HomeMy WebLinkAbout3012 COOLIDGE AVE - Building Permits' Aop��cant to fi11 in a11 spaces exceot those within neavy ooraer Iines ana sign all appropriate aeclarations. y �
Gi�TY OF COSTA-MES�CONSTRUCTI'ON�PERMI�T - PE /IT� NO ; ;TRACT NO. � ; LOT NO: . UNIT NO�. � ' v I � i � - 1
Proje�t Address � � � � 6 � . C� �L' f- �6"���� � 1 ! , + ' � '
Appl¢a`nt'S Mailing Address ' ��-� � �f°JC fl(��F'i— - TYPE OF CONSTRUCTION I NEW' ADD ALTERATION REPAI R ! � � ��4� _ T�
� Owner's Name� � ° �' ' �phone��p `! ��SCRI TION OF W❑OFK/USE OF 8 O OT ER _ _ � q,p, # � r ' _� ' � : _ i Zone � '
' ` ' '
_ i Address 3d�.a ' , fi� � C1 e' 3% ' i( ' I' DG` i S Main Bwldin9: � � � ' Accessory Building: � �
� � :�65 T� 1r h�rc �1�4S �:-� r� Nt' I r� _
Arch/Eng. � 'SenseNo.`'"`"'�� � TVPEOFPERMIT ; GRADwG LJFOurvoa710iv STRUCTURAL ' ;� Front: . - ' � I ' � � - p
� Add�¢55 ' � � �+����{� �.'. � � ❑ bENANT' ❑ ELECTRIGAL' 0 PLUMBING O MECHANICAL ' 6 RCa� � � . � � . 1 '� . N
Contractor'sName'. • � Phon�-Z�L��a� . :� OTHER � � � ' 'S � � � .0 � Right '" -t' - ' "` . - . _ .. � "- -N'
) � ' � • . PROJECTDESCRIPTION'Sc?.�FT. � - oCCUa�qrvGV '
- � Addresslmailingl--1 "� � � . � - ' y e� 'K � , , ' ; G
• . 1 u' � �CONSTRUCTIONTVPE ' VALUATION,Sp��'�D. �g Left! � . i�
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City LiCense No. , ZON6 GRA�ING CLL VDS. ' ACRES' '
LICENSED CONTRAGTOR OECLARATION ' ' � `� ' � Plny.,R¢f. # � • ' � Parkirig Req./Provided � E
� 1 hereby afti�m that 1 am licensetl untler provisions ot Charte�'9 (commencing � Reroa�ks • -' r � .' � '� �� ' Pldnni�g Notes: � � - ' � M
� with section 7000)bf Division 3 Of [he BuSiness antl P�of2551ons�Cotle, antl � ` � ' � ' � _ � ,
� my Imense is in full Po/rc'�e'an ffect. ' ' /! C � ,i i _ ' � 1 , • � � i � � � ' ' ' ; � I '; _ - � ' ' � � i . S
� License Class _` ' �� L' No `�'��' �� �b � ' , � - � ,
Date �-1-'Z-�� a'anat' re _ i�u.t/:��-�l/w-�. 3 ' C: � ; ( 1 � ' PLUMBING ' =FEES � � -
WORKERS' COMPENSATION DECLARATION ' �� � • � � ' • � � - - ' . - � - 4- ' .' � �
I hereby atfirm'tnat I have a certiticate oi consentto s�-msure or a�certificate r Bar Sink - r Showers� �� �. - - � � . � ' ELECTRICAL ' ��_ °' ' FEES �
� �t Workers' Compensation rosurance, or a ;certifietl copy thereof^(Section� � ; ( , gackflow P�evente[ Service Sink . • ; � � �
300, Lab. C.) I ' � ! � ' : Automatic Washer . Transformer ❑ 15-50 KW : . '
olicy No. ' � Company � I � Backflow Irrigation ' � ' $ewer Ca ' ' - � '- ' • ' ❑ 50 + �(W; �� j
P : , Construction Pole Sub.
