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Home My WebLink About362 18TH ST - Building Permits� � Applicant to flll in all spaces exeeo� ihose within neavy boreer Iines ana sign al1 gns. �CIT� OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. ProjectAddress ��OZ.. E• ��d�' S�( � ��249 I I/24/87 46e33 TYPE Of CONSTRUCTION NEW ADD ALTERATION REPAIR � Applicant'SMailingAddresS ❑�ONVERSION ❑DEMOLISH ❑OTHER p,p,# ' ' Zone Owner's Name Phone��f DESCRIPTION OF WORK/USE OF BLDG. Address � in, Z �• �g��'�7 S Main Building: Accessory Building: ' Arch/Eng: License No. TVPE OF PERMIT GRADING �OurvDATION STRUCTURAI T Front � Address ❑ OTHERT ❑ ELECTRICAL LUMBING ECHANICAL A Rear N Convacror's Nam �� Phone pqp,�ECT DESCRIPTION Sq. F oCCUParvCV — C Right � N Addre55�mailing) CONSTRUGTIONTYPE�/. VALUATION$ �%Lii�� g Left G City Lir.ense No. ' ZONE GRADING CU. VDS. ACRES R LICENSED CONTRACTOR OECLARATION � 71ng. Ref. # Parking Req./Provided " E I hereby anirm tnat I am Ii�ensetl untler provisions ot Chartcr 9(commencln9 Remarkr. i ,� C�� Planning Notes: - M wi[h 5ection 7000) OI DlviSion 3 oi tne Business antl ProtesslOns Cotle, antl my license is In full force antl eHect, , T License Class License No. S Date Signature " PLUMBING FEES ' WORKERS' COMPENSATIDN DECLARATION BarSink Showe�s � I hereby atfirm that I have a certificate of consent to selt-inzure or a certincate . ELECTRICAL FEES � Workers' Compensation Insu�ance, or a Certiti¢tl CoOY tM19reof (Sectlon . 0, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transtormer ❑ 15-50 KW .�cyNo. Company Backflowlrrigation SewerCap ConstructionPoleSub. �SO+KW Certitietl copy is hereby furnishetl. Certlfietl copy is filetl with the dty Building Divislon. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date APP��ant . ' EXEMPTION FROM WORKERS' COMPENSATION DE RATION Clarifiers Solar ColleCtorS DishWaSher - Meter ❑over 100amps (ThissectiOn neetl not be coTPleteO ff [ha p �mit is to� n¢ undreG (E700) or iess). Dishwasher Solar Piping Dryers �Gas ❑Electric Sub Panel � I certlfy that in the perforrt�ance of tne for i is p H is issuetl, I . snall not employ any person in an nn as eco subject to the Drinking Fountains Solar ank Fan � Workers' C epsallon Laws of Califo la. Motor 0-1 HP �1 %- 8 � �ate ��K�1 yignature _ Floor DrainS .� S ming Pool w/Spa p q U - . NOTICE: If, after making tr�s tleclara on, you sho Itl become subject to the _ . Sola� �9-15 HP �16-15+ Wotke6' Compensation p10�islon5 ot tlle Labol Co�e, y0u mu5t /orthwith FIOOI SinkS �i081 Fixtu�25 MiclOwavC comply wilh Such provi5ions or thi5 pe�mi� shall be tleoTetl �evoketl. CONSTRUGTION LENDING AGENCV ' GaSSerViCe � Outlets WaterCloset DeviceBoxes � I hereby affirm that Ihere is a conSlruCtion Ientling a9ency focthe Pe�fo�manca P�IC Llght o! [h¢ work for which this perml[ is I55uetl (SeC[ion 309] CW; CJ Int¢rC¢ptOrS Water H¢et¢f �� Outl¢t5 Lentler's Name Range �entler's Atltlress - � Kitchen Sink Water Service - ' Switche5 Sign . � OWNER BUILDEH OECLARATION I hereby aHlrm that 1 am axempt irom the Conlractor's License �aw for the Lavatories Auto-Wash �� Garbage Disposal Standing Sections tollowing reason (Section 7031.5 Business antl Professional Code: Any city or county which requires a permit to const�uct, alter, improve, tleTolish Or ropal� P—T�2p Laund� T�3 5 - any structure, prior to its issuance, also requires the applicant for such pormit Y � Generator �0-5 KW �5-15 KW Trash Compactor to file a si9netl statemenl that he/she is licensetl pursuant to tne provisions oi Roof Drains � � the Con[racto�'s LiCenSC Ld'�' (Cnapte� 9(commentin9 with 5¢ctlon ]000) of Division 3 ot tne Business antl Professions Cotle) or that he/she is exemp[ [nerefrom anE lhe basis for ibe allegetl exemption. Any violallon of SecHon , , �. 