HomeMy WebLinkAbout649 SURF ST - Building Permits��ia��sa-s2�a • Fax(�ia>>sa-aess • www.ci.costa-mesa.cBq31LDING PERMIT
JobAddress: '649 $URFST
Suile:
Vicinity:
Parcel Number: 42224104
Applicant: ALEXANDER, IVAN D
Address: 649 SURF ST
COSTA MESA, CA
Owner: ALEXANDER, IVAN D
Address 649 SURF ST
ConUactor:
Address:
Zip:
Arch :
Address:
COSTA MESA, CA
Phone:
Zoning:
Phone: 949-717-5444
2ip: 92627
Phone:
2ip: 92627
Phane:
License:
Eng:
Address:
77 hAIM UMIVt� IiVJ IA MCJH, liM `JZOLO
ISSUED BY
Status: ISSUED
Applied: 10/27/2003
Issued: 10/27/2003
Phone:
Zip: License: License:
SCOPE OF PERMIT
RE-ROOF EXISTING OPEN PATIO COVER. COVER BUILT-UP ROOFING. .
Plan Check: $0.00
Permit: $23.50
SMIP Res: $0.50
SMIP Com: $0.00
Other. $0.00
Inspection: $0.00
Total: $24.00
SETBACKS
MAIN STRUCTURE Frant 0- 0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Righl 0- 0
Right 0= 0'
$500.00
$500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 7, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or it work is suspended or abantloned
tor a period of 180 tlays.
INSPECTIONS: In order for the work authorizad under this permit lo be considered legal, such work must comply with all applirable codes, and all
requlred Inepeetiona and final epproval must be obtained. Failure to obtain insDections and final approval will result in the expiration oi this parmit.
FOR INSPECTIONS CALL: (714) 7545626
>446-46 (W00)
WORKERS'COMPENSAnONDECLARAnON:
I hereby ettirm untler penalry of perjury one of the following declarations:
❑ I heve end wlll maintein a certi��cate of consent to sell-Insure tor workers' compensation, es pmvided br by sectlon 3700 0l tha Lebor Code, tor the pertormence of ihe
work far which this permit is i5suod.
❑ I have end wlll maintain workeC¢� �mpensation insurance, as required by sectlon 3700 ot tlie Lehor (,�tle, for the padortnance ot Ihe work for which ihis permit Is Issuetl.
My workars' comperi�ior Ifisu�ce wrrier entl pqtl9zaumber are:
Cerner.
neetl
oi less.)
Policy Number:
�I cehify Ihet in the pertortnanc of Ihe work tor whlch this pertnit is issued, I shall not employ eny peroon in any manner so as to bec me subject to ihe workers'
compensatlon laws oi Calitorri , ancy,igree e�l I shoulC become subject to the workers' compensation proWslons of Seciion 370 of the Labor Code, I shall torthwith
comply with these provisions. �� %� ^
Appliwnt Signature: Y Date: C7
WAANING: FAILURE TO SEWRE WORKERS COMPENSAi1pN WVERAGE IS UMAWFUL AND SHNLL SUBIECT AN EMPLOYER TO CRIMINAL PENPL ES AN� CIVIL FlNES�IP ONE HUNORED
T/KK15AND DOLIARE (5100,000), IN ADDRION TO iHE COST OF COMPENSATION, DAMNGES AS PPOVIDED WR IN SECiION 3lO60F iHE LABOR COOE.IMEREST, ANO ATTORNEI"S FEES.
LICENSED CONTRACTORS DEC4ARATION:
I hereby aNirm that I em licensetl untler provlsions of Chapter 9(commencing with Section 7000) of Division 3 of the Buslness and Professions Code, and my Ilcense is In full
forCe and eMecl. Lic. N Cleu A
Contrectors Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aMirm that there is a Construction lentling agency lor the pertormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lentlers AAdress:
SigneWre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm Ihet untler penalty of Perjury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Code: Any ciry or county which reqUires e permit to constmct, alter, improve, demollsh, or repair any strucNre, prior to its Issuence, elso requires Ihe ap0licant for such permit
to flle e slgneC statement that he or she Is Ilcensed pursuent to ihe provislons ol tha Cantrectors License Law (Chepter 9(commencing wlih Section 7000) of Divislon 3 of the
eusineu end Prolessions Code) or thet he or she is exempt therefrom anA the besis for Iha elleBed exemption. Any violation of Section 7037.5 by any epplicant for e pertnit
u cis ihe epPlicant to e civil penelry ol not more than tive �undred dollers ($500).):
I, as owner ot Ihe praperty, or my employees with weges as their sole compensation, WILI �O TNE WORK, and the structure Is not intendetl ar oNered for sele (Sec.
