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HomeMy WebLinkAbout617 LAKEVIEW LN - Building Permits� � � PflOJECT AOOflE55: 6 S 7 LAKEVI EW LN OWNEpO flESS: PASCO MANAGEMENT CO� P.O,HOX 2966 1 COSTA MESA, CA 92628 AHCHIENGINEEfl: 6 4 1— 0 5 9 3 aooAess: flEG.NO.: � UNIT: �� uwT: PEPMITTEE: ORION CONSTRUCTION ( 714 ) 363-0727 �i nooeess: Zg OAStCLIFF DR LILENSEO CONTpACTOP o�cuAniioN: N I GU�Em ina� � am �icensee urwer prmwa�ns���bap�r 9(cammencinp wi�� Section 7000� oi Division 3 0l ��e Business ana Pm�ess�ons Co�tle. an0 my license is �n lull lorce an0 ellecl. ciTr uc.: 0 4 10 srare uc.: 4 S S 4 5 9�- �u55' H��y� �aie: � Signaiure: /����•s� - - -- WOHHEBS' OMPEN RTIONOECIABATION: I�ereCyall twveacenificateal�nsentla�n5urearacertilicateofWorkers' CAmoenulion Insurance. or a mrtilie0 wpy t�ereol I�c 380U. LdE. q. Poucrxo.: 046-93UNIT03554 E%P.DRTE: OSIOLI94 •omraxr: STATE FUN� � Certilie0 mpy is �ere0y fumisAed. Cerlifie0 wpy B/iIN wiN t�e dty BuiWinq Di '� Da�e:._lLl. 7'�' APVlkant: � �. EXEMPfIONFXOM WOH ENS'�OELUN�TION: secipn neeE mt Oe mmpki i� Ne pcml ¢ are �unCreO (5100) a leu�. I t¢rii�y IIWI in Ihe performarrce 0� Itle w0A lot wNth iks p¢rmit i5 icv�eG. I LWI n0i Cmp�ay any person in y manner so a5 io �ecome subject Io ine workers' CAmoe�sation Laws of Calilomia. oale: SipnaWre: xonce: u. aner �wny mrs aecw�arw, rou snome oecome swcen m me wwkers Compemation DrOvisions ol Ihe Lahor COEe. you musl IOrthwifll comDN �^�� SUCh prov5i0n5 or I!>5 pGrmi SIWII be OL¢me0 revOk¢G. CONSTflUCTION LEx01NG �GENCY: I here�y aflirm inat Ihe2 is a COnstmction IenEolg agenty lor Itre pehormance ot tAe vrork for w�it� I�iS Dl�mi� i5 i55uM (5¢Ciion �497, Gv. C�. LENOEN: ROOflESS: OWNEB BUILOEP OECLAMTION: I nem0y allirm Ilut 1 am eKemp� Imm tAe Canvactars' SUte lkerae Law lor the IOlbwinA �eamn �Section 709L5 Business anJ Prolessional CWe: My dty al counry whic� reQuira a permii �o comiruct. alter, improve, OemolisR or re0aii any siructure. p�io� lo its iSSuance, al5o repuires t�e applipnt for suctl permil to lile a siAneO sWtemenl tliai �U5t1e 6 licenud pursuam to ine Orovisions ol ine Comractors' State Lkense Law (CluOter 91�mmendnp witn Section 7000) al ONision 3 0l Ine Buvness an0 Piolessions Coae) ar I�al tM/s�e is exemD� ��e�etrom an0 t�e EasS lor I�e alleOeA eaempiion. Any violalion ol Seclion 7031.5 Gy dny dppllWoi �Ol d pCf11Gi $uGitCtt I�E ippOG�i IO ] GW pCNliy 01 MI IMrE 111d� �Iv! 111111EfEC OW13R ($.)00�. I, as owner of tice Dropeny ar my emqoyees witn wapes az ineir sde wmpe�ation, witl ao tne work. anE ��e ❑ simcmre is not imenGed or olhrea for sale (SecUon 70aa, Business ana Pmiessional CoAe: IDe Caniractors' State Licensa Law Eoes nol aoDM �o an Ovmet ol a pwpiny wtn OWOs or imw�'es ��erCM, anA wM a0M suth woA �im5ell/Icersell or Inrouph Ais Or ber own emDlpyees, proviEeO Ilui Such imD��'em¢nis 2re n01 inl¢ntlea Or 0��¢r¢4 �or sale. II, hOw¢v¢f I�e Ovilainp or impmvemem is 5oW wit�in one year ol camDletion, t�e owner vM tuve t�e GurEen ol D�0 ��s�e Ei0 not CWPo or improve �Or Ih¢ Durpose 0� Shce). I, as owne� ol Ihe pmperty, am eMGusivery coniractinp rritn IiunuO coniractors to consirutl tne project (Section 70a4, Busineu ❑ an0 Prolessians CaOe: Tho Cootrxtors' State Lite�Se Law Gce5 nOt aDON �o an wmer ol D�VeM'�0 Cud05 or ImprOVC51A¢tton d00 Wh0 COIIIIdCIS IOf SY[11 OfOjtCIS wilA d COIIIIdCI0l�5) IICEf15! pUfSUdIII 10 111! LOOIIdC�0�5 61ate Liwnse Law). I am aware inai O�ool ol t�eir Worker's Campensation insurance shoNO Oe provi0e0 to me. �� 1 am e�empt uMer Seciion: B. 8 P. C. I br Inis rea5on: Dale: Pmer. I eo hereGy cenily Ihat 1 am awart ol an0 uMerslana ine repuiremm6 of Cdlibmu Mplih an0 Salety CoAe SettPons 25505, 25539, an0 2557a antlt�at I or any lulure �uilEing o[cupan�wilVvrillnol (cirUe on¢) ne¢dlo camply wilh SaiG state wtles antlthe reQuiremenis lora permil loi cans�mtlion or moEtl¢alion Imm I�e Air Ouahiy Manapemeni USMci. NesiOeniul constru[tion appliaiions are exempt imm Ihese D�ovisions. Date: pODlicanl: I hereDy certily I�al I �ave reae Ihis ap0�icaGon an0 slate tlut t�e above