HomeMy WebLinkAbout2040 MONROVIA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: ZO4O MONROVIA AV
Suite:
Vicinity:
Parcel Number: 4225p525
Applicant: LAGUNAS, LUIS
Address:
Zoning:
Phone: 949-646-2206
Zip:
owner: LAGUNAS, PEDRO & LAGUNAS, LUIS
Address 2040MONROVIAAVE
Contrector
Address:
Zip:
Arch :
Address:
COSTq MESA, CA
Phone:
Zip: 92627
Phone
License:
Eng:
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 09/27/2000
Issued: 09/27/2000
Phone:
Zip: License: License:
SCOPE OF PERMIT
ADD BRICK VENEER TO FIVE COLUMNS; CHANGE-OUT WINDOW IN FRONT OF PROPERTY. WORK ALREDY COMPLETED. ��
PERMIT IS TO LEGALIZE CONSTRUCTION DONE WITHOUT PERMITS. -- ,
FEE SUMMARY
Plan Check: $0.00
Permit: $44.85
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $45.35
PLANNING & ZONING
SETBACKS ,� �_
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existina: 0
Rear * 0- 0
Rear 0- 0
Required: 0
_ Calc Valuation:
Claim Valuation: �
Left 0- 0 � � Right
Left 0- 0 Right
Proposed: 0
0 0 � �
� �
si,zoo.00
g�,zoo.00
NOTES: ��
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N0710E: The work authorized by this permit shall comply with all applicable handicap access requirements unde� Calitornia statutes and �elated
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
tor a period of 180 days.
INSPECTIONS: In oider for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetions and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2oos-ae lvoo) /
\
WORKERS'COMPENSAnON DECLARAnON: -"
I �ereby affirtn under penaly of perjury one oi ihe following declarations:
❑ I heve entl will meintain a certificate of consent ro self-Insure lor workers' compensetion, es provided for by section 3700 of the Labor Code, lor the pertormence oi the
work tor which lhis pertnit is issued.
❑ I have and will maintain workers' compensation insurence, as required by seclion 3700 of Ne Labor Code, for ihe pertortnance of I�e work tor whicti this pertnit is Issued.
My workers' compensation Insurance cerner antl policy number are:
Cartier: Policy Number:
(fhis section need not be comp/eted i/ the permit is veluetl af one hundred dollars ($100) or /ess.J
❑ I certify t�et in the pertormance oi the work for which this permit is issueQ I s�all not employ any person in any manner so as to become suhject to the workers'
compensetion lews of Celifomia, end egree Ihat'd I should becoma subject to lhe workers' compensation provisions ol Section 3700 0l Ihe Labot Code, I shell fort�with
comply with these provisions.
Applicam Signature: Date:
WARNINO: FAILURE TO SEWRE WORKERS' CAMPENSATIqJ COVERAGE IS UNUWFUL ANO SHALL SUBIECi AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
T/IOUSNND DOl1ARE (5100.000�, IN ADDITIIXJ TO THE CO6T OF COMPENSFTION, DAAMGES AS PROVIDED FOFi IN SECTION 3106 OF THE lABOli CODE, INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aHirtn that I am licensetl untler provisions oi Chapter 9(commancing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
fome and eflect Lic. N Class a
Contrectofs SignaWre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn that thera is a construction lending agency for the pertortnance ot Ihe work for which ihis pertni� is issued. (Sec. 3097, Civil Cotle).
Lentlefs Name: Lenders Address:
Signature: � Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn that under penalry of perjury Ihat 1 am EXEMPT FROM TME CON7RACTOHS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or county which requires a permit to construct, alter, improve, demoiish, or repair any structure, prior to its issuance, elso requires the ap0licant for such pertnit
to file e signed stetemem that he or she is licensed pursuant to the provisions ot ��e Contractors License Lew (Chapter 9(commencing with Section 7000) of DlWsion 3 of the
BuSiness end Professlons Code) or that ha or she is exempt lheretrom and the basis for Ihe allegetl exemption. Any violalion of Section 7031.5 Cy any applicent for e pertnit
su ' cts the applicant to a civil penalry ot not more than tive hundred dollers ($500).):
I, as owner of Ihe property, or my employees with wages as Iheir sole compensation, WILL DO 7HE WORK, end the structure is not intendetl or oHeretl for sale (Sec.
