HomeMy WebLinkAbout285 PRINCETON DR - Building PermitsTO WHOM IT MAY CONCERP7i
Ret Property at 285 Princeton Driv
Marci�l��y 1975
y
e�v
Y
The enclosed breezeway, which also may be called a room addition
has been made to conform to all code requirements. Also the
patio cover at the above ad ss also meets code provisions.
�
RDHicb
RICHAR6;;D. HANHART
Building Safety Director
«.,
f�
I
�
� �noncssaremim+o: 285 PRINCETOri DR
owxexswweica+w�m: SABALA RONALD G
�onnEss: 285 PR'INCETON DR
COSTA MESA,CA 92626
545-0095
IVPL. Y.UWNi ADDIIE54:
YICXRECTOPENtlMffA: t1Glq.:
uNr:
Cll 011 ENO.'8 AOORE55: UNT:
c«+m�cTarswu� CHAMPION ROOFING ( 213 ) 259-0451
CONfPAC10A5YY11Nfi 3257 VERDUGO
�op�: L.A. CA ��.: 429981
9 0 0 6 5 �,,,,
LICENSED COMRRCTOPS DECL�flRTION: I Mreby eRrm uMer peraXy d perjury Nm I em Icaiusd uMx pm�eima d Cheqx 9
(�m.�a .,nn s«i� �000) a o�o� a w� a�� �e vw�.�, cae,. ,�a mr u�.o o� mn �„�a,rtea.
cmuc.No.:042725 uc.cuss: C-39 uc.No 429481 • P: 00/00
otl,: � %/ 9��i/ �� . .
OWNEN BUILDEN OECIANATION: I hareW elfiim unEer pen y of 0 ury Ihet I em evamq from Ihe aNr Licanee law tor IM
Idbwiq iees�n 1�� l0.'11.5 Buaima enE Rdmaiap ciY a county whid� npuirte e canWc�. Mx.'vnpwe.
e.mden, a reo� a,y swcwe, w+« io as :.�, emo �aw�e. ma erW�,� m, eucn ve�w m r�.. ��oa.wa�em mm ne v.ne
a ik,��a wo��,� io me wo.��o�� a ma com,ae«s u�,.a �. [CheWer e(comme��p wnh Seaion )0001 d D'vinion J d �M
Buainesa eM Prolesaiona Caie� or ihe� ha a eha e examq ih>ehom end ihe ba6s Iw the elbpaA aaemqion. My violmion ai Saenn
]mt.s W em� epqimni r« a o�u wqees �he epdceni io. civi� oere�ry a na maa �nm� fxe huMree ad�en �Ssoop.
� I. es avmer M tM P�Po�Y or mY+mObY�a �h wepes m �hei wle oompanaelion, will Eo IM xo�lc. eM tlw etulurt o irot inlaWed
or oRereC br ede (Seciion J01�. Bwinea vM PMevabna Code: The Comrmon limnae lawdaea rwt epplyto en owmrot property
who buiM a inqwee �M1ereon. md Wo Eom auch wwk Nmdt a MneY aWaph �e a har own emplvyeea. pwided the� wM
�mw�ma,�e are na �m�d «aruae i« aw. n. no..e.�.. ma w�knq a mpw,mem'm.w .nw� o�. r.., d�W�i�. m.
owiwr-builder xill have the W Nen d provinB he or aha d'N rwl Wiltl w improve for iM W�e d aeb).
� I, d ox�w d iM V W�Y, em e�tlirendY mmrmM Mith lioarued canvectwe to cmmw Me pM� (Seeion )W�. &niness and
Pmteeaima Code: TM1e ConireGae licen» lew dou na eW�Y �o en owrw d V W�Y who Wilde or imD�'m iheraan enA Wn
mnirecd lor euch projaqa v.i�h e oonVedor(e) IcenaeC W�auen� �o iha COMredas Limnea Lew).