Certitietl cooY is'hereby tuimshetl,
8 . � _ . . _ . , , ,
Certifietl copy Is tlletl with the city Builtling Divislon. "� ' �. � ;J � Bathtubs .� Sewe� Connection t � ' Cooking�Unit Mete� ❑up to 100 amps � ,
Da[e � ' APPlicant ' •� '� T ^� ' � .` . • � ,
EXEMPTION FROM WORKERS COMPENSFTION DECLARATION'�� ,'(..�f:' , ; Clarifiers� - . ' � � { $olaf�ColleCto}5 - . Dishwasher ' - . Meter ❑Over,-100"amp5 ' " '
(TM1iS section neeG not be mmplet¢tl if the pe�mit is fOr One huntlr¢tl ($100) or ' � - � - � - _ . _,_
less). � � ' � - � �. .. Dishwasher- ' • , � Solar Pipirig - Dryers ❑Gas ❑Electric • � Su6 Panel ' • '
I certify that in tM1e pe�fo�mance of thC work TOr whicti this permR.is�fssuetl,sl ` . - " . ,. _ _ ', •' -
� shall �not em0loy any p¢rson �in any manne� so as to become�subjecL'to the D�inkipg'FOuniain5 �� � Sold/ Tank � � Fd❑ � "
Workers' Compensatio Laws of Calif rnia. � ^ . . .-- .� - -- ' , , Motors �0-1 HP �1 % - 8 .
Date' � = Signature �+�� l-'M— ��' �� Roor�Drains -'+ � ' ' ' Swimmin Poolw/S a' ' ' " I - . ' • �
�� 9 P ` F.A.U." IncSolar09=15�HP'�16-754
NOTICE: If, aft�M1is!tleclaration, yoqshoultl become subject to the - — � �
�Workers' Compensation plovisions of'the Labor Cotle, you must forthwith �� � FIOOI SinkS - U�i031 Fi%tuI25 t' � Microwdv2� �
comply with suth• provisions or [Itis Oevmit shall �be tleemetl �evoketl. !
CONSTRUCTION LENDING'AGENCV � GaSSerVice �Outlets . WaterCloSet' • DeviceBoies � � �':
I hereCy atfirm.ihat there is a eonstruction lentling agency fo� the performanCe � POI¢ Light
ot the work , for which this permit' is issuetl (Settion 309] Civ. C.) Interceptors '. � Water Heater � � Outlets . . � Range � �
Lentler's Name
�_ _�ender�s addre`ss � � � � _ Kitchen Sink , ' Water Service _ - _ Switches -i� - - - -Sign � � � - - -
OWNER BUILDEH,pECLARATION ' ' . , � . � ' -
,. 1 hereby afti�m that;l am exempt?rom�Me Contractor's License Law ror the Lavatories � Auto-Wash � Garba9e Disposal Standin9 Sections � '
following-reasan (Sectionb031.5 Business antl Protessional Cotle: Any city'or ' , � � ' �
county which requires a permit to construct, alter; improve,�tlemolish or repair P-Trap ' . Laundry Trays . Generator DO-5 KW �5-15 KW Trasli Com actor
any structure, prior;to i4s issuance, also requires the applicant for such permit P -
� to file a si9netl statement tnat he/she is licensetl pursuant to the provisions'ot Roof Drains ' • 7 ' '
� the Gontractor's License Law (Chapter 9(commencinq with Section ]000) of . •
- Division 3.of tne Business antl. Protessions Cotle) or,that be/she is.exempt - � , . __ . _ _. __ ' �
'�[heretrom antl the ba5is,fOt the allegetl exemption. Any violation of Section 4� � , . ' _ � . � �, �
'031.5-by any applicant for a permit subjects (he applicant toia civil • ' � �
enalty of no[ more tnan�tive huntlretl tlollars ($500). , 1 � - - � -• • $ 3 . . - � � . � � � . � ! I
❑ I, a5 Ownel of [he• property or my em0loyee5 with waqes as their SOIe Rein5p8cti00 P¢B $15 � ' ISSu¢ Fee , ' '
' compensation,•will'tlo"the work, antl the structure is not intentletl orbfteretl ' ' ' Reinspection Fee� - �$15 Issue Fee � - _$ 3
, . for sale (Seciion; 7044,. Business �antl Professional Code: tThe �ConVactor's . - - • . MECHANICAL. ' � � ' . FEES �. �
� � Litense Law tloe5 not'dpply to an owner of a property who builtls or improves - � ' • _
thereon, antl who tloes such work himselqherself or tnrough his or her own � �Pe � �❑ � � .{- �DEVELOPMENT SERVICES REQUIREMENTS: ; �{
i� employeez, provitletl that such improvements are not intentletl or offeretl Por ' Boilet .. . I . Hood or " T . ,� , , .
