HomeMy WebLinkAbout1943 REPUBLIC AVE - Building Permits STB CITY OF COSTA MESA
44.- ''6,g BUILDING DIVISION
> •
: %j•rr,., �` S', DEVELOPMENT SERVICES DEPARTMENT • P MIT NUMBER
tIPIKal'±, PERMIT E02-00927
•y e
Cpm-.Pomo
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1943 REPUBLIC AV Status: ISSUED
Suite No Applied: 10/09/2002
Vicinity: KITCHEN AND LIVING ROOM Issued: 10/09/2002
Parcel Nunmber: 42252134
Applicant: LEWIS, JAMES K JR ISSUED BY: a/1----------
Address:
/Address: 1943 REPUBLIC AVE
Phone:
COSTA MESA,CA , Zip: 92627 _
949-642-4608
Owner LEWIS, JAMES K JR
Address 1943 REPUBLIC AVE - •
' .
Phone: .., .
•
• COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: .000000 •
•
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 12 LIGHTING FIXTURES,9 OUTLETS, 10 SWITCHES AND 1 SERVICE
PANEL TO 200 AMPS. LOCATED IN THE KITCHEN AND LIVING ROOM ONLY.REF.:B01-00715
FEE SUMMARY
• Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting ' $0.00 0
Temp service test $0.00 - - - Busway/100 ft . $0.00 0
Res.a/c package $0.00 ' Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 , 0 Transformers,up to 1 kva/kw $0.00 0
Pool/Spa • . , $0.00 0 • up to 10 kva/kw $0.00 0
Lighting Fixts $13.20 12 up to 50 kva/kw $0.00 0
Recept Outlets - $9.90 9 • up to 100 kva/kw $0.00 0
Switches . ;$11.00 10 , ` - over 100 kva/kw $0.00 0
Non Res Appr $0.00 ' 0 • - Low Voltage Equipment $0.00 ' 0
Res Appl $0.00 -_0., Low you Wiring System/Ckt • • $0.00 0
Service to 200a , $30.50 1 Misc.Conduit $0.00 0
Service to 1000a - $0.00' < 0 : Misc.Conductor -$0.00 0
Service over 1000a - - $0.00 >_0_, - - Circus(gen or ride) - $0.00 0
Motors to 1 hp - $0.00 , 0 Circus(mech ride or lights) $0.00. 0
Motors to 10hp $0.00 0 - - ,Christmas Tree Stand • - $0.00 0
Motors to 50hp $0.00 > 0 Fireworks Stand' $0.00 0
Motors to 100hp $0.000 - Other Electrical Fee $0.00
Motors over 100hp
Communication drops $0.00 - - 0' - . Investigation Fee , ' $0.00
Sub panel to 200a $0.00 _ 0 • ' Plan Check Fee $0.00
Pole Light Pkg $0.00 `0 - Reinspection Fee $0.00
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.Failure to obtain inspections and final approval will result in the expiration oft'p`eimit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS f) I -1
$WORKE 1S'COMPENSATION DECLARATION: i
I hereby affirm under penalty of perjury one of the following declarations: •
❑ I 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
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued,
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit Is valued at one hundred dollars(5100)or less.)
fI certify that in the rformance of the w for whic his permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
7t01 compensation law f California nd a e that if sh uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these r visions.
�>':Signai lure ,,/�/` l . Dalai I e>-- 0 O `a
WARNING:FAILURE TO SEC E WOiiKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DO.LARE(5100, 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 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
force and effect.Lic.a Class It
Contractor's Signature: Date:
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: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I 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(3500).):
❑ 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 Code: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.If,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.).
lam ezem• nder se.jj Business and Professions Code for this reason:
nature: ■ 1 Met " goatef — /0 ^4 --O 3-
Owner ID verified 'y driver's license. .1 Yes 0 No Dl ivefe.Licensrallo.^. rExpir eS:^6 —70•-04
Verification of Ownership by(type of d. 'men i.e.-property tax bill or deed): . __
DIVISION OF INDUSTRIAL SAFETY 'ERMIT CERTIFICATION:
0 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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Cale 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? 0 Yes 0 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 then 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes j No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
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 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or 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? 0 Yes 0 No
8 (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 COMPUANCE 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 a 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-des ib d props fpr in action oses.I agree not to occupy or allow occupancy of any building authorized bbyy this permit untillffiinal inspection.
