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HomeMy WebLinkAbout162 LEXINGTON LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERT N0. 3 !`,� TRACT NO, LOT NO. UNIT N0. • Project Address 162 Lexington V w 71 61' I/ 13/6u SqC- R. •Applicant's Mailing Address 10422 Trask Ave. G.G. 92642 - TYPE OF CONSTRUCTION LI NEW CI ADD LI ALTERATION U REPAIR.,' 4r Charles Holliday 979-6805 111 CONVERSION CI DEMOLISH LI OTHER • r q-p,# Zone Owner's Name y Phone DESCRIPTION OF WORK/USE OF BLDG. - f Address 162 Lexington r S Main Building: Accessory Building: - • Arch/Eng. • License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION E O ffyy�� ❑ STRUCTURAL Front Address ❑ TENANT ❑ ELECTRICAL L•J PLUMBING ❑ MECHANICAL B Rear N 530-2440A I Contractor's Name A—aB)es Plumbing—Heatin hon¢ OTHER C Right N 10422 Trask Ave. G.G. 92642 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G Address(mailing) CONSTRUCTION TYPE VALUATION $ S Left City License No. 6664 ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided r I hereby affirm that I am keens • • der prov sof Charter 9(commencing Remarks: Planning Notes: I c np M with section 7000) of Divisl• 3 of the Busines and • •jssl• s Code, and Replace Water Heater RECEIVED JAN 6 iJES� T my license is in Wnlorce an• f t. "0307 S License.plass l• '3O Li—±en a 'o. Date • • Sign�,.� PLUMBING FEES WORKERS' COMPENSATIO DEC •T •N Bar SinkShowers ELECTRICAL FEES \ I hereby affirm that I have a c= Mica • of c• sent to self-insure or a certificate 1• of Workers' Compensation In uran , a certified copy thereof (SectionBackflow Preventer Service Sink Automatic Washer Transformer -' ry� 3800, Lab. C.)978832 Republic Indemit - 0 15-50 KW ' 1, Policy No. Company p y Backflow Irrigation Sewer Cap (Construction Pole Sub. - ❑ 50+KW 1 ® Certified copy is hereby furnished. ce tif'�ed ppy is filed with the city uildi�g nand Bathtubs Sewer Connection Cooking Unit • Meter ❑up to 100 amps Date sL—�o Applicant �•••e$ ���bing EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers ' Solar Collectors Dishwasher Meter Dover 100 amps • , I (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping I Dryers ❑Gas ❑Electric Sub Panel , 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 Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01'/x-B Workers' Compensation Laws of California. • - • Date Signature Floor-Drains • Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ 'NOTICE:If,after making this declaration,you should become subject to the — - Workers' Compensation provisions of the Labor-Code, you must forthwith Floor Sinks 6 Urinal - Fixtures - Microwave ---' ' comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet _ Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors 1 Water Heater- •, Outlets Range Lender's Name • - _ • Lender's Address . . Kitchen Sink 'Water Service Switches • , Sign • OWNER BUILDER DECLARATION .. I hereby affirm that I am exempt from the Contractor's License Law for the L. Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit . to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's 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 any applicant- for a permit subjects the applicant toa civil penalty of not more than five hundred dollars($500). $ 3 • • 0 1, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's . MECHANICAL FEES 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 his or her awn Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered foryp Zoning Approved By Date sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 proven, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By / ,,•, y Date •-• prove for the purpose of sale). 0 /—I2 IVY I/f•/, ' 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System Application Issued By Date tractors to construct the project.(Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- ' tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _. PLAN CHECK $ ' PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PERMIT ISSUANCE $ � PLUMBING $• 4610 S.0� Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby cert' hat I have ad this •.••p1'••t'•n and state that the above ❑0.100,000 BTU 0100,000 BTU . GRADING $ information • correct. I agree o co y ,II city and county ordinances ELECTRICAL $ and stet. •ws relating to • ding ns a •n, and hereby auth•rpizr�e repre- PLAN CHECK 50% $ MICROFILM $ sentativ— of t-' • enter •o• / ab• • mentioned • oB lYr • inspe t'. purpo •� r MECHANICAL $ -. TOTAL FEE $ 5_DO Signa' /f—r� !a Driver. ,/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ • CMF 086- 46,rev.10/8-"White - Building: Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. ',Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55: Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings . , 58. Electrical Conduit-Undrgrnd. • 8. Foundation , . r 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd'. ' • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof;Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-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 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing CEO 39. Water Service-Final jf. 40. Gas Service-Final 41. Solar Domestic-Final ��- 42. Backflow Preventer 0 43. Backflow Irrigation' cr. 44. .Landscape Irrigation System 45. Sound Attenuation 'r 46. Handicap Regulations 47. FINAL STRUCTURE & BUILIJING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date AODRESS OF BMLDNO: 162 LEXINGTON LN WIT: CITY OF COSTA MESA - BUILDING PERMIT • aYNEWS NAME IF KNOyIN: COOK, SHARON S DPPM Mn- P 077791 ADDRESS' 162 LEXINGTON LN COSTA MESA, CA 92626 PERMIT NO; B 072291 PLAN CHECK NO: N GOVT; N SUPP : N "PP MING ADDRESSCONSTRUCTION TYPE; PERMIT TYPE ; STR PURPOSE; OTH ARCHITECT OR ENfRIRFA: 11C. : JOB DESCRIPTION T/OFF SHEATH & REROOF W/COMP SHINGLES SQ FT ; 2, 924 ARCH.OR EHG'S ADDRESS: WIT: CLAIM VALUE: 2, 924 . 00 CALC-VALUE: 2, 924 . 00 GROUP OCC : R-3 1 CONTRACTarSNAIIE STOUT ROOFING INC ( 310 ) 923-6775 CONTRACTORSMAJUNO P 0 BOX 4309 COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRESS: DOWNEY CA MHO.: 402536 ****+r****ac****4 «* -*******a<acat*>E*****-tit444*acrr**+r-N****s**rxai•*****+r•*.*.x******s****** 90241 UNIT: Z ON INC R EQU IR EMENTS LICENSED CONTRACTORS DECLARATION:I hereby Slim under penaly d•.i or that I am licensed under provisions d Chapter 9 SE TB ACK S • (commencing with Section 7000)d Division 3 d the Business and Professions'Art..end my license is in full force effect Cm LIC.NO.: 059377 /amu°'° C 39 L10.N`' 025 /: E3 10 95 MAIN BUILDING ACCESSORY BUILDING Dale: S-jo-_/ _ C tadm 4 . £� ' / FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN OWNER BUILDER DECLARATION:I hereby affirm under penaly of perjury the I am exempt from the Contractors Law ler the following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to'. .:, • ern improve, demdeh,a eim repry structure,Pee to its issuance.also madras the applicant for such come to fib d a signed that he or she PARKING REQ; PROV; PARCEL ; 41916432 ZNE; REF NO: is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(cumnendng with Section 7000)of Division 3 of the PLANNING NOTES> Business end Professions Code)or that he or she is exempt therefrom and the bean for the alleged exemption.My violation of Section > 7031S by any eDpkcaafor a permit subjects the applicant toe ova(bnelrydnotmore than Ms hundred dollars[5500)). ************************************************,t****************************** ❑ I,as owner of the property or my employees with wages as then*de compensation,will do the work,and the structure is no intended or offered for sale(Section 7Ws,Busiross and Professions Code:The Contractors License Lew does not apply to an owner of prwPen), DEVELOPMENT SERVICES REQUIREMENCTS who builds or improves