HomeMy WebLinkAbout1166 CHARLESTON ST - Building Permits ADDRESS Of BUILDING: 1166 CHARLESTON ' ST unit CITY OF COSTA MESA — BUILDING PERMIT
amERSNUIEIPKNohN: BROWN, GERALD E FLOOD : X 46 PERM NO: B 074638
ADDRESS: BROWN, MAUREEN A
4 1166 CHARLESTON ST PERMIT NO: B 074638 PLAN CHECK NO: N GOVT: N SUPP : N
•
COSTA MESA,CA 92626
APPL.IAIUNDADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF RESHEATH & REROOF 24 SQ W/ COMP SQ FT: 4 , 700
ARMOR ENG.'S ADDRESS: UNIT:
CLAIM VALUE: 4 , 700 , 00 CALC—VALUE : 4 , 700 . 00 GROUP OCC: R-3 IN-1
CONTRACTORS NAME: DUTTON CUSTOM WOODWORKS ( 714 ) 898-4365
cotanCTORSYMRlD 13292 CHERRY ST COMMENTS : SMOKE DETECTORS REQUIRED PER 1991 UBC
ADDRESS: WESTMINSTER CA ug,fa; 676374 ********************+aSE->Est*******x-*******u-******+t***ie******JR**HESE*x***if*****N.****-)4
92683 WIT: Z O N I N G R E Q U I R E M E N T S
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 S E T B A C K Jr
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
CITY Up.No.: UC.CLASS: B LIC.NO.: 676374 EXP: MAIN BUILDING ACCESSORY BUILDING
t0 _ i b .�'�--- - FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dae: Contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
t
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law for the
following reason(Section 7031.5 Business and Professions Code:Any city or county whim requires a permit to construct,alter,Improve, PARKING REQ: P R O V: PARCEL: 1416 91 16 Z N E: REF NO:
demolish.or repair any structure.prior lo Its issuance,also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES>-
is licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the
Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permieubjees the applicant to a civil penalty of not more than Me hundred dollen[2.5001). ***************************{t*********3E************************1E******},-e3E********
o I,as owner of the progeny or my employees with wages as their sale compensation,will do the work,and the structure is not intended D E V E L 0 P M E N T S E R V I C E S 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 apply to an owner of properly
who butds or improves thereon,and who does such work himself or herself or through he or her own employees.provided that such
improvements are not intended or offered for sate,U,however,the building or improvement is sold within one year of completion.the ZONING APPROVED BY DATE: '.
owner-builder will have the burden of prising he or she did not build or improve for the purpose of sale).
❑ I.as owner of the propend.am exdusivey contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE:
Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon and who r"
contracts for such projects with a contradoris)licensed pursuant to the Contractors License Law).
❑ lamexempt under Section B.8 P.C.,for this reason: APPLICATION ISSUED BY: ��I�/� DATE : �^
**************iE******* . . . * . **********� . **
Date: _ Owner: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,end
25536,and that I or any future building occupant will/wit not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit forconstruction or modification from the Air W70;anagementDiatdd.ResidentW pp
construction are exempt from these
provisions. PERMIT 72 . 00 . 50
Dae: Applicant; SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedantions: ISSUE FEE
❑ I hays and WII maiMain a certificate of consent lo aelf-insure for workers'compensation,as provided for by Section 3700 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the performance othe wodfor which this pang'isIssued. TOTALS----> 72 . 50 0 . 00 0 . 00 72 . 50 72 . 50 . 00
❑ I here end wit maintain workers'compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for whim this permit is issued.My workers'compensation Insurance caner and policy number are:
