HomeMy WebLinkAbout263 22ND ST - Building Permits .
xxif
•L4 CITY OF COSTA MESA
:`a. r. BUILDING DIVISION
l•1 •••••••••...••
•• 4 ) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
7.b• PERMIT
+'"s E99-00279
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 263 22ND ST Status: ISSUED
Suite No Applied: 04/06/1999
Vicinity: Issued: 04/06/1999
Parcel Nunmber: 42615305 n ^ _
ISSUED BY: V
Applicant: BARTLING, DAVID E
Address: 263 E 22ND ST
Phone: 949-642-5976
COSTA MESA,CA Zip: 92627
Owner: BARTLING, DAVID E
Address 263 E 22ND ST
Phone:
COSTA MESA, CA Zip: 92627
Contractor:
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
2 LIGHTS,2 OUTLETS AND 3 SWITCHES,REF B99-00427.
•
FEE SUMMARY
Quantity Quantity
ISSUE FEE $22.00 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 $2.00 2 up to 50 kva/kw $0.00 0
Recept Outlets $2.00 2 up to 100 kva/kw $0.00 0
Switches $3.00 3 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 $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 $29.00
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 permit.
FOR INSPECTIONS CALL: (714)7545626
DECLARATIONS. j, I) �,-„�
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have end 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 it 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 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.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cale).
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(commenting 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 properly 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 co tors 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 purs the o, icense Laws.).
I axe �I 7 :iktr, � D Ll Business and Professions Code for this reason: l
re: it -•=`
:x. 's: # 113:7 fAUO
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(38)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? 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 II 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 0 No
(Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
_-._.m_..beet-frome.._.terboundaesoaschoo?,_.,. , e.._._............ .. ._..._...__........._....._....._._....
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? 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 COMPUANC c D A •. •TON 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 co ••• ' a Yprr laws and ity ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described• •I%/ Ins '•,`uoccupy rpo - .I agree not to or allow occupancy of any building authorized by this peri until final Inspection.
r I/ . rr4SJ) ner(s) 4/ e
And/Or •uthorized Applicant Date
CODE' IN$PFCTION TYPE PIE PIRMLS CODE' g$SPECTION TYPE PAIL 1N11TIAL6
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing •
phi /
200 Final Re-Roof 210 Final Electrical 7 27- !7 .-
•
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
r r
! , 1r-fir CITY OF COSTA MESA
'' _ BUILDING DIVISION
> •" PERMIT NUMBER
;' `^• DEVELOPMENT SERVICES DEPARTMENT
�• '. PERMIT
✓699-00427
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 263 22ND ST Status: ISSUED
Suite: Applied: 03/29/1999
Vicinity: Issued: 04/06/1999
Parcel Nunmber: 42615305 Zoning:
ISSUED BY:
Applicant: BARTLING, DAVID E
Address: 263 E 22ND ST
Phone: 949-642-5976
COSTA MESA,CA Zip: 92627
Owner: BARTLING, DAVID E
Address 263 E 22ND ST
Phone: 949-642-5976
COSTA MESA,CA Zip: 92627
Contractor:
Address:
Phone:
Zip: License:
Arch : Eng:
Address: Address:
Phone: Phone:
Zip License: Zip: License:
SCOPE OF PERMIT
ADD 105 SF TO THE EX. EAST SIDE OF A SF RESIDENCE,CONSISTING OF A 57 SF EXTENSION TO THE EX.
BEDROOM AND A 48 SF ENTRY.
FEE SUMMARY
Plan Check: $97.34 Calc Valuation: $8,557.50
Permit: $149.75 Claim Valuation: $o.00
SMIP Res: $0.86
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $247.95
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 Existinq: 2 Required: 2 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 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. Fd "
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:
Cartier: Policy Number:
(This section need not be completed it 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:
WARMNG:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND OOLLARE($1011,000),IN ADDf ION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.# 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).
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
Bus' 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
iff is the applicant to a civil penalty of not more than five hundred dollars($500).):
40. 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 co rectors 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 pu t t. -l�- ir LicM1e��se� Laws.)
I am exe•, ( A `1 ' o L'1 "'1 Business and Professions Code for this reason:
Signature: /(0///ter — re:.
Owner ID vs'1Ordb driver- fse. at es 0 No Drivers License No. Tres: �fl - O
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-bullder,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? 0 Yes O No
(Section 85850.2 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:
CERTIFIC• • OF 0 - 4 E . ORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.e.greeJr SAPIZ
• �1`y+ll s t: aws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
b:• ••• 4 '.sr- • purposes.I agree not to occupy or allow occupancy of any building authorized by IJI pgr.It until final inspection.
