HomeMy WebLinkAbout152 22ND ST - Building Permits Page 1 of I
ROBBINS, REBECCA
From: CHO, DAVID
Sent: Wednesday, February 22, 2012 4:41 PM
To: ROBBINS, REBECCA
Cc: CHAMOUN, CHARLES
Subject: RE: 152 22nd Street- Block wall
Becky: I visited this location in the field. The corner cut-off at the adjacent property's right-of-way line is
excessive, so we will waive this requirement. I spoke with Raja and he agreed. I've let Randy Speer
know also. Let me know if you have any questions.
David Cho
Assistant Engineer
Transportation Services Division
City of Costa Mesa
phone:714.754.5017
fax:714.754.5028
email:david.cho@costamesaca.gov
From: ROBBINS, REBECCA
Sent: Tuesday, February 07, 2012 2:16 PM
To: CHO, DAVID
Subject: 152 22nd Street - Block wall
Hi David,
I talked to Brad and got the maps showing the ultimate right-of-way for the property. Given that Elden
Avenue and 22nd street are substandard for secondary and collector streets, do you foresee any issues
with the fence being constructed along the ultimate ROW/properties lines?
•
Thanks!
Re ecacvRobbtna•
Assistant Planner
City of Costa Mesa
77 Fair Drive,Costa Mesa,92628
Ph.(714)754-5609 Fax. (714)754-4856
www.costamesaca.gov
Costa Mesa
02/22/2012 •
. . - CITY OF COSTA MESA •
os . BUILDING DIVISION
F I
em--' I 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
91
\s. Wit FOR INSPECTIONS CALL: (714)754-5626
°°p PERMIT NUMBER: E11-00078
PERMIT TYPE ELEC STATUS: ISSUED •
APN: 42606101 DATE ISSUED: 05/03/2011
ISSUED BY: KJB
•
JOB ADDRESS: 152 22ND ST CM Suite/Unit:
Vicinity:
SCOPE OF WORK: SERVICE UPGRADE TO 200 AMP.NO RELOCATION OF SERVICE.
05/23/11 A SUPPLEMENTAL PERMIT AS FOR ROMAX LINE THAT HAS BEEN WIRED INTO THE SUBPANEL.
OWNER: SCHROEDER,ARTHUR Address: 152 22ND ST Unit:
PHONE: 714-889-8448 City/State/Zip: COSTA MESA,CA
APPLICANT: SCHROEDER,ARTHUR Address: 152 22ND ST Unit:
PHONE: 714-889-8448 City/State/zZip: COSTA MESA,CA .. . ` -3307 8
CONTRACTOR: License No.
Address: Unit: PHONE:
City/State: ZipCode: CELL:
ELECTRICAL PERMIT FEES
• Rs,
Electrical Plan Check Fee: $0.00 �s
Electrical Permit Fee: $72.20
Reinspection Fee $0.00 � � I
TOTAL FEES $72.20 /�^ , .I
i . -
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.'
CODE O. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALS
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified b drive. .,license."'1<es ❑No
I hereby affirm under penalty of perjury one of the following declarations: r rer s L cense No
x612s: S-- (c-I y
❑ I have and will maintain a certificate of consent to self-Insure for workers' Veli Ica ion of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ElI hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(This section need not be cnmpleled A the permit is valued at one hundred dollars($100)or less.) 2 Art 2Sec.341,The B.California Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Dale
the Labor Code,I shall forthwith comply with these provisions.
Division of Industrial Safety Permit Number:
Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No
Lic.# Class# (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
Contractor's Signature Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: a „,-.r ti hazardous materials)? 1:1 Yes 0 No
N-4.., el el (Section 25534 of the California Health and Safety Code provides that the
Lender's Address:A R ^--i"' titir ' * *?.-` . .4 Costa Mesa Fire Department may require the preparation, certification and
': jr�t - of r^ af i"j filing with the Fire Department of an RMPP by businesses which are required
S to register acutely hazardous materials with the Fire Department.
r. r,,,�� Signature" ''-1 �� A-" s Date
Il - 4. If an RMPP is presently required, has Section 25534 of the California
j t t` nit Health and Safety Code been fully complied with? ❑Yes 0 No
OWNER-BUILDER DECLlfRATIONSa i'i
� s3..
