HomeMy WebLinkAbout330 SYDNEY LN - Building Permitsr:M
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COSTA MESA BUILDIN6-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use [nk Only
BUILDING ��S�f ���N�i ����
ADDRESS ��
OWNER��I�I�S Y� I l �/�YI
MAIL � _ l i _ � . , � _ / �
TE
CITV
BRANCH
ADORESS
TEL.
ADDRE55 �
CONTRACTO
ADDFES ��y � _�_(
U/� -Z�% Jf� ��' TEL./
CITY G�/ � NO.y73 �
STATE CITY /
LIC. NO�� � � LIC. NO. (J S
SIZE NO.OF BlDGS.
OF LOT NOW ON LOT
VSE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and hea[ing work.
VSE OF BUILDING AND WORK TO BE PERFORMED
I hereby acknowletlBe that I hava reatl this application antl state
ffiat the above information �s co��ect and egree to comply wlth
ell laws regulating buildinp cons2ruction, and I shall not employ
eny pe�sOn in viOlatiOn of th¢ Wo�kman's compensation laws oi
tha State of Celifornla.
1 hereby cartify that 1 em prope/ly licensetl as a contractor untlar
tha Stete of California Business antl Professions Cotle, Oivlsion 3,
Chaptar 9, antl that such licanses are in tull force end effect, or I
am exampt from the provisions nf tha Siata ot Calitornia Business
entl Protessionz Cotle, Division 3, Chaptar 9.
Signatura of � —
Permittee
AUMorized ABe�t
IA;; PA1�.
zn-���,.-00 a2n : w:}� =65.5��
APPLICATION FOR STRUCTURAL PERMIT
FECEIVEDBV DATEFECEIVED D EISSUEO
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BUILDING ��O
ADDRE55
ED / n � ' � DATE �
{�V,1�
,p%% NO.OF USE OF f�4�W �
YARDS
VAIi.
FOi'. �PEC
THE AMOUNT S
THE PURP06E OF
VALVATION
$�9 �
YARDSAPPROV
BET. MAIN &
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VN UNDER VALUATION IS FOR
'ABLISHING A PERMIT FEE ONLV:
PERMIT FEE $
PLAN CHECK S
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TAX y
TOTALPAID E
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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 ompletely — Use Ink Only
FECEIVED BV DATE RECEIVED DATE ISSUEO
BUILDING
ADDRESS
r PERMIT NO.
OWNER A.P. NO.
MAIL BUILDING
ADDRESS ADDRESS
TEL. TRACT LOT 9LOCK
qTY NO.
CONSTRUCTION NEW ADD L P
LENDER �,
v
BRANCH
OWNER
ADD P ESS VALUE
ARCHITECT TEL. USE S
OR ENGINEER
FIFE
ADDRESS ZONE TVPE GROUP
APPROVED
CONTRACTOR BV DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW
CITV NO.
PLANS BUILDING
STATE CITV YAROSAPPROVED VARDSAPPFOVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLDGS. (FPOM C/LSTREET)
OF LOT NOW ON LOT RONT FT. FT.
USE OF
EXISTING BLDG. SI FT.
Sepacate permits are required for L. SIDE FT. FT.
electric, plumbing and heating work.
REAR FT. FT.
USE OF BUI�DING AND WORK TO BE PERFORMED OISTANCE BET. BEf. MAIN&
MAIN BLDGS. ACCFSS, eLDGS.
VAR.�k DATE
C.U.P.# APPROVED
APPROVED
I hareby ecknowledBe thet 1 hava raetl this appllcation and state
that the above information Is cor�ect entl apree to comply with
ali laws re8uletin8 bulltling constructlon, entl I shall not amploy
any Derson In vlolatlon of the workman's compensation laws of
the Stata of Calitornle.
I hereby celtify t�at I em properly Iicenwtl as e contracior untler SQ. FT.
the State ot Californla 6ualnesa and P�ofeSsions Cotlo, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
C�apier 9, antl that such lieences ere In full forea end affeet, or I THE PURPQSE OF ESfABLISHING A PERMIT FEE O LY:
am exempt from She provlsions of She Staie of Cellfornia Business VALUATION PERMIT FEE S
antl Professions Cada, Dlvision 3, Chopter 9.
PLAN CHECK E
SlOnuture of � /
Permlttae $ TAX $ �
AuthorizadAgent TOTALPAID $ ��
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