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HomeMy WebLinkAbout297 ROCHESTER ST - Building Permits • slat a EE RECEIVED ,5, '7 -5k Vu COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL /N COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT TT BUILDING �j BUILDING ; AI •wC� �s �t ��)\ "2. Z.� 7 I/C6G/cc?S far,2%... `COSTA MESA.{ CALIFORNIA� FFOR OFFICE USE ONLY OWNER , I�� N O�/ . I SIJ I RECEIPT NO. P�t�l Tj Q, { MAIL 3 L 7 - ; aL /P ^ Vr„ 1 y� 'VEO BY DATE �CEI�E.D� DATEJISSUED ADDRESS I UY'YI�-CaGL` It.. `ll G� 1 5 7 (/,{C/. '7// CITY T /K� II-/ A AA TN O.% BUIL ING ADDRESS 2 / 11.Q C- el / re1 , ARCHITECT ��Q it LIC. c. COSTA MESA, CALIFORNIA OR ENGINEER •1A„(�{O NO. ,j{ ,�, //�11__ C'�• /�. FIRE "3 (//J /,ILS ADDRESS I IT 1 ��� •� 1 ZONE type ' IrOuP il 4 ll CONTRACTOR OU I`! S1 L.bIZI L CT.NTO. BYPROVED DATE ADDRESS OOP\ • ZONING r I20NC NO.OF USE OF NEW LEGAL LOT Y '//>Lr,/{y( PLANS BUILDING {� DESCRIPTION NO./ /� BLGCKCI• I I,C�I �1 I- /,/ f • A.P.NO.Clop / ) ,/ I y I/") /G`�4? IIS r riy CSIZE //'rG/p „dor /.pc: / e F, M /.�`/((;c. irRp,//E 6). 1 DA s' a-... OF LOT (p/ ' C ' -I D I NOW.ON LOT NO.OF S N04t YREQUIRED u/ HALLOWED USE OF (CENTER LINE ST.) - EXISTING BLDG. UI'7� L. FRONT f SETBACK LINE FROM J4g' 1/ /% TR�J ff CENTER OF STREET j r0 REAR YARD I\-3'0 R.SIDE ^/ I/ FT. IN. J S / / 1/ SIDE YARD I LEFT RIGHT b O L.SIDE .-5---FT. IN. DESCRIPTION OF WORK / REAR .[ FT. IN. • NEW hi II ALTERATION I II ADDITION I --/ REPAIR IIIMdVWG II DEMOLISH I HOLD FOR SPECIAL REQUIREMENTS BUILD •G 1 5 7 3 NO.OF ,( tA. IjA:I j I SIZE • - • - t ' ROOMS -T STORIES 1 �` / la./ EXTERIOR WAL6__ ROOF I/ J COVERING S-T VC/-C ICOVERING /�VG/c = CS/ gilt , •f 7 - <-17 USE OF BUILDING AND W RK TO BE PERFORMED bup y >( At r, C/a F2+ 57c'° ') IO'. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LAW EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING coo Nl�iUGTIo VALUATION• / S IGNATURP OFy_ J,,z' Ter) PERMIT FEE $ r� C - PERMIE /� o /A1/��/�I Ih I; � $ 74 / // PLAN CHECK $ /E�/� ,/AUTHORIZED AGENT ,�(1IVII/ ��ii f/(�(/✓ TOTAL FEES S!'C - /nl"