HomeMy WebLinkAbout226 21ST ST - Building Permits S
sin
M CITY OF COSTA MESA _
;ut BUILDING DIVISION PERMIT NUMBER
1. 1 :."- ' DEVELOPMENT SERVICES DEPARTMENT
PERMIT E99-01050
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 226 21ST ST Status: ISSUED
Suite No Applied: 11/8/1999
Vicinity: AT SIDE OF ATTACHED GARAGE Issued: 11/8/1999
Parcel Nunmber: 42614137
ISSUED BY:
Applicant: MCLAUGHLIN, NEIL C.
Address: 226 21ST STREET
Phone: (949)722-9536
COSTA MESA,CA Zip: 92627
Owner: MCLAUGHLIN, NEIL C.
Address 226 21ST STREET
Phone: (949)722-9536
COSTA MESA,CA Zip: 92627
Contractor: &l,/'ILt 1L,
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
UPGRADE EXISTING ELECTRICAL SERVICE TO 125 AMP.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res. a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(34-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 $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 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 $30.50 1 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 1hp $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 $54.00
Intermed Pole $0.00 0
COMMENTS/SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations.(Ord. No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS na
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less)
❑ I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 o1 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 RNES 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 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#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fore permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
1111 I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.-7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exemP under sec. Business and Professions Code for this reason:
Signature: r Date: //r/FIs
Owner ID v 'tied by driver's li se. ❑Yes 0 No Driver's License No. Expires: OHO 0
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high,(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
..._.-- Management and
Prevention
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management PProgram for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of thispplication a_pPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? I�Yes u No
(Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATIO OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and ' • ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describe roperty for inspection purp• - .I agree not to occupy or allow occupancy of any building authorized by this permit un fin inspection.
Si. -y a Of Legal Owner(s) 66bate
And/Or Authorized Applicant Date
CODE• INSPECTION TYPE PAIL IN1ITIAL@ PODEF INSPECTION TYPE PAU INTRIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing e7 p p
200 Final Re-Roof 210 Final Electrical D /3Qi1- fl NP 2
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
CITY OF COSTA MESA
44w. BUILDING DIVISION
>t ____ Ai i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
Pr
�... PERMIT
B02-00890
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 226 21ST ST Status: ISSUED
Suite: Applied: 06/20/2002
Vicinity: REAR OF RESIDENCE Issued: 06/20/2002
Parcel Number 42614137 . Zoning: - - , •
•
Applicant: ONEIL, AARON ISSUED BY:
Address: 765 S STATE COLLEGE BLVD#1
Phone: (714)871-4165
FULLERTON,CA Zip: 92631
Owner MCLAUGHLIN, NEIL C
Address 226 21ST ST
Phone: (949)722-9536
COSTA MESA,CA Zip: 92627-2126
Contractor: MURDON CORP DBA AMBIANCE ADDITIONS
Address: 765 S STATE COLLEGE BLVD#1
Phone: (714)871-4165
FULLERTON,CA
Zip: 92631 License: 541733
Arch : Eng: •
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
ADD 180 S.F.ICBO#4590P,SCREENED PATIO TO REAR OF EXISTING RESIDENCE.
FEE SUMMARY
Plan Check: $117.81 Calc Valuation: $9,400.00
Permit: $181.25 Claim Valuation: $9,400.00
SMIP Res: $0.00
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $299.06
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or 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
required inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit/
FOR INSPECTIONS CALL: (714)754-5626 �S
244646(WOO)
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.
rhave 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.
y workers'compensation Insurance carrier and policy number are:
Carti` vrar C .Isr.rc..ti .n - n cpoliey NUmberti 071e--ck ^o o-1 1^-t 77
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of C:'•..': d agree that If I should become sir. _- - - - . compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with then..
,Appticant_$jgnature. y IDater a zo -
WARNING:FAILURE TO RE WORKERS'COMPENSATION COVERAGE IS U r, ' • - "t L SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOC ARE(Suwon]).IN AOOMON 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 arlcd Professions Code,and my license Is in full
force•endeffect..uc 3 3 CClass.I_1 i�
Contractor's Sign; /i a Dates t-O a •L
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 Cale).
