HomeMy WebLinkAbout104 YORKTOWN LN - Building Permits IPROJECT ADDRESS: 104 YORKTOWN LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06946E
OWNER'S NAME: CORN, MILTON
AODRESS: 104 YORK TOWN LN PERMIT NO: B 069466 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH & REROOF W/Ct t4 & HOT MOP SQ FT: 2, 508
ADDRESS: UNIT: C-0 Ads
CLAIM VALUE; 2, 508 . 36 CALC—VALUE; 2, 508 . 00 GROUP OCC; R-1 /
PERMITTEE: STOUT ROOFING, INC. ( 310 ) 923-6775
ADDRESS: 9700 WASBURN RD COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
DOWNEY CA 90241 **+E********************************************************ar**kk*+t**************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 05977r STATE LIC.: 402536 cuss: C-39 EXP; 10/95
a l_Q��6 0L � Signature: _ _ MAIN BUILDING
IN REAR; FT IN FRNT: ACCESSORY BUILDING
ORNERS'L MPEN A710NDEClARATION: Ihereby affirm that lhave acenificateol consent tosel4insureoracertilicateofWorkers' FRNT; FTFT IN REAR: FT IN
CompensationIAeyapci ac�tlfiedcopythereof(Section3800,Lab.S.5/19/95 LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: 7 I L[C 7 EXP.DATE:
COMPANY: AIG , z2 PARKING REQ: PROV: PARCEL: 41916238 ZNE; REF NO:
/ `7 Certified copy is hereby furnished. C1 Certified copy is filed with the city Building Division. PLANNING NOTES>
4Io/44( >
MPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed II the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
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 became
subject to me Workers'Compensation Laws of California. ZONING APPROVED BY DATE;
•
Date: Signature: BUILDING APPROVEDBY
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor 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 for APPLICATION ISSUED BY; DATE: O
1277
which this permit is issued(Section 3097.Civ.C). *************************************R1et it if************************* * - * •**:r.'
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State 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 , 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/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). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, wit 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 to an owner of a property who builds or improves thereon.and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.U,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00
orimprovemento is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT GRADING PLAN—CHECK
imp roe puens of d t.
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 4 . 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. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
torthisreason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 508 , 00
I do hereby cendy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES
25534 and that I or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements tor a
permit for construction or modification from the Air Duality 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-mentioned 01 00170722-00170723 TOT 54,50
m rt Ior insecuoDATE: 0/_3/94 TIME: 13:37
p y purposes.Q3 9
Date', 101�f(� /t-1 Signature: A
( Dov s License on Social Security u:
1641.46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
� POOL PA
CONSTRUCTION AND PLANNING
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
_Electrical Conduit Utility-Undrgrnd. 54. Forms
•- -4..Etectrical Conduit.-Qndrgrnd. 55. Electrical Bonding
"15.-,5teel Reinforcement 56. `Rough Plumbing & Pressure Test '
b._Etectrical UFER1�'irnd. 57. APPROVAL TO COVER-GUNITE
'',:7. Footings . 58. Electrical Conduit-Undrgrnd. =
,
8. Foundation - 59. Gas Pipe. 0 Undrgrnd.,Test
_, 9. Water Pipe•Untlrgrnd. • 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. Sekver Cap 63. Heater & Vent-Final
13. Roof Drains -1
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- y F
Rough rectorireplace Cin _ APPROVAIS _Permit # >
• i, " i T -� 1:
21.;Duets, in.Stcflcture, - ' 70. Qnderg;avni,j Htnllro
22. Duds, Ventilating : • ^ fl71. ProductPrping Glias ❑Oil
23.-Gas'PInfRniirgh 8/ Test - ; ! 1}.472. Undergroc�td FIu;lij- ,
24.rRoof Framing -a .. - . a E:73:r.'Undergrn&.Storage'Tank 0 Gas 00ll
25. Roof Sheathing c1 . -- �/q_qq :tZ. ,, -...74C.:Ofierheacillydrot
26:1T-Bar Ceiling (Structural) &_Monocoat - n 75_Dry Chemical - I -
27._Frameand Flashing .i• ` r 76T'&ryStandpipe � '
_28 Lathing-& Siding] - • • t 77.:' FIXED SYSTEM E'INA(E ..
'29. Insulation -' ' _r. • „ 7B:.FIRE PREV. FINAL -
x.30. DrysvaliNaiffing • . - HEALTI*PEPTs. REQUIREMENT
,1'31, Plaster Blown Cor - .792FINAL INSPECTION 1.
