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Home My WebLink About1109 SALVADOR ST - Building Permits • r s I ti i� r CITY OF COSTA MESA A 9^ BUILDING DIVISION �' DEVELOPMENT SERVICES DEPARTMENT B98-0099-1y 0• �� PERMIT PERMIT NUMBER %4-e (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1109 SALVADOR ST Status: ISSUED Suite: Applied: 06/09/1998 Vicinity: • Issued: 06/09/1998 Parcel Nunmber: 14161134 Zoning: Applicant: OLSON, RICHARD D Address: OLSON, LISA M COSTA MESA,CA Phone: 1109 SALVADOR ST Zip: 92626 Owner: OLSON, RICHARD D Address OLSON,LISA M COSTA MESA,CA Phone: II 1109 SALVADOR ST Zip: 92626 Contractor: - Address: Phone: • Zip: License: Arch l Eng: Address: Phone: Zip: License: SCOPE OF PERMIT REMOVE EXIST.WALL& INSTALL 6x12 BEAM&MODIFY EXIST.STAIR. FEE SUMMARY Plan Check: $81.09 Calc Valuation: $7,000.00 Permit: $124.75 Claimed Valuation: 87,000.00 • SMIP Res: $0.70 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $206.54 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 NOTES: c\\1? EXISpre% 25 ofy 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 authoriz ' permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final appr - 'ure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (71 • • DEf,.1Afl TIONS 5 a • 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 sell-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 canter 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 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 workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. - Applicant Signature: • Date: 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 OOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.0 Class 4 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). Landers Name: Lenders 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 II 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.). ❑ a exempt under sec. Business and Professions Code for this reason: S.r etur*. ' ate: ua„-:r ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: II 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.Tide 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: I 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 akPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No (Section 65850.2 of the Califomia 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 Safely Code Section 42303 been made? ❑Yes 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: 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 stat:,laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the :..v escAbed property for insp , o s.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ^C3/4—qa 1,�Sjur`atur: c _ Owner(s) Date ` And/Or Authorized Applicant Date SgDEJ, INCPECTION TYPE 2ATE tow 000E• INSPECTION TYPE 2ATE MEALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final P Prevention 202 Final Factory Fire Place _ 220 F' -wet 203 Final Sign _ Z 204 Final Demolition 2446-46 `- -AftUNE530iBUi�01NG'-11Vy-bALVAUVri: b1 - WIT: . . . _. . . . . CITY OF .COSTA MESA - BUILDING PERMIT ri )—t/ ) /7l� CNNERS N.WEIf KNOWN: OLSON, RICHARD D • PERM NO: B Otl 1955 rOLSON LISA M "0°"' 1109 §ALVADOR ST PERMIT NO: B 087955 PLAN CHECK NO: N GOVT: N SUPP: N OSTA MESA,CA 92626549-1313 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH APPL.MAKING ADDRESS: JOB DESCRIPTION : T/O SHEATH & REROOF W/LT TILE ICB0#3523 SQ FT: 10, 100 ARCHITECT OR ENGNEER: UC.No.: MK OR ENG.'S ADDRESS: ORT: CLAIM VALUE: 10, 100 . 