HomeMy WebLinkAbout2206 RUTGERS DR - Building Permits , 4 t9 CITY OF COSTA MESA
qe BUILDING DIVISION
•„' �. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT ✓B03-00388
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2206 RUTGERS DR Status: ISSUED
Suite: Applied: 03/10/2003
Vicinity: TRIPLEX Issued: 03/10/2003
Parcel Number: 41906210 Zoning:
Applicant: DUARTE, MARCO ANTONIO ISSUED BY:
Address: 2206 RUTGERS DR
Phone: 949-650-2357
COSTA MESA,CA Zip: 92627-1626
Owner DUARTE, MARCO ANTONIO
Address 2206 RUTGERS DR
Phone:
COSTA MESA,CA - Zip: 92627-1626 •
Contractor:
Address:
Phone:
Zip: License:
Arch : Eng:
Address: • Address:
Phone: - Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF OF A TRIPLES. REPLACE SHEATHING AS NECESSARY:COVER WITH 25 YEAR COMP SHINGLES.TRIPLEX IS
APPROX 2280 SQ. FT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,000.00
Permit: $97.25 Claim Valuation: $4,000.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
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
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)
DECLARATIONS •
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work fo(((which this permit is issued.
My workers'compensatjpn I s ranee carrier d 'cy number are: /�
Carrier.
S%-ii Policy Number: U/
(This section need not be complef it t e pe t is valued at one hundred dollars($100)or less.)
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 worleirs'compensation provisions of Sect' n 3700 of the Labor Code,I shall forthwith
comply with these provisions. 1 ��
Applicant Signature: /L's//Pp In 772n.i1 pun.v I r Date: ' 1 1z `- - J
WARNING:FAILURE 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.ft Class IS
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).
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 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 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
su cts the applicant to a civil penalty of not more than five hundred dollars($500).):
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.). •
O 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.).
O I am exempt under sec. Business and Professions Code for this reason: I e
L
Signature: .- . ,r, ;. i / .fie- Date:
I VD
Owner ID verified by driver's license. 4 s 0 No Driver's 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,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? 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 application a ermit for such construction or modification
0
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 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 0 No
B (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 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.I agree not to occupy or allow occupancy of any building a7Abo4zed by is p_ ermit until final inspection.
n'ta'/Y/J /9 7O/1 1 fivgylr //� 1 1 (0-5
Signature Of Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE t. INSPECTION TYPE PALE INT111ALS CODE t $NSPECTION TYPE • OAT INTmtu
1616 Fixed System Final Fire Prevention __ 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
7
200 Final Re-Roof J'''249 n97 `�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
ADDRESS OF WILDING: 2206 RUTGERS DR UMT: CITY OF COSTA MESA — BUILDING PERMIT
CWNEWSNAMEIFIMO tROMERO SERGIO PERM NO: P 081316
ADDRE55:2215 MEYER PL OSTA MESA, CA 92626 548-5565 1 ^
/e PERMIT NO: P 081316 PLAN CHECK NO: N GOVT: N SUPP : N
APPL.MAIUNG ADDRESS l CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR ENONEEm D4 ND.: JOB DESCRIPTION : STRAP 3 WATER HEATERS / REF B-81153 SQ FT:
ARCH.OR ENG.'S ADDRESS: UMI:
CLAIM VALUE: CALC—VALUE: GROUP OCC :' R-3 /
CONTRACTORS NAE: COMMENTS: REPAIRS
CONfRACfOR4 YMlgq 3E 161E 3E iE 3E 34*3E 3E 343E**3E 3E 34*3E 3E 43E 3E 3E 3E 34 iE*3E**3E 3E iE 1E 3E 3E*3E*iE*1E 3E 1E*3E 3E*34 3E 3E 1E 3E 361E 3E 1414 3E fE*3E iE**3E 3E 1E 3E 1E 3E 3E 3E 3E*3E 3E 3E
ADDRESS NO UHT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby 'm under penaly d perjury that I am licensed under provisions of Chapter 9 SETBACKS
tam
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my Scan is in full(arcs end effect.
