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Home My WebLink About2432 BRITTANY WOODS LN - Building Permitst f.� 40 M�S t � o, ' -- t u. � �� »a> �sa-sz�3 • Fax (�ia� �sa-aess CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job Address: 2432 BRITTANY WOODS LN Suite: Viciniry: UNITS 2432 THRU 2438 Parcel Number: 43913210 Appliwnt: COOTER, LYLE Address: 23015 DEL LAGO Owner: Address Contrector: Address: Arch : Address: LAGUNA HILLS CA Zoning: Phone: (714) 5831858 Zip: 92653 BRITTANY WOODS CONDO ASSOC. 2432 BRITTANYWOODS LN - � , , Phone: \ . COSTA MESA, CA � Zip: 92627 PRO-TECH WEATHERPROOFING 23015 DEL LAGO LAGUNA HILLS CA Zip: 92653 Phone: Phone: (714)583-1858 License: 620476 • . � Eng: ' � Address: PERMIT�IUMBER � �8�00-00025 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 01/O6I2000 Issued: 01IO6I2000 Phone: Zip: License: license: SCOPE OF PERMIT � REROOF EXISTING 4-UNIT CONDOMINIIIM (70 S�). REROOF WITH STONE COATED STEEL BY -METRO TILE- OVER EXISTING LAYER OF SHAKES. ' � � 4•UNIT CONDO INCLUDES: 2432,2424,2436, 8 2438 BRITTANY WOODS LN. � Plan Check: $0.00 Permit: $335.25 SMIP Res: $2.10 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $337.35 SETBACKS MAIN STRUCTURE Frant 0- 0 ACCESSORY Front 0-0 Rear 0- 0 Rear 0- 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Calc Valuation: Claim Vaivation: Right 0-0 Right 0-0 szi,000.00 Szt,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap accass requirements under Califomia 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 1 BO days, or if work is suspended or abandoned for e penod of 180 days. INSPECTIONS: In order for the work authorized under this permi� to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetlona and tinel approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiretion of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATION DECLARATION: I hereby aHirm under penalry af petjury one of the following tlaclarations: . � � ❑ I have antl will maintain a cehifiwte of consent to setl-Insure for workers' compensation, as provided lor by section 3700 of ihe Labor Coae, for the peAortnance of Ihe wark for which this permit Is luued. ' � I have and will maintain workers' compensauon insurance, as required by secGon 3700 ot the Labor Code, tor Ihe pedortnance of Ihe work for whic� this permit is issuea. My workers' compensation Insurance carner end policy number are: , 1 G Carder. V� �t n�N' O��=: PolicY Num�er. � L 3'J� 7'"I �/?? (This section need not be complet�tl il the permit is velued a( one huntlreC Uollers ($100) or /ess.) ❑ I certly that In the pertortnance of tha work tor which t�is pertnit is issueQ I shall not employ any person In eny manner so es to 6ecome su6�ect to Ihe workers' compensation laws of Califor�ie, and agrea that If I should become subJect to t�e workers' compensation provisions of Section 3700 of ihe Lebor Code, I shall lorihwith comply with thesa provisions, �% —� Q Applicent Signature: /1'i Dete: �( �-� WARNING: FAILUPE TO SECURE W05KER ' PENSATION COVERFGE IS UNUWFUL AND SMHLL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND GIVIL FINES UP TOONE HUNDRED THOUSAND DOLIARE (5100,000), IN AODITIIXJ TO THE WST OF COMPENSATION, DAMFOES PS PROVIOED F-0P IN SEGTION 3]OB OF THE LABOR CODE, IMEREST. AND ATTORNEY'S FEES. LICENSED CONTRAC70RS DECLARATON: I hereby effirm Ihet I em Ilcensetl 4ntler provisions of Chapter 9(commencing with Section 7000) of Dlvision 3 of Ihe Business and Profession Cotle, entl my license is In full lorce antl eHect. lic. x 1 2.0 �I �7 /e Class N /' .