HomeMy WebLinkAbout2214 STATE AVE - Building Permits t
PROJECT ADDRESS: 2214 STATE AV • UNIT: CITY OF COSTA MESA .— BUILDING PERMIT . PERM. NO: .P • 049336
OWNER'S NAME: LOW, PHILLIP Q
-muss: p 0 BOX 20101 PERMIT' NO: P 049336 • PLAN CHECK NO: N GOVT: N SUPP: N
FOUNTAIN VALLEY,CA 92728 .
- CONSTRUCTION TYPE: PERMIT TYPE: .PLU :PURPOSE: OTH
ARCH/ENGINEER: REa.xD.: JOB DESCRIPTION • : REPLACE SEWER LINE SQ '
ADDRESS: UNIT: FT: ,
CLAIM VALUE: .
CAL VALUE; GROUP OCC: R-3 /
• PERMITTEE: RESCUE ROOTER ( 714 ) 835-1602 '
ADDRESS: 1085 N MAIN ST COMMENTS : X - '
ORANGE CA 92667 **********************yrarsrsr**dr******�kek*ykak�k**�F*sr** eF***yk*+k*sk�Far*******************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G REQUIREMENTS
71100)of Division 3 of the Business and Professions Code,and my license is in full force and effect. / SETBACKS
DnT UC.: 3440_8„STATE LIC 3 53 173 . (/
Date: /0 ,,' I� Signature: C 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: FT IN FRNT; FT. IN REAR: ' FT IN
Compensation Insurance,or a certified copy thereof(Section 3800, Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN"
POucYND.: WP010840-90 FMP.DATE: 01 /01 /91 •
COMPANY: PACIFIC COMP PARKING REQ: PROV: • PARCEL: 42207307 ZNE: REF NO:
❑ Certified copy is hereby famished. Certified copy is file Th the city Bui dingph. ^) PLANNING NOTES> '
n [{/— 7�n >
Date: / — Applicant:/U Applicant: - **********************************************1E*.**********************4********
EXEMPTION FROM WORKERS'COMPENSATION DECIMATION: (Riffs section need not*mmDleted K the permit is for one hundred($1 W)or less). DEVELOPMENT .'S E R V I C E S ' R E Q U I, R ,E M E N T 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 o the Workers'Compensation Laws of California. , ZONING APPROVED BY �)
DATE:
Date: Signature: • _ - . -
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; . DATE:
Code,you must forthwith comply with such provisions or this permit shall be,deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• •) DATE: 6- - 0
which this permit is issued(Section 3097.Civ.CI. *********************3(,********************3E**, ********************* **** *ie **
LENDER: ***************************************************_****************************
ADDRESS: LEGALIZATION:N F E E SUMMARY , STRUCTURAL SEGMENT :N
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 5 . 0 0 -
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 - 2 5% 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 ,
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 00-
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————> 5 . 00 3 . 00 0 . 00 8 . 00 8 . 00 , 00
r 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 issold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 8 .00 OVER/SHORT: 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 8 . 00
❑ 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 ****.*.*.*.**.*.*.*.***.**.*****.**.**.M**.*****.****.1!****.********.***-********.**.************.aF,M.*.
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: • TYPE . QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: PLU 1 SEWER, BUILDING / TRAILER 5 . 00 5.00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and
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 END OF FEES •
I permit far construction or modification from the Air Quality Management District.Residential construction applications are exempt from ( .
