APP' 'CATION FOR BUILDING PERMIT CITY JF PACIFIC GROVE DATE 2-L 7 -80 PERMIT NO../ / .2 ASSESSOR'S NO. 4-4 42-9 TRACT,>74· ,€4¢I ef Location Of Work 4 i o (Jain u 4 \-O\ /0. /3./4 Block Al f 71 - ID Owner *f,44.-, 9LW7-G e- 3-LA·yA--e Gr.53, Address Phone 44 6- 9/ 74 Contractor 04.961 6 r Address Phone Eng./Arch. Oct ,Mey Phone Art,-Ir*qq Financed by E-740. p. r VALUATION RECEIPTNO. STORIES TYPE SITE DIMENSIONS & AREA 1 OWNER BUILDER SURCHARGE <*39, ooe€m A SURCHARGE OF FEES SET BACKS IN FEET COVERAGE DATA 10% OR'$3.00 PERMIT i 1€'7 F FRONT St DE SIDE REAR ALLOWED WHICHEVER IS Vy' EXISTING GREATER IS PLANCK. j -Q 2 - REQUIRED BECAUSE SUB-TOTAL , - FIRE ZONE USE ZONE BLDG. TYPE NEW OF THE INCREASED SMIP 2-1 -0 .S P b TOTAL NUMBER OF 2 22 4 PENALTIES INSPECTIONS TYPE IMPROVEMENT NECESSARY ON OWNER TOTAL 1 g /9 * O BUILD O REMODEL ADD TO ¤ REPAIR ALTER ¤ MOVE Q DEMOLISH OTHER BUILDER PERMITS DESCRIPTION OF WORK AUTHORIZED DVWY. PERMIT NO. ELE CONTR. MECH. CONT. PLUMB. CONT. VARIANCE NO. DATE ARCHITECTURAL APPROVAL NO. DATE USE PERMIT NO. DATE TREE PERMIT NO. CURB GUTTER & SIDEWALK PERMIT NO. EXPIRATION OF PERMIT THIS PERMIT EXPIRES IF THE BUILDING OR WORK AUTHORIZED HEREIN IS NOT COMMENCED WITHIN 1 DAYS FROM DATE OF APPROVAL, OR IF WORK IS SUSPENDED FOR A PERIOD OF 120 DAYS OR ABANDOND AFTER EXPIRATION. THIS PERMIT MUST BE RENEWED BEFORE THE WORK MAY BE COMMENCED AGAI Warning: Trees on the streets of Pacific Grove are public property and under Ci control. Permission to remove trees may be obtained only from the City. This permit does not Include any signs or Ilood lighting GRADE LINES AS SHOWN ON DRAWING ACCOMPANYING THIS APPLICATION ARE ASSUMED TO BE CORRECT IF ACTUAL GRADE LINES ARE NOT THE SAME AS SHOWN. REVISED DRAWINGS SHOWING CORRECT GRADE LINES, CUTS AND FILLS, TOGETHER WITH COMPLETE DETAILS OF RETAINING WALLS AND WALL FOOTINGS REQUIRED MUST BE RESUBMITTED TO THIS DIVISION FOR APPROVAL IN CONFORMITY WITH THE PROVISIONS OF SECTION 3800 OF THE LABOR CODE OF THE STATE OF CALIFORNIA, APPLICANT SHALL FILE WITH THE BUILDING INSPECTOR THE CERTIFICATES, DESIGN- ATED IN (1) AND (2) BELOW AND/OR SHALL INDICATE ITEM (3), (4), OR (5) WHICHEVER IS APPLICABLE. (1) CERTIFICATEOFCONSENT OF SELF-INSURED ISSUED BY THE DIRECTOR OF INDUSTRIAL RELATIONS (2) CERTIFICATE (OR EXACT DUPLICATE COPY) OF WORKMEN'S COMPENSATION INSURANCE ISSUED BY AN ADMITTED INSURER. A THIS APPLICAZION BECOMES A SUAJBnip•11 WHEN PROPER(yFILLED OUT, SIGNED BY APPLICANT AND APPROVEDS:30°ING Ullu v 11 Application Aoo,6; //-c 7£-*V* ING INSPECR THE ABOVE APPROVAL GRANTS PERMISSION Td' DO THE WORK COVERED BY THIS APPLICATION IN ACCORDANCE WITH PLANS AS APPROVED AND All APPLICABLE COUNTY AND STATE ORDINANCES, REGULATIONS AND LAWS GOVERNING LOCA- TION, CONSTRUCTION AND OCCUPANCY OF BUILDING. O (3) THE COST OF THE WORK TO BE PERFORMED IS $100 OR LESS. M.(4)1CERTIFYTHATINTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED THAT I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. O (5) 1 CERTIFY THAT THE APPLICANT IS LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING AT SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND SAID APPLICANT'S CALIFORNIA STATE CONTRACTOR'S. HALF DAY NOTICE IS REOUIREO FOR ALL INSPECTIONS LICENSE NO /1 m ASSIFICATION IS IN FULL FORCE& EFFECT. APPLICANT'i. C V I AL'·A.1.4 Q SIGNATURFV[ 06€·rt , OCR Text: APP' 'CATION FOR BUILDING PERMIT CITY JF PACIFIC GROVE DATE 2-L 7 -80 PERMIT NO../ / .2 ASSESSOR'S NO. 4-4 42-9 TRACT,>74· ,€4¢I ef Location Of Work 4 i o (Jain u 4 \-O\ /0. /3./4 Block Al f 71 - ID Owner *f,44.