7044, Business and PmfesSioPs Code: The Conlrflctors License Law tloes not apply to en owner of property who bulltls or impmves theraon, and who does such work
himsell or herself or through his or her own employees, provided that such improvements ere not Intended or oMeretl lor sele. II, however, the building or improvement is
sold wilhin ona year of comple�ion, (he owner-builtler will have Ihe burden of proving ihel he or she did not build or improve for purpose ot sale.). �
❑ I, as owner of the pmperty, am EXCLUSNELY CONTRAC7ING WITH LICENSED CONTRACTORS to construcl I�e projed (Sec. 7044, Business end Pwlesslon5
Cotle: 7he contraaors License Law tloes not epply to en owner of propeny who 6uilds or impmves t�ereon, end who contract5 �or such project with a coniractor(s)
license pursu t ta the Contraciws License Lews.).
❑ I am exempt tler s Business antl Prolessions Code for this reason:
Signature: � Date: �
Owner ID ventietl by tlnver's liCense. es ❑ No Odver's License No. Ezpires:
Vetlficetion of Ownership by (type of document, i.e. - propehy tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY 7ERMIT CERTIFICATION:
❑ I hereby cenity that no exwval�on tive (5) or more teet in depth imo which a person is required to tlescentl, will be mede in connection with work authodzetl by Ihis
permi�, and that no building siNcture, scattolding, lalsework, or tlemolition or dismantling thereof, will be more then ��irry-six (36) teet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, Celifornia Adminis«ative Cotle).
❑ As ownerbullder, I will not emp�oy enyone to do work which would raquire e pertnit from the �ivision ol Industrial Safery, as noted ebove, unless such person has e
permit to do such work from the division.
Signature: Oate:
Division ot Industnal Safery Permit Numbec
CERTIFICATE OF COMPLIANCE AND AUiHORVAl10N OF ENTRV: I ceniy under penalry ot perjury thet I have reed ihis epplication end s�ate Ihe� the Inlormatlon given Is
correct. I agree to comply with all stata laws end city ordlnances relating to builtling construction, end au�honze representatives oi ihe CIry oi Casta Mese to entar upon �he
eDove-tlescribed Oroperty for inspection purposes. I egree not to occupy or ellow accupancy ot any building authonzed by this permit until tinal inspection.
ignatu Ot Le ,�Jv'R/qr(s)'
��• �+E� � c
qn OrAuthonzed Applicant
�� . . ' I�. �'
1618 Fixed System Final Fire Pre�ention
1288 Pool Spe Final
200 Finel Re-Roof
201 Final BIacWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Finfll Demolition
Q�g �:S
/0a7�
Date
COOEI MSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elec�rical
212 Final Fire Preventlon
220 Final Planning ApprOval
222 Final Site
250 FinalBuilding/Occupancy
PdIE It�Ali
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noon�ssorem�axc: 649 SURF ST
owr+easw�eiviawm: CAMPHELL SHEILA
AODNE55: 6O2 S 16�TH ST
SPANAWEY WA 98387
206-531—�403
�vv�. �mmc �oo�ss:
ANCXRECT OH ENC�NHN:
YKIL ON ENQ'S ADDPE55:
uc rio.:
UNT:
VNT:
�«m+.c*arsr,.� SAOwCASE HUILDERS 1714 ) 962-8906
CWiHACTOR4M�IlMO 10311 CIRCOLO DE JUAREZ
�ooxEu: F.V. CA uc.r+o.: 729001
92640 uxT:
110EN5ED COMFACTONS OECLAXATION: 1 Mmby ell�n undr perely d pmjury Mei 1 em IicroseE uMm prmivima d Chaqm 9
(cwnme�rp vrith Section 1000) ol 0iviaion 3 d Ue Buvneea end Prdeevone Gode, vM my Ibenee o in tull lace eM eMed.
