HomeMy WebLinkAbout849 18TH ST - Building Permits(714) 754-5273 • Feu (714) 754-4856 • www.cl.Coste-mesa.ca.us i i rnin unrvc. �.va � r mwn, �... acoco
ELECTRICAL PERMIT
Job Address: 849 W 18TH ST
Suite No B
Vicinity: UNIT B REAR YARD ( INDUSTRIAL COMPLEX)
ParcelNunmber: 42406105
Applicanl: HUCKS, HOWARD
Address: 419 MAIN ST . � � ��
S7E 234 � � Phone: 774-749-1839 , -
HUNTINGTON BEACH, CA' � Zip: 92648 � -
Owner. �BOYD, WILLIS BLAIR SR-TR .
Address . 1946 E EDINGER AVE-
SANTA ANA, CA
Phone:
Zip: 92705
e
Contractor: HARTFORD CONSTRUCTION CO
Address: 419 MAIN ST . ' �� . ,
STE 234 � - Phone: 714-749-1839
HUNTINGTON BEACH, CA Zip: 92648 '
� .
License: 428674
Status: ISSUED
Applied: 11/13I2001
Issued: 11I73I2001
ISSUED BY: "
' . �
' SCOPE OF PERMIT
INSTALLATION OF SOLAR PANELS ON AN FREE-STANDING A FRAME STRUCTURE IN A REAR FENCED
INDUSTRIAI YARD. 1� SUB PANEL TO 200A, 25 MISC ELEC'E�UIP (ARRAYS), 4 LOW VOLTAGE
EQUIPMENT, 4 MISC CONDUIT, 4 MISC CONDUCTOR, 1 HR PLAN CHECK FEE.
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units) �
Pool ! Spa
Lighting Fixis
Recept Outlets �
Swiiches
Non Res Appl �-�
Res Appl ` � �
Service to 200a
Service to 1000a �
Service over 1000a
Motors to 1hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
523.50
50.00
$0.00
$0.00
$0.00
50.00
50.00
50.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
50.00
50.00
50.00 -
$0.00
$0.00
530.50
80.00
$0.00
50.00
$0.00
Duantity
0
0
0
0
'0
0
A
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
FEE SUMMARY „ '
:/ : _
Temp Dist System / Lighting
Buswayl700ft �
' Standing Section
� � Misc Electrical Equipment
� ' � Transformers up to 1 kvalkw
................uP to 10 kva/kw
.................up,to 50 kva/kw
.................up to 100 kva/liw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt W ring System / Ckt
Misc. Conduil
Misc. Conductor
Clrcus ( gen or ride)
� Circus (mech ride or lights)
� Christmas Tree Stand
, Fireworks Stand
� Other Electrical Fee -.
Investigation"Fee
Plan Check Fee
Reinspection Fee
Quantity ,
$0.00 0
so.00 a
$0.00 0
$455.00 25 �
$0.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
$72.80 - 4
so.00 0
$72.80 4
$72.80 4
$0.00 0
� $0.00 0
$0.00 ' 0
$o.oU o
547.00
$0.00
$O.OU
$0.00
TOTAL CALCULATED FEES $774.40
COMMENTS I SPECIAL CONDITIONS
i
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permlt shall automatically expire and become void Ii work Is not commenced wlthin 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit lo be considered legal, such work must comply with all applicable codes, end all
required Inspectione end final epproval must be ohtained. Faiiure to abtain inspections and final epproval will result in ihe ezpiration of this permit.
FOfl INSPECTIONS CALL: (714) 7545626
zaaasa�amo>
� • ' -..- tl.- r :
, . . - � •, ;.l4F� ?R:-.::-7,= _
WORKERS' COMPENSATION DECLAqATiON:
I hereby eMirtn under penalty af per�ury ona of Ihe following declarelions:
I❑ I have entl wlll malnteln e cenificete of consent to selt-Insure for workers crompensatlon, as providad far by sectlon 3700 of the Lebor Code, far the peAarmence of the
work br whith IhiS permit Is issuetl.
i❑ I �ave end will main�ain workers' compensatlon insurence, es require0 by section 3700 of the Le6or Cotle, for the peAortnance of Ne work for which this permit Lv issued.
� My workers' compensatlon Insuranca cerder end polity number ere:
Cartier: Policy Number:
(Thfs s lon nsed no! be crompleted l! Ne pemut � vefued et one �untlreOOo/lers ($100) or IessJ
I certity Ihat in �he pertortnence of th ork for which this it i uetl, 1 II not employ eny person in any manner eo es to �ecome subject to t�e workers'
compensetion laws of Calltomi§.e tl e�at I. h d e subJ the workere' crompensation proNsions o1 Sectlo 3700 o Ihe Labor Cotle, I shall lorthwith
compty with these provlsio g-(�� / /%��
AppllcentSignetura: Date:_�%//-+ ��
WFPNING: FAILURE TO SE URE WORKERS' COM NSATION COVERAGE IS UNLAWFUL AND SHALL SU6IECT AN EMPIOYER TO CRIMINAL PENALTIES MID CNIL FlNES UP TOONE HUNORED
THOUSAND DOLLARE (5100,OD0),IN ADDfTION TO THE WST OF COMPENSATION, OAAMGES AS PROVIDED F-0R IN SECTION 3]OB OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I herehy affirtn that I em
� rores end ettect. �c. a_
� Conlrectols Signamre:
7000) of Dlvision 3 0l the Buslne a end�yrolessio�n; Code, entl my Ilcense Is in full
aass » _ � /S % /�/G
oe�a: �.�p7�
CONSTRUCTION LENDING AGENCV:
❑ I hereby eflirm that there is a cnnstruction landing agency lor ihe peAormence ol Ihe work tor which this permit is Issuetl. (Sec. 3097, Civil Code).
