HomeMy WebLinkAbout1039 WESTWARD WAY - Building Permits (CPSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Corn etely — Use nk Only
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING(01 3i a
ADDRESS ((�/ ((((���//// / n �s yN
OWNER A.f.,.�.' ale„fro yQr 42I 0 `�0 f/D/z/V 0i PERMIT NO.
MAIL /I'' '' ,f� BUILDRNG10 q f � _ _hin / z v
ADDRESSZ4/90 W. t1/ El ADDRESS (��Ar] nf//Y r/-L/
TEL _ Ir. Oa //��
CITY Ng NO74¢5 .gg11, TRACT , ' /COCK
'
CONSTRUCTION // FeP NEW ADD ALTER REPAIR '• A• •FMOI LSH
LENDER as..•Z \ /
BRANCHSA
X /' / �'q /
/ JA ` l 011 er- /—Ti^e/
ADDRESS /-.i�`s t r/iiia O j E' '
VALUE
ARCHITECT4/ TEL -il__ 1rt.ni � /19%A $
OR ENGINEER C._ ��r •- 2'7 _
ADDR ESS2��s3 WAS fc t;41 r, /yB 4 n ZONE TYPEe�GROUP
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APPROVED
CONTRACTOR (9(§/ys eY BY DATE
ADDRESS n '
TEL. Z!.., L.J .OF USE OF N G✓
CITY NO. A i /. LANS BUILDING ' -
( , _ i -"
STATE CITY YARDS APPROVED YARDS ED
LIC.NO.Zg ge, Z LIC.NO. MAIN BUILDING ACCESS A. BUILDING
I (FROM Cl T- ET
W SIZE 0
L OF LOT S AG • I NONO.W OF ONBLDGS.LOT . RONT FT.
et USE OF
co EXISTING BLDG. R.SIDE 4. /r. FT.
Cl,
FSeparate permits are required for L.SIDE FT.
electric,plumbing and heating work.
REAR
',T. FT.
(. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CMAIN BLDCS. ACCESS.BLOCS. /
VAR.
:".1 � //77 dt !J C.U.P� 1 (p0 APPROVEDS/7_74
''' � /� BA]�'ROVEDn/. ' OPIl DATE f".2/':77 TT
.1 / 1`,rte///\ n'-
14
A.
o I hereby acknowledge that I have read this application and state N
[C that the above information Is correct and agree to comply with
m
G, all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of m
W the State of California. —1/
I hereby certify that I am properly licensed as a contractor under /3 y4 SQ. FT. J 43O— • N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR A
Chapter 9, and that such licenses are In full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business VALUATION et
and Professions Code,Division 3 Chap 9. PERMIT FEE § ro
PLAN CHECK $ r,)
Signature of O
Permittee $ TAX § u.
V
Authorized Agent TOTAL PAID $