HomeMy WebLinkAbout862 DARRELL ST - Building Permits'nw������ 862 DARRELL ST
! wrt�rxsew'eiv�u�avn: RALSTON, RANDALL H
�. �noness RALSTON, JOANN D P
II62 DARRELL ST
OSTA MESA,CA 92627549-7663
�vvi. �uuxo �ooness
1fICNIfECT OP FNtlNFEN:
coum�cTarswu�: MOORE , S. EVERTTS
camncroxs�uiwo 1.1630 WARNER AV
�M: CITY OF COSTA MESA — BOILDING PERMIT
PEAMIT NO: B 079438 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE; S'TR
uc.ra:
uHr:
(714)756-1266
�p� FOUNTAIN VALLEY CA � �, 694561
92708 �N,, 509
UCENSED COMRRCTOFS DECLANRTION: I hereby eR'vm undar penaAy d parjury Mel I am liceneed uMer povieione o/ Chepis 9
(cwnmemiq wilh Sec�im )Oa0 d Diwun 3 M Iha Bwi�n aM PMmaions CoEa eM m license w in lull bm vM eMee.
cmuc.No.:0,6266� uc.cuss: H uc.No./: 6�45�i1 EXP: 12/96
Dete: � ^ /� � ` Y Comreaa: _ /YJ � � � J U /��
OWNER BUILDEP DECUPATION: I he'eby elfirm unEar penely at perjury that I em eiamq tmn the Gomreqwa Limme lew la Iha
lolbvnnp reeaon (SeUion ]031.5 Busvreea eM Proleeaiana Cada: Any cLy a eounly wfiiM repuiiea a peemX to omelrutl, eller,'unprove,
demd'oh, or npei eny sirueWea, pein to ua iseuenea. eko raquiree iM epplimnt Iw weh pam! lo fib e mpmE Mtement tlet M a�he
n licenwd punuenl Io IM povisionn d �he Conveaora Lioenee lew �Cheqm 9(cammemAiq with Sedion )000) ot Div6bn 3 of �M
Buaircn enA PMe�aom Codal or ihei he a ehe ia naemp Iherehom end iM beaa la Ne alleped axemqion. My vioWion d Seaion
)W1.5 Cy am/ epplicent lu e permil subjeds Ihe epplieN �o e d�nl perely d �a1 more Ihen Me hurd�ed doAen �55001).
� I,esow�nardNepapenyormyempbyaeewvhwepesaslheieolemmperoation,wlldolhewak,eMtMet�udune�imeMaE
a oflarod loreeb (5ectbn ]Daa. Buvrea eM ProlesaionsCade: ThOCmireqon Limme lawtlom M ryply loen oxner d papMy
wlro Wide a inpmvm thareon, end who Eaes such vrork Mmmtl a herseX a �hrouph ho a Mr own employaan, potided ihm wch
improvemerW ua mt imerded a d1ereE lor sab. tl, Irowever, Ihe Wikirp ar hnqovemeN e eald wuhin ar yea d mmpleton, Ne
owrerbuiMlar will heve IM WNen af pv.•i�q M or she d'k iat build w impo.e la IM pn�oee d ede�.
� 1. av owier d iM poMM. em aztlusiveh' oonlred'n6 xilh ticenseE conireclas to mv4uU IM pqetl (Seaun )011. Bue'ura enE
vAr��. cod.: rne c�vma. u�o� �w eo� oa eow �o � ow�� a o�v wno w�a. «�o�o m�.o� �e wno
comrern M sucM1 prqada wilh e canirmor(s) leensed punuent to tM Convecron Licenae Lex�.
❑ I am e�emq urdar Sxiion: B. 8 P.C.. br �hia renwn:
i ao narenr ceniry uw i em e.are d e�a ��d.ni�a me rea�irema�n d cdywnie Heenn ene seie�y coee seeiare assos, zss�. ene
Y553a. eed tlw I w enY �ure Wiking mapaM vrill / wil ml (e�eb an) neeE to eanply wih eeid uma mdu ud tha rpwmname br
apeimnlaconelruclionamadifiraiionhwntheAi u�OTl.renepamemDinna.qeeideMielconqrud'nneppice�ionseramemqimmtheae
ao�:ro�a.
ode: nypiicdn:
WOPREN'S COMPpISA110N DECLRNATION: I Mreby elfi�m uMer peneliy d paijury me d �hs blloxi�p daduatona:
❑ I Mve eM xil meinian. wnifrat. a mn�ant to.sMinaure M warkra' wmPametbn. u Mo+�dad la W Seeim 310o a Ihe lebar
Coda, la tM pa�lamema d tM v.oM la wNch Ihn paimil b osued.
❑ i n.Ve a�e �;e �m.:�.enw.� �v�� ��w,�. a. bc��e W s.a�on a�oo a ub �wo. coe.. r« me o�«menm a m.
wak ta which �ho permil o imued. My wakne' wnpeneaibn insureMe ramer eM pdiq numEer me:
c�a:
� Pdiry Number:
I(This rtMiwr need nd be romplerod i �hs pertnt is b orre hundred ddleis (S�OpJ w Ma.)
�' I ceniy Ihm in ihe pe�iwme�e d the vroA br �Mch Ihie pe�mn e ieaued, I eMll iw1 emdW NY pa� in vry menner eo ea to
bxoma wbl� lo Ihe waNars campeiwtian kwn W Cdilwnie, eM eprae Ihet il I ehouM bacama eWjeA to iM v.vNa�'
ewnpanwian provisom d Saeion 3)00 d IM Lebor Code. I ehall /Mh/vm�h aqmpy wn/h Nwe piwuioeu.
� Deb: � ^ � O � � (I MWiraM: //( r�� /ZI a O: �.
Weminp: Fel/uro ro ucuro woM'x�' mmperuetlon covsreps h unlewlN, ane �Nll wbNct en xnployp ro MMiul paultlp uM
' clHl flro� ay ro ons I�u�Ored fhouaM JolYn (S1Pq0001, In Wfltlon b M� eosf ol eompru�tbM1 Cemspu u povlME M In
9xtlon 8106 0l tl's LMor COW, Inbn�l, and attomsyY /rx
CONSTflUCTION LRlDINO AQENCY: I Mroby e1F�m uMer perehy d perjury thm iMre n e mrMrutlbn Wk'up epmcy M tM
�no��� d me woM i« wn�m mo ro�e �a ma�ad (saaon aw�. cN. c).
