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HomeMy WebLinkAbout2818 SERANG PL - Building Permits ADDRESSOp&fLOM3: 2818 SERANG PL SPIT: CITY OF COSTA MESA - BUILDING PERMIT mvNEBSNSLEIVIDchm: BILL DOUGLASS PERM NO: B 08473b ADDRESS: 2818 SERANG PL 2818 SERANG PL PERMIT NO: B 084738 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT ORENfgJIEER: LIC.No.: JOB DESCRIPTION : T/OFF ROOF INSTALL CLASS C SHAKE SQ FT: 12, 536 ARcx OR ENG•s ADDRESS: uPIr: CLAIM VALUE: 12, 537. 00 CALL-VALUE: 12, 536. 00 GROUP OCC: R-3 /U-1 CNTRACTTRS'MMUG R0260S AND AL ONBARROWS INCORPOR ( 714 ) 557-7440 COMMENTS: SMOKE DETECTORS REQUIRED CONTRACTORS MNLmG SANTA ANA CA uc xo.. 327802 ****+t'*****************�P*********tL****x�E** +E*********BELE*�E**�E*****BELE***x** ****** ADDRESS: 92707 UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby anion under penally of perjury thatm I alicensed under provisions al Chapter 9 S E T H A C K S (commencing with Section 7000)of Division 3 d the Business and Professions Code and my license S in full forte and effect. CITYLIC.No.: 020924 uc.cuss: C 39 LIC.NO.: 327802 EXP• 11 /97 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 9J// 7/77 Contractor: �/fL—�'/��T]('I//� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ER BUILDER D CLARATIDN:I hereby affirm under penalty peryry that I am exempt from the Contractors License Law for the following reason(Section 7031.5 Sunless and Professions Cade:Any cit or openly which requires a permit to cooalraN.alter,improve, PARKING RE,(Q�• P ROV: . PARCEL: 13932113 Z NE: REF NO: •emdlsh.or repair any structure,prior to is issuance,also requires the applicant for such permit to fib a signed statement that he or she PLANNING N O T ES> ,licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the > Business and Professions Code]or that he or she a exempt therefrom and the basis far the alleged exemption.Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty And more than five hundred dollen MOOD. ****************************************************************************iP** o I,as owner of the properly or my employees with wages as Mei sole compensation.will do the work.and the structure is nth intended DEVELOPMENT SERVICES R EQU IR E M E N'.T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does nil appy to an Owner of propend who builds or improves thereon,and who does such work himself or herself or through he or her own employees.provided that such pr imovements are rot intended or offered for sale,ft.however,the building or improvement I.sold within one year of completion, ZONING APPROVED BY DATE: owner-Wilder will have the burden of proving he or she did not build or improve for the purpose of sale). - ❑ Las owner of the property,em exclusively contrmng with licensed contractors to construct the project(Section 7044.Business end BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not appy to en owner d properly who builds