HomeMy WebLinkAbout357 MONTE VISTA AVE - Building Permits�oonessovam�ou+c: 357 MONTE VISTA AV
oxm�Rs"WEiFaa"": HANLEY, ROHERT
�ooness: HANLEY, MELANIE W
357 MONTE VISTA AVE
COSTA MESA,CA 92627
.vvi. �uuNc �oo�ss:
1NCNItECT OP Ell(iNiEN:
ACN.OflENG:S AUDflE55:
uc. xo.:
u"T: GARAG
UNT:
mNrn�cTarsw�ue ROSS & BARROWS INC, ( 714 ) 557-7440
ca�m.crartswuw+c 260 E. ALTON AV
moneu SANTA ANA CA ucr�o.: 327802
92707 • uxr:
LICENSEU CONTRACTOHS UECLANATION: I haroby ell�m uMm penely d pe�jury thei I am IicemeE uMer pwi�ona d Cheplar 9
(mmmarienp wnh Section ]000� ol dviaion � d Ihe &ni�roes eM PrW»siona Code, eM my limnse n in IUA lorce eM etletl.
cmuc.No.:02pgZq uc.cuss: C_39 uc.No.: 327802 XP: 11/96
.�1 0�,: � - 5 - 9'C ��,�� �/'X�. � �,-�.-..a
�:
f OWNEp BUILUEN UECIAFATION: I hxeby �rm urMer panelly d per'Wry ihei l em axamq Irwn �ha Conlreqon Licanse Lew iw IM
- �da.?�o neso� Iseeon �a�� s aueinesa v�a a.b�ania,. code: ��y c�r « coumv wniN reaNrea e v�a io m,swn. enm. �mpow.
demaon, w repei ary swnure, o�� �o ns osuenca. ebo reyuirae �M epd��� br sucn permC lo Ib e egiwE ate�amant �het ne «.ne
o lioansed W�� �o IM povuiom d �M Conlrenon liceroe lew �CM1eWer 9 I�me�np wYh Setlion JOW) W Diveion 3 d Iln
Businev ard Prdesium Cade� a Ihei he a eha ie examq �heralmm arM ihe baais fa Iha eileped eaemqion. My vblelun d Sxtbn
)ai1.5 by e�ry epplirani iw a permn subjeas the epqcau �o e frvJ perutly oi rot more then IMe huMred ddlara �55ooq.
❑ i.�o�.dn»c�wanr«mr�dm��%wn..,a,,,,ine:��re��.w�ndo�w�x.�,a�.we�n�„w�ma�eee
,a
� on�ea i« ub lsen� �wa. e�m� �,d rw.s� cam: me comraaon ���a �..d� �a awN m�, e�.d wooam
wb buitla a mD�'es ineeeon, aM x}a doea euM work limadl or Meaetl or throuoh he a hm own empb/eas. proviEeE ihet sueh
impro.emmn era M interded a aflered lor sab. tl. Mwaver. Ne Witlifq w mqoveniem b eald xUNn one Y� d comqetion. iM
ow�ror-WiNer xiA heva ihe buMen al peovin0 � a ahe did mi build « impove la Iha Ouryme d sele).
� I. aa owrier d iM peopaM. � andusiveN �^�rmip r.nh lieenxd eonveeion to eonmrud the pojeG ($edion'lpaa. &nineaa enE
PMenons Gotla: Tha Comreaae licmae lew Eoes na eVWY w en owmr W pweM who bwtla a imG�'ro iM1erson eM who
convacta 1« wM O�I�a nnM1 e can�reaor(e) licanaed Wnuani io �ha Gonlredae License lawl.
