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Home My WebLink About1098 SEA BLUFF DR - Building Permits t • CITY OF COSTA MESA �j^�7^ ""w"71rj7 G-- BUILDING DIVISION Y :� ,,.. �I . DEVELOPMENT SERVICES DEPARTMENT PER NUMBER 1. 1 .._.±�. l PERMIT et P03-00821 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1098 SEA BLUFF DR • Status: ISSUED Suite No Applied: 12/16/2003 Issued: 12/16/2003 Vicinity: Parcel Nunmber: 42203137 ISSUED BY: . � Applicant: SZABO, KEVIN Address: 2737 S CRODDY ' • - STE D " Phone: (714)241-1414 SANTA ANA,CA Zip: 92704 / - - , - , � Owner: WOLFE, FRANCES ATR • Address 1098 SEA BLUFF DR , Phone: - - COSTA MESA, CA Zip: 92627 Contractor: COAST ROOTER PLUMBING HEATING &AIR CONDITIONING . Address: 2737 S CRODDY - . . ' STE D • Phone: (714)241-1414 . SANTA ANA,CA Zip: 92704 ' License: 529127 • Arch/ Eng: / _. - - - - - , Address: - - Phone: Zip: Licenser , • SCOPE OF PERMIT WATER HEATER CHANGE OUT. - , ' -FEE SUMMARY- ' AMT QTY - AMT. -QTY - , AMT QTY ISSUE FEE , - '$23.50 ,. - , , Laundry Tub/Washer ' $0.00- ' 0 .t., - Sump Pump - $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 -; Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap , $0.00 0 Trap Primer, 2,,"$0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal ' $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brki•Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors- $0.00 0 "Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 - Septic Tank $0.00 0 Wash.Basin, $0.00 0 Dishwasher . $0.00 0 Sewer Cap for Demo $0.00 0 ' • Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 WaterCloset(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower - $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 - Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 . 0 Water Service $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord•No0.92728,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446.46(6/00) DECLARATIONS -) C �) 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 self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the wfor which this permit is issued. I have and will maintain workers'••mpensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'co nation Inss -n warner and policy number are: Carrier: M. Policy Number: (This section need n e comple:.® a permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the pedorman - 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 Califoml: :nd agree that if I should become subject to the workers'compensation provisions of Section 3 00 of the bor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: I I(-{•/� \(Y�j� t/ WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOI I ARE($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 DECLAI3ATION• I hereby affirm that I am licensed and • Ions o & r 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.a Class a Contractors Signature: 7t 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). Lenders 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($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.). ' O I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Op 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to d0 work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has e 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 Califomia 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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes all No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑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 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) co-2-li /P And/Or Authorized Applicant I IRe CODE I INSPECTION TYPE QAIL MALI CODE! INSPECTION TYPE QAIE 5lIMAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical p /� 1266 Pool Spa Final 208 Final Plumbing L 5 03 5Nf 200 Final Re-Roof 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 • 9 CITY OF COSTA MESA 4 BUILDING DIVISION F ,, vinnis,, 4) DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER 4. 7 PERMIT BB03-00278 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 1098 SEA BLUFF DR tf • Status: ISSUED Suite: Applied: 02/18/2003 Vicinity: Issued: 02/18/2003 Parcel Number: 42203137 Zoning: Applicant: MC CARTHY, JULIA ISSUED BY: Address: 22622 LAMBERT ST STE 303 Phone: (800)499-1340 LAKE FOREST,CA Zip: 92630 Owner: WOLFE, FRANCES A TR Address 1098 SEA BLUFF DR " , . Phone: , COSTA MESA,CA Zip: 92627 Contractor: ' BIENEK ROOFING Address: 22622 LAMBERT ST STE 303 Phone: (800)499-1340 LAKE FOREST,CA Zip: 92630 License: 651509 Arch : - Eng: Address: Address: Phone: - Phone: • Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING SHAKE ROOF, INSTALL OSB,AND APPLY COMP SHINGLES. FEE SUMMARY ' Plan Check: $0.00 Calc Valuation: $5,800.00 Permit: $125.25 _ _ _ _ - ___ - Claim Valuation: $5,800.00 SMIP Res: $0.58 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.83 • 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: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-08(8/00) DECLARATIONS ( i fj 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 self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the for which this permit is issued. 