HomeMy WebLinkAbout421 FORD RD - Building PermitsOWNEA W �_ T.ONf: C(1_ - DATE (�_?_(�1
JOB ADDRESS 1,91 _A FnrA AnnA BUILDING PERMIT NO. -16r.0(1
CTIfj-(10 FIRE ZONE DESCRIPTION OF WORK
DATE I GROUP i TYPE t7
SUBCONTRAGTOR
OCCUPANCY
Form 210-SM-11-59 5-B P i1�IT p�421) HnLD FOR SPECIAL REQuuzr.rn�n►� , lfas9p
VALUE
AP. No. LOT #9 T1tACT #3'] S FIRE ZdNE DESCRIPTION OF WOAK
,.�;,:� ECTIONS (// DATE �GROUP I Bc J TYPE V
[�'��,.�'rgmund Soi1Gg.(4r U.G. Water (ri �i% PERM17
..-.. _______, ,.__ . . � � .+—I SUBCONTRACTOR I .
OCCUPANCY I I I� I
Form 210—SM-11-59 S-B PUNITS B�c� (y'� � HOLD FOR SPECIAL REQUIREMEN7'S � 1L�591 �
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CO3�TA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CA1-�RORNIA
For Applieanf fo Fill In Complefely
TYPE OR PR�INJT
ADDRE65 �-f- / ^� / / �G ��I- f K
COSTA MESA CALIFORNIA
OWNER W. G. Lone Co. .
� ARCHITECT
USE OF
EXIBTING BLDG.
88TBACK IANH PROM
W. Coast Highway
�rt Beach Californi
.41-B1 No: MI-67731
3 No. oP 61a06.
x 1 6 NOW ON LOT
5Z � REAR YARD
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DESCRIPTION OF WORK
ROOP
CO COVERII
AND WORK TO BE
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F E RECEIVED
�p,qAY 2 6 i^�1
fINANCE DEPT.
CITY .OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
BY
rL�'�I`t
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ZONING
NO. OR 88 OP N6W
PUHe em�o�Ha
YARD6 EVES
APPROVED ALLO
, (ClNTER LIN6 8T.1
_ FRONT - S�i
1 HHREBY ACKNOWLeGOH TXAT 1 HAVB fte�� 1'N19 APPLIGTION
AND eTAT� TNAT THQ ABOVE 18 GORRQGT AND A6Ree TO COM-
PLY WITX ALL GITY ORDIN NCEB AND 8Y�1TE F180ULATING
BLIILDINO CON9TRUG�7jN� // � _
SIGNANRE OF Y� % /�
� AUTHORIZE� AGENT
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PURPOBQ OF ¢BTABLIBHINp A PERMIT FEQ ONLY.�
VAWATION � /�L
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A MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX Df7 C08TA MEBA. CALIRORNIA
For Applieanf fo Fill In Complefely
TYPE OR PRINT
BUILDING Q,U S- G �'o,e,p ,Q�
ADORE88
COSTA MESA. CALIFORNIA
OWNER W C. G G�G GD
MAIL 300 � Ga
AODRESS �T N��'N�
Cin ��i,i�2T BE1luf NoM� �7�'�
OR ENGINEERH'�����G�T �✓�%IT�N�.JJV' ���
ADDRESS'�� �� �o/y o,JWEA<THTe
CONTRAGTOR in/, G, L o n/6 C O
noowFc5�0o �`( Cd.437'%��01�/�%
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F�E RECEIVED
(�` 619fi1
� � `n^AYNCE DEPT.
APPLi�� �'jR�1�
BUILDING
For Office Use Only
R8G8111GD BY
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FIRE
LIC.TNO. /.�i / I _ �I NO. /�%/ �J %%� / Lew�
oesaar
BvZEnr �y X �3 � INO;•OP-BLDOB.a
8[TBAG1c LIN[ PROM � /O ��AR YARD /�
CeNT6P OP BTPHBT /
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61DE YARO LEFT ���y RIGNT
DESCRIPTION OF WORK
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1?tJl�t Ex J�/�TS
f g�TL�cHGO CAr2Po�2'T�
1 H81i8BY ACItNOV/LHDOB TNAT 1 HAVB RBAD TXIB APPLIGTION
AND 9TAT8 TNAT TH8 ABOVH IB CORPHCT AND �OR88 M COM-
PLY WITM ALL CITY OIiD�NANLHB AND BiAie B 116ODUTIN6
9UILDINO CONBTRI�I/g,� Ory/
81GNATURB OF Y / / � /'_
� AUTHORIZED
woc i i✓ - cu ra.eu
COSTA MESA. CALIFORNIA
ZONING
NO.OP USH OP N
PL�NB 'Y BYILDINO
YARDB
APPROVHD
(C[NT6N LINB 9TJ
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TME AMOUM BHOWN UNDHR VALUATION IB P00.
PUN088 OP 88TABL19X�Np � PBRM�T PHH e
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COSTA MESA BUILDING-SAFETY DEPARTMENT
�"� P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUI�DING /'
ADDRESS G
OWNER OR /'�rjrJ, �
TENANT �/f�r�Ro7e�.
AD�RE55�2j rvw �D A ^ �_ l�
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CITV t�(J�,/T/V ���A NOL�(� y
Nd4ee6
APPLICATION FOR S"
NO. //S�
3�.` �or Z
NEW ADD ALTER REPAIR
5.50 7L'
PE��50 TC
BRANCH OW R hU(% /�//�/G•
ADDRESS �� �� VALUE
AFCHITECT %O� Th. V` TEL.�rso n�� USE L( � $
CONTRACTOR d�I�/�� BYPROVED DATE ` Z
ADDRESS
TEL.
CITV NO.
o-Fi STATE CITV %�PPROVEDSETBHCKS
LIC. NO. LIC. NO.
{r� SI2E NO.OF BLDGS. (FROM C/L STREET)
� OF LOT NOW ON LOT qONT FT.
a USE OF
i.N. EXISTING BLDG.
h
FSepara[e permits are required for L. SIDE FT. �
� electriC, plumbing and heating work. REAR FT. "
F USE OF BUII�ING AND WOliK TO BE PERFORMED P�qNNING ACTION
� � /
"� SK (..�(� DATE
¢ APPROVED
� APPROVED /0. �
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0 I heraby ecknowladee thet I have reetl this appllcaiion entl steta �
y� that the ebove Informatian is corract antl apree to comply with
�. all laws reBulatinp builtling connruc2lon, enG I shall not employ �
,Z any person in violation of M¢ workman's compansation lews of d
� tha Stata ot Californla. -
x m
3 � hereby cartity cnat � am properly licensetl as a conttactor untler SQ. FT. N
the Stata of CalifOrnia Business and Protessions Cotle, Dlvision 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR m
Chaptar 9, antl that sue� licanses are in full force antl eftact, or I THE PURPOSE OF ESTABLISMING A PERMIT fEE ONLV: �
am ezempt from e provlsionsof [heSCd of California Business a
antl Professio 0 s, DivisioT 3, Chapter 9 VALUATION PERMIT FEE $ , D i% �
�� PLAN CHECK $ ^
0
$iBndtUfB Of �� �� LL
Parm�fttee $ TAX y S b u
Authorized A nt Date — TOTAL PAID S � s�
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