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INSPECTIONS et al
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TYPE V
GROUP
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SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
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TEMPORARY SERVICE OR POLE
UNDERGROUND POWER
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ROUGH WIRING
Heatima and
Vent.
TRENCHES FORMS STEEL REINF,
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BOND BEAM "STEEL REINFORCE
SHEATHING
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FRAME AND FLASHING X
LATHING — IN OUT -/%,
PLASTER. BROWN COAT
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STRUCTURAL,FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL
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PLUMBING, FINAL AND GAS TEST
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ELECTRIC, FINAL
BUILDING, FINAL
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43578
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
' aU ^LDING /A/1 -7 L_
OWNER LIS YIC �(
MAIL
ADDRESppS��� �67d I/r y / I -KV
TEL
CITY IYKat/ h'T H No. -Z,5-11(
CONSTRUCTION
LENDER
BRANCH
[ADDRESS
ARCHITECT .._. _ TEL.,/..., -
C
BUILDING
AODRESI
FIRE
ZONE
APPROVED
'FR 0013291 ***215.111
FOR STRUCTURAL PERMIT
R
RMIT NO.
NTRACTOR
tlY us. i e / f/
DRESS
that the above Information is correct and agree to comply with
TEL.
NE
NO. OF
USE OF N
TY NO.
PLANS
BUILDING
ATE CITY
YARDS APPROVED
YARDS APPROVED
. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
E
NO. OF BLDGS.
(FROM C/L EET)
snd Professions CO a Division 3, Cha ter 9.
LOT
NOW ON LOT
FRONT FT.
FT.
E OF
[EoF�,IVING
Signature pi
�s/1 ./
ISTING BLDG.
SI T
FT.
Separate permits are required for
L. SIDE 'iT.
FT.
electric, plumbing and heating work.
REAR i
FT.
UAND WORK TO BEP RFORM ED
DISTANCE BET.
BET. MAIN &
Gsx/bO
MAIN BLOCS.
ACCESS. BLDGS.
VAR.#`
DATE
C.U.P./�
APPROVED
APPRoD/!'L�s/L'1
Hort /l. 7%-%
1 hereby acknowledge that I have read this application and state
that the above Information is correct and agree to comply with
LD FOR 1'L•\.1..L
1 EQ
all lows 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
SQ. FT. =
46
THE AMOUNT SHOWN UNDER VALL
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PER
am exempt from the, rovislons of the State of California Business
VALUATION
PERMIT FEE $
snd Professions CO a Division 3, Cha ter 9.
Signature pi
�s/1 ./
PLAN CHECK 5
1 TAX t
Permittee '
$ /-/// -/ 1A
Authorized Agent - - I TOTAL PAID 4
N
n
tILVItYV I
ON IS FOR D
FEE ONLY:
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LL
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COSTA MESA BUILDING -SAFETY DEPARTMENT
A IF RNIA92626
P.O. BOX 1200 COSTA MESA, C L O
A L1 ATI N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completel—,Use Only
RE E D
OATS RECEIVED
D E ISS E
_
!Ink
BUILDIADDRENG/,9/3
/O/3 S''/� "'V v""�
'PERMIT NO.
OWNER GA L �.S /{/�
A.P. NO.
MAIL
ADDRE S/O/—? /�G
ADDRESS
TEL.
CITY NO.
TRACT
LOT BLOCK
CONSTRUCTION
W
A
ALTERREPAIR
LENDER
BRANCH
OWNER
ADDRESS
VALUE
USE (/ S
ARCHITECT TEL.
OR ENGINEER N
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED
CONTRACTOR
BY DATE
ADDRESS
TEL.
CITY NO.
ZONE
NO. OF
PLANS
USE OF NEW
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO.OF SLOGS.
IF ROM C/L STREET)
OF LOT
NOW ON LOT
FRONT FT.
FT.
USE OF
EXISTING BLDG.
R. SIDE FT.
FT
Separate permits are required for
L. SIDE FT.
FT.
REAR FT.
FT.
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET,
BET. MAIN &
MAIN SLOGS.
ACCESS. SLOGS.
VAR.*
DATE
C.U.P.+//+
APPROVED
APPROVED
DATE
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 em properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Coda, Division 3,
Chapter 9, and that such licenses are in full force and affect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
VALUATION
PERMIT FEE E
PLAN CHECK E
Signature of
TAX E
Permittee
$
Authorized Agent
TOTAL PAID E L