HomeMy WebLinkAbout2190 BOSQUE SPRINGS - Building Permitso?/8p�g2/g.�6,8�?�96 86� M�16.84 TIL,f
CO oT s XE A OOSDIIA MESAFETYCALID PAIA 9 MMT APPLICATION F §STRyffyW PERMI'� 1,6.84 TL
For Applicant to Fill in Completely — Use Ink Only
RECEIVED By PERMIT
BUILDING
ADDRESS
A.P. NO.//5 = 2,3� Z.
ADDRESS
OWNEROR
TENANT M.D. Janes Co., Inc.
UNIT OR
SPACE NO.
MAILING
ADDRESS 2950 Airway Ave., D-9
TR.NO.LOT
/.S e�0
57
BILK.clrY
Costa Mesa 92626 TEL
NEW
I ADD ALTER REPAIR
MOVING DEMOLISH
CONSTRUCTION N/A
LENDER
BRANCH
OWNE .,D.
ADDRESS
US LUES/7
ARCHITECT TEL
OR ENGINEER Sampler I1 N 549-252
77
ZONE , TYPE GROUP
Park, Irvine 92714
ADDRESS17922 Skyz
CONTRACTOR Owner
APPROVED
BY DATE
ADDRESS
TEL.
CITY NO.
STATE CITY
LIC. NO. LIC. NO.
APPROVED SETBACKS
SIZE NO. OF BLDGS.
OF LOT I rreg • NOW ON LOT Y'
(FROM C/L STREET)
FRONT FT.
USE OF (77�
EXISTING BLDG. 7'
FT.
Separate permits are required for
electric, plumbing and heating work:
L. SIDE FT.
/
REAR f FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
(9 Unit Condominium gt:
'�(�—/.,5
DATE '13'%
APPROVED
Attached Garages.
°P i
O b/
HOLD FOR SPECIAL REQUIREIvIEN I b
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
me State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Coda, Division 3,
Chapter 9, and the such licenses are in full force and effect, or I
am exempt from a provisions of the State of California Business
and Professions C e, Div' 3, Chapter 9.
Signature of %
Permittee �/
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
$ 7 t7//��
��'7'.J�
PERMIT FEE $
PLAN CHECK $"�/• �O
TAX
or
Authorized Ag DaSe
TOTAL PAID $
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