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HomeMy WebLinkAbout192 YORKTOWN LN - Building Permits I r CITY OF COSTA MESA o5`' "'F, BUILDING DIVISION )••i„,. ,���• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 N'oP afi PERMIT NUMBER: P09-00115 PERMIT TYPE PLUM STATUS: ISSUED APN: 41916546 DATE ISSUED: 09/03/2009 ISSUED BY: BJK JOB ADDRESS: 192 YORKTOWN LN CM Suite/Unit: Vicinity: RESIDENCE AND GARAGE SCOPE OF WORK: CHANGE-OUT OF A WATER HEATER LOCATED IN AN ENCLOSURE BETWEEN THE RESIDENCE AND GARAGE. OWNER: HUNT,VICKIE Address: 192 YORKTOWN LN PHONE: • City/State/Zip: COSTA MESA,CA APPLICANT: ZARATE,SIXTO Address: 1720 WHITTIER . PHONE: 949-646-1185 City/State/zZip: COSTA MESA,CA CONTRACTOR: EVANS PLUMBING INC License No. 498867 Address: 1720 WHITTIER PHONE: 949-646-1185 City/State: COSTA MESA,CA ZipCode: 92627 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I. INSPECPON TYPE DATE INTITIALS CODE 4 INSPECTION TYPE DATE INTITIAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ID-II Oi fly 41‘14147.3 200 Final Re-Roof 210 Final Electrical J 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ 250 Final Building/Occupancy 4110) 11110t to WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No, Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the perform of the work for which this permit is issued. \. have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are' person is required to descend,will be made in connection with work authorized A A d1 t by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier.* /P r/�02YpL/� z�/,�.,zf-v� N- ,((i/1 -�/ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seam need not be completed dth(the is valued at one hundred dollars($1c0)oreess) 2,Art 2,Sec.341,Title B,California Administrative Code). �f Policy Number: 4 0 1 0 5 7.5-CoL ❑ As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become su ct to the workers' compensation provisions of Section 3700 of Applicants Signature Date the Labo e,I sh ort . ' c mpl these provisions. ., C ., p q Q 7 Division of Industrial Safety Permit Number: Applicants S re / ) Date. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. /.. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.:#—._ / . • Class#.. l — ?e (Section 25533 of the California Health and Safety Code, with some / /" -7 ?— 1^© exceptions, requires registration with the Costa Mesa Fire Department by � each business which at any one time has on hand a quantity of acutely 1,-1 Dornracto •r. re Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Section65850.2n furnishedothe Califomia Govemment Code requires dithnt the mitreq ). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). 0 I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If'yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for control officer 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 CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.), 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 ❑ I am exempt under sec. ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. ature o gal 0oDate signature Date Q I� — _ A 9 3057-46(3/07) AndlOr Authorized Ap Date ADDRESS OF BUILDING: 192 YORKTOWN LN DHT' CITY OF COSTA MESA — BUILDING PERMIT 'slosh' PLIgE IF KNOWN: HENNESSY, JOAN A PERM NO: B 073622 ADDRESS: 4219 W HOOD AVE BURBANK,CA 91505 PERMIT NO: B 073622 PLAN CHECK NO: N GOVT: N SUPP : N APPL.SWUNG ADDRESS: CONSTRUCTION TYPE: VN PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 2, 999 ARCH.OR ENG'S ADDRESS: UHT: CLAIM VALUE: 2, 999 .00 CALC—VALUE: 2, 999 . 