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 076290
PEAMIT NO: B 076290 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION :.T/OFF AEROOF W/BUILT-UP SQ FT: 1,200
CLAIM VALUE: 1,200.00 CALC-VALUE: 1,200.00 GROUP OCC: U-1 /
COMMENTS: T/OFF EXISTING AND REROOF SOOSF GARAGE W/HUILT-UP �
+tit*�rit*it+f�rit+t+��*x ***it�tx��r�r**�*��r**itx �r��tsr*x�+Fit**x�*+tit+E�*�*#it+r*it*x��*+t+��it�raE�r******�r*��u
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 43914105 2NE; REF NO:
PLANNING NdTE5>
�
iE fE 1E �!F 1f 1F1f 1f 1E'k 1E 141E 1E # dE 1flF'IE # if 1E iE�i! 1k iF if'IF 9E 1f'If if'!f iE#iE ikif M 1f iE1kiE dF iE if �f' 1k if Ih1E if 1E 1E if if iF ii1F if iE IE iE iF �lh 16 iF # if IE 1E 1E 1k�lf iE iE iE iM1 iE
D E V E L O P M E N T S E R V I C E S R E Q U T A E M E N T S
ZONING APPROVED BY DATE:
HUILDING APPROVED BY : DATE: _
� IemeumquMerSeetion�. B.dPG..lw�hbeeewn: I APPLICATION ISSUED BY:
ik 1E1EiEk iE 1EiFlF1f iE iF IElf iF IE iE k1F 1f IE 1E
De1B �"�'� LEGALIZATION:N F E E S U M M A R Y
i ao nawr ��r uw i.m e.�a a�e ��rs�,a ub �.a��«n. a ca�o� �nn d,d s�rwr coes s.a� zsws, zssai, �d
255�a, eM tl�v I a eny Mure Wildiip oaupent will / wil rw� (artb ma) nead io cwnply weh eaid s�eb cadea eM iM requiremend br
epemNlamnWclionwmodifitalimhanlMR'raTy�.iarepamen�0islrip.peekenlielmns��utluneppk�ffi'vuenssamqirom�heae BLDG PMT PLUMBING ELECTRIC MECAANZC
a�.
De�e: MdceN:
WOFKEN'S COYFFNSATION DECLAHATION: 1 Mraby effi�m urqar pene�y of pa�ury wre d Na IoAowirq EeCaretbns:
� I M1eve ud W meinlen e canAicela d mrtunt lo aetlirtwre for wurkers romparimlion, ea provideE tw by Setlbn 9100 tl IM leba
cae. �« �n� wn��a a ine w�x ta �n mo v� a��e. �
Cl i n� �a m� �m� �n��; �v�:M ��„�. m Ac���d W se�,r� �7ao a m< �e« coee. ro� ms o�rom,�oa a ma
T wM la xfiirh Nia parmii is imueE. My wvkeee' wmpevmion insureMe raeier end pol'iey wmber ere:
c�a,: FOUNDATION EXPIRES
PolkyNumbac � W . . M1 07/O1/96
(mis s.nbn neee nor be comdetee M �n. w�� a n. w,. nundnd eoNv.lsiaol or bv.)
� 1 nnty rtui in i�e pMwmenea a ihe woA br whieh ihie peemu u ievued, I enell rol empby erry ponon in eiry menner eo ea io
becmn wbjed to iM worMcn' romperuwion lavn d CnLlomia, aM pryoe�Ihm A I elwuld Exmr wbjM io iM xarkan'
romDemetion Pa+a s d SMion 3]OD d �M laEar GOEe. I Yall ip�hwtlh o�%"/ \/«�/T /' �'—'
`, D�e: ,� - 4� 5'L ww�,✓r/
.,.�
Weminp: FaOun ro s�cun wo6eri comyewtlon covsrap� b unbwNl, entl eMll u0pcf en �mployx ro ctlMru/ penaltln erW
Nvll 9rrs �q b aro h�ndrs! fhouaeM CWlan (S10q WOA ��1Wn ro fhs coat o/ rompmufbrt d+mepu u provkHtl ror In
Sxtlon 9]P6 0l Me LWor COW, /ntme�t, entl etromsy'a Iroa.
