HomeMy WebLinkAbout744 CENTER ST - Building PermitsOWNER MONSON. ROBT.
�106ADDRESS 744 Center
_� GENERAL CONTRACTOR Owner/E
�AP '�.116-042-12 LOT 10
� IN. .CTIONS
,\soi�
GAS
WATER
ROUGH PLUMBING
PftOP. SWR. LINE Q NOUSE CON. �
SPRINNLING SVSTEM '
MISCELLANEOUS
HOUGN HEFTING AND �IR CONDITIONING
TEMPORAHV SERVICE OR POLE
UNOERGROUND � POWER �
ROUGH WIRING
TRENCXES FORMS STEEL REINF.
FLOOR SYSTEM
BONO BEAM ❑ STEEL REINFORCE rf
SHEATHING
FRAME RN� FLASHING
LATHING - IN ❑ OUT n
PLASTER, BROWN COAT
SYu.}� URAL, FINAI
HE:ii`iP7G. VENT.. REFRIG. AND A.C.. FINAL
DATE
ILDING PERMIT N0. 37233
Yatio
��7�t�PI�
SUBCONTRACTOR
0
ER
�.116-042-12 LOT 10 TRACT 1
�GNS
�W ATER
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON,
SPRINKLING SYSTEM
MISCELLANEOUS
ROtIGH HEATING ANO AIR CONDITI
TEMPORARY SEFVICE OA POLE
UNOERGROUND � POWER �
ROUGH WIRING
TRENCNES FORMS 5Tt
FLOOR SVSTEM
BOND BEAM ❑ STEEL REINFf
SHEATHING
FRAME ANO FLASHING
LATHING — IN �] OUT ❑
PLASTER, BROWN COAT
ST URAI, FINAL
NEn_.eG, VENT., REFRIG. AND A.
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILOING, FINAL
DATE
UBCONTRACTOR
ERMIT N0.
!
u
4
G
PH0.IECT RDOHESS: � q 4 CENTER ST
OWNEfl'SNAME:DI CARLO MADELINE T?2
noosess: �44 CENT�R DR
- COSTA MESA,CA 92(i27
FflCH/ENGINEEfl:
ADOflESS:
flEG.NO.:
UNIT:
UNIT:
reaminee: FERRARA ROOFING ( 714 ) 642-8233
nooness: 3013 GARFIELD
COSTA MESA CA 92626
LICENSEO LONTflpLTOfl OECIAPATION: I here�y a�lirm Ihat I am IicenseA unaer pmvision5 0l Chapler 9(commencing wi�� Seclion
7000� of Division 3 0l �Ae 9uslness antl Professions CoEe. antl my license is in lull �orCe ana ¢��ect.
ciTruc.:C�6798 STATELIC.:342�•� y� cuss�a39
Da�e: ���o� Sipna�ure: 4_J%�/_7 _ _�_ �
WOFKEB OMPENSATION DECLANATION: I �ereby allirm IAaI� �aue a certiliCa o� tan5eni � insure or a terti�iCale o1 Worker5'
Compensa0on Insurance, or a certilieU copy Ihereol (Seclion 3800, lab, C�.
POLICY NO.: E%P. OATE:
COMPFNY:
❑ Cenilie0 coOY is hereby �umisAed. � Cenified copy is �ileE wit� Ihe ciiy Builaing Oivision.
�ale'. ApplicanL
E%EMPTIONFflOMWOflNEBS'COMPENSATIONOECLAIIATION: (i�i55et1i0nneeUnaihetompl¢�edil�Ne errtuli5loro�hUnCr¢4�5100�or1¢55�.
I cetlily Iha� in Ihe petlormance ol �he work tor w�ich Ihis permil is issue4l SAall nol em bP'Jl�y���fffSSS 8n m any manner so as to became
5ubjeci lo �h orkers' Compensalion Laws ol Cab�o�oia_T� �`, / �
+�-�,. i�c �i
Oaie: , Signamre� rs- -� �. iw�
NOTICE:II fier making IhiS aeclaralion, you shoultl Geco e SUGjecr�e Workers mpensalion p Ovisions olt�e La�or
Co�e. you must bri�wil� comDly wii� such pmvisions or this permil all De tleemea revoked.
CONSTNUCTION 1EN01NC FCENCY: I �ereby allirm Ihat ��ere is a cons�mction I¢naing agency �Or ihe peAormance o� �he work lor
which �his oermil is issuetl (Section 3097. Civ. C�.
