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HomeMy WebLinkAbout1059 SANTA ROSA AVE - Building Permits CITY OF COSTA MESA •• 'o •, BUILDING DIVISION • :' - ' DEVELOPMENT SERVICES DEPARTMENT t . PERMIT PERMIT NUMBER B98-02011 ✓ (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 • BUILDING PERMIT Q�� Job Address: 1059 SANTA ROSA AV Status: ISSUED �!/'- t Suite: Applied: 11/04/1998 Vicinity: ROOF OF SFD AND ATTACHED GARAGE Issued: 11/04/1998 Parcel Nunmber: 41205211 Zoning: Applicant: CURETON, SCOTT A Address: CURETON, VICTORIA R . COSTA MESA,CA Phone: 714.556.5206 1059 SANTA ROSA AVE Zip: 92626 Owner: CURETON, SCOTT A Address CURETON,VICTORIA R COSTA MESA,CA Phone: 1059 SANTA ROSA AVE Zip: 92626 • Contractor:"' Address: Phone: Zip:, License:- Arch icenserArch/Eng: Address: • Phone: Zip: License: SCOPE OF PERMIT OWNER BUILDER PERMIT.TEAR OFF EXISTING ROOF ON SFD WITH ATTACHED GARAGE. RESHEATH WITH 1/2"OSB BOARD SHEATHING. INSTALL NEW 2'X 4'VENTING SKYLIGHT.APPLY NEW 40YR PRESIDENTIAL COMPOSITION ROOFING ON DWELLING AND TORCH DOWN ON GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,700.00 Permit $99.75 Claim Valuation: $4,700.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $100.25 • 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: • • 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 • DECLARATIONS WORKERS'COMPENSATION DECLARATION: 4 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. J o I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) O 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 DOLLARE(s100,000),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.Lis.4 Class 4 Contractor's 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 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(5500).): O 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 WIC, Business and Professions Code for this reason: \ Signature: Y' ( Date: //�d/� 9 gOwner ID verified by driver's license. es 0 No Driver's License No. Expires: /2'Y"7 8 Verification of Ownership by(type of d umen6 i.4.-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 t0 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,ore 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? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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 II 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 ❑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: CaERTIFI COMPLIANCE AND AUTHORIZATION OF ENTRY: Ii certify under penaltyof perjury that I have read this application and state that the Information given is come .I agree mply th all s laws rid cityordinances relating to building construction,and authorize representatives of the Ciry of Costa Mesa to enter upon the Same -described a insp n pu oses.I agree not to occupy or allow occupancy of any building authorizedD is erns n final inspection. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE L INSPFnlnN TYPE Dam !MALS QUI INSPECTN)NTYEE ME MAAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing 200 Final Re-Roof iZ"(--rg 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 ADDRESS OF BUILDING: 1059 SANTA ROSA AV °NT` CITY OF COSTA MESA — BUILDING PERMIT °"NERSNAMEDPwowN:CURETON, SCOTT A ADDRESt1059 SANTA ROSA AVE FLOOD: AH 38 'PERM NO: P 076568 COSTA MESA,CA 92626 2.7.41 PERMIT NO: P 076568 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAIUNG ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH ARCHRECT ORENGNEER: LC NO.: JOB DESCRIPTION : C/O WATER HEATER SQ FT: ARCH.OR ENG.'S ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / CO"mACTOBSNAME:NOCK PLUMBING ( 714 ) 895-1246 COUBAcnOBSMNUNG11610 SEABOARD CIR COMMENTS: X CREW STANTON CA uc.HO.: 511971 #SEdE9taEiE#♦EfEdtdt3t*****dE3EdEfE********dtdEdEdtdEdtiElElEiE♦E1E1fiElEx-#+EihfESEStdEiEiEiEfEfEdtik9EfESEiElEdtif****+E+EiE#dtiklE*1E 90680 LIME ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under orations of Chapter 9 5 E T • B ACK S (commencing with Section 7000)of D/isun 3 of the Business and Professions Code,and my license is in full force and effect. crTYLIC.NO.:05038 LIG.CLASS:C-36 LIC.NNO.: 5�11971 EXP: 02/97 MAIN BUILDING ACCESSORY BUILDING e: Z Z caned«: �\KXC pLuM.t3)A, �/i� LEFT: FT FT IN REAR: IN RGHT: FT FT IN IN FRNT: LEFT: FT FT IN REAR: IN RGHT: FT FT IN IN R BUILDER DECLARATION:I hereby affirm under penally of perjury That I am exempt from the Contractors License Law for the f lowing reason(Section 7031.5 Business and Professions Code:Any GAY or county anima.which requires a Penne to a a.altar,image, PARKING R E PROV: PARCEL: 41205211 Z N E: REF NO: radish,or repair any structure,prior to its issuance,also requires the applicant for such parses to file a signed statement that he or she o licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencin0 with Section 7000)of Division 3 of she PLANNING NOTES> w Business and Professions Code)or that he or she is esem pt therefrom and the basis for the alleged exemption.My violation of Section > 031.5 by as applicant for epermit subjects the applicant toe ices'[penally d not more than fie hundred dollen(SSDD)). ************************************************h******************************* ❑ I.as owner of the properly ormy employees with wages as their sae compensation.will do the work.and the awcturaa not intended or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an owners DEVELOPMENT M E N T S E R V I C E $ REQUIREMENTS who buids or improves thereon.and who does such work Nmseff or herself or through hi or her own employees,provided that such (1/ owprovements ere not intended or offered for sale.If.however.the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: ner-builder will have the burden of proving he or she did no build or improve for the purpose d sale). ❑ I,as owner of the property.am exclusively contracting with licensed contracts to construct the project(Section 7044.Business and �' DATE: Professions Code:The Contractors License Law does not apply wh to an owner of property who builds or improves thereon and o BUILDING APPROVED BY : E" contracts for such protects with a conuador(s)licensed pursuant to the Contractors License Law). � —- v• Z ❑ I am exempt under Section: B.AP.C..for thisreason: APPLICATION ISSUED BY: �� � J DATE: ® �— Dale: owns: ************************************** ************************* * I do hereby certify that I am aware of and understand the requirements d California Health and Safety Code Sections 25505,29993,and LEGALIZATION:N F E E SUMMARY STRUCTURAL SEG ENT:N 25534,and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Av3aly egemed District Residential condruaonappicetioneere exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 7 . 00 Date: Applicant: 25% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN (,U o I have and wit maintain a certificate of consent to self Code.forth,performanceoftheworkforwhichthispermitisissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE -insure for woken'compensation,as provided for by Section 3700 of the Labor ISSUE FEE 20 . 00 D h-'D I have and will maintain workers'compensation insurance,as required by Section 3700 of the labor Code.fix the psbrmance of the TOTALS—--—> 7 . 00 20 . 00 0 . 00 27. 00 27 . 00 . 00 work for which this permit is issued.My workers'compensation insurance carrier end policy number are: Cartier: STATF' EXPIRES REVENUE DIVISION TOTALS--> COLliECTED : 27 . 00 OVER/SHORT: . 00 ' Policy Number: WM('I2111111(1 09 /30 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed d the perms is for ono hundred dollars 151001 or reser 27 . 