. sdle:Jf, howeveq;the'builtling or Improvement Is Soltl within ona year of com- � C2nopy � TypE I I !❑ _� Zoning Approved By � DdtB
�_pletion,�the owner wilf have the burtlen,of p�oving he/she tlitl not builtl or im- Duct- Under Ground � � . � . I�� , � guilding Approved By _ � � � Date
�,p�ova tor the pu�pose of sale). ' - �
' �d, as owner.of'the.property, am exclusively contractin9 with �licensetl com � Duct -Structural , Refrigeration System i '. �- 'Appliration Issued By � -� � Dat �,� 2 - ��
, tractors to construct the project (Section ]044, Busine55 antl Protessions Cotle: ' ' � 4., _ .
' j The Contractor's:License Law aoes not appry to,an owner ot.property who Duct-Ventilating ; � ; �4-100,OOOBTU'0100,OOOBTU. � �' ! , .. , SU M R1GOF�FEES . ' '
builtls'or improves�thereon; and wno conVacts�for such projecti with a wn- - �• � ��`J�
tractor(s)ti�cense-pursuant to.the Contractor's License��aw). I am aware that ' � ' ; BUILDING PERMIT+ !$ ���� � ..SMIP , � . $ ' '� `-�
' Exhaust System ❑ �.MWtiple ❑ System Repair/Alteration ,
. proof of their Worker's Compensation insurance shoultl�be provitletl to' me. . - . . I ' t -- , ' '. � ' . :
� - � . • , . . � � � _ , PLAN,CHECK i . $� � PERMIT ' � � .
� L7 I am'exempt untler Section '' ��8: &�P C. for this reason'� :� F,irepl/Fact. BIL,ICBO # Fire Dampers � _ . - . ,
' ' - � ^ � � PLUMBING � �'$; � ISSUANCE .' ,$ _
� oate� '• ' owner � ' Hea�tinq System & Ducting_ � ' Registers' � • - - "" � ' � � ' ENERGY P.C: �$
� . � . � �. �� � . . ' � - PLAN�CHECK .25% �$ � .
1 nereby ceitity.thaY I have�rea0'this application antl stafe that the above �� DU100,OOOBTU �100,OOOBT , � " �� ' ' ELECTRICAL :- • �.$� GRADING' $�'
;� information is correct�l agr¢e to compty wrth all city dntl�county ottlinances ' -' ' , .�
,� antl state Jaws relatin9:to bwltling construction, antl hereby aumorize repre-. � � ' -' - PCAN CHECK 50�. �$ � � MICROFILM" $, - �
sent5tives of 1} city;to��enter upon, the above-men[ionetl-property;for: - - ' - //
� i inspection our os s. - i'� � i ' Date,_�=�__� ' � , � - � MECHANICAL ,$ � TOTAL FEE LL,$ G��5�'
� � Signature' _ � n � � ^ • � peinspee[ion Fea � .- ,$75 � � luue Fae . � ��$� 3 PLAN CHECK 25%, $� ' ' ' ' � C' � � �
'�
Driver5' LiCense or 55 � ' 1
CMF 0865-46,`rev: �1Oj84' �WHite - 6uilding; CanSry - Applicant; Pink - Accountin9: Goltlenrotl - Assessor Y
CONSTRUCTION AND PLANNING . � . POOL & SPA� ��
APPROVALS Permit # � Date � Inspector qppROVALS 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 . '
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE, ', ..
