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HomeMy WebLinkAbout162 21ST ST - Building PermitsIF • C • • (� J' IO2I PAID C. COSTA MESA BUILDING-SAFETY DEPARTMENT OCT 21-69cnsAQO ` P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APWPLIrCATION FOR BUILDING PERMIT BUILDING)+ q RECEEP/ V DAT 49ED ATE--.2ISSUED7 ADDRESS 1 t• K: . 02,, 1 sy ,,/ � (Oi1 !/(/ (O /60 R�1dg7 yQ, OWNER MORRIS . Pie RG01V A.P. NO. / I )�j—o73�o3 PEJ7E , ADDRESS .9A 1,{C. ADMAIL ILDING DRESS / 1' �?/„1Q_♦ 2 _ [ y� 0w u;-U CITY ////'•�I��, /nes TEL. /��/® /V/TRACK!, N'17 Ji Cci'Sy BLOCK H Z CJ'J � A 1 1 le s A N O. 4--O a Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH d m LENDER N o fv e J D BRANCH ' J N OWNER 6.211121: At- s��iai a W ADDRESS 03 J 7 1 7 VALUE (/OO�o J CO ARCHITECT TEL. USE, $ a OR ENGINEER NO. U to FIRE W < ADDRESS }] // ZONE 3- TYPE "'V GROUP// I /_a. uri (�/I'1�\ w z CONTRACTOR QCc)�I/6-R 3/1/C / BVPROV ED /7/7, DATEf O ���(9Y • CP a J ¢ ADDRESS s ��+-w'" .��,�, 111 w TEL. ZONER NO.OF +1 USE OF NEw 1 p Mn .$1•I Zr CITY NO. PLANS O`. BUI LO DING♦ [�.�.1�(,�/.(1A„� STATE CITY YARDS APPROVED YARDS APFROO1l6 \ LU Ir LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING D 0 • SIZE t� �Na OF BLDGS. 0, (FROM C/L STT RREET) OF LOT 6 0 X bre I NOW ON LOT oG FRONT 47FT.FT. FT. USE OF EXISTING BLDG. ResI dN�1I�CR R.SIDE ,SFT.--pr� • FT. I— SIZE OF ' NO.OF r��� Z NEW BLDG. ROOMS STORI ES L.SIDE ✓ C?'T. FT. a EXTERIOR WALL ROOF V COVERING COVERING REAR .� T. FT. • • J USE OF BUILDING ANI WOR. Te s_ PERFORMED DISTANCE BET. BET.MAIN& 1 -;.--7-4-4:171.-: - - _--',7-- .'_-1t MAIN BLDGS. ACCESS.BLDGS, D. • O _ ': / C VAR. AP ROVED(n—G-627 f{�(.�LnC:,^' Arm)/ w� b� ' n DATE / o ---g1-672 € n-a!Ze ei• - 44..94 HSLnei - HOLD PO PEC'AL REQUIREMENTS 0 U I hereby acknowledge that I have read this application and stateR"''-1 / q D that the above information is correct and agree to comply with - /p /94.-9..x_., CC all laws regulating building construction, and I shall not employ I— any person in Violation of the workman's compensation laws of , CD the State of California. m Z I hereby certify that I am properly licensed as a contractor under SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e CC am exempt from the provisions of the State of California Business / VALUATION (/(/+ co and Professions Code, Division 3,Chapter 9. PERMIT FEE $ j Signature of 1 a p _ Permittee ♦ $ (S/©D PLAN CHECK $ E Op LL Authorized Agent TOTAL FEE $ +-- °c .ti* i •J Ci •• J1 040 ; • 4 • • • , i .., 4 Palu003533* ****10.50 [}.� �i7 la 22 77cN�:. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to �6 in Completely—Use Ink Only / 8 RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS / 2 E./n•Sr /_ �Q�rt LL OWNER WOOr-/71reG eft.) (� . A.P. NO. / O _rp .` 07 / Ila 7 MAIL / Q BUILDING ^ ADDRESS/ Gas / '� c.c 7i'� ADDRESS/�2' �6� .LIs 1, /� ,,rte TEL. '�'e^'�'C.E1 Area/ o /� CITY COS 4/51 ///Pf4I NO. TRACT LLO'I't•cS� BLOCK CONSTRUCTION NEW I ADD ALTER REPAIR (MOVING DFMO11SH LENDER A- BRANCH OWNER a / R�W t(�`ijJ ADDRESS pn/ V UES ARCHITECT TEL. USE ✓ v.�•(/ S // \ OR ENGINEER TO. JFIRE -r-4�/I `\!V—• ADDRESS ZONE �TSYPEE� / GROUP ..— C/ A APPROVED / I�/1. 4--e fg— 4 I CONTRACTOR if Ain' LAtud Cit-mc/Iq.r( BY LA DATE Ol Ol ADDRESS Sc3A] Fi erre S/ / � 140,1 TEL. ZONE NO.OF USE OF NEW � ��/ NO.cZ =Zi p�.�/ !`/�(t � PLANS 0 BUILDING y/fit,,, CITY L- /7 !I v�`" Iy STATECITY YARDS APPROVED YARDS APPROVED gLIC. NO. 28� 6M S7 LIC.NO. MAIN BUILDING ACCESSORY BUILDING M W SIZE NO.OF BLDGS,(j (FROM C/L STREET) ..sss///111 a. OF LOT NOW ON LOT / FRONT FT. /I /(, gyp./FT.�i�qs , • Q USE OF //�� I' /Vh/C/`LC/LJ��C/� EXISTING BLDG. I rn`n A9 'L'P/XlI R.SIDE ///���� FT. ,� cA FSeparate permits are required for L.SIDE FT. T electric,plumbing and heating work. 0 REAR FT. FT. W USE OF UILDING AND WOARK TO B PERFORMED F ( DISTANCE BET. BET.MAIN& AP h4/d l+/Si Cot/��a{{lj ��F!�/< for MAIN BLDGS. ACCESS. BLDGS. 'ft C , Sett.).--49. /2 go(/.(-f 2 " - ( VAR.*Is DATE -i A (/ 1 C.U.P.qW q �/'�/ APPROVED �J Y' --PLY ROVED/'�// /'Y'�/� DATE 6����( 0. QI hereby acknowledge that I have read this application and state N a„ that the above information is correct and agree to comply with m 0x all laws regulating building construction, and I shall not employ al Z any person in violation of the workman's compensation laws of o 14 S the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. tv the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:— e em exempt fro the provisions of the State of California Business a erg VALUATION PERMIT FEE �7 and Professions ode, Division 3,C.•• $ Ot CSL/ m Ad PLAN CHECK E 'n 0 Signature of ,{ /-� Permittee /� a. S I (/—t/!/ ' TAX S -r 5Q 2 U Authorient TOTAL PAID S AO,SD