Loading...
HomeMy WebLinkAbout1156 KINGSTON ST - Building Permits CITY OF COSTA MESA BUILDING DIVISION h�j••,„ 1I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 PERMIT B03-01984 ,tel J • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cansDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUI• Job Address: 1156 KINGSTON ST Status: ISSUED Suite: Applied: 11/17/2003 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 11/17/2003 Parcel Number: 41204205 Zoning: R1 R1 �, `/ Applicant SELL, RON - - - ISSUED BY: k V Address: 18032 LEMON ` Phone: (714)528-1758 - , YORBALINDA;CA<' Zip: 92686 - %�, `� Owner SCHUREMAN, JOHN A- _ - Address ,1156 KINGSTON - . , - - „ �i� Phone: \ COSTA MESA;CA - - Zip: 92626 .,,..\ ,, �, Contractor , SELL ROOFING COMPANY vv/ Address: 18032.LEMON, Phone: (714)528-1758 ' YORBA LINDA,CA ' ` ' Zip: 92686,' License: 1 323842 Arch : . . - Eng: _ Address: - - -, - Address: , . Phone: - ., Phone: ” ' 'Zip: "' - -License: License: - SCOPE OF PERMIT TEAR OFF EXISTING SHAKE ROOF. INSTALL SHEATHING,'FELT AND COVER WITH EAGLELITE TILE.ICBG 4660.. . FEE SUMMARY ' Plan Check: -. $0.00 , - - Calc Valuation: $8,900.o0 Permit: $167.25 Claim Valuation: , $8,900.00 SMIP Res: $0.89 --' - - - - ' `SMIPCom: - ._ $0.00 •-7 , , Other:, ,`, $0.00 .- - Inspection : • \.$0.00 '/ \ ;,,Total: , $168:14 - - . - /' V\::V - > `\:. . PLANNING &ZONING ' - —7,/ SETBACKS/, 'l MAIN STRUCTURE Front 0-0 : Rear - 0-0 Left 0-0 " Right . ,0-0 �- ACCESSORY NFront 0-6: ' . ' Rear - 0-0 Left "0-0 Right . 0-0 / / PARKING Existing: �0-- Required: . 6 Proposed: 0 NOTES: - . ,— " 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. • 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. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS ( ) n WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end 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 work for which this permit is Issued. have and will main in w rkers'compensation ins ranee,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Isissued. My workers sur ardor a alloy number are: /06 G 5-5-77 Cartier. Policy Number: (This section need not be completed/the 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 manna(so as t become subject to the workers' compensation laws of California, agree that it hould become subject to the workers'compensation provisions o Section 700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: n1 Date: 11 11 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESA CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDMON 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 that I am licensed under provisio of_.h..er•(commencing with Section 7000)of Division 3 of the Business and Professions�pa d my license is in full force and effect.Lic.# Class# LY Contractors Signature: /11191W-�� Date: ( t i (-ILO_ 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). Lenders Name: Lenders Address: Signature: Date: 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.). t a pt under sec. Business and Professions Code for this reason: Date: Owner e m D verified by drivers license. 0 Yes 0 No Drivers 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: I 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? 0 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 application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes u 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 0 NO (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cale). 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 0 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 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 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- spection os s. gree ��not to occupy or allow occupancy of any building authorized by this permit untl final inspection. ,tur�Le / ( I ki In 1 (:)...