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Home My WebLink About2342 FORDHAM DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2342 FORDHAM DR Suite: Vicinity: ROOF Parcel Number: 14148210 npplicant: RANDY NORLAND Address: 29622 VIA CEBOLLA LAGUNA NIGUEL, CA Owner: WILLIAMS, SCOTT,� ' Address /2342 FORDHAM DR . � , . � ' �COSTA MESA, CA �' - _ " Convabtor: �NORLAND ROOFING 'Address: 29622 VIA�CEBOLLA LAGUNA NIGUEL, CA Zip: 92677 Arch : Address: Zoning: Phone: (949) 495-2002 Zip: 92677 - Phone: � Zip: 92626-6318 - Phone: (949)495-2002 License: 716788 Eng: , , � � � Address: Phone: Status: ISSUED Applied: 04/26/2004 Issued: 04/26/2004 ISSUED BY: � . �:� . � . �, , Phane: , �' Zip: ' � License: - License: _ SCOPE OF PERMIT . , ' TEAR OFF EXISTING ROOF. INSTALL 7/16" OSB, 30# FELT, 30 YEAR COMFOSITION SHINGLES AND FLAT ROOF. 35 SQUARES INCLUDES ATTACHED GARAGE. ' � � � -� ' - ' � � - ` � FEE SUMMARY , Plan Check: $0.00 � Permit: $153.25 SMIP Res: ,' $076 SMIP Com: $0.00 Other: ' $0.00 Calc Valuation: Claim Valuation: „ s�,soo.00 $�,soo.00 dnspection: ; �,$0.00 ' • - ,__ _ � � - � , . � � .; �.� .. . �Total: �5754.01 � . /� �� PLANNING & ZONING ,' SETBACKS_ . ` - � , , � � �- � " % . � � , . , :�" ' ;. MAINSTRUCTURE�Front 0-0 � � _ Rear�_ 0-0`= -�. _�Left,= OcO:�� - - � Right �� 0-0;,� ,;, j% , ,. . . , , - . - � �`. ' �i / ACCESSORY Front .- 0- 0 �� Rear � 0- 0 � Left 0- 0� .�. Right ��0- 0";. �/ , . . , „ ti� .. - . . PARKING F�isGna: �' 0 - - Reouired: 0 � � Proposed: 0 � � � � � " \ .. . ,�: - � , ,._ . - _. " i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. INSPEC710NS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all raquired Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (774) 7545626 . zanws �s�oo� WORKERS'COMPENSA710N DECLARATON: I hereby affirtn under penalry oi perjury one oi the tollowing tleclarations: ❑ I have and will m$intain a certificate of consent to self-Insure for workers' rnmpensetion, es provitletl for by seciion 3700 ot tha Labor Code, for the padormence ot the w�ork tor which thi9`permii is issued. ��I.nBve antl will meintain workere' compensation Insurance, as required by seaion 3700 of the Labor Code, for the pertortnance of the work for which this parmit is issued. My wor/ker�s' compen� ation Insurance carner end policy number ere: Cartierf S —J� —�7/'N'✓% POH� ry'��r:.' �l�' �9�� (This"secnon need nat be comp/eted i! the pertnit is velued af one hundre0 dollars ($100) or less.) ❑ I cetlify t�at in the pertor� c f Ihe work br which this pertnit is issued, I shall not employ any person in any manner so as to become subject to iha workers' compensation laws of 511fo a, end agree that' sho d become subJect to ihe workars' compensation provislons oi Section�0 oi the bor Code, I s�all forthwith �com lywith Ihese,%p �vi 'e s�. /f� ' ! '/ Applicant SlgneNre:_ �,Y—'—1 // "( Dale: Y Z 6 (� `/ � T SECUftE WORKERS' COlAPENSATION COVERAGE IS UMAWFUL AND SHALL S1161ECT AN EMP�OYE TR O CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDfT10N TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE IABOR CODE, INTEREST, AND ATiORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: lem CONSTRUC710N LENDING AGENCV: Chapter 9(commencing with Seciion 7000) of Division 3 ot Ihe Business a�ntl Pmteuions Cotla, arC, my license is in full ❑ I hereby aHirtn that there is a consiruction lending egency tor the pertormance of Ihe work for which this