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HomeMy WebLinkAbout3358 WISTERIA CIR - Building PermitsCITY OF WSTA MESA REQUEST FOR OCCUPANCY TRACT N0. "��� LOT N0. 1 1 �I ADDRESS ���� `-V �A,��-�-0. DATE �I`��]-wi 1 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) � (was or were) C�-k advised that this tcact has not been given fina \spection nor has it been accepted by the City of Costa Mesa as having complied with the conditiona of approvaS which were imposed by [he City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees [o indemnify and hold the City harmless from any claim reaulting in damage or pereonal injury to the undersigned by reason of the aforementioned uncompleted condition. RECEIVED CITY Of COSTd MESA Pi'.'INIYf UF.P7. JAiV 2� 1973 A� PM 7�8�9�ID�ll�12i1i2�3i4�5i6 � BY �G/ � �,�L/ `� � �� �c C. Purchaser BY L�r�,�C� � C�� �G���iv Developer and/or auchorized zepresentative BY .i%GcCCC�� /1c��Ir,� Lender Z . ww a c� z za O u~i am J 7 J N Q W p] J J m a U N Za W � aW WZ J Q m Z J � ww � _ z� w� 70 F z a U J a a Q 0 H N z 0 H U � � H y z 114 .S 5 J COSTA MESA BUILDING-SAFETY DEPARTMENT ilARP•O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicanf to Fill in Comp/etely BUILDING � � �� ADORESS Wisteria Circle P.UG 15-7?Pa�oO01062'� *�*126.05 CP15p ;ATION FOR BUILDING PERMIT BV D'lE2/'IV�� DATF IS�UI /7 !1 OWNEF LarwinSouthern Calif., II1C. A�P�NO. MAIL BUILDING ^� ADDRESS 16255 Ventura BZVC�. ADDRESS J��� No.`986-88� TRACT �71� LOT arv Encino, Calif. CANSTRUCTION � LENDER Larwin Southern Calif. BRANCH 16255 Ventura Blvd. ADDFE55 Encino, Cdllf. ORENGINE R Larwin No�273-44 ADDFESS 9100 wilshire,Beverly Hil CONTFACTOR Larwin Southern Calif • ADDRE55 ],Fjzrj�j Ventura BIVC�{. TEL. c�rv Encino, C�l.i£. No.986-88 l C NO. 1(�13�.�. LICYNOB-1 S12E � NO.OF BLDGS. OF LOT GO X LOO I NOW ON lOT O USE OF EXISTING BLDG. SIZE OF NO. OF NEWBLOGL�F3G ROOMS STORIES L E%TERIOR WAL ROOF ' COVERING �tllCCO COVERING Wd. Shing USE O�G AND WOFK TO BE PERFORMED I hereby acknowletlge that I have reatl this application antl state ffiat ffie above information is correct and a0ree to comply with all laws regulating builtling construction, antl I shall not emplay eny person in violation of the workman's campensation laws of the State ot California. I hereby certity t�at I em properly licensetl as a wntractor untler the State of California Business entl Professions Code, Divisicn 3, Chapter 9, antl that such licenses are in �ull force antl effect, or I am euempt trom the provisions of the State of California eusinass and Professions Code, Division 3, Chapter 9. Sipnature ot �,�/� Permittee �'�1'/L9f-� D. DOW[1S Authoiizetl ABent OWNER �./�f'%� s Es /�, FIRE ZONE T APPRO BV 20NE NO.OF 'Q PLANS VARDS APPROVED MAIN BVILDING (FROM C/L STREET) DI5TANCE BET. MAIN BIOGS. V AR. #` 0.U.P. # APPROVED 1. //_� VALU$ C7lr BIOCK VARDSAPPROVED DATE /.7 U m b SQ. FL -� o THE AMOUNT SHOWN UNDER VALVATION IS FOR � THE PURPOSE OF ESTABLISHING A PERMIT FEE ONIV: m ¢ VALUATION � � PERMIT FEE $ � J m $ �DQ • P�pN CNECK $ ' E � `o LL TOTAL FEE $