HomeMy WebLinkAbout581 YORKSHIRE ST - Building Permits�
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CITY OF COSTA MESA
�,0�'TpMF,p B!/ILDING DIVISION
4
F. �g2 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax Q14) 754-4856 • www.ci.costa-mesa.ca.us
�, ` fi FOR INSPECTIONS CALL (714) 754-5626
``°°^�^�"' ' ' PERMIT NUMBER: B11-00170
PERMIT TYPE B_ROOF2
APN: 42213402
JOB ADDRESS: 581 YORKSHIRE ST CM
Viciniry:
Squares: 0
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
06/03I2011
KJB
$4,500.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF, INSTALL NEW SHEATHING, AND COVER WITH CLASS A ROOFING MATERIAL-
MINERAL CAP. ROOF PITCH IS 2:12. RESIDENCE ONLY. DOES NOT INCLUDE ATTACHED GARAGE. COMPLIANCE
FORMS ATTACHED TO JOB CARD AND CITY PERMIT.
THIS PERMIT REPLACES B08-00121.
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card
OWNER: JOHNSTON, PATRICK H
PHONE:
APPLICANT: JOHNSTON, PATRICK H
P,HONE: 949•548-8360
CONTRACTOR: OW NER-BUILDER
Address: Unit:
City/SWte/Zip:
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
$o.00
$111.25
$0.00
$1.00
Address: 581 YORKSHIRE ST
City/State/Zip: COSTA MESA, CA
Address: 581 YORKSHIRE ST
Ciry/State/Zip: COSTA MESA, CA
License No.
License No.
PHONE:
License No. 000000
CELL:
PHONE:
PHONE:
Unit:
Unit: :
HOURS FOR GONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav. Lahor Dav. Thanksoivino Dav and Chrictmas nav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California slatutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for lhe work authorized under this permit to be wnsidered 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 lhe expiration of this permit.
COOE1. INSPECTIONiYPE �ATE INIt11AL5 COOEt INSPECTIONTYPE DATE INTlIALS
1616 Fixetl System Final Fire Prevenlion 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof � ����' M� 210 Final Elecirical
201 Final BIocWRetaining 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
�
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalry of perjury one of ihe following declaretions:
❑ I have and will maintain a certifcate of consent lo sel4lnsure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which Ihis permit is issued.
❑ I have and will maintain wurkers' compensation insurance, as required by
section 3700 of Ihe Labor Code, for �he peAortnance of the work for which Ihis
permit is issued. My workers' compensation Insurance carrier and policy
number are:
�Femef��
(This seQun neeC nof be mmple(ed Al�e peimrt rs valued af Me �undred tlo0a�s (5100) oi less J
yNumber:
❑ I certi(y �hat in the performance of lhe work for which this permit is
issued, I shall not loy any person in any manner so as to become subject
to lhe workers' mp n �on laws of Cali(ornia, antl a9ree that if I should
become su6jec to [h wor rs' c mpensation provisions of Section 3700 of
the Labor Cod , I sh o with c mply with these provisions.
A�� � m4� ignaWre �"Oate�
WARNWG FAIL RE T SECURE WORKERS' COMPENSATION COVERAGE
IS UNIAWFUL N SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVI� FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($700,000�, IN ADDITIUN TO 7HE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm [hat I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of �he Business and Professions Code, and
my license is in (ull torCe antl eNect.
Lic. # Class #
Conlrac�ors SignaWre �ate
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm Ihat there is a construction lending agency for �he
peAormance of Ihe work fv which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atldress:
Da�e
OW NER-BUILDER DECLARATIONS:
I hereby aKrm Iha[ uqder penalty of perjury Ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5.
Business and Professions Code: Any city or counry which requires a permit ro
constmct, alter, improve, tlemolish, or repair any stmcture, prior to its
issuance, also requires Ihe applicant for such permi� lo file a signed statement
[hat he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapter g(commencing with Section 7000) o( Division 3 ot the
Business and Professions Code) or thal he or she is exempt Iherefrom antl
the basis for (he alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit 5ubjec[s the applicant to a civil penalty of no� more than
five ndred dollars (3500�.):
I, as ovmer of the pmperty, or my employees with vrages as Iheir sole
co pensation, WILL DO THE WORK, and the structure is not intended or
oKered (or sale (Sec. 7044, Business and Pmfessions Code: The Contractors
License Law does not apply [o an ovmer of property who builds or improves
lhereon, and who doe; such vrork himsel( or hersel( or through his or her ovm
employees, pmvided that such improvemems are not imended or oftered for
sale. It, however, the building or improvement is soltl within one year of
completion, the owner-builder will have the burden o( proving that he or she
did not build or improve (or purpose of sale.).
❑ I, as ovmer of fhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to consWct �he prqecf (Sec. 7044, Business and
Pmfessions Code: Th@ contractors License Law does not apply to an owner of
pmpeAy who builds or improves thereon, and who coniracts for such project with
a contractor(s) license pursuant to the Contraclors License Laws.).
❑ I am exempt under sec.
Busines nd Protession de for this reason:
�
� �
� -v /�
�a�� � , a e ` '
]OS'l-66(3/O))
Owner ID verified by driver s� .❑ Ves ❑ No
Driver's License No. Ezpires:
Verifca�ion of Ownership by (rype of tlocumenC i.e. - property tax bill or deed):
DIV�,SION OF�NDUSTRIAL SAFETY PERMI7 CERTIFICATION:
❑ I hereby certify that no excavation frve (5) or more feet in tlepth into which a
person is requiretl to tlescentl, will be made in connection wi�h work authonzed
by this permit. and Ihat no buildinq strUcture, scaffolding, (alsevrork, a demolition
or dismantling ihereof, will be more than [hirty-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Ttle B, Califomia Administra[ive Code).
