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HomeMy WebLinkAbout198 BRANDYWYNE TERR - Building Permits� ��.7.�:�3� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely �—� Use Inlf.Only BUILDING.�'� � Q�U�iF iN/G /i�iRF OWNEF�f MAIL ADDRESS,�y CITV CONSiRUCTION BRANCH ADDRESS ADDRESSpl��Z �IU�' �( �iUr'�(• p/� • CONTRACTOR Q � (j�LjfE�. AODRESS � TEI. CITY NO. F STATE CITV LIC. NO. LI0. NO. � OF LOT D, NOW ON LOTs�.b ^ a USE OF � EXISTING BLDG. /(/ � FSeparate permits are required for � electric, plumbing gnd heating work. (.�. USE OF BUILDING AND WORK O 8E PERFORMED A ..7 Q � i a � w �� 4660 37082i9 J7T•1;1..:TU' �G�S�n80� 3e/0�8"/�,i�9. +T77`]1CKTD APPLICATION F(7R�19tUQ�i�.��MIT �A `� ^, ECEIVEDBV DATERECEIVED nervicc�icn AD TRACT FIFE ZONE APPROVED 20NE � NO.OF PLAPLS VARDSAPPROVED MAIN BUILDING (FROM C/I..6�RrLT) DISTANCE BET. MAIN BLDGS. VAR.�`r7f� �� C.11 P a��� . ' PERMIT NO. / i � LOT BLOCK M VALUE � $ GROUP / � �DATE � USE OF NEW BUILDING VARDSAPPROVED ACCESSORV BUILDING BET. MAIN & ACCESS.BId DATE i � I heraby acknowledge that I hg�e reatl this application end rtata � � that the above information Is correct antl a8ree to comply with m a all laws re8ulating builtling co�struction, antl I shall not employ i � any person in violation of e workman's compensation laws of ° � tha State of Celiforn(a. Z� ��_ � f� m 3 I hereby certify that �y �icensetl contractor under � SQ. FT. �CJ �v She State of Califor fa usi antl Pro ions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATIO IS FOR m Chapter 9, antl tha li s n full force end effect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE ONLV: � am exempt from t p vi the State of Celltornia Businea a VALUATION PERMIT FEE S and Proiesstons Co e, i' , Chapter 9. � 70. S o PLAN CHECK $ ^� Signetura of n� LL Permlttee $ X � TAX $ !� � �� � U Authoriza t v � TOTALPAID $ � MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 F C W 0. Q � y Y" F G w F Q � ..7 Q 7 r .� CC w a O C a Z 67 "y. 3 For Applican[ to Fill in Completely - Use Ink Only BUILDING ADDRESS �t 7 �3,�8•Branduwune Terrace °ENaNr°RYe12ow Brick Road Bui2ding Co. MAI LI NG ADDRESS 2082 Buisness Center Dr., #145 TEL. CITV �r______ NO. ovo_ac BRANCH n„ ADORESSS%4S ARCHITECT EIl APPLICATION F��I'R���Q1it%A�. RECENED BV A.P. NO. BUILDING ADDRE55 VNITOR SPACE NO. NEW I ADD IALTER �REPAIR IMOVINGIDEMOLI Federal Savings OWNER , Orange, Ca 92668 7 �... USE ,aooaess666 Baker St., #267, Costa Mesa CONTRACTOR A�ORESS 7n CITV j STATE LIC. NO. j�l SIZE OF lOT 2 USE OF EXISfING BLDG. TEL. Na� 833-8638 CITV �ic. rvo.19429 INO. OF BL�OGS. NOW ON LOT n Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowletlBe that I have reatl this application end stete that the above infotmation is correct antl agrea to comply wlth all laws reguleting builtling consttuction, end I shall noi emplay any parson in violation of the workman's compensation laws of the State of California. I hereby certify ffiat I am properly licensetl as a contrector untler the State of California Business and Professions Cotle, Division 3, Chepter 9, and ffiat such licenses are in full force antl effect, or I em ezempt from tha provisions of the State of California eusinass and Professions Code, �ivision 3, Chaptar 9. Signatura of ���/// • Permittee _� �//� � / �7 or fyl � 7 r/ ( Authorizetl ABeni Date APPROVED APPROVED SETBACKS L PLANNING ACTION OATE APPROVED $ THE AMOUNTSHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: VALUATION PERMIT FEE $ 3�. PLAN CHECK y � $ TAX $ �—" TOTALPAID $��� �� � C i m m � m e N m n 0 f u