00 CALC—VALUE: 10, 100.00 GROUP OCC: R-3 /U-1 A+ ROOFING (714 ) 775-1947 ca+NAm°RSHAUE11237. SLATER AV COMMENTS: SMOKE DET. REQ PER 94UBC, REROOF 2800SF RESIDENCE W/TILE ( 5 . 8PSF) CGBNACTOWSMMID10 FOUNTAIN VALLEY CA 675241 ****************************+r*+ ****+c*******+ ****************************+r****** ADDRESS: 92708 UC.NO.: ZONING REQUIREMENTS WIT: SETBACKS LICENSED CONTRACTORS DECLARATION:1 hereby affirm under penalty of perjury that I ern licensed under provisions of Chapter 9 (commencing witsV 72/91 t�mnea�p)d Prdeaaiona cgd� n f is int rd MAIN BUILDING ACCESSORY BUILDING CITY s°..N/o.: UC.CLASS: uo.: FRNT: FT IN REAR: FT IN FRNT: • FT IN REAR: FT IN V Date: —/ 21 fe cant c.N , LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ' OWNERS LDERDCLARATION:Ihereby affirm under penally dperjury that lam mat from the Contractors License Law for the PARKING REQ: PROV: PARCEL: 14161134 ZNE: REF NO: 'Wowing reason(Section 7031.5 Dueness and Professions Code:Any city or county idh requires a name,to mrobuct,alter.improve, smolish,or repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES>, .s licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the > Business and Professions Coder or that he or she is exempt therefrom and the basil for the°He rd exempton.Amy violation d Seton *******,*.*.********.**.***.**.**,*******************************.************M********* 7031.5 by any applicant for a perms subjects the applicant to a civil penalty of not more than(We hundred dollars(55001). ❑ I,as owner of the property ormyempoilt yeeswwagesastheesole compensation, structure D E V E';L O P M E N T SERVICES REQUIREMENTS or offered for sale(Section 7044.Business and Profession Code:The Contractors License Law does not apply to an Owner of popery whobit orknpnvesthare°n,and who'ices surthwork hinseltorhna°"hrwghho a her°*"empioryees.ProvidedChat such ZONING APPROVED •BYDATE: r improvements we not intended or offered for sale.I.however,the building or improvement is sold within one year of completion,the owner'buider will have the burden of proving he or she did not build nr improve for the purpose of salt). ❑ I.as owner al the properly,emexdtavey contracting with licensed contractors toconatrw the project(Section 7044.Business and BUILDING APPROVED BY. : DATE: Professions Code:The Contractors License Law does nor appy to an owner of property who bull ot improves thereon and who _ /�� contracts tor such projects with a contractor(s)licensed pursuant to to Cathedra*license Law)' APPLICATION ISSUED BY : ` _1 DATE: 11 El I tun exempt under Section: B.8P.C.,orthis reason: *********************4**** *****MMM**M*. M MMM*** Dee: owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify Dud I em aware d and understand the requirements of California Health and Safely Code Sadism 25505,25533.and 25536,wither«any hours building oosupent,win/ea not(cimd me)need to comply with said rete codeeandtheneuhenem for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit le oorttkn or moddretion bore the the Act Gushy Management Dimnct.R®detW zonelsdton appimiav we exempt from Moa PERMIT 174 . 75 1 . 01 SMIP/NON—RES Date: Applicant: PLAN WORKERS COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedermom: ISSUE FEE • ❑ Ihave dwild mntancertificate d acteoonsenttoseliworkers'compensation, provided BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE e Code.for the performanceofthewokforwNahthispanniissued. TOTALS----> 175 . 