HomeMy WebLinkAbout2278 CORNELL DR - Building Permits"�= - COSTA MESA BUILDING DEPARTRAENT R��E���p
� I I COS7A MESA CAUFORNIA �E,� �S�
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" FOR APPLICANT TO FILL IN
BUILDING ADI}&�SS �'z 7� �-h'�'�o.�� �
Mail A�dd-res�t '�lss:�2 0
City_C�l(}_ _%%�e-a-_ _ _ _Ph. No. _ _ _ _ —
Address %6 f' 3 `? �l�-e!�-A2�'� �o-1t�+ yo�.
City Lic. No. State Lic. No.�s
Size of Lo i ��' AP N2�����
' /' �. / s � (`..//
Setbacks: C/L Street—a:si.'' -� �•' '^1 Rear_�zz[cz�+�
•. �
Side Yard - Right �--V-«-e^�--- � Lef �'
� ��� t.
1 Type/ of Fence � �� � �� _ c.,�(�'K ' -
6"' Ci. J -- `/ • �n- .�1 ' t
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I hereby acknow edge that I have r d this application and state
that the above is correct and agree to comply with all City Ord=
inances and State �ecrws regulating building construction.
FOR OFFICE USE ONLY
VALUATION
��� �
Permit Fee
Plan Check
TOTAL FEE
� MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------ " ' ' '
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
ite Issued 3
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ADDRESSOF 9NLqNG:
,woacss:2278 CORNELL DR
COSTA MESA,CA
AVPL.WJIING ADOPE55:
92626
UNT:
�qCNRECT OX FNfyNFFN: 11C. NO.:
ANCH Ofl EN4'41UDf1E55: UNT:
mxm�aarsru�: SOUTHERN CAL ROOFING ( 310 ) 542-9565
carm�croxsxuuxo 4704 NARROT ST ' �
aooxess TORRANCE CA ��: 408752
90503 „M,
110EN5ED CONfHRCTONS DECLANRTION: I heraby aMim uMs paiutly d pa�ury thm I em licanaed uMm prwiabm d Cheqr 9
(commewrq vfih Sec�ion ]000� d Division 3 ot ihe Busi�was eM Prdeseione Gode, aek my licenee u in lull Mce arM e11eU.
cmuc:No.: uc.cuss:C-39 uc.No.: 4 8752 EXP•
Dme: �' (— �� �'IS Cmvetlor �yv..- ��
.�
OWNEN BUILDEH UECIAHATION: I haieby elfimr urMer penelly d perjury �hei l em eRemq /mm the COMredon Lioenae lew lor ihe
Idbwip �anton (�bn )031.5 Bus'vieae enE Pm/xsbm Cade: A�ry c1Y a�mY'�� �eVuiree e pe�mil b mmbucl. ella. impove.
Eemdsh, a repei eny eVunure, prior to ea asuenm, e6o reQuiree �M applimnl far wch pe�mn to file e fi0�ad ele�emenl ihel M a eM
n IicemaE W�auem ta tha povisiane o! IM ConVepon Limrrea Lew �Cheqm 9(mmma�ry wilh Sepnn 1000) d DH'sion � d the
�n�.��s �,d vrd�� coeal ��nm � w�na �. a.amq ma„� ,�a me � i« u,s d�a ��qo�. a�r.�w�, d s«+�
�q�'.t.�;1.5 by enY eDplicenl lor e parmil auEjeGs iha epplicent to e rivil penelry W nd mae ihen Ixe huMred tldlen �5500�.
I. ea ovmer o11M propenY a mY �WoY�a �h wapes es the'v ada mmpamqbn. wiil Eo IM wark. e�M Ihe swciure u na intendeA
�i orofleredimeele(Seclion]Oal.Bueire�vMProteneioneCoCe:TheComreeanLiceneaLewdoeaMepplyloanowmrdpropery
wM1a buitla w inpmvee iharem, ard Wn Ams such waM IimeaM a hanel or Nraph he a Mr oxn empbyaee, provided thet euch
impmvemmia ve roi inteMed a d1ereE la seb. M, howevx, tha buJCinp w'unOmvemeM ie soN wilhin me yearW oompbtion, tM
awrier-0uiker will heve Ihe Wken W pro+irq he m ahe d'd iwl Euik or imprwa lor tM W�a d eeb�.