LENOEfl:
AOOHESS:
OWNEfl BWLUFB OECLABATION: I �ereby altirm �hai I am ¢xempl Irom �Ae fAnlraC�ars' State License Law lar the follovnng reason
(Seciion 7031.5 Business antl Pmlessional Code: Any city ol counry w�ich requires a permit Io ConSlmci, aller, impmv¢, demolis�. or
repair any slmclure, prior to rts issuance. also re0uire5 �Ae apPlicant for suc� permi� lo lile a 5ipneA s�atemen� �hat �elshe is licensetl
pursuam to Ue pmhsions ol t�e Cantraaors' State License Law �CIuO�er 9(wmmencinq with Seciion 7000) al qvivon 3 of i�e Business
an0 Pmfessions Coae) ar t�at �e/s�e is exempl I�eretrom antl ��e basis lor t�e allegeG eeempiion. Any violation af Seciion 7031.5 Ey
any avDlicanl for a permit subiects ihe apPlicant lo a civil penally ol nol more tnan hve nundreJ dollars (5500�.
I, as owner al the pmDeny ar my employees wit� wages as their mle compenution, vrill tlo tAe waA, an0 I�e
❑ stmcwre is not intendea or oaerea for sale �Senion 70aa. Business anG Pmhssimal CoOe: T�e Contractors' S�a�e License Law
aoes no� ap01y Io an owner ol a pmpeny wlp GuiIGS or improves t�ereon. and wM aaes suc� vrork �imsel�/her5ell or thmuAh
his or �er own employees. pmvidetl Ihal suc� impmvemems are not intended or OIIereG br Sale. I�, however I�e 6uilding or
impmvemenl i5 5oitl vn�hin One year ol [Omplelion, the owner vnll have t�e burtlen o� p�ovinp he/5�C tliE nOt huiltl or imprOve
lor Ine Durpose of Sale).
I, as owner oi t�e pmpeny. am e�clusive1y conVactinp with Iicense0 coniracmrs m consimcl Ihe D�olect 1Section 7044. Business
❑ antl Pmle55ions CoGe: The Conlractors' $ta�e License Law tloes nol aODty lo an owner o� D�opeM1y who Owltls or imD�aves ��e�¢on
and who conVatls br such pmjecis wil� a contracior(s�license purwanl�o Ihe Contraclars' Stale License Law1.l am aware
t�at prooi ol t�eir Worker's Campensairon insurance s�oWO be DrwiOed to me.
� I am eAempl uneer 5¢[lion: 8. d P. C.
lor Inis reason:
Date: Pxner.
I ao �ereby cenily �hat I am aware al ana unGersianE i�e repuiremenis ol Califomia Mealih anE Satery Cotle Sections 25505. 25533, ana
25534 ane I�al I or any INure building octupanl wilVwill nol (circle one) nee0 to tomply wilh 5ai0 slale cDtles antl I�e reQuiremen�s for a
peimil far cansimction or mOGitication Irom Ine Air Ouality Managemenl Oisirici. fle5i�enGal fAnsimetion aDP����ions are erempt Imm
Ih25¢ p�Ovi5i0115.
Da�e: AOVlicanL
� �ereDy cerUly tAat 1 have read t�is a001ication an0 stale IIWI tAe aUove inlarmatiUn is fArrect. I agree to comON ��h all
oramances ana yale lavrs rela�ing lo UuilEing wnsVutlian an n r E amMrize repreumatives ol thi Io en upon IAe t
V�ooeny loi �peciian pUrpo5e5. ^_ ^ �_ ^
oxie: '
DriveiS Litense or Social Securiiy x:
SignaWre:
i6aL46 wnne—Buil�ing; Green—Coae Enb¢emem; Canary—Applicam; Pink—Revenue; GOIEenrotl—Assessor
CITY OF COSTA MESA - BU:LDING PERMIT
PERM=T NO: B 061906 PLAN CHECH NO: N
CONSTRUCTION TYPE: 5-N
PERMIT TYPE: STR
PERM NO: B 061906
GOVT: N SUPP: N
PURPOSE; ALT
JOB DESCRIP?'�ON : REROOF WITH COMPOSITION SHINGLES SQ FT: 2,700
CLAIM �.�A�tJE: 2,700.00 CA�C-VALUE: 2,700.00 GROUP OCC: R-3 /M-?
