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JOB ADDItESS �ll�q �
GENERAL CONTRACTOR T
AP No. LOT
INSPGCTIONS
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PIRG 7,ONE
DAT� NOV
VALUG: $ 17Z0'j .00
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DA'I'G I GROUP TR.T TYPE v 7,ONE
SUBCONTRACTOR
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIFORNIA
For Applieanf fo Fill In Compiefely
TYPE OR PRINT
3�y9 �r�r� Law,
COSTA MESA. CALIFORNIA
Lot �, Tract F4� ;. � E,�E�V ED
FINANCE DEPT.
APPLICATIO��j}O�FP�ATA MESA
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For Office Use Only
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P.o. Box zo66 "`
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, Jamison No`544-0040
225 "D�� St.. Tustin FIRE
ADDRESS 2131 SO• A2't8S18
CITY $&IItA �i11H
LIC.TNO. 2OH676 No: KI 9-2204
OF LOT OOOO � �o. oF BtDGe.
NOW ON LOT O
USE OF None
EXISTING BLDG.
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DESCRIPTION OF WORK
BUILDING NO. OF
SIZE ROOMS
EXTEHIOR W�aster ROOF
COVERING COVEF
USE OF BUILDING AND WORK TO E
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