HomeMy WebLinkAbout2073 FEDERAL AVE - Building Permits •
CITY OF COSTA MESA F
44#1e.
- BUILDING DIVISION
> N _. •. , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
Ft /s r PERMIT
11.14411 ����
o ,s B05-00080
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2073 FEDERAL AV Status: ISSUED
Suite: Applied: 01/18/2005
Vicinity: Issued: 01/18/2005
Parcel Number: 42250303 Zoning:
lc—
Applicant: KRIS WATSON ISSUED BY: S /
Address:
Phone: 909-238-5593
•
Zip:
Owner: COOKE, THOMAS J TR
Address )"2073 FEDERAL AVE -
Phone:
COSTA MESA,CA Zip: 92627
Contractor MODERN ROOFING
Address: 2219 W OLIVE AV •
SUITE 282 Phone: 888-311-7663
BURBANK,CA
Zip: 91506 License: 807881
•
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT •
T/OFF AND REROOF 1600SF RESIDENCE W/COMP SHINGLES
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: 52,100.00
Permit: $83.25 Claim Valuation: 52,100.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $83.75
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all'applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244648(6/00)
DECLARATIONS I c '
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
i I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued.
My wo,(k�rs'clpmpens Ion Insyrance carrier and policy number are:
Cartier: ,2'�Z�'.bC OL Policy Number: (9!.e29Q6'/-Zen'
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'oompensation provisions of Section 3700 of the Labor Code,I shall fonhwIth
comply with these provisions.
ApplIcant Signature: — Date: /- /3i`-05
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(VOODOO),IN ADDmON TO THE MST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed provisions of Chapter 9(commencing with Section )of Division 3 of the Business and Professions Code,and my license is in full ^
force and effect.Lk.e >0 Class C" 39
Contractors Signature: -- 1 Date: /-it-Or
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,es owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
. license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes 0 N
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does Or will the applicant or present or future building occupant require for the work which is the subject of this application permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feat from the outer boundaries of a school? 0 Yes 0 No
(if'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Date
/--/f.OS'
And/Or Authorized Applicant Date
COME f INSPECTION TYPE PAff. INTmALS CODE! INSPECTION TYPE PATE Ifs
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
ow
200 Final Re-Roof 1-21-o- 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
ADDRESS OF BUILDING: 2073 FEDERAL 'AV UMT: CITY OF COSTA MESA - BUILDING PERMIT
OMNEAS NAME IF KNOWN: MORALES, GEORGE M PERM NO: P 074872
ADDRESS: MORALES, BACH T
1017 BEGONIA AVE PERMIT NO: P 074872 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
APPL.MAIUNO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO. JOB DESCRIPTION : REPAIR SEWER LINE ON SITE SQ FT:
ARCH.OR 040:5 ADDRESS: MT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
cONmACTONSNAME: RESCUE ROOTER-ORANGE COUN ( 714 ) 558-0284
CONTRACTOR'SMMUN0 1085 N MAIN ST COMMENTS : REPLACE SEWERLINE ON SITE ( NO OTHER WORK AUTHORIZED)
ADDRESS: ORANGE CA uc.NO.: 353170 ***********************+t**********iE** **********+tit**+ESE* x*AE**x.**. .**AE E* ***it+r+E**
92667 Ute: Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under palely of perjury that I am licensed under provisions of Chapter 9 S ETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in Iu5 force end effect.
cm LIC.NO.: 034408 UC.cuss: C 36 UC.No.: 353170 12/95 MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
9. Date:/ a-2 7- 53
Contractor: .e.G� ` ���/ LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUreason
701.5 Se: des andy ffirm Professions
C•ode:Any
am exempt born apen lodweticemelaw/athe PARKING REQ: PROV: PARCEL : 42250303 ZNE: REF NO:
IWloNER reason(Rection ARATI BN:I hee bnd Pidesnder Code:Any e' ar gmmfy N}exe ngdrs t e he Con ra ons Li e,seer,improve,the
/ .molish.or repel any structure.prior to its issuance,also requires the applicant for etch permit to file a signed statement that he or she PLANNING NOTES>
'tensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
sines and Professions Code)or that he of she is exempt therefrom and the basis for the alleged exemption.My violation of Section > i 4- ,
'031.5byanYepplican for a Pernik subleds the applicant to a civi penalty of not more than Tide hundreddogen 155001). i(iE1EfEfFiElffE1E1E1fifiEiflEifiE1E****iFiEfFiFiElfiflEiElE****1E***iEfE****lE****1E****1EHEffiEiElE1F1E1fifiFiEififlEiEiEaE7Eil***
❑ I.ns owner of the laopuayor MY employes with wages as Mai este compensation,will do the war ,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an bwnerof property
who buids or inimwes thereon,and who does such work himself or herself or through his or her own employees,provided that such
improvements are not intended or offered for sale.i,however.the building or improvement is sold within one year of completion.the ZONING APPROVED BY DATE:
ownerbuilder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I.as ower of the property,an exdusive contracmgwim boensedcontractors toconstruct the untied(Section 7044.Business and BUILDING APPROVED BY : '�/. DATE:
Professions Code:The Contractors License Law does not apply to an owner of property who builds or inleoves thereon and who
contracts for such projects with a contrectorls)Icesed pursuant to the Contractors License Law).
