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Home My WebLink About2862 CORVO PL - Building Permitsc� �ecT�oowess: z862 CORVO PL OWNEP'SN�ME: MS KATHLEEN SHEMKY nooeess: SAME 557-5711 AflCN/ENGINEEfl: ROONE38: flE0.N0.: hxrt: UNIT: PENMITTEE: CUESTA CONSTRUCTION i 7 � 4) 557-5877 eooecss: 3195 AIRPORT LOOP C CM CA 92626 LICENSED fANTMCiOB OECIAMTION: I Aereby aKrm that I am licer¢eA untler pmvivons of Ctupter 9(wmmeMinp xi[� Sectlon 7000) ol Oidsion 3 ot Ihe Business anE Pmfessians Cade, an0 my Ilunse is in tull force anA ellect. cirv uc.: 0 51 15 9 sr�Te uc.: 5 6 8 4 6 6 cuss: H Date: � Sipnature: WOqKEPS' COMPENSATION DECUMTION: I �ere0y allirm t�at I have a cetliticate af wnsent ta sell-Insum or a certifiote oi Workers' Compenution nsyra,pc� Qr � SCrtniee coey mereo� (Sectio�P �.�ao. l�'L / O 1/ 9 0 roucr xo.: 1 1 V C L 'vrnNr: STATE :enilkE copy a heaty turtrislxtl. ❑ Certitie0 copY is ftle0 the city BuiWinO Oivi5lon. a _ d � Q A ' Date: ADD�� EIIEMPfION FBOM WONIIFf13' COMPENSATION OECLAMTIO :(fAis secUan not be comDleteA il iM permit is lor oire hmkre0 (Et or kss�. I ceniry Ihat in tAe pedormanc¢ ol tAe work lor w�ich t�is Dermit is iss . i shall nat emDlay any person In a manner so as to Oacome suDject ro I�e Workers' CoproPensation Laws ol Califomu. � Date: O' l � SiOnaWre� �'� NOTICE: If, atter makinq tAis Eeclaation, you slro come SUEject to tAe Wo rs' Co censaibn prm�siwu,of Ne L CoOe, you must IonMvi�� comDly xitA such pmvuians ar tNs Oermit shall be AeemeU revakeE. -' - COHSTBUCTION LENOING �GFNCY: I �ere0y aKrm tAat t�eie is a consWttion lendinp aqemy lor IAe peNormanu ol t�e woA tor whic� I�is permi� i5 issuM (��on 3W7, Clv. C). �2 ' 1 lFNOEB: RDDAE38: OWNEH BIIROEB OECUMTION: I AereUy affirm tAat I am evempt Irom Ne Contrattors' State License Law tor Ne fallovnn0 �eason (SeMiw 7031.5 Business anA Pmlesslonal COGe: My dry at counry wNCA requires a De�mA ta wnstruct, alrer, improve, EemWis�. or rt0air any 5lrupure, pnor to Bs Issuance, also requires tAe ap0licant tor suc� permit to lile a sipned statement that hUs�e is licenua pursuanl to Itre D�� of �M ConVacrors SWte licenu Law �Chapter 9(wmmencinp with SecGon 7400) of Oivivon 3 of the Businass anE Prolessions Cotle) ar IhO� he/she is esempt ihereimm anG the Gasis lor tAe atle9eC exem0�� Y Molatlon ol Section 7031.5 Cy any applicam ior a permit suDiects I�e apDllunt �o a dvil penalry o� not more than irve Aunere0 Gollars (SSWI. I, as owner at the D�oDeM or my employeas witA wapes as their sole compensation, will do the xrork, an0 Ihe ❑ simttura is not in�en0e0 ar oflereA lor sale (Section 7044, Business anE Pmfessional COUe: The Comactors' State License Law Eoes not appy ro an awner ol a pmOertY wha huilds or improvas t�ereon, ana w�o does suc� woM1 himulVhersell or ihrouAh Ais or her own employees, providetl I�at such impmvements are not intended or offare0 br ule. II, however t�e �uil0lnp or , Improvement is so10 wnNn ane year of completian, Ne owner will hava Ne bureen oi pmNnq �e/sne Uitl not EuilA ar ImD�a�e ' lor tne purpose of sale�. I, u owner at Itre proDeM. am exdusively WnI�aCW p wi(� IiElnSlE COni(dCI0f5I0 LOIISINtI Ih8 D�WBG� (Secllm 7041. Business ❑ an0 Professians Ca08� Tha Coniractors' SU[e License Law Ooes not appry to an owner of Droperty wAo butl0.s or impmves Nereon anG wtw conlrocis fOr SucA prol��s wiN a wniractor(s) lirenu Oursuant to the Coniractori State License Law�. I am aware Nat prool ol Ueir Worker's Compenution insu2nce sMulA Da provideG to me. � I am exempt unGer Sec[ion: B. E P. C. tor Ihis reuon: Date: Owner. I Eo �ere0y certity Ihai I am aware of anE unOerswnE ihe 2puiremenls of CaliforNa Health anE Salery Cotla SecGons 25505, 25533, and 25534 anE itut I or any fmure Ou0Ein0 �Dam wiNwill rrot (circle one) nee0 to compty wit� sai0 state codes anE me requirtments for a permitlor constructwn orm�iliwtlon hom[ne NrUualdy Manapement Oistricl. Hesitlentulconstmction appliwtlons are exemptimm Ihese DroW5ion5. Datt: Appliwnt: 1 here0y ce�iry ituLl have reaA this application an0 state t�at the aEova information is correct. I