pertnit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lender's Adtlress: Signeture: Da�e: OWNER-BUILDER DECLARATIONS: I hereby affirtn ihat untler penalry oi perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, eusiness end Professions Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant lor such permit to file e si8netl statement thet he or she is IicenseG pursuent to the prodsions of the Coniracbrs License Law (Chapter 9(commencing wit� Section 7000) oi DlNsion 3 ot ihe Business and Professions Gode) or Ihet he or she is ezempt therefrom end the basis for iha alleged exemptian. Any violetion of Sectian 7031.5 hy any applicant for e pertnit subjects the applicant to e civil penalty of not more Ihen live hundrad dollars ($500).): ❑ I, as ownar of the property, or my employees with wages as their sole compensatlon, WILL DO 7HE WORK, antl Iha structure is not intendetl or oHeretl for sale (Sec. 7044, Business and Protessions Gode: The Conireciors License Law dces not apply to an owner of D�operty who builds or improves Ihereon, and who tloes such work himself or hersetl or through his or her own employees, provitletl that such improvements are noi Iniendetl or ottared for sale. tl, however, ihe building or improvement is sold within one year of completion, ihe owner-builder will have the 6urden ot proving that he or she tlitl no� build or improve for purpose of sale.). � ❑ I, as owner of the properry, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Pmfessions Code: The contrectors License Lew does noi epply to an owner of propeny who bullds or improves thereon, antl who contracis for such pmject with a contractor(s) license pursuant to Ihe Contrectors License Lews.). ❑ I am exempt under sec. SignaNre: Owner ID verifiad by drivefs license. ❑ Ves ❑ No Business and Professions Code for this reason: Vedfication of Ownership by (rype ol document, i.e. � property tau bill or aeetl): DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: Orivefs License No. Dale: Expires: ❑ I hereby certify that no excavation fiva (5) or more feet in depih inio which a person Is required to descend, will be mede in connection with work authodzed by Ihis permit, and that no building structure, scallolding, falsework, or tlemolition or dismamling thereof, will 6e more than Ihirry-six (36) feet high. (Chap. 32, Grp 2, Ah 2, Sec. 341, Title 8, Califomla Administretive Code). ❑ As ownar-builder, I will not employ enyone Io do work which would require a permit irom ihe Division of Industnel Setery, as noted above, unless such person �es a permit to do such work tram the division. Signeture: �ate: Division of Intlustnal Safety Permit Number: CERi1FICATE OF COMPLJANCE AND AUiHORVATION OF EMAY: I cenify under penelty of perjury that I have reatl this epplica�ion end state that the inlortnetion given is correc�. I egree to comply with all steta laws and city ordlnances relating to buiiding constmction, end authonze representatives of ihe Ciry of Costa Mesa lo enter upon Ihe flbove-descnbed property tor inspection purposas. I agree not to acupy or ellow occupancy of eny building autharized by this pertnit uNil tinal inspection. 