I hereby affirm that and r perialt1roftperlury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for then,following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city tr county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fcr non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No
thereon,and who does such work himself or herself or through his or her own 8 (If'yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
diddinnnt build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
L ENSED CONTRACTORS to construct the project(Sec.7044, Business and
Pro essions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
[3am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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
author' this per ' ntil final inspection.
I 2"
- p// Signatur-5:; - -. 0 .—
Sign cure e 1
3057<6(3/
And/or Authorized Applicant Date
City of Costa Mesa, Development Services Department
-^—� 77 Fair Drive, P.O. 1200, Costa Mesa, CA 92628-1200
Costa Mesa Phone: (714) 754-5245 Fax: (714) 754-4856, www.ci.costa-mesa.ca.us
APPLICATION FOR MINOR MODIFICATION REQUEST Minor Mod # MM - 12 - 0I
(See Title 13, Ch. III, Section 13-28(j)Minor Modifications, of Municipal Code)
PROPERTY ADDRESS: 152 2-1-419-; ) Coska. . Mesa, (,A qD-(al-1
PROPERTY OWNER: ptr+llur Schroeder Phone 1I3/4- %%q- Vita
Address 152 twit a - Email or Fax# OK-{4hk✓SCllyarder&mho°.com
City C OSha, MacaoState CA Zip Code g 21021
Property Owner's Signature r/ . _//�//.G.,,,. -_ Date% I /25-h a'
AUTHORIZED AGENT: Phone
Address Email or Fax#
City State Zip Code
Authorized Agent's Signature Date
PROJECT DESCRIPTION: (Provide project description&justification for approval below:)
Q nStYllc+inn flc a (n' heinhl' wt,ctnru blit uall. Wall nn )la449'4.nr-tion nF ptirrr4rn IS Sr+ •
rJ nn �L
�v.rL Ing {v++m �rx�mtrh�lini awl will bt roylSivl.Ci(d or d/fnrahv[ Screen bloc. ?rn Ave-, a •
-
d SWt6(.L 6 (eq,UAVd.-TANS prion of The wall will k tans-NV-CA Of- deynratiVe St,yi4 I9loc6.•-(tic.
015a6(4 rrelAnkA due #n 444 nvr, , Jpr✓+u's Wo-hon M
across - .e Stvee4- rn SF, MA.tA Arwten,ak,
C,hurrh , ltnr° lot of Fol- x✓tlhc on Odin emit 4-h-e .nc'Skn(r of 0' Sr-i-bccr walls and
Lcntr', 414uJrntlohF +hr eitu hborhrnd• AAAi11nnalhu, 44e e4ciinu (1 S* /V_ (1 ktu4hf -Prn(-e
fnht'.' nut .nnn -14,4 iniWrin✓JSItten t OjSc4back_ would orrvenI 4-M-
1 ,c
concrete pit .Purr forlorn -bin ,,o an4 would also 61V( an euisEAl -Wee,.
J ' J
•
•
CONCEPT PLANS/DRAWINGS ARE ATTACHED: YES ❑ NO
OFFICE USE ONLY BELOW
THIS MINOR MODIFICATION REQUEST IS 0 APPROVED I 0 DENIED BASED ON THE FOLLOWING FINDINGS:
51 The improvement O will not be / 0 .will be materially detrimental to the health, safety, and general welfare of persoi
residing or working within the immediate vicinity of the pfoject or to property and improvements within the neighborhood.
(rhe improvement e is / 0 is not compatible or considered as an enhancement to the architecture and design of the
existing and anticipated development in the vicinity. This includes the site planning, land coverage, landscaping,
appearance, scale of structures, open space'and any other applicable features relative to a compatible and attractive
development.
Zone: i ` V \ Approved by: Decision Date: 2 11C)`I (Z'
Appeal of this decision shall be filed within 7 days of the decision date noted.above by remittance of the appeal fee and
according to the procedures set forth in Title 2, Chapter IX, of the Costa Mesa Municipal Code.
