HomeMy WebLinkAbout368 19TH ST - Building Permits,.
CITY OF COSTA MESA
� � ~F'r9 BUILDING DIVISION
F�� 77 FAIR DRIVE. COSTA MESA. CA 92626 • �714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
���� FOR INSPECTIONS CALL: (774) 754-5626 �
PERMIT NUMBER: E09-00180
PERMIT TYpE ELEC
APN: 42630119
STATUS: , ISSUED
DATE ISSUED: 0710112009
ISSUED BY: RMD
JOB ADDRESS: 368 E 19TH ST CM Suite/Unit:
Vicinity: , , .
- ' . i
SCOPE OF WORK: ELECTRICAL PERMIT TO UPGRADE SERVICE PANEL TO 100 A, SAME LOCATION AND ADD 5 CIRCUITS TO KITCHEN
AREA.
OWNER: IVANS, JANET A TR
PHONE: g49-722-7736
APPLICANT: SULLIVAN, BETH
PHONE: 949-933-2749
CONTRACTOR: 1 SUPERIOR ELECTRIC WC � -.
Address: 1048 IRVINE AVUnit: UNIT 408
City/Siate: NEWPORT BEACH, CA ZipCode: 92660
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $59.50
Reinspection Fee $0.00
TOTAL FEES $59.50
Address: 616 ST JAMES RD Unit:
City/StatelZip: NEWPORT BEACH, CA
Address: t0481RVINEAV Unit:UNIT408
City/State/zZip: NEWPORT BEACH, CA
License No. 883400 •
� PHONE: 949-933-2749
� ' CELL:
NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statutes and related
regulaGons. (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 wtles, and all
required inspactions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
cODE t. InsvecnoxrrvE onh i�3 S2oS.! LsvEcnoHrne np�* iHnn��
1816 Fixed System Final Fire Prevention 206 Final Merhaniral
1266 Pool Sp3 Final 208 Final Plumbing ��
200 Final Ra.Root 210 Final Electnwl
201 Final Blo�k/Retaining Wall 212 Final Fire Prevention
202 Final FaCtory Fire Place 220 Final Planning Approval
203 Final Sign 222 Fin215ite
204 . Final Derrqlition 250 Final Building/OcCupanry
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalry of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure br workers'
compensation, as providetl (or by section 3700 of the Labor Cotle, for the
peAormance of the work for which Ihis permit is issued.
❑ I have and will maintain wnrkers' compensation insu2nce, as required 6y
section 3700 0( the Labor Code, fw the peAamance of the v.ark (or which Ihis
permit is issuetl. My workers' wmpensation Insurance cartier antl policy
number are: /�
�arrie� STA�T� SAIs (GM1tI f'llU..�
(This sea�bn neetl �rot Oe oompefed ame perrrW k.a uGetl a� are nuMreOCdWrs (f �00) akss.)
Polic`y✓umbBr: � 8�j �� 08 � � I
❑ I certify thal in the peAormance o( Ihe work for which Ihis permit is
issued, I shall not employ any person in any manner so as to Decome subjec[
to the workers' compensation laws of Califomia, and agree ihat if I should
become subject ro the workers' compensation pmvisions ol Seclion 3700 of
Ihe Labor Cod 1 shall forthwilh comply with these provisions.
07 -oe-�9
Ap�IIWn1's �gn e Dale.,�`..
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERP,GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL
P[NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF TNE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 ot the Business and Professions Code, antl
my license is in full lorce and ef(ect. /�
LiC:11..� DD �FJ ss�#a (�'�/ �
D 7-o'r -0 5
� n12eW5 ignaNre - ��,r — -
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a consWctbn lentling agency for the
peAormance of the wurk fa wfiich this pertnit is issued (Sec. 3097. Civil Code).
Lender's Name:
Lender'S Address:
SignaWre
OWNER-BUILDER DECLARATIONS:
I hereby affrm Ihat under penalty of perjury that I am EXEMPT PROM THE
CONTR4CTOR5 LICENSE LAW for lhe (ollowing reason (Sec. 7031.5,
Business antl Professions Code: My city or county which requires a permit to
consiruct, alter, improve. demolish, or repair any sWcture. prior lo its
issuance, also requires the appliwnt for such permit to file a signetl statement
that he or s�e is licensetl pursuant to the provisions ot the Contrectors
License Law (Chapter 9(commencing wit� Section 7000) of Division 3 ot the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the allegetl exemption. Any violation of Section 7037.5 by any
applicant lor a permit subjects the applicant to a civil penalty of nol more than
five hundred tlollars ($500).):
❑ I, as owner ol the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the sWCNre is not intendetl or
oBered for sale (Sec. 7044. Business anG Professions Code: The Contractors
License Law tloes not apply to an ovmer ol property who builtls or improves
thereon, and who Ooes such work himsell or herself or through his or her own
employees, provided that such improvements are not intended or oRered lor
sale. If, however, the building or improvement is soltl wilhin one year of
completion, the owneo-builtler will have the burden o! proving that he or she
did not build or improve for purpose of sale.).
❑ I, as ovmer ol the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct lhe project (Sec. 7044, Business an0
Professbns Cotle: The contractors License Law tices not appy to an owner o/
pmperty wfio builds or impmves thereon, and who contracls for such project with
a contracta(s) license pursuant b the Cont2ctors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
305]A6 (3/0])
Owner ID verifed by driver s license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification ot Ownership by (lype of document, i.e. - property lax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify thal no exwvation frve (5) a more (eet in depth into which a
person is required to descend, will be made in connecibn with xork autlorized
by Ihis permit, antl that no builtling structure, scaffdding, false�wrk, a tlemolition
or dismanlling thereof, will be more than thirty-s& (36) feet high. (Chap. 32. Grp
2, M 2, Sec. 341. Title 8, Cali(omia Atlministrative Code).
