HomeMy WebLinkAbout1553 WINTERGREEN PL - Building Permits ADDR
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ERS NAME KNOWN: 1553 WINTERGREEN PL saner. CITY OF COSTA MESA - BUILDING PERMIT
OWNER4 NAPE IF KNOWN:
ADDRESS: ELLISL GAKKY L L$KpA -DI 1-1 2 is frnSyi=
9849 EMMONS CIR
FOUNTAIN VALLEY,CA 92708 PERMIT NO: B 085575 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MATTING ADDRESS:
CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: OTH
ACM ITECT OR OR
sae.NI: JOB DESCRIPTION : 1/OFF RERUUF W/BUR SQFT: 7, 400
ARCM oR ENa•s ADDRESS: r • MT:
CaflRACTORs-AYE CLAIM VALUE: 7, 400 . 00 CALL-VALUE: 7, 400 . 00 GROUP UCC: R--3 /
cUARAcroRS MIAMI JD JONES ROOF CRAFTER ( 714 )826-4827
6 11 SAN
S111HO - COMMENTS:
OMMENTS : X
BUENAUENA PARR CA 4�Jb ititiiiWWeoFiW
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WW Wot F er e i iw WwW
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7VbLV Z (DWG Ht. QU1ttM1N 1S
UCENSED CONTRACTORS DECLARATION:I hreby affirm under prelyd
perjury due Iemfoamed In underprovisionsand
(commencing*Rh Section)OW)of Division 3 of the Business and Prd.e,bn.Code.and my license is a le force end effect SETBACKS
Cr' s• NO.: - UC.CLASS:
029223 C3 43 9'i� EXP : 09/98 MAIN BUILDING ACCESSORY BUILDING
atr. - - sett. - FRNT: FT IN REAR: FT IN LEFT:
FT IN _REAR: FT IN
OWN BUILDERDECLARATION:I hereby.Ram under•:• LEFT: t 1 IN RGHT: FT IN Lt.t 1 : t l IN RGHT: t 1 1N
ry I am exempt from the Cabal=dor Liceree Lew I«the
1.�• .reason(Sadon 7031.5 Bushes,and Prof ..- :city or... . which requires a pone to epreauct.Idler.improve, -
• , •uh«repo any swctun,pea its eatance.... .• . ..the applicant for such perm to fie aelped statement esu he or she BARKING REQ: - PROV: PARCEL : 13936132 ZNE: REF NO
-; -.. --• pursuant to the aawmorth d de Cpr Is tate .. ._Law end t r 9(aammee st weh Sedan 7Og0)d latah o 3 e tote PLANNING NOTES>.
wended arm port
Code(«tom M pr she u e ant t a chat m eM Ibo bine Ir tle e5og^l axsmgon.Aoy viaeon d Sadon •
4'; 1.5 by any applicant or a permit subjects the applicant to a Coit purely of not more than fire hundred dollars[55009. •>
•
❑ I,as owner ofle Bmpaeem wihofessins Cod:Thwo ractois License Law a work.notandaMy toaOM.,OimrpW
their 1!**VIC A fin W ire w it Costwsevt9!'It Cow It x l(•wwWsrit t er w w x'Rwxwwx'!hl!•stwdeIt vswww mi se se ie Co w se Co w sr w*st-sfx x xi lh'R'l ii•w iii iii w Ww it**
Ofns
offeredbuild or improvesthreon.Buand who arra such wokhimselThe banal or
Lighs or her own emplyeenawnrdhat such
L E V to L lJ Y M t, N T S E R V I C E S tic E Q U i R E Ni E N' I S
Cola Widenth ref Thereon.efwed foreeu hworkver.the Mthroughimprovement
a«hrdwithimond.pwidedtomCottle ii'
imndnx eller are mal intended ebur ae of
pr ing he I,hewed-, b buildingnor mfor th p p soldawithin one year d compleron,the / .
ower.rcdM.rwinna..InaW�dandpahlergo.«.neeidmWud«imprae.l«m.p�apa..d.w). ZONING APPROVED BY LATE:
❑ I,as owner d the property,am exclusively rantradap with Screed contractor to construct the project(Sedco 7044,&emrs and
Professions Code:The Contractors License Law does not apply a an over of properly who builds or improves thereon and who
contracts for midi projects with a comadods)licensed pursuant to the Contractors License Law). BUILDING AP PRUV'ED B Y . LA 1 E;
❑ I am exempt under Section: B.8 P.C.,for this reason: _t---_
ED
APPLICATION ISSUED BY : DATE: ..
