HomeMy WebLinkAbout2813 NEVIS CIR - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 2813 NEVIS CI
Suite:
Vicinity:
Parcel Number: 13943149
Applicant: COON, ROGER
Address:
Owner: ABLETT, NORMAN F
Address ABLETT,-NORMAN F TR -
NAPA, CA
3030 GLADYS CT
Convacmr: R C ROOFING COMPANY
Address: 11782 REVA DR
GARDEN GROVE CA
Zip: 92640
Zoning: R1 R1
Phone: 774-534-6205
Zip:
Phone:
Zip: 94558
Phone: 714-534-6205
License: 456490
Status: ISSUED
Applied: 09/18/2001
Issued: 09/78/2001
ISSUED BY: �
Amh : Eng:
Address: � � Address:
' Phone: - �� - Phone:
Zip: � License: License:
SCOPE OF PERMIT
REMOVE SHAKE RROF, INSTALL NEW SHEATHING, COVER WITH 40 YEAR COMP.�PARTIAL RESIDENCE AND GARAGE.
ALL PORITONS OF ROOF THAT ARE SHAKE ARE'BEING RE-ROOFED.. "- '
Plan Check: $0.00
Permit: $111.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $111.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front . 0- 0
PARKING Existina: ' o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation
Right 0-0
Right 0-0 .
ss,000.00
$5,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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.
I INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
' requlred Inapeetlons and final approval must be obtained. Failure lo obtain inspections and final approval will resWt in the expira0on of this permit.
I FOR INSPECTIONS CALL• (714) 7545626
>msss (yao�
WORKERS' COMPENSA710N DECLARATION:
I �ereby aftirm untler panelty of parjury one oi the toilowing tleclerations:
❑ I heve end wlll malntaln e certificete ot consent to self-Insure for workers' compenSation,res :ovlded for by section 3700 of the Labor Cotle, for the pertormence of Ihe
work tor whiCh this permit is issuetl.
❑ I heve end will maintain workers' compensatlon Insurence, es requiretl by section 3700 of the Labor Code, for the parfortnence ot Ihe work Por which this pertnit is issued.
My workers' compenSetlon Insurance carder and policy number ere:
e
Carrier: Policy Number:
(Tbis section need not be comp/efed i! Ihe permit is valued et one hundred dollars ($100) or /ess.J
❑ I cenify ihat in ihe peAortnenca of ihe work for which this pertnit is issued, I shall not emplay any person in any manner so es to become subject to ihe workers'
compensatian laws of Ca omia, and aqree that if I should become sub�ect to the workers' compensation provislons oi Sectlon 37p0 of the Labor Code, I shell fonhwith
comply with these pro i s. r/��..,,� ^vy / Q A
Applicent SigneNre: � /G,-- WV Date: 1 � V' u �
WARNINO: FAILURE TO SECURE WORKEf1�r COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO GVIL FlNES UP TOONE HUNDRED
THOUSANO Oq1ARE (5100,000). IN ADDITIQV TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR M SECTIIXJ 3]OB OF THE 1A90R CODE. IFf�EREST, PND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby a%irm ihat 1 em Ilcensed under provisions of Chapter 9(commencing with Section 7000) of Oivision 3 of the Business and Professions Code, antl my license is in full
force and eHect. Lic. A Class N
ConiractoYs Signature: [Y� � Dete:
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirm ihat there is a wnstruction lentling agency for the pertormance oi ihe work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Neme: Lentler's Atltlress:
Signature: Deta:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn the� untler penalry of perjury Ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a pertnit to consiruct, aller, improve, demolish, or repair any structure, pnor to its issuence, also requires Ihe applicant tor such pertni�
ro file e signetl statement that he ar she is licensetl pursuem to ihe provisions of the Contractors License Law (ChaD�er 9(commencing with Section 7000) of DiWsion 3 of Ihe
Businass end Prolessions Code) or that he or she is exempt thereirom entl the basis for the alleged exemption. Any vloletion of Section 7031.5 by any applicant for a perrr�'
subjecis ihe epplicant to a civil penalry oi not more then five hundred dollars ($500).):
❑ I, as owner of the properry, or my employees with wagas as thair sole compensation, WILL DO THE WORK, antl ihe structure is not intended or otteretl for sale (Sec.