� 5' �l 7 7 Contrac�oYs SignBlure: /}� Oate: _/_ � - OoT CONSTRUCTION LENDING AGENCV: ❑ I hereby attirtn tha[ there is a �onstruction lending agency tor Ihe peAormence of Ihe work tor which this permit Is issued. (Sec. 3097. Civll Cotle). Lendar's Name: Lentlefs Address: SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm t�at under penalry of perjury t�ai I am EXEMPT FROM 7HE CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or county which requires a pertnit to consiruct, alter, impmve, demolish, or repair any simcWre, pnor Io its issuance, also requires the appliwnt for such pertnit to fila a signed siatement that he qr sha is licensed pursuant to the pmvisions ot the Conirectors License Lew (Chepter 9(commencing wlth Section 7000) of Division 3 of the Business antl Professions Code) Or that he or she is eaempt thereimm antl the basis for t0e allaged exemption. Any violation of Section 7031.5 by any applicent for e permit sub�ects the applicant to e civil pe�alty of not more than five hundred dollars ($500).): ❑ I, as owner of ihe property, Or my employees with wages as thelr sola compensation, WILL DO THE WORK, antl the structure is not intended or ottered for sale (Sec. 7044, Business antl Protessions Coda: Tha Contractors License Lew tices not apply to an owner of pmperty who huilds or improves theraon, entl who tloes such work himself or herself or through his or her own employees, provlded that such improvemenis are not intended or oNeretl for sale. If, however, ihe 6uildin9 or improvement is sold within one year of compietion, ihe owneo-builder will have ihe �urtlen of proving ihat he or she did not build or impmva fa purpose ot sale.). ❑ I, as owner of the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the prqect (Sec. 7044, Business and Pmfessions Cotle: The contractors Licensa Law tloes not apply �o an owner ot property who huilds or improves thereon, and who contracts for such project with a contracbr(s) license pursuant to ihe Contractors License laws.). ❑ I am axempt untler uc. Signeture: Owner ID verifiad 6y drivars license. ❑ Vas ❑ No Business and Profassions Code for this reason: Venfication of Ownership by (rype oi document, i.e. - property �ax 6ill or dead): Drivar's License No. Date: Expires: DIVISION OF INDUSTRIAL SAFE7y PERMIT LERTIFICATION: ❑ I hereby certify that no excavation five (5) or more leet in depih into which a person is raquiretl to descend, will ba mede in connection with work authorizetl by ihis permit, antl that no huilding Structure, swttoltling, felsework, or demolition or tlismantling thereot, wlll be more ihan ihirty-six (36) feet high. (C�ap. 3.2, Grp 2, Art 2, Sac. 347, Title 8, Calitornia Administrative Code). ❑ As owner-builtler, I will not employ anyone to tlo work which woultl require e permlt from the Division of Industrial Safety, as noted above, unless such person has e pertnit to do such work from ihe tlivision. Slgnalure: Da�e: Division of Intluslrial Sefe�y Pertnit Number: CERTiFICATE OF COMPLIANCE AND AIJTHORIZATION OF ENTRV: I certity under penalty of perjury that I have reatl ihis application and state that the infortnation given is corcect I agree to comply with all siate laws anC ciry ordlnances relating to builtling conswction, end authorize representatives of the Ciry ot Costa Mesa to enter upon the abova-tlescribed pmperty lor insppction purposes. I agree not to occupy or allow occupancy of eny bulltling authorizad by this permit until final inspection. COOE1, INSPECTIONTYiE 1616 1266 Of Lelial Owner(s) , Date Fixatl System Final Fire Prevention Pool Spe Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition 26ag.a8 Ea� II�dLS I�'--- � COOE 1 INSPECTION TYiE 206 Final Mechenicel 208 Final Plumbing 270 Final ElecMcal 212 Final Fire Preventlon 220 Finai Planning Approvel 222 Final Site 250 Final Building/Occupancy Q9IE irmm��s � CITY oF cosTA n CON TRU TION PERMIT . Project Address � Applicant'sMailingA ress � �/ � Owner's Name Phoned�(.