00 o I certify that in the performance of the work for which this permit is issued,I shall not empty any person in any manner so as to became subject to the works'compensation lawn of Cauomie agree : should become subject to the workers' ************************************'******************************************* mpensation p of ion 3700 of the Labor Code,I h axn• with -provisions. •• �''7 /���`eeeddd I N D I V I D U A L F E E B R E A K D O W N e: Z �//�� Applicant'. —. wa Ing:Fallunfosecurewodaicompewtioncaanga n/ewlt*andaNllsub/ectenwrp/oyscrocr/Mnalpenaltiesand TYPE QTY D E S C R I P T I O'N UNIT COST TOTAL COST I Ones up to one hundred thousand dollars($100,000A In addition to the coat of compensation,damages as provided for in Section 3706 of the Labor Code,Interest,end attorney's fees. +< PLU 1. WATER HEATER AND/ORtVENT 7 . 00 7 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this pent is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: cle;\ I certify that I have read this application and state that the above information is correct.I agree to ccnply with MI city and county ordinances y tA-.} and stale laws relating to building caner/4 On end hereby authorize representatives of this city to enter upon the above-mentioned property 1 for inspection purposes. rr rE: i.. _ RON NOCK r : . - Date: 2"2 em Signature of. .r epplca. (5151-46 WP) White-Builig&'"d1:Green- Appicent:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING) POOL & 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 3;E4ectricai Conduit Utility-Undrgrnd. 54. Forms .r'r4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding � .5...-SEeel Reinforcement,7 56. Rough Plumbing & Pressure Test 6.-NectricalUFER:Grad. 57. APPROVAL TO COVER-GUNITE ' 7-Footings - 58. Electrical Conduit-Undrgrnd. a - 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. r -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 ElectricalConduit 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 FIRE DEPT. REQUIREMENT • - r 20. Rough FactoryFirepiace - ' . ' 1,- , APPROVALS -Permit# - 21. Ducts:in Structure- ' _' _ 70. Underground Hydro • 22, Ducts.Ventilating .-:',..6. * " • r-- ' 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe•Rougk.& Test 72. Underground Flush rt 24. Roof Framing - -73:'Undergrnd.Storage Tank 0 Gas 0 Oil 25. Root Sheathing i. - ' ' . - 74-.'Overhead Hydro 26. T-Bar Ceiling (Structural) & rvlbnocoat - • 75: Dry Chemical 27. Frame and Flashing . - 76. Dry Standpipe 28. Lathing & Siding - • 77. FIXED SYSTEM FINAL 29. InsulationC 7FIRE PREY. FINAL • 30. Drywall Nailing . . - HEALTH DEPT. REQUIREMENT .31. Plaster Brown Coat -- • 79. FINAL INSPECTION 32. Electrical Power MeterFinal e 80:-FOOD CERTIFICATE ISSUED itcr _�\' "�- ' .33. Ftnal'Eledtic . � _ ,• Notes: 3 .5 i6-1 � ;34. Final Heating & Air Conditioning- • 35. Final Gas Pipe-Test , ti -. -r • 36. Hood or Canopy • - _ 37. Final Factory Fireplace - a 38. Final Plumbing . 3.�ate-"s! S : . 39. Water Service-Final z • "40. Gas Service-Final - 41. Solar Domestic•Final• - _ . 42. Backf low Preventer _ - A - , 43. Backflow Irrigation ' .. •44. Landscape Irrigation SYSteill rt - 45. Sound Attenuation • 46. Handicap Regulations' . 47. FINAL STRUCTURE & BUILDING A ' 48. FINAL PLANNING ' 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co ' • - 51. CERTIFICATE OF OCCUPANCY No. Date �� ` Pfl0.1EL'ADDflESS: 1059 SANTA ROSA AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 049010 /4OWkt NAME: PAMALA HAYES 0RES3: 1059 SANTA ROSA AVE PERMIT NO: B 049010 PLAN CHECK NO: 05745-.90 S GOVT: N SUPP: N COSTA MESA,CA 540 5624 92626 CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: ADD ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION 34LF-5 . 5FT HIGH CITY STAND. BLOCK WALL SQ FT: 234 • ADDRESS: UNIT: CLAIM VALUE: 1 , 000 . 