HomeMy WebLinkAbout213 21ST ST - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _
L ITY OF COSTA MESA CONSTRUCTION PERMITCT LOT 1001 10/26/84 260E0 • 7L
Project Address 1. 1 D-1 91 ea 540- {M ry}
Applicant'sMailingAddresss ,5'4 V..__t TYPE L • • • ALTERATION
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Owner's Name Sic Lit I^ ,61..-eyr&Phone�y�y. ■ • • ■ • •LISH • • A.P.THER # • I Zone
DESCRIPTION OF WORK/USE OF BLDG
Address -2_ I 7/ --2-/ 5-4- C (7‘-.,. • ' - S Main Building: Accessory Building:
•Arch/Eng. License No. • • • FOUNDATION T Front O
Address - El TENANT I ' - AL 0 PLUMBING 111 MECHANICAL B Rear N
Contractor's Name Phone• • OTHER 7 A
e ���� K
C Right N
Address(mailing) • �- ' • O
O( .PROJECT• RUCTI•DESCRIPTIONTYPE :. • �_'Lf-•! �.i • S Left
City License No. ' GRADING• •S. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided
N 'E
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Planning Notes: M
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with section 7000) of Division 391 th Business and Professions Code, and
my license is in full force and effe /1 PT
License Class I �Llcense,No. S
Date Signature • PLUMBING FEES .
WORKERS' COMPENSATION DECLARATION
Bar Sink Showers
'hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
Workers' Compensation. Insurance, or a certified copy thereof (Section Service Sink •
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J00, Lab. C.) Backflow Preventer Automatic Washer Transformer 0 15.50 KW
Policy No. • Company IIIi Construction Pole Sub. 050+KW.
8 Certified copy is hereby furnished. '
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Our.to 100.
Date .Applicant '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONClarifiers Solar Collectors 1Ejt.snlII.I,puL
(This section need not be completed if the permit is for One hundred ($100) orless).' • Solar Piping
I certify that in the performance of the work f0 which this ermit Is Issued, I
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shall not:employ any person In any man r as to be subject to the • Solar Tank ■a ■
Work{ 92.rgnSatLQp yaws of Callfornla{�� �p�gpe
Date/ Ll— 0'( Signature �J ' ^L( t✓per • Swimming Pool w/Spa } ■11 . t4 !■
'NO IC :If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith UrinalFixtures
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY . ,
•• '
- • Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit Is issued (Section 3097. Civ. C.) • Water Heater•
Lender's Name - '
Outlets Range
Lender's Address Kitchen Sink Water Service Switches
OWNER BUILDER DECLARATIONf Sign
1 hereby affirm that I am exempt from the Contractor's License Law for the Auto-Wash - . Garbage
following reason (Section 7031.5 Business and Professional Code: Any city or Disposal
county which requires a permit to-construct,alter,improve,demolish or repair Generator 00-5 ■ 1
any structure, prior to Its Issuance, a requires the applicant for such permit ' ®'�
to file a signed statement that he/she is licensed pursuant to the provisions ofRoof Drains , '
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the Contractor's License Law,(Chapter 9.(commencing with Section 7000)of
Division '3 of the Business and Professions Code) or that he/she Is exempt
^refrom and the,basis for the alleged exemption. Any violation sof Section
31.5 by. any applicant for a permit subjects the applicant_to a civil
natty of not more than five hundred dollars(5500). I II
❑ I, as owner of the property or my employees with wages as their sole Reinsnection Fee •: $15
Compensation, will do the work,and the structure is not intended or offered Reinspection Fee $15 Issue Fee ' $ 3
for sale (Section 7044, Business and Professional Code: The Contractor'sI MECHANICAL - FEES
License Law 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 ownDEVELOPMENT
employees, provided that such Improvements are not intended or offered for Hood Or Type 1 1❑ • ..
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type I I 0ZoniApproved •'
pletion, the owner.will have the burden of proving he/she did not build or im- •- ,
, prove for the purpose of sale). Building Approved By r. :
❑ I, as owner of the property, am exclusively contracting with licensed con- • Refrigeration System =�d ■ •.
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 • ❑0.100,000 BTU 0100,000 BTU
L0F FEES
builds or improves thereon, and who contracts for such;projectswith a con- - - ' - •w,
tractor(s) license pursuant to the Contractor's License,Law). I am aware that ■Exhaust System 0 Multiple 0 System Repair/Alteration I
proof of their'Worker's Compensation Insurance should be provided to me.