�v / Address Arch/Eng. License No. � _ Address � f Conttactor'sNam� � Phoney Address (mailing) Ciry LicenSe No. LICENSED CONTRACTOR DEGLARATION � I her¢by affirm IhaL 1 am IicenSeU untler O�ovisions of Charter 9(commencing with seclion 7000) of Division 3 of lhe BuSiness antl Protessions Cotle, anC my license Is in fu antl effect. LJcen L e R Date Si9nature ,WORK RS' MPENSATION DECLARATION ' I hereby aftirm that t have a certifiwte ot mnsent to self-insure or a certificate of Workers' Compensation Insu�ance, o� a�certif� Opy �th��ction 3800, Lab.��^�� Policy No. �� _'___�_�.� —_ Company �¢rtifietl coOY 15 f eetlbwithrthehc tlY � wn.�f ��j�, Date - APPlicant ��_ .�//�� / EXE TIOA�RKERS' COMPENSATION DECLARATION (This sec[ion naetl no[ be completetl if ihe permit is for on¢ huntlretl (E300) or less). I certlfy tM1at in the pe�(o�mance ot the wo�k for whlch this perm�t is issuetl, I 5M1a11 not employ any p¢�son In any manner so as to become zubjetl to the Workers' Compensation Laws ot Calitornia. Oate Signature NOTICE: It, atler mdking this tl¢claratiOn, you Shoultl become Subject ro lne Worke�s' ComOensation p�ovisions of the Labor Cotle, you muSt forthwith comply wilh SUGh p�ovi5ion5 0� this pe�mi[ snall be AeemeO revokeG. CONST(1UCTION LENDING AGENCV I hereby a(/lrm that there is a construction Ientling agency tor tne partormance ot the work tor whlch thlz permit i5 i55u¢tl (SectiOn 309]'Cfv. CJ �entler's Name � Lontler's.Atltlress OWNER BUILDER DECLARATION I hereby af(ivm that I am exempt irom tne Con[ractor4 License Law fOr the following reason (Sectlon 7031.5 Buslness antl Professional Cotle: Any clty or county whiGh requires a permit lo con5trutt, alt¢r, ImOtove, Demolis� or repalr any structure, prlor to Its issuance, also requ(res tne applicant tor such permit to tile a signetl slatem¢nt thdt ho/She Is-Iiceni¢tl OurSuant to th8 prOVISiOns of tha Contractor'S License Law (Cnao�er 9(tommentlnq with Sectlon 7000) of 7lvision- 3 ot th¢ Bu5ine55-antl Pro�e55ion5 Cotle) or thdt'hG/ShG is exempt herefrom antl [he basis tor lhe allegetl ex¢mptlon. Any violalion of $ectiOn 7031.5 'by any applicanl fOr a p¢rmlt SUDjecti tne applicant t0 d Civil �enalty of.not more than Bve �untlretl aollars,(E500). 1, as owner ot the Prope�ry o� my Cmploye¢s wlth wages as thei� sole compensation, will tlo.the work, antl Ihe structure Is not intentletl or o/teretl � for sale (Sectlon 7044, Business antl Professional Cotle: Thu Contractor's �• License Law tloes not apply to an owner.of a Oroperty who bulltl5 or imprOves thereon, antl wno tloes such work nimsel//hcrselt or tnrou9h his or ncr own employoes, provitled that sucn Improvementz are not intentl¢a or offeretl for sdl¢. 1f, howevCr, the bulltling or imp�ovement Is soltl wit�in one yea� of com- pletlon, the owner wlll nave lhe burtlen of provin9 he/she tlltl not buila or Im- � rove for the purposc ol sale). �� I,-as owner o/ the property, am exUuslvely contractin9 with Ilcensetl con- . LIdCL015 t0 COfIStlOCI th! pfOjBCf ($CCII00 7044, BUSiO253 dntl PfOtC5Ti0lIS COtl¢: Tbe ConVactor'S License l.aw does nOt apply to an owne� of pwperty-wM10 builtls or ImD�oves thereon, ana who contracts for such projects with a con- tractor(s1 ucense pursuant to me Contractor's License Law). I am aware tnat , proof of their Worker's CompensaHon'insurance shoultl Ge provltled to me. ❑ I am exempt unUer Section - B. & P. C. for this reason � � Date ' ' Owner � I hereby certify i�at I have