HomeMy WebLinkAbout232 21ST ST - Building Permits f.
4;.)
CITY OF COSTA MESA
4 BUILDING DIVISION
s. •:j' ;' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
/B02-00409
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us • 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 232 21ST ST Status: ISSUED
Suite: Applied: 03/25/2002
Vicinity: FRONT YARD Issued: 03/25/2002
Parcel Number: 42614136 Zoning:
Applicant: CATON, JIM ISSUED BY:
Address: 12561 AGNES
Phone: 714-638-2315
GARDEN GROVE ' • Zip: 92841
Owner: HESSE, TYLER J
Address 232 E 21ST ST
Phone: (949)631-8148
COSTA MESA,CA Zip: 92627-2126
Contractor: JIM CATON MASONRY
Address: PO BOX 1288
Phone: (714)638-2315
GARDEN GROVE,CA
Zip: 92642-2315 License: 305339
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CONSTRUCT APPROX.50 FT OF 6 FT HIGH BLOCK WALL ON RT PL PLUS A 12 FT RETURN. BLOCK WALL PER CITY
STANDARD.
• FEE SUMMARY
Plan Check: $31.14 Calc Valuation: $1,240.00
Permit: $47.90 Claim Valuation: $0.00
SMIP Res: $0.00
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $79.04
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 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
2446-48(eroo)
•
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: •
❑ I have nd 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
w or which this permit is issued.
I have and will maintain,vorkers' aeon insu ce,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is`�0Jiss�ued.
My workers'com a ion In r nce ' r and cy number are: ^ a
Carder: i ZZ Policy Number: ey - 0( t3° /
(This section need not e completed if the permit is valued at one hundred dollars($100)tt 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 a e that if I should become subject to the workers'compensation provisions of Secti 3700 of the Labor Code,I shall forthwith
comply with these p /) / 3 �r 5/o Z_
Applicant Signature: L/ '` '1 /yz`�/`2 Date: L
WARNING:FAILURE T EC RE WORKERS'COMPENS TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARS 5100,0001,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed underr9visi h to commencingwith Section 7000)of Division 3 of the Business and Professions Code,rimy lice., In full
force and effect.Lic.# '47U /�/1 Class# y y
Contractor's Signature:/ , ?t J _ / 7� el Date: 4 /Z.C- crL_-
CONSTRUCTION LE ING AGENCY: C'�
❑ 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 wilt have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title B,California Administrative Code).
❑ 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 WIII 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 filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
-
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes 0N
(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? 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 a,aermit for such construction or modification
from the South Coast Air Duality 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 far 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 ❑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 compty 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.
iignature Of y/Owne� r�f ,�j ��Z�0�
And/•✓rrhorized Applicant Date
PODS• INSPECTIONTYPE PATF 110,1$ CODE• INSPECTIONTYPE PATE MALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof .,p'OZ !!z! 210 Final Electrical
• ! Z
201 Final Block/Retaining Wall et A!-� 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
•THIS SKETCH IS FOR INFORMATIONAL PURP066 •SOLID WALLS/FENCES BETWEEN Z-0&6'IN HEIGHT SHALL
ONLY. APPLICANT IS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10 FROM FRONT PROPERTY LINE
AN ACCURATE REPRESENTATION OF THEIR PROPERTY
IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WAILS/FENCES SHALL NOT EXCEED 7 66 IN HEIGHT
wmIT}ff INmRMATION PROVIDED ON THIS SHEET : • Wrflffl4 ia of THE FRONT PROPERTY IRJE(NOT CURB LINE).
•VERIFY DISTANCE FROM CURB TO PROPERLY LINE
AND SHOW ON PLAN. VERIFICATION FROM THECLIY'S
NOTEDI INEDRMG EERING DIVISION IS REQUIRED. CALL(716)7514343
ADDITIONS, DELETIONS, OR CORRECTIONS SHALL
BE APPROVED BY THE PLANNING DIVISION t� 2-bugo�7
--44 b to ct-waft( AP IV ILEntal
PLANNING DIV.
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,t'.r_' rim and epe:,/. MU iT be Ob permit the Division of: i' .
-V'y+:ail a,efgesdeftdaron same WNtloulwlNlen f
to V 'n. Sat „CNN of Costa Masa.
11 st: , ,antes planand 'loess SHALL NOT be he.to.: or to bean+,'rov. iv
Vo s of e3yS'ily of Costa Mes. Ord nance andlor St. a I,
':L m.r1'r�nitKA.rn m-+ten,- null ann void if the MiiIN'r
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... • I U
Wes i1(sle J— '
E STREET
LOCK WALL LAYOUT FOR BUILDING PERMIT
V / 11,cq k i< /( Pralci'6the0c ,iA._ Cawv &S d 4 Kea_-
PLANNING DIVISION
gjyir .
