HomeMy WebLinkAbout3044 DONNYBROOK LN - Building Permits(714) 754-5273 • Fvc (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
3044 DONNYBROOK LN
REAR OF SFD
14116601
App�icant: DUNN, YVONNE
Address: 3044 DONNYBROOK LN
COSTA MESA, CA
Owner: DUNN, JOHN E
Address 3044 DONNYBROOK LN
Contractor.
Address:
ISSUE FEE
Temp service lest
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixls
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Morors to 1hp
Motors to 10hp
Motors to 50hp
Motors to t00hp
Motors over 700hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
COSTA MESA, CA
OWNER-BUILDER
ISSUED BY:
Phone: 714-540-1189
Zip: 92626
Phone:
Zip: 92626
Phone:
Zip:
License: 0
SCOPE OF PERMIT
SERVICE CHANGE-0UT FROM SOA TO 200A FOR AN EXISTING SFD.
Quantity
523.50
50.00
50.00
50.00
$0.00
50.00
50.00
50.00
50.00
50.00
50.00 � ,
$30.50
50.00 '
so.00
50.00
50.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
50.00
50.00
SD.00
0
0
0
0
0
0
0
0
,�,
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Status: ISSUED
Applied: O6l14I2001
Issued: O6/14I2001
�uantity
Temp Dist System I Lighting $0.00 0
Busway /100 ft $0.00 0
Slanding Section � $0.00 0
Misc Electriwl Equipment 50.00 0
Transformers up to 1 kva/kw $0.00 0
................up to 10 kva/kw $0.00 0
.................up to 50 kvalkw 50.00 0
.................up to 100 kva/kw $0.00 0
..................over 100.kva/kw . 30.00 0
Low Voltage Equipment $0.00 , 0
Low Volt Wiring System I Ckt, ,$0.00 0
Misa Conduil � '� $0.00 � 0
Misa Conductor . 50.00 0 �
Circus ( gen or ride) � � 50.00 � 0
Circus (mech ride or lights) ' $0.00 0
Christmas Tree Stand � 50.00 0
Fireworks Stand ' ' 50.00 0
Other Electrical Fee - 50.00
Investigation Fee � $0.00
Plan Check Fee $0.00
Reinspection Fee 50.00
TOTAL CALCULATED FEES 554.00
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Calilornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12•21•92)
EXPIRATION: This permit shall automatically expire and become void il work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for lhe work authorized under this permll to be considered legal, such work must comply with all applicable codes, and all
requlred Inapactiona end flnal epprovel must ba obtained. Feilure to obtain inspections and final approval will result in the expiration ol ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
2d4&d8 (flNO)
WORKERS' COMPENSATION DECLARA710N:
I hereby aHirm under Denalty oi per�ury one ol the tollowing decleratlons:
❑ I heve end will melntain a certilicate ol wnseni to self-Insure for workers' compensetlon, es provided for �y section 3700 0l the Lebor Code, for the pertortnance ot Ihe
wark tor whic� t�ls pertnit is luued.
❑ I �ave en0 will meinieln workers' compensetbn Insurance, es requiretl Oy section 3700 ot Ihe Lebor Ca�e, lor ��e pertormanca of the work lor whic� Utls pertnit is iswetl.
My workers' compensetion Insurence carner entl pollcy num6er ere:
Certiec Policy Number:
(This section need nat be completatl i/ Ne perm/f /s velued et one buntlred tlollero ($100) or Iess.J
❑ I ceniy thet In the pertormance o1 the work lor whic� thLq pertnit is issued, I shell not employ eny person In eny menner so es to �ecnme subjeq to the workers'
compensetlon laws ol Califomle, en0 egree that It I shoultl becoma sub�ect to t�e workero' compensation proNslons of SecUon 3700 of the labar Cotle, I shall forthwlih
camply with Ihese provislons.