� I em ecam r Senbn' B. 8 P.C.. br Nis �
Deia: Owner:
1 Ao Mmb/ ceniy Nel I am ewere d erM uMenleM �M1e �uirem a ellanie Ilaellh enE Sdery Code Satliam 25505. Y553�. end
p553C, eM tlu� 1 w eny Mure Euikuq omqent will / wil rwl (tlrc naed to cwnply wi� eaM a da erd IM'pu'vammb M
epeimnlaeanVuctionormod'ifie�ationhomlMAv ue�y anepement0iatri .Reaitlenlieleonet nappL tionaerae[anq�ramMeea
pI0YI510f19 ��
Dete: __-�A �DOlicem:
WOPKER'S COYPENSATION UK4P�TON: I Meby elfiim u dry d p«jury am d Ne Idbv tlumuro:
❑ i new e�e »;� �me:� e cenrcme a m�+am m s.n;�w� t« �xa: wmpenWion, n providad la by Semm 3]OO d �M labor
Cotle, lor �he pa�lormence of �he wwk Iw whic� thie permn ie iasued.
�] � nm» e�a.a m.m�e:,.�a.• o�nomwa, ��re�a. m�a��.d M see� s�oo d ma i.ee, wd.. a, me w�famano. a m.
.on��«.n;a,m�ve�am�.�,sa.Mr.«�'�i�'���,�e�«�eowkr��mn«�e: EXPIRES
c�e,:
Pdiy Number. 0 5/ O 1/ 9 7
(1hz sxYion neee nw be compleleC 1 tM permR k M me hundmd dolbn /t�ool a Iw.l
� I cerliy Uw in the pe�lamerre d iM w«k la v.hkh ihis paimit e iaued. I ehdl � mmpby e�ry in anY menr�x o m lo
n«o�,b �d«a m ins �.,� �o�m�, m.,� d c.u�r. a ro� u� n i.nw�wni� ro ma .wy.�
mm� qovis��o ion 3]00 oi lhe LeEor Code. I Ihv.ilh oompy wrhlM pmnwo
Daze: �/ Apd��
Wamlrp: Fe/lun b�xuro woM'sn'romps�uetlon cowreye I 1u( antl �htll �Wfsel en emp/oyu AMmI pen�Mu aM
crvn ro.• w ro on. nunar.a rnouuna awi.n (1+av,00al, �n Itlon ro tlu ro�t ol rompxwfbrt a�W u povMed br In
Sxtlon J106 0/ fM Labor Cadr. Inrorest, ans ettom�y'� M1u.
CONSTflUCTION LENDINO AGENCY: I Mreby eifirm under panely d parlNry �hel �M1en ie e mn9ruapn bMiip eper�cy br IM
p,n��� w ma.w� m,.n�d, mo ro�+ �• =�+ad lsaao�, aoe�. cw. C).
LENDEH'S NAME:
LENOEP'S ADORE55:
� cenM �het I heve raed Nis eodiration erd ame ihet ina eEova inlametbn u conae. I earae to canpv xnn all ary erd m+M' ad'mmme
eiM slele kwa relelme �o buikip conAruction erd hereby eiNwr¢e mp�eaen�eiivea d Ihe tily b enter upon Ihe abv.e-men�'w�ad pnpwty
�°'�"'"°°�v�`°O9B9 JACKIE RAZO
Dme: -LL1 �'� ' ��
(5151 J6.W P) " WM1ile-Buildiq 8 Selery; Grem-Fb; Car�ery-Appicenl; Fnk�ievenue: (3oldmm�Maeam�
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: B 078679
PERMIT NO: H 078674 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF RESHEATH; REROOF W/ 40 YR COMP SQ FT: 5,000
CLAIM VALUE: 5,000.00 CALC—VALUE: 5,000.00 GROUP OCC: R-3 /U-1
COMMENTS: RESIDENCE REROOF
�*�*�***�r����x ***�****�**�*x �*�����*****�x�*�**��*�r*�*�r�r+�*� �r��*�*��r�r*��*����*�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN AGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14138518 ZNE; REF NO:
PLANNING NOTES> •
�'.i
iE k 1t iE iE 1E 1F iE 1E iE iF 1E IE if 1f 1E 1f k �E dF if iF �F iF ik �f iE if if 1k 1E fE iE 1E 1E 1E 1E 1k 1E 1k 1E iElE fE iE �E IE fE 1E 1E fE 1E 1f 1E fElE if 1E iFlF If 1E ik 1F iF 1k iE 1E 1E fE 1E iE fE 1ElE 1ElF iE iE
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 fi M•E N T S
ZONING APPROVED BY DATE:
HUILDING APPROVED BY : DATE: �/
APPLICATION ISSUED BY: DATE: /—.I ' 9