❑ I am exempt under Section: B.APC..fog this matron: APPLICATION ISSUED BY: - DATE: I0 2:7 _ V
********************************************** *** ************* **
Date: ONAe LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N
(do hereby certify that I am aware of and understand the requirements of California health end Safely Code Sections 25505,25533.and
26534.and Mw for soy Munk building occupant wiR/cog rwr(dmb anal need bcoenpty with said rima Dudes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit to Wnstuclion or mnddaation from the A'rrarbgement District.Residential constnW ion eppluliore are exempt from these
provisions. PERMIT 15 . 0 0
Date Applicant: - - PLAN 25% i. SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury we of the following declarations: ISSUE FEE 20 . 00
❑ Ihave and wiimaintain aunilcmeof consent toself-insure for workers'compensation.spMd
provided for BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Cods, d
ePmmwethe work for wrack gie issued. TOTALS----> 15 . 00 20 , 00 0 . 00 35 . 00 35 . 00 . 00
❑ I have and coil maintain workers'compensation insurance.as required by Section 3700 of the Labor Code.for the performance of the
work for which this permit is issued.My workers compensation insurance carrier end pumber are:
Canter ARGONAUTd INS Cu EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 35 . 00 OVER/SHORT: . 00
Policy Number: WC/45580040 /8 01 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
is section need not be completed I the pemnt is for one hundred lagan(SILO(or less.) 35 . 00
•
o I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner iso as to
become subject to the workers'compensation laws of California,and agree thin H I should become surfed to the workers' *******************************************************************************
compensation provisions of Section 3700 or the Labor Code,I • hwlh comply ' those // INDIVIDUA L: F E E BREAKDOWN
Dare: j a a.? - 7-5- APPIiceN. -Alb.- -/®r✓—v
✓
Warning:Failure to secureworken'compensation caw �n ,end shall subject an implorer to criminal penalties end TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
clvll fines up to one hundred thousand dollen($104000).In addldon to the cost of compesatfon,damages as provided for In
Seddon 3706 of the Labor Code,Interest,and adpmey'a fes. PLU 1 SEWER, BUILDING / TRAILER 15 .00 15 . 00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that them is a construction lending agency for the END OF FEES
performance of the work for which this perms is issued(Section 3097,Civ.C). .
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and stale that the above information is conn.I agree to cam*with all city and county ordinances
and stale laws relates;to building construction and hereby authorize representatives of(his ab.to enter upon the above-mentioned property
•
fon inspection punpoaee. JOE V I ERA
RNa�
/iliaGci om�s7-77 /< ` 01 R0:.C71 -J:.1143157 TOT
Sig d Owner/Agent/Applicant/Contractor
.Oil
LATE: ;Lw' Per 7: - L -
(5151'46.WP) White-Building 3 Safety-,Green-Rle;Canary-Apparent:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL PA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
'._3-: Electrical Conduit•1Jrility-Und •
rgrnd. 54. Forms
;4j"Electrical Conduit Undrgrnd. 55. Electrical Bonding
,415.j$ttpgl Reinforcement 56. Rough Plumbing & Pressure Test
Ir --C,m -
6. 2 btrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
u�
%;rill;
F
il:; ootings 58. Electrical ConduLtUndrgrnd.
•r'8. Foundation -- • 59. Gas Pipe, O Undrgrnd., Test
:-.8. Water Pipe-Undj rnd. _ 60. Backwash LineLP'Trap, 0 Undrgrnd.
- c .
