HomeMy WebLinkAbout222 20TH ST - Building Permits v I
PROJECT ADDRESS: 222 E 20TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06776E
- ---UWNER'sNAME: LANGE, HERTA P
ADDRESS: 222 E ' 20TH ST PERMIT NO: E 067766 PLAN CHECK NO: N GOVT: N SUPP; N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE; OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ALUMINUM PATIO ENCLOSURE, ICBG # 4383 SQ FT;
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
PERMITTEE: MC CURRY, DALLAS H GEN CO ( 714 ) 672-7271
ADDRESS: 29665 JURA CT COMMENTS ; REF; B-67765
MENIFEE CA 92584 *************** ********-******************************************x*x**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 mmencing with Section Z ON ING REQUIR EMENTS
7000)of Division 3 of the Business and Professions Code,and my rise is in full force and effect.
CITY LIC.: 0//5754/ STATE LIC.: 475246 /),5: P; Q9/95 S E T B A C K S
Date: C ( C Signature: C % ��� �— MAIN BUILDING ACCESSORY BUILDING
1 BKERS'CO PENSA ION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
POLICY NO.: 0710204-93 EXP.DATE: 08/01 /94
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 42620109 ZNE: REF NO:
'❑ Certified copy i
�/errehy urnished. G Certified copy is Tiled wthi1Iee//ity B�wtdin Di/visi PLANNING NOTES>
r. e: * k/ 5)e Applicant: ..1:1? Y�_.-- **##*####*#*1e*###*#####***##*********##*##***#**#****#**#*########*###********#
TION POM WORKERS'COMPENSATION DECLARATION: (This section need)not be competed ifthe permit is for one hundred(5100)or less). D EVEL OP MEN T SERVICES REQUIREMENTS
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. ZONING APPROVED BY ,
• DATE;
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: - ^A, DATE:
which this permit is issued lsectian 3097.Civ.C). ##*####***##*#*#*##### #le###***## x ;x>r ,. 5
LENDER: ****************************#***************************************** ;*****M **
ADDRESS: LEGALIZATION:N FEE SUMMARY STRUCTURAL SEGMENT: N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3 75
repair any structure:prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • 50% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit suDlects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 3 , 75 15 . 00 0 . 00 18 . 75 18 . 75 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.It,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 18 . 75 OVER/SHORT; 00
• for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 18 . 75
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law).l am aware **#**###*###******####*******#****#*+E****#*#****#iE****1f*******#**************#*
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDO W N
❑ I am exempt under Section: B.8 P.C.
tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner: ELE 1 FIXTURES, LIGHTING 1 ST 20 EA. . 75 75
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 3 R EC E P T/OUTLET 1 ST 20 EA, . 75 2 . 25
25534 and that 1 or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residentlal construction applications are exempt from ELE 1 RECEPT/S14ITCH END 10 STF 20 20$ EA, , 75 , 75
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the abovInformation is correct.I agree to comply with all qty-and county
ordinances and state WS re aging to budding construction and hereb th tire represent tines�oo tt�his city to enter u thea e•menlioned
property or insp tun poses.
i//%`"' �
ale L Signature/ r4�/ w�w01 00162980 00162980 TOT 13.75
e's2icenseorsocial$ecumya: DATE: 06/28/94 TIME: 10:20
1641-46 Whine—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL ._ SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # - Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. 57. APPROVAL TO COVER.GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit
21. Ducts,in Structure - 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding •
77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric [� -9c 9&c-rics: 4 v 044/-
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
•
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date •
SOFBDILDINO: 222 E 20TH ST DMT' CITY OF COSTA MESA — BUILDING PERMIT '"
dNE ElFMlaN:LANGE, UDO T RM NO: B 077506
ADDREss:222 E 20TH ST
COS)A64ESA C6 92627 PERMIT NO: B 077506 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MAIUNO ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: DEM
ARCHITECT OR ENGNEER: UC.NO.: JOB DESCRIPTION : DEMOLISH DETACHED GREEN HOUSE SQ FT:
ARCH.OR ENG.'S ADDRESS: DMT:
CLAIM VALUE: 100 .00 CALC—VALUE: 1 , 000 .00 GROUP OCC : R-3 /
CONTRACTOR'S NAME:
CONTRACTORS MARINO COMMENTS : DEMOLISH DETACHEDGREEN HOUSE
ADDRESS: UC.NO.: ****RE**RE***RER ********RE**RE**IE*3 ********dE********************#*****HEREREREHE*********
UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull kite end effect.
CITY sec.NO.: UC.CLASS: LIC.No.: EXP: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dale: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law lot the
'Slowing reason(Section 7031.5 Business and Professions Code:Any city or county valid requires a penin toconsaud.alter.improve. PARKING REQ: PROV; PARCEL : 42620109 ZNE: REF NO:
oldish,or reps/any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Law]Chapter 9(commencing with Section 7000)of Dirolon 3 of the PLANNING NOTES>
Business and Professions Code]or that he or she b exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permit subjects the applicant to a GM,penalty ofnd more than five hundred dolars]5500fl. iEiEfElflfiflfdEiEiFfEiE3Eif3flfiEifiEi(-jE1EiEiflEiElE#f!#lElEiflkikiEi(itiE#IflEfEiEifdEifiElE#iEiE1E1E1ElE1E1EN-lE1E##)EM-)FiEfE1E1ElE1E)EjE-lEfEiEIEiE
❑ I,as owner of the property or my employees wilt wages as their sole compensation,will do the work,and the Structure is not intended D E V E L O P M E N TS E R V I C E S R E Q U I R E M E N T.., S
or offered for sale(Section 7044,Business and Professions Code:TheContra ora License Law does not apply to an owner of popery Q
who bolds IN improves thereon.and who does such walk himself or herset or through his or her own employees,provided that such 2-
improemena ere net intended or offered tor sale.I,however.the building or improvement is sold within One year of completion.the ZONING APPROVED BY • DATE:
owner-builder will have the burden d proving he or she did not build or improve for the purpose of sale).
erT-
❑ I,as owner of the property.am exclusively contractile with licensed contractors to construct the project(Section 7044.Business and BUILDING APPROVED B Y DATE: %
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who
contracts for such projects with a comrada(s)licensed pursuant to the Contractors Uceree Law).
