construct,alter Improve,demolish or repair .
any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains ' - Garbage Disposal Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of
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the Contractor's License Law (Chapter 9(commencing with Section 7000) of -
},5$..vision 3 of the Business and Professions Cotle) or that he/she is exempt . . Generator'00-5 KW 05-15 KW Trash Compactor
)lefrom and the basis for the alleged exemption:Any violation of Section
"01.5 by any applicant for-apermit subjects the applicant to a civil Reinspection Fee 3
LJnatty of not more than five hundred dollars($500). : Pa $25 Issue Fea $
I, as owner of the.property or my employees with wages as their sole - Reinspection Fee $25 Issue Fee $ 3 •
compensation will do the work, and the structure is not intended or offered - MECHANICAL L FEES '
for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to:an owner of a property who builds or Improves : Boiler' Hood or Type I 0
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thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate
employees, provided that such improvements are not Intended or offered for - Canopy Type 11 ❑
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sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground -
pletlon,the owner will have.the burden of proving he/she did not build or im- Building Approved By Date
drove for the purpose of sale). . Duct-Structural Refrigeration SystemApplication Issued By s ',�//'dr.I Date. �- /Tr
LJ I, as owner of the property,am exclusively contracting with licensed con- ❑0.700,000 BTU ❑10.0,000 BTU
tractors to construct the project (Section 7044,Business and-Professions code: Duct-Ventilating SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who : -
builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ : '
tractor(s) license pursuant to the Co rac},of t License Law). - . PLAN CHECK
AI 1 am exempt under Section t7 "1 -B.& P.C.for this reason Firepl/Fact.Blt. ICBG# $ PERMIT '
kit cc. P Ott,M WI - - PLUMBING $ ISSUANCE ,$
Date 2-- Owner W L• -'• --�^ Heating System& Ducting 'ENERGY P.C. $
• PLAN CHECK 25% $ C.
I hereby certify that I have read this applies on and state that the above 00100,000 BTU 0100,000 BTU /� D GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ (g i (/
andstate laws relating to building construction, and hereby authorize repro- - MICROFILM $
sentatives of this city' o ter upon the above-mentioned property for PLAN CHECK 50% $
Inspection gU�py�ez�. p '/
Signature wN"<-4^�., Date ZJyL�g7 MECHANICAL $ TOTAL FEE $ •�r 0 6
Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK 25% $ '
Drivers' License or 5S# • •
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CMF 0865-46 rev.12/83 White-Building;Canary"Applicant;Pink-Accounting;Goldenrod -Assessor '
- r.*CONSTRUCTION AND PLANNING - .POOL A r - _ . - •
APPROVALS Permit# Date Inspector APPROVALS ' Permit Date Inspector _
1'1. Temporary Electrical Service or Pole 52: Pool & Equipment Location : :. .
2. Soil Pipe-Undrgrnd. - - 53. Steel Reinforcement - ,_ 'i - • _ ,
3. Electrical Conduit Utility-Undrgrnd. 54- Forms„ - ..
r_ .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcement - 56. Rough Plumbing & Pressuie-Test - o
6: Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE-
7. Footings 58. Electrical.Conduit-Undrgrnd. - - -
8. Foundation '59. Gas Pipe, 0 Undrgrnd.,Test=- . •
9. Water Pipe-Undrgrnd. .60. Backwash Lines, P-Trap,'0 Undrgrnd.- r, '
10. Structural Floor System 61. APPROVAL-TO DECK -
11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final . - - . •• •
12. Sewer Cap '63. Heater & Vent-Final .
13. Roof Drains 64. Plumbing.System -.Final- .
14. Rough Plumbing 65. Electrical-Final- i - - ,
15. Rough Electrical-Conduit - - - 66.. Solar System-Final - -- .- ' - --- '
16. Rough Electric Wiring - - - -67. Fencing &'Access Approval -- - - - - " '
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING -
18: Rough Electrical-I Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT .
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20: Rough Factory Fireplace APPROVALS Permit# _ -
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21. Ducts, in Structure - ' 70. Underground Hydro , ,
22. Ducts, Ventilating , 71. Product Piping 0 Gas ;D Oil i _
Gas Pipe-Rough& Test025.
