HomeMy WebLinkAbout1168 BOISE WAY - Building Permits •
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May 4, 197? - . •
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TO WHOM • 'MAY rCONCERI'
t �at\1168.Boise Way in Costa
• The addition to the residen �Yal compliarice ..with t2?e •
M1. esa wasy'.construeted in °substan emit ,number
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•
requirements
of the' . wilding :codes- under.P.
30728 •
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fet Director . .
Building' Sa y,'
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ADDRESS OF BUILDING: 1168 BOISE WY uNT: CITY OF COSTA MESA BUILDING PERMIT
I
oWNEP :NAMEIR KNOWN: JIM POWELL
, FLOOD : X 46 PERM NO: B 073794
� ADDRESS: 116 8 BOISE WAY
COSTA MESA, CA 92626 PERMIT NO: B 073794 PLAN CHECK NO: N GOVT: N SUPP : N
751-5376
APPL.MAIUNGADDRESS: ' CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/O & RESTH & RE-ROOF W/COMP . SHINGLES SQ FT: 5, 500
ARCH.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 5, 500 . 00 CALC-VALUE: 5, 500 . 00 GROUP OCC: R-3 /M-1
cONTRACTGITSNAME: CALTON ROOFING ( 714 ) 549-2725
carimAcrowsuhau10 3125 MCKINLEY COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 1991 UBC
ADDRESS: COSTA MESA CA ue.No.: 587704 *+E**RE***REat***********************at*************#*+ESE#*******RE***************a(-*+E+E
92626 uMr: Z ONING R EQU IR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby all inn under penalty of perjury gat I am licensed under provisions of Chapter 9 S E TB ACK S
( endng with Section 7000)of Division 3 d the Business and Professions Code.and my license is in full force and effect.
ITY IC.NO.: 0511 9 UC.CLASS: C39 Lie.No.: 87704 EXP: 10/95
� v MAIN BUILDING ACCESSORY BUILDING
ro/ � FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
let contractor: N G
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
NER BUIL ER DE LARATION:I hereby affirm under penally of m perjury that I eexempt from the Contractors License Law for the
following reason(Section 70315 Business end Professions Code:Any city or county which requires a permit to constnal,alter,improve, PARKING REQ: PROV: PARCEL: 14169138 Z N E: REF NO:
demolish,or repair any structure,prior to its issuance,also requiresFemur the applicant for such peto fila a signed statement or FRNT: •
emenl heshe PLANNING NOTES>- •
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 Coded or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation d Section I
7031.5 by any applicant for a permit subjects the applicant to a soil penalty of not more thanfile hundred dollars[S5001). ***************RE***************************************************************
❑ I.asowner o the property or my employees with wages as their Bole compensation.win do the work.and the structure is not intended D E V E :L OP MEN T SERVICES R E Q U I R E M E N T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not app
y to an owner of miserly
who bolds or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such "'v /r
improvements are not intended or offered for sae.If,however,the building or improvement is sold within one year d completion,the ZONING APPROVED- BY DATE: "�•
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I.as owner of the property,am exdusively contracting with licensed contractors to construct the project(Section 7044.Business and
Professions Code:The Contractors License Law does not sooty to an owner of property who builds or improves thereon end who BUILDING APPROVED B Y : DATE: %
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License law). 'J r
❑ lamexempt under Section: B.spC..for this reason: APPLICATION ISSUED BY: }��� DATE: r r 7
************************************* ************************ **
Da Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SE MENT:Y
•
I do hereby merrily that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,end
25534,and that l«any future building=anvil winlwuf not(circle ane)need to comply with said mate codes end the requirements t« .BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit forconeuactinn or modification from the A'e . ty anagement District.Residential constnotion applationsareexempt from these ,
Provisions. i ,
PERti Ty fl}< lfl1 . 00 ..., k 55
Dale: Applicant: f ��/ t V SMIP/NON RES
PLAN iEQUIF3gcA
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one d the bdbwirg dedwatioro: ISSUE F E �( E1°R
❑ Ihave and wit maintain acertifiatedmnsenttosejfinsure for workers'compensation,as provided for bySxfbn3700of the Labor BUILDING-DI -> T ISSUE PLAN-CHECK TOTAL PAID DUE
Code,f«the p.d«maadmewn f«which ldapenn is issued.
