HomeMy WebLinkAbout1821 NEWPORT BLVD - Building Permits OWNER THOMAS DATE9-30-60
JOB ADDRESS 1821 Newport Ave. • BUILDING PERMIT NO. 12929
GENERAL CONTRACTOR Neon Enterprise VALUE $ 101.00
AP. No. 116-091-22 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK Facia Sign
INSPECTIONS DATE I GROUP TYPE ZONE C2
Underground Soil U.G. Water
SUBCONTRACTOR _ PERMITS ISSUED
U.Aerground Gas DATE NUMBER
t head Water and Gas _
Il"u$gh Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power _
Rough Wiring —
Trenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
Frame and Flashing
Lathing, In Out
P4;t ,er, brown coat _
v>`;f Yaing Fixtures, Final .
Electric Fixtures, Final
Building, Final 7/JM fr /C—r.-6,
OCCUPANCY
Form 210-5M-11-59 5-B P 12929
OWNER GREEN, EVELYN F. DAE h-25-55ar
JOB ADDRESS 1821 Newport Avenue BUILDING'PERM IT NO. 1158
GENERAL CONTRACTOR Owner-Builder VALUE $ 922.00 --- -
' Lrr AP# 116-081-22 BLOCK TRACT Storage addition to Commercial
Building
GROUP F2 TYPE V ZONE C-2 FIRE DISTRICT 1168
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench
Foundation Forms and Grade to Garage
Rough Framing S'le.jSe MS5--gr-SS— o c , F.4 a. . (Veru,.(e A4 ..s!
Plumbing,Rough to Slab /' /
Plumbing, Rough Complete ��
Temporary Pole I 5 �� OQI'�
10
Wiring,Rough/lY't pis'-I/'Sr 9,(�'✓ >/-+"' ••� S 7-.BSc 9',L 1 : ( ��
Heating,Rough a AP ((ff 0 0 1
Heating,Final ' {/1 1�
Sewer, House Sewer,St. el/ Iv vb
Septic Tank or Cesspool ilk ,• /
Lathing, In Out k,/(f' 4 2rua S.
Nie ti
ering
P,umbing,Final,Fixtures Complete iJ 1.
Plumbing,Final Gas Test -
.. Wiring,Final - Air �� _-• !,Jiv eta,'/ a,✓
w-
Occupancy e' /-- . *,
Fnrrn 910 f:_H 15110 1-SS
OWNER MRS. EVELYN GREEN / DATE in-2h-55
JOB ADDRESS 1821-18 9 N- •ort Blvd BUILDING PERMIT NO.
GENERAL CONTRACTOR Crank Bros.. VALUE $1,hh3.00
LOT BLOCK TRACT Reroof 'i roofs Gan 7i P- ._ -. or
• House Vortz Jeweler
COUP J TYPE V ZONE C2 FIRE DISTRICT 1-6 Z 1
PERMITS ISSUED
' INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench
Foundation Forms and Grade to Garage
Rough flaming ) _
Plumbing,Rough to Slab //��
Plumbing,Rough Complete III
Temporary Pole MI,+A
Wiring,Rough infra
Heating,Rough LINSf
'Heating, Final tatr-illak
Sewer, House Sewer,St. � 'AlainSeptic Tank or Cesspool AM atrial
Lathing, In Out ' 7
Plastering
Iibing,Final,Fixtures Complete
P.umbing, Final Gas Test
Wiring,Final F _
Occupancy
1.'nr.n 910(;_H 15001-55
• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. II12:3-7
g� Ij , ♦'�
PE I NO. TRACT NO. LOT NO. UNIT NO.