❑ As owner-builder, I will not employ anyone [o do work which would
require a permit from me Division of Industrial Safery, as noted above, unless
such person has a permil lo tlo such work from Ihe division.
Appl¢anfs SgnaWre Date
Division of Intlustrial Sa(ety Permit Number
HAZARDOUS MATERIALS ANU EMISSIONS CERTIFICATION:
1. Will the applicant or present or fu�ure building occupant need to fle and
certify a 6usiness Plan (or emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Sec�ion 25505 0( �he California Heal[h antl Safety Code reqUires, with Some
exceptions. Ihal a Business Plan be (led with the Costa Mesa Fire
Department by every business which has a[ any one time during a reported
year a quantiry of hazardous ma[erials equal to or greater �han a weight of
500 pounds, or a volume of 55 gallons, or 200 cu6ic feet o( compressed gas
at standard tempera�ure and pressure).
2. Does or will the applican� or present or (uture 6uilding occupant neetl lo fle
a registration lorm /or acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safety Code, with some
exceptions, requires registration wilh the Costa Mesa Fire Department by
each business which a[ any one time has on hantl a quantity o! acutely
hazartlous 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 wiil the applicant or presen� or fuNre building occupant need �o
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 ot the Cali(ornia Health and Safety Code provides Ihat Ihe
Costa Mesa Fire Department may require ihe preparation, cerlifCation and
filing with ihe Fire Depariment of an RMPP by businesses which are required
to register awtely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Safety Cotle been (ully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject o( lhis application a permi[ for such constmction
or modi(cation (rom the SoWh Coast Air Quality Managemenl Dislnct or from
any other air polNlion conhol district or agency? ❑ Yes ❑ No
(Section 658502 0( the Califomia Govemment Cotle requires that Ihe requestetl
in(ormation be furnished on applica[ions fa non-residential building permits).
6. Will any part of lhe facility to be constructed under this permi� be within
1000 feet from the outer bountlaries of a school7 ❑ Yes ❑ No
(If "yes", the facili�y must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a permit (rom the South Coast Air Quality Management Distn�t or other
air polWtion conhol district or agency is required for the vrork which is the
subject of Ihis application, have all of ihe disclosures prescribed by California
Health and Safely Code Sec�ion 42303 been made? ❑ Yes ❑ No
8. Q( "yes", attach certificate of compliance from the appropnate air polWtion
control oKcer).
CERTIPICATE OF COMPLIANCE: I certify tha[ under penalry of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
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 [o comply with all state laws and city
ordinances relating to building constmction, and authorize representatives o(
Ihe Ciry of C la Mesa to enter upon the above-describetl property for
inspection p rp ses. I agree no[ to occup or allow occupancy o( any builtling
authorized-by tl is permit til fi inspe ion.
i
r��e, �,n � � a�.
_ _ �
Antllo�Aw „�ize0 O��caol Dale
� Certii'icatc uf Com„�iance: �Resid
Alterations'
Prnjecl
General Intm-mation
Site Addresa�� Fi
Enforcemen�
Climalc Zunc tl
Building Typ��ingle Tamily ❑ Multi Family Circle tl�e From Orientation: N, E, S, R�, or de@rees
Conditioned Floor Areu (C�A): � Proleci Type: ❑ Alterations ❑ Emelope O Fene:
Replacement or Change Out d Duct keplacemen
NOTL'.� Tbi.s fon» ix� nnl ln hc ue�ad )'m�Nc�vG� Cnnstr��cted liuildings m� f1 ddlYinns'
/tt.vdnfim� Vttlues For Opnryuc Sm��nres (/m� Fvrring use dm Mass and Finring Sn�fps Consu�uction mGle below)
CF-IR-ALT
(Ya e 1 of 5)
H of Smries
/-00 70
� ���
Assem6lp Alterfltiun
❑ Upening of framed carit�' alone-A6eraiions Ihn� invoh�e (he opening o/Ihe fi�mned caviry� ofo wp[f, ceiling, orjloor mus! insmll (he
mmidaiorr �niniminn insidcnion vnlue per,¢I SQfw' the nitered aaa�embl�e Fifl in Cofumns A-C and en�er mandaior�� insu/atimi value in Column H.
� Repincement of enTire assemb)p-Repluceme�v o/-an enlire wa(l, ceiling, m�,Jloa� assembfj� reyuires (he insm!loiion ofCanyoneni
Yucknee-D insuln�ion valuea inTable 157-C. Fill in Colmm�s A-J. .
Ror the (urred oortiuned of Mass Waiis see
i Framing Thiclu�ess,
Assembly Name Material Spacing, U- ]A4
or Tvoe � and Size' or Other' factor' Nu�
Nme.� Fa_jm�i�eAassembGe+, accoumingfor Cottlinuous Insularion R-value, a�ee
Construcfion Tuble belon•.
Caviry
s From JA4 Table
�antinuous JA4 Proposed
Insulation Assembly Assembly
R-Value' Celf Vaiue� U-facrory
vse Ihe Mass a��d
1. ra� Tng/ID indicaie !he identificqiiwi name diai mntches lhe 6uilding plans.
2. Indicate the Assem6lr Nun�e or rype: RooT/Ceilittg, Wal/s, Floors, Slabs, Crow! Space, Doors ond e�c...lndica�e fhe Frame rype and Size: For
N�ood, Meta/, Metal Buildinge', Nlass, en�er 2x4, 2x6, m' e1c... see JA4 for other' possible,fi'ame rype assensGlies.
