HomeMy WebLinkAbout652 BEACH ST - Building PermitsAVD���ant to fill in all spaees exceot those within heavy coraer Iines antl sign a11 approoriate tleclarotions.
CITY OF,COSTA MECS CONSTR CTIO PERMIT ,�J^`� 'N��. TRACT NO. LOT NO. UNIT N6. '
ProjeSCAddress ✓ � r V` � '
AQplicant's Mailing Address i TYPE OF CONSTRUCTION rvEw Aoo a.LTERA7�ON REPAIR
Owner"s Name � CONVERSION ❑ DEMOLISH ❑ OTHER
��I^�� � Phone � DESCRIPTION OF WORK/USE OF BLDG. A P#
Address -�� -�� � S Main Building:
E
Arch/Eng. License No. TVPE OF PERMIT GRADING �❑,/FOUNDaT�orv STRVCTuanL T Front
Address ❑ OTHERT ❑ ELECTRICAL IJ PLUMBING ❑ MECHANICAL A Rear
Contractor's Nam Phone pROJECT DESCRIPTION 50. FT. OCCUPANGV C Right .
Address (mailing) _ � K
Cit LicensPNo \ �� CONSTRUCTIONTYPE VALUATION$ g Left
Y ZONE GRADING CU. VpS. ACRES PIO Ref. #
LICENSED CONTRACTOR DECIARATION • 9�
I M1ereby affi�m thai I am licensetl untle� p�ovi5iOn5 of Cha�te� 9(commencin9 Rema�ks: Pldnniny NOt¢5:
I Y ]000 f D' I' 3 t Ih 8" tl P i I C tl d � '
w tn sec ion ) o iv sion o e usiness an ro ess ons o e, an
my license is in fuly(or4 ntl e(fec[.
License�ij�a 5 �%«L i nsa No.
'��te �n ' Si9nawre
/OftKERS'COMPENSATION OEGLARATION
� hereby affirm tha[ I have a certificate of consent to self-Insure or a certi(icate
of Worke�s' Compen5ation Insurance, or a[ertifi¢tl mpy Ine�eof (Section
3800, �ab.r C, �% %� �
� PolicY No.'i �' -( ✓� V� � ComPanY ��.
�rYfie�tln/ �oOY a filetlbwithrthencitY lItli g)� tv%'� o� /�/}��
Date � (.2��'� AppliCant�r-�/� (// ��-/' � / _
EXEMPTION FROM WORKEFS' COMPENSATION pECLARATION
�This section neetl not be completetl if the permit is tOr on¢ huntlretl ($100) or
less).
I certity that in the per(ormance Of the work tOr which this perm�t is issuetl, I
shall not empioy any person in any manner so as to become sub�ect to the
Workers' Compensation Laws of Califo�nia.
Da[e � - Si9nature '
NOTICE: Ii, a(ter making this tleclaration, you shoultl become subject to tne
Workers' COmpensation prOvisions of the Labor Cotle, you must forthwith
mmply with iuch 0/ovlsions o� this pe�mit shall b¢ tleemetl ,revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby aftlrm that tnere Is a construction lentling agency for the peiformance
of ihe work for which this permit'i5 i55uetl (Section 309].'Civ. C.)
Lentler's Name
lentler's Atltlress
OWNER BUILDER DECIARATION � �;
I hereby affirm that I am exempt trom the Cont�acto�'S License'Law for the
followinq reason (Seclion ]031.5 Business antl Protessional Cotle: Any city or
munry wnicn requires a permit to construct, alfer, improve, tlemolish or repair
any structure, prior to its issuance, also requires tne ap0licant for such permit
file a siqnetl statement that he/sne is licensetl pursuant to the provisions o(
� Contractor's License law (Chapter 9(commencing with Section 7000) of
�isiOn 3 ot the Bu5ine55 antl Protession5"Cotle) or that he/she is exempt '
,aerefrom antl lhe Dasis tor the allegetl exemption. Any violation of Section
7031.5 .by any applicant for a permit subjects the applicant to a civil
�enalty of not more than five huntlretl tlollars ($500).
