HomeMy WebLinkAbout325 VICTORIA ST - Building PermitsOWNER
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ROUGN HE�TING �N� AIN COND
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TRENCMES FORMS
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NE�TING. VENT., REFRIG. �ND A,
PLUMBING. FIN�L AND WS TEST
BUILOING. FIN�L
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SUBCONTRACTOR
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COSTA MESA BUILDING•SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use lnk Only
BU��DING �
ADDRESS � (/
OWNER Q�
MAiL .� �♦ /�„ _.n / /4_ .
CIY�
BRANCH
AODPESS
ADDRE55
CONTRACTOR
ADDRESS
Ct7�
STATE
UC. NO.
SIZE
OF LOT
USE OF
E�'�L� N�L�
TEL.
NO.
.:�ldil.
TEL.
NO.
CITV
IIC. NO.
NO.OF BLOGS
NOW ON �OT
Separate permits are required for
elec[ric, plumbing and hea[ing work.
OF BUILOING AND WORK TO BE PERFOR�
1 he�eby eeknowletlpa that I hm�a reatl t�is apD��cetion antl stete
that tha abova Information is conect antl eB�ee to comply wlih
all laws repuletinp builtling construction, and I shall not employ
any Person in violation ot tha workman's compensaiion laws of
tha Stata af Celifornie.
I he�eby cartity that I am prope�ly Ilcensetl as a contractor undar
the Stete of Calitornio Business nnd Profeutona Cotle, Divlaion 3,
Chepter 9, antl thet such Iiconeea ore in full force antl etfecS, or I
em exampi from tha provisions of iha State of Callfornie Businass
and 7rofessi s Code, D� n 3, Chapte .
Sipnatura of �
Pe�rY��ttea
Aut�orizetl ABent
PA1� I
R�.T-7•7Fcr�r.00 3��6::• ''�^t�5.50
APPLICATION FOR STRUCTURAL PERMIT
RECEI ED BV DATE RECEIVE DATE I E�
Z.� /n•7.7� /n �'-.
BUILDING
ADORESS
OWNEA
FIRE
VALUE
OF �71USE OF
VARDS APPROV ED
VAF. �-`
QU.P. �
v FT.
BET. MA{N &
ACCE55. BLOGS.
DATE
APPROVED
in_✓/�%
�
m
i
m
�_ SQ. FT. rv
TNE AMOUNT SHOWN UNDEfl VALUATION IS FOR m
� THE PURPOSE OF ESTABLISHING A PERMIT FEE ONIV;
e
VALUATION PERMIT FEE $ p
�
n
/� PLAN CHECK E ^�
s ca"�4 � o
TAX S LL
f
U
TOTALPAID E