HomeMy WebLinkAbout3067 CLUB HOUSE CIR - Building Permits(714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 3067 CLUB HOUSE CI
Suite No
Vicinity:
Parcel Nunmber: 13951503
Applicant: HALAJIAN, VAL
Address: 7338 ETHEL
NORTH HOILYWOOD, CA
Owner: OLSEN, KENNETH K JR TR
Address '30521� VIA VENTANA � -
. � � SAN�JUAN CAPISTRANO, CA
Contractor: ALAP ASSOCIATES GP
Address: 7338 ETHEL
Arch / Eng :
Address: ,
NORTH HOLLYWOOD, CA
Phone: 800-444-8865
Zip: 91605
Phone:
Zip: 92675-1732
Phone:� 800-444-8865
� . Zip: 91605 �
License: 771905
� � � Phane: _
. ' Zip: ' . ' .
License:
Status: ISSUED
Applied: 11/06/2002
Issued: 11/06/2002
ISSUED BY:
- SCOPE OF PERMIT
CHANGE OUT WATER�HEATER. - '
FEESUMMARY
� ' AMT �QTY AMT
ISSUE FEE - $23:50 � Laundry Tub / Washer � . $0.00
Backflow irrigation $0_00. 0 Landscape Irrigation $0�.00
BackFlowPreJenter , $0.00����' 0 ' P-Trap-,. � �0�.00
.Bathtub � $0.00' •, 0 ' Pressure Regulator � . �0.00
Clarifier System $0.00 `"�0' `� � '" �° � "'Process Piping (per 10 ft) $0.00
Connectpce,Soda,etc) $0.00 �0�,�,-' Receptors � - . $0.00
DenWl Units � ' $0.00 . 0 ���. �; � , Septic Tank �, $0.00
Dishwasher . , . $0.00 • 0 : `Sewer Cap for Demo , $0.00
Drain, Floor � ��, ,$0.00 . � ' 0 '� �"� Sewer Connect $0.00
Drain, Rainwater . $0.00 � 0� � Sewer Private Line $0.00
Drain, Roof $0.00 . 0 � . � �Shower 50.00
Drinkin9 Fountain $0.00 - ^ 0 �• Sink, bar � - . ��u0.00
Expansion Tank $0.00 -. �9.. Sink, commercial $0.00
Gas Earthquake Valve $0.00 �0 - � Sink, Floor • � $0.00
QTY
0
0
0,
0 -
0
0
0
0
0
0
0
0
0 _
0
SumpPump
Swimming Pool
Trap Primer
_ : -. Urinal
� � Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
. Wash Basin
Wash Basin Set
. Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
� Water Service
AMT
30.00
$0.00
$0.00
$0.00
30.00
50.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
. INSPECTIONS: In order for the work authorized untler this permit to be considered legal, such work must comply with all applicable codes, antl all
��I required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
�'� FOR INSPECTIONS CALL: (714) 7545626
2446-06 (6/00)
WORKERS' COMPENSATION DECLARA710N: ' —
I hereby aHirm under Denelry ot perjury one oi ihe following declaretions:
❑ I heve end wlll maintain a cenificate ot consent to self-Insure for workers' compensation, es provided tor by section 3700 of the Lebor Code, for the pertormance of the
work for w�ich �his permit is issuetl.
I ve end will maimain workers' compensetion insurance, es require0 by section 3700 of the Lebor Code, for the pedortnance of Uie work for which MIs permit is issuetl.
y workers' �prn tion Insu e carrier and p�oylic�y �num�berp are: �� � ��� �� 1
Carner. �i1V�� ����liv✓���-- PolicyNumber: �. %.�7
(This section need not be comp/eted i! fhe permit is velued ef one hundred dollers ($f 00) or less.)