00 CALC-VALUE: 880 .00 GROUP OCC: M-1 J PERMITTEE: PAMELA HAYES (714 ) 540-5624 ADDRESS: _ 1059 SANTA ROSA COMMENTS : STUCCO ON BOTH SIDES OF WALL C.M. CA 92626 *****>taE**3r*xx-e<*************->E*x- *x*x-*****3t->Ex** **qt******x-*-tt-*aE#* tratd *********Mit** UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY UC.: STATE UC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that)have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: 25 FT IN REAR: FT - IN Compensation Insurance,or a certified copy thereof(Section MO,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL : 41205211 ZNE: R1 REF NO: ' Certified copy is herebyftrnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> CONSTRUC25TT TAPP0OX.F34 FLBL0CK WALL 5 FT 6 IN HIGH SET Date: Applicant: ***********************if-*-1E#*dF******7t***********3(-******iF************** ******** EKEMPDDN FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENT- S 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 mew rkers'/Commpensation Laws p1 California. / - ZONING APPROVED BY SGL DATE: I —V1 9,v Date: 9 7/ 7e 1 Signature: I/ — 'as. At-•-•410NOTICE..lf,after making this declaration,you should become subject to the Workers'Compensation /ovisions of the Labor BUILDING APPROVED BY : DATE: • ' Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. (I _ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y : , I�s DATE: 1 which this permit is issued(Section 3097,Civ.C). ******************************************** **********************Tr(rF 'iF *'7(- LENDER: l • **-*******************aE**********-1E********JE**************************AYE*:IEif-*Y,-***** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURALSEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING • (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 23 . 00 - . 50 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 Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 14 . 95 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID ' ' DUE © structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 23 . 50 0 . 00 14 . 95 38 . 45 38 . 45 - . 00 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 completion,the owner will have the burden of Droving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 38 . 45 OVER/SHORT: r 00. ' for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 23 . 00 . 50 ' 14 . 95 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and`who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D O W N ❑ I am exempt under Section: B.&P.C. forthisn:/aG ( 4,7714/41 �� / TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: / IT / IDwner- SFR 34 RES-CONCRETE BLOCK WALL / FT . 20 .00 680 . 00 I do hereby c ify that am aware of and understand the requirements of California Health and Safety Code Sections 05,25533,and SFR 200 ALTER BY VALUE RESIDENTIAL NOZONE 1 .00 200.. 00 25534 and that I or any future building occupant wilVwill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: /O.. / I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county v /°,7 '/ ordinances and state laws relating to budding co struction and hereby authorize representatives of this city to enter upon the above-mentioned / ; property for ins ction u '' , purposes. ,`' pA Di O3Ofi4c62 OQOd?6b4 'j Ccs' -8 r5 Date: CO . Signature: ? - �i--r>a &J / '� A IC{ ' DATE= O9i17/.0 TINE j'1D:?2 Driver's License or cial Security 00 `l )� 16c-4G While-Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor Y .RUCTION AND PLANNING POC SPA Date Inspector ! Date Inspector . ROYALS Permit# APPROVALS Permit # I •1. Temporary Electrical Service or Pole 52. Pool & Equipment Location i' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding11 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test t - 1 6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE I' 7. Footings . 