ap2e to comply wii� all city an0 counry or0inances anU state Wws relatlnp to Uuil0in0 constmction and here0y a,i onxe representatives ol Ais ciry to enD• upon the a�ove-mentioned propeM forinspection purpo es. / Date: ��f�, D SipnaWr� ��,�,( � oriver's isense or Soda� secudry 1801J8 W�Ite—BuiWiip; Grean—CaCa Enlorcement; Canary—Applicem; Pink—Ravenue; GOldenroE—Assessor CITY OF COSTA MESA — HUILDING PERMIT � PERM NO:�BEP 048511 PERMIT NO: BEP 048511 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE: ELE PLU STR PURPOSE: ALT JOH DESCRIPTION ; ALTER HATHROOM SQ FT: 4,700 CLAIM VALUE: 4,700,00 CALC—VALUE: 9,700.00 GROUP OCC: R-3 / COMMENTS: VARIFY COMPLIANCE IN FIELD �*�r**��r+r*� �r*�*�r��r**�*�*+r��r�*��+r***��*��**�� r��+r�r��r�r��r�r��r�+r�r*�*+r�rar*��r* Z O N I N G R E Q U I R E M E N T S S E T H A C K S C� ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- 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 RE • � PROV: PARCEL; 13933313 ZNE: REF NO: PLANNING N�TES> > if ff i4 if it ih fE ff ff i(� M' iE i41k iE ik iF'!t if i! ik ik'N' �E iF if 1! i!'!k!4 if if 1E'1!'1t ik if !k')f 1E 1!� if 1F if if f%fE i4 if i! if if' ih'7f !f ih if i�' i%!k ik i4 i%if'� iE i4 ih 1F �'K- i4 ih if -0E!4 if i%if D E V E L O 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 ; �^ APPLICATION ISSUED H � ***+r�+r**�r�r�**�+r*�r�r�r�*� iEiEiE�lEiEilikiEititiE3ElEikiFiEiEikit±tiFikififiEiFiFiEiE�lE�1f-ikit HGXd4-� LEGAlIZATION;N F E E S BLDG PMT PERMIT 72,00 PLUMBING ELECTRI-I 2.00 ll,l 25R 5,0 M-,M A R Y MECHANIC DATE: : DATE:��% / O �3FiF iE iE �k iE iE i! 1E iE if��F'iF'�'�F£3E iF ik 1k �f If 1F iF 1F 1E IE i6 if it iE iE If iF 1f 1f iE iE iElE iE 1f iE iE fE STRUCTURAL SEGMENT:Y FIRE SMIP/R50 GRADING SMIP/NON—RES PLAN . % ' � ISSUE FEE 3.00 15.0,0 ': BUILDZNG—DIV—> PERMIT ISSUE PL�AN—CHECK TOTAL PAZD DUE TOTALS----> 85,75 18,00 .'0.00 103.75 103.75 .00 REVENUE DIVISION TOTALS--> COLliEC,TED: •� 103.75 OVER/SHORT: ,00 BLDG PMT PLUMHING ELECTRIC MECHANIC •� FIRE SMIP/TOT GRADING PLAN—CHECK 72.00 5.00 26.25 � " , ,50 ikifiFiEitakiEifififitiEiEiEiEifiFikifif3fifiEiliEifafilififlkikiEiEiFiEiF. *iFiEikiEkitiEiEifiElkfkiFiflf3EiliEifititlFiffEiElEiEiEiEilklEiE�EiE1EiEilifiE 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 4700 ALTER BY VALUE RESIDENTIAL' NOZONE 1,00 9,700,00 ELE S FIXTURES, LIGHTZNG 4'1' ST 20 EA, ,75 3.75 ELE 1 RECEPT/OUTLET 1--ST 20 EA, ,75 ,75 ELE 1 RECEPT/SWITCH ,' 1''ST 20 EA. ,75 .75 ELE 2 MOTOR/POWR APPARATUS � 0.0�= 1,0 HP 3,00 6,00 PLU 1 WASH BASIN •4� - 2,00 2,00 END;�OF FEES SiViOKE DE1�E�TOR i , � YIEQUIR�� ' ___ �1 0006t291—DU0672S4 3r��' i0�.� ... � � • c;miva TI"'c: i?:a; � � CONSTRUCTION AND PLANNING � . . ..?� � SPA , Date Inspector Date Inspecto� APPROVALS Permit # - APPROVALS Permit # �. T,- 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. . , 53. Steel Reinforcement 3. �Electrical Conduii Utifity-Undrgrnd. 54. Forms �� 4. Electrical Conduit-Undrqmd. 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. Foundation •, 59. Gas Pipe, O Undrgrnd., Test .' 9. Water Pipe�Undrgrnd. �' � 60. Backwash �ines, P-Trap, Q Undrgmd. i 10. Structural Floor System j• 67. APPROVAL TO DECK � 11. Prope�ty Sewer 4�ne & House Connection -� � - 62. Backwash & Receptor�Final n 12. Sewer Cap � � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final �' 14. Rough Plumbing ;� 65. Electrical-Final ' 15. Rough Electriwl-Conduit � 66. Solar System-Pinal � ' 16. Rough Electric Wiring ,+� -rj� 67. Fencing & Access Approval � 77. Rough Wiring Sign �i 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 OGas ❑Oil 23. Gas Pipe�Rough & Test � ' � - 72. Underground Flush 24. Roof Framing � 73. Undergrnd. Stora9e Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling �Sttuctural) & Monocoat . � 75: Dry Chemical . � 27. Frame and Flashing �� p(v� 76. Dry Standpipe . ' 28. Lathing & Siding � �� 77, FIXED SYSTEM FINAL 29. Insulation _. � � � 78�. FIRE PREV. FINAL " 30. Drywall Nailing g��Q (�(,�/� - HEALTH DEPT. REQUIREMENT � - 31. Plaster Brown Coat ' ��79. FINAL INSPECTION' 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED �- 33. Final Electric � � Notes: 8..