1flkiEiF1F1E1F1E1EiE1k1E1k1E1fIf1E1E�E!llkif 1EiklfiEiEiE1E1F1ElE IE1E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBZNG ELECTAIC MECHANIC FIAE �SMIP/RES GRADING
PERMIT 99,75 � � - 50
PLAN � � ,SMIP./NON-RES
ISSUE FEE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL�'� ;-•PAID DUE
TOTALS----> 100.25 0.00 0,00 100.25 : ,1`00.25 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 100,25 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
99.75 .50 ., �
�E 1E iE fE ik iE iE iE iE 1E iE iE 1E 1E 1E 1E �E iE 1E i("IE iElE fE 1E 1F 1F 1E iF dE 1F dF 1E �k i43k 1k iE 1F iE 1E fE fE 1E'k'IE k iE 1E iF 1E ft 1E iE �E iE if 1F 1E 1E if 1E it iE iE 1k 1E iE 1E 1E iE i! 1f iE �E iE iF �E'lE
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 I O N UNIT COST � TOTAL COST
SFR 5000 ALTER HY VALUE RESIDENTIAL NOZONE � 1.00 5,000.00
END OF FEES � r
iI -
. ' �
I
,�� ,.
, Yr�' . .. . . .
s
� CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# .Date Inspector APPROVA�S Permit-# Oate Inspector "
i. Temporory Electrical Service or Pole • 52. Pooi & Equipme�t l.ocation � -
2. Soil Pipe-Undrgrnd. . : . 53. Steel Reinforcement ,'
3.��Electricai Conduit Utility�Undrgrrid. 54. Forms '
�� 4.�Electrical Condvif�Undrgrnd.�� • � 55. Electricai Bonding � �
"� 5. Steel Reinforcem¢nt "� 56. Rough Plumbing & Pressure Test � '
6: Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
- 7-. Footings __ . 58. Electrical Condu'rt-Undrgrnd. .
, '
8. Foundation �- ; ' 59. Gas Pipe, O Undtgmd., Test
C' 9. Water Pipe-Und�grnd. � '� 60. Backwash LinesiP-Trap, rJ Uneirgmd.
10. Structural Floor Svstem - -'�� 67. APPROVAL TO DECK ".
17..-Property Sewer Line & House Connection - 62. Backwash & ReceptorFinal .
12. Sewer Cap ` � 63. He�ter & Vent-Finai '
73. �Roof Drains � fi4. Plumbing System � Final .
14. Rough Plumhing �` 65. Electr.ical�Final
15. Rough Electricai-Conduit - ; ` &6. Solar�System�Final ' •
16. Rough EleMric N'iring ;_ 67. Fencin9 & Acces3 ApPro�al � •
17. Rough Winng Sign � �� ' 68. RPPROVED FOR� PLASTERING '
16. Rough Electricai-T Bar Ceiling 69. POOUSPA SYSFEP,7S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i
20.�Rough Factory Fireplace ^ - -� . APPROV�ALS -_� Permit,'� � �
21.�`Ouces,in-Structure` ,,, - � � �'-. 70.�-UndergroundHydro '
22. Ducts, Ventilatin9 � - ' - � 71. Produc[-Piping G�Gas ❑ Oil
k
23. Gas`Pipe�Rough & Test , � 'f `: 72, Underground Elush ' - i
24.,Roof Framing� � ._ � : • y-� _ 7�, Undergcnd.StorageTank OGas 13-0i1
25. Roo7, She3thi�g :- . � 74. Overhead H dro " �
.7: �G �Cc� - �
26.:T�Bar CeiGng (Struczurall &�Monowat �; � r��: 75.�Dry Chemicai . _�
27: �Frame and Flashing�� - _ � _ � 76.' Dry Standpipz_ _ - `:� �
- I
. 28. �athing & Siding-. � . -�r ^ {� ». :_ • . . .� 7�7, FIXED SYSTEM.FINAL
' 29. Insulation - -' " " - �� �� � �' 7�. FIRE PREV. FINAL , �
r
30. Drywail fdail'rng � �� � `� ' �_ � - HEALTH DERT.-REQUIREMENT
� 37. Piaster Qr,owp Coac,. _ � j � r, 79. FINAL'�NSPECT_10N �- � -
32:-ElectricalPower \4ete,r,�Final „„ � �v �:; 806. FOOD CERTIFICATE 4SSUED � �
. 33.,�inat Electric ;, � " ; � " Notes: _ - � ' .