or improves thereon end who (�,/ contracts for such projects with a contractor(s)licensed pursuant to the Contractors license Law). APPLICATION ISSUED B Y: 4$1 r 4 `% DATE: •40II ❑ tem exempt under section: B.B P.C..for this reason: ****************************** ***************************** ** Date: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby cattam aware that I aaware of and understand the requirements of California Health end Safely Code Sections 25505,25533,and 25534.and atloranyhaurebuildingopemantwinfwino(circleone)needt000mpywmsaidstalecodesadtherequirementsfor BLDG PIT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit famnstructian or modiNxrianhan the Ar Ouekty Management District.Resident's'construction apptketirn are exempt from these PERMIT 199 . 75 1 . 25' provisions. Date: Applicant: PLAN SM I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE ❑ Ihave and wilmaintain acenilneteoconsent toself-insure bnwwkes'cornpensation,asprovdedforbySedim3700oftheLabar BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE RICode,for the performanceofteworkforwhichthispermitiissued. TOTALS----> 201 . 00 0 . 00 0. 00 201 . 00 201 .00 . 00 W I have and wit maintain workers'compensation insurance,as required by Section 3700 of the Leber Code,for the performance of the work for whkh this permit b issued.My workers' " n° m end policy number ore: cash: imputes EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 201 . 00 OVER/SHORT: . 00 Policy Number. 046-36 0006302 10/31 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I the panne is for one hundred dollars MOO)or less.) 199 . 75 1 . 25 ❑ Iecom tsaliethpekcedMewnrkfa which oispeioit is iandalshall eial employ any come suey manner mmlo ******************************************************************************* become subjectaiini to the workers'ncompensationhework rlaws California,is and agree that if I should become subject to the workers' aomper a7ion provisionsof Section 3700 of the Labor Code.I shall forth 'h o.7mp&with t provisions. INDIVIDUAL F E E BREAKDOWN 629 Warning:Failure to mountworkers'compensation coverage is unlawful,end shall wart an employer to criminal mettles and TYPE QTY DESCRIPTION UNIT COST TOTAL COST civil lines w to one hundred thousand dollars(5100,000l in addition to the cost of compensation,damages as provided for In Seclfon 3706 of the Labor Code,Intens(end attorney's fees. SFR 12536 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 12, 536 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a combustion lending agency for the END OF FEES performance of the work for which this parol is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and stale that the above information i correct.'agree to comply with all thy end county ordinances end state laws relating to building construction end hereby authorize representatives of this city to enter upon the above-mentioned property farinspectionpurposas. NANCEE KILBOURNE 09-17-1997/02:33 P4/9201.0 Print Name RCF)A:t1-tdlGill Cf CI V/7/57 PERMIT :084?36 sgnature d legentlAppirantlContreda (5151.46.WP) White-Building A Safety:Green-Fle;Canary-App5cant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POG , SPA • APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe•Undrgrnd. ;a 53. Steel Reinforcement ,U;3x�'iectrical Conduit L'I{ility-Undrgrnd. 