❑ I certity ihat in ihe peAormence of the work for which this permit is issued, I shall not amploy any person in any manner so as to become subject to ihe workers'
compensetion laws of Califomia, and agrae that if I should become subject to �he workers' compensatlon provislons of Section 3700 ot Ihe Lebor Cotle, I shell fonhwit�
comply with these pro Is ns// � �
Applicent Signewre: '�X ����-- Dete: �/ —�o—� 2—
�
WARNIN(3: FFILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENAlTIES AND CIVIL FWES UP TOONE HUNDRED
TIIOUSAND DOLLARE (5100,000), IN ADDRION TO THE COST OF fAMPENSATION, DAMAGES AS PROVIDEO FOR IN SECTION 37060F THE LABOR CAOE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm �hat I am licensed under pmvision p�°f 9/ �commencing with Saction 7000) of Division 3 ot the Business and Pr94essjpns Cotle, and my license is in full
force end eHecL Lic. N i ��� / V� qass x �_�.�_�
ContrectoYs SignaNre: � Date: �(� 6 �o'�--
L
CONSTRUCTION LENDING AGENCY:
� I hereby aHirtn that there is e consiruction lendinq agency for ihe pertormance oi ihe work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lender's Address:
Signalure: Date:
OWNER-BUILDER DECLARA710NS:
I hereby aHirtn thet under penalry of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any city or county which requires a pertnit to consiruct, alter, improve, demolish, or repair any stmcwre, pnor to its issuance, also requires the epplicant tor such permit
to file e signed stetemem that he or she is licensetl pursuant b the provisions ot Ihe Comrectoro License Lew (Chapier 9(commencing with Section 7000) of Divislon 3 of ihe
Business and Prolessions Code) or that he or she is exempt Iherefrom and ihe besls for the alleqad e:emption. Any violetion ot Section 7037.5 by any aDPlicant tor e permit
subjects the applicant to a civll penalty ot not more ihan tive hundred tlollars ($500).):
❑ I, as owner ot Ihe property, or my employeas wlth waqes as Iheir sole compensation, WILL DO TME WORK, and the structure is not intendetl or otfered for sale (Sec.
7044, Business and Pwfessions Cotle: The Coniractors License Law does not appty to an owner of property who builtls or Impmves thereon, antl who does such work
himself or herealt or t�rough his or her own employees, provided ihat such improvemenis are not intanded or oNeretl (or sale. If, however, the building or improvement Is
sold within one year oi completion, ihe owner-builder will have the burden of proving ihat he or she did not build or improve for purpose oi sale.).
❑ I, as owner ot ihe pioperry, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consWct Ihe project (Sec. 7044, Business and ProFessions
Code: The contractors License Lew tloes not epply to an owner ol pmperry who builds or Improves Ihereon, antl who contracis lor such project wl�h e contractor(s)
license pursuant to'ihe'Coniractors License Lews.).
❑ I am exempt untler sec. � Business end Protessions Code for this reason:
Siqnature: ` Data:
Owner ID ventied by driver's license. ❑ Yas ❑ No Driver's License No.
Veriticetion at Ownership Dy (rype oi daument, I.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICA710N:
Expires:
❑ I hereby certity that no excavetion five (5) or more feat in depih into which e person Is required to descend, will be mede in connection wiN work authodzetl by this
permit, and that no building strucWre, scallolding, talsework, or demoli�ion or tlismantling thereof, will be more Ihan thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
347, Ttle 8, Celifomie Administrative Cotle).
❑ As ownervbuiltler, I will not employ enyone to do wark which would requira e Dermit trom the Division of Indusinel Setery, as noted above, unless such person hes a
permit to da such work irom ihe tlivision.
Signature: Date:
Division of Intlus�nal Safe�y Permit Number:
CERi1FlCATE OF COMPLIANCE AND AU7HORVATON OF ENTRY: I certify untler penalty of perlury that I have reatl this application and state thet ihe information given is
correct. I agree to comply with all state laws and city ortlinances reiating to 6uilding consiruction, and authonze representa�ives of the Ciry of Coste Mese lo enter upon the
ebove-described property for inspection purposes. I aqree not to occupy or allow xcupancy of any building euthorized by this pertnit until finel inspection.