LENUER'S NAME:
LENDEfl'S ADUPE53:
1 ceMity Ihel I �eve reed thie epplcmion enE stete ihei the ebwa iMormetion n mrrw. I epiee to wmply wilh ell dry uM mumy adinerime
eM aime lewa releting lo buildvg conaVuqion eM hereby aulhorrze repreaenialivee d ihis ary to enter upon Ihe ebwe-meMionetl p�opeiry
�«in9ped1O1pu`P°°" MIKE MOORE
� ` ///'��
om,: `t -��'l
Sipnelure d Ownm/ApenVApPicenUConlrector
(5151dfi.WP) Whne-Buildvq 8 Selery�, Oreeo-Fle: Cenery-Applum; Pink-Revenua; OOMenro�Anmv
PERM NO: H 079438
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION ; T/OFF & REROOF W/COMP SHINGLES SQ FT:
CLAIM VALUE: 2,500.00 CALC—VALUE: 2,500.00 GROUP OCC: R-3
2,500
►I
COMMENTS: REROOF 1836SF RESIDENCE W/COMP
*�+�*�x*����**��**�***��**�**�*�r****�***���**��r****��r**�***��***�***�****�«�x��+�*
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 42236222 ZNE: REF NO;
PLANNING NOTES:>
� ,�
i�
i6 if ik iF if iE 1F 1E iE iE IE iE iE iEdE iE 3E iE iE dE iE if IE IE IE 1E IE 1E iE IE iE iE if 1E iE iE fE iE if if IE if 1E iE iflf !E 1f iE iE 1E iE IE 9E 1E iE 1E'IEiE 1F ik if !E iF if iE iE if fE IE 3E �E iE iE iF 1E IE iE i(�
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
r/.
ZONING APPROVED BY DATE: 5:i,
BUILDING APPROV•ED BY : DATE: .
APPLICATION ISSUED BY: DATE: �'� ��'
iFiflfiflEiElEiElEififlfiFiElEifiElfiElE3EjE 1E1EiEikiflEiflllE�f iE1E
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 74.75 '� ,50
PLAN � SMIP/NON—RES
ISSUE FEE ' �
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ��; PAID DUE
TOTALS----> 75,25 0.00 0.00 75.25 � 75.25 .00
r
REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT_' GRADING PLAN—CHECK
74.75 .SOr
if iE iF iE iF iF if if ih iF 3(-iF 3F iF i@ if� i(� if� if iF iF iF iE 1E iE if IE if iF iF i@ If iE iE 3E iE iE 1E �E if IE iElf iE 1F IE iE ih iE iE iE if iE if 1E if 1E if iE * if if 1F iE * fE 1E 3E aE 3E iE iE 1E 3Elf iE aF iE iE
I N D I V I D U A L F E E B R E A K D O'W N
t,
TYPE QTY D E S C R I P T I O N UNIT,,COST TOTAL COST
SFR 2500 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 2,500.00
END OF FEES .�
� _ _Jr-�
i ^ / ��
01 00214678-00214699 TOT 75.2�
`�.�'DATE: �89/.10%95 TItlE: 15:49
�.a ... ,. �.. • . .. , .
--.
CONSTRUCTION AND PLANNING � � t _& SPA
�'�- - �Date I�spector � ' X - Date � Inspector .
APYROVAL5 Permit # . • APPROVALS PermiY# _
,.
1. Temporary Electrical Service or Po�e . _' " 52. Pool & Equipment Location , . �
2. Soil �Pipe•Uridrgmd. � - � - 53. Steei fleinforcement ' � . • �
3. Electrical COnduit UtiiitY-Undrgrr�d. ' � 54. Forms � '. �i
4. Electrical Conduit�Undrgrnd. �' . 55. Electrical Bonding � - � �
" 5. Steel Re�ntorcemenf , � � �56: Rough Plumbing & Pressure '�est - -
6.-Electrical UFER 6rnd. . 57; APPROVAL TO COVER�GUNITE � �
�- 7. Footings "'"" - 58. Electricai Conduit-Undrgrnd. �
- B.��Foundation 59. Gas Pipe, � Undrgrnd., Test
- 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap,-O Und�gmd. -
10. Structural Floor System . �61. APPROVAL TO�DECK .
11. Property SeWer Line & House Connection 62. Backwash & Receptor�Final i
12. Sewer Cap � � �_ � 63. Heater & Vent�Final '� � -
13. Roof Drains � 64, Plumbing SYStert - Final �
14. flough Plurnbing , ' 65. Electrica6Final ' , ,
,
15. Rough Electrica6Conduit . ' 66. Solar System�Final ' �
16. Rough Electric Wiring , � "67. Fencing�& Access ApProval ,
17. Rough Wiring Sign '_ � . 68. APPflOVED FOR PLASTERING� �
78. Rou9h Elect�irai-T Bar Ceiling 69. POOUSPA SYSTE69S FINAI "
79. Rough Heating & Air Conditioning - - � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireptace .- � ' = APPROVALS. Permit #
27.�Ducts, in Struaure ' " , .`. 70-Underground Hydro
22. Ducts, Ventilat(ng- . -_ !� 71, Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test '_ ' - - 72, Underground Fiush � �
24. Roof� Framing �� �� � - - 73. Undergrnd. Storage Tank O Gas O�.OiI
25. Roof Sheathing ' �_ � ly��: �_ 7q, Overhead Hydio
.