' 34. -final Heating& Air4Conditioning . { " , � :' - � . _ -
35. Final Gas Pipe-Test " - " + ' • " _� ' ; �,
, �.
36.`'Hood or CanopY ,_ - ' _ ` � -
37.'FinaTFactory Pireplace - -' - ' � . ' �.
+
. 38. PinaFPl�mbing • . .. . r �- _ , . _ -�--
- 39. Water Service-Finai � �� � « ' ^ _
- • • .. K. .-
40. Gas Service-Final _ ` `�
�S i I � i. _� .
. 41. Solar pomestic-Final , ��� r ,:, � - +
x r j
., 42.�Backflow Preventer" �J � .. .. ' ' � i Z �/...q�� _' �"� �'� �
C' 7 / - �
43. Backflow Irrigation� ' . .- � ' - • - _ -�
;
�4A. �anc7scaPe Ir.aipation Svstem�-;., -, t , - - . _' �-3D-y(C .� ��� Q � _ L�.G��
` iN
45.'Sound Attertuation� - ? �- ' � - � �� - 7 *
. : ... .. . -: ,, w .:,, . c���s_lcsu-} �f �2��!_�e?/� �
�.46. "Handicap.Regulatio�s ' _ . . . _ - - - : �
47. FINAL STflUCTURE & BUIIDING Q_�_G1/_ �wv `. -
v -L Y
48._FINALPLANNING ' : . z; • . ' �
49.:Electric Release to Edison • • -
50..Gas Release to Sout�em California Gas Co , � _ , • . , � . •
51. CERTIFICATE OF OCCUPANCY � - . .
No. Date
%
OWNER COLLEGE PARK DATE 3-],Z-5']
JOB ADORE53 285 Princeton Drive BUILDING PERMIT NO. #LtSBO
GENERALCONTRACTOR Harbor �onstruction VALUE a�.�.�2��•�0
LOT 9 BLOCK TRACT 3166 Res, w/det. �3T. -
GROUP I St J TVPE V ZONE FIRE DISTRICT 4659
PERMIT8ISSUED
INSPECTIONS � DAT SE SUBCONTRACTOR DATE I NUMBER
Trench
i Forms and Grade to Gara
toSla6 wm�y„_GS �l�/,(:YYL(��tC72�-�����, e�2'
Complete �-65 S'-8•S'7
Wiring, Rough
Heating, Rough
Heating, Final
�/Sewer, House �P/�� Sewe
Septio Tank or Cesspool
Lathing, In Out
Plastering
Plumbing, Fin�ai, Fixtures Co
Plumbing, Fin,al GasTest (:
Wiring, Final
Occupancy
FOflM 210 3M IO�vS
10
�
�w��3%�i���/irir��
st. l'i2G5 I�-S=.f71��_!!_Cm�7.'.,11i„� I,�-�9-ti71 S�'"79%-
,26
�
�
�
. ,
_ 1
' , . "" . �(�59
COSTA MESA BUILDING DEPARTMENT
P. O. 80% 31 ]
COSTA MESA. CALIFORNIA
FOR
BUILDING �[
ADDRE55 l
OWNE�
ADDRE55 G � �
aTr SANTA
ARCHITECT
OR ENGINEER
ADDRE55
CONTRACTOR
ADDRE55
LEGnI LOl
DESCRIPT�ON NO.
A.P. NO.
SIZE /
OF LOT hIl J�
TO FILL IN
�rj PRINCETON [�RIVE
COSTA MESA. CALIFORNIA
ANA� CA�IF. TNO. KI �
uc.
NO.
FEE RECEIVED
'�031. � �, � � � � �
fINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIpT NO. PERM��/1
U
NECEIVEO BY OwTE FE EIVEO OATE ISSVEO
�3 - -�S MAR 1 2 �
BUILIJING
COS7A MESA. CALIFORNIA
FIRE
ZONE
���. 62 �o�E�l��
NO.
