HomeMy WebLinkAbout3036 CAPRI LN - Building Permitsi �.
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(714) 754•5273 • Fax (714) 754-4856
�ob Address: 3036 CAPRI LN
Suite:
Vicinity: PATIO ONLY
Parcel Number: 13946124
Applicanr. SWORD, LARRY
Address: 3364 NEVADA AV
Cq
COSTA MESA
CITY OF COSTA MESA
BUILpING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning: R1 R1
: Phone:- p14)751-7663
' Zip: 92626 ,
Owner: BONNETT,PATRICIAATR
Address 3036 CAPRI LN �
CbSTA MESA, CA
Contracror SENTRY ROOFING CO
Address: . 3364 NEVADA AV-
CA � ..
' - � COSTA MESA
Zip: � 92626- �
Phone:
Zip: 92626�-
Phone: (714)751-7663
License: 487659
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T
PERyIR NUMBER
�
�699-01503
T7 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 09/20/1999
Issued: Og/20/1999
ISSUED BY:
„�
�Arch : , � : : � � Eng: �
Address: � , Address:
� "' Phonei � ' �� _ Phone:
, /
• Zip: . . � License: . '. License:
SCOPE OF PERMIT •
-� REROOF PATIO OF SINGLE FAMILY RESIDENCE (6 SQ). TEAR OFF EXISTING ROCK ROOFING WITH EXISTING
� SHEATHING TO REMAIN. INSTALL BUILT-UP ROOFING - DIBITIN TORCH APPLIED MEMBRANE. .
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: si,sis.00
Permit: , $69.25 � � -_ � _ � ClaimValuation: g�,sia.00
SMIP Res: . $0.50 � ,'
SMIP Com: $0.00 -
Other. $0.00
Inspection: $0.00 , �
Total: $69.75
� � - � <� � � � � � PLANNING & ZONING � � - �
;'
SETBACKS
MAIN STRUCTURE Front 0• 0 �_ Rear • 0- 0 LeR� 0- 0 . Right 0- 0 �
ACCESSORY Front 0- 0 Rear � 0= 0� ., LeN 0- 0 � Right 0- 0 ,'
PARKING Existin : 0 Requiied: 0 Pr000sed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permi( shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period ot 180 days.
INSPECTIONS: In order }or the work authorized under this permfl to be considered legal, such xrork must comply with all applicable codes, and all
requlred Inapectione end flnal approvel must be obtained. Failure to obtain inspections and tinal approval will result in the axpiration of ihis permit.
FOR INSPECTIONS CAL�: (714) 7545626
WORKERS'COMPENSAnON OECLARAnON: � �
I hereby aHirtn untler penelty of Derjury one of the following tleclarations: ,, �
❑ I have antl wlll malntein e certificate of consen[ to self-Insure for workers' compensation, es provitletl for by section 3700 of ihe Labor Cotle, for the pertormence of ihe
work tor whiCh ihi5 permit is issued.
❑ I have anC wlll malntain workers' compensauon insurance, as required by section 3700 of Ihe Lebor Code, for Ihe pertortnance oi �he work for which this permlt is iuuetl.
My workers' compensation Insurance carrier and policy numbar ere:
Cerrier: Policy Number.
'(This secNon need not be comp/ered i/ ihe permit is valued ef one hundred dollars (S 100) or /ess.J
❑ I cenify thet In t�e performance of the work for which ihis pertnit is Issued, I 5hell nol employ eny pereon in eny manner so es to become suh�eC� Io �he workers'
compensetion lews of Califomia, entl agree tha,t%'f I should /b/ecome subject lo Ihe workers' compensation provisions of Section 3700 of the Lebor Cotle, I shall forthwith
camply with Ihese rov' ' ns. (/YI OL4'.uG'titi %' �Y �7%
ApplicantSigneture: i �L ��/ Date:
WARNING: FAILURE TO SECUPE W ERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND dVIL FINES UP TOONE HUN�REO
THWSAND DOLLARE (5100,000). IN AODRION TO iHE COST OF COMPENSAiION, DAMAGES AS PHOVIDED f-0R IN SECTION 3IO60F THE LABOR ODDE, INTEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am
force antl eNect. Lic. M_
Contractofs Signature:
ot Chepter 9(commen ng with Section 7000) of Oivision 3 of the Busir79ss �d�rofessions Cotle, end my license is in tull
qass a G� ��
Dete: ' � �
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm thet Ihere is a construction lending egency for the peAormenca of iha work for which this permit is issued. (Sec. 3097, Civil Cade).