10. Structural Floot7Svstem 61. APPROVAL TO DECK
11. Property Sewer Line & Hous?-Connection 62. Backwash & Reeeptor-Final
12. Sewer Cap r. - 63. Heater & VentPinal
c .
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing. r 65. Electrical-Final
15. Rough Electrical-Conduit -. 66. Solar System-Final
16. Rough Electric wiring . 67. Fencing & Acca Approval
17. Rough Wiring Sign - 68. APPROVED FO.R'PLASTERING t
18. Rough Electric&T-,T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning r r - FIREDEPT.REOUIQEME ,T -
20. .Roug^b FE- tobiFireplace 'V ; . `. ' APP O V f1LS,, PeKmit 4
21. Ducts,in-Strticcturei* •• _ O r,----..: F 70.p.inder3Rd I 'dro ,
22, Ducts, Vent Hit ' - -
il t • - ?¢ 4' kr'X t
- . -' s .: 71. Produal.Piping 0-Gas E Oil
23. Gas Ape-Rough & Test • _ _
tr* ' • T cr T E_ rj 72, Undergrotrjd Fjlsh
24. Roof'Framing nrd.Stoagg Tank D Gas ❑Oil
- : :
1
25. Roof-Sheathing ri.r _ •. V .4 •• C.- 74: Overhead Hydr:d `
T
26., -Bar Ceiling (Strfcfural) & klonocoat F 75_. Dry Chemical .,
27.;frameand Flashing ; .,r•-- * c •r S1 76. Dry Stae pipe..-;t!r• x R
' 28. Lathing &'•Siding;1 • _;_ -- * ' 771 FIXED SI?STE ifr1 NAL-
29. Insulation' _ _ •• •_ 7titi,FIREEPREV. FJINTAL
'� 30. Drywall Nailing '. ,,, r r < • L c :,HEALTfl DEPT. REOUIR=EMENT
\\ --
rr 31. Plaster Brown Coai. _ ?'r• ? 79 NAL LNSPEC1tION - -
o- -;- TrT • 1' r• -
32. " lectricaLPower MervFinal , 4 C:._8Q, F OD CERTIFIOATE I�S1:&E0,
__, 33. FinatC;Ele,GtriG, ?I* ' N tes:/a sa _573-- r`�tzo,�� A. ?c
34, Fina'€.Htin4& At1yC9ndItioniRir ;r ,. . , Y• ,-.r ,. -
35. F,inalGag Pipe;Test , -
. c . - :. " -i a --
' 36. .Hcod'or'Canopy c ' • s n 7- -
-
37. Final Factory Fireplace .'7•7 Hi- rt- ..ia,
38. Final'Plumbing -i* yN I /y� -5 ,. : a L
_ - - /tri /�'
1 39. Water Service-Final 4 - x
-. - '4." .. .,
h 40. Gas Service-Final v- ' c " •" ' C'•" =' 4
41. Solar Domestic.Fial. .: _ A " - �•c - . '- -
42. Backflow Prevents!: s %- r'F - -
: _ t' r m,. .i
43. Backflow Irrigatic,- " - a 7 r' l
C., n . r
44, Landscape IrFpatiOrtSystem"`Il' t`' - Gry n- ::r' ; _
5. Sound Attenuation}
•i •r; E1 e E- - i
46. Handicap-Regulations - _ ^ T 7c _ x
n1 �. C.
47. FINAL STRUCTURE & BUILDING r c - r
48, FINAL PLANNING : - I .T y '
.49. Electric Release to Edison , c, _
'50. Gas Release to Southern CaliforniaGas Co * `;- ` N .
51. CERTIFICATE OF OCCUPANCY
No. Date
•
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
NI CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. -
/
CONSTRUCTION PERMIT /0— =2 .t 1065 1 /21 /82 5.00 TL
tProject Address o/J feat e rim./ ✓G TYPE OF CONSTRUCTION t - . - -
N Ownere:6go/ fret' ,VJyy
et' COO/te, Phone . I, 0 NEW 0 ADD 0 ALTERATION f.,.,t _
Addrea�a75 Fe Aer.4/ Ave ❑ REPAIR 0 CONVERSION ❑DEMOLISH z
Arch/Eng. License No. 0 OTHER A P ZONING REGULATIONS
DESCRIPTION OF WORK
Address ��77 ZONE PLNG. REF. 716
Contractor? egor s fes)h7� T.f/e Phone-272 „is/74 TYPE OF PERMIT BUILDINGCK C/L 5T. TO BUILDING
SETAddress S PROPERTY LINE
/ 33 Zej L�A.41 /w/ 0 GRADING 0 FOUNDATION 0 STRUCTURAL SID TYA RD
LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING OMECHANICAL SIDE YARD
I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code, and my license Is in full force andeffect. REAR YARD(TO P/L)
License Class el License No. / /471 PROJECT DESCRIPTION PKG.SPACE REQ. PROVIDED
Date/n2 -4-.24•1-P/ Signature r
c- t-,a- /,i7L/ SO. FT.
