HomeMy WebLinkAbout2792 REDWING CIR - Building PermitsIPESS: z79z REDWING CI uNiT:
NAME:GRAHAM CHARLES WILLIAM
IPES5:279z R�DWING CIR
COSTA MESA,CA 92626
2419636
AXCHIENGINEEH: HEG.NO.:
A�OHESS: IINIT:
PEHMITTEE:LUKE ROOFING (714)633-8798
aooness: 932 N VATAVIA ST
ORANGE CA 9266�
LICENSEO CONTFPCTOX �ECLAPATION: I hereby affirm Iha� I am licensetl untler pmvisions of Chapter 9(commencing wiih Sec�ion
]000� ol Opyvpn3�I�he,Busfness antl Pmlesyo0i Lod¢.,dn0 my license is in I �o�r,and e��
1/3,S 4 41Lb48 7
CITY LIC.: STRTE LIC.: CLAS
oate: (o - 7' �3 Signamre�. _ �
WOFKEBS' COMPENSPTION OECLAflFTION: I hereby affirm thai I have tlificaie of consenl to self-insure or a cetli�icate of Workers'
Compensa�ion Insurance. ar a ceni�ied copy Ihereol �Seciion 3800. Lab. C).
POLICY NO.: ESP. OATE:
COMPANY:
❑ Cenihetl copY �s hereby fumishe0. ❑ Certibe0 copy is bletl wi�h t�e city Builtling Division.
Dale: ApD�icam:
E�MPTION FAOM WOHKEflS' LOMPENSpTION UECIANpTION: (T�is section need nat �e comple�ed i� the permA is br one �unOretl (51q1) or less�.
I,tetlify I�a� in I�e pedormance ol Ihe work for whic� this permit is issued. I shall not employ any Derson in any manner so as to become
Subject lo �he Workers' Gompensation Laws o� Cali�amia. �� �
Da�e: � ' �' g� SignaNre:
NOTICE: II, aller making tAis Oeclaration. you shoulA become subjee o t�e WorkeK Compensation pmvisions af �he Lahor
Co�e. you mus� lorthwith comply wi�h such pmvisions or Ihis De�mit 5hail be tleemed revoketl.
CONSTflUCTION LENUING AGENCY: I here0y ailirm ihal Ihere is a conslmctinn lentling agency for the pedormance of the work lor
which Ihis permii is issuetl (Sec�ion 3097. Civ. C).
LENOEfl:
nooeess:
OWNEB BUILUEB UECLANRTION: I hereby affirm tha� I am exem0� �mm the Coniracbrs' S�ate License law �or Ihe �ollowing reason
(Sec�ion 7a31.5 Business ana Professional Cotle: Nny cily of coun�y which reQuires a permit Io conSlmct, al�er, improve, tlemolish, ar
reDair any s�mclure. prior to its issuance. also reQuires �he applicanl for such permit �o �ile a signetl stalement that he/she is licensed
pursuantio Ne pmvisions oilhe Conirac�ors' State License Law(Chapter9�cammencing with Sec�ion 7000�of0ivision 3 oithe Busine55
anA P�olessians Code) or �hat he/s�e is exempt Iherelmm and �he basis lor the allegetl exemption. Any viala�ion oi Sec�ion 70315 by
any applicam for a permil su�lems Ihe apDlicani Io a civil penaliy of not more ihan �ive huntlreJ dollars (E500�.
I. as owner ol I�e pmperiy or my emplay¢es wilh wages as Iheir sale compensation, will do Ihe work. an0 Ne
❑ s�mcture is not in�ended or o�fered br sale (Seaian 10a4. Business and Professional Code'. The Contracmrs' Siale License Law
aoes nol appty Io an owner of a prop¢rty who OuildS orimpmves Ihereon. and who Ooes such work himself/herself or�hrough
his or her own employees. provitled Ihai such impmvemenis are not intentled or oiferetl lor sale. If, however ��e builtling or
im0�ovemenl is 5010 within one year o� comple�ion. �he owner will have I�e buraen of pmving Ae/she did na� builtl or impmve
lor the purpose ol sale).