(White-Planning; Canary-Building; Pink-Applicant; Goldenrod--Authorized Agent) (�\
t G\rr0 U A/` M19
PsWOVW -?Or 2 (0. \cS1-se aLV- krovn ?f0Pe-6- \\ ,rte o
�-E r W0A PcP, 1vos� i rivl� S icj;_os-Qbr 17eyv1kC}
Page 1 of 1
ROBBINS, REBECCA •
From: CHO, DAVID
Sent: Wednesday, February 08, 2012 4:09 PM
To: ROBBINS, REBECCA
Subject: RE: 152 22nd Street- Block wall
Hi Becky, I spoke with Raja and widening of this section of 22nd St. is unnecessary. So the setbacks for
the block wall can be measured from the existing right-of-way lines.
The setback on the Elden side needs to be 5', but it looks like they are seeking approval for 0' setback.
Corner cut-off on 22nd side is necessary because of neighbor's property line as noted. Let me know if
you have any questions,
David
From: ROBBINS, REBECCA
Sent: Tuesday, February 07, 2012 2:16 PM
To: CHO, DAVID
Subject: 152 22nd Street- Block wall
Hi David,
•
I talked to Brad and got the maps showing the ultimate right-of-way for the property. Given that Elden
Avenue and 22nd street are substandard for secondary and collector streets, do you foresee any issues
with the fence being constructed along the ultimate ROW/properties lines?
Thanks!
Rebecca.RobbCnaw
Assistant Planner
City of Costa Mesa
77 Fair Drive, Costa Mesa,92628
Ph. (714)754-5609 Fax.(714)754-4856
v ww,costamesacaMov
•
Costa Mesa
•
•
02/10/2012
2P469 STREET 1'/RG/N/A PLACE
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/ Screen Block Wall y �� A i
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12' 6' >< 10' > `
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1 'roposed 6' Height I
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Secondary Entry //
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•
II
PLOT PLAN Garage
152 22nd Street Driveway
Not to Scale 1
"4-' GI CITY OF COSTA MESA lbC4 G/
e`wi . BUILDING DIVISION
" w
�' �^ ^� ' DEVELOPMENT SERVICES DEPARTMENT A7/NT
Te. 510411 PERMIT
PERMIT NUMBER t
' tom P99-00048
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 152 22ND ST Status: ISSUED
Suite No Applied: 02/01/1999
Issued: 02/03/1999
Vicinity:
Parcel Nunmber: 42606101
Applicant: NOCK,RON
Address: 11612 KNOTT ST
Phone: 714 895-1246
GARDEN GROVE,CA Zip: 92841
Owner: ATKINS, ROBERT LLOYD
Address P O BOX 8296 �{ 4` ID
NEWPORT BEACH,CA Phone: M_Zip: 92658 ell^4 9rf /
pAs6t.�'IV
Contractor NOCK PLUMBING
Address: 11612 KNOTT ST
Phone: 714 895-1246
GARDEN GROVE,CA Zip: 92841
License: 707775
Arch/Eng:
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
DISHWASHER. .
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.001 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $8.75 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) 30.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $30.75
COMMENTS/SPECIAL CONDITIONS
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626 .
DECLARATIONS r J (-�
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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
2.york 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: ^/' L
Carrier: Jnr--.,//�A /-- /�-�r/� Policy Number: _Ai Le--)di-7 2 3 � (1 G
?
(This section need not be completed it the permit is valued et one hundred dollars MOO)or less.) _
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions, ,
Applicant Signature: 11 r L Date: — `-71- Y Q
WARNING:FAILURE TO SECURQ W RKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES P 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,end my license is in full
force and effect.Lic.M —76?7 7 5 Class if r `3
Contractor's Signature: Date: L— ty- - g
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 Lew(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Cade)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).):
Vtri ll /'_j II
0 I,as owner of theproperty,ormy,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 Professidns,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 orhei.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.).
O 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. ❑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).
O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 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? p Yes O No
(Section 65850.2 of the California Govemment Code requires that the requested Information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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.
eturei/
Of Legal Owners Z I ate
And/Or Authorized Applicant Date
CODE t INSPECTION TYPE DATE =ALS CODE I INSPFCTION TYPE DAZE IdDIIALS
1616 tem
206 Final
1266 Plxed oo FinaSpaFlnal Fire Prevention l 208 Final Plumbing Mechanical
/'cam in by Bt
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 Bullding/Occupancy
2446-46
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERM TRACT NO. LOT NO. UNIT NO.