M- _-_-. « B.B .C..fo
erso$P7044 PthW�ER Dom$ WORK APPLICATION ISSUED BY: DATE:
awn,• ' ..e" Ower: iEiEiEfEiE1EiElE##N-#1EIEiE1EiEiEiFiE#IE1E+E1E##iE3EiE#if#iflf#ii-3t-1E iFiEiE1E#1Eif3fiE1(�EiE1E1E3E##)EjE1EiEiElE9fiE*** `l
'"""�' �'
tomLEGALIZATION:N F E E SUMMARY STRUCTURAL SEGM NT:Y
Ido . -• unify that I am aware of and understand the requirements of California Health and Sdety a Sections 25505,25533,and
25534.and construction
builoingo saidom theArQll/wylna(gementDSeedkcdmWwMnaate wdeeasard eeremprfmrntese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
permit for that
Fmodifiman occupant
ant Quality Managemenrcle t tostomply with d'l applications anaroe requirements
is forr
provaione. PERMIT 34 .75
Dale: Applicant: SM I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of petury one of the following declarations: PLAN 5
0
ISSUE FEE
o I have CodeandMpeaintaina ofthewdwnsenttose bserefor wueenacompensation,as provided for bySedion3700of the Labor BUILDING—DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
coag.for the purfoma edthewokrorwNohmepemneiesand. TOTALS----> 35 . 25 0 . 00 0 . 00 35 . 25 35 . 25 . 00
❑ I have and wit maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this permit S issued.My workers'compensation insurance carver and policy number are:
Carder: REVENUE DIVISION TOTALS--> COLLECTED : 35 . 25 OVER/SHORT: . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed/the permit is for one hundred dollars/Sf00)or less.) 34 . 75 . 50
❑ I canny that in the performance of the work for which this permit is issued.I shall net employ any person in any manner so as to
become subject to the workers'compensation laws of Calilamia,and agree est A I should become subject to the workers' .K..N..)F.*.1f.)E.1E.IE.M..IF*.)E{(-.)f{E.N-**.N-*****.)E*.IE.N..IF{(..ll'•*4Er(..)E.x.*{(-d(.{(.{(..N.ifif..K.i(..lE.)E.lfaE.{p{(..M*.j4.N.%**.**********..N..1E*,N.#****1(.
compensation provisions of Section 3703 of the Labor Code.I shall fonhwnh amply with those provisions. IND IVIDUAL FEE BREAKDOWN
Date: Applicant:
Warning:Failure to secure worker/compensation coverage/s unlawful,end shall subject en employer to criminal penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(Sl00000),In addition to the cost of compensation,damages es provided for in
sallon3706ofthe Laborabor Cod Interest,and arcomeyafees. NO FEES WERE SELECTED FOR THIS PERMIT
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the
performance of the work kr which this permit is issued(Section 3097.Cit.Cl.
LENDER'S NAME:
LENDER'S ADDRESS;
I certify that I have read this application end date that the above information is coned.I agree to comply with all city and county ordinances
and state laws relating to building construction and hereby authorize representatives of this dry to enter upon the above'mentioned property
for inspection purposes.
UDO LANGE
Pr I lop
71:. nJ:u'_''"'-C 0.7r5.?..;.] Toy . -c --
1/ _ / Date: ! G'F! uzs03 ':r .rJ.:r 09:1Y .,n..
Signator: •'er/ir-nt/Ay'icant/Contractor
l
(5151'46 W P) White-Building&Safety;Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING - ,- POC SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
•
3. Electrical Conduit Utility•Undrgrnd.. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
.5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd, • 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final
16, Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing . 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT, REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test .
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System ■.
45. Sound Attenuation
46. Handicap Regulations
47. FI NAL STRUCTURE & BUILDING S 7.16 6644
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 222 E 20TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 068624
OWNER'S NAME: LANGE, HERTA P
ADDRESS: 222 E 20TH ST PERMIT NO: E 068624 PLAN CHECK NO: N GOVT: N SUPP : Y
COSTA MESA,CA 92627
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH
x1( ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ALUMINUM PATIO ENCLOSURE, ICBG # 4383 SQ FT:
• ADDRESS: UNIT:
1It CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE MC CURRY, DALLAS H GEN CO ( 714 ) 672-7271
ADDRESS: 29665 JURA CT COMMENTS: REF: B-67765, UPGRADE METER, RE#B67766
MENIFEE CA 92584 ******�F*rF+FFH+Cx+EaF*x-+Fx-�F+eiE3FrE*****ic-xit**rFyE****ak*************************************FF
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed nder provisions of Chapter 9(commencing with ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my lice n full force and effect. SETBACKS
9
caruc. 15 STATELIC.: 475246 - B
Date signature:—
'�� MAIN BUILDING ACCESSORY BUILDING
WORKERS' OMPENS nON DECLARATION: (hereby affirm Chau haveacendicate of consent to t-insure or. • iicate of workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL : 42620109 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
*******************************************************************************
Date: Applicant DEVELOPMENT SERVICES REQUIREMENTS
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section i•ed not be completed if the permit is foro ••. . ..($100)or less).
I certify that in the.-rformance of the work for which this permit is is .I shall not employ any person i 'mann' o as to become
subject to the W. en's'Co sensation Laws of California. ZONING APPROVED BY DATE:
Date _ L signature: '_ /% �/ BUILDING APPROVED BY : DATE:
NOTICC• If.after king Mi declaration,you should become subject to the Werke: Compensation prs ions of the Labor
•
Code.you must forthwith comply with such provisions or this permit shall be de' ed revoked. LZ I /q
A
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lenthng agency for the performance of the work for APPLICATION ISSUED B Y: . DATE: `J` l_1.
which this permit is issued(Section 3097,Civ.C). *'**'1F**'lE**'!E********.***'*'N'************-*********** *******3F*******'*****************
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 18 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed e0% SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 4 . 50
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500).
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 18 . 50 4 . 50 0 .00 23 . 00 23 . 00 . 00
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 23 .00 OVER/SHORT• . 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sale).
,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 23
0 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ***,*,**,*,***,*,*********,*********,**************************************************
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E B R E AK DOWN
❑ I an,exempt under Section: B.8 P.C.
for this reason TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18 . 50 18 . 50
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. /
Date: Applicant: 01 00166662-00166662 TOT
I hereby certify that I have read this application and state that the a.: 'information is correct.I agree to comply with all city and countyGATE: 08/25/94 TIME: 20.00
ordinances and state laws relating to budding construction and her. orize represent-tines of this ' •x ter upon the above-mentioned 11%2 8
property for ins ection pun' uses. /
n!
Date: U] Signature: '-/� ��
Driver's License or Social Se dry to:
164146 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
Jr N ..
t
CONSTRUCTION AND PLANNING POt.� & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit $ Date, Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5, Steel Reinforcement 56. Rough Plumbing & Pressure Test •
-
6..E1ectrical LIFER Grnd. t. 57. APPROVAL TO COVER-GUNITE
1
7:.Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10, Structural Floor System 61. APPROVAL TO DECK
•
11, Property Sewer Line & House Connection 62. Backwash & Receptor-Final •
•12. Sewer Cap i _ 63. Heater & Vent-Final
13. Roof Drains - 64, Plumbing System - Final
14. Rough Plumbing - ' / 65. Electrical-Final
15. Rough Electrical-Conduit . • 66. Solar System-Final
16. Rough ElectricWiring r 67. Fencing & Access Approval
17. Rough Wiring Sign + 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. •Rough Factory Fireplace - APPROVALS • .Permit
21. Ducts, in Structure , ' ?70. Underground Hydro
22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 OU
21.Gas'Pipe-Rough &Test -- -1 '72. Underground FIuslt
24. Roof Framing _ 73. Undergrnd.Storage Tank 0 Gas 0 Oil
r 25. Roof Sheathing - •' . 74.' Overhead Hydro
26..T-Bar Ceiling (Structural) & &lonocoat i. 75:Dry Chemical i
., 27. Frame and Flashing . 76. Dry Standpipe , , . -
'.28. Lathing & Siding I . •• 77. FIXED SYSTEM FINAL
•
29. Insulation 78:FIRE PREY. FINAL 7,
30. Drywall Nailing i i I HEALTH DEPT. REQUIREMENT
1
31. Plaster Brown Coat • . . 79; FINAL INSPECTION
32. Electrical Power Meter-Final .., 9 80. -FOOD CERTIF[GATE ISSUED '
33. Final Electric1 �� � Notes:
'34. Final Heating.& Air Conditioning . . .