Lentlels Name: Lenders Adtlress:
� Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I herehy eHirm Ihat under penelry ot per�ury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the I011owing reason (Sec. 7031.5, Buslnass antl Professlons
CoOe: Any ciry or wunty w�ich requires a pertnit to consiruct, elter, improve, demWish, or repair eny siructure, pdor to its Issuance, also requires t�e epplicam tor such pertnit
to file e signetl stetement thet he or she Is Iicensed pursuent lo Ihe proWsions o1 the Conirectors Ucense Law (Chapter B(cnmmencing with Sealon 7000) of DMsion 3 ot the
Business entl Professions Code) or t�at he or she is eaempt therelrom end t�e basis tor ihe elleped exemption. Any violetion of Sectlon 7031.5 by eny epplicent for e pem+'
sub�ecta ihe epplicant to e clvil penelry of nol more Ihan live hundred dollers ($500).):
❑ I, es owner ot Ihe property, or my employees wifh weges es t�eir sole wmpensation, WILL DO THE WORK, antl ihe structure is not IntentleO or ottered for sala (Sec.
7044, Business entl Professlons CoOe: The Contractors Ucense Lew tloes nat apply to an owner ol properry w�o Cullds or improves thereon, end who does such work
himself or hersell or through his or her own employees, provitleA ihai such imprwements ere not intentletl or oflered tor sale. It, however, Ihe building or Improvement is
Soltl wit�in one year of completion, ihe owner-builder will have iha burden of proving thet he or she did not builtl or Imprwe for Durpose of sale.).
❑ I, as owner of the property, am EXCLUSNELY CONTRACTING WRH LICENSED CONTBACTORS to wnstruct tha proJect (Sec. 704a, Businass antl Profassions
Cotle: The cantractors License Law tloes not ap0y to an owner of OmPerty who builds or impmves thereon, end who contracts tor such prqect wiN a contractor(s)
license pursuant to Ne Contradors license Laws.).
❑ I am exempt under sec. Business end Protessions Code for this reason:
Slgnature: Date:
Owner ID verifietl by drivel9liCenSe. ❑ Ye5 ❑ No Dnvefs Llten9e No. Expires:
VedNcetlon of Ownership by (rype of tlaumenL i.e. - property tex blll or deed):
DIVISION OF INDUSTAIAL SAFETY PERMR CER7IFICATION:
❑ I �ereby cently that no excevetlon five (5) a more leet In depth Into which e person lv requiretl to descend, wlll be made in connectlon wiN work euthorizetl by Ihis
pertnit, and that no bullding structura, scaHoltlinp, falsework, or tlemdilion or tlismantling Ihereol, will be more than thlrty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomia AdministretNe CoCe).
❑ As owner-builder, I wlll nol employ enyone to tlo work which would require e pertnil Irom the D'Msion ol Indus�Aal Saley, as noted ebove, unless suc� person has e
permit ro do such work from t�e tlivision.
Signeture: Date:
Divislon oi Indusirial Sefery Permit Numher.
CERTIFlCATE OF COMPLJANCE AND AUfNOHVATON OF EMRY: I certity untler penally of perjury Ihal I heve read ihls appliwtlon end state Ihat the inlortnation given Is
conect I egrea to comy ty with ell stete lews and ciry ordlnences relating to Duiltling wnstructlon, end authorize representatives of the Ciry of Coste Mese to enter upon t�e
ebove-tlescribe� p4rty lor inspecfion purposes. I egree not to occupy or allow occupency of eny building authorized by this permit until final inspectlon.
Si f I Ow e Data
/� . �7� �/
nd/O AutliorizedApD�cam Date
COpE �, INSPECTIOXTYPE Qdg �ELS
1618 Fi:etl System Flnel Fire Prevention
1268
200
Pool Spa Finel
Finel RaRoof
201 Finel Block/Retaining Well
202 Final Fectory Fire Place
203 Finel Sign
204 Finel Demolltion
CQUE� INSPECTIONTYVE
208 Finel Mechenical
20B Finel Plumbing
210 Finel Electrlcel
212 Flnal Fire Preventlon
220 Final Planning Approvel
222 Final Site
250 Finel Building/Occupency
��
//-Z7-Dl
��
(
CIT��('Q-F COSTA
Prorct�Address _
��'Aoo�icant's Mailin<
UCTION FERMIT
ADDileant to fill in all spaces eneeo< <�osa within heavY eorOer Iines antl si9n all aoo�opriala aeelantionf.
PERM NO�S�I TRACT NO. LOT NO. UNIT NO. A P,dy
Owner'sName (c.�Y/��N7f-J�Y�C/�l.L phone
Address ��y�i F._�n�N—_-l-+E� ,--rg/-��✓Ti4 N�9
Arch/Eng. LicenS¢ No.
Address p }}}
Contrattor's Nam d P one(_7� �'3
AddresslmailinglyG��t� E. FD//ICleE2 ���} fi
Ciry Li�¢nse No. �5�9� ,
LICENSED CONTRACTOR DECLARATION
I�hereby affirm that I am Iicensetl untler provisions of Chartor 9(commencln9
with ipction 7000) of Division 3 of t�e Businezs antl ProfaSsions CoCe, an0
my license is in fWl force antl et ct S
Licenz CIa55 � Litense
Date " � SiqnaWre
WORKERS' COMPENSATION DECLARATION
� hereby aftirm ihat I have a certificate ol consent to self-Insure or a certi(icate
�t Wo�kers' Compensation Insurance, or a certi(letl copy thereof (Sectlon
J800, Lab. C.)�lp'�/� �� '�e
PolicY No. Q/O �`^ 7�� ComPanY �r/ �� N�i
�Cer�{(ietl copy is hereby furnishea. '
Ce fietl� op7y�( iletl with tne city B il 9 �ivisio7. _�7
Ddte � /_��_Y�7( > _ Appiicant �
EXEMpTION FROM WORKERS' CO PENSATION DE LARATION
(Thiss@diOmneetl nol be <Ompletetl i1 Ne permit B f0� one hu�Cred (§700) or
less).
I ter[ily (habin the parformance of the work (or which tnis Oerm�t Ii issuatl 1
shall not employ any person in any manner so as to become subject to [�e
Workers' Compensation Laws of Califomia.
Date S�9na[ure
NOTICE: 1f, atter making this tleclaration, you shoultl become sub7ett to the
Workers' CompenSallon provisions o/ tne Labor Cotle, you musl forthwith
tomply with such provisions or tni5 parmit shall be tleemetl revoketl.
