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HomeMy WebLinkAbout215 19TH ST - Building Permits *DURESS OFB BUILDING: 215 E 19TH ST Ian 1 /2 CITY OF COSTA MESA — BUILDING PERMIT owOERSKAMEDnamtCAMPBELL PETER C PERM NO: E 081552 As0REm215 E 19TH ST COSTA MESA,CA 92627 PERMIT NO: E 081552 PLAN CHECK NO: N GOVT: N SUPP : N APpL.MADaic ADDREss: •ii CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH ARCHITECT OR 131�lEER: ' sec c. JOB DESCRIPTION : ELECT METER SQ FT: ACK OR OP.'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ctemucfORS wait: CORR/STOnMmaD COMMENTS: X AOORF59: MHO.: ififiEiEiE1EifiE*iE1E*iE1E1EiE*iEifiEiEiE1E*kiEiEiEiE#iEiE*iEifilk1E**iEif1EiE1EiE*ifiEiEif*#iEifiE1E1E1EN-#1E*iEif1EiEif*if1E#iEiE1Eif*iE1Eif UMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Slim under penalty of perjury that I am licensed under pro.dona of Chapter 9 SETBACKS• (=amercing with Section 7000)d Division 3 d the Business end Professions Code.and my License is in lull force and effect CITYUC.NO.: LIC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Deter' Coraradoc LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I ser exempt from the Contractors License Law for the Icemen:[reason(Section 70315 Buse=and Pmleaaipro Code:Any W or omaay=WI=tares a Perms to construct'alter,"enmwa. PARKING REQ: PROV: PARCEL : 42540419 ZNE: REF NO: I vaofeh,or repel any structure,prior to III issuance.aso requires the applicant for such penult to file a signed statement that he or she licensed pureed to the provisions of the Contract=License Law[Chapter 9(commencing with Sedcn 7000)of Division 3 of the P L ANN I NG NOT ES> .=nese and Professions Code[or That he or she is exempt Therefrom end the basis for Ihe alleged exemption.Any violation d Section > 7031.5 byanyePPlicaritar a Pemmwtleds the WPlicd to a civil penalty dnot more than five hundred dollars(S5001). if♦EififiE4iE1E1E1E9f1E1EiElEififiEN-##iEiE1E1EiEififiElEifiE if#iEilk1E##iEiEiEiEiEkifiEiE1E#itiEiElEilklElEifiElEdfiEiElEitifiElEiElEiEiflEkiEififif♦E ❑ I.=owner al lin Prolog=of mY emPlaYees Inth sieges es thes sole compensation,will do the work,and the amount is nal interded DEVELOPMENT S ,E, R V ICES R E Q U I R E M E - N T S or offered kr ado(Section 7044.Business sed Professions Code:The Contractors License Law does not apply to en Owner of properly who buds or inpmses thereon.and who does suds work himself or hard or through his or her own seok1'ees,ptoMed that such Impovemdsme rd iraerded ordlned for wait d,how«n,the WSW"or inpravem.m:add within ar.Yew S oompldion me ZONING APPROVED BY - DATE: ownr.Wdder wig have the burden of proving he or she did not build or improve for Ife purpose dub). I,es owner al the property.an'exclusively contract in,With(wised`onbeda"tocoranid the project(Section 7044,Business and BUILDING APPROVED BY : DATE: _ Professions Code:The Contract=License Law does nor apply ban owner of properly who builds or improves thereon and who - ^ /I contracts for suit proptls with a contractor(s)foamed pursuant 10 the Contreras lirenee Law). `, /1 (� /. lam .. plunder Sedum: B.SP,C., / ``1 1 ' APPLICATION ISSUED BY: _ AAS DATE: vM11 #`TEST Dela: Owner: k 'CL/ C�-a-V-�`r kis° 7FiEiF1F1FIR1E1EfFiflflElElEikiflFifif*** .•r IE ff ilk fE lE if fb iE lE 3E*?17113:) k IF iE 1F 1E if IE doEGALIZATION: N F E E, S U M M A R Y STRUCTURAL SEGMENT: N j .. certify dm I em aware of and urdwnaed the requirements of CaliforniaCalimaa Reedit and Sally Code Sections 25505.25533.and aoand ha I or any future buikTvp=up=wig/will not(mule one)need to comply with said dale codes and the requirements for amelonamsmedonormodd�timbamtheAiraaaktyMim.pldDidrid.ResidwlalodwmdonapPdratimsdexmwtmmU.se BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ate. PERMIT 16 . 25 Date: Applicant: 50% SMIP/NON—RES PLAN WORKERS COMPENSATION DECLARATION:I hereby diem under penalty of perjury one of the following declarations: ISSUE FEE 22 . 00 ❑ Ihaveendwa maintain a certificate of concis to*StimXe kit wnkeri cpnperaetones provided for bySadion 3700 of Labor V the LBUILDING—DI —> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the peelomianceance c4 the work for*tech thismdb® permit TOTALS----> 16 . 