Loading...
HomeMy WebLinkAbout2517 WESTMINSTER AVE - Building Permits — ' CITY OF COSTA MESA to BUILDING DIVISION :jam; 1 8 DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER ft a • PERMIT 06-01703 A (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caBIILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2517 WESTMINSTER AV Status: ISSUED Suite: Applied: 10/10/2006 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 10/10/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 43919104 Zoning: Applicant: EVE, DARYL Address: 5151 WALNUT AVE UNIT 2 Phone: 949-653-5722 ISSUED BY: Ail IRVINE,CA Zip: 92604 • Owner: SCHWARTZ, ROBERT B ' - Address 2611 REDLANDS DR-- - - i_ ': ' - . Phone: N COSTA MESA,CA Zip: 92627 - _' '1 ' V ' - , Contractor " SUNDANCE-ROOFING'CO, � Address./,5151 WALNUTAVE " - N v ' / UNIT 2\IR // z/;�� Phone: 949-653-5722 ' / >A` r VINE, - „� / V.0 ' % Zip: 92604/ :, • License: 718369 N /Arch ' ' "-/ Eng: " ' Address: __ Address: _ , A , � Phone: •- . Phone: • Zip: - License: , License: - - SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING ROOF(COMP/ROCK),REPAIR/REPLACE SHTG AS NEEDED,-2 LAYER-i 5# FELT,APPLY"30+YEAR COMP SHINGLES."20 SQUARES PITCH APPROX 3 TO 3.5:12 N FEE SUMMARY _ Plan Check: $0.00 - - Calc Valuation: 55,500.00 / Permit: $125.25 Claim Valuation: $5,500.00. SMIP-Res:- $0.55 SMIP Com: - ,H Other $0.00 Inspection: $0.00 '- - ' Total: $125.80 - ' - . . . PLANNING & ZONING SETBACKS MAIN STRUCTURE Front ,0-0 . Rear 0.0Lek 0-0 Right 0-0 %, ,-. • ACCESSORY Front 0-0.', , `Rear 0-0 , Left 0-0 - Right 0-0 " /, / PARKING v Existing: 0 _ Required: 0 Proposed: 0 - J1 r1i. 2 ll NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within-180 days,or If work is suspended or abandoned fora period of 180 days. .` '' • r INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 2446-48(8/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will'malntain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is I"cHad. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed l/the permit Is valued at one hundred dollars($100)or less.) ��( >t I certify that In the perfo ,•-- -•work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' / - compensation - if Ilomi: an. - _=?that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the : . ... .ons. //�S /� Applimnt:Stwmture: Date. �cr/O—fib WARNING:FAILURE TE( SECURE WORKERS'COMPENSATION ENCOST O COMPENSATION. IT UN.DAFUL AND SHALL SUEFOR I AN SECTION TO THECRIMINAL PENALTIES I AND CIVIL AND A O TO ONE HUNDRED. THOUSAND OOUARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECRON 37060E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 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 full force and effect.LJc.-N--.7/gy. nl Clesfl C't77 Contractors Signature_ Y a-P� Datef-• 49-/0-Ori, CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or 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 to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale,). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes ❑No Drivers License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: _ - _ Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air duality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection .urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. aa -re Of L:gal •n Date A4d/Or' ut o I t DOTE 1 INSPECTIONTYPE DATE INTIRAL$ CODE( INSPECTON TYPE QAIE erImAL$ 1616 Fixed System Final Fire Prevention - 206 Final Mechanical 1266 Pool Spa Final /� / 208 Final Plumbing 200 Final fie-Roof /0/L%'6 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy i 1 air N i":. .'�l �� 1 INTERNATIONAL TESTING CORPORATION I, �P O � 6173 Cherry Ave., Long Beech, Calif. Long Beach GA 2-6550 -GA 2-7500 - NE 6-7821 9 1670 Babcock Avenue, Costa Mesa, Calif – Costa Mesa Mi 6-4826 . KI 5-8888 '� 3552 Buena Vista Ave., Lemon Grove, Calif. — Lemon Grove HO 3-7751 REPORT ON SPECIMEN TESTS 6t1 T1s Identification No. : P-363-481- 5 Client : . C. E. Moseley Architect or Engineer: _ Contractor: Laguna Pools Signal Gwtite Structure : Swimming Pool-2517 Westminster,Costa Mesa) Sample From: West Wall at Light Mix: 4.5 - 1 P.S.I. 3,000 Total Water: Shot dry should be 3% Gal. per sack Field Nos . : Age : 7 Days 28 Days Specimen Nos . : JP-1 JF-2 !ltU Date Made : 9-9-63 9-9-63 4 Date Tested : 9-16-63 10-7-63 ROOT-) NOV 4 1953 Average Size: 6.25 x 12 6.25 x 1 g City of Cost D ^' mesa Area, So. In. 30.68 30.68 gpilda COMPRESSION ---, % ti l'\ Total Load, Lbs . 72,000 98,750 Lbs . Per Sc. Inch: 2,350 3,220 Specimens Made By: John Blauwnski Specimens Delivered By: Carl Moseley Specimens Received : . 9-11-63 I� �3 cc: C. E. Moseley (4) ��P % l _II_TERNA'iON IAL 1s4TINC CORPORATION DML:r 1� -.�� • CITY OF COSTA MESA CALIFORNIA, P.O. BOX 317 From the Office of the Planning Department • Regarding Building Permit No. 20+75 Date: Dec. 2, 1963 Location: 2517 Westminster Avenue, Costa Mesa Dear Pool Owner: The Costa Mesa Planning Department called at your property to inspect the Swimming Pool. Our interest in pools is for the purpose of safety and to be sure all provisions of Section 9298.9 of the Municipal Code • have been met. Section 9298.9: 1. No swimming pool shall be constructed closer than five (5) feet to any property line, measured from water line of pool. 2. No swimming pool shall be constructed under any electric power lines or on any electric power easement. 3. No swimming pool shall be constructed unless the yard surrounding such pool is completely enclosed by a six (6) foot fence or the pool itself is enclosed with a fence six (6) feet in height and hav- ing a self-locking type gate or gates. Note: (Gate should close and latch on a free swing). Your pool will not receive final approval until the requirements of the aforementioned Section of the Municipal Code have been completed. The following disposition is noted in reference to your pool: U No one was at home. EI No springs on gate. ED Improper latch or defective hardware. NO LATCH [J Wall surrounding pool not 6' high. 0 Other. c Telephone 646-2411 and ask for the Planning Department so that an appointment may be arranged. Since you have incurred certain liabilities through the installation of a pool, it is requested that these matters be taken care of as soon as possible so that your pool will be a safe one. Sincerely yours, 1i"Jy /6 By 1/ 0 „ / Planning Technician OWNER FINNEGAN, JOAN C. DATE APR 2 1964 JOB ADDRESS 2517 Westminster Ave. BUILDING PERMIT NO. - 220145 �e GENERAL CONTRACTOR Owner-Builder VALUE $ 1,860.00 - AP No.119-151-014 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Add Bath&Leun.ti INSPECTIONS �S'g ture DATE GROUP I TYPE V ZONE R1 Res S 1;��� �I'�,_ (-5--CV PERMITS ISSUED C $'. J7iiJ SUBCONTRACTOR DATE NUMBER Oki- .s-f -cr Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing M4-x 9-/b tu-S R-- ��l tH" 12-ea.