HomeMy WebLinkAbout1145 SALINAS AVE - Building Permits �" CITY OF COSTA MESA .�
,t•0- m �, BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT B98-00899
J44t4borwro
dP PERMIT PERMIT NUMBER
(714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1145 SALINAS AV Status: ISSUED pA Q
Suite: Applied: 05/26/1998
Vicinity: Issued: 05/26/1998
Parcel Nunmber: 41208203 Zoning: R1 R1
Applicant: GREER, JASON
Address:
Phone:
Zip:
Owner: YASUDA, TETSUYA
Address 1145 SALINAS . - - _ ' '
Phone:.
COSTA MESA,CA• - _ :Zip: 92626 : - - - :,\
Contractor.' i ACTION FIRST ROOFING SERV
Address: " 07472 SLATERAV
Phone:
, HUNTINGTING BEACH CA Zip: 92647 �� .
License: 688649 may`
Arch/Eng: -' �` '-
Address: - lt,,, I - - -
Phone: ,
_Zip:" ,. -
License: - . , -
SCOPE OF PERMIT - v.
T/O EXISTING&REROOF THE HOUSE W/PERFECT SHAKES, ICBG#NER5S20.FIRE RATED MIN. CLASS"C"REQ.
FEE SUMMARY :- '
Plan Check: $0.00 —- - _ Calc Valuation:" $9,900.00
Permit: $162.25 _ - - / 7`-. Claimed Valuation: $9,900.00
Other .$0.00 / /
Ins• pection: $0.00 • J - -
Total: $163.24 .
PLANNING &'ZONING ,
•
SETBACKS
MAIN STRUCTURE Front 0-0 . . Rear," 0-0 Left 6-'0 " `Right 0--6( , i�
'i
ACCESSORY Front 0-0 Rear 0:0- • . •Left - 0:0 = '
Right 0-0
PARKING Existing: 0 Required: 0 i Proposed: 0 ,
NOTES: . -
•
EXPIRATION: This permit shall automatically expire and become void if worlds 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
. S
DECLARATIONS
W¢4K&RS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are: .
Cartier: Policy Number.
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Celifomla,and ag(ee that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions. \
Applicant Signature: J\ ' ' ' Date:�J / c”?
WARNING:FAILURE TOOECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
T11Or WAND DOLLARE(5100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# Class#
Contractor's SignatureSr— Date�c LC)'7Cn- ' I
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 em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
I
Owner ID verified by driver's license. 0 Yes 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 INe(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 Califomia 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? ❑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 Califomia 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 11 an RMPP is presently required,has Section 25534 of the California Health and Safely Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this permit application a it for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ID Yes 8 No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health 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 es 0 No
, 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: r Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end 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 authorized by this permit until final inspection.
'.,___Signature Of Legal Owner(s) Date �i
And/Or Authorized Applicant ..--.0 - Z�Date
;ODE L INSPECTION TYPE gAIE MAL4 LQQH 615PFRInN TYPE BATE =ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final208 Final Plumbing
200 Final Re-Roof G-/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
2446-46
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OWNER McLAIN DEVELOPMENT COMPANY DATE 2-1-79 •
JOB ADDRESS 1145 Salinas Avenue BUILDING PERMIT NO. 46869
GENERAL CONTRACTOR (homer builder DESCRIPTION of WORK Res. w/ att. gar.
AP NO.412-071-04.01LOT 5 TRACT 10276 FIRE ZONE I VALUES 60,396.
INSPECTIONS 417-027-01 Signature Date TYPE V GROUP I S J ZONE PDR-MD
SOIL3. SUBCONTRACTOR PERMITS ISSUED
GAS 1.
.r1.� l' 0 % Date Number I Signature
Tie --x TE546 3 /z -7,7 Plumbing
ROUGH PLUMBING^11 "f_j /r To"SF C2,-)ttia , %ma 3-6-)9 X76, —
PROP. SWR, LINE '.) HOUSECON. J-75 {r 267 1 n - 5�1-) /n/(Gt'] '7 -
SPRINKLING SYSTEM //""}} �eF�e,��( ,y?'�y 7 /43'�/3y�
MISCELLANEOUS 4 �>� 0441-1 .12 �• !^J 7 743Ci 4�(�/��p.p/G�f.//)�
ROUGH HEATING AND AIR CONDITIONING tet4 V 79 AP I10 -7--5-19 7(.3R1 //
TEMPORARY SERVICE,YOR POLE I
UNDERGROUND LC POWER G' Ot e/ 3-1J-
ROUGH WIRING �. 1P-P--.77 Heating and Vent.
