HomeMy WebLinkAbout480 19TH ST - Building PermitsowNea
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ROUGH PLUMBING
PROP. SWR. LINE HOUSE
SPRINKLING SYSTEM
ROU6X WIliING
TRENCNES FORMS STEEI
FLOOR SVSTEM
BOND BEAM ❑ STEEL RfINFORi
SHERTMING
FRAME qN0 fLFSXING '
LATHING — IN �� OUT ✓�}—
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PIUMBIHG. FIN�L 11N� G�5 TEST �
DATE
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BVILDING ,((�i�) � 1�;� /'T
ADDFESS 4�iC/ l � �
OWNER LA1L.�/✓r`��� D�"Gw� r�"""
MAIL '7)�� � MI�� �
ADDRESS
CITV 'v�`�jvfvT yOv"K�''FY NO. n'"S`'�"�
CANSTRUGTION
BRANCH
ADDFESS
ADDRESS ' ���'_Y�,V ST � g�
CONTRACTOfl � /N NE/V
ADDFESS
CITV
STATE
LIC. NO.
512E
OF LOT
USE OF
TEL.
NO.
CITV
LIC. NO.
NO. OF BLIX'aS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
UILDING AND WORK TO BE PERFORMED
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1 hnreby aeknowlatlpe that I heve read ihis appllcation antl state
ihat the ebovo informailon is corraci antl egreo to comply with
all lews regulatin8 bulldinB construcilan, and 1 shell not employ
eny parcon In vloletion of Me workmen's compansetion lewa of
the Stato of Celifornia.
1 hereby cartlfy chet I em proparly Iicansatl es e contractor untlar
the Steta of Callfornie Business entl Professions Code, Dlvialon 3,
Chapter 9, antl Mat such Ilcensas ara in full forca antl etfact, or I
am exempt from tha provl5ions ot the Stata of Cellfornla euslnecs
entl Professlone Coda, Dlvicl 3, Cha er 9.
Sipneture of
Permittae
Authorizatl ABent
OCT 11-77PpI��O 523� *��*96.84
cr�sn
,TION FOR STRUCTURAL PERMIT
BV DATERECENED nnrcicci�c..
A.P. NO. �/ (S "/j`rF �
f
BUILDING � �
ADDFESS
TRACT
W ADD R P
OWNER ��f��L�/'�
USE !T�" Ll�r''7(/Y'�
FIRE
ZONE TVP
APPROVED
BV
20NE �/ NO.OF
PLANS
YARDS APPROV ED
MAIN BUILOING
(FROMGLST T)
�
VALUATION
$ `,�' o'p�
� `TTLI S,�
LOT 6'/ I BLOCK
USE OF NE ��
BUILDING
YARDS APPROVED
DATE
APPROVED
nerc�C��/
PERMIT FEE $
PLAN CHECK §
TAX S
TOTAL PAIO §