HomeMy WebLinkAbout805 GRAYLING BAY - Building Permits:.
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COSTA MESA BUILDING-SAFETY DEPA42TMENT APPL� FOR STRUCTURALPERMIT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
�ElCo I PE MI?� �Q �
For Applicant to Fill in Completely — Use Ink Only �
ADIDRESS Tract 10626 � A�P� N�� 141-01 �—oq Q 'f" T�L �{J Z
BVILDING 1 (N �' � S
OWNEROR M.D. Janes Co., Ii1C. ADDRE55 �,
TENANT
UNIT OR
ADDREss 2950 Airway Ave., D-9 SPACENO.
TR•NP��� LOT BLK.
cirv Costa Mesa No�979-3376
ODNSTRUCTION NEW ADD LTER REPAIR MOVING OEMOLISH
LENDER NOt selected ✓
/\
BRANCH N/A
OWNER
ADORESS N/A VALUE
ARCHITECT TEL. USE E
ORENGINEER Danielian tx li660C.
F� �
ADDRE55 3848 Cam llS DI. N.B. 20NE TVPE GROUP
APPROVED
CONTfiACTOR owner BY DATE
ADDRE55 8
TEL.
CITV e NO. e
STATE CITV APPROVED SETBACKS
LIC. NO. e LIC. NO. e
SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT SSO � x 334' NOW ON LOT e ROM FT.
USE OF
EXISTING BIDG. N A I ' F
Separate permits are required for L. SIDE
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
�� �� (/ / 1 —O A APPROVED�i /�-� (
i /� „�Ro� /�°' ,?-l5' - 7
I �ereby ncknowletlge thet I have raetl this appliceiion anE ztete
Mat ffie above intormetion is corroct end aprea to comply wiffi
all laws repulaNnB buildinB �onsVuction, entl I chall not employ
any verson in violation of the workmen's compansation laws of
Me State of Calitornia. (�
I hereby cenify t�at I am proparly Ilcansatl as e contractor vntler � SQ. FT.
the State of California B�siness entl Profasaions Cotle, Division 3, THE AMOUNT SHOWN VNDER VALUATION IS FOR
Chaptet 9, antl that such licenses ara in full forca anC aftect, or I THE PVRPO$E OF ESTABLISHING A PERMIT FEE ONLV:
am axempt from t provisions of the Stata of Cellfornia Business VALVATION
antl Professions Co e, Divi�n 3, Chaptar 9. PERMIT FEE E
PLAN CHECK S � 0
Signatvre ot g �� � �J
Permittee � TAX S
AuthorizedAp . D e H�1%I79 / TOTALPAID E`J 'm
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• CO OT BOXE 2008 CIOSDT'A M SAFCALI ORNAIA 9 62� �P�CATION FOR STRUFTURAL PERIvIITti � ��}
RECEIVEDBV PERMIT
For AppGcant ta Fill in Completely — Use Ink Only
ADIDRES� /Of!/`:O '3 A'P•NO.
BUILDING
OWNER OR � ADDRESS
TENANT
MA1 LI NG UNIT O R
ADDRE55 SPACE NO.
TR.NO. LOT BLK.
CITV �\ TEL.
NO.
COKSTR N NEl'✓ ADD LTER REPAIR MOVING DEMOLISH
LENDER
BRANC V
OWNER
ADD ESS VALUE
ARC ITEC TEL. USE 5
OR E GINEER N
ADD SS ZONE TVPE GROUP
AVP /Z ��� �
CONTRACTOR BV DATE
ADDRESS
TEL.
GTV NO.
STATE CITV APPROVEDSETBACKS
U0. NO. IIC. NO.
SIZE NO.OF BLOGS. (FROM C/L STREET)
OF LOT NOW ON LOT R M FT.
USE OF
EXISTING BLDG.
Separate permits are requ'ued for L. SIDE FT.
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PI,ANNING ACTION
DATE
APPROVED
APPFOVED
I h¢reby acknowletlga thet I �ave reatl this epPlication antl rtate a`
n
theT t�e ebove infotmetion is corract antl aB�ae to comply with �
all laws regulating builtlin8 construction, end I shall not employ �
any perwn in violation of ihe workman's comp¢nsation laws ot m
Me State of Californie.
m
I hereby certify that � am properly licensetl as a tonbactor untler SQ. FT, N
the State of Californla Business antl Protessions Cotle, Division 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR m
Chapter 9, end tha such II enses ara in full torce entl aftect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE NLV:
am exempt trom e prov ions of the State of California Businass iO
VALUATION PERMITFEE S`b •O �
antl Protessions , Di ision 3, Chapter 9. �
n
AN CHECK f ^�
SIB^aiure of o
Permiriae $ LL
TAX § �
or V
Authorizetl A n ate
TOTALPAID E' O �
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