inlormation 6 correCt. I agree to compty wii� ail Gty antl county ortlinances an0 statelaw5relatinglo �uildinp cons�mction anG �ereEy aW�orrzerep�esen�alivesolt0is cityio¢n�eruponille a�ove-menlionetl O�oOe��Y �or inspe lian pur0o5¢5. /y �� Or �cr/ � Oa�e: o SiAnawre: N��✓"^— Oriver's License or Social Secmity M: ��-� � � �6Ab<6 Whne—Bulltling; Grom—CODa EnbrcomenC Canary—Applicant: Pink—Ravenue; Goldonme—Assessor CITY OF COSTA MESA – BUILDING PERMIT PERM NO: B 06366 PERMIT NO: B 063662 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: 5–N PERMIT TYPE: STR PURPOSE: REP JOB DESCRIPTION ; AEPLACE SIDING NEA#224 UNITS 617 6 619 SQ FT; 4,200 CLAIM VALUE; 4,200,00 CALC–VALUE: 9,200,00 GROUP OCC; R-1 / COMMENTS; REMOVE SIDING REPLACE W/STUCCO UNIT 621 1k 1f k M if if 1F if 1E k fF 1f if 1E iF if iF if iF iF if iE if k if if if M if if if If M �f ilif iF if k�f �f if it if ik iE �F1k M iF if iF 1f i� k if if iE if if iF iE �E 1E �E M iF iE iF ff i! ik if If if *�E ik k Z O N Z N G R E(J U I R E M E N T S 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 93405012 2NE: REF NO; PLANNING Nt31'ES> 7 k �F k if 1E �Fif iF it it kiFlF �t Mif 1E iF k if.if-�k if 1E if iF iF if iE if it if k 1F iFif iF iF iF iF �E k M if if iE 1f �f If it k k If if k if it if if if 1flF �f iF k i! iF iflk if 3f if k iE i! �flf iF it D E V E L O P M E N T S E R V I C E S R E(j U I R E M E N T S 20NING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY• DATE; �i Z� � ififlfiFkkkkkiFifiEififkkkiFifkiklf kkiflfk�llfifiFlE ikfk �f if 1f if if �tiF if if iF4 iF iF 1f k iF if it if �F if iE k if if if if k if iF iE iF iF k iF k iF if 1f k 1f k if M 1f M ik 3f 1k 1f M!f it iF ff M if k k �t if ik i! if k iF ik if iF ff k if ff 1f k �t �F iF if LEGALIZATION:N F E E S U M M A R Y STAUCTURAL SEGMENT;Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 50 ' ' . SMIP/NON–RES PLAN ISSUE FEE BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTALS----> 72,50 0.00 0,00 REVENUE DIVISION TOTALS--> COLLECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC 72.00 TOTAL PAID DUE 72.50 72,50 .00 72.50 OVER/SHORT: .00 FIRE SMIP/TOO GRADING PLAN–CHECK kifkifMlkkkM4ifkiFlkMlfiflfk�flFkikkifkifikifiliflFlfMifiFMk�flfifMififiFlElFiFiFMMkifkifiFkiFifkkiFkikiFifklfiFiFkifMififklfiFk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 4200 ALTER BY VALUE RESIDENTIAL NOZONE 1,00 9,200,00 END OF FEES s 01 00145734-001457g,�, T C�'Y 72.Sp DaTE: 0?/26/?3 TIflE: 13:43 CONSTRUCTION AND PLANNING PC & SPA APPROVALS Permit # Date Inspector APPROVAI.S Permit # Date inspector 1. Temporary Eiectrical ServiCe or Pole 52. Pool & Equipment Location � 2. Soil Pipe•Undrgrnd. �� ^ 53. Steel Reinforcement ,�3:��EJettrical Conduit UdLty-Undrgmd; 54. Forms 4.�Electrical ConduR�U�drgmd. � 55. Electrital Bonding S. Stpel Re;^farcement � 56. Rough Plumbing & Pressure Tesi " �.�� E�eFtncal UFEF�fp�pd. ` 57. APPflOVAL TO COVER•GUNITE .: � � d. Gaotirgs •� - � - 58. Electrical Conduit-Undrgrnd. � ' 3;� Fo�ndaUon ' ' 59. Gas Pipe, � Undrgrnd., Test ' -� -.3. Weter Pipe�Undrp:r.d. 60. Backwash Lines, P-Trap, O Undrgmd. 16. Strvctural Ffoor System ` 61. APPROVAL TO DECK 1'. Property Sewer LinQ & Ho�,se ConneCtion 62. Backwash & Recepior•Finai 12. Sewer CaP - . 63. Heater & Vent�Final 13. Roof Drains - 64. Plumbing System � Final 14. Rough Plumbinq 65. Electrical�Final 75. Rough Electrical_Conduit • 66. Solar System-Final 16. Rough Electric Wiring ' 67. Fencing & Access Approval 17. Rough Wiring Sjgn 68. APPROVED FOR PLASTERING 18. Rough ElectriWl•T Bar Ceiling 69. POO VSPA SYSTEMS FINAL 19 Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT 20..Rougt� Fqatory� Fi�Place � cni a�7 n O c, �pw ��' � J'ItiWI � �:: � i- r.• WPPRONAL-S�: � Perr[rIt # �• n' .� ' C y. - �-. ��. . ..tr � ti x 7. 21. � uCi?, iq $tr�G�ur��•. �(-(.• HS :u � r '; y c. '� �`7 f M y M � � t � 0. �dergrouQ,d��}lyry�O 22. bucul Ventilating •a. � nS r. � � s �L� * 77. Producc FiSLfrig Q'6a'3 D Od 23.`Gas�PlPe�tioug &'T�st ' '� i � � •�� • -•., � "�' • r-', '�' 1\ � � .,;ti �,�,t r.� .y �,}. �.