„ I, as owner ol �he propeny, am exclu5ively COntrat�ing wilh Iicensed conlractor5 io ConSVut� �he Dro�et� (Seclion 7044, Busine55
❑-� and Professions Cotle: The Coniractors' Sia�e License Law tloes not apply �a an owner ai pmpehy who builas or impmves thereon
and who coniracis lor such projects wrth a conVac�or(5� license pursuan� to Ihe Contratlors' S�a�e License Law�. I am aware
��a� pmoi of their Worker's Compensation insurance shoultl be OroviOed b me.
� I am exempt unAer Seaion: B. 8 P. C.
for I�is reason:
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 062493 PLAN CHECK NO; N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR
JOB DESCRIPTION : T/OFF RESHT REROOF W/ COMP
PURPOSE; �T
SQ FT: 6,700
CLAIM VALUE; 6,700,00 CALC-VALUE: 6,700,00 GROUP OCC: R-3 /M'1
COMMENTS: SMOKE DETECTORS RE� PER UBC lk1210
+t*�**x��r*�r��r***�e+t**�r*�t*�t�t�t*�t +r****�r�r�r�r�rx***x*�r�r****�r**+��t****x**�t�r�r�r*�r�r*�t**�t�***
Z O N I N G R E Q U I R E M E N T 5
ssTBAcxs
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING -----'---
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IA1
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 13916203 ZNE; REF NO;
PLANNING N01'ES>
i
�r****�r�rr� �r�r**�t**�t�r�e�,e�r�r�e x �r�e�r�e�r�r�r�t�r��r*�t�r*�r�t�t�t�t*�t���t�t**�t�r�t�t�r �r*�t�t�r�r**�t�t**�r�t�r*,r* ��r�t
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 HY• i" DATE: 6.�
*�r*�rx�+�**�r*�r�r*+��rx�**��r�rir�� ��**�r�**�* �r*
�r*�r*�t�t*�*�r�r�r�r�t�r*�t�t�t�t��t*�r*�r�r�r�t�t*+t�e*�t**�r� r�r**�r*x*�t�e*�e�e��r�r**�t�t*�t�rr�t�t�r�t***�r�r*+t***�r�t
" LEGALIZATION:N F E E �S U M M,A R.Y. STRUCTURAL' SEGMENT:Y
HLDG PMT PLUMBING ELECTR C rMECHANIC FIRE SMIP/RES GRADING
PERNIT 90.00 � " 67
r.' ' SMIP/NON-RES
PLAN r.�,� . '
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 90.67 0,00 ;\�J0;00 90.67 90.67 ,00
REVENUE DIVISION TOTALS--> COLLECTED�: 90,67 OVER/SHORT; 00
BLD90PM��T PLUMBING ELECTRIC MECHANIC FIRE SMIP/T67 GRADING PLAN-CHECR
i! it iF �t iE �f iE k iE If df if 1k ik ff if lkik k �E ik 3E if iE ik iF iF 1f if iE �Fik if �t�f iE if ft 1f if if k iF ikiFif iF �f 1E �t iE �FiE ft ik iE ibik it iF iE iE it iF iE iEik�I(� iF iF ik 1E iF 1F iFiEiFjf 3f
I N D I V I D U A L __F�:E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N-iy-,� UNIT COST TOTAL COST
� —/- \
SFR 6700 REROOF BY VALUE RESIDENTIAL N020NE 1.00 b,700.00
END�OF.FEES
J
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il/,,.
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.
Dale: Ownec
I ao hereby cer�ify ��ai I am aware ol antl under5tan0 �he requirements ol Cah�amia Health and Salery Catle Sec�ions 25505, 25533, ana
25534 antl Ihat I or any IUWre builtlmg accupant willlwill noi (circle one� need to comply wit� said s�a�e cotles and �he repuiremenis for a
permi� lor conslmction or modilication Imm �he Air �ualiry Managemem �istncl. Resiaential cons�mciian apDlicalions are exempt �mm
I�ete provisions.