��D 'gnawre Ot Legal Owner(s) ��_ 6
—O `
Antl/Or Authorized Applicent
CO�E �. INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1268 Pool Spe Final
200 Final Ra-Rooi
201 Final Bixk/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
BAIE INiRIALS
CO�E� INSGECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Elec�fical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuiltlincyOccupancy
�g �
y,�ro�o� j31�L
, Applicant to fill in a11 spaces eacept t�ose within neavy borEer lines ana sign ali aoo�aD��ate tleclarations.
CITY OF COSTA'MESA �, T �, � � � P RMIT NO. f ' � TRAC�Yh1i%t� V. LOT NO. , BLD . . �
CONSTR� CTION PERMIT ' _ -- _ � " ' „ '
—'%O/�'�i� � ` �= `
Pr�'j2ct Address' 1" � � - TYPE OF CONSTRUCTION NEW . � ADD ALTERATION . REPF11 R
1 '
' ' ' 1 3L6 .12/2�/��3 ` � ' , 5.�b ,ll
ApplicanYS Mailing Addr¢55. ' � � ' '� n' � ❑ C�ONVERSION ❑ OEMOLISH ❑ OTHER � A,p. �E, � ;, r
OWnef'S�Name _,5 . I !,�yb-u36J, DESCRIPTION OF WORK
" � � e �'1 Phone , ., � , , .: � �� , S Main Building: :
Address- �_'✓�F ' ' • - . . � _ . . � E ' ,
f , TYPE,OF PERMIT GRADING FOUNDATION STRUCTURAB , T FfoM�•
Arch/Eng. _ _ LicenSZ NO' ❑ TENANT � ELECTRICAL �❑ PLUMBING O MECHANIGAL ' 8 Rear '�
Address� �� . � . . . ' .. '`. . ❑,oTtiER� _ -• . � .� _ . ' C Right
�/�- 'l(� PROJECT DESCRIPTION 5G1: PT. -,' oCCUPaNCv Left
Contractor.'s Nam ' - �' , '� 1� �` Phone � . � K .
Addres5 (mailing) ' w ° - O v✓l C fZQ ' CON'STRUCTION TVPE � `' � � VAWATION $ � $
� 3 . - , ZONE � ' GRADING CU.YDS, ACRES P�ng. Ref. #
Ciry lic?nie No. ' , -
LICENSED CONTRACTOR DECLARATION - Remarks: ' � ' � ' � � . � . � � Pe�kiOg RCq:/Provid¢d
I' nere�yaflirm th$t, P am licensetl untler provisions ot Charter 9(commencing
xith�section �000) of �ivision 3 of the Business antl Professions GoOe, a tl i . � � ,' ; � Use of Building:
ny license�is i or � a e fecL I .
ucense Ci s � � , � ' e �No ' � � PLUMBING , FEES Planning Notes:
Jate � Signature' � /� � _
ORKE S' CO 1PENSATION DECLARATION � "- ' , Bar Sink � Showers
� \
ereby ffirm that I nave a certlficate ot consent m selt-insure or a certificate ; �� gackflow Preventer , � Service Sink � '
� Workers' Compensation Insurance;,or a'cert��o�theieof (Section' ' '
3800, i.5b. c��.�9�/� • - , Backflow Irrlgation � Sewer Cap . . �
Policy No. " C6mpany ' � , ,
[�, �ertrtietl mpY.is hereby fumishetl. '� 9 / ��,�� ; ' Baffitubs ' Sewer Connection
EJ Ce ' ie w 5 tiletl with the city B in d,oision. Y/ � � .
