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HomeMy WebLinkAbout1164 KINGSTON ST - Building Permits C dezine properties inc. August 12, 1981 CERTIFIED--RETURN RECEIPT REQUESTED Mr. John W. Baumgardner 1164 Kingston Street Costa Mesa, CA 92626 RE: WIMBLEDON VILLAGE HOMEOWNERS ASSOCIATION As managing agent of the above captioned Association, we have been requested by the Board of Directors to inform you that your application for approval of the installation of a pool has been denied for the following reason : The routing of the utility service line through the backyard of your neighbor does not conform to the plan which you submitted. The Architectural Committee will not approve any plan which utilizes the easement area, granted to your neighbor, to run the utility lines. You are hereby informed that you have three (3) days from the receipt of this letter to remove the subject line, and to restore the area to its original condition and the satisfaction of your neighbor. When this is accomplished the Committee will reconsider your written request to approve the pool installation . A copy of this letter is being sent to the City of Costa Mesa to indicate the Association's lack of approval at this time . DDEVLNEnPROPERTIES , INC. 0 David L. Anderson, CPM Director of Management DLA:sf cc : City of Costa Mesa Building Safety Department Board of Directors 0 Q 0 0 0 3301 w. mac arthur boulevard, sante ana, california 92704 546-4270 • 0 I i1 o aou e4fo vin, g, e.Tw�u. nq Laboratories 2 I. 11.1. 3310 Airport Way/Mailing Address P.O. Bo. 47 / Long Beach, CA 90801 /(2131426-3355 /12131 636-2386 /(714)828-6437 • TESTING BRANCH OFFICE 1ST 4,0 Nonb H.up,, Su.e1 l Sanla Ana,CA 92703 I IT 1415314045 August 19, 1981 EXAMINATION NO. 81-9399 COMPRESSION TESTS ON GUNITE CYLINDERS Jack Hubbard 3106 Ostrom Avenue Long Beach, California 90808 PROJECT SWIM POOL - J. Baumgardner #E3673 "ADDRESS 1164 v ston et. , Cost, I-sa n') ; c••-:Tia ARCHITECT CONTRACTOR Anthony Pools .ENGINEER SUBCONTRACTOR R. J. Kolodziej Anthony Pools SAMPLE FROM Shallow end, deep end, bond beam SPECIFIED MIX . 4.2 to 1 L STRENGTH 2,000 DATE CAST 8/12/81 SLUMP SPECIMEN SIZE 611 x 1211 DAiETESTED 8/19/81 8/19/81 8/19/81 • • SPECIMEN NO. 1 2 3 • COMPRESSION 7-Days � 7-Days 7-Days 77. TOTAL LOAD LBS 65,000 66,000 57,000 • POUNDS PER SO. IN. 2,300 2,335 2,015 AREA. SO IN. 28.27 7-Day Average: 2,175 COMPLIANCE. 7-Day tests comply with specifications. MADE BY DELIVERED 8Y RECEIVED ON: SPECIMENS Jim - J. Hubbard 8/13/81• DISTRIBUTION Jack Hubbard - 3 • Costa Mesa Building Dept. - 1 024 1981 ALL REPORTS ARE SUBMITTED AS THE,CONFIDENTIAL PROPERTY OF CLIENTS AUTHORIZATION FOR PUBLICATION OF OUR REPORTS�USIDNS OR EXTRACTS CTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL IS A MUTUAL PROTECTION TO CLIENTS THE PUBLIC AND OURSELVES c1,„, `I H�• Gunite ( I--)--- REPORT OF INSPECTION ON Masonry ( ) Concrete ( ) BILL TO: Address: OWNER: pea7p PROJECT: 1.4 • :Iter-aetZ Address: //4y 2 3.t le-rt , B �O�� Permit[ No. 5//ry9© Peo/ sibm / 04 At: , Sp Li-vit d Contractor: �/ i A : Sri, Address: deg-- r� idtZ� ,4t, . ee U Engineer: 1O.,. L0 4..„,e5, ./ Subcontractor: . / (Gunite) Address: ,.ly_e 414_, . Masonry or / s / n Concrete) Inspector: 69az,4-- Lw2 4'C�/J ---- Address: Mix Used: A/. 2, / Slump, inches: Admixture: Designed Strength, PSI : ;),E9D9 The following inspection was performed in accordance with the approved drawings: Cu.Yds. No. of DATES Placed Cyls. Remarks 471.1 111. lazni. ..kftd, 'attic dic24447 te.