WORKERS'COMPENSATION DECLARATION - OCCUPANCY-CONSTRUCTION TYPE STREET WIDTH PARK FEE$
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY DATE
certificate of Workers' Compensation Insurance, or a certified copy
.}�-
thereof (Section39e L-anb.C-Company�P,avie r L�F GRADING CU. YDS. ACRES SPECIAL CONDITIONS:
P^gcy No. g/t7L.Y tf
'ertifled copy Is hereby furnished. REMARKS:
:ertlfled copy Is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
This section need not be completed if the permit is for one hundred
$100) or less).
certify that In the performance of the work for which this permit is
Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers Compensation Laws Of California. UW EBBING GARAGE
Date Signature BATHTUBS SHOWERS SO.FT SO FT
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW._1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS • APPLIANCE 10-50 KW_50+ KW
revoked. 4
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP_1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+ HP
formance of the work for which this permit is Issued (Section 3097
Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES .
Lender's Name _
Lender's Address DRINKING FOUNTAINS • GAS TUBE SIGNS
OWNER BUILDER DECLARATION -INTERCEPTORS CLARIFIERS POLE LIGHTS
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNO I NULI IUN
Any city Or county which requires a permit to construct, alter, POLES METERED SUB
improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN ' SUB
quires the applicant for Such permit to file a signed statement that he -
is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP
BChapter 9 (commencing with Section 7000) of Division 3 of the
usiness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT ay Q.
basis for the alleged exemption. Any violation of Section 7031.5 by _
applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS -
zt more than five hundred dollars ($500).
„ as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS '` , . , '
sole compensation, will do the work, and the structure is not intended -
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE '
Contractor's License Law does not apply to an owner of a property - ,� 7Q APPLICATION APPROVED BY DATE
who builds or Improves thereon, and who does such work himself or ISSUE FEE
through his own employees, provided that such Improvements are not -
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK
Is sold within one year of completion, the owner will have the burden SUMMARY OF FEES
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMTP $
❑ I, as owner of the property, am exclusively contracting with AND DUCTING -
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT
and Professions Code: The Contractor's License Law does not apply to - _I ISSUANCE $
s
an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ O'er/)
tracts from such projects with a contractor(s) licesned pursuant to SYSTEM 100,000 +BTU PLAN CHECK S GRADING $
the Contractor's License Law).
❑ 1 am exempt under Section B.& P.C.for this BTU ELECTRICAL $ $
reason PLAN CHECK $ MICROFILM $
Date Owner - - SYSTEM REPAIR,ALTERATION TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $
•PLAN CHECK $ V
AD-
Information is correct. agree to comply with all hitt' and county VANCEPC $_
representatives
epres ata iv and state laws relating to count
upon the above mentlonetl • �'
property for ect�iof p Osez. La.(f
Signature p^� �R�� Date���V-I� FINAL FEE $
Drivers'License or SS$ ISSUE FEE -
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNIN POOL&SPA
¢�5! Date Inspector APPROVALS Permit# Date Inspector
APPROVALS Permit# , - - _
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing & Pressure Test
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe,.❑Undrgrn,Test
9.. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑ Undrgrn
10. Structural Floor System 52. APPROVAL TO DECK
11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final
12. Street Sewer Connection - 54. Heater &Vent-Final
13. Rough Plumbing 55 Plumbina Svctrm - Final
14. Rough Electric-Conduit 56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating & Air Conditioning 58. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING •
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL •
20. Roof Framing
21. Roof Sheathing j'� , o
22. Frame and Flashing NOTES: `f- IU,ja_ PAD � 22--43
23. Insulation 1.4 if �4 tat( 44:1 Alla{,p
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat _
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating &Air Conditioning
30. Final Gas Pipe-Test
31. Final Plumbing • q/9/r3 ,%qy
32. Water Service-Final
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System
36. Sound Attenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING
_ 39. Special Requirements Completed
40. Electric Release to Edison i
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
PROJECT ADDRESS: 12073 FEDERAL AV UNIT` CITY OF COSTA MESA - BUILDING PERMIT PERM NO; P 053380
OWNER'S NAME. COOKE, THOMAS .J
ADDRESS: 20.73 FEDERAL AVE PERMIT NO: P 053380 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: 642-6141 REG.NO.:
ADDRESS: UNIT:
JOB DESCRIPTION : INSTALL WATER HEATER SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
PERMITTEE: EARLS PLUMBING ( 714 ) 772-3470
ADDRESS: 1533 W. LINCOLN COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME
ANANHEIM CA 92801 *************************** **#*****+t• ******N.x* *****EFTA*** *********>E*+;***x***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code, and my license is in Lull rice and effect.
