HomeMy WebLinkAbout1904 CHURCH ST - Building Permits CITY OF COSTA MESA
BUILDING DIVISION
,..v,,,rr �. DEVELOPMENT SERVICES DEPARTMENT PE T NUMBER
4. !�
� PERMIT
, ,,e E06-01142
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesasa.us .77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1904 CHURCH ST , •, ' Status: ISSUED
Suite No Applied: 10/11/2006
Vicinity: Issued: 10/11/2006
Parcel Nunmber: 42626301
Applicant: DONALD SAENZ `' -� ..
Address: 5722 BELGRAVE AVE ' - • ISSUED BY:
Phone: 714-244-8980 .
GARDEN GROVE,CA Zip 92845 •
Owner: WARD,.CAREY D.T. .
Address 20100'BROOKHURST ST
Phone: - . .
.
HUNTINGTON BEACH,CA Zip: 92646-4938:- ,
Contractor: DONALD SAENZ
Address: 5722 BELGRAVE AVE ,
•
Phone:"714-244-8980
. GARDEN GROVE,CA Zip: 92845
. License:374652
SCOPE OF PERMIT
INSTALL 1-200 AMP SUBPANEL AND 2 NEW METERS.TO SERICE BOTH 1904 CHURCH ST AND 126
E 19TH ST.SAME LOT WITH TWO DWELLINGS
FEE SUMMARY •
Quantity ,- - - - - Quantity
ISSUE FEE $23.50 _ Temp Dist System/Lighting $0.00 0
•
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section --- $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 / '0' ' Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 ---0 - _ _ up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 ,.. 0 - up to 50 kva/kw $0.00 0 '
Recept Outlets - $0.00 0 up to'100 kva/kw $0.00 . 0
Switches $0.00 0 " ' over 100 kva/kw $0.00 0
Non Res Appl . •. $0.00 , 0 Low Voltage Equipment •$0.00 0 -
Res Appl . $0.00 0 Low Volt Wiring System/Ckt $0.00 .'0 .
Service to 200a $61.00 2 ', -,• Misc.Conduit $0.00 0 •
Service to 1000a $0.00 0 Misc.Conductor $0.00 0 '
Service'over 1000a . > '$0.00 0 a ,-/ •- Circus(gen'or.ride) $0.00- 0
Motors to 1 hp • $0.00 0 Circus(mech ride or lights) - $0.00 0
Motors to 10hp.. '$0.00 t:- : 0 .Christmas Tree Stand • - $0.00 0 •
Motors to 50hp , $0.00' , 0 :Fireworks Stand $0.00 0
Motors to 100hp " '$0.00 0 - Other Electrical Fee -$0.00� ' _
Motors over 100hp-�\ $0.00 -. - 0. - - ,�'
Communication drops .$6.-00',:, -0 .- " ' -Investigation Fee. $0 00- ,.l- � / .
Sub panel to 200a Ay $30:50 " , 1 .-- _ ,Plan Check Fee " - $0-00 -
Pole Light Pkg $0.00 . ' • '0- Reinspection Fee • • . $0.00
Sign Circuits $0.00'• 0
Temp Pwr Pole $0.00 ', '0 , • - 'TOTAL CALCULATED FEES $115.00
Intermed Pole '$0.00 0 .
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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 void 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 this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(6/00)
DECLARATIONS )
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier Policy Number:
(Re action need not be completed if the permit is valued a1 one hundred dollars($100)or less.)
❑ hat in the performance of the •. for which this permit Is issued,I shall not employ any person In any manner so as to become subject to the workers'
ation laws of Gafford:,a: :e that if I should become subject to the workers'compensatgDpggqprovisions of Section 3700 of the Labor Code,I shall forthwith
.. th these Provisions /_--�
•... .:nt Signature: ` De1A: `/_p{// � 11 Yl
WARNING:FAILURE TO SECURE WORKERS'•• SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(4100,000),IN ADDITION T•f''E(oct OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SEC1 ON3706 OF THE LABOR COOE,INTEREST,AND ATTORNEY'S FEES.