Lender's Name: Lenders Address:
Signeture:
OWNER-BUILDER DELLARATIONS:
Date:
I hereby aHirm thet under penalry ot per�ury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following raason (Sec. 7031.5, Business end Professions
Code: Any city or county which requires a pertnit to construct, alter, improve, demolish, or repalr any siructure, prior to its issuance, elso requires ihe applicant for such permit
to file a slgned stetement ihat he or she is licer.sed pursuent to ihe provislons of the Contrectors License Law (Chepter 9(commencing wlih Section 7000) of Divislon 3 ot ihe
Business and Professions Code) or that he or she is exempt t�ereirom end Iha basis tor t�e allegetl eaemption. Any violation of Sectlon 7031.5 by any epplicant for a permit
sublects the eppllcent to e civil penalry ol not mora than five huntlretl tlollars (5500).):
❑ I, as owner ol the properry, or my employees wi�h wages es their sole compensation, WILL DO THE WORK, and the structure is not intentletl or otteretl lar sale (Sec.
7044, Business entl Protessions Cotle: The Coniractors License lew does not appry to en owner of property who builtls or improves thereon, end who Ooes such work
himself or hersell or Ihrough his or her own employaes, pmvitled thel such improvements are not intended or oHered tor sale. If, however, Ihe building or impmvement is
soltl within one year of completion, the owner-builder will have the burtlen of proving ihat he or she did not build or improve for purpose of sale.).
❑ I, as owner oi the property, em E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct ihe prolecl (Sec. 7044, Business end Professions
Code: The contractors License Law does not apply to en owner of property who builtls or improves thereon, antl who coniracis for such project with a coniractor(s)
license pursuant to the Canirectors License Laws.).
❑ I am exempt under sec. Business end Professions Cotle for this reason:
Signeture: Date:
Owner ID verlfied by driver's license. ❑ Ves ❑ No Drlver's License No. Expires:
Verifica�ion oi Ownership by (type oi document, i.e. - propetly tex bill or deedJ: __
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATON:
❑ I hereby certlty thet no excavetion tive (5) or more feet in depth into which a person is requlretl to descend, will be made in connection with work authonzed by this
permit end thet no building structure, scaHolding, falsework, or tlemolition or Gismantling Ihereol, will be more t�an ihirty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Administrelive Cotle).
❑ As owner�bulltler, I will not employ anyone to do work which would requlre a permit tmm the Division ot Intlusirial Safety, as noted above, unless such person has a
pertnii to tlo such work from the division.
Signature: Date:
Division of Industrial Sefery Pertnil Number.
CERTIFICATE OF COMPUANCE AND AUTHORVATION OF ENTRV: I certity under penelty of perjury that I have read this application antl state that the intormation given is
corracL I agree to comply with all stete laws and ciry orGinances relating to building constmctlon, and authonze represantatives ol the City oi Costa Mesa to enter upon ihe
ebove-Oescnbetl propeny lor inspection purposes. I agree not to occupy or ellow occupency ot eny buliding authorizetl by Ihis permit untll finel inspection.
�QOE �, INSGECTIONTYPE" '
1616 Fixetl System Finel Fire Prevention
1266
200
201
202
203
204
244&OB
Pool Spa Flnal
Finel Re-Roof '
Finel BIocWReteining Wall
Final Fectory Fire Place
Final Sign
Final Demolition
�e�5, g_. i�e�a _94
Applicent � Date
P.AIE ItIIIDALS
� I
� � / n,'
COOE� INSPECTIONTYPE
206 Final Mechaniwl
208 Final Plumbing
210 Finel Elettrical
2/2 Final Fire Preventlon
220 Final Planning Approvel'
222 Final Site
250 Final Building/Occupancy
QAIE IMIfIALS
< � J
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e
JBAaiiij� �0 1967
City oP. �oata F'-eea
Forz 1200
Coatn i-ieea. Californic
3ubjoct: Rciques¢ to uao A.B.8.-D.i1.�'
i:eex 3irs:
3�36 `�
�Ob Q�C�Z'Btl3� F��v� ^.
e�i
Hld�. Pere,it iIo. % ��( d
1a plumbin.g contraotor oP oubject singlo zsoily dtrelling� I hereby
roqueat�per�iesion to use spprove3 Acryloaitaile-Buta3lene-utyr�ne
(�1.�.9. ) plastic drain waate a,-�d vent ( D.W.V. } pipe and YitCi�,,,s
in tho plumbin�; eyate� of th33 home as an niterrsate raaterial,
inetallation �hall be in compliance with the carrent instnlla_tiou
etezdnrcie and aqy codification or condition� establieheci b;,�; you�
Qepa�toent.