7044, Business and Pmfeuions Code: The Contractors License Law dces not apply ro an owner of property who 6uilds or improves Ihareon, and who does such work
himseli or herselt or throu9h his or her own employees, provided that such improvements ere not Intentletl or oHered for sala. If, howaver, the huiltling or improvement is
sold wiihin one year of wmpletion, ihe owneo-builder will have the burden ot pmving Iha� ha or she did not build or improve for purpose of sale.).
❑ I, es owner oi the proDerty, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The wNrectore LJcense Law tloes not epply to an owner of pmperty who builtls or Improves thereon, and who contracts br such project with a contrector(5)
license pursuant ta the Coniractors License Lews.).
I am exeyipl under�s . Business antl Professions Cotle tor this reason:
ture: ti 7�l� ' Date:
�r IO veritied 6y dnvef5 liCense. ❑ Ves ❑ No Driver5 License No. ExpireS:
Venfica�ion of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certify iha� no e:cavation tive (5) or mora feet in depth into which e person is required to tlescenq will be made in connection with work euthorizad by this
pertnit, antl that no building structure, scattolding, falsework, or demolition or dismantlinq thereof, will be more than ihirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
341, Ttle 8, Celilomia AdministraWe Code).
❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from the Division ot Industnel Sefety, es noletl above, unless such person has e
pertnit to do such work irom ihe division.
Signatura: Date:
Division of Industnal Safety Permit Number:
COOE I. INSVEC110N TYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Final BIocWRetaining Well
202 Pinal Factory Fi�e Place
203 Final Sign
204 Final Demolition
pdg 7i�$ �! INSPEC110NTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electntal
212 Final Flre Prevention
220 Final Planning Approval
222 Final Site
250 Final Buiiding/Occupancy
PAIE 1[�L9
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(714) 754-5273 • Fa�c (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
�ob Address: 2040 MONROVIA AV
Suite:
Vicinity: WHOLE HOUSE
Parcel Number: 42250525
Applicant: MILLER, DALE
Address: 13781 NEWHOPE ST
CA ' �
GARDEN GROVE-: � /,='.; � �
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owner: HAUK;'SNANDY�` � �
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Address 2040�MONROVIAAVE� � -
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Contrectoi �DALES ROOFING' �
Address: A 13787-NEWHOPE-ST
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�� �� ��� ��� GARDEN,G OVE
';i``� �� Zip� 92703i;�
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Zoning:
Phone:
Zip:
Phone
, ZIP.
Phone:
NUMBER
513
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 09/20/1999
Issued: 09/20/1999
ISSUED BY:
(7i4) 534-639&_ �,Y `
-92703 � • _ ;.��
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92627 � � . -: -�'\ i �� � ,
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(714) 534-6398 ��'� �� � _ �
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License: 503508 ��"�� '� �� �� ����
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•!Phone::��'� �
License:
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Address:
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Phone: � . � ��,
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�'Cicense: ,;� y
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�� \� ` =' `' �' SCOPE OF PERMIT �V � � ? � ' ' '
F .� .
�� ; REROOF EXISTING SINGLE FAMICY�RESIDENCE (16 SQ). REROOF OVER EXISTING 2-LAYERS OF COMPO$ITION �- -
,. � SHINGLES.WITH 20 YEAR COMPOSITION`SHINGLES. SUBJECT TO PRE-ROOF INSPECTION. � r � �
r. . . ....._-..,... . �...__ , . i
�
' � FEE SUMMARY ` , � . 1
� Plan Check°t�� $0.00 � � ��� '�� Calc Valuation %� �' �. ,$2,soo.00�
,; j
����, Permit���� $83.25 � _ '"' � _.j � �' �• :Claim Valuation. �• • � S2,9oo.00
SMIP Res •�r $0.50 " - � ' �' ' � `' �
- / . � ', '
`, SMIP Com � " $0.00 f �i;'�� r� � 1' � �
` Other � '� � $0.00 --- ' ��"-� ,`.. j�,�
��Inspection ��j�$0.00 — ) � ,;,., � , �, .�
','� . ;,� .. . �. �
��'=. Total:� $83.75 � � �
� �
� ` , ,, ",
t��' ���`' , - • PLANNWG&ZONING. �. -� ;��,� � '
SETBACKS � � � , � �� ' - .