- e Ve And/Or Authorized Applicant t Date coca# LNSPECTION TYPE - QM INTIRALS CODES INSPECTION TYPE PATE UMW S 1616 Fixed System Final Fire Prevention 206 Final Mechanical _ 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof /J.-Z.4-al 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 PROJECT ADDRESS: 1156 KINGSTON ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 05722E OWNER'S NAME: SHARON & JOHN SCHUREMAN ADDRESS: 1156 KINGSTON ST PERMIT NO: B 057226 PLAN CHECK NO: 01641-92 S GOVT: N SUPP: N COSTA MESA CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: SIR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; 15211SF ' TRELLIS—TYPE' PATIO COVER SQ FT; 152 rT ADDRESS: UNIT: CLAIM VALUE: CALL—VALUE: 2, 097. 60 GROUP OCC: R-3 / PERMITTEE: GREBBS CONSTRUCTION ' ( 714 ) 637-4108 • ADDRESS: 2056 N. CHOUTEAU COMMENTS• SMOKE DETECTOR(S) REQUIRED IN HOME. iE ORANGE CA 92665 ******** ********************* T6>F********3F*** **********y6******* ******x**** ** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQUIREMEN TS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: 055196 STATE LIC.;6194 07 c}nss: Date: ,.....t.-- Z ___./P!/— / —� Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 83 FT IN REAR: 10 FT IN FRNT: T IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3010, Lab.CI. LEFT: 14 FT IN RGHT; 15 FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: 1 2 7 72 3 4 EXP.DATE: 1 0/0 1 /92 COMPANY: STATE' FUND PARKING REQ: PROV: PARCEL; 41204205 ZNE; PDRM REF NO: AprCertified copy ishereby furnished. ❑ Certified copy isfiled with the mgDroision. PLANNING NOTES> PROPOSED 152 SQ FT. LATTICED PATIO COVER 10FT, FROM Sr-- p. /� > REAR PROP, AND MIM, 5 , FT, FROM SIDES, Date: 7 _( 2� Applicant P// ********7E*****1f-*********************1E*******************!f***ME*******#,Lf********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the perat is for one hundred($101)or less). D E V E L O P M E N T SERVICES R V I C E S R E Q U I R E M E N-T 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. ZONING APPROVED BY : Q'1;�'..g DATE: -'S—/ 17-2= Date: Signature: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY :_s _ 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 ' t,4 ! �1 DATE; �t(/�l' which this permit is issued(Section 3097,Civ.C). *****..****.*************• ' ' :. 7 �. .N.****.****.*****..**,*.*.*,*.*A iF''f�F iF *N, 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 SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or P ERM I T 5 4 . 0 0 ,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 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 35 . 10 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 properly 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 35 . 10 89 , 60 89 . 60 . 00 does not apply to an owner of a properly 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. If,however the building oriip REVENUE DIVISION TOTALS--> COLLECTED• 8 9. 60 OVER/SHORT improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve0 0 for purpose at sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TUT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 00 50 .�5 10 ❑ 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).l am aware **************************************************************************k**** , that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EA KDOWN o I am exempt under Section: B.A.P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 152 RES—PATIO COVER—POST & TRELLIS 13 , 80 2, 097 . 60 I do hereby certify 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 will/will not(circle one)need to comply with said state codes and the requirements for 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 re s I ives of this city to enter upon the above-mentioned property for inspection purposes. 