- 6621 ,- 1/2-9,H5 : ••,f . e0 G
CITY OF COSTA MESA CONSTRUCTION PERMIT " 1 132
1 s /8..)! ,UEWAO.2T •. • I I . : I
Project Address
I Applicant's Mailing Address c TYPE OF CONSTRUCTLQN ' LI NEW- U ADD U ALTERATION U REPAIR v
-❑ CONVERSION I.Al DEMOLISH ❑ OTHER • A.P.# 4'ay as0? Zone
Owner's Name- C'�• R�dEU�LOPily� gpe DESCRIPTION OF WORK/USE OF BLDG. •
_ /� •
Address 77 FA/'Q 0Q. 0',n . ..-Per/fO A9s IC-O S O' /re S Main Building: Accessory Building: -
Arch/Eng. License No. ' TYPE OF PERMIT -LJ GRADING- FOUNDATION ❑ STRUCTURAL T Font •
Z
•
Address - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear , . . N
L Q, ❑ -OTHER A 8 I
Contractor's Namr•//�A i,A1-11.,,7
a1{q� G/7 (9!/7j `Phones g / PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Ri ht - - _ G
Address(mailing)R / AI Q L' 7/ as .
_ ! ••�5 s�- CON STRVCTION TYPE VALUATION$ /DOG.00 $ Left . - . .
City License No. rl" �J • ZONE 1 • _ GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided - E
LICENSED CONTRACTOR DECLARATION Q
ti
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: _ Planning Notes: - ' M ,
with section 7000) of Division 3 of the Business and Professions Code,and T
Ao my license'is In full for - and effect. 4 -
Ucens- Class Lice ir,,�_.� sLi� S
1 • nate • ' ea Signature • •✓La. PLUMBING FEES
\ IORKERS'COMPENSATION DECLAR• •ON •
Bar Sink Showers
I hereby affirm that I have a certificate'of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer .- Service Sink
3800, Lab. [-�l• ���/ �/ •
- Automatic Washer - - Transformer ❑-15-50 KW
k!) Policy No. 142`-'4 'n 7- Cgmpany -- ' Backf low Irrigation Sewer Ca - •-- - ❑ 50+-KW
1 P Construction Pole Sub.
8 Certified copy is hereby the city cRpy,isJjlje))with the city B in• Division. Bathtubs Sewer Connection Cooking Unit I Meter Dup to 100 amps 1
/ Date 6 ��'.... Applicant 'G ' �:N At TI N •
•
-EXEMPTION FROM WORKERS'COMPENSAheperDE•NA' Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the perm' •Is for one hundred ($100)of
less). ' Dishwasher I Solar Piping Dryers ❑Gas- ❑Electric • Sub Panel ,.-r) ,
I certify that In the performance of the work for which this permit ts'cssued, I
shall not employ any person in any manner so,as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01W-8
Workers' Compensation Laws of California, - •
Date Signature - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 015 .15}
' NOTICE: If,after making this declaration,you should become subject to the
Workers' Compensation provisions of.the Labor Code, you must forthwith ' Floor Sinks Urinal ,
comply with- such-provisions or this permit shall be deemed revoked. , . - - Fixtures ; Microwave - - --- -
CONSTRUCTION LENDING- AGENCY - r •
Gas Service Outlets Water Closet ' ' Device Boxes I Pole Li ht
1 hereby affirm that there is a construction lending agency-for the performance - - - 1 9
of the .work for which this permit is'Issued (Section 3097 Civ. C.) Interceptors. • Water Heater 4 '
Lender's Name - - - -- I ' p - Outlets Range
Lender's Address - - • Kitchen Sink 'Water Service Switches Sign
OWNER BUILDER DECLARATION _ •- •
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - :Auto-Wash •- - •
following reason (Section 7031.5 Business and Professional Code: Any city or - Garbage Disposal ;$Landing Sections
county which requires a permit to construct,alter,Improve,demolish or-repalr ' P-Trap ' Laundry Trays ' Generator 00.5 KW 05.15 KW
any structure, prior to its issuance, also requires the applicant for such permit - - Trash Compactor
•
• to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains ' '
the Contractor's License Law(Chapter 9(commencing with Section 7000)of 5 -
• Division 3 of the Business and Professions Code) or that he/she Is exempt
therefrom and the basis for the alleged exemption. Any violation of Section - _ - I
7031.5 by any applicant for a permit subjects the applicant to a civil '
•
penalty of not more than five hundred dollars($500). I 1 I
-U 1, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $-3 ' • - --
compensation, will do the work,and the structure is not Intended or offered Reinspection Fee I $15 Issue Fee. 1 $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or Improves _- .
thereon, and who does such work-himself/herself or through his or her own •- 1 Hood or Type I ❑ ' • DEVELOPMENTS CES REQUIREMENTS:
employees, provided that such Improvements are not Intended or offered for Boiler -
sale. If,'however, the building or Improvement Is sold within one year of com- — - Canopy Type II ❑ Zoning Appro'•• - Date
Motion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Ap• y 1 Date '
prove for the purpose of sale).
