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HomeMy WebLinkAbout313 20TH ST - Building Permits ADDRESS a BUILDING: 313 E 20TH ST Ul t CITY OF COSTA MESA - BUILDING PERMIT Ow1ERStUMEIFIDI0w1E DARRELL RIPLEY PERM NO: B 084944 ADDRESS 313 E 20TH ST COSTA MESA,CA 92627 PERMIT NO: B 084944 PLAN CHECK NO: N GOVT: N SUPP: N a/PPL.MAIM ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF & REROOF W/COMP. & BUR SQ FT: 7, 200 ARCH.OR ENG'S ADDRESS: UNIT: CLAIM VALUE: 7, 200 . 00 CALL-VALUE: 7, 200 . 00 GROUP OCC: R-3 /U-1 CONTRACTORS NAME: CONTRACTORSMMLMG COMMENTS: REROOF HOUSE W/COMP & GARAGE W/BUR ADDRESS: 110.110.: ******************************************************************************* SMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby dlisn under penalty of perjury dal I am licensed under provisions of Chapter 9 SETBACK S (commencing with Section 7000)of piloting,3 d the Business and Professions Code.and my license is in full force end effect. C' C.NO.: 69 37 UC.CLASS: C-39 UC.NO.: 3496 EXP: 62/98 MAIN BUILDING ACCESSORY BUILDING 9�� p Contrera; FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN �'J 77/%A �)� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN • R ILDER ECLAPATION:I hereby affirm under panty of perjury that I am exempt from th/Contractwe License Law for the following reason( ion 7031.5 Business and Professions Code:Any city or county which requires a permit to contnd,alter,improve. PARKING REQ: .c PRO V: PARCEL: 42629503 Z NE: REF NO: ..„.• jemnlSh,or repel any structure,prior to es issuance,also requires the applicant for such perms teller a signed statement that he or she L••icensed pursuant to the provisions at the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES-5- ' i--`ainese and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >,,. ,i;03t.5 by any applicant fora permit subjects the applicant to a civil penalty of not more then the hundred dollen(S5001). FDI,ad owner property or my employees with wena egthen sale compensation,will do the work,and the structure® urenth intended E V ESI;-'O P M E N T S E R V I C E S R E Q U I R E M E N 'T S or offered for sale(Section 7044.Business and Professions Code:The Contractors Ucene Law does not apply to an ownerd property . he weds a inproves thereon,and who does such work Nmselt or hereto or through his or her own employees,provided that such improvements are not intended or dieted for sale,I.however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build Cl improve for the purpose of sale). • ❑ I,as owner of the property.am«dutvefy COetradi g with licensed contractors to co aW the prged(Sedton 7044.enskha end1 Professions Coda:The Contr don License Law does not apply to an owner d propertyimprov.who wide or thereon and who BUILDING APPROVED BY : DATE: convects for such projects with a coniradons)licensed pursuant to the Contractors License Law). i ❑ lamexempt under Section: B.A P.C.,for this reason: APPLICATION ISSUED BY• DATE: 7111111 Date: Owner: **************it'it3t3tdtatit4itiFdfifitifif***7F*** df ********lEiE**************** • ** LEGALIZATION:N- F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify Thal I em aware of end understand the requirements of Cd'tomia Heath end Safety Code Sedans 25505,Path's.end 25534,end that I or any future building occupant will/will not(circle one)need to comply with said date codes end the requirements for a permit mrconswdionormodfication from the Ai 7MCGnagemenlDistdd.Residentialconetnaionapplmianareexemptfromthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 137. 25 . 