Signed by: / y�_
B' !� D. Plv-a!bir Co.
6ddreas: 2202 d, 5th.-ut.
Scsnta dna� Galifornia
y � K
Bebruary 2?. 1450
City of Costa ?"�eea
�oa 1200
Co�ta F7esa. Callfornia
� ,
r
�
Subject: Requeat to use E.H.S.-D.tF.Y. : �
Job 9ddrese� �j f%.S' 6 �y,�,1 �,�
� � , rvr /
Bld�. Perriit P:o. �
Aesr Sirs: ���6 v
�s ormor oP subjeat singlo f�;mily clxelling.� I horeUy requeat
�orrdseion to uao apprroved Acryloni2rile-Butadiene-Styreno
&H.`i) plastic druin iaa3tr� and vont {ll.H.Y.) pipe and f:tti�e �
zn the plu�bi�; systzn; of tni� hoc:e as un altert�ata maCerial.
7[ne+tallation �nall be in coapliance i3th the current inetallation
standaxYis en3 sin,y Qodific�tion or conditiqns eat-abliohed by
yovx dapartment. ,
��Sin rely.
--P� � ����
Gsoi•�e ieak�ey (or3sr) �
S 3 L. Suil3era
1�15� Erookhnrat Stx�eet
('+EZY�@Il GTOP;,+� CslifOt'n38
AVolicant to fill in ali spaces exeept those witnin neavy eoraer Ilnes antl sign all aooroDriate aeclarations.
CITY.: F COSTA EJ�(I S�. CO}U,STR�UC�, ION PERMIT PERMIT NO. __ r, TRACT NO. LOT NO. UNIT NO.
� �Project Addiess �1�.� �ti �-'+t�1�
Applican:'sMailinrg' hA_ddress �a"� _ti��,�nl�l/*oG2�r.lJ:�_J1,2
Owner's Name ' • X''(i� � Phone �78
Address -�A�/`ne
Arch/Eng. License No. �
Address `--y
Contractor's Name ��' `i' b�� Phone yy \0�3
Address (mailing) �a"� i- �To^�^�'� � �v �-
City License No. �il �- � � �
IICENSED CONTRACTOR DECLARATION
I hereby affi�m lha[ I am licensetl untle� provisions of Cha�ter 9(commencing
witn section �000) of Division 3 of the Business antl Professions Cotle, antl
mv Iicense is in tull torce and ettect. �G /
Licens CIasS� T-LIC¢pSCNo.��l ��
Date� Signature _ _(a2- � —
� WORKERS' COMPENSATION DE�RATION
I hereby affirm that I have a certificate of consent to sei/-insure or a cerlificate
of Workers' Compensation Insurance, or a certitiea copy tnereot (Section
�0, Lab. ,C�.),1 c al�r
.cY No. r�.�L�C��IJoi�J-ni^omPanY J�� �� �
6,} Certifietl copy is hereby furnishetl.
�LJ Cer ifie%��copy i leA with the city B tlin 'visio
Date ��CJa� Applicant '
EXEMPTION FROM WORKERS' CO PENSATION DECLARATION
(Thizsec[ion neetl not be completetl if the permit is for one hundretl ($100) or
less).
1 certify Ihat In [he perfo�mance of the work for whlch this pe�m�t is Issuetl, I
shall not empioy any person in any manner so as to become subject to the
Workers' Compensation LawS o( Cali(Omia.