SETBACKS
CITY LIC.: 005(.238 STATE LIC.:21765CLAS 6
Dale: 8/ /I9/ Signature:_, - — MAIN BUILDING ACCESSORY BUILDING
WORKERS'COM NSATI DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN
CompensationInsurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICYNO.: UCA-11686 EXP.DATE: 03/0I /92
COMPANY: (INICARE PARKING REO PROV: PARCEL: 42250303 ZNE: REF NO: •
'7 Certified copy is hereby furnished. C}4 Certified copy is filed with the city Ad' Division. PLANNING NOTES> -*-
Date:4. 'I/r/ Applicant: fE*********#*ii****-:.*********if*******************iF-)6***-lF****3F*?F***3F*****}:*apo;*i(;r****
EXEMPTION FR M WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100 or less). DE VELOPMENT SER V IC EQ..-- REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
• DATE:
Date: Signature:
NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - -I DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �yJ��
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED Y: (�//( - #151 it DATE: 42-C/`" ///
which this permit is issued(Section 3097.Civ.C). ********************** **#******************** *ie******* n-**
LENDER: ie**********}i******)i**Y.*******1(********3E*3i.' ***y.***ie**Xi-***Y..**;f*******************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Oivision 3 of the Business 25% (2) SMI P/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN .a
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($50). ISSUE FEE 3 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2 . 00 3 , 00 0 . 00 5 , 00 5 . 00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.ff,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 5 . 00 OVER/SHORT: . 00
for the purpose otsale). BLDG PMT PLUMBING ELECTRIC MYCHANIC FIRE SMIP/TOT GRADIING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 5. 00
:J
❑ and Professions Code: The Contractors'Slate License Law does trot apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuanttothe Contractors'State License Law).tam aware **.*********y,..**i{.**.********************arE}c*;{.*.****************iF*****3(*a{it*7(***I6***}:*
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.a P.C. I N D I V I D U A r' , F E E BREAKDOWN
for th¢reason: TYPE QTY D E S C R I P T I 'O N UNIT COST TOTAL COST
Date: Owner: PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534 and that I or any future budding occupant witliwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from -)
(hese provisions. „•
Date. Applicant:
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county %1 /
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned 4-
property for inspection purposes.
___g/2�_,// Signature' LT'•. 3C0 i ii'L C7f'5t5ep 7 i r.'_i' _
DatDriver's License or Social Security a: g )FirrEt OS/26/71 TINEP:-t
`
164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL .PA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Servic;o{ Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. .tea • . 53. Steel Reinforcement 1%:r
3. Electrical Conduit Utility-Undrgrnd. Ow- Forms •
4. Electrical Conduit-Undrgrnd! 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation
. _ i,,I 59. Gas Pipe, Undrgrnd.,Test <
9. Water Pipe-Undrgrnd. Y- ✓- 60. Backwash Lines, P-Trap, 0 Undrgrnd. •
10. Structural Floor System ,Lf � 61. APPROVAL TO DECK •
7
11. Property Sewer Line & Hpu;eaConnection;jry 62. Backwash & Receptor-Final t
12. Sewer Cap ` 't' t
63. Heater & Vent-Final • /•2.
Y'
13. Roof Drains f ''
y , 64. Plumbing System - Final ,.
