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HomeMy WebLinkAbout2365 COLUMBIA DR - Building Permits. . . ' � . � . � •. -i .. " ' ; ` . - . ' . . � . . ' . • . � � � . . I.. � .� .. . . .. . . . ' . . . . ' .. . , � � _ , ' � ,>': � � ' .. a . . . . . . � • + ' ' . _ . .:� . . ,� ' _ , . . . . . . . , � . . . ' . . - , . , . . t-' . . , . . . . _ . - ' , � . , . •. _ . �. April- 17, 1973 . � - . " . . . ' ' ' •1 ' �. � .. . . . � . . , • . , ' '. � . . . . ', � .� .. ' ' ` . . , ' .. . � 1 ' ' . ' . . � . . .. . . . .., . -.- : . - � - . � �, . . � '. . . ' , . . � ' �. . . . ` . . t' . .. ' . ' . . ` ' , ' _ , , r � . . . . . . ,., . ' ' . . , � . . . _ � � _ � � •4 ,• .. • . • - � �. � � , � ' � ' • � . , - .Mr." Charles.Hanaen � . � .. ' ' . . , ' 2365. Columbia Dzive � � , • , ' -. . -:.Costa�Mesa, California � 92626 — : : ; . - _ Dear Sizt , ' . , ":� , -. . - '. A building permit.fias:been fseued� to Anthony Poolc to conatruet.. �. '. a;pri'vate ewirmaing pool' o . our property,. , - .- . � . , ' t � In ozder'that yourrpool l.ba a eafe one and for che puzpose , • of adyisiag you,of your reapons bility regarding Che requirements . . . . of the Costa Mesa:Municipel'Code,:we refer you to Secti'on 8107, a� .,, �, ' • copy of which''ie tachea.". ',, ' , � - , „ This�letter is ,.reqted to you in ordez that'you will be avare � of oui oidinances and an make a compleEe safety check of.your pool-.,, . -. r - _ . � . erea. � - _ - - , . . , , . . + _.. , . ' . . , , ' �.. � Sincerely'youra� . : _ �:��t;aa;�.. . • . _.�.,;:�:. . : �' . , � ' " . ' : • „ . ' RICHARD HANHART - : � � - � - � : Building.Safety Diiector. .. ' RHtcD _• , . , ... -. . � . - . ' � . • . �. i. . - , .. ' ;` . . -. -� i , ; ` i� �_ . ' _ .. '. . � . : ' ' . . ' �. - • . , ' � � . . ^ .. - . " ,�, ' - . ' 1 . . . .� . . . . . . .. 't . , . -. .. ' - ' ' � . INSYEGrTIGN L TESTING ENGINEERS r" GMEMICAL i PHYSICwL �N�LYSIS 0.ADIOG0.�PHY %�RnY GAMMe R�Y r.o. ee. �r � >>io ���vo,� w.� i„a e..�F, c.ur. vo�oi �L3J �Ibll55 • �]i3� A363)N ' �>��J e1oJ�)i $inc• 1898 RFSEA0.CH i EN�IRONMENiAI TESLIN6 CORNOSION ENGINEERING L ♦NAlY51S ULiPASONIC 4��GNEiIC � YENEiRANT 1511.p NorfA H..p.. 5��..� S.nr.'A... C.111o..1• �i]03 � � �]I�f Sll-t015 Ezamination: $C]3-40a2 COMPRESSION TESTS ON 'GUNITE CYLINDERS Mr. Jack Hubbard 3106 Ostrom Avenue Lon9 eeach, California 90808 PROJECT Swtmming Pool for HpNSEN noDREss 2365 Colurobia Drive, Costa Mesa SAMPLE FRO M Shallow End, deep end, bond beam ♦PCMIIECI CON1qACtOR AnthonY Pools EHGIntEo • SUBCONT0.AC ON R. J. KolodziaJ ' - Same - SDECIFIED MIX 4 LO I STRENGiH DATE CAST DATE TESTED CYLINDER NO. COMPRESSION TOTAI LOAD, LBS. POUNDS PER SQ. IN. COMPIIANCE CYLINDERS 6-1�-73 6-21-73 1(5-5/8"x Iz-1/2") 7-Day 59,000 z,375 CYLINDER SIZE 6-21-73 2(5-3/4��x 12-1/2") 7-Day 50 ,000 �,925 7-Day test eompltes wlth specifteations. MADE B1 Don HcBee DEIIVENED 6Y Dave a�r3���� 2,000 psi See Betow' 6-21-73 ' '4"HOLD" 3 `:'; . > 5"HOLDn (5-3/4"X12-1/2") 6"HOLD" 7-Day 74,500 2,,$60 ....;.