__1-3-,T, j(a,— Miscellaneous ,,??�- Prop. Swr. Line El-House Con. 0-St. Swr. 0 1 .g( VW "72yrti uy.j 5/WI,y 4(',25'.L _- Sprinkling System O J /v Construction Pole Underground 0 Power 0 Rough Wiring (fl_ -.111/QGSl R e-g-�'c. j)//0/6 5( .- 3i 2 j Trenches 0 Forms'0 Steel Reinf. 0 / , 41 //— G i7-4 Floor System Bond Beam Va- Steel Reinforce di ff%/ -,2 , 47. deo, iiir G7-2"" Sheathing / i• ¢ ;CO -, /_'. Frame and Flashing / e. • 7 6 c ' Lathing— In p' Out,p� e _ j_ - ca li . Plaster, brown coat 12-e>--1-12-_ Refrig. 0 Air Con.0 Final Y„,oz 1,ng, Final k=' .,. •ging Fixtures, Final / an Final Gas Test Electric Fixtures, Final ke. 7-25 Gi Building, Final ------- 1j©/ C G6 - -- - - ' - - - - - - OCCUPANCY ,/ • Form BU4-5M-3-63—S-n P 2201ac 22045FEE RECEIVED COSTA MESA,boILDING-SAFETY DEPARTMENT APR 2 7 1964 , P.O.•BDX 317 COSTA MESA.CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT . _o • TYPE OR PRINT BUILDING For Office Use Only BUILDING 25 I . .7 ("T O' ADDRESS W \-N44i RECEIPT NO. PERMIT NO COSTA MESA, CALIFORNIA /�I' 2 0 V .. RECEryED EY DATE RECEIVED DATE ISSUED �� I OWNERyrkis&X t A arv,.MAILBUILDING l 7ADRESS I ADDRESS 'S' AI t _ lain Sao.. , TEL. �j ZONE TYPE GROUP.�FIRE 'q G CITY ./. NO. p 1300 \\VV//��,���- APPROVED ARCHITECT .j AJkWi'EL. BY DATE1$7A/- 0R ENGINEEnM.JJO. LI 4%LAr ZONING ADDRESS `L^ ll \/V 1�,C.„,,,v L. Ct ZONE NO.No: USE OF NEW 8�]1 r.V% yl /e4 I' PLANS 2 I BUILDING A CONTRACTOR ` ),,,N�t." 9 �.,L /� �N�/'y/HHHIf'/w L GAL ADDRESS ZJ I ' Wc,j._ .'I OA,D DESCRIPTIONEI.0� Y / 3 en ciao_(y�' rn ['� CITY Vi'Y_ " V.�LATh.- A.P.NO. I/ [ Y /.S-/ Or NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL. SO'TO SIDE a REAR P.L. LIC.NO. NO. SIZE r / EAVES OF LOT -57l3� I NOW ON LOT ALy REDDS APPROVED (U YARDSREAPPROVED TI USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. /( (FROM C///LSTrRE�ET) SETBACK LINE FROM ,I REAR YARD SO-V FRONT /-Y/ihr. �O �� T'�T. CENTER OF STREET 1.I( "4E41' [�� SIDE YARD LEFT 1 ' C. I RIGHT ' i© CS R.BIDE /0 (FTt •"-"''E FT. 'DESCRIPTION OF WORK L.SIDE __SFT. Fr. NEW ALTERATION ADDITION X REAR .570 FT FT • \ DISTANCE BET. BET.MAIN a REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.SLOGS. BUILDING F� g NO.OP -I VAR.# DATE SIZE iZ X 1st, ROOMS I STORIES I C.U.P.# q APPROVED EXTERIOR COVERING LL COVERINGOABYPROVE& //,A DATE USEOF BI�II.,p,NG AND W RICO F41 E$[A D I'lf'LV(l� rlAwn°Nkv+� �'y�. xv /15/ o 6Q.FT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE t', AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE AWS REGULATING VALUATION A 0 m BUILDING CON O - ('� SIGNATURE OF PERMIT FEE $ -1 N PERMITTEE �. MMQ//��, ((��)),,,,,,�-�^ / / . 