CITY LIC.NO.: LIC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I we exempt from the Contractors License Law for the
following reason(Section 70315 Busnesa and Professions Code:Any city or aunty which requires a permit to construct,alter,improve, PARKING REQ: P RO V: PARCEL: 41906210 Z NE: REF NO:
bmdeh,or repel any structure:prior to is issuance,eio requites the applicant for such Penni'to file a signed statement that he or she PLANNING NOTES>
s licensed pursuant to the portions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the > ,)
Business end Professions Code]or that he a she a exempt therefrom and the basis for the alleged exempiol.Ary violation of Section
7031.5 by any applicant for a permit subjects the applicant to a dun penny dna more than five hundred draws(5503]). 363E**3E 3E 3E 1E*3E*3E 3E 3E 3E*3E 3E*iE*3E 3E 3E 3E 3E 3E 3E 3E 3E 3E 3E*3E*3E 3E 3E 3E**3E 3E 3E 3E*3E*1E*34*3E 3E 14*3E*3E***3E*3E 3E*3E 3E**3E 3E 3E 3E 1E 3E 3E 3E
❑ L as Dena of thepropeMamyempmwea withwagee as their sole compensation,wYdo me work.end the structure is no intended DEVELOPMENT S E R V I C E S R E Q U I R E M E N T S
or offered for sale(Sedan 7044,Business end Professions Code:The Contractors License Law does no appfy to an rvmer of property
who With or in proves thereon.and who does such week tinsel or herself or Ihiough he or her own employees,provided that such
ro
improvements are tintended adored for sale.If.however,the building or inprwementMsold within one yard completion.the ZONING APPROVED BY DATE:
X ownerbulder oil have the burden of proving he or she did not btdd or improve for the purpose of sale).
❑ I.es°wwe'dthe propmy.amexctual.*ceferectin eithlamed caeUMonbcarbwthe Feted(Sedon7°44.&wirtess°rd BUILDING APPROVED BY : i . , , DATE:
Professions Code:The Contractors License Law does not apply to en owner of properly who builds or improves thereon and who
contacts la such projects with a cadmcto(s)licensed pa°uens to the Contractors license Law). Ir'�'�l
❑ lam exemptundB.KP.C.,for Nereason: APPLICATION ISSUED BY: 1 \-4 DATE: j- 24--97
3E***********363E******************************3e*** Nr 3E 1E 34*3E 3E iE 3E iE 3EfE*iE 1E tE 1E 3E 3E 3E 3E 3E*
Data: Ir� 7 owns: LEGALIZATION:N F E E S U M M A`F2 Y STRUCTURAL SEGMENT:N
I do hereby certify that I we aware of end understand the requirements of Calla7,..00_________
and Safety Code Sections 25505,Penn.and
25534.and that lor any future building occupant oval/w0 nor(circle a»)reed towith said Stele codes and the requirements ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for oonnWdionor modification from the Ai3r yuTi y7!.anagenwu District Residential mndrwion appfutonsre exempt from these PERMIT 33
provisions. .0025% SMIP/NON—RES
Date: Applicant: PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of Wirt one of the following declarations: ISSUE FEE 22 . 00
�'
❑ thawend dlmarn°nacompare oconsent toseSinstrefor workers'mnp°rutlon.=provided for bySaction3700dthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.fa the adormence of the work for which this permit a issued. TOTALS----> 33 . 00 22 .00
❑ I have and
d dl maintain workers'compensation insurance,a°required by Section 3700 the Labor Code,for the performance of the v, 0 55 . 00 5 5 . 0 0 0 0
wxkfor w which °°""°a®°d'My ° a
°a'compensation asp" "° °°` REVENUE DIVISION TOTALS--> COLLECTED : 55 . 00 OVER/SHORT: . 00
Caner: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
Privy Number. 55 . 00
(This section need not be completed t theon
pt is for one hundred doe +s($100( Mal
X❑ Henry that in the pert• . d the work la whichthis a
non o is issued,I shall nemploy any omen in any manner so as to
booms sm.
become to the . . ..campenwon tows dCalifornia. d thin GammB I should aged to 1M worm,. 3E3E**************************3E3E**************3E36363E******3E3E3E3E3E3431•3(•3E3E3E3E3E43E3E3E3E3E3E3EN***
/ +mensal on:. . m. abs cos.,I sena r won Dan IND IVIDUAL F E E BREAKDOWN
Dale: Applicant
Warning:Feu to secure • err conpenadon average Is unf.w?u and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
chill fines w to one hundred thousand dollars 01O4000A in add/tion the cost of compensation,damages as provided for In
Section 3706 of the Labor Code,Interest,and attorney's less. PLU 3 WATER HEATER AND/OR VENT 11 . 00 33 .00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penatly of perjury that there is a comm11ndon lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C). r....