Th
IFf WA"'Na re Of Legal Ow, ) K. Date
And/Or Authorized Applicant Date
CODE IP INSPECTION TYPE PAIS INeLE CODE I INSPECTION TYPE DATE MEALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root 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 r"5/'7 / .4i
q
2446-46
•
OWNER S HOMES, INC. DATE 2-19-62,
-4 lid-St,
JOB ADDRESS • BUILDING PERMIT NO.161439
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 16,746.00
AP No. 118-150-34 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res.w/att.Gar.
1 'ECTIONS Signature DATE GROUP I $, JTYPE V ZONER1
Soil *Ms ?-2-C PERMITS ISSUED
Gas /H,s 3- 9-O'— SUBCONTRACTOR DATE NUMBER
Water 142 44-1 c__3_ -0-2-•
Rough Corn. Being. ❑ Air Cond. 0 '
Rough Heating Ih t,(/ 7-.2-7 -1.-., .0./,,, / ,,.j7i _d
Rough Plumbing A-H S 4-1.41-4y . / `" / -G,-%.
Miscellaneous , /
Prop.Swr.Line louse Corr. p St.Swr. 0 caic ir/w/4 I. 7/ften. >f c *iv
Sprinkling System ,y r ,
Construction Pole + La-PC 7.- L 5-(pLIiii. _,( b?/ ,2=a/_6. - 1 —f�:..I I
Underground 0 Power CI
Rough Wiring / r r!i C,�(L_ -r_a9Qz/ � a 1Jl(l _
Trenches Tr Forms 7(a" Steel Reinf. 0 Kb _
Floor System (j or/ •� -rJ,�V' ✓ f
Bond Beam 0 Steel Reinforce
Sheathing0" ��}��L���� _ `
�— CT
Frame and Flashing �-j f /-j_ Gy gam/ /
Lathing — In ❑ Out ❑ 6 fire-----• -- 4—/f_C y /l
T 1r, brown coat • Me-- ZS —6 Y 6
h.—.g. D Air Cond. 0 Final
Heating, FinalIK
Plumbing Fixtures, Final J �_ Q.t.�+r�.m
Final Gas Test /J, i__e-s/, ,AA7s9!'•, / I_'1'`i 33/
Electric Fixtures, Final / „ SC2 f.fP 11_
Building, Final .d n'A b'
OCCUPANCY f•' 0 ��
cam RIM.FSA — 7.F1 1-r-an l:nP CDP(•'"Ar Dvnrrrocxxcwrmc IAlflO
Fp RECEIVED
FEB 91962
CgSTA MESA BUILDINGS TY DEPARTMENT FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA ME§A
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING
BUILDING
ADDRESS
(, t 2zdSf
COSTA MESA. CALIFORNIA For Office Use Only
STYLELIN_EJIHOMES. INC. I RECEIPT NO. I PIRMITNo.
OWNER /C 9
MAIL I C/ l 7 S T
RECEIVED�BY DAYS C Di DATE ISSUE
ADDRESpIS��/�J `D (. L / ¢ I/` O( EB 1 9 1962
CITY / €LPO x-T I3eG /, ryE y(.31/y BUILDING
� (( 1 2 ADDRESS
ARCT
.i EER 0 l �'(4)l/ILo eLJ rEoM4/e-�1/, COSTA MESA. CALIFORNIAIF (^y/
ADDRESS 7 0 L'JI N)' Ce C/' FIRE
ZONE TYPE GROUP kJ i y}
CONTRACTOR ( 2/A) e { APPROVED
BY DATE
ADDRESS ZONING
CITY ZON 'E —� I PLANSNO. F I BUILDINGUSE OF S 77.-- ti,
•
LIC NO. NO.ATE TEL. LEGAL f� `r/'! 2.--P I( -7-,rNenro
DESCRIPTION
SIZE Q c (( / / 3 t No. OF BLOOD. 6 // s--a — 3 V
OF LOT Q I /J /� 7�J O ( Now oN Lor A.P.NO. /
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM / Iµ,7 (CENTER LINE ST.)
CENTER OF STREET�\/O ' REAR YARD
iii;7\ FRONT J 7--FT. �_ IN.
SIDE YARD ((LEFT . I RIGHT a / R.SIDE FT. IN.
DESCRIPTION OF WORK
A L.SIDE FT. �- IN.