Applicant SlgnaWre: Dele:
WMNIN�: FAILURE TO SEWflE WORKERS' COMPENSATION OOVEMGE IS UMAW FUL M1D SHALL SUBJECi AN EMPLOYER TO CHIMINAL PENALiIES AND GML FlNES UP TO IXJE HUNDRED
TFKKI$!W D DOLLARE (5100,000), IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOFi IN SECiION 3]OB OF THE LABOR CODE, IMEHEST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby etfirm ihat I em Ilcensetl untler proNsions af C�apter 8(commendng with Saction 7000) ot Division 3 0l the 8usiness antl Profeulons Cotla, end my license is in full
torce end eflect. Llc. a Cless a
Contrectors Signeture: Date:
CONSTRUCTON LENDING AGENCY:
❑ I hereDy eflirm t�at t�ere Is e constructlon Iending epency lor the pertortnance ol Ihe work lor which this pertnil is issuetl. (Sec. 3097, Civil Code).
Lenders Neme: Lentler's AtlAress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn ihat untler penelry of perjury tha11 em EXEMPT FROM TME CONTRAC70RS LICENSE LAW lor Ihe tollowing reeson (Sec. 7031.5, Bus(neu end Professions
Cotle: Any ciry or counry which requlres e permit to construct, elter, Improve, demalish, or repair eny structure, prior to iLs issuance, also requires I�a applicani lor such pertnit
to file e sipnetl stetement that �e or s�e b IkenseA pursuant ro Ne provislons oi Ihe Contrectors License Lew (Chapter 9(cammencing with Section 7000) of Division 3 of Ne
Business and Professions Cade) or that he or sha is exempt thereiram end the Dasis lor the elloped exemptlan. Any Nolation of Saction 7031.5 by any applicant tor e pertnit
subjects the epplicant to a dvil penalry W not more then frve hunOretl tlollars ($500).):
❑ I, es owner ol Iha properry, or my employees with weges es Iheir sole compensation, WILL DO THE WORK, entl the structure is not intended or ottered for ule (Sec.
7044, Business and Protessions Code: The Contrectors License Lew does no� appty Io an owner of property who bui105 or ImOroves Ihereon, and who tloes such work
himself or hersetl or throug� his or her own employees, providetl ihat such imprwements are not intendetl or oNered br sele. It, havever, the 6uiltling or imprwement is
soltl within one year of wmpletion, the owner-builder will have the burtlen ol proving Ihet he or she did not builtl or improve for purpose of sala.).
&7 I, as owner of tha property, am EXCLUSIVELV CONTRACTNG WI7H LICENSED CONTRACTORS to construct t�e project (Sec. 704a, Business antl Professions
r Catle: The contractors License Law does not eppty to en owner of DroOerry who builds or improves thereon, entl who coniracts for such project with a contractor(s)
license pursuam to the Comrecrors License L�vsJ.
❑ lam�
SignaWre:
Owner ID v
Vedlication
I'untler sec. I Business entl Professions Cotle lor Ihis reason:
7%a�-P i(/1L�ev Date: —
by drivefs license. �Yes ❑ No Dnvets License No. Expires:
by (type ot daument, i.e. - properry tax bill or Eead):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I �ere6y canify ihat no exceveti0n tive (5) or more leet in depth Into which e person Is required Io descentl, wlll be meda In connecUon with work authorized by this
pertnit, end Ihet no building swctura, scaflolding, lalsework, or demolitlon or dlsmemling thereof, will be more then tMrry-six (36) teel high. (Chep. 32, Grp 2, An 2, Sec.
3a1, T11Ie B, Celifomle AOminlstrelive CoCe).
❑ As owner-builder, I will rwt employ enyone to tlo work w�ich would require e permit Iwm lhe DiWsion ot Intlustdal Satety, es natetl eDove, unless such person hes a
permit to do such wark tram the division.
