HomeMy WebLinkAbout3075 ROANOKE LN - Building Permits ADDRESS OFBUIlJ10iG: UNIT: ' cz -Goo
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amen NAME IF WNW3075 ROANOKE LN CITY OF COSTA MESA - BUILDING PERMIT
� u MITANI, ANTHONY F FLOOD: X 47 PERM NO• P 087536
MITANI, BARBARA J
3075 ROANOKE LN PERMIT NO: P 087536 PLAN CHECK NO: N GOVT: N SURP : N
APR.amLING ADDRESS: COSTA MESA,CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE : PLU PURPOSE: OTH
ARCHITECT ORDADDIES: uCNO JOB DESCRIPTION : INSTALL DISHWASHER SQ FT:
ARCH.OR ENG.'S ADDRESS: DNF:
co"IRACFat•s NLt�: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /
caONI1IA ORS WRUNGNOCK PLUMBING ( 714 ) 895-1246
11612 KNOTT ST COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT
ADDREss: GARDEN GROVE CA ucNo: 792775 *+Fit**�t�t**�E�E�t�E�t**it�F*�t�F**�E**** -*******it*�t�t*�E*�F�E*atN•�tit�t�t�F*at�F*****�E**�F�E�E�tat*stat**icat+E**
92841 �"' 17 ZONING REQCJI R EMENTS
LCENSED CONTRACTORS DECLARATION:I hereby affirm under penady of perjury that I am licensed under provisions of Chapter 9 SE TB ACK S v
(commencing with Section 7000)ol Division 3 of the Business and Professions Cde and my License is in lull force and effect.
CRT LIC.NO.:0503 6 /LK.c ' C-36 UC.No.: (17 V EX • : 02/99 MAIN BUILDING ACCESSORY BUILDING
Dae: ,f/ 7// C ca°atia FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
OWNER BUILDER E UR ON:Ihereby affirm under penelydperjury that I ant exempt Contractors License Law la the LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Awing reason(Section 7031.5 Busnesa and Professions Code:Any city or county which requires a perm%to combust.afe,improve.
emolish,or repair structure, to its isuance,alo requires the applicant for such permit to file a signed statement that he or she PARKING REQ: PROV: PARCEL : 14151212 ZNE: REF NO:
licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 ol the PLANNING NOTES>
Business and Professions Code)Of that he or she is exempt therefrom and the basis for the elected exemption.My violation of Section >
7031.5 by any epplicanl for a permit subjects the applicant to a civil penalty of not more than live hundred dollars 155001).
❑ I.mownerdlhepropenyamyemggeeswthwageseateiedemmpeneton.Wtdothework.andthesNMure'anotilteded *******************************************************************************
or offered for saki(cereal 70ad.Business and Professions Code:The Comracton license Law does not apply to anower d property D E V EL OP MEN T S ER VIC ES �; R EQUI R EM EN T S
who bolds or d improves thereon.ewho does such work lensed or herself or a or through hisher own employees.provided that such
improvements are nit intended or°Herd for sale.D.however,the building or improvement is sold wuhin one year d completion,the .-ownerdmiNa a
der will have e burden preying he she did not built o bimprove d sale). ZONING APPROVED BY DATE:the purpose
-
construct
❑ P�esuas owner Cotie:TMthe properly.
Centred a kr,se convecting e"a a memww a Fi° why°builis°(Section r IMCCeves t aannd el.°
contracts In such projects dm projects wa comraa(s)licensed pursuant to the Contraplicense Law). BUILDING APPROVED BY _ DATE:
❑ I am exempt under Section: ' B.AP.C.,for this reason: APPLICATION ISSUED BY: 7
DATE:
Date: Owner. *******************************************************************************
I do herebycenity that l am aware of ed understadthe requirements of California Health ed Safely Code Sed'vre 25505.25533.and LEGALIZATION:N F E E S U M M A R-Y STRUCTURAL SEGMENT:N
25534.end IMI I or any future building o°wpant will/will not(circle one)need to comply with said state codes and the requirements for •
a permit to construction or mdificationfromtheAbrualnylcIrnagement District Residential conatmdonappkcations are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 8 . 75
Date: Applicant: 2 5% SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:'hereby affirm under penalty of perjury one d the Moves;declarations: PLAN
❑ Ihave end will edor cunt cecl rtificate this brwukere'c°mperuWion.as pander to by Section 3700dtM labor
ISSUE FEE 22 . 00 i
Code.falMped°rlman<edwe wrkf«weigh mia perms i.issued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ I lure end wil maintaii*eskers'oxnpertsation insurance es required by Sediai 3700 d the Labor Code,for the performance of the TOTALS----> 8 . 75 22 . 00 0 . 00 30 . 75 30 . 75 . 00
II wok for which the penes is mud.My waken'compensation insurance wrier and pokey number are:
Cartier COLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 30 . 75 OVER/SHORT: . 00
Poky Number.