�"Q'p - �� 34. Final Heating & Air. Conditioning• '. � �� p/��. V / u✓ - r L (1 35. Final Gas Pipe-TCst • ' ' � - 36. Hood or Canopy . � '�� _ A'/� �,, � - � � ` 6�� -! '�7f2 -37. Final Factory Fireplace - �. • 38. Final Plumbin9 � Z�Q�j (�,p . � • 39. Water Service-Final � 40. Gas Service-Final . 41. Solar pomesticFinal � . 42. Backflow Preventer ' 43. Backflow Irrigation ' ' 44. Landscape Irrigation System _ 45. Sound AttenuaUon i • 46. Handicap Regulations' • � � . FINALSTRUC7URE&BUILDING �3�--qQ � 48. FINAL PLANNING " 49. Electric Release to Edison� , 50. Gas Release to Southem Califomia Gas Co - � � 51. CERTIFICATE OF OCCUPANCY _ _ No. Date � .� �/'h�i 0� ��'s/`r �i��5��'�� a�/�� _ � �l''n,� � lc�. t�t:t6n.e� A-��u-�}�.� 9oY2 3� T�HIS DOES NOT CO �TITUTECFINAL PLANNING APPROVAL. $ � qO' IN�ALS DATE � / � / _ �� ,Q�PSSe� �,� ��S � ��6z �r� � �s/9 /h'CS9' �o�odovd � �� c��a' ��' 01 s�» ��7 �O1z��w� �(� � r�� ,-�a�' "� ' � �}'. "�-�.� � l � �— -- — — I `J fi'�7 I� a� �'�� ,y I U' �I � � �V1 y,�l - H1�ol' sY��r � b � 1��5 �' � 9 � �� ii� � � � � �� M��nM �aN , �b� U�� . �� ; I �� l Q�1 �r �'��,� ��\ � W �� k � ,� �,,�� ,�, �� , - -FPWECT F90PES5: Z 8( z CQRIJQ PL ' OWNEN'S N�ME: j{LLEN SFiEMKE �ODNESS: 2$EIZ CORVO PL COSTA MESA CA 92626 (714)fi47-9444 RflCNIENGINEEB: �� RFG.NO.: UNIT: �OONESS: UNIT: rewMirree: PETRONELLA ROOFING ( 714 ) 548-1645 �ooeess: 2626 NEWPORT COSTA MESA CA 92627 LICENSED CONTMCTOP OECIAMTIOry: I �ere0y allirm tAat I am IicenseE unAer pmvisians al C�aD�ar 9(commencing wi[h Section 7000) af ONision 3 of the Busineu an0 Prolessions COGe, license rs in full torce antl elleq. cinuc.: 0-32'6—'05 sra�uc.:0046 70 cuss: C 3`9 � Oale: ��_ SiqnaWre: �� WONKENS' CaMPENSR710N OE[lAXq7i0N: I Mrc0 eflirm tlut I have a uNficate ol �nt m ul4msum or a ceNfkate oi Workers Compensaiion I s di py �hereol �Senion 3800, LaD. roucr xo.: ��az!� �� ezr, o�h: �� O S/ 9 0 IcoMvnxr: STATE FUND � Certifie0 copy is hereDy lumishep. � Certilie0 w is fil xith I�e ciry BuilAinA Di 'sio� ,ele: � � � �v Applicani: E%EMPTION FNOM V/OBI(Efl8' COMPENS�TIOX DECUNITION: (ihis seciion neeC not be cnmpletetl if [he permit is lar ane hunOreA ($100) ar leu�. I certiy IAat in ihe Deharmance of ihe Work lor which ihls Dermit is issued, I shall nat employ any Derson in any manner so as to 6ecome su01ec1 ta the Warkers' Compensation Laws ol Calilamia. Data: Sipnature: NOTICE: If, atter maMing Nis Aecl��qon, yau s�aultl Oewme suUject to ihe Workers' Campensatlon D�wisions of Ne Labor CaEe, you mus� lorthxrth compy ��p such provaions or ttns permit sAall De AeemeO rewke0. CONSTBIIC7ION LFN�ING �GENCY: 1 �¢reEy afiirm ttwt t�ere is a consiruction lendinp apencry for t�a pedormance of the work for wAicA IAis permit i5 issue0 (Seciian 3p97, Civ. C). IENDER: �ooxess: OWNER BUIIDER �ECUMTION: I here0y amrm Ihat I am exempt iram t�e Convactors' State License law for tha lollowinp reason (Section 7031.5 Business ana Pmlessional CoGa: My ciry al counry whic� requires a permit �o constmct, alter, impmve, Aemalis�, or repair any stmclure, D�o� �o its issuance, alm requires t�e apDlicant tor such permit ta file a sipne0 statement ttut he/she is Ilcenud pursuant ta t�e D�ovisions of the Contqcrors' State License Law (CAaO�e� 9(commencinq wR� Section 7000) al Oivision 3 oi tAe Business antl Professions Cotle) or thai �elshe is exemD� t�emlrom anU t�e Oasis br t�e alle0e4 exemD�ion. My violation al Sectlon 7031.5 Ey any aODlicantfor a permit sublecis tha ap0licant to a civil Denalry of nat more than iNe huntlre0 Uollars (5500). I, az awner al t�e propeM1y or my employees wit� wapes as Neir mle compensatlon, will tlo Ihe work. anE Ne ❑ structureis natintentlea orottere0forule(Sactron 70Cd; Buaness anE PmfessianalCaOe: TM Contactors'State License law tloes noe appty ro an owner at a property who OuilEs or imDraves ihereon, anE who does suc� wod �imself/�ersetl or I�rouOh �is or h¢r own emDloyees. pravi0e0 that suc� �mprwements are nat intenGed or oifere0 lor ule. II, Aowever the �uilUing ar ' improvement 5 SoIU vritNn one year of comde6w. Itre owner xill tuve Ne OuNen oi prwinp Irc/s�e Ei0 not EWE ar ImD�ave tor Ne WN� of ule�. I, az awner ol the pmce�. am ezclusiveN conlractin0 �+�h licenset contractors to wnsimp Ihe D�ol�� (��on 70C4, BuSineR ❑ aM Pralestions CoOe: e COntractws' State llcenu law Ooa not appy ro an mmer af prope�tywlp hWOs or improues thereon an0 wlro rAmrac�s �or suc� Dmjet6 wiih a wntrattor�5) Izense pursuant ro the Conlraciors SWta Ucense Law). I am awara t�ai prool of t�eir Warker's Comp¢nsabon insuance s�oNU be DrovideG �o me. �: I am exempt un�er Section: 8. 