35.-Final Gas Pipe-Test ' '
36. Hood or.Canopy..,
37. Final Factory Fireplace '
38. Final Plumbing - , . -
•
•
39. Water Service-Final '
40. Gas Service-Final _ -
41. Solar Domestic-Final - '
42. Backflow Preventer
43. Backflow Irrigation . I
•
44. Landscape Irrigation System - "
45. Sound Attenuation - - • -
I
46. Handicap Regulations - -
47. FINAL STRUCTURE & BUILDING . `
48. FINAL PLANNING ,
. 49.•Electric Release to Edison I -
50. Gas Release to Southern California Gas Co - t - .
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 222 E 20TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT LPERM NO: B 051'18::
OWNER'S NAME: LANG E, HER 1 A P
ADDRESS: 222 rE 20TH ST PERMIT NO: B 051782 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: 646-4862 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : INSTALL EXT. VINYL SIDING ( ICBO# 3663 ) SQ FT: 4 , 700
PERMITTEE: CLAIM VALUE: 4 , 700 . 00 CALC—VALUE: 4 , 700 . 00 GROUP OCC: R-3 /
ADDRESS: AM 6 (7 ) 4 ) 937-0101
20 N ECKHOFF ST COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME.
**
ORANGE CA 92668 ********* %* * ***# *% *
** * * * **** *x*** E#)c#*###)e####r%*#x###%%###*-;i*#x#•*##%#>E*?4##
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 04 y 126 STATE LIC.:473042C S B
G(
Date: meq/ Signature:— ff. MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' ERNT: FT IN REAR: FT IN FRNT: FT IN REAR: F'i' IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGH T: FT IN
POLICY ND.: RMWC1178824 EXP.DATE: 11 /0 1 /91
COMPANY: NATL UNIOK. FIRE PARKING REQ: PROV: PARCEL: 14131109 ZNE: REF NO:
Certtlied copy is hereby furnished. Certified copy is hlod�vnth thep'ry Bu�il/d�in�g/Divis/ion PLANNINGNOTES>
Dale Applicant: •
•
#%***##%##*Y'%#*####*#kip#######*####iP#**#*3r#9E#?r)F*#%d(###-1r*#kir 3P li ii)c3E*?F i(-%iiX#+X#?^ie 3(#-%f
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed if the permit is for one hundred(5100)or less). DEVEL OPMENT SER VICES REQUIR E M E N TS
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.
ZONING APPROVED BY ,
DATE: 'A.:
Date: Signature:
NOTICE:If,alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: 04-a39 j
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. , - - - —
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for t —���► DAT--
which _
APPLICATION 'ISSUED BY;
which this permit is issued(Section 3097.Civ.C). • ..'�,�,��— .
LENDER: **#**%***##*%***#*#**********# - .#******* :***#***#*#*)E***};#*3'#***********)f***.mak
ADDRESS: LEGAL I'LATION:N F E E S ; M M A R Y STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECT' I C MECHANIC F IRE SMIP/RES GRADING
ISection 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT T 7 2 . 0 0 50
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions 01 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/ —RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 72 . 50 0 . 00 0. 00 72 . 50 72 . 50 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.ll,however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 72 5 0 OVER/SHORT: ,00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/'TOT• GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with anor(s)license pursuant to the Contractors'Slate License Law),l am aware #.k.%*#,)E*%###%r.k,*%,ii.%**)F)f##**)(,#}:}*%x%.*{(-##.1c.%##?i•#*#%•**k.il.*#ii.)E*)E}'.************ .)(.)(.*w:*hh. :**
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. IND I VIDUAL F E E BR E AKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 4700 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 700 . 00
25534 and that I or any future building occupant wilVwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: - Applicant: _.
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county r- r] AO1C ' C
ordinances and state laws relating to building construction and hereby authorize 'presentatives of this el to enter upon the above-mentioned 01 tC62555S7—C' 3S.57U .T :.53
property for inspection purposes. DATE: 04/2../91 TI"c'
1 j .G
�/ �YY g
Date: •7� d.� / / Signature: / sta.. oat - al •
Driver's License or Social Security e:
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING PO%SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # - Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing • 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 5-2-11 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 9Z-11 a'Wuc[
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 222 E 20TH 5T UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06776!
OWNER'S NAME: LANGE, HERTA P
ADDRESS: 222 E 20TH ST PERMIT NO: B 067765 PLAN CHECK NO: 02324-94 L GOVT; N SUPP ; N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION ; ALUMINUM PATIO ENCLOSURE, ZCBO # 4383 SQ FT: 168
ADDRESS: UNIT:
j. PERMITTEE: MC
VALUE: 5, 000 , 00 CALC—VALUE: 6, 216 .00 GROUP OCC: R-3 /
MC CURRY, DALLAS H GEN CO ( 714 ) 672-7271
ADDRESS: 29665 JURA CT COMMENTS: CONST, 168SF ALUMINUM PATIO ENCLOSURE I ,C,B4O # 4383
MENIFEE CA 92584 *******+6***e6*�E*�E�E*�F�r*er�6>t�F+diff ***�L�6***e6�Eer�M**�LeL+t�6#+E�Fe6+F*s6** �6 #***E6**e6**+E**s*+Ett*e6*#
• LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and mj license is in lull force and effect. SETBACKS
CITY LIC.: 0`7154 STATE LIC.: 47'5 24 F// CLASS: B P: 09 /95
�Q dr/iv Signature:lyjlJ// q� ✓f MAIN BUILDING ACCESSORY BUILDING
ORNERS' OMPENSATION DECLARATION: Thereby affirm that have acertificate of consent to sel4i re or certificate of Workers' FRNT; 68 FT 6 IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT; 59 FT IN RGHT: 5 FT 9 IN LEFT: FT IN RGHT: FT IN
POLICY ND.: 0710204-93 EXP. DATE: 08 /01 /94
COMPANY; STATE FUND PARKING REQ: PROV; PARCEL; 42620109 ZNE: R1 REF NO:
❑ Coddled copy is hereby furnished. DI Certified copy is tit 'th the city Building Division PLANNING NOTES> ENCLOSED PATIO TO BE ATT TO EX RES , FT STBK IS SEPARATION,
�C/) fid/,w// / > INCREASES COVERAGE TO APPROX 424 : APPROX 588 OS STILL PROV
Date: o J1 �/� .1 Applicant:d'---`‘4?�` "--��-�--J ********************************************************************il-ieyf********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be mpkted if the permit ii or one hundred(SIDO)or less). DEVELOPMENT SERVICES REQUIREMENTS
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 / 89
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY �!• ' 5 v''` DATE: (� — 2 - EQ
�
Date: Signature: /ter 2
ode.NOTICE:If,after making this declaration,wiShu should seoomi subjectmithe deemed remOensatign provisions of the Labor BUILDING APPROVED BY DATE: y'— $—e�
Cade.you must forthwith comply with such provisions or this permit shall be deemed revoked. �M / 9
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; �-/1'_ DATE: G^ 'Ca-0 ,
• which this permit is issued(Section 3097.Civ.C). **********************************.*.*x******************************-e„e**de*•-*****
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT : Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 90 . 00 6 2
•'i repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 58 . 50
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5510). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 90 . 62 0 . 00 58 . 50 149 . 12 149 . 12 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED : 149 . 12 OVER/SHORT: . 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
• I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 9 0 , 0 0 6 2 5 8 50
L• 7 and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN
o I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date), Owner: SFR 168 RES—PATIO COVER—ENCLOSED PATIO 37 ,006, 216 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534'and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these,' uvisinns.
