HomeMy WebLinkAbout514 PIERPONT DR - Building Permits(�ia) �sa-sz�a • Fax pia� �sa-aess
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
CITY OF COSTA MESA �
BlIILD/NG D/VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
514 PIERPONT DR
41803313
RON
Address: W/ NOCK PLUMBING
Owner: FISCHER, MARION M
Address 514 PIERPONT DR
COSTA MESA,CA
Contractor: NOCK PLUMBING
Address: 11612 KNOTT ST
ArchlEng:
Address:
GARDEN GROVE . CA
INSTALL NEW WATER HEATER
ISSUE FEE
Backflow irrigation
Backflow Preventer.
Bathtub
Clarifier System
Connect pce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
AMT
szz.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
PLUMBING PERMIT
Phone: 714-895-1246
2ip:
Phone:
Zip: 92626
Phone: 714 895-1246
Zip: 92841
License: 707775
Phone:
2ip:
License:
SCOPE OF PERMIT
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trep $0.00
Pressure Regulator $0.00
Process Piping (per 10 k) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen - $0.00
Sink, service/mop $0.00
Spa (private) So.Oo
Spa (public) $0.00
Qn
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
���
PERMIT NUMBER
P98-00831
77 FAIR DRNE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 11/09/1998
Issued: 17/09/1998
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1�)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
water Service
Water Sokener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCULATED FEES:
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$11.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$33.00
Qn
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned
for a period of 180 days. .
INSPECTIONS: In order for the work authorizetl untler this permit to be considered legal, such work must comply with all applicable codes, and all
required inspectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
V
WORKERS' COMPENSATION DECLARATION: —
I hereby attirm under penaly ot perjury one ot the tollowing decleretions:
❑ I heve and wll6meintdln a certificete of consant to self-Insure tor workers' compensatlon, es pmvitled tor by section 3700 oi the Lebor Cotle, for ihe pertormence ot lha
� w./ork for w�ich Ihis pBrtnit is issuetl.
�,{/i nave antl will meintain workers' compensation insurance, es raquiretl �y section 3700 of �he Lebor Code, tor the pedortnance oi ihe woB For which this permit is issued.
My workers' compenSation Insurance cartier enA pollcy number are:
Cartier. � P> U%%� �J r."L� Policy NumDer: � UX'J�/- 7S 3 y �O �Z
(This section neeC nof be oompleted i! the perm/t is va/ued ef one hundred dollers ($100) or IesS.J
❑ I certily Met in Me per(ortnance o( Ihe work (or which Ihis pertnif is issued, 1 shell noi employ eny person in any manner so es fo become sublecf fo ihe workers'
compensation lews o� Calitomle, entl egree that II I shoultl become subJect to the workers' cnmpensetion pmvlslons of Sectlon 3700 of the Labor Cotle, I shell forthwith
comply wit� t�ese provisions. SY
Applicant Siqnature: �{\ 1--�� Data: //—/ z--
WAFiNING: FAILURE TO SECUpE WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SHP1L SUBIECT lW EMPLOVEfl TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
hKK1SAND DOLLARE (5100.00p), IN ADDf710N TO THE COS� OF CqAPENSATIqJ, DMMGES PS PROVIDED FOR IN SECfION 7N8 OF THE UBOR CODE, INTEREST, PND ATTORNEY'S FEES.
LICENSED CONTRACTOpS DECLARATION:
I hereby aflirtn thet I em Iicensed untler rovisions of Chepte mmencing wlih Section 7000) oi Dlvision 3 of t�e Business and Prafess'ur.s Code, and my license is in full
force and eXect. Lic. p ��—� `%% 7 � Cless p G 3�
Contractors Signature: __`� � �—�—� � Date: //-i 2_—
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn Ihet Ihere is a consVuction lending egency tor the peAortnence of the work tor which this permit is issued. (Sec. 3097, Clvil Code).
