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HomeMy WebLinkAbout278 23RD ST - Building Permits 05Th'44,. - 1CITY OF COSTA MESA J. . BUILDING DIVISION -- ••• PERMIT NUMBER i; DEVELOPMENT SERVICES DEPARTMENT PERMIT B00-00414 -*S�APOP4OE0\9S�- (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 278 23RD ST Status: ISSUED Suite: Applied: 03/31/2000 Vicinity: ADDITION @ REAR OF HOUSE Issued: 06/28/2000 Parcel Number: 11913301 Zoning: Applicant: PARK, JAE Y. ISSUED BY: Address: 12711 NEWPORT AVE. Il TUSTIN,CA Phone: (714)573-0510 SUITE F Zip: 92780 • Owner: KIM HYUN K Address 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92844 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 0 Arch : ' - Eng: ORION ENGINEERING • Address: - - Address: 22365 EL TORO RD. Phone: LAKE FOREST,CA Phone: (714)649-3207 SUITE 222 Zip: License: 92360 License: SCOPE OF PERMIT CONSTRUCT 264 SF ADD TO GAR;520 SF ADD TO SFR;20 SF PORCH; REBUILD 156 SF GAR; REFRAME AND REROOF EXISTING 1,661 SF HOUSE; REMODEL KITCHEN,BATHS AND LAUNDRY FEE SUMMARY Plan Check: $667.78 Calc Valuation: $105,896.40 Permit: $1,027.35 Claim Valuation: $58,356.00 SMTP Res: $10.59 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,705.72 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 NOTES: • 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 it 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 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. O 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.) ❑ 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 that 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 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($1X,000).IN ADDITION TO THE CflST OF 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.# Class# 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).): O 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 2 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: c.40_ \) / i4 Date: a4/240o Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. / Expires:n2, 0/ 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,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? ❑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 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? ❑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 aEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? al Yes L-I No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). l-..any---__t-oty t_be con h __-d-_ 6 Will any part of the facility to constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves 0 No (II'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? 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 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 and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. C%6 �) /C DeS/W,0. J Synature 01 Legal Owner(s) e And/Or Authorized Applicant Date ;ODE INSPECTION TYPE DATE INTITIALS CODE Y INSPECTION TYPE DATE INTITIALS 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 204 Final Demolition 250 Final Building/Occupancy $'///7 D/ PTt` 2446.46 (/ `p5iw MF's AS9 CITY OF COSTA MESA �', BUILDING DIVISION ( " PERMIT NUMBER to :'i DEVELOPMENT SERVICES DEPARTMENT PERMIT • E00-00606 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 278 23RD ST Status: ISSUED Suite No Applied: 06/28/2000 Vicinity: ADDITION @ REAR OF HOUSE Issued: 06/2812000 Parcel Nunmber: 11913301 Applicant: KIM HYUN K ISSUED BY: Address: 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Owner: KIM HYUN K Address 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Contractor: OWNER-BUILDER Address: Phone: , • , . Zip: License: 0 SCOPE OF PERMIT ELECTRICAL PERMIT FOR ADDITION&REMODEL OF EXISTING SINGLE FAMILY RESIDENCE. INSTALL 17 LIGHT FIXTURES,35 RECEPTACLE OUTLETS,&28 SWITCHES. REF:B00-00414 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 $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 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 $18.70 17 up to 50 kva/kw $0.00 0 Recept Outlets $30.95 35 up to 100 kva/kw $0.00 0 Switches $25.84 28 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 