HomeMy WebLinkAbout789 GRAYLING BAY - Building PermitsF
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COSTA MESA BUILDING-SAFETY DEPA TMENT pPPLr ' FOR STRUCTURAL PERMIT
P.O. BO% 7200 COSTA MESA, CALIFORNIA 92626
R�C_EIVED/ PE M1�6 NQ �
For Applicant to FJI in Completely - Use Ink Only TD 7
ADIDRES$ Tract 10626 .� A'P' N�''TI�� I�Qy Q t 41� �LI Z
BUILDING L'N '� / S
OwNEROR M.D. Janes Co., Inc. nooaess t_
TENANT
UNIT OR
MAILING y950 Airway Ave., D-9 SVACENO.
ADDRE55
TR.NPO�-� /� LOT BLK.
cirv Coeta Mesa No�979-3376 � ��
CONSTRUCTION NEW NDD LTER REPAIR MOVINC DEMOLISH
LENDER NOt selected �/
/\
BRANCM N/A
OWNER
ADDRE55 N/A
VALUE
ARCHITECT TEL. USE f
ORENGINEER Danielian b [iS80C.
F � -,
ADDRE55 3848 Cam llfi DI. N.B. ZONE TVPE GROUP
APPROVED
CONTRACTOR OWi12I BV DATE
ADDFESS B
TEL.
CITY e Np. e
STATE CITY APPROVEDSETBACKS
LIC. NO. e LIC. NO. e
(FROM GL STREET)
OF LOT 55� � x 334 � NOW ON L�� e OM FT.
USE OF
EXISfING BLDG. N T
Separate permits are required for L SIDE
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED P�.qNNING ACTION
� y� l� " /f '] ( 1 —d /"� APPROVED Z /"'�' 1
r /, o .o,rraov �! ' .�-1 `7' - %
1 Aeraby ecknOwletlpB that I heva rea0 thif epplicexion nntl na�e
that tna ebova Intormetion i� corroct end aprao t0 comply wlth
all laws repuletinp builtlinp conrtructlon, entl I shall not employ
any peraon in v(olation of Me workmen's eompensation lews of
Me 5[em of CelifOrn(a.
1 hareby certify thet 1 em proDarly Iicensetl as e contrector untler S�. FT.
the 5[axe of Californlo Butinass entl Profasslons Coda, Division 3, THE AMpUNT SMOWN UNDER VALUATION IS FOR
Chapter 9, entl thet su[� litenms are in tull forte entl 8lfact, or 1 TME PURPOSE OF ESTABLBHING A PERMR FEE ONLV:
am azampx trom t provisions of Ne Stete of Celifornia B�siness VALUATION
entl Professions Co e, Divi iDn 3, Chaptor 9. PERMIT FEE E
$ignatura ot / VLAN CHECK y � O
Parmittea // � 5(j/� ZQt/•� TAX S Q/�m
A�thorizetlAp r $�1���9 / TOTALPAID S' ��
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COSTAMESABUILDINGSAFETYDEPARTMETfi�� APPLICATIONF.ORSTRU TURALPE ITw���
P.0.80X1200 COSTAMESA,CALIFORNIA92626 no'�� �:F���
RECEIVEDBV PERMIT
For Applicant to Fill in Completely — Use Ink Only
ADORESSr^ �O(�Z(� 3 A.P• NO.
BUILDING
OWNER OR ADDRE55
TENANT
MAILING UNIT OR
ADDRE55 SPACE NO.
TR.NO. LOT BLK.
C�T�' �\ TEL.
NO.
CpNSiR N NEW ADD LTEii REPAIR MOVING OEMOLISH
LENDER
BRANC V
OWNER
AD� ESS VALUE
ARC ITEC TEL. USE 3
OR E GINEER
ADD SS ZONE TVPE GROUP ",
APP /z!(/ �
CONTRACTOR BV DATE ( [
AD�RESS
TEL.
CITY NO.
STATE CITV APPROVEDSETBACKS
LIC. NO. LIC. NO.
512E NOAFBLDCS. (FROMGLSTREET)
OF LOT NOW ON LOT RONT FT.
USE 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 PLANNING FCTION
DATE
APPROVED
APPROVED
I haieby acknowlatlpo that 1 heve reatl this apD��cation antl nate
t�at Me above IMormation is eorract entl eB�ea lo comply wkh
ell lows �apuletlnp builtlinp consnuction, antl I shell not emptoy
any perwn in violetion of the workmen'z compensation lews of
Me Stata o/ CalHomia.
1 hereby certHy Nat I am proPnrly Iicensetl ea e contrector untler S�. FT.
t�e S�ate ot Calitornie Business antl Protessions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR
Chapter 9, antl tha sut� li enses are In full torte entl affact, or 1 THE PURPOSE OF ESfABLSHING A PERMIT FEE NLV:
em axampt from e prov' ions ot tha5tece oi Callfornla Busineas VALUATION PERMIT FEE S /�
anC Protessions , Di �sion 3, Chepcer 9. �V •O
Slpneture Of N CHECK S
Perminae 5 TAX S
or
Authorizetl A n ate
TOTALPAID f,D D
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