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Home My WebLink About961 PAULARINO AVE - Building Permits(714) 754-5273 • Fax (714) 754d856 • www.ci.coste-mesa.ca.us n FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT .lobAddress: 961 PAULARINOAV Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 41808110 Applicant: ELLIOTf, JAMES Address: 324 S EARLHAM ST ORANGE,CA Owner: OWEN, CLAIRE E TR Address 961 PAULARINOAVE Zoning: Phone: (714) 997-4936 Zip: 92669 Phone: COSTA MESA, CA Zip: 92626-2847 Contractor: ELLIOT ROOF MAINTENANCE AND INSPECTION SERVICES Address: 324 S EARLHAM ST ORANGE,CA Zip: 92669 Arth : Address: Phone: (714) 997-4938 License: 465344 Eng: Address: ISSUED BY: Status: ISSUED Applied: 11/12/2004 Issued: 11/12/2004 Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE: T/0 EXISTING CAL SHAKE ROOF, 1/2" CDX SHTG, 1 LAYER 30# FELT, APPLY "50-YEAR ELK ASPHALT SHINGLES." 1900 SQ FT Plan Check: $0.00 Permit: $153.25 SMIP Res: $0.76 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $154.01 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existin : 0 Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0-0 s�,sa�.00 $7,so7.00 INOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related I regutations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all required Inspectlons end tinel approvel musl be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5828 �� WORKERS' COMPENSATION DECLAflATION: . . . _ I hereby eliirm under penalry ot perjury one ot the tollowing declarations: � � ❑ I heve end wili maimein a cetlificete of consent to self-Insure for workers' compensation, es provided for 6y secllon 3700 0l Ihe Lebor Code, for Ihe peAormence of Ihe work for which this permit is Issued. , � I have entl will melntaln workers' compensetion insurence, es required by section 3700 of the Labor Cotle, lor Ihe Oerfortnance ot the work for which this permit Is issued. My workere' compe^satlon Insurence cartler end pollcy number ere: /I Carner: S�/f �1.' �4N%% Policy Number: O B O��/O �� UO �y (This section need nat be comp/ef�fle permif Is valued at one hundred dollars ($100) or less.) ❑ I certity thet in Ihe peAormence of lhe work for which Ihis permit is issuetl, I shall not employ any person In eny menner so es to become suhject to the workers' compensetlon laws of Celifomla, e�d egree that if I shoulA bacome subject to the workers' compensatlon proNSions ol Section 3700 of Ihe Labor Code, I shall forihwlt� comply with these �p is�iones. �1 / ApDlicant Siqneture:�l�"' j' �lT � oate: D�O��D ti WARNING: FAILURE TO SECURE WORKERS' �MPENSATION COVERAGE IS UNLAWFUL AND SMFLL SUBJECT AN EMPLOVER TO CRIMI PE TIES AND CIVIL FINES UP TOONE MUNDRED TIKKISANO WLUFE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAN.AGES AS PROVIOED FOR IN SECTION 3]O60F TME LABOR COOE, IMEREST, AND NTTORNEI^S FEES. LICENSED CONTRACTORS DECLARAnON: I hereby eNirtn ihat I am torce end eflact. Lic. N Contractor's Signature: ot Chapter 9(commencing with Section 7000) of Division 3 of the Business and class a c — Code, and my license Is in tull ' CONSTRUCTION LENDING AGENCY: '❑ I �ereby eNirm t�et ihere is e consWction lending agency for ihe