Loading...
HomeMy WebLinkAbout1807 HUMMINGBIRD DR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - PERMIT NO. 8 TRACT NO. • LOT NO. UNIT NO. C Z2 CITY OF COSTA nnESAp CONSTRUCTION. PERMIT E (n/ 9325 6/09/ 7 I t - T' Project Address i0 07 ilomm///ia ,to Applicant's Mailing Address 'S*�£ /' ,G. TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION H REPAIR r Owner's Name x IUL/A Ll7nCBy Phone@049-4107/13 El CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# . Zone DESCRIPTION OF WORK/USE OF BLDG. Address /8o7 trebery/w/ /.pi 7/ COSt Me$-4 ce- S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT LI GRADING ❑ FOUNDATION��77( U STRUCTURAL T Front O Address . �1,xQ �' ❑ TENANT ❑ ELECTRICAL. ❑ PLUMBING pc,LMECHANICAL B Rear N Contractor's Name 3 Qt0 Sri, .JIC Phonl27J�)fl/3170 ❑ OTHER _ A I PROJECT DESCRIPTION SQ. FT. OCCUPANCY. C Right N Address(mailing) .53-41/ CaesS De-4 1 M. S. (A- ya Cy y KG ,,// R CON ST RUCTION TYPE VALUATION$ s Left _ City License No. (7T/77 ZONE GRADING CU.YDS. ACRES - LICENSED CONTRACTOR DECLARATION - Ping. Ref. # Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: - Q with section 7000) of Division 3 of the Business and Professions Code,and - • M my license is in full force and effect. 7� - T License Class (�-.2 O —Lie s �Q�i]Q9a7 S Date G-9-t1 Signature /fes-7/ /G-• PLUMBING / FEES q'y: RKERS'COMPENSATION DECLARATION / Bar Sink Showers :.rereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES q Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap • Construction Pole Sub. 050+KW 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Bathtubs Sewer Conne• ion Cooking Unit Meter ❑up to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Co -ctOrs Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($100) or less). Dishwasher . Sola •iping Dryers ❑Gas ❑Electric Sub Panel 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 tobecome subject to the Drinking Fountains • ar Tank Fan , Motors❑0-1 HP µd'9,-8 Z pb Workers' yompen{a�xon Laws of Califor/0� Date 4- 7-!(1 Signature .DLjIv.C" Floor Drains Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration,you should be me subject to the Inc.$01st ❑9-15 HP ❑16-1$+ Workers' Compensation provisions of the Labor Code, ou must forthwith Floor SinkUrinal Fixtures `comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Out!: Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance9 of the work for which this permit is issued (Section 3097 Civ. C.) Interce• ptors Water Heater Outlets Ran ¢ Lender's Name9 Lender's Address - Kitchen Sink Water Service 1 Switches Sign n�I OWNER BUILDER DECLARATION - 2D I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or /-.. county which requires a permit to construct,alter,Improve,demolish or repair p-Trap`A LaundryTrays • any structure, prior to its issuance, also requires the applicant for such permit -- - y Generator ❑B-5 KW ❑5-15 KW Trash Compactor •to file a signed statement that he/she is licensed pursuant to the provisions of Roof'Drai - 'he Contractor's License Law(Chapter 9(commencing with Section 7000) of - __ d .Ica T I _n_ 'vision 3 of the Business and Professions Code) or that he/she is exempt /- -- ___ erefrom and the basis for the alleged exemption. Any violation of Section r /031.5 by any applicant for a permit subjects the applicant to a civil , penalty of not more than five hundred dollars($500). 