LI I� as owner oi the property or my employees with wages as their sole
�.. c.r�nn wiu nn the wnrk_ rntl the sVuc[ure is not intentletl o� of(e�etl
ale (Seclion /Oa4, Cusiness ana rro*essionai t,oae:
se Law tloe5-nOt apply to an owne� of a property who
m. ana who tloes such work himselt/herself or throi
ployeez, provitletl that Such Improvements are noc mtenaea or o**erea ror
e. If, however, Ihe builtling or improvement is soltl within one year of com-
tion, tM1e owne� will have the burtlen of proving h¢/she tlitl not builtl or im-
we for the purpo5e of sale). - �
1, a5 owne� of the property, am exclusively cont�acting with Iicensed con-
ctorsto construct the project (Section 7044, Business antl Protessions Cotle:
_. Contractor's License Law tloes not applY to an owner of property who
Itls or improves tnereon, antl who conVacts for such projects with a mn-
ctor(s) ucense pursuant to Yhe Contractor's �icense Law). I am aware tnat
ioi ot their Worker's Compensatlon insurance shoula'be provitletl to me.
I am exempt unde� Section B. & P. C. fo� Ihis reason
Bar Sink
Backflow Preventer
Bathtubs
Clarifiers
Dishv.2sher
Drinking Fou
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavamries
P—Trap
Roof Drains
Reinspection Fee
Outlets
$15
Boiler
Duc[- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System � Multiple
Firepl/Fact. Blt. ICBO #
Date Owner Heating System & Ducting
I hereby certify that 1 nave reatl this application antl state that the above ❑0.100,000 BTU �100,000
iniormation is correci. I agree to wmply with all dty antl county ortlinances -
antl state laws relating to builtling construction, antl hereby authorize repre-
sentatives of tl7�'5 cit t enter pon the above-mentionetl property for �
inspection pu�p65 5. /� _ �/ -
• Signature D'ate / -
Orivers' Licenze or 55 � - Reinspection Fee
=MF 0865-46, rev. SO/84 WM1ite - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - A55essor
$15
Showers
Service Sink
Sewer Cap � -
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service -
Auto-Wash
Laundry Trays '
laue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑o-i00000eTu ❑ioo,000
System Repair/Alteration
Fire Dampers �
Registers ,
Isue Fee
FEES
$ 3
$ 3
Automatic Washer
Construction PoleSub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches � -
Garbage Disposal
Generator �0-5 KW [
Fee
2one
Accessory
Parking Req./Provided
ELECTRICAL
Transtormer ❑ 15-50 KW
o so + Kw
Meter ❑up to 100 amps
Meter ❑over'100amps
Sub Panel
Motors �0.1 HP 01'/, - 8'
IncSolar �9-15 HP 076-15+
Microwave j •
Pole Light
fiange
Standing Sections
5 KW Trash Compactor
$15 Issue Fee �
0
FEES
� $ 3
Z
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5
DEVELOPMENTSERVICESREQUIREMENTS: ' � �
2oning Approved By � Date �
Buildin9 Approved By Data
Appliwtion Issued By Date
, SUMMARV OF FEES • . ,
BUILDINGPERMIT $ �SMIP , $
PLAN�CHECK $ PERMIT
PLUMBING $ �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C.� $
ELECTRICAL , $ • � GRADING $
PLAN�CHECK 50% $ - � MICROFILM ' $ O�
MECHANICAL $ _ TOTAL FEE $
PIAN CHECK 25% $ �
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector pppROVALS Permit #� Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location;;
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �a�}
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding {�;;
:, �
5. Steel Reinforcement 56. Rough Plumbing & Pressure�Test
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnii�
8. Foundation 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL TO DECK
11 . Property Sewer Line & House Connection 62. Backwash �& Receptor-Final .
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Fough Electrical-Conduit 66. Solar System-Final
16. Rough Elearic 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 �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical� �
27. Frame and Flashing 76. Dry Standpipe '
26. Lathing & Siding 77. FIXED SYSTEM FINAL ,
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co ���
51. CERTIFICATE OF OCCUPANCY �i
No. - Date �t
,'
�
PflOJECT RODFESS: 6 J � 3 taCH 5�,
OWNEfl'SNAME: �OHR�s'O�, ELT'LA�ETY
ROOflESS: 6 � 2 ��.,aCH S 1�
COS"1i MnSA,CA 92627
RHCNIENGINEEP: �L$�-79Q5 BEG.NO.:
aooness:
UNIT:
uxiT:
PENMITTEE: HIIVT�.NG'�UiV dEACH GLASS ( 7;�, ) 848-5230
aooaess: 17�2712 GO�iiAR� 3
LICENSEo CONTBACTON DECLAflATION: I hereDy af�irm thal I am licensetl untle DA �5ion5 o�Ch�p�er 9(commencing with Section
70�0� ol Orvision 3 af �he Business antl Pro�essians Gode, ana m hcense is in fulliorce anA eifect.