- Date: Owner, ********WWww w*********w:pi at-mein-z z it wit z sr eiei sew xxx*twat lawn zxir z at Few se Witei xeiei Cox ziW
Ido hereby ceniy that I am aware d and understand the requirements d Caliomie Health and Scary Cale Sections 25505,25533,and L EGAL I Z AI I nN(N Y E E SUMMARY STRUCTURAL S - -ME I: Y
25534.and that 1 or any future Waking occupant will I will rat(dime one)need to comply with said mate codes and the requirements for
the from
prowirene. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE r SMIP/RES GRADING
Dare: Applicant PERMIT 137. 25 74
SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally or perjury one of the following dedaraoae: PLAN
❑ I have and MI maintain a certificate of consent to sell-insure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE FEE
Code,for the performance the e work l«which this prmiebsued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ I have and MI maintain workers'mmpnWion insurance.as required by Sector 370odthe Labor Code,for the performance of the Turmas_---> 137. 99 0. 00 0 . 00 137. 99 137 . 99 . 00
work for Mich this it la issued.Myexcitexciters' m
e 'compensation insurancecarrier carrier end policy number are:
X Carder
Policy Number ST Th FOND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 137. 99 OVER-/SHORT: . 00 '
issection need Abecompleted ithe pewee ey«6rtlmarTeVASI1klielehtfi.hl 01 /01 /98 BLDG PMI PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT" GRADING PLAN-CHECK
J I certify Thal in the ped«mence d the work Tor ehoh this permit is issued.'shell not employ any person in any manna so a,to 137. 25 . /4
become subject to the workers'compensation laws of . agree that i I should became to the worked' .
peesaton provisoredSecton 37004 the .I shallonh cam with ......Xi ii*S """ """"""*Xi W* Ciiai '""
n W WW WWWWWiiWW WitwwwwitwwWzx-eixeieieiwwCow*eiateiatw*neiei-xxxxz--m--wwiiW WWWilew W-eiwwWWW kitwWWWWWWit
ore: ���3-g / INDIVIDUAL F E E BREAKDOWN
Ward g:FSWure to secure workers'compensation sun and shed fact an employer to adnYnel penalties end
dell W d hundred hdred thousand dollars($104000($104000 n thin cost compensation,danmpn s provided ler in 1 Y P t• QTY 1J t. S L li 1 P 1 1 U N UNIT. COST TOTAL COST
5 on 3705 of the Labor Code,(Merest,and attorneys 1t1I
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally d pedant thin(here is a rwnraian landing agency I«the SFR 7400 EROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 400 . 00
performance of the work for w:hid,the pronto issued(Section 3097,Cir.C). I END OF FEES
LENDER'S NAME
LENDER'S ADDRESS:
I cents that I have read to application and side that the above information is coned.I agree to comply with all sty and county ordinances
end state laws robing to Widng consoudke end hereby authorize representatives d this city a enter upon the abovsmentiored properly
for inspection purposes.
'Ti; :ui -�I. tiae)ctH
I1-83-1997/62:26 PN/1137.99
tName RCPT8:81-8814918
/L. ^//1- t Dale, ft-2 PERMIT:085575
Sgneture d Oredkyp�pkem radar
(5151-08.WP) While-Buildup&Safely;Green-File;Canwy-Apptcant:Pink-Revenue:Goldenrod-Assessor ,
r
CONSTRUCTION AND PLANNING POOL 'A
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 Reirrtercement 56. Rough Plumbing & Pressure Test _ ,
- 6: Electrical UFER Grnd, 57. APPROVAL TO COVER-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.