Caner: REVENUE DIVISION TOTALS--> COLLECTED : 72 . 50 OVER/SHORT: . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This sed/on need nor be completed y the Penna is Apr one hundred dollars($1001 or lees.) 72 . 00 . 50
"❑ 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,and agree that H I should become subject to the workers' *******************************************************************************
I - compensation provisions of Sedion 3700 o the Labor Code,I shall lonhwith comply with those provisions. I N D I V I D U A L F E E B R E AK D O W N
Date: I0 — I g- 4 C Applicant: . di
Waco/ng:Fellure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal maids,and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil lines up to one hundred thousand dollars otocto00),In addition to the cost of compensation,damages as provided for In
Seddon 3706 of the Labor Code,Interest,andettomeys fee.. SFR 4700 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 700 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is e condrudbn ending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,CN.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is coned.I agree to comply with all city and county ordinances
and stale laws relating to building construction and hereby authorize repreeentatbes of this city to enter upon the above-mentioned property SMOKE
(/J m�nrina�^peyaionw�'rpoannas. DAVID DUTTON q SMOKE DETECTOR
> 1Y0"v./ I `-� t u a •
Date: Io- (8- ` REQUIRED
Signature of Owner/Agent/Applicant/Contractor 71 09: ?'- -L.,J'5:':45 TO'f' 72.5:s
CPTE: _r. .." _ _ ve.E a .". .ri
(5151d6.WP) White-Building&Safety:Green-File:Canary-Appicant;Pink-Revenue;Goldenrod-Assessor
II CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS 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
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test t
6. Electrical LIFER 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,
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 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
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing /0_!4_ 475 �(4( 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 Domestic-Final
42. Backflow Preventer -�
43. Backflow Irrigation
44. Landscape Irrigation System -r-
45. Sound Attenuation
46. Handicap Regulations
47., FINAL STRUCTURE & BUILDING /0-26_etykkg_
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
Applicant to in all spaces except those within heavy border lines and sign all appropriate declarations.
"4111/ACIT MESA a PE IT NO- TRACT NO. LOT NO. BLDG.NO.
CONST N PERMIT - 9663
Applicant's Mailing Address p� TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR 9I _6 I 1 /j ./ •.
Project Address/1/69.1,52 ('.4- 5��C 7 'J q_ f� p 0 CONVERSION ❑ DEMOLISH 0 OTHER
7 /-4/_./.e. 7S Phone-5-306100i 00O DESCRIPTION OF WORK
's Na�neZONING REGULATIONS
Address 7•11 67 rxae-4sfl~J
TYPE OF PERMIT 0 GRADING U FOUNDATION 0 STRUCTURAL A.P.* ZONE
Arth/Eng. License No. 0 TENANT 0 ELECTRICAL ❑ PLUMBING 0 MECHANICAL PLNG.REF.sW BUILDING
Address _ 0 OTHER TO BUILDING op-rya/Ark Cr' CT
r' PROPERTY I INE REAR YARD(TO P/U
Contractor's Name. .,, �'-e&-�• Phone J'Sf'7.3fv.-')'PROJECT DESCRIPTION SQ.FT. OCCUPANCY
Address(mailing) SOS( }, �� aCONSTRUCTION TYPF VALUATION - -
LEFT SIDE YARD RIGHT SIDE YARD
License No. � ZONE _ GRADING CU.YDS. ACRES PKG.SPACE REQ. PROVIDED
LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH PARK FEE$
I hereby affirm that I am licensed under provisions of Charter 9(commencing
with section 7000) of Division 3 of the Business and Proles ions Code,a d SPECIAL CONDITIONS:
my license is In ull force and attack! �iGJ
License Cyj� �Tb Uca sa N -/// ! /) PLUMBING
Date / /,2� / Signature l�" "� 1'tO rs--/ ELECTRICAL
WORKERS'COMPENSATION DECLARATION Bar Sink
hereby affirm that I nave a certificate of consent to self nsure or a certificateSewer Cap
Automatic Washer Meter Dover 100 amps
