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HomeMy WebLinkAbout3257 IOWA ST - Building Permitst (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 3257 IOWA ST Suite: Vicinity: RESIDENCE AND ATTACHED GAR4GE Parcel Number: 13904318 App�icant: SMALLDON, JOE Address: P O BOX 4076 SAN CLEMENTE, CA ; Owner: KOCH, CHRISTOPHER LEE Address 3257 IOWA ST COSTA MESA, CA Contractor: JOSEPH M SMALLDON Address: P O BOX 4076 Arch : Address: SAN CLEMENTE, CA Zip: 92674 Status: ISSUED Applied: 01/15/2002 Issued: 01/15I2002 Zoning: ISSUED BY: ' Phone: 949-248-8124 Zip: 92674 Phone: Zip: 92626 Phone: 949-248-8124 License: 519720 Eng: Address: i i � �� / � � . / � Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O EXISTING HOT MOP DOWN TO SHGT, INSTALL 3/4" 1X6 T&G AT EAVES, INSTALL 3/8" PLYWOOD OVER EXISTING 3/8" PLYWOOD TO MATCH 3/4" SECTION, �APPLY 2 LAYERS OF 30# FELT, INSTALL "25-YEAR ELK COMP SHINGLES. 3:12 PITCH; 2400 SF Plan Check: $0.00 " Permit: $111.25 SMIP Res: $0.50 SMIP Com: 30.00 Other: 50.00 Inspection: $0.00 Totai: $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0. 0 PARKING Existin : 0 NOTES: 0 Rear 0- 0 Rear 0-0 Required: 0 FEESUMMARY PLANNING & ZONING Lefl 0- 0 Left 0- 0 Pro osed: 0 Calc Valuation: Claim Valuation: Right 0. 0 Right 0-0 EXTENSION ALLO�ED ss,000.00 55,000.00 NOTICE: The work authorized by this permit shail comply with all applicable handicap accessGeMiEd�t�'un��t7�li�j/r�ctat�tes ralated regulations. (Ord. No. 92-28, § 1, 1241-92) C/�n EXPIRATION: Thls permit shall automatically explre and become vold if work Is not commenced wlthin 7 BO days, or if work Is suspended or abandoned for a period of 180 days. ' , INSPECTIONS: In order tor ihe work autharized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectiona end final epprovel must be obtalned. Failure to obtain inspections antl tinal approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 26CBd6 (8�00) i WOflKERS' COMPENSATION OECLARATION: ' I �ereby eflirtn untler penalry ol perpiry ona ot the fdbwing deUaratians; � ❑ I have and wlll maintein e ceNficate ol consenl ro self-Insure br workers' compensetlon, as provitled tor by section 3700 of the Lebor Code, lor the pedortnence ot che wark for which I�is pertnli is issued. � have antl will meintain workers' compensa��� insurance, as required by seclion 3700 0l Ihe LeDor Cade, for ihe peAormance of tho work lor which Nis pertnit l9 issuetl. My workers/' compensa n InsY rance carrler end policy number ere: L/ ^ l _ Q J Cerner: S�Yb�w �N^r/C PpIICyNumber. � 7�¢d—L ( (Thls sectlon need nof be oompleted i! fhe pemtit ls ve/ued et one �untlred dW/ars ($700) or IeuJ ❑ I certity that in ihe pertortnance ol e worlc tor wNch Ihis pertnit is issued, I shall not employ eny person in eny menner so as to became suD�ect ta Na wwkers' compensation laws ot Celllomia, tl egred ��et II I 5hould became sub�ect to Ihe workers' compensetlon provislons of Sectlon 3700 at tha Lebor Cotle, I 6hell torthwlih comply with Ihese pra ions. —` � AppllcantSlgneWre: Date: ��+�/L � � WARNINO: FFILURE TO SE E WORKEPS' COMPENSATION COVERAOE IS UMAWFUT AND SHALL SUBJECi AN EMPLOYER TO CRIMIWIL PENALTIES AND CNI� FlNES UP TOONE HUNDRED TKKISANDDOLURE�51 ),INADDRIONTOTHE�T��.