HomeMy WebLinkAbout171 22ND ST - Building Permits ADDRESS OF BOLDUC: 171 22ND ST WIT: CITY OF COSTA MESA — BUILDING PERMIT
ONNER'SNAaE IF KNOWN: PHIPPS, MARGARET PERM NO: B 078957
ADDRESS: 171 22ND ST
COSTA MESA,CA 92627 PERMIT NO: B 078957 PLAN CHECK NO: N GOVT: N SUPP : N
` ApL.MMgOADONE54: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: uc.NO.: JOB DESCRIPTION : T/OFF & REROOF W/COMP SHINGLES SQ FT: 1 , 000
ARCM.OR ENG11 ADDRESS: INT:
CLAIM VALUE: 1 , 000 . 00 CALC—VALUE: 1 , 000 . 00 GROUP OCC : R-3 /
cGNmACTDIrsNANE: IMPERIAL ROOFING ( 909 ) 350-9059
CONIRACTORSYARDID 14726 SLOVER AV COMMENTS : REROOF 1000SF RESIDENCE W/COMP
ADDREss FONTANA CA uc.ND. 579387 ******+r*4*********x** *Nx******** ************* *********+L*+E**** ******IS*******
92335 urT: Z ONING R EQUIR EMEN TS
UCENSED CONTRACTORS DECLARATION:I hereby aMm under pally of perjury jitreunde. el Chaptw 9 S E T B A C K S
(mnmercmg with Section 7000)of Division 3 of the Business and Pmlession Code,anIn fug andCmUCNO.: UC.CLASS: C 39 UC. .: 5797 E MAIN BUILDING ACCESSORY BUILDING
y^J/ � ,� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date:]( �' ! I/1 Contrana I'' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWN BUILDER DECLARATION:I hereby euros under pan d• 'hat exempt tan the Cavbon Lbws Law for the
lSb greason(Sedbn703+sae:waendPrdeswecods:Any dyamatlywdrrNnapdruspemhr000robud,ad«.Mhaan, PARKING REQ: PROV: PARCEL: 42613308 ZNE: REF NO:
vndoh,a raper any couture:prior o is essence,who rotates the epp&ard to such permi to Do a signed statement that he a she
tensed pursuant to the provisions of the Contractors Bowe Law(Chapter 9(commencing with Section 7000)d Dnsion 3 d the PLANNING NOTES>
moss and Professions Code)or that he a she a exempt therefrom and the basis fa the sloped exemption.Any violation d Section �'>
7031.5 by any app9c nlfor a pend objects the app/cant to adv penalty of no man than NO hundred down 155001). *******************************************************************************
❑ I.as thaw of the aopenya my enporees win wages s thee ode compensation.al do dr work,end me Orudurs isncl irritated D E V E,' L OP MEN T SERVICES REQUIR EMENTS
or offered for she(Sectors 7044,Business and Professions Code:The Cadradon Lame Lew does rat aptly to an www of aopwty
who beide or improves thereon.and also does such work tFrew&or hersel a through he a her own employees.provided that such
bnaovemfl me nil Seeded a°Head for sob.g,however,the bulling a"Winn a sold wrhMae Yee at mi,ptelon.the ZONING APPROVED- BYDATE:
ownereuiler will have the burden of Proving he a she did rot bid Of improve for the purpose of We),
o I,es°w'"rdthe paweny.smemmnb ccint'°°ngw"h rmaedcentnetmle°ma"rnthe pmj°° •d
(Bin 7O44.Beaba,and BUILDING APPROVED BY : DATE:
Professors Code:The Contract=License Law does not apply b an owner Fogerty who Molds or bnprwee thereon end els
cora or such goods with a m°rwaor(s)Ecaned pursuant to the Contractors License Ura).
❑ I am exempt wderSection: B.AP.C..for this reason: APPLICATION ISSUED BY: DATE: g j
Date: O°"10f'' LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby candy that I an aware of and udwsund the ree.vemeb d Caxads Heats and Safely Code Sections 25505.25533,and
25534,and that I or any Muni beading DonorswogI.1not l(db ore)need to complysakirequirequirement,w
comply wilt rots codes andthe rserna
apenb lamutrucoma modification haetheAi eropanwt District Residential ammudionappicatws as exempt nom twee BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
lanniaiOnt PERMIT 34 . 75 ,50
Dere: „nnym„e: SMIP/NON—RES
PLAN
WORKERS COMPENSATION DECLARATION:I hereby dhm under penalty of perjury one d the following dedmalos: ISSUE FEE
❑ Ihave ardwig maintain aescalate dmwnttoetlrnmwfor waken*compwhstbtaprwkledforbySerfwh3700otheLNa BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code. "
e°° marc.° "°°" f" " "h °h
`" °a awed,
TOTALS----> 35 . 25 0 .00 0 . 00 35. 25 35 . 25 . 00
❑ I have and vel methinks workers'compensation Murano*,as required by Seton 3700 tithe Labs Code.w the pafmsnoe d the
aakfawerNwspaawnn°w.Mywak«amnpwdanwaa emwwpdKyemt«an. REVENUE DIVISION TOTALS--> COLLECTED : 35. 25 OVER/SHORT: . 00
Caner. REVENUE
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
rive maim naw nor be canpiered t Ma pent is Ice one herded dogma 151001 o is) 34 . 75 . 50
certify the in tha performance al the work ler which this permit b
❑ Ibers subject the weaken'compensation large hs of C./Mania. /• '. r0'peson
0Lshall not ,. i! s `A manner
cawaak0AV *******************************************************************************
mmpaeatim Seaton 3700 d the labor Code,l - �% ,. •• tad,• !" INDIVIDUAL F E E BREAKDOWN
9 Date: a— Operant: / .
Warning:Failure to secure worker's'compensation coverage is unlawful,and I r en employer to criminal pwulles and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
chll Mess to one Modred thousand dollars 0104000A M sddlrbn to sits roar of compensation,amigos as provided for In
Section Xon37oftheLaborCode,InrsnL
Intents,.
spmISlea SFR 1000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 000 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under porgy of perjay Ow there is a mWndon lending agency for the END OF FEES
performance of the wok to which this Fermi is issued(Seaton 3097.Ch.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and date that the above intonation is coned.I agea b comply with aS Ow and county ordinances
and stale laws reing to buidic costrudon end hereby authorize repraswelvss of this city to enter upon the stove-mentioned nope y
forinspectionpurposes.