ciTr uc.: � 4 � �.� STATE �IC.: � O S S F3 _
Da�e: SignaWre: —
WOPNEPS' C MPENSA ON OECIABATION: I hereby affirm Ihat ce �o sel4insure or a ceniticaie ol Workers'
CampenSalion Insurance, or a cerlifietl copY �hereo� (Seciion 3800, Lab. C).
voucvNo.: �3kC.0006630003 E%P.OATE: O(.��Q�ljL
camvnNr: NA'r:ON;dIDF M[JTiJ
r C¢tli�iea copy is hereby fumishetl. ❑ Cetlifie0 co is� c Builtling OiviSion.
.�e: �� �I Applicant:
E%EMPTION FPOM WOPNENS' COMPENSpTION UECLAflATION: (This section ne ' �e permi� is for one hundretl ($100) or less�.
I certily t�ai in Ihe pedormance o� t�e work lor w�ich t�is permi� is issuea. I shall noi employ any person in any manner so as to become
sub�eci lo the Workers' Compensalion Laws o� Cah�arnia.
Da�e: ' SignaWre'.
NOTICE: I�. aller makinq Ihis tleclaration. you shoul0 become sublec� ro Ihe Workers' Compensation pmvisions ol �he La6or
Code, you mus� fotlhwil� campty wilh such pmvisions or �his permit shall be OeemeO revoked.
CONSTBOCTION LENOING RGENCY: I �ereby altirm Ihal ihere is a con5lmciian lenaing agency �or Ihe pertormance ot �he work lor
which Ihis permii is issuea (Sec�ian 3097. Civ. q.
LENUEH:
PUDPESS:
OWNEfl BUILUEB OECIAHRTION: I here6y allirm that I am exempt Irom ��e Contractors' Stale License Law for Ihe lollowing reason
(Sec�ion 7031.5 Business antl 7rotessional Cotle'. Nny ci�y ol counry which reQuires a Dermit to con5imct, alter, impmve, Oemolis�, or
repair any simdure. prior to its issuance, also requires [he apDlican� for such permi� �o �ile a 5igne0 s�a�ement �hat helshe is licensetl
pursuam m t�e pmvisions of the Comramors' State License Law (Chapter 9(commencing with Section 7000) oi Oivision 3 of the Business
and Pmfessions Cotle� or thal he/she is eKempl thereimm and Ihe basis �or Ihe alleged exempiion. Any violation o� Sec�ion 7031.5 hy
any applican� for a permil subjecis Ihe applicant �o a civil penal�y ot nol more �han five huntlre0 Aoltars (5500�.
I, as owner of ihe pmpetly or my employees with wages as Iheir sole compensation. will tlo ihe work, anJ ihe
❑ s�mc�ure is no� imended or oitere0 �or sale (Section 70a4. Business ana Pmtessional CoOe: TAe ConVactors' S�a�e License Law
aoes nol apDly Io an owner ol a D�openy who builtls or impmves thereon, an0 who tloes such work himselVherself or �hmugh
his or her own employees, pmvi0etl Ihal such impmvemems are not in�ended or ofleree tor sale. I�, however Ihe OuilOinp or
impmvemenl is soltl wi�hin one year ol compleiion, the owner will have Ihe burtlen of proving he/she �itl not hui10 0� impmve
lor Ihe purpose of sale�.
I, as owner oi Ihe pmDerty, am exclusively conlracling wilh licensetl coniratlors �o constmc� �he pmle�� (Sec�ion 704a, Business
L� and Pm�essians CoOe', The Conlractors' Sfaie License Law does not apply to an owner of pmDe�Y who Ouilds or impmves thereon
antl who comracis lor such pmiec�s with a contracmr�s) license pursuam �o ��e ConVacmrs' S�ale License Law). I am aware
thal prool o� IAeir Worker'S Compensa�ion insurance should be pwvitletl to me.
