HomeMy WebLinkAbout787 GRAYLING BAY - Building PermitsF
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COSTA MESA BUILDING-SAFETY DEPAkTMENT APPLf ' FOR STRUCTURAL PERMIT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
R CEIVED PE MIT
For Applicant to Fill in Completely - Use Ink Only � 7�O ! 76 N° �
ADORESS Tract 10626 Jf' A'P'NO'14I� "I�Q� Q t��� �(J Z
BUILDING `1N �I' M S
OWNER OR M.D. Janes C.O. � i[1C. ADDiiE55
TENANT
VNIT OR
ADDREss 2950 Airway Ave., D—I SPACENO.
TR•NPO�.� ` LOT BLK.
cirv Costa Mesa No��979-3376 � ��L
CONSTRUCTION NEW ADD LTER REPAIR MOVING DEMOLISM
LENDER NOt selected ✓
�
BRANCH N/A
OWNEii
ADORESS N/A VALUE
ARCHITECT Danielian � (�S60C, TEL.
USE S
OR ENGINEER
Fr —
ADDRESS 3S�iH CdID US Dr. N.B, zoNe TVPE GFOUP
APPROVED
CONTRACTOR owner BV DATE
ADDRESS B
TEL.
CITV A Np, e
STATE CITV APpROVEDSETBACKS
LIC. NO. 8 LIC. NO. e
SIZE � � NO.OF BLDGS. (FROM C/L STREET)
OFLOT SSO x 334 NOWONLOT e ROM FT.
USE OF
exisTirvc e�o�. N A
Separate permits are required for �. si�
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PIJ\NNING ACTION
,� 4 �- a 79 - o A� o�Eo Z 2b 9
r /� , �Ro� /� ' .?-!�'- 7
I heraby acknowletl8e t�et I �ave raetl this applicatlon antl stnte
that the obove informetion is correct and agrae to comply with
ell laws requlating builtlinp consttucNon, and I sholl not employ
eny perzon (n violation oi Me workman's compensation laws ot
the State of California.
I nereb cenif xhat I am �^ SQ. FT.
Y y prooerly licensetl as e contracto� �naer
the Siate of Californle Business antl Profassions Cotle, Divlsion 3, THE AMOUNT SMOWN UNDER VALUATION IS FOR
Chapter 9, antl that such licences are In full torce entl affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ON�V:
am exempt from t provfsions of the Stat¢ o( California Businass VALVATION
antl Profassions Co e, Divi !0� 3, Chepter 9. PERMIT FEE b
/
Signature of / ^` PLAN CHECK E � D
Perm�`ttee � � S �J� �tJ.��/ TA% S �J,
7�'m
AuffiorinatlAp 8/1��79 TOTALPAID E 7
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� COS�T B�ME,200 COSDTIA M SAFCALI ORNplA 9 62� �PLICATION F,OR.STRUFTURAL PERMITw 5 �;,
RECEIVEDBV PERMIT
For App6cant to Fill in Completely — Use Ink Only
ADOflES� /D(��(� 3 A�P•NO.
OWNER OR BUILDING
TENqNT ADDRE55
MAILING UNIT OR
ADDRE55 SPACE NO.
TR.NO. LOT BLK.
CITV �\ TEL.
NO.
WKSrR N NEW ADO LTER REPAIR MOVING DEMOLISH
LENDER
BRANC V
OWNER
ADD ESS VALUE
ARC ITEC TEL. USE S
OR E INEER
ADD SS 20NE TYPE GROUP I'
APP [ Z • l ` 7
CONTFACTOR BV DATE
ADDRESS
TEL.
CITY NO.
STATE CITV AP7ROVED SETBACKS '
LIC. NO. LIC. NO.
512E NO.OF BLOGS. (FROM C/L STFEET)
OF LOT NOW ON LOT ROM FT.
VSE OF
EXISTING BLDG.
Separate permits are required for L. SIDE FT.
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED GLqNNING ACTION
DATE
APPROVED
APPROVED
I �ereby acknowletlpe t�et 1 have �eatl t�is apP�IcaHon antl state °`
n
Mat <he above i�formetio� is corract end egrea to comD�v V+ith
all laws rapuleUnp b�ilOinB �e^rtruction, end I shall not employ �
eny perwn in vlolallon of ma warkman's compansation laws of m
the SteCe of Calitornla.
m
I heroby certity t�et 1 em pro0erly licensad as e contractor �nder SQ. FT. ti
Ma State of California Business antl Professions Code, Divizion 3, THE AMOUNT $HOWN UNDER VALUATION IS FOR m
Chapter 9, enC xha sve� li anses ere In toll force entl eHect, or I THE PURPOSE OF FSTABL6MING A PERMIT FEE NLV: �
am exempt from e orov' ions ot the Stete ot California Businen VALUATION d
anA Protessions , Di ision 3, Chapter 9. PERMIT FEE S`b •Q N
n
AN CHEGK f �
Sip^etufa ot o
$ LL
Permittee 7AX f f
or V
Authorizatl A n ate
TOTALPAID S' O D
TL