HomeMy WebLinkAbout2020 ORANGE AVE - Building PermitsPERMIT TYPE
CITY OF COSTA MESA .
BUILDING 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
JOB ADDRESS:
Vicinity:
PERMIT NUMBER: M07-00518
MECH EXPIRED STATUS: ISSUED
DATE JO- v� 10oj ' DATE ISSUED: 10/30/2007
ISSUED BY: BJK
2020 ORANGE AV CM- Suite/Unit: '
SO. FT:
0 -
-
$0.00
.- 13TU
:$0.00:..
SCOPE OF WORK: REPLACE/CHANGE-OUT�35,000 WT WALL FURNACE.
NO OTHER WORK AUTHORIZED WITH THIS
PERMIT.
OWNER:
LEAKE, KENNETH J� ' - -•-Address' -
2020 ORANGE AVE -Unit: • '
PHONE:
.. -
- - - City/State/Zip:
COSTA MESA, CA. -_
APPLICANT:
YENULONIS, LAURA , - Address:
Unit:
PHONE:
909-213-1640 City/State/zZip:
-
CONTRACTOR: ALLIED PLUMBING'- HEATING - AIR CONDITIONING.
License•No. 610780
Address:
422 JENKS ClUnit - PHONE: 714-998-4300 -
City/State:
CORONA, CA ZipCode: 92880
CELL:
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE:
- $38.30
PLAN CHECK FEE:
$0.00
INVESTIGATION FEE:
:$0.00:..
REINSPECTION FEE:
- $0.00.
TOTAL FEES: $38.30
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 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 t. INSPECTION TYPE DATE INTRIAL5 CODE INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266. Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition - 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penally of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This section aetxlot be gimpleted tf the petm4 is valuadat me hundred itallats (15100) or less.)
Policy Number:
I certify that in the performance of the work 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 of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
e Labor Code, I shat rthwith comply with these provisions.
O \p-3o-6�
Applicant's Signature Date
WAR NG: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UN W UL 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 affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. ^ ^
Lic. # ��Zn Class # �� V
)0-3) -0-1
Contractor's Signature Date
CONSTRU ON LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signature Data
OWNER -BUILDER DECLARATIONS:,, -
I hereby affirm that under penalty.of-perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW�.rftir the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, (,improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is 'licensed pursuant to the provisions of the Contractors
License Law (Chapteri9'(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she.
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature
3057-46(3107)
Data
a ,
Owner ID verified by driver's ,e. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high_ (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicant's Signature
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code 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 during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
fling with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safely Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I.cerlify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signature Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
A.Signatu 1 Legal Ovmegs) Data
- kcz�Odi-
And/or Authorized Applicant Date
CITY OF COSTA MESA
A �StN "' 4q BUILDING DIVISION
F77 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
�"'°"°"°fi PERMIT NUMBER: P10-00091
PERMITTYPE PLUM STATUS: ISSUED
APN: 42620104 DATE ISSUED: 07/07/2010
ISSUED BY: KJB
JOB ADDRESS: 2020 ORANGE AV CM Suite/Unit:
Vicinity:
SCOPE OF WORK: REPLACE MAIN GAS LINE TO RESIDENCE.
OWNER: LEAKE, KENNETH J Address: 2020 ORANGE AVE
PHONE: City/State/Zip: COSTA MESA, CA
APPLICANT: BRYANT, ROBERT Address:
PHONE: 714 641-1545 City/State/zZip:
CONTRACTOR: C AND R DRAINS INC License No. 531746
Address: 1525 MAC ARTHUR BL. PHONE: 714-641.1545
City/Stale: COSTA MESA, CA ZipCode: 92626 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $33.30
TOTAL FEES: $33.30
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 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 0. INSPECTION TYPE DATE INTTALS CODE p INSPECTION TYPE DATE INTPAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical ev
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wait 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
`performance of the work for which this permit is issued.
I
/El, I have and will maintain workers' compensation insurance, as required by
i section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier: 1 i iiT/ l/ll
(This section need not be completede tnhhe�p7ermita vaWo y anehundred dollars (SIX) orless)
Policy Numbers ��i/sl' V!/2 ��� (I
❑ I certify that in the performance of the work 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 of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, I s II f with cc with these provis ons
v
rA dlcay'S' t9 aWre `Date
WARNING: FAILURE TO 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, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force an effect.
Cu.t: #� %'/ Class # - ,t
i U _
dors D to
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Date
3057-46 (3/07(
Owner ID verified by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicant's Signature
Division of Industrial Safely Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the Califomia Govemment Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(if "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized tt permit until final iggpection.
(—And/or Authorized Appllaant ' ' Date
From the Desk of ...
R. L. UNGER
August
TO: Donald Dungan, City Attorney AUG 2 1966
Subject: Side Yard Encroachment - N pt wa M&58
Coleman Property Game ` i0d- S Oak'Z O�
Confirming our verbal conversation las t -
day on the Coleman property garage, here is what I
think we should do -
1. Arrange to allotr the garage to split the
side yard steback line (l.*') and encroach
into this area 4'.
