HomeMy WebLinkAbout153 THE MASTERS CIR - Building Permits A ESSCc BUILDING: 153 THE MASTERS CI Ler: CITY OF COSTA MESA — BUILDING PERMIT
tEST+AMEIEa+C'"N'KINZIE, FREEMAN X TR PERM NO: B 080860
ADOREss153 MASTERS CIR
COSTA MESA,CA 92627 PERMIT NO: B 080860 PLAN CHECK NO: N GOVT: N SUPP : N
ADPL.MAIRRO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR MENEM 11GND= JOB DESCRIPTION T/OFF FLAT ROOF & REROOF W/BUR SQ FT : 1 , 837
ARCH.OR EMa7 ADDRESS: WIT:
CLAIM VALUE: 1 , 837 . 00 CALC-VALUE: 1 , 837 .00 GROUP OCC: R-3 /U-1
coxmACTDInNAAICRANK BROS ROOFING CO ( 714 ) 548-5569
CONTRACTORS MAILING 126 COMMERCIAL WAY COMMENTS : X
ADDREss:COSTA MESA CA uc.ND.: 408677 *itltit*iE+tit****N-* -x -iE -***St*** -itx-****iluSESE*****it*****St*etlt***SE*x*****iEitlE*ltetat -N-*******
92627 UNT: Z ONING R EQU I R EMEN TS
LICENSED CONTRACTORS DECLARATION:I hereby Nim under penalty of perjury that I am licensed under provisions of Chapter 9 S ET B ACK S
(commencing with Section M050)of Division 3 of the Business and Proles s Code,and my license is in full force and effect,
Cm NO.005993 UC.CLASS:C39 Eic 4086V EXE : 06/97 MAIN BUILDING ACCESSORY BUILDING
_ i 7�Q/(� FRNT:
LEFT: FT IN REAR: FT IN FRNT:
LEFT: FT IN REAR: FT IN
—� Contractor: `� FT IN RGHT: FT IN FT IN RGHT: FT IN
0 N• BUILDER DECLARATION:I hereby affirm under • In Ian exempt limn the Contractors license Law for the
moo .rearon(Sedbn703i5BuebeMadPrafessbns ayarwaywtimreeirmepermetto°aewn,°ber,irwroe, PARKING REQ: PROV: PARCEL: 11939136 ZNE: REF NO:
dish,a repab any ebuctme,prior to its issuance.no the applicant for such permit to fib a Biped statement that he or she
is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7003)d Division 3 d the PLANNING NOTES> -moi
Business and Professions Coyl or the:he or she is exempt therefrom and the basis for the alleged exemption.My violation el Section )
7031.5 by any applicant for a pennll subjects the applicant to a ant penally of rd more than tae hundred dollars 155000. ***************.******,********-.******,**-****,*-********,******************')E.*.*********
❑ I,a°ownerothepopnyormyemployeeswithwagorsestheirWecompensation,willdothewad,andtheswdureindintended D EV ELOPMENT SERVICES R EQUIR EMENTS
or offered for sale(SectiUr 7044,Business and Professions Code:The Contractors License Law don not apply to an iswnerd properly
who beide or improves thereon end who does such work himself or herself a through his or her own employees,provided that such •�.
imamrornenl°uernl'Mendeda dferedthe eab.Il'however,the buildingor inprovernad is"Id wAhinawyeerdmmpletion,db ZONING APPROVED BY DATE:
owner.buldr will have the burden of proving he or she did not build or improve for the purposed sole).
