HomeMy WebLinkAbout304 CAMPBELL LN - Building Permits` 3b4�� �,�pb�Q
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BLDG # 13
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COSTA MESA BU DING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely - Use Ink Only
BUILDING'^�_�G /�4� �f`r'�y"
AODRESS�C/ � l_ �vv��•
OWNER Mariners Savings & Loan Assoc,
1515 Westcliff Dr.
cirr Newpc
CONSiRUCT10N
IENDER
BRANCN
ADtlRESS
ARCHITECT
OR ENGINEER
ADDFlES$ 1'J�
GONTRACTOR
Beach
Same as above
noor+ess 1665 Placentia Ave.
cirV Costa Mesa
STA7E
uc. No. 336725
SIZE
OF LOT Vazious
USE OF
EXISfING BLOG.
S
- _ �
. - . - , , _ ."1 , -. � .. ., . . ., . _ ,
APPUCATION FOR STRUCTURAL PERMIT
ECEWED BV OATE RECEIVED DA7E ISSUE
�i_�n_'�
BUILDING
ADDRESS
No�' 642-4000 TRi
rE �. 549-4002
Suite H FIRE
Irvine ZONE
APPROVED
BY
TEL. ZONF�/y�
No.646-1164 iC<�
CITV V�4RDS API
uc. No. 14664 MAIN BUI
NO.OF BLDGS IFROM GL T
NOW ON LOT ONi
Separate permits are required for
electric, plumbing and heating work.
USE OF BUIIDING AND WORK TO BE PERFOF�
Tnf-al flnitc � d
E
NO.OF USE OF NEW
vues euaan�
BEf. MAIN &
AQL�. BLOGS.
DAYE (� f�
APPROVEOS/ ✓
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0
✓ IlLl:1:::....[ y� I
'� hereby aeknowledge that I have r this appliea on antl staxe ��� "''"' � �
:�at t�e above iniormetlon Is correct and agrea to comply with �
�II laws repulating buil0ing connruc[ion, antl I shall not employ � �
my parson In vlolat(on ot the workman's compensetion laws of m
:ha State of Celifornia.
herepVi certify that I am properly licensetl as a contracior untler SQ. FT. emi
�e State of California Business antl Proteuions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOfl �d�
:hapt0r 9, and that sueh lieenses ere in full for e antl eftact, or I THE VURPO6E OF ESTABLISHING A PERMR FEE ONLV; �[�
�m exempt tro rovisio�s of the State of a'fomie Business "V
VALUATION PERMIT FEE E
ntl Profeuion Co ivislo 3, Chepter 9. h
m
M
ipnature of 1 /�.� n lAN CHECK S LL �
ermittee �' $ ' � � //h/) TAX S � �
7�.ciC/ • � �)
�utholized Apent / TOTAL PAID S �
L h..
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30`� Camp6�c
-, :
COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BO% 1200 COSTA MESA, CALIFORNIA 92826
APPIJCA770N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Uae Ink Only
RECEIVEDBV DATERECEIVED UED
BUILDING
ADDRESS PERMIT NO.
OWNER A.P. NO.
MAIL ���
ADORESS ADDRESS
TEI. TqqCT �OT BLOCK
CITV NO.
ODP6'TRUCTION
LENDER
BRANCH r
OWNE
ADDRESS E
ARCMITECT TEL. • = —
OR ENGINE
FIRE
ADDRESS ZONE T/PE
APPROVED OATE
CONTRACTOR BY
ADORESS
TEL. ZONE N0.0G USE OF HEW
CITV NO. �� ���p�
STATE CITY YARDSAPPROVED YAROSAPYROVED
llG. NO. LIC. NO. MAIN BUILOIN6 ACCESSOfiV BUILOIN6
SIZE �pfg�� (PROMGLSTREET)
OF LOT �pW ON LQf FT FT,
USE OF
EXLSTNG BLD4
Separate permits am requ'ued for � F FT
electric, plumbing and heating work.
REAN FT. fT.
USE OF BUILOING AND WORK TO BE YERFORMED p�5{qNCE gE{, BET, MqIN 8
MNN BLO(i6. AOCE$. BLDC36.
VA0. t DATE
C.U.P.t APiROVED
pWfIWED
I ��nDV xknowNtlp� tMt 1 har� r�eE Mi� �p011ceHon anE tbp
MOt Ml� ObOv� 111:OfT�t1011 �� COff�Ct ��14 lQIM t0 COTpIY WIIFI
ell law�'rpulninp bulldlnp conrtruction, snC 1�hell not �rnploy
eny parton In vlolrtlon ol the wor4men's tomp�mallon law� of
the Snh of CelHorn4.
1 ��rabY c�rtify Met 1 sm proDerlY Ilc�nr0 n� eontrxtor unda Sd FT.
Me SLta ot Cali}ornl► Butin�u enE Profmlona Cods, DNhion 3, TNE AMOUNT SMOWN UNDEN VALUATION IS FO/i
Chepnr 9, m0 that wc� Iiunw ar� In full 1we� antl eM�ct, m 1 7ME R1RPO6E OF 6TABLL4MING A PERMR FE ONLV:
em ex�mpt from tha provlslons of th� Stsn o1 CSINornla BuAnw yp�UATION pERM1T FEE {
anE Prot�nlan� Cods, ONIYo� 3, Chepmr 9.
PLAN CHECK •
Sipnature o1
Pamlttee f TA% t
Authorf:ad Apent TOTAL PAID �
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