26. T�Bar Ceiling (Structuraq & Monocoat � � = 75. �Dry Chemical - _ '
27. �Frame and Flashing • 76. Dry Standpipe_ : ' '
28. � Lathing & 5iding �- •� ._ � � • J7. FIXED�SYSTEiN�FiNAL r'
29. Insulation _ - ' � � '' T ' � 78. FIRE PREV. FINAL '� - "
30. Drywall Nailing ', � � �� � � 4 - . HEALT.H DEFT,-REQUIREMENT
31. Piasier Brown Coat _ r � ," � 79. FINAL�NSPECTION `` - ��
32.-Electncal Puwer Meter-Pinal � , - 80. FOOD CERTIFICATE ISSUED
33. Finai Eiectr�c � ' �� ' * '� Notes: - - '_ ' .
34. finalHeatir�g��&Air�Conditioning r ; � _ � _ - _
35. Final Gas Pipe-Test � ^' " - - - _
i r' ' m ` -
Y. `.
36.�Hood or Canopy .,, -, � . ., - �, �, -�� ' . _.
� 37. FinatFacto�Y Fireplace - ' - . � � i �� "' - �
38. Fina1�Pl0mbing , , � �� � i � ' S - r �
39. Water Service�Final� ' �' ,� ' ��t -
- " ti: � -
40. Gas Service-Final � ._ , Y ;, � � � ���� _ � . -:
� 41. Solar pomestic-Final ' ' • " ' : -^ - �
' 42. Backflow Preventer ' � �' - '.
`
' - - �
43. Backflow Irrigation ' .. + �j �/_p� - / ,� : �/ y
. -1 � E G �.��� � �toT �'' L�Y c� �
44. Landscape Icrigatio� System. ., � -' � - , - /�,,,/�
- . . _ .. :._ (G--"�`
45.�Sound Attenuation - - ' - " - �
" - c-�r.•
-`46. Handicap Regulations � _ , ' � ' �� � - _ " _ � �� _
42. _F�NAI STRUCTURE & BUILDWG ��y'� �Cfj� •� - _ ,_ •�� �'
48. FINALPLANNiNG -- `� _. �_., ; :-
A9. Electrie Release to Edison _
50. Gas Release to Southern Califomia Gas Co . _. ..- � `
51. CERTIFICATE OP OCCUPANCY = .
No. Date
_n
/
--�omessaeuaar�c: $62 DARRELL ST
a�asw�uEiFa�*+: RALSTON, RANDALL H
�ooness: RALSTON JOANN D P
862 DAR{2ELL ST
OSTA MESA,CA 92627548-6535
�vx. uuuxo �ooness:
�ACNIfECT OII FIltlNHN:
AM.011 ENG'S /i00PES5:
`� Ica+m�aarswuE: AIRFLO INDUSTRIES
cam�croxs�uiwc 130 W VICTORIA ST
UMT:
ua wo.:
UNf:
(800)359-6374
AODNE53 GARDENA CA ucw.: 232111
90248 uHr.
LICEHSED CONTFACTONS DECUNATION: I Mreby � uMm penely d{mjury that I em lirormed undx proviaione d Cheptar 9
(commenarp v.nh SeMion l9oo) of DiWsion 3 d Na Buaineeo uq Pmiesvons C de, erd my 4oerue u in hll laca enE eiletl.
�cmuc.No.:�'�j'�`1 uc.cuss: $ uc.No: 211 EXP:
Dme: �^/ 7�� Comreaor:
OWNEfl BIIILOEH OECUINATION: I hereby elfiim undar penely ol parlury �hel I em a�emq Imm IM COMre lioanae Lew la Ihe
Idbwiq reeam (�ion 1031.5 &nims eM Rduvona COEe: A�ry cry a aounry xfiich �eyuiree e pmn9 �o carobuct. e4x. impro.e.
demd'nh, w repei vry eVuciura, pbr to Ia aeuence, ebo reQuim iM appli�ant fa wch permN to Rb a eipned nmamenl Rw ha a ahe
ic IicenaeE W���t lo IM pwieona d IM CaMretlon Lirome law IClaqer 9(mmmanonp Milh Satlion )000) d piviion J d IM
Buzm�a aM Prolea+ons Cade� or Ihel ha a ahe ia ezemq �hxelrwn end ihe beaie la �he elleped uempion. My vblelion d Sedion
]W 1.5 M enr eDWimnt t« e iamn wM� IM eOWiranl lo e rnil P�M d ria man �hen liva nuMred dd4n �SSO011.
� I,mawr�erMihepropa�ywmyamployeeswMhweyesestheieolemmpaneetion,xilldothexwk.endNeaWCWnimlinteMed
«MueEfur We (',ection )ae. eudmn eM Prdmvme Cotle: The Contreaan Lirome taw doaa mi ePONtoen ownerd popeny
wlo W1As a inprwee ihareon, end who Eoea auch xroM Mmeall or heneY ar �hraph ho a her own emplv/eee, poWdad Ihet auch
impmvemml! arB � iNeMed a dlueE tw 9eb. tl, lrowever. �M WtMiiq u inpwamaM rm fod xilhin qq yw ol compls�on. Ma
awrer-buitlar will heva Ihe buNen W prwing he or ehe did nat build or improve Iw Ihe purpoee of aele�.
❑ I. n ox.w d il» pwe�ry. em utlusively coniraaip xiih IimneeE convanas ro canm�a Me prqetl (Sequn )oa. Busi�a eM
Pmfeeaiaru Cade: The COMretlon Licenea Lew doee ml epply to en owner d prapeny wha Witla or impwr tMraon eed v,fio
conlrecb lar wrJi propde wXh e comrma�a) liceroed pursuem to �he Conlradm Liceme lewl.
❑ I em ewemq under Seciion: B. b P.C., br �he reewn:
Dete: Owner:
I do hereby unity Ihel I em ewere d eM undenta�d Hre rpuiramante ol CelLomu HeeM1� eM Sefery Code Swbro?5505, 255�3, enJ
]5590, eM tlbt I a eny Mun buiki�p oaupenl xill / wil mt (acb one) need io comply wih seid qata mdm uM �Ir reyuiremeMs for
epemi�taoon�iuu1ionormodifiWionkamtMR'v u ie�0i�rv�ty enepementDie�riq.ResiEeMialconsVutlonappiretbroerememplmmlhue
FfON910119.
oero: �odK.m:
WORKEN'S COMVFNSATION DECLM�TION: I Mreby elfirm uMx prutly d pej�vy one W ihe bYow'up Eetlent'nm:
❑ I new erM xio mamen. eenE' �a M eansem to seM.inaure Iw xvekere' eomV��ion, ea povNeE 1« M Saaian 3]00 d iM laEar
:�iOjB. �IX ��18 Ge1�M110M! C� UIB Mq�[ �IX W�1IC�1 �h0 jI01TI1 M Itl11Bd.