Date: Applicant:
I hereby certify that I have read this application and state that the above int. ation is correct.I agree to comply .' alt city and county
ordinances and state laws relating to building construction and hereby aut •N' epresentatives r this city to ent' •Li Ile above-mentioned
property forriinnspect,n purpos•s. ��
da: "` �� �' SignaWre: r �/ 01 00162981-00162983 TOT 149.12
driver's License or Social Security#: DATE: 06/28/94 TIME: 10:21
1641-46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
•
CONSTRUCTION AND PLANNING POOL &
APPROVALS Permit# Date Inspector • APPROVALS Permit # - Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection _ 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit • 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Ges ❑Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas C Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric - 7 Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUI LDING /o4tf Li�J,, 4c41
48. FINAL PLANNING
•4
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - ..
51. CERTIFICATE OF OCCUPANCY y ' •
No. Date
3
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\o QUOet,
o e
# c��-1(o5 .
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THIS NUM ER MUST ACC-OMPA
• ALL P.N.,PEZTZOM REQUESTS
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ADDITIONS, C� `E IONS, OR CORRECTIO
BE APPROVED BY THE PLANNING DEPA'TMEN
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1 I PiANNiNG i;EPT.
61➢:JCCi TO BIC:). DEPT. i80 ;
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Applicant to fill in all spaces except those within heavy border Iinet and sign all appropriate declarations.
PERM NO. _ ACT NO. car NO. G
CITY OF COSTA MESA tCONSTRU(jTION P RMIT R p `� UNIT NO. A P sly L.
z6 20 —_ ! zone b 1_
Project Address z�Z C. 2 0�(! Sr. `-'�� o �� Qw�p ' S Main Building: Accessory Building:
Applicant's Wiling��dress S A PIE- TYPE OF CONSTRUCTION LI NEW ADD LI ALTERATION LI REPAIR E 7� �� / / /� Z
Wiling:Tress
❑ CONVERSION ❑ DEMOLISH ❑ OTHER - S FD T Front 9 4 D
Addess•as 2Z2 E. LAI Phone646Rt�'�6 DES RIPTION OF 0-K U E ••F BLDG. = • - . 11 � B Rear ! 1 N
Address E 2o AI 81'f • ► - ,.�'-x.93?�!5" 1, ....1 • � A (D(e� lS {-0AftGf.
Arch/Eng. License No. TYPE OF PERMIT � GRADING NI FOUNDATION A STRUCTURAL C Right S 70/ G
�J LIAddress TENANT ❑ ELECTRICAL 0 PLUMB G ❑ MECHANICAL/ � S Left 4 / 2 /
Contractor's Name ��17 Phone El OTHER L e'At)..�f fl C9‘,..er I Ping. Ref.# Parking Req./Provided Q
. Address(mailing) PROJECT DESCRIPTION SQ. FT. K' fj• OCCUPANCY_ 0. r
y PlanningNotes: i9b 4� I -l- oh -1-Tb P� !1 M
CONSTRUCTION TYPE 7T--M VALUATION$3C 720 • .I•-t�-
City License No. ZONE GRADING CU.YDS- ACRES' ri/,.. la (41'111/ or W(' II ii'Ca S.
LICENSED CONTRACTOR DECLARATION n(� Pc
/T v
I here•- that I am licensed under provisions of Charter • -- clog Remarks: nC / 75 - a /L T c -p< "ft 2' ` •s-D et•tdio a
.s.with section 7•t• : •Ivislon 3 of the Busin - • essions Code,and T
-•Ijcense is in full force an. . . ELECTRICAL \ FEES
[se Class - • se No.
a Signature PLUMBING FEES I Automatic Washer Transformer 0 15-50 KW 3 N
'ORKERS'COMPENSATION DECLARATION _ '• / Construction Pole Sub. 0 50+KW
:reby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink I Showers [vfb talc Z
Workers' Compensation Insurance, or a certified copy thereof (Section f Cooking Unit Meter Cup to 100 amps 3
3800, Lab. C.)-. • Backflow Preventer Service Sink - Me
Policy No. Company - Backflow Irrigation Sewer Cap •
Dishwasher Meter Dover 100 amps
Irrl--'-'-IIIl Certified copy is hereby furnished. Dryers Gas ❑Electric Sub Panel
L 4Certified copy Is filed with the city Building Division. 2 Bathtubs ..4_v kit L. j11.,.? Sewer Connection. • L., — 5 N
Date - Apppcani: ^ ' r
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • Fan Motors 00-1 HP ❑1 X-8
(This section need not be completed if the permit Is for one hundred ($100)or F.A.U. Inc.Solar 09-15 HP ❑16-15+
les5). �
- J Dishwasher Solar Piping -
I certify that-in the performance of the work. '.r hich this permit is Issued,I Fixtures
shaall not employ an person in any man as q become..bject to the prinking Fountains Solar Tank Microwave
Workers' s�yylgn La of Caiiforni / / Device Boxes
Date �r3/ Signature -_4•fit 4 - —� ' Floor Drains Swimming Pool vv/Spa Pole Light
NOTICE:If,after making this declaration, you should roma sub'- ct to the 3 Outlets
Workers'.Compensation provisions of the Labor Code, you mu forthwith Floor Sinks Urinal Range 2-Z6.,
comply with such provisions or this permit shall be deem-d revoked. - ,
CONSTRUCTION LENDING AGENCY Gas Service Outlets p spec" •„ co
I hereby affirm that there is a construction lending agency for the performance Water Closet 8 Switches 9 , 13
of the work for which this permit is issued (Section 3097 Civ. C.) interceptors Water Heater 1 Garbage Disposal Standing Sections Iv'-1, 3 .r
Lender's Name /
Lender's Address ✓ Kitchen Sink r-t�`[� litWater Service 2 N Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION _f
i.hereby affirm that I am exempt from the Contractor's License Law for the Lavatories pe..yA t._t` Auto-Wash CO SU_ .-
:,'P.'•wing reason (Section 7031.5 Business and Professional Code: Any city or f
,s„, 9
'',:` ;ty which requires a permit to construct,alter,Improve,demolish or repair P-Trap LaundryTrays I •.
