Loading...
HomeMy WebLinkAbout1852 ILLINOIS ST - Building Permits CITY OF COSTA MESA l mt. Q BUILDING DIVISION .41* , 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us / FOR INSPECTIONS CALL: (714)754-5626 It- "pa^ i PERMIT NUMBER: B11-00289 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13904126 DATE ISSUED: 09/08/2011 ISSUED BY: MDM JOB ADDRESS ` 11852ILLINOIS S}.CM Ae Suite/Unit: Vicinity: Squares: 2800 Valuation: $11,500.00 SCOPE OF WORK: 2,800 SQ FT RE-ROOF,REMOVE EXISTING ROOF,REPAIR DAMAGED PLYWOOD, INSTALL NEW SHINGLES OVER EXISTING PLYWOOD,CLASS A FIBERGLASS NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: DEPT OF VETS AFFAIRS OF STATE OF CAL Address: %MARCUS,STEVEN ANDIDEBBIE Unit: COSTA MESA,CA PHONE: City/State/Zip: 1852 ILLINOIS ST ;s 1-00289 APPLICANT: JEFF EDER Address: Unit: : PHONE: 949.307.5067 City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA,CA 92707 CELL: • ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 :I r,;r Reroof Permit Fee: $209.25 -t'r' Card Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $210.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 ;,l;I Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1.12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE 9. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE DATE IN➢11ALs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof )( g—iH—// c L 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention , 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 1 Ii'I / WORKERS'COMPENSATION DECLARATION: . ,Owner ID verified by drive...license. El Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: r Drivers License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are; person is required to descend,will be made in connection with work authorized �( by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: 1o.t•? U) 51.. .0 LS-o Ct- l..L.--y st--M or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This seabn need not be completed d the permitk valued at one hundred dofa ( 00)or less.) 2,Art2 Sec.341,Title B,California Administrative Code). Policy Number: �i3 (�(-)(� ��. n(� ❑ As owner-builder, I will not employ anyone to do work which would 0 I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: gppliWm's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas �- I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.ft 527&orf. Class# C±— '39 (Section 25533 of the California Health and Safety Code, with some \\ exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and . filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. • Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars(5500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes',attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of 'sLr� Signature Date property who builds or improves thereon,and who contracts for such project with "CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to upy or allow occupancy of any building authorizerybptF�,permit u . n. L A q — 8 - 20(1 Signature of Lega ens Date Signature Date 3057.46 13/07) --- And/or Authorized Applicant Date . t Prescriptive Certificate of Compliance: Residential CF-1R-ALT Residential Alterations (Yage 7 oi'S) . Project Name: I Climate Zone e III al'Stories 67 General Information lt$ iressae 1 sca --c-, _ . Enforcement Agency: I Date: Building Type 0-Single Family 0 Multi Family Circle the Front Orientation:N,L,S,Vi,or degrees Conditioned Floor Area(CFA): Project Type: 0 Alterations 0 Envelope O Fenestration 0 Roof 0 HVAC keplacemeni or Change Out ❑ Duel Replacement 0 Water Heater NOTE: This form is not to lie user'for Newt).Constructed Buildings or Additions . • Insulation