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HomeMy WebLinkAbout120 LEXINGTON LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO, TRACT NO. LOT NO. UNlo. 0375 4/01 /35. 5 p 7._ CITY OF COSTA MESA ' CONSTRUCTION PERMIT S2 -^• - - . Project Address x,20 Len/vJ TDA •• C TYPE OF CONSTRUCTION. U NEW D'ADD ``��1I ALTERATION LI REPAIR i • Applicant's Mailing Address Sete an n A ; - ^C C /-s� � 111 CONVERSION -❑ DEMOLISH El OTHER' A.P.# I Zone I Owner's Name' A /� Phone 7� ,DESCRIPTION OF WORK/USE OF BLDG. I`'_) Address '`"•L- . S Main Building: Accessory Building: Arch/Eng. • License No. TYPE OF PERMIT I�I .❑ GRADING FOUNDATION .❑ STRUCTURAL - T Front • ' . . o�� ID TENANT Q ELECTRICALPLV(vl�G 0 MECHANICAL B Rear - N ' Address; ,' • („,t -�E-- II_��IbSr- Contractor's Name a / . Phone iS"-_- .- ❑ 'OTHER A I II PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address lmailing) -� � ea„ _ � +•' AO Ar 4.4; [ I K G CONSTRUCTION TYPE • VALUATION$ S Left City License No. _ 3Q 3S ZONE 4 I GRADING CU.YDS. •ACRES R LICENSED CONTRACTOR DECLARATION • - Ping. Ref.# Parking Req./Provided - E I•hereby affirm that-I am licensed under provisions of Charter 9 (commencing Remarks: - ' I Planning Notes: Q • with lection 7000) of Division 3 of the Business and Professions Code, and - M my license is in fullforce nd effect. 4 - T License Class_L=/t0ff'' ��i License No. _ • • S Date $S FEES - Signature - PLUMBING WORKERS'COMPENSATION DECLARATION' Bar Sink Showers I Hereby affirm that I have a certificate of consent to self-insure or a certificate''' • ELECTRICAL FEES of .Workers' Compensation Insurance, or a certifi copy' ereof (Section • • Backflow Preventer • Service Sink -' 3800, Lab. C.rp a 1 q jO 1 "-'�"'�" • + Automatic Washer: - Transformer ❑ 15-50 KW P icy No. (,J ,S Company l�ti•lA Backflow Irrigation Sewer Cap Construction Pole Sub. • ❑ 50+KW Certif fed copy is hereby furnished. (J , Ce lfions cypy liked d with the city Bul g DivPsion Bathtubs Sewer Connection Cooking Unit . Meter Dup t0 100 amps Date 3---.48-8- Applicant - LLCIC 'r • - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers i Solar Collectors Dishwasher ' 'Meter Dover 100 amps . • _ (Thissection need not be completed if the permit is for one hundred ($100) or . - . .p ' less). Dishwasher Solar Piping Dryers ❑Gas. DElectric Sub Panel - ' I certify that in the performance of the work for which this permit is issued, I . l . shall not employ any person in any manner so.as to become subject to the Drinking Fountains Solar Tank ' Fang " ' Workers' Compensation Laws of California., _ Motors ❑0-1 HP ❑1'/z-.8 j . Date Signature • Floor Drains -Swimming Pool w/Spa - F.A.U. ' NOTICE: If,after making this declaration,you should become subject to the . — _ _ Inc.Solar❑9-15 HP U16-15+ I Workers' Compensation provisions of the Labor Code, you must forthwith . Floor •Sinks - Urinal . .-- Fixtures 'Micro-Wave - comply with such provisions or this permit shall be•deemed revoked. . CONSTRUCTION LENDING' AGENCY Gas Service . Outlets - Water Closet, Device Boxes ' I hereby affirm that there is a construction ding agency for the performance Pole Light , of the work for which this permit sued (Section 3097 Civ. C.) Interceptors e. ' Water Heater . Lender's Name 2 Outlets Range Lender's Address ' • -- Kitchen Sink. Water Service - - OWNER BUILDER DECLARATI N • Switches . Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories .. Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city orGarbage Disposal Standing-Sections . county which requires a permit to construct,alter,improve,demolish or repair p-Tiap - LaundryTrays - . ' any structure, prior to its issuance,•also requires the applicant for such permit y Generator ❑0-5 KW❑5.15 KW Trash Compactor 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 to a civil - — _ enalty of not more than five hundred dollars ($500). • I I, as.owner of the property.or.my employees with wages as their sole Reinspection Fee - ,$15 Issue Fee; 3$ I • compensation, will do the work,and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee ! $15 -Issue Fee $ 3 ' License Law does not apply to an owner of a property who builds or improves _ ' FEES thereon;and who does such work himself/herself or through his or•her own - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler i Hood or- Type I 0 sale.le, if,If, however, the building or improvement is sold within one year of com- - Canopy 'Type II 0 - Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground •Building Approved By Date rove for the purpose of sale). _ /��7,t LI I, owner of the property,am exclusively contracting with licensed con- • Duct-Structural .. R¢frigeratiOn System Application Issued By -q� Date lc- tractorsrs to construct the project (Section 7044,Business and Professions Code: VV The Contractor's License Law does not apply to an owner of property who . Duct-Ventilating . ❑D100,000 BTU ❑100,000 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 . I } . BUILDING PERMIT $ • SMIP $ ' proof of their Worker's Compensation insurance should be provided to me. I PLAN CHECK $ • PERMIT 0 I am exempt under Section 4/rnB.& P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire Dampers ' Date - Owner • Heating System& Ducting Registers • PLUMBING. $ �•00 ,ISSUANCE $ I hereby certify that I have read this application and state that the above 0B-100,000 BTU 0100,0006T• PLAN CHECK 25% $ ENERGY P.C. $ information is correct. I agree to comply with all city and county ordinances ' ELECTRICAL $ GRADING $ • and state laws relating to building construction,.an hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ i sentatives of this cit n ; upo abo enclosed property for inspection purposes 7 ?078` • • Signature .� Date MECHANICAL $ TOTAL FEE $ L b r Drivers' License or SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 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 UFER,Grnd. _ • 1 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,,El Undrgrnd. 10. Structural Floor System _ 61. APPROVAL TO DECK ' 11. Property Sewer Line& House Connection i 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 • , . I APPROVALS Permit# 21. Ducts, in Structure • '70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough&Test72. Underground Flush , 24. Roof FramingI 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: y/, o'.5--- Ge, r C. i ? c.-co - 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 1 36. Hopd or Canopy - 37. Final Factory Fireplace . 38. Final Plumbing A 6ECI • 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 48. Special Requirements Completed r 49. Electric Release to Edison • - e - - 50. Gas Release to Southern California Gas Co - ' 51. CERTIFICATE OF OCCUPANCY . • . - - - No. Date ' ` . . _ . _ - PROJECT ADDRESS: 120 LEXINGTON LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069579 pi OWNER'S NAME: COHN, MILTON ADDRESS: 120 LEXINGTON LN PERMIT NO; B 069579 PLAN CHECK NO: N GOVT; N SUPP : N COSTA MESA,CA 92626 GONSTRUGTION TYPE: V—N y + CC� yPERMITTYAPE; STR PURPOSE; ALT ARCM/ENGINEER: REG.ND.: d(•� t�t§E_t1vt1tf _ 'rib #L:btri Di �LtltttI WI@tMt LiHOT MOP SQ FT : 2, 508 ADDRESS: UNIT: CLAIM VALUE; 2, 508 , 00 CALC—VALUE; 2, 508 . 00 GROUP OCC: R-1 / PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 ADDRESS: P 0 BOX 4309 COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DET. REQUIRED I DOWNEY CA 90241 *****�Lr�rtlr�rlet*r�r�L�F�k�L�StlL�L�L�t+a*�F**�LFF+L�Lr�Fr6�L*ir*�L�F�6�6�6**********+r*x**4*sF******+r**x******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ON ING REQUIREMENTS wool of Division 3 of the Business and Professions Code.and my license is in lull forte and effect. SETBACKS tunic: �5 77 gmEm.: 402536 cuss: C 39 EXP; 10/95 Date:_ signature: MAIN BUILDING ACCESSORY BUILDING WORKERS' MPEN ATION DECLARATION: Thereby affirm tna Ihave acertificate of consent to self-insure or a certificate of workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation In ur nr5e ora certified copy thereof(Section 3000,Lab.Cl LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: J022699 EXP. DATE: U5/19/95 anew AIG �xx PARKING REQ PROV: PARCEL; 41916309 INE: REF NO; El Certified copy is hereby furnished. L]`Certified copy i tiled with the city Building Division. PLANNING NOTES> _ 1 > Date: 'OI, �1/f Applicant: _..../ ********************************************************************.