LICEN -: • -ACTORS DECLARATION: -
' I h. eby affI r I am licensed . d:/•rovisio • Chapter 9(commencing with Section 7000)of islon 3 of the But
sions Code,and my license is in full
to
.. A���_ •
Date: „•
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sate(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I em exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑Yes El No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Masa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,Or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materiels equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No IIIf
(Section 25534 of the Calitomla Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 It an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aggermit for such construction or modification.
from the South Coast Air Quality Management District or from any other air pollution control district or agency'? LI Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 end 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which is the subject of thl
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinan
regarding Hazardous Materials and Emissions.
Signature: Date:
•
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information giver
correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the Cl f Costa Mesa to enter upon
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit II ' I i pact
Signature Of Legal Owner(s) \ Da
And/Or Au�lpdxed llcant C J Date/V/12•157
CODE A INSPECTION TYPE en. ltm➢ELS CQOEE QISPECTION TYPE Iflm(
1816 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical h3/-eU 3/11�
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval '
203 Final Sign 222 Final Site
204 Final Demolition - 250 Final Building/Occupancy
i
OWNER BARRETT, RAY DATE 5-5-58 —
JOB ADDRESS 19(1)1 flhnreh St.rap+. BUILDING PERMIT NO. 6690
1G'EERAL CONTRACTOR H. M. Gardner VALUE $ 13,6115.00
�.P. No:3-1 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Residence & At. Garage
GROUP I & J TYPE V ZONE Rh PLAN Na 6690
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
n �- DATE NUMBER
Trenches Forms Steel t 4- .53
Floor System ✓-' E 3
Steel Reinforce Chimney Re-Rod j4 6 y; i"Y
Bond Beam 2�/if. L, -n-se
"Frame and Flashing &-' - L 3V
Lathing, In Out ' :P' 7— ? -M-.
Plaster, brown coat
Underground soil "Vic WIG Pipe Test,gfJ s_13-z-8.- jr.. ,4 UJior 5=4-Sse /2 9'52.
"Top Out S--Co-S& �y
Furnace �cN�...._ehlifrc S9-f'Y 4074:5 , 2H-3�' (/!,',L-,..-.G-&i-a-d ,1L9. J- 8— /a- 96/
Gas Vents v
Rough Plumbing IW. /a')$59<
• Cesspool Septic Tank
Prop. Swr. Line ,.I,y)-touse Con.6 4'St. Swr. -1_201..61{
Sprinkling System
Heating Final 4 Pt../�S7 _
Plumbing Fixtures, Final n LWr Qr/1- Il'�d q
Final Gas Test t-h'& L yl/. craj. 5 - n �l a
Construction Pole '7 .r. ('egety ob... O4- (T,- 4 4,-- 4 ¢X /_ c t G/C/ 1(Y/V
Underground Power 15
°f�j
Rough Wiring L 5 1958 YI,11,13s y �/
Fixtures, Final jPj,f �'�,( "--..
=OCCUPANCY y.', R'r/ 3-1(
Form 210-5M-1.57
6690
OWNER BARRFTT; R.AYMt7ND P. DATE 3_9_59 _
JOB ADDRESS 1904 Church St, BUILDING PERMIT NO. 8789
GENERAL CONTRACTOR Owner - Builder • VALUE $ 1;200.00
3479/711:11 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Garage
GROUP J TYPE V ZONE RI! PLAN NO. . 99
INSPECTIONS DATE SUBCONTRACTOR -- PERMITS ISSUED
DATE NUMBER
Frache rm Steel
Floor Sys m
Steel Reinforce Chi. .ey Re-Rod IS '
Baud-Beam . Finiry - der 7// ./3
Frame and Flashing e 1 -- lis/,j
Lathing, In Out4 0,0
Plaster, brown coat /f' •i 11 '
Underground soil /14.15 W/G Pipe Tv(:j.{Sc_n,r-
Top Out 3'43-56/
Furnace
Gas Vents .
Rough Plumbing 7. Y -bt rq-'a- ,J 3-..c.9-_,-? / 74 0/ ---
Cesspool Septic Tank •
Prop. Swr. Line House Con. St. Swr.
Sprinkling System .
