HomeMy WebLinkAbout1156 GLENEAGLES TERR - Building Permits 11111,
CITY OF COSTA MESA BUILDING SAFETY DEPARTMENT Wier
MOVE INSPECTION REPORT
DATE OF APPLICATION September 19. 1972
NAME CLAYTON, Earl E. APPLICATION NO„ 622 BUILDING DEPARTMENT FINDINGS?
PRESENT LOCATION 11611 Westminster Blvd. , Garden Grove, Ca. 1.. The building or structure is so constructed or in such condition
as to be dangerous. NO ,X\ YES
PROPOSED LOCATION - 1156 Gleneagle Terrace, Costa Mesa, Ca.
2. The building or structure is unsanitary or is infested with
PRESENT USE Res.w/att.garage USE AFTER MOVING Res.w/att.garage pests. NO x YES
SIZE OF BUILDING 30 X 50 TYPE (STUCCO; ETC. ) .StJCCD 3. The building or structure is a dwelling or habitation which is
unfit for human habitation.
FLOOR JOIST SIZE: X SPACING CC SPAN NO \‹ YES
RINGER SIZE: X SPACING CC SPAN 4,. The building or structure is so dilapidated, defective, unsightly
or in such condition of deterioration or disrepair that its
STUD SIZES 2- X 4 SPACING It' CC SPAN relocation at the proposed site would cause appreciable harm or
be materially detrimental to the property or improvements in the
RAFTER SIZE: 2— x 6, SPACING 211 CC SPAN district within a radius of 1,000 feet from the proposed
I site.
CEILING JOIST SIZE: X SPACING _ CC SPAN NO . . .-K, YES
ROOF COVERING Ccs, 9 Ci-(i6 (1i GS ROOF TYPE (GABLE, ETC.) 6f SLC.
J PLANNING DEPARTMENT FINDINGS:
CORRECT ROOM SEPARATION? )1e LOCATION OF WAXER HEATER . ALL
� L. The building or structure is compatible with the buildings and
RANGE VENT? Ve 5 SUFFICIENT WINDOW AREA? l V 5 structures in the district within a radius of 1,000 feet from
the proposed site.
PLUMBING CONDITION (TYPE) &n O D r- Q&P Pi NO YES
ECTRICAL CONDITION (TYPE) --LI - . i ( i ' MIL J . ,C ,)4'( 2. The proposed use of the building or structure is prohibited by the
zoning laws of the City.
AGE OF BUILDING APPEARANCE STRUCTI.312(10 Li 6noO NO YES
CONDITION 6 000 3. The building or structure is of a type prohibited at the proposed
location by any law or ordinance of the City.
REMARKS NO YES
4,, The moving of the building or structure would cause unreasonable
damage to the trees, plants, or shrubs on and along the public
streets.
NO YES
RECOMMENDED BOND IREMENT INSPECTION DATE
5. REMARKS
hi.\ S
DEPUTY B SING OFFICIAL
PLANNING DEPARTMENT
r "
FORM 811 48
CITY OF COSTA MESA BUILDING SAFETY DEPARTMENT
Permittee CLAYTON, Earl E. P.O. Box 1200 Costa Mesa, California 92626622
Application No.
Address _ 2909 South Holladay REQUIRED RELOCATION CORRECTION LIST Desar. ofBldg. Res.w/att.garage
Santa Ana Ca.
City > Size of Building •
30 x 50
This is o copy of the corrections and work to be accomplished to the building you propose to locate. It will Present Address 11611 Westminster Blvd, Locality Garden Grove
serve to inform you of the required work to be done before said building can be occupied at the new address. These
corrections are the terms and conditions of the Relocation Permit and are required to be completed within 60 days Proposed Address 1156 Gleneagle Terrace Costa Mesa
from the dote the permit is issued.
NOTE: This is not a permit. Do not move the building or start any work until you have posted the required Floor Joists ( ) Studs ( ) Rafters ( )
bond and obtained the Relocation Permit. Ext. Wall Covering ( ) Roof Covering ( ) Ceiling Joists ( )
ATTENTION: ITEMS CHECKED ARE YOUR CORRECTIONS
V STRUCTURAL / GENERAL
1. New (one, tie) foundation and V20. Install landings and steps at all ex- 2. All existing plumbing to be made sant- �/ 1. Any damage done to building as a re-
underpinning to comply with Building terior doors to provide ingress and tory and all new work to comply with suit of relocation work must be repaired
/ Code. egress from building. Uniform Plumbing Code. in compliance with Building, Electrical
,V/ 2. Provide under-floor ventilation in ex- 21. Brush coat entire exterior stucco. 3. All waste lines to be cast iron from and Plumbing Codes.