7044, Business and Professions Code: The Conirectors License Luw does not apply to an owner of property who builds or improves ihereon, and who does such work
himseN or herself or �hrough his or her own employees, provided that such improvemenis ere not Intended or oNered for sale. If, however, the 6uilding or improvement Is
sold within ona yeer of complation, the owner-builder wiil heve the burden of proving that he or she did not build or improve for purpose ot sale.).
❑ I, as owner of ihe propeey, am EXCLUSNELV CONTRACTING WITM LICENSEO CONTRACTORS to consimct the project (Sec. 7044, Business end Protessions
Cotle: The conirectors License Law does not apply to an owner of propeny who builtls or improves thereon, entl who conirects for such proiect with e contractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am exempt under sec.
Signatura:
Owner ID ventiad by tlnvels license. ❑ Ves ❑ No
Business and Pmfessions Cotle for ihis reason:
Verificetion ol Ownership by (rype ot daument, i.e. � proparty taz bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Dnver's License N0.
Date:
Expiras:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is requiretl to descend, will be matle In connection with work authorized by Ihis
permit, and that no building structure, scafloltling, falsework, or demolition or dismantling thereof, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia Adminisirative Code).
❑ As owner-builtler, I will not emplay enyone to do work which woultl require a permit from the Division ol Industriel Sefety, as notetl above, unless such person has e
permit to tlo such work from ihe division.
SignaWre: Date:
Division of Intlustriel Safety Pertnit Numbec
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTAY: I certify under penalry of perjury that I heve read Ihis application and state ihat the infortnetion given is
correct I egree to comply with all state laws and ciry ordinances releting to building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon Ihe
ebove-tlescnbed property for inspection purpases. I egree not to occupy or allow occupancy of any building authonzed by this permit until final inspection.
n Signature Of Legal Owner(s) � §� I
(,G�fr-- U
AnNOr Authorized Applicant ate
COOE t. INSPEGTIONTYPE
1616 Fizetl System Final Fire PreveNion
1266 Pool Spa Finel
200 Finel Re-Roof
207 FIneI BIocWRetaininq Wall
202 Final Factory Fire Place
203 Finel Sign
204 Final Demolition
PAIF 1tlIII1844
� �
COOE 1 INSPECTION TYPE
206 Final Mec�enical
208
210
212
Final Plumbing
Final Elet�rical
Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
P� 1HI�L$
' Ablett
IRlSULATION CERTIFICATION
2813 Nevis c:ircle Costa Mesa Oran�e_
'__--- NumDer �n0 Sbee[ CItY County
SnOCivi110n ' LOt NumDl�
DESCRIPTION bF INSTALIATlON
ROOF
Materinl 8�and Name
Thickneen (incbes) �� �4N.wl�: ���.� Thermal Resis�ancc (R Value�
EXTERIOH WA�L ��"d�'' 3�y`�
Malerid , Brand Neme
Thkknrsa (incheil �� `� Tl+ermN Resina�e IR Vabcl �
CEILING
Ban or Blnnket Type 1%S� � Bnnd Namc
Thickness I��cheil TMermal Resista�ce IR Vatue�
Loou Fill Type_ Bnnd Name
Minimum Thickness linchesl �—� �C� Number of bags Weight per Oa9
Area Covered�Ih=1 Therma� Resiiiance (R Valuel
FLOOR,ELEVATEO
Material Brantl Name
Tnic4ne�s lincnesl Tnermal Res�sta�ce IR Vaiuel
FLOOR,SLAB 4
Matenai 'Brand Name
Tnfcknrsi f��ches) _ Tnermai Aesls�a�ce lFi Value)
Widt� fint�esl ___
FOUNDATION WALL '
Material — 8�a�d Name
Tnickness I��chesl _. " _ Tnermal Resistance IR Val�e)
�" , , DECLARATiON
ID
1 �ereEy cenify i�ai the above' insWat�on was insralled in the bu7iCing at t�e above loca�lo� �� rno�o�mance v�ixn �he
cmrent requlnions urting E�ergy Conservation S�a�derds �O� nev. resfdential build��gs Iloca�ed in Title i4 0� t�e
Gldorn7a AtlminitVa[�ve Code).