,I i
•
TYPICAL 611 CONCRETE BLOCK FENCE
a
Cement Coping Optional. . I GENERAL- NOTES
Channel Block With 1.3/80 I'�: ■, -- _� I
Horizontal Top of all •
Fences •
H '� MI 11"
MORTAR: One Part Plastic Cement, and
• Three Parts Sand
t GROUT: One Port Cement, Three and
For Fences 5'or Less il MINIM It
I� One Half Ports Sand
Vert.Bars 3/8"¢at 4'-0"O.C. d o COPING:
a = One Port Cement, Three
For Fences Higher Than 5' a x Ports Sand
Vert.Ban 3/8"t8 at 32" O.C. �� z- izi i'Ll ' CONCRETE: Well Mind I:2-1/2: 3-1/2
I a = Mal of 7- 1/2 Gollens of
FIII Cells Solid Wish Grout1'f > z Water Per Sack of Cement
Where Steel Occurs y - ' •Rcminrting Steel Shall �I et
3 s ` GROUT MAYBE POURED FROM TME TOP
Conform to Sec.A•15'39 l u p - OF THE FENCE IN CELLS WHEqE STEEL
A.S.T.M. i OCCURS.
z ~ II �• 'CE LLS ANO AREAS OF HORIZONTAL REIN
1• 881 W n -, FI • I c FORCEMENT SHALL BE CLEAR,CLEAN 6
AllSteel Co he lappedI� �,, _ -24"or to Codei� - FREE OF ALL MORTAR DEBRIS,ETC.
NATURAL GRADE 1'� ' -.� " -
'\, v r l L- i. '.
TWO 7/8"0 BARS O
CONTINUOUS TOP - " y ' • +_ -
6 BOTTOM WIDTHill 10 16. 0 C MAX • '' 1
SEE CHART ' b
HOQILSTEEL MUST BE TIED IN BELOW • • i .: . 01 PTH ( s' CARTHTCOTH
PLACE AT TIME OF TRENCH I/3 THE HEIGTH OF FENCE
INSPECTION. yy 1 'LOW BOTTOM OF FOOTING
-A lo' -.: SCALE: 1/2n :: II
FOOTING REQUIREMENTS CHART 7 . ."
WALL HEIGHT 6' 5 - 41. 31 1
WIDTH • . 14" 14" 12�. 12"
•
THICKNESS 10" . 10" 8 " 8 "
DEPTH OF EARTHTOOTH 24" 20" 16" 12"
SPACING OF EARTHTOOTH 12' 14' , 16' 16'
BUILDING DIVISION
tsl
city of Costa/ Mesv
WALLS, FENCES, AND LANDSCAPING
STANDARDS'AND SPECIFICATIONS
R-1 ZONE:
I
E- • -' 10'
w - - - - - - - - - - - - - -'
2?..; I
$, ' 36" maximum I I + Section A-A
± ' ; wall/fence height I j I
4:4-5,a I I 1
y �r;. w
a w highall/fence line I 6' high 36" maximum
I 9 I
5 r.:r3 t i wall/fence line i wall/fence height
'sr3.. •
I I 1
isti: CORNER LOT '' r, T • • •
35 ft. -�Q, r� m • t.t. ,.,at Lt. C. . . a, �..�1,.� fi ix S c a�
"°in1. - -htr ,ir. 'r`.1: IINNIN9 N{k }}
35 ft. •
25'-27' CURB
STREET
II IJIII I III II 11 Height of walls, fences, and landscaping shall conform with Figure 1 (on reverse side
1 of this hand out) to allow for visibility at intersections and driveways.
NOTE:
• Corner/street cutoffs may be increased or decreased by staff due to street
design/configuration.
• Any walls or fences exceeding the specified height limits require discretionary review and
approval.
• Check with the Building Division for any additional requirements.
R2-MD, R2-HD, & R-3 ZONES:
Walls, fences, and landscaping shall conform to the standards and specifications for the R-1 zone.
Exception: On corner lots, wall and fences in excess of 36" in height shall be set back 5 feet from the
street side property line.
COMMERCIAL/INDUSTRIAL ZONES:
No fence or wall shall obscure the setback landscaping required adjacent to a public right-of-way.
FIGURE 1 ``
4. ".
