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HomeMy WebLinkAbout2473 NAPOLI WAY - Building Permits(714) 754-5273 • Fau (�ia) �sa-aess • www.ci.costa-mesa.g�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 2473 NAPOLI WY Suite: Vicinity: ROOF, UNITS 24�3, 2475 AND 2477 Primary Occ: R Type of Construdion: V-N Parcel Number: TPN006021 Zoning: App�icant: SIMMONS, D�BORAH Address: 2163 PACIFIC AV Owner: Address Contrador. Address: Zip: Arch : Address: Zip: COSTA MESA, CA BACK BAY GARDENS HOA C/O OPTIMUM PROP MN_GT TUSTIN, CA 17731 IRVINE BL . SUITE 212 HIRSCHMAN, RP AND SONS INC 9582 HAMILTON qVE SUITE 281 " � HUNTINGTON BEACH, CA 92646 Phone: License: Phone: 949-631-9280 Zip: 92627 Phone: 92780 Zip: Phone: 714-960-8329 License: 781923 Eng: Address: ISSUED BY: Status: ISSUED Applied: 02/Ot/2006 Issued: 02/01/2006 Phone: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTAL� 1 LAYER 15# FELT, 50 YEAR COMPOSITION SHINGLES AND REPAIR/REPIACE SHEETING AS NEEDED. 40 S�UARES FOR UNITS 2473, 2475 AND 2477 NAPOLI WY. FEE SUMMARY Plan Check: $0.00 Permit: $293.25 SMIP Res: $1.71 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $294.96 PLANNING 8 ZONING SETBACKS ACCESSORY PARKING Front 0-0 Front 0-0 Existinq: 0 Calc Valuation: $i�,o�z.00 Claim Valuation: $n,on.00 Rear 0- 0 � Left 0- 0 Right ,Rear 0-0 Left 0-0 Right Required: 0 Pr000sed: 0 ��. NOTICE: The work authorized by this permit shall comply wiih all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92J EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 7 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all raqulred Inspeetlons and Nnel epprovel must be obtainetl. Failure fo obtain tnspecifons and final approval will result in the expiretion ot this permit. FOR INSPECTIONS CAIL: (714) 7545628 eano-eo �aw� WORKERS' COMPENSATION DECLARATION: � _ I hereby aHirtn under penalry of parjury one ot Ihe lollowing declaretions: ❑ I have end wi�l meintain a cenificete ot consent to self-Insure for workers' compensation, as provitletl for by section 3700 of the Lebor Code, tor the pedortnance ol the work lor whiCh this pertnit is i55ued. 1 heve entl will meintain workers' compensatlon insurance, as requiretl by sedlon 3700 ot Ihe Labor Code, for tM1e pertormanca ot the work br which INs pertnit is Issued. �—'My workers' (gmPen$ation Insutence wrrier antl policy numbar ere: efone Palicy NumDer: �DW�' ��(O orless.J � , ' �- „ ❑ I certify that iP the peAortnance of the work lor which this permit is i55ueQ I shall not employ eny person in any manner so as ro become subject to the workars' compensation laws of Calilomia, end egree tha{{{ il I should bewme sub�ect lo ihe workers' compensetion pro�isions of Section 3700 of the Labor Code, I shall torthwith tOmply with Ne58�� p�� M^� � Appticent5��e;= � !!