CITY roj OF COSTA _r NS U�CTIlJ PERMIT NO3O3 /_ Air A.P.# Zone
Proj 'Address RA-- 'sd 294 G l0 7 S Main Building: Accessory Building: "
r•cApplicant's Mailing.� Address)) /��"-2 0 tQ,i/ 34'rearr TYPE OF CONSTRUCTION U NEW ❑ ADD IJ ALTERATION LI REPAIR
Owner's Nam ttt'lC$4-ce/.rc nn/YArthone 2a-9e V' ❑ CONVERSION ❑ DEMOLISH El OTHER -' TB Front N
,./ 7 DESCRIPTION OFWOR./USE D : DG. 4 - -4 --- —�- A/ Rear I
Address /5%4- -E• a. ca--". _s.�.._- - i - '
TYPE OF PER IT IN GRADING L FOUNDATION • STRUCTURAL C Right N
Arch/Eng. _License No. K G
Address ,�pp ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left R
Contractor's Name��q OL(f/Ve4"'---ectI_re1" Phone ❑ BOTHER ( Ping. Ref.# Parking Req./Provided E
Address(mailingl rtNer--' C f Ion PROJECT DESCRIPTION SG. FT. /3r,o OCCUPANCY Planning Notes: M
�+��Q.r - Vj CONSTRUCTION TYPE VALUATION$ OQ
City License No. •♦ 1 P_Y" ZONE GRADING CU.YDS. ACRES T
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code,and
my license is in full force and effect. ELECTRICAL FEES
License Class _License No.
Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. 0 50+KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
• Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter ❑up to 100 amps
1, Lab. CJ Backflow Preventer Service Sink
.cy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps -
_
8 Certified copy is hereby furnished. Dryers ❑Gas DElectric Sub Panel
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Date Applicant Fan Motors 00.1 HP ❑1'h-8
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for one hundred ($100) or - F.A.U.
less). DishwasherInc.Solar 09-15 HP ❑16-15+
Solar Piping -
I certify that in the performance of the work for which this permit is issued, I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave -r
Workers' C999ff?!!111pppg�s tion Laws of Calif�io�a
Date If/�'r•7/ -P$ Signature.S�•+..e.0 a,) (i9LO cH� Floor Drains Swimming Pool w/Spa Device Boxes Pole Light '
NOTICE:If,afte//making this declaration,you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service Generator ❑0-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION "
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - --
following reason (Section 7031.5 Business and Professional Code: Any city or _ - -
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays " I
any structure, prior to its issuance, also requires the applicant for such permit -
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt • Reinspection Fee ! $15 Issue Fee ' - $ 3
rn-refrom and the basis for the alleged exemption. Any violation of Section -
5 by any applicant for a permit subjects the applicant to a civil
' Ity of not more than five hundred dollars($500)- DEVELOPMENT SERVICES REQUIREMENTS: '4
k. i, as owner of the property -vi
Issue Fee $ 3 J
and the structure is not Intended orofferetl Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's Reinspection Fee I $15
MECHANICAL FEES Building Approved By , " Date ��
License Law does not apply to an owner of a property who builds or improves
C thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ Application Issued By ' 1--'.. Det:
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑
pletlon, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground • SUMMAFW OF FEES '✓
prove for the purpose of sale). BUILDING PERMIT $ 5'7'00 SMIP- . $ • S 0
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration SystemPLAN CHECK $ PERMIT c.
tractors to construct the project (Section 7044,Business and Professions Code: -
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con- _- -
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. -- _ ELECTRICAL $ GRADING $
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $
PLAN CHECK 50% $ c-
--fl
///• -?/e' owner ��& -6.. Heating System&Ducting Registers MECHANICAL S�.S
LI
I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTI.
$ TOTAL FEE $
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned pr perty for
Ins ectionurpos0 .
Signature p^, �Q C " 4ar Date dt -
•
Drivers' License or SS# -' Reinspection Fee $15 Issue Fee $ 3
Cl 00020720-00020721 TOT 54.50
0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
DATE; 11/29/SS TIME: 16:25
r
CONSTRUCTION AND PLANNING POOL v- "?A
Date Inspector •' Date Inspector
APPROVALS Permit# APPROVALS Per.. _.
