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HomeMy WebLinkAbout2566 ELDEN AVE - Building Permits PAID SEP 28-77cfl—sA001478* *****5.50 • 44728 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 0 y • RECEIVED BY DATE RECEIVED D#TE ISSUED BUILDING { ) a 1 / -2!- ADDRESS�d , Jif V �ZJ C-# / y OWNER /000C-#S C, iI I . ACP. NO. / / AL. MAIL O/l /I a BUILDING / / rii a ADDRESS ! (// 42r 42 /E-R-, ,Cr: ADDRESSTE �j ((J('7 f(f CITY /V :/.4.XQ 42 42i S10L TR ACT5�_� LO BLOCK CONSTRUCTION /' NEW ADD LALTE}l REPAIR MOVING \nEM01 ISH LENDER BRANCH OWNER JOUtS _ .J • ADDRESSARCHITECT n J') }/ en) � s VALUE ' 7 it OR ENGINEER '?7l+{' '��'I7 ( ,�(("�)� NOL,.0--`liC y(/{/v USE �/� "� /l�!/�•/,/}— L7 E ADDRESS /33 / I ,� •� J(pI/(�/T�h FIRE TV'E y GROUP '''///111^� APPROVED ,iiir,_, r DATE —' I, v/ CONTRACTOR �(J�L /rte - the BY ADDRESS /ti/5 d 6V .„L_,,,U.f ZON ///��� NO.OF USE OF NEW y� TEL. �k- �PLgNS © BUILDING � h/ CITY CJ �` �L_ NO. !l/��� F. STATE / CITY YARDS APPROVED YARDS APPROVED gLIC.NO. 0O�ci 7') LIC. NO. MAIN BUILDING ACCESSORY BUILDING CO SIZE NO.OF BLDGS. (FROM CO_STR 0. OF LOT NOW ON LOT / FRONT T. A // t FT. Q USE OF y �/-'� �/�� 1 EXISTING BLDG. ,-CC/`1y)"V R ODD _ T. FT v) FSeparate permits are required for L.SIDE FT. 0/ jLK electricit- ,plumbing and heating work. REAR FT. MVV/ K. FT. I.W., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0 MAIN BLOCS. ACCESS.BLOCS. VAR.# DATE ..1 �� Q , r C.U.P.sW APPROVED APPROVEDgen Cil eJ-//fir//� _RY DATE IY W 0 I hereby acknowledge that I have road this application and state � cd that the above information Is correct and agree to comply with co.. 0. all laws regulating building construction, and I shall not employ I Z any person in violation of the workman's compensation laws of o 5 the State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. t)i the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR to Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the tate of California Business VALUATION PERMIT FEE E (') e and Protonic ode, vision Cha er . �`� in co Signature o r� PLAN CHECK $ c Permittee /O c.7.,c.7., ei'�S 0` Ol/ TAX $ _so u Authorized nt TOTAL PAID $ 5: So