�
Forcier Construction CompanyL
Genrai Contoctor �Buileer�
_�'���. -�.� .
Sgnatvre ana Tiue
81270 r V
Licens< Numo<.
May 26, 1982
. SuC Contnclw pmul�tion ADD�����oij L�cemt NumDer
S�qnalwe an0 Tilie
Figure4-7 E..�+oieo�+co�-,pra�cecrn�t•cue
4-5
ADP��cant to fill In all spacei wlthin heavy Do�Cer lines antl si9n all approp�iate tlecla�alioni. v
i F COSTA'MESA - �PE�t� IT ryO `L TRA�Cj' O. LOT N,q. BLDG. NO. � ' �- � � ' -'
CONSTRUCTION PERMIT (7 ( T � ��3"7� �CS , . 9052 �12/04%81 ' ' 402.03 TL'
Project Address .' �,� _ . C TVPE OF CyONSTRUCTION -- ' ' � - �
OWner ; LuTi - --- Phone j G ❑ NEW LYAOD ❑ ALTERATION - � ' � , '
f ♦ Z
AdAfe55 Z, '; ' �jV��' `'`�- "" OREPAIR uCONVER510N ❑DEMOLISH ,
Arch/Eng. -- ' LicenseNo. � ��oTHER� AP� ZONINGREGULATIONS
DESCRIPTION OF WORK
Address ' � � � � � ' C ZONE - PLNG. REF. �� �
Contrsctor C�(���� ' Mn. �Phone, I.°�}�` TYPEOFPERMIT . ' . . . e ' . . ��OPU I LpING i��
SETBACK ST. ERTY LINE �
Addre55 � �`j � � � • �✓C ❑ GRADING ❑ FOUNDATION �STRUCTURAL LIDE VARD O? � ..
LICENSED CONTRACTOR DECLARATION - EF
❑ TENANT ❑ ELECTRICAL �PLVMBING �MECHANICA 5IDE VA /O
I nereby aftlrm that I am IlcenseU untler provlsions o( Charter 9(com- � , •. \ q�GHT
'mencing wllM1'sectlon 1000) of Dlvislon 3 0( tM1a Buslness antl �❑ OTHER •- "�� �
%oteS5iOn5 CotlG' antl my IlcenSe is In full tOr antl ¢ifect � � REAR YARD (TO P/L) � „
PROJECTD SCRIPTION
LlCensCCla � �' ���ICenSe.Noc � — O PKG.SPACEREQ. PROVIDED ��
Date Si9nzture e-� -1Y11`Ll,�drl ' - ' SQ.'FT. � _ _� _�
7 . �' ' -V.•. \ C. STREET WIDTH PARK FEE $
WORKE S' C MPENSATION DECLARATION � ' - OCCUPANCV� CONSTRUCTION T-VPE
I hereby affirm that 1 have a certlficate ot consent to selt-Insuro or a VALUATIONsT!Py..Q�ZONE Z�NING APPROVED BY DATE
'certlfitat0 OI Worker5' Compen5dtion InSUrance, or a certl/ietl copy � - -
thereof'(Socllon 3800, l.ab. C.). � ' GRADING CV. VDS. ACRES SPECIAL CONDITIONS:
'cY NO. Cort�Pany . . . ' _' ' " . _ _ . ' _ . _ _ '
]erNfletl copy i5 hereby furnlshotl. - - - REMARKSi - • . - - ,
j� Certlfletl copy Is filetl wi[h [ho,clty Builtling Divislon. � - r` '
'$XEMPTION F0.0M WORKERS' COMGENSATION DECLARATION' ' ' - - ' - - ,
-(T.his sactlon neeE not be completetl it tM1e permi[ is (or ane huntlretl .. _ . . - . .. .. _ _ _ _ �• '
SE300) or Iess1. ' � � ' -
cerUfy thd[ ln the perto�mance oL[hC work fOr_whiGh [hls pe�mil I5 _
I55ue0, 1 shall not emplOy any person In any manne� 50 a5 to beCome PLUMBINCi� PLAN CHECK ELECTRICAL PLAN CHECK
�SubIBCt to the Workerz' Compensatlon l. ws ot Glifornla. ' _ ' _ _ _
Date � Si9na[ure BATHTUBS SHOWERS - � �
NOTICE: If after�makin9 [his tloclaration, you shoultl become tubjec[ TOILESS 1 URINALS ' GENERATOR" 0-1 KW-1-l0.KW � �
