HomeMy WebLinkAbout1206 PARNELL PL - Building Permits y_Lc CITY OF COSTA MESA
o' ��� BUILDING DIVISION
.,m";� ,
t;; DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
• PERMIT
r M99-00176
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 1206 PARNELL PL Status: ISSUED
Suite No Applied: 04/15/1999
•
Issued: 04/15/1999
Vicinity:
Parcel Number: 14104607
ISSUED BY:
Applicant: BELL,RALPH
Address: 11801 MAC ST
Phone: 534-2593
GARDEN GROVE Zip: 92641
Owner: NIXON, ELLA R
Address: 1206 PARNELL PL
Phone:
•
COSTA MESA,CA Zip: 92626
Contractor: CRYSTAL AIR
Address: 11801 MAC ST
Phone: 534-2593
GARDEN GROVE Zip: 92641
License: 655036
Arch l Eng:
•
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
REPLACE F.A.U.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $22.00 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $13.25 1 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0
Ref rig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0
Appliance $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $35.25
COMMENTS/SPECIAL CONDITIONS
Spi ;$
Ogt
•
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
DECLARATIONS �1.J
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.
win I have and wit 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 end policy number ere:
Cartier: Policy Number:
(This section need not be completed i/the permit/s valued et 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'
co -.- 'on laws• ia�e that if I should become subject to the workers'compensation provisions of Section 3700�1Tof the Labor Code,I shall forthwith
m•I with hese prT_/5. /
re: Date: •
••-. • =. AILURE TO SECUR- ORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN PLOVER T IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
'OUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENS • ONTRA ORS DECLARATION:
I here• affirm 1. I a ' licegsed wI rprovlsions of Chapter 9(commencIng with Section 7000)of Division 3 useless :‘,• Prgf@ssicns Code,and my license is in full
f. :net 6 effect.Llc - D b Class N Ott
Contractor's - ature: \D� Date: a
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: 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 em exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's 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 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 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 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 Califomia Health and Safety Code been fully complied with? 0 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 Replication apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑No
(Section 85850.2 of the California Government 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? 0 Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California 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:
CERT1HCATE'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 alLstate 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 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
_ rs)/
SignaC,/ture a• -- a •:r(s) _ Det
311* " • .Or Authorized Appli t Da e
CODE II INNSPECTIONTYPE PAIS 24I171ALS CODES INSPECTION TYPE PAIL NiTt
1616 Fixed System Final Fire Prevention 206 Final Mechanical lb'd -o9 43
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Flre Prevention
202 Final Factory Fire Place 220 , Final Planning Approval
y.. 203 Final Sign 222 Final Site
204 Final Demolition . 250 Final Building/Occupancy
2446-46
PROJECT ADDRESS: 1206 PARNELL PL 22.E
UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 068975
OWNER'S NAME: NIXON, ELLA R FLOOD; X 46
ADDRESS: 1206 PARNELL PL PERMIT NO; M 068975 PLAN CHECK NO; N GOVT; N SUPP ; N
COSTA MESA, CA 92626
CONSTRUCTION TYPE; 5—N PERMIT TYPE; MEC PURPOSE; ADD
ARCH/ENGINEER: flEG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION ; REPLACE A/C UNIT SQ FT ;
PERMITTEE: CLAIM VALUE; CALL—VALUE; GROUP OCC; R-3 /
ADDRESS: S 6 S HEATING & AIR COND ( 714 ) 837-2000
943 DARRELL COMMENTS; NO OTHER WORK AUTHORISED BY THIS PERMIT
COSTA MESA CA..92 ,627 **************************+e+rTr***************TF****** *********TF*TrTF*****vF*iE#*Tr***
LICENSED CONTRACTOR 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. Z 0 N I N G REQUIREMENTS
CITY LIC.: sraTE LIC.: ss: S E T B A C K S
027758 39381B -2o EXP ; 12 /94
Date: p-5 —1--1--—i M Signature:_ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: Ihereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• PROV; PARCEL ; 14104607 ZNE; REF NO;
Certified copy is hereby furnished. 0 Genii ied copy is filed with the city Building Division. PLANNING NOTES>
> •
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT S ER V I C E S' REQUIREMENTS
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
1
subject to the Workers'Compensation Laws of California. FYQ4-51 -- 1
/NT. ZONING APPROVED BY DATE;
Date: ' 1 1- - 41 Signature:s
NOTICE:5- 1'
