HomeMy WebLinkAbout809 GRAYLING BAY - Building Permits�
FS
W
H]
a
a
�
y
�
F�
O
�
F
Q
G
J
�
r
.a
�
m
4 '
0
a
o.
z
�S'
3
���i�'w�+�tv B�A�j 775777`)�8�6�85�89�IG%3�959799�o�c
L4ti,qs1Bay 30���93���J72�'i�S7.�853 9ii2i�� �2°����9T:
COSTA MESA BUILDtNG-SAFETY DEPAfiTMENT APPL�C��' FOR STRUCTURAL PERMIT
P.0.80X1200 COSTAMESA,CALIFORNIA92626 _
For Applicant to Fill in Completely - Use Ink Only
BUILDING Tract 10626 /J n
AODRE55 � /al/L�'iliJl. 7
OWNEROR M.D. Janes Co., Inc.
TENANT
ADDRE55 2950 Airway Ave., D-9
CO6C8 Mesa TEL.
cirv No. 979-33
CONSiRUCT10N rjOi selected
LENDER
BRANCH N/A
ADDRESS N/A
ARCHITECT Danielian b Assoc. No��546-3h�
OR ENGINEER
nooaess 3848 Camnus Dr__ N n
CONTRACTOR OWI10I
ADDRESS 8
TEL.
CITV A NO. e
STATE CITV
IIC. NO. e LIC. NO. e
OF LOT ri50 � x 334 � NOW ON LO S e
USE OF
EXISTING BLDG. j�j�({
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
I �ereby ecknowletlpe thet I have reatl thia epplicetion entl rtete
that the above Info�mation is corract antl epree to comply wiffi
ell laws repuleNny builtlfnp consnuctlon, entl I ahall not Bmploy
any person in violation of Ma workmen's compansation Iaws of
the Stete oi Celitornla.
I hereby certify fhat I am proparly licansetl as e contrector �nEar
the State of Calilornie Business antl Professions Cotle, Division 3,
Chapter 9, antl t�et such licenses are In full force entl etfact, or I
am ezempt from t provisions ot the State of Celtfomia Businass
antl Professions Co e, Divi iOn 3, Cheptar 9.
/
Signatura of
Permitte¢
or $/17/79
Authorized Ao D
`Ya /��}�
A.P. NO.'TI'Oq I
BUILOING%� � �
ADDRE55 V (}�
UNiT OR
SFACE NO.
TR.NPb b� LOT
NEW ADD LTI
OWNER
�USE�
FlCLS
N° �
�t—
REPAIR
VALUE
S
APPROVEO
BY DATE
APPROVEDSETBACKS
(FROM GLSTREET)
OM FT.
L SIDE
REAR FT.
PLANNING ACTION
� / 1 'O9/'y DATE Z ^ L
APPROVED LL
.nPvaov5eY . , /J �%`3� /_7_ � c.i _
TME AMOUNT SHOWN UNDER VALUATION IS FOF
THE PURPWE OF ESTABLISHING A PERMIT FEE ONLV:
VALUATION PERMIT FEE E
�M� ^` PLAN CHECK § � D
SV� �'�/U,V✓ TAX 5 Q/,m
i •+
TOTALPAID E % .��
m
n
o �`
m \
� Qm
� e
N \
m �
n
0
4u �
i�el71
u �\1
F
4L
W
a
Q
y
�
S
F
G1
W
�"i
a
O
:�
a
>
i'
J
�
�
G.'
O
�
a
z
�
'�
3
,`yx'J
COS�TB�MEZ�BUcos�7�aM $AFCALI ORNAnR962E1Vi-� APPLICATION@ORSTRUCTURALPERMITyL.�,;;
RECEIVEDBV PERMIT
For Applicant ro Fill in Completely — Use Ink Only
ADIORESSr_ ( D(�Z(� � pP N�
BUILDING
OWNER OR ADDRE55
TENANT
MAILING UNIT OR
ADORE55 SPACE NO.
TR.NO. LOT BLK.
CITV �\ 7EL.
NO.
ODNSTRU N NEW ADD LTER REPAIR MOVING DEMOLISH
LENOER
BFAN V
OWNER
ADD ESS VAIUE
ARC ITEC TEL. USE 5
OR E GINEER
ADD SS 20NE TVPE GROVP
AP rZ ��` �
CONTRACTOii BV �ATE
ADDRESS
TEL.
CITV NO.
STATE CITV APPROVEDSETBACK$
LIC. NO. LIC. NO.
SIZE NO.OFBLOGS. (FROMC/ISTREET)
OF LOT NOW ON LOT ONT FT.
USE OF
EXISTING BLDG. T
Separate permits are required for L SIDE FT.
electric, plumbing and heating work.
FiEAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PL.ANNING ACTION
oah
APPROVED
APPROVED
I �ereby ecknowledpe xhat 1 nave reatl iMls applicetion end [tnte °i
�
that the above information is correct end apree to comply wl[h
all lews reg�leting b�iltling conzhuction, antl I shell not ampl0y �
enV percOn in violation of ihe workman's compensation lews of m
Me Statt of Califo��ia.
m
I �ereby certlfy that 1 am properly licensetl as a contrector untl¢r SQ. FT. rv
the Stata of Celifornia B�siness antl Professtons Cotle, Division 3, THE AMOVNT SNOWN UNDEH VALUATION IS FOR m
Chapter 9, entl tha such II enses are in tull force antl affact, or I THE PURPOSE OF ESTABL6HING A PERMIT FEE NLV: e
am eaempt from e prov' ions of the Stata of California Business VALUATION e
entl Profassions , Di ision 3, Chapter 9. PERMIT FEE S`b •D N
n
SIg^eture of CAN CHECK i o
Parmlttee 5 TqX i f
or u
Authorizetl A n ate
. TOTAL VAID S' O D
il