TOTALS----> 81 . 55 0 . 00 0 . 00 81 . 55 81 . 55 . 00
7Cj ] I have and wit maintainmaintainworkers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this pernni is issued.My workers'compensation insurance carrier and policy number are:
Carrier: STTE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 81 . 55 OVER/SHORT: . 00
Policy Number; 285-9UN1185 / ifs 01 /01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed d the penny is for one hundred dollars moot or less.) 81 . 00 . 55
❑ arty that in the performance of the work for which this permit is issued,I shall n. .mploy an •arson in any manner so ash'
• inject to I e workers'compensation laws of California, and - ree : N I shout. .... a subject to the waken' *******************************************************************************
• Penssafq/n prow d section 3700 of me Labor I hi .. y with t a INDI, VIDUAL F E E BREAKDOWN
C■ Applicant: / :1�C •
"- Ing:Fall reto secure workers'compensation coverage 1st 71.III Pr,end If subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines W to one hundred thousand dollars($104000),In addition to the-..t of compensations damages as provided ler In
Section 3706of the Labor Code,interest,and etromey'afees. SFR 5500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 500 . 00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there 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 reed this application and state that the -•.,a information is correct.I agree to comply with all city end county ordinances
and state laws relating to building construction and ••y a •orize representatives of this city to enter upon the ebove.mentioned propend
for inspection purposes. RICK K 'HE
— 1001u3°0-00138371 TOT
c1,5!
DATE: nfi:dr, TItE 13.06ate -ArimN: : _a• Dare: V�r� r
ig y:?of • -/AgenUA.."w . tad.
or---•"4a.WP) White-Building&Safety;Gree .;Canary-Appcant;Pink-Revenue;Goldenrod-Assessor .
4 POOL _
CONSTRUCTION AND PLANNING . 1
�t ( - Date Inspector / Date Inspector
♦APPROVALS Permit# - - APPROVALS Permit #_ .
__;-
1. Temporary Electrical Service or.o)Q 52. Pool & Equipment Locatiori,
2. Soil Pipe-Undrgrnd. t`- 53. Steel Reinforcement . h+ Nt2 ,
3y�Electrical Conduit.Utility-Undryrtt6. 54. Forms !.T• • - t ..i.'-
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
�4�..
35: Steel Reinforcement, 56. Rough Plumbing & Pressure Test
6tElectrical UFER.Gind. 57. APPROVAL TO COVER-GUNITE 7 , '
7...Footings y 58• . Electrical Conduit Undrgrnd: - '' �
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
z,-
9. Water Pipe-Undrgrnd. c. 60. Backwash Lines,P-Trap, UI Undrgrnd. f
10. Structural Floor System •. . 61. APPROVAL TO:DECK -' .r '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final_
12. Sewer Cap - ? ' ' '
63. Heater & Vent-Final {
17
13. Roof Drains _ 64. Plumbing System ;Final ,/..1 f
14. Rough Plumbing. , 1/4.-,:: 65. Electrical-Final I. • Fir'. /.,s,'s
15. Rough Electrical-Conduit ' ` 66. Solar System-Final ./l
. .16. Rough Electric Wiring . . S • 67. Fencing & Access-Approval - '
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17. Rough Wiring Sign .68. APPROVED FOR PLASTERING '
18. Rough ElectricaIT Bar Ceiling -69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace _ C ' y r APPROVALS. ,'.: Permit# ' r-
21. Ducts, in Structure - 4.- _ ' 70. -Undergrougd Hydro I.
22. Ducts, VentileIinf - _ ; ;, . : 71. Product PipingtTGas 0Oil
23. Gas Pipe-Rough & Test - r- r; -i 72. -Unde_rgtound Flush -
24. Roof Framing a - -- -- _ ; 73:`Uriddrgirid.Storage Tank.O Gas 0 Oil
25. Roof Sheathing • v �l)" f-d4 ' 74;Overhkad Hydro ,
26. T-BaTCeiling (Structural) & Mohocoat " - ' 2274 75;rDry Ch€mical _ • • `
27. Frame and Flashing = - :N* 76. Dry Standpipe,-=r' -
28. Lathing& Siding ' .-= , - ", ' . 77•. FIXED SYSTEM-FINAL,.•,
29. Insulation cs • t 78, FIRE PREV FINAL - r
30. Drywall Nailing _ i ., " ' :HEALTH DEPT. REQUIREMENT
31. Plaster Brown-Coat , _ - r. w > 79. FINAL INSPECTION - _
. 32. Electrical'Power Nteter-Final "1.1 `- 80 FOOD CERTIFLICATE ISSUED
- 33.33. Final•.Electric •~- - ` .�
„ Nates:
_
34. FinalHeating'& Air Conditioningy r r: --
35. Final Gas.Pipe-.Test ,' .. • .. / .r ' .2..-_-. .�f- - .
M
c. 36. Hood or Canopy ' _. • - '` `•r- -- •
- 37. Final,Factory Fireplace - - - ' '" - - n�
38. Final-Plumbing - •_ - Y --
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a:
39. Water Service-Final. T. -
- 40. Gas Service-Final r �- :: - .1-
_ _ 4 i~ - • _
• 41. Solar Domestic-Fina( - - r ,
- w.,42. Backflow Preventer r - - - '
li
43. Backflow Irrigation t x:-. . 7." -.
44. Landscape Irrigation System - *- " - - ' rte' .t:-
45. Sound Attenuation e. F ` ;
46. Handicap Regulations - •
-
47. FINAL STRUCTURE & BUILDING 47.-(.3-1516cN -
48. FINAL PLANNING ' '`'
49. Electric Release to Edison r --' '
50. Gas Release to Southern California Gas Co - --- `• _ _ ,
51.. CERTIFICATE OF OCCUPANCY '
No. Date
(OWNER JACKSON, C. M. DATE 9-4-69
}JOB ADDRESS 1168 Boise Way BUILDING PERMIT NO. 30728
{GENERAL CONTRACTOR R.B. Ttschmacher DESCRIPTION of WORK Add Den and Patio to Res.
AP No. 141-691-18 LOT 12 TRACT 5_005 FIRE ZONE VALUE $ 3,500.00
()_INSPECTIONS Signature • Date GROUP I & J TYPE V ZONE R-1
NSOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number Signat,.
WATER r--(9-0/. /J sPlumbing��J�J///, ��[,�y+�
ROUGH PLUMBING /t Q�1--t- &,z at—, (j_,.a4 1-/7-Gy 6rJJr�'
PROP. SWR. LINE ❑ HOUSE CON. ❑ / l /
SPRINKLING SYSTEM
MISCELLANEOUS •
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER ❑
ROUGH WIRIN ? n;,y 4,-/- Gil Heating and Vent.
TRENCHES ORMS STEEL REINF. ❑ . 7N (-
FLOOR SYSTEM litFp
BOND BEAM ❑ STEEL REINFORCE CI //
SHEATHING t -IO-9
FRAME AND FLASHING �y /p--3 7
LATHING - IN n OUT ❑ .1 re---1e-61
PLASTER, BROWN COAT / --,--lyy
STRUCTURAL, FINAL E civic
HEATING, VENT., REFRIG. AND A.C. FINAh ,/ /�j
PLUMBING, FINAL AND GAS TEST itiate4 4 31J/1� /# 7, �l � �i
ELECTRIC, FINAL R +12,11 -)p .
BUILDING, FINAL lege F/_/S-:,Th;
‘111-30728 SEP -ti-69Pat6OO 087* ****39.00
cnsa
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
• •
APPLICATION FOR BU LDING PERMIT ,
For Applicant to Fill in Completely
RECEIVED ,y D T REC IyEp
BUILDING / }' el,:_ii 7 4 9 Dfy}'E $$Zoe
ADDRESS i��yf1 I: 6 p..1A{tJJ's �qa�/IY �/I' / / p �7 ,/ r/// /L/ 6 (/�
C /'! . \74C/I toI :ic hi)AI �is _. A.P. NO. '- b1I/ 3 .5V-7M-
OWNER
MAIL / / / N'" BUILDING O
W W ADDRESS (t!peon-Cc ?/4/ L / //��// ADDRESS
a U CITY C • en . / NO. 5 Yls-Wk TRACT, U S I LOT-3)"• BLOCK
z Z CONSTRUCTION err /� NEW ADD ALTER REPAIR (MOVING OFMOLISH
d m LENDER /����{'7l's'$7 PIY t �I/Y� J 7 , /AA' q�//
J Ct BRANCH CA0n�r C)•j'i LIdX,�` VVI \ GC�L.4,
J N OWNER
ADDRESS VALUE A/}� •
CO J offkicvt... iii
J m ARCHITECT TEL. USE I f� $ J`r/ V '� a
Q OR ENGINEER NO,
Z N Q
WQ FIRE /1
Ir ADDRESS ZONE TYPE GROUP
0- 141 9 ,/
�J (' APPROVED �� f ATE / `J`
mO CONTRACTOR R.4 'r/,r.e:4'i'I Q C 4,4 ._So Al BY L�//v
Z 7 /
51 cc ADDRESS �U;;. �/ h/• ,GVrr1P,f PN /4" Al'
W W /'? TEL Z( NO.OF.-�/ USE OF NEW
Z0 1- CITY CA/ph A'# (-/tOe 1 NO.rip ye/..5. �� PLANS BUILDING
W 0 STATE Y CITY YARDS APPROVED YARDS APPROVED
j O LIC. NO. .A ?ii-3S- d LIC.NO. MAIN BUILDING ACCESSORY BUILDING
SIZE INO.OF BLDGS. 11
(FROM C/L STREET �( ///
OF LOT 5®.Y/OQ NOW ON LOT / RONT (,� /t-{' FT.
