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Home My WebLink About2568 CARNEGIE AVE - Building Permitst r Job Address: 2568 CARNEGIE AV Suite: Vicinity: HOUSE AND GARAGE ROOF Primary Occ; R3 Type of Conslruction: V-N Parcel Number: 14137308 Zoning: Applicant: RAY, ROSS Address: 2192 AMERICAN AV SUITE A COSTA MESA, CA Owner: CALL, JEFFREY L Address 2568CARNEGIEAVE COSTA MESA, CA' Contracmc ACL WEATHER'ROOFING Address: � �2192 AMERICAN AV � � . � SUITE A - . � . � COSTA MESA; CA ,' Zip: 92826 �.= ,�� Arch . � Address: . , , � Phone: Zip: l.icense: Phone: 949-646-8694 Zip: 92626 Phone: Zip: 92626 Phone: 949-646-8694 License: 739271 Eng: Address: ISSUED Slatus: ISSUED Applied: 12/19/2006 Issued: 12/192006 Phone: License: SCOPE OF PERMIT TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15ii FELT ON A 4:12 PITCHED ROOF AND REROOF W/ ASPHALT SHINGLES ON AN ATTACHED HOUSE AND GARAGE. REPAIR AND REPLACE SHEATHING AS NEEDED. ' Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.64 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 FEE SUMMARY Calc Valuation: $s,aoo.00 Claim Valuation: $s,aoo.00 i Total: $139.89 - � � , PLANNING 8 ZONWG SETBACKS ��.: _ MAIN STRUC7URE 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 Exisiina: 0 ` Reauiredi 0 Pr000sed: 0 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, 1241-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned (or a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetions and Iinal epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446�a6 (6/00) WORKERS' COMPENSATION DECLARATION: I hereby aHirm under penalry of perjury one oi ihe following declarations: ❑ I have and will maintain a certificate of consent to selM1lnsure tor workers' compensation, as provided foi hy section 3700 of ihe Labor Cotle, for the pertormance of the work tor wh�ch Ihis permit is issued. ❑ I have and Will maintaimworkers' compensation insurance, as required by section 3700 ot the Labor Code, for the pedormance of ihe work br which Ihis pertnit is issued. -; My,workers �mpensation Insurance carrier antl policy numbar are�. � - - -_ - . - �'.-� - . 'Cer�ner:. ' Policy Number: (This section need not be complefed il (he 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 ihe worke�s' compensation laws of Califomia, and a ree that if 1 should become subject to the workars' compensation provisions of Section 3700 of the Labor Code, I shall forihwith complywitdthes� rov ions. ApplicanlSigriaWre: C3G(?2L� . Date:. - � 2—�� .. WARNING: FAILURE TO SECURE WORKERS' CAMPENSA N CqVERAGE IS UNLAWFUL AND SHALL SU�,IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FWES UP TOONE HUNORED T1/OUSAND DOLL4RE ($100,000�, IN ADDITION TO THE COST OF CqMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3�O60FTHE LABOq CADE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 oLlhe.Business�nc�r9fessions Cotle, and my license is in tull �� Giass #, � S � re: �i Date: _.. .�. � .� . CONSTRUCTION LENDWG AGENCY: ❑ I hereby affirm ihat there is a consimction lending agency for ihe pedormance of ihe work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Address: Signature: Date: OWNER•BUILDER DECLARA710N5: I hereby ettirm tha� under penalty of perjury Ihat I em EXEMP7 FROM THE CON7RACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry which requires a permit to constmct, alter, improve, demolish, or repair any simcture, prior m its issuance, also requires ihe applicant tor 5uch permit b 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 Proiessions Cotle) or that he or she is exempt thereirom and the basis for ihe alleged exemption. Any violation oi Section 7031.5 by any