�i2. Underground�Flu�tti��. �. ,.i ) e , . . ., .. . . . 24.�800 .Framing•• i r�[ • -�r. - � �_� s Y. .�3.,�lndergmcL:�StorageTartk �Gas ❑Ot[' 25. Roo She^athing ' �: v� � � � :�� ^ • , : ,F �: - ,. �. * a �, � . � �/4.,;F?�verhead Hydro :, � 26.. •BaiiCeiling (StrucWral) & [vtonoeoat . 'n i_ *��n < 75. Drq Chemical � - � � _ 27. Frame and Flashing' � ` L '� - �6. �d?� Standpi� e, J'` '~ '�� -� ,,:.-. =•s r m. R -r• i�� ' .. . �'I # .�;rt.' � " �2�8. Lat� Siding � ,. rn • td � ., � (.C'.Q�• � 77. 1FIXED SY-ST.EM'F.I7VAL � � - - � - �29. Insulatiort ' � "' ' - , 78„FIRE PREV, fINA� rt _ � n'i0. Drywall Nailiag �� ��� x� �-� HEALTH QEPT.�FGEQUIRENJENT '31. Pla:ter B,XQwrUCoat y ` � ,., :� � , �.79.'FINAL INSpECTIQ�I � �-' � �-.', � Ht M '�2. rElectrira� Power Meter��inal , > �, { . ,8:0. iF00D CE � IFIQqTE ISSt1E0 � ,/� 33. ninal Electric _ "' � I�lote : '� �,tF/�-/ . . ' , . � . ;. m . ` ,� l,lsu-i-; 61;r; G:4�fv�, ;rhr.i /l � -�4. �F,inal Heat.ing & A15 Coi4ditiorjin�;� � " S �L7r93 �;�` ' ` �7 ' � 35. Fin�i Ga5 PipO.Test '^ '7 ` ^ �1 �1 . �� .. x H ^O -• rr � F 36. �Ioo$or CanoPY � � -• , ,�, ' � � • . �. (�1 ' ? �. i� J 'r T. 37. Eina�FaGtory Firepfece � � i '� �� - �� ' � i - � . � �+ �38. Final�Plum6ing `..� �� �� ; � ' � } � : . ' c39. Wate� Service-Finaf � � .. x �'� v•: � r ' o• '� �0. Gas Service�Final , '= � F _`" . , ' , v r r g �t ;r, < � ::�„' 'l:p 41. Solar pomestia-Final •- c � � �- A-z S `- �� > ' ; n � .� .� �42. $ackflow Preventer ' 4 � � � ^ `+ '�� �.' ^ . � • .t. _ . r7 43. Backflow Irriyation � ��S : � X � l. o i 44. Landscape Irr.jgatiorj System �`�; r r, L y ` � '_�;, ;�. ' j� :45. ��$ound Aftenuation r�-- i�' n s ' � - y F�C x^ . .46. `Handicap.RegulatioAs - �, `� ' - � ! "-� ••'" � i L. 47. F,INQL STRUCTURE & BU�LDING � � _._.>�; � 48. FINALPLANNING ' " ` " T � " .� r . ,49..Electric Releaze to Edison � - ; : � � a _ - .r �. 50. Gas Release ro Soutqem California Gas Co e � s _ "' ; '_ � . r 51. CER IFICATE OF OCCUPANCY' :i: ,; , ;;� ., , f , . No. Date PflQIECTROUPESS: 61'� LAKEVIEW LN OWNEfl'S NFME: �jASCO MANAGEMENT CO nooRess: P O.HOX 2968 COSTA MESA, CA 92628 AfltH/ENCINEFP: 6 4 1— 0 5 9 3 RODPE55: AEG.NO.: UNIT: uxiT: PEHMITTEE: ORION CONSTRUCTION ( 714 ) 363-0727 aoosess: Zg OAICCLIFF DR LAGUNA NIGUEL CA 92677 UCENSEO CONTRACTOB OECIABATION: I hereby aflirm that I am IicenseA under pmvisions ol Chapler 9(commen[ing with $ection 7000) ol �ivision 3 0l I�e Business and Professions CoOe. antl my license is in full torce an0 et�ect. CITY LIC.: 4 1 0 O STATE LIC.: 4 S S 4 S p�� CLA55' H -Da�e: � SigreWre: %�'t�'i•—� WOXKEfl C MPENSpTION �ECLABATION: I hereby a��ir have a certibca�e o onsen� ta SelfAtl ure or a certifica�e ol Workers' Compensa�ion Insurance, or a cenifieU copy ihereol (Sec�ian 3800. Lab. C). ✓ eoucvNo.: 046-93UNIT03554 E%P.OFTE: OLIOSI94 coMvaxr: STATE FUN� � Cetlitied copy is �ereby lumished Certifietl copy is �ile0 wi�h ihe ciry Building �ivision. �� �ale: 3 � pPPlican�: E%EMPTION FflOM OPKEBS' COMPENSRTION UECIABATION: s seciion need no� be com ete0 il ihe Oe is �or ane hUndretl ($11q) ar less�. I cenily ihat in I�e Oedormance of �he work for whicA Ihis permi� is issued, I shall no� employ any pers in any manner so as �0 6ecome subleci Io the Workers' Campensation Laws a� Califomia. Oate: Signamre'. NOTICE: II. aller making Ihis Oeclaration, yau s�oultl become sublec� ta the Warkers' ComDensa�ion provisions of lhe labor CoOe. you mu5i lorl�with compty wilh such provisions or I�is permii shall 6e Oeemetl revoketl. LONSTPUCTION IENDING AGENCY: I �ere�y affirm that there is a tonsimction IenAinA agency for ihe peAormance of ihe work for w�ic� Ihis permii is issued (Section 3097. Civ. C�. LENUEfl: PODPE55: . OWNEH BUILDEN OEClAXR710N: I here6y aifirm t�at I am exemPt imm ihe Contractors' State License Law for t�e iollowing reason �� (Section 703L5 Business and Pmfessional CoOe: Fny ciiy oi coun�y which reQuires a Oermit to consimct, al�er, impmve, demoliSA, o� repair any stmclure, prior to its issuance, also reQuires �he ap0licani for such permfl �o lile a signetl s�a�emen� iha� helshe is licensetl