NL I ALTERATION I I ADDITION REAR Z ]FT. ` IN. 0
REPAIR I II MOVING I V DEMOLISH I BYPROVED ed re o DATE T-// ?/`L
BUILDING// / Q.#NO. OF 7 / coed
SIZE /,�O G ROOMS STORIES / HOLD FOR SPR I 1
EXTERIOR WALL -� J ROOF C q R92UIREMENTS
COVERING STC C L/I COVERING s.h �/ e _.4.- �e,„/,9...0 �-
USE OF BUILDING AND WORK TO BE PERFORMED _P
Dig ell 1n y 'i a rYacXP.-/_ .1 /.536 p-
4l- o .� qdO 0
C ay P/ 9 4j a - ""�
I HEREBY ACKNOWLED E THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF �^ /�/�' J // '7/4 PERMIT FEE $ �y�—`
PERMITTEF /! +'/ girl
It $ / !'� / / PLAN CHECK $ // 4
AUTHORIZED AGENT i
�_ TOTAL FEE $ 4
OWNER SHARP, RICHARD DATE 4-14-66
JOB ADDRESS 261 E. 22nd Street BUILDING PERMIT NO. 25592
GENERAL CONTRACTOR Air-Vent DESCRIPTION OF WORK patin Cover
.o.118-152-16 LOT TRACT FIRE ZONE VALUE $ 299 oo
INSPECTIONS Signature Date GROUP ,T TYPE TV ZONE R-J.
Soil PERMITS ISSUED
as SUBCONTRACTOR I Date Number Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line ❑ House Con.0
Sprinkling System
Miscellaneous
QRough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing — In ❑ Out O
er, Brown Coat
._ _,tural, Final Electric
Heating, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final G- �7W r
Building, Final 1,
> P f 25592 CITY OF COSTA MESA
f COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APR Hf/ 1 1966
For Applicant to Fill In Completely APPLICATIONfFOR PERMIT
•TYPE OR PRINT Y`' ' 4; I rvc
e a : k:,
BUILDING t 63e 22. Na
ADDRESS
RECEIPT NO. PE13v92
'5
COSTA MESA. CALIFORNIA G 3I
(� ` R[C[V pA/ D 4D {/1:+6c
MAIL OWNER R\ CA1 i1a d SLARg ADDREIN Ndi
ADDRESS 2. 63 & - 2 Z /
TEL. d ZONE E GROUP
FIRE
CITY N0.�4-(-1619'
APPROVED / yL
( HITECT 1 ?n �� NO BY C DATE /J Ie
ENGINEER /.
ZONING Ij
ADDRESS '.4I'74. N . ✓EQnto..ITj L.•A .
>:PN,[/ I NO.OP I UY[OP N[W
(AAA'
l('f/l) PUN[ UBEOINO erg^'
CONTRACTOR p I CL i4.JT
'1 NEw(62 DT Ne:WrS
I p LEGAL
ADDRESS too 9 S - m no `a.ES Tit- DESCRIPTIO
.Or .2g l' /14�1q o K 4 >A'r $3
CITY A.P.NO. �I . e�- — / / r
�ATE �j NOTE: NO HAVE OVERHANG SHALL BE LESS THAN
LIC..NO. 2 II763 /� „Rots-so-3a
Ro s-so-33CG 80'TO SIDEa REAR P.L.
EAVES
OFLOT'Q_ fc (3 /,J 7i I NO.OF BLD011.
NOW OREATALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. F. D
(FROM C/L STRff
SETBACK LINE FROM FRONT �._.k/ FT.
CENTER OF STREET REAR YARD
SIDE YARD I LEFT I RIGHT R.SIDE £t4�F/'/r. _ FT.
' DESCRIPTION OF WORK L.SIDE .z.;:.z.;:tei FT.
NEW ALTERATION ADDITI N REAR RT. FT.
DISTANCE BET. BET.MAIN&
REPAIR _moving; DHMQLIBH MAIN SLD¢S, ACCESS.BLDGS.
BUILDING I I NO.OF VAR.# DATE
SIZE 13 h �Z_ ROOMS STORIES C.U.P.# / ,, APPROVED// //
EXTERIOR WALL I COVERING ALL•.� APPROVED ! 0 / /// ,. ATE `('r( 7�6 6
COVERING �✓✓V t�Q//4VY
USH qIt BUIL DIN4 AND WORK 2. BE�HSR-RO . ` V 0'
nn !Ei 7`
A 77.4-Lt.v Z t, 3-_ J,
19 G so.FT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT' AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. 713
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m0 D
BUILDING CONSTRUCTION.
O (teaPERMIT FEE $ S
SIGNATURE OF (�
PERMITTEE �.`^^� Gp'y W
* 31 Z PLAN CHECK S
AUTHORIZED AGENT V On Gy\, .._ CO
.. .. ... s.- .. TOTAL FEE IF