5 by any appllcant tor a permit subjeG[s Ihe aOP��cJnl to a Civll Ity of no[ more Ihan fi�e huntlretl tlollars-($500). . . i, as owner o( [ho prOPErty or nty employe05 with waqo5 as thei� sole ReinSpeCtiOn FBe $15 Issue Fee $ 3 '' compensatlon, will tlo the �+ork, antl the structuro Is not In[entletl or otferetl Reins ection Fee $ 3 for sale (Section �044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES P $�5 Issue Fee License Ww tloez not avo�Y �o an owner of a property who builtls or improves tnereon, antl who tloes suth work himself/herseli or throu9h nis or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provitletl that sucn �murovements are not Intentletl or otferetl tor Boiler Hootl or Type I ❑ sale. It, however, lhe bulltling or improvement I5 soltl within one y¢ar Of cOm- C2nOpy Typ2 II ❑ . ZOning AppIOV@d By Ddt¢ � pletion, the owne� will have the bu�tlan of proving h¢/5he tlitl not bulltl o� Im- DUct - Und¢� G�OuOd ' prova tor the purpose of sale). Building Approved By�1 � Date ❑ I, as ownel of Ihe propCrty, am exUusivery contlacting wltM1 licensetl con- OUct -$LluCtuf81 R¢ili9¢fatiOn $y5t¢R� AppliWtioO ISSIIBd By b /�- tlactolst0 con5truc[ tbe pr0lect (5eclion 7044, BUSinGss antl PrOfession5 CoOe: I��'�Ddtfl �� Z4� The Contractor's License I-aw does not apply to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FE 5 builtls or Improves thereah, antl who conVactS br sucn projeGls with a con- - tractor(s iicense pursuant to the Contracior's License Law). I am aware thai Exhaust System ❑ MWti I SVstem Repair/AI[eration BUILDING PERMIT $ Z� ��Z7 SMIP $ �� p�ryo ( o�their Worker's Compensa'on insurance s Itl be provitletl to me. PLANCHECK $ �.S•33 PERMIT M 1 am exempt untler 5ection .& . C. tor th{s reason FirepllFact. Blt. IC O Fire Dampers ' PLUMBING § -�V � ISSUANCE $ Date� � pwner Heating SyStem & Ductin Registers PLAN CHECK 25% 5 �'— ENERGY P.C. $ I hereby certity that I ha�e reatl t s Iicatlon antl slate that tne above ❑0.100,000 BTU �10 ,OOOBT GRADING' $ iniormation is wr t. 1 a9ree comply with all ciry antl county ordinances ELECTRICAL $ antl stale laws r �ng [o b41tl' g c ns(ruclion, antl hereby aUthorize repre- MICROFILM $ sentatives ot t i cit � n r on the above-mentionPa property for PLAN CHECK 50% $ r� Inzpettlon pur e ,� MECHANICAL $ �'�� . TOTAL FEE $_�'�.L�� Si9nature �atu Orivers' Llcense or 55 # .� Rainspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ �� CMF OB65-46, rev. 30/B4 Wh�te - Builtling; Canary - APplicanq Pink - accountlng; Goltlonrotl - Assossor ,/ CONSTRUf.TION AND PLANNING POOL & SPA -.. � � - Date Inspector 'Date Inspector APPROVALS . Permit # APPROVALS Permit # - . 1rTemporary,Electrical.Service or Pole 52. Pool & Equipment Location ' ' � , 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement , • , � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Electrical Conduit-Undrgrnd. 55. Elec[rical Bonding - � , 5. S[eel Reinforcement �� 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.'• 57. APPROVALTO COVER-GUNITE 7. Footings �� _ 58. Electrical Conduit�Undrgrnd. ; . �8. Found�tion 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd.�' . 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 67. APPROVAL TO DECK ' i t. 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 EI ctriral-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 ❑Oil� 23. Gas Pipe-Rough & Test 72. Underground Flush � � - 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil - 25. Roof Sheathing 74. Overhead Hydrb • . ,_ � 26. T-Bar Ceiling �Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing �� . 76. Dry Standpipe � 28. Lathing & Siding ""' 77. FIXED SYSTEM FINAL i : 29. Insulation 78. FIRE PREV. FINAL � • 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat � "' 79. FINAL INSPECTION '". 32. Electrical�Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' � 33. Final Electric Notes: � �. � � ., - 34. Final Heating & Air Condltioning � ' 35. Final Gas Pipe-Test .. �_ 36. Hood or Canopy 37. Final Factory Fireplace �� 38: Final Plumbing � ' � 39t Water $ervice-Final - . � " • , 40. Gas Service-Final , � �, 41. Solar pome'stic-Final 42. Backflow Preventer � c -, '4y�. Backflow' I�rigation 4' ' , � �,: ,-i� _ ' ..'. %44: Landscape Irrigation SYstem s � � �. , - �.� ('45. Sound Attenuation . � ' C�, � � 4fi,�Wandicap Regulations � ' ' �- ' � 47 FINALSTRUCTURE&BUILDING � ` •- '�i ,' •) 48. Special �Requirements Completed � .� � . �� ' � i 49. Electric'.Release to Edison ' , � 50. Gas Release to Southern California Gas Co � � 51. CERTIFICA�E OF OCCUPANCY � ;. No. ' Date ' ' ' \ - . . . . -'.. � a 4• AVG��ant to ti11 in ali svaces exceo� tnose witnin neavy Eoreer lines anG sign ail approo�iate aeclantlons. CITV Q,F COSTA S CONSTRUC��ON PERMIT PERMIT NO. _ TRACT NO., S,QT NO. UNIT NO. Project Addreas �� - �-- ` �� -� s -i�, �- 2�— ' Applicant"s Maili Address ) Owner'sN�e��- /�- Phon�7J Address � �-�� ,�./� !� Arch/Eng. _�.a—•�1.-�L� I�rc,,,co Nn. G Z�� na��e,s � �V pA /��,,,Paca- cei:fi�'ri ,,k Zu6 �v �3? Contractor's Nam�C—� 1�-L�• CK�'JL/�1C ldQ7 phone�]-�Y 7 Addresslmailing) �1 �'�� S�/"�� City License No. �-�'i7, � LICENSED CONTRNGTOR DECLARATION 1 hereby afti�m that I am �icensetl unUe� provi5lon5 of Charter 9(commencing with section 7000) ot �Ivislon 3 of the Business antl Professions Cotle, antl my Iicense is ip.lJull t rce antl effect. a�/ Lice e Class - ense Nd O��^ Date " � � 5'g [ WORKERS' COMVENSATION DECLARATION I hereby aftirm tnat 1 have a certiticate of consent to self-insure or a certificate ' Wo�ker5' CompenSatiOn Insurante, o� a certi(' tl copy ther¢Of ($ection D0, Lab. C ' � � oucv No. �� 6�� comPanv � %uNi% Ce fietl copy is �ereby furnishetl. ' - ert fletl� y i etl with the city Buil� D�sppi � Date APPlicant Fl ��_� EXEM TION FROM WORKERS' COMPENSATION DECLARATION (Tnis section neetl not be completeA if the permit is for one huntlretl (5300) or lezz). I certily that in the verformance of the work for which thls permR is issuetl, I sltall not employ any pQrson in any manner so az to Decome subject to the Workers' Compensation �aw5 ot California. Date Signature � NOTICE: If, after making this tleclaratlon, you snoultl become subject to the Wo�kers'- Comp¢n5ation provisions of the Labo� Cotle,'you mu5t �ortM1with" comply with such proVizions or tltis pe�mit shall be tleeme0 �evoketl. CONSTRUCTION LEN6ING AGENCV I hereby aftirm that lhGre I5 a conztructlon 1¢ntling agency tor the perto�mance of lne work �for whiCh lhis permit it ISsu¢tl (Section 309] Civ. CJ Lender's Name Lentler's Atlarezz OWNER BUILOEH �EGLARATION � 1 hereby aftirm that 1 arn exempt from the Contractor's Licenso Law for [ne tollowing reason (Sectlon 7031.5 Business antl Pro(essional Cotle: Any city or county which requires a p¢rmit to construct, alter, improva, tlemollsh or repair any Structure, p�lor to I[5 Issuance, alm reqW/es the appliCant fOr such pe�mit [o file a signetl Sta[emept that he/She is licensetl pu�suant to the provisions of the Con[ractor'S Licenie �aw (Cbapler 9.