lstructure, prior to its issuance, also requires the applicant for such permit y
CU�1ile a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ` 1• = •-
Jr,,:z Contractor's License Law(Chapter 9(commencing with Section 7000)of 11
:: ision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee "; E-9-
., CSirefrom and the basis for the alleged exemption- Any violation of Section
1031.5 by any applicant for a permit subjects the applicant to a civil
WRY of not more than five hundred dollars($500). I DEVELOPMENT SERVICES REQUIREMENTS: cr•
�'�I. as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered 1 Zoning Approved By r�s� :g ate
' for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By CI•r' 2 Date .t^�-$\
License Law does not apply to an owner of a property who builds or Improves p < .O -Octthereon, and who does such work himself/herself or through his or her own Application Issued By Y�CF .bate -�—I V V
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ •
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES v _
pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). - BUILDING PERMIT $ '730 ' � SMIP 4 $ 2 . S 7
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK o
tractors to construct the project (Section 7044,Business and Professions Code: $ (5° PERMIT 1
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ti - ISSUANCE $ -
builds or Improves thereon. and who contracts for such oroiects with a con- __ ENERGY P.C. $
tractor(s) license 0ursuant to tne Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHE� 2 % Sr-c '/•
proof of their Worker's Compensation insurance should be provided to me. ELECTRIC ,�}Y�I I�C (� ) GRADING $
❑ I am exempt under Section B. : P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLANIQ;1IC I( If�SpBCLiOftb� MICROFILM $
Date OKIVACS Owner Ss' r Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ 1 I 7 �2
I hereby certify that I have read t i applicati•n and Ate that the above ❑0100,000 BTU 0100,000 BTU la
information is correct. I agree to comply with all city a • county ordinances Oakte CHECK 6�•1a•r--'���
and State laws relating to building construction,and hereby authorize repre-
sentatives of this city t- en er upo•the above-mentioned property for
inspection purposes. D e to 7A \
Signature j'-" - �i - - (j�
Reinspection Fee $15 Issue Fee $ 3 O S Q00;
Drivers' License or SS '� 304••U ,''.J0, TOT •
.
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor �� 1 \\ DATE: 35/ID/1715/ TIME: :'7;p:
�: . � _. .
CONSTRUCTION AND PLAN( ,. 'C h SPA
Date'"r- Inspector Date Inspector
APPROVALS Permit#-7' APPROVALS, Permit#
1. Temporary Electrical Service or Pole 6 ,'f� 'L 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - i 6"�� 53. Steel Reinforcement
3.::Ele'cti'ical Conduit Utility-Undrgrnd. ; 54. Forms - -,i
4.•Electrical Conduit.Undrgrnd. 55. Electrical Bonding ,,•
"/'''
5:I Steel•Reinforce�ent 6--1-qo 6.C4.16e 56. Rough Plumbing & Pressure Test
6. Elec'•tricalUFER/Grnd. t 6,,sgp 'We/ 57. APPROVAL TO COVER-GUNITE ,,f
7. Footings 6_ ft eie, 6,(...v- it 58. Electrical Conduit-Undrgrnd. '.
B:,Foundation dY � � 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. J'
10. Structural Floor System 61. APPROVAL TO DECK - a -
11•.•Property Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sewei Cap - 63. Heater & Vent-Final
13. RoofDrains 64. Plumbing System - Final
,r
14. Rough Plumbing 1 /041 120 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 1.;14,190 Cm_ge. ol
" ' ""ting & Access Approval
17! RoughWNiring Sign 68. APPROVED FOR PLASTERING
18'. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Condjiioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - • APPROVALS Permit# - -
21: Ducts, :Structure .' 70. Underground Hydro
22. Ducts,-Ventilating :' �� 71. Product'Piping 0 Gas 0 Oil
23.,Gas PiPe?ough'<•st '✓ 72. Underground Flush
24: Roof Framing „rig', 73. Undergrnd.Storage Tank O Gas O Oil
25!Roof Sheathing••. ��N,/'y� �j� 74. Overhead Hydro
• (`
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27 Frafiejand Flashing trft(t ( B�/ 76. Dry Standpipe •287 Laihdg&i 'Siding -r Ca \ Qt 77. FIXED SYSTEM FINAL
29. Insulation 1 -- 1\ l4 Of 78. FIRE PREV. FINAL
30. Drywall Nailing ;-t, L k\t" oig HEALTH DEPT. REQUIREMENT
31. Plastep Brown Coat V '' 79. FINAL INSPECTION .
32. Electrical Power Meter-Finale - 80. FOOD CERTIFICATE ISSUED
33. Final Electric f Notes: •
34. Final Heating & Air Conditioning -, . .
35. Final Gas Pipe-Test
u
36. Hood or Canopy v
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final - '
40. Gas-Service-Final
41. Solar Domestic-Final' N... t
-42. Backflow Preventer'- •• 'J -
43. Backflow Irrigation • .
4 ,
44. Landscape Irrigation System 1
45. Sound Attenuation- EXPIRED ♦� anis
46. Handicap-Regulations Income ete Inspections
47. FINAL STRUCTURE & BUILDING Date .. ` t- sig 2/14-
48. Special 1
Requirements Completed J' L'
49. Electric Release to Edison `
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY. • i '1
J
No. Date •
Applicant to fill in all spaces except those within heavy borderilines and sign all appropriate declaratit ns. 69_341& s
CITY OF-COSTVW, ICON RU(jTIO PERMIT BE 3 &cc NO. TRACT NC. k . UNIT NO. AP # £4 "lis -�01 - ect zone at
Project Address FOh/s.a6• fes. `f'YI cT r•-c 5-esa`"�'-^j �V' L •JC S Main Building
�/ Accessory Building:
Applicant's Mailing�A rldr ss / S' rA�fM`E ^� TYPE OF CONSTRUCTION NEW U ADD Li ALTERATION U REPAIR
E '5 f f O
Owner's Name (Ado LA/JQ Phon O! ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 1' Front 1 /�
n� DESCRIPTION OF WORK/USE OF BLDG. /V,Off.�/ 3 GQ r A Rear 1,52 sl N
Address 2 �2 �O!to -St-. C . M. r
IC R' t _ 5" N
Arch/Eng. License No. TYPE • PERMIT . GRADING III FOUNDATION III STRUCTURAL i K / I G
Address --- - Ell TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S- Left (ILL R
//j� ❑ OTHER Ping. Ref.# Parking Req./Provided E
Contractor's Name /•,J Phone 222.4 OCCUPANCY �� / ySQf 1) /l QQ.i M
PROJECT DESCRIPTION SQ. FT. Planning-Notes:Notes: 1 / 3
Address(mailing) 9 T
CON ST RUCTION TYPE VALUATION 59 � �� r-O �t�,s ' �n^ ,-
City License No. C L *�`-x-c�7` - 1-/'l.L.l.f•`A
ZONE - - GRADING CU.VDS. ^r•orcl Dl �. - S.