� 1. as owror d ��e pmpwy, am e�tlu�ivety oonlrmiq wnh liceneed con4ectas ro cmetrud IM paject (�� )�. �++inave erd
Prolesdons Code: The Contredwe L'cenae lew doea m� apyy b en owner d prape�Y ��iks w imqwee thereon erd who
wnvecv lor arh prqxla xilh e conlredm(s) licemed Wnuent to tM Comraqae Limn Lew�.
� I em examq uMer Sec�on: B. 8 P.C., br thia reg�7
/
Dele: , � Ovmer:
i m n«eM cenM u�ei i em e.de d.�e ��si�,a ma ���reme�re d cm�anie Heenn ene semv caaa s.e�. asws, 2ssas, �d
255Ja, eM that I«eny M1nuie Wikinp aa�pent vnll / wal nM (drcb one) need to comply wih eaid etete cadee enE ihe requiremenb lar
epartnillmoonnVudionamodifwianhwniMA'r�y enepemamDimria.ReeiEeMialmnst�Wianeppiratiomvseiemqlmmihma
povisione. .
Dme: ApplceM: '
WONKER'S COMPENSATION DECUIN�TION: I Mreby etfim� uMer pxieXy W perjury me d IM IWbxi�q da lareturu:
❑ I heve eM Mie meimein e cenilcm. M caneeni �o eaM.inare br waken' can0«iemion. u wovided i« bv Seaion alao af tM Lebar
Code, far iM pa�lormence ol tM wwk la wMch thie pe�mu ia iaeued.
� I heve eM xil meimem woMen' mmpeemtion imuraM.e. m rpuind by Seaim 3'ro0 d Ms Lebor Code. M IM pe�ameMa d tM
,.axi«wn�a,in�sv�n�sn.�e.My��S�����°�°oawr��mna�<: EXPIRES
c�,:
Polby Number: — -� 0 7/ 13 / 9 6
�is senion need nn M romdeteJ % Ne PmmR u M wro h�nEmd Gdlars Rtwl a lue.)
I cenM �� in the pMormerca d the work Iw wh'rh ihie permil n i»ueE, I ahNl m� amplry eiry pereon In vry meruier w u io
bacome eubpd to IM xqke�5' tompensetbn lexa ol CelAanie, vM apree 1 ehwld wbptl Io iM MaMeii
��mo��m''�] a«�se�= a s.a�„�(��$o(o a� me i.e« coes. i.nd/i /iy1jw//q� o� 1���
De�e: ( � II � / l AVdiceni: / '6 L�6 '
f7 b 1
. Weml�q: F�Nun (o ssc�ro worten'rompxuetlon cavereps la vnlewful, aiW sIWI �ub/�cl en xnplaysr ro MMroI penettlu enC
�, c/vll Ilnu yr b als huMrer/ fhousud tlo/Nr� (S10qP001. In �tltlltlon b Ms cwf o/ ronpxu�tbM1 Ceinps e� proHtled b� In
SxNon J106 0l tli� Ltlor Cotls, InNluf, ane attomsy'a /su.
�CONSTHUCTION LENDINO AOENCY: I hereby elfilm under penelry d perlNry �hm �here o e conatiud'wn bMi�q pency br Ne
�� p,do�enm a me woa io, wn�d, mo w�� a s�e (sm�m aos�. ca. q.
