HomeMy WebLinkAbout783 GRAYLING BAY - Building Permits1.
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COSTA MESA BUILDING-SAFETY DEPA4iTMENT APPL� FOR STRUC7URALPERMIT
P.O. BO% 7200 COSTA MESA, CALIFORNIA 92626
R CEIVED PE MIT
For Applicant to FiII in Completely — Use Ink Only �%�O � %� N� �
ADDRESS Tract 10626 .� P'•P• N�' ITI'll-� I`Q� Q 'f' T�� �/J Z
BUILDING �1� � / S
OWNEROR M.D. Janes Co., Ii1C. ADDRE55 �.
TENANT
UNIT OR
MAILING Z950 Airway Ave., D-J SPACENO.
ADDRESS
TR.N���� LOT BLK.
��T� Costa Mesa No��979-3376
ODNSTFUCT70N NEW ADD LTER REPAIR MOVING DEMOLISH
LENDER NOt selected �/
/\
BRANCH N/A
OWNER
ADDRESS N/A VALUE
ARCNITECT TEL USE E
ORENGINEER Danielian b i1660C.
_ �( '
ADDRESS 3848 Cam llS DI. N.B. ZONE TVPE GROUP
APPROVED
CONTRACTOR owner BV DATE
ADDRESS B
TEL.
pTV e NO. 8
STATE CITV P�P7ROVED SETBACKS
LIC. NO. 8 LIC. NO. e
SIZE � � NO.OFBLOGS. (FROMC/LSTREET)
OF LOT SSO x 334 NOW ON LOT e ROM 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 PERFOFMED P�qNNING ACTION
� � l� {j ) / ( �O/J j1 APPROVED C� � ! f
I /J O APPROV /�. ��� � �i
I �ereby acknowletlpe that I M1eve reetl this application antl neie /
that the eCove Iniormation is correct and aprea to comply wit�
ell laws ragulatinB Duilding conrtruction, entl I ahell not employ
any person In violation of tha workman's compensation lawz af
the State of California.
1 hereb certif that I am "SQ. FT.
y y properly lirensetl as e coniracmr unCer
tha Siate of Callfornia Business antl Protessions Cotle, Oivision 3, THE AMOUNT SNOWN UNDER VALUATION IS FOR
Chapter 9, antl t�at such licensas are in f�ll force antl effect, or I TNE PURPOSE Of FSTABLISHING A PERMIT FEE ONLV:
am exampt from t provisions ot the State ot California Business
antl Professionz Co e, Divi ipn 3, Chapter 9. VALUATION PERMIT FEE E
/
Signaare of PLAN CHECK y / D
/ / v
Permittee 5 (J� �TJ,�J TAX f �m
AuthorizedAp / D e �ILJ�%9 / TOTALPAID S 7
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� COS�TB�MEZA�B CIOLDInNM SAFCALIFORNAinez62� '�PLICATIONEORLS'IRU�TURALPERh�IT���m.
RECEIVED BV PERMIT
For Applicant ro Fill in Completely — Use Ink Only
BUILDIN�� /O / IJ / � A.P. NO.
ADORESS (Q! (0
BUILDING
OWNER OR ADDRE55
TENANT
MAI LI NG UNIT O R
ADDRESS SPACE NO.
TR.NO. LOT BLK.
CITV �\ TEL.
NO.
NEW ADD LTER REPAIR MOVING DEMOLISH
CONSTR N
LENDEP
BRANC V
OWNER
ADD ESS VALUE
ARC ITEC TEL. USE E
OR E GINEER
ADD SS ZONE TVPE GROUP
APP (Z ��� �
CONTFACTOR BV DATE
ADDRE55
TEL.
CITV NO.
STATE C�TY AF7ROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OF BLDGS (FROM C/L STREET)
OF LOT NOW ON LOT FROM FT.
USE OF
EXISfING BIDG. E
Separate perntits are required for L. SIDE FT.
electric, plumbing and heating work.
REAR FT.
USE OF BVILDING AND WORK TO BE PERFORMED PLANNING P.CTION
DATE
APPROVED
APPROVED
1 �ereby ecknowletlBa t�at I have reatl this epP��cation antl rtete °i
n
that t�a ebove In}ormation is torrect and aBree to comply wlth
ell laws repulating builtling conrtruction, and I shall not amploy
any person In violetion of Me workma� s compensatio� lawz o< m
me Stete of Calitomia.
m
I �ereCy certify t�at I am Oroparly licens¢C es a conttactor untler SQ. FT. rv
the State of Celifornia B�sinass antl Professions Cotle, Division 3, THE AMOUNT SHpWN VNDER VALUATION IS FOR m
Chapter 9, en0 t�a such li anses ara in full torce antl ettect, or i THE PVRPO6E OF ESTABLSHING A PERMIT FEE NLY: '
am exempt from e prov' ions of the Stete ot Calitornia 8usiness e
VALUATION PERMIT FEE E �b •D
antl PrOfe551on5 , Di �Sion 3, Chaptef 9. vi
n
HN CNECK S iO
Signature Of o
S �`
Permlttee TAX E F
o/ V
Auffiorizetl A n a[e
TOTALPAID S' D a
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