Oale: ADPlicanl:
I �ereby cetlify Ihal I have reatl I�is apPhcation antl s�a�e Iha� Ihe above inbrmaiion is correcL I agree lo comply wi�h all cily antl county
ordinances anU Sla�elawSrelalingio building ton5lrut�mn and hereby au�horizerepresenlaiive5otthis tityio ¢nteruponlhe ahove-menti0ne0
�roperly for inspeciion pur0ase5. ��
oate. 6' 7- S�J Signa�ure. �' V
oriver's License ar social Secunly p:
164La6 W�i�e—Bwldmg: Green—Code EnlorcemenC Canary—ApphcanC Pmk—Revenue', Goltlenrotl—Assessor
01 00140509-00140510 T�J T 90.b7
BATE: G6/07/93 TIhE: L19:46
NSTRUCTION AND PLANNING '- P��� & SPA �!
?ROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
t.`Tempo2ry Electrical Service or Pole 52.. Pool & Equipment Location
�. 2.� Soi� Pipe-Undrgrnd. , � ' S3. Stee� Reinforcement _
� 3..Electricai CotMUitlltility-Undrgrnd. 54.. Forms '
r +
' `!}.`�Elecrrical Cond�dii;Undrgrnd. 55. Electrical Bonding
c,
' rs. �6teei�Reinfordement � 56. Rough Plumbing & Pressure Test
�('L'�lectrical UF-ER Gmd '- 57. APPROVAI TO COVER�GUNITE �
, � .. `_
, .`,�ootings '� 58. Electricai ConduiFUndrgmd. �`��
� t'=� Foundation � 59. Gas Pipe, � Undrgrnd., Test _
_ 9. Water Pipe-Undigmd. 60. Backwash Lines, P-Trap, L7 Undrgrnd. ,
90. Structural Floor System 67. APPROVAL TO DECK . �,
_71.' Property Sewer Lioe & House Connection 62. Backwash & Recepior�Pinal
72.�Sewer Cap _ .. 63. Heater & Vent-Pinal
7 3. Roof Drains � _`, 64. Piumbin9 System � Fina� .
14. Rough Plumbing � - 65. Eiectricai-Final
15. Rough ElectriCal-Conduit 66. Solar System-Final
' i6. Rough Electric Wiring . 67. Fencing & Access ApProvai
17, Rough Wiring=Sign 68. APPROVED FOR PLASTEflING
18. Rough Electrical-T Bar Ceilinq 69. POOI/SPA SYSTEMS FINAL
79. Rough Heating & Air ConditioningT r � _ , �, F�I,RE_j�EPT�flEQUfREME�VT
2Q: fiQuglifa4rur�ls-Fireplace ��` S � ;3.,",. � r� APP.�SO�-r�GSC Rejmit #_�-?��_. I
2}. 6ncts�"+n SZiuctur� • • � -� � -'* � = 70 �Unde^rou�d �3ydro "
' C � �l%N. �.�•
� . t. 1 Q.r � � �T.. � 4S' �
275. D.ttcts�.Vem,ilaTiag. .• �� c x y = 77. Produe;(�ipin§ UGas ;L'70i1
23�. Gas P'rpe�Rough &:Test � :��- - r ':>� rt � 72, Underqr�Jnd Ft6sW-' x `- %
�
��'. R�of Fiamin s �.: . -- ` - ' x " S - r I
9-,: ,r. , ��.a ,: . 73. Underg�d.StoFag@;Tank C Gas G�pil
r -
25. Raof ��eathing^-. � ��v ;w / � * ;rG?Overhead Hyd#r,) _ � �
_ _ r8�`� �.�= -
� L . 7T�rY Cha�nical,. � G c{ .
2fi, T-�ar Ceiling (SS�'6cturall B�Nlonocoat Y T'�, T" " � ',�
Z�. Frame-and�:Flashicig j. . rJ r= s 76. Dry Sta�ipe-� < ��
�.