hb aero need not becompleter it the is NWCrn 17934102 1 09/01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
one30 . 75
❑ I cenfitd
y that in pee)'. - the work for which this permit is issued,I Mall not employ any portion in any manner so es to
become a . to t compensationd
workers' laws California. . t - loud become subject to the workers'
compere Provis�rl1d •ion 3700 d the Labor Code,I shall 1. 'h' ....pmdsions. *******************************************************************************
Date: / 7i Applicant: Aisle INDIVIDUAL F E E BREAKDOWN
II
Warning: Ibre to secure workers'compensadon coverage Is un Land shall subject an employer to criminal penald and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dears C 17),In addition to the cost o/compensation
damages as provided for In
Section 3706 of Me Labor Cods,Intone,end attorney's Ira
CONSTRUCTION LENDING AGENCY:I hereby affirm under pens*d construconstructionpe ay that there is constructionMack.;agenthe for PLU 1 DISHWASHER 8 . 75 8 . 7 5
pedamance d the work kr which this permit is issued(Section 3097,Cu.C). END OF FEES
LENDER'S NAME
LENDER'S ADDRESS:
I certify that I have red this application end date that the above intonation is coned.I agree to amply with all city and county ordinances !1
and state laws relating to bulkingconstructionngconstruction and hereby authorize representatives de city to enter upon the abwemamioned property ��— .O Do
fa inspection Wnpcses.
,/m RO11111111 `NOCK y(OQ 04 Z2 1338/11:50 AH/530.75
Pd=Name / ' kCPTO:Ai 0a21AZ°.
Dae: ?� DA 1�/0 PERMIT:087536
Signature of OwnenAgentiAppkcant/Contsdor
I
(5151<6.WP) WMe-Bufdig 4 Safety:Green-File:Canary-ApØcant;Pink-Revenw:Goldenrod-Assessor
,
CONSTRUCTION AND PLANNING ROSPA
APPROVALS Permit# Date Inspector APPROVALS 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 UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9.-Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
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 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 0 Gas Q Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T^Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical '
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes: .
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test ,
36. Hood or Canopy R. ,
37. Final Factory Fireplace -
38. Final Plumbing 4_ 04 642-3 4
39. Water Service-Final p '
.40. Gas Service-Final
l�"o6a�
41. Solar Domestic-Final - f
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System •
45. Sound Attenuation
•
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
J'
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA Iy CONSTRUCTION PERMIT PERMITAO����� 'TRACT NO. LOT NO. UNIT NO.
Project Address .;,n i 1!5r
l JOyr/K°..� I off i/�IJ YY . [ y� `i*e l �f- �. TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION IJ REPAIR •�O• <<s�'�'•
Applicant's Mailing Addrenss�/1 ���1q'q�1i II I 1MI PhonefSVU'V N 0 CONVERSION ❑ DEMOLISH ❑ OTHER _- -- A.P.# + lt�' ^
Owner's Name �M DESCRIPTION OF WORK/USE OF BLDG. r' -
Address ��11 )� - El
S Main Building: Accessory;By't7ding: +�y�
Arch/Eng. License No. TYPE OF PERMIT LJ GRADING U'FOUNDATION ❑ STRUCTURAL T Front tf" n'� 1✓-7 p
Address //.�r��) ❑ TENANT LI ELECTRICAL rY/J?PLUMBING ❑ MECHANICAL Rear . 4 C -R
I/TORAll �L e I ' Phones% 11 J 0 OTHER •
C Right ;, � C A LS'" N
Contractor's Name I
r�� '/�/��,�1��d1 PROJECT DESCRIPTION SQ. FT. oCCUPArvCY
Address(mailing) ���133 �/t���=�� ' S Left QVV�
��//''�� CONSTRUCTION TYPE VALUATION$
City License No. IJV�JJ� ZONE GRADING CU.YDS.
