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HomeMy WebLinkAbout1507 Tustin Ave - Building Permitsr V ►fW CF COSTA MESA CONSTR{'UC TION PERMIT Pro]ees ct Address' 1 S a_7 TU SE- Lt -, 14 11 2 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations, PERMIT NO. AC NO T N . UNIT NO. Applicant's Mailing Address c��,� a Owner's Name Phone � q p n �! 7 AcWress Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) City License No. %LICENSED CONTRACTOR DECLARATION I herebyaffirm that I am licensed under provisions of Charter 9 (commencing with sect !on 7000) of Division 3 of the Business and Professions Code, and my I€cense is In full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure or a certificate if Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company " ®Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shalt not employ any person in any manner so as to be me su ect to the Work s' Co en tiR Laws of Ca' ornia.l3 Date Signature u ��y NOTICE: If, after making this declaratio , you $hou d become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ofthe work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the toltowing reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 47031-5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's LiCense Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for sale, If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale), I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law doe$ not apply to an owner of property who builds or Improves thereon, and who contract$ for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). i am aware that proof of their Worker's Compingtignprance should be provided to me. ❑ 1 am exempt under Sect€ons , B. & P. C. for this reason Date Owner 2nj ` I hereby certify at I have read this application and state that the above Information is correct- I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of th€s c€ty o ent���,,,LLL upon the above-mentioned property for ,inspection purposes / f� �\ 1! t/ Signature `�!Y\ D e vim,-+- - Date.�5]J�SI( Drivers' License SS =�' " - - _� co 96 i:1 -J i- d 3 l q �.... R6Vf 3(]b7 1/13/88 LaJBei: I TYPE OF CdNSTRUCTION W ADD �LT �4Tw L REPAIR ❑ CONVERSION ❑ DEMOLISH THEA tt 4� DESCRIPTION OF WORK/USE O BLDG. •S TYPE OF ERMIT G AOING FOUNDATION STRUCTURAL 1:1 TENANT EL RICAL 9 PLUMBINGPg. MECHANI L ❑ OTHERdA r PROJECT DESCRIPTION r�SCri.�FT. OCCUP CY CONSTRUCTION TYPET VALUATION $ 3P. 79!1• f• ZONE GRADING CU.YDS. ACRES A.P. ylf, .., �� � Zone Main Building: Accessory Building: T Front 3 O B Rear LthAi N fight 1 ) 6%l ' N S Left --L {- G R Ping. Ref.-=# Parking Req./Provided E IT Remarks: % T O�I� ' Planning Notes: `k. lipO Al fit, '0-5 M A c asher onstruction Pole Sub In x, n, - ..... .. ... ECTRICAL Transformer © 15-50 KW C] 50 + KW ._ S, FEES PLUMFa BING FEES Bar Si k Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs.AJCir 1 Sewer Connection king Un' Meter up to 100 amp loll Clarifiers Solar Collectors Di er Meter ❑over 100 amps '57 Dishwasher Solar Piping DrAs ❑Gas ElElectric Sub Panel Drinking Fountains Solar Tank Fan Motors ❑0-1 HP ❑ 1 /i - 8 3 � Floor Drains Swimming Pool w/Spa F. A. LIL Inc. Solar El 9-15 HP El 16-15+ Floor Sinks Urinal Fixtur Microwave Gas Service "f R Outlets Water Closet co ice Boxes Pole Light interceptors Water Heater Outlets �,P. Range Y Kitchen Sink Water Service Switches Sign ' Lavatories Auto -Wash Garbage Disposal Standing Sections P -Trap Laundry Trays Generator 00-5 KW ❑5-15 KW Trash Compactor Roof Drains Z MO �.' +,O Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ MECHANICAL FEES Boiler Hood or Type I ❑ Canopy Type I I ❑ DEVELOPMENT SERVICES REQUIREMENTS: zoning Approved By Building Approved ey Application Issued By �� �( Date Date<+��K�$1. Dat !� Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑i00,000 BTU Duct - ngQ&rA BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ SUMM RY O F SMIP $ ~� PERMIT 1� ISSUANCE $ ENERGY P.C. $ �, u �r —"—tom GRADING $ MICROFILM $ Q 33•r� TOTAL FEE $ �t7+ r• Exhaust S s I i le System Repair/Alteration Firep1lFact. Blt. ICBG # Fire Dampers Hemg System &Ducting 1 46a 100,00o BTU 1:1100,000 BT Registers Reinspection Fee $15 Issue Fee $ OV CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ':CONSTRUCTION AND PLANNING POOL & SPA ' 'APPROVALS Permit # �i Date ' inspector APPROVALS Permit +_ Date Inspertor 1...-Temporary Electrical Service'or Pale 52. Pool & Equipment Location •, 2. Soil Pipe-Undrgrnd. l 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 F 6• Electrical UFER Gr' nd. 57. APPROVAL TO COVER GUNITE • 7., Footings �' r 58. Electrical Conduit-Undrgrnd. 8. Foundation -� 59. Gas Pipe, ❑ 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 IV 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13, Roof Drains E. 64. Plumbing System - Final r 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 661 Solar t �y,stem-Final 16. Rough Electric Wiring / ✓ 67 . Fencing & Access Approval g l f V. Rough Wiring Sign 68. APPROVED FOR PLASTERING If t i^ •.18: Rough Electrical=T.Bar Ceiling �t � ✓`✓ 69. POOL/SPA SYSTEMS FINAL rf �i ; 6. Rough Heating & Air Conditioning FIRE DEPT. REOUIREN(ENT " APPROVALS Permit # ` 20. Rough Factory Fireplace 21. Ducts, in Structure E! 70. Underground,Hydro 22. Ducts, Ventilating Of 71. Product Piping ❑ Gas tjbO 23. Gas Pipe-Rough & Test 72. Underground Flush �f ; 24. Roof Framing 73. Undergrnd. Storage Tank ❑-Gas ❑ Oil ' r r.. 25. Roof Sheathing 74. Overhead Hydro r T, 26. T-Bar Ceiling (Structural) & Monocoat r• . s 75. Dry Chemical . 27. Frame and Flashing •--..�- 76. Dry Standpipe A •'i : ,� 28. Lathing & Siding. 77. FIXED`SYSTEM FINAL• kV •'. - , 29. Insulation Y 78. FIRE PREV. FINAL ' �.•i� - I ------------ 30. Drywall Nailing, �•_ HEALTH DkPT.. REQUIREMENT 31. Plaster Brown Coat �} p 79. FINAL,INSPECTION";✓! 32, Electrical Power Meter-Final a 80. FOOD CERTIFICATE ISSUED r,.. 33. Final Electric Notes: ' y n! � J 34. FinarHeating & Air Conditioning 35. Final Gas Pipe Tdst 36. Hood or Canopy .FOS .. 37. Final Factory Fireplace�� 38. Final Plumbing 39. Water Service-Final �1 40. Gas Service-Final 41. Solar Domestic-Final ,. 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape'lrrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL"STRUCTURE & BUILDING , 48. Special Requirements Completed 49, Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ;} No. Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA"MESAPmt IT NO. ` ' r7'' ' TRACT NO. LOT NO: "BLDG. NO. ' QONSTR.UCTION PERMIT 1. s ' r;—� _ Project Address TYPE OF CONSTRUCTION ).>� __ �.'.­ - ) 972 -Owner j•5O Q A-" Phone 17 NEW _ 11 ADD ❑ ALTERATION r Address •-' ' W-21 - =,F ❑ REPAIR ❑ CONVERSION ❑DEMOLISH r ©.OTHER i TT ZONING REGULAIONS^ " Arch/Eng.