. v l `T/^s ^Q 1
EsTlgRatlsra. t.:ag`3I.Owner(s� (,=_Date '
And/Or Authorized Applicant Date
CODE/ INSPECTION TYPE MMIE II6L9 CODF( INSPECTIONTYPE MI itiDDNAI
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1008 Pool Spa Final 208 Final Plumbing
200 200 Final Re-Roof 210 Final Electrical al 7i• �-0
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
CITY OF COSTA MESA
4
BUILDING DIVISION
)' r,,,, , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
�
: ri� PERMIT
+WPoRmso E01-00808
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1943 REPUBLIC AV Status: ISSUED '
Suite No Applied: 09/19/2001
Vicinity: NEW DETACHED GARAGE Issued: 09/19/2001
Parcel Nunmber: 42252134
Applicant: LEWIS, JAMES K JR ISSUED BY: _
Address: 1943 REPUBLIC AVE
Phone: 949-642-4608
COSTA MESA,CA.: - Zip: 92627 ,
i
Owner/ ,LEWIS, JAMES K JR / • V-\A
Address ' ,1943 REPUBLIC AVE .,
V ' ; Phone: r ,
COSTA MESA,CA Zip: 92627 -
Contractor: OWNER-BUILDER
Address: .. . . �
' --Phone:
. Zip:
License: 0 . _ _
SCOPE OF PERMIT '
/ ' ELECTRICAL PERMIT FOR NEW 520 SF SINGLE STORY,DETACHED GARAGEFOR AN EXISTING SFD.
10 LIGHT FIXTURES, 15 OUTLETS, 5 SWITCHES, 1 SU&PANEL TO 200A-. REF: B00-00715 ,
-_FEE_ SUMMARY '
Quantity Quantity '
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 . - Transformers up to 1 kva/kw $0.00 0: _ '
Pool/Spa $0.00 0 • up to 10 kva/kw $0.00 "0
Lighting Fixts $11.00 10 - •up to 50 kva/kw $0.00 ' 0
Recept Outlets $16.50 15 . - up to 100 kva/kw. _ $0.00 , 0
Switches . � $550," ( ;''5;' • - over 100 kva/kw . $0.00 0 '
Non Res Appl. $0.00 - 0Low Voltage Equipment $0.00 . 0
Res Appl $0.00' • - 0 Low Volt Wiring System/Ckt $0.00 - 0• ,
Service to 200a $0.00 " \0,' , Misc.Conduit $0.00 0
Service to 1000a , $0.00 0 - Misc.Conductor • " $0.00 0
Service over 1000a $0.00 . 0 Circus(gen or ride) $0.00 0 ,
Motors to 1 hp $0.00 " 0 Circus(mech ride or lights) $0.00 ' , O.
Motors to 10hp $0.00 ' 0 , Christmas Tree Stand - $0.00 .-0
Motors to 50hp $0.00 _ 0 . Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 . - 0 . _ - .
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $30.50 1 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $87.00
Intermed Pole $0.00 0
COMMENTS/SPECIAL CONDITIONS
•
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. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(6/00)
DECLARATIONS n -fes)
WORKERS'COMPENSATION DECLARATION: .
I hereby affirm under penalty of perjury one of the following declarations:
❑ I 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
work for which this permit is Issued.
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($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 workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FNLURE 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 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
force and effect.Lic.# Class#
Contractor's Signature: Date:
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).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I 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 pem4'
yjects 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 Code: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.If,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 un sec. Business and Professions Code for this reason:
Signature: (/ l ltn. , I Date: C7— /S — O/
Owner ID verified by ers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Owners ip 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? 0 Yes 0 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? 0 Yes 0 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)?
