HomeMy WebLinkAbout1680 SCENIC AVE - Building Permits c ` 4-0621 2 1 845 8/25/78724. 9 T .
. ` COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only �/f�-
RECEI DR Ly(ED DATE ISSUED
BUILDING e A.� i L3�
ADDRESS SEEK f{Uaii
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/' aieza e yer- r-.A 5 - A.P NO./29-✓6;,-- /-'7O PERMIT NO.
OWNER
MAIL
ere/
�s�}-� BUILDING /� r ( ^
ADDRESS /e / eAKEZ �,�) ADDRESS V ` e, c.-� f Uc -
CITY Cas7q /a.:\ No.5/6—e/10r TRACT Y LOT /BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOIISH
LENDER
BRANCH
WNER
ADDRESS //,�rrte� - VALUE
ARCHITECT OR ENGINEER.kV C17 '1 TEL
6'.�0' WISE
ADDRESS/44' N. C/C4'V $ t- . ZO E �� TYPEFIRE ! OUP 1 /�
APPROVED X
CONTRACTOR BY DATE
ADDRESS
TEL. ZONE NO.OF VSE OF NEW
CITY NO.
//'/I/ PLANS 0,-
BUILDING l
F_
STATE CITY YARDS APPROVED YARDS APPROVE
LIC. NO. y� LIC.NO. MAIN BUILDING ACCESSORY JJBUILDING
(FROM
OI
R. F ZE
LOT b X Z Jv I NOW ON LO /L
4
FRONT C0 FT.r)G � ,[.�p,.,/
sE USE O -
F
h EXISTING BLDG. — R.SIDE 6!9
FT. C ..ezPev
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F Separate permits are required for L.SIDE "FT. FT.
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electric,plumbing and heating work. REAR 6/
W 5FT. FT.
(.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
'r // (� p.+ MAIN SLOGS. ACCESS.BLOCS
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/ b0 / r CU.P..tj//1_725-34. APPROVED/30//8
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)'-. RO j�e�J DATE ��
a HOLD FFORRCCSPECTA REOUTREMFNr'
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0 I hereby acknowledge that I have read this application end state 'n
r.
IY that the above information is correct and agree to comply with
L all laws regulating building construction, and I shall not employ m I
Z any person in violation of the workman's compensation laws of 53
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the State of California.that 24 4/350. FT. {�2/0 HeZ L cm+q
I hereby certify that I am properly licensed as a contractor under /
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR p
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q
n
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ o \
and Professions Code,Division 3,Chapter 9. ut
PLAN CHECK S 4,70-6061, m
Signature of // • m `
0
Permittee $ 1(/5,OO(� TAX S�/5/ 9 2 •
Authorized Agent 5?
a,
L�q TOTAL PAID S
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f ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR3STRUCTURAI PERMI�44.00 7L'
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECF'IVE BY 'PERMIT / 42/F///(T//n/
For-Applicant to Fill in Completely —Use Ink i ,y �1 wI //y/
BUILDING A.P. NO.
ADDRESS i Lir �'$../ �)��
BUILDING //1/{-
OWNER OR ADDRESS
TENANT
UNIC
R
MAI LING SPACE NO.
ADDRESS
TR.NO. LOT BLK.
TEL.
CITV' NO.
NEW ADD ALTER (REPAIR MOVING DEMOLISH
CONSTRUCTION
LENDER
BRANCH D/ 4,9Q �_ �]/J
OWNER Cs�L
gi
ADDRESS rip
T TEL.
USE a $
OR EN EER NO.
•As•RESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL.
CITY NO.
E• STATE CITY APPROVED SETBACKS
gLIC.NO. LIC.NO.
Ly SIZE NO.OF BLDGS. (FROM C/L STREET/
SOF LOT I NOW ON LOT FRONT FT.
Q USE OF
4, EXISTING BLDG. R.SIDE FT.
IA
_=•
FSe..rate permits are required for L.SIDE FT.
G - -ctric,plumbing and heating work: REAR FT.
Imo, USE OF WILDING AND WORK TO BE PERFORMED PLANNING ACTIO
a .
O DATE
Q I APPROVED
APPROVED
)" --_EtY DATE
a
IQ
Cr 0 I hereby acknowledge that I have read this application and state m
(4 that the above information is correct and agree to comply with
R. all laws regulating building construction, and I shall not employ a
Z any person In violation of the workman's compensation laws of 2
S the State of California. -
al
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR a
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ .t0 Y
and Profession Code, Divis on 3,Cha ter 9. v+
-t-- �- PLAN CHECK $ a
Signature of _ u.
Permits S TAX $
or Author Bent Date a-1i i97 TOTAL PAID $ 0 —'—