/[ roe,�:� _ ,��D�v �WaRNING�FAILURE YO SECURE WORKER$' COMP NSATION COVERAGE IS UNLqWFUL AND SFIALL SUflIEGt AN E�LOYER TO CRIAANAC PEN/�TIES AND dVIL FlNES UP TOONE HUNDRED THOUSAND DOLLApB ($100,000). IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SEETION 37060F THE LABOq CODE. INTEREST, AND ATTORNEY'S FEES. LICENSED CONTqACTORS DECLAHATION: Chapter 9(cqmmencing with Section 7000) of Divislon 3 0l the Business a�nd Professions Code, and my license Is in full CONSTRUCTON 4ENDING AGENCY: ❑ I hereby aHirrP that there is e conSlruction lending agency }or the peAormance of the work for which IN5 permit is issued. (Sec. 3097, Civil Cotle). Lender's Neme: lentler's Address: Signature: _ OWNEF-BUILDER DECLARA710NS: Date: 1 hereby aftirtn ihai untler penalry of perjury Ihai I am E%EMM FROM THE CONTRACTORS LICENSE LAW lor iha following reason (Sec. 7031.5. Business entl Protessions Coda: Any city or c0unty which requires e permit to construc�, alter, improve, tlemolish, or repair any structura, pnor to its issuence, elso requlres the applicant for such permit to file e signed statBment thet he or she is licensed pursuant to the provisions ot �he Contreaors License Lew (Chepter 9(commendng with Sectlon 7000) of Division 3 ot the Business end Professions Cotle) or Ihet �e or she �s azempt therelrom and Ihe basis for the alleged evemption. Any violation of Sectlon 7037.5 by any epplicant for e permit subjects the eppliwnt to a civil penelry of not more than five huntlretl dollers ($500).): ❑ I, as owner of the propeny, or my employees with wages as their sole compensalion, WILL DO THE WORK, and Ihe strucWre is noI intentled or ofleretl tor sale (Sec. 7044, Business and Prolessions Code: The Contractors License Lew tloes not apply to an owner of propeny who builds or improves ihareon, and who tloes such work himsell or herself or Ihrough his or her own employees, providetl that such imp�ovemenis ere not Intended or oHered for sele. If, however, the building or improvement is sold wilhin one year of completion, the owner-builtler will have the �urden ol proving that he or she did no� bu�ltl or improve tor purpose of sale.). ' ❑ I, as owner of ihe property, am EXCLUSIVELV CONTpACTING WITH LICENSED CON7qACTORS to conslruct tha prolect (Sec. 7044, Business and Profassions Code: The coi�trectoB License Lew does not apply ro an owner ol property who builtls or impwves thereon, antl w�o contracts lor such pmlect with a wntractor(s) license pursuant to ihe Contrectors License Laws.). ❑ 1 em ezempt ondar sac. Husiness and Pmiessions Code tor Nis reason: Signature: Date: Owner ID verified by dnver's license. ❑ Yes ❑ No Driver's License No. Expires: Vedfication oi Ownership by (type of tlocumam, i.e. - pmperry tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby canify Iha� no eacavation tive (5) or more feet in tlepth into whic� a person is required to descend, will be mada in conneaion with woilc authonzed by t�is permit, entl iha� no building simcture, scaflolding, falsework, or tlemolition or tlismantling thereof, will be more than Ihitly-six (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Califomia