CON57RUCTION LENDING AGENCV -
I hnredy atfirm Uat tneru is a conslruttlon Ien0ing agency for the per(ormance
ot tho work foi which tNs permit is IssueC (Section 3097 CIv..CJ
Lentle['s Name ,
LenGer's Aatlrezs
OWN�R BUILDER DECLARATION -
I horeby afflrm Ihat I am oxnmpt frpm iho Conlractor'S Licenso Law for the
tollowing reason (Saction 7031.5 Business antl Profe55ional Cotle: Any cily or'
county whicn requires a permit to construct, alter, improve, Oemolis� or repair
any structure, prlor to its issuance, also requires the applltant tor such permit
to fila a signetl slatament lhat M1e/she Is Iltensad Oursuant to the provisions of
thn Cpniractor'S License Law (ChaOter 9(commenUng witn Section 7000) a('
Division 3 ot t�e Businezs antl Pro/ezsions Cotle) or t�at ne/she is exemPt
�thCrefrOm an0 IhG bdsi5 to� the alleqetl exOmptiOn. Any viOlatlon of Sectlon
]031.5 by any applican[ for a permit subjects the applicant to,a civil
��enalty a( not moro lhan live nuntlretl tlollars (f500�.
I, as owner ot l0a proporty or my emDloyees wlth wa9os as tneir sole
CompOnsaliOn, will tl0 the work, antl th0 slNCtufe'IS not IntentleG or-0ffBfatl
(or sdle (Section 7004, Business anU Professional CoOe: Tno Contraclor's
LicenK �aw tloez not appiY to an owner of a Drooerty who builtlz or improves
tharepn, untl who tloes su<h work Nmtell/bersetf or tnrou9� N5 or her own
¢mpl0yee5, ProviUotl tltat such ImprOvoment5 a�¢ nOl IntGntletl Ot ofl¢retl for
wio. 11, however, lhe bullAin9 or improvement is soltl wllhin one year af com-
pletian, tne owner will have the burtlen ot proving he/she tlitl nol builtl or Im-
nrova for the purposa ol sale).
n In witn ucensea con-
r am clusivel W tract
t�the ro e t ex Y 9
❑ I s owner o 0 Y.
a. v
tract0/st0 con5truct [ho p/ojecl (SCCI100 JO4A� BUSIOB55 dOC PIO:CSSI005 LOGB:
The Contractor'S License Law dOes nOt dpP�Y �o dn ownar o� prOpe�ty wh0 �
builtls or improves tbareon. anC wno convacts ior such oroiects wltn a mn-�
tractOr(51 Lcense pursuan[ to [ne ConVattor'S License Lnw). 1 am aware lhat
proof o( their Work¢�'s Compensation InSurance ShOuld be P�ovltletl to ma,
❑ � dm exempt untler $ectlon 8. 3 P. C. for this reason
Date Owner
1 hereby certify that I have reatl this application ana ztate that the abova
inlorrnation is correct. 1 agree to comply wlth all city antl county orAinan<es
antl s�ate laws r "n9 to builGmy� nsy uclion, antl �e�eby authorize rep�e-
santatives ot t s ity to entey,/poythe above-yientionad property for
Inspettion pur se
Slqna�ure
Drlvarz' License or SS �
0865.46,rev. 5/88
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR S Mtin Building:
E
Q CONVEq510N ❑ �EMOLISH � OTHER �E2�o F T Flont '
DESCRIPTIONOFWORK/USEOFBLDG. , A Reer
TVPEOFPERMIT GRADING FOVNDATION STaUC7URAL C Right
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S• Left
��oTHER t. ee� ���.('�U�ST/Z{ ii T3:•G'ji Ping. Ref. �
PqOJECT DESCRIPTION 5�. FT.!�% �+ �e � OCCUPANCv
---�--- Planning Notes:
GONSTftUCTIONTYPE VALUA710N$ �%��%�S
ZONE GRADINGCU.YDS. ' ACRES . .
Remarks: .
Sink
Preventer
Drinking FOUn[ains
Floor Drains
Floor SinkS �
Gas Service Outlets
Interceptors �
Kitchen Sink
Lavatories �
P—Trep .
Roof Drains
Reinspec[ion Fae . I $15
Boiler '
Duct - Under Ground . �
Duct - Structural
Duct - Ventile[in9
Exhaust System ❑ Multiple �
Firepl/FacLBIt.ICBO� �
Heating System & Ducting
❑o-i oo,000 eTu o i oo,000 er
; � Reinspection Fee � $75
Wnite - Builtling: Canary - Appliwnt: Pink - qccounting: GoltlenroC - Azsassor
ShOwers
Service Sink
Sewer CaP .
Sewer Connection
Solar Collectors �
Solar Piping
Salar Tank
Swimming Pool w/Spa
Urinat
Water Clozet
Water Heater
Water Service '
Auto-Wesh �
laue Fae
Hood or Typel ❑
Canopy Typell ❑�
Fefri eration 5 stem
9 Y
❑aioo,000eru ❑ioo,000
System Repair�AKeration
Fire Damperz
Reginers � .
laue Fee
FEES �lutomatic Washer
Canstructian Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electrii
Fan
F.A.U.
Fixwres
• Oevice Boxes
Outlets
\< Switche5 �
�7 Garbage Disposel .
, Generetor �0.5 KW �5�
2orre
Accessory Builtling:
Parking Req.lProvided
ELECTRICAL - -
Transformer ❑ 15-50 KW .
❑ 50+KW
Meter ❑up to 700 amps
Mete� L�over 700amps
Sub Panel � ' '
Motors 00.1 HP � 1 Y, - 8
Inc. Solar �9-15 HP �16-15+
Microwave _ .
Pole Light � '
Fiange •
� $tending Sections
5 KW Trash Compactor
� � Reinspeaion Fae �$15 I I Issue Fee
§ 3 DEVELOPMENTSERVICESRE�UIREMENTS:
Zoninp Approved By
FEES BuildinB APP�oved By
APolication lssued Bv �
FEES
§ 3
SU M Y OF FEES � �,9
BUILDING PEFMIT $ � �SQ SMIP $ 0
PLAN CHECK -
$ PERMIT
PLUMBING $ ISSUANCE � $.