�, ,.. 0.EGEIVED ON 6-15=73 DISttI�UTION: Jack Hubbard - 3 � Costa Mesa Bui lding Dept. l��i���rr i��,�,- `r - � _ �. ,.�Uf� u (; iS�3 ,,'" f l {�I ,�..�-�.-�-g''`.:�� �.�..._-�.�_,� .0 ec�o=;s .=E si,e...:ieo .s r..r eo^.��o�Y-..; ��, r= . o• <<�r�..s •�-..oAir.*io� �oA =�eue.non o. o�A A�Poors eo�ewsio�s o= e. t=.trs �40�. ow ave..,�� ve rveu is .+csr=c�;. =e �o �. �._ •«.=o��..�. .s . Muru.� vao*eenov .o eucnts r�c r�eue •no ouAsc�v�s 930�6. e \ ' Aop�icant to fiil in all spatts exceo< <hose .�� ' " CITY oF CosTA naESA (T�T��N TRUCTION PERMIT [,/ ��Project Address � �' `^' �u� �`�"�- � r �'��/ry ��� Applicant'sMailingAddress � S n �. N �. ?(07,(, `� L�- Pho�� � 6 �d. Owner's Name Address ��'�'T � � L 1 p'� Areh/Eng. license No. Address Contractor's Name _ Phone Address (mailing) � City License No. LICENSED CONTRACTOR DECLARHTION I hereby aftirm that I am licensetl untler provislons of Charter 9(commencing with section 7000).of Division 3 0� the Business antl Professlons cotle, antl my Iicense is in full force antl effect. � ' License Class License No. Daie ' Siqnature � WORKE0.5' COMPENSATION DECLARATION I hereby affirm tM1at I have a certificate of conseM to selt-insure or a certiticate of Workers' Compensation Insurance, or a certifietl copy thereo/ (Sectldn 3800, lab. C.) . Policy No. Company � Certifietl caOY is hereby fumishetl. � - � Certifietl copy is tlletl with the city Builtlin9 Division. �e ApPlicant . �%EMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completetl if [he permit is (ar one huntlretl ($300) or less). 1 certity that in the pertormance o( tM1e work for wM1lch this pe mk is issued, I shall not employ an person in any man so to co�5ubj ct to the Workers�o n Laws of Calitorni �ate Signature NOTICE: If, af er making this tleUaratiOn, you shOul e ome subject to the Workers' Compensation provisions of the Labor Cotle ou must (orthwith wmply with such•provisions or this permit shall �be Oeemetl revoketl. CONSTRUCTION LENDING AGENCV - '� I hereby atfirm that there is a construction lentling agency tor the per/ormance �� of tne work :tor .wM1lch thi5 permii i5 issuetl (Section 309] Civ. CJ i Lentler's Name Lentler's Aatlress - � � OWNER BUILDEft �ECLARATION � I hereby aftirm that I am ezempt from the Contractor'S License Law'for the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which re0uires a permif to consttuct, alter, improve, tlemolish or repair any structure, prionto its issuance, also requires tne aoP�icant tor such permit to file a signed 5[atement that he/she is licensetl pursuant to the provision5 0( tne Contractor's License Law (Chapter 9(wmmencin9 �+itn Section ]000) of �ivision 3 of the Business antl Professions Cotle) or tnat he/she is exempt tM1erefr m antl the basis',tor [he allegetl exemption. Any violation oi Section 7031 by any applicant tor a permit subjects the applicant to a civil e ty of not more lhan five huntlred dollars ($500). I^ as owne� of the' property � � ^ will tlo the work, i5 �sale (Section 7044, Business antl PrOfe55ional COAe: •The Contractor'S :nse Law tloes not app1Y to an owne� of a property who bulltls o� improves :reon; and who tloes such work himself/herself or tM1rough his or her own employecs, provitled Ihat Such improvemen[5 are not intentletl or offeretl for sale. If,�howevei, the builtling or improvement i5 soltl wi[hin one yea� of com- -D�etion, the.owner will have tne burtlen'of proving M1e/she tlitl not builtl o� im- p�ove fo� the putpose of Sale). ❑'"I, as ownev of the property, am exclusively cont�acting with licensetl com [racto�5to wnstruct the project�(Section 7044, Business antl Professions Cotle: The ConVactor's License Law tloes not apply to an owner ot property who builtls or improves [hereon, antl who contracts for such proj¢Cts wiih a con- Irac[o�(51 I�cense pu�suant So the Contracto�Y License Law). 1 am aware that proof of their Worker's Compensa[ion insutance shoultl be provitletl to me. ❑ I am exempt untler Section _ B. & PqC. fgf thi; reason Date ���y/a� Owner. I he�eby certi�y that I have reatl info�mation is correct. 1 agree to c antl state laws relating to builtlinc sentatives ot this c' y to ter inspection pur0ases �e Signature Drivers' LiGense or 55 � ntl stat�that the above y antl county ortlinances hereby authorize repre- nentionea orooertv tor neavy bortler lines antl sign all appropriale tleclaralions. 10. LOT NO.� UNIT NU. TVPE OFCONSTRUCTION LJ NEW.IJ ADD U ALTERATION IJ REPAIR� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONOFWORK/USEOFBLDG. � TVPE OF PERMIT GRADING ❑ FOUNDATION � STRUCTURAL � ❑ TENANT ❑ EI.ECTRICAL ❑ PLVMBING � MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5c1. F7. ocCUaArvCv CONSTRUCTIONTVPE - VALUATION$ ZONE GRADINGCU.VDS. ACRES' Remarks: 8ar Sink Backflow Prevenrer Backflow Irriqation Dishwasher, ' Drinking Fountains Floor Drains . Floor Sinks Gas Service , Outlets IniDrcaninrs . Kitchen Sink - - Lavatories F ,Trap Roof Drains � � Reinspaction Fee $15 Boiler ' Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO # H,�e ing System & Ducting � 6A0-100,OOOBTU�100,000BT� ReinspectionFee � I '$75 CMF OBfi5-46, rev. 10/84 WM1ite - - Appllcant; Pink - Accounting; Goltlenrotl - A55ezsor Showers Service Sink ' � Sewer Cap Sewer Connection � Sola� Collectors � � Solar Piping � ' � Solar Tank � Swimming Pool w/Spa ' Urinal Water Closet � Water Heater �Water Service � Auto-Wash luue Fee $ 3 Hood or 'Typel ❑ . Canopy Type I I ❑ ' Refrigeration System ❑ai00000eru ❑ioo,000eTu System Repair/Alteration I Fire Dampers . � � Registers ' � Issue Fee �'� � $ � A.P. # S Main Buildi E T Front B Rear A C Right, K Left S Ping. Ref. # Planning Notes: Zone � Accessory Building: � ' � ' Parking;Req./Provided � ELECTRICAL ' . , _ Automatic Washer � Construction Pole Sub. Cooking Unit Dishwasher - ' Dryers ❑Gas ❑Elec Fan ' F.A,U. Fixtures ' ' Device Boxes Switches -• �- - — � Garbage Disposal Generator �0-5 KW �5-15 KW . � Transformer LI•15-50KW -. ❑ SO+KW -. Meter. �up