cmuc.No.: [ uc.cuss: g uc.po.: 7Zg001 EXP:
Dme: � ^3 � "�1 Cmneaa:
�W NEH BUILOEF UECIAN�TION: I Innby dfirm uMar peraly d perjury ihet I un a�emp Irom Ihe CoMretlm Liceros law la Me
Ibvnq renaon (5eaion lW 1.5 Bwiwaa eed PMastione Code: RnY uY a eouM' xM1iN n0u'um e Ca�mn �o awuwe4 etlr. "vnVrova.
xmolmM1, or repei eny el�uei�re, peim b ilf eauenee, eleo reQuiref iM epplirant for e�eh pem�il �o file e eq�A etelament Net M a eM
n lironsed WA�� lo Ihe peovisione ol tM COMreGon Lieen+e Lew �Cheplx 9(aommmdip xilh $eqon )OW) d Divcion 9 d ihe
Buairea ard Rdea'vru COMI a �hel he a sM u uemp ihaeleun ard �he bem 1« Ne e0eab aaemNun. My vidalun d Ssaion
lW 1.5 Ey enY eVGI'vanl iw e partnG subjeee the epplicent to e �'rN penelly d iat mare ihen iNe �uMred tlal4n �55W11.
� I.esoxmrdthepopenyamymmWv�ea+Mhwapasmlheieoboompenamion.willEotMxak.eMtlrem Tneom�intandeE
a oNered la sab (Secuan ]OM. Busiro» eM PMaeevuCade: The Camreaan Lioenee law doea not epplyto en ownm d qopeM
rM buida or inpwe+lherean. end xfio doee euN xak Ivmmtl a MnM a Waph he a hsr own amCbRa*. pa'� �he wM
_ 'vnpiovemexa era nd imerdaE a Weeed ta eab. X.Iwwmer.IM WiNi�q a inqo.ernem u eotl xnhm me Y� d mmplation. iM
o.�e,��n« �;u na�e m. ww� a v���e na «.na ed �a w�u «�w� �w me wmo.a a.w�.
� I. ro owrer d �M O�P�Y. em ezduvvdY mn�red�q xnh licevad cannaciwe W cmmue the Mq� (Seaun ]011. Buemm� uM
Prduaiwu COCe: The Caufsfwe licenae Lew doee mi eGMY w an owrer d pW�Y who buiks or'unDp'�m iMrean eM who
canhMS br m�d� V4a� wilh e catlretla�elliceiueE O�ueM Io IM CONretlm Lioenfe lew).
❑ I em esamq uMer Sac�im: B. 8 P.C.,1« �hu reeaon:
Dme: O�n«
i do n.�nr �r inm i� a.� a�a �u�,a me �.w�� a cwo�,m �nn �e s.�r c�a s.am. usos. zssv..�w
25530, eM Me� I a enY �un WiNiiq ¢wpen� will / wll rM (tircb wro) naed to canpF/ wih eeN qPoe oodes eM tM reQuinmdNs /ar
eG�atacauwctionamadif�ianhwniMAi�IY eneC���0i9rip.Reaidmtielm�iuennePG�iauene*emplmmNme
pv+isia�e. ,
Dtle: �VW�
WOflKEq'S COYPENSATION OKLAR�TION: I heraby dfirm wdar pmMy d p'ryW ar d tM Idbvrirp Eedvalbm:
❑ �nev.,ne.amemlah.cenCcmeNoa,sen�iu.en:mumbr.ake�:canro�mian.e,no.�dedraMa.monarooa�n.lee«
Code. lor tAe pMamvKa d tM work la which Iliu pemiA u iaued.