these provisions. ;�. �
AppliWni:
Date: - I��,
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 OCT
ordinances and state laws relating to building construction and he authorize representatives of this city to enter upon the abo'�e-mentioned - ) 1990
property for inspeecticti9n—A'u7Jr 0 I •`
Date: /D�/ / Signature: (/I l _,ar%kY'- I
CITY OF COSTA MESA
Driver's License or Social Security • I
164146 White—Building;Green—Code Enforcement;Canary—ApplicanC Pink—Revenue;Goldenrod—Assessor -
• CONSTRUCTION AND PLANNING .4\6 POOL & SPA
APPROVALS Permit# Datet Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole: -• 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.-, y' 53. Steel Reinforcement
•''3..Electrical Conduit Utility-Undrgrnd_.;" 54. Forms
'.4,. Electrical Conduit:Un '
drgrnd. � 55. Electrical Bonding '
c-• S Steel Reinforcement c >: 56. Rough Plumbing & Pressure Test •-
'• 6�Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -
.� 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. APPROVALTO DECK
11. Property Sewer Line:& House Connection M/�� �p 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 ElectricWiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectricatT Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL • '
19. Rough Heating & Air Conditioning „ _ r ,Q, , FIRE_DEPT. REQUIREMENT
20.-Rough Factory Fireplace i ,r+ -.1• __ , -w.. „ :APP ROVA LS.7F.;Per init # - -
21. 0uCts, in-Striktur! '• '-�-• + s C • „ v � .b dj i'
- r
S -+ I. , -,x- . .-70. Undergrbund�Hydro ][
22.•.Ducts, Ventilating ''�, E C7 -71. Product-Piping 0 Gas 0•Oil
23. Gas Pipe-Rough &Test ' ^re }`� i '1- ,•- t :72, Underground_,Flush'
24.Roof Fri-Ming' ^r, =1 ^'" ,. 4:.; "
z, _ . •73.,',Undergrnd.Storage:Tank 0 Gas 0 Oil
25. Roof Sheathing '., i0 - _ ,
- ' > 7q,• Overhead Hydroa:74
1.
26.1,T-8; Ceiling (Struc'tural) &'Monocoat 4 0 >.. - * a 75.:;Dry Chemical c,- • , .�
27.: Frame and Flashing r., * r I-I II it er4a µ 76. Dry Standpipe -' ' _ ,r,
X28. Lathing`& Siding _:�If t 4, 77.-.:FIXED SYSTEM:FINAL +L+ .-
29. Insulation 5. �• S x K 78=_FIRE PREV. FINAL r;: F,
X30. Drywall Nailing ' ,_. t ,• L+ w •:. •",HEALTH;DEPTDREQUIREMENT
;31. Plaster Br-own-Coat f - - , .'79. FINAL INSPECTION i �, y
4 r-4.32. Electrical'Power Meter=Final * 80.t'FOOD CERTIFICATE ISSUED .
r -
33.:Finat Electric• 0 ?' Noyes: •I "',t t -i _ f•.1
.. r r i'- t r.....:,:'
;34 YFinah Heating& Air'Conditionirig- ".rrtf a ''^- Or. •-' -IC'
35.rFinal Gas Pipe-Test, t.; -, 4 > - o ;�-, * •r;;
.. - 4 v . ,-t
36j1ood or CanoPY - h , . no a tr
. '-37. :Final•Factory Fireplace :: E-1:-. 0 * x _ s. ti
c
:38. Final'.Plumbing x �0 �• (�� * 4 S r
_ . .
•
39. Water Service-Final , z
c : :\ .
r;40. Gas Service-Final C1 "" + rn ;` "", ,'.': } 1
-41. Solar Domestic-Final ' i IT, 1- a . ,
42. Backflow Preventers - ' I :e 1, r.; ,>6• , - - - =r, _
Cr t;
43. Backflow Irrigation:it - . -- 7: - - cS
rr44.,Landscape Irrigation System-rj ' r ''1 - i •7 "_ -' ' ; `t
z - _. w: NC z fir.
245.`•-Sound Attenuation.- -7 • •• ,. r; ;r: z !- c t• - -•
Re ulations T
46. HandiceP' 9 r
r47.-FINAL STRUCTURE & BUILDING I
Cf n - - -•
48.'FINAL PLANNING; -`" ti
�49.`Electiic.Release to Edison - .,- `
-501Gas Release to Southern California;Gas Co - <_ r) ' "r' I '
51. CERTIFICATE OF OCCUPANCY -- - '
No. Date
1
•
Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations.
I CITY OF COSTA-MESA . PER NO. TRACT NO.-- LOT NO. -BLDG.NO. . - . -- - -'- - --
•CONSTRUCTION PERMIT F" /091 ' r Ct• //
Project Address State Q,)e: .- - - TYPE OF CONSTRUCTION c47� I•_LG/�I-'•• .} IJoC.. 71
'OwnerMe., r1:r1
Ph� 5 9 j$q 0z NEW 0 ADD ❑ ALTERATION - • - - .- .
