HomeMy WebLinkAbout121 BROADWAY - Building Permits 2'70173 PAID
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 82826
. For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING f', / , For Office Use Only
• ADDRESS .jC+•-cr //✓nC & 'G✓r4C7
RECEIPT NO.
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ERMIT COSTA MESA, CALIFOFNIAi RECEIVJBY fZ/ EC FJ .07.,„:":„,:r.� DD
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OWNER / r- VJAL/ L' 9...,-.4ADR88S /5'-3 JP/ AUIDLRDG /9/ .�
Cc // TIL. /`� / FIRE _
CITY J/017Pfe( NO. 6n4.3(f ZONE TYPE GROUP' / ///f
'HITECT J ✓P/ TEL /1 71fr/ B7ROVED �7 y DATE /�J (� /
[NGI NEER / /lei-, NO. /• G
( f ZONING J .>[A�
ADDRESS /G 3-7 J✓1 E, b0')
40Nn„ NO.OF USE OF NEW
�7 J// /� / FLANS n/BYILDINO
CONTRACTOR /�/��'1I/J�F tj+ ( CJ'YL�T/J /�y�-�,��i
/ LEGAL NZ4' /• i 6 �I
ADDRESS //+(�a./7 Sc./4 Gr €/1� ' DESCRIPTIO
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CITY l ojA /JJ x�/ A.P.NO. J I / � 10 3— 13
STATE l j /' 7' TEEL.. �1 i_23,4
80NO'70 80IDE a REAR P.4 RAVE O SHALL BE LESS THAN
• LIC,NO. .01/46
/ _ EAVES
F
OLOT !J (5-- / /2 S NO.OFryLDGS. ALLOWED jU.B.C.REQUIREMENT)
ei. SE OF / _ YARDS APPROVED YARDS APPROVED
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EXISTING BLDG. /&7'V C4'1. !7 C C ' MAIN BUILDING ACCESSORY BUILDING
' (FROM C/L STREET)
SETBACK LINE FROM G �7( Cir/ FRONT - /e . FT.
CENTER OP*TREAT
.1- i REAR YARD
SIDS YARD I LEFT (-..// I RIGHT R.SIDE - FT.
DESCRIPTION OP WORK L.SID C52-7142. FT.
ALTERATION X NM _ REAR !J"/a FI'. Fr.
DISTANCE PET. BET.MAIN Q
I- REPAIR -MOVING/ DEMOLISH MAIN BUD,' ACCESS.BLDGB.
BUILDING '/.4I 5-006.OF VAR.* DATE
SIZE " ( ROOMS STORIES / C.U.P.# APPROVED
EXTERIOR WALL J' ROOF •
APP • • r"
• COVERING I COVERING BY - i ( LY/" DATE O i
USE OF BUILDING AND WORK TO BE PERFORMED ��� _
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HOLD FB SPECL1t, }tcntrrpmvirrvTS w
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I HEREBY ACKNOWLEDGE THA HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. E13
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGU ING VALUATION
BUILDING CONSTRUCTIO J�
f' SIGNATURE OF /� �y///7��/jam O J� PERMIT FEE $5/ (/!J p
PERMITTEF ` "�' �iF�'/ '-G �- p
1 7 PLAN CHECK $
-. AUTHORIZED AGENT �J�
TOTAL FEE 495"'