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Home My WebLink About134 BROOKLINE LN - Building Permits • 1, PROJECT ADDRESS: 134 BROOKLINE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069622 OWNERS NAME: TUCHMAN TERRY F TR ;muss:, Ass: 1742 LERNER LN PERMIT NO: B 069622 PLAN CHECK NO: N GOVT; N SUPP: N SANTA ANA,CA 92705 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE : ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH 6 REROOF W/COPM 6 HOT MOP SQ FT: 2, 508 ADDRESS: UNIT: CLAIM VALUE; 2 , 508 , 00 CALC—VALUE; 2 , 508 , 00 GROUP OCC: R-1 / PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 ADDRESS: P 0 BOX 4309 * ****** *** * sL*** * D* * * ** ***T *ID* r* S*O** D*** ** * *DDOWNEYCA 90241 * ** ** *i + * * * * * ** ** 4 *B * E * * ** * ** ********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70°0)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: 059377 STATE LIC,: 402536 cLAss: C 39 EXP: 10/95 Date:101Signature: MAIN BUILDING ACCESSORY BUILDING FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN ;vORKERS'COMPS SATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN Compensation copy thereof(Section 3800.Lab.6.5,19/95 POLICY No.: AIG EXP.DATE: PARKING REQ: PROV; PARCEL: 41916350 ZNE: REF NO; COMPANY: ❑ Cenilied copy is�is hereby furnished. C2 Certified copy is filed with the city Building Division.Date: 1 01 PLANNING NOTES> • Applicant: DEVELOPMENT SERVICES R E U I R E M E N T S EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(PM or less). Q 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: BUILDING APPROVED BY ; DATE: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. iti 41; CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: x DATE; 1 0 LO which this permit is issued(Section 3097.Civ.C). 'µ**'**'µ***'*'µ***'N'***********'*'µ * '***********************-**********" LENDER: *************************** * ************************************************* ADDRESS: LEGALIZATION:N E E SUMMARY STRUCTURAL SEGMENT;Y 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 SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 , 00 , 50 repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the properly or my employees with wages as their sole compensation, win do the work, and the TOTALS----> 54 , 50 0 , 00 0 , 00 54 . 50 54 . 50 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law 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.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 54 . 50 OVER/SHORT; 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). 54 , 00 . 50 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business ❑ and Professions Code: The Contractors's'Stare License Law does not apply to an owner of property who builds or improves thereon ******************************************************************************* and who contracts for such protects with a e License Lal license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BR EAKDOWN O I am exempt under Section: B.8 P.C. forma reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 ,00 2, 508 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District,Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply With all city and county 01 00170730-00170731 TI)T 54.50 ordinances and state laws relating to building construction and h•reby authorize representatives of this city to enter upon the above-mentioned DATE: 10/28/94 TIME: 13:40 property for inspection�purposes. Date 1'Q /n n Signature:�x _ + or Driver's bi Social Security•: U014899 . 1641-46 While—Budding:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor -t+- , • CONSTRUCTION AND PLANNING AOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. t - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms _ 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ¢.,Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • lb. 