HomeMy WebLinkAbout745 GRAYLING BAY - Building Permits(: ruy/tiig 494p 7Q1, 411 y6 y7y9,ks GiL3�66���6rY� 71
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COSTA ESA ILDIIAMESA, CALIFORNIA9 sze APPLICATIONF6kT*R1ef.901PERMIT683.50 TL
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For Applicant to Fill in Completely - Use Ink Only _
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BUILDINGA.P.
ADDRESS Tract 10626 '
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TTENA TOR M.D. Janes CO. Inc.ADDRESSL�
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BUILDINOWNER
UNIT OR
SPACE NO.
MAILING
ADDRESS 2950 Airway Ave. D-9
T1636 24 LOT
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SLK.
CITY Costa Mesa NO. _
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NEW
NEW
ADD ALTER IREPAIR
IMOVINGI
DEMOLISH
CONSTRUCTION
LENDER Not Selected
BRANCH N/A
OWNER
ADDRESS
VALUE
USE $
ARCHITECT Danielian b Assoc. TEL'546-3
OR ENGINEER
I
ZONE ✓
TYPE GROUP
ADDRESS 3848 Campus Dr. N.B.
CONTRACTOR owner
APPROVED
BY DATE
ADDRESS e
TEL.
CITY a NO. ID
STATE CITY
LIC. NO. A LIC. NO. e
APPROVED SETBACKS
SIZE
OF LOT 550' x 334
IND OF BL
NOW ON LOS
(FROM C/L STREET)
FRONT FT.
USE OF
EXISTING BLDG. N/A
R. SIDE AT,
Separate permits are required for
electric, plumbing and heating work.
941
L SIDE
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTIONDATE
2
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2� 1 7 -0 I A
APPROVED
APPR PiO
,Z '19e— J
I hereby acknowledge that 1 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.
1 hereby certify that 1 am 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 affect, or I
am exempt from the rovisions of the State of California Business
and Professions Cad Divi 'o %3, Chapter 9.
SIgna r
Signature of
/17/79
LoPq Authorized Apa to 8 LTOTAL
3 sL 14
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
$ 5l Vf op
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PERMIT FEE S
PLAN CHECK S�(�./,S
TAX $
PAID 96 3•