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HomeMy WebLinkAbout157 18TH ST - Building Permits �=, kJG 1O-76uOO 952* *****5.5O 42433 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP C TI FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only RECE DATE RECEIVED 0 E IS$UEQpp111 BUILDING / &/t " 5 / . /� ADDRESS ``te/tt // �// 2(/� ` �• CJ-ean// I / f _ j,4 � vYl RMIT NO. OWNER J zz �J ///// A.P.NO. �/ ADDRESS / V� Act GLltc f4Y ADDRESS BUILDING /s7 G •/a 5h MAIL Aa � ��T(q..��.��j .ynzt� �as � / o TELCtA re 2s Nw_CT ' • • 1 LOT/a� BLOCK CITY /4 /ye,s NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVING nFMOI ISH LENDER r-___ BRANCH OWNER e. seCNti ADDRESSit VALUEl ARCHITECT TEL. USE �' f 0 • $ �J[� OR ENGINEER NO �/ FIRE �1 ADDRESS ZONE T PE GROUP APPROVED IC DATE 2rVVr�l 7 CONTRACTOR GU V e4 eBY `y ` Q ADDRESS ''mss CITY NOL ZOO / '�.O_F Le BUILDING NESE OF /-� F STATE / / (r, CITY YARDS APPROVED YARDS APPROVED \- U LIC. NO. a.�-I 6 / J� / LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLOCS, II (FROM C/L STREET) O. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF ' t ,N., EXISTING BLDG. k_R.SIDE • . F sL 5 Separate • permits are required for L.SID,! ` F / FT. c electric,plumbing and heating work. REA 1 T FT. La USE OF B LDING ANO WO TO ERFORME F DISTANCE BET. BET.MAIN& C �9'LI-1 a ��/L'! 1_t7 MAIN BLOCS. ACCESS BLDGS. VAR.# DATE C.U.P.# APPROVED RAP: 3-1APPROVE Ps DATE ..1 IY lit 0 I hereby acknowledge that I have read this application and state n n ad that the above information Is correct and agree to comply with m 0. all laws regulating building construction, and I shall not employ si Z any person in violation of the workman's compensation laws of I.LI= the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. a 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 F f: am exempt from the provisions of the State of California Business a VALUATION PERMIT FEE $ and Professions Code, Division 3, Chapter 9. �/ m Signature of �, V� PLAN CHECK S. ^ �I F!/1 L��L- C�{ $ v TAX $ o P"_ ltln W Permittee Authorize ntTOTAL PAID $