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 i 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 i 22. Ducts, Ventilating - r r 71. ProducfPiping 13 Gas 0 Oil 23. Gas Pipe-Rough & Testi. • .. . ,72. Underground Flush , 24.;Roof Framing - • 73: Undergrnd.StorageTank ❑Gas ❑Oil 25. Roof Sheathing - . If-c-9f ‘1A-11_ 74. Overhead Hydro . - 1 1 I 26.•T-Bar Ceiling (Structurals & Monocoat75-7 Dry Chemical I 27. Frame and Flashing ' . . 76.'Dry Standpipe 28, Lathing & Siding • %' • 77. FIXED SYSTEM FINAL 29. Insulation . • 78. FIRE PREY. FINAL . 30. DrywalLNailing ^ s HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat, . ' . 79.'FINA L INSPECTION ' . 32. Electrical Power Meter-Final I , . - 80.•-FOOD CERTIFICATE ISSUED 33. Final Electric - ' Noses: 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 Domestic-Final . a 42. Backflow Preventer, - 43. Backflow Irrigation • - 44. Landscape Irrigation System_ ' 45. Sound Attenuation - • - • 46. Handicap Regulations • - . - • 47. FINAL STRUCTURE & BUILDING C,_7-gs 6-44 - i , 48. FINAL PLANNING , - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - . 51. CERTIFICATE OF OCCUPANCY - - No. Date PROJECT ADDRESS: 134 BROOKLINE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 060249 OWNER'S NAME: TUCHMAN CLAIRE TR ADDRESS: 1629 VETERAN AVE #6 PERMIT NO: M 060249 PLAN CHECK NO: N GOVT: N SUPP: N LOS ANGELES,CA ' 90024 CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH 540-9695 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : FAU CHANGE OUT SQ FT: ADDRESS: UNIT: CLAIM VALUE: 2, 100.00 CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: GEORGE BRAZIL ( 714 ) 535-7905 ADDRESS: 3022 N. HESPERIAN WY 101 COMMENTS• SMOKE DETECTOR REQUIRED PRIOR TO FINAL SANTA ANA CA 92706 ********ai****************** * TETETE�Fit+r* TE�tTr*x **SFTEriFr�tiE*r�tRP**TETe�E**Ft*�E**TE*TPr* �E* LICENSED CONTRACTOR DECLARATION: hereby affirm that I a eased under provisions of Chapter 9(commencing with Section Z O N I N GS ERTEBQAUC IKRSE M E N T S kr) 7000)of Division 3 of the Business and Prof essions Code,and m license is in full force and effect. CITY LIC.: STATE LIC.:44 306 u a Date: I7 AQ2Signature:_ • e_ _ Nittfiy. MAIN BUILDING ACCESSORY BUILDING WORMERS'COMPENSATION DECLARATION: I hereby affu that I have cenutiateo consent to sell-insure aceniluate el Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance or a certified copythereof(Section 3800.L...C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PDucyNO.: (j��R0298489-01 EXP.DAT-: 01 /01 /93 COMPANY: $RELIANCE INS.CO E PARKING REQ: PROV: PARCEL: 41916350 ZNE: REF NO: ID Certified copy is hereby furnished. QX Certified co.. is fil d wit t . Beach,• .• . PLANNING N TES> ilit - 'Date: 12 App.,: • ._dia1 Ad • *************************************iE***************************************** EXEMPTION FROM WORMERS'COMPENSATION DECLARATION: (This section need not be competed if the penlit lifer one hundred($100)Or less). DEVELOPMENT SERVICES 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:It.after making this declaration.you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : ' DATE: Code.you must forthwith comply with such provisions or this permit shag be deemed revoked. y CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY. DATE. r� - wNch this permit is issued(Section 3097.Civ.C). ************************** �{F ** s ****iFiF********{esf{EiE#1F{ElfiF{e{E{F.*i* **{e * *** LENDER: ************************************-****************************************** 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 SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 00 repair arty structure.prior to its issuance,also requires the applicant for such periled to Me a signed statement that h94he is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business S 2 SMIP/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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dears($500). ISSUE FEE 15.00 AliI. az owner of the progeny 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 m offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15. 