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 •I
13. Roof Drains _ 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
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-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 ❑Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24, Roof Framing ' 73. Undergrnd:Storage Tank p Gas 0 Oil
25. Roof Sheathing a-24-17 74. Overhead Hydro.
26. T-Bar Ceiling (Structural ) & Morlocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding : - 77. FIXED SY5TE61.FINAL',
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final l• 80./FOOD CERTIFICATE ISSUED
33. Final Electric • 'Notes: - -
34. Final Heating &'Air Conditioning .
35. Final Gas Pipe•Test ••., -
36. Hood or Canopy ' - : • +' .--
37. Final Factory Fireplace .
-
38. Final Plumbing '
39. Water Service-Final ;
40. Gas Service-Final - I - r
41. Solar Domestic-Final . - • .
42. Backflow Preventer - • - •
- 43. Backflow Irrigation - • (6, 1 7,_-c A.40 ( G� . z-a� r
44. Landscape Irrigation System i _ _ - - ��y(�`�"-`
45. Sound Attenuation r -, _ .
i 46; Handicap Regulations. : . i
47. FINAL STRUCTURE & BUILDING / S•A4-
S
' 48. FINAL PLANNING 6 (� _ .,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - I -
_51. CERTIFICATE OF OCCUPANCY. .. , . '"
No. Date
% PROJEL'TADDRESS; 1553 WINTERGREEN PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 057644
DWIrCR•s NAME: ELLIS GARRY D
ADDRESS:
9849 EMMONS CIR PERMIT NO: B 057644 PLAN CHECK NO: N GOVT: N SUPP: N
FOUNTAIN VALLEY,CA 92708
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
AflCH/ENGINEER: 968-4148 REc.xD.: JOB DESCRIPTION : T/O RESHT REROOF W/LIFE TILE SQFT: 2, 600
ADDRESS: UNIT: ld
PERMITTEE: CLAIM VALUE: 2, 600. 00 CALC—VALUE: 2, 600.00 GROUP OCC: R-3 /
ADDRESS: `D JONES ROOF CRAFTER ( 714 )826-4827
BUENA11 SpNKYSIDRO CA 90620 COMMENTS• ICBG #2656T SMOKE DETECTOR REQUIRED
LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect SETBACKS
CITY LIC.: 060-5--9223 STATE LIC.: 435996 CLASS: C39
ate: 97 signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby of firm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.ora certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 285-920000243 EXP.DATE: 01 /01 /9 3
COMPANY: STATE FUND PARKING REQ• PROV: PARCEL: 13956132 ZNE: REF NO:
❑ Certified copyco/ is hereby furnished. CR Certified copy is filed with the ct uilding Division. PLANNING NOTES>
• Date.--4,-5 '"7 l— Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (T' tion need completed if the permit is for one hundred(SAW)or less). D E V E• L O P M E N T SERVICES REQUIREMENTS
I certify That in the performance of the work for which this permit is issued.I s not employ any person in any manner so as to become
subject to o me Workers'Compensation Laws of California. ZONING APPROVED BY DATE: r
Date: Signature:
NOTICE:II.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: --
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. •
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work forL.—
which this permit is issued(Section 3097,Civ.C).
APPLICATION ISSUED BY; '// DATE:
• ********************** *********************** **91*******
LENDER: ******************************************' - **********************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensedS U
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business $MIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, w01 do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 54 . 50 0 , 00 0 .00 54 , 50 54 . 50 • 00
does not apply loan owner of a property who builds or improves thereon,and who does such work himself/herself or through
hor
improvements solor her own d within onevided yeaf ofthat
completioimprovements
ohe owner will have the burden of offered
poving he/she dihowever
not build or improvee iREVENUE DIVISION TOTALS--> COLLECTED: 54 , 50 OVER/SHORT: , 00
forme purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusive) contracting with a contractors to construct the project(Section 7044,Business 54 . 00 • 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon •.
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ****,*,*,*,**,**,*,*,*,***,*,***,*,**********,***,**,*,*****************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN
x
• Cron tnis reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: Owner: -
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533•and SFR 2600 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 600 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions,
Date: Applicant: - '
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned1 -,'I 1,1. _F-. -- :.I -- - -
property for inspection purposes. _ _ - • -
Haw to —C-9Z Signature:
Onvw's License or Social Security is:
164146 White-Buddino:Green-Code Enforcement;Canarv-Aothcant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL .PA
\-r APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Servige or Pole;,o 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. t- a' ' 4 53. Steel Reinforcement
mo,•r a i . 1
. 3 EIectr eaI CondaQUtility-Unclrgrncea't 54. Forms
.4, EfectriCal Conddir*Mdrgrnd. 0..7. 55. Electrical Bonding
5. tgelcinforcegifa lx 56. Rough Plumbing & Pressure Test
r1L
6: bectrical UFER•Grnti. 57. APPROVAL TO COVER-GUNITE 4
4m - .:,t •n>.