CONSTIiUCTtON LENUING AGENCY: 1 Mraby effirm uMm peneXy d parjury ihei theee is e memrudion bnd'up epeney Im iM
�n�e�ce d �na ..oM i« »��cn me aa�� n esuee (sea� aos�. ci.. c�. �
LENDEP'S N11ME: '
LENOEH'S RDDPE54:
1 eeNN �hei I Mve reed N'n eCdketion eM paie iMt Un ebo+e iNamdion u mrred. I epeee to mndY xit� e4 dIY W oouNY adinerieea
end etme lexa mimip io WilEinp can�rudion erd Mreby euhor¢a ropawn�e�ivee d ihis ary to entar upon iM ebova�mamuned pmpaM
briropedan puposes.
NANCEE RILHOURNE
/� PnINO O /
�/� a./��! C/(J lY'L�+�a� Dme:� � � �4
. �� S�pneNre olOx+rerlAgenVRppYranVGonlreun
(515td6.WP) W�ile-Building 8 Selary; Grea�le; Carary-AppYcail; Rnk-Revenue; GddamaFAamma
PERMIT 29.00
PLAN
ISSUE FEE
DATE: �- s � �l�o
�iF##1f!(�iEiEiEiE1Flf 1Fif
STRUCTURAL SEGMENT:Y
FIRE SMIP/R`ES GRADING
5 0'
SMIP/NON-RES
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 29.50 0,00 0.00 29..50 29.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 29.50 OVER/SHORT: .00
BLD29PM�T� PLUMBING ELECTRIC MECHANIC FIRE SMIP/TST� GRADING PLAN-CHECK
dF # iF 1F if I! if IF # if iF if 1F 1f 1f' 1E i! If ik 1k 14141f 1F if if 7E iF M�'lE 1E 1F if iF Ih 1f iE if 1E'N"!(' if 1Eif 1E if'IE if 1k IE If if 1f IE 1FiE if 1F1f if iE 1f 1F i6 if ik iF If 1E # iE 1F 1E if iF if 1E iE if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR � 1200 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 1,200.00
. END OF FEES
0
�1 ��199853-00199359 T O T 29.SII
DpTE: 02/OSI45 TI14E:'12:44
�
nooncssoFaunuu+o: 357 MONTE VISTA AV
°""�as"d'E'F"'°"": HANLEY, ROBERT
�� "D°"��' HANLEY, MELANIE W
357 MONTE VISTA AVE
COSTA MESA,CA 92627
i1VPL. IWl1NG ADDIIE53:
01Ti GARAG
�HCNrtECT OR ENC�NfFN: IIC. NO.:
PCN.OR ENQ'S AOOflE55: UNT:
��cT� �:ROSS S BARROWS INC. (714)557-7440
ca�m.croes�u�wo 260 E. ALTON AV
�o�� SANTA ANA CA ucw.: 327802
92707 u�r:
UCENSED COMHRCTOFS DECLAH�TION: I Mmby ell'rm uMm penely d perjury tlw I em limmed uMer po�dben d Gheqm B
(canmerciiq �+i�A Setlun 1000) d Oiri»iwi 9 d �he 8ueinea eM PNeaecne Coda. ud mY � n� IuA Ipcs vq eHeq.
cmuc.No.:020924 uc.cuss: C-39 uc.No.: 327802 EXP: 11/96
� \
oeie�. �� ��j. com,eam: � G� 1ty+�A
OWNEN BUILDER DECIAIi�TON: 1 henby effilm umbr penely d perN�Y �� I em eumq Imm IM CoMredon lioense law la �M
lalbwiq neean (Seeion ]OJI.S Busne�e aM Prdeasiona CoEe: RnY ��Y a�+nry whidi �puirea e pemin io conain�. elier, imywa.
