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Home My WebLink About1098 WESTWARD LN - Building Permits •- CITY OF COSTA MESA — BUILDING PERMIT .. ! ER'S NAME If KNOWN: WESTBLUFF HOMEOWNERS ASSO PERM NO: B 076829 *30 111 PACIFIC #250 IRVINE CA 92714 • PERMIT NO: B 076829 PLAN CHECK NO: N GOVT: N SUPP: N 727 260 `.MMLRlG ADOaEw: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH • ' ARCHITECT ON ENGINEER: MC NO.: JOB DESCRIPTION : T/OFF & REROOF W/BUILT—UP SQ TT: 6,800 . j ARCH.OR ENG.'S ADDBFSS, DMT: - i CLAIM VALUE: 6, 800 .00 CALC—VALUE: 6,500.00- GROUP OCC: R-1 / CONfRACTOR's NAlff: Ra P . HIRSCHMAN .(714 )960—8 329 _ �— -- CCNTRACTORSMMLNG 8855 ATLANTA COMMENTS: REROOF SUNIT CONDO ADDRESS INCLUDES /10924,1094“1096098 —WESTWARD AOORESS: HUNTINGTON BEACH CA MAO.: 475948 *+F+L+ENN-*+flfN-�f*N***If-ifff�f*EfN-ffAL-*EEN-4x*M2**At**44** f*N*** tfif*if+fAEm**tE*x-******ie******it*x*ft** 92646 uin 285 ZONING REQUIREMENTS UCENSED CONTRACTORS DECLARATION:I hereby elf km Under Penalty of Perjury teL I tan hoeraed under evasions of Chap ac 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in full force and effect, clrYuc.NO.: 038468 uc.cuss: C36 UC� 475948 EXP: 04 /96 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Data: Qj—IS—SI Cora LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perary that I am exempt from the Contractors License Law la the fdiowkg reason(Section 7031.5 Business and Professions Code:Any city or county which requires a Permit to construct,aper,improve, PARKING REQ: PROV: PARCEL: 93523005 Z NE: REF NO: demolish,a repair any etnldure,prior to its issuance,alio requires the applicant for such permit to file a signed statement that he et she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Se ori n 7000)of Decision 3 of the PLANNING NOTES>Business and Professions Code)or That he or she is exempt therehorn and the basis for the alleged exemption.My violation of Section ,'> t' 7031.5 by any applicant for a permit subjects the applicant to a five penalty of not more than five hundred dollars[S5001). ********************************************************************* ase******** ElI.eaownerdthepropertyormyemployeeswithwagesatheiredecomprnation,willdotedwaleendthestructuresndintended D E V E :L 0 P M E N T SERVICES R E /Q U I R E M E N S or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to en owner of property who butts or inproves thereon,end who does such work himself or herself or through he or her own employees,provided that such improvements are rot intended or offered for sale.If.lowever,the building or improvement is sold within one year of completion,the ZONING APPROVED BYDATE: owner-builder w ill have the burden of proving he or she did not build or improve la p. d the purpose sale). o I,as owner of the propend,em exclusively contracting with Goateed contractors to construct the project(Sadiron 7044,Business and /J; ' Professions Cede:The Contractors license Law does not apply loan owner of property who buidthereon and or improves thereand who BUILDING APPROVED BY : DATE: contracts to such projects with a contractor(s)licensed pursuers to the Condors license law). / ❑ Iamexempt under SadionAthis . : a. P.C..torreason: APPLICATION ISSUED BY: S V DATE: .1 ********************************************** ****************** ** I. Date Owner LEGALIZATION:N F E E S. U M M A R Y STRUCTURAI.� SEGMENT:Y I do hereby artily that I am aware of rn and understand the requireeris d California Health and Safety Code Sections 25505,25533,and -..i / 25534,and that I or any Mum building occupant will/wit not(circle one)need to comply with said pate codes end the rqukemens for e permit for construction crenodike/ion from the ArWanageaN District.Residential oonn melanoma are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions' PERMIT 90 . 00 . 68 Dale: Applicant i' SMIP/NON—RES • WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN ISSUE FEE ❑ IhaveandwmmeinuinscedfeebdoomennoeeMreureorwaken'camperwatal,eepraide idlabyBUILDING—DIV—> PERMIT ISSUE PLAN1CHECK TOTAL PAID DUE Code,lot the penamancadthe watttr*tech this pem><.:,a„ed. s«.ion3TwdmeLebr TOTALS----> 90. 68 0, 00 k 0 . 00 90. 68 90 . 68 . 00 o I have and will maintain workers'compensation insurance,m required by Section 3700 of the Labor Code,for the performance of the work for which this puma is issued.My workers'compensation insurance carrier and policy number are: Cavia: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 90.68 OVER/SHORT: 00 Policy Number: 1255R90-94 10/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed i the pante S for one hundred dollars(5100)or lass) 90 . 00 i . 