Adminlstrelive Code). ❑ As owner-builder, t will frol employ anyone to do work which woNd require a permit tmm the Division oi lndusirial Satety, as noted abwe, unleu such person has e permit to tlo such work irom ihe tlivision. Signature: Da�e: Division of Intlustrial Safery Permil Num6er. CERTFICATE OF COMPLIANCE AND AU7HORIZATiON OF EMAY: I cenity under penalry of perjury thet I have read ihis applicetion and state �hat the infortnation given is correct. I egrae to comply with ell stale lews end ciry ordinances relating to building constmction, antl au�horize representativas of �he Gry of Costa Mesa to entar upon ihe above-tlescnbed property for inspection purposes. I agrea not to acupy or ellow occupancy ot any building euthorized by ihis pertnit until final inspec�ion. Ot Legal CODE 1. INSPECTIONTY_FE 1616 Flzed System Final Fira Pravemion 1266 Pool Spa Final 200 Finel Ra-RWi 201 Finel BIocWRelaining Well 202 Finel Faclory Fire Plece 203 Final Sign 204 Final Demolition DRTE F�ffi o /?�"� 40DE� INSPECTIONTYPE 206 Finaf Mechanical 208 Final Plumbing 210 Final Electncal 212 Finel Fire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupancy PAIE � 1[�ELS � Location 2449 2449 Napoli Wy 2473 Napoli Wy Permit # 606-00127 53 Contractor Hirschman, RP & Sons Inc 9582 Hamilton #281 Huntinaton Beach CA 92646 , .,, �......._.,, , ., _.. __„� ..._ 9582 Hamilton #281 Huntinaton Beach CA 92646 hirscnman, rcr a sons inc 9582 Hamilton #281 Huntinaton Beach CA 92646 -�oon�ssaewiomo: 2q7] NAPOLI WY a��rarw�EiFi°�°"": JONES, KENNETH C ADDNE44 Z q � 3 NAPOL I WAY COSTA MESA,CA �vr�. Yuiwo .00ncss: MCNIfECT OP 01�lffA: IpCII OR ENY'S IODflE55: uNr: 57 CITY OF COSTA MES'A•,— BUILDING PERMIT 92627 PERMIT NO: B 073272 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR ��� JOB DESCRIPTION . T/OFF AND REROOF W/CLASS A 3 PLY ROCK UNf: �+"�T�%""� ROSS 6 BARROWS �NC. ( 714 ) 557-7440 carn�crone�uian 260 E. ALTON AV eooxcu: SANTA ANA CA ��� 327802 92?07 uM: --- 4CENSED COMRACTOflS OECLAR4TION: I heraby eflim ur�da pa�y d perjury �het I am Ikeneed uMu provieions d Chepm 8 ( �Minp r.rA Saction )000) d Drvoon J d tM Buaineu enE Prqp�pti �a. enE mY lioems e in lull /oru enA eMetl. uc.N z0924 uc.cuss:C_39 uc.No.: 9z�g02 EXP: 11/95 Dme: � J Canlreaor: %/�/�1�// Ym ..rKt 7��- '..0 NEP 6UILOEP OECl1flAT10N: I Mmby eifirm under penely W per'ryry Ihet I am eump Irom tM aNretlore lironee law la Ihe �'��Ihw+q rmaon l5edian )0315 &niess and Prdemon+ Cada: AM ciY a oouM' xAiN n0am a P�4 to aorebuct. elim.'unpo-.e. "wJemoleh, a repv eiry ewclirte, p'v ta ea eaueMe, a6o repuirae Ily epp��� la euch pamil to Rb a eqred ewamant Mm M a ehe n IiceneW punuem �o tM provisiom W tM Contreeare Limn» Lew jCMpr e(canmene�p xilh Sapion )Opp) tl Divebn 3 d iM Bu�'viem eM Rdanbm Coda� «�hu he a Me b acemq iherdrun� ud IM beae la tM eAepeE uemplion. My videlion W Setlion )W �.5 by eny epd�� lar e permil wEjada the eppl'ran �o e tivil q�ryy d nd mas tMn 1'xe hundrtC dd4n �i500��. � I.eaounerdiMPW�YttmYw^WM�x'thwsYa!mtheibbmmD��.