Wring System/Ckt $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 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $98.99 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS • 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 permf�j FOR INSPECTIONS CALL: (714)754-5626 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 et 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 that 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 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE 15100,000).IN ADDITION TO THE COST OF 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.N Class It Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: O 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: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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).): O 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.). uz 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 en 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: /,/ 600 €Q/ T9 Cate )) /L-+ Date: O/p/Oe Owner ID verified by drivers license. 0 Yes G4Jo Driver's License No. SS4' Expires: itA4,0/- 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,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 B,California 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: 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 Califomia 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 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 Califomia 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 akermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? 13 Yes 0 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? in Yes ❑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 ❑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 and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. J /G = o -2-y`eo - Signature Of Legal Owner(s) ate And/Or Authorized Applicant Date CODE it INSPECTION TYPE PATE INTITIALS EON I INSPECTIONTYPE BATE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing - 200 Final Re-Roof 210 Final Electrical S/iO/Of 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 2446-46 • `pfoie-titS: CITY OF COSTA MESA N', •, BUILDING DIVISION ( •^••••• PERMIT NUMBER J. .� DEVELOPMENT SERVICES DEPARTMENT • PERMIT • • noRano X94* M00-00257 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 278 23RD ST Status: ISSUED Suite No Applied: 06/28/2000 Issued: 06/28/2000 Vicinity: ADDITION @ REAR OF HOUSE Parcel Number: 11913301 ISSUED BY: Applicant KIM HYUN K Address: 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Owner: KIM HYUN K Address: 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Contractor: OWNER-BUILDER Address: Phone: Zip: .. • License: 0 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT MECHANICAL PERMIT FOR ADDITION&REMODEL FOR EXISTING SINGLE FAMILY RESIDENCE. INSTALL 1 GAS PIPING, 1 FACTORY FIREPLACE, 1 HOOD W/MECH EXHAUST,2 VENT FANS, &ALTER 1 HEAT/COOL SYSTEM. REF:800-00414 FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 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 $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $6.15 1 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $10.65 1 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $10.65 1 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 $14.50 2 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 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 Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $79.15 COMMENTS/SPECIAL CONDITIONS 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 1 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 / DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: o 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 career and policy number are: Career: Policy Number: (This section need not be completed it the permit is valued et 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 that 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 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF 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.N