Lender's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a cMl penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 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 end certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gag at standard temperature end 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 Califomia Health end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and tiling 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 aaermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No
(Section 65850.2 of the California Govemment 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
\ ur el OwnSl{s)� Date
�And/Or Authorized.Appli ca %Date
CODE t INSPECTION TYPE OilE INTRIALS CODE0 INSPECTION TYPE aT.E RIIIDSLa
1616 Fixed System Final Fire Prevention 206 Final Mechanical _
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Well 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 B(/3�/02-• ` ill )
`•y(U MF CITY OF COSTA MESA
BUILDING DIVISION
>:l Ott• l -. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
F 1 � � I PERMIT
o IM E02-00512 •
(714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
•
Job Address: 226 21ST ST Status: ISSUED
Suite No Applied: 06/20/2002
Vicinity: REAR OF PROPERTY Issued: 06/20/2002
Parcel Nunmber: 42614137 • - .
Applicant ONEIL, AARON ISSUED BY:
Address: 765 S STATE COLLEGE BLVD#1
Phone: (714)871-4165
FULLERTON,CA Zip: 92631
Owner: MCLAUGHLIN, NEIL C
Address - 226 21ST ST
Phone: (949)722-9536
COSTA MESA,CA Zip: 92627-2126
Contractor MURDON CORP DBA AMBIANCE ADDITIONS
Address: 765 S STATE COLLEGE BLVD#1
Phone: (714)8714165
FULLERTON,CA Zip: 92631
License: 541733
SCOPE OF PERMIT
ADD 180 S.F.ICBO,SCREENED PATIO TO REAR OF EXISTING RESIDENCE. REF:B02-00890
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $2.20 2 up to 50 kva/kw $0.00 0
Recept Outlets $4.40 4 up to 100 kva/kw $0.00 0
Switches $2.20 2 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 $32.30
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 pe
FOR INSPECTIONS CALL: (714)754-5626 /
•
2446-46(6/00)
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.
�.71efave 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 carder and alley number are:
Card? Oto e1 1•J CA... o n4 ( POIICY'Num_her D3(<w-- 0 zI 75-
(This section need not be completed If the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should•- • - o the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with thes. - •• ions.
cppllcent Sig _ ��� . t1 • - -o - o-L-•
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARS($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 here�rm.lhat.j.am-licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 ef-the.Business andel Professions Code,and my license Is In full
Jor`e and effect:L ic-N-' 3 3 Cla9s u--- bS
Co>tr ctor's.Signature:-. f_ s owe: 4. -
__
CONSTRUCTION LENDING AGENCY: •
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031,5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document.i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 6,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:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be flied with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,ora volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes ID No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). _
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If yes•,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No —
8 (II yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signe• e Of Legal O r(s) Date
_ 20
IAn�Qr • .dzed 14plicaT `—Date-��
CODE r INSPECTION TYPE RASE ECM CODES INSPECTION TYPE PATE a fflALB
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing Q
200 Final Re-Roof 210 Final Electrical 1/18/02 R1,O
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 CITY OF COSTA MESA •
` :`4 �►reilikBUILDING DIVISION
I-r '� : ( DEVELOPMENT SERVICES DEPARTMENT 74. WW411
PE IT NUMBER
PERMIT
,�B99-01399
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 226 21ST ST Status: ISSUED
Suite: Applied: 09/01/1999
Vicinity: Issued: 09/01/1999
Parcel Number: 42614137 Zoning: /'/ .-�_
Applicant: STEVE BURR ISSUED BY: V
Address: 711 WEELO DR -
Phone:'- (714)548-2965. -
COSTA MESA, CA " 7'; - - i Zip: 92626
i.