USE OF T,� .� /
EXISTING BLDG. Sf4- R SIDE r r FT. " FT.
1- SIZE OF .n fNO. OF / J
Z NEW BLDG. /. 'C/Z ROOMS / STORIES + L.SIDE FT. FT.
Q EXTERIOR WALL ROOF n r�
V COVERING WALL.....,_ ROOF
_COVERING /?(/tic _ REAR �/,Q FT." FT.
41
J USE OF BUILDING AND WORK TO BE PERFORMED =
a DISTANCE BET. BET. MAIN
a MAIN BLOCS. ACCESS.SLOGS.
Q - VAR.# DATE
O Ate'.A/ . I71- (j- Lt' C.U.P.# /' ' n APPROVEDI- .
/
2f/ —BY ROVED( / / /// DATE 74 y/o 9
0
UI hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
CO the State of California. m
c2 0
z I hereby certify that I am properly licensed as a contractor under / SO. FT. �/D o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOW DER VALUATION IS FOR o
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTAB ISHING A PERMIT FEE ONLY:
CC
, am exempt from the provisions of the State of California Business VALUATION tw
and Professions Code, Division 3,Chapter 9. --J1 �� m
® PERMIT FEE $.2. a N
Signature of re .>%! p f� m
Permittee f/`�-�-� sv '1 $3 g \TOTAL
PLAN CHECK $ ` tt�'Authorized Agent37 ry _LL FEE $
r,
N^nu" MC GAVRAN, Frank VMIL 8-23-76
`JOB ADDRESS 1168 Boise Way BUILDING PERMIT NO. 42539
`GENERAL CONTRACTOR Owne r/Bldr. DESCRIPTION of WORK TreJ lis
\'AP No. 141-691-38 LOT TRACT FIRE ZONE VALUE $ 500.00
INSPECTIONS Signature Date TYPE GROUP ZONE 77_l
SoIL PERMITS ISSUED
4.P SUBCONTRACTOR
GAS Date Number I Sinnott
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE 0 HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND [J POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS fl STEEL REINF. 0 Rt., 'p.(blf
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE 7
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT El
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING. VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST H
ELECTRIC, FINAL /J /0.77 BUILDING, FINAL (
SPECIAL REOIIIREMENTS
•
PAr6
42539 ISG 2.13-76E757001659* *S-.::t;.5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only �_..y_�
joilRECEIVED BY ?Y2'' '
ATEI�D" I �YY
BUILDING jJta`�OiSC /ZZ ''''ADDR (Y
O WNEESSt^ b �/t V p p (( Mil PERMIT NO.
OWNER Frp,FIkLfi II cG f'V�/1 A.P.NO.f I I-nl /��i
MAIL / BUILDING
ADDRESS /!/ ({p M5C_ pp/�//���, ADDRESS jlb IS RQ,se. Co,.
TE CITY its hi
.c . J1/5t! NO.S4O ` 3 ACY -
L10 BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH '
LENDER 3-�/ '
•
BRANCH rr+''�Q/� ,t / �'t /� ,s ,, ,
OWNER 1'g• so fL'G17v PA-/t/ �•
ADDRESS ��t�� (/ pyt( y�
ARCHITECT - TEL. USE 1 \t'0VIC \ Lftlik `A`LU$
OR ENGINEER NO.
FIRE
ADDRESS ZONE / TYPE GROUPf
/�/j'/t /�/t� APPROVED / s 217
CO NT R ACTOR //��fj�J��, akel BY / _ DATE (/
ADDRESS �YJ V /�p�I ^J
TEL. V �E ` PLANS ` BUIL
CITY CITY NO. f� _7
-�5+ STATE CITY YARDS APPROVED YARDS APPROVED
C. LIC.NO. LIC.NO. MAIN BUILDING
(FROM C/LSREST) ACCESSORY BUILDING
W SIZE NO.OF BLDGS.
