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Home My WebLink About262 22ND ST - Building Permits a i t 4co "ftsq CITY OF COSTA MESA Y v,� A BUILDING DIVISION PERMIT NUMBER 1-' "`-'!" ' DEVELOPMENT SERVICES DEPARTMENT °, �; PERMIT B99-01918 (714)754-5273 •• Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 262 22ND ST Status: ISSUED Suite: Applied: 12/2/1999 Vicinity: HOUSE&ATTACHED GARAGE Issued: 12/2/1999 Parcel Number: 42608115 Zoning: Applicant: SKIRZYNSKI, JOHN Address: 10782 S.MEADS AV ISSUED BY: / Yv1./�— Phone: (714)771-0118 ORANGE,CA Zip: 92869 Owner: CHILA, GREG K Address 374 SUMMERWOOD DR Phone: FREMONT,CA Zip: 94536 Contractor: SHARP ROOFING Address: 10782 S.MEADS AV Phone: (714)771-0118 ORANGE,CA Zip: 92869 License: 571575 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(32 SO). INSTALL 1-LAYER OF 30#FELT UNDERLAYMENT&30 YEAR GAF COMPOSITION SHINGLES OVER EXISTING LAYER OF 20 YEAR COMPOSITION SHINGLES. 'SUBJECT TO PRE-ROOF INSPECTION. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 53,500.00 Permit: $97.25 Claim Valuation: $3,500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. 1 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. [SI, I have and will maintain workers' nsation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.ss My workers' rhpeensatig0.Ip5urance mer and policy number are: a35- 000777 - (5 Carrier �I�•li.-�` �1��`�1 Policy Number: (This section need not be completed it the permit is valued: •ne hundred dollars($100)or less.) O I certify that in the pertoce of I e rk for w his permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws .f Cali ia,an.a. thasY1 ... • .ecorne subject to the workers'compensation provisions of Section 37p0 of{he Labor Code,I shall forthwith comply with these • visi• / /// S Applicant Signature: Date: /2- 2 9 / WARNING:FAILURE TO SE• RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(SI•.,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 provissgs of eater 9 mmencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is In full force and effect.Lic.# ' 7 7 Class# C/- 3 7 Contractor's Signature: 0 Date: )2!7-7 5 • 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 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(5500).): 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: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person Is required to descend,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 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,ora 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 0N (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 apernit 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 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 WIII 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"ye?,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 Califomia 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 s-te laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly or inspe on purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 4! / ?I 4r eJf Legal Owner(s) ^ l2 `c,Date M L 11 And/Or Authorized Applicant Date BODE I INSPECTION TYPE 2DIE INTITIALS CODE I INSPECTION TYPE ME JNTTTIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final208 Final Plumbing _ 200 Final Re-Roof /7-7 f f 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 2448-46 fillMLA'MIS/flUVIIIINIJ "' " .1-1-/Cl/ (G h JOB ADDRESS 262 E.22ND St. • BUILDING PERMIT NO. 35666 GENERAL CONTRACTOR Owner.Builder DESCRIPTION of WORK Res. w/att Gar. N AP No. 118-161-02 LOT TRACT FIRE ZONE . VALUE $ 27,000.00 4IN CTIONS Signature Date GROUP T ,STYPE V ZONE R-7 Sol_ l 5ta2-73 SUBCONTRACTOR PERMITS ISSueD GAS Date I Number Signature WATERaq^/js/.-W-- , PIum41 ROUGH PLUMBING SL/-6/ 3f� /�' `• /� ( ami PROP. SWR. LINE ROUSE CON. 44-5-4C4-7--73 Sof (/ / �/]- 4?..R / SPRINKLING SYSTEM /✓/-j j'2.Z.'73 / �J/B,/ - � f2 _/S /3hX MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING I27y52.-.2-7 TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ y ROUGH WIRING / j [• ". y He. in• and Vent. � TRENCHES FORMS ��n� G •- r / a_..� �L ,.��7�tt i FLOOR SYSTEM ......41t - 2-1 BOND BEAM 0 STEEL REINFORCE fl SHEATHING 4 a 0 -y/-7 FRAME AND FLASHING '`-_ O / LATHING — IN n _____ W��L"r"r'..l -'rl? PLASTER, BROWN COAT JSWt C"-F— 11 STP_'zTURAL, FINAL ppp ch C HB!