PLAN CHECK 25% $� ENERGV P.C. $
ELECTRICAL $ �GRADING $
PLANCHECK 50% $ MICROFILM $ �) •
MECHANICAL S TOTAL FEE $ 25..�3�D
PLAN CHECK 25% $ � � �
Q S O�J014712-00014713 T r� T :73.40
DATE= D9/19/S8 TIHE: 12:09
N
I
N
G
R
E
�
M
T
S.
�Y.
�
MCY�NSTRUCTION AND PLANNWG POO� � SPA
Date Inspector Date Inspector
, '11PPROVALS Permit # � {J APPROVALS Permit #
t,
1. Temp�ary Electrical Serviceor Pr f 52. Pool & Equipment Location
� 2. Soil Pipe-Und�gmd. `o � �� 53. Steel Reinforcement ��1
i3? Elect�ic.�l Cond6ij lkitiry-Undrgrnd. ift �=� 54. Forms `" �
✓
4� �•.�. • !1 ") J �
.� Elect�rical CondJii`UPd�grnd. � 55. Electrical Bonding ;�
i�
5� S�gel'Reinforce.meqt��� W .�% 56. Rough Plumbing & Pressure Test �
;� /r'.
„..
6� �IecYrical UF�R,�yGrnd. ' f� �� � 57. APPROVAL TO COVER-GUNITE ,%'r �a
�. � � .
Tl �oot`ngs ���� -'�� `�'� 58. ElectricalConduibUndrgrnd. �� � �,
8. Fouqtla�ion �� �� � r 59. Gas Pipe, O Undrgrnd., Test �_,�
� v i �
B:' W�trr Pipe�UndrQrnd. '��i � 60. Backwash Lines, P-Trap, O Undrgmd. ��
- �, � .
1U. SRuctuial Floor System ,�� :� 61. APPROVAL TO DECK `"�.
1rt�J PF perty Sewe� Li'rt2 & House Co.hiiection �; i,- 62. Backwash & Recepror-Final
12rSe"1Ner Cap j�, •� �t,� : �� ,�ff 63. Heater & Vent-Final �
13. �Rpof�D`ceins :..� ! (�•j! f, j 64. Plumbing System - Final �( �
�. , i.
74. R�ugh`Plum6ir�gj i �� v 'r `r:
.���� 65. Electrical-Final
15. R[�ugh Electrical-Conduit � 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
•:i17a Rough Wiring 5ign 66. APPROVED FOR PLASTERING
:18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
_ �
Y19. Fiough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
�2Q. Rough Factory;gireplace APPROVALS Permit #
,.�
J21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough &yTest 72. Underground Flush
�24.�RooTFraming �f��;• � 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing:' %I 74. Overhead Hydro .
26. T-Bar Ceiling (5tructural) & Monocoat 75. Dry Chemical
27.� Frathe and Flastiing 76. Dry Standpipe
i •
28. Lathing & Sidin9 77. FIXED SYSTEM FINAL
�
29.i In�ula[ion "� ' 78. FIRE PREV. FINAL
30) D ywall Nailing � f� HEALTH DEPT. REQUIREMENT
� 31i PlasterBrown�Coat �; 79. FINALINSPECTION
32: Elr.ctrical Powe�:Meier-Final , 80. FOOD CERTIFICATE ISSUED
33. Final Electric 1 Notes:
34�. Final Heating & Air Conditioning �� `Q/� �
35. Final Gas Pipe�7est �
36. Hood or Canopy
37. Final Faaory Fireplace -
38. Final Plumbing
39. Water Service-Final .
40. Gas Service-Final
r
41. $olar pomestic-Final •
42. Backflow Preventer � '� h � �
43. Backflow Irrigation . • ' "� •
44. Landscape Irrigation System � '��
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �� �
?R. S�ecial Requirements Completed
49. Electric Release to Edison . . � J
5. Gas Release to 5outhern California Gas Co ��� ' ,, ]
�:�
51. CERTIFICATE OF OCCUPANCY /, � �
rY
No. � Date � . . •
. _
i "
:. . � : . : -. ��.� :%0
C05fA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSfA MESA. CALIFORNIA
fOR APPL/CANT TO F/LC /N COMPLETELY
TYPE OR PRINT
BUILDING
A ESS
O �MESA, CALIFORNIA
�=EE RECEiUED
, �«'���'�%
FINANCE DEPT.
APP�1 G�CT C�E�AFI�fSAPERM IT
,fj�� BUILDING
'�!�
fOR OfF/CE USE ONLY
RCCEIPT NO. PEHMIT
S � �� �, r
�C N�o: C S '
�N I FIRE
ZONE
STAT� �� qppROVED
LEOAL I LOT r� �� I ryc �/'v"1� I�•��'3A
OESCflIPTION NO. /S � BLOCK � TRACT
A.P. NO. I h� l� V � � i
slzE �,� ��x F•�c, I no. oc e�oas.
OF LOT 3 � Now ON �OT
USE OF � -n� � T
EXISTING BLDG. �
6ETBACK LINE FHOM / .� �.. � __ _ _ .". __ A � �
u
DESCRIPTION OF WORK
I �IIALTERATION I IIADDITION
I II MOVING I II DEMOLISH
' �J� NO.OF /
Q(j ROOMS STORIES
�ZLC�(!NC ICOVERING �p/�n�L
ILDING AND W RK TO BE PERFORMED
I HERHBY ACKNOWLHOGE TXAT I NAVE NE�D THIB APPLIGATION
•NU 9TATE TMAT TH8 ABOV6 IS CONRECT AND PGREE TO COM�
PLY WITN 1LL CITY ONDINANCE9 AND STATE LAW9 PEOULATIN6
BUILOINO CONBTPUCTION. �% ./ � '
SIGNATURE OF�,�L.� ' 1-'1 ��'7�1�.'� �i��4.t-
PERMITTEE
' ,��y( �L/ ' ' /a+� ��
AUTHORIZED AGFJNT
:057A ME5X, CALIFdRNIA
� �
TYPE GRO/UP
' DATE( y �� `
ONING
NO. OF UBE OF NE
PLANB BUILOINO
DAT S�
EVES �
ALLOWED
� iJiiT � R - �..
THE /�MOUNT 6HOWN UNDER VALUATION IB FOR THE
PUqPObH OF HBTABLIBHING Il PERMIT FEE ONLY.