01 00114250-03114752 T�uT �9„:41 // DATE: 05/04/ 2 TIME: 15:39 iv-- Dale: <--/- q.v.: Signature 1 Driver's License or Social Security 4: 1641.46 While—Builtline::Green—Code Enforcement:Canarv—AoolicanC Pink—Revenue:Goldenrod—Assessor ' CONSTRUCTION AND PLANNING POCI'PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service of 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-Undrgrnd. • 8. Foundation I 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. i 10. Structural Floor System - . 61. APPROVAL TO DECK . /, 11. Property Sewer Line & Hotise 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-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. Underground Flush 24. Roof Framing 73, Undergrnd.Storage Tank 0 Gas 0 Oil 25. 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 ! 1 _ 78. FIRE PREV. FINAL 30. Drywall Nailing -: HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! i 79. FINAL INSPECTION 32. Electrical Power Meter-Final ; - _ , 80. FOOD CERTIFICATE ISSUED 33. Final Electric - - Notes: 34. Final Heating & Air Conditioning I. 35. Final Gas Pipe-Test ‘,,. • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final . . . ' • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low Preventer I ' 43. Backf low Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations /// - 47, FINAL STRUCTURE& BUILDING (�/ ' � _ Ql- 48. FINAL PLANNING -- - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 1 51. CERTIFICATE OF OCCUPANCY No. Date 1 !+inr _ NOTE: SHOW AND DIMENSION PROPOSED ADDITIONS, DELETIONSCORRECTIONS SHALL PATIO COVER AND YARD AREAS • BE APPROVE" BY THE PLA. ;;;i;•o DEPARTMENT II - +_ tEE�'DETA'ICS-O NY2EV ER9f-SIDE -- - - {� 1-1-01-----NX; . e. ® I ' 7 i' r 1 \ T ii "'• •.•• ,/ROOF SHEATHING I I!16\ ' ! I ! I rsd-14' r}, \ XRAFTERS•,••••.... O,E RHA,G ,, 1 \ AT__0.C. • 1 . I I: 1 IME 11 tL *z �\ 'r--'- r co \ _X_ BEAM I \ T=STRAP-EICSIDE ' iP--.��1/�y�.. R BOT BEAM \ PP1 ia.wCit No .O •awv Penult I• ACCOMPANY y1GG/ g 'City of Costa Mesa Building Dept. Zi w a w o THIS Nl1NB• P.ITIONTREQUESTS I y \___� Z% DATE is/ 1e4a o a. a f ALL I I j�l V �'J9 9 °'TH S E PLANS MUST BE ON JOB AT AU_ TIMES M4KFo cr i o 1 O I ANGES WITHOUT PR O R APPRtg/AL OF DE7110 le r.- -r-I I ; OFC A MESA - T o N z c0 w HE`I;SUANCE O �r�'�61Nn>•r_ OF AQfSiMIT OR APPROVAL rfFO w > PLANNI DEPT. PLAN V FIDSPEr"n"A-'$'!, ,O;, vy RECCESTRUED TOI=F�AJ z 0 U- T TO . DEPT PERI.I7`FOR, iR A ¢-9.O?:I O° %$1=IIOL iON OF ANV F= o - Q I I THE f P'iOVIS' NS OF THIS CODE.140 P- m,AT P:4SL* VNG TO Ge E- 0 r • AUTF f IT rr, ,A c 4,•.n ,Ot q,0 FR-ilc:..NF . F to SY I DA � , ScOfc, TO:ORAIN r P,CATE, T B 1 C LLQ v rP.4�l AST tABOVEESLAB o ,ALU' �� iall FOR INSPEOYI®• ^S �' r • } I I,AVI n bAI D �Ury FUNS Ail) {+ •N9. SPEC 'F.Ar.r c c AE M i c VCNiL HE W'LC. 'G O fl 1 F}.JMT}+ERE261GAfFG•:1.„r-A$HING0r „L„,OF 139.0 SNI I I LL / 1.t at , SAD pl_:P:S AIWOOD_aFLOOR)F 3 on FROM PREVFII'C ---J C� �, / IRUILD?7IG OFCONSTRUCTION EF?RE:.0^i T1P_IERSDI2i�F�S LI D. 7545626 ''L� ' I +i_�LLA:ICH OP THS CODS OR O?ANY OTHER 0412NA OF or 754-5627 STREET • �11�IKE pE1 � R 1JE(� i 'r � SIDE ELEVATION • PLOT PLAN CONSTRUCTION DETAILS 20uu,ROOF CONNECTION D ppn ENT DETAILS SERVICES DEPARTMENT , . PATIO COVER • • BUILDING SAFEPY.DIVISION T Y P PLANS COEDGER SOLID BLOCK L \. I RgFTER OWNER: - DATE : fl ADDRESS: _ PHONE: 1/2" DIA. X 5" LAG SCR. CONTRACTOR: :. LIC. NO. AT 32" O.C. • - ADDRESS: (HONE:• ' DETAIL I RAFTERS RAFTERS CARPORT, PORCH OR PATIO LIGHT WEIGHT ROOF COVER OF APPROVED FOR NOT SUPPORTING CEILING LATH, FIBERGLASS, ALUM, BUILDING PERMIT By Date SIZE SPACING SPAN SIZE SPACING SPAN CR a CL "TECO" 2"x4" 12"O.C. 9' -6" 2"x4" 16"O.C. 9'-6" GRIPS OR JOIST 16" 8'-0" • 24" 8'-O" CRNI•:RAL NOTES: HANGER 24" 6' -6" 32" 6'-6" 1. These plans must be CONT. I♦� LEDGER �'/ 48 32" 6'-0" 48" 5'-6" kept .on the job at n -5'-016'-6" n ,- " all time during 2"x6 16 16 6 2"x6" 12" 16'-6" 24" 14'-6" construction. 16" 14' -6" 32" 12'-0" 2. All framing to be 3/8n DIA. X 5" LAG SCR. 24" 12' -0" 48" 10' -0" Douglas Fir N92 AT lb " O.C. 32" 10'-6" 2"x8" 24" 19'-0" grade minimum. 