HomeMy WebLinkAbout167 18TH ST - Building Permits AUG 10-7607OO 954' *****5.50
4240,5CRSO
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APAN FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only RE E / DATE RECEIVED
BUILDING p/�[7�� (i AT ISS
ADDRESS //�yrRe 7 /9 �O 7/ z �/7 J^,/, �V NO.
OWNER / /I se,...„/ //MAIL A.P.NO. I! // �`^y
ADDRESS /3c /?cc (/ r1 7' ADDRESG S �, / ` _/
CITY C o� ('t le-,r„c.c N o`.ce."vyo1� N4ff,Cc," • H 69LO'r ''d...12gy-OCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI LSH
LENDER
BRANCH • Sect,/
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OWNE Q
ADDRESS VALUE
ARCHITECT TEL. USE /T'--- E
OR ENGINEER NO.
FIRE
ADDRESS ZONE ifiT�PE GROUP 1
APPROVED l/yam, /.f.,� \(`1t•1
CONTRACTOR Q��ti �/ BY
DATE (/ f7 _
ADDRESS
TEL. Z OF VSE OF NEW
CITY NO. NSBUILDING •
F
STATE CITY YARDS APPROVED YARDS APPROVED 1
LIC.NO. 472(�i�45-/c9./e7 / LIC. NO. MAIN BUILDING ACCESSORY BUILDING �
ralSIZE I NO.OF BLOCS. (FROM C/L STREET)
A. OF LOT NOW ON LOT FRONT FT. / FT.
Q USE OF I'
cn. EXISTING BLDG. R.SIDE `/J
CAt
Fi
Separate uin are required for L.SI FT` n
electric,plumbing and heating work.CI RE FT. (r„)/I,ll�,l/v ��FT.
k7 USE OF BU LDING AND TO BE Pd RFORMED
F 5 ,/ D LCED BET. BET.M.B Si
QQ }[J e A./O /� �/ MAIN BLOCS. ACCESS. BLOCS.
Q VAR.*
C.U.P.qS DATE
APPROVED VED
ROVELn✓ /I/ �/r
> _ DATE 8a— /V �jGL
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Q I hereby acknowledge that I have read this application and state n
C that the above Information Is correct and agree to comply with co
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0. all taws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of u
S the State of California. m
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N
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 FEE ONLY'
am exempt from the provisions of the State of California Business � e
VALUATION PERMIT FEE $ o
end Professions Code, Division 3,Chapter 9. �� n
,�–'PLAN CHECK E o
Signature Of //�� U
Permittee iL11./1 / 1 / 9,-C 5 TAX E
Authorize Agent U
TOTAL PAID E ���/