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HomeMy WebLinkAbout272 21ST ST - Building Permits O� s9 CITY OF COSTA MESA 4 BUILDING DIVISION .,.' _ - DEVELOPMENT SERVICES DEPARTMENTFla PERMIT NUMBER • 1:01 PERMIT B05-00236 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 272 21ST ST Status: ISSUED Suite: Applied: 02/07/2005 Vicinity: ROOF Issued: 02/07/2005 Parcel Number: 42615105 Zoning: • Applicant LEHMAN, JEFF ISSUED BY: Address: 2415 MARGARET DR Phone: (949)646-3571 NEWPORT BEACH,CA Zip: 92663 Owner: WAYNE, ETHAN Address 266 21ST ST. Phone: 714-375-2816 COSTA MESA,CA Zip: 92627 Contractor: J S L ROOFING INC Address: 2415 MARGARET DR Phone: (949)646-3571 NEWPORT BEACH,CA Zip: 92663 License: 747706 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOFING, INSTALL 30#FELT UNDERLAYMENT,&REROOF WITH 30 YEAR COMP. SHINGLES(28 SO.). FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,200.00 Permit: $125.25 Claim Valuation: $5200.00 SMIP Res: $0.52 SMIP Com: $0.00 Other: $0.00 - Inspection: $0.00 Total: $125.77 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 2446-46(6/00) DECLARATIONS I i 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. aril have and wi mantain worker ' ompensatlon Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers' o ensatlon surance rier and policy number are: Cerrier:,. S rp,olicyNumber: a-1 •--11;• 3 L(Thirsection need not be completed if the permit is valued at one hundred dollars($100)or less.) (.y'" `� -�• ❑ I certify that in the perform:•.• • he work for whi - 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.,'• /and agree -.i I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro 0 ^ Applicant Signature: ii.,.--',�., _ % a Date: 2— / eD S� WARNING-FAILURE TOS- - -S'COM-' SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYERAO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED • THOUSAND DOLLARE($1.•.r.', 4 AD'• ION TO THE COST OFCOMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed nd' .ovision• h.- er 9(commencing with Section 7000)of Division 3 of the Business and Elyosslons Code,and my license Is in full force and effect.Uc.R ft Il f/ 'e/ Glass N Corltractor's'Signature; _ �i'' _ rate:r_• Z — 7 — CS"- 1 / � 1 / .;r ,_ CONSTRUCTION LENDING Ae�NCY: ❑ 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 t0 the provisions of the Contractors Ucense 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 ha or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,em 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 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 Caste 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 ❑No (Section 25533 of the California Health and Safety Cede,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5..... ....... . 5 Does he will the t0Air or present a future building occupant at y other for the work which is the subject of this application aPPermlt for such construction or moth/lcatlon from the South Coast Air Quality Management District or from any other air pollution control district Or agency? Yes 01 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 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? 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 MID AUTHOR 'TION 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 wi • all state laws 1,,,v; city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property f•'Inspection put es.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 'J/ Signatu(Of Legal Owner(s) 7..-- 7 — VS I' f Ad•CrAuthodzed,APpllcant-. ,r _ Date CODEC fn•. a'. PATE !MALI DOBE lt INSPECTION TYPE v i. PEE ME&$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof Lp /— �'-2-A '0 7 � 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 3JECT PROPERTY INFORMATIO, 1) Property: 272 E 21ST ST, COSTA MESA CA 92627-2170 C015 APN: 426-151-05 Use: SFR County: ORANGE, CA Tax Rate Area: 15044 Total Value: $115,883 Census: 632.01 Prop Tax: $1,594.34 Land Value: $70,598 Map Pg: 31-E2 Delinq Tax Yr: Impry Value: $45,285 New Pg: 889-B3 Exemptions: Assd Yr: 1997 Phone: 714/645-4587 % Improved: 39% Owner: STELLE GEORGE & PRISCILLA D Mail: 463 BROADWAY; COSTA MESA CA 92627-2318 SALES INFORMATION IMPROVEMENTS LAST SALE PRIOR SALE Bldg/Liv Area: 852 Transfer Date: 11/15/79 #Units: Sale Price/Type: #Bldgs: Document#: 1340300056 #Stories: Document Type: $/SF: 1st TD/Type: Yrblt/Eff: 56 Finance: Total Rms: 5 Junior TD's: Bedrms: 2 Lender: Baths(F/H): 1 Fireplace: Seller: Pool: Title Company: Bsmt Area: Transfer Info: Construct: SITE INFORMATION Flooring: Air Cond: Improve Type: Lot Size: Heat Type: Zoning: Lot Area: Quality: County Use: 1 Parking: Condition: Bldg Class: Park Spaces: Style: Flood Panel: 060216-0047E Site Influence: Other Rooms: Phys Chars: Legal: L254/NEWPORT HEIGHTS NWLY 60.5 FT SELY 3 Comments: Copyright© 1996-97 Experian Page: 1 of 1 LHYPICK 4_;11 IN _ R CHARD DATE -6-68 " JOB ADDRESS 272 E. 21st Street BUILDING PERMIT NO. 28542 GENERAL CONTRACTOR Adobe Engine = DESCRIPTION of WORK Block Wall AP No. 118-353-07 LOT 254 TRACT ,Bptg FIRE ZONE VALUE $275.00 I^�t'72'CTIONS Signature Date GROUP ,T TYPE TIT ZONE R-3 PERMITS ISSUED GAS SUBCONTRACTOR Dote I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING / Heotin. and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. Q it r r , 6 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE SHEATHING FRAME ANP FLASHING LATHING -- IN n OUT n PLASTER. BROWN COAT STRUCTURAL, FINAL Electric HE 1. VENT., REFRIG. AND A.C., FINAL PLL .NGt FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING. FINAL IN" lige- 1-17/414 MC- IF7/�1d • - 28542 ,ii _6-6E'J.°0O 212 d*****3.O0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 02620 • For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ADDRESS / For 011ke Use Only a ADDRESS oc 7a -{/7.7r RECEIPT NO, PERMIT NO. V COSTA MESA. CALIFORNIA // /� J RE EI[I/��D SY DATE RECEIVED rDATE IBBU/RD,(/ a oWNER R/C,`/7.ARt l A. /y,ITT"rtertL 7 s6'-PO v �O -(O✓ i �jy / BUILDING i^ ADDRESS .2 72 /' / 4 ADDRRS' -� �,J TEL • ZONE TVP GROUP (�/](.7y/ }; CITY Cn,i//'1 /PM"S/'� No..r�.�3.�1. -IRE � Kit/ /1/) (�G APPROVED �' ARCHITECTBN R/T!J G(7p NO. SP•3 S,�4C By DAT! ZONING gist `i A..ORESS // •F /- 6 ./. ✓ Y ZONE NO,OF i� � USKOF NEW /� /J _ / PLANS !� BUIL ma CONTRACTOR A f/dd,K FNn in/F_F,e c TGA /^�l /n' •� p '"�� .-/' LEGAL V U/ 1 '/ / ADDRESS 1 i-LC- 3 /\ i cesm(�//�v .S/t. DESCRIPTION t L/ O e!l�S �j lUi CITY �6/d/�/;Y A.P.No. /(2 - ! .LS - G 7 f ��� �/� NOTE: NO HAVE OVERHANG SHALL BE LESS THAN ., STAT! TEL ;1 80'TO SIDE A REAR P.L EAVES LIC.NO.� ,,JJ P. NO. ,5!` 3 ,I_2S/b Y F LOT (/JO•.�f(l P. 3 I NOW ON OTE SL. ALLOWED (U.B.C.REQUIREMENT) USE OP YARDDAPPROVED YARDSAPPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING f - (PROM C/LSTREET) SETBACK LINE FROM FRONT FT 5 0 FT. CENTER OF STREET REAR TARO I l SIDE YARD I LEFT I RIGHT R.SIDE FT. PT. -' ti (DESCRIPTION OF WORK L S SIDE PT, Fr. 5' r ALTERAT ADDITION REAR FT. T. N � REPAIR I �I�MOVINO ION j DEMOLISH 8N { DDISTANCE BE r.erMAI B LDS OS . { BUILDING NO,OF VAR.# DATE SIZE ROOMS STORIES C.U.P.# / APPROVE 'j' EXTERIOR WALL I COVERING ROOF APPROVED / / /,( 1 ATE COVERING UE/1 L, / {� /�Zr� l C- �` a +. wig Of'_BUILDING AND - -/ PERFORMED Dc/� (/ JO" 4-/ S/1J// pl SO.PT. I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O % AND STATE THAT THE ABOVE,IS CORRECT AND AGREE TO CAM. PURPOSE OF ESTABLISHING A PERMIT FEB ONLY. PLY WITH ALL CITY ORDINANCES AND RATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION. PERMIT FE! $ 0,O/) C ` PERMITTERDFAd 4 ,4 ,- O 7aw PLAN CHECK 5'( AUTHORIZED AGENT OO �1. .. .. u:jp„•.a•11% t.. I .:.,a: ✓.. ... .-i+� _ TOTAL FEE 5 • OWNER GRANT, FRED R. / DATE 3-21-56 . JOB ADDRESS 770-72 E. 21st St.. BUILDING PERMIT NO. 2519 GENERAL CONTRACTOR Siguard Hanson VALUE $111,640.00 I.^T AP 118-11.10-U BLOCK TRACT Rental ( Duplex) GROUP I & J TYPE V ZONE Ril FIRE DISTRICT 2538 PERMITS ISSUED INSPECTIONS DATE" A � SUBCONTRACTOR DATE NUMBER Footing Trench 14 Foundation Forms and Grade to Garage Rough Framing o,./ 8 Plumbing,Rough to SIaB� �'� `�/�J Plumbing, Rough Complete ;U/c3 —iG V4, tAer ; (C l•. •; ,.. _ _ ,7 s-,-4 !///.26 Temporary Pole 1/ Wiring,Rough /,'C,3 /-J•/9'.r( 10 ei17/ av1S-s 4. 02/ 76' w ? / ?7 — Heating, Rough "h„ s Heating, Final /hdift-1221_L'LS I/./i 4- 4{-1-7 Co cis"o...9 /Sewer, House ✓Sewer,St. ` ' (te,If d // +'—, -j 6. .V.3/7 - Septic Tank or Cesspool V Lathing, In X Out)1\ y,...-t4 4 2-7=-1 a P ring a—nn - c - ' -14. PI1...lbing,Final,Fixtures Com.pppletql,�%/ !,s--c. �1 e Plumbing,Final Gas Test I+'j, ,,I,(I 1 - •; , (de t „X, 7-6 -5-(0 2 r' Wiring, Final A „fie - - C ` // ii y- G - r2 _/I-:--moi Occupancy /0" ? ' j--5-i5- RM FO210 3M 10.55 r 2519 Costs Mesa Building Department APPLICATION FOR PERMIT • _ • 111 EAST 20th STREET 2538 BUILDING 1 COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANTyTO FILLINReceipt No. Permit No. BuildAddress aa / "i'/ 7' 2 / QZ,A'/�C� . i Costa Mesa, California Received by I1 Date Reed. Dateeed Nearest �r�(' - /— 3 --77-C‘ `b 6 Cross St. l.../e11M(A. A . a. ' Building Address Owner�i(LUp V-. 6:19--11/4-N.)i Costa Mesa, California Mall E.Address 2(pa _ CG. t 1 , Nearest Tel. , Cross St. City TAMP' 1\ No. L{F,- (,� /Oi. ZoneN• Gro Architect or Lia .I Engineer NO. Approvf .��ss by -' �!!jj•;; Date Address I " CORRECT.'1 -` ..tractor a/ /SCity Lia D IL) No. ft..'d'• 19 195h Address / 2-71! V///4ot ,e� ,'. /lout a ____ Legal Lot I Description I No. I Block I Tract • I 1 , �•e a�•���i �'►� (Attach Metes and Bounds) ,f�J '/$—a--14 C - i.TR 8 �. I +!- r No.of Bldgs. 7_ jj(�3L Y.7 Size of Lot (Z/J,L; I Now on Lot Use of No.of No.of COY CIF AZA 'OSA a Existing Bldg. •� .— I Families I Rooms CV P� 1,,, Setback Line from Rear Yard /P Center of Street Side Yard /J/��y .:r /�'/L�� Z DESC ON OF WORN - ir �"Pv"u�recit: New I Alteration I I Addition I . ' Repair I I Moving I I Demolish I Buildin GNo.of Size (.4 I( �/� Rooms of Stories 7. Itenor Wall^ Roof Tering (✓LLo I Covering 4Cid— APPROVALS Use of New Building (1vtA -\ Q_ 0 . Foundation Location Inspector Date \ Forms,Materials, (\, )U 0 Lt..' \ Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply • Lath. Int. _ with all City ' ances and State Laws regulating Ibuilding constru on. Lath.Ext Signature of Permittee �'/ ��i"y, Plaster,Int Authorized Agt Plaster,Ext Valuation Permit Fee $ ,3C/L, e o Masonry Reinforced �,,( / �7 Plan Check$ / 7- d ° Bond Beam $ // G 5 9, Total J Fee $ J � • C O FINAL cnvw, nnn C Tan oar n_R4 -, - a. • o a a. a - - - '-- COM- 1 "-r.c ott1 di„ .. Street • PLOT PLAN Show location and distances from property line and between buildings. _•