�] i nem.nd �;e �m.:,.wn,a.� comw�w�, ��,�a. e. �.c��.a M seabn wao a m. iem. coae. w me o�«menw a me
I ������p�p��Mr��R�LIANCE•������m���� EXPIRES
c��:
aa�, N�mn�,: 0 7/ 0 7/ 9 7
/mr:.,eeion ireea mr w canvbroe � u. v�e s ro. o�e n��d,ad ddre�. fs,oul o. reb.�
� I cM'ty Ihel in the pMwme�e M �M work M wh'rh thu pnmu 6' , I Mell M empby eiry paean n em� menrw so m �o
becoma wbjed �o iM xwFne' mmpeneation kxs d Gelilomi pres Hw M I ehouk becana wbjee m iM wakere'
wmpaJnmtion p�m�viyaune ot Seaian 3]00 0/ lhe leEa COAe. athwnh wmpN xeh Iho ( ''
Deb: / ^I' "/�P AOd�'anu ,
Weminp: FeNun M�scuro worter�' mmpxustlon coverep� h unkwN( mdLull wbmct an �mp/qw ro crlMiul pw�aMa uW
dvll flnu ap ro an huMrH UrouuM Fo/knlJIOQPOOA ��/�n ro(M cwt ol romvauatbn, tlemsps� �s povWW br In
Sxtlon 91P6 0/ tlro LMor COM, lnfsn�f, ene attomsy'a /esa
CONSTi1UCT10N LENDING R6ENCY: I henEy elfirm uMer penelry ol perlury thei �here ie a cwwrutlbn N�Mi�p eyency br Ihe
�no�� d m,.� i« ..m� ina �� o m�e (sea� aos�. cw. c).
lENOER'S NNAE:
LENOEP'S RDUNE53:
I cMity Ilal I heva reed thie appli�ation eM 5ete Ihe� Ne abova iMame�ian ia conep. I agree �o camply wn� ell rily enE couMy ad'meMee
uM eiate kv.sraldingtobuilEinp mnevudion erd herebyeinhor¢e�eprexntativea olihisdtyromteruponlhe above�membned peoperly
Iw ie�peaion purpwes.
o�<: % 1—`l;�
(5151de.WP) Whne-Buildip d Sefmy; GreemFle; Cenary-AppFcanl; Pink-Revenue:0oldanrod-Avwsaor
CITY OF COSTA MESA — BUILDING PERMIT ^I
PERM NO: E 07R448 \
PERMIT NO: E 078448 PLAN CHECK NO: N GOVT: N SUPP: N�
CONSTRUCTION TYPE: V—N PERMIT TYPE; ELE PURPOSE: ADD
JOB DESCRIPTION : 190 SQ FT PATIO ENCLOSURE SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: ICBO #2138P &3421P / REF B-78447
iE 1E 1E iF 1E IElE iE 1ElE 1f if �f iElE 1f 1E 1E 1E iElE iF 1E iE if iE iF 1F iE iE iE 1E iE iE 1E 1E iE 1E �E if ik if IElE 1E iE �E 3E iF iE iE if 1E iE iE fF if 1E if iF jE fE jf fE iE 1E iE 1E iElF ik 9E fE iElE �1! jE aE fE
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 HUILDING — ------
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: 42236222 ZNE: REF ND:
PLANNING NOTES>
i
'lE k iE 1E iE k!E!F 1E iF iE 1E'k �E iElf if !F!f if !E iFlF ik 1f i(-1E 1E iF!! 1k 1E iE it iE iE iE iE iE 1E'k IE 1E �f if iE iE fF if !f 1F 1k iE if 1f 1! ik iE �E 1f iE fE'IE iE iE 1E �F 1f iE 1F 1E iE i(� 3E iE iF iElE iE
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 5
ZONING APPROVED BY .
BUILDING APPROVED HY : '
APPLICATION ISSUED BY; '
iE 1E 1E 1E iE 1E fE 1f 1ElE if 1E dE iE 1k iE ff fF ik iE iE if
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 10,00y
509
DATE:
DATE:
5 DATE : / " Z� 91O
�FiFiFiElE iE if iE iF iE iE if iE�iFS�iE iE
STRUCTURAL SEGMENT;N
FIRE SMIP/RES GRADING
SMIP/NON—RES
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 10.00 22,00 0.00 32.00 32,00 .00
REVENUE DIVIS'ION TOTALS--> COLLECTED; 32.00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
32.00
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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
ELE 2 FIXTURES LIGHTING 1 ST 20 EA. 1.00 2,00
ELE 6 RECEPT/OCTTLET 1 ST 20 EA, 1.00 6.00
ELE 2 RECEPT/SWITCH 1 ST 20 EA. 1.00 2,00
END OF FEES
;]1 3���ra� -_�i.?•,�,?i'- � t 7 ,
[�wTEr . --i;1[: ..;t�i
CONSTRUCTION ANDPLANNING .
, APPROVALS Permit # � �-_ ' Date
1. Temporory Electrical Service or Pole
2. Soil Pipe-Undrqrnd. ,-' � _
3. Electrical Conduit Utiliry�UnilPgrnd.- �
, 4. Electrical COndvit-Undrgrnd. � •
5. Steet Reinforcement-
6. Electrical UFER Grnd.
7. Footings -
-'8r Foundation �� .