32.-Electrical Power Meter-Final l` . r,80rrFOOD CERTIFICATE ISSUED
33. incl EI-ctrit - r• ' Notes
t = ` _ ''
,. -
734. Finonon
al Heatin4.& Air Cditiing' i ' _ S
. -r
35.i-Final Gas Pipe-Test. ' �� ,• _,
r
.36. Hood or.banopy r,r - . r - 1• { i
37. Final Factory FiFeplace•. ' -:.'" I 1' • t ''r
-38. Final Plumbing ,- - } - .,
39. Water Service-Final• ` -
40. Gas Service-Final' . . I
141. Solar Domestic-Final : -
42.'Backflow Preventer. - . I •• . _ i1
43. Backf low Irrrn rgatio - - -
-_44. Landscape Irrigation System,
'; j. -u - ,
_45. Sound Attenuation -iv. • + '
t • 11 ,• ♦ , ...
-46. Handicap.Regulations '
I.
47.-FINAL STRWCTURE & BUILDING 4.lq- q5(tom . -
46. FINAL PLANNING r i` - „ r. ,- .
49. Electric Release to Edison . =r
1.50. Gas Release to Southern California Gas Co _ ,.): ,
51. CERTIFICATE OF OCCUPANCY
No. Date
-
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLD �X38 6/14/n
/I /,/�/i
CONSTRUCTION PERMIT P( 3(4
3e•, Ti
Project Address a. - • TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR
Applicant's Mailing Address L /� (// / ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 12one
Owner's Name _ . •
7Q(!� {� - Phone s/J s�Q7 DESCRIPTION OF WORK
Address ✓ I.
S Main Building: Accessory Building: 2
0
TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL T Front N
Arch/Eng. AI 4 License No. 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICALI
B Rear
Address 0 OTHER A N
yys // ) t /Jg
Contractor's Name Mt/ tLeni]1f�m rAftc;#4.(/ Phone, PROJECT DESCRIPTION SQ. FT. OCCUPANCY CK Right G
Address(mailing)fi Map QZ.p tkssTµ .ZoY4,e. 6 9Q7J/ CON STRUCTION TYPE VALUATIONS s Left E
City License No. 367 35 ZONE GRADING CU. ACRES Ping. Ref.# Park.Fees $ 0
LICENSED CONTRACTOR DECLARATION U
Remarks: Parking Req./Provided I
I hereby that I am licensedion under provisions f charterroi (commencing R section -
mithis 7000)fullore and of 3 of the Business and Professions .de,and Use of Building:
my license Is in full forf�and of ect. E
Licens, ass ` -- Lista o. Art: PLUMBING I FEES Planning Notes: E
Date Signature «." ..ore
WORKERS'COMPENSATION DECLARATION Bar Sink Showers T
T
ereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S
Workers' Compensation Insurance, or a certified copy thereof (Section
4800, Lab. C.) Backflow Irrigation Sewer Cap _ • ELECTRICAL FEES
Policy No. Company
8 Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer ❑ 15.50 KW
Certified copy is filed with the city Building Division.
Date - _ Applicant Clarifiers Solar Collectors . Construction Pole Sub. 0 50+KW
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping
(This section need not be completed if the permit is for one hundred ($100) or P 9 Cooking Unit Meter ❑up to 100 amps
less). Drinkin Fountains
I certify[hat in the performance Of the work for which this permit is Issued, I 9 _ Solar Tank Dishwasher 1 Meter Dover 100 amps
shall not employ any person In any mann r as t come sub t to th .
workers�wlepa Laws of Califo ' �� 1/� Floor Drains Swimming Pool w/Spa Dryers OGas ❑Electric Sub Panel
Date rJ C �/ s declaration,
e � '/K.trfr�
Work /)C Comp m i< this declaration,you r become subject to la-- Floor Sinks • Urinal
Werke s' Compensation provisions of the Labor Code, you must forthwith Fan Motors❑0-1 HP 01%-8
comply with such provisions. or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar ❑B-15 HP 01615+
CONSTRUCTION LENDING AGENCY -
I hereby affirm that there is a construction lending agency for the performance Interceptors / Water Heater A! Fixtures
of the work for which this permit is•Issued (Section 3097 Civ. C.) Microwave
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address - • -
OWNER BUILDER DECLARATION Lavatories Outlets Range
1 hereby affirm that I am exempt from the Contractor's License Law for the p—Trap'following reason (Section 7031,5 Business and Professional Code: Any city or p' Switches
county which requires a permit t0 construct,alter,improve,demolish or repair Sign
any:structure, prior to its issuance,also requires the applicant for such permit Roof Drains - Garbage Disposal Standing Sections '
to file a signed statement that ne/she Is licensed pursuant to the provisions of
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
'vision 3 Of the Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05-15 KW Trash Compactor
•refrom and the basis for the alleged exemption. Any violation of Section ,
•31.5 by any applicant for a.permit subjects the applicant to a civil
enReinspection Fee
LJmalty of not moro than five hunred dollars($500). $25 Issue Fee $ 3
I, as owner of the property or my employees with wages as their sole MECHANICAL — Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not Intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves • Boiler Hood or Type I ❑
thereon, and who does such work himself/horse)) or through his or her own Zoning Approved By Date
employees, provided that such Improvements are not intended or offered for Duct-Under Ground Canopy Type 11 0
sale. If, however, the building or improvement IS Sold within one year of cpm- Building Approved By - Date
pletien, the Owner will have the burden of proving he/she did not build or im- 1 , (
;eve for the purpose of sale). Duct-Structural Refrigeration System Application tossed By�LXTJ 1') Date
tiC
O I,as owner of the property am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating LiSUMMARV OF FEES .
