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Home My WebLink About2111 WALLACE AVE - Building Permits CITY OF COSTA MESA ;ra ' BUILDING DIVISION J DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER F I •._ I , PERMIT *NbitPaa,r,,.4' 04-01257 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2111 WALLACE AV Status: ISSUED Suite: Applied: 07/13/2004 Vicinity: ROOF Issued: 07/13/2004 Parcel Number: 42246109 Zoning: Applicant: KYLE LEWIS ISSUED BY: Address: 4071 E LA PALMA SUITE K Phone: 714-632-3800 ANAHEIM,CA Zip: 92807 Owner: LUMANTAS, LEONITO F Address 4469 DAHLIA ROAD Phone: CHINO,CA Zip: 91710 Contractor LEWIS & SONS CONSTRUCTION Address: 4071 E LA PALMA SUITE K Phone: 714-632-3800 ANAHEIM,CA Zip: 92807 License: 416525 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT- TEAR OFF EXISTING ROOF. INSTALL 30#FELT,30 YEAR COMPOSITION SHINGLES,AND REPAIR/REPLACE SHEATHING AS NEEDED. 19 SQUARES INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,575.00 Permit: $97.25 Claim Valuation: $3,575.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: ' $0.00 Inspection: $0.00 • Total: $97.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 - PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/OO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number. (This section need not be completed i(t�••rmi s valued at one hundred dollars($100)or less.) ( 'W I certify that in the performan e/ e for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C'Iif• it =nd ee that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro ', ns.. / / O� /Applicant Signafin i '- _- / (-Date:-. 7 -/5-01( TO SE• RE WORKERS' MPENSATION COVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($1(+,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. / LICENSED CONTRACTORS DECLA• ' ON: I hereby affirm that I am liven ed •yf.rovisim •f Chapter 9(commencing with Section 7000)of Division 3 of the Business an Professions Code,and my license Is in full —__ / i (force end effect.Lic..# pi. (Class# P.• ‘Contractors Signature_, i f Date:--. ,— 3-Oil CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,wit be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safely,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). occupant ea-r._s_ acutely 2 Does or will the applicant or present or future building occupant need to file a registration form for acuhazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit/or such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes Ll No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF •• PLI 7 E AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to • ply !h all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described •r••erty 1. inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. �t Signature Of Legal Owner(s) Date S ?i -0yTAnd/Or'Aiithorized Applicant- - 7-/ ' Date— CODE I. INSPECTION TYPE QM IfIDIB15 CODE( INSPECTION TYPE PATE ILIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof r7-aa-0"\ L-*`^ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy OWNER TOBIAS & ORR ✓ DATE 1_26_55 JOB ADDRESS 2111 Wallace Av- _- BUILDING PERMIT NO. 7 • GENERAL CONTRACTOR Dike & Colegrove VALUE $ 8,500.00 L1.. 8 BLOCK TRACT 1881 Single Family Residence 'GROUP I TYPE V ZONE WI FIRE DISTRICT 8711 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench 5-'-1 1 .2. -/: s3— . Foundation Forms and Grade to Garr gee--,�_ Rough Framing $�� '' Plumbing,Rou to Slab CC'' 1'.4 a ' • Plumbing, Rough Complete 4 3 -2.3-U „-, o/'(vQ,-74, ,/4 -Cr / 11-3 Temporary Pole n Wiring,Rough 8-4.-6 i-21-13- -tr-n-!,./ C.e.z-c-t , 3-,V-fc 8/; . Heating,Rough ({ ` Heating,Final -76-1---05-_g_g .S- 2 J.t fWve 01 L-,h b„9 /a�' S` T. Sewer 7'/JIJJ S 12-Sg - l1 / /Sr Tank of Cesspool g, Tc- n-- / /-ii--s---s— /y �7 L. ng R�� U 3'- --3--33- Plastering S5 / Plastering8--a_•6 rPlumbing,Final,Fixtures Complete f,64:0Plumbing,Final Gas Test/2A- .7Lb .1 � y„ V,274 - i •G Wiring,Final / ,7 i5' •• Occupancy 7' -"? S/ �1 , Form 210 G-R 1/4 12-53 ' Costa Mesa Building Department APPLICATION FOR PERMIT 8� 111 EAST 20th STREET BUILDING 1 � COSTA MESA, CALIFORNIA 4 ' FOR OFFICE USE ONLY FOR APPLICANT TO FILL 1N . Receipt No. Permit No. Building Address 2111 Wallace Ave. , Costa Mesa 377/ 24—f Received by Date Recd. Date Issued Costa Mesa, California Nearest - "016 -.CC- Cross JCross St. Hamilton to Victoria Building Address Owner Tobias & Orr Costa Mesa, California Mail Address 419 E. 17th. St. Nearest Tel. Cross St. City Costa Mesa No.Li.8-1159 Zone C, I No.of I Type . / I Group �., Architect or Lic. (`� Plans (� Engineer Hugh Gibbs No. Approved by Date Address Long Beach CORRECTIONS CityLfc. 