HomeMy WebLinkAbout2928 PEMBA DR - Building PermitsowNEx BUSSEY, L
JOB ADDRESS 2928 Pemb�
GENERAL CONTRACTOR
AP No.113-652-2�! LOT
INGPECTIONS
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FIRE ZONE
DATE I GROUP
DATE (j-2(y—Ej2
BUILDING PERMIT NO.
VALUE $ �qK_nn
DESCRIPTION OF WORK COml71.B1,Wfl11
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SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 91] C08TA ME8A. CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
COSTA MESA CALIFORNIA
� BIZE
■ 98TBACK LINe PROM
FE RECEIVED
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CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
NHCEIPT NO. M(I/�/,Ji�()
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BUILDING
ADDRESS
COSTA MESA. CALIFORNIA
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APPRi
BY
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I. 1 I NO. OP BLDO6.
DESCRIPTION OF WORK
NO. OF
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NO. OR / I U6E OP N8W
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A. P. NO. �.� ✓ I�. `7 j'�
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YARDS EVES
APPROVED ALLOWEO
fCENTER LINC BT.1
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1 HeREBV ACKNOWI.ED08 THAT 1 MAVE REAO THI9 MPLIGTION THg AMOUM BXOWN UNDfiR VALUhT10N 18 FOq TNE
hNU BTAT6 TNAT THE ABOVB IB CO ER AND AGftEe TO COM• pUPP098 OP 86TABL19NING � P¢RMIT P¢e ONLY.
PLY WITH ALL C TY OfiDINANCEB O 9TAT¢ LAW6 PEODUi1N0
aui�DixG coNe VrnoN. VALUATION �J
BIGNATURE OP PERMIT FEE $ J
PERMITTB
S � � 'J V6 PLAN CHECK $ ��
AUTHORIZED AGENT � _�
TOTAL FEE
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX S77 C08TA MEBA. CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
BUILDING � ZP �%n�jQ �i—�
ADDRES9 �
COSTA MESA. CALIFORNIA
OWNER'�LYCG�% NY�ST C D
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NO.
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ceNTen on Bineei � REAR YARD��
SIDE YARD I LEFT `(% I RIGHT �
I DESCRIPTION OF WORK
BUILDING NO. OF
BIZE ROOMS Sl
CO ERING WALLS?�'� �I GOVERING � �
USE OF BUILDIN AND WORK TO BE PERFORM
/ _ A I�YI 2 � S
GdQ
I HHRBBY ACK DGE THAT I XAVI
AND eTATe �T T ABOV¢ IB CORP
PLY WITH LL CIiY flDINANCH ND
BUIIDIN6 ONBIfI ION.
■ AUTHORIZED AGENT
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APPLICATION' FOR, PERMIT
�'IBUILDING �:�ry�
�l
For Offiee Use Only
aeceirr Ho. penN�r
�
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
ZONING
zoNe I NO. OP I use ov rv
R�1 PLANe 2 BUIIDINO
�«e,w,,.0 1 1 � — � S 2 '
APPROVED
READ THIB APPLIGTION {HE AMOLINT 9HOWN UNDER VALUATION 18 FOR TX!
GT ANO A6NEH TO COM- pUPP09E OP E9TA9LIBHING A PENMIT FEE ONLY.
6ULATNO
VALUATION Y
� j� J`/�� PERMITFEE $ �J �
C/ /Q
s J� PLAN CHECK b // �
TOTAL FEE � ��
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