VALUATION 6
^` PERMIT PEE $ ����
g L(1� C� PLAN CHECK $ 3/ �
TOTAL FEE S � / I ''
� �. ' �,• 13?�2
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 3f7 C08TA MEBA. CALIRORNIA
For Applieanf fo Fi11 In Complefely
TYPE OR PRI T
BUILDING / �
ADDRE68 �
COSTA ME6h GALIFORNIA
t
STATE ! ✓'. ./.�� TEL. /� �JG��.
LIC. NO. �/ NO. V�'7
SIZE I NO. OP e�oca.
OF LOT NOW oM lAi
USE OF � � /
eriar�u� a�nr �^YL 5 'l�/Q.
�.�7-.�"0�'
FEE �ECEIVED
C3 � �a� -� o -9�
FINANCE DEPT.
APl�l�i!A�(O���t �$�AIT
BUILDING
For Office Use Only
RECEIPi NO. eE•yp11iNQ�
�� � yG��
� DATH RECEIV2D � DA EOI� �./ �
' �il��(J• �8� X�'
CASTA MESA, CALIFORNIA
APPROVED
ZONING
C I NO. OP � I U88 OP D
;�� / rLAN9 BUILOINO
I � �
LHOAL 1 ) � j] � ��— .�%
BHiBAGK LIN6 FROM �j /� (C6MeR LIN6 BTJ
CeNT6R OP eTRe6i REAR YARD J FRONT '
:�
SIDE YARD ILEFT � RIGHT R.SIDE
DESCRIPTION OF WORK
NO. OF
WALL I ROOF
COVERII
IILDINy AC3D `NORK TO BE
� � 7 ..L .7iY±.�
n /J �
- �(�v—o
�/
I HEABBY ACKNOWLEDOBOVG IS LORRECT MID A6R86 M CpN- Tx! AMOUM BNOWN UNDEH VALUATION �6 pOR TH6
AND BTATE THAT TX8 A pUN09E OP 89TABL19HING • PHRMIT PE2 ONLY.
PLY WITH �LL.L WTY ORP�XANCE9 ANO BTATB LAWB R80ULATNO
BULLnINa GONsinucTloN. . ' . VALUATION
SIGNATURE OF �Gu �� �� �1 � PERMIT FEE E `�
PERMI7TH � ' ((( / OJ �✓jD � o
���{{{'''/,� �/jJ $ �� � PLAN CHECK $
AUTHORIZED AGENT �/�//�/�.�(i�./ � � �
TOTAL FEE
.�
. - - � s���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 C08TA M68A. GALIFORNIA
For Applicant to Fill In Complefely
COSTA MESA. CALIFORNIA
cw o�er M�sa �.rid.
Sy 3 6 Tl., Tv e'o
' p/V'(.�,•O��FGff Ci9�o:
T TEL.
� 81ZE
� B6TB�CK LINH PPOM
FIRE
FEE RECEIVED
APR 2 1962,
FINANCE OEPT.
CITY� OF COSTA MESA
APPLICATION FOR PERMIT
.11 s�� BUILDING
For Office Use Only
fl8L81PT NO. • ICQI�IOPMO.
ev
COSTA MESA. CALIFORNIA
ZONING
Ho. or �') uee ov rv
�L.�N6 �f- BUILDING
NED• �eaw� f � o/ D S� �
DEeCRIPTION
�� I NOWOON LOTB � /I �j �/(Q V �� C/
4. P. NO.
DESCRIPTION OF WORK
BUILDING Q �p—� NO. OF �
SIZE y k ROOMB 6TORIE6
EXTERIOR WAL�/a ROOR C a M(J Q.
COVERING C/Q �C COVERING
U8E/ �OP_BU�ILDING AND WORK T P PO MED
'.� J�
(! a--/ / � _ J R
1 HBFIHBY ACKNOWL6tl�8 TMAT I NAV6 PBAD TM19 APPLIGTION
•HO BTATB THAT TH6 ABOVB IB CORAECi ANp AORE6 TO M�
PLY WITH ALL CITY O��NANC68 AN� BTATE LAWB RHO NG
BUILDINO CONBTRUGT�G�j•
BIGNATURE OF L
PERMITTE
AUTHORIZED AGENT
UNl eT.)
0
TX6 AMOUNT BHOWN UNOBR VALUATION IB FOR THE
PU18098 OP EBT�pL18HING A P¢RMIT FEB ONLY.
VALUATION (� �y
PERMIT FEE $ /7"� �/�
$ r [� ` '" PLAN CHECK $ �, � /
�J /�� /
TOTAL FEE �i7�/ . ' J
�
�'
.,�� .� . -. � � ;�i'�8�s
COSTA MESA BUILDING-SAFEN DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNU
For Appiiconf fo Fill In Completely
TYPE OR PRINT .,
■ MAII
COS7A MESA. CALIFORNIA
9
TEL.
LINB FROM
TEL.
NO.
TEL.
s-7 Qrb
OP BLDO6.
DESCRIPTION OF WORK
F"F�E RECEIUED
' ARR 6 1962
FINANCE DEPT. '
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RlCEIPT NO. T .
!Y
FIRE
ZONING
ZONE NO. OF U6E OF NEW
_�, I PLANB � BUILDING
LE6AL ���0 �
OE9CRIPT�ON
A.P.NO. I / VJ� �V ��—}D /
YARDS �-Q-j CPEY �
APPROVED ALLOWED
(CHNTBR LINE BT.) _ 6L O .
REPAIR I IIMOVING I IIDEMOLI6H I ByPROVED � DATE '
BUILDING NO. OF ` `
SIZE ROOM6 STORIES G � �� /
PXTERIOR WALL ROOF ^ �
COVERING I COVERING T� 5�1
U6E OF BUIL�ING AND WORK TO BE PERFORMED
� 5 - o P _ /,� 8
- � � �-5 —To , d ,
O' ' � /l,�-O-�- - � � O /
I H¢RHBY ACKNOWLBDOB TXAT 1 HAVB RHAD TXIB MPLIGTION TH6 AMOUM BHOWN UNDER VALUATION 19 POR TXE
AND BTATE THAT TNE ABOVE IS CORRBCT AND AORHB TO COM-
PUPP086 OR EBTqBLIBXING q pEqMIT FEE ONLY.
