HomeMy WebLinkAbout1877 SWAN CIR - Building Permits PROJECT ADDRESS: 1877 SWAN CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 052055
OWNER'S NAME: JONES WINDELL W •
ADDRESS: 1877 SWAN CIR PERMIT NO: B 052055 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
545-7421
7I.10BARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF 3000SF RESID & GARAGE W/SHAKES SQ FT: 4, 500
ADDRESS: UNIT:
CLAIM VALUE: 4, 500 .00 CALC—VALUE: 4, 500 . 00 GROUP OCC: R-3 /M-1
U PERMITTEE: LEE ROOFING OF COSTA MESA ( 714 )642-7223
ADDRESS: 1653 SUPERIOR COMMENTS: X •
CM CA 92627 ******sE********************+R******sE*sL*******sR***********x*N*+t*sr**********sE***st*
LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
700M of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 028751 STATE LIC.:3fj9686242r71-49
Date: 5-- — ` slgn '/ - MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: Thereby affirm that l have a certificate of consent toself-insureor a certificate of workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT I N
Compensation lgsp:apcq.ryq.ceTtllied appy thereof(Section 3800.Lab.Cl 6/30/91 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: atVV710 LS`J4 EXP.DATE: V
\ - COMPANY: USF&G CO. ARKING REQ• PROV: PARCEL: 13952415 ZNE: REF NO:
,,yy{{
Certified copy is hereby furnished. L'T Cenifi opy is filed with the city Building Division. LANN ING NOTES>
Date:�—/V —(7IAP prcan4J-t �—Q, — ************* ******************************************************at**********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E'.j. O P M E N T $ E R V I C E $ R E Q U I R E M E N �T $
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 California. ZONING APPROVED BY DATE: `.
Date: Signature: BUILDING APPROVED BY : DATE:
NOTICE:If.atter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor '
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• C i)— DATE; c-1J -I
which this permit is issued(Section 3097. Cw.C). ************** *******'*'N'********************************************** * *Yr**
LENDER: *******************************************************************JF***********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I 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 72 . 00 • ,50
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 70001 of Division 3 of the Business pLAN •
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE •
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 tote compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered toe sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . SO 0 .00 0. 00 72 . 50 145 . 00 —72 . 50
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through I '
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 72. 50 OVER/SHORT; 00
improvementis sold sale). one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
• for the purpose of 72 . 00 • 50
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business
❑ and Professions sdo Theh projects with
State contractor(s)
onlraseLaw doesprsuatoonhe Controf ctorsrty' abuildse .ol am aware
*******************************************************************************
and who contractsCo for he with a e Licence Law
awidoese not apply ttatoe Contractors'ofaprope'StatehLaw).uildseimproves thereon
aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8.P.C.
for this reason: TYPE QTY D' E S C R I P T I O N UNIT COST TOTAL COST
Date. Owner: SFR 4500 REROOF BY VALUE RESIDENIAL NOZONE 1,. 00 4 , 500. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES '
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 •
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
V//
Dale: Applicant
I hereby certify that I have read this applicationand state that the above information is correct.I agree to comply with all city and county ?,
ordinances and stale laws relating to building co auction and hereby authorize representatives of this city to enter upon the above-mentioned / '
property m[inspection purposes. )��
s-i N-r c /C CI 00087274—00007275 r� .,
Date: sgnam` DATE: 05/14/91 TIME: 11:54
Driver's License or Social Security e:
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONST$JCTIGai AND PLANNING - PO 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 Reinforcement
;;.``3°Electrical ConduitiUtility-Undrgrnd. ' 54. Forms
. -;4. Electrical Conduit-Undrgrnd. - • 55. Electrical Bonding
•3.5,'S?eel Reinforcement - 56. Rough Plumbing & Pressure Test '
-'.6. 'ElectricalOFERGrnd. 57. APPROVAL TO COVER-GUNITE
•
' ?•7: Footings r 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. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -
t
12. Se&er Cap 4 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 Electric'Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace 4 • - - z t ,APPROVALS ' 7-Permit # .