terior wall of building to comply. ✓22. Paint exterior wood and (trim) with fixture opening to 3' beyond building.
qor-two coats of oil paint. _ 4. Flat vents not permitted, correct in -2 Deed restrictions are not enforced by
3. Remove all termite and/or rotted lumber attic. this Department; they may prohibit this
and replace with solid timber. 23. Engineer's Computations Required.
p J relocation. Check your deed and other
1l 24. Fireplace and Chimney to comply to 5. One 4" vent required for building. records before moving this structure to
4. Remove porch. Code or to be removed or rebuilt. _ 6. Install approved gas vent for (water /' proposed site.
5. Remove brick chimneys. _25. Termite certificate. heater ) 1//
tie 6. Remove all loose or damaged plaster _ 7. Antisiphon ball cock required on toilet 3. Occupancy of this building shall not be
and recover. tank. permitted until the corrections listed
7. Minimum wall construction to be 2x4"-16"o.c. - 8. Water supply to all fixtures must be hereon and all State laws reaulatina
(a) Provide studding for interior above the flood rim of fixture. building construction have been corn-
(a)
exterior walls. I9. Connect house drain to sewer (ilesmsF- plied with.
�(b) Add_between existing studs. oµ.}-ec-4.e-_pprnvnrLari vat. 'ewn1e
_V. 8. Unable to inspect ceiling joists and ern'
roof rafters; they may be oversponned. -10. Plumbing system to comply to present
Relocation Inspector will check for Uniform Plumbing Code. Inspection of building at present site.
Code requirements at new site. ELECTRICAL
9. Ceiling joists overspanned. Provide 1. Completely rewire this building to meet RICHARD D. HANHART /
strong bock or other means of support._ Uniform Wiring Code.
_ll. Owner installing own plumbing must Director of Building Safety.
10. Roof rafters overspanned. Additional 2. Remove electrical cord wiring thru-out. _ obtain Plumbing Permit before cam-
bracing required to bearing partitions. 3. Remove noncomplying electrical service mencing any work. Plumbing Code BookJ ,,. �J
11. Access to attic required. Provide equipment and install new electri cal available at Building Department. by ... /.0.4%/...r....... - G _7Z
18" x 18" scuttle. / service. /-ELocATION IN=EC OR DATE
_12. Door from bathroom not permitted to ✓ 4. Repair and/or revamp electrical wiring HEATING
open directly into kitchen. Close this which has been damaged or is in haz- Amount of Bond
door and provide an opening into an- / ardous condition. _1. Obtain Heating Permit and clearance
other room. -- 5.5. Move electrical service entrance fitting on existing furnace and heater.
13. Minimum ceiling height is 7'-6". Raise and service conduit to meet with the -2. Heating Permit and Inspection required
hereby in __ requirements for the new location of if furnace or heater is installed. I acknowledge that I have read
_
this building. Check with Power Co. _3. Furnace or heater to comply to present this correction list and that I agree to
14. Window area in
insufficient. Add sq. ft.
6. Electrical system to comply to present Heating Code. comply with the corrections listed hereon
15. minimum area for room is Uniform Wiring Code. _4. NOTE: If Butane or Propane Gas is to and with all State Lows regulating build-
- 7. Owner installing own electrical wiring be used, contact Heating Supervisor ing constructions.
sq. ft. - must obtain Electrical Permit before before installation.
_16. Range vent(6"x8")required to outside commencing any work. Electrical Code Signature of
air in kitchen. Book available at Building Department. Permittee
17. Replace stucco (siding) damaged or re- PLUMBING
moved by relocation to match existing. ,
18. Stucco exterior of building. NOTE: The following checked items are ZONING Address
19. Buildingwill require new (fire retard- a few of the main corrections to be made.
9 _ 1. Complete Zoning of Permit. Authorized Agent
ant), (roof covering), (roof repair), _ 1. Remove noncomplying pipe and fittings
(composition shingles),(wood shingles), from gas piping system and test gas
(rolled roofing) and (grovel). piping after relocation. Address
CITY OF CnSTA MESA
PAR. EES
Fee Payment Receipt N2 048
Project Address /13 G G 46:4/S 9 6 6'S 75/P. __ Park Area #` 1
A. P. No. //6' - 63/ - 3r
Building Permit No. 33'7'7 3
Owner's Name N /10 A M .5
Mailing Address i.,3"4/ '7 O4/k Sr / F. r/.