- 1 J CLEAR FOR
p ._45
�` VISBLITY
b ro 4a r
SECTION A-A
WALL/FENCE
\\ 76 76"
I I I
` x U1t
GRADE
rx
WALL/P, ii /FENCE — m
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INI =AUS
ADOPTED BY RESOLUTION: NO. 01-29 on May 7, 2001
' M CITY OF COSTA MESA
< 9 • BUILDING DIVISION
,,, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
I.t " ' t ' PERMIT
IPIWaa
.%AbioRrini,a�' B01-01752
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 232 21ST ST Status: ISSUED
Suite: Applied: 10/31/2001
Vicinity: HOUSE&ATTACHED GARAGE Issued: 10/31/2001
Parcel Number: 42614136 Zoning:
Applicant: PATOCKA, NICOLE ISSUED BY:
Address: 1653 SUPERIOR AVE
Phone: (949)642-7222
COSTA MESA,CA ' Zip: 92627
Owner: HESSE, TYLER
Address 232 E 21ST ST
Phone: (949)631-8148
• COSTA MESA,CA Zip: 92627
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
Phone: (949)642-7222
COSTA MESA,CA
Zip: 92627 License: 349686
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(26 SO). INSTALL 1 LAYER OF 15#FELT
UNDERLAYMENT&REROOF WITH 25 YEAR DIMENSIONAL SHINGLES,OVER EXISTING ROOFING.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,000.00
Permit: $83.25 Claim Valuation: $3,000.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other $0.00
Inspection: $0.00
Total: $83.75
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
•
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2406.46(WOO)
N
•
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
r oa for which this permit is issued.
Al have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Ins nce carder and policy number are:
-Calder � ACe Lina y (72-67).--6 I LAfl-t cr&d'6
Policy Number:
_(This section need no completed if the permit is valued et one hundred dollars($)00)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 s Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these prov)Gons. _
Applicant Signature:_ LDate:, i�a ',A (-0 t
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(3100000).IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that amlicens d d ovis of Chapter 9(commencing with Section 7000)of Division 3 of the Business end tPyfessions Code,and my license Is in lull
force and effect.Lie.ft ) 'J 1 � Class t C /'Si - hIL
Contredods.Signatuie:- � Date:" - /U -• 2,1-In(
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 pemY
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 properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.704.4,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,end 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 feel 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,faisework,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 e
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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan bo filed with the Costa Mesa Flre Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the Califomla Health and Safely 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 end pressure).
.._ pant— _ _._..r.__...._.._.._.....cutely
3 Docs 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 Safely 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 compiled 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 a ermit for such construction ar modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 31 Yes 31 No
(Section 65850.2 of the California Govemment Cade 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 0 No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code).
_a.._ ._ pollution
_ ..t of t
7 Ifa a permit fromn the-South-Coast l res Qualitycri ed by CaliforniaDistrict or dhSr airteion ooncontrol district3 or agency? is required for the work which is the subject of this
application,have all of the disclosures prescribed by CalifoHealth 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.
ignature Of Legal Owner(s) Date
/S• 1,t1— 31—0
• it•r Authoiizetl"Appllcant / Date
;ODE I INSPECRONTYPE PAM INTRV+L$ ;ODE( PISPECTION TYPE PAIS PALS
1618 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final . 208 Final Plumbing
200 Final Re-Roof ts21-OL ( c4.4/- 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
,5111 CITY OF COSTA MESA
4 BUILDING DIVISION
>y' ..4r DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
r 1 � �� I
4 /A • PERMIT E02-00149
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 232 21ST ST Status: ISSUED
Suite No Applied: 02/25/2002
Vicinity: Issued: 02/25/2002
Parcel Nunmber: 42614136
Applicant: HESSE, TYLER J ISSUED BY:
Address: 232 E 21ST ST
Phone: (949)631-8148
COSTA MESA,CA - Zip: 92627-2126
Owner: HESSE, TYLER J
Address 232 E 21ST ST
Phone: (949)631-8148
COSTA MESA,CA Zip: 92627-2126
Contractor: OWNER BUILDER
Address:
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
PERMIT TO LEGALIZE A SERVICE UPGRADE TO 200 AMP FOR A SINGLE FAMILY RESIDENCE.
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 Flxts $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 App! $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 California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(600)
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 secdon 3700 of the Labor Code,for the performance of the work for which this permit is issrled.
