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Home My WebLink About3084 JOHNSON AVE - Building Permitsr. , .. 7 � M CITY OF COSTA MESA �`""' , BY/LDING DIVISION >t�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wvnv.ci.wsta-mesa.ca.us F °� fi FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: 609-00197 PERMIT TYPE B_ROOF2 APN: 14159202 JOB ADDRESS: 3084 JOHNSON AV CM Vicinity: Squares: 1370 �. . STATUS: DATE ISSUED: ISSUED BY: Suite/Unit:: ' " Valuation: ISSUED 09I14I2009 BJK - $9,000.00 SCOPE OF WQRK: REROOF FLAT PORTION-OF SFD ONLY: T/O B.U.R. AND REPLACE WITH MODIFIED 3-PLY ROOF WITH #5 GRAVEL. 1370 SQ FT � . WORK INCLUDES REPLACEMENT OF AN EXISTING BRISTOLITE SKYIIGHT. ICC #2469 � _ OWNER: �RICKSON,ROBERTB � , PHONE: APPLICANT: HEIL, MIKE - PHONE: 949-6973418 CELL CONTRACTOR: HEIL CONSTRUCTION SERVICES Address: 3131 LINCOLN WYUnit: City/State/Zip: COSTA MESA, CA 92626-2822 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTALFEES $0:00 $167.25 $0.00 $1.00 $168.25 Address: 30&4 JOHNSON AVE Ciry/State2ip: COSTA MESA, CA Address: 3131 LINCOLN WY City/State/Zip: COSTA MESA, PHONE: License No. License No. License No. � 678817 949-697•3478 CELL � CELL: 714•549-2111 PHONE', PHONE: Unit: Unit: 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: 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 wnsidered 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. CODE 1. INSPEGl10N lypE 1616 Fixed Sys�r,m Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rpp( 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition OpTE INTITIRLS � � 1.1 i. � �. P CODE I INSPEGTION TYPE 206 Final Me�hanical 208 Final Plumbing 210 Final Eleclncal 212 Final Fire Prevenlion 220 FinalPlanningApproval 222 Final Site 250 FinalBuilding/Occupancy DATE INiITIRlS r � � WORKERS' COMPENSA710N DECLARATION: I hereby aKrm under penalty of perjury one of the lollowing declarations: ❑ I have and will maintain a certificate o( consent to self-Insure for workers' compensation, as provided for by sec�ion 3700 of the Labor Code, for Ihe pertormance of ihe vrork for which Ihis permit is issued. � � � I have antl will maintain workers' compensation insurance, as required by section 3700 of lhe Labor Code, for the peAormance ot the vrork (or which this pertnit is issued. My vrorkers' compens tion Insurence wrrier and policy numberare: � ��` � � ;Cairier: �l'�� (Ths SeIXion neetl no16e mmpKlete� tl Ne parm�7R lsQvalved at one M1undmd tlollers (5100) or Iess.J PolicyNumber� �'� l—��`"�� ❑ I certi(y that in the peAormance of the work for which �his permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensa[ion laws of Califomia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labo , I fo y�f m ly vnth these provisions. ` � Q Applic s5i naWre • Dalea� WARNING: FAIL E TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) o( Division 3 of �he Business and Professions Code, and my license is�i1n yfulltyforce and e((ect. �Lic. #' "16 O � �lass #'� �" � L . ConVactor's Signatur � CONSTRUCTION LENDING AGENCY: ❑ I hereby aftirm that there is a construction lending agency for the performance of [he wvrk fa which �his permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Atldress: SignaWre Date OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counly which requires a permit to construct, aller, improve, demolish, or repair any s[mcNre, prior to its issuance, also requires the applicant for such permit to �le a signed statement lhal he or she is licensed pursuant lo the provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business an0 Professions Cotle) or that he or she is exempt therefrom antl the basis tor Ihe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects ihe applicant to a civil penalry of not more than fve hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe slmcWre is not intended or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves ihereon, and who does such work himself or herself or ihrough his or her ovm employees. provided that such improvements are not intended or offered for sale. I(, however, the building or improvement is sold within one year of completion, the ovmer-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS to construc� 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 (or such project with a contracta(s) license pursuant to the Contractws License LavS.). ❑ I am exempt under sec. Business and Professions Code