„.ati ....4_,4_4(.474m. _street, )0 J es-- .e , o 4, e nt ' vo Auict Copies of Reports to: (Indicate which Bldg. Dept. & furnish address of any not listed) APPLICATION FOR A BUILDING PERMIT BUILDING PERMIT NO. Electrical , / 5 CO Tract 10278 Block Lot a 7 C Permit No. �/' _, -. Building1164 Kingston St. Plumbing S. Addres0 // 9 9d Permit No. /9/O / • D Cross Mechanical / / 1 Area Costa Mesa Street Permit No. a m' Owner John W. Baumgardner Type of Project: ❑ New ❑ Alter ® Addition Address ❑ Repair ❑ Convert ❑Demo ❑ Occupancy Pmt. 1164 Kingston St Phone A.P. Sup.Dist./ City Costa Mesa '1 °97626 957-1429 Ins'.Area Architect/ R.J. Kolodziej 17818 Designer License No. Zone Spl.Pmt.No. Setbacks P/L Front C/L St. Street Width Address c871 Firestone Blvd. - City So. Gate zip90280 Phone928-3381 Yards Left Right Rear Eave Prof. Left Right Engineer License No. R.J. Kolodziej 17818 C Parking Spaces Required Provide Covered gp Address5871 Firestone Blvd. m CityZi Phone Struct No.of No.of -V �J So. Gate '90280 928-3381 Height Stories Family LICENSED CONTRACTOR'S DECLARATION Park Fees ❑ Yes Fee ce m I hereby affirm that I am licensed under provisions of Chapter 9 Required No C.T. Receipt — (commehcing with Section 7000 of Division 3 of the Business and Zoning Approved By: Date « Professions Code,and my license is in full force and of ect 7y License Clam r-53 License Number I90179 > Date 6 '1 81 Contractor Anthony Pools _ Misc. E Address 5871 Firestone Blvd. Proposed USC Li: City and Zip (; I r, q(��p(� Phone of Structure private siwm pool/spa N cONSTROCt1$kleta 1NGAGENCY 928-3381 2 I hereby affirm that there is a construction lending agency for the a performance of the work for which this permit is issued (Sec. 3097, Oct. Type Code Class Const. Year • Civ.C.). cash y Lender's Name USE/OCCUPANCY SIZE SQ.FT. c Lender's Address 7.1 OWNER-BUILDER DECLARATION Y I hereby affirm that I am exempt from the Contractor's License Law 1. lufor the following reason: ❑ I, as owner of the property, or my employees with wages as their 2. C sole compensation, will do the work, and the structure is not ---- -- - -- - ---- -- r intended or offered for sale. - 3 3 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. r 0 I am exempt under Sec. , B&PC for this reason 4' w G Date Owner E WORKERS'COMPENSATION DECLARATION Total Valuation V o I herebyaffirm that I have a certificate of consent to self-insure, ❑ No or a certificate of Workers' Compensation Insurance, or a certified Encroachment Permit Required ❑ Ves c copy therergf. Grading Pmt. , Grading 3 Policy No!.1677321-9Company PaC. Emp. Ins. Co. Required Ves CI No Pmt.No. 0 Certified copy is hereby furnished. IC Rough Grading -o a ixi Certifed FYs filed with(Drawly)n31 s Approved by: Date 0 Q 3Date Applicant_ F CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE - - - - - --' - • 2 (This section need not be completed if permit is for $100 or less). C I certify that In the performance of the work for which this permit is Q issued, I shall not employ any person in any manner so as to become i subject to the Workers'Compensation Laws of California. PERMIT FEES Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with suchSpecial Electr ilial $ Invest. $ provisions or this permit shall be deemed revoked. I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Plumbing $ COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PUR- Pre-Grade POs6•l� • Pools 6-4-81 Inspection $ / /./- Pre-Grade Permit Sig .el'fb o ,1.