HomeMy WebLinkAbout766 WESLEYAN BAY - Building PermitsME�/ 8 70 72 -zq
COSTA MESA BUILDING -SAFETY DEPA T T DAPI/LICATIONFORSTRUC`fURALPERMIT'-I TL
P.'D. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely - Use Ink Only
BUILDING
A J9.NO�Qs%/�Op�O //d"el!v .`E -
ADDRESS Tract 10626
BUILDINGOWNER
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TENANT M.D. Janes CO., Inc.
ADDRESS
b
UNIT OR
MAILING
ADDRESS 2950 Airway Ave., D-9
SPACE NO.
TR.NO. LOT
BLK.
TEL.
CITY Costa Mesa No. 979-3376-
17/1
NEW ADD ALTER IREPAIR
MOVING DEMOLISH
CONSTRUCTION
LENDER Not selected
BRANCH N/A
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OWNER R'Ve-� rf-b-
ADDRESS N/A
VALUE
ARCHITECT TEL.
USE
E
OR ENGINEER Dan' 1'51116-3691�y/J�
3 2
3
V ��
ADDRESS 3848 Cam
ZONEr /� TYPE
GROUP ✓
APPROVED
CONTRACTOR Owner
BY
DATE
ADDRESS Q
TEL.
CITY a NO. e
STATE CITY
APPROVED SETBACKS
LIC. NO. 6 LIC. NO. e
SIZE NO.OF BLDGS.
(FROM C/LST T
OF LOT 550' x 3341 NOW ON LOT A
FBM
USE OF
N/A
EXISTING BLDG.
FT.
Separate permits are required for
L. SIDEFT.
electric, plumbing and heating work.
REAR IF FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
ACTIIOON
r /'a / 14
DATE
2
An"
APPROVED
APPR
2 —lel—
I hereby acknowledge that 1 have read this application and Rate
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and affect, or I
am exempt from the/provisions of the State of California Bysiness
and Professions Cotl Divisign3, Chapter 9.
Signature of
Permittee
or
Authorized Authorizetl Agent e
' THE AMOUNT SHOWN UNDER VALUATIONIS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE GNLY:
VALUATION I PERMIT FEE E
PLAN CHECK 6 5d
$ Sd /pCrU' TAX f
TOTALPAID S