-- -- - `-- - r' - -'-License No. - - - A. P. .� DESCRIPTION OF WORK Address ZONE _ PLNG. REF.. Cdntractor-' G' "' _ - - Ph6n TYPE OF. PERMkT _ -' To QP10 DING PROPEF Addres ^5 - a� -/�- ❑ GRADING ❑ FOUNDATION ' ❑ STRUCTURAL SETBACKL T. TY LINE', SIDE YARD - LICENSED CONTRACTOR DECLARATION - " ❑-TENANT ©T,ELECTRICAL ❑PLUMBING-©MECHANICA _LEFT EHYA N I hereby affirm that I am licensed under provisions of Charter 9 (com= • -with , ❑ = RI n mencing section 7000) of- Division 3 of the Business and dTHER "O j Professions Code and my license is In full force and .effect. - - - -- -- - ' - "� ~� ' : i UESCRIP �ON PROJECT TI REAR YARD (TO P/Lj License Class icanse'No. _ Date�f_ Signature - •' - r SQ. FT. - - - PKG. SPACE REQ. PROVIDED , r STREET WIDTH PARK FEE $ - WORKERS' COMPENSATION ARATION - ' OCCUPANCY - CONSTRUCTION TYPE ' (� I hereby -affirm that I have a ,Cate of consent to self -Insure or a certificate -'of Workers' Compensation- Insurance,-nr-a-certified copy VALUATION ZONE - -- ""-- ZONING APPROVED BY DATE " _' '0 thereof (Section 3800, Lab, C.). , GRAOING•CU. YDS. ACRES SPECIAL CONDITIONS: ' • . -- -� .. -- - - - -- - - - - kCertliied copy is hereby -furnished. - - - :REMARKS: �,QEr'ilfietl copy is.filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - - (This section -need ,not, be completed if_the_per.mit.is-for one,hunciretl _ _ _ _ _ _ ' - ($100) or less). 1 certify.that-in the performance -of -the work for which this -permit' is issued, I shall not employ any person En Any manner so as to become •, PLUMBING ;,- PLAN CHECK _ ELECTRICAL PLAN CHECK - subject to the Workersi.Compensatior,. L21 -California' ' Date Signature BATHTUBS SHOWERS NOTI E: If after making thisde r n, you should became'subject TOILETS' ,;� URINALS -'- - GENERATOR 0-1 KW 1-10 KW, to the Workers' Compensation pr vi rts of the Labor Code, you must TRANSFORMER forthwith comply:with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS T "- `APPLIANCE• - 10-50 KW_50'+-KW z -1 revoked. — _ - ­ - -- I— --- ----- - -- -- CONSTRUCTION LENDING AGENCY - - KIT. SINKS D[ ERS MOTORS 0,1 HP 1-10 HP `; -- - hereby affirm 'that there is a construction Lending agency for the per- SERVICE SINKS -' f MPS'" - "- "'" - - - ••(INC..SOLAR)- 10-50 HP -----:50 + HP - -- 5221 formanceof-the work for which this permit is issued (Section 3097 40— -' - - FLOOR SIN FLOOR DRAINS FIXTURES OUTLETS" SWITCHES Name_ _ _Lender's _ Lender's(Atldress ' k "�' ice` -- -��-, '_ -- - - -•"_- - DRINKING F_O TAINS - ° ___ --GAS-TUBE SIGNS - - ; -- � - OWNER'BUILDER DECCARATION� �' " -" '" INTERCEPTOR C IERS- - � 7 'POLE LIGHTS I herebyaffirm that•I am exempt from the Contractor's License Law for the following- reason- (Section' 7031'5 Business'and Professions' Code:- Any city or cnunty which requires a permit to construct, alter, SWIMMING POO TRAP - """"" - - -- -• POLES METERED SUB improve, demolish or repair any'structure, prior to its'Essuance, also re=" WATER SERVICE ALTERATION-' PANEES MAIN' SUS quires the apl.licant for such permit to file a signed statement that he - - is"'licensed'pursuant'to'the'provislons of the-Contractor•s'License law' GAS SERVICE TCUTLETS SERVICE - ""'- AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the ' Business and Professions Code) or'that he is exempt -therefrom -and the, 'WATER HEATERS BTU OUTPUT dais for the alleged exemption. Any violation of Section 7031.5 by 'for "a' -subjects the 'applicant to *"'Civil - tj - - • " £' i - ` """ "` "- "' `'--'" "' ar'Splicantpermit penalty �"-'_io_t more than five hundred dollars ($500). SEWER CONNECTIO .. - u 1, as owner of the property, or my employees with wages as'their _ _ OLAR TAN!