HomeMy WebLinkAbout1035 EL CAMINO DR - Building Permitsa
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COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
5501 4/18/80 40.10 TL
APPLICATION FOR STRUCTURAL PERMIT
BUILDING � 1- 1 /1 _ m `i o ck-A.P.
ADDRESS 1 ��{. 1 RJ
NO.
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TENANT OWNEROR .tJl Q mrs ^..1R�'Yl II�r
BUILDING
ADDRESS
_
MAILING
SPACE NO.
p
ADDRESS Q e- lr;�'
T R.NO. LOT
BLK.
� TEL
CITY \nlr NO.
NEW AD ALTER REPAIR MOVING DEMOLISH
CONSTRUCTION G_L
LENDER
BRANCH
OWNER
ADDRESS
VALUE
ARCHITECT TEL.
$�O
OR ENGINEER N
r -2 -
ADDRESS
20NE TZr—
GROUP
DATE
CONTRACTOR
BY
ADDRESS �jPpJ
TEL.
CITY NO,
STATE CITY
APPROVED SETBACKS
UC. NO. LIC. NO.
SIZE NO. OF BLDGS.
(FROM C ET)
OF LOT ya. S NOW ON LOT
RO FT.
USE OF
EXISTING BLDG. D
Separate permits are required for
L SIDE FT.
electric, plumbing and heating work:
REAR 4.FT.
'SE OF BUILDING A D WORK T 'BE PERFOR ED 4ii,
_hiJ
PLANNItVG-ACTTON
DATE
APPROVED
APP/prV
I hereby acknowledge that I have read this application and state
that the above information Is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
the State of California Business and Professions Code, Division 3,
THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect, or I
THE PURPOSE OF ESTABLISHING
A PERMIT FEE ONLY: -
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
VALUATION
MIT FEE $
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Signature of 'T
s �v
//L)/jJ-�
PLAN CHECK $ O
Permittee l/lrj�L,(i�t/
$
TAX $ "f
or
V
Authorized Agent Date
TOTAL PAID $ LL -1 0 am
I
NOTARIZED STATEMENT U. RESPONSIBILITY
TO WHOM IT MAY CONCERN:
Bldg. Permit =#
This Permit #
600 Newport Center Dr., Ste. 483
Newoort Beach. Calif. 92660
Street Address AP Number
National Investment Properties, Inc., Managing Partner,
for El Camino Plaza Shopping Center (Costa Mesa) , as Owner in Title of the above referenced
a co -partnership,
property, do hereby authorize:
STANLEY ROBERT STANBRIDGE and
Name Telephone No.
LIA CARMELLA STANBRIDGE, Husband ?9 Wife
1035 El Camino, Costa Mesa, California
Street Address
Costa Mesa California 92626
City State Zip
to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of
the above referenced property.
Should any person become an employee engaged in the improvement of the property, I shall immediately provide
Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building
Division of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person,
company or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim
resulting in damage or personal injury to myself or any other parties.
NATIONAL INVESTMENT PROPERTIES, INC., Managing Partner,
for E1 Camino Plaza Shopping Center (Costa Mesa),
a co -partnership
Printed Name
Thomal L. Channeli9Y181Ufe Chairman of the Board
Notary's Statement:
CMF 0779-66
April 14, 1980
Date
Ill
To 446 C
(Corporation as a Partner of a Partnership) TI
STA'I'N OF CALIFORNIA
COUNTY OF
ORANGE } SS.
t.
On Apri 1 1 9$0 , before me, the undersigned, a Notary Public in and for
grid_ Slate,_ persopally, appwred Thomas L. Channell -known to me I,, be the
Secretary of. _..
the within instrmnent and known to me to be the persons who
executed the within instrn ment on behalf of said corporation.
said corporation being known to me to be one of the partners of
the partnershi-p therein nam don,. partnership
that executed the within instrument, and aeknowledgud to me
that a'uch corporation cxr, rated the same as eueh partner and
That such 'Inership exec tle the -same. n
WITNES �d 2t ii .al.
Signature (�•�
Name (Typed or Printed)
known to me to be the
the corporation that executed
OFFICIAL SEAL
F. DAVID BUECHE
NOTARY PUBLIC - CALIFORNIA
PRINCIPAL OFFICE IN
ORANGE COUNTY
My Commission Exp. lune 24, 1983