--2---)--- .. -� ant A Date Rec. No. $ Issue $ Ptd flt-AES.C. Print •:plicant's/Agent's Name All spaces within this box must be completed to process Clhn Check By: oprApprove ovetl: CMF 033546(BU-28) rev.6/80 PROJECT ADDRESS: 1164 KINGSTON ST • UNIT: r : r CITY-'OF COSTA' MESA - BUILDING PERMIT PERM NO: B u4958Z OWNER'S NAME: SOLIS, HERNANDO _ ADDRESS: COVEY-SOLIS, VICKIE PERMIT NO: B 049582 PLAN CHECK NO: N • GOVT: N SUP?: N ' 1164 KINGSTON ST - COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5-N PERMIT TYPE: 5TR ' PURPOSE: ALT (7.14 ) 751-3108 ' • ARCH/ENGINEER: REG.NO.: . JOB DESCRIPTION: : : C/O SLIDING: GLASS DOOR & EXTEND SLAB ' SQ FT: .'800 • • ADDRESS: I UNIT: • CLAIM VALUE: 800 . 00 CALC-VALUE: 800 . 00 GROUP OCC: R-3 . • Lr : - PERMITTEE:.ALAN TILFORD ( 714 ) 630-5516, - I ADDRESS: 2774 DIANA AV COMMENTS : NO INCREASE IN ROUGH OPENING. - - ANAHEIM CA 92806 • ***-****-*--**********-********************************-atm*********.***x-***8E-xBE******** LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section • . Z ONING R E Q. U I R E M E N T S • 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T ,B A C K S CITY UC.:051681 STATE LIC.:5 51 3 5 5 LASS: B 1 Date:�0-1-3—pd Signature:— MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affir at11.i certificate con nt to self-insure or a certificate of Workers', FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT: IN. . 'ompensation Insuranc or rtdi opy thereof(Section 3800.Lab. C) LEFT: r FT IN RGHT: FT IN LEFT: FT IN RGHT: r FT IN tucYNO.: 116�/451-a11 EXP. DATE: 12 / 1 /90 , COMPANY: STATE FUND - PARKING REQ: PROV: PARCEL: 41204209 ZNE: REF NO: ❑ Certified copy is hereby furnished. N Certified copy is filed with the city Building Divi ' . PLANNING NOTES> Date: /0X23 -70 Applicant:////� ******************** *******************)E***M************************5**JE****** • EXEMPTITIO-N FROM WORKERS'COMPENSATION DECLARATION: (This section need not be con„eted if the permit is for one hundred($100)or less). D EVEL OP MEN T SERVICES R E Q U I R' E M E N.,,T S 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: , Date: Signature: BUILDING APPROVED BY , DATE: • NOTICE:u,after making this declaration.you should becomesubject to the Workers'Compensation provisions of the Labor ._4, Code,you must forthwith comply with such provisions or Ibis permit shall be deemed revoked. ) _ /q CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY- , i i * DATE: 0�1�/j O which this permit is issued(Section 3097.Civ.CI. ************************ *****DP **iF * **************** */ **£9�'31'F 9EEE is-wg-** LENDER: *****4E********************************** * ********************************** • ADDRESS: LEGALIZATION:N - • F E E S - U M A R Y . • STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l 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 ' 21 . 00 • repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed stalement'that he/she is licensed 4 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 : ' . 50 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 • ' BUILDING-DIV-> PERMIT ' ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS 21 . 50 0 :00 '110 . 00 21 . 50 21 . 50 . 00 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law , does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through r his or her own employees,provided that such improvements are not intended or offered for sate.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 21 . 50 OVER/SHORT: . 00 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 of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT , GRADING PLAN—CHECK - • - • 21 . 00 . r I - . 