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Home My WebLink About316 MAGNOLIA ST - Building Permits in/ CITY OF COSTA MESA ; 4a t -, BUILDING DIVISION 1. I '7 1.:1.: ' - DEVELOPMENT SERVICES DEPARTMENT PE UMBER • PERMIT 0-00063 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 316 MAGNOLIA ST Status: ISSUED Suite No Applied: 01/31/2000 Issued: 01/31/2000 Vicinity: Parcel Nunmber: 11725203 ISSUED BY: Applicant: NOCK, RON Address: 11612 KNOTT ST Phone: (714)895-1246 " GARDEN GROVE,CA Zip: 92841 Owner: , SCHICK, JACK F TR Address /316 MAGNOLIA ST Phone: COSTA MESA,CA Zip: 92627 Contractor NOCK PLUMBING • . Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 License: 707775 Arch/Eng : - Address: • Phone: • Zip: License: - • SCOPE OF PERMIT WATER HEATER CHANGEOUT. - FEE SUMMARY AMT QTYAMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00. 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 - 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial ' • $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 ' Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen • $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related Iregulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned I for a period of 180 days. IINSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS- ( J , _.) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ Ive and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit is issued. ( tr _I Have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for me performance of the work for which this permit is issued.Acha - My workers'compensation Insurance carrier and policy number are: ' /' Ir Carrier: tc l O .&f[R/r Policy N /&LtK-4F /'31Y0 (/ ` -(This s`ecf/on need not be completed lithe permit is valued at one hundred dollars($100)or less.) - ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these Prov ons. - D de-ra App ical nt Signature:e: � Date: z - 3 'WARNING:FAILURE TO SECURE WORKERS'COMPERSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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 affirm ihaP4am�ansa• der. •v'L,s nns.gf C�4 ter 9(commencing with Section 7000)of Divisionrr3-oLthe-Business and Proles/sloes Code,and my license is in full Jorce.and.effact:Lie. . '� /� ( Class k 7 C ,. Contractor's Si) - - - _ 1Date: 7 7—_3'- 2-0-'P) CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: I OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however.'the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cole). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S ure Of Legal Owner s) Date ' 3- C0 i And/Or Authorized Ap ' nt .. (�Date - CODE Y INSPECTION TYPE DATE INTRALS CODE* INSPECTIONTYPE PATEINRRALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical CO 1266 Pool Spa Final 208 Final Plumbing ?-`42O'�-� t11V 200 Final Re-Roof _ 210 Final Electrical 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 _ 2446-46 PROJECT ADDRESS: 316 MAGNOLIA ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 06729. OWNER'S NAME: SCHICK, JACK F ADDRESS: 316 E MAGNOLIA ST PERMIT NO: B 067294 PLAN CHECK NO; N GOVT: N SUPP : N --*f COSTA MESA, CA 92627 ' CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: ALT 1714 ) 548-6425 ARCH/ENGINEER: eEG.NO.: JOB DESCRIPTION : T/OFF & RE—ROOF W/COMP . SHINGLES SQ FT: 5, 600 ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: 5, 600 . 00 CALC—VALUE: 5, 600 . 00 GROUP OCC: R-3 /M-1 ADDRESS: OLSEN ROOFING CO. , INC. ( 310 ) 634-8470 6951 NEWTON AV COMMENTS: SMOKE DETECTORS REQUIRED PER 91 UBC. REROOF 3200SF RESIDENCE LONG BEACH CA 90805 1n8E-*+F********1F*aF*****aEiF*+FaF****** -*+F1E******y63t*+F**3Fak*1:* -*r******+F*ak************** - 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 Iiii e is in full force and effect. SETBACKS • CIT LIC.: 033906 STATE LIC.:254149 el ' C-39 Dale: J �.