Heating Final
Plumbing Fixtures, Final A. -(.j
Final Gas Test
Construction Pole
Underground Power - Q
Rough Wiring /' ./e t 4nnc-792a,t-f4. 64-`7-r7 43.717 b''
Fixtures, Final ,r. .2.4 /
-OCCUPANCY ' -'• i \
Form 210—SM-1-Si Or - -
R7R9
OWNER WILSON, H. E. DATE 11-12-57
JOB ADDRESS 1904 Church St. BUILDING PERMIT NO. 5973
F61
, CONTRACTOR Owner—Builder VALUE $ 336.00
11 AP. i'6. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Cement Block Wan Fence_
GROUP TYPE ZONE PLAN NO.. 6004
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenched Forms Steel
Floor Sys m •
. Steel Rcinfor
Bond Beam
Frame and Flaahing
•
Lathing, In Out
Plaster, brown coat •
Underground soil W/G Pipe Test
Top Out
Furnace •
Gas Vents
Rough Plumbing . ,
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final
Plumbing Fixtures, Final _
Final Gas Test
Construction Pole
Underground Power
'Rough Wiring .
Fixtures, Final
OCCUPANCY 04- /i
Form 210-5M-1.57 5973
1,1
•
/A, COSTA MESA PBUIBLDING7 DEPARTMENT .• I 6004 °' ✓EE RECEIVED
c.
COSTA MESA CALIFORNIA I if - / sl7 V C.1/4__
C.L. OF STREET----
FOR APPLICANT1TO\FII:I.�INhj
BUILDING ADDRESS � / 9I 0 /)LFI,TY a-11 r
l ___ __„�PROP LINE _ Owner H+ (/lJ �'� �� �"Sit_
// r 10 FT. FOR 60 FT. STREET— 5 FT. Tali: ER \ i Mail Address 3/ 3 3' r
I FT. STREET
1 I I City deeA., Ph. Noel)• Jr_- in 10 Y
Contractor 1'b- '- -'s-- Ph. No.
I Address • 8
1 , 50 IIF PROP. City Lic. No. • State Lic. No.
0H G
1 50 FT w cc Size of Lot 126 X t9 _ AP No. II Q O/ - 0/
►-`—
Lai \ 1 Setbacks: C/L Street SS Rear 4 /
¢ IT ¢ u. Side Yard - Right Left_ ��.5 /l ,/�,rp���
t~n r a1 v Type of Fence � �1
a� �"�C
I u. ALLEY OR PROP, LINE cI J /,. I - s
O. . ty a1
I'--: ¢ w \ -'1 I I hereby acknowledge that I have read this application and state
1 v CO 4= I r/ that the above is correct and agree to comply with all City Ord-
ti N_ep cit,] LU i W I finances and State Laws regulating kilding construction.
I— ' F p ° (� I Signature r —
® o I of Permittee /���
A a �i •U m FTI I Agent
a
37 6 IN. O a' I I
FT. a" )- a W I 40 FOR OFFICE USE ONLY
w < f m - _
I z 4{ V v' i I F T ` � Permit No.
a co I I " y 7 3
m I I .;
•
re 60 FT ST. _...1 Received by Date Received Date Issued
a
I //-• /09-6— /-/- -S
I50 FT. ST. 1 J i 1= I
f, l — �:-C. — LINE __ t' _ _ _L. ___ — _ _ _ iii i . VALUATION C-o
Permit Fee $ a
$ 3 Plan Check $
C.L. OF STREET-.....„ I 0-'1,
TOTAL FEE a'
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- — ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
•
._ 6640
COSTA
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 317 MAy -1-58QOa¢s15a 8. ****46.00
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING /901+ / ,�OKH BUILDING
ADDRESS L!,(/ ��'JJJ
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. P RMIT(�NO.
OWNER A 84,1 err �v(v
MAIL 7 // (e
RECEIVVEEDA BY DATE RECEIVED DATE ISSUED_
ADDRESS / 2.I C t U ( C� 14A J„- 3--/-5-4 Sty --, d-
CITY 0 ( 21/1 e
ADDRESS
ARCHITECT LIC
ORF' NEER IC.
. COSTA MESA. CALIFORNIA
ADDRLSS # ^jff FIRE
P 4-liZONE
u �/ Y NI DC ZONE `� PIOANS TYPE GROUP
CONTRACTOR /(TJv, , a/I /\/ I/ i d.