Owner: OGDEN, EMILY PAULINE TR
Address 106-9TH-ST - • - -
. , i / Phone:
• BALBOA,CA Zip: 92661 - - -A -\
Contractor: ,(STEVE-BURR /
Address: ,711 WEELODR/" , :� �
/ 7/;(-,-7'/' Phone: (714)548-2965
/.: i -
COSTAMESA, CA ,
' Zip: 92626=-/ License: 635586 -
Arch •- • ' Eng: '
Address: / - Address:
%Phone:, .- • - Phone:
. . /
' Zip: License: License:
•• SCOPE OF PERMIT
/
. LEGALIZE FOR A ROOFING PERMIT.TEAR OFF REPLACED ROTTEN WOOD AND INSTALL 30 YEAR COMP ON THE
PITCHED SECTION AND WITH 28LB BASE AND PLY WITH CAP SHEET ON THE FLAT SECTION.
FEE SUMMARY -
Plan Check: $0.00 _ , /"- Calc Valuation: $4,500.00
Permit: , $111.25 Claim Valuation: $4,500.00
• SMIP Res: , - $0.50 - — - 1 % - - ' ,
SMIP Com: $0.00 _ /
Other: $111.25 = -
Inspection. $0.00 • . '
Total:' $223.00 .
•
PLANNING &ZONING
SETBACKS '
MAIN STRUCTURE Front 0-0 ', Rear 0-0 ' Left 0-0 Right 0-0
ACCESSORY Front " 0-0 " " Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0 '
NOTES: • ,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-2192)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days. -
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS
WORKEp,: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.
,h 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 wo '•compensation InsjFance cam r and policy number are: 17/6.
// 4 /
Carrier: be K- Policy Number: O 7 6 5-q
(This section need not be completed it the pe it is valued at one hundred dollars($100)or less.) 1
❑ I certify that in the performan e 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 C.Hoy'a,and t if I should become subject to the workers'compensation provis' ns of Section 3700 of the Labor Code,I shall forthwith
...tura:
SEC �. I �tate:
'CRC�WIL PENALTIES AND FINES UP TO ONE HUNDRED
• G:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT t 'R TO
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES.
LICENSED TRACTORS D LARATION:
1 h: ,•y rm that I am Iicens y�der pr v j TN Chapter 9(commencing with Section 7000)of on 3 of the Business an Pr fesaipD$-bode,and my license is In full
ores a d effect.Lic.b CO 7`j $o Class N C.— S
Contractor's Sign : Dat —7_4'9
CONSTISOIDN LENDING AGENCY:
❑ 1 ereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
enders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 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? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aaermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed Under this permit be within 1000 feet from the outer boundaries of a school? 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
or
ig•- ee Of Le!. • ner(s) iu/ Date
•
And/• Authorized ••licant Dat
CODE I j)SPFCTION TYPE PAIL 1NTRIALS CODES INSPECTION TYPE g1E INTITIALS
1616 Fixed System Final Fire Prevention __ 206 Final Mechanical
1266 Pool Spa Final ct /r 208 Final Plumbing
200 Final Re-Roof 9�l�' /pI tl 210 Final Electrical
201 Final Block/Retaining Wall _ - 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign _ 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-46
THIS PERMIT IS ISSUED .
COl7NTY OF ORANGE SUBJECT TO ANY FEDERAL •
•
BUILDING DEPT. RESTRICTIONS. __5-3
636 No. Broadway Permit No..- -- ..Q
Santa Ana, California Application for Building Permit
Phone: KI 2-6211 AND FOR A
Certificate of Use and Occupancy
1— yC - 4--/
/ /� /� ,�/ /� Date /� G
1. OWNER'S NAME._-,g..CO• �I O ( Al►4 NN 1 .ig, PHONE�:l gA 6 Vg
MAILING ADDRESS.._3 � / E ' �" �`1- �/ CITY_ 4t.
G!: . ' , 0./Va�a
Name _. - Namei(
.-. . -...- ..' '--
(Architect or Engineer) / 4 �(Contr for •
Address Address__3 �L ''•'
e MI
City------------------- -----... -.... ---'---'---- City ele2t
�.
