HomeMy WebLinkAbout542 HAMILTON ST - Building Permits��
Pfl0.1EtTp�OPESS: j4Z :-I�ILTON $T
OWNEfl'SNAME: BILL wII,LIp,%']$
nooeess: 5331 WAITEFOX UR
RANCAO PAiO� VERDE
CA 902'74
� 21337II4764
UNIT: p
� AflCM/ENGINEEX: NEG.NO.:
:� AOUXESS: UNIT:
� PEPMITTEE: AILT.Y WZLLIAMS ( 714 ) 631-7753
nooxess: 542 EiAMILTON
C.M. CA 9?.6?.6
UCENSEO CONTBRCTOB OECIABATION: I hereby a�hrm ��atl am licensetl under D�ovisions of C�apter 9(commencing wilh Sec�ion
7000� of Orvlsion 3 0� i�e Business antl Pmtessions CoOe, anU my license is in lull farce and eHecl.
CITY LIC.: STFTE IIC.: CLASS:
Date: SignaWre:
wOBREHS' COMPENSATION DFCLAHFTION: I hereby alfirm ihat I have a cenificate ot consent to seli-insure or a certificate ot Workers'
Compensalion Inmrance. or a certifie0 capy ihereol �Seciian 3800. LaD. C�.
POLICY NO.: E%P. ORTE:
COMPANY:
� Cehi�ieU COpY is hereUy lumishetl. ❑ Certilietl copY is �iletl vnih the city BuilAing Division.
Daie: p001icani:
E7(EMPTION FBOM WONKEBS' COMPENSRTION OECIABAT10N: (This s¢ttion n¢etl nat Ue Complete� iRhe Oefmi� is lorone hUnOr¢tl (5100) or 1¢55�.
I certily ihat in I�e petlormance ol the work �or whic� �his permii is issue0, I shall no� employ any De�son in any manner so as lo become
subject �o ihe orkers' o�ensation Laws ol Califomia. ��� 'A���r
Da�e: 7� Signamre: � �� �� ��� � t-/f1 �
NOTICE: I�, afl�.r making this declamtion, you s�oultl become suqect m �he Workers' Compensa�ion D�ovisians ot �he Labor
Catle. you must fonhwiih comply wiih such pmvisions ar t�is permii shatl be deemetl revaked.
CONSTflULTION LENDING FGENCY: I hereby alfirm Ihat there is a consimction lending aAency lor t�e pedormance of the work for
which Ihis permit is issuetl (Seclion 3097. Civ. CI.
LENUEP:
aooxess:
OWNEB BUIIDEB OECIABATION: I hereby aflirm ihal I am exempt irom t�e Coniracmrs' State License Law for the following reason
(Sec�ion 703L5 Business antl Pmfessional Cotle: Any city o� couniy which requires a Oermi� to constmct, alter, impmve, demolish, or
repair any S�mtWre. prior to i�s i55vante, also reqUires ��e ap0litan� lor Suc� permi� to file a Signed 5la�ement �hat he/5he is litens¢tl
pursuam Io Ihe pmvisions of Ihe Comraclors' S�ale License Law (Chap�er 9(commencing wi�h Sec�ion 7000) o� Divisian 3 at �he Business
an0 Pro�essions CoOe) or ��al he/she is exempi Iherefrom and ��e basis lor �he alleged exemplion. Any dola�ion oi Sec�ion 7031.5 by
any applicam for a permit suble��s ihe apDlicanl to a civil penalty o� nol more than five AundreO Oollars (5500�.
I, as owner of Ihe prop¢tlY or my emoloyees wiN wages as ineir sole compensation, will do tAe work, and the
❑ simclure is not intentle0 or offered br saie (SecUon 7U44, Business antl Vwfessional Cotle: T�e Conlracrors' Slaie License Law
aoes not apply Io an owner of a pm0erlY who �uilds ar impmves Ihereon, antl who tloes such wark �imsell/he5ell or lhmuAh
his or her own emDloyees, pwvi0etl thal such impmvemen�s are not inlendetl or oflerea lor sale. Ii, however the Ouilding or
im0�ovement is 5010 wiihin one year o� complelion, the owner will have Ihe 6urJen oi Dmving he/she tlitl not build or improve
for t�e purpose oi sale�.
I, a5 owner o� �he property, am eeclusively comraciing wi�� licensetl contractors m constmci Ihe D�olec� (Sec�ion 7044, Business
� antl Professions Cotle; The Contracmrs' State Licenu Law Ooes not appry ro an owner oi pmperry who butlAs or imDmves ihereon
antl who comracts lor suc� pmjects wi�h a caniracmqs)license pursuantto ihe Contractors' State License Law1. I am aware
Ihai pmol oi Iheir WOBer'S Compensa�ion insurance shoultl be pmvided Io me.
� I am eKempi under Seciion: B. 8 P. C.
for �his reason� 7���
Date: ���// -'� Owner:/i`'t"C/� �Z/� `
I tlo hereby [etlily �hai I am aware ol antl untlerstantl ��e requiremenis of Califomia ealth antl Sa�ery Code Sections 2550.5. 25533, antl
25534 and Ihat I or any fuNre Duilding occupani willlwill not (drele one) need to comply wiih Said slale toaes an0 ihe reQuirements tor a
permit lor cons�mclion ar mo0ilicalion Imm Ihe Air �ualiry ManaAemen� �istric�. flesiDenlial conslmction applica�ians are exemp� �mm
Ihese pmvisions.