U I, as'owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Appliceti•I 1_ :d By ( Datn
tractors to construct the project (Section 7044,Business and Professions Code: -_--- - �-` _
The Contractor's License Law does not apply to an owner of'property who Duct-Ventilating ❑0-.100,000 BTU ❑100,000 BTU V •it 1_
, . MA- EES
builds or improves thereon,and who contracts foL such projects with a con: 1 ' 1 \ •
tractor(s) license pursuant to the-Contractor's License Law). I am aware that ' Exhaust System 0 Multiple 0 System Repair/Alteration B 3 DI P IT $ A ► SMIP $
proof oftheir Worker's Compensation Insurance should be provided to,me.. •
°LAN OH G $ W PERMIT
❑ 1 am exempt under Section B.& P.C.for lois reason Firepl/Fact.BIL. ICBG# Fire Dampers I{LUMB N • 17`� ISSUANCE $
Date Owner _ I Heating System& Ducting I Registers P C 25. $ ?JAW ' ENERGY P.C. ' $ I
I hereby certify that_' have read this application and state that the above _ ❑0.100.000 BTU 0100,000 BTL_ . - E C RICAL $ Mk GRADING $
Information is correct I agree to comply with all city and•county ordinances ' v - •
•
and state laws relating:to building construction,and hereby authorize repre- n• , MICROFILM $
sentatives of' this,city to ter up he above-mentioned 'property for PLAN CHECK 50% $ /
•
MECHANICAL - $ TOTAL FEE . $
Inspection agyppses. is f r 1
•
Signal urrQS.L
Pink -Accounting; Goldenrod - Assessor - - - --
CONSTRUCTION AND PLANNINts ruOL & SPA
APPROVALS Permit# Date 'Inspector APPROVALS Permit# Date Inspector
�1. Temporary 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. Electrical Bonding
5. Steel Reinforcement ' . - 56. Rough Plumbing & Pressure Test •
6. Electrical LIFER Grnd: - 57. APPROVAL TO COVER-GUNITE •
.-7. Footings 58. Electrical Conduit-Undrgrnd.
i8. Foundation 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK •
11. Property Sewer Line & House Connection �/// ��� 62. Backwash & Receptor-Final
//Z
12. Sewer Cap /8G _te 63. Heater & Vent-Final
13. Roof Drains / • 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit - - 66. Solar System-Final
• 16. Rough Electric Wiring • 67. Fencing & Access Approval
17. Rough Wiring Sign: 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts,,Ventilating 71. Product Piping ❑Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & 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 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 Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace •
38. Final Plumbing '
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation .
44. .Landscape Irrigation System
45. Sound Attenuation • •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 1/2/go' 3 /
•
48. Special Requirements Completed KKK
49. Electric Release to Edison - - • - ' -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY. - . . '
No. Date I
25� 16 II C9tYF CSS MESA
• COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 20 1966
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92026 gg��
For Applicant to Fill In Completely PLICIPPLIT
TYPE OR PRINT -BUNDI
BUILDING` / y For Office Use Only
ADDRESS fila/-/297 - 9Z.P z,,,- !/'""�--
RECEIFr NO. P„RIT HO.
COSTA MESA. CALIFORNIA 2Z 5gI.6
henget.
(,[( //// e 24,, ./ 9 RICE T DATY 1 yl.6� f41
OWNER //p12G�Ot �/vw%/+�'1+uwv7 [�- BUI MG �y /�'!'Pr1/ry �j le 66 1/�/�//�
MAIL ADDRESS !(��� Js'z 4 t9 /.e.T
ADDREESS ��J� • FIRE
�f_
CITY&Fierela, {621./2 DIY/O'L NO. ZONE ///��� TYP GRO/UP �jry
IITECT TEL...^^^��� E PROVED//�( 2ATE(� �IC.C/
MGINESK • p D D D NO.