❑ � new d.a .0 meimen ..Mw.� wmc.mmion rtw„enro. m mvurtee w sea:M 3l0o a m. �.ns ca.. b. �ne c«�wmenn d �ns
work Iw Mfiitli Nu permn e iaued. MY wa4ae' mmpenemion inararice urnar and pdicy numEer ere:
c�« GOLDEN EAGLE E}CPIRES
PdcyNumber. Nw�<i'35 = 6� 1 1/ 1 5/ 9 7
(Th� .mainn roed nw w rort�pbfae, w ro*�, o m. o,e hundne ema. mool d�.1
❑ I mrlly Uut in iM pMormerce d Rw wak br xfich �hu pertnn ia inued. 1 Mdl � empby enY Oe� ��Y �^� ^^ n to
becmie n+bl� �o �M xarMes' compensetion bvn d CWmda. ud e0ew Ne� J I ehadd bacane nApa �o tM wvMn'
canPe�bn D�+�e'vm d Sabn �>00 d iM lebar CaAe. I tlWl IM�/y'Q�\h comW xiN Nw pwieion�.
Om��t���l Morrau:'� w 1 —1
Wamlip: FeYun b ueun wortai m�ewtlon rov�rap� h un4nNl, md aIWI iub/�ef �n empl ro MMreI pxultlu uW
c�w nnu w ro a,s n�nd,.d rnou,.ne adw. fitW oaoA m seniwn ro ms co.t o� nmVMwwa m�w u vAvww ror �n
Sxtlon J105 0l tlro Lebor Cods, Inronst �� ettomsy'� lsu.
CONSTqUCl10N LQlOINO RGENCY: I MraEy eifiim uMm paneXy d pe�jury ihm tAxa e e ca�runbn kMi�q epency b ihe
peAwmerce d IM xak tor whirli tha permi u uwed (Setlion 309J. CM. GI.
LENDEP'S NAME:
LENDEN'S ADDFE55:
I cerlM ttut I heve reeE �he eGWiution erd pate Ihet Me ebo.e iMammion o conee.l e9na io romPN wn� M tlIY eM oouMYad'vwKee
eM stale kxs �dm'vq to driMip consin�mon end hmebY eWivrza �epasan�eVree dMa �Ly lo eNx upon tM ebwa�mentoned paperry
���°�'0�°� MIKE BURNS
�� � �_ Dme: ����1�(„
Sprw d Omier/ApanVApp&anUCont
(515f�6.WP1 Whee-Buiknp d Seiery: �reerFl�e: GeneiY-App��: Ank�imeni»:Oddarvo�Nwua
CITY OE' COSTA MESA — BUILDING PERMI'P
PERM NO: B 08142
PERMIT NO: H 081425 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF 6 REROOF W/COMP SHINGLES SQ FT: 4,000
CLAIM VALUE: 4,000.00 CALC—VALUE; 4,000.00 GROUP OCC: R—:1 /
COMMENTS: REROOF 2300SF RESIDENCE W/COMP SHINGLES
�trtf�at**atet�t*�**�t*f�ft*i�iti��t*�tit�tx�etat*x��t*�tatatatatat***x�*x�**it***it**ft**x�**�tatf�f�x�*at*****x�*�t�-�-*f�
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 HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGfIT: FT IN
PARKING REQ: PROV: PARCEL: 42229104 ZNE: REF NO:
PLANNING NOTES>
7 �
if if iE 1f 1f ik 1E 1E 1ElE 161E 1E 1E ff 1E 1E IE 1E 1E 1E 1ElElE IE �E 1E iE fE fE 1E 1E 1E 1E 1E i! 1E 1E 1k fE i! fE iE iF 1k 1F iF IklE 1E iF if if ik iE k 1E ib ik iE 3E IE IE !f 1F 1E 1E Ik if if iE fE if 1E if !E !f k K'
D E V 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 APPROVEU BY .