PLY WITX ALL CITY ORDINANCEB AND BTATE LAW9 R80ULATINO
BUILDINO GON9TRUGT�ON. VALUATION �c].
81GNATURE OF PERMIT FEE $ �—//�
PERMI7TE
$��� � PLAN CHECK $ —"
AGENT � ITOTAL FEE $ o��
�
�•
� � . I 689�
COSTA MESA BUILDINCy-SAFETY DEPARTMENT
v. o. eox sn W6TA MEBA. CALIPORNIA
For Applitant fo I%ill In Complefely
TYPE OR PRINT
BUILOING /� 7
AOORE55 (.
COSTA MESA CALIFORNIA
�E�
T
i
■ ARC�'�TECT
NO. OP BIDGB.
USE OF
EXI6TING BLDG
98TBACK LINE FROM
DESCRIPTIOM OF
■ EXTERIOR WALL
�'r',i
f�b
FIRE
�\
�� FEE RECE��v��,.,,,
,�"� �I✓ APR 19196Q
r FINANCE DEPT.
APPLICATION FOrR�TF�EfA�IIEOSTA MESA
BUILDING
For Office Use Only
' RECEIPT NO. P6H�fyl��(1�
I O y.
ev 1 ow� wecarvan L orr iesv , l
COSTA MESA. CALIFORNIA
APPROVED �T%�I � DATE / ��/ � ' V
BY L/ /�— c' �
�7
ZONING
ZON6 I NO. OF � I U68 OF NEW O- �
PLANB BUILDINO �
/� �
DEBCRIMION 1• ' /IX''CLV � /� O/' V 0
A. P. NO. I —f G� G��
YARDS EVES
APPROVE� ALL !
tcer+rex ur+e er.)
]
m
3-6
�� (/Q�//.1
� v
I HHqHBY ACKNOWlPDG2 Tf1AT 1 V6 R6AD i1118 APPLIGTION THq �MOUM BXOWN UNDEH VALUATION IB FOH TH6
AND eTATE THAT TM8 ABOV6 RPEGT AND AORHE TO COM- pUliP08E OF HBTABLIBHING • PBHMIT PEE ONLY.
PLY WITH ALL CITY OR�IN D BTATB LAW9 REOULAT NO
9u�Lo1Na coNairtucilOn NA ATION
SIGNATURE OF � ' PERMIT FEE $ �—�
PERMITTE / �{� �U a
$,1 / // /� PLAN CHEGK S —_
V l/V F
AUTHORIZED AGENT � Q
TOTAL FEE LL
%. 19331
� COSTA MESA BUILDING-SAFETY DEPARTMENT
_• P.O. BOX 8�7 C08TA MHBA, GALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING P�/� / 1 /g� Cy(
AODRESS �� �7 �V VA
COSTP. MESA, CALIFORNIA
� STATE
■ USE
7.. I NO; OF BLDOB.
FROM ��
;eei � � RW4R YARD
LEFT ' ' I RIGHT '
DESCRIPTION OF WORK
'BUILDIN6 �_. NO.OP �_
SIZE ' ROOMS 8T0
EXTERIOR WALL \.. ROOF �'"
� xexear �crcnow�eoos rxwr 1 XAVB qBAO TX18 APPL�CATION
AND 9TATE TXAT THE ABOVE 19 COHNBCT AND AOREE TO COM-
PLY WITH hL� CITY OAOINANCHB AND YTATH LAWB'N80ULATINO
BUILOINO CONBTRUCT�ON.
61GNATUREOF � I%� �
PERMITTEF �
AUTHORIZED A6ENT . �
�E� ��fl12�!id �R�
FINN1!CE DEPT.
APPLICATION OR PERMIT,
BUILDINa�� vr �OSTA MESA
For Offlca Usa Only
116C61PT rv0. PEqMIT NO.
.-�y�' �i� ��.
ZONING
NO. OP U86 OP N6W �`,'YahG
PLANO � BU�LOINO
PoY 4� 8a.� /'/�''`'`� �
/%/o — /60 _ a7
AVE OV ERHAN6 6HALL BE L688 THAN
EAVEB
ALLOWED '
VARO9APPROVED
MAIN BUILDIN6
VAR. �
YARD9 AP
ACCESSORY
DAT.6
1:[:
N
$G. FT, m
THE AMOUNT BXOWN UNDER VALUATION 19 FOR THH i
PUHP08H OF 88TA9LIBXINO A PERMIT FEE ONLY. �
VALUATION / �j � m
� PERMIT FEE ��� �
y � � m
s�c.e��� nc 6 s
Ii.� LL
�
�� 20441
�w° .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. 9�X Sl] C08TA MCBA� CALIFORNIA
For Appllcanf to Fill In Completely
' TYPE OR PRINT
eu��oiNo y' -
ADDRE68 �
GOSTA MESA. CALIFORNIA
n9 �• 1 �
6TATE
LIC. NO.
SIZE
OF LOT
USE OF
EXISTIN6 BLDa.
BET�ACK LIX[ IROM
■ EXTERtOR
I� Heaeev �
AND BT�TE
PLY WITH
BUILOINO C
�� AUTHORIZBD AGiNT
��
TEL.
NO.
TEL. R
��
�
NO. OI
OF WORK
THAT I XAVB
�VH �6 COppl
FEE RE�IVEU
eus •� a
APPLICATION FOR PERMIT
FINAN��u6frf�.
CIT'f°O��fMiilE�'�'
RHCEIK NO. PI
'- (N " ' ZONING M
ZO[� / I NO. OI UB6OI N[W U+ thy IiYt l �
•�� PIANO O pU1LO�N0 / �
6 ' ��� �
LHOAL �OY J �L�Q�' �� T�
O� OeBC1111T10N ����
/ / �
' A. P. NO. //(O — I!G O � C� �
NOTE: NO EAVH OV6RHAN6 SHALL BE LE35 THAN O.
3 90'TOSID6QXEARP.L.
EAVE8 ��
Doe. ALLOW6D (U.B.C:REOUIREMENT)
GS
YARD9 APPROVED YARDS APPROV6D
.. MAIN BUILDINO AGCESSORY BUILDING I
1 FROM GL STRHGT) � ��
l
FRONT FT. FT.
