HomeMy WebLinkAbout2184 ELDEN AVE - Building PermitsV OWNER
� JOB AC
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BUILDING PERMIT
VALUE
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
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APPLICATION FOR BUILDING PERMIT
for Applicant to Fill in Completely
RECEIV D
BUILDING
ADDRESS �
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SIZE NO.OF BLDGS
OF LOT NOW ON LOT � FRONT FT.
USE OF
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UI heraCy acknowletlpe thet 1 have reatl thia appllcation antl atata
� thet the ebo�e Information is correct entl aprea t0 comply with
� all lews reBubUnB builtllnB �onavucNon, end 1 sha�l not employ
� any Oarson in viota4on ot the workman'i compensatbn laws of
N Me State ot Celifornla.
ZI hereby certify that I am proparly Iitensetl as a contractor untler SQ. FT.
ffie Steta of Califomla Business end Professiom CoOe, Divlsicn 3, THE AMOUNT SH
Chapter 9, antl that such licenzes ara In full force antl effact, or I TNE PURPO6E OF I
am exempt from the provisionsof theSteta of Cal{tornla Business VALU.�+TION"
and Professione Cotle, Divhlon 3, Chepter 9.
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DATE �
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