Date'. Applicant:
Ihereby retlily�hatl havereatl this application antl slaie tha��he above inlormalion is correcL lagree to comply wi�h all ciry antl county
mdinances antl stale laws relating lo builtling cons�mction antl hereby auihorize representa�ives ol lhis^iry ro en�er upon ihe abave-mentianed
pmpetly lar ins ection rposes. � 'A ✓�� �,
•� �� r�
Dale: 2� SignaNre:
oriver's License ai Social Security p:
16aL46 W�ne—Bulltlmo', Green—Cotle Enforcement: Canary—Aoolicanl', Pink—Revenue: Goltlenmtl—Assessor
CITY OF COSTA MESA - BJILDING�PEkMIT
PER�IIT NO: B 058248 PLAN CHECK NO: 03097-9]. L
CONSTRIICTION 'PYPE; V-N PERMIT TYPE; STR
JOB DESCRIPTION ; NaW SFD
C_LAIM VALt7E: 100,000,U0 CALC-VALUE; 101,'709.30
Yt�KM NV; t! U7�G4t
I;VVI; N JUYY;
PURPOSE: NEW
SQ FT: 2,101
GROUP OCC: R-3 /
COMMENTS: NEW SFll
IE �lE iE if �1f dkdf iE%�� if-�%� iE �)f 1f �� iEif �% %�lE iE 1F �Y.� 3f if 1E ik �1F�?F iF %� M�Ir �lE �%�7F 3f IE�-If �3E �X �lE If 3E dE # K� 3f 3E dE 3f IF iE iE 1f �F �lf -1F lE K�� 9E dE #?E #�lE �1E iE lf �� iE af iE ±E �k iE
7. O N I N G R E Q U I R E M E N T S
sET�acxs
----------- MAIN BUILDING ---------- --------- ACCE550RY BUxLDiNG --- -----
FRNT: ?8 FT IN REAR: 10 FT IN FRNT: F'T iN REAR; FT IN
LEFT: 16 F"t IN RGHT: S FT T.N LEF1': FT IN RGHT: FT IN
PARKING REO• A PROV: 5 P:4RC�EL: 422021Z2 ZNE• R2 REF NO• DR-88-66
PLANNING NZS'TzS> ONE DETACHED APARTMENT T3NTT UF A TWO [JNIT PROSECI'. PARKING
> SfiOWN ABOVE IS TOTAL FOR PROJECT. REAR STBK IS SEP, P F t. E
�If� i(� ii �fE �}; � iE �3t If 9e �k �R-0E iE �lf �k�iE �t �IF �lF if �rt if �1E �X �1E �K �Yr �lf 1E �k �� d4if ii �f �%if �If )E �Ih 9f 3E �fE if �IE �K �Y. �� if �%�%�%�If iE �}' df IE iE ii 3:-�� �1F 1f �lE �lf��N� :�F �)f��SE � �lE #` iE 3E iE iF1!� �Y,-
D E V E L O P M E N T S E R V I C E S R E Q II I R E M E N T S
20NING APPROVED HY ; SC C __ DATE; ��9 Z
BUILD3NG APPROVED BY :�/C /�'— DATE: Q-a_��
APPS,ZCATION ISSUED AY;��!� .��' DATE; ����
i(�#3f�IFif�lEiFifif�R�1E�7f�E�M#iE1E�1E#-IE�IE���iF�ll� ���' �IEj(�lf-�iEdF�7t��lElF�lf�.� �1F�fYr� �ii
1E if �7F-i(� M�IE �7E �lE �)E if if �% if��k �If �f *�lE dE �f �?f-�iF �K� Yr iF if }�% if i'r iF dF �%iE �lE-It-1E if iE -1E if i(-�� iF iEdF lE �� �E -N� iE iE 9k �if jF iF �Y %� ?F �iE iF #E dFiE jE iE if �%# iF 3EiE iE �Ic�7ed;� iE �T �7f
LEGAI.I'LATZON;N F E E S U M M A R Y STRUCTURAI� SEGMENT;Y
BLDG PMT PLUMB'tNG ELECTRIC MECHANIC FIRE SMIP/RES"�=;GRADING
PERMIT 646,50 10,'x.7:�-?- `'
SMIP/NONcRES
PLAN 420, 23 � �� �,�-
ISSUE FEE � . `?
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 656,67 O.UO 920,23 1076,9D 10'16.90 . .UO
REVENUE DIVISION TOTALS-->: COLLECTED; 656.67 OVER/SHORT;, �.—J .00
BLDG PMT PLliMBING ELECTRIC MECHANIC PZRE SMIP/TOT GRADING'P.%AN-CHECK
6A6.50 10.17 '-'"
if i(� iF1E if iF iE �IE ii� iF iE iE If iF if �f if #!e iF if iF i6 iE k if if•!E If �F �IF iF iF iF iE iF iE k Ic�K iE-IC� iE if k� ie ii� iE iF ik }. iE IE jFiE #!(� ik } i-iE ib 3h IF } iF �le if iE141F �lE 3f��� ib 3e 34 i%
I N D I V'I D U A L F E E b R E A K D A W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 1300 DWE-TYPE V-WUOD FRAME -GOOD
SPR 318 RES-BALCUNY, EXTERYOR STAIRWAY
SrR 273 RES-GARAGES TYPE V
SFR 210 RES-CARFORT
END OF FEES
EXPIRED
��an����ko lnspections
�i�ie � �--- S�� _-
69.00 89,70Q,00
13,ft0 5,?R8,90
27.30 4.722.9U
13,80 2,Sy8,00
'11 DQ11S7°5-�}9a.197£7 "tf�' � -�
9ATE� �7i"a�li: iltt�: +;:<<.!
CONS'i RUCTI�IN AND PLANNING � � POO1 'PA -
'AGPROVALS Permit# Date 'Inspector qppROVALS Permit,-+� Date �nspector�
�1. Temporary Electrical Service or Pole � - � 52. Pool &-Equipmenr Location -
2. Soil Pipe�Undrgmd. , � � 53..Steel Reinforcement - .
3. Electrical Conduit UtilityUndrgrnd. - 54. Forms -
4. Electrical Conduit-Undrqrnd. �- -. . - 55. Electrical Bonding
5. Steel Reinforcement . 56. Rough P�umbing & Pressure Test
6. Electrical UFER Gmd. - 57. APPROVAI TO COVER�GUNITE
7. Footings . 58. Electrfcal Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd.; Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P�Trap, �"Undrgrnd.
