HomeMy WebLinkAbout284 WILSON ST - Building Permits 16837 FEE
mARER 2 CE�IVED
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA �FIINANCE DEPT.
For Applicant to Fill In Completely APPLICATION FOO PLI�IY�f9STA MESA
, s/f TYPE OR PRINT -BUILDING
ADDRESSBUILDING
O- "4. 409 e! ,ors. (2-9-4')
COSTA MESA. CALIFORNIA For Office Use Only
OWNER /•D�,6i a)/4�3 I RECEIPT NO. I T6B37
MAIL .7. /. /�O J _ REC 8D BY Tfi VED TEMV18' EVEr
ADDRESS C /9e/P fY, ,K.�I '�� 6�
TEL. BUILDING
CITY CO�STg /72aA NO. ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO. p
ADDRESS FIRE ,1Ip C
ZONE 1./Y PE GROUP
CONTRACTOR _47/--6,./ APP/{/R�O/V jLi/�
ADDRESS BY✓ Jj1 (Wx�-l/�/ jl�h//JJ ZONING DATE [may/�� �//
ZONEiii HOOP LSE!
SE OF NEW gar)-61Y
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BUILDING C
le
STATE TEL. LEGAL / //) %/.g
LIC.NO. NO. EGARIPTION V 6Y / a /ALN NI
OF NO. OF BLOCS. o/p
OF LOi If/(O x 1 NOW ON LOT / A.P.NO. 1/9.-- �3� P A[ p-0-2-,
USE OF YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.) ,�
CENTER OF STREET //��
REAR YARD FRONT .. 11 FT. V'-
SIDE YARD I LEFT I RIGHT R.SIDE FT. / / IN.
DESCRIPTION OF WORKIIN '
VT-ALTERATION
� L.SIDE FT.
NEW I•' ALTERATION I- II ADDITION I REAR -'-"FT. IN, " '
REPAIR I II MOVING I II DEMOLISH I BPPROVED�1/. 0�A DATE 3- ) 5'6)--
BUILDING NO. OF [N
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
e4 CO A w70.� "fa 7-6 F/� e / �/lGhc ick Il
...i>e ' d A/L. -T�� y//� r ' ��Ae'' a 3c'/ ' /OC x
I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT T ABOVE IS CO CT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL !RANGES D ATE LAWS REGULATING
BUILDING Co ON. VALUATION //
SIGNATURE / /
'� � PERMIT FEE $ T
PERMITTEE ( / ea
T- _
_- -
� �, ` (/✓�.l 9T67-�f' $ X PLAN CHECK $
AUT F D>�D AGENT / ' o
TOTAL FEE $