48" 8' -0" 32" 15'-6" 3.. Rafters may not DETAIL 2 2"x8" 24" 15'-6" 48" 13'-6" attach to facia ex- 32" 13'-6" cept for 101bsroofs — 48" 11 '-6" as shown on detail illo IOzt OR .'LIGHT WEIGHT ROOFS 4"x6" 24" 17'-0" HEADERS 20I1,sroofs must use ONLY CONNECTION DETAILS 32" 15'-0'; a continuous ledger 36" 14' -O" LIGHT WEIGHT ROOF ONLY attached as shown 2" X FACIA-MIN. REO. 4"x8" 24" 21 ' -0" SIZE POST SPACING on details #10+#2. illa�. - 32" 19' -O" 18'-0" 4x4 6' -0" 4. Light weight roofs 36" 4x6 9' -O" may attach to facia pm " 48" 16'-0" 4x8 12' -0" for 14' span max. , MN 10 4"xL0" 32" 22'-0" 4x10 15'-0" spans over 14' must Nti 36" 21'-0" CARPORT, PORCH OR PATIO use a continuous APPROVED METAL 48" 20'- ledger as shown in " SIZE POST SPACING detail #3. HANGER 72" 17' -0O" 4x4 5'-0" 4x6 8'-0" DETAIL 3 4x8 10'-0" z 4x10 12' -6" p. n0,`-tan,0 • PROJECT ADDRESS: 1156 KINGSTON ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05579"; OWNER'S NAME: SCHUREMAN SHARON ADDRESS: 1156 KINGSTON STREET PERMIT NO: B 055797 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA CONSTRUCTION TYPE: V-N PERMIT TYPE; STR PURPOSE: ALT • 859-2500 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : DRY WALL 2 SIDES & TOP OF A GARAGE SQ FT: 1 ,400 ADDRESS: UNIT: CLAIM VALUE: 1 , 400 . 00 CALC-VALUE: 1 , 400 . 00 GROUP OCC: - R-3 / PERMITTEE: GREBBS CONSTRUCTION ( 714 ) 637-4108 • - ADDRESS: 2056 N. CHOUTEAU COMMENTS: DRY WALL ONLY! ! GARAGE - USED AS SUCH ORANGE CA 92665 **************;'H*********************+H+t**********+E ********3E****** ************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provi'ons of hooter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full for •nd , e SETBACKS CITY LIC.: 055196 STATE LIC.:6194077?�y$s' : ---n�Te+///`9 z- Signature: (/ MAIN BUILDING • ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN mpensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Aura: 1277234 EXP.DATE: 10/01 /92 OMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 41204205 ZNE: REF NO: ‘13 Certified copy is hereby furnished. ❑ Certified copy issffiled wiwith[he city B 'di inion. PLANNING NOTES> (� '�C / > ice_ or —/'�// Applicant IE*************)F*****************************************************..--.. ****** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E L O P M E N ,T S E R V I C E $ R E Q U I R E M E N e.T $ 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. ZONING APPROVED BY r: DATE: ' Date: Signature: si NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : It.. _ DATE: !.o Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. el CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• _. DATE• I 1� which this permit is issued(Section 3097.Civ.Cl. *************************** *--)t ****** * *******************3e** * ******* LENDER: ***************************************** ********************************* ADDRESS; LEGALIZATION:N ' FEE S U M • R Y STRUCTURAL' SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'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 33 .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 SMIP/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 progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 33, 50 0 , 00 0, 00 33 . 50 33 . 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 peered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED• 33 . 50 OVER/SHORT• 100 • improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING ,PLAN-CHECK I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33, 00 . 50 /"F ❑ 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).l am aware *********************************************************************',***IE****** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN /r ❑ I am exempt under Section: B.8 P.C. • for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST r Date: Owner: ' SFR 1400 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 001 , 400. 