Date %- Abdlicant %//'t—�//� � Clarifiers � . , Solar Collectors , � \•
'EXEMPTAON FHOM WORKERS^,COMPENSATION'DECL'ARATION ' ' '
(TnissecYion neetl not be completetl it the permit is for one huntlretl (y300) or
less): � ' . �
I certify that in the pertormance oi the work tor which this perm�t is issuetl I
shall not employ any person in any manner so as to become subject to t�e
Workers' Compensation Laws of Calitornia. . " ; .
Date Si9nature � '
NOTICE: If,'atter making this tleclaration, you shoultl become subject to the
'Workers' Compensation provisions ot the Labor Cotle; you must torthwith �'
mmpty with' such �provisions or this permit shall be+tleemetl revoketl.. '
.CONSTRUCTION LENDING AGENCV�' ' ' �� '
I nereby afflrm that theie is a�construction lentling agency tor the performance
ot the 'work for whicF� thls permit is' issuetl .(Section+ 3097 Civ. CJ; '
Lentler's! Name' � ' �
Lender's Atltlress, ' '
OWNER BUILDER DECLARATION ' ' " � �
I herebylaffi�m that I am exempt f�om the Contractor's License Law fo� tne �
followinq reason (Section�]031.S.Business antl Prafessional Cotle: Any city or '
.coun[y whlch requires a permit to construct, alter, improve, tlemolish or repair
any st�ucture, pnor fo Its is5uance, als0 �equir¢s the applicant fo� such pe�mit
,to lile a'signetl statement that he/she is licensetl pursuant to the provisions ot
s+';e eontractor'sLicense Law (Chapter 9(commencing with Section 7000) of
„- vlsion�3 ot the,Business antl P�ofessions Cotle),o� tnat M1e/Sh¢-is exempt
(>p�`2refrom,antl the ba5i5 for'the allegetl exemption: Any.violation ot Section
"i031�.5 by any applicant tor' a permi[ zubjects-the aOP�icanf'to a civil
�enalty of not more than five huntlretl tlollars (y500). . .
LJ I,��aS�own¢r of the p�ope[ty o� my employees with wd9¢5 as their Sole
compeniation, will'tlo the work, antl the structure is not Intentletl or offeretl
for saler(Section 7044, BuSiness antl Professional Cotler The Contractor'S
License Law tloes not apply to an owner of a property who builtls or improves �
thereonJantl:who aoes such work himself/herself or through his or her own �
employee5, p�ovitletl that such improvements are not intentletl or of(eretl fo�
sale: If, however, Ne builtling or improvament is sold within one year of com-
pletion, tne owner will have the burtlen of proving he/she tlitl not builtl or im- .
.�rove for the purpose of sale). .
LJ I, as owner ot the property, am exclusively contracting witti licensetl con- �
tractors to construct the project (Section ]044, Business anG Protessions Cotle:
The Contractor's License Law tloes�nobapply to an owner of property who
builtls or improves tnereon,'antl who contracts for such projects with a con-
tractor(s)licensa pursuant to�the Contractor's License Law). • ,
❑ I(am exempt untler Section B. & P. C. for this r¢ason ;
Oate � Owner '
1 hereby certify that_I have reaE.this aoPlication antl state that the above
License or.55
CMF
"WhiteT Builtling; Canary--
Drinking Fountains
Floor Dreins:
Floor Sinks
Gas Service Outlets
Interceptors� �
Kitchen Sink � ^
Lavatories ` . . -
tdof Drains _ • `y -
ReinspeMion Fee �- $25
Duct - Under Ground
Duct-Strucmral �,
Duct - Ventilating �
Exhaust System ❑ Multiple �i
Firepl/Fact.elt.ICBO# � �
Heating System & Ducting
� ❑0.100,000 BTU �100,OOOBTI
T i i
� Reinspection Fee
Pink -ACGounting; Goltlenrotl -Assessa�- "
$25
Solar Tank �
Swimming Pool w�
Urinal
Water Heater� .
Water Service � �
. � `"+ "
, i � .