�PENSATIIXJ,DMMGESASPROVIDEDFORINSECTIqJ37080FTHEUBORCADE,IMEREST,ANDATTOFNEVSFEES. LICENSED CONTRACTORS DECLARATION: I hereDy eNirm thet I am Iicensed under provlslons oi Chapter 9(cammenGnB with Sectlon 7000) ol Divislon 3 al t�e Busi eu entl Professions Catle, and my Iicense is in tull �orco end ettect. uc. a / c�ass �3 � Contrectofs Slgnaiure: Dete: _,��. I S �'1_ CONS7RUC710N LENDING AGENCV: � I hereGy eNirm Ihat ihere is e constructlon IenCing a9ency lor Ihe peAartnance at t�e work for which this pormit Is Issued. (Sec. 3097, Civil CoOe). Landefs Neme: LentleYs Atltlress: Signeture: Date: OWNER-BUILDER DECI'ARATIONS:: a'�' i /; n I �ereby eHirm that unCer penalry of per�ury Ihet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business entl Protesslons CoCe: Any ciry or counry which requires a perrnit;�o consiruct, alter, improve, tlemolish, or repair eny siructure, prlor to Its issuance, elso requires the appliwnt tor such pertnit ro fla e signetl stetement Ihat he or she Is Iicensad Ouisuant to the provisions oi the Coniractors Llcense Lew (Chepter 9(cammencing wit� Sectlon 7000) ol DMsion 3 of the Business and Professions Code) w[hat ha or she�u'ezempt therefrom end the besis br tha elleged exemption. Any Ndatlon af Sedlan 7031.5 by any epplicant for e pem+: sub�ects the applicem to a civll penalry of not mole Ihan Me hundred dallars (5500).): ❑ I, es owner of ihe properry, or my employees wilh wages as t�eir sole wmpensaUon, WILL DO 7HE WORK, end the structure is not Intended or oHered for sale (Sec. 7044, Business and Professions Cotle: Th6 Coniractors License Lew tloes not apply �o an owner of property who builds or improves thereon, antl who does such work himself or hersetl or through his or her own employees, DroNded thet such improvements ere not imendetl or oNered lor sale. If, however, Ihe 6uilaing or improvemem is sold within one yaer oi completion, the owner-builtler will heve ihe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of Ihe property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to ConSiruct Ihe project (SecJ044, Business and Pmfessions COCe: 7Te contreciors Licensa Lew tloes not eppty to an owner of pmpeny who builtls or Impmves thereon, ena who wnlrects br such prqect with a contrecior(s) license pursuant to the Contractors License Lews.). ❑ I em exempt under sec. Business end Pmfessions Cade for this reason: Signatura: Date: Owner ID verified by driver's license. ❑ Ye8 ❑ No Dnvers License No. Expires: Vedlication of Ownership Dy (type of daument, i,e. - pmPerry tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR GERTIFICATION: ❑ I hereby canify Ihat no excavation live (5) a� more faet in tlepth into which a person IS required to descend, wlll 6e metle in connectlon with work authorizetl by Nis pertni�, end �hat no huliding structure, SceHo�dinp, falsework, or tlemolition or dismantling thereol, will be more then Ihirty-six (36) feet high. (Chap. 3.2, C�rp 2, A� 2, Sec. 