HomeMy WebLinkAbout188 23RD ST - Building Permits •
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INSULATION CERTIFICATE
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This is to certify that insulation has been installed in conformance with the current energy
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i \. HALF—MOON-LANE -1-TRACT 16600-COSTA MESA
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i CEILINGS: 9
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-19 6-1/2" e
i WALLS: 0
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-13 31/2" 0
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P GENERAL CONTRACTOR: SHEA HOMES LICENSE# e
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3 SCHMID INSULATION CONTRACTORS, INC. LICENSE#221517 C-2
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i• BY: , '2 G TITLE: PRODUCTION ASSISTANT DATE: 11/23/2005 •
o ANNETTE PATTERSON
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1 INSULATION CERTIFICATE 01
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0 HALF MOON LANE-PHS-1-TRACT 16600-COSTA MESA
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LOT 21 i
CEILINGS: 0
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WALLS: e
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-13 3 1/2"
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I iGENERAL CONTRACTOR: SHEA HOMES LICENSE#
0 BY: TITLE: i
SCHMID INSULATION CONTRACTORS, INC. LICENSE#221517 C-2 i
BY: / iyon TITLE: PRODUCTION ASSISTANT DATE: 11/23/2005 ;i
0 ANN�TTERSON $
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w15STIPAf Installation Certificate : Residential CF-6R
AIB CONDITIONING INC.
Site Address PERMIT#
188 23RD STREET Bldg: -Unit: - Z'
1.BUILDER INFORMATION
Shea Homes SUBDIVISION: Half Moon Lane
603 S.Valencia Avenue CITY: COSTA MESA
Brea,CA 92823 COUNTY: ORANGE
INSTALLING CONTRACTOR: WESTPAC MR CONDITIONING
2. PROJECT INFORMATION
DISTRIBUTION TYPE DUCT OR PIPING R-VALUE
Flexible Ductwork in Flexible Ductwork Will have
Attic and Between Floors a R-Value of 4.20 or Better
I, the undersigned,verify that the equipment listed in the category above my signature is the equipment installed and that the equipment met
or exceeds the requirements of the Appliance Efficiency Standards. In addition, I have verified that the equipment is equivalent to or more
efficient than the equipment specified on the Certificate of Compliance submitted to demonstrate complience with the Energy Efficiency
Standards for residential buildings.
3.HEATING INFORMATION
HEATING MANUFACG HEATING UNIT ACTUAL EFF. HEATING EOUIP HEATING
EQUIP. MAKE MODEL# AFUE CAPACITY LOAD
Furnace Lennox G40UH-48B-090X 80%
4.COOLING INFORMATION
COOLING MANUFACT COMPRESSOR ACTUAL EFF. COOLING EQUIP HEATING
EQUIP. MAKE MODEL# SEER CAPACITY LOAD
A/C Lennox IOACC-036 10%
The building design heat loss and design heat gain rate have been determined using a method specified in Section
150(h)of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection.
5.THERMOSTATIC EXPANSION VALVE(TXV):
Thermostatic Expansion Valve(or Commision approved equivalent) is installed and access is provided for inspection.
YES 0 NO O N/A O
6.SUBMITTED BY:
/.1 et/ V? Zeas
iiri Installing HVAC Contractor Date
\W Iexi s\CrystalReports\Purchasing\CF6R_Report.rpt
Job#:4887 Lot:21 Bldg:-Unit:-
•
3�c CITY OF COSTA•MESA
4 a9 BUILDING DIVISION
s i�'„ , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
�: PERMIT
4- rbc' mmo 1 5-00388
(714)754-5273 • Fax(714)754-4656 •'www.ci.costa-mesaEcfTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 188 23RD ST Status: ISSUED
Suite No Applied: 04/27/2005
Vicinity: LOT 21 Issued: 04/27/2005
Parcel Nunmber: TPN00556
Applicant: WILLIAMS, GARY }
ISSUED BY: ` `
Address: 1450 N.TUSTIN AVE . . -
Phone:
SANTA ANA,CA • Zip 92705 ,
Owner SHEA HOMES '
Address 603 SOUTH VALENCIA AVE
Phone: 714.985.1300
BREA,CA Zip: 92823 ,
Contractor OWNER-BUILDER '
Address: " - -
Phone:
Zip:
License:000000 •
SCOPE OF PERMIT ,
LOT 21/PLAN 3B
ELECTRICAL PERMIT FOR NEW 1693 SF SINGLE FAMILY RESIDENCE FOR"SHEA HOMES".INSTALL
• 4 LIGHT FIXTURES,4 RECEPTACLE OUTLETS,&2 SWITCHES IN GARAGE,& 1 RES A/C
PACKAGE.
