HomeMy WebLinkAbout771 GRAYLING BAY - Building Permits8qV 74/, 4/,? 4/6 �Y7 f� 9 �s /� 74,66 5� G i� 3i �� 1i �r iy
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OT MESA)X120ILDIIAM SATCALIFORNIA9 sie �• APPLICATTONF60*R&i.tO ,PERMIi683e50 TL
RS
For Applicant to Fill in Completely — Use Ink Only
BUILDING�L
A.P. O. —�I� �Q �I1Z
ADDRESS Tract 10626 % '
OWNEROR
BUILDING
i Al
TENANT M.D. Janes CO. Inc.IUNIT
UNIT
ORMAILING
NO.
N
ADDRESS 2950 AirwayAve. D-9SPACE
TjfxO/—t/ LOT BLK.
TEL
(J(o GEI
CITY Costa Mesa NO.
NEW ADD LTER REPAIR MOVING DEMOLISH
CONSTRUCTION
LENDER Not selected
BRANCH N/A
OWNER
ADDRESS
VALUE
ARCHITECT Danielian b ASaoc, TEL. _
USE $
OR ENGINEER
0.
Ikdr
ADDRESS 3848 Campus Dr. N.B.
ZONE TYPE GROUP
APPROVED
CONTRACTOR owner
BY DATE
ADDRESS ID
TEL. '
CITY a NO. ID
STATE - CITY
APPROVED SETBACKS
LIC. NO. 9 LIC. NO. ID
SIZE NO.
(FROM C/L STREET)
OF LOT 550' x 334' NOW ON LOS
I
FRONT FT.
USE OF
EXISTING BLDG. N/A
Separate permits are required for
L SIDE
electric, plumbing and heating work:
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNINGACTION
2
-7p
/ "(-Q/J/ rj
APPROVE
DILZ
APPR /�• A
Z Le/y__ /
I hereby acknowledge that I have read this application and stets
Mat 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 workmen's compensation laws of
the State of California.
'Lzi'iSL
1 hereby certifythat I am properly licensed as a contractor under
70 SO. FT.
the State of Cellfornio 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:
em exempt from the rovisions of the State of California Business
and Processions Cod Divi ' 3, Chapter 9.
VALUATION PERMIT FEE S
PLAN CHECK 5 /_ A
s't'/ , 5
Signature of
'�,r/, W
Permittee
G
$ 5 (1/ N'r TAX S
or
8
1
Authorized ABe ate
Q TOTAL PAID $ 6 V 3