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Home My WebLink About108 DANBURY LN - Building Permits(714) 754-5273 • Fax (714) 754.4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 108 DANBURY LN Suite No Vicinity: Parcel Number: 41916321 Applicant: ANDREWBEEKER,16 Address: 1308 LOGAN SUITE H COSTA MESA, CA MECHANICAL PERMIT Phone: 714-979-2070 Zip: 92626 Owner: SCRANTOM,CHARLES Q SR & HELEN C Address: 108 DANBURY LNC. . , �- = - Phone: 714-392-6656 COSTA MESA, CA Zip: 92626-6519 it SUITE H Phone: 714-979-2070 „ COSTA MESA, CA - Zip: 92626 ` License: 754456 - SCOPE OF PERMIT " CHANGE OUT 1 FAU LESS THAN 100 K BTU FOR SFD. Contractor: KLONDIKE AIR INC Address: 1308.LOGAN Status: ISSUED Applied: 12/202005 Issued: 12/20/2005 ISSUED BY:�_ ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU . Repair/ All Cooling/Heat Inst / Rep. Recess Wall. Htr Refrig Sys <100 k BTU. Refrig Sys >100 k BTU. Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers> 10000cfm Floor Furnace -- Floor or Suspend Heater k" Quantity .. - $23.50 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $14.80 1 $0.00 "-0`-_ $0.00 0� $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00'. 0 $0.00 0 $0.00. 0 $0.00 0 4 r6 FEE SUMMARY 'Repair/ Alt Absorbtion Unit, Repair / All Refrigeration Unit Ventillation System Evaporative Cooler Commercial Incinerator Domestic Incinerator -Compressors/Absorption Systems Up to 3hp/100k BTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU , 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to %hp Over 50 hp Other Mechanical Fee - Investigation Fee- -" Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS/ SPECIAL CONDITIONS Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 " $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00. 0 $0.00 $0.00 $0.00 $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (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 under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Fallure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7645626 2446-46 (6100) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the for which this permit Is Issued. have and will intain workers• compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' co pensetion Insuranc-e,/carder anAtl policy number are: '•arrigr: `� _.J' li _ I�iJN l� Pol'wy lif— 22Q–�� . (7)us°section need n_ot be completedif the permit /s valued of one hundred dollars ($100) or less.) ❑ tFl n the perfor of the worwt�! issued, I shall not employ any person In any manner so as to become subject to the workers' compensation Taws of lifor Ia, and a subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply these pr ision AppiTM 5t n re: 'rDate: WARNINGi.FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affi that I am licensed under provisions of Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force anal` tt 7 �i �(NClass If Cohtrec"` t"ods,,Signature: G�a�....� Date: 7 –?_ [7— CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date_: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................_............................_............................................................................................................................................................................................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................. ......................................................................................................................................................................................................................................................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP, by businesses which are required to register acutely hazardous materials with the Fire Department. ....................................................................................................................................................................................................................................................................................... ............................................................................................. 4 Ii en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ..................................