REF:805-00175 '
FEE SUMMARY
•
Quantity Quantity
ISSUE FEE $23.50 . • Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $54.50 Standing Section $0.00 . 0
New Res(1-2 units) $94.81 1693 Misc Electrical Equipment; •; • $0.00 " 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw ' $0.00 0
Pool/Spa $0.00 0 • up to 10 kva/kw $0.00 - 0
Lighting Fixts . $4.40 - '4 • up to 50 kva/kw ,• $0.00 0
Recept Outlets $4.40 ' 4 up to 100 kva/kw ' $0.00 0
Switches $2.20 2 over 100 kva/kw • $0.00 0
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl • $0.00 0 Low Volt Wiring System/Ckt ,c$0.00 - 0'
Service to 200a $0.00 -0 Misc.Conduit •.., $0.00 0
Service to 1000a $0.00 . . 0 Misc.Conductor - "$0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) - . ''$0.00 0
Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 - Christmas Tree"Stand $0.00 0
Motors to 50hp $0.00 0 - Fireworks Stand $0.00 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 becomevoidif 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 Inspectionsand 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,
2446-46(6W00)
DECLARATIONS (n
WORKERS'COMPENSATION DECLARATION: -
I hereby affirm under penalty of perjury one of the following declarations:. - - I. .•
❑ 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: ,
Carrier: Policy Number: '
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.) '
I certify that in the performance of the work 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 Califo. ia,and agree the I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith '
comply with these provisl ''JJ /�n7
Applicant Signature: /�Ai
W 7,662. Date: 7 P 74.�
WARNING:FAILURE TO SE• RE WO. COMPENSATIOUNLAWFUL MD SHALL SUBJECT M EMPLOYER TO CRIMINAL PENALTIES MID CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,.... Dm TO THE COST SAI1ON,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
force and effect.Lk.N Class e
Contractor's Signature: Date:
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.). •
XI,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 pursua•t to the Contractors License Laws.).
❑ I am exam. der sec. / Business and Professions Code for this reason:
Signature: a - 'f 7�AS" Date: yi7/Or'
Owner ID v,rifted• driv's license. �"No Driver's License No. Expires: af.,/'/!09
Verification of•wnership 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,will 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 Safety,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:
I 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
materiel? 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). __ _ _
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous 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 Califomia 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 ap_germit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Wit 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 California Health and Safety Code).
other
t e. pollution
c..tr l ____....
7 Ifa a permit from the South Coast res Quality Management iDistrict Heor Sr airpo dn coon 4l district03 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? ❑Yes ❑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 COMPLIANCE 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 com y with 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 ro r for inspe ion p r .I agree no o occupy or allow occupancy of any building authorized by is per t until final inspection.
� u� 4 Yi?7�Osr
gnature Of Legal Oar Date
// And/Or Authorized Applicant Date
;ODE! INSPECTION TYPE DAIF NEBO ;ODE! 'INSPECTIONTYPE .- • QLlf. Its
1616 Fixed System Final Fire Prevention • ' • 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing _
200 Final Re-Roof ' 210 Final Electrical . , . �2g7S
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 BuildinglOccupancy ! -
t' CITY OF COSTA MESA
BUILDING DIVISION
}?' ..4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT ' /5-00228
INThromso et
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us "77 FAIR.DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 188 23RD ST Status: ISSUED
Suite No Applied: 04/27/2005
Issued: 04/27/2005
Vicinity: LOT 21 •-
Parcel Number: TPN00556 - . _ ISSUED BY: r`f Rk'�
Applicant: WILLIAMS,,GARY -
Address: 1450 N.TUSTINLLAVE .� ,. , ' •
, , /
:SANTA ANA,CA - - -Zip: 92705•. - . '
Owner ,'SHEA HOMES-''T-" - _ , " - . ,
Address: 603 SOUTH VALENCIA AVE "
Phone: 714.985.1300
' BREA,CA''H Zip: " 92823
Contractor OWNER-BUILDER
- Address: - -
•
Phone:-
' Zip: _
License:000000
' SCOPEOF-PERMIT
LOT 21/PLAN 3B , 7 - '
MECHANICAL PERMIT FOR NEW 1693 SF SINGLE FAMILY RESIDENCE FOR"SHEA HOMES".