FEE
Single Family * No. of Units / @ $338.27 = 338; .27
Multiple Family ** No. of Units @ $238.78 =
Total Fee 3 3 r. .2 7
Planning Department Approval Date —`27- 7 V By Alr .t/n� neflr -
Applicant's Signature d
* City Ordinance 72-44 ONO OhI�O
•• City Ordinance
C
inance 72-45 �
• °/" 'gip , T�2�IWWWnq Lab rabe &Of OouL 12 Cacfot 2ta, J,1 .
0 °
y
� �d �4 P.O.:BC% 47 . 3310 AIRPORT WAY • LONG BEACH, CALIF. 90801.. (213( 426-3385 . 12 UI 636-2386 . (]14) 828-6432
PRANG: OFFICES!
TESTING 1514-D Norm HMPer Street fir= - Noe Der"u<!b.Toeing
Saa!e Ane.CeSb.n,a 92101 P.O.Bow A2
(1141 53130+5 SBI 1 Long Sean‘.Con!.90801 12111 616.2114
• `Revised Report
June 11, 1976
Examination: 76-3714
GUNITE
COMPRESSION TESTS ON ICXHB CYLINDERS
• Bob Henderson I
12118 Stonegate Lane •
Garden Grove, California 92645
PROJECT SWIMMING POOL
ADDRESS 1156 Gleneagle Terrace, Costa Mesa, California
SAMPLE FROM 3 from floor deep end; 3 from bond beam same area
ARCHITECT • CONTRACTOR
Owner
ENGINEER SUBCONTRACTOR
B. C. Adams J & J Gunite Co.
SPECIFIED
MIX 6 Sack STRENGTH 2,000
• DATE CAST 6/4/76 SLUMP '
DATE TESTED 6/11/76 6/11/76 6/11/76 *6-18-76 *6-18-76
CYLINDER NO. 1 • 2 3 *4 *5
COMPRESSION 7 days 7 days 7 days *14 Days *14 Days
TOTAL LOAD, LBS. : 59,000 44,000 57,000 *49 ,000 *85,000
POUNDS PER SQ. IN. 2,085 1,555 2,015 * 1 ,735 * 3 ,005
' REMARKS : 14-Day Average : 2 ,370
COMPLIANCE : 14-Day test complies with specifications .
MADE 6Y DELIVERED BY RECEIVED ON
CYLINDERS . Allen Henderson • 6/7/76 •
DISTRIBUTION:
Bob.Henderson - 2 -
Costa Mesa Building Dept .
a
•
•LL REPORTS ARC S'JOMITICO AS 1h?: CONE I OC NTIAI. rno”tRTY <:I CLIENT'S r.:0T110RI1.AT10N IDR Plie LIGATION or OUR R/,^DRYS, C CLUGION:.. OIl E.Y..
!R.^.T9 FROM OR 11 e'C.RO!NO THEM IS RESrRVFD I.TNUPOO 00R w11.1"CI1 APrRUVAL AS A M'JTVAL PnOTCCIIOH TO CLICNTR, T:-!C PIIOLIC ANO nu...ELVES.
330-I2
1
.5 lobs-
- 44- - _ . d € t, l c e e2e 1 ci
..X/14 `
Li , St oto-a-t �. d .
_
.fre,,t_ter .61--caxed, y-0-0
— - � - - sue
G�a,a�-awe ._: Cu:cv - 1., cam, ✓� pee—de,
f pa
Gunite j �'
REPORT OF INSPECTION ON
Cone e
BILL TO:. . ,
Address : /7.s'Y' /� A.i.,_Qe e •
0 VN E R: /6,2 ,1?-- _____
PROJECT: ' Cc>4.v4.,. tore .i:frr-rNo/7C/%
Address : /7c( .2 Ifr..-P-yeq Permit No. 9/7y3
Architect: Contractor: r2-(424.4.Q-L
_ Address : Address : p-.--g-,
-- _Eng.Ineer: Subcontractor: cT l/ / , ce
(Gunite ,
' Address : -csve C JtA_3 Masonry or C Ca,,, --.?"Oar`
'' Concrete) � —
Inspector:. r / 4 p(// ,c„ ' Address :
Mix Used: CPQ Rebar :
Slump , Inches : r • .. .