00 0 . 00 24 . 00 24 . 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 or hisprovement is sold thin provided eoft Completioch n�thements owner»ill have e not intended burden fofDovingsale he/she did nothowever build or improvelREVENUE DIVISION TOTALS--> COLLECTED. 24 .00 OVER/SHORT• 00 for the purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00 • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or Improves thereon and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* that moot of their Worker's Compensation insurance should be prodded to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: 8.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 I do hereby certify that I am aware of and understand the requirements of Calitorn'. ealth and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to imply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management Distr.I.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the about mbrmation is con cit.I agree comply with all city and county ordinances and state laws relating to building construction and h real a •f representative•of 1. y enter upon the above.mentioned property for inspecno cur e I • , , Date: I�� Signature: A Ar Q W II Driver's License or Social Security e: 1641-46 Wtme—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNINGOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit #_ Date Inspector 1. Temporary Electrical Serv[ce or Pole-c...7 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. r' - c7 53. Steel Reinforcement 3.,itictrt'sal ConduirUtility-f7ndrgrndx. 54. Forms 4: Electrical CondJit•Undrgrnd. • . 55. Electrical Bonding r 1 m 3,,$tgel Ll einforcetne�•tTt cS A. 56. Rough Plumbing& Pressure Test rnd. e 4 57. APPROVAL TO COVER-GUNITE 44 ..1 II._ UF ER Tu 7"Footings _ _ c C 58. Electrical Conduit•Undrgrnd. _ j$yrdL , ndation 59. Gas Pipe, 0 Undrgrnd., Test - 9. Water Pipe-Undrg+'nd. 60. Backwash Lines, P-Trap, L Undrgrnd. 10. structural Floor `$'stem - 61. APPROVAL TO DECK y i 11. Property Sewer Lin & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap i 63. Heater & Vent-Final 13. Roof Drains 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 Electricil.T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT � .. r - 'z Q- r, c' o'tiv:-. - * - 5 20:rt o9h Factary Fkreplace I tA,r, C r; ^> t PPRt7VA`StlCPerntit # t " `t 1 A -r 2 x S-- -'et �, J'- Y T N'-1-- > x rY 2 j" t =•1-' XS - -1 . .* w 4 Z. SN --LC r v -r 21. Duffs, in-StructuF. t •• •• -is -+x .. -i70. Undergrouettl:Hydro • 22. Due-TS, Ventitatirrg,x : cc' •` - 71. Product"p,p' g 0"(�as C}Oil 23.r' ,as Pip •Ro h$�'test a ' x 8 •,y t . 1 r' C , u� `� .n 4c ,. „72. Underground Flusti„ r 24.1Root Framing nx :- C-r ' > > -T - , ` �73tzUndergrnff'.StorM lank p Gas 0 CII 25. Roof,Sheathing '<., 7. v „ a -h :� "_ 1 '7400verhead �iydro •26.-T-Bar Ceiling (Staiotural) &.Menocoat >; X •" " 75_Dry Chemical a: -• - ' ,. c x r', -.. " x x t -. 7. X S 27. 'Frame and Fieshig k r > * 76:Dry Stand a e :-' a ' r• 28. Lat ling_& Siding • c Tx. s s E •• - -* h 77,_ FIXED SYS�TER'! �1NAL' r '29. Insulatio7t c 4: " •• ti * 'T' . . 78gFIRE PREV. FINA3. r > :c C. J ., r ! 1 .a ^ .1 v ,;30. Drywall-Naittng ,^n * x r HEA LTHrDEPT'. REQUIREMENT . -31. Plaster 3 own Co/t..:: y r r p T.79. FINAL INSPgECTION R - - ,. ,' 32._fc.lectri r Y r tvletx rr ..teSrFinal. ...< :J Y.8* c 0.r.FOOD CERTIFI�AIWE ISSUED ... .33.`FinaJ Electric, Jp .r, , - "Nqs: - _ ,34.;^Final Heating;& AirrcSnditioning; ,- (?�iy'61L a r. y Cc: K 440 35. Final Gas Pi{3"e TeeY- -e t' > • r 7a • 5, r. -C C _L_ x _ : •- 36. Hood or Canopy;,], ; T- - - • S_ no r.. �1 .- "n 7• K r -37:-Final Factory Firep9at`e._ ' Str �' c •r• x x Z. In I •. .• �� r: V p x .i, v- J -, .- 38. Final Plumbing ,Gr ..