demoloh. or repei eny svucture, par �o es asuence, e6a rx�uirae t�e applirent lor auch permn io file e iqned e�etement thet he m eM
is li[ansad W�� lo IM pwifiona ol �he ConVetlwe Li�nae Lew �CMplaz 9(��entinp wil� SeCun )OOO) d Div'vion 3 W �he
Busiresa artl Prdeasum Lode� or ihel he a Nro u e�emq �heralmm end tM bmu for the elbqaC ecemqion. My videlion W Sepion
]0�1.5 by erry epptira�u lar e permn aubpa� the eppliani Io e aNl peneMy d nal more tMn Me hunEnE ddlen 13�11�
❑ i.�o.,�.dmev,ovanv«mr�wor��wnwaeas�mao-me�o��..;uroub.«k.�eo».wn�rea�am��aae
«Mmee br ub (Sacwn ]as. Busrea aM Prdmaiona Coee: Tha Conlrerfaa L'cxue lewdoea m ewN �o an awrer d papeny
who buiM a inpaes �heleon. md Wa do» auW wAc Nmaetl «Mnell aWaqh hs a her oxn emP�. P��� Ihel euch
�'mpewemam era rid "upxdaC a aHemd Irc eab. M. however. iM buiNi�q a inpwemxp u wk xilhin ane Y� d eompbtion. iM
,.w�., �;n n.ro m. w�d� a o'w��a na a, � a�a �a anm o� �mwa+ia ma wmaa a.wl.
� I, m oxner d �he popMy. am urbmvely mntreGiq wnh licamed canvaclpe lo cansbutl Ne poptl (�� ]Ou. &ai�roaa eM
Pmleeaiom CoAe: ihs LOMreewe License lew Eom � eppl� �o en owrw d popMy xTo dnYa a impwer Ihmeon end wlw
conirecb lar wtli yqeaa wnh e coMredw(a) licene.e! punuen� lo Ihe Conireuon Iicenae lawl.
❑ I am uemp uMer Sxvion: B. 8 P.C.. iw IAh reeaon:
Oma: Owner
I tlo M1ereby cendy UW I em ewera d erd wiEeislerM Iha reQuiremeNs d Cellomie HmEh eM Selety Cada Swbm 255p5, 255J�, erd
2551a, enE 11b1 I a erry tulwa bwki�q om�pen� will / wll rw� (arcb me) med to rompy w1M1 uid qale wdm eeM IM repuirmmams la
e V�b lamrotv.tiann moEilretionhamtMAi�—ene4�ment Oiqrid. RetlEentW armMian WP�idn en eRemq Imm Neae
WOFKEfl'S COMPp1411TI0N DEttAFATION: I Iroreby elfirm under pareAy d pe�jury ane W IM IOWwinp ASWelbro:
� I heve eM wJ meinten e<end'cala d wnaem io ceH�innure fw workeie compeme�ian, n paideE for Ey Seaion J]00 d tAs Lebor
COEe. in iM pe�iwmerce d Ne xak Iw which �hu paimii ie iauatl.
I"i i n�. �e me �m�.Anwn oomo�.vo� ���re��, m rea��roa M sw�, aroo d� �.no, cae., i« ma w�«�� d ma
1� woA tor whiM Nb pemin ia iesueE. MY ��n �mpenxtion iruurarica umar vtl pdicy number ere:
c.�,: Fn[iNnATTON EXPIRES
P�N��«: lass�� �� �a 07/01/96
�rnrs sea�, �,�e �w e. �dxed i me v�+R � ro. o� w�dree ddiem /s�ool «.e:s l
❑ I oenN � m� ro�a�� d�he wark fa whieh ihia pamin u ivi»d. I aM1eA ml emplvy emy pason in ercy maneror m es to
becam wM� io �M xoM1na' canGameiion kvn d Celifomu. eM prea tlw G 1 shauld bxmn w4� io tM r.oMa%
�vn�� wo+��oM a s«a� a�oo d ma �no, coda. i.n�m m�n�n ob .nn ma. w�..
