HomeMy WebLinkAbout637 RHINE LN - Building Permits /
42520 F.
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in-Completely — Use Ink Only
/�./L `�/) L 1/ RECEIVED BY DATE RECEEIV D e . e
ABDIDL
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SSG/. 33 S'f! 377 4 , �r7 /dai A 7-2-? . . ! �y�1 - .
OWNER h'Et1Z£tt- FNreefili.SE.f-l3��v�ne A.P. NO. / l--e 1 D / I,�.
/ - /� BUILDING /
ADDRESS _J Q N, LA 1�/IE9 ADDR ESSG/ 33Q'(p�9 ���,{-`
CITY Le • 9 DO � NO. TRACT 929/ I( LOT BLOCK
CONSTRUCTION /) //A> NEW ADD ALTER REPAIR MOVING DFMOI ISH
LENDER (I/�'L/r ` ' L/
BRANCH /I /Y�`�[ ITEL rZC2 :�.I ,
OWNER
ADDRESS / VALUE ••
ARCHITECT TEL. USE' /v�/r 1toewV. o $15/000
OR ENGINEER N
FIRE
ADDRESS ///Lw y ZONE PE GROV �/
IL GO ilei �E2 APPROVED e- l7
CONTRACTOR BY DATE (,(J
ADDRESS
TEL. E NO.OF USE OF NEW OPIT
T.CP PLANS . BUILDING
CITY NO.
JDO
(- STATE �7 CITY YARDS APPROVED YARDS APPROVED
LIC. NO. 2)o 79,5 LIC. NO. MAIN BUILDING ACCESSORY BUILDING
Is SIZE i NO.OF BLOCS. (FROM C/L STREET)
C. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF GGL
EXISTING BLDG. R—sIQE i/_"kT ) i FT.
to �/j(y/•/�1 iG7
FSeparate permits are required for L.SIDE FT. FT.
m Ci electric,plumbing and heating work. REAR FT. FT.
F. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
Q MAIN BLDGS. ACCESS.BLOCS.
C VAR. ��7T A
..I I U/Z( ,� oA/ ZO C.U.P.qfs f APPROVED
Q
APPROVED D — // ,2/
SATE G Lp
ce -TOLD FOR. IPEC1i L REQUiREMtERTc
oI hereby acknowledge that I have read this application and state to
= that the above information is correct and agree to comply with m
O. all laws regulating building construction, and I shall not employ
Zad any person in violation of the workman's compensation laws of v
{
= the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. a
the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: —
us
am exempt from the provisions of the State of California Business 00 v
VALUATION PERMIT FEE E
and Professions Code, Division 3, Chapter 9. n
Signature of / Ly//� /� PLAN CHECK E �J�� /5 0
Permittee • NEL rZ E� iy /G {� $ /56000 TAX EC./TTDeit
9 2U
Authorized Agent TOTAL PAID $62S,07