Values For Opaque Surfaces(for Furring vse the Mass and Furring Strips Construction sable below) Assembly Alteration ❑Opening of framed cavity alone-Alterations that involve the opening of the framed caviy of a wall,ceiling, or,floor mull install the mandatory minimum insulation value per§150 for the altered assembly. Fill in Columns A—C and enter mandatory insulation value in Column H. 0 Replacemenl of entire assembly-Jleplacement of an entire wall, ceiling,as floor assembly requires the installation of Companenl Package-Li insulation values in Table 151-C. Fill in Columns A-J. . Opaque Surface Details Far the furred portioned of Mass Walls see Furring Strips Construction Table below. A • B C B ' HE ' F G H... .I. �. 9 Proposed 5"na" Values From JA4 Table ' Framing Thickness, Framed Continuous JA4 Proposed Tags Assembly Name . Material Spacing, 1A4 Table Cavity Insulation Assembly Assembly ID' or Type' and Sizer _ or OtheNumbers _ R-values R-Value Cell Values U-factory - Note:For.furred assemblies,accounting for Continuous Insulation It-value,see Page JA4-3 and Equation 4-i. Ear calculating furred walls use the Mass and 'Faring Construction table below. I.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Spade,Doors and etc-Indicate the Frame type and Size: For • Wood, Metal, Metal Buildings, Mass,enter 2x4,2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness.for muss in inches or Spacing between framing members enter; 16"0'24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4. Based on the Climate Zone;enter the Standard U-factor from Table 151-B, C orD for each different assembly blame or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0". 8.Enter the raw and column of the U-factor value based on Column F Table Number and enter the Assembly U-factor in Column.l 9. The Proposed Assembly U-facto', Column.1,musi be equal to or less than the Standard IJ-factor in Column E to comply. • Furring Strips Construction Table.for Mass Walls Only A 11 • C 'll 1 E F _ G B 1 j d IC L M Proposed Properties of Masonry and Concrete Added Interior or Exterior'Insulation • Walls From Itefercnee in Furring Space.from Reference Joint Append'n:Table 4.3.5,4.3.4,4.3.7 Jainl A ipendb:Table 4.3.13 :, o .c tf ' L— IP 44' �• u p e.< : a. O V - U... m 0., Assembly u` .rt �' c o„ y ._ ., Final Mass Name or .1A49able -, o F „ a, f- R °o t e " Assembly Thickness' 'I pe' Number' < .R g 5 w c w di i= v'. c '` u Cr": Il-factor"..) Comment 1111=111 . Illn=1111 I •l .I r/....:..,..,.a.... m,„”i,..r- It egist'atlan Date/Tune: HERS Provider: Prescriptive Certificate of Cntnplir Realdentinl4i CF-IR-ALT - Residential Alterations (Pu;e 3 of 5) , r n Yrnlact Nnmc: 1 Climate'Lsmn 11 a nrStories ROOFING PRODUCTS(COOL ROOFS)g/5/03/2 When the area of exterior roof surface to be replaced exceeds-"tare than.50%of the existing roof area, or snore than 1,0110 fur, whie/mvar•to SS. the atm'rnoftng area must omen the roofing product"Cool Roof'requirenents of§IS2(b)IHi, 152(6)IHIi, or 152(b)1H111, Check applicable alternative nr exception below((the roof alteration is exempt front the roofing product "Cool Roof"requirements. Note:if any one of the alternatives,nr exception below is checked, the Aged Solar Reflectance and Ther-real Emluanes requirements for roofing products in §118(1) are not applicable. Do nnt/Ill table below. El Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with n Low Sloped. Less or 2:12 pitch. Cool Roofs Not Required in Climate Zones I through 0 and lb with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less thou 5lb/f12. Alternatives to §1S2(h)t}II and §152(b)HII,Steep-slope roof(pitch > 2:12) Cl insulation with a thermal