❑ As owner-builder, I vnll not employ anyone to do work which would
require a permit from the Division ot Intlustrial Safery, as notetl above, unless
such person has a permit lo ao such work from lhe division.
Appifanl's SignaWre Date
Division ol Industrial Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or Wture building occuDant need to filo antl
certily a �usiness Plan for emergency re5pon5e lo release or Ihrealened
release of a hazardous material7 � Ves ❑ No
(Section 25505 of the California Health and Safety CoCe requires, with some
eaceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one lime tluring a reported
year a quanlity of hazardous malerials equal to or grealer Ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at slantlard IempereWre and pressure).
2. Does or will the applicaN or present or future builtling occupant need lo Ne
a registration form for acutely hazardous materials7 0 Yes ❑ No
(Section 25533 of the Cali(omia Health and Safety Code, with some
exceptions, requires registration wiN Ne Costa Mesa Fire Department by -
each business which-at any one time has on hand a quantiry o( awtely
hazartlous materials equal to or greater than a weight ot 500 pounds, or a
volume of 55 gallons, or 200 cubic (eet ot compressed gas at stantlartl
temperature and pressure).
3. �oes or will Ihe applicant or present or (uWre building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Satety Cotle provitles that the
Costa Mesa Fire Department may require the preparation, certifiwtion and
filing vrith lhe Fire Deparlment of an RMPP by businesses which are require0
to register awtely hazartlous matenals with the Fire Department.
4. If an RMPP is presently requiretl, has Seclion 25534 of the California
Health antl Safety Code been lully complied wit�? ❑ Yes ❑ No
5. Does or will ihe applicant or pre5ent or future building occupant require !or
the work which is the subjecl o( this applicalion a permit for such wnstruclion
or modification from the SoWh Coast Air Qualily Management District orlrom
any other air pollution conlrol dislrict or agency? ❑ Ves ❑ No
(Seclion 658502 of the Califomia Govemment Code requires that the requesle0
information be fumisheC on applications fa non-residential building permits).
6. Will any part of the facilily to be constructetl under this pertnil be wilhin
1000 leet from Ihe outer boundaries of a school? ❑ Ves ❑ No
(If'j�es", Ihe facilily musl meel lhe reQuirement of Sactions 2553a antl 42303
o( the Califomia Health and Salety Code).
7. If a permit from ihe South Coasl Air Quality Management District or other
air polWlion contml disirict or agency is required for the work v+hich is ihe
subject of Ihis application, have all of the tlisclosures prescribetl by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'j�es", attach certifiwte of compliance from the appropriate air pollution
control officer�.
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury Ihe
information given above is correcc I agree lo comply with all slate laws and
city ordinances regarding Hazaraous Materials and Emissions.
CERT�FICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury thal I have read this appliwlion and stale that
the informalion given is correcl. I agree to comply with all state laws and ciry
ordinances relating ro building construction, antl authonze representatives of
the City o( Costa Mesa to enter upon the above-described property (or
inspection purposes. I agree not to occupy or allow occupancy ot any building
authorized 6y Ihis permit until final inspection.
Si aWreoile Own sl ) �aie
� -OZ"p..p5
AMlor.Aull rizeEApP��nl '—��� Dale
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mes��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
,lob nddress: 368 E 19TH ST
Suite;
Vicinity: HOUSE AND GARAGE
Primary Occ: R3
Parcel Number: 4263�119
Applicant: GERALD MARTIN
Address: 3103 GINGER AVE
UNIT A
COSTA MESA, CA
Owner: IVANS, JANET A TR
Address 676 ST JAMES RD
NEWPORT BEACH, CA
Coniractor: MARTEC ROOFING CO
Address: 3103 GINGER AVE
UNIT A
COSTA MESA, CA�
Zip: 92626 � � �
Aroh :
Address:
Zip:
Phone:
License:
Type of Construction: V-N
Zoning:
Phone: 714-444-1002
Zip: 92626
Phone:
Zip: 92663-5855
Phone: 714-444-1002
License: 752008
Eng:
Address:
Status: ISSUED
Applied: 03/29/2006
Issued: 03l29I2006
ISSUED BY:`
Phone:
License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF MATERIALS AND INSTALL 1 LAYER OF 30# FELT AND REROOF WITH 30 YEAR COMP SHINGLES ON 1,650SF
HOUSE AND S50SF DETACHED GARAGE. REROOF OF HOUSE AND GARAGE SHALL BE DONE CONCURRENTLY. REPAIR AND REPLACE
SHEATHING AS NEEDED.
FEE SUMMARY
Plan Check: $0.00
Permit: $111.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: 5111.75
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0 �
PARKING Existin : 0
Rear 0. 0
Rear 0• 0
Calc Valuation: ga,ass.00
Claim Valuation: ga,ass.00
Lek 0- 0 Right 0- 0
Left 0-0 Right - 0-0
Reauired: 0 Pr000sed: 0
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: This permit shall automatically expire and become voitl if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetions and Iinel approval must he obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS GALL: (714) 7545626
�
WORKERS'COMPENSArON DECLARATON:
I hereDy eKrtn under penalry oi perjury ona of the following deGarations:
❑ I have and will maiNain a ceniticate oi consent to sel4lnsure �or workers' compensa� n, as prWided for Dy section 3700 of ihe Lebor Code, tor the pertormence ol Ihe
work lor w�ich this De�mit i5 issuetl.