INSTALL 2 FAU'S, 1 DUCTWORK; 1 FACTORY FIREPLACE,-4 VENT FANS, 1 FIRE DAMPER,8
- . 2 A/C CONDENSORS. .
REF:B05-00175 - •
FEE SUMMARY,
•
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 . 0
Inst FAU <100 k BTU $29.60 2 _Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 ' ' Ventillation System $0.00 0
Repair/Alt Cooling/Heat $13.70 1 - Evaporative Cooler $0.00 0
Inst/Rep:Recess Wall Htr $0.00 0 Commercial.Incinerator_ $0.00 0
Refrig Sys<100 k BTU $0.00" -: 0 .. Domestic Incinerator--',7. $0.00 0
Refrig Sys>100 k'BTU $0.00 ' 0 " " . Compressors/AbsorptionSystems
Gas Piping . $0.00 .,- 0 Up to 3 hp/100 k BTU: $0.00 0
Factory Fireplac - $10.65 1 , 3 To 15 hp./500k BTU . $0.00 0
Hood w/Mech Exhaust ' $0.00 0 _ 15 To 30 hp/1,000'k BTU $0.00 0
VAV Box ; .. $0.00 0 ' . " 30-To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $29.00 . . 4 Over 50 hp/Over 1,750.BTU $0.00 0
Appliance $0.00 " 0 Boilers„- }�
Fire Dampers - -$7.25 ' 1 '' Up to 3 hp ' $29.40 2
Smoke Dampers ' $0.00 ' 0 3 To 15 hp - - / $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp , _ $0.00 0
Air Handlers> 10000cfm $0.00 0 ' "Over 50 hp $0.00 0
Floor Furnace $0.00 0 • Other Mechanical Fee
•
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 expireandbecome void if work Is not.commenced within 180 days,or if work is suspended or abandoned
fora period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to-be considered legal, such work mustcomplywith 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)7545626
.
2446-46(6/00)
DECLARATIONS (—`� r
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•lnsure 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:
Carrier: Policy Number:
(This section need not be completed if the permit is valued et one hundred dollars($100)or less.)
', certifythat in theperformance of the work for which this-permit is issued,I shall riot employ any p y nperson in any ions of a do to become t subject to the,I shall f
compensation laws of C. omia,and agre: if should b::. e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these•r•v'- • s. u
Apprlcant star ske: r /- // Deter- d' .271.: 0
WARNING:FAILURE T• O' ERS'COMREN'• ION VA PAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI' PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($1••,•.r,IN••DITION TO THE•.• • COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.A Class 4
Contractor's Signature: Date:
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).
Lenders 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).):
r
*` aownersiof the pofty, r me: hen wonth wages asis their sole not apply WILL DOn Trof WORK,and the Structure is noes eeonor who d 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.). -
AI,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 Contrac ors License Laws.).