' 1}L-L..-113-
'- ZONING
ADDRESS - / � ��I L USE
OF NEW/ / =pN[/' , ,NOAOP
/
BUILDING
CONTRACTOR '721 +�K+H A
ADDRESS 386 E- l9 di-dill- oucnlmoN t�1 "� 7l'-(l/ Lam/ T�I'o
y�-- �y� p� A.P.NO. 1/v` - 0 "' / - ..2- Y
CITY (�y � ///w'w
• NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
LIC.NO. I /STT NO.TELL/-.P-eeD 7 SO'TO SIDE O REAR P.L
SIZE
,pp �, EAVES
OF LOT I W I X 1 o S I I NOW ONLLOOT . / ALLOWED (U.B.C.REQUIREMENT)
-
I YARDS APPROVED YARDS APPROVED
USEOF ,^. . O _ MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. C'�O vC./V .I PROM C/L STREET) •_ _Mp 1 l
SETBACK LINE IROS I.T96
CENTER OP STREET REAR YARD PRONT/f y(EiiIRAr � (//il
SIDE YARD I LEFT RIGHT R.SIDE. F7. /�/
DESCRIPTION OPWORKL.SIDE -0--"Fr- Fr.
NGN ALTERATION /� ADDITION REAR R. RT.
DIST. BET.MAINS
REPAIR MOVING QEMQLISH MAIN BLDQS. ACCESS.BLOCS.
BUILDING NO.OF VAR.* DATE
SIZE ROOMS STORIES C.U.PP..# ^ APPROVED/
COVERINGEXTERIOR
WALL I COV BRING B7FR Th E'`/J, t /' DAT[ (��lJ-17
USE OF BUILDINS AND WORK TO BE PERFORMED rJ' X ,'' R'
T-t,>T,.D- tJ % ,a`- v/,F.(`A w
fl a..r -7-itaitais . ;
SQ.FT.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION TNI AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
913
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
VALUATION ^� oO b
BUILDING CONBTRUCTI 4 2: 5 S10
PSIGNATURE ERMITTEE OF in/ r PERMIT RHE3V E
s I PLAN CHECK S
/6 w
AUTHORIZED AGENT �3D� o- �9 �-D
j r TOTAL FEB $
Irma Mesa r)7tutuub _impartWO
~, 117 EAST 20th STREET 1 ,' ib `-�'_•"~�tCt 4
-COSTA MESA, CALIFORNIA v - r P - r--�—"
FOR OFFICE USE ONLY
- 'FOR APPLICANT TO FILL IN + Receipt No. Permit
GNo.
Address / rR/ /k,e-sin/ 4- •fr / z //.�0
li Recel by Date Reed. Date Issuedr-
Costa Mesa, California ,
Nearest r_ .'�-�/"s-r �1$=S'$
Cross St. • • Building % ,
/J ; Address /tie/ 9fi9A' r/eta.t�- .
Owner ....4---L'-�� _ Costa Mesa, California
Mail /
Address _�J a Nearest ''Cry
p Tel. /• !1 i, Cross St. f
City ( - No. .44- 3.7 C Zone I No.of I Type ,/ I Group_
Architecto Lic, Plans If
Englnee 7 No. � Approved /"
by L� Date �.0
n CORRECTIONS
City Llo. ,
Contractor 6K.17 -s.� No. [��4 -> y tea-•/r 0'2-1-- C�--icy.--c.-Q
- -Address ii ' iii Se- &.I p�3�/ taireleniit
Legal 1 /�
Lot lre i/` / =
o
Descri•tion No. Block C- Tract • --- _
(Atta h Metes and (ounda)_ . - , - ,r,- ...-.4.2..."b. __
No.of Bldgs. ® t
Size of Lot ......4-0,14/ /O SS I Now on Lot / 1/ i�...:2 4i a
Use of No.of . No.of - f` •' ' --AV T
Existing Bldg. I Families I Rooms - ,a 6
Setback Line from �-• Rear Yard `•
Center of Street 1x . Side Vaeda:4�S('q qv - "- D
DESCRIPTION OF WORKr•
New I I Alteration I I Addition ii( _ C�-� OF, COSTAESA
. .)