.9. Water Pipe�Undrgmd.�. • �
10. SEruaural Floor System � '
t i. Properry Sewer Line & House Connection
12. Sewer Cap • '
�
13. Roof Drains
14. flough Plumbing �
15. Rough Electrical�Conduir � . - -
16. Rough Eleciric Wiring �
17. Rough Wiri�9 Sign . ' .
78. Rough Electriral-T Bar Ceiling �
79. Rough Heating & Air Conditioning
20. Rou9h Factory Fireplace , �
21. Ducts, in.5truccura , , � _ ,
22. Ducts, Ventilating: � "� �
23. Gas�Pipe-Rough & 7est ' '
24. Roof Framing �- � � .- , -.
25. Roof Sheathing • � " '
26. T�Bar Ceiling (Siruc[ural) & Monocoat �
27. Frameand Flashing� . '
28. Lathing & 5iding - . ' �
29. Insulation - � " �' `
.. �
30. Drywall Nailin9 -- . " .
37. Plaster Brown.Coat'
32. Electrical Pov�ier Meter-Final -
33. final Eiecir�c ,' � _ -(�' 7iU �
G
34. Finai Heatii�9-& Air�,Conditioning "
35. �Final�Gas PiPe-Test -- "' �
36. Hood or Canopy ` ; �r _ �
37. Final Pactory Fireplace = ' '
38. Final.Plumbing � , �� � �- '
39. Water Servioe-Final •
40. Gas Service-Final ' _ _
41. Solar pomestio-Final . � -
42. Backflow Preven[er. � -
43. Backflow irrigation
44. Landscape Ir[igation System . � ���
�
- `' ' F _&SPA `-
Inspector � ` ' ' � � � � � Date I Inspector
_, , APPROVALS j. Permi(#
" � 52:. Pooi & Equipment Location -
53. Steel Reinforcement "
�- 54. forms �
55. Electrical6onding .
. 56. Rough Plumbing & Pressure Test
57, APPROVALTOCOVER�GUNiTE. .
, 58. Electricai ConduiT=Undrgmd. •
� 59. Gas Pipe, O Uridrgrnd., Tesi
60. Backwash Lines, P-Trap, O Undrgrnd. .
61. APPROVAL TO DECK" �
62. Backwash & Receptor�Final :
� 63. Heater & Vent-Final �
B4. Plumbing System - Fina{ .. � �
65. ElectricabFinal
66. Solar System�Final "
67. Fencing & Access Approval �
68. APPROVED FOR�.PLASTERING
69. POOL/SPASYSTEMSFINA�
FIRE DEPT. REQUIREMENT�
r
. APPROV�ALS Permit,� -
_ � ' 70.`Underground Nydro ' �
��'' �� 71. ProductPipingLlG:rs ❑Oil
- 4 „ 72. Underground FILsh - �
� � ' 73. Undergrnd. Storege Tank L� Gas ❑ Oil
- � - 74. Overhead Hydro -
� -1� 75. Dry Chemicat � -'
76. Dry Standpipe _ -
� ^ 77�. FIXED-SYSTEM:FINAL � - -
f 78. FIRE PfiEV. FINAL � "
- , . HEALtH DEPT. REQUIREMENT
' 79'. FINAL INSPECTION � �
j- '� 80. FOOD CERTIPICATE lSSUED
� ��`lJC� Notes: - _ ' _ ' � _
� �' ' ' - -
� � _ • -. _ ' ' , _
,� -_
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� .
_ ,.
i
45. Sound Attanuauon. - ._
46. Handicap'Regulations .- � "
47. FINAL STRUCTURE & BUILDING '
a
48. FINAL PLANNING
49. �Electrie Release ro Edison � ��
50. Gas Release to Soufhem Califomia Gas Co
51. CERTIFICATEOF;OCCUPANCY
No. Date
�
.
�
L'
�oonasaeaim+c: $62 DARRELL ST
oxr+EaswwEiFa�m+: RALSTON, RANDALL H
��� RALSTON JOANN D P
862 DAR{2ELL ST
:OSTA MESA,CA 92627548-6535
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AXCNffELT ON FNtlNEER:
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c�m�cTarsw� AIRFLO INDUSTRIES ( 800 ) 359-6374
caxmncronsxuuxc 130 W VICTORIA 5T
�ooxEss: GARDENA CA uc.ra.: 232111
90248 uxt:
110ENSEO COMflACTORS DECLAPATION: I hereby eRvm uMar pane4y d pe1jury ihet I em licenaed uMer prwieiore d Chaqa 9
(comme�n0 �h Seclwn ] oi Dirivun 3 ot the Buai�ae ard Pmfeavoru Code, ard my lioenx e N lull lace eM Metl.
cmuc.No.:�p�3 uc.cuss: b uc.N.. z zlll EXP:
om.: �—� �J., c�vma:
OWNEH BUILDEN DECLAPATION: I IenEy elfirm uMer penely N perjury thel I em uemq Imm ihe Comrm lew ta tM
Idb'xn9 ieason (Seaion )0�1.5 &ni�ma end PMeavms Coda: AnY ciY a ooumy Mfiidi rewine e pemiil lo construct. ellx.'unOrm*.
damd'nh, or repev e�ry etiudure, pnor to na aeuerice, ebo requiree ihe epplirenl Im wch perm0lo file e eq�wd eWemsm ihal he w aM
o liceneed pu�suent lo the poviaions W Ma Conveaora Liunve lew �Choper 9(mmmanrirp wil� Swun )Oa0) d Di+eion J d tM
Busnea erd Prdaaiom Coda� a tlw ha a Nro o axemp tharalmm end �ha bevia la iM elbpeE aaemqion. My videlbn d Saaun
)031.5 by eny applirani lar e permit aubjeds �he epplicen� �o e avil panelly of na mae then livs hurd�ed ddlen �fSW�).
� I.esovmardthepropenydmyampiqeeewfhwap»mlheieobmmpenution.willdoihsxwk.uMNeat�uctunwrwlin�eiMed
or Mered br eele (Seclion 101a, Buvnm end ProtasaoneCode: The ConireWore licensa lewtloee iwt eppylo en ownard propaity
W�10 �111Q90I �IIW��S �hBIB011. Yld Wiq �OBS 9UC�1 WJI�( �W119lM M �1BIfB� IX I�RqIQh �1B Of �IBf OMT tl11DbR88. P�� �� BYC�1
impovememe era rot imarded or allered la sab. II. Mwever, IM buikirq a inpwemmt ie edd wnhn pw year ol compWion, IM
wnx-0uiNe� xill �eve tM1a burEen d povirp M or ahe did nd build w improve far IM WN�e d eele).