•
ADDRESS. 1343UYiaN TOA
/l766/ Y PROVED 4I//e' DATE .1:1i- ilti '
LEGAL LOT CDR' C.I IONS
DESCRIPTION NO.l BLOCK TRACT/O • - ^ ONS
DA.P.NO. // 9 V /3 r ` fLpp, iyCL)\ V 1E
SIZE DoT � % )C / .ao NO. F Lor$. CITY OF COSTA MESA
nW i i tININ<G DET.
USE OF !JF S/OOlirr. d / SUB./UR 70 BLDG. DEPT. REG.
EXISTING BLDG.
SETBACK LINE FROM
CENTER OF STREET ` REAR YARD / /�
i g BYa DATES/7?
YARD RIGHT LEFT / r(J PLAN TECH.
DESCRIPTION OF WORK
NEW Xif ALTERATION ADDITION
REPAIR MOVING DEMOLISH �
5 ZE.DING 3 CX66 NO.OF eROOMS AN.
/ }� {¢ �
COVERINGWALL�J`(J/�`Lel OCT
' COVERING /( G ✓/r �/r 4 a , --e_-,
'USE OF
BUILDING arc-r/he/Yr tl /0 91 ' '
r
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND .
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. n VALUATION rt
SIGNATURE OF+ , / l+C PERMIT FEE 5 3 y� I
PERMITTEE L , �/ -- �"`a7 / (�,�✓I�
$ 2 3 L/� PLAN CHECK $ I6 . ✓/
AUTHORIZED AGENT ' e 7 TOTAL FEE $ g. L� F
8189 d EE RECEIVED
COSTA MESA BUILDING DEPARTMENT 3/f is-1 Vi
P.O.BOX 317 FINANCE DEPT.
COSTA MESA. CALIFORNIA
CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDINGBUILDING
ADDRESS //eV Lp/Aupe /
•/
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
A /m/ RECEIPT NO. yEERMIT
OWNER R4/ 42 iib 44��0� (o, 9
MAIL // ,��//` YY RECEIVED BY DATE RECEIVED '7 DATE ISSUED
ADDRESS i% ' eW4 tG4 � �f,y4� J - 1:S /
TEL. 1 BUILDING
CITY QST NOL// 70c7 ADDRESS
P$GHn LST NO. COSTA MESA. CALIFORNIA
Ofi�-�RER (sap) NO.
FIRE
ADDRESS ZONE
S� LIC. ZONE / PS S ^ ,, TYPE GROUP
CONTRACTOR I� CITY NO. �✓
TEL. APPROVED3�—
ADDRESS NO. BY ��' DATE
LEGAL LOT 2. CORRECTIONS
DESCRIPTION NO. 7 BLOCK TRACT/Q$6 (D�, 'Rr�l Trrr���y OV
A.P.NO. !!j Ofl-c/
AP5 k ® 9 ED
SIZEF .) X iy0 I NO.ow OF BLOCS. / l V
OF LOT Now ON LOT •
USE OFp % / CITY OF STA MESA
EXISTING BLDG. yGJ6 71-11‘'N'"UTA
SETBACK LINE FROM (J y / SUBJECT TO t �G. DEPT. REG.
CENTER OF STREET REAR YARD
SIDE YARD RIGHT LEFT /,,/ // ((�� p
DESCRIPTF WO t3Yl.P�I t��" UA7F
I17p7p •
PLAN TECH.6-n7
NEW X ALTERATION II ADDITION
REPAIR Ptlp MOVING -11lµ111 DEMOLISH -
BUILDING ROOF
SIZE /� �, 7
ROOMS STORIES /
EXTERIOR WAL ,./ ROOF
COVERING �TGGp COVERING Dark �
USE OF NEW ��'/� /~ 1jy
�I/
BUILDING 4/2013f
The Amount shown under valuation is for the
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH15 APPLICATION AND p� of establishing a permit fee only.
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. VALUATION J�
I7
SIGNATURE OF //�/��_ .- 'yy�... PERMIT FEE $ U
PERMITTEE �• "!lHrlf�((� $ 0Z.° L/w n PLAN CHECK $ y THORIZED AGENT 1 TOTAL FEE S AR - `9'�r