40oE �. INSPECTIONTYVE 1616 Fixad System Final Fire Pravention 1268 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReteining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PIl� It�91� " ��. '� G.l�jf� CODEt INSPECTIONTYPE 206 Final Mec�anical 208 Final Plumbing 210 Finel Elecincal 212 Final Fire Prevention 220 Final Planninq Approval 222 Final Site 250 FinalBuilding/Occupency (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us Job Address: 2342 FORDHAM DR Suite No Vicinity: Parcel Nunmber: 14148210 Applicant: ANDERSON; GEORGE Address: 2804 HONOLULU AVE VERDUGO CITY, CA Owner: WILLIAMS, SCOTT Address 2342 FORDHAM DR COSTA MESA, CA Contractor. MASTERSERV INC Address: 2804 HONOLULU�AVE Arch / Eng : Address: ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clanfier System Connect Qce,Soda,etc) Dental Units Dishwasher Draiq Floor Drain, Rainwater Drain, Roof Drinking Fountain VERDUGO CITY, CA J PLUMBING PERMIT Phone: (800)806-7374 Zip: 91046 Phone: Zip: 92626-6318 Phone: (800)806-7374 Zip: 91046 License: 580017 Phone: Zip: License: SCOPE OF PERMIT COPPER REPIPE AND WATER HEATER CHANGE-OUT IN AN EXISTING SFD. 1 WATER HEATERNENT, 1 WATER REPIPE. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. AMT $23.50 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 , _. FEESUMMARY �TY AMT � Laundry Tub / Washer � " $0.00 0 � � Landscape Irrigation 30.00 0 � P-Trap $0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 ft) 50.00 0 Receptors $0.00 0 - Septic Tank . $0.00 0 Sewer Cap for Demo $0.00 0 , Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 03/OS/2003 Issued: 03/OS/2003 ISSUED BY: AMT Sump Pump $0.00 Swimming Pool $0.00 Trap Primer $0.00 Urinal $0.00 Vacuum Brkr Bkflow(1-4) $0.00 Vacuum Brkr Bkflow(5+) $0.00 Wash Basin $0.00 Wash Basin Set $0.00 Waste and Vent System $0.00 Water Closet (Toilet) $0.00 Water Heater / vent $12.30 Waler Piping (Inst or Rep.) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiiements 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 Inapactions and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaases��ao) WORKERS'COMPENSAnON DECLARAnON: � I hereby eHirtn untler penalry of perjury one oi Ihe following declaretions: , - , ❑ I heve antl will maintein e certificate of consent to self-Insure for workers' compensation, es provided for 6y section 3700 of the Labor Code, for the pertortnance of the r whlch t�is pertnit is issuetl. I have arM will maintain workers' compensation insurance, as requiretl by section 3700 ot Iha Labor Code, for ihe pertortnance of the work for which this pertnit is issuetl. M worker ' m eynsatlo�n Insuranc carrier end oli number are: /J� � ��.` � '/ . Carner:Y �'�i/'7��L.�I ` P� PolicyNumberf/f/�J✓ 7SZi T�� (Thls section need nof be comp/efetl il the pertnit is valuetl at one huntlred dollars ($100) or /ess.) , ❑ I cenify that in the Oertortnanc� of t�e work for wh'isyl pertnit is issuea, I shall not employ eny person in any manner so as to become suDject to the workers' compensatlon laws o�Calit ia, end agrae tt Hfl sh � be subject to the workers' compensation provisions of Sectlon 3 00 of th Labor Code, I shell fotlhwith complywiththes uWi s. � Appllcan�Signeiure: Date: � d�'� WARNING: FAILURE TO SECURE WO ' COMPENSATON COVERAGE IS UNLAWFUL rWD SHALL SUBJECT AN EMPLOYER TO CflIMINAL PENALTIES AND GVIL FlNES UP TOIXJE HUNDRED THOUSAND DOLURE ($100,000). IN D ION TO THE COST OF COMPENSATION, OAMAGES AS PiiOVIOED FOR IN SECTION 3]O6 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensetl mf�s}Qns ol hapter 9(commencing with Section 7000) ot Division 3 of Ihe Business antl rofessi9Us Code, and my license is In full force end ettecL Lic. N •N Class x � r3(� Conlractols