The Contractor's License Law does not apply to an owner of property who
builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ $MIP. $
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK • $ - PERMIT
0'1 am exempt under Section ' B. & P.C.for this reason Firepl/Fact.Bit. ICBG# •
PERMIT
ISSUANCE $
Date Owner Heating System&Ducting• PLUMBING. r$ S .no
PLAN CHECK 25% $ ENERGY P.C. $ I
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BT
information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $ ' • GRADING $
and state laws relating to building construction,and hereby authorize repre- MICROFILM $
sentatives of this city to enter upon t ajtove-mentioned pr rty r PLAN CHECK 50% $
Inspection pu g' AIL MECHANICAL $ TOTAL FEE $ jet
CO
Signator 4.-- ' Date Reinspection Fee $
Drivers' License or SS .... ��� ■ $25 -- Issue Fee $ 3 PLAN CHECK 25% ,
CMF 0865-46 rev.12/53 white-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
CONSTRUCTION AND PLANNING POOL PA • .
Date Inspector - . -'Date' Inspector
APPROVALS Permit# APPROVALS- Permit-#
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 Reinforcement 56, Rough Plumbing & Pressure Test•
6. Electrical UFER Grnd. . 57. APPROVAL TO COVE R-GUNITE
-
7. Footings 58. Electrical Conduit-Undrgrnd. -
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test •
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd, • .
10. Structural Floor System 61. APPROVAL TO DECK - r
11. Property Sewer Line & House Connection i 62. Backwash & Receptor-Final . -
12. Sewer Cap 63. Heater & Vent-Final . '
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 0 Gas 0 Oil ,
23. Gas Pipe-Rough& Test 72. .Undergrqund Flush. .
24. Roof Framing 73. Undergrnd.Storage Tank O Gas boil i
725. Roof Sheathing ' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical .
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL -'
29. Insulation 78. FIRE PREV. FINAL - •
30. Drywall Nailing 'HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED i ,
33. Final Electric Notes:,
34. Final Heating& Air Conditioning 1 .
35. Final Gas Pipe-Test -
36. Hood or Canopy . - _
37. Final Factory Fireplace •
38. Final Plumbing Vida- LEA)
39. Water Service-Final -
I
-
40. Gas Service-Final ' - • '
41. Solar Domestic-Final • _ . • •
42. Backflow Preventer -
r .
43. Backflow Irrigation
44. Landscape Irrigation System -
45. Sound Attenuation p
46. Handicap Regulations _ . - '
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed ,
49. Electric Release to Edison '- - •-
• I
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY -• - - -
No, Date - - _ . _
OWNER SAN V/91% BUILDING COMPANY DATE 6-1-64
JOB ADDRESS 104 Yorktown Lane BUILDING PERMIT NO. 22281
GENERAL CONTRACTOR same VALUE $ 15,735.00
AP No. LOT 298 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res watt gar
IS[;SECTIONS Signature DATE GROUP Da TYPE V ZONE BQ
!,:(4 ;/J-.�/�1�� '��lqr� PERMITS ISSUED
Gas r7 1_ �/ SUBCONTRACTOR DATE NUMBER
RoughIstg K -f
on. Refri ❑ Air Cond. ❑
Rough HeatibQ/f/ / -//-G6 35�J'I >9
Rough Plumbing 7J-S�-- y �'�..t�N / �lc-,/- SC t� 3 t1 � ,--
Miscellaneous
Miscellaneous (t
Prop. Swr. Line CA House Con.liSt. Swr. ❑ efri f///a7 (-1"--X- ( DEC 9 1954 4C ,7vl-
S§prinkling System // i
Construction Pole oL k,4
Underground C] Power •❑ ,,�i
Rough Wiring �p��`�` 9/ /7r�� ` (G.[_�1ea#1-640,74e, 7-10-G� ,2 33 /7
Trenches 0 Forms 0 Steel Reinf. 0 /,J m 1- 6/ /
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing 46 L•.3i — : 6
Frame and Flashing - / , - —9 G
Lathing—In ((JV Out Y irr a- all
Plaster, brown coat - /O 6 ce
FA '¢;,;. 0 Air Con. 0 Final
rit.3 ing, Final Planning Nal.
