HomeMy WebLinkAbout3391 CALIFORNIA ST - Building PermitsG77G
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING �"') /i 1 Fo C/1 / I.pa
ADORFSS l� V C /- /I
OCT —8-69%.'SAB00 343* *** 129.00
APPLICATION FOR BUILDING PERMIT
OWNER e 1,4� LADDR
MAIL ,/
ADDRESS ��07 nn�++QQ TEL.CITY N Ii l.Ii�alNO..j 7'CONSTRUCTION , . T l rl r/
BRANCH /`o Mg QnCI. WA
ADDRESS,tt
USAN P9e �-sAL-rl r
ARCHITECT TEL.
FI
APPROVED
CONTRACTOR
1
ADDRESS ,�
m
a 3/,
2
NO. OF /
USE OF NEW
TEL.
�
CITY r1N/A
,A
NO. 7
rVALUA-TIIONpB
PLAM
BUILDING
STATE
PERMIT FEE S/
CITY
YARDS APPROVED
YARDS APPROVED
/� p
LIC. NO. I-.� (—
3
LIC. NO. ra
MAIN BUILDING
ACCESSORY BUILDING
TOTAL FEE $
(FROM C/L STREET)
SIZE
NO. OF BLDGS.
OF LOT
NOW ON LOT
FRONT FT.,
FT.
USE OF
EXISTING BLDG.
FT.
SIZE OF
NO. OF
NEW BLDG.
ROOMS STORIES
L. SIDE T.
FT.
EXTERIOR WALL
ROOF
COVERING
COVERING
REAR
USE OF BUILDING AND WORK TO BE PERFORMED
nicrenlrc cvT
oar ..,. �.� n.
/� 1 VAR. DATE
y9y/ L,:, n.. pg y^ a& WALL AT7 A41 C.U.P. APPROVED
/ _ tl_ APPROVED J /D ... �. .v
I hereby acknowledge that I have read this application and state
that the above information Is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
am exempt from the provisions of the State of California Business
and Professions e, Divislo , Chapter 9.
Signature of
Permittee Ue- _
Authorized Agent
— _
m
N
SO. FT,
o
AMOUNT SHOWN UNDER VALUATION ISFOR
URPOSE OF ESTABLISHING A PERMIT FEE ONLY:
rVALUA-TIIONpB
PERMIT FEE S/
PLAN CHECK S
�C�
TOTAL FEE $