LICENS • CONTRACTOR DECLARATION / y, n �y „d 2.{, ��l
I hereby aftir I am licensed under provisions of Cha - : •mmencing , Remarks: pct` $s$Lt L pc g(. to . - L-bp( / WUl I , l�(.U(�l-•t--U�-c'f r J
CFy
with section 7000) o • • •2 3 of the Bush.- . • •rofessions Code,and e
my license is in full force and effe -_ • j TRICAL FEES
sense Class - License r —
te - Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
ORKERS'COMPENSATION DECLARATION Construction Pole Sub. ❑ 50+KW
e eby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers
/ orkers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter pup to 100 amps
380 , Lab. C.) Dishwasher Meter ❑over 100 amps
Poli y No. Company Backflow Irrigation Sewer Cap
• 8 ertified copy is hereby furnished.- r —
s• `_ Dryers ❑Gas ❑Electric Sub Panel
ertifietl copy is filed with the city Building Division. Bathtubs Sewer Connection
Dat Applicant Fan Motors 00-1 HP ❑1'/h-8
EX MPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors —
-
(Thissection need not be completed if the permit is for one hundred($100) or. - Dishwasher Solar Piping F.A.U. Inc.Solar ❑9.15 HP ❑16-15+
les -
I certify that in the performance of-the wor f which this mit is issued,I p g r Fixtures Microwave
shall not employ an person In any ma as fe bec subject to the Drinking Fountains Solar Tank
Worker L enp n Laws of Califor / y�gme§/_ "/J Device Boxes Pole Light
Date • 1� f) Signature /d�� swr� Floor Drains Swimming Pool w/Spa , r
NOTICE: If,after making this declaration, you shout become ject to the s Outlets Range '�
Workers' Compensation provisions of the Labor Code, you m t forthwith Floor Sinks Urinal -
comply with such provisions or this permit shall be deemed revoked. _
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Clo set 3. Switches Sign • Z 'l
I hereby affirm that there is a construction lending age cy for the performance 1
of the work for which this permit is issue Section 3097 Civ. C.) " Garbage Disposal Standing Sections
Lender's Name Interceptors Water Heater
Lender's Address - Kitchen Sink Water Service Generator ❑0-5 KW 05.15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - -
Sowing
reason (Section 7031.5 Business and Professional Code: Any city or
my which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Tracts
structure, prior to its issuance, also requires the applicant for such permit ,
ile a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
Contractor's License Law (Chapter 9 (commencing with Section 7000) of
ision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
refrom 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
penpIty of not more than five hundred dollars($500). - DEVELOPMENT SERVICES REQUIREMEN rx1�/
CTI, as owner of the property or my employees with wages as their sole Reinspection Fee ` $15 Issue Fee $ 3 l !'.� 5 iS/v"
compensation, will do the work, and the structure Is not Intended or offered Zoning-Approved By �7 M Data
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By t•7 n •- \ Date T_�-Q,q
License Law dues not apply to an owner 01 a property who builds or improves _
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ Application Issued By �Sh Dat
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES
Diction, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). - BUILDING PERMIT $ /.� • DO SMIP $ s 7 9'
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System _ PLAN CHECK $ PERMIT
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $'
builds or improves thereon.and who contracts for such oroiects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation Insurance should be provided to me. aY
❑ I am exempt under Section B.& P C.for this reason Firepl/Fact.BIt. ICBG dk Fire Dampers ELECTRICAL $ 2 I - GRADING $
,,,(�, ' PLAN CHECK 50% $ MICROFILM $
Date ‘S /�,�' / Owner .I• �. Heating System& Ducting Registers MECHANICAL ' $ TOTAL FEE $ 14'hy
I herebycertifythat—I have read th application 2nd state/ at the above ❑0.100,000 BTU ❑ioo,000 BTU PLAN CHECK 25%
Information is correct. I agree to comply with all city and c• my ordinances - $
and state laws relating to building construction,and hereby authorize repffr$$o11ff- F,
sentatives of this cl /o enter upon a above-mentioned property f
Inspection purposes(/�y/ /' •a' (�
Signature 6/ (xA (�/ Date b.�O. 2l 1
Reinspection Fee' $15 Issue Fee $ 3 l� 37 • , -
Drivers' License or 55Q/ -/ `J, 01 00O3 X02-09D3a303 L G' ,
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor U��Ft Q.����4y Tlli�: 1�':^h•
CONSTRUCTION AND PLANNI SPA
APPROVALS Permit# Date - Inspector APPROVALS Permit# Date Inspector
-
:1. Temporary Electrical Serv;ce or Pole 52. Pool & Equipment-Location - '
2. Soil Pipe-Undrgrnd. ; 53. Steel Reinforcement
{ •
Electrical Conduit Utility-UAdrgrrid. .- 54. Forms
ty!.Electrical Conduit!Undrgrnd.l 1 55. Electrical Bonding
5.1Steel Reinforcement • 56. Rough Plumbing & Pressure Test . •
6. Electrical OF ER Grnd. li 7 9'I,�-- 57. APPROVAL TO COVER-GUNITE
7::.Footings 1- CTS-C-
. is,,
S 58. Electrical Conduit-Undrgrnd.
8.'.Foundation (7 59. Gas Pipe, 0 Undrgrnd., Test
•
9>„Water Pipe-Undrgrnd. •
60. Backwash Lines, P-Trap, 0 Undrgrnd.
10r Structural Floor System A t0 ts5 e ii, 61. APPROVAL TO DECK
/
11: Property Sewer Line & House Connection r ! 62. Backwash & Receptor-Final
• 12. Sewer Cap 'I • 63. Heater& Vent-Final
13.,Roof Drains I 64. Plumbing System - Final
14. 'Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16'. Rough Electric Wiring /p/f749 "C 67. Fencing & Access Approval
17. Rough Willing Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceilirig 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
` , A
21. Ducts, in Structure r" 70. Underground Hydro
22. Ducts, Ventilating �' r' 71. Product Piping 0 Gas 0 Oil
23.'Gas Pipe-Rough & Test •- 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing _ 4/f l$i P � 74. Overhead Hydro
J 26. T-Bar{Ceiling (Structural) &,Monocoat ( (( 75. Dry Chemical
27. Frame and Flashing i 76. Dry Standpipe
ii
28. Lathing& Siding /y/4 All 77. FIXED SYSTEM FINAL
29. Insulation //��� 78. FIRE PREV. FINAL
1,
30. Drywall Nailing � /a /!// HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' ' • 1,17/t5
• (%Q f- 79. FINAL INSPECTION
32. Electrical Power Meter=Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric : ;, Notes: /////2 /F-7 i/
� E5�my
34. Final Heating & Air Conditioning 17, / `O K G-b Gyia-ft
35. Final Gas Pipe-Test I I
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final ,
41. Solar Domestic-Final
42. Backflow Preventer ' :,
•
43. Backflow Irrigation ;
•
44. Landscape Irrigation System
45. Sound Attenuation -
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING tict
--4 P-'t-
48. Special Requirements Completed �O� l9�‘v6 L49. Electric Release to Edison
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Date ,
OWNER • Lr,g. _7;. DATE - - •
JOB ADDRESS 222 F. 20th Strpat BUILDING PERMIT NO. 32f,9
GENERAL CONTRACTOR (lyric.=, "Thr.. VALUE $ 253.00
AP118-100-07
L�.. BLOCK TRACT Block Wall
GROUP .T TYPE t7TT ZONE Rh FIRE DISTRICT 9309
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench �� -/7-
Foundation Forms and Grade to Garage
++��
Rough Framing v �" 7 '.S-3-d G J9-ZU Arc"
Plumbing,Rough to Slab
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heating,Rough
Heating,Final
Sewer, House Sewer,St.
''c Tank or Cesspool
L ng, In Out
Plastering
Plumbing,Final,Fixtures Complete _ +'
Plumbing,Final Gas Test <
Wiring,Final /
Occupancy ':.2 2-4-1
FORM 210 3M 10.55 269
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 3l7 3302 BUILDING I
COSTA MESA, CALIFORNIA
NoonFOR OFFICE USE ONLY
FOR APPLICANT TOFOR BuildinAIN Receipt No. Permit No.