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test l 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK i • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final II 12. Sewer Cap 63. Heater & Vent-Final 1; • 13. Roof Drains - 64. Plumbing System - Final 1; - 14. Rough Plumbing 65. -Electrical-Final j} i 15. Rough Electrical-Conduit 66. Solar System=Final t' 16. Rough Electric Wiring 67. Fencing & Access Approval t' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL il 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # I 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil I23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73- Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster 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 f=actory 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 V414/ . 48. FINAL PLANNING 'v+ '/ 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date ^ PRWECTADDRESS: 1059 SANTA ROSA AV UNIT: CITY OF COSTA MESA BUILDING PERMIT PERM NO: B 047221 OWNER'S NAME: ROYCE & CAROLYN ENGLISH ADDRESS: SAME PERMIT NO: B 047221 PLAN CHECK NO: 03891-90 S GOVT : N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH 557-6459 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : LEGALIZE 348SF PATIO COVER SQ FT; 348 • ADDRESS: UNIT: - CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 4, 802 . 40 GROUP OCC: R-3 / PERMITTEE: CAROLYN ENGLISH ( 714 ) 557-6459 1 ADDRESS: 1059 SANTA ROSA COMMENTS : CITY STANDARD PATIO �.�p.�p . >F C .M. CA 92626 **** ** �c* >F ** ***x*** x**********>F> *** �r*>F�aN********gr>E****SIVIVKE DETEG TOR LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U I R E M E N T S 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B ACK S REQUIRED CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: 14 FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: 10 FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POUCY : EXP.°ATE: COMPANY: PARKING REQ: PROV: PARCEL: 41205211 ZNE: R1 REF NO: 0 Certified copy is hereby furnished. ❑ Certified copy isfiled with the city Building Division. PLANNING NOTES LEGALIZING EXISTING PATIO COVER ON AN EXISTING RES . Date: Applicant: *********************************************************************$********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(3100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work or which this permit is issued,I shall not employ any personj� in any manner so as to become subject to the Workers'Compensation La sof California. gAt4 Al o r ZONING APPROVED BY SCL DATE: �' O �o Date: lIC — f' 9v Signature: (° � 7 ` BUILDING APPROVED BY DATE: NOTICE:If,after making this declaration,you should become subject o the Workers'Compensate provisions of the Labor -:' Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. „pp p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: 'O 1 D which this permit is issued(Section 3O97,Civ.C). ******************************************* ********************************* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E S. U M M A R Y STRUCTURAL SEGMENT :Y • OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Cade: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 . 00 .1 A . 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 3 -i, SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 46 . 80 -^ - .t and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by - r' /, any applicant for a permit'subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE . I, as owner of the property or my em loyees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLANLCHECK' TOTAL PAID DUE EN structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . 50 0 . 00 )46 . 80 119 . 30 119 . 30 . 00 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 REVENUE DIVISION TOTALS——> COLL COLLECTED,: 119 . 30 OVER/SHORT: 00 forthe purpose offsale).rovement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business k 72 '00 ,/ 50 46 . 