��y'.(goptings ;rro ;y 58. Electrical Conduit-Undrgrnd. .
',jb ,ijndation 1,-.,\.-K- 59.
59. Gas Pipe, 0 Undrgrnd., Test •
<9. Wier Pipe-UndVjrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor.System 61. APPROVAL TO DECK
s
11. Property Sewer Lin€l& Hot:Ise Connection 62. Backwash & Receptor-Final
,.t Li --
12. Seer Cap ca
❑. 63. Heater & Vent-Final
C- -
13. Roof Drains 'C 64. Plumbing System • Final
v
14. Rough Plumbirt§ C' 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric-, /iring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricbl'T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
.r - �'.� - 4' '7 _ 133,- :X X t_ at
20. •Ro 1 h Factory Fireplace 1 z,r `t^ * 0 - - - * 1PPROVFtCS=:oQPer�rrit# ' �` "T
2L�-- .'1. in-Striictur'g ' .. - �'•
y . ,. -r .1-
.. , S c . .70. Undergroarid:Hytho
- 2 t
22. Dues, Ventilating * p ^ t :C# -". -, 1, Productl• ftlipg GTl s D,0i1
23:-Gast-Pipe'Rot h & test ms x ^r i -c .0* :t; . 72. Underground FltisT; , z ,`.. r
24.-Root Framing•- n :-i-' * > C " - - 'S/3.clJndergrnt;StoragiSTank �Gas ❑Oil
25. Rood,Sh•
e =y '_ ;; to ` 9' C,0 4; . j4Overhead Hydro° °
26.•T-Bar Ceiling (Structural) &.-Moonocoat -. _ i- t 75.ypory Chem al .` ` , -
4 Lr
A
27.7Fra a and Ftlashi� " �� " ` I ., • '' ' ' s
Rg e'x x s y ..s. 76��Y Standpi.Pe - i, >
•-28. Siting' ' = {^ z ••I •4 Yt *_ 77?2FIXED SYSTEI I",P_INAL4a _ T
'29. Insulation j• :S " .. ID .r ,q l L7 -
. 78:"-FIRE PREY. FINAL
.'30. Drywall Nailing nc * • �,. HEALTHCEPT?REQUIREMENT
+ 1-, V, . \ ••i r, n ,r
`31. Plaster Browp1Coat*„ 5 I •r r - 1r ,79J'FINAL IN- PECTICIN L7-tiI •
s -.t. - .
---32.cElectrical,Po%cer Meter`Final i - A :a •. 080.*FOOD CERTIFICATE ISSUED
s =\ em
�33.'.`:Finkj Ele�,ctri F"' T, ¢ .� AX Thlotes: C, zi q y n
,04.-Fin91 Heating& Air Conditio 3gc n x �..}, iL S i-. L f a C
c ,t ,' , J A
Finet Gas PiPB-Te T`, •}•Z : ' •i� •- '7 - w0 tr. • •r `u;,
4 T
r36.fHo0 or,Canopyr;T ; • - - k t- I • r. X X. .'.:.a SW
'-37.:Fina1 Fa^tory Flipped".^ ' -6 t'" 4„° tr e £ C .•r, r
Y L y n
,738. FinabPltipbing * n, t -� I E w 1 - TJ
Y r
39. Water Service-Final- 1 os 1, r I ` t �, r • . ".-1:1 1. tr. -%
I. ..
.40. Gas Service- nal X .,i y.,.t„ tT, ` I. Y ti x
:41. Solar DomesSc-Final S -^• 6. •• ? 0S^-' -
n * 1 l rr '7D _ -a .- ._
42.5Backflow Preventers, t- �j • J l I r -
43. Backflow Irrigation -:5.I. V s - v t = -
•
„44. Landscape Itcigati4 Systeme;: or. :: • • .. v i i •. CU :7 _ + ?r C
,. C. _-t - 4. --.. C. -t > ` £ -
<45.'Sound Atterivatiorr 'u:!-•, VA F. * *. .. . , rt.4 `.. 1. *
- • •• .Y n n ' -
- 1 •
~ r: w n
:i46.Handicap•Regulatiojis _ .t `i .x i. ' - =;,
S
47.-FINAL STRfd.CTURE & BUfL.DING t I : •'i��
48:SINAL PLANNING , n 6 - ;; �J
c49.cElectricTReleasetoEdison 1 . 4. ,, y, . -'� r '-
G..