72 Dale: Applicant: SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby elpenaltyfin..under penalty of perjury one of the following declarations: PLAN oI have and MImaintaina certificate of consent to self-insure for workers'canpersabn,asprwkedla by Section 3700 d the Labor ISSUE FEE Code,for thepedamanceofteworkforwhichthispermtisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE L7 Ihave er,d,„Imawai,workers'compenmux,insur«we,esrequired bySection 3790of1 Labor Code.for the p,dmhd oacethe TOTALS----> 137. 97 0 . 00 0 . 00 137. 97 137 . 97 . 00 F� work for which this permit is Sued.My workers'compensation insurance Ganser and policy number are: Canis: STATF FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 137 . 97 OVER/SHORT: • . 00 poky Number 17nnci4R-97 06/30/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK nes section need not be completed y the permit is for one hundred dollars(Stool or kiss) 137. 25 . 72 o I caddy that in the performance d the work for which th'- '- ' - -..• ...• .. . ., person ®a peon in any manner to become surfed the workers'compensation laws of .'..,•': : . agree that t l ./ Id .... . subject to the workers' ******************************************************************************* ne peation.. 'skinslen 3700 d me labs toes. anti o h campy with y- provisions. t - IND I V IDUAL F E E BR E AK DOWN / Applicant:e.: _ Fal rtosee workers'compernation coverage is unlawful,end shall subject an employer to criminal penalties anti TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST . • to one issired thousand dollen($100,0001 In addition to the coat of compensation,damages as provided for In on 3706 of die Labor Cory,Interest,end attorney's fora SFR 7200 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 200 . 00 • 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 whir,the permit a issued(Sedan 3097,Civ.C). LENDERS NAME: LENDER'S ADDRESS: I certify that I have read this application and alma thee the above information is coned.I agree to comply with al city and county advances end state laws relati g to building construction end hereby authorize representatives of this ally 10 enter upon the above-mentioned property for inspection purposes. —cis • • •LEXSON /} 89-38-1997/89:51 RN/1137.97 / sem/ .. :-_ Date: 9 g '/ 3815 PERMITRC: 1 984944 /_r Signature • • •rlRpenUApp' • vitt:.. r (5151-46.WP) White-Buildng 8 Safely:Green-Re:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor COr4STRUCTION AND PLANNING POOL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector _i 1. Temporary Electrical Service oriole • 52. Pool & Equipment Location' . i 2. Soil Pipe-Undrgrnd. - `j-' 53. Steel Reinforcement y- s 3. Electrical Conduit Utility-Und gmd:' 54. Forms 'r 17 i. , • 4 Electrical Conduit•Undrgrnd. 55. Electrical BondingI j '' -t l .- S. Steel Reinforcement 56. Rough Plumbing & Pressure Test =•6. Electrical UF Grnd. - 57. APPROVAL TO COVER-GUNITE J. -• 7,Footings 58. Electrical Conduit:Undrgrnd. -8. Foundation - 59. Gas Pipe• , 0 Undrgrndt,.Test •t, 9. Water Pipe-Undrgrnd. '' 60. Backwash Lines;P Trap, 0 Uhdrgrnd. 1• i 10. Structural Floor System 61. APPROVAL TO1DECK- :; 11. Property Sewer Line & House Connection - 62. Backwash & Receptor1Finall . . 12. Sewer Cap • ! 63. Heater & Vent-Final 13. Roof Drains ✓ ' 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final ? • 75. Rough Electrical-Conduit 66. Solar System-Final i1 - 16. Rough Electric Wiring - 67. Fencing & Access-Approval - N 17. Rough Wiring Sign - 68. APPROVED FO . RPLASTERING. 18. Rough Electrical-T Bar Ceiling -69. POOL/SPA SYSTEMS FINAL 1. 