*********** EXEMPTION FR M WOIIiiiI(FRS'COMPENSATION DECLARATION: (This section need not be competed it the permits for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I cendy 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 NOTICE:It.after making this declaration.lywiyou should become subject to the Workers'eemCompensation provisions of the Labor DATE: ' + Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 1 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; DATE; ,I D which this permit is issued(Section 3097.Civ.C). ************************** * **********{F*********.*.7p***.N..)E{F**.**.***.* *. ************************** 4****************************************** *** **** ADDRESS: LEGALIZATION:N F E E SUMMARY 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 54 , 00 . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES 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(S500). ISSUE FEE I, as owner of the property or my em loyees with wages as their sole compensation, will do the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 , 0 0 0 , 00 S 4 , 5 0 54 . 50 0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employeeP, provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED; 54 , 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 faror the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 , SO ❑ and Professions sdo The projects rs'withState contraseLaw doespursuant la the Contrpropertywho builds ,ol es thereon ******************************************************************************* and who contractsCo lar such Contract with a contractor(s) not ly to the Contractors of propeState wh License Law),I em aware that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BR EAK D OWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 508 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and stale laws relating to building construction and he eby authorize representatives of this city to enter upon the above-mentioned property tor inspectio purpose . LQ� r DA700170613-00170614 TO Date: 'v• Signature: Driver's License or octal Security a: Iona/94 T 1nE: 13:10 s4'5a 1641-46 White—Building:Green—Code Enlorcemont:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor IIII CONSTRUCTION AND PLANNING POOL & SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location I 2. Soil Pipe-Undrgrnd. - .,r• 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. s 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6 Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7.'Footings - 58. Electrical Conduit-Undrgrnd. 1 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 I 12. Sewer Cap • 63. Heater & Vent-Final I 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-7 Bar Ceiling 69. POOL/SPA SYSTEMS ANAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough 6actoyy Fireplace 1 ,; y . • . zAPPROVALS t Permit # , 1 21. putts,in Structure, r -70. Underground Hydro I I 22. Ducts, Ventilating . . .. 271. Product-ping f..1 Gas DOd p 23.'Gas Pipe-Roygh & Test - _ - -72. Underground Flush .. ' , 24.,Roof Framing ::73.'Undergrnd.Storage-Tank 0 Gas ❑Oil 25. Roof SheaIhing _ • /'ilif d� -74.:'Overhead Hydro . 26. .T-Bar Ceiling (Structural) &_Monocoat` 75.:•Dry Chemical 27. Frame and Flashing " • „ '„ 76.Dry Standpipe - ,•, 28.'1Lathing& Siding .i . •• 77."FIXED SYSTEM I NAL• 29. Insulation _ - , 78. FIRE PREV. FINAL 30. Drywall Nailipg ` 1 (' -.