HomeMy WebLinkAbout471 FAIR DR - Building PermitsUWNtK
JOB ADDRESS
GENERAL COI
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BUILDING PERMIT N0.
SUBCONTRACTOR
5 ;I+ �n?3s
COSTA MESA BUILDING-SAFETV DEPARTMENT
1 P_O_ 6(1X 1200 COSTA MESA. CALIFORNIA 92626
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NOV 18-6�0 813+� �*°347.25
APPLICATION FOR BUILDING PERMIT
For A plicant to Fill in Completely �� _
RECEIV BV DAT AECEIVPE DA E ISSUED
BUILDING �� ���TO ��r���
ADOPESS � �]
PE RM`T�V�J• 7
OWNER Fair Harbor Co. n.P.No. 141-491-4&5 3
MAIL BUIIDING d O -/0
ADDRESS ADDRESS _
TE L. 6�
CITV NO. ACT LOT BLOCK
CONSTRUCTION W A P �
LENDER �
BRANCH
OWNEfl
ADDRESS /
ARCHITECT TEL. S (Ij ��G � VAWS /O�a:�O�
�
OR ENGINEER N
FIRE
ADDRESS ZONE TVPE GROUP
APPROVED
CONTRACTOR BV DATE
ADDRE55
TE�. NE (� NO.OF ^ USE OF NE
CITV NO. -C� '( P�`�' p� BUILDING .
STATE CITV VARDS APPROVED VARDS APP OVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OFBLOGS. (FROMC/LSTREET)
OF lOT NOW ON LOT FFOfYT FT. I�' FT.
usE oF � Y y' 6,r�"
E%I5TING BLDG. ��j ( O 51 FT.
SIZE OF X NO. OF '1 � I
NEW BLDG. ROOMS STORIES L. SIDE FT. FT.
EXTERIOR WALL ROOF J� �
COVEFING COVEPING REAR FT. O FT.
USE OF BUILDING AND WORK TQ E PEFFORME DISfANCE BET. 'BET. MAIN &
� 9'� H O YS. L!/ MAIN BLDGS. ACCE$$. BLDGS.
VAF. q� DATE
4V.P.#'- - �� AGPROVED -
APPROVE �i..- � � L
(l
I hereby acknowled8e that I have reatl ihis appiication antl state
that the above information is correct antl agree to comply wi[h
all laws regulating builtling constructio�, antl I shell not employ
any perwn in violatlon of the workman's compensation laws of
the State ot Califomie. ` �7Q �/� m
I hereby �certify that I am proparly licensatl es a contrecror untlar / O S�. FT. � 'd F/ �fPK-�V/G o
the State of California Businass entl Profezs(ons Cotle, Dlvislcn 3, THE AMOUNT SHOWN VNDER VA�UATION IS FOR �
Chopter 9, antl thet such licansas era In tull torce entl aftact, or I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: Q
am exampt from the provisions of tha $tate of Cellfmnla Businesa
and Professions Cotle, Division 3, Chepter 9. VA�UATION � m
'I�ri^-�� PERMIT FEE $ �.3 / � O �'+
)� 7
Slpnature of r /fA _ LQ �� �� ['� m
Permlttee �W�� � $ PLAN CHECK $/ �J E
f �/ 7) `/� o
Authorizetl ABent /OJ �. (�%a TOTAL FEE S��/• `'�/ LL