BUILDING APPROVEC� BY :
APPLICATION ISSUED BY
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 87.25
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 87.75 0.00 0.00
FIRE
TOTAL
87.75
DATE:
DATE:
DATE: ' �'. 31��
1fiElEiEfE1ElE1E 1FiE
STRUCTURAL SEGMENT:Y
SMIP/RES GRADING
50
SMIP/NON—RES
PAZD DUE
87.75 .00
REVENUE DIVISZON TOTALS--> COLLECTED: 87.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
87.25 ,50
1E 1E iElE 1f iE IE iE iE 1E iElb 1E if ik if 1E if ib 1k 1f iE iE if if IE if if 7f iF iE 1E 1E 1E IF iE IE if !b 1E IF 1F Ik 1E 1E iElF if iF iE 1E iE IE if 1f 1F IE 1Elf 1E iElE if ik iE IE 1E if fE �E 1E if i! 1f 16 iE �E If fk
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 4000 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 4,000.00
END OF FEES
01-31-1997/12:88 PM/f87.75
RCDTq:81—B881413
PERMIT:081425
n_.-�
CONSTRUCTION AND PLANNING P� & SPA
APPROVALS Permit # Date inspector qppROVAIS Permit # Date tnspector
1. Temporary Elecvical Service or Pole 52. Pool & Equipment Locacion
2, $oil Pipe-Undrgrntl. • - � 53. Steel Reinforcement
, 3. Electrical Conduit,Utility-Undrgrnd. 54: Forms
4. Electrical Conduit-Undrgrnd. ' 55. Electrical 8onding
� 5. Steel Reinforcement 56. Rough Plumbing & Pressure�Test
6. Electrical UFER Grnd. 57. APPROVALTO COVEft�GUNITE
7. Footings _. � - 58. Electrical Conduit-Undrgrnd.
8. Foundation �- 59. Gas Pipe, O Undrgrnd., Test
� 9. Water Pipe-Und[9rnd. - 60. Backwash Lines, P-Trep, O Undrgrnd. •
10. St�uctural Floor System 61. APPROVAL TO DECK �•
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final .
12. Sewer Cap " 63. Heater & Vent�Final
73. Roo� Drains 64. Plumbing SYstem � Final
74. flough Plumbin4 65. Electrical-Final
15. Rough Electrical�Coriduit , - 66. Solar System-Final
16. ROugh Electric Wiring 67. Fencing & Access Appro�al _..
17. Rough Wiring Sign 68, APPROVED FOR PLASTERING
18. Rough Electrica.L�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL '
19. ROugh Heatinq & Air Conditioning FIRE OEPT. REQUIREMENT
20. Rough Factory Fi�eplace �_ , ' APPROVALS- � Permit # .
21. Oucts, in Structure - � 70. -Underground Hydro
22. Ducis, Ventilatinj �� 71, Product Piping CGas [70i1
23. Gas Pipe-Rough & Test . - 72, Underground Flush.�
24. ROof Framing• � ' 73. Undergrnd.StorageTank �Gas OOiI
25. ROof Sheathing ' . 74. Overhead Nvdro -
26. T-Bar Ceiling (Structurali & Monocoat ` 75. Dry Chemical -
27. Frame and Flashing � • 76. Dry Sta�dpipe
28. LBthing&Siding '� _ 77: FIXEDSYSTEM�FINAL
�� 29. Insulation " -� - .' 76, fIRE PREV. FINAL �
- 30. DrYwall Nailing ' ' '� HEALTH DEPT. REQUIREMENT
31. P18ster Brown Coaf' � _ ' . J9. FINAL 1NSPECTiON � ,
32. Electricai Power Meter�Final �� 80. FOOD CERTIFICATE ISSUED
33. Final Electric. . , � Notes: . - ,
34. fitta{ Heating & Air Condiiioning � . - � . � . �-
35. Fina� Gas Pipe-Test �� � � -
36. Hood or Canopy � � � •
37. Fina1 Factory Fireplace � � � � -
38. Final Plumbing - �
39. WOter Seivice�Final �-
4�. Gas Service-Fi�al .
