HomeMy WebLinkAbout820 16TH ST - Building PermitsowNER �pp
JOBADDRE
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GROP. SWR. LINg � HOUSE CON
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MISCELLANEOUS
ROUGH NERTING AND �IR CONUIT
TEMPORRRV SERy�[E OR POLE
UNDERGROUN� [� POWEfi �
ROUGH WIFING
THENCHES �- FORMS ST
FLOON SYSTEM
1180ND BEAM [] STEEL HEINF
� SHE�THING
roFRAME AND FLR.^�HING
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BUILOING,FINA4
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REFRIG. ANO A.C., FINAL
ANO GAS TEST n
DATE
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING �� �{,(� _—F—`
ADDRESS -rt 1
OWNER OR
TENANT � D
MAILING ���� �i�
ADDRESS
�(� ('^ TEL.
CITY( aaY'TA- 1�/1l4CIl. NO.InLLC Z�
BRANCH
ADDRESS
ARCHITECT
CONTRACTOR
ADDRESS 2
CITV
F STATE
� LIC. NO.
[i,� SIZE � �
O. OF LOT
a USE OF
� EXISTING BLDG.
�
_ TEL.
CITV
LIC. NO.
INO. O LBF�DGS
NOW ON LOT
FSeparate permits are required for
� electric, plumbing and heating work:
�,W„ USE OF BUILOING AND WORK TO BE PERFORA
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3587 6/04/81 4G.22 TL
APPLICATION FOR STRUCTURAL PERMIT
RECENED B PERMIT �� ���
A.P. NO. 2 ^
BUILDING � /_
ADDRE55 C(J
UNIT OR
SPACE NO.
�R.NO.� LOT �n
i.r
NEW ADD ALTER REPAIR MOVING DE
APPROVEDSETBACKS
ION
DATE
VAIUE
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� 1 hereby acknowlatlga that I hava raatl this application antl state °�'
(� thai the abova information is correct antl agree to comO�V �'ith �
a all laws regulaiing building consttuction, and I shall not employ �
,'� any person-in violation of the workman's compensation laws of m
� the State of Celifornia. m
3 I hereby certify ihat I am prope�ly licensetl as a conbactor unEer SQ. FT. �
the State of Californi Busineu antl Professions Cotla, Division 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR ro
Cha r 9, and t ch licensas are in full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLv: �
am xempt from the visions of the e ot California Business VALUATION PERMIT FEE $ a
an ProfassionsCotla, i isio Chap r9. �n
m
Pign�rureof � (�' $ / �/..� �� TAX CHECK $ �1 �1 U
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1 �lJ O
Authorizetl ABent Date TOTA� PAI D S ���