1. Temporary Electrical Service or Pole C• 52. Pool & Equipment Location '
•
2. Soil,Pipe-Undrgrnd., 53. Steel Reinforcement ; !
-3. Electiical Conduit Utility-Undrgrnd. .,1 54. Forms 1 .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 6 I
5.IStgel!Reinforcement 56. Rough Plumbing & Pressure Test
6. ElctricalUFER-Grnd.-j1 57. APPROVAL TO COVER-GUNITE• i,
I .
7: Footing5 f !; . 58. Electrical Conduit-Undrgrnd. i'
i
8. .Founiation _!_,_ _ 59. Gas Pipe, O Undrgrnd?, Test 1
9. Water. Pipe-Undrgrnd. ` ') 60. Backwash Lines, P-Trap, O Undrgrnd.
10.IStr,uctural Floor System I 61. APPROVAL TO DEC14 I .I
11'. Property Sewer Line & House Connection 62. Backwash & Receptor-final '
12. Sewer Cap . 63. Heater & Vent-Final 1 i
13. Rdof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final •
x ,
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
✓17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
181 Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
'1q. Rough Hbating & Air Conditioning FIRE DEPT. REQUIREMENT
' 0. Rough Factory Fireplace APPROVALS' Permit#
E
:21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑Oil
23. Gas Pipe-Rough &:Test 72. Underground Flush
24. Roof Framing 'l 73. Undergrrid.Storage Tank O Gas O Oil
25. Roof Sheathing ,, 74. Overhead Hydro
26. T-Bar'Ceiling (Structural) & 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 t,• HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
34. Final HNotes: 'r'!�' N P.34. Final Heating
& Air Conditioning 'T 0 t,
35. Final Gas Pipe-Test .1/,
36. Hood or Canopy
37., Final Factory Fireplace •
38. Final Plumbing '
39. Water Service-Final
40. Gas Service-Final ,
41. Solar Domestic-Final
42. Backflow Preventer '
43. Backflow Irrigation . 7 _73-
44. Landscape Irrigation System -1)
45. Sound Attenuation „ .
46. Handicap Regulations 4.1 r f¢?O 4..(1 L, 1
47. FINAL STRUCTURE & BUILDING . T,., SO 3 1C1 J p c 2iLtri'(-1--
48. Snecial Requirements Completed
49. Electric Release to Edison
♦
50..Gas Release to Southern California Gas Co ' ;U
-...---
51. C€RTIFICATE OF OCCUPANCY l i!
No. Date cja . ")
COUNTY OF ORANGE - /
BUILDING DEPT. Permit No.. 3Par
636 No.Broadway -
Santa Ana,California Application for Building Permit
Phone:RI 2-6211 AND FOR A
'Certificate of Use and Occupancy
Date
/ i
1. OWNER'S NAME.._L PHON .. 7 6-jy
(�J lr 1.
MAILING ADDRESS..-716 . ` - 4,,V_ CITY07- 4 •
Name Name ---
(Architect or Engineer) ( .n or)/�� et
Address - Address 3'�//lp6�� ,yy``,�E ,) ,..-- �K�'.
City City e GC.
State State �{� 4 )-P v
Lic. No Phone Lic. No PhoeSe�`r
PROPOSED USE- 7ae{ t
LOCATION /`d &:. r 4- L"� ��'S_41#121CC
2.
