Loading...
HomeMy WebLinkAbout223 ROBIN HOOD LN - Building Permits CITY OF COSTA MESA L0515511k4--s BUILDING DIVISION FtK' s( 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us • FOR INSPECTIONS CALL: (714)754-5626 '% ^"° PERMIT NUMBER: BC11-00104 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 04/2812011 ISSUED BY: CAC JOB ADDRESS: 223 ROBIN HOOD PL CM - Suite/Unit: APN: 42620248 Zoning: , , Vicinity: •Primary Occ: Const Type: V-B SQ. FT: 676 Valuation: $182,462.40 SCOPE OF WORK: 676 SQ FT SINGLE STORY ADDITION. SCOPE OF WORK TO INCLUDE: REMOVAL OF ALL WALLS OF THE EXISTING DWELLING. EXISTING SLAB AND GARAGE ONLY TO REMAIN. EXISTING RESIDENCE IS 1622 SQ FT.ADDITION IS 676 SQ FT.TOTAL SQUARE FOOTAGE OF RESIDENCE WILL BE 2, 298 SQ FT. RESIDENCE WILL BE 4 BEDROOMS WITH 3.5 BATHS. 1 FAU < 100 KBTU 1 AC UNIT<100KBTU 1 KITCHEN HOOD 6 VENT FANS. 1 AC UNIT 60 LIGHTS 50 OUTLETS 32 SWITCHES 1 SERVICE UP TO 200 AMPS 1 GARBAGE DISPOSAL 2 BATHTUBS 1 GS OUTLET(1-4) 1 GAS REPIPE 1 LAUNDRY TUB 6 P TRAPS 2 SHOWERS 1 KITCHEN SINK 6 WASH BSINS 4 TOILETS 1 WATER HEATER OWNER: PINNACLE EQUITIES INC TRUST Address: 223 ROBINHOOD PL Unites' ' 403' .044 Phone: 949-294-5387 City/State/Zip: COSTA MESA,CA APPLICANT: SMITH, BRAD Address: Unit: : Phone: 949-631-3682 City/State/zZip: CONTRACTOR: License No. Phone: Address: Unit: Cell: City/State: ZipCode ARCHITECT: BRADFORD C SMITH,ARCHITECT License No.C14146 PHONE:949-631-3682 ENGINEER: RIGHT ENGINEERING License No.C70882 PHONE:949-855-2300 COMBINATION PERMIT FEE SUMMARY '.'a'i i:LLS OF THE Building Plan Check: $948.06 • . :D DI 1 IN 3 Building Fees: - $1,458.55 • OiT4.s i ri 3.5 Electrical Fees: $258.11 - "t!1L: o 32 Mechanical Fees: $92.45 Plumbing Fees: $274.65 S I H 11A-t l! SMIP Residential: $18.25 SMIP Commercial: $0.00 Bldg Std Admin Fund $8.00 „ - 4.1 TOTAL FEES: $3,058.07 "Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 ..+L.: Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day, Labor Day,Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. ;r' " j. =nr. 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. CODE S. INSPECTION TYPE DATE IN1111AL5 CODES INSPECTION TYPE '.r GATE IN ALS '1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing X 9.23 200 Final Re-Roof 210 Final Electrical X 9-a a•N--; 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 1r 204 Final Demolition 250 Final Building/Occupancy /yk [• 3-" • WORKER COMPENSATION DECLARATION: Owner ID verified by driv license. ❑Yes ❑No fr./ r I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: El I have and will maintain a certificate of consent to self-Insure for workers' Verification of•Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gry (This section need not be completed d the permit is valued at one hundred dollars($100)or less) 2,Ant Sec.341,Title 6,California Administrative Code). Policy umber: 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless is ued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to a workers' compensation laws of California, and agree that if I should become subject to the workers' Compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I sh�„+, f omply with these provisions. / x _ _ 1 Division of Industrial Safety Permit Number: rapt .nf mature Da HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my li -rise is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No 0 ' 0 Clas # 13 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by er, �" 1 /2 F�Ir each business which at any one time has on hand a quantity of acutely con -c r'ssi tore 6i 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely • Lender's Name: hazardous materials)? ❑Yes ElNo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No 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 (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California - License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 'I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature o egal Owner(s) /� ate Signature Date P//7 3057-46(3107) (((/ Andlor Aut 'zed Apply/cut "N % Z�Da e CO-28-2011/0i :17 PM . _ .. LISER.:LB . NEWPORT-MESA UNIFIED SCHOOL DISTRICT f -74* 1152 - - CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 / • 148, 52- To: ti , City of Costa Mesa District Receipt No. ( ) City of Newport Beach 00 1 o41. ( ) County of Orange Plan Check Nd Applicant: (( P/� t!.S 7/fl NO do Al Si. r'� c . p Address: 460 95 n Afirk-A1?ratite c R7 AI & • r4 . / 2/co Telephone Number: 949- 2 `�`{(_ 53 81 �y Tract/Parcel and Lot Number(s):� � m42 6 - 202 - 