of Workers' Compensation Insurance, or a certified ••py thereo Section Backflow Preventer Sewer Connection
Lab C) //_ - Construction Pole Sub Panel
�70 3 94,// f /' A-a Backflow Irrigation Solar Collectors
Policy' No; /!/ Gompan \ Cooking Unit Sub Pole •
C Cer ifietl co DY
Is hereby furnished. ` Bathtubs Solar Piping
Lam, r[I tied copy is fitgd with the city Bullding'DIvIsio c '/����7� - Dishwasher Motors ❑0-1 HP 0115-8
Date // ///Applicant _ -/��'GY.✓�l./ Clarifiers Solar Tank
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION $wimmirlglPooh,.,�q \ qq Dryers ❑Gas ❑Electric _� Inc.Soler 09-15 HP 016.15+
(This section need not be completed if the permit is for one hundred ($100)or --.q t \ d�
less) -•r,,0j Fan Microwave
' I certify that in the performance of the work for which this permit is issued I Drinking Fountains Urinal t----_ a /nom
not employ any person In any manner so as to become subject to the _ F.A.U. Pole Light
workers' Compensation'Lasi of California. Floor Drains Water Closet. fl- i • �(n$ _
Date - Signature - Fixtures
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks - Water Heater -Cf� ) Range
Workers' Compensation provisions of the Labor Code, you must forthwith // Device Boxes Si
comply with such provisions .or this permit shall be deemed revoked. Gas Service Outlets - Water Service /'� n
9
CONSTRUCTION LENDING AGENCY y ���J, Outlets Standing Sections
I hereby affirm that there Is a-Construction lending agency for the performance ' Interceptors • / 7
of the work for which this permit is issued (Section 3097 Civ- C.) Switches Trash Compactor
Lender's Name - Kitchen Sink p
Lender's Address •
OWNER BUILDER DECLARATION Lavatories • - Garbage Disposal
I hereby affirm that I am exempt from the Contractor's License Law for the' p-Trap' Generator 00-5 KW 05-15 KW •
following reason-(Section 7031.5 Business and Professional Code: Any city or p -
county which requires a permit to construct,alter,improve,demolish or repair - Transformer 015-50 KW -
any structure, prior to Its issuance, also requires te applicant for such permit Roof Drains • ..
to file a signed statement that he/she is licensed pursuant to the provisions of ❑5U+KW
a Contractor's License Law(Chapter 9(commencing with Section 7000)of Reinspection Fee $15
vision 3 of the Business and Professions Code) or that he/she,is exempt Showers Reinspection Fee ' $15
•
erefrom and the'basis for the alleged exemption. Any violation of Section - - Meter Cup to 100 amps Issue Fee . -$ 3-- '
031.5 by any applicant for a'permit subjects the applicant to a civil .. - -
malty of not more than five hundred dollars($500). Service Sink Issue Fee $ 3 Zoning Approved By Date
LI I, as owner of the property or my employees with wages as their sole MECHANICAL ~
•
compensation will do the work,and the structure is not intended or offered Application Approved By Date
for sale (Section 7044, Business and Professional Code:'The Contractor's - -- - --- --- ---- - -- ---- - !�
License Law does not apply to an owner of a property who builds or improves ' Boiler Refrigeration System Application Issued By ij)/ �� Date /f/�C�'JOV
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 Duct-Under Ground •• ❑0.100,000 BTU ❑100,000 BTU
sale. if. however, the building or Improvement Is sold within one year of corn- SUMMARY OF FEES
pietion, the owner will have the burden of proving he/she did not build or im- - System Repair/Alteration $
Love for the purpose the of poperty,e). ; Duct-Structural y p BUILDING PERMIT SMIP
tr t ras owner of the project sem exclusively contracting ing wittAlprofeisionstl con- .
.Thetors Contractor's construct the project(oes not 7044, osinessantl si t Cotle:--' Duct-Ventilating ._ PLAN CHECK PERMIT ,
The s or License does not apply to an owner of withpropertya who ISSUANCE $
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 PLUMBING