❑ I.a owner of the properly.am exclusively contractile with licensed contractor to m proud the prged Medial 7044.Bunten and
Pr fessiaa Code:The Contractors License Law does not apply to an owner of property who buns or Improves thereon and who BUILDING APPROVED BY : DATE: ..--d
contracts for aids projects with a eonir°da(e)licensed pursuant to the Contractors License Law). / (�/
❑ tam exempt underSewon: B.AP.C.,for this reaam,: APPLICATION ISSUED BY: ��kF*�E DATE: iE / V
************************************** *************************** * *
Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGM NT:
I do hereby certify that I am aware of end understand the requirements of Calif aria Health and Safely Code Sections 25505,25533,and
ap
25530.and that I or stuction«modi from buildin theAtell/veIIIuSeZiy snnotiperecircle ntDisr need
w iinnie comply
nh Jddior�i ionne codes naanscenreqtf�rommIIesne BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 59 . 50 . 50 ,
Den: Applicant: SM I P/NON-RES
WORKERS COMPENSATION DECLARATION:I hereby elfinpenalty of perjury one o to mrmisn
following d. a: PLAN
ver
❑ Ihave and wmeintanacerlr�edoassenttoseu;nsurefor workrcompensation,
s' asprovdedlabySectoroa
Section 3700 ISSUE FEE
a
Code,for the pedamancedthe work fawhich this permit isissed. BUILDING DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
_fl Ihave adwmainanworkrs'rermpe,monisurane,asremewbyydm37mdmeLaborCode•fprthewformarrsdth. TOTALS----> 60 . 00 0 . 00 0 . 00 60 .00 60 . 00 , 00
1� work la which this permit is issued.My waken'compensation insurance corder and policy cumber pre:
Carrier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: ^- 60 .00 OVER/SHORT: , 00
Polity Number. 7A5-9F,11NTT774 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
•
(This section need nor be complexed I the permit is for one hundred dollars 151001 or[wea) 59 . 50 . 50
❑ I certify that in the Oedema/ice d The work for which this permit la i Med,I shall not employ person in any manner°o as to
m eubied to the workeri compenealion laws d Catdomie, d agree that H I become eubled to the workers. *******************************************************************************
q pef sawn provisions a Sedan 37of the Labor Code,I shall hweh empty I N D I V I D U A L F E E B R E A K D O W N
Date: C ) - 3 -9 Applicant:Inc:FaDure n secure workers'conysnsston covarapll• ,and shah relent an employer to criminal pinemee and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil linos W to one hundred thousand dollars(d10fi M /flan to the Coat of corrym°sfyrs damsgss as provided for In
Saton3yOOolmaatorCay,inyaatadaronaya SFR 1837 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 837 . 00
J.. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for wham this pend is issued(Section 3097.CS.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I ceniy that I have read this application end data that the above information is correct.I agree to comely with all city and county ordinances
and sun laws relating to building construction end hereby authorize representatives of this city to enter upon the above.menieed property
for inspection purposes.
II JIM CRANK
0100220967-00220968 TOT 60J
INIIMIPPr •nrtName Date /).-1
�/xDATE: 12/13/95 TIRE: 09:11
ignelure d Owner AgenVAprAcan ..I:•m (v
(5151-4a.WP) While-Buidi e&Salary;Green e;Canary-Appicant:Pink-Revenue;Goldenrod-Assessor
_ a
\\ - CONSTRUCTION AND PLANNING - POO WA
111 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. b - 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 Drains64. 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 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: q/ n.C1 - - 2'' /n�
34. Final Heating& Air Conditioning 1Z-t3 - 4P- a CfrO k
35. Final Gas Pipe-Test C
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 ' /G q( J4_-
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. - 9130 2/ 10/86 ;00;, TL
•
CITY OF COSTA MESA CONST/R,UCTION PERMITJPERMIy�O. /) TRACT NO. LOT
NO. UNIIIT�NNO.
Project Address /53 e /4fl.ske-s ('.�A r g azo/ U ALTERATION TJ REPAIR
GoApplicant's Mailing Address // / / TYPE OF CONSTRUCTION ❑ NEW ❑ ADD _
Owner's Name ��yl7je' Phone U;3r�r(pDOc} ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Building:
Z
Arch/Eng: License No. TYPE OF PERMIT IEGRADING ❑ OUNDATION CI STRUCTURAL T Front 0
/, /}
III TENANT CI ELECTRICAL PLUMBING
❑ MECHANICAL B • N
Address - /(//� � ��/ � 7rnl •
A Rear• N .