pursuanllo �he pmvisions of the Contraclors' State License Law (Chapter 9(commencing wilh Section 7000) of Division 3 oi Ihe Business and Protessions Code) or �ha� helshe is e�emp� thereiwm antl �he basis �or Ihe alleged exempiion Fny viola�ion ot $ec�ian 703t5 by any ap0licant tor a permit sublec�s Ihe applicant to a civil penalry o� no� more �han �ive huntlretl tlollars (E500). I, as owner o� Ihe DmDeMY or my employees vAih wages as ineir sole com0ensation, vnli do t�e work, an0 Ihe ❑ 9mcNre is no1 m�en0ea or offere0 for sale (Section 70aa. Business anU Professional Cotle: T�e Contractors' S�a�e License Law does noi appty to an owner oi a pmperty who builtls or impmves �hereon. antl w�o tloes such woB himsel�/hersel� or ��mugh his or her own employees, pmvitle0 Ihat suc� impmvemenis are no� in�entleA or o��eretl for sale. I�, however the 6uiltling or impmvemenl is solJ vnthin one year ol completion, the owner vnl� have Ihe 6urtlen ol pmving �e/she did no� �uild or impmve for ihe pmDose af sale). . I, as owner of Ihe propetly, am exclusively conirac�ing wi�h licensee contracmrs m constmc� �he Dmlect (Sec�ian 7044, Business ❑ antl Pmfessions CoOe: T�e Convactors' State License Law Uoes not apply to an owner oi pmDerty who huilOs or imD�oves thereon anA who ConVac�S �Or SUCh projetis wi�� a tonVac�or(5) liten5e pursuan� IO Ih¢ ConVattors' Sia�e License law). lam aware t�at D�oof of roeir Worker's Compensation insurance should be pmvi0ed lo me. � I am eremp� untler Sec�ian: B. 8 P. C. for ihis reason: �a�e'. Owner. I ao hereby cehily �hat I am aware of ana un0e¢land Ihe requirements of Califomia Heal�h antl Sa�ery Coae Sec�ions 25505, 25533, and 2553A antl Nai I or any iNure Dwltling accupani will/will no� (circle one) neea �a comply wii� said slale co0es antl �he reQuiremenls for a permil far canslmction or motldica��an Imm ��e Air Oualiry Management DisVicl. Re5i0ential consimclion applica�ions are exempi imm �hese provisions. Date: NpPlicanl: I hereUy cer�ity IAat I have reaU �his apPlicaiion ana slate that the a�ove in�ormaiion is corteci. I agree to comply wi�� all city antl counry ortlinances antl slalelawsrelalinglo builtling constmction and hereby authanzerepresen�atives ol�his ci�ylo enleruponihe a6ove-men�ione0 pmp¢rry lar inspection purposes /�—� `/'7�7� � �Oate: a L3 Signaiure� /"Y✓1"^�--� �fA-"*—�-M�1� �nver's Llcense or Social Security x: *�.� �� � � 164La6 Whi�e-6uil0inq: Green—CoOe EnforcemenC Canary—AoolicanC Pink—Revenue: GOltlenraC—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 06379 PERMIT NO: B 063792 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: S—N PERMIT TYPE: STR PURPOSE: REP JOB DESCRIPTION ; REPLACE SIDING NER#229 UNITS 610 6 612 SQ FT: 6,200 CLAIM VALUE: 6,200,00 CALC—VALUE: 6,200,00 GROUP OCC; R-1 / COMMENTS; REMOVE SIDING REPLACE W/STUCCO UNIT 619 �t*****��e***����t�t�r�r***�***�r�rx�*�r�*+r+r+r**�+�**rr�r*�� ��r**�r+�*�r***�r�rx �***�r***�t*******� ** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 93905012 ZNE: REF NO: PLANNING NCSTES> i *****����r*�e��e����e****,�*���**+�*x�*+�**�**�e,r�***,�+��r,�,r�**�**��*�r*��*�e�*��;�*��r��**�*�r D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T S ZONING APPROVED BY DATE; " HUILDING APPROVED BY : APPLICATION ISSUED BY: DATE ;" r IE 3Eaf 1E iF �IE iE 1F iF 3f jE iE if iE if 4 i(� 3F iE jf if if iE if if iE *�E �!E 3E iFiF'3F{�iE iE iEiEiEiEiEiEiEiEiElFiElEiElEiEikkiliElElEitiEiElE�EiFiEiElFifiElEiEi!!ElEiflEiElEiEiE iEifiElEiFaE3E1FiEiE1FiE1EiEiEiEikiEikiFiElEiFlEiEiE3E�f1EiEiE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 90,00 62 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR TOTAL PAID DUE TOTALS----> 90,62 0.00 0.00 90.62 90.62 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 90.62 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 90.00 _62 1f if 1f k iE iE iE if 3k iE iE if ik �k �f 1E iE iE iE i! ff it iE 3E iF if if if if 1f if iE �F �E �E if 3E if iE iEiE if if iF il�lEiEiflk if i! 1! 