HomeMy WebLinkAbout574 CENTER ST - Building PermitsUX'fitK vi+i vr �.wiea rus.uf
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OR SYSTEM
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5' TURAL. FIN�L
H� .NG. VENT., REFRI
PLUMBING. FIN4L �ND
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BUILDIN6 PERMIT N0.
SUBCONTRACTOR
_ �_�:3847
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.eOX1200 CUSTAMESA.CALIFORNIA92626
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�„? 2a-7��:,,.00� �r,5� r:,::.�,�;r5.50
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
/ RECEIVEDBV DATERECEIVED DATEISSUED
ADIDRESS �J / /�/y�i��✓
� � C�.i'�' �� �KC%-=iti, / �(7 / ' A P
OWNER / A.P. NO. //C�J �' C/b
� - BUILDING !`�tj �
MAIL ADDRESS J 7 / S/
ADDRESS
' TEI. TRACT �� LOT I BLOCK
CITV NO.
CONSTRUCTION W ADD ALTE P
LENDEFi �
BRANCH /�
OWNEr�LiTY oi �ri�e /17
ADDRESS
VALUE
ARCHITECT TEL. SE G � $
OR ENGINEER N
FIRE
ADDRESS ZONE TVPE GROUP
CONTRACTOR �� , ��/��—' APPROVED
gy DATE
ADORESS�S�j �/Lr� '(,-is.y fi�
TEL.r ZONE NO.OF USE OF NEW
,/� �y��c/ �2 PLANSd BUILDING
CITV /�i e�7 yv..� NO.' / T%
STATE i� CITV �'ARDSAPPROVED VARDSAPPROVED
LI0. NO. ��G �; G� LIC. NO. MAIN BUILDING ACCESSORY BUILDING
S12E NO.OF BLDGS. (FROM C/L STREET)
OF LOT NOW ON LOT ROM FT. FT.
USE OF
EXISTING BLDG. ;/� „� S � FT
/
Separate permits are required for L. SIDE FT. ` F.
electric, plumbing and heating work. �
REAR FT. FT.
USE OF BUILDING AND WORK TO BE PEFiFOflMED DISTANCE BET. BET. MAIN
� MAIN BLDGS. ACCESS. BLDGS.
�/ VAR.�{`+ DATE
/Jw21� C.U.P.�y'+ APPROVE�
APPflOVE�^`�Q J� � `�� �
W
I hereby acknowletlBa thet I have reatl this appllceNon antl state
ihat the above info�mailon is correct antl eBree to eomply with
all laws reBulatin8 bullding construction, and I shall not amploy
any parson in violation of the workman's compenseSion laws of
ihe State of Callfornla.
I he�eby certify that I am properly licansetl as e coniracior under SQ. FT.
tha SiaSe ot Californla Business antl Professions Code, Oivision 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR
Chapter 9, antl that such licenses ere in full force antl etfact, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from tha p�ovlsiong of theSiata of Califo�nla Business VALUATION PERMIT FEE $
end Profes5ions Code, Dlvislon 3, Chepter 9. �'�%
SIB�ature of //j � � � � PLAN CHECK $ �-
Permittae •�GA/.'.�rt/ $ � .�- TAX $
Authorizatl Apant TOTAL PAID $ �