, , Isue Fee -
Hood or �� Type I ❑ - �
Canopy Type II� ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
� $ 3
Issue Fee � I $ 3
Auromatic
' " " ' .. I 2one' ( . • . .
�e: _
. - Accessory Builtling: � i - � 2
_ ,, ' ' N
.. � � . �
; i �
. Park.Fees $ �
� 1 ,
� . ELECTRICAL � , '
Tran'sformer � 15-50 KW
� , � � 50,+KW
� N
� . G �
R �,
� E
� _ Q
U
�
R �
E
M`
� E
N .
, T
S �
iFEES �
t i
'Cooking Unit �� � . +- Meter ❑up to 100�amps �� � "
Dishwasher %� � Meter ❑over100amps, � '
Dryers ❑Gas' �Electric 'Sub Panel
Fan, . . ... Motors �0-1.HP �1'l:_. 8 .
� F.A.U. InaSolar.�9-15 HP �16-15+ � .
Fixtures ' . � � Microwave � �
DeviceBoxes ' �Pole.Light ' � �
Outlets ' ' , Range • � ' j
Switches � , � � Sign - 1 �
Garbage Disposal Standing Sections � � � �
Generetor �0-5 KW �5-15 KW 'Tresh Compactor � �
�' '
Reinspection Fee ' $25 •�uue Fae� ' $�3
� PUBLICSERVICESREQUIREMENTS: ' : . ' '
Zoriing Approved By Data
Application Appraved By Date '
Application lisued By— � Dat y�"7 �
� - �SUMMARV OF FEES
BUILDING PERMIT $ _ SMIP $
PLAN CHECK � $ PERMIT �
— PLUMBING $ �' �SSUANCE $
, PIAN CHECK $. / ENERGY P.C. $ '
ELECTRICAL $ � GRADING $ - �
� PLAN CHECK $ MICROFILM � $ ��r �
— . MECHANICAL �.$ ' TOTALFEE ;$�G✓
� PLAN CHECK $ . �' • �
.. .. ..- _ - . J
1
{
i
yC . .. . � . . ... . . .. ... .. _ . .. .
. CONSTRUCTION AND PLANNING � ' ' POl . SPA - ,
���-�$ '� Date Inspector - Date Inspector
�
'� ApPROVALS -Permit #� � . � , APPROVALS Permit # .
�d Temporary Electrical $ervice or Pole . . 52..Pool & Equipment Location �"�''
' 2.'. Soil Pipe-Undrgrnd. '� 53: Steel Reinforcement I '
- "3.;Electrical Conduit�Utility-Undrgmd. � 54. Forms - . �
: 4. Electrical Conduit-Undrgrnd. � , • • 55: Electrical Bonding � � . '.
��5. Steel Reinforcement ' f - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd'. � - . 57. APPROVALTO COVER-GUNITE . •
7. Footings , -� � 58. Electrical Conduit-Undrgrnd. �
8. Foundation ' � � � - 59. Gas Pipe, O Und�grnd., Test
9. Water Pipe-Undrgrnd. , � � 60. Backwash Lines, P-Trap, O 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 "
�1�6. Rough Electric Wiring - 67. Fencing & Access Approval ' �
i
� 17r 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. UndergroundHydro
22. Ducts, Ventilating , 71. Product Piping � Gas ❑ Oil
�23. Gas Pipe-Rough & Test . 72. Underground Flush
24.�Roof Framing � . . 73. Undergrnd.StorageTank OGas' �Oil
25. Roof Sheathing ' � - 74. Overhead Hydro , �
-26.�T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical
27., Frame and Flashing , - 76. Dry Standpipe .
