HomeMy WebLinkAbout747 GRAYLING BAY - Building Permits.\
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DBDXCOMESACALIFORIA9
For Applicant to Fill in Completely — Use Ink Only
RE V P MIT
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BUILDINGADDRESS Tract 10626 '
A.0 -4o -j+-091-69 12�-2
BUILDING
t r a
OWNEROR M.D. Janes CO. Inc.ADnggS
UNIT OR
SPACE NO.
MAILING
ADDRESS 2950 AirwayAve. D—
TRffj6O/�/ LOT
I(J fD GFJ
BLK.
CITY Costa Mesa NO.TEL
979-3376
NEW
ADD LTER
REPAIR
MOVING
DEMOLISH
CONSTRUCTION
LENDER Not selected
BRANCH N/A
OWNER
ADDRESS
VALUE
USE $
ARCHITECT Danielian b Assoc. TE
OR ENGINEER L.546—
I
ZONE
TYPE GROUP
ADDRESS 3848 Campus Dr. N.B.
CONTRACTOR Owner
APPROVED
BY DATE
ADDRESS e
TEL.
CITY a NO. e
STATE CITY
LIC. NO. B LIC. NO. e
APPROVED SETBACKS
SIZE
OF LOT 5501 X 3341
NO. OF BLDGS.
NOW ON LOT
(FROM C/L STREET)
FRONT FT.
USE OF
EXISTING BLDG. N/A
R Sing AT
Separate permits are required for
electric, plumbing and heating work:
1
L SIDE
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
ACTIO//N
2
Z� 7 -0JJpI A
APPROVED -2--16-77
APPR /�.Q
—
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.
I hereby certify that I 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 effect, or 1
am exempt from the revisions of the State of California Business
and Professions Cod Divi 'dry 3, Chapter 9.
Signature of
Permittee
or
Authorized Aga ate 8
.
Z33 SL
SO. FT.
ITHE AMOUNT SHOWN UNDER VALUATION IS FOR
ITHE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
N/;G/ %s�PLAN
$ op
PERMIT FEE $
CHECK $�(F/IS
TAX $
TOTAL PAID $