applicant Por a permit subjects ihe applicant to a civil penalty of not more than five huntlred dollars ($500).): ❑ I, as owner of the propeny, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe s�mcture is not intendatl or ottered for sala (Sec. 7044, Business aMf Protessions Code�. The Contractors License Law does not apply to an owner ot propeny who builtls or improvas thereon, antl who tloes soch work himself or herself or ihrough his or her own employees, provided that such improvements are not intentlad or oflered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have ihe burden oi pmving ihat he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business antl Professions Code: The Contractors License Law tloes not appty to an owner of property who builds or improvas thereon, antl who coniracts for such project with a coniractor(s) licanse pursuant to the Coniractors License Laws.). � I am exemp� under sec. Signawre: Owner ID veritied by dnver's license. ❑ Yes ❑ No Business and Professions Code for Ihis reason: Verification of Ownership by Qype oi document, i.e. - property taz bill or deedj: Driver's License No. Date: Expires: DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby cedity ihat no ezcavation five (5) or more taet in depth in�o which a person is required to descend, will be made in connection with work authorized by this permit, and �hat no building stmcture, scaHolding, talsework, or demolition or dismantling thereot, will be more ihan thiny-si: (36) feet high. (Chap. 3.2, Grp 2, Atl 2, Sec. 341, Title 8, California Adminisirative Codej. ❑ As owner-b�ilder, I will not employ anyone to do work which would requira a permit fmm ihe Division of Indusirial Safery, as noted above, unless such person has a permi� to d0 SUCh work irOm ihe division. Signature: Date: Division of Industtial Safery Permit Number: CERTFICATE OF COMPLIANCE AND Al7fHORIZATION OF ENTRY: I cerlity under penalry of perjury iha� I have read Ihis application and state Nat the informa�ion given is correct. I agrea to comply with all state laws and ciry ordinances ralating to building consiruction, and aulhorize representa�ives of the Ciry of Costa Mesa to enter upon ihe above-described pmpetly for inspection purposes. I agree not to occupy or allow ocapancy of any building authorized 6y this permit until tinal inspection. CODE N, 1NSP.ESeiIpHT�'PE 1676 Fixed SyS�em Final Fire Prevention 1266 200 201 202 203 Pool Spa Final final Re-Aooi Final8locWRetaining Wall Final Factory Fira Place Final Sign 204.. -Final�emO�ition. ., ,_., __ . OATE INTITIALS . Date CODEN INSVELTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical DRTE INTRIALS 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site . . , . _ „ . . ...... . . . . .. 250_ ,Final Building/Occupancy ,,, _ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 2568 CARNEGIE AV 14137308 DAVOR STANIC 3190 AIRPORT LOOP BUILDING G COSTA MESA, CA CALL, JEFFREY L Phone: 714-241-0284 Zip: 92626 Address 2568 CARNEGIE AVE ' Phone: COSTA MESA, CA Zip: 92626 Contractor: BENRICH SERVICE COMPANY INC Address: 3190 AIRPORT LOOP ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 7000a Motars to 1hp Motors to tOhp Motors to SOhp Motors l0 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign CircuiLs BUILDING G COSTA MESA, CA Phone: 714-241-0284. Zip: 92626 License: 502927 SCOPE OF PERMIT ELECTRICAL TO INCLUDE: UPGRADE ELECTRICAL SERVICE TO 200 AMPS. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway/t00ft Standing Seclion Misc ElecVical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt Misa Conduil Misc. Conductor Circus ( gen or ride) Circus (mech ride or lighls) Christmas Tree SWnd Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: OS/OS/2003 Issued: OS/OS/2003 ISSUED BY: � Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 30.