for lhis reason: SignaWre 90A46 (3I0>) � 4 , Owner ID verified by tlriver s I�. ❑ Yes ❑ No • Driver's License No. Expires: Verifcation of Ownership by (rype of documen[, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby ceAdy that no excavation fve (5) or more feet in depth into which a person is required to tlescend, will be made in connection with vrork authonzetl by this permit, and that no building strucfure, scaHolding, falsevrork, a demolition or dismantling �hereo(, will be more Ihan thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Caiifornia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a permit (rom the Division o( Intluslrial Safety, as noted above, unless such person has a permit to do such work from Ihe division. Appliranl's SignaWre Division of Industrial Safety Permit Numbec _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to fle and certify a Business Plan for emergency response to release or threa[ened release o( a hazardous material? ❑ Yes ❑ No (Seclion 25505 of [he California Heallh antl Safety Code requires, with some exceptions, that a Business Plan be (iled with the Costa Mesa Fire Depanmem by every business which has at any one time during a reported year a quanti[y of hazardous materials equal to or grea[er than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will �he applicant or present or fuWre building occupant nee0 [o file a regis�ration form for awtely hazardous materials? ❑ Yes ❑ No (Seclion 25533 of ihe Cali(omia Health and Safery Code, with some exceptions. requires regislralion with the Cosla Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous ma[erials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperaWre and pressure). 3. Does or will the applicant or present or future building occupant need lo prepare an RMPP (Risk Management and Prevention Program for acutety hazartlous materials�? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides tha[ the Cosla Mesa Fire Department may require ihe preparation, ceAifcation and fling with the Fire Department of an RMPP by businesses which are required to register awtely hazardous materials wilh the Fire Department. 4. If an RMPP is presently required, has Section 25534 0( the Calitomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuNre building occupant require for the work which is the subject of this application a pertnit for such conslruction or modification from the South Coast Air �uality Management Dislricl or /rom any other air pollu[ion con[rol tlistric[ or agency? ❑ Yes ❑ No (Section 658502 of Ihe Califomia Govemment Code requires that the requested information be /umishetl on applications fp non-resitlen[ial builtling permits). 6. Will any parl of the faciliry to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑ Yes ❑ No Qf "yes", the facility must meet the requirement ot Sections 25534 and 42303 of lhe California Heatlh and Safety Code). 7. If a permit from the South Coast Air Quality Managemen[ District or other air pollution control dis[rict or agency i5 required for the work which is lhe subject of this application, have all of lhe discbsures prescnbed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certificate of compliance from Ihe appropnate air polNtion control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree ro comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Sgnawre Daie CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I ceAify under penalty of perjury fhat I have read this application and state that Ihe information given is correct. I agree to comply with all state laws and city ordinances relating to building constmction, and aNhorize representalives of the City o� Costa Mesa ro enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building au�horized by lhis permit until final in5pecti0n. Sgnel of O 5) Date Antl/ A honz APP nt ----1�� CITY OF COSTA MESA � B!/ILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT TYPE MECH APN: 14159202 JOB ADDRESS: 3084 JOHNSON AV CM Vicinity: MECH DUCT SQ. FT: 0 PERMlT NUMBER: M09-0008'! STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: SCOPE OF WORK: REPAIR/ALT COOLING/HEAT DUCT AT AN EXISTING SFD. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. ,, ISSUED � 09114/2009 BJK OWNER: ERICKSON, ROBERT B �� Address:. 