❑ �. aa ow.b, a i�» wowro. � a.�M oo�ireano wiln 4oevea ca,Yenv. �o canmw u�e wM� (swun rou. ewims. w
Pmleeeiom Cotle: The ConireGon Licenae Lew tlo» ml epply b en owmr d qqnnY ��iN� n imqovp thxeon vq wlw
eonvazls iw wdi prol�a v.nh a eomemor(s) Icensad punuem to ihe Conlradan Lieenaa lewl.
� I em exemp uMm Sa,Mion: B. 8 P.C., br Ihie �aevon:
DNe: Ow�nr:
I do hereby cerlity Ihet I em ewere af erd uMenlend the rx�uiremema d Celiomu Hml�h erd Setety CoEe Seubm 25505, 25533, end
255J0, md thtl I a airy lulure WiMup ocpy�en� will / wi1 ml (dmb me) naed lo wmply Wh aeid tle�e mdee md IM rpu'uemenb fa
apermAlwmmVuctionamodilrationhaniMAi eu�ly enepemantDiatnd.ReviEeMielconst�udianeppkmlimeerememplromtMes
panawem.
Da1e: AVWiceM:
WOPKEN'S COMVENSATION OECLAPITION: I MraEy elfirm uMar peneAy d pmjury aie M IM Idbwi'p Eetle�mbne:
� IhevevMwllmeimm�ecMMceiadoonxnitoesM�inwreforxarken'cpnpaneeton,mpwideEfabybeaion9]OUdtMlebar
Cade, lar �M pMmnenca d Ne xwk lar wh'x:� ihe pnmil u iauad.
r] � n.v. ene mo mdmein.ronm�s ownpe�.e�ia, m:uranc.. m ma���d M seaian wao a me �mor coee. �« m. w�«meMe a m.
7C woA la which Uie pamil b aaued. MY ��' �Pe�� imurar�ce mmr vd pd'iry number ere:
cdrer: RELIANCE EXPIRES
Pdicy Number: (] Q%� Q%� 9%
(TM1is aedion med nw be mmWered / tM G�X is M orre huMied ddbm (f�001 a bv.) .
� I ranh � in �ha pariwmenra d IM wark br whch t�u permA iv iaueE. I ehell ml emplo� ary panm m em� marvier eo m to
become subjed lo IM woMers' mnpenemion lexs d Celil��99II�p�� eM epree Ihn il 1 tlwuM become wbjae to tM wken'
mmpenaetian Op�isbna d Sedan 3]00 o/�he �COEe.I�M1qlllorp�wnh ,mnm�Upea p�oNdone.
om.: �—c�,e n�m: i �Y� �� i
Weminp: Fellun ro secun rortsri ronpelustlon eoreraps Is unlewN( aM �IWI iu6Ject �n xlploysr ro crlMml pwltlpW
clHl llroa up b ms hinOrW flwumnJ tlo/Nr� (5100,000), In adE/tlon b fhe cwl o/ eompxuefbn, tlerrapu e� prov/tleC br In
SscHon J106 0l U1s Labo� COM, /ntws�t, entl eMomsyl leu.
CONSTflUCT10N LENDINQ A6ENCY: I hereby eifirm unAer penely d parjury thm tMia is e oonatiudion bMi�q eparicy br tM
oa�o,m� d m. � m, .mKn ine �.�� n m�a (saeo�, aas�, ca. c�.
LENDEN'S N4ME:
LENDEq'S RUURE55:
I cenM �� I hava reeE Ihie epplicmian ud mete ihet ihe ebova inlamelion ia corted. I prae lo compy xtllh ell dly eM oouMy ordinenue
end e�ele lew5 rele�inp la builEvp eonsVutlbn eM hereby eulhoraa ropeaeeMetivm d Ihe dly lo mter upon tM abwe�meMoneA papMy
loriropeaion w�0�%. .
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iB�ure d OxnaHAgei Appkcam/ r da
(S151J8.WP) Whne-Buikip85elety;Greari-Fle;Cenary-AppFum;Pink-Rewnue:OokemoE-Neeaw
\
CITY OF COSTA MEs"A — BUILDING PERMIT
PERMIT NO: B 078447 PLAN CHECK NO: 02693-96 L
PERM NO: B 078447
GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR pURPOSE: ADD
JOH DESCRIPTION : 190 SQ FT PATIO ENCLOSURE SQ FT: 190
CLAIM VALUE; 3,000,00 CALC—VALUE; 7,400.50 GROUP OCC: R-3 /
COMMENT5: ICBO #2138P &3421P
***�t�t�r���e***�r***�r*�r*****�t�r**�r*�t� ��r*�t**�t�tit#* �t �r�t*��r*�ru �� *�eu � * �e� **x+�+�#�r�ex �*��r�****
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 HUILDING ---------
FRNT: FT IN REAR: 20 FT IN FRNT: FT IN REAR: FT IN
LEFT: 10 FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42236222 2NE: R1 REF NO:
PLANNING NOTES> CONSTRUCT ENCLOSED 190 SF PATIO IN THE REAR YARD. "-'
% � �.