(commencing with 5ectlon ]000) of _ Division 3 ot the.Busiqess antl Protezsions Cotle) or that he/she is exempt �'�,�� eretrom antl the baslg for the alle9etl axemptlon. A�Y violatlon of Section 31.5 by any appllcdnt for a permit subjects tM10 applicanl lo a civil „ lalty of no[ more [naq �ive huntlretl tlollars (§500). ' y.'1 I, a5 owne� of the property or my employ¢es with wage5 as Ih¢i� sole compensa[ion, will Oo,the work, antl the sVucture is not IntenCetl or offeretl for sale (Section �044, Business ana Proteszional Cotle: The Contrac[or's License Law tloes not apply to an owner ot a propertY who builtls or improves lhereon, antl wlto tloes Such work himself/herself o/ tM1�Ough hi5 0� her own employees, provitletl that such improvements are not intentletl or offered for sale. If, howaver, the bp�ltling or improvement Is soltl within one year ot com- ', oletion, tne �owner wlll have tne burtlen o/ proving he/sne tlitl not builtl or im- prove tor the purpose ot sale). ' ❑ I, as owner o( the property, am excWsively conVacting with Iicensetl con- ttatt0/s t0 construct the project (Settion 7044, Bu5ine55 antl Proles5ions Cotle: The Contractor'S Litenxe law does not apply lo an owner of pro0erty who builas or improves thareon, antl who conVatts tor such projects with a con- tractor(s) IIC2lISC plllSlldOl LO LI1C COfILldCiOl'S L�CEOSC LdW). I dRl dWdlE ihdt proof of iheir worke.'s CompensaHon insurance shoula be provltletl to me. '❑ I am exempt untler $¢ction B. & P. C. fOr this reason Date Owner - 1 hereby certifY �hat I nave reatl 1 info/mation is correCL I a9ree to co antl state Iawz relatlng to builtlin9 � sentatives ot tnis cit � e ter Inzaec[ian Purpoi¢5. Signature Drivers' Licenze o� 55 q}- a oa�e -, v-y] � �y� � � TYPE OF CDNSTRUCTION NE ADD ALTERATION REPAfR ❑ CONVERSION ❑ DEMOLISH ❑ OTI�E$ T,T_�. TVPE OF PERMIT LJ GRADING LJ FOVNDATION LJ STRUGTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJEC7 DESCRIVTION 50. FT. OCCUaaptF„„ CONSTRVCTIONTVPE •VAWATION$.�� f�GF LL ZONE GRADINGCU.VDS. ACRES__ Remarks; Preventer Irrigation Clarifiers � Dishv.rasher Drinking Fountains Floor Orains Floor Sinks ' ' " Gas Service Outlets Kitchen Sink Lavatories Roof Drains ShoWers. ' Service Sink Sewer Cap Sewer Connection Solar Collectors SOlar Piping Solar Tank Swimming Pool w/Spa Urinal •Water Closet Water Heater � Water Service Auto-Wash Laundry Trayf Reinspection Fee � $15 I I Issue Fee I $ 3 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust Sys[em ❑ Multiple Firepl/Fact Blc ICBO •# Heating System & Ducting ❑ a i oo,000 sru O i oo,000 Reinspeaion'Fee � $15 CMF OB65-46, rev. 10/84 White - Builtling: Canary - Applicant; Pink - Acmuniing; Goltlenrotl - Assessor Hood or , Type I ❑ Canopy Typell � Re(rigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers . � ' Issue Fee u A.P. # S Main Buildi E T Front B Rear A C Right' K Left S Ping. Ref. # Planning Notes: � 0 Automatic Washer Construction PoleSub. Cooking Unit Dishwasher - � Fan ' F.A.U. Fixtures Device Boxes OuUels Switches Garbage Disposal Generamr �0�5 KW =EiS _/' � / _ � � _ _ ' Zone Accessory Building: � Z O , N I N G R arking Req./Provided ' E Q M T 5 ELECTRICAL Transfo�mer, � 15-50 KW , ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Motars OO-1 HP O1'f.`- 6 Inc.Solar �9-15 HP �16-15+ Microwave � Pole Light Range FEES Standing Sections 5-15 KW Trash Compactor . '' Reinspection Fee $15 Issue Fee - -$ 3 FEES DEVELOPMENT SERVICES REQUIREMENTS:r^' ' `/�� ny� / ZoningApprovetl8y � "�/ �"� DateSJ�� 8� Building Approved 6y Date r�. L.�`�. Application laued By ' Dat � � �� 7T _ SUMMMM/ /A�RVDOuFFEES � BUILDING PERMIT S � SMIP $ PLAN CHECK $ �O • Y'U pERMIT � PLUMBING $ ISSUANCE $ PLAN CHECK 25% $' ENERGV P.C. $ � - ELECTRICAL g GRADING . $' � PLAN CHECK 50°6 $ MICROFILM 5 � MECHANICAL S TOTALFEE $ ��•�� $ 3 PLAN CHECK 25% $ ' CONSTRUCTIQN AND PLANNING , � POOL & SPA APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector t. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' � I 2. Soil Pipe-Undrgrnd. i 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Electrical Conduit-Undrgrnd.. 