reatl this 5ppiiwtlon antl st5te that the abave iniormation is correcL I agree to compty wiN all clty antl county ortlinances i antl.xtate laws relating to builtling construction; an�l bereby authorize repre- senta[ives of ,[�Y �o enter� VPon the abyve-mentionetl Oroperty _fAr inspectian p s ' Signature Drivers' License or 55 CMF 0865-46, rev. 10/84 to fill in ail spaces those wit�in �eavy bortler lines anE si9n all a00/a0riate Eecla�atians. TRACT NO. � LOT NO. UNIT NO' TVPE OFCONSTRUCTION NEW 'ADD ALTERATION REPAIR � �❑ CONVEIi510N ❑ DEMOLISH ❑ OTHER AP ,� ' � DESCRIPTION OF WOFK/USE OF BLDG. � S Main Buildir TYPE OF PERMIT GRADING�UNDATION STRUCTURAL T Flont ❑ TENANT.❑ ELECTRICAL PLVMBING ❑ MECHANICAL B Rear ❑ OTHER C Rlght PROJECT DESCRIPTION� Scl. FT. oCCUvarvcv CONSTRUCT,IONTVPE VALUATION�$ S LCft ZONE 'GRAOINGCU.YDS. IiCRES p�ng.Ref.# � Remarks: � � � � . Plannina Nmcc� Sink � �- <flow Preventer � <flow Irrigation . ltubs •— . . � ifiers ' iwdsher ' � .- F�OOf �f21O5 . ' Floor Sinks � uas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains I � ' Reinspeclion.Fee $15 Duct � Under Ground Duct. Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0-100,000 BTU 0100,0006T �, � Reinspection Fee � � �$15 Builtling; Canary - Fpplicdnh Pink - Accountin9; GolGenrotl - As5e55or Showers Service Sink Sewef Cap Sewer Connection Solar Collectors � Solar Piping - Solar Tank � Swimming Pool w/Spa Urinel Water Closet Water Hearer �Water Service Auto-Wash laue Fee Hood or Type 1 � � Canopy Type 11 ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration �Fire Dampers flegisters � � Iswe Fee —FEES � $ 3 $ _3 ., El Automatic Washer Caristruction Pole Sut Cookin9 Unit Dishwasher . � ' Dryers �Gas C Fan • F.A.U. ' Fix[ures - ' Device Boxes Outlets Switches Garbage Dispoul Generator DO-5 i �3439 9/19/86 i � 'Accessory Building: ' ' 5000 2one. _" Z O N I ' N � G R E � M T S E Transformer ❑'15-50KW � I ' � I - ❑ 50+KW _, Meter ❑up to 100 amps Meter �over100amps . _ � Sub Panel ,: � ' Motors�0-1HPO1'/:-8. � �Ina Solar �9-15 HP �j6-15� KW L15�15 KW � Reinspeetian Fee � DEVE�OPMENTSER 2oning Approved By_ Building Approvad By Appliwtion luuad ey_ Pole Light • � � Range 'Sign " . _• . _' Sianding Sections ' ' Trash Compactor . �$15� � � Issue Fee CES REDUIREMENTS: � s3 I — )ate � SUMMARV OF FEES - � ._ . � , BUILDING PERMIT $ . 'SMIP . $ PLAN CHECK $ � � PERMIT, � PLUMBING _ $ �� ISSUANCE. $ , PLAN CHECK 25%. $ ' �ENERGV-P.C. $ ' ELECTRICAL � $,� ` � GRADING -. $ ' � � PLAN CHECK 50% $ : MICROFI�LM _ $ �j�/� � MECHANICAL $ `i , TOTALPEE , $ _� PLAN CHECK 25% $ �� , � ' 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 Gmd. 57. APPROVAlTO COVER-GUNITE ' ' � 7. Footings 58. Electrical Conduit-Undrgmd�7, � - 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test: �., 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O�E)ndrgrnd. u.. , 10. Structural Floor System , 61. APPROVAL TO DECK ( j , 17. Property Sewer Line & House �nnection 62. Backwash & Receptor-Final:i 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-Flnal � 16. Rough Electric Wiring -� 67. Fencing & Access Approval 17. Rough Wiring Sign 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24: Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing � 76. Dry Standpipe , 28. Wthing & 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-Pinal 80. FOOD CERTIFICATE ISSUED - 33. Final Electric Notes: � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' � � � 36. Hood or Canopy 37. Final Factory Fireplace _ 38. Final Plumbing ' y,�p.Y( L�,�,j � � � 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer � ' ' 43. Backflow Irrigation • , , • 44. Landscape Irrigation System • , � � � 45. Sound Attenuation • 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING � 48. Special Requirements Completed . . , � ' 49�. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co � , 51. CERTIFICATE OF OCCUPqNCY � No. Date , .- � BLDG a 5�� oEc -,-„�"„—sqoo 3,3� ;*� i os.a8 4 � � COSTA MESA BUtLDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely - Use Ink Only RECEIVEO BV DATE HECEIVED D TE ISSUED '/ BUILDING �/b � fL ADORESS V � / //ij� � PERMIT NO. OWNER Mariners $dVlI1Q5 Fi IAdR 2iSSOC. A.P. N � MAI L BUILDING ADDRESS 1515 Westcliff Dr. ADDRES V rE�.642-4000 TRACT 1�148 LOT BLOCK aTv Newport Beach No. corasra�cnoN Same as above W LENDER BRANCH � � OWNER ADDRESS AW O�w OF EN INEEfi RO K1t0i TE�' 549-4002 � Oov Suite H FIRE ADDRESS 17931 Sk Park Circle, Irvine zoNe V GROUP AVPROVED CONTRACTOR Woodtree Dev. Co. � ev OATE �� nooaEss 1665 Placentia Ave. TEL. Z�NE NO.OF/J USE OF NEW cirv Costa Mesa No. 646-1164 �Z P� (� BUILDING �"'" STATE ��Tr 14664 wARDSAPPROVED VARDSAPPROVED uc. No. 336725 LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF lOT VdT10llS NOW ON LOT ONT FT. FT. USE OF EXISTING BLDG. p Separate permits are required for L SIDE FT cT. electric, plumbing and heating work. �y REAq � FT. �D FT. USE OF BUILDING AND WOpK TO BE PERFOFMED DSTANCE BEf. BEf. MAIN & `r0 a nits - 1 MAIN BLDGS. ACCE55. BLOGS. VAR.� DATE /� Total = 1543 s. ft. c.u.v.�. �� qppqOVED �CJ -�� Total Gar. = 600 s. ft. �Rov P• 3�d � ... 1 hereby aeknowledpe t�at I have reatl thia epplieation end steta • � � ' Mat the ebava Informatlon if corract antl agree to comply wit� � ell lews repuletlnp builtling eoMtruetion, antl I shall not employ any potwn In vlaletlon of Me workman's compeneallon laws of �. Mo Smta of Caiitornla. I hereby eartify Mat I am properly Iicensed ea a eontteeior untlar Sa. FT. i Ma Smte ot Callfornia Bucinea! antl Protauiona Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR j Cheptar 9, entl ch Iieanaes era in tull force entl effxt, or I THE PURP06E OF ESTABL6HING A PERMIT FEE ONLV: ' em exampt fr m Na p ovisio of the State o alifornla Busineu VALUATION PERMIT FEE S � entlProfeasio aCotl Ivi�lQn aptar ��,///))) ` 1 /�� " PLAN CHECK S � � Sipnetura of \ . � / / Pa�mlttee v $ �� D TAX S � / � Authorizatl Apant TOTAL PAID S � .,_J For Applicant to Fill in Completely — Use Ink OWNER ��G MAIL ADDRESS CITY CAPbTRUCTION LENDER BRANCN ADDRESS ARCHITECT OR ENC��NEER ADDRESS CONTRACTOR ADDRES CITV F STATE � LIC. NO. CWi OF LOT a USE Of � EXISTING �y.+ rT+ F L1 [.�. USE OF I a c .�] a > i" � w 0. 7133 3/10/7B 7133 3/10/78 APPLICATTON EOR�STRUCTURA HECEIVED BY DATk RECEIVED p� TEL. NO. GTV LIC. NO. N0. OF BL[%S. M01N ON LOT Separate permits are required for electric, plumbing and heating work. UILDINO AND WORK TO BE PERPORA 20NE VAR i� C.U.P, y. APPROVED � 1 herabv ecknowlatlpa thet I �eve nad thl� eppliaetion end ttnm y' thet the abwa informetfon b corr�et any ep�ea to comply with d+ ell lews rpulatinp builtlin0 conRruccion, and 1 ��ell not amploy Z eny pevsu� In vlolatlon oT Ma workmen's companietion lew� of T! Ma Stete of CeiHornla. � 3 I hereby cartify Mae I em prooerly Ilun�e0 aa e contrector un0e� SU. F the SUTe ot Celifornie Bufinns and Ptotaaiom Code, D�vislon 3, THE AMOUNT Chepier B, end thet weh Iicanw� ero In full fores end Nfact, or 1 77iE PUHPO6E C am azaR�P< from Me p�ovislont of tha SteM of Cell�Ornla Buainap VALUATION enC ProfasNons Coda, OWifton 3, Chepar 9. SIB�eturo of �� Pe�mittPo $ Authorisetl Agent D/1TE eOaCKTO IA C m a m N MN UNDER VALUATION IS FOR m fABLISHINO A PERMR FEE ONLV: � PERMITFEE s �� n PLAN CHECK { ^ 0 LL TAX f f , u TOTALPAID d �