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 should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# Class a
Contractors 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).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a si ed 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
Busines nd 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
ubj the applicant to a civil penalty of not more than five hundred dollars(5500).):
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 exam /L Business and Professions Code for this reason: /��„–�
Owner ID if license. � Date: („`J����_
Owner ID verifietl b dri s license. es 0 No Drivers License No. Expires:
Verification of Ownership by(type of docum nt,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? 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)?-
0 yes
aterials)?❑Yes 0 N
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application rmit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI a,Yes LI 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? 9 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 •m•ly =II state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describe• •r,•• / action purposes.I agree not to occupy or allow occupancy of any building authorized by this per until lin I pectio
Signature Of Legal Owner(s) Dae
And/Or Authorized Applicant Date
EODE t INSPECTION TYPE DAIS D$T91AL$ coDF E INSPECTION TYPE DAIS MALI
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final 208 Final PlumbingI. . z /
i
200 Final Re-Roof 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
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. J- Li I /!i I/ -_o.- • TI
CITY OF COSTA MESA+ ' PE •
• R IT NO./ �, •TRACT NO. LOT NO. .BLDG.NO.
CONSTRUCTION PERMIT ry p,_ �2D .
. Applicant's Mailing Address lea-War �Ctx•' '� t r deq TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION REPAIR -
e 2 3 /C ,�M. A'ti a^ Ct,a 0 CONVERSION ❑ DEMOLISH 0 OTHER
Project Address. ,�QQ
Owner's Named t L/ hone �s+�'ty DESCRIPTION OF WORK ZONING REGULATIONS
Address i52 a'21 -"""JO_ TYPE OF PERMIT U GRADING U %BtJNDATION U STRUCTURAL A.P.3y ZONE
Arch/Eng.., - License No. • - - 0 TENANT 0 ELECTRICAL r41Ap•✓CLUMBING 0 MECHANICAL PLNG. REF.# - - BUILDING '
SFT RACK r(1 ST
❑ OTHER TO BUILDING REAR YARD (TO P/L)
AddressPROPERTVSINE
• Contractor's a Phone `f ^4 ` PROJECT DESCRIPTION SQ. FT. OCCUPANCY
1 LEFT SIDE YARD • RIGHT SIDE YARD '
Address(mailing) - CONSTRUCTION TYPE VALUATION$
ZONE GRADING CU.YDS. ACRFS PKG.SPACE REQ. PROVIDED
License No. __ • -
LICENSED,CONTRACTOR DECLARATION Remarks: • STREET WIDTH PARK FEE S •
-
I I-hereby affirm that-I am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3-of the Business and Professions Code,and SPECIAL CONDITIONS: -
I my license is in full force and effect. - -
' License Class • License No. PLUMBING - .
Date I Signature •- . Bar Sink Sewer Cap - ELECTRICAL
WORKERS'COMPENSATION DECLARATION - -
•
• veby affirm that I have a certificate of consent to selNnsure or a certificate -Backflow Preventer ' • - Sewer Connection -,- - Automatic Washer - - - Meter Driver 100 amps
Norkers' Compensation Insurance, or a certified copy thereof (Section - -
_.UO, Lab. C.) I , • Baikflow Irrigation• Solar Collectors ' Construction Pole , ' Sub Panel
Policy Nb. ' Company • - Cooking Unit Sub Pole
8 Certified copy is hereby furnished. Bathtubs $Olen Piping
Certified copy Is flied with the city Building Division. - Dishwasher - r,' ' Motors ❑0-1 HP 013443
r Clarifiers Solar Tank -
' Date Applicant - - -
' EXEMPTION:FROM WORKERS'COMPENSATION DECLARATION Dishwasher • Swimming Pool w/Spa ' Orye}5 OGas -❑Electric - - Inc.Solar❑9-15 HP ❑16:15+ ' "
-
j (This section need not be completed if the permit Is Ionone hundred (*100).or
less):_ i _ • Fan + + Micro,.rave
I certify,that in the performance of the work for which this permit is issued I Drinking Fountains Urinal - • - - -
• shall' not employ any person In any manner so as td become subject to theF.A.U- I Pole Light
Workers',Compensation Laws of California.. I : Floor Drains ' Water Closet
, Date Cignature - 1 - Fixtures = I Rsn e -
- NOTICE:If,after making this declaration,you should.become subject to the -I- - Floor Sinks . .. - . - Water Heater - .- _ - • -.L- g _ - '
Workers'; Compensation, provisions of the Labor Coda, you must forthwith - - - Device Boxes , '
• comply with such provisions-or this'permit shall he 'deemed revoked: ! `+�II Servic¢ 'Outlets sSLI" Water Seryice Sign +
CONSTRUCTION LENDING AGENCY v Y _ .