�e OF LOT I NOW ON LOT j FRONT FT. FT.
Q USE OF '
4 EXISTING BLDG. B.SJDE 51 - FT. FT.
CI)
F "'II Separate permits are required for L.SIDE 1 FT. FT.
electric,plumbing and heating work.
WREAR nI1 FT. • FT.
F. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
q (' /^� w �J�j n •� /. MAIN BLDGS. ACCESS.BLDGS.
tize t i L o fAt-m oc VVAR. #c�ya,'r DATE
PAPPROVED 15
?1713
a.
I hereby acknowledge that I have read this application and state �� '�� �_(/wi n
p: that the above Information is correct and agree to comply with ^ �»• +>•'J m
L all laws regulating building construction, and I shall not employ .L cam^ ^
C�L.f�ltiJ
Z any person in violation of the workman's compensation laws of m
.W`4" the State of California.
I hereby certify that I am properly licensed as a contractor under 5Q. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: -
am exempt from the provisions of the State of California Business - a
and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ 5j Co N
_r— M
/' PLAN CHECK $ No
• Signature o�/f^ n .. �//yy✓� L
Permittee /.t�IL f/( .[, �//t $ �oO TAX $ ` �f• U
Authorized Agent ,, TOTAL PAID $ 3-;5-0
•
90740 FEE RECEIVED
•
t.. STA MESA BUILDING:SAFETY.DEPARTMENT (WI 7 1963
P.O.BOX EIT COSTA MESA,CALIFORNIA ((±±TTFINANCE
�QQ��DppEPMMT..��'pp
For Applicant to Fill In Completely A�PLICA&IS9 i I"FELIT •
TYPE/20R PRINT BUILDING '
/0... W1 For Office Use Only
BUILDING / `a i ..
ADDRESS 11 6 4 Way RECEIPT NO. /kIT,F{R(1
. COSTA MESA. CALIFORNIA • �'LI iL.A`J
RfCE1 QD BY DATE RIMMED DATE ISSUED
•
OWNER Diori:haa.te,a partnership /D' "
�'�j
MAIL BUILDING / !y)
ADDRESS 15939 LasFiores St. ADDRESS L' n
FIRE V �yr�
CITY Fountain. Valley NO..'5316792 ZONE TYPE GROU J/J'
APPROVED
ARCHITECT TEL BY DATE
OR ENGINEER C 14111 Pr NO.KR591ln7
A1ahZONING
:i>p i �
ADDRESS
- ZONE NO.OF 'l USE OF N �"
ZONE() - PLANS�( I BUILDING r /n
CONTRACTOR Bonser Const. e.. I/` + V'`
q LEGAL (.
ADDRESS 15939 LasFlores - DESCRIPTION
Fountain Valley A.P.NO.
CITY
L,. /ry NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.NO.215049 NATEO`•5316792 or TO SIDE BREAR P.L.
•
EAVES
SIZE (' I NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 1001X601 NOW ON LOT none
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. none
(FROM C/�LSJ'REET)
SETBACK LINE FROM I I FRONT �(. ) FT. PT.
CENTER OP STREET 50 //"
REAR YARI3 1
SIDE YARD I LEFT• 51 - I RIGHT' 5 t R.SIDE FT. FT.
DESCRIPTION OF WORK - L.SIDE S' FT. 3 2 FT.
NEW X ALTERATION, ADDITION REAR FT. FT.
DISTANCE BET. BET.MAIN ft
REPAIR - MOVING - MAIN BLDGS. ACCESS.BLDGS.
DEMOLISH
{{J o8p RO /
VAR.Ge DATE
SZEI�I )1SUft- OMS O STORIES 2 C.Li.P.* APPROVED •
EXTERIOR WALL. ROOF APPROttt !O —li G
COVERING SIiUCQO I COVERING shinale a" �(/V✓L^�. DATE
USE OF BUILDING AND WORK TO BE PERFORMED CCG!! (�7IJ e____"
single ram. res . with .attach
garage - Cl
— �,r SQ.Fr. B
I HEREBY ACKNO OCE "' D THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE T THE AB.J AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. D
1I
PLY WITH AL CITY ORDC r TE LAWS REGULATING
BUILDING CO STRUCTIo / VALUATION PERMIT FEE $ N
SIGNATURE•.
PERMITTE _ oa
41.... I $245720__ 33_
PLAN CHECK $ E
AUTHORIZED AGENT TOTAL FEE g 99
r
:/