lin, D A-�Q ,...4r „,„
TRENCHES n FORMS n STEEL REINF. 2". C '3�f I9q ,(rj
FLOOR SYSTEM e...5-%fi 79" �yI v�/�/7/�`/'- S(p
BONO BEAM J STEEL REINFORCE D t/ TArjY fir ^/-i3(h)c-7 �933
SHEATHING _ / TN,,, CI
FRAME AND FLASHIN
te ,:
LATHING - IN OUT -,' 'r
PLASTER. BROWN COAT 6 s//JJ.2 fj-21
�I/
STRUCTURAL,ING, FINAL /y[ 4..lID7t� L L/ .i' _....1
PLUMBING,
,�j7{ E
HEATING, VENT., REFRIG. AND A.C., INAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL 7.S-
BUILDING. FINAL 7�6-1
BUILDING.
• i
046869 66E8 10/12/78 1008.-73 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 'i3OSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
RECEIVED BY DATE RECEIVED
BUILDING
ADDRESS 91-act 10276 Lot 5
OWNER McLain Development Co. A.P.NO. 4112-Ota -0/
MAIL ' BUILDING //�1( a �•
ADDRESS 1470 Jamboree Rd. ADDRESS `i 4/.1pSm./mita /WE •
CITY Newport Beach NNo.'640-6800 TRACT/O.Z 76 I LOT BLOCK
CONSTRUCTION NEW (ADD ALTER REPAIR MOVING DEMOLISH
LENDER
BRANCH (1,2(:
' .4 •
OWNER
ADDRESS / YVALUE/ , //
OR ENGINEER Corbin fu Mai N..ARCHITECT .752-5567 US 1-'. . s / (O
FIRE
ADDRESS 3661 Spruce; Newport Beach ZONE TYPE --*--- -
tal
APPROVED
CONTRACTOR McLain Development Co. BY DATE
•
ADDRESS 1470 Jamboree RI. • ZONE NO.OF USE OF NEW
CITY Newport Beach TEL.. 640-6800 PPR-niD (PLANS BUILDING RES •
F STATE CITY YARDS APPROVED YARDS APPROVED
gLIC. NO. 273875 LIC. NO. MAIN BUILDING ACCESSORY BUILDING
1.17 SIZE NO.OF BLOGS. (FROM C/L STREET)
L OF LOT I NOW ON LOT ' FRONT a FT. 6 FT.
Q USE OF
.fin EXISTING BLDG. •E - FT. G - FT.
in
F-1
Separate permits are required for L.SIDE y FT. 0 FT.
c . electric,plumbing and heating work. REAR
I FT. 0 FT.
F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET-MAIN&
C MAIN BLDGS. ACCESS.BLDGS.
La VAR.# DATE /
aSingle family residence, - C.U.P.# Z E- 78-3 y APPROVED .21.27 78'
7 • new house APPROVED • / •
r --
w ., , HOLD FOR SPE I IAL RE•UIREMEN'I'a
O .. I hereby acknowledge that I have read this application and state
N
Cd that the above information is correct and agree to comply with n
co
C+ all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of ' s
v
W t the State of California.
3 I hereby certify that I am properly licensed as a contractor under SQ. FT.IIOUSe 2157, Garage 585 a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; —
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE v
and Professions Code, Division 3,Cha• r -. $
�O m
AA PLAN CHECK $ O — No
Signature of ' �, / /! 1 LL
Permittee / / 1. $4D 39tra TAX $
19
Authorized Age/ , /' ww r // TOTAL PAID $ b i 1 kJ] 'Og
r
s
46869
• COSTA MESA BUILDING-SAFETY DEPARTMENT 2616 2/01/79 209.00 TL'
P.O.60X,1200 COSTA MESA,CALIFORNIA 92626 '2916 -2/01179 2O9_.000KTO
APPLICATION FCQBSfRU�HR1�NApL6 ILFILIMIT I A
For Applicant to Fill in Completely —Use Ink Only _..-
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING
ADDRESS 1145 Ra1inac AVP nue '
I cI a'n velC"gig°. _ PERMIT NO.
OWNER ���7Pe A.P. NO.
MAIL ADDRESBUILDINS 114 Salinas Avenue
ADDRESS 5
CITY NOL TRACT 102761 LOT 5 BLOCK
CONSTRUCTION NEW ADD ALTER JREPAIR MOVING OFMOLISH
LENDER
BRANCH
OWNER McLain Development Co.