TEL. APPROVED
NO. BY
TRACT 3 i 66
NO.OF BLOGS.
NOW ON LOT
SETBACIt LINE FROM C �
<ENiER oF SiA[ET /O REAR YARD �
SI�E YARD RIGHT �j LEFT �-�-
DESCRIPTION OF WORK
NEW X ALYERHTION �AOOITION
REPAIR MOVING DEMOLISH
BUILDING I �79 ROOMS STORIES
SIJF
WALL
T��F
COVERING
NCE � DETACHED
$TTTE TNiT TNE ABOVE I$ GONRECT qND PGflEE TO COMPLV WITM qLL
CITY OFOINRNCES AND $TATE Lh�H6 PEGULATING BUILOING CONSTRIIC-
TiO�v. VALUATION
SIGNATURE OF r, PnR K NO .
PERMITTEE
, � r I I ,2��
DATE
CORRECTIONS
PERMiT FEE S �'O "
PLAN CHECK S I �('
TOTAL FEE S �� � veMr
ri
smi
Gn5
W RTER
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. [
SPRINKLING SVSTEM
MlSCELlANp0U5
ROUGH ME�TING AND AIH CONOITI01
TEMPORAFY SERVICE OR POLE
UNDERGNOUN� � POWER �
ROUGN WIRING
TRENCHES FORMS STEEI
FLOOR SYSTEM '
BONO BEPM � STEEL REINFORi
SMERTNING
FRAME AND FLASHING '
LATHING - IN rJ OUT n
PLASTER, BpOWN COAT
STRUCTURq�, FINAL
HEFTING, VENT., REFRIG. RN� 4.C.
PLUMBING, FINAL AN� GAS TEST �
ELECTHIC, KINAL
BUILDI
�
���
TRACT FIRE ZONE VALUE
SUBCONTRACTOR
� '�
i _ Q
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BPX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING _„� 'T_ . .l. _ n __ .
OWNER
MAIL
CITV L;(�!$//j
CONSTRUC�ION
BRANCN
ADDRESS
ARCHITE(
ADDRESS
CONTRAGTOR �(�
ADDRESS
CITY —�
STATE �
LIC. NO.
SIZE /� rX I�
OF LOT �OJ
USE OF
EXISTING BL�G.
SIZE OF • �
NEW BLDG.
EXTERIOR WALL.
TEL.
NO.
TEL.
CITY
LIG. NO.
NO.OF BLDGS.
NOW ON LOT
�/� �� NO. OF
ROOMS L STOF
ROOF (�UGK
D ./I COVERING
!D WORK TO BE PERFORMED
PAlL'
��R?o-�s�„-<.o0 6�,� ��A�:�35.50
AP LI A ION POR BUILDING PERMIT
tiECEI E 8 DATE RECEIVED D T ISSUE
��� �
�� PERMIT NO.
A.P. NO.
BUILDING n p` ' �•�C..�,�/
ADOFESS OLO •� ��� l��v
TRACT���G/ LOT / BLOGK
FIRE
ZONE
APPROVED
USE
YAROS
MAIN
DATE % �
DISTANCE BEf. BET. MAIN &
MAIN BLDGS. ACCE4.BLD
VAR.� DATE
C.V.P.qW APVROVED
I heraby eck�owletlpe thei 1 hava reatl this applicatlon entl state
thet t�e ebo�e informatlon Is corrett entl apraa to comply wi[h
all lews .oqulating builtlinp constr�etion, entl I shall not employ
any parzon N violeUon ot t�e workman's compen�allon laws of �
t�e Stato af Calitornie.
1 hereby cert�ty t�at I am proparly Iicensed as a contractor untler SQ. FT.
tha State of California Businass antl Protessiona Cotla, Divisicn 3, THE AMOVNTSHOWN UNDER V
Chepmr 9, antl that such Iieanses ere In full forte antl effact, or I THE PURPO6E OF ESTABLlSHING A
am exemp2 t�om ihe provisions of tha State of Celifornia B�sinau VALVATION
antl Professio�s Cotle, Division 3, Chapter 9.