14. Rough Plumbing 65. Electrical-Final
15. 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 Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd.Storage Tank 0Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar 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 Brown Coat • 1 79. FINAL INSPECTION
e
32. Electrical Power Meter-Final c( 80. FOOD CERTIFICATE ISSUED
33. Final Electric •.� Notes:8/3O/4/ t.UONgWool -1 rr c4¢O•GF
34. Final Heating& Air Conditioning : •��
35. Final Gas Pipe-Test
ii
36. Hood or Canopy „ILL)
37. Final Factory Fireplace I •
38. Final Plumbing • ?(glee (.to
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44, Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 'TV
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
-...-;OWNER COOKE, THOMAS DATE 2-13-bti
JOB ADDRESS 2073 Federal Avenue BUILDING PERMIT NO. 28205
GENERAL CONTRACTOR Air Vent Awning DESCRIPTION OF WORK Patio Cover
AP No. - -• LOT TRACT FIRE ZONE VALUE $ •j 40
I- 'ECTIONS Signature Date GROUP j TYPE 7V ZONE R-7
cL.8.
SUBCONTRACTOR I PERMITS ISSUED
Gas Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.0
Sprinkling System
Miscellaneous _
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0 _
Rough Wiring I Heating and Vent.
Trenches O Forms 0 Steel Reinf. 0 I
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing—In 0 Out 0
Plaster, Brown Coat
Sr-'^tural, Final Electric
I .ig, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final /�
Building. Final „7. YVI e AZ// R`//L.ir
711.1P.
• 28205 �:1,: ,.2sz ��►**�s.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92028
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
eu1LDINSa .�LJ�C/ For Office Use Only
ADDRES /3 PFS OFF 11. Av /MCKIPT NO. PERMIT N.D.
COSTA MESA. CALIFORNIA RICE / (/
i.
OWNER / /TT/m/9S /00 Al oC'77/1„2:25--(tet
� C�
MAIL �j /- BUILDING _
ADDRESS 2e' /3 rcOE�AZ Ave-- ADDRESS
/ �/�
TEL.411"- FIRE V
CITY LO S rn ///Ts3/S) NO. c- - ZONE J//TY/�PyE IILJJ�����/ GROUP
/� BYAPPROV[D � /�(/\ DATE 2`/�-
NGIIN 8R tC5Fr , '%-Er No b/79C / !!!��/��\
'n �/ :of�v NO.OF ZONING OF NEW
ADDRESS 3/�/ ,.,� (�/1 � fP/Y(.OA[T Le Ae (J
�J ^ I I PLANS Z I BUILDING l RTIL, ,-'01102-
CONTRACTOR
ev ,
CONTRACTOR At—/�r-ArrA&'wiNfy-/i . ) /I ,..L) 11 ''
LEGAL �� 43 ) tr dc/ ILLI l7 i L
ADOREGBl�9 Sn. /Q2AA/G s,aSTF.Ee _ DESCRIPTION ,}
A.P.NO. // s- 4riz _ 3
CITY AVIV N F Lain
Ce/-/90/02-
&NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
LIC..NO.�6/-/tk /OZ TEL
DO'TO SIDE REAR P.L.
SIZE I NO.OF BLDGB. VES
ALLOWED . (U.B.C.REQUIREMENT)
OF LOT NOW ON IAT I
YARDS APPROVED YARDS APPROVED
USE OF /' /J MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.J/IYGrLK
E Anneo-Y GS,O. .(FROM�G LSTRB[TI
SETBACK LINE PROM +� / RRONTIJD y1 FT. �X,S FT.
CENTER OF STREET REAR YARD 3Q
SIDE YARD I LEVY 1 J / I RIGHT /3 / R.BIDE i S r. L Fr.
DESCRIPTION OF WORK `` / L.GIDE /9" rr. 12. PT.
_ T[RATI N ADDITION JG�, RGR (] PT. - PT.
DISTANCE,BET. 1 BET.MAIN&
REPAIR MOVING OBMOUSH MAIN BLDGS. J014 ACCESS.BLOCS.
BUILDINQ/ , 9 NO.OP VAR•# / - DATE
SIZE �L ROOMS / STORIES i C.U.P.* APPROVED
EXTERIOR WALL ROOT APPROVES IL/eV p
COVERING I COVERING Auyn,Nu,m, BY I� �{.p - DATE Z- i 3 -es
USE OF BUILDING AND WORK TO BE PERFORMED� 0.