00 I do hereby certify that 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 will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from these provisions. . Date: Applicant: �" i I hereby certify that I have read this application and state that the above information'.co;ct.1 agree to comply with all city and county -• ordinances and state laws relating to budding construction and he'• authorize repe'•int. / of this city to enter upon the above-mentioned property for inspection purposes. i' D ///4/ 9, , a �1� • 01 00106:;'e-U;,)A3-,3'' TOT= - :! Driver's License or Social Security M: e ' F+'t' ' OAiti: 01/1- '42 TZfi..: V.•..t 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • I CONSTRUCTIONAND'PLANNIN. .. 'L " . PA ' Date Inspector Date Inspector - APPROVALS Permit# t - - •_ .. APPROVALS Permit # - 1. Temporary Electrical Service'r Pole .- 52. Pool & Equipment Location 2. Soil Pipe•Undrg�nd._ -:- ry i - • 53. Steel Reinforcement � 3. Erectrical Conduit Utility-Uniirgrnd. • _2 54. Forms ' 4. Electrical Conduit uhdrgrnd, ' 55. Electrical Bonding • 5. Steel Reinforcement � '_ 56. Rough Plumbing & Pressure Test 6...Electrical OF ER Grnd. . - 57. APPROVAL TO COVER-GUNITE 7: Footings - •� 58. Electrical Conduit-Undrgrnd. 8. Foundation .4-.9 / 59. Gas Pipe, 0 Undrgrnd., Test,421 ` • 9. Water Pipe-Undrgrnd. ' " - l 60. Backwash Lines, P-Trap, 0 Undrgrnd. -, 10. Structural Floor•System - j( ' 61. APPROVAL TO DECK `•I 11. Property Sewer Line & House-Connectio'f• 62. Backwash & Receptor-Final //1 12. Sewer Cap ..../,- .;' - E�r 63. Heater& Vent-Final - �• �j. 13. Roof Drains `/ s - 64. Plumbing System • Final 14. Rough Plumbing 65. Electiical-Final ' 15. Rough Electrical-Conduit • 66.-Splar 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.r Ducts, in Structure - - f -70. Underground.Hydro 22. Ducts, Ventilating, • •- • - - 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe`Rough& Test 172. Underground Flush 24.'Roof Framing - ; ; •73.'.Undergrnd'Storage-Tank 0 Gas 0 Oil 25. Roof Sheathing - -" •74. Oyerhead Hydro , 26.'T-Bir Ceiling (Structural) &-Monocoat c -- • " 75. Dry Chemical -- 27.,Frame and Flashing r - 76. Dry Standpipe • 287 Lathing & Siding . ! . - . _ 77. FIXED SYSTEM FINAL 29. Insulation - 78.:FIRE PREV. FINAL 30. Drywall NailingHEALTH DEPT; REQUIREMENT v - ti--2 66. 31. Plaster Brown Coat - i •- , 79. FINAL INSPECTION - - 32. Electrical Power Meter-Final 80.:FOOD CERTIFICATE ISSUED 33. Final Electric .i, t -Notes: - - 34. Final Heating & Air Conditioning - - _ - - •35..Final Gas Pipe-Test. - - I 1-' • 36.'Hood or Canopy , . - 37.'Final Factory Fireplace 1'i-'N; " - •38. Final Plumbing - Ii (i . . f -.39. Water Service-Final - 40. Gas Service-Final • _ • 41. Solar Domestic-Final • 42. Backflow Preventer - • 43. Backflow Irrigation - . 1 44. Landscape Irrigation System- ': .= i, - - - 45. Sound Attenuation - _ . MS. Handicap Regulations 47.<FINALSTRUCTURE& 80LDING 1.-Q12-044:- . �'( „e ,fJ-__/ k-- 41441 48. FINAL PLANNING /� [�"kiV' _49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I.`i.[ - _ _ - 51. CERTIFICATE OF OCCUPANCY - - No. Date . PROJECT ADDRESS: 1156 KINGSTON ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 05579E OWNER'S NAME: SCHUREMAN SHARON ADDRESS: 1156 KINGSTON STREET PERMIT NO: E 055798 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: OTH 859-2500 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : DRY WALL 2 SIDES & TOP OF A GARAGE SQ FT: • ADDRESS: UNIT: - PERMITTEE: GREBBS CONSTRUCTION ( 714 ) 637-4108 • CLAIM VALUE: CALC-VALUE: • GROUP OCC; R-3 / ADDRESS: 2056 N. CHOUTEAU COMMENTS: ADD ELE. FIXTURES .— �L 8 577 ' ORANGE CA 92665 ****+E**�F�6�E�E****�6*�6***�F******�E* * *�Fk �E+k aE* * *****>FSE***+EkE**+E*aE+E->fkE**.