Dva:9 �� � ApplreniG�`�-��!����}'j�L.t�
Weminp: FeNun ro sxun rorkeri rompawtlon covxqs Is unleMvl, eM • IIWb/�cf ur emp/oyw ro ulMiW pona/tlu �iM
elvll nnes w ro aro nurtlrM rhouaeid Ao/kn /tIP0.0001� �n eM/tbn ro tli. roar ol romp�nutan a�W u prov/OM ror /n
Srotlon 9�5 0l tiv Ldm COM. Inferesl, md ettomeY'� /wx
CONSTFUCiION �ENDINO ROENCY: I MraEy �rm under panelry al Po�N�Y �� �� n e cmetivaion bMirq epency lor iM
rono,m��o d m, �on i«.n�a ine ��� �. o�,oa (sea� aas�, cN. c).
lENOEN'S NAME:
LENDEP'4 AODNE%:
I cenily thm 1 Ama nad Nia epqicetian ud utle Ihei Ihe ebove inlormelion ia canea. I ep�ee to compy wuh ell my ud mw1Y pCi�vMes
LM 8�81G bw! RIPofq 10 buiklq COrtbWC11 eM hBlBby 0NM12a �epe9eMelirea CI �hp Ny b an1 V upan �hp 96q9�Rg1111MlE ptopsl�y
10IIn9papion pufpoeee.
NANCEE KILBOURNE
(�� PnN Name �J /
�Iy-y:w.-+a_� �iY � �it��--3i� Dmap� ��� ��IG�
!% �� Sgrelured rlAgenVRPCF��on�reclor
(515t<6.WP) WMe-B�iNig 8 Selery: G(aeMFle: Ganery-AppMant: Rnk-Ra.enua: Galdenrod-Aseesavr
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 076290
CONSTRUCTION TYPE: V—N
PLAN CHECK NO:
PERMIT TYPE: STR
PERM NO: H 076290
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : T/OFF REROOF W/BUILT—UP SQ FT: 1,200
CLAIM VALUE: 1,200.00 CALC—VALUE: 1,200,00 GROUP OCC: U-1 /
COMMENTS: T/OFF EXISTING AND REROOF SOOSF GARAGE W/HUILT—UP
�*+t*�x���****�**x�*�*�+�*�**�+�*� *�*x *��� *�*��**x ��r�*�***�**�***+�***�r�*� �x���x �rt*�+tu�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 43914105 ZNE: REF NO:.,
PLANNING NOTES>
i-
fE 1E iE 1E iE �f !E iE iE ik fE * if 7E if iE 1F �f df if if 1E 1E 3E 1! iE 1E iE iE 1E iElE 1ElE fE 3E jE 3E iE iF jE iE 1E iF iF iE ik 1E iE IE if If jE 1E 1E iE fE iE iElE IE 3E 3E 1E iE jE iF iE iE fE 1E 1E iE if 1E iE 1F �)F!E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
i,
ZONING APPROVED BY DATE:
a
BOILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: S� DATE: � S�rl�o
ifiFlFikif-1EiEiFlflElElk1ElE.ifaEif�lFik1f1E1EiF�FiFiF3FiF�F�fiFiF�FiF3f7F3F�F�F�TF3F���fit-3f Tf�f3F3f7'f�FiFiElEiEiEiEiEfEiflFif fE�E
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 29.00 .50
SMIP/NON—RES
PLAN
ISSUE FEE
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> , 29.50 0.00 0.00 29.50 29.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 29.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CAECK
29.00 .50
if 1Elf 1E if ik 1E 1E iF if !f iE if iE �E 1E if 1f 1E iE iE �E 1E IE IE iE iE iE if iE iE iE 1ElE iE iE 1E 1E IE 1E �E 1E iF if 1E 9f 3f iF iE iF iE 3f If iE iE IE iE IE fE k!E iE if �f iE iE if 1E iE 1E iE if iE 3E 9E �E IF ff iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 1200 ALTER BY VALUE RESIDENTIAL NOZON£ 1.00 1,200.00
END OF FEES
�.,• _ _ - 'I+� ��'r ` L''L
i4 �� _f.