❑ I have and
ansation insurance, es requiretl Dy section 3700 ot ihe Labor Code, tar Ihe peAormance ot Ihe work lor which ihis pertnit is Issued.
carrier end oolicv numher pre: „
PWIcy.Nur mber.�-j-,�O�L't�j2 ^ZOO �o
oNessJ
❑ 1 certity Ihat in the peAormflnce ot the wo k for which this pertnit is Issued, I s�all not employ eny person in any manner so es to become subject to the workers
compensation laws ot Cellfom' en ae that if I s 6ultl become subject to the workers' compensation provisions of Saction 3700 of Ihe Labor Code, I sha0 torthwlih
comply with these prOhsion .
Applicant�Sipn� � � Dale: -� 3/2�1/�'6
WARNINOrFAILUFE TO SECURE WORKERS' COMPENSATIqJ COVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPIOVER TO CRIMINAL PE TIES M10 CNIL FlNES UP TOONE HUN�RED
THOUSPND DOLLAflE (St00.OW1. �N ADDfTIIXJ TO THE WST OF COMPENSATION, DAMAGES AS PROVIOED FOfi IN SECTION 3IO60F THE LABOR CODE, IMEHEST, AND AiTORNEVS FEES.
LICENSED CONTRACTOqS DECLARATION:
I hereby aHirm that I am IicBnsed untler provisions of Chap�er 9(commencing with Section 7000) of Divlsion 3 of ihe Business a Pmfessions Coda, antl my license is in full
lorce end.ettecLLic..#. 7fZ o0 3� � �Gless'a� �-3�J
Contreaors Signature: --� �r L�f� � Date—'�� '��'Z9' u 6. _
CONSTRUCTON LENDING AGENCY: I
❑ 1 hereby aflirtn ihat fhe�e is a wnsiruction lending agency for ihe peAortnance ot the work tor w�ich this pertnit is issued. (Sec. 3097, Civil Cotle).
Lentler's Nama: Lendels Atltlress:
SigneWre: _ Date:
OWNER-BUILDER OECLMATIONS:
I hereby affirm thet under panelty ot per�ury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for iha following reason (Sec. 7031.5, Business end Professlons
Code: Any ciry or counry wnich reduires a permit to wnstruct, eltet, improve, demolish, or repair any sWcture, prior to its issuance, also requires the applicant tor such pertnit
ta tile a signetl statemem that he or she Is Ilcensed pursuant to the provisions of the Comractors License Law (Chapter 9(commencinq with Sectlon 7000) of Division 3 0l Ihe
Business entl Protessions Code) or that he or she is exempt therefrom end the basis for the alleged exemption. Any violation of Section 7031.5 by any epplicant for a permit
subjects the applicant to a c���l penelty ol nm mora than five hundred dollars ($500�.):
❑ I, as ownar ot the property, or my employees with wages es Iheir sole compenution, WILL DO THE WORK, and the struc�ure Is not inten0etl or otteretl for sale (Sec.
7044, Business and P�olessions Code: 7Te Coniractors License Law tices not apply to en owner of properry who builtls or improves thereon, and who tloes such work
himself or herself or tl+rough his or her own employees, provided ihat such improvements are not intended or oHered for sale. If, however, ihe builtling or improvement is
sold within one year o� completion, the owner-builtler will heve the 6urtlen ol pwving that he or she did not build or improve for purpwe oi sale.).
❑ I, as awner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professions
Cotle: The comractors License Law does not apply to an owner ol propany who builds or Improves Ihereon, and who conirac�s tor such prolect with a con�ractor(s)
licensa pursuant to tho Contrectors Licanse Lews.).
❑ I em e:empt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID veri�ied by dnver6 �icense. ❑ Ves ❑ No Driver's License No.
Verificetion ot Ownership by (rype ol daument, i.e. - property tax bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certily that no excavetion fiva (5) or more feet in tlep�h into which a person is required to descentl, will be made in connection wit� work authorizetl by ihis
permit, antl that no builtling strucWra, scaflolding, falsewotk, or tlemolilion or dismantling ihereof, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, California Atlminisirative Code).
❑ As ownerbuildar, I will not employ enyone to do work which woultl require a permit Irom the Division ol Industnal Safery, es notetl ebove, unless such person hes e
permit �o do such worK from tha division.
Signeture: Date:
Division ot Indusirial Satety Permit Number:
CERTIFlCATE OF COMOLUWCE AND AIfTHORIZA710N OF ENTRY: I certify under penalry of perjury that I have read this applicalion and state �hat the information qiven is
correct. I egree to compl it ell stejp plyew�s entl ciry �nances retating to builtling consiruclion, end euthorize representatives of Ihe City of Costa Mesa to enter upon Ihe
above-descnbed prope f �s 6n po ee nof fo occupy or allow occupancy of eny building authonzed by Ihis p�rmit unyf tina�nspec�ion.
cs 3 24; b
�-� I tature Of Legal Owner(s) , Date
ApNOr Authonzed Appifcant � Date�-��
GOUE I, INSPECTIONTYPE
i676 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Fool
201 Finel Block/Reteining Well
202
203
Final Factory Fire Plece
Final Sign
204 Final Demolition
D�TE IMRIALS
L�71 / �n.