Address -al + � 9
C. �d .
Costa Mesa, California Rec iv by Date Rec'd. Date Issued
Nearest // if I 17— 3 ''S-611-3—C6)
Cross St. O' Ya VUG �7 Building I
Owner A IM'i Ste nter Address `o '
Mail Costa Mesa, California
Address �, 0' /3„,.... 3L/ Nearest
City (-()1/e5 /11-92,3No..li 4-I..a7 Zone`/ Mans Type Group
Architect or Lie. r
Engineer No. Approved
by Date
-(dress CORRECTIONS
City Lie.
_..ntractor 61AflJti No.
Address
Legal I Lot I I
Description No. Block I Tract
(Attach Metes and Bounds)A�_//t/Lyf— 0 7
tt�r No.o dg0 7 '
Size of Lot 9O't 3 0'a INow on BlLots `� v -,;Th 11V`-���
O
Use of No.of No.of . 1 .r.,jib a
Existing Bldg. 1114 I Families Rooms_ a 4,
Setback Line from i Rear Yard , �,� Z
Center of Street �� Side Yard .c/21: y
DESCRIPTION OF WORK -
New I X I Alteration I I Addition I _ . --
Repair I I Moving I I Demolish I Gill Or 1.;te-1,1 ,i
Building No.of
_Size Rooms Stories
,.rior Wall I Roof —
iering Covering APPROVALS
Use of New
Building Foundation Location Inspector Date
/_ Forms,Materials,
/3/oc/dA4 It X6 )(1 y .{ Under-Pinning
Nall-. 4.ft hqk third 3i.— 7ef/ le«.y FrBraci glrBoltsps,
I hereby acknowledge that I have read this ApplicatiO4
and state that the above is corre d agree to comply Lath. Int.
with all City Ordinan and ate Laws regulating
building construe Lath.Ext
Signature of
Permittee . CJ�rL Plaster, Int
Authorized Agt Plaster,Ext
Valuation Permit Fee $ ocn — Masonry Reinforced
Plan Check $ Bond Beam
$ ave Total
Fee $ FINAL
cnou>ne n.1" n P.a 5.
,,.
a
c Stu
J
a
0
o`
'ti
cosrr
h• /1
•
01_4 Street
PLOT PLAN
Show location and distances from
property line and between buildings.
OWNER SPENCER, ALBERT DATE 7-30-56
JOB ADDRESS 222 E. 20th Street BUILDING PERMIT NO. {3396
GENERAL CONTRACTOR Owner Bldr. VALUE $ 2lt0.00
1......f BLOCK BLOCK TRACT Block Wall
GROUP J TYPE I ZONE FIRE DISTRICT 3)436
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench 7 3D
Foundation Forms and Grade to Garage •
41116
Rough Framing
Plumbing,Rough to Slab I
Plumbing, Rough Complete Mg
Temporary Pole ..l'
p
Wiring, Rough tl i Te
Heating,Rough v,
Heating, Final f<7
Sewer, House Sewer,St. J`
" 'tic Tank or Cesspool t
ling, In Out 'Ii
Plastering M
Plumbing,Final,Fixtures Complete
Plumbing, Final Gas Test
Wiring,Final ‘
�r am
Occupancy 19j
, / I 3396
FORM ala 3M 10-53
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box3!7 3436 BUILDING
- ' COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
• FOR APPLICANT TO FILL IN 1 Receipt No. 1 Permit No.
Building (y
Address 2(2--.2... .E_• .)-0 t -Att.,/• 33,6
Costa Mesa, California Rec/e�ivzed,byy Date Recd. Date Issued
Nearest ylt • - !7 7— 30 —c"-& / -30 4 Co
Cross St. x0— `h— ®Ya HS,-Q_ Building
y.— J Address
Owner �}�Jje S�QNCYY•
Mall Costa Mesa, California
Address /,D.j10 3a/ (222. L:---., "1„,tug.) Nearest
�,.�[.d r Tel. Cross St.
City 750.5 Mesa No..4-, 1-#221 Zone I No.of I Type Group(1
Architect or Lic. Plans 4y/
Engineer No. Approved
by Qate
"•idress-.infractorAP i- nn" S .
-.infractor 014/%%e V' Noy Lic.,
Address 2 Bove • CITY OF COSTA MESA
Legal I Lot • I I PLANNING LMPT.
Description No. Block //I Tract :,UOJLCI TO CLOG. 01:11T. RCC.
• (Attach Metes and Bounds) ,4p /! k—/47,- 07
No.of Bldgs. UA 1 t 7 ?-n—S—‘,
Size of Lot,t9•ikX330 I Now on Lot .7 PLati r brrl 0
Use of No.of No.of z/ 9
Existing Bldg. 24-v1.1,5 Families 7 Rooms''T5^1 _ 5
Setback Line from -1 I1., Rear Yard r-14* -:` 1 Y '� i I s . .., Z
Center of Street / Side Yard / •t I I) 1 \ \ ; ) ' y
DESCRIPTION OF WORK _ __- . =- r
New I X I Alteration I I Addition I !1
Repair I I Moving I I Demolish I
Bath/Mr
Bleat will No.of n /�! c� 1 t� 1
Size 4' X 7r Rooms Stories CITE( I I�r { .7 1 V f 1 . ;-.1/9
I erior Wall • I Roof — _ . . -
tering Covering APPROVALS
BU- /ajar //€ W, .At' 4 x • ' Foundation Location Inspector • Date
r� Forms,Materials,
4 X4 XI4 bloke Under-Pinning
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 Sta ws regulating
building construction. Lath.Ext.
Signature of //
Permittee G ••-C/( Plaster, Int.
Authorized Agt. Plaster,Ext.
Valuation Permit Fee $ oz --- 1 Masonry Reinforced
$ 9(
7 V/�— Plan Check$
Total Bond Beam
- i' Fee $ --- I FINAL
`r0RM 204 10.55 O. P.4 S.
llna-trr q • sir
,•
d•'
etCew+eM ! •3 fI p I k c
it.‘,
krlJAPPROVED
CITY OF COSTA MESA
. • y ----- -, PL'\N.I<li;G DEPT.
SUBJECT TO BLDG. DEPT, KEG.
MOO,4
TO 74" 'Sri P/ • DATE-7-3D s > '
_142r
•
•
f.17t Street Jx •� c• ,�
PLOT PLAN
Show location and distances from
property line and between buildings.
,
. • ,. % . .t i - Y\ -..
. 040. an( 411
UWNCK TANGR ruetAv -- - - IIAIC 36461
JOB ADDRESS 222 East 20th street- - BUILDING PERMIT NO. •pril 11, 197;
GENERAL CONTRACTOR Owner—builder DESCRIPTION of WORK Legalize patio cover & binrkwa
SAP No. 118-101-1B LOT 213 TRACT Nit. Ht��RE ZONE VALUE $ 600.00
LI 7.CTIONS Signature Date GROUP TYPE ZONE Rl
SUBCONTRACTOR PERMITS ISSUED
JGAS Date Number Signature
Ct WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. n
?SPRINKLING SYSTEM
MISCELLANEOUS
CROUGH HEATING AND AIR CONDITIONING
\1*TEMPORARY SERVICE OR POLE
\C UNDERGROUND n POWER El
'�ROUGH WIRING Heating and Vent.
TRENCHES n FORMS ❑ STEEL REINF.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
H' IG. VENT., REFRIG. AND A.C., FINAL
PL ♦ING, FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL _ -^ g /74
1 C/ r6-7'
•-
36461
Pr:..