LENDEH'S NAME:
LENUEF'S ADDflESS:
1 ceniN the11 heve reed iho eppliration end etme tl�el the ebova int«metion io wrrq. I pree to comply wilh ell dy eM counry oNinencee
eid s�ele lewa iNelip lo buiNip conslr�tlim eM hereby eNhaixa 2peeenletrves d Ihe tily to anler upon Ihe ebove-mento�E pmpaity
r°""'°°"'°"w'°°"''CALVIN EWALD
/�/7 ^ Pn
_ Y.(.a� /' . / Dale �I � —
s�a�mure a w�nna,ovnaN vco�o-eaa
(5t51-IB.WP) WhXe-BuilEiq 8 Sefary; Oraert-Fle; Cenery-Applmnl; Fnk-Rwenue; Oddenrod-Aeseaor
�
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: H 073190 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: STR
PERM NO: B 073190
GOVT: N SUPP: N
PURPOSE: OTH
�JOB DESCRIPTION : T/OFF REROOF W/COMF SHINGLES SQ FT: 2,f300
CLAIM VALUE: 2,800.00 CALC—VALUE: 2,800.00 GROUP OCC: R-3 /M-1
COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 280���$j��,���
***�*�*****�x*******�r*�****�***�*******�rt*��*���*�+��***� f�
Z O N I N G R E Q U I R E M E N T
S E T B A � K 5 REQUtRED
------------ MAIN BUILDING ---------- --------- ACCESSORY BIIILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41905402 ZNE: REF NO:
PLANNINC NOTES>
i
iE iE 1f iE iE 1f 1F 1f 1f 3E iE 1E iE if 1E iE If iF ik 3ElE iF iE fE if jE 1E 1E �k iE iE iE 1F iE if 1E iE iF �F 1E �k iF �IE iE iFlE iElf �f ik 9E �E iE iE iF iF ff ik iE fE �f !F af �f fElE iE iE iF 3Elf iE 9E jt iE iF iE iE �E
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
�
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: II�
iFiEiEjEififif3EiFiEjFafiEiEiEiEifiEiFiEiliE�t3FiF3F3F3FiFiFiF�F3F3E3FiF3f3FiF7F3FiF'iFiF��'i��,� �F'�F3F7FiF�F�FiFifiEifiEiE3EiEiE3EiE ��FfEiE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 .50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
54.50 0,00 0.00 54.50 59.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 59.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00 ,50
iE fE if aE jE ff iE iE 1E IF aE iE fF iE 3f jF if iE iE iE iE iE iE iE �E iFlE iF iF iE �E iE 1F iE aE iE jE iF If ik iElE iE iElF if �flf iE 3f jf k if iE iE 3klE ff * iE iE iE if iE dE fF iE ik 3f iE �)E jE 1F iE iE if 9E jE 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2800 REROOF BY VALUE RESIDENTIAL NOZONE ]..00 2,800.00
END OF FEES
EXFIRE�. .
DATE /� Lf �i�+ �
C:1 UDi:`.8)5—Ot1a352?6 TC'ai" :�4.50✓
?�?E: Q1%?i/?5 T1t7E: i3:;?
�
CONSTRUCTION AND PLANNING
APPROVALS Permit �r
1. Temporary Electrical Service or'Pole
2. Soil Pipe-Und�grnd. �
3. Electricai Conduit Utility-Undrg�rid.
4. Electrical Conduit•Undrarnd. �
5. Steel Reinfortement �
6. Elect�ical UFER Grnd.
7. Footings
B. Foundation -
9. Water Pipe-Undrgrnd.
70. Structural Floor System '
11. Property Sewer Line & House-ConPectit
�
12. Sewer Cap +
73. Roof Drains - ............... �. � . '...�
14. Rough Plumbing �
75. Rough Electricai•Condui[ � �
16. Rough Electric Wiring
77. Rough Wiring Sign
18. Rough Electrica�-T Bar Ceiling
19. Rough Heating & Air Conditioning �
20. Rough FactolY Fireplace
21. Ducts, in Structure �
22. Ducts, Ventil8ting
23. Gas Pipe�Rough & Test �
24. Roof Framing
25. Roof Sheathing �
26. T�Bar CeiVing {StructuraVl & Monocoat
27. Frame and Flashing
28. Lathing & Sid��g �
29. Insu�ation .
30. Drywali Naiiing
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Ca�oPy �
37. Final Factory Fireplace
38. Final Piumbing
39. SNater Service�Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Pre�enter_ ,
43. Backflow Irrigatiori,-.
44. Landscape Irrigatibn.System
45. Sound Attenuatio� il";
46. Handicap Regulati ns `�.:�
47. FINALSTRUCT �BUILDING
48. FINAL PLANNIN �~�-
49. Electric Refease t�isbn;
50. Gas Release to So rn California Gas
51. CERTIFICA7E OF, CCUPANCY
_ Date
POOL & �
Uate Inzpector qPPROVALS Permit #
i- 52. Pool & Equipment Locatio.n
- 53. Steel Reinforcement •
54. Forms -'
.�
' 55. Electrical Bondinq
56. Rough Plumbing & Pressure Tzsi
57. APPROVAL TO COVER-GUNITE
58. Electrica� Conduit-Undrgrnd.
59. Gas Pipe, i.7 Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrgrr.d.
� .i 61. APPROVAL TO tJECK " .