1 hereby affirm that there Isla:construction lending agency for the performance + interceptors Outle[s •
! Standing$actions •
+
• of the work for which this permit is issued (Section 3097 Civ: C:1 - -
• Lender's Name - - - Kitchen Sink' •. - , _ ,' Switches jr ash Compactor
•
Lender's Address• t ' ' _ - - - r Garbage Disposal • '
OWNER'BUILDER DECLARATION - Lavatories'-. , , - • . - ,
' I hereby;affirin that I am exempt from the-Contractor's License Law for the , - • - - ,- I Generator 00:5 KW 05-15 KW i '
following reason (Section 7031:5 Business and Professional Code: Any city or P.-TrapI _ - '
-county which requires a permit to construct,alter,improve,demolish or repair • - - Transformer 015.50 KW i '
."any structure, prior to its issuance,also requires te applicant for such permit Roof-Drains - -
to file a signed statement that he/she Is licensed pursuant to the provisions of , ' - 050+ KW Reinspection Fee '
t Contractor's License Law(Chapter 9(commencing with Section 7000)of - ' ' - $15
Ion 3 of,the Business and Professions Code)-or that he/she is exempt Shinn/ere • - . • ' Reinspection Fee $15 •-
'-Ya from-and the basis for the alleged exemption. Any violation of Section •- Meter pup to 100 amps 'Issue Fee $ 3
1 -'•.5 by'any applicant fora permit subjects the applicant to a civil - _
�,,{ #aFelty of not more than five hundred dollars($500). , Service Sink, Issue Fee $ 3 Zoning Approved By Date
Irl/� til, as owner of,the property or my employees with wages as their sole , I MECHANICAL ' •
•
v c666---mpensation' will tlo the work,xnd the structure Is not in[ontled or offered Application Approved By nate •
.�for sale (Section 7044, Business and.Professional Code::The Contractor's , /'
License Law does not apply to'an owner of a property who builds or improves Boiler . • Refrigeration System Application Issued By �' Date / -3/ 3
thereon, and who,doessuchwork himself/herself or through his or her own '
employees, provided that such improvements are not Intended or offered for ❑0.100,000 BTU ❑100,000BTU - i
sale. If, however, the building or-improvement Is sold within one yeanof com- Duct-Under Ground SUMMARY OF FEES
• pinion, the owner will have the burden of proving he/she did not build or im-
DQLove for the purpose of sale). , ; - Duct-Structural System Repair/Alteration BUILDING PERMIT 5' SMIP ' $
LJ I,as Owner of the property,am exclusively contracting with licensed con- • - ,
,-tractors to construct.the project (Section 7044,Business and Professions Code: Duct-Ventilating - ' _ ' ' ' , 'PLAN CHECK, $ ' PERMIT
The Contractor's License Law does not apply to an owner of property who S• QQ ISSUANCE $
, builds or improves thereon,and who contracts for such projects with a con- , Exhaust System 0 Multiple 0 - PLUMBING $�
•
tractor(s) license pursuant to the Contractor's License Law): - + PLAN CHECK $ GRADING $•'
❑ Lam exempt under Section • - B.& P.C.for this reason Firepl/Fact.Bit.ICBO iW + S
�f ELECTRICAL $
' Date �/�'1'1 r :3/'83owner _.J_].a3• —��.,j v�ar'WL ' • ' Heating System&Ducting' _ t MICROFILM $ 1 '
I-he y certify that I have.read this appli tion and state that the above •• - 00.100,000 BTU 0100;000 BTU- - • - - - PLAN CHECK $ ,
' Information Is correct. i agree to comply with all city and county ordinances - .MECHANICALI $ TOTAL FEE ! $,
andstate laws relat'•, to building construction,'and hereby authorize repre- Hood or Type I ❑' - '
•
sentatives of t to en u••n the above-mentioned property for Reinspection Fee $15 LESS '�
Inspection Durp. / t3 Canopy Type II ❑ ash PLAN CHECK. $ I l
Signature /-sat le ' " rte ' Date /- 3!-/g .3. I • I ADVANCEDI PC $
• •
Applicant;Pink-Accounting;Goldenrod-Assessor - - - ' - - - ' - ---- - - - -
•
CONSTRUCTION AND PLANITVJN POOL '4,.
'' Date Inspector Date ,Inspector
• APPROVALS Permit# APPROVALS Permit#
I 1. Terpporary Electrical Service or Pole 52. Pool & Equipment Location
2-. Soil Pipe-Undrgrnd. 53. Steel Reinforcement . .
•
3. Electrical Conduit Utilitv-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-Undrarnd. •
•
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • .
r
9. Wateer 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.E 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 OGas OOil •
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 (Structuralh& 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 j Dias:3
31. Plaster Brown Coat 43'5.070- •d,�gy"
32. Electrical Power Meter-Final
33. Final Electric
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 1J`I`i�
•
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. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
•
51. CERTIFICATE OF OCCUPANCY
No Date
— _ . ..