performance of Ihe work br w�ich fhis pertnit is issuetl. (Sec. 3097, Civil Cotle). Lantlers Name: Lentler's Atldress: SignaNre: Date: OWNER-BUILOER OECLARATIONS: I hereby aHirtn the� untler penelty of perjury ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe fallowing reason (Sec. 7031.5, Business antl Prolesslons Code: Any city or county which requires a permit to consimct, alter, improve, tlemolish, or repeir eny stmcNre, prior to its issuance, also requires ihe applicam for such permit to file a slgned statement that he or she Is Ilce�setl pureuant lo lhe pmvisiorts ot the Contractors Lica�se Law (Chaptar 9(commencing with Section 700�) af Divislon 3 ot the Business end Professions Code) or Ihel he or she is exempt therefrom and Ihe basis lor ihe ellegad ezemption, Any violation of Saction 7031.5 by any epplicant for e permit sublecis ihe eppllcam to e civil penalty of not mora then tive hundred dollars ($500).): ❑ I, es owner of the pmperty, or my employees with weges as iheir sole compensetlon, WILL DO TME WORK, and ihe structure is not intended or otteretl tor sale (Sac. 7044, Business end Professions Cotle: The Contractors License Law tloes not epply to an owner of property who builtls or improves thereon, and who tloes such work himself o� herself or throuqh his or her own employees, provided that such improvements ere not Intended or oHeretl for sale. If, however, ihe builtling or Improvemenl Is sold within one year ol completion, the ownerbuilder will have ihe burden ol proving thel he or she did not builtl or improve lor purposa oi sale.). ' ❑ I, as owner of the properry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons�ruct Ihe project (Sec. 7044, Business end Professlons Cotle: The contractors License Lew does not epply to an owner of propeny who bulltls or Impmves Ihereon, antl who contrecis for such project with e comractor(s) license pursuant to the Contractors License Laws.). ❑ I am exampt untler sec. Business entl Professions Code for this reeson: Signature: Date: Owner I� verilied by tlrivefs license. ❑ Yes ❑ No Onvers License No. Expires: Vedfication of Owners�ip by (typa ol document, i.e. - property tac bill or daed): DIVISION OF INOUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I �ereby certity �het no axcavation tl�e (5) or more feet in depth into which e person is requiretl �o tlescend, will be made in wnnection with work au�horizetl by this permit, antl that no building sWctu(e, scaHaltli�, talsework, or demWition or tlismantling thereW, will be more than lhirty-six (36) teet higfi. (Chap. 32, Grp 2, A6 2, Sec. 341, 7tle B, CalHomla Adminisiretive Cotle). ❑ As ownerbuilder, I will not employ enyone to do work which would require e permit Irom the Division of Intlustriel Safery, es noted eDove, unless such person hes e pertnit to do such work irom t�e tliv�sion. Signeture: Date: Division of Industriai Sefety Permit Number: CER71FlCA7E OF COMPLIANCE AND AUTMORIIATON OF EMAY: I cenity under penairy ot perjury that I �ave read this application and sta�e that ihe inlormatlon given is correct. I agree to wmply wlth ell stete Idws and city ordinances relating ro bulltling constructlon, antl authodze