3. Enier �he lhiclrness for muss in inches or Spacing 6erH�een jraming members en�er; I6 "or 24 "OC; or Other far al! odier assem6l�� descripliwi
a�uch as Cnnereie Sa�dwich Panel, Spandrel Panel, Logs, StraH� ➢ale Panel and etc....
4. Based ai Ihe Ctima�e Zone; enter7he Standm�d U fac�a-fi�om Table 151-13, C or D for each dif(er'em assembl�� Name or 1� pe.
5. Enter tRe TaGle number Jlm1 closeh� resemGles �he yroposed assemblr.
(. L•nter the R-va(ue �ha� is being installed in �he wall carin� or 6e�ween Uie fi�nming: olher-wise, enler ••0,,.
7. Lnter thc Conti�maus ]nstda(ion R-value,fw' the proposed assemblp; olherwise, enier "0".
6'. Lmer the rnw and cnlunm o(!he U-fac�m� value based on Colurnn F Table Number and en�er �he As,sem6lp U-fuc7or in Colunm J
). The Propased dssemblr U-(ne�m�, Colxmv� J, mu.ri Ge equal to m' lesa� thun (he Stmvdurd U-fac�or in Colunvn E to convnll�.
Fmling Strips Constrimtion Table fm Mass Walls Only
A B C D L F G H ]� d IS L M
1'ruposed Yruper[ies of Masonry an�3 Cuncretc Added Interior or �xterior Insul:�tiun
N';dls Prom Itefcrence in Purring Space from Reterencc '
Juinl A� endix' Tqble -0.3.5, 4.3.G.4.3.7 Joinl A iendfx Table q.3.13
_ - >. _
U V� � 1 u - U
�, m . o-' . � n� ' �,
m a o _ V„ �
Asscmblp �- j _ �. F u o �� � L e u >•.v Flnal
Mass Numc or JN4 Table .� _ �: m- F F o t A o_ " � Assembl%
Thickness' T e Aiumber <�" � = w�� � � 5 i' c �•�` u�i r U-factor"'� Comment
�
Kegi.sU'ulinn Nurnber: Regis�ralion Ua�el1'imer HL2S Prnvider:
200b' Reside��tiul Crnnplinnce Form.t flugu.xl 2009
Cerfificatc of
Yroject Nvme:
Climatc
ROOTING PRODUCTS (COOL ROOFS) §Is1�12
Wl�en Uae nrea of ezierior rnaf simface m Lc replaced eeceeds uinre 1Har: 50% of lde esis�ing roojaren, or inore
rhe ne�v rnnfni aren iw�ecl xiee( fhe ronfue nrodnc! "Cno!
or 152(b)]Hiii.
CF-IR-ALT
N of
Check opplicaGle n[ternnlive or ecceplion Lelnw if 1he r�ojalteration is ezempiJinm �he rooJing produci "Co�l Roaf" requiremen�s. Nate: Ijan��
one af Uic alrernotives or nsceptimv be/ow is checked, (he Aged Solar 2e/lec�ance mid Thermal Emtltance requiremen�s for roofingproducts in
,�LB(iJ m�e noi app[icable. Do nat fill tab(e below.
❑ Conl Roofs Not Requircd in Climate Zones I-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones I throu�h 9 and 16 with a Steep-Sloped Roofs (pitch greater than 2:12) and pwduct unit weight less
than 516/ft .
Alternatives to §152(b)1Hi nnd §I52(h)Hii, Steep-slape roof (pitch > 1:12)
❑ Insulntion with a themml resistance of at least 0.85 hrfl''�°F/Bhi or at least a 3/4 inch airvspace is added to the roof deck
over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to §I51(�10; or �
.❑ In climate zones 10, 12 and 13, with I fl'. of free ventilation area of attic ventilation for every 150 ft oFattic �oor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance oPthc roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
O Building has radiant barrier i�i the attic meeting Ihe requirements of §151(�2; or
❑ Building has no ducts in the attic; or �
❑ In climate zones ] Q I l, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exceptiun W §152(b)1Hiii, Low-slope roof (pitcli <.:12)
❑ Buildine has no ducis in [he attic.
❑ Itoofmg area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
. O Roof constr�ctions that have thermal mass over the mof inembrane with at least 25 Ib/R= is exempt from the below Cool Roof criteria.
Note: tf no CRRC- I iabel is avaiiahle, Ihis compliance method cannot be used, use
Check lhe annlicable box beloe� if Exempt fmm the Roofine Products "Cool Rc
Product ID Number�
CRRC Producl ID NwnLer can
Roof Slope Product Weight Product
2:12 > 2:12 < 516/frz >_ 516/ftZ Tvpez
��
❑
�
0
�
�
�
0
G
Approacii to show compiiance,
Aged 5olar Thermal
Reflectance��4� Emittanc
❑4
�4
n^
❑4
❑^
Indica�e lhe rype ofpmdnc� is being usedfar (he roofrop, i.e. single-j�IJ� roof, asphall roof, ntela( roof. elc.
/f die Aged XeJleclonce is nm availab(e in.Ure Cool Roo(Roiing Council'.s Raied Pr'oduc! Direcrop� iLen use Ihe Ini�ial Xefleciance value fi�om �he same
direclnr�� m�d use (he eg�mtion (0.2+OJ(P��������— 01J �o obiain n colcula�ed aged vulue. Wher'e p i,s Ihe Irtilio( Sofa' ReJlec�ance.
