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Home My WebLink About3044 ROYCE LN - Building Permits CITY OF COSTA MESA 'rr BUILDING DIVISION .r: c`i4 i DEVELOPMENT SERVICES DEPARTMENT : • a 1 PERMIT P IT NUMBER " °� B05-01274 (714) 754-5273 • Fax(714)754-4856 • www.cl.00sta-mese.B.UsILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3044 ROYCE'LN Suite: - Status: ISSUED Vicinity: RESIDENCE AND ATTACHED GARAGE Applied: 08/01/2005 Primary Oct. R-3 Dwellings/Cong Res<10 Type of Construction: V-N Issued: 08/01/2005 Parcel Number 14116404 Zoning: R1 Applicant: JOSEPH W-GOBSTER - Address: 1067 CHEYENNE , COSTA MESA,CA Phone: (714)540-0147 Zip: 92626 Ar ISSUED BY: r ir owner: BROWN, GILLIAN N, '' Address 1 LAKE TRAIL • IRVINE CA Phone • - s. i Zip 92604 �" a Contractor: JOSEPH 1N LOBSTER r i Tr> Address: 1067 CHEYENNE ^^ue , ' Phone: 714 540-01472. COSTAMESA'CA ' 'r Phone: (714) �;- ZIP`- 92626 - License: 362397 w x e K Arch : i =r:. a. Address: , ,/,::"..t Eng: ri ?.t, -- " Address Phone: )1.r " - Phone *n � ve ° r SCOPE OF PERMIT 0.5 REROOF RESIDENCE<<WITH ATTACHED GARAGE TIO EXISTING WOOD SHAKE ROOF,7/16 OSB SHTG 1LAYER 15#FELT APPLY"30-YEAR COMP SHINGLES,"2300 SO FT 4;A" Plan Check $0 00 Permit $125 25 - " Calc Valuation 1< � $5,300, SMTP°Res t $0 53 Claim Valuation o0 SMIP x $s 300'00 Gom a - Other $0 00 Inspection $0 00 - • '',Total , $125 78 SETBACKP1-ANNING &ZONING MAIN STRUCTURE Front 0 0 • . . 1„:".4.-".., Rear 0 0 6 • Left .;0710 - ' i ' s 4 r a Right,.. 00 s ACCESSORY .t':-:,:„`,-=11:-... - Front .�0 0 Rear 0-0 X `' Lett 0 0 ""'' " Ri ht' PARKING * % —r , 9. o 0 �Exi. suna 0 ` Re drred f 0 r po : --� Proposed„ • 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 it 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 244646!6/001 DECLARATIOUS • 1., ij n 0' • 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 me 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 shouldbecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions Applicant Signa 4ue. ��rr��,, /e y O CDal-- c�'J'o..s WARNING:FAILURE TO SEC ria''.;RKERS• PENSATICN COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML AMES UP TO ONE HUNDRED THOUSAND not ARE($100,... ADDITION 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�zQ9(commencing with Section 7000)of Division 3.of the Business and Professions Code,and my license Is In full L force and effect. lc.l `L 3Q J LClass Contract Signatu _ cry cDate.� Lir /Z 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: 1 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 end 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 contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. gYes 0 No Drivers License No. Expires: Verification of Ownership 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,faisework,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 e permit to do such work from the division. Signature: Data: 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? 0 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 implication 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? Yes 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 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 Califomla Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If Net,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 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 inspection purposes.l agree not to occupy or allow ncr'rpancy of any building authorized by this permit until final inspection. rCgatuXLegal ) Date r dlOr Authorize Applicant --!" CODE ( Data CODE I RISPECT1ONTYPg 1A1 =Ma , CODEC INSPECTIONTYP6 gag MALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final e p �jy/�� 208 Final Plumbing 200 Final Re-Roof S, I/ ✓"k t' 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 fol ADORESSOFBUILDING: 3044 ROYCE LNBMT' CITY OF COSTA MESA - BUILDING PERMIT ' • C YNERS NAME IF KNOWN: BROWN, GILLIAN N PERM NO: M 076380 ADDRESS: 3044 ROYCE LN COSTA MESA, CA 92626 PERMIT NO: M 076380 PLAN CHECK NO: N GOVT: N SUPP: N 733-3731 APPL•MMUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: OTH ARCHITECT ORENaNEER: DC.NO.: JOB DESCRIPTION : REPLACE F.A.U. SQ FT: ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALL-VALUE: GROUP OCC: R-3 / CONTRACTOR'S NAME: A.B ,C. HEATING & A/C ( 714 ) 540-0972 CONTRACTORS MMIING 2951 GRACE LANE COMMENTS : X ADDRESS COSTA MESA CA 140.ND.: 133298 **TE*****************-*-*****'**'M'*-*'M'******IF*******x-y *****IERF** -*+FIFIF F****ac-*******+F*** 92626 UNIT: Z ON