*+6******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions-of Chapter 9(commencing with Section ZONING R EQUIR EMEN TS 7000)0l Division 3 of the Business and Professions Code.and my license is in ful fon' nil effect. SETBACKS • CITY LIC.: 055196 STATE LIC.:6 19407 Los: :. . I— /9 - 9.1 Signature: MAIN BUILDING ACCESSORY BUILDING , WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN mpensationllsygance�gr•d,certdiedcopy thereof(Section 3800.Lab.C)O/01 /92 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN .ICY NO.: 1 L 2.7 4 EXP.DATE: 11 OMPANY; STATE FUND PARKING RE • PROV: PARCEL: 41204205 ZNE: REF NO: `KJ Certified copy is hereby furnished. 0 Certified copy is file I the cit u Division. PLANNING N TES> d-r—/ / 4 /� !1 > • ~ L Z� Applicant: / ****3E**3***IE**********************ilk,***3f**!k****If*****aE*************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need net be completed if the permit is for one hundred(5700(or less). DE VEL OPMEN T S' E-1R VICES 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 become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE; Dale: Signature: ' • NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. - _.CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance f the work for APPLICATION ISSUED BY: 1 _ DATE• {/ C/Si—[ L- whichthispermitisissued(Section 3097.Civ_C). ( **********************************.ae*- ** • ***********************4*iF*it-********* LENDER: 7 *************************************** '" a ************************************ ADDRESS: - ' LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N ( BLDG PMT PLUMBING ' ELECTRIC MECHANIC FIRE SMIP/RES GRADING OWNER BUILDER DECLARATION: hereby affirm am exempt hic the Contractors'Stateonstnse Law for the ve, reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3 75 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed • 50% SMIP/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.My 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 15. 00 I. as owner of the property or my em Ioyees with wages as their sole compensation, will 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----> 3 . 75 15, 00 0. 00 18 • 75 18 , 75 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through I . his or her own employees,provided that such improvements are not intended or offered for sale.D,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 18 . 75 OVER/SHORT• 0 0 forptheepurpose of sae)hin 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 • I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 18 . 75 ❑ 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 contractors)license pursuant to the Contractors'State License Law). l am aware ************************************************************************le*aF**** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: owner: ELE 2 FIXTURES LIGHTING 1 ST 20 EA. , 75 1 . 50 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and ELE 2 REC EPT/OOTL ET 1 ST 20 EA. . 75 1 • 5j 0 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements fora ELE 1 RECEP T/SWITCH 1 S T 2 0 EA, . 75 , 7 5 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. END OF FEES Date: Applicant I hereby certify that I have read this application and state that the above information is err ct agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize replies¢ ti s this city to enter upon the above-mentioned property tor inspectionpurposes. 01 po e 01 0010633`-00106335 T R: E 7.5 01i 1 i S� TUE: 14;2I . I 4-�/'"y- 9 2 Signature: RY a Driver's License or Social Security k: 1641-46 White-Buildino:Green-Code Enforcement:Canary-AoolicanL Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLA4JIN.-_. 1L - SPA i Date . 'Inspector Date Inspector APPROVALS Permii# - 1:Temporary Electrical Service or,Pole . ' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd._ = i -• 53. Steel Reinforcement f . 3. Electrical Conduit Utility-Undrgrnd, . ,4i - 54. Forms . • 4. Electrical Conduit-Undrgrnd' 55. Electrical Bonding ' '-- 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -' - 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7.