HomeMy WebLinkAbout2226 STATE AVE - Building Permits I
-c'i CITY OF COSTA MESA
4 ' BUILDING DIVISION
>
:j i .•� DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
1. 1 ..4.4.47-i, i
PERMIT B06-01571
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cEMILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2226 STATE AV Status: ISSUED
Suite: Applied: 09/20/2006
Vicinity: DUPLEX Issued: 09/20/2006
Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N
Parcel Number: 42207305 Zoning:
Applicant: WOLSKY, BRIAN '
Address: P 0 BOX 771 I'
1p
Phone: 714-847-9332 ISSUED BY: silk
HUNTINGTON BEACH,CA , .Zip: -92647, r
Owner: SKYTTE, BIRTHE'B . " _ -
Address 12702 AMETHYST ST " � "
1 . .
z , Phone: • _ - -
.
GARDEN GROVE,CA: , ' - Zip: 92845 ,
Contractor.,i',TOM'BYERROOFING -
Address:/70,0 �'i 0 BOX 771 - �, -
/
/ , '�� Phone: 714-847-9332 , N . _A
/ ,.,/ `,HUNTINGTON BEACH,CA ,
Zip: 92647-'i ', License: 575002 - , , - '
Arch Eng: _ ,
'Addiess: - . - Address: '
_ - - Phone: •
Zip: ' License: - -- . ' License:
SCOPE OF PERMIT
,REROOF DUPLEX:T/O EXISTING COMP ROOF,REPAIR/REPLACE SHTG AS NEEDED,2 LAYERS 15#FELT,APPLY 20-YEAR GAF COMP
SHINGLES.2700 SOFT PITCH 3:12/ " .
/ t >-r- :.-r - -v FEE SUMMARY - -
Plan Check: ' $0.00 .• r ..1/-;' . . ._I ' it: .2'.... - Calc Valuation: ` $6,330.00
Permit:" . $139.25 - Claim Valuation: $6,330.00
' • SMIP Res: $0.63 .\ - 1 "
SMIP'Coin: - $0.00 l\-_ '`-',J' '
\‘ Other`..' $0.00 —
Inspection: $0.00 ' .
Total: ' $139.88 - -
�. . _- -
� ,PLANNING & ZONING '
SETBACKS �:e'-n " ,
, •/
MAIN STRUCTURE'Front,/-0-0 Rear_.' 0-0 Left 0-0 Right . ,0-0
-' 1:-",- - - - ,
ACCESSORY Front, 0-0 -Rear, 0-0" Left 0-0 2 Right 0-0
PARKING \ Ekistmq - 0 Reouired 0 Proposed 0 C7
. .., �' )
. ..
(R-- ,
-P 2
._., _ . _.. . ... , . ._., . .
_ ... .. .
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. 'ti. _
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(&OO)
DECLARATIONS t ( )
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
e�ork 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.
mCMy errss'coornrnn enation Insurance carrier and policy number are: P /6/6 CZ
(This section need not be completed i/the permit is valued et one hundred dollars($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 subject to the workers'
compensation laws of Califomi agree that If I ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provl '
nt5lgnature: P *
WARNING:FAILURE TO SECURE WORKE ' TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
T/K1rISAND DOLLARE(5100,000).IN ADDM TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEYS 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 Profespi ps Code,and my license is in full
force and effect.6A1S}S5o2 l R C }<]
C ttssigrieturer iger G7 /
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($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.).
❑ 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,end 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 0 No Driver's 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,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 Safely 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? 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 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 D 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 ❑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.
i.natu a Of Legal Owner(s) I / Date
I. nI U te
•n. • _:.-.+.!.... 1FceM
ODE 1, INSPECTION TYPk QM • 24MALS CODE! INSPECTONTYPE PATE SEALS
•
1618 Fixed System Final Fire Prevention 206 Final Mechanical
1286 Pool Spa Final y� —/,�.r—,/�..r� 208 Final Plumbing
200 Final Re-Roof P 2cA vt Yi 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 __
•
,M1>
• March 4, 1970
Mr. Dov Duncan
2226 State Avenue - _
Costa Mesa, 'California
Dear Sir: _ ,
•
• A building permit has been issued't Anthony Pools to construct -
a private swim,:ning pool on your property. - .
In order that your pool will-be, asafe and for the purpose _
of advising you of your res sibility regard ng•the requirements
of the Costa Mesa Municipal C le, .iwe "refer you=to. Section 8107, a
copy of which is attached.- . .. - -
This letter , directed to yo iri order that 'you will be-mare' .
• of our- ordinances a d-can make •a complete safety check of your pool • 4
area. b •;
' - Sincerely yours,
• .
•
RICHARD,HANHART " . . .
