HomeMy WebLinkAbout1578APPLICATION
Pj .,, . COUNTY OF •
DEPARTMENT OF COUNTY ENGINEER
BUILDING ..RMIT BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN
ADDRESS
G
SS
LOCALITY
DiamDnd Bar ZIP
NEAREST
CROSS ST.
NO. OF BLDGS.
ASSESSOR
LOT NOW ON LOT None
MAP BOOK
PAGE
PARCEL
33
DISTRICT GROUP
TYPE FIRE
PROCESSED BY
31152-A BLOCK LOT NO.
CONST, ZONE
OWNER PRE5LEY OF SO. CALIF No: 540-0500
F%R
STATISTICAL CLASSIFICATION
SEWER MAP
SS P.O. BOX 2200
CLASS NO.
DWELL. UNITS
BK PG
Newport Beach CA. ZIP 92663
USE ZONE MAP
ECT R TEL.EER architectural Concerno. 979-0451
SPECIAL
CONDITIONS
SS 77 Brookhollow Dr./Santa Ana,
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NOTEL.
ACTOR 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.
FRONT PROP. LINE
HIGHWAY WIDTH
CITY CLASS B-1
CONSTRUCTION LENDER
+
NAME AND BRANCH linknown
BLDG. SETBACK FROM
SIDE PROP. LINE OF
(STREET)
ADDRESS CITY
SQ. FT. NO OF NO OF CHECK
1343 ISTORIES 2 1
HIGHWAY + YARD
TOTAL SETBACK FROM
SIDE PROP. LINE
TYPE OF EXISTING
HIGHWAY WIDTH
SIZE FAMILIES ONE
DESCRIPTION OF WORK Plan 96-B NEW
+
Single Family Dwelling ADD ❑
CORNER CUTOFF
YES ❑
NO ❑
Gar. - 530 sq. ft. ALTER ❑
El
IN OPEN SPACE
YES ❑
NO ❑
USE OF REPAIR
❑
IN COASTAL PERMIT ZONE
YES ❑
NO ❑
EXISTING BLDG. DEMOL
APPLICANT TEL
(PRINT) K �th D. S No. 5 0-0500
�1J
BY (SIGNAT
E
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
I'�
rf
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.
j
SIGNATURE � �
FINAL
BY
PERMITTEE
DATE
ADDRESS 4600 Cairpus Drive
Newport Beach, CA. No 540-050
P.C. Fee $
ter'
Permit Fee.,
CITY
FFjY
..
Issuance Fee
7
f
VALUATION
7
f
3 5.
Total Fee
PLAN CHECK VALIDATION
co 1578 y 2� 78
''P)S 76A638A CE #803A 6/76
CK. M.O. CASH
23 168.80#
PERMIT VALIDATION CK. M.O. CASH