• 1---__
COSTA MESA BUILDING DEPARTMENT N° 27 B
111 East 20th Street
A
Costa Mesa, California
a- 2 / S-5‘ . 1:
Date /
i
CITY OF COSTA MESA
CERTIFICATE OF OCCUPANCY
Building Permit No Electiical Permit No 4e-Plumbing Permit No /4
Use of Building ' .444ea...-2. •-• —-----
The building located atae-Td-e---5,04.---art {NH-
4
Lot / Block Tract / 7 S-7 .91
(See reverse side for Metes and Bounds)
has been inspected and found to comply with the provisions of all City of Costa Mesa Or-
dinances
.'
applicable thereto for a Group X Occupancy.
rirtel
iSS 0: A. J. VOLZ •
City Bi.i.inOffic
(Owner of Build' ) By
: 0 Original—Owner 0 1st copy—Gas Co. 2nd copy-11;on co. 3rd copy—File
rip2m 2116 C-11 In 12-63
•
ltg 9:s3 7 oa r gn gy.-�u ao in All ill . _ .DATE 6-8-56
' ,x`
°DADDRESS 232 .--24s i C . SEP 2 4 1957 1- BUILDING PERMIT NO. 16.
GENERAL CONTRACTOR Owner-builder VALUE $ 2,832.00
To continue work under Permit #1476 but
L AP 118-011-33 BLOCK TRACT enclose breezeway to den.
GROUP I & J TYPE V ZONE RW FIRE DISTRICT 3192
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
�/ _ DATE NUMBER
Footing Trench ' ' DTVI b—/7�
Foundation Forms and Grade t• Garage'L
Rough Framing t- G If 2(>-.+L
Plumbing,Rough to Slab
Plumbing, Rough Complete h)(°5 Jr//vitt 1100..A.....:4
Y
Temporary Pole nn�'� ((���� ,�/ .
Wiring, Rough Q'�•G't '�{� ;*3. / LC-'-7& 6—/.z-.St as/3 , '
Heating,Rough
Heating,Final
Sewer, House Sewer,St.
Septic Tank or Cesspool
Lg, In Out
Plaaaering ' 3.er j'2, ' 67
Plumbing,Final,Fixtures Complete \M 7/ '
Plumbing,Final Gas Test P5'1 Nty s vii /` N ( ^ a / '27'
Wiring,Final as, Ari ( 5.ey ' . v dou 1
`
Occupancy Tar /n—hi—at
rORM 210 3M 10-55 3160
CX4,5% .<cti-10 , a'- " 41--s„e✓
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 3!7 3192 BUILDING 1111
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
Building /
Address ` _ �_ ,f i /a (,
Costa Mesa, California Received by Date Rec'd.
Date Issued
Nearest /°G4-7) %' 7I �, ‘.--2- (-6,
L
Cross St. fl/J7sj////6722/7 j3j97 Building
Address
Owner /040//4• /? /fj4//L//7
Mail y Costa Mesa, California
Address 7 J 2'nZj�r rr Nearest
Tel. Cross St.
City / . d No. ! /2; Zone / I No.of I Type /,, /�/ Group y
Architect or Lic. Plans
Engineer An /209/[2,/,...orNo. Approved
by Date
Address 0-92 ,t 7/sr tr- CORRECTIONS
...ntractor Ala 37/2/z,(4,7 NoLic.
Address 232 /Z•,-tr sr-- c
Legal I Lot I I
Description No. Block I Tract 4r -
(Attach Metes and Bounds)hen",/,,/,•----#//-77 _ ^t ^_
I, No.of Bldgs. J
Size of Lot 73/y/AQ '1 Now on Lot / } Ij / A.'\ I I 1 I ��
Use ofNo.of No.of I -''1---i _ 1 ,.- ,k1 II I z
Existing Bldg. „errI Families/I Rooms , N�` x- J I)
Setback Line from / Rear Yard -
Center of Street dei Side Yard 2O/6d' .11.i I i •5 Ig� 3 j
DESCRIPTION OF WORK r
New I I Alteration I I Addition I/�1� /'ITV nr nnnvrn nitres 11
VII ! VI l,VOIPl IV!LOtt
Repair I I Moving I I Demolish I
Buildingize ,.5Z /No.ofm A /
Size ooms J Stories
erlor Wall I Roof
.ering inert, I Covering CO4,44 APPROVALS
Use of New "9/711)I �J, Foundation Location Inspector Date
Building 6i9R/90! — jilt", /l/GN
Forms,Materials, \
s�u/rly /2 'in—f IWA, t /VOO.c Under-Pinning r . . .