76 0 . 00 0 . 00 175 ,76 175 . 76 . 00 )c]. I have and wis maims worker'compensation insurance,as required by Section 3700 dCode,led the Labor r the performance the work for which this permit is Sued.MYwarkef' Thein 13erandPdicynumbelan: EXPIRES REVENUE DIVISION TOTALS--> .COLLECTED : 175 .76 OVER/SHORT: . 00 Carrier: 4411C—OGUATTT1060 01 /01 /99 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Policy Number: 174 .75 1 .01 (This section need not be completed I the permit is for one hundred dollars(51001 or lase.) ❑ I certify that in the performance of the work for which this perms is' ,I dull not aro'person'n em manner so as lo *************************M*****M************M*****M**MMM*******MMM*MMM***MMM*** become subject to the workers'cemperaalion laws of Cam' , agree that I N D I V I D U A L F E E BREAKDOWN `°'�'' nom d Becton 3700 d the labor Code,1 em theith ca _ \ De.: 7 w � APd w: TYPE QTY DESCRIPTION UNIT COST TOTAL COST 7 Warning: allure secure works:conga setlon coverage I nlaMW,and shell subject an employer to criminal penalties and dynnnea w nen hundred thousand dollars(5104000), add/goner theccal ofconpesetro4 damages aa provided for In SFR 10100 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 10, 100 . 00 Section 3706 of the Labor Cod,Interest,end edmey s/ear. CONSTRUCTION LENDING AGENCY: I hereby affirm under pen*of perjury that there is a emtncticn lending agency for the END OF FEES performance of the wok tor whidi this permit is issued(Seton 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct.I agree to campy with ell city and eeenyordimrwes • and state laws relating to buildingconstruction and hereby authorize uMof e repreetiveathe city to enter upon the abovv e'meatvd property leiiiiy wnpoeea.JASON SMITH 04- -1998/ -81.70 RCP1i:til 3d2.E03 nt a GEkhIT :b&795::. / iSi.net rAgenU..ppmnUConlradon Mat Oir 0 (5-.1<6.WPI Whit-Building 8 Safety:Green-File:Canary-Applicant:Pink-Revenue:OoldenuMNseawr CONSTRUCTION AND PLANNING PO. s SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or-Pole'' 52. Pool & Equipment Location'; - 2. Sbil Pipe-Undrgrnd. 53. Steel Reinforcement - ,,._, n -+ ;?3..Efectrical Conduit,Utility-Undrgrnd. 54. Forms . , ":4;'Electrical Con4tit-Ondrgrnd. • 55. Electrical Bonding 0-r. 5,;•Steel Reinforcement 56. Rough Plumbing & Pressure Test • tr --& Electrical UFESF C3nd. 57. APPROVAL TO COVER•GUNITE = OWNLH BOWEN, FRED UAIt 2-16-70 JOB ADDRESS 1109 Salvador Drive BUILDING PERMIT NO. 31385 _ --GENERAL CONTRACTOR Tropicana Patios DESCRIPTION of WORK Patio Cover AP No. 141-611-34 LOT 30 TRACT 5023 FIRE ZONE VALUE $ 588.00 INSPECTIONS Signature Date GROUP .T TYPE V ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISS ED GAS Date Number 1 Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 7 FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM 7 STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL +� // q BUILDING, FINAL ,j/f/ ..{/7y/j c' ` /S PAID -a irUr tY Srfc6.0Q 13B;D -1 ._.l 16-705i-00 413 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely �j/ R�E,,CEEI DD RY DATE RECEIVEDEIDATE ISSUED ADDRESS/j6 I 60±441, o /l�� i� -/G'/U z -/6-re ADDRESS A OWNER to y,t/�j� /�j�// PERMIT NO. .V' -" A.P. NO. MAIL BUILDING /j / ' z ADDRESS LU tliSS //a 9�/s�(-'//�v/tnij '/TEL. ADDRESSSq //a % 4�y e /'�. 0_f...) CITY w_ [' /k- " " e ',!