representetives of the Ciry of Coste Mesa to enter upon the above-descnbed D�operty for inspection puryoses. I agree not to acupy or ellow occupency ot any building authonzed by this pertnit uNil final inspection. � Signature O egal Owner{c)- �� AnNOr Autpo�ied Applicam CODE �• INSPEGTIONTYPE 1676 Fixetl System Final Fira Preventian 1266 Pool Spa Pinel 200 Finel Re-Rool 201 Finel BIocWRetaining Wall 202 Finel Fectory Fire Place 203 Final Sign 204 Finel Demolition �. i w�_ . ��",�Q�'t, `-�iSf�U�� CQOE I INSYECTION TYPE 206 Final Mechanical 20B Final Plumbing 210 Finel Electncal 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 Finel Building/Occupancy GAIE It�LS (714) 754-5273 • F� (714) 754-4856 • wv+w.ci.costa-mesa.ca.us BUILDING PERMIT Job nddress: 961 PAULARINO AV Suite: Vicinity: ROOF Parcel Number: 41808110 Zoning: Applicant: ELLIOT, JIM Address: 324 S EARLHAM ST - � - - " - ' ., -Phone: (714) 997=4938 ORANGE, CA , - , ' Zlp: 92669 Owner: OWEN, CLAIRE E TR Address 961 PAULARINO AVE � Phone: COSTA MESA, CA Zip: 9262G2847 Contracror: 'ELLIOT ROOF MAINTENANCE Address: � 324 S EARLHAM ST . , . Phone:. � p14) 997�938 ORANGE,CA 2ip: 92669 : License: 465344 � Arch : Address: Zip: Phone: License: �� ' REPAIR ROOF. TEAR OFF 900 SF, B.U.A. ROOFING ONEPLY. GRAVLAR SURPACING. DOES NOT INCLUDE GARAGE. � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $83.25 $0.50 $0.00 $0.00 $0.00 $83.75 _ SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front �0-0 PARKING Existinq: o NOTES: � Eng: Addre55: 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/08/2002 Issued: 04/08/2002 ISSUED BY: . - , - � , Phone: �� License: :mll _ SURFACING'AND RE-ROOF USING A DIBITEN FEE SUMMARY ' � � PLANNING & ZONING Rear 0- 0 Rear 0- 0 Required: 0 Calc Valuation: Claim Valuation: Left 0- 0 Right 0- 0-� , Left 0- 0 �� Right - 0- 0 . , Proposed: 0 � ' s2,osa.00 s2,o9a.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21•92) EXPIRATION: This permit shall automatically expire and become vold if work is not commenced within 180 days, or ii work Is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspaetione and Iinal approvel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 +aa+a twu� WORKER'$' COMP�cNSATION DECLARATION: � � I hereby aHirtn under penalry of perjury ofre ol the tollowing declarations: ❑ I have entl wlll melnteln a certiflcate of wnsent to selFlnsure for workers' compensetion, es provided tor by section 3700 of the Lebor Code, for the peAortnence W ihe work tor which this pertnit Is issued. �I have and wlll maintain workers' compensatlon insu2nce, as required by section 3700 of the Lebor Cotle, for the peAortnance of Ne work for which ihis permlt is issued. My workers' compensation sura cer.ri�fe—r end� p�^ollcy number ere: �� Carrier. � �� T—V 1 1� policy Number: O'�� (1'h!s secNon need not�mp/eretl i/ the permitls velued ef one hundred dollers ($100) or /ess.J ❑ I certity that in the pertormence of t�e work tor whlch Nis permlt Is luued, I shell not emplay eny person in eny menner so es to become sub�ad ta the workers' compensatlon laws ol Califomia, and agree thet If I shoultl 6ecome sub�ect to lhe workers' compensation provlsions ol Sectlon 