2. Tie this encroachment by Agreement into the
requirement of the existing house on the
Coleman property, i.e. that no substantial
structural changes are to be made on either
structure vrlthout permission of the City
Council.
3. To allow no additional building on this
property other than temporary or accessory
structures such as patio roofs, fences, etc.
4. Be certain that when and if the house is
moved, the garage also is moved.
Matt Laborde informed me verbally this date that
these conditions vrould be agreeable with bis client.
I told him you wuld twite the Agreement.
RLU:amR. L. Unger, City Manager
cc - Building Safety v
Planning
RECRM, RICHARD
AUG 1 01962
cuG 1 -1 Ar' ' 1 7-26-60
PTTTT.TTTWr- PPPUTT Wn
AP. NOAi u—iU1—Uµ LOT TRACT
FIRE ZONE DESUIUPTION OF WORK
INSPECTIONS
_
DATE I GROUP J TYPE V ZONE
Underground Soil U.G. Water
SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Underground Gas
---
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
AM
Prop. Swr. Line House Con. St. Swr.
T
Sprinkling System
Heating, Final
n ,)
Plumbing Fixtures
I
Final Gas Test
Construction Pole
11--k
Underground Power
Rough Wiring
'
Trenches!10Forms l q} Steel
7- - 6
Floor System
I V
Steel Reinforce Chimney Re -Rod
Bond Beam
Sheathing
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final p.B'lM
Y
OCCUPANCY
Form 210-5M-11-59 S -B P HOLD FOR SPECIAL REQUIREMENTS 12608
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O• BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA..
FE�E� RECEIVED
IY�T� JUL 2 L 1960
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
O`1
r'
1
RECEIPT
NO. ��P�irISEI{O.
OWNER
f'V/il�JvIMJ
MAIL
RECEIVED BY DATE RECEIVBO DATE ISSUED
I
ADDRESS O L�- /'
L —(. O 6(J
NOL.
BUILDING
CITY _��
ADDRESS
ARCHITECT TEL .
COSTA
SA. CALIFORNIA
ER 9° -I- j2
OR ENGINENO
FIRE h
IC
/GROVE
ADDRESS
Z NE
E
��
AP qq
Y6
CONTRACTOR
BY Ell'
DATE' 6
P reF1ZONING 4
ADDRESS
Z
NO. OF
(PLANS
USE OP NE
CITY
�1--�
BU 11 UN
STATE TEL.
LIG. NO. NO.
LEGAL A
DESCRIPTION V I
Le
SIZE
NO. OF SLOGS. Z
I
I " O �•
OF LOT
NOW ON LOT
A P NO
OF
YARDS
EVES
EXISTING BLDG
EXI
APPROVED
ALLOWED
SETBACK LINE FROM rl
CENTER OF STREET REAR YARDFRONT
FT. lid-(/ ' IN.
SIDE YARD ILEFT
(RIGHT
R. SIDE
C FT. IN.
DESCRIPTION OF WORK
! Ir'�
L. SIDE
FT.
NEW I II ADDITION I
REAR FT. IN.
LIVOVINlII I
REPAIR DEMOLISH
APPROVED 1
DATE
DING NO. OF
HOLD FOR SFE
ZEQUI2"i.iCi..':J
SIZEBUIL
Q ROOMS STORIES
...
EXTERIOR WALL ROOF
I
l
/-
1-J)
COVERING COVERING
USE P BUILDING AND WORK TO BE PERFORM
1 HEREBY AC OWLEDGE THAT 1 HAA READ THIS APPLICATION
THE AMOUNT SHOWN
UNDER
AND STATS AT THS ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING
VALUATION IS P R TH
A PERMIT FE NLY
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
PERMIT FEE $ 1�
BUILDING CONSTRUCT] G
i�VALUATION
SIGNATURE OF
0
PERMITTED0
$ L `
{{{{
PLAN CHECK $
_
AUTHORIZED AGENT
I
TOTAL FEE
O`1
r'
1
Hold for Special Requirements:
No substantial alterations or additions are to be
made to existing house and garage.
Instead of the 12.5' required side yard setback from the
property line on Sierks Street, the owner is encroaching
6.5' into the required setback (6' from the property
line) and an Agreement to this effect will be forth-
coming from the City Attorney's office.
OWNER ROUSR, Mr. & Mrs
)OB ADDRESS 2220 Ogee g,_
G NER ,CONTRACTOR Gentosi:
TE 3-27-58
BUILDING PERMIT NO.
VALUE
AITo.` LOT 291 TRACT }7p} q_FIRE ZONE DESCRIPTION OF WORK Residence
INSPECTIONS
coat
Final Gas Test
DATE I SUBCONTRACTOR
PERMITS ISSUED