Signeture: Da�e:
Divislon ol Intlustnel Salety Parmit Number:
CERTIFlCATE OF COMPLIANCE AND AUTTiORIZA710N OF EMRV: I conity under penelry oi perjury �hal I heve read Ihis epplication end state Ihat Ihe intortnation given is
correct. I e ree ro compty wIN all siet lawsp clry ordinances relelinp to huilding consWction, antl emhodze represenleiives ot Ihe City of Costa Mesa to emer upon Ihe
eb_ oyq-tle$� ribed property for inspe lo pu 6I es I egroe not to occupy or eilow occupancy ot eny building euthorizod by lhis permit until linel inspec'on.
�/ /� - /.-�-Q /
Signatu Of Legel Owner(s) � Daie
AnNOr Authonzed ADOlicent Date
CODE �. INSFECTIONTYPE
1616 Flzetl System Finel Firo Prevenlion
1266 Pool SDe Finel
200 Final Re-Rool
201 FIne181ocWReleining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
PAlE II�ELS
COUE I INSPELTION TYPE
206 Finai Mechanlcal
208 Final Plumbing
210 Final Elecidcel
212 Pinal Fim Proventlon
220 Finel Planning Approval
222
250
Finel Sile
Finnl Bullding/Occupancy
Pdg It��ki
ApPlicant to /ill In all sPaces vaceot lhofe within �eavY DorCer Iinas antl sign all apo�oo��ala tleclaratlons.
CITY OF COSTA SA CON TRUCTION PERMIT P{� M2� Q,� TRACT NO. LOT NO. UNIT NO. A P�, Zone
y_� � c.�
Project Address �y �7 . S Main Building: Accessory Building:
AppliCant's Mailin Atldr¢ii �^�S�� / TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E F�onf Z
Owner'S Nem@ �D�7/lD /L[�(/hwn . � � CONVERSION ❑ DEMOLISH ❑ OT R � ' T O
/��,,� � Phon DESC IPTION OF WORK U$ F B}-DG. B Reer N
Address +'���� �� � ��'1 �' 'L �
i C Right N
Arth/Eng. Litense No. TVPE OF PERMIT GRADING FOUN ATION TRUCTURA G
� �� K left
AddrC55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ��S�Q S R
Contractor's Na Phon � ��oTHER Ping. Ref. qW Parking Req./Provided E
Address (mailing) [� - {Z PROJECT DESCRIPTION 5�. FT.v OCCUaArvCV Planning Notes: M
CONSTRUCTION TVPF VALUATION 5 ��• T
City Lic2n5C No. ZONE GRADING CU. VDS. ACREi $,
LICENSEp CONTRHCTOR DECLARATIDN
I hereby ai�irm thdt 1 am Ilcensetl untler prOviilOni of Chdrt¢� 9(commencln9 Remarks: �,M
with sectlon ]000) of qtyISIOn 3 Of [he Business and Profe55iOns Co0l, and
my license is in tull lor� XnmWfeZ�. . a9 � ELECTRICAL FEES
LJcen ass L���� e se
Date Siqnature PLUMBING FEES P�utomatic Washer Transformer ❑ 15�50 KW
WORKE 5' COMP NSATION DEGLARqTION Bar Sink Showers
Construction Pole Sub. � 50 + KW
I hereby affirm that I have a certi(iwte of Consent to self ure or a certifica[e COOkin Unit Mecer ❑u to 100 am 5
r'vorkers' Comoensation Insurance, or a certi(letl copy thereof (Section BaCkflow Preventer Service Sink 9 P P
t_ y No.la����?-�-� Company ��� Backflowlrrigation SewerCap Dishwasher Meter ❑over100amps
❑ Cer[ifietl c py is �e�eby furnis�ed. Dry2rz �Gas ❑Electric Sub Panel ,
��CerF I with the tl[y Bui tlin 8athtub5 Sew¢r Connection