341, Tule B, Calllamle AdministretNe Code). ❑ As awner-builder, I will not employ anyono to do work which woultl require e permil irom ihe Division of Intluslnel Sefety, os notetl eDOve, unless suc� person hes e pertnit to do such work from the dlvision. Signaturo: Date: DlWsion ot Industnal Satery Pertnit Number. CER71FlCA7E OF COMPLIANCE AND AlJTT10R17ATION OF EMRY: I cetlity untler penelry oi perjury t�al I have reetl Ihis epplicetion and state that the informetlon given is wrrect. I agree to wmply with ell state laws end ��ry�ardinances relaiing to Duiltling canstruction, end authodze representatives ot Ihe Clry ot Casta Mesa to enter upon Ihe ebove-tlescribetl pmperty lor insDecNon purpose9� I agree not to occupy or allow occupancy at any building euthonzed by t�is permit until final inspection. CODE �. INSPECTIONTYPE ieie Flaea System Final Fire Prevention 1268 Pool Spa Final 200 Final Re-Roof 201 Flnal Block/Retalning Well 202 Final Factory Fire Place 203 Final Sign 20d Final Demolilion �7�� CIIIII.\b '� � ��/ cData � L < J Date COOE� INSPECTIONTYPE 206 Final Mec�anical 20B Finel Plum�ing 210 Flnel Elecirlcel 212 Finel Fire Prevantlon 220 Final Plenning Approval 222 Finel Site 250 Final Builtlingi0aupency �� � June 4, 2003 CITY OF COSTA MESA � P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENTSERVICES DEPARTMENT Christopher Koch 3257 lowa St. Costa Mesa, CA 92926 PERMIT NUMBER (S): FOR: PROJECT ADDRESS: BUILDING DIVISION NOTICE OF PERMIT EXPIRATION 602-00060 Re-roof 3257 lowa St., Costa Mesa Our reCords indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project and additional fees may be required to finalize expired permits. According to our records, the permit(s) listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contact this office so we may correct our records. A time extension may be granted if you intend to commence work and complete the project. Requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you need to request an inspection please call our Inspection Request Line at 714.754.5626. If you do not contact this office within 10 days, your permits will expire on June 19, 2003. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resotve this matter. Sincerely, i�����.�L����� Mary Jane Weidenkeller O�ce Specialist II Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planninq Division (714) 7545245 FAX (714) 754-0856 • TDD (714) 754-5244 • wvm.ci.wsta-mesa.w.us CITY OF C('-TA MESA PROPERTY DETAILS �'ORT Owner: Koch, Christopher Lee Resident Koch, Christopher Site Address: 3257 lowa N City/Zip: Costa Mesa / 92626-2004 Parcelld: 139-043-18 Location: Costa Mesa City Neighborhood: Unknown Wealth Code: 7.2 Legal Desc.: N Tr 3648 Lot 15 Zoning: Unknown Subdivision: Unknown Usage: 122: Single Family Residential Style: Unknown Construction: Unknown Year Built: 1960 Stories: 1 Bdrms: 3 Baths: 2 Full Heating: Unknown Cooling: Unknown Irr. Lot: Unknown Terrain: Unknown Water: Unknown Sewer: Unknown Sqft 1st Sqft 2nd: Sqft Bsmt: Sqft Total: 1450 Market Value: $211,495 Assessed Land: $142,548 Assessed Bldg: $68,947 Assessed Total: $211,495 Percentlmproved: 33% Delinquent Taxes: Sale Date: Dec-20-2002 Sale Amt.: Deed Type: Intrafamily Transfer Volume & Page: Seller: Koch Jennifer Tille Company: Multi-Parcel: No 3257 lowa N Costa Mesa, CA 92626-2004 Phone: (714)434-6594 Phone: (714)434-6594 Tax Address: 3257 lowa St City/Zip: Costa Mesa Own.Occ.: Yes School District: Newport-Mesa Unified Census Tract 063805 Year Listed: 1995 Ttl. Rooms: 6 Bsmt. Type: Unknown Bsmt. Fin.: Unknown Gar. Type: Attached Garage Gar. - Cars: Gar. Sqft: Roof Mater.: Unknown Roof Style: Unknown Attic Type: Unknown Condition: Unknown Lot Dim: Lot Size: .138 acres Lot Sqft: 601128 sq. feet Gross Tax Semi Ann.: HB920 Credit Semi.: RB Credit Semi Ann.: RBA Credit Semi.: Homestead Exemption: Spec. Assmt. Semi.: Tax Semi Ann.: Mortgage Date: Mortgage Amt.: Mortgage Type: Volume & Page: Lender: Mortgage Term: Mortgage Rate: Blktop Paving: Concrt Paving: Carport: Deck: Patio: Pole Barn: Pool: Fireplace: Gas: Electric: Units: $1,190.90 $1,190.90 Unk. Unk. No Unk. Unk. Unk. No 1 Unk. Unk. Dec-20-2002 $25,000 Equity Line Of Credit Washington Mutual Bank Fa Unk. / Adjustable The information is deemed reliable but is not guaranteed. 2001-2002 Tax Year Copyright 2003 Haines Printed Jun-03-03 SOUTH ORANGE CA 8 June 2003 Ed Petros, Chief of Inspection Ciiy of Costa Mesa P.O. box 1200 Costa Mesa, Ca. 92628-1200 Re: Permit No. B02-00060 Re-roof Project Address: 3257 lowa Street Dear Mr. Petros, In response to the letter from Mary Jane Weidenkeller dated 4 June 2003 I am writing you to request a time extension of the Permit. The work is done and the two issues of re-connecfing the fau vent pipe and re-taping the joint at the furnace were completed within two days of the inspection. However we failed to follow up and request another inspection at that time. The reason for the request for an extension at this time is my work schedule will not allow me time off to meet with your inspector before the 19ih June deadline mentipned in the lette� and my wife Jennifer is in Arizona assisting her mother in preparing to relocate to California. My wife will be returning about the 20ih of June at which time she could call and arrange for the final Inspection. If the extension is not possible we would of course pay the additional fees required and make an appointment with a building Inspector to complete the final Inspection. Thank you for your attention and assistance in this matter. Cordially, Christopher Lee Koch 3257 lowa Street 714 434 6594 CI1Y OF COSTA MESA BUILDING SAFETY DEPARTMEYT CERTIFICATION As the undersigned, I ata fully acrare of' the responsibilities as o»�ner bi:iider. I hereby certify that the personnel listed belrnr, who are presently performing vork at �3 � S��� W� are employed by me. I vill withhold Social Security deductions, Sta[e aad Federal income taxes. They are also covered by Workven's Compensation Insurance as prescribed by the State laws of Califomia. NAME 6 ADDRESS C�-� ,� fF��,-rl��✓� Date f?