68 I cents that in the performance of the work for which the puma is issuued.I shall not employ any person in any manner Po as to - , become subject to the workers'compensation laws o CsMonla,and agree Mal if I loud became subject toted workers' **************************************;E**************************************** compensation a s d Section 3100 of the with comply with those provisions., Date' y�1C-1 C APPf • 7 I N D I V I D U A 'L• ? ;F.1 E £ BREAKDOWN Weming:Falluretosecureworkericompenatoncoverapeisunlwful,andshallatjectanerployerfocdMr.elpNWtlsand TYPE QTY DESCRIPTIO N ': UNIT COST TOTAL COST civil fines up to one hundred thousand dollars f$100,000),In addition to the cost of compensation, a. on,damages Provided for le Section 3105 of the Labor cad.,Intents)and srroattorney's m.yfaSFR 6800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 6, 800 . 00 CONSTRUCTION LENDING AGENCY:I hereby alSm cinder penalty or perjury that Mere is a construction lending agency to the END OF FEES performance of the work for which this panne is issued(Section 3097.Cs.C). LENDER'S NAME: LENDER'S ADDRESS: I . I certify that I have read this application and pate that the above information is coned.I agree to comply with all coy and county ordinances and state laws reetkg to building construction and hereby authorize representatives of this city to enter upon the abowvmentioned Property for impaction purposes. BOB HIRSCHMAN - - Print Name r - . .• ••. r, Date: 4--/c H ?/ ., , / � � 7 3g e r/Agens'ApW UCo tredr L (5151'46,WP) White-Buildi e A Safely;Gran-fele;Canaryepplant;Pink-Revenue;Goldenrod-Assessor CITY OF COSTA MESA 6�g BUILDING DIVISION • ___ 8 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �, rso PERMIT 444 M03-00665 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1098 WESTWARD LN Status: ISSUED Suite No Applied: 12/19/2003 Issued: 12/19/2003 Vicinity: Parcel Number: 93523001 ISSUED BY: Applicant: STEVE SCHNIERER Address: 422 JENKS CIR Phone: 714-998-4300 CORONA,CA Zip: 92880 Owner: LEIBRICK, PETER FREDERICK Address: 1098 WESTWARD LN Phone: COSTA MESA,CA Zip: 92627-3994 Contractor: ALLIED PLUMBING - HEATING -AIR CONDITIONING Address: 422 JENKS CIR Phone: 714-998-4300 CORONA,CA Zip: 92880 License:610780 SCOPE OF PERMIT CHANGE OUT FURNACE MECHANICAL TO INCLUDE: INST FAU<100K BTU FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 • Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 _. Compressors/Absorption Systems Gas Piping $0.00 0 - Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0- 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 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 for a period of 180 days. 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)754-5626 244646(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain 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. XI 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 issued. My workers'c1mpe ation Insurance carrier and policy number are: Carrier: ZUc c5n YY-)GC\C C C\ Policy Number:lJ3f�GCZQ ct3—en (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the 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 laws of allfomia,and gra that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these si s� Applicant Signature: Date: (Zf i`►'n3 WARNING:FAILURE TO ECURE WO RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOI ISAND DOLLARE($100,006),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.Lic,k 7 Class a Ci—C) Contractor's Signature: Date: V)i�T/O3 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). Lender's Name: Lender's 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,end 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 properly,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 driver's license. 0 Yes ❑No Driver's 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(36)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: 1 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? 0 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? 0 Yes 0 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 0 N (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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ 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? 0 Yes 0 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 Quality 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (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 purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. r(s) I Z/19/0-3 Date Ano 4 plicant Date ;ODE/ 111SPECTIQN TYPE RATE INTITLAL$ COM INSPECTIONTYPE PAISz� ;rrt 1616 Fixed System Final Fire Prevention 206 Final Mechanical I -a RC1 1 • K 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BIocldRetaining 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 • • • ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION F9BU RI /IlhatIr PERMIT 5.50 Th P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 I RE EIS VEC�BV PERMIT 3t9 902,7 a 2" For Applicant to Fill in Completely— Use Ink Only V'�nL(///�— rL// / BUILDING k09g �� LIZ A.P.NO. 1 / 5-‘6:7- - 01) 1,:?),-2 q . ADDRESS `` (_�) OWNER 01:6mC `N,= J ADDRESS BUILDING 1o9 TENANT UNIT ORN MAILING SPACE NO. ADDRESS a 1`--�� TR.NO. LOT BLK. TEL. CITY C. I. NO. •••• NEW ADD ALTER (REPAIR (MOVING DEMOLISH CONSTRUCTION LENDER BRANCH "/C�� OWNER f� ADDRESS USI` �1ASe VALUE �a...