Class N 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: Lenders 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,altar,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).): O 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: 646 \\)) ) Expires: .o.277/9/1:// Verification of Ownership by(type of document,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,California 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: 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? ❑Yes ❑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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit 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 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 ❑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? 0 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 comply 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final ins action. /�_ 06//9 0o . 'Signature Of Legal Owner(s) te Anlaninzecfnelicant CODE I INSPECTION TYPE DAN INTITIAL$ CODES INSPECTION TYPE ATE INTITIA.$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical D 4 (//�A.I. 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 204 Final Demolition 250 Final Building/Occupancy 2446-46 • • 9, CITY OF COSTA MESA lrA' BUILDING DIVISION p MIT NUMBER DEVELOPMENT SERVICES DEPARTMENT PERMIT • ; Eo,9t• , P00-00336 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 278 23RD ST Status: ISSUED Suite No Applied: 06/28/2000 Issued: 06/28/2000 Vicinity: ADDITION©REAR OF HOUSE Parcel Nunmber: 11913301 ISSUED BY: - Applicant: KIM HYUN K Address: 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Owner: KIM HYUN K Address 12822 ALAMITOS WAY Phone: (714)537-6952 GARDEN GROVE,CA Zip: 92841 Contractor: OWNER-BUILDER • Address: '• •• Phone: Zip: License: 0 Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT PLUMBING PERMIT FOR ADDITION&REMODEL OF EXISTING SINGLE FAMILY RESIDENCE. INSTALL 2 TUBS, 1 DISHWASHER,2 SHOWERS, 1 SERVICE SINK,2 WATER CLOSETS,& 1 WATER HEATER. REF: B00-00414 FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $19.60 2 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 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 $0.00 0 Dishwasher $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $19.60 2 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $9.80 1 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(SandAutO) $0.00 ' 0 • - TOTAL CALCULATED FEES: $94.60 COMMENTS I SPECIAL CONDITIONS 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 / DECLARATIONS {I - 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($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 that 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 MD SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100.000),IN ADDITION TO THE MCT OF 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.q Class 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.). • re 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: tr ') 7 Date: /96/2,00 - Owner ID verified by driis tic nse. ❑Yes 0 No Driver's License No. // Expires: //J/y 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, 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? ❑Yes ❑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 then 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 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 pan of the facility to be constructed under this permit be within 1000 feel 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 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 ❑No B (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penally 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 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 and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Cede / ,� ; 0/z Vac) Signature Of Legal Owner(s) D And/Or Authorized Applicant Date CODE I INSPECTION TYPE RAIL INTITUL$ CCU I INSPECTION TYPE RAIL INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical /1 ) 1266 Pool Spa Final 208 Final Plumbing R !o.so( en) 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 2446-46 .. • COSTA MESA PBUIO. B DINGOX ? DEPARTMENT I 7096 • COSTA MESA CALIFORNIA 1 w 71t: j APPLICANT TO C.L. OF STREETS `I` 'f `.