� . x 5_-•a . t _ 39. Wafer Service-Finah' . v x e ,c C'>'t - -•z'T. ' r- t k > 1 Y C f • K : .40. Gas Service-Final x 7 ,LS K ,a #: „ ^4' • . '.411. Solar Domestic.Final.a - •• •- -a x x •r,3 .r _ a r 42'-B42.' Preventec - .',- . v 43. Backflow Irrigation' "c, < • e ,J x ' •- >' '. '44. Landscape Irrigation System,`:'= * ,r. '7 �x c .X .4 Er,: s `t' o �l �S_9 r, - Q c S : :6 A5 Sound Attenuationt. r _ * ,. _7 .7i . _ ''46. Handicap Regulatieps _ - x r : J. a S. ;:o - Y �: 47.-FIr�AL STRUCTURE & BUILDING - - •- '^ .• _c _ • 48:-FINAL PLANNINd. _ •: . L - , '' e2 z49:-Electric Release to-Edison ' +• - 'C - '"50,-Gas-Release to Southern California Gas Co r r I, ,� ' - "51. CEF_1TIFICATE OF:OCCUPANCY - * x I. .1 No. Date vn'ILI SM VISTA BUILDING COMPANY VHIC 10-4—b( JOB ADDRESS 134 Brookline Lane BUILDING PERMIT NO. 27643 GENERAL CONTRACTOR Same DESCRIPTION of WORK Residence W/Att. Garage AP No. LOT gl 71 TRACT 5 60 FIRE ZONE VALUE $ 18:.114.00 INSPECTIONS Signature Date GROUP T R. 3 TYPE V ZONE R-3 SOIL 4.4i 5-n71, G7 SUBCONTRACTOR PERMITS ISSUED GAS Q'19x5 /],tL {7a F�52 Date I Number I Signor WATER P�M silly L� i"!7 JL`'/ �/ �_/ �_ ,P9lumbingROUGH �9/r ❑ �� /j 3 4b'(i? -04.1e49 -N//ACL, /O-S— ; ' t'7..7A S PROP. SWR. LINE HOUSE CON. a SPRINKLING SYSTEM _ MISCELLANEOUS y r�i ROUGH HEATING AND AIR CONDITIONING /'I�-S'/Z d Z) TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING // Heatin and Vennt. j/t- _ TRENCHES �ORMS ❑ STEEL REINF. ❑ it i@/[,��2 a.7 iw/ /�/-�7 S S77 FLOOR SYSTEM 4. I .n/31//T BOND BEAM in STEEL REINFORCE in SHEATHING C 1\14 16? FRAME AND FLASHING o i /O./7 LATHING - IN RI,.....---OUT t /�-5 l7 PLASTER, BROWN COAT C //S76`$ STRUCTURAL, FINAL }'J� /��,IeC(t�ypn,� ,f� HEATING, VENT., REFRIG. AND A.C., FINAL S a7r-opt/C. /(/(/1L e ata bite /r2_I2 L7o7/X,7 ELECTRIC, FINAL PLUMBING, FINAL AND GAS TEST n Cq 6-G V/'//`^- BUILDING, FINAL 2'!b r�b/�'r/G-5- 27643 COSTA MESA BUILDING-SAFETY DEPARTMENT OCT --11-67-Pg-,-2,,OD 11 T' f, "C P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 For Applicant to Fill In Complotoly APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING I-% 1 1 /l;;__o For Office Us* Only ADDRESS 1 �"(ti '4/ RECEIPT NO, {RMI COSTA MESA. CALIFORNIA 2! l(�7 �Ja .V ttc� Rac{`, D.e DI, tNEC72,7 DA/T�71eeY-C7 OWNER V'f6''ll �_�j�J.`,',11.,C .I n, ocA � /J 7�oZl��/. �V•'! (9/ BUILDING ADDRESS al a-1-€ N' ADDRESS '/ //(( ♦♦ '� UT �A,. ��^'��jj �y FIR[ CITY ')cu.4 t:(/I/ .6 N ' &I9.ICC? ZONE TYPE 1/ ORO ARCHITECT ^ APPROVED � . 9- 4 7 OR ENGINEER MM �tt tj, 699J]�:"agoign 17 1 BY' /{� DATE 7'- �-fo /�/ ADDRESS Rvf.~ Vf'VG, ),52�J�iu'H� :o /� NO.OP eZ�ONINGOYNEW r PLANS / usa BUILDING 1<j .-J^ O'er. ,it, q-tea CONTRACTOR �c 1.--___ A-7l l .�- !S` (o� LeSCR /� DESCRIPTION ADDRESS (-... 1.(�L/ CITY 0 �(,t.LL� A.P.NO. 7 -' 0. - NOTE: NO SAVE OVER ANG SHALL BE LESS THAN STATE TEL SO`TO SIDE G REAR p.L LIC.NO. NO. SIRE 41--0 x'C I NNo OW ON 5' ALLOWED (U.B.C.REQUIREMENT) OP LOT 1/�OY YARDS APPROVED YARDS APPROVED USE OP_ MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/LSTREET) SETOAC LIK NE FROM FRONT OFT. FT. CENTER OP STREET REAR YARD SIDE YARD I LEFT RIGHT R.81D[ en. FT. — DESCRIPTION OF WORK L.SIDE n FT. Fr. NEW I ✓II ALTERATION I ADDITION P REAR () PT' RT' ill DISTANCE BET. BET.MAIN S REPAIR MOVING DEMOLISH MAIN BLOGS. ACCESS.BLDGB. � L. VAR•# DATE SZDINqO•LQ k."70 1O OOOFS T/ STORB5 c.v..PP...# APPROVED ^� /n/"//� EXTERIOR WALL E COVERINGROOF 01.t •EP ft-,.-2-01 DATE f- (- (- COVERING USB OF BUILDING AND ORK TO,�H[P[�1R�FO�RMEJD 61-iTI 0. dmf !!,(!!i� lldi,1 d Ott-4 n '/ 01 I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT EHOWN UNDER VALUATION IS FOR THE O ANO STATE THAT THE ABOVE.10 CORRECT AND AGRES To COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL c NANCES AND STATEEG LAWSRuvuma VALUATION BUILDING CON UCD HDI, iO — W SIGNATUREEFIMITO A �'f PERMIT FEE 5 E A /t/^�� c >6 /, PLAN CHECK $ 3o — w° AUTHORIZED GENT 0 TOTAL FEE $ Gj