HomeMy WebLinkAbout1000 SUNFLOWER AVE - Building Permits45'_0
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADDRESS
OWNER
MAIL
CIT�1.s/r
CONSTRUCTION
BRANCH
ADDRESS
ADDRESS
CONTRACTOR
ADDRESS
CITY /JAL
SIZE
OF LOT
TEL
NO.
TEL.
NO.VZ:5!�
CIT
LIC. NO.
NO.OF BLOTS.
NOW ON LOT
1021-77PAIB001111* ***166.51
CHSA
AP/L4I ON FOR STRUCTURAL PERMIT
RE
DATE RECEIVED
T S UED
PERMIT NO.
A.P. N
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TRACT D
LOT BLOCK
OWNER c U(/'•}�
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USE AtC /%e•
FIRE
ZONE TYPE -V GROUP
APPROVED
By
DATE
ZON NO.OF USE OF NEW j)
PLAPLS BUILDING
YARDS APPROVED YARDS APPROVED
Separate permits are required for C �r 0
electric, plumbing and heating work. -R� -?, F
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. &
MAIN BLDGS.
r,. // A /— ). /. VAR. 16. 1 DATE
1 hereby acknowledge that I have read this application and state
Met 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
the State of California.
I hereby certify that 1 em properly licensed as a convector under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or l
am exempt from the provisions the State of California Business
and Professions ode, Divislo , CI epter 9.
Signature of
Permittee .•✓/✓/ +���+++^^^
Authorized A ant
VALUATION
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PERMIT FEE S
PLAN CHECK S
TAX $
TOTAL PAID f
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IS FOR m
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