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AAESA BUILDING DEPARTMENT i
P. 0. BOX 317 ,
COSTA MESA CAUFORNIA
C•L. OF STREET
' �iPROP LINE
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I 10 FT. FOR , 60 FT. STREET
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MAXIMUM 4 FT. FENCE MAY BE PLACED ON OOTTED LINES--=---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SO�ID LINES
I 6"730 I
FOR AFPLICAr
BUILDIN/G,� AD�DR/,E,SS�
Owner 11L�1. ! l'Lt.A..e �
Mail Address � � � 1 ��
City�A�:��Y'►��tOL- �.[+ .
FFE RECEiVED
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��IVa�CE DEPT.
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City Lic. No. State I�. No.
Size oE Lot��`�,,, �%J AP No..� ����8—�Es� �'-(o�
Setbacks: C/L Stree �t .y� --R�erar� p�� � rS%y��
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Side Yard - Right [`��� Left �� �
Type oE Fence �� �` ,'���w �� ��
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I hereby acknowledge thai j have read this a`p�Sf catio�a�d
that the above is correct and agree to comply with all City
inances and State Laws regulating building construction.
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Received by Date Received
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VALUATION
Permit Fee
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Plan Check
TOTAL FEE
USE REVERSE SIDE FOR DETAILS
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COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31�
COSTA MESA. CALIFORNIA
P R APPLICANT TO FILL IN
BUILDING/� / / � ' ^ �%% .dA
ADDREScffiQCC l.i e l' 7l�/ �
COSTA MESA. CALIFORNIA
OWNER G/{iL(�f
MAIL
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CITY NO.
ARCHITECT LIC.
OR ENGINEER NO.
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CON� ,�O NO.
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ADDRES O2 S•' N
teen� LOT
osscaivnov NO. � BLOCK T
A.P. NO. � � /
SIZE � ,
� NO. F BLOGS.
OF LOT y X Z' now oN �01
lJSE OF
EXISTING 6LDG.
s[lenck �irv[ rAom �
cervreR or srr+ecr d REAR YARD
SIDE YARD RIGHT / LEFT _ /
DESCRIPTION OF WORK
NEW ALTERATION ApDITION
REP MOVING � DEMOLISH
BUI � �s J 14t.�iNO.OF
S��F t/wA r!� w�. �• ROOMS � STOFIES
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��IVAf�ICE DEPT.
r.ITY OF COS�Q �ESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPi NO. /P/.5.RMIT NC
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RECEIVE� 9Y L�FTE RECEIVEO OPTE ISSUE
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COSTA MESA. CALIFORNIA
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I XEREBY ACKNOWLEOGE THnT I' HnVE flEf�D iH15 nPPLICATION AND
STATE THRT TNE /�90VE IS COFRECT ANO AGREE TO COMPIV WITH ALL � /
CITY OROINPNCES ANO STATE LAWS REGIILATING BVILUING CONSTPIIC�
rioH� • yp�UATION
SIGNATLIRE OF • PERMiT EE $
PERMITTEE ��� {� ,// /,i
$ �j� � �� PLAN CHECK �
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AUTHORIZE� AGENT � TOTAL FEE $
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