. 62. Backwash & ReceptorFinal .
' �� 63. Heater & Vent�Final '. � , �'
. �4, 64. Plumbing System - Final , ��
r 65. Electricai-Fi�al . "
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYS7EMSFINAL �
FIRE DEPT. REQUIREMENT
APPROVAIS . Permit #
a
Date I Inspector
70. Underground Hydro
71. Product Piping rJGas OOiI
" . � � 72. Underground Flush -_ "
r
`.
73. Undergrnd.Storage Tank O Gas ❑ Oil iy=y ��
74.� Overhead Hydro � a
75. Dry Chemical '��'f
^
76. Dry Standpipe • � Q,.
77. FIXED SYSTEM FINAI . '
76. FIRE PREV. FINR� •
HEAL'fH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
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9
CITY OF COSTA MESA
NOTICE OF PERMIT EXPIRATION
TO: ALFONSO ESPINOSA DATE: October 4, 1996
2278 Cornell Dr.
Costa Mesa, CA 92626 PERMIT: B 73190
PROJECT ADDRESS: 2278 Cornell Dr., Costa Mesa, CA
Our records show that the listed permit(s) were obtained for property improvement or altera[ion at the
above address. According co our records, the permits have not had a final inspection. If you have any
information to ihe convary, such as a signed off inspeccion card, please contact this office so tha[ we
may correct our remrds.
The permits were obtained by:
(X) CONTRACTOR
( ) OWNER
Name: SOUTHERN CAL ROOFING Phone: L14) 542-4565
To construct or install: REROOF
License Number: 408752
Permits are valid for 180 davs from issuance or your last inspection, per Section 106.4.4 of the 1994
Uniform Building Code. If you do not con[act us within 10 davs, your permit(s) will expire on
October 18, 1996. Additional fees may be required to finalize [he permit.
If you have any questions, please contact THE BUILDING DIVISION, at (714) 754-5273, between
8:00 a.m. and 430 p.m. and staff will be happy to assist you.
Tony e Ba�c�
Buildin Official-
B
TCDB:ijh
CITY OF COSTA MESA, BUILDING DIVISION, POB 1200, COSTA MESA, CA 92628-1200
PHONE (714) 754-5273 • FAX (714) 754-4856
ti
OWNER REAMES. N. B. DATE g_13-70
JOB ADDRESS ZZ78 Cornell Drive BUILDING PERMIT N0. 32169
�GENERAL CONTRACTOR n`.mor�n��t 1 Aor DESCRIPTION of WORK n.,r��ho.� T nrt. u....�e
AP No. LOT TRACT FIRE ZONE VA'LUE
INSPECTIONS Signature Date GROUP J TYPE
SOIL
___ �I JV�l.V1�IRNlIVR
ATER
ROUGM PlUM81NG
LANEOUS
AND AIR CONOITIONING
UNDERGROUNO � POWER U
ROUGH WIRING
TRENCHES �] FORMS � STEEL REINF.
FLOOR SYSTEM
FRAME ANO FLASHING
LATHING - IN rl
OWNER MANSOP7, ROPIALD A. DATE 10-22-58
iOB ADDRESS 977�i Corncl l hr_ BUILDING PERhIIT NO. �873
GENERALCONTRACTOR DePretto & HuUp VAL[lE$ 26(t,00
AP. No. LOT 20 TRACT 281�5 FIRE ZONE DESCRIPTION OF WORK Block Wall Fence
GROUP TYPE ZONE PLAN NO. �
INSPECTIONS I DATE I SUBCONTRACTOR I DATE NUMBER
coat
7873
OWNER
JOB ADDR�SS
GENERAL COD
AP No. ]_],5_1
INSPECTIONS
OCCUPANCY
c
3dANSON, Ronald
LOT
DATE
VALUE $
TRACT FIRE ZONE DESCRIPTION OF WORK
Signature DATG GROUP I TYPE p 7.ONE
Z � SUBCOLSTRACTUR - �t
Res
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 977 COBTA MEBA. CALIFORNIA
For Applicant +o Fill In Comple+ely
TYPE OR PRINT
BUILDING ..�
ADDRESS (�� t"f Y3 Iv <A � I��
COST MESA. CALIFORNIA
s mA��
■ ARCHITEGT
■ 6TATE
TEL.