8 P. C. - lor cnis rzason: Oata:� Ownec I Oo nereoy cetliry IAat I am awam at an0 un0erstan0 the reauirements of Calitamia Heatth ane Salery CaOe Sections 25505, 25533, an0 25534 antl IAat I or any luture Uuilding o��u0ant will/wlll nat (circle ane) neaG ro com0ly wit� saitl state co0es antl the reQuiremants tar a permit br consimctwn or modificatinp hum tAe Nr ualiry Manapement District. Residential consimction appliwtions are exempt imm ��ese provisions. Dale: Ap0licani: I nere0y ceniry tAat I luve rtaA tNs applicauon an0 state Nat Ne aEwe intorrtaUon'a cartect. I a0�e to comON �� a0 tiry an0 caunry ortlinarrces anG state laws reWfinp to DuilEinp cp¢tructbn au[Mrin represenlaWes ol INs ary ro enter upon Ue aEwrmentioned pmpeM �or inspection purposes. ` ^ t�� p � Date: ✓ — %� _( U Sipnawm: Driver's �icense or socia� Securiry x; 184td8 W�ite—BuilOing; Greer�e Enforcement; Cenary—Appliennt: Pink—Revenue; GoltlenroC—Anaeemr CITY OF COSTA MESA — BUILDING PERMIT PERM NO; H 047420 PEAMIT NO: B 047420 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PUAPOSE: ALT JOB DESCRIPTION : RE—SHEATH S RE—ROOF W/30 YR DIMENSIONAL SQ FT: 4,500 CLAIM VALUE: 4,500,00 CALC—VALUE: 4,500.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTOR(S) RE(JUIRED IN HOME. �r**�r�**�r****�e��r**��*****�r**�r�r*�r*****��r�e�e*�r**x**�r+ex**+r�r�r***�ex***��e***�r+r*�r***�r** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FANT: 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; 13933313 2NE; REF NO: PLANNING NOTES> > i! ff 1f fk if ik if if iF iF iE if �t 1k 1! it 1k if k M ih M M k N if if iklk ik ik it it if if iF ik if ik 1f if 1f if if 3f if 1E 1F k iF iE if 1t M* �t 1k 1t M if 1F 1f ik iE 1F if 1E iF iF if 4 i! M iE M iF iF iE it D E V E L O 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 HY : DATE; APPLICATION ISSUED BY: . DATE: S- 2 l—�d it if ik iF 1k ik if iE if 1t 1f k if iF ik 1!!k i! iF iF it iF F�'iF7F�'��{E **{f **** if 1F��F1f if itMlkifikkiEiEiFiFititifiF1F1k1kklkMilititMMikitifitikikiE3kfkkikiEiFif MiFifkifiFifMiklfiFkkif%1EMiFMkifiEiFiFMiFlEM�Fif1FM�FiElEikiEiE LEGALIZATION:N F E E S M M A R�Y STRUCTURAL SEGMENT:Y i , BLDG PMT PLUMHING ELECTRIC_.MECHi�NIC . FIRE SMIP/RES GRADING PERMIT 72.00 � - ;' . 50 . SMIP/NON—RES PLAN � • ISSUE FEE ' '• BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL PAID DUE TOTALS----> 72.50 0.00 0.00 ' 72,:50 72.50 .00 REVENUE DIVISION TOTALS--> COLLECT.ED;� � 72.50 OVER/SHOAT; .00 BLDG PMT PLUMBING ELECTRIC MECFIANIC FIRE SMIP/TOT, GRADING PLAN—CHECK 72,�0 .5�. �� . ik if ik it iF M 1f iF iF if if if fk If 1f !f k if 1E if ih iF 1f %fk if 1k if 4 iF iklk ik ik iF iF ik ff 1f it 1tlk ik iF iF ik ik k k iF if it 1f !f ik k iF it k ik it iF iF if if i! ik 1f ik ik k ik k it If if 1f ik iF 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 4500 REROOF BY VALUE RESIDENIAL NOZONE 1.;00 4,500.00 $ND OF FEES ' . .. ' `. . �� , �QE 0006136S-OOubi356 T�a T bFriE� 05l2J19D TIFfE: 13:47 =a.so J �, � + � CONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit# - Date Inspector qppROVAIS Permic# Date Inspector 1. Temporary Electrical Service or Pole ; f 52. Pool & Equipment Location �2�.Soil.Pipe•Undrgrnd.. �- �.;� " 53. Steel Reinforcement ' �'3^�Electrical Cond�ivUtility-Undrgrnd?� � ' S4. Forms � � ^ 4.�Electr.ical Conduit-Undrgmd. :_S 55. Electrical Bonding . . .:.•-- `.:5::Steel:Reinforcemeni Y 56. Rough Plumbing & Pressure Test -� >- (;'6>-Elect}ical UFER G nd. ,� 57. APPROVAL TO COVER�GUNITE -•�7.