.—f) - - r yeme�Fj re Sto s i/`" __ - n
Bram
I hereby acknowledge that I have read this Application ��� iP- �/
and state that the above is correct and agree to comply \ 1 d •
with all City Ordinances and State Laws regulating
building construction. Lath.Ext.
Signature of 6't ' -� //'/A-
Permittee ��1./!iC V✓ �Q Plaster, Int
Authorized Agt. Plaster,Ext. �y/�'� �
Valuati-�on 71 4 Permit Fee $ .. / /• a• ry,'einf Z'y��tlir�2��i%
rii// 1 Cn / Plan Check$ Bond Beam
$r / 0 -3/ Total e p O
+- Fee $ FINAL
. 1---,
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.p❑cosTP
a JUN`8'`4I U1fEsA 7.530- r‘::' -di p
•
•
•
Street
PLOT PLAN
Show location and distances from .
property line and between buildings:
OWNER RATTJXR, PAT. R DATE 7-6-55
.JOB ADDRESS 232 E. 21st St. BUILDING PERMIT NO. 1..1476
GENERAL CONTRACTOR Owner-Builder VALUE $ 1,7014.00
- AP #118-011-33
' L. 1 BLOCK TRACT 1759 Garage, hobby 'shop & breezeway
GROUP I TYPE V ZONE Rh FIRE DISTRICT #114314
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench ,$-C--g 7-7---CS
Foundation Forms and Grade to Garage
Rough Framing
S
«
o I _ ! /- f6-S4
Plumbing,Rough to Slab-
'
la . 1
Plumbing,Rough Complete J/,.1y-&A 2 �/i ;G-, _ -( 2 8A<
TemporaryPole ' Il._"G
Wiring,Rough ON)i /' (�/ _ -
Heating, Rough /�,,u{ yn 7___ _/' •
Heating, Final I� J I '//.� ' I N •
Sewer, House Sewer,St.-r
Septic Tank or Cesspool djo
",,`.,.
Out
Plastering
Plumbing,Final,Fixtures Complete
Plumbing, Final Gas Test
Wiring,Final _
Occupancy
1956
Al 2 1956
. .
. Costa Mesa Building DepartmentIUATIUIN FOIL rLltivuT
- 111 EAST 20th STREET BUILDING
COSTA MESA, CALIFORNIA ' rL
bi, ..
FOR OFFICE USE ONLY
'. FOR APPLICANTTOFILL IN Receipt No. Permit No..,
Address .4244 e2%.ai S/ L _ i47
I. Receive by Date Recd. Date Issued
Costa Mesa, California
rc G- /��,3�H % S--S—S
. Nearest
Cross St.1„,,0 27/. n 7 ' .„,/fire- Building 3 _ � — �/ it
' Address Ar
Owner /0/5622 40y,,,/l/` Costa Mesa, California
Mail
' Address 772 .€ 2/4r___57— i Nearest / . ' �j�' �J`''
Tel. Cross St.UJ- / 1.(JS/ C 4 C
City -i J /// J No._ at/ „lc_ Zone No.of I Type—I Group /
Architect or Lic. Plans l
Engineer rn e/f////� No. ' Approve:
by Date
Address 2 2 �2�� SCrr ty Ic CORRECTIONS A.
.itractor /7/1 4:22a2p No. t , >✓
rr
Address i C' J/ '; _.✓'/L 6
Legal Lot r I�f/
Description I No. I Block TracWj} + 1. , r, i-
(Attach Metes and Bounds)gP//R—D//— :7 i It
/�i /q Z No.of Bldgs.
Size of Lot 7.7 X///fi I Now on Lot / T rw
Use of No.of No.of Irow`__ s `i_ . 73
Existing Bldg. /Q�f Families I Room 3
Setback Line from ar Yard I V --� Z
Center of Street co/O Side Yard -9 C ' ` 2.
DESCRIPTION OF WORK JUN 1 6 1955 r
New I I Alteration I Addition Ix CITY COSTA MESA
Repair I I Moving I I Demolish I OF C�
BuildingNo.of
Size 9.1—,2,.V3 irJRooms 2 Stories /
-rior WallRoof
ring JTaCCCI I Covering C'27,0,,t2 APPROVALS
Use of New He
Building t�AR417e S//Q,O tc fef,7fl4�r 4: FoMaterials,undation Location
Forms, Inspector Date
<O”
Under-Pinning ,
Frame: Fire Stops,
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 Ordinances and State Laws regulating :
building constructio
Signature of //n Plaster, Int.
Permitteeii'
Plaster,Ext.
Authorized Agt.