37 of t�e Le6or Code, I s�alllorthwlih camply with these pro�v ion�s,. ` Q- A�pplicen(S�ignewra� v"-'o-� �� i Dete: � Ol(� � WARNING�. FAILURE TO $ECUFE WORKERS' COMPENSATIIXJ COVEMGE IS UNIAWFUL AND SHALL $UflIECT AN EMPLOVER TO CRIMINAL PENA�TIES AND CIVIL FlNES UP TOONE HUNORED THOUSPND OOLLARE (5100,000), IN ADDIiION TO THE WST OF COMPENSATION, DAMNGES AS PROVIDEO FOR IN SECTION 3106 OF THE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: . I hereb aMirm ihat I am licens yder o s C a ter 9 commencin with SecNon 7000 of Division 3 of ihe Business an rof ode, entl m license Is in lull force nd.eNect..Lic_#>- (O� P 9 ' �less,p �-�� Y �� co vactor's�signature:-- �.+.. lr.L ate: n 2�_ .: .�. �-��-�- � �` - � - 2 CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm ihat there is e construction lentling egenty tor Ihe pertortnance ol tha work for which ihls parmit is issued. (Sec. 3097, Civil Catle). Lendafs Name: LentleYs Atltlress: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby eNirm that under penalry of perjury thei I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Professlons Cotle: Any ciry or county which requires e parmit to construct, alter, Improve, tlemolish, or repair eny sWCWre, prior lo Its issuance, elso requlres the applicant for such pertnit ta file a signed statemem Ihet he or she is licensed pursuem to the provisions of tha Cantrectors License Lew (Chepter 9(cammencing wlth Section 7000) of Division 3 of Ihe Business and Professions Code) or that �e or sha is e:empt therefrom and Ihe basis for the ellegetl exemptioa Any violation of Section 7031.5 Dy any epplicant for a pertnit subjects t�e applicant to a civil panalry of not more than five huntlred dollers ($500�.): ❑ I, es owner ot the property, or my employees with wages as Ihelr sole compensation, WILL DO THE WORK, en0 the sWcture Is not Intended or oHeretl tor sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does nol apply to an owner of property who builds or improves Ihereon, end who does such work himself or herself or through his or her own employees, provided ihat such improvemenis ere not intendetl or oNered tor sale. If, however, the buildinq or improvement is sold within ona yeer ot completion, the owner-builder will have the burden of proving thet he or she did not build or improve for purpose of sale.). ❑ I, as owner of lhe properry, am EXCLUSIVELV CONTRACTiNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The conirectors lJcense Law does not eppy to en owner of pmperty who builds or improves ihereon, antl who contracts tor such project with a coniracror(5) licensa pursuant to ihe Contractors License Laws.). ❑ I am exempt untler sec. SigneNre: Owner ID veritied by drivers liCense. ❑ Ves ❑ No Business antl Profeuions Coda for this reason: Venfication of Ownership by (rype of daumeni, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: Drivefs License No. Date: Expires: ❑ I hereby ceNiy thet no excavation five (5) or more feet in dapth into which e person is requlred to descen0, will be metle In connection wllh work euthorizetl by ihis permit, and Iha� no building structura, scattolding, lelsawork, or demolition or dismantling