HomeMy WebLinkAbout814 JENNIFER LN - Building Permits. :a;�d.— �.�
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COS7A MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
ADDRESS 814-A B C Jennifer Iane C.M
OWNER R1C1]tiiCl S2W2�.1 II1C.
ADDRESS 136 Rochester Street
TEL.
CITV iYlatsi MP4'i qi�ii% NO. ji4i-4ql
BRANCH
AODRESS
ARCNITECT _ __ _ , TE
CONTRACTOR
ADDRESS
CITV
F STATE
� LIC. NO.
W SIZE
� Of l0T
a USE OF
� EXISTIN6 BLDG.
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TEL.
NO.
CITV
LIC. NO.
NO.OF BLDGS.
NOW ON LOT
� Separate permits are required for
� electric, plumbing and hea[ing work.
(.W., USE OF BUIIOING AND WORK TO BE PEFiFORMED
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FQ'�G'77�N�U�� �.�j'•� ��.��:156.50
APPLICATION FOR STRUCTURAL PERMIT
RECEIVEDBY OATERECENED neTc�cc��cn
�V//
BUIIDING
ADDRESS
OVEO
C:
VALUE
j,JE NO.OF USE OF N
f PLANS� BUILDI�
VARDSAPPROVED YARDS
DI5TANCE BET.
MAIN BLDGS.
VAR.�k,._ "
DATE
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� I �ereby acknowledge Net I havo raed thia epplicetion entl state �
� thot the above Information Is correct antl a8reo to comply with
a ell lews lBguleting bulltling conrtruction, entl I shell not amploy m
Z eny poro0� �� ��olation of tho wOrkmon's compensntion laws of
� tho Staie of California. � -
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3 I hereby certify that I em proDa�lv Iicensed as a conttactor �ntlor SQ. FT. � G L (/ H
tha Stata of Calitornia Busine�s antl Vrofasslona Coda, Dlviaion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chnpter 9, entl tha[ such Iteances uro in fu11 torce end eifoct, or 1 THE PURPO6E OF ESTqBlISHING A PERMIT FEE ONLY:
am axampt irom i�e provislons of tha Smm of California Businen VALVATION PERMIT FEE E �
nntl Protessions CoEo, Dlvision 3, Chapter 9. m
PLAN CHECK S ^�
Sipnetura oi /•/y//� � • �
Pu�mlttee $ /�y � TAX S LL
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A�thorl P.Ba^t TOTALPAID E
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
.,nR-n.7i�.�.�GUiJO 607 C':tt.u2J.�.C�
APPLICATION FOR STRUCTURAL PERMIT
For Applican[ to Fill in Completely — Use Ink Only qEGEI V ED B V DATE RECEIVED
DATE ISSUEO
BUILDING
ADDRESS 8 Q—
PERMIT NO.
OWNER �'(h3r(i 5�11 II1C. P"P' N�'
eui�oiNc / � E
ADDRESS 136 Rochest St'Y t. �+DDRESS �s/ '�
TEL. TRACT LOT BLOCK
CITV NO.
CANSfRUC710N W A P
LENDER
BRANCH
OWNER ��ELL--
ADDRESS � VALUE
OR ENGINEER SdIll AtilYD3 �+] NEL. _ SE S
FIflE
AODRESS ZONE TYPE GROVP
APPROVED
CONTRACTOR �Lps BV DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW
CITV NO. P�� BUILDING
STATE CITY 1'ARDSAPPROVED VAR�SAPPROVED
IIC. NO. '281(1H Bl �IC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT NOW ON LOT RONT FT. FT.
USE OF
EXISTING BLDG. FT
Separate permi[s are required for L. SIDE FT. FT.
electric, plumbing and heating work.
REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN &
MAIN BI.DCS. ACCESS. BLDGS.
VAfi. sl� DATE
C.U.P.� AGPROVED
APPROVED
I hereby acknowlatlBe that I �eve reetl this application entl smte i
thai the abova Infotmetlon ia corre<t and aprea io comply wlth
ell lawa re0uletinp bulltllnB conrtruction, and I shell not amploy � �
eny percon in vloletlon of tha workman's compensaUon lewa ot �
tho Stata ot Cnlifornia.
I hereby certlty that I om properly Ilcensetl as a contrector untlar SQ. FT. N
the Stete of Cali}ornle Buelnon antl Professlona Code, Dlvielon 3, TNE AMOUNT SHOWN UNDER VALUAT�ON IS FOR m
ChaptO� 9, e�tl Shat eueh Ilcensas e�B In full fo�te enE offect, a� I THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLY: �
am ozampt from iha provlalons of tha Stnte of Cellfornio Buslneca VA�V ATION PERMIT FEE
entl Profeaslons Cotle, Dlvlflon 3, Chepter 9. m
PLAN CHECK b '^
Sipnoture ot �
LL
Parmittae 5 TAX S f
U
AuthorizadA t TOTALPAID E �
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