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Home My WebLink About1953 FLAMINGO DR - Building Permits • 4`, ' F 9 CITY OF COSTA MESA BUILDING DIVISION > '„,7 iirsat., DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER I s I PERMIT no; P02-00763 fi (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1953 FLAMINGO DR Status: ISSUED Suite No Applied: 12/30/2002 Issued: 12/30/2002 Vicinity: ON-SITE Parcel Nunmber: 13947202 ISSUED BY: Applicant: MYERS, ROBERT Address: 2944 RANDOLPH AVE Phone: (714)647-3200 , COSTA MESA,CA - Zip: 92626 " Owner: BANKER, EDWARD E Address 1953 FLAMINGO DR Phone: . COSTA MESA,CA Zip:." 92626 Contractor: AB&R PLUMBING Address: 2944 RANDOLPH AVE . • Phone: (714)647-3200 " COSTA MESA,CA Zip: 92626 License: 669867 • Arch / Eng: - - - - _ Address: _,. . _ Phone: ZIP:. . • - License: - - SCOPE OF PERMIT REPLACE ON-SITE SEWER LATERAL.NO WORK ALLOWED IN THE PUBLIC RIGHT-OF-WAY. _ FEE-SUMMARY ` AMT QTY 'AMT QTY AMT QTY ISSUE FEE $23.50 _ Laundry Tub/Washer $0.00 ..0. " Sump Pump ' $0.00 0 Backflow irrigation $0.00 0 Landscape Imgation $0.00 0 " Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub - $0.00 0 . " Pressure Regulator $0.00 0 Urinal-' $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 ' Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) " $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units .$0.00 0 Septic Tank $0.00 0 Wash.Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 - ' Wash Basin Set $0.00 0 Drain,Floor $0.00 0 - Sewer Connect $0.00 0 Waste andVent System $0.00 0 Drain,Rainwater $0.00 -0 Sewer Private Line $24.65 1 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 -0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar . - $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 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(6/00) 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 it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for whin permit is issued,I shall not employ any person in any manner so es to become subject to the workers' compensation laws of Calif.-mia,and agree •. I should become subject to the workers'compensation provisions of Sect n 3700 of the Labor Code,I shall forthwith comply with the-d•rovisi•. J-� Applicant Signature: i, .///AL Date: ( 0 WARNING:FAILURE T•. • ORKER- COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S oo,OCo),IN ADDRI, TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions• hapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class• Contractors Signature: Ib 4 Date: I 1-1'40 HUG r' 0(0tzlyz 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). Lenders Name: Lender's 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 property,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 or her 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 owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ 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 exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 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 Califomia 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 al 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 at 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 ❑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 California Health and Safety Code provides that the 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 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 California 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 a•r': -: to occupy or allow occupancy of any building authorized by this permit until final inspection. Signatur' •f Legal Owner(s) Date Gll. _ X2/3 I • ' Y •r.Or Authorized Applicant Date CODE t INSPECTIONTYPE DATE INIliIAU CODES INSPECTIONTYPE PATE INSIIIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 1-1 '03 EW 200 Final Re-Root _ 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 ADDRESS OFBUILMNG: 1953 FLAMINGO DR u"T` CITY OF COSTA MESA - BUILDING PERMIT afNExsNAMEIF"awx:BANKER EDWARD E FLOOD : AE-46 PERM NO: B 086132 ADGRESS: 1953 FLAMINGO DR COSTA MESA,CA 92626 PERMIT NO: B 086132 PLAN CHECK NO: N GOVT: N SUPP : N 434-7926 APR..N"NumADOREss CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH Its ARCHITECT ORENODIEER: UC.NO.: JOB DESCRIPTION : T/O & RESHEATH & REROOF W/COMP SHINGLES SQ FT: 6, 641 ARCK OR ENG:S ADDRESS: WIT: CLAIM VALUE: 6, 641 . 