Loading...
HomeMy WebLinkAbout2341 Ticonderoga Way - Building Permits • ` CITY OF COSTA MESA O 04, Ofp I' BUILDING DIVISION 11% 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 61 FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: P09-00150 PERMIT TYPE PLUM STATUS: ISSUED APN: 41916403 DATE ISSUED: 11/19/2009 ISSUED BY: RMD JOB ADDRESS: 2341 TICONDEROGA WY CM Suite/Unit: Vicinity: - V,• • SCOPE OF WORK: REPAIR AND REPLACE PORTION OF GAS LINE FOR SFD. REF#: C09-2688 OWNER: CHASE MERRITT RESIDENTIAL LLC Address: 1201 DOVE ST SUITE 572 PHONE: 949-623-8961 City/State/Zip: NEWPORT BEACH,CA APPLICANT: STRASSENBERG,TOBY Address: PHONE: 949-945-3962 City/State/zZip: • CONTRACTOR: OWNER-BUILDER License No. 000000 Address: . PHONE: City/State: ZipCode: . CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $33.30 TOTAL FEES: $33.30 • 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 'I-ao-o9 by 60L, 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 ell ell r 1 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. Yes 0 No ii I hereby affirm under penalty of perjury one of the following declarations: IDrivers-L'idense No. ./Z-17-a ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e..-pry tax bill or deed): 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 maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Cartier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed it the permit is valued al one hundred dollars($100)or less.) 2,Art Sec.341,Title 8,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would f-#I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California. and agree that if I should become subject to the worker mpensation provisions of Section 3700 of the Labrd� Shall forth pl• y with these provisions. Applicants Signature Date if_yg— tool Division of Industrial Safety Permit Number: 1Applicant's Signawre ,o422.. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECUR:j.RKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractors Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safely Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and 1?as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building 9 stun of by this permit until final inspection. y 11-11 -- 2009 Si stuof Legal 0 next Dale / �Signawie3',.:--� />»' ( Date 7 --' 11-4 - zoo 3057-46(3/07) Andlo:AulMriied:Appliw Date ADDRESSORBMLONO: 2341 TICONDEROGA WY UMT: CITY OF COSTA MESA — BUILDING PERMIT aYNEWS NAME IF MOWN: FLORES, VINCENT H PERM NO: B 072591 ADDRESS: 2341 TICONDEROGA NY COSTA MESA, CA 92626 PERMIT NO: B 072597 PLAN CHECK NO: N GOVT : N SUPP : N APDL.RASING ADORES& CONSTRUCTION TYPE: PERMIT TYPE : STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC NO.: JOB DESCRIPTION : T/OFF, SHEATH 5 REROOF N/COMP SHINGLES SQ FT : 2 , 924 ARCH.OR DG'S ADDRESS: UMT: CLAIM VALUE: 2 , 924 . 00 CALL—VALUE: 2, 924 , 00 GROUP OCC : R-3 / OONTRAcronm@ STOUT ROOFING INC ( 310 ) 923-6775 CCNTRACTURS'UJUNG P 0 BOX 4309 COMMENTS: SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRESS DOWNEY CA mpg, 402536 +,t,r•.+.E**,E«+i•+r****s*Kr**+Ea+*.**,I..Nr****** -arca-*******+r,E*..,twf*,Er<r+***<*+r+c+E.c.+c*crit*.* 90241 UMT: Z ONING R E Q U I R E M E N T S LICENSED CONTRACTORS DECLARATION:I hereby affirm under wally a.�1, that I am license!under provisions a Chapter 9 S E T B A C K S (commencing with Sects 7000 of Division 3 of the Business end Professions,r. and my license is in hill force a ran1 .NO.: 059371/ uc.cuss: C 39 LIC.NO.: )153 EXP 10/Q5 MAIN BUILDING ACCESSORY BUILDING 2 /�RNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ...:,,,.,5, . 