HomeMy WebLinkAbout1668 Samoa Pl - Building Permits 4520 - FEE RECEIVED
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 317 FINANCE DEPT.
COSTA MESA, CALIFORNIA
APPLE-PION COSTA MESA
FOR APPLICANT TO FILL IN FOR PERMIT
ADDRESS 1668 Samoa Place BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
Co. RECEIPT NO. PET:167
OWNER Summerland Land C (22■■ (ZZZl FI`/
MAIL RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS 1124 So. Beverly r„.......„70 _4.2_o7d'c7 ',RATE 2 ^ tos7
TEurestview BUILDING
CITY T.ns Angeles . Calif. Na 5_x828 ADDRESS _
ARCHITECT e Lt. COSTA MESA. CALIFORNIA
AR ENGINEER Williams NO.
FIRE
ADDRESS] 12) So. Beverly-Los Angeles ZONE
OUP,
SummerlandLandLONE NO.OF
Co.CITY LIC. PLANSTYPE GR
"UP
CONTRACTOR CNO. 6185 V.
112 So. Btverly TEC.rstSlhe�'1 APPROVED
ADDRESST. p 11. sn p ' I,;O 11 "Fk10. !!�i rrSs ((�j BY DATE
LEGAL LOT CORRECTIONS
DESCRIPTION NO. Q5 BLOCK TRACT2 353
A.P.NO.
SIZE (� NO.OF BLOCS.
OF LOT 610o NOW ON LOT none
USE OF
EXISTING BLDG.
I
SETBACK LINE FROM �J
CENTER OF STREET 501 REAR YARD 29 1
SIDE YARD RIGHT 51 LEFT 6 '
DESCRIPTION OF WORK-
NEW X ALTERATION ADDITION Li
REPAIR MOVING. DEMOLISH
BUILDING 1 NO.OF
SIZE 12211 ROOMS 5 STORIES 1
EXTERIOR WALL ROOF Composition •
COVERING StUnCO COVERING Sini ng l s
USE OF NEW 1i
BUILDING Si ngl e. FATgi 1 tT Thspl ling
c/ CZ7� 9-
en
I HEREBY ACKNOWLEDGE THAI HAVE AD THIS APPLICATION AND
STATE THAT THE BOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINAN AND STATE LAWS REGULATING BUILDING CONSTRUC.
TION. /� VALUATION
-v eGI- PERMIT FEE $26.00
SIGNATURE {/yj��,�/
PERMITT /D ‘ A --- PLAN CHECK $13.00
$
AUTHORIZED AGENT 4�'-/ • TOTAL FEE S37}(
•O0 ‘41. 1