10. Structural Floor System � 61. APPROVA� T0� DECK -
11. Property $ewer Line & 4iouse Connection 62. Backwash & fieceptor�Final
12. Sewer Cap 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing System � Final
14. Rough Pl�mbin9 � � 65. _Electrica6Finai
15. Rough Elearical-Conduit 66. Solar SYstem-Final �
i 6. Rough EIBMric Wiring � 67. Fencing & Access ApP�oval
77. Rough Wi�ing Sign . 68. APPROVED FOR PLASTERING
18. Rough EI¢ctrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. flough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas D Oil
23. �Gas Pipe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd.Stora9eTank OGas ❑OII
25. Roof Sheathing � - 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemicat
27. Frame and Flashing ' 76. Dry Standpipe . �
28. Lathing & Siding . 77. FIXED SYSTEM FINAL
29. Insulation . 78. F�RE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. fiEQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final � � 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas P�Pe�Test
36. Hood or Canopy ,
37. Final FactorY Fireplace • .
38. Final Plum6ing � �
39. Water Service-Final ,
40. Gas Service�Final
41. Solar pomesticFinal ' '
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations P 1 R E D
47'. FINALSTRUCTURE & BUILDING ' �_�� 5
48. FiNAL PLANNING ' � � �t _
� � - - � $Ig ----._..._0.
49. Elearic Release to Edison . '/'
50. Gas Release to Southern California Gas Co
51. CERTIPICATE OF OCCUPANCY
No. Date
rRaEcraooness: 542 HAMZLTON ST
OWNEfl'SNAME: BILL w�1.1.1.�is
ADONESS: S33 WHITEFOX DR
RANCHO PAiOS VERDE
� CA 90279
213-378=4764
� AflCH/ENGINEEfl:
• RO�HE55:
NEG.NO.:
�N�T: B
UNIT:
PEflMITTEE: BIT.LY WILLZAMS ( 71.4 ) 631-�7753
nooxEss: 5q2 HAMILTON
C.M. CA 92626
LICENSEO CONTBAC70B UECIAflFTIUN: I here�y atfirm tAat I am licensed unaer pmvisions of Chapter 9(commencinA with Section
7q10) ol Division 3 0l Ihe Business and Pm�essions Cotle. and my license is in �ull lorce an0 efleci.
CITY LIC.: STFTE LIC.: CLRSS:
Da�e: SignaNre:
WOflNEflS' COMPENSRTION OECLAflATION: I hereby allirm that I have a cetlificate of consent to self-insure or a cehilicate nf WoMers'
Compensaiion Insurance, or a certi�ietl coDY �hereol (Seclion 3800. Lab. C�.
POLICY NO.: EXP. ORTE:
COMPFNY:
� Cetlili¢tl Copy i5 Aefehy �umishetl. ❑ Certified copY is �iletl wiN the ciry Builtling OiviSion.
�a�e: ApDlicani'.
EXEMPTIUN FBOM WOHREBS'COMPENSpTION OECtABRTION: (T�issection nee0 notbecomDleteaifthe permitisfarone hundred�$100�orless�.
I cenily ihat in Ihe peAormance of ine work for which inis oermit is issueQ I shall not employ any person in any manner so as to 6ecome
sublect lo Ih/e� Woders' nComDensalion Laws of Cahfomia. /� y� �
Daie';/ L-�/7 � Signature: �" y/J' nf/���"/
NOTICE: II, after making ihis Oeclara�ion, you shoultl become su lect to t�e Workers' Compensation pmvisions of the Labor
CoOe. you mus� lorihwith comply with such provisions or�his Oermi� s�all be tleemed revoked.
CONSTflUCTION LENDING AGENCY: I hereby aftirm iha� Ihere is a con9mction lending agency lor Ihe petlormance of �he work for
which Ihis permi� is I55ueU �Sec�ion 3W7. Civ. C).
LENOEfl:
nooaess:
OWNEfl BIIILOEfl OECIAflRTION: 1 �ere�y alfirm Iha� I am exemp� imm �he Con�mc�ors' State license Law tor Ihe tollowing reason
(Seclion 7031.5 Business anU Pro�essional Code: Any city o� counry whi[� requires a permil to conStNCL ai�er. impwve, tlemolish, or
repair any s�mc�ure. prior lo iIs issuance. alm requires Ihe applican� for such permil to file a signed slaiemem tha� he/she is Iicense0
pursuant Io ihe pmvisians ol I�e Contractors' State License Law (Chapter 9(commencing with Section 7000) of Division 3 0l the Business
an0 Professions Cotle) or Ihat �e/s�e is e�emp� ��erelmm and �he hasis fo� �he allegeU eeem0�ion. Nny violation ot S¢ction 7031.5 6y
any applican� �ar a permii su�lects the applicant to a civil penalry of no� more �han five hunOretl tlollars (5500).
I, as owner ol �he pmpetly or my employees wi�h wages a5 �Aeir sale compen5aiion, will Oo Ihe work, and ��e
❑ simcwre is not inlenaed or ofieretl for saie (Section 7044, Business an0 Pmiessional CoOe: The Coniractors' Stale License Law
tloes not apply Io an owner oi a pmpetly w�o builds or impmves Ihereon, and who does such wo�k himselfl�erself or �hwuAh
his or her own employees, pmvitled Ihat suc� impmvemen�s are no� intended or oHered for sale. II, however t�e builtlinq or
im0�ovement is soltl within one year of comple�ion, the owner will �ave �he buraen oi proving helshe tlitl noi Euild or impmve
lor Ihe purpose ol sale�.