MAINSTRUCTURE Front 0=0 -, ��:Rear�- 0-0 . - Left� 0-0' � .Right 0-0 �=; . „;�
' �,� � ' . . - ' . � ' ' :� - . .
ACCESSORY � � � :Front 0= 0 , Rear 0- 0 � . .Left 0- 0 - � � RigFit � 0 �0 ' , "
� ,-
PARKING Ezistin :� 0 � Required: 0 Proaosed: 0
NOTES , "
EXPI D
DATE � � �� �
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: 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 780 days.
INSPECTIONS: In order �or the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectione and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby attirm under penalry ot perjury ona ot the tollowing tleclarations:
❑ I have antl will maintain a certificate oi consenl to seli-Insure for workers' compensation, as provided for by section 3700 oi the Labor Code, for the perfortnance of the
work tor which this permit is issued.
❑ I have entl will maintain workers' compensation insurance, as required by section 3700 ot Iha Labor Code, tor the peAortnence of Iha work for which this permit is issuetl.
My workers' compensation In urance car and policy number ere: �/ _ o
Cerrier. S�%��'P � Policy Number. o� �J S / 9 o�a / fiY�
(TM1is seclion need not be completed il fhe permit Is velued et one hundred dollars ($100) or less.)
❑ I certity that In the pert ance o e work for whi his permit is iuued, I shall not employ any pereon in any menner so es to become subject to the workers'
compensation laws alif ia, agre hat if Id become subject to ihe workers' compensation provisions ot Section 3700 of the Wbor Code, I shall forihwith
comply with ihese p o'sians Q,�7 p.
Applicant Signeture: ./ � Date: / �`� — / /�
WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
iHOUSAND DOLLARE ($100,000), IN ADDITIIXJ TO THE CQST OF COMPENSATION, DAA4IGES AS PROVIOED F-0R M SECTION 31060F THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm �hat I am
force antl aflect Lic. N
Contraaofs SignaWre:
Chapter 9(commencing with Section 7000) of Division 3 oi Ihe E
Class #
, Date:
Cotle, and my license is in full
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirtn that thare is a construction lending agency tor the pedormance of ihe work tor which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signature:
OWNER-BUILDER DECLARA710NS:
Date:
I hereby aHirtn ihat under penalry of perjury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW For iha following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or couniy which requires a pertnit to consWct, alter, impmve, demolish, or repair any siructure, pnor to its issuance, also requires tha applicaN for such permit
to file a signed statement Ihat he or she is licensetl pursuant to Ihe provisions ot the Coniractors License Law (Chapter 9(commencing with Sec�ion 7000) of Division 3 of ihe
Business and Professions Code) or that he or she is ezempt therefrom antl lhe basis for the alleged exemption. Any violation of Section 7031.5 by any epDlicant for e permit
subjects the applicant to e civil penalry oi not more than five hundretl dollars ($500).):
❑ I, as owner of ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, and lhe structure is not iniended or offeretl for sale (Sac.
7044, Business and Protessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who does such work
himself or herseH or through his or her own employees, providea that such improvements are not intended or offered for sala. tl, however, the building or improvement is
sold within one year of completion, ihe owner-builder will hava ihe burden of proving that he or she tlitl not builtl or improve for purpose oi sale.).
❑ I, as owner of the properry. am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business antl Protessions
Code: The coniractors License Law tloes not apply to an owner of properry who builds or improves ihereon, and who contrecis for such project with a coniractor(s)
license pursuant to the Contractors License Laws.).
❑ I am e:empt untler sec. Business antl Professions Code tor ihis reason:
Signa�ure: Da�e:
Owner ID verilied 6y dnvafs license. 0 Yes ❑ No Drivels License No. Expires:
Verification oi Owners�ip by (type of document, i.e. - property tau bill or deed): _
DIVISION OF INUUSTRIAL SAFETY PEHMIT CERTIFICATION:
❑ I here6y certify that no excavation five (5) or more teet in depth into which a person is required to tlescend, will ba matle in connection with work au�horized by this
permi�, and Ihat no builtling struc�ure, scaHolding, talsework, or tlemolition or tlismantling Ihereof, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Ttle 8, Calitomia Adminisirativa Code).