' • - Building Safety Director
RH:dh
•
•
j
OWNER DUNCAN. DOW DATE 3_3_70
niJOB ADDRESS 2226 State Avenue BUILDING PERMIT NO. 31466
GENERAL CONTRACTOR Anthony Pools DESCRIPTION of WORK Pvt_ Swim Pnnl (Duplex)
�AP No. 115-643-05 LOT 5 TRACT 3717 FIRE ZONE VALUE $ 1.500.00 _
� INSPECTIONS Signature Date GROUP I TYPETTT ZONE R-2
y� SOIL SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER J�� Pl umbi g
ROUGH PLUMBING HO y .47 Vow C . -5-5-,o s77S-S-7 /'
PROP. SWR. LINE ❑ USE CON. ❑ ///AA
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLEjcz
UNDERGROUND L POWER `L
ROUGH WIRING CeiY Heating and Vent.
TRENCHES D FORMS D STEEL REINF. 0
FLOOR SYSTEM
✓✓✓�`, O � �^
t"-
BOND BEAM n STEEL REINFORCE n cr -
SHEATHING /1
FRAME AND FLASHING 7/Ce
LATHING — IN n OUT n S -
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric _
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST fl
ELECTRIC, FINAL
PAI
3 1466 MAR -3-7GI:prO� 059* ****n.50
e
'f COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely REC D DiSAE RECEIVED DATE ISSUED
BUILDING ADDRESS 2226 State /lye- t / /<i--3-- 778 ---1y7d
OWNER Dow Duncan A.P.NO. //�J (p7 —(/ Le
P /I'Y
MAIL BUILDING 2226 StatE Avenue
ADDRESS
Z > -or70J ADDRESS
WW
• U CITY NOL TRACT 3717 LOT 5 BLOCK
Z I- CONSTRUCTION ^ NEW ADD ALTER REPAIR MOVING DEMOLISH
z L
O-cn LENDER I/A'/�/(J X
am
J D BRANCH
JN OWNER D. Duncan
<L11 ADDRESS '
CO J.IQ ARCHITECT C. Adams TELSp32210 USE swimming pool VALUE 1,500.00
to OR ENGINEER NO.
Z Q FIRE �•
Z cc ADDRESS ZONE TYPE GROUP �j
aw APPROVED ?it
q 1
W Z CONTRACTOR Anthony Pools BY // ATEJ—d 70
J o
ca ADDRESS 5871 Firestone Blvd.
WW p TEL. ZONE INO.OF USE OF NEWW /YI/
O= CITY South Gate NO. Sp32210
R--€2 PLANS BUILDING Q
Z F l�'oc "_
W- O STATE CITY YARDS APPROVED YARDS APPROVED
cn X LIC. NO. 190179 LIC. NO. MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLOCS. (FROM C/L STREET) IL
OF LOT NOW ON LOT FRONT FT. / FT.
USE OF
EXISTING BLDG. roci•ence and garage R.SIDE FT. SFT.
H SIZE OFNO.OF
1
Z NEW BLDG. 300 ROOMS I STORIES 1 L.SIDE FT. 7FT.
UEXTERIOR WALL ROOF
COVERING I `COVERING REAR FT. . FT. _
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
1
a MAIN minas. ACCESS.BLOCS.
fit
a private swimpool in _. VAR.# DATE
NO C.U.P.# el/Lk gPTE 3
of = =' y dwelling ROVED DATE 3 -3-70
a U N'pl e� 0
U A.
I hereby acknowledge that I have read this application and state
r that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F,• any person in violation of the workman's compensation laws of
fA the State of California. - to
zI hereby certify that I am properly licensed as a contractor under SO. FT. p
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
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 VALUATION
and Professions Code, Division 3,Chapter 9. /r 0' 0 CO
PERMIT FEE $ ,✓J/�
g 1,500.00 O
Signature of ��jj GG T m
Permittee n! /J ra_Zzg_/.l _ $ PLAN CHECK $ /.-✓ 0 E
te
Authorizetl Agent 00,2,56 pu.
TOTAL FEE $
OWNER SKEET JEFFERY • DATE 5-31-77
JOB ADDRESS 2226 State Avenue BUILDING PERMIT NO. 44083
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Legalize patio Cover
AP No. 115-643-05 LOT 5 TRACT '717 FIRE ZONE VALUE $ 360.00
INSPECTIONS Signature Date `TYPE V GROUP S ZONE R-2
SOILSUBCONTRACTOR PERMITS ISSUED
GAS Date I Number I Signature
WATER Plumbing
ROUGH PLUMBING ^
PROP. SWR. LINE I J HOUSE CON. 0
SPRINKLING SYSTEM
I
2 MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING' •
TEMPORARY SERVICE OR POLE
UNDERGROUND [J POWER ❑
•- �� ROUGH WIRING Heating and Vent.
c.,%1pp1 TRENCHES FORMS STEEL REINF.
'S FLOOR SYSTEM
BOND BEAM f STEEL REINFORCE [1
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT
PLASTER, BROWN COAT _
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL ..,1,1 fir-/,^77
PAIU
•I
N • 44083 MAY 31-77cfsT001431* ****10.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only APP AION FOR STRUCTURAL PERMIT
RECE V DIP(Y DATE RECEIVED DAT SSUEEID
ADDRESS 27 /1�r ^ vC �..5 /-? 7-
ADDRESS -r--�+/��(��-pJ\ rT C ` �/ PERMITPENO.
