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Home My WebLink About3389 SUMMERSET CIR - Building PermitsPflQIECT�DOPFSS: 3]HS SUMMERSET CI OWNEfl'S N►ME: UPTUN ' aooxess: SAME AS AHOVE 714/966-02`42 RflCHIENGINEEH: nooxess: flE0.N0.: uxn: PEHMITfFE: NOCK PLUMBING' (714)895-1246 � RO�BESE: SSE]LO SEABOARD CIRCLE STANTON CA 90680 LICENSEO CONTMCTON DEIXAMTION: I here�y atlirm ihat I am licensed un0er Drovisians of Chapter 9(commencinq vnih Section 7000) oi Oivision 3 of the Business and Pmlessians Ca�e, anU my licenu is in full force an0 eHect. ciTruc::050386 $T^TE�B�511971 �J �u$$ C-36 oate: %— S' — g0 Signamre: -Y-�M i�li(rT� '"9KEBS' COMPENSRTION DECIAMTION: I herehy attirm that I have a certificate ot cansent to self-insure ar a ceNiiwte of Workers' iensation Insurance, or a certified copy thareof (Section 3800, LaE. C). ' .crxo.:1167992-90 ezr.o�Te: 03/O1/51 cornraxr:STATE FUND ❑ Cetlitie0 coDY 5 hereby Wmishe0. � Cehitie0 coDY is filetl with Ihe ciry BuilEinp Division. � Oate: � "� S ' � � APPlicant: �� EXEMPf10N FNOM WOHIlENS' COMPENSITION OECIAf1AT10N: (Ihis un nee0 not be compl¢teE if ihe permil is for ane huMreO (310�) or Mss). I cenity that in the pedormance of the work for w�ich this permit is issue0, I shall not employ any Oerson in any manner so u ta �ecome sublect to ihe Workers' ComOensation Laws of Califomia. � �a�e: " � ' 'SiqnaNrO: NOTICE: If, atter makinq this Oeclaation, you shoultl become subject to tAe Workers' Compensation pmvisions oi t�e Labor Cade, yau mu5i IarthvntA comply with such proNsians or t�is permii shall ba deemed revoked. CONSTXUCTION LFNOINC �GENCY: I �erehy affirm that there is a consimction Ien0in0 aqency for ihe pedormance of Ihe work for wAitRihis permit is iuuea (Seclion 3097, Civ. C). , IFNDEfl: RUDflESS:' " ' OWNEB BUIIDEB OECUMTION: I AeieDy afArm that I am exemD� hom the Caniracrors' State License Law for the lollowing reasan (Section 7031.5 Business anE Professional Cade: My ciry oi counry which requires a permit to consimct, alter, imDrove, UemolisA, ar re0air any stmcture, D�or to its issuance, alw requires the appliwnt br such permn to lile a si0�ea statement tAat Ae/she is licensetl pursuant to Ihe D�oNsions oi tAe Contraclors' State License Law (ChaDter 9(commencing wit� Section 7000) ol Oivision 3 oi tAe Busineu an0 Profeuions Code) or t�at Ae/s�e is exempt �hereimm and ihe Easis lor Ihe alleAed exemD�ian. Rny violation af Section 7031.5 by any appliwnt for a permit sublecis ihe applicant to a cidl penalry oi not mom than ilve hunOreO Oollars (5500�. I, az avmer of t�e pmperry or my emplayees with wayes as their sole comDensatian, will tlo ihe work, anA Ihe simcture is not intended or offereE for sale (Secbon 70A/, Business and Professional COEe: The Contrectors' State License Law tloes not aDPM �o an owner al a proDerry who �ullAs or improves tAereon, antl who Ooes such work himself/herself or tAroupA his ar her own emDloyees, provitled that such improvements are nat intentled or ottere0 for sale. II, however.[�e buildinq or improvement is soltl within one year ot completion, the owner mll have Ne buNen al pmving Ae/she Oitl not builC or impmve ' for ine ouroose oi sale). I, as owner of the pmperry, am exclusively contactin0 ��h IicenseU contracmrs m constmct tne pmle�� (Sec6on 7044, Busineu ❑ anA Professians CaUe: The Contractors SGte Licenu Law Aaes not apDly to an owner of propeM who bmlUs or improves mereon anE who con[racis for such pmlecls with a coniractor(s) license pursuant to [Ae Contactors' State License Law�. I am aware that proof of their Worker's Compensation insurance should 6e DmviEeG ro ma. ' � I am e�empt unGer Sec[ion: B. 8 P. C. lar this reason: Date: � Ovmer. I Oo Aerehy cenity thai I am aware of anC un0erstan0 ihe reQuirements oi Calitomia Heatth ana Safery CoEe Sec[ions 25505. 