`-_Footings �;r -i 58. Electrical Conduit�Undrgmd. V 8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test • 9. Water Pipe-Un�rgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. .. 10. Structural Floor System , 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -12. Sewer Cap -� ,.;�� 63. Heater & Vent-Final ;n 13. Roof Drains „ �- 64. Plumbing SYstem - Pinal ' �14. Rough Plumbing � ��' 65. Electrical-Final � 75. Rough Electripl-Conduit � 66. Solar SYstem�Final � 16. Rough ElectriG.Wiring � ' . 67. Fencing & Access ApProval J 17. Rough Wiring'Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &,Air Conditioning �FIRE DEPT. REQUIqEMEN7 n � � J .1 f � i' - � `7 .� i :r � - O 1 2prRough �F.actOry F�replace :-"r,�. = � * � � T,�, � �APPROVALS,`",�,Pei�mit # - � _ 21t-Ducts, in St7uctu�eY ^ •• � �: � � ^^"� `� cr c x ,`�ti -;;. ; 770. Undergroand Hqdro " 22�Ducis, Ventilating': ' '`'%� `i ,� ;� =;; ,,; t77, product Pping OG�as QOiI 23r•Gas�Fipe�Rotigh&�est • m �^S � " G �i � �7y, Vndergroend FIosA _ � y - 24'-�Roof Fiamiri� ' ' ' �� y � ' 9 j:• �� ;� " y � y t. :73 ; Undergrnd. Storagg,�nk;O Gas ❑ Oil 25. Roof Sheathing!'*i�' �v + s: �� v' Cu�. �. �74,^,p�erhead Hydro- , 26`;T-Bar Ceiling �St%�aturall &�Monocoat *'� y `� :�; � 75�DIY CherAical ,� q• `� ,y > -, 27•..�Frame and Flashi.ing ,7c,^ �: _ .+ xy � 76. Dry Stand"pipe ` � � ; � :'28^La2hing&��tling�;' _ _ '� '- " � ,"� � 77-: FIXEOSXS�,TEMFINAL�, -� �. r ?. .. , . ��29. Insulation • ^y� � S �• ' �� k 7&- FIRE PREV. FIN�L ' > =` �• � . .. i ''30. DrywaIlTlaii ng ;_ ,� � `, : ` y ; S �,HEALTH�DEPfi, REQUIREMENT ��31. Plaster Brown Coan S � c��' k . � �: r'79.�FINAL INSPECTION . J =� --=� - - m � 32:7Electrit3l Power-fN�ter�F�inal, ' * '' '� � .� �80: jFOOD CERTIF�CATE ISSUED� - . � y.. . � . �. . .� {33�Findl Efectric ;�i� Tl r' � �?� i NoTes: -��' - _ 'r I ;� C34:�Final Heatin,`g & AiT Contlitioning`� !,7 � - ; ' 4 : � • -� �� = �'!- �35 �FinalGasPi�pe�Te'st ,,� .. > � � i 3cs= �� ,/�� •� � ;�� x'36. �Hood o�Canopy�'. p ^ T � `.• r • � . ,�' s - � x- -� � T� � S : t ' •� 3� !r; a U G. -� a H � J ,y :r ? 1•: % '� + _ �37...Final Factory FiieplaceG . •_� x ; �' :� ac ,5'�� 6' � Q �38. Final Plumbl�ng � �- - t j `y. x 'S a� � - _ . . ., "39. Water Service�FinaJ; y x Y /� ` . -Q� - � ' P'i�!/ h. c�^e ;;40. G8s Ser.uice=Final a� .•7 w�t^C^ s r� J? G�' r'-"� ..c . n:. _ -n a� J_ lt ke�!' ✓ ' 41. Solar pomeificPir�al' :;j �� 'x � � � m .,, � i: - � (iW � 42. Backflow Preventer• � iJ �� ' � �' � r. j^ • "� -' .^� .�'a n.,.-� a... s: -i ;:;pv : �- c t � �.: S S a. a: , � v, .., r� 43. Btcktlow Irngatio7 �, �, ;,^, a: a �� G- f '� `i `.,,y� , ;"� Q�� :r44; Landscapel"rrigationSystem��'+�� w '�" � `� `�'-,"' � ��' �'`� '� !' � r n. v �l r^ I.^. ti �9' _ n: Y� T i J T Y`�" ^ *: r-. � e"' D. c,^, c... t-.;' � r-I r' . _. v„ i `'45`;Sound.Attenuation ... � �-> • ty• -.p x -`46:•Hendicap Regulations -� O �' � '� � � �� •� '-''o =� '' t- >t �> _ ^v ;i + ,�47�FIWAL STFiUCTUTiE & BUI'LDING y � � '� � ' C��' � � , a � �� /- U �i f C 'Y :-. 48:.FINALPLANNING F^�^ ' �� [ �* ` 7 '" ¢ ' `' ` r � � � �. x � :� rs * C • a49''Electric�Release to�Edison � " i � `� � ' "' - � ' � � or t, n c a' O =50�Gas;Release to Southem California Gas Co i ^ � � �'' � ' ='h °- �� '' c�r s)' S DS' (l � i. O 'S1. CEflTIFICATE OF OCCUPANCY ' ' ,- :� �"` •• ' r •' No. Date - CONSTRUCTION AND. PLANN NG • POOL & SPA ; � � -� \L t \,� cC\:I '� " Date Inspector � ' Date Inspector APPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical Service or Pole � 43. Pool & Equipment Location � � � . Soil Pipe-Undrgrn ' � 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding - - ' - . tee ein orce - S 47. Rough Plumbin & Pressure Test �' ' " 6. ElectricalUFERGrn � 33v � 48. APPROVALTOCOVER-GUNITE- ' "- � 7. ,Footings . ',a _ j 49. Electrical Conduit-Undr rn �8. . Foundation , � 50. Gas Pipe, ❑ Undr rn, Test ' ' 9. Watgr Pipe-Undrgrn 57. Backwash Lines P-Tra �❑- � � ridr rn � 70. Structural Floor System - 52. APPROVAL TO DECK � � � 71.. _ Property Sewer Line & House Connection 53. �Backwash & Rece torFinai 12. Street Sewer Connection � - 54. Heater & Vent-Final 13. Rouqh Plumbing - � 74. Rough ElectrioConduit - �56.' Electrical=Final � 15. Rough Electric-Wiring - • 57. Solar System-Final � 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts in Structure � APPROVED FOR PLASTERING. 