LENDER'S NAME :elr^
LENDER'S ADDRESS: y�,"� .ff+
I certify that I have reed this application end stale that the above information is correct.I agree to comply with all dty and county ordinances nI / C'- ' L
end stale taws relating to buildingmnstnxxon and hereby waxen,representatives o this city to enter upon the above-mentioned property �// r
forinepedorpo
nasescwfi
IO ROMERO . - I
/Ire( . JAN 2 4 1997
Print Name. 424>SG a r/ygentrAp leant/ContractorCR OF COSTA MESA
/
(5151d6.WP) ' White-Buildup A Safely.Green-Fl: m
:Canary-Appim;Pink-Revenue:Goldenrod-Assessor
,' CONSTRUCTION AND PLANNING _ POC 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
I
- 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - -
,r 4. Electrical Conduit-Undrgrnd. _ . 55. Electrical Bonding •.
' . 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
• ,,-•-6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
4.
7. Footings 58. Electrical Conduit-Undrgrnd. -
1 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 T. 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 _ EIO,E_DEPT_.REQ7.UIREMENT
S w
20.-Rough Factory Fireplace - . - _ ; . APPROVALS L. Permit#. -
21. Ducts, in Str ciure' " ' = 70.:Underground Hydro -
Ducts, yentIla tinge ' •E' • ' < V "
22.-
�� •t •= 71. Produ_ct'PipingC_ •OOiI
23.;Gas-Pipe-RoGgh & Test r` - m r= _* 1 ' 72. Undergrodnd Flush ;'
24. Roof Framing ..L.'-''.
- ,". • ' ` • -
_ 73. Undergrnd.Storage Tank O Gas Obil
25. Roof Sheathing + _ •_ T n -t 74. Overhead Hyde.
` - r•26..T-Bar Ceiling (Structural) & Monocoat 5. Dry Chemical,- * IJi,_
27. Frame and Flashing ` - : e - r�. 76. Dry Standpipe'-"- ;` � •
28. Lathing& Siding A - _ _ F '- , P. FIXED-SYSTEM E•INAL-.
29. Insulation W •• _ i - it 153.-:FIRE,PREV. FINAL c_•
30. Drywall-Nailing ,T. _ -. ^ it --_ c,tHEALTH DEt'T.�REQUI,iEMENT
r _.
31. Plaster Brown Coat - 79. FINAL--INSPECTION " .. --
- 32..Electrical Power Meter-Final -• 1..1i - $0. FOOD CERTIFICATE
.
33.:-..F inal Electric Y. Notes: * / �.
34. Final Heating;& Air Cpriditioning - - r
35,-Final Gas Pipe-Test. :2- - -•
_ r
• 36._Hood or Canopy * t-
r
37. Final Factory Fireplace- - - • '
'
38. Final Plumbing -• - ~ F - e
39. Water Service-Final' - �; -- - t:
40. Gas Service-Final - ' r ` - -
41. Solar Domestic-Final 2- 'q r ' r: • = r 7 k
42. Backflow Preventer T _ - • .. -' - t:'•
43. Backflow Irrigation -- _ r - - ;
44. _Landscape IriigatiohSystem : ._ - - : . _ _ ,� - w
-45. Sound Attenuation , . • •- - - - ' • ' , _ x
46.•Handicap Regulations v r
47.-FINAL STRUCTURE & BUILDING i r f -
f. w.-4:d
48. FINAL PLANNING - _. .
.149 _Electric Release to Edison ,
50. Gas Release to Southern California Gas Co - ' -
'51. CERTIFICATE OF OCCUPANCY '
No. Date
*o0 ssastumm 2206 RUTGERS DR WIT: CITY OF COSTA MESA — BUILDING PERMIT
a sT4ExSNAMEIIuuI*ROMERO, SERGIO PERM NO: B 081436
T Aoayss:2215 MEYER PL
PERMIT NO: B 081436 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92626 548-5565
APPL.YMUNG ADDRESS: CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: 0TH
ARCKRECT OREN3INEER: LC.No.: JOB DESCRIPTION : T/OFF & REROOF W/BUR TO 2ND FLOOR ONLY SQ FT: 1 , 000
ARCM.OR ENO's ADDRESS: WIT:
CLAIM VALUE: 1 , 000 . 00 CALC—VALUE: 1 , 000 . 00 GROUP OCC: R-1 /
comm ctocrsfwlEPRO ROOFING CO. ( 213 ) 733-2411
CONTRACTORS MARAO 2029 W. PICO PL COMMENTS: RE—ROOFING ONLY
ADDRES9:L .A. CA uCNO.: 674063 *******************************************************************************
90006war Z O N I N G REQUIRENENTS
UCENSED CONTRACTORS DECLARATION:I hereby Slim under d ponNy Me It reed under provisions d Chapter 9 SETBACKS
(commences;with Section 7000)d Division 3 d the Business and Code,end my is in hi fan and Bled.