COOE 1 INSPECTION TYPE
206 Final Mec�anical
20B Finel Plumhing
210 Flnal EleciriWl
212 Finel Fire Preveniion
220 Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
Qsff. u�ei$
�
�
�
Pfl0.1ECTp00NESS: 368 E 19TH ST
OWNEN'SNAME: IVANS—WILLMS JANET A
aoosess: 3 6 8 E 19 TH S'f'
COSTP. MESA,CA 9Z627
AflCHIENGINEER:
FDUflE55:
NEC.NO.:
UNIT:
uxrt:
PEXMITTEE: FIHILLIP WILLMS (714)722-7736
nooaess: 3 6 8 E 1 9 TH S T
C.M. CA 926'l6
LILENSEO LONTBRLTOB oECIABRTION: I hereey allirm inat I am licensetl unaer pmvisions ol CnaO�er 9(commencing with Section
7p10) ol Division 3 0l I�e Business and Prolessions Coae, antl my license is in tull force an� e�fect.
ciTv uc.: sTnre uc.: cuss: EXP :
Oate: Signamre:
WOBKEflS' COMPENSATION DELLANA710N: I �ereUy affirm ihal I have a cenifitate of consent ta sell-insure or a cehificate of Warker5'
fqmoensation Insurance, ot a cendied copy tnereot (Section 380f1. Lao. C1.
POLICY NO.: E%P. OATE:
COMPANY:
� Cerliliea caOY is �ere0y tumrs�etl. ❑ CetlilieE topy i5 IileO wiih I�e City BUilGinp Divisian.
�ate: AOPlicanl: '
E%EMPTION iflOM WOBNEHS' fAMPEN5AT10N DECUNRTION: Q�iS 5 ion ne¢tl nol �e Comple�eG i� llle pefmi� is �or onE hunOfed ($100) or IeSt�.
I cenily Inat in I�e OeAormance ol ihe work lor which t�is permit' i ued, I shall not employ any De�son in any manner 5o as to become
Suhjetl lo Ihe Workers' ComOensa�ion LayvS al Calilomia.
i:— 2 Z—
Date: Signamre:
NOTICE: If, alter maMing this aec amtion, you S�Ou me SUGlect to t�e Worker5' fAmpenSation provi4ons of tAe La�Or
Cotl¢. you mus� �orihwth campty mU suc� pr0 � n Or INS Oermit Shall be deeme0 revoke0.
CONSTBUCTION LENOINC RGENCY: 1 hereby allirm I` there is a Constmciion Ientlinp agency lor I�e pedormance o� the work for
w�ich I�is permil is issued (Section 3097'Gv. C�. ,
LENOEfl:
aooness:
OWNEH BOILUEN oECLPHATION: I here6y affirm Ihat I am exempl imm ihe Coniractor5' State License Law for Ihe following reason
ISection 7031.5 Business ana Professional Coae: Any Gity of county whith requires a permit to consiNc6 alter, impmve, tlemolish, or
repair any slruclure. prior to its issuance. also requires ihe appficant lor suctl permit to lile a sipne0 statement ihat he/she is licensetl
pursuam to tne pmvisions ol the Contracmrs' State Llcense Law (Chapter 9(commencinA wit� Section 7000) oi Oivision 3 of the Business
, an0 Pmlessions Code� or that �e/she is evempt therelmm anU the hasis for Ihe allegeE eKemD�ion. Any violalion of Section 7031.5 Uy
any ap0lican� br a permi� sublect5 t�e ap0liwntia a cidl penaliy of nal more tlwn M1ve huntlre0 Oollars (5500�.
I. as owner ol ine pmpeny or my employees witn waAes as �neir sole compensation, wiil Oo ihe work, antl the
� stmcture is noi imeneee ar otiered far sale IStttion 70a4, Business anG Pmfeuional Cotle: T�e Contracrors' State Lirense law
Eoes nol appty to an owner of a O��DQ�Y w�o GuilOs or impmves t�ereon, anG w�o daes such wOrk himself/hers¢If or throu0h
�is ar her own emDloyees. pwviae0 t�at suc� �mpmvemenis are not intentleG or oflered for sale. If, however ihe Euilding or
impmvemeni is 5010 vn�hin one year oi com0�eti0n. IAe owner vnil �ave lhe burG¢n oi Drovinq he/SAe UiA no� builE or imOmve
for ine purpase ol salel.
I, as owner of t�e pmperty, am exclusively coniraclinp with licensed contractors lo cansimct tAe D�ale�� ISection 704C, Business
❑ an0 Pr01¢55ron5 CaOe: The Conirac�ors State License Law Eoes not apply to an owner ol pmperry who Uu'AG5 Onm0�we5 thereon
anA who conlratis br sut� prole��s vnlh a ConVatiof(5�lit¢n5e pursuan� lo l�e onlrati0r5' $Iaie LitenSe Law�.l am awdr¢
Ihal Omoi o� Iheir Worker's Compensalion insuranCe Shoultl be pmvi4eA �o me.
� I am edempl unaer Setlion: B. 6 P. C.
lor this reason: � 6
Date: / l— �� � �y Owner: �
i tlo nereby cenily �hat I am aware ol antl unaersiantl Ihe requiremenis ol Ca or a Healih an0 Salety Coae Sections 25505, 25533, antl
2553a ane Inal I or any luWre Ouiltling ocaDan� will/vnll no� �circie one) neetl � omply wit� sai0 s�a�e cotles antl t�e requirements lor a
pe�mit lor con9mclion ai moaification imm I�e Air Oualiiy Managemeni OisVici. HesiOenlial conslmciion aDPlicaiions are exem0� ��om
ihese pmvisions.