�.AEotlar.wM.eMthe�wcn�mum�"vnadeE a aRaad W eeb (Sectian )oa. Buvmu eM Pminewna Cada: The Contreeasllowa lew Eoea mt eDdYto en owrord pW�Y W�ID �Il�if V IIIC�aV 1�MIGIXI. MY� M�D 40l0 SIIf�1 NIXk IIYIIMI� M �1Ml� IX 1�1IWd1 �1C IX �IG ONT MII�4li. P��� �119� WC�1 IIIIP�mlNO Bf! INM IMGIIQl� Q Gfll1ld �IXlBIB. d. �1PNT2f. ��b b1YM11110IX �IIC���lM 0 Wb WII�1YI lYM Y!Y C� Cq11dB1O11.1�18 o.�s�aau« .iu nme ma w�w, a ww�ro ne «.ne eid na Mwd « imwwe ia ur wm�. d wel. � I. m owrcr d �ha pW�Y. em u�FaMy contrm�q xnh fican*W contranae w mmrW tlro pal� (Sepion )Oab. Bw'vme eM vid.dm+coee: Tne comi.aon �cem. te. aos na ewh m.� o.�w a ww�r wro aum «�po.. ma.em .m wno cmpxb lur wxh prqaw wM e awrermr(e) ficemeE W��eM to iM CanlrWa� limnse lew�. PERM NO: B 073272 GOVT: N SUPP: N PURPOSE: OTH SQ FT: 1,824 CLAIM VALUE: 1,824.00 CALC—VALUE: 1,824,00 GROUP OCC: R-3 / COMMENTS: GARAGE ONLY ��x*�t*x*+e*+FiE��iFet**at*x+��*�*+�atxit�+����afar***if �atat��ree�ififx�+�+�at*���x*�iE*x�*******ie��*�*at*iE Z O N I N G R E Q U I R E M E N T S S E T B A C K S ----------- MAIN BUILDING ---------- -------- ACCESSORY PUILDSNG -------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: PT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT TN PARRING REQ: PROV: PARCEL: 43914].55 ZNE: REF NO: PLANNING NOTGS> i � �E fE jE iE 1E iE jE iF jE Ik 1E if if if iE iE iE iE iE iE iE 1E 1E 3E fE iE iF iE 9E ib if �F iE �f iE k 1F 1E if iE jE iE iF iE 1E iE iE iE jE if IE IE aE fE iE iE 1f iF if if iE 1E if iE iE iE iFlF iF 3E 1E iE If iE if iE jf if fh 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 T S ZONING APPROVED BY __ DATE: � r i+�i�.���es���:zen�.�av p,,,,,,.,,,,a,ow.,see�,: s.av.c..m,mm,,,,o,,: APPLICATION ISSUED BY: ' Dma: Ownar: 1f� �lE iE dF �7f ik 1f iE fE aF if-iF iE iE 8E iE iElE �E N� 9E iE , ik I tlo heraby ceniN �� I em ewere W eM uManiuW tM reQuirememe W Celfanie Fbellh uM Sdery Code Safbm 25505. u53'f, end L E GAL I Z AT I ON : N F E E S M M A R Y 255�. aM tlw I n erry Mun buiNinp ocaryant xiil / wil ria (amh c�) � �o canply wIh uid qals codn ud �M requiremems br epeimnlammwnionamoEifKalionhwntMAr u3eTly�. �anepemen�pqq�p,p�idemidconaruaioneppfulionserememqfmmUwe BLDG PMT PLUMB7NG ELECTRIC MECHANIC FIRE �°""°"' PERMIT 43,00 Deta: Applcem: W OPKER'9 COMPEN9�TION DECLAH�t10N: I Mreb� elfi�m uMa peny�y d perjury ms ol �hs btlowi�q deduaz'vn: � I heva ud vril meinten e canE'rata d mumt to aetlimun br vpyy�� �pM��, n po+idad In by Samm 3100 d �M leba Coda, la IM pe�armuica d tM wk Iw wNch Nn pemiil u u�ueO. �I �ma uk vAI meinten waM1en' camD�+vion ireurenro. n m�'ved M Satlian �)00 d Ne leErc Coda. br �he D��m� G iM work lor wh'rA i�ia Ve^^n k u�ued. MY wakon' canWrumnn Iruurenca fur'nr enE VdwY mimber ore: c.m.,: FnrTNn T7nN EXPIRES ra:.vN�mee�: u1qS7� 7�'�'�1'� 07/O1/96 (lhis mel'on MW mtW mnNMeJ / IMVa'mt e b ms Mmdnd tla0en IflWf a Isw.) � I ronN tlW in Ne OMame�rw d �hs wark M xfiiM ��u D�G ie iewatl. I ehell m� emOM �YVa� in enY man�r eo n lo jjjwww . wq,a m me wona.