Cpeck Goa if!!�c dge�l Refleclmse is n coludaled naG�e using (he equotion abave.
Calcidate tlre SRl value Lr using �he SRI- Wa�kxhee� u� hrtu�//ww�r.enerrv co ¢nv/lille24/and en�er Ihe resulting valuc in Ihe SR! Colu�m� above ond atluch ucopy of
�he SRl- Workslieei io thc CFIR. �
� apply Liyuid rield Applied Cuatings, Ihe coating must be applied across lhe entire roof surface and meet the dry mil thickness or coverage
commended by the coatings manufacturer and meei minimum performance requirements listed in § ll 8(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating
Cement-Based Roof Coating
Other
Regis�rution Number: Registra�ion Du�elTime: FIEILS Provider:
2008 Residentia! Compliance Fmms � August 2009
cate of
AZleration.s
Yrojecl 1Vame:
ce: Itesidential
C(imate Zone f/
Cr-1 R-ALT
(Pn,�e 5 01� �l
IS' of Sturies
HERS V�RIFICAT101�' SUMMARY The enlorcemeni ngenei� should yar specia! ��rtemion �0 1hc HEIiS 64eus�u�e.r speci(ied in thi.+
checldisr Gelore. /1 c�ompleted emd sioncd CF-4R Fm'nr.fm� �JI ihe nrensures specilied shnll be suLmitied io tire building irn�pector befm�c� Jinol
DIICI Senlino &"re5tinc HLIiS'veriJicnlion is require[I,for �hia mcn.+zu�e.
� 1'LS ❑ NO 1'C5: Li Climute Zoneti � antl 9-I G, if mort thaii q0linear feet of ne��� or replacemenl ductx eve insltilled in unconditioned
� space, tl�e ducts ure tn be sealed per §152(b)IDii und the newly instulled ducts are tu be insulated pei 1151(117 0.
❑�XC�1'T10�: Lxisting duct systems tha� are estended; �vhicL are cunsh�ucted, insul;�te�l w� seuled with as6estus.
❑ Yi5 ❑ NU 1'ES: ]n Climate "Lones 2 and 9-76, if the existinE space-conditioniug system (H\+AC equipmeni and ductingl is replactd, die
� ducts arc to be sealed per (152(b)iDi. �
❑ Y�S ❑ NO 1'�S: ]n Climam Zones 2 and 9-I G, if the existing HVAC equipment is replaced (including the replacement of the air handlei,
� outdoor condensing unit of n splii system, cooling m� heating coil, or the furnace heai exchzngei`) the ducts are tu 6e
sealed pe� §]52(b)lE.
❑ F.XCEPTION: Duct systems th�t are documented to I�nve Leen previuusly sealed confirmed tLruugli H�RS
� verificatiou iu uccurdnnce with prucedures in the Reference Residential Appendix I:A3.
� � ❑��XCEPTIO�: Duct sys[ems with less thxn 40 linear teet in unconditiuned space. � � ;
❑ EXC�PT10�: �xistin� duct svstems constructed, insulated m� seuled �vith asUesws.
ReiYigerant Charge - Spiit S}�stem HERS verifica�ion rs require� for +hi.r measm e.
r] 1'�S ❑ NO YLS: ln Climate Zones 2 and 5-15, wlien the existing HVAC eguipmeN is replaced (including the replacement of the air
hai�dler, ontdoor condensing uni� of a split system A/C or heat pump, cooling m� heating coiL or the fumace heat
exchaneeri a refrieerant cliaree measurement shall be verified per §152(b)1F.
Centt•a] Fan Integrated (CFI) Venfllation S,ystem and Fan Watt Drah�
Tlie ventilation requirements of §150(oj do not apply tn existine residential homes.
Ducted Split Systems - Air Conditioners and Heat pumps: Airflo�' HERS verilicaiion is required_for rhis nieasure.
❑ 1'LS ❑ NO YES: ln Climate Zones 1 U t6rough 15, wlien the existin� space-conditioning system (HVpC equipment and ducting) is
� replaced. the eirflow and ian watt draw shal l be verified ner � 152(b)1 Ci to meet the renuirements of 6151(f17B.
• I
Company:
that this
z
��
i(% `s
lf Applicable D CEH or
(Certification H):
-�' 3
Responsible Iluildine Desirner's Ueclaratiou Statemenl
� 1 am eligible under Dh�ision ± of Ihe Culiiorniai Susiness und Professions Code to �ccept responsibility tor the buildino desipn identi5ed bn
[his Certificate of Complianec.
• 7 eertify thai the energy (ea�ures und perlormanec specifmntion:. 1or the building dnsipu identiLed on this CeniiYe,ne of Campliunce confonn
tu lhc rcquircmenls of Tillc 24, Psnte 1 and G of [he Culilurnia Cocle of'Regulatiuns.
• Thc building design te, tures IdeniiGed on thi:�. Ceniflcnie n{' Compliancr• nrc cunsisieni wilh thc inionnatiun pruvided to dncumeN thir.
buildin� design on th: olher applic�ble complianec lonnc, wurl:sheets; calculations, plans and speciLcatiom�. subn�iitted tu qx enlorceinent
u¢encr tbr 2onrnr�l with this buildine nennii .mulication.
N;une:
:,'nmpany.
Address:
Cuy; StatcfZip:
Si�naturc:
Date:
License.
Phone:
Far a.e,cis4mee nr questions regnrtling Zhe EnereP Suutdar•ds, cnnlacl (hc L•nerdi� Hoflinr ut: J-8(10-7i2-.'i3!l0.