to 100 amps .' Meter ❑over 100 amps . _ Sub Panel � ' � � Motors DO-1 HP �i'/:-8� . IncSolar �9-15 HP �i6-15� - Microwave � Pole L•ight , Range Sign ' - Standing Sections ' . Trash Compactor _ Z O N I N G R E Q M T S FEES �_ Reinspection Fee $15 Issue Fee ��' '$ 3 DEVELOPMENTSERVICESREQUIREMENTS: ' . � Zoning Approved By � Date Buildin9 Approved By � Date� Appl" t Iss d By ^ Date -�;-i.vixn � SUMMARV OF FEES . . BUILDING PEFMIT $ SMIP $ - PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ ' PLAN CHECK 25% $. ENERGV P.C. $ . ELECTRICAL $ GRADING $ � � PLANCHECK 50% $ MICROFILM�. 5 MECHANICAL $ � TOTAL FEE $ ��7z_ � � PLAN CHECK 25% $' r,� ooantss2-annasssa Tr�T aa.a� CONSTRUCTION AND'PLANNING POOL&SPA , � � Date �-Inspector � � -� - ` Date Inspectpr APPROVALS Penpit # � APPROVALS Permit #, . �. 1:tTemporary ElectricaF uervice or Pole � ; 52. Pool & Equipment Location . il 2� Soil Pipe-Undrgrnd. � 53. Steel Reinfarcement �� 3. Electrical Conduit Utility-Undrgrnd. ; 54. Forms, - � I 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE 7.�Footings . �!� , . 58. Electrical Conduit-Undrgrnd. 8;tiF.oundation �C��' . - 59. Gas Pipe, � Undrgrnd., Test 91'Water Pipe-Undrgmd. � . 60. Backwash Lines, P-Trap, � Undrgmd. 10. Structural Floor System ' � 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final. 12. Sewer Cap . 63. Heater.& VenDFinal 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 Wjring Sign 68. APPROVED FOR PLASTERING .d8. Rougl7.Electrical-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace �� � � APPROVALS Permii # � 2�1. Ducts, in Structure 70. Underground Hydro K22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test � 72. Underground Flush � 24. Roof Framing . 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing �� 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 `� fY; 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED ��� � 33. Final Electric � � Notes: ' � 34. Final'Heating & Air Conditioning � / G ' � 6 35. Final Gas Pipe�Test , � �� 36. Hood or Canopy , ;f - � '•. 37�. Final Factory Fireplace �� - :� , . . 38. Final Plu'mbing �k - � � � ' �, 39. Water Service-Final ,� �4 - � � � � • ., - 40. Gas Serdice-Final f� � - 41. Solar pomestic-Final - - . . +j ° . ; 42. Backflow Preventer _ � }� . ,' � , � 43. Backflow Irrigation �� E ' , !, � '� � , '� 44. ,Landscape Irrigation System � )} � � , � • � " � � . r �. ' 45. Sound Attenuation ` � � � � -� � ' � • t � 46. �Handicap Regulations , � � . � � � , 47. FINALSTRUCTURE&BUILDING � _ - .. , ,. � '� � , � 48. Special Requirements Completed - � i�' � ( 49. Electric Release to Edison ; � ;�- .- � 50. Gas Release to Southern California Gas Co � ^� � � ! 51. CERTIFICATE OF OCCUPA�'�Y ' � . � � � No. � Date � � � ;�'� �� -OWNER DIKE Sc COLEGROVE DATE ��_k� _ JOB ADDRESS 23bS Columbia Drive BIIILDING PERMIT NO. 5j�)a1. G�NERAL CONTRACTOR gp�p VAL[lE $ lly�1�6.00 AP. No. LOT ��q 1'RACT pqC�K PIRE ZONE DESCR[PTION OF WORK S' p�l a Rr4 &(*araoa GROUP I& J TYPE V ZONE Rl PT.AN N[l. Kl�l O � INSPECTIONS I DAT'_I SUBCONTRACTOR I DATE PIRMITSNUMB R n � . coat -Final Gas Test Fiaal .