3084 JOHNSON AVE' Unit: PHONE: , �� City/State/Zip: COSTA MESA, CA � APPLICANT: HEIL, MIKE , � Address: 3131 LINCOLN WY llnit: PHONE: 94g-6973418 CELL - City/State/zZip: COSTA MESA, CA - CONTRACTOR: HEIL CONSTRUCTION SERVICES " License No. 678817 Address: 3131 LINCOLN WYUnit: PHONE: 949-69734'18 CELL ',- � ,� Ciry/State: COSTA MESA, CA ZipCode: 92626-2822 CELL 714-549-2111 - MECHANICAL PERMIT FEE SUMMARY MECH ITEM FE�: , $37.20 PLAN CHECK FEE: . � $0.00 INVESTIGATION FEE: � $0.00 REINSPECTION FEE: , $0.00 TOTAL FEES; $37.20 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: 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 wmply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. cooe �. ixsaecnoN rrr� 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWR>�aining Wall 202 Final Factory Fire Place 203 Final Sign � 204 , Final �emolition � INIIlIALS COUEp INSPELTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 FinalPlanningApproval 222 Final Site � 250 Final Building/Occupancy URTE INIITIRLS 9� 3� �-(�� WORKERS' COMPENSATION DECLAfZpTlO' I hereby aHirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certifw[e of consent to sel!-Insure for workers' wmpensa�ion, as provided for by section 3700 of the Labor Code, for the performance of the work for which ihis permit is issuetl. �` �"�. I have and will maintain workers' compensation insurance, as required by secibn 3700 of the Labor Code, for the �eAormance of the work (or which this pertnit is issued. My workers' compensation Insurance carrier and policy number are: � , 1 �j ',Carrier: �'�S,K ` � (fiis se[fion neeG iCp1l �e comple(ed i(the peim� is v�avlue^d� at one �untlred tlollars (5100) a less ) Policy Number. T � 3___r_��Zp S D T ❑�I certify that in the performance bf the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o/ Califomia, and agree that if I should become� c o the workers' compensa � n provisions of Section 3700 of the Latfor I sh^ for hwi h yo p� vi these provis' ns � �' /Y e Applitdnf aW�e Dale' WARNING: FAILURE O SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARqTION: I hereby affrm that I am licensed under provisions o( Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and eNect. �Cic: # `- � �� Class # � � ` �1 a Conlrac� sSignature ,Dale CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that there is a consWction lending agency for the peAortnance of ihe work fa which this permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Atltlress: Signawre Da�e OWNER-BUILDER DECLARATIONS: I hereby aHirm ihat under penalty o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Pro(essions Code: Any city or county which requires a permit to construcl, alter, impmve, demolish, or repair any structure, prior to ils 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 Ihe Business antl Professions Code) or that he or she is exempt therefrom and the basis for Ihe alleged exemp[ion. Any violation of Section 7031.5 by any applicant (or a pertni� subjects the applicant b a civil penalry o( not more than fve huntlred dollars ($500).): ❑ I, as owner of the property, or my employees with wages. as iheir sole compensalion, WILL DO THE WORK, and the struclure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovm@r o( properly who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided ihal such improvemen[s are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the ovmer-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as bwner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe pmject (Sec. 7044, Business and Professions Code: The contractors License Law does not appty to an owner of property who builtls or impmves thereon, and who contracis (or such project vrith a conlracta(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Pro(essions Code for Ihis reason: 309�46 �3/0]) r ! Owner ID veritied by driver s license. ❑ Ves ❑ No Driver's License No. Expires: Verifcation of Ownership by (type of tlocumen[, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetldy that no excavation frve (5) or more (eet in tlepth into which a person is required to tlescenQ vrill be matle in connectbn with work authonzetl by this pertnit, and that no building sWcture, scaffdding, falsework, a demolition or dismantling �hereof, will be more Ihan Ihirty-six (36) (eet high. (Chap. 32, Grp 2, M 2, Sec. 341, Title 8, Cali(omia Administrative Code). ❑ As owner-builder, I will no[ employ anyone to do work which would require a permit from the Division o( Industrial Safety, as npted above, unless such person has a permit to do such work from the division. Appficanfs Signature Division of Indusirial Satety Permit Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will lhe 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? ❑ Yes ❑ No (Section 25505 of the Califomia Health and SaFety Cotle requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time dunng a reported year a quantity of hazardous materials equal to or greater than a weight ot 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at stantlartl temperaWre and pressure). 