-L I-� + '7111 t I V IA' BUILDING ADDRES 7 j � ��PROP. LINE _ _ _ FINANCE DE T. I Owner /• � S't.fs / r IF I --- -- _i I2 FT. 6113-FOR �;I OF (1"?A AL,h � 10 FT. FOR 60 FT. STREET�F50 FT. STREET Mail Address •� c ����� City GL £2 _ Ph. N .c I I — I , — I I Contractor 1L7 ` IE /J 1 I Ph. No Adddress ,/L- �+ ,/ 1 -50 Fit IF FRONT )0F PPROF! F City Lic. No. State Lic. No. a �T 50 FT, w Size of Lot /1 X 9r'T AP No.)/9— / 5_3-0 -. , , I- Setbacks: C/L Street So �� Rear14‘ OI I CC J Cr LL Side Yard - Right eft 01 0. v J Type of Fence ! I ALLEY OR PROP 14E i ccd / !, r ' • /. F' Z . j� C , I hereby acknowledge that I h e read this application and state \) ? Nrp Si . .c'. ` I that the above is correct and agree to comply with all City Ord- _ .• • y w inances and State Laws reg • g buil. /gg construct' n. �1 O tya i _� a i- Af n "' � I" I Signature a 'I ® G U S' p 101 1 of Permittee \I C'x 1 Agent I N � o � � U • 7 6 IN.,_ R >`° 2 tl z 1 FOR OFFICE USE ONLY FT. � � I 40 I W V Z N a I FT , J I I Permit No. a m I 9096 0 1 K 60 FT ST. Received by Date Received Date Issued a q II lam' 1 �` . "---i4.,•-72 7-a.. a 7- - 8 —��PROP. LINE t` - _ _ - - Till �' VALUATION e "--c.,� ' p Permit Fee $ $ Plan Check $ C.L. OF STREETS TOTAL FEE $ — ' MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - --- MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS OWNER T ONl'1 M1UHAEL DATE ,1-23_p( JOB ADDRESS 278 E. 23rd Street BUILDING PERMIT NO. 265597 GENERAL CONTRACTOR Alum Kool Awning DESCRIPTION OF WORK att. alum. pat . cover fo. 119-1'33—01 LOT TRACT FIRE ZONE VALUE $ 400.00 1,...PECTIONS I Signature Date GROUP J TYPE IV ZONE Hi Soil PERMITS ISSUED Gas SUBCONTRACTOR I Date I Number I Signature Water Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.❑ Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 Rough Wiring Heating and Vent. Trenches CI Forms 0 Steel Reinf. ❑ I Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing—In 0 Out 0 " 'ter, Brown Coat ctural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final n Building, Final (m_.]/ GC - JAN 23-67 00 702 *****3.00 • ". . 2C597 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING Li- macaw,' For Office Use Only BUILDING 7 �/ C' _2340( {� i- ADDRESS /I / a664--���� R[CaIPT ND P2r397 COSTA MESA. CALIFORNIA r.59 //ff v ��Vw REC�WED •Y DATE RECEIVES_, it !-SUED OWNERrn .e222 �ALµ� �-/--?3-A7 //Doz' --1,7 fl BUILDING // 4-1 St ADDRES, a 7 g9& -• .3.4",__, J ADDRESSFIRE �jf D T. . ''J� (/� ��r Tom. G ZONE TYPE GROUP Nc CITY`✓a. f!., //7e-Q-LL._ NO. /S1 0 SU APPROVED r` 7 R•NITECT INEER It- //1 NO, yW •}02/ie in // " '� DATE /_�✓ (o/ . RESS 3 12 3 co % GY.5 f— _ _ ZONING a l NO. •UIUllorN� ,7—I OO aI BUILDING CONTRACTOR° PJ 4 4440 � e (Ti IMAM LEGAL NN,1 l '95f C (1 ADDRESS 37^5 (y] .a DESCRIPTIONCITY J^/J Q- A.P.NO. //9-/do" LIATEp"� / !/ �/ NOTE: NO NAVE OVERHANG SHALL BE LESS THAN C.NO. i / y-// La NQ,�LL 7y 5' LT'O 130"TO HIDESREAR P.L. / ( EAVES SIZE I NO.OF 51.001. / ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT / YARDS APPROVED YARDS APPROVED USE OP /. ^^ nom^�raA/ MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. /7.(AhYA-1 art (FROM C/L STREET/ //,I1�.�.P. SETBACK LINE FROM FRONT FT. Pr/ ( PT. CENTER OF STREET REAR YARD r/j 74 SIDE YARD I LEFT I RIGHT R.SIDE FT, NC/FT. DESCRIPTION OF WORK L.SIDE PT, 44 PT. N ALTERATION _ ADDITION )C REAR PT. 7 PT. DISTANCE BIT. BET.MAIN& REPAIR -MOVING _DEMOLISH MAIN BLDGS. ACCESS.BLDGS. VAR.* DATE BUILDING NO.OF SIZE ROOMS STORIES `F C.U.P.* APPROVED COVERINGWALL I COVERING e APPROVED 2 DATE I €2 3 -67 USIt„OF BUILDING AND WORK TO BE PERFORMED -1:7-- 11, , a. 19`x`x r z - ;z3 y T (� 1 I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. I3 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION '] BUILDING CONSTRUCTION.! , - // PERMIT FEE V �'(/ 0PI SIGNATURE OFI� JS d,"LJ /i. _ PERMITTEE `^'�-L^7a/ ki4 -� S. _ �� �� � qp� � sZe PLAN CHECK S AUTHORIZED AGENT � t TOTAL FEE V %.