Date: Apolicanl:
I hereby cerlity I�at I have reatl t�is aOVlicali0n anA Slale �hal ��e abov¢
ordinance5 ana siale laws relating lo �uilUing conS�Nclion an0 hereby aN�
pmperiy for insp¢ction Dur0ose5. (/
Oate:_�� — ��''_'" � Signalure:
n.�„or� i �.o��� ,,, c���,i so.��di� . .. .... . .. . . .
IaA�eeto comply with all city antl county
th¢ ciry to enter upOn the ahove-mentione0
16Gba6 Whilo—Boilaing: Green—Coee Enlorcomem; Can ry—Hpplicanl; Pink—Revenue; GolCanroO—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM A70; H Q7Q02_
PERMIT NO: H 070Q29 PLAN CHECY, NO: 04659-94 L GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR FURPOSE: OTH
JOB DESCRIPTION : 62LF CITY STANDARD BLOCK WALL SQ FT: 62
CLAIM VALUE: 1,200.00 CALC—VALUE: 1,290.U0 GROUP OCC: R-3 /
COMMENTS: BLOCK WALL
+r��c*+t*�t*«-�r r�,r+F�x-♦t.*���*��*-�c��c��x����*jtx*�r�r��t*��+r-��r-�-r--u���+�a��x�taf+t*r*xar-��rac*����c��t�*���-x-�r�r+t�uic+rri+
Z O P7 I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN BUZLDING ---------- --------- ACCESSOF.Y HUILDING ---------
FRNT: FT Ir1 REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT ZN RGHT; FT IN
PARKING REp• PROV; PARCEL: 42630119 ZNE; R1 REF NO:
PLANNING NdTES> CONSTRUCT 30" HIGH, 15' LONG HLOCK WALL• CONSTRUCT 62' LONG,
> 6' HIGH bLOCK b�TALL. WALL SETBACK 10 FEET FRUM FRONT P/L,
iF if if it �)f 1! 4 if fE �)t i(� if �f Y-?f if if �f i! if if if �If iE jf if # jf �)f iE jf �Y iF if it il+E 1� iF it ik if i� if 1f if if # 1E if M iF iE 4 iF iF �)f if-if iE iF if 1f iL if * if �- iF iF if i! if iR?f V 1f aE if
D E V E L O P M E N T S E R V I C E S R E Q U I P. E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROC'ED BY : DATE:
APPLICATION ISSUED BY: �� DATE: 1 u-
if if iM1 �f if 1lif iE if'if a` fE iE'Y'M'1f')f �S 1f if 1f if 7f�f 1f ;h �f if'Ifif 1��� i�i�f�f 1f if if 1f ifif 1t y i!� if iF_F�iF if#-Y M iF % if Y�F iF 1' 1M1 4 iE t`-M� iE ifif
'M' iE M' 1! 1f 1f 1F if'If if af +4'If if 3f iF M-'M iF'If'1! 1F'1f ih if M 1f'If �R if'k'If 1E Y'� iF if �f'If M 9F'k if Y- iE?f Y iF �N� if 9f iF tf 1f if'k af # if iE'1F iF'lE #f'M M M?!� if if 1! if TF 1f'lf M iF'N- 4 iF
LEGALIZATIUN;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIF:RES GRADING
PERMIT 31,00 ,50
SMIP /NODI—RES
PLAN 20,15
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE FLAN—CHECK TOTAL .� PAID PUE
TOTALS----> 31,50 0.00 20,15 51.65� • 51.65 ,00
P.EVENUE DIC'ISION TOTALS--> COLLECTED: 51,65 OVER/SFiOP.T; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GP.ADING PLAN—CHECY.
31,00 �,50 20,15
if ff aE �li {F iF if iE if if if if if if ak 1f 1f iF iE M af if it M ic M iE if if if iF iE it if iE ii iF {f if iE M iE r iF iF iF iE M i4 3f iR iF if it iF+R if ic iF if IE>f 3E K IE �c iR iF ic * if if iF i� iR aF if At, i4
I T7 D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 62 RES—CONCRETE HLOCK WALL / FT, •20.00 1,240.00
END OF FEES '
• • ,
I �� /
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5
or oai7aza7-nou2269 T��T
DA7E: li/22/94 T1FfE: i4:17
CONSTRUCTION AND PLANNING ��� 'PA I
APPROVALS Permit # Date Inspector AppAOVALS Permit # Oate Insnector �
1, Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soit Pipe�Undrgrnd. 53. Stee� Reinforcement
3. Electricai Conduit Utility-Undrgrnd. 54. Florms
4. Electrical Conduit•Undrgrnd. 55. Eleciritai Bonding .
5. Steel Reinforcement u-y�,�..� ��y�( 56. Rough Plumbing & Pressure Test
6. Electr.cal UFER Gmd. 57. A'PPROVAL TO COVER�GUNITE
7. Footings �/_LY� Ct ��'„� 58. Eiectricai Conduit�Undrgrnd.
�i
8. Foundation � 59. Gas Pipe, O Undrgmd., Tesc
9. Water Pipe•Undr9rnd. ` 60. Backwash �ines, P�T�ap, � Ur,drqr�d. �
10. Structural floor System 61. APPROVAL TO DECK
1 t. Property Sewer line & House Connection 62. Backwash & Receptor�Fina!