00 GROUP OCC: R-3 / CONTRACTORS NAME STOUT ROOFING INC ( 310 ) 923-6775 caNTRACTORS MdduHG P 0 BOX 4309 COMMENTS: SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRESS: DOWN EY CA UC.NO.: 402536 ****************+t*****♦EiEif*+tiFiE1E#iF1ElEiE+tiEiFiE*iE3EifiEiflF**♦F1f*#if*♦E*1E#iEfElE#+F+F+t+E+E***IF*******1E 90241 UNC: Z ON ING REQU IR EMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Profess' e,and my license is in full force flea. CRY LIC.NO. 5 77a C 39 LIC. 025 6 EX 10/ 5 MAIN BUILDING ACCESSORY BUILDING �� � RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dae: cont.: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors Lioene w for the following reason(Section 7031.5 Business and Professions Code:Any city cc county which requires a permit to construct, er,improve, PARKING REQ: PROV: PARCEL: 41916546 Z NE: REF NO: demolish.or repai any structure,prior to its issuance,also requires the applicant for such permit to Be a signed statement that he or she ...licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Swan 7000)of Division 3 of the PLANNING N TES> r :ninon and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section > .031.5 by any applicant for a permit subjects the applicant to adell penalty of not more than the hundred dollars($5001). *********************************els********************************************* ❑ fewgthe ° ce�d �asC ° ° r'°lliem'end plstructure ' wmr°pem DEVELOPMENT V E L O P M E N T S E R V I C E S REQUIREMENTS Q U I R E M E N T S ordksale(Seet 7044. and demeConorsLcensl� ttaaenawnerprope who bolls or improves thereat,and who does such work himself or herself Of through his or her own employees.provided that such .A improvements are not intended or offered for sale.5,however.the building«improvement is sold within one year of completion,the ZONING APPROVED BY DATE: - owner.builder will have the burden of proving he or she did net build or improve for the purpose of sale). ❑ I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY DATE: Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contract«(°)licensed pursuant to the Contractors License Law). ❑ Iamexempt under Section B.a P.C.,for this reason: APPLICATION ISSUED BY: iE DATE: 4—;&--- *********** ** Date: °°er LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby cattily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,end 25534,and that I or any future building occupant will/will not(circle one)need to comply with said state codes end the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/RES GRADING a permit tor v u anana constructionor modification from the Agemem Distrix.Residemi°l construction applications are exempt from these prossiont PERMIT 54 . 00 . 50 Date: Applicant: SMIP/NON—RES PLAN WORKERS COMPENSATION DECLARATION:I hereby alarm under penalty of perjury one of the following declarations: ISSUE FEE o Ihaaeend oil maintainacertifiatedconsent toselfinsurel«w« compensaion.asprovi keradedfobySecion3700 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE cad..f«teperformancew new«kf« r wnmapem issued. TOTALS----> 54 . 50 0 . 00 0 .00 54 . 50 54 . 50 . 00 (1 1 have end Nil maintain workers'compensation insurance.as required by Section 3700performance of the Labor Code.for the perfor ce of the ]� work for which this permit is issued.My workers'compensation insurance carrier and policy number are: Carder STATE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT: . 00 Policy Number: 044940000468 / 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK section need nor be completed if the permit is for one hundred dollars($100/or less.) 54 . 00 . 