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Home My WebLink About2436 LITTLETON PL - Building Permits t` CITY OF COSTA MESA AC BUILDING DIVISION •. •� ,r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 _. PERMIT 'ka,,,moso 644 P05-00843 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT . Job Address: 2436 LITTLETON PL Status: ISSUED Suite No Applied: 11/082005 V Issued: 11/082005 Vicinity: Parcel Nunmber: 41913305 a / Applicant: _PAT ANTHONY .f ' ._ - ISSUED BY: Address: 1556 S ANAHEIM BLVD,,- - - ., STE F -'„C/.-' - P 7c:: " 4-758-7725 - ANAHEIM,CA - c ' . ip 92805 , �.\',, Owner WALSH, MAURICE - - -- - N Address!• 700 ALEPPO STREET; �� N.,,,, ' - - c Phone - ' NEWPORT BEACH CA Zip: 92660 •• N ' ,A • Contractor: PACIFIC COAST COPPER REPIPE COMPANY , 'Address: . 1556 S ANAHEIM BLVD - - ��' STEF - :' Phone: 714-758-7725 Q,`• _ • ` v�,' 'ANAHEIM,CA • Zip:" 92805 \ -, A`;, - - • License: 661428 - : �1` ` tv' - „ - - - - �� ;A � ti SCOPE OF PERMIT COPPER RE-PIPE . • _ `� l - -_ s ' v ' ' ' " FEE SUMMARY / 1 7 AMT QTY = - -.-AMT ' QTY : . ' I QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 -0=J Sump Pump $0.00 , 0 Backflow irrigation $0.00 0 Landscape Irrigation_ $0.00 0 Swimming Pool .-$0.00 ' 0 Backflow Preventer $0.00 0 ' - P-Trap •"" $0.00' '0V'. - Trap Primer $0.00- 0 Bathtub' - $0.00 0 - - Pressure Regulator- "- 10.00 0 -' Urinal ,,. --$0.00 ', 0 Clarifier System- : $0.00 0 , Process Piping(per 10 ft)__ $0.00` 0 ' Vacuum Brkr Bkflow(1-4) - $0.00 " 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) _ -$0.00 ' 0 Dental Units $0.00 0 , Septic Tank •$0.00 " 0 Wash Basin '.j ' $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo _$0.00 0 Wash Basin Sets , $0.00 0 Drain,Floor ' $0.00 0 Sewer Connect $0.00 - 0 Waste and Vent System ''' .$0.00 ' 0 Drain,Rainwater $0.00 0 Sewer Private Line i _ .7 • $0.00 0 Water Closet(Toilet) /$0.00 0 Drain,Roof $0.00 0 Shower _ $0.00 0 Water Heater/vent`. ,' $0.00 0 Drinking Fountain $0.00 0 Sink,bar • $0.00.. ..0 Water Piping(Inst or Rep.) $9.80 1 Expansion Tank C $0.00 . 0 SinK commercial `,' $0.00 --0 Water Re=pipe \�, , $0.00 0 Gas Earthquake Valve ' ' $0.00 0 0 ,-• 'Sink,Floor .y-,�.' $6.00. -0. , '•''-•.'""Water Service $0.00 0 Gas(1-4 outlets) . $0.00 ��0 - • Sink,kitchen '$0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) ,'$0.00 „ 0;�''-- Sink,service/mopl - ""*• $0.00 1'0 ;'OTHER'0`-, S0.00 Gas Repipe N $0.00'/ 0 -HH• ,1/4,,-Spa(private): " -$0:00 ' 0 `•.r- =. VIOLATION'• ' , P (P ) /� $0.00 Gas Service $0.00' ' . 0- Spa(public) ` . • $0.00 0 - ; PLAN CHECK , - $0.00 Interceptors(Grease,Oil) ' $0.00, <; 0 - - '. - - _ REINSPECTION ' $0.00 0 Interceptors(Sand Auto) $0.00 ,-j 0 • ' r'.-- -- _ - - _ _ - / .' - ' i : ' - - TOTAL CALCULATED FEES: $33.30 / 1' COMMENTS/SPECIAL CONDITIONS �: _. - - ,. ,.27 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 win result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(8/00) DECLARATIONS fl WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell-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. • I have and will maintai 'work rs'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. - My worker en anon surence c�fri rand Poll umber are: /' 2 (� Oe e •.