(�/f`��//I �/'yj;(N� Signature: ds MAIN BUILDING ACCESSORY BUILDING w,-KEII OM' lSAifiECLARATION: I hereby affirm I .t 4 certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT : FT IN REAR: FT IN ompensation Insure ce.or a certified copy thereof(Section 3800, C). LEFT : FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICYNO.: 456122-93 EXP.DAT . 07/21 /94 COMPANY: STATE FUND PARKING REQ; PROV: PARCEL: 11725203 ZNE; REF NO; ❑ Certified copy is he-by furnished. EN Certified copy isgi ith the city Building Division. PLANNING NOTES'>/ ,- , , ' / Date: A� Applicant'. A.1/ **************1E****************************************************iE*'********** 4 PTION FROM WOR RS'COM'ENSATION DECLARATIO : (1' on need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREME N S T S I certify that in the performance of the work for which This permit ed.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California' ZONING APPROVED- BY • DATE: Dat . Signature: e NOTICE:It,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY . DATE: 'r/? Code.you must forthwith comply with such provisions or this permit shall be deemed revoked _ A CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; DATE: 4 which this permit is issued(Section 3097,Civ.Cr. *****.****.***.*a{:3(.*********************M iE iE)(******1E*#**************# Cr----- LENDER: *******************************************************************ir******** ** 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 repair any structure.prior to its issuance,also requires the applicant for such permit to the a signed statement that he/she is licensed PERMIT 81 . 00 / . 56 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN forpermittheapplicant a civil noir of not more than five hundred dollars 500. �A/'� T any applicant o ahebipdsorto penally will ) ISSUE FEE r— ISSUE111�1QFE DET I, as owner of the property my employees with wages as their sole compensation, will ct the work, and the BUILDING—DLL > PERMIT PL �'f.Tj'� OR PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 81 . 56 0 . 00 0 ...20 8 11 �-5 81 . 56 . 00 doesis not applywto pl owner. of a property who buildsmror improves not into and who does such work ,himself/herself thbr through 7 l y�F--^ I �^ his or her own employees.provided that such improvements are not intended or offeredfor sale.If, however the buildingor j�-('AF_IQ '�/] improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE ENUE D IC I S ION TOTALS--> COL L EC TED. 1 OVER/SHORT; . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT" GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 .156 Eland Professions Codo: 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. o I am exempt under Section' B. a P.C. INDIVIDUAL F E E BREAKDOWN tor thrs reason: TYPE QTY DESCRIPTIO N . 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 5600 REROOF BY VALUE RESIDENTIAL NOZONE j" 1 . 00 5, 600 . 00 25534 and that I or any future building occupant will/will riot(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: 1 I hereby certify that I have read this application and state that the above info❑atron is correct.I agree to comply with all city and county ° sand state laws relating to building construction and hereby aur epresentatives of this city to enter upon the above-mentioned 4-- +' •' /property rinspection purr ores ::} /t Da ' Signature'. 7.40"1/4„. 01 00161026-00161027 TOT 81.56 Driver's License or Socia Security 4: DATE: 05/24/94 TIME: 10:43 1641.46 White—Building;Green—Code Enforcement:Canary—A tic nt:Pink—Revenue:Goldenrod—Assessor CO-'1'STRUCTION AND PLANNING • POOL ... SPA 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 Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical LIFER Grnd 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrernd. 