HomeMy WebLinkAbout302 CAMPBELL LN - Building Permits�' . � BLDG # 13 �
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CO&TA MESA BU � DING-SAFETY DEPARTMENT
P,O. BOX 7200 COS7A MESA, CALIFORNIA 92626
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aEc—�-��'°'000 3si� �**Z6037
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APPLtCATION FOR STRUCI'URAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RECEIVED BV �ATE RECEIVED ❑qTF ISSUFn
BUILfJ�NG��^
A DOR ESS �J(/Z'
OWNEFl Mariners Savings & IA371 ASSOC. A.P. NO. �
MAIL BUILDING -
ADORE55 1515 Westcliff Dr. ADDRE55
TEL. 6�}Z—QOOO TRAi
CITV Newport Beach NO.
CpNSTFUCiION W A
,FN„FR Same as above , �
BRANCH
ADDfiES'
TEL.
ADDRESS
f] FIRE
20NE
APPROVED
TEL.
cirv Costa Mesa No. 646-1164
uc No. 336725 iic�No. 14664
SIZE NO.OF BLDGS.
OF LOT Vdr1011S NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and hea[ing work.
USE OR BUIIDING AND WORK TO BE PERFORMED
Tntal tinihc — d
I harabY acknowledge thet I have r�H this appliceYon and steta
Mat ih0 above Information Is corract anA aprae to comply wiih
all laws reBuleting builtling conrtruetlon, antl I shall not amploy
any pevso� �n violatlon of Me workman's com0ensation laws of
Me Stata of Celifornia.
1 hereby certlfy thet I em propeNy Ilcensed as a contrector untlar
Ma Ste[e ot CalHornle Business end Profeulons Cotle, Dlvialon 3,
Chapter 9, entl thet such lieanses are In full for e antl atfeei, or 1
am exempt fro rovislons of the Stete ot a fornle Business
anG Professlon Co ivislo ' 3, hapter 9.
Sipnature of /�
ParmlttBe � ���U
Authorlietl Agani
VARDSAPPROVED
MAIN BVILDING
FROM C/LSTREET)
VAR. #
C.U.P. $�
THE AMO
THE PURP(
VALUATION
$ IG3�Zc�
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USE OF NEW
BUIl.O1NG
VAflDS APPROVED
ABLISHING A PERI
PERMIT FEE E
PLAN CHECK E
TAX E
TOTALPAID E
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ON IS FOR �
FEE ONLV: �i
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For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADDRESS
�
OWNER Q
MAIL
ADDRE55
TEL.
CITV NO.
BRANCH
ADDRESS
ARCHITECT
OH ENGINEEP
ADORESS
7141 3/10/78 983000 TL
APPLICATTON FOR STRUCfURAL PERMIT
RECEIVEOBV DATERECEIVED p ccucr
BUILDINC
ADDRESS
TRACT
FIRE
ZONE
APPROVED
LOT I BLOCK
AODHESS
TEL. ZONE NO.OF USE OF NEW
CITV NO.
PLMLS BUILOING
.�F+ STATE CITV '�ARDSAPPROVED VARDSAI
� IIC. NO. UC. NO. MAIN BUILDIN6 ACCESSOR
{a7 SIZE NO.OF BLDGS (FROM GL STREET)
4 Of LOT NOW ON LOT 7
a USE OF
� EXISIING BLDG.
y
FSeparate permits are requ'ued for � si F
o electric, plumbing and heating work. AEAR FT.
F USE OF BUILDING AND WORK TO BE PERFORMED ��A� � ��N �
OMPJN BLO(S. AOC�. BLO(
VARt DATE
'-� C.U.P.t APPAOVED
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� APPROVED
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� I hereby ecknowlWO� Mat I �ave r�aA thi� ap0�icetion aM �ats
y� that Me abova Information If eOrcaet ana eprea to eomply wlth
4 all law��rpuletlnp builEinp conrtruetlon, enA I�hall not amploy
Z any verwn in vloletlon of the workman'� comp�nwNon Isw� of
TMe Stete of CeUfomle.
3 I �ereby cMify that I em proporly IlceniaA n e contraetor unEn SQ. FT.
Me Stau of Celifornla Bualnws end Profwlons Coda, DWhion 3, TME AMOUNT SHOWN UNDEH VALU
Chaptor 9, enC t�et wch Ncenps era in full force end effacq or I TME PURPO6E OF 6TA8LISHIN6 A PEfU
am exempt from the O�ovlslons of thaSteta of CalMornla Buslnao VALUATION PERMIT PEE {
anG Profeulon� Code, DWiqon 3, Chopbt 9.
SIB���ra ot VIAN CMECK {
Pmmlttw S TAX {
Authorizad Apont , TOTAI PAID i
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