7. Footings � . � 58. Electrical Conduit-Undrgrnd.
8. Foundation � - 59. Gas Pipe, O 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
72. 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. Rougli 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 O Gas � Oil �
23.� Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - �� � , 73. Undergrnd. Storage Tank O 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 � � -
32. Electrical Power Meter-Final 80. FOOD C RTIFICATE ISSUED �
- 33. Final Electric � � Notes: �( S
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 D3 �
�� �
40. Gas Service-Final � �
41. Solar pomestic-FinaP � - ' � ��
42. Backflow Preventer �
�43. Backflow Irrigation - � . � �,
•�44. .Landscape Irriqation System , � ' � �
45. Sound Attenuation � , � . _
46. Handicap Regulations _ . -
47. FINALSTRUCTURE&BUILDING '
48. Special Requirements Completed - ' �
49. Electcic Release to Edison . � -
50. Gas Release to Southern California Gas Co '
..
51. CERTIFICATE OF OCCUPANCY . n� •�
No.� � - Date _ ��
Ty e
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PLANNIi � �EPT.
/�� SUB�IE�CSQ TO 8���, �7EPT. RE0.
�% v.'.J.L�DA?E..r~�
�RECfOR OP MNN�^iG
PATIO COVER DETAIL 6/1/67
�STAT E—j—��
SPACING SPAD
SIZE � � � �
OVERHANG
, � „ RAFTERS: �*
«� cur.rM � r� SLOPED FOR �RA�N
--. _�—nr
4� %
�- B A M
X �
ST 7E SIZE
3�16 x Z��'
f �
�
.� ..
Z POST-BEAM
f , _ i CONNECTION
�� . 'y
PO T
3/g x S�Lags 32% �
Predrill Ledger �
Predrill Eaisfing '/y3 Deep
JOIST HANGER—
Or other approved
of suppurt ♦ fie.
ALL LUMB£R DOUCLAS i/R
CONSTRUCT/ON' GRAOE
�X � �
S W S E SHO�ING
SHOW IOCATION ON REVERSE SIDE,
� SIOPE TO DRAIN—
6 .!: o.
,\
DROP PATIO FLOOR
�_ : � ` ' PUDDLED SAND FILL ,
•�� o Re move G.ass A�d Weeds Doan To Notura� Grade
� �.: . �:
�`? ' CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT
POST ANCHOR ��� 7# GALLONS PER SACK CEMENT.
For Pipe Post. Embed �12� � ' Provide 26 Ga G.I. Floshing At Wood Floor Const.
Pipe In Footinq• ,
Provide Flmg¢ Or Weld Plate Screwed Or Bolted To Frame. �
. +� -
FORM BU-�0 ;j •`
CONTINUOUS
�EDGER
TYPICAL JOIST ANCHOR
NOTE � USE REVERSE SIDE FOR PLOT PLAN.
NO I A t —�li I NO 2
FOR OPEN E6G CRA7E FOR SOLID SHEATHING.
ALUMINUM OR PLASTIC SHINGLE$ OR BUILT UP
ROOF COVERIN� ROOFING.
MAXIMUM SPAN SiZE SPaCiNG MAXIMUM SPAN
17� O�" 2x6r 12% 15� I�
I 6� 0" 2'x 6` I fi'/o 13" 3"
I 5" 0" 2'x 6� .� 24% 10' II"
12" 0" 2"'x,4"' ; 12% 9' II•,
I I� 0" 2'x 4" 16'% - 6' g•
i o' o' rx a• 2d�i� �' i,.
NOTE: FOR PROPOSED OR FUTURE ROOM;OR WHERE PATIO
�WALLS ARE TO BE BUILT. USE N0.�2 CHART: ONLY.
WIDER RAFTER SIZE MAY BE INTERPOLATED�: FOR
SPACING ONLY.