Date Applicant � Fan Motor5�41HP�1'h-8
EXEMPTIO FROM WORKERS' COMPENSATION OEC RATION Clarifiers $Ola� COII¢Ct0�5
I¢ssissection neetl not ba <ompletetl if the permit is lor on nOretl (E300) or Diihwasher Solar Piping F.A.U. Inc.Solar �9�15 HP �16-15+
1 ce,rtity that In Ihe perto�manCC Ot tbe wb�k fOr whlch this pe�m�t is i55uetl I Fi%tU�Ei MiCroWav2
shall not employ any pnrson in any mann¢r so as to become subject to t�e Drinking Fountains Solar Tank
workers' Compensalion Laws of California. DeviCe BoxeS Pole Li ht
M Data 99�aturc PloOr Drains Swimming Pool w/Spa 9
W� NOTICE: If, alter making this Oeclaratlon, you shoulC become subject to tne OutlQts Ren e
�"� WorkCrs' Compensalion prOviSions of lhq �bor Cotle, you mu5t forthwith FIOOf $ink5 Urindl 9
I rompry wlth SUCh provlsions or Ihis bB/mll Shall bG tleemetl revoketl. Swi�Ches �
CONSTRUCTION LEfJDING AGENCV GaSSCfviCe Outlet5 WatCfCl05et � Sign
(V I M1meby aill�m that Ihlru Is a conitruttlOn Ientling dg¢nGy fOr [he pertormdnte -
Garba e Dispoul ' Standing SeCtions
' of the work tor w�ich this pormit is iisuetl (Sectlon 309� Civ. C.) Intercept0�s WacerHeatE� � 9�
Lentler'S Name
,(� LenAer's Atltlress Kitchen Sink Water Service GeneratOr �0-5 KW �5�15 KW TreSh Compacror
�%' OWNER BUILDER OECLARATION
I he�Cby atflrm lhal I am oxempt Irom the ConVacror's Llcense Ldw fo� lhe LeVetO�iCS AUtO�Weih
following reason (Saclion 7031.5 Busineis antl Profeisional Cotle: HnY city or
County whiGh fUquir85 a pefmll IO cOnslr4Ct, alter ITplova, tlGmolish or lepalr P-Tfdp �,BUOdIy Tf8y5
any sVUGlurn, p�lor t0 Its ISSudnCa, a150 rlqW�eS t�te apP���dnt to� SUG� Pe�mit � i
to file a si9netl statument lhat ne/she is qcunseG pursuant to ibe provisions of ROOf D�eins '
tne Contractor'S L�cense Law (Chapter 9 ��pmmencing witb Sactlon 7000) o/ -
D�vision 3 01 th0 Bu57nes5 antl PrDIGi5iOn5 CoGU) ol lhat he/sh< Is exempt ` RBinSpBtti011 FOB �1�J ISSUB F8e 5 3
t�--+Irom antl the basis for lne allo9etl ax¢mption. Any violatlon o( Sectlon
5 by any applicant tor a pe�mil subjeClS lne applitanl t0 d clvil
L:y of not mora than Bva huntlreG tlollars (5500). S 3 DEVELOPNIENT•SERVICES REQUIREMENTS: _
i, as owner oi tno property or my omployaes with wa9es as their sole Reinapaetion Fee $15 Isue Fee Ze�i�p�qpp�oved By � Date
compensation, wlll tlo Ne work, antl tne s[ructum I5 not Inlentletl or ofteratl -' � '
for sale (Section 7044, eusiness and Protessional Cotle: The Contractor's MECHANICAL FEES Building Appraved By �'Date
License law tloes nol apP�Y to an ownor Ot a property who builtls or improves �
lheleon, antl wllo tl0¢s suCh wolk Illmzell/helsell Or IllrougM1 his oI h¢r Own BOiI¢I HOOd OI Type I ❑ APPIiCBtlOf1 Jifued By DBta `
employCCs, provltletl [nat Such Imp�ovem¢nts arB n0t Inl¢ntl0tl o� offeretl tor �.