�t I, as owner of the pmperty, am exclusivety coniracting with licensed coniractors to conslNct the project (Section 7044, Business
L^1 and Pmlessians Code: The ConUaclor5' S�a�e License Law does not apply �o an owner o� pmpetly who builtls or impmves thereon
antl who tonlrat�s lar such pmjetis wi�h a con�raCtor�S�liCense pUrsUant b Ihe ConVactors' Slate LiCense Law�.l am aware
ihal pwof of I�eu Worker's Compensation insurance should De provide0 �o me.
,� I am exempt un0er Section: B. 8 P. C.
for ihis reason: , y(� y� �/��
�a�e. 7/ ZO/q� Ownei: /.%��' /''�.�—l�L4�s��=—I
1 tlo �ereby cenify tha� I am aware oi antl untlerstand Ine requiremems o� Califomia Heal�� anA Safery CoOe Sec�ions 25505, 25533, anE
25534 antl �Aal I or any �uture builtling accupanl wiil/wiil no� (circle one) neetl to comply wi�� said state coaes anA Ihe requiremen�s for a
permil lor cons�mction or modtlication Imm �he Air Ouality Managemen� Dislric�. Residenlial con5tmciion applica�ions are exemp� Imm
Nese pmvisions.
�ate: App6canl:
I here�y cerlity ��a� I hare read Ihis appl¢alion and s�a�e Iha� the a�ove inlormation is carrecL I agree fo comply with all ciiy ana counry
ordinances antl sta�e laws relaiing lo bmlding constmction antl hereby auNorize reDresen�alive5 of this ciry �o enter upon �he above-mentionee
pmperty forinspection pur0ases. r.
r
- 7 z� s�a �I,�,d',�'������.
�a�e: � � SignaWre: �
Onver'S License or Social Seariry q: �
i64t�A6 Whpe—Butltling: Green—Cotle Enlorcement; Ganary—Hpplicanf, Pmk—Revenue; Goldenrotl—Assessor
CITY OF COSTA MESA - HUILDING PERN,IT
PERMIT NO: B 058247 PLAN CHECK NO: 03U98-91 L
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR
JOB DESCRIPTION : NEW SFll
CLAZM VALIIE: 100,000.00 CALC-VALUE: 101,709.30
�
PERM NO: B 0�8?47
GOVT: N SUPP: N
PTJRPOSE: NETrt
SQ FT: 2,101 �
GROUP OCC; R-3 /
COMMENTS; NEW SFD
dE �1F�fF�If 1EdE dE �%� 9(�-1F if �� �1f if if iE i: if 9E i( �%�-lE �� dF iEiE if 9E�� jf jE 9(� dF If 9f 9E dE �lf df 9E 3f if �X� 9E�fF df aE �k� �lE iFjF3E iF�7f �IE�fF�%��E 3EdE �7E iE �Y iF �f if 9E -%if i(�-7E IE �1F�)E iE'%�N if �IE
Z O N I N G R E Q U I R E M E N T S
sEz�acxs
------ — ---- MATN HUILDiNG ---------- --------- ACCESSORY BUILDING ---- ----
FRN'L; 10 FT ZN REAR: 24 FT 1'N F'RNT: FT IN REAR: FT I2J
LEF'I: 16 FT IN RGHT: S FT IN LEFT: E'T IN RGHT: FT IN
PARKING TtEQ• 4 PROV; 5 PARCEL: 42207122 ZNE: R2 REF NO; DR-8$-66
PLANNING NUTESi ONE UNIT OF A TWU UNIT I)ETACHED APARTMENT PROJECT. PARKZNG
> SkOWN ABOVE IS FOR TOTAS. PROSECT. P, F 6E
iC� �lE iEiE �lf If �%9E if�iE if iEiEiF N� �K iE-Yr 3f �1(��lE if iE 1F�k �1F if iE iE 1f �k iE �lEif iE �3E �IF�%if iE �lf�-0E iE1E �� �Jf If iE �1F# �X� ic�1F ikit �IF�IE �If��%�iFiF i4 iE 4E if iF�IE �%� iE�ik #`� iE if �YF��7F if �%if if
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 /
ZONZNG APPROVED BY . S� G^� DATE: %(�(jl'Z
BUZLDING APPROVED BY ; v�—T DATE: �?0/9�-.
APPLICATION ISSIIED HY• S� DATE: ��S
iF ikl�FlE iE iE iE if� 3E ik iE iE -lE iE 9h 1f iE iF�1E if !f 1(- jFif iF 1E If iE �E iF if �IC�lE7FiFiF'iFif iE
iE iEle �1F 9E �1F �IEdF�If %� i(��E �%�%�If d(--IE i6 �IE iF if �IF-)EiE iF�ikii* �1E �lFlE �If if if 1F If �)E iF N-.i(..X..%..%� it�lE�� �1F ��lf �%�%lE -k �7E ik 1E�� �lEiEiE IE �� # iE-1f �7f if iE if-%3E �iE �)f �N�-?F# �1@ i� # 9f
LEGALIZATION:N F E E S U M M A R Y STRU(:T[JRAL SE(�MENi';Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 5MIP/RES GRADING
PERMI'I' 646.70 10.17
SM:iP /NON-RES
PiAN 420.23
ISSUE FEE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DJE
TOTAL5----> 656.67 0.00 920.23 1076,90 1076.90 ��" ,00
R:VENUE DIVISION TOTALS--> COLLECTED; 656,67 OVER/SAORT: ' 1�,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAD3NG PLAN-CHECK
646,50 10,1'7 ' � =-
�<�
1E 1E i(� iE�IE �IE IE i(� If if ik �S� N� ��lF iF 1F 3c if jE �1f� IE 3E jE K� If if it ii�-1F �lE if ik iF 3E if i! it 1k �)E 3F1E ih 1f ih �1f- if -lE 3F ih if 3f 1't �#f jF Y.� �IE �K jE �i!� i4 if� M� i� iF iE ic if� iF 1E ic ic 1(�'k�ie jE i4�K�
I N D I C' I D U A L F a E B R E A K D O W N
TYPE QTY U E S C R I P T I O N
SFR 1300 DWE-TYPE V-WOOD FRAME -GUOD
SFR 318 RES-BALCONY, EXTnRZOR STAIRWAY
SrR 273 RES-GARAGES TYPE V
SFR 210 R�.S-CARPORT
E X P I fi E D END OF F'EES
fncaniplete Inspections
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�1ate ,_ ` s�g _bl L k�'�
UNIT COST TOTAL�COST
�..—.:-: .