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for ihe work authonzed under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlrad Inspeetlona and tlnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448d81B100) WORKERS' COMPENSATION DECLARATION: I hereby eNirm under penalty ot perjury one ol the following tleclarations: ❑ I have end wlll mainteln e ceniticate of consent to self-Insure for workers' compansatlon, es proNded for �y section 3700 of the Labor Code, tor the peAormence oi the work Por which this permit is issuetl. '� 1 have and will maintain workers' compensation insurance, as require0 by section 3700 of the Labor Code, Por Ihe pedormance of the work br w�ich ihis permit is Issued. L�My work r' coq�p"ensetlon Insurance ca��rrie( end policy number are: �1 �Certler: ?pJ�F� Cc�wuPenSc��bn Ins F�^�^s� PolicyN� umher��—�bZ�'�'TZ `(Th .is sectlon need no( be complefed fhe permi( is velued at one h�ndred tlollars ($f 00) or Iess.J � _ � [a I certify ihat in Ihe pedormance of the work for which this permit is issuad, I shall not employ eny person in any menner so es to bacome subiact to ihe workers' compensetlon laws ot Callfornie, entl egree that if I should ecome sub�ect to Ihe workers' compensalion provisions of Secti n 370 of the Labor Code, I shell torihwith �comply�with�lhese provisions. ^ r 9 ''• / 103 /O �APPlica�t Signeture:_ = �-a "`^��- " Dete� -�-' �V'D —� � �WARNINO: FAIWRE TO SECURE WORKERS' COMPENSAiION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED THOUSFND DdY1RE (5100,000). IN ADDRION TO iHE CQST OF COMPENSATION, OAMAGES AS PHOVIOED FOR IN SECTION 3�O60F THE LABOfl CODE, IMEREST, AND AiTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn that I am licensed undery rovisia face end.e� Lic. a � SO "`q Z CONSTAUCTIPN LENDING AGENCY: of Chapter 9(commencing with Secilon 7000) of DlNsion 3 of the.Business and Professions Code, antl my license is in tull �Gass a 1 G ! � �. Dater =� 'JS o S o 3 ❑ I hereby 9nirtn ihai there is a construciion lending agency for the pedormance of Ihe work for whic� ihis permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentlers Address: Signature: Date: OWNER-BUILOER DECLARATIONS: I hereby ettirtn Ihet unCer penelry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, 9usiness antl Protesslons Code: Any city or counry which requires a pertni� to consWct, alter, improve, demolish, or repeir eny slrucWre, pnor to its issuance, also requires the epplicam tor such permit to tile a signed stetement thet he or she Is licensed pursuant to ihe provisions ot the Contracbrs License Lew (Chepter 9(commencing with Sedion 7000) of Dlvision 3 of ihe Husiness end Professions Code) or ihat he or she is exempt iherefrom and ihe besis for t�e ellegetl exemptlon. Any violalion ot Sec[ion 7031.5 by any applicant tor e parmit subjects the applicant to a civll penelty ot not more than five hundred dollars ($500).): ❑ I, as own0r ol lhe pmperty, or my employees with wages as their sole compensation, WILL DO 7HE WORK, antl ihe sirucmre is not intended or ottered lor sale (Sec. 7044, Business and Pmlessions CoOe: The CONractors License Law does not apply lo en owner of propeny who builds or improves ihereon, and who doas such work himself or herself or ihrough his or her own amployeas, provitlatl Ihat such improvemenis are not intended or oHered for sale. If, however, ihe building or improvement is sold within one year ol completion, Ihe owner-builder will have the burden of proving