I(cgie'u'aiion7JinnGer': Jfegisu'aiion Loie/Timc' F/ERS' ('rpi•idcr.-
2001; lfasideivial Convp(iance Frn'ms - Aaigux� 3(lOJ
t
! �a
CITY OF COSTA MESA
BIIILDING DIVISION
r'
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754�856 • www.ci.wsta-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B08-00121
PERMIT TYPE B_ROO�_�, 3� �p �� STATUS: ISSUED
APN: 42213402 �� / DATE ISSUED: 04/14/2008
��'T� �- _ . - ISSUED BY: KJB
JOB ADDRESS: 581 YORKSHIRE ST CM, �., Suite/Uniti:. :
Vicinity: RESIDENCE ONLY - ?`- � � � . � . . '- � , .�
Squares: 3000 ';"` �` ` " � - . �,--' Valuation:���� . � $4,500.00
i
SCOPE OF WORK: TEAR OFF EXISTING ROOF,�INSTALL NEW SHEATHING, AND�COVER��WITH�CLASSA-ROOFING MATERIAL-
MINERAL CAP. ROOF PITCH� IS 2:12. RESIDENCE ONLY. DOES NOT INCLUDE ATTACHED GARAGE ����-
* ` r 4,
OWNER: JOHNSTON,.PATRICK y-i'' Address:- 581 YORKSHIRE ST Unit:
PHONE: � � , . , City/State/Zip: COSTA MESA, CA , �
APPLICANT: JOHNSTON, PATRICK�H, �� � �� .�� � Address: 581-YORKSHIRE ST - UniC :
: . -.. ,. . . . � � � :?
PHONE: 949-548-8360 . � � - - " City/State/Zip: COSTA MESA, CA - �
CONTRACTOR i ' ` � - License No. ,
Address: Umt: � C � , �� PHONE:, � ' . � _
City/State/Zip: � � CELL: , ��
ARCHITECT: - . � - - License No. - - � PHONE:
ENGINEER: ' " License No. - PHONE:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
TOTALFEES
$o.00 `
,$111.25.�- ..
`' $0.00
$177.25� ;�-. .
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under Califomia sWtutes and related
regulations. (Ord. No. 92-28. § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed 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.
GOOEf. INSPECTIONTYPE ORTE INTIlIALS COOEO INSPEC710NTYPE DRTF� IN7171AL5
1616 Fized System Final Fire Prevenlion 206 Final Mechanical
1266 Pool Spa Final . 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final BIocWRetaining Wall 212 Final Fire Prevention
202 F,inal Faclory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building�Occupancy
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WORKERS' COMPENSA710N DECLARATIO�
I hereby aKrm under penally of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-lnsure for vrorkers'
compensation, as provided (or by section 3700 of Ihe Labor Cotle, for Ihe
per(ormance of Ihe work for which this permi[ is issued.
❑ I have and vrill maintain workers' compensation insurance, as required by
section 3700 of the Labor Code. (or Ne pertormance of ihe work for which this
permil is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This sed.on need nol be cnmple(ed Alhe pe�mit is value� af one huntlretl Collarz
Policy umber:
I certify that in the peAormance of the vrork for which this permit is
issued, I shall t employ any person in man r so as to become subject
to the work s' ompensation law o Cali rni , and agree that if I should
become s�ject t ihe er ' co ens ion� mvisions of Section 3700 of
the Lab r ode I �hwi t y' Ui se provisioI^s.
, �` ��
[ ppli�anP _igna re `�a�e�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), 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 affrm that I am licensed under provisions of Chapler 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and eftect.
Lic. N Class #
Conlraclor s Signalure Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that ihere is a constmction lending agency for the
pedortnance of lhe work fa which lhis permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's AddreSs:
SignaWre �ate
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury [hat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any sWcture, prior to its
issuance, also requires the applicant tor such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contraclors
License Law (Chapter 9(wmmencing with Section 7000) of Division 3 0/ the
Business antl Protessions Code) or that he or she is exempt therefrom and
ihe basis for the alleged exemption. Any violation of Section 7031.5 by any
applica for a permi[ subjects ihe applicaN [o a civil penalty of not more than
fve h dred dollars ($500).):
I, as ovmer of the property, or my employees with wages as their sole
co pensation, WILL DO THE WORK, and ihe slrucWre is not intended or
offered for sale (Sec. 7044, Business and Pro(essions Code: The Conlractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or offeretl for
sale. If, however, Ihe buildinq or improvement is sold within one year ot
completion, the ovmer-builder will have [he burden of proving lha[ 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 constnict Ihe project (Sec. 7044, Business and
Protessbns Cotle: The con�2ctps License Law dces not appty to an ovmer of
pmperty who builds or improves thereon, and who contracts for such project with
a cont2ctor�s) license pursuant to the Conirectors License Laws.).
❑ I am exempt under sec.
Business a rofessions Code for this son:;
/ � � U
/
�9neWre � ��Dale- �
3051-46(3/W) �-- �-- "—
a.. 1 (
Ovuner ID veriled by drio �ce �] Yes ❑ No ��
Dnver's License No. Expires:
Verifcation of Ovmership by (rype of tlocument, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICATION: �
❑ I hereby certdy that no ezcavation frve (5) or more feet in depth in[o wfiich a
person is requiretl to tlescend, vrill be made in connectan vrith work aulhorizetl
by this permi�, and that no building s[ructure, scaHolding, lalsewurk, a demolition
or dismantling thereof, will be more than thirty-six (36) (ee� high. (Chap. 32, Grp
2, Art 2, Sea 341, Ttle B, Califomia Administ2tive Code).