resistance of at least 0,85 hr•02'"F/tam or at least a 3/4 inch air-space is added 1n the roof deck over no attic;or ❑ Existing ducts in the attic arc insulated and sealed according to §151(f)10;or ❑ In climate zones 10, 12 and 13,with I tt.of free ventilation area of attic ventilation for every 150 R2 of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least It-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or ❑ Building has no ducts in the attic;or • ❑ In climate zones 10, I I, t3 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §152(h)IHlii,Low-slope roof(pitch<2:i2) CI Building has no ducts in the attic. Other Exceptions . ❑ Roofing area covered by building integrated;photovoltaic panels and solar thermal panels arc exempt from the below Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ih/ft is exempt from the below Cool Roof criteria. Note: If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Rooting Products"Cool Roof' Requirement: Roof Slope Product Weight Product Aged Solar Thermal •CRRC Product ID NumherI < 2:12 >2:12 < Slb/ftr > 51b/ft'` Tyne` I Reflectance''' Eminence SRI5 - 1 ❑ 1 ❑ IDIG 04 I 0 ❑ I ❑ 1 ❑ ❑^ ❑ 0 ❑ 0 04 . 0 ❑ 1 ❑ ❑ ❑^ ❑ ❑ I ❑ ❑ ❑^ I. The CRRC Product ID Number can be obtained from the Coal Roof Rating Council's Rated Product Directory at www,caolrmofs,ars/nroducta'/seorch,phn 2. Indicate the type of product is being used for the roof top,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is not available in.the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the tante directory and use the equation(0.2+0.70rr,raur 0.2)to obtain a calculated aged value. Where p ix the Initial Solar Reflectance. it. Check box iftlm Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SIU- Worksheet at lion://wtmr.enervnca,pnv/IItle24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the Cp-IR, To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §1180)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating 0 Other • Registration Number: Registration Date/Time: TIERS Provider: 2008 Residential Compliance Forms • August 2009 • • Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Pa[.e 5 of 51 . , )'rgjecl Nome: Climate Zone iJ v: of Stories: HERS VERIFICATION SUMMARY The enforcement agency should per special anemia? in the PIERS Measures specified to this checklist belon. A completed and signed CT-Alt Farm Jar all the measurer specified shall be submined in the building inspector before lined inspect ion. Duct Sealing & Testing PIERS Verification is require:for this measure. ❑YES ❑NO YES:Ii Climate Zones 2 and 9-16,if more then 40 linear feet of new or replacement ducts arc installed in unconditioned space,the ducts ore to be sealed per§152(1))IDii and the newly installed ducts are to be insulated psi §15 (ft)O. ❑ EXCEPTION:Existing duct systems that Ore'extended, which are constructed,insulated or sealed with asbestos. ❑'YES 0 NO YES:In Climate Zones 2 and 9-16, if-the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per(I 52(b))Di. 1�'YES D NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handle], outdoor condensing unit of a splil system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per§152(b)IE. ❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION:Duct systems with less than 4W linear feet in unconditioned space. ❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos. Refrigerant Charge- Split System HERS verification is required for this measure. I]YES 0 NO YES:In Climate Zones 2 and F-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil, or the furnace heat exchanger)a refrigerant charee.measuremem shall be verified per F)52fb11F. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of CI 50(o)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflo* HERS verification is required.far this measure. - C ITS 0 NO TES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment anti ducting)is replaced,the airflow and fan watt draw shall be verified ver§152(b)1 Ci to meet the renuirements of ti 151(117B. • 2;i Documentation Author's Declaration Statement • •• I certify that this Certificate of Compliance documentation is.accarate and complete. Name, ` Signatu • t G( \ n Compel)t: Date: il( atc t -4,c_eai_ Le-1 G - S - )o It Address: If Applicable❑.CEA or fJ CEPE 21,0 (Certification II): City/State/Ztr: Phone: ...i�c e�*L �LL. 2:7.1:37 7t 7 " 5-3—)- 7'1510 Responsible Building Designer's Deelarntiun Statement • 1 am eligible under Division 3 of the Cal if onlia Bu sin css and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • ) certify that the energy features and performanee specifiendom:for the building design identified o]this Certificate of Compliance conform to the tuquiremems of Title 24,ParIs I and b of the California Cody of'Regn)atioas. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance farms,worh,sheets,calculations,plan::and epeeilieallnice submined to the enforcement fluency for approval with this building permit application. )fume: Signature: Company: Date: Address: License: • Cnv/StatclZlp. I Phone: For assistance or questions regarding the Energy Standards, contact the Energy Donnie at: 1-/110-772-3300. CITY OF COSTA MESA o, � BUILDING DIVISION > .„„ ) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMITIPPICa ,, P mo B02-01303 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1852 ILLINOIS ST Status: ISSUED Suite: Applied: 08/16/2002 Vicinity: REAR WALL Issued: 08/19/2002 Parcel Number: 13904126 Zoning: Applicant: WATTS, ROXANNE ISSUED BY: Address: 1849 OHIO PL Phone: 714-545-5086 COSTA MESA,CA Zip: 92626 Owner: DEPT OF VETS AFFAIRS OF CAL Address MARCUS,STEVEN AND DEBBIE COSTA MESA,CA Phone: 1852 ILLINOIS ST Zip: 92626-2209 0110 Contractor: OWNER-BUILDER �Q Address: Phone: A-•c I Zip: License: 0l�' Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 6'HIGH BLOCK WALL 65'IN LENGTH PER CITY STANDARDS ALONG REAR PROPERTY LINE. FEE SUMMARY Plan Check: $31.14 Calc Valuation: $1,300.00 Permit: $47.90 Claim Valuation: $0.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $79.54 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6ro0) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed ll the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37050F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lic.A Class k Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil-penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properry-or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his ocher own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is /.sold within one year of completion,the ownei:builder will have the burden of proving that he or she did not build or improve for purpose of sale.). 9 I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am a under sec. Business and Professions Code for this reason: Signature: a/ -► Da/te,: r7 Zi Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. /Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas et standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safely Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 It an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 1111 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ...._—..._ any part..._ —..._.._ F _ _. _ 6 Will of the facilityto be constructed under this emit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree1not to occupycor allow occupancy of any building authorized by this permit until final inspection. ���1 r _�� Signature Of,Legal JOwf�t --Daj / 1`!