HomeMy WebLinkAbout157 18TH ST - Building Permits �=,
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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(/� `
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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
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ADDRESS ''mss
CITY NOL ZOO / '�.O_F Le BUILDING NESE OF /-�
F STATE / / (r, CITY YARDS APPROVED YARDS APPROVED
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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
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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 $