Signetur : Date: .3'�Jr�G7 CONSTRUCTION LENDING AGEN . ❑ I hereby affirm that there is a construction lending agency for the peAortnance ot the work for which this pertnit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lendels Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby e%irm Ihat under penalry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Protessions Cotle: Any ciry or counry which requires e permit to consiruct, alter, improve, tlemolish, or repair any siructure, prior to its issuance, also requires ihe applicant tor such permit lo ille e signed stetemant that he or she Is licensed Oursuant to the provisions ot the Contrecrore lJcense Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 ot the Business and Professions Code) or Ihet he or she is eaempt therefrom end the basis for Ihe alleged exemption. Any violation of Section 7031.5 Dy flny epplicent for e pertnit subjects ihe epplicant to e civil penalry of not more than five hundred dollers ($500).): ❑ I, es owner ot ihe properry, or my employees with wages es their sole compensation, WILL DO THE WORK, and the structure Is noi intentletl or oHered for sale (Sec. 7044, Business antl Professions Code: The Coniraciors License Law dces not apply to an owner of property who builds or improves thereon, and who does such work himsetl or herseN or through his ar her ovm employees, providetl that such impmvements are not intentled or oflered for sale. tl, however, ihe building or impmvament is soltl within one year of wmpletion, the owner-builder will �ave ihe �urden of proving that he or she ditl not �uild or improve for purpose oi sele.). ' ❑ I, as owner oi the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions Code: The contrectors License Lew tloes noi apply to en owner ot property w�o builds or Improves thareon, and who coniracts for such project with a coniractor(s) license pursuant to Ihe Contractors License Laws.). ❑ I am exempt under sec. SigneWre: Owner ID v8riti8C by dnvefs liCenSe. Yes ❑ No Business and Professions Cotle for this reason: Venficalion of Ownership by (rype ot documem, i.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: DnverS LiCense No. Data: Expires: ❑ I �ere6y certity ihat no exwvation tive (5) or more feet in tlepih into which a person is required to descend, will ba mede in connaction with work authorized by Ihis permit, and ihat no building siructure, scafloltling, falsework, or demolition or dismantling thereot, will be more Ihan ihirty-six (36) fee� high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle 8, Calitornia Adminisirative Code). , ❑ As owner-builder, I will not employ anyone to do work which would reQuire e permil irom the Division ot Intlustnal Safery, es noted above, unless such person hes e pertnit to do such work Iwm the division. Signature: Date: Division ot Indusirial Safery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify under penalry of perlury that I have reatl ihis application and stete that the information given is wrrect. I egree to compty wlih all state laws and ciry ordinances relating to building conswction, and au�honza represen�atives of the Giry of Costa Mesa to enter upon the ebove-descnbed properry for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by �his pertnit until (nal inspaction. cooe �, iNsrecnor+rrve 1616 FixeC System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Fectory Fira Place 203 Final Sign 204 Final Demolition �� S—C� a� Da�e Q�F� IIRITIALS �� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 . Final Fire Prevention . 