� I am exempl unJer Sec�ion: B. 8 P. G.
�or �his reasan:
Daie: Owner
I do hereby cetlily �hal I am aware ol antl untlerstan0l�e requiremenls of Cali�omia Heaith antl Safery Cotle Seclions 25505, 25533, and
2553a ana �Aai I or any future �uilding occupanl willlwill not (circle one) neetl to comply wi�h said state codes and �he reQuiremenls lor a
permil tor consimction or motlification imm �he Air Oualily Managemenl Uis�net. FesiOeniial constmc�ion applicalions are eeemD� ��om
ihese omvisions.
�ale: Applican�.
I hereby cer�dy thai I �ave read thls applicatlon antl staie �ha� �he abova in�ar ion 15 co�leci. I agree Io compty with all clty antl counry
ortlinances antl Slalelavrsrelatingio �uil�ing conslmc�ion an er y a r r� enta�ives ofihis cilylo en�erupon��e abave�mentionea
pm0erry Ior inspeclian purp ses.1
'Date'. �� �` Signa�ure-
Oriver's License or Social Security n:
Applican�; Pink—Revenue; Goltlenratl—Assessor
CITY OF COSTA XESA — 9UI�i�ING P=3MIT P�RM NO; $ U53601
PERN.I'�' NO; B OS3601 P:,A!v C�i�CK NO; N GOVT: N SGPP: V
CQNS"1'RJC9'lON TYPE: F�ER.'�1'': ,TYPE: S1R PTJRPO$E: O�H
JOB D'a.�,CRiPT�ON ; WiT:DOW (:dANGEOU'i / EkISTi;�G OPi�7�=NGS SQ r"": 3,725
C..A�X VALUE: 3,715.00 CALC—VALi7E; 3,7I�.00 GROJP OCC: R-3 /
CO�.`4EtiTS• REFLACc WINDQYiS IN EXiST_T1eG OP�K'.NGS
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2 O\ I N G R E Q U 1 R E N: E N T S
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--- -------- MA�N BGILDING ---------- --------- ACCESSORY BC;ILOING ---------
FRNT; FT 1N REAR; FT iN FRNT; FT '�1 REJ�t: cT IN
LEFT: FT �ti RGHi : FT Ih Lc:F: ; FT IN RCFi': : PT �N
PARKING REC1: PROV; PARCr:L; ?22'4I19 ZNE: REF NO:
Pi,ANN �:NC Nt7TES>
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7.O2�ING APP�tOVED BY .
HU�LD2NG APPROVED 3Y ;
APPLiCATION ZSSUED AY; �
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LEGAL'I7,AT:ON:N r E
BLDG P.wT P�U:hB�NG
PnR,v�T 63,00
P i.AN
25SUE FEE
auiLvr�c-n�v-> N�.�r:ir s
TOTALS----> 63.50 0,
UAiE.
UATE : :i
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DATE: T�� 'i. �i i
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S U M N. A R Y STRiiCTiiRAi� SEG";r.N�:Y
IC ;;ECHAN�C rTRE SM,IP/RES GRADING
JO'
5N.IP/h'ON—iLS
P�x.N- ex�.ci:
0.00
REVENUE DT_ViS.T.ON TOi'ALS--> COLI,EC'fED:
B1,DG PN.i PLIJN.3Ii�G �I,ECTRIC ME.CHANIC
6:i.0U
TOTAi. PAIll ..� DiTE
63. SU 63, `i0 .--, .OU
63,SU OVER/SHORT: .00
riRc SN.'iP/';O'1' GRADTNG �?LAiv—C3ECY.
.50 .
#'k ii� f i'.� It iF ##� �P �lEi!� �e i(� iE 1r 3e # 3E i'r 3c �1? �h� # iF �A� 1't #�h # 9E-0!� If 3i�-% 7F iF ie #-Ih i'r If iE 1'r -k i4 ir # 3f if ii- W�)f ie 3: *- 3E ## ii• �Y # ti� � 1�'� ii- ti ii k'�i: iE !4 iE 3�� ii� M� 3F i�:�#
S N D I V i D U A L F E E 3 R� A Y, ll O W N
TYPE QTY D E S C k I F T I O N TJVTT COST ��i0'z'Ai, COS'.'