COMMENTS: SMOKE DETECTORS RE�UIRED PER THE 1991 EDITION OF THE UBC. �O�
���*��;����*,�.�,����_,�.�����*�*�� -,�,�,�,��**.�#�*,��,����#�����«*������*�*�*.....„p,ET�E�„�u
Z O N I N GS FATE�QAU�IKRSE M E N T S SMpKE
��L11RED
----------�- MAIN BUILTJING ---------- --------- ACCESSORY BUIL i V---------
FRNT: T 1N REAR• FT IN FkNT; FT ZN REAR; FT IN
LEFT: FT I!v RGHT: FT IN LEFT: FT IN RGIiT: FT IN
PARKING REp • PROV: PARCcL: 42920213 ZNE: REF NO;
PLANNING Nt3TESi
�
iE #' 3f 1E iE if iE iE 3E iE iE 3f iE iE iE iE iE iE if �E �E 3E iE iE �1E �)E 3E if if # if IQlElE �lE iF iE iE-lE iF #�1F i(� iE if iF-1E iE 1f #if ## il-�lf �!E iE iE il� iEi!!E if iE iE�!(� ## if 1flE �1E # if iE iE ic i'r jF
D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S
ZONING APPROVrD BY
BUILUING APPROVED BY
iF iP jE # i� if iF iF iE if 3F iE 3e #?
LEGALIZATION:N
BLDG PMT
PERMST 59.00
DATE;
� DATE:
,�-���%'�'�-. DATE . 2
iEiFr...c�� )tx �R�fFX 3F..%%RR ie'iF�)1'x�Fitlt3FYiFi!##'k###iEiEiEitlefclt-��#?f
ififif #iFiEiElEiFiFifif3Fif�]fiEdEiEiFiE##ii �E� -#�lE1f�lFif#3f1@iEiE1EiE#iEiF###3FaF�)Cif#######3E�kif�f
F E E S U� M,.M A R Y STRUCTURAL SEGMEAiT:Y
:, i
PLUMBING ELECTRZC•� hI.ECi(ANIC i!: FIRE SMIP/RSS� GRADZNG
PLAN ^ • _ SMIP/NON-RES
� ./ r
� 1 �
iSSUE FEE ' �i '�
HOT_LDING-DSV-> PERMIT _TSSUE � PI:AN-CHECI{ TOTAL PAID DUE
TOTALS----> 59.50 0.00 Q.00 �. 59.50 59.50 .00
^ ,. � ,� . .
REVENUE DIV�S�ON TOTALS--> COiLECTED:'• '�,�9.50 OVER/SHORT• 00
3LDG PMT PLUMBING ELECTRIC MECHANZ•C:, �+F'1RE SMIP/TOT GRADING� �L•AN-CHECK
54.00 � -� =•. ; � ,� y�)•• .50 :.
,(�'s�J ../� /�/� VI� +
iE �'� #'K"�'� �' * jf'K' *"� *"�i' i�' i� *�"� i4'� i%')%'x' *'�'� �"� i�' �i'� �f'1C #* ji �% �{"�^�:' i%�' i�' �t i�' )C'K' i�' i�"�'K' i�' �"i�"iZ' if i�' * i%{%i:' #* iE iE %'# �%i�' �f �(' �i' ii i�' �"�'�f
i N D I V I D U A I,� E;;E E� B,iR E A��C-•D O W N
TYPE TY U E S C R I P T I O N ✓` �� j�� • •
Q p/' r i�` -'UNIT COST TO'iAL COST
SFR 2700 REROOF BY VALUE RESIDEI3TT_,�, OZONE '�� 1.00 2,700.00
� END OF F££S� .' �
!. A� , � �
i ,; .., �.�:
D ��!'� �,
ir�comPjetel nsPections� �� ��, �_'