50 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business ' ❑ 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 ********************************************************'*************K'********* 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.&P.C. , tor this reason: . TYPE QTY. DESCRIPTIO N: ; UNIT COST TOTAL COST • Date. Owner. SFC 800 ALTER BY VALUE COMMERCIAL NOZONE 1 . 00 800 . 00 I do hereby cedity 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 -1 /, • permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • - these provisions. .,•p r , Date: Applicant: .. I hereby certify that I have read this application and state that the above information is correct.I agree to c• dy with all city and county - �•' 58 Yf t r9 •a- ordinances and state laws relating to building construction and hereby au rite representatives of this city to con the above-mentioned, . ' � • 01 00072658-(:(10116 9 TOT T "11..511 properly for inspection purposes. DATE: 10/23/90 TIME: 13:52 , i Date: /0" 2-31-70 Signature: «. • Driver's License or Social Security It: 1641-46 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor • CONSTRUCTION AND PLANNING JL & 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE . • 7. Footings - . i) 58. Electrical Conduit-Undrgrnd. 8. Foundation (/' 59. Gas Pipe, 0 Undrgrnd.,Test 1 ' 9. Water Pipe-Undrgrnd. 'C:r i 60. Backwash Lines,P-Trap,0 Undrgrnd. .'. 10. Structural Floor System 61. APPROVAL TO DECK L ' 11. Property Sewer Line & House:Connection y;, 62. Backwash & Receptor-Final ' 12. Sewer Cap • r. . r _- 63. Heater & Vent-Final /fr;' 13. Roof Drains I ' / , ' 64. Plumbing System - Final j" 14. Rough Plumbing r. 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 t ' - r 1 : APPROVALS -Permit # ' ' 21: Ducts, imStructure, . .. 7 , , 170. Underground Hydro • 22. Ducts, Ventilating. - f , , - = ! :I. 171. Product'Piping OGas OOil • 23. Gas Pipe'Rough & Test ,:i ' a t-f •i j. J72. Underground Flush , 24: Roof Framing - ' ' •' : _ • ' ,! ! -73:;Undergrnd.Storage tank O Gas 0 Oil 25. Roof Sheathing I. . It , t -74:1Overhead Hydro i 26.t7-Bar Ceiling (Structural) & Monocoat ' ' = ;-,. 75:a'.Dry Chemical ' , 27.' Frame and Flashing. . ;,,., p r, ;i .,]; j 76. Dry Standpipe. " t 28: Lathing& Siding t Z'' t4. '' • "I a' 77;' FIXED SYSTEM FINAL' , , tn,, •i •1 p . . , yl f n, 1 it y '29. Insulation . - • • r ' f h 1 78..FIRE PREV. FINAL •30. Drywall-Nailing • 1 '' vt'i 'HEALTH DEPT: REQUIREMENT 31. Plaster Brown Coat,. . h, , -71 ; ..79. FINAL INSPECTION . '. ,., •32. Electrical Power Meter-Final I � ' y-• 1804,'FOOD CERTIFICATE ISSUED ,.33.'Fina,1 Electric • - ql !ri 1 INotes: i'., ; . , ,•,34. Final Heating & Air Conditioning '4-- '.� - / n j/ [_ // 35;"Final Gas Pipe-Test ,• // 'e I /0 t , a�tR.. - 6T n ,_36. Hood or Canopy �,. t,J .. ... 1.r •r. '37: Fide! Factory Fireplace' ' • ' ' 10 y,.• ,f. 1 I 38. Final Plumbing •• I $ %.' -• I •.39. Water Service-Final ~' f /' • 1 ,1,40. Gas Service-Final ; • . 1; .41. Solar Domestic-Final • I. ' t ' "' ' • 42-Backflow Preventer ;, i - - 43. Backflow Irrigation - ' -) , . ' .44. Landscape Irrigation System 45. Sound Attenuation - 46.. Handicap Regulations " , 47. FINAL STRUCTURE& BUILDING /®ea-lto 197144:7 - 48. FINAL PLANNING �ti;i 1 _49. Electric Release to Edison i 50. Gas.Release to Southern California Gas Co , ' , , 51. CERTIFICATE OF OCCUPANCY . 