5-3�— ' c«a.a«:� ♦ � i�� t* "EFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN DOWNER BUILDER DECLARATION:I hereby affirm under penaky d perjury that I am exempt from the Contradon License w for the .following rason(Sedion7031.5 Baleen and Profession Code:Any city or county whim requires anent tocrekud, improve, PARKING REQ: PROV: PARCEL : 41916403 ZNE: REF NO: ' temaah«repelanystructure.portotsissuance.eeorequirestheapptkantforsuchpenihtofibesignedstatementthatheorshe PLANNING NOTES> e licensed pursuant to the provisions of the Contractors License Law;Chapter 9(commencing with Section 7000)of DHeion 3 of the r Business and Professions Cede)or thal he or she is exempt therefrom end the basis for the alleged exemption.My videtion of Raton > 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred taws(55000. **************4.***********************************14*t*********ifr****:4MYi***Yh M** I.nowner of thepropeny ormyempayees with wages as thekede compensation,wig do thewok.and thestructure is nor intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044.Business and ProfessionsCode:The Contractors License Law does not appy to en owner of property who buids or improves thereon.end wind does such wok Nmselt or herself or coor through he or her own employees.provided that such improvements ere t intended or for sale.I.however.the building or improvement is sold within one year d completion,the ZONING APPROVED BY DATE: ( cvner.builder will have the burden of proving he or she did not build or improve for the purpose of sale). I,nowise of the progeny.am exclusively contracting with licensed contractors aenaud the project(Sechin 7044.Business ere BUILDING APPROVED BY DATE: Prohaon Code:The Contradors License Law does rd apply a an owner of property who builds or improves thereon and who contacts for such projects with a omalicensed ador(a) p rsuant to the Contractors License Law). I,IammimputderSection: B.AP.c.,ro Ns reason: APPLICATION ISSUED BY : � DAT 3 _ 9 *******+f******4*********************** **********,*w*::*s****.E******y ** -e*fr Date: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y I dol eby candy I am aware d and understand the requirements of Cationic Stealth and Safely Code Sedan 25505,25533,and 2S534'id that l d airy future building occupant will l soil not Sato one)need a campy with said mete costae and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e perms f«oonnuction or modification hon the AiSualty anagenwa District.Residential oonemdon eppfations an exempt from these PERMIT 59 , 00 , 50 provisions. Dam: • App�ra PLAN • S M T P/riot]—RES WORKER'S COMPENSATION DECLARATION:I hereby slam under Pandy a Perim),one of the following dedarati ns: ISSUE FEE 0 Ihave and MI maintain acertificate of consent toseg4nare for workers'conpnmion,asProvidedfor bySodim3700oftheLeber BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE cent.i«thaneduma eatnewdkarwNanmiapemeie nut. TOTALS----> 54 . 50 0 , 00 ' 0 . 00 54 . 50 54 , 50 . 00 I have and wit meintal,workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the wdkf«whim role neneeiesced.My workers' Alta insurance rend peMiom namben are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED; 54 . 