HomeMy WebLinkAbout1033 WESTWARD WAY - Building Permits Y�JJ,['��t�' _.
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COSTA MESA BUILDING-SAY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
- APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Ink Cptly
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING )3 / � r�
ADDRESS slip
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r/ hA i_ HOWitr� ��+rS. N .?-O�t021G 3,a ERMIT NO.
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OWNER r� �� J
AMAILDDRESS 2 _.L /Jwi BUILDING taid
/`(/Q'W CtG3 1YADDRESS/ s-3 �'/ uln �rCITY NA ,sNozgs¢µll TRACT 6 Z•OILy�J,C7 BLOCK 120 ,
CONSTRUCTION i�i) / // NEW ADD ALTER REPAIR MOGI(J� 'DFMOLLSH
LENDER ftph-2 F
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BRANCH 5Asir caf
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ADDRESS �' V-LUE
ARCHITECT TEL. r / S
OR ENGINEER r • : es LAI -
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ADDRESS L!/�{'3 WQS I!li"r'(� /Y/ � ZONE TYPE GRO UP�jr
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APPROVED
CONTRACTOR �1i/Nekm- BY DATE
ADDRESS �,�y� {h�I
TEL. �7/J_ ' frLA � BUILDING EW
CITY NO.
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F• STATE CITY YARDS APPROVED YARDS APPROV
LIC. NO.262823 LIC.NO. MAIN BUILDING ACCESSORY BUI ING
1x1 SIZE ♦� NO.OF BLIrtS, (FROM C/ ST EET/�17
L OF LOT c.G NOW ON LOT 4 FRONT FTf/ FT.
Q USE OF
EXISTING BLD SLOE FT.
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Separate permits are required for L.SIDE 4A T. FT.
electric,plumbing and heating work. c22.57-T.
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[�r] REAR L� FT. FT.
[.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
3
GGI MAIN BLOCS.
/ ACCESS.BLOCS`.
..1DATE
`4 " r `.' I, i) C U.P,VAR.$'YZ z,-4 APPROVED ,J;J7-77
'>" �� I' .APPROVED T.
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• • • S•ECIAL REQUIREMENTS
oI hereby acknowledge that I have read this application and state n
IY that the above information Is correct and agree to comply with m
a• all laws regulating building construction, end I shall not employ
i
Z any person in violation of the workman's compensation laws of v
VA the State of California. ',/j
I hereby certify that I am properly licensed as a contractor under �/% SO. FT. � i • N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business sr
VALUATION PERMIT FEE $
and Professions Code, Division 3 Chapt r . in
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PLAN CHECK $ n
signature of o
Pormlttee S TAX S
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Authorized Agent TOTAL PAID S