Iheraof, will be more Ihen thirty-six (36) teet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Title 8, Celifomie Adminisiretive Cade). ❑ As owner-builder, I wlll not employ enyone to da wark which would require a pertnit Irom the Division ot Intlustrlel Safery, es noted ebava, unless suc� person hes e permit to do such work from ihe division. Signature: Date: Divislon ol Industriel Selery Pertnit Number: CERTFICATE OF COMPLIANCE AND AUiHORIIATION OF ENTSiV: I certify under penalry of perjury that I heve read ihis epplication and state ihet the information given is correct. I egree to comply with ell s;ete lews end ciry ortlinences relating to bullCing conswction, end authodze representatives of t�e Ciry oi Costa Mesa to eNer upon the ebove-descnbed praperty tor inspedion purposes. I egree not to occupy or allow occupency of any building euthorized by this permit until tinel inspection. CODE �. INSPECTIONTYPE 1616 Fixed System Final Flre Preventlon 1266 Pool Spe Final 200 Finel Re-Roof 201 Finel Block/ReteinlnB Weli 202 203 204 Final Fectory Fire Place Finel Sign Finel Demolition PdIE 1NiIIISLS ti"iI_ CZ, �i COOE 1 INSPECTION TYPE 208 Final Mechenical 208 Finel Plumhing 210 Finel Electdcel 212 Finel Fire Preventlon 220 Final Planning Approvel 222 Finel Site 250 FinelBuilding/Occupancy � It� CITY UF COSTA MESA CALIFORNIA P.O. BOX �12Q0 FROM THE OFFICE OF THE PLANNING DEPARTMENT Jonuaty 25, 1967 O�+noro of Lote 1, 2 and 3 Trc�ct. 5442 The City of Costa Mesa wishes to advise you that in revising street addresses, the nimibers listed belaa were changed: Lat 1, Yroct 54G2 2 3 01d Address 9B1 Ptnlarioo Avenun 965 ?anlnrino Ai�eaue 4G7 Paularino Av�nuc New Address 965 Paulnrino hvanua 967 Pmulariuo h9er�uo 969 Paulasino AVeauo For your convenience we are listing the agencies belva that we will notify of this change. In addition to those listed, you may desire to notify your correspondents of the change. rlb cc: Your cooperation in this matter is appreciated. Southern Calif. Edison Co. Southern Co. Gas Co. Costa Mesa Co. Water Dist. Pacific Telephone U. S. Post Office County Clerk (4) Public Works I�pt. Engineering I�pt/ Bldg. Safety Street Fi le Pacific Facility Test Center Bond Departrnent Very truly yours, W. L. Dunn Director of P1arvLing By : //1 ��.� Planning Technician CITY OF COSTA MESA CALIFORNIA P.O. BOX �Q�2�0 FROM THE OFFICE OF THE PLANNING DEPARTMENT F@fl• .W� 29�% Orner� c1 lote 1� 2, me 3 uF 2'ract ShL2 963 �u�ersao avem,e The City of Costa Mesa wishes to advise you that in revising street addresses, the nwnbers listed belaa were changed: Old Address Lctt 1, '4aoL 5�2 9bS P+n►lerin0 Ave. Q �� ., �� . �� O II �^ q n 3, y�� N N New Address 9�1 Paulersuo ave. N6.^� O p 'Ii �i1 9 O r 9°+9 <� 4 For your convenience we are listing the agencies belaa that we will notify of this change. In addition to those listed, you may desire to notify your correspondents of the change. Your cooperation in this matter is appreciated. Very truly yours, W. L. Ihmn Director of Plarviing � rlb cc: Southern Calif. Edison Co. Southern Co. Gas Co. Costa Mesa Co. Water Dist. Pacific Telephone U. S. Post Office County Clerk (4) Public Works Dept. Engineering Dep� Bldg. Safety Street File Pacific Facility Test Center Bond Depax�tent Planning Technician � ,, �„ �, � _ ... _ �. _._ .....