� • '� �• •, • \..�
$IQ� �-�-'�"_ ��
�tC �. �._.�.'m'"`.• r i �
;�f � , �1 �0138035-00138036 T O T 54.`0
� . �r .��.- � DATE: 04/27/93 TIflE: 14:15
f
� ��
COPSTRUCTION ANDPIANNiNG
r
APPROVALS Permit#
1. T imporary Electncal Service o� Pole
2. Sod Pipe-Undrgrnd.
3. Electrical Conduit Utdity•Undrgrnd.
4 Electricai Condu�t�U�'d�9��d.
5. Sieei Reinforcement
6 E�ectr,cai UFE� G�nil
7. Foot�ngs
8. Foundat�on
9. Water Pipe�Undrgrnd. ,
r
10. Structural Floor SVstem
7 7. Property Sev:er Line &�louse ;onnection
72. Sewer Cap ,
73. Roof Oro•ns
14. Rough Plumbin�
75. Rough Electricai-Condurt
16. Rough Electric Wiring
ll. Rough 1Viring Siyn
18. Rough Elp�rira!�T 8cr Ced�r.g
19. Rough Healing & A�r Cor.diLonmg
20, flough FaC.or;� Firep'ace
21. Ducts,in Structure
22. Ducts, Ventilahrig . .
23. Gas Pipe�Ro�gh & Test
24 Roof ��aminy
25. 9oc' S�eaY.vnq
26. T-Bar Ce�hnq IStru�wrall Rl iUonocoat
27. Frame and Flasiiing
28. La2hing� & Sidiny
79. Insulat�on
3�. D���.:a!'. ��a.' r.g
31. Plaster Cro�vn Caat
32. Eiecir.c�l Por.er .'.'=tr-.F�na'.
33. Firai Electric
34. Fin�i HeaUng & i.i� Cooditi0n�r.g
35. Fir.al Gas Rpe�Te�t
36. Hond or Cacopy�
37. F.^.al F�cior�� F�-ed_az:
38. Final Pfumbmc�
39. `.'iater Servica�Final
40. Gas Serv�ce�Final
41. Solar pomest�:c-F�nal
C2. Backflow Precenter
43. Backflow Irr�gation ,
44 iacdsc.:ue I� r:qauc'�;wstev.
�. 45. Sound Attenuation'
� .
' 46. Hand�ca� Re3ulatidn; � � +
I
47. FINAL STRUCTUR� &'$}JILDING
I 48. FtNALPLANNIA;'i � ,7-
49. Electric Re'ease to _B-�S-nn;
50. Gas Release to Southern-�;
51. CERTIFICATE OF•OCCUI
o.-___._ _ _ .. - Date
Gas
Da[e
@
0
POOL PA
laspector qppROVALS Permit,$
52. Pool & Equ;pment Locat�on
53. Steel Reinforcement
54. Forms
55. Electrical Bo�ding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GVNTr
58. Electrical Conduit�Undrqrnd. �I
59. Gas Pipe, O U�drgrnd., TcSt '
60. Backwash Lines, P�Trap, �1 Undrgrnd. ���
, 67. APPROVAL TQ DECK ��
62. Bac�c�wa;h & Recepmr Fc�t�
63. Heater & VenbFina�
u4. Pwm6ing SVstem f� a4
65. Elcctricel�Final
66. Solar SYstem-Finai
67. fencin� & Access Approval '
68. APPROYED FOR PLASi ERIRG
69. POOL/SPASYSTE;.7SFINAL
FIRE DEPT. REQUIREf�9EiVT �
APPROVA! 5 Permit =r
Date �Intpector
70. UndergrounG HyUro
71. Product �'iping L� Gas ❑ Oil
72. Underground FI�S��
73. Undergmd. Stor:,r Tank �_ � Gas ._, Oil
74. Ovurhsad Hy�rc _ �
75. Dry Chem,cai
76. Dry Stacc'n:Pe
77. FIXED SYSTEPA FINAI.
78. FIRE PREV. Flh'P.L
HEALTH DEPT REQUIREMENT
-i9. Flydql ItJS"ECTiON
30. FODD CF,-�TIFiC?,7E i�,5'�.:ED ` �
Notes: y'/���t �/ /� _ � r�
71ti a�.KC �O e'F
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-Incomplete.tnspect;ons Y,�;- 1
�ate �J�� S�g-�C"_ ;
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- -- - -I
=�'�osta Mesa�Building Departmen�96 APPIdCATION FOR PERMIT �1
111 EA3T 20th STREET B U I L D,� N G �
*' COSTA MESA, CALIFORNIA J
FOIt A.PPLICANT TO FILI. IN FOR�OFFICE USE O1VLY
_ Reeeipt No. Permit Na.
8uildin9 '� � ' CIi51i`9Y $�YB�: (� /) ,9�` �
Address v
CiOS� 9&� �i�OPIII& Received by Date Rec'd. Data issued
rvearest POmOII� 5treeS 6�'2'9'`r`� 7— �— S�
Cross St. Building
C13ffDk8yRauc�Y307ri¢aoffOzm3go Addreu
Owner �'iOSt2
Mail 1 Eaet I7tS Sio
Address Nearest
�,pets& ?uled�a3 Te1.l.i8�5548 crossst.
City No. Zonc I No.