to the Workers' Compensation provislons of the Labor Cotle, you must � - TRANSFORMER �
for[nwitn comply with such provislons or this permit shall be tleemetl LAVATORIES �OUBLE LAVS APPLIANCE 30-50 KW=50 + KW '
revokotl. - "_' '_" ' _ " _ _ . " '. .. ' _
CONSTRUCTION LENOING AGENCV � KIT. SINKS � � DISHWASHERS - MOTORS 0-1 HP_1-10 HP -
�
I h¢reby affirm that there I5 a construction�lendin9 agenCy for [hu per- �SERV ICE�SINKS ' SUMPS .= "'t --' ' ' ONC. SOLAR�--, 10-50'HP='50'+ HP � ' -
�Pormance of.the viork for��which this permit�is issuetl (Sec[lon 3097 -
��°•.�•1� � FLOOR SINKS. FLOOR DRAINS' � FIXTURES OUTLET SWITCHES
Lentle'r.'skName. .. .. . ' . .. ' ` _ _" ' ' ""_" • "__ ' _ "
Lantler's Atltlrex• '- �
Df31NKING�FOUNTAINS GASTUBESIGNS'- '��
OWNERBVILDER'DECIARATION " - ' c - ' '" " POLELIGHTS �- - " " '
I he�oby afflrm tha[ I am exemp[ from tM1e ConVactor's �icensa Law lor INTERCEPTORS CCARIFIERS .
'tne'following reason" (Section 7031:5' Business antl- Protesslons Cotle:' SWIMMING POOL�� P,TRAP - - - -'
Any city or county which requires a' permit to construc[, alter, POLES METERED SUB
improve, tlemolish'or repair any structure, prior to its issuance, also ra- yyqTER SERVICE � ALTERATION- � PANELS � MAIN -• - SUB - -
qWres [hcap4licant Por such permit to file a si9�etl statement that ha
is Iicensetl purSuanYto the•provislons of [he.Contractor's License Caw GAS SERV ICE OVTLETS �. SERVICE �- � - AMP —.
(Chapter 9(commencing with Sectlon 7000) of� Division 3. of_the. �
Business antl Professions Cotle) or tM1at ne'I5 exempt therefrom antl [he yyqTER HEATERS BTU OUTPVff � �'' � �-- -- - ' - "
�sis for Ihe alleqetl exemptlon. Any'violation ot Section 7031.5 by
y applicant for'a permit'subjects the'applicant'to a civll' penalty _ SEWER CONNECTIONS� � � � � � � � � - � � � � �
not more Ihan five huntlred tlollars ($500) ;� � -� '
L] I; as owner of tne property, or my employee3`wiih waqe{as thelr � SOLAR TANK „ COCLECTORS ' �' ' ' - ---
sola compensation, will tlo Ihe work, antl the.struc[ure is nol Intentletl. 'ISSUE�FEE �
or oHeretl for sale. (Section 7044, Business and ProfeSsions Cotle: The SOLAR PIPING SVS.� �(J Qp � � 00
Contractor.'S Licenze-Law tloes not apply ro dn own¢r O/ a properly . --- - 9 qPPLICATION APPROVED BV DATE.r.�
who bulltl5'or Improves thereon, antl wh0 tloes such work himself or ISSUE FEE � V �v _"
[hrough-hls own employBeS; p/ovitletl that such.improv¢ments are not _
Intenaetl or olferetl for sa1e. If, howoveq th¢ builtling or Improvament MECHANICAL � � PLAN CHECK SUMMARY F FEES
is soltl. within one year o/ complelion, the owner will have [he Durtlen �� ' ' BVILDING - �y ^' ' 2�'Z
oi provin9 he tlitl not builtl�or improve Po� the purpose of sale). HEATINGSYSTEM 0-100,000BTV PERMIT E���I� SMIP ••. E