ACRES tQ��1I R
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parkinytteq./Provided.'' E
I hereby affirm that I am licensed under Provisions Of Charter 9 (commencing Remarks) - Planning Notes: ��'�('1 '�sy _ Q
with section 7000) of Division 3 of the Business and Professions Code,and 5lslyll!'S�2 11./ 2 11 M
my license is In full 1•r .ntl effect. s T
License la ce se s,L.' a S
Date ' l Signature grin .- - !•SIMS!" PLUMBING -FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
'\ I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
f Workers' Compensation Insurance, Or a certified copy thereof (Section Backflow Preventer - Service Sink
900, Lab. I/J�,`,g ,w. /i •� r Automatic Washer Transformer 0 10-50 KW
Policy No. `"'l1 tt�t company1-%-C (,l. Backflow Irrigation Sewer Cap0 50+KW
- Construction Pole Sub.
[.Certified copy is hereby furnished.
X Cert' ie opq'y/�•`�flied with city ui ' v" "o Bathtubs • Sewer Connection Cooking Unit Meter Cup to 100 amps
Date :'I I' u / thean L(� -.
EXEMPTION FROM WORKERS'COMP NSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(Thissection need not be completed if thO permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
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 Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of California. Motors❑0-1 HP ❑l h-8
•
Date Signature_ Floor Drains - Swimming Pool w/SpaF.A.U.'
NOTICE: If,after making this declaration,you should become subject to the — Inc.Solar 09-15 HP ❑1615+
Workers' Compensation provisions of the Labor Code, you must forthwithFloor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Li ht
I hereby affirm that there is a construction lending agency for the performance - g
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors I Water Heater Outlets
Lender's Name '� Range
Lender's Address • Kitchen Sink Water Service - - -
OWNER BUILDER DECLARATION - - Switches • Sign .
• I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following.reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' Laundry Trays Generator ❑05 KW ❑5.15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor ,
to file a signed statement that he/she Is licensed pursuant to the provisions of Hoof Drains
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt - - - - - -
'he- •rom and the basis for the alleged exemption. Any violation of Section - -
\ by any applicant for a permit subjects the applicant to a civil
%of not more than five hundred dollars ($500).
U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 ' Issue Fee $.3
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL, FEES
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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0ZoningA roved B
sale. If, however, the building or Improvement is sold within ono year of com- Canopy Type II ❑ pp y • Date
prove the owner se lif have the burden of proving he/she did not build or im- Duct- Under Ground 'Building Approved By Date
prove for the purpose the oale). - _ Mit
0 t as owner tr thet property,roject exclusively7044, sinesscontracting with licensed con- Duct-Structural Refrigeration System • Application Issued By Dat:
hetors construct the project (Section to
Business and Professionsfproperty
Code:
The Contractor'smproLicense Law does not apply an s owner pr withta who Duct-Ventilating ❑6100,000 BTU 0100,000 BTU
builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES -
tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $
• proof of their Worker's Compensation Insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration
PLAN CHECK $ PERMIT
❑ am exempt under Section B. & P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers - �1�r�}S�W ISSUANCE $ � �7
PLUMBING $ !y tom`^` ,_�- t
Date Owner Heating System& Ducting Registers ENERGY P.C. $
_ PLAN CHECK 25% $I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BTU— - GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $' -
and state laws relating to building construction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $
sentatives of this i y to enter upon t e 'above-mentioned �prropertypfor �l
inspection may(,:psi /- 'a ! / L/ Date 5 I� -O MECHANICAL $ TOTAL FEE $ (IS V V
Drivers' at
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod -Assessor
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit# Date Inspector APPROVALS 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 C
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GIJNITE
7. Footings , 58. Electrical Conduit-Undr rndr'
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, D Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK Ii
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 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 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & 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-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: u.Zy,,e7 CG4kiest,4
6mit
zo.3 VIZ
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing •
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-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 OCCUPANCY
No. Date _
OWNER NORTEIGATE DATE JUL 5 1963 np
JOB ADDRESS 3075 Roanoke Lane BUILDING PERMIT NO. 19998
GENERAL CONTRACTOR Bonseer 'Construction, Inc. VALUE $ 16,332.00
AP No. LOT 27 TRACT 48011. FIRE ZONE DESCRIPTION OF W_ORKSn43.Fam.Dw1.W/al
INSPECTIONS Signature DATE GROUP I & J TYPE V ZONE R1 Gar.
Soil -,Cf- _'17= PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water /14+57-24--4.7Rough om. Refrig. p Air Cond. 0
Rough Heating /f� A s.../y- ���j^„yy JUL 2 6 1963 2114
Rough Plumbing ,V- f. .,1_ 6 --7:---- -- ( -�--, JUL 1 2 P. -al 'A,
Miscellaneous f''
Prop. Swr. Line ❑p House Co O St. Swr. 0 4- DJ- ';-L-G 3 'V�i�� (?w,., ,.._an...„.._an...- AUG 8 19• - �”'
Sprinkling System WS /o -ca � v ti -.ac_ `" yJ:%�•, -�
Construction Pole
=Mr
&.