OWNER C)E \ GC g�MAILy/i1p A.P. NO. /,� .-C//.3 -[O�S^A A
ADDRESS Riv(o 2 KtGc-c.c ll�.. ADDR ESSBUILDING 2��Qa ✓lr/�� �7`�
TEL. TR AC T.2/ LOT BLOCK
CITY 1-41J�,LTI AG(�TU7•S �Ia NO x(!03.6544
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMO.ISH
LENDER
BRANCH OWNER js Ceg%/ Ckc
ADDRESS r`.,��lr 1 ¢ /ryiT°.ALUE /n1/'�
ARCHITECT TEL. US Et 65A S4 ?S" $ Se
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE�'-- GROUP JJJJ
) //mss APPROVED LJ. 3/-7, -
(ONTRACTOR Qt.L.IM `� L//dh N BY ('D�ATE�-) ✓
ff��ADDRESS V 1b 'E s�.�StY
'TEL. ZONERNO.OF^ USE OF NEW‘E.'L'Nld.ol',E
CITY • NO. 1.jr
BUILDINGE.W so. cast
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
Eta SIZE NO.OF BLDGS. (FROM„sC/L STREET/���
0- OF LOT NOW ON LOT FRONT 477HF l.W4 9 FT.
G USE OF y•
�., EXISTING BLDG. R.SIDE 10 FT. FT.
Ca
(-1
Separate permits are required for L.SIDE Si FT. FT.
electric,plumbing and heating work.
Ci REAR 1 FT. FT.
, E OF sBUILDING AND WORKd)� /
O BE PERFORMEDt /-� DISTANCE BET. •
BET. MAIN&
QI� L` � . L('7€i) 1'rM a l t/( ./2_ MAIN BLDGS. ACCESS.BLDGS.
\ VAR.* DATE
M • C.V.P.# � -I APPROVED
APPROVeWQ Qr,Q O ?ATF v V / 22
IX .
W
0 I hereby acknowledge that I have read this application and state in
ed that the above information Is correct and agree to comply with N.n
co
CI-1CI-1all laws regulating building construction, and I shall not employ
i
Z any person in violation of the workman's compensation laws of
5W the State of California. /�D
SQ. FT. Ti
,3 I hereby certify that I am properly licensed as a contractor under - co
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN VALUATION IS FOR co
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTAB A PER IT FEE ONLY:
am exempt from the provisions of the State of California Business /D ,r- w
and Professions Code, Division 3,Chapter VALUATION P MIT FEE 4e
ry M PLAN CHECK $ m
Signature of A////� - 2/D o
Permittee -t I b 4 $ J,/C/ TAX $ LL
!`U//I se
Authorizetl Ager TOTAL PAID $ /a
FI RECEIVED
J
12506
Jllt_ 111960
•'COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
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
ADDRESS 2226 State Avenue ./" ie
. COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. 1 .0416 A�D6
OWNER • • •1 ' ,•4j.[ISI
RE ' D BY DA . REG' ! DATE ISSUED
- �:.��IMi, 7 1 N.-.
•• L BUILDING 5,."
TE
CITY Costa Mesa NDI9-1151 ADDRESS
ARCHITECT G I3 %& TNT/1-1E9770COSTA MESA. CALIFORNIA
OR ENGINEER 1 e rook /1
Garden Grove FIRE j� ..!/ /
ADDRESS ZONE TYPE !r GROUP CONTRACTOR Dike & COlegrOVB, Inc. APPROVED DATA 1 ;961 II
ZONING
ADDRESS 1533 Raker S},. /
CITY Costa Mesa, Calif. 7 e— I NO.OF \ use of x�fv i 6,
{J11 PLANS //' BONDING
LEGAL JI
STATE TEL.16729 NO. KI 9-11 1 DESCRIPTIONSOrLOT Lot 5, Tract 3717
•I 100 OF SLOGS
NOW ON LOT • A.P.NO. \.C"--t-
USE
C
• e YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
CENTERSETBACK OLNE FROM 421 REAR YARD 26? (UNTER LINE BT.) I/
FRONT / a.FT. IN.
SIDE YARD I LEFT 5! I RIGHT 51 R.SIDE . cFT. IN.
DESCRIPTION OF WORK
L.SIDE S FT. IN.
NEW I X V ALTERATION V ADDITION I REAR ` 6 Ft IN.
REPAIR I IIMOVING I II DEMOLISH I BYPROVED ` P -'1 DATE - (Qp
MELDING 1758sq.ft• ROOMS 10 STORIES 1 \1/ J
EXTERIOR WALL, ROOF
COVERING suCCO COVERING comO.rock
USE OF BUILDING AND WORK TO BE PERFORMED
Multiple family dwelling with
attached garage (two living units)
Plan BR Gar 420 sq. ft.
I HEREBY 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 PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCT N. VALUATION
SIGNATURE 0
j ��-' PERMIT FEE $ 37.00
PERMITTEE 18.50 i.
Dike & Co grove, Inc. CV
• $ 17,926.0 PLAN CHECK $ z
AUTHORIZED AGENT TOTAL FEE G O
a