❑ I, ar owner-ot the propei[y, am exclusivety��c6ritractin9''�'��h qND OUCTING -
❑censetl corltractors to construct the project (Section ]044, Business /]00,000 + 8TV �� pLAN CHECK y�. �s� 2 PERMIT �
antl'Professions Cotle: Tne Cbnvacror'S License Law'tloes no[ apply to - � �- ISSUANCE- $
an owner of prop¢rty who builtls or Improvei thereon, antl whO.con- ftEFRIGERATION� 0-300,000 BTU PLUMBING § O • ,'
'tracts trom�such projects with a contractor(s) -licesnetl pur5uan[ to �SYSTEM " ""' ' - ' - � - -� � - - - GRADING- $
theConlractor'sLicenzel.aw). IOO,OOO+BTU �� GLANCHECK�:$���/��_��n.� 1 . , �"
�� I am exempf untler Sectlon � � B. & P. C. /or this ELECTRICAL .�9 $
BOILERS BTV $
reason -' - -' ' " PLANCHECK $' MICROFILMS
SVSTEM REPAIR,ALTERATION —tY--
�Date - - ' Owner ,� ` � TOTAL FEE $
I n¢�¢by.certify lhdt,l nave read tttis appllCation antl Stale thal [ne dbOv2 EXHAUST SVSTEM MULTIPLE MECHANICAL $� . . �
- PLAN CHECK S- ' LE55 AD- _ _ __ . _
Inlo�mallon is CO/recL I agree to comply with all city antl cOunty �w � � Q VANCEPC $-
,Ortlinances antl sla[e IawS r¢latln t0 cOnstfuGiion, antl heleby dulbol128 G • �-. / a � '' - • "
representatives 1�th'� ci y t enler upon the above en ionetl � ' ' _
P�oPertY- fOr SO ti i P ei. _ � O� p
FINAL FEE S
Slgna[ure D te '
Drivers' License or 55 � ISSV E FEE
CMF 0865-46 White-8ulltling; Gnary-Applicant; Pink-Accounting; Goltlenrotl-Assessor ,
• ,�' 19Q03
�OSTA MESA BUILDING-SAFETY �EPARTMEM
P.O, BO%911 C09TA MC9A. CALIPORNIA
For Applicant }o Fill In Complataly
Tf. �4I T"PE OR PRINT Lot 38
B°"°'"° J 3 t(ti,io _e C'
ADDRESB
COSTA MESA, CALIFORNIA
AODRESH 1653 Minorca Drive
���,�. Costa Mesa
ARCHITEGT E.G.Kaltenbach
OR ENGINEER
ADDRESS 9772 Katella Ave. i
CONTRACTOR Mesa Verde Develo{
,,,,,e«, 1653 Minorca Drive
FEE REC.�; �D
JiIN 1 0 lg� `
FAIPPL�ICqiIO�P•F•b_� PERMR
CITY OF C�6jibIN�A
For Offica Use Only
R6CCIPT NO. PlqMIT NO.
—" - euaoiNo
AD�RE59=
FIRE
1�9395 ZONE
CO.
�
ZONING
NO.OP U880FNE
PUN9 BUILDI! n
NOTH: NOEAV80VERHAN08HALLBELES9THAN
�G.NO. IHI3ZZ Na• KI�0395 90'TO61DE8RPJIRP.L
p EAVES
OF107 pJr X IQO I�o.oPeLDae.o ALLOWHD (U.B.C.REOUIRHMENT:
NOWONLOT ypRDS MPROVED YARDSAPPROVED
USEOF ___ MAINBUILDINO ACCESSORYBIIILDIN6
EXISTIN6 �LD6.
(FROMC �EETI
6ETBACK Llryg pqOM FRONT� FT. PI'.
CENTER OP 8}RH6T � REAR YARD �O
SIDEYARDI LEFT 2S I RI(SHT �O R.SIDE RT�D �.
/
DESCRIPTION OF WORK �. sio rr. Fr.
2�82 5. ft
USE OF BUILDII
sin le fan
Plan 2 A
).OP q VAR.JC DATE
)OMH � BTORIHB L C.U.P.SF APPROVED
ROO� S p e� 5 In9 e APPROVEp / ((' �
o�..�., wv IA -�Ani narn i��F
1 HEREBY A�KNOWLEDOH THAT 1 HAVE NEAO TXI6 APPLICAT�ON
•NO STATE T HH ABOVE 19 COpqER ANO AOH88 TO COM.