sale. It, nowever, tno builtling or imorovemant 1s soltl witnin ono Year ot com- �anOpy Type I I ❑ ' - SUMMARV OF FEES �
oletloq tne owner wlll navo tho burtlon ol proving ha/the tlla not builtl or im- DUct - Under Ground � ,
prova for tha purposo oi sain). BUILDING PEfiMIT $ � Z� SMIP $�
❑ I, as o.vner oi the o�oocrty, am exclusivery tontractlng wich Ilcensea con- Duct - Structural Refrigeretion System P�AN CHECK $ PERMIT
Iraclorsto <OnsVutl [he prO�ecl (Section 7044, BUSIne55 antl Pr01e55iOns Cotla:
The Contiactor's License l.aw doos not aoP�Y �o an owner ot property who Duc[- Venlilating ❑0-100,0006TU �t00,000.BTU � �PLUMBING $ IS$UANCE $
builtli o� ITDrOves thereon. antl who conVac[5 1or such o�oi¢Cts wlth a con-
tractor(s Lcense pursuane [o �ne Convaetors Licnnse Law). I am aware that Exheust System ❑ MWtiple ❑ System Repair/Alteration � . P�%�N CHECK 25% $ ENERGV P.C. $
prooi o� tpeir Worker's Compenutian �nwrance shoultl be proviaetl m me. ELECTRICAL $ - GRADING $
❑ I am exempl untler Settlon B. 6 P. C. for this reason F{repl/Fact. Blt. ICBO # Fire Dampers MICROFILM $
Heatin S st g y� PLAN CHECK 50% $
Date Owner _ g y em & Ductin Re isters • � � Z s�
❑0-t00,000BTUO100,000BT MECHANICAL $ TOTALFEE $
I hereby certity that I h o reatl thls appllcation antl state that the above � PLAN CHECK 25% —•
intormation Is correci. I g o comply with all city antl coun[Y ortlinances $
antl state laws rola[ing o b il 'n conztruc[lon, antl hereby authoNze repre-
sentatives oi this nt r� n the above-mentionetl�r perty for �
InSpeGtian pulpoSeS. � �
Signature � � � Rainsveetion Fee $15 Izwe Fee 5 3 \ ' . 01 GOD28684—O.ni1�L$6Q5 li"�' � -i,`_��
Drivers' License or 55 � � � .- �ATE: 0-/�lfs�`j '�F(�E; !t;��
0865-46, rev. 5/88 WNte - BUIltling; Canary - Applicanp Plnk - Accounting; Golaenrotl - ASSesso�
CONSTRUCTION AND PLANNING i POOL s'� SpA
APPROVALS Permit# Date Inspector AppROVALS Pe�.___:# Date Inspector
1. Temporary Electrical Service or Pole �, 52. Pool & Equipment Locatlon c-
_;
2. Soil Pipe-Undrgrnd. : i � . 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrrid: 54. Forms
4. Electrical ConduiD-Undrgrnd.�' ' 55. Electrical Bonding �.
5. Steel'Reinforcement' • _ 56. Rough Plumbing & Pressure Test `
i _.
�
6. Electrical UFER Grnd.� 57. APPROVAL TO COVER-GUNITE ��
7rFoptings ' � . 58. Electrical Conduit-Undrgrnd.
8.� Foundation � ,- _ �� 59. Gas Pipe, O Undrgrnd., Test I'
9. Water Pipe�Undrgrnd. `� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. �Structural Floor System , � 61. APPROVAL TO DECK
