HomeMy WebLinkAbout204 22ND ST - Building Permits - y
�,5� 'Z�� • CITY OF COSTA MESA
4 BUILDING DIVISION
:r,,„ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
;. PERMIT
4%bonJ Bo2.o,s,2
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 204 22ND ST Status: ISSUED
Suite: Applied: 09/18/2002
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 09/18/2002
Parcel Number: 42607101 Zoning:
Applicant: MARSHMAN, JOHN ISSUED BY:
Address: 17671 METZLER LN
STE B2 Phone: 714-969-6053
HUNTINGTON BEACH,CA Zip: 92647
Owner: KOPP, EDWARD
Address 204 E 22ND ST
Phone:
COSTA MESA,CA Zip: 92627
Contractor: COASTAL ROOFING CO SOUTH
Address: 17671 METZLER LN
STE 82 Phone: 714-969-6053
HUNTINGTON BEACH,CA
Zip: 92647 License: 767366
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF: TIO EXISTING WOOD SHAKE, 7/16" OSB SHTG, 1 LAYER 30# FELT, APPLY"30-YEAR COMP
SHINGLES."
19 SQUARES
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,980.00
Permit: $125.25 Claim Valuation: $5,980.00
SMIP Res: $0.60
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.85
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
244646(&De)
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 carder and policy number are:
Carrier: .! Policy Number:
(Thy section need not be completed/f the permit is valued at on hundred dollars($100)or less.)
W I certify that in the perform: e of V' rk for which thi permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation law •f Car o ni nd a•,:e that If I sh Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with the •vis•• .
Applicant Signature' 4. _� Date: �- /T/- O
WARNING:FAILUR-TO S. URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND.• -RE($1...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 CO -ACTORS DECLARATION:
I hereby affirm that I am licensed u ter provisi• s • Chapter•(commencing with Section 7000)of Division 3 of the Business ions Code,and my license is in full
force and effect.Lic.# dR.,.'_i - Class 4
Contractor's Signature: � %ta Date:
CONSTRUCTION LEN•'N •GENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more then five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of 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 Drivers 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 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or wit 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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Di Yes j�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 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
B (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 ell state laws and city • •Inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described p •,_, ori inspection purposes.I .•ree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
/, f Legal/La-• r( !-A-€10
And/Or Authorized Applicant Date
•I .PEC110N TYPE CbIE INTITIAL$ CODE E INSPECTION TYPE PAU tt
16 • ixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final '/ 208 Final Plumbing
200 Final Re-Roof q—z .o 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
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sT CTURAL APPROVAL ONLY •
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SE ATE PERMITS ARE REQUIRED 4I z I • �
ELECTRICAL, PLUMBING, m 114
HEATING, VENTILATING AND I Tr)
REFRIGERATION WORK I '4 1
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ALL INSPECTION REQUESTS
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FOR Bi11L0,1!GS WHERE PERSONS ARE TO
I BE ER PLOYED, WE SUGGEST THAT THE $ i
• STATE OF C..LIFORNIA DIVISION OF
INDUSTRIAL S'.FETY SE CONSULTED FOR
ADDITIONAL REQUIREMENTS. 7)>sI 19 5 j I j
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TYPICAL 6" CONCRETE BLOCK FENCE
2
Cement Coping Optional I GENERAL- NOTES
7 Channel Block With 13/8 `i 1
Ii �
0 Horizontal Top of all
Fences lIa-111111 r MORTAR: One Part Plastic Cement, and
6" Concrete Block Fence Three Parts Sand
v-.--'IimI
GROUT : One Port Cement Three and
For Fences 5' or Less 1' o all.= � • One Half Parts Cement,
Vert. Bars 3/8" 0 at 4I-0110.C. COPING: One Part Cement, Three
For Fences Higher Than 5' S C Parts Sand
Vert Bars 3/8" 0 at 32" O.C. = CONCRETE: Well Mixed f.2-1/2: 3-1/2
Provide Inspection and ' > Z Max. of 7- 1/2 Gallons of
_ Water Per Sack of Cement
Cleanout Hole at Location > -
of Vert. Reinforcement 4-
0
I REINFORCING STEEL SHALL CONFORM TO
'��_ -I� SEC. A-I5-39 A.S.T. M.
Fill Cells Solid With Grout w o ALL STEEL TO LAP WHERE SPLICED, 2-0;
Where Steel Occurs I, Uin 11'�--'I If GROUT MAY BE POURED FROM TOP OF
111111 INN FENCE IN CELLS WHERE STEELA OCCURS.
HOLES SHALL BE CLEAR, CLEAN, AND
l/ _ � " ��---" ---.—..-- FREE OFCT ALL MORTAR, DEBRIS, ETC.,WITH
NATURAL GRADE INSPECTION HOLES AT BOTTOM.
,_,r0.,_,, . A$1DD.�9 �� 44Jl� BONDS SHALL BE PROVIDED BY LAYING
�w�)" °.' .° ' = . BLOCKS IN STRETCHER COURSES SO
�;tiial, =o N p 6 e e THAT VERTICAL JOINTS ALTERNATE IN
TWO 3/8" 0 BARS - •
EACH COURSE.