11{aaa,,, Masonry Reinforced _
Valuation Permit Fee $ 9 O a
00 Plan Check$ / Ipa Bond Beam
$ /70.1- -.--- Total
Fee $ 9 0ct FINAL
••-•
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JUN 16-55PDcosrA 148a * **
MESA %r 9.00
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Street �' �'.
PLOT PLAN
Show location and distances from - _
property line and between buildings. ) i •,
.
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fes.
'ON
OWNERAlGard 'Cory i • ";' z_,%`' —
DATE 12/18/53
i 5
JOB ADDRESS .2TjCC r _ lZ'St Street BUILDING PERMIT NO. 6 . ,
GENERAL CONTRACTOR Dike & Colegrove VALUES 8800.00
LOT 1 BLOCK TRACT 1759
s GROUP I TYPE V ZONE R4 FIRE DISTRICT
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
�/� ATE NUMBER
Footing Trench 701„,.• / SL
Foundation Forms and Grade to Garage
� /
Rough Framing I«-/Y 7 ' J
Plumbing, Rough to Slab Yt�'� .CC"' 7-`IC - f! Lido Plumbing 1/4/54 16
Plumbing, Rough Complete j114-1-4G/017
Temporary Pole .. ''22 /IGkl I,}AtJ /2S
Ir Wiring, Rough W.1'f '
fig/ 11 _lel-
.
L
. Heating,Rough `I6 v� "ye-
Heating,Final /4/�J li
Sewer
Septic Tank or Cesspoole
Lathing P�'�/ �j7_,
//f J V
Plastering 4 . c�Plumbing,Final,Fixtures Complete 4)$ '-9Plumbing, Final Gas 5est J Jl, )/e/b 45 `_Wir4ng,FinalY/ y
Occupancy 7 GG r/ u a s 1 3/ a (7
Form 210 GH 1M 12-58
esa Building Department 5 APPLIppCA�TI ION FOOD , PERRI 4
111 EAST 20th STREET _D_V I L..D_�I-NO` ,!!f
COSTA MESA, CALIFORNIA - 'R..; f• '
i FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit:No. ,
Building f `. �c., , C. I
•
Address 237_Taent,Y first Street I i
Costa Mesa, California Re eivedby Date Recd. Dae lss ed 1
Q� DEC 16 L,,,0 ILI/1/•1
Nearest gV} a
Cross st Orange Avenue Bui din i '7�1
Address ; I I ;
Owner Algard Corporation Costa Mesa, California
Mail
Address 490 Bolsa Av. Costa Mesa. Nearest •
Tel. Cross St. , j
City Costa Mesa No.Bea. 6829 Zone No.of Type I Group
Architect or Lic. , I Plans / I l;-
Engineer Hugh Gibbs No. Approved
Gr, y
by Date 4e//L "3
Address Long Beach, Calif. :� CORRECTIONS .'
City Lic.
• Contractor Dike & Colegrove No. 170 + •
Address 419 E. 17th St. Costa Mesa
LegalLot - __ •
Description I No. 1 I Block I Tract 1759 -
(Attach Metes and Bounds) '
No.of Bldgs.
Size of Lot 75 x 101 I Now on Lot None - - - - -- - - - — `� o
Use ofNo.of I No-of - -� 70
-- Families Rooms
-' '
Setback Line from Rear Yard 26'
Center of Street 50' Side Yard CI /- • at�!?.F1. '. 2
2
DESCRIPTION OF WORK c ti
New ' I I Alteration I I Addition I (� (i '��Qf�,f�t�p__
"_Repair I I Moving I Demolish I�,EI� (" �17181J
" Building No.of
Size 28-6 x 52-6 Rooms 6 Stories 1
Exterior Wall tnI Roof CITY .1;1} A V�ov
Covering $ DDD Covering COmpO Dr �•�
Use of New Foundation Location Inspector Date
Building 1 Family Residence Forms,Materials,
Under-Pinning
Frame: Fire Stops,
Bracing,Bolts
Lath. Int.
1 hereby acknowledge that I have read this Application
and'state that the above is correct and agree to comply Lath. Ext
with all City Ordinances and State Laws regulating
. building construction.
Signature of C AI nt rruQVE Plaster,Int.
! h i) ��•
Permittee '� Plaster,Ext.
Authorized����111A(gt,�•, - GCs-) (714.--
Masonry Reinforced
Valuation SD V O Plan Check
Fee $
VV /
Plan C $ n Bond Beam
$ Total
Feei f^'I G o FINAL -
i
Ymm 304 G-ti 151 12-53
"Fly
c •
L
.
• Street
PLOT PLAN
Show location and distances from
property line and between buildings.
- is i