220 Final Planning Approval 222 Final Site 250 FinalBuildingiOccupency ly—o ,�� CITY OF COSTA MESA PLANNING DEPARTMENT A. P. No. 141-482-10 Bldg. Permit No. 3 2 2 3 3 Project Address PAfO SEP -3-7C�rssa�0 095 ��::+��:40.00 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt 2342 Fordham Drive. C.M. Owner's Name John A. PUrdy Bachelor or 1- Bedroom Units � @ $25.00 = 2 - Bedroom Units 1 @ $40.00 = $40.00 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = $40.00 . Total Fee Total number of Dwelling Units Planning Department Approval Date 8-26-70 Park Area No. 16 gy WLDPd Applicant's ! �� ! OWNER c^G+, j�SB�'St��BS DATE 1y-12-56 - IJOBADDRESS 23(}�'' FOPdhBd Dt1yB BUILDING PERMIT NO. Q6I1O GENERALCONTRACTOR Roven-Spiegel Co VAWE $ 11i� pQ 1 �-l0 BLOCK TRACT ii ']50 S;++gie es ta�aE.��a ' GROUP T,Q; ,7 TVPE p ZONE � FIREDISTRIC7 7(i(� PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE � NUMBER Foundation Rouoh Frai J Plumbing,.RoughtoSlabr'C,V>a-v„c,� i6j�67-+6 GG(..aM.... M1C1��,.,..b.. 9-//'SG G3/7� Plumbing, Rough Complete �'/1 (� S /I 6 � Temporary Pole Wiring, Rough �nn �/%i //'�/�Y .�Ti(��p.�z- Z��U �S 3"� � Heating,Rough � IVI CS i' 1` '6 �.�.,�D�.:.l�,. �,s --(rl:$ 9-�3-SL („40_� — Heating,Final /�S S 7 VSewer,House L Sewer,St.�Q S '-�� J,%3, �-�, ��„>. R-15=S� vr/5Y ` Seotic Tank or Cesspool � I g, In Out x ,w '7- � P�__.arin9 �/�/� � ' % PlNmbing, Final, Fixtures Complete N s�'�D �s'i ='�J�- Plumbing, Fin,al GasTest IS /NN S_ S'�'.� ^� 7� `_ _ � '� i� J Wiring, Final �%i�QY 1 1957 B Occupancy /��J-f f�a'17 - FORM 210 3M 10-95 ' sa Building Department 111 EAST 20th STREET -COSTA MESA, CALIFORNIA FOR APPLICANT TO FIId. IN Costa :r ��/!�%�//T ��C!G//� C %�//�%� ess f� J,Co 'l��( �� %'/ ' ,Cd� ��P'�� 3� No:l�� itect or Lic. ieer ��-F �/�G. No. ess ��/l�v� /-%:��. � > ii�%/.�i Size of Lot of r 71G�� Si -,�/�. Lot / I I " No. of Bldgs �'D Now on Lot INo.of No.of Families Rooma <�lJ��— c ae�v•�a �.S Addition /' No. of ?< <G�J Rooms � Stories 7%C�� I Roof Coverin�C.�4r`i/r APPLICATION FOR PERMIT � BU .D NG ,' FOR OFFICE USE ONLY - Receipt No. Permlt No. a- G � ;eived by Date Rec'd. I ' Date Issued �,.,, �iJ �`( 2 "� l� , /.� �, Costa Mesa, California Nearesf Cross St. CORYtECTIONS APPROVALS - - �� -�" � Forms,Maferials, � P ��.(�6� Under-Pinnfng , � Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Ini. with all City Ordinances and State Laws regulating building construcfion. � Lath. Ext. Signatureof '�� j�-��,-6T Permittee �7 Plaster, Int. Authorized Agt. plaster, Ext Valuation e mit Fee $ c ^^ Masonry Rei�forced $�� j T tal heck $ � r'� Bond Beam Fee $ �L'� FINAL RM 204 S-SP 2M 6-55 � , ��; COSTA MESA BUIL�ING-SAFETY.DEPARTMENT P.'O. BOX 817 C08TA MfiBA. CALIPORNIA Fo� Appliean+ io Fill In Completely � TYpE OR PRINT Aoo E's8 1 v o 2I� �J a�, �c COSTA MESA. CALIFORNIA OWNER � 1 " � `JV eeai� _ .� . � r_ ., � . � - - - ^ TEL. c�n C�S'%n MESA No. AF CT TEL. ADDRESS iI cirv S N � 6TATE LIC. NO. OFLOT /O� r�Qn� U6E OF PXIBTING BLDG. _ 88TBACK LINH PROM �EE RECEiVED ,��"��_�� '�aaNc� oE�yt: APPLICATRE}� IQ�R��IP'� • BUILDING For Offiee Use Only FiECE1PT NO. PlFMIT NO.. COSTA MESA. CALIFORNIA FIRE /✓'( /A wd ZONE TYPE b�-«'U`r:" � �T CON�S�+jCAQ( ByPROVED DATE 5 S'7' ZONIPIG ZONE NO.OF U6E OF NEW � I PLAN9 � BUILDING NO. 