2 Does or will the applicant or present or fuW re building occupant need to fle a regisVation (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Satety Cotle, with some exceptions, requires registration wilh (he Costa Mesa Fire Deparlmenl by each business which at any one time has on hand a quantiry of acutely hazardous materials equal to or greater [han a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at sfandard temperaWre and pressure). 3. Does or will Ihe applicant or present or future building occupant need to prepare an RMPP (Risk Management and Preven�ion Program !or acutely hazartlous malerials)? ❑ Yes ❑ No (Section 25534 of lhe California Health and Safery Code provides tha[ the Costa Mesa Fire Deparlment may require the preparation, certification and (ling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 0� the California Heallh and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fu[ure building occupant require for Ne work which is the subject of this application a permit for such construction or modifcation (rom the South Coast Air Quality Management Disirict or fmm any other air polWlion control district or agency? ❑ Yes ❑ No (Seclion 658502 of the Califomia Govemment Code requires that the requestetl information be fumished on applica[ions fa non-resitlential building permiis). 6. Will any part of the facility to be constructed under Ihis permit be within 1000 feet from lhe ouler boundanes of a school? ❑ Yes ❑ No Qf "yes", Ihe faciliry mus[ meet the requirement of Sections 25534 antl 42303 of lhe California Heal�h and Safery Cotle). 7. if a permit from Ihe South Coast Air Quality Management District or other air polWtion control distnct or agency is required for the work which is the subject of this application, have all of the disclosures prescnbed by Califomia Health and Safery Code Sec[ion 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance trom the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of pery'ury the information given above is correcL I agree to comply with all state laws and city ortlinances regarding Hazardous Materials and Emissions. Signawre Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certi(y under penalfy of perjury that I have read this application and state that ihe information given is correct. I agree to comply with all state laws and ciry ordinances relating to building constmction, and aWhorize representatives of Ihe Ciry of Costa Mesa to enter upon Ihe above-describetl property for inspection puryoses. I agree not to occupy or allow ocwpancy of any building authorized by this permit until final inspection. Signalur � a w ( Dat AnOI AU�� 2¢ ApPy �� Oa e1�. � �� / I ��- i PflOJECTROUHESS: 3OH9 JOHNSON AV OWNEH'SNAME: ERICFCSON, ROBERT B aooREss: 3089 JOHNSON AVE COSTA MESA,CA 92626 PPCHIENGINEEP: AOONESS: a uxiT: I „ CITY OF COSTA MESA - BOILDING PERMIT PERMIT NO; P 065028 PLAN CHECK NO: N CONSTRUCTION TYPE: 5-N PEAMIT TYPE: PLU REG.NO.: UNIT: PEflMITTEE: GEORGE BRAZIL ( 714 ) 541-9753 aooness: 3022 N. HESPERIAN wY 101 SANTA ANA -f(?no CA 92706 LICENSEO CONTPACTOB DECLANATION: I �ere�piryrtfm}��Qensea untler pwvisims oi Chapler 9(commencing with Section l0pp) ol �iviSion 3 01 1�¢ BuSinCSS anG ProleSsiOdSCA]e.SdVm I¢ense is in lull fo eifect. cirv uc.: 0 5 3 8 2 4 STATE IIC.: •—' �� cuss: �-•� Uaie: /�—��—�� Signamr:_ _ y�y' WOflKEHS'COMPENSRTION�ECLAflAT10N: I�¢r¢Oya��i inat haveaceniliwteoiconsent�osM-insureoracenilicaieoiwarkers' Comoensation �is��e� ey �clt�ea covv �nereoi �Seai . LaD. ��1 / O 1/ 9 9 eoucrr+o.: REPUBLIC EXP.OPiE: COMPFNY: c� Cetli�ieG copY is �ert�y Wmishetl. C7 Ce�ilietl copY wi�� the ciiy Buil g Diviion. Oate: �/ � ✓ /--� Applicanl: El(EMPiION FPOM WORRENS'COMPENSRiION DECLAPATION: iAissttlion ne¢OiwlbecomDleleOif�h ermilislorone hunUretl�511p�orle55�. I cehily ihat in IAe Oetlormance ol t�e work lor w�ich ihis permit is