50 OVER/SHORT: 00 Pokier: Pawn Number: ivy—JYVVUV90o / 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed I the panne is for one hundred dollars rr($1wwf00/or leas) 54 . 00 . 50 o certify I shall not Itai in the performance of the work for which this permit is i subject to the workers' laws of California, agree lInsho.M .. t•U. o .Nr he Do as to becomea44 workers' r***** ************************ ***** * * * i ** ***** * *************** cs * 4: ******* ***** compensationprodaan aa semea n 3700 the Labor l Oe. anal macertenp with con. / INDIVIDUAL F E E BREAKDOWN Date: Applicant: ✓� /i Warning:Failure to secure workers'conpensafon coverage launl5WYu4 and shall subject an employer to ed penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Fines up to one hundred thousand dollars($100,000),in addition to the cost of compensation. • • s provided kr In Ca Section 3706 of the Labor Clnlerest,and attorneyslees. SFR 2924 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2 , 924 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally a perjury that there is a constnwon lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097.Cb.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application end data that the above information is cones.I agree to comply with a0 ey and county advances and state laws retains to buidiug construction and hereby authorize represent/Mess of this ey to enter upon the above-mentioned property for aapectionpurposes. DAL ENE BURFORD ...—r Di 001=3123-00183124 TOT 54.50 DATE; 05/31/95 TIME: 11:40 e: a•ire• - tAgaVA bath • radon (5151-4e.wP) White-Buildip&Slay:Green-Ale;Ca ary-Am:S a t Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING % miag `PAO- . SPA APPROVALS Permit #-- Date ,n.,,,ee?^r_ , 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 UF ER 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 & Hduse Connection 62. Backwash & Receptor-Final r 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. Lindergrnd.Storage Tank (7 Gas ❑Oil 25. Roof Sheathing /_/n_q5 6cv, 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat (JJ=-- 75. Dry Chemical 27. Frame ancfVlaihing ` '- 76. Dry Standpipe 26. Lathing&Siding •- - - 77. FIXED SYSTEM FINAL 29. Insulation - 28..$IRE 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: k 34. Final Heating & Air Conditioning , r 7 L��5 - ho0cv-/� / -'/Cv 35. Final Gas Pipe-Test /14•Fto era. A-e/ �/ _-/G 36. Hood or Canopy ._ . r At-4. ZZ Sucks, /. /1I GS►• - /� `' 37. Final Factory Fireplace 'SGC !�Q D"^Lr' !a Y 38. Final Plumbing 39. Water Service-Firrit: 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 /etf,-er eseve c- 48. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No Date • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ _ _ 6833 _ _ i PER IT NO. TRACT NO. LOT NO. UNIT NO. I/31 ��5 I 7.00 CITY OF COSTA MESA CONSTRUCTION PERMIT _ • . ProjecfAddress 231 I 'TIcoracler - I -73S� .S.L.6.o. . 16 - I . • Applicant's Mails ;Ad, ass _ -TI ♦ c(x,O TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ALTERATION Li REPAIR '° ' G ' — , 5+4 _ p�5!] ❑ CONVERSION El DEMOLISH III OTHER - A.P .# /I I!J �• I / I (D 2 Zone R,3• Owner's Name 11 S. '� Phone O O DESCRIPTION OF WORK/USE OF BLDG. K _L VJ -• . Address 1-�1IT1Cn ra if eQoce.A- S Main Building: .Accessory Building: Z, Arch/Eng: License No: TYPE OF PERMIT -� GRADING FOUNDATION (� STRUCTURAL • T Front t 0' ' • Address ❑ TENANT _❑ ELECTRICAL LI PLUMBING ❑ MECHANICAL BB Rear N Contractor's Name ' a 1 Phone • ❑OTHER rrr 01 1 Q0.