State State 4 If v 3 / / p/(
Lic. No. Phone i Lic. No. !! . Phone 4---yfl T
PROPOSED USE: -. .. - -- -- Y 74-472-
2. JOB LOCATION V )C E_-i,
(House No.) f,/.�N e oft Stree ) ( own or School District)
SW toe ry 4E 7f��
3. LEGAL DESCRIPTION: Lot an... -y - lock Tract
(Metes and Bounds Description— a re rse n f
4. CORNER LOT ( ) INTE Lin I it. )A'1 -THROUGH LOT ( ) SLOPE OF LOT ( )�` B�
5. SIZE OF BLDG.:_-Y4-1C_ Q_--__.AREA• r 31,1[JA_SIZE OF LOT:-.-7N.L-_x_1 ...AREA: _7.ree( ./j l
nn /7J'•tn-in O UU
6. HEIGHT OF BLDG • 7---P- CEILING HEIGHT- u �/_ NO. OF STORIES.._ L'U
7. NO. FAMILIES rf" f„ Size of Smallest Bedroom: _1/_ /-1 j Size of Kitchen
d: _>/9.x-..i-L)
8. EXTERIOR WALL CONSTRUCTION• � .f INTERIOR WALL COVERING--J,1x .
(Frame, Stucco, Etc.) „ /t (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard from Center Line of Street Ti-.6 1-/L/�I/� ..---
Nearest
Nearest Side Yard._. ear Yard.- fj ,Distance in Feet Between Bldgs. on Same Lot
...........„
1U. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
/ u /'
11. For (a) Footing: Width I4 Depth in Ground /V - Width of Wall , '1
Accessory /
Bldgs. and (b) Size of Studs: -XX � Spacing /( "CC Material of Floor oenet`."""G
Similar
Structures:
(c) Size of Floor Joists: Spacing "CC
•
(d) Sizriof Rafters: Spacing "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, paint-
ing and sewage disposal $ ol��.?Jtr \
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL
LAWS OF THE CQUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed I_ 44t1At
/ --- (Ow.er)
Plans Filed /- y57- ✓—
By•
(Authori ed Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY
P dee GROUP Bldg. Permit - $ / APPLICATION HEALTH
Plan Check $ J� -_---- TYPE ZONING FIRE
Total - - - $ .4/7.,0,0__
PLANS AND
DIST. MARSHAL
Receipt No. - - -.... .3 J MAP- SPEC'S STATE.
Paid to _ SHEET NO 'Jr CORRECTIONS ENGINEER
Date 1_-_i fr G/ VERIFIED CAL
atMDU tuE
, COUNSP GTORNG
/ i „
DATE..-A1 9 '‘77 Ile% de:'
•F -.. -uTY
5M-7-50 dil
C Y1t--
OWNER HECKER, CLYDE W. AND HALERIE DATE 8/7/59
JOB ADDRESS 226 East 21st St. BUILDING PERMIT NO. 100514
GENERAL CONTRACTOR Owner-builder VALUE $ 5/000•C°
A' 'o. 118-110-23 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Relocate move-inreE
'INrECTIONS A r1z{i DATE I GROUP I & J TYPE V ZONE R14
Underground Soil/y/7% U.G. Water fit, 57.y_44t PERMITS ISSUED
Underground Gas LE.$ 4p SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas -77
Rough Heating -7172-5, /,y�Lc� 1 .-fy_02
Rough Plumbing_k d/q-?-w' oeeV�q- .aC1A.v,,L u� O 1J.6�/S S_
iv
Miscellaneous
_______4fi/A)Ar
£sorrSWf the House Condi-ACSwr. e/?$
Sprinkling System
Heating, Final kb/L/j12:„Q0.-27
Plumbing Fixturesfrr _ _ // I�ti
Final Gas Test r7V/n'-9 _ - /
Construction Pole i 7 -L-I //
Underground Power �� 0.3
Rough Wiring to• e/i .-Jii.,a�,on, f //- it _/c' v ltpf 4I
Trenches/1137i-Formsiold- Steel $-'u-yq 1 �
Floor System ettprrp
Pteel Reinforce Chimney Re-Rod —_P Rcam
5. .king
Frame and FlashingWI
�
Lathing, In Out �' t2
Plaster, brown coat i, 7 VI_
Plumbing Fixtures, Final ,i S`_ _-e_t`
Electric Fixtures, Final n �'
C1 l3
Building, Final � /�-)d .}�� \
OCCUPANCY hC'-c, ( //r-.3-L t,.,22
Form 410-3M-4-59 HELD FOR SPECIAL REQUIREMENTS ....EE d /;—w4,„. 2?_�lUUy11
•
h _ I -1 0054 HOLD FOR SPECIAL REQUIREMENTS
COSTA MESA BUILDING-SAFETY DEPARTMENT _
P.O.BOX 317 COSTA MESA. CALIFORNIA 1
I. �.((
AUG
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT 195g
TYPE OR PRINT I /Iv 11(:1 L DEPT
BUILDING, /1[�
BUILDING J Sri) P'ICCrI
ADDRESS 226 East. 21st Street •1L
COSTA MESA. CALIFORNIA FOR OFF/CE USE ONLY1-1;01-16
•Ulyae u nn lleCKer RECEIPT NO. I .PER � .