1E iE 1Eif 1E iE if if 1Elf iE if iE iF iE iE iE 7E iE 1E iF iE iE iE k 1F iF I N D I V I D U A L F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 6200 ALTER BY VALUE RESIDENTIAL NOZONE 1,00 6,200.00 END OF FEES O1 C014b313—D014d319 T�] 7 9d.ti2 DATk: 09lC!,3,�93 TItIE: 09:14 CONSTRUCTION ANp PLANNWG PG & SPA � APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. � 53. Steel Reinfortement „3. Electrical Conduit Utility-Undrgrnd. � 54. Forms ,.4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding •5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. �Electrical UFER Grnd� . 57. APPROVAL TO COVEfi�GUNITE 7. Footings 58. Electrical Cqnduit�Undrgrnd. S'. Foundetion � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P�Trap, O Undrgrnd. 70. Structural Floor System , 61. APPROVA� TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Piumbing System - Final 14. Rough Plumbing 65. Electrical-Finai 15. Rough Electrica6Conduit 66. Solar System-Final 16. Fiough Etectric Wiring 67. Fencing & Access App�oval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Ba� Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � , 20. Rough Factory Fireplace i�. � r��� � ' - APPROVA�LS�- ��Permit# ��' i - i * 21. •Ducis, in Structure;` � F , ` � �" � l � � � . . �: � i ::. ,. 70. Undergrciund }iYdro - 22.�Ducts,Venti�ating � � �� �� �t - �y�, producLPipirlgO�ias ❑Oil 23. `Gas�Pipe-Rou h &'Tes� ' � � „ 9 � x �� , .. i72. Under9round,Flush�;i, , . . ,, i � 24.iRoof Framing• . � � i r� •�t *-• � V3.� Undergmd?StorageTank OGas ❑Oil 25. RoofSheathing � '" ' �-' " '.7q..Overhead Hydro � 26. T�Bar. Ceiling iStructu�al) & Monocoat - - 75. �Dry Chemical -- �� 27.�Frameand Plashing , � , 76. DryStandpipe � � ' i28.'Lattiing&Siding �� � �. -• 77,�,'FIXEDSYSTEM�FINAL � 29. Insulation ' " ' � � I. _ 78„FIRE PREV. FIf�AL � - � i:30. Drywall Nailing � � I � � HEALTH DEPT: REQUfREMENT '�37. Plaster Brown Coat ,� � j ' 79.' FINAL INSPECTION ' ,, i32.�Electrical Power MeterFinal ��� � � � 80.. FOOD CERT CATE ISSUED 33. Finai Electric' • r ' ' � Notes: �' �� � ' , , 34., Final Heating & Air.Conditioning . . ' �, � , ' � } , 35. Finai Gas Pipe-TesT � , � � � ' :, � ' . � 36. Hood or CanoPY , . - � � � F r � . i - �37. Final�FactoryFireplaCe � � I i � �' � 38. Final Plum6ing .� . � I . . - i39. Watec Service�Final i I ' . . , " ' � '40. Gas Service-Final . � . I � _ . � 41. Solar pomesticFinal � Y 42. 8ackflow Preventer ' - � � . � I I I• 43. Backflow Irrigation ' • ' - a :44. Landscape Irripation System ' . ., • - ', r � . , . 45. �ound Attenuation ' � • � � 'r� 46. Handicap Regulations .� / _ L _ I ... ..- 47. FINALSTRUCTUR�&BUILDING J//:2y/O� ' • ! /� 48. FtNALPLANNWG , � :49. Electric Release to Edison � � � �� 50. Gas Release to Southern California Gas Co � - 51. CERTIFICATE OP OCCUPANCY , . , No. Date � acc�i oosess: 617 LAKEVIEW LN OWNEP'SNAME:HROOKVIEW CONDOS CONDOS AOONESS:(73O PAULARINO CM., CA., APCHIENGINEEfl: ROOFlESS: flEG.NO.: UNIT: UNIT: PEflMITTEE:MESA ROOFING CORPORATION (714)548-3012 aooncss: gq3 W. 17TH ST COSTA MESA CA 92627 LILENSEU CONTBACTOB DECLIBATION: I hereEy aliirm ��a� I am licensed u ' Chapler 9(cammencing wi�� Secfion 7000� ol Oivsion 3 of IOe Business ana Pmtessions CaOe. an is m lull laae an0 e ec . QTY UC.: ^�J� STATE U4�j 6 4� CIAr . — Daie: _ � Signapu . — ¢g WOflNEBS'COMPENSATIONDECLINATION: 1�ere�y irmihatlhave ¢ateofconsemtoselbinsureoracenifiwteaiworkers' Compensa�iorLnSyrbn�.pr1ape�I��o,Qy tnereof (Sectian 3800. La� Cj� i POLICV NO.:YWI. 9 b V E%P. OATE: O/ I O S � 9 4 comvaxr:GOLDEN EAGLE � C¢riiliea copy is herehy Wmis�etl. � Cehilietl cop '' i IAe ciiy Builtlin rvi IOate: /' � J / � qppli�L �—��i /� E%EMPTION FflOM WOPREBS' COMPENSATION OECUflATIOtI (ihi55ec�eA noI De campletetl iI lAe permil i5lorone hunGreO (511p) or less�. I cen0y tnal in Ihe Detlo�mance ot I�e work tor whic� I�is permi� is issued. I s�all not employ any DQ«n in any manner so as Io �ecome subje[I la I�e Worker5' Compensatinn Laws ol Cablomia. Oare: Signaiure: NOTILE: II, ailer making t�is Jeclaration, you S�oWC become SUUlect �o Ihe WOBers' ComDenSaiion O�a�isions ol ��e LaUor Cade. you mUSi lort�wil� comDly wii� sut� Omvisions