HomeMy WebLinkAbout163 18TH ST - Building Permits PASO
AUG S, 10- ,6cpA00 953* *****5.50
42434
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP I A ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
REG I DATE RECEIVED
BUILDING /r ..„ ,_ ,,,..7, 5/___ D I/SJSUE2,,L.
ADDRESS /OXY
^ �e-CUC 7/
/'i^//t , PERMIT NO.
OWNER !i//M A.P.NO. 7
MAIL / ADDRESBUILDINGS ��`
ADDRESS / /Poe 41cy �lr ,/ J(� ADDRESS �/,-,�3' •ri8�
CITY fl . `Flt A-t ea.“; TE NO1_,..-n4:1
.6 Iec /f 3" N AtT I ,�s . OTT BLOCK
CONSTRUCTION — - NEW ADD ALTER]REPAIR (MOVING OEM LIS
LENDER
BRANCH � /� •
OWNER — �1/..
ADDRESS ,.,,—J VALUE 4,0
ARCHITECT TEL. USE �I//CP'1 $
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OR ENGINEER ----
NO.NFIRE
STRUC1T/ \
ZONE V GROUPADDRESSAYPROVED CONTRACTOR �L[/(,�-(/fr BVDATE�7J rj(J�}i/���tCCC
ADDRESS Site�.l,ysi OF i( USE OF NC�J_ '_v'I
TEL. � i/{il��hl(y� „jyBUILDING
CITY NO. C/
IF STATE /// CITY YARDS APPROVED YARDS APPROVED I I
gLIC. NO. ?SI G/� /� / LIC.NO. MAIN BUILDING •CCE$$ORV BUILDING \ 1
la SIZE / NO.OF BLDGS. (FROM C/L STREET) ��
/
On OF LOT NOW ON LOT RONT FT.
et
XE OF �� '/.
EXISTING BLDG, R SIDE FT /
1 ,A 6 /
SF Separate permits are required for L.Sl /1/Jt/�FT. /
G electric,plumbing and heating work. RE L IVIY' FT. 4 FT.
W USE OF BUI INC AND W ¢�.TO BEP FO MED
QF 1'•P A *-444 ,yF / DISTANCE BET. BET. AIN O
,INC r7/�(/(�r A,�j r�P/s(/ MAIN BLOCS. ACCESS,BLOCS.
VAR.* DATE
'� C.U.P.NO
/APPROVED
1
APPROV / V:/7X(
..+ ...__BY DATE /�
a
0.
a0 I hereby acknowledge that I have read this application and state n
IX that the above information Is correct and agree to comply with es
a• all laws regulating building construction, and I shall not employ
i
Z any person In violation of the workman's compensation laws of
Sthe State of California. m
I herebycertifythat I amSQ. FT. a
properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 0
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE 0 LV:
am exempt from the provisions of the State of California Business a
VALUATION PERMIT FEE $ ._---
and Professions Code,Division 3,Chapter 9, 4/
in
in
PLAN CHECK $ re
Signature of �j /� �'kf 1 �/� LL
Permittee /j�l( (A��\ (i�(.t/J $ �(/U TAX $ J(/ S
�) U
Authoriz gent TOTAL PAID $ �.. 60