25533, anC 2553A anU ihat I or any fuWre �uilOinA occupant vnll/vnll not (circle ane) nee0 to comply wR� saiA sWte cotles and the requirements for a permit tor consVuction or motlifiwtion fmm the Nr �ualiry Manapement DislncL Resitlential consimctian aDO��ions are exempt from these Drovisions. Oate: ADPlicant: I Aerehy certiry Ihat I have read Nis apDliwtion antl state ihat Ihe aUave informa�ion is correct. I agree to comDly �tith all city an0 rnunry ortlinances an0 state laws relatiny to bull0ing wnswction anA hereby authonze reprasentatives of I�is city ro enter upon the aDwe-mentioned propeM �ar insDection purposes. n' Oaie: � — �� Signaiure: M�✓✓� /� �7r /� Driver's �icenu or Sociai Securiry d: 1691-06 W�He—Builtling; Green—Cotle Enlorcemen�; Canary—Applican�; Pink—Revenue; GobanroE—Asseanor CITY OF COSTA MESA — HUILDING PERMIT PERMIT N0: P' 047973 PLAN CHECK NO: N CUNSTRUCTION TYPE: PERMIT TYPE: PLU JOB DESCRIPTION : WATEk HEATER REPLACEMENT CLAIM VALUE: � CALC—VALUE: ' PERM NO; P 047973 � GOVT; N SUPP: N - PURPOSE: OTH SQ FT: GROUP OCC: / COMMENTS: * ' -�-***+t�t�t-��**i��-�rx-�r±e*�*:�*�***�r�r*�***�x��ti�**�**x�i��t�t***�**i�*�-*-x��t+t+t�-**�*�r**�t*�t-*x��*at* Z O N I N G R E Q U I R E M.E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --=--=--- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: . FT IN REAR; FT IN= LEFT: FT IN RGHT: FT IN LEFT: ; FT IN RGHT: FT IN i '` PARKING REQ: PROV: PARCEL: 11910302 ZNE: REF NO:, PLANNING NOTES> j � , �E if iE if iE i4 �1F iE iE �IF iE iE 3E iE iE if ik iE iE jE iE jE 3F �1F iE jE iF it 3E iE iE iE �lE iE �)f iE iE 3E iE iE iE iE iE iE iE fF iE iE iF �)E �1E jE jE # if iE iE iE iE iE i(-�lF if �F iE iE iF iE iE iE �If if 3E 9E jE iE-1E iE iE D E C� E L O P M E N T S E R V I C E S�'R E Q U I R E M E N T S ZONING APPROVfiD BY � �DATE: BUILDING APPkOVED BY : � DATE: APPLICATION, ISSOED,HY:� DATE: �� ?E9EikiE%iEjfiEifiEifjEjfiEjfiEikjfikiEiEiE. iEiEiEiEit-1fiFitiFiE3F ��ifi6 jE df iE iE iE iE',E ib iE if 9E iE if iE 3E iE iE IE iE iE iE iE'lE iF �E fE iE iE jE iE iE iE �E iE if iE if iP if if 1t it 3t * iE ib if if iE iF iE �lf iE iE �E iF iE 3E ff if iE iE iE iF if iF iE iE 3E iR iF * iE �E iE iE jf iE iE LEGALIZATZON:N F E E S.0 M M A R Y STRUCTURAL SEGMENT:N � BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMZT ZzSt • ,� SMIP/NON—RES' PLAN ISSUE FEE 3.00 v� , HUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE TOTALS----> 2.00 3.00 -�,.0.00 5.00 5,00 .00 REVENUE DIVISION TUTALS--% COLLECTED: 5.00 OVER/SHORT: �.00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK s.00 .;j r; iE iE it iE jE iE �lE yf ## ih j(-iE iE it iE Y iP iE ie� jE'iE 3F *# iE iE iE iE iE ih if ik iE ik.3f iE iE iE 1E iE iE if 1E iE iE iE iF iE iE iF iE iE iE iE 3f i(� iE iE it ik iE-1E iE 1E jc-iE iE iE if 7f iE iE jh iE iF iF 1E iE I N D I V I D U'A li F E E B R E A K D O W N TYPE QTY D E S C R Z P T I U�N UNIT COST TOTAL COST PLU 1� WATER HEATER AND/OR�VENT 2.00 2.00 END OF FEES 01 {70D5656?—ODOb65E9 Te_iT GATE:.�71?1/9U „TIi'EE� 1.�C1 e 5 �R CONSTRUCTION AND PLANNI. . � . OL & 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 Reinforcemen[ � � � 3. Electrical Conduit Utiliry-Undrgrnd. - 54..Forms � .- i 4. Electrical Conduit-Undrgrnd' � _ . 55. Electrical Bonding . 5. Steel Reinforcement - - 56. Rough P�umbing & Pressure Test 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE 7. Footings � - � 58. Electrical Conduit-Undrgrnd. ' 8. Foundation � ' � 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pips-Undrgrnd. � � , - 60. 8ackwash Lines, P�Trap,-O Undrgmd. - 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 � 74. Rough Plumbing ' '� -. 