Architect j�j$YeC���j� �io• Pla.
Enpineer No. Approved Cy
Address
Size of Lot
Center ot
New
Repair
Building
10 �
Bounds)
R 1 Z�
o.00.smc•
��Q
O'tJg2� iNj@O8=
F3f•C7
Alteratlon � � Addition
Movtng I I Demolish
Z�'��� No. of C�
California
�
��1LY��
�ring y'�� � covertng ------ APPROVAI.S
.,,.eolNew lmg,,,.,,tt� d�/elE4�
Buildfng ""'�`Y $ Foundation Lxation Inspecto
.^C08 g73R�g6 Forms, Materials,
Under-Pinning
Frame: Fire Stops,
Braeing, Bolte
I tiereby acknowledge that I have read tlus Application Lath. Int.
and state that the above is rnrrect and agree ta mmply Lath. Ext.
with all Clty Ordinances and State L.aws regulating
building constructlon.
Signatureof Plaster, Int.
Permittee
n Plaster, Ext �
Authorized Agt. .� 1 (Q jtf�, Q �J �_
Masonry Reinforoed
Valu�ation 'PermltFee$ '�q
Plan Check $ �j. Bond Beam —avyy
$�� ��� Feeal $,Z.y� A� FINAL C� � �%
CfIYY Dl16 I]�Y 9Y P-R6
Gruup
Date
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I PLOTPLAN.�, �,-�t^ _ ... . . . ._
� Show locatlon iSod�.dl�noe�sF from i1 -� • ' �� � '�'
t�r1,4{ �' -
property Iine and between buildings. . - , , �
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COSTA MESA BUILDING-SAPETY DEPARTMENT '�EE RE�E�V�
P. O. BOX 317 COSTA MESA. CALIFORNIA
� ��—y-�y
fOR APPL/CANT TO f/LC /N COMP[ETfLY APPLI�� �Gffd.PERMIT
TYPE OR PRINT C'������
BUILDING
ADORE55 �Ay
COSTA MESA. CALIFORNIA ryI� OFF/CE USE ONLY
�uG\P
I RECEIPT NO. IA ��Rf.tt}
I� ��
fy^
FECEIVEO BT OATB qECEIV DATE IS:
/— � �%—
� BUILDING
� ADDRESS
COSTA MESA. CALIFORNIA
FIRE • I
ADDRE55 �—
LEGAL LOT �e)
oescrsi�iorv I NO. O BLOCK /if/ TRAC'
A.P. NO.
� � — fi -'� �
$12E I NO.OF BLOG9.
OF LOT Now oN toi
USE OF
EXISTING BLDG. Q
SETBACN LINE FFOM ��P' V
c[Hicrt oF sia¢Er — REAR YARD
SIDE VARO ILEFT ✓ IR�GHT
DESCRIPTION OF WORK
NE' I IIALTERATION I IIADDITION
REPAIR I IIMOVING I IIDEMOLISH
BUILDING NO.OF
SRE '�� ROOMS STORIE:
EXTERIOR WALL .���� ROOF J l
COVERING ' COVERING ��
LJSE OF.BUILDING AND�1p�ORK Tq BE PERFORMED
I HEFEBY ACKNOWLEDGE THAT I HAVE REAO THIS PPPLIChTION
ANO STATE TH/�T TME ABOVE IS COflPECT AND AGREE TO COM�
PLY WITH ALL CITY OR M1NCES AND TqTE L/.WS RI`�
BUILOING CON6THUCT N �
SIGNATURE OF /
PERMITTEE �
ZO'NING
ZONE ` / NO. OF /� USE OF N
�" PLANH / BUILDINO
1 1/ ^!•�
BYPROVE� / , v�
e //�
� DATE
YARDS �'EVES�
REQUIRED ALLOWED
(CENTER LINE BT.1
___"'_ t,'�U _ -1—
�
THE AMOUNT 6HOWN UNDER VALUATION IS FOfl THE
PfIRPOSE OF EST/�BLISHING A PERMIT FEE ONLY.