Repair I I Moving I I Demolish I
wilding / N No,of ;I
ize /0Z./ 4 /, Rooms Stories 7- 1/ /
Exterior Wa Roof fi rJ,I(UD
Covering o'",,�,,•1,..r y/ I Covering , i APPROV' .0 • A
Use of New
Foundasion Location Ins or Date
Building - • -_- L . . - -- Forms, Lo alio,
de 41
_ . ,{. Under-Pinning A
t. �%" , Allsro r 4i Frame: Fire Stops, • '
f Bracing,Bolts i
—,t
,
I hereby acknowledge that I have read this Application „ Lath.Int.
and state that the above is correct and agree to comply Lath.Ext. , ,
with all City Ordinances and State Laws regulating
bung const n
'/^
Signature of Piaster, Int. i
Permittee
IPlaster,Ext.
Authorized Agt.
Masonry Reinforced
Valuat' Permit Fee $ Co, o O
o�{a��71 l o , Plan Check$ �, p n Bond Beam
t
$ ae, . _ Total O 0 FINAL
•`• Fee $ 7 Asil
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12929 FEc RECEIVED
i COSTA MESA BUILDING-SAFETY DEPARTMENT OCT 3 1980
P. O. BOX 917 COSTA MESA. CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely APPLICATION F611.141}yP ►TJSTA MESA .
TYPE OR PRINT
1 BUILDING
BUILDING 7(i^ i A1��, PO AT ANE ADDRESS COSTA MESA./1JCALIFORNIA For Office Use Only
�
Ho A4_4 /. RECEIPT NO. I /cZPERMIT9.29
OWNER /\
MAIL - F , / RECEIVED BY DATE RECEIVED_ TE ISSUED
ADDRESS� '•'"Z /�/A� C . /J* / �� /yr� Q-- •�O �O 'IOt7
CITY [,O S {.a' /v? I/� .4 NO. ADD ESS ( (/ o2/ >eni 4/A j__,-- .
ARCHITECT ENGINEER TEL. COSTA ESA. C IFORNI
OR NO. I �/*
FIRE L
ADDRESS ZONE • TYPE GR Uj�
CONTRACTOR n EC Ne rAf rg,hee 1A ABY PPROVED DATE S -� �a
ADDRESS 4 L.1/ 3 1 al' ONING �. -cc.,,
N rivo c'0 tT SCA/j'I ZONE NO.OF USE OF NEW
CITY N\ C'• 0 [%PLANE I BUILDING _0_1;
STATE I' TEL. LEGAL r �' (�f i k1
LIC.NO. �� O ���[N NO. DESCRIPTI .O 7'��/p �I /C7//ITh I i 7l
SOF LOT /O o )c I O ISI NOW OOFN LOTS A.P.NO. G- o Q l _ i1' 2-
USE OF ` 1/ Q l I.. YARDS EVES
EXISTING B DG, -S.lr' ()P[ . APPROVED • ALLOWED
SETBACK UNE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT ( _ T. IN.
SIDE YARD (LEFT' I RIGHT R.SIDE T. IN.
DESCRIPTION OF WORK
L.SIDE Zr. .
NEW I XII ALTERATION I III ADDITION 1 REAR n ^T. o IN.
REPAIR 'I II MOVING I II DEMOLISH I APPROVED t�BY / L.y 1 / • DATE / 45�O
BUILDING. NO. OF ?' CCC"'""""0.1.---77)
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
...S/til c L I4-C X oC«ul
PA-1 tvrij! d/V L- 'r'
I HEREBY ACKNOWLEDGE THAT I HAVE READ TNIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.JVALUATION �-
SIG MATUR OP {i ^ �� PERMIT FEE S 607
/, //j,//1 �',,1�/ PLAN CHECK $ 'j Y
AUTHORIZED AGEN /� ((/✓✓ehe-cey l $/O/ TOTAL FEE $p{ O
6