-Address ,)j -4 �„ W4 . Ai *&tct ns-) - - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH '
Arch/Eng. -' License No. - - - - ❑OTHER ZONING REGULATIONS
- DESCRIPTI•N OF WORK�dt 4/1-(0.4-1A'P'le ' '
,Address — • - . . --- . . . - _ - - .• -
7 r'.'Ll•'. '.A bI 'ZONE , PLNG. REF. at- •
Contras f -I a l� - -P j`• 1y1 • TYPE OF PERMIT. D • SDBtJiLDI LAG -
SETBACK C/L ST. PROPERTY LINE
Address 'a 1 _ &. �J) �` (•L -- . 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD
LICENS D CONTR•CTOR DECLARATION -- - -- -- ^ 0 TENANT 0•ELECTRICAL PLUMBING ❑MECHANICAV LEFTS + -
I hereby affirm that I am licensed under provisions of Charter 9(cam- - _ _ _ RIIDGHTARD
mencing with-section 7000) of Division 3 of the 'Business-and -❑ OTHER
Professions Co.o -, ++ my license is In full f. c- a•• - ect. REAR YARD(TO P/L) -
Lice s 1• Lice e .• vL.� - 3 PROJECT DESCRIPTION _. - -. _ •
geg'¢s Cyr Y 1 , le. SQ FT. PKG.SPACE REQ. .PROVIDED
Date" '-'• ., signacu�ILl��� ��� - STREET WIDTH , PARK FEE$
WORKERS'COMPENSATION DECLARATIO ` N� „`„7OCCUPANCY_CONSTRUCTION TYPE -
I hereby affirm that I have a certificate of cons: r - i .ZONING APPROVED BY ,, DATE
certificate of orke ,C.am ensation Insurance, or a certified copy VALUATION ZONE -
thereof a �Bo�v$ �•}/� GRADINGCU. YDS. • a ACRES 'SPECIAL CONDITIONS: • '
Policy f�+ '1 I om Pant 7/'D _ _ • • _ -
❑ Certified copy is hereby furnished. - - - ---- - `- REMARKS: - - — . - ' .,
❑ Certified copy is filed with the city Building Division. - - ,
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - . - -"
. -
(This section need not be completed-if the permit is for one hundred - _ _. _ . . '
($100) or less). -
I certify that in the performance of the work for-which this permit is _ - _ _ -_
Issued, I shall not employ any person In any manner so as to become ' PLUMBING . ' - PLAN CHECK ELECTRICAL PLAN CHECK -
_
subject-to the Workers'Compensation Laws of California. UWtLLING - GHRHGt
•
Date Signature -- - BATHTUBS SHOWERS 50 FT SO FT •
NOTICE: If after making this declaration, you should become subject TOILETS „ 'URINALS - GENERATOR .
0-1 KW_1-10 KW - -
to the Workers' Compensation provisions of the Labor Code,you must _ TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW._50+ KW - '
• revoked. -_ - . - -_ . ---_ . _ - _ _ .- .- _ _ _
CONSTRUCTION LENDING AGENCY • KIT.SINKS DISHWASHERS -- - 'MOTORS 0-1 HP_1-10 HP " '
I hereby affirm-that,there is a constructionJending agency for-the per- SERVICE S-INKS - I -' SUMPS ' - __„�.•,• -(INC.SOLAR)- -•10-50'HP=50 +'HP . -
formanceof the work for which this'permit•is issued (Section309_7. • -
Civ. C.). FLOOR SINKS-„q,•,,,,.�•�FL-OOR'6RAINSa Era E iI%TURES - -OUTLETS SWITCHES ”`
Lender;s_Name - 1 -
Lentler's Address • DRINKING FOUNTAINq AA 11 --1t- j GAS TUBE SIGNS -- - - - '
OWNER BUILDE •
R DECLARATION ' „ _ �- `• -II
I P• OLE LIGHTS - -
I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTOR$ CLA R•I,F IER$ t 'rr.;-a -
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL fl PTRLIf - xi' e® -' -' LUN51 KUL l IUN• - - -
Any city OrCountywhich requires a permit to construct, alter, fJ 4 �. POLES METERED SUB _
improve,tle molish or repair any structure, prior-to its issuance,also re- WATER SERV ICEALTERATION PANELS MAIN' - 's SUB
quires the applicant for such permit to file a signed statement that he '
is licensed pursuant to the provisions of the Contractor's License Law GAS SER\$CE O T TS _ - SERVICE -- - -- AMP '
(Chapter 9 (commencing with- Section 7000) of Division 3 of the _ '
I Business and Professions Code) or that he is exempt therefrom and the WATER Ht` P t�3. .--a--7--VES‘' �++•a _ - 7-
basis for the alleged exemption. Any violation of Section 7031.5 by �j, V -- . _ - _
any applicant for a permit subjects the applicant to a civil penalty- SEWER COi•I - - -- '
of not more than five hundred dollars ($500). _ '
0 I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS
sole-compensation, will do the work,-and the structure,is.not intended_
or offered for sale. (Section-7044, Business and Professions Code: The SOLAR PIPING SYS. . -..ISSUE FEE •
..
