HomeMy WebLinkAbout2728 LORETO AVE - Building Permits s
CITY OF COSTA MESA
frO`'T""'FS',p BUILDING DIVISION
Fa a 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
z. FOR INSPECTIONS CALL: (714)754-5626
At
°* PERMIT NUMBER: B11-00217
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 14130217 DATE ISSUED: 07/21/2011
ISSUED BY: RMD
JOB ADDRESS: 2728 LORETO AV CM Suite/Unit:
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2000 Valuation: $5,500.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL A MINIMUM OF 2 LAYERS OF 15#FELT ON A 2:12 PITCHED
ROOF AND REROOF WITH 30 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 20
SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED.COMPLAINCE FORMS ATTACHED TO JOB CARD AND
CITY PERMIT.
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card
OWNER: REDWINE, PAULINE TR Address: 2777 BUTTERMILK LN Unit:
PHONE: City/State/Zip: ARCATA,CA
APPLICANT: GIRAM,JOSEPH Address: Unit: :
PHONE: 218-359-51S9 City/State/Zip:
CONTRACTOR: B G TILE AND CONSTRUCTION INC License No. 817992
Address: 18350 HATTERAS STUnit: SUITE 254 PHONE: 818-776-8144
City/State/Zip: TARZANA, CA 91356 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $125.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $126.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays
New Years Day,Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day
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 p. INSPECTION TYPE DATE INTITIALS CODE i INSPECTION TYPE DATE INITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof n/ a/ I I eP 210 Final Electrical
201 Final Block/Retaining Wall __00 212 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
v
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver a ncense. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property 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
`u /al' by this permit,and that no building structure,scaffolding,falsework,or demolition
Cerner r/ [A /? or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
-(9lru secim need no,
be eteddthe pet
is valuer at one hundred doaars(Sf00)aress) 2,Art 2,Sec.341,Title8,California Administrative Code).
Bolicy Number: .0/J COOO cite?
0 As owner-builder, I will not employ anyone to do work which would
❑ 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' compe ation laws of California, and agree that if I should
become subject to t wor, rs'compensation provisions of Section 3700 of
the Labor Code,I fo with comply with these provisions. Applicant's Signature Date
7-2/ /1/ Division of Industrial Safety Permit Number:
pecanrs Signature coa1e------ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'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 licen(s��m/is inf
ullforce and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
L ,#3' p !� lass#-CSG�/G 3� (Section 25533 of the California Health and Safety Code, with some
,x ,_/ exceptions, requires registration with the Costa Mesa Fire Department by
-- 4 each business which at any one time has on hand a quantity of acutely
(,Contrector'ssignarre �`-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 ❑No
(Section 25534 of the California Health and Safety 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? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California 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 California 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? ❑Yes 0 No
(hereon,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
❑ I, 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: I
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 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
authorized by this permit until final inspection.
Sign .e of L , I Owner(s) Date
Signature Date / _/(
3057-46(3/07) - 2/ 1
J'd;SrAuthorized Applicant 0Date
, . t
Prescriptive Certificate of Compliance: Residential CF-1R-ALT
Residential Alterations (Page l of 5)
_
'rajecLNt me: i Zooe ti t! oaf Stories'
h
EItoog
General ittlormatiot
5•p1#'ss:Zofila Ave Enforcement Agency4/44 his vvDate: -7_21_ t
Building Type 2-Single Family 0 Multi Family Circle the Front Orientation:N,E,5,W,or degrees
Conditioned Floor Area(CFA): Project Type: 0 Alterations ❑Envelope O Fenestration M Roof 0 HVAC
_Replacement -i
• or Change Out ❑Duct Replacement 0 Water Heater
NOTE:ThLr frena+is not to be user!for Nerply Constructed Jailtlings vs Additions
...Insulation Values For Opaque S'ur fitces(for Furring use the Mass and Furring Strips Construction table below) !/
...Insulation
Assembly Alteration
o Opening of framed cavity alone-Alterations that involve the opening of the framed cavity ofa wall, ceiling, teflon'must install the
mandatory minimum insulnnon value per§150 for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H.
❑Replacement of entire assembly-Replacement of an entire wall, ceiling,or floor assembly requires the installation of Component
Package-D insulation values in Table 151-C. Fill in Columns A-J.
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
A - B C 1 D • E - F -- C _1 II- . - .I. . J
1Proposed Ste Now
Standard Values From 1A4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
Mt or Typet andSizet or Other3 i factor" Numbers _ R-value6 R-Value Cell Values U-factor9
- - -
Note;Far Jurred assemblies,accounting for Continuous insulation R-value,see Page JA4-3 and Equation 4-1. For calcul wing furred walls use the Mass and
;Furring Construction table below,
1.Far Tag/ID indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:Roof/Ceiling, Walls, Floors,Slabs, Crawl Spade,Doors and etc...Indicate the Frame type and Size:For
Wood, Metal, Meta!Buildings,Mass, enter 2x4,2x6, or etc,,. see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"0C;or Other for all other assembly description
such as Concrete Sandwich Panel,Spandrel Panel.Logs,Straw Bale Panel and etc....