�/• An Or A➢ttRlrized(Ap�plicant �Dfate CODE! INSPECTION TYPE PATE MEW CODE! INSPECTION TYPE gA1E MALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final BIock/Retalning Wall 212 Final Fire Prevention 202. Final Factory Fire Place • - 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy n � •� Q� ' �Pla,` e.xa� 66"10‘,") -I- C L. — --- - - - -- — it/ laIbe,- w6-) 4551 • (`DAaLYA,cp jto 2 - 60QS - /os ' rs' iO? ('moiITY OF COSTA MESA PLAC; ;! :G DIV. IV:SION OF BUILDING SAFET YCT/TO_BLDG. DEPT. REG. CITY OF COSTA MESA 1/�7� DATE B/7 oz APPROVED tlY _.— fie Ibis ant of pians.•1 spa,Ndeaa4N MUST be kap!on this Etat all faces and A is unLixfitl to inzikYa'rv:::aani Atiwal4noclogi:f;cototantemdssuntra!INphisCnofadda a� Safat;.t:ur:, a Mas_. 7 T";s:ar„naal paNVt.ixw.M!ia.r�SHALLNataahatInttiSW°baanextant m :^f lny City'tit.Cas!a Masa Ordinance eau&ala fan. !!W `.hav;ta:.171.win z.,atl2xri: ;;i ,:,r;;"arrhxc n; wdm�i.! it t: ..-.., ....,...,..,.. ._-...r..._ .... .....,. v �.c:l'I YLIt} a�� cf iztr... IJliAb St-. i I TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping BlockWithpnonal 0 t I. -- -II 1=i GENERAL- NOTES Channel 1.3/8 Horizontal Top of all H IM � �- Fences MORTAR: One Part Plastic Cement, and Three P MI GROUT: One PartrCemenrts t,Three and For Fences 5'or Less illStand yen.Bars 3/8"¢at 4' A" O.C. !d o ii One Half Parts COPING: One Part Cement, Three a x For Fences Higher Than 5' ± 6 ,I MI IN Parts Sand Ven. Bars 3/8"0 at 32" O.C. cc W a - -— - CONCRETE: Well Mixed 1:2-1/2: 3-1/2 Max of 7- 1/2 Gallons of Fill Cells Solid With Grout III > 2 Ill 1II Water Per Sack of Cement Where Steel Occurs > - Rclnlnrcing Steel Shall Imp, CI 3 `A GROUT MAY BE POURED FROM THE TOP 1.'I I �_ OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15-39 ' w o OCCURS. A.S.T.M, II Z ~ I '-, MIS CELLS AND AREAS OF HORIZONTAL REIN I w n FORCEMENT SHALL BE CLEAR,CLEAN& All or .to be Lapped , I In FREE OF ALL MORTAR DEBRIS,ETC. All or to CodeIn IMI NATURAL GRADE III " 1 SII II /!//,.`./ham ' IV O e 4 • TWO 7/0"0 BARS 'IMEM • - 0 CONTINUOUS TOP I &BOTTOMIII 1�WIDTH ihl TO 16' 0 C MAX e SEE CHART s HO X.ST EEL MUST BE TIED IN BELOW DC PUI CV CARTHTCOTH PLACE AT TIME OF TRENCHI I , 1/3 THE HEIGTH Or FENCE INSPECTION. L -BLOW BOTTOM OF FOOTING o" z' �� SCALE: 1/2" = II FOOTING REQUIREMENTS CHART WALL HEIGHT 6 ' 5 4' 3' WIDTH 14" . 14" . . . . . 12". . 12" THICKNESS10" 10" 8 " 8 " DEPTH OF EARTHTOOTH 24" 20" . . 16" 12" SPACING OF EARTHTOOTH 12' 14' . 16' 16' � l BUILDING DIVISION llI—, 'S I \,. l r . .kr--e—•—Th , . 'THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN 2'4'&6'IN HEIGHT SHALL ONLY. APPLICANT IS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10' FROM FRONT PROPERTY LINE. AN ACCURATE REPRESENTATION OF THEIR PROPERTY IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WALLS/FENCES SHALL NOT EXCEED 2'6'IN HEIGHT WITH THE INFORMATION PROVIDED ON THIS SHEET. WITHIN 10'OF THE FRONT PROPERTY INE(NOT CURB LINE). •VERIFY DISTANCE FROM CURB TO PROPERTY LINE AND SHOW ON PLAN. VERIFICATION FROM THE CITYS ENGINEERING DIVISION IS REQUIRED. CALL(714)7545343 FOR INFORMATION. Vali ricH i I Y RE90EMCE �� m I :Id I 4 IppiqI I I I 014OF'GoSDSP\ DP It Slv0y \picAlvR torkic _ D6e 1,40Y , i �a3<4 pc v.-”e c.to/" . Wry ��t ..�;7}lm / b ., tTN. „c�r'Pa`1rtnt^"'4-o eoto? , a. fct yQ 3,.S.-T;,,-1.,;^,..Sil^:2 ,. sz 'J..�-`..11`. :rr.n N°' 1,�t1.0'd .;V:2-ns AE90EMCt lam&vti •1`3 info .10CL: .1'.. :i'.•.'.,:,il:Vi I I+EgOE :o:; .