54. Forms c s ..* 'r 4:xElectrical CondiiitoUndrgrnd. 55. Electrical Bonding . x d J C ..• r . c'.H.�Sieel Reinforce` mt.: 56. Rough Plumbing & Pressure Test M. >0414.ECectrical UFER.G td. 57. APPROVAL TO COVER,GUNITE ^i `�•7. -•Footings ,^ r • 58. Electrical ConWt-Undrgrnd. •• �' II, t w� v 59. Gas Pipe, 0 Uadrgrnd., Test a'. r_Foundation 9. Water Pipe-Uncirigrndt 60. Backwash Linss,'R-Trap, O.Undrgrnd. "1 • 10. Structural FlooESystem 61. APPROVAL 191)ECK - r< a .. 11. Property Sewer�.inet& HouConnection - 62. Backwash & Receptor-Final,' 12. Sewer Cap O C -C n63Ht & VEar 13. Roof Drains ._ 64: Plumbing System - Final r 14. Rough Plumbing .n 65. Electrical-Final 15. Rough Electrical-Conduit -- 9 66. Solar System-rn.-. 16. Rough Electric"Wiridg67. Fencing& Acce�Approval . 17. Rough Wiring Sign i • 68. APPROVED FOR PLASTERING rn 18. Rough Electrical-T Bar Ceiling ' ' 69. POOL/SPA S'P 1EMS FINAL 19. Rough Heating & Air Conditioning -FIRE DEPT. REQUIREMENT _ - .. .-r . -• 7' 7'-'rr-' x I; I, :v 2011:100 h FactoTry Fireplace ; .C[^ C'" "* O C `+ I: .�7 APP}OCr} ?✓O E etmit#1 g" !n 21.`_Duct`s,intStrVtctutE:;_ , .. .. . . S rJ 1-t* ,-j 70rUnddrgrmnnd 13ydrn * 22. Dugs, VQntii tin :, `I� r C ti H is d 71. Prod (ping fGas ;EJ Oil x t or ri r: r tD I I I o-' A 23 Gas'ipe,_fiough &'' est 1 ms :i: r! < 0* r+ 72. Underground i'Ituh., .* -24!:Root Framing X.* I F•`-+ i , O * 5 Undergmd.Strt eTann�C C3Gas IlOil t !Y A > r rr . I , Y+:* 5.: tJ T n'+r V • > .�-- v �rr+2:71N :* 25. Ro41'Sl athing ,� / f 76•:.overhead Hyci t: 26.T-Bar Ceiling IStrnaurall &`tlernocoat 1»:1: Dry Ch ical y to- C 'z * 27:yFra,T a and Ft%shi'nr' I: :t' o7 l. c `' , 9: ,r C. n y oil. 76.6. Dry StaPer-, a 26.'�Latlting-.& Siding'-r.i. P' ��:: * S 77. FIXE( "SS'S1 p1t-FINctL , I-1 29. Insulation "--. xr • •• * ;r7 +: m n;:fi g x: ii. FIRE PREY. FINAL .* x :T -7 30. DrywatleNailtag x r * 1 �Is rHEALTH DEPT:REQU15EMENT .. 31. Plaster own1Coda`. c i r•tr' I I ! c: Cr 79. FINALs--- J NSPECtON .K a i. , n^ .I. -p. irr+--- -•--`tr -`9-. 32:JEIectricatPower Meter FinaI1 .e 0' r to 811. FOOD CERTIfI�OATE-SSUED 1 33.; in EI tri =.{ t:; a; *U. k _ IVptes: .y yr+ t .-+ O tV._ s. 2 34-r-FinJf Heeetingj& AiriConditiontsn r7 * I {k a S !;5 t 5 0C -t ,n , '> 1 I 1 . ru >J t "a * M 35;•Final Ga.?Pi 0m . :1: r-+ I ' ' it.Itic. ,_ ` ' ZO my * 'r' .FS`U r 36. HoO;:l orncanoPY n ' h : r `t I 1 t 1`tr E t zG x nr 0n' 3., 37`-FinbT Factory Firerilacd.,. , �:� y :* '�1 I I k S z t r . 0. , .. .. ' a i..; t. ct .t r • 38. FinalPlop-1643g x ;L ;; i I n S ,-I ixs i O ", 39. Water Setvice-final* I w t ` r, o67 * in X ru t S * x1 >, c.