3 D I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ I compensation, will do the work, and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ ZoningApproved • sale. If, however,the building or improvement is sold within one year of com- Canopy Type II ❑ pP By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved BY o� Date }' prove for the purpose of sale). lf_X'9 0-Qi O r ❑ I, as owner of.the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating I TP0-100,000 BTU 0100,000 BTU , op SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). Tam aware thatExhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ -MIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT 0 I am exempt under-Section B• .& P.C.for this reason -. Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING • $ ISSUANCE $ Date - owner - Heating System&Ducting Registers • PLAN CHECK 25% -$ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTL - T. 1A GRADING $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- sentatives of his city to e ter upon the above-mentionedproperty for inspection p r oses. p r,.� MECHANICAL $ 017 Drivers'ure e or SS Date - —a �' TOTAL FEE $ �Y'• J� Gaar9 Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ /-,_dO License or SS$ / }� CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1'. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. , 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. foundation 59. Gas•Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 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. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T•Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough 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 O Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION . ,.' 32. Electrical Power Meter-Final U 80. FOOD CERTIFICATE ISSUED • 33. Final Electric 6-41-n trw Notes: 34. Final Heating & Air Conditioning -/l-1(( CED 35. Final Gas Pipe-Test 36. Hood or Canopy 37:Final Factory Fireplace 38. Final Plumbing ' •. . 39 VWater Service-Final • 40. Gas Service-Final ' • . , 41. Solar Domestic-Final :. • •• '42. Backflow Preventer '. , -43. Backf low Irrigation • V 44. Landscape Irrigation System - I :45. Sound Attenuation ' - 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO, 6,7(512 DATE 34,!///4/9 LOT N0. r/ ADDRESS /4O7 di/Ming/4? 4/r.),1/29) . The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-ehe=they) (was :w.-_._e) /cam ' advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. esnecz BY Purcha BY O Dev-loper and or authorized representative BY Lender • 30003RA 17-6St1n,5 00 908* ***189.75 `% COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT _ RECEI�/�g`� DAT��EF RECEIVEp BUILDING // q-/�i / R t'—i5SylED, ADDRESS 1807 Hummingbird Drive JL�/�� H 7 /H�d Y�J t/O OWNER Jamaica Const . Co. A.P. NO. PEHyT�IR_3 MAIL BUILDING /y l� Li,LdADDRESS 2850 Mesa Verde Drive ADDRESS 420'/ (I/51Aq,,Li 6i/ 4. Z / / CITY Costa Mesa NOL CL U .5490395 TRACT 675 LOT 31 BLOCK Z C CONSTRUCT, / , NELY ' ADD ALTER I REPAIR MOVING DEMO'ISH O N LENDER �(�LC.eL7 �LK4a-clNyLl--r"'AO /d /\J`/ 0- U J 0 BRANCH4_2Qat to OWNER if/ Q W ADDRESS ','/, �J� /J / - 9 > ,'/ / '�� L m J Y"YC/� VAC J4A/ L!/` K 7Q��J ' ,.,/t, -I • �/� (//J.