� P, ,y/// "' Number' / (_/_/ /y � n (Thissection n not a completed if the permit Is valued at one hundred d. ars($100)or less.) ❑ I certify that in the performance work r which •' permit s i-/s•• shall not employ any person in any manner so as to become subject to the workers' compensation laws of Callfomt an egr that if ould be 'u:=ct to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisio AV' ;,. _ AppllcanLSfgnature ..'v ro e:• -» '`! O �D �W NG FAJkURE'TO SECUR WORKERS'COMPENSATION COVERAG •-UNLAWFUL AND SHAH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED T' USAND DOLLARE(5100.000),IN ADDITCN TO THE COST OF COMPE •TION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby afflrm.thal l.am licensed. de rov/gnha 9 corn encin with Section 7000)of Division 3 Lthe•Business and r ss53? le,and mylicense is In full -forte and effect.Lic.), aL h. or S.Slgna onlntctture: ` • al .Datep— — DS CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency or the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's 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 ls licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business end 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.). O 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 properly who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑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). _ ...__t...__ _ ....._...._.__ _ 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 then a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). . _ c ..__ prepiTi_ o " el__ 3 Does cur will the applicant or present or future huiltling occupant need to prepare en RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the Califomia 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 Code). 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 B (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:1 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 • 'fy 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 ordi :- ' •I. ' • o building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspec' urposes.I a• .:not to oc• • •r allow occupancy of any building authorized by this permit until final inspection. gnatur gaga Owner( / Date .......r thodzed'••:scant (( CODES I(1$PECT1ONTTPE ' DATE - IN1TT1AL9 "' PPE 1 ILISPECTIONTYPt QaIE 1/M8LS 1616 Fixed System Final Fire Prevention 206 Final Mechanical �� 1266 Pool Spa Final 208 Final Plumbing i i'(y -0 111 (5 200 Final Re-Roof - 210 •Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy s�yDRESS a BUILDING: 2436 LITTLETON PL ENT: CITY OF COSTA MESA - BUILDING PERMIT RSTOME IFIDa"' WALSH MAURICE PERM NO: B 078503 '°OREs5: 2436 LITTLETON PL Ji COSTA MESA,CA 92626 PERMIT NO: B 078503 PLAN CHECK NO: N GOVT: N SUPP: N 646-5437 IPPL.MM19a ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: 0TH ARCHITECT OR ENGINEER: MHO.: JOB DESCRIPTION : T/OFF ROCK ROOF & RECOVER W/25YR GAF SQ FT: 4 , 100 ARM OR Dal ADDRESS: WIT: CLAIM VALUE: 4 , 100 . 00 CALL-VALUE: 4 , 100 . 00 GROUP OCC: R-3 /U-1 coMRACTORSNAIIE SHARP ROOFING ( 714 ) 771-2225 CaITNACTORSMMINO 20062 FRANK ST COMMENTS: RESIDENTIAL REROOF mannORANGE CA LIcw: 571575 **+L*******it**RE*aEREit*it*lir*Rr***EE*Rtit***it*itit****+EiritiritirRrie*Reatittrx****atit****at***itat*it*REfr** 92669 Inn: Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby dfim wider penaly of perjury pat I em provision d Chaps 9 SETBACKS (commencing with Section 7000)d Division 3 of this Buskins arid Profession Code,and my is Toros and affect. CRT LIC.NO.: q 266 LTC.CLASS: C-39 LI 71 EXP ; 02/97 MAIN BUILDING ACCESSORY BUILDING 9 ll FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT E.I,N Date: 7,4 gD Crw.dr LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT N 'WNER BUILDER DECLARATION:I hereby affirm under Tenant d that I am exempt than the Contractors liens Law for the • nkg ranee 70315 Business end Professors Coda:Any r'y«county with rem"aaepemi to contuctt after.improve, PARKING RE PROV: PARCEL : 41913305 ZNE: REF NO: �Meh.