HomeMy WebLinkAbout320 17TH ST - Building Permits�f ,: 25si2
- � COSTA AAE5A BUILDING-SAFETY DEPARTAAEPR
V.O. BOX 127C COSTA MEBA� CALIFORNIA Y2620
Por AppllmM ro Fill /n ComplN��y
TYPE OR PRINT
COSTA MESA. CALIFORNIA
'4� SNOINB[R •A �- E N �
aeoa � 1?%x.._ �• V c a. m c.� I �. i
-T
�o�croa �: ct, • �l e, a T
ADnR6W ��O �i a. M H J G!1 t g%6.a,.
��, A.� .� �
ucTNo. ��/%G3 0'S3o-33��
812E •r"� / X�'/.�. ,�T I xo. oI eLao�. %'i
OP LOT �J ( 1 NOW ON LOT �/
USH OP
EXIHTINOBLDO. 'Cd f-{'� �'
B6T�ACK LIN6 FROM
C8xi8� oP Bfp[tT RGR Y '
B1D�YAHDI LCIR RIOITT
DESCRIPTION OF WORK
1 H[P6lY ACkflOWL�DO� TMAT.1 XAV6 PtAD'YI�IO AP�L�GTON
AND BTAT6 TNAT TNC ApOV[,IB CORXtCY AND AON[6 M COM•
PLY WITX wLL CITY �RDIN11NCi� 11ryD OTAT[ IJ1M1/ R�OYIATINO
lUILOINO CONeTRyR10N.
81GNATURlOP �I ,. ���
P8RM17T6s
AU7HORIZ[O AORNZ \YXY � ` — ,
crb�
6T
ciTY v� ����� ��sal
APR 22 1966
AMLICATION FOR PERMR
��UI Dlt�i `p^���
� �.J'Y
R[C[IIT NO. �MO
ZONING
no. or � u.a
ruws suty
YARDf MPROVFD
MAIN BUILDINO
ecr.
VM. �j
�-�.5�,�-- Co�
7— �'Y'/'- c�
i0 BXALL �6 L688 THAN
YARDBAPPROVHD
ACCH880RY BUILDINO
7
L �_
eer. i
ACCE
DAT6
APPR
(A.L+
1Xt AYOYNi YNOWN UND6H VALUATION 19 POR TH8
►YqP08[ OIr iYTAOLI6XIN0 A P6RMIT Pi8 ONLY.
a
m
�
�
x
0
�
r7
�
E
W
I
I "
• � � � 2�7�7�7
_, NAR 77-69�MSA00 733 0***��*$.00
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 -
ForApp�icant to Fill in Comp�etely APPLICATION FOR BUILDING PERMIT
RECE ED DASE RECEIVED n�r� ��u �
BVILOING �/„�O
ADDFESS ✓ � �
1 �
OWNER R'Y�L A.P.NO.
MAI L /[ BUIIDING
�! ADDRESS �I J- �/�Id �� �+DDRESS ��
Z .
W W TEL. TRACT �
a U CITv �.Ly,� NO. -
Z
Z Q CONSfRUCTION W ADD
� LENDER
� N
2 p]
J 7 BRANCM
' � OWNER
Q ADDRESS
C
ARCHITECT TEL.
J a OR ENGINEEfl N �
U Q FIRE
w � ADDRESS ZONE
d W r 9 APPROVED
J O CONTRACTOR /'IL(/� , ./ -37C � BY
m ` /J ! �
J� ADDRESS 1%Oj s G"Ci',wri►-rld -P
LOT
VALUE
W w ZONE NO.OF USE OF NEW I
ZF CITY .� NOL S'bQ�/I �� ��� O BUILDING
y� l C NO. LICVNO. /pZ/ (f vMA NSBUILD�INGD ACCE SORV BUILDDING
�y�-3� �
�� 512E NO.OF BLDGS. (FROM C/L S ET)
OF LOT ' NOW ON LOT pNT FT.
USE OF
EXISTING BLDG.
H SIZE OF NO.OF
Z NEWBLDG. ROOMS STORIES L SI� F.
�% COVEFOINGALL COOERING REAR f
US OF BUILOINCp AN WORK �P RFOHMED DSTANCEB
� I� � MAINBL
�
Q VAR. aW
O C.U.P,9h
r APGROVED
N
Z
O
UI heraby ecknowledpe xhat I �avo reatl this application entl atate
_ [he[ [he abova information lt tOrrect end eprae to Gomply wlth
� all lows �eBulaNng builtling conctructlon, entl I shall not employ
nny parson in vlolation oi [he wOrkmen'4 tOmpBnsation lawa Ot
��� y the Stato ot Celifomia.
4
l ? 1 �erebY certify tha[ 1 em proparlY ���enaetl as e coniractor �ntlar S�. FT
1 the Stete of California Businass antl Profassions Cotle, Dlvialcn 3, THE AMOVNT S
Chaptar 9, antl that such Iie nsos are In f�ll forca end effect, or I THE PURPOSE OF
am azempt from tha ons of the 5 of Californla Buslneu VALUATION
entl Profassions Co rvlcion 3, Ch
sia�a,�,. o, - �D� °�
Permittae 5
Authorizetl ABeni
FT
DATE
APPROVED
_ . _ _ O'
W
0
!N UNDER VALUATION IS FOR �
ABLISHING A PERMR FEE ONLV: Q
PERMIT FEE $ � �
m
PLAN CHECK $ �� E
0
� LL
TOTAL FEE $ �