VALUATION /
PERMIT FEE $ � (� •
5 /L/- // �PLANCHECK $ �
/ wii
TOTAL FEE S �Q•
I
... l �, 37232
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626 � �
+ P I ATION FOR BUILDING PERMIT
ForApplicant to Fill in Completely qE ei v oq7 E RECEIVED
BUILDING '`� ��/ ! p y� /� ,• � (�(_ � _ DATE IS UED
ADDRESS /� �/ / i/ T�J � Cl- �ij =3��
h PEFINI�`f�0�'i
OWNER �C� � Pi Y� T �FxISO A.P. NO . �' � � 1 L.�.:G
AODRESS C� V/J G7/\ (�- (� �•/'� BUILDING 'f —
Z ADDRESS
W W ^ TEL. TFACT LOT BLOCK
�- U CITV � � �I .� �C ��� � NO. � ����
~ Z CANSTRUCTION W ADD P
ZQ
O � LENDER
am
J � BRANCN — N, �\ '
J tn .��' OWNER O�J IV S �J
� w ADDRESS ryn�C VALUE �
� ARCHITECT .— TEL. - S ��� IA�+C�aKi $�.J.�,'!
N OR ENGINEER N
V Q .��' FIFE E .Y>,
W� ADDRESS ZONE TVPE GROUP 1�
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MAIN BLDGS. ACCESS. BLDGS.
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� STATE
UI he�aby acknowletlge that I have reatl this application antl state Q
� that the above intormation is cOrrect and a8�ee to comply with
� ell laws regulating builtlin8 construc[ion, entl I shall noi employ J
r eny person in violation ot the workman's compensation laws of
Me Sta[e ot California. � m
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zI hareby certify that I am proparly licensetl as a contractor under, SQ. PT. � o
Me State of California B' tl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, end ihat licanses ar in full force antl eftect, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONIV: m
am exempt trom �e provisions ot t e tata of Califomia Businass ¢
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COSTA MESA BUILDING-SAFETY DEPARTMENT
� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
PL TION FOR BUILDING PERMIT
Fo� Applicant to Fill in Completely RE ei OATE RECEIVED
% DATE ISSVED
ADDRESS '/ y � Q � e � ' '3 - � � 3 —73
OWNER � � �l � c�n 5LJ A.P. NO. I I lQ—OYZ�JZ PERNJ�NQ�`
J L,�
ADDRESS /�- � ' /,3n1C � � � � BUILDING ;��/Lj G'��
ADDRESS 'T j
'CITV v� �' Q/�'[�S r•L NOL(oya'� i TflACT�C.�LO� LOT �� BLOCK
CONSTRU�ION ��� W A
LENDER
BFANCH
�� OwN E F O
AODRESS
VALUE Py
ARCHITECT� �r TEL. S S
OR ENGINEER N
� FIRE T
ADDRESS ZONE TVPE GROUP -+l
APPROVE ���( �i2
CONTFACTOR 'r� BV OAT ✓1'�_J
ADDRESS
TEL. ZON NO.OF USE OF N W
CITV � NO. I� P�� � gUILOING �-��CQJI_.
STATE � CITV 1'ARDSAPPROVED VARDSAPPROVE�
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUIIDiNG
SIZE /+� NO.OF BLDGS. (FROM GLSTREET)
OF LOT V �� NOW ON LOT qONT FT. �� FT.
USE OF n (`
EXISTING BLDG. TC% � FT FT.
NEWBLF .���� ���-/ROOMS l/ STORIES / LSIDE FT. �• �FT.
E%TERIOF WALL �� � ROOF /� � 1
COVERING � �i COVERING !t �.:- REAR FT. tJ.� 7 FT.
USE OF BUILOING AND WORK TO BE PERFORMED DIS7ANCE BET. BET. MAIN &
/� MAIN BL �. ACCE55. BIDCaS.
`' �-" T� � \��/ �� n� C VRP. qW APPFOVED
APPROVED � �J: ��3
J/
I hereby acknowledge [he[ I have reatl this appllcation antl state Sj�.,ZE ,
[hat me aoo�e intormation is correct antl agree [o comply with
all laws reguleting builtling consttuciion, antl I shell not employ
any perso� �� ��ola[ion of the workman's compensation laws of
the State of Calitornia. .
� SQ. FT. pX
I hereby GerHty thet I am properly licensetl as a con[rectar undety
Me State of Calitornia entl Protessions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VA� ION IS FOR
Chapter 9, and th uch licans¢ ere in tull torce antl effect, or I THE GURPOSE OF ESTABIISHING P. PERMIT FEE ONLV:
em ez¢mp< tro t1:e provisions f the Siate of C Iif nia Busineu
antl Prote4si Cnoe, Diii�� - . �A� VALUATION � �
PERMIT FEE S
SIB^ature ��
Permtttee $ ���df� PLAN CHECK $ --
' (f V
Authorizetl Ageni TOTAL FEE $ �L�
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