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa plication aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? n Yes a No (Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ...............................11...11.......................1111.........................................................................-...................................................... 6 Will any part of the facility to be Constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................ ..............................................o.r...................................................................................h.!-.............................................. 7 a a permit from the South Coast res Quality Management District or other air pollution control district n agency Is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? []Yes ❑ No 6 (IF'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si nature Of MI_Dwner(s) Date ((u7cypr~ WhWze&AppliGBFIV Date CODE P. INSPECTION TfPE DATE I11fR1ALS CODE_t INSPECTM'NPE 1616 Fixed System Final Fire Prevention 206 Final Mechanical )a�� V 1266 Pool Spa Final 208 Final Plumbing P 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 222 Final Site ' 204 - Final Demolition. - 250 Final Building/Occupancy PROJECT ADDRESS: 108 DANB URY LN UNIT: OWNER'SNAME: STEWART, RAY N ADDRESS: 5062 HAMPTON CT WESTMINSTER,CA 92683 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: STOUT ROOFING INC (310)923-6775 ADDRESS: P O BOX 4309 DOWNEY CA 90241 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full lorce and effect. CITY LIC.: W597 STATE LIC.: 4025367 1_, LASF s;_C 3 EXP: 0/95 Date: �O Signature.-if/�1Y�/C� WORKERS'TION DECLARATION: I hereby affirm that I have a tertilieate of consent to self -insure or a certificate of Workers' . Compensation IBcuraoee2gc a.i�tified copy thereof (Section 3800, Lab. 65/19/95 POLICY NO.: JA CCI LG G tl EXP. DATE: COMPANY: ,,--yy ❑ Certified copy Is hereby furnish d. L? Certified cc CY is IlM/1 ed�]wlfh t/hee city B/ullOing DlvviiS�ion. Date: � -V Applicant .fl / Y // /.,.I � EXEMPTION FROM WORK RS' COMPENSATION DECLARATION: (This section need not be completed if the Permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: m nation provisions of the Labor NOTICE: u alter making this declaration, with s you should become subject permit to the Workers' re pe s p Code. you most forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve. demolish, Or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale) I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). 1 am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: IDate: Owner'. I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection ureases. (0 Dale: _� Signature:�G!� �L Driver's License or Social Security a: 1641.46 While—Building. Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069604 PERMIT NO: B 069604 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION : T/O RESTH 6 REROOF W/COPM S HOT MOP SQ FT: 2,508 CLAIM VALUE: 2,508,00 CALC—VALUE; 2,508,00 GROUP OCC: R-1 / COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED 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--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING RES: PROV: PARCEL: 41916321 ZNE: REF NO: PLANNING N TES> PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54,00 > 50 9E 9E 9E 49f 9FM JE 9E 9E 9f♦f*49Eif aE iE*9E 9f 949E*9E M 9E*♦E 9F 9E aE 9E 9E Mif aE 9E 94♦f iE iE 9F 9f 9E 9f 9F 9E♦f 9f 9F*9t*9E 9E 9t 9t*iF 9t �!*9E 949E**9r 949E*9t 9E aE 9E 9E 9E*9E iE**9E 9t 949E 9E 9t 9t 49E r9t 9t 9E if 9E 9E 9E it*9E 9E 9E 9E*94**i49E***9E 9f 949E 9E *9E 9Ek 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 SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 DATE: BUILDING APPROVED BY : APPLICATION ISSUED BY; 9E 9E 9E 9f 9FiE 149E iE 9t 9f 9f 9f 9F'9E if 94 iE iE iE 9t 9f iE 9E 9E 9E 9E if 9t iE 9E 9F 9E 9f 9E iE * 9F 94 9F 9f * 9f 9F 9F 9E it 9E 9E 949f LEGALIZATION;N BLDG PMT PLUMBING PERMIT 54,00 DATE: DATEir E E S U M M A R Y STRUCTURAL SEGMENT:Y ELECTRIC MECHANIC FIRE SMIP/RESP GRADING 50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 54,50 0,00 0,00 54,50 54,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54,00 50 9E 9E 9E 49f 9FM JE 9E 9E 9f♦f*49Eif aE iE*9E 9f 949E*9E M 9E*♦E 9F 9E aE 9E 9E Mif aE 9E 94♦f iE iE 9F 9f 9E 9F**94 k9E 9E 9E k 9E 9F 9E 9E*af*k9E iE 9E 9E *9F i49E 9E 1494 if**94 iE iE 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 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 2,508,00 END OF FEES 01 OD170692-00170693 T017 54.50 DATE: 10/28/94 TIRE: 13:30 - (:QNSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector r.,OL &SPA APPROVALS Permit # Date , I Inspector 1 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2, Soil Pipe�Undrgrnd. 