-Footings _ 58. Electrical Conduit-Undrgrnd. 8.,Foundation - -^ 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. /, 60. Backwash Lines, P-Trap, 0 Undrgrnd. s 10. Structural Floor System A ,/t' 61. 'APPROVAL TO DECK - 11. Property Sewer Line & Hiisi Connectio)!� .r • 62. Backwash & Receptor-Final 12. Sewer Cap - - _ 63. Heater& Vent-Final ..•_....,=-...�1 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit Frrr Solar System-Final 16. Rough Electric Wiring Age-2g �i �� . _ncing & 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 i A APPROVALS Permit# - , • 21. 'Ducts,in Structuie -70, Underground Hydro 22.pucts, Ventilating - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe:Rough & Test - - 72. Underground Flush', • - - 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing74-Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75: Dry Chemical - 27: Frame and Flashing. � 1, . 76. Dry Standpipe ._ - •28. Lathing& Siding • , • 77. FIXED SYSTEM FINAL • 29. Insulation • - 7a FIRE PREV. FINAL s - - - • , 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat' , 79. FINAL INSPECTION )2. Electrical Power-Meter-Final /c23/1z 80. FOOD CERTIFICATE ISSUED 33. Final Electric , • - ;, _ Notes:34. Final Heating& Air.Conditioning 35:,Final Gas Pipe-Test _- ' „ i '. - ' * r • 36 Hood or GanoPY 7 ' - - • l \i' - ' , • 37: Final Factory Fireplace • r ' t : 38. Final Plumbing , ` - i _ : . 39. Water Service-Final- 40. Gas Service-Final . - -41. Solar Domestic-Final + - • • - • 42.''Backflow Preventer. - , 43. Backflow Irrigation • - .. ,44. Landscape Iriigation System -, - . • - - • ` •45. Sound Attenuation a • • 46. Handicap Regulations . ' 47. F I NAL STRUCTURE& BUILDING - T 4 48. FINAL PLANNING y, • -49:Electric Release to Edison 50..Gas Release to Southern California Gas Co i 11 - ' 51. CERTIFICATE OF OCCUPANCY No. Date µ „Ail TA BUILDING-SAFETY DEPARTMENT ... , APPLICATION FOR STRUCTURAL PERMIT lti:. P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED BY 'PE (�V/IoH�A/7-lam,0 - For Applicant to Fill in Completely -Use Ink Only /7� .BUILDING A.P. NO. eta-041— u ADDRESS Tract 10278, Lot 4 OWNER BUILDING 11 C/ �,.,_ - yi 51- TENANT OR McLain Development Co. ADDRESS �f Ip r yglQ UNIT ORMAI J ADDRESS 1470 Jamboree Rd. SPACE NO. 1 L. TR.NOiO�73 LOT ± (BLK. CITY Newport Beach, NO.640-6800 NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER V BRANCH OWNER ADDRESS VALUE tax ARCHITECT TEL. USE $ OR ENGINEER Corbin/Yamafuji NO 752-5567 �/('^/(� _yV��r'''11 ADDRESS 3661 Spruce St. , Newport Beach ZONE 1v IIDTVPE GROUP APPROVED CONTRACTOR McLain Development Co. BY DATE ADDRESS 1470 Jamboree Rd. • CITY Newport Beach TEL. NO. _640-6800 FSTATE - CITY APPROVED SETBACKS i—ig LIC.NO. 273875 LIC. NO. 18873 W SIZE I NO.OF BLDGS. (FROM C/L STT .,„ ET) 0. OF LOT I NOW ON LOT FRONT 70M0IET. Q • USE OF H. EXISTING BLDG. R SIDE 5 ET, con Pa'F Separate permits are required for L.SIDE FT. electric,plumbing and heating work: REAR LO FT. (W„ USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q G .:1 Single family residence, ��p JJ APPROVED y, New house ROVEDCtjj�/r 1/j/� TjATE la /47R Ia w — O. I hereby acknowledge that I have read this application and state n ya that the above information is correct and agree to comply with ,. CL. alln laws regulating building construction,workman's and I shall not employ a i Z any person in violation of the compensation laws of mO the State of California. ��j fig/ ,I hereby certify that am properly licensed as a contractor untlarO. FT. /�•/ [� N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR B A Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business I and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ ! QQ N /.� n Signature of PLAN CHECK $I o ��f/ 0 Permittee ww'� 1 q or /s'� $ 7/f ^TAX $ /d� U • Authorized nt Date TOTAL PAID 3 06.,.8x,