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HomeMy WebLinkAbout480 19TH ST - Building PermitsowNea W ATER 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 ✓�}— PLASipR, BAOWN COAT �yCr_ S,;'�'{�n`,"SpYURAL, LIN�L � �' N�;:�,3�1G. VENT., REFRIG. AND A.C. PIUMBIHG. FIN�L 11N� G�5 TEST � DATE SUBCONTRACTOR :[�l F � a a y y S F G W F a c .i Q i �- a a w a O �i a Z W S7 3 �4 ��4 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 � 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 §