ns
Plumbing Fixtures, Final � / � �• °Y° i, /
Final Gas Test /(S t , - , L _ �'f -'r-"`'
Electric Fixtures, Final _ \ �-� o°"
Building, Final // i'�Y ,
OCCUPANCY `'I /
Form BU4-5M-3-63—S-B P HOLD TOR SPECIAL RFQUH&Mv-LTE%
1
,COSTA MESA BUILDING-S�AFETY DEPARTMENT FEE RECEIVED
I P.O.BOX 917 COSTA MESA.CALIFORNIA MV 1 9 S
•
For Applicant to Fill In Completely APPLICA-1 W?'5R(PERMIT •
TYPE OR PRINT (,I.BUILDING(I1 M
BUILDING For Office Use Only
ADDRESS 104 Yorktown Lane
RECEIPT NO.
COSTA MESA. CALIFORNIA 27.N1
RICE R BY DATE RECEIVED DATE ISSUED
OWNER San Vista Building Co. Illy 1 11184
BUIL ING
MAIL
ADDRESS 1166 E. 58th Street ADDRESS
CY Los Angeles 11, Calif. rNOAD 37187 FIRE ITZONE TYPE GROUP:74_i
ARCHITECT TH APPROVED DATE
OR ENGINEER Raymond Levanas NDLOR 37010 BY
ZONING
A . .ss 3432 Via Oporto, Newport Beach frit
�I NO.NO; I DBE Dl NW
�_ '1
PUNS BUILD_NN � 14CONTRACTOR San Vista Building Co. -
ADDRESS 1166 E. 58th Street DESCRIPTION Tract 51601 ��(
//- Lot 2,98
I
CITY Los Angeles 11, Calif. - A.P.NO. CMM .. � 7. � r/
NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
LISTA
E 192782 TEL.
E AD 37187 90'TO SIDE&REAR P.L.
C. EAVES
SIZE I NOO.OOF'BLOCS. O ALLOWED (U.B.C.REQUIREMENT/
OF LOT 20 x 70
YARDS APPROVED YARDS APPROVED (�
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. None y
' (FROM C/L STREET)/ (/ !�
SETBACK LINE FROM 13 I FRONT '7 FT. ( FT.
CENTER OP STREET 1 REAR YARD _ /� x=.!0 I RIGHT 0 R.SIDE (/I�/PT. FT.
SIDE YARD LEFT
DESCRIPTION OF WORK L.SIDE l' FT. FT. ...
ht./
CrI-NE X ALTERATION ADDITION REAR FT. FT.
DISTANCE BET. ACT.MAIN CL
Z
MAIN SWISS. ACCESS.SLOGS. c
REPAIR _MOVING •EMO/,L/ISH
BUILDING NO.OP / r E VAR.* DATE / IId
Co / 646 O
SIZE d2 OX3 �( ROOMS IC7 STORIES C.U.P..jF r��� APPROVED / /3
EXTERIOR WALL„ ROOF APPRO E, \�}IY`JI1.1' I ,� r J S. (j �/ O�
COVERING atuCCO COVERING Shin-1e _ BY I AM'I�• DATE J J °
USE OF BUILDING AND WORK TO BE PERFORMED 1 Ce
ResidenceDI
Zettaxz _
itt
w✓ (.5
l�
.1/6/260'FT. ,( - 4(20Z' o a.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN DER VALUATION IS FOR THE
AND STATE THAT, ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O o
PLY WITH ALL CITY O DINANCES AND STATE LAWS REGULATING VALUATION /-/ D SL
BUILDING CONSTRUCT! N. J N Q
1 _ PERMIT FEE $
SIGNATURE OF /C LA.L i 1 .L/ `J /,
PERMITTEE / l/`� $ /O7 /�./`PLAN CHECK $ ���Lc,
AUTHORIZED AGE / Y
S TOTAL FEE 5 w,