Admixture:— . Brick :
Designed Strength, PSI : d •
Inspector: elceip/.a lea, Block:
- The following Inspection was performed to accordance with the approved drawings. •
Cu.Yds. No. of
DATES ' Placed Cyl . S 1/I'Remarks .
ti-`/- 2‘_ )-7 __�__ 3 61'1 CR__e-�/(/
aigt s„___ .
at
. 142 2d.eta& r_ig reYzP e'e f-t -gyp.... _ '
. tc", C-ic ' -07.o.."
--► , C fPa • /9 (>
f/ /4 ,
Copies of Reports to: (INDICATE WHICH BLDG. DEPT. S FURNISH ADDRESS OF ANY NOT LISTED)
330-2 - /—
•
i t7/ 2
•
Twining Labarator.3es
R
i
eV ,� ,P.O. 80X 47 . 7310 AIRPORT WAY . LONG EEAC4, CALIF. 9080! . (213) 4263:55 . (213) 636-2386
a (714( 828-6432
.. BRANCH OF::CES:
TESTING 15Nonp Hnrgr S•'ee1 .? Non On•ruc'i..Teg:no
N..,
SW, Celllomle 92701 ��. P.O.Bo.N
(]4 5)! /4
(511/ 5 F,±. long Beach,CeBI,90001 PM 0)5.21[6
�u N
June 11, 1976 •
Examination: 76-3714
GUNITE
COMPRESSION TESTS CN LIDNCRETTE CYLINDERS
Bob Henderson
12118 Stonegate Lane
Garden Grove, California 92645
PROJECT SWIMMING POOL 417a 3.
ADDRESS 1156 Gleneagle Terrace, Costa Mesa, California
SAMPLE FROM 3 from floor deep end; 3 from bond beam same area
ARCHITECT CONTRACTOR
Owner
• ENOINEER SUBCONTRACTOR
B. C. Adaas J & J Gunite Co.
SPECIFIED
MIX 6 Sack STRENGTH 2,000
DATE CAST 6/4/76 SLUMP ' •
DATE TESTED 6/11/76 6/11/76 6/11/76
•
•
CYLINDER NO. 1 2 3
•
• COMPRESSION 7 days 7 days 7 days
TOTAL LOAD, LBS. 59,000 44,000 57,000
•
•
POUNDS PE:t SO. IN. 2,035 1, 555 2,015
•
•
MADE BY DELIVERED BY RECEIVED ON
CYLINDERS Allen Henderson 6/7/76 •
DIETRUUTION:
Bob Henderson - 2 •
Costa Mesa Building Dept. •
•
ALL RE:ORTE ARE SSUCHITTED AS THE CONrIDEVTIAL PROPERTY Or CLIENTS. AUTHORIIATIO.1 FOR FU9'_1CATION Or Our RE^OVTI, coNcLVSIOHN EX!
TRACTS rgOM OR REDA:O1NC THEM IS RE:IERVED RENDING OV R WRIVT'EN APPROVAL AS A MUTUAL PROTECT:ON TO CLIENTS. THE PUSLIC ANO OURSELVES.
310.12
•1
CITY OF COSTA MESA
BUILDING SAFETY DEPARTMENT
SPECIAL INSPECTOR
INSPECTOR'S NAME 5i4-' y
. !
LABORATORY NAME eeitey�/ at,l
ADDRESS J
TELEPHONE ,�1�f��,,
JOB ADDRESS /2.5'6
5 (/' art- aye, ?Lit
OWNER'S NAME
WORK PERFORMED - DATE /77-af'73 BUILDING PERMIT NO.NOTE: All special inspectors are to be registered with inspector's
registrar at the office of the Building Safety Department.
Inspectors shall furnish proof of affiliation with an ap-
proved testing agency; or, a state-licensed architect or engineer;
or he shall be in the direct hire, under state and federal pay-
roll regulations, of the owner/developer of the proposed project.
This proof shall be in the form of a signed letter from any one of
the above three.
REMARKS:
OWNER ADAMS, H. DATE 9-30-74
JOB ADDRESS 1.156 Gleneagles Terrace BUILDING PERMIT NO. 38773 .
GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Res.w att.Gar.
/ o115-631-38 LOT TRACT FIRE ZONE VALUE $ 3,000.00
I. ECTIONS Si nature Dote TYPE V GROUP I & J ZONE R1
SOIL t/ /o PERMITS ISSUED
GAS SUBCONTRACTOR
WATER �, a[- arid s Plumb'{{p7/py��J(����� Dote Number Signature
ROUGH PLUMBING S y- - ' ��� 4Li[/V Il 4pr-� fah61/�'�'-
PROP. SWR. LINE ®HOUSE CON. �/ 4 nsali ti 610,0•C-- '
SPRINKLING SYSTEM
MISCELLANEOUS .
