HomeMy WebLinkAbout306 CAMPBELL LN - Building Permits:
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COSTA MESA I
P.O. BOX 1200
�BLDG # 13 '--.I -. , � - . . .- .. . . _
^ " - - - ..., , �„' ;
�FETY DEPARTMENT `j��p �a yy�(DbDV I
1, CAUFORNIA 92626 T' "^'�
APPLICATION FOR STRUC7IJRAL PERMIT
�or AppGcant to Fill in Completeiy - Use Ink On1y
RECEIVED BV DATE RECEIVED DATE ISSUE
BUILDING '^ � ' " ^ Q �
ADPAESS�,�VZ �
_/ / PEflM1T N .
OWNER Mariners $dVlIIGJS & Loan Assoca A.P. NO. �
AnORFSS 1515 Westcliff Dr.
cirr Newport Beach
CON�RUCT70N $dIIIE d5 dbOV2
LENDER
BRPNCH
ARCMITECT
aooness�/ySl
CONTRACTOR '
cirv Costa Mesa
STATE
uc. No. 336725
SIZE
OF LOT �73i10115
USE OF
EXISYING BLDG.
V. G
Ave.
BUILDING �7
ADDRE55 (^,'7 —
TE L. 64
NO.
No ' 549-40i
_Suite H
APPROVED
BV �
TEL. ZONFfy�
ruo.646-1164 �Cl�
LICVNO 14664 YMA Nsfi
NO.OF BLDGS.
NOW ON LOT
Segarate permits are required for
eiectric, plumbing and heating work.
USE OF eU1lO1NG ANO WORK TO BE PERFORMEO
m,.� � i n.,; t � _ n
E
BET. MAIN &
ACCE.S. BLDC�S.
OMTE /�
AWROVE� �
pATE� ,vI �
1 herehY aekrowlndge t�e4 1 hava ��(1 [Ois appllcaKoa a�d stace �- �" `�� t' �" `' -"' `'-'-" '` '�
Mat t�e above information is corratt antl aprea ta comply with �
m
311 IaWs regulating builtlinp conrtructipn, entl I sM1all not employ �
3ny person in vioietlon of the workman's compe�setion laws of m
Ta State of Celitornia.
m
herebVi certify that 1 am properly Iicensetl as a contraccor untler SQ. FT. n
he State of California Business antl Profaui0�s Cotle, Div(sion 3, THE AMpUNT SHOWN UNDER VALUATION IS FOA �
:heptdr 9, antl thai such licanses are in fuli for e and eftect, or 1 THE M1FiP06E OF ESTABLSHING A PERMR FEE ONLV: �1
im exempt fro �ovisions of theState of a'fornia Buzineu VALUATION PERMIT FEE /
intl Profession Co ivisi0 3, hapter 9. s v� �
m
LAN CHECK S "�
'�ipnanre of 1 � $' J� � TAX f , u�
'armittee
wthofizetl Aqant �� �
TOTAL PAID j L h� �
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0.
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COSTA MESA BUILDING•SAFETV DEPARTMENT
P.O.BO%1200 COSTAMESA,CALIFORNIA82826
APPIICATION FOR SfRUCNRAL PERMiT
For Applicant to fiiU in Completely — Uae Ink Ody
HECEIVEDBV DATERECEIVED UED
BUILDING
ADDRESS VERMIT NO.
OWNEH A.P. NO.
MAI L ���
ADDRESS ADDHE53
TEL. 7qqCT L07 BLOCK
CITV NO.
ODfSTRUCfION
LENDER
BRANCH r �
OWNE
ADDRESS E
ARCMITEGT TEL. ' • = —
OP ENGINEER
FIRE
ADDRESS 20NE TVPE R U
AVYROVED pqTE
CONTHACTOR BY
ADDRE55
TEL. ZONE N0. OF USE OF NEW
CITV NO. %�� ����'
STATE C17Y YARCSAoiROVED YARDSAiFpOVED
llG. NO. IIC. NO. MAIN BUILDINO ACCESSORV BUILDINO
SIZE �pF�pp� (FROMGLSTREE7)
OF LOT NOW ON 111T T F7.
USE OF
EXbTiNG BLDG
Separate permiu are requ'ved foc F FT.
ekctric, plumbing and heating work.
REAR FT. FT.
USE OF eUILDING AND WOHK TO BE GENFORMED p�{� gE7, gE7, µq�N 8
MAfN BLOCS. AOCE�'i. BLOCS.
VA0. t OA7E
C.U.P.♦ APVROVEp
APPiqVED
I MteDV xknOwNtlp, tMt I hav� rutl thi� p011caHan enE �tsb
Met th� ebov� infottnet(en (t eorntt sntl aWw To COmP1Y wIM
ell law��rpule�lrp bulldinp con.trueMon, snC 1 Nall not �mploy
any parwn in vlolation ot the workman's comWmatlon I�ws ef
Uro Sme of GNfornk.
1 ��reEy cvHfy MM 1 sm propeilV II<�nrC n e eonamtor unEu SU. iT.
the SLb of Csllfornia Buslnw and Vro}mlons Cotls, OhMion 3, TME AMOUNT SMOWN UNDER VALUATION IS FOR
Chapbr 9, �na t�at Wch liunr, er� In full forc� end Hf�ct, or I TME PURP'O6E OF ESfABLBNING q VERMIT FE ONLY:
em axsmpi hom Ma provlslons of th� Stet� of C�IMornla Bu�inw VALUATION PERMIT FEE i
anA Prof�olont CoOs, DMIWn 3, C��pbr 9.
Slpnatura of PLAN CHECK {
P°rr^�ttea f TA% f
AuthorizWApsnt TOTAIVAID •
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