ar IhiS Dermi� Shall be aeemeU revoketl. CONSTflOLTION LENOING PGENCY: I hereGy aflirm Itwi t�ere iS a canstmc�ion IenGing ap¢ncy for ihe p¢tlormance ol Ille wark lor whic� ��is De�mi� is issuea �Seciion 3097. Civ. C�. LENOEfl: R�OHESS: OWNEN BUILOEH UECUHATION: I �ert0y a��itm Itu� I am exemp� Irom l�e CAntratlar5' State License Law for the lollowinp reason (Section 7Q3L5 Business an� Pml¢ssional CoOe: Any ciiy of wunry whic� repuires a permil Io con5imcl, alter, improve. Aemoli50. or reoair any slmcture. prior lo Rs issuance, also requires ine apolicanl lor sucn permit ta file a signea statemenl lnat he/sne is licensea pur5uani lo Ihe O�ovisions ol lhe Conlratlors' Staie Licenre law (C�aO�er 9(commencing vnih Sec�ion 7000) o� Oivision 3 oi Ihe Business antl Pro�esvons fAde) or t�al ne/sne is enemo� iherefmm antl t�e Easo lor I�e allegetl exemption. Pny violation ol Section 7031.5 Dy any applicanl for a permit sublecis Ih¢ appliwni Io a ciWl p¢nalty al noi rtwre I�an INe �unGred Uollars (5500). I, as owner ol Ine pmpeny or rtry employees wil� wages as �Aeir 5ole compensation, will Ga Ihe work, an0 Ihe ❑ slmclure is noi inieneed oi o��ered for sale (Seclion 70aa. Business antl Pro�essional Code: The ConlracmrY Slale License Law Ooes noI apply to an ownei ol a pmpe�y who builGs or imOroves lhereon, anG wAo Ooes such work �imseli/hersell or thmugh �is ar hei awn employe¢5. pwvitled Ihai Sut� impmv¢meni5 are noi inlenE¢G Or oif¢reU lOr uie. II, however I�e Ouil�ing or imo�ovemen� is sald wii�in one year of com0letion, ihe owner vrill �ave ��e GurGen oi Dwving �e/she GiG no� �uild or im0��'e foi ine purpose ol salel. I, as owne� ol Ihe pmpetly, am exclusively contraciing wiih licensetl conVanors to conslmn �he pmlec� (Seclion 70C4, Business ❑ and Professions CoEe: The Contrac�ors' State License Law Ooes nat app1Y �o an owner of pmpeny who �mlds o� improves Ihereon antl who coniracis lor suc� pmlecis vnl� a conVactoqs�license Dursuant to t�¢ Coniractors' Slaie Lit¢n5e Law�. I am awar¢ I�a� pmol ol I�eir Wo�ker'S Compensalian insurance s�oultl �e Omvitled lo me. � I am exemp� under Seciion: B. 8 P. C. for �Ais reason: Date: Q�vner. I Oo hereGy cetlify Ihal I am aware ol ana unAerslana ��e requiremenls ol Calilomia Healt� anA Safely Code Seclions 255U5. 25533, antl 2553A and iha� I ar any IUWre buildinp occupan� willlwill nol (circle one) need to comply wi�� saia Slaie co0e5 an0lhe reQuiremenis lor a permii for canstmclion or motlificaiion Imm �he Air Ouali�y Managemeni Di5lricL Resitlential canslmc�ion apDlications are eKemp� Imm IhQSP O�Ovi5i0�5. Da�e'. ApPlicanC I hereby cerlity�hai I �ave rea01hi5 apPlication anA sla�e Ihat��e above ortlinances an0 statelaws rela�ing�o builtling consimclion and o�operlV lorinsoec�ion purooses. oate'. ���� Signat — I agree lo complY wi�� all cily antl coun�y Wit ciry to en�et upon Ihe above�menlione0 �river's License oi Socia� Sewrity a: 164La6 White-0uil0ing: Green—Cotle Enlo¢emen�: Canary—App�ican�t Pink—Ravenue; CaolCanraC—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064022 PERMIT NO: B 064022 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: �� PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/OFF,-sii�I 6 REROOF W/COMP SHINGLES SQ FT: 8,645 CLAIM VALUE: 8,645.00 CALC—VALUE: 8,645.00 GROUP OCC; R-1 / COMMENTS: REROOF W/COMP SHINGLES, INCLUDED 619-621-623 LAKVIEW LN *�r******r**+c*�r*�r**+t****w*�r***+t�r****+t�r��*+r*it*rir**�*rr***�rx�+t**********+tr*�c�+t*r�r** Z O N I N G R E Q U I R E M E N T S S E T B A C K S --------- MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN ERNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: ET IN RGHT: FT IN PAAKING REQ• PROV; PARCEL: 93405012 ZNE: REF NO: PLANNING NdTES> i �titr****��tr�trr�rxrfr�x��r�r**wr*it*i�itx*ie�r*�efr*x*+r+rwr******x�*«*+r�r*�e�e+t+t**r*�r�r*+r*�irx+ritr�r D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N T,S ZONING APPROVED BY . BUILDING APPROVED BY : APPLICATION ISSUED BY; ff ff if 1f ff M ik M M 1f M M M!t!t * M iF M!t!! ft kMMMffMfflFffMMifMMltMffMMffMMfflfMlkMMklflfltffMkk4lFiflFffltlFMlfffllkMifiFfFIF