Contractor's License Law-does not apply to an owner of a property_ . - - - - ,_
who builds or improves thereon, and who does such work himself or ISSUE FEE `� `�O 'APPLICATION APPROVED BY -` - DATE'
' through his own employees, provided that such improvements are not _ _
Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK •
SUMMARY OF FEES
is sold within one year-of completion, the owner will have the burden. '_
of proving he did not build or Improve for the purpose of sale). . BUILDING _ - ,
❑ I, as owner of the property, am exclusively contracting with AND DUCTING HEATING SYSTEM 0-100,000 BTU _PERMIT •$ SMIP $
licensed contractors to construct the project (Section 7044, Business 100,000 + BTUPLAN CHECK $ • PERMIT” _ •
and Professions Code: The Contractor's License Law does not apply to - - ISSUANCE -$
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU - 'PLUMBING $!- r >"�<� -
tracts from such projects with a contractor(s) llcesned pursuant- t0 SYSTEM - - - - -- - - GRADING- $ ' C1
the Contractor's License Law). 100,000 +BTU PLAN CHECK $ - • f , • /1
❑ am exempt under Section - B. & P.C.for this BOILERS BTU ELECTRICAL $ S �t
reason - - --' . MICROFILM $ ' I
Date - Owner - -- - -SYSTEM REPAIR,ALTERATION •PLAN CHECK $ TOTAL FEE$
I hereby certifythatt have read this application and state that the above .EXHAUST SYSTEM MULTIPLE :MECHANICAL $ LESS'
information is correct. I agree to comply with all cityand county ?PLAN CHECK $ �-- •VAN E p I (
9 PY VANCE PC $_ ;'�
ordinances and state laws relatit, to Construction,and hereb authorize.
representat e of thi city t•' enter •o I he ab t d - -
property a'1�o a ur•.=; p(L'([v.¢I
519natur• 4) 'I•. ,I Ir a • • ,1f' ,nate " " 1 _ ••- - - _ - .-- - FINAL FEE $. j�
Drivers'License or SS* ' ' "ISSUE FEE - -- - - - - - - -.-
CMF 0865-46 ,White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL&SPA ., .. k - ,
APPROVALS Permit# Date Inspector APPROVALS Permit# - • Date y Inspector
1. Temporary Electrical Service or Pole ' . 43. Pool & Equipment Location 'r! - ' - - - •
2. Soil Pipe-Undrgrn 44. Steel Reinforcement ..1 - r f.
3. Electrical Conduit Utility-Undrgrn _ - ;45. Forms - -.
' 4. Electrical Conduit-Undrgrn46. Electrical Bonding .
5. Steel Reinforce, - - 47. Rough Plumbing & Pressuie:Tesi. 1 ' ' '
•6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE• - '