DA;R:2 E NS
/ PnM ;. 9�/J
Dat✓1
le.— / • �are of OnedApenUApp&e°/C°nlrador
(5151daW P) While-Building A Safely:Green-Fb:Canary-Appkunt:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POO" SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspectoy
1. Temporary Electrical Service o"r Pole 52. Pool & Equipment Location
-%
' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement '
3. Electrical Conduit Utility-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-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe•Undrgrnd. , 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System - :-I 61. APPROVAL TO DECK
11. Property Sewer Line & House Conpedtion 62. Backwash & Receptor-Final„
12. Sewer Cap
1 63. Heater& Vent-Final •
13. Roof Drains . ' 64. Plumbing System - Finfai " •
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. 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 0 Gas 0 Oil
•
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑O.I
25. Roof Sheathing
Q 2-16 6614-----74.1 Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat YY vv 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 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
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
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System .
45. Sound Attenuation
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING f-2._?6. ,6v6L
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
OWNER WITZERMAN, D. E; DATE 10-759
JOB ADDRESS 171 22nd St. • BUILDING PERMIT NO. 10487
GENERAL CONTRACTOR Owner Bldr, VALUE $ b00.00
AP. No.118-072-10 LOT TRACT FIRE ZONE DESCRIPTION OF WORKSter. to Ex, Gar.
II ECTIONS DATE_I GROUP J TYPE V ZONE R 1
Uh.,.erground Soil U.G. Water PERMITS ISSUED
Underground Gas — SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System _
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole _
Underground Power
Rough Wiring
Trenches Forms Steel }%l /O —7`J7 _
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
S� thing
I ,e and Flashing
Lathing. In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final
OCCUPANCY S /6 —n..9 NOV
Form 210-3M-4.59 10487
> .. ... 1048; v.-LEy �RECEIVED
«t/
COSTA MESA BUILDING-SAFETY DEPARTMENT /p - G- S y
\ P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
FOR APPLICANT TO flit IN COMPLETELY APPLICATION' FORARERINIT
TYPE`E OR PRINT BUILDING
ADDRESS / 7' a `-11-1' ar' TIM
p
•
COSTA MTESA. (CALIIFORANIA ryR OFFICE USE ONLY
OWNER 0, �, G.) l / 4- R "IA /'�/ I RECEIPT NO. I l�BZ I
MAIL /2f 224�(r S/ RECEIVED BY I DATE/t rC7- II DATE0- ^/
ADDRESS ,r/+6 //-�. dI / J '/EDB I 7 //Y- ✓
CITY G� �/ / 1 /�'"'�/J TN O. G
y. .4.rn ADDRESS / '7/ . .3_ ,./ s
ARCHITECT LIC. COSTA MESA. CALIFORNIA
OR " (NEER NO. -
FIRE
ADDRESS /1 A/p( Q ZONE TYPE�- GROUP///
CONTRACTOR U&/YLR /3LD, L CT HTO. APPROVED /,//. 1 / /%'
I n )� BY f /r/I DATEt/
ADDRESS /71 f- CV5T/U///��� ,>JFSA ZONING �1.��Lr.c fir_'
LEGAL I LOT /� I •-7I'4.1I. ZONE NO.OF 7 U66 OP NEW
DESCRIPTION NO.
Sc'r) BLOCK /TRACT f'� yIRUNS ....2._
I au1LDINa��.*`��� �r
• A.P.NO. // '1 — n / (./ BYPROV ED� ..5./. /./ r DATE /E- 4.74- 7
OF LOT Cr F / •.3 (- I NO.OP SLOGS. 7 YARDS �� EVES
NOW ON LOT REQUIRED ALLOWED
USE OF Gal/7 (CENTER LINE ST.) �J//
EXISTING BLDG. �J FRONT /" FT. Let Ze-Lk'IN:--
Le
SETBACK LINE FROM 1 ✓�
CENTER OF STREET REAR YARD -' R.SIDE ✓ FT. IN.
SIDE YARD I LEFT I RIGHT L.SIDE ---2L FT. IN.
DESCRIPTION OF WORK
REAR �FT. IN.
NEV 17 II ALTERATION I ‘..)qr II ADDITION I.1 ,
REPAIR I II MOVING I II DEMOLISH I
S ZIE DING //1'y/L / NO.
/ STORIES '
1 EXTERIOR fWAA�LLS/a INURING C Ci1P ifl'
COVERING WALLS
USE OF BUILDING AND WORK TO BE PERFORMED
sere AA 6 S
XG c wit; e4$ . .
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTR ON.�J ' 1/p VALUATION
SIGNATURE OF i G /, / �_ .^", C� PERMIT FEE $ —
PERMITTEE al 'OM y/Cirt Y
$ PLAN CHECK S
AUTHORIZED AGENT
TOTAL FEE S a3 —