❑ As ownervbuilder, I will no� employ anyone to do work which would
require a permit from Ihe Division of Industrial Safety, as noted above, unless
such person has a permit to do such vrork fmm Ihe division.
Apvliran(s SignaWre Dale
Division of IntlusMal Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the appliwN or present or tuture builtling occupant need to fle and
certify a Business Plan for emergency response [o release or threatened
release of a hazardous material? ❑ Yes ❑ No
(SeCtion 25505 of Ihe California Heal[h antl Safety Code require5, wilh 5ome
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantity of hazardous materials equal [o 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 presenl or future builtling occupant need to fle
a registration form for acutely hazardous ma[erials? ❑ Yes ❑ No
(Section 25533 of the Cali(omia Heal[h antl Safery Code, with some
exceptions, requires regisiralion with �he Costa Mesa Fire Department by
each business which at any one [ime has on hand a quantity of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feel of compresseC gas at standard
temperature and pressure).
3. Does or will the applicant or present or future huilding occupant need to
prepare an RMPP (Risk Managemen[ and Prevention Pmgram (or aculely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of ihe California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certifcation and
fling with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or future building occupant require for
the work which is the subjecl of Nis aOPlication a pertnit for such construc[ion
or modi(cation from the South Coast Air Qualiry Management District or from
any other air polN�ion control tlisMct or agency? ❑ Yes ❑ No
(Section 658502 of the Cali(omia Govemment Code requires that Ihe requestetl
in(ortna[ion be fumished on applications fa non-residential building pertnits).
6. Will any part of [he (acility [o be construc[ed under Ihis permit be within
1000 (eet from the outer boundaries o( a school? ❑ Yes ❑ No
Qf'yes", the facility must meel the requirement of Sections 25534 and 42303
of the Califomia Health and Sa(ely Code).
7. If a permit (rom the South Coast Air Quality Management District or other
air polNtion contml 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 Safery Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", anach certifcate of compliance from fhe appmpnale air pollution
con[ml officer).
CERTIFlCATE OF COMPLIANCE: I certify thal untler 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. �
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state that
[he information given is correcL I agree to comply with all sta[e laws and city
ordinances relating to building construction, and authorize representatives of
the Ciry of C� Mesa to enter upon lhe above-tlescribed property for
inspection pyfpose I agree not to o allow occupancy of any building
authorized y Ihis rmi[ until final'� 5 ecti . � _/
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�,'Si9n _ e of L 1 _ ." te .
JOB ADDRESS or s ire venue BUILDING PERMIT N0.
� GENE�ACTOR er r. DESCRIPTION of WORK A am. . o es.
SOIL
GAS
WATEF
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. �
SPRINKLING SYSTEM
MtSCELLANE0U5
ROUGH HEATING AND A�p �ON�ITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUNO � POWER �
ROUGM WIRING
TRENCHES FORMS STEEL REINF
FLOOF SYSTEM
BONO BEAM n STEEL REINFORCE �J
SHEATHING
FRAME ANO FLASNING
LATHING - IN [-J OUT []
P� '�TEF, BROWN COAT
:TURAL, FINAL
Ht�fING. VENT., REFRIG. ANO R.C., FINAL
PLUM9INQ FINAL RN� GAS TEST n
ELECTRIC, FINAL
BU�L�ING, FINRL
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
Pa�v Q.�.1i
<rF , �-����.,.. o �L,�; � a.5c
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Compleiely REc iv o ev DATE RECEIV
BUILDING DATEISSUED
ADDRESS 5a1 YORKSHIRE AVENUE ��.�— —
P
OWNER MELVIN ALEXANDER /�.P�NO. �S �
MAIL BUILDING
ADORESS 581 YORKSHIRE AVENUE ADDRESS 581 YORKSHIRE AVENUE
CITV COSTA I�SA NQ�� — ?�A� LOT BLOCK
CONSTRUCTION NONE W °'
LENDER
BRANCH NONE X
ADDRESS . NONE OWNER l
OR EN IN ER OWNER NEL. USE VAL S✓ D�
FIRE T
ADDRESS ABOVE ZONE / TVPE GROUP 1—
CONTRACTOR OWNER ByPROVE DATE /3�
ADDPESS ABOVE ' � � � �
TEL. ZON NO.O VSE OF NE
PLA BUILDING
urv p p No. p.
STATE CITY YARDS APPROVED VARDS APP VED
LIC. NO. NONE ��G, ryp, NONE MAIN BUILDING ACCESSORV BUILDING
OF LOT 63 X ].00 NO.OF BLDGS. 2 (FROM C/l ST ET)
NOW ON LOT qppJ7 FT.
Exsr°,nica�oc. SINGLE FAMILY RESIDFs'NCE soe VFT. FT
N'EW BLDG. 13 � Y` 22 ��fipOMS ��' STORI ES ONE L. SIDE FT.
COVE R�INGAL�TUCCO COVOERING ER REAR FL �--
USE OF BVI�DING AND WORK TO BE PERFORMEO N DISTANCE BET. BET. MAIN&
MAIN BLDGS. ACCESS. BLDGS.