�
21. Dutts, in Structure, so - _ ,.. -`,70. Underground Hydro
22. Ducts, Ventilating „ '•`_ • , , . : `- ' ' ;71. Product Piping O Gas O:Oil .
23;Gas Pipe-Rough & Test ., . ; ,., 72. Underground Flush
24. RoOf Framing •� •737'Undergrnd'.Storage Tank'0Gas ❑Oil •
25. Roof Sheathing L ."• 5`��':Q� '74?Overhead"Hydroa. C
26. T-Bar Ceiling (Structural) & Monocoat - co ••--, '_a 1 75: Dry Chemical - .-- u
27. Frame and Flashing , 'I -1 3.- v 76: Dry Standpipe :>. _
28. Lathing& Siding - -- ] > it i •: Ir. ••i • • 777' FIXED SYSTEM FINAL •`
29. Insulation ---'. `. " • ,. 1 I ,. ' 78 FIRE PREY. FINAL a . 'I., -
'30. Drywall•Nailing aI 1• 1 - HEALTH'DEPT. REQUIREMENT
31. Plaster Brown Coat; - •-:. I I I. ` • 79. FINAL INS,ECTION :
:-32. Electrical Power Meter;Final - = ti I • :80.•,FOOD CERTIFICATE ISSUED
y.33..Final EI&ctric - ' ,v I , , ' Notes: ''
.34 _Final Heating& Air•Conditioning `': r �_ I �. Jr .z. 2: "'H
n
35.'f Gas Pipe-Test` x M !' ; ' •'' ''-
.Hood or Canopy xi - ' ,, y; - c _____I_____I,36.
37. Final Factory Fireplace, •;.r 1 T : „ ' .. `'.
T.
38. Final Plumbing r t
39. Water ServicerFinal` • -' n i ( , la r .-d - .
.,40. Gas Service-Final • s-'
-:41. Solar Domestic-Final- . . •' - _ I I !. . C.
42.�Backflow'Preventers , '1' , ' (, - ,1
43. Backflow Irrigation ' - -
,44. Landscape Irrigation System. ,. - _ _ - _ , _ � " _
o �_ er-
•45.-Sound Attenuation w • % -
46. Handicap,Regulations r of -
47.-FINAL STRUCTURE & BUILDING 5. I &pcti - t-»
48.- FINAL PLANNING `S - 1 : •
c 49..Electric Release to Edison . I o. •
50. Gas Release to Southern California Gas Co • 1 I j _ " • .
.51. CERTIFICATE OF:OCCUPANCY
No Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERM NO. TRACT NO. LOT NO. UNIT NO.
,'CITY-QF COSTA MESA CONSTRUCTION PERMIT, E c,c' 0
3 A.P.# Zone
Project Address 18 7 srt7A.'/ �'/12C LE `'/an - I ff � S Main Building: Accessory Building:
Applicant's Mailing Address S Ani a / TYPE OF CONSTRUCTION LI NEW U ADD H ALTERATION H REPAIR E Front Z
(/{/ .�s✓FS Phone ❑ CONVERSION D DEMOLISH ❑ OTHER T O
Owner's Name DL-'�t_ 74/2-/ DE,C IP 10 F WORK SE OF BLDG. B Rear - N
•Address _ . of RGCt • Y A A I
Arch/Eng. License No. TYPE O PERMITGRADING El FOUNDATION ❑ STRUCTURAL C Right, - G
N
Address - El TENANT Li;
q ELECTRICAL El PLUMBING El MECHANICAL $ Left R
Contractor's Name Phone
C7 'OTHER Ping. Ref.# Parking Req./Provided E
• PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes: M
CityAddLicensess e(mailing) o CONSTRUCTION TYPE VALUATION$City License No. ��� ZONE GRADING CU.YDS. ACRES T
LICENSED CONTRACTOR DECLARAT ON S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing ' Remarks:
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. . ELECTRICAL FEES
License Class License No.