18: Ducts, Ventilating � . 19. Gas Pipe-Rough & Test �� 60. POOL/SPA SYSTEMS FINAL �. . 20. Roof Framing � . ._ � ' . 27. Roof Sheathin - -- 22. Frame and Flashin - NOTES: . �. � 23. Insulation . � � 24. Lathing & Siding 25. Drywall Nailing - . 26. Plaster Brown Coat � 27. Electrical Power Meter-Final - � 28. Final Electric � � 29. Final Heating & Air Conditioning _ � 30. Final Gas Pipe-Test 37. Final Plumbing ' 32. Water Service-Final ' 33. Gas Service-Final � � 34. Solar pomestic-Final � 35. Landsca e S rinklin S stem ' 36. Sound Attenuation � ' 37. Handicap Regulations � ' � 38. FINAL STRUCTURE & BUILDING . $ ,. � 39. Special Requirements Completed - � 40. Electric.Release to Edison " � 41. Gas Release to Southern California Gas Co. � - 42. CERTIFICATE OF OCCUPANCY ' No _ Date Applicant to fill in dll s CITY OF COSTA MESA GERMIT NO. CUNSTRUCTION PERMIT g � Address � Address 0 License No. 1 within �eavy borGer Il�es anG ".n all apOrop�iate Eaclardtionz. TRACT NO. LOT NO._ BLDG. NO. � - �O I t'S`� � I TVPE OF CONSTRUCTION � ❑ NEW ❑ ADD - ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑,DEMOLISH ❑ OTHER DESCRIPTION OF W�RK�_ Contractor p � _ rnone � �y- - TVPE OF PERMITK_ - - , �-� . �Addrei5 � � O .� . �OGRADING,1�,/T�FOUNDATION �STRUCTURAL -� ,LIGENSED CONTRACTOR DECLA ATI N ' ❑SENANT�LJ'ELECTRICAL ❑PLUMBIfJG ❑MECHANICA I hereby afiirm lbtt I am Ilcensetl �u tler provisioni of Charter 9(com- i . - � .�`, mBntin9 _wit� 5ectiOn ]000) .of DlviSion 3 of the Busines5 antl, " �'OTHER ' Prolesslons .Cotl a my license is in full rorte an effect. pROJECTDESCRIPTION- Ucens Class � � Licens N Q ' - ' "- "' Dat"�On,� 19nature .. , �_ S�. FT. _ ' " . . WORKERS' COMPENSATION D IARATION OGCVPANCV'�'J'�� '� CONSTRUCTION TVPE I hereby affirm that 1 have a ce tificate of consent to selY-Insure or a VACUATION!�O/�'�ZONE �certHicate of Workers' Compen5ation Insurance, Or a cartifietl copy _ 'thereo( (Section 3800, Lab. C.). : �� ///S,�Q�� GRADING CU. VDS. _ ACRES Policy No. ' Company �� - n CertHietl copy IS nereby turni5netl. REMARKS: ,. � . ' �ertifled copy is liletl with tho tlty,8uiltlin9 DiJision. � � � ., . .MPTION FROM WORKERS'�COMVENSATION DECLARATION -- - - ' (lhis section neetl noi be completetl i� [he pe�mit is lo� one huntl�etl � , (E100) or lessl. - � � -. . ' _ . - - -'- ' " I ce�tl(y th�t in the�per/ormante of [h¢ work for whiGh this permit Is' issuetl, I shall not employ any person In any-mannerso as to become - PLUMBING -' PLAN CHECK ' " Subj¢Ct to the Worker5' CompensdtiOn LawS of Californid. _ DafG Si9naturC � � BATHTUBS " - SFIOWERS'� ' ' NOTICE: I! after rtiakinq this tleclara[ion, you shoVltl become zubject . TOILETS . � . VRINALS- ' -' t0 Ihe Workers' Com0en5aLon provislons ot ihe tabor Cotle, you musl -� - torlhwith comply with sucb provisions or ihis permit shall be tleemetl LAVATORIES �DOUBLE CAVS rCVOketl. ! CONSTRUCTIONLENDINGAGENCV � ' " ' "KIT-.SINKS' -- -' DISHWHSHERS-• I liereby affirm that lhera is a construction lentling �gency lor the per SERV ICE SINKS . SUMPS �-� '' ' - (ormante of Ihe work lor whlch tbis permit is Issuetl (Section 3097 Civ. C.). . _ __. _ -. _ _ . _ - - - - FCOOR SINKS ' -" FLO�OR DRP,INS " '" f ' - Lender's Name Gentl¢r'S Atltlre55 ORINKtNG FOUNTAtNS - - ' - ' - ' OWNER.BUILDER DECLARATION. '��NTERCEPTORS"' CLARIFIERS '" - "� I hereby affirm Snat I am exempt irom tha ContractorY License Law for the following reason (Section,7031.5 Business antl Professlons.CoOe: SWIMMING POOL � -�PTRAP --- - ' Any city or county whiGh requi�e5 a permit tV ConStruc[, alter, improve, demolish or repai� any structure, prior to i�s issuance,also re- yyqTER SERVICE - ALTERATION � quires [hC ap4�icant fo� sucM1 pe�mlt to tile d Signetl SfatemEnt that he is Ilcensetl pursuant to the provisions of the Contrarlor's License Law GAS'SERVICE " " OUTLETS ' � (Cbapler 9(commencing with $ecUon 7000) o( oivision 3 of the BuSiness antl, Profeszions Cotle) oc that ne is exemp[_tnerefrom antl the yyqTER�HEATERS- �--BTU OVTPUT - ba5i5 for ihe allegetl exempiion. Any violation of 5eo(ion ]031.5 by any apPlicant for a permit subjecis the ap0��n[.