69.00 Fiy,-,`700,00
13,80 4,3fl8.4U
17,3U 9,722.90
1�.80 �,B9B4OU
01 00114784-00119755 �'y�"�' ;;;, �
DA7E� �7/?0/92 TIIiE: ;3�4�
�
CONSTRUCTION AND PLANNING _ - POOL ,PA . �
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
7. Temporary�Electrical Service or Pole _ � . 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd._ 53. Stee� Reinforcement '
3. ElecVical Conduit Utility�Undrgmd. 54. •Forms
4. Elettrical Conduit-Undrgmd. . 55. Electricai Bonding "
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. ElectritalUFERGrnd. 57. APPROVAL7000VER�GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd.
8. Foundation � ' 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor Sysiem 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sewer Cap � 63. Heater & Vent-Final ' �
13. Roof Drains 64. Plumbi�g System - Final
14. Rough Plumbing 65. Electrical-Final '
15. Fough Electrical-Conduit ' 66. Solar SYstem-Fina� �
i 6. Rough ElectYic Wiring 67. Fencing & Access Approvai
77. Rough Wiring Sign 68. APPROVEO FOR PLASTERING
18. Rough Electrical�T Bar Ceiting 69. POOL(SPA SYSTEMS FINA�
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace � . APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating ' 71. Product Pipin9 �Gas �Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe '
28. Lathing & Siding 77. FIXED SYSTEM FINAL �
29. �nsulation -' 78. FIRE PREV. FINAL .
30. Drywall Nailing " HEALTH DEPT. REQUIREMENT
31. Plaster Bwwn Coat ' -�� . 79. FINAL WSPECTION
32. Elecirical Power Meter-Finai .80. FOOD CERTIFICATE ISSUED •
33. Final Electric � Notes: -
34. Pinal Heating & Air Conditioning . � --- : '
35. Final Gas Pipe-Test �
36. Hood or CanopY �
37. Final FactorY Fireplace � � , -
38. Final Plum6ing .
39. Water Servic0-Final .
40. Gas Service-Final ,
41. Solar pomestic-Final �
42. Backflow P�dventer
43. Backflow Irrigation '
�
44. Landscape Irrigation SYstem
45. Sound Attenuation
46. Handiwp Regulations �
47. FINAL STRUCTURE & BUILDING , � � E X P( Fi � D
48. FINAL PIANNING .
� �i;.r.
49. Eleatric Release to Edison ' (jgh _ S�g
50. Gas Release to Southern California Gas Co ti, �
51'. CERTIFICATE OF OCCUPANCY
No. Date
PHOJECi RDOflE55: j tt z �,D,f✓j j f�'j'�j.] �^'j'
OWNEP'SNAME: B'1LL WILLIANSS
pUDflESS: 5331 WHITEFOX DR
RANCHO PA105 VERDE
CA 90279
2133784764
APCMIENGINEEH:
AUOflESS:
flEG.NO.:
uxiT:
UNIT:
PENMITTEE: HILLY WILLIAMS (714)63i-7753
aoosess: 542 HAMII,TON
C,M. CA 92626
UCENSEO CONTflFCTOP UECUIBATIUN: I �ere�y affirm I�a� I am license� under pmvisions o� Chapler 9(commencing with Sec�ion
7000� oi Division 3 of �he eusiness antl Professions Code, an0 my license is in tull force and e��eci.
CITY LIC.: STATE LIC.: ClASS:
�ate: Signaiure:
WOflREflS' COMPENSFTION OECIABATION: ' I here0y allirm ihal I have a certifiwte o� consem m sell�insure or a cetli�icate ot Workers'
ComDenSalion Insurance, or a certified copy ��ereof (Sec�ion 3804 Lab. q.
POLICY NO.: E%P. OATE:
COMPRNY:
7 Cenified copy is here6y �umishe0. ❑ Ceni�ietl copy is Iiied wiN the ciry Building Division.
Oate: ADPlicant:
E%EMPTION iBOM WOPREBS' COMPENSATION OECIAPRT10N: Qhis seclion neea not be complele0 il Ihe De�mil is lor one hunOrtH �5100) or less�.
I ceriily Iha� in ihe Derlormance oi �he work lor which this permi� is issueq I s�all no� employ any pe�sonip any manner so as to �ecome
su�le�� �o �he Wo�ers' omPensa�ion Laws ol Calilomia. ��� l���
y� �
�ale: � � � Signalure:'/f�
NOTI E: II, a�ter making this declaration, you shoul0 become subje 1 �o �he Warkers' Compensation pmvisians o� Ihe Labor
Coae. you musl fanhwiih camplY wi�h such pmvisions or this permi� shall 6e deemed revoke�.
CONSTPUCTION LEN�ING AGFNCY: I here�y a��irm Iha� Ihere is a conslruction lentling agency �or Ihe pedarmance ot �he work �or
w�ich Ihis permi� is issued (Section 3097. Civ. C).