II,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY
Code.you must forthwith compry with such provisions or this permit shall be deemed revoked. i DATE'
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for e `r• /p r 1-`'l'
which this permit is issued(Section 3097.Civ.C). APPLICATION ISSUED BY. L} DATE; CA 1f
LENDER: • *******************************************************************************
ADDRESS: LEGALIZATION; N FEE - SUMMARY STRUCTURAL SEGMENT;N
OWNER BUILDER DECLARATION: Ihereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING EL ECTR IOC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 9,00
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE •''J
15 , 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for safe(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 9 . 00 15 . 0 0 0 . 00 2 4 . 0 0 24 . 00 , 00
does not apply to an owner 01 a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTAL S--> COLLECTED: 24 . 00 OVER/SHORT; . 00
forme purpose al sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 24 . 0C
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).l am aware *,*,*****,**********,**********************.****************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. I N D I V I D U A L F 'E E B R E AK D O W N
for this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date: Owner: ./S
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 . 00 9 , 00
25534 and that I or any future building occupant wiIVwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES'
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from
these provisions.
I her• Applicant' /
hereby certify that have read this application and state that the above information representatives
is correct. agree to comply with all city-andme county _///
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes. .
•
Date: 5•Z1---4Signature: i 0100168224-00168224 TOT 24.00
Y DATE: 09/22/94 TIME: 10118
Driver's License or Social Security 4:
1641-46 White—Building:Green—Code Enforcement Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING PO. . 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 Undrgrnd.
10. Structural Floor System 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 Hyciro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23, Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing Si 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 et-256" -Pi-- I4
35. Final Gas Pipe-Test hlS� LE -
36. Hood or Canopy .
37. Final Factory Fireplace .
38. Final Plumbing �-�Z-�-�si _�
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer '
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date -
Go5tp"'FS., Cl Y OF COSTA MESA
ohI4 4 CALIFORNIA 92626 P.O. BOX 1200
to
J•4 •� FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY •
t�11roo Pf'
Project Address fd-OD 8412.0041 1 L. (1111. 6+. 5:9-61(- Permit #1/4-e�88? /
Project Name Zype f e
Owners Name O, ) . Iv ) x v^-)
Owners Address City Use Cnly
Owne
}}r
s Telephone, 55 7-O z$
)
I (Jll✓dc. 1, A /x 0 c as Cwner, Contractor, -A (strike out all
except one) do hereby attest that employment of any person, or persons, is not
anticipated at the time of seeking the above-referenced permit. In the event that
any person, or persons, are employed under the provisions of this permit, I shall
immediately cause a valid Certificate of Workmen Compensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own cost, and to indemnify and hold harmless, the City,
its officers, agents and/or employees, frau and against, any and all liability,
damage, costs, losses, claims and expenses, howsoever caused, resulting directly
or indirectly frau, or connected with the improvement under this permit.
I further state that I have read and fully understand the implication and re-
sponsibilities of the above statements, and will comply with all provisions of the
Contractors State License Law found under the Business and Professions Code,
Division 3, Chapter 9, of the State of California.
Print N
110
c22 , 244444
Signature Date '
CMF 0777.46
/?o& PA-gm EL L Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTR UCTJ N PERMIT PE IT NO. 7 9 TRACT NO. LOT NO. UNIT NO. A P ,As I Zone
Project Address 2/� `f•J N
razwe_ +,e - 1� S Main Building: Accessory Building:
Applicant's Mailing A dress Geri J TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION L REPAIR E Front Z
r���5—��j ❑ CONVERSION D DEMOLISH D OTHER T 0
Owner's Name " M, Phond±7�Z�L'7 DESCRIPTION OF WORK/USE OF BLDG. i A Rear N
Address
TYPE OF PERMIT El OUNDATION U STRUCTURAL SIC Right N
Arch/Eng. License No. K G
Address rj /, ❑ TENANT ❑ ELECTRICAL PLUMBING 0 MECHANICAL I, s Left R
Contractor's Name_Ill L Ph,,.,,fJe7 Qr ❑ OTHER Ping. Ref.dp Parking Req./Provided E
`Li /�y�!/// PROJECT DESCRIPTION SQ. FT. OCCUPANCY O
Address(mailing) (, d4o� # f//( Planning Notes: M
^?RC
CONSTRUCTION TYPE VALUATION$ T
City License No. (' ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION S.
