HomeMy WebLinkAbout791 GRAYLING BAY - Building Permits..
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COSTA MESA BUILDING•SAFETY DEPAfiTMENT APPLI ' FOR S'I'RUCTURAL PERMIT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
R CEIVED PE MIT
For Applicant to Fill in Completely — Use Ink Only �%�0 � %� No �
BUILDING A.P.NO.ITI�v'�I�O� Q '}'�-�Z �L1 Z
ADDFESS Tract 10626 . ,�fr'� /
BUILDING �1N �' �^ S
T�ENAN �R M.D. Janes CO.� IRC. ADDRE55
MAILING 5 ACENO.
ADDRE55 2950 Airway Ave., D-9
TR.NPb 6�.G LOT BLK.
cirv Costa Mesa nTio�979-3376
NEW ADD LTER REPAIf3 MOVING DEMOLISH
CONSiRULT10N Not selected �
LENDER
BRANCH NIA
OWNER
ADDRESS NIA VALUE
ARCHITECT Danielian t5 i1S60C, TEL.
USE S
OR ENGINEER
F� -,
ADDRESS 3848 Cam U8 DI. N.S. ZONE TVPE GFOUP
APPROVED
CONTRACTOR owner BY DATE
ADDFE55 e
TEL.
CITV e NO, e
STATE CITY P�PPROVEDSETBACKS
LIC. NO. � LIC. NO. e
SIZE � � NO.OF BLDGS. (FROM C/LSTREET)
OF LOT 55� x 334 NOW ON LOT e RONT FT.
USE OF
EX4STING BLOG. j�] A
Separate permits are required for L SIDE
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND wORK TO BE PERFORMED PI_P.NNING ACTION
„�{ y- /f ) / 1�O j"� APPROVED Z s'^' � f
i /J o � caPAov � ' .�-1 `/ - %
1 hereby ecknowletlpe that 1 �eva reetl this appl(caUon antl stete
that the above Iniormetion is carrect antl apree to comply with
all iaws regulatinp bV��dinp conzvuction, antl I shall not employ
any person in violation of Ma workman's comp¢nsation lews of
tne State ot Celifornla. (d7
I �ereby certify thet � em properly licensetl as a conttactor untler ' `� SQ. FT.
the State af Celltornla Business entl Protessions Code, Division 3, THE AMOUNT SHOWN VNDER VALUATION IS FOR
Chaptar 9, and thet such licenses are In full force antl affect, or I THE PUFPOSE OF ESTABL6HING A PERMR FEE ONLV:
am exempt from t Provisions of the State of California Business VALVATION
antl Professions Co q Divi i9n 3, C�apter 9. �ERMIT FEE E
� PLAN CHECK E � �
Signature Of 5 �� �L �J
Permittee � TAX E
Au[horizetlAg P 8�1���9 / TOTALPAID y' �
37 � T:
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• COSTA MESA BUILDW GSAFETY DEPARTM�I�ti-� pPPL1CAT10N FAR STRUC711RAL PERMIT .�� �
P.O. BOX 1200 COSTA MESA, CAUFORNIA 92626 � ��' �� � `� ' � " '
RECEIVEOBV PERMIT
For Applicant t'o Fill in Completely — Use Ink Only
BUILDIN�� /D /Z / � A.P. NO.
ADDRESS ( (0 f0
BUILDING
OWNER OR ADDRE55
TENANT
MAI LI NG UNIT OR
ADDRESS SPACE NO.
T0..N0. LOT BLK.
dTY �\ TEL.
NO.
�bTR N NEW ADD LTER REVAIR MOV�NG OEMOLISH
LENDER
BRANC V
OwNER
ADD ESS VALUE
ARC ITEC TEI. USE E
OR E GINEER
ADD SS ZONE TVPE GROUP "�
APP lZ �L/ �
CONTRACTOR BV DATE T
AD�RESS
TEL.
CITV NO.
STATE CITV P.7PROVEDSETBACKS
LIC. NO. LIC. NO. '
512E NO.OF BLOGS. (FROM C/LSTREET�
OF LOT NOW ON LOT M FT.
USE OF
EXISfING BLDG.
Separate permits are required for L. SIDE FT.
electric, plumbirig and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PLqNNING ACTION
onre
APPROVED
APPROVED
I �ereby ecknowletlge that I heve reatl this application antl nate
that the above intormation is correct end apree to comply with
all lews reg�tatlnq builtlin0 construction, antl 1 shall not employ
any person in vlolation oi Me workman's compenmtiOn laws of
the State ot Celifornia.
I hereby certify that I am properly licensetl es e conbector untler SQ. FT.
the State of Calitornia Business and Professions Cotla, Divizion 3, TME AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl tha such li anses ere in full torte antl ef}ect, or I THE PVRP�E OF ESTABLISHING A PERMIT FEE NLv:
am exempt from e prov' ions ot ihe Stete of Californla Business VALUATION PERMIT FEE
anC Professions , Di tsion 3, Cfiapter 9. S�b •O
SiB�ature of AN CHECK S
Permittee 5
TAX S
pr
Authorizetl A n ate
TOTALPAID S'D �
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