HomeMy WebLinkAbout767 HUDSON AVE - Building PermitsLot 13 Tr,
144=172
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING
ADDRE6S Avenue
COSTA MESA CALIFORNIA
MAIL
TEL.
IBCTNEL
O. 61195 No. MI 6-3PP7
SIZE , h I A A ._ / I NO. OF SLOGS.
88T0ACK LINT PROM
1
CENiPJt OP BTREBT
REAR YARD
,
I
SIGNATURE OF
PERMITTE
I
+DESCRIPTION
SIDE YAR, LEFT J
a
PLAN CHECK 5 175-0
RIGHT -T-
DESCRIPTION
OF WORK
NO. OF
EXTERIOR WA�UCC0 (ROOF Mod shingle ,
COVERING COVER
USE OP BUILDING AND WORK TO BE PERFORMED
F E RECEIVED
IWAY 17 ICS
FINANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT
SE"/1NO.� .I
By I DATE
'l �1iIIY'i(O�I '. VYii
COSTA MESA. CALIFORNIA ^
APPROVED
BY DATE
ZONING
ZONE I NO. OP I (IBE OP NEW
R 2 -1 PLANS BUILDING wl at gar
LEGAL ... ... _ i I —
YARDS
APPROVED
(CENTER LINE ST.)
U
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
BUILDING CONSTRURION.
SIGNATURE OF
PERMITTE
�-
�--
PERMIT FEE $ ✓ '�
a
PLAN CHECK 5 175-0
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AUTHORIZED AGENT
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