11. Property Sewer Line & HouseConnection 62. Backwash & Receptor-Final
12. Sewer Cap �^� 63. Heater & Vent-Final �
13. Roof Drains ' � 64. Plumbing System - Final •
14. Rough Plumbing 65. Electrical�Final .
75. 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 Fleating & Air Conditioning FIRE DEPT. REQUIREMENT
20'. Rough Factory Firep�ace � APPROVALS Permit #
21. Ducts, in,Structure � 70. Underground Hydro
22. Ducts,,Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing �"�� � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing : 74. Overhead Hydro
26. T-8ar 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 BioWn Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal S0. FOOD CERTIFICATE ISSUED
33. Final Elec[ric � Notes: _` v.�� s
34. Final Heating & Air Conditioning � _� _V � �
35. Final Gas Pipe-Test -
t.. G
36. Hood or Canopy 3 �
Pf P
37. Final Factory Fireplace , Z _ -
38. Final Plumbin _ •�� ��J �
9 R�F ,v � i✓S'7iL ,:- - o�r ' S f;F---._ � f%
39. Water Service-Final �
40. Gas Service-Final '
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
ll
44. Landscape Irrigation System ! �
45. Sound Attenuation
46. Handicap Regulations � � K ' �
47. FINALSTRUCTURE & BUILDING - - C� �p V /dG � {Q- /
48. Special Requirements Completed
49. Electric Release to Edison �•
50. Gas Release to Southern California Gas Co � •
51. CERTIFICATE OF OCCUPANCY � ' '
No. Date ; ' '
i
JOBADDRESS ��n -�� �y
GENERALCONTRACTOR N31B CO.
L 1f19 BLOCK
GROUP 1
INSPECTIONS
Footing 7rench
Foundation Forms and Grade to
Rough Framing
Plumbing, Rough to Slab �
� Plumbing, Rough Complete
Temporary Pole
Wiring, Rough i
I Sewer, House St
Seotic Tank or Cesspool
l .ig, In ��2Q� 1
Plastering
Plumbino. Fin�al, Fixtures
Wiring, Final
Occupancy
Fnrm'L70 (
St.
V ZONE �1
DATE I SUBCONTRACTOR
DATE 9/2�/55
BUILDING PERMIT NO. 1857
VALUE S E.00O.00
FIRE DISTRICT 1881
PERMITS ISSUED
DATE I NUMBE
. Costa'Mesa Bnilding IDepartment� ��� APPLICATION FOR PERMI'1'
. ��r_ 171 EAST 20lh STREET B U I L D l N G '
� .. � - COSTA MESA� CALIFORNIA
FOR Od+'FICE USE ONLY
FOR APPLICANT 9.'O FII.L IN Receipt No. Petm�NO.
Building ��_ o �y� "�..tc�.— (% %
Address „
Receiv by ate Rec'd. Date Issued
Costa Mesa, California S�P 1 9 1955 -� S
Nearest Hatson
crosssc --Bonnvbrook Lane s�ua�oo
iress 8002 Central Avenue� Nearest
Garden Grove Te1• Le.9-2158 cross st.
� No. Zone
hitector Dav19 & Qui le �ic. C—].790
�ineer g Y No. Approved
iress 43 Malaga Cove Ylaza�Palos Verdes b
The Hale Com an cicy �to. 3422
tractor P Y No.
iress 8002 Central ave„ Garden Grove
nei�Minn I Nnt 1�2 I RIn..L 1 T.�..� 234
(Attach Metes and Bounds)
s$Sl � No. of Bldga None
Size of Lot Now on Lot
Useof No.of No.of
Existing Bldg. I Families I s
SetbackLinefrom � RearYard t
Center of Strcet 5� Side VarA
I� -Z.TiT�]tF�ii
S
*ring $t�1CC0 � Covering Shake
of New
Building Sinp,le family ch+elling with
attached garage.
I hereby aclrnowledge that I have read this Application
and state that the abwe is mrrect and agree to comply
with all City Oidinances and State Lxws regulating
building construction.
s�gnatureof THE HALE COAtP
Permittee
! �
Authorized Agt t Q O�
VSa�I�'atlon �RD� Permit Fee $ � �
Plan Check $ � � �
$ S, � ° ° To�� 7
Fee $ �J "�
HM 204 S-BP 2M 6-55
Costa
, California
APPROVALS
Lxation � Inspecto�
Bracin9. Bolts
Masonry Reinforced
Bond Beam
Date
O
�
�
PLOT PLAN
Show location and distanees from
property line and between buildings
e
°EP 21 �SPD�Es�� S75a {r :�.�:23 n