HomeMy WebLinkAbout2558 ELDEN AVE - Building Permits SEP 28-770
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44724
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only A
rr�, yam.+/ RECEIVED BY DATE RECEIVED D•TE ISSUED
A DIDRESS //.tc1/J / ./� I� Ali
OWNER /IJ O U�� v • A.P. NO. ' ...
- "� 21E.. T 4
BUILDING
MAIL � 0 / / O� 1 4 ADDRESS ��� �i��/(� I'
ADDRESS CJ ///���,,,��� Y (J/(//) ` T�Q'e[� F
CITY �1/�t/ /J*Cr / �'� NOL TRACT 3 4 1 LOT 3� BLOCK
CONSTRUCTION /" NEW ADD ALTER REPAIR MOVING DFM
. LENDER
BRANCH OWNER )n U/CSC 2t i,
ADDRESS
�}j�y� VALUE
ARCHITECT _ TEL $_ LOC./1W _ �' $ - i,i �—
OR ENGINEER/2 �� A f w tre
FIRE
ADDRESS J�J. _ ZONE TY'E GR!UP
Alan, APPROVED
CONTRACTOR ', , ,e. BY OW DATW ,
ADDRESS ,c -/C /0 —et( ",&../a: --nn
/�^/p-n, ' TEL. ZON `2,PLANS OF so,A USE OF NE
CITY Oie.)J"r� s `= NO. �/ BUILDING
ou. STATE C� CITY YARDS APPROVED YARDS APPROVED
LIC. NO. go -_a7 LIC.NO. MAIN BUILDING _ ACCESSORY BUILDING _
4SIZE I NO.OF BLDGS. / (FROM C/L STRE )
4 OF LOT NOW ON LOT ! FROM , _ T.
Q USE OF z'/l� 0 L7/7V7
ca EXISTING BLDG. ! R,SIDE FT. FT.
F Separate permits are required for L.SIDE FT��L/ T.
electric,plumbing and heating work. C. —z�
W - REAR CTT. T. ,
.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& '
nQ MAIN BLDGS. ACCESS.BLDGS.
...1 A �) /�n VAR.# DATE
'et
.PN , /` ��• C.U.P.# /� �[/'/�y�—(r(/J����APPROVED r� 2
7 APPRO' /'A�/�'� r / �� //
.›.d _BY AP [ DATE �4
I4
0 I hereby acknowledge that I have read this application and state n
m
te that the above information is correct and agree to comply with y�
4 all laws regulating building construction, and I shall not employ
i
Z any person in violation of the workman's compensation laws of m
the State of California. A
I hereby certify that I am properly licensed as a contractor under S .FT. a
O
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 qq iO
VALUATION PERMIT FEE $ ,4t00 v
and Professions Code,Division 3,Chapter 9, n
PLAN CHECK $ to
Signature of / b 00 O
U.
Permittee A A �MA• $��•�� C fO
/ TAX $
Authorized AA tU
` TOTAL PAID $ ���