HomeMy WebLinkAbout532 19TH ST - Building Permits34229
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. HOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
FA 22-7r44 16. 936* ****34-500
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APPLICATION FOR BUILDING PERMIT
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VALUE
DATE2 -22-
BUILDING
USE OF NEW
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hereby acknowledge that 1 have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
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I hereby certify that I am properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOT
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
THE PURPOSE OF E5
am exempt from the provisions of the State of California Business
and Professions Cod., Division /3^Chhapter 9.
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Signature of � /
VALUATION
Permittee ( �-VV J
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Authorized Agent
VALUE
DATE2 -22-
1
USE OF NEW
BUILDING
VAR[N APPROVED
ACCESSORY BUILDING
FT.
VALUATION 1S FOR
MAIN &
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VALUATION 1S FOR
A PERMIT FEE ONLY:
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