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HomeMy WebLinkAbout757 GRAYLING BAY - Building Permits0 i C, rayl+M� BqV 74; 4/.? y61- f7,,403', 66' 0, 6,y Y1 - DgoLZD3ZoMz7 ZS/ a61 Zla/ COSTAMEnBLaDINBss!ETYoDTAEJAPP LICATONF8R�R1C1@kaPERMI1683a50 TL DAMn Z i� REC V P MIT ' 02N2 4 6 For Applicant to Fill in Completely - Use Ink Only BUILDING ( 7 A.P. O. —� (O 112 ADDRESS Tract 10626 OWNERBUILDING OR SL�i /a TENANT M.D. Janes CO. Inc r UNIT UNIT ORMAILING N SPACE NO. ADDRESS 2950 AirwayAve.,D- T1IXO/ -� / LOT BLK. TEL. (f fo (.Q1 CITY Costa Mesa NO. 979-3376 ADD LTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER Not selected BRANCH N/A OWNER ADDRESS VALUE ARCHITECT Danielian 6 Assoc. TEL.546-3 USE E OR ENGINEER I ZONE ADDRESS 3848 Campus Dr. N.B. TYPE GROUP APPROVED CONTRACTOR owner BY DATE ADDRESS e TEL. CITY A NO. e STATE CITY APPROVED SETBACKS LIC. NO, B LIC. NO. e SIZE NO. OF 'LOGS. (FROM C/L STREET) OF LOT 550' X 334' NOW ON LOT B FRONT FT. USE OF EXISTING BLDG. N/A R. SIDE Separate permits are required for L. SIDE electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Z 1^O p �G P �C I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and 1 shelf not employ any person In violation of the workman's compensation laws of the State of California. Z -33$L 1 hereby certify that 1 am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the rovisions of the State of California Business 'a VALUATION PERMIT FEE S and Professions Cpd Divi , 3, Chapter 9. PLAN CHECK $6�/,5 Signature of ov Permittee s sG f TAX S4- L4M LO/17/79 8 LTOTAL Authorized Age ate PAID S6 3•