PLY WITH A CITY DINANCBB ANO 8TAT6 LAW9 P6 I.ATINO
eu��wnc c ernu �ox.
SIGNATURE
PERMIITE
AUTHORIZED AGENT
i�- , o. � 'I. '4�9a•�`"
, f�,/�/� �,� ,�y �j�
Q:fY � O
TX8 AMOIINT BXOWN UNOER VA A ION IH POq TH
PIIpPOeE Op HgTABLIeHINO A PEHMIT FCe ONLY.
VALUATION �,�
PERMIT FEE S
� ad � PO
S %/� y � 00
� •r/f
TOTALFEE S ///
i r+i V.
i�a7'� �une lo
JOB ADDRESS 2tS1� Nevis-Circle BUII.DING PF.RMIT NO.
_AP
or
DESCIiIPTION OF WORK 7
FIRE ZONE j VAL1
Date I GROUP J TYPE
SUBCONTRACTOR
•�
R 1
;-`� 243�2 �. ,_
� �COSTA MESA BUILDING-SAFETY �EPARTMErIT
P. O. BOX 91] C08Tp MESA. CALIFORNIA
For Applicanf �o Fill In Completely
TYPE OR PRINT
ADDRE59 L[J/�J ���I7 L�/C �G.LL
COSTA MESA, CAI.IFORNIA
OWNER L.Eo !� I�ANTAS
MAIL 18/`-j �(/�-✓/,, G/I�GLF_
ADORbLB
c�rr ID.SJ'/a ML"StI, CdGiF rT,o • 54-�
OR ENIGENEER OK/NF_ TL Hp�"
n w,v��
SIZE ��•—•�~� ��� /wH�Y NO.OPBLO06.
OF LOT,PP�• k��2�'FT F���O poW oN LOT
USEOF �£�� p�c,V7-�,QG
EXISTING BLD6.
6ETBACK LINH FROM ,�oFr. / �
CENTER OF 6TH66f REAR YARO '/�� C
SIDB YARD LEPT I�'-O �/ ' RIGXT `1`� � O��
DESCRIPTION OF WORK
EXTERIOR W LL!'� "-���}
COVERING S 4CG I
usB oF Bu1lDING AND WqP
�o�(/C;CF_' _ -
T/ooL_ �Nf_D
D�N JoOLS
�I HEREBT ACKNOWLHOO¢ TXAT 1 H/.VE qGAO TMIB �PPLIGTION
AND STATE THAT THC ABOV6 IS CORRECT-ANO AOp88 TO COM.
vLv wiin aLL CITT OROIN�NCEg�11ND19TAT6�LAW8 Ri0{1lATING
BOILOING CONHTROCTIOfI_ i// / / r
A6ENT
ceT� r^ :Ls�� �Esa
JUN 16 1965
CATION FOR PERMfT
ku.F�f���A� �
FIRE '
ZONE /�-� TYPE GRO P
APPROVED 1/ � y I/ //
BY Ufo ��_D (oS
ZONING ��
ZON6 NO.O� U860PN6 �
•LAX6 pUILDINO
�eo.� — � K -',� �H 3 � /
oeccximo� �
/
A. P. NO. / � � � ���r
NOTE: NOEAVEOVERHAN68HALLBELESBTHAN
90' TO SIDE @ REAR P. L.
EAVES
ALLOWED fU.B.C.REQUIREMENT'.
YAR�SAPPROVED YAR�SAPPROVEp
MAIN BUILDINO I ACCESSORY BUILDIN6
( FROM C/L�TREETj�_
FRO T �FT. ��� �� Ff.
w ¢�ne �cr. lo Fr.
DISTANCE BLT. I BET.I
MAIN BLDGB. ACCE
VAR. �j DATE
�%� N
7 sq. F7. "
TXE AMOUNT BXOWN UNDER VALUATION IH FOP TMH F
PUHP09H OP 66TABL19HIN0 A PERMIT FEe ONLY. a
VALUATION �j p0 m
� �O PERMIT FEE $ . S m
$ �3 =
a
�1 1�i