LEGALI2ATION:N F E E S U M H A R Y BLDG PNT PLUMBING ELECTRIC MECHANIC PERMIT 108.00 DATE: DATE ;� DATE: M k if f1lk if k 1f 1f 1f 1f /f 1F M iF 1tiF M M� if 1t 1f M k STRUCTURAL SEGMENT:Y FIRE SMIP/RES GRADING 86 SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 108.86 0.00 0.00 108.86 108.86 .00 REVENUE DIVISION TOTALS--> COLLECTED: 108,86 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 108,00 ,86 M1tiFkitikMkiFifitlkifMlfltiFikifMlfkMMlkMMlFifkllftfFMMiflfiEiEMitiFitMMiFlFiFlflfkiFMMkifltMffMikMMMiEMIkMitiFft7FffMM%iFiflf I N D I V Z D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 8645 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 8,645.00 END OF FEES snnoK� a����CTOR REQUIRED �Ji 00:47k98-00147499 T O T `vATE: Ui/2�/93 T1IiE: 11�46 �CONSTRUCTION ANO PLANNING APPROVALS Permit � � - 7. Temporary Elecvical Serv.�e or Poie;�,; r "� .�,_SQilPipe-Undr�rnd. ,`_� '��? S,-'_ iv �'r-�-^_.,='rl-' i� �Electrcal Con�'a?�aiihty�Undrgmct:'� _ �' .:y._-__. � �`,�I�ctricai Cond��'-�idry�nd. � ry� -=?��� ., � -`'i"J-_ q;7. Sbsel Reintorc@�crh :� y;. .:'? � V -� .- ;r..��E!ectricat UGEF.4`�,frd a ,��.�Foot�ngs ' ----T'-�- r-- 4 i.. ' ,y�. Fou�dat�on �r tq^. V:ater Pipe�Un �grnd. -, C' �3 �. St�ucturai Plo�ji System � " i ' 'tU. Prape ty Sev�eT:Lirj: R Ha�se CarrEction :.. -,��"'-- 12. Sewer Cap �, :� .� J 13. Root Dra�ns _ � - --"c-%o 14. Raugh PlumGirig 75. Rough Electri�i•Condurt � 16. Rough Elect���Niring I 17. Ro�gilV�.nng�lgn �--- 18. Rougt Elee[rir,y6T Bar CeiLr.q 19. Ra�v� lieatir.q & A�r Cor.d�t o^ 22SDu�'(s. '1=int�:tir�.{ r , '" : r-¢, �. 23�GarPipt,4ca"]'Jh&�es; -=�S S t ^ r_ �.0 24'tflG� Ff�min'g my ' �'F, .. j --ti 'I Z5. Rea! 515:a�;-L thin3 J* -�Z � �, m ��i .� 26�`?�U�r Ceiling (Stynrturall Br�A�!?;acoat J "'�-:i'�- 27:.iFrame:�nd FL.shinu �xx - u7_..�t� '"28. Lathin,t��e S�3in;w;. y '�Q'C ,r y.r J r, -n �-;-rJ--cr•. ..--�r 29. In;ulation • Nx S •• � - y �- n `' 30. DrywalEl�la�ting �y ,,, i 1(T-'tj`_fT+----r- :31. P:m•: �� �o��f'f Ca�a 5 -n;P i^' -��w^-<� ' "a�i>--- ... �� ^�32. ^Eledric�l Pq.�eri'c}%ter'�E�nal� I r� cj ��-.i-__�� _-�,- �33�'r.'tr, EIecV � r i C �34• � rH N�4t�n'�&,4�!�C�t'Si:idi�:;• m '��.��� # � �-�� I•'s5n„_ � a Gc� PiF. Tr;, p; •• 1�-�•-tr - - -:si-e-- c- - - - a36�Ha?�.f o�,;Canopvr` �'- i �� -� � �i �+ -�� � .. S.T_LL_ ,-y37..F�n�. Fawto�Y Fir�'+acea; i .- �-- ^ - - �� ..�- �,"38. Firy Ple`tnbing ' � '� ''' . . � � �a�« i �i'_ ;'39.�LVaicr 5¢�.vicri�Fi •' sWO. Gas Seri»te-F1nal''� � ^� CTT:T = a: _; • cn v � � �..-. ?] �At. Sola� D��1,nesY;cRinal� R. �� � ..._�_�„�r:__- 42. Bachflos'u PrzventEn N i�-�S 7 N_�l �-a -1 43. 8ad�.flow Ir��atPiki;. j;"" YD. JUll1�U r(.lIC�+Yoi��-� � .. .. ,?161•Hani�ca�Res�lat�c�is -+ � r i ^.. •• 47=r IIc�L STRCICTU�fE � BU1iDING t-n'i-�-- 48�;�fAL PLANiUIN[f i i-�- ,,, • . ..�. w i �49:'�ler�ric.f�eleaseto�dison � �- � �0'•+.�a:CRelease to Souzhern Calif �i�a Gas Dare Date � Inspector P(. & SPA APPROVhLS Permit;'.= 52. Pool & Equ�pment Locatlon 53. Steel Reinforceinent 54. Form, 55. Electrital Bord�ng 56. Rauqh Plumh:ng & Pressure Test 57. APPP,OVt�!. TQ CvVF9�Gl'��.�'F 58. Elr+ct.ca' Corc,r�t�U�tlrnn�. 59. Gc; P�pe, . �1�!..c•.�d.. Trst u0. Bar:.r.�sh L��.a-, P.Tr�P, �o�y�nd 61. AFFFC'.VAL TCl DECK 62. Bacc.._;h ;4 Frczrtr� � , :ai 63. H:.;tr 26 VenbF.nai G4. Plumn;�g Systcm � F���al G5. Electrical�F nal 66. Solar�SVstem�l=in�. 67. Frnr.in� & Accass APn�o�a! 68. AGPROVkD FOR P: �STERING G9. POOIiSPASYSTEAlSFWAL i i Date I InsAtctu�� � � I ---� _,FI �E[�F°T.PxEQUTA4P(�7�:.�T I I - - > �1 S� C' r. i r . N ' '.(. l: _t :^ f i ,� �7,1.�7 Q lj Y: j„ . 5 -� C. 1� PPY,'�iV��y-n3-�c.Pee::�i[ ,'+_#-':`-�."-I I { ' ' ?--rt-a'Ki-F'__5-�"7'Q ?--�--^�3-� t � 1 ' t> H70. �'ind��•[+fpy,v F:�.o i. � ` ��= F V) =r� ,I ��i�p'- , � � v. ;; , � s IQ71. Produc�r'{��a�c ,.: C=ys ��Oi; --rr.-' -�"_'-�. �,-7�-i-�r.-x+-r -- - - .. � :. i.` J+ ♦..72. L'iiU��rq�oe71: c �57�. : i F- ., � i �_'C�G�_�'- -_•t__ � 'a-� '-a' - - - - - - �� n p T x r �_ m '- �-� m� � c . � � . � Ir� ��-r�.J3-�Undurnm4.Storcirp^ki,�G:.s , G,I� �--`U� � --i3-. - - -v-- .