50 U I certify that in the performance of the work for which this permit is is. ,I shall not employ any person in manner so as to become subject to the workers'compensation laws of California, •roe that N I should become to the rkers' *****************************{(********************{F{E3 **3F*******{(-{f************** convertproorons of Seer of the Labor Code,I shall nmply pthose provsions INDIVIDUAL F E E BREAKDOWN Dela: Se Applicant: It Lid . /..--Ar Warning:Failure to secure worker'compensation coverage Is .nlewlul,and shall subject an employer to criminal snaffles and TYPE QTY DESCRIPTION UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000),In addition to the cost of compensation,damages as vided for In Secdon 3706 of de Labor Code,interest,and attorney's less. SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 2, 999 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this pearl is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above inlmnatpn is correct.I agree to comply with all cry and county ordinances and state laws releE i•to building construction and hereby authorize representatives of this city to enter upon the above•mentioned property for inferiors DARLENE BURF• .D Pdnt Name S / ` 01 00187620-0018?621 Y 7_7 T 54.50 IW� /� �Ii�� A. / Data �� L/ 9� QAIt. 08/u4/9.5 TIME: 08:4; ,-.Signature of Owner/Agen&Ap:cant/Contractor (5151.46 WPI White-Building&Safety:Green-File:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor I POOL ' 'A CONSTRUCTION AND PLANNING t APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector ^p 1. Temporary Electric& Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement :.3:Electrical Conduit Utility-Unci grnd. 54. Forms - .4.'Electrical Condua-Urrdrgrnd. 55. Electrical Bonding f y='S..Steel Reinforcergent'• 56. Rough Plumbing & Pressure Test A 6. Electrical UFER'GFnd. 57. APPROVAL TO COVER-GUNITE . -'=7,-Footings 5B5 3 . Electrical CondUjLUndrgrnd. 1 :8.- Foundation - - 59. Gas Pipe, 0 Undrgrnd.,Test =`9, Water Pipe-Undrg*nd, ' 60. Backwash Lines, P-Trap, O.Undrgrnd. `? • 10. Structural Floor System . 61. APPROVAL TO ark K{_ • 11. Property Sewer Line & House:Connection • 62. Backwash & Rece'ptor-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 7I 66. Solar System-Final 16. Rough Electric Wiring _ 67. Fencing & Access Approval - 17. Rough Wiring Sign - 68. APPROVED F0R'PLASTERINC . 18. Rough ElectricaLT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditionirig FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fl Pace ' '^t" A;C r j -•,; 5APPI?OVQ&&,'4:S- ^'Permit# w, 7- 21. Ducts;in StruLture- •• �= >. 5 P '. 70. ;Undergo-6d Hydro F i 22. Ducts, VentilaUngrc.a r - `' 71. Produdi•king O,--Zas 0 Oil 23. Gas Pipe-Rougfi & Test i _ M5 r, ^ 3* 72. Underground Ffnth'= a - ' - - - C , _. ., yr - 24. Rbof Framin _:t I E'i-' ••E , = 7 cs 9' is F - ,.,.t '. 73T Undergrn-8,Stoiai Tank:❑Gas ❑Oil . . • 25. Roof Sheathing -� 5jzc- £6.45 ' 74'•Overhead Hydro -- .- - . 26. T.Bar Ceiling (StructLrall & Mo�7:o•.Coat '� - di 75,. Dry Chem_ ical ;_ - Y. - '' s 27. Frame and,Flashing-r j,r - =,, 76. Dry Standpipe ; ._ 3 - 28. Lathing&'Siding > v j'A- ,. E " •' 7E FIXED SYSTERaINA[_, r- - 29. Insulation • Y. s 'i 7&: FIRE PREY. FINAL - - 7 '30. Drywall Nailing Er:, _ NEALT!DEPT.- REQUIF;rEMENT 31. Plaster Brown coat a S i - - : 79:• FINAL ICVS_EECTION >: _ -- 32, ElectricarPoweMterm r inal : "80,x, FOOD CERTIFICATE ISSUED_ 7 x r: T C' -33, Final,Electric-, -,. _ , - _ Notes: _ ;!r -: ._ c 34. Fina LHeating & Ain Co_nditionirig s t * _ -- r S C- - -, -:r y 35. Final GascPipe-Test_, _ 'll .. X --i k -, - - 36. Hood-or Canopy _ a ' 1 A :: L .'=' s _ X37. Final:Factory Fireplace,- . I P ` - _ ��� 38. Final Plumbing 7 c: t >. = - '•' : - t I . _ f -. :. - x 39. Watei Ser34ce-Final' .. - r` :. H 40. Gas Service-Final x - . - ( -r: ma - . c.;- J . F -• OX r cr 41. Solar Domestic-Final 2 r. _ _ `, - 42. Backflow-Preventer - r - t;- 5:-, • - 7 - F. * .