4/� / Location of Project: / /� % /[ O R/Amoco p cm) �'/5 6 7 ) Number of Square Feet of: ,{ 9 Residential Space ('D7 6 x $1.84 Total I) 2 4 3 O Commercial and Industrial Space x $ .30 Total Commercial/Industrial Project is: (Check One) _ Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdicfon. Checks are to be made payable to Newport-Mesa Unified School District. / By: C%&I u C/c m th h Authorised Representative The above representation as to square footage is true. Applicant agrees that if it is later detemined that such representations are not true,then this certificate shall automatically terminate and the appropriate City/County shall be notified. Date: 00/ 4c Cnets Appecert 4. CITY OF COSTA MESA o�oy ,� BUILDING DIVISION t :tar' , 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us °. FOR INSPECTIONS CALL: (714)754-5626 ltoi; ,:o*`' PERMIT NUMBEF{ ©q y PERMIT TYPE ELEC STATUS: FINALED uu APN: 42620248 DATE ISSUED: 04/06/2011 ISSUED BY: KJB JOB ADDRESS: 223 ROBIN HOOD PL CM Suite/Unit: Vicinity: SCOPE OF WORK: TEMP POWER POLE FOR RESIDENTIAL CONSTRUCTION.REF:BC11-00104. OWNER: PINNACLE EQUTIES INC TRUST Address: 223 ROBINHOOD PL Unit: PHONE: 949-645-5200 City/State/Zip: COSTA MESA,CA APPLICANT: VALDOVINOS,AGUSTIN Address: Unit: PHONE: City/State/zZip: CONTRACTOR: NATIONAL CONSTRUCTION RENTALS License No. 687160 Address: 1550 E CHESTNUT AVUnit: PHONE: 714-285-0243 City/State: SANTA ANA,CA ZipCode: 92701 CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $47.00 Reinspection Fee $0.00 TOTAL FEES $47.00 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE O. INSPECTION TYPE DATE INTInALS CODE INSPECTION TYPE DATE INIInALS 1616 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 204 Final Demolition 250 Final Building/Occupancy 1-I I H11 by r,t6(- WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 sec`om3700'of the.Laboi-Gode, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is-issue`dit M-'yl1workai compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a nurser are: �/ 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thu section need not be completed a the penile is valued at one hundred dollars($/00)or less) 2,Art 2,Sec.341 Title 6.California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code, I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES, 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code. and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractor's Signature Dale 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes CINo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penally of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). O I, as owner of the property,or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If"yes', attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Owner(s) Date Signature Date 305746(3/07) And/or Authonzed ApphUnt Date __08 :)3 EE� RE CEN ED COSTA MESA BUILDING-SAFETY DEPARTMENT LCpt/ 77- 7�0 . .YJ P.O.BOX 317 COSTA MESA, CALIFORNIA FINANCE DEPT. EOR APPLICANT TO FILL IN COMPLETELY ' APPL{e�q.IEngO�Wi RMIT TYPE OR ED°BUILDING Lang' A . COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY E t�Develonment Corporati I 1 RECEIPT NO. Ii PF OWNER p62(R'9J MAIL RECEIVED BY DATE RECEIVED S� O11Qn . ADDRESS • E. 1 th Street A 'Cr I ^/ ^ b IJ'9 CITY �:nS'�' MP SA Calif.] TN O.•.' 011BUILDING 59' ADDRESS ARCHITECT Carl on & LIC. COSTA MESA, CALIFORNIA OR ENGINEER • Garden • NO. ' ADDRESS Garden Grove ' FIRE ,/ 1 n /� Dike • ZONE TYPE !/ GROUP p..{L�1y CONTRACTOR Colegrove, Inc.Inc• 4 STATE 167293 • APPROVED U BY DATE ADDRESS 419 E. 17th Street ZONING LEGAL LOT �J]328 ZONE NO.OF USE OF NEW, �'� ' DESCRIPTION I NO. I BLOCK TRAGI �/ PIAN/S /Y' I BUILDING .4._/: �, `[ /, , BY N , 0 _ J DATE///—/YJ —�1 C SIZE 45' x Q] How ory LOTWQ[lQ YREQUIRED ALLOWED OFF LOT Zi USE OF (CENTER LINE ST.) L. EXISTING BLDG. \ •• - FRONT ✓-DFT. IN. SETBACK LINE FROM CENTER OF STREET h8 REAR YARD 3-71/c .. R.SIDE 5-FT. IN. SIDE YARD LEFT 51 (RIGHT 51 :,1_SIDE J FT. IN. DESCRIPTION OF WORK - �> / ��/ REAR / FT. IN. NEW X I ALTERATION I ADDITION REPAIR I II MOVING I DEMOLISH • BUILDING NO.OF •. SIZE 1601 ROOMS • STORIES ROOF COVERIING WALL stolen) ICOVVERING shake R. : USE OF BUILDING AND WORK TO BE PERFORMED S' ,• - -R ' residence with attached garage Plan X 750 E I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CDM THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION.qVALUATION SIGNATURE OF V PERMIT FEE $ 36.00 PERMITTEE r�� $ 16,4 1 PLAN CHECK $ 18.00 AUTHORIZED AGENT Dike & olegrove, Inc. TOTAL FEE $ 54.00