-9•47) OWNER MATRJWGA, GEO -F: - - DATE 6-18-56 JOB ADDRESS 278 Twenty ttikid St. BUILDING PERMIT NO. 3206 GENERAL CONTRACTOR Dike and Golegrove VALUE $ 6 p)858.00 L 314 BLOCK TRACT n2959 Sing. Res. w/att gar GROUP I & J TYPE V ZONE Rio FIRE DISTRICT 323$ PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR ,_� j_,i (� 7DATE NUMBER Footing Trench Ci tt -d y- Foundation Forms and Grade to Garageii// y/_-_'-,3 Rough Framing r .. .7c ✓�7= ? 0.�. Plumbing,Rough to Slab pct'Tv4 t 5 l�7� s_ +, _ / . , G Plumbing,Rough Complete �,-r�v6'il_-=, .'4Y , ��-", � _ - -S 5 7 F re- Temporary Pole _ rUG Wiring, Rough �4,7;26 ..- �/'f'6 -Aef11x c .tet, I 3 195. 02,1/ 2 — Heating, Rough �]j� O/�r/7nL �/O Heating, Final di/VI ip sb ,, -;-_ �.l. )itt' II • " 00 2 Sewed;H�o_u_se3 Sewer,St. en? imp -Midi ' , 2.c../:4-1-.0>_/;--, 5, 7-3 G / G FY '— Septic Tank orCes pf sl 7 - ,. � Li,' 7-,CC ,c G g 7 L ig, In Out ' dal Plastering i .r //..,,. Jr Plumbing,Final,Fixtures Complet ,14/2/./1-, ' I\ /"t „-� Plumbing, Final Gas Test fi. .p �I 6 G /�{ Wiring,Final 49 ele 0/6- - - — Occupancy ,,,C' t i ' FORM 210 3M 10-55 Costa Mesa Building Department APPLICATION FOR PERMIT P. O. Box 3!7 BUILDING • 4 COSTA MESA, CALIFORNIA 1 FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Building Receipt No. Permit No. Address 278 Twenty—third St I 307 0 G Costa Mesa, California Receivedeceiivby Date Reed. Date issued Nearest //r✓ ‘—'45---3—/ 4 —42— 4j cross st. Westminster St Building Address owner George F. Matranga Mail 17th St Costa Mesa, California Address 419 E• Nearest Cross St. City Costa Mesa TNo.'ti. 8-1159 zoneP�,l No.of Type Gro T Q Architect or N7 I Plans `rJ Engineer Carlson & Middlebrikit Approved by Date Address Garden Grove CORRECTIONS City Lie. ,tractor Dike & Colegrove No. 2707 Address 419 E. 17th St LegalLot I Description I No. 3�+ I Block I Tract 2959 (Attach Metes and Bounds) dg Size of Lot 60 X 138 No.of Now. on BlLots. none _ • --- . Use of No.of 1 No.of - 0 Existing Bldg. none I Families I Roll. pp, 5, is Setback Line from Rear Yard 71 . 2 Center of Street 50 Side Yard 15 / Z D DESCRIPTION OF WORK - i r New I X I Alteration I I Addition I Repair I I Moving I I Demolish I Building „ ,,,, No. . '! . '..m `.:. -' •” .,t Size 998 sq ft Rooms 51- Stories 3. Exterior Wall I Roof _' ering Stucco I Covering Comp APPROVALS oBuilding Foundation Location Inspector • Date Buil g- Stele family res aad—gar Forms,Materials, Under-Pinning Plan X63BR Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating building construction. Lath.Ext Signature of Permittee Dike/i /i and Cale Plaster, Int Authorized Agt. C 1a, / Plaster,Ext. Valuation Permit Fee $ o2:2 -- Masonry Reinforced U O Q Q S 8-- Plan Check $ // Bond Beam $ Total Fee $ �� — FINAL . .ORM 204 1055 0.P.&5. Y • • Y . • J 6 J p COiT: a . G i • Street - . PLOT PLAN Show location and distances from Property line and between buildings. 1 J =C \ • 4‘,i ..,...:�� 3• i ` c c OWNER JOfJcrfOq, F A DATE 6_u-1_5A JOB ADDRESS 278 Last 23rd Street BUILDING PERMIT NO. 6883 GENE AL CCIN�RlACTOR Johnston Constr VALUE $ 19n0s0 ' AP. No. LOTF1RE ZONE DESCRIPTION OF WORK 34 TRACT 29 59 Enlarge rumpus rm, • r 'uP r TYPE V ZONE 'J), PLAN NO. 6°A3 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel /4- L —11-5_, Floor System Steel Reinforce Chimney Re-Rod Bond Beam ,.m Frame and Flashing CC 7-� ,> Lathing, In Out g"--E—P. 7 -,f--C y Plaster, brown coat 44.-y p-S. R -res Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank • Prop. Swr. Line House Con. St. Swr. Sprinkling System • Heating Final I ging Fixtures, Final E. . Gas Test Construction Pole Underground Power Rough Wiring 1:X7 7._7 L :it f1: Soli MATO oI‘,/ (—I—311 6,6_953" Fixtures, Final —)-�Jr' -1 OCCUPANCY 73T j- ,_scnc 6883 Form 210-5M-1-57 • • 6883 r=hE REC IVSD COSTA MESA BUILDING DEPARTMENT P.O.BOX 317 �o }% COSTA MESA. CALIFORNIA F'/VQICC nF T FOR APPLICANT TO FILL IN��� APPLICATION' �FfORSI�ENtMMIT ABUILDING DDRESS SA ` 7 y 4E-7 chi-2:� .Tr BUILDING COSTA MESA. CALIFORNIA FOR FOR OFFICE USE ONLY F/� !b _ / JC 04. RECEI T NO //AT S U .45 OWNER r d ILJ CIYryQ ADDRESS r7 BY �T/0 4T//Sss0 Er 4/1c2 �/1 / v TEL. BUILDING -J 7 _ �j "�7�t CITY ��/ -/f[, ,`/�f—' NO. ! ADDRESS OC/ pC '3 OR ARCHITECT 'I / 10' irViL COSTA MESA. CALIFORNIA OR HITICT ��� C. Vit.