HomeMy WebLinkAbout8873 (9)APPLICATION FOR• • 1.
DEPARTMENT OF COUNTY
DIVISIONBUILDING PERMIT BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
ADIDRRESS
BUILDING
ADDRESS
LOCALITY
CITY DlamOnd Bar ZIP
NEAREST
CROSS ST,
NO. OF BLDGS.
ASSESSOR
SIZE OF LOT NOW ON LOT None
MAP BOOK
PAGE
PARCEL
31152-A 3$
DISTRICT GROUP
TYPE FIRE
PROCESSED BY
TRACT BLOCK LOT NO.
CONST. ZONE
OWNELFRESLEX OF SO. CALIF. No540-0500
STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS P.O. BOX 2200
CLASS NO.
DWELL. UNITS
BK PG
CITY Newport Beach, CA. ZIP 92663
USE ZONE MAP
ARCHITECOR TEL
ENGINEE$ir6hitectural COncernN0979-0451
NO.
SPECIAL
CONDITIONS
ADDRESS77 Brookh011ow Dr. , Santa Ana,CA.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NO ❑
TEL.
CONTRACTOR Same as Owner NO.
BLDG. SETBACK FROM
LIC 289274
FRONT PROP. LINE OF
(STREET)
ADDRESS NO.
HIGHWAY + YARD
= TOTAL SETBACK FROM
TYPE OF EXISTING
LIC.
B-1
FRONT PROP. LINE
HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER
Unknown
+
NAME AND BRANCH
BLDG, SETBACK FROM
ADDRESS CITY
SIDE PROP. LINE OF
(STREET)
SQ. F NO OF NO OF CHECK
h51 2 1
HIGHWAY + YARD
= TOTAL SETBACK FROM
SIDE PROP. LINE
TYPE OF EXISTING
HIGHWAY WIDTH
SIZE STORIES FAMILIES 1 ONE
T
DESCRIPTION OF WORK Plan 96-A NEW
+
Single Family Dwelling ADD ❑
CORNER CUTOFF
YES ❑
NO ❑
Gar. - 508 SCE. ft. ALTER ElIN
❑
OPEN SPACE
YES ❑
O ❑
REPAIR
USE OF
❑
IN COASTAL PERMIT ZONE
YES ❑
O ❑
EXISTING BLDG. DEMOL
APPLICANT TEL
(PRINT) Kenneth D. Stark 9-0500
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i
BY (SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATIONINSURANCE
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SIGNATURE OF
FINAL
"BY
PERMITTEE
ADDRESS4600'Carrpus Drive
Newport Beach, CA. No 540-0500
P.C. Fee $ ®
Permit Fee
1 f
CITY
Issuance Fee
VALUATION
" r
Total Fee
PLAN CHECK VALIDATION
ras 78137AY-E ka1 ,;A;! / / 2
CK. M.O. CASH
16.a0#.
PERMIT VALIDATION CK. M.O. CASH
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