CI yes 0 N
(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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication agermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes LJ No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
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 0 No
(II"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Duality Management District or other air pollution control district or 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? 0 Yes ❑No
B (It 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 co y 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 pro a for inspe pyfpases.1 pg(ee not to occupy or allow occupancy of any building authorized by this permit until final inspection.
l/n11 ( LI�-v r(s) g —1 el — V 1
' Signature Of Legal Ov4ner(s) Date
And/Or Authorized Applicant Date
;ODE t INSPECTIONTYPe QAIE INTITIALS CODE• INSPEC1ONTYPt ;ATF RIODNLs
1618 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing p7�,.
200 Final Re-Roof 210 Final Electrical 9///05 Eke/k .
201 Final Black/Retaining Wall 212 Final Fire Prevention
-Eke/kr). _
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition ' 250 Final Building/Occupancy
,- .
On Ms CITY OF COSTA MESA
4 BUILDING DIVISION
o/l„,� DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
f 1 www:
o PERMIT
BOO-00715
4`bemo.rwrio. fit
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT n FAIR DRIVE,COSTA MESA,CA 92626
BUILDIJob Address: 1943 REPUBLIC AV Status: ISSUED
Suite: Applied: 05/18/2000
Vicinity: FAMILY ROOM&DETACHED GARAGE Issued: 05/01/2001
Parcel Number: 42252134 Zoning:
Applicant: LEWIS, JAMES _ _ ISSUED BY:
Address: 1943 REPUBLIC AV . _ . . - _-
- Phone: 949-642'4608 -
COSTA MESA,CA , Zip: 92627
•
Owner: LEWIS, JAMES K JR -
Address "1943 REPUBLIC AVE • - '
Phone:
COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: ' 0 . , • .
•
Arch : - - Eng:
Address: •• - - ' . Address:.
Phone: - Phone:
Zip: License: License:
• . - - - -
' SCOPE OF PERMIT.'. r- .T
CONSTRUCT NEW 520 SF SINGLE1STORY'DETACHED GARAGE AND.REMODEL EXISTING 200 SF ATTACHED GARAGE TO ',
BECOME ADDITIONAL LIVING ROOM AREA--RIGHT SIDE EXTERIOR WALL OF GARAGE WILL-ALSO BE MOVED IN ' / ,
APPROXIMATELY 2'-TO ALLOW THE MINIMUM-REQUIRED 10'WIDE DRIVEWAY TO BE-PROVIDED TO ACCESS THE NEW ' F !-
2-CAR GARAGE:- „ -a,. __ _ "..i- - -,
48%LOT COVERAGE.PROPOSED--ALL ONESTORY.SO.5 FAR ISOT.EXCEEDED' F� - 1//I' l •- /
t -�
IN / . , I •
r
/. _
AS PER CONTRACTORS REQUEST, PLAN CHECK IS HEREBY EXTENDED TO MAY,14,2001.AFTER THIS DATE,THE /4/� " i 1
AND NO }
PLAN CHECK EXPIRES MORE EXTENSIONS ALLOWED _-11- r `�' '
SA 11/29/00
- �
22.6FAR - a:-vS _ _ jir ,4
•
-;''.\-\` ,3'` .t 4. FEE SUMMARY {c + - �"/;�/ i
Plan Check S245.21,,',.--, ,,,� Ca10 Valuation J .$23,319.75
Permlt, <$377 25. � ` -� .F- Claim Valuati•on:: /7 '
d'_� o r _ , j $20,000.00
SMIP Res-�� $2332 �± \��.� `�' `' c> l' �� � ��� � 6.--<0(//
SM IP Com:\ "'\.$660 / ' "-
\� 1,
Other: $0:00 .,5 , ,,; - - \ ' ,.
Inspection: V1,00*,,4 ! - y
-`� �1 � . )�� )i /)- / -
Total: $624.79 - - - . . -
-PLANNING-S.-ZONING
SETBACKS
MAIN STRUCTURE Front 32-5 Rear 47-0 Left 5-11 Right 12-6
ACCESSORY Front 93-0 Rear 10-0 Left 32-0 Right 22-0
PARKING Existing: 1 Required: 2 Proposed: 2
NOTES:
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.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
1
DECLARATIONS ( )
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:'
❑ I 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
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed it the permit is valued at one hundred dollars($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 workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,0oo).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS 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
force and effect.UC.0 _ _ Class it
Contractor's Signature: Date:
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: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I 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 Code: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.If,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 p suant to the Contractors License Laws.).
