HomeMy WebLinkAbout3041 JEFFREY DR - Building Permits4�
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� COSTA MESA BUILDWG-SAFETY DEPARTMEN7
P.O. BOX 1200 .COSTA MESA, CALIFORNIA 92626
16
For Applicant to Fill in Completely — Use Ink Only
BUILDING - '
aooaess ._ 3 41-A.B,C Jeffrey Drive. C.1
OWNEfl R1C.1`]ci1"C3 .5'2Wp1]. TS7C.� '
' ADDRESS 136 RocYiester Street - � �
crrv Costa Mesa • 92627 �n,o`.'642-49
CANSTFUCTION . ' . " - •
LENDEF UI1�410N�I'1
. BRANCH � ' �
ADDRESS -
ARCHITECT _ _. ., . '-TEL.�.,. ...
Ff6 -2-7;�.,���300 i�.13*� *** 167.04
APPLICATION FOR STRUCTURAL PERMIT
RECEIVEDBV' DATERECEIVED DATEISSVEO
15/�._p�-oi,oa,oa,0 _ PERM1�Y�d
BUILDING
nooaess,�'D
TRAC
W ADD ALT R R Po
OWNER ��,ry�/G,
....Ti�.�_ l%.
ADDRE55 .13( RQ `(,.L'LeSY£i St. C.OSY:d MeS3 ZaNE ' �.' TVPE Y � GRO
. ' . . ' • APPROVED -�
CONTRACTOR . ' BV - �DATE
� ADORESS . . ' , • �� • '. . - . .
� � TEL. Z O.OF " USE OF N 11
CITV ' � � NO. . ' � PLANS . ,BUILDI
F STATE �CITV , 'NAROSAPPROVED VARDS,A
� LIC. NO. .'l8].615 B]. " LI0. NO. , ,� ��' MAIN BUILDING ACCESSOR
(y SI2E ' � NO:OF B�DGS. (FROM GL STRE .
�. OF LOT- " � . NOW ON LOT RONT . F .
a USE OF - . . . . .
�.N. EXISTING BLOG. SI I FT
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� � F � � Separate permits are required for �. �' � ' �� �. sioe '� Fr. ' �
q electric, plumbing and heating work. REAR FT: '
W USE OF BUILOING ANO WORK TO BE PERFORMED
' F' ' DIS7ANCE BET.� . BET. MAIN &
� Qn . - ' MAIN BLDGS. ACCE�. BLDi
� VAR.# ' DATE
� C.U.P. —� /? ROVED '
Q
• � • • ` ' • . � � APPROVED
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W . HOLD EQ� SF�EC `r, F��
QI hereby acknowledBe ihat I heve reetl this application antl staie . .,. . •
y� ffiat ffie above informaiion.is`correct antl agree to comply with�� ._
a all laws regulating builtling consttuction,- antl P shell not employ . � •
� z . any person,ln violation of �the workman's compensation laws of � -
' W the State ot California. ' . � -
3 I hereby certify ,that I em properlp,licensetl as a contractor untler SQ. FT.. �
the State ot Californie Business end �P�ofessions Code, Division 3, THE AMOUNT SHOWN UNDER VALU
. Chapter 9, antl ffiat such Iicensas ire dn tull }orce antl effect, or 1 THE PURPOSE OF ESTAHLISHING A GERt
am'exempt from ffie provisions of ffieStata af Cal(fornia Businecs VALUATION � �
- PERMIT FEE �$
entl Professions'Code, Dlvision 3, Chapter 9. . . � .
' Signatura of - '� /'� /y � * � � PLAN CHECK g
f / /
" Parmlttee . $/ /, �D� 'TAX . ' S
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AuffioN ABent � ' . ' ' ' .'TOTA�PAID $
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�T FEE ONLY: , �
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. COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFONNIA 92626 '
For Applicant to Fdl in Completety - Use Ink Only
BUIIDING '_" _ _ _ _ _' ' _ ' _ "
OWNEF
MAIL
CITY C
CANSTRVCTION
LENDER
BRANCH
ARCHITECT
OR ENGINEER
AODRE55
CONTRACTOR
ADDflESS
CITY
TEL.
NO.
TEL.
NO.
h�aR -9-77�y;;Q� b35 a•�*�241.ti0
APPLICATION FOR STRUCCURAL PERM[T
RECEIVED BV DATE RECEIVED DATE ISSUEC
PERMIT NO.
A.P. NO. . . .
ADI RIE S�D�� EFF/C�
TRACT LOT BLOCK
W AD A P
OWNER �EC-�
USE T��� . VALV§ y��
�
FIRE
ZONE TVPE GROUP
APPROVED
ZONE NO.OF USE OF NEW .
PLAN$ BUILDING
i-Fi STATE CITV �'AFiDSAPPROVED VARDSAPPFOVED
LIC. NO. 28161H Bl LIC. NO. MA�N BUILDING ACCESSORV BUILDING
{ii SI2E � NO.OFBIDGS. ' (FFOMGLSTREET)�• '
6. OF LOT � ' NOWONLOT FROtYT FT.' FT.
� USE OF . ' ' '
EXISTWG BLOG. SIDE FT.. . FT.
�
'� Separate permits are required for �. sioe. Fr. Fr.
. � elecVic, plumbing and heating work. REAA Fr. ' FT. .
� USE OF BUILDING AND WORK TO BE PEflFORMED
F . . DISTANCE BET. � BET. MAIN & �
�Q � MAIN BLDGS. ACCE55. BLOGS.
VAR. ql� DATE
-� Tri lex with attached ara e c.u.a. � • avPaoveo
¢
7 " • ' APPFOVED
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� I hereby eeknowled8e thet I hava reatl this applicetion entl state Q� � �
n
� thai the above Intormation is corract antl a8rea to comply with r� m
� 4 all laws raBulatlnB building conrtrucHon, end I shall not employ � �
z , any person in vlolation of ffie workman's compensation laws ot � o
5� the Steta ot California. ' ,�
3 � hereby certify thai I am properly Ilcensetl as a conttector untler _ SQ. FT. H
the State of�Callfornia Business end P�otessions Code, Oivision�3, THE AMOUNTSHOWN VNDER VALUATION IS FOR m
Chapter 9, and Mat such Iicenses are In f��l force and effoct, or I THE PUiiPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from tho provisions of tha Steta oi Celltornia euslness - iO
VALUATION PERMIT FEE ,§ P
� antl Protessions Code, Divielon 3, Chepier 9. �n
m
Slpnetura of . � P�AN CHECK y o
Permittee
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Authorizotl A t - u
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