HomeMy WebLinkAbout964 DAHLIA AVE - Building Permits130
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QC, 15-72cMsA001078* ***126.05
COSTA MESA BUILDING-SAFETY DEPARTMENT'S
201BRP•O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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gPPLIATION 'FOR;BUILDING-PERMIT..,.
For Applicant to Fill in Completely-
RVCEIEIJBY DATEAEC^EIVDATISSU
BUILDING l
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- OWNER Larwin Southern California ' Inc.
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A.P. NO.MAIL
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'ADDRESS -16255 Ventura Boulevard
BUILDING
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CITY Encino, COIIfOlT11a ,NO.986-8H9O
TRACT'7.7/ A. LOT BLOCK
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.CONSTRUCTION _ -� _
Larwin -SOuthern.Callfornl a'
NEW I ADO I ALTER I REP41B-
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BRANCH 16255 Ventura Boulevard-
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.ADDRESS `- � :.Encina California ':^
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ARCHITECT p';,; TE
LARWI - t`JuL27 ". 3-4464
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9100 WIIShIre Blvd: 'Bev. HIIIS
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CONTRACTOR Larwin Southem. California Inc.
APP O E - •_�I'/
BY' �tr/r�Rti� DATE'
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"ADDRESS 1 255' a a
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.ZONE' NO OF /'' USE'OF.NEW+' 1 )
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CITY "; Encino COWOrnla•�N OL 273-4464
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STATE CITY.
YARDS APPROVED YARDS APPROVED'
NO. 19131.1 LIC. NO. 13=1
MAIN BUILDING ACCESSORV.BUILDING
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-SIZE __ NO: OF. BLDGS.
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OF LOT. .1' - -• NOW ON LOT 0,
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FRONT FT - FT.USEOF
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SIZE OF NO. OF. -
14'36 1'
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NEW SLOG. ROOMS STORIES
L. SIDE' FT:
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.EXTERIOR WALL' � ":`
COVERING' IStUCCO
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COVERING O tl Shlnale
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USE OF BUILDING AND WORK TO BEiPERFORMED
.DISTA NCE BET.
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MAIN SLOGS..^
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Construct Sin ie Famil si nC
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APPROVED, ,
APPROVED
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-.hereby, acknowledge that I have read this application and stateHOLD.FOR
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aboveinformation is correct antl agree to comply with
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all Iaws.regulating building construction,- and I' shall' not employ
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any person in violation of the-workman's compensation'laws of
N the State of. California.
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I hereby, certity thaCl am�properly libensetl as a contractor under
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THE .AMOUNT SHOWN UNDER VALUATION IS FOR
-. the State of California Business and Professions Code, Division 3,
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,Chapter 9, and that such licenses are.in full force and effect, or I
- THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt fro m.the' provisions of the State of California Business '
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VALUATION
and Professions Code„Drvision'3,-Chapter.9. - -
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PERMIT FEE $ -
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Signa tureo/f//��/J/�/f///t �.�OwnS
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to
Permittee �1zi
$�(/ [! :
PLAN' CHECK' $ ^�
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TOTAL FEE