HomeMy WebLinkAbout638 RHINE LN - Building Permits n pi;a:. 'IS 821.59
COSTA MESA BUILDING-SA JFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely i Use Ink Only
RECEIVED BY DATE RECD D TE ISSUED
ADDRESS 428630 63?(,3d 636( 8_�sime /`]'7 �'^f&o—T6
1 i / �^/4 p/_/sem+ zAtie A / E4iviy/T fiys��,
OWNER/Ant-26e !f r /otte A.P. NO. 7/B. O/T�l rp DIBUP / o f�
MAIL 710 �t1, /4 l2EA ADDRESS —638LDINGQ,,le2g410EL.
ADDRESS
TEL. TRACT 1941 I LOT Y BLOCK
CITY 2, 4, NO.
CONSTRUCTION Wig NEW ADD A R REPAIR MOVING DFMOI ICH
LENDER �,y(/[r/� �/
BRANCH 1144//`/ lJy ern
Y OWNER ge tl &
ADDRESS �(� ///J,r�/�, VALUE /J
ARCHITECT TEL. USE ""' �f s��/'�� 5 L 1 / v
OR ENGINEER N . FIRE
,�/f"
ADDRESS
ZONE TYPE y GROUP ��
CONTRACTOR 660 i[ /L
APPROVED P /ATE X20-7/4
ADDRESS '
TEL.
.fl INO.OF ZO U ILDING W �V�U
CITY ATE QQ NO. -'<VVlL PLANS BUILDING C-OM
EI
LTC. NO. 27o 2J.,S� CITLIC.
N O. YARDS
BUILDING VED
ACCESYARDS
SORY BUILDINGU
Li] SIZE i NO.OF BLOCS. (FROM C/L STREET)
L OF LOT NOW ON LOT FRONT /FT. FT.
USE OFcn `^�
EXISTING BLDG. R—SIDE 6 FT.
rr, GG "�A✓✓r ''ter.,
Separate permits are required Cor L.SIDE Arnt FT.
`— electric,plumbing and heating work.
REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED .-
'DISTANCE MAINBLD BET. BET.MAIN&
MAIN BLDGS. ACCESS. BLOCS.
/ VAR.# DATE
Q (v Uvfr OAJ S C.U.P.g� 7���7 APPROVED
>. APPROVED — 19 —�/_
_BY
DATF tsVV
ce -IOW Pc-311 ' . ;:......-„_,....,........._. .. : -.3
Esti _
o I hereby acknowledge that I have read this application and state n
(X that the above Information Is correct and agree to comply with m
L all laws regulating building construction, and I shall not employ
Z any parson in violation of the workman's compensation laws of
Lst the State of California.
I hereby certify that I am properly licensed as a contractor under SO. FT. w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE to
e
pm exempt from the provisions of the State of Calif ern la Business VALUATION ¢gR OD
PERMIT FEE S V
and Professions Code, Division 3,Chapter 9. to
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Signature of C •e �E•Ltt"it_ 11 A PLAN CHECK S 9l�a Zp 2
Permittee �7 V sx - /f // $ f 3d040 TAX $ 7/g 3
—UMI 1(/R I • Q
r L U
Authorized Agent TOTAL PAID Si 2
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