• �e.��, m.. a cardunn d,e w�.e uw a i.m�da e��. .apa m m. �.� � aiumian qwieum d Seuion 9]00 d the lebar Coda. I qW 1 hwnh p�y wGl� IFw /pwidwu. —/ roc�fram: -����i�A.�f-cc>.c� �lip: F�INn ro wcun woikw�i rompwiutlon cwxry� ls v�yM/�I, uW MWI Wdpcl �n wlployw ro Mm'rolpwMu eM � nH� nn.. w ro on. nurelse tlau,.ne don.n (S�ataooA �+��non ro m. co.t or mmy,wuetron esmsv.... wov�ese ror �n �'�, Sictlm J1P6 0l M� LeDor Cah, Intwf, eM ettomsys Isp. CONSTPUCTION LENDINO AGENCY: I ha1eby dfirtn uMer per�eny d perN�Y �� ��� 4 e aonnruaion kMirp epericy br the y,do,mence a �ne wAc �« rnitl� �ne va^^� e ewea (saaun ao9), civ. c). LENDEP'S NMIE: LENOEN'S �DDPE54: I ceniN �� I hew read iho epplke�ian vM mele tlal Ne ebave infam¢�p� o conatl. l eprae Io wmply wi�h dl rimy enE couny adv�v�a end slete lewa MminO �o buiWmB con�rud'an eM hereby eutMrize repreaeniMivee d Ihis cny io enter upon Ihe aDwe+mmioned pmperly iwinapafun Wrpoeea. NANCEE KILBOURNE � DW: 3 (5�5t�e6.WP1 WAns-BuiWipBSelary:GrearFk:Ca�ary�pp{��:Rnk-Rwanue:Oddeneo�brwr� PI,AN ISSUE FEE BUILDING—DIV—> PEAMIT ISSUE PLAN—CHECK TOTALS----> 43.50 0.00 . s 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 43.00 DATE: DATE:� � �� iEiFitititifi6ic� t�#aE E STRUCTURAL GMENT: SMIP/R50 GRADING SMIP/NON—RES TOTAL PAID DUE 43.50 43.50 .00 — 93.50 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN—CHECFt .50 *******�at�x�x��r*it*ie+�**�r**f�*it**�**ftx�*at**it*�*�x��r*�-��*�-+���*�*�x�*ie*�tx�*******atx-*iretk** 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 1824 REROOF BY VALUF. RES'IDENTIAL NOZONE 1,00 1,824.00 END Ofi FEES �: QOi35:`3—Q02S52:4 T O T Go.='� DATF: 0;/?7!4S 'fIflE: !::;? 7i CONSTRUCTION AND PLANNING POUI & SPA qPPROVALS Permit #� Date Inspector qppROVALS Permit �h � Date Inspector i i. Temporary Electrical Se�vice or Poie 52. Pool & Equipment Location �� z, gpil Pipe•Undr9md. ' . 53. Steel Reinforcement 3. Electrical Conduit Utility�Undfgmd. 54. Forms ' 4. Electrical Conduii�Undrgrnd. 55. Electrical Bonding �. � 5. Steel Reinforcement ' S6. Rough Plumbing & Pressure Test 6. Electricaf UFER Grnd. 57. APPRQVAL TO COVER�GUNITE � 7. Footings 58. Eloctrical Conduit-Undrgmd. $, FOundation 59. Gas Pipe, G Undrgrnd., Test 9. WEter Pipe-Undrgrnd. � 6Q. 8ackwash Lines,P�Trap, O Uhdrgrnd. 10. Svuctural Floor SYstem 61. APPROVAL TO DECK ' i t. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final � 12. Sewer Cap � 63. Heater & Vent-Final . 13. Roof Orains 64. Plumbing SYstem � Final � 14. fl0ugh Plumbing ,� 65. Electricai-Final �. 15. Rough Electrical�Conduit � 66. Solar SYstem-Final ' 16. ROugh Electric 6Viring j 67. Fencing & Access ApVroval 77. Rough Wiring Sign 68. APPROVEO FOF PLASTERING ' 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT 20. Raugh Factory Fireplace APPROVALS Permit # 21. DUcts, in Structure 70. Underground Hydro 22. Oucts, Ventilating 77. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergmd.SmrageTank OGas ❑Oil 25. Roof Sheathin9 t�_f/, •�lv�/ 74. Overhead HYdro � /� < 26. T-8ar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. LTthing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, fIRE PREV. FINAL 30. Drv�vall Nailing HEALTH DEP7. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:�yp'� /�� s,wa Q� %✓� .� � � �v 34. Final Heating & Air Conditioning a /A�� e� �x / /� cti• /[ ^w� 35. Final Gas Pipe�Test . 36. Hood or Canopy 37. Final Factory Fireplace , 38. Final Plumbing ' 39, Water Service�Final 40. Gas Service-Final 47. Solar pomestic-Final 42, gackflow Preventer 43. Backflow Irri9ation 1 44. Landscape irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING .�3 � �c,�-�/ 48. FINALPLANNING �' 49. Electric flelease to Edison _-- 50. Gas fleiease to Southem California Gas Co -- 51. CERTIFICATE OF OCCUPANCY ' No Oate ' p�� DOYI.E & SHIF Developmient Co. , Inc. ��ATE 6-3- & Shields INSPECTIONS j FIRE ZONE DESCRIPTION OF WORK J DATE GROUP I&J TYPE V ZONE PERMI' SUBCONTRACTOR .,....�. i COSTA.MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 9�7 COBTA MC9A, CALIRORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING y3 ADDRESS COSTq MESA. CA IFORNIA OWNER o e. �c v 4� . MAIL �3 -(�_ //Iqh ef C' 1/ A�DRE59 v � TE L CITY %i� [ / NO: �-a ARCHITECT 1 C I Q N�L�JI�� OR ENGINEER ( AI]t]RFB9 �� � V V�ia ,f� LAMbr yr) (�P.^�� FEE�� R�ECEIVED FINANCE DEPT. �l�d'a�RFA1G@��c91�$@w�nrr BUILDING fOr OffiCe USB Only PHCHIpT NO. P��OI 6.+ vs'W 5 �Ta9�-G.`3 .lUils�sau i` ss a`Y' � 7� �.�U TYPH � GROU � �HD DATB ZONINCi �*, �,A . �� NO.OP/� UB80RN . _ NOTE: NO fiAVE OVERNANG SHALL BE LE55 TMAN BTATE / /� T6 n � D 1, 90' TO HID6 @ REA P. L. LIC. NO. �� S� -U- NO (� EAVE9 9IZE �3 xS3•U� I�o.ore�oaa� ALLOWED fU.B.C.REQUIREMENT) OF LOT Now oN wT YARD9MPROVED YARDSAPAROVED USE OF -� MAIN BUILDIN6 ACCESSORV BUILDING E%ISTING BLOO. ( FROM C/L SfRBHT) seiancK �INB RNOM ']� PqONT � FT, FT, C6NT8ROPGTI�6QI' ��� •�Q R6ARVARO � R. SIDE O FT. ' FT. 81DEYARDI LHFT �— I R�pqT � DESCRIPTION OF WORK . sio O Fr. NEW ALT6RATION ADDITION REAR `�' FT. FT. D16TANG6 BET. BET. MAIN Q REPAIR MOVINO DHM L18H MAIN BLDOB. ACCE55.9LD68. BUILDIN6 NO.OR G V�•# DATE SIZE 33 ��r3.Sro ROOMB " 6TORIH9 � C. U. P. APPROVyED� EXTERIORWALL ROOP STI/N�(,� APPROV ` �- COVERING �✓<< O COVERINO � BY � DATE V US6 OF BUILDINa AfiD WORK TO B6 P6RFORM6D C.fi eHtci � /�//Al.�lfc( G�'/-I^� ` /p !� � a 0 % c �o�- ��`r0 SQ.:T. �i� o I H8R88Y ACKNOWLgOOH TX�T 1 NAV6 P6�O THI9 APPLIC�TION TH8 �MOUNT 8M UNOBH VALUATION IB POH THE _ •NO BTAT6 TXAT TN6 ABOVB 19 CORflHCT 4NO AOPB[ TO COM- P11RP08[ OI [B 6L19XIN0 A PEHMIT P88 ONLT. Q pLY WITH ALL CIT' OqpINANCU AHD BT�T[ LAWY N[OYLAT�NO yALUATION 6UILDINOCONBTRURION. ey pgRMITFEE $ �r�� SIGNATURE OF � � l C,h C s/� �� � � a PERMITTb V/ e � p '-^N^'.A 4 AUTHORIZHD AOiNT � � . /{ vW` TOTAL FEE $ �/ �