28. Lathirig & Siding ' ' 77. FIXED SYSTEM FINAL
29. Insulation . � � 78. FIRE PREV. FINAL
, 30. Drywall Nailing . � , , � HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown Coat ' 79. F,INAL 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 . . y///l�c� („�(i ' . . � ' • -
39. Water Service-Final - � . � , •
40. Gas Service IFinal ' � - -
41. Solar�Domestic-Final • . , _ �
42. Backflow Preventer � � � � � � . � - �
43. Backflow Irrigation � � � ' � � � '
44. ,LandsCape Irrigation System � ' , . , � . '
45. Sound. Attenuation � � � � � � , . -
46. Handicap Regulations' � � , ' , �
47. FINAL STRUCTURE & BUILDING � � - ,
48. Special Requirements Completed � ' ' � �
49. Electrie Release to Edison , - �• � �- - - - � � ' '
50. Gas Release�to Southem California Gas Co ' � - � . � � � , �
51. CERTIFICATE OF OCCUPANCY . . . '
No, " Date '
. �354�
COSTA MESA BUILDING-SAFETY DEPARTMENT �
P.O. BOX O17 COHTA M88q, CALIPORNIA �� �
For Applicanf to Fill In Complefely
TYPE OR PRINT
BUILDIN6 3067 Club House Circle -
ADDRE53
COSTA MESA, CALIFORNIA �
Ri<
OWNER Mesa Verde Dev.Co. � �
MAIL BUIL
ADDR6S9 2a`JO Mesa VQZCZC.' DT. ADDI
��r,, Costa Mesa No9�9o395 ZONF
APPF
ARCHITECT _ .. .. . .. TEL.I...O..I.0 nv
1823 E. 17th St. S.A.
Same as Owner
6TATE 1g1322 TEL. .
LIQ NO. NO.
SIZE �5 X'70 I no. on aLoos. Q
OF LOT NOW oN LOT
USEOF �����_��
EXISTING BLDO.
6ETBACK LIN6 pROM '
EFf I 1iII3MT ' '
DESCRIPTION OF WORK
x �� � ��
BUILDING1500 NO.OR 6 '
SIZE ROOM9 STORIEf
EXTERIOR WALL.S.tUCCO I ROOF $ul1.tUP
COVERING COVERINO
USE OF BUIIDING AND WORKTO BE PERFORM6D
Res.w/att.Gar. D/ �_ _, /
�1 HEREBY ACKNOWLED08 TMAT 1 MAVB RBAU TI{�G �pPLICATION
ANO 6TATE THAT TX6 ABOVE IB COPRECT ANO AOqEH TO COM-
PLY WITH AL ITY OHDINANC68 AND 9TAT[ LAW9 RHOULATINO
BOILDIND CO eTRYCTION.
� AUTHORIZfiD AGHNT
FEE RECEIVED
��.�� 25 T965
FINANCE DEPT.
AI�L ICAtION S�pR"P�kM1T
BUILDINC;
For Office Use Only
pY
V aRouPl & J
ZONING e"�
NO.OF UB60FNE
PLANB 2 I BUILOINO 081^Ape
o •-o
� Lot 3 mr. 4660
none
EAVE OVERHANG SHALL BE LE33 THAN
YAR�9 MPROVED
MAIN BUILDINO
IJ
VAR. �
YARDSAPPROVED
ACCESSORY BUILDING
.� I
N
DATE
APPROVED 11-16�
"" .✓—� � � 6 .�
HOLD FOR SPEC�AI� KCIjUtK:.m����.�
�
See permit on t 1 ior condit
151� so. �.440 J �
TH! AMOUNT eHOWN UNDEP V�LIIATION I6 FOR TXH g
PURPOSH OP BBTABL�BHIN6 ♦ PERMIT F¢e ONLY. 0
VALUATION '/ `' m '
' PERMITFEE $ �/ �� �
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$�C� A C E �� p
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� TOTAL FEE $ � � "�
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GENERAL CONTF
VERDE DEV C0.
0 7 C�ous
or
DATE
DESCRIPTION OF WO
F1RF. 'LONN: VALUE $
I GROUP I& J TYPE V
SUBCONTftACTOR