� .-. A: 5 .-.Ti 40. Gas Service-Rtpal :e rtr C.-'^ S * '*: I 0 4-, ON k -. 4-, . .-I T -r cf• a 41. Solar Domesttc-Final S 'f •• n. IH K ,-, tY * I �is tr. :-:to r * 7: .7 - 42.TBackf low Preventer.�r'. `-, * J I 1 4r r �,� K 7 ��-i a, a r.1 tri'm•r., c. -- 43. Backflow Irr'Igationt SSS -4 ' xH ) * 3 tv _44. Landscape Irrugatioil System t-47 TS; r >t: m C 7 O r r t'3 n: & Zr) t N o '�C..: (r` - .C.. r S Orr ._St r� 15ound Atte uationr '4 I' S rn :^ C. : : 1--iCr s 1T,a x R6.'Hlandicap•Regulaticns a 5 „ I-7 .. 1 t=/j� .s C�� g• 47c3FINp.L STRUCTURE & BUILDING `6 Ij 'Y I I:illgrIERL 48. INAL eL.ANNING.T rrr I I -lb ----1-4 rV .T) r- t m H , T .-519 nEleczric Release to Edison i :i: ^ I 1 , 1: e: h::'• * '" w I r nt C •C`. 'r ';50.�Gas,Release r9 Southern Calif ginia Gas Co r i I •-Ea = . tris * - • 'S1, CERTIFICATE OF OCCUPANCY _ Al 0 .,: . T .,t. .r r. .7 No. Date 0 SS,tl'�'?h@a/llt, ACC�i C831i5111Lg73 �LV/(hU V U r1 /� E E U U E J U P003/3 MEEKER CEDAR PRODUCTS(19671 LTDMISSION, B.C. 1.800.66 3.8761 I NUMBER /GRADE 11 ndsp& 1°e a Se a ar S I a !es Quality I I e 1 1 I I I c evaluation atfi ap'It able•udding cola s a dards. ‘. — . U 24"(610mm1 x 1/2'13001 Medium Handspht&Resawn Western Red Cedar Shakes it cti0flentimitommakDAY •, santtir c—.---_ 0 a/.itadiled'�y � mCoveraae 'f0A1tt5 68 4tlles (Exposu ber c333 u 111 14SseC3100 C- PACKING DAT _wCG3(lFks�i D 78537 OCI� 1C1� 1 0 e Appli kvition °teommen o a o ojs C (ROOF APPLICATION( alangft(-wm ift,4),;sT((°ttan-P51j visit. 0 roadontol(CAD'J8 NV CS*Y3r ft a tilk o-o nLel't,&MT*(ccloM al Wirt' PxW@ UGD fklikk 0k,- ilikakeiL iR' CN'1 (coo V.r Coll ea as dP10 1611,0' W(0l eii 1Q)alt&a WI aciditnN ft ?r mrd caaw,ft tip. a arntn(aY7 ft enlItaqi110191 a tending auto art gim-4tho'.i ai ipirdi o oen gilloja 6W`, 121ln PASS mOQoFSSg3 .00s;"In bkiP@gdpil Qin iiniultla- SC'amg 0127• oo Xyl (ROOF PITCH I -SzelTh gh'RN;Ri„Rritgylfrii Ititi:.F3s"f'al,"�LojS d'Ln:7i Pb- a @i k^ rt6trrtc:>rn ID Cninrit 4rnn� *int all(pnLlhl iFi 440.9*for (moan triocJ mg Iry($Ilhl it (LIufelrei)lniewoi ft1'itIvitt I=ASTENERS( 0,37 Ira 0ApRo;(41(doirma t r% .Aiblif -*11 _s1' E. F7n2706ti 1rtvw:6) IMM ms4B)d:nel`S'a rc ijan 1: z5 02 Bb t^.d4t1r. :JIM!,, kileki tab o o 0141:k:,4- 9 Iktocnik INWP link 12141-e lika E ndltitl i t7Sa9'glgeriTiit 414,:,14e •-i i'.lIaD 0 `GL:.'t i[r rA:;:dela,, pfgagpti(1u ofern!). o e Quo eawir@ICIf"7 mos ft.. IYnina?)3r.a'," ((tJ(306e},CV lial o e )Qt'D fingEaa CVIN b V/B1I41661rDi I I[z;�. e o s"- e eot�a-a.op,56@1 trt-''an?,yjllM ls-11A GGEKIIRgiJ-C l )Q7o ery ^Qii onnmibiro(Xh*J*a v,4.I(aA' @'spaces-betwe•n-sha es tgottilaikPfloratiQiiNarA4 :•40--"3 \. (ADDITIONAL INFO Di.00itie 1QJe(ftv=lCA 'e• o UMW arranty available €71 F-D @w Mat(CRP OShi- pre-ucts Naegsar dura CI3. available t2IIGu rte eirmanent trilca p otection back-e(.+tag 71123 iiaa -eiit ii Warrant 3ndgOs, ose Pe ervative ¶k aluuae(1 e.