�o_a_civil .penal[y -SEWER�CONNECTIONS --- ' -- '' o' �ot more Ihan live huntlretl dollars ($500). as owner ol the-properiy, or my employees vaith wa9es as tneir SOLAR 4ANK -- COCLECTORS ' , " f .ompen5ation, will tlo the wo�k, antl tM1e structu�e i5 nol intentletl orvt(eretl for SaIC. (SeGtion ]044, Busine55 antl� Profe551ons Cotle: The 'SOLAR PIPING SVS. -� � ' � COObaGtor's licens¢ I.dw tloes not apply [o an oW�¢r Of a property - , who builtls orimproves Ihereon, antl -who tloes sUCh work himself or ISSUE FEE �" - " throUgh his Own employees, provitletl that such Improvement5 are no[ - intentled or offer¢tl for sdle. If, howGver, lhG builtlipg pr Improvement- MECHANICAL PLAN CHECK � is soltl within one yea� of completion, the owner w{II nave the burtlen - ol -provin9 he� tlitl -nol builtl or improve for the purpoze o/ sale). - '- ' �' - - HEATING SVSTEM 0-300,000 BTU . ❑ I, as owner o/ the O�operty, am exclusively contracting wi[h qND DUCTING - - - Iicensetl coniractor3 to mnstruct the project (Sectian 7044, Business 100,000+BTV antl Pro(e55ion5 CotlC: The Contrac[o�'s License LaW tloes not apply to __ ' .- an owner of.property who builtls or improves thereoh, antl who con- REFRIGERATION 0100,000 BTU � tiacls Irom such p�ojecl5 wilh a contrattor(s) lic¢snetl pursuant to SVSTEM. - the Conlractor's License Law). � 100,000 t BTU � ❑ I am exemp[ untlor Section B. & P. C. tor this gOILERS BTU � reason .. . . - - Date Owner SVSTEM REPAIR,ALTERATION - I hereby-certifythdt I hdve r¢atl thisaOP�ication antl 5(ate Iha[ Ihe above EXHAUST SVSTEM MULTIPLE inlormation is c rrecl. I agre to comply with all tily antl munty ortllnancCs antl ate laws relal' g tp'�Onzlruction, antl hereby autM1orixe r¢presentativ oi Ihis city tq/�,M1 t r upon the above mentionetl� - - property fo nspectlon p pqSaS. �� _ _ �,_ _ � Drivers' Li(ense or 55 ��/� I ISSUE FEE .. CMF 0865-46 Wni[¢-Builtling; Canary-Hpplicant; Pjnk-Accounting; Golden�otl-Assesso� • 4754 4/16/82 , 64.02 Jl.; ZONING REGULATIONS A.P. � � — � ZONE � �� PING. REF. $ 0.EAR VARD (TO P/LI '��j /�'� �.(�j / PKG. SPACE R EQ. . PRO V I DED STREET WIDTH i PARK FEE 5� ., �ZONING AVV,ROVtO BV /�d//�JL1=�/ai tiI/� ///,�/ � � ll�^'f // 1 � S[(��' SPEpAL CONDITIONS: � � � � EIECTRICAL " PLAN CHECK - .,� �,� � GENERATOR ' ' "� TRANSFORMER 0-1 KW_ 1-30 KW �APPLIANCE ' 30-50 KW -_50 + KW ' . MOTORS 0-1'HP_1-10'HP � , � (INC.�SOLAR).- 10-SOHP-=50+HP • - FIXTVRES ' 'OVTLETS SWITCHES' -- GAS TUBE SIGNS ' ' " '" � � POLE CIGHTS- ' '- - ' ' " -- - - �POLES METERED -SUB � PANEL'S '- MAIN SUB' - SERVICE - ' "" -'AMP ' "ISSUE FEE - " - " ' • i APPLICATION APFROVED BV -' DATE'" - - ' SUMMARV OF FEES BUICDING-- .��( - PERMIT S��'''=��f "SMIP . § � • S O �PLANCHECK §�'_.2_i='�+ PERMIT � - � ISSUANCE $'- - PLUMBING 5 � �. - - � GRADING - E - PLANCHECK E , _ • , , �' ,, ELECTRICAL S � � 5 • �1 PLANCHECK 'S -MICROFILM S I MECHANICAL' $ . TOTAL FEE E PLAN CHEC�K $ ' LESS AO- � � _ . { VANCEPC S_ F�NAL FEE 5 "' �� r^. '. TYPICAL 6�� CONCRETE BLOCK FENCE Cement Coping Ootional Channel Block With 1-3/8 0 Horizontal Tap of all Fences For Fences 5' o� Less .—�� VettCBars'3/8"'0'ai 4''-0:' O.C.., b i .� �r :'�.�� M1.!.'�6-y°,�l,�. Fbr fences�.�ghei TBan 5' � —'- Vert. Bars 3/8" 0 at 32" O.C. x=>•• hi`GG7 ii: Y'll? Fill Cells SolidfWith�rou r��q Where Steel Occurs Y .t3� :4SC5 .C3R C:t P,)3UL�3 Reinforcing Steel Shall c Cbnform to Sec,A-15•39. --- A Ex::svW� 1� NATURALGRADE TWO 3/8" 06ARS CON7INUOUS TOP & BOTTOM ALL STEEL MU$T BE TIED IN PLACE AT TIME OF TRENCH INSPECTION. x .T�.' o'I.o'_� � � N .-i - > �WIDTH It•� _� SEE CNART '+ BELOK' Iole \ n ' .. e. .