LENDEN:
aoonEss:
OWNEP BUILUEB OECLABATION: I hereby afiirm ��al I am exemp� �mm Ihe Caniramors' State License Law �or �he �ollovnng reason
(Seclion 7Q71.5 Business antl Pmfessional Cotle: Any cily oi coun�y which requires a permit Io conslmci, alier, impmve, Oemolish, or
repair any slmclure. priar lo i1s iuuance, also reQuires ihe aoPlicant tor such permit to file a sipne0 s�a�ement that helshe is licensetl
Dursuant Io tAe pmvisions of ihe Contracbrs' State License Law (ChaD�er 9 �commencing wit� Section 7000) of Division 3 of the Business
antl Pmfessions Cotle) or �hat he/she is exemD� Iherefrom antl �he �asis �or �he alleged exemption. Any viola�ion o� Secfion 7031.5 by
any applicantlor a Dermii sublecis �he applicanllo a civil penalry o� not more than �ive hundreJ dollars (5500�.
I, as owner af the pmpeny or my employees wi�h wages as �heir sole compen5aiion, will do �he work, an0 �he
❑ simctureis notintentletl oro��eretl Iorsale�Semion 7044. Business an0 Pmfessional Cotle: T�e Coniracmrs' Slate License Law
tloes no� appty ta an owner o� a pmperty who builas or impmve5 ihereoq and who tloes suc� work himsel�/hersel� or �hmugh
his or �er own emplayees, pmvidetl �hat such impmvemenls are nol in�entleA or olferetl lor sale. If, however �he huilding or
improvemen� is soltl wi�hin one year o� complelion, �he owner will �ave the buraen of pmving hels�e tlid noi build or impmve
lor �he purpose af sale�.
I, as owner o� Ihe propeM1y. am exclusively coniraciing wi�h licensed con(ractors �o constmc� �he prolect (Section 7094, Business
� anA Pmfessions COUe: The Con(rac�ors' Stale License Law does not appty to an owner ol O��DehV �a buiitls or impmves ther¢on
anU w�o mmracis lor such pmlecis with a coniractor(s) license Dursuantto the Coniracmrs' Sia�e License Law),I am aware
Iha� pmol ot ��eir WoBer's ComOensation insurance sAoulA be provitle0 �o me.
� I am exemp� untler Section: B. 8 P. C.
fo�r -17�is r ason P ✓l
Oate: `��,! L Owner:�'��'/'����"—"�� .
'�. I tlo Aereby ceni�y Iha� I am aware ot and unOerslanA Ihe reQuiremenis oi Califomia Healt� anJ Sa�ely COUe Seclions 25505, 25533, an0
�i 25534 and Ihal I or any �uWre builtlmg occupant will/will nol (circle one) need �o comply wiN saitl 5�aie coAes antl [he requiremen�s �or a
permi� lor conslmclion or moAilication hom Ihe Nir Ouahry Management DistricL Re5i0ential conSVuction applica�ions are exempt tmm
�hese provisions.
Daie', ApplicanL
I M1ereDy cetlity t�at I have read Ihis app6ca�ian anA state Ihai Ihe a0oue informalion is correcL I agree �o comply wi�h all ci�y and coun�y
ortlinances antl sla�e laws relaiing lo building consimclion antl �ereby aut�orize representaiives of �his ciiy lo enter upon �he above-meniioned
pmp¢rry �ar inSpeCiion purpases. � r
Oate: � Signature: ys,<'A� � ^ ' ""T��'^
Oriver's License o� Social Seari�y a: )
t6at-a6 Wmte—Builtling; Green—Gotle Enlorcemem; Canary—AOPlican�; Pink—Revanue: Goltlenro0—Assessor
CITY OF COSTA MESA — HUZLDING PnRMIT PHRM NO: GRA 058145
PERMIT NO: GRA 058249 PLAN CHECK NO: 03U96-91 L GUVT: N SOPP; N
CUNSTRliCTION TYPE; V—N PERMIT TYPE: GRA PURPOSE: NEW
JOB DESCRIPTION ; GRADING FOR Z N'nW SFD SQ FT:
CLAIM VALliE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: GRADING FOR2 NEW SFD
*���c* �� x�� ��**�*��r*x x�r�*��r�� �x x�***�*��x* ��*��x+�x��� �� ��**��r*�*�e***��c �� � �r:� ��*a��
2 O N I N GS ERTFH�AUCTKRSE M E N T S
------------- MA7N RUILDING ---------- --------- ACCESSORY BUTLDING ---------
F'RNT: 28 FT IN I2EAR: lU FT 1'N FRNT; FT TN REAR; £T IN
LE:FT: 16 FT iN RGHT; 5 FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • 4 PROV: 5 PARCEL: 42202122 7.NE: R2 REF NO: DR-88-66
PLANNTNG NC3TE5> ONE IJNIT OF A TWO UNZT DETACHED APARTMENT PROJECT, PARKING
> SHOWN ABOVE IS TOTAL FOR PROJECT.P, F 6 E
3E ##�%� lE iE �!f if iE if dF iE iE iEdf �k if 1E � i(-fE iE �k �� �! iF if iE �ff �lE Y.� �� 1f �1f iFif #�IE�IE iE �If �k #�iF �)f �k iE jE if !F �lE iE� 1F if jFif iE�E�It �lE �IE �IF �%if �a �k iE iE �N if �3E �lE i 9F�� iF iE �)E
D E V E L O P M E N T S E R V I C E S R E Q ii I R E M E N T S
7.ONING APPFtOVE:D BY DATE:
BUSLDING APPROVED BY : �J ��— DATE: �� �.