28. L•'3thi� &.$ididg-: •� - r: _ ••f�. k 7:L. FIXEC3���ST�FINI�`L.._ <' T
29. Insulation •:' <` �� -.. ' s:� 7.$. FIRE PREV. Fltv l x= �> i
� 30. Orywa�l Nailin�,,; . :;_ � ,; r � 4iiEAl�ti �EPT.T�tEQU1�EMENT
37. Plaster Srown �oat; •: x 79, FINALitii"SPECTuON �� � =
- � ` `-
3�. Elect[r�al �we�N.lAier:Final �ti � i � $Q? FOOD CERTI�i`CATE.(SYUED ,� � �
r TM � ' I- �: x . «, -j
3..��. inal Eijec�eac : r � ' ` I +e Y �� I�tates: �= ��=r +..� _ ;� �
� . � -*�- -"- - ' - . �/
� 33. F'mal J�ieatiag &'Rir G'onditioning " ' 7 �_ I �* ' R/_,'� �3 ' �?" �r _ _ .� �i�-�
-T_.t � _"�_ i�'_l� � .- c
35. Finai Gas d.ipe:�(est�_ . I r_. �� y�n .:T%\ F �:in �L1
_ C(_ -i�__no\.O�I i�+'��
36. Hood.or Canop� � � i '• �% '- rv n ��
� �� � �n :o � :,
+ � ' r, -
r � X r : r •
37. F�nal �actory Fireplace - . ��r. .' x ���
38. F�tial Plumbin9 � : '" , •. . ��. � � � ._ .K L -� "----
�� 39. Water ServiCe-Final . ' _ > r y T ' �. "
_ �
� -
40. Gas Servic�Final�� r � �� - I< � _, ^! .
� . .. rri-; �� :: ��>. .:
' 41. Solar pomt�stiaFinal �' ' � '- - '� '- ?
_ r . ..� r � .. _. ,
r . . .. _ • _
4�. Backflow P.eventer . �N x > >'- � ' .� '
r - '�s x •r -��•.2 y; " V i
43. Backflow t�rigation y ' ' . �; :', ; �' � � -!
,� � -�.. r :�_ :� � ' !.� :�
44. Landscape irripation System� - :h : ?: _ _ �,
' . r , _ .; ,� [ � � - `, . -
d5. Sound, Acienuatidn . �. �� ,. > � . :_ . . M . �
46. Handicap Reg�ia�ions ' ' - � •-� -- - •
j � � K af [i ^ "' �
. 4'h Fk?JAL ST�?UCTj9RE & 8FJILDING q�� '�" �' _ �'� .
48. FINAL PLANNING '6� vi�� -'* + c�' ,� �i - z � 1
r
- 49. E{ectr,ic RElease to Edison � ` ^ � � `� x - '
`_ � . �G •r C
50. Gas Reiease to Southem Califoroia Gas Co , � ' Y�> - - ' •
',. _ ' , ' �. .. -
51. CERTIPICATE OF OCCUPANCY �. � �"' .� � -=
No. Date ., -
-•
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this ������'L�`� day of
r> .
�� �L-''� - , by and between � l�'r`'�- '--��1�r���"—'
, ` �
hereinafter referred to as "LANDOWNER;' and � C��+�<�
�
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book\��� `� , Page 3� s� �� of Miscellaneous Maps,, in the office. of the County Recorder
of said County. The party wail shall be permitted to encroach
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
'S � r�.-��� iac�'t)�
,
ign ure)
D`CGr.1A T �3ir'.�d
Name (Typed or Printed)
ADJACENT PROPERTY OWNER
�J� �
T'Jl/'n; � ��?��a..,
(Sign t re)
?PI,hC'� �7_ L''yl �� r.�/
Name (Typed or Printed) .