Underground ❑ Power :0
' Rough Wiring ?ad ?a-ZG a )727. /.3 ,e_,_. F-7 --6/ a- & 0-0
Trenches Ii r Forms&- Steel Reinf. 0M.----0- ,/�`
Floor System F 7
Bond Beam 0 Steel Reinforce ❑
Sheathing it i-Ze9-3
Frame and Flashing _
Lathing — In � Out 01----- {
Plaster, brown coat / `T/ la_0t-5-#7/4.-1/.�1
Refrig. 0 Air Con. 0 Final
Heating, Final fig% #6"9-i 43
Plumbing Fixtures, Final yy�) /(0-4'4.3
Final Gas Test /nD /B 7 v i
Electric Fixtures, Final !i.I/
Building, Final -r f —/N h7 G- I
OCCUPANCY ,
Form PU4-6M-3-63--S-13 P
19998
COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED
P.O.BOX 917 COSTA MESA,CALIFORNIA
JUN 9 1 1163
For Applicant to Fill In Completely APPLICATION FO PERMIT
TYPE OR PRINT k�lf��jSSI FINANCBfuli s
BUILDINGs.)7S I} OAO0 t?E 4 - >_ C1TYF4TF t1S!A 9Anly
ADDRESS 71
RECEIPT NO. PerMITocgs
COSTA MESA. CALIFORNIA IVVd/�`1�...,J/.AI LLLJJJJL�Jj
RECEIV=•BY DA ' RECEI 0 DATE ISSUED
OWNER Northgate %i. JUL 5 19F3
MAIL ADO EISS
ADDRESS 1 Golden West
11FF,, ^t FIRE I ,, ,
CITY Westminster, Cal. NE0097-7S2µ ZONE TYPE GROUP
APPROVED
ARCHITCT TEL.
eR ENGINEER C. Hiller NO. - OO BY DATE
ZONING ONING
ADDRESS Box 11, Anaheim Cal. USE OF
in
CLl
ZON2.." I NO.OF
PLANS ' / BUILDC
CONTRACTOR Bonner Constr•} Inc.
LEGAL 7 �(— _
ADDRESS 133141 Golden West DESCRIPTION�> T • I +`-
CITY Westminster, Cal. A.P.NO. -er
1p NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
LIC NO.215Oµ9 NO. 8917-782!4 30"TO SIDE @ REAR P.L.
EAVES
SIZE x loo
NO.OF SLOGS, ALLOWED (U.B.C.REQUIREMENT)
OF LOT 6oloo plus I NOW ON LOT O
USE OF YARDS APPROVED YARDS APPROVED
' EXISTING BLDG. r MAIN BUILDING ACCESSORY BUILDING
(FROM C STREETE4-4
CENTER LINE FROM 501 plus REAR YARD 23121• FRONT 0PT. 1
CENTER OF STREET 7 / /
SIDE YARD I LEFT t I RIGHT I •lUs R.SIDE • 3 F' . / FT.
DESCRIPTION OF WORK L.SIDE .l FT. " FT.
( I '
NF >> X ALTERATION ADDITION REAR . FT. AFT.
4
�i DISTANCE BET. BET.MAIN @
REFnIR _MOVING DEMOLISH MAIN BLDQS. ACCESS.SLOGS.
BUILDING r NO.OF VAR.# DATE
SIZE 1&X IJit ROOMS 7 STORIES 2 C.U.P. APPROVED
EXTERIOR WALL ROOF 7,�,,,., APPROV ie ..�
COVERING stUCCO I COVERING Shingle BY Ct,�,�h DATE 6-
• USE OF BUILDING AND WORK TO BE PERFORMED \\\
Sine e family Watt gara•P # X 4
w
N
440 a
I HEREBY ACKNO 8 THA HAVE R H O THIS APPLICATION THE OUNTT SHOWN UNDDER VALU ION IS THE
AND STATE TH THE A oirORRECT ND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. F
PLY WITH A CITY ORD• ND S LAWS REGULATING O
BUILDING cH STRUCTIO VALUATION q
SIGNATOR 0 - PERMIT FEE S / (JIi LI
PERMITTE -.4iJ $ /// �'.. �' -_A. C. SI E
AUTo.
HORIZED AGENT N
TOTAL FEE $ ,�1