3Contractor Dike & Colegrove . 101 Address 419 E. 17th. St., Costa Mesa Lel Lot Description I No. S I Block I Tract 1881 gil (Attach Metes and Bounds) a 0 Size of Lot 60 X 130 I Now.ofon Bldgs.Lot NoNone Use of I No.of I No.of a Existing Bldg. Families Floo s Setback Line from Rear Yard b01plus .1Af\ 2 6 i555 Center of Street 55, Side Yard 51 pl DA X. DESCRIPTION OF WORK New I X I Alteration I Addition CITY-.OF COSTA - MESA Repair I I Moving I I Demolish I Building No.of Size 12001 - Rooms 6 Stories 1 Exterior Wall Ro Covering Stu6ISO of Covering Comp°. APPROVALS Use of New Building Single Family Res. Foundation Location Inspector Date Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating .- building construction. Signature of Plaster, Int. Permittee Plaster,Ext. Authorized AgR ;. .. giJa MilSunry Reinforced Valuation Permit Fee $ ZL. Plan Check $ 3.00 Bond Beam $ 8,500 Total Fee $ 25.00 FINAL rf1RM 204 G-H 2M 5-54 - J 0 o a . a • • Street 1" - 1 PLOT PLAN ; �. • . IG ,,. , Show location and distances from _ ' property line and between buildings. • - rl ' OWNER JOHNSON, Loren DATE 5_7_43 JOB ADDRESS 2111 Wallace Avenue BUILDING PERMIT NO. 36601 GENERAL CONTRACTOR Santa Ana Tent & AwningDESCRIPTION of WORK Aluminum Patio Cover 115-431-09 LOT 8 TRACT 1881 FIRE ZONE VALUES 350.00 11:4-tCTIONS Signature Date GROUP J TYPE V ZONE Rl =SOIL SUBCONTRACTOR PERMITS ISSUED LATER Date Number j Signature Plumbing TROUGH PLUMBING ' PROP. SWR. LINE Q HOUSE CON. ❑ ZSPRINKLING SYSTEM JMISCELLANEOUS &ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER O ROUGH WIRING Heating and Vent. TRENCHES D FORMS 0 STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLATER, BROWN COAT Si URAL, FINAL Electric HEA.ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL )� BUILDING, FINAL fie LST �f^3-.15 36601 FAI'- ''COSTA MESA BUILDING-SAFETY DEPARTMENT w -7'��—"OO 31 �•*x.50 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to fill in Completely z PLC ION FOR BUILDING PERMIT ED V DATE RECEIV DATE ISSUED BUILDING '9 '/� /- 1 t, •ttig%•• J /� I l� if 7 - I 5_7-7s ADDRESS `ill / •'.iff/ IY/ qq �QQpp,,�� y �� 1 PERMIT •1 MAIL OVVNER..„ • DDDR ESS i// ' / / /Q Y- s V-, BUILDING Z ADDRESS tu iii \ / v-L ct, 17.rte Nil. . NO. ke_�] �,. TRACT/�� LOT • K� aU CITY LLL...,,"'..."' F Z Z Q CONSTRUCTION NEW A D ALTER REPAIR MOVING DFMOIISH — I-LENDER / tl o3 _ID BRANCH n nzC�� /J C )O 1_/ J N OWNER [! <L11 ADDRESS c0 J _ VQ� VALUE -CO ARCHITECT TEL. US $ Xx�•� to OR ENGINEER N . 0Q FIRE T WCC ADDRESS -c- �j p ZONE Z/TYPE GROUP vEL7( ar.- J/e.tA..MAPPROVED DATFL� 7 2'� CONTRALTO BY CO Z .7J cc ADDRESSi202, ) � ' W W �� ZONE NO.OF SE OF NEW 0= /y TEL. - r, /J PLANS ��. BUILDING �,IT/� Z F CITY 20 ask_ \F�s�.1v NO64J'D4. 9 / I6G / J w 0 STATE 'l CITY YARDS APPROVED YARDS APPROVED NIT LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 0O SIZE NO.OF BLDGS. (FROM C/ S ET) OF LOT`.0 n /l'/'O I NOW ON LOT / RONT FT. FT. USE OF / EXISTING BLDG. 4J&.PI-1-. / R.SIDF /' FT. FT, I— SIZE OF w t C. NO.OF Z NEW BLDG.y 0 X ,2.� ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL.. ROOF U / _ COVERING Sat/S.° COVERING REAR at, FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 MAIN BLOCS. ACCESS. BLDGS. 0 Q VAR. DATE On (6 — /—leLIMC.U.P.sAPPROVED I-- APPROVE • 3 RV 1012h _ATz 611E o UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with /1t CC all laws regulating building construction, and I shall not employ (J I— any person in violation of the workman's compensation laws of _ \ co the State of California. m Z «(TTTIJJI 50.FT. 2 I hereby certify that I am properly licensed as a contractor under o the State of California Business and Professions Code, Oivisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • am exempt from tl e provisions of the State of California Business and Professions Critic), Division 3,Chapter 9. VALUATION m JJ> PERMIT FEE $ j Signature of ^t' 1 -�-�/ - � /)hT m Perm lttee �[ .( •/E�!'t.tsT'Lt, t/` $C71 L11/V/ PLAN CHECK $ E o` u Authorized Agent ` TOTAL FEE $