Lentlefs Name: Lentlefs Atldress:
SignaWre: Date:
OWNER-BUILDER DECLqRqTIONS:
I hereby aHirtn ihet untler penalry of perjury thet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or counry which requires a partnit to construct, elier, Improve, tlomolish, or repair eny structure, pnor to its issuance, also requires the applicam tor such pertnit
ta lile a signed statement thet he or she Is IlcenseA pursuant to the provisions ol the Gontredore License Lew (Chapter 9(commencing with Section 7000) oi Division 3 of the
Business and Profeuions Code) or Ihat he or she is exempt theretmm and Iho basis for Ihe allegad exemption. Any violatlon oi Section 7031.5 by any applicant tor a pertnit
subjects ihe epplicent ro e biv�l penelry ol not mora then tive hundred dollars ($500�.):
❑ I, es owner ol the properry, or my employees wlth weges es Iheir sole oompensation, WILL DO THE WORK, and the sWcture is not intentled or oHereU for sala (Sec.
7044, Business and Professions Code: The Contrectors Ucense Lew doas not appty to en ownar ot properry who builds or impmves thereon, and who does such work
hlmsalf or hersell or ihrough hls or har own employee9, prOvitled thet such Improvemenls ere not intendetl or offereA lar sale. If, however, Ihe building or Improvement is
sald within one year of completion, the owner-builtler will have ihe burden oi praving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of ihe D�oparty, em EXCLUSIVELY CONTRACTNG WITM LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business end Professions
Code: The con�rectors License Lew tloes noi apply �o an owner of pmperry who bullds or Improves Ihereon, antl who conirects for such project with a coniractor(s)
license pursuent to the Contrectors License LewsJ.
❑ I am e:empt untler spc.
Signature:
Owner ID verified by tlriver`s licen5e. ❑ Ves ❑ No
Business enA Protessions Code lor ihis reason:
Vedficetion oi Ownership by (rype oi document, i.e. - propeny tex bill or deed):
DIY7SION OF INDU57RIAL SAFETY PEHMR CERTIFICATION:
Driver's License No.
Date:
Expires:
❑ I hereby ceNfy Ihat no e:cavetion Ilve (5) or more teet In tlepth into which a parson is requiretl to descend, wlll be matle in connection with work euthorizetl by 1Ns
permit, antl Ihet no b�iltling structure, ecettolding, felsework, or demolitlon or Aismantling thereof, will be more then thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celifornie Adminisiretive Cotle).
❑ As owner-bullder, I will not employ enyone to do work which would requiro a pertnit irom the Dlvision of Indusirlel Setery, as noted ebove, unless such person has a
pertnit to do such work iram the division.
SignaWre: Date:
Dlvision of Indusinel Sefery Pertnit Number:
CERTIFlCATE OP COMPUqNCE AND AllTNOFiVATON OF EMRY: I certity under penalty o( perjury that I have read this application arW state that the intormation given is
correct. I agree to comply wit� all stete laws antl ciry ordinences relating to building construction, end authorize representatives oi the Ciry of Costa Mesa to enter upon the
above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any builtling authorized by ihis pertnit wtil tinal inspection.
Signeiure OI Legel Oaner(s)
And/Or Aulhonzed Applicant
COOE I. INPVECTIONTYVE
1616 Fixed Syslem Fi�el Fire Prevention
1266 Pool Spe Finel
200 Final Re-Root
201 Finel BlocklRetaining Well
202 Finel Factory Fir� place
203 Final Sign
204 Finel Demolitlon
2446-46
��
�� �QpQ,( INSVEC110NTYPE
206 Finel Mecheniwl
20B Final Plumbing
210 Finel ElecMcal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Si�e
250 Final Building/Occupancy
QAg URIDdLS
� � • �
Pf0.1Eti AOOPESS: S 1�I P I ERPONI' DR
OWNEP'SNAME: FISCHER JOHN G
aooeess: 519 PIE{tPONT DR
COSTA MESA,CA 92627
NBCHIENGINEEB:
ADONESS:
HEG.NO.:
IINIT:
UNIT:
PEflMITTEE: ALL—COAST ROOFING ( 714 ) 650-2244
FDOflE55: '2SO7 WALLACE AV
&O�T�� �1F�SA CA, 92E��7
LILENSEo CONTflACTO OE 10 here�y affirm I�a1 I am Iicense0 untler pmvisions of aD�e� 9lcammencing wiN Section
7000� oi Dirsion 3 al �he Business anG Pmlessions Coae. an0 my license is in Iu0 tarce anA efiecl.