- ri -.-.-:-.1.: 43. Backflow Irrigation ; x=-- " -• - -yam 44. Landscape Irrigation'System a:- _ n ii C) ""- ' , n% -- - e ;) F. 5_' n k S. -- 45. Sound Attenuation j.• A s .::'4_ . - - - 46. Handicap Regulations - +� " n: " = S • 47, FINAL STRUCTURE & BUILDING `Q..31,g11 4.1„ett. 'Cr^'`- t _ 48. FINAL PLANNING" -r c44 i ' * - k Y f S '. ✓( • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co t I - - * 51. CERTIFICATE OF OCCUPANCY/ * .-4 _ o" - r - No Date OWNER SAN VISTA BUILDING COMPANY DATE 6-1-64 JOB ADDRESS 192 Yorktown Lane BUILDING PERMIT NO. 22247 GENERAL CONTRACTOR same VALUE $ 3.11.835.00 LOT 197 TRACT 160 FIRE ZONE DESCRIPTION OF WORK res w/att gar l gYECTIONS Sig aatt�ure _DATE GROUP pa TYPE V ZONE RS Soil i/ 4/ SUBCONTRACTOR PERMITS ISSUED Gas ✓✓✓ DATE NUMBER Water • • Rough Corn. Refrig. 0 , , Air Cond. ❑ , Rough Heating ,,,����JJ 0j 'e .J- • `/ z1ils, 3,s-3e// Rough Plumbing . v / 4 Ai a • .44„„),"", i• /-!o V cZdl rt ,\\/ Miscellaneous (/ Prop. Swr. Line ❑ House Con. 2(St. Swr. 0 1•4 IF/ / A-L t-a-F_-- . 4FC 9 1963 4 0 7 4 t Sprinkling System / Construction Pole ltri Underground 0 Power ,❑ Rough Wiring ,ie gyp- 72? .5 _..9..e-_--, SEP 1 7 1964 23 4 3 Trenches ❑ Forms 0 Steel Reinf. 0 , ,gyp • Floor System t 'v l • 7 C}t' py„v,i„q Dept • Bond Beam 0 Steel Reinforce ❑ / Rw. -'�� __ Sheathing tie Q- _ • _ ,_ / . / Frame and Flashin•_ is /0 L �� wait D��' lift'l r Is;',Pg— Ingcoat 1 , c /v�/ C 1/ Jq! •" i- ^*sr, brown coat . /g 7` - =...gi Rettig. 0 Air Con. 0 Final . Heating, Final - , / Plumbing Fixtures, Final Final Gas Test /S'7d / /, 6 Electric Fixtures, Final - �/�ep_1'z zb( Building, Final , '% £TjS---' OCCUPANCY Form 8U4-5M-3-Ga-s-B P HULL+ rUr, arLLtAL REQUIr.it i.IiTS • 22247 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT ANY 1 9 Taft P.O.BOX 317 COSTA MESA.CALIFORNIA (� DIEFEAT \ For Applicant to Fill In Completely APPLICk 41 TYPE OR PRINT % t D""' For Office Use Only BUILDING I 9// Po.,,4 ADDRESS -f LA/ O✓v�L RECEIPT NO. PERMIT NO. COST MESA. �CA�LIFORNIA / 09747 SUED OWNER JL1..... �t�[\t\ REGI D Y • .6R f9�V10ED _ JI MDATE-B 1964 y� BUIL IRO / Y ADDRESS r t , ,c �y ADDRESSFIRE '["7' '�/ T CITY t 1/. // NO� )//7 ZONE TYPE _, �/ GRou.2-4-v APPROVED ARCHITECTTEL BY DATE OR ENGINES NO7OVD AL YS Lgy 3 LII - &g �}�-"'�� ZONING --� %I a144.. Z no. U860P �'1 /'j� I PLANE I BUILOIN•� ��./. /C CONTRACTOR .\(1.L,L V r „tr..... \"J\ •, LEGAL J /‘ V I ` I' ! ADDRESS ' 1 6Ip� 8 • „still DESCRIPTION CITE // A.P.NO. / LL / • / / J ` c At '7 y�1/J NOTE: NO EAVE OVERHANG SHALL B LESS THAN LIC.NO. `?5Q7f Z T%-, /) 3 //l! / EAVES SIDE @REAR P.L. SIZE C e) IJ e2 O I NO.OF SLOGS.D ALLOWED (U.B.C.REQUIREMENT t,.. OF LOT X NOW ON LOT USE OR YARDS APPROVED YARDS APPROVED EXISTING BLDG. .0-r..Q MAIN BUILDING ACCESSORY BUILDING • (FROM C/ STREET) 67/. SETBACK LINE FROM /2 j FRONT �I PT. FT. • CENTER OF STREET CO^� n FT. .-I REAR YARD O ,/ SIDE YARD I LEFT I RIGHT O R.SIDE PT. /`) DESCRIPTION OF WORK L.SIDE (.l FT. FT. , NEW _ X ALTERATION ADDITION REAR () PT. F.1,•NEW DISTANCE BET. BET.MAIN @ MAIN SLOGS. ACCESS.BLDG'S REPA. MOVING DEMOLISH 1}L ,4J N ��jj VAR.# DATE BUILDING NO.OF Q ^ SIZE o°1�X 3 .ROOMS .S' STORIES d , C.U.P.# APPROVED EXTERIORWDI ROOF C� I1 APP OVIiD g COVERING COVERING JJ�•L•r?L BY I LL(/‘ DATE • -• : :UILDINO • D WORK TO BE PEsir RMED Cat, ( jin—. a 4,- n� r36g e4.Fr. 920 Z" G b I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 0 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION -"" 0 BUILDING CONS UCTION. 7{YlN SIGNATURE OF PERMIT FEE $ ^ S PERMITTED $ /h// i3 ___. .. . X O AUTHORIZED AG T y y TOTAL FEE 5 /