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 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-I 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. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil • 25. Root Sheathing 6!-2-1C( 6(196e- 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 -I 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Arc Conditioning 35. Final Gas Pipe-Test - 1- -4, 36. Hood or Canopy 7 -a 37. Final Factory Fireplace II-_ 38. Final Plumbing r.-% -5 • 39. Water Service-Final �. f 40. Gas Service-Final {4•1 ? 41. Solar Domestic-Final • 42. Backflow Preventer (p-/ -4!✓ cid-Sr p- • 43. Backflow Irrigation y L - 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /-27-q`l blab' ' 48. FINAL PLANNING 49. Electric Release to Edison - 1 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • OWNER SCHICK, JACK DATE 2-15-66 JOB ADDRESS 316 Magnolia Aveneu BUILDING PERMIT NO. 25270 GENERAL CONTRACTOR Richard W. Thompson DESCRIPTION OF WORK Add Mn, Patio & Aet,. Garage Al'No. 117-252-02 LOT TRACT FIRE ZONE VALUE $ 1f,825...00 NSPECTIONS �Sigoat a Date GROUP I&J TYPE V ZONE R-1 oil n�f•L- leg-4 PERMITS ISSUED Gas SUBCONTRACTOR 1�f{Y(r Date � Number I Signature Water -(�� _ : Plumbic• \ Rough Plumbing / dlt: _i_ ,iiiGf/J)l��Y..' 4/ , Prop. Swr. Line�f-Iouse Con. E &. .. ^ *y-,1ZtJi V1 7-6_et, Sprinkling System / Miscellaneous - . Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 Rough Wiring z? 6 Heating and Vent. Trenches E Forms m- Steel Reinf. ❑ h 7ycc Floor Syst• 1.-- - - ---;-r lenkyd 6- a Bond Beam 0 Steel Reinforce 0�- � Sheathing /bie-4.0 L 17,57-0.7 .5,607%.4-7 G 77Q et/ e Frame and Flashing tar Lathing—In (g/Out j3 Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final „},,cte f'Q,ee. /;--2--i-6a6i$;1 Plumbing, Final and Gas Test 0 i •7 Electric, Final Iq '7•;f•6 (a Building, Final ,q;--- _ S/ 6l • ?5276 INOF C CS i A MESA COSTA MESA BUILDING-SAFETY DEPARTMENTL FEB 471966 P.O. BOX 1200 COSTA MESA, CALIFORNIA 02620 For Applicant to Fill In ComplkNly IC IGiv i. PE' TYPE OR PRINT'' is u - Foi In Use Only BUILDING , /� II ADDRESS 1�> (,. Ma �( n L iii - RECEIPT NO. PERMIT NO. COSTA MERV CALIFORNIA /j'.� /j_� 96 276 ) Al / / RZC7/ ZA nR Q[, pAT[I6 6J), OWNER M} T A1_ C/re S.eA/eir l // OC/ 1/®Jv MAIL / 'n fid"' BUILD NG ADDRESS �,(1 C. /'/ d / 4 ADDRESS I G /V 11-�AfM / �7/� CITY "C•/>'/• TEL ZONE TYPE ' GROUPT_+�- NO. �/ IliCEHNIO NEER TEL. . it46cv 6 PROVED//v��i DATE 2 �� O. C_ . Dj ZONING ADDRESS NO.OP / USE OF NEW 0 ��}O�,_y�¢ 1 I I PLANK ' V I BUILDING M'-Of'(l�6, afifi r CONTRACTOR P/!bp II/-,1s I L�/JZI2aIIn,4 S.L ��L / !VJ ADDRESII tV U qG /N P S//�L/15/"P/ U N DESCRIPTION /(J7 ^ 'I ( 1 CITY i 'M. A.P.NO. /I ! - ,, cd '-- 6 3 ///��ATE • ` c NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC..NO. /3 T / 999107 EAVES /N9, tc /T- ,2 �� 80•TO SIDE B REAR P.L Barite, SIZEOF LOT 5� *Ia a/1Gr 1 NOWT SLOGS. wTIIII ALLOWED (U. .RTI JP YARDS APPROVED YARDS APPROVED USE OF n p S / /p� �, MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. // O --1 (FROM C/Ltrinity) I& r / SETBACK LINE FROM FRONT A/ CENTER OF STREET REAR YARD / i SIDE YARD I LEFT I RIGHT R.SIDS C T. I/J FT. DESCRIPTION OF WORK L.SIDE 5"FT. () FT. le_v ALTERATION ADDITION ' v'' REAR I() FT. .7 PT. DISTANCE BET. BET.MAIN& �� REPAIR MOVING MAIN BLDOS. ACCESS.SLOGS. DEMOLISH V S ZE�INGot I,.� �f ROOMS / STORIES I C.U.P.�F APPROVEDE / ROOF CO■E�RIINNGKKRIOR WALL'f A/ COVERING�g�(a C �- APFROV[D P12 .4 DATE a r7-6 b w 4dJ "'t/ ik00 ' ,frit/4R 4,i;n , IA/✓ F/ SI? 5 rr ) Li/ -gps,,, (4119 0 0Cowva a) rr/ 1559 I i 2 527 SG.FT. '3,F S 2 76 I HEREBY ACKNOWLEDGE THAT-I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION is FOR THE G AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION a'A 00" \ ,�/'j� /,� PERMIT FEE $ I " and PERMITTTTEr O� / ""'� r/ $4 g'�_5 PLAN CHECK S / W AUTHORIZED AGENT I G fr v - . . TOTAL FEE 5