HomeMy WebLinkAbout926 CAPITAL ST - Building Permits5168 FEE RECEIVED
-COSTA MESA BUILDING DEPARTMENT W 21 1951 -tr C ,
P. °. BOX FINANCE DEPT.
COSTA MESA, CALIFORNIA
((;;��TTyy nnFF rrnn pp MM��
CP 4P
FOR APPLICANT TO FILL IN APPLICRA R M IT
BUILDING9�(p
C ST.BUILDING
ADDRESS J
CO TA MESA. CALIFORNIA
FOR OFFICE USE ONLY
1
RECEIPT NO.
PER
OWNER��,Al OJiJS
D A ILIAI
RECEIVED BY
DATE RECEIVED
�/- -
DATE ISSUED
IVINY 3 1 195
ADDR..ESSSS✓ -S -S -
X72
TNO./}-/
NG
CITY / J '��S
ADDRESS
ARCHITECT LIC.
OR ENGINEER NOO..
COSTA MESA. CALIFORNIA
FIRE
ADDRESS
ZONE
CITYLIC.
ZONE —q
pOA l05
TYPE GROUP
/V
CONTRACTOR NO. /(J
APPROVED
ADDRESS �/'r/�/ NO.
DATE
_
LEDAL
Lor
�
CORRECTIONS
DESCRIPTION
NO. G
BLOCK
TRACT/
A.P. NO.
SIZE / ��//O—j. ` T
�C
NO. OF SLOGS. O
OF LOT LI C �.l C/
NOw ON LOT
USE OF
EXISTING BLDG.
SETBACK LINE FROM � /� J
CENTER OF STREET \ l / REAR YARD `/
SIDE YARD _ RIGHT �? LEFT sr
DESCRIPTION OF WORK
NEW JL_j ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BUILDINGJ NO. OF
anF / ROOMS \— STORIES
f[tl
JAL fYJ1J �'7 --J J
I HEREBY ACKNOWLEDGE THnT HAVE READ IMI APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES
AND STA/TTEE///L//gJyJS REGULATING BU IL JG['I/N�G1/\1ff��p^N/�BTRUC
TION, �] 71L4 V1Y'W/
SIGNATURE OF
AUTHORIZED AGENT
LUATION
PERMIT FEE 5
rA'JJ /'7��
V
PLAN CHECK $ /ypZ ^
TOTAL FEE S ✓�
`�'"'