❑ A5 owner-builder, I will not employ enyone to tlo work which would require a permit from �he Division of Indusirial Safety, as noted ebove, unless such person has e
permit to do such work twm the division.
Signature: Date:
Division of Intlustrial Safery Parmit Number:
CERTIFICA7E OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty ot perjury that I have read this appiication and state that the information given is
correct. I agree to comply with all state laws and ciry ordinances7elating to building constmction, and authorize representatives of ihe City ot Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this Dermit until final inspection.
ff re Of Legal Owner(s) te
� �i -,� -�
An Or Authonzed Applicant ate
COpE 6 INSPECTIONTVPE
1616 Fi:ed System Final Fire Prevention
/266 Pool Spa Final
200 Final Re-Foof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
zms-as
PAIE INiRIALS
CODE I INSPECTION TYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electncal
272 Final Fire Prevention
220 Final Planning Approval
222 Final Sita
250 Final Building/Occupancy
ppTE RLS
ITTINDGE R. M. �
OWNER f DATE 9-21-56 -
JOBADDRESS 2OI{O MOIIPOY].8 APB• BUILDINGPERMITNO. 3�3�1
GENERALCONTRACTOR BudRet Builders VALUE $ 1.i20.00 .
, 5i3
GROUP I
INSPECTIONS
Footing Trench
Foundation Forms and Gra
Rough Framing _
Plumbing, Rough to Slab
Plumbing, Rough Compiete
Temporary Pole .
Heating, Rough
Heating, Final
Sewer, House Sewe
Septic Tank or Cesspool
ng, In� Out
F.__:erina '
Plumbing, Final, Fixtures
Plumbing, Fin,al Gas Test
Wiring, Final
Occupancy
FORM 310 3M 10�•+3
St.
TRACT 171Z
0 zoNe R�
DATE I SUBCONTRACTOR
Add, to exist dwell.
DATE
PERMITSISSUED
C�osta Mesa Building Departruent :1PPLYCATION FOR PERMIT
... `; P.O.Box3�� .��2 BUiLDING '
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
�' FOR APPLICANT TO FILL — eece�Pt rvo. Perm�t rvo..
nadai�s9 D � U � � 7 �'�
Costa Mesa, California Received by Date Rec'd. Date Issue$/
Nearest '�� ` �/",
CrossSt. Buildin �� . O! A���U t 4
Address /s'
Owner �
ma�� Costa Mesa, California
Address Nearest
Te�, Cross St. -.
Cfty �%%LG6zC�— No. Zone !� No.of Type Group 4
Architector Lic. 0 1 I Plans I
Engineer No. � Approved%�G Dat�S / W6
by ��
ress
City Lic. � . �� ^
Contractor No. ��
�� .
Address
Legal �ot � I C1TY O /• i
Description I�`10. ,�/d I Block � Tract�/%vl ,.,-�;.� , � r�. ,
�/ - ,.•�
(Attach Metes and Bounds) / � J —� �7 'ol� -
/ No. of Bldgs
Size of Lot (� � �%L> � Now on Lot — 0
ljse of No. of No. of 70
Existing Bld I F.amilles I Rooms �
Setback Line from Rear Vard Z
Center of Street � Side Yard y
DESCRIPTION OF WORH �
New I I Alteretion f I Addition I
Repair I I Moving I I Demolish I
, �ilding/��� , No.of
_e Rooms 2 Stories �
��iterio9Wall�.,�_ I Roof 9 �� ApPROV��s
Coverin _y�� Coverin
Use of New G� _ �
Building .(LP([/ �y�y� Foundation Lacation Inspector � Date
Forms, Materials,
Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state tha2 the above is wrrect and agree to comply Lath. Int.
with all CIty Ordinances and State Laws regulating — ---a'
building constru 'on. � Lath. Ext.
Signatureot � �
Permfttee � Ptaster, Int
Authorized Agt. Plaster, Ext.