FOR PROPOSED OR FUTURE ROOM OR WHERE IPATIO
_ WALLS ARE TO BE BUILT SUBMIT'�•GOMPLF _T.F HOUSE
AND ADDITION PLANS ;
KOLI:, K, td.
JOB ADDRESS 3012 C
GENERAL CONTRACTOR
AP No. 1�11-1�111-OZ LOT
INSP�CTIONS
OCCUPANCY
'ORM BU4 - 5M - '.
' nnT� 6-8-62
: AVE. BUILDING P�RMIT NC
Masonr,y Contr. vALUE $ 2 •�—
TRACT FIRE ZONli D�SCRIPTION OF WORK
Signature DATE GROUP�t..Wd�.YPE III 7.ONE
PERM7
SUBCONTRACTOR *,,,,,,�,T
��` ��
� � %!^_ i.'rJ
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 C08TA MEBA. CALIFORNIA
For Applicani io Fill In Complefely.
TYPE OR PRINT
BUILDING q /n'� �
AODRESS J � . ✓ 6Ci
COSTA MESA CALIFORNIA
d MAIL
■ 6TATE
�U
� 86TBACR LINB FROM
�
TEL. ..�.
�o: JQ Ua96�
�(� � No. oF a��a.
) � NOW ON LOT /
�� Y
/ [� �
I LEFT / � I RIGHi �
DESCRIPTION OF WORK
I , II I —.II
FEE REC�iVED
� ,�'/JUN 8 l962 '
APPLICATION FORFPERMITE DEPT.
BUILDI�GTY OF COSTA iVIESA
For Offiee Use Only
NECEIPT NO. 1 'F8IMf1�0.
COSTA MESA.
FIRE
ZONE
APPROVED
ZONING
zotuy�� I PLANS �Z_I eu �o naEW'f����
% 4i ,/
oeecxirr�oH L� Z7 iiC Y �J� i
n. P. No. � // —' � `� </ — a Z
YARDS EVES
APPROVED ALLOWED-
(CENTBP LINE ST.1
�
�
�l
BUILDING `--� NO. OF (� J/1/
SIZE ROOMS �— STORIES �
EXTERIOR WA�L IROOF -
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMEO
' i
oc e O
6 /� �r 1
I HEHEBY ACKNOWLED6E THAT 1 HAVE R¢A� TH19 APPLIWTION THE AMOIINT BHOWN UNDER VALUATION IB POR THE
ANO BTATE THAT TH6 A90VE IB CORRCLT ANO AGREE TO COM-
PURPOBE OF EBTABLIBHING A PERM�T FEE ONLY.
PLY WITH ALL CITY O e9 AND 8l' LAW RE6ULATIN6
BUILDINO CONBTFIU � VALUA710N � � Q'
SIGNATURE OF PERMIT FEE $ `
PERMITfE �` �
� - $ � O � PLAN CHECK $
AUTHORIZED AGENT
OWNER COLGATE, MICHAEL DATE 4-11-77
BUILDING PERMIT N0. `+.
SUBCONTRACTOR
G�5
� WATER
� J ROOGH PLUMBING
o` PROP. SWR. LINE
d SPRINKLING SYST
�� MISCELLANEOUS
ROUGH HEr1TING P
R
UNDERGROUNO � POWER �
ROU6H WIRING
TRENCNES FORMS STEEL R
FLOOR SYSTEM
BONO BERM � STEEL REINFORCE
SHEATHING
FRAME AND FL/.SHING
LFTHING — IN � OUT [-]
PUSTER, BROWN COAT
STRUCTURAL, FIN4L
MF>TINf, VENT_. HEFRIG. �NO A.C.. F
_. ' .
�,'��� 43795
COSTA MESA BUILDING•SAFETY DEPARTMENT.
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
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CITV
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ADDRESS
TEL.
TEL.
AODRESS
CONTRACTOR O ��
-i
ADDRESS "
TE l..
CITV NO.
STATE . CITV
LIC. NO. � LIC. NO.
SI2E � I NO.OF BLDUS.
OF LOT NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
electric; plumbing and heating work.