ING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I em licensed under provisions of Chapter 9 S ETB ACK S (commencing with Section 7000)of Division 3 of the Business and Professions Code.end my license is in full force and effect, Llc."o.: 00 041 LIC.CLASs: C-20 LI3 98 EXP: /96 MAIN BUILDING ACCESSORY BUILDING CContra, `F FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Dae: /� • — LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OW R BUILDER DECLARATION:I hereby affirm under pen of perjury that I ant exempt f e Contractors License law/or the Jin rearon(Section 7031.5Buaressand ProfesslomCode:Any cry«county which requi epermhl000mmct.ab«,improve. PARKING REQ: PROV: PARCEL: 14116404 ZNE: REF NO: doh,IX rapes any structure,prior tato ds ssuance,8190 requires Iia applicant 1«such perms to DIB a signedstatement char he Or BIM( Kensed pursuant to the provisions the Contractors License Law(Chapter 9(commencing with Section 1000)al Drv'sbn 3 d the PLANNING NOTES> Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section > a.* 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more then lie hundred dollars l$500)). ******************************************************************************* ❑ I.as owner of the progeny or my employees with wages as thele sole compensation.will do the work.and the studios is not intended D E V E L O P M E N T S E R V I C E S R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not applyto an owner of properly ,� Q who bads or improves thereon,and who does such work himself or herself IX through he or her own employees,provided that such improvements are not intended or offered for sale.lf,however,the building IX improvement is sold within one year of completion, ZONING APPROVED BY ''''.1 DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ Las owner of the propend.am exdtn vely contracting with licensed contractors to construct the project(Section 7044,Business and ' Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY : ,, DATE: contracts for such projects with a conlrector(e)licensed pursuant to the Contractors License Law). 45176❑ IamexemptunderSection: B.AP.C..fortireason: APPLICATION ISSUED BY: M DATE:Dale: ownrer: **************************************** ** *4F..,,-e• .,...************** * ** LEGALIZATION:N F E E SU MARYV STRUCTURGMENT: N I do hereby certify that I oro aware of and understand the requirements of California Health and Safety Code Sections 25505.25533.end 25534,and that I«any future building ng n(Laity will/all not(circle one)need to comply wih said state codas and the requirements for a remit for construction modification from the Air Management District.Ressidentalconpructionappicationsare exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING prweans. PERMIT 9 . 00 Dale: _ _ Applicant: 25% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following decimalizes: PLAN ❑ I have and will maintaina canlfbae of consent to see-insure for workers'compensation.as provided for by Section 3700 of the LaborISSUE FEE 1 15 . 00 Code.i«the performanced hewaklIXw permit BUILDING-DIC > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE o I have and will maintaworkerscompensation insurance,as required by Sedim 3700 of the Labor Code,for the performance of the TOTALS > 9 , 0 0 15 , 0 0 0 . 00 24 . 00 2 4 , 0 0 0 0 n work for which this permit is issued.My workers'compensation insurance carder and policy number are: Cartier: UNTTFD OACTFTC EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 24 . 00 OVER/SHORT: .00 Policy Number: (-44A11177711 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I the penile is for one hundred dollars(51001 or less.) 24 . 00 ❑ I cert that in the performance of the work for which this permit' issued,I shell not employ any person in any manner so as to become subject to the workers'compensation laws of Calif e.and agree that N should become subject to Irk workers' **************************************************************************{E**** W ions tam of-$Mroy 3700 of the LaborCode.I 1 . •°f those provisions. D e. g L//G APg /0�/ INDIVIDUAL F E E B R E A K D O W N rip:Failure to secure workers'compensation coverage sun/ewM,and shall subject toyer to MMnel pena/tlo and i, TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST It'll lines up to one hundred thousand dollars f$104000),In addition to tile Calf of romp ' don,damages es provided for In 9setlon 3706 of the Labor Code,Interest,and attorney's fees. MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). LENDER'S NAME; LENDER'S ADDRESS: I certify that I have read this application and date that the above information is correct.I agree to comply with all dry and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for ins.:.ion purposes. RUSSELL BANGERT • //n • N f 6Prir Date: f 9e- / U 01 [02CO3'5-52OGt 5 T OT 24.00 Signature ofOwner/Agent/App• W. tredo DATE: ' '•M'•• 11:,0 (5151-4e.WP) While-Building A Safely;Green-File:LCenery-Appicent;Pink-Revenue;Goldenrod-Assessor 7 CONSTRUCTION AND PLANNING - POt I 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 r 3. Electrical Conduit UtilityUndrgrnd. 