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Coda, and
my license is in full fes�//• a.d effect. • ELECTRICAL FEES
Licens�`1a s Pre. e I ns� o.i be
Date{ Signature ta��� /- PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
�/p 0 50+KW
`r+ORK S'COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub.
' treby affirm that I have a certificate of consent to self-Insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter ❑up to 100 amps
..d11o, Lab.4.1.-1, '/ p� /,, ,,,/ Backflow Preventer Service Sink
1 Policy No. /C V%3T �07 Company . 1'e, �if/z Backflow Irrigation Sewer Cap Dishwasher Meter Clover 100 amps
certified copy is hereby furnished.
� eCee Dryers ❑Gas ❑Electric Sub Panel
.Date 'i' t Is filed with the city B in ;Igy �J � Bathtubs Sewer Connection
Date Applicant Fan Motors 00-1 HP ❑1'/s-8
EXEM I FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed If the permit Is for one hundred ($100)or Dishwasher Solar Piping F.A.U.
less). inc.Solar 09.15 HP 016.15+
I certify that in the performance of the work for which this permit is issued I FiMUr¢s
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes ' Pole Light
NOTICE: If,alter making this declaration,you should become subject to th0 ¢Outlets Ran
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 9
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater a A?1 .Garbage Disposal Standing Sections
Lender's Name to
Lender's Address Kitchen Sink Water Service ._ Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash .
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit -
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains -
--1 Contractor's License Law (Chapter 9 (commencing with Section 7000) of
ision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
'ofrom and the basis for the alleged exemption. Any violation of Section
_ .31.5 by any applicant for a permit subjects the applicant to a civil
e.enalty of not more than five hundred dollars($500)• r DEVELOPMENT SERVICES REQUIREMENTS:
• Zoning Approved By Date
I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure Is not intended or of fared
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES. Building Approved By ^ Date
License Law does not apply to an owner of a property who builds or improves (2)thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Date
employees, provided that such improvements are not intended or offered for -
sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II 0 , SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
prove for the purpose of sale). — BUILDING PERMIT $ SMIP $
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration SystemPLAN CHECK $ PERMIT
tractors to construct the project (Section 7044, Business and Professions Code: ///��� .�
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU PLUMBING $ �Ss ISSUANCE $
builds or Improves thereon. and who contracts for such oroiects with a con-
tractor(s) license pursuant to the Contractor'sExhaustSystemRepair/Alteration
License Law). I am aware that 0 Multiple 0 System . PLAN CHECK 25% $ ENERGY P.C. $
proof oftheir Worker's Compensation Insurance should be provided to me. • - ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers MECHANICAL
I hereby certify that I- have read this application and state that the above 00-i00,000 BTU 0100,000 BTL $ TOTAL FEE $
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for
inspection put es. e / L�
Dat¢ (G/Q "1 Cu ?$
� .3 0,1621.133a�3•133 � LI(
Drivers' License or SS ti / Signature 711
Reinspection Fee $15 Issue Fee $ 3 DATE: 03/19/59 T1 : 1,3:31
0865-46,rev. 5/88 White - Building; Canary -Applicant: Pink -Accounting: Goldenrod - Assessor
CONSTRUCTION AND PLANNING PO' \SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Po( 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
•
8:'Electrical Conduit Utility-Undrgrnd. 54. Forms
•
4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
Electrical UFER,Grrid. 57. APPROVAL TO COVER-GUNITE
T..Footings �- 58. Electrical Conduit-Undrgrnd.