Date Signature
NOTICE: If, after making this tleclaration, you shoultl become subject to the
Workers' ComOensation provisions of [he Labor Code, you must (orthwith
comply with such provisions or tnls permit sha11 be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby aifirm tnat tnere is a mnstruction lentling agency tor the perfarmance
ot the work for which this permit is issuetl (Section 3097 Civ. CJ
�enaer's Name
LentleYs Atldress
OWNER BUILDEN DECLARATION
I M1ereby affirm lhat I am exempt from the ConVactor's License Law for the
fallowing reason (Section 7031.5 Business antl Protessional Cotle: Any city or
county which requires a permit to con5truct, alter, improve, tlemolish o� repair
any structure, prior to ifs issuance, also requires the applicant for such permit
to file a signetl statement that he/sbe is IicenSetl pu�suant to the provi5ion5 of
lhe Contractor4 LiGense Law (Chapter 9(wmmencing with Section ]000) of
Division 3 ot the Business antl Professions Cotle) or that he/she is exempt
therefrom antl tne basis tor Ihe allegetl enemption. Any violation of Section
')-'931.5 by any applicant fo� a permit subject5 the ap0licant to a civil
s�"•�nalty of not more tnan five nuntlretl tlollars ($500).
-.'J I, as owner of [be property or my employees with wa9es as their sole
��compensation, will tlo the work, and the structure is not intentletl or offeretl
for sale (Section ]044, Business antl Professional Cotle: The Cont�acto�'S
LicenSe Law tlaes not apply to an owner ot a p�operty wtto builtls or improves
lbereon, antl who tloes Such work hlm5elf/hers¢If o� through hi5 or he� own
employees, provitled that such improvements are not intentletl or oifered for
Sale. It, howeve�, the builtlin9 0� imOrovement is soltl wlthin one yea� of com-
pletion, the owner will have the burtlen of proving he/she tlitl not builtl or im-
p�ove for tM1e purpose of sale).
❑ I, as�owner of the property, am exciusively contracting with Ilcensed con-
tractorsto construct the project (Section 7044, Business antl Protessions Code:
The Contractor's License lzw tloes not apply to dn owner of property who
builtls or improves thereon. antl wno mnVacts for such oroiects with a con-
tractor(s) hcense pursuanc ro me ConVactoYs License Law). I am aware that
proof of their WorkeYs Compensalion insurance shoWtl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for this reason
Date owne.
I hereby certity that I have reatl
intormation i rrecL I agree to �
antl state 1 relating to builtlinr.
sentatives o,this city to enter
n antl state that the above
dty antl county or0inantes
anE hereby authorize repre-
ve-mentiOneC �Pro�-p�ert�y� fjor
_ Date,,,1��J�
TYPE OF CONSTRUCTION LI NEW U ADD LI ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. (�-� rvo'F �✓I ��'r�
Ta/PE OF PERMIT Ll GRADING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL
❑ �OTHER �G- � : �l
PROJECT DESCRIPTION SQ.FT. / oCCUaarvCv
CONSTRUCTIONTVPE �� AJT� VALUATION$ ��/�G�6
ZONE GRADINGCU.VDS. ACRES
Remarki: + f � fQ �
��i �s wd � �c,� .� 2 S e�. r z��o
IUMBING FEES
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
lavatories
P-Trap
ftoof Drains
Reinspec[ian Fee
$15
Duct-UnderGround
Duct-Structural �
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFact. Blt. ICBO dk
Heating System & Ducting
❑0.100,000 BTU 0100,000 BT
Reinspection Fae
Driver�Lfcehse or 55 � -� -- � �
0865-46. rev. 5/8B White - Builtlin9: Canary - Applicant; Pink - Accountin9: Goltlenrotl - Asse55or
Sis
Showers
Service Sink
i4`ewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
�1�later Heater
Water Service
Auto-Wash
A.P. #
S Main Building:
E
T Front
ARear
C Pight
K Left
S
Ping. Ref. #
Planning Notes:
Accessory Building:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
ConstructionPoleSub. � 50+KW
Cookin9 Unit Meter ❑up m 100 amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric SubPanel
Fan Motors �0.1 HP �1 %- 8
F.A.U. Inc.Solar �9-15 HP �16-15+
Fixtures
Device Boxes
O utlets
SWitCh¢5
Garbage Dispoul ��—
Generetor �0.5 KW �5-15 KW
Zone
Range
Sign
Standing $ections
Trash Compactor .
Reinspection Fee $15 Issue Fee
$ 3 DEVE�OPMENTSERVICESREQUIREMENTS:
Issue Fee Zoning Approved By
FEES Building Approved By n ��,/
Hood or pe I ❑
Cano Type 11 ❑
Refrigeratlon System
❑0-t00,0008TU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
FEES V
SMIP � �
PERMIT
ISSUANCE
ENERGV P.C.