19. Rough Heating & AirConditioning _ t EWE QEPT.,,REQUIREMENT - I 20. ,Rough Factory FireRlace - w. _• -. '1 ;, :,.APPI`�OV,/kLSJ.' Permit# . -i• 21. Ducts; in Structure ' •• _ 70. .'Underground Hydro P, 22. Ducts, Vegtilating . -- _ t • 71. Product PipingDZias a Oil 23. Gas Pipe-Rough & Test _ '- _ 4. ' 'I 72. Underground Fltuh _, . 24. Roof-Framing'• '• ' - ' - I - 73: Undergrnd.Storac Tpnk O Gas 0 Oil 25. Roof:Sheathing •t _ /� /� 74: Overhead Hydrta +� _� 26. T-Bai•Ceiling (Structural) & rtAoTiocoat ,'c, 75- Dry Chemical ,. j - 27. Frame and Flashings r >' .' 76. Dry Standpipe - 28. Lathing &.Siding .T71, ' - : , ;t 77',, FIXED SYSTEM FINAL - - - 29. Insulation • r . rI 7& FIRE PREY. FuN3aL ^ k. 30. Drywall Nailirr�j ;. .J I r J ;HEALTJi DEPt. REQUIREMENT 31. Plaster Brown'Coat I. ._ - - r. 79. FINAL INSPECTION I -; I. a=.-. ,. •1,-, ,. . 32. Electrical=Power MeterFinai 80': FOOD CERTIFICATE ISS.0 ED ,�. - .t I c 33. AnalrElectric '- i '•: - Notes: , ' • 34. Final Heating& Air Conditioning - - t 35. Final Gas Pipe:.Test- , f - .. r -I r _ J'. .c �- . - - 36. Hood-or Canopy - t : ; 37, Final.Factory Fireplace x 38. Final Plumbing ,' . ' - _ ° 39. Water"Service-Final - - . . .r• 40. Gas Service-Final . ' _ - _ , -- 41. Solar Domestic-Fina( - .' . ' is. - 42. Backflow Preventer . . ' 1. 43. Backflow Irrigation i $ . - 44. Landscape Irrigation System : I '% ` I •i. 45. Sound Attenuation _ D 46. Handicap Regulations _ -• ' L'"' M i. x 471, FINAL STRUCTURE & BUILDING lip_2_7.47 6 461- H M r 48. FINAL PLANNING - - i "I:, -ii ,; 49, Electric Release to Edison • �c`� _G 50. Gas Release to Southern California Gas Co - - ' Sit CERTIFICATE OF OCCUPANCY ' - g No. Date APR14-70BOO 820 c-i****40.00 CITY OF COSTA MESA PLANNING DEPARTMENT - wisa A. P. No. 118-175-14 Bldg. Permit No. �57i4/8 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 313 E. 20th Street, Costa Mesa Owner's Name Don Allred Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = $40.00 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = $40.00 Total Fee Total number of Dwelling Units 1 Planning Department Approval Date 4-14-70 Park Ar No. 8 By , WLD:pd Applicant's Signature LO-/YU PAID APR 14-707000 82084****40.00 CITY OF COSTA MESA PLANNING DEPARTMENT '- A. P. No. 11'i-174-1$ Bldg. Permit No. 3i6, ',? PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 313 F. 2e'tt etrot. LoSta -esa Owner's Name =en A11rc' Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = $47.0^ 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Fee Total number of Dwelling Units Planning Department Approval Date 1+-114-7i Park Area No. 1 By ULD:rd Applicant's Signature �� 16473 FEE RECEIVED • Y ' ,_ ' FEB 271962 COSTA MESA BUILDING-SAFETY DEPARTMENT /{"Y FINANCE DEPT. P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPEORPRINT BUILDING ADDREBUILDSS 3/3 E"°'( 2•o �S Sf COSTA/MESA. CALIFORNIA r For Office Use Only OWNER if At,.( fie LJa!f{n Pn7 ! �. I RECEIPT NO. I �PBp2t1 MAIL n ) RECEI D BY ID: IVSD , I pADATTE IIISS/USED ADDRESS Pr dl11( Ud I V BG fel .-/-�l C/�� ./ / TEL. BUILDING CITY ,MO&, 1tr/ Rna./� NO. ADDRESS ARCHITECT ��/_/ /I �/ L. COSTA MESA. CALIFORNIA OR ENGINEER ,)1j�!!/?ll CJS rAfien7Y�t' O. ADDRESS 1-/'. • f. FIRE I / ZONE TYPE // GROUP L / V // - / �/ AA APPROVE/ ry> 7 - / BY '� DATE ./ 2/ ADDRESS ZONING CITY e--• ZONE R-1 NO OF z I USE OF NEW . ^yam 7� STATE ncI•� ) //11 TEL. LEGAL for l LIC.NO,�['�� �f'�ti/ NO. DESCRIPTION LO( ad S N�HjJ j/� SIZE 7�� (-2) I NO. OP FILMS. 8 'J OF LOT O (/ NOW ON LOT.