^— Contractor's Name // �` hone ❑ 'OTHER
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right
Address(mailing) l� �� K G
�'1 �s ` CONSTRUCTION TYPE VALUATION$ S Left R
City License No. —s / /3 _ ZONE GRADING CU.YDS. ACRES - E
LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: �] 1986 M
with section 7000) of Division 3 of the Business and Professions Code, and RECEIVED f CB 3 - T
my license is in ful /.ntl effect. /S—� - S
License 'a-s ;i/ v >•eps��. `y l' ! PLUMBING FEES
Date ignature T
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL . FEES
'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 3800, Lab. Automatic Washer Transformer 0 15.50 KW
•-
Policy No. 4?a1 Company Automatic
Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
_,Eertiffed copy is hereby furnished.e -
47. Cerci a cO� s fi lth the city l i Ri io ,f Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps
Date
'�-er�-A Applicant !L"//( If���'l`�
EXEM ION FROM WORKERS'COMPENSATION DECLARATION Clarifiers 'j • Solar Collectors Dishwasher Meter Dover 100 amps ,
(This section need not be completed if the permit is for one hundred ($100) or f
less). Dishwasher Solar Piping ►, Dryers ❑Gas DElectric Sub Panel
I certify
1 that in the performance of the work for which this permit isissued, 1
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
'NOTICE: If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith .Floor Sinks I. Urinal ■ Microwave
CONSTRUCTION
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device BoxesPole
I hereby affirm that there is a construction lending agency for the performance Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater
Lender's Name __ _. -. p Outlets Range
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 Lavatories Auto-Wash Garbage Disposal l 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 Laundry Trays • Generator 00-5 KW 05-15 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
herefrom and the basis for the alleged exemption. Any violation of Section
031.5 by any applicant for a permit subjects theapplicantto a civil
penalty of not more than five hundred dollars($500). T
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered 1 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 own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. 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 .
prove for the purpose of sale). �(14
O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date V-10 '
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 ■ Multiple ■ ■ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me.
PLAN CHECK $ PERMIT
❑ I am exempt under Section B. & P.C.for this reason :• — PLUMBING $ .6-0 0ISSUANCE $
Date Owner Heating System ' Ducting
Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ■0-100,000 ■ 00001 : GRADING $
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 t city to enter upon the .bove-mentioned property for ��^
inspection our o s. i o /_ �, MECHANICAL $ TOTAL FEE $ eJ
Signature // / / Dat
Drivers' License or 55- -�
- Accounting; Goldenrod - Assessor
•
.CONSTRUCTION AND PLANNING POO. .SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
i` 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, O 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 ❑Gas ❑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 L _[ c''
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 2
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison - -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER UNITED SAVINGS & LOAN DATE 4-27-70
JOB ADDRESS 153 The Has' rs Circle' BUILDING PERMIT NO. 31746
GENERAL CONTRACTOR Rynea . Smith DESCRIPTION of VI : Residence W/Attached Garage
AP No. - LOT 14 TRACT 6508 FIRE ZONE VALUE $ 24.731.90
INSPECTIONS Signature Date GROUP I & J TYPE v ZONE R-1
SOIL 1'1 c1c' —7o SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER /jt Cr-/72e Plumbing ,
ROUG
SING
PROP.SWR. p HOUSE CON. V � h ✓-Z.L /fit _ . , y -. f 8 -7o � 3-
SPRINKLING SYSTEM ((( I (I L
MISCELLANEOUS �y J
ROUGH HEATING AND AIR CONDITIONING le r V.-7-7,
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING r`C `I_Z ,(j Heatinga V t .gyp p _
TRENCHES FORMS �] STEEL REINF. / ,�'^G^70 A�� � ApO'�Q 0y/��j4�
FLOOR SYSTEM ,f-43-r4V �/ �•6//-7O /'+0/
BOND BEAM n STEEL REINFORCE LI v�
SHEATHING ♦t.