� ALUE f/�' -CO ARCHITECT TEL US E_JL1A, (.V/(�(s(.', $ j9,58G Q OR ENGINEER Kaltenbach NO 5478049 ///��� ��' w N FIRE -#1/43 �///J/�er W W ADDRESS 1823 E. 17th ST. , S.A. ZONE TYPE GROUPO•tY, V a.W W ZAPPROVED JO CONTRACTOR Jamaica Const . CO. BY DATE mZ .it ADDRESS2850 Mesa Verde Drive W W TEL ZONE NO.OF USE OF NEW Singl fain. ZF CITY Costa Mesa No. 5490395 R1 PLANS 2 BUILDING _ w/att q:,r O STATE CITY YARDS APPROVED YARDS APPROVED Wn tt LIC. NO. 193122 rLIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZENO.OF BLDGS. OF LOT I NOW ON LOT 0 FRONT y 6 FT. FT. USE OF EXISTING BLDG. R.SIDE C FT. FT, F SIZE OF NO OF ZZ NEWBLDG.2690 SQ• ROOMS 9 STORIES 2 L.SIDE b FT FT. EXTERIOR WALL ROOF rr�� // Ci COVERING Wd/SSul. COVERING WOOd REAR e(U' FT. FT. —I USE OF BUILDING AND WORK TO BE PERFORMED a single family residence DISTANCE BET. BET.MAIN& M MAIN BLDGS. ACCESS. BLOCS. ct w/att . garage VUR.* DATE O APPROVED I— Plan 269—C APPROVED wfav W• L. D DATE 4-10-69 Z a/u1 d-Iii 0 UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with cc all laws regulating building construction, and I shall not employ F•, any person In violation of the workman's compensation laws of U) the State of California. n 2 bCI O. FT 67�t 96V 9 oe ? I hereby certify that I am properly licensed as a contractor under t�—�LQ 0 the State of California Business and Professions Code, Division 3, THE AMOUNT SOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b am exempt from the provisions of the State of California Business CC VALUATION and Professions Code. Division 3,Chapter 9. // trt m PERMIT FEE S o7Ir D Signature o /,s Permittee Jfama ice Construction Company s23931% PLAN CHECKS ,`1s/''J93,} E Authorized Agent ` h -abut TOTAL FEE $ /V /' /�LL OWNER LACY, E. DATE 11-12-76 JOB ADDRESS 180/ Hummingbird Drive BUILDING PERMIT NO. 43001 GENERAL CONTRACTOR Marcus W. Stoneman DESCRIPTION of WORK Patio Cover f,` -r,,g, 139-6O2-U3 LOT TRACT FIRE ZONE VALUE $400.00 • IW:.; ECTIONS ' Signature Dote TYPE V GROUP j ZONE R-1 sou. ' SUBCONTRACTOR PERMITS ISSL ED .S GAS Date I Number Signature WATER Plumbing ROUGH PLUMBING 1 I I PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING' TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. TRENCHES FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE R SHEATHING • FRAME AND FLASHING LATHING — IN n OUT fl _PI "ER. BROWN COAT S TURAL, FINAL Flertric HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST in 1 • ELECTRIC. FINAL /� BUILDING. FINAL P.C. "-nit,I�t t, ' 'r 1P-7e-p7.7•00(f;'.' Or 'Mg t... . -.1i- • ce 43n01, COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIS. DATE RECEIVED ID ISSUEO, BUILDING I�//]]^ LLQ/�///( '' ' ,/A i��� ADDRESS /il'y C� 7 4t�/11FdIGB(tD -- �zat'�r f `37 /O0 43 ERMIT NO. OWNER mQ L's LAG`/ A.P.NN MAIL / BUILDING / ADDRESS 5 /✓I r_ ADD RESSl o 07` .}!rnm/77 /t/ O �+ TEL. TRACT ti7S LOTS/ S'BLOCK CITY QS-IA J/Yl Xs A. NO.rT¢p^'S—/g9 CONSTRUCTION NEW AD ALTER REPAIR MOVING OEMfU ISH LENDER p BRANCH p A r OWNER [--/cr[� ADDRESS /�//)�r (/ ' VALUEis ARCHITECT TEL. IISF /' /d'f�t7 W " 5 ®O r OR ENGINEER NO. FIRE T ADDRESS ZONE YPE GROUP ��y/�� • APPROVED /y h.— le) CONTRACTOR f/ '�QC t)� \�`Sjp��-n )Ed)�44: •BY / DATE Ia !!!! 7 �// ADDRESS ¢S S/G/Lf/ fFU� / TEL. ZONE NO.OF USEOFNEW /'��I PLANS BUILDING C ICIT ft / ///O,- ,4 N� t / - - STATE CITY ' YARDS APPROVED YARDS APPROVED LIC.NO. a Q 9 4 4 LIC. NO. 6.9,..Q' MAIN BUILDING ACCESSORY BUILDING IR SIZE ANO.OF BLDGS. ` (FROM C/L STREET) 0• OF LOT 4s-- x //Q NOW ON LOT FRONT FT.r FT. Q USE OF 4 EXISTING BLDG. r6 C /i Ceil S� B.SIDE / FT. :7....................F/ S Separate permits are required for L.SIDE }/ FT. FT.c. _ electric,plumbing and heating work. REAR /e. FT. FT. LW • I-. USE OF BUILDING /2.*:)WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& A / Ur 4.A/6/t JtrtO A4T t/cL- r— MAIN BLOCS. ACCESS. BLDGS. VAR.* — DATE '111/ F if XIST/dOG Pit T/O SL4,S C.U.P.