ROUGH HEATINGAJ.oIT� .a_q_7 -
TEMPORARY SE�V(I,C E OR POLE
UNDERGROUND IXI POWER 7j 2..7S
ROUGH WIRING t~" *3" /-75
,/ Heatinctand Vent.
TRENCHES 0 FORMS [7 STEEL REINF, 0 `�-J�i���_' a,a/'7.---1/•;•"4 n
FLOOR SYSTEM ryl'h @ At%-7 -C`/1{��fJ• 141-,- '/ 4
BOND BEAM n STEEL REINFORCE 7 / /
SHEATHING V'.- -0,1c" y
FRAME AND FLASHING r-� J/ a 3 J• 6-7
LATHING - IN OUT Igo !L J-36 • *-
PLASTER,
PLASTER, BROWN COAT
TURAL. FINAL �a.',�.. ""' Electric
H. iNG, VENT., REFRIG. AND A,C^„ FINAL RLC .t-1-9-I5 //L*9jti y3poG1 , a'S�/-75' 3267p
PLUMBING, FINAL AND GAS TEST I l 7' $ .3 9 9,5
ELECTRIC, FINAL . C *-v9- .
BUILDING. FINAL % -7- C.
SPP 30-7L].y,i,a0i210 0***171.00
X 8773 ,Il, 31-7L1 ,...02842:•- ****59.91
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626alir f
AP.L1 r ATION FOR BUILDING PERMIT '�f�'J
For Applicant to Fill i C pee __ n` RE�,•aj� _'
BUILDING , • jl�'-=r� A _= ���// (� • - D TE ISSUED ,/
ADDRESS _ - -
PERMIT NV.
OWNER r� p y�t'� /,� Q A.P.NO. I ( -Cn i -Se) ..3X77---;) /ide
MAIL
Zw . ADDRESS ( 1 0 1 1 ,\V1L^J/�Q. _a . ADDRESS SNG (I '(13 /V
0 0 CITY ' V e C V.. NOL l'a 2.31 y` TRACT94 LOT%) BLOCK.
CONSTRUCTION NEW ADO ALTER REPAIR MOVING f1FM01 ISH
O N LENDER
J tj BRANCH
OWNER ADAMS
AD �"RESS Q VALUE
ARCHITECTC _A TEL.
USE SINE{l4 (fdfglLY at $�� �-
OR ENGINEER A • t. l.k t Q. ' NO. I +
WZ Q FIRE T/'!J-IJ'�
2 ADDRESS ZONE T PE GROUPS �+
W LL YPROV ED `r'/[i.{l
W Z CONTRACTOR BY DATE (/
o]Z
J K ADDRESS
W w TEL. ZO NO.OF USE OF NE�'�•,t 1p�-',p'��
0= CITY NO. ` I PLAN52 BUILDING W/ r �� L
Z 1-
- r
W O STATE CITY YARDS APPROVED YARDS APPROVED
N 2 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
0 O SIZE c NO.OF BLDGS. (FROM C/L STREET/
OF LOT/P'OI 97• ILk //(p , 3Z I NOW ON LOT Q FRONT S FT. 6rr FT.
USE OF
EXISTING BLDG. Q p R.SIDE I. J0 FT. FT.
I- SIZE OF
Z NEW BLDG. 2 I4--��0-c 5 '4""ROOMS t STORIES Z L.SIDE /CC FT. FT.
_V EXTERIOR
O EERIING AL,....t. I ROOF
COVERING .�OJh.e L.,- REAR I ±SFT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
• _MAIN BLDGS. ACCESS.BLDGS. •
0 r� _(� 'Ll p -VAR.#
DATE
<Y•"`�iX-%�•`•`l C.U.P.# `) APPROVED
!/� APPROVED/�{ J7/ Yl r'& 7 7>"
CO /( �• _EY /. 11 DAT e" ./
0
C.)