�EfE1EiE1EfEiEiklkiE1f1f1fiEiE�ElE�EiEiEfElklEfEiElFiEiE1EfElfiEiE�E�E1E1f1E1FiE1EiF1FiFiElkiEiffElEfE1E1EiliElEiE7FlElElFiElEiEiElFifiEiE.1F�F�EiElE1E1EiE1FiE
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
ZONING APPROVED BY �.4�,• PATE: �O''Z� —�G
BUILDING APPROVED BY ; Wsp DATE; �I�' Z— �
APPLICATION ISSUED BY; � DATE: '� Z— �i
iE1EiE1EiEiEiE1E1E'lE'1E1kfElkiEiE�E1EiflElElEiF7F�iF3F3F3FiF�(F3F3F7fiFiF3f'�FiFiF3F3F�Tf��f 7f3F1fiElEiEiEfE1E1EiE'1E �IEif
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 137,25
PLAN 89.21
ISSUE FEE
FIRE%'"" SMIP/RES GRADING
' 74
%' SMZP/NON—RES
i� �
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL %[ PAID DUE
TOTALS----> 137.99 0.00 89.21 227.20 227.20 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 227.20 OVER/SAORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT„ GRADING PLAN—CHECK
137.25, .74' 89,21
in
if 1ElE 1E 1E 1E 1flE ff�lFlE iE �E 1F iE if iE 1E fE fE �E �E iE 1E 1E iE iE iE iE �E 1E'k iE iF 1E 1E 1E iF iElE if iE 1f !E if 1E 1f 1E 1k 1E 1E iE if 1h iE iF iE iE i� 1f fE �E fE 1E 1E 1E iE iE iE iE iE iE iE iE iE iF k �E �E
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 190 RES—PATIO COVER—ENCLOSED PATIO 38°;95 7,400.50
END OF FEES
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. JOL & SPA
CONSTRUCTION AND PLANNING . _ _ �� . , . r � '
�Date Inspecfor ' Date - �Inspector
� APPROVALS Permit # , _ , APPROVALS Permit # . 1
i. Temporary Electriral Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe-Und�grnd. " r ' - � �,53. Steel Reinforcement ' �
• 3. Efectrical Conduit Utility-UndTgmd. . - � 54. Forms, '�� 7'
4: Electrical Conduit�Undrgrnd. � 55. Electrical Bondinq ;�
• 5. Sreel Reinforcement� - 56. Rough Plumbing & P�essure Test . ��r
�
6. �Electrical UFER�Gmd. ' 57. APPROVAL TO COVER-GUNITE �-�
' '�. Footings - � � 58. Electrical Conduit�U�drgmd. '
, 8. 'Foundation -. - 59. Gas Pipe, � Undr9rnd., Test `�
•�-�9. Water Pipe-Undrgrnd. � - � 60. Backwash �ines, P�Trap, �C1�ndrgmd. _
10. St�uctural Floor Svstem - ��-� 61. APPROVAL TO D�ECK '...
it. Properry Sewer �ine & House Connection - 62. Backwash & Receptor�Final�=� �
12. Sewer Cap � 63. Heater & Vent-Final •
13. Roof Drains �-'"� � 64. Plumbing System - Final
74. Rough Plumbing" �� 65. Electrical�Finai � � �
15. Rouqh Electrir.af•Conduit . . � 66. Soiar System-Final
16. Rough Elettric W�ring ;`"�� 67. Fencing & Access ApProval
17. Rou9h Wiring Sign ` ' � �681 APPROVEO FOR.PLASTERING
78. Rough Electrica6T Bar Ceiling ' ' � 69. POOUSPA SYSTEP;IS FINAL
79. Rough Heating & Air Contlitioning • FIRE DEPT. REQUIREMENT -
20. Rough Factory Fireplace - . �� - -, APPRpVALS ^ Per.mit# � -
21. Ducts, in-Structure�' ., , � ., � 70. `Und"erg"round Hydro
22. Outts, Ventilating= _ . _ ` 77. Product Fiping O�Gas OOiI
23. Gas Pipe`Rough &�Test - -. ' . �. � 72, Underground Flush , -. .
24. Roof Framing - -� - � 73: Undergrnd. Storage Tank O Gas O Oil
25. Roof'Sheathing ' � � . , 74. �Overhead Hydro
26. �T�Bar� Ce�ling �Struc{uraq & Monocoat � . 75. Dry Ghemical . � � " -'
27. Frame and Flashing �� ` - _ ' _ " 76. Dry Staniipipe' �' ' �
28. Lathing & Sid�ng �. � � - 77: fIXED SYSTEIA FINAL .
29. Insulation - � �' ' - t 78. FIRE P(iEV. FINAL . -
� 30. Drywall Nailing � � HEALTH DEPT. RE�UiREMEN7
31. Plasier Brown Coat ' � �� ; _ 79: PINAL INSPECTION ` � ' �
� 32. Electrical PoNier Meter-Final ' � .- SOr FOOD CERTIPICATE ISSUED
33. Finaz'Electric_ ' � � ' - No`tes: �. �_ ; _ . ._
34. Final-Heating.& Air Conditioning_� , � y � ,` � ; _
35. �Final GarPipe�Test • - � . � � " � :
36. Hood or�CanoPV � � , , . R� � . '. � ' -
37. �Finai Factory Fireplace _ ' � � � - ' ;
38. FinaLPlumbing �- � , � - � _ _ -
: 39. VJater Service�Final . • , . � "
' �, 40. Gas Service-Pinal ; , " � . ' � �
�_ 41. Soiar �omestioPina7 �. _ � ,
42. Backflow Preventer t � _ . � r . . , ; :
43. Batkflow Irriqation • _. ` !a_A_/J'�- �,�� ��/ .1�/� `
Q � 7 ��� �
44. Landscape Irrigation System _ - - - - � _ � . . ��_
45.�Sound AttenUation .- . r ._ '. . - - •�.� , - -
,46.'Handiwp Regulatioris - . - ' ' : � ' :' �.
47. FINAL STRUCTURE & BUILDING g �y-� � : � _. � .
48. FINAL PLANNING � - , � , ' . .
�49. Electric Release to Edison . . - � - .
50. Gas Release to Southern California Gas Co �
51. CER7IPICA7E OF OCCUPANCY " . -- _ ,
No Date
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Thr reports were sent to our �artment by mistake, R
A& E L A B O R A T O R.1 E S
C O N 5 U L T A N T 5
Date: 5/28/59
Lab No.: 1233
Job No.: 59-A36
Job Identification: Anthony Pools, Inc.
862 Darrel St.
Costa Mesa, Caiif.
Contractor: AnChony Poolsj Inc.
Date of Record: 5���19
COMPRESSIOP; TEST RE`�i ORT - GUIVITE
Cylinder No.:
Mix Design No.:
Slump:
Nominal 5ize:
Area;
Date Made:
Date Tested:
Age;
Compressive. Strength
Total Load:
P.S.I.:
Design P.S.I.:
Distribution
McFadden
Anthony Pools
Building Department
Costa Mesa
io31
6 x 12
28. 27
5/19/59
5/2'7/59
7 days
82,500
2,9i8
1,200
Confoxms to Specifications
Respectively submitted,
A & E LABORATORIES
������'���
�
' R�c�ivEO �`
„
.d(J1V .r �;;' :
Cily of Casta Mest
Buil�it;g O�sp:.