AREA BETWEEN �XISTING HOUSE AND C URP��£' APPFOVED� —
ATTACHED GARAGE AND E TE DING �ROVE��
ROOF FOR PATIO COVER.� �yy�J _ �
I hereby acknowletlge that � have reatl this appli ion an state S_7ATE-
Nat ihe above intormation is eorrect end aB�ee to comply wiih
all laws regulating builtling conshu<[ion, entl 1 shull nOt employ C�O
any person in violation of [he workman's compensetion laws oi
/ y
m
the ta[e of Calitomle. �
1 �ereb eeraif [hat I am SQ. FT. � o
v y properly licensatl as a cantracmr unticr
the Stam of California Businoss entl Professions Cotle, Divisicn 3, TME AMOVNTSHOWN UNDER VALUATIONI FOR
Chaprer 9, antl thot sue� lieenses ore In full force antl oftoct, or I THE PUpPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
am axempt from the provisions of Na $tam ot Colifomia Businnss �
VALUATION � I �> �
antl Protassions Cotlo, Dlvislon 3, Chapter 9. PERMIT FEE 5 �
�
sienatura of / m
Permittee ����� �r+�a�'�. ` SlX �� � PLAN CHECK 5 [7 � � E
o`
AuthorizedAgent ^ �u� LL
TOTAL FEE� $
�
UWC
JOB
@:
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��+-�a-Q-Z¢ iWti1C ^,tf•rotsr.le=�as^'..-s`�"_7----
ADDRESS
�ERAL CON1'RACTOR
DATE p�T 2 1964 ,
BUILDING PERNIIT NO. 2iO�ili � .
SUBCONI'RACTOR
�S
23044 FEE RECEIVEO
STA MESA BUILDINCrSAFEfV DEPARTMENT OCT 2 1964 �
� P.O. Bb%9f7 C08Tq MEBA, CALIFORNIA FINnA`NC�!En �TDEPT. ��
For qpp�icont fo Fill In Completely APPLYICRTIOri1'F�R"PETiMR
TYPE OR pRiNr . BUILDING
eu��oiNa /�" I,v For Ofiice Use Only
ADORE69 % I Q S V
116C[�Ii NO. P[qMIT NO.
COSTA MESA, CALIFORNIA � O •�
�p R[CCIV Y DAi[l�'llV O OAT8139U a
OWNER ` �P • l ��/�
ADDRE58 ^�i Y S / �L ADOR694 � CJ� I2S �� R�
,}. PIRE -
CITY B / c2 f NO. '=ONH TYP 6ROUP
APPROV80 �O y �
ARGHITEGT TEL _ BY ATE
r'� �NGINEER NO. '
Z NG
n_JRESB tp NO.O UB80PNHW .
PLANB BUILO�
CONTRACTOR 1
LlOAL {('�l� 1 �
� D88CRIRfOl7' �
ADDRESB
CITY A. P. NO. � / S _ ���
NOTE: NOEAV80VERHAN68HALLBHLESBTHAN
STATH �_ TEL �� 90' TO SIDfi @ REA(3 P. L �
LIC. NO. NO.
EAVES
SIZE ��i X I No.oP9LDo5. ALLOWEO (U.B.C.REQUIREMENT)
OF LOT � NOW oN LOT
YARDSAPPROVED YARDSAPPROVED
USEOF L MAfN BUILDINO ACCESSORYBUILDlN6
EXISTIN6 BLDp, � T .1 e
(FROM C/�'�S/[)REET
eETBwCK LINB PpOM �� � PRONT /" � FT.
CENTEH OP BTPqh� REAR YARD
J ' � .
SIDE YARD I IEFT I O � O'„ RI6HT W R' 81D8 ��
/
DESCRIPTION OF WORK �.sioe � rr �� Fr.
�V ALTBRATION ADDITION
v REAR l_J PT. " I FT.
DIBTANCE BET. BET. MAIN 6
MAIN BLDG9. ACCESS. BLDG9.
REPAIR MOVINO DEMOLIBH
BUILDIN6 / NO.OP VAR.Jf DATE
SIZE A ROOM9 6TORIEH C.U.P. APPROVE . /
EXTERIOR WALL -y ROOP � AP�ROVHD � ��j
GOVERIN6 S/�lCt6 COVERINO 8 DATH
USEtOF BUILq�Na A D WORK TO BE P F9R�{HD �
Y o o'v+� �!v ct-
f < < 9 0
,
�
so. er. �
1 M8plBY ACKNOWLHO08 TXAT 1 HAVB qBAD TXIB �PPLIGTION TH8 MOUNT 9NOWN UNDHP V�Lt1AT10N 19 POA THB =
•N� 9T�T8 THAT TH8 �BOVB IB CORHER �NO AOpHB TO COM. PURP098 OP 89T�B�19HINO • P6PMIT PEE ONLY. �
VLY WITH �LL C�TY OP�INANC89 �NU eT/�T8 LAW9 OULATINa ypLUAT10N M
BUILOINOCON4TRUCT�ON. lll� �� m
PERMIT FEE S �
PERMITTE e OF �-- / , / � /O ! � m
$ �, `� � i� �
AUTNORIZED ARENT TpTw FEE IJ
OWNER
2-2h-55
JOB AODRESS 581 Yorkshire Street BUILDING PERMIT NO. 958
GENERAL CONTRACTOR Dike 8� Cole�rove VALUE $8����.��
LOr $ BLOCK TRACT 2313 Residence i'c C2I'DOT't
GROUP I
;INSPECTIONS
Footing Trench
Foundation Forms and Grade to �
Rough Framing
Plumbing, Rough to SIa6 �
Plumbing, Rough Complete �'
,Temporary Pole
.Wiring, Rough
Heating, Rough
:ieating, Final
Sewer r r(.% - G�- S/
S : Tank or Cesspool
L.. .mg
Plastering
Plumhing, Final, Fixtures Compli
Plumbing, Final GasTest /,$ -
W iring, Final
Occupancy
Form 1I0 GH 1M 12-69
TVPE V
IDATE
-i�
ZONE �4
SUBCONTRACTOR
vie�
PERMITSISSUED
I NUMBER
Mesa B ' g Department
117 EAST 20th STREET �o
� • COSTA MESA, CALIFORNIA ' — �
FOR APPLICANT TO FILL IN
Building
nddress 581 Yorkshire St.