JOB (House No.) \� ( me f Street) own or Sch of District) •
3. LEGAL DESCRIPTION: Lot' I V // 1 Block //� tact
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( )( ) JN E OR,Lo,e76 en/ . ( THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OP BLDG.a �.4- AREA:... �do I.0-
SIZE OF LOT• p V y AREA:... 7•
/. /
6. HEIGHT OF BLDG • / 7/ CEILING HEIGHT NO. OF STORIES
7. NO. FAMILIES....L " t - Size of
Smallest Bedroom Size of Kitchen
• 8. EXTERIOR WALL CONSTRUCTION: INTERIOR-WALLCOVERINGe
' (Frame, Stucco, Etc.) �� (Plaster-Drywall, E )
9. SETBACKS: Front Yard From Center Line of Street ° %j/
Nearest Side Yard / d Rear Yard Distance in Feet Between Bldgs. on Same Lot
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND /USE OF EACH. ��
11. For (a) Footing: Width /'L Depth in Ground / Width of Wall ---r--1-5—
Accessory 41P1/
/� /
X Li Spacing / Co , / �
Bldgs. and (b) Size of Studs ,----,---- "CC Material of Floor 4 VP f rf��'?il-
Similar
Structures:
(c) Size of Floor Joists- [�7 > G Spacing / Cr "CC
(d) Size of Rafters- I K C Spacing /4!,, "CC •
12. VALUATION OF PRV10D-WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal gc 1/¢�7..t7- '
• 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed• 77
�' ** ( caner)
Plans Filed
By
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: /9:e. CHECKIN BY ki
Bldg. Permit • $ GROUP T APPLICATIO , /HEALTH
Plan Check • $ y3 ___ TYPE . :-- ZONING • (� FIRE
Total $ / DIST. /���� PLANS A 1 ARSHAL
C
Receipt No. _/0 MAP - " SPEC'S.... TATQ..)
Paid to 3 N SHEET NO CORRECTION / EER
Date
{-27'1l VERIFIED
/ •
46 '
RMIITT ISSUED B •
DATE y2.91/-5 / - a4-7(1-4-
91.4-2-51
47 .... �J
9M-2-5t TT
' r
%Costa Mesa Building Department APPLICATION FOR PERMIT N.
�-- It 111 EAST 1 COSTA MESA, CALIFORNIA h STREET 356 BUILDING
% car FOR OFFICE USE ONLY
FOR APPLIC TO FILL IN ReceiptPermit No.
Address �� vL� " - r I rd No. �- �
Costa Mesa, California Received by Date Recd.•
/ pate Issued(
Nearest r/, ' yam b ,�/��r(
Cross St '�' ' 37Building
Address / yLe - ;al
Z Y .,
Owner - Costa Mesa; California
Mail £S c2 G) Q
Address a 7e) e ^ Nearest
Cross City ..c--t..--cc. No. Zone Stp No.of Type....111
I Group
Archlreet or Lic. /(��I Plans I I
Engineer No. Approved V
by Date
Address CORRECTIONS
City Llo.
.itractor No. •
Address
LegalLot r - • A 1
Description I No. I Block(� ' I Tract
(Attach Metes// and Bounds) J/d ' c 0 a / — /g �' `
Size of Loth ba, DZ(/331l Now.onB Lots
Use of No.of -No.of z
Existing Bldg. I Families I Rooms jj
Setback Line from Rear Yard 7-s
Center of Street Side Yard 2_,_ q CJ i y
DESCRIPTION OF WORK JUNG r
New I‘74- I Alteration I I Addition 111 \�CC�_
Repair I I Moving I I Demolish I. �tV
Size n a..‘ No.ofSize Q Rooms i Storieserior WaRoof 'eringI Covering ass, APPROVALS
Use of Buildin
Foundation Location Inspector Date
g -�"��/'�� Forms,Materials,
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 construction.
Signature of Plaster, Int.
Permittee
Plaster, Ext
Authorized Agt.
Masonry Reinforced
Valuation y// Permit F e $
U Plan Check $ Bond Beam
$ Total
Fee $ FINAL
FORM 204 G-M 2M 5-54 _._._.
at•
T.
• 2
o / . 1
c u
J I c -
OL ' i� O J - / •l
�. o
a.
W 1
\
— ii: a
S
Street ' y', i
i i . .
G _ .
• PLOT PLAN '
Show;,l Ncation/I andi distances from
f . R
property line and! between buildings ,t
• -1
Do you entry workman's Compensation •
Inwaraelce? Yea pR iQ'o` 0
I am aware of Provision 3700 of the State
Labor Code which requires every employer
to be insured against liability for
workman's com ensation.