� ARCHITECT E (NEENEL. A♦ '�p,�'/YW)'-1� , OR ENGINEER NO _ ADDRESS ZONE TYPE GROUP 0. BYPROV ED DATE CONTRACTOR ADDRESS \Z'�0c, @C1),.. TatZ[1� .... CIT vG.63tbaje._ ctszLN .��siC� O Iy STATE CITY ��11 APPROVED SETBACKS LIC.NO. c1,Cj,Z_ LIC.NO.\8(847 to SIZE INO.OFBLDGS (FROM Cit.STREET) G, OF LOT NOW ON LOT FRONT FT. C USE OF 4 EXISTING BLDG. R.SInF FT. VI F Separate permits are required for L.SIDE FT. • electric,plumbing and heating work. REAR FT. Ir] F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION G ` \P, DATE a > � \ APPROVED CCC///��- S12 APPROVED )••• im__E Y DATE a 4.1 n.o 1 hereby acknowledge that I have read this application and state N, y that the above information Is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ > Z any person In violation of the workman's compensation laws of v 'U the State of California.I m I hereby certify that I am properly licensed as a contractor under SQ. FT. c+ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to am exempt from the provisions of the State of California Businessp �,11 a andDivisl.n 3,Chapter 9. VALUATION PERMIT FEE S �OV PLAN CHECK S rn o Signature of \ q Q Permittee \ lv/"lV'�'/ u IZINQ�� S IAX $ • O 0r ll rl2/�-/� U Authorized Agent Date. (tJ a/at)`� TOTAL PAID S • OWNER FINE mmy DATE 10/31/80 JOB ADDRESS 1098 Westward Lane BUILDING PERMIT NO. 50927 • GENERAL CONTRACTOR The Tomas Group DESCRIPTION of WORK Solar Racks AP No. LOT TRACT FIRE ZONE VALUES 500.00 Ity' CTIONS Signature Date TYPE GROUP ZONE SUBCONTRACTOR PERMITS ISStjED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING 7-41, 1 &1A3 OU e I f& . tM /r�g(04 1 PROP. SWR. LINE n HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND El POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES (l FORMS ❑ STEEL REINF. 0 FLOOR SYSTEM r v P ' E D i YBONO BEAM n STEEL REINFORCE n EX I� pecnbiro rd fn+DtitGICt9l 1-)FRAME AND FLASHING ^CI LATHING - IN n OUT n /, h Sig ___LLL---��••�� 'HPLASTER. BROWN COAT Date SKS El/STRUCTURAL, FINAL Electric $44,17 ,G, VENT„ REFRIG. AND A.C., FINAL aPL'3`,' ING, FINAL AND GAS TEST n ELECTRIC. FINAL Rlul nluc plum Wry COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only ' RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING , 1 ADDRESS 0W A.*„ /_/� 1 a- PERMIT NO. OWNER # / /.-.,a' /� I t1 saL/LI A.P. NO. 4 -�{ Ic2 u1O J�i�p� 1 �, 1 ADDRESS C-4MAIL /..0411 y/, /wcl/. ADDRESS BUILDING f 0 I(J} fat. Nv r CITY / a �T_NOL�� `J TRACT �JJ ✓ SLOT l/fA �OCK CONSTRUCTION „Vent/eZ. ADD ALTER REPAIR MOVING`' ' DEMOLISH BRANCH /SJ/�y [ ale . ADDRESS // / �/% OWNER a aro at a., _ I. 2 I' V• UE ARCHITECT TEL / ' - / - S p P �` $ OR ENGINEER '‘ Ns,. _ FIRE ' ADDRESS ali ,i1,/—...,......!7/ / Ali11, ZONE TYPEIC GROUP /�� APPROVED • CONTRACTOR (��_fv/l-,CJ , BY DATE ADDRESS ��o llf..y��E- /� TEL. Z�/z�J-3�IPA % _BUILDING ELXJ��W�Ui�� CITY NO. r `"I sl/ F STATE / CITY YARDS APPROVED YARDS APPROVE iLIC. NQ/ ��Z3 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOCS. h (FROM L S riEEETL) /' /� ` /� 0. OF LOT f NOW ON LOT V FRONT [p4- Fa. _ {///iatictf (. ( O., USE OF cia EXISTING BLDG. R.SIDE �'''1] FT. `� (_ 24 y }0) FSeparate permits are required for L.SIDE .2. / FT./ar FT. electric,plumbing and heating work. /�.� WREAR Al 1L FT. 1.-, USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q /^�A^- /n''�t- ,// MAIN BLD�GGS�.��% ,/�2 ACCESS.BLDGS. �/r D �� GN`�s'/I✓ v/I” •`-% C VRP.tW fi�J I ty DATE APPROVED 9 11-1o> o> /JJ__ ,/ ) APPROVED / _ ? 00 /rXJf7R/Y HOLD FOR SPECIALEREQLTIREM�NI"$ 0.. I hereby acknowledge that I have read this application and state n C that the above Information is correct and agree to comply with m tlx all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of W the State of California.I �/'j/ / �/) /_ - I hereby certify that I am properly licensed as a contractor under /`� 7�/ SQ. FT. ��IV ' 1�� N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that ch licenses:sr- in full orce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from - : •�•v ions of .e State .f Calif.rnia Bunn ss y and Professions•od i Ion 3, t/ap :�9 VALUATION PERMIT FEE $ N In PLAN CHECK $ I, Signature of jai ` o Permittee 1 S V. P- TAX $ u U Authorized Agent TOTAL PAID $