72. Underground Flush! _ - -
Roof Framing •- • 73. Undergrrid.StorageTank 0GIs-0Oil - '
Roof Sheathing 74. Overhead Hydro -
i .
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - ,
27. Frame and Flashing 76. Dry Standpipe ! • ..
28. Lathing& Siding 77. FIXED SYSTEM FINAL ' - - 1
29. Insulation ' 78. FIRE PREV. FINAL ', ,
30. Drywall Nailing HEALTH DEPT. REQUIREMENT .
31. Plaster Brown Coat 79. FINAL INSPECTION ' '
32. Electrical Power Meter-Final „)1Y� 80. FOOD CERTIFICATE ISSUED
a,
33. Final Electric I ( ( _ N_otes:. _ '
34. Final Heating & Air Conditioning 1 - •
35. Final Gas Pipe-Test _ - - - ' .-
36. Hood or Canopy ' -
37. Final Factory Fireplace 1 ' r - , • -
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38. Final Plumbing • 3 - T ii
39. Water Service-Final l -
40. Gas Service-Final . .
41. Solar Domestic-Final - - - -
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42. Backflow Preventer -
43. Backflow Irrigation
44. Landscape Irrigation System , • - _ .,
45. Sound Attenuation - - - -
46. Handicap Regulations . . I I . `
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47. FINAL STRUCTURE & BUILDING I - ` 1 I ,
48. Special Requirements Completed I •
49. Electric Release to Edison - . --- • J '
50. Gas Release to Southern California Gas Co ' p
51. CERTIFICATE OF OCCUPANCY- - - - - . -j- .-- - '
No. ' Date - -- - - r- -
- 0 MAR 1 1 1957
OWNER TURNER;-WILLIAM J. DATE 11-23-56
JOB ADDRESS 1370-Watson Ave. BUILDING PERMIT NO. #3933
GENERAL CONTRACTOR Owner Bldr. VALUE $ 258.00
AP113-251-8
L... 154 BLOCK TRACT 1321 Block Wall
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GROUP .5 TYPE I ZONE 1 FIRE DISTRICT 11032
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
/ DATE NUMBER
Footing Trench &1 /�' 2.4-
Foundation
Foundation Forms and Grade to Garage
Rough Framing
Plumbing,Rough to Slab
Plumbing, Rough Complete 4 S/
Temporary Pole ifirnair /
Wiring, Rough �11ir' J
Heating,Rough le r /_ ....---
Heating,
'Heating,Final SS—
Sewer, House Sewer, St. Imr —aaller -
S- 'c Tank or Cesspool
L ng, In Out
Plastering
Plumbing,Final,Fixtures Complete
Plumbing,Final Gas Test
Wiring, Final g�
Occupancy / _/t/o IlL
FORM 210 3M I0.55 3993
Costa Mesa Building Department APPLICATION FOR PERMIT
111 EAST 20th STREET df122 BUILDING 1
COSTA MESA, CALIFORNIA
•
FOR APPLICANT TO FILL IN FOR OFFICE USE,ONLY
v car ��--_ _R_ecei_pt No.rd PermltiNo.
Building L370 W.g7s ..4va I— �I=193
Address
Costa Mesa, C&lifOrnia' o t4�' ReceivedRebyeDate Recd. Date Issued
Nearest �l�L .1 f e ,nn / ��— a2 .a 4- t 9 -, G
Cross St SrT.401.1A/ C N &/4Y - �7P n , Building
J. / '•nl, Address
Owner o4Fnr Costa Mesa, California
Mall M n 1
Addresss; (3 L 0 �1�nw4TjcM • v cr• 6i/, L (Nearest
Cross St.
City, (_.C,ti�'} •/I,LS}�. TNo./ Z,74/)5 onfl / I PNo.of lans I Type Group /)
Architect or Lia / 1
Engineer No. Approved
by Date
Address
City Lic. ,-, OIt C S
ItractoreV) Kota. No. I;t I•'S !f�...; ik AR iI�
Address r '.= diY Cr . ;"Es4
LegalLot i J rj:, .1.s,1 1 Tom'
Description I No. f 7 7 I Block I Trac
t.un.tcK. 1_4.4..G.:,I1_4.4..G. rcu
G. vcri. ,.
(Attach Metes and Bounds) )/ 3—.25 7.