Signed:
OWNER FISHBACH, J.E. V DATE 6-25-54
I Cal 1'
JOB ADDRESS ,...1g2-E. 22nd St• BUILDING PERMIT NO, 346
GFNERAL CONTRACTOR Owner-Builder VALUE $ 960.00
LOT AP# 118-081-18 BLOCK TRACT �� Private Garage
GROUP 'J TYPE V ZONE R-114 FIRE DISTRICT #356
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
,22.eLC -a tor C....- DATE NUMBER
Footing Trench d &-t 7-6-4-.1
Foundation Forms and Grade to Garage�
Rough Framing 4�.'G 7 9-�f
/3 L
Plum bing,Rough to Slab -44/0F 1 D
Plumbing,Rough Complete !
Temporary Pole a
Wiring, Rough v-+..-. „- " u 9s l..e-
Heating,Rough ,47e cR 2 pelt
Heating, Final "Je+A.te 'i-- -;wu/l"
Sewer 4Th 11
Sr Tank or Cesspool I�/
1a....ag.S��t/r eelCU; kir LLCS� /do?J .
Plastering 7(�i� ii/ ,)>
Plumbing,Final,Fixtures Complete ,1,104.1-J2-
Plumbing,
4/O/(J,ePlumbing,Final Gas Test /Pt-e
Wiring,Final 'rJ/7:'S Myr- -- i / G -610L . ' , / 1
Occupancy rLt- C/ a. / L
's>_.r J r- n> Jr--62-4 e.JAn�
GL.�!
Form 210 H 1M 12.65
.l.41P �. 7— C—f
Testa Mesa Building Department /lOg PLICATION FOR PERMIT
r •'� 111 EAST 20th STREET ✓/ BUILDING
• COSTA MESA, CALIFORNIA
-r FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN(J� Receipt No. Permit No.
BuilAddress /3;2
d Lt z,`r� `.f /nY( la 7 fO
Received by Date Recd. Date Issued
Costa Mesa, California
Nearest 0 -.i.3 "S_r
Cross St. iC.G{ / Building
ale/
E , Address
M 11 //tt CC �7 ,Q 7/- Costa Mesa, California
Addre�sss /5 7,2_ E .22_ h� ?S- Nearest
Tel. Cross St.
city t29-Jr,: 0,cc' No.L; Z 37b '2ones, fe I Plans No.of I Type / I Group f
Architect or Lie. fh 1`
Engineer No. Approved
by Date _
_Address CORRECTIONS
/ City Lie.
,tractor & L No.
Address
Legal Lot
Description I No. I Block I Tract
(Attach Metes and Bounds)/4 ,xP-afi, /'
ine
Size of Lot (y� (+� NowNo. on Bldgs.Lot 0
Use t _ ^ D- I No.ofFamilies/
f l Roof f_
Existing 27
Bldg. -t-r}u•'i'-- Families/ Rooms (O
Setback Line from Rear Yard 75 i 2
Center of Street �x, Side Yard t/ D
DESCRIPTIONr
IX
OF WORK
New I Alteration I I Addition Ix -.
Repair I IMoving I I Demolish I
Building,.�!! No.of
Size Y" 7 / V Rooms Stories
rior Wall ' a , I Roof (7!� ' ,
ring / I.� ' Covering • APPROVALS
-Use of New
Building / - i / Foundation Location Inspector Date
' t__.-t__.- 0 GYM Forms,Materials,
87-1 aj 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 construction.
Signature of .',/p,/> Plaster, Int.
Permittee
/LJC . u��'✓�+--
Plaster, Ext.
Authorized Agt.
Masonry Reinforced
ValuationPermit Fee $ . O 0
3 �i j7 Plan Check $ ,..,S-0 Bond Beam
$ G� FeeTotal $ ,,2.-. CO FINAL
FORM 204 G-H 214 5-54
• .t..
1 -
a)
. .• -—
. • • .
0. •
0
L. nn COSTA
o. 1.
c. 23-55riliM-286Z frA.***2.50
• • •1
, •
•
• _
- •
. _
- - - - •
. • • . . •
• ,
•
Street •
PLOT PLAN
Show location and distances from
property line and between buildings. .
_
•
•
•
•
• .
