HomeMy WebLinkAbout763 GRAYLING BAY - Building Permitsi
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COSTA MESA BUILDING•SAFETYDEVARTAENY, APPLICATIONF8k*R&t@iRPERMIT683.50 TL
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
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For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADDRESS Tract 10626
REC V P MIT
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A.P. O. —09 I L/ -f fO II +dr� 121-2
BUILDING /A>
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TENANT M.D. Janes CO. Inc.ADDRESSZ
UNIT OR
SPACE NO.
MAILING
ADDR2950 Airway Ave. D—
TIF624 —� / LOT
I(J (O G(p
BLK.
TEL
CITY Costa Mesa NO.979-3376
NEW
ADD ALTERIREPAIR
IMOVING
DEMOLISH
CONSTRUCTION
LENDER Not selected
BRANCH N/A
OWNER
ADDRESS
VALUE
USE $
ARCHITECT Dan' I' n & Assoc. TELS
OR ENGINEER 0.
I
ZONE
TYPE `" GROUP
ADDRESS 3848 Campus Dr. N.B.
CONTRACTOR owner
APPROVED
BY DATE
ADDRESS ID
TEL.
CITY B NO. e
STATE CITY
LIC. NO. B LIC. NO. G
APPROVED SETBACKS
SIZE
OF LOT 55111 x 3341
NOF
NOW ON LOS
(FROM C/L STREET)
FRONT FT.
USE OF
EXISTING BLDG. N/A
R. SIDE OAT,
Separate permits are required for
electric, plumbing and heating work:
L SIDE
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING
2
'7ACCTIONp /�
� I—O / A
^}�
APPROVED 2-� s I
APPR ��
rJ �7
Q AT�G.
I hereby acknowledge that I have read this application and creta
that the above Information is correct and agree to comply with
all laws regulating building construction, and 1 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 a$ 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 the rovisions of the State of California Business
and Professions Cod Divi 'dry 3, Chapter 9.
Signature of
Permittee
or
Authorized Age ate8/17/7c
Z.3 �1$L
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
GG ov
$ S i l l /
PERMIT FEE E
PLAN CHECK S(r S
TAX 3
TOTALPAID E6 3,