- -o ('pj t j O 0 Yeay Limded Cuaiar-�nl�f*oD Q�LRIA in o anon regarding ourprodubts and warrantym I formation R1hI-.00663-8761,`- ei a� '-i.- ,S`'� J i` // / r_-- a ourOZ_., N PrdtluctsLtd / V '+ ;„.. .,... ,: '� ,rx 33458 arbour G•SC15r- Mission�B C,.Canada V2V 2W4. 4 B6 \ I • j 14711 FES RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JUN2O1.71 P. O. BOX 817 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Con Completely , APPLICATIo61T poFpG MVt MESA BUILDINeft, t,. TYPE OR PRINT G 04 V"''cc'' '' BUILDING ADDRESS / T l! - �F�7 A{. COSTA MESA. CALIFORNIA Y For Office Use Only OWNER (7,n )... ,(P aes � Nee i RECEIPT NO. Pir Np. MAIL ,y� RECEIVED'IBY I DA REECEIVED/ DATE ISSUED ADDRESS /45'3 f/AiORaA .1,RI e. r` - I �`/)'D /I �/' -„ 2G-(-I //�� TEL. ,� BUILDING CITY( ,.z.7 Q PIC.j A NO.I11 /O=JS ADDRESS AP TELT TEL COSTA MESA. CALIFORNIA `1 .INEER W. II.foRA e AI No.,L-/1-7A1167 pn�)� y�I� // ADDRESS nil \AJ, 194' .c7 ('1).sTA I / SA FIRE • YPE.'�-T/•''/�� / ///, / ZONE TYPE [ "GROUP CONTRACTOR G.9L%�+ /(/ er 216. APPROVED �I I'M DATE • ADDRESS)/Ij.j /i/ A)IRRCP pie I,VC'- ZONING 044' n h1 0 CITY(/„� JS iIBS A L/ INOAN.O ) IUSE OF N BUILDING STATE (J/�CNO 1 ) NO. k� Q- 7�.75 DEecRlPloN .A ors 0 --7,7 9.3 — /a i SIZE I NO. OP NOW ON OT. .ik q 6 d OF LOT A.P.NO. (-'\.`Q/ti-)--' USE OF YARDS EVES EXISTING BLDG, APPROVED ALLOWED SETBACK LINE FROM (CENTER YN8 ST.) CENTER OF STREET REAR YARD FRONT PT. IN. SIDE YARD LEFT I RIGHT R.SIDE - r 1. - IN. DESCRIPTION OF WORK L.SIDE FT. IN. NE I XII ALTERATION I II ADDITION I REAR FT. 0 IN. / II MOVING I II DEMOLISH APPROVEDVE /GQ/4 /� DATE 6 , -Ifi REPAIRI . BUILDING NO. OF 01--/SIZE ROOMS STORIES EXTERIOR WALL I ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED - /s/_c.2rL ,�j�/ C2: , �l�- a-/X / X 4y 1/Its I HEREBY ACKNOWLEDGE THAT I AVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.7 COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCES AND S ATE LAWS R8 LAYING a” BUILDING cogBTRu ION. //� �� C VALUATION //J� ' SIGNATURE OF Gte-xr / V /f• ?_ PERMIT FEE S �oi�� PERM ITTEF kW n S (//j/�//��/J�, PLAN CHECK S / A — AUTHORIZED AGENT (/✓(/( / �1 B'U ¢ TOTAL FEE $.'J 04 �� a \' II / �. 41. ... _ e !a ct gr -Yrc;CO;i;' rD,t�7�A , 13983 / U � t� i�c ,Lu v '� � COSTA MESA BUILDING-SAFETY DEPARTMENT v ��NAN'CE GDEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING - - ' '2 Cr) ADDRESS IL,0....-...c1 1 COSTA MESA. CALIFORNIA For Office Use Only OWNER Investors Marine Inc. I RECEIPT NO. I 1I11r�Bg.i MAIL RECEIyeD_ BY 10•02.RECEIVED DATEI ISSUED ADDRESS 1600 W. Coast Highway //� I �.` I G'AR 6 1261 Newport Beach TEL.Mt-1655 BUILDING /j CITY NO. V/ ADDRESS �N��JLJ/j/I♦ / YITECT TEL. COSTA MESA. CALIFORfyYA NGINEER Same NO. 2:18/09 ADDRESS - FIRE V ?/ /j ZONE TYPE GROUP CONTRACTOR Mesa Verde Builders Inc. APPROVED BY DATE 1653 Minorca Drive ZONING ADDRESS t• Costa Mesa Calif . LONE NO.OF USE OF NEW aZ� / CITY ) �I I PLANS�'I BUILDING LICTNO. 