CITY UC.NO.: / �uC.CULSS:C-39 Ix. a:6 4063 /� FAXP: MAIN BUILDING ACCESSORY BUILDING
2L(� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
414 3 ` Contractor: \i6' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
V'.'I" R BUILDER DECLARATION:I hereby drum under penally of that I am exempt from the Contractors License Law for IM
o ovine renan(Section70315 emboss end Professions Code:Any city a county Mich requites apemslonestnc,aner,'mmol. PARKING REQ• PROV: PARCEL: 41906210 ZNE: REF NO:
demolishsl amu toiMprdyameC�rada�iicense .9911 requires the empanel 9(cormy such browowSwion7i0a signed 300)of 'D& nthat 3oftlshe te PLANNING NOTES>
Business and Professions Coda]or the he or the is exempt wherefrom end the basis for the alleged exemption.My violation of Seaton >
7031,5 by and apparent for a name subjects the appTran to acid penalty of not more then fee hundred dales(S500)). *******************************************************************************
❑ L es owner orthe pronely or mysoybean wthwapae nthen sob compensation ado Me marc end thesauture is not Ts/ended DEVELOPMENT SERVICES R E Q/y U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:TM Contractors License Law does riot aptly loan owner d property yd
who budder or emcees thereon,and Nov does such wait himself or herself or through he or her own employees,provided that such
improvements ere roe intended a°feted for sae.a,however,the briding a improvement s edit within we yew d axmpetian,the ZONING APPROVED BYDATE:
ownerbuider will have the d proving
burden he or the did nit or buildimprove ford the purposesale).
❑ I.as owner of the property.am exclusively ooraraditg with licensed contractors to construe the project(Section 7044,Business and
Professions Coda:TM Contractors License Law does not apply to an owner of property who bulbs or improves thereon and who BUILDING APPROVED BY : DATE;
connects pro
Ar sad,projects with a contractor(s)(finned persued the to Contractors Law).
❑ Ianexempt under Sxuon: B.a P.C..lawsreason: APPLICATION ISSUED BY: DATE: —1
************************************* ***************************** * *****
Dat`' Owner: LEGALIZATION:N F E E SUMMARY STRUCTURA EGMENT:Y
I do hereby certify that I am aware d and understand the requirements of Cddania Health and Safety Code Sections 25505,25533,and
25.574,end that I or arty Mute building compere will I will riot(circle one)need to comply will said rote codes and the requirements for
apemt for nrocMian onoddwdionfrom the As 0u01yMnupenent District Residential construction eppEcaoman axone from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Provisions. PERMIT 34 . 75 . 50
Dee: AppltJra: SMTP/NON-R E S
WORKER'S COMPENSATION DECLARATION:I hereby Wrath°pa
em oder persduy one of the 101109999 dedven:ioISSN
IUILE FEE
❑ Ihave and wUmNdewe cortical.oftheMdm,ratosespemebwMan'wnperuatuu,npwidadlabySecticn3T00dtMlebar BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Cede,faflypromwceo the makfopwNch Mspennrtsissued.
❑ Ihave and will maintainworkers•compensationinsurowe.mtequiiredbySection 3700of the Labor Code,fothe performance oftM TOTALS----> 35 25 0 . 00 0 . 00 35 . 25 35 25 . 00
work for which this permit is issued.My workers.compensation insurance tinier and poky number are:
Carder: REVENUE DIVISION TOTALS--> COLLECTED: 35 . 25 OVER/SHORT: . 00
Poky Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
owe section need not be completed d Me permit's for one named doe t$tOD)o sett 34 . 75 . 50
X❑ I candy that in the performance d the work for which this permit•. .�not employ any In any manner o as to
become tubi to the workers:compensation laws of Cd. s,and ..,tee . ';I . d eubied to the workers' *******************************************************************************
� peneeion d qSectbn 0700 d IM lobar Code.I forth h sum., •
' ; ! � 4% INDIVIDUAL F E E BREAKDOWN
Warning:Faun,n,fo ae/n workers'
rMouard (on coverage
over a Iunlbnbaria ntyc ancost of to or'Renal netinand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Seela3msoraaLdwrCode:Iw s4sltd.mneYsf. SFR 1000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 14000 . 00 for la
CONSTRUCTION LENDING AGENCY:I hereby arum under penally of perjury that there is e constrwin landing agency ler the END OF FEES
performance of the work for which this plank Is issued(Sedsn 3097,Cs.C),
LENDERS NAME: n
LENDERS ADDRESS:
I certify that I have read this appicev,and sate that the above idormation is correct.I were tocomply with all say and county ordinances •
and sate Laws re taimp to Wading construction and hereby authorize represeaeures of this city to enter upon the abwa.mentiioned popery •
fa inspection purposes.
