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JOB ADDRESS 881 W. 17th St. �-i--�-+t BUILDING PERMIT NOL4333
GENERAL CONTRACTOR Jan Klt COI7St, � VALUE $ 1�500.00 5���-S '� G(
AP.No.110—c71—yvy LOT TRACT
IK CTIONS DATE
Unoereround SoIl U.G. Water
F. e
FIRE ZONE DESCRIPTION OF WORK
GROUP TYPE
SUBCONTRACTOR
c
PER
Reside Nes.
ZONE M�
ISSUED
1�:�33
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIFORNIA
Fo� Applieanf fo F711 In Complefely
TYPE OR PRI�T
BUILDING 8'� �, � r S--
ADORE69
COSTA MESA CALIFORNIA ,
, 6HTBACN LINB FROM ��'�� �
FE� R�C�����
�� APR241961
FINANCE DEPT.
CITY DF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
�RHGlIPT NO. PERMIT NO.
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�Y ADDRE68
TE�. COSTA MESA. CALIFORNIA
NO.
FIRE
ZONE TYPE GROUP
APPROVED
BY DATE
.O �`� ' . ZONING ) ,�.�
2 I NO. OP I U86 OP N8W
PLANB BUILDINO
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NO, OP BIDOB.
NOW ON LOT p, p, NO. � O L'
VAROS EVES
APPROVED ALLOWED
/7 _ _ (C8NT8R LINB 9T.1 i
� I LEFf � , I RIGHT / � /
DESCRIPTION OF WORK
BUILDING�UX �-7U ROOMS
BIZE
EXTERIOR WALL/./vG^ ROOF
COVHRING W �� GOVERR
'U88 OP BUILDING AND WORK TO BH
r
APPROVED
BY
r
1 HBPHGY AGRNOWI.CDOB TMAT I HAV6 R6AD TXIB APPLI�ION
TX8 AMOUNT BXOWN UNDHR V�LUATION Ip POR TH8
AND BTAT6 THAT TH8 ABOV6 IB CORReCT�AND AOp88 T COM- pUPP08B OP C9TABLIBXIN6 A nepMlT PHe ONLY.
PLY WITX ALL CITV ORDINANC89 AND ATB UW8 II60ULAT�NO
BIItLD�NO CONBTRU ON. / VALUATION �!
81GNATURE OF /• �tt PERMIT FEE $
PERMITTQ � � � cj�7 D � n
S �J �� PLAN CHECK S
AUTMORIZED AGENT �
TOTAL PEE �- �
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