HomeMy WebLinkAbout625 RHINE LN - Building Permits 1
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in,Complletellyy "-Use Ink
/Only
/ RECEIVED BY D E cE�lJy/jD
BUILDING f! 621/62C) )IMAM L'. �� /�J D�.E 0 .74 :
ADDRESS (P /�1\/re n "'�� A /�
OWNER//&rze/L\i N etzratfeS—"B/(Oato L'i A.P. NO. �J+ / D ' O P I I,•
'
O
BUILDING •
ADDRESS 71a Al &Ae4 ADDRESS
62], 623
I/�7��" 4tair.'
TRACT 4/7241/ LOT G I BLOCK
CITY 4�r90-1, NO.
CONSTRUCTION i) a p NEW TADD ALTER REPAIR MOVING DFMOI ISH
LENDER // O r
•
BRANCH /114/A/
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` !`I«� OWNER AA y2F2
ADDRESS I I VALUE //j�
ARCHITECT TEL. USE ?cm ohmo S //'/ QQ
OR ENGINEER NQ, FIRE FIRE iJ`j
ADDRESS ��// ZONE /�//'7/T///YYPPPEE J GRODUr-)_...0•--2‘P_
�sto Ailart2E/L APPROVED //Zit/—
CONTRACTOR
CONTRACTOR BY DATE
ADDRESSTEtrL/ E NO.OF,' USE OF NEWS t)N�
CITY NO. I\ IPS s..� BUILDING CDP
STATECITY YARDS APPROVED YARDS APPROVED
LIC. NO. 2707 LIC, NO. MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLOCS. (FROM C/L STREET)
L OF LOT NOW ON LOT FRONTS—eiFT. FT.
Ul Q USE OF EXISTING BLDG. �r(,V,
-. R,$IQE "LAW
FT.
r/]
F^Z- Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work. REAR FT. FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F MAIN BCE BET. BET. MAIN&
0 y MAIN BLDGS'.. ACCESS. BLDGS.
I.:5
✓ 's/ i r V/7/l(•CJB C.U.P.#VA /?-� DATE
APPROVED
APPROVED- BY J DATE g. r 91.ZG
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z • OLD FOR PEC!AL REQL1dr r:NI''`
Q I hereby acknowledge that I have read this application and state n
C that the above information is correct and agree to comply with co
—
S all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of m
W the State of California.
T m
P- I hereby certify that I am properly licensed as a contractor under 50, FT. J
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR al
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E
and Professions Code, Divisio 3,Chapter 9. ���r O q
PLAN CHECK E sof. /. 2
Signature of i.�L/� /� /,J
Permittee LiD t L/ 2-64 - ly •(C 4` $ //70d TAX $ sI U
Authorized Agent / TOTAL PAID $5G s/ a y-
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