APPLICATTON ISSUED BY; ���_�� � �.� DATE: ���''.L' ,
if�lfiE*�lf�lEifiE�if�%�1Eif�%�9E-1f-�1E�7E�7f�IE�JE3F1F7FiF ii7F'iFR�' � iF� it�f�"if -iFiFY3F7F�GR�F#�kdf���EdEjf�kiF)f #*
iE �1F �IEif� �1E if iF�IE �lE 3E �%�k �k if -N� iF3f �k ik iF �lE if �1E iE �If 9E iF �Ik �lE iF �IE 1E �%"k �F �%d'e �I4�X� dF �If iF iE iE iE �7E iE 1E �lE iE �lf �lE �lE if ik�iE� �lE �IE�iE �lE �IE #�% iE-lf �7E 1F iE �K� 9E �lE if�-lf iE#-N-iE �if -1(-
I.�EGALT7.ATIpN:N F E E S U M M A R Y STRUCTIJRAL SEGMENT:N
BLI)G PM1' PLUN,BZNG EI.ECTRIC MECHANiC FIRE SMIP/RES GRADING
PERMIT 2',50
SMIP/NON—RES
PLAN i5.O0
ISSUE FEE 3,00
B[IILDING—DIV—> PERMIT ISSUE PI�AN—CHECA 'I'OTAL PAIL•1._.-' DUE
TOTALS----> 22.50 3.00 15,00 40.50 �i0,.50-�:—�. .00
�":�
REVENOE DIViSION TOTAI,S--> COLLECTED: 25,50 OVER/SHOR'P; - ,00
BLDG PMT i�LUMHTNG EI.ECTRIC MECHANIC F'IRE SMIP/TOT GRAnTNG;.PI.AN—CHECK
� 5 . �;�,
ik }}!f ik if� iF iE �)f iF iF�IF if iF iF 1f !f 1E fElF iE 1f 1E iE �lf iF IF iFiE iF i(� iE ik if iE iF iE � if� iE 7f )E iE iE 1F 1E iE if 1E %� 1f 1F ii� if ie iE Y i6 aE if� iE �F iF �F iE i(' if iF jk 3b ii� ii� ie iF 3F ii� ii if� it iE
I N D I V I D U A L F a E H R E A Y. D O W N.
TYPE QTY ll E S C R I P T I O N UN3T COST • �., TOTAL COST
'i :
NO FEES W�RE SELnCTED FOR THIS PERMIT
tXPIR��.
incorriplete lnspect�an'
� i
i702t � - — $Ig �-- _ _�_"
�
e, ueiie��s-ao�i4�sa F�-� �
GFlT[= 07/20l92 TIf(c: i3.42
�.
CONSTRUC7�ON AND.PLANNING - P��' 'PA -
.APPROVALS Permit# Date - Inspector p�ppROVALS Permit# Date Inspector'
i. Temporary Electriwl Service or Po�e � �' 52. Pool & Equipment Location '
2. Soii Pipe•Undrgrnd. � . 53. �Steel Reinforcement �
3. Electrical Conduit Utilfty�Undrgmd. - 54. Forms � -
4. Electrical Conduit�Undrgmd. 55. Electricai Bonding �
5. Steel Reintorcement � - 56. Rough Plumbing & Pressure Test
6. ElectritalUFERGrnd. - 57. APPROVRLTOCOVER-GUNITE
7. Footings ' 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. - � 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Fioor System � 61. APPROVAL TO DECK
1 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Orains 64. Plumbing System - Flnal'
14. Rough Plumping � 65. Electricai�Final .
75. Rough Elect�iwl-Conduit 66. Solar System-Final �
76. Rough Electr�c Wiring 67. Fencing & Acczss ApProval _
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Eiectrical-T Bar Ceiling � 69. POOUSPASYSTEMS F.INA�
19. Rough Heating & A"rr Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit #
27. Ducts, in Structure 70. Undergrounci Hydro
22. Ducts, Ventilating � 71. Product PiPing O Gas OOiI
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank � Gas � Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ' 76. Dry Standplpe
28. Lathing & Siding . � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat �� 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Condiiioning
35. Final Gas Pipe�Test �
36. Hood or Canopy
37. Final FactorY Fireplace
38. Final Plumbing ' '
39. Water Service-Final '
40. Gas Service-F�nal
47. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation -
44. Landscape Irriqation System
RED
45. Sound Attenuation {� mpl te Inspections
46. Handicap Regulations - `� ? _
47. FINAL STRUCTURE & BUILDING .�
48. FINAL PLANNING �
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
i.
51. CERTIFICATE OF OCCUPANCY
No. Date
COUNT'Y OE ORANGE
BUII.DING DEPT.
636 No. Broadway
Santa Ma, CaGfornia
Phone: KI 2-6211
Application for Building Permit
AND FOR A
Certificate of Use and Occupancy
Permi[ No....7..Q.3_, � 2�
Dare.. / /�.lLiGC/�: /�, 9'�2
- --- ----
r" ' ._. /� �
1. OWNER'S NAME_..._._.._.. - �n�" - -�.:. C-.r'-'- � � �-- - - - - � - PHONE :"�.e-:- S/ S 2..P
MAILINGADDRESS_��f-�- - - �....�`I.�'..v,,..1.�.7:C�..�l:.- - CITY �.g_/!t?._.../%7�S/��
Name .:... -- ..
Address
City --------_:__..
State
Lic. No._---------
-- -_....-- �
(Archit�br gineer) �
. _ _.... _... ........---�----------------... _.....
� ..
._......----�-----------------..._. __ _---..
Phone---._.
Name
Addrees
City --------------..
Scate
Lic. No...---.._---....
` (Contractor) .
��
----'� --- -----------...._.._.----------:...--
.Phone---�-----.....----. �__----�---
PROPOSED USE:..._�.:..'`�./c..'�-.,G1.�._..�.(!`'.L�K��S�AJ71,--���1.�f'.O.FJ..�D.�L�`-.�/Y�IC//j�.
'/ . /� _. •
JOB LOCATION---.�."...�-..----- GCl . /''I:er-» � , L Y7� ti/. • �UJ < T�a %�'�P4 �
-- - -"---'.-"--------...----..."- ---..._-�----"-----...--.....---____------......--.....------ -'-- ��----._.......
