HomeMy WebLinkAbout363 16TH PL - Building Permits"�d �'� .1�_,`� i0
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX �17 COHTA MBBA. CALIFORNIA
For Applitanf to Fill In Complefely
TYPE OR PRINT
BUILOING �/ ij i/� PL��i�� � R f.�[
A��RFAR _ G� ] �O
COBTA MESA. CALIFORNIA
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OF 8iDG8.
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BHT9�CK LINE FROM � n {
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/ / /
SIDE YARO LEFT S RIGHT b
DESCRIPTION OF WORK
� BUILDING i/ �, i NO. OF
Il�
AND
�EE R�CEiVED
3_�_ c� �� ��
fINANCE OEPT.
�j�y �� GOSTA MESA
AP I A ON FOR PERMIT
BUILDING
For Oifiee Use Only
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BUILDING � /3 Js / /� Qj �-
A�DRESS (</ Fs� G' ✓�
C05TA MESA, CALIFORNIA
APPROVED
LE�AL
NO. OF � I U8E OF NeW
PIJ�NB B1111DIN0
.S'
0
3-�
1 X¢PHBY ACKNOWLQDG¢ TMAT I NAVE RCAD THIB APPLJGTION 1NH AMOUNT BHOWN UNOEP VALUATION 18 FOR TH!
ANU BTATH THAT iH8 ABOVe 19 GOPRCCT ANO AOREB TO CON- p�ppOBE OP EBTABLI8HIN0 A PEpMIT FEE ONLY.
PLY WITH ALL CITY INANC66 AND ATH lA B li80ULATINO
HUtLDINo CONe 1 VALUATION
BIGNATURE O ` / ' PERMIT FEE S ��
PERMITTE . /�J 6 �� . �J rC n
S PLAN CHECK S � /
AUTHORIZED AGENT �` 5-e �
TOUL FEE 'J �� 4
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO% 917 COBTA ME&A. CALIFORNIA
For Applicanf fo Fill In Comple+ely
TYPE OR PRINT
BUILDING �J/ �j // � �Q�—
A��RE68 7 �O _J ��
COSTA MESA. CALIFORNIA
1 STATE
NO. OP BLDti9.
� BeTB�GK LINB FROM
DESCRIPTION O� WORK
NG
G W�"7�GG6 I COVERI!
BUIL�ING AND WORK TO BE
II HHRBBY ACKNOWLHDOC THAT 1 NAVB R6�D THIB MPLIGTION
AND BTATE THAT THB ABOV6 I6 CORRCFf ANO AOREB M COM-
PLY WITN ALL CIiY OINANC88 ANO 8�AT6 1.�}'/8 1i80ULATNO
BU�LOINO CONB�N./ /� I
'AUTHORIZED AGENT
—
�EE RECEI�ED
.3��-c��� s�,
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
P6CHIPT NO. P6P
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C05TA MESA. CALIFORNIA � ���
FIRE
ZONE
BYPROVED (
ZONE I NO. OF
PLANB
LEOAL % , �
6T. )
U8H OP N8W
BUILDINO .
� P' / / — � �
CG'
� -a--/.>o
TNE AMOUNT BHOWN UNOBR V�LUATION �B POR TH6
PURPOBH OP EBTABLI9HIN0 A PeRMIT F!E ONLY.
VALUATION �
7.p PERMIT FEE $ �
l 3 Co �/ a
e
S PLAN CHECK S / �
/ F
/�� ¢
TOTAL FEE y