// �y No.of Bldgs. 3 ��
Size of Lot 69 r\ '15 I Now on Lt / ti�'-„s_"- — OATh /1
Use of I No.of No.of �t�r� z
Existing Bldg. E51p2,JC2, Families) I Rooms$,N0 EI
Setback Line fromrG Rear Yard _j Z
Center of Street 7 'f- Side Yard - ty-7i— D
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
a
Repair I I Moving I I Demolish Ies
Building No.of
Size Rooms Stories
E-•-rior Wall I Roof —
ring ��� Covering APPROVALS i
L__of ge toe.•k V+ALL (CII 1-. x S i Tt P
Building Foundation Location Inspector Date
,1 Forms,Materials,
B\OGk Under-Pinning
- Frame: Fire Stops, /IV
' Bracing,Bolts i:
II hereby aclmowledge that I have read this Application p
and state that the above is correct and agree to comply Lath.Int
with all City Ordinances an State Laws regulating At
building cons}ructilon. a Lath. Ext
Signature old .1t _
Permittee )J.J �t,LLV Plaster, Int
Authorized Agt. Plaster, Ext. Q
4'
Valuation Permit Fee $ aa...— Masonry Reinforced Si
c��— Plan Check$ — Bond Beam Q
$ J Total
Fee $
FINAL
FORM 204 S-SF 2M 4-55
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SeruAc-Ks
• I-- ROOT - 5v + - .
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PLOT PLAN
Show location and distances from
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OWNER College Mesa Co. DATE 9/2155
JOB ADDRESS 1370 Watson BUILDING PERMIT NO. 1909
GENERAL CONTRACTOR Hale Co. VALUE $ 9,000.00
Iii2.1. 1514 BLOCK TRACT 2341
r
GROUP 1 TYPE V ZONE Rh FIRE DISTRICT #1933
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
F-7,
Footing Trench f� '-
Foundation Forms and Grade to Gaara7qe'� .‘
Rough Framing 0'_ 1-1.7 .,/
Plumbing,Rough to Slab '�' ,2 4) ,//
Plumbing, Rough Complete N/ .
2- 2 ..-J P�-,A�f-c�'h � ty- >� , s('_, _ .902 9 (
Temporary Pole � �/
Wiring, Rough 1--/(3 "a� �.0.-u- --.— ("fee-vI /��0—L //y��-
V
Heating, ugh /
Heatin m / s.h .,r,Q,, ,+2 ld- 7-SS _3 /1 Cl ��
Sewer, �O Ia1 Sewer,St. 6/0A (dti4_ (`a i, <----r
r 'lc ank or Cesspool
jog, Inu OutX eeGl S / ij —
• Plastering '` b ' 3_
Plumbing,Final,Fixtures Complete 9.(1. , ,ij ol.14T ArI/ /��I
Plumbing,Final Gas Test 1 r A i A9.C,J(sr.,L1-o ' /1 AM )€��� y//Y
Wiring,Final "Vet y'2 Lr)-C_ S r
Occupancy he.e 13r41-3-6.
Form 210 G-H 1500 1-55 '
,,,i,• ( . 9* esa Building Department APPLICATION FOR PERMIT
111 EAST 20th STREET BUILDING '1
wKc. taOSTA MESA, CALIFORNIA 1933
s—. FOR OFFICE USE ONLY
. ' 4C APPLICANT TO FILL IN I Receipt No. I 77
ee®N��
o.
Building
Address 1370 Watson Ave.
Costa Mesa, California Re y by Date Recd. Date Issued
/�� ISEP 1 91955 61-a�-5�
Nearest
Cross St. College St. Building
Address
Owner College Mesa Company Costa Mesa, California
Mall
Address 8002 Central Ave. Nearest
Tel. Cross St.