O I am exam• nder se /i Business and Professions Code for this reason: .e.---.-
5ignatureY 1i954. 7iI Igatentiityi s
wner
OID =rifted. d' pr's license. _' • 0 No Driv_.i. censeNo° LF es,:ingiviei
Verification• n• ner ip by(type of doc ment,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will 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,Califomia Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division,
Signature: Dale:
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 ❑No
(Section 25505 of the California Health end 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),
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Califomia 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 for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ 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 California 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? ❑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 COMPLIANCE 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 comply with all state laws : • city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described pro rty for insp: tion .r��s.I agree not to occupy or allow occupancy of any building authorized by this rmit nth final inspection.
y g7Os
Sig'atuie OFLege•vrie7( ,i777— Date
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE' " DATE " - tNTRIAL$ - ' LODE I ' INSPECTION TYPE - gy;l�lF// r 1.11
1616 Fixed System Final Fire Prevention 206 Final Mechanical[!J
1266 Pool Spa Final 208 Final Plumbing •
200 Final Re-Roof ' - 210 Final Electrical i •
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/Occupandy - '
CITY OF COSTA MESA
tot) BUILDING DIVISION
>:1',,„, DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
PERMIT 05-00288
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 188 23RD ST Status: ISSUED
Suite No Applied: 04/22/2005
Issued: 04/22/2005
Vicinity: LOT 21
Parcel Nunmber: TPN00556 ISSUED BY:
Applicant: WILLIAMS, GARY
Address: 1450 N.TUSTIN AVE
Phone:
SANTA ANA,CA Zip: 92705
Owner: SHEA HOMES
Address 603 SOUTH VALENCIA AVE
Phone: 714.985.1300
BREA,CA Zip: 92823
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
LOT 21
PLAN 3B
PLUMBING PERMIT FOR NEW SINGLE FAMILY RESIDENCE FOR"SHEA HOMES".INSTALL 2
BATHTUBS, 1 DISHWASHER,7 GAS OUTLETS, 1 WASHER, 1 PRESSURE REGULATOR, 1 SEWER
CONNECTION,2 SHOWERS, 1 KITCHEN SINK,UP TO 4 VACUUM BREAKERS, 1 WASH BASIN,2 WASH
BASIN SETS, 1 WASTE&VENT SYSTEM,3 WATER CLOSETS, 1 WATER HEATER, 1 WATER PIPING,
& 1 WATER SERVICE.
REF:B05-00175
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $9.80 1 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer 50.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $19.60 2 Pressure Regulator $9.80 1 Urinal $0.00 0
Clarifier System 50.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $12.30 1
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $9.80 1
Dishwasher $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $19.60 2
Drain, Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $9.80 1
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $29.40 3
Drain,Roof $0.00 0 Shower $19.60 2 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $9.80 1
•
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
2446-46(6/00)
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 sell-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 if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work 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 California,and agree Thal If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
-NotLSAND DOLLARE(5l00,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 31060F THE LABOR WOE.INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.I Class a
Contractor's Signature: Dale,
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 penally 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).):
er of rty,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7 Iness 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 appy 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 der sec.�� Business and Professions Code for this reason:
Si nature .Z-. / Date: CiA.2/�.r-
9 •
Owner I verified dm at–,
license. 0 No Drivers License No. Expires: t
Verification nershlp by(type of docu .i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more Iselin depth Into which a person is required to descend,will 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 Safety,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).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑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? ❑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 ag$ormit for such construction or modification
from the South Coast Air Ouality Management District or from any other air pollution control district or agency? j�Yes LI 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? ❑Yes 0 No
(If"yes'',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a pernif 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 0• COMPLIANCE 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 afire'• •comply with ell state le.:JJ city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abovr-• property for i .pec'•n •r es.1 et ••: not to occupy or allow occupancy of any building authorized by t Is permit until final inspection.
eArAfr
�.na 0.,.., r(s) / / Ufa
9/
W AndP r •.prized Appli Date
CODE I SSystem
DAN gLTRIAL$ CODE INSPEMechanical
cTani DM
1618 Fixed System Final Fire Prevention 206 Final Mochenical
1266 Pool Spa Final 208 Final Plumbing 1279 kc • -E--
200 Final Re-Roof 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
5n M - CITY OF COSTA MESA
4 BUILDING DIVISION
rrie 4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4. PERMIT 05-00175
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.gl`lLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 188 23RD ST Status: ISSUED
Suite: Applied: 01/31/2005
Vicinity: LOT 19 Issued: 04/18/2005
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: TPN00556 Zoning:
Applicant: WILLIAMS, GARY -y l
Address: 1450 N.TUSTIN AVE ISSUED BY: '""
Phone: 714-245-9760 X24
SANTA ANA,CA Zip: 92705
Owner: SHEA HOMES LTD
Address 603 SOUTH VALENCIA AVE
Phone: 714-985-1300
BREA,CA Zip: 92823
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : WILLIAM HEZMALHALCH Eng:
Address: WILLIAM HEZMALHALCH ARCHITECTS INC Address:
SANTA ANA,CA Phone: 949-250-0607 Phone:
2850 REDHILL AV STE 200
Zip: 92705-5543 License: C12920 License:
SCOPE OF PERMIT
LOT 21
PLANS 3B
CONSTRUCT NEW 1693 SF SINGLE FAMILY RESIDENCE WITH NEW 466 SF GARAGE. 1ST FLOOR 710 SF&2ND FLOOR 983 SF.A
FIREPLACE MODEL#4236(ANSI UL127)WILL BE INSTALLED.