- • - j� PROJECT DESCRIPTION SQ. FT-1°* l IV YI Ga( 11 'ntOY V/V1 C Right Address(mailing) G V- CONSTRUCTION TYPE ,VALUATION$ 5s�1• _$ Left City-License No: ZONE - GRADING CU.YDS. ACRES - E. LICENSED CONTRACTOR DECLARATION merge • 2Q 'h 2 ..I ,�y��}(J Ping. Ref.# Parrking Req./Provided - I hereby affirm that 1 am licensed under rovi@pions of charter 9 (commencing Remarks: I r l�.n {qe �D� I 23?i 3 (,✓�✓}�Q•GLClw Planning Notes: Co" to(de 69 fp�(t " �%A� M with section 7000) of Division 3 of thews nes and Professions Code, and c/r�s�./ _ s T my license is in full force and effect. merrier y.l�p / ce 11 yl J/ Qom/( /].s�: p cheS $ Ucense Class L e No. r,KA`(.J7 ( ee- �rce "'��I y,, tZ � ,,,.L.� Date ' - Signature PLUMBING •' FEES ,TWO lMK.fO1n,1r1,lIJ�"1 aJ Nip Lei nail'II-t,u - WORKERS'COMPENSATION DECLARATION. Bar Sink • Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate >f Workers' Compensation Insurance; or a certified copy thereof (Section Backflow Preventer Service Sink, • Automatic Washer Transformer ❑ 15-50 KW- •"Policy No - Company Backflow Irrigation Sewer Cap Construction Pole Sub. ' B Certified copy is he • reby furnished. - - • .Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100_amps Date Applicant . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers : • Solar Collectors Dishwasher • Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or 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 ' , Tank -- — shall not empl y any person in any nngrso s t ecome subject to the Drinking Fountains Solar Fan Motors❑0.1 HP ❑1%'-8 Worker' Qum rw Laws of Calif rr'a/ (e1/ �b, • . Date I I J J ti Signature �`yy Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9215 HP �16-1 + NOTICE:If,after making this declaration, you sho Id be o e subject to the • Workers' Compensation provisions of the Labor de, you must forthwith Floor Sinks Urinal Fixtures Microwave. - ♦. 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 lending agency for the performance • Pole Light of the :work for which this permit is. Issued (Section 3097 Civ. C.) Interceptors Water Heater - Outlets Range Lender' Name Lender's Address - - Kitchen Sink • 'Water Service • OWNER BUILDER DECLARATION Switches Sign • . I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories , Auto-Wash , Garbage Disposal 'Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair P-Trap _ 1110-5Laundry Trays - Generator0-5 KW❑5-15 KW any structure, prior to its issuance, also-reduires the applicant for such permit - 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.'(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 _ , '031.5,by any applicant for a permit subjects the applicant to a civil - �' alty of not more than five hundred.dollars($500). • - • I,- as owner of the property or my employees with wages as their sole ..Reinspection Feo I $15 Issue Fee $.3 : .r c mpensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee I $ 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 own - - DEVELOPMENT SERVICES REQUIREMENTS: f employees, provided that such improvements are not intended or offered for Boiler - Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- --- - -- - Canopy Type II ❑ Zoning Approved By v/ -0111C--`Les Date I pletion, the owner will have the burden of proving-he/she did not build or Im-• Duct-Under Ground ' • Building Approved By' ' Date 1 prove for the purpose of sale). -- - j �_Is ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By s �Y/�s-' Date 1 O tractors to construct the project (Section 7044,Business and Professions Code: ..l The Contractor's License Law does not apply to an owner of.property who Duct-Ventilating - ❑0-100,000 BTU ❑700,000 BTU SUMMARY OF FEES I builds or improves thereon,and who contracts for such projects with a con- 71^�� • tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 1V SMIP $ proof o/ their Worke 's Compensation insurance should be provided to me. PLAN CHECK $ �'�✓t) PERMIT • 0:1 m x pt Q�t,action. B.& P.C.for this reason ' Firepl/Fact.Bit. ICBO# Fire Dampers ' '1-'�'�''`� PLUMBING $ •ISSUANCE $ Date 3.5 % owner - Heating System& Ducting Registers 1 PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above El 0-100,000 BTU 0100,000 BTI. GRADING $ I information is correct. I agree to comply with all city and county ordinances -. • ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ • MICROFILM` $ sentatives of this city to e /err upon the above-mentioned prope ty for inspection •�oses. ny� _ Date 1'`Jal - MECHANICAL $ I TOTAL FEE $ (.7' 00 Signature 1• �+' , 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 POO. 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. Form ' 4. Electrical Conduit-Undrgrnd, - 55. Electrical Bonding - 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE , 7.1 Footings 58. Electrical Conduit-Undrgrnd. • . ,87 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 . ;__i 71. Product Piping 0Gas 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 • r 36. Hood-or Canopy ., 37. Finel'Factor,y Fireplace • 38. Final,Plumbing 39, Water Service-Final 40. Gas,Service-Ficial • 41. Solar!Domestic-Final - • 42. Backf low Preventer • • 43. Backflow Irrigation . 44. Landscape Irrigation System 45. Sound •Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING g%f7J Q� ,/Bryn �� ,v Qs Q0r'r\ 48. Special Requirements Completed %O p `K (/ I • 49. Electric Release to Edison • - - • • 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY - - No. - Date 1 • I . • 11 k #21 02 v g24I— W234 VANGUARD 1116? 1111, 1118 if 21i 1122 ,4 tr. SOY _ I01/ a.' 105" log W 10 5"" D w WS IC'! I w 105 10'[_, 107 I01/2 a o7 lob I. 107 10 107 IOC, 107 _Lab_ 10 c1 _IDS___. 09 _1oR • 109 0: 109 toy 107 _1rrii Ill Ho o, I ito Ill In z III UO N ill _ILO 113 1128 II2. w 113 1125 112 0 113 0 113 1119 HA_ p 113 1120 .__.1 1 115 114 [ IIS a �? I m 11 Lf I17 ' rt 0 Ocls �• O .,�- ` , a II6 117 , H u7 r( 4 on' M T _116 r< 0 It9 Tai- TSC7TT7Orr0 11$ Ill 11 Ilq lJMn n n Qnrn ., rnm IIf? I R1 rG r( ''(, r6 rc c6 os cr r(.. rc l eLD I a 1 �� a [ c rt el n r< r( ri rc rt cr ., • 1M) 1130 I.IINUTEMAN WAY 0324 #334 ti 111; :'4 & 11 5 MINU'1'EI4AN WAY HI3 II \otsSr �� 0 4, r+ IV136 i1131113 411 132_ {137 - � q01 2� tt O . y 1 11 `rj S0 O 0 3 , * •ma 1414 . 0� O1 `t 14`! ' 2 . NW [, 039 SARA1'OGA WAY 1136 �,I' OGA WAY 06 rH I,SS rc — r t _ \ 0. ,w el •• 1•, 156 ' I rif A t et 6ricTcctc< K d�Op O` , Ih •1135 q3g� 1137 7 y�� ��r-, �� �•c�` nict n n c( <S c -_-_ • `er.�ti�G � 11S H403, RICIIFlOND WAY 042 [ 1143 01 . co •q 011D c (;IIt 1154, If; 18 ', I31 I ;O Q• I,� ;r) t1i,�ritt:lr1,C�� r! — 1 �SY> Ina :_t-. 