00 CALC-VALUE: 6, 641 . 00 GROUP OCC: R-3 /U-1 cCNTRACTORS"AME:ULTRA LITE ROOFING (714 ) 899-9935 ca+TRAcT0R'SM UNG 5082 BOLSA ST COMMENTS : SMOKE DETECTORS REQUIRED PER 94UBC, REROOF 2400SF RESIDEENCE AODRESS:H.B . CA UCNO_ 616679 at*at************3t******SEi(* (-**3t*********x-*************+r*N**+t7*meNg "* R 92649 LINT' 105 Z ONING R E Q U I R E M E N T S 4f f`4,E LICENSED CONTRACTORS DECLARATION:I hereby aFem under penalty of perjury that I am licensed under provisions of Chapter S SETBACK S - II,q (commenting with Section 7000)of Division 3 d the Business and Professions Code,and my license is in full force end effect '; '� W;ED cmUC.No.:051t�o2 UO.OUSS:C_39 uc.No.: i6'. EXP: 03/98 MAIN BUILDING ACCESSORY BUILDING 9 R ----- Dere: 12110 /al 1 Contractor: ice f i / ---•—•. FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FTIN OWNER BUILDER DECLARATION:I hereby affirm under peaty of perjury that I ser exempt from thStractons license Law for the following reason(Section 7031.5 Business end Professions Code:Any city or county which requires a permit to construct.alter,improve, demolish,rrepai any structure.prior to ire s issuance,also the applicant for permit to filea signed statement that he rahe PARKING REQ; - PROV: PARCEL: 13947202 ZNE; REF NO: i, licensed pursuant lo the provisions d the Contractors License Law[Chapter9(commenting with Section 7000)d Division 3 d the PLANNING N T N G NOTES>'l� 14L usiness and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation d Section >nr 0315 by any applicant fraPermit subjectsMb the applicant to panalrydnot more than flee hundred donate($5001). **************#3E******************************************************;t******** o I.es owner of the property or my employees with wages as their sole compensation,will do the work.and the structure is not intended or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of property D E V E L O P M E N T S ER VICES R EQU IR EMEN T'S who buids or improves thereon.and wt.0 does such work himself or herself or through his or her own employees,provided that such improvements me not intended or offered for sale.N,however,the building or inprovemenl is sold within one year of completion,the owner-builder will have the burden of proving her she did nal build or improve for the purpose of sale). ZONING APPROVED- BY DATE: ❑ I,es owner of the property,am exdudvaly contracting with licensed contractors to construct the project(Section 7044,Business end <) :' Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILD ING AP P RO V PD BY : DATE: contracts for such projects with a contrador(s)licensed pursuant to the Contractors License Law). ❑ lamexempt under Section: B.&P.C..for Mb reason: APPLICATION ISSUED BY: DATE: t' tt0l� Dale: Owner ************************************************ . ********************n* *ytk* ** I do hereby candy that I am aware of end understand the requirements of CeMomia Health end Safety Code Sections 25505,25533,and LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y 25534,and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for ....,^ r a permit forCOMICtien r al aremrehW modification from the Ai yement District.Residential ion applications are exempt horn these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE MTP/.RES GRADING provisions. PERMIT 124 . 75 . 66 Dale: Applicant: SM I Pt/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under Penalty of penury one of the following dedrmloru: PLAN :• '� o I have and ovcoman a certificated consent to self-insure nsure fon workers'compensation,as provided for by Section 3700d the labor ISSUE FEE aal Code,frtheperforrmaneoftheworkfrwhichthispermitisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ I have and will maintain workem'compensation insurance.as required by Section 3700 of the labor Code.for the prormanoe of the TOTALS----> 125 . 41 0 . 00 0 , 00 125 . 41 125 . 41 . 00 X work fr which this permit is Mind.My workers'compensation insurance carrier and policy number are: Carrier (;nT.nFN FAC;T,F EXPIRES REVENUE DIVISION TOTALS--> COLLECTED; ] 25 . 