VAR. �i
DATE
��
LIC TION �N8 AMOUNT 6NOWN UNDEH VAWATION 19 POR TH8
TO OM- PURP096 Op 66TABL�6M�N0 A PEqMIT FEE ONLY.
u �No yALUATION
PERMIT FEE $ � �—
s yl��-- � � _'—
3 --
TOTAL FEE $
� � 24677
� COSTA MESA BURDING-SAFETY DEPARiMENf
P.O. BOX 7Z00 COSTA MESA� CALIF0�7NIA 9202!
Por AppI1mM fo FIII In ComplNdy
TYP@ OR PRINT
8fAT6
LIC. NO
srze
OF LOT
USH OR
COSTA MESA. CALIFORNIA
f
wo. a� e�oo�.
DESCRIPTION OF WORK
WALL ��AI NOf
eo�
ILQINY AND WORK TO
1 MBRCeY ACKNOWL[DO[ TXAT.1 MAV[ RYD TNII AP!
I1ND 6TI1T6 THAT TN� AlOY[,19 CORR[R ANO AORH[
PLY WITX ALL CITY ORDIlU1NCf! ApD RAT{ GW� Ilil
BUILDINOCONBiRUCT
8I6NATURlOP � �,
P8RMI7T8
AUTHORIZ[D AO[N7
CITY OF C�;�STA MESA
SEP 3 1965�
w
uaw�ce�cn�rtion
A.P.NO�///n
NOTH: NOlAVCOVHR
7/0' TO HID6 e RBAH F
EAVEB
ALLOWHD
YANDf MPROVlD
MAIN BUILDINO
ZONING �
� us�orncw
sun.c�n �
Q� O d3-�nnc nn.'}- �
1���
HANOBHALLG6Ld88TNAN `
.L
(U.B.C.REQUIR6M6M) �
YARDB APPROVHD _\
ACC6H80RY BUILDINO Y
_ �u. �A =�
, �3 ,�, 6
s ���� �
2 70 „ -
VM. �G
DAT6
_ z-6�
' a
w
�
eC. rr. �
TI� IIMOYM /HOWN UN06fl VALUATION IB POH TH6 �
ryRPO![ 01 �DiAGYlXINO A P6PMIT PHH ONLY.
VALUATION 00 ' � o O �
PBRMITF86
� oo €
�' � TOTKLPEE I V w �
. � 26341
C05fk MESA BUILDINGSAFFIY DEPARTMEPlr
• P.O. BOX 7200 COgTA MESA� CALIFORNIA 02lM
For App11rnM'fo FUI In Complehly
TYp6 OR PRINT
COSTA MF.'SA. CALIFORNIA
�/ / e�a
n�ii�»�Ia IdPfst �dV/.�
euiu
a � / ADDR
y PIRt
'.t(d /Y .i• C�-�% 22 ZOn6
MPRI
T� er
IR NO.
m
iR ✓ �
LaoAL
BTATH
LIC. NO.
6IZ8
OF LOT
L'SH OP
EXISTINO BL
BBTBACK LIN6
no. or e�ow.
DESCRIPTION OR WORK
WALL
�6 riPrr�h � �s�
1 NRN6GY ACNNOWLHD06 TNAT.1 MAVB 11tAD TMI� M�YGTON
ANo BTAT6 TNAT iMt 1100YF 10 COqq[GT ANO AOMB[ YO CAY.
PLY WITN �lL CITY OrtDINAN�v MD CTAT[ tAW� RiOYLATINO
sU�LO1N0 CONHTRURIOM.
816NATURlOP � �
PeRM1TT6
AUTMORIZ6D AOINT
NOV-3-66 00 159 ��*�'*�'3.00
A►PLICATION FOR PERMR
BUILDING
%01 �IIY UH OIIIy
ZONIN(i
BHALL 8H LC68 TNAN
YARDEAPPROVlD I YARO9 APPROVHD
MAIN BUILOINO ACCH880RY BUILDINO
tOMC/ RRH[f)
,.,, � r�. L /O'. � .'
vwn. #
DATB
�y DATi �U b
a
m
�
�. �. �
'�� �YOYNT �XOWN UNOCIi VALUATION 19 �OR TNQ �
PIIRPoB[ O► ifTAGIJENIXO A P6RMIT /8f ONLY. �
VALUATION - � � 7
� PBRMIT PH6 �
s /�D � w
TOTAtPEE ��_
. - � 28278
COSTK MESA BUILDING-SAFETY DEPARTMENT
• P.O. BOX 1200 COSTA MEBA� CALIFORNIA 92020
For AppOmM ro Ftll In Compfetoly
TYPE OR PRINT
oR� �y9 i-�/ /�� J' t
CO3TA MESA. CALIFORNIA
wHeR � f! /J ✓S �O
o a.., S�y 9�/��-1- .I' f
�— ,-
NO.
rnor
DESCRIPTION OF
BUILDINO
size
HXTERIOR W�� r
PLY WITX wt� c�n
euaomoconsrnu c
H16NATUR6 OP
PBRMITTH
AUTNORIZqD AO[NL
�
0
�—s-�oo o�,• *�►**z�.00
ArPLICATION FOR PERMfT
BUILDING
for OHIc� U» Only
�.�.�n �o. .,
ZONING
MO.OI U�60IN[W
ruw ? euao�ng ..
uow�
A.P.NO. //Ci' "/(n //'— J
N0T8: NO BAVR OVBRHANO BNALL D8 L68H TMAN
YARDi MPROVlD
MAIN BUILDINO
VM. JF
YARDBAPPROVBD
AGCHBSORY BUILDINO
eer.
wcce
DATB
WfaR111� (f ii
�
✓ G A // �
8C. R. �
1D TNI� �l�LIGTON TMQ AYOIINT �MOWt� UND6fl VALYATON I! POR TNH �
AHO AOR6[ YO COY. N MOoi O► itTAlLIGMINO A P6AYIT P6H ONLY.
ra uws w�ouunxo ��� iaN � ]
v� /J �U PBRMIT PH8 �: ` �p
✓ //� G
s��� (1/ � � w
O�
TOTAL RH6
APR —9-69cMSA00 429 ��****5.00
.-:..:,� 29959
COS7A MESA BUILDING-SAFETY DEPARTMENT
P.O, BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PEpMIT
For Applicant to Fill in Comp/ete/y
/i REGEIV D V DATE RECEIVED OA''7TEQIS/S�UED
ADDRE55 V ��� �� � ��' ��� :X./7�
OWNER g� C � �r��l�D�O7 PERMIT � .