( COLLECTORS .sole cornpensation,.will do the work, -and the structure isnot-intended _ _ or offered for sale. (Section 7044, Business and Professions Code: The I P I N G SYS ISSUE FEE .Contractor's -License Law does not apply to. an owner of a property - - - ._ -- -- - - - who builds or improves thereon, and who does such work himself or ISSUE FEE - ; BY ----- APPLICATION APPROVED BY`-'-- - 'OA - - .through. his own employees„provided that such Improvements are not- r intended or offered for sale, If, however, the building or improvement MECHANICAL PLAN CHECK ;', .� `�s _ SUMMARYOF FEES ' _is sold within. one-year of completion, the owner. will have the burden, BUILDING - - --- - ' - - S of proving he did not build or Improve for the purpose of sale). HEATINGSYST_EM 0-100,0006TU ,' PERMIT $ SMTP' $ '- -0-1,-as owner`of-the-property, amexclusivelycontracting-with AND DUCTING _- _ - «•: ' ^PLAN licensed contractors to construct the project (Section 7044, Business and -Professions -Code:- The'Contractor's License•taw does not apply to 100,000 +BTU ^ � CHECK _ $ PERMIT , - - - - ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU , PLUMBING r ' .tracts- from -such -projects with -a contractor(s) licesned- pursuant to -SYSTEM - - - ' -- - - - _ - -- - - -- - GRAD_ ING $ - the Contractor's License Law). 100,000 + BTU _, ] PLAN CHECK ,,$ Tf ' ❑ •I am exempt under sKtiEn B. & P; C. far this BOILERS BTU i ELECTRICAL $ �� _ 'reason-----'- _ - � -'- ""MIC"ROFILM $'� PLAN CHECK '$ ti Date - - Owner - - SYSTEM REPAIR, ALTERATION - , _ .,,TOTAL FEE-$ -MECHANICAL .I.hereby certifythat 1 have read„this application and state that the above EXHAUST SYSTEM_ ,MULTIPLE - - _ _ $- I i LESS AD- information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ _` ordinances and state laws relating to construction, and hereby authorize_ '1 , , _ .` �• • , - - ' representatly of this city to enter upon the above mentloned property for ns e�•,fJau.., purposes. Signature Date/� i FINAL FEE •$ _ Drivers' Liwe or SS 9 ISSUE -FEE - - - ` CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # -C;1 I Jz Date Inspector POOL & SPA APPROVALS Permit # Date Inspector~ 1. Temporary Electrical Service or Pole 43. - Pool & Equipment'Lo-6ation- 2. Soil Pipe-Undrgrn 44, Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrn_ 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein once 47. Rough Plumbing & Pressure Test ' 6. Electrics! OF ER Grn 48. APPROVALTO COVER-GUNITE - 7. Footings _ 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ Undrorn 10. Structural Floor System 52. APPROVAL TO DECK ' .11. . Property Sewer Line & House Connection _ 53. ece tor-Final- Backwash & Receptor-Final- 12.- 12.- Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit •56: Electrical -Final r 15. Rough Electric-Wiririg 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. . Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POO L/SPA SYSTEMS F INAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21., Roof Sheathingt NOTES: + 22. Frame and Plashing 23. - Insulation 24. Lathing & Siding j- 25. Drywall Nailing 26. Plaster Brown Coat 11 27. Electrical Power Meter -Final l 28. Final Electric. ' 29. Final Heating & Air Conditioning` 30. Final Gas Pipe -Test 6 31. Final Plumbing 32. Water Service -Final _ 33... Gas Service -Final 34. Solar Domestic -Final 3- 35. Landscape.SPrinklinq System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING- s 39. Special Requirements Completed " 40. Electric Release to Edison 41, Gas Release to.Southern California Gas Go:' 42. CERTIFICATE OF OCCUPANCY No: Date M ►m Z 3 STA MESA BUILDING -SAFETY DEPARTMENT �i'.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only f ILDING --/'IDRESS l V /NER OR NANTILING_ {^I APPLIQATION FOR STRUCTURAL PERMIT RECE Itl MA) A. P. NO./ / / � BUILDING±DORES,/,e //nse UNIT OR SPACE NO.� 16 TL TR.NO. BLK. TE CITY7919 CITY NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION ,} LENDER '1 BRANCH OWNER ADDRESS �j V UE D ARCHITECT TEL. USE L S OR ENGINEER ADDRESS ZONE PE GROUP BYPROVED DATE S ZZ /? CONTRACTOR&O'TC-170-p ADDRESS r a 3 �. 57 O Q S; CITY STATE CITY LIC. NO. )­efl% 3, �� , LIC. NO. PPROVED SETBACKS SIZE No. OF BLDGS. 1.2.3 (FROM C/LST T) OF LOT L_ NOW ON LOT -FRONT 1144 C/ USE OF / /f EXISTING BLDG. Separate permits are required for L. SID electric, plumbing and heating work. 1 REAR . USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION I hereby acknowledge that l have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ REQUIREMENTS— any person in violation of the workman's compensation laws of the State of California. �]�� I hereby certify that I am properly licensed as a contractor under ! SO. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In fust force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE 5 and Professions a, Division 3, C ter 9. OCi Signature PLAN CHECK S — Permortte $ 3/� TAX $ 6 fz EE// s Authorized Agent Date TOTAL PAI 0 $ / 16 TL . r COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. SOX 317 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDINGLJ ADDRESS COSTA MESA. CALIFORNIA 60— AUG 14 Esso SA APPLICATION FOR PERMIT BUILDING For Office Use Only 7 Y a RECEIPT NO. IT�NO. OWNER I R&C6Z SY D R2�>r BD� r—, 1�,1 AMAIL'DDRESS J' F/ {� G/ 0 TEL. � BUILDING' CITY NO. ADDRESS 0 ARS V1T$GT TEL• , r. COSTA MESA. CALIFORNIA O GINEER NO. FIRE ADDRESS ZONE TYPE ` GROUP CONTRACTOR I �.,� APPROVED BYct) _4t DATEIj ADDRESS L40NING ZO NO.OF UBE OF HEW I CITY 'r ,r L PLANS I"- BUMBINO STATE A TEL.- , - '!- L;.AL �y I L LIC, NO. DEBCRIPTI N V v SIZE NO. OF BLDOB. J1 OF LOT NOW ON LOT A. P. NO.USE / V YARDS EVES EXISTING BLDG i) (.I. APPROVED ALLOWED SETBACK LINE FROM(CENTER LINE ST.) CENTER OF STREET R YARD S FRONT JT FT. -'� IN. SIDE YARD 1 LEFT I RIGHT R. SIDE J / FT, IN. DESCRIPTION OF WORK L. SIDE � FT. IN. LTERATION ADDITION EAR c� FT, IN. BBYPROVED!rHATE PREPAIR,j MOVING DEMOLISH NO.OF ROOMS STORIES LLROOF COVERING USE OF BUILDI C+ AND WO K TO BEP MED 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPUCATION THE AMOUNT SHOWN UNDER VALUATION ISPOR THE AND STATE THAT THE ABOVE Ig CORRECT AND AGREE TO COM- PURPOSE OF HSTABLISHIHO A PERMIT PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING FEE ONLY. VALUATION BUILDING CONSTR(ICTIn PERMIT FEE $`� SIGNATURE OF PERMITTEE $ PLAN CHECK $ AUTHORIZED AG9NT TOTA1-. FEE 7 Y a