6A TO
FRAME AND FLASHING � > 77l4 70
LATHING - IN OUT 71 _'/-76
PLASTER, BROWN COAT i. 14s gliAgfrO
STRUCTURAL, FINAL A J, rEle�ct '
HEATING, VENT., REFRIG. AND A.C.,^FINAL �Mj'�f Sj�CD-2f1-7c- /CL2GNY✓ Cld(J ee. 6 -Il7.O 8/V7---
PLUMBING, FINAL AND GAS TEST 1 J /14.jo-j-]o
ELECTRIC, FINAL �/,}d /a -79 7p
BUILDING, FINAL lob1lTZ
746PAID 133.50
?P 2Q-7rcn$701683* t:**
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATIONn ���////// FOR BUILDING PERMIT
RECE DTA— EC€INFIPERIJPAR DATE SSUEDf
BUILDING
O"`/
ADDRESS 153 The Masters Circle '0777 OWNER United Savings 8 Loan Assoc. A.P.NO.
MAIL AOIDRE
S 153 The MLDING asters Circle
Z ADDRESS 9800 S. Sepulveda Blvd. /_- d
n. U CITY Los Angeles, Calif. NNO` 670-7550 TRAc LOT/9 BLOCK
Z
Z I LENSTRUCTION NEW ADD, ALTER REPAIR MOVING DEMOLISH— co LENDER Owner
n. m I
J D BRANCH
Jto OWNER lin lted Savings E Loan Assoc.
CO -I ADDRESS VALUE
CO• ARCHITECT TEL. USE $
JQ OR ENGINEER R.J . Maivick NO. 839-3840
U(1> FIRE
WIZ ADDRESS 1538 N. Century, Santa Ana ZONE TYPE GROUP
aw
APPROVED
J O CONTRACTOR Ryness-Smith Co. BY DATE
m
71= ADDRESS 140 E. Industry Ave. Single fam. res. w/
w w TEL. ZONE NO.OF USE OF NEW
zI- CITY La Habra, Calif. No. 879-3111 RI PLANS 2 BUILDING att. 2 car carage
WCC STATE
LIC. NO. 1964 ARCITY APPROVE
BUI DIINGD ACCESSORY BUILDDING
YARDS APPROVE
N¢ LIC.lc. NO. 167538
D O (FROM C/L STREET)
LOT 40 x 106 NOW ON LOT
SIZNO.OF BL
OFf./U FT.FRONT ��//
� FT.
USE OF 7
EXISTING BLDG. R.SIDE 3 FT. FT,
Z NEW BLDG. 1580 ROOMS 5 STORIES I L.SIDE 3 FT. FT.
Q EXTERIOR WALL ROOF I b
V COVERING Stucco COVERING Wood Shake REAR n FT. FT.
—I USE OF BUILDING AND WORK TO BE PERFORMED
CL DISTANCE BET. BET.MAIN&
MAIN SLOGS. ACCESS. BLDGS.
0
Q VAR. /5-677 DATE 3./7—�r/
0 Single family dwelling 8 two c.U.P /_6Y APPROVED/O-4, /!�
z car attached garage __ay D W L D. ATE 4-24-70
O Lot 14 Plan 2-AR aft fit9
UI hereby acknowledge that I have read this application and state
M that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
V) the State of California. ^/ / t0
? I hereby certify that I am properly licensed as a contractor under /� r�(P SQ. FT. ®y o
the State of California Business and 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: c
CC
am exempt from the provisions of the State of California Business
and Professions Co••,Division 3,Chapter 9. VALUATION d0 m
PERMIT FEE $ N
Signature of / / T s 2/[ 7j/ y3!^D CO
E
Permittee rt/ Se I /,r/et $O'17 TOTAL FEEPLAN K $/33 Sc, .
Authorized Agent C u.