,
cZ �G} �1 R��'u? lr� Ci C-'tl�Gl;�, ����-���5_��- �f_Y�.�� C�
(Addressl, b���A ��A ; �/\ . (Address) - � �
�_ r1
�} '�. G ��
NOTARIZATION REQUIRED
n �r .
? \�b„y�� AAy ComMsslon Ezpire;:
1806-46 � a f{�.S" C{12.�, ir/�'�
k. -.�_:�..:-: —��—.•--
v
CERTIFICATE OF ACKNOWLEDGMENT
State of Califomia
County of �����
� SS.
f^��: �..--m.�.�.> .-Y..�,.
�.. QFFICIALSEAL
� �� ��,' . SALLY E. AI?MSTRON�
� i � � ^ ��,, "e Notcry public-Callfomla
ORqNGE�OUMV
s ` <"r}m': MN, Commission E�Iree
F. _- ••,• /�:,dV e9. 19iA
t-. �.-.-.:.:::�.. - �.-_—�.�s-o.-'
On b Z`�i 3 before me,
( a[e)
personally appeared nl �✓�' T. %Si
J • G v!L
£..
0
personally known to me (or roved to me on the_basis_oLsatisfactorv
evidence) to be tLe p r�'�whose nam is/�isubscribed m the within
insvument and acknowledged to me that he/she/t�}r�xecuted the same in
his/hedt�D authorized capacity( .C�s�, and that by his/her/�signaturef�
on the instrument ihe perso���r the entity upon behalf of which the
perso�acted, executed the insvument.
WITNESS my hand and official seal.
�OWNER g�g�C HOMES COl
JOB ADDRESS 2792 Redwing C:
GENERAL CONTRACTOR same
'AP No. LOT
INSPECTIONS
SOIL
GAS
W ATER
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING AN� Alft CONOITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUND � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BONO BEAM � STEEL REINFORCE �
SHEATHING
FRAME ANO FLASHING
LATHING - IN �J OUT �]
PLASTEft,BROWN COAT
DATE
BUILDING PERMIT
(:VVCS
�•
JUP f7 TYPE V ZONE
SUBCONTRACTOR PERMITS
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
SFP 79-6�SqOO 631 �**�*�5.00
APPLICATION FOR BUILDING PERMIT
For Applicant to Fil/ in Completely
RECEI O D'iE jijCilVE� p�i��En �
BUILDING ' � ' � y �� �p
ADDRESS�% ��[(l//�- f�
OWNE G �!$I/ O/6 �GR A.P. NO. P �IT �/ �
MAIL + ' ADIDRIE S � / / � 'F GJ� '\
nooRess .�Do S- n�Kd2 �)1���� C/
CITY G/Lh "+� t NOL,� �-SyS ' TRACT �S� LOT p� `� BLOCK
CANSTRUCfION N1 /\DD A R P
LENDER
BRANCH
OwNER Tf%/t�{��%F CO'YJ'!
ADDRESS �.p /'��;� VALUE
ARCHITECT�y-- TEI. S L(i(/l/!/ �'� $ �
OR ENGINEERI �Q N
`' �/ FIFE
ADDRESS T J . � S�J -�_ ZONE TVPE GROUP �
APPROVED
CONTRACTOR G BV DAT �
ADDRESS
TEL. ZO�� � NO.OF USE OF NEW a e
CITV NO. P�� �+' BUILDING
STATE CITY �'ARDSAPPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILOING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET) � y� _l/
OF LOT NOW ON lOT FRONT FT.
" �FT.
USE OF L
EXISTING BLDG. FT. J_ / FT
SIZE OF NO. OF
NEWBLDG. ROOMS STORIES l.S1DE FT. � FT.
EXTERIOR WALL ROOF
COVERING COVERING REAR FT. Z FT.
USE OF BUILDING AND WOI7K TO BE PEflFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDCS.
VAR. # DATE
�'��'/O GoO�' /dG C.U.P.# APPROVED
APPROVED �_/r—��
I hereby acknowledpe thet I have reatl this application and state
that the above intormaiion is corracx and agree to comply with
all laws regulatinB builtling construc2ion, antl I shell nat employ
any pe�sOn in vlolation of the wo�kman's tompensation laws Of
the State of Californie.