80 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and.who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *************************'***********' ***'******'********************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: /� rf .512 / TYPE QTY DESCRIPTIO N.” UNIT COST TOTAL COST Date: JC— OF -- 6 0 ( Owner['2/ /' .5–A/2 A / .. SFR 348RES—PATIO COVER—POST C TRELLIS 13 . 80 4 , 802 . 40 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OR- FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. . xi' Date: Applicant: ' • I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county "p ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the abov}}}'''mentioned r property for inspection purposes. /..' �f D Y Date: 6 d— 5 d Signature: (,".�il�/s-fp.�,./�/ [ `i <A 01 00060345-00060347 TOT 119.30 Driver's License or Social Security x: DATE: 05/08/90 TINE: 10:41 164146 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTIO11t{ND PLANNING POOL & SPA APPROVAL'S Permit# Date Inspector APPROVALS Permit# , Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. $oil 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 r 7. Footings 58. Electrical Conduit-Undrgrnd. .� 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 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 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace _ APPROVALS - Permit # 21. Ducts, in Structure 70. Underground-Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas O'Oil 23. Gas Pipe-Rough & Test 9 72. Underground Flush 24.- Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - c, 74. Overhead Hydro' 26. T-Bar Ceiling (Structural) & Monocoat 75.. Dry Chemical 27. Frame and Flashing- 76. Dry Standpipe • 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation 78. 'FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter:Final 80. FOOD CERTIFICATE ISSUED 33: Final Electric Notes: 34. Final Heating & Air Conditioning -1( L9- S bQe ✓ .&// - /c{id[, 35. Final Gas Pipe-Test 174' t‘. CSC/KY KY�C L ;fraC cam 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 5--11-78 48. FINAL PLANNING 49. Electric Release to Edison . 50. Gas Release to,Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date NOTE: SHOW AND DIMENSION PROPOSED PATIO COVER AND YARD AREAS Ilik60-0 SEE DETAILS ON REVERSE SIDE t x 2 LATTICE »-/d-o 4 0•c. 24-o�'{ •••,,.. ROOF SercsAMS.M6 nit- I _ - Pang - 1 l /4.6 X 8 RAFT E RS/ ,•"• =.Co vsR= ; y of Costa Mesh L�Uildiniti�4..c. j i —S ( c� 9 o LD. E 6 19 LD ' 4 XI_ BEAM THESE PLANS MIDST BE Ot'a01,i,T ALL TIMES RAKE T-STRAP EA. SIDE , Li) CHANGESJWITH()JI PRIOR iFPROVAL OF DEPT. FOR POST-BEAM c `.I� ?� co _CONNECTION. o O O�O ei%% 't OR RAI TING OzA P.,7-MIT OR APPROVAL OF• d F 'U Pi Af«'AND SPECIFICAI IOr S SHALL/30T�! CONSTRUED-10 BE A a Z PMF firt. .LOT- i T '` ° L.�1 N APpf OVALODE. C EI IOLAT ION OF ANY W a W Tr.E FRCIf !fR',•;-TFIIS i ODE.K.�EPPRESUMING CF I- H O Z d INE ONS TO GIVE - m n a .N a ALI7HO TO VIOLATE CC CA.=1CP2. TF�PRCV!SIONS OF THISSi aCC i CGDE SHALL BE VALID EXC=PT IN Sp FA S�S THE WORK OR USE N d �I II a 0 Wi'ICH 1T AUTHORIZES IS L;WEUI_ O K Z OI ✓n � U 1 I ISSUANCE OF A P- i Z n r, V O i �/a, y! .e. ERN,1163A. . UPON PLANS AND { _1 O 2 U - - -- NC T PREVCpV'Y H: BUILDING OTFICU.I. ! Q J . N O W W T ^EOU!F TNG THE L/JFiF CTION OF E(yRpP;�ATIO' WLL Z_ X _I Z O a� APPR:�� 'VED aT', ,FROM "IFF:OORIC2" 1 o z m ! �. ASA f' '. 7Q g \ OU a /�y o - CRY Of. C•STA MESA �� 1 ( f,� SLOPE TO DRAIN PABOLATVE LAB AB'y rile 1 1lLT TO WtL0. DEPT. no. aci \ Celt- DATE 'S ..6 'T *'26 GA. G.I. FLASHING' ni 1 1 11111101:411O!MARINOWOOD FLOOR _J—L__ J CONSTRUCTION PIERS 12" SOJA o a ix _ O z• ADDITIONS FF.FTIONS, OR CORRECTIONS SHALL SIDE ELEVATION LL • DPAPFI�STY THE PLANNING DEPARTMENT PLOT PLAN CONSTRUCTION DETAILS • 201b5,ROOF CONNECTION DEVELOPMENT DETAILS SERVICES DEPARTMENT PATIO COVER BUILDING SAFETY DIVISION T Y P PLANS CONT. SOLID BLOCK - LEDGER ura RAFTER OWNER: Eoyca A. SA/G4/_MI DATE : 41Ay 7, /990 iva ADDRESS: / 759 J4sery kosAs AIN PHONE: 4'57 - 6459 I/2" DIA. X 