TEL.
NO.
TEL.
NO.
USE OF � �
EXISTING BLOG. � � - � �
86TBACK LINE PROM �
ceNTeR oF STREeT REAR YARI
SIDE YARD I LEFT � I RIGHT
DESCRIPTION OF WORK
� NO. OF
EXTERIOR WALL
COVERING �
U6E OF BULLDING
_ . • �.
FEE RECEIVED
�PR 5 �ssa
FINANCE OEP7. 6�
�ITY Of COSTA MESA
PPLICATION FOR PERMIT 1� .;
y� �
BUILDING �
For Office Use Only
RECEIPT NO, PERMIT NO. �
. �OSTA MESA. CALIFORNIA
AP �1 pATE � � y
c� ZONING
N. OF USE OF NEW �/ �
I FLAN9 Y� I BUILDING � �
LEGAL �O / `��U � � � U C S
D¢BLRIPTION
e ou., �/ ,r—i]� _ b`i�
IceNTaR LINe BT.)
1 HEREBY ACKNOWLECGR TAAT 1 HAYE qIIAD THIB APP111GTION THE �MOl1NT BHOWN UNDER VALUATION �e FOR THE
AND BTqTE THAT THE ABOVE �9 CORHECT AND AGftE¢ TO COM- pURPOBE OF EBTABLIBHING A PERMIi FEE ONLY.
PLY WITH ALL WTY ORO�N CE8 AND BTATE 8 GULA
em�oixo coHernuci�oN. � �AL ATION
� L�-O
SIGNATURE OF =� PERMii FEE $ /�i '
PERMITTE I e
' / $ �� �'] �D, PLAN CHECK $ �' � �
AUTHORIZED AGENT ��' � �
TOTAL FEE LL
JOBAD'DRESS 2278 Cornell �rive c.Y�� � BUILDING PERMIT NO. #S1OO
. �
� GEMEiiAL CONTRACTOR I+1('IO Constr. Corp. VAL E$ ].], SHL OO
_....LOT_____ 2Q � BLOCK TRACT 2i�15 ReS, w�8tt. ¢ar.
-_- GROUP I& J rvae V ZONE RL� FIRE DISTRICT 5085
� " PERMITSISSUED
_INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
Foundation Forms and Grade to Garage
Rough Framing S�
Plumbing, Rough to Slab r^ �.c-S 5_
Plumbing, Rough Complete �Ii�� �
Temporary Pole
Wiring, Rough �-%� %
Heating, Rough �17"�' —
Heating, Final yrl.(irj /0
sewer, House�/� Sewer, St.%{�/fs' y
Septic Tank or Cesspool
Lathing, In Out � y
Plastering �i£ g
Plumbinu. Fin.al. Fixtures Comolete%Y1LC /a�
'.:i e � i i� i �v v
- :L - _ y�o c� y s�
� -.7-�.5- �o /t��' �/
_ ,,, _ �., - ,,, .. . .-
.�.-;:?„�',`'� r
. ��8�
COSTA MESA BUILDING,DEPARTMENT
P. O. 60X 31 �
COSTA MESA, CALIFORNIA
FEE RECEIUED
� �� ' `�i � °� s � "9� Q
FINA�tCE DEPT.
GIIY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
a���o�N� 227g Cornell Drive BUILDING
ADDRE55
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIpT NO, pE T
OWNER Sherwood Forest Develo ers $3 ����
MAIL 3404 Via.Lido RECEIVEO BY' C�ATE RECEIVED DaT ISSl1�D�� �
ADDRE55 �� �'�/ IviAl� ?
aTv New ort'3e3c�i TNo Har. 7171 qDDRE�s"s
ARCHITECT LIC
oRENciNEEa.'�.�1J_TnORd L���1n13 No. C��� COSTA MESA. CALIFORNIA
ADORE55 3432 Via Oporto, N. B. ZONE
Lido Constr. clrv �Ic. 4 iorv€�y poeN$ rvvc � cAouv
CONTRACT ' NO. (%�1 P
3404 Via Lido, N. B.TEL HaY. 7y7y APPA�V o
ADDRE55 NO. BV OAiE
�E�A� LOT . 20 ZH2S CORRECTIONS �
oesceivnoru NO. BLOCK TRACT
A.P. NO.