_ "K j_z_Q
82-83-1997/11:28 8M/f35.25
RCPT8:81-8801468
d �✓ Data PERMIT:081436
(5151 y5.WP) Whae-Builing A Sder.Green-Re:Conroy-Appired;Pink-Revenue:Goldenrod-Ammar
POC SPA
1!" CONSTRUCTION AND PLANNING
( 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P•Trap, ❑ 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 .. r FIRE-DEPT. REQUIREMENT
20. Rough Factory Fireplace _ - APPROVALS Permit#
21. Ducts,in Structure - , 70.,Underground Hydro
22. Ducts, Ventilating - - 71. Product Piping D'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 - r, - 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 T 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:
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 zi&-q? FesC42,1C42,1-Se e-
`- w G , +- C54. /J - gic 7-
48. FINAL PLANNING _ ,Creo.L .04
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date
2206 RUTGERS DR °Ni' C CITY OF COSTA MESA - BUILDING PERMIT
Ia :
wNERSNAKEIFKfYN: GUTIERREZ CECILIO PERM NO; B 081153
ADDRESS: *AGENT SERV OF AMERICA
0 BOX 60 FOR THE BFC OF CITYDS INDUSTRY,CA 91716 PERMIT NO: B 081153 PLAN CHECK NO: 00126-97 S GOVT: N SUPP: N
IDOL.NAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; OTH
ARCHITECT OR ENGINEER: Lt.NM: JOB DESCRIPTION : OUTSIDE STAIRWAY REPAIR, REPLACE AS BEFO SQ FT; 3, 000
ARCH.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 3,000 .00 CALC-VALUE: 3,000 . 00 GROUP OCC: R-3 /
CONTRACT0RS NAME:MURRAY 'S HARDWARE ( 714 ) 543-4023
CONTRACTORSYMUNG 210 S MAIN COMMENTS: REPLACE DAMAGED OUTSIDE PRIVATE STAIRWAY
ADDRESS: SANTA ANA CA uC.ND.: 715427 *ltltltlEiEiEfEitiEitiEftitltrilEfEltfElffPlEiffElElfx•iEltifiFititiEit1E1E****#fF1E1FiE****1EiEifikltiEihlElElEfEltltlE3EiEiElE****1F3Ff41fftiE
92701 UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I an licensed under prmgid.of Chapter 9 SETBACKS
(commendwith Section 7040)of I:A*1m 3 of the Business and Professions Code,and my license'.'n full force end effect
CRY UC. �(, A LIC.CLASS: B 1154 P: MAIN BUILDING ACCESSORY BUILDING
Date: \l ` ') con ..• k V FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that 4 exempt from the Cont •on License Law for the •
folios/mg reason(Sedior.7031.5 Business and Professions Code:Any city or mon width requires a perms to construct.alter.improve, PARKING RE PROV: PARCEL: 41906210 Z NE: REF NO
(modish.or repel any structure,prim to its issuance,dso requires the applicant for such pend to fib e signed statement that he or she
a licensed pursuant to the provision of the Contractors License Law[Chapter 9(commencing with Section 7000)of od Dysn 3 the PLANNING N TES> >
Business and Professions Codel or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
}I
7031.5 Worry epptiosnt for apermit weeds the applicant toacivil penalty dnot more than fore hundred dollen[f5001)' *********************************************************************:**********
ElI,as owner et the properly or my employees with wages as their sole compensation.will do the work.and the structure is not intended D E V E L O P M E N T SERVICES R E Q/�n U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Lew does not apply loan owner of properly M
who builds or'improves thereon,and who does such work Finned or knell 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 ZONING APPROVED BYDATE;
owner-builder will have the burden d proving he or she didnot build or improve for the purpose of sale).
❑ I,as owner of the property,coon exclusively contractig wall licensed contractors to construct the project(Section 7044.Business end I. /
Professions Code:The Contractors license Law does not apply to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for arch projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ lam exempt ander Seven: B.aP.C.,for this reason: APPLICATION ISSUED BY: DATE: qatAtql.