65. Electrical-Final ' 75. Rough Electrical-Conduit ' � 66.�Solar_SYstem-Final - � � i 6. Rough Elactric Wiring � � �. � 67. Fe�cing & Access Approval , � 77. Rough Wiring Sign . ' 68. APPROVED-FOR.PLASTERING - 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA�SYSTEMS�FINAL 19. Rough Fieating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Dutts, in 5truciure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe�Rough & Test . 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemicai 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation .,'�1.� 78. FIRE PREV. FINAL .-r 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: �2 / 4� J�G�iQ1�7lTl�LPl2riD p5 �FtfL� 34. Final Heating & Air Conditioning Zl1.a U�S - L��.� 35. Final Gas PiPe-Test 36. Hood or Canopy ' . 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Fina� . � 40. Gas Service-Final � 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation � � 44. Landscap¢ Irripation System - 45. Sound Attenuation � - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 'f ' � i 48. FINALPLANNING 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date '� (�ia) �sa-sz�s • Fax (714) 754-4856 Job Address: Suite: Vicinity: CITY OF COSTA MESA BlIILDING DIYIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT 3389 SUMMERSET CI HOUSE & GARAGE Parcel Nunmber: 41207325 BUILDING PERMIT Zoning: Rl R1 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08/19/1999 Issued: 08/19/1999 ,4pp�icant: SELL ROOFING COMPANY ISSUED BY: Address: 17072 ROSEBUD _ `.- - ._ � , , , � ,� -.' " � Phone:- 714-9933328` „` �,�„ . YORBALINDACA��',.--"�_'i 'Zip: 92686 ��,=�=`.. ,f:/�� ,- � �, � . .. � ! i� � ��' owner. ROULSTONE, JAMES E '� �' ' ' i� �� `'�`Y\'�- ��, Address 504 PARKSIDE DR ` � � ��_ - � � �� j�� '� � t , t �Phone`_-_`'`' , tiK-..; � �� J fj�'PALATINE IL i' - � , � Zip 60067 ��` � � � . � j V�`� ,/' � j� \ /�i � . - �1 \ ,��. .� ��/ i / �\'��` Cont�acror:�_ SELL-ROOFINGCOMPANY t` > � i�`' � � / � -i - i iii , ,,�1, �.��. i ��A �Atltlress: '17072�ROSEBUD A �� ;� � � i � �� ! � �� ;',) ;�j�� Phon� 714-9933328 ��'_`-� � � , ' \ �,�.'� � , y` 1 � � YORBA LINDA CA �- .. ; ,� � �'�.� '��, � i, ,,; � � _Zip: ; 92686- License: - 323842 _ �� _ ' � '�. � ,._. _ ��i:. � ' �\, A. �, i. . . ' � �'Arch :�� . . ; j � , ' `�,,,�,/ > _ Eng: . � �,� . ��, . r ,'.AddPess_� � If' _ , � i� �� --� -,�� Address: � ' ` �•� - � � '� f � L � ,a ' - �� _ 'i �, � /'. ! Phone � _ - � � - - , . A -� , /�.. Phone: � � � � �� .�, `_ .. .. ' � .�fl'.\ � -- %� � — - � �� '� � . : Zip: /�'��- > ��\ License: \ Licerise: _ . . � � "i � �_ � � i ' f ' � . _ - SCOPE�OF PERMIT - � J � . , ` „`, . , �� REROOF - T/O, INSTALL 1/2" OSB BOARD; 2 LAYERS OF 30# FELT AND-NEW,ICBO #4660 EAGLELITE ROOF�, �1 � � - � . .� ., ..... _ .. .. ...... . . , � � ' FEE SUMMARY - = f � _ � PI8f1 ('.hBCk y�, $Q�0 ' , _ .� , ; � ___ _ : , � r � (�,01C V0�U0TIOf1: - j . _�$8;960'00, Permd'•.; $167.25 � ' ,� `'"-:ClaimValuation: , $e,eeo:oo' ��`. SMIPRes : $0.90 _ v- _— j� . � �,. � �;rr ;'SMIPCom ^. $0.00 � , , �� r • `� � Other: ', `�. , $0.00 � � . /; % . �:� ;�,� �'Inspection: �;� $0.00 - -- � � � �' � ; , �/ • � �� . ��l, ? _ i . ��; Total:' �$168.15 , � � ' � :� , � � �� , � � �� . � �_ � PLANNINGBZONING', ' =� �%%-`� � � �� _ _ . . . ' \ '. j �. 