512E ' NO.OF BLOGS.
OF LOT 2 �iOw oN �01 O
USE OF
E%ISTING BLOG. �
SETBACN LINE FROM A �
C[rvi[A oF sriteei �jO� REAR VARD ZY� 1
SIDE YARD RIGHT S� LEFT S�
DESCRIPTION OF WORK �
NEW }{ ALTERATION ADDITION ' �
REPAIR MOVING DEMOlISH
SIZIEOING 14�� sq. ft.� Ro MS U STORIES i
EXTERIOR WAL ROOF
COVERING (�(10 COVERING Rock
USE OF NEW Dwelling - .-;- G'� �
BUILDING
I HEHEBY ACKNOWLE�GE TMPT I HAVE PEAD TXIS 4PPLICFTION LNO
STATE TMAT THE 4BOVE IS CORRECT AND AGREE TO COMPI.V WITM ALL '
CITT ORpINANCES FNO $TATE LAWS REGULATING BUILUING CONSTRUC- '
iiON. ' , VALUATION �i
SiGNATURE OF � PERMIT FEE S a-(J '�
PERMITTEE /g I/ (/ �
$ // Y 7 � PLAN CHECK $ �7�
1 f� �/
AUTHORIZEO AGENT / TOTAL FEE $ r L� �e�
Z .
a U
Z
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- 32169
COSTA MESA BUILDING-SAFETY DEPARTMENT�
P.O. BOX 1200 COSTA MESA; CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING /�A' �l' ��*w
ADDRE55 L_L. / M �lw
OWNER ��h,����AG S
ao �o
MAI l
ADDRESS
/� TEI.
CITV /�aTA I���A NO.AA•
BRANCH
ADDRESS
ARCHITECT
ADDRESS A
CONTRACTOR
ADDFESS
CITV
STATE
LIC. NO.
SI2E
OF IOT,'
USE OF
EXISTING BIOG.
SIZE OF
NEW BLOG.
EXTERIOR WALt
COVERING
USE OF BUI�q.
TEL.
NO.
CITV
LIC. NO.
INo. oF �a�oc,s.
NOW ON LOT
NO. OF
� ROOMS
ROOF
COVEFING
WOFK TO BE PER
hUf 12-70cnsn�0 676 0*�***9.0�
APPLICATION FOR BUILDING PERMIT
RECEIVEO BV [j(�TE RECEIVED naTE Issul
' 7 �, _
A.P. NO. � l3� � U� �
BUIIDING a�
ADDRESS
L.� O
TRACT� J LOT
EW ADD A R P
OWNER
�^ (�/� �',,''A, VALUE
USEf /1[lI�L/ TY�^'�/ �
FIRE
ZONE ' TVPE � GRC
ON NO.OF ,
PLANS
VARDS APPROVED
MAIN BUILDING
FROM C/L STREET)
VAR #
C.U.P. #
APPROVED
� � � �
i�-/3'%d
USE OF NEW
BUILDING
VARDSAPPROVE�
ACCESSORY BUILDIN
DATE
APPROVED
&.
I hereby acknowledge that I have read this application antl sta2e
that the above intormation is correct antl agree to comply wiffi
all laws regulating builtling construccion, and I shall not employ
any person in violation of the workman's compensation laws of
ffie State of Califomia. � �
�
I hereby certify that I am property licensetl as a controctor untler SQ. FT. o
the State of California Businass and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licenses are in full force antl effect, or I � THE PURP�E OF ESiABLISHING A PERMIT FEE ONLV: Q
am exempt from the provisions of the Stare ot Calitornia Business
antl Professions Code, Division 3, Ch pter 9. VALUATION /� �
� PERMIT FEE $ . l;J j
Signature of ^\/,I bl//�/ m
Permittee �� L $ J� �1.0 �/,_^ PLAN CHECK $ " E
(J I /(.�.I o`
Authorized ABent %6 'LL
TOTAL FEE $ V