ihat he or she did not build or improve for purpose of sale.). � ❑ 1, es own9� of ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prqect (Sec. 7046, Business an0 Professlons Code: The �ntractors License Law does not apply to an owner of propeny who bullds or improves Ihereon, and who wntracts for such pwject with a contrector(s) license pUrsuant to the Contractors License Laws.). ❑ I am exemp� untler sec. Business antl Professions Cotle lor ihis reeson: Signeture: Date: Owner ID venfietl by drivels license. ❑ Yes ❑ No Drivefs License No. Venfication ot Ownership by (rype of document, i.e. - property �aa bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PEHMR CERTIFICATION: Expires: ❑ I heraby cenity Ihet no excava�ion tive (5) or more feet in tlept� in�o which e person is required to tlescend, wlll be matle in connection with work euthorized by this permit, end ihat no 6uilding siructure, scaHolding, falsawork. or demolition or dismantling thereof, will be more than t�irty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celifomia Atlministra�ive Cotle). ❑ As owner-Duiltler, I will not employ enyone to tlo work which would require a permil irom �he Division of Intlustrial Safery, as noted above, unless such person has e permit to do such work Irom iha division. Signeture: Date: Division of IntluS��al Safery Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I certify under penal�y o� perjury ihet I have read this epplication end state thet �he informetion given is correcL I agree to comply wilh all state laws end city ordinances relating to building constmction, antl euthonze represenfatives ot the City of Coste Mesa to enter upon the above-described property for inspection puNoses. I egree not to occupy or allow occupancy of any building authonzed by this permit until linel inspection. C31 COpE 1, INSPECT14NSYPE 7616 Fixed 5ys�em Final Fire Preveniion 12fi6 Pool SDa Finel 200 Final Re-Roof 201 Final BI�k�Retaining Wall 202 203 204 Final FSctory Fire Place Final Si9� Final Damolition O�TE 1[�9L5 COOE I INSYECTION TYPE 206 Final Mechanical 20B Final Plum6ing 210 Finel Electncal 272 Final Fira Prevention 220 Final Planning Appro�al 222 Final Site 250 Final BuildinryOccupancy G,S�JS(oj { Date �1 �g �� 1^-I�-'— M/" uwrvr;it n�ix:� xtt;iuu�u� Unr�: >- f o� JOB ADDRESS 25 Carnegie AVe. BUILDING PERMIT NO. 2 120 n Gh:NF,RAT. CONTRACTl1R (kunar_RIAr_ DESCIiIPTION OF WOAK Fnc.Rreezwa.v tc� Fb[_Fam.Rm. ZONE Rl SUBCONTRACTOR or Final � � I Flectric :nt.. RefciH. and A.Q. NSnal T dwa... �1i, _. r-7- e s .�: 24�GC� ��COSTA MESA BUILDING-SAFETY DEPARTMENT P: G. BO% 917 COSTA MEBA. CFLIFORNIq For Applicanf lo Fill In Completaly TYPE OR PRINT � BUILDIN6 a,-6� �,� re �, ��, � ADDRESS COSTA MESA, CALIFORNIA OWNER O G AODRE58 ^'� J � n'l r y 6 � E �� cin C�S no' �yf ARCHITEGT TEL. y�� OR ENGINEER � w i� G IQ NO. ADORESS S '". ...rv� MAY 7 1965 � � � � PPLICATIaNN-FOR�2RM BUILDING For Offiee Use Only PHC8IPT NO. ZO ' I NO.OF I UB60PN8 ' �q p� PLAN9 �v BUILUINO CONTRACTOR V w 1� � L60AL I j. S� � �EHCRI'iION /� Q �� ADDRE88 A. P. NO. � O CITY NOTE: NO EAVE OVERHANO 9HALL BE LE39 THAN STATE TEL. 90' TO SIOE Q REAR P. L. LIC. NO. NO. 8AVE5 SIZE ( Ho.oFeLDae. ALLOWED fU.B.C.REqU1REMENT) OF LOT O NOW On LOT YAROSAPPROVED YARDSAPPROVED USEOF c MAIN BUILDIN6 ACCESSORY BUILDING EXI3TIN6 BLO6. D M V ( FROM C/L STR ET 6ETBACK LINE FROM ��- �' FRONT FT. ' CENTER OF BTHEET REAR YAR� 61DE YARp I LEFT ^ I RIOHT �^ R. SIDE FT. � FT. DESCRIPTION OF WORK �. ame / �. � F-r. NEW ALTERATION ADDITION � REAR FT. DISTANCE BEf. ET. MAIN Q MAIN BLD H. ACC6SS. BLD09. REPAIR M VIN6 DEMOLI6H BUILDINO � � NO.OP VAR�# DATE SIZE � ( ROOMB � 9T RIE � C. U. P. APPROVED EXTERIOR WALL ROOF ,Q MPROVED COVERING ' �• COVERIN6 /'-X BY ` 1� USE OF BUILDING AND WORK TO BH PbRFORMED �%✓ G� C7 S l 1:� Q'� t[/ � �i /.