GRADING
MICROFILM
.�
TOTAL FEE
N
I
N
G
R
E
Q
M
T
S.
FEES
$ 3 Dl Qa0=�7�5-�D02II7fo T!�7"
�A7E' 0'a!°C: �?� TIl�H: i3:3�]
i��..]�
t . .
; 'CONSTRUCTION AND PLANNING POOL. A _
t� Oate 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-Undrgmd. � 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .
:6; Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7.'�.F,00tings , , 58. Electrical Conduit-Undrgrnd. i
8� Foundation , 59. Gas Pipe, O 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 i
13. Roof Drains � 64. Plumbing System - Final .
14. Rough Plumbing � 65. Electrical-Final
15. Rough Ele�tF,^ycal-Conduit 66. Solar System-Final
16:, Rough Ele tric Wiring ,'_ 67. Fencing & Access Approval
•17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
�1,8. 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 O Gas ❑ Oil
23. Gas Pipe-Rough & Test �� 72. Underground Flush �
24. Roof Framing � •• N_,.... � 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing - , 74. Overhead Hydro �
i
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 1 : HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � _ 79. FINAL INSPECTION
32. Electrical Power Meter-Final• 80. FOOD CERTIFICATE ISSUED
33. Final Electric "• Notes: ��i 0
34. Final Heating & Air Conditioning I�� ��-
t
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 i ;��
43. Backflow Irrigation � � �
44. Landscape Irrigation System
45. Sound Attenuation " -�
46. Handirap Regulations y( Qp �� 3v
47. FINALSTRUCTURE & BUILDING � �' S ,Q � ��
48. Special Requirements Completed
49. Electric Release to Edison ��
50. Gas Release to Southern California Gas Co , •
51.CERTIFICATEOFOCCUPANCY " ' •
No; Date ���' � �
INSPECTION CARD DESCRIPTION OF WORK„'e —✓Uv �
pERnnIT n10. p. This job is �not released until final inspection is called for and
.3% $ D approved. It is the duty of the owner or permittee to call this
ot+TE i55uED offica upun completion of work covered by the permit.
Z – i �J— Q'C/
BUILDING DIVISION OWNER: �L�/�N��
COSTA MESA 754-5627 /�
• ADDRESS: 30.3� �0.�1�1
PLUMBING INIT. DATE HEATING INIT. �ATE
❑ U/G Plbg. _ ❑ Rough
Rough _ ❑ Final
Final
ELECTRICAL INIT. DATE
❑ U/G Elec. _
❑ Raugh _
❑ Final _
, CMF 0751-46 (BU-22) Rav. b/BO
LI WG Water
STRUCTURAL INSP. DATE
❑Trenches-Steel _
❑ Framing _
❑ Final
or
Final
Lane
rcaE
SUBCONTRACTOR
&
�2g�60
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1209 COSTA MESA� CALIFORNIA BZE28
For ApplfrnM }o Ffll In Completdy
TYPE OF2 PRINT
6i ARCHITECT
COSTA MESA. CALIFORNIA
. . A I/
i:
�
;r f3z
� EXISTINO BLDO. ��
e¢TBACK L�N61ROq ; /•7
/
!!T i�C� RIOXT
DESCRIPTION OP WORK
1 N6RGDV ACRNOWL[Wt TNAT.1 NAV6 R�AD
AND BTAT6 THAT TN6 AlOV[.IB CORR[R A�
PLY WITN ALL CITY ORGIN11NCiOf�(IO �TAT[
eui�oina coxernucnox.
81GNATURC OR //� �
P6RMITTis �
AUTXORIZ6 AOQIiT /
P"10QOt�o6* ***173.25
1AA 3o-68cnsa
ArPLICATION FOR PERMR
BUILDINO
For Offln Us� Only
n[cnrtxo. rt_ rty�r,x9
`7 (l% F �i'
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r D4[n�cclv[D' O�T[�aeueo
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TYP OROUR' r,
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ZONING
xo.o� u.c
•wt� �/' eu��
YARDBAPPROVED
MAIN BUILDINO
v�. !t
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N6 SHALL �E Ll88 THAN
YApCeAPPROV6D
AGCHHHORYBUILDIN6
DAT6
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