/(/sl� %% �G'l� ��� OCCUPATZON �f � Signed• �i (�f%'� Addzess: ,Z � % )ri�al C�� �l'/�s� uw� ntK_ JQB ADDF GENERqL AP No.13 INSPECTIi SOiL GAS W ATER ROUGH P�UP PROP. SWR. SPPINKLING CRAFTS, James 3257 Iowa Street BING LINE ROIIGN HFATING AND AIR CONOITIONING TEMPORARy SERVICE OR POLE UNOERGROUNO � POWER � ROUGH WIRING F�OOR FRAME AN� FLASHING LATHING - IN � I Ol1T PLASTER, 9ROWN COAT NEATI PLUMBING. FINAL AND GAS T FI F[TFIr FINCL UAIt 4-17—/5 BUILDING PERMIT N0. SUBCONTRACTOR s� - ' 39878 ��� ��-7sf`:�oo a��= ��u��o.50 ��:� • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. 60X 1200 COS7A MESA, CALIFORNIA 92626 ForApplicant to fillin Completely APPLICATION FOR BUILDING PERMIT RECE ED BY O TE RECEIVED D TE IS$UED BUILDING ` raw ! (� y- �/ ADOFES$ ���7 � -�' %I J � ' - n(/�pI E OWNER ��71�� "�'/\TFT�� A.P.NO "� 3'� MA7L BUILOING I� If� Z . ADDRESS 3r�. •T � L(1 �1ODRESS � cT W W /� TEL. TPACT LOT � BLOCK a U CITv ` O S� G NO. ZZ W AD A P Q CqNSTRUCTION O � LENDER am � J � BRANCH n J y OWNER n �`� m J ADORESS /�/J�� /� VALUE J m ARCHITECT $ E����CT/ T7JO l�(/v $ a OF ENGINEEfi N . U N FIRE wa 20NE TV E� GROUP Q ADDRE � d w APPROVED / W Z CO TRACTOR BV �ATE '� 'O mZ J � DDRESS � ^ � w w TEL. ZONE NO.OF USE Of NE� ' Z F ITY NO. P�� BUILDING � r- / v w O ST E CITY �'AR�S APPROVED VA OS APPROVED y¢ ll0. L MAIN BUILDING ACC SSORV BUILDING �O � (FFOMGLS EET) SIZE NO.OF BLDGS. Cr� OF LOT � O O NOW pN LOT � ROM' � / FT. USE OF �� EXISTING BLDG. �� � O U� S T. FT F SIZE OF �/ NO. OF r� Z NEW BLDG.I / X I FOOMS STOFIES L. SIDE FT. FT. L% COVEEFl�INGALL GOV�ERING LU /A/L( FEAR FTfp /� FT. J USE OF BUILDING AND WORK TO BE PERFORMED DI5TANCE BET. BET. MAIN & a MAIN BLDGS. ACCE55. BLDGS. a //'/ �c O � L Z� ID iv v.[.- C URP.qp APPROVED F APPROVED r � � � r TE UI helaby acknowl¢tlpe thet I heve reatl this appllcation antl state � that the above information is carrect end apree to comply with � all laws ragulating building conrtrucNon, antl I sha�� �ot employ 1.� � F any person in violation ot the warkman's compensation laws ot y the Siate ot Calitornie. T r m zI hereby cer[Ify thet I em pro0erly Iicansatl as a cantractor under SQ. FT. yO v %� o [ha Staxe of Cellfornie Business a�tl Professions Code, Oivislcn 3, THE AMOUNT SHOWN UN�ER VALUATIQN IS FOR ' Chaptar 9, and that such licenses are In tull torca and etfect, or I THE PURPOSE OF ESTAgUSHING A PERMIT FEE ON Y: � . am ezempt from the provisions of the Sta2e of California Business . ¢ antl Professi 5- tla, Division 3, Chapte 9. VALUATION /�� �� m � QO PERMIT FEE 5 � j SIB�ature o I I / L'� � / .�' m Permittee GGt/ $ J OO PLqN CHECK $ E �� o Authorizetl gent - LL TOTAL FEE $ OWNER INTRIERI� D. �. DATE LO-22-70 JOB ADDRESS 3257 Iowa Street BUILDING PERMIT N0. 32369 AP No. 1 99-043- GAS W ATER PROP. SWR. LINE U MOUSt CON. U SPRINKLING SYSiEM MISCELLANEOUS ROUGH HEATING AND AIR CONOITIONING UNDERGROUN� � POwE ROUGH WIRING TRENCHES � FORMS � FLOOR SVSTEM BOND BEAM ❑ STEELi SHEATHING FRAME AN� FLASHING i PLASTER, BROWN COA MEATIp PLUMB STEEL REINF. NFOftCE . SUBCONTRACTOR �. - � � �2369 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.eOX 1200 COSTA MESA.CALIFORNIA 92626 Z . ww a U rZ zF ON am J � J N 0] J m J Q U � Z a W � d W J Q m Z J � W w � _ Z F- W � N � �O OCT 7_2-70�F;su00 967 �****�5.00 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely a RECEI EO BV DATE RECEIVED DATE ISSUED BVIIDING�J�S .L Q i.