•
„ 8: Foundation • 59. Gas Pipe, E Undrgrnd., Test •
- 1 9. Water Pipe-Undrgrntl. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
•
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line& House Connection 62. Backwash& Receptor-Final
12. Sewer Cap - 63. Heater & Vent•Final
13. Roof brains 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
19t 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 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 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 Note :3/20/7 Leer CARO. L lab
34. Final Heating & Air Conditioning &/27/ai Lr-9-04-en . e43
35. Final Gas Pipe-Test g eg- ts"? LST Ga-en, C_-G7
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing r/e,w4 L#V)
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer Ire
43. Backflow Irrigation r
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. _ Date
OWNER NIXON, Oliver DATE 11-17-76
JOB ADDRESS 1206 Parnell Place BUILDING PERMIT NO. 43053
GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Blhrkwal1
No. 141-046-07 LOT TRACT FIRE ZONE VALUE 5500.00
InSPECTIONS Signature Dote TYPE V GROUP J- ZONE p 1
SOIL SUBCONTRACTOR PERMITS ISS4ED
GASDate I Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE LJ^
HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES FORMS STEEL REINF. �'
FLOOR SYSTEM
BOND BEAM [ 'STEEL REINFORCE in
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT in
ITER. BROWN COAT
,CTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST in
ELECTRIC. FINAL
/.I w .o nli e
• •` 43053 OPAL/
'1V '17-7ua,;c:0(1012* •,.iltr;nY 5.5O
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APP1 ' 7'1 N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
(/nor,. _ / (//r j REC I DATE RECEIVED Dq/� jI SUEE/}D/
BUILDING / 2_C9 Cp CA/Z.4P�! 1 1 • % / ��{,�/
ADDRESS �) rie/64.7
RMIT NU
OWNER C Y._..I (/�etc N ()CQA) A.P. NO.
MAIL ^ AUIDDIEG6 /WIif,ADDRECo
S'''S+++ J ADDRESS J
CITY ( oSIVA OA 654 NO.TETRACT( 7/ Liar' BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMDI ISH
LENDER \T//
BRANCH ®L,
OWNER - Mita AJ
ADDRESS A 4
ARCHITECT TEL. USE (/J �� /� L $ 4S
OR ENGINEER NO.
FIRE V
ADDRESS ZONE T PE � GROUP
/ APPROVED s'�
CONTRACTOR / BY j, ,� �� DATE •
ADDRESS ,.fit �///J//,
TEL. ZONA / IND.OF,..—, USE OF NEE''"(i
CITY NO. �`(/ PLANS/ BUILDING
F STATE CITY YARDS APPROVED YARDS APPROV 0
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
U
SIZE I NO.OF BLDGS. (FROM C/L STREEJ)
C• OF LOT NOW ON LOT FRONT FT. FT.
Q
USE OF //
EXISTING BLDG. R.SIDE ///fT-
'I,
FSeparate permits are required for L.SIDE FT`" FT.
electric,plumbing and heating work. REAR F1— FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET.MAIN&
Q MAIN BLOC'S. ACCESS. BLDGS.
MoD./'- I rd VARP. DATE
:..1
G girsi tear C.U.P.# ///III APPROVED �7 7
p (��� �� al ette + CI ri, a$PPROVE 4 /�`DATE //// !
4 . . ////
p I hereby acknowledge that I have read this application and state Aid j ,S .n v P/y./ 3041 'N
n
I% that the above information is correct and agree to comply with / /` C/C ��cttt/// "x/
M. all laws regulating building construction, and I shall not employ /�/ � ' m
anyZ personte in lifor8pn of the workman's compensation laws of �r �' w
W the State of California.
k▪ki I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, end that such licenses are n full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the •rov -Ions of ata of California Business y
and Professions Co._ • 3,C VALUATION PERMIT FEE $
Ili �7 ' m
PLAN CHECK $ m
Signature of / m
Permittee $ TAX $ SrT b.U
Authorized ' <ent TOTAL PAID $ ,J;
" OWNER RANDALL, ROBERT DAIE 5-21-70
��ttJOB ADDRESS 1206 Parnell Place BUILDING PERMIT NO. 31881
GENERAL CONTRACTOR Fred C. B_cbmid DESCRIPTION of WORK Patio Cover - FAJCLac€n
ISI '0.141-046-07 LOT 168 TRACT • 2671 FIRE ZONE VALUE $ 1.339.00
ii._. ECTIONS Signature Date GROUP J TYPE V ZONE R-1
OIL PERMITS ISS ED
-N-GASSUBCONTRACTOR Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINED HOUSE CON.