CONTINUOUS . . . .I I
�-i I F--0--WIDTH TO 16' O.C. MAX.
p • SEE CHARTe p.
STEEL MUST BE TIED IN 'I i BELOW - e DEPTH OF EARTHTOOTH
PLACE AT TIME OF TRENCH •
IJJI o,I 1/3 THE HEIGTH OF FENCE
INSPECTION. ° o, L 1 L BELOW BOTTOM OF FOOTING.
1_4(S0_1 heyjcif2.. SCALE: I/2° = I'
CHART
HEIGHT. 6 ' 5' 4' 3'
WIDTH 14" 14" 12" 12"
71 THICKNESS 10" 10" 8 " 8 "
DEPTH OF EARTHTOOTH . . . 24" 20" 16" 12"
SPACING OF EARTHTOOTH. . 12' 14' 16' 16'
OWNERS NAME:
City of Costa Mesa, California JOB
PERMITDDRESS:NUMBER:
Building Department SIGNATURE:
Am
FORM BU26_2M_8-.62
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(t,U OWNER REBER, GEORGE DATE 3-2-64
C JOB ADDRESS 204 East 22nd. Street BUILDING PERMIT NO. 21693. •
GENERAL CONTRACTOR owner-builder VALUE $ 1320.00
SAP No. 118-122-20 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Det. Garage
C INSPECTIONS Signature DATE GROUP J TYPE V ZONE R2
s PERMITS ISSUED
6 _ SUBCONTRACTOR DATE NUMBER
dr Water
Rough Com. Refrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous •
Prop. Swr. Line 0 House Con..❑ St. Swr. ❑
Sprinkling System
Construction Pole
Underground .❑ Power '&214.h_
Rough Wiringrilii1CAPR-nu; 1rte2
Trenches Forms 0 Steel Rend. 0 gen3 a4.
Floor System
Bond Beam 0 Steel Reinforce 0 ,,
Sheathing itaj
Frame and Flashing 11E74 rR ( CE
Lathing—In ❑ Out ta-' a - c
Plaster, brown coat bt}4A- H^(6- 5
Rcf-ig. 0 Air Con. ❑ Final
I ..g, Final
Pia nbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final 0v20t 4-1/. -Cc/
Building,
Building, Final 4/-L¢-Co _
OCCUPANCY
Form BU4—SM-3-63-5-B P 21.621
21693 FEE RECEIVED
ttOSTA MESA BUILDING-SAFETY DEPARTMENT MAR 2 1964
P.O.BOX 917 COSTA MESA.CALIFORNIA FINANCE
\ rrRI7y IMV rVF PCRMIf
For Applicant to Fill In Completely APPLICA
TYPE OR PRINT BUILDING
BUILDING 9- ./^ .y (� Se-
RECEIPT
Office Use Only
ADDRESS �� t�s/ � ry ./"
gHCtIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA /'
Q r RL /y{•� �{ 3T R2HI yly 3DATP�IB=UEp_/
OWNER rt.-: ,Rin- I ! C7- a` / ` •. //� //' __.(/Oyu 7 L ;4"
MAIL r� ADDREBU I SNG S
7r / s/ /'Z -oft .
ADDRESS 571/11P
FIRS
/� TEL ZONE E / GROUP J •
CITY C O-�/} Al 6:14- NO. N O
APPROVE
ARCHITECT �.�'( - TEL. BYef? DATES �4 51
OR ENGINEER (' �' NO.
ZONING // (�
AD_ '68 Z 6 NO.OF �, �fSE OF NEW 2 "p-
••• PLANS BUILDING
-v:y
CONTRACTOR V .�1/�t.Jl (J d 1 1/ G n V` Vol?)
I / F
LEGAL
ADDRESS �n �( L" DESCRIPTIO I
CITY
SA frig A.P.NO. 1/ & - /02L.— 3----
NOTE:
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. sr TO SIDE @REAR P.L.
LIC.NO. NQ.
EAVES
SIZEOT /u 5 .lJ' I tom, I NO.OF BLDNOW ON LOT /GS. ALLOWED (U.B.C.REQUIREMENT)
OF Lc.
USE OF (1 �� YARDS APPROVED YARDS APPROVED
EXISTING BLDG. I( MAIN BUILDING ACCESSORY BUILDING
- (FROM C/L STREET)
SETBACK LINE FROM /jet y
CENTER OF STREET /1 jeREAR YARD / FRONT FT. 3
SIDE YARD I LEFT S,t2 ! I RIGHT -.IS
J/ R.SIDE FT. Fr.
DESCRIPTIONrIOF WORK L.SIDE FT. 30 F7. •
NEV '\
`TALTERATION _ ADDITION REAR FT. .3 FT._
DISTANCE BET. BET.MAIN @ • i j
MAIN BLDGS. ACCESS.BLDGS.
