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HomeMy WebLinkAbout769 GRAYLING BAY - Building Permitsa i� 3 99V 74/, 414"61- f7,, V LA$J4 a BsT3OZ6 zaszzsN/��P3LI0CA TIONF8k*R&�OiPERMI1683a50 TL COSTA ME2ABRDINEA D�(aLAMESACALIFORNIA9 _ REC V P MIT I AAS G2 -N2 +x % For Applicant to Fill in Completely - Use Ink Only BUILDINGADDRESS �` A.P.o. _091-69 (a114411-12-1-25 Tract 10626 EOR BUILDING `� & TENATM.D. Janes CO. Inc i UNIT OR MAILING N SPACE NO. ADDRESS 2950 AirwayAve. D-9 Tfrj�0/ -7 / LOT BLK. (JlOL�O CITY Costa Mesa NO. _ % NEW ADD LTER IREPAIR IMOVING DEMOLISH CONSTRUCTION LENDER Not selected BRANCH N/A OWNER ADDRESS VALUE ARCHITECT Danielian S Assoc. TEL'546- USE E OR ENGINEER I ZONE 3 ADDRESS 3848 Campus Dr. N.B. TYPE `" GROUP I APPROVED CONTRACTOR owner BY DATE ADDRESS e TEL. CITY B NO. e STATE CITY APPROVED SETBACKS LIC. NO. A LIC. NO. e SIZE NO. OF BLOCS. (FROM C/L STREET) OF LOT 550' x 334' NOW ON LOT B FRONT FT. USE OF EXISTING BLDG. NIA 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 �Op— --1 77Z APPROVED � � APPR '0p- BY G 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 I shall not employ any person in violation of the workman's compensation laws of the State of California. 233SL I hereby certify that I am property licensed as a contractor under SQ. FT. the Stere 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 VALUATION PERMIT FEE E and Professions Cotl Divi 'Ott 3, Chapter 9. �a PLAN CHECK S& 115 Signature of �[� op Permlttee N/;/; $ Sq/ 1 TAX $ or Authorized ABe ate B TOTAL PAID S 6 3,