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• COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant
APPLICATION FOR BUILDING PERMIT
to Fill in Completely
��(( ll R CERVBY D TE RECEIVED DATE ISSUED
BUILDING ADDRESS47D.c. E Jo t/1 St 0 1.b-I 1! �Il."J�1t--13
/'� ( c (/ /C) x PER 3OL+b i
OWNER atis7Av LAZY Cy(_ A.P.NO. J
MAIL ��II �r ++// BUILDING 22�J 1�' 2^--�-�t .-r-
ADDRESS °Acca E. ., 2a7% sr
ADDRESS 222 C zc
z . `,J p/ry N£ui`d2T "02
0 U CITY Corr A MESA TNE01_..‘
q qq(�(„ TRACT flys. LOT7.23 BLOCK
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Q CONSTRUCTION NEW ADD ALTFR REPAIR MOVING DEMOLISH
O-N LENDER
am
_ID BRANCH
OWNER COS—rev LAN CC-
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ADDRESS t� / �/q, /J/f {..n-r,-
J-03 03 OR ENGINEER Cw"I�11=/c-.. TOL. USE Iz� t7✓K-LG`d.LC /4..�Cd LUE yy�(
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FIRE
WCC ADDRESS ZONE ��� TYPE GROUP
a Lynr� I APPROVED a-/i"-7,
J O CONTRACTOR G �/ N El+_! [( / /4 PJ/ BY 00-2X61.•
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CO 2 p Lo -(�c Com.
:IX ADDRESS E/7
W w TEL. ZONE/f NO.OF OI USIF NEW
O= CITY NO. /� l/ PLANS�'� BUILDING e4/4-4-/-----
Z H
- O STATE CITY YARDS APPROVED YARDS APPROVED
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to cc LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
J O (FROM C/L STREET)
SIZENO.OF BLDGS. �r/]
OF LOT I NOW ON LOT FRONT FT. �fr`� FT.
USE OF �r.�,�
EXISTING BLDG. B..$IDE FT. t/ / / FT.
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. 0 FT.
< EXTERIOR WALL ROOF /} LL� .
III
COVERING COVERING REAR FT. �✓ v T.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
n MAIN BLDGS. ACCESS.BLDGS.
Q6 f ()n f a' !1 /1 // VAR.# DATE
0
.`/'1"{ry.L_%^/C. /a {K�'U r Leh - C.U.P.# s/� APPROVVEyD/ ^j
N3o < Z C01J-e1/ _ay ROVEDG/„ yy// DATE/^-•J�,
o - Lea4 ize /���
UI hereby acknowledge shall 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 a
F any person in violation of the workman's compensation laws of
(!_f/ m
CO the State of California. /� b
I 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 5
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: d
LC
am exempt from the provisions of the State of California Business
and Professions Code, ivision 3,Chapter 9. VALUATION L O a m
t PERMIT FEE $ (N
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E
(�
Signature of []
•
_te
Permittee ..X. �� 4247Q---�4247Q--- $ 6 PLAN CHECK $ E
O
Authorized Agent 45.--e.--;—:' .
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••• TOTAL FEE $
/ OWNER LANGE, GUSTAV DATE u-9-77
JOB ADDRESS 222 East 20th Street BUILDING PERMIT NO. 44987
GENERAL CONTRACTOR San Juan Pools DESCRIPTION of WORK Private Swim Pool w/spn
No.118-101-18 LOT TRACT FIRE ZONE VALUE $ 7,000.00
..,PECTIONS
Signature 1 Date GROUP V TYPE J ZONE $-1
.� Pool Location _ RG /Z')'71 SUBCONTRACTOR PERMITS ISS TED
i Dote I Number
3 k -" Signature
Forms
•Main Drain •
--"C c1
Steel Reinforce
Elec. Bond Electrics^, nn,n7�
Approval to Cover •
V Ai. /1-7-71 4 J lin ti-9-99 96.1°[t
Underground Electric rt"P &c 12-2-2? 6/- . L(�l.,ni ja�'77 �,�
Gas Piping Test CG /7...5.77 Plumbing •
Filtering System Lines AC /Z'7-77 i_/l � /11-77 q 7 31
Backwash Lines and Recep. %I .2-6-)7 73/7a
Electrical Final _ 1
Heater and Vent Final CANCEL.
er System Final Fencwsh and Recep. FinalI t/ /FencinggFinal o _
4498 Nov -9-77m00 423+ ****60,50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only QSS
�-1�1 ij RECEIVED BY DATE RECEIVED / �ElLCsr
U
FASUDIDLRDEISNSG a2OC GD �>�sT,
TOWNER G U5774-0 L_A-NGE A.P.NO.// j/ �NG P-1 /'/W—�! V Pc
MAIL ADDBUILRESS S %2 C C . 2Or i. S_�
ADDRESS F�f] �n
TEL. AA wreR.7 v!D
CITY NO. 17,ALTER
TRACT LOTeri BLOCK
CONSTRUCTION NEW IREPAIR (MOVING f)FMOLISH
LENDER
BRANCH
OWNER GL :-----4_ • / ��
S :-----4w `i ost '
ADDRESS
VALUE
ARCHITECT TEL. 4 $
OR ENGINEER NO
FIRErr
ADDRESS ZONE T PE i GROUP,
I�� CVA-A./
'/CONTRACTOR %S/CT7C.
�02S BY 4` DATE II� (�9 — 7
ADDRESS /760 pieAt St✓/?
,t�L TEL./-�� �O ZONE/2 PLANS BUILDING NO.OF USE OF E`W
CITY 7� //s'G� NO.e7 Y/J-<7 D1 / .2_ F�
rfir
E• STATE �y CITU VAROS APPROVED YARDS APPROVED
LIC.No. 3x3 9a S LIC.N(� 3J MAIN BUILDING ACCESSORY BUILDING
ral SIZE NO.OF BL (FROM/C5/"` STREET)4—
A. OF LOT NOW ON LOT FRONTJd a. "-LSM Se ref.
Q USE OF (214,
1-1U) EXISTING BLDG. R.SITIF h FT FT.
',
Separate permits are required for L.SIDE /l ('F'A5��(// FT.
aF.
electric,plumbing and heating work. REAR re ,v FT.
Al USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
MAIN BLDGS. ACCESS BLOCS. -
+/A 5T4LLA-77t / e A /.2 X3o VAR.# DATE
C.U.P.s+ APPROVED VED
APPROV
/1 -2-27
n' n7
>. ,tigeazAs ,0000, DATE
..1
C.
W
a.O
I hereby acknowledge that I have read this application and state 'n
84 that the above information is correct and agree to comply with
m
gl• all laws regulating building construction, and I shall not employ i
Z any parson in violation of the workman's compensation laws of E
SSW the State of California.
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. H
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: _
am exempt from the provisions of the State of California Business to
VALUATION n e
PERMIT FEE $
and Profess' s Code,Division 3,Chapter 9. •LSO ,n
m
Signature, �/ PLAN CHECK $ AO 00 c
/�/// //�.(s/.{) C
2
Permlt'tee �. ! $ �C 'A> TAX $ ..LD o
` / U
Authorize Agent ! TOTAL PAID $ 4.74(D_