i55ueC. I 5hail nol employ any person in any manner so as to Oecame subleci to Ihe Workers' Compensalion Laws o� Calilomia. Dare: Signamre: NOTICE: I1, after makinp Ihis Oeclaralion, you sAoula Uecome subjec� lo Ihe Workers' Compensation pwvisions ol Ihe La�or Coee. you musl tonnwiln comvly wiln sucn provisions ar this oermit snall Ae deemetl revoketl. CONSTBUCTION 1EN01NG AGENCY: I �¢reCy a�lirm tha� Ihere is a tonSlmtiion lentling agenty lar th¢ Oeriormante oI t�e work br whlch I�is permit is issuea �Setlion 3097. Civ. C). LENDEH: aooxEss: OWNEO BWLOEB OECIABATION: I �ereby allirm Ihai I am exempt irom ihe Contracbrs' $tate License Law �or I�e followinB reason (Seclmn 7031.5 Business an0 Pmiessional Coee: Any city ol counly whic� repuires a De�mit Io conslmct, alter, impmve, Eemolish, or repair any stmcture. prior lo i1s issuance, also requires ��e applicant lor such permi� Io lile a signe0 slaiemenl ��al he/she is licensed pursuam to Ihe pmvisions o� ��e ConVacmrs' SIa1e License Law (C�ap�er 9(commencing with Section 7000) o� Uivision 3 0l i�e Business an� Piolessions Catle� or �hat he/she is exempt Ihereimm ana Ihe basis for Ihe allege0 exemplion. Any violation of Seciion 703L5 �y any applican� lor a permi� su�le��s �he aOPlicanl lo a civit penal�y of not more Ihan live huntlreC Coilars (E500). I, as owner ol Ine Dropeny or my employees with wages as Ineir sole comoensalion, will ao ihe work, and Ihe ❑ s�mcWre is not intenUeO or olleretl lor saie (Seclion 7044, Business an0 Pmlessional Code: T�e ConVanors' State License Law aoes nol apply lo an owner ol a propetly who OuilAs or impmves t�ereon. antl w�o does suc� woB himseli/hersell or �hwugh hls or her own employees, proviaetl tha� such impmvemenis are nol in�enaeA or oftere0 lo� sale. I�, however ��e 6uiltlinp or impmvemeni is sold wi�hin one year ol comple�ian, Ihe owner will have Ihe �uraen ol DmvinA �e�she ditl no� �uilU or impmve for ihe Ourpose ol sale�. I, as owner al I�e pmperly, am erclusively conirac�ing wil� licensed canlractors lo constmcl ihe pruject (Sec�ion 70aa, Business ❑ ana Pm�essbns Cotle: The CONractors' Slaie License Law Ooes noi apply to an owner of pmperty who builas or impmves thereon and who conlracls lor such projects wii� a conVacior(s�license Dursuan�lo Ihe ConVactors' Slaie License Law),I am aware , ��a� pmal ol Iheir Woiker'S ComDensalion insurance s�oultl De D�ovitl¢d to me. � I am exempl un0er Stttion: 9. 8 P. L. lor t�is reasan: Oate: Oxner. I do hereUV [eNly I�at I am aware ol an0 unaer5lanG Ihe re0uiremenis ol Calilomia Healih anA Salety Coae Sections 25505, 25533, antl 2553d and thal I oi any luwre Euildmg acu0anl vnlVvnll noi (circle one) neetl Io compty wiih 5ai0 5�aie cotles anA Ihe repuiremenis for a permi� lo� conslm[lion ar mo0ilication Imm t�e Air ualiiy Managemeni DislriCi. Fesi4¢nlial con5lNtiion a071iWti0n5 are exem0� ��om Ihese O�ovisions. oate: Aooiicanc I hereby [eriify IAaI I have rea0 i�i5 aOD�ita�ion an0 Slaie Iha� I�e above in�armaii0n i5 cOrreCi. I agree l0 COmOh �lh all City and [ounry oramances and sla�e laws relaling Io buildmg conSlmclion antl hereGy aWhorize representaY es o� Nis cily lo enier upon Ihe above�mentionetl pmperly for inspeciian puCrooset //�'�'�'�( �ate: // ��'" /� Sipnatu! / ) �f �river'S License or Social Securiiy a: �! 16aL46 Wlnte—Building', Greon—Cotlo EnlorcemenC Canary—Applicanf, Pink—Revenue; Goldenrotl—Assessor PERM NO; Y Ub�UGN C�U "i': N SU �Y: N PURPOSE: OTH JOB DESCRIPTION :.REPLACE WATER HEATER SQ ET; CLAIM VALUE; CALC-VALUE: GROUP OCC: R-3 / COMMENSS: PLUMHING WORK ONLY IF iE �lh jf if it �N-* iFlf if 1E if if if if -k iE 1E iE dE iE iE-lE if 3E iR -lE iF-%�-%-lE iF * iF if iM1 iE �f -iF iE iE -lh df iF 1E �It aEif jE-1F-1F % N� iE Y if if if iE iF ## if �It it N� # iF if iF iF �M if if if iE �IFiE Z O N I N GS ERT�H�AUCIKRSE M E N T 5 ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13907102 ZNE; REF NO: PLANNING NOTES> 1 if i! if if if it M if iF it if ik iF #E ih if if if if # iE it jE iE if if it if i! M ih iF 1F 1E iF iP 1! if if 14 iE iE �F k iF if if df 1E iE �E �E il-if if fE if iF if if i� it 1E 3R i� iF at iF if if �f i! if if i: if if iE if D E V E L O P M E N T S E R V Z C E S R E Q II I R E M E N T S ZONING APPROVE� BY DATE: BUILDING APPRO�'ED BY : DATE: APPLICATION ISSUED BY: �*�««�**��*�*�*«�*�***��.