*****�F�F**********�F** **************EF*x***** *+ESE **ENEFttRF�E+E�r+r**********AE***E * **
Date: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby terrify that I ant aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,end
25534,and that I or any future building ompent will/MI cot(circle one)need to comply will said Mate codes end the requirements for
aperme for construction or madifcationfromthAi OueNy Management District Residential mmlnMioneppfratire axe exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 74 . 75 . . 50
Date: Applicant: SMIP/NON-RES
PLAN 48 . 59
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE
❑ I have and wil maintain a certificate of consent lo selfinsurefor workers'compensation,es provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
m
Code.mama pedom,enceof the wank tor Na
with this pariah i.Issued. TOTALS----> 75 . 25 0 .00 :'48 . 59 123 . 84 123 . 84 .00
❑ I have and ail maintain workers'compensaton insurance.as required by Sedan 3700 of the Labor Code,for the performance d the
work tor which this pens is issued.My workers'compensation insurance caner end policy number are:
Carder: REVENUE DIVISION TOTALS--> COLLECTED: 123 . 84 OVER/SHORT: . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(]his section need not be completed i the permit is for one hundred dollars(5100)or less.) 74 . 75 •. . 50 48 . 59
o I certify that in the performance of the work for which this permit is issued,I i I nal employ any• ' in any manner so as to 1
uN to the workers'compensation laws d Calif. . and ag S But A 1 °h.,I .:. bed to the workers' *******************************************************************************
corn nsatien of salon 3700 d the Labor Code :+.ill • 'h! pry with .. I N D I V I D U A L F E E BREAKDOWN
Date: t '4 Appf • C _ _ .� _ t� 1..
Warning:Failure to noun workers'compensation coverage Is unlawful,end,• 11oubHct en employer to criminal panellist'and. TYPE QTY DESCRIPTIO N - ' UNIT COST TOTAL COST
civil free ry to ora hundred thouaennd dollars($104.000),In•ddldan to tin -r of compensations damson as provided for in •
Section 3706 of The Labor code,Inrsru(and attorney's fess 1SFR 3000 ALTER BY VALUE RESIDENTIAL NOZONE 1 .00 3, 000 .00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a connndion lending agency for the END OF FEES
performance of the work for which this pets is issued(Section 3097,Civ.C). d n
LENDER'S NAME: w/ r
LENDER'S ADDRESS:
I certify that have read this....:. Mills that the above information is coned.I agree to comply with all city and county ordinances `r
and la -relating to 0. .. and hereby authorize representatives d this dry to enter upon the abo e.mentioned properly
f•�j'L•pry-4•r!purposes
1 e� 81-14-1997/11:88 RNK123.84
; a a 510011 Ude Ill l`�-1 PERMI11 eg Al 8888449
y Sig Ire domed . nUAPDIcenaCantractor
PERMIT:081153
(5151.46.WP) White-Building&Safety;Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
,,.� _
"
I. CONSTRUCTION AND PLANNING POC SPA `
Ii
APPROVALS Permit# Date Inspector APPROVALS Permit # Date - Inspector
1. Tetilporar Electrical Service or Pole .
Y 52. Pool & Equipment Location - a
2. Sod Pipe-Undrgrnd. 53. Steel Reinforcement `' -
4-3�gle`etrical Condit U 'lity•Undrg'rnd. 54. Forms ` - - •
--4^.Electrical CondiJit lhdrgrnd. - - - • 55. Electrical Bonding
...r••T'i� co-
4'$teel Reinforceifientr.: 56. Rough Plumbing & Pressure Test
"--htlectrical UFER Gczad. 57. APPROVAL TO COVER-GUNITE
Crr -. .
„}. Footings rS 58. Electrical Conduit-Undrgrnd.
car Foundation a, • 59. Gas Pipe; ❑ Undrgrnd., Test
1-,..,:t• .-• Pipe-Undrgrnd. o 60. Backwash Lines, P-Trap,O Undrgrnd.