= r-- - - 74�'Ell,.r.�ad i:v..a'' r. �� _�',- � -� - - -- - ' -. _ . ? i^ t> G^ •'-"_ `: c r-1 7 7 .' . r 75E �; Y Cherr+c�J •_. � c t�i n �J----[+7o--J�--+'-S-.,r,-x- - -- --- � �� k r. 76. Dry 5!anS"..,ca� :.a; ♦ ;� 1 �,.. ; s_- �Sr_,--'�'==-`'�-'a- -- -- ..�t'} 77yFIXED��EC�:�WAIfi;., �, `n i fK-� -- , - ! I+�� 7&rFIHEPREV_FI,"'•� �.> � �' . -_- - _.."7_ �' i � _ " � F � `�'.�4LTFi�iJEPT�: ii�QT11Rj�.-,,fViENT ; � ' . i -Y _�_' __iJ_.•_-_4._ y....�___ -._-r-1-__ . -^ s ._. i I; . ,79. F',';P� I'�ix�C`:x'< >, ~ : _ �k - _ '_n] Q - _-N_ - ' _i_.�= �:r+ I 1 . y-_ � .F * 'd0��F00DCE-H"I'F�,.h�[ I��tiFDti � I k-x- �r--- --�- -'72�--v----�;�---- - -- ' � a� Ra6•s. � -7.^•7 x� J N[a ---r.- .T+.^-_ _L- r; c� ; � 5 !l:: K S ti� -- - - - ' ���K � J �-fl . T� ' , . . }� .{' -'...�. - T j _y-�.�_>; �. %_ _ _ _ �_�} p - .^-..o _G-: i- �'� . . �.i-- - .'s_ ';-'- --'-�`%---_`-. � l S T C� 7 I *.`, ":' -I'_ fiI Tl -T`�'__-_ K'r1 '�''7 _- -}ti ^Y_ _ __'�-_ -_ CO' _ _ _ _ ' fR � Y (� --��� �--- -- -�n_ s � 'r r ; .� r r O _�"T�_� `t "' � _-'___- _ _' � + '-c- - _.:: � �. --� - 7' �� � z - _�-�__'__-G..A-_^J-_ ____ _ _ ---t y -- �x �C� a I _ y � �., . ,o�: t:.� -- --- 1 t r � :c---� - -r- ---- > i � r. * c' �� -r .. � ���- �--- � -^`--- `�� ` -� M -- - - --- - ----� .t i � � i � F • !•.• . -� # ,., t,. Y. . � i 'r � �h� Y � _ __�1 Y r -. O V� t � � 1 + r ' _P, �U �l. -1 S � i .+ .l I ;'l ' r.a_�1._-� f .L' � y C L�- '_ - _ '_ '� .� X -4 _ _____. _ _.. S T _ _. _ - i a___ '� _ ___ . _. __ � ;-� y r � x !�- " _ _ 1 4 � � k� � _ J Y ^J . i � - -1 �__ __"_ . � JOB ADDRESS GENERAL CON A P N�- INSPECTIONS sm� GPS WRiER. [d"���• ROUGH PLUMBING R CON�ITIONING UNDERGROUND LJ POWER ROUGH WIRING BON� BEAM [] STEEL REINFORCE SHEATHING FRAME NN� FLASHING IATHING — IN OUT PLASTER.BROWN COAT HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AN� GAS TEST ELECTRIC. FINAI DATE.NYV s 1974 BUILDING PERMIT VALU SUBCONTRACTOR �itD/�lj �'3 �: �.. _ .: cJ . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applic�n[ to Fill in Cc�r�pletely . _ ADDRESS OWNER HELTZER ENTERPRISES-BROOKVIEW MAIL ADDRESS 740 N. La Brea Avenue ac"'i arv Los An eles CA 90038 No�937-2 F— Z Z Q CONSTRUCTION o N LENOER United California Bank � � BRANCH Main Branch J N m � ADDRESS 600 S. S rin St. L.A 0 m ARCHITECT Fields & Silverman TEL.6S3—O J a OR ENGINEER N UN w Q aooaess 113 N. San Vicente Beverl H a W � � CONTRACTOR Geor e J. Heltzer mZ �� ADDRESS 740 N. La Brea Avenue � W TEL. z F CITV Los An eles CA 90038 No• 937-2 — � STATE CITV �� uc. No. 3144 LIC. NO. � � SIZE NO.OF BLDGS. OF lOT NOW ON LOT ' USE OF EXISTING BLOG. PAIo "rR 1R-74�,.S.00 518� x*'.��ZS.�o APPLICATION FOR BUILDING PERMIT FE 6V TE ECEV D DATEISSUED PERMII`[J�' � A.P.NO. 'b� �O3 `'��'�� BUILDING + ADDRES TRACT�j�C. LOT BLOCK W D P � ' OWNER LUE (` / s e � _ s fn � FIRE 20NE TVPE GROUP APPROVED sv onre Z E NO.OF USE OF NEW LF �.pNOO '3 PLAFS ,2 BUILOING G A VAROSAPPROVED VAqDSAPPFOVED MAIN BUILDING ACCESSORV BUILDING F SIZE OF NO. OF } Z NEW BLDG. ROOMS ' STORIES 2 L SIDE FT EMERIOR WALL ROOF V COVERING Plaster COVERING WOOC1 FEAR � FT J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. a Residentia MAIN BLDGS. a �/ y. O C/ ��[. 1/ � C VRP.9W� � � APPROVED h z 0 U1 �ereby ackhowlatlpe fha[ I have reatl t�is aOPlica[ion antl sta[e � that tha above information is corract and agree to comply with � all laws regulatinB builtlinB consttuction, antl I shall not employ F any person ih violation ot ihe workman's compensation laws ot y Ma S[eie of Calitornia. � ZI hereby certify Mut I am properly licensed as a contrector under � �O SQ. F" ihe State of Californie Business entl Professions Coda, Divisicn 3, THE AMOUNT: Chapter 9, a�tl thet such licenses are In full forca antl effect, or 1 THE PURP06E O am ezempt from the provisions of the Stete ot CalHornia Business antl Protessions Cade, (` ton 3, Chepter� VALUATION Signat�re ot — � �/�'' ��D Permlttee /ir � $ �% Authorizetl F�gent BEf. MAIN & zo �3 �R2 - m 0 ER VALUATION IS FOR NG A PERMR F�EE wONLV: m FEE $ ✓W � m HECK $ � / � � E e LL FEE $