❑ I am exe under s . Business and Professions Code for this reason:
Signature: (A . Date: ,S " I — c /
Owner ID verifie drivers license. ❑Yes r 0 No Drivers License No. Expires:
Verification of Own rship 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,Gm 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:
I 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? 0 Yes 0 No
(Section 25505 of the Califomla 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? 0 Yes 0 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 end 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a,aermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or 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? 0 Yes 0 No
8 (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 F COMPLUWCE 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 agre comply with ell state laws and ci ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describ roperty for icti urposes.I a ee not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Si r OAI f Legal Owners Date
And/Or Authorized Applicant Date
CODE I, I(ISPECTION TYPE PAM j)71mALS CODES INSPECTION TYPE pAAtE INTaALS
16t6 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
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 �1 �,7j��
204 Final Demolition 250 Final Building/Occupancy %" 13-03 cs[r -
- ,. • MF,
CITY OF COSTA MESA
BUILDING DIVISION: P6K
' �'�`� ' DEVELOPMENT SERVICES DEPARTMENT
4 .
'''"'kkkkkk vv�''���bbbbaa PERMIT c t e.:.. - PERMIT NUMBER
"'� B98-01889
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1943 REPUBLIC AV Status: ISSUED
Suite: Applied: 10/19/1998
Vicinity: Issued: 10/19/1998
•
Parcel Nunmber: 42252134 Zoning:
Applicant: LEWIS, JAMES K JR
Address: 1943 REPUBLIC AVE
Phone:
COSTA MESA,CA Zip: 92627
Owner: LEWIS, JAMES K JR
Address 1943 REPUBLIC AVE
Phone: .
COSTA MESA,CA Zip: 92627 - .
Contractor:
Address:
Phone:
Zip:
License: . _
Arch/Eng : .
Address: -
•
Phone:
Zip: -
License:
,SCOPE OF PERMIT
REROOF 1700 SQ. FT.OF ROOF
FEE SUMMARY
Plan Check: $0.00 -- - Calc Valuation: $1,700.00
Permit: r $54.00 , Claim Valuation: $1,700.00
SMIP Res: $0.50
SMIP Corn: $0.00 '
Other: $0.00 •
Inspection: $0.00
Total: $54.50 ,
PLANNING &ZONING
SETBACKS . , -
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0:0 Right 0-0
ACCESSORY Front - 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 . Required: 0 Proposed: 0 -
NOTES:
•
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
fora 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. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS . ( I ) n - -
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I 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
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued,
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number.
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
-g 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 workers'
LLLLcompensation laws of California,and agrea that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these visionfij (� -
Applicant Signature: l'.- \ Date: 1 0— t S—SQ,
WARNING:FAILURE TO SEC WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOU.ARE(5160,000),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 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
force and effect.Uc.# Class 8
Contractors Signature: Date:
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).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS: •
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end 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 Ucense 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
?if
subjects the applicant to a eiv,l 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.
t 7044,Business and Professions Code: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.If,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.).
If 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 ContractorsLicense Laws.).
❑ I am exe under sq. Business and Professions Code for this reason:
Signature: n.., tj` (� 1 \.. Date: Ca— Ili-ds q
Owner ID verifi driver's license. ❑Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-properly 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,end 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? 0 Yes 0 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? 0 Yes 0 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? p Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or 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? 0 Yes ❑No
8 (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 end 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 inaction pmArpos agree of to occupy or allow occupancy of any building authorized by this permit until final inspection.