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 Existin t: 0 Required: 0 Proposed: 0 . ,, NOTES: �� NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California staWtas and related , regulations. (Ord. No. 92-28, § 1, 12-27-92) 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 oi 180 days. ' INSPECTIONS: In order for Ihe work authorized under this permit to be considered legal, such work mus� comply with all applicable codes, antl all required Inapectlons end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permi�. FOR INSPECTIONS CALL: (714) 754-5626 � WORKERS'COMPENSAnONDECLARAnON: I hete6y Bfrirm under penelry of perjury one of Ihe following declarations: ❑ I have entl wlll maintain a certiticate ot consent to self-Insure tor workers' compensation, as provitletl tor by section 3700 of the Labor Cotle, for ihe peAormance of �he work tor which Ihis permit is issued. ❑' 1 have antl will main ain workers' mpensat�'pn insurance, as required �y section 3700 of the labor Cotle, tor the peAormance ol Ihe work tor which this pertnit is issuetl. M worke ,!�m sation I �e�nc�e car�Q,'y'' end olic number are: �j / v Carner:Y !��/K. �ww�` P Y Policy Number. /C/ �(O ��/ /Th/s section need not be coma/efetl il the nermit Is valued et one hundred dollars /5100) a� /essJ ' ❑ I cenify thet in Ihe pedormance of ihe work for which this permit is issued, I shall not employ any person in any mannar so as to 6ecome sublect ro tha workars' compensation laws of Califom' , tl agree � at if I oultl become subject to the workers' compensetion provislons of Section 3700 oi the Lebor Code, I shall forthwith comply with Ihese provision . ApplicentSignature: Date: �—�— � � WPANING: FAILURE TO SECURE WORKERS' OOMPENSATION COVERAGE IS UNL4WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DAM4GES AS PROVIDED FOR IN SECTION 310G OF THE LABOR fAOE, INiEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am licensed un r ov" "i force antl ettect. Lic. N Contracmrs Signature: 9(commencing with Section 7000) of Division 3 of ihe Business antl P�fessioys �pde, end my license is in full ! Class k � i :% �y � / Date: � CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm that ihere is a consimction lending agency for the pedortnance of ihe work tor which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lendefs Address: SignaWre: OWNER-BUILDER DECLARATIONS: Date: I hereby attirm ihet under penalry ot perjury that I am EXEMPT FpOM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which requires a pertnit to construct, alter, improve, demolish, or repair any stmcWre, prior to its issuance, elso requires the applicant for such permit to file a signed statemem that ha or she is licensed pursuant b Ihe provisions ot Ihe Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business antl Professions Code) or ihat he or she is exempt Iherefrom and the basis for the elleged exemption. Any violation of Section 7037.5 by eny applicant for e permit subJects ihe applicant to a civil penalry oi not more then five huntlred tlollars ($500).): ❑ I, as owner of the pro0erty, or my employees with wages as their sole wmpensation, WILL DO TNE WORK, and the structure is not intended or o%eretl tor sale (Sec. 7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner oi property who huilds or improves thereon, antl who does such work himsatl or herself or t�rough his or her own employees, providetl that such improvements are not intentlad or oHeretl for sale. If, however, ihe builtling or improvement is soltl within one year of completion, ihe owner-builtler will have ihe burden ot proving Ihat he or she did not build or improve for purpase ot sele.). ❑ I, es owner of the pwperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo consiruct the project (Sec. 7044, Business entl Professions Cotle: Tha contractors License Law does not epply to en owner oi property who builds or improves thareon, antl who contwcts for such prolect with a contractor(s) license pureuam ro ihe Contractors License Laws.). ❑ I am e:empt under sec. Business and Protessions Code tor this reason: Signaiure: Date: Owner ID veritied by