'C ( i- O U O� LEGAL ' �� DE6CRIPTION INO. OF BLDO6. ; ., � � rvow oN LOT q, p, NO. YARDS � EVES APPROVEO ALLOWEO 6ENTEP LINE 9T.] . DESCRIPTION OF WORK :RIOR WALL IROOF :RING GOVEI OF BUILDING AND WORK TQ: L�( v C�L ( v Q 1 HEHEBY AGKNOWLB[ ANO 9TATE THAT THE PLY WITX ALL CITY C BU�IDINO CONBTfNGT SIGNATURE OF PERMITE AUTHORIZED AGENT ' 1 HAVE R¢AD TH19 APPLIWTION 18 GOMECT A � A6RE8 TO COM- E8 AND HTA'�LAW9 pgOULATIN6 ...; � �Y �.!) J I {� FLa�; �,�r. � ' rt.r.�.. . - �---�-'�� THE AMOUNT BHOWN UNDER VALUATION Ie FOR THE PURPOBE OF EBTABLISHING p PERMIT FEE ONLY. VAWATION � dy � PERMIT FEE N m $ / PLAN CHECK $ l E TOTAL FEE � LL , . 32233 Z a U � Z za o� am c Q] J m J Q U N za w� aW J Q m z J � W W � _ Z � W � N � �O H z Q COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 PAI4' s {;{;kt: SFP -3-7�ri00 094 •� f38.50 � - APPLICATION FOR BUILDING PERMIT For Applicant to Fil/ in Completely RECEIj!EQyaV ' DATE RECEIV� OATE ISSUED BUILDING �� -��/[ O �ydU ADDRESS '� Q ERMIT NO. OWNER � A.P. NO. � ' MAII ADDRIESS�`)�� /r(yI)/%'UW dl��. AD�RES - '3 Y y ^ n - TEL3yS-3 � TRA°T p� �GJ ��T (1 BLOCK CITV � NO CONSTRUCTION NEW ADD A ER P LENDER �/ � BflANCH j ' OWNER ��O i� I�l (i � � - AODRESS / AL E ARCHITECT /-- TEL SE R{ $ OR ENGINEER O W M�'--�Y NO. ' f � FIRE ADORESS ZONE TVPE��JJJ GROUP � �/� APPROVED � +� � CONTRACTOR � �,�} v� : BY � DATE .J ADDRESS ZON NO.OF USE OF NE TEL. p�p,ryg gUILDIN CITY NO. STATE CITV YARDSAPPROVED VARDSAPPROVED LIQ NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE / � NO.OF BLDGS. (FROM C/L STR T) . OF LOT � LQ"O �,� NOW ON LOT I FRONT FT. USE OF '� � �� '�"'^` EXISTINGBLDG. ES\ I�i..C! �. SIDE FT. FT. NEWBLOG. I��/ ft0 MS C.i STORIES � L.SIDE6 FT.� FT. EXTERIOR WAL - ROOF S-�SA- � S� COVERING ��Gl COVERING /�i REAP FT. FT. US OFI _�/I�ILDING AND RK TO BE PERFORMED DISTANCE BET. BET. MAIN & C9�(1 1 VL ' % MAIN BLOGS. ACCESS. BlDGS. 1 �/ � VAR.,$ DATE . ,�j G� C1 (�() ) % �% : �/—�J C.U.P.� APPROVED �y�� APPROVED / -7Q � ( I hereby acknowledge that I have reatl ffiis application and state that the above infarmatian is correct and a8ree to comply with all laws regulating builtling cOnsVuction, antl I shall mt employ any pe�son in violation of ffie workman's compensa[iOn laws of the State ot Calitomia. � a a I hereby certity ffiat I am properly licensetl as a coniracior under �) SQ. FT. ' � ffie State ot Calitornia Business antl'Professions Code, Divisicn 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in tull force and effect, or 1 THE PVRPpSE OF ESTABLISHING A PERMIT FEE ONLY: ^ am exempt from ie p�ovisions of the State of litornia Business � � antl Protessions �de, Division 3, Chapter 9. VALUATION pERMIT FEE $��'�Q � Signature of �„d yn n Permitt � �'/ /�,�.. PLAN CHECK $ �/ �J�Q E �Y Autho ' d Agent /� �� Q u TOTA� FEE $ JOHN A JOB ADDRE55 ZS4L r� GENERAL CONTRACTOR DATE OCCUPANCY Form 210—SM—il-59 S-B P SUBCONTRACTOR BUILDING PERMIT NO. vnz.uE � 19 .00 PERMITS ISSUED Q� OWNER ,�JOB ADDR GENERAL � � I. CTI( soi� r� PURDY� JOHN A. ROUGH HEATING ANO AIR CON�ITIONING TEMPORARV SERVICE OR POLE UNOERGROUNO � POWER � ROUGH WIRING TRENCHES FOFy�vyS, yfEEt REINF. FLOOR SYSTEM �� 7 �7 � f BON� BEAM � STEEL REINFORCE ❑ SHEATHING FRAME AND FLASHING rn.�n LATHING — IN � OOT ��.,yr.y,i9_vi P� '�R, BROWN COAT URAL, FINAL H. .�G, VENT., REFRIG. ANO A.C., FINAL PLUMBING, FINAL AND GAS TEST � ELECTRIC. FINAL DATE 9'3-7� BUILDING PERMIT of FIRE ZONE VALUE GROUP I TYPE SUBCONTRACTOR ••