1 • - No. Date _- 6695 1 1 �1 4/79 :36P. 14 TI, COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - •RECEIVED BY 1P241700 OOO No I1 For Applicant to Fill in Completely -Use Ink Only /�( /Y//U (�� BUILDING Tract 10278, Lot 8 A.P.NO. ‘`r--` a—d z-D--0 ADDRESS BUILDING //1 TENANTOEROR McLain Development CO. ADDRESS if �1 KJn h t_ UNIT OR MAILING SPACE NO. ADDRESS 1470 Jamboree Rd. TR.NO. LOT BLK. TEL- )oJ.7� S CITY Newport Beach NO. 640-680 CONSTRUCTION NEW ADD ALTER REPAIR I MOVING DEMOLISH LENDER it- BRANCH OWNER ADDRESS VALUE ARCHITECTTEL. USE $ OR ENGINEER Corbin/Yamafuj i NO. 572-556 ADDRESS 3661 Spruce St. , Newport Bch. ZONE PIC-WIdTYPE GROUP APPROVED CONTRACTOR McLain Development Co. BY DATE ADDRESS 1470 Jamboree Rd. EL CITY Newport Bch. nNO640-6800 F STATE CITY APPROVED SETBACKS i—ig LIC.NO. 273875 LIC.NO. 18873 W SIZE NO.OF BLDGS. (FROM CIL SSTREET) I. OF LOT NOW ON LOT FRONT -0 FT. Q USE OF (p7 � EXISTING BLDG. R.SIDE 17.7T. cn ra' ESeparate permits are required for L.SIDE .5 FT. C electric,plumbing and heating work, REAR I D-'19T. F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION 'C a P.:1 Single family residence, DATE APPROVED New house APPROVED g /g kitkit (j)14 DATE 1O/(O l .l W Cg 0 aI hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with W all laws regulating building construction, and I shall not employ SQ. FT. : '. �I Z any person In violation of the workman's compensation laws of (yY7• t the State of California. to � I hereby certify that I am properly licensed as a contractor under N (, ` the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT���({{FEE ONLY;Td am exempt from the provisions of the State of California Business VALUATION PERMIT FEE Ems,/ 0 V lk and Professions Code, Division 3,Chapter 7 a+ SST re Signature of PLAN CHECK $ '^ ( /� o Permittee GM T."'j $�/ 'TAX :1044C: ±���t, IL or GI {P U Authorized Age Date TOTAL PAID ` COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR-STRUCTURAL PERMIT2J.3..28 Tl.. P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - ' REC VE BY PERMIT• ' For Applicant to Fill in Completely — Use Ink Only 5/q 90 BUILDINNG G 1164 Kingston St. A.P.NO. -eta,-O 4Z—O / BUILDING // 4 IC/j1/4/6 7Cw.,-n ICT7 TENANT OWNER OR ADDRESS `(f' U�(�y�/G/ TEJohn W. Baumgardner UNIT OR MAILING 1164 Kingston St. SPACE NO. ADDRESS TR.NO. LOT BLK. CITY TEL 1 278 ' 8 CostaIONMesa NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION cash LENDER X . BRANCH OWNER • ADDRESS VALUE ����y.rr�� ARCHITECT TEL. USEnrivate cw'm nnnl/sna s/ rr `°. ORENGINEERQ-J volodziej NO. 92R-R' R1 �//�_�../j�//�/ ADDRESS Ct$]1 Firestone Rv1Vd_ ZONE hi–g1120 TYPE GROUP CONTRACTOR Anthony Pools BYPROVED . DATE • ADDRESS 5871 Firestone Blvd. CITY So. Gate TEL.NO. 928-3381 w STATE CITY APPROVED SETBACKS LIC. NO. 190179 LIC. NO.006083 ICSk SIZE NO.OF BLDG (FROM C/LL STFfE ET) f S. C. OF LOT NOW ON LOT 1 FRONT `21e FT./°_ < USE OF Arp, h EXISTINGBLDQJrivate residence R SIDE L J FTA_, /�/� /) F • Separate permits are required for L.SIDE /3 /FT. Oefi ✓`���`� G7 electric,plumbing and heating work: REAR 7`FT. I, F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q c DATE QAPPROVED me s, • _DATE (1,-1Z –V}/ C W 0 • I hereby acknowledge that I have read this application and state n cg that the above information is correct and agree to comply with 44 all laws regulating building construction, and I shell not employ i Z any person in violation of the workman's compensation laws of m .WW. the State of California. .: I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR D J Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEEcONLY: e am exam• - rom he provisions of the State of California Business VALUATION PERMIT FEE ��0 .. < bo and Pio .• �>•d_e�,DZivishapter 9. $ _ 1 Signa ure .f .e ^� PLAN CHECK 5 �T4 S� 2, Permoltt - /Anthony Pools $ '5l TAX $ �• Auth. zed Agent Date 6-4-81 TOTAL PAID $ a/a•, V