� �a � p a 0 � Ie z GENERAL- NOTES MORTAR : p�e Part Plastic Cement, and T�ree Parts Sand GROUT : One Purt Cemenf Three and One Holf Parts S�and COPING: One Part CemeM, Three Parts Sond CONCRETE: y�rei I Mixed ;:2- I/2 : 3- I/2 Max. of 7-I!2 Gollens ct VVafer Per Sack nf Cement GROUT MAV BE POURED FROM THE TOP OF THE FENCE IN CELLS WHEFE STEEL OCCURS. CELLS AND AREAS OF HOR120NTAL REIN- FORCEMENT SHALL BE CLEAR, CLEAN & FREE OF ALL MORTAR DEBRIS, E7C. PROVIDE CLEAN-0UT AND INSPECTION HOLES AT THE BOTTOM OF CELLS CON- TAINING VERTICAL REINFORCEMENT. BONDS SHALL BE PROVIDED BV LAVING BLOCKS IN STRETCHER COURSES SO THA7 �VERTICALJOINTSALTERNATEIN EACH COURSE. �EPTH OF EAR7HiCOTH I/3 iHE HEIGTH OF FENCE BELOW BOTTOM OF FOGTING. SCALE: I/2��= 1� FOOTING REQUIRFMENTS CHART WALL HEIGHT . . . . . . . . . . .6�. . . . . . . . . . . . 5�. . . . . . . . . . . . 4� . . . . . . . . . . 3� . w�orH . . . . . . . . . . . . . . . ia" . . . . . . . . . . . ia" . . . . . . . . . . . i2". . . . . . . . . . . i2„ THICKNESS . . . . . . . . . . . .10��. . . . . . . . . . . .10�� . . . . . . . . . . . 8 ��. . . . . . . . . . . 8 �� DEPTH OF EARTHTOOTH . . . 24'� 20�� . . . . . . . . . . . 16��. . . . . . . . . . . 12u SPACING OF EARTH700TH. . 12� . . . . . . . . . . .14� . . . . . . 16�. . . . . . . 16� 1� OWNERS NAME: _SHE/2M�"N _ _ _ _ _ _ _ C��y 0� �OJIQ �IiSQ California JOB ADDRESS c��=�0211U � �_ �� PERMIT NUMBER:_ _ Building Department SIGNATURE _ _ _ _ _ _ _ _ _ _ _ _ � _ r�o:�•, n��a�-zr�._r_e> STRUCTURAL APPROVAL ONLY SEPARATE PERWfTS �RE REQU1RcD FOR ELECTRiCAI_, PLll�ABING, HEATI^:G, vFtiTiIATIMG AND REFRIGERAiIOtJ 'NOR}( P"':��%s�l�� Tt',_4.../�.L�GS� THiS NU,r3�R "' S? F,CCOi41PANY ALL 1hSi �CifD:d REQUESTS � __. . _ _ - ;'lii� hc ; ERS( wG suca�s� SAFETY DE CqNSULTED FOR . •-. _ pPPROV�D [ryy of Costa Mesn Building Aept. �/�. � v SOB AT ALL TIMES TM�E PUNAN�EST eE ON MAKE NO CI-1 Wl�HOUT PRIOR APPROYAL OF DEPT. THE ISSUANCE OR GRAN[ING Of A PERMIS �R Ap��' OF PIAdS ANO SPECIFICATIONS SNALI N07 p� �� TO BE A PERMIT fOR, OR f N APPROVAL OF, Of ANY OF THE PftOVISIDP:S OF �HtS CODE. NO PER'd SUMING TO GIVf AUTNORITY T� ��jE nR ��` � pRRYtuSWHE WORK OR USE WN CHLLiT AUlNORt� �� THE ISSURNCE Of A PERMIT BAS� � R�� SPEC1FiCATID�S SHALL NOT PREVfNS S1SE �u��'' �Et�� fROM 7HEREAFlER REQUIRING THE ��Z�� E� IN SAID PLRYS AND SPECIFICATfO'.�� t, �� BUIIDING OPERATIO��S CODE R �E � � �� IN YIOLATIC j�j�T �udi��n c� rtrry) G9�p./t �/t e2ca.�as-�- 3Z' NESIUENCE �8G 2 �iUd J�� ' STREET RESIOENCE � �PR�� CI1Y OF COSTA MESA I PLANNNIG OEPt. uiuEcr ro etua. o�r. eeD. ouxro� a ru�wo RE9�DENCE �ec�cP � o Ci� `,Qe«��..�cP�� , . '��'i�b� ��/�j, � JUL 31196f �ja" COSTA MESA BUILDING-SAFETY DEPARTMENT {�ANCE DEPT. P. o. Box s,� �o�A M�A. �,,��+�� ITY Of COSTA MESA For Applicanf +o Fill In Complefely PPLICATION FOR PERMIT TYPE OR PRINT gU1LDING BUILDIN %L GC ADDRESS GOILC/L% COSTA MESA. GALIFORNIA FOr Of'IfC@ USB OIIIj� OWNER SET%�' TT• ✓EN A6�8�� No. � pEn��o. �4 MAIL //�1 RE�IVHD BY DATe N8G81V6D DATH 168UHG A�DRE55 L' � / 02 � -,��-G! TEL.�/• BUILDIN6 (� �/ - ' CITY � D$' f{ -$� NO. - 3� qDDRH88 G' ARCHITECf ie�. COSTA MESA CALIFORNIA ` OR ENC�INEER NO. AUDRE6S RIRB 1/ ZONE TYPE V GROUP / CONTRAGTOR ES {'E p L E APPROVED BY DATE AODRESS o2 c . ZONING CITY G T CS ZO�( ^ I I Pl-AXe Z I BB Lo�NO (y /' , STATE TEL. O �qa�� s �� O� LIC. NO. i/ NO. � �� 1! oe9CRIPT1oN � � SIZE ��OO S. F— I NOW ON LOTOs O ��. OF LOT A. P. NO. ' USE OF YAROB EVES EXISTING BLDG. APPROVED ALLOWED BHTBAGK LINE FROM / 1¢M[R LIN6 tT.I �/ �� ceefiea oP eirteer REAR YAR y M FRONT 7/ FT. IN. SIDE YARD LEFT / �/'�,�,+ I RIGHT � R.SIDE �� FT. � IN. DESCRIPTION OF WORK �,5- �r � u �.s�oe g�ZE��NG �SSE S ��OOMS � STORIHS � ' ` CO ER'INGWALLWOO COI C VER�NG�� %% L USEs F BUILDING AND WORK TO BE P8 FORMED J �rGG E' M/L� �n��c' �Y Gq�2.l�E' /j_�5'3AN, ST�.YOAiPD PL.¢.y Sso - y�/ C� 1 HEREBY ACKNOWLED6E TXAT 1 XAVB RBAD TNIB APPLIGTION TryQ AMOUNT BHOWN UNDER VALUATION I! POR TX! AND BTATE TMAT THE ABOVE IB GOHR¢CT AND AGPBt TO COM- pUIiPOBH OP eeTAeLI9N�Na A v6qNIT FEE ONLY. PLY WIiH ISY OPDI CE9 ND 9TAT8 lAW6 MH ULATINO Bu1LDINo CO BTre ION. �/ // VALUATION / SIGNATURE OF �/v PERMIT FEE $ � F� � /y�y N PERMI � $�/� �// � P�N GHECK $ /" � e � �i AUTN IZED AGENT TOUL FEE ��' � 4