ADDRESS VALUE
ARCHITECT TEL. USE $
OR ENGINEER NO. <. _ ........-...._.,,...:.�, -. -„
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS ZONE INC.OF USE OF NEW
TEL, PLANS BUILDING
CITY NO.
.F. STATE YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE 'NO.OF BLOCS. (FROM C/L STREET)
P. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
V) EXISTING BLDG. _R.SIDE FT. FT.
CI)
(-4
Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work.
A - REAR FT. FT.
I.W. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN Si
Q _MAIN BLDGS. ACCESS.BLOCS.
VAR.# DATE
.7 C.U.P.# APPROVED
Q ,
APPROVED •
>'. . BY DATE
..1
a
0 I hereby acknowledge that I have read this application and state
N
Ci that the above Information is correct and agree to comply with N
a. all laws regulating building construction, and I shall not employ m
Z any person in violation of the workman's compensation laws of m
rzi the State of California.
I hereby certify that I am properly licensed as a contractor under SQ. FT. co
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business co
VALUATION PERMIT FEE $ 0O co
and Professions de,Division 3,Chapter,9 209 vi
PLAN CHECK $ ^I
Signature of C o
Permittee /�t46 Al;
( $ TAX $ U.
2
Authorized ge t4G �, ` TOTAL PAID $ 209.00
' 7482 4/26/79 318.73 Tb '
•
• COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
' P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVED BY PERMIT 0 41I7:,i/l 4
For Applicant to Fill in Completely -Use Ink 013
/ Yr •O ...n: /J ••
, A.P. NO. y(2 - O c./2—O /
ADDRESS y�
OWNER OR KK��C-�p mu-s
ADDRESS /j Li S .y..� �.$4, 4L
TENANT 4•\ `\\N t�l - Qt�C.N \ Go-
�r�p UNIT OR
MAILING ADDRESS \� O PM\J 1-F� 9.. . SPACE NO.
TR.NO.^ LOT BLK.
ndi
CITY (s)?.., QOe.I .eDRAc..4A . NO.h`l -b/�00NEW ADD ALTER LR`MOVING DEMOLISH
LENDERCONSTRU \„,.'�oml
� Sm\ /,}(7S t -�e.W `x/
BRANCH 3131 ,L •• t ' J11 • C / evAi
ADDRESS F.OS A(VS���s occAo OWNER '/(,�//,T,
''11��''� pp --\\ 1, �-s USE M '1k W VALUE$3j1 44
AOR ENGINEER oczv IV \/PmAF uo ‘ TNO`.'gs ..s41
•
ADDRESS 300 Ic?...0\C1_ Q. •% 14'Z.', ' ZONE YPE GROUP
iiirt C. APPROVED -
•ONTRACTO\,R1\ LAAa - CC�,\1%LC)tf�Kk Nr ��l BY r�i-� DATE
ADDRESS LflO _ c\Mb()9-.c _ A£•�./`HO�, L,�
TE
CITY ��,\slQl &' ) pcQ I NOL _GjRO0
F+ STATE CITY APPROVED SETBACKS
LIC.NO. a73In5 LIC.NO.
IQ SIZE NO.OF
LOT NOW ON LOTS (FROM 0 fps)
C/LSTREET) (C� E
Q USE OF
en EXISTING BLDG. R.SIDE _FT`L Q
... /44, 1••••• 1 1
FS+ Separate permits are required for L.SIDE FT. •I/
C electric,plumbing and heating wort REAR FT.
F. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
DATE
Q �gR\M�E� W hl-Lr-�I CIC (-\1 APPROVED
`//
✓• CC�fIC.- . c. �G0� \•\ C1J Vd A.PPROVED etae - DATE Jib-
.-1
1 7C M
m
w
O 0/hereby acknowledge that I have read this application and state N
m
g that the above information is correct and agree to comply with N.
0•1 all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of m
5Lu the State of California. / /D •
FT. a
gi.
• I hereby certify that I am properly licensed as a contractor under
D
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOBE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the rovisions of the State ofofCalifornia Business - VALUATION e
and Professions Code ivision 3,Chapter 9 /i PERMIT FEE $ r N
- Signature Qf� /"/\,}��.t /rte) ^ _ _ PLAN CHECK $ lai 2
Parmlttee �[ �r' / $ (� / /1T71 TAX $ fU.