� , � � � - - ' � � 54�9 FEE RECEIVE ' - �,.K-� y �, t y� 1 COSTA MESA BUILpING DEPARTMENT FIIVANCE DEPT. ��, ' P.O. BQ% 31� COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT AooR �5s . 2 6 Columbia Drive B U I LD I N G COSTA MESq, CALIFORNIA FOR OFFICE USE ONLY ' RECEIPT NO. pERMIT NO. OWNER S� � Mq'L RECErvEO 9V DnTE PECENEO OATE ISSUEO ADDRE55 th St eet '� '- �2 TEL. BUILDING ' � CiTY NO. ADORESS ARCHiTECT Carlson 8C ��c COSTA MESA. CALIFORNIA OR ENGINEER NO." ' FIRE AD�RE55 - ZONE - ZONE NO.OF TYGE Gf1011P QTV LIC. vurvs CONTRACTOR NO. I ADDRE55 E 1 th S reet TNO.LS 5�11 APPROVED ' BY DATE LEGAL LOT ^ CORRECTIONS oesceiPnorv NO. F � BLOCK TRAGT L A.P. NO. y SIZE - MO. OF BLOGS. 1 � oF �01 riow oN �or none USE oF � J E%ISTING BLOG. ;.p^ seTencK urve Faom $UBJECT TO L G. DEPT. REG. c[rviea oF sieEEi 1 � REAR YAR� 2� SIDE VARD RIGHT �' LEFT 1 � DESCRIPTION OF WORK . PLAN TcC NEW ][ ALTERATION ADDITION REPAIR MOVING DEMOLISH BIJILDING NO.OF SRE ROOMS STORIES EXTERIOR WALL RpOF COVERING COVERING USE OF NEW ' BUILDING I HEPE9V AC NOWLE�GE THAT I MqyE REAO THIS APPLICFTION AND STl�TE TMtT TME ABOVE IS CORRECT prvp AGREE TO COMPLY WITH ALL CITY OliDINFNCES wNO STI�TE LAWS qEGULAT G ONSTRUG riorv. - VAWATION M SIGNATURE OF � PERMIT FEE $ 34�vv PERMITTEE PLAN CHECK S 1 $ 14�14b.00 TOTAL FEE $ �e'�f AIITHORIZED AGENT Dike and Colegrove 1.00 � , .. .. ., .. . .. . . � . . . " .� .. .. ' `_ Til. ';d' �i7.:t, �.� . . � .� � � . c' , . . �; •� �. � . �_ .. .. ._ . _ . . . .- .. _. : . .,i ..� -� -r.`�'.(_�: 7.t-- • - � — ' � � � . . � - , - � 9 :,�.i . y � .. _ . _ . . � , : t� _ . � ' . . " " ' . . r .... �- . - '.n - .-� � ` _ .' ' . ' •, f` " . , � . • � .,'r;;�� , ".c,:.,, --- - - - - - . - { -. .. ` -.. .. .. ' ` . ., ^ _ --._ :. -. 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' , . . ` .. __.r., S.; �=(�`f.^,i.:]Dri•:i y..�.r; . � ; .�. � � .. �� • .: .. " _ ' i_. j . . \ , �:� . . . . ��:� r,;; ;,o:cG . .. .. • , . . '_ ;,.. __...._...._'._ _...,:�_..___...._......_._-.--..._._...____... _ _ - _ .. .. ........... _ ,........ ,_. t y� i ' j � .. _- _._:� .. ::.•i�Jy i"",'��:x�;: � - ' {. . . . . � ; .,r° � ... � �"" � �. .,��.,.;.�U.i , . ' :. ... --....._._� ._ .__ -. _;__ ' . . �. , �: . � . ' � ° . �Y- , ,. _ .. '_.._ ._-� :. ` �P � �-�d�[�. l , , � � f ' �. . � . . . . . ` ..� ' . . �� y. J ���J �1�''i � �`a., •� . �\ �'\ y � �. � �� � !., ., , .i}. lt ,�b',F1 ^` �-y°J.01,P ' _ . . � �:, . . . ' ' __ ___....'.� . ..._. '. . . ' :, ' . fr _ _ ' '. ' ._ . �_ _. . f - �••I"'_' ' �'" . .'.,; ....,.' . . _1 . '. _' " .' . " .. . .� � . . . . ' . .� - , . ' ' ' _ . .. .' __' .' .. _ t.. • ' �%4 "O� �i�fnl' �1S �. � -_'.'. '. ' .'.': '.:�•r_. . �.� . ,�. . . r , , , _ _, , r� . . _ . . _ . . . . . ... _ _ � - . � tL':r�:., ..._ �� _ . ..���.. •.� �.��...�L-...� .�. .'. . .. . � � . . ._ .. ... . . � .. _ �:....