I
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CONDITIONING
TEMPORARY SERVICE 04 POLE
UNDERGROUND El POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHESFORMS ❑ STEEL REINF. 4 r AT
FLOOR SYST M ,./A,t
BOND BEAM n STEEL REINFORCE IA y ft, 67 ( _
SHEATHING a /
FRAME AND FLASHING It Zr 7C
LATHING — IN n OUT f (((
PL$CTER, BROWN COAT
S (URAL, FINAL Electric
HEn,ING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST t^J
ELECTRIC, FINAL Lei
���q
BUILDING, FINAL L b-A (t/yy^/�Jj _ _
31881
r 4 ' . PALO t R *tzskh
S. MAY 21-70crisnOO 91;9* 21.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For ApplPA [�icant to Fill in Completely wig BV DATE RECEIVED^7DATE ISSUED
ADDRESS f
BUILDING /la0.14 ! BLL L I— .5 _ 2/_/ 0 ?/^72)
•
OWNER • �. ♦ ')ALL- A.P.NO. '.— / i '-4 P€RMI 3
MAIL
BUILDING /a o� raze(
ad, -�� s
ADDRESS ADDRESS :�)([(�
W W �oc�� /t A��� TEL. TRACT a 6 ' LOT/6 'BLOCK
0- U CITY J M NO.
Z NEW ADD ALTER REPAIR MOVING DEMOLISH
I— Q CONSTRUCTION
—
O v LENDER K
CL m
J D BRANCH
J V /L
) OWNER 2L ettflicele
Q W ADDRESS -1
op J VALUE . /fir 44
•m ARCHITECT TEL. USE $ <334,1-4
�� /
J Q OR ENGINEER NO
U N FIR -- -��/y
WCCQ ZONE TYPE [, GROUP
ADDRESS �/ (( -7
JO CONTRACTOR /-Rep C Sc h pilo a APPROVED ��� / DATE o.J ��/J/rJ
CO z // /�'��i�,
JCC ADDRESS,gO 6 p EM ERy asi'+ RTl)Lu w _
NO.OF USE Oolta—i
zi CITY A ,gA6 R I\ NOL ZONFjx / PLANS a BUILDIN J
W
V)¢ �STATE � CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D OSIZE
(FROM��C/yyLL{�SS--�TRX7�gT) `
OF LOT ,6.i/ x /r2C° NOW ON LOT FRONT/( r4 W /cc v FT.
USE OF
7 J/
EXISTING BLDG. R.SIDE I F ��Q.. FT.
I— SIZE OF NO. OF
2 NEW BLDG. ROOMS STORIES L.SIDE a FT. /
,v FT. .
UEXTERIOR WALL I ROOF ,/ "a
_ COVERING COVERING REAR .V41FT. FT.
J USE OF BUILDING AND WORK To BE PERFORMED DISTANCE BET. BET.MAIN&
d
C- MAIN BLDGS. ACCESS. BLDGS.