25 22 . 00 0 . 00 38 . 25 38 . 25 . 00 ❑ Mays and oramabaao workers'compensation intorno,.as required bySwim3700 cid.labor Code,kr the performance of the work for which this permit is issued.My workers'compensation insurance carder cid policy number are: Carrie REVENUE DIVISION TOTALS--> COLLECTED : 38 . 25 OVER/SHORT: . 00 ri' PoNumber: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK This section need not be completed l the penal is for pro hundred dollars(51001 or lass.) 38 . 25 ❑ I ow=that in the performance of the work for which the permit is issued,I shall ml employ any person in any manor so as to become subject to thewM1ri compensation taws oCafdornia.and agreeha at should betmesubled to the workers' **je**********3f******3EIt************%****3E************1E*1E*3Llf*******1E*1E*)EIE****4E*if if compensation provisions d Section 3700 of the Labor Code,I wit forthwith compy with those provisions. INDIVIDUAL F E E BREAKDOWN Data: Applicant: Warning:Failure to=cure aotkare'conpersation eov«age Is rmbaMand shall subject an employe ro criminal petddes cid TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil floss nup to one hundred thousand dollars($704000).hr addlllon to the cost of compensation damsons as provided for In bb, Saan 3705 of the Labor CoInterest and attorney's lees. `�7f ELE 1 SUB—PANEL .7-77" �� 16 . 25 CONSTRUCTION LENDING AGENCY: 1 hereby affirm under penally of perky that en =dire a construction agency kr the END OF FEES ;,. ' r r 1�' penorce d the work for which this perm a issued(Section 3097.Civ.C). A` LENDER'S NAME '(/�I ma LENDER'S ADDRESS: - •� FE; r, 1 I candy the I her read this appflc tan and mete that the above kdanlatitn is conal.I agree l0 oomph'with an cry and cart/ordouus and state laws relating to building construction end hereby authorize repruenlatives of this city to abler upon the ebwtrmdioned property ei'Fly 0. Irl in.Patcn Pxes Poe . ( �� PETER CAMPBELL .L Pd Name �, i/� 7-817 r �� 4 L Date: Signature d•SAped/AulcemT,mtrwa (5157 Ia.WP) W1d. 1.a Salty:Green-Rb:Caney-AWiwa:Rik-Revenue;Goldenrod-Assessor Pir711117/ POO SPA /CpNSTRUCTION AND PLANNING Date Inspector / APPROVALS Permit# Date Inspector APPROVALS Permit # p 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms w 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-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 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 OGas OOil 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) & Monbcoat 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. Piaster Brown Coat - - 79. FINAL INSPECTION 32. Electrical Power Meter-Final __ /// / 80. FOOD CERTIFICATE ISSUED 33. Final Electric CV�f}�/ '-- 7�- -{�lVotes: 34. Final Heating& Air Conditioning • 35. Final Gas Pipe-Test 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 48. FINAL PLANNING 49. Electric Release to Edison 50.Sias Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF WILDING 215 E 19TH ST DMT: CITY QFCOSTA MESA - BUILDING PERMIT mcwsw"mmNCAMPBELL, PETER C PERM NO: E 081551 ADDRm 21 5 E 19TH ST COSTA MESASCA 92627 PERMIT NO: E 081551 PLAN CHECK NO: N GOVT: N SUPP : N APPL.SWUNO ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: OTH h ♦ e. ARCHITECT ON DEMMER: UC NO.: JOB DESCRIPTION : ELECT METER SQ FT: ARCH.OR EN3.'S ADDRESS: WIT: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 / CONTRACTORS NAME CONTRACTORS MMUNO COMMENTS . X . ADDRESS: MHO.: *3E***3E3E*3E3E*3E*3E3E3E3E3E3E3E3E**3E*3E3F3E1f4*3E33334333Elk33E33E1k1E33 fE*3E3E33E#3EIE3E**1E3lf#1EN-1E iE*3E*41f 3Elf3E3E3E WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Nim under purely of perjury that I am lies-ad under provisions of Chapter S SETBACKS (commencing with Section 7000)of Divisor 3 d the Blaine*,and Proles:e s Code.and my license is in full farce end effect. CITYUC.NO.: UC.CLASS: IJC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: Contractor. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the fallowing reason(Sedlan 7031.5 Business and Professions Code:Any city county which raeuiree a permit to ansman.aper,improve. PARKING REQ: PROV: PARCEL : 42540419 ZNE: REF NO: lemdsh,or repel any structure,prior to its issuance,eso requires the applicant for such wane to file a signed etatemem that he or she licenced pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Dirison 3 d the PLANNING NOTES> .usirou and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Sedion > 703t.5 by any epphcent fore permit subjects the apPlicant toe civil penalty d not more then fee hundred dollars($500[). I,as agmen d the property or my employees with ********************************.i(-iE 3E 3E 3E 3E 3E 3E**3E 3E 3E 3E 3E 3E 3E 3E 3E 3E 3E 3E iE 3E 3E 3E 3E 3E 3E 3E*3E 3E 3E 3E 3E**3E 3E 3E 3E 3E 3E iE*3f ❑ wages as side compensation, the work.and the structure is intended DEVELOPMENT ' S E' R V I C E S REQUIREMENTS or offered for sale(Section 7044,Business and Professions Cade:The Conflation License Law does rappy to an Owner of property builds or improves thereon,and who does such work Nmasff or herself a through he or her own employees.provided that such improvements are not intended or offered for sale,I,however,the buildingor improvement is sold within one year d completion,tat ZONING APPROVED BY `- ` DATE: owner-bailer will have the burden d proving he or she did not bull or improve for the pewee d sale). YO I,a ower of the property.an.exclusively corarecing with kanseed contractors to ansaud the project(Section 7044.Business and Professions Code:The Contractors License Law does na appy b properly owr propy who builds improves proves thereon end who BUILDING APPROVED BY : ,04'< DATE: cantrem for such prapds with a contractor(s)Steeled pursuant to the Common Loran Law). A" ' ' ❑ tema. .. SaGtire: R.AP.C., APPLICATION ISSUED BY: DATE: l \` + 0. C 1 _ _ Li \J 3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E'3F********.„*..3 *** 3E 3F if #3E****###3f3 *3E3E3E3F3E3E3E3E 3E3E Date: Ower. V G—lti /J✓J"��`��� LEGALIZATION:NpplySUMMARY STRUCTURAL SEGMENT:N 1•Orly that I am aware d and understand the requirements e)California Health end Safety Cale Sections 25505,pawn,and 2y. requirementsdthatl«anyMurebuildingoccupantwill/willno(ciamme)needtocomplywillsadpetecodesandtheeee BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING permit for construction or modification from the Airuary enagement District.Residemiel construction applications are exempt from these PERMIT 16 . 25 . Dov: Applicant: WORKER'S SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under peavey of pr)«y one of the following dedsrdoe: PLAN ❑ Ihave and wiimaiMenetong-tan dconsent loselfin n,ubrworkosrep«am « ien,asprovdedforti bySeon3700oftheLabor ISSUE FEE 22 , 00 Code.i«thepen«rmanceoftheworkforwhichthiepemmisissued. BUILDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ lhave and wilmaiMenwalwe'compensation insurance.esrequired bySrsion370g5NMo eLaborCodeforthepmenceofthe TOTALS > 16 . 25 22 . 00 0 . 00 38 . 25 38 . 25 . 00 work for which this permit is issued.My workers'compensation insurance carrier and policy number we: Cartier REVENUE DIVISION TOTALS--> COLLECTED : 38 . 25 OVER/SHORT: . 00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (fhb section need nal be completed I the pone is for one hundred dollars($IDS/or loss.) 38 . 25 ❑ 1 aney that in the performance of the work for which thio permit is ieaued.I shell not employ any person in any manner so as to became subject to the workers'aompeneation laws of California. and agree that f I Mam Mould become eubied to the wdss' 3E***W***********************************#********3E***3E3E3E3E3E*1E*3E*3E*3E*3E*3E*3E*3E*3E*** compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. INDIVIDUAL F E E BREAKDOWN Date: Applicant: Warning:Failure to secure waiters*compensation coverage Is unlawful,and shsf.zsset an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST dvIl tines up to one hinds d thousand dollars(SI04000A in addax,to the cost of conpensatbn,damages as provided ler In Sadat 3705 of the Labor Code,Interest,and ananstlea sea ELE 1 SUB-PANEL 16 . 25 16 . 25 CONSTRUCTION LENDING AGENCY: I hereby affirm under petty of perjury that there is a construction lending agency f«the END OF FEES g 47 7 ;; 't t-..,, performance d the work for which the parrots issued(Sedan 3097,Ch.C), r l:. • LENDERS NAME: . 1 'yt� i Lwtt .