SFR 3715 P.LTBR BY VALUB RESIbENTIAL N07.ONE i.00 ��� 3,7i5.00
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CONSTRUCTION ANDPLANNING P��� 4
A� Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Ptumbing & Pressure Test
6. Electrital UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System . 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Eiectrical-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. POOUSPASYSTEMS 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. Produci Piping O Gas ❑ Oil
23. Gas Pipe-ftough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �.i1� ��� ._ �� p,(t� ��'_
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
' iosta Mesa Building Department ✓ APPLICATION FOR PERMIT
�C ' 111 EAST 20th STREET �.�i9 ._B U I_L D..I�.N�
� COSTA MESA, CALIFORNIA _, , �I(
� �OR OFk�ICE USE ONLX �
FOR AiPLICANT TO FILL IN '� � Receipt No. Permit.No.
Building � � 3 � '
nddress 652 Beach Street � - ��O `v.
Costa 1VTesa, Ci3,�01711& Rece�ve y; Date Rec'd. Date Issued !
/ i
Nearest � �1�j% - b �� 5 .� � � ��O S �,
crosssc. lqth Street Building
Address i
owner Harbor Estates ' Costa Mesa, California � �
Mail
Address �19 Fast 17th St.reet. Nearest '
City Costa Mesa No�,i. 8-1159 Zone St No.of Type. / � Group
Architector 8I' SOIl ' 1 2 2t77d��— ��' �I P��ns I 1� �
Engineer No. Approv � ,
-- �.., n�«. �
Address Garden Grove
City Lic.
Contractor Dj.ke & Colearove No.
Address 419 Fast 17th Street
Leg�a�l �ot I
Descriotton � No.46 Block ' Tr
Attach Metes and Bound:
ize of Lot 56 X u�
fil•3iLa
Useof I No.of No.of
Existing Bldg. riOT10 , F,amilies 1 Room
Setback Line from Rear Vard ' •
CenterofStreet 5�� SldeYard 5�
DESCYLIPI`ION OF WORK
New I x I.>Iteration I I Addition I
Repair I I Moving I I Demolish I
=1 Building C,, No.of 61 � 1
�� Size u5�- �l• '�Rooms � Stories
Exterior Wall I Roof
Covering rJtUCCO Covering �mP• A��R�`7a��s
Use cf New
B,,;ia;,,y 5ingle £amily residence Foundation Lacation Inspecto
— Forms,Materials, _�" '�
and �arage Under-Pinning
il 7 C Frame: Fire Stops�
�` — — _ Brecing, Bolts
I hereby acknowledge that I have read this Application Lath. Int,
and state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and State L.aws regulating
building consUUction.
Signature of Plaster, Int. _
Permittee �ke & Dolegrove _
— Plaster, Ezt.
Aufhorized Agt.
Masonry Reinforced
Vaivation Permit Fee $ � , p 0
p- Plan Check $ p Bond Beam
S O��� Total �S— v0 FINAL
Fee $
-. 1'o�'m 2�4 GH 1M 12-53 '
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COIiRECTIONS
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1 LV 1 1 LAl\
Show location and distances irom
property line and between buildings.
1L'td 1 ti-55R�c0,�s.�Tn� a
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OWNER HAFBOR ESTATES DATE 6—�.G—SJr �
JOBADDRESS (��� $Parh S+ BUILDINGPERMITNO. j��(»
GENERALCONTRACTOR Dike & �olegrove VALUE $ 8���0.�0
�o'r Lt6 BLOCK TRACT 1986 Residence & Garage (single)
Gfioup J, rrpe V ZONE 1tl� FIRE DISTRICT i � q
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR
_ DATE I NUMei
Trench ��� Z
;ion Forms and Grade to Garage
'—ramin�g , �
,g, Rough tBrb - , � �
ig, Rough Complete�� Q,,� $
arv Pole 7,.-
3-S s �j
•S.s—' /a G
t-<�i a
Sewer,House / Sewer,St. ��I�� //o.�.P�/ CrQ�//—.SS ���!�%�
Septic Tank or Cesspool , I
Lathina. In Out Q //:i�
Plastering
Plumbing, Fin:
Plumbing, Fina
Wiring, Final�
Occupancy
E'orm'L10 G-
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