HomeMy WebLinkAbout782 WESLEYAN BAY - Building Permits�
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COSTA MESA BU" 71NG-SAFETY DEPART�EN� pPP! ',TION F9R�'CRl3i'fd�L PERMIT�2�. 97 7 i
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For Applicant to Fill in Completely — Use Ink Only
ADIDRESS L�Z A..NO. G�"''—ORI�� O��'F�Z IZI Z
OWNEROR qDIDRE55 le �lM;ra 8
TENANT M.D. Janes Co. Inc.
MAILING UNIT OR
SPACE NO.
ADDRE55 2950 Airwa Ave. D-9 Tp,�po ).� / LOT BLK.
ciTv Coata Mesa No� 979-3376 �ot.�->
COKSTRUCr10N NEW ADD LTER REPAIR MOVING DEMOLISH
LENPER [f0 elec 0d
BRANCH N A
OWNER
ADDRE55 VALUE
ARCHITECT TEL. VSE E
OR ENGINEER — T/
ADDRESS ZONE � TYPE V GROUP /� �+
APPROVED
CONTRACTOR gV DATE
ADDRESS e
TEL. �
CITV e NO.
r.F+ STA7E CITV APPROVEDSETBACKS
LIC. NO. Q LIC. NO. A
g,� SIZE NO.OF BLDGS (FROM C/L STflEET)
a OF LOT Q� x 334 � NOW ON LOT e RONT
� USE OF
,��, EXISY�NG BLDG. "
I
�
F Separate permits are required for • �. sioe r.
� electric, plumbing and heating work. qEAR FT.
� VSE.PFHU�tDING�AND WORK TO BE PERFORMED ��,4NNING ACTION
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pI heroby acknowletlBe that I heve reatl t�is epplication antl state �
� that ihe ebova informetion Ia correct entl apree to comply with
a all IaWs repulating builtling eonstruction, antl 1 shell not employ
z any Oerson in violetion Of the workman's compansation laws of
Sthe Siate of California. ? (d� f
� I hereby certify that I am properly licensatl as a contractor �nder SQ. FT.
t�e S[ate oi Calitamia Business antl Professions Cotle, Division 3, THE AMOUNTSHOWN UNDER VALUATION IS FOF
CM1epter 9, entl tM1et mc� licansas ere in full force antl effect, o: I THE PUFPOSE OF ESTABLISHING A PEFMIT FEE ONLV:
am exempt from th' p�ovlsions of the Stete ot California Businen VAI,UATION
and P�oiessions Coy , Div�siv� 3, Chapter 9. PERMIT FEE S
Signaturaoi / / —' / PLANCHECK b ��� L��j
Perml�tee �% � SLGSR �"�D'�� TAX S �
or � �
AuxnorizatlAg _ te R�17�7Q TOTALPAID S�,�S
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"� COSTA MESA B°��`<�r:�31NGSAFETY DEPARTME�APpL,..ATION FOR STROCTURAL PERMIT
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RECEIVEDBV PERMIT �
For Applicant to Fill in Completely — Use Ink Only
BUILDINY� i A.V. NO.
ADDRE55 G+
BUIl01NG
OWNER OR ' I ADDRE55
TENANT
MAIUN VNIT OR
ADDRE SPACE NO.
TR.NO. LOT BLK.
TEL.
CITV NO.
COf�bT ON NEW ADD LTER REPA�R MOVING DEMOLISH
LENDE
BRANCN
OWNER
ADDRESS VA�VE
ARCNITECT 7EL. USE 5
OR NGINEER
ADDRESS ZON TVPE GROUP
APP � �/iL �
CONTRACTOR BV DATE %
ADDAESS
TEL.
CITY NO.
STATE CITV APPROVEDSETBACKS
�IC. NO. LIC. NO.
512E NO.OF BLDGS (FROM C/L STREET)
OF LOT NOW ON LOT ONT FT.
USE OF
EXISTING BLDG.
Separate permits are required for L SIDE Fr.
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PIJiNNING ACTION
DATE
APPROVED
APPROVED
I hereby acknowletlBe thet I hava reatl this eppli�ation antl rtate °�
n
t�at xhe ebova Informetion is corrocx entl apree to comply wlth �
all laws repuiating builtlinp construction, antl I z�ell not amploy �
any person in violation of t�e workman'a compensation laws of
Me Siate of Celitornie.
m
I �eraby certify that I am properly licansed as e contrector under SQ. FT. �+
tne Stata o1 Califor ia Businass antl Proleulons Cotla, Division 3, THE AMOVNT SHOH'N UNDEF VA�UATION IS FOR m
C�apter 9, antl t� such licances ere In full force antl eftaci, or I THE PURPp6E OF ESTABLISNING A PERMIT FEE ONL�: �
am exempt from e orov' ons of the State of Californie Business VALUATION PE0.MIT FEE S / �
antl PYote55iOnS ' n J, C�apte� 9. {�•QO m
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Sipna2ura o PLAN CHECK y o
Pe�mlttee 5 TAX S LL
or � �
Authorizetl nt Date M U
TOTALPAID SIb •W