7. Footings 49. Electrical Conduit-Undrqrn
8. Foundation 50. Gas Pipe, 0 Undrgin,Test , . -
9. Water Pipe-Undrgrn 51.- Backwash Lines. P-Trap.'D'UndraYn -
10. Structural Floor System 52. ' APPROVAL TO DECK i ' 1 - - - -
11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final •
12. - Street Sewer.Connection • ' 54.. Heater &Vent-Final �^ i , . ,
13. Rough Plumbing 55. ' Plumbing System - Final
14. Rough Electric-Conduit • - - - .56. Electrical-Final - ., .
15.. -Rough.Electric-Wiring "-' - - • 57. Solar System-Final • - • - .. '
16. • Rough Heating & Air Conditioning - 56. Fencing.& Access Approval
17. ..Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating -
19. Gas Pipe-Rough &Test . - 60. POOL/SPA SYSTEMS FINAL '
•20. Roof.Framing . - ._ _ - •
21. Roof Sheathing -'-- �7 � y
22. Frame and Flashing . _ yjyc� is ✓ Acct.,„50/1.7n.y7
��ec � C
23. Insulation 'NOTES: //G . .
24. Lathing & Siding _ _ - . _
25. Drywall Nailing • , _ • -
26. Plaster grown Coat - - .
27. Electrical Power Meter-Final _ . _ •'
-
28. Final Electric . _ . . ' - - - ' - -
29. Final Heating & Air Conditioning
30. Final.Gas Pipe-Test - •
31. Final Plumbing . . ' •
•
32. Water Service-Final _ - _ - ;y . - • ' •
33. Gas Service-Final . - 1 - - Ct - --
34. Solar Domestic-Final ' -
35. Landscape Sprinkling System - '
36.-• Sound Attenuation - . . - '
37. Handicap Regulations - -'-'1,-; - - • - - • . .
38. FINAL STRUCTURE& BUILDING .. -. - - - ' -
39. Special Requirements Completed • '
40. Electric Release to Edison - - -
41. Gas Release to Southern California Gas Co. - - -
42. CERTIFICATE OF OCCUPANCY • • •
NotDate - I - -
,1
12508
it 1
COSTA MESA BUILDING-SAFETY DEPARTMENT • 'FINM+CE p�'�T,
P. O. BOX 917 COSTA MESA. CALIFORNIA CM of COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR-PRINT UILDING BUILDING
B
ADDRESS 2214 State Avenue r�
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. P T NQS
I
OWNER Columbia Homes, Ise. _ I tri
ADDRESSIL1533 Baker St. RECEIVED BY I 13K2 R`CEIyii c1 DATE ISSUED .
TEL. /Ii-ii - IC/ i/� 1 laMm
CITY Costa Mesa No. KI9-1151 ES
ADDRS L�
ARCHITECT C 1 Qn & TEL. LE97747 COSTA MESA. CALIFORNIA
OR ENGINEER T Sddlcbrook NO. �/ Y �/�
FIRE
ADDRESS Garden Grove ZONE TYPE . GROUP(-f ( r
coNTRACTORDlke & colegrove, Inc. APPROVED DATE.Ii i �
1533 Baker St. ZONING*YD IN
ADDRESS IA I
/ N NO.OF UHE OF GN
a DIY l
Cl.n. Costa Mesa, Calif. IA _� I PLANS I I BUILDING • r ,(V /ly'ly/pnI
LIG.NO. 167293 NO.KI 9-1151- DE8CP1PT1� Lot 7, Tract 3717
61ZE A P NO. {"l��l`-'�
OF LOT 65 x 97 NO. OF BLOTS.
NOW ON LOT n0
USE OF none YARDS • EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER of STREET 4�I REAR YARD 28' FRONT 170 FT. IN.
7' I gr
SIDE YARD LEFT RIGHT R-SIDE 7 FT. IN.
DESCRIPTION OF WORK - rJ FT. IN.
L.SIDE �T
NEW Ix II ALTERATION I I ADDITION I REAR. �/ FT. ly IN.
REPAIR II MOVING I I DEMOLISH I APPROVED , ' r ,\.- l y DAT�YI p ��
MELDING 1758 sq.ftROOMS 10 STORIES 1 `/'.,/ " (J�'
EXTERIOR WALL, ROOF
COVERING stucco COVERING rnRR1.r0Off
USE OF BUILDING AND WORK TO BE PERFOgMED
Multiple family dwelling with
attached garage (two living units)
:lei AR
Gar 420 sq. ft. •
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY.
PLY WITHALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONST-R-UUCCTTIIO�jL �J��{/(�,/ VALUATION
•
SIGNATURE PERMllTTEF OF , v / PERMIT FEE $ 37.00 9
$17,926E80 PLAN CHECK $ 18.50 44
I
AUTHORIZED AGENT Dike & Colegrove, Inc. 55.50 H
a TOTAL FEE $ u '