----- A.P.NO. I/ --- /7 L — /-5--- 3 EXISTINGEOFYARDSBLDG YARDS EVES •1fc 1/oso APPROVED ALLOWED SETBACK LINE FROM �I (CENTER LINE BT.)y/ 7 CENTER OF STREET 4 /^ REAR YARD /7. FRONT 1/ /I, FT. --- IN. SIDE YARD I LEFT I RIGHT I7 R.SIDE //L FT. IN. DESCRIPTION OF WORK L.SIDE r/ 6 FT. IN. NEW V IIALTERATION I II ADDITION I REAR / /• 3 FT. IN. REPAIR I II MOVING I II DEMOLISH I ��41- DATE 27/3/a -L- BUILDING NO. OF SIZE ( ' /3 ROOMS �j) STORIES r EXTERIOR WALL ROOF 1 /�., /' ° COVERING ,S 1 .- u COVERING /-/' Cle I 51� USE OF BUILDINGD WORK TO BE PER ORMED ,suv/e f$A„ O/y vers ham. - / fag 1-4. .n1 a R fl, - - , War I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AM• SHOWN UNDER VALUATION IS FOR THE ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSEOSE OF OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING / BUILDING SIGNATURE OF�uCTlopl( G� � �. VALUATION y/ PERMIT FEE $ Yp PERMITTEF �rf// /� �5 D a_ $ / PLAN CHECK $ /O — AUTHORIZED AGENT L'yr g TOTAL FEE - ....6*--.- OWNER ALLRED, DON DATE 4-22-70 JOB ADDRESS 313 E. 20th Street BUILDING PERMIT NO. 1161R GENERAL CONTRACTOR Larry Johnson DESCRIPTION of WORK Add Den & Bedroom to Res. A 118-175-14 LOT 3 TRACT 4050 FIRE ZONE VALUE $ 5.040.00 IN... ECTIONS Signature Date GROUP T TYPE V ZONE R-1 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date I Number Signature WATER Plumbing ROUGH PLUMBING • PROP. SWR. LINE n HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ ROUGH WIRING ��/�� /13i�0 Heating and Vent. TRENCHES FORMS ISI STEEL REINF. 0 Wil v-Z�-re FLOOR SYST `"� ✓V y-27-70 BOND BEAM El STEEL REINFORCE n i5./ //. SHEATHING /off a l//// 7 D FRAME AND FLASHING of IV S-/2-ZD LATHING — IN K1 OUT ® div c-/r-TO PL'-SER, BROWN COAT 7.12-70 S' 'URAL, FINAL / �J, HEA I ING, VENT.. REFRIG. AND A.C., F INAL /g2 a 4,7„. -Z fate atj ,7,, •,itO / PLUMBING. FINAL AND GAS TEST n ..[) { / /fes ELECTRIC. FINAL /1 /.' 1' 2.7C ___ _.... _.__ _... .n :9 I ur - t 9 PAIDw It- 4• 8 6 18 APR 11!-70—U0 821<:- ***g•l9 CO cyst COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT REC IVSD BV DATE RECEIVED D TE ISSUE BUILDING zo r. I J.-I LI-7b i/t{{ •y Z,�.� ADDRESS ,I M�• 4.V�,�� n '7 PAR MI:NOb OWNER Hat MS - WIJ ho, A.P. NO. / 1- // S I1 ` /6/e MAIL _ _ iy BUILDINGDRS � P . aunt S'I . Z ADDRESS :SI .5 Q. G�� C ��]] ADDRESS LLA�CI �-� a.wliiU CITY �//� TEL. et/q TRACT 45-0 LOT .3 BLOCK HZ l�S � NO. �4IZ Z Q CONSTRUCTION ./������" `�� //yyst� NEW ADD ALTER REPAIR MOVING DFMOLISH Om LENDER ER '/[�Sxe- x J D BRANCH `n' ((Jh�JJ�^/n w ^ wo s J to OWNER f,Q'KJ ( QoMA • mQ w ADDRESS //y� J II ,J/1/� �, I � /� Fj /�'/ 03 ARCHITECT TEL. USE 0.4AL am 49l/LV1S�/z✓7o Q OR ENGINEER NO. Z co FIRE w [L ADDRESS ZONE CI TYPE GRO 1 J 11-1 Rat' S1 / APPROVED �^/ !� •2e CONTRACTOR JO W1it$Ov\ BY \ 91 DATE -...2-.2.- /[/ mZ �/(U' Jir ADDRESS Fe 430x 13i• w w `•. ^ n'L ZONE NO.OF USE OF NEW �L th z CITY (J1JQ �j ECF{�VL NOL44F-0'ies-* ei PLANS BUILDING Ann. ler STATE �� D@ � CITY YARDS APPROVED YARDS APPROVED N LIC. NO. L7 7 LIC.NO. MAIN BUILDING ACCESSORY BUILDING D SIZE J r� NO.OF BLDGS. / (FROM C/L STREET)�I OF LOT -2SX (! ' 30 I NOW ON LOT / FRONT ya FT. FT. - USE OF J EXISTING BLDG. /Qltl Ys' IL SID€ 'L1 FT. FT, I- SIZE OF 30/ G NO. OF �7 / /�/�� Z NEW BLDG. "� X 1�'� ROOMS ` STORIES / L.SIDEAra FT/ 2 FT. Q EXTERIOR WALL ROOF �J�/�I�'f 7 / U COVERING LAO I COVERING /-0�etV REAR FT. ,(� FT. . J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d 0- MAIN BLOCS. ACCESS BLOCS. n DATE < n ,�7" �� /�s4cn '70 // to VAR.