I hereby certify thet I am properly licensetl as a contractor untlar SQ. FT.
the State of California Business and Professions Cotla, Divisicn 3, TNE AMOUNT SHOWN UNDER VAI.UATION IS FOR
Chapter 9, antl that such licenses are in full torce entl ettect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from tha provisians of the State ot California Business VALUATION ��M O
antl Professions Cotle, Divislon 3, Chapter 9. �_
�7—� �7 � FERMIT FEE $
SIB^ature � ) / /1�„�„„yy�
Permktae �'�-a. �/ ///• � `_� " ��---• $ �� PLAN CHECK $ ��_
Authorizetl Agent TOTAL FEE $ a�—
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�OOOG
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
:a"i � �-�i�n�..���� 9fl�'1E uiefr � 6�.25
APPLICATION FOR BUILDING PERMIT
Fo� Applicant to Fill in Completely
FECEI V DAJ'� R�C�'IV�E pq���E�
BUILOING � ��� U
ADORESS �i
OWNER Jamacia �.ORSt. CO. A.P.N�. P�{ �
MAIL BUILDING �,l / �_I
AODRESS P�O. BOX 1967 ADDRESS 7y1 C�/��N .�.
CITV Orange� Calif rTvo�5475951 TRACT6757 �or 26 a�ocK
CAN5TRUCTION GTeat WeSteTn S/L NEw noo a r
LENDER
BRANCH Santa Ana
nooAess 4401 Crenshaw Blvd. L,A. OWNER
VALUE � �/
ARCHITECT Ka.ltenbaCh TE�5478046 S §
OR ENGINEER N
FIRE //
ADDRESS 1823 E, 17th Street S.:i. ZONE TVPE 4 GROVP �
APPROVED
CONTRACTOR Jama 1'd C.OIlSt. C.O. e�' OATE
ADDFESSPO BOX 1967
ZONE NO.OF USE OF NEW S1I1CJ dlil
cirv O�ange� Calif No�5475951 Pu+� eui�owc
STATE CITV VARDSAPPROVED VAqDSAPPROVED
��c. n,o.193122 LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SI2E NO.OF BLDGS. (FROM GLTSTREET)
OF LO�O X ZOS NOW ON LOT � FFONT V FT. FT.
USE OF l
EXISTING BLDG. S FT FT.
NEWBLDG.2�'OO SQ�FTAOOMS lo STORIES � LSIDE D FT. FT.
EXTERIOR�yp�l� ROOF /
COVERIN(3YV/ StUCCO COVERING W��a REAF H FT. FT.
USE OF,BUI `DING,,4 ND.Wp FK TO BEP FFOFMED
Slllg'12 2'dlllllj� resic�ence ry7qjNBLDGST ACCESS.IBLDGS,
with attached ara e. �AR.* DATE
g g C.U.P.# qPPROVE�
Plan 220-AR A�ROVED w. L. D. 4-10-69
/�u4 �ti
I hereby acknowledge that I have reatl this application antl state
that tha above intormation is carrec[ and eBree to comply with
all laws regulating builtling construc[ion, and I shall not employ
any person in violation of the workman's compensation laws of
the State ot Calitornia. �^/
I hereby certity that I am properly licensed as a conttactor untler �� 3d �SQ. FT. J`7 �/� �
the State of Calitornia Business antl Professions Cotle, Divfsicn 3, THE AMOVNTSHOWN UNDER VALVATION IS FOR
Chapter 9, antl that such licenus are in tull force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from the provisions of the State of California Business VALUATION
antl Professions Cotle, Division 3, Chapter 9.
P�' PERMIT FEE $ � O
SignatureJramai Cons ion Company ,(—
Permittee $ 33, � i PL,AN CHECK $ J i �
Authorizetl Agen �� TOTAL FEE $ �(Q i�S