REF:G04-00010, PA-03-47,T-03-06
SEE PA-03-47/7-16600
FEE SUMMARY
Plan Check: $228.83 Calc Valuation: $173,682.50
Permit: $1,408.15 Claim Valuation: Woo
SMIP Res: $17.37
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $1,654.35
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 20-0 Rear 19-0 Left 5-0 Right 18-5
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
Lfor 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
2446-46(WOO)
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:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars(3100)or less.)
t121--1 iertify that in the performance of the work 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 California.and a.re- that If l should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these p 1,4 ions. � // a
U ,./
_Applica Signature: (fir[) / �pate:a—/'/'War
-WARNING:FAILURE T.�W4a+KERS'COMPEN.COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE( Nr),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
' I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.a Class a
Contractor's Signature: Date:
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 DMsion 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).):
lit lc:d 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 end 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
lisold 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 exam under sec. ♦ Business and Professions Code for this reason: U
Slgnatur te:-� I,�O/Ur
S Ov verifi by rivers lice �'Ves ❑No Diiver's Liconse No. L Of0//9/06)
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
I
\ 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,will 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,Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,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).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous 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 appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes lJ 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 ❑No
(If yes",the facility must meat the requirement of Sections 25534 and 42303 of the California 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: Dale:
CERTIFICATE OF COM UANCE 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 com y with all state la s d city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described r for insp p es.I agree not to occupy or allow occupancy of any building authorized by t is p rmit until final inspection.
/ �l 18�0�
ignatare Ot,Legal' - LQat.A=,*
N
And/Or Authorized ..plicant Date
CODE I INSPECTION TYPE PETE INTRIAL$ OBE t INSPECTION TYPE PAIL IBIQISL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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 /
//T204 Final Demolition _ 250 Final Building/Occupancy J ❑
`pSTgittt_� CITY OF COSTA MESA
CD P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
7/ w�:,.�.,,
Y1 - 1 .
V- p DEVELOPMENT SERVICES DEPARTMENT
~��pPONGfR�44
January 24, 2005
To:
Building Safety Division Comcast Cable
Code Enforcement Newport-Mesa Unified School. Dist.(2)
Communications Pacific Bell
County Clerk Police Dept. - Planning & Research
County Planning and Dev. Services Sanitary District Engineer
County Registrar of Voters Sanitation Division Office
County Tax Assessor So California Edison Company
Engineering Division (2) Southern California Gas
ESRI State Board of Equalization
Fire Admin. - Training Officer U. S. Post Office - AIS
Fire Admin. - Mark Brown (Station 6) U. S. Post Office, Adams
Fire Prevention Thomas Brothers
Irvine Ranch Water District File (2)
Mesa Consolidated Water District
OLD ADDRESS NEW ADDRESS A. P. NO
190 23rd Street 188 23rd Street None at this time
(Address change affects only the one lot at the corner of 23rd and Orange Avenue)
Your cooperation in this matter is appreciated.
Sincerely, /
L- l /)O LCL( e. t L)- /C ,c/l�Ck'(,u
lla Bouwens-Killeen i/ "` '
Principal Planner
c: Kimberly Brandt
Vi Pham
Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245
FAX(7141 754-4856 • TDD(7141 754-5744 • w.....,,-i rnct.an.cn
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