�/ C�T. Fp ��. m� d�' s4. �. � o 0 1 HEREBY ACKNOWLEOOE T AT 1 NAVE READ TXIB APPLICATION TNe AMOUNT BXOWN UNOER VALUATION 18 FOR TH8 � RN� BTAT6 THAT THE ABOV IB ORR6CT ANO AOAEB TO COM. PURPO6H OP EBTABLI6HIN0 A PERMIT FEE ONLY. 0 GLY WITH wLL C�TY OpOI ND B T8 LAWB R UL6 1 O yqLLlAT10N BUILOIIVO CON6TRUCTIO . / 6',.O m PERMITFEE S V • q SIGNATURE OF � PERMITTE � m i S 9a � �7 LA O AUTHORIZEDA6ENT / BO � TOTAL FEE �� es-1� a Bni1FLi►g Department 171 EAST 20th STREET COSTA MESA, CALIFORNIA � APPLICANT TO FILL IN �568 Cerneaie Ave. Costa Mesa, California Nearest Cross St Owner Mail Address or Lot New I S 1379 Wall APPLICATION FOR PL�'K1V11T 3 BUILDING �� FOR O�'FICE USE ONLY I I �S�%� Received by Date Rec'd. Date Issued ��,�-r✓ � 5-� G AUG 1 4 1956 Building Address Costa Mesa, California Tel. Cross No. J zone LiC. No. Appn b Cfty Lic. — r Const.Coaa. 3761 53 I slock j rract`z727 — iounda) — No. of Bidga — Q �j Now on Lot �No.ot I No.of _ Famflies Room Rear Vard 0 Side vard 5 [P'i'ION OF WORH — Alteration I I Addition I Date CORRECTIONS APPROVALS — Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is correM and agree to rnmply Lath. Int. with all City Ordinances and State Iaws regulating building consCruction. Lath. Ext. Signatureoi�Ql,bOT Construction Co. Permittee Plaster, Ini � Authorfzed Agt. Plaster, Ext Valuation Permft Fee $ �� Masonry Reinforoed Plan Check $ � Bond eeam S 11,200. Tota� Fee $ � � FINAL ro� zoa s-ar zM a-as � � Data PLOT PLAN Show Iocation and dis�inces fram properSy Iine and between buildings '' COSTA MESA BUILDING-SAFETV DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 i Fdr Applicant to Fill in Completely BUIL.�ING +^� C� n %1 .. _ � A�".�� OWNER MAIL CITV 1 f`IX2't b CON5TI7UCTION i LENDER � BRANCH ^ ADDFESS ADOFESS ADDRE55 , �� arv � STATE � IIC. NO. � SIZE �)" OF LOT � USE OF EXISTING BLDG� SIZEOF .�1e� OF BUIL � K�a� . aOC. LCiS'�0. O.-C h�P n� a m�sc � TEL. �jyC1— 1�5G� No. E�c�qj— TEL. L1�`a1"C�i 1� �•s \ TEL. .�TCS No. ��Un GfTY �``�� 6-� LIC.NO. � iNO. Of BLDGS. � NOW ON LOT NO.OF ` ROOM$ ROOF �U COVER WOFK TO BI EO \ r,� 31-7i�PAiUO(i�a�s�: •:,..:•::57.5; APPLICATION FOR BUILDING PERMIT RECEIji�D�Y DATE RECEI_ED DATE `SSU�D ` IU/ �7 � P� % O'- � P A.P. NO. I � � BUILDING �') � C C.o ADDRESS �SL; T � CS C\IPQ�Q 1(YI6: _ OWNER K��1 �u j��QY` n VALUE �QLO S ( 17Pc' S Q FIRE � ZONE TV E GF/iOUJP �J APPROVED � ��^� � gy / DATE �/ b ZON NO.OF USE OF NEW ! PL4NS BUILDING.I�iA�, iH A/� / �'•j-.�%LLLa1 YARDSqPPqOVED VARDSAPPROVED MAIN BUILDING ACCESSORV BUIIDING DIS�ANCE BET. MAIN BLDGS. VAft. � �r � FT & DATE APPROVED ., ....� "/ �. I hereby acknow�ed8e thai I have reatl Mis application and steie � that the abova information is correct antl agree to comply with all laws regulating builtling consttuction, antl I shall not employ any person in Jiolation of ffie workman's mmpensation laws of the State of Cal�tornia. �� ) T� � I hereby certity thai I am properly licensetl as a contrectot untler �, SQ. FT. o the State of California Business and Professio�s Code, �ivisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in tull force and effect, or I TME PURPOSE OF ESTABLISHING A PERMIT fEE ONLY: ¢ am exempt trom the provisions ot ffie S[ate of Califomia Businass VALUATION antl Professions Cp�ie, �ivision 3, Cpgp te��r 9. /�� _ �'/ m !1/��J (J'T-tit�` �tll PERMITFEE $ Q � � Si9natureof �. �JqL S�LV"L •._�'t � �J m Permittee % $ �� ...1 9 PLAN CHECK $ � E � . l`.�•'wy.3� C ' o Auffiorizetl AgePt LL TOTAI fEE $ -