`` 11// o - 14 -al 11
Sig ature Of Legal Owner(s) Date
And/Or Authorized Applicant . Date
CODE I. INSPECTION TYPE DATE W1]DME CODE I INSPECTION TYPF DATE URmALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final -///��" 2 208 Final Plumbing
Y/
200 Final Re-Roof ® 210 Final Electrical _
201 Final BIocWRetaihing Wall f"_ 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
2446-46
`ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT
f North, Broadway - •B •® NG
SANTATA ANA, CALIFORNIALI
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
I -- "-RECEIPT'N07.'"' -'" PERMIT NO.
BUILADDRESS 1949 Republic Ave. - 3S-2-1-_. I ,7/ 39 sZ
SCHOOL GIST.
OR TOWN Costa Mesa R CEIVE• BY• DATE OF APPL. DATE ISSUED I
NEAREST A /APIg ',2.--C3 CROSS ST. Dogwood St. NOVI, - ^
OWNER CHINOOK HOMES INC. ADDRESS
MAIL •
ADDRESS 9363 WI LSHI RE BLVD• 1.0((( SCHOOL OIDIST. :Q cr-a, — _- :J
CITY BEVERLY HILLS NOL CR. 5� NEAREST I ' ✓/�E�
CROSS ST.
ARCHITECT,o R TEL, /1,p ZON$y�` NO. OF TY���PPPFFF/// I GRO��{111P
ENGINEER LAIN & MCKERRAC HER NO. SY•64H91 /y1 I ;PLANS I // ��
ADDRESS 2110 E. WALNUT Si.. PASADENA SETBACK LI. ,ROM CENTER OF ST. 5f /
TEL. REAR YARD _ SIDE YARD -10I
CONTRACTOR NEWPORT VISTA CO.No. CR. 5k361 / /f)
BYPROVED � 'DATEit.1 .13
ADDRESS9163 WILSHIRE BLVD. . BEV.HILLS /,
p CO TIONS
LEGAL
DESCRIPTION I LOT NO. 281 I BLOCK 1712 '
(ATTACH METES A BOUNDS) I
TRACT _. • .- - _ - •
M PLUS I NO. OF BLOCS.
SIZE OF LOT 7200 SQ.FT NOW ON LOT 0
USE OF I NO. OF I NO. SF ;\ - "- - ---
USE OF BLDG. NO. OFS ROOMS
DESCRIPTION OF WORK
NEW I x I ALTERATION I I ADDITION -- - O
0
O
REPAIR I I MOVING I I DEMOLISH I Z
D
BUILDING 1• NO. OF r
SIZE ICl4 SQ.FT ROOMS 5 STORIES 1
WALL I ROOF COMPO
COVERING STUCCO COVERING SHINGLES
USE OF NEW
BUILDING RES IDENCE,Att.CATPOTt
•
1 APPROVALS
FOUNDATION: LOCATION INSPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, , /. Aa
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING .�. !/
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS.
BRACING, BOLTS // JAI 1-/�i �`7J
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
/
LATH. INT. ..,L/9 / 27 1,
SIGNATURE OF NEWPORT VI SaarO. LATH. EXT. + -J
PERMITTEF
/_Y. .� PLASTER. INT. /�j, 9.(rl
AUTHORIZED AGT-. p- ��n "����YY-•4JW(JVJJ PLASTER. EXT. _-dik / �s/ v�
$ h83O.00 P. C- $ MASONRY REINFORCED
FEE -
$
/ BOND BEAM
VALUATION !/
a FEE P�. FINAL a'/r v--).y -4-y.
. : ?. .'.I `. f
-wAz w
. _a ._ _. .. PLOT. PLAN -
_ .32 boo,-rt O(;
. _ _ _JI: I g32i:e! ;CT.:, IHJ
. - fC`�� T 3J_11' Y_'Tgiv__ } . .
t.
T
?f ' . .0.i ATP. 1\` nas,n:1 c-OT. .1P _
i '
:f f f,o . .
m
_
m _
STREET.
c.. .IT' x
=I
r - ..,. _ L'_- - _,• t T9.03 4-1._3f - _..
OnHO?
LI 322t: I naJ OCDUTE _ - _
-'- --
- - - __ -_. 3w JtJ
•
--
i; r, uA 30I -.3ElI.IWI
1 :
•
fit