5" LAG SCR. CONTRACTOR: (Owning Hear N✓ LIC. NO. — AT 32" o.c. ADDRESS: Jt►Masa of 0171) PHONE: CDETAIL� RAFTERS RAFTERS APPROVED FOR CARPORT, PORCH OR PATIO LIGHT WEIGHT ROOF COVER OF BUILDING PERMIT NOT SUPPORTING CEILING LATH, FIBERGLASS, ALUM. By Date SIZE SPACING SPAN SIZE SPACING SPAN 2"x4" 12"O.C. 9'-6" 2"x4" 16"O.C. 9'-6" CR a CL "TECO" GENERAL NOTES: GRIPS OR JOIST 16" -0"8' 24,� 8,-0„ HANGER 24” 6' -6" 32" 6'-6" 1. These plans must be CONT, kept on the job at LEDGER r, 32" 6' 6" 48" 5'-6" 48" 5' -0" 2"x6" 16" 16'-6" all time during 2"x6" 12" 16'-6" 24" 14'-6" construction. 16" 14'-6" 32"• 12'-O" 2. All framing to be 543" DIA. X 5" LAG SCR. 24" 12'.-O" .... .. . . . 48' 10'-0" Douglas Fir NR AT Ib " 0.C. 32" 10'-6', - :2"x8" -, 24" t 19'-0" grade minimum. 48" f'. 8' -0".. , ,: • t:`. .` 'r'32" 15'-6" 3. Rafters may not DETAIL 2 C x8 24 15 6 � 48" 13'-b" attach to facia ex- 32" 13'-6" ' " ' cept for 101baroofs 48" 11' -6" • as shown on details; 10lbs.OR LIGHT WEIGHT ROOFS 4"x6" 24" 17' -0" HEADERS 20Ib5roofs must use ONLY CONNECTION DETAILS 32" 15' -0" a continuous ledger 36" 14'=`0" G LI6HT.,WEZGHT ROOF ONLY attached as shown 2" X FACIA-MIN. REO. 4"x8" 24" 21,',-0;1.w..:...r - SI_ZE;' ;;,TL POST SPACING on details #14*2. 32" 19'._O" . . .., 4x4. . 6'-0" . _...._. .� ,. 4. Light weight roofs �� 36" 18'-0" 4x6 •- . 9'-0" • may attach to facia ►=� 48" , 16'-0" 4x8 • ' 12'-0" for 14' span max. , !•� iteg RAFTER 4"x10" 32" ' 22'-0'' 4x10 15'-0" spans over 14' must `. " use a continuous 36" ; 21'-0 ,;I CARPORT, PORCH OR PATIO ' ledger as shown in APPROVED METAL 48" 20' -0" SIZE POST SPACING I detail #3. HANGER 72" ' 1`72--"---- _ . - 4x4. ... ' - 5''-0"- ------ 1 C4x6 8'-0'.) DETAIL 3 4x8 l0'-0" 4x10 12'-6" G ann 29579 COSTA MESA BU COSTA MESA, C DEPARTMENT IAN -7-690-s 00 211* ***1 28./`_ P.O. BOX 1200 COSTA CALIFORNIA 02626 c, For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING L„ Q N For Office Use Only ,i' BUILDING ADDRESS 1059 Santa Rosa RECEIPT NO. FP COSTA MESA. CALIFORNIA LJJ /.7 RECEIVED BY DATE RECEIVED DATE ISSUED • OWNER Heltzer Enterprises-Costa Iles .04=04:6 �a�-/p,�6�-��' -���6� MAIL ADCRESS/Q'S9 yJ0..t.LJ�T( . ,/t/ �/1� ;, ADDRESS 144 South La Brea Avenue GROUPS -913"W^/t FIRE 3 � CITY Los Angeles 90036 TTioO:936-1104 ZONE TYPE / • k- ARCHITECT TEL 5. /?,7(14) BYPROV[D DATE OR ENGINEER Frank Gonzales NO. 732-68]8 1336 E. Chapman Avenue ZONING i ADDRESS Orange, California 97668 ZONE NO.OF UE[OP NEW Res. SSI CONTRACTOR George J. Heltzer & Assoc. R1 I PUN. 2 BUILDINoAttach.Garage LEGAL ADDRESS 144 South La Brea Avenue Nocturnal. Lot 54. Tract 6617 CITY los Angeles California 90036 w.P.No. None NOTE: NO RAVE OVERHANG SHALL BE LESS THAN .; LIC.NO. 20L098 NO,TATE 936-1104 90'70 SIDESREAR P.L. EAVES SIZENO.OF SLDGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT I NOW cm ion n YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING :.ti EXISTING BLDG. .(FROM C/.STREET) SETBACK LINE FROM 5 ^/ .' CENTER OF STREET REAR YAND?5 I-611 i FRONT F 1' FT• v SIDE YARD LEFT 51 I RIGHT 8'-411 R.SIDE 7 FT. y FT. DESCRIPTION OF WORK L.SIDE SFr. n. i, NEW X ION ADDITION REAR / ) Fr. c PT. I: DISTANCE BET. BET.MAIN R p REPAIR _ IIQVINQ _DEMOLISH MAIN SLOGS. ACCESS.BLOCS. 5. VAR.* DATE BUILDING NO.OF ;` SIZE ROOMS STORIES 2 C.U.P.# APPROVED EXTERIOR WALL ROOF APPROVED ��/� pi COVERING R till'CO COVERING wood shi nal el BY li1/(/I// DATE 0/36 /61) ",' USE OFDU[LOINS AND WORK TOBEPERFORMED 01/1 a Tlwelling and Attarhed Garage Plan 404D - Lot 54 I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE . AND STATE THAT THE ABOVE IS CORRECT.AND AGREE TO CON. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. R1 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /J� D 0 BUILDING CONSTRUCTION. VJ/ ' PERMIT FEE $ ,� SIGNATURE OF • PERMITTE. 1f � a?T7 P. SO AUTHORIZED AG[; /.,- 1/, ��. /�L�a A` TOTAL FEE $ 5 E•..