„�ljSPk Tie 3• f( , 9ob1¢ I It ..r 5\ ;..n\'?T' ... WI ..' :\'1' t I n tri� `'_ r c W ` `•. r �a pm •A r Mol i• r \ -_____ - - STREET BLOCK WALL LAYOUT FO BUILDING PERMIT PLANNING DIVISION II t J RJ..,I Ili DECLARATION OF AUTHORITY Bldg. Permit# FOR AGENTS OF PROPERTY OWNER This Permit# TO APPLY FOR PERMITS Street Address: «61 /LL(NF/S cr, COSM M67,4 cA AP Number: MAW- 1. I (we), frenCIt/ MRRCdt , declare that I am the Owner of Title of the above referenced real property, and that I (we)herebyrauthorize: y /' / `Name: Wt Y dr),i 1/1 ) Telephone Number.0/�`i>5(/� � (/ �l�/ Street Address: /i7 Q Oh to / v /City: /72�f - State: (774 Zip: "J./ 2F// to obtain permits in my behalf,as owner/builder,for 15LOC/! 6r/4 LL at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa,as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or ' personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that' theh" foregoing�ris true and correct. Executed this /i7L1t day of v 20 O 2 ,at COSTA Hera ,California. • Print Name: fY/�/,�6�A/ Signature: '�i' �/y"" Date: 3//0 Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attomey to secure this permit in any behalf. 0779-46 6ev.11/00) • N. , Ll , n , x Y e 4 G €&aa9 V� OWNER-BUILDER 9 VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I. I personally plan to providethe major labor and materials for construction of the proposed property improvement. a Yes ❑ No 2. velliavgnotj signed an application for a building permit for t e proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 104206 (REV.9/98) i r I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my personal knowledge, in compliance with this State law. Signed: S+-i..... Date: -//irk Name: STIfll' /'4-4446- (Printed or Typed) C.D.L. For more information call City of Costa Mesa Building Division at(714)754-5273. 104246 (REV.ASB) don%9. Cal l OF COSTA MESA �., s P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 ry Ory, ,�cni F1 rr�i I/;Z J !a DEVELOPMENT SERVICES DEPARTMENT <Q<yy\\OWIEO BUILDING DIVISION NOTICE OF PERMIT EXPIRATION June 4, 2003 Steven Marcus 1852 Illinois St. Costa Mesa, CA 92926 PERMIT NUMBER (S): B02-01303 FOR: Block Wall PROJECT ADDRESS: 1852 Illinois 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 resolve this matter. Sincerely, • Ma Jane Weidenkeller Office Specialist II Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • viww.ci.costa-mesa.ca.us Property Profile , Page 1 of 1 DataQuick•* land and property data you can build r Property Profile ©2003 DataQuick Information Systems.This information is compiled from public documents and is not guaranteed. Primary Owner: MARCUS,STEVEN Secondary Owner: Mail Address: 1852 ILLINOIS ST COSTA MESA, CA 92626 Site Address: 1852 ILLINOIS ST COSTA MESA, CA 92626 a q, Telephone Number: (714) 549 8238 Csat • n Y ;I , APN: 139-041-26 ats. Reference APN: c k_ CAIIFQrx^A a Census Tract: 638.052 V Housing Tract Number: 3648 Geo Level..0 Lot Number: 58 Page Grid Old: 27-B3 Page Grid New: 858-G4 Legal Description: N TR 3648 LOT 58 Subdivision: Property Characteristics Bedrooms: 4 Year Built: 1960 Square Feet: 1,556 Bathrooms: 2.0 Garage: Lot Size: 6,825 sq ft/0.16 acres Total Rooms: 7 Fireplace: Number of Units: 1 Zoning: Pool/View: Use Code: Single Family Residence Heating/Cooling: Sale& Loan Information Transfer Date: 10-16-1980 Seller: Document: 0.13.7.91.09.8.9 Transfer Value: Cost/Sq Feet: $0.00 Title Co.: First Loan Amt: Lender: Last Trans W/O$: Loan Type: Interest Rate Type: Last Trans W/O$ Doc: Assessed& Tax Information Assessed Value: $184,204 Percent Improvement: 37.73 Homeowner Exemption: Y Land Value: $114,704 Tax Amount: $2,119 Tax Rate Area: 15045 Improvement Value: $69,500 Tax Status:current [Report Menu] [Select New Target Property] http://www.gotitle.com/cgi-bin/profi le.asp?rmt=TOPS&graphic=%2 Faccounts%2 FT07378%2 Fcompan... 06/03/2003 CITY OF Cr -TA MESA PROPERTY DETAILS r ''ORT • 1852 Illinois Costa Mesa, CA 92626-2209 Owner: Dept Of Vets Affairs Of State Of Cal Marcus Steven Phone: (714)549-8238 Resident: Marcus, Debbie Phone: (714)549-8238 Site Address: 1852 Illinois Tax Address: 1852 Illinois St City/Zip: Costa Mesa/92626-2209 City/Zip: Costa Mesa/92626-2209 Parcel Id: 139-041-26 Own.Occ.: Yes Location: Costa Mesa City School District: Newport-Mesa Unified Neighborhood: Unknown Census Tract: 063805 Wealth Code: 8.0 Year Listed: <1993 Legal Desc.: N Tr 3648 Lot 58 Zoning: Unknown Subdivision: Unknown Usage: 122: Single Family Residential Style: Unknown Construction: Unknown Year Built: 1960 Ttl. Rooms: 7 Blktop Paving: Unk. Stories: 1 Bsmt.Type: Unknown Concrt Paving: Unk. Bdrms: 4 Bsmt. Fin.: Unknown Carport: No Baths: 2 Full Gar.Type: Attached Garage Deck: Unk. Heating: Unknown Gar. -Cars: Patio: Unk. Cooling: Unknown Gar. Sqft: Pole Barn: Unk. Irr. Lot: Unknown Roof Mater.: Unknown Pool: No Terrain: Unknown Roof Style: Unknown Fireplace: 1 Water: Unknown Attic Type: Unknown Gas: Unk. Sewer: Unknown Condition: Unknown Electric: Unk. Sqft 1st: Lot Dim: Units: Sqft 2nd: Lot Size: .157 acres Sqft Bsmt: Lot Sqft: 6838.92 sq.feet Sqft Total: 1556 Market Value: $180,593 Gross Tax Semi Ann.: $1,033.67 Assessed Land: $112,451 HB920 Credit Semi.: Assessed Bldg: $68,142 RB Credit Semi Ann.: Assessed Total: $180,593 RBA Credit Semi.: Percent Improved: 38% Homestead Exemption: Delinquent Taxes: Spec. Assmt. Semi.: Tax Semi Ann.: $1,033.67 Sale Date: Oct-09-1980 Mortgage Date: Sale Amt.: Mortgage Amt.: Deed Type: Unknown Mortgage Type: Volume& Page: 13791/989 Volume& Page: Seller: Lender: Title Company: Unknown Mortgage Term: Multi-Parcel: No Mortgage Rate: The information is deemed reliable but is not guaranteed. 2001-2002 Tax Year Copyright 2003 Haines Printed Jun-03-03 SOUTH ORANGE CA FEE RECEIVED 1204:6 () d\ MM 1 61966 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 1852 Illinois St• COSTA MESA. CALIFORNIA For Office Use Only RECEIPT NO. PERMIT NO. OWNER Vermont Avenue Land Co - I• -$ ?� `i 5 MAIL RECEI D BY DATE RECEIVED DATE ISSZED ADDRESS 419 E. 17th St. ,r"/O-66 MAY 1 7196 BUILDING CITY Costa Mesa NO.Li81159 ADDRESS ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA OR ENGINEER . NO. ADDRESS Garden Grove FIRE /� ZONE TYPE 7" GROUP D /J�J// APPROVED CONTRACTOR Di - . • - • - . BY DATE ADDRESS /.19 E. 17th St. ZONING �( ZONE NO.OF USE OF NE.Sin tie fam CITY Costa Mesa R-1 PLANS 2 I BUILDING W/ att gar. STAE LCT NO. 16724 NO. Li . 8-1159 DESCRIPTION (lot 58, Tr. 364.8 SIZE I NO. OF BLOCS. OF LOT 651 X 1051 NOW ON LOT none A.P.NO none USE OF YARDS EVES EXISTING BLDG 1 .s- APPROVED ALLOWED SETBACK LING FROM C (CENTER LINE ST.) =sass or STREET 501 REAR YARD 351 FRONT FT. IN. SIDE YARD I LEFT 81 1 RIGHT 71 R.SIDE / FT. IN. DESCRIPTION OF WORK • ovL L.SIDE FT. IN. NEW I XII ALTERATION I II ADDITION / REAR .1 I) FT. IN. REPAIR I II MOVING I II DEMOLISH I APBYPROVED W. T. D DATE 5-13-60 BUILDING NO. OF /'�� SIZE .Gsc ft NOOF 7 STORIES 1 /jam/ EXTERIOR WALL ROOF COVERING sturco COVERING Cr,mm�n.. RC Pc Mc USE OF BUILDING AND WORK TO BE PERFORMED Single family residence with attached garace. Plan 20A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLJCATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNTSHOWN UNDERVALUATIONIS FOR THE PURPOSEE OF ESTABLISHINNG A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE OF ..-..,C, PERMIT FEE $ 36. PERMITTEF o $ 16101. PLAN CHECK $ 18• AUTHORIZED AGENT Dike & Col ova, Inc. $4• n TOTAL FEE - E