REPAsat MOVING DEMOLISH _
BUILDING NO.OF VAR.# DATE
/_
SIZE Q A /`T ROOMS STORIES 1 C.U.P.# APPROVED
EXTERIOR WALL..I �/ ROOF o APPROY \\ \ 0) -V
COVERING , I COVERING l 'Fn BY DATE ,; l? /1
USE OF BUILDING AND ORK TO BE PERFORMED
UYcp..L._
fir
1 4
�Oyizr- d 7s N
SQ.FT. 7+ ./ m
I HEREBY ACKNOWLEDGE THAT I HAVE - - - THE AMOUNT SHOWN UNDER VALUATION IS OR THE •F
CORRECTAND STATE THAT THE ABOVE IS PURPOSE OF ESTABLISHING A PERMIT F ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /p gra) m
BUILDING CONSTRUCTION.
A+n PERMIT FEE $ 7 Me j
I 5V B
PERMITTEF
$ e PLAN CHECK $ / L o
/ /� S n
TOTAL FEE $
OWNER McFAPTIRN, Ff1PTR DATE 10-25-78
JOB ADDRESS 2O4 East 22nd Street BUILDING PERMIT NO. 1Ag35
GENERAL CONTRACTOR nwnar-Rni ldPr DESCRIPTION of WORKDATE
kwall
AP No. 118-122-20 LOTpn 2q3 TRACTNW2t.Hts.FIRE ZONE VALUES 2.000.00
I SCTIONS Signature Date TYPE TTT GROUP T ZONE R-1
IAl su r PEf2MITS ISSLED
\c As SUBCONTRACTOR
Date Number Signature
WATER Plumbing
1 ROUGH PLUMBING
PROP. SWR. LINE E HOUSE CON. 0
SPRINKLING SYSTEM
kM I SCEL LANEOUS
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE _
UNDERGROUND fI POWER 0
ROUGH WIRING Nesting and Vent. .
TRENCHES H FORMS 0 STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n CANCELLED
SHEATHING DATE,a-16- BY ,_
FRAME AND FLASHING
LATHING — IN r OUT fl
PLASTER, BROWN COAT
STRIICTURAL, FINAL Electric
HE 5. VENT.. REFRIG. AND A.C., FINAL
PLU...dING. FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL
048935
t- 7657410/25/78 30.50 IL
COSTA MESA BUILDING-SAFETY DEPARTMENT '.'•' I
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ek
APPLICATION FOR STRUCTURAL PERMIT l
For Applicant to Fill in Completely —Use Ink Only
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING ,y r9Ck t`- 7 � ,"> S` ` D- 2
ADDRESS 5 .1/ p q .2
OWNER EbN^ I �C\ rF& TTeA A.P. NO. f/Q -'2f - O P
l' 1� ,( t)-1),
ADDRESS SfF/vl�.. AS MAIL .60-vF, BUr, t ,2,0 ye. •Z0-°
M -
TEL. NW PT Yee
CITY COST,c �S� NO. S4\Q 2try TRACT+ hic,•r& LOT 193 BLOCK
CONSTRUCTION 14 / NEW ADD`/ ALTER REPAIR MOVING DEMOLISH
LENDER v �r�� j'' Js�
BRANCH OWN ER,�/',,�j/(�+//Q�l(/IJJ��,���(�[��{��-/�t, C—Ra_ 0.�+_"`
ADDRESS Par
G(/!L/il/ ZAO
VALUE
ARCHITECT L �/ TEL. USE g !
OR ENGINEER ��t NO.
FIRE
ADDRESS ZONE P
ØGROUP7rrAPPROVED /CONTRACTOR (9 % C/i4 U (Lp rp BYDATE/ 0 �
ADDRESS l OctC
TEL. ZONE /JO
/ INO.OF �J USE OF NEW G
CITY NO. /�/ PLANS /`, BUILDING f,./A-LL
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
OC
W SIZE NO.OF BLS. (FROM C/L STREET) /
D. OF LOT NOW ON LOT FRONT FT. (ft T.
G USE OF T. yl
EXISTING BLDG. R.SIDE FT.
N
.
.
FSeparate permits are required for L.SIDE �r y.0 Ft y FT.
6. electric,plumbing and heating work. REAR �"' 1 FT.
IQ• USE OF UILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q 2i MAIN BLDGS. ACCESS. BLDGS.
(Z / ,I p VAR.# DATE
QCa KS-I-Tooct' 6 C44 tai-i- Acn cWyk—Q_ C.U.P.# APPROVED it(
/2.417/
s
} —BAPYl� .I
PROVED �, , DATE /1/
W �
lY
W
O I hereby acknowledge that I have read this application and state n
Ce that the above information is correct and agree to comply with m
W all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of x
Wthe State of California. .:
m
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, and 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 Business70 a
and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ D m
Signature of � `/�/'1� m�J,1 �y/,�/� AC PLAN CHECK $ MAO e
Permittee (,6 G� 11�`? '� "G�Fi ��� Sail"
il" TAX $ 0
I�7/[ O
0
Authorized Agent TOTAL PAID E 30.