-- �/
it MG>'A'L L /tZ,,/IY7. aln4 le//Fr,C y1G
(r v,c tesr,) i rT/JCH'FJ7 7» IPF�D.t 'O
0,- 5;ANrLP eon/da-y" /C F6i!! SQ.PT. Z
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION Is FOR THE j
AND STATS THAT THE ABOVE IS CORRECT.AND AGREE TO coil. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. 217
PLY WITH ALL CITY ORDINANCES AND STAT[LAWS REGULATING VALUATION O
BUILDING CONSTRUCTION.
It—
SIGNATURE OP /j /J l/J O'6 PERMIT FEE S pp
PERMITTEE �/�/J ) ALA /r7',r- /%'J�/(J 0
L $ `� X PLAN CHECK $ R.
AUTHORIZED AGENT Z --es
6 TOTAL FEE $ !C/
NIANGE COUGNc N&BUILDING rth DEPARTMENT . APPLICATION FOR PERMIT
oaway
SANTA ANA, CALIFORNIA -_ _ BUILDING : . .
1
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ECEIPT NO: PERMIT NO.
BUILDING / ,“ /� J'771
ADDRESS 2073 Federal Aie. • - rte!//-/
SCHOOL DIST. RECEIVED BY DATE OF APPL. DATE ISSUED
OR TOWN /� (//
NEAREST c.a. Ip •23- C -2- O/ /
CROSS ST. Victoria S . �y? y- J /(y IIS
OWNER BANNOCK HOMES, INC. ADDRESS ,f) a7 ( e /ererz<A7f(c-
MAIL SCHOOL GIST. Cos �y//� Jam..
ADDRESS 9363 WILSHIRE BLVD. �• OR TOWN Co,J ZrL //cs'�! . ,
CITY BEVERLY HILLS TEL. (-R. 54361 NEAREST ♦♦♦♦♦♦
CROSS ST. � 6 a I '.
ARCH ENGINEER ARIN Bc MCKERRACHERNpL'SY. 64891 ZONE
/ I PLANS I TYPE I GROUPc Jr
ENGINEER 1^.P4 f C /,I
ADDRESS 2110 E. WALNUT ST., PASADENA SETBACK LIW,FXQXI CENTER OF ST. 5
iit
REAR YARD 0I t* .r SIDE YARD 1-716"
1 VTRACTOR NEWPORT VISTA CO.NO CR. 54361 APPROVED
BY DATE
ADDRESS 9361 WILSHIRE BLVD., BEV.HILLS
CORRECTIONS
LEGAL
DESCRIPTION I LOT NO. 431 0
1 I BLOCK 1712
(ATTACH METES & BOUNDS) _
TRACT
67 K 110 I NOW ON LOT NO. OF S 0
SIZE OF LOT ,
USE OF I NO. OF I NO. OF < '
EXISTING BLDG. FAMILIES ROOMS
•
DESCRIPTION OF WORK
NEW I X I ALTERATION I I ADDITION I O
A
O
REPAIR I I MOVING I I DEMOLISH y
BUILDINGNO. OF r
SIZE 1034 SO.FT ROOMS 5 STORIES 1 - P
WALL COSHNNG
. `. ui'
COVERING STUCCO COVERING SHINGLES °r'
USE OF NEW
BUILDING RESIDENCE I/jl/
a-- Cyrovy Ll
2.
APPROVALS
FOUNDATION: LOCATION IN PECTOR DATE s
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS ' FORMS. MATERIALS. Dr. ( K �( /1
APPLICATION AND STATE THAT THE ABOVE IS CORRECT - UNDER-PINNING a V Ka
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES • FRAME: FIRE STOPS. �� �-/U `
BRACING. BOLTS (J
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. (']
LATH. INT. ) .- /
SIG
PERMITTEE - . `.� �- is--6:-..
LATH. E%T.
Alla
i . PLASTER. INT. _✓ / /)• -S3
AUTHORIZED AGT� /.)�'� X y
Q /�/� •� PLASTER. EXT. ..! /"�„1 I y- / SI
$ 4830.00 P. C. S -- MASONRY REINFORCED f
FEE l y
S / BOND BEAM
VALUATIONaur
^ { q
_ ___. FEE hr FINAL _„ l�'i 717-1
•
Is]
zA. w
J
-fid . .PLOT PLAN J •
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o
•
a
z. .31. J , =1: .. ; 3J:.114
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A71( t .T, IL•'; IA / ._ 0112
CJJ1.'-.Y3 . . CVJ 311113J1 .�
2 f' f r !�
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STREET
• X
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33J0111512 33313T3
33113C 1
3311:01 ^.3
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