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HomeMy WebLinkAbout1058 WESTWARD LN - Building Permits _ __ . . 4;6 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely— Use Ink Only APPLICATION FOR STRUCTURAL PERMIT rat � RECEIVED BY DATE RECEIVED DATE ISSUED ADDRBUILDING Lc ADDRESS / y ✓. �� 0�(��'•�'�O7PERMITNO.OWNER ��MAIL ADDRESS 2, /`�J6!/,TEADDRTsyic: 58 // /op/y5 tnelLi CITYAV/ `/ • NiL - TRACTS nr 1 'LDT/O~- B • CONSTRUCTION/ ' n /--/-�� P1�iry- ADD ALTER REPAIR MOV e DEMOLISH LENDER Lisa- ` .Y.Uf Alt Q, //�/ BRANCH J'•(�`�-�/ ALI�M��/ //eainie- ADDRESS J I7 li l�l t OWNER I VALUE ) ARCHITECT �(ry TE /-� S en, �� / r// A, $ 1 ADDRESS ER////JJ(J //// �� - '// ,N1e1ioIRE � /rFr -4J/ ///.E,121J ZONE TYPE / GROUP 1 '���/!!G//.� APPROVED CONTRACTOR ../ BY DATE [_/ ADDRESS r -, TEL. `���/(tr�t' O.OF USE O CITY NO. A � Pj BUILDI G Mi•y� STATE //77 CITY - YARDS APPROVED YARDS APP ED E LIC. N eeeepz kz LIC.NO. MAIN BUILDI G ACCESSORY ILDING ir W SIZE 11.. NO.OF BLDGS. (FROM C/ R- //s C. OF LOT NOW ON LOT O FRONT i v r Ana_ a USE OF �t / co EXISTING BLPG. &IDE �tJFT.(/.% •. FT, CC F Separate permits are required for L.SIDE FT. Ci electric,plumbing and heating work. REAR r. FT. (W., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ` -eCQ I ' MAIN BLDGS. ACCESS. BLDGS. DATE C URP# ,. - APPROVE. APPOr ROVED/�Q�t// Al/ _- /-21—..77/ 7 W HOLD FOR SPECIAL REQUIREMENTS 0 I hereby acknowledge that I have read this application and state n g„ that the above information is correct end agree to comply with m :LI all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of a W the State of California. I� I hereby certify that I am properly licensed a a contractor under , SO. FT. ���3D•. [LR+ N the State of California r sl -ss and Professi• s Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, a_Ad.t s P enses are In full arca and eff- t,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt fr' •r• 'sions •. the Stat of California tuskless a VALUATION PERMIT FEE $ and Professions ' •••, •�n n ,Chat- m �,�, / PLAN CHECK $ rg o Signature of o U. Permittee - $ TAX $ 2 U U Authorized Agent TOTAL PAID S