111121[1111 • 052.7r: 1 1 .3 I Z 11 E?) h -S10 I�Alr.n� rr4 in I S_ _18[ :: _► 1 r 0 I s mg hr's . �+ �c i; r II 041 044 Igo 12c SPR a I6 IL _ _0 "fir �Nr:;— _ �_ _ c c IPO Ill _I i. 4 tof- - - ( O f;:g r( n 7" J- _� ( c 1'1 rI,S rn , d\ rn r! 1+, Irl In U) . •rl _Ir 7. _11 fl— ( _I r_ i 1 s_ i i 2_ —1--- '1 r, 11 1. f '1 If ;, )'I'/ '-I rl ccrr < cL � • ( c'< ,'! , ( ct << I`1`/ HimARA WAY II{nixl•:w11I.T� WAY SIDE VIE(Al • 4IVINI; Roots # 23if/ C`(/ 440.49- -7'I comDER0058 VAL ONLY P d FE k:QUIP_D SEPArAT EF'U P` • E GE /1././N1 r; Sols r, i , �/ . _ _._��___.___ ,, . DIA CV .._..__... 1 IJl /(2 cam Meso eui! Ing ®epl. i^ . rE T. I Q` p� 7/ ' e5 FO•t R.t11C ti . V! TO�CI J\ 061 RN A + 2, i%. : 19 I:f:SPLG� u rr� g� , ... � ' y a',E' ; f \'\ l !c�' THESE PLANS MUST BE OH OB AT ALL TIMES Ili:,UFCRN A i�fHl�;O:; J. ip;OG:.. i�,L -,aFCTY L 3 P >� ��n - MAKE NO CHANGES WITHOUT PRIORI APPROV ti Y C 0 N S U L T L".? r u i3 A 0 i T I 0 N A L )EE w L C SI!E Y �✓I p l � � OF DEPT. � OUtfiiP�E1�iT5. I , 9�� L Y i \ THE ISSUANCE OR GRANT VC CF A PERMIT CR APPROVAL / _—(� 1-V-IN•Cy-- R o 0r✓j OCA OF PLANS AND SFECITICAT!O S SHALL NOi BE CONSTRUED - '•:'/(�,� i 3 'I-3 lC. i TO BE A PERMIT FOR, OR FN APPROVAL OF, ANY VIOLATION f,"/Ia�A' 2 '( 1 c ii OF ANY OF THE PROVICIONS C, THIS CODE. NO PERMIT PRE- (9.a 1 SUMINO TO LIVE AUTHORITY TO VIOLATE OR CANCEL THE 1 I -C I c v N D<_ R04/9 ,I PROVISIONS CF 1H13COLEY 4ALL BE VALID, 17,CEPF IN SO - I FAR AS THE NDh,K OR USE WH CH IT AUTHORIZES IS LAWFUL; I t� 3 td ISSUANCE OF A P.RMIT BASED UPON PLANS AND , / / Ill -I 1 / --i a 'I SPECIFICATIONS SHALL NOT Pi EVENT THE BUILDING OFFICIAL' �-e CD I FROM THEP.ECFTLJ REQUIRING THE CORRECTION OF E$RIMS .I IN CA;-:.3 FLANS AND SPECIFIC•TIONS C"1 FROM PREVENTING C'UILCINC CPERATIONS BEING P "IED 03 THEREUNDER WHEN .! I`! VICLATICN OF THIS CODE IR OF AN( OTHER 0.3D1N 10 -APP.:is:B it. _ - - I,i� _ _._ ''nr. rITY. _�.__..�_..�..��.. • 1 t• , a tali! /A-Q-'yU 1. • C i O�COSTA MESA • . n '0 PLANNING DEPT- 1 0-1n ° (� X (rr 8 Deo 3ETWEEN LIvlNC ROOMS SUBJECT TO BLDG. DEPT. co BY'l 1.Wq DATE..I/3 des- - DIRECTOR OF PLANNING • RECORDING REQUESTED BY ac MAIL TO: • CITY OF COSTA MESA , Building Department (Name) 77 Fair Drive (Address) . Costa Mesa, Catifurnia 92626 RE: 2341 Ticonderoga Wa y • and 2343 Ticonderoga Wa y C.M. 92626 SPACE ABOVE THIS LINE FOR RECORDER'S USE COVENANT AND AGREEMENT TO HOLD PROPERTY AS ONE PARCEL The undersigned hereby certify that we are the owners of the hereinafter legally described real propert; located in the City of Costa Mesa , County of Orange, State of Californias Lot 06 and a 1/334th undivided interest in common in and to Lot 1 of Tract 5160, in the City'of Costa Mesa, County of Orange, State of i California, as per map recorded in Book 181 pages 40, 41 and 42 of Miscellaneous Maps,, in the office of the County Recorder of said county. Together with non-exclusive easements and non-exclusive rights of way over, under and upon Lot 1 for necessary or desirable ingress and egress, television cables, poles, wires and conduits for electricity, telephones . and other purposes and accouterments thereto, sewers, drains, water, gas and steam pipes, and accouterments thereto, and for such roof overhangs • and other encroachments of a like or dissimilar kind; and easements on .