HomeMy WebLinkAbout437 17TH ST - Building Permits673'7
COSTA MESA BUILDIN b PA TMENT
P. O. BOX 317
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING I J �cAsr 1 %� $T
ADDRESS 7 %�
u'EE RECEIVED
j- /,,I -6'q VL`
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
COSTA MESA. CALIFORNIA
FOR OFFICE USE ONLY
r �/ / I L'�• I'
RECEIPT NO.
PERMIT NO.
OWNER /� /i�iy�
MAIL O (•� ^�,
8a /
RECEIVED BY
DATE RECEIVE
DATE ISSUED
ADDRESS a
1'-
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IIZJII/
BUILDNG
CITY /1VG-117.V ,(J1,-,90�"NO.
ADDRESS
ARCHITECT LIC.
OR ENGINEER NO.
COSTA MESA. CALIFORNIA
FIRE
ADDRESS
ZONE
CITY LIC.
LONE J NO_NBF
/vJ
TYPE � / GROUP
CONTRACTOR Tl (/1.• /VC NO.
(/,/
TEL.
APPROVED
_ADDRESS ✓ NO.
BY DATE
ESCRI
PTION
rao
BLOCK
�cf'
A.P. NO. I '3 -1;z/ -/C
ACORRECTIONS
f yJ E�!
SITErO X 3
NO. OF SLOGS.
JL It%
a o
OF LOT J V
Naw DN LOT
'
USE OF
G DEPT'
BLDG.
h(,=�•I'�II
.EXISTING
SETBACK LINE FROM
BiLCI TU
CENTER of SiREEi REAR YARD
SIDE YARD RIGHT LEFT
/
DESCRIPTION OF WORK
PLAN T.�
NEW
ALTERATION
ADDITION
REPAIR
MOVING
DEMOLISH
BUILDING NO. OF
SIZE ROOMS STORIES
E%TER I OR WALL
OOF
COVERING
_COVERING
USE OF NEW
BUILDING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE HEAD THIS APPLICATION AND
THAT THEAG C
THAT THE ABOVE I$ CORRECT ANDD AGREE TO COMPLY WITH ALL
CITY AND E LAWS REGU UILOI G CON RUC
CITY
VALUATION
TION.
PERMIT FEE S
SIGNATURE OF
PERMITTEE
PLAN CHECK S
TOTAL -FEE S
AUTHORIZED AGENT
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