HomeMy WebLinkAbout991 19TH ST - Building Permits._-�� , 2 I `�90
�EOSTA MESA BUILDING-SAFETY DEPARTMENT .
P• O. BOX 91] C08TA MEBA. CALIFORNIA
For Applicant fo Fill In Completely
TYPE OR PRINT
BUILDINQ n ( j�� �
A�DRES&, �J / •�� � z
COSTA MESA. CALIFORNIA
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DESCRIPTION OF WORK
WALL I ROOF
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I HEHEBY ACKNOWLEOOB THAT 1 XAVB RBAD THIB
AND BTATg TXAT THE ABOVB IB CORqECT AND AG
PLY WITH ALL CITY ORpINANCiB A Ip eTATB LAWE
BOILDIN6(,ONBT0.UCT10�� / i ;
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SIGNATURE OF
PERMITTE
AUTHOR�IfiD A6ENT
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PIRH
FEE RECEIVED
l�AR � 4 �964
FfNANCE D�PT.
CITY Of COSTA MESA
APPLICATION FOR PERMR
BUILDING
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iHALLBE ES87HAN
(U.B.C.REQUIREMBNT)
YARD9APPROVED �
ACCESSORY BUILDIN6
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DATE , �
APPROVfiD
'ARD9 APPROVED
MAIN BUILDINO
VAR. �
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TX8 AMOUNT BXOWN UNOEP VALUATION IB ROP THe 5
pIIPPOBB OP EBTABLIBHINO A PEqMIT F68 ONLY. p
%ALUATION � _I m
PERMIT FEE �
// 0
/��-� m
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4
TOTAL FEE � �
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, 4141.�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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For Applicant to Fill in Completely — Use Ink Only
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CONSiRUCTION �' /I +�'
LENDER /VO�%�
BRANCH
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ADDRESS S I�i/L�/�
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CITY NO.
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a OF LOT /\ /
a USE OF
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FSeparate permits are required for
0 electric, plumbing and heating work.
� USE OF BUILDING AND WORK TO BE PERFORMED
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P I T[ON FOR STRUC7'URAL PERMIT
RE BV DATE CEI E �=E���G
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A.P. NO. I — ' P��I� ' � •
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APPROVED
� I he�eby ecknowlatlpe thai I hava reatl this appllcetion antl stete
y� that tha above Information Ia corfecT entl eprae to cOmply wlth
� ell lews ragulatlnB buildlnp conrtruction, and 1 shall not emp�oy
Z any person In vlolatlon of t�a workman's compensa<lon lawa of
� the Staie of Celifornle. � A `
C/
3 I hereby certify thet I em properly IlcenuE aa e contrector untler
the SWta of Cellfornie Businesa antl Profesz(on� Code, Division 3, THE AMO
Chapter 9, entl that such Iicenms ere in full force and effect, or I THE PURPC
am exempi from the provi5ions of theState of Callfornie Businass VALUATION
entl Professlona Code, Dlvision 3, Chapter 9.
SIB�ature of _/ /�// � � �A .9�
ermlttee l�� .�-�'� /Y1 ���
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Authorizetl AOant
NO. OF
PLAKS
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DATE � `�
USE OF NE
BUILDING�
_ VARDS APPROVED
BEf. MAIN &
ACCESS. BLDi
DATE
APPROVED
PERMIT FEE S
FLAN CHECK S
TAX E
TOTALPAID E
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