E.pctor(t) license pursuant to the Contractor's License Law). •• PLAN CHECK $ GRADING $
U I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit-ICBG* $ ,
• - ELECTRICAL $
Date - Owner ' Heating System&Ducting ' MICROFILM $ • '
I hereby certify-that I ye read this application and-state that the abo e . -- 00100;000 BTU 0100,000 BTU . PLAN CHECK $
information Is correct! ag ee to comply with all city and county ordinan s - ' • TOTAL FEE' $ '
and'state laws relating to uVdi g construction,and h reby authgQoriize r re- SME
'MECHANICAL $
Sentatives of this/cit e t upon above-me tioned O/o )4 for • Hood or Type I ❑ Reinspection Fee $15 LESS •
inspection purposes. /// Canopy 1 II 0 PLAN CHECK $ • ADVANCED PC $
Signature I -'
Accounting;Goldenrod-Assessor
Illia Ict i CONSTRUCTION AND'PCANNING' `.-1 '4- c 1. _POO :PA ` '"1
h APPROVALS Permrt#,- '- "Date --' rinspector Date -Ins{1111
< ' 'APPROVALS' Permit.# c
r Temporary;Electrical Service o'r-Pole 6? ; ' :52 Pool &Equipment Location < • '-. - -
Soil Pipe-Uhdrgrrid ' j r ` I c 1 53. Steel Reinforcement - -
'3• electrical Conduit Utility Undrgrrid I = ' ('54.'. Forms - • '
t' 4' Electrical Conduit-Undrgrrid' I - • .155.. Electrical Bonding - -..-
Ii..;
5: dteel ,ReinforcementI = ,'.- II;_ 56. Rough Plumbing_& Pressure Test - t -
c
6. Electrical OF ER Grnd. -Ic 4 r, ` 57. APPROVAL TO COVER-GUNITE: • _`
7. Footings I I 1 i ; F 7_ 1 t-, - F_ n I I -:58. Electrical Conduit-Undrorndf. ,
,
8. Foundation _ ' f' - 59. Gas Pipe, O:Undrgrnd.,Test:-
9. WaterPipe-Undrgrnd. .' - ' : _ '`60. Backwash Lines,P-Trap,t0 Undrgrnd. -
10. Structural FI&or System ' . . ' - • • - , -61. APPROVAL TO DECK - i -
11. Property Sewer Line& Houser Connection ' - 62. Backwash'& Receptor-Final •
12. Sewer CaP ; - - -
.! • ' 63. Heater& Vent-Final -
13. RoofDraink I I y •' .64. Plumbing System - Final - ' - -
,. 14. .Rough Plumbing I - 65. Electrical=Final - - -
_
'.ii
't c C'15.-IR"o`ugh Eleciricalttiriduit`j`"j - ;--;- r r "1 r -' -I. �-I--?- '66.1--Solar System-Final - ' - - � - - - '-
irE
cr.16. IRough-Eleetric,Wiring- I ' I a , ,: I r. ' ! r . - 671 Fencing&Access Approval: - 3 . 1 r :
i t ;17. R8ughWiring'SignI2 II, : ' I `_ ' .:• I I; 68.' APPROVED FOR PLASTERING ,
= ii 18: tRough Electrieal;T,Bar Ceiling, l I, I - := ; , - , 69.; POOL/SPA SYSTEMS FINAL _
19Rou h Heating &'Air`ConditidninI. . i " I 1 , ! It I I I
e .1 J - L _. I .• `. 1 i . , I • FIRE DEPT. REQUIREMENT. -
; 20.I.Rough factory Fire-place 1 l . r I I c I I r APPROVALS• Permit# :
. 21. 1Ducts,in Structure) I I „ i i I i I i 70! Underground Hydro ' '
22. ,Ducts, Ventilating ' , c I ' 1 I ' � I '71., Prbduct Piping ID Gas DOH ,
C •"23. GasPipe-Rough & Test _ i i ;,- p 1 I i 72. Underground Flush •
jt24. Roof Framing ' , ` • .' i , v 're 1 , I I. 73! Unde'rgrnd.Storage Tank O Gas, OOiI
25, Roof Sheathing I I I '', ' I It I ' i = X74. Overhead Hydro -
. 26. T-8ar Ceiling (Structural)-& Monocoat 1 i I . II': nt 1 75. Dry Chemical -iI
• • 27. Frame and Flashing- = I II I I ^ 1 , 76. Dry Standpipe -
28. 'L'athing &Siding: } ; ' i ;, •i 77. FIXED SYSTEM FINAL '
t_29.!'.Insulation $ ", •' �: { I I ( `78: FIRE PREV. FINAL .. '
3:30. Nailing ' . , , . q I i I I . ' ,Notes:l/•1),'9i4'o'ioAA/./> 75'6/04/Ai4 -k'-:''4_ /1 'C ,
31. Plaster Brown Coat 1 ' - I I; 'r •, I I-
' I 1 i L;'. . /" ' GrJ3_.r l.,`.`r; '.-;�t ./II. - ..
aw . _
h 32.tElectrical,,Power Meter;Final i ' 11 t i -
33. °Final Electric I ' ' ' I ,
34. Final Heating& Air Conditioning '' I
35. FinalGaspPipe;Test '- I RI et I i ! .. Ir- I . I _
36. Hood or Canopy-' ^ I , ' 1 . 1 i • , - - I
' I
37. Final Factory Fireplace 1 I:' c � `' . ! ' - • 1 - -
-
38. Final Plumbing '
39. Water Seli rvice-Final I ' I
40. Gas Service-Final j I 1 I it j
41. Solar Domestic-Final I 1 I '
1 I1 rt _ _ i - • .
42. Backflow preventer 4 ' , tri. r _ .
I ' i I I[V I r _,I . l' . I . .