#s APPROVED/ 7 APPROVp nATF /L- 12 /} -a iS w r O. I hereby acknowledge that I have read this application and state g that the above information is correct and agree to comply with s'.P1]�/r� / / • / r l 0, all laws regulating building construction, and I shall not employ i / to Z any person in violation of the workman's compensation laws of J/,e _ 8-10-27‘ u k7 the State of California. I hereby certify that I am properly licensed as a contractor under Zoo SO. FT. N the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business a and Professions Code, Division 3,Ch.•ter 9. VALUATION PERMIT FEE $ o ,ov n m / -.---- PLAN CHECK $ r rn Signature ofA y o Permittee ate - - -Vs/- _f„...,• ice. $ .�©® TAX $ �9 LL / P� TOTAL PAID $ .0 Authorized Agent 'Sc O OWNER IACEY, MRS. EDWARD DATE 9-1-70 JOB ADDRESS 1807 Hummingbird Dr. BUILDING PERMIT NO. 32222 %GFNERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Com.Wall F x.139-602-03 LOT TRACT FIRE ZONE VALUE $ 100.00 INSPECTIONS Signature Date GROUP .T TYPE 111 ZONE R1 4 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date WATER Plumbing I Number Signature ROUGH PLUMBING PROP. SWR. LINE❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER LI ROUGH WIRING /,>t/ Heating and Vent. TRENCHES FORMS STEEL REINF. 7/2./rt, FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PI c.R, BROWN COAT S. /URAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST n ELECTRIC, FINAL ,,f BUILDING, FINAL dig cAcIra "�: 22222 ' i COSTA MESA BUILDING-SAFETY DEPARTMENT SEP -1-7(T�hs-°n00 004 *****5.00 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 1 p,np7. l4 M f ei / /1/j A' KATION FOR BUILDING PERMIT fbC1+P /CerftTUF1/�/h Comr e e V/V RECEI a BY DATE RE EIVED Ey IS ED BUILDING :.,__.y - • ADDRESS - _ ,y-� O / 7O OWNER// fLce , > dl-GCiG��I J 2 A.P.NO. ( ig— VOS -03 P �7-2_Z MAIL // sBUILDING j O /70 7 `,�'/. _ 4 ADDRESS '/ Z ADDRESS(,, ,,rr / ��r!!!-�/Jl1/J�� 19 if92YJ�ln �J Qt ♦ ,^ 11 U CITYe/�F24t, ��-c2 r( NOa(G'S/iy/ TRACT 61 i�7 LOT 3/ BLOCK Z YY// / Z < CONSTRUCTION /^) NEW ADD ALTER REPAIR MOVING f1FMTH ISH CL O- m LENDER /s� ' `�s ? A '., a J N BRANCH /A '' OWNER �H+ (til ����J'`��Q�. m J LU ADDRESS R/1/74//�'i VALUE-CO ARCHITECT /I '-I Q OR ENGINEER Ai) /1 r NOTEL. USS $ V Cu, / FIRE �1 \\ d X ADDRESS 1(lt /1- ZONE \ \ PE I ROUP //�' / y'� APPROVED ` /1 7--- ILI 0 O CONTRACTOR \ I( l�+ BY DATE 1/ CO J go ADDRESS /� W W TEL ZO� ( INO.OF p ' USE OF NEW _ /I�/ ZH CITY NO. PLANS ✓ BUILDING „�t(/f'//�-' W-O STATE CITY 4- YARDS APPROVED YARDS APPROVED NCC LIC.NO. 0LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZENO.OF BL OF LOT - -7.9/ I NOW ON LOS / FRONT FT. FT. USE OF EXISTING BLDG. 400<,.e R SIDE FT, FT, I— SIZE OF //}} NO.OF Z NEW BLDG. �;f"f I ROOMS2fr ST RIES L,SIDE FT. F—_ EXTERIOR WALL ROOF U ,`{ � / //COVERING f A• COVERING }�I/ v,,i _ REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d MAIN BLOCS. ACCESS. BLOCS. , 0- 1�1� )) Q C/ 1 Ik cc. w1 In-( VAR.# DATE p [O�YY^��'1'�.V I� -T/ �r' C.U.P.# APPROVED f/1 1 11 Y O L.G -Del u APPROVED //// 9 �/ n 0 Z �Y s!' 'Q a DATE / o -a5i�l J]/F Ste, 64, en I//) UI hereby acknowledge that I have read this application and state p that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of N the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 am exempt from the provisions of the State of California Business CC and Professions Code, Division 3,Chapter 9. VALUATION a Signntur6 /�/i/��/}� ///J /��ye / \ PERMIT FEE $ V co D Perm itte��r- v�� (V[^"�"t-�G[ LV �[/� S /O/` 1 PLAN CHECKS E u. Authorized Agent TOTAL FEE $ 4