HomeMy WebLinkAbout2673 HARBOR BLVD - Building Permits 33169.
c.. COSTA MESA BUILDING-SAFETY DEPARTMENT )UN 17-71�MS�OO 742 v****�O.00
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
. APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
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RECEIVE?B DA-TE RECEIVE
ISSUED DATE
ABUDIDLRDEINSSG K %3 "jn� b01c ] , -/9- 7/ 6--/7- V
OWNER - / X A-ef✓/4 5s A.P.NO./ 37_3 607-00Z_ PERMIT NO.
AMAIL
DDRESS 3/17E• `R-�c«Ar7- BUILDING a67 3 e4
ADDRESS
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BLOCK
d U CITY t G NOL-ZI 3 RACE LOTCJ
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z C CONSTRUCTION j ' NEW APD ALTER REPAIR (MOVING DEMOLISH
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co J ADDRESS ,r,I,I,��,,��((//pp VALUE J
nn m ARCHITECT / TEL. USE //,✓/41A $/ �
J < OR ENGINEER NO.
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cc ADDRESS
/� APPROVED /� `
W Z CONTRACTOR PArro 5; 6)kr,S, BY03 Z
(56,<+ -DATE L-I ���/
.7.J cc ADDRESS /ggc, O/ ?/Vfh /¢yo /
Lu W TELZONA NO.OF USE OF NEW
Z= CITY Gr Mr NO.d49.4e)✓ �� PLANS gm& BUILDING 7!/
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O.' STATEIC. CITY. YARDS BUILDING YARDSESAPPROVED
N(r LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
D 0 (FROM C/L STREET)
SIZE I NO.OF BLOCS.
OF LOT NOW ON LOT PONT ,_F41,A6 FT.
USE OF
EXISTING BLDG. A.SID i , FT. FT,
I— SIZE OF NO.OF
Z
Z NEW BLDG. ROOMS STORIES L.SI FT. FT.
Q EXTERIOR WALL ROOF
COVERING COVERING REA FT. FT.
• USE OF BUILD) G`AND WORK.TOB ERFORMED �/ DISTANCE BET. BET.MAIN&
y 7iPe/ N a /}U b•p A-� /`. 07 :r MAIN BLOCS. ACCESS.BLOCS.
Q VAR.# DATE
O ��A/072-2- A" C.U.P,# APPROVED
I— Y, APPROVE —/ �—I /
fn AY tS/ ler DATE
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UI hereby acknowledge that I have read this application and state
7 that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
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the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are In full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: u
CC
am exempt from the provisions of the State of California Business
and Professions Code,Di n 3,Chapter 9. VALUATION I^
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PERMIT FEE $/ / ni
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Signature ofl• ) m
Pennine I /$ ( ti0b)V PLAN CHECK $ �� E
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Authorized Agent /4/4t�— u.
TOTAL FEE $