-- -. I4EAL7H:DEPT. REQUIREMENT y 31. Plaster Brown Coat i ' ' i' ' ,7.79` FINAL INSPECTION • ' 32. Electrical, Meter-Final - �• . , : .80...FOOD CERTIFICATE ISSUED 33. Final,Electric f Notes: 34. -Final:Heating& Air•Cogditioning ' _ _ lc ,.. 35. Final Gas Pipe-Test : : - 36. •Hood or Canopy ., _ - I I' • .r . 37. Final'Factory Fireprace ' - • .I" .. 38. Final,Plumbing , 39. Water Service-Final - I 1 t` • .00. Gas Service-Fina ' , - Service-Finer' ,. I • 41. Solar Domestic-Final - - ' , 42. Backflow Preventer : ' , - I �; 43. Backflow Irrigation _• I ,44. Landscape Irrigation System . : - - .0 . , 45. Sound Attenuatidn 4 - - 46. Handicap,Regulatibrjs _ . • _ I 47. FINAL STRUCTURE & BUILDING i '-- l- 48. FINAL PLANNING' •'_ ,1 .�!Y ' •• 49. Electric Release to Edison . - " - t.._. .; 50. Gas Release to Southern California Gas Co t-� , 1 - ... 51. CERTIFICATE OF OCCUPANCY . - - .• . No. Date OWNER SAN VISTA Building Co. DATE OCT 3 0 1983 JOB ADDRESS 120 Lexington Lane BUILDING PERMIT NO. 7n(7(� GENERAL CONTRACTOR San_V3sta Building Co, VALUE $ 154_35,OO AP No. LOT lI$ TRACT 5140 FIRE ZONE DESCRIPTION OF WORK Reg v/att.gar. INSPECTIONS Si nature DATE GROUP TM v ZONE Q Soil mi‘-i.7 I PERMITS ISSUED Gas ���777_ ��3r12G✓ SUBCONTRACTOR DATE NUMBER Water de /A-9-G-3F Rough Com. Refrig. 0 Air Cond. 0 Rough Heating //_ ?--5--Z/(�l �,, \ I ,�o• Rough Plumbing _de- �_/fj-L qnT— �� Yi k-1-gyp, 3410- — Miscellaneous Prop. Swr. Line ❑ House Con.S'St. Swr. ❑ Q #3-a-‘4,1 (/,,,,...,"- L,-,-/- NOV 1 3 1963 ? , Sprinkling System Construction Pole Underground 0 Power ,❑ `/sA Ronan wiring 3-2,41-074 "r' f7',1Z. Vie. „ann. /-2.S-2.,Y2,?-72 Trenches 0 Forms 0 Steel Reinf. 0 t a f7-- 3_/C_y'' _ Floor System _ Bond Beam 0 Steel Reinforce 0 Sheathing ` �- /(� SL., , Frame and Flashing o- -2-31 C 7 e� //�j Lathing- In 0 Out a- ? e • C . / _ Plaster, brown coat a7-/A � J65e • Vitt,' Refrig. 0 Air Con. 0 Final I/ Heating, Final O. /4 �y % Plumbing Fixtures, Final 9 !p/ Final Gas Test /5-at- d q- j i LI Electric Fixtures, Final 6{ y y J 10 (1 -/.4,..,-o't <V;y45, p(OG Building, Final _d. / 4,1 _ OCCUPANCY Form BU4--5M-3-63—S-B P HOLD FUR SPbCIAL REUU11thMEIV IS 20626 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT $Er D L80i P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE (��DppEPMMT..��pp For Applicant to Fill In Completely XPPLICITIL�TTTFO(l'PEIfMIT TYPE OR PRINT Lot 48 BUILDING Lexington Lane For Office Use Only BUILDING ADDRESS 120 f RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA RccElvfD Er DATEI OCT 3 0 1904 OWNER San Vista Building Co. f�'i 7-a.5--1,9 MAIL BUILDING ADDRESS 1166 E. 58th Street ADDRESS' FIRE �o?O � ZONE tQUP I •TECITY Los Angeles 11 NoAD 37187 / APPROVED ARCHITECT OR ENGINEER Ra N,•nd LevanN s ETOR 37010 BY DATE ZONING, ADDRESS 3432 Via Oporto, Newport Beach yA� NO.OP •' USE or � y O CONTRACTOR San Vista Building Co. ,� I PLANS , BUILDIN Q�b/ •. D LEGAL 7 ADDRESS 1166 - 58th Street DESCRIPTION Tract 516/0 - of 48 • CITY Los Angeles 11 A.P.NO. `1C ` /fid VS NOTE: NO SAVE OVERHANG SHALL BE ESS THAN STATELIC.NO. 192782 ITdEOL. AD 37187 30"TO SIDE 8 REAR P.EAVESL SIZELOTI 20 x 70 NO.OF BLD NOW ON LOT". O ALLOWED (U.B.C.REQUIREMENT/ OF YARDS APPROVED YARDS APPROVED USE OF None MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREE1 SETBACK LINE FROM l3 I REAR YARD 2•211 FRONT C CENTER OF STREET SIDE YARDI LEFT 0 I RIGHT 0 R.SID FT. FT. DESCRIPTION OF WORK L.Sm Fr. FT. NEW X ALTERATION ADDITION REAR FT FT. DISTAN B BET.MAIN 6 REPAIR MOVING DEMOLISH MAIN BLD ACCESS.BLDGS. • BUILDING NO OF Plan #4 VAR.# DATE SIZE 20 .x 34 Rooms 6 STORIES 2 C. .P. A„_ APPR•VED EXTERIOR WALL 0tUCCOI ROOF - Shingle :7 ‘ 'COVERING COVERING Ar la DATE 9-1 6:1-63 - USE OF BUILDING AND WORK TO BE PERFORMED Residence and Car.ort 4 _f ' i s� BQ.Fr y� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOVM UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 67BUILDING CONSTRU Ip� � H IIvISTA BUILDING CO PERMIT FEE $ SIGNATURE OF _ m STTEF AUTHORIZED AGEN s N. Starbird $ /5J 735 A' ' .25:5-100 4 TOTAL FEE .A.-0