HomeMy WebLinkAbout571 19TH ST - Building Permits��
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,__ __, COSTA MESA BUILDING-SAFETY DEPARTMENT AFPLICA'CION FORISTROE5WRA1. PERMIT 5.50 T"L
� P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 -�
C V PERMIT -
For Applicant [o Fill in Completely — Use Ink Only N" � 4 8 6 9
6UILDING (� / �/ A.P. NO. �� �� �' 3 Z
ADDRESS tiJ ( � � � � �
OWNER OR �J� Lc�S I� ADDRE55 � � �, q� �`
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ADDRESS�Z32 �jC�i����,�/ SPAGENO.
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NEW ADD ALTER REPAIR MOVING OEMOLISH
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ADDRESS VALUE
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OR ENGINEER N �
ADDRESS ZONE TVPE GROUP
CONTRACTOR � K.%y e�L ByPROVE DATE ��y ��
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CITV NO. � O (�
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� LIC. NO. Z(1� LIC. NO. I
{,y SIZE NO.OF BLDGS. (FROM G TRE T� 1��
C. OF l0T NOW ON LOT ONT
a USE OF �/
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� Separate perrttits are required for L. SID //
� elecVic, plumbing and heating work. qEAR G,
�,W. USE OF BUIIDING AND WORK TO BE PERFORMED PWNNING C ION -
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Q � I�Ar'�� APPROVED t)
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� I hareby acknowletlga thet I have reatl this application and stete C
y' that the abova infotmation Is corract nnd eB�ee to comply wlth
a ell tawe reBulating building construction, and 1 shall not amploy i
'Z any person in vlolation of ihe workmnn's compensation lews ot :
� Me Stata ot Califomle.
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3 1 �ereEy cenify that I am properly Iicensetl as a eonttector untler S�. FT. �
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Ne Stata oi Californie Businesa antl Profasslons CoGe, Division 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOF m
Cheptar 9, antl that such litenses era In full force and eftaet, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am ex¢mpt trom tha provisions of the Steta of Cal�or 1 usinosa VAIVATION � PERMIT FEE 5 �O �
and Prafessiona COde, Dlvision 3, Chapier /
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% PLAN CHECK S m
s�g�a<��. o, J/d0• LL
Permittee 5 7 TA% 5 Q f
or
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AuthorizedABent Date TOTALPAID E � S
,_ _ , COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
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OF LOT
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NO.
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LIC. NO.
NO.OF BLDGS.
NOW ON LOT
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Separate permits are required for
electric, plumbing and heating work:
UILDING AND WOFK TO BE PERFORMED
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2756 9/II/79 5.50 TL
OR 5,�,'jURAL PERMIT
ERMIT *t0 4g779
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A.P.NO. 'I(O�/IG.I�27
BUILDING �`�'
ADDRE55 ��
UNIT OR
SPACE NO.
TR.NO. � LO
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NEW ADD LTER
USE
ROVE�
APPROVEDSETBACKS
PLANNING ACTION
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� BLK.
�AIR MOVING DEMOLISH
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DATE �
APPROVED
I heraby acknowletlBe thet I have reetl thia eppliwtion antl rtate '�v�-U FOR SPECIAL REQU:3E(v1{=N•r�� ^
that the ebove information is corract and epree to compiy wiM
all lawa rapulating builtlin9 �onsttueNon, end I shall not employ o
any parson in violatlon of the workmen's compensation lews of
Me Smm of Californie.
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1 hereby cartify t�et I am properly Iieensetl es e contractor untlar SQ. FT. ^�
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the Steta of Californie Businesa antl Profeulona Cotla, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Cheptar 9, entl that sueh Iieanws ara In full torca antl effect, or I THE PURP06E OF ESTABLSMING A PERMIT FEE ONLV: �
em axampt from tha provltionsof the Stete of Calltornia e�sinecs VALUATION PERMIT FEE E � �O q
antl Professiona Cotla, Dlvislon 3, Chapter 9. �
PLAN CHECK 5 � "�
SIB�atura of �% � Q �
Parmlttea � S GOO ,�,r. TA% E ,� f
or V
Authorized Apant Date � TOTAL PAID S � �
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� COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O.BOX7200 COSTAMESA,CAIIFORNIA92626
For Applicant to Fill in Completely — Use Ink Only
ADDRESSs �•� l .-Ty r
T� NANT�R'. ' I�LGS I M1
MAILiNG
ADDRESSS �� �`
CITV COS� '7��% �I�7 � NOL� •C.L
CON5TFUCTION
BRANCH
ADDRESS
� ARCHITECT TEL.
OR ENGINEEF N
CONTRACTOR V K I��P K�
ADDRESS
TEL.
CITV NO.
F STATE. pTV
i LIC. NO. LIC. NO.
�Yi
(a� SIZE NO.OF BLDGS.
C. OF LOT NOW ON LOT
a USE OF
'� EXISTING BLDG.
.`n.
F Separate permits are required for
� electric, plumbing and heating work:
�,W. USE OF BUILDING AND WORK TO BE PERFORMED
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I hereby acknowletlge that I hava reatl this epplication end state
that th¢ above informeSion is co��act and agrae to comply with
all lews repulating builtlin8 construction, and I shall not employ
any person in violatlon of the workman's compensetion lews of
the State of California.
1 he�eby certify that I am p�ope�ly licensetl es a coniracior untler
the State of Californle Business antl Professions Cotla, Division 3,
Chepter 9, antl that such licenses ere in full torc an effect, or I
am exempt from the provisions ot the Stata ifor ia Business
and Professior�s Cotle, Dyision 3, Cf�r 9
or
Authorizetl
9227 !2/2B/79 8050 TL
APPLICATION FOR STRUCTURAL PERMIT
RECEIVEDBV PERMIT A1U 49449
19
A.P.NO. ///_�/J/.n/ ^
�isie
UNIT OR
SPACE NO.
TR.NO. LOT BLI
NEW ADD ALTER IREPAIR MOVING DEMOLI
OWNERT��(�' ���.�'`LS
1
VALUE
USE $
�r Nj•
//
APPROVEDSETBACKS
REAR FT. 1
PLANNING ACTION �
DATE �
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iarrn v Lj � �
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���LD EOI2 SPP;CIAL RCQLJIR,GNiF.N � G ^
a'
m
SQ. FT. �
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THE AMOUNTSHOWN UNDER VA�UATION IS FOR m
THE PURPOSE OF E57ABL�SHING A PERMIT F ONLV: e
a
VALUATION PERMIT FEE $ N
m
PLAN CHECK $ "�
0
$ /Nj � TAX $ � f
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TOTALPAID S �// �%