� it LENDER'S ADDRESS: i f' _ i`iti I tenify that I have read Nis applic ton and date that the above intonation a caned.I w t� /Pr�and stale laws reking to buiidig consuudion and herebyswat tt eanpupon hecirysd oouionedinsneay �' • C, authorize representatives of city to enter uponlhe°bow-menlbned property 7997 for inspection purposes. PETER CAMPBELL�/l i)Rif ono oI` Q _ Dale: 7— C 7 .C� 01- C CO yA Mfc�y. S'•natuoe/Ovnar ...VA•• recto (5151 4a.WP) WINe-Buiiding&Safety;Green-Ede;Canary-Applcan:Pink-Revenue;Golderaod-Assessor CONSTRUCTION AND PLANNING .1 POO SPA Date Inspector APPROVALS Permit# I Oate Inspector ' }APPROVALS Permit # 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electri1al Conduit Utility-Undrgrnd. 54', Forms . 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding I 5. Steel FFzinforcement56. 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 & 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' r - - - - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test - ' - 72. Underground Flush ' 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing74. 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 i 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - . . -t. 79. FINAL INSPECTION 32. Electrical Power Meter-Final ��,�S�'/Q�2 �- r, 80. FOOD CERTIFICATE ISSUED 33. Final Electric - f - • " Notes: • - 34. Final Heating& Air Conditioning t - - 35. Final Gas Pipe-Test - 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 ' Y •- 45. Sound Attenuation . . - , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING . _ 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co - .. - 51. CERTIFICATE OF OCCUPANCY No Date ammenr NTY OF ORANGE • {UILDING DEPT. ' - s _ 636 No. Broadway Permit No \ Santa-Ana, California Application for Building Permit 5 o�� ' Phone: KI 2-6211 AND FOR A _ Certificate of Use and Occupancy if r 1^ 7 • ///�/ ///�) ////� Date " ' K l 9sv 1. OWNER'S NAME__i�i1A.!1edre✓4_-1 /l ' ( „ PHONE: MAILING ADDRESS/7J 6 .._'.!A i.)'''(.JAl; CITY.CErt, aht b Name . _ C __ u`l..-s Name • (Architect or Engineer) ( ontracto Ler „C �V Address - Address City City• State State "' Lic. No. Phone / Lic. No. - . Phone PROPOSED USE: ar"'•'�l � v (� 'zt 9y") 2. JOB LOCATION_ I � t.,� . i -r `a- Z2i4-eltlet (Ci/ + 71 Y` •'2 �/ (House No.) (Name of Street) ^� (Town or 7 School District) 1 v' LEGAL DESCRIPTION: Lot I Block �„fJ Tract 61 (-1-- (Metes and Bounds Description—Use reserse side of form) 4. CORNER LOT ( ) INTERIOR LOT ( X) THROUGH LOT ( ) SLOPE OF LOT ( ) / oo�� � // n O 5. SIZE OF BLDG.: d:af---X_/444 AREA• 3 / / SIZE OF LOT:._I--57-X_SO_AREA: 7 Co O 6. HEIGHT OF BLDG 'Y / CEILING HEIGHT: __5.__�j NO. OF STORIES Ii 1 0h------,/------Size of Kitchen: __,�_Qi 6'__ 7. NO. FAMILIES .._.__� Size of Smallest Bedroom: _ a /,�h�� " ' 8. EXTERIOR WALL' CONSTRUCTION:_ f dL1./�l INTERIOR WALL COVERING P•'�t4iiebe1_A<ieeet/) (Frame, Stucco, Etc.) (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard from Center Line of Street :)' "2Ct___1_56 / Nearest Side Yard._.1_Q_;!,/� Rear Yard Distance in Feet Between Bldgs. on Same Lot....../.(.__ ,. __________ I/ ./. 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. If/ // 11. For a) Footing: Width 14 , Depth in Ground / d� Width of Wall . 1? Accessory V �/ / Bldgs. and b/Size of Studs: .______ Similar ) a.:X -4 Spacing /._� "CC Material of Floor.. . __.(�_„1-- Structures: �yn / G(c) Size of Floor Joists: /dee_C Vs� "CC q e('d)i Size of Rafters: dL /)(._ Spacing _ i `-t( "CC 12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical .wiring, heating, fire sprinklers, paint- ing and sewage disposal $.__/_D-'� ie • 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed:_.. _ a. a /V. /174-4/V7.1-r (Owner} Plans Filed- By. (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: T CH(EpCKING BY Bldg. Permit - $. GROUP__._fro 1 _..___...... APPLICATION `2'G 1 9' HEALTH Plan Check - $ TYPE ata. L0 No. ZONING FIRE Total $ DIST. co _ (/ MARSHAL---------------------- Receipt - �� / PLANS AND _ MAP SPEC'S STATE Paid to - - 23224.._._ SHEET NO M�� CORREi� j ENGINEER Date ��_ _ VERIFI:Ti ' '� CAL 10 i l�/ � 74.677,x .-� PERM SSUE BY: ertay✓ DATE 140-27 - Rea....... ./ Gam(/ / s yire