181269 TEL.OKi 9-0395 DESCRIPTION V _24 SIZE 941 x 1001 I NO. OP BLOCS. 0 OF LOT NOW ON LOT A.P.NO. USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACKI LINE FROM REAR YARD R !/G_ 451 11 (CENTER LINE ST.) • CENTEROFSTREETs FT.1 IN. SIDE YARD I LEFT 61-611 I RIGHT !n5 1 R.SIDE 7/ FT. IN. DESCRIPTION OF WORK L.SIDE (p FT. hIN. b---FT. { (� V I X II ALTERATION I 0 ADDITION I REAR , f- 1 b- FT. f/.. _Ai IN` REPAIR I II MOVING I I DEMOLISH I BYFROVE• 4 IC DATE 3 –3-6,1/ BUILDING1600 S. .rt.NO. OF 6 1 �/ SIZE WW �S ROOMS STORIES _ i _.�— EXTERIOR WALL Si•ing ROOF 4131.e or / p, COVERING & stucco I COVERING shingle .r y�y USE OF BUILDING AND WORK TO BE PERFORMED Single family residence and garage Model No. 620-A Attached garage 462 Sq.Ft. I HEREBY ACKNOWIIEDOE THAT I HAVE READ IS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT IT E AB VE IS CORRECT AND AGR E TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI ORD ANCES A STATE GULATING OF ESTABLISHING A PERMIT BUILDING CONSTR /V 4,,,,,, . / / VALUATION SIGNATURE OF( /i / `I �� I ,�l,� PERMIT FEE $ 3 PERMITTEE r `'V�� l� Z025_9,ea $ �T'� R l s / !� PLAN CHECK / Q`�' • AUTHORIZED AGENT TOTAL FEE $ 1S'Jro 0 1407 8/20/79 60.50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE BY PERMIT ' For Applicant to Fill in Completelyp�y�} —Use Ink Only 860 OWNER ADDRESS •BUILDING 4 0/Q 4 V Ano. 1— -� 3�` — 13 /' BUILDING �g1Q SeRAr1CT TENANT // ADDRESS O t) LIUL )14 udie i! UNIMAILING _ p �J SPACEC N ADDRESSE6ZR �/Q a NO. CITY LO Jtir �11.ipA Cs NO.E TR.Nq. _O^ LOT 70 1BLK. TEL. C�.� CJJ[ CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER BRANCH OWNER/CJ CLE 4.16- MCI -u, ADDRESS .r. VALUE /m ARCHITECT TEL. USE 7E Ai �JO IT OA� $ "'G s-0 OR ENGINEER NO. V / ADDRESS / ZONE / ( TYPE r GROUP �7��{{ CONTRACTOR /9-13 C p a_i AJ —) BYPROV ED (t/( DATE 6I Lo-( / ADDRESS r TEL. CITY NO. F STATE CITY APPROVED SETBACKS LIC. NO. LIC.NO. W SIZE NO.OF BLDGS. (FROM C//LS....T//ccRfl EG�ET) L OF LOT NOW ON LOT FRONTK..? Q USE OF G'// 43, EXISTING BLDG. �.s,', CNt C R.SIDE / ! FT. va FSeparate permits are required for L.SIDE electric,plumbing and heating work.Itc REAR Ce;eli'raprie -" IQ USE 2.. BUILDINGkND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED V Ari —BAPYPROV(`I/�� • DATE 8:20-7? ..1 a m CI hereby acknowledge that I have read this application and state NN pv that the above information is correct and agree to comply with C. all laws regulating building construction, and I shell not employ i Z any person In violation of the workman's compensation laws of 2 W the State of California. Co.Z' ZiI SO. FT. m I hereby certify that I am properly licensed as a contractor under n the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE S //� and Professions Code,Division 3,Chapter 9. y'c/. CSO n Signature o,�1�-,///�- o - PLAN CHECK S 7�, ci� 2 Permittee �-f'�/�Cs� TAX S L or 7� • �lt U Authorized Agent Date �/l _ 8gcob TOTAL PAID $ (c.CD ,CO