970 ANAHEIM & PUENTE RD.—CITY OF INDUSTRY—CALIF.
E D G E W O O D 3- 1 2 9 3
OWNER SCHIIIT2, DONALD DATE 5-11-59
JOB ADDRESS 862 Darell BUILDING PERMIT NO. 9250
GENERAL CONTRACTOR Anthony Pools VALUE $ 2i�,�p_pp _
AP. No.11S—S%2-22 LOT TRACT . FIRE ZONE DESCRIPTION OF WORK SWlirl POOl
INSPECTIONS
SUBCONTRACTOR
0
9�Kn
L, '
'�-: - y�,� ` rEE�RECE(VED
/ �IAY 1 1 �g89
CC7�TA MESA BUILDING-SAFETY DEPARTMENT FINANCE OEPT.
P.O. BOX 3f] COSTA MESA. CALIFORNIA CITY OF COSTA MESA
FOR APPUCANT TO F/LC /N COMPLfTELY APPLICATION FOR PERMIT
'�'YPE OR P INT BUILDING '
euaoinc
ADORE55 �V
COSTA MESA. CALIFORNIA FOR OFFICE USE ONL!
I RECEIPT NO. I i1gFtM
OWNER V
MAIL �/ RECEryED BY OATE pECENED AT I�S:
ADORESS (O � � , J —�� J2 ./'l2i x'� � f
� � � y_ „ / TEL. BUILDING �
�
STATE
LEGAL ILOT � I I�Y�%3 ZONE
oescA ei oN NO � BLOCK TkACf�
A.P. NO. �-� S./ if�� �-. /" BVPf
SIZE //� q NO.OF BLOGS./ ypq�
OF LOT Y� O� (/ O NOW ON LOT REQI
USE OF tceH'
EXISTING BLOG. FROI
SETBAC% LINE FROM J //�� �
CENTER OF STREET ['J � REAR VARD Y/ R. 51
/
SIDE YARD LEFT � IRIGHT L.Sf.
DESCRIPTION OF WORK
MESA, CALIFORN
group
ZONING /
NO.OF USE OF NEW
pLANS � BUILDIN6
LINE ST.)
R�
REPAIR I IIMOVING I IIOEMOLISH I
BUILDING lC✓h�00M5 STORIES
SIZE /•.� l�\7
EXTERIOR WALL IROOF .
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
I HEREBY AGKNOWLEUGE THAT I HpVE RERO TMIS APPLICATION qHE AMOUNT SHOWN UNpEP VALUATION IS FON THE
ANU STATE TNAT THE qgOVE IS COFRECT AND qGREE TO COM-
PLY WITH NLL C pINAN<ES pND STATE LR 5 REGULATING PURPOSE OF ESTABLISMING A PERMIT FEE ONLY.
eu��oirvc co euci� r�. VALUATION
SIGNATURE F � J �. PERMIT FEE $ lO�
PERMITTEE .
. ^ �� $ � PLAN CHECK S 5 �
AUTHORIZED AGENT � TOTAL FEE $ �
,p. r
OWNER
ADDRESS
BRISTOL ESTATFS
a62 �arrell Street
DATE
BUILDING PERMIT
GENERALCONTRACTOR S. �r. H�salcer VALUE $ 8,t�56.��
LOT 7G BLOCK TRACT 2S%3 Syil?ZE iZ2S. W�2.t�. 22T'
GROUP �- � aT TYPE V ZONE H�y FIRE DISTRICT 365t�
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
Trench
ion Forms and Grede to
Rough Framing
Plumbing, Roughlo
Roug
Final
st.
Lathing, In �
Plastering
Plumbing, Final, Fixtures
Plumbing, Final Gas Test
Wiring, Final
Occupancy
FOHM 310 3M lO�v3
N�
osta Mesa Bailding Department APPLICATION FOR Y'ERMIT
-; P.O.Box3�� ,���� BUILDING �
= COSTA MESA, CALIFORNIA
r �+ OR APPLICANT TO FILL IN FOR OF'FICE USE ONLY '
Receipt No. Permit No.
Building �6, � / � �
Addreu � LL ,� v
Costa. Mesa, Ci'd��OTI11& Ret?}�ed Date Rec'd. Date I�ed
Nearest � ' � t%/ � ���� � �
CrossSt. `�,� � j�,/ /,� Building '
Address
Owner .✓� d �.. S .C�%
Ma�i / Costa Mesa, California
Address lj ��v�Q, %./a/�t�'S ,(�� Nearest �
�-� . Tel. �}-�4� Cross St.
City /,r-M��.,�" �j //� No. T/(, J��S� Zone /i �/ I No. of I Type �/ Group �,
eng�neer
Address
Contractor �(/-.
Address S
Legal I Lot
Description No.
Size of Lot
Use of
.4�City Lfc.iJ
.f-'�:No. "/
I
Block ` I Trat
No.of No.oT
Families Rooms
�.r / RearYard,�s�s
J-� Side Vard iry'p.,� '
IPTION OF WORH
Alteration I I Aaaition I
rcepair I i moving � i oemaisr
Building No.of i
Size �`��/ � Rooms .�. Stories
CORRECTIONS
Covering _,! %,.G.G�j � Covering /COG/� L�PPROV.�ris
Use of New � -
Building ��- ,y�� ,�J�v�-LL.i• Foundation Location Inspector
Forms, Materials,
gr/ ,�-� j Under-PinNng
�14� ,�r�C � Frame: Fire Stops,
Bracing, Bolts
I hemby acknowledge that I have read this Applicatlon
and state tha2 the above is correM and agree to comply Lath. Int �
with all CIty Ordlnances and State Laws regulating
building construction. Lath. Ext.
Signature ot /��� � p -,�L
Permittee ��l'ls.o/.s�C> �('/.C7 Plaster.lnt
Valuation Pe�mit Fee $ o! o( — Masonry ne
``/ � Plan Check $ — gond Beam
$ �d `j�� Total j� � FINAL
� Fee
xM zoa �o�ss o. >. e s.
Date
2 I
D
r