OWNER VII Prie A.. Fte('Iee,r / 6-y
MAIL RECEIVED BY DATE R/ECEIVEDp /AT SSSUEDD
ADDRESS 226 East 21st Street ] -v r I a - _7
EL.. y
CITY One ta '1esa TNO 'II 6-2q-1ypILDING
DRESS
ARCHITECT LIC. COSTA MESA. CALIFORNIA
OR INEER None NO. ----
FIRE /
ADDRESS ZONE TYPE I GROUPcjlG
STATE APPROVED
CONTRACTOR Owner LIC.NO. �--- BY L � DATE ��(/
ADDRESS 226 En St. 21 st Ltrp.r.c+t i ZONING
LEGAL LOT 5 1-1:7
+ Ii1 TIONE /I NO.OF I USE OF NEW •
DESCRIPTION-1I NOp. I BLOCK ,1. •• IT ACT (YI/ PLANS /�I BUILDING ,
A.P.NO. 118 J_••s APPROV / /,/�/' tie
L/
¢ • BY // � C/� DATE ee(C-5
SIZE 1 1 NO.OF BLOCS. YARDS V S
OF LOT 1001X71 ]NOW ON LOT 1 REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. Si nrrl e nn it Cl"/ad1 'r "
_ FRONT /41FT. 4 IN. \
SETBACK LINE FROM 931 V\\vvv)
CENTER OR 6TREET REAR YARD 1O 1_ R.SIDE _3 V FT. IN. O ((,,
SIDE YARD I LEFT K I I RIGHT 3Q 1
P. i
L.SIDE FT. IN. b
DESCRIPTION OF WORK / 0
REAR / FT. IN.
NEV If I ALTERATION tt ADDITION ^, N'1 U,77 ryI-
REPAIR A I MOVING I A DEMOLISH , j"•.. ii i C� a-g n
SIZE 1 NO.OF .+ LLL���
SIZE O 6 Sal- fi;- ROOMS y STORIES 1 K) lc 4". „ S 1 y lr
›tl
EXTERIOR WALL ROOF R+>y 1, , 5 I it V 11J A
COVERING ,57;11 enf) COVERING wO Cl Shirt" e FAi
USE OF BUILDING AND WORK TO BE PERFORMED (� ///� rn
Si nn•1P nnit r7wrll5nn (!e".---.112-al
.r� ala - Ii:
�..r�uCst- 14_• -t/ '
ci
reo, stucco & nlaster. sewer A. i „ �ASo; ;�rn .VPD 5/I/
, &utilitz rn
o:1Fume Gonne tons ! r per/
I EBY�ACKKNNt THC O THAT I HAVE READ THIS APPLICATION
AN $ITH ALL A't'THE ORDINANCES
IS CORKER ANO AGREE TO COM- UR OE OF SHOWN UNDER PET T IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PUR E OF ESTABLISHING PE IT FEE ONLY. LA
BUILDING CONSTRUCT] N. VVV
VALUATION
SIGNATURE OF 7__ � /� //( APERMIT FEE $ /�B'E N
. PERMITTEE Z'/ 4V ,�1 _\
/� $6 R.�J a PLAN CHECK $ (/— _'i
AUTHORIZED AGENT / VVV PSP TOTAL FEE S /r o-Y
OWNER BICKERS, Frank DATE 8-2-71 _
JOB ADDRESS 226 E. 21st Street BUILDING PERMIT NO. 33480
ERAL CONTRACTOR R. M. Wilson DESCRIPTION of WORK Screened Patio Cover.
