HomeMy WebLinkAbout777 GRAYLING BAY - Building Permits.�
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COSTA MESA BUILDINGSAFETY DEPA TMENT APPL� ' FOR STRUCNRAL PERMIT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
RgC�EIVED PE MIT
For Applicant to Fill in Completely - Use Ink Only `f� %�o � %�o N� �
AD'DRESS Tract 10626 /# A�P� N�.141-oq �—aq Q '�' TIZ �/J Z
BUILDING C'N �I" � S
°ENqN �R M.D. Janes Co., IiIC. A�DRE55
UNIT OR
MAILING y950 Airwa Ave. D-9 SPACENO.
ADDRE55 }' �
TR.NP� �� LOT BLK.
cirv Costa Mesa No�979-3376 �
CONSTRUCT70N NEW ADD LTER REPAIR MOVING DEMOLISM
LENDER Not selected �
BRANCH N/A
OWNER
AODRESS N/A VA�UE
ARCHITECT TEL. USE E
ORENGINEER Danielian � l�SSOC. -
��� �
ADDRE55 3848 Cam US Dr.' N.B. zoNe TVPE GROUP
APPROVED
CONTRACTOR OWI12L BV DATE
ADDRESS 8
TEL.
CITV e NO, e
STATE CITV APPROVEDSETBACKS
LIC. NO. e LIC. NO. e
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT SSO � X 334 � NOW ON LOT e FRONT FT.
USE OF
EXISTING BLDG. N A I
Separate permits are required for L. SIDE
electric, plumbing and heating work.
REAR FT.
VSE OF BUILDING AND WOflK TO BE PERFOFMED PLANNING ACTION
,� 4 - u -� �q -d ,a. �ROVED Z 2� ��
i /� ,�Ro� /� ' .?-<5' - 7
1 �ereby acknowletlge that 1 hove reatl this applicetion and ztEte
Mat the above informetion is correct and apree to comply with
all laws re0ulatin8 builtlinp conrtr�etion, and I shall not employ
any person In violation of the workman's compensation laws of
Me State of Calitornia. �(d3
I hereb certif that I em `r SQ. FT.
V Y �roperly licensed as a contrector untler
the State of Calitarnia Business and Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR
Chapter 9, antl that such licenses are in full force end eftect, or 1 THE PVR�OSE OF ESTABLISNING A PERMIT FEE ONLV:
am eaempt from t provisions of the State ot Celifornia Businaes
and Professions Co e, Divi �n 3, Chapter 9. VALUATION PERMIT FEE y
Signature of PLAN CHECK $ / D
Permittee / 5 �j� �,�J v
TA% § �,m
Authorized Ap D 8�1���9 TOTAL PAID E?
97 � T:
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• COSTA MESA BUILDING-SAFETY DEPARTM�� APPLICATION EOR.STRUFTURAL PERMIT� �^
P.O. BOX 1200 COSTA MESA, CALtFORNIA 92626 '» �� � °� ' �' ' ' ' �' "'" "'
RECEIVEDBV PERMIT
For Applicant to Fill in Completely — Use Ink Only
ADIDRE55�_ �O(�`:O 3 A'P' NO.
BUILDING
OWNER OR ADDRE55
TENANT
MAILING VNIT OR
ADDRESS SVACE NO.
TR.NO. LOT BLK.
TEL. .
CITY � NO.
NEW ADD LTER REPAIR MOVING DEMOLISH
C01�6TRUCE N
LENDER
BFANC
OWNER
ADD E55 VALUE
ARC ITEC TEL. USE S
OR E GINEEF N
ADO SS ZONE TVPE GROUP I'
APP f Z • l`_ 7
CONTRACTOR BV DATE
ADDRE55
TEL.
CITV NO.
STATE CITY APPROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OF BLDGS (FROM C/L STREET)
OF LOT NOW ON lAT ON7 FT.
USE OF
E%ISfING BLOG. �
Separate permits are required for L SIDE pT.
electric, plumbing and heating work.
REAF FT.
USE OF BUILDING AND WORK TO BE PERFORMED PWNNING ACTION
DATE
APPROVED
APPROVED
1 hereby acknowletlge that I �ave reatl this applicstion antl ztare �'
n
[hat t�e ebove information is �orract end agree to compiy with
ell iaws rBB��ating building construction, entl I shall not employ �
eny person In vlolation Of the wo�kman'z compensation lawf O� �
Me Stata of Celifornia.
m
I �ereby cartify t�at I am properly Itcensetl az a contractor untler SQ. FT. �
tha Stare oi Celifornia Business antl Professions Cotle, Division3, THE AMOVNTSMOWN VNDER VAIUATION IS FOP m
Chaptar 9, enE the such li enses ere in f�ll force anE effect, or I T1E PURPOSE OF ESTA8�6HING A PERMIT FEE NI.Y: �
em azempt from e prov' ions ot the State of California Business VALUATION a
antl Profasslons , Di ision 3, Chapter 9. PERMIT FEE S�b ,Q N
n
AN CHECK S '^
SiB^atura of o
� LL
Permlttee TAX S f
or V
Authorizetl A n ate
TOTALPAID S' O D