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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.o. BOX 7200 COSTA MESA. CALIFORNIA 92626
Nov 18-6�'—°00 82ox ��� 312.75
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ForApplica�.t.to Fillin Completely APPLICATION FOR BUILDING PERMIT
RECEI V D TF,.fiE/Elp p D FE SUE
BUILDING ���z> � �!����j�
ADDflE55 �
OWNER
Fair Harbor, Co. A.P.No. 141-491- 4 8� 5 PEpMt( A�
.. � eu��o�r,c ' l0/-1o�j
MAR �Y ^'�i ?�.. „�!:.f F��v? � ADDRESS
ADDRESS
TEL. TRA LO BLOCK
CITV �� NO.
CONSTRUGTION W A
LENOER
BRANCH .
OWNER�
ADDRESS VALUE
ARCHITECT TEL. 5 $
OR ENGINEER
FIqE
ADORESS ZONE TVPE GROUP
APPROVED
CONTRACTOR BV DATE
ADDRESS
TEL. Z E NO.OF USE OF NEW
CITV NO. �
PLAfS BUILDING
STATE CITV �'ARDS APPqOVEO VARDS APPROV D
LIC. NO. LIC. NO. MAIN BUILOING ACCESSORY BUILDING
SIZE NO.OF BLDGS. (FROM GL STREET) "
OF LOT NOW ON LOT R M FT. FT.
USE OF � �
EXISTING BLOG. FT
SIZEOF — X NO.OF �� ���
NEW BLDG. y � �AOOMS STORIES 2 L SID �
EXTERIOR WALL ROOF
COVERING COVERING ' REAR FT. �. �� FT.
VSE OF�BVILDING AND WORK TO BE PERFOFiMED DISTANCE BET. BET. MAIN &
�LL . H O Y5. MAIN BLDCS. ACCESS. BLDGS.
� VAF. � DATE (�
C.U.P.3W ' APPROVED I�' � � a
,�Ao� 9- 6
N
I hereby acknowlatlga that I have raed this epplication antl stete
the[ [he above intormetion is eOrrect antl apree to comply with
all lews reBulating builtling conatruction, antl I shall not employ
any Oerson in violation of the workman'a compansation laws of
the Stete of Celifomie. ,y
I hereby certify that 1 em properly licansetl as a conbactor untlar U SQ. FT.
the Stete of Cal(lornie Business entl Profeszions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOF
Chaptar 9, and t�at such licanus ere in tu�l torce antl affect, or I THE PURP06E OF ESTABLSHING A PERMIT FEE ONLY:
am exempt trom the provisions of the Siate of Celitornie Business yp,LUATION � Q
antl Protessions Cotla, Division 3, Chepter 9. ��.-yy�r��() PERMIT FEE $ 2�L/���
SiB�ature of � „ � y�„ �?
Parmlttee � ��V��"�� ��� § , PLAN CHECK S /� � �
Authorizetl ABeni ^
�% TOTA� FEE S �IoC�
OWNER FAIR i1ARBOR C0.
JOB ADDRESS air ive
GENERAL CONTRACTOR a hurst-Comst
AP No. 1 1- 1-4&5 LOT TRAC
INSPECTIONS Si n �
SOIL /
GAS
W ATER
ROUGH PLf/MBING �
PROP. SWR. LINE HOUSE CON.
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONOITIONING
TEMPORARV SERVICE OR POLE
UNOERGROUND POWEH
ROUGH WIRING
TRENLHES ORMS S1EEL REINF.
iL00R SVSTEM
BOND BEAM STEEL REINPORCE
SHEATHING
FRAME AND FLASHING
LATHING - IN OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
NEATING, VENT., REFRIG. AN� A.�.. FINAL /
PLUMBING, FINAL AND GFS TEST
ELECTRIC, FINAL
BUIL�ING, FINAL L
DATE 9-25-69
BUILDING PERMI
FIRE ZONE VALUE
SUBCONTRACTOR