12. Sewer Cap 63. Heater & Vent•Final
73. Roof Drains 64. Plumb�n9 System - Final
14. Rough Piumbing 65. HactricaV�Finaf
75. Rough Electrical-Condu�t 66. Solar SVstem�Final
76. Rough Electric Wiring 67. Fencint� & Acces, Approval �
17. Rough Wiring $ign 68. APPROVED FOR PLASTEFING
1$, Rough Electrical�T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rougfi Heating & Air Conditioning FiRE DEPT. REQUIREMENT �
20. Rough Factory Pirepiace APPROVALS Permit # �
21. Ducts, in Structure 70. Uriderground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipa-Rough & Test 72. Underground Flush
24. Roof Framing 73. Underyrnd. Storage Tank O Gas � Oil .,
t
25. Roof Sheathing 74. Overhead Flydro "` �
%a.:
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemicat ;_ ;
27. Frame and Flashing 76. Dry Scandpipe -- �
!
t
28. Lathing & Siding 77. FIXED SYSTEM FINAL y;.R. ,
a
29. Insulation 78. FIRE PREV. FINAL r--; j
30, Drytvali Nailing HEALTH OEPT. REQUIREMENT �
31. Ptastes Brown Coat 79. FINAL tNSPECTtON
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Finai Heating & Air Conditioning
35. Finai Gas Pipe•Test
36. Hood or CanopY
37, Final Factory Fireplace
38. Final Plumbi�g '
39. Water Service-Final .
40. Gas Service•Final �
47. Solar pomestic-Final
42. Backf(ow Preventer Z���Gi ,,,_ �CG �
(
43. Backfiow Irrigation
44. Landscape Irripation System �
45. Sound Atcenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
46. FIfJAL PLANNtIVG . �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CEATIFICATE OF OCCUPANCY
No. Date
`� ADP�icant lo f7il tn all s0aces axcept ihose wil�in �eavy bortler Itnes anE sign all appropriate Oeclarat�ons.
1�C1TY�pF COSTA MESA -
C'ONSTRU�IOItI�PERMIT . �
ProjectAddress =�6R .� /9 f^' Sr. CO.f: � b�ILJA
Applicant's Mailin Address r'¢�"�-E �
owner's Name �N•LL�O` G✓.C�qsr vhonr� �� �
Address, .��' B E G'T� •n ` G/�%; .
'Arch/Eng. License No.
Address
Contractor's Nam�/��• �RW 2 Phone
Address (mailing) .
City LicenSe No.
LICENSED CONTRACTOR DECIARATION �
I hereby affirm Ihat t am licensetl untler provislons ot Char[er 9(commencln9
wlth 5ection ]000) ot Divislon 3 of tM1a Businass antl Profeszions CoAe, antl
my Iicense is in tWl torte antl eitect.
License Class License No.
Date Si9nature
WORKERS• COMPENSATION DEGLARATION � .
' hereby affirm tnat I have a certiflca[e of consent to self-insure or a certiTicate
� `-Workers'�Compensation Insurance,-or a certifietl• copy�thereof-(Section -�
A00, Lab. C.) . . ,
Policy No, � Company
�Certiiietl copy is hereby furnishetl.
Certified copy is filetl wit� the'city Builtling Division. " ,
�ate ApPlicant �
-EXEMPTION FROM�WORKERS' COMPENSATION DECLARATION -
(This section neetl not be completetl it the permlt Is for one nuntlretl (5100) or �
less). �
I certlfy that in [h¢ Pe�fo�mance o( th¢ wo�l q�[hIs pe�m�t is i55ueB, I�
shall not emplOy any p¢�son in any man fo e<om9 Subjet[ to [he
Workers' Corp�en ti n laws of Californ" .
Date ��% — `�� � � Signature
NOTICE: It,'after making this tleclaration, Y sboultl become sub7ect to the �
Workers' ComOenutlon provislons of the Gor Gotle, you must forthwith
compty w�th such provisions � or tnis permit shall be tlaemetl revoketl.
CONSTRUCTION LENDING AGENCV'. ' �� �• ' •
I hereby afflrm tnat there is a construction lentlin9 agency tor the performance
o( the work tor which this, permit I5 issuetl �(SecHon 3097 Civ. C.)
Lentler's Name ' .
Lentler's Adtlress
OWNER BUILDER DECLARATION �
I hereby af(irm that I am exampt from tha Cantractor's License Law !or the
following reason (Se<tlon ]031.5 BuSiness antl Professional Cotle: Any dty or �
countY whith requires a permit to construct, alter, Imvrove, tlemoiish or, repair
anY structure, prior to its issuance, also requlres the appliwnt for zuch parmit
'tn file a sianed statement [hat ho/she is Ilcensatl ou�suant to the o�ovlsions of
i1.s any appucant tor a per...IIInnn
ena oi not more Ihan flve �untlr�'e1
� as owner ot Ihe� property �
_ ypenialiqn will tlo [he work, antl th�
tor salo (Sec�lon 7044, Builneis antl
License Law tloes not apply to an ownar
[hereon, and who tloes 5uch work hlm!
employ ees, provitletl that suU ImOrover
sale. Ii, however, the bulltling or improu
pletion, tha owner will have the burtlen
�rOva for lhe purposo of salej.