thereon,end who does such work himself or herself or through his oremployees, ch her own provided that su improvements are rot wended or dieted for sere.D.however,the building or improvement is sold within one yea of completion.the owner-builder will have the burden d proving he or e did not buildpurpose or improve for the purpose of sale). ZONING APPROVED BY DATE : Ilipet I,as owner of the property,ant exduvrely contracting with licensed contractors to construct the project(Section 7044,Business end ' Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY - DATE; r — contracts for contractor(s)such projects with a contractor(s)licensed pursuant to the Contractors License Law). [)j l am exempt under Section: B.a R.C..Ion thisreason: APPLICATION ISSUED BY; 51MDATE ; ," -/2 --93r— Rate:lista: Owner. ************44***********44*44 I do hereby certify that I am aware of and understand the requirements of Cal/an lleallh ad Soley Code Sections 25505.PCS'''.andLEGALIZATION:N F E SUMMARY R Y STRUCTURAL SEGMENT:Y a 534.perm Idnd Natdo ormrebuilonfg rom thA oueioyl ranagreaerw)neadmidnplyccastnd date mdesnsamthe empltromthse BLDG PMT ELECTRIC MECHANIC FIRE SMIP/RES GRADING permit Id coat Ior an fmoedbxtiinthent Quaky Managerneoe)nie toslomply w th said t ecodeiard exemptemosthese PLUMBING / prosons. PERMIT 54 . 00 . 50 Date: Applicant SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of the hAowbg declarations: PLAN ❑ have and wil mental,a certificate d consent to self-insure for worker:compensation,asSectiond provided for by 3703 the Labor ISSUE FEE I n ae..f«thepenpm.w.d he crkt«w:ntnapend sassed. BUILDING-DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE have end will maintainworkers'compenashen insurance,es required by Sediw 3700 o the Labor Cade,for the performance of the TOTALS----> 54 50 0 00 0 . 00 54 50 54 50 00 dk for whim this permit is issued.My workers'c mpenealion insurance carder end polity number ere: Gather: err. _ EXPIRES REVENUE DIVISION TOTALS--> COLLECTED; 54 , 50 OVER/SHORT: . 00 Policy Number: SG '7'3c Ga 05/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need nor be completed if the perm!is For one hundred dollen 131001 or lett.) 54 , 00 . 50 o I candy that in the perfomance d the work for which this permit is nes I shall not employ any person in saner es as to become subject to the workers compensation laws of California, ree Nat' I should become to the **************************4444***********4***4444*******4**********4*4*4*4**4** compensation previsions of Sedan 3700 of he Labor Code, J • h ph �thoJse provisions Date: ,5-1-W-9J Applicant: `��p2' I N D I V IDUAL F E E BR E AK DOWN Warning:Failure to secure workers'compensation coverage is unlawful,and shall subject an employer to criminal roes and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST doll fines up to one hundred thousand dollars($104000),M addition to the cost of compensation,damages as sided for In SectIon 3706 or use Labor Code,Interest and attorney's fees. SFR 2924 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 924 . 00 CONSTRUCTION LENDING AGENCY: I hereby elfim under penally of perjury hat there is e construction lending agency for the END OF FEES performance of the work for whits this perm a issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read Na appTcation end dab that the above information is conedt l agree to comply with all thy and countyordinan es and stale laws tela' building construction and hereby authorize /•..•...Mathes of this ay to�enteer Noon /�ha above-mentioned popery for inspection Purpme� lir /F 1 !yr /l. /C— / w Print t.! � - / 01 00181946-00181847 TOT 54,50 L r P-271(------ t2 JGJ� DATE: 05/12/98 TInE: 15:43 _/// t_r L=`L. i / � sale: Signature of-Owner AgenVApplwnlyC• tractor (5151-46.WP) White-Buildkg A Safety:Green-File:Canary-Aplcenl:Pink-Revenue:Goldenrod-Assessor • CONSTRUCTION AND PLANNING 'POOL& SPA APPROVALS Permit# Date I is�iector 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 I 56. Rough Plumbing & Pressure Test -' 6. Electrical UFER Grnd. ! 