�_.l G� O.� �" /d `�'7O ADDRESS '7 '? PERMIT NO. OWNER D.J..LiJ'%� �� A'P�N�' � ADDiiESS � C�j /.�Ot�LIS S� BUILDING _ L1 ADDFESS (�< CITV G',�j '� S ,(� �, NOL r S TRACT LOT / BLOCK' CANSfRUCTION ^ � )� �'�' �+DD A P LEN�ER /i�d�✓�% BRANCH ' OWNER ADDRESS �/ /��� VALUE` �q� ARCHITECT TEL. U lY/IL 5 Vv `�' OR ENGINEER N . FIRE T ADDRESS ZONE TVPE GROUP .,.L ,� APPROVED CONTRACTOF �(,��'IC/C�- ✓�.0 G B�' DATE ADDRESS TEL. �ON NO.Of USE OF NEW CITV NO. � P�� D BUILDING STATE CITV �ARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSOPV BUILDING SI2E NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. $ E FT. FT SIZE OF NO. OF NEW BLDG. FOOMS STOFIES L.SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. PT. VS O�BVILD�NG P�ID WORK TO BE PERFORMED DI5TANCE BE . BET. MAIN & � c .� dC MAIN BL qCCESS. BLDGS. —� rj � VAR.qW OATE 1.�V%C /(7 .� .C%C/P /Oil�S c.u.P.vw APPROVED APPROVED � � L��. ' I hereby acknowletlge tl+at I have teatl this aDPlication antl state that the above information is mrrect antl agree ro comply wiffi all laws regulating builtli�9 �onstruction, antl I shall nat employ any person in violation of the warkman's compensation laws of the State of California. I hereby certify [hat I arn P�operly licansetl as a contractor untler SQ. FT. [he Stare of Culifornia eusinezs antl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapte. 9, antl that such licenses are in full force antl affoct, or I THE PURPp6E OF ESTABLISHING A PERMIT FEE ONLV: em ¢x¢mpt from the pro��sions ofthe Sta[e ot CelitOrnie Businass VA�UATION end Professions Co�o, Div�sion 3, Chap[er 9. �_ Q O '� PERMIT FEE $ SiO�a[ure of��/ � ,�%;��u�� __� Permittee �' ��� ���� a� PLAN CHECK $ , �DO. Authorizetl Age �� / TOTAL FEE 8� � O r� ' ���i�u COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 317 C08TA MEBA. CALIFORNIA 0 For Applicani fo Fill In Compleiely TYPE OR PRINT AODRESS 2 Ip77¢ S�'i• COSTA MESA. CALIFORNIA � MAIL E. 17th St. TEL. TEL. SIZE NO. OP OF LOT �iii � Y � nii t Now oi 66TBACK LINE FROM CENTER OP BTIiEET C � REAR YARD 61�E VARD I LEFf 'S � I RIGHT S� DESCRIPTIOM OF WORK BUILDING NO. OF SIZE SQ �fi5. ROOMS EXTERIOR WALL ' ROOF COVERING IGOVERII USE OF BUILDING AND WORK TO BE APPROVED ZONE R- LE6AL ' ~ � �^^ ^� �r^i � -._',�'i.',.+5-1 �, . No ^� t�, n _ -OC - _;=JrL' APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. PERMIS�NO.� COSTA MESA. CALIFORNIA ZONING NO. OF I U8H OF NEW PLANS /Lj 6UILDIN6 `, Lot 15, Tr. 364 none YAORDS EVES APPROVED ICBNTBR LINE BT.) i .• 1 XEREBY AGKNOWLEDGE THIIY � HAVE RCAD TXIB APPLIGTION THE AMOUNT BHOWN UNDER VALUAiION IB POR THE AND eTATe THAT TH8 ABOVE �S COPRECT AND AGREE TO COM- p�pp09E OF, EBTABLI9HING A PERMIT FE¢ ONLY. PLY WITH ALL CITY ORDINANCE9 AND BTATH LAWe RHGULATING 9u1LDIN0 CONBT`PUC�iION.%/ VALUATION SIGNATURE OF �v PERMIT FEE $ �S• PERMI7TE $ ZS�OµS� PLAN CHECK $ AUTFIORIZED AGENT �11Ce & legrove� II1C• TOTAL FEE