� : .I�'yf. .._. . �' . . � _ . •�. � .. .. L:�:a �... �:R�' � . __.__ !. "_ , . ''.. , . . . , . ���.f..- .I.�r 4 '-�-" .., _ _ . '� � .... . ._ , ,,�,,� �� , . i e.., ._ _. . . :,,. � ' i � . . ' � ,�.• J � .. - . ' . ' f : � ' .i.�.. . _ � � _.�.. . ; , , . . - .,.,., , . . ".' t - e . ��,,.�----.- i- � - _. , __ :.:.:_-..,= - '' -- — - -' . ... _ - � _ --�. , .� f-P-.- "'^'— . ,, OWNER .� JOB ADDRE ��APNo. �(����-�n LOT INSPECTIONS Pool Lceation - � Forms Main Orain Steel Reinforce Elec. Bond � � Approval to Cover Underground Electric � Gas Piping Test Filtering System Lines _ . Backwash Lines and Recep. _ Electrical Final Heater and Vent Final Filter System Final Backwash and Recep. Final _ Fencing Final , ,., , :S lbia Drive ithonv Pools T'_i��' Si nature � � DATE BUILDING P DESCRIPTION of WORK Pri FIRE ZONE VALUE $ �te GROUP TYPE �-� SUBCONTRACTOR Electric � , 7� • %� jj �Plumbing n , �_�- �-•- 3b476 � COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely SVILDING 2y6C L•�L�i��}i � • AODRESS J J , OWNER C��+S HANSEN MAIL . Z AD�RE55 W W TEL. a U � clrv . . . No. - ZZ Q CANSTRUCTION - , O� LENDER C'ASYl mm � J 7 BRANCH . � ' J V) . a W ADDRESS 7 nooaess jt3'/1 r�1FtG5'1'UNE liLVll. CONTRACTOR Anthoriy Pools ADDRESS 5871 Firestone B�.�iC1♦ CITV � SOUti11 �ti9 NOLSp32ZZO L C No. 1901-79 LICVNO. 512E - NO.OF BLOGS. -0F LOT ' � � I NOW ON LOT VSE OF o� EXISTINGBLDG. . Y'eS1C�ei1Ce (%: �$1'a�ie R BUILDING ADDRESS TRACT FIRE ' ZONE APPRC , ��� � �t-� ���;;e�� ssr� =•x,<,:35.G0 ON FOR BUILDING PERMIT 2365 Coiur�za sr 95K �oT l'� Ny� NO.OF � PLAN$ VARDSAPPROVED F.N VALUE �]iR DOOZ $ 2`iOO.00 YPE ROUP � DATE J^ VSE OF NEWxJ/��U� BUILDING�J � VARDSAPPROVED ACCESSORV BUILDINI FT. �� ' ' FT ' � H SIZE OF � NO. OF ' �� / �� - Z NEWBLDG. ROOMS ' STOFiIES LSIDE ,.J FT.�U . FT. U EXTERIOR WALL ROOF ' � �\ . COVERING COVERING REAR , FT.CJ FT. J USE OF BUILDING AND WORK TO�BE PERFORMED � DISTANCE BET. BET. MAIN & �' . MAIN BLOGS. ACCESS. eLDGS. a ' Q �� VAR.# � DATE O C.U.P.# ' APPROVED F ' .APPROVED PF N� Z , O . ' � U I hereby acF,nowledge that I have reatl ffiis application antl state . ' - - S��'+ � ' that [he above inPormation is correct and �agree ro comply with �. all laws re841ating builtling' consttuction, antl I shall noc employ . - ` � F any person �n violation ot the workm5n's compensation lawsbf � ' y the State ot California. _ � /l, , . �,? 1 hereby cer�{fy ffiat �l am properly licensetl as a contractor under V SQ. FT: ' ' �[' , tha Stare ot California Business antl Professions Code, Divisicn 3, �� HE AMOUNT SHOWN UNDER VALUATIO F , Chapter 9, a�tl tha[ such licenses ara in full force and effact, or I THE PURPOSE OF ESiA8LI5HING,A PERMIT FEE ONI am eaempt frortLRhe'provisions ot ffie State of ornia Business ' VALUATION ' /n� ,antl ProtessiFpns Code, Division 3, Chapter 9 � p PEFMIT FEE $ ��/ ��' Signature of _ ✓'. �� - ��� 27�0�00' . „ . L Permittee L /L'ZL�'C ' ' ' $ ' PLAN CHECK $ � a! ,�p ' Auihorized ABent yQ� q//�ccq . , . . � � TOTAL FEE $ rS m O i ¢ m ry J E o` LL r