USE OF BUIL�ING AND WORK TO BE PERFORMED
I hereby acknowlatlge that I have �eatl this application antl state
that the above information is corract and egree to comply with
all lews reBu�atine building consvuction, antl I shall not employ
any person in violation of ihe workman's compensation laws of
the Stete of Cellfornia. _
i heraby cartify thet I am prope�ly Iieensetl es a contrector untler
t�e State of Cellfornia Business entl Professions Code, Dlvlsion 3,
Chepter 9, and thet auch Iicenses are in full force and effeei, or I
am exempt from the provisiona of She Sieie of California Bustness
and Professions Code,jvision 3, Ch ter 9.
Slqneture of y � �
Permittee C
Authorizetl Agent � '
���,:
a�� Ti-7���;�,{�(; s��ss::- :4�:ir�:��5.`�0
AI�PLIqA'�ION FOR STRUCTURAL PERMIT
REC 1' � DATE FECEIVEO neTc icci �vn
�
PERMIT NO,
BUILDING
ADORESS
VALUE
FIRE
ZONE
USE OF P
BUILDING
VAR
MA
DISTANCE BET. I BET. MAIN &
MAIN BLDGS. �ACCESS.BLDC
VAR.aI� DATI E • •
�
n
m
i
d
SQ. FT. rv
THE AMOUNTSHOWN UNDER VALUATION IS FOR m
THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLV: �
VAIUATION , PERMIT FEE $ d
J�
m
�(i PLAN CHECK $ ^�
� �
$ � g� TAX § T LL
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' TOTALPAID S �
Y. �,� � LOT 2 TRAFT �28�
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COSTA MESA BUILDING-5,4FETY DEPARTMENT
P. O. BOX 917 COSTA M�A. CM.�FORNIA
Fo� Appiicant to Fill'.In Complefely
� TYPE OR' Pi21NT �
I MAIL
I SfATE
COSTA MESA. CALIFORNIA
KENNETH W.'KOL
�7:
FE� R�CEIVED
� JAN 111�2 '
v tl�� �
arv o� casra �a
APPLICATION FOR PERMIT
BUILDING
For Office Use Oniy
REC81V�!� DY I DATE PEC��ED I AT
VENUE .%C-i �
CA L I FNp.M I O Zz qODRESS
7E�. COSTA MESA. CALIFORNIA
un ______
""'__""""_'�'_"__"_
TEL.
>> q� Np. M i. 6-�
� v ��^ � NO. OF BlD¢9.
88TBACK LIH6 PMOM . /
ceMeR oP srneei (7 � REAR YARD
SIDE YARD I LEFf H� I RIGHT /�
DESCRIPTION OF WORK
vrw � I i. II e� reosrin.0 � - I� aoo�nnu
SZEtSUI'LDR� 4015 S�No.oi
S F ROOME
EXTERIOR WALL ROOF
COVERING COVE:
USE OF BUILDING AND WORK TO I
� 2 sroaiEs 2
ZONING
ZONE NO.OF UBH OF N¢W %�
� 3 PLANB —L� BUILDIN6 (vJ�
L80AL / -/— -Z � � � (J Z p
oeecxirriox `a'� � o
t , (CCNT6R LINB BT4
� FT.
`S FT. `
V FT. —_
I S C FT. �/� .
��_ DATE �/�i
t !
C(
i HEREBY ACKNOWL¢DGe THAT 1 XAVI% READ TH19 APPLICATION THH AMOUNT SHOWN UNDER VALUATION 19 POR THE
AND BTATe THAT THE ABOVE 19 CORW�T AN� A�RHB TO COM-
PUPP09E OF, ESTFBLI6HING A PERMIT FE8 ONLY.
PLY WITX �LL CITY OROINANC88 AND �ATE IAWB RHOULATING
BUILDINO GONBTRUGTION. ' VALUATION 1
SIGNATURE OF /�/ �� �/J PERMI7 FEE $::J G'��
PERMI7TE $ / �f •SY�� PLAN CHECK $ �`� �
£
AUTHORIZED AGEN7 2
70TAL FEE `5 �� 4