HomeMy WebLinkAbout759 GRAYLING BAY - Building PermitsFST
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REC VP MIT
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For Applicant to Fill in Completely — Use Ink Only
BUILDING •I
A.P. O. —09I 24 r12 12j-2.
ADDRESS Tract 10626 &jZal ZOWNER
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R
BUILDING
ADDRESSL�i (� Al
TENANT M.D. Janes CO. Inc.
UNIT OR
MAILING
ADDRESS 2950 Airway Ave. D—
SPACE NO.
T�1x(o0/ —t / LOT SLK.
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(J LTJ
CITY Costa Mesa NO.
NEW ADD ALTER I REPAIR IMOVINGIDEMOLISH
CONSTRUCTION
LENDER Not Selected
BRANCH N/A
OWNER
ADDRESS
VALUE
ARCHITECT Danielian IS Assoc. 36
USE $
USE
OR ENGINEERNO.
I
3
ADDRESS 3848 Campus Dr. N.B.
ZONE TYPE GROUP
APPROVED
CONTRACTOR Owner
BY DATE
ADDRESS e
TEL.
CITY a NO. A
STATE CITY
APPROVED SETBACKS
LIC. NO. 19 LIC. NO. e
SIZE NO"
OFSLOGS
(FROM C/L STREET)
OF LOT 5501 x 3341 NOW ON LOT B
FRONT FT.
USE OF
44T.
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
PPLANN-NING ACCTIONp
2
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APPROVED � 16 / 1
APP �p
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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.
233s�
I hereby certify that I am properly licensed as a contractor under
SO. 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:
amexempt from the rov inions of the State of California Business
'
VALUATION PERMIT FEE E
and Professions Cod Divi 3, Chapter 9.
PLAN CHECK 36P(�/, 5
Signature of
'(,s/,
Per mIttce
G
$ S I y) -N'/ TAX i
Or
Authorized Ape at¢
Q
TOTAL PAID S 6V 3•
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