55. Electrical Bonding 5. Steel Reinforcemen[ ; • � 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Gmd. �i . . 57. APPROVAL TO COVER-GUNITE 7. Footings � 58. Electrical Conduit-Undrgrnd. 8. Foundation � ' � 59. Gas Pipe, O Undrgrnd., Test . ' 9. Water Pipe-Untlrgrnd. i 60. Backwash Lines, P-Trap, � Undrgrnd. � 10. Structural Floor System � 61. APPROVAL TO DECK � ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final I � 12. Sewer Cap � 63. Heater & Vent-Final ' 13. Roof Dreins . ' 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 O Gas �❑ Oil /' � 23. Gas Pipe-Rough & Test � 72. Underground Flush ,� 24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil . � 25. Roof Sheathing � 74. Overhead Hydro � I 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 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown �pat 79. FINAL INSPECTION �� 32. Electrical Power Meter-Final 80.� FOOD CERTIFICATE ISSUED - 33. Final Electric .. Notes: . " 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test , � �- 36...Hood or Canopy . , � 37.'Final Factory Fireplace _ ' • 38"FinalPlumbing �� . � 39. Wa[er Service-Final � ' � � �� 40. Gas Service-Final , . � - 41. Solar pomestic-Final' � ' "' 42. BackflowPreventer ; • .�' ;� �. " .r; -43. Backflow Irrigation � - � � :, •�� ' �44'• Landscape Irrigation System ' , ' ' � � � .45y�Sound Attenuation� � � ,• i i� ' 'fj. .46..Handicap Regulations � '� � •' � �'. 47. FINAL STRUCTURE & BUILDING 8' . ' , .' _: . . 48. Special Requirements Completed ' ' - � - �� • 49. Electric Release to Edison � ,' ' ' � ` � ^� r. . 50. Gas Release to Southem California Gas Co � � - - . w � 51. CERTIFICATE OF OCCUPANCY � • No _ Date - ' , Z a U Za � N am J � J N Q W 0] J • ¢I J Q U N Za W � aw J Q m Z J � W yA O= Z F W � (n Q 70 �0801 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 SEA 25-6�°00 776 7.00 CPSA � ***** APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REC�D DATE REC�ENED DATE ISSUED BUILDING � �'L7 �.� _7.0 ADDRESS �� _ /� ' �� PERMIT NO. OWNER '� � r A.P. NO. d— MAIL AD'DRIE S�� GI� ��/ ADDfiE55 � � i TEL. 7RACT LOT � G BLOCK CITY NO.� CAN5TFVCTION P IENDER ` 1 BRANCH / • OWNER ADDRE55 VALUE AFCHITECT TEL. $ ORENGINEER FIFE ADDRESS ZONE TVPE GROUP APPROVED /�// Cj 2 _� � CONTRACTOR � yt BV // DATE/ d � ADDRESS � TEL. Z NE NO.OF USE OF NEW CITV NO. P�� BUILDING STATE CITV �'ARDSAPPROVED VARDSAPPROVED ` IIC.NO. LIC.NO. MAINBUILDING ACCESSORVBUILDING 512E NO.OFBLDGS. (FROMGLSTREET) OF LOT 7j � S�• U NOW ON lOT RONT FT. FT. I � USE OF (( 1 � EXI5TING BLOG. T. FT SIZE OF NO.OF NEW BLDG. ROOMS `— STO(iIES l. SIDE FT. EXTERIOR WAL ROOF COVERING �CO COVERING REAR T. � FT. USE OF BUIIDING AND WOFK TO BE PERFORMED DISTANCE BET. BET. MAIN& MAIN BLOGS. ACCESS. BLDGS. e . 1 ` VAR..itr DATE T ! C.U.P.�W APPROVED APPROVED 6 9 I he�eby acknowlatlge that I have reatl Shis application entl state thet tha above information is cor�act antl ap�ae to comply with ell laws ragulating builtling conscruction, antl I shall nat employ eny Derson in violation ot the workman's compensatlOn laws of m the State ot Celifornia. � I hereby certify ffiat I am properly licensed as e contrecror untler SQ. FT. � o tha Stete of California Businesa and Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VA�UATION IS FOR � Chepter 9, antl thet such licenses are in full torce and etfect, or I THE FURPOSE OF ESiABLISHING A PERMIT FEE ONLV: Q am ezempt from the provisions ot the Stata ot Calitornia Business VALUATION m antl Professions Cotla, Divislon 3, Chapter 9. PERMIT FEE 5 � �� 66 � SI nature of �� ( � E Parmittee .��7,�� 5 � �e/ PLAN CHECK $ `a Authorized Ageni LL TOTAI FEE $ � O_O