City Garden Grove No Le.9-2158 Zone/) is I No.of 1 Type ,/ croup
Architect orDavis
G Plans V
Engineer Davis & Quigley No, C-1790 Approved
by Date
Address 43 Malaga Cove Plaza,Palos Verde: CORRECTIONS
tractor The Hale Company No. Lbw 3422
Address 8002 Central Ave. .Garden Grove
Legal I Lot
I
Description I No. 154 I Block I Tract 2341
(Attach Metes and Bounds)
4935 No.of Bldgs 'Thi
u �
Size of Lot Now on Lot None 11`
Use of I No.of I No.of ) L(, 7�_ � V 1)3
Existing Bldg. Families Rooms J���
Setback Line from , Rear Yard 38' «�[C Z
Center of Street 52 Side yard 6 I ry r D 9 1 tg55
DESCRIPTION OF WORK 3L.1
New I X I Alteration I I Addition I CUSTA iiliS�
Repair I I Moving I I Demolish I CITY `!.F
Building No.of
Size 1310 Rooms 6 Stories 1
� for Wall Roof —
' ring Stucco Covering Shake APPROVALS
f New Foundation Location Inspector Date
Building Single family dwelling with Forms,Materials,
attached garage. Under-Pinning
Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath.Int.
with all City Ordinances and State Laws regulating
building construction. Lath.Ext.
Signature of
Permittee T HALE COliPAQPlaster,Int
Authorized Agt. Plaster,Ext.
SILVIA LARDNER
Valuation Permit Fee $ 4 a Masonry Reinforced
9( O Q CJ TICheck $ `3 Bond Beam
Fee $ oar...- FINAL
FORM 204 S-RP 2M 6-58
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• A: SEP 2? 55PisaEsa 627a •7c' '25.00
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Street
PLOT PLAN
Show location anddistances from
property line and between buildings.
OWNER TURNER, William J. DATE 4-19-62
JOB ADDRESS 1370 Watson Ave. BUILDING PERMIT NO. 16908
GENERAL CONTRACTOR Owner-Builder VALUE $ 5,040.00
AP No.113-251-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Add Fam.Rm.to
I 'ECTIONS Signature DATE GROUP I TYPE V ZONE R-1 Res.
Sou PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. ❑ Air Cond. 0
Rough Heating A-W V•j5-C z 4 Xze (/ �t0��v? ✓\
Rough Plumbing
Miscellaneous
Prop.Swr.Line 0 House Con. 0 St.Swr. 0
Sprinkling System
Construction Pole
Underground 0 Power ❑ -r� �p
Rough Wiring li It ir-5-4 " %117 =n-67 _!_
� O a__.
trenches LJ Norms U Meet Item!. LJ Kit k e -d 1 - r,
Floor System _
Bond Beam 0 Steel Reinforce 0
Sheathing ¢moi{_ - 6 2--
Frame
Frame and Flashing /1-C#7,_
Lathing — In R.-#-0111 Era".- ^
F er, brown coat r%f� 27�
L .g. 0 Air Cond. ❑ Final
Heating, Final —
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final ( A/je'A Cz. I Q(7i
Building, Final /�V`J (I CI'
OCCUPANCY
FORM 6114.5M — 7.61 16vu8
. lssos FEE RECEIVED
82
COSTA MESA BUILDING-SAFETY DEPARTMENT APR 1 S
F. O. BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT.
CIOF COSTA
For Applicant to Fill In Completely APPLICATION�FOR PERMITMESA
TYPE OR PRINT
BUILDING 1310 W 1 50 N Ain BUILDING
ADDRESS
COSTA-'MESA. CALIFORNIA For
TTTOffice Use Only
W 1111130%1V :Mat v3ty RECEIPT NO. I P� MIT yO.e
OWNER /(/L��• 5/°.l
MAIL RECEj BY I DATFJ'EC ?De DATELIBB SD
ADDRESS (�� 4 �/1T�� C
TNEOLLfb
CITY�O y�KAq BUILDING
ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
F
OR GINEER NO. __
AOL..0S FIRE P
��//��� ZONE PE 1/ GROUP•/_//��J
CONTRACTOR QfY At Lit B a'( BYPROVED= DATE 4j/ % .• 6
ADDRESS 44nta- ZONING
CITY C-040171414.544
ZONE F NEW Pi.»il
"� I I PNO.NO;
`BUILD1N0USEOF ��/M U 5
STATE TEL. LEGAL LOIS /S'-G/ TO . Z 7 y /
LIC.NO. �( NO. DESCRIPTION
F L
OOT (0? /� I 1 I NO. OF
NOW ON LOTS
I
A.P.NO. i l 3 — Er( — 0 9
USE OF (�� YARDS EVES
EXISTING BLDG. ROI PDX•• APPROVED ALLOWED
SETBACK LINE FROM / / (CENTER LINE ST[.) / .