(Hwse No.) (Name of Scrcet) (Tawn or Schoo] District) �
i .
LEGAL DESCRIPTION: Lot.._-�_0._----------...._----------Block ...._._.-----"--------------._...... Tract.....3.��.----..---._.._..
(Metes and Bounds Desrnption—Use reverse side of form) � -. :
CORNER LOT ( ) INTERIOR LOT {�O THROUGH LOT ( )' SLOPE OF LOT ( )
z
SIZE OF BLDG.:.L�. %�.. �.�- - AREA:�iC�.�'t_ �7 -.SIZE OF LOT: �-�-.X..�%.�R�EA:.... - -- -----
�/ i ��
HEIGHT OF BLDG.:...L...._ 6--.-__-----..--__-----CEILING HEIGHT:---..-�-!�'Q.�_�-.---:NO. OF STORIES---_--.._J-------------------
Y
NO. FAMILIES----_X-._..__-..-_•------_._Size of,Smallest Bedroom:._...___-�-__...---_-..--_ Size of Kitchen_-_-..---x..-_-.-
'---------
EXTERIOR WALL CONSTRUCTION ....._ ��:�?'"h.:..Q...:._...INTERIOR WALL COVERING..._._ ��_!.:'.�'.�.Lr....._...
(Frame, Stucco, $tc.) . • , .. . ..' " (Plaster-Drywall, Etc.) F
SETBACKS:.Front Yard From Center Line o� Streec.._..._�.�� ......_ ....................................._..
Nearest Side Yard.....�..__...Rear Yard.....J.-......_.._.Distance in Feet Between Bldgs. on Same Lot.__...___/�._:.._ .................
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTUAES AND USE OF EACH.
I1. For
Accessory
Bldgs. and
Similar
Strucmres:
/i
(a) Footing: Width___.......�.Y��....Depth in Ground..-.��Z_.......-Widthof
(b) Size of Studs:_�.-�-1i=k__�F:.------Spacing_..-----�C:�-.--........CC Material of Floor.....�{Jr�/��eo.%�o...._
c� L i4- �'"--------------.5 acin — .,CC ,
(c) Size of Floor Joists----------------_... P g--�-----------------------...--..
� / � i� .
(d Size of Rafters:-----------_--.:..._.--- ..
) C 7' v --------..:----..Spacing...........-`---....---------------- CC
12. VALUATION OF PROPOSED WORK: Indudi�g a1] labor, plumbing, elecvical wiring, heating, fire sprinklers, painting and
/�loo __ ...,
.....�. . _-sewage disposal� $---'t'77f'� ��- --v----_......
yZs�
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
� � (�,�,�
. Signed:...._ �<.(-t�e`4,---\--/�-----'=-_--'--"-'`-_'-�C!�-._..__....._--
(Owner)
Plans Filed:...
SkeyzQ
FEES:
Bldg. Permit - $..
Plan Check - S..
7'otal - - -7� S..
Receipt No. p�C� ..
Paid to • -
Date............- - -..........
0
BY:.......
(Authorized Agent)
ARTIVIENTAL USE ONLY
�� CHECKING BY
� GROUP.:_..Sd �[:.�.... APPLICATION��HEALTH ............................
......
...
'�i � TYPE.... - - __...... FIRE
ZONING. _....._......¢L..---
'___.__. DIST. �o r' PLANS AND MARSHAL .........................
MAP --......_C..�..R �` -
G �- SPEC'S - -- -- �� - STATE ................. --- ...
J �........: ..
_.,_.____ SHEET NO........,.. -- CORRECTIONS ENGINEER
i�- --- -----..._--- - -..- _.... VERIFIED- ---....__.... CAL._......_ _ ............:..
PERMIT
DATE - --'�'f.� ./�( SY�
5 M-e-51 �
NTY
DEPUTY
��
RIGGS, CHARLES A.
JOB ADDA
GENEftAL
i
2
OCCUPANCY
AUG 1 0 1961
ACT FIRE ZONE
DATE I GROUP I
Form 210—SM—i l-Sq 5-B P •
10-28
VALUE $ lO1.UU
DESCRIPTION OF �VORK StUCcO
TYPE V ZONE
SUBCONTRACTOR
16�
13�.(�4
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MESA. CA1-�FOitN1A
For Applieant fo Fill In Complefely
TYPE OR PRINT �
BUILDING ,9"yR �A/II /I � A/ �%7 •
annarac
A MESA. CALIFORNIA
TEL.
USE OF
EXISTING BLDG
6¢TBAGK LINE FROM
NO. OP.BLDGE.
DESCRIPTION OF WORK
BUILDING
91ZE
EXTERIOR WALL
� .1—. . �/ •
NO. OF
iBBY ACKNOWLEDGE THitT I HAVE READ THiB MPLIWTION
6TATE TXAT THE ABOVE IB GOPRELi AND A6REC TO COM-
NITH ALL CITY OilO1NANCEe AND 9TATE IAWB REOULATINO
NG E OF���N G. / / �,{
iii�1
� F�R�CEIVED
ocT 2o1�6A
FIN9NCE DEPi,
CITV OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
BUILDING
A�ORESS
COSTA MESA.
ZONING
ZONl��I NPUN9 I BUILDING
LEOAL �y ��./L/��
DGeCRipT10N �V ( ' / � ' � D!
A.P.NO. � S—� O �
YARDS EVES
tcexrsw une er.1
�
TXE AMOUNT BHOWN IINDER YALUATION� 18 POR THE
PUPP09E OP H6TABLIBMING A�PERMIT FEE ONLY.
VA4UATION -
$ /p� � P@RM1T FEE $ �
V / � PLAN CHEGK $ ^—_
TOTAL FEE
F
0
LL