1=Structural Floor System 61. APPROVAL TO DECK
117:Property Sewer Line & House-Connection 62. Backwash & Receptor-Final
12. Sewer Cap `'
• 63: Heater & Vent-Final
13. Rgpf Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final _ '
.s -
15. Rough Electrical-Conduit tr' ' 66. Solar System-Final
16. Rgtigh Electric 4Virin§ 67. Fencing & Access Approval ' - - -•.
17. Raugh Wiring Sign V 68. APPROVED FOR PLASTERING
c•
18. Rb-ugh Electricd(T Bar Ceiling '69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
r, r, • r-- ems- -_. -.41-r Nt ,- n Sr* _ "L-0.7: -.. C^. 7.k i-. c
20. Mouilt Fcotor"`y, Hifi:lace <7 a' O = e'= ' APPEOVAY '' Pe?mit# T
21. I0 ucte, incStrunture;* •• •• �•,5 k . O -r 70.!'PJndeigteund 14dro
22. _Ducts, V.I G., mut ' * e < s Er 71. ProdurtjPiping`C{ asDOil
23. 'Gas Ripeaaougjt & Test -:5 r t'l _ %X ` -+.r x C
r " 72. Underground Rusk- ti
24. RooFrem'ng" rny. I r t ? G - * . 73 Undergrt?d.Storr e,Tan OGas Otil
25. Roof.She�xhin x a_ .. 4 v. 1.t V `y* ,, r-,F+!.., u
g g ~i V ♦* O :'U 74 Ove#ead Hydro
26. CT-BJ?Ceiling (Stralairal) & Modcc acoat x0 , a C* 7g.pry,_ Che meal ..,...7:1 K
27. ,game and Flashigg* -rn_ ..• c >4 a: 7$. Dry+Starldpipe'i- ' _ • • -
28. Lathing & Sit't'ing? cl ' 6= x x 2 " ••' 7 , FIXED$$;{sSTEjIYFlNAJ-� 1 to
- r o :.:t r: O I
-I o to?: t.. -, .. .. • r. of
29. Insulation" • Ca* •• 'i: � 7K FIRE PR EV. FINAL x > r
71 J
30. Drywall [Lailirig 2* "
tr.. _ I rt-t_E1 AL7 DEPrRECIUIF EMENT
, 31. Plaster Brown-oat* s n-r• : 1 � r 7f3r. FINAL l ds`•PECTaoN x J v
, 32. IectricagcPotpr gaiter- rival ! } tti 1 ; . 8 FOOD CERTIFJC-ATE 1Sci.IEf_ a.
r I x m tc It: - c - = tr;
- 33. FinahElesrtricl n+;: n C *, 1 I I* Notes: rr 1.. ; O. t.:ri
34. :Fina' HeSYinC,�, Air Conaitioni .a ^ * " "* c'- /Q t h 111011-17
�� �y��J-
M >t Ir: 9M M g i I 1* :t G `` a ','cit.... _,-„,r a/'1O�'4 �r-_-
l- r,' -r1 t : c I 4 r , ,t._-TiS r.- f"!Os`C.ef
35. 'AinaTGastpipe•Tea.:. .. t< H I I i*. 1/1_
E. _i .. .R. " :7 �cwyy' ,L'G
-• 36. Hoo0'lor'Canopy * r. Mr-7. a. y r , Lis : S ZQ. - !/ trM
ni.. 37. IE.inal1 aclory Fire Iece--s; -,_-,f-. c .', r:; I p.�,- Tl -
�. 1 1 -. ,. _
.. 38. Final=Plumbing a:'t �•C. v x 1 " k S � * . C
^'1 ..7 7 Y 1:^ -. g ( I *. C F "•,C,
39. Vater Service.Pin� ` f -. t I Ii..k - c J tial T. G. Lc-
? 40. Gas Service-Final ' .n <7'7- S * m I lx b'-.i ac-
- . . r t.:- m ' I i It t-- • .C.."- z ,i
41. 'Solar Do'mests-Fina4 S 7 ;'. CJ I IX
n ,�, _ z 7: _
x
42. Backflowifreventer r r' •+ - I pis c; =c_• • r 7 ,�
Y. .�• r�.:� *. ,- .. m rl.; t-
43. Backflodrlrrigation; �. .; Ir x ,..: a _
c4rt•r
4. Landscape Irrigation System , ' r r - O V* e X _ =,: t. _
+45. Sound Attenuation: * h M m* I- r r `M1 • '-r
6. Handicap-Regulations C x a: 7 az •S - e
q * c ! tar ser t",,,-1 C
7. :IIN:9.L STRIRTURtE & BUILDING11-027.-_-,C/710.1.441": '�'c=
g. y . r_
48. :FINAL PLANNING' -- t r: • I * r ^x E"
-, .. r , ; ir r 1 ,^, .I t < '
49. "Electric f3please to Edison ; "' 1 i tr. T. rs- x ' '
50. gas Release to Southern Califoni e'Gas Co I '•: -• - n ' -- ' ; C
• =,
51. CER-TIFICATE OF OCCUPANCY ,' ;• C -
No. Date
3�J
.1-1-1:. 7\\- . Lc: _ st
T U. \ .