0 PAT,/!, //�. /� 1' G
y" 0 0 V ii Fi CL C.U.P.#. APPROVED
I— APPROVED/de/41 f 9 / ''7 n
C/) BY DAT'CO - 2/— 7
0 •
C~.1 I hereby acknowledge that I have read this application and state enitfet...1:12
14. .- --?.74
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
y he State of California. ID
Si / ID
B
z `�(/I hereby certify that I am properly licensed as a contractor under SO. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and,rthat such licenses Bre in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: o
CC
am exempt from the provisions of the State of Calif a Business _l
and Professions Code D' ' ion 3,Chapte 9 VALUATION / /f'!/ co
,�,] PERMIT FEE $ N
Signature of """��, //,t Lr _ Dm
Permittee. rr.v//y • /-'7'L--7 - $/3 7 PLAN CHECK $ E
v// ` / �l a
LL
Authorized Agent. TOTAL FEE $
OWNER COLLEGE-MESA COMPANY DATE to-11-56
JOB ADDRESS 1206 Parnell Place BUILDING PERMIT NO. #382/I
GENERAL CONTRACTOR The Hale CO. VALUE $ 10880.00
L 168 BLOCK TRACT 2671 Single dwelling we/att. gar._
GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 38541
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench c /-/-r ,
Foundation Forms and Grade to Garage" //-.Z./-
Rough Framing �,,� /i;,, 7
Plumbing, Rough to Slab 5u7i' 1 .yt 5-y QLviahrw 1 1M L.• /O -3 0-5 7a Z3 /
Plumbing,Rough Complete VVC&S )j7•• -,Sa 0
Temporary Pole
Wiring, Rough O 1?7 r [_//��Q[.vn.iP
f- _ 4-.2(.-St• 3G a 4 v
Heating,Rough YV!C-5 ;44-..rd
H-ating, Final M/tS , - - .nze r✓ 7✓.e - /e7-/,J -.1/ /`sx c7 3 ✓
5 ewer, House 7' Sewer,St.m,%S b-2 rz-4 .S, I )/-J/„--,y (p 761/45-
Se-Fio Tank or Cesspool
I ng, Ini Out ���'.1 /-a3-Sr
Plastering Itrf'J 3-/ S7
Plumbing,Final,Fixtures Complete] 443 /r-s7 --_ _ --.1Plumbing,Final Gas Test/j- /y//¢S' /t/ if - .1'.<....-...7 I a <<
Wiring,Final JUN 3 Iy5 VC8 , -
Occupancy 4 ii-S .2 -J'$
FORM 210 3M 10.55
a Mesa Building Department APPLICATION FOR PERMIT
_�✓ ;,,_ 111 EAST 20th STREET egsc4 BUILDING 1
O' COSTA MESA, CALIFORNIA
Ie- FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. PermitvNo.
Building • 3 c ,/
Address 1206 Parnell Place
Costa Mesa, California Received by Date Rec'dDate Issued _
Nearest `1° /� —70 -c (or/ M —7/ `Ic
Cross St. Loren Lane Building
Address
Owner College Mesa Company Costa Mesa, California
Mail
Address 1777 W. Lincoln Avenue Nearest
Tel. Cross St.
City Anaheim No.KEY 3-3161 Zone I NPo.lansof I Type / Group
Architect or Lic. !/
Engineer Davis & Quigley No. C-1790 Approved
by Date
Address43 Malaga Cove Plaza,Palos Verdes CORRECTIONS
Contractor The Hale Company No,y LI°- 3422
Address 1777 W. Lincoln Ave. Anaheim
Legal I Lot I I
Description No. 168 Block Tract 2671
(Attach Metes and Bounds)
I No.of Bldgs.
Size of Lot 66 x 110 Nowon Lot None 0
Use ofNo.of No.of 70
Existing Bldg. I Families I Rooms A I)
Setback Line from Rear Yard 30 Z
Center of Street 60 Side Yard 7/6 y
DESCRIPTION OF WORK
New I X I Alteration I I Addition
0
Repair I I Moving I I Demolish
Building No.of
Size 1260 Rooms 6 Stories 1 0
Exterior WallI Roof
Covering Stucco Covering Shake APPROVALS IUse of
New
Foundation Location Inspector Date
Building g Single family dwelling with Forms,Materials,
attached garage. Under-Pinning w
Frame: Fire Stops, -O
Bracing,Bolts
I hereby acknowledge that I have read this Application O
and state that the above is correct and agree to comply Lath. Int. O
with all City Ordinances and State Laws regulating Al
building construction. Lath.Ext.
Signature of THE HALE __- ANY
Permittee l_:LJMY Plaster,Int.
Authorized Agt. Plaster,Ext. C
Valuation Permit Fee $ 26.00 Masonry Reinforced123
Plan Check $ 13.00 Bond Beam
$ 10,880.00 Total o
Fee $ 39.00 FINAL 0
FORM 204 S-BP 2M 6-55
d
C y
d _ J
o d
a`
•
.