1 CC) $ $ (�® PLAN CHECK $ ^/ G "AUTHORIZED AGENT ^j `�~� 4 TOTAL FEE $ 1 3 OWNER FINNEGAN, JOAN, .. . . . . . DATE AUG 2 9 1963 JOB ADDRESS 2517 Westminster Avenue BUILDING PERMIT NO. 201475 1 GENERAL CONTRACTOR Laguna Pools VALUE $3}200.00 AP No.m 119151-4• LOT TRACT FIRE ZONE DESCRIPTION OF WORK pvt. swim pool - INSPECTIONS Signature DATE GROUP J TYPE III ZONE RI Soil PERMITS ISSUED SUBCONTRACTOR C _ _ _ _ _ DATE NUMBER ' R.._e Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating _ Rough Plumbing ,y,, ,f- . i / 9 ----------- ` � o Y-7 E Miscellaneous ", i 9 39...1--s) / ....- Prop. Prop. Swr. Line 0 House Con.0 St. Swr. 0 Sprinkling_System Construction Pole Underground 0 Power ❑ 7-2.143 21- /n1 s Rag 43 �Ifl-r,/� cee 9-aY -G3 ,-2ir7 iO (il Trenches 0- Forms ❑ Steel Reinf.,� /t r-.022,-1. 1 Floor System U' Bond Bea Steel Reinforce 7y /�,5L ? �+ Sheathing Frame and Flashing Lathing — In ❑ Out 0 1' Plaster, brown coat h Refrig. 0 Air Con. 0 Final fl,k'i� i• ,Hr-'"ng, Final V I ling Fixtures, Final rcet //n - q I Final Gas Test - `��� Electric Fixtures, Final J ' � � Building, Final ' // fr?>. I ` OCCUPANCY Form B114-6M-3-63 S-B P HOLD FOR SPECIAL KU •rea OM 'Ll)4(7 it , COSTA_MESA--BUILDING-SAFETY DEPARTMENT FEE RECEIVED I P.O:SOX 917 COSTA MESA.CALIFORNIA \ / For Appliccipt to Fill In Completely AUG 2 9AI9 CATION FOR PERMIT TYPE OR PRINT FHP np Only AUDLRDESG y ,� I / Ae$.� H\4. S Pr Prue CITY OF STA �ES RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA �^ RECEIVE/Z.: DA RE HIV D DATE ISSUED OWNER oaf 1—L... eRx� nlS' �3 ,y`-��-Gj BUILDING y / j.^. •��^7/^.s.�„ . ' MAIL I , , /A, ADDRESS �/ G(!�" "'' ADDRESS A,,, lNeS o.,kwG c- 1 SUP .---- FIRE CO CITY TEL. ZONE GROUP tr ARCHITECT TEL. 1. '• ABPPROV DATE a- ..9 OR ENGINEER A_ lb ' . NO. w - .6. f (� l /� ,'n ZONING ADDRESS 8237 Pt.--\Se... A-V.0495.2 Su.SB.q,aa is,c,V-�t� HONY/// / NO.PLANE /-� BBUOP UIILDIDINGENW l CONTRACTOR t, r 81 w a Pc e1 ` �-//'J y [� I I LEGAL / //� IISII ADDRESS S'O( {S{L�-�S� S�• So-L. DKSCRIPTION.- BOJ'-Y �• C S CITY Ca.-.`� 14,A.jL A.P.NO. ' / - I✓ I- '/ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATELIC.NOM.4g0 NO. k1• Z-t 3t� sr TO HIDE@REAR e.L. SIZE J/S,�.,�� 'v , 1 l s NO.OF BLOCS. ALLOEAVE �(U.B.C.REQUIREMENT) OF LOT {ptF l�'C� I Now ON LOT ' YARD- A P O EV D YARDS APPROVED UF MAIN BUILDING ACCESSORY BUILDING EXSISETOING BLDG. SL.�1$. B FaL...L. RCS. (FROM C/LpS�TREET) SETBACK LINE FROM �_� FRONT /C FT.--F �(i ' FT. CENTER OP STREET REAR YARD SIDE YARD I LEFT I RIGHT R.SIDE FT. FT. DESCRIPTION OF WORK L.sips..? SFr. Fr. NEW X ALTERATION _ ADDITION REAR 3s . _ FT. DISTANCE BET. BET.MAIN@ /0 i/ REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDG$.1 BUILDING //7 I/� 0 NO.OF VAR.# DATE SIZE ///LJ 000 ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL APP O�1/ D�7/J GG �I /� COVERING COVERING BY �,(' �/ 0�pATE n^O ��(J - USE OFBU DIN NDWORK TO BE PERFORMED / HOLD FOR SPECIAL REQUIREMENTS N. SL..,............,_g rOG n eo.FT. G 7. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT ND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY OR• �•;_ AND St S REGULATING BUILDING CONSTRUCT N. Cli SIGNATURE OF A _ VALUATION PERMIT FEE $ /✓ m PERMITTEF all'af a —. $ OP , pLAN CHECK $ 7-' e /' 0 AUTHORIZED AGENT TOTAL FEE $ wc2 . LL