**��. * ��»�* � « � � �*�*°�*��*�� `�� 3 iE 1E iF iE iE iE iE iE iF if iF if �E iE if if k�lf if if if iE iE 3F 1E if iElF iF iE iE if it if 1E if if ff M 1f iE iE if it !f iF if %iF ff iF iE #+E iF if K iF if iF if iF iF iF M it if if �E if if %IE it iF if �E iF iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PL[1MBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7.00 25R PLAN ISSUE FEE 20.00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK �43i�.i�;�----= �r_F>,F:� �`c�•_4�4h 4h..'ca� p��r�BLbC�PMT'��PLUh1BIN� ELECTRI��aI�ECHANDC 2%.�� SMIP/NON-RES TOTAL PAID DUE �7�,vnF,� a�.r��ca .00 27.00 OVER/SHORT: 00 FIRE SMIP/TOT GRADING PLAN-CFIECK if iE iE fF iF if ff if if 1F ff iE if if iE iE iE if if ff %if if it * ff aE ff i! �f if iE if iF if 1f if iF if if if if if iF iE 1f if if if M iE �If iE?f if if �E fE iE fF iE �1F iF iF iE iF if af iE jE iE %?f af iE iE iE if iE I N D I V Z 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 PLU 1 WATER HEATER AND/OR VENT 7,00 7.00 END OF FEES ?3 00?5117?-pC1:�t;77 i'C� T ?'•.G� i+ATE� iL23/93 iIME: 13:1d � CONSTRUCTION AND P4ANNING - Dace APPROVALS Permit � � t. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgmd. 3. Electrical Conduit UuhtY�Und�qrnd. 4. Electrical Condu�t�Undrg�nd. 5. Steel Reinforcemem 6. Electrical UFER Grnd, � 7. Footings • 8. foundation � � 9. Water Pipe�UndrgmA: � 10. Structural Floor SYstem t t. Property Sevver Line & Hcuse Conr.action 12. Se�.ver CaP _'. 13 Roof Ora�ns _. _ �- 14. Rou�h Plumb�ng 75. Rou�h Electr�wl-Contlu [ i6. Raugh Elettric Wiring 17. Rough Winng Sign 18. Rough Electricai�T Bar Ceibng 19. Rough Heating & Air Cond�t�oning 20. Rough Factory Fireplace 21. Ducts,in Structure 22. Oucts, Ventilahng 23. Gas Pipe�Rouph & Test 24. floof Fram�ng 25. Roof Sheathing 26. T�Bar Ceiling (Structurall & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 37. Plaster Bro�vn Coai 32. EleclriC31 ?ovrer i5etcr�F�nal 33. Pinal Eiecrric 3A. Final Heatinc, & A�� Condifon:ny 35. Final Gas P�pe�Tcrt 36. Hood or Canopy 37. F�nal Factory F��epiace 38. Final Plumbing 39. Water Service�Final A0. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irnqaunn System 45. Sound Attenuation 46. Hand�,cap Reguiations 47. flPfAl STRUCTURE & BU4LDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southem Caiifomia Gas 51. CERTIFICATE OF OCCUPANCY Date POOI 'PA Inspector APPROVALS Permic; 52. Pool & Equipment I.ocaOon 53. Steel Reinforcement 54. Forms 55. Electrical Bor.dmg 56. Rough'Iumbing & Pressurc 7est 57. APPROVAI TO COVER�GUNiTE 58. Electrical Conduit�Undrgmd. 59. Gas P�pe, O Undrgrnd., Test 60. Backwa5h Lines, P-Trap, L: Undrq�nd. 61. APPROVAL TO DECK 62. Back�.t�ash ti� Rec�ptor�Fui�l 63. Heaier & Vent-��nai �, 64. Plumbing SVsrem - F��al -� 65. Eiectrical-F;nal _ 66. Solar System-F;nai � 67. Fencing & Access Anp�uv�l 68. APPROVED FOR PLAS7ERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT T APPROVALS Permit;: 70. Undergro.:r.d Hytlro 7{. Procfuct P;pir.g � Gas �:0�� 72. Underground Flush 73. Undergmd. Storsge Tan!c C Gas � O�i 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 76. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT e 79. FINAL iNSPECT10N 80. FOOD CERTIFICATE ISSUED Notes: Date � Inspector � �� oowEsswewinwc: 3084 JOHNSON ACT UNT: wmexsxu�eiviu�onr+: ERICKSON, ROBERT B FLOOD: X 47 noo�u: 3084 JOHNSON AVE � COSTA MESA,CA 926'l6 (714)979-7463 IiVFL.IWWlO �OONE55: � �. � �� I 1fICXRECi OP fNtlNEEX: 11C. N0: iRCN.OH ENG.'S AOONE55: UNT: ca�mecrarswue: CRANK BROTHERS ROOFING CO ( 714 ) 548-5569 CRlIN�CTORSYNIdIG 126 COMMERCIAL WY ��, COSTA MESA CA ��,�, 408677 92627 �N,: LICENSED COHrNACTONS DECLRHATION: I hemby allirm unEer peneEy of perjury Ihet I em licemed unEer proviaiona d Cheplm 9 (commeria(p �h Seciion ]OW) d Division 3 d ihe Busir�esa ard Proleeciarre Coda, eM my licensa u in lull lorte end eHed. cmuc.No.:005993 uc.cuss: C 39 uc.No.: 908677 EXP: 06/96 De�e: �� q � y S^ Comretlor. �� GA'«/� ��^^ /d'o'� OWNEP BUILOEN OECLANRTION: I hareEy �mi unCer peneAy d perlury Ihet I em ecempt Imm Iha CoMretlon license Lew lor ihe lolbw'v�p reewn (SeUbn 1031.5 Busiiess eM Prolensiona Cade: Rny e4y a eounty whitli eeQuiree e permu �o mnsWet, ellm, improve. jemdsh, or repei eny svucium, prior w ns'sweMe, eleo repuirea �he epplicent fa euch permil lo file e cqrod ewemen� ihei he m sha IbanseE puiwwenl lo Ihe paieiara d the Coniredora licenae lew ICheplm 9(oommenii�p wnh Smion ]000) d Drv'wion � d �M iwinam ard Prdea'a�s Cada� ar ihm ha a she