Ar No118-112-05 LOT TRACT FIRE ZONE VALUE $966.00
INSPECTIONS Signature Date GROUP J TYPE ZONE R-1
SOIL SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER U
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS Q STEEL REINF. Q
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
"MING — IN n OUT n
.STER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING. VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL n,/
BUILDING. FINAL .62.-7/717 2-2 •/'/
•
33480
•lIn -z-71Ctis';OO 093 dc.','", :iii ^C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely gEC�E IJV//LE L�D../g/]Y �ff�,TE7REC�E/IVED DATE o ^7
ADDRESS Z., :2,6 5 �/ � i O` " / / I O —.?-ISSUED,
OWNER TY {:ft /. If keYs A.P.NO.//9 //2-n� Pestmir Sir
MAIL
BUILDING £ et /CG_�[,
ADDRESS rV{, yam- ADDRESS oC
a U CITY , 'l?e.` NOtii . --r � 'D TR T /� '� `LO7 C3 BLOCK
2
CONSTRUCTION NEW ADD AL REPAIR (MOVING nFMn16H
z 0. m LENDER
•
,J D BRANCH - //
J 07C• OWNER�A znettlj -e/�d/I�
CO J ADDRESS 1111 LUE / V(D
ARCHITECT r� J /�..� TEL. USF ,C.0 s "'A✓Kf'11.f'1,� $ (0(�
..-1C OR ENGINEER r o A ` 14V ,vim NO.
U W FIRE 'j�./•�
WCC ADDRESS ,I9 ' I ',s ZONE TYPE -Tr-GROUP '`.-
J O CONTRACTOR eg I ISI W 1 1-4
1 S3�eA. 7' BYPROVE /� DATE 7���
m Z /f b'0O do 1- 41.1ty- TZ I �V`
J ADDRESSC -/y/ _ z ///� OF USE OF _
Z F=- CITY ` C/ALlt1 Auk. N�L�(/ I Y•(�OV ZON Fjt44
/ PLANS sa BUILDING 2a Minn)
tEDCITY
wo¢ STATE LIC. NO. / SJ r/' •� LIC,NO. /'V Y•R6M/AIIN BUILDING ACCESSORY BARDS APPROVED YARDS UILDING
U SIZE NO.OF BLOCS. (FROM C/L STqgE�)
OF LOT I NOW ON LOT FRONT FFr' FT.
USE OF
EXISTING BLOG. FL SIDE /2 FL FT.
I- SIZE OF NO.OF -1"Z NEW BLDG. ROOMS STORIES L.SIDE tFT. FT. ,
CaEXTERIOR WALL ROOF
l
_ COVERING COVERING REAR MSFT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 �) J / �. MAIN BLOCS. ACCESS. BLOCS.
CL /GL`4 ( / / DATE
Q C (1W7 vL//4l .iZLC'Y't" C URP.tlt APPROVED --7
0
Akin r —.13YAPPROVED bbb� DATF 2-02- //
Z
'�
0
UI hereby acknowledge that I have read this application and state
D that the above Information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
co the State Of California. /QD ,co
a
I hereby certify that I am properly licensed as a contractor under ��IIo SQ. FT. o
the State Of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 6,
Chapter 9, and that licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from o pr visions of the State of California Business Cr
�jJ VALUATION ad coantl Profession ode, vision 3,Cha ter 9. / PERMIT FEE $/ n
Signature Of l/ /y� �}
.........••••••• •". m
Permittee $y�`� PLAN CHECK $ E
de)Au[horizatl Agent TOTAL FEE $40