HomeMy WebLinkAbout636 17TH ST - Building Permits6634
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 317
COSTA MESA. CALIFORNIA
FOR APPLICANT TOE14 IN
BUILDING • i ,
ADDRESS (J
PH 22-58fJecsa�767a *****6.00'
APPLICATION FOR PERMIT
BUILDING
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COSTA MESA. CALIFORNIA
FOR OFFICE USE ONLY
RECEIPT NO.
�„E�IT NOC
3
OWNER
MAI L
VvD BY
O E RECB Ejh
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DATE SU
ADDRESS
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TEL.
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BUILDING /- i /
CITY
NO.
ADDRESS b
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ARCHITECT
A uNO. 0�
COSTA MESA. CALIFORNIA
OR ENGINEER
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,
FIRE 2
ADDRESS
ZONE/
CITY LIC.
i0
NO. OF
P Ns
TYPE GROUP
CONTRACTOR -57d--1444-
NO./
' / ] / %
TNOLIEJ I
BYPROV �� Z �/
/
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c DATE
_ADDRESS
LEGAL
LOT
DESCRIPTIONCORRECTIONS
NO.
BLOCK R
�
A.P. NO.
Q 4 Q
SIZE
OF SLOGS.
y f�
OF LOT /
'
Now ON LOT
USE OF
rValP
CITY Di= "STA MESA
E%I STI NG BLDG.
SETBACK LINE FROM49
SUBJECT TO UG. DEPT. REG.
CENTER OF STREET
REAR YARD
SIDE YARD RIGH LEFT
DESCRIPTION OF WORKDA
PLAN TcCH
NEW
I JJALTERATIOIN'
ADDITION
-
REPAIR
MOVING
DEMOLISH
BUILDING
'� No. OF
SIZE
ROOMS STORIES
EXTERIOR L
ROOF
COVERING
_COVERING
NEVBUILDING
BUILDIDI NG
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r
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE
15 CORRECT AND AGREE TO COMPLY WITH ALL
CITV ORDINANCES AND
STATE LAWS REGULATING BUIL INE CONSTRUC.
VALUATION
PERMIT FEE $
TION. •
SIGNATURE OF(
PLAN CHECK $
PERMITTEE
E
$ ?e7/y \
1.•��
AUTHORIZED AGENT
[
TOTAL FEE $ 7
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