I, ds owner of the p�operty, am ax<I
tractorsto constructthe projett 1Section
T�e ContractorY Licanse law does noi
buiias or Improves thereon, antl who <�
tractor(s) licensa pursuant to the Contra�
❑ I am exempt untler Section
Date Owner�_�
TYPE OF CONSTRUCTION LJ NEW U ADD IJ ALTERATION U'REPAIR
❑ CONVERSION ❑ DEMOLISFI ❑ OTHER
DESCRIPTION OF WORK _ _
TVPEOFPERMIT U GRADING LIFOUNDATION U STRVCTVRAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING� ❑ MECHANICAL
❑ �OTHER ' ' �
PROJECT DESCRIPTION� Sq.FT. ' oCCUanNC
C O N ST RUCTI ON TV PE V ALUATI ON $�
ZONE GRADINGCU.YDS. ACRES_
Remarks: �JD ALANS �C.1F_CF'�5�.4�2Y �
anGln9 with $eCUon ]000) oT
tle) or that he/she is eaempt
lon. Any vlolation of Section
�.cts the applicant to a Uvil
500).
h--ag^ �ole
ure Is not intentletl or of(eretl
onal Cotle: Tne Contractor's
operty who �uiltls or improves
elf or through his or her own
�e not Intentlea or offeretl tor
5 5oltl within one year of com- ,
ing he/she tlitl not builtl or im-
conVacting with Ilcensetl con-
3usiness antl Professloni Cotla:
lo�an owner o( property who
for such projects with a con- � '
cense�.aw). �
�8. & P. C. tor this reason
�
�.ion antl SAate Ihat tha above
, .0 .. ... ....... .. ...wi.,,.,�e. -�
Bar Sink
Backflow Preven[er
Backflow Irrigation � .
Bathtubs
Clarifiers � ' .
Dishwashe�- � ' "
Drinkiny Fountains .
Floor Drains
Floor Sinks '
Gas Service � Outlets
Interceptors
Kitchen Sink - � �
Lavatories -
P—Trap
Roof Drains ' �
Reinspec[ion Fee $25
Boiler ' - . • ,
Duct,- Under Ground �
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/FacL Blt. ICBO #
Heating System & Ducting
❑ 0.100.000 BTU O 100.000 BT
Reinspac[ion Fee � $25
7/83 White-guiltling:Canary-Appliwnt;Pink-Accounting;Goltlenrotl-Asse55or
Showers
Service Sink
Sewer Cap
Solar Collecb
Solar Pipin9'
Solar Tank
Swimming P[
Urinal �
�1�12LQf CIOSC2�
Water Heater
Water ServicE
laue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
00.100,OOOBTU ❑100,OOOBTU
System Repaii/Alteretion
Issue Fee
$'3
$ 3
e
A.P.SW � �
S Main Buililing:
E
T Front
A Rear
C Right
gLeft
Ping. Ref. #
Parking fieq./Providi
Use of Building:
Planning Notes:
Automatic Washer
6710 10/C4/93
- 12ane
Park.Fees
ELECTRICAI . . �
,Transformer ❑ 15-50 KW
❑ 50+KW
I
Meter ❑up to 100 amps
Dishwasher � Meter ❑over100amps
Dryers �Gas ❑Electric ' Sub Panel
Fan' � Motor5�0.1HP�1X-8
F.A.U. � � InaSolar �9-15 HA_016-15+
Fiztures � � �Microwave '
Device Boxes Pole Light �
Outlets ' Fange � - �
Switches Sign
Garbage Disposal � Standing Sections � •.
Generator �0�5 KW �5-15 KW Trash Compactor __ .
� Reinspection Fae
—
PUBLIC'SERVICES REyO��
ZoninO APProved By�!
Appliwtion Approved By
Applifation luued'By_
BUILDING PERMIT
PLAN CHECK
PLUMBING
PLAN CHECK �
ELECTRICAL
PLAN CHECK
MECHANICAL �
PLAN CHECK
Issue Fee
2`_�,35' (Tl.
Z
O
N
I
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G
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Q
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T
S
FEES
$' 3
IV / �
SUIM'MA—RV_ OF, FEES '
$ _-�� SMIP -''�•$ D.SO
$ PERMIT
$ ISSUANCE � $
$ ENERGV P.C. $
$ � GRADING -�! $
MICROFILM $ �
$ � 2S. 35
$ TOTALFEE ,$
s'
.'_ CONSTRUCTION AND PLANNING . � - �
APPROVALS Permit # - Date
, 1: Temporary Electrical Service or Pole �
, �
` ; Soil Pipe-Undrgmd. � - �
3: Electrical Conduit Utility-Undrgrnd. ' �
a
'4. Electrical Conduit-Undrgrnd. � : � � _
'5. Steel Reinforcement _
6. Electrical UFER Grnd. •
7. Footings � •
8. Foundation ' �
9.. Water Pipe-Undrgrnd. ' � '
10. Structural Floor System �
i l' Property Sewer Line & House Connection
12. Sewer Cap �
�
13: Roof Drains �
14. Rough Plumbing
15. Rough Electrical-Conduit - -
'16. Rough Electric Wiring b
�17, Rough Wiiing Sign �
18. Rough Electrical-T Bar Ceiling
�19. Rough Heating & Air Conditioning -
2Q. Rough Factory Fireplace �
21'. Ducts, in Structure '
22. Ducts, Ventilating �
23. Gas Pipe-Rough & Test, '
24. Roof Framing � - � �
25. Roof Sheathing , '
�
26. T-Bar Ceiling (Structural) &� Monocoat � - , "
27. � Frame and Flashing ��
/O
26. Lathing'& Siding ,
29. Insulation • ,
30: Drywall�Nailing � �
31. Plaster Brown Coat�-? � .
32. Electrical Power Meier-Final
33. Final Elbctric
34. Final Heating & Air Conditioriing .
35. Final Gas Pipe-Tes[ � - � -
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. Handiwp Regulations� � � _
47. FINALSTRUCTURE&BUILDING --
48. Special Requirements Completed -
,
49. Electric Release to Edison � -- - -
50. Gas Release to Southern California Gas Co '
�
51. CERTIFICATE OF OCCUPANCY � •
!o. Da[e
\S
Inspector ��ApPROVALS•v Permit# � Date Insp
, 52.. Pool & Equipment Location
� 53. Steel Reinforcement
= ' � 54. Forms � �" �
� 55. Electrical.Bohding .
i
� 56.'Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
. , � , � 58. Electrical Conduit-Undrgmd.
