HomeMy WebLinkAbout1067 WESTWARD LN - Building Permits 969 /
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use I my
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING
ADDRESS D` vV�/Ar, / / /-mss
/ .ie - //4/ ��. ��Wi/�d/�D.�r Q'g PERMIT NO.
OWNER (/�J_rW.vr'jGJ/ A.P. O. 'Xh7�
MAIL nn orf BUILDING
ADDRESS 6 a -y 42711.W.0' ADDRESS jno, 7 lidi � 1J.
CITY 0+ j3 NS. � , . TRACT i Tj LO /01• aOa "CK
CONSTRUCTION 42 7 tJ EW ADD ALTER REPAIR MOV . �e MOLISH
LENDER
BRANCH 4 A.
ADDRESS iT ,*y�,s--. OWNER J �/VA �Q/`�
ARCHITECT ��((,,,, A '11444_,...? USE e ,I1�/{, �/ {✓$
OR ENGINEER /.L tV I S-r
�-/ FIRE
ADDRESS 244—; -'NQ �B ZONE TY CROUPY
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APPROVED
CONTRACTOR dir.t7. AL." BY DATE
ADDRESS `� '
TEL. (/J',Jsj� �s�NO.OF /f USE OF NE �.ar AI
CITY NO. /�[` —>/r//PLANS L-BUILDING
F STATE CITY »' 111���YARDDSS APPROVED/` YARDS APPR ED
LIC. NO. 6 T.82.3 LIC.NO. MAIN BUILD!ppppppIIIIG ACCESSORY B ILDING_
W SIZE �1 NO.OF BLDGS. (FROM C/L S
O. OF LOT c.4 NOW ON LOT 0 FRONT 4 T. FT. _
Q USE OF
Vl EXISTING BLDG. _R.SIDE 3 34)e4- FT.
LC
F Separate permits are required for L.SIDE he, FT.
electric,plumbing and heating work.{dzlREAR FT.
k USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& •
Q MAIN BLDGS. ACCESS. BLDGS. .
ED
VAR.sW DATE tea/
Q 2- 66444, friA C.V.P. //�Qj �D� APPROVED 1
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Y ROVEOr�IC/,l— SATE J -I / 7
z -TOLD FOR SPECIAL REQUIREMEN15
a
0 I hereby acknowledge that I have read this application and state n
ed that the above information Is correct and agree to comply with a
(3i• all laws regulating building construction, and I shall not employ
Z any person In violation of the workmen's compensation laws of
W,
= the State of California. , 10 t�
I hereby certify that I am properly licensed as a contractor under Q SO. FT. 5 , a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
ID
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ `t
and Professions Code, Divisio ,Chap yr 9. n
1
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Signature o I` / PLAN CHECK $ — LL
Permittee ��%. . ��`4..s. - $ TAX $
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Authorized Agent TOTAL PAID $