HomeMy WebLinkAbout717 19TH ST - Building PermitsZ
WW
M0
Z
z�
f] co
O. m
J fn
J N
M W
m J
CO
J Q
Z N
Z Q
W �
aw
J 0
m Z
J cc
W W
Z _
Z_H
W0
70
39597
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING
ADDRESS
OWNER
MAIL
ADDRESS
CITY
CONSTRUCTION
LENDER
BRANCH
ADDRESS
F.Q 11-75�f�s•DO 313 35.0
APPLICATION FOR BUILDING PERMIT
I hereby acknowledge that I have read this application and state
that the above Information Is correct and agree to comply with
all Iowa regulating building construction, and I shall not employ
any parson in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or 1
em exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
Signature of ✓ /
Permittee
Authorized Agent
m
SO. FT. rAk o
THE! AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION �1 33;:r— „
�J PERMIT FEE $
$ (/ U PLAN CHECK $ f ' E
FEE
D�A7TE RECEIVE
.2--,/ 7
DATE ISSUED
-.—//—�
ADDRESS
t,
-O5��-O
PERMIT• �,I
/ 59
APPROVE
_/T
ENG
LOT
BLOCKNEW
ADD
A TER
RFPAIFI
MOVING
nFivIoLISH
PILO. OF
2
�2
CITY NO.
ALU$O�� OO
I hereby acknowledge that I have read this application and state
that the above Information Is correct and agree to comply with
all Iowa regulating building construction, and I shall not employ
any parson in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or 1
em exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
Signature of ✓ /
Permittee
Authorized Agent
m
SO. FT. rAk o
THE! AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION �1 33;:r— „
�J PERMIT FEE $
$ (/ U PLAN CHECK $ f ' E
FEE
FIRE��
ADDRESS
ZONE YPE GROUP
APPROVE
jam,
CONTRACTOR
By
DATE7— _J
ADDRESS
TEL.
ZONE
PILO. OF
2
USE OF NEW �.r pG
BUILDING
CITY NO.
.2PANS
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE NO.OF BLDGS.
(FROM C/L STREET)
&
OF LOT NOW ON LOTFRONT
FT.
FT.
USE OF
f
EXISTING BLDG.
/
FT
_EXISTING
SIZE OF r r NO. OF
NEW BLDG. X ROOMS / STORIES
LSI FT
FT.
EXTERIOR WALL
ROOF
COVERING WOO V
COVERING Woo "
REAR FT.
FT.
USE OF.BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
O
MAIN BLOGS.
ACCESS. BLDGS.
O
VAR. qs
DATE
C.U.P.^
APPROVED
APPROVEDG/IL/ :fl -y
_._, _2 _//— %S '
M1
I hereby acknowledge that I have read this application and state
that the above Information Is correct and agree to comply with
all Iowa regulating building construction, and I shall not employ
any parson in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or 1
em exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
Signature of ✓ /
Permittee
Authorized Agent
m
SO. FT. rAk o
THE! AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION �1 33;:r— „
�J PERMIT FEE $
$ (/ U PLAN CHECK $ f ' E
FEE