o exemq iharehom end �ha basia lw Ne albged ezemqion. My videtion d Seaun )m1s W eny Wdicen� lor a wrmil wq �e �na evolira�t m e dvil oenelly a nd m«a ihen live nuMred ao�len RSOOU. ❑ I, es owner W �he pmpeny or my empbyeas wnh we0ea ea ihek eole compensation, will do iM woA, end ihe simcNre o nM inlended or allerad lor seb �Saclion>Oaa, Businma end Prdeasions CoEe: TM Contrepwa Licanae lew Eoee ml epph �o ��'�er W piapeny wM10 bulde ar'unprovea thereon, uM wfio Eoee euch work NmsaH w InnM w Nrouph hb or her own employeae, pmndaG ihel euch ' pouementa are rot ime:ded a WereE la eele. H. Irowevar. �ha buiNirp « vnpwmmenl is add wnhin wre yeer W mmpbtion. �he owmr-0uilder vrill heve tM WNen d prwi�p M ar ehe d'd � Wik or imprare fa �M W�e d We�. � I. m ox.nr M tM propaM. � asdusNey mnlrediq xil� IicenseE canvxtwa to wnsh�d ihe piojM (Seaion ]OId. Busirisa vd Prafeasiona Code: TM Contrenors Licensa Lew Eo» rrol eppy io en awner d prope�y who puilde w imqoves Iheroon ard x1w conlrecb lor suM projecb wilh e mnveaor(s) Icensed puroueni io Ihe ConVaGoro Licenae lew�. � 1 em ezampt andar Sedion: B. 8 P.F. �a Ihie roeaon: Dele: Ownx: I do hereby <arliry iM1a� 1 em ewere d ard wdentend �he reQuirementa d CelAwnia HmM1� end Selery Coda Seqbns 25505, 255J�, eM 25530, eM thei I ar eny iNure buildirp awpent xill / wtll ewl (arcb one) need to rompy wih eaitl atela mdes end tM raQuiremema br o�e: Avd�� WOFKEH'S COMPENSATION DKL�NATION: I MreEy elfirm uMer pnelly W parjury ar d tlre latloxiip Eetleretons: � I heve end xill mamem e cenilcele d mneenl to eeX�mure br waMere wmpenWion, m providad la by Sulion 3]00 d ihe lebor Cede, iw tM pe�lamence W iha xnM br whic� �hn permit ie ievuad. �I hero enE xil mein�en worken' mmpamelion inaurarcs. m rpuiretl by SeCion �]00 d ihe Labor Code. br iM pailarmenm W Ihe waxi«`.i,�mn��a�.��e.Myw«wnS'�ATE��FUND«�'d��m�v�: EXPIRES c�«: Policy Number �— O S/ 01 / 9 6 s seclion nesd nw 6e com0lefed d �M peimif ie br one hundretl Colbrs /Sf00/ w hae J � I canLy Ihel in iha paAormence oi iha wark lar whch �hie pefmA ie ieeuetl, 1 ahell na emplq eny peiron in enY menner eo m to bacome eubjae io tM woAere' wmpenaetbn kwe d CelHanie, enE prea Ihel it 1 ehouk becoma eubjea lo �M waken' mmC^(^��^ proviaiom d Seqion 3i00 d Ihe lebor Code, I ehdl lo�hwilh compy �mh thove provisione. Oate: � ' � Appli�anl: _ �� Wam/np: Fellun ro�xun worka�' compmwtlon eavenp� b unbwNl, end sMll subJ�ct an xnployx ro etlMm/ p�n�IHu e�W c/vll nma up ro on� nunarW rMuuiM doll.n (StOo.ouJ1, �n xM/tron ro tli. cwt or romp.iwrron, eurrps, o prov/tlM ror /n 9ectlon 3]06 0/ tlu LWor COM, Inhroq �nJ ettom�yY Isu. CONSTHUCTION LENDINO �DENCY: I hereby etfirm uMer penely d Porjury thet Ihen u e consiNtlbn bndiip eqercy M �he paAwmarroa d Ihe xwk far whid� ihi permY n eauad (Sed'on 308], CN. C). LENDEF'S NI1ME: LENOEH'S ADDPESS: I ceMiy Ihet I heve ned thia epd�ion enE stma �hei tha ebava iniwmelion e wrteG. I epree lo wmply wilh ell tlty eM county ordinenms eed awa lewe reletmB to WiMinO �nsvueim aM Mreby aulhwae ropreeenieiivee d iho rily lo emer upon ihs ebow-mantioned propaM ,��„��a C,4�� /��/y{�J 1 Neme /� c� ( T// ^ Dale: ��I 7 ��"J/ $ipnelure ol Oxner/hpenVApP��retla CITY OF COSTA MESA — BUILDING PERMIT PERMIT N0: B 0742q6 PLAN CHECK NO: N PERM NO: B 074246 GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/O REROOF W/BUR FLAT GRAC'EL ROOF S� FT: 2,875 CLAIM VALUE: 2,875.00 CALC—VALUE; 2,875.00 GROUP OCC: P,-3 /M-1 COMMENTS: REROOF SFD AND ATTACHED GARAGE/SMOKE DETECTORS REQUIRED *�*�**��***��*�*��**��*��*****�*��*��**��*�'S11j10 KE�C��'��Q �i Z O N I rl G— R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ------ --- --------- ACCESSORY BUILR�CQUIR E D_ FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14159202 ZNE: REF NO: PLANNING NOTES?; �- �t 1E iE iE iE iE 1f if 3f �f 1k if� 1E iE if � if 3f if aE 3E IE 1E iE iE iE 1E �E 3E 3E �E �E iE if iE if * 1k 1E �E dE 1E iE 9E iE 9E 3E iE iElE iE if iE iE iE �Fdf !f iE fE iE aE iE iE iE if iflF fE iF.l� 1f -1f 1E iF iE �E iE i! * D E V E�L O P M E N T S E R V I C E S R E Q U I R E M E N fi S r�.. ZONING APPROVED BY DATE: BUILDING APPROVED BY : _ DATE: /'' APPLICATION ISSUED BY:� ��r.�'��Ti�f��"�� ********�t-******�*�****'i�: i� E� � � �� LEGALIZATION:N'� F E E S U M M R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 54.00 PLAN ISSUE FEE HUILDING—DIV—> TOTALS----> PERMIT ISSUE PLAN—CHECK 54 50 0 00 0 UO FIFtE :i DATE: jE -0F �E 3E iE iE iE iE ��F iP�if �F�ciFiF if iE STRUCTURAL SEGMENT:Y SMIP/RES GRAUING 50 SMIP/NON—RES TOTAL PAID DUE . . . 