— NO�Q9-o�.6o Y(fa g TRACT / tarJL-OOfJ.T��444"' "`BLOCK Z Q CONSTRUCTION NEW ADD ALTFR REPAIR MOVING DFMOI ISH O LENDER / a m /� -J D BRANCH _I• , Jin OWNER F,'eD6WGYV - 0 m J ADDRESS VALUE JQ ARCHITECT TEL. $)SE S. /G'4V OR ENGINEER NO. U Q FIRE T W CC ADDRESS QQ ZONE TYPE / ,�f�GROUP �// J Q CONTRACTOR /c-/may Ni /v APPROVED W-- /SATE 2_X,0 co z w w ADDRES6Y/, 2. aw. VC r., R p ZON NO.OF USE OF N [(,e.Gv+'�r ' 0. //.fir TEL�/ PLANS BUILDING� V.7 ,p z F CITY 1.�1 1.1 P a 4_ No944-757/ —/ Q \M.U1D r —0 STATE CITY YARDS APPROVED YARDS APPROVED up O LIC. NO.2�//'/(� 7 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE / / ANO.OF BLDGS. (FROM C/L STREEEX) r / OF LOT _ re IfNOW •ON LOT FRONT /�/ FR' ,�. FT. USE OF , — EXISTING BLDG. R.SIDE , 1r FT. FT, I— SIZE OF NO.OF f ZZ NEW BLDG. ROOMS STORIES L.SIDE e?D FT. FT. 0 EXTERIOR WALL I ROOF _ COVERING COVERING REAR „a0 FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d C- GSMAIN BLD . ACCESS. BLOCS. QVAR.# DATE fy 72() V O Li6 IZ C.U.P.# APPROVED I— APPROVED /'/ / 7 z _BY !N .ATE o. — I —7O o VI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of CO the State of California. e) X�/_Oe FT Z I hereby certify that I am properly licensed as a contractor under / 'J, . . 0 the State of California Business and Professions Code. Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR j Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2 am exempt from the provisions of the State of California Business VALUATION and Professions Code,Division 3,Chapter 9. com PERMIT FEE $ r 00 Signature of m Permittee an Lt/ �r'G-£� $ 6-19" PLAN CHECK $ - E `p Authorized Agentu TOTAL FEE $ �' CO 70233 COSTA MESA BUILDING-SAFETY DEPARTMENT FEE R E C E I V E D - P.O.BOX 317 COSTA MESA,CALIFORNIA - 8UL 2 5 Igo For Applicant to Fill In Completely APPLICLATIO4� FOR'Pis ERMIT TYPE OR PRINT /:�Y �ByUILDING g BUILDING IMX O#IceUU bWI� ADDRESS 1109 Salvador Street I RECEIPT NO. /Yy[�(/.��(!y y' COSTA MESA. CALIFORNIA I TT,T1 J) RECEIVE/a: RE IV D DATE ISSUED OWNER Mesa Del Mar Develnnment Cr). D3.63 JUL 2A 1QQ1 p BUILDING MAIL ADDRESS 3800 E. Coast Highway ADDRESS Oriole FIRE ///1 TEL ZONE TYPE GROUP\�C CITY Corona Del Marr Calif.. NO. 3 422 ARCHITECT TEL. Gp iole APPROVED DATE OR ENGINEER MaCCO Realty Co. NO. 3.4122n ZONING ADDRESS Same as above ZONENO.OF USE OP NEW b.Lngl• fen lb R-1 I PLANS 2 I BUILDING "/ att pas. CONTRACTOR Ma000 Realty Co. l O DESCRIPTIONDESCL Lot 30 Tract 5023 ADDRESS Same as above DESCRIPTION A.P.NO. none CITY Same as above NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.NG207343-ADB-1 No'Oriole 3-1.1220 SOSTATO SIDE D REAR P.L. EAVES OSIZE F LOT 721 x 971 I NO. GN LOT None ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. ➢innP (FROM C/L STREET) SETBACK LINE FROM CENTER OP STREET 521 REAR YARD I FRONT .. FT FT. FT. SIDE YARD I LEFT RI I RIGHT 101 DESCRIPTION OF WORK L.SIDE CR FT. FT. REAR . Fr. NEW • X ALTERATIQN _ ADDITION BET.MAIN D MAIN BLID.S. ACCESS.SLUGS. REPAIR Cy '"�' MOVING DEMOLISH NO.OF SIZE BUILDING-. ROOMS 7 STORIES 2 APPROVED EXTERIOR WALL Wood & ROOF Shake APPROVED COVERING _ COVERINGBY f %, USE OF BUILDING ••-I'. KTO BEPERFORME• • ' • I• - -11•l • .0 • I • - -• I ,- • i• •• _ garage plan 500 DR Garage ' 1.160 S.F. N SO.FT. • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION ' BUILDING CONSTRUCTION. $ �� N SIGNATURE OF*, r R l+ nil PERMIT FEE j PERMITTEE G = >�v >f 23,925.00 D L� 7-5-0 0 AUTHORIZ D AGENT/ a E) \ TOTAL FEE S /02/5 o