❑ I,a_m exempt under Section ' B.&P C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers- , PLAN CHECK 'S PERMIT ,
Date ,�- �a' Owner ' I Heating System& Ducting ' Registers ' -
I hereby'certify that I'have'read this-application and'state-that the above - 001 00:000 BTU 0100,000 BT - --' - 1 - - - - -
information is correct. liagree to comply with all city and county ordinances •
and state laws relating to building constructio and hereby authorize reprePLAN dHECK-
•sentatives of th' city ;to nter upon the ove-mentioned Property�for '
'inspection purp a �z/�
/ Signature s_,/N- j' • Date/ /'T
Drivers' License or SS# - , Reinspection •Fee $15 Issue Fee i $ 3
'CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
ill-ir
CONSTRUCTION AND PLANNING POOL ;PA
Date Inspector Date Inspector
APPROVALS - Permit# �_ APPROVALS Permit
1. Temporary Electrical Service or Pole . . 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. - • 53. Steel Reinforcement i
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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. Footings4 58. -Electrical Conduit-Undrgrnd. - . ••
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8. Foundation , • 59. Gas Pipe, 0 Undrgrnd.,Test •
9. Water Pipe-Undrgrnd. - I 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 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 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 El Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
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24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 0il
25. Roof Sheathing i I - • 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - - X75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding • 77. FIXED SYSTEM FINAL
29. Insulation : ' • i 78. FIRE PREV. FINAL
30. Drywall Nailing 113 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' H 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes:
34. Final Heating.& Air Conditioning i •
35. Final Gas Pipe-Test
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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 • . rr^^
47. FINAL STRUCTURE & BUILDING IFS, Di-
48. Special Requirements Completed (L"
49. Electric Release to Edison ' • .
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date _ .
11
OWNER - LOCKWOOD, JAMES H. I
DATE 3-2-55
JOBADDRESS 213 East 21st Street BUILDING PERMIT NO. 975
GVERALCONTRACTOR Owner-Builder VALUE $ 12,080.00
LLii 243 BLOCK TRACT Np�rt11. H. Tract Residence
• GROUP I TYPE V ZONE Rh 'FIRE DISTRICT 981 `
It
• PERMITS ISSUED + .
INSPECTIONS DATE SUBCONTRACTOR
gr'.-6-4
f �{ _ DATE, NUMBER _ II
Footing Trench c,- .3 -/D j,~ N
Foundation Forms and Grade to Garage _ I i : ' 1
Rough Framing k:---6�- ,.5 " "s s
Plumbing,Rough to Slate:6)9,1 1.2A�Ll 7� t� J l
Plumbing,Rough Complete kiet.3 - ), p`re,�� —e-, ,,,,4„i^�- 3 - 1-c /y- S v
Temporary Pole J, // ,/ q -III
I Iy,�f,
. Wiring, Rough ht/..5 ✓! Y'J c-,'�`vi�t- 21 _,�G .S- I-"C- 9Z/ '•t 17
. Heating,Rough NN L-&Fl
Heating, Final _ \ '',/
Sewer, House Sewer,St. a-o 3 S"� /4r1S S'�O
s- Tank or Cesspool �+,(/ " 1 • a r
L ng, Inx (Duty IgG :27 r _ �1 u _A . I ,
Plastering /r .,'enyr i it
Plumbing,Final,Fixtures Complete -��a�0MrLy_ / c ' , ')
Plumbing,Final Gas Test 7J, rqa aI r� N' )Ii
Wiring,Final A✓, . \ `�VI� _ �/ t , I,
Occupancy v r
Form 210 G-H 1500 1-55 .. \ - / V
_;aMesa Building Deparrlment J/ p APPLICATION FOR PER111 EAST 20th STREETV9p� BUILDING
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ce e t Permit No
Building �J / }� y/0-1-d 7 • `[_ 9.71
Address �[, d ( 7�
Costa Mesa, California Received by Date Re •d.
IS
NeareS
Cross t "9` `�. ck-I-17--/ � S/T
Building
/ _�� Address
Owner-)414E5 141,, e•e u `� r • Costa Mesa, California
Mail !�/i E 2/7 f C- • • Nearest
Address
^ ��^ �//�n Tel.L/_ G,,/,I/p Cross St.