- ' 59.-GasPipe,O�Undrgrnd.,�Test � � ,
. 60. Backwash Lines, P-Trap, O Undrgrnd.
• • • 61. APPROVALTODECK
62. Backwash & Receptor-Final '
_ � 63. Heater & Veni-Final
� 64. Plumbing System - Final
65. Electrical-Final �
- ' � - 66. Solar System-Final . - � ' -
' (_7 67. Fencing & Access Approval -
� � ' ' 68. APPROVED FOR PL'ASTERING
69. POOC/SPASYSTEMSFINAL
� � FIRE DEPT. REQUIREMENT
� 'APPROVALS Permit #
' 70. Underground Hydro
� 71. Product Piping � Gas ❑ Oil
. � 72. Underground F�lush �
� - 73. Undergrnd. Storage Tank O Gas ❑ Oil
. 74. Overhead Hydro
� � 75. Dry Chemical ,
L! .L 76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
� HEALTH DEPT. REQUIREMENT
' 79. FINAL INSPECTION
�
80. FOOD CERTIFICATE ISSUED
, Notes:
' _
3e-
c
�
" OP � NGE COUNTY BUILDING DEPAR7'MENT
� � 636 North Broadwoy � '
. �% SANTA ANA, CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING _p � �
ADDRESS . .
SCHOOL DI57.�n r �� s,' �� ��i'r
OR TOWN L 1 �1� �
NEAREST A y� �
caoss sr. ,�c'�Wc.�+31 IV1H�1 @�Inn N31yS /
ARCHITECT OR
ENGINEER
ApDRE55
1;�� � nVVttGS.S
LEGAL
LIC.
n� NO. OF BLDGS.
SIZE OF LOT,�U S n�3� NOW ON LOT �
USE OF NO. OF NO. OI
E%ISTING BLDG. F�hu�ies I R
SETBACK LINE FROM: RE9R YARD
CENTER OF STREET S� SIDE YARD .S�
DESCRIPTION OF WORK
NEW I � ALTERATION I I ApOIT�ON
:TERIOR WALL l7/ /'f`�T rl ROOF
)VERING �L�1J 'Gf't covei
'E �F NEW '
LDING ��£.LL /�/C/' .
` V
� APPLICATION FOR PERMIT't—�
�uo��a�� 1
FOR OFFICE USE ONLY
�� 2� �yMy N2Ja
E,p.BY. // � � / �� D�'/ / E�
���
I7T1
DIST. '
J'
T. �
FOUNDATD
1 HEREBV ACKNOWLEDGE THAT 1 HAVE READ THIS FORM'�
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDE�
AND AGREE TO COMPLY WITH ALL COUNTV ORDINANCES FRAME: FI
BRACI
ANO STATE LAWS REGUTATING BUIL�ING CONSTRUCTION.
LATH. INT.
SIGNATURE OF �� ^�_�A ��'����� LATH. E%T.
, J� AUTHORIZED AGT.
PERMIT FEE S
VALUATION $ � puH CNECN S
� . yyt� -
�TOTAL
.FEE �� S
SM 9-90�69
ALS,
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property line orid between buildings.
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. . ,.
ORANGE COUNTY BUILDING DEPARTMENT
f 636 North Broadway
• �� SANTA ANA, CALIFORNIA
POR APPLICANT TO FILL IN
BUILOING Q/ (� /�
AOORE55 �„[!pQ Q� ����• �
SCHOOL �IST./�
OR TOWN (.,i��� �� �
NEAREST L�..� ���..ys��' �.6. ��"/
CROSS STl1 T
CITY �7n� f�
ARCHITEQ OR
ENGINEER
ADDRE55
�NTRACTOR
..ODRE55 [ �_ L
TEL.
NO.
LIG.
NO.
LIC.
NO.
]ESCRIPTION I NO. L I BLOCK p� I TF
(ATTACH METES & BOUNDS) d �+�� TLL.�
SIZE OF LOT JQ I� ,���[, �IOW ON L�(
USE OF ( NO. OF
EXISTING BLOG.. Fnh!iues
SETBACK LINE FROM: REAR YAR
CENTER OF STREET , SIDE YAR
DESCRIPTION OF WORK
NEW I z I ALTERGTION I I ppl
EXTER
�IROOF
COVE
ES
OF
APPLICATION FOR PERMIT
�'l�Y�'�����
FOR OFFICE USE ONLY
RECEIPT NO. PER
8-2. �� ���
BY DATE REC'D. E
�� �� � �� ��
ILDING
DRE55��
i00L DIST.
Jh I IT
I�
CORRECTIONS
FOUNDATION: LOGATJ,
I HERE6Y ACKNOWLEDGE THAT 1 HAVE READ THIS FORMS, MATERI
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING ;
ANO AGREE TO COMPLY WITH ALL COUNTV ORDINANCES FRAME: FIRE STOPS. '
BRACING, BOLTS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH. 11�T.
SIGNATURE OF �/� �s,� LATH. EXT.
PERMITTEF ��✓f�„¢'4n� �t'^F�.-.r.r"�
PLASTER, INT.
11 AUTHOii1ZEO AGT. PLASTER. EXT.
PEnMiT Fee $ MASONRY REINFORGED
VALUATION S ^w^� ,' p�wH CNecrc S � BOND BEAM
� ' ���V
- 'P � �'�S �: • : i �FOTAL FINAL
�JM 9.90.69
4 ]I
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property line and between buildings.
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