! PERMR FEE
SIBABLVfB O} �� L/ / �
Pe�mlttea S /T � PLAN CHECK
Authorized AOant TOTAL FEE
TAX p
0
4TION IS FOR '
AR FEE ONLY: a
� � ti
7
- E
'�� LL
JOB ADDRESS «37 f'
GENERA�.CONTRACTOR
AP No. ��3g��
INSPECTIONS
SOIL
GAS
WATER
ROUGM PLUMBING
PROG. SWR. LINE Q NOUSE C(
SPRINNLING SYSTEM
MISCELLANEOUS
ROUGM HEATING RND AIR CONO
TEMPORARY SERVICE Oq ppLE
UNDERGROUND � POWER [
ROUGH WIFING
TflENCHES FORMS
FLOOR SYSTEM '
90ND BEAM ❑ STEfL REI!
SHEATHING
FRAME ANO FLASHING
LATHING - IN ❑ OUT n
PLASTER, BROWN COPT
STRUCTURAL, FINAL
ME4TING. VENT., REFRIG. AN�
LO
FINAI
FI
SUBCONTRACTOR
z-zy—%7
[�27
� ,
:�9665
COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING �ri! /a �� O� A
ADDRESS b V �� /C
OWNEflTN�F � ' ��IYI /T�
I
A.P. NO. I�I —
BUILDING
ADDRESSZ�
:at:.
-�° ��-;s�,.;.G0-o9s:+ �-=*��6.5C
FOR BUILDING PERMIT
a U CITV `vQS ! A PS/� NOL J-�S/ TRACT 3/(� LOT BLOCK
ZQ CONSTRUCTION f—
O y LENDER
am �
J � BRANCH �%
J (n � OWNER .—^�NC ' t IJ%/%
Q w ADDRESS f q ,/ �J'
mm ARCHITECT TEL. /'�rv OY�"� VALU$ oO�QO
J N Ofi ENGINEER
V Q FiRE
w� ADDRESS 20NE VP GRO P
aW /J
JO CONTRACTOR DcJ er�� •/(L � BYPROVE DATE �
m� AOORE55 S A/!(CJ �S � �(/v
w W ZONE NO.OF USE OF NEW
� TEL. �,1' p�p,ry$ 2 BUILDING
Z � CITv NO.
W O STATE CITV �'AflDS APPROVED VARDS APPROVED
� Q LIC. NO. LIC. NO. MAIN BUILDING ACCESSOflV BUILDING
7 O (FROM GL STREET)
SIZE �— NO.OF BLOGS. ^
OF LOT NOW ON LOT ROMi �T-Y� fT. FT.
USE OF 'f O /JQ I
EXISTING BLDG. // C�- 5 FT
H SIZE OF t � NO. OF �
Z NEWBIOG. Z ROOMS 57�RIE5 1.S10E 6 FT. FT.
Q EXTERIOR WALI ROOF
�% COVERING COVERING AL� REAfi d� � FT. FT.
J USE OF BUILDING AND WORK TO 8E PERFORMEO OISTANCE BET. BEf. MAIN &
a MAIN BLOGS. ACCE�. BLpGS.
a
Q '/ VAR.qW DATE
O L � C.U.P.+� APPROVED
� APPflOVE�s,� �G��/
N
2 TF
O
UI �oreby ecknowlodBa that I hava reed this appllcallon and stete
that the ebova information is corract and epree to comply wIM �
� ell laws repuletinp builtlinB consvucNon, antl 1 shell not amploy Tj�
F nny parson in violation of Me warkman's componsetion lewa of
y [he 5[nte of Celifomla. � m
? I horeby car[Ify t�et I am properly Iicenfatl ae a contractor untler S�. FT, O
t�e Stote of Celitorn(a Business and Profauion� GOGa, Dlvisicn 3, TNE AMOUNT SHOWN UNOER VALUATION IS FOR a
Chapmr 9, entl thet such licenus era in iull torca antl aftoct, or I THE PURPO6E OF ESTABL6HING A PERMR FEE ONLV: ¢
nm axempt from the provlsionzot Ne Ste2e of Califor a Buainass VALUATION
nnd Prolessio�a Cotlo, D�ision ,_C,�aDtar 9. � m
—� � � PERMR FEE $ j
Sipno[un of ��) � m
Permittea � 3� V(/ PLAN CHECK $ E
� 0
LL
Aut�orizetl Fpont TOTAL FEE $