«mai any strums.,pro to irequirese .also requires the applicant for such petTS Nat to Me a signed statement he«she Te licensed pursuant to the provision d the Contractors License Law[Chapter 9(commencing wish Section 7000)d Derision 3 d the PLANNING N T E S.> Busmees and Pdienon Code)or that he or Ste a exempt thaehrn end the basis for the alleged exemption.My violation d Section > 7o31.5bYanYapdiclfor a permit subjects theepplirad to a cid penalty dnot MOM than foe hundred dollars[MOD. *******ft*****!t********!t!t****************************************************** ❑ I.asorwdthepnpeltyrmy°mplryeeawahwepantheirnMmmgrmr'ere,willdolMwork.endthestmdwaisnotemended DEVELOPMENT S E R V I C E SR E Q(� U I R E M E N T S or offered for tele(Section 1044.Business and Professions Code:The Contractors License o applyinner does rto an er d property ld who braids or inproes thereon.and who does such work himself or hersel or through he or her own emplyms.provided IS such impmernw ere red blended rwred f«we.U.lepw«r.the luddinp«inpovemerl I add'Whin pas yen d omrpMon.Oe ZONING APPROVED BYDATE; owner.buider will n...the burden d proving he or she did not bid r hnprove kir rp The purposed We). ❑ Prd°monns Codde:The am"Sant"'LcenseeLLaw'do°n m err*kvw owner of prwr nndwhooth.lam oS"Ibn 7°4°th:raeon and"idwho BUILDING APPROVED BY DATE: contracts for such projects with a contractor(s)licensed pursuani to the Contreras license Law). El B. P.C..for reason: APPLICATION ISSUED BY: /� DATE; 2-9 —9� Dale: Owner: - - LEGALIZATION: N F E E SUMMA STRUCTURAL SEGMENT :Yr I do hereby certify that I am aware d end understand the requirements d Cafirnia Heath and Safety Code Sections 25505,25533.and 25534,and Nei or any blurs building occupant,writ/wD no(circle one)need to comply wth said state codes and the requirements for •snit tor construction r tuction modifmionfom thAi uB i Mananrptwi District.Residential construction applications are these ese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 99 . 75 . 50 Date: Appicent: S M I P/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby Slim ender penalty d perjury one d the following declarations: ISSUE FEE ❑ Ihew and wiimeintana"rig icatecice dloaadinarebwrke.'wnpen..ton.npro.dedf«S,S.mm37DDdtheLab« BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Coda,for the mdndthe m ran. . uwhich this panne eSued. TOTALS----> 100 . 25 0 . 00 0 .00 100 . 25 100 . 25 . 00 11 have I hend Mi midair workers'oompon inund nce.enquired by Sead n 3700 the Labor Cale.Tor the performance mance the &— work for Mach this penal is issued.My waken'compensation insurance weir and policy number ere: Gather: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 100 . 25 OVER/SHORT : . 00 Poky Numbs — 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (Thio Manx,need not be completed I the palm*is for one hundred defiers(Stool or leas 99 . 75 . 50 manner ❑ Ib.Oommend in the. ct the workers:ctor:ton oonence ol the work for Laws ch d permit .,1/ I..i J/. �je.r 'moa s' ******************************************************************************* ernpr.r d Scion JJW d the Lenon cod..I•. . 