Valwatlon Permit Fee $ �i Masonry Reinforced
/ �� ,�, Pian Check $ �' Bond Beam - �
$ � Total
Fee $ � "� � FINAL
, FOHM 204 10�[S D. P. 8 5,
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PLOT PLAN
Show Iocation and �dislances from
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VAIVCR YV1Y:/V� YLL\1[i L• Uq�[ `�� �/
JOB ADDRESS 2040 Monrwia Ave. BUILDING PERMIT N0.3 59
GtNtKAL lU�
' AP No.115- j
IN`^FCTIONS
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� WATER
ROUGH PWMBING
PROP. SWR. LINE
SPRINKLING SV51
MISCEL�ANEOUS
LOT TRACT FI
HOtISE CON.
HEATING AN� AIR CONOITI
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❑NDERGROUND �_J POWER U
ROUGH WIFING
TRENCHES FORMS STEEL REINF.
FLOOR SYSTEM
BONO BEAM ❑ STEEL fiEINFORCE ❑
SHEATHING
FRAME ANO FLASHING
� 'NG. VENT.. REFFIG. ANO A.C.. FINAL
ING, FINAL FNO G
.RIC, FINAL
BUILOING, FINAL
SPECIAL REOl11REMENTS
SUBCONTRACTOR {-
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_ � 39659
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
�re P°`°OQ,00�� w��=iG.So
PG'%`iCY,S�
APPLICATION FOR BUILDING PERMIS
For Applicant to Fill in Complefely
REC VE BV OATEFECEIVED DATEISSUED
BUILDING., /� n u � a-a�-�
ADDRESS ' `- (�� %U/CO�1.Q/ AC�/ a -ab
OWNER y�j ijLCIJ :� t'S A.P.NO. S' /3—�5 P TN
� ./� ) ADIDRIEs avya (/i��'����
ADDRESS -� O L /// RZ1�/� �-y
a U CITV p ��(' NO. _�I TRACT'� I� L(]'f�/ � BI_oCK
Z Q CONSTRUCTION � W A
O � LENDER
am
J � BRANCH
J N OWNER
m J ADDRESS
m ARCHITECT TEL. S
• J a OR ENGINEER
U Q FIRE
w � ADDRESS ZONE
d W 1 APPROVED
W 2 CONTRACTQR �(/' .�/i 8�'
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J � ADDRESS
VALUE
DATE � -� G
W w 20 NO.OF /� USE OF NEW"
�= CITV NOL P�+� G.. BUILDING �
2 �
w O STATE CITV �'ARDS APGROVED VAFDS APi
y� LIC. NO. LIC. NO. MAIN BUI�DING ACCESSORV
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SI2E NO.OF BLDGS. rjG
OF LOT 7 X/��j NOW ON LOT ROM t
USE OF �C
, EXISTING BL�G.
F SIZEOF /'�� /1 (-} NO.OF .y
Z NEWBLDG. ��d ROOMS STORIES L.SIDE S
a EXTERIOR W L ROOF
V COVERING COVERING REAR ��
J USE OF BUILDING AND WORK TO BE PERFOFMED DISTANCE BET
a MAIN BLOC6.
a
Q vna. vl�
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F APPflOVED/.
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UI hereby acknowletlge that I have reetl this applicetion and state
thet ihe ebova information is correct and apree to comply with
� a1V Iaws regulatinB bui{tllnH <onstmctbn, antl 1 shall not employ /
F any person in viDlation of Me workmen's campensation laws of
y the State of California. '�
Z I he�eby certify that I am properly Iicensetl as e conttector untler
2he Sm[e of Celifomia Bueiness entl Professiom Cotla, Divisicn 3, THE AMOI
Chaptar 9, antl that such licenses are In full torce antl effect, or I THE PUflPO
am axampt from the provisions of ihe Stat� California Business
and Protessions Cotle, Divisio� 3, Chap2er . VALUATION
Signei�reof �� /I'M,
Permittea $ �?T/(I
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Authorized Agent
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FT S
FT �
BET. MAIN & -
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S/ 7pTE
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IN UNDER VALUATION IS FOR �
'ABLISHING A PERMIT FEE ONLY: Q
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'PERMIT FEE $ � �
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PLAN CHECK $ E
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LL
TOTAL FEE $
�ORA�lGE COUNTY BUILDING DEPAifTlNEt�T • � APPLICAYION FOR PERMIT .'
„ �'�'.� • 636 North Broodway
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