CITY LIL.: ///���G STATE LIC.: ClASS: i n�
192 598440 C39 ����
Date: ��.�.— Signa�ure: _ _ _(J��—�
WOflNEBS' COMPENSA�ION DECLAHATION: I ACreDy a�lirm Iha� I M1ave a Cetl ale a� tonSeni io Sell�in5ure or a te�i�itaie o� Workers'
Compensaiion Insurance. or a cenifie0 copY �he�eol ISec�ion 3800. La� CI.
POLICY NO.: E%P. ORTE:
COMPANY:
❑ C¢riilietl capy is �ereby Iumi5�e0. ❑ C¢tlilied tapy is �ile� wi(h �he Ciiy BuilCinp Divisi0n.
.e: Applicant:
E%EMPTION FBOM WOPKENS' COMPENSATION OECIAMTION: (TNs sectqn nee0 no� GE comDlNeG il Ihe permi a la ane hmbrM (510U) or kss�.
I[emty Ihat in ihe Oetlormance oi t�e work lar wlii�� I�iS permi� is issuea. I S�all nol ¢mpip/JQy pp{son m any manner w as to E¢come
Subleci lo �he W rkers' ompensa�ion Laws al Califomia ��� �{ II/ /
i i�� i
Oacer � Siqnamre: �-�`--
NOTICE: I, after aking ihis declaralion, you shoule G¢come suEiect t 11 . Workeri ComOensation pmvi9ons af ihe labOr
CaOe. yau mus� tarlhwiih compty wilh such provisions or I�is Oermii s �e tleemeA revokeU.
CONSTflUC71oN LENDING AGENCY: I nere�y affirm Nat �neB is a wnstmction lenaing apency for tAe pedormdnce of the work for
which �hrs oermitis issue0 �Section 3097. Gv. q.
LENUEN:
RODflESS:
OWNEP BOII�EB UECLABATION: I her¢�y a��irm �Aat I am exemp� Imm �Ae COn�ratlOrs' S�ate License Law �or I�e lollowing reason
(Section 7Q3L5 Business an0 Pmlessional CoUe: Any ci�y of county whicb repuires a permit ta consimci, alteL imprOve, Oemolish, or
reOalr any slmclure, D�ior �o its issuance. also repuires tAe apD�icant lor suc� permit to lile a signetl statemem t�at Ae/she is licensed
pursuani Io I�e provisions ol ihe ContracloK Stale License Law (Chapter 9(commencing wiih Seclion 7000) ol Division 3 of Ihe Business
ane Pmlessions Code) ar that he/she is exempt iherelmm an0 I�e basis lor t�e alleqetl exemption. Any violation ot Section 7031.5 hy
any applicam 1or a permit Suble��s IAe aDPlicanl Ia a civil p¢natly ol no� more I�an �ive AundreE d011ar5 (E500).
I, as owner ol ihe pmpeny or my employees wi�� waqes as Iheir sole compensa�ion, will tlo the work, and Ihe
❑ slmcWre is not inlendetl or ollered �or sale (Section 70aG. Business antl Pmlessional CoOe: ihe Camrac�ors' S�aie License Law
tloes not apply lo an owner ol a propeny who bmltls or im0�oves Ihereon, an0 wno tloes such work himsell/nerself or ihmugh
�is or �er own empldyees, provi0etl thal such impwvemenis are not intenaed or offere0 for sale. II, however Ihe builtling or
improvement is saltl wnhin one year ol completion, ihe owner will have Ihe hurtlen of pmving helshe di0 not bui10 or impmve
tor �he Durpose of salel.
' I, as awner ol Ihe pmOe�Y. am e�clusiveiy conimcting wi�h Iicense0 conlractors to constmct the pmject (Section 7044, Business
❑ antl Pm�essions COUe: The Coniractors' Siale License Law Oocs nol apply lo an owner of propetly who �uAas or impmves Ihereon
antl w�o tontracts lar 5ut� prole��5 wi�h a Canlrati0qs�liCense pursuanl �0 Ihe ConVaClOrs' Stale License Law�. I am aware
IAaI pmol oI Iheir Worker'S Compensalion in5uranre ShoNA 6e OmviDeO la me.