A.P. NO.
ADORE55 �/'j.L Q ADI RIE S� ��l�� �i
z . $os
� U TEL.
CITV � (� � NO. TRA T A� LOT BLOCK
Z
CONSTRUC7'ION , � `Q W P
'O N LENDEF t
,a m
J � BRANCN ' �
J N OWNER
� ADDRESS V L E W� � '
ARCHIT6CT TEL. S 3 • D'
J N OR ENGINEER
V Q FIRE �� -� O
w� AD�FESS ZONE TVPE GROUP f�
�' W APPROVED - ` \
J O CONTRACTOR p� /� S � pL /LQ BY DATE �(��
mZ �y ',1 V
J� ADDRESS � �(_ a f�L[_/�Ji( �{�/ pl.
w w TEL. '/` ZO E NO.OF USE OF NEW
Z� CITY g �p�, Q p� N0.61�-(�(,�� � P�� BUILDING �j
.��'
w� STATE CITV YAROSAPPRpVED VARDSAPPqOVED
j O LIC. NO. LIC. NO. MAIN BUILOING ACCESSORV BUILOING � •
SIZE NO.OF B�DGS. (FFOM GLSTREET) �
OF LOT NOW ON LOT ROM FT. FT.
VSE OF
EXISTING BLDG. FT
. F� SIZE OF NO. OF
Z NEWBLOG. AOOMS STORIES � L.SIDE FT. FT.
U EXTERIOPwP.LL ROOF
COVERING �—��� COVERING -�� REAR FT. FT.
US `F 9UILDING A D WORK TO BE PERFORMED DISTANCE ET. BEf. MAIN &
I/ G' V � Y' i`L �'L- 7 MAIN BL ACCESS. BLDGS.
t� �( VAR.qW DATE
O �� ot �L e TJ K �/�/ �.V.P.� qPPROVED
� �' APPROVED
N a '
Z
O
� F
V I hereby acknowletlBe tnat 1 hava reatl this applicetion antl ztate .
� � t�at Ne ebove intormation is wrrect antl aBree m comply wiffi
� e71 lews reBulntln8 buildMB <onstruction, antl 1 shell not amploy
F„ eny peran� in vloletlon of the workmen's compensetlon lawa of
y 2ha State ot Celilornlo, m
b
ZI hereby cerH(y Not I am properly liconsetl aa a controcror untler SQ. FT. o
tha State ot Californio Businesa antl Professions Cotla, Divislon 3, THE AMOUNT SHOWN UNDER VAIUATION IS FOR �
Chepxer 9, antl that cuch Ilcansas ara in tull torce entl afiaet, Or I TNE PURP�E OF ESTABLISHING A PERMIT FEE ONLV: m
em exampt Irom tho provlsiOns Oi [ha Stata ol CelHornle Business � �
VALUATION
entl ProfesslOna Cotle, Divislon 3, Chapter 9. r
PERMR FEE 5 ]
SiB�etvra ot � m
Petmfttee ,� � / � S�� �""'- PL4N CHECK $ �� E
�� `o
AvthorizOtl ABent LL
TOTAL FEE $
J
. ,396 � 8
COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
Far Applicant to Fill in Completely
BUILDING J /�y �N ST
ApOflESS �
OWNER
MAIL !//_ �
x ADDRESS �r�e�
a U Gri 5
Z
COPiSTRUGTION /
� N LENDER /�
am
� � BRANCH
JN
a �� ADDRESS
m
J Q AFCHITECT
N OR ENGINEER
VQ
w� ADDRESS
p, W
CONTRACTOR
m Z
J � ADDRESS —
W W
z F cirv
r 0 STATE
y � LIC. NO.
� � SIZE
OF l0T
USE OF /A'n
EXISTING BLDG. / I 1 i
TEL.
NO.
CITV
LIC. NO.
NO. OF BLOGS
NOW ON LOT
BUILDING
ADDRESS
FIRE
ZONE
APPflOV E D
V
PAI� — �Yi:�rir
=F81$-75�,�:•�0 446�.: 3�.5�
N fOR BUILDING PERMIT
DATE RECEIVED nerc �ceiu
F SIZE OF NO. OF
Z NEW BLDG. ROOMS STORIES L.51 T
U E%TERIOF WALL ROOF
COVE ING COVERING REAR FT.
J USE BUI G AN O E P ED DISTANCE 6Ef.
� MAIN BLDGS.
C �
Q VAR.�
O C.U.V.qp
F � PPPHOVED
N
Z
O
UI �eraby eeknowlatlpo thet I have reatl tn(a oppllcallo� enC �mte
� that tha abova InformpUon b corract entl eprea to eomply wIM
� ell lews rapulatinp builtlinp conftructlon, entl I ahall noi employ
� eny person in violation of Ma workman's compansaNan laws of
y Me State o� Celtlo�nte.
? I hareby eenify thet 1 em proPerly IlcanaeG ea e eonttactor unEer S�. FT.
cM Stero Of Celifomla Budnen end Profeulom Co Divlaicn 3, THE AMOUNT Si
Chapter 9, entl t�at sueh Iic nre In tull toree n effoet, or I lliE PURPQSE Of
am exempt irom Ma p�ovi a a Stata of C 7f nle Bualnen VALUATION
e�tl Protacilons iv Io 3 CM 9. �
Sipnat�ra of
Permlttea $ ��O
Authorizad Apeni
VALVE �V'
'T� 'Z. S L�
TV E ROUP � �
% DATE „� � \
USE OF . �
BUILO
D VARDS APGROVED �j,(
ACCESSORV BUILDINO `t,j
BET. MAIN &
� j ]I 1
�
, ' �
�
UNDER VAlVAT10N IS FOR
LISMING A PERMR FEE ONLV: Q
m
RMIT GEE $ �
�(�! m
4N CHECK $ � r� E
�i `o
J LL
TAL FEE $