Date Signature PLUMBING I FEES Automatic Washer Transformer D 15-50 KW
WORKERS'COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate •
of Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter Dup to 100 amps
3800, Lab. C.)
Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
U Certified copy is hereby furnished. Dryers ❑Gas DElectric Sub Panel
—
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant Fan Motors❑0-1 HP ❑1Y.-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U.
less). Inc.Solar 09-15 HP 016-15+
I certify that in the performance of th¢ 'k for which this permit is issued,I Fixtures
shall not employ an person in any e� 'ner so as to be bject to the Drinking Fountains Solar Tank Microwave
Workers' pensat' ws of Cali ia.
Date i9na a Device Boxes Pole Light
Floor Drains Swimming Pool w/Spa
NOTICE: per tioi g this declaration,youshouldbey^--- stIi to the
Workers' Compensation provisions of the Labor Code, you.must forthwith - Floor Sinks Urinal Outlets Range
comply with such provisions or this permit shall be deemed revoked.
- - .
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign ._
I hereby affirm that there is a permit
lending Sfor the performance
C.)
of the work for which this permit is issued (Section 3097 Civ. C.) ' Garbage Disposal Standing Sections
Lender's Name Interceptors Water Heater
Lender's Address • Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor,
-
I OWNER-BUILDER DECLARATION I "Pe4 s_/ L. 11 3o
I following
a rethat amon exempt from the Contractor's License Law for the Lavatories Auto-Wash Aa c"
county reason (Section t.t andBonnets , Professional Code: Any city or -
anynt whichrrequires a permitissuance,
c ,construct,alter,improve, t uc or repairP-Trap Laundry Trays
any structure, prior its that he/, also requiresicethe applicant for such ions permit
to file a signed statement hapte is pursuant to the provisions of Roof Drains '
the Contractor's License Law (Chapter 9(commencing with Section 7000) of Ir"-
Division 3 of the Business and Professions code) or that he/she is exempt Reinspection Fee ! $15 Issue Fee �-s -
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 -
I.E.EI, aof not more than five hundred dollars($500). 3 DEVELOPMENT SERVICES REQUIREMENTS:
I, as owner of the'property or my employees with wages as their sole ReinspectionFeed $15 Issue Fee $ Zoning Approved By Date
compensation, will do the work,and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved ByDat
License taw 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 ■ Application Issued By Date
employ�i.;, provided that such improvements are not intended or offered for Boiler
Hood or Type I sale. If,•M1owever, the building'or improvement is sold within one year of cam- Canopy Type II ■ SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
rove for the purpose of sale). BUILDING PERMIT $ SMIP $
-r. 0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural -
tractorsyr+construct the project (Section 7044,Business and Professions Code: PLAICHECK $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct,Ventilating ■s
I1huhu1I1Ihh1rhlhhIhhh1
PLU INC $ ISSUANCE $
builds or improves thereon.and who contracts for such-oroiects with a con- ENERGY P.C. $
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ PLAN CHECK 25% $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
IA am exempt under Section / B.& P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers "
/ %-�=t-/��� InC011ip IC lire" tof15 PLAN CHECK 50% $ MICROFILM $
Date _i /-�L'� t Ow - ' Heating System& Ducting Registers TOTAL FEE $ y'J�/
411110; MECHANICAL $ LI
,S-18(
hereby certif tha I have read this application an -. e above ❑0-100,000 BTU 0100,000 BT
information is correc . I agree to comply with all city and county ordinances sar■ __-- LAN CHECK 25% $
sen state to is elatingitto building construction, and hereby Guthgqq+++iz pre- ■. _ �
inspection
o his city to enter upon the above-mentioned y[Aper for
inspection poses, 7
bate
Reinspection Fee $15 Hue FeeIn
G R7 ODOC-1:'23-00049223 �"1]i Y •.I`
Drivers' License or 55 -__ �' (I GA'TF: Gd/2383 Y CJ , 7- —.l it
• l I1.. ia._t
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting: Goldenrod - Assessor
t
CONSTRUCTION AND PLANNING POOL&SPA •
APPROVALS Permit# Date Inspector APPROVALS Permit# ! ' Date Inspector
1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location s-}'
2. Soil Pipe-Undrgrnd. • _ 53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd. ,. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5"Steel:Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE •
].: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. 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 •
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring • 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL •
29. Insulation • 78: FIRE PREY. FINAL
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:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy •
37. Final Factory Fireplace
38, Final Plumbing
39. Water Service-Final •
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation •
44. Landscape Irrigation System E X P I_R E D
45. Sound Attenuation dile iripfete fllspections
46. Handicap Regulations Date _ , Sig �.e.
47. FINAL STRUCTURE & BUILDING -
48. Special Requirements Completed •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY ' I
No. • Date
Lot 68.
Tr. 5781 24089 CITY OF USIA MESA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.Box 317 COSTA MESA,CALIFORNIA MAY 11 1965
For Applicant to Fill In Completely APPLICATIONpgLIFOR PERM
TYPE`Q1 .PRINT IH,_J AU(AI J
BUILDING / a 77 4.--nil./A4/2 '
ADDRESS O RECEIPT NO. �4gwr-ryaL
COSTA MESA, CALIFORNIA I
RISC BY RLC[ D� DATE ISSUED
OWNER Pemba Subdividers, Inc. f O( 4 MAY 1 A IctS
BUILDING j '817 .SWAN C .
MAIL 2850 Mesa Verde Drive ADDRESS
ADDRESS
FIRE
CITY Costa Mesa NOL. 549039E ZONE TYPE GROUP 4-4+ .1
APPROVED
OR ENIGINEER E.G.Kaltenbach IT+o'547804C BY DATE
ZONING
ADDRESS 1823 E. 17th St. Santa Ana
Z N[ NO.Ora USE or NE al E illb Th. r
_ I I
PLANS.y BUILDING! /� I
CONTRACTOR Pemba Subdividers , Inc. V Y V� (/�� 1 1
LBSAL / _ T V.Q . � f /
ADDRESS 2850 Mesa Verde Drive D[EDRImoN 11`l/�) u
CITY Costa Mesa A.P.NO: '(jr
NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
C TNG, 187318 IT,IQ' 5490395 3O TO SIDE REAR PLL_
HAVES
SIZENO.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT 66x120 NOW ON LOT 0
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG,
r (FROM CC//L$TREE711
SETBACK LINE FROM p T t FRONT FT. V
cop FT.
CENTER OP STREET 28 REAR YARD 44 /
SIDE YARD I LEFT 10 t I RIGHT 6' R.SIDE iJ FT. FT.
DESCRIPTION OF WORK L.SIDE ,10 FT. FT.
NEW I MOVING DEMOLISH
ALTERATION ADDITION
REPAIR
REAR I cf FT. FT.
II' DISTANCE BET. BET.MAIN a
MAIN BLOBS. ACCESS.SLOGS.
VAR.# DATE
BUILDINGNO.OF
S ZE 50X49 ROOMS 12 STORIES 2 C.U.P. APPROVED
EXTERIOR WAA{, ROOF APPRO �J�//'�✓` �
.
COVERING I,LUC'CO COVERINGWoodShinglc BY DATE �� Q
USE OF BUILDING AND WORK TO BE PERFORMED
\ Single family residence with
attached garage
pi
� 5-7 2390 SQ.FT. �/D .. er
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 FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION et ('rU
BUILDING CONSTRUCTION. PERMIT FEE $ � ry
SIGNATURE OF
PERMITTEE 7,M24an'- J G
�/7 1
s 3 ) IA-C6 PLAN CHECK s
AUTHORIZED TOTAL FEE 5 / 17 2.