HomeMy WebLinkAbout2030 PLACENTIA AVE - Building Permits�,o
GENERAL CONTRACTOR C
nr.xoll -3 3-17 LOT
OCCUPANCY
Form 410—SM-11-59 5-B P
DATE
CT FIRE ZONE DESCftIPTION OF WOAK Dem03.
DATE I GROUP I TYPE V ZONE
'--I SUBCONTRACTOR I _ PERMITS ISSUI
�2�28
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 3f7 COBTA ME6A. CALIFORNIA
For Applicant fo Fill In Complefely
TYPE OR PRINT
BUILDING I1Q �O, �
ADDRE6S d `
COSTA ESA CALIFORNIA
NO. OF B1D66.
� BHTBACK LINe PROM
DESCRIPTION OF WORK
WALL
■ U8E
NO. OF
FIRE
ZONE
APPROVED
ZON6
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CITY OF COSTA i�1FSR
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
RBCHIPT NO. I p� � ^ �
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9Y OA�}� PtC61VED DATE 183UHD
i'i X-.�-GaI Q-.�_4�v
COSTA MESA. CALIFORNIA
TYPE ✓ GROUP
DATE
ZONING
( I PLANB � I U88 OFj j{EW .
BUIIDINC�
urve er.�
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I HEREBY ACKNOWLEpOB TXAT I XAVE P¢AD THIB MPLIGTION THE AMOUNT BHOWN UNOBA V�LUATION IB FOP n�e
AND BTATE THAT iH6 ABOVE IB CORPBCT A!ID AGRE2 TO GOM- pURP08E OF. EBTABLIBHINO A PERMIT FEE ONLY.
PLY WRX ALL CIT' ONOINANCEe 6TAT8 UW8 IiH TINO
BUILDINO CON N. $ALUATION � -
SIGNATURE O �i1 ., 1 i /�/ � PERMIT FEE $ ��
PERMITTE �•��•.�
PLAN CHECK $
AUTHORIZED AGENT � _
TOTAL FEE
%