� I am exempi under Sec�ion: 0, 6 P. C.
br ihis reason:
�a�e'. Ownec
I �o hereoy cenily inat I am aware ol antl understanU Ihe reQuiremenis af Calilomia Healih anC Salety Coee Sections 2550.5, 25533, antl
2553A an0 inat I or any luture Uuilemg acupant wilVwitl nol �ci¢le one) neea lo comply wittl SdiO state co0es and the reQuiremenis for a
permil lai canstmction or moddica�ion Irom �he Aii Oualny Management Disiric�. flesiaen�ial con9mc�ion applica�ions are exempi Imm
Ih¢SC D�OVI51005.
oa�e: ADolicanc _
Ihereby tetldy IAdI I hav¢ reaa I�iS appliCa�iOn antl SlalelM1al Ihe
ordinanres and state laxs relating to builaing twsimclion an01rere1
propeny lorinsp°Cuon purpOses.
Dale: _ __%'�`a_L��l_j_— SiAnaiure: �
Driver'S 6ce � e ar Social $etuniy x:
I agree to camply vn�� all city antl coun�y
Ify�Uty �o enier upOn Ihe a�ve-meniionetl
i5q��a6 Wnne—Bwltlrt�g: Green—Cotle Enlorcemenf. Canary—ApO�iwn�; Pink—Revenue: oltlenrotl—Assessar
CITY OF COSTA MESA — HUILDING PERMZT PERM NU; B 05523
PERMIT NO: H 055236 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; INSTALL 20 YR FIBERGLASS SHINGLES O/COMP SQ FT; 2,100
CLAIM VALUE: 2,100.00 CALC—VALUE: 2,100.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR(S) RE�UIRED IN AOME, q�r�t �y�-�r *���
******�r��tx�t�r�+r�t��***�r*�e*�r*+t�** �r*�r*�r�t�t**�r*������*�t�t*�r�r�t�ru**�f�C lJC�li 1 L.�4'i
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- ------- ACCESSORY BUI���� � �
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PArZKING REQ• PAOV; PARCEL; 41803313 2NE; REF NO;
PLANNING Ni3TES>
> .
iE �E iE iF iF 3E iE iF iF iE�F if iE iE if iE iF 3E ik iE 3f 3f 3f iF if if if �f k 1F if it iP ik iE if iE iE �E �f iE iF iE iF iF%iE iF iF iF iE 3E )F jE if 1E If #F if iE iE fk iF 1E iE 1E iF if iF if 1E iE !f iE iF if if if 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE: ,
APPLICATION ISSUED BY• � DATE• ///
�t*�r�r********������*��t� *�r*�*�***�t�f�x*
iE�EiEiFiF�EiF1EiEiEiEifiEiEififififiFlEiflElEifiElE�FiElEifiEifitiE3F±f1E iEiF ifif�EiffFiElfiEififlfikiElfiklfiFiEif1E1E3EififiFiElEiEifif)E�firlflf#iF
LEGALIZATION:N F E E S M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54,00 ,SO
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 59.50 0.00 0,00 54.50 54,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 54,50 OVER/SHORT; ,00
BLD54P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT� GRADING PLAN—CHECK
iE iE jf ik iE iF if iF 1F 1F �E �E iE it iElf iF iF iFlf 1f 1f iF if iE k IE 1F iE iE If 1E �F iF iF if Ik fF N�iElE iE aE iE if IF 3E 1F fE k aF aF iP 1F iF 3E jF iE iEif iE iE if iF if iF if iE #� iF iF iE iE i4 * lE if af af
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
SFR 2100 REROOF BY VALUE RESIDENTZAL NOZONE 1,00 2,700,00
END OF FEES
. � � - = � : : . . :
�
-� �
.M. ;
� CONSTRUCTION AND PLANNING • POO�. A
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
, 1. Temporary Electrical Servic S_,r.Pole �,.� 52. Pool & Equipment Location - +