CENTER OF STREET REAR YARD FRONT �'/Q,O4.( FT.4 en✓i,-,f IN.
SIOE YARD I LEFT I RIGHT R.SIDE C FT. IN.
DESCRIPTION OF —
WORK L.SIDE FT. i N.
II
NEW I II ALTERATION I II ADDITION IX REAR 3/ 'I FT. p IN.
REPAIn /y��yI III MOVING I NO. OF /II DEMOLISH I APPROVED .. /,O DATE ��e1t/67-
SIZE DING'D/� �-'/J ROOMS / STORIES / '"�/�1'I/'
EXTERIOR WAL1I ROOF �I/A Y�
COVERING alk Ca COVERING 'TTr#(�
LSE OF BUILDING AND WORK TO BE PERFORMED
%o '
0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATS THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CON UCTI ON. VALUATION /—
I PERMIT FEE $ u
SIGNATURE OF ill/$,- E't
PERMITTEE w`^'�+�"L `,�/ • L 1 _
$I` / X PLAN CHECK $ /Cl.5 L
AUTHORIZED AGENT l -f/ 5 d 0
TOTAL FEE • :St S
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 3!7 BUILDING
COSTA MESA, CALIFORNIA 10251
FOR OFFICE USE ONLY
FOR L PPLI 4LNT TO[��L IN Receipt No. Permit No.
BuildinAddress / /V WA 5OM /It
V'C.. I ' I 3 ., 7
Costa Mesa, California Received by Date Recd. Date Issued
Nearest / 4,�1 /•� I // " /7-a /A/5-4 t
Cross St. O I eC (l Qi ,( Building
rill" 0Os/ Ci/ Address
Mail / i hi r
Costa Mesa California
Mail / i C `e
Address �70 W / Ap7.2,51.
✓Q_'y/• ✓ ���/ Nearest
Citye Us nig /rW�j�/ Nol+4� 5--_
7 /-ylJ Cross St.
ZonI j ( I Nlans I Type // Group 9'
Architect or tic.
(!"� /
Engineer No. Approved
Date _
Address � CORRECTIONS
ContraMo
M1-t•, np 6w �k City Lie.
Address i S Legal �
Description I No.Lot ��� I Block TfSct'�y�1 //3–237–of.
•
'(Attach Metes and Bounds) 2.3'7/ // 3– .v 51-07
No.of Bldgs.
Size of Lot 6 X//5– I Now on Lot / • •
Use of y/I [ No.of No.of // t; F;^. f?vel �' I I 31
Existing Bldg. Il e J/6eeee. I Families/ I ROOM8C. _ !.F ll �� '.,
Setback Line from O Rear Yard V 'r ! J , ;.-- z
Center of Street + Side Yard.P.,1.-. _ CITY 0k (-O` l '1 ".-.,,,. D
DESCRIPTION OF WORK pLr.r:r--- " r
New Ix I Alteration I Addition _ s DEPT. REG.
.�� I
Repair I I Moving I I Demolish I _ BY_���_� :,T: //—
Building No.of pi ary T¢C Q
Size Rooms Stories
Exterior Wall I Roof —
Covering I Covering APPROVALS
APPROVALS I
BuildingewsLUilC� $/oC(C WALL Foundation Location Inspector • Date
Forms,Materials,
sill )c S/ X Ices Under-Pinning
Frame: Fire Stops, a
Bracing,Bolts G!
I hereby acknowledge that I have read this Application e
and state that the above is correct and agree to comply Lath. Int _
with all City Ordinances 4Jfl
}nd State Laws regulating Al
building construction. ALath.Ext.
Pignatueeofi/A__SignatureCA._.-r Plaster, Int
Authorized Agt / Plaster,Ext. O
W
Valuation Permit Fee $ Masonry Reinforced N
i Plan Check $ Bond Beam
$ Total (/, O
Fee $ ! FINAL 0
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PLOT PLAN
Show location and distances from
• property line and between buildings.
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