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. y worke -'�c'o'�mp:ejn.fsa�tion urance carrier and policy number are: / -�}-a Carrier: ' y - ' — ' A-- Policy Number: I LL / Iv (This section need not be completed it 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 pot 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 the p ' lo Applicant Signature: /f! & VL4 l Date: 2 —` '—0 WARNING:FAILURE TO S RE WORKERS'COMPENSATION COVEIS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND 00I. ARE(5100,000),IN ADDITION TO THE COST OF COM SATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.b )7 L��`"�(/ Class k Contractors Signature: /11, Date: 2 — I 8.--o- G../ '-V_ 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). Lenders 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 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.It,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • O I,as owner of the properly,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: Owner ID verified by drivers license. 0 Yes ❑No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,1alsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully Complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a Permit 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 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 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 state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describedproperty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /i��SignaIi ! G f. :g:I 0 mer s) -, - I p Q3 Date And/Or Authorized Appl•lht 0 Date CODS E INSPECTIONTYPE DATA INTIOAL5 CODE INSPECTION TYPE DATA )NTRIAL$ • 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa FinalC#'4#4#"--- ///�� 208 Final Plumbing, 200 Final Re-Roof T.21.-70) `� 'v/Y 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 OWNER WOLFE, MR. DATE 9_27_78 JOB ADDRESS ing8 sex. muff Drive BUILDING PERMIT NO. 46762 GENERAL CONTRACTOR Forrest Dickson DESCRIPTION of WORK Patio Cover AP No. 422-031-37 LOT 24 TRACT •105 FIRE ZONE VALUES 650.00 NSPECTION$ Signature Date TYPE V GROUP .T ZONE R—G SOIL M GAS WATER Plumbing SUBCONTRACTOR ill Dote Number Signature ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE • UNDERGROUND ri POWER 0 ROUGH WIRING Heating and Vent. TRENCHES H FORMS H STEEL REINF. H FLOOR SYSTEM BOND BEAM D STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL PElectric HEATING. VENT„ REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL 14:22,)8 q! T,7 �� fI Ue p603 9/25/78 7.50 TU V fi.+ . .1 _ ._ - ... COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PPLICA TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink'Only R Cr E. .+ DATE RECEIVED:, n� ""• Q'E ISSUED BUILDING _ ///Qqry�A/�Offf �J L �' ADDRESS e — ; �` ,I . ... /r,.�.-,.. �1]i✓ '� �`s' OWNER iJoLFF A.P.•NO.422 -U✓/- n �� BLDING MAIL ADDRESS/09 , tc-i}f(///rf PR- • ADDRESS/09 SEnc C/F, /Z • CITY(S 7,4 A/ES/4 TNO5 - TRACT 9� LOT..25/ BLOCK CONSTRUCTION / IOL NEW ADD ALTER I REPAIR MOVING DEMO] ISH LENDER f BRANCH OWNER e. ADDRESS eery� 8 U �n ARCHITECT TEL. USE /O W $ ,J D OR ENGINEER NO. FIRE �r/y 3-r ADDRESS //yy {T.� Die-ids-SO '� - t ZONE TYPE " —GROUP `1! ) / I . � ,3- L/iCKSO�r - APPRO E �/ ,,,///fff/// -^\/ CO NTRACTO / V OC• BY f DATE'/y -(lJJ` ADDRESS 6•/M I #79imFi� /gag . C. `['_^o' TEL ZONE NO.OF USE OF NEW�/(� CITY 7647Q 5 Q, �S NO.9//9% - 4IZ PLANS 7 BUILDING .Fi STATES CITY YARDS APPROVED YARDS APPROVED gLIC.NO. I LIC.Ne. , MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET), yA 0.., OF LOT I NOW ON LOT FRONT / KFT. Q USE OF 4 c& EXISTING BLDG. R,ySIDE e FT. ' FT. CA FSeparate permits are required for L.SIDE /0 FT. ( /f FT. Ci electric,plumbing and heating work. REAR /0 FT. 6 ft FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& C )�] /� MAIN BLDGS. ACCESS.BLDGS. (j t�EAJ /./eoo //grit)r 14[�kLO VAR.# DATE .0 Jj/j C.U.P.#rye APPROVEDAPPQ /60 T _BY ROVEI//J r� �� • _DATE/- 02.5 —25 CC A. I hereby acknowledge that I have read this application and state N n. a that the above information is correct and agree to comply with m Cl" all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 2 IA:14 the State of California. I hereby certify that I am properly licensed as a contractor under AO SO. FT. ry 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: am exempt from the provisions of the State of California Business to VALUATION ' PERMIT FEE �- o and Professions Code, Division 3,Chapter 9. $ in /// in PLAN CHECK $ • m Signature of 65-61-SIL. �� r� o Permittee .9,i/� /� /' $ (�•/ TAX $ •� U L• . Authorized*Agent/ TOTAL PAID $ 7, 57