-- --. adjacent Lots of said Tract for roof overhangs and other encroachments • of a like or dissimilar kind. . for the purpose of compliance with applical building codes with regard to doorway openings (state purpose) , in property line walls. we do hereby covenant and agree with said City that the above legally described land shall be held as on( parcel and no portion shall be sold separately. This covenant and agreement shall run with the land and shall be binding upon ourselves, and future owners; encumbrancers, their successors, heirs, assignees and shall continue in effect until such time that the integrity of the existing .property line walls are restored to their original condition. City building permits and inspection shall be required at time of said restoration. • Dbted: This 31 day of ' Qq rt,cc . , 19 S� . • 'Ma_ ' (/V• 1 ? :::, ,,._TA__,Cv/ okitgn) • •(h ,7tL' j (Sign) . A/ . Approved for Recording: • STATE OF CALIFORNIA • COUNTY OF Orange 1SS. On January 11 , 19A5 before me,the undersigned,a Notary Public in and for said State, personally appeared Mark W McKenzie and Lura L. McKenzie and Arthur R. Mc, . o Kenzie --• ------- ----- --• - --• - -. --------, • --• ------ APPROVED AS TO FORM - . known o me w4 u to be the person S whose names subscribed to the within instrument and acknowledged BY+ GA ^)1 °a•�=--_ That they executed the same. • + OFFICE OFFICIAL SEAL CITY ATTORNEY'S MESA WITNESS my hanJ and official seal.' x LINDA HAMILTON OF COSTA a a � t s F NOTARY PUBLIC-CALIFORNIA CITY q iv" PPoNCIPAL OFFICE IN Signature c •Y,�- f� ORANGE COUNTY F,,:- °My Commission Expires June 17, 1988 Li Oda Hamilton Name(Typed or Printed) ' "0 a3 t iui (This area for official seal) "'• ""` Pall V10ia Du.Luu1.rVV 1,UPII"al,l Anasu 7'01Vol?1 JOB ADDRESS- 2341 Ticonderoga Way - BUILDING PERMIT NO. 27530 GENERAL CONTRACTOR Same as above DESCRIPTION OF WORK Residence W/Att. Garage AP No. 910-01-87' LOT 87 TRACT 5160 FIRE ZONE VALUE $ 181114.00 INSPECTIONS Signa ure Date GROUP I &J TYPE y ZONE R -3 Soil Ir` La SUBCONTRACTOR I PERMITS ISSUED Gas - Date I Number 1 Signature Water T ( -^'7t-C• ,I � � •lumbin:, Rough Plumbing r .It MIAVA% ,ci O/Os��ithr Prop. Swr. Line 0 House Con..V/ i / Sprinkling System Miscellaneous Rough Heating and Air Conditioning _fW7/ Temporary Service or Pole Underground 0 Power 0 Rou:h Wirin• y: C �/dt�• Heating and Vent. Trenches iLr Forms c Steel Reinf. Er /i0 n t_ ,Q/1 .. f ---4_ ��, ;� ../ _y S- o.- Floor System ,i72 Bond Beam 0 Steel Reinforce 0 Sheathing , 17,/4 GS 47 Frame and Flashing ri 2.j . A; Lathing—In '117... Out-i Aga / Plaster, Brown Coat j G Structural, Final "1,6 ,�► Electra Heating, Vent., Ref rig. and A.C., Final a" NC"--_ -6 r(r //Zit/ 7f�1 i i •fnf� rrt Plumbing, Final and'eW.! �7�it% -{B' rrar Electric, Final .420 , , Building, Final Oa �; 2 /530 I ,i� A MESA BUILDING SAFETY DEPARTMENT SEP 1 6Yist, 338: ***.":9'..: !;O .O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING �1 fr For Office Use Only 13ADDRESS 4 I L.CJ/•A( bf 0-c5./.` (U� RECEIPT NO. 27530 COSTA MESA. CALIFORNIA ,{�.�!/�y4- 47� 17 LL }Ql���H ucto /�� JJw</ Oilisitati J FIRE GROUP e.....-0,-- APPROVED -0 Jf- CIT(mitt �` NO ZONE TYPR (/1J— ri�1�1 APPROVED ORCHITIC► A o / wit A39 BY' DATE OR ENGINEER /� r't4 6 n q0-bcf.),— PG' .7- GI-c-Q ZONING 5 ' 4L ADDRESS 1�.f ZONE NO.OF U[[OPN[W o_ /'� Rai PLAN[ 2-1 BUILDING /(/ �� CONTRACTOR l(Ielek--l-1 /r J �+ /� ,, �.t� DESCR [''4- 7 'Matt !(o-p ADDRESS InnO-[IN�`^� DESCRIPTION �'p��SS11 U �j' G /J CITY C/' A.P.NO. / a 0� 0 D/ STAT¢ TEL NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.NO. NO. 8O•TO SIDES REAR p.L EAVES SIZE 0'7 I NO.CS,I 09. ALLOWED (U.B.C.REQUIREMENT) OF LOT M1 / YARDS APPROVED YARDS APPROVED UBE OP i MAIN BUILDING ACCESSORY BUILDING EXIBTI as - - (FROM C/L STREET) SETBACK LINCPRU* FRONT OFT. PT CENTER OP STREET REAR YARD SIDg YARD LEFT RIGHT � R.SIDE 0FT, PT. I DESCRIPTION OF WORK L SIDE OPT. PT. NEW ALTERATION ADDITION REAR OPT. FT. DISTANCE BET. BET.MAIN a REPAIR MOVING DEMOLISH MAIN BLDGB. ACCESS.BLOCS. BUILDING �I -7 NO.OP VAR.