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final 12, Sewer Cap 63. Heater & Vent-Final r • •' 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 5 25_gcj tom; 74. Overhead Hydro 26. T-Bar Ceiling {Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 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. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /r j-q( 6144- 48. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . No. Date OWNER sainaulding CO. DATE OCT 3 0 1983 JOB ADDRESS 1(Q laxingbotnutrte BUILDING PERMIT NO. 2061i0 GENERAL CONTRACTOR Can Vi ita 3iildi _Cn. VALUE $ 14.,$35.00 AP No. LOT 156 TRACT 5150 FIRE ZONE DESCRIPTION OF WORK Res.Hiatt.gar INSPECTIONS Signature DATE GROUP ma TYPE V ZONE R_3 Soil ,i 44' J'17 SUBCONTRACTOR PERMITS ISSUED Gas DATE NUMBER Water 1:77.—//-42-47 Rough Com, Refrig. 0 Air Cond. 0 Rough Heating /-/f_4y " •-i.f-6 fr .2 -2D Rough Plumbing %/o-6y g /d-3/-C3 596 6 — Miscellaneous Prop. Swr. Line 0 House Con. 0'St. Swr. 0/e )-/3-G9' ewe_ �'f' tUN 1 3 1963 - •-'. Sprinkling System Construction Pole /"n" Underground 0 Power ❑ i /j11f/4Y T Rough Wiring ��/ � • „e • `h7`� .zb“-) /-3-“, a,7e v Trenches❑ Forms 0 Steel Reiff. 0 :1_-- — G `� /1_p , Floor System /„Lk Bond Beam 0 Steel Reinforce 0 /f/q1 (+ Sheathing oL y — �( 3 Ma- i/' Frame and Flashing �//L _// 7” L •f. •fa( " .- , Lathing— In t- Out[{/ arnr p faa iFf G r y ,_ get. , , Plaster, brown coat , . s 3 '•F ...nit ',i 1 - Refrig. 0 Air Con. .❑ Final L Heating, Final /./f S / //_ Plumbing Fixtures, Final Ef. _ Final Gas Test ACP -MI 3-/ �I _ / Electric Fixtures, Final - 73-/ -4l Building, Final_3-/3-d/ `/ — OCCUPANCY • Form 5134--5M-3-0.3—S-B P HOLD P9R SPtLIAL RhQUIRLMENTS 20640 FEE RECEIVED SEP 2 61963 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely CJJZ LI F AT ETO O RO IT TYPE OR PRINT Lot 156 BUILDING For Office Use Only BUILDING ADDRESS 16P -he'd neton Lane RECEIPT NO. 'PyWy1 Mp.,/� COSTA, MESA. CALIFORNIA L 0E6401 - RECEIVED/9Y DATE RECEIVE DATE ISSUED OWNER San Vista Building Co. !Zi y-a5- 3 OCT 3 0 1983 MAIL BUILDING' // �✓n I ADDRESS 1166 E. 58th Street ADDRESS /t0 Y '��� CITY Los Angeles 11 TEL. AD 37187 ZONE TYPE {� GROUP / � APPROVED gr EHNIMVER Raymond Levans NQ OR 37011 -BY DATE ZONING __ i ADDRESS 3432 Via Oporto. Newport Beat Eo /I No.or ^ I USE OF N`0!/ ' Si IA / - PLANe / BUILDIN { , CONTRACTOR San Vista Building Co. PI LEGAL ADDRESS 1166 E. 58th Street DESCRIPTION IVT/-Tract 5160.6 - Lot/ 156 '- J CITY Los Angeles 11, A.P.NO. • l I lie x 3 1 3'�/ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN ST TEN192782 TE. AD 37187 EO^TO SIDE a REAR P.L. Q. EAVES SIZE I NOW ON LOTS O ALLOWED (U.B.C.REQUIREMENT) ' OF LOT 20 x 70 YARDS APPROVED YARDS APPROVED • USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. None (FROM C/L STREET) _ SETBACK LINE FROM 13I 6110" FRONT CENTER OF STREET REAR YARD SIDE YARD LEFT 0 I RIGHT 0 - _R.SIDE DESCRIPTION OF WORK L.SIDE FTJ' FT. NEW X ALTERATION _ ADDITION REAR 0 DISTANCE BET. BET.MAIN e REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING 20 X 32 NO.OF 5 Plan #3 2 VAR.# DATE SIZE y ROOMS STORIES C.U.P APPROVED COVEREXTERI NGR WAL`�C11CC0 I COVERING Shingle BYPR� DATE 9V 8-63 USE OF BUILDING MID WORK TOayERFFORMED Residence and carport ima ,le-1,4 ---Her ) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION /HE 6/SCI. SHAWN UNDER VALUATION IS FOR THE c AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF L€TABLISHING A PERMIT FEE ONLY. i O PLY WITH ALL CITY ANGER AND STATEULAWS REGULATING VALUATION /J G cO BUILDING ya VISTA BUILDING CO. /"a N SIGNATURE OF PERMIT FEE ' PERMITTEE /� y//`J m �LLLV� N.........._...7 ./. (/ JSP" PLAN CHECK $ 0 AUTHORIZED AGE aures N. Starbird TOTAL FEE 5 702