54. Forms - t ' 4'. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • '8. Foundation _ 59. Gas Pipe, 0 Undrgrnd.,Test 1 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 r ' 12. Sewer Cap • • 63. Heater & Vent-Final 13. Roof Drains64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit - - - 66. Solar System-Final 16. Rough Electric Wiring `- 9 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 _• - - APPR_OVALS Permit# 21. Ducts, in Structure .1, 70. Underground Hydro 22. Ducts, Ventilating _ , • ' ' • 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test • _ _ - 72. Underground Flush 24. Roof Framing- - -. L • 73,1 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 BrownCoat • - ' 79. ANAL INSPECTION • _ 32. Electrical Power Meter-Final • r 80. FOOD CERTIFICATE ISSUED - 33. Final Electric _Si qes• ,,- Notes: i _ 34. Final Heating& Air Conditioning _ �ZJI3 • rj\/ 35. Final Gas Pipe-Test • I - _ 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 -. . y � - - 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 OWNER College Mesa Co. / DATE 9-15-55 JOB ADDRESS 30114 Royce Lane BUILDING PERMIT NO. ]796 1 GENERAL CONTRACTOR The Hale Co. VALUE $ 8,000.00 LOT 57 BLOCK TRACT 311 Single dwelling GROUP I TYPE V ZONE pJ, FIRE DISTRICT #1812 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR c� DATE NUMBER Footing Trench dr-eel y Zv-S.S n t -,_ ---- Foundation Foundation Forms and Grade to Garage /0-/ '4 ,A4.---C.41 Rough )tct- -`- Rough Framing a g/ � ,w2-'a-. Plumbing,Rough to Slab47" G/G /� ' �'s j ,LyCr.0,y,,r1 ,ecern.04 /O-/9-ss 2a ...s-E Plumbing,Rough Complete)a--/5/ 1l -hk--473. U a Temporary Pole • Wiring, Rough �� Y'rIv.i 47- /-S.1 /70 7 f-rsr'`- Heating,Rough , d''E.-mr-(•Sr/ /2 % y�'e. g Heating,Final i<j .�'� _ /Sewer, House/.�//- ..S wer,St. 'Jill ( j Edi. /r-0,9.3-sem'3r.° 6 , Septic Tank or Cesspool t, Lathing, In p.-p- O Out n4 / / 45 Plastering -tom - JJJ Plumbing,Final,Fixtures ComFirplete F Plumbing,Final Gas Test- ( GL '-- f( \�feel//A ` Wiring,Final .�,e2G-e J _ Occupancy 14a yt,, 4 L9 Pnrm 9111 f:_1-1 1500 1-55 -„ Costa Mesa Building•Department APPLICATION FOR PERMIT e 111 EAST 20th STREET 1812 BUILDING 1 COSTA-MESA, CALIFORNIA • FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN 1 Receipt No. I Permit No. Building 7 Address 3044 Royce Lane Costa Mesa, California Received by Date Redd. I Date Issued Nearest t.--, .... ?—/ 3 S� SEP 1 5.1955 Cross St. Watson Avenue Building 4' Address Owner College Mesa Company Costa Mesa, California Mail Address 8002 Central Avenue Nearest Tel. Cross St City Garden Grove No. LE 9-2158 Zone No.of Type 4/ Group Architect or Lie. L' I plans I .,/, / .•. Engineer Davis & Quigley No. C-1790 Approved by Date Address43 Malaga Cove Plaza,Palos Verdes CORRECTIONS Contractor The Hale CompanyNoy Lic. - No. 3422 Address 8002 Central Avenue, Garden Grove LegalLot I Description I No. 57 I Block I Tract 2341 (Attach Metes and Bounds) No.of Bldgs. Size of Lot 7034 I Now on Lot None • 0 Use ofNo.of A No.of Existing Bldg. I Families I Rooms - ', Setback Line from 50, Rear Yard 35, Center of Street Side Yard R I y DESCRIPTION OF WORK r New I X I Alteration I I Addition I Repair I I -Moving I I Demolish I Building No.of Size 1270 Rooms 6 Stories 1 Exterior Wall I Roof Covering Stucco Covering 4 Shake APPROVALS Use of New Foundation Location Y; Inspector Date Building Single family dwelling with Forms,Materials, "`' attached garage._. Under-Pinning Ti Frame: Fire Stops, Cri Bracing,Bolts l il I hereby acknowledge that I have read this Application o and state that the above is correct and agree to comply Lath. Int cin with all City Ordinances and State Laws regulating civ building construction. Lath.Ext. II Signature of I Permittee T SHALE 00MP Plaster, Int. rn Authorized Agt. ' / �' 4-L Plaster,Ext rr1 SILVIA LARDNER Valuation Permit Fee $ '�'� Masonry Reinforced :1 - Bond E_ O a' . Plan Check$ ' ' -" $ J Total Bond Beam Fee $ ..?�3.� FINAL O FORM 204 S-RP 2M 6-55