54.50 ' ,; 54.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT,'GRADING PLAN—CHECK 54.00 .50 '- iE iE �E 3f iE 3E fE iE iE if iE 1E iE ik iE iE i!!E if 1E iF if ff iE iE if �f 1ElE if fE if jE iE iE �)E iE iElf jE iE �E iE 3f iE if if 3E �E if �E jE 1E iF �E fE 1E 1ElE iE iE iE jE 1E ik i(� if jf 1f iE 1E �E jE �A iF iE iE �1E 3E I N 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 2875 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 END OF FEES • Q 2,875.00 V ai oois�4�F aniso47� -rr-e�- DATE: 04i19/R: TI�E: OS:Z9 JT�� (5151�C6.WP) While-BuiIE'up 8 Setely;Oreart-FIe;Cenary-App4raN: Pink-Ravenue: Galdenro�qeeeaeor / CONSTRUCTION AND PLANNWG PQ01 '�PA APPROVALS Permit# Date Inspector pppROVAIS Permit# Date I�spector t. Temporary Electric2�.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. Efectricai Bond'ing 5. Steel Reinforcement 56. Rough Plumbing &?ressure Tesi 6. Electrical UFER Grnd. 57. APPflOVAL TO COVEfl-GUNITE 7. Pootings 5$. Electrical Conduit�Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgmd. � 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structurai Fioor System , 61. APPROVAL TO DECK ' 1 i. Property Sewer Line & House Connection 62. Backwash & Receptor-Pinaf 12. Sewer Cap 63. Heater & Vent-Fina! 13. Roof Drains � � 64. Plumbing System - Final 74. Rou9h Piumbing 65. Electrical-Final ' 75. Rough ElectricabConduic �. 66. Solar System-Final i6. Rough Electric Wiring � 67. Fencing & Access ApProval 17. Rough Wiring Sign �� 68. APPROVED FOR PLASTERING � 78. Rough Electriral�T 6ar Ceiling 69. POOUSPA SYSTEA4S FINAC ! 19. Rough Heating & A�� Conditioning FIRE DEPT. REQUIREMENT I 20. Rough Factory Fireplace APPROVALS Permit # ! 21. Duccs, in Structure 70. Underground Hydro I 22. DuMs, Venti�ating 71. Product Piping OGas i.70i1 23. Gas Pipe�Rough & 7est 72. Underqround Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Fioof Sheathing ��j��'��y(�,/�� 74. Overhead Hydro 26. T-8ar Ceiling {Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation '- 78. FIRE PREV. FINAI 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Piaster Brow� Coat 79. FINAL INSPECTIQN 32. Electriwl Pow2r MeterFinal �� 80. FOOD CERTIFICATE ISSUED 33. Final Eleciric Notes: 34. Pinal Heating & Air Conditioning 35. Final Gas Pipe-Test - , 36. Hood or Canopy ;, 37. Final FaMory Firep�ace � 38. Pinal Plumbing � 39. 4Vater Service-Final 40. Gas Service-Final 41. Solar pomesticFinal i 42. Backflow Preventer �u��'�_ �� /1_S, ../% _ oF� d-4"/"� 43. Backflow irrigation {-. � �� /�l ._. �l�� 44. �endscape irripatio��vscem � 45. Sound Attenuationt.„.1 r.;. � 46. Handicap Regulatiods�i ��' 47. FINALS7RUC7UR�&B.UILDING �.)��i��y(j. . i v - ! p 48. F�NAL PLANNING.� -` 49. Electric Release to Ediso!''�'. ,� 50. Gas Release to Southem California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No._ - Date ' 17037 �COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 C08TA MEBA. CALIFORNIA For Applicant fo Fi11 In Complefely TYPE OR PRINT BUI{.DING 30 8 y To:i�.ro.� i4ve. ADDRESS COSTA MESA CALIFORNIA �,T., Beverly Hills No CR.- ARCHITEGT TEL. OR ENGINEER -- NO. F�E RECEI�fEC� u/ MpY 17 �1' �+ rINAi�CE DEPT. ClTY 0� COSTA MESA APPLICAT{ON FOR PERMIT BUILDING For Office Use Only RECEIPT NO. PERMIT^XP� HECEIV$D �Y I � TAE,f�CEJVED I �ATE I65UED t C/ `Y? 62 • f n 1 U� BUILDING '�Q$ Johnson Avenue ADDRESS COSTA MESA. CALIFORNIA FIRE ADORESS 2 Ol Benedict Can on Drive ZONING ZON NO.OP USE OF NEW C�TV Q PPZV H 119 alifornia �—I IPLAN9 � auitotnc ., LIC.TNO. 1��. NO. CR. "O—� `FU �ecwL Oti ZO DE6CRIPTION � SRE No. oF et_ooe. ,.r � Fvi M .._,., .... . -- - � U6E OF EXI9TING BLDG. 6QTBACK LINH PPON CEMGR OF eTREET �i � REAR YARO SI�E VARDDESCRIPTION OFRIWORK' NEW I X II ALTERATION I II A�DITIO� EXTERIOR WA ROOF COVERING COVEI USE OF BUILDING AND WORK TO 1 � _ G'nm RP.0 W�A� \C£NTFH LiNE 8T.1 � FRONT � d REAR Z � APPROVED /p�' BY L�11 SJ -�i 3 �L � _ �r�.r �.1,, � GL �" �,� - I HHqEBV AGKNOWLHOOB THAT 1 XAVE REAO THI9 APPLIGTION TX! AMOUNT BHOWN tINOEH VALUATION FOP THE ANO BTATE THAT THE ABOVE 18 CONHECT AND AGfiEH TO COM pURP09C OP E9TABLIBH�NG A PEqMIT�FEE ONLY. PLY WITH ALL GI OAOINANCE9 AN� 9TAT6 8 HEq+�LATI a�ir.uer� o�Nc �cTl/N. / �� ` / . VALl1ATiON I ['/// A /✓.t% PERMIT FEE $ / ( `— $ 21,024.00 � AUTHORIZED f/I