•
I hereby acknowledge that I have read this application and state N
that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
any person in violation of the workmen's compensation laws of
Hthe State of certify hat California. FI JI�J �/" / m
Z I hereby that I am properly licensed as a contractor under !I-`/' ISO. FT. )V/ 5 ' . .-Q/o o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
am exempt from the provisions of the State of California Business S
and Professions Code,Division 3,Chapter 9. VALUATION /�/ f H
PERMIT FEE $ O
Signature of �` ...61 yn - /_ 2�--(/� (J m
Parmitte° lel �7�v 4"�"� $ /i?�{U rV 1 PLAN CHECK $ ���_ E
LLLGGG / 1/l/' O
LL
Authorized Agent TOTAL FEE $
OWNER ADAMS. Herb DATE -23-76
`.i JOB ADDRESS 1156 Glen-Sag-keg Terrace BUILDING PERMIT NO. Ai 721
N. GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Pvt. Swim Pool w/Spa
rJ '.o. 115-631-38 LOT TRACT FIRE ZONE VALUE $ 400.00
ECTIONS Signaturel1 Date GROUP T TYPE T-T ZONE P-1
Pool Location KLL .-2.3 SUBCONTRACTOR PERMITS ISSUED
Date Number Signature
Forms / I
Main Drain
Steel Reinforce
Elec. Bond /\ Electric ,,,, nn �
Approval to Cover 2.W 6440Qrn'IP.L1011et • 51..2?-1‘963,,9/
Underground Electric 'es.c__ 7-ZL7G /
Gas Piping Test "e_ 7-LZ Plumbing _ /
Filtering System Lines QAC- t.-i, V DL4fltt,`att 9'?3-7t 6f 1/Y
Backwash Lines and Recep. Ya-_L Is44V
Electrical Final s.4 943' '
N-'ter and Vent Final IQ� is 3Ity
System Final 5
Backwash and Recep. Final 'c. torten
Fencing Final Ake, f-41'Z
4 1 73 t ii 23-76�,���001297' ***'^142.50
• 4i7?3 •
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only RECy�I V F�BY VT E,g/yI DAIS IS DL
BUILDING / /` 54 / C,A/ C `-!f�'" !/1 N� /yC'—zT'7
ADDRESS //Sp L'—/a G/J r!'�.G.�S119.4%. l - .. /�/JJ
OWNER 10/51
91
ADDRESS �� ��r BUILD NG�l ) / � P / �
MAIL - ADDRESS 'is
CITY Cos tot /YJ, �¢ NO.TEL67u_0/74, TRACT 70 . LOT. Q BLOCK
CONSTRUCTION NEW AD jJ ALTER REPAIR MOVING DFMOLISH
LENDER
BRANCH OWNER ADAM s
ADDRESS
L, VALUE
ARCHITECT TEL. USE — .Y�///�ry 1 POOL.
$ ��
OR ENGINEER NO.
FIRE
ADDRESS - ZONE TYPEGROU
�` APPROVED
CONTRACTOR fJ a,a)ti _ t/dr BY DATE *--,76
ADDRESS ('A-sg,.( E
TEL • /'ZO NO.OF USE OF N � ,.y/ q/��
CITY - NO.��. 0772 ;
I7J / PLANS BUILDINCC--.lir//! ,00.
(y STATE CITY YARDS APPROVED YARDS APPROVED
a LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
IX - (FROMC/L STREET)
Cu SIZE • NO.OF BLDGS.
a OF LOT NOW ON LOT / FRONT FT. �'FT.
Q USE OF
co, EXISTING BLDG. Sv Ale a- Fen/A Y B.SIDE FT. v FT, '
to / •� �y/—'
E Separate permits are required for L.SIDE FT. V/�FT. Ci/
electric,plumbing and heating work. REAR FT. lQ FT.
44. USE OF BUILDING AND WORK TO B PERFORMED DISTANCE BET. BET.MAIN&
///c//J����'— / MAIN BLDGS. ACCESS. BLOCS.
.a pot
s� i/di i _n 7 /y/} 4 i . VAR.. ' - DATE
;�•(//'/V neje /4„
C.U.P. APPROVED
Q
a / _ BAPPPROVED//f.�0 �DA-r4 �.7--z
.a /VA_A_ ,l
N.
Cu
- a I hereby acknowledge that I have read this application and state n
in
pe that the above Information is correct and agree to comply with
a all laws regulating building construction, and I shall not employ m
Z any person in violation of the workman's compensation laws of E
x the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and.Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business to
VALUATION q 9
and Professions Code, Division 3, Chapter 9. PERMIT FEE $aAr �.(� N
////IIIIen
PLAN CHECK $ / 1. 2
Signature of //� (/ _ /�• o
Permittee f V $ TAX $ a'
I � Sd
Authorized Agent TOTAL PAID $ (l•/ .5