Costa Mesa, California �
Nearest
cross st. Hamilton su
Adi
Owner A. R R ,Fr H_ Tnrt_
A�h �t�t o� Miaa�
Engineer
r`vo: Le-915S0
,.Dike & Cole rove city �ic1301
ontracto g No.
ddress 419 E. 17th St., �osta Mesa
�escrption I tvo g I elxk I Traetz37-3
Attach Metes and Boundal
Size of Lot 63 x 99• 2z
Use of
Existing Bldg.
Setback Line from
Center of Strxt 5� �
DESCRIP'1Z�
New I X I eirn�a
Size
Exterii
Coveri
Use of
Buildi�
r
Demolish
PPLICATION FOR PERMIT
BUILD��NG '�
FOR OF'FICE iJSE ONd.Y
Recei t No. Permit
�-��o qs�°�
ed by �Tdate Rec'd. � Date laued
Costa Mesa, California
Type
Date
CORRECTIONS
No• oT �"
1 . f' . Rooms Stories 1
Roof
Stucco coveri�g Comp APPROVALS
sidence and C2sport �Foundat+on Location Inspecto
-- Forms, Materfals,
Under-Pinning
Frame: Fire Stops,
Bracina. Bolts
I hereby acknowledge that I have read this Application
and state that the above is Nrrect and agree to comply
with all City Ordinances and State I.aws regulating
building construction.
Signatureof
Permittee
Authorized Agt. � � �
Valuation Permit Fee $ 02
Plan Check $
$ $�0��•�� 7otal
Fee $ � �
M
FINAL
Int.
Ext.
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C- _ `
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• li.`].l�:i .
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� 1. .J�' , �ail.. . •
� Street . '-'. _ '. _ _ _ � i •
� ', � _
-, . PLOT PLAN - -- .-, :. . . . . - , ''. . - . '
� Show locatlon and disYances from � � � � • � '� �
� -p�operty line and betuveembuiidings. � -
� r. " .,r� �-•I.. �.i:,• � . ,
• • .r ' rviS�:.
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20347
� EO�fA MESA BUILDINGSAFETY DEPARTMENT F E E R EC � I V E D
P.O. BOX 91] COSTA MBBA. CALIPORNIA AUG z �963
For Applicant to Fill In Completely AP��Q{�S�I ��ERMR
TYPE OR PRINT CITY OBt�19IFksMESA
eui�oiNo � � �' For Oiiita Usa Only
wooaess Q- �
� RHCEIP! NO. P MIT NO.
COSTA MESA, CALIFORNIA �, O �
=pZ81V6D � ��.i8/89UEO ,
OWNER r � er ` Q
a G
MAIL � ADDRESH G^!/ � `
ADDRE89 • Y� Q
FIRB
/� THL. 20NH GROUP
CITV l' C ' NO.
` APPRO ..� / 3
ARCHITECT �O�L NQ. BY DATH «
"ENGINEER
ZONINCi
n..ORE93 / I NO.OP u880PN6w
GONTRACTOR
Q(,�/I! C/' — 84/ �PC/' Pune '• euaoino
L60AL
��� D88CRIRION –Q
ADDR688
�
CITY �—_ A. P. NO. � � O
NOTE: NO EAVE OVERHANG 6HALL BE LESS THAN
STATE TEL. 90" TO SIDE @ REAR P. L.
LIC. NO. NO.
SIZE � X G� � I NO.o�ptcae. / ALLOWED (U.B.C.REOUIREMENT)
OF LOT NOW ON LOT
YAROSAPPROVED YARDSAPPROVED
USEOF ��S��p�C� MAINBUILDINO ACCESSORYBUILDING
EXISTING BLD6.
(FROM C/LSTREET)
8ET6ACK LINH FROM �� !� FRONT FT. FT. �
CHNTEfl OP 9Tfl8ET REAR YARD
/ � �
61�EYARDI LEI-T I R16HT 6 R.61DE Ff. Ff.
DESCRIPTION OF WORK �. s�oe rr. F-r.
'Y •• ALTERATI N ADDITION REAR Ff. �.
DISTANCE BET. BET. MAIN Q
REPAIR MOVINO DEMOLI6H MAIN BLDOS. AGGESS.BLD69.
BUILDIN � INO.OP VAR•# DATE
SIZE O ROOM9 6fORIEB C.U.P. APPROVEO
COVERIN6WALL COV�ERING BYPROVED p S-' 3.-�,3
USEOFBUILOINOANDWORKTOBEPERFORM6D a _� _F Z
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I XHpCBY �CKNOWL8D08 TNAT 1 X�V6 pBAD THIB �PPLIGTION n�e AMOUNT 6X UNDCP V�LYATION 18 POq TMe =
/�ND BTATB THAT TN8 A90VH 19 COpqBCT ANU AOflHB TO COM. PUNPOBH OP 8 BLIBH�NO • PBRMIT PE8 ONLY. �
PLY W�TH �LL CITY ORDINANCBB ANO 9TAT8 LAWB qHOYLATIHO ypLUAT10N m
Bl11LO1N� CON9TRUCf10N. p
PERMITFEB S
BIGNATURH OP � m
PERMITTE / /�,� / lJ
8 I Q
AUTHORIZEOAOENT / /�( �� �
TOTALFEE $ ✓