------ ` . i � � � _I __ ,� . .. �_-------- ,�>,,, i/!. ; ! ; l/:1- U i r' ,;,.''. � :-:;.: ;, i ,,:.,:�.I , - I` �� 9�i'.i i 979 i�%7'� i r;;�) 'i ,. I ; � ,: :, :; ;`� C�� i (' ) 1 '�.J �. � ' � �- - . � . : :'.;`i;.�j�-I,.,. r ; ,. , ;. . ., ;� � . , �" ; \� ; C,� :�- �..� � � � . _ _ ,} ��,,, �,� ;, . ' .� �,. ;� . ,.f; ,. � �:: � � �; � � ::i . �� . �, � I�%�-1 r+�.ln n.::�:v� .. . . 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"' � , ,;:.. � . `,s.,,,r F' �. ,�: � 'n �I ` l :li(1 .. �9 I �,,.>' :., ' ;;�.i �;�I. ;.'/ iJ /'JI '/'1 :a�:i�.i_.,1�,'.�� ..i_ 1.� . ,..:.�. . .n' . ....�....._.. ...... . . . . .. .. ..., . . ....�.. ... ...... ,. .. ' ' " i"J -!)%i.1 '- i.s'I' . �.� � C_ � .i �� ... :�� :�� ,; ,.��,- :� � ., , �,{; E �;�,,, -1.2J AC. ..._...._......_...... .,... . --.... .._ ..... . ..,..... _ . .. . .. - ;:r. -' . • . r,�_..,�.� _..-.-. .r.�•...... . .. . —. . -. — ---r-- i � ,!:� � „ � , ". � ! i , i`..i + ,J ' ,.:o' I ..a.,' <.. ' _ _ _._"_. I ..._._"._ . . "_ _7`' ._'__ z I �'�' � „ z� � �. 1. U/ dC. •J ' I I i vv-ca�v��.��;.r..., �s+. ... , .,. . . 's't. , ?:"�""�.":? x.. : : �345a FE� RECEIVE� COSTA MESA BUILDING-SAFETY DEPARTMEMT �� JAN 2 7 1865 ��A.O,BOS9f� COHTAME9A,CALIFORNIA � ��{i FINAhCE DEPT. � �¢ ��r � �� Fo� Applicant to Fill In Complefely J,(i �/ i4PPLICA 10 F S RSA TYP OR PRINT �a BUILDING / For Offlca Use Only AODRES9 � /� y l l�E 11[C[IITNO. PHNMIT COSTA MESA. CALIFORNIA Z3�I R[C[IV � OA [_1R7[y p DA[6I�Bi r ( H l_ J OWNER ST / _ S � `� OiIY �}� � AODRE88 . � IY .S- J ADDR6�H9 ( � �U �� l�v * O PIRH I / I TEL. 9[]NP_ TVPE GR�I1P � - ZON(NG � AOORE98 .S'.S- ) � ✓</ ZON[,� � NO.O� V680IN6W � �^ � �lANO GYILDIN CONTRACTOR o a /� O `�' LCO�L y�'l � / D88CRIIlION '�'� AODRE88 '� ' c/ � / � / A. P. NO. I�'� 1• CITY � L' ^ NOTE: NO EAVE OVERHANO BHALL BH LE59 THAN STATE TEL 90' TO BIDE @ REAR P. L. LIC. NO. � � NO. � J EAVEB OFLOT�.%- y� Dp � hO.o�e�00e. /� ALLOWED (U.B.C.REQUIREM6NT) NOW ONIAT L/ YARD9APPROVHD YARDSAPPROVE� USE OF MAIN BUILDINQ ACCE980RY BUILDIN6 EXISTING �LDG. (FROM GLSTRE8T�1� /��"� � BHTBACN LINB FHOM / µ/yvr�v CBNTBa Op qTRHQT ,) REAR YARD . �L V FRONT Pf. FT. � / i( SI�HYARDI L6PT '/U,I RIOHT 1�" R.BID6 FT. �/ A'. /1 DESCRIPTION OF WORK L. SID �. Fr. , NEW � ALTHRATION��—I ADDITION REAR �� FT. �, tT. 1 DIHTANCE BET. BET. MAIN B REPAIR MOVIN6 I DEMOLISH MAIN BLDG3. ACCE95. BLO09. BUILDIN6 NO.OP / VAR.$C OATE SIZE ROOMS �j BTORIE$ �- C.V.P. APPROVED EXTERIOR WALL ROOF / APPROVH ~ GOVERIN4 5'T�CcJ ( COVERINO OOc(. 8 � DATE �/�� U8fi OF 6UILOfNC AND WORK TO BE PfiRFORMHD S ' L �. .!. - _.li,li��vn ac.�r �-- a7�'� � �� w � /= �'�Q /I/ �� .. c'lo. Rr. / o I HEHEBY ACKNOWLCDO6 THAT 1 MAV6 qBAD TN19 APPLIC/�TIOH TM� AMOUNT 9HOWN UNOHq VALUATION IB POH THH S �NO 9TAT8 TryAT TM8 ABOV[ ID CORHECi ANO AOqlE TO COM� PUflP088 01� 88TABL19HIN0 A PBHMIT R88 ONLY. Q PLY WITH ALL CITY OHDINANCU �HG YTI�Tt L�W9 HtOU TINO ypLUAT10N aUILDINa GpryBTHUR�ON. pERM1T FEE // SIONATUREOP ' f� � �"� PERMITfE -�Y �(% i ,//�ZjZ / �/,(/ m S�I !/0 /— � c• 1 0 AUTHORI;�D A6ENT �y � TOTALREB