# APPROVED p ft�/� lf�tl/J % JC/ J N yc G�N12,44egkGa., _ DROVED/444 t DATE J�� �t�- /D , Z O UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I-- any person in violation of the workman's compensation laws of CO the State of California. , ^ m ��, o ? I hereby certify that I am properly licensed as a contractor under 50. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a am exempt from the provisions of the St . of California Business VALUATION and Professions Co.:,Division 3 Chapt: �� 0• 0 n C • /�s BG PERMIT FEE $ Signature o - ' ) Cf/1 / 0 Permittee �� Cea.4"----.1111. $56(70.--- V'/� 7`' PLAN CHECK $ /(D ' 0 a E n o Authorized Agent ` cQ 6 0 LL TOTAL FEE $ aV UWNCK ATJ RED URIC 1-3n-7fi JOB ADDRESS 3i 3 Fast ?nth street BUILDING PERMIT NO. 47483 GENERAL CONTRACTOR er�ni DESCRIPTION of WORK Blockwall AP No. 118-175-14 LOT TRACT FIRE ZONE VALUE $400.00 — I :CTIONS V� Date (TYPE GROUP ZONE L._ ii Z GAS SUBCONTRACTOR P- :M TS Date Number Si.nature V WATER Plumbin. }ROUGH PLUMBING -- -_ 4,np(,\\PROP. SWR. LINE 0 HOUSE CON. 0 -- SPRINKLING SYSTEM -- MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 nil -- ROUGH WIRING - Heath"! I and Vent. TRENCHES FORMS • STEEL REINF. Miler a ��j` FLOOR SYSTEM -- BOND BEAM U STEEL REINFORCE M -- SHEATHING -- FRAME AND FLASHING -- LATHING - IN OUT == �= PLASTER. BROWN COAT ST' TURAL. FINAL ' HI G, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST a -- ELECTRIC, FINAL nill.- BUILDING. FINAL raWairSPria INIIIMIIIIIIIM=IIIIII PAIL) 4.14Q3 �AR 30-76c.,-.on1602,$ *****5.50 1 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only x / { 3i3 EAsy 20 5,7_ 1 n�/]yy RECEI �OATE RECEIVED pr�f/?1i BUILDING ,l far c A / / n ^ ,t/ , A.P.NO., I R - (7s (q PERMIT NO. OWNER ? �'l-h` I`( E / / �`� ADDRESS 3/J f (0 JR Y BUILDING %t 20�. C MAIL ADDRESS Q -�� ,r ''}}..��pp�� �� TEL. TRACT I11�-' LOT BLOCK CITY �K/L.n /rm'/�L� NO. 51/1017/r CONSTRUCT"Ofl f r ' l- pC NEW ADD ALTER REPAIR MOVING nFMOLISH -'R LENDER`/ r}-v1L( (ILC Ps/J,Q f�Ai;F rt BRANCH ,C0-,C0- , , OWNER iaLl ADDRESS //��/f /pQ ��ytVALUE Lr� ARCHITECT TEL. USE A./�C//1 �L'VKiV $ OR ENGINEER NO. FIRE ADDRESS ZONE VPE GROUP //�� ,,,1 APPROVED 9'-30-7i� i CONTRACTOR.( //.C/1L&t /ear/ BY DATE .��J'/��p ADDRESS 4�`-"` TEL. ZO NO.OF USE OF NEW Cot veil l CITY NO. 1 � PLANS 2 BUILDING �� o-F. STATE /Jct/SCC CITY ,t[ ' YARDS APPROVED YARDS APPROVED LIC.NO. G Q J LIC.NO. W(__., MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLDGS. (FROM C/L STREET) A. OF LOT NOW ON LOT FRONT FT. t °FT. 1 Q USE OF 4 EXISTING BLDG. _R,SIDE FT. ..(9-.FT. 16 F5+ Separate permits are required for L.SIDE FT. / L F tV T. w electric,plumbing and heating work.Ci REAR FT. FT. QUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q //� Id 19,11501/27 {'///A `/ ,,,/// n-,/ MAIN BLDGS. ACCESS BLDGS. af(/ L 1�/SOA/�/ /Za VACUR.;XIs �j APPROVED ��♦ //f� / 111111 APPROVED rs,y_J DATE J -3o-71 cc, �1 C� \A/"[Vim` a W O I hereby acknowledge that I have read this application and state n N 6i that the above information is correct and agree to comply with m ' all laws regulating building construction, end I shell not employ i 2{� any person in violation of the workman's compensation laws of E r2 the State of California. �; m I hereby certify that I am properly licensed as a contractor under SQ. FT. a: the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ym Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: " am exempt from the provisions of the State of California Business /s a and Professions Code,Div! on 3,Chapter 9. VALUATION PERMIT FEE $ 5,o(/ v, m I• PLAN CHECK $ " 'n Signature of �Q ��/� o u. Permittee '""{� �-�/z� $ 90 TAX $ eSQ 6 �/ U Authorized Agent TOTAL PAID $ a5 • So