�'-��y�r"y�rpp��n��'�3, VENT., REFRIG. AND A.C., FINAL in Y9- ./.f,4. /. a��"1��3��.q.� PLlfS ING, FINAL AND GAS TEST MI a 'x7_3 ELECTRIC, FINAL a�Ie�r'L!>�r BUILDING, FINAL ,�% a. C - SPECIAL REQUIREMENTS / Kle 5-6 Gh /�} %� / COSTA MESA BUILDING-SAFETY DEPARTMENT " ' " I - 00v"" P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely - .. - -� / -1 sr RECEIVED BY DATE RECEIVED DATE ISSUED BUILOING �/ ADDRESS ov-& — 2>'i-41h s . //--,2-/-7 //-�-I - - /iio��R� PERMIT NO. OWNER A.P.NO.BUILNG // �-1 MAIL ADDRE S ea 6, O._ --P-/tiD 1/. Z ADDRESS O.W W NEL.0 CITY NO. TRACT I ' LOT BLOCK W I- CONSTRUCTION NEW ADD IALTFR I REPAIR (MOVING DFMfI ISH O N LENDER J 7 BRANCH /44A:71/07-add-g_. J fn OWNER Q W ADDRESS �J 2 CO CO ARCHITECT TEL. USE R4 if1,44Tl D$2-7�� J N OR ENGINEER NO. U Q FIRE W K ADDRESS ZONE TYPE GROUP O. 41 W 2 APPROVED J O CONTRACTOR BY DATE co Z J ir ADDRESS W lL TEL. ZONE NO.OF USE OF NEW 0= CITY NO. _ PLANS BUILDING ZH W0 STATE CITY YARDS APPROVED YARDS APPROVED to m LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D SIZE NO.OF BLDGS IFROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. FL$IOF FL FT. I- SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL ROOF V COVERING COVERING REAR FT. FT. �- J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& O. a MAIN BLDGS. ACCESS.BLOCS. VA DATE O RES, 4 - g-42. C URP,#APPROVED F APPROVED V) ABY DATE Z 0 I— C.) I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ F any person in violation of the workmen's compensation laws of N the State of California. co ZI hereby certify that I am properly licensed as a contractor under SQ.FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • CC am exempt from the provisions of the State of California Business VALUATION '/ and Professions Code,Division 3,Chapter 9. /y �J of PERMIT FEE $ N D Signature ofm Permittee Sc 7erS.p,..Se--SZt.AN CHECK $ .--- E o Authorized Agentr4' 6-0 u. ••• TOTAL FEE S 35666 ':ov –8-7?-0ocms, 282* ****48.89 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE Iv D v P IC TION FOR BUILDING PERMIT For Applicant to Fill in Completely I /if /7414�IVED E /D9/ $ �, ADDRES2Z. .jT OWNER A1-4-11 1.- //4i;r✓r r a/ A.P.NO. //- -/ /-D PERMIT NNNO. MAIL /wA (/O BUILDING .Ifc� � � \'� Z ADDRESS,/,<C l /•-en/-.p yp ADDRESS �E✓PA SOL 00.. U CITY Cori, A e SQ NOui L</c h ) 7) TRACT//eatsrlJj/ LOW47 BLOCK Z z< CONSTRUCTION ADD I ALTER REPAIR MOVING/ nFMOI ISH Z 00.m LENDER _ID BRANCH Aneoperz____- ‹Jto OWNER J ADDRESS r44-'(7040 //��yyzz//ff //nn VALUE /�..{�Jy J m ARCHITECT TE tom._ USE 49/i��CT17,1T' $��°W Q OR ENGINEER T TgMI P»rrt NO�Q�/'7 •_ / W IL ADDRESS ] El Ce?vrlrrin Epe'! Tit Sliss ZONE TYPE ' GROUP /TS a 41 APPROVED / w Z CONTRACTOR ®(1"a/p J— BY DATE J Q CO Z J Q ADDRESS • W w TEL. ZONE_^/ INO.OF /J USE OF NEYreer, L✓//OTJ� O= CITY NO. PLANS pr'-" BUILDING 6'A/�/Pfr�^- Z F cnO STATE CITY YARDS APPROVED YARDS APPROVED cn 2 LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 0 O (FROM C/L STREET) SIZE INO.OF BLOCS. OF LOT 6:5- Y f 27ts- NOW ON LOT •Q- Ni FT. FT. USE OF EXISTING BLDG. - s FT. I-" SIZE OF ,j NO.OF Z NEW BLDG. /LWW Ir ROOMS S STORIES I FT. /--,, < EXTERIOR WALL h/Ooci-I'- ROOF _ COVERING ct-Zr cera I COVERING Wil O, FT. J USE OF BUILDING AND WORK TO BE PERFORMEDDISTANCE BET. BET.MAIN& S BLOCS. ACCESS.BLOCS. a MAIN Q DATE O finU S P APPROVED F s s / In /' DATE// Z O • •l n I' Iql•.b ~ I hereby acknowledge that I have read this application and state �1 FF, I D that the above information is correct and agree to comply with - / TAX EC all laws regulating building construction, and I shall not employ I- any person in violation of the workman's compensation laws of Me State of California. -/)h coN / y (l /'� to ? I hereby certify that I am properly licensed es a contractor under / SO. FT. tel/ o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:a/ et am exempt from the provisions of the State of California Business VALUATION a and Professions Code, Division 3,Chapter 9. `- n �.(, PERMIT FEE $ D Signature of ^ v 979-----.. �//� m Permittee -ti'4-1 L-• \ SO 7a40 PLAN CHECK $ I/ E Authorized Agent u •.. TOTAL FEE $