47. Solar pomestic•Fina� "- _ ' , - .
42. Backflow Preventer ' - ' • .
43. Backflow Irrigation " � ' _ �
44. Landscape Irrigation System �
45. Sound Attenuation � �
46. Ha�dicap Regulations �
47. FINALSTRUCTURE&BUILDWG _C�� -
'' /
48. FINAI. PLANNING r
49. Elsctric Release to Edison �
50. Ges Release to Southem Califomia Gae Cv � �� �
51. CERTIFICATE OF OCCUPANCY' -
No. Date
OWNER j-jA]i$OR ESIATES � DATE 6-16-55 �
JOBADDRESS 6lt9 Surf St. BUILDINGPERMITNO. �1'2
GENERALCONTRACTOR Dike & �ole�rove VALUE $ 8�����0� �
LOT %(j BLOCK TRACT 1986 Residence iSin�le)
CROUP I TVPE V ZONE iW FIHEDISTRICT �125
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR
pATE NUMBER
Footing Trench %"�Z �
Foundation Forms and Grade to Garage
Plum
Heating, Final //�
Suwer, House � Sewer, St.
Septie Tank or Cesspool
Lathing, In Out
Plastering
Plumbing, Final, Fixtures Com e1
Plumbina. Fin.al GasTest /(S �
OccupanCy {�-u/Q6 /� �
s,...... oi n r� v i cnn l A9
�^ Costa 1VYesa Bnilding Department �/ APPY.ICATION Y'OYt PEdZNIIT
� S COSTA ME A? CAL FORNIA �`t��. __� _B._U_I_L.D_,I� N G "'-- 9.
FOIZ APPd.ICAN� TO FdLL IN �OR OF&'ICE US� ONLY '
j Receipt No. Permit!No. '
Aadr�e5: 649 Surf 5t. � �:� �
Costa Mesa, California Rec,,,e�%ived b o Date Rec'd.��— e�� Date Issued �
Nearest �i'�-�li ' 6��6 —S J I �0��6��J 1
crossst. 419 �st 1%th Street e��id��9 ,
Address � �
Owner Harbor �states • Costa 1Vlesa, Catifornia �
Mail �
Address 47:9 East 17th Street Nearest -
Tel. Cross St. •
City Costa Mesa No.1+1.5—ZZS�I Zone' I No.of I Type I Gruup
Architector �,rlson & Middle&i¢aok Plans I � :
Engineer No, qpproved � � ,
by ' Date
Address Garden Grove ! � Q)ORYZECTIONS �
City Lia — -
Contractor Dike & Colegrove rvo. ]301 � �
Address 419 East 17th Street - ,
Legal Lot _ _ . , .�� , i
Deseription I No.�b I Block I Trect19$6 -, 1 L nc�
%�!�'�.
(Attach Metes and Bounds) - ��—ed
No. oT B�dgs.
Size of Lo4 6� X u� I Now on Lot none -- �-- —-- �
Use of I No.of No. of
� -e��� �
Existing Bldg. riORC , F,amiliesl I Roovys_5� - �
. __. _ .. . _ , - ..__ _' _' _ _ _' - . - - . . .. . _ _ _
Setback Line from Rear Vard - Z
Center of Street 5�� Side Yard 5� , _, y
D�+ SCILIPTIOlY OF WORK — — - �
New I X I Alteration I ! Adtlition I ' �
— , .....,. . . , ' " .,.. , _ ' . '
Repair I I Moving I I, Demolish I
'-i Building � No. of 1
Size 9%�- .�Q.�. Rooms 5� Storie5 1 —
Exterior Wall I Roof
Ccvering $tUCCO Covering COItlp� APPROVALS
USP of New
euilrling Single Fami].y Residence FoundaYion Location Inspectar D.ate
— — Forms, Materials,
Under-Pinning
J� G Frame: Fire Stops,
Bracing, Bolts
Lath.lnt.
I hereby acknowledge that I have read this Application
and state that the above is wrrect and agree to comply
with all Ci!y Ordinances and State I.aws regulating Lath. Ext.
builcling construction. .
Signature of Plaster, Int.
Permittee D1k2 &. COle T'O
� , Plaster, Ext.
Authorized Agt. "
Masonry Reinforced
Valuation Permit Fee $ �D . e o
Plan Check $ � p O Bond Beam
$ �� O G Feeal s � 3. �° FINAL
i.,...., �ne r._u �v v_zs
i
$how location and distances from
property line and between buildings.
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