't. •wtln.. ! wtlh %*'; :may 7 i 1 / � /A INDIVIDUAL F E E BREAKDOWN Date: �' ! *rowan: Warning:Failure to sear eworkala'compensation coverage Is , ' , end shall subject n employer to catSrtpwlaWn and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST de fines eta to one hundred thousand dollars 0104 000),in adUdon to the cost et compensation,damages as provided for In Section � a, 37Ddotda orcodrnaeatanearon•yataea SFR 4100 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 100 . 00 CONSTRUCTION LENDING AGENCY:I hereby ahem under way d perjury that there is a construction lending agency for the END OF FEES performance of the work for*hid,this palmi is issued(Section 3097.Ce.C). LENDER'S NAME: LENDER'S ADDRESS: T I certify that I have reed this application and 4..that the.„/i tonnmion a correct.leges to comply with al dy and county ordinances a PrP IRED - and state laws relating to building and . .i .'•arepresentatives d the ray to enter upon the above-medioned popery aal��_ J ,'n, - i«inspection penmen OFI t / ` . •K I + i�� V. " X ie. / DATE / " .- Signature d Owren/ayentrAppimnt/Crurectr Date: ',AA( (4151-45.WP) While-Buldig i Safety;Green-Ala:Canary-App a a:Pink-Revenue:Goldenrod-Assessor 4 CONSTRUCTION AND PLANNING PC & 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 UFER Grnd. 57. APPROVAL TO COVER-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 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 12' 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 Oil 25. Roof Sheathing - 7-:25"<d 96 lit( _ 74. Overhead Hydro :.a" 26. T-Bar Ceiling (Structural) & Monocoat �� 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe '� p 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 Plarnbing 39. Water Service-Final • 40. Gas Service-Final • 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System -• .4q. Sound Attenuation - • • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date Y • 8508 A t_wv.ov. !, COSTA MESA BUILDING DEPARTMENT ,-I cl Vei P.O. BOX 317 FINANCE PT. COSTA MESA, CALIFORNIA CITY OF rnRT^ P9FCA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING 2436 Littleton Place BUILDING ADDRESS COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERMIT OWNER Mesa Highlands, Inc. SJ MAIL RECEIVED BY DATE RECEIVED OAT ADDRESS 1555 Placentia / c-9/1 2 -. S -J E6 Newport Reach, Cal. NO. NI 6-3227 AD G CITY TEL ADDRESSILDIN ARCHITECT LiO. OR -'NEER same IC. COSTA MESA. CALIFORNIA FIRE ADDRtoS}{y) - same ZONE LIC.CDNTHA.0 ICfR Koll Const. Co. CITY CC. 1217 ZONE ^ pOs lDg TYPE GROUP O. APPROVED VADDRESS same NO. Same BY DATE LEGALO O 9 CORRECTIONS DESCRIPTION NO. BLOCK TRACT 202 A.P.NO. . SIZE (/ Q/� NO.OF SLOGS. OF LOT irreg. 80 x 73 NOW ON LOT 0 USE OF C EXISTING BLDG. SETBACK LINE FROM CENTER OF STREET 50 REAR YARD 21 • SIDE YARD RIGHT 5 LEFT 5 DESCRIPTION OF WORK NEW S ALTERATION ADDITION REPAL, MOVING DEMOLISH BUZE 61 42ILDING 1611 — 420 NROOMS 6 STORIES 1 • SI EXTERIOR WALL ROOF COVERING stucco COVERING hot-mop USE OF NEW BUILDING Residence & Att, Garage Plan 1-D' The Amount shown under valuation is for the I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL purpose of establishing a permit tee only. CITY ORDINANCES AND STATE LAWS REGULATING BUILDING C NSTRUC. TION. VALUATION PERMITTEE E OF , '' PERMIT FEE $ 35.00 PLAN CHECK $ 17.50 $ 15, 967.00 I 52.50 AUTHORIZED A ENT TOTAL FEE $ BMF