2. Soil Pipe-Undrgmd. w- 53. Steei Reinforcement ':
�
. 3.• Electrical Conduit LDlity-lfn�rgmd. ' 54. Forms
� 4. Electrical Conduit�Urfdrgrnd. 55. Electrical Bonding
5',StGel Reinforcentei[�t? 56. Rough Plumbing & Pressure Test
i 6. Electrical UFER Grntl. 57. APPROVAL TO COVER�GUNITE �
I' 7i �Footings ;�� -. 58. Eiectrical Conduit-Undrgrnd. �
8;� Foundation �_ `� 59. Gas Pipe, O Undrgrnd., Test l
� 9. Water Pipe-Undrgrnd. �• 60. Backwash �ines, P-Trap, O Undrgmd. �
�
10. Structural Floor System - 67. APPROVAL TO DECK ,
11. Property Sewer Line & HoUie.�onnection 62. Backwash & Receptor�Final '�
12. Sewer Cap '�' _ ,
. 63. Heater & Vent-Final
13. Roof Drains - .-. .� 64. Plumbing System - Pinal `-' '�
14. Rough Plumbing . . 65. Electrical-Final '
15. Rough Electrical,Conduit 66. Soiar System-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval .
17. Reugh Wiring Qign 68. APPROVED FOR P�ASTERING �
18. Rough Electrical;T Bar Ceiling 69. POOUSPA SYSTEMS FINA�
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - t.- ,
20. Roug"h FactorY Fir.eplace � •� �-" � ' •� + AppROVA'LS� "' Rermft # ?�
� .� ?. . � .\ �• . S .♦ . x . J - k t
2L;Ducts,inStruLturej; ' -, `� � ' � ; " +� ' ��, � ' `�
_ ,. i0. Undergroupd- ydro .
22. Ducts, Ventilating - •_. _ �� � q7, Product Piding �`Ga5 ❑Oil
23. Gas'Pipe-'Rough &'Yest . , " - . 72. Underground Flush: - - �
24. Roof Framing� �•%� � • � 73.'Undergmd?Storag�'Ja�nk OGas �OOT
25. Roof ShCathing � _ �" ' �� ' _ '� � � �q,��Rrhead F;ydro; � .
26. T-BanCeiling (Structural) & Monocoat �- �' _ � � • 75.cDry Chemical ' - - '•�'
27. FrameandFlashin�g, '.u.,: ' _ - . � 76. D'ryStandgipe ,. � ' ' -
�28. Lath�ng & Siding� •! . r s • •• • � . 77; -FIXED SYSTEM�INAL� "
29. Insulation , . �'� � ...• �• . ��� ; . 78.yFIRE PREV. FINAL Y . � �.
_ ,
.30.DrywallNailipg --� � , . :i: e HEALTHDEPT.REQUIREMENT
37. Plaster Brown Coa,� �, ; , 79. •FINAL IN.$P,ECTIQN - - „
r
� 32. ElectricalPower Meeer-Final � ` � - � ' y � �� .80. +f00D CERTIFICATE ISSUED ! �
33. Final Electric '' � � ' �� � 'Notes: - `
�34. Fina� Heating _& Air Conditioping,. � � � �, �. . _. ; - � � _ - -
35. ,Einal Gas Pipe-Tesi t"'- • ` ' • ' '� ' _
�i.:'
�36. Nood or CanoPY j 1 � . � ':� t . ., ,
. �e> F
w
37. •Final Fac[ory FireplBce _ ' � �' ` %�` ' ' ,
1 � � �x' r
� 1
38. Final Plumbing . �� �� � . � ' �� � . . '
"39. Watei Service-Final • � ! � ' - ' 1
n i . �
',40. Gas Service-Final , . �� ` � ' �
, . ,. ' . . � . , .
:41. Solar pomesNcFinal � � + '_ � � • ` �
,f � , a
� '42.�Backflow�Preventer� , , , � . `
43. Backflow Irrigation � ' � '+ • ` '}. . -
i. .-
•l F ' � • f �
,44. Landscape IrRigation System, . - , � L - -. -a ,.
45. Sound Attenuation ' ' - - � �
� � .( •
46. �Handicap Regulations , � � .j- � • - � ,
47. FINAL STRUCTURE & BUILDING S 4 fL -�` �
48.'FINAL PLANN�NG � . '.� . ' .
' 49. Electric Release to Edison : , . , • `
, i� i
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF �CCUPANCY . . ,. - . . , �-
No. Date
UrvNtK
DATE 1-1
BUILDING PERMIT N0.
AP No. LOT TRACT FIRE ZONE VALUE
V °.CTIONS Si n �re Dare GROUP I& J TYPE
�As � � _�� SUBCONTRACTOR
PROP. SWR.
SPRINKLING
ROUGH HEATING AND AIR CON�ITIONING
TEMPORARV SER�ICE OR POLE
UNOERGROUND ❑ POWER �
ROUGH wIRING
REINF.
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