HomeMy WebLinkAbout743 GRAYLING BAY - Building Permits(: ray /00d 6qV 74, 43 y6 4171s /�5�,66 S� G i� 3i �6i6?i
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COSoeMESASIsAt3ooTAEY, APPLICATION F6ft*R#6PERM683.50 7T1 L
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For Applicant to Fill in Completely - Use Ink Only
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BUILDING
ADDRESS Tract 10626
BUILDING
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OWNEROR M.D. Janes CO. Inc.ADD
UNIT OR
SPACE NO.
MAILING
ADDRESS 2950 Airway AVE. D-
TR�r�O6—t/ LOT
BLK.
CITY Costa Mesa NO.979-3376
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NEW
ADD ALTER IREPAIR
IMOVINGIDEMOLISH
CONSTRUCTION
LENDER Not selected
BRANCH N/A
OWNER
ADDRESS
VALUE
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USE $
ARCHITECTTEL.
OR ENGINEER Danielian b ASSOC. 546-
1
ZONE 3 ITYPE
GROUP
ADDRESS 3848 Campus Dr., N.B.
CONTRACTOR owner
APPROVED
BY DATE
ADDRESS B
TEL.
CITY A NO. B
H
STATE CITY
LIC. NO. B LIC. NO. e
APPROVED SETBACKS
SIZE
OF LOT 550' X 334'
NO. OF BLOGS.
NOW ON LOT
IF ROM C/L STRE ET)
FRONT FT.
O.
Q
12
USE OF
EXISTING BLDG. NIA
4
HSeparate
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permits are required for
electric, plumbing and heating work:
L. SIDE
REAR
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
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DATEQ
APPROVgED ^te f 1
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APPR
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hereby acknowledge that I have read this application and state
that the above Information Is correct and agree to comply with
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all laws regulating building construction, and I shall not employ
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any person in violation of the workman's compensation laws of
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SD. FT.
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Me Stets of California.
I hereby certify that I em 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 Me rovisions of the State of California Business
and Professions Cod Divi�3, Chapter 9.
Signature of
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THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
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PERMIT FEE $
PLAN CHECK 6
t+"r
TAX $
Permittee
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$ 5l f
srY
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TOTAL PAID
Authorizetl Ape _ate _