X, \ r- ,.
•
b —
, ._ .
r
ItI
'ham o ,\
Irt t1 \\ � • \\ 4 N •
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•
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w s
+-) p B--- D -p
o (p `P�
l- Y j \ r. U.
fic . .
ca 9D ` \ _
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6) a r \,
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>vm o -•
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„l I DIVMIthUflt BUILDING SAFETY aio s' o `\ - •'�.
OCJ1W OF COSTA) MESA 'U fu ^� \
i "ijI � t i. ,\--,r4 --1
s
U BY
This set of plans and specifications MUS r be kept on thls,Job at e8 times
and Itis unlawful to make any changes or:Iteration on same without written i - - - -
7 permission from the Division of Building: Safety,City of Costa Mesa. ._ - . . .
'Y The stamping of this plan and specificatld SHALL NOT be held to pent It, - - -
... or to be an approval of the violation of y provisions of any City of Costa 'f
- i•, • Mesa Ordinance and/or State law. .. 1 1 c.1-3_
C> These alas end permit shall expire by limitation and become null and veldt •
• the building or work is not commenced and maintained active per UBC§303 - -
(d)within 180 days of issuance. fJ -
CITY OF COSTA MESA
.. '$) SERVICE REQUEST & PUBLIC ASSISTANCE FORM
—09— 77
Date � .9
Time rfc-m0
Caller's Name � � /
"" �
Address �r fi„.4---, Phone , SW"-
o
9 737
Nature of Request: (location. type. seve it ) �.,/a44—,e... �Z��^
a,- ,L - /i ' .i.e> ase-Z
eit
yeetd &I)4-e& .a•e-Cs •rx---
Referred to ,/ — — _
- .._` Call back
s
< Service Only ltr C tre
i
1.
� Y - 4/140W I Information Only I 1
Pe - n Receiving Call -. ---_A._�:404 's �)rta5
CMF 037848 J ,�
8070 I
r ' U ECE E0t
COSTA MESA BUILDING DEPARTMENT itfr y/5
P.O. BOX 317 FINAL CE DEPT.
COSTA MESA, CALIFORNIA CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ADDRESS 2206 Rutgers Drive A, B, C BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
�T L+.. RECEIPT NO. P�GIt3,
OWNER Towne Estates, Inc. U�vv I
MAIL 1555 Placentia RECEIVED BY DATE RECEIVEDJOE 155 EB
ADDRESS � //'X/-.f e 4z Se J
CITY Newport Beach, Cal TNO:MI 6-3227 BDD EISNS 2_20 4 r?u '5 PSS
ARCHITECT uO.
OR ENGINEER owner NO. COSTA MESA. CALIFORNIA
FIRE
ADDRESS ZONE
20rvE NO.OF TYPE TROD
CON Ac bRKoll Const. Co CITY No: 8534 Z PLANS
ADDRESS Same NO. Male BY
ein" DATE
LEGAL LOT 2788 CORRECTIONS
DESCRIPTION NO. 11 BLOCK TRACT
A.P. '1}'
NO. y 1",% }, 11 \
SIZE NO.OF BL {Au: N t, ,
OF LOT 60 A 100 NOW ON LOT OT /.q�0 G S]. C Ti IT:
OF T :� .:' F li hl II-d '(.
EXISTING BLDG. rJ I-i .7L�� `, AA
SETBACK LINE FROM � 4�� `� ' t V ~,
CENTER OF STREET 45 ft REAR YARD 10 � / n
SIDE YARD RIGHT 10 LEFT 10 �6-�(=-••E� /L\�`se
DESCRIPTION OF WORK ( D U:11 r
yf VAR. r�c9�aF'Pf20vEDAS-°
NEW S I ALTERATION I ADDITION
REPAIR MOVING ljlli) DEMOLISH
BUILDING 7In0 sq ft ROOMS 12 STORIES 2
EXTERIOR WAL4 S ROOF
COVERING stucco COVERING hot mop
USE OF
BUILDING Apts. . Triplex and attached
3 car garage. 2:2Ve0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND • �/D
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. VALUATION `n
SIGNATURE 05.24r_67,„(cit
PERMIT FEE $ �� `LPERMITTEEPLAN CHECK S 4/Q,S-49
S �� �3�' TOTAL FEE $ 61 J�a V°Ni
AUTHORIZE A