- FIRE ADD ZONE CONTRACTA //,r C NC 8)-9# ZONE j7 NPO.OF TYPE / GROUP oaf_ • O'(/ ,��� A�'i TEL. APPRO D ADDRESS 7V 3 . BY re' ATE LEGAL LOT [/l J'') �/( CORRECTIONS DESCRIPTION NO. 4,1 BLOCK BLOCK / TRa 7J - • A.P.NO. / f / 3.' �o J APPROVED SIZE OF LOT ii[6 e, 13c j,2jac- INOWONLOTS USE OF ldPArr.P CITY -, ST a MESA EXISTING BLDG. G/ V5-9— HL=.I�1:r SIG DEt•1'. SETBACK LINE FROM 5' p REAR YARD SUBJECT TO DG. DEPT. REG. CENTER OF STREET �J L� SIDE YARD RIGHT LEFT `` ��ff��////�� DESCRIPTION OF WORK BY 01/ca— DATE �'� r/IIII' FFFFFFLAN TcQ iCtj NEW ALTERATION _ II ADDITION REPA MOVING DEMOLISH BUILDING NO.OF . SIZE ROOMS STORIES EXTERIOR WALLC //��ROOF ��nn / COVERING V �(r(�(/COVERING wV• USE OF NEW& // i� ^s-e BUILDING • ,/ (�JG I HEREBY ACKNO -E TN' 1'NAVE READ THIS APPLICATION A O STATE THAT THE ABOVE IS C•'REC AND GREE TO COMP WITH A L CITY ORDINANCES AND STAT W. REG • CONSTRUC• TION. VALUATION SIGNATURE OF -y //• i /� / ��/ CO PERMIT FEE $ Q Q -' • PERMITTEE — )feC_ PLAN CHECK $�• AUTHORIZED AGENT TOTAL FEE $ n.... ' �Gi� OWNER F. R. JOHNSTON DATE 7-2-58 ._ JOB ADDRESS 278 E. 23rd Street BUILDING PERMIT NO. 7096 GENERAL CONTRACTOR OwnerVALUE $ 100.00 11b10-91 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Grape Stake Fence ',UP TYPE ZONE PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing 8./&/6 7 -.24•S Lathing, In Out Plaster, brown coat Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System • Heating Final 1 'ling Fixtures, Final . F..._, Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final OCCUPANCY • 4.- $. £{ 7 • ) 947 Form 210.-5M-1-57 7096 OWNER J:r7.n..rSTnis r R_ DATE 9-15-58 JOB ADDRESS 2711 Fast 23rd Street • BUILDING PERMIT NO. 72h9 GENERAL CONTRACTOR .rchnstnR Constr. VALUE $ 1.1108.00A49LLOT 34 TRACT 2959 FIRE ZONE DESCRIPTION OF WORK rarpnrt r UP j TYPE V ZONE F PLAN NO. 79119 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED rrrrff '' DATE NUMBER Trenches 1— rms Steel s.R 7/2.!IjST: Floor System 1J ' Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing � /VVzo/,x Lathing, In Out • Plaster, brown coat Underground soil WIG Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating Final f ing Fixtures, Final A.__. Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final -OCCUPANCY • i'1_ I/'&ij r/yq 'Form 210-5M-1-57 V / 7249 7249 ' EE RECEIVED S3- i-6-8 v ---- COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN {�] APPLICATION FOR PERMIT BUILDING 27� J 2 3 /J/// �' BUILDING ADDRESS ` C/./.. /..COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. Mrt OWNER ... �� /' a� • i � MAIL /� RECEIVED BY ;FE RECEIVED TE` Sfr ADDRESS �I/r- //yy //57- tenn rL {///yy �J GVJ����/,f/ 2 CITY l a, �XJA TI O.�/�U 79 ADD EISS /�7(1 •V ^ �J ARCHITECT GINE LIC. COSTA!OSMESA. CALIFORNIA OR I TER NO. FIRE ADD.._dS /� /)�// ZOyNSE / / Ti,.as g f/ ZDI j .OF PLOANS 7 TYPE / GROUP CONTRACTOR C, _� C o 1 1K� 'c{, TEL. hQ APPROVED ADDRESS �� f c/ NO. / U J� BY DATE LEGAL LOT 3 DESCRIPTION NO. BLOCK TRAC ' /V CO ION A.P. NO. //e/gy-0 I a, I ;'L 7 �,. a SIZE ��(�LLL ri„.„, NO.OF BLDcs. d7 �` Oh COSTA MESASF LOT (SVYI NOW oN LDTPIH NNiNC DEPT. ESE of n SUBJEC�• BLDG. DEPT. R ' EXISTING BLDG. • SETBACK LINE FROM CENTER OF STREET _CO REAR YARD + • , am(! y/\ S BY PLAN TECH. DAT 1 J SIDE YARD RIGHT LEFT , DESCRIPTION OF WORKa. c4'} / 1 NEW ALTERATION ADDITION REPA,.. MOVING Ip DEMOLISH BUILDING / Y/ NO.OF IM (�YYII�� //R�OOMS /��S��T/OJ�R,I/ES/-�„/ T� �/ / /� .///.�. CO EXTERIOR a 9 //_�/„'�3A�OF -!-4/Nt ... V ab C a4Aat / USE ERIN M1M1 CC�TTT�C/UCCOVERING /' / (� USE OF NEW r • I//-1V//Yor Ld BUI DING (( 1 -Lk If HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND S - ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL y6Y ITY ORDINANCES AND STATE L W' RE • ;CIL•ING CONSTRUC- TION. VALUATION 7- Z t- y, SIGNATURE OF /i��! , ,. 4 PERMIT FEE S d PERMITTEE / //6 /.- PLAN CHECK S C// $ AUTHORIZED AGENT I TOTAL FEE S / `_-- SMT