City �- j4r,A- /v1St, No. a Wes Zon No.of Type I Group
Architect or Lic.U/F, t4 I Plans I /./
Engineer n IAN/'ALEt1 NO.4,4 70...,.4 • Approved
by Date
Address E . tent - 1401.4)ol Sr,
E
4 tity Lie. CORRECTIONS
. ..tractor 6 (.T/WE R.-• No. /51/-144
/y/ /�
Address 1-/ 3 EY/'0r ST G//Vc �coa J^t� //' " " \
Legal Lot ,I //1 �� )) L%/�� �
Description I No. 7 3 I Block I ) ►lY Ar 11„
} G
(Attach Metes and Bounds) '1 /,/",r7 /. /'""
No.of Bldgs. /61/147k
�✓� --
Size of Lot I Now on Lot
Use of . No.of No.of Fr' ,� .J_/ 44
Existing Bldg. #f S, p/✓6E. I Families /I Roomer' ��� ���fM"�.l v •/ �N
Setback Line from r Rear Yard/p0 t! G'IIJ� tr
W Y u e
Center of Street .S S Side Yard S'r li
DESCRIPTION/ OF WORK P� ,Qrl/ r
New I V I Alteration . I I Addition I / _ I#.-,
,911- -
Repair I I Moving I I Demolish I FEB 2 5 1955 Z/-8-90.17
Building / ��tt i, No.of
Size �!0 7 Frut f ?oms C Stories / —
•rior Walls em., 1 Roof //// ��� ��
_ ering yfr(�,r.,,-r.( • I Covering S/4i/PYtr
Use of New �q
Building �es/D 4,4� �/1,,n. ' Foundation Location Inspector / Date I)
b"- Forms,Materials,
Under-Pinningme: Fie Stops,
inftFrame: j
Bracing,Bolts
I hereby acknowledge that I have read this Application Lath. Int. / \
and state that the above is correct and agree to comply Lath. Ext. /
with all City 'nances and State Laws regulating
building const c • n. / \, /
Signature of
j /A� Plaster, int. // _/
Permittee V�cit.. Plaster,Ext V F:/x"
Authorized Ag . j/
Masonry Reinforced ./ `/—
Valuation Permit Fee $ 3 p /
•+•f� Q O. Plan Check $ „5-4.J Bond Beam
$ /a"') Total -
Fee $ 3S OQ FINAL f
EL IRM 204 0-1-1 21.1 5-54
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PLOT PLAINT
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JOB ADDRESS 213 East 21st Street L-ouu& I. BUILDING PERMIT NO.3001
GENERAL CONTRACTOR Owner VALUE $ 12 nBn_00
LOT 2/3 BLOCK rRACTNpt-Hgts Residence w/Har(Renewal Permit)
s..,;
G+'itYUP I & J TYPE V ZONE RII FIRE DISTRICT 3038
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE _ NUMBER
Footing Trench
Foundation Forms and Grade to Garage
Rough Framing
Plumbing,Rough to Slab
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
Sewer, House Sewer,St.
Septic Tank or Cesspool'
Lathing, In Out
PI ring
PI_ ging,Final,Fixtures Complete 4.41 G-/-5t
Plumbing,
-/-
Plumbing,Final Gas Test JO a( L -
Wiring,Final 4//L95 "Aft-c.
Occupancy .�n.P/�/•�R'i'
to Mesa Building Department - APPLICATION FOR PLRMIT
11.
P. O. Box 317 3C35 - BUILDING '1
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 1 Receipt No. I Permit No.
BuilAddress 1i/3 e 7 /�.S r 3B 0 I
Costa Mesa, California Received by Date Rec'd. CDate Issued
Nearest ,, ,/ �/ '�� �- AS--S-C, `l-/�-J�
Cross St. /UCLL'i!4 /•Y/ 4--/
Building'
��,t Address
Owner 113 GL-Q&d//,� , X(/z7C4. reri z1
Mail Costa Mesa, California
Address 2...-I 3 f_ 2, / --;-/ TI'� c / L r-/-1 - Nearest
• _ Tel, f Cross St.
City c-t' c0/f , No.[-. p S Zone No.of Type / Group /�
Architect or-/ Lic. _ I Plans ( (
p` �//G[tel No 7// I) Approved elk--
Engineer
/ by Date
Asidress t C-O S r4 me i0 -S"/ CORRECTIONS
//11,,�� City Lic.
•
_.ntractor U"w`Y.QQ/4. No.
Address Y/ / 3 j /n11-.1;-/-, C./t-ii .
Legal Lot 77 11 •�� 77,) ,-.-----..
Description No.,J'( 713 Block Tract iii "`^ \ � I f���
(Attach Metes and Bounds) VHS I Ic.-, N i+' ) Ji
No.of Bldgs. l /J
Size of Lot Now on Lot
Ilse of �� LNo.of I No.of . -'11 I ; !:11313 / y
Existing Bldg./( `�/)�J���,j Families Rooms
Setback Line from Rear Yard �ttj 1-3 -
CenterofStreet S-� Side Yard �i-'
DESCRIPTION OF WORK \ / e!TY OF COSTA 'iESi% q r
New I VI Alteration I I Addition I /r-Builds I I Moving I Demolish I 'Suilding K�r��,3il" Roof /Size `T`/ Rooms Stories p � �� �...ky//1;47rn-A-:-34-)Brier Wal1k� ,�/,PCC9 I Roof �/ I -Ciro �""' `�"Bering J1f `r_/10tt Covering,- 1 APPR, VS
Use of New 1 _/�{..� 6sBuilding I Foundation Location / or - Dat
` - - \Forms,Materials, /
- / ,,,,y Under-Pinning
�n1 /C X Frame: Fire Stops;
C„L,,-�
4,1„..v....-L,
`�� c�r�i B acing,Bolts
I hereby acknowledge that I have read this Application 9 /
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building construction. "w'v� Lath.Ext.
Signature of
Permittee /f11"'O' l Plaster, Int
Authorized Agf Plaster, .
Valuation `,0 �/ ermit Fee $ /S 0 0 my Reinforced
0[ Q ,,,fff ,,,��1, Plan Check$ "� Bond Beam
$/01 /k I , Total n
G� Fee $ /Sc FINAL
FORM 204 1055 O.P.&5. N
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Ci. d, ,w( i „:55a C'r.rt:15,r i
0
Street
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PLOT PLAN
Show location and distances from
property line and between buildings