tlrivafs license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - propetly tax bill or deed): DIVISION OF INDUSTRIAI. SAFETY PERMIT CERTIFICATION: ❑ I hereby certiry that no excavation five (5) or more feei in depih into which a person is requiretl to Descenq will be made in connection with work authorized by this permit, and ihat no building stmcture, scaHoltling, talsework, or Demolition or tlismantling thereot, will be more Ihan Ihirry-six (36) fee� hig�. (Chap. 32, Grp 2, ArI 2, Sec. 341, Title e, Califomia Administrative Code). ❑ As owner-builtler, I will not employ anyona to tlo work which woultl require a permi� irom the Division of Indusinal Safety, as noted above, unless such person has a permit to do such work from the division. SignaWre: Date: Division ot Intlustnal Safery Permit Number. CERTFlCA7E OF COMPLIANCE AND AUiHORIZATION OF ENTRV: I certity under penalty of perjury that I have reatl this application flnd stata that the infortnation given is correct I agree to comply wi�h all state laws and ciry ordinances relating to building construction, antl au�horize representatives ot Ihe Ciry of Costa Mesa to anter upon the above-descn6ed propeny tor inspection purposes. I agree not to occupy or allow occupancy of any building authorizatl by this pertnit until final inspection. Signawre Le wner(s) � ��ate �� ` AnNOr Authorized Applicant Date E Y INSPELTIONTYVE 7616 Fixed System Final Fire Prevention 1266 200 201 202 203 Pool Spa Finel Final Re-Rooi Final BIocWRetaining Wall Final Factory Fira Place Final Sign 204 Final Demolition 2446-d6 P�E INTITIALS CODE 1 INSPECTION TYPE 206 Finai Mechanical 208 Final Plumbing 2i0 Finai Eiectrical 212 Final Fira Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupancy Q.� NTI ITIRLS F C 4 Q .�. � � F O W F a ci ..a > �^ � a w a Q ai a z 3 �%�.�"# � "� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Comple[ely - Use Ink Only BUILDING ADDRESS TraCt 10277, Lot 17 OWNEFl McLain Development Co. MAIL 1470 Jamboree Road ADDRESS TEL. cirv Newuort Beach No. 640-68 BRANCH ADDRESS ARCHITECT _ . . ,__ . .. TEL. 3661 Spruce St., Newport Beach CONTRACTOR McLain Development Co. ADDRESS 1470 Jamboree Road cirv Newport Beach rTio�� 640-6800 STATE Z.738�5 CITV LIC. NO. LIC. NO. OF LOT 4S X ZOF) NOW ON LO 5 USE OF Separate permits are required for electric, plumbing and heating work. UILDING AND WORK TO BE PERFORMED Single family residence, New House I hereby acknowledBe that I have reatl this application and stete that the above Information is correct entl aprea to eomply wlth all laws regulaNng builtlinp construction, entl I shall not employ any oerson in violatlon ot Me workman's compensation laws of Me State of Celifornia. I heteby cert(fy that I em properly Itcensed as a contractor untler 2he Stara ot CelHornfa Business entl Professions Cotla, Dlvislon 3, C�eptar 9, entl thet such Iicenses are in full forca antl effect, or 1 am exemDt from the provlslons of the State of California Business end Professions C de, Division 3, ChapterR. i Slpnatura of � t �) !' f� Permittee �— Authorizetl A e t I � 38j9 2/2J%.79 293..19 j'L APPLICATION � U a �� T�93•19CKT"0'� —.,—, , �� '�i-i5�'" - - i a� -- - - �� A.P. NO. YI Z� � 4�� ADDRE S 3 �� TRACT ZOZ%% FIRE 20NE APPROVED ZONE VARDSAPPROVED MAIN BUI�DING (FROM C/L STREET) Id � PEIiMIT NO. 1% TE USE OF NEW BUILDING R� VARDS APPROVED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCE55. BLO VAR.� �/�y DATE C.V.P.qW Z��/p�3�% qPPROVED APPROVED , .1 p ��" ca, i` HOLD FOR S 'CtAL Rti N n w House 1685 m sn. Fr. �'age 436 N THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLSHING A PEPMR FEE ONLY: � VALUATION PERMIT FEE S a N � m PLAN CHECK S "� 0 $ ��{� LL / / / TAX S � / `/ p TOTALPAID §