-, 9LW7-G e- 3-LA·yA--e Gr.53, Address Phone 44 6- 9/ 74 Contractor 04.961 6 r Address Phone Eng./Arch. Oct ,Mey Phone Art,-Ir*qq Financed by E-740. p. r VALUATION RECEIPTNO. STORIES TYPE SITE DIMENSIONS & AREA 1 OWNER BUILDER SURCHARGE <*39, ooe€m A SURCHARGE OF FEES SET BACKS IN FEET COVERAGE DATA 10% OR'$3.00 PERMIT i 1€'7 F FRONT St DE SIDE REAR ALLOWED WHICHEVER IS Vy' EXISTING GREATER IS PLANCK. j -Q 2 - REQUIRED BECAUSE SUB-TOTAL , - FIRE ZONE USE ZONE BLDG. TYPE NEW OF THE INCREASED SMIP 2-1 -0 .S P b TOTAL NUMBER OF 2 22 4 PENALTIES INSPECTIONS TYPE IMPROVEMENT NECESSARY ON OWNER TOTAL 1 g /9 * O BUILD O REMODEL ADD TO ¤ REPAIR ALTER ¤ MOVE Q DEMOLISH OTHER BUILDER PERMITS DESCRIPTION OF WORK AUTHORIZED DVWY. PERMIT NO. ELE CONTR. MECH. CONT. PLUMB. CONT. VARIANCE NO. DATE ARCHITECTURAL APPROVAL NO. DATE USE PERMIT NO. DATE TREE PERMIT NO. CURB GUTTER & SIDEWALK PERMIT NO. EXPIRATION OF PERMIT THIS PERMIT EXPIRES IF THE BUILDING OR WORK AUTHORIZED HEREIN IS NOT COMMENCED WITHIN 1 DAYS FROM DATE OF APPROVAL, OR IF WORK IS SUSPENDED FOR A PERIOD OF 120 DAYS OR ABANDOND AFTER EXPIRATION. THIS PERMIT MUST BE RENEWED BEFORE THE WORK MAY BE COMMENCED AGAI Warning: Trees on the streets of Pacific Grove are public property and under Ci control. Permission to remove trees may be obtained only from the City. This permit does not Include any signs or Ilood lighting GRADE LINES AS SHOWN ON DRAWING ACCOMPANYING THIS APPLICATION ARE ASSUMED TO BE CORRECT IF ACTUAL GRADE LINES ARE NOT THE SAME AS SHOWN. REVISED DRAWINGS SHOWING CORRECT GRADE LINES, CUTS AND FILLS, TOGETHER WITH COMPLETE DETAILS OF RETAINING WALLS AND WALL FOOTINGS REQUIRED MUST BE RESUBMITTED TO THIS DIVISION FOR APPROVAL IN CONFORMITY WITH THE PROVISIONS OF SECTION 3800 OF THE LABOR CODE OF THE STATE OF CALIFORNIA, APPLICANT SHALL FILE WITH THE BUILDING INSPECTOR THE CERTIFICATES, DESIGN- ATED IN (1) AND (2) BELOW AND/OR SHALL INDICATE ITEM (3), (4), OR (5) WHICHEVER IS APPLICABLE. (1) CERTIFICATEOFCONSENT OF SELF-INSURED ISSUED BY THE DIRECTOR OF INDUSTRIAL RELATIONS (2) CERTIFICATE (OR EXACT DUPLICATE COPY) OF WORKMEN'S COMPENSATION INSURANCE ISSUED BY AN ADMITTED INSURER. A THIS APPLICAZION BECOMES A SUAJBnip•11 WHEN PROPER(yFILLED OUT, SIGNED BY APPLICANT AND APPROVEDS:30°ING Ullu v 11 Application Aoo,6; //-c 7£-*V* ING INSPECR THE ABOVE APPROVAL GRANTS PERMISSION Td' DO THE WORK COVERED BY THIS APPLICATION IN ACCORDANCE WITH PLANS AS APPROVED AND All APPLICABLE COUNTY AND STATE ORDINANCES, REGULATIONS AND LAWS GOVERNING LOCA- TION, CONSTRUCTION AND OCCUPANCY OF BUILDING. O (3) THE COST OF THE WORK TO BE PERFORMED IS $100 OR LESS. M.(4)1CERTIFYTHATINTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED THAT I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. O (5) 1 CERTIFY THAT THE APPLICANT IS LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING AT SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND SAID APPLICANT'S CALIFORNIA STATE CONTRACTOR'S. HALF DAY NOTICE IS REOUIREO FOR ALL INSPECTIONS LICENSE NO /1 m ASSIFICATION IS IN FULL FORCE& EFFECT. APPLICANT'i. C V I AL'·A.1.4 Q SIGNATURFV[ 06€·rt , Heritage Society of Pacific Grove,Historical Collections,Historic Properties of Pacific Grove,Walnut,410 Walnut,WALNUT_161.pdf,WALNUT_161.pdf 1 Page 1, Tags: WALNUT_161.PDF, WALNUT_161.pdf 1 Page 1