`'ONSTRUCTION AND PLANNING POO� & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspe4tor
y t. TemporarY Electrical Service or Po'le 52. Pool & Equipment Location '
2. Soil Pipe�Undrgrnd. •� � 53. Steel Reinforcement •.I -
<
' 3, Electrical Conduit Utility-Undrgrnd. 54. Forms � �
4."Electrical Conduit�Und�9rnd. ' 55. Electrical Bonding '
�5. Steel Rei�fortement , 56. Rough Plumbing & Pressure Test '
6. Etecv;cal UFER"Grnd. 57. APPROVAI TO COVER�GUNITE �
7. Footings 56. Electrical Conduit-Undrgrnd.
8. Foundation �.. 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. 6ackwash lines, P�Trap, � Undrgmd.
10. Structural Floor System '^, 61. APPROVAL TO�DECK
11. Property Sewer Line & House Corinection 62. Backwash & Receptor-Final
12. Sewer Cap �� 63. Heater & Vent•Final '
73. Roof Drains 64. Plumbin� System � Final '
14. RoughPlumbing ��. 65. Electrical�Final
15. Rough Electrical-Conduit ' 66. Solar SVstem-Finat
,
76. Rough Electric Wiri�g .... 67. Fencing & Access Approval , •
17. Rough Wiring Sign - 66. APPROVED FOR PLASTERING .�
18. Rough Eiectricai�T Bar Ceiling 69. POOUSPA SYSTEi�iS FINAL
79. Rough Heating & Air Conditioning FIRE pEPT. REQUIREMENT
20. Rpugh Factory Fireplace ,. APPR�OVALS .- Permit #
21. Ducts, in $tructure•� • � 70. Underground Hydro `
22. Ducts, Ventilating . 71. Product Piping C1G.s OOiI
23. Gas Pipe-aough & Test 72. Underground Flush
24. Roo4 Framing 73. Undergrnd. Storaye Tank O Gas ❑ OiV
25. Roof Sheathing , Z-�[�,.�' �(� 74. Overhead HYdro
26. T�Bai"Ceiling (Strunural) & Monocoat 75. Dry Chemical -
27. Fiame and Flashing: 76. Dry Standpipe •-
28. Lathing & Siding ' � � 77. FIXED SYSTEM FINAL
29. lnsulation • , � 78. FIRE PREV. FINAL
30. Dryevall Nailing - NEAL7H DEPT. REQUIREMENT
31. Plaster Brown Coat . � . � 79. FINAL INSPECTION
32. Electrical Powei MeterF�nal - 80.�FOOD CERTIFICATE ISSUED
�33. Final Electric Notes:
34. Final Heating & Air Conditioning . -�
35. Final Gas Pipe�Test -
..36. Hood or Canopy " , �
- 37. Final Factory FirePlace �
-38. Finai Plumbing �
�39. Water $ervice�Final
- 40. Gas Service-Final - " • �
41. Solar pomesticFinal . - .
42. Backflow preventer � �
43. Backflow Irrigation � � �
44. Landscape IrriQation System ,' _ � � _ - '�
45. Sound Attenuation � , �
46. Handicap Regulations - '
47. PINAL STRUCTURE & BUILDING � Q'� � ' �
48. FINAL PLANNING '
49. Eiectrie Fielease to Edison � -
50. Gas Release to $outhern Californie Gas Co
51. CEATIFICATE OF OCCUPANCY
No. Date
oWNER DOYLE & SHIELDS DeveloImment Co.,Inc. DATE 6-3-63
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 91] C08TA MBSA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
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APPIICATION FOR PERMR
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For Office Use Only
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I XHRBOY ACKXOWLHOOB THAT I XAV[ RCAD THIB APPLIGT�ON
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SIGNATURE OF'
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VALUATION
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