# DATE BIZH bC.�'Q lV ROOMS vOF . --L., C.U.P.�FL�� {/�/ APPROVED J / EXTERIOR W�cult COVERING 1�-V' T/t— J .PROVE 1.� O"� DATE / -S-67 EOVERING /y�N_ u l O USE OPI PERFORKED 01---72 1 14 � n Gj�Gai(_I-/R.T i( A L1-I `/A l!/ ` IVj C 1 3 /3/8Q.PT. 7 70 a e 1 I HEREBY ACKNOWLEDGE TEAT.I HAVE READ THIS APPLICATION TME AMOUNT SHO NDER VALUATION IS FOR THE C AND STATE THAT THE�L OVE IS CORRECT AND AGREE TO CON. PURPOSE OP ESTASUJSHINO A PERMIT FRE ONLY. PLY WITH ALL CITY 0 .• AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTIO777 y' P SIGNATURE OF / 1 oc) PERMIT FEE 5 4p� PERMITTER C..WL to'tit �\ ,y/ O� c S /�/// PLAN CHECK E Q� n w AUTHORIZED A•ENT \\\ TOTAL PEE 5 / v uWNLR MC KENZIE, A. R. DATE 6-16-70 JOB ADDRESS 2341 Ticonderoga Way BUILDING PERMIT NO. 31956 GENERAL CONTRACTOR Owngr-Builder DESCRIPTION of WORK Patio Cover 4AP No. 930-03-87 LOT 87 TRACT 5160 FIRE ZONE VALUE $100.00 INSPECTIONS Signature Date GROUP ,J TYPE V—n ZONE R-3 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date I Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL _ Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL � .�/o,, BUILDING, FINAL /1 /r- -Z7-7o 3 I 9E 1 PC,!:,‘,‘ JUN 16-70cr t-UU 1631 al***tri Pc COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECEI�jEDD BY DATE RECEIVED ATE ISSUED BUILDINADDRESSG .231/40 T/coeicer F2.0t4— 3�/t ' & —/(0'70 b _/(o-7o ////`' y {C OWNER Afl< j Meerieci /C- A.P.NO. �,���-03-er ` .SNYo MAIL .iBUILDING �� /ADDRESS 2/ / 77.004/1)4.406./9- �00./t&4o a- ADDRESS TI C tUb6 'o6 Z a O e©yra 6 / ((�� TEL. ` CITY EJ/�� NO. TRACTSiGO LOTBLOCK Z CONSTRUCTION NEW ADD ALTER REPAIR MOVI G f1FMO1I$H O N LENDER �� rJ-A/E aco J 0 BRANCH ..---- J �j L`/ JN OWNER A./7 Al eta-J.6 < J ADDRESS .�/�- VALUE -m ARCHITECTJ Q OR ENGINEER 4vt/�E 2 NTEL. LIS r "�sf 5 O to FIRE ZONE 3 TYPErks�GROUP LS Q w CC ADDRESS ��C' }}......----,x 6":•—/16: �_/ •//� W Z CONTRACTOR aceta�EZ� BVCt.Uri PROVED /7....4/1-' �4 DATE(,Qf /1 /n J O /C I J Z _ yn ,y-�'__ J W ADDRESS Ww TEL. ZON ea NO.OF USE OF NE y Z F CITY NO. / \ PLANS,2-- C BUILDING W O STATE CITY YARDS APPROVED YARDS APPROVED V)2 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING n 0 (FROM C/L STR(E ET SIZE NO.OF SLOGS. �/l y, OF LOT I NOW ON LOT FRONT /P,( 7. --c,-_162r FT. USE OF J2.5 EXISTING BLDG. G 0J FA f{; R.SIDE 0 FT. FT. 1- SIZE OF NO.OF �/ Z NEW BLDG. ROOMS STORIES L.SIDE .d...4/FLT -2---10 FT. U EXTERIOR WALL ROOF �Q _ COVERING COVERING REAR t-t-'tom/KT. -e- . --162, FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0- 0 MAIN BLDGS. ACCESS.BLDGS. 0 PAriO tiefz. C.U.P.# APPROVED N „ . AAPPROJD. /t2^ , �/ b ......-70_gDATE ( Z C - '/ 0 V I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with IL all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of (q the State of California. �O m m ? I hereby certify that I am properly licensed as a contractor under SO. FT. o the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: R• am exempt from the provisions of the St of California Business VALUATION /� and Professions C a, isi n Cha 9. M. PERMIT FEE $ `/ . 00 N D Signature of( yd m Permittee / 5 /OO fly�1/ PLAN CHECK $ �• E �� o . Authorized Agent TOTAL FEE ado