OWNER FISHBACK, MRS. J.E. J DATE 3-21-55
JOB ADDRESS 152 East 22nd Street BUILDING PERMIT NO. 1076
C" 'ERALCONTRACTOR Owner-Builder VALUE $ 380.,0n
LOT AP# 118-081-18 BLOCK TRACTnn��'' Bathroom addition on dwelling
GROUP I TYPE V ZONE Rh FIRE DISTRICT 1089
PERMITS ISSUED
I\MSPECTIONS ' DATE SUBCONTRACTOR
S I/C� DATE NUMBER
Footing Trench LGc6y tiW •1
Foundation Forms and Gra4e.tto/Carraay ' i
Rough Framing SEv'�K aj�,'Sim
Plumbing,Rough to Slab / //// '� �` ^SJ \
Plumbing,Rough Completer:b. 1LLS sy/ -J S X,4 '. 41-,_ K—uj,SC /7 L/
Temporary Pole -fa? ��
Wiring, Rough ,. --/3-,sr i�1 �C -,c. /i-J" 9.$•f
Heating,Rough n,
Heating, Final af+ (' ,r'
$ewer, House/1 - Sewer,St. /(j ,/• — , r
:Tank or Cesspool `� r�
Laming, In Out (l- I.a.-1�l}, , ;ILL �//i
Plastering e3il n.✓ - jb-I'/JS.- l ��
Plumbing,Final,Fixtures Complete -S� _■►
Plumbing,Final Gas Test FFY.: At VT/O • 1 -�
er
Wiring,Final -- a #5 (/O�j.'j _
Occupancy • 2“--", A— ' f
w n..,,7111 aa-I 1r11111 LA
• .4.•ti COSTA MESA BUILDING DEPARTMENT '
P. 0. BOX 317 I 6300
COSTA MESA CALIFORNIA
FOR APPLICANT TO FILL IN
C.L. OF STREET—" • e,, ,. ,,.STA •a K. *+ta1 '
BUILDING ADDRESS
�iPROP LINE �T \ Owner • �� /.
10 FT. FOR 60 FT. STREET�FgOFFTSSTREEIFF T Mail Ad less cog4 6 /y `.0,13,d1q�/( r"� t Y.
City - Ph. No, E /6 O S L.
• I • Contractor tri-'1 -01,-- Ph. No.
Address
50 FTI I F FRON City Lic. No. State Lic. No7. .
J , OF PROP. F -
150 FTS w Size of Lot (0 I X Az D AP No. ii $—0 B/^ /�
I- ` N Setbacks: C/L Street / 7 in / Rear ,..-5
d
ft ilkJ z Side Yard - Right Left/
y r -- _ o V _i Type of Fence - G�
LL �•L C � " IP IN rc d
0. �b ° -
1="': __-12: -` ¢ d -'l ,, I hereby acknowledge that I have read this application and state
vis._ �j x that the above is correct and agree to comply with all City Ord-
1 ( arp !�" 4 w ` / q �, inances and State Laws regulating building construction.
1 ¢ 0 0 {. / Signature t
„ p p 10 /2-/ ID of Permittee `j- �.Q/��^•-ct�
aV m / ". I Agent tt//////
37 6 IN. O FOR OFFICE USE ONLY
FT �' n,. W z
I— z _ 40
J \ IP/
U N `� i FT I Permit No.
Sf P� co -'a-00 I S ,7 60 FT ST Received by Date Received ,7 Date Issued
I50 F T. ST. �- /`�.-f- i i I ` /' // S 6 / / 7 d'
-"I PROP LINE i
1 _ VALUATION7r 7 -
L - --..�—=-- -- - - - i - - - - - Permit Fee $ i • 0--0
I
1 $ / Plan Check $
C.L. OF STREETS i i- p
•
TOTAL FEE $ - '
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES –– – ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
OWNER FISHBACK, J. E. DATE 1-17-58
JOB ADDRESS 152 E. 22nd Street BUILDING PERMIT NO. 6300'
fF GW.ONTRACTOR Owner Bldr. VALUE $ 110.00
P°.,No. i0 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Redwood Fence
_ .)UP TYPE ZONE PLAN NO. 6300
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches Forms Steel . Irr : .
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing _
Lathing, Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
Furnace
Gas Vents
Rough Plumbing
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
- j.',ysjng Final
a`'%bin, Fixtures Final
Final Gas Test
Construction Pole
Underground Power
Rough Wiring w
Fixtures, Final Zfelara,CIWAR
OCCUPANCY
Form 210-5M-1-57 61nn