4. Based on the Climate Zone;enter the Standard U-factor from Table 1.5)-B, C orD for each different assembly Name or type.
5.Enter the Table number that closely resembles the proposed assembly.
6. Enter the R-value that is being installed in the wall cavity or between the finning;otherwise, enter "0".
7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0".
8.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly (Hactor in Colunm J
9.The Proposed Assembly it-factor, Column,1, must be equal to or less than the Standard U-factor in Column E to comply. •
Furring Strips Construction Table for Mass Walls Only
A ( Is • C I D J E , F C U 1 .1 It L M _
Proposed Properties of Masonry and Concrete Added interior or Exterior Insulation
Walls Front Reference in Turning Space from Reference
. Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13
o r C C' 11
-
o t `, 1 d V 1) .
tt LL O e .° 44 v;
I
Assembly <-e j � it F' . H o m, G..0 e e Final
7.
Mass Name ar .IA4 Table v ? F t1 o t a E E ' _ ;' Assembly
Thickness' Type Numhe' < �, = ui . LL LL u° a < : tt•i c , U-facto"'- Comment ,
d
•
. l
i I I
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms Augury 2009
Prescriptive Certificate of Complian. -residential CF-1R-AST' '
Residential Alterations (Page 3 of 5)
r)ecl_Nnme: y� Cll�iintc.Zotie.tl 4 of Stories
Re (l200F
ROOFING PRODUCTS (COOL ROOFS)§1510912
When the area of exterior roof surface to he replaced exceeds more. than 50%of the existing roof area,or more than 1,0001?, whichever is
less, the new roofing area roast neer the roofing product "Cool Roof'requirements of,§152(h)IHi, 152(b)1Hli, or 1.52(b)IHl I,
Check applicable alternative or exception below If the roof alteration is exemptfrom om the roofing product "Cool Roof requirements. Note:if any
one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Eminence requirements for roofing products inn
7.4n MN are not applicable, no not Jill table below. _
)$"Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 51h/ft.
Alternatives to §152(b)IHi and §I52(b)Hli,Steep-slope roof(pitch >2:12)
-❑ Insulation with a thermal resistance of at least 0.85 hrfl2.'7/Bm or at least a 3/4 inch air-space is added to the roof deck
over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to§151(010;or
❑ In climate zones 10, 12 and 13,with I ft2.of free ventilation area of attic ventilation for every 150 112 of attic floor area,and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§15 1(1)2;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to§152(b)tHiii,Low-slope roof(pitch 52:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ft2 is exempt from the below Cool Roof criteria.
Note: if no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable boa below if Exempt from the Roofin Products"Cool Roof'Requirement:
Roof Slope Product Weight Product Aged Solar Thermal
CIIIt0 Product ID Number' < 2:12 >2:12 < 51b/ft2 > 51b/ft2 Type2 Reflectanec3'4 Eminence SRIS
❑ ❑ D 0 ❑4
❑ 0 0 ❑ ❑4
❑ 0 0 0 ❑n
❑ ❑ 0 0 ❑4
❑ ❑
0 ❑ ❑4
I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.org/products/search,ohn
2. Indicate the type of product is being used for the roof top,i.e.single-ply roof asphalt roof metal roof etc.
3. If the Aged Reflectance is nor available in.the Cool Roof Rating Council's Rated Product Directory then use'she Initial Reflectance value from the sante
directory and use the equation(0.2+0.7(pa,t,;at—0.2)to obtain a calculated aged value. Where p is the initial Solar Reflectance.
4. Check box if the Aged Reflectance is o calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at httod/www.enermi.ca.govaille24/and enter the resulting value in the SRI Column above and attach acop),of
the SRI- Worksheet to the CT-IR.
To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§1180)4. Select the applicable coating:
0 Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Farms - August 2009
1 .•
I.
Prescriptive Certificate of Compliance: Residential CF-7R-ALT
•
Residential Alterations �-- (Paut S as)
ProfrNiyy`�: 40 C ml ate'Lone it I A.-o -stories- - .
•
HERS VERIFICATION SUMMARY The cnforcemem agency shaufd par special Intwaion at the HERS Ivleaseu'e.r speci/iecl in this
checklist below. A completed and signed CF-4R Form for all the measurer specified shall be submitted in the building inspecmr before final
inspectiana.
Duct Sealing & Testing HERS verifl canon is required Jar MIs measure.
❑ YES 17 NO 1'ES.In Climate Zones 2 and 9-I 6,if more than 40 linear feel of new or replacement ducts are installed in unconditioned
space,the ducts are to be sealed per§152(b)!Dii and the newly installed ducts are to he insulated pal §151(f)10.