n f t
::50.,,Gas Reledse to Southern California Gas Co ' t I i• s , .1 •
'.51. CERTIFICATEOF-OCCUPANCY , • - . r - • -
No. Date
41-#1 2 ) 859 .'.A`. 2 •PAID 01136::' ***17L30
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECE L;fjN DATE RE IVVED DATE ISSUED
BUILDING �II//''TT// ,u I6_ °
ADDRESS 1553 Wintergreen P1. ....6
PERMIT NO.
OWNER Harbor Mesa Corp. A.P. NO. rl I Dirt"
P 7
MAIL BUILDING ��
Z _ADDRESS 15117 Ventura Blvd_ Rm A ADDRESS /�5�/� f z r t
Lu W TEL. TR AC7�j7� / LOT BLOCK
D.0 CITY Sherman Oaks,.Cal 91403 N0.986-5077
Z CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH
OI— _LENDER -
J D BRANCH `/
J N — OWNEI Lj.A/[.r0"�l� n I/t
J VI _ADDRESS (''II jj -�////� VALUE
m ARCHITECT `TEiti) USE 'SIJ'"�" $ ��
U <
_OR ENGINEER Rappoport NO. h52_557$. FIRE /�
Q
WCC ADDRESS 146 N. PnhArtRnn Blvd. ZONE TYPE GROUP_'r�
a W APPROVED
W Z CONTRAPASM-9IY9t' j / Inc. BY DATE
J0 _ YWa LP
m z
-P.�-1-'tP
J w ADDRESS 151]7 VenturaPtBlvd. I/
W tL TEL. ZONE NO.OF/r��� USE OF NEV1�jJ/�.OJ-
ZF CITY Sherman Oaks,Cal 91403 NCL 986-5077
pa P PLANS BUILDINGS
LL 0 STATE ‘3 CITY YARDS APPROVED YARDS APPRO ED
cilD
o LIC. NO. 88991 LIC. NO. MAIN BUILDING ACCESSORY BUILDING
SIZE •NO.OF BLDGS. (FROM C/L J�
STREET/
OF LOT 66.5 X 96.6 NOW ON LOT None FRONT -._J ✓FT. FT.
USE OF „.- /
EXISTING BLDG. NOM' R SIDE 5-FT.//z I FT.
2 NEW BLDG. 56 % 59 ROOMS 9 STORIES 1 L.SIDE t5 FT. 6 r, FT.
Q EXTERIOR WALL ROOF / �J
O _COVERING Stnree COVERING Rork _REAR d FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1
a — MAIN BLDGS. ACCESS. BLDGS. _
Q enee VAR. 4t77_‘�/ DATE .. (/
O — C.V.P. / APPROVED —tp—�/
h _ "kit EL -9eQr 40�. -BY Ap,R6 -is 19— los 02/DATE 6--/'5-- 6.9
0 • tyke'''.
..--e_.-12--- f C - 04x/ r
UI hereby acknowledge that I have read this application and state HOLD F° yam/
that the above information is correct and agree to comply with R SPECFAL
CC all laws regulating building construction, and I shall not employ R�QIJIREMENTS”
i_ Any person in violation of the workman's compensation laws of 2 r _
fn the State of California. // m
z I hereby certify that I am properly licensed as a contractor under ���� SD. FT. 6 6 o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR •
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
em exempt from the provisions of the State of ornia Business VALUATION
end Professions Code.Division 3,Chapter 9. m
CD PERMIT FEE $ -Nit air 7
Signature of f / , / ,/ /� —� {'7 0� at
Signature
.`/��/A. /J�fA $ �' 7 �2{. PLAN CHECK $ t+ /r E
:4.17 / o
Authorize AgentAR. �.�s u.
TOTAL FEE $ / 7/