43. Backflow Irrigation1 ? ,0 ' 1 i .%I• 'J , ! _ '
44. Landscape Irrigation_System 1 - - _
45. Soundr'Attenuation ¢f: ' < I I ., ; . , ' 1 ' ' _1' ' • - - , - _
46. Handicap Regulation's I ' ` r I I ';'i r- - • -
47. FINAL STRUCTURE& BUILDING I^ l I - j I ' I . , V •
48. Special Requirements Completed I I 1 j .
49. Electric Release to Edison) : F I I I _ , - '
50. Gas Release to Southern California Gas Co I 1 l I I ! - 1
51. CERTIFICATE'OF OCCUPANCY & L ! ' 4-.' . _" ' ' , _ ,
No II II 1 I Date I . i 1 1 '
A. 20757 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT . OCT 7 Iti
P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT.
PPL c7,'T �olptMAW
For Applicant to Fill In Completely I R
TYPE OR PRINT BUILDING
For Office Use Only
ADDRESS 1166 Charleston St.
RECEIPT NO. 1r7
COSTA MESA, CALIFORNIA "LJ aII /lF,�•
RECHIV{DBY ATS -y- DA�S {JE11
OWNER Northa�Ite, a �artnershlp l/C/ (/ !U // /y/
BUILDING
MAIL
ADDRESS 15939 LasFlores St. ADDRESS
FIRE � oo .q��/L/n�
Dm/Fountain V lley
TEL. ZONE ZONE TYPE GROUPOa-y
APPROVED
OR ENGINEER C' Hiller No1L'52007 BY DATE
ADDRESS Qnohpi m ZONING
zoN HO.OF ust of / �•��
'" ' PLANS z BUILDI / .YP'T •
CONTRACTOR RnnCPP CinYlet nL+ LEGAL �./J �� r 1' •(O r.5-3V
ADDRESS 15939 LasFlores St. DESCRIPTION /^((����' JA, 1�
Fountain V.T1iey A.P.NO. ` J
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATETEL. 3O•TO SIDE a REAR P.L.
LIC.NO. 2150)49 NO.531 6792
EAVES
SIZE I NNO.OF BUDGE.OW ON LOTnflnp ALLOWED (U.B.C.REQUIREMENT)
OF LOT 11 9X60
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. none
(FROM C/L STREET)
SETBACK LINE FROM
CENTER OF STREET C n I REAR YAR.A1..11''9, I FRONT (� FT. FT.
7 (—
SIDE YARD LEFT 6I I RIGHT 51 R.SIDE ) FT. - FT.
if
DESCRIPTION OF WORK L.SIDE (c Fr.. FT.
NEW X ALTERATION ADDITION REAR FT. FT.
/
DISTANCE BET. BET.MAIN Q -,
REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.BLDGS.
VAR.# DATE
BULDIING NO.OF
SIZE l59Sgft ROOMS 5 STORIES 1 C.U.P.#A APPROVED
EXTERIOR WALL ROOF APPROV l D - lF- C
COVERINGS ti ren I COVERING chi rr1P BY �p, DATE l
USE OF BUILDING AND WORK TO BE PERFORMED " 1`'�4i_A_A�.`''.1..
single family res w/attach tar.
/. N a
SD.PT.
I HEREBY ACK • THAT I HAVE 'EAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _
AND STATE T THEECORRE T AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH A CITY 0 • ;[yy:. ND ATE LAWS REGULATING VALUATION p
BUILDING C• STRUCT; 1 /� ;
SIGNATOR O' ' // PERMIT FEE $ 7
PERMITTEE �'_ n��/ -
s /ry 7 Q5 C s
l S
/ 0
AUTHORIZED AGENT �'7� ,J E
TOTAL FEE $