O EXCEPTION:Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑YES ❑ NO YES:In Climate Zones 2 and 9-16, if-the existing space-conditioning system(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(b)lDi.
YES ❑NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handler,
outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be
sealed per§152(b)IE.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
" d EXCEPTION: Duct systems with less than 40-linear feet in unconditioned space.
❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos,
Refrigerant Charge- Split System HERS verification is required for this measure.
❑YES 0 NO YES:In Climate Zones 2 and 5-15,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil, or the furnace heat
exchanger)a refrigerant charge measurement shall be verified per§152(b)IF.
Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw
The ventilation requirements of§150f o)do not apply to existing residential homes.
Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
- ❑ YES ❑ NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(1-IVAC equipment and ducting)is
replaced, the airflow and fan watt draw shall be verified mer§152(b)l Ci to meet the renuirements of§151(fl7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Nana: Signature: •
a oil
I/
.any: / Date:
Cb3e- Ts�
it 2nct itA jilt 7 2/—/r
Address: If Applicable❑CEA or ❑CEPE
faro jIGH i�4- •t/- .,3t cj _(Ccrtihcation 11):
City/State/Zip:
1L �i (` l�- 976' eye/4
'Responsible Building Designer's Declaration Statement
• 1 am eligible.under Division 3 of the California Business and Professions Code to accept responsibility for the building design identifled-oii
this Certificate of Compliance.
• 1 certify that the energy tenants and performance specification:.for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this;Certificate of Compliance arc consiMen!with the infinnation provided w duuunnn this
building design on the other applicable compliance lonnc,worksheets,calculations,plans and specifications submitted to the eniureenrenl
agency for approval with this building permit application.
Name: Signature:
Company: Date:
Address: License:
Onv'State/Zip: I I'Ii one':
Tor ussismnce or gaestion,c regarding the Energy Standards, contact the Energy]-Janine at:3-80 0-772-33(JO.
'•— -•-- - +•' L^ ItCt(isirmnlll Dale/Time: IlEftS Provider:finer:
. 12309 F EES RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 17 MO
P. O. BOX 917 COSTA MESA. CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely APPLICATIONvfOROGERIP MESA
TYPE OR PRINT Lot # 74
BUILDING ad� hex P1an.4C BUILDING
ADDRESS -83 -.._---' -r
COSTA MESA. CALIFORNIA For Office Use Only
I�/(g o,
OWNER Mesa Del Mar Development Co. I RECEIPT NO. lino,
MAIL Suite 1, 3800 -E. Coast Highway RECEIVED BY DATE RECEIVED I ISSUED
ADDRESS /! �/ G -./41-6 O -- E7r h n
CITY Corona del Mar •
TEL Or 34220 BUILDING -
ADDRESS 832 Cortez Street
CT
ORCHITENGE EER Raymond Levans TEI-No. Or 37010 COSTA MESA. CALIFORNIA
ADDRESS 3432 Via Oporto, Newport Beact ZONE
FIRE '// Yk
TYPE K GROUP
CONTRACTOR Macco Corporat ion APPROVED
BY _ DATE
ADDRESS 3800 E. Coast Highway ZONING .
y�
ZONE NO.OF USE OF NEW
CITY Corona del Mar �' I PLANS BUILDING
LEGAL
LIC.NO. 99808 TEL.STATEOr 3-4220 DESCRIPTIONLGt •4 Tract 3749
SIZE 93 NO. OF BLOCS.
70 x
OF LOTNOW ON LOT A.P.NO.
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROMpp (CENTER LINE ST.) J�
CENTER OF STREET 50 REAR YARD 35 FRONT (/ FT. IN.
SIDE YARD I LEFT 5 I RIGHT 5 R.SIDE eC FT. IN.
DESCRIPTION OF WORK L.SIDE /0 7` FT. IN.
NEW I X II ALTERATION I II ADDITION I REAR $5.;;7,7 S /-J / / IN. A.
VMOVING I V DEMOLISH I APPROVED /�/� DATE {�//(//�
REPAIRI /// ,l
SBZEOING60 x 37 jROOMS NO. OF 7 STORIES 1
ROOF
COVERING WALLEXTERIOR _�����77StuCCVI COVERING Wood Shingles /4 /I b
USE OF BUfDFM-' WO IRK TO BE PERFORMED
Construct Single Family Rettdence
with attached garage
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
ANO STATE THAT THE ABOV IS CORRECT AND AG E TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDIN NCE AND ST E LAW REGULATING
BUILDING CONSTRUCTION. w VALUATION
SIGNAITU E OF A PERMIT FEE $34.00
PERM $ 14,563.00 PLAN CHECK $17.00
Project Manger
AUTHORIZED AGENT TOTAL FEE : 51.00 0
LL