53, Steel Reinforcement - 1 Electrical Conduit utility-Undrgrnc{. 54. Forms .4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' 5.=Steel Reinforcement 56. Rough Plumbing & Pressure Test . .6,_ Rfectrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE -' J. 'Footings 58. Electrical Conduit-Undrgrnd. 'Foundation - - 59. Gas Pipe, 17 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P-Trap, ❑ Undrgrnd. I ; 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 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Sar Ceiling 69. POOL/SPA SYSTENIS FINAL I 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -APPROVALS . _ Permit 20J,Rough Factory Fireplace ' .1 a: ,, r 21, Oucis, in Structure; ... I -'70. Undeergg round Hydro 22. Ducts, Ventiiatirig _ ` :71. Product Pj Ping 0Gas ❑Qil 23. Gas Pipe-Ro_: h &' Test 72. Underground Flush 24. Roof Framing '• j 73i, Undergrrid. Storage'Tank O Gas ❑ Oil 25. Roof Sheathing >•'; L •�6-�5Gwl�.74:,Operhead Hydro 26.7Bar Ceiling {StructuraU &.Nlonocoat^ r 75:'Dry Chemical 27. Frame and Flashing 76. Dry Stanbpipe 28. Lathing & Sidingnr - - .i; t = - •• 77.' FIXED SYSTEM FINAL 29. Insulatigp y 78. FIRE PREV. FINAL •30, Drywall Naiiino f, HEALTH DEPT'. REQUIREMENT 31, Plaster Brown Coat' ';k ;' _79.'FINAL INSPECTION 32.. Electrical Povyer MaterrFinal - 1 • ,-80,.-FOOD CERTIFICATE ISSUED 33. Final Electric "Nofes: 34, Final Heating'& Ain Conditiamng 35. Final Gas Pipe-Test' I' - 36. Hood or Canopy,. 37, Final Factory Fireplace .; r;. ' ' 11 I 1 38. Final Plumbing _ i - 39. Water Service•Final« i t ' 40. Gas Service-F,inat;' : ., - o 41. Solar Domestic-Final •• '-` -' 42. Backflow Preventers 43. Backflow Irrigation* '^ r ,' 44. Landscape Irrigation System,, 'r' - •- } - ' 45.• Sound Attenuation -46. 'Handicap,Regulatrons 47. FINAL STRUCTURE&BUILDING 48. FINAL PLANNING ; 49.-Electric Release to Edison .50. Gas Release to Soutpern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. _- Date V ,PkVDhj AP No. LOT 23 TRACT S160 FIRE ZONE DESCRIPTION OF WORK reB watt "ir INSPECTIONS Signature D TZ GROUP I&J TYPE V ZONE Soil S < Gas 7, SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Water Rough Com. 'Reffik. D Air Cond. O Rough Heating – Rough Plumbing I Miscellaneous__ Prop. Swr. Line ❑ House Con. ip'St. Swr. D - _ ;C 4 1963 S rinkling System Construction Pole Underground D Power D Rough Wiring f< Trencheslo Forms D Steel Reinf. D Floor System Bond Beam D Steel Reinforce D Sheathing Frame and Flashin Lathing — In Out _ Plaster, brown coat e 6 Refrig. D Air Con. D Final Heating, Final Plumbing Fixtures,Fi al Final Gas Test a– Electric Fixtures, Final _ Budding, Final I OCCUPANCY ?2184 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA OWNER San Vista Building Co. MAIL 1166 E. 58th Street ADDRESS n,r Los Angeles 11 .NL. AD 37187 Via ODorto NO. OF BLOOS. SETBACK LINE FROM l 3 1 CENTER OF STREET 1 REAR YARD 61DEYARDI LEFT 0 I RIGHT 0 DESCRIPTION OF WORK ucw I X II e, Tre eT,nv I II enn,r,nv M� 2 I I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE TH THH ABOVB le CORRECT AND AGREE TO COM. PLY WITH AL CI Oq DIN ANCHS AND STATE LAWS REGULATING BUILDING COq STRU ISN. t SIGNATU RE OR _ 1 FEE RECEIVED. . MAY i 19en FINANCE DEPT. APPLICGffObQ FFM3P1kAWSA BUILDING For Office Use Only RHCKIPT NO. I -PEAWT NO. ISSUE 1 1964 ZONING ic—. I PUNe IS BUN.DIry /l DESCp1If10N Tract 5160 - Lot 23 2 2 NOTE: NO EAVE OVERHANG SHALL BE LESS AN SO' TO SIDE 3 REAR P. L. EAVES ALLOWED (U. B.C. REQUIREMENT) dc YARDSAPPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING L. SIDE .� FT. FT. In REAR \/ FT. FT. W ` DISTANCE BET. BET. MAIN B W MAIN BLDGS. ACCESS. BLDGS. VAR.# DATE � / fi Q� C. U. P. iF APPROVED O, APPR �NMkDATE i W a BY 1 a u w a a �I5-L/ '^ � ?/ SQ. FT. YOYJ THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 2 O PURPOSE OF ESTABLISHING A PERMIT FEH ONLY. O VALUATION / Q PERMIT FEE $ H •.'11 D O PLAN CH ECK S �� o 4