41 OVER/SHORTY . 00 Policy Number: KTUrr25"782R—n2 06/13/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (Thin section need not he completed d the perms is for one hundred dollars/4100)or iass.l 124 . 75 ❑ I certifycertifythat in the performance d the work for which this permit is issued.I shall nemploy any person in any mannereo as to k.. become subject to the workers'crnPeneation laws of Cahfrna.end agree that N I should beans subject to the workan' ******************************************************************************* compensation p iris of Section 3700 of the Labor Coda,I shall fon cam provisions. INDIVIDUAL F E E BREAKDOWN Date 11_ /TO 4-1 Applicant: Warning:Failure to secure workers'compeneadon coverage Is unlawful,and shall subject an amp tocdrdnal penaltes and TYPE QTY D E $ C R I P T I O N UNIT COST I TOTAL COST civil fines up to one hundred thousand dollars(Shag 000),In addition to the cost of compensation,damages as provided for in Settlors 3700oftlrs Labor Code,interest and atromsyslow SFR 6641 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7 -. 6, 641 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there ie a construction lending agency ror the ENDOF FEES peace-manes d the work for which this permit is issued(Section 3097.Civ.C). i h . LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building constmdion and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purpesea. • 12-10 1937101:12 Ri]/$12 .41 ROBERT FLANAGAN Nana 2�/7�9 PERMIT a 086132 ' Y/ r( Date: % w /l s ure Ag.m/Antmar_ (5151-48 WP) White-Building&Safety:Green-Fle:Canary-Appicant:Pink-Revenue: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 UF ER 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, 0 Updrgrnd. 10. Structural Floor System i 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 0 Gas ❑Oii 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing h---6 -'t7 ea..„,_ 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 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 Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System / Z -11-47--- u- cbtGApt_GI` �,- 45. Sound Attenuation ` , l `1) _/-.._ . , 46. Handicap Regulations ` y �''`��'"� 6 � 47. FINAL STRUCTURE & BUILDING /Z_24.-ta 48. FINAL PLANNING Ll 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Tot 55 • i ��q FEE RECEIVED MAR 31.rag COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING Tye • M1�T/1lQ,� ADDRESS 1953 Flamingo Drive RECEIPT NO. ligq9 COSTA MESA, CALIFORNIA fT•�{IJ.,IJJ RECETIBY DATE RECEIVED DATE ISSUED OWNER Pemba Subdividers, Inc. _ 2,94-9D AD , A 4 . MAIL BUILDING ADDRESS 2850 Mesa Verde drive ADDRESS Z ( CITY Costa.Mesa . . NO.TEL.5490395 ZOO E NE TYPE {�/ GROUP V ARCHITECT G Kaltenbach TEL.5478046 BYPROVED t' DATE OR ENGINEER NO. ' 1833 E. 17th St. , Santa. Ana ZONING AL SS bSLL+�.. faur, IONE NO.OF USE OF NE�y/ ('Ywtitr • R-'1 PLANS 2 BUILDING/ att ear. CONTRACTOR rel S C o� 1_ - O DESCRIPTION Lot 55, Tract 5289 • ADDRESS CITY A.P.NO. none STATE 187318 TEL. NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 30'TO SIDE 4 REAR P.L. LIC.NO. NO, SIZE 70x100 EAVES NO.OF BLDas. O ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. ..,_____----------- p (FROM C/LL STREET) SETBACK d SETBACK LINE FROM 501 281 `)t/FRONT F . FT. CENTER OF STREET • REAR YARD - -- - - SIDE YARD LEFT 51 I RIGHT _51 R.SIDE SFT. FT. DESCRIPTION OF WORK L.SIDE ?In'. FT. NEW X ALTERATION _ ADDITION REAR (J T/FT. FT. DISTANCE BET. BET.MAIN& R . .4 MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDOS. VAR.# DATE BUILDING 2 481 NO.OF 9 2 SIZE ) n ROOMS s1 - lEB - C.U.P..}C APPROVED EXTERIOR WALLyL��1(]'� ROOF riln le APPRO.y'CW_+ ^„ ,t. z'- COVERING � C �COVERING , g BY `) i "v ` DATE l_V v USE OF B ILD NC A` WOK at�ac �" ` — Single family garage House 2,030 sq.ft. Garage 451 sq.ft. Plan 54 - AR 1 020316T GQ glva a - o I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINAN ES AND STATE LAWS REGULATING VALUATION /y� m BUILDING CONSTRUCTION. PERMIT FEE $ 6 N SIGNATURE OF O PERMITTED ®/1N//J m $J I37 35�sao AUTHORIZED AGE 3i.6-s 14 - TOTAL FEE $