•
•
• Street - _ `J •
PLOT PLAN
Show location and distances from •
a property line and between buildings.
--
H
O
0
•
•
p. •
0 .
o
III
9?
G1 r.:.
.
CD
OWNER JONES, MR. - DATE 2-13-59
JOB ADDRESS 1206 Parnell Place BUILDING PERMIT NO. 8623
GENERAL CONTRACTOR Fairway Lumber Co; VALUE $ 108.00-
. AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Redwood stake fence
UP TYPE ZONE PLAN NO. 862
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches Forms Steel i
Floor System
Steel Reinforce Chimney Re-Rod I In_
Bond Beam .ittl.
Frame and Flashing /1 .E EMI=
Lathing, In Out I.It- ' Mara •
Plaster, brown coat ,, i Ir . ®L— S
Underground soil WIG Pipe Test I' .I; P.' X ,.r/a' 4 / V r
Top Out <II I : ti 0,v Martal=ri.1
SWFurnace 1-2
Gas Vents —'d I /W' Ise/ / IIff
Rough Plumbing i ,fir „/ / IAV"
Cesspool Septic Tank `/ •.;i /
Prop. Swr. Line House Con. St. Swr. nig A /
Sprinkling System —f —
H^-ting Final —` ,v /
Sint Fixtures, Final / —
boat Gas Test /
Construction 'ole /
Underground Power /
Rough Wiring
Fixtures, Final
OCCUPANCY
Form 210-5M--1-57 8623
•
COSTA MESA BUILDING DEPARTMENT
P. 0. BOX 317 I 8623
r COSTA MESA CALIFORNIA
CI- OF STREET------ EEL REC
IVIED FOR APPLICANT TO FILL IN
BUILDING A DRES - + <i
c,J 1 �� ?LI' p �y� 10(c• i9Rlvel/ /'�/.
//�� PROP LINE 'i-E� OwNllgt` n-3>4V%-S .
l/ i --- --JI - - T - 12 FT. TINT�R FINE NCE LPT
10 FT. FOR 60 FT. STREET 50 FT. STREET CITY (F COST' MSI+ Mail Ages /•�o� �ti %��'
City (t%t/s' //L=�.q Ph. No. /
Contractor!%)/Q'1117 Al* a Ph. Na 4% /-O/C°
Address /l•}ia CC/1e ,gzi/i>S1P 'h in/ .5r t '
50 � i City Lic. No. /1 . / - State .clNo//Z.�,1•�'�.e,
OF PROP.
1- /o0
150 FT f� w cr Size of Lot AP Noecori�i g� R 'aeO-2/
1- WI I- Setbacks: C/L Street -�,or"# Rear •— 0 /I
m z y K _ {
LU _I a ts. Side Yard - Right '- Left •
r---- --- . a Type E 11 d 7�//rte 7r/
i- ----�—, d a of Fence 7LF alto
O ALLEY OR P OP, LINE\ lNI�� t al ij /.3f �p/4H�a ./S-C. ( yt/
1=--: .-�• •' . 1 - �„ --, i I hereby acknowledge that I have read this application and state
J co U.Z1 that the above is correct and agree to comply with all City Ord-
It N_rp �.';,... - inances and State Laws regulating building construction. '
Signature i" /f
�- ' ', /� 1 q 1 O of nater tea'1 �IUL" �z'^ r�? ?X..(�-Ei✓ 1/4/2 -
FT I LG/ .-
"; • i
L. , , Agent c4v rale:
c r U
37 6 IN. : ; 1— . i ?; 3 - i 4o i FOR OFFICE USE ONLY
FT. i 1�.� FI ` 15 FT
J �'_f Ci ; a I P rmit JNo.
z 14-i- - m i 8643
ce IE' 60 FT ST. Received by Date Received Date Issued
4 a •' 1 r ..--"V`-"A" /f ,17
I50 FT. ST. -'1 1 I
t PROP LINE t` - _ - - - VALUATION -co
\\\I- --r�---- �-- -- - - J Permit Fee $
0
m
I I $ /t! C12' Plan Check $
C.L. OF STREETS Ie'0
TOTAL FEE $
...._..-7,_.2„.•
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS