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Home My WebLink About289 21ST ST - Building Permits CITY OF COSTA MESA it'aThe BUILDING DIVISION :'j'� s $ DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER F I .,,.:sat 1 PERMIT B06-00244 4t be.0 Fan so et (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.gl9LLDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 289 21ST ST Status: ISSUED Suite: Applied: 02/15/2006 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 02/15/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42621510 Zoning: Applicant: DICKSON, MARK Address: 816 E ADAMS AVE . Phone: 714-366-5663 ISSUED BY: ads_ ORANGE,CA Zip: 92867 /i • Owner EISEMAN, JOSHUA AND DEBBY Address 289 21ST ST Phone: COSTA MESA,CA Zip: 92627 Contractor: AUSSIEBLUE ROOFING Address: 816 E ADAMS AVE Phone: 714-366-5663 . ORANGE,CA Zip: 92867 License: 834789 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING COMP ROOF,REPAIR/REPLACE SHTG AS NEEDED,1 LAYER 30#FELT,APPLY "30-YEAR ELK COMP SHINGLES."2600 SQ FT FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,000.00 Permit: $139.25 Claim Valuation: $7,000.00 SMIP Res: $0.70 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 • Total: . $139.95 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 • • • 1 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 • 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.) &[BJ Isscertify that in the performance of the work for . -' h 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 at if shout acorn's subject to the workers'compensation provisions of Section 700 of��lhhne Labor Code,I shall forthwith comply with these provisions. fy � � Applicant.Sig�:�:- / Dreier, WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100.0110),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 thaal am licensed and r provisions o ha t r 9(commencing with Section 7000)of Division 3 of the,Bysiness an Proff sslgps Code,and my license is in full force and effect.Lic_8� y Class a Contractor's Signature: t. i� Dated?/547e 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 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 properly,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 properly 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. Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of . me t,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? C 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 ❑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? 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes 0 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 t7 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 stale 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. /I,�.1�e 01 Owner(s) rj�` e 06 And/Or Authorized Applicant-4, i ( to CODE I Ifileiglarel DATE INRRALS CODE. INSPECTION TYPE RAM Iti�AL$ 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 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 OWNER ..�....... ".,sa-"n‘n.n... DATE -' r� JOB ADDRESS •• S BUILDING PERMIT NO. �� RAL CONTRACTOR ; ,; 'oo• I seat. DESCRIPTION of WORK ' • ' `� AAO. `— _pp LOT TRACT FIRE ZONE VALUE $ • ��•�• �•� INSPECTIONS Signature Date TYPE V GROUP 1 & 3 ZONERI SOIL Y S 5--22-75 SUBCONTRACTOR PERMITS ISSUED GAS Date Number ISignature WATER "C Plumbing ROUGH PLUMBING S/L,'] 'A t O )O/ Y:.Zo-Sid 73 V5—„,--- PROP. SWR. LINE 2-'HOUSE CON. [ . ."-p.s SF PaTti-r-- to-a?")— GDSD0 SPRINKLING SYSTEM �` MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING /y/1L+ TEMPORARY SERVICE OR POLE J'-_ UNDERGROUND 9 POWER 9 ROUGH WIRING Heating and Vent. TRENCHES 9 FORMS 9 STEEL REINF. 9 ® 1jp/Q, ,, jJ, . 6_23-?c 1/7C1S�- FLOOR SYSTEM V U(F BOND BEAM 9 STEEL REINFORCE 9 SHEATHINGp FRAME ANO FLASHING SHEATHING ''. O LP VG -- IN OUT O PL £R, BROWN COAT / .22. 7 STRUCTURAL, FINAL - ��7 fes' Electr' HEATING, VENT., REFRIG. AND A.C., FINAL 0 Vral F� ek.��jta./ e,0{A a-7aj •/7/6// PLUMBING, FINAL AND GAS TEST I^ygips p..09 _ i. insc32 ).,I_ PAID COSTA MESA BUILDING-SAFETY DEPARTMENT "AY -6-75crcsc00 191* ****73.45 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED B D E R CEIVED DATE ISSUED BUILDING �y �} {• / r- )// ADDRESS � cj c,-9� J///t.4-C /� �V e-76- �/7 �� (72.4) 4 69,-(//4 -Z4,- 1 t8 - 143 -0B PERMIT NO. OWNERA.P. NO. MAIL ,5' / / BUILDING Sr zADDRESS fly I41 Z. 3 ) C ADDRESS Z8 & Z% cC C.Z CITY s7��/ NO - I..ft4 //?SG TA"'• fT/s' (1126C241- BLOCK Z< CONSTRUCTION / NEW ADD ALTER REPAIR MOVINfi DFMOI ISH 0-co LENDER Y---- a / JN BRANCH �[_ Rs�QrC ��SGD125 OWNER _I J ADDRESS �,,'v/ // VALUE •m ARCHITECT TE n.,3_ USE ( / ( If,- $ �"1 ''' JN OR ENGINEER 41 Jest/ i?/Y'S NO �•+ ) 4 O In FIRE 1 /e w cc ADDRESS /5.--.2... b/��z�itc °//f ZONE yP V GROUP G ', Z w ,/w _/ -/ / r~�7 JZZ CONTRACTOR MVV ex/ 'Y' „95rortlAyr�/ APPROVED ////`22-1P DATE\.5. / /Sri Ca Z 1 JIt ADDRESS r G y 3..> q .� Z I- CITY rij S 77 A/ NOTEL0T-9t3s5 Z 1 PLANS C. BUILDING WrACAR- 1 W O STATEry/ CITY YARDS APPROVED YARDS APPROVED sn OE LIC.NO. ) 7 , /C3 6 LIC.NO. MAIN BUILDING ACCESSORY BUILDING ry��\ 00 (FROM C/L STREET) 14 J SIZE NO.OF BLDGS. OF LOT CO X / V NOW ON LOT r FRONT SD FT. FT. USE OF EXISTING BLDG. y R.SIDE C FT, FT. Z NEW BLDG. id/` S/q ROOMS STORIES L.SIDE FT. FT. •C EXTERIOR WALL ROOF V COVERING 7r�CCCCOVERING O REAR 4O FT. IOr FT. • J USE OF BUILDING AJD WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ' d C- MAIN BLDGS. ACCESS BLDGS. 'Q r� O / / C.U.P.# G..� (p APPROVED J -4-Jr I- NR DATE 75-7r I 0O • HO�bI SPcCIA a REQUIREMENT! C~) I hereby acknowledge that I have read this application and state a 14 I rn D that the above information is correct and agree to comply with cc all laws regulating building construction, and I shell not employ TAX / I.- any person in violation of the workmen's compensation laws of (q the State of California. a) ? I hereby certify that I am properly licensed as a contractor under S0. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that sue lice -s are in full force : d encl. •r I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ¢b em exempt from the p •visl• -of the State of G fornia ass and Professions Cod. •ivis •ro ,Chep er 9. a- VALUATION (///r1./.---- -� m / PERMIT FEE $ N J Signature of ?3-o o o �'7 m Permittee -.�. / $ �.J J PLAN CHECK $ / - E / p Authorized • Pent TOTAL FEE $Or'/j�,%-LL a- - /l - WNtR MC LEAN, .lames R. _ OAIt 4_8_76 JOB ADDRESS 289 East 21st Street BUILDING PERMIT NO. 41538 GENERAL CONTRACTOR fhuner/R1 dr DESCRIPTION of WORK Patio Cover A '1.18-143-27 LOT TRACT FIRE ZONE VALUE $ son on eIN.. ECTIONS Signature Date ,TYPE VII GROUP I ZONE 12-1 SOIL PERMITS ISSI.ED GAS SUBCONTRACTOR iDate Number Signature WATER Plumbin_g ROUGH PLUMBING ,1 PROP. SWR. LINE C HOUSE CON. n �C\SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND n POWER n ROUGH WIRING Heating and Vent. TRENCHES Li FORMS 13 STEEL REINF. C FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PL^'TER, BROWN COAT S 'URAL. FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL /� BUILDING. FINAL - - �L'7, �IWW�Cc-Vila _ 41538 APR —8-76F„s°OO 460* {rtrf. •*-i•5,50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O-BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only //��/� l-- 7 �` RECE DATE RECEIVED D E I Fes///� LDING ADBUDRESS �T 2 L P. . IG 214-- SI- {� f r /c !L'�•/ wc. P. Ut &e� - /41 —/G1I— -2 /' RMIT NO. BUILDINGOWNER C A.P. NO �^ ADDRESS 2-PA SIG. al -1- St • ADORES ,TE - G ' Q /-�� CITY Ccaa- h��-Sa NO. as-6a. R•CT ,MLOTp�jLy BLOCK CONSTRUCTION NEW... AD ALTER REPAIR (MOVING DEMOLISH LENDER /LyJ BRANCH ADDRESS / OWNER ^ fa6 L/ ) VAWL,” OARCHITECTR ENGINEER 7(-- / NO. USE /��3 0 ��/ O E FIRE ADDRESS ZONE TYPEROUP/ O4,/ lJ�-�7Ait - ... APPROVED //�{{r-- /� Sit CONTRACTOR �((/ r7 s4 ,/sr// BY O%W DATE!/ ADDRESS TEL. ZO ) NO.OF USE OF NE PLANS BUILDING CITY TNO.E G‘ F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO, LIC. NO. MAIN BUILDING ACCESSORY BUILDING r ,1 NO.OF BLOCS. (FROM C/L�,T•piEET) Com. OF LOT SIZE SQ u / .Qn NOW ON LOT I FRONT- T"r/ FT. FT. USE OF 41 EXISTING BLDG. R.SIDE/C. FT FT. t" l FSeparate permits are required for L,SIDE .5 FT. FT. electric,plumbing and heating work. n (y - REAR o7/.j FT. FT. Q7ASE OF B fDING•A D 7,0 TO EPERFORMED DISTANCE BET. BET.MAIN& � 0 1/V. • r J 0 ( Le /L MAIN BLDGS. ACCESS.BLDGS. "'J CURP.# DATE A APPROVED ,UA-lid ea-Vert RYeAP� �f /� r Yiw�f✓ DATE / //.�/ DP w B. 0 I hereby acknowledge that I have read this application and state o tY that the above Information is correct and agree to comply with y� 4 all laws regulating building construction, and I shall not employ S Z any person In violation of the workman's compensation laws of o 0.7 S the State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business a VALUATION PERMIT FEE $ 6 00 and Professions Code,Division 3,Chapter 9. I n a � �/ PLAN CHECK $ C O Signature o A-L'Kn�/ `d" Perm lttee LJ $ TAX $ U Authorized Agen TOTAL PAID $ 5e 6 40287mt 1e-75P -OU 1778* ****x3.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT �j �{ C� N/y RE{C IIVV�E(py.BY D TER EI D DA EIS ADID R ESS 2 $ / G . 4/-��1 ,J/ � OWNER CA/4i A9 5 A.P. O Ig—,y,3 P RMIT NO. - /MAIL BUILDING ADDRESS pax 376 ADDRES q -• /� -1- zor� o is O-0 CITY Ts/57>"/ NOui L fI/-y/Jf� ne,s 5 LOTaw SILT BLOCK I— Q CONSTRUCTION /� N W ALTER FAIR MOVING DWv1OLISH O- V) LENDERD /1'6 N,4 `r7C/`1 -.. am J 7 BRANCH to/d to t /e __ J N OWNER /�^[/ r� RI J ADDRESS /QrK /�� ALUE 73:8:10 zre- J 03 ARCHITECT TEL. USE $ Q OR ENGINEER NO. U N Q FIRE WCC ADDRESS ZONE TVP „illGROUP a w ,/ APPROVED 7' W Z CONTRACTOR,# c/�V,ljsQCJA 5 BY T DATE / l� ,s J O CO Jcc ADDRESS Bak 3 76 W w `� TEL. ZO NO.OF a USE OF E Z H CITY / �"'/ 5 7/N NO.F3g. /?s5 1 PLANS BUILDIN O�r �/'� w- 0 STATE / CITY i YARDS APPROVED YARDDSDSS APPROVED �•G co 2 LIC. NO. J 6 LIC. NO. MAIN BUILDING ACCESSORY BU DING / =0 SIZE NO.OF BLOCS. (FROM C/L STREET) /� ^/ cI OF LOT SU X 15_D INOW ON LOT FRONT FT. r? C)T. OC / ��7""/// USE OF — � EXISTING BLDG. R,SIDE FT. �f FT, I— SIZE OF NO.OF ,�]� ZZ NEW BLDG. ROOMS STORIES _L.SIDE FT. l�T. V EXTERIOR WALL I ROOF COVERING COVERING REAR FT. OT. ...J USE OF BUILDING AND WORK TO BE PERFORMEDCIL DISTANCE BET. BET.MAIN& CL MAIN BLOCS. ACCESS.SLOGS. C- Qj/ VAR.# DATE O a/,�// �j_// C.U.P.# APPROVED N /20 /err _a�R � �� rf—i��7r Z )ATE 0 U I hereby acknowledge that I have read this application and state O that the above information is correct and agree to comply with CJ'R�C CC all laws regulating building construction, and I shall not employ �. F any person in violation of the workman's compensation laws of co. the State of California. e I92 Z SOFT. o I hereby certify that I am properly licensed as a contractor under . e the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER ya LuATIONIIS FOR Chapter 9, and that such licenses are in full to ca and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT-FEE ONLY: m CC am exempt from the provi ' ns of the State Califor Business VALUATION and Professions Co , Div' n 3,Chapter 9 G. A re PERMIT FEE $ Oa Ir0 D Signature of /// co Permittee /11 A c $iA w PLAN CHECK $ E UUU(f^v c9.p Authorized Beni LL TOTAL FEE $