3,1•r'' 2
or f//'yl //I 444"x"[[[/// f '
Authorized Ag Date TOTAL PAID —
$ Cs- a
OWNER McLain Development Co. DATE 6_8_79
JOB ADDRESS 1145 Sal Inas Ave BUILDING PERMIT NO. 48205
GENERAL CONTRACTOR Owner-Buil der DESCRIPTION of WORK 81' B1 ockwal 1
AP No. 412-042-01 LOT TRACT FIRE ZONE VALUE $ 3,000.00
tINSPECTIONS Signoture Dote p TYPE GROUP ZONE PDR-MD
...OSOIL _ PEIRMITS ISSUED
'aro _ SUBCONTRACTOR
Dote Number I Signoture
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND C POWER 0
ROUGH WIRING
R1Heating and Vent.
TRENCHES/y' FORMS [] STEEL REINF. ' 4rjr fr-f1f-7U
FLOOR SY EM
ONO BEAMJII STEEL REINFORCE
HEAT HING
FRAME AND FLASHING
LATHING — IN fl OUT R
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT.. REFPIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST '^.
ELECTRIC. FINAL •
BUILDING. FINAL /la,//4. •7L AO-79
-
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION,Fo 'aSTRUvIWWH.PERMIT f4i8.1 LII
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - -- - --RECEIVED BY 'PERMIT 7�1g 48205
For Applicant to Fill in Completely - Use Ink Only 1 V
BUILDING A.P. NO. /' 2 -,'7 I -o/
ADDRESS 5� 1 ., BUILDING
�.N lI r�
TENANT TOR �' ! \ I\1 N ' IZVIELLyQ"1� \(,V - ADDRESS/� //S1
f Ch q ,— I I w.l A s au L_
UNIT OR
MAILING SPACE NO.
ADDRESS ‘4-�0 ��\AC(l,�o'(LE�. -
TR.NC,,\\ ,r �\Q�/\�p �\\\ ��/��(Roo SPAC . LOT .BLK.
CITY �CW Poet VJ „AC\'f NOLz V /027 -477
CONSTRUCTION \\ 1 NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER \CA(1 ME ( ``` P \*I(�(-7s A `\^o1\tA
BRANCH t, _SW
-73l UlLVy.E- t\-. IA
. IOO IO
` OWNER ���//�/r�//�
ADDRESS SLMm�, // A / ` ezi LUE
ARCHITECT (� y t TELTC _ 6�'I - USE / $
OR ENGINEER \/jJ/Qg\t'A IIA"PYU..S 1 NO. i J� 1
ADDRESS 661 dA f2ugs__ t to Q'pcc a)kittct., ZONE �J]�1•bTTY E GROUP
CONTRACTOR --C�`-\�CsA v t;1Jt.11}9 c Nil (-O. BY
PROVED'• n// DAT4 �9
ADDRESS ``(CS�I pO"n'c\��70.,Y Pte%' --j �( p. •`�/CI /
F CITY \yCr`a$`YOF� NOL0,o,6t'o0
STATE aims-16 CITY APPROVED SETBACKS
41 IC. oC l�p"75 LIO.
SIZE ANO.OF BLDGS.O.
(FROM CA-STREET)
6OF LOT NOW ON LOT FRONT
i• USE OF , reEXISTING BLDG. q.SIpFj• 4 FT.
c.,D _
et'
Separate permits are required for L I EEik flifi
electric,plumbing and heating work:
O REAR Fr.
I.„ USE OF BUILDIN AND WORK TO BE PERFORMED
///�� PLANN ACTION
DATE
.� fag r �, (,,.Y//^ APPROVED /�
> APPROV6�/i / e _y[ _�9
r / G ' �V (�(i(/ ➢ATF (/
.a
a
w
QI hereby acknowledge that I have read this application and state m
c4 that the above information is correct and agree to comply with
O. all